• Journal of the Korean Wood Science and Technology
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• v.46 no.2
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• pp.118-124
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• 2018

Juglans mandshurica is a fast growing hard species, which is a tree in family of Juglandaceae and has a wide distribution in China, Korea and eastern Russia. Plant materials from J. mandshurica have extensively been used in folk medicines to prevent or cure gastric, esophageal, lung and cardiac cancer. As one chain of our searching for anticomplementary agents from natural sources, two epimeric ellagitannins, [2,3-O-4,4',5,5',6,6',-hexahydroxydiphenoyl (HHDP))-(${\alpha},{\beta}$)-D-glucose] (I) and pedunculagin (II) were purified from 70% acetone extracts of the stem barks of J. mandshurica by Thin Layer Chromatography and Sephadex LH-20 column chromatography approaches. The chemical structures of the isolated compounds were characterized by MS, NMR, and a careful comparation with published literatures. The epimeric ellagitannins I and II exhibited inhibitory properties against a classical pathway of complementary system with 50 % inhibitory concentrations ($IC_{50}$) values of 65.3 and $47.7{\mu}M$, respectively, comparing with riliroside ($IC_{50}=104{\mu}M$) and rosmarinic acid ($IC_{50}=182{\mu}M$), which were used as positive controls. Thus, the work indicated both the two secondary metabolites possess excellent inhibitory activity and might be developed as potential anticomplementary chemicals.

• Journal of Chest Surgery
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• v.30 no.10
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• pp.1040-1043
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• 1997

We report a patient who suffered from bronchiolitis obliterans organizing pneumonia(BOOP) after Ivor Lewis operation for esophageal cancer. The patient presented low grade fever, dry cough and mild dyspnea at day after operation. Chest roentgenograms and chest CT revealed bilateral patchy and infiltrative shadows. The respiratory symptoms worsened and respiratory failure developed with mild elevation of WBC count despite of conservative treatment. An open lung biopsy was done and the biopsy specimen showed bronchiolitis obliterans organizing pneumonia(BOOP). After several weeks of steroid therapy, there were marked clinical, physiological and roentgenographic improvements. Our experience suggests that BOOP may be one of the underlying pathology in a number of patients presenting with ARDS after thoracotomy. Since steroid therapy may improve survival in these patients, thoracic surgeons should heighten their index of suspicion for this entity. Early histologic diagnosis should be considered in patients with treatment-resistant ARDS after thoracotomy.

• Journal of Korean Academy of Nursing
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• v.23 no.4
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• pp.528-543
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• 1993

Vitamin E, which has its advocates in the treatment of diabetes mellitus. autoimmune disease, cancer and peripheral vascular and thromboembolic disease, has now been alleged to have a powerful antioxident effect and to affect various biological activities such as fertility factor, inhibition of human platelet aggregation and stabilization of biological membranes. The present study was designed to test whether vitamin I(alpha-tocopherol) can : (1) enhance the hemagglutinin response to sheep red blood cells (SRBC), (2) modulate Arthus and delayed type hypersensitivity(DTH) to SRBC and contact hypersensitivity to dinitrofluorobenzene (DNFB). (3) enhance the mitogenic response of murine splenocyte, (4) decrease the recovery of Cryptococcus neoformans from brain, lung, liver, spleen and kidney of infected mice and (5) have an inhibitory or enhancing effect on the induction of active systemic anaphylaxis(ASA) induced by chicken-gamma globulin (CGG) in mice. Mice were given either intramuscular injections of 0.3ml (300mg) of vitamin I before immunization or were infection for 10 consecutive days or were given by vitamin I esophageal intubation, 0.1ml(100mg), for 20 days before sacrifice for the mitogenic response experiments. It was found that vitamin E treated mice showed a significant enhancement in hemagglutinin response, Arthus reaction and DTH to SRBC and contact hypersensitivity to DNFB. There was no significant difference in the mitogenic response to phytohemagglutinin(PHA), but the response to concanavalin A(ConA) or pokeweed mitogem(PWM) was increased in vitamin E-treated mice. Interestingly, the vitamin E administration before C. neoformans infection decreased significantly the recovery of C. neoformans from brain lung, liver, spleen and kidney of the infected mice as compared with that of the control mice, strongly suggesting that vitamin E pretreatment may increase the resistance of mice to the fungal infection. Unexpectedly, vitamin E administration enhanced the production of CGG -induced ASA. Taken together, it can be concluded that vitamin I administration may in-crease the humoral and cellular immune response and resistance. to C. neoformans infection, but enhance the induction of ASA to CGG. Further studies are necessary to clarify the underlying mechanism accounting for these effects.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.19 no.1
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• pp.21-27
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• 2008

Total laryngectomy is the most useful procedure tor advanced laryngopharyngeal cancer, but it remains the major problem such as loss of voice. Voice restoration is essential for every patients who undergo a total laryngectomy. Ideal voice rehabilitation methods can resolve three factors. First, every laryngectomee can produce voice sufficient for communication, second every patient should be allowed to use both hands freely during phonation, and last, the voice restoration methods should be easy and safe without complication during and after treatment. Among various voice rehabilitation procedures during or after total laryngectomy, it can be divided electronic and pneumatic methods. In pneumatic methods, there are also divided both pulmonary air and non-pulmonary air methods. The non-pulmonary air methods include esophageal speech, buccal speech, and pharyngeal speech. Pulmonary air methods are divided into surgical and non-surgical such as pneumatic speech aid. In the surgical methods, there are neoglottic operation, tracheopharyngeal shunt, and tracheopharyngeal shunt operations. Recently, tracheoesophageal shunt with or without prosthesis are being recognized the most effective method. Blom-Singer low pressure prosthesis, Panje button, and Provox are well known types of prosthesis in the tracheoesophageal shunt operation. Amatsu method is a kind of famous tracheoesophageal shunt method without using prosthesis. Authors tried to review the published articles for evaluation of effectiveness and problems of tracheoesophageal shunt operation with or without prosthesis. In conclusion, indwelling type of prosthesis and pharyngeal myotomy and plexus neurectomy are recommended for higher success rate during tracheoesophageal puncture procedure. More over, Amatsu method is also one of the recommended voice rehabilitation procedure during total laryngectomy. In this situation, pharyngeal myotomy and plexus neurectomy may be helpful for better fluent communication.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.2
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• pp.111-114
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• 2018

We report a case of pulmonary aspiration during induction of general anesthesia in a patient who was status post esophagectomy. Sudden, unexpected aspiration occurred even though the patient had fasted adequately (over 13 hours) and received rapid sequence anesthesia induction. Since during esophagectomy, the lower esophageal sphincter is excised, stomach vagal innervation is lost, and the stomach is flaccid, draining only by gravity, the patient becomes vulnerable to aspiration. As the incidence of perioperative pulmonary aspiration is relatively low, precautions to prevent aspiration tend to be overlooked. We present a video clip showing pulmonary aspiration and discuss the literature concerning the risk of aspiration and its preventive strategies.

• Archives of Plastic Surgery
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• v.49 no.5
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• pp.617-632
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• 2022

Tracheoesophageal puncture (TEP) and voice prosthesis insertion following laryngectomy may fail to form an adequate seal. When spontaneous closure of the fistula tract does not occur after conservative measures, surgical closure is required. The purpose of this study was to summarize the available evidence on surgical methods for TEP site closure. A comprehensive search across PubMed, Web of Science, SCOPUS, and Cochrane was performed to identify studies describing surgical techniques, outcomes, and complications for TEP closure. We evaluated the rate of unsuccessful TEP closure after surgical management. A meta-analysis with a random-effect method was performed. Thirty-four studies reporting on 144 patients satisfied inclusion criteria. The overall incidence of an unsuccessful TEP surgical closure was 6% (95% confidence interval [CI] 1-13%). Subgroup analysis showed an unsuccessful TEP closure rate for silicone button of 8% (95% CI < 1-43%), 7% (95% CI < 1-34%) for dermal graft interposition, < 1% (95% CI < 1-37%) for radial forearm free flap, < 1% (95% CI < 1-52%) for ligation of the fistula, 17% (95% CI < 1-64%) for interposition of a deltopectoral flap, 9% (95% CI < 1-28%) for primary closure, and 2% (95% CI < 1-20%) for interposition of a sternocleidomastoid muscle flap. Critical assessment of the reconstructive modality should take into consideration previous history of surgery or radiotherapy. Nonirradiated fields and small defects may benefit from fistula excision and tracheal and esophageal multilayer closure. In cases of previous radiotherapy, local flaps or free tissue transfer yield high successful TEP closure rates. Depending on the defect size, sternocleidomastoid muscle flap or fasciocutaneous free flaps are optimal alternatives.

• Journal of Chest Surgery
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• v.56 no.6
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• pp.420-430
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• 2023

Background: This study provides an update to a landmark 2004 report describing demographics, training, and trends in adherence to thoracic surgery practice standards in Canada. Methods: An updated questionnaire was administered to all members of the Canadian Association of Thoracic Surgeons via email (n=142, compared to n=68 in 2004). Our report incorporates internal data from Ontario Health and the Canadian Partnership Against Cancer. Results: Forty-eight surgeons completed the survey (male, 70.8%; mean±standard deviation age, 50.3±9.3 years). This represents a 33.8% response rate, compared to 64.7% in 2004. Most surgeons (69%) served a patient population of over 1 million per center; 32%-34% reported an on-call ratio of 1:4-1:5 days, and the average weekly hours worked was 56.4±11.9. Greater access to dedicated geographic units per center (73% in 2021 vs. 53% in 2004) has improved thoracic-associated services and house staff, notably endoscopy units (100% vs. 91%), with 73% of respondents having access to both endobronchial and endoscopic ultrasound. Access to thoracic radiology has also improved, particularly regarding positron emission tomography scanners per center (76.9% vs. 13%). Annual case volumes for lung (255 vs. 128), esophageal (41 vs. 19), and mediastinal resections (30 vs. 13), along with hiatal hernia repair (45 vs. 20), have increased substantially despite reports of operating room availability and radiology as rate-limiting steps. Conclusion: This survey characterizes compliance with current practice standards, addressing the needs of thoracic surgeons across Canada. Over 85% of respondents were aware of the 2004 compliance paper, and 35% had applied for resources and equipment in response.

• Journal of the Mineralogical Society of Korea
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• v.12 no.1
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• pp.43-53
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• 1999

The medical mineral menas a single mineral or a complex of minerals. It is natural material. using the medical action of he major or the minor elements, and traditional medicine stuff which has been used since long time ago. Jusa, cinnabar as the mineral name, is the product of the hydrothermal process. It is used to relax the body and cure high blood pressure, apoplexy and cardiopathy. Jusais the major component of "An shin hwan" and "Woo hwang chung shim hwan" nowadays because it has such an excellent calm effect. In addition, it is used to cure cancers such as esophageal cancer and gastric cancer. Jusa composed of mercuric sulfide causes mercury poisoning such as Minamata disease. It is dealt with mineralogical property and chemical composition medical stuff in Korea and China, as well asmercury poisoning and medical action of Jusa in this study. In order to predct accumulation of the interior of the body of the major and minor elements in Jusa, leaching experiment of Jusa by artificial gastric juice was done as well as thermodynamic reaction modelling to know concentration of each species of body fluid. The minor elements of 24 species such as As, Pb, Cd, a and Fe by leaching reaction of Jusa and artificial gastric juice were leached. We can know the fact that as is less than 1 ppm, Hg is less than 25 ppm and Cd and m are not detected. In addition, mercury exists as species of Hg2+, HgCl+, HgCl2, HgCl3-, HgCl42-, HgClOH, HgS(H2S)2, Hg(HS)3-, HgS22-, HgOH and Hg(OH)2 by reaction modelling between Jusa and artificial gastric juice. The concentration of sulfide complexes is 24.2 ppm and that of others is less than 10 ppm. According to increasing pH, the concentration of HgS(H2S)2, Hg(HS)3+, HgS22- and Hg(OH)2 increases, whereas the concentration of HgCl+, HgCl2, HgCl3- and HgCl42- decreases. Therefore, Jusa is very useful for the development of new medicine because it is possible to predict formation of the body species and species accumulation on mercury known as a toxic element and concentration changes of toxicity and efficiency.city and efficiency.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.22 no.2
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• pp.119-125
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• 2011

Background and Objectives : Temporary or permanent vocal paralysis can be occurred after head and neck surgery such as thyroid cancer, esophageal resection, and chest operation including lung parenchymal resection, due to a vagus or recurrent laryngeal nerve injury. The authors aimed to determine the clinical efficacy of using Calcium-Hydroxyapatite (CaHA) for permanent unilateral vocal cord palsy patients. Materials and Method : Between July 2008 to July 2010, among patients with chief complain of hoarseness and aspiration, only who were diagnosed as unilateral vocal cord palsy under laryngoscopy, were selected. The patients included 3 females and 13 males age range between 29 to 79 and average age was 60 years old. Results : The hoarseness range were $8.94{\pm}0.77$, $4.63{\pm}1.02$, $4.31{\pm}1.30$ statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Also aspiration were $7.44{\pm}2.48$, $3.63{\pm}1.82$, $3.19{\pm}1.91$ statistically improved during the same period. The result of voice analysis showed that the frequency range shows decrease at 1 week and 3 months after the injection compared to that of the preoperative result in both male and female group (Male: $161.63{\pm}32.78$ Hz, $139.13{\pm}30.63$ Hz, $146.67{\pm}34.20$ Hz ; Female: $244.62{\pm}26.62$ Hz, $244.91{\pm}42.03$ Hz, $237.50{\pm}38.95$ Hz). The Maximal phonation time were $2.75{\pm}1.06$ (sec), $8.88{\pm}3.46$ (sec), $8.44{\pm}3.71$ (sec) statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Conclusion : Injection laryngoplasty with CaHA in unilateral vocal cord paralysis is very safe and efficient procedure to improve a voice disorder, a swallowing difficulty, and a quality of life for those patients with a sacrificed RLN, a cancer invasion of the nerve, and a prolonged vocal cord paralysis which is more than six to twelve months.

• Journal of Preventive Medicine and Public Health
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• v.30 no.4 s.59
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• pp.697-707
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• 1997

This study was performed to estimate the quantity of the effects of tobacco price raise on the smoking rate, and the smoking attributable deaths in Korea. The data were collected by questionnaire survey from 538 male of male workers. The questionnaire contained items on age, sex, living place, status of education, smoking history, the intention to quit smoking when the tobacco price be raised. The questionnaire, were distributed to the offices of enterprises, hospitals, research centers, and public agencies and then collected. Data were analyzed by using the age specific smoking rate, relative risks of eight major smoking related diseases, vital statistics, and the population attributable risk of deaths of smoking males. On the other hand, the impact of the tobacco price raise on the population attributable risk of death due to smoking in Korea was estimated by applying the presumed smoking rate after the price raise. The results obtained were as follows: 1. The smoking rate of male white color workers in large cities was 59.5%. 2. The proportion of male smokers who has the intention to quit smoking when the tobacco price be raised was 61.5%. 3. The proportion of male smokers who has the intention to quit smoking if the price of tobacco be raised was proportional to the degree of increasing tobacco price. It is estimated that if the tobacco price were raised more than four times as now, the presumed smoking rate goes down as low as 26.7%. If the tobacco price be raised 20% each year, presumed smoking rate is 46.2%. 4. The number of attributable male death of smoking estimated by using 8 major smoking related diseases(lung cancer, laryngeal cancer, esophageal cancer, stomach cancer, pancreatic cancer, cerebrovascular disease, ischemic heart disease, chronic obstructive pulmonary disease) was 25,863 death each year. That is 20.1% of total age over 20 male deaths. 5. f the tobacco price were raised more than four times as now and all smokers who has intention to quit smoking quits smoking, 12,336 lives, or 47.7% of smoking related deaths could be saved. 6. IF the actual practice rate of quitting smoking among male smokers with intention to stop smoking when the price of tobacco be raised is 10%, 25%, or 50%, then the expected decrease of death numbers when the tobacco price were raised more than four times as now can be 1,112, 3,483, 5,796 respectively.