• Advances in pediatric surgery
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• v.7 no.1
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• pp.54-58
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• 2001

Slide tracheoplasty. as a treatment for congenital tracheal stenosis, has been recently reported to have good results and quite a number of advantages as compared with conventional tracheoplasties. The aim of this study is to report a new surgical technique modified from the slide tracheoplasty. "the slide cricotracheoplasty" for the congenital cricotracheal stenosis. A girl was born by Cesarean section and the diagnosis of esophageal atresia (Gross type C) and cricotracheal stenosis (30 % of total length of trachea) was established. Esophageal atresia was successfully corrected at the 8th day of life. At the 31st day of life, corrective surgery for congenital cricotracheal stenosis. the slide cricotracheoplasty. was performed with success. Slide cricotracheoplasty is almost the same procedure as slide tracheoplasty except for two technical features. First the cricoid cartilage was split on its anterior surface. Second the split cricoid cartilage was fixed to pre vertebral fascia to maintain enough space to accommodate the sliding caudal segment of trachea because of the stiffness of the cricoid cartilage. We believe that the sliding cricotracheoplasty is a new surgical technique for congenital cricotracheal stenosis that has similar results and advantages as the sliding tracheoplasty.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.13
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• pp.5337-5341
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• 2015

Background: Individual susceptibility to cancer has been attributed to polymorphisms in xenobiotic metabolizing genes. To evaluate the association of the Leu432Val polymorphism of cytochrome P4501B1 (CYP1B1) with esophageal squamous cell carcinoma (ESCC), we conducted a case control study in Kashmir, India, an area with a relatively high incidence of ESCC. Materials and Methods: We recruited 404 histopathologically confirmed ESCC cases, and an equal number of controls, individually matched for sex, age and district of residence to respective cases. Information was obtained on various dietary, lifestyle and environmental factors in face to face interviews, using a structured questionnaire, from each subject. Genotypes were analysed by polymerase chain reaction, restriction fragment length polymorphism and sequencing of randomly selected samples. Conditional logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs). Results: Among the three possible variants, we did not find any Leu432Leu genotype of CYP1B1 in the study population and the genotypic distribution of Val432Val and Leu432Val carriers was nearly equal in both cases (89.6% and 10.4%) and controls (88.9% and 11.1%) respectively. We did not find any risk associated with this polymorphism in the current study (OR = 0.64; 95% CI: 0.55 - 1.64). Conclusions: The study indicates that (Leu432Val) polymorphism of CYP1B1, is not associated with ESCC risk. However, replicative studies with larger sample size are needed to substantiate the findings.

• Journal of Chest Surgery
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• v.27 no.2
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• pp.140-147
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• 1994

Reconstruction of the pharynx and cervical esophagus presents a tremendous challenges to surgeons. Over the past 2 years[1990, Dec.-1993, Jun], the free jejunal graft has been performed in 17 cases in Korea Cancer Center Hospital.The indications of this procedures were almost malignant neoplasms involving neck and upper aero-digestive tract; Hypopharyngeal cancer[12 cases, including 2 recurrent cases], laryngeal cancer[2 cases], thyroid cancer[2 cases, including 1 recurrent case], cervical esophageal cancer[1 case]. There were fifteen men and two women, and the mean age was 59.6 years. The anastomosis site of jejunal artery were common carotid artery[16 cases] or external carotid artery[1 case] and that of jejunal vein were internal jegular [15 cases] or facial[1 case] and superior thyroid vein[1 case]. The length of jejunal graft was from 9 cm to 17 cm[mean 13 cm] and the mean ischemic time was 68 minutes. There was one hospital mortality which was irrelevant to procedures[variceal bleeding] and one graft failure[1/16]. Other postoperative complications were neck bleeding or hematoma[3 cases], abdominal wound infection or disruption[5 cases], anastomosis site leakage[1 case], pneumonia[2 cases], graft vein thrombosis[1 case], and food aspiration[1 case]. The function of conduit was excellent and ingestion of food was possible in nearly all cases. Postoperative adjuvant radiation therapy was also applicable without problem in 7 cases. During follow-up periods, the anastomosis site stenosis developed in four patients, and the tracheal stoma was narrowed in one case but easily overcome with dilation. In conclusion, we think that the free jejunal graft is one of the excellent reconstruction methods of upper digestive tract, especially after radical resection of malignant neoplasm in neck with a high success rate and low mortality and morbidity rate.

• Journal of Chest Surgery
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• v.35 no.4
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• pp.296-302
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• 2002

The classic approach for esophagectomy is via the combined thoracic and abdominal approach. Controversy exists whether patients with esophageal carcinoma are best managed with Ivor-Lewis esophagectomy(ILO) as combined thoracic and abdominal approach or transhiatal esophagectomy(THO). The THO approach is known to be superior with respect to operative time, severity of leak, morbidity/mortality, and length of stay, but may represent an inferior cancer operation as a result of survival disadvantage due to inadequate mediastinal clearance compared with ILO. Accordingly, we reviewed the results of our esophageal resections to compare these outcome parameters for each operative approach. Material and Method: From January 1993 to July 2001, We performed a retrospective review of all esophagectomies performed at Keimyung University Dongsan ·Medical Center; 27 underwent THO, and 45 underwent ILO Result: The two groups were comparable in terms of age, sex, and stage of the disease. Mean tumor length and mean operative time were 3.81cm and 354 minutes for THO versus 5.31cm and 453 minutes for ILO, respectively (p<0.01 and p<0.001). Respiratory complications were 11.1% for THO versus 35.6% for ILO(p<0.05). Hospital mortality was 11.1% for THO versus 22.2% for ILO. There were no significant differences between THO and ILO with respect to other types of complications, amount of blood transfusion, leak and stricture rates, and hospital stay. Overall long-term survival at 5 years was 37%, respectively. Conclustion: There was no significant difference in long-term survival of patients of both operative approach. ILO had significant difference in respiratory complications associated with hospital mortality. Hence, THO is a valid alternative to ILO for well selected patients. And either approach appears to be acceptable depending on the surgeons, preferences and experiences.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.22 no.5
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• pp.241-265
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• 1989

The purpose of present study is to describe the taxonomy and early life history of Korean pomfrets, genus Pampus. Egg diameter varied from $0.83\~1.27mm\;and\;1.05\~1.41mm$ in P. argenteus and P. echinogaster respectively. Larvae of P. echinogaster of 16.5 mm in total length has full number of fin rays and enter the juvenile period. The egg is matured at 185.0 mm in total length in P. argenteus and at 95.5 mm in total length in P. echinogaster. P. echinogaster is ossified from jaw bone at $8.5\~10.0mm$ in to1 length and followed by ossification of vertebrae and visceral skeleton. P. argenteus and P. echinogaster are distinguished by the morphology of jaw, fin and isthmus. In P. argenteus, wavy ridges extends over the upper part of pectoral fin and gill membrane is broadly united to isthmus, while in P. echinogaster the ridges are limited to the base of pectoral fin and gill membrane reaching isthmus. These Pampus spp. are easily distinguished based on internal features, such as number of vertebrae, gill raker, pyloric caeca, epipleural bone, esophageal sat and length of intestine.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.32 no.5
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• pp.642-648
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• 1999

The digestive tract of the black sea bream, Acanthopagrus schlegeli is composed of esophagus, stomach, intestine, anus and four or five pyloric caeca. Pyloric caecum is a blind sac in shape and originated from pyloric portion of the stomach. Relative length of But (RLG), that is length of digestive tract to standard length, is 1.04 (n=10). Histological layer of the digestive tract is composed of serous membrane, muscular layer, undeveloped submucosal layer and mucosal layer. The mucosal folds of the esophagus are regular branched form, Esophageal muscularis mucosae is well-developed. Mucosal epithelial layer is composed of cuboidal or columnar epithelium and mucous secretory cell. Microvilli are absent in the free surface of mucosal epithelium. The mucosal folds of the stomach are regular unbranched form. The stomach has a well-developed muscular layer and muscularis mucosae. Microvilli are present in the free surface of mucosal surface epithelium. The fundic portion of the stomach have a well-developed gastric gland and more numerous secretory granules than the other parts. The mucosal folds of the pyloric caeca and the intestine are irregular branched form, Intestine is divided into the anterior, mid and posterior intestines with length of mucosal folds and histological features, Posterior intestine has a more developed striated border and goblet cells than the other parts. Mid intestine has a more abundant absorptive cells than the other parts in the intestine and pyloric caeca.

• Journal of Korean Neurosurgical Society
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• v.47 no.3
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• pp.174-179
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• 2010

Objective : Cricothyrotomy and tracheostomy are performed by physicians in various disciplines. It is important to know the comprehensive anatomy of the laryngotracheal region. Hemorrhage, esophageal injury, recurrent laryngeal nerve injury, pneumothorax, hemothorax, false passage of the tube and tracheal stenosis after decannulation are well known complications of the cricothyrotomy and tracheostomy. Cricothyrotomy and tracheostomy should be performed without complications and as quickly as possible with regards the patients' clinical condition. Methods : A total of 40 cadaver necks were dissected in this study. The trachea and larynx and the relationship between the trachea and larynx and the surrounding structures was investigated. The tracheal cartilages and annular ligaments were counted and the relationship between tracheal cartilages and the thyroid gland and vascular structures was investigated. We performed cricothyrotomy and tracheostomy in eleven cadavers while simulating intensive care unit conditions to determine the duration of those procedures. Results : There were 11 tracheal cartilages and 10 annular ligaments between the cricoid cartilage and sternal notch. The average length of trachea between the cricoid cartilage and the suprasternal notch was 6.9 to 8.2 cm. The cricothyroid muscle and cricothyroid ligament were observed and dissected and no vital anatomic structure detected. The average length and width of the cricothyroid ligament was 8 to 12 mm and 8 to 10 mm, respectively. There was a statistically significant difference between the surgical time required for cricothyrotomy and tracheostomy (p < 0.0001). Conclusion : Tracheostomy and cricothyrotomy have a low complication rate if the person performing the procedure has thorough knowledge of the neck anatomy. The choice of tracheostomy or cricothyrotomy to establish an airway depends on the patients' clinical condition, for instance; cricothyrotomy should be preferred in patients with cervicothoracal injury or dislocation who suffer from respiratory dysfunction. Furthermore; if a patient is under risk of hypoxia or anoxia due to a difficult airway, cricothyrotomy should be preferred rather than tracheostomy.

• Journal of Yeungnam Medical Science
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• v.2 no.1
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• pp.253-258
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• 1985

The congenital tracheoesophageal fistula without atresia of the esophagus is considered a rare variant, and the literature concerned to the tracheoesophageal fistula without atresia, is little in adult especially. The 22-year-old male was admitted to Yeungnam University Hospital with his chief complaints of weight loss (6kg/6 months), abdominal discomfort, and intermittent coughing. The diagnosis was made by the endoscopy and esophagography. The fistula was 1.5cm in diameter, 0.5cm in length. The level was around second thoracic vertebra. The operation was performed transpleurally through the right third intercostal space and the fistula was secured with interrupted silk suture after division. The fibrotic adhesion was seen around the tracheoesophageal fistula. The postoperative course was uneventful, and postoperative esophagogram revealed ho extraluminal leakage. Herewith we report this unusual case of isolated tracheo-esophageal fistula with review of literatures.

• Korean Journal of Bronchoesophagology
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• v.3 no.1
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• pp.61-69
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• 1997

A total of 55 patients underwent surgical managements for postintubation tracheal stenosis from July 1975 through March 1997. All but 8 had received ventilatory assistance. The patients had S cuff lesions, 17 stoma lesions, 7 at both levels, 5 at subglottic lesions. Thirty two patients underwent the sleeve tracheal resection and end-to-end anastomosis. Five patients performed a wedge resection and end-to-end anastomosis. Twenty two patients received the Montgomery T-tube for relief of airway obstruction. Simple excision of granulation tissue was done in 7 patients. Rethi procedures(anterior division of cricoid cartilage, partial wedge resection of lower thyroid cartilage and T-tube molding) were performed in 2 subglottic stenosis patients. And the other subglottic patient was received permanent tracheal fenestration at 1975. The tracheoesophageal fistula patient was done sleeve tracheal resection and end-to-end anastomosis with interrupted double layer closure of esophageal fistula site. Cervical approach was used in 49 cases, cervicomediastinal in 13 cases and median stemotomy In 6 cases. Techniques for obtaining tension-free anastomosis included a cervical neck flexion(15-30$^{\circ}$) in all sleeve resection patients and laryngeal release in one. The length of resection was 1.5 to 5.0 on A total of 41 patients(74.5%) had good(24 patients) or satisfactory(17 patients) results. But in ten cases, the restenosis of anastomosis site which is the most common complication was developed Two of them underwent a second reconstruction and 8 patients required T-tube insertion for airway maintenance. Three patients(5.4%) died. The causes of death were tracheo-innominate artery fistula(2) and sudden obstruction of airway(1).

• Radiation Oncology Journal
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• v.25 no.4
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• pp.193-200
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• 2007

Purpose: This study evaluated the pretreatment expression patterns of MDM2, p53, and pRb proteins to determine if the expression patterns could predict the outcome of concurrent chemoradiotherapy (CCRT) for esophageal squamous cell carcinoma and aid in the decisions for the selection of treatment modalities. Materials and Methods: Fifty-one patients that were treated with definitive chemoradiotherapy for stage $I{\sim}IVa$ esophageal squamous cell carcinoma were selected for this study. Radiotherapy was administered with daily $1.8{\sim}2\;Gy$ fractions up to a median dose of 54 Gy for primary tumors, and with four cycles of cisplatin/5-fluorouracil chemotherapy that was administered every 4 weeks, the first two cycles of which were administered concurrently with radiotherapy. Expression of MDM2, p53, and pRb was investigated by immunohistochemical analysis using pretreatment biopsy specimens. Results: MDM2, p53, and pRb were detected with high immunoreactivity in 19.6%, 27.5%, and 66.7% of the patients, respectively. However, there was no significant correlation between expression of these factors and clinical outcome. By the use of multivariate analysis with nine covariates-age, tumor location, tumor length, stage, pathological response, clinical response, MDM2 expression, p53 expression, and pRb expression, only pathological response and stage were significant factors for cause-specific survival. Conclusion: Expression of MDM2, p53, and pRb was not found to be clinically significant for predicting outcomes after CCRT in this study. Further studies with a larger patient population and longer follow-up periods are needed to re-evaluate the expression pattern and to identify new predictors for CCRT response.