• 대한통합의학회지
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• 제9권1호
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• pp.49-57
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• 2021

Purpose: The purpose of this study was to investigate the effect of manual lymphatic drainage (MLD) methods on muscle tone, pain, and depression in patients with breast cancer. Methods: The study had a two-group pretest-posttest design. A total of 24 patients with breast cancer voluntarily participated in the study. Subjects were randomly assigned to the MLD (n=12) and control (n=12) groups. Measurements of muscle tone, pain, and depression were taken prior to starting the intervention and after completing the 4 week program. The muscle tone, pain, and depression were measured using noninvasive muscle tone measuring equipment, the short-form McGill pain questionnaire, and the Beck depression inventory, respectively. The intervention was performed for 20 minutes a day, three times a week, for four weeks. A paired t-test was used to compare pretest and posttest values within each group, and an independent t-test was used to compare to pretest and posttest changes between the groups. Results: Comparison of the effects within the groups revealed significant reductions in muscle tone, pain, and depression in the MLD group after 4 weeks (p<.05), whereas the control group showed no differences. Comparison of the effects between the groups revealed significantly better reductions in muscle tone, pain, and depression in the MLD group than in the control group after 4 weeks (p<.05). Conclusion: These results suggest that MLD is an effective method for reducing muscle tone, pain, and depression in patients with breast cancer.

• 대한통합의학회지
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• 제10권3호
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• pp.73-84
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• 2022

Background : Lymphedema is a progressive disorder characterized by the impairment of lymph flow from tissues to the blood circulation system. This occurs as a result of damage to the lymphatic system. Complex decongestive therapy (CDT) is a multimodal, conservative therapeutic approach that is used for the management of lymphedema. CDT consists of a combination of compression therapy, manual lymphatic drainage, exercise, and skin care. Purpose : This study aimed to provide a review of available physical therapy interventions as well as general care guidelines for patients with lymphedema. Methods : The recommendations and guidelines for physical therapy management, medical management, and general information were reviewed from the following sources: 1) The American Physical Therapy Association, 2) The Norton School of Lymphatic Therapy, and 3) The International Society of Lymphology. This review contains general information, including the medical management and the importance of physical therapy in lymphedema. Physical therapy management should be based on an assessment of the patients' presenting impairments, including based on inclusion or exclusion of physical therapy interventions. This review also outlines a step-by-step approach that starts with disease diagnosis and progression all the way through to rehabilitation as an outpatient. Conclusion : Depending on the patients' journey to recovery and the requirement for rehabilitation, physical therapy interventions should focus on the patients' needs including pain, appearance, physical function and general rehabilitation. We hope that this review will provide information on evidence-based physical therapy and general care to patients with lymphedema.

• 대한영상의학회지
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• 제81권5호
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• pp.1222-1226
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• 2020

림프종은 비외상성 유미흉의 원인 중 높은 빈도를 차지한다. 문헌에 따르면 비외상성 유미흉에 대해서 흉관 색전술을 시행할 경우 외상성 유미흉의 경우에 비해 치료성적이 낮은 것으로 알려져 있다. 이 논문에서는 비외상성 유미흉이 있던 림프종 환자에서 흉관 색전술을 시행하고, 추가적으로 피부경유 종양 직접 천자 색전술을 시행하여 좋은 결과를 얻었기에 이에 대한 증례를 보고하고자 한다. 본 증례는 77세 남자 환자로 림프종에 동반된 유미흉을 치료하기 위해 흉관 색전술을 시행 받았고 그 후 유미흉의 양이 줄어들었으나 지속되는 흉막삼출을 호소하였다. 이에 피부경유로 폐를 침범한 림프종을 직접 천자하여 이차 색전술을 시행하였고, 이후 흉막삼출이 호전되어 성공적으로 흉관을 제거하였다. 이 시술은 림프종과 동반된 유미흉이 있는 경우에 시행할 수 있는 새로운 치료 선택지라 할 수 있다.

• 대한수의학회지
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• 제41권3호
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• pp.281-285
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• 2001

This study was performed to investigate the gross anatomical features and microscopical structures of the hemal nodes and the hemolymph nodes in the sheep. The hemal nodes and hemolymph nodes were observed mainly in periphery of the thoracic and abdominal aortae of the animals. The size of hemal nodes was generally smaller than that of the hemolymph nodes, and the shape of the both organs was spherical or ovoid. The color of the hemal nodes was red, while that of the hemolymph nodes was grary with red bands. The hemal nodes were surrounded by a relatively thick connective tissue capsule and there were extensive subcapsular sinuses distended by a great number of erythrocytes. Although a few number of lymphatic nodules and small areas of diffuse lymphatic tissues were observed in the parenchyma, no typical cortex and medulla were defined in the hemal node. Small numbers of blood vessels were found at the connective tissue capsule but lymph vessel was not observed microscopically in this organ. The hemolymph nodes were covered by a relatively thick connective tissue capsule and there was a hilus in each node. The parenchyma was divided into cortex and medulla. The cortex was composed of a few numbers of lymphatic nodules and some diffuse lymphatic tissues. The medulla comprised medullary sinuses and cords. Afferent and efferent lymph vessels were observed at the periphery of the capsule adn the hilus, respectively. The subcapsular and medullary sinuses were not extensive but filled with small numbers of erythrocytes. The stroma of hemal node and hemolymph node was composed of reticular cells and fibers, and the capsule and trabecula consisted of collagenous fibers with smooth muscle fibers.

• 한국식품영양과학회지
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• 제41권1호
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• pp.73-78
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• 2012

트랜스 지방 과다섭취는 심혈관계 질환의 위험인자이다. 이 연구는 녹차의 섭취가 대표적인 트랜스 지방인 elaidic acid의 소장 흡수율에 미치는 영향을 조사하기 위해서 설계하였다. 소장 지방 흡수를 in vivo 상태에서 측정하기 위해서 흰쥐의 '소장지방흡수모델(mesenteric lymph duct cannulated rat model)'을 이용하여 십이지장주입관(intraduodenal catether)과 림프채취관(lymph duct cannula)을 각각 십이지장과 소장 림프관에 설치하였다. 십이지장주입관으로 주입된 지질유화액은 $180.0{\mu}mol$ elaidic acid, $400.0{\mu}mol$ triolein, $20.7{\mu}mol$ cholesterol, $3.1{\mu}mol$ a-tocopherol, $396{\mu}mol$ sodium taurocholate 그리고 24 mL PBS 용액을 기본성분으로 했고 이 지질유화액만 공급받은 동물을 대조군(control), 녹차추출물이 추가된 지질유화액을 공급받은 동물을 녹차군으로 하였다. 지질유화액은 시간당 3 mL씩 8시간 동안 주입하였고 동시에 소장 림프관에 설치된 림프채취관으로 분비되는 림프 시료를 매시간 8시간 동안 채취하여 분석하였다. 결과적으로, 8시간 동안 소장 림프채취관으로 분비된 림프의 양은 녹차에 의해서 유의적으로 감소하였고 elaidic acid의 흡수율(분비율) 또한 녹차에 의해서 유의적으로 감소하였다. 콜레스테롤, 올레산, 인지질의 흡수율도 녹차에 의해서 유의적으로 감소하였다. 이상의 결과들은 녹차가 elaidic acid 뿐만 아니라 기타 주요 식이성 지방들의 소장흡수를 억제하는데 효과적인 수단이 될 수 있다는 것을 증명한 연구라 판단된다.

• Journal of Gastric Cancer
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• 제13권2호
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• pp.93-97
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• 2013

Purpose: Endoscopic submucosal dissection has recently been practiced on a differentiated type of early gastric cancer. However, there is no clear evidence for endoscopic treatments of signet ring cell carcinoma. The aim of this study is to identify the predictive clinicopathological factors for lymph node metastasis in signet ring cell carcinoma for assisting endoscopic submucosal dissection trials. Materials and Methods: A total of 186 patients with early signet ring cell carcinoma who underwent radical curative gastrectomy between January 2001 and September 2009 were enrolled in this study. Retrospective reviews of their medical records are being conducted. Several clinicopathologic factors were being investigated in order to identify predictive factors for lymph nodes metastasis: age, gender, tumor size, type of operation, tumor location, gross type, ulceration, Lauren's classification, depth of invasion, and lymphatic invasion. Results: The lymph node metastasis rate for signet ring cell carcinoma was 4.3% (n=8). Of the 186 lesions with early signet ring cell carcinoma, 91 (48.9%) tumors were larger than 15 mm in size and 40 (21.5%) showed submucosal invasions in the resection specimens. In multivariate analysis, only the lymphatic invasion (P<0.0001) showed an association with lymph node metastasis. To evaluate cutoff values for tumor sizes in the presence of lymph node metastasis, early signet ring cell carcinomas with lymphatic invasions were excluded. In the absence of lymphatic invasion, mucosal cancer with tumor sizes <15 mm had no lymph node metastasis. Conclusions: Endoscopic submucosal dissection can be performed on patients with early signet ring cell carcinoma limited to the mucosa and less than 15 mm.

• Asian Pacific Journal of Cancer Prevention
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• 제15권20호
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• pp.8651-8656
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• 2014

Purpose: To study the expression of angiogenin-2 (Ang-2) and its receptor Tie-2 in colorectal cancer and discuss the possible mechanisms behind this process. Materials and Methods: Using the streptavidin-peroxidase (SP) immunohistochemical method, paraffin sections from 100 colorectal cancer samples and 10 samples from tumor-adjacent normal tissue (> 2 cm from the edge of the gross tumor) were tested for protein expression of Ang-2, Tie-2, PI3K, and AKT. Reverse transcription-polymerase chain reaction and Western blots were further used to measure expression of the 4 genes and proteins in 20 freshly-resected colorectal cancer samples and tumor-adjacent normal tissues. Results: In colorectal cancer tissues, the expression of the Ang-2, Tie-2, PI3K, and AKT genes and their proteins was significantly higher than in tumor-adjacent normal tissues. Protein expression in poorly-differentiated adenocarcinoma was higher than that in well and moderately differentiated adenocarcinoma. According to Duke's classification, the protein expression in Stages C and D was significantly higher than that in Stages A and B. In the group with lymphatic metastasis, the protein expression was higher than that without lymphatic metastasis. Conclusions: In colorectal cancer, the expression of the Ang-2, Tie-2, PI3K, and AKT genes and their proteins is markedly higher than those in tumor-adjacent normal tissues. No correlation was observed between protein expression and gender, location, or histologic type. Correlations did exist between protein expression and differentiation level, stage of Duke's classification, and lymphatic metastasis; in colorectal cancer tissues with lower differentiation levels, higher stages of Duke's classification, and lymphatic metastasis, the expression of all 4 proteins was higher. The study of their expression patterns and relationships with aggression and metastasis will provide a valuable experimental foundation for assessing prognosis and targeted therapy of colorectal cancer.

• Journal of Gastric Cancer
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• 제10권4호
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• pp.162-167
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• 2010

Purpose: The incidence of lymph node metastasis has been reported to range from 2.6 to 4.8% in early stage gastric cancer with mucosal invasion (T1a cancer). Lymph node metastasis in early stage gastric cancer is known as an important predictive factor. We analyzed the prediction factors of lymph node metastasis in T1a cancer. Materials and Methods: A total of 9,912 patients underwent radical gastrectomy due to gastric cancer from October 1994 to July 2006 in the Department Of Surgery at Samsung Medical Center. We did a retrospective analysis of 2,524 patients of these patients, ones for whom the cancer was confined within the mucosa. Results: Among the 2,524 patients, 57 (2.2%) were diagnosed with lymph node metastasis, and of these, cancer staging was as follows: 41 were N1, 8 were N2, and 8 were N3a. Univariate analysis of clinicopathological factors showed that the following factors were significant predictors of metastasis: tumor size larger than 4 cm, the presence of middle and lower stomach cancer, poorly differentiated adenocarcinoma and signet-ring cell carcinoma, diffuse type cancer (by the Lauren classification), and lymphatic invasion. Multivariate analysis showed that lymphatic invasion and tumor larger than 4 cm were significant factors with P<0.001 and P=0.024, respectively. Conclusions: The frequency of lymph node metastasis is extremely low in early gastric cancer with mucosal invasion. However, when lymphatic invasion is present or the tumor is larger than 4 cm, there is a greater likelihood of lymph node metastasis. In such cases, surgical treatments should be done to prevent disease recurrence.

• 한국식품영양과학회:학술대회논문집
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• 한국식품영양과학회 2001년도 International Symposium on Food,Nutrition and Health for 21st Century
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• pp.74-87
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• 2001

Evidence shows that the serum level of cholesterol (CH) is decreased with increasing green tea (GT) consumption. This presentation summarizes our recent findings on the effect of GT extract on intestinal absorption of [$^{14}C$-labeled CH and phosphatidylcholine (PC). Ovariectomized (OX) adult rats were infused intraduodenally with lipid emulsions containing radiolabeled lipids [$^{14}C$-CH or $^{14}C$-phosphatidylcholine (PC)] in the presence of GT extract or catechins to determine the rates and amounts of CH absorption and the intestinal hydrolysis and lymphatic output of PC. During lipid infusion, lymph was collected hourly for 8 h. The lymphatic absorption of $^14C$-CH was drastically lowered by infusion of GT extract at two dosage levels (GTl =5.4 mg catechins/h and GT2 = 15.1mg catechins/h). The cumulative lymphatic absorptions of $^{14}C$-CH in rats infused with GT1 and GT2 were 20.7$\pm$4.3 and $4.8{\pm}4.1{\%}$ dose, respectively, whereas the absorption of $^{14}C$-CH in rats infused with no GT extract (GT0) was $36.3{\pm}1.1{\%}$ dose. GT extracts also significantly lowered the absorption of-tocopherol (TP) in a dose dependent manner ($29.6{\pm}4.9{\%}$ dose in GT0, $20.8{\pm}5.8{\%}$ dose in GTl, and $7.9{\pm}5.4{\%}$ dose in GT2 groups). Both (+)-catechin and EGCG significantly lowered the lymphatic outputs of $^{14}C$-radioactivity after intraduodenal $^{14}C$-PC infusion. A significantly higher amount of $^{14}C$-PC remained unhydrolyzed in the intestinal lumen of the EGCG rats ($22.8{\%}$) compared with the (+)-catechin ($15.8\%$) and control groups ($11.9\%$). GT extracts, (+)-catechin, and EGCG significantly reduced the absorption of TP. The inhibitory effect of GT extract and catechins on lipid absorption may be mediated in part through the inhibition of pancreatic PLAz. The findings provide the first direct evidence that green tea and catechins have a profound inhibitory effect on the intestinal absorption of CH in OX rats. Results suggest that green tea and catechins may be used as a dietary or pharmacological means of lowering cholesterol absorption.

• Journal of Gastric Cancer
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• 제1권2호
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• pp.77-82
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• 2001

Purpose: The most important prognostic factors in gastric cancer are depth of invasion and lymph node metastasis. Therefore, the prognosis for serosa and lymph node negative gastric cancer is favorable. However, there is no general agreement on the prognostic factors in this subset of patients. This study was undertaken to evaluate the prognostic significances of venous invasion (VI), lymphatic invasion (LI), and perineural invasion (NI) in T1 and T2 gastric cancer without lymph node involvement. Materials and Methods: We retrospectively evaluated 206 patients with T1 and T2, lymph node negative gastric cancer who underwent a curative resection from 1989 to 1993 at Kangnam St. Mary's Hospital, Seoul, Korea. The Chi-square test was used to determine the statistical significance of differences, and the Kaplan-Meier method was used to calculate survival rates. Significant differences in the survival rates were assessed using the log-rank test, and the Cox regression method was used to evaluate independent prognostic significance. Results: The rate of VI, LI and NI correlated well with the depth of tumor invasion. The rates of VI (+) for T1 vs T2 was $0\%\;vs\;5.1\%$, of LI (+) was $5.6\%\;vs\;26.8\%$, and of NI (+) was $1.6\%\;vs\;26.8\%$ in NI (+). There were 13 recurrent cases, 10 cases out of the 13 were T2 gastric cancers, and the recurrence rate was higher in LI (+) and NI (+) cases than in LI (-) and NI (-) cases. The 5-year survival rates were $93.4\%$ in LI (-) cases, $77.4\%$ in LI (+) cases, $92.5\%$ in NI (-) cases, $74\%$ in NI(+) cases, $95.9\%$ in LI (-) NI (-) cases, and $73.9\%$ in LI (+) NI (+) cases. Multivariate analysis demonstrated that simultaneous LI and NI was the only significant factor influencing the prognosis. Conclusion: These results suggest that simultaneous lymphatic and perineural invasion may be an independent prognostic factor in patients with T1 and T2 gastric cancer without lymph node metastasis.