• Journal of Gastric Cancer
• /
• v.5 no.1
• /
• pp.1-9
• /
• 2005

Purpose: The debate is still on-going as to whether a transthoracic esophagectomy (TTE) or a transhiatal esophagectomy(THE) is the proper treatment for patients with cardia and esophageal cancers. This study tries to demonstrate and assess the efficacy and the validity of both surgeries. Materials and Methods: In a retrospective study, data from 52 cases of patients with esophageal and/or cardia cancer who received a surgical operation during the last decade were analyzed. Results: A TTE was done in 20 cases and a THE in 32 cases. The average times for the operations were 558.0 min for a TTE and 451.7 min for a THE (P>0.05). The estimated blood loss was 1,825.0 ml in a TTE and 1459.4 ml in a THE (P>0.05). The amounts of transfusion during the operations were 3.9 units in a TTE and 2.6 units in a THE (P<0.05). Post-operative complications occurred in 15 cases of TTE and 23 cases of THE. The average length of stay in the hospital was 25.6 days for a TTE and 20.6 days for a THE. The 5-year survival rate was $10\%$ for TTE patients and $28\%$ for THE patients (P>0.05). Conclusion: For most factors, including morbidity and mortality, there was no statistically significant difference between a TTE and a THE. However, a THE is expected to be more convenient, leading to a shorter operative duration, a shorter post-operative hospitalization and lesser amounts of hemorrhage and transfusion. Hence, the THE may be a more valid or efficient surgical method for those patients with cardia and esophagus cancer who require a resection of the esophagus. (J Korean Gastric Cancer Assoc 2005;5:1-9)

• Korean Journal of Ichthyology
• /
• v.10 no.1
• /
• pp.115-127
• /
• 1998

The digestive tract of the rockfish, Sebastes schlegeli composed of pharynx, esophagus, stomach, intestine, anus and ten or eleven pyloric caeca. Pyloric caeca is blind sac of banana shape, and that is originated from pyloric portion of the stomach. The relative length of gut(RLG), that is length of digestive tract to standard length, is about 1.56(n=10). Esophageal muscularis consists of thin outer layer of longitudinal muscle and thick inner layer of circular muscle. Mucosal epithelium consists of columnar epithelium with short microvilli and contains numerous mucous secretory cell. The mucosal folds of the stomach are regular, and the muscularis consists of longitudinal, oblique and circular muscle layer. The chief cell of the gastric gland have a tubular mitochondria, endoplasmic reticula and numerous secretory granules in electron-dense. However, parietal cell contains small mitochondria, endoplasmic reticula and vacuoles in low electron density. Mucosal epithelium of the pyloric caeca and intestine composed of columnar epithelium, goblet cell, rodlet cell and dark cell. Columnar absorptive cell in the pyloric caeca and intestine contains well developed mitochondria, endoplasmic reticula, vesiculated granules in high electron density, pinocytotic vesicles and multivesicular body. Rodlet cell have a well developed cytoplasmic capsule and the endoplasmic reticula in the cytoplasm. Dark cell showing a high electron density in the cytoplasm and contains well developed mitochondria. Columnar epithelium of the intestine have a well developed intercellular junction and the microvilli which contains actin filament originated from the cytoplasm. Mucosal epithelium of the intestine have a longer microvilli and more abundant goblet cells than in the pyloric caeca.

• Radiation Oncology Journal
• /
• v.25 no.2
• /
• pp.79-92
• /
• 2007

[ $\underline{Purpose}$ ]: For the first time, a nationwide survey in the Republic of Korea was conducted to determine the basic parameters for the treatment of esophageal cancer and to offer a solid cooperative system for the Korean Pattern of Care Study database. $\underline{Materials\;and\;Methods}$: During $1998{\sim}1999$, biopsy-confirmed 246 esophageal cancer patients that received radiotherapy were enrolled from 23 different institutions in South Korea. Random sampling was based on power allocation method. Patient parameters and specific information regarding tumor characteristics and treatment methods were collected and registered through the web based PCS system. The data was analyzed by the use of the Chi-squared test. $\underline{Results}$: The median age of the collected patients was 62 years. The male to female ratio was about 91 to 9 with an absolute male predominance. The performance status ranged from ECOG 0 to 1 in 82.5% of the patients. Diagnostic procedures included an esophagogram (228 patients, 92.7%), endoscopy (226 patients, 91.9%), and a chest CT scan (238 patients, 96.7%). Squamous cell carcinoma was diagnosed in 96.3% of the patients; mid-thoracic esophageal cancer was most prevalent (110 patients, 44.7%) and 135 patients presented with clinical stage III disease. Fifty seven patients received radiotherapy alone and 37 patients received surgery with adjuvant postoperative radiotherapy. Half of the patients (123 patients) received chemotherapy together with RT and 70 patients (56.9%) received it as concurrent chemoradiotherapy. The most frequently used chemotherapeutic agent was a combination of cisplatin and 5-FU. Most patients received radiotherapy either with 6 MV (116 patients, 47.2%) or with 10 MV photons (87 patients, 35.4%). Radiotherapy was delivered through a conventional AP-PA field for 206 patients (83.7%) without using a CT plan and the median delivered dose was 3,600 cGy. The median total dose of postoperative radiotherapy was 5,040 cGy while for the non-operative patients the median total dose was 5,970 cGy. Thirty-four patients received intraluminal brachytherapy with high dose rate Iridium-192. Brachytherapy was delivered with a median dose of 300 cGy in each fraction and was typically delivered $3{\sim}4\;times$. The most frequently encountered complication during the radiotherapy treatment was esophagitis in 155 patients (63.0%). $\underline{Conclusion}$: For the evaluation and treatment of esophageal cancer patients at radiation facilities in Korea, this study will provide guidelines and benchmark data for the solid cooperative systems of the Korean PCS. Although some differences were noted between institutions, there was no major difference in the treatment modalities and RT techniques.

• Korean Journal of Veterinary Research
• /
• v.27 no.2
• /
• pp.157-166
• /
• 1987

The distribution of hepatic veins within the liver in 28 Korean native cattles were observed. Vinylite solution was injected into hepatic veins of seventeen specimens for cast preparation. The angiography was prepared in eleven specimens by injecting 30% barium sulfate solution into hepatic veins, and then radiographed on a X-ray apparatus (Shimadzu 800 MA 120 Kvp). 1. About two thirds or three quarters of the circumference of the Vena cava caudalis was embedded in the liver. The embedded portion was about 14~19cm in length. 2. The principal branches of the hepatic veins were Vena hepatica sinistra, Vena hepatica media, Vena hepatica dextra and Vena hepatica dorsolateralis; the three main hepatic veins were Vena hepatica sinistra, Vena hepatica media and Vena hepatica dextra. 3. The Vena hepatica sinistra joins the Vena cava caudal is near the esophageal impression of the liver. It gave off three or five branches to the left lobe. 4. The Vena hepatica media joined at the Vena cava caudalis close to the Vena hepatica sinistra. In all cases, Vena hepatica media opened near the diaphragmatic part of the liver than the Vena hepatica sinistra. It ran obliquely through the medial part of right lobe and quadrate lobe, giving off branches on each side. 5. The Vena hepatica dextra consisted of one(25 cases, 89.29%) or two separate veins(3 cases, 10.71%), joining to the Vena cava caudalis between the right and caudate lobes. 6. The flap of membranous tissue covered the dorsal half of the entrance of the Vena hepatica sinistra, media et dextra into the Vena cava caudalis. 7. The vestige of the ductus venosus persisted in the 12~18 months old cattles. 8. The anastomosis was observed in the intralobar and interlobar areas.

• Radiation Oncology Journal
• /
• v.3 no.2
• /
• pp.123-129
• /
• 1985

A retrospective analysis was undertaken of 46 patients who were referred with squamous cell carcinoma of the esophagus during the period of March 1979 through October 1982, and who were treated by curative radiotherapy in the Department of Therapeutic Radiology Seoul National University Hospital. The overall two-year actuarial survival rate was $20\%$ Survival was analyzed with respect to the site of the cancer, its size, radiation dose, and degree of response. Patients with the best two-year survival rate are the ones who had the tumor no of more than 5cm in length $(39.3\%)$ or confined to the upper third of the esophagus $(29.5\%)$. An optimum radiation dose ranged from 1600 to 1700 rets. Patients to complete response had $42.4\%$ of two-year actuarial survival, but those to no response had $0\%$ of survival.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.11
• /
• pp.6411-6413
• /
• 2013

Adenocarcinoma of esophagus (AE) is a complex disease, affected by a variety of genetic and environmental factors. Much evidence has shown that the MutY glycosylase homologue (MUTYH) plays a key role in the pathogenesis of many cancers. However, there have been no reports on influence on AE in the Han Chinese population. The objective of this study was to investigate this issue. A gene-based association study was conducted using three single nucleotide polymorphisms(SNPs) reported in previous studies. The three SNPs (rs3219463, rs3219472, rs3219489) were genotyped in 207 unrelated AE patients and 249 healthy controls in a case-control study using polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). The results revealed that the genotype distribution of rs3219472 differed between the case and control groups (OR=1.66,95%CI=1.11-2.48, P=0.012), indicating that an association may exist between MUTYH and AE. These findings support a signifcant role for MUTYH in AE pathogenesis in the Han Chinese population.

• Advances in pediatric surgery
• /
• v.14 no.1
• /
• pp.27-36
• /
• 2008

Fundoplication is a common surgical procedure for gastroesophageal reflux disease (GERD). Recently the procedure has been performed with increased frequency laparoscopically. The aim of this study is to review our 11 years experience with fundoplication in infants and children. From October 1994 to December 2005, 59 fundoplications in 55 patients were performed at Sungkyunkwan University Samsung Medical Center. Medical records and laboratory results of these children were retrospectively reviewed for sex, age, symptoms and signs, coexisting disease, diagnostic methods, treatment modalities and length of operative time. Open fundoplication was performed in 41 cases and laparoscopic fundoplication in 18 cases. Simultaneous gastrostomy was done in 27 cases. Recurrent GERD symptom occurred in four patients (7.2 %) within 2 years after first fundoplication and all 4 patients had re-do fundoplication. There were no intra- and immediate post-operative complications. Gastrointesitnal symptoms were the most common indication for fundoplication in neurologically normal patients. The most frequent diagnostic studies were upper gastrointestinal series (76.3 %) and 24 hour esophageal pH monitoring (78.2 %). Fundoplication had been increased since 2004 and mostly done laparoscopically. In conclusion, our 11 years' practice of open and laparoscopic fundoplication indicates that both approaches are safe and effective in the treatment of GERD for infants and children.

• Parasites, Hosts and Diseases
• /
• v.57 no.3
• /
• pp.257-264
• /
• 2019

We tried a series of morphological and molecular approaches to identify a new species of Stellantchasmus (Digenea: Heterophyidae) originating from the wrestling half-beaked fish, Dermogenys pusillus of Thailand. Adult worm samples of the new species were recovered from hamsters experimentally infected with the metacercariae from D. pusillus in Thailand. Two isolates (Thai and Korean) of Stellantchasmus falcatus were used as comparative control groups. Worm samples of 3 Stellantchasmus groups were morphologically observed and molecularly analyzed with the mitochondrial cytochrome c oxidase 1 gene. The morphological characteristics of S. dermogenysi n. sp. are similar to S. falcatus originating from brackish water fish, but minor difference was noted including the absence of the prepharynx, position of the ovary near the ceca end, smaller body size, and shorter esophageal length. A phylogenetic tree derived from neighbor-joining and maximum-likelihood methods suggests that S. dermogenysi n. sp. is separated from S. falcatus supported by high bootstrap values. The relative divergences persist between these host-specific trematodes, which we suggest should be recognized as 2 distinct species. Comparisons of S. dermogenysi n. sp. with S. falcatus isolated from mullets in Thailand and Korea indicate a genetic divergence of mitochondrial DNA of 19.4% and 21.7%, respectively. By the present study, a new species, Stellantchasmus dermogenysi n. sp. (Digenea: Heterophyidae), is proposed in Thailand based on molecular evidences, in addition to minor morphological differences between S. falcatus and the new species.

• Journal of Cardiovascular Imaging
• /
• v.31 no.1
• /
• pp.18-23
• /
• 2023

BACKGROUND: Three-dimensional (3D) transesophageal echocardiogram (TEE) is the gold standard for the diagnosis of degenerative mitral regurgitation (dMR) and preoperative planning for transcatheter mitral valve repair (TMVr). TEE is an invasive modality requiring anesthesia and esophageal intubation. The severe acute respiratory syndrome coronavirus 2 pandemic has limited the number of elective invasive procedures. Multi-detector computed tomographic angiography (MDCT) provides high-resolution images and 3D reconstructions to assess complex mitral anatomy. We hypothesized that MDCT would reveal similar information to TEE relevant to TMVr, thus deferring the need for a preoperative TEE in certain situations like during a pandemic. METHODS: We retrospectively analyzed data on patients who underwent or were evaluated for TMVr for dMR with preoperative MDCT and TEE between 2017 and 2019. Two TEE and 2 MDCT readers, blinded to patient outcome, analyzed: leaflet pathology (flail, degenerative, mixed), leaflet location, mitral valve area (MVA), flail width/gap, anterior-posterior (AP) and commissural diameters, posterior leaflet length, leaflet thickness, presence of mitral valve cleft and degree of mitral annular calcification (MAC). RESULTS: A total of 22 (out of 87) patients had preoperative MDCT. MDCT correctly identified the leaflet pathology in 77% (17/22), flail leaflet in 91% (10/11), MAC degree in 91% (10/11) and the dysfunctional leaflet location in 95% (21/22) of patients. There were no differences in the measurements for MVA, flail width, commissural or AP diameter, posterior leaflet length, and leaflet thickness. MDCT overestimated the measurements of flail gap. CONCLUSIONS: For preoperative TMVr planning, MDCT provided similar measurements to TEE in our study.

• Journal of Gastric Cancer
• /
• v.3 no.3
• /
• pp.139-144
• /
• 2003

Purpose: Because of an improving gastric cancer detection program and treatment methods, we can expect improved survival of patients with gastric cancer. Given the longer survival times, the chance of an occurrence of multiple primary malignant tumors other than stomach is increased in the same patients. The purpose of this study is to analyze the clinical characteristrics and the survival of patients with gastric cancer and other malignancies. Materials and Methods: A retrospective study of 3669 patients with gastric cancer observed at our department between January 1994 to December 2002 was conducted. Associated tumors were diagnosed using the Warren and Gates criteria, and included tumors that were not considered to be a metastasis, invasion, or recurrence of the gastric cancer. Results: Of all 3669 patients, $2.07\%$ (n=76) had primary tumors other than gastric cancer, $63\%$ of which were synchronous (n=48) and $37\%$ metachronous (n=28). The mean age of the study group was 64.9 (65.5 in males, 61.8 in females), and the male-to-female ratio was 4.8 : 1. The most common cancer associated with gastric cancer was a hepatocellular carcinoma ($23.7\%$), followed by colorectal cancer ($17.1\%$), esophageal cancer ($10.5\%$), breast cancer ($6.6\%$). Of the 45 patients who had undergone a resection, 14 were in stage I, 12 in stage II, 13 in stage III, and 6 in stage IV. No statistically significant differences were found between the synchronous and the metachronous groups with regard to age, sex ratio, differentiation, and stage. The 5-year survival rates of the metachronous and the resected patients were significantly higher than those of the synchronous and the non resected patients, respectively. Conclusion: Due to increasing length of the follow-up period for patients with gastric cancer, another malignancy may develop in other organs. Therefore, physicians should pay attention to detect other cancers early in these patients, and a surgical resection is recommended as the treatment of choice in the management of multiple primary cancer associated with gastric cancer.