• 한국가시화정보학회지
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• 제7권2호
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• pp.22-27
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• 2010

The delayed gastric emptying flows have been visualized in this study when a gastric graft replaced an esophagus after esophagectomy. To construct visualization models for gastric grafts, the path data of gastric graft were extracted from the CT images for real patients and then the experimental models were made from silicone tube by considering elasticity of real stomach. During experiments, 200 ml of water or glycerin was poured into the gastric graft model and the gastric emptying time for total volume of fluid to pass pylorus was measured from the successive images captured by a high speed CCD. The gastric emptying time was compared according to the change of diameter and path (front or rear path) of gastric graft, and pyloroplasty or not. In case that the pyloroplasty was not conducted, the smaller was the diameter of gastric graft, the shorter was the gastric emptying time. However, if the pyloroplasty was conducted, the larger diameter of gastric graft was better for the gastric emptying. Although the rear path gave rise to longer gastric emptying time than the front path, it did not matter, if the pyloroplasty was conducted.

• 대한기관식도과학회지
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• 제2권1호
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• pp.63-70
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• 1996

Reconstruction for hypopharynx and cervical esophagus after wide resection of extensive hypopharynx and larynx cancers have been used various methods including myocutaneous flaps, gastric pull up, md jejunal or large bowel free graft. Recently, the authors had experienced hypopharynx and larynx cancers with extension to the posterior hypopharyngeal wall and thoracic esophagus. Of course, these reconstructive methods should be selected in accordance with the patient's age, physical status, extend of prim.:W lesion, and defect after on block resection, however, gastric pull up was performed in hypopharynx cancer which had skipped lesion in the thoracic esophagus and jejunal free grafts were performed in case 2, 3 which had a extended lesions to the posterior pharyngeal wall. Some complications were noted, which were successfully stabilized by conservative managements. The gastric pull up and jejunal free graft were considered suitable methods for reconstrunction of hypopharynx and cervical esophagus, however, further studies are necessary about it.

• 대한기계학회논문집B
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• 제36권7호
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• pp.697-703
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• 2012

본 연구에서는 식도 재건 수실 시 유문 성형 여부와 위장 이식편을 이용한 식도 접합 경로에 따른 음식물 역류 현상에 대해 고찰하였다. 위장 이식편의 두 가지 접합 경로(전방, 후방)는 환자 10 명의 CT 영상으로부터 얻어졌으며, 식도관 모델은 RP 로 제작하였다. 식도관은 유문 성형 여부의 두 가지 유문 모델에 연결하였고, 다양한 압력과 펄스폭을 적용하여 역류되는 유체의 체적과 최대 역류 높이를 측정하였다. 그 결과, 역류 체적과 높이는 압력에 따라 증가하였으며, 유문 성형을 하면 전방 경로가 후방 경로보다 역류되는 체적과 높이 작게 나타났다. 역류량은 펄스폭이 증가하면 증가하나 최대 역류높이에 대한 영향은 유문 성형 여부에 따라 달라진다.

• 대한의생명과학회지
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• 제23권3호
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• pp.238-250
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• 2017

Patient's primary tumor-derived tumor cell lines likely represent ideal tools for human tumor biology in vitro and in vivo. Here, we describe eight human gastric carcinoma cell lines derived from established tumors in vivo upon subcutaneous transplantation of primary gastric carcinoma specimens in BALB/c nude mice. These xenografted gastric tumor cell lines (GTX) displayed close similarity with primary gastric tumor tissues in their in vivo growth pattern and genomic alterations. GTX-085 cells were resistant to cisplatin, while GTX-087 was the most sensitive cell line. GTX-085 was the only cell line showing a metastatic potential. Epithelial cell adhesion molecule (EPCAM) expression was especially strong in all tissue samples, as well as in cell cultures. GTX-139, the largest tumor graft obtained after injection, displayed distinct expression of CD44v6, fibroblast growth factor receptor 2 (FGFR2), and prominin 1 (PROM1, also known as CD133). In summary, we established eight xenograft gastric cancer cell lines from gastric cancer patient tissues, with their histological and molecular features consistent with those of the primary tumors. The established GTX cell lines will enable future studies of their responses to various treatments for gastric cancer.

• Journal of Chest Surgery
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• 제57권1호
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• pp.62-69
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• 2024

Background: Cervical esophageal cancer is a rare malignancy that requires specialized care. While definitive chemoradiation is the standard treatment approach, surgery remains a valuable option for certain patients. This study examined the surgical outcomes of patients with cervical esophageal cancer. Methods: The study involved a retrospective review and analysis of 24 patients with cervical esophageal cancer. These patients underwent surgical resection between September 1994 and December 2018. Results: The mean age of the patients was 61.0±10.2 years, and 22 (91.7%) of them were male. Furthermore, 21 patients (87.5%) had T3 or T4 tumors, and 11 (45.8%) exhibited lymph node metastasis. Gastric pull-up with esophagectomy was performed for 19 patients (79.2%), while 5 (20.8%) underwent free jejunal graft with cervical esophagectomy. The 30-day operative mortality rate was 8.3%. During the follow-up period, complications included leakage at the anastomotic site in 9 cases (37.5%) and graft necrosis of the gastric conduit in 1 case. Progression to oral feeding was achieved in 20 patients (83.3%). Fifteen patients (62.5%) displayed tumor recurrence. The median time from surgery to recurrence was 10.5 months, and the 1-year recurrence rate was 73.3%. The 1-year and 3-year survival rates were 75% and 33.3%, respectively, with a median survival period of 17 months. Conclusion: Patients with cervical esophageal cancer who underwent surgical resection faced unfavorable outcomes and relatively poor survival. The selection of cases and decision to proceed with surgery should be made cautiously, considering the risk of severe complications.

• 대한두경부종양학회지
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• 제16권1호
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• pp.26-32
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• 2000

Background and Objectives: Various flaps are using for reconstruction of hypopharyngeal and esophageal defect. However, complication and indication of each flap are not fully analyzed. Patient and Methods: Records of 52 hypopharyngeal cancer patients who had surgical treatment and 13 other head and neck cancer patients who underwent hypopharyngeal and/or esophageal reconstruction with flap were retrospectively analyzed. Eighty three percent(54 cases) of patients needed reconstruction other than primary pharyngeal closure. Five split thickness skin graft, 1 pectoralis major myocutaneous flap, 20 forearm free flap, 13 jejunal free flap, 15 gastric pull up were used. Result: Flap failure was noted in 2 cases who had subsequent gastric transposition. Wound dehiscence and fistula were most common problem of forearm free flap. Most fistulas were developed in patients with conduit type reconstruction of forearm flap while there wasn't any fistula in patient with patch type reconstruction. Stenosis of lower anastomosis was the frequent problem of jejunal transfer. Gastric pull-up has frequent com-plication of stomal stenosis. All but three patients had reached oral feeding postoperatively. Conclusion: Based on this study, forearm flap is effective in partial hypopharyngeal defect while jejunum is the choice for circumferential defect. Gastric pull-up is for combined esophageal defect.

• Journal of Chest Surgery
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• 제16권4호
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• pp.584-593
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• 1983

Esophageal reconstruction was performed in 344 patients with irreversible stricture of the esophagus resulting from caustic burns at National Medical Center from 1959 to 1982.There were 113 males and 231 females, and ranging from 2.5 to 58 years of age, and mean age was 26.5 years, and 25 cases were less than 10 years old. Caustic materials were 286 [83.2%] alkali and 50[14.5%] acid. The most frequent stricture site was upper thoracic esophagus as 56.7%, and the next was cervical as 31.4%, and lower, 11.9%. The stomach was involved in 10.8% totally, and hypopharyngeal stricture was also noticed in 3.2%, and in 3 cases, hypopharyngeal reconstruction was needed due to extensive scar change. In 329 of total 344 cases, colon interposition was performed without resection of the strictured esophagus except 4 cases which were complicated T-E fistula or perforation, and most of them, about 10-15 cm of terminal ileum with right half of the colon was used as the graft. The left colon with anti-peristalsis was used as graft only in 30 cases. The most common postoperative complication was anastomotic leak as 16.7% of total cases, and it was 12.5% from neck, 3.3% from ileocolostoma and 0.9% from cologastrostoma. Next common complication was neck stenosis [8.8%], aspiration pneumonia [6.4%], and graft necrosis [3.9%] in order. Overall operative mortality was 5.5% [14/329], and main causes of death were graft necrosis, sepsis due to anastomotic leak, gastric bleeding, and intestinal obstruction. Besides of colon interposition, according to shape or level of the stricture, plastic repair or segmental resection and direct anastomosis was done in 9, and 1 of them were complicated stenosis at the anastomotic site. In lower stricture, esophagogastrostomy was done in 10 cases, and 1 case expired due to hepatitis, and anastomotic stenosis was occurred in 2 cases at 1.5 months and 2.4 years later. During follow-up of 298 cases colon interposition from 6 months to 22 years, 82.6% was excellent, and 2.9% was complained of mild discomfort, and 4 cases were dead laterly, but 3 of them were not related to reconstruction.

• Journal of Gastric Cancer
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• 제4권2호
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• pp.121-125
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• 2004

Purpose: Esophagojejunal anastomotic complications after a total gastrectomy include leakage, stenosis, bleeding, and abscess formation. Especially, the mortality rate for esophagojejunal anastomotic leakage is $80\%$. Although these complications hare been reduced by the usage of the EEA stapler, they are still serious and depend on various factors: the surgeon's experience, the stage of disease, the extent of surgical intervention, the method of operation, and the patient. Some local factors, such as vascularization of the graft, traction on the anastomosis suture line, and local infections, have been implicated as contributing to these complications. Materials and Methods: During the period $1995\∼2003$, of the 850 gastrectomies for gastric carcinomas, 171 were intra-abdominal total gastrectomies. All of these 171 operations were performed by one surgeon using a routine D2 lymph-node dissection and a 25-mm EEA stapler on an antecolic end-to-side esophagojejunostomy. In the 77 cases a seromuscular reinforced suture at the esophagojejunostomy site was performed, and in 94 cases, a whole layer reinforced suture with absorbible materials was used. We evaluated the incidence of complications according to age, sex, stage of patients, and combined resection. Also, we compared the incidences of complications for seromuscular and whole layer reinforced sutures. Results: The complications are major leaks ($2.9\%$), minor leaks ($3.5\%$), stenosis, bleeding ($1.8\%$), and abscess formation formation ($1.8\%$). In the five cases of major leaks, there were four mortalities with operative methods. The other patients with stenosis, bleeding, and abscess formation were treated conservatively with success. The incidences of complications were not related with age, sex, stages, and combined resection. The incidences of complications for the whole layer reinforced suture group ($2.9\%$) were less than those for the seromuscular reinforced group ($8.8\%$, P=0.04). Conclusion: The most serious complication of esophagojejunal anastomosis is major leakage with an $80\%$ mortality. The other complications are stenosis, bleeding, and abscess formation, for which no mortalities occurred during this study. Whole layer suture of the esophagojejunal anastomotic site is an important method for preventing leakage.

• 대한수의학회지
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• 제40권3호
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• pp.497-504
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• 2000

To document that effects of hyperbaric oxygen(HBO) and ${\alpha}-tocopherol$ on full-thickness skin grafts in rat, we performed full-thickness skin grafts bilaterally on each rats. The HBO-treated rats were received HBO twice daily for 90 minutes at 2 ATA. Surgical control rats were not treated with HBO. ${\alpha}-tocopherol$ treated rats were received the agent via oral gastric tube daily for 3 days preoperative and a fourth dose 1 to 2 hours postoperative. HBO plus ${\alpha}-tocopherol$ treated rats were received HBO and ${\alpha}-tocopherol$ as mentioned above. Biopsy specimens were taken from each rat at the time of grafting and on days 2, 4, 7, 10, 14, 21, and 28, then were processed for tissue-concentration of total glutathione(GSHt), oxidized/reduced glutathione level, and thiobarbituric acid-reactive substance(TBARS) levels. The percentage of viable graft on day 10 ranged from 67 to 93%, and was not significantly different among the each other groups. The percentage of viable graft were, however, higher in HBO plus ${\alpha}-tocopherol$ treated rats(78.6%) than in HBO alone treated rats(59.1%), ${\alpha}-tocopherol$ alone treated rats(66.7%) and surgical control rats(58.2%). TBARS concentration had a significant increase from preoperative concentration at day 2, and peak concentration at day 4(p<0.01). Concentration then decreased to preoperative concentration at day 28. GSHt concentration of free skin graft had a similar patteren of change in four groups and decreased significantly from preoperative concentration at day 2, returning to preoperative concentration by day 7(surgical control, HBO-treated, and ${\alpha}-tocopherol-treated$, alone) and 28(HBO plus ${\alpha}-tocopherol-treated$). Percentage of the concentration of reduced glutathione decreased in surgical control, HBO-treated and, ${\alpha}-tocopherol-treated$(p<0.05), and HBO plus ${\alpha}-tocopherol-treared$(p<0.01) on day 7 after surgery, whereas the concentration of oxidized increased significantly in HBO-treated(p<0.05), ${\alpha}-tocopherol-treated$(p<0.05), and HBO plus ${\alpha}-tocopherol-treated$(p<0.01).

• 폴리머
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• 제36권3호
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• pp.326-331
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• 2012

본 연구에서는 혈액투석 시 필요한 혈관접근통로로 활용되는 expanded poly(tetrafluoro ethylene)(ePTFE) 인공혈관을 표면 개질하였다. 생분해성 합성고분자인 poly(D,L-lactide-$co$-glycolide)(PLGA)와 함께 항암제로서 뿐만아니라 항증식제제로서 널리 쓰이고 있는 파클리탁셀을 인공혈관 표면에 코팅함으로써 PLGA가 생분해됨에 따라 파클리탁셀을 서방할 수 있도록 고안하였다. 인공혈관의 다공구조 특성을 유지하면서 인공혈관 표면에 1.96 mg/$cm^2$의 PLGA가 코팅되었음을 ATR-FTIR을 통해 확인하였다. 또한 0.263 mg/$cm^2$의 파클리탁셀이 인공혈관에 코팅되었음을 HPLC로 확인하였다. PLGA를 코팅함으로써 인공혈관의 모듈러스는 감소하였으나 인장강도는 향상되었다. 약물방출 실험 결과 PLGA의 생분해거동에 동반하여 코팅된 파클리탁셀의 약 35%가 28일 동안 지속적으로 방출되었다. 이러한 지속적인 파클리탁셀의 방출은 장기간에 걸쳐 신내막 과형성증을 억제하여 혈관의 개존율을 향상시킬 것으로 기대된다.