• Korean Journal of Head & Neck Oncology
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• v.5 no.1
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• pp.39-46
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• 1989

Kimura's Disease is a chronic inflammatory and proliferative condition producing subcutaneous masses especially in the head and neck area. This report of our experience with 5 patients with this disease is the first in the Korean surgical literature. Kimura's Disease is thought to be part of the larger spectrum of the entity known as angiolymphoid hyperplasia with eosinophilia (ALHE). It is characterized pathologically by hyperplastic lymphoid follicles, eosinophilic infiltration, and vase 비 ar proliferation. It produces masses which are most common in the area of the parotid, submandibular gland and upper neck. These masses occupy the subcutaneous tissues but also extend into salivary tissue and into upper neck nodes. One of our patients had masses in the groin. The tumors are extremely vascular due to the presence of new proliferative vessels and sinusoids. The average age of our 5 patients was 35, but all but one case were younger than 38 years of age. The male: female ratio was 3 : 2, and the average duration of symptoms was 5,2years. All patients had peripheral blood eosinophilia. All had multiple masses, sometimes symmetrical. The management was surgery alone in one case, surgery and steroids in one case, surgery and radiotherapy in two cases, and all three modalities in one case. The relationship of this entity to ALHE and our experience in the management of this disease are presented. A clinicopathological discrepancy alerted us to the existence of Kimura's Disease. A nineteen-year old male presented with subcutaneous masses over both mastoid areas present for 3 years (Case III). When biopsy on each side was reported as 'eosinophilic granuloma' we submitted the slides to an internationally expert pathologist. Symmetrically occurring tumors in the peri-parotid subcutaneous areas did not fit any category of neoplasm or granuloma known to us. The diagnosis, made by Dr. Gist Fan at the Ochsner Clinic, was Kimura's Disease. We found two additional cases in a review of soft tissue eosinophilic granuloma previously reported at Presbyterian Medical Center, and since then have diagnosed two new cases. These five cases constitute the basis for this, the largest series to be reported in Korea. These vascular, tumor-like lesions of the skin, subcutaneous areas and subjacent structures of the head and neck have been a variety of names, such as angiolymphoid hyperplasia with eosinophilia, eosinophilic hyperplastic lymphogranuloma, angioblastic lymphoid hyperplasia with eosinophilia, histioid hemangioma, and epithelioid hemangioma. The history of this disease spectrum dates back to 1937 when Kimm and Szeto (1) reported 7 cases of 'eosinophilic hyperplastic lymphogranuloma' in the Proceedings of the Chinese Medical Journal. In 1948 Kimura and his associates(2) reported additional cases in Japan under the title 'On the unusual granulation combined with hyperplastic changes of lymphatic tissue.' From then until 1966 several hundred cases were reported in China and Japan. The first report from the West was by Wells and Whimster(3) in the British Journal of Dermatology, in 1969. These authors coined the term, angiolymphoid hyperplasia with eosinophilia (ALHE). Since that time a debate has ensued as to whether Kimura's Disease and ALHE are distinct entities, or whether Kimura's is part of the larger spectrum of ALHE, perhaps a later or advanced phase. From the clinical perspective, surgeons should be aware of the diagnosis of Kimura's Disease not only as part of the differential diagnosis of head and neck tumors but also because these lesions are indolent, and generally require conservative surgical removal as part of the management program. CASE I. A 37-year-old female company employee presented in August 1982 with submental swelling of 12 years' duration and with inguinal swelling of 7 years' duration. The submental mass measured 5x5cm. and the inguinal mass was 8x4cm. in size. Peripheral eosinophilia varying from 14% to 40% was found. On August 20, 1982, the submental mass was removed and a superficial groin dissection was done. In May 1983 an intraoral lesion of the palate was removed. The patient is free of disease. CASE II. A 23-year-old unemployed man visited this hospital for the first time in July, 1984, with swelling of the right cheek present for 6 years. The mass was soft and ill-defined but measured 10x20cm. and extended from the submandibular upper neck to the zygomatic arch, and from the mastoid to the cheek, over the parotid gland. Eosinophilia varying from 27% to 29% was noted in the peripheral blood. On March 21, 1986, the lesion was resected. The procedure comprised an extended superficial parotidectomy from the temporalis fascia to the upper neck. Post-operatively radiotherapy 3000 rad tissue dose was administered using the 6 MeV linear accelerator. The patient remains free of disease. CASE III. A 19-year-old student came to the clinic with masses over both mastoid areas, present 3 years. On the right there were two adjacent lesions, one over the mastoid, the other in the upper jugular level of the neck. On the left it was a single mass over the mastoid. Eosinophilia varied from 13 to 32% in the peripheral blood, and 11.6% in the bone marrow. Incisional biopsy revealed 'eosinophilic granuloma' and a trial of predisolone was employed. The mass increased in size so a small dose of radiation (600 rads) was used, with substantial regression,. The lesion on the left was excised and follwed by 1000 rads radiotherapy. Finally recurrent tumor on the right side was removed on November 5, 1985. The patient remains free of disease. CASE N. A 29-year-old local merchant had had swelling of both upper necks since childhood. At the time of his first visit on March 17, 1986, the right submandibular mass measured 5x3.5cm. and the ,right upper neck and parotid tail mass measured 2.5cm. On the left there were masses in the upper neck, the largest of which measured 2.5cm, and of the parotid tail, 2.0cm. in size.(See Fig. 1) Peripheral eosinophilia of 39% was recorded. Left side partial parotidectomy and resection of the upper neck and subdigstric mases was done on May 2, 1986. The mass involving the right parotid tail and upper neck nodes was removed on Angust 7,1986. Postoperatively the patient was placed on prednisolone 30 mg. per day. No definite masses are palpable. CASE V. A 66-year-old housewife informed us, at the time of her first visit in May, 1986, that she had had multiple neck masses since 10 years ago. On the right side there was a 2.5cm. subcutaneous mass of the upper neck, over the upper jugular chain. On the left there was a 9x4.5cm. mass involving the entire parotid, the post-auricular area and the upper neck. A third mass presented in the submental area and measured 3.5cm. (See Fig. 2) Eosinophilia of 51% was noted in the peripheral blood. partial excision of the left upper neck lesion and complete excision of the submental mass were performed on june 6, 1986. post-operatively she was placed on 20 mg. of prednisolone daily, but when the mass re-grew after two months she was referred to Radiation Therapy for a 2500 rad course of treatment. A barely palpable thickening remains.

• Journal of Sasang Constitutional Medicine
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• v.11 no.2
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• pp.119-150
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• 1999

In spite of recent remarkable recent development in both western and oriental medical sciences, there is still only a shallow understanding of individual differences for various prognoses of incurable diseases and immunopathy diseases. Nevertheless, the care, cure and prevention methods of Sasang Constitutional Medicine are broadly used as an effective treatment of incurable diseases like immunopathy diseases and stress-related diseases and diseases due to aging. In this sense, the establishment of classification norms is urgent and essential for the worldwide application of Sasang Constitutional Medicine(SCM). This study began with the confirmation process of whether Sasang Constitutional types exist in Americans. To accomodate for cultural differences, the distinguishing tool was readjusted so that Sasang Constitutional Types in Americans could be determined. Hence, the selected tool is the new QSCCII+, which is a newly revised English version of the QSCCII. QSCCII was made and standardized by Dept. of SCM in Kyung Hee Medical Center and Dr. Kim7). The evaluation methods of the old version were improved in the new QSCCII+ through necessary statistical manipulation. The original QSCCII was officially authorized by the Korean Society of Sasang Constitutional Medicine as the only computerized version of Sasang diagnostics. This study is the first attempt to design a new diagnostic tool for the classification of Sasang Constitutional types in North Americans with the revision of QSCCII. The subjects of this study were selected from the cooperative people among the students and staffs of the University of Bridgeport and the patients who visited the Clinic in the Health Science Center. This study takes for about 1 year from 1998. 8 to 1999. 8 The conclusions of the study can be summarized as follows: 1. Sasang constitutional types also exist in Americans. It can also naturally be inferred that Sasang Constitutional types exist in all human beings, for there are many different human races in America. 2. There are more So-Yang In's than any other types in American white people. This result confirms the hypothesis that there also exist Sasang Constitutional types in westerners. 3. The result of repetitive tests suggests that the new QSCCII+ is an effective diagnostic tool for westerners when we consider the constant diagnostic results of the QSCCII+. 4. Sasang Constitutional types exit in the sample group regardless of racial difference. 5. The question items that were not often checked by Americans need to be modified into more understandable expressions. 6. The standardization of diagnosis for Americans should be established by use of the QSCCII+ 7. It can be guessed that there are many Tae-yang In's among the 71 persons who could not be clearly classified by the QSCCII+. Due to the scarcity of Tae-yang-In in general, it is important to improve upon the discernability of the QSCC II+. 8. The results of the Sasang Constitutional distribution in North Americans are as follows: The percentage of So-yang In distribution in the sample group is 36.25%(87persons), that of Tae-eum In is 13.75%(33persons), and that of So-eum In is 20.41%(49persons).

• Sim-seong Yeon-gu
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• v.37 no.2
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• pp.184-254
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• 2022

Through this thesis, the psychological meaning of the Korean folktale 'the servant who ruined the master's house' was examined. The opposition between the master and the servant is a universal matter of the human psychology. It can be seen as a conflict between the hardened existing collective consciousness and the new consciousness to compensate for and renew it. From different angles, it has become the opposition between man's spiritual and instinctive aspects, between the conscious and the unconscious, or between the ego and the shadow. In the folktale, the master tries several times to get rid of the youngest servant, but the servant uses tricks and wits to steal food, a horse, the youngest sister, and all money from the master, and finally, take his life. It ends with the marriage of the youngest sister and the servant. Enantiodromia, in which the master dies, and the servant becomes the new master, can be seen that the old collective consciousness is destroyed, and the new consciousness that has risen from the collective unconscious takes the dominant position. In an individual's psychological situation, it can be seen that the existing attitude of the ego is dissolved and transformed into a new attitude. In the middle of the story, the servant marries the youngest sister by exploiting naive people to rewrite the back letter written by the master to kill him. This aspect can be understood negatively in the moral concept of collective consciousness, but it can also be seen as a process of integrating mental elements that have been ignored in the collective consciousness of the Joseon Dynasty, symbolized by a woman, a honey seller, and a hungry Buddhist monk. The new consciousness, represented by the servant, has the characteristics of a trickster that is not bound by the existing frame, so it can encompass the psychological elements that have been ignored in the collective consciousness. Such element may represent compensation or an alternative to the collective consciousness in the late Joseon Dynasty. The master puts the servant in a leather bag and hangs it on a tree to kill the servant. However, the servant deceives a blind man; he opened his eyes while hanged. Instead of the servant, the blind man dies, and the servant is freed. As the problem of the conflict between master and servant is finally entrusted to the whole spirit (Self) symbolized by a tree, the blind man gets removed. It can be understood as an intention of the Self to distinguish and purify the elements of recklessness, stupidity, and greed included in the trickster. Through these processes, the servant, which symbolizes a new change in collective consciousness or a new attitude of ego, solves the existing problems and takes the place of the master. While listening to the cunning servant's performance, the audience feels a sense of joy and liberation. At the same time, in the part where the blind man and the master's family die instead and the servant becomes the master, they experience feelings of fear and concern about the danger and uncontrollability of the servant. The tricksters appearing in foreign analogies are also thoroughly selfish and make innocent beings deceive or die in order to satisfy their desires and escape from danger. Efforts to punish or reform these tricksters are futile and they run away. Therefore, this folktale can also be seen as having a purpose and meaning to let us know that this archetypal shadow is very dangerous and that consciousness cannot control or assimilate it, but only awe and contemplate it. Trickster is an irrational manifestation of revivifying natural energy that rises from the unconscious as a compensation for hardened existing structure and order. The phenomenon may be destructive and immoral from the standpoint of the existing collective mind, but it should be seen as a function of the collective unconscious, a more fundamental psychic function that cannot be morally defined. The servant, a figure of the trickster archetype, is a being that brings transformation and has the duality and contradiction of destructiveness and creativity. The endings of this folktale's analogies are diverse, reflecting the diversified response of the audience's mind due to the ambivalence of the trickster, and also suggesting various responses toward the problem of the trickster from the unconscious. It also shows that the trickster is a problem of inconclusive and controversial contradictions that cannot be controlled with a conscious rational attitude, and that we can only seriously contemplate the trickster archetype within us.

• Journal of the Korean Wood Science and Technology
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• v.10 no.3
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• pp.13-44
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• 1982

1. Since long time ago, it has been talked about that soaking wood into water for a long time would be profitable for the decreasing of defects such as checking, cupping and bow due to the undue-shrinking and swelling. There are, however, no any actual data providing this fact definitly, although there are some guesses that water soluble extractives might effect on this problem. On the other hand, this is a few work which has been done about the effect of water soluble extractives upon the some physical properties of wood and that it might be related to the above mentioned problem. If man does account for that whether soaking wood into water for a long time would be profitable for the decreasing of defects due to the undue-shrinking and swelling in comparison with unsoaking wood or not, it may bring a great contribution on the reasonable uses of wood. To account for the effect of water soluble extractives upon physical properties of wood, this study has been made at the wood technology laboratory, School of Forestry, Yale university, under competent guidance of Dr. F. F. Wangaard, with the following three different species which had been provided at the same laboratory. 1. Pinus strobus 2. Quercus borealis 3. Hymenaea courbaril 2. The physical properties investigated in this study are as follows. a. Equilibrium moisture content at different relative humidity conditions. b. Shrinkage value from gre condition to different relative humidity conditions and oven dry condition. c. Swelling value from oven dry condition to different relative humidity conditions. d. Specific gravity 3. In order to investigate the effect of water soluble extractives upon physical properties of wood, the experiment has been carried out with two differently treated specimens, that is, one has been treated into water and the other into sugar solution, and with controlled specimens. 4. The quantity of water soluble extractives of each species and the group of chemical compounds in the extracted liquid from each species have shown in Table 36. Between species, there is some difference in quantity of extractives and group of chemical compounds. 5. In the case of equilibrium moisture contents at different relative humidity condition, (a) Except the desorption case at 80% R. H. C. (Relative Humidity Condition), there is a definite line between untreated specimens and treated specimens that is, untreated specimens hold water more than treated specimens at the same R.H.C. (b) The specimens treated into sugar solution have shown almost the same tendency in results compared with the untreated specimens. (c) Between species, there is no any definite relation in equilibrium moisture content each other, however E. M. C. in heartwood of pine is lesser than in sapwood. This might cause from the difference of wood anatomical structure. 6. In the case of shrinkage, (a) The shrinkage value of the treated specimen into water is more than that of the untreated specimens, except anyone case of heartwood of pine at 80% R. H. C. (b) The shrinkage value of treated specimens in the sugar solution is less than that of the others and has almost the same tendency to the untreated specimens. It would mean that the penetration of some sugar into the wood can decrease the shrinkage value of wood. (c) Between species, the shrinkage value of heartwood of pine is less than sapwood of the same, shrinkage value of oak is the largest, Hymenaea is lesser than oak and more than pine. (d) Directional difference of shrinkage value through all species can also see as other all kind of species previously tested. (e) There is a definite relation in between the difference of shrinkage value of treated and untreated specimens and amount of extractives, that is, increasing extractives gives increasing the difference of shrinkage value between treated and untreated specimens. 7. In the case of swelling, (a) The swelling value of treated specimens is greater than that of the untreated specimens through all cases. (b) In comparison with the tangential direction and radial direction, the swelling value of tangential direction is larger than that of radial direction in the same species. (c) Between species, the largest one in swelling values is oak and the smallest pine heartwood, there are also a tendency that species which shrink more swell also more and, on the contrary, species which shrink lesser swell also lesser than the others. 8. In the case of specific gravity, (a) The specific gravity of the treated specimens is larger than that of untreated specimens. This reversed value between treated and untreated specimens has been resulted from the volume of specimen of oven dry condition. (b) Between species, there are differences, that is, the specific gravity of Hymenaea is the largest one and the sapwood of pine is the smallest. 9. Through this investigation, it has been concluded that soaking wood into plain water before use without any special consideration may bring more hastful results than unsoaking for use of wood. However soaking wood into the some specially provided solutions such as salt water or inorganic matter may be dissolved in it, can be profitable for the decreasing shrinkage and swelling, checking, shaking and bow etc. if soaking wood into plain water might bring the decreasing defects, it might come from even shrinking and swelling through all dimension.