• Archives of Craniofacial Surgery
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• v.11 no.1
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• pp.53-57
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• 2010

Purpose: The radial forearm fasciocutaneous free flap is currently considered as the ideal free flap for reconstruction of mucosal and soft tissue defects of the palate. But the availability of stably attached oral and nasal mucosal lining is needed. In addition to this, for better operation field, operating convenience and esthetics, we planned a prelaminated radial forearm free flap. Methods: A 64-year-old male patient was admitted due to a $4{\times}4.5cm$ full through defect in the middle of the hard palate caused by peripheral T cell lymphoma with actinomycosis. In the first stage, the radial forearm flap was elevated, tailored to fit the hard palate defect, and then it positioned up-side down with split thickness skin graft. Two weeks later, the prelaminated radial forearm free flap was re-elevated and transferred to the palatal defect. One side covered with grafted skin was used to line the nasal cavity, and the other side (the cutaneous portion of the radial forearm flap) was used to line the oral cavity. Results: The prelamination procedure was relatively easy and useful. The skin graft was well taken to the flap. After 2nd stage operation, the flap survived uneventfully. There was no prolapse of the inset flap into the oral cavity and the cutaneous portion of the flap was mucosalized. The procedure was very successful and the patient can enjoy normal rigid diet and speech. Conclusion: The use of prelaminated radial forearm free flap for hard palate reconstruction is an excellent method to restore oral function. Based upon the result of this case, microvascular free flap transfer with prelaminated procedure is a valid alternative to the prosthetic obturator for palatal defect that provides an improved quality of life. It should be considered as an integral component of head and neck cancer therapy and rehabilitation.

• Journal of Gastric Cancer
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• v.4 no.1
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• pp.1-6
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• 2004

Purpose: Despite numorous reports on the relationship between the level of carcinoembryonic antigen (CEA) in gall bladder bile and liver metastasis in colorectal cancer, no similar studies have been carried out for gastric carcinomas. We, therefore, undertook the present study to establish the relationship between the gall bladder bile CEA and liver metastasis as well as the post-operative survival rate in gastric carcinoma patients with curative resections. Materials and Methods: In 373 gastric cancer patients (252 males, 121 females, age $21\∼76$ years) operated on at Kosin University Hospital between 1989 1996, the CEA concentration in the gall bladder bile was determined during the operation and the value was related to the rates of post-operative survival and liver metastasis during follow-up period. Results: The overall rate of patient survival decreased gradually with increase in TNM stage. The 13-year postoperative survival rates for stages Ia, Ib, II, IIIa, and IIIb were $95.7\%,\;92.5\%,\;79.9\%,\;50.9\%,\;and\;43.3\$, respectively, and the 10-year survival rate for stage IV was $22.6\%$. The patients with a high ($\geq$10 ng/ml) biliary CEA showed a significantly lower rate of survival than those with a low (<10 ng/ml) biliary CEA. The 13-year cumulative survival rate was $55.4\%$ for the high CEA group and $76.5\%$ for the low CEA group (P<0.01). Also, the patients with a high biliary CEA showed a significantly higher rate ($11.5\%$) of liver metastasis than those with a low biliary CEA ($1.9\%$) (P<0.000). In patients with TNM stages (I and II), the CEA level did not affect the post-operative survival rates ($95.4\%\;and87.7\%$ in the high and low CEA groups, P>0.10), but in those with high TNM stages (III and IV), the survival rate was significantly lower in the high CEA group ($25.9\%$) than in the low CEA group ($57.8\%$) (P<0.05). Conclusion: These result suggest that the gall bladder bile CEA level obtained in an advanced-staged gastric cancer operation may be used in predicting the post-operational survival rate and in sorting out patients with a high risk for cancer recurrence, especially in the liver area.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6077-6081
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• 2012

Background: This study was performed to analyze the prognostic implications of pretreatment or preoperative thrombocytosis in women with gynecologic malignancies. Material and Methods: We surveyed 2 medical databases, PubMed and EMBASE, to identified all relevant studies. A total of 14 (n=3,490) that evaluated the link between thrombocytosis and 5-year survival were included. REVMAN version 5.1 was used for our analysis and publication bias was evaluated using the Begg's funnel plot and tested by STATA 11.0. Risk ratios (RRs) with 95% confidence intervals (CIs) generated by the random effect model were used to assess the strength of any association. Results: 709(20.3%) of the 3,490 patients exhibited thrombocytosis (platelet counts > $400{\times}10^9/L$) at primary diagnosis, and their mortality was 1.62-fold higher compared with the others (RR=1.62, 95%CI=[1.28-2.05], p<0.0001). Thrombocytosis failed to have a stronger effect on the survival of advanced patients of stages III to IV in our study (n=478, RR=1.29, 95% CI=[1.13-1.48], p=0.0003), nor in women with cervical cancer in stage IB (n=1371, RR=1.73, 95% CI=[1.71-2.58], p=0.007). In addition, when adjusted for different carcinoma, it was associated with worse prognosis for all except the ones with vulvar cancer (n=201, RR=0.43, 95% CI=[0.14-1.29], p=0.13). Conclusions: This meta-analysis indicated that thrombocytosis might be associated with a worse prognosis for patients with gynecologic malignancies but without specificity or sensitivity for the ones in advanced stage. When adjusted for different gynecologic malignancies, it showed a significant effect on survival of all except vulvar cancers.

• Korean Journal of Heritage: History & Science
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• v.44 no.4
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• pp.86-111
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• 2011

Wan is a tableware in which boiled rice or soup, side dish are put, and it is a representative model which shows the development of personal tableware. From the establishing period of Hanseong Baekje, the form of wan which is Jung-do Style(中島式) Plain Pottery of previous period Proto-Three Kingdoms Period was succeeded to, but wan is produced and used as a wan baked in the kiln, which is far development of the producing technique including hardness and clay. By and large, the size of $0.3{\sim}0.4{\ell}$ was the majority and the production technique of wan which used carefully selected soft quality clay are largely confirmed to be two methods which are, first, basic method by which on a clay tablet on the rotating table, clay band is accumulated and moulding is finished, and second, the new method which had the same basic moulding as that of basic method but in the last stage takes wan off the rotating table and reverse it to trim the bottom and remove the angle of flat bottom. The former, basic production method is the classical production method since wan of Jung-do Style Plain Pottery and wan was produced and used for all periods of Hanseong Baekje. On the other hand, the latter is the production method obtained through form imitation of China made porcelain flowed into through interchange between Baekje and China, and through comparison with Chinese chronogram material it is estimated to have been produced and used after middle of 4th century. Therefore it can be known that the Baekje people's demand for China made articles was big and imitation pottery was produced and used with Baekje pottery. In addition, bowl with outward mouth are confirmed in multiple number in Lakrang(樂浪) pottery wan and it is assumed that wan was the form produced under the influence.

• Korean Journal of Heritage: History & Science
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• v.37
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• pp.65-89
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• 2004

Up to now, the studies for a pond of ancient palace of Korea are mainly achieved in a landscape architectural field. In fact, we can't grasp the general aspects but we are only heard about the fragmentary ruins and remains by the people who are in charge of an archaeological excavation. In this thesis, therefore, I attempt to grasp the relational categories of the ponds of an ancient palace of Korea, and find out the ideological backgrounds of the ponds of a palace construction through classify them excavated so far. The ancient ponds of Korea are divided to the class of square ponds(I) and curved ponds(II) according a shapes of planes. The class of square ponds(I) are subdivided to the form IA of the class of square ponds and form IB of the class of square ponds by whether it has an island, artificial hill and ornamental stone or not. And the class of the curved ponds(II) are divided to the form IIC that is only composed of curves in shore and the form IID that is composed of curves and straight lines. According the size, it is divided to a small size that is below the maximal diameter, 20m, and a large size that is more than 45m, after all, the ponds of the ancient palaces are devided to IAa, IAb, IBa, II Ca, IICb, IIDa. The square ponds and the curved ponds are co-exist from the initial stage when a pond of a place was found in our country and are succeeded or changed after Silla unified the three Kingdoms. In other words, we can infer a continuity from the earlier stage from the fact that there is a flat figure ground mainly constituted by the ponds of a palace mixed up of a straight line and a curved line in United Silla Kingdom while it succeeds the ponds of a palace that has a square form of Goguryo in Balhai. Different from the successional relation of the flat figure grounds, in an aspect of the elements of the construction, the site of the arbor at the top of the island and the bridge facilities in a field of a palace those are not exist in three Kingdoms period are appeared in United Silla Kingdom. The point that this aspect is simultaneously appeared in a neighboring country, or Japan, allows us to infer that there may be some motivations cause the changes in a construction of the ponds of a palace of Korea, China and Japan from the latter half of the 7th century to the first half of the 8th century. The ideological backgrounds of the ponds of a palace construction are divided roughly into Taoism and Buddhism. We can recognize that the ponds of a palace made up of the islands, the artificial hills and the garden rocks reflect Taiosm, considering the records of the ponds a palace of Korea and China are all use the term, Taoism, or the concrete statement represents that the islands, the artificial hills and the garden rocks are used in the description of the ponds of a palace of Korea. Both two are, therefore, obviously differentiated from the ponds of a palace that doesn't include them. We can conclude that the ponds of a palace that doesn't include them are colored by Buddhism since they are overtly distinguished from the class of curved ponds that reflect Taoism at the same period and they are identical with the site of an ancient temples in an aspect of their type and construction.

• Tuberculosis and Respiratory Diseases
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• v.51 no.2
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• pp.108-121
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• 2001

Background : The $p16^{INK4a}$ (p16) twnor suppressor gene is frequently inactivated in hwnan non-small cell lung cancers (NSCLCs), predominantly through homozygous deletion or in association with aberrant promotor hypermethylation. Death-associated protein kinase (DAPK) gene influences interferon $\gamma$-induced apoptotic cell death and has important role in metastasis of lung cancer in animal model. Hypermethylation of promoter region of DAP kinase gene may suppress the expression of this gene. Methods : This study was performed to investigate the aberrant methylation of p16 or DAP kinase in 35 resected primary NSCLCs by methylation-specific PCR (MSP), and demonstrated frequency, diagnostic value and clinical implication of aberrant methylation of two genes. Results : Thirty-two cases were male patients, and 3 cases were female patients with an average age was 57. $8{\pm}10.5$ years. The histologic types of lung cancer were 22 of squamous cell carcinoma, 12 of adenocarcinoma, 1 of large cell carcinoma. Pathologic stages were 11 cases of stage I (1 IA, 10 IB), 13 cases of stage II (1 IIA, 12 IIB), and 11 cases of stage III (9 IIIA, 2 IIIB). Regarding for the cancer tissue, p16 aberrant methylation was noted in 13 case of 33 cases (39.4%), DAP kinase in 21 cases of 35 cases (60%). Age over 55 year was associated with p16 aberrant methylation significantly (p<0.05). Methylation status of two genes was not different by smoking history, histologic type, size of tumor, lymph node metastasis and disease progression of lung cancer. There was no correlation between p16 and DAP kinase hypermethylation. Conclusion: This investigation demonstrates that aberrant methylation of p16 tumor suppressor gene or DAP kinase showed relatively high frequency (74.3%) in NSCLCs, and that these genes could be a biologic marker for early detection of lung cancer.

• Radiation Oncology Journal
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• v.19 no.3
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• pp.230-236
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• 2001

Purpose : To evaluate treatment results in terms of local control, complications and survival after reirraidiation in recurrent cervical cancer following definite radiation therapy. Material and methods : From November 1987 through March 1998, eighteen patients with recurrent cervical cancer following definite radiation therapy were subsequently treated with reirradiation at Keimyung University Dongsan Medical Center. In regard to the initial FIGO stage, one patient was stage la, five were stage IIa, three were IIb, two were IIb and two were IVa. The age range was 37 to 79 years old with median age of 57. The time interval from initial definite radiation therapy to recurrence ranged from 6 to 122 months with a median of 58 months. The recurrent sites were the uterine cervix in seven patients, vagina in ten and pelvic lymph node in one. Reirradiation was peformed with external radiation and intracavitary radiation in twelve patients, external radiation and implantation in four and external radiation alone in two. The range of external radiation dose was $2,100\~5,400\;cGy$ and the range of the total radiation dose was $3,780\~8,550\;cGy$. The follow-up periods ranged from 8 to 20 months with median of 25 following reirradiation. Results : Fourteen of eighteen patients $(78\%)$ had local control just after reirradiation. The two year disease free survival (2YDFS) rate was $53.6\%$. There were statistically significant differences in the 2YDFS according to both recurrent site (2YDFS $28.5\%$ in uterine cervix, $71.4\%$ in vagina, (p=0.03)) and the total dose (2YDFS $71.8\%$ in >6,000 cGy , $25\%$ in $\leq6,000$ cGy, p=0.007). Seven of ten patients who were followed for more than 20 months remain alive and disease free (7/18, $39\%$). Patients treated with external radiation and intracavitary radiation had a higher rate of 2YDFS. Seven patients including 4 patients with no local control experienced local failure in the uterus or vagina and two patients died with distant metastasis. Complications included rectal bleeding in 3 patients, bowel obstruction treated with surgery in two, hematuria in one, radiation cystitis in two, soft tissue swelling in two and vaginal necrosis spontaneously healed in one. There was no statistical difference in complications according to the total dose or the time to recurrence from initial radiation. Conclusion : In patients with recurrence following definite radiation therapy in the uterine cervical cancer, reirradiation may be effective but requires an effort to reduce radiation induced severe complications.

• Journal of Gastric Cancer
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• v.17 no.1
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• pp.33-42
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• 2017

Purpose: Endoscopic submucosal dissection (ESD) in early gastric cancer causes an artificial gastric ulcer and local inflammation that has a negative intraprocedural impact on additional laparoscopic gastrectomy in patients with noncurative ESD. In this study, we analyzed the effect of ESD on short-term surgical outcomes and evaluated the risk factors. Materials and Methods: From January 2003 to January 2013, 1,704 patients of the National Cancer Center underwent laparoscopic gastrectomy with lymph node dissection because of preoperative stage Ia or Ib gastric cancer. They were divided into 2 groups: (1) with preoperative ESD or (2) without preoperative ESD. Clinicopathologic factors and short-term surgical outcomes were retrospectively evaluated along with risk factors such as preoperative ESD. Results: Several characteristics differed between patients who underwent ESD-surgery (n=199) or surgery alone (n=1,505). The mean interval from the ESD procedure to the operation was 43.03 days. Estimated blood loss, open conversion rate, mean operation time, and length of hospital stay were not different between the 2 groups. Postoperative complications occurred in 23 patients (11.56%) in the ESD-surgery group and in 189 patients (12.56%) in the surgery-only group, and 3 deaths occurred among patients with complications (1 patient [ESD-surgery group] vs. 2 patients [surgery-only group]; P=0.688). A history of ESD was not significantly associated with postoperative complications (P=0.688). Multivariate analysis showed that male sex (P=0.008) and laparoscopic total or proximal gastrectomy (P=0.000) were independently associated with postoperative complications. Conclusions: ESD did not affect short-term surgical outcomes during and after an additional laparoscopic gastrectomy.

• Radiation Oncology Journal
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• v.36 no.2
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• pp.147-152
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• 2018

Purpose: To evaluate the treatment outcomes of adjuvant external beam radiation therapy (EBRT) and vaginal brachytherapy (VB) following radical hysterectomy in cervical cancer patients with involved vaginal resection margin (VRM). Materials and Methods: We retrospectively reviewed the medical records of 21 patients treated with postoperative EBRT and VB for positive VRM FIGO stage IB-IIA cervical cancer between 2003 and 2015. Concurrent platinum-based chemotherapy was administered to all patients. Results: The median whole pelvis EBRT dose was 50.4 Gy (range, 45 to 50.4 Gy). In the VB, the median dose per fraction, number of fractions, and total dose delivered were: 4 Gy (range, 3.0 to 4.0 Gy), 4 fractions (range, 3 to 5 fractions), and 16 Gy (range, 12 to 20 Gy), respectively. At a median follow-up of 46 months (range, 9 to 122 months), local recurrence was observed in 2 patients, and distant metastasis was present in 7 patients. All patients with local recurrence subsequently developed distant metastases. The 5-year local control, disease-free survival, and overall survival rates were 89.1%, 65.9%, and 62.9%, respectively. Of the 21 patients, 7 patients (33.3%) reported grade 2 acute toxicity; however, there were no grade 3 or higher acute adverse events. Grade 1-2 late toxicities were observed in 8 patients. Late grade 3 urinary toxicity was reported in 1 patient. Conclusions: Adjuvant EBRT and VB showed excellent local control and low toxicity in cervical cancer patients with positive VRM. Although limited by its retrospective nature, the findings from our study provide evidence supporting the use of additional VB in pathologically involved VRM.

• Journal of Gastric Cancer
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• v.7 no.2
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• pp.74-81
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• 2007

Purpose: Routine pancreatico-splenectomy with total gastrectomy should no longer be considered as the standard surgical procedure for gastric cancer because of the lack of proven surgical benefit for survival. The aim of this study is to evaluate the clinicopathologic factors and the survival of patients with locally advanced gastric cancer and they had undergone combined pancreatico-splenectomy with a curative intent. Material and Methods: We retrospectively reviewed a total of 118 patients who had undergone total gastrectomy with distal pancreatico-splenectomy from 1990 to 2001. The patients were divided into 2 groups: 90 patients who were free from cancer invasion (group I), and 28 patients with histologically proven cancer invasion into the pancreas (group II). The various clinicopathologic factors that were presumed to influence survival and the survival rates were analyzed. Results: The rate of pathological pancreatic invasion was 23.7%. The tumor stage, depth of invasion, pancreas invasion, lymph node metastasis, lymph node ratio, curability and the hepatic and peritoneal metastasis were statistically significance on univariate analysis. Among these factors, the tumor stage, lymph node ratio and curability were found to be independent prognostic factor on multivariate analysis. The 5-years survival rates were 36.2% for group I and 13.9% for group II. The morbidity rate was 22.1%, and this included pancreatic fistula (5.1%), intra-abdominal abscess (4.2%) and bleeding (4.2%). The overall mortality rate was 0.8%. Conclusion: Combined distal pancreatico-splenectomy with total gastrectomy with a curative intent was selectively indicated for those patients with visible tumor invasion to the pancreas, a difficult complete lymph node dissection around the distal pancreas and spleen, and no evidence of liver metastasis or peritoneal dissemination.