• Journal of Gastric Cancer
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• 제12권1호
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• pp.36-42
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• 2012

Purpose: The aim of this study was to evaluate the surgical outcomes of abdominal total gastrectomy, without mediastinal lymph node dissection for type II and III gastroesophageal junction (GEJ) cancers. Materials and Methods: We retrospectively reviewed surgical outcomes in 67 consecutive patients with type II and III GEJ cancers that were treated by the surgical resection between 2004 and 2008. Results: Thirty (45%) patients had type II and 37 (55%) had type III tumor. Among the 65 (97%) patients with curative surgery, 21 (31%) patients underwent the extended total gastrectomy with trans-hiatal distal esophageal resection, and in 44 (66%) patients, abdominal total gastrectomy alone was done. Palliative gastrectomy was performed in two patients due to the accompanying peritoneal metastasis. The postoperative morbidity and mortality rates were 21.4% and 1.5%, respectively. After a median follow up of 36 months, the overall 3-years was 68%, without any differences between the Siewert types or the operative approaches (transhiatal approach vs. abdominal approach alone). On the univariate analysis, the T stage, N stage and R0 resection were found to be associated with the survival, and multivariate analysis revealed that the N stage was a poor independent prognostic factor for survival. Conclusions: Type II and III GEJ cancers may successfully be treated with the abdominal total gastrectomy, without mediastinal lymph node dissection in the Korean population.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6411-6413
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• 2013

Adenocarcinoma of esophagus (AE) is a complex disease, affected by a variety of genetic and environmental factors. Much evidence has shown that the MutY glycosylase homologue (MUTYH) plays a key role in the pathogenesis of many cancers. However, there have been no reports on influence on AE in the Han Chinese population. The objective of this study was to investigate this issue. A gene-based association study was conducted using three single nucleotide polymorphisms(SNPs) reported in previous studies. The three SNPs (rs3219463, rs3219472, rs3219489) were genotyped in 207 unrelated AE patients and 249 healthy controls in a case-control study using polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). The results revealed that the genotype distribution of rs3219472 differed between the case and control groups (OR=1.66,95%CI=1.11-2.48, P=0.012), indicating that an association may exist between MUTYH and AE. These findings support a signifcant role for MUTYH in AE pathogenesis in the Han Chinese population.

• Journal of Chest Surgery
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• 제25권12호
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• pp.1530-1536
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• 1992

From January 1984 to December 1991, One hundred sixty five patients with carcinomoa of the esophagus were treated surgically at the department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital. Among them, hospital records were available in 121 patients and were included in this study. There were 115 men and 6 women, with ages ranging from 40 years to 79 years[mean age of 59.2 years]. The most frequent preoperative symptoms included dysphagia[72.7%], weight loss[60.3%], chest pain or discomfort[14.9%], general malaise[13.2%]. All were treated surgically: 100 patients were managed by curative or palliative resection with reconstruction, and 6 by palliative bypass surgery. In 15 patients, explorative thoracotomy or laparotomy was only done due to unresectability. [operability: 87.6%, resectability: 82.6%] All specimens[those from resectable 100 cases] were sent to pathology, and histopathologic examinations were done; squamous cell carcinomas were found in 95 cases, adenocarcinoma in l. Adenosquamous carcinomas were found in 3, and malignant melanoma in l. Postoperative complications occurred in 34 cases; anastomotic site leakage[10], which was followed by empyema in 9 of them, wound problem[7], hepatic failure[6], pneumonia [3], post-operative bleeding[3], chylothorax[2], post-operative stricture[2], sepsis[1], and tracheobronchial fistula[1]. Hospital deaths were in 6 cases[Hospital mortality: 5.0%]. During the follow up period, 26 patients were proven to be recurrence of cancer locally or distantly. The one, two, and five-year actuarial survival raf.es were 71.3$\pm$4.5%, 57.4$\pm$5.6%, 34.7$\pm$8.9%, respectively. The data from this study suggested that esophagectomy with reconstruction of gastrointestinal tract could be performed with a low operative mortality and a few serious postoperative complications and achieved reasonable long term palliation for carcinoma of the esophagus.

• Journal of Chest Surgery
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• 제25권5호
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• pp.504-510
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• 1992

Overall 25,095 cases of general thoracic surgery were analysed, which were performed by 48 institutes in Korea during recent 6 years[242 hospital-years]. The proportions of tumorous disease and infectious disease to be operated were 6,864 cases[27.4%] and 6,775 cases [27.0%], The most common organ involved for operation was lung-bronchus 16,542 cases [69.5%], and remainders were pleura 2,500 [10.0%], esophagus 2,433[9.7%], mediastinum 1,902[7.6%], chest wall 1,297 [5.2%], and diaphragm 421 [1.7%] in order. Among 6,864 cases of tumorous diseases, the most common causes for operation were lung-bronchus tumor 3132 cases [45.6%] and most of them were lung cancer 2,731 cases [88.7%]. In the 2,019 cases of primary lung cancer with known cell type, squamous cell carcinoma 1,296 cases [64.2%] and adenocarcinoma 460 cases [22.8%] were the most. The common types in the 1,207 cases of mediastinal tumor with known cell type were neurogenic tumor 348 cases [28.8%], thymoma 311 [25.8%], and teratoma 252[20.9%]. The annual cases of operation for tumorous disease including malignant tumor were increased steadily. Operation for infectious lung diseases [including bronchiectasis and tuberculosis] were about twice common than infectious pleural disease [i.e. empyema], and operations for tuberculous disease occupied about half cases of infectious lung disease. In 11,456 cases of other disease entities, excluding tumorous and infectious disease, there were bullous lung disease 9,074 cases[79.2%], benign esophageal disease 484[4.2%], myasthenia gravis 356[3.1%], chest wall deformity 483[4.2%], and diaphragmatic lesion 421[3. 7%] in order. We propose that above results for inquiry can be used as the basic data of general thoracic surgery in Korea.

• Journal of Gastric Cancer
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• 제19권3호
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• pp.290-300
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• 2019

Purpose: The optimal method for intracorporeal esophagojejunostomy remains unclear because a purse-string suture for fixing the anvil into the esophagus is difficult to perform with a laparoscopic approach. Therefore, this study aimed to evaluate our novel technique to fix the anvil into the esophagus. Materials and Methods: This retrospective study included 202 patients who were treated at our institution with an intracorporeal circular esophagojejunostomy in a laparoscopy-assisted total gastrectomy with a Roux-en-Y reconstruction (166 cases) or a laparoscopy-assisted proximal gastrectomy with jejunal interposition (36 cases). After incising 3/4 of the esophageal wall, a hand-sewn purse-string suture was placed on the esophagus. Next, the anvil head of a circular stapler was introduced into the esophagus. Finally, the circular esophagojejunostomy was performed laparoscopically. The clinical characteristics and surgical outcomes were evaluated and compared with those of other methods. Results: The average operation time was 200.3 minutes. The average hand-sewn purse-string suturing time was 6.4 minutes. The overall incidence of postoperative complications (Clavien-Dindo classification grade ${\geq}II$) was 26%. The number of patients with an anastomotic leakage and stenosis at the esophagojejunostomy site were 4 (2.0%) and 12 (6.0%), respectively. All patients with stenosis were successfully treated by endoscopic balloon dilatation. There was no mortality. Regarding the materials and devices for anvil fixation, only 1 absorbable thread was needed. Conclusions: Our procedure for hand-sewn purse-string suturing with the double ligation method is simple and safe.

• The Plant Pathology Journal
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• 제22권3호
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• pp.203-210
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• 2006

Fumonisins are a group of mycotoxins produced by a pathogen Fusarium verticillioides in infected maize kernels. Consumption of fumonisin-contaminated maize has been implicated in a number of animal and human illnesses, including esophageal cancer and neural tube defects. Since the initial discovery, chemistry, toxicology, and biology of fumonisins as well as the maize-Fusarium pathosystem have been extensively studied. Furthermore, in the past decade, significant progress has been made in terms of understanding the molecular biology of toxin biosynthetic genes. However, there is a critical gap in our understanding of the regulatory mechanisms involved in fumonisin biosynthesis. Here, we review and discuss our current knowledge about the molecular mechanisms by which fumonisin biosynthesis is regulated in F. verticillioides. In addition, we discuss the impact of maize kernel environment, particularly sugar and lipid molecules, on fumonisin biosynthesis.

• Journal of Chest Surgery
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• 제29권1호
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• pp.115-119
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• 1996

방사선 치료 후 발생한 악성 섬유성 조직구종은 아주 드물며 일반적으로 예후가 나쁘다. 52세 남자환자가 6개월 전부터 발견된 흉골부위에 발생한 동통성의 종괴을 주소로 입원하였다. 환자는 5년전 식도암으로 방사선 치료를 받은 병력이 있었다. 종괴는 절개생검상 흥골육종으로 진단되어 항암약물요법을 5회 시행하였으나, 종괴가 점점 커져 수술을 시행하였다. 수술은 흥골을 덮고있는 피부와 늑연골을 포함하여 흥골 전절제술을 시행하였고 이로 인한 결손부위는 자가늑골 이식, 양측 대흥근 근육판과 피부이식으로 흥벽재건술을 시행하였다. 수술후 조직소견은 악성 섬유성 조직구종에 일치하였다. 수술후 경과는 순조로왔으며 36일째에 퇴원하였다.

• Tuberculosis and Respiratory Diseases
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• 제60권2호
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• pp.235-238
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• 2006

외인성 지방 흡인에 의한 지방성 폐렴은 대부분 양성의 경과를 취하지만, 본 증례에서처럼 드물게 심한 호흡 부전을 동반할 수도 있으며, 스테로이드 치료에 호전을 보인 1예를 경험하여 이를 보고하는 바이다.

• 대한후두음성언어의학회지
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• 제29권2호
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• pp.67-69
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• 2018

The development of office-based, unsedated transnasal esophagoscopy (TNE) has proven to be a major technological advance and with time and experience the application of this technology is becoming more widespread. TNE has allowed otolaryngologists to perform a variety of diagnostic and therapeutic procedures in the office setting. Studies consistently demonstrate that the image quality and diagnostic capability of TNE is equivalent to conventional esophagoscopy. The modern TNE endoscopes offer high quality optics, air-insufflation, and irrigation capability through a 2-mm working channel, and the ability to perform biopsies and select procedures. In general, the role of TNE in the head and neck patient is three-fold : to screen for synchronous and metachronous esophageal squamous cell carcinoma (ESCC) ; to differentiate post-treatment changes/symptoms from malignancy ; and to perform certain office-based procedures. TNE offers many specific advantages to the head and neck patient that are not afforded by conventional esophagoscopy. Because of surgical and postirradiation changes, many HNSCC patients have trismus or neck stiffness preventing completion of conventional transoral esophagoscopy. Perhaps most importantly, TNE provides enhanced patient safety, increased tolerability, better practice efficiency, and cost savings. For these reasons, TNE has become a particularly useful tool in the otolaryngologist's armamentarium.

• Radiation Oncology Journal
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• 제17권2호
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• pp.166-171
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• 1999

목적 : 방사선치료에 대해 타과 전문의나 일반의 또는 일반인들이 문의하는 경우 왜곡된 견해를 가지고 있는 경우를 많이 만나게 된다. 이에 방사선종양학 강의를 듣기 전 학생들이 방사선치료에 대해 갖고 있는 단편적인 견해를 파악하고 암 종류에 따른 좋고 나쁜 이미지를 알아내어 학생들과 의사 또는 일반인 대상의 방사선치료 교육과 홍보에 이용하고자 이 연구를 시행하였다. 대상 및 방법 : 방사선 종양학 강의를 듣기 전이고 임상 실습을 시작하지 않은 의학과 3학년 학생들을 대상으로 방사선치료의 실제적인 내용에 대해 어떻게 알고 있는가와 암 종류에 따른 좋고 나쁜 이미지를 설문의 형식으로 조사하였다. 암 종류는 남, 여로 나누어 한국인에 호발하는 암 중에서 선택하였다. 설문에 참여한 학생들의 수는 142명으로 남학생이 118명, 여학생이 24명이었다. 결과 : 방사선치료에 대해 학생들이 갖고 있는 단편적인 견해에 대한 설문 7개 중 지식에 관한 것이 6개인데 이중과반수의 학생에서 올바르게 알고 있는 항목은 1개에 불과하였다. 또한 항암화학요법과 방사선치료에 대해 56$\%$에서 부정적인 반응을 보였다. 학생들은 대장암, 폐암, 식도암, 간암, 유방암, 자궁암에 대해서는 나쁜 이미지를 가지고 있었는데 이들 암들은 국내 방사선치료 환자의 56$\%$,를 차지하며, 위암, 백혈병에 대해서는 좋은 이미지를 가지고 있었다. 결론. 많은 학생들이 방사선종양학 강의를 듣기 전에는 방사선치료의 기본적인 내용을 잘못 알고 있으므로 일반인들에게 이에 대한 홍보가 필요하겠다. 또한 많은 학생들이 항암치료에 대해 부정적인 생각을 가지는 경향이어서 치료 효과가 좋은 암들에 대해서는 구체적인 교육이 필요하고, 암 종류에 있어서, 혐오하는 경향이 있는 대장암, 페암, 식도암, 간암, 유방암, 자궁암은 방사선치료의 역할이 크므로 이러한 암들에 대해 방사선치료의 긍정적인 역할을 적극적으로 홍보하는 것이 필요하다고 생각된다.