• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.11
• /
• pp.5587-5591
• /
• 2012

Objective: This study was performed to evaluated the efficacy and safety of continuous infusional paclitaxel and 5-Fu as first-line chemotherapy in patients with advanced esophageal squamous cell cancer (ESCC). Methods: A total of 22 patients with advanced esophageal squamous cell cancer with no indications for surgery and radiation therapy, or recurrent patients were enrolled from October 2008 to November 2010. All were treated with PTX 20 $mg/m^2$ was administered through a 16 hours continuous intravenous infusion on days 1 to 3, 8 and 9. DDP 3.75 $mg/m^2$ was given on days 1 to 4 and 8 to 11, continuous infusional 5-FU over 24-hours on days 1 to 5 and 8 to 12 at a dose of 375 $mg/m^2$, and folacin 60 mg orally synchronized with 5-Fu. The treatment was repeated every 21 days for at least two cycles. Results: 22 cases of all enrolled patients could be evaluated for the effect of treatment: 2 cases were CR, 9 cases PR, 5 cases SD and 2 cases PD, giving an overall response rate of 68.2%(15/22). The median time to progression was 7.0 months. The adverse reactions related to chemotherapy were tolerable; the most common toxic effects were marrow depression, alopecia, and fatigue. Conclusion: Low-dose continuous infusional PTX over 16-hours and 5-fu over 24-hours is a promising regimen with good tolerability in treating patients with advanced esophageal squamous cell cancer.

• Advances in pediatric surgery
• /
• v.10 no.1
• /
• pp.31-34
• /
• 2004

The laparoscopic splenectomy (LS) became popular over the last 10 years. The advantage of LS over open splenectomy (OS) includes short hospital stay, improved cosmesis, less development of postoperative intestinal ileus, and less analgesics required. The purpose of this study is to evaluate the outcome of LS at Asan Medical Center from January 1999 to January 2003. The records of 14 consequent children who underwent splenectomy were reviewed retrospectively. Patients characteristics, morbidity, mortality, operative time, blood loss, and hospital stay were analyzed., Seven patients age 5 to 15 years underwent LS under the indications: idiopathic thrombocytic purpura (ITP, n=3), hereditary spherocytosis (n=3), and myelodysplastic syndrome (n=l). Seven patients, age 7 to 16 years, underwent OS during the same period for ITP (n=7). Median operative time was 120 mInutes (80 to 170 mins.) in OS, and 270 minutes (110 to 480 mins,) in LS (p<0.05). Median length of hospital stay was 6 days (3 to 8) in OS, and 4 days (3 to 6) in LS (p>0.05). Median splenic length was 12.0cm (9.2 to 18.0) in OS, 14.0 cm (10.0 to 19.5) (p>0.05). Accessory spleens were identified in 3 of 7 LS and 1 of 7 OS cases. In the LS group, there was no conversion to open surgery. Two patients in LS required blood transfusion postoperatively. LS in children can be performed as effectively and safely as OS.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.10
• /
• pp.6061-6064
• /
• 2013

Objective: To explore the feasibility of pulmonary lobectomy combined with pulmonary arterioplasty by complete video-assisted thoracic surgery (VATS) in patients with lung cancer, and summarize its surgical methods. Materials and Methods: Twenty-one patients with lung cancer in Beijing Chest Hospital Affiliated to Capital Medical University from Feb., 2010 to Jun., 2013 were selected, males and females accounting for 15 and 6 cases, respectively. Ten underwent right upper lobectomy, 5 right lower lobectomy, 4 left upper lobectomy (in which left upper sleeve lobectomy was conducted for 2) and 2 left lower lobectomy. At the same time, local resection of pulmonary arterioplasty was performed for 12 patients, and sleeve resection of pulmonary arterioplasty for 9. Results: Twenty-one patients recovered well after surgery. Thoracic drainage tube was maintained for 3-8 days, with an average of 4.9 days, and hospital stays were 8-15 days, with an average of 11 days. There were no deaths in the perioperative period, and the complications like pulmonary embolism, bronchopleural fistula, chest infection and pulmonary atelectasis did not occur after surgery. Conclusions: Performance of pulmonary lobectomy and pulmonary arterioplasty together by complete VATS is a safe and effective surgical method, which can expand the indications of patients with lung cancer undergoing thoracoscopic pulmonary lobectomy, and make more patients profit from such minimally invasive treatment.

• Korean Journal of Bronchoesophagology
• /
• v.13 no.1
• /
• pp.29-32
• /
• 2007

Background and Objectives: Improvements in the fields of neonatology and surgical subspecialities make tracheotomy possible to the younger population. But complication rates for infantile tracheotomy are significantly higher than that for the other pediatric tracheotomy. This study was designed to present our 9-year experiences of infantile tracheotomy and to evaluate the effect of several factors of complications. Materials and Methods: From 1996 through 2004, 60 tracheotomies were performed. Charts were reviewed with respect to indications for tracheotomy, underlying diseases, success rate in decannulation and length of support time until decannulation, complication and mortality rate. Results: There were 41 male patients and 19 female patients. Ventilatory support for neurological impairment(38.3%) was the leading indication for tracheotomy, followed by subglottic stenosis(36.7%), laryngomalacia(13.3%). Decannulation was accomplished in 60.0% of infants with an average of 56.5momths with tracheotomy. Complications occurred in 43.3%. There was one tracheotomy-related mortality in case of tracheal atresia. Most common complication was subglottic stenosis. Conclusion: Infantile tracheotomy had significant morbidities and its outcomes are thought to be usually related to the underlying disease and age. To prevent complication, early decannulation is advisable, and for long-term tracheotomy patients, regulation of reflux and infection may be necessary.

• Journal of Korean Neurosurgical Society
• /
• v.46 no.3
• /
• pp.221-225
• /
• 2009

Objective : Surgical treatment of posterior inferior cerebellar artery (PICA) aneurysms is challenging due to limited surgical accessibility. Endovascular approach has a benefit of avoiding direct injury to the brainstem or lower cranial nerves. Therefore, it has recently been considered an alternative or primary modality for PICA aneurysms. We retrospectively assessed outcomes following detachable coil embolization of saccular PICA aneurysms. Methods : From February 1997 to December 2007, we performed endovascular procedures to treat 15 patients with 15 PICA aneurysms. Fourteen patients with 14 PICA aneurysms morphology of which was saccular were reviewed retrospectively. Twelve patients had ruptured aneurysms. The aneurysms arose from the PICA origin site (n=12), the PICA lateral medullary segment (n=1), or the PICA tonsilomedullary segment (n=1). Results : Complete aneurysm occlusion was achieved in 10 patients, residual neck in 3, and residual sac in one. Radiological follow-up was performed in 7 patients with mean duration of 34.7 months (range, 1-97 months) and showed stable or complete occlusion in 6 patients. There were no rebleeding or retreatment after endovascular treatment. Thromboembolism was the only procedure-related complication (n=4 ; 28.6%). Asymptomatic PICA infarction occurred in two patients and symptomatic PICA infarction in two elderly patients with poor clinical grade. Of these procedural PICA infarction cases, 1 symptomatic PICA infarction patient developed ventriculitis and septic shock leading to death. The clinical outcome was good in 10 patients (71.4%). Conclusions : In the present study, detachable coil embolization has shown as an efficient modality for PICA saccular aneurysms challenging indications of microsurgery. However, thromboembolic complications should be considered, especially in poor clinical elderly patients with ruptured aneurysms.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.27 no.2
• /
• pp.183-187
• /
• 2005

The coronal approach has been used for over a century by neurosurgeons to access to the anterior cranium. Indications for the coronal approach expanded from use in the correction of congenital skeletal anomalies to applications in acute maxillofacial trauma and secondary deformity correction, oncologic surgery and reconstruction, and esthetic surgery. Complications were such as injury to frontal branch of the facial nerve, motor nerve paralysis, hematoma under flap, trismus, ptosis, epiphora, infection and anterior temporal depression. $Medpor^{(R)}$ is made up of dense polyethylene connected in porous structures. It is easily shapable without collapsing the pores due to it's hardness and tissue growth takes place at the porosities. Based on these advantages, $Medpor^{(R)}$ has been used in augmentation and restoration in craniofacial defect. A temporal depression after the coronal approach for treatment of Le Fort III fracture was successfully reconstruction with $Medpor^{(R)}$ and we report this case with review of literature.

• Parasites, Hosts and Diseases
• /
• v.38 no.4
• /
• pp.209-236
• /
• 2000

The last two decades witnessed significant advances in the efforts of immune-parasitologists to elucidate the nature and role of the host mucosal defence mechanisms against intestinal nematode parasites. Aided by recent advances in basic immunology and biotechnology with the concomitant development of well defined laboratory models of infection, immunoparasitologists have more precisely analyzed and defined the different immune effector mechanisms during the infection; resulting in great improvement in our current knowledge and understanding of protective immunity against gastrointestinal (GI) nematode parasites. Much of this current understanding comes from experimental studies in laboratory rodents, which have been used as models of livestock and human GI nematode infections. These rodent studies, which have concentrated on Heligmosomoides polygyrus, Nippostrongylus brasiliensis, Strongyloides ratti/5. venezuelensis. Trichinella spiralis and trichuris muris infections in mice and rats, have helped in defining the types of T cell responses that regulate effector mechanisms and the effector mechanisms responsible for worm expulsion. In addition, these studies bear indications that traditionally accepted mechanisms of resistance such as eosinophilia and IgE responses may not play as important roles in protection as were previously conceived. In this review, we shall, from these rodent studies, attempt an overview of the mucosal and other effector responses against intestinal nematode parasites beginning with the indices of immune protection as a model of the protective immune responses that may occur in animals and man.

• Korean Journal of Head & Neck Oncology
• /
• v.16 no.1
• /
• pp.37-41
• /
• 2000

Background and Objectives: The most commonly used incision for parotidectomy is modified Blair incision, but it has unsatisfactory cosmetic result due to long exposed scar in the neck. Therefore, we introduce an alternative approach with more acceptable scar named modified facelift incision. We report it's techniques, indications and disadvantages with our experiences. Materials and Methods: During the 1999, 15 patients were underwent parotidectomies using modified facelift incision. We studied the postoperative complications and the cosmetic results respectively. Results: There were 11 benign tumors, 3 malignant tumors, and 1 chronic inflammation. Total parotidectomy was performed in 2 malignant tumors and chronic parotitis patients. The others has superficial parotidectomy. In terms of operation field, there was no difference between classical incision and facelift incision. Partial facial nerve palsy was noted in 2 cases, who required sacrifice of branches of facial nerve because of malignant tumor invasion. There were no specific complications associated with this type of approach. Postoperative cosmetic results were satisfactory in all cases. Conclusion: Modified facelift incision provides better cosmetic result than conventional incision without narrowing of operation field. We believe that it is a safe alternative approach to all parotidectomy cases especially to women and patient with keloid skin. The only limitation of this incision is poor adaptability for combining neck dissection.

• Clinical and Experimental Pediatrics
• /
• v.49 no.11
• /
• pp.1140-1151
• /
• 2006

Inherited metabolic disorders are individually rare but as a whole, they are nor rare. Since Archibald Garrod introduced a concept of "inborn error of metabolism" or "chemical individuality", more than 500 diseases are currently known, affecting approximately one in 500 newborns cumulatively. They frequently manifest with acute, life-threatening crisis that require immediate specific intervention or they present with insidious diverse symptoms and signs involving multiple visceral organs or tissues as well as central nervous system, hampering a correct diagnosis. In addition, many pediatricians are not familiar with all diagnostic and therapeutic strategies for diverse inherited metabolic disorders. However, the prognosis of affected children are heavily dependent on rapid and effective treatment. In this lecture, practical guidelines for the specific diagnosis based on diverse clinical features of inherited metabolic disorders will be described. Many sophisticated laboratory tests are available for confirmatory diagnosis of each disease, which challenge to general pediatricians with respect to knowledge about biochemical metabolite assay test, enzymatic test and DNA diagnostic tests. Sample collections, indications, methods and interpretation of results in varying laboratory tests will be listed as well.

• Journal of Korean Medical classics
• /
• v.26 no.4
• /
• pp.23-42
• /
• 2013

Objective : This study was conducted to sort the five viscera symptoms which can be applied to Five Viscera Source Point Acupuncture, based on Suwen(素問). Method : 1. We selected and analyzed the sentences from Suwen, which included the five viscera symptoms. And then we sorted the five viscera symptoms which can be applied to Five Viscera Source Point Acupuncture. 2. These words - 'Liver', 'Heart', 'Spleen', 'Lung', 'Kidney', 'Reverting yin(厥陰)', 'Lesser yin(少陰)', 'Greater yin(太陰)', 'First Yin', 'Second Yin', 'Third Yin', 'Pericardium' and 'Extreme yin' - were used as search terms. Result & Conclusion : Forty-three symptoms of liver which can be applied to Five Viscera Source Point Acupuncture were extracted, twenty-one symptoms of heart, twenty-five symptoms of spleen, twenty-eight symptoms of lung, and forty symptoms of kidney.