• Tuberculosis and Respiratory Diseases
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• v.72 no.2
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• pp.124-131
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• 2012

Background: DNA damage-inducible 1 (Ddi1), one of the ubiquitin-like and ubiquitin-associated family of proteins, may function in the regulation of the ubiquitin-proteasome pathway, which has been validated as a target for antineoplastic therapy. We investigated Ddi1 expression in human lung cancer tissues and evaluated the relationship of this expression pattern with clinicopathological factors in patients with non-small-cell lung cancer (NSCLC). Methods: Ddi1 expression was examined by immunohistochemistry in tumor tissues from 97 patients with stage I NSCLC, who had undergone curative surgical resection at two tertiary referral hospitals from 1993~2004. None of the patients received preoperative chemotherapy and/or radiation therapy. Results: Thirty-nine (40.2%) of the 97 cases were positive for Ddi1. Ddi1 expression was dominantly seen in cytoplasm rather than in the nuclei of cancer cells in all histological types, whereas adjacent nontumoral lung tissue showed negative Ddi1 staining in most cases. Ddi1 expression tended to increase in well-differentiated tumors but without statistical significance. Positive Ddi1 expression was associated with a tendency for better disease-free survival and disease-specific survival, although the difference was not significant. Conclusion: Ddi1 expression is a property of NSCLC. Because Ddi1 could be a potential target for cancer therapy, more research is needed to evaluate its role in NSCLC.

• Journal of Chest Surgery
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• v.48 no.2
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• pp.105-111
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• 2015

Background: The aim of this study was to establish whether pulmonary lobectomy using video-assisted thoracic surgery (VATS) can be safely performed by trainees with limited experience with open lobectomy. Methods: Data were retrospectively collected from 251 patients who underwent VATS lobectomy at a single institution between October 2007 and April 2011. The surgical outcomes of the procedures that were performed by three trainee surgeons were compared to the outcomes of procedures performed by a surgeon who had performed more than 150 VATS lobectomies. The cumulative failure graph of each trainee was used for quality assessment and learning curve analysis. Results: The surgery time, estimated blood loss, final pathologic stage, thoracotomy conversion rate, chest tube duration, duration of hospital stay, complication rate, and mortality rate were comparable between the expert surgeon and each trainee. Cumulative failure graphs showed that the performance of each trainee was acceptable and that all trainees reached proficiency in performing VATS lobectomy after 40 cases. Conclusion: This study shows that trainees with limited experience with open lobectomy can safely learn to perform VATS lobectomy for the treatment of lung cancer under expert supervision without compromising outcomes.

• Journal of Chest Surgery
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• v.38 no.3 s.248
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• pp.253-257
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• 2005

The patients with primary lung cancer who have symptoms of angina pectoris commonly have underwent coronary artery bypass grafting (CABG) prior to lung resection. Recently, there are attempts to conduct simultaneous operation of CABG and lung resection to reduce disadvantages of staged operation, such as repeated general anesthesia, two wound incisions and delay of lung operation. These attempts generally report good results. Three patients underwent lung resection and CABG simultaneously, and had good post operative status without recurrence of cancer and angina pectoris. We conceive these as worthy cases to report.

• Tuberculosis and Respiratory Diseases
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• v.47 no.1
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• pp.117-122
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• 1999

Primary germ cell tumors of the mediastinum are rare, accounting 1-5 % among all germ cell tumors and 10% of all neoplasms in this area. Approximately 85 % of these tumors occur in men with a mean age 29 years. 'These tumors are mainly found in the anterior mediastinum and appear grossly as large lobulated masses. They are frequently invasive at the time of diagnosis and almost 90% of patients are symptomatic. Primary nonseminomatous germ cell tumor arising in the posterior mediastinum is very rare. We report a case of 37-year old male arising from the posterior mediastinum. Serum tumors markers including alpha-fetoprotein and $\beta$-hCG which are usually elevated in germ cell tumor were not elevated. He was found to have a primary mediastinal embryonal carcinoma with pulmonary metastasis at open exploration. He was treated with debulking surgery and cisplatin-based chemotherapy, died of sepsis after 15 months postoperatively.

• Clinical and Experimental Pediatrics
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• v.49 no.11
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• pp.1227-1231
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• 2006

Intestinal tuberculosis presents with nonspecific and variable clinical manifestations. It is rarely seen in current clinical practice and the diagnosis may be missed or confused with many other disorders such as Crohns disease and intestinal neoplasms. The route of infection by tuberculous enteritis is variable and the treatment regimens used for treating pulmonary tuberculosis are generally effective for tuberculous enteritis as well. Uncomplicated tuberculous enteritis can be managed with a nine to 12- month course of antituberculous chemotherapy. If not treated early, the prognosis for intestinal tuberculosis is poor, with an overall mortality of between 19 percent and 38 percent. However, 90 percent of patients will respond to medical therapy alone if started early. Therefore, early detection and treatment is essential. Here we report a case of intestinal tuberculosis secondary to miliary tuberculosis.

• Tuberculosis and Respiratory Diseases
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• v.57 no.2
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• pp.118-124
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• 2004

Lung cancer is the leading cause of cancer death for men and women in the industrialized world. It is desirable to detect disease at a stage when it is not causing symptoms and when control or cure is possible. If the screening test detects patients with the disease at an early stage, they can be examined to confirm the diagnosis and intervention can alter the natural history of the disease. The results of screening programs designed to detect early lung cancer using either conventional chest radiograph or sputum cytology are disappointing for a diagnostic screening test. Because of advances in helical CT imaging techniques, screening for lung cancer has been suggested as a possible method of improving outcome. Findings in recent publications suggest that substantial dose reduction is possible in chest CT. The advantages of low-dose CT are more sensitive than chest radiograph for detecting small pulmonary nodules that may be lung cancers, shorter scanning time than conventional chest CT scan without intravenous contrast injection, cheaper cost than standard CT, low radiation dose. However, the true clinical significance of the small tumors found by screening is still unknown, and their effect on mortality awaits future investigation. Furthermore, in addition to detecting an increased number of lung cancers, low-dose CT found at least one indeterminate nodule in many of all screened patients. The majority should be benign but evaluation of all these indeterminate nodules is not a trivial problem in routine practice. In conclusion, lung cancer screening with low-dose CT is a complex subject. The true effectiveness of lung cancer screening (a reduction in mortality from lung cancer) with low-dose CT can be determined through well-designed randomized control trials with enrolment of appropriate subjects.

• Journal of Gastric Cancer
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• v.18 no.2
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• pp.109-117
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• 2018

Purpose: This study aimed to investigate the outcomes of laparoscopic gastrectomy in very elderly patients with gastric cancer, who have outlived the average lifespan of the Korean population (men: ${\geq}77years$, women: ${\geq}84years$). Materials and Methods: Between 2004 and 2015, 836 patients with gastric cancer underwent a laparoscopic gastrectomy. They were divided into the elderly group (EldG) and non-elderly group (nEldG). Propensity score matching for covariates of sex, tumor depth, node status, and extent of resection was performed. Clinicopathologic characteristics, and surgical and survival outcomes were compared between the 2 groups. Results: The EldG had a higher American Society of Anesthesiologists (ASA) score and a higher number of comorbidities. There was no significant difference in the post-operative complications, except for pulmonary complications, which were more frequent in the EldG (5/56, 8.9%) than in the nEldG (0/56, 0%). The EldG had a shorter overall survival (OS), but cancer-specific survival was similar for both groups. Among deceased patients, 2 (25%) and 8 patients (50%) died within a year of surgery in the nEldG and EldG, respectively. Univariate and multivariate risk factor analyses for OS showed that age, ASA score, tumor, node, metastasis (TNM) stage, and occurrence of complications were significantly related to deterioration in OS. Conclusions: Laparoscopic gastrectomy can be safely performed in very elderly patients with gastric cancer who have outlived the average lifespan of the Korean population. However, impact of laparoscopic gastrectomy on improving survival is not clear, and careful patient selection is recommended.

• Korean Journal of Biological Psychiatry
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• v.18 no.2
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• pp.90-94
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• 2011

Objectives It is well-known that tobacco smoking is related to various disease entities including chronic obstructive pulmonary disease, inflammation, cardiovascular disease, and neoplasms. The prohibition of smoking is important for the protection of these health problems. Regarding leptin, ghrelin, glucagon-like peptide 1 (GLP-1), and nerve growth factor (NGF) levels, correlations with the smoking are suggested but the reports on the effects after smoking cessation are not sufficient. Method The changes of plasma levels of leptin, ghrelin, GLP-1, and NGF levels were analyzed after quitting smoking in Korean adults. Eleven participants succeeding in quitting smoking among 37 male smokers were included in the final analysis. The plasma levels of NGF, leptin, ghrelin, and GLP-1 were measured before and after 8-weeks period of smoking cessation. Results The plasma level of leptin increased after 4 weeks of smoking cessation. In addition, the plasma level of NGF increased after 8 weeks of smoking cessation (p < 0.05). Conclusion Our results suggested that smoking cessation induces increases in leptin and the NGF level after smoking cessation. Many toxic materials including nicotine in the cigarette may be related to these changes of plasma level of leptin and NGF, playing a key role in neurogenesis and synaptic plasticity.

• Journal of Chest Surgery
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• v.25 no.6
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• pp.598-604
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• 1992

Rhabdomyosarcoma is the most common soft tissue sarcoma in childhood and acounts for 6% to 15% of all cases of childhood cancer, Rhabdomyosarcoma in seventh most common form of childhood neoplasms, following acute leukemia, tumors of the central nervous system, lymphoma neuroblastoma, Wilm`s tumor, bone tumor. Rhabdomyosarcoma can arise anywhere in the body, but primary site in the thorax is relatively rare. We experienced a case of aveolar rhabdomyosarcoma arising from intercostal muscle, A 12 year-old woman was suffered from the intermittent left chest pain radiating to the scapular area and dyspnea, On physical examination, pulmonary friction rub was heard on the left upper lobe area. Qn adimission, the chest simple radiography revealed a 7 x 6, 5cm sized radio-opaque mass with pleural effusion in the superior mediastinum and the CT showed a well difined radio-opaque mass including the destructed 2nd rib and pleural effusion. The percutaneous tra-nsthoracic needle aspiration biopsy was likely to show blastoma. After the chemotherapy[vincristine, actinomycin-D, cyclophosphamde] was done to treat blastoma, the pleural effussion was subsided and the mass was slightly decreased by 4.5x 4. 5cm. For treatment and diagnosis, we performed en-bloc resection and the defected chest was reconstucted with Gortex patch. Grossly, the specimen was colored graysh-white and arised in between two ribs The microscopic findings showed that the tumor cells were small round with scant pinkish cytoplasm on the H-E stain and the tumor cell nests were grouped by reticulum fibers and showed alveolar pattern on the silver stain The electromicroscopic finding presented that the cytoplasm contained tangled fibrillar and flocculent materials. The histopathologic findings were compatable with laveolar rhabdomyosarcoma. She was discharged without any complication. After discharge, she has been treated with radiation theraphy and chemotheraphy, and not recurred untill last follow-up We report a case of alveolar rhabdomyosarcoma arising to intercostal muscle, developed in 12 year-old waman, with brief review of literatures.

• Tuberculosis and Respiratory Diseases
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• v.68 no.4
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• pp.231-235
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• 2010

Lymphadenopathy in the thoracic cavity is frequently caused by inflammatory diseases. In very rare cases, the node-bronchial fistula has been reported to be the cause of complications of pulmonary tuberculosis. A male patient with necrotizing pneumonia and mediastinal lymph node enlargements identified by chest computed tomography was also found to have a node-bronchial fistula caused by lung cancer. The patient was treated for tuberculosis with pneumonia for one week before a definitive diagnosis was made. A further investigation revealed him to have non-small cell lung cancer (NSCLC, adenocarcinoma) and multiple mediastinal lymphadenopathies accompanied with the node-bronchial fistula. We report this specific case that had been previously treated for tuberculosis but was later revealed to be NSCLC accompanied with a node-bronchial fistula.