• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.3
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• pp.241-250
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• 2023

Helicobacter pylori is a gram-negative pathogen commonly associated with peptic ulcer disease and gastric cancer. H. pylori infection has also been reported in cholelithiasis, cholecystitis, gallbladder polyps, and biliary tract cancers. However, the association between H. pylori and gallbladder and biliary tract pathologies remains unclear due to the paucity of literature. In response to the current literature gap, we aim to review and provide an updated summary of the association between H. pylori with gallbladder and biliary tract diseases and its impact on their clinical management. Relevant peer-reviewed studies were retrieved from Medline, PubMed, Embase, and Cochrane databases. We found that H. pylori infection was associated with cholelithiasis, chronic cholecystitis, biliary tract cancer, primary sclerosing cholangitis, and primary biliary cholangitis but not with gallbladder polyps. While causal links have been reported, prospective longitudinal studies are required to conclude the association between H. pylori and gallbladder pathologies. Clinicians should be aware of the implications that H. pylori infection has on the management of these diseases.

• Journal of Gastric Cancer
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• v.7 no.4
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• pp.228-236
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• 2007

Purpose: We have evaluated changes of body composition for patients that underwent a radical gastrectomy for stomach cancer by the use of available bioelectrical impedance analysis during the first year following surgery. We plan to utilize these findings in nutritional and physiological studies. Materials and Methods: We evaluated clinical changes in body composition in patients using the bioelectrical impedance method (Inbody 4.0, Biospace, Korea), between November 2003 to November 2004. A total of 98 patients agreed to enroll in this study among all of the patients that underwent a radical gastrectomy. Results: The average weight decreased by 6.7%, and 9.4%, within the first and 6 months after surgery, respectively (P<0.01). The fat free mass (FFM) dropped by 4.9% within the first month and there were no more changes after this period (P<0.01). The fat mass (FM) and visceral fat area (VFA) decreased 24.3% and 14.1% within the first 6 months (P<0.01), respectively. The reduction effects for female patients were greater than for male patients for weight, FFM and VFA (P<0.05). The edema index was higher in patients with stage III-IV disease than in patients with stage I-II disease (P<0.05). There were significant differences for Billroth I and Billrothl II patients as compared to patients that underwent an esophagojejunostomy for a reduction of the FM, as measured in the in the 12th month after surgery (27.6%, 22.1%, and 41.2%, respectively; P<0.05). Conclusion: Since nutritional supplementation and an improvement in body weight loss after a radical gastrectomy is significantly related with quality of life, nutritional and physiological studies should be greatly considered. In this study, bioelectrical impedance analysis was very useful in analyzing the diminution of body composition and we hope this study on the nutritional and physiological aspects related to a radical gastrectomy will be useful for later studies.

• Radiation Oncology Journal
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• v.8 no.1
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• pp.85-93
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• 1990

A series of 25 patients with residual, recurrent, and unresectable gastric cancer received various combination of surgery, radiotherapy (RT), chemotherapy (CT), and hyperthermia (HT). They were placed into 7 categories; 1) CT and HT-14 patients; 2) RT and HT-15 patients; 3) surgery, RT and HT-2 patients; 4) surgery, RT, HT and CT-1 patient; 5) RT, HT and CT -1 patient; 6) RT and CT-1 patient; 7) RT alone-1 patient. Three patients had curative resection. 21 patients received irradiation with tightly contoured portals to spare as much small bowel, kidney and marrow as possible. Hyperthermia was applied regionally once or twice a week for 23 patients using 8 MHz radiofrequency capacitive heating device (Thermotron RF-8). HT was given approximately 30 min after RT 7 patients were treated with CT: 4 patients received HT and concomitant Mitomycin-C; 3 patients received HT and sequential 5-FU+Adriamycin+Mitomycin-C. There was not any treatment related deaths. There was also no evidence of treatment related problems with liver, kidney, stomach, or spinal cord except only one case of transient diabetic ketoacidosis. The tumor response was evaluable in 22 patients. None achieved complete remission.11 ($50\%$) achieved partial remission. The response rate was correlated with total radiation dose and achieved maximum temperature. 9 of 14 ($64\%$) received more than 4000 cGy showed partial remission; especially, all 3 patients received more than 5500 cGy achieved partial response.8 of the 12 patients ($67\%$) who achieved maximal temperature more than $41^{\circ}C$ showed partial response in comparing with $25\%$ (2 of 8 patients, below $41^{\circ}C$). The numbers of HT, however, was not correlated with the response. 3 of the 25 patients ($12\%$) remain alive. The one who was surgically unresectable and underwent irradiation alone is in progression of the disease with distant metastases. The remaining two patients with curative resection are alive with free of disease, 24 and 35 months, respectively. The median survival by response are 11.5 months in responders and 4.6 months in non-responders.

• Radiation Oncology Journal
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• v.15 no.2
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• pp.113-119
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• 1997

Purpose : Radical gastrectomy is main treatment of gastric cancer. But the result is not satisfactory with surgery alone. Most of pattern of failure remain locoregional recurrence. To improve 5 year survival postoperative chemotherapy with or without radiotherapy has been used. We analyzed patients with stage III and IV stomach cancer who had radical operation and received postoperative radiation therapy combined with or without chemotherapy retrospectively. Material and Method : From March 1985 to June 1993, 68 patients treated with curative resection and received postoperative adiuvant radiotherapy with 36Gy or more were evaluated. Median age was 60 years(range 28-66 yrs) . Patients were followed from 3 to 133 months with median follow up of 48 months. Thirty seven patients had non signet ring adenocarcinoma, 29 signet ring cell, 2 other cell. Patients with stage IIIA, IIIB, IV disease were 19, 25 and 24 respectively Chemotherapy was given to all patients except two. Results : Five-year overall survival and disease-free survival rate were 36.6% and 33.6%, respectively. Prognostic factor affecting survival were assessed. High ratio of jnvolved/dissected Iymph node, signet ring histology showed Poor Prognosis with statistical significance. Presence of residual tumor after surgery, stageIV. split course of radiation therapy, age, number of involved Iymph node, number of Iymph node dissection and grade of tumor affected survival without statistical significance, Type of chemotherapy did not affect survival. Recurrence was documented in 34 patients. High recurrence was seen in omentum and peritoneum with 23.5%, and remnant stomach, anastomosis site, A-loop and I-loop had also high recurrence with 13.2%. In field locoregional recurrence was 20.7% and total distant metastases were 39.7%. Total intraabdominal failure was 47.1% and extraabdominal failure was 13.2%. Treatment toxicity was considered to be acceptable. 22.1% of patients had grade 3 and only 1 patient had grade 4 leukopenia. Six Patients(8.8%) had weigh loss more than 10%. Conclusion : Treatment toxicity was acceptable with combined treatment with chemotherapy and radiotherapy. Locoregional recurrence was relatively low compared to distant failure with addition of irradiation. Peritoneal and omental seeding was high Five-rear surival was increased with combined modality. Radiation may eradicate minimal residual disease and improve survival, To evaluate role of radiation Prospective randomized study employing chemotherapy alone and chemotherapy plus radiation is necessary. Futhermore to reduce intraabdominal failure, role of intraabdominal chemotherapy in addition to combined chemotherapy plus radiation has to be explored.

• Journal of Gastric Cancer
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• v.5 no.1
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• pp.40-46
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• 2005

Purpose: Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms of the gastrointestinal tract. GISTs are positive for the expression of c-Kit protein at immunohistochemistry, and their clinical presentations vary. This retrospective study was performed to evaluate the clincopathologic characteristics of GISTs and to define the prognostic factors. Materials and Methods: 40 patients who underwent a complete resection of a GIST during the period $1996\~2003$ at the Department of Surgery, Korea University College of Medicine, were studied. We divided them into low- and high-risk. groups by using tumor size and mitotic count: 23 cases were low risk, and 17 were high risk. Clinicopathologic features, immunohistochemical findings, and prognoses were compared between the low- and the high-risk groups. Results: The mean age of the 40 patients was $61.3\pm11.1$years, and the male-to-female ratio was 1：1.1. There was no significant difference in age and sex between the groups. A comparative analysis revealed tumor size, mitotic count, clinical symptoms, preoperative pathologic diagnosis, ulceration, and necrosis to be variables that had statistically significant differences between the high- and the low-risk groups. In the univariate analysis, tumor size, mitotic count, ulceration, necrosis, and abnormal endoscopic ultrasound findings were associated with disease-free survival, but in the multivariate analysis, mitotic activity was the only independent factor associated with disease-free survival. 8 patients had recurrences during the follow-up period, and four of them were treated with STI-571 (imatinib mesylate, $Gleevec^{(R)}$). The treated patients have survived until now; however, two of non-treated patients died from disease progression. Conclusion: Based on this study, tumor size, ulceration, and necrosis are significant factors affecting survival, and mitotic activity may be a useful prognostic marker. STI-571 may be used in an adjuvant setting because the drug has shown anticancer activity in patients with recurrence or metastasis.

• Journal of Acupuncture Research
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• v.26 no.2
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• pp.91-101
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• 2009

Objectives: Osteoporosis is the most common metabolic disease of the bone, and is one of the most important major public health problems world wide. It is more occurred in female than male, but as the osteoporosis of men is increasing, therefore bone fractures of men are increasing. So we investigated the factors which are related to Bone Mineral Density(BMD) of male for prevention of osteoporosis. Methods: We measured the Bone Mineral Density(BMD) of lumbar spine($L_2$-$L_4$) and femoral neck in 5198 male, using dual energy X-ray absorptionmetry(DEXA; DPX-alpha). And then we analysed the 8 factors - age group, bone mass index(BMI), amount of smoking, drinking, exercise, and fast blood sugar, gastric disease, thyroid disease - which are related to BMD of male. Results: 1. In age group according to ${\ll}$Hwangjaenaekyong Somun, 黃帝內徑 素問${\gg}$, T-score was the highest at 17-24(三八歲) years group and decreased rapidly after 57-64(八八歲) years group in both lumbar spine($L_2$-$L_4$) and femoral neck. Therefore we concluded that T-score of male in lumbar spine($L_2$-$L_4$) and femoral neck change according to age group in ${\ll}$Hwangjaenaekyong Somun, 黃帝內徑 素問${\gg}$. 2. In BMI(body mass index), T-score of lumbar spine($L_2$-$L_4$) and femoral neck were the highest in obese group than non-obese group. In comparison of age group according to BMI, T-score of lumbar spine($L_2$-$L_4$) was significant difference in 17-72 years group and T-score of femoral neck was in 25-72 years group. 3. In exercise, T-score of lumbar spine($L_2$-$L_4$) and femoral neck was increasing as exercising more. In comparison of age group according to exercise, Both T -score of lumbar spine and femoral neck were significant difference in 25-72 years old. 4. T-score of lumbar spine($L_2$-$L_4$) was the highest in men who have taken exercise daily, and T-score of femoral neck was the highest in men who have taken exercise 1-3 times for a week. Conclusions : The age group in ${\ll}$Hwangjaenaekyong Somun, 黃帝內徑 素問${\gg}$ is related to BMD of men. And risk factors - BMI, exercise - are related to BMD of men. Therefore we expect that this study will help for prevention of osteoporosis of men.

• Korean Journal of Community Nutrition
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• v.17 no.3
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• pp.341-352
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• 2012

It is well established that excessive sodium intake is related to a higher incidence of chronic diseases such as hypertension, stroke, coronary heart disease, cardiovascular disease and gastric cancer. Although the upper limit of the current sodium intake guideline by WHO is set at 2,000 mg/day for adults, sodium intake of Koreans is well over 4,700 mg/capita/day implying an urgent need to develop and implement sodium intake reduction policy at the national level. This study investigated the cost-effectiveness of the sodium intake reduction policy, for the first time, in Korea. Analyses were performed using most recent and representative data on national health insurance statistics, healthcare utilization, employment information, disease morbidity/mortality, etc. The socioeconomic benefits of the policy, resulting from reduced morbidity of those relevant diseases, included lower medical expenditures, transportation costs, caregiver cost for inpatients and income losses. The socioeconomic benefits from diminished mortality included reductions in earning losses and welfare losses caused by early deaths. It is estimated that the amount of total benefits of reducing sodium intake from 4.7 g to 3.0 g is 12.6 trillion Korean Won; and the size of its cost is 149 billion Won. Assuming that the effect of sodium intake reduction would become gradually evident over a 5-year period, the implied rate of average return to the sodium reduction policy is 7,790% for the following 25 years, suggesting a very high cost-effectiveness. Accordingly, development and implementation of a mid-to-long term plan for a consistent sodium intake reduction policy is extremely beneficial and well warranted.

• Tuberculosis and Respiratory Diseases
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• v.39 no.1
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• pp.55-61
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• 1992

Background: The lung is the most common site of metastasis and usually it manifests as a single or multiple nodules in chest X-ray. But less commonly the cancer spreads through the lymphatics and X-ray shows diffuse reticulonodular densities. Sometimes, patient is presented with respiratory symptoms only with interstitial lung infiltration before the signs of primary tumor and in that cases, the differential diagnosis with other interstitial lung disease is required. We have experienced 5 such cases, who were diagnosed as lymphangitic carcinomatosis by transbronchial lung biopsy. Methods: Clinical manifestation, pulmonary function test, modified thin section CT, bronchoalveolar lavage and transbronchial lung biopsy were done. Results: The primary tumor was gastric cancer in 3, lung cancer in 2. Pulmonary function test showed restrictive pattern with low DLco in 2 patients and obstructive pattern in one. Bronchoalveolar lavage showed lymphocytosis in 4 patients and malignant cells were found in one patient. Transbronchial lung biopsy revealed malignant cells localized to the lymphatics (peribronchial, perivascular and perialveolar). Cell type was adenocarcinoma in 4 and squamous cell carcinoma in one. Conclusion: Rarely lymphangitic carcinomatosis can be presented as diffuse interstitial lung disease and easily diagnosed by transbronchial lung biopsy.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.1
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• pp.1-6
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• 2009

Many of our contemporaries suffer from the symptoms of phlegm-fire, which is caused by stress, processed food, heavy diet, and unseasonal fruits and vegetables. With consultations from 'Euihaklpmoon', 'DongeuiBogham', and 'Ji-San's clinical lectures' this research, which is mainly focused on phlegm-fire, concluded as following. Phlegm-fire is caused by congestion of seven emotions, congestion of qi, complication of phlegm on fire, depletion of body fluids after long periods of disease, heavy diet, or congenital unbalance of yin-yang and qi-hyul. Concentration of phlegm-fire on the head causes headache, dizziness, frontal headache, tinnitus, and auditory dysfunction. The patient usually complains breaking pain. Dhamhwabang of Yijin-tang, Chunghoonhwadham-tang, and Yijin-tang variation for right headache can be used. Concentration of phlegm-fire on the thorax causes insomnia, palpitation, and insanity. Samhoohndham-tang variation, Chungsimgondhanhwan can be used. Concentration of phlegm-fire on the gastric region causes reflux of gastric acid, eructation, vomiting, abdominal discomfort, dysmenorrhea, and fluor gentalis. Yijin-tang variation for abdominal discomfort, Yanghyulsamul-tang, Hwadhamchunghwa-tang can be used. Shin type or Gi type, female with prevalence of qi and tendency of fire, female with dark facial color, female with raised eye tails and large noses, female with pointed noses, and male or female with large noses and mouths are likely to possess phlegm-fire. Abdominal discomfort of male with thick eyebrow and headache of Gi type female is usually caused by phlegm-fire.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.19
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• pp.8495-8497
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• 2014

Purpose: To investigate whether it is safe to use leucogen tablets 60 mg three times per day (180 mg for a day) and whether this regimen could reduce the incidence of febrile neutropenia caused by chemotherapy. Methods: This prospectively designed study focused on the safety and effectiveness of leucogen tablets 60mg three times per day for a group of cancer patients during chemotherapy for mainly lung or gastric cancers. The tablets were administered from 5 days before until the termination of chemotherapy. Neutropenia and other healthcare encounters were defined as events and occurrence was estimated for comparison. Results: We identified 39 patients receiving leucogen tablets 60mg three times per day, including 11 with gastric, 12 with lung and 16 with other sites of cancer. The mean age was 65 (29-75) years and there were 27 male and 12 female patients. The mean duration of leucogen tablets intake was 59 days. Eighteen patients were treated with taxane-based, 4 with irinotecan-based and 17 with other chemotherapy. The incidence of febrile neutropenia was 0%. Twelve patients were found severe neutropenia (grade III/IV), and the duration of severe neutropenia (grade III/IV) was 5 days. Treatment-emergent adverse events were attributable to complications of myelosuppressive chemotherapy or the primary disease (i.e., alopecia, nausea, asthenia, neutropenia, and severe hepatic renal dysfunction). No chemotherapy was delayed and no treatment related death was observed. Conclusions: This study suggested that leucogen tablets 60mg three times per day (180mg for a day) are safe and could be effective for preventing febrile neutropenia in patients with chemotherapy.