• Journal of Gastric Cancer
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• 제9권1호
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• pp.31-35
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• 2009

위장관 칸디다증은 대개는 면역성이 저하된 경우에 기회 감염으로 발현되는 것이 일반적이다. 위장관 칸디다증 중식도 칸디다증이 가장 많은 빈도를 차지하고 있고 주로 면역기능이 억제된 환자에서 잘 발생하지만 드물게 건강한 성인에서도 보고된다. 현재까지는 양성 위궤양에 병발된 위장관 칸디다증이 흔히 보고되었지만 위선암에서 발견된 칸디다증은 비교적 드물다. 저자들은 속쓰림과 소화불량을 주소로 내원한 72세 여자환자에서 수술전 위선암과 칸디다증으로 진단되어 fluconazole을 경구투여를 통하여 칸디다증을 치료한 후 위전절제술을 시행한 증례를 경험하였다. 본 증례의 경험과 문헌 검색을 통하여, 저자들은 위암 수술 전 위암과 함께 위 칸디다증을 진단받은 환자에 대하여 칸디다에 대한 약물 치료 후 수술을 권유하는 바이다.

• 한국의사학회지
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• 제30권1호
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• pp.11-22
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• 2017

This paper is a study on the life and clinical reasoning of Kim Goo Young (1958-2014). Offering a new perspective through his interpretation of Donguibogam (東醫寶鑑), Kim introduced his unique theory of Korean medicine, 'The Theory of Byeongin (病因論)'. Kim recognized the confusing situation of communication between people studying Korean medicine and tried to make a new standard based on the principle that many people can share. 'The Theory of Byeongin' offers a newly constituted "Donguibogam" focusing on 'Byeongin' (病因, pathologic origin) which can be translated as the cause of a disease. In so doing Kim recognized 'Byeongin' as the most important factor in 'Byeonjeung' (辨證, classifying the origin), or the classification method of symptoms. In addition, Kim recognized how 'Byeongin' was considered to be a diseased lifestyle, and tried interpreting. The patient's lifestyle to treat diseases. As a result, 'The Theory of Byeongin' is a theory consisting of an intuitive structure, reducing notable elements like Yin Yang Five Movement theory. The theory's significant characteristic is its easy application in clinical settings due the established core principles which are based on Kim's insight and clinical experience. This study contributes to the understanding of the theoretical and clinical development of Korean medicine through deeper studies on 'The Theory of Byeongin' and Kim's medical theory.

• 한방안이비인후피부과학회지
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• 제27권2호
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• pp.1-13
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• 2014

Objective : The purpose of this study is to understand conspicuous features of geroderma with visceral manifestation theory(臟象論). Methods : We categorized skin aging into wrinkles, hyperpigmentation, dry skin and face flush. After investigating the reason, histological changes and mechanism of each classification in western medicine, we interpreted them according to the malfunction of five viscera(五臟) in Korean medicine. Result : The results are as follows. 1. Pathologic change of dermis and subcutaneous fat makes wrinkles. We consider wrinkles as the malfunction of the spleen(脾). 2. Irregular synthesis and disproportion of melanin makes hyperpigmentation. We consider hyperpigmentation as the malfunction of the liver(肝). 3. Dry skin is attributed to a subtle disorder of epidermal maturation. We consider dry skin as the malfunction of the lung(肺). 4. Facial flush is detected in rosacea and menopausal hot flush, which are both related with blood vessel abnormality. We consider facial flush as the malfunction of the heart(心) Conclusion : We interpreted the pathologic changes and mechanism of skin aging in western medicine as the decrease of five viscera(五臟) in visceral manifestation theory(臟象論) of Korean medicine. Further studies are needed to apply these hypothesis to clinical diagnosis and treatment.

• Archives of Plastic Surgery
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• 제37권4호
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• pp.452-456
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• 2010

Purpose: The schwannoma is a benign peripheral nerve tumor arising from the Schwann cell of the nerve sheath. Only 2-8% of schwannomas arise in the hand and wrist. Misdiagnosis is frequent such as ganglion and neurofibroma. This article documents and clarifies the clinical features of schwannomas arising in the hand and wrist, and emphasizes importance of differential diagnosis and meticulous surgical extirpation under magnification. Methods: The author reviewed clinical features of 15 patients with pathologic final diagnosis of schwannoma developed in hand and wrist during the last 12 years from 1998 through 2009. The review included the sex, age of onset, duration, preoperative diagnosis, location, involved nerve, preoperative symptoms and. Postoperative sequelae after surgical extirpation of the lesion with magnification, or without magnification of the surgical fields. Results: The chief complaints were slow growing firm mass in all patients, and followed by pain in 40%, and paresthesia in 40% respectively. The lesions were developed solitarily in 14 patients (93%). The postoperative pathologic diagnosis and preoperative diagnosis were coincided with only in 6 patients (40%). Other preoperative diagnosis were soft tissue tumor in 4 patient (26.6%), and ganglion in 3 patients (20%), and neurofibroma in 2 patients (13%). In all patients who were undergone surgical excision under the fields of magnification, all symptoms were subsided without any sequelae. Meanwhile muscle weakness, paresthesia, hypoesthesia and /or accidental nerve resection developed after surgical excision with naked eye. Conclusion: Schwannoma in hand most commonly appears as a slow growing solitary mass with pain or paresthesia. The chance of preoperative misdiagnosis was 60% in this series. To provide good prognosis and less sequelae, careful and elaborate diagnostic efforts and meticulous surgical excision under the magnification are necessary in management of schwannoma.

• Journal of Chest Surgery
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• 제2권2호
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• pp.155-166
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• 1969

Heterotopic abdominal homograft of canine heart was carried out in 20 pairs of dogs. Of these 12 cases were subjected as a control and 8 were subjected to immunosuppressive group. The dosage of immunosuppressive agent was 5mg/kg/day of Imuran [Azathioprine] for 3 days preoperatively, 10mg/kg on operative day and 5mg/kg/day postoperatively. For reducing the metabolic demand, the donor heart was preserved in 4degree heparinized saline solution for approximately I4 minutes. In the most of the cases, transplantation was performed with the technique of end-to-side aorto-aortic anastomosis and end-to-side pulmonary artery-inferior vena cava anastomosis at the infrarenal portion. Five out of 20 grafted dogs were survived more than one day. The longest survived 18 days in the control group and survive more than 60 days in the treated group. The survival cases were 3 out of 8[37. 5%] in the group of dogs treated with lmuran and 2`out of 12 [16.6%] in the group of non-treated. A prominent gross findings of the grafted heart was a minimal to moderate degree of dilatation of the heart with or without thrombosis in the cardiac chambers and/or anastomotic site. The case number 10, 15, and 19 showed moderate hypertrophy in grossly. The microscopic findings were as follows; 1. There were early hypersensitive histologic reactions such as interstitial edema, cellular infiltrations and early degenerative changes in the myocardium in the cases of 3 hour survival. 2. In the cases of more than 6 hours survival, organizing thrombosis of myocardial vessels, vasculitis,myocardial necrosis and lymphocyte, plasma cell, round cell infiltrations were noted. In the cases of more than 12 hours survival, the degree of these histologic changes especially in the non-treated group were more intensified than in the treated. 3. In the cases which survived more than one day, so called homograft specific histologic changes were milder in the immunosuppressive group compared with the control. 4. All the host hearts showed no evidence of pathologic findings histologically. Among the homologous canine cardiac transplantation tissue reaction, was milder and suvival time longer in the group treated with immunosuppressive drug.

• Radiation Oncology Journal
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• 제34권2호
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• pp.96-105
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• 2016

Purpose: The standard radiation dose for patients with locally rectal cancer treated with preoperative chemoradiotherapy is 45-50 Gy in 25-28 fractions. We aimed to assess whether a difference exists within this dose fractionation range. Materials and Methods: A retrospective analysis was performed to compare three dose fractionation schedules. Patients received 50 Gy in 25 fractions (group A), 50.4 Gy in 28 fractions (group B), or 45 Gy in 25 fractions (group C) to the whole pelvis, as well as concurrent 5-fluorouracil. Radical resection was scheduled for 8 weeks after concurrent chemoradiotherapy. Results: Between September 2010 and August 2013, 175 patients were treated with preoperative chemoradiotherapy at our institution. Among those patients, 154 were eligible for analysis (55, 50, and 49 patients in groups A, B, and C, respectively). After the median follow-up period of 29 months (range, 5 to 48 months), no differences were found between the 3 groups regarding pathologic complete remission rate, tumor regression grade, treatment-related toxicity, 2-year locoregional recurrence-free survival, distant metastasis-free survival, disease-free survival, or overall survival. The circumferential resection margin width was a prognostic factor for 2-year locoregional recurrence-free survival, whereas ypN category was associated with distant metastasis-free survival, disease-free survival, and overall survival. High tumor regression grading score was correlated with 2-year distant metastasis-free survival and disease-free survival in univariate analysis. Conclusion: Three different radiation dose fractionation schedules, within the dose range recommended by the National Comprehensive Cancer Network, had no impact on pathologic tumor regression and early clinical outcome for locally advanced rectal cancer.

• Radiation Oncology Journal
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• 제34권2호
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• pp.106-112
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• 2016

Purpose: To identify possible predictors of pathologic complete response (pCR) of rectal cancer after preoperative concurrent chemoradiotherapy (CCRT). Materials and Methods: We conducted a retrospective review of 53 patients with rectal cancer who underwent preoperative CCRT followed by radical surgery at a single center between January 2007 and December 2012. The median radiotherapy dose to the pelvis was 54.0 Gy (range, 45.0 to 63.0 Gy). Five-fluorouracil-based chemotherapy was administered via continuous infusion with leucovorin. Results: The pCR rate was 20.8%. The downstaging rate was 66%. In univariate analyses, poor and undifferentiated tumors (p = 0.020) and an interval of ${\geq}7$ weeks from finishing CCRT to surgery (p = 0.040) were significantly associated with pCR, while female gender (p = 0.070), initial carcinoembryonic antigen concentration of <5.0 ng/dL (p = 0.100), and clinical stage T2 (p = 0.100) were marginally significant factors. In multivariate analysis, an interval of ${\geq}7$ weeks from finishing CCRT to surgery (odds ratio, 0.139; 95% confidence interval, 0.022 to 0.877; p = 0.036) was significantly associated with pCR, while stage T2 (odds ratio, 5.363; 95% confidence interval, 0.963 to 29.877; p = 0.055) was a marginally significant risk factor. Conclusion: We suggest that the interval from finishing CCRT to surgery is a predictor of pCR after preoperative CCRT in patients with rectal cancer. Stage T2 cancer may also be an important predictive factor. We hope to perform a robust study by collecting data during treatment to obtain more advanced results.

• 대한두경부종양학회지
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• 제32권2호
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• pp.5-8
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• 2016

Background and Objectives: The aim of this study was to evaluate the safety and the feasibility of thyroidectomy for aged (${\geq}75$ years old) thyroid cancer by reviewing postoperative morbidity and pathologic characteristics. Materials & Methods: The clinical records of patients submitted to thyroid operation between 2014 and 2015 with histopathological diagnosis of thyroid cancer were analyzed. Clinical variables included age, gender, preoperative symptom, final pathology, length of stay, comorbidities, American Society of Anesthesiologists score, postoperative complications, and mortality. Results: There were 30 patients aged more than 75 years old, and only one patient passed over with postoperative pneumonia. There were 8 male and 22 female patients. Half of the patients presented with symptoms such as palpable mass (33.3%), voice change (6.7%) and dyspnea (6.7%). The pathologic diagnosis was thyroid cancer in all cases. The median postoperative hospitalization time was 4 days. There was one perioperative mortality case observed in this study. Conclusion: Thyroid surgery in patients 75 years or older can be performed except extensive surgical resection. Aggressive histology and extent of surgery may be an important factor of perioperative mortality and morbidity.

• 대한임상검사과학회지
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• 제37권3호
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• pp.190-196
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• 2005

Helicobacter pylori (H. pylori) infection is uncommon in developed countries, yet is common in underdeveloped and developing countries. Infection rate of H. pylori is minimally influenced by economic, environmental, and public health status and genetic factors. Korea is a developing country with a high incidence of H. pylori infection and gastric carcinoma, which is one of the leading causes of death. For this reason, accurate clinical and pathologic data on H. pylori-associated disease are very important. Intestinal metaplasia accompanies chronic gastritis and increases the risk of gastric carcinoma. For this reason, the relationship between H. pylori infection and intestinal metaplasia is very closely linked. Because of this, as the antecedent condition is guessed, it examines the relationship of the H. pylori and the intestinal metaplasia. Intestinal metaplasia is thought to be the basis in the development of intestinal type gastric carcinomas. Recent investigations showed that inflammatory reaction in the gastric fundus affect the development of gastric carcinogenesis. To verify neutrophilic activity in the gastric fundus and development of intestinal metaplasia in both gastric fundus and antral mucosa, their relationship was studied using 159 healthy patients who had undergone gastric endoscopic biopsies without any identifiable pathologic disesaes. When neutrophilic activity accompanied, incidence of intestinal metaplasia was significantly increased (p<0.05). H. pylori infection was statistically and significantly associated with the presence of intestinal metaplasia (p<0.05). These results suggest that H. pylori infection affected the development of intestinal metaplasia in the stomach. These results will help our understanding of H. pylori infection in the pathogenesis of intestinal metaplasia, a preneoplastic condition of the stomach. To reduce the incidence of gastric adenocarcinoma, eradication treatment of H. pylori is recommended when there's a neutrophilic activity in the gastric fundus.

• 한국산학기술학회논문지
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• 제10권3호
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• pp.613-619
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• 2009

SHI-1909를 초산과 TNBS에 의해 rat에 유발된 염증성 대장염 모델에서 5일 동안 경구 투여 하여 대조약인 프레드니솔론과 그 치료 효능을 비교 조사하였다. 7% 초산과 5% TNBS 용액을 polyethylene 튜브로 rat의 항문에 점적하여 염증성 대장염을 유발하였으며 점적 후 초산과 TNBS 대조군은 말단의 대장부위에서 궤양과 염증 증상 같은 병적인 소견을 보여 염증성 대장염이 잘 유발되었음을 확인할 수 있었다. 약물의 투약기간 중 염증 치유 변수인 실험동물의 중량과 식이 섭취량 변화를 관찰하였으며 실험이 종료된 후에는 실험동물을 희생시킨 후 대장의 길이와 궤양, 병적인 소견을 조사하였다. SHI-1909의 투여는 중량변화와 식이 섭취량 등에서 대조약과 필적할 만한 결과를 나타내었으며 특히 대장의 손상 정도 평가에서 대조약물인 프레드니솔론보다도 더 우수한 효과를 나타내었다. 이러한 결과로부터 SHI-1909는 IBD의 치료에 가능성이 있는 치료 약물이 될 수 있을 것으로 사료된다.