• Archives of Plastic Surgery
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• v.47 no.4
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• pp.305-309
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• 2020

Breast cancer treatment-related lymphedema (BCRL) is a common comorbidity in breast cancer survivors. Although magnetic resonance imaging (MRI) is widely used to evaluate therapeutic response of patients with various medical conditions, it is not routinely used to evaluate lymphedema patients. We conducted a systematic review of the literature to identify studies on the use of MRI to evaluate therapy for BCRL. We hypothesized that MRI could provide information otherwise not possible through other examinations. On October 21, 2019, we conducted a systematic review on the PubMed/MEDLINE and Scopus databases, without time frame or language limitations, to identify studies on the use of MRI to evaluate therapy for BCRL. We excluded studies that investigated other applications of MRI, such as lymphedema diagnosis and surgical planning. Of 63 potential articles identified with the search, three case series fulfilled the eligibility criteria. In total, 53 patients with BCRL were included and quantitatively evaluated with MRI before and after manual lymphatic drainage. Authors used MRI or MR lymphagiography to investigate factors such as lymphatic vessel cross-sectional area, tissue water relaxation time (T₂), and chemical exchange saturation transfer. The only study that compared MRI measurement with standard examinations reported that MRI added information to the therapy evaluation. MRI seems to be a promising tool for quantitative measurement of therapeutic response in patients with BCRL. However, the identified studies focused on only manual lymphatic drainage and were limited by the small numbers of patients. More studies are necessary to shed light on the topic.

• Radiation Oncology Journal
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• v.8 no.1
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• pp.29-34
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• 1990

Total of 154 patients of pathologically proven and previously untreated nasopharyngeal carcinoma who were treated in the Department of Therapeutic Radiology, Korea Cancer Center Hospital during the period from 1964 to 1984 were analyzed. Minimal follow-up period of survivors was 3 years. Thirteen percent of the patients had $T_4$ primary lesions and $65\%$ had stage IV disease. Total radiation dose to the primary site was $1550\~1750$ ret in 82 and above 1750 ret in 72 patients. Local control was obtained in $79\%$ of patients. Significant prognostic factors for the survival were tumor dose (above vs. below 1750 ret), age (below vs. above 30 years), stage (AJCC I-III vs. IV), T stage ($T_1\;vs.\;T_2-4$), and N stage (NO vs. $N^+$).

• Radiation Oncology Journal
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• v.35 no.1
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• pp.55-64
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• 2017

Purpose: The outcomes and toxicities of locoregionally recurrent non-small-cell lung cancer (NSCLC) patients treated with curative radiotherapy were evaluated in the modern era. Materials and Methods: Fifty-seven patients receiving radical radiotherapy for locoregionally recurrent NSCLC without distant metastasis after surgery from 2004 to 2014 were reviewed. Forty-two patients were treated with concurrent chemoradiotherapy (CCRT), and 15 patients with radiotherapy alone. The median radiation dose was 66 Gy (range, 45 to 70 Gy). Lung function change after radiotherapy was evaluated by comparing pulmonary function tests before and at 1, 6, and 12 months after radiotherapy. Results: Median follow-up was 53.6 months (range, 12.0 to 107.5 months) among the survivors. The median overall survival (OS) and progression-free survival (PFS) were 54.8 months (range, 3.0 to 116.9 months) and 12.2 months (range, 0.8 to 100.2 months), respectively. Multivariate analyses revealed that single locoregional recurrence focus and use of concurrent chemotherapy were significant prognostic factors for OS (p = 0.048 and p = 0.001, respectively) and PFS (p = 0.002 and p = 0.026, respectively). There was no significant change in predicted forced expiratory volume in one second after radiotherapy. Although diffusing lung capacity for carbon monoxide decreased significantly at 1 month after radiotherapy (p < 0.001), it recovered to pretreatment levels within 12 months. Acute grade 3 radiation pneumonitis and esophagitis were observed in 3 and 2 patients, respectively. There was no chronic complication observed in all patients. Conclusion: Salvage radiotherapy showed good survival outcomes without severe complications in postoperative locoregionally recurrent NSCLC patients. A single locoregional recurrent focus and the use of CCRT chemotherapy were associated with improved survival. CCRT should be considered as a salvage treatment in patients with good prognostic factors.

• Parasites, Hosts and Diseases
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• v.51 no.3
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• pp.335-341
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• 2013

Balamuthia mandrillaris is one of the 4 amebas in fresh water and soil that cause diseases in humans. Granulomatous amebic encephalitis (GAE), caused by B. mandrillaris, is a rare but life-threatening condition. A 4-year-old, previously healthy, Thai girl presented with progressive headache and ataxia for over a month. Neuroimaging studies showed an infiltrative mass at the right cerebellar hemisphere mimicking a malignant cerebellar tumor. The pathological finding after total mass removal revealed severe necrotizing inflammation, with presence of scattered amebic trophozoites. Cerebrospinal fluid (CSF) obtained from lumbar puncture showed evidence of non-specific inflammation without identifiable organisms. A combination of pentamidine, sulfasalazine, fluconazole, and clarithromycin had been initiated promptly before PCR confirmed the diagnosis of Balamuthia amebic encephalitis (BAE). The patient showed initial improvement after the surgery and combined medical treatment, but gradually deteriorated and died of multiple organ failure within 46 days upon admission despite early diagnosis and treatment. In addition to the case, 10 survivors of BAE reported in the PubMed database were briefly reviewed in an attempt to identify the possible factors leading to survival of the patients diagnosed with this rare disease.

• Journal of Chest Surgery
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• v.25 no.8
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• pp.863-870
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• 1992

The low profile Ionescu-Shiley pericardial xenograft valve had been initially introduced to have improved hemodynamic performance and expected superior durability, However, subsequent clinical reports and laboratory studies have repeatedly indicated early failure of the valve from mechanical reasons in valve design, A total and consecutive 169 patients underwent isolated MVR with the low profile Ionescu-Shiley valve at Seoul National University Hospital from November 1984 to October 1989 [Group ISLM]. Five patients [3.0%] died within 30 days of surgery, and early survivors were followed up for 734.9 patient-years [Mean$\pm$SD, 4.9$\pm$2.0 years], Late mortality rate was 0.136% /patient-year [pt-yr], Linearized incidences of major complications were: 0.953% embolism /pt-yr; 0.680% bleeding /pt-yr; 0.272% endocarditis /pt-yr; and 0, 408% primary tissue failure [PTF] /pt-yr, The actuarial survival was 99.4$\pm$0.6%, and probabilities of from thromboembolism and from PTF were 90.7$\pm$4.6% and 95.9$\pm$2.6% at 8 years, respectively These results were compared with the clinical data from the 291 patients of isolated MVR with the standard Ionescu-Shiley valve at the same hospital during the period between October 1978 and June 1983 [Group ISUM], Group ISUM included 11% of patients younger than 15 years of age, whereas Group ISLM did no patient of this age. The mean age at the time of surgery was significantly younger in Group ISUM than one in Group ISLM [P<0.001]. Differences were not statistically significant in operative mortality, mean follow-up period and linearized incidences of thromboembolism, bleeding and endocarditis, between two groups, However, the linearized rate of PTF was lower [P<0.001] and probabilities of freedom fro PTF higher [P<0.001] in Group ISLM at least up to postoperative 8 years. While the features of PTF of the standard valve was predominantly degeneration with calcification and stenosis, the ones of the low profile valve was cusp tear and incompetence. It remains, however, to be seen whether the low profile valve fails mostly from mechanical reason, and further follow-up will still be necessary to determine the differences in mode of PTF of two valves.

• Journal of Chest Surgery
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• v.22 no.2
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• pp.212-219
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• 1989

We utilized pulmonary artery pressure monitoring system in risky patients for preventing the postoperative pulmonary hypertensive crisis and for sampling the mixed venous blood. And this mixed venous blood oxygen saturation [MVSO2] or partial pressure [MVPO2]tells us many meaningful patients state. We selected 59 cyanotic congenital heart diseased patients, who were operated in our hospital from Nov. 1987 to Oct. 1988, in the Department of Thoracic and Cardiovascular Surgery, Seoul National University Children\ulcorner Hospital, who had pulmonary artery pressure monitoring catheter and who made us know their mixed venous oxygen condition. We found that there was no close relationship between MVPO2 and Cardiac Index [C.I.] during early postoperative period, but on the first and second day after operation the correlation coefficient was increased as r=0.35[p=0.008], r=0.78[p=0.0001]. So we concluded that the correlation between MVPO2 and C.I. was more reliable with time going as hemodynamic stabilization. And we experienced no survivors whose MVPO2 was under 20 torr, but that was not the only factor for death. From these results, we conclude that we can consider the MVPO2 [or MVSO2] representing C.I. after stabilized postoperative condition of the open heart surgery patients, but during early postoperative period, in addition to this MVPO2, we should do also apply other parameter such as urine output, arterial blood pressure, left atrial pressure and pulmonary arterial pressure for exact estimation of the patients status.

• Journal of Chest Surgery
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• v.22 no.2
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• pp.246-255
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• 1989

A total and consecutive 291 patients of isolated single mitral valve replacement using the Ionescu-Shiley bovine pericardial xenograft valve operated on between October 1978 and June 1983 were retrospectively studied for the durability of the substitute valves based on the structural degeneration of primary tissue failure which had been proved on their re-replacement surgery. The mean age at the initial surgery was 32.4*12.5 years, and the operative mortality rate was 5.2 %. The early survivors of 276 patients were followed up for a total 1148.3 patient-years[mean\ulcornerD, 4.16*2.57 years]at the follow-up end of June 1988. They experienced 4 major late complications: 1.045 % thromboembolism/patient-year [pt-yr]; 0.871 % bleeding/pt-yr; 0.610% endocarditis/pt-yr; and 3.309% overall valve failure/pt-yr or 1.655% primary tissue failure/pt-yr. The actuarial survival rates were 89.4*2.2% and 87.7*2.5% at 5 and 10 years after initial surgery respectively. The probabilities of freedom from thromboembolism were 95.1*1.6% and 93.2*2.0% at 5 and 10 years after surgery. Nineteen patients underwent re-replacement of the Ionescu-Shiley valve because of primary tissue failure, and there was no operative mortality. The incidence of primary tissue failure was highest for the patients less than 15 years of age occurring in 9 out of 27 patients [33.3 %] or 8.68 %/pt-yr, while it was 4.0 % or 0.96 %/pt-yr for the rest of patients older than this age. The probabilities of freedom from primary tissue failure were 96.7*1.4 % and 84.2*3.8% at 5 and 9 years after surgery. The freedom from tissue failure increased as the age limits of cumulative younger patients were increased while it decreased as the age limits of cumulative older patients were decreased. Although it is clear that the Ionescu-Shiley valve would degenerate prematurely in young patients, the definite age limit could not be identified when the risk of early failure was significantly high.

• Journal of Chest Surgery
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• v.22 no.6
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• pp.1092-1100
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• 1989

Since May 1987 to April 1989, fifteen patients have been subjected to coronary artery bypass graft [CABG] including coronary thromboendarterectomy in 3 patients at Hanyang University Hospital. The correlation between the preoperative coronary angiography, electrocardiography, clinical status, operative finding and postoperative blood flow, complication and degree of clinical improvement were evaluated. 1. Ten patients [67 %] were male and five patients [33 %] were female, Ages ranged from 30 to 68 years. [average 52.2 years] 2. The angina by types of presentation was stable in 3 patients, unstable in 12 patients with resting, postinfarction and progressive angina as the criteria of unstability. 3. The number of involved vessels were single in 6 cases, double in 4 cases, triple in 5 cases including 1 case of left main coronary arterial disease. 4. The distribution of sites of distal anastomosis revealed predilection to left coronary arterial system [83 %], especially left anterior descending arterial system. 5. The author performed 4 cases of single bypass, 4 cases of double bypass, 5 cases of triple bypass and 2 cases of quadruple bypass. Of these 15 patients, 3 patients received coronary thromboendarterectomy, LAD in 2 patients and right coronary artery [RCA] in 1 patient. 6. The distal anastomosis were performed first with using saphenous vein grafts as conduits in all cases except 1 case using Gore-Tex conduit because of deficient in length and narrowed internal mammary artery and sequential bypass methods were employed in last 6 cases. 7. One operative death occurred and therefore, mortality rate was 6.7%. The perioperative myocardial infarction were occurred in 3 cases [20%] and its cause was supposed that they were triple vessel disease and therefore, aortic cross clamping times were relatively long. 8. All survivors were followed for 17.7 months on an average [range 5-28 months] and they have had symptomatic improvement except 1 case having mild degree of angina at 1.5 months after operation.

• Journal of Chest Surgery
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• v.27 no.12
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• pp.989-994
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• 1994

Between January 1986 and August 1993, 11 patients underwent surgical repair of ventricular septal defect [VSD] complicated with myocardial infarction. The ages of patients were ranged from 22 years to 83 years with a mean of 64 years. There were 8 male and 3 female patients. The preoperative cineangiograms of all patients were reviewed to measure both ventricular function and to evaluate coronary artery disease. The mean time interval between occurance of VSD and operation was 13 days. The operations were performed as soon as possible if there were hemodynamic derangement. Postmyocardial infarction VSD were repaired simultaneuously with coronary artery bypass graft in 3 patients, repaired with left ventricular aneurysmectomy in 6 patients, with left ventricular thrombectomy in 1 patient and with mitral valve chordae repair in 1 patient. There was no early death [within 30 days]. There were 6 postoperative complications; one with perioperative myocardial infarction, two with recurred VSD on postoperative 1 and 6 days respectively, two with lower leg embolism associated with intraaortic balloon pump insertion, one with wound infection. Of the complicated patients, 1 patient with lower leg embolism performed left above ankle amputation. Among two patients with recurred ventricular septal defect, one patient is doing well without problem. On follow up echocardiogram, the residual VSD was occluded completely. However another patient was with recurred VSD died 3 months after the operation because of congestive heart failure. Of the long term survivors, all patients are in NEW YORK Heart Association functional Class I or II. Although number of patients were small, our results of surgical closure of postmyocardial infarction VSD were favored to the others. Moreover, seven patients with preoperative cardiogenic shock among 11 were performed early operation after diagnosis of ventricular septal rupture. All of the patients were survived and doing well during the follow up period. Therefore early diagnosis with aggressive preoperative care with intraaortic balloon pumping and early operation seems to be very important for prevention of deterioration of vital organ.

• Natural Product Sciences
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• v.12 no.4
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• pp.247-253
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• 2006

The antitumor activity of crude saponin mixture obtained from Luffa tuberosa (Roxb.) (Fam; Cucurbitaceae) hairy roots (CSLT) in mice transplanted with Ehrlich ascites carcinoma (EAC) was investigated. The EAC-bearing mice receiving 150 and $300{\mu}g/kg$ body weight, (i.p) of CSLT have shown a dose dependent elevation in tumor-tree survival and a highest number of survivors were observed after administration of CSLT $(300{\mu}g/kg)$, which was considered as an optimum dose for its antineoplastic action. The mean survival time (MST) for this dose was approximately $47.1{\pm}0.74d$, when compared with $19.0{\pm}0.36d$ of untreated control. Administration of $300{\mu}g/kg$ CSLT resulted in 130% long-term increased survival time. The measurement of body weight, tumor volume, packed cell volume, viable and non-viable count indicated the efficacy of CSLT in tumor-bearing mice, there was a significant recovery in hematological profiles, and there was depletion in lipid peroxidation levels, and the antioxidant enzyme activities such as GSH, SOD and CAT were restored to near the normal levels. The CSLT was found to be devoid of conspicuous short-term toxicity in the mice when animals were intraperitoneally injected with 250, 500, 750 and $1000{\mu}g/kg$ bodyweight. The treated mice showed conspicuous toxic symptoms only at a dose of $1500{\mu}g/kg$. Mortality of the animals was monitored up to 14 d post drug treatment, $1/7^{th}$ of the $LD_{50}$ dose has been considered for the optimal antineoplastic activity.