• Journal of Digestive Cancer Research
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• v.6 no.1
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• pp.1-5
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• 2018

Eosinophilic gastrointestinal disease (EGID), a chronic allergic condition characterized by dense infiltration of eosinophils in the digestive tract, is classified into two types, eosinophilic esophagitis (EoE), which features dense infiltration of eosinophils in the esophageal epithelial layer, and eosinophilic gastroenteritis (EGE), in which the entire digestive tract including the esophagus may be involved. Patients with EoE only have esophageal symptoms, since the other parts of the digestive tract are not involved. On the other hand, 80% of EGE patients have lesions in the small intestine. The esophageal epithelial layer in healthy individuals has no or negligible infiltration by eosinophils, while the small intestinal mucosal layer, especially the distal small intestinal mucosa, can show dense eosinophil infiltration even in the absence of disease. Therefore, histological changes observed in cases of EGE are not qualitative but rather quantitative, as compared to EoE, which has qualitative histopathological changes, indicating important pathogenetic differences between the types. Comparisons of clinical, laboratory, and morphological characteristics between EoE and EGE have revealed several interesting differences. Both EoE and EGE patients are frequently affected by atopic diseases, such as bronchial asthma and allergic rhinitis, and elevated plasma levels of Th2 type cytokines and chemokines are also similarly seen in both. On the other hand, age at diagnosis differs, as the former is generally found in individuals from 30 to 50 years old, while the latter appears in all age groups. Additionally, 80% of patients with EoE are male as compared to only 50% of those with EGE. Furthermore, approximately 60% of patients with EoE respond favorably to proton pump inhibitor (PPI) administration, whereas EGE patients rarely show a response to PPIs. Nevertheless, both diseases show a similarly favorable response to a six foods elimination diet and glucocorticoid administration. These similarities and differences of EoE and EGE provide important clues for understanding the pathogenesis of these EGID types.

• Korean Journal of Clinical Laboratory Science
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• v.36 no.2
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• pp.269-273
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• 2004

Squamous cell carcinoma(SCC) associated antigen is a subfraction of TA-4, a tumor-associated antigen first described by Kato and Torigoe in 1977. TA-4, obtained from squamous cell carcinoma cancer tissue of the uterine cervix, has been characterized as a glycoprotein with a molecular weight of approximately 45,000 daltons. SCC antigen has been studied in other squamous cell malignancies including lung, esophagus, head and neck, anal canal, and skin. SCC antigen is shed naturally through sweat, saliva and other body fluids. Contamination of specimens, tray, bead dispenser or other accessories with sweat, saliva or aerosols can cause falsely elevated values. To reduce the possibility of contamination, gloves should be worn in all phases of assay preparation, and when handling specimens, accessories or reagents that will be used in SCC and Thyroid function test(TFT).

• Korean Journal of Bronchoesophagology
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• v.11 no.2 s.22
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• pp.10-15
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• 2005

식도와 인두 재건은 연하작용을 원활하게하고 발선기능을 보존하면서 위험부담이 가장 절은 술식을 선택하는 것이 원칙이다. 술식의 선택에 고려되어야 할 주요 인자는 결손부위의 크기, 창상의 상태, 술전 방사선치료 여부, 환자의 전신상태 등이다. 부분인두결손에는 유경근피판(pedicled myocutaneous flap)이나 유리피판이 적합하며 방사선 치료를 받은 경우는 유리피판이 유리하다. 흉곽입구 상부에 국한된 인두와 식도의 전체둘레결손에는 전완부, 외측 대퇴부, 공장의 유리피판이 좋다. 전완부는 피판이 다루기 쉽다는 장점이 있지만 공여부에 합병증이나 미용상의 문제가 있고 외측 대퇴부는 공여부의 문제는 매우 적으나 피판의 사용이 전완부에 비하여 약간 제한적이다. 공장은 허혈에 약하고 공여부 합병증이 다른 피판에 비해 불리하다. 저자의 경험으로는 흉곽상부에 국한된 결손의 재건에 환자가 비만하거나 대퇴부에 털이 많은 경우는 전완부 유리피판이 좋고 그렇지 않으면 외측 대퇴부 유리피판을 선택하는 것이 좋다고 생각된다. 흉곽입구 하방까지 연장된 결손이나 식도전적출술로 인한 결손에는 위전위술이 가장 적합하다. 방사선치료 등으로 창상에 혈관보호가 요구되는 경우는 대흉근피판이 유용하다. 앞으로 새로운 재건술의 개발이 이어지겠지만 모든 환자에게 맞는 이상적인 재건술은 없다. 재건술마다의 장단점과 제약점을 파악하고 환자의 조건에 따라 가장 적절한 재건술을 선택하는 것이 중요하다.

• The Journal of Korean Medical History
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• v.35 no.1
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• pp.69-86
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• 2022

This study examined guange (關格) in Yixuerumen (醫學入門) from a new perspective and evaluated its value in terms of emergency medicine. We compared and analyzed the definition, symptoms, and treatment methods of guange in Yixuerumen with related clinical presentations in modern medicine. Guange includes nausea and vomiting, dysphagia, dysuria, and constipation without diarrhea. A representative disease related to dysuria is uremia, while one related to constipation, nausea, and vomiting is enterocleisis, and and a third related to dysphagia is chronic esophagitis and esophagus cancer. Li Chan, the author of Yixuerumen, recognized guange as an emergency of serious eating and elimination disorder as various symptoms of diseases (病症) gradually get worse from the perspective of external diseases (外感病) and miscellaneous diseases (雜病) and handled it in various ways including yin-tonifying medicinals (補陰藥), qi-tonifying medicinals (補氣藥), qi-regulating formulas (理氣劑), phlegm-dispelling formulas (去痰劑), and "water rising, fire falling" formulas (水升火降) in addition to emetic formulas (催吐劑), diuretic formulas (滲利劑), and interior-attacking formula (攻裏劑). Concepts like guange in Yixuerumen were somewhat useful when handling the applicable emergencies at the level of then medical treatment.

• Korean Journal of Hospice Care
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• v.3 no.2
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• pp.34-54
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• 2003

Every one experiences death one day, however no one can knows exactly what it is because people can not experience death until it comes, it is therefore impossible to judge correctly on the phenomenon of the death. On the whole, man experiences indirect death through the mass communications such as TV drama, fiction, magazine etc because those methods can easily access by every one. In addition to this, people usually acquire the negative awareness of death through the dramatic change of story like dying of cancer for dramatic effect by giving scare and fear to the cancers. The purpose of this study is to provide basic information on the spiritual care that enables the facing death patients to accept death as a part of life and divert hope from scare about after death by comparing and analyzing of two aspects of death meaning I.e, Korean fiction and the end stage cancer patients. Additionally, for medical staff to understand the facing death cancer patients by making to aware patients correctly and provide the better quality of care. The study was performed from September 28, 2002 to February, 28 2003. The materials of this study were collected by direct data obtained from observation, interviews, note and diary of end stage of cancer patients and written materials acquired from Korean contemporary fiction. Participants of this study were 4 end stage cancer patients including 2 lung cancer patients, 1 liver cancer patient and 1 esophagus cancer patient. The methodology used in this study was divided into two types; Huberman & Miles methodology was used for fiction to find and categorize subject, and Colaizzi, one of phenomenological methodology was used for end stage cancer patients to find the major meaning, subject and categorization. 1.The death investigated in the fiction, was found as a progress of negative emotion, acceptance and sublimation, life related subjects in the negative emotion were tenacity for life, anxiety, lingering attachment, responsibility, abandonment and death related subjects were shock, isolation, fear, scare and rejection. Acceptance related subjects were acceptance, destiny, secularism, preparation and arrangement, and sublimation related subjects were sublimation through Christian and Buddhism. 2.The death showed in the participants was negative emotion, acceptance and sublimation, life related subjects were repentance, anxiety, responsibility and hopelessness, and death related subjects were dejection, solitude, anger, fear and scare. The acceptance was a type of religious acceptance that admitted instantly by reaching an understanding with the God, and death was accepted as a progress of preparation, arrangement, acceptance and hope. Sublimation related subjects were Christian sublimation and relief or destiny incurred from self-reflective sublimation through communications and thoughts. 3.The death in view of fiction and participants were positively accepted both death and negative emotion, and the study disclosed the fact that death was sublimated dependent on religion. 4.The progress of negative emotion, acceptance and sublimation was disclosed more complicated and various in the real end stage cancer patients and acceptance only found in the patients on the form of religious acceptance, according to the results compared with fiction and real end stage cancer patients. The death showed in the fiction was standardized, gradated and similar progress with psychological status of Kubler-Ross. However, death in the participants was showed complex and various feelings simultaneously, and sometimes they accepted death positively. The sublimation through religion was found in Buddhism and Christian in the fiction and mostly Christian in the participants due to a number of Hospice patients. It was found that negative emotion various types of death was more found in the participants than fiction. It is therefore necessary to study on the response of death in various types. In the participants death was incurred more systematic and variously, we knew that nursing practice focused on experience of participants is required and reality on death is much profound than we analyzed and presented, lots of situations and reactions should be premised because we can not completely rule out the negligence possibility of care mediation of participants. In caring for the facing death patients, we discovered and confirmed again through this study that the spiritual care should be needed as a mediation method.

• Radiation Oncology Journal
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• v.11 no.1
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• pp.43-50
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• 1993

We evaluated frequency and types of chromosomal aberrations by ionizing radiation in cancer patients treated with radiotherapy in our institution. Twenty-five patients with various types of carcinomas such as lung, uterine cervix, esophagus, rectum, head and neck and pancreatic cancers were studied immediately before and after external beam radiotherapy. The frequency of aberrant metaphase prior to treatment was $4.93{\%}$, which was higher than that of control group. Especially in lung cancer, the freuqency of aberrant metaphase was three times higher than control group. A comparison of chromosomal abnormalities observed before and after radiotherapy demonstrated that proportion of aberrant rnetaphases was significantly inreased to $22.13{\%}$. Major chromosomal aberrations like structural abnormalities showed remarkalbe increase from 65.45 to $88.45{\%}$ after the treatment. Also the numbers of chromosomal alterations per cell were increased by a factor of 6.5. Aberrations with two or more break points were more prominently increased, compared with aberrations with single break point. The number of chromosomal break points was noted to be higher than expected value in No.1, 3, 8 and 11 chromosomes and lower in No.13, 15, 17 and 21 chromosomes. Based on this study, we believe that the distribution of chromosomal breakage is related with gene and chromosomal rearrangement which could result in the development of cancers.

• Radiation Oncology Journal
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• v.17 no.2
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• pp.166-171
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• 1999

Purpose : To get the data for public information and education of medical students about radiation therapy (RT). Materials and Methods : We evaluated the knowledge and attitudes towards the RT and cancer in the third grade medical students who did not receive a lecture before starting the poly-clinic education about radiation oncology in our medical school, We obtained a total of 142 answers from the students that completed the questionnaire. Results : More than half of the third grade medical students answered 1 question correctly and 5 questions incorrectly among 6 questions about knowledge of RT. Incorrect answers were done about the frequency of RT, hair loss, the period of RT, re-RT, cost of RT, Fifty-six percent of students didn't wish to prolong the survival time from 1 year to 3 years with long courses of chemotherapy and RT. They had bad images about cancer of colorectum, lung, esophagus, liver, breast, cervix which consist of 56.3$\%$ of patients receiving RT. Conclusions : Public information about the basic points of RT should be considered. Also the students showed the pessimism about the anticancer treatments such as chemotherapy and RT, so the exact results and positive aspects of anticancer treatment should be educated more. Especially it is needed to inform the students and the public the positive aspects of RT in some cancers (colorectal, lung, esophageal, hepatic, breast, cervix cancers) which the students had bad images about.

• Radiation Oncology Journal
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• v.13 no.3
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• pp.233-241
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• 1995

Purpose : To analyse clinical outcome and prognostic factors according to treatment modality, this paper report our experience of retrospective study of patients with esophageal cancer Materials and Methods : One hundred and ten patients with primary esophageal cancer who were treated in Presbyterian Medical Center from May 1985 to December 1992. We analysed these patients retrospectively with median follow up time of 28 months, one hundred and four patients($95{\%}$) were followed up from 15 to 69 months. In methods, twenty-eight patients were treated with median radiation dose irradiated 54.3Gy only. Fifty-six patients were treated with combined chemoradiotherapy. Sixteen cases of these patients were treated with concurrent chemoradiation and the other patients(forty cases) were treated sequential chemoradiotherapy. In concurrent chemoradiotherapy group, patients received 5-FU continuous IV infusion for 4 days. Cisplatin IV bolus. and concurrent esophageal irradiation to 30 Gy. After that patients received 5-FU continuous IV, Cisplatin bolus injection and Mitomycin-C bolus IV, Bleomycin continuous IV, and irradiation to 20 Gy. In sequential chemoradiotherapy group, the chemotherapy consisted of 5-FU 1,000mg/$m^2$ administered as a continuous 24 hour intravenous infusion during five days and Cisplatin 80-100mg/$m^2$ bolus injected, or Bleomycin, Vinblastine, Cisplatin, Methotrexate were used of 1 or 2 cycles. After preoperative concurrentm chemoradiation twenty-six patients underwent radical esophagectomy. Results : Ninety-three patients could be examined for response assessment, By treatment modality, response rates were $85.1{\%}$ for radiation alone group and $86.3{\%}$ for combined chemoradiation group. But in operation group, after one cycle of concurrent chemoradiation treatment, response rate was $61.9{\%}$. The pathologic complete response were $15.4{\%}$ in operation group. Overall median survival was II months and actuarial 5-year survival rate was $8{\%}$. The median survival interval was 6 months for radiation alone group, 11 months for combined chemoradiation group and 19 months for operation group. And also median survival was 19 months for complete responder group that 8 months for noncomplete responder group. In univariative analysis, statistically significant prognostic factors were tumor size, clinical stage, tumor response, and operation. In multivariative analysis, significantly better survival was associated with clinical stage, tumor response, radiation dose, and operation. Conclusion : Compared with radiotherapy alone, combined multimodality may improve the median survival in patients with localized carcinoma of the esophagus and toxicity is acceptable.

• Journal of Chest Surgery
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• v.38 no.2 s.247
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• pp.157-163
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• 2005

Background: Clinical outcomes of esophageal cancer have not been satisfactory in spite of the development of surgical skills and protocols of adjuvant therapy. We analyzed the results of corrective surgical patients for esophageal cancer from January 1992 to July 2002. Material and Method: Among 129 patients with esophageal cancer, this study was performed in 68 patients who received corrective surgery. The ratio of sex was 59 : 9 (male : female) and mean age was $61.07\pm7.36$ years old. Chief complaints of this patients were dysphagia, epigastric pain and weight loss, etc. The locations of esophageal cancer were 4 in upper esophagus, 36 in middle, 20 in lower, 8 in esophagogastric junction. 60 patients had squamous cell cancer and 7 had adenocarcinoma, and 1 had malignant melanoma. Five patients had neoadjuvant chemotherapy. Result: The postoperative stage I, IIA, IIB, III, IV patients were 7, 25, 12, 17 and 7, respectively. The conduit for replacement of esophagus were stomach (62 patients) and colon (6 patients). The neck anastomosis was performed in 28 patients and intrathoracic anastomosis in 40 patients. The technique of anastomosis were hand sewing method (44 patients) and stapling method (24 patients). One of the early complications was anastomosis leakage (3 patients) which had only radiologic leakage that recovered spontaneously. The anastomosis technique had no correlation with postoperative leakage, which stapling method (2 patients) and hand sewing method (1 patient). There were 3 respiratory failures, 6 pneumonia, 1 fulminant hepatitis, 1 bleeding and 1 sepsis. The 2 early postoperative deaths were fulminant hepatitis and sepsis. Among 68 patients, 23 patients had postoperative adjuvant therapy and 55 paitents were followed up. The follow up period was $23.73\pm22.18$ months ($1\~76$ month). There were 5 patients in stage I, 21 in stage 2A, 9 in stage IIB, 15 in stage III and 5 in stage IV. The 1, 3, 5 year survival rates of the patients who could be followed up completely was $58.43\pm6.5\%,\;35.48\pm7.5\%\;and\;18.81\pm7.7\%$, respectively. Statistical analysis showed that long-term survival difference was associated with a stage, T stage, and N stage (p<0.05) but not associated with histology, sex, anastomosis location, tumor location, and pre and postoperative adjuvant therapy. Conclusion: The early diagnosis, aggressive operative resection, and adequate postoperative treatment may have contributed to the observed increase in survival for esophageal cancer patients.

• Korean Journal of Head & Neck Oncology
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• v.14 no.2
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• pp.236-243
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• 1998

Objectives: Local invasion of the thyroid cancer that is invasion of the upper aerodigestive tract, neurovascular structures of the neck and superior mediastinum, is infrequent and comprises of 1-16% of well-differentiated thyroid cancer. However the proximity of the thyroid gland to these structures provides the means for an invasive cancer to gain ready access into theses structures and when invasion occurs, it is the source of significant morbidity and mortality. So locally invasive thyroid cancer should be removed as much as possible, but still much debates have been exist whether the surgical method should be radical or conservative. This study was desinged to evaluate the clinical characteristics and the surgical treatment of the locally invasive thyroid cancer. Material and Methods: At the department of otorhinolaryngology of Hallym university, 10 patients diagnosed as locally invasive thyroid cancer among the 81 patients treated for thyroid cancer between 1991 to 1997 were retrospectively evaluated. Results: Of the 10 patients, 3 patients had histories of previous surgical treatment with or without radiation or radioactive iodine therapy. The site of invasion of thyroid cancer were trachea(7 cases), recurrent laryngeal nerve(5 cases), mediastinal node(5 cases), esophagus(3cases), larynx(3cases), carotid artery(3 cases), pharynx(l case), and other sites(4 cases). The operation techniques included 1 partial laryngectomy and 1 partial cricoid resection, 2 shavings and 3 window resections of the trachea, 1 sleeve resection of the trachea with end-to-end anastomosis and 1 cricotracheoplasty for tracheal invasion, 2 shavings and 1 partial esophagectomies for esophageal invasion, and 1 wall shaving and 2 partial resections with $Gortex^{\circledR}$ tube reconstruction for carotid artery invasion, and so on. Conclusions: These data and review of literature suggest that the surgical method should be perfomed on the basis of individual condition and complete removal of all gross tumor with preservation of vital structures whenever possible will offer a good result.