• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.4
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• pp.287-294
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• 2006

Vascular thrombosis and ischemic necrosis still remain the most significant threats to the survival of free flaps. To date, neutrophils have been implicated in the pathogenesis of postischemic injury. Several studies have demonstrated that modulating the neutrophil response to ischemia-reperfusion injury can decrease the extent of the injury. In addition, some authors noticed that mast cell counts were also increased in flaps exposed to state of ischemia/reperfusion. So, we designed to evaluate the role of mast cells in ischemia/reperfusion by blocking histamine and to compare the effect of L-arginine, a nitric oxide precursor which is known to prevent neutrophil-mediated tissue injury. Epigastric island skin flaps were elevated in 30 rats and rendered ischemic. Thirty minutes prior to reperfusion, the rats were treated with intraperitoneal saline, diphenhydramine, cimetidine, and L-arginine. The necrosis rate of flap at 7 days, the number of neutrophils and mast cells at 20 hours were evaluated. In conclusion, histamine receptor blockers as well as L-arginine significantly decreased flap necrosis in a rat skin island ischemia-reperfusion flap model, but the protective effect was not significantly different in both agent groups.

• Journal of Gastric Cancer
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• v.15 no.3
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• pp.218-221
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• 2015

Gastric metastasis from ovarian carcinoma is extremely rare and the prognosis for patients is poor. We report a case of multimodal treatment improving the survival time of a patient with gastric metastasis from ovarian cancer. A 73-year-old woman with known serous ovarian cancer was admitted to the hospital due to epigastric pain and dyspepsia. On esophagogastroduodenoscopy, a protruding mass was noted at the gastric antrum. She underwent distal gastrectomy with Billroth I anastomosis and lymph node dissection, including the para-aortic lymph nodes. The final pathology revealed gastric metastasis from ovarian serous adenocarcinoma. In this case, after cytoreductive surgery, chemotherapy was performed each time a recurrence was diagnosed, and remission was accomplished. She survived for 108 months after the first diagnosis of the metastatic tumor in the stomach. Multimodal treatment of metastatic lesions since the first diagnosis allowed the patient to survive longer than those in previous reports.

• Childhood Kidney Diseases
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• v.19 no.2
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• pp.167-170
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• 2015

Hypereosinophilic syndrome (HES) is characterized by the presense of hypereosinophilia with evidence of target organ damage. We report a patient diagnosed with eosinophilic cystitis and HES. A 7 year old boy had hematuria, dysuria, and increased urinary frequency for 1 day. Laboratory examinations revealed hypereosinophilia (eosinophils, $2,058/{\mu}L$), hematuria, and proteinuria. Abdominal sonography revealed diffuse and severe wall thickening of the bladder. The patient was treated initially with antibiotics. However, his symptoms did not improve after 7 days. A computed tomography scan demonstrated severe wall thickening of the bladder and the hypereosinophilia persisted (eosinophils, $2,985/{\mu}L$). The patient complained of chest discomfort, dyspnea, epigastric pain, and vomiting on hospital day 10. Parasitic, allergic, malignancy, rheumatologic, and immune workups revealed no abnormal findings. Chest X-rays, electrocardiography, and a pulmonary function test were normal; however, the hypereosinophilia was aggravated (eosinophils, $3,934/{\mu}L$). Oral deflazacort was administered. A cystoscopic biopsy showed chronic inflammation with eosinophilic infiltration. The patient's respiratory, gastrointestinal, and urinary symptoms improved after 6 days of steroids, and he was discharged. The eosinophil count decreased dramatically ($182/{\mu}L$). The hypereosinophilia waxed and waned for 7 months, and the oral steroids were tapered and stopped. This case describes a patient diagnosed with eosinophilic cystitis and HES.

• Journal of Chest Surgery
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• v.9 no.2
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• pp.293-297
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• 1976

One mid-esophageal carcinoma underwent esophagogastrectomy using an exclusive right thoracic approach entailing mobilization of the stomach through the esophageal hiatus. 62 year old male farmer was admitted with chief complaints of dysphagia and weight loss of 5 Kg. for 6 months, and regurgitation after soft meal for one week prior to this admission. Preoperative esophagogram revealed stricture with fungating mass at the level of the carina, which was diagnosed as squamous cell carcinoma at the time of esophagoscopic biopsy about 33 cm from incisor. Bronchoscopy revealed no invasive lesion or carinal fixation, and laboratory examinations were excellent for operative intervention. An exclusive right thoracic approach through right 5th rib bed was made for radical esophagectomy, mobilization of the stomach through the esophageal hiatus and primary esophagectomy. Postoperative recovery was uneventful except increased bronchial secretion due to senile emphysema, and follow up for 5 months after esophagectomy revealed good functioning esophagus with mild epigastric fullness after meal. Exclusive right thoracic approach for radical esophagectomy seems to be the procedure of choice in selected cases.

• Journal of Chest Surgery
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• v.38 no.3 s.248
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• pp.233-236
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• 2005

Cardiac hemangioma is an extremely rare benign tumor. A 65 years old woman was admitted due to epigastric and chest pain, After we confirmed cardiac tamponade with right atrial mass by chest CT, we performed surgical resection of the mass and identified hemangioma with capillary endothelial hyperplasia on pathologic examination. Therefore, we report the case with literature review.

• Journal of Chest Surgery
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• v.23 no.2
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• pp.285-298
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• 1990

The records of 67 patients who had been operated as an esophageal cancer during the period from 1973 to 1989 at the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital were reviewed retrospectively. The results were summarized as follows ; The age ranged from 28 years old to 80 years old. The highest incidence was 5th decades, then 6th decades, and the incidence of male was 10 times as the incidence of female[M:F= 10.16: 1]. The locations were lower esophagus 44%, middle esophagus 38.8%, upper esophagus 11.9% and cervical esophagus 4.4% The frequent symptoms were dysphagia [88%], epigastric or substernal pain and discomfort [29.8%], weight loss [20.8%], and laryngeal dryness [1.4%]. The most common interval between the onset of dysphagia and admission was 2-3 months; 82% of patients was within 6 months, The cancer consisted of stage I [3%], stage II [11.9%], stage III[47.6%], and stage IV [33.7%] The resectability of cancer was 67%. The organs of substitute were stomach in 21 cases, right colon 6 cases, and jejunum in 8 CRSCS. The relation between invasion of tumor and lymph node metastasis was analyzed: mucosal involvement: 1 case/2case, muscle invasion; 0/2 full thickness; 4/6, adjacent structure 7/12. Postoperative complications were pneumonia, pleural effusion, hoarseness, mediastinitis, anastomosis site leakage, reoperation due to stenosis, chylothorax, empyema, mechanical ileus, wound infection, meat impaction at anastomosis site, and repair of gastrostomy site leakage. Adjuvant therapies were irradiation [15cases], chemotherapy [14cases], and Bougie dilatation [4 cases],

• The Journal of Pediatrics of Korean Medicine
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• v.27 no.4
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• pp.39-49
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• 2013

Objectives In the theory of Korean medicine, rice straw (RS) has been used effectively as treatments for dyspepsia, diarrhea, enteritis, inflammatory epigastric diseases and various dermatitis. However, the theory has not been studied intensively yet about anti-inflammatory effects for human. This study was to investigate effects of RS for a treatment of allergic contact dermatitis (ACD) induced by 2,4-dinitrochlorobezene (DNCB) in mice. Methods In this experiment, effects of RS were investigated on changes in body weights, dorsum skin thickness, clinical aspects on the dorsum skin, spleen and body weight among these four groups; normal group (NOR), control group (CON), RS spread group (RSS) and RS spread and administer group (RSS+Adm). In addition, the effects on proliferations of splenocytes were also investigated in vitro and in vivo study. Results RSS group and RSS+Adm group showed increasing in body weights, diminished dorsum skin thickness and treated dermatitis on dorsum skin. In RSS+Adm group, spleen weights were lowered significantly compared to CON group. Conclusions In conclusion, these data suggest that RS can decrease symptoms of ACD significantly, and it shows the anti-inflammatory and immunosuppressant effect as well. Therefore, RS can be useful to treat patients with ACD.

• Journal of Yeungnam Medical Science
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• v.13 no.2
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• pp.360-366
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• 1996

Pure primary hepatic rhabdomyosarcoma in adult is very uncommon. There have been only five previous case of primary rhabdomyosarcoma of the adult liver. A case of hepatic rhabdomyosarcoma was diagnosed in a 52 year-old female. She was admitted to the hospital due to the epigastric pain and weight loss. A CT scan of the abdomen showed a large hypodense mass with focal calcification occupies most of the both lobes of the liver. The liver biopsy showed massive liver tumor composed entirely of oval shaped cells showing light microscopic and immunohistochemical evidence of rhabdomyoblastic differentiation. We report a case of hepatic rhabdomyosarcoma with review of literature.

• Journal of Yeungnam Medical Science
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• v.28 no.2
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• pp.165-172
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• 2011

Gastric glomus tumor is a rare mesenchymal tumor that originates from modified smooth muscle cells of the glomus body. Glomus tumors are commonly observed in peripheral soft tissue, such as dennis or subungal region, but rarely in the gastrointestinal tract. A 39-year-old woman was admitted due to epigastric soreness. Upper gastrointestinal endoscopy revealed a subepithelial mass measuring 3.5 cm with central ulceration at the lesser curvature-posterior wall of the antrum. Characteristically, contrast enhanced abdominal computed tomography scan demonstrated high enhancement of the submucosal mass up to the same level of the abdominal aorta in the arterial phase; this enhancement persisted to delayed phase. Due to the risk of bleeding and malignancy, wedge resection of the submucosal tumor was performed. Histologic findings were compatible with a glomus tumor.

• The Korean Journal of Pain
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• v.26 no.4
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• pp.396-400
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• 2013

Conventional transcrural CPB via the "walking off" the vertebra technique may injure vital organs while attempting to proximally spread injectate around the celiac plexus. Therefore, we attempted the CT-simulated fluoroscopy-guided transdiscal approach to carry out transcrural CPB in a safer manner, spreading the injectate more completely and closely within the celiac plexus area. A 54-year-old male patient with pancreatic cancer suffered from severe epigastric pain. The conventional transcrural approach was simulated, but the needle pathway was impeded by the kidney on the right side and by the aorta on the left side. After simulating the transdiscal pathway through the T11-12 intervertebral disc, we predetermined the optimal insertion point (3.6 cm from the midline), insertion angle (18 degrees), and advancement plane, as well as the proper depth. With the transdiscal approach, we successfully performed transcrural CPB within a narrow angle, and the bilateral approach was not necessary as we were able to achieve the bilateral spread of the injectate with the single approach.