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Clinical Analysis for the Result after Curative Resection of Esophageal Cancer (식도암에서 근치적 절제술 후의 성적에 대한 임상적 고찰)

  • 이재익;노미숙;최필조
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.356-363
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    • 2004
  • Esophageal cancer is an aggressive disease with a poor prognosis. Recently, every effort has been made to improve the long term survival, but the general prognosis for patients with this disease remains poor. In this study, we reviewed 8 years of experiences with esophageal cancer patients managed in our department at Dong-A University Hospital and evaluated the effectiveness of cervical lymph node dissection performed selectively. Material and Method: From January 1995 to August 2003, 70 patients underwent esophagectomy for esophageal cancer in our department. Among them, 51 patients who underwent curative resection, had no double primary tumors and no neoadjuvant therapy were analyzed retrospectively. In most patients, intrathoracic esophagectomy and cervical esophago-gastrostomy was performed. Since 1997, 3-field lymph node dissection was performed selectively. Result: There were 46 men and 15 women. The median age was 60 years. The tumor was located in the upper third part in 10 patients (19%), middle third in 21 (41%), and lower third in 20 (40%). Majority of the patients (90%) had squamous cell carcinoma. Cervical anastomosis was made in 41 patients, and intrathoracic anastomosis in 10. 2-field lymph node dissection was done in 40 patients, and 3-field lymph node dissection in 11. The pathologic staging were as follows: stage I in 9 patients (17.6%), IIA in 20 (39.2%), IIIB in 7 (13.7%), III in 11 (21.6%), IVA in 2 (3.9%), and IVB in 2 (3.9%). The in-hospital mortality was 3.9% (2 patients) and complications occurred in 24 patients (47%). Overall actuarial 1, 3, and 5-year survival rates were 74.4%, 48.4%, and 48.4% including operative mortality. The 4-year survival rate did not differ significantly between 3-field lymph node dissection group (50.5%) and 2-field lymph node dissection group (48.9%). In 3-field lymph node dissection group, the respiratory complications were more frequent and operative time was significantly longer. Conclusion: We think that curative resection for esophageal cancer can be performed with acceptable mortality, and aggressive surgical approach may improve the long term survival. even for advanced stages. Effectiveness of 3-field lymph node dissection needs further investigations.

Genesis and Characteristics of the Soil Clay Minerals Derived from Major Parent Rocks in Korea -I. Rock-forming Minerals and Mineralogical Characteristics of the Parent Rocks (한국(韓國)의 주요(主要) 모암(母岩)에서 발달(發達)된 토양점토(土壤粘土) 광물(鑛物)의 특성(特性)과 생성학적(生成學的) -I. 조암광물(造岩鑛物)과 광물학적(鑛物學的) 특성(特性))

  • Um, Myung-Ho;Lim, Hyung-Sik;Kim, Young-Ho;Um, Ki-Tae
    • Korean Journal of Soil Science and Fertilizer
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    • v.24 no.1
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    • pp.1-9
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    • 1991
  • A study was carried out to investigate the composition of rock-forming minerals and mineralogical characteristics of the five major parent rocks in Korea. The identification was done through the analyses of chemical. X-ray diffraction, thermal(DTA, TG), infrared spectroscopic, and microscopic methods. Among these methods, X-ray diffraction was considered to be the most rapid and effective way to identify minerals in the parent rocks. The main rock-forming minerals of the parent rocks were feldspars, quartz, and micas in granite and granite-gneiss, calcite and dolomite in limestone, quartz and calcite in shale, plagioclase and augite in basalt. A small amount of sesquioxides was identified as a accessory mineral by means of DTA from the parent rocks of Weoljeong series(granite) and Cheongsan series(granite-gneiss). The abrasion pH affecting the soil formation ranged from 7.5 to 8.4 in the parent rocks containing ferromagnesian minerals and carbonates. In the granite and granite-gneiss of which the main rock-forming minerals were feldspars and quartz with low content of biotite, the abrasion pH ranged from 6.2 to 6.4. In chemical composition of the parent rocks, Si, AI, and K oxides tented to increase with higher contents of quartz, feldspars, and muscovite, while Fe and Mg oxides with higher content of biotite, chlorite, amphiboles, and augite. Higher ignition loss in limestone and shale resulted in the release of $CO_2$ from calcite and/or dolomite.

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The effects of the mulberry and silkworm intake on androgen receptor mRNA and myogenic regulatory factors expression of rats muscle for resistance exercise (오디와 누에 섭취가 rats의 저항성 운동에 따른 androgen receptor mRNA와 myogenic regulatory factors의 발현에 미치는 영향)

  • Yang, Sung Jun;Kim, Chang Yong;Lee, Jo Byoung;Kang, Sung Sun;Lee, Jong Jin
    • Journal of Sericultural and Entomological Science
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    • v.51 no.2
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    • pp.99-106
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    • 2013
  • The purpose of this study is to investigate the effects of supplementation of mulberry powder, mulberry extract and silkworm powder during the 8 weeks of resistance exercise on Androgen receptor(AR) mRNA and Myogenic regulatory factors(MRFs) expression of rats muscle. Fifty males, Sprague-Dawley rat, were randomly divided into 5 groups: CON(control group, n = 10), REG(resistance exercise group, n = 10), MP REG(mulberry powder intake and resistance exercise group, n = 10), ME REG(mulberry extract intake and resistance exercise group, n = 10) and SP REG(silkworm powder intake and resistance exercise group, n = 10). After climbing the ladder without weights during the 1 week of adaptation period, the rats in the resistance exercise group were trained to climb a 0.98-m vertical(80 degree incline) ladder with weights in their tail during 7 weeks(10 times each day, 2 days per week). After exercise, the skeletal muscle was extracted from the flexor hallucis longus. After separating the total ribonucleic acid (RNA) of each group, quantitative polymerase chain reaction was used to analyze RNA quantitatively. AR mRNA and MRFs expression revealed that all of the treated groups had significantly difference. AR mRNA expression increased in ME REG $6.24{\pm}1.85$ and SP REG $9.68{\pm}0.28$ fold compared to CON. Myod mRNA expression increased in MP REG $6.04{\pm}0.47$, ME REG $4.31{\pm}1.58$ and SP REG $8.11{\pm}0.57$ fold compared to CON. And myogenin mRNA expression increased in MP REG $4.11{\pm}0.42$, ME REG $4.12{\pm}0.45$ and SP REG $6.50{\pm}0.61$ fold compared to CON. In conclusion, during the resistance exercise, providing mulberry and silkworm gives positive effect on AR mRNA and MRFs expression increase.

Treatment and Results of Olfactory Neuroblastoma (후각신경아세포종의 치료 및 결과)

  • Wu Hong-Gyun;Kim Il Han
    • Radiation Oncology Journal
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    • v.18 no.3
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    • pp.177-181
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    • 2000
  • Purpose : Rarity of olfactory neuroblastoma makes it difficult for treating Physician to Practice with a consistent protocol. This study is peformed to analyze our experience with various treatment modalities for patients with olfactory neuroblastoma. Discussion includes review of some recently published literatures. Methods and Materials : Between June of 1979 and April of 1997, 20 patients were treated under the diagnosis of olfactory neuroblastoma at Seoul National University Hospital. There were 14 male and 6 female patients. Age at initial treatment ranged from l3 to 77 years with median or 24 years. fifteen or 20 patients had Kadish stage C. They were treated with various combinations of surgery, radiation therapy and chemotherapy; surgery+postoperative radiation therapy+adjuvant chemotherapy for 2 patients, surgery+postoperative radiation therapy for 6, neoadjuvant chemotherapy+surgery for 1, surgery+adjuvant chemotherapy for 1, surgery only for 2, neoadiuvant chemotherapy+ radiation therapy for 3, radiation therapy+adjuvant chemotherapy for 1, radiation therapy only for 3, and no treatment for 1 patient. Results : Follow-up ranged from 2 month to 204 months with mean of 39.6 months. The overall 5- and 10-year survival rates are 20% and 10%, respectably. Four patients are alive at the time of data analysis. One of four living patients was treated with radical surgery, postoperative radiation therapy and adjuvant chemotherapy, two patients with radical surgery and postoperative radiation therapy, and one with radical surgery only. Conclusion : Multidisciplinary approach, including radical surgery, pre- or post-operative radiation therapy and chemotherapy, should be addressed at the initial time of diagnosis. Although limited by small number of the patients, this study suggests importance of local treatment modality, especially radical surgery in the treatment of lofactory neuroblastoma.

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Treatment Results of Esophageal Carcinoma Treated by Radiation Therapy (식도암의 방사선치료 성적)

  • Kim Mi Sook;Yoo Seoung Yul;Cho Chul Koo;Yoo Hyung Jun;Yang Kwang Mo;Kang Jin Oh;Ji Young Hoon;Lee Dong Han;Ryoo Baek Yeol
    • Radiation Oncology Journal
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    • v.18 no.3
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    • pp.182-186
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    • 2000
  • Purpose : To determine treatment or이ecol for inoperable esophageal cancer patients, 껜e evaluated survival rate and prognostic factors. Materials and Methods : We evaluated esophageal cancer treated by curative or palliative am in KCCH from 1992 to 1996, retrospectively. Recurrent or underdose case below 40 Gy were excluded. The number of male and female were 35 and 5, respectively. Thirty-eight patients were squamous carcinoma and 2 patients were not biopsy proven. Ten patients were treated with radiation therapy and chemotherapy Median dose of radiation therapy was 59.4 Gy and the range was $40\~60$ Gy. Results : The median survival is 6.5 months and 1-year survival rate was $28.3\%$. Age, location, radiation dose and chemotherapy were not significant prognostic factors. Median survivals of patients with below stage III and over stage IVA were 7.6 and 6.2 months respectively, but it is not significant. Conclusions : The survival for esophageal cancer is very poor. For patients with curative aim, chemotherapy must be considered. For patients with palliative aim, short-term external beam radiation therapy and/or brachytherapy must be considered.

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Treatment Outcome of Postoperative Radiotherapy in Extrahepatic Bile Duct Cancer (간외담관암의 수술 후 방사선치료 성적)

  • Choi, Young-Min;Cho, Heung-Lae
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.27-34
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    • 2003
  • Purpose : To evaluate the efficacy of radiotherapy, and the factors affecting survival in patients of extrahepatic bile duct cancer, by analyzing the results of postoperative radiotherapy Materials and Methods : Between October 1991 and July 2001, 21 patients with extrahepatic bile duct cancer, who received radiotherapy after a radical resection, were retrospectively reviewed. The patients' ages ranged from 39 to 75 years, with a median of 61 years, and a male to female ratio of 16 to 5. The numbers of patients with proximal and distal bile duct cancer were 14 and 7, respectively. From the postoperative pathological examination, 19 of the patients were found to have microscopic residues, and 7 to be lymph node positive. Patients with AJCC stages I, II and III were 10, 10 and 1, respectively. The total radiation dose administered was 4,500$\~$6,300 cGy, with a median dose of 5,040 cGy. The follow up period was 20$\~$81 months, with a median of 57.5 months. Results : The overall and disease free survival rates at 3 and 5 years were 41.0 and 29.3$\%$, and 41.6 and 29.7$\%$, respectively. The influences of age, sex, tumor location, differentiation, microscopic residue, neural invasion, 7 and N stage, the stage itself, the dose of radiation and chemotherapy, on survival were evaluated. The T stage and the stage itself were found to be significant from a univariate analysis (p<0.05), but the degree of significance was limited by the small number of patients. A recurrence occurred in 12 patients (57.1$\%$), 5 in locoregional sites, 4 in distant sites and 3 in a combination of locoregional and distant sites, and the sites of distant metastasis were the liver, 6, and the bone, 1 Grade 2 or 3 acute leucopenias occurred in 2 patients and grade 2 chronic peptic ulcers occurred in 4, who were all recovered by conservative management. Conclusion : Postoperative radiotherapy is feasigbls in extrah데atic bile duct cancer, with tolerable toxicity, but prospective studies, with a large patient enrollment, are needed for the evaluation of the effects of postoperative radiotherapy and the related prognostic factors.

Effect of Recombinant CagL Immunization on the Gastric Diseases Induced by Helicobacter pylori in Mongolian gerbils (CagL 재조합 단백질 접종후에 Mongolian gerbil에서 나타나는 Helicobacter pylori 감염에 대한 반응)

  • Bak, Eun-Jung;Jang, Sung-Il;Choi, Yun-Hui;Kim, Jin-Moon;Kim, Ae-Ryun;Kim, Ji-Hye;Woo, Gye-Hyeong;Yoo, Yun-Jung;Lee, Sung-Haeng;Cha, Jeong-Heon
    • Korean Journal of Microbiology
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    • v.48 no.2
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    • pp.109-115
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    • 2012
  • Helicobacter pylori is an important factor of chronic gastritis, digestive ulcer, and stomach cancer. CagL, a virulence factor of H. pylori, is well-known as a pilus protein which acts as adhesion to host cell and a component of Type 4 secretion system. In this study, we evaluated the protective response of recombinant CagL protein (rCagL) using Mongolian gerbil animal model for H. pylori infection. The cagL gene was cloned from 26695 H. pylori followed by over-expression and purification of the protein in E. coli. Mongolian gerbils were immunized with rCagL protein mixed with aluminum adjuvant via intramuscular injections once a week during 4 weeks. At a week after the last immunization, the Mongolian gerbils were administrated with H. pylori 7.13 strain into the stomach and sacrificed to measure antibody titer on rCagL by ELISA and bacterial colonization in the stomach, and to examine the histopathological changes and cytokine expression at 6 week after challenge. Antibody titers on recombinant protein were significantly increased from a week after the first immunization. There was no significant change of the number of bacterial colony between control group and immunized group. The relative stomach weight was significantly decreased in immunized group, but the significant change of histopathological assessment was not observed in the stomach. Cytokine expression such as IL-$1{\beta}$ and KC also was not significantly different between control and immunized groups. These results indicate that rCagL could effectively induce the formation of the specific IgG antibodies. However, bacterial colonization and histopathological lesions could not be inhibited by the immunization in the stomach, indicating not enough protection against H. pylori infection. We consider that along with CagL other adequate antigens could be needed stimulating immune response and inducing protective effects against gastric disease, and also a better adjuvant could be considered.

Evaluation of Quality of Life according to Temporomandibular Disorder Symptoms in Dental Hospital Worker (치과병원 종사자에서 측두하악관절장애 증상에 따른 삶의 질 평가)

  • Kim, Dong-Kook;Lim, Hyun-Dae;Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.37 no.1
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    • pp.61-72
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    • 2012
  • Temporomandibular disorder(TMD) is relatively prevalent disease, and quality of life may be impaired in TMD patients. Like general population, dental hospital workers are also exposed to the risk of TMD. But, many of them tend to overlook or tolerate their symptoms for lack of time and interest. Therefore, problems may become more serious, causing interference of performing task and decrease of quality of life. The aim of this study were to obtain data for TMD prevalence in dental hospital workers and to evaluate quality of life according to TMD symptoms. Subjects were recruited from Wonkwang University Dental Hospital. After consent, subjects completed quality of life questionnaire and were evaluated for subjective and objective signs and symptoms of TMD. Subjects were classified into 4 groups : (1) normal group (2) joint disorder group, (3) local myalgia group, and (4) myofascial pain group. The result of the study indicated that TMD negatively influences the quality of life in dental hospital worker. TMD symptoms can deteriorate quality of life in dental hospital worker. Future effort to make protocol for proper management is needed.

Clinical Assessment and Cephalometric Characteristics of Patients with Condylar Resorption in Teenagers (10대 하악과두흡수 환자의 임상적 평가 및 악안면 골격형태에 대한 연구)

  • Chun, Yong-Hyun;Hur, Yun-Kyung;Jung, Jae-Kwang;Chae, Jong-Moon;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.35 no.1
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    • pp.61-73
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    • 2010
  • The aim of this study was to investigate clinical assessment and cephalometric characteristics in 10s patients with condylar resorption, who visited in the Department of Oral Medicine Kyungpook National University Hospital at 2006, by use of panorama, transcranial view and lateral cephalometric radiograph. The results were as follows; 1. Clinical assessment 1) Total number of patients were 59. Female was 47 and male was 12, Females were predominant and patient's age ranged from 12 to 19. 2) Most of the patients had Grade II condyle resorption. 3) The number of who had Class I occlusion was 27, which was the largest group. The number of patients with openbite was 20. Average overjet was 3.58mm and average overbite was 0.97mm. 4) Most of the patients had parafunctional habit. 5) The patients of showing the pain in condylar resortion was 41 and the case of not showing the pain was 18. 6) Treatment duration of 23 patients were less than 1 month, 28 patients were treated with supported therapy. 2. Cephalometric Characteristics 1) A 16-year-old female patients showed smaller SNA, SNB and larger articular angle significantly as compared with those of normal group. 2) A 17-year-old female patients showed smaller SN, SAr, TPFH, ramus height and larger SN-GoMe, FMA, articular angle significantly as compared with those of normal group. 3) Over 18 years old female patients showed smaller SN, SNB, TPFH, ramus height and larger ANB, FMA, SN-GoMe, LAFH, articular angle, gonial angle significantly as compared with those of normal group. 4) Over 18 years old male patients showed smaller SN, TPFH, ramus height and larger FMA, SN-GoMe, LAFH, articular angle, gonial angle significantly as compared with those of normal group. 5) There was no significant difference between 10s and normal group in mandibular body length.

Effect of Low-Level Laser to Oral Microorganisms (저출력 레이저가 구강미생물에 미치는 영향)

  • Yoon, In-Jong;Auh, Q-Schick;Chun, Yang-Hyun;Hong, Jung-Pyo
    • Journal of Oral Medicine and Pain
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    • v.35 no.1
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    • pp.31-39
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    • 2010
  • This study is to observe the bacteriocidal effect of the Low Level Laser (LLL) against oral microorganisms which are related to the occurrence of periodontal diseases and oral malodors. The Porphyromonas gingivalis 2561 (P. gingivalis 2561) and Prevotella intermedia (Pr. intermedia) were treated with photosensitizing substance-toluidine blue O (TBO; C.I. 52040) and then radiated with the LLL which has 650nm wavelength for 1, 2, 3 and 5mins. continuously upon varying distances of 1, 2 and 3cm for each experimental groups. The results are as follows; 1. The P. gingivalis 2561 which was treated with TBO and then radiated with LLL at a distance of 3cm for 1min. showed 99.99% higher antibacterial effect in comparison to the experimental group treated only with TBO. 2. The Pr. intermedia which was treated with TBO and then radiated with LLL at a distance of 3cm for 1min. showed 99.8% higher antibacterial effect in comparison to the experimental group treated only with TBO. 3. The bacteriocidal effect of the P. gingivalis 2561 treated with TBO was found to gradually increase as the radiation time of LLL extended from 1min. to 3min. at 1min. intervals. 4. A slight decrease in bacteriocidal effect of the P. gingivalis 2561 was found as the radiation distance of LLL increased from 1cm to 3cm at 1cm intervals. 5. The bacteriocidal effect of the Pr. intermedia was found to slightly decrease as the radiation distance of LLL increased from 1cm to 3cm at 1cm. intervals. As the results shown above suggest, the bacteriocidal effect of LLL was found to increase as the radiation time extended and the distance shortened. Moreover, even the experimental group radiated with LLL at 3cm distance for 1min. which showed the lowest level of bacteriocidal effect, was found to have 99.8% higher bacteriocidal effect than the experimental group which was treated only with TBO and, therefore, this clearly shows the bacteriocidal effect of LLL against oral microorganisms. Thus, the use of LLL is thought to become very useful for suportive treatment for periodontitis and implantitis, and controlling oral malodors as long as it is used within the limits where there is no side effect.