• The Journal of Korean Medicine
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• v.35 no.4
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• pp.98-103
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• 2014

Objectives: Advanced malignant melanoma (MM) has a poor prognosis, with an expected 2-year survival rate of 10 to 20%. It has long been recognized as an immunogenic tumor, and is worse for elderly patients. Many studies have suggested that herbal treatments improve immune functions, but few clinical studies have reported on this topic. Patients and History: We present two cases of female patients (72 and 77 years old, respectively) with advanced MM. The 72-year-old female patient was, at first, diagnosed with MM with multiple bone metastases. She received resection of the primary lesion, but refused further chemotherapy. The 77-year-old female patient was diagnosed with cutaneous MM of the left heel, with suspicion of sentinel node lymphadenopathy; however, she also refused any conventional treatment due to old age. Course of Therapy and Results: Both patients were exclusively treated with standardized allergen-removed Rhus verniciflua stokes (aRVS) extract combined with Bojungikki-tang (BT, Bu-Zhong-Yi-Qi-Tang in Chinese or Hochu-ekki-to in Japanese). Both patients are still alive and doing well (Feb. 2014), demonstrating that the 72-year-old patient has lived for 27 months and the 77-year-old patient has lived for 31 months without disease progression since the aRVS and BT administration. Conclusion: We suggest that the combination of aRVS extract and BT could be a candidate for overcoming the cancer's immunoediting process especially for elderly MM patients intolerant of conventional treatment.

• Tuberculosis and Respiratory Diseases
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• v.72 no.2
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• pp.182-186
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• 2012

Miliary brain metastasis from the lung is uncommon and has a poor therapeutic response. We report a case of pulmonary adenocarcinoma combined with multiple brain cystic lesions that were initially misdiagnosed as neurocysticercosis. A 53-year-old male who never smoked was admitted to our hospital with complaints of agitation and cognitive impairment. Brain magnetic resonance imaging showed innumerable, small nodular lesions with a central, low signal intensity in whole brain parenchyma. His symptoms were not improved by the empirical praziquantel medication for disseminated neurocysticercosis. After a transbronchial biopsy from the right middle lobe, we could diagnose the primary lung adenocarcinoma with a single nucleotide polymorphism in the epidermal growth factor receptor exon 20 at codon 787 (Q787Q). His neurologic symptoms and imaging findings have been gradually improving with a first-line Gefitinib treatment for five months. We recommend a more active diagnostic approach including biopsy in case of atypical imaging findings.

• The Korean Journal of Pain
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• v.34 no.3
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• pp.346-368
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• 2021

Background: Recalcitrant disc herniation may result in chronic lumbar radiculopathy or sciatica. Fluoroscopically directed epidural injections and other conservative modalities may provide inadequate improvement in some patients. In these cases, percutaneous neurolysis with targeted delivery of medications is often the next step in pain management. Methods: An evidence-based system of methodologic assessment, namely, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used. Multiple databases were searched from 1966 to January 2021. Principles of the best evidence synthesis were incorporated into qualitative evidence synthesis. The primary outcome measure was the proportion of patients with significant pain relief and functional improvement (≥ 50%). Duration of relief was categorized as short-term (< 6 months) and long-term (≥ 6 months). Results: This assessment identified one high-quality randomized controlled trial (RCT) and 5 moderate-quality non-randomized studies with an application of percutaneous neurolysis in disc herniation. Overall, the results were positive, with level II evidence. Conclusions: Based on the present systematic review, with one RCT and 5 non-randomized studies, the evidence level is II for percutaneous neurolysis in managing lumbar disc herniation.

• Archives of Plastic Surgery
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• v.33 no.5
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• pp.531-535
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• 2006

Purpose: To report our experience of retro-angular flap for reconstruction of the midface defect. The midface, including nose, lower eyelid, and intercanthal area, is the very prominent area of face. Also midface is more vulnerable to trauma and skin cancer and defect of mid face of highly perceptible. Reconstruction of mid face is difficult because of complexity of anatomy and functions. Following factors should be considered in reconstructive prcedure of midface. First, multiple procedure may need for complete the reconstruction of mid face defect. Second, secondary reconstructive surgeries such as flap rotation or skin graft may need for donor site morbidity. Third, the color, texture and thickness of the skin used are not always complacency. Methods: 8 cases of the midface defects (3 cases of lower eyelid, 1 case of intercanthal area, and 4 cases of nose) from skin cancer were reconstructed with retroangular flap from March 2004 to August 2005. Results: Satisfactory result were obtained in color, texture and donor site scar. There was no major complication such as wound disruption, hematoma, and atrophy of flap. But partial necrosis of flap and bulkiness were observed one case in each. Retroangular flap is simple procedure that can be preceded in one stage under local anesthesia closing primary wound closure. It will leave less visible donor scar, acceptable color, texture and thickness of the skin. Conclusions: The retro-angular flap could be suggested as a safe and effective method for midface reconstruction.

• BMB Reports
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• v.50 no.9
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• pp.472-477
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• 2017

The transcription repressor Bach2 has been proposed as a regulator of T cell quiescence, but the underlying mechanism is not fully understood. Given the importance of interleukin-2 in T cell activation, we investigated whether Bach2 is a component of the network of factors that regulates interleukin-2 expression. In primary and transformed $CD4^+$ T cells, Bach2 overexpression counteracted T cell receptor/CD28- or PMA/ionomycin-driven induction of interleukin-2 expression, and silencing of Bach2 had the opposite effect. Luciferase and chromatin immunoprecipitation assays revealed that Bach2 binds to multiple Maf-recognition element-like sites on the interleukin-2 proximal promoter in a manner competitive with AP-1, and thereby represses AP-1-driven induction of interleukin-2 transcription. Thus, this study demonstrates that Bach2 is a direct repressor of the interleukin-2 gene in $CD4^+$ T cells during the immediate early phase of AP-driven activation, thereby playing an important role in the maintenance of immune quiescence in the steady state.

• Journal of Ginseng Research
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• v.45 no.1
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• pp.41-47
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• 2021

A wide range of studies have steadily pointed out the relation of oxidative stress to the primary and secondary causes of human disease and aging. As such, there have been multiple misconceptions about oxidative stress. Most of reactive oxygen species (ROS) generated from chronic diseases cause oxidative damage to cell membrane lipids and proteins. ROS production is increased by abnormal stimulation inside and outside in the body, and even though ROS are generated in cells in response to abnormal metabolic processes such as disease, it does not mean that they directly contribute to the pathogenesis of a disease. Therefore, the focus of treatment should not be on ROS production itself but on the prevention and treatment of diseases linked to ROS production, including types 1 and 2 diabetes, cancer, heart disease, schizophrenia, Parkinson's disease, and Alzheimer's disease. In this regard, Korean Red Ginseng (KRG) has been traditionally utilized to help prevent and treat diseases such as diabetes, cancer, inflammation, nervous system diseases, cardiovascular disease, and hyperlipidemia. Therefore, this review was intended to summarize in vivo animal and human clinical studies on the antioxidant activities of KRG and its components, ginsenosides.

• Tuberculosis and Respiratory Diseases
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• v.62 no.2
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• pp.149-153
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• 2007

A pulmonary blastoma is a rare malignant tumor of the lung that is composed of epithelial and mesenchymal elements and resembles the structure of an embryonic lung. Pulmonary blastomas have a very poor prognosis and make up 0.25 to 0.5 percent of all primary malignant lung tumors. A pulmonary blastoma usually manifests as a solitary parenchymal mass or nodule and multiple subpleural mass with effusion on chest X-ray and computed tomography. We encountered a very rare case of pulmonary blastoma in a 52 years old male. He complained of abdominal pain, fullness, and dyspnea. The radiology examination revealed a huge lung mass invading the mediastinum, heart, diaphragm, and liver. The percutaneous needle biopsies were performed, and this tumor was diagnosed as a pulmonary blastoma. We report a biopsy confirmed case of a huge pulmonary blastoma invading multiple organs.

• Clinical Endoscopy
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• v.56 no.3
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• pp.315-324
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• 2023

Background/Aims: Image-enhanced endoscopy can detect superficial oro-hypopharyngeal squamous cell carcinoma; however, reliable endoscopy of the pharyngeal region is challenging. Endoscopy under general anesthesia during transoral surgery occasionally reveals multiple synchronous lesions that remained undetected on preoperative endoscopy. Therefore, we aimed to determine the lesion detection capability of endoscopy under general anesthesia for superficial oro-hypopharyngeal squamous cell carcinoma. Methods: This retrospective study included 63 patients who underwent transoral surgery for superficial oropharyngeal squamous cell carcinoma between April 2005 and December 2020. The primary endpoint was to compare the lesion detection capabilities of preoperative endoscopy and endoscopy under general anesthesia. Other endpoints included the comparison of clinicopathological findings between lesions detected using preoperative endoscopy and those newly detected using endoscopy under general anesthesia. Results: Fifty-eight patients (85 lesions) were analyzed. The mean number of lesions per patient detected was 1.17 for preoperative endoscopy and 1.47 for endoscopy under general anesthesia. Endoscopy under general anesthesia helped detect more lesions than preoperative endoscopy did (p<0.001). The lesions that were newly detected on endoscopy under general anesthesia were small and characterized by few changes in color and surface ruggedness. Conclusions: Endoscopy under general anesthesia for superficial squamous cell carcinoma is helpful for detecting multiple synchronous lesions.

• The Journal of the Korean bone and joint tumor society
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• v.20 no.1
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• pp.7-13
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• 2014

Purpose: As well as patient survival, the restoration of postoperative function such as ambulation is important in limb salvage operations for treatment of malignant bone tumors involving the proximal femur. The authors analyzed clinical outcomes of limb salvage operations using tumor prostheses for metastatic or primary malignant bone tumors in the proximal femur. Materials and Methods: From February 2005 to January 2014, 20 cases (19 patients) with malignant bone tumor involving the proximal femur with pain or complicated pathologic fracture were treated with segmental resection and limb salvage operations with tumor prostheses. Mean age was 63.1 years (range 35-86). Fourteen patients were male and six ones were female. The mean follow-up period was 20 months (1-94 months). There were 15 cases of metastatic bone tumor, 4 cases of osteosarcoma, and 1 case of multiple myeloma. The primary tumors of the metastatic bone tumors included 4 lung cancers, 3 hepatocellular carcinomas, and 3 renal cell carcinomas. Other primary tumors were breast cancer, thyroid cancer, colon cancer, prostate cancer, and malignant spindle cell tumor, each in 1 case. Modular tumor prostheses were used in all cases; (Kotz's$^{(R)}$ Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey) in 3 cases, MUTARS$^{(R)}$ proximal femur system (Implantcast, Munster, Germany) in 17 cases). Perioperative pain was assessed with Visual Analogue Scales (VAS). Postoperative functional outcome was assessed with Musculoskeletal Tumor Society (MSTS) grading system. Results: Out of 20 cases (19 patients), 11 cases (10 patients) survived at the last follow-up. Average postoperative survival of the 9 deceased patients was 10.1 months (1-38 months). VAS score improved from pre-operative average of 8.40 (5-10) to 1.35 (0-3) after operation. Average postoperative MSTS function score was 19.65 (65.50%, 7-28). The associated complications were 2 local recurrences, 3 hematomas, 3 infections, 2 scrotal swellings, and 1 dislocation. There was no case of periprosthetic fracture or loosening. Conclusion: Limb salvage operation with tumor prosthesis is an appropriate treatment for early pain reduction and functional restoration in malignant bone tumors in the proximal femur with pain an/or complicated pathologic fractures.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.1-11
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• 2003

Purpose: To analysis of the result of the treatment of metastatic diaphyseal fracture of the humerus with closed interlocking intrameduallry nailing. Materials and Methods: Among surgically treated 29 patients with pathologic or impending fracture of diaphysis of the humeurs, 13 patients (16 cases) treated with closed intramedullary interlocking nail were selected for the study. The final result of pain relief and functional recovery was evaluated by modified rating system of Perez et al. Results: Primary cancer was diagnosed after fracture was developed in 2 patients and pathologic or impending fracture was occurred average period of 28.9 months after primary cancer was diagnosed. The main primary malignancies were multiple myeloma, lung cancer and breast cancer. Mean survival after humeral metastasis was 11.7 months. The final result was superior to fair in 13 of 16 cases, and poor in 3 cases with progression of tumor spread or distant dissemination to the ipsilateral fingers. Except the latter 3 patients and other 3 patients, who died before 3 months postoperatively, bony union was achieved in 10 cases. There were no complications related to surgery. Conclusion: Closed interlocking intrameduallry nailing is accomplished with brief operative time, small amount of bleeding and provides immediate stability with resultant early return of function to the arm. Additionally it allows early postoperative irradiation. However, some of our cases shows that intramedullary nailing can accelerate tumor spread and metastases elsewhere, so that serious consideration must be given in planning this treatment. In conclusion, the functional status before fracture, life expectancy, type of tumor and extent of involvement should be carefully considered to decide operative treatment of metastatic disease.