• Journal of Gastric Cancer
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• v.16 no.2
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• pp.120-124
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• 2016

Primary squamous cell carcinoma (SCC) of the stomach is a very rare disease. However, the pathogenesis, clinical characteristics, and prognosis of gastric SCC are controversial and remain to be elucidated. Herein, we report a case of primary gastric SCC of the remnant stomach after subtotal gastrectomy. A 65-year-old man was admitted to our hospital due to epigastric discomfort and dizziness. He had undergone subtotal gastrectomy 40 years previously for gastric ulcer perforation. Endoscopy revealed a normal esophagus and a large mass in the remnant stomach. Abdominal computed tomography revealed enhanced wall thickening of the anastomotic site and suspected metachronous gastric cancer. Endoscopic biopsy revealed SCC. Total gastrectomy was performed with Roux-en-Y esophagojejunostomy. A 10-cm tumor was located at the remnant stomach just proximal to the previous area of anastomosis. Pathologic examination showed well-differentiated SCC extended into the subserosa without lymph node involvement (T3N0M0). The patient received adjuvant systemic chemotherapy with 6 cycles of 5-FU and cisplatin regimen, and he is still alive at the 54-month follow-up. According to the treatment principles of gastric cancer, early detection and radical surgical resection can improve the prognosis.

• Journal of Gastric Cancer
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• v.10 no.2
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• pp.69-74
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• 2010

Purpose: Laparoscopic gastrectomy has been common treatment modality for gastric cancer. But, most surgeons tend to perform laparoscopy-assisted distal gastrectomy using epigastric incision. Delta-shaped anastomosis is known as intracorporeal gastroduodenostomy, but it is technically difficult and needed many staplers. So we tried to find simple and economical method, here we report on the results of liner-shaped gastroduodenostomy in totally laparoscopic distal gastrectomy. Materials and Methods: We retrospectively reviewed the medical records of 25 patients who underwent totally laparoscopic distal gastrectomy using liner-shaped anastomosis at School of Medicine, Ajou University between January to October 2009. The indication was early gastric cancer as diagnosed by preoperative workup, the anastomoses were performed by using laparoscopic linear stapler. Results: There were 12 female and 13 male patients with a mean age of $55.6{\pm}11.2$. The following procedures were performed 14 laparoscopic gastrectomies, 11 robotic gastrectomies. The mean operation time was $179.5{\pm}27.4$ minutes, the mean anastomotic time was $17.5{\pm}3.4$ minutes. The mean number of stapler cartridges was $5.6{\pm}0.8$. Postoperative complication occurred in one patient, anastomotic stenosis, and the patient required reoperation to gastrojejunostomy. The mean length of postoperative hospital stay was $6.7{\pm}1.0$ days except the complication case, and there was no case of conversion to open procedure and postoperative mortality. Conclusions: Linear-shaped gastroduodenostomy in totally laparoscopic distal gastrectomy is technically simple and feasible method.

• Biomolecules & Therapeutics
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• v.23 no.4
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• pp.350-356
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• 2015

Functional dyspepsia (FD) is a prevalent idiopathic upper gastrointestinal (GI) disorder characterized by diverse symptomatology including epigastric pain or discomfort, postprandial fullness, and early satiety. Although its pathophysiological mechanisms have not yet been fully established, the available studies suggest that the etiology of FD is invariably multifactorial. Benachio-F$^{(R)}$ (BF) is a proprietary liquid formulation of 7 herbal extracts that has been proposed to address this multifactorial etiology using multi-drug phytotherapy. The pharmacological effects of BF, in comparison with those of two other herbal products (Whalmyungsu$^{(R)}$; WM and Iberogast$^{(R)}$; IB) were evaluated in rats. In a laparotomy-induced rat model of delayed GI transit, BF significantly accelerated the delayed gastric emptying caused by morphine, apomorphine, and cisplatin, and also significantly increased mean gastric transit, as compared to the control animals. BF markedly increased gastric accommodation in rats and produced higher gastric volume values than did the control treatment. The effects of BF were generally comparable or superior to those of WM and IB in these models. Furthermore, BF significantly stimulated biliary flow, as compared to the control treatment. These results indicated that BF might have great potential as an effective phytotherapeutic agent capable of reducing GI symptoms and increasing quality of life in FD patients.

• Pediatric Infection and Vaccine
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• v.25 no.1
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• pp.54-59
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• 2018

Pleural paragonimiasis is uncommon in the pediatric population and therefore can be challenging to diagnose. This is a case of a 6-year-old girl with pleural effusion who had been having intermittent persistent epigastric pain and erythematous rash on the face, hands, and arms for 6 months. Exudative pleural effusion with prominent eosinophils and serum eosinophilia were observed. As patient showed high immunoglobulin M (IgM) titers against Mycoplasma pneumoniae, she was treated with antibiotics; however, the pleural effusion did not improve during hospitalization. Despite showing negative stool ova and cyst results, patient's serum and pleural effusion were positive for Paragonimus westermani-specific IgGs on enzyme-linked immunosorbent assay. Respiratory symptoms, pleural effusion, and skin symptoms improved after praziquantel treatment.

• Archives of Reconstructive Microsurgery
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• v.7 no.1
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• pp.15-19
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• 1998

Microsurgical free-tissue transfer has allowed surgeons to salvage injured limbs but choosing appropriate healthy recipient vessels has proved to be a difficult problem. Retrograde flow flaps are established in island flaps. Retrograde flow anastomosis could prevent the possible kinking and twisting of the arterial anastomosis. By not interrupting the proximal blood flow to the fracture or soft tissue defect site, the compromise of fracture or wound healing might be prevented. We wished to estabilish an animal model in rat for a retrograde arterial flow based free flap. Nembutal-anesthetized male rats; weighing 250 to 300 gm, were used. The femoral artery and common carotid artery were exposed and divided. The systemic and retrograde arterial pressure were quantified by utilizing a parallel tubing system connected with peripheral arterial line. In this study, the retrograde flow was not pulsatile and the retrograde arterial pressure was 64-65mmHg, with a mean arterial pressure of 106-109mmHg. An epigastiic skin flap, measuring $3{\times}3cm$, was raised with its vascular pedicle. The epigastric free flap was transfered in the same rat from femoral vessels to carotid vessels in end to end fashion. We anastomosed the donor arteries to the distal parts of the divided recipient arteries and the donor veins to the proximal parts of the recipient veins. Twelve experiments were performed and the transplantations succeeded in 75 percent of them. In the remaining 25 percent, the experiments failed due to thrombosis at the site of anastpmosis, or other causes. This animal model represents an excellent example of retrograde arterial flow free flap transfer that is reliable.

• Journal of Yeungnam Medical Science
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• v.31 no.2
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• pp.139-143
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• 2014

Spontaneous intramuscular hematoma of the abdominal wall is a rare condition characterized by acute abdominal pain. It is often misdiagnosed as a surgical condition. It used to be associated with risk factors such as coughing, pregnancy, and anticoagulant therapy. Most cases of abdominal wall hematomas were rectus sheath hematomas caused by the rupture of either the superior or inferior epigastric artery, but spontaneous internal oblique hematoma was extremely rare. In this report, we present a case of spontaneous internal oblique hematoma in a 69-year-old man with non-dialysis chronic kidney disease who was taking cilostazol. The patient complained of abrupt abdominal pain with a painful palpable lateral abdominal mass while sleeping. The abdominal computed tomography showed an 8 cm-sized mass in the patient's left internal oblique muscle. The administration of cilostazol was immediately stopped, and the intramuscular hematoma of the lateral oblique muscle disappeared with conservative management.

• Journal of Yeungnam Medical Science
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• v.26 no.1
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• pp.63-69
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• 2009

The incidence of coexisting hyperparathyroidism and empty sella syndrome is rare and the etiology end incidence of their coexistence is not known. The association of hyperparathyroidism and the empty sella syndrome may be related to multiple endocrine neoplasia (MEN) syndrome due to a genetic disorder. We experienced a rare case of hyperparathyroidism presenting as acute pancreatitis combined with empty sella. We report here a 37-year old female who manifested epigastric pain because of acute pancreatitis. She had hypercalcemia due to parathyroid adenoma. A pituitary gland was not visible in the sella turcica on MRI scans. On genetic analysis, she did not show a mutation of the MENIN gene. Empty sella is thought to be a coincidental finding with hyperparathyroidism.

• Journal of Sasang Constitution and Immune Medicine
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• v.20 no.3
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• pp.51-57
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• 2008

1. Objective This study aims to establish the concept and classification of the Janggyeol(藏結) pathology introduced in the Sasang Constitutional Medicine literature. 2. Methods Different editions of Dongui suse bowon, including the Gabo version and the Sinchuk version, were compared for differences and similarities in the concept, symptomology, pathology, and therapeutics concerning the Soeumin Janggyeol disease. 3. Results and Conclusion (1) In the Gabo edition, Janggyeol(藏結) is introduced in the "Soeumin Interior Stomach Disease" section and the "Soeumin Summaries" section. However, instead of being included in the interior-based pathology, it is proposed as an independent disease category that is similar to and yet separate from the Taeeumbyeong Simhabiman (epigastric congestion) variations of Sugyeolhyung and Hansilgyeolhyung. Further, passages from the "Soyangin Summaries" section outline the underlying pathology in detail to show that this symptomatic pattern can be included in the exterior-based pathology. (2) In the Sinchuk edition, Janggyeol(藏結) is introduced in the "Soeumin Cold-based Stomach Interior-Cold Disease" section. Similarly to the Gabo classification, it is proposed as an independent disease category not necessarily included in the interior-based pathology that can be compared to the Taeeumbyeong Simhabiman(太陰人 心下 滿) category. The detailed pathological explanations in the "Soyangin Summaries" section suggest that this disease pattern is included in the exterior-based pathology. (3) Janggyeol(藏結) can be understood as a Taeyangbyeong Wigasil(太陽病胃家實) pathology in the Gabo edition and as a Taeyangbyeong Wigasil(太陽病胃家實) pathology in the Sinchuk edition.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.2
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• pp.157-160
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• 2018

Chronic silica nephropathy has been associated with tubulointerstitial disease, immune-mediated multisystem disease, chronic kidney disease, and end-stage renal disease. On the other hand, acute intentional exposure is extremely rare. The authors' experienced a 44-year-old man who took rapid cement hardener (sodium silicate) in a suicide attempt whilst in a drunken state. He visited the emergency department approximately 1 hour after ingestion. Information on the material was obtained after 3 L gastric lavage. The patient complained of a sore throat, epigastric pain, and swollen to blood tinged vomitus. Proton pump inhibitors, hemostats, steroid, and fluids were administered. Nine hours after ingestion, he was administered 200 mL hematochezia. Immediately after, a gas-troenterologist performed an endoscopic procedure that revealed diffuse hyperemic mucosa with a color change and variable sized ulceration in the esophagus, whole stomach, and duodenal $2^{nd}$ portion. Approximately 35 hours later, persistent oligouria and progressive worsening of the renal function parameters (BUN/Cr from 12.2/1.2 to 67.5/6.6 mg/dL) occurred requiring hemodialysis. The patient underwent 8 sessions of hemodialysis for 1 month and the BUN/Cr level increased to 143.2/11.2 mg/dL and decreased to 7.6/1.5 mg/dL. He was discharged safely from the hospital. Follow up endoscopy revealed a severe esophageal stricture and he underwent endoscopic bougie dilatation. Acute cement hardener (sodium silicate) intoxication can cause renal failure and strong caustic mucosal injury. Therefore, it is important to consider early hemodialysis and treatment to prevent gastrointestinal injury and remote esophageal stricture.

• The Journal of Internal Korean Medicine
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• v.42 no.3
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• pp.431-436
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• 2021

Objectives: This study aims to determine whether Korean medicine improves epigastric symptoms of biliary dyskinesia without unfavorable side effects. Methods: A 37-year-old woman who had chronic dyspepsia with intermittent back pain had gallstone-like sludge identified on ultrasound scan. We administered Saenggan-tang and used ultrasound examination to observe the changes in symptoms such as dyspepsia, the occurrence of back pain, and gallbladder contraction. Results: After 2 months of taking Saenggan-tang, symptoms such as dyspepsia, abdominal pain, headache, and back pain improved. In addition, biliary motility improvement was evaluated by ultrasonography. Moreover, there was no occurrence of any side effects. Conclusion: This study suggests that Korean medicine might be effective for managing biliary dyskinesia.