• Korean Journal of Community Nutrition
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• v.17 no.1
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• pp.101-108
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• 2012

The purpose of this survey is to investigate the nutritional status and dietary intake of gastrectomized cancer patients in Asan Medical Center. The subjects were 98 patients, who underwent a gastrectomy due to gastric cancer and were admitted to the General Surgery Department during March 2007 to December 2007. We examined general characteristics (sex, age, clinicopathological stage, type of operation), anthropometric data (height, weight change), biochemical data (red blood cell RBC, hemoglobin HGB, hematocrit HCT, mean corpuscular volume MCV, total lymphocyte count TLC, albumin, total cholesterol), dietary intake and dietary intake related symptoms. Weight loss of gastrectomized patients was $9.0{\pm}4.3$% from preillness weight to visiting out-patient department (OPD) weight. Biochemical data (RBC, HGB, HCT, MCV, TLC, albumin, total cholesterol) significantly deteriorated after gastrectomy. However, outpatient visits were all restored to the normal range. Postoperative energy intake was $785.0{\pm}164.2$ kcal, which corresponds to $41.6{\pm}9.6$% of daily energy requirement. The cause of poor oral intake is mostly fear, abdominal pain and abdominal discomfort. Therefore, to control pre-or post-operative weight change in the future requires, focusing on the body weight to maintain a normal or usual nutrition by interventions and increased caloric intake during hospitalization for the development of nutrient-dense meals. In addition, as the main reason of the lack of intake of meals after the gastrectomy was fear, the patients should be actively encouraged to consider the importance of eating proper meals.

• Korean Journal of Head & Neck Oncology
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• v.13 no.1
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• pp.62-68
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• 1997

The papillary carcinoma is the most common malignant neoplasm of thyroid gland and the prognosis is better than anyother type of thyroid carcinoma. However, the thyroid is closed to the important organs such as esophagus, trachea and larynx, there are some possibilities to invade these organs. In case of advanced disease, not only surrounding structures but also mediastinum and cervical lymphatic chain can be involved or distant metastasis develops frequently. Therefore in these cases the prognosis is worse and the rate of inoperable case is more than those of non-metastatic group. Generally, the treatment modality for papillary thyroid carcinoma consists of surgery, postoperative thyroid hormone and radioiodine therapy. If the tumor invades surrounding structures, cervical lymph node or mediastinum, total thyroidectomy and wide excision of tumor invaded area including mediastinal dissection and neck dissection is necessary. Recently, the authors have experienced a case of locally invasive and recurred papillary thyroid carcinoma without treatment for 7 years. The patient was performed previously thyroid lobectomy and isthmusectomy 13 years ago. We had determinded surgical therapy for this patient and performed mass excision with overlying skin, completion total thyroidectomy, right type I modified radical neck dissection, left lateral neck dissection, thoracotomy with supramediastinal dissection, shaving of diffusely involved trachea and skin defect reconstruction with pectoralis major myocutaneous flap. After operation 2 cycles of radioiodine therapy were taken. Now the patient is following up at the outpatient base and no evidence of disease state for postoperative 16 months. So we report on this case with a brief review of literature.

• Women's Health Nursing
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• v.16 no.2
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• pp.126-136
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• 2010

Purpose: This study was done to evaluate factors affecting active early detection behaviors of breast cancer and performance rate of breast self examination (BSE), physical examination and mammography. Methods: The participants were 264 women from an outpatient breast clinic of a university hospital and materials were collected from March 2007 to February 2008 using a structured questionnaire. The data were analyzed using $x^2$ test, logistic analysis. Results: The rate for BSE was 58.3%, for physical examination, 55.3% and for mammography experience, 63.4%. Women with all of these active early detection behaviors accounted for 31.8% of the participants. Various factors such as age, income, marital status, and menopause showed increased significant performance rate. The explanation power of logistic model was 48.5%, and was significant for age, income and health belief. Factors related to high performance rate were being over 40 years of age, high income and high health belief score. Conclusion: Active early detection behaviors were not high in spite of marked increases in breast cancer incidence. Encouragement for women practicing early detection behavior is important, but there is also a need to develop interest and support for the low performance group. More sustained education and public relations are needed to further improve active early detection behavior.

• Journal of Genetic Medicine
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• v.18 no.1
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• pp.64-69
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• 2021

Primary cilium has a signal transduction function that is essential for brain development, and also determines cell polarity and acts as a mediator for important signaling systems, especially the Sonic Hedgehog (SHH) pathway. TBC1D32 is a ciliary protein, implicated in SHH signaling. Biallelic mutations in the TBC1D32 gene causes a kind of ciliopathy, heterogeneous developmental or degenerative disorders that affect multiple organs, including the brain. Here we report a boy who carried compound heterozygous variants in TBC1D32. The patient showed hypotonia, respiratory difficulty, and multiple anomalies at his birth. He was diagnosed with congenital hypopituitarism and treated with T4, hydrocortisone, and growth hormone. Despite the hormonal replacement, the patient needed long-term respiratory support with tracheostomy and nutritional support with a feeding tube. His developmental milestones were severely retarded. Hydrocephalus and strabismus developed and both required surgery, during the outpatient follow-up. Whole-exome sequencing indicated compound heterozygous variants, c.2200C>T (p.Arg734^*) and c.156-1G>T, in TBC1D32 gene. This is the first Korean case of TBC1D32-related ciliopathy and we reported detailed and sequential clinical features. This case demonstrated the utility of whole-exome sequencing and provided valuable clinical data on ultra-rare disease.

• Journal of Ginseng Research
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• v.46 no.5
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• pp.636-645
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• 2022

Background: Ginsenoside Rg3 and gemcitabine have mutual enhancing antitumor effects. However, the underlying mechanisms are not clear. This study explored the influence of ginsenoside Rg3 on Zinc finger protein 91 homolog (ZFP91) expression in pancreatic adenocarcinoma (PAAD) and their regulatory mechanisms on gemcitabine sensitivity. Methods: RNA-seq and survival data from The Cancer Genome Atlas (TCGA)-PAAD and Genotype-Tissue Expression (GTEx) were used for in-silicon analysis. PANC-1, BxPC-3, and PANC-1 gemcitabine-resistant (PANC-1/GR) cells were used for in vitro analysis. PANC-1 derived tumor xenograft nude mice model was used to assess the influence of ginsenoside Rg3 and ZFP91 on tumor growth in vivo. Results: Ginsenoside Rg3 reduced ZFP91 expression in PAAD cells in a dose-dependent manner. ZFP91 upregulation was associated with significantly shorter survival of patients with PAAD. ZFP91 overexpression induced gemcitabine resistance, which was partly conquered by ginsenoside Rg3 treatment. ZFP91 depletion sensitized PANC-1/GR cells to gemcitabine treatment. ZFP91 interacted with Testis-Specific Y-Encoded-Like Protein 2 (TSPYL2), induced its poly-ubiquitination, and promoted proteasomal degradation. Ginsenoside Rg3 treatment weakened ZFP91-induced TSPYL2 poly-ubiquitination and degradation. Enforced TSPYL2 expression increased gemcitabine sensitivity of PAAD cells and partly reversed induced gemcitabine resistance in PANC-1/GR cells. Conclusion: Ginsenoside Rg3 can increase gemcitabine sensitivity of pancreatic adenocarcinoma at least via reducing ZFP91 mediated TSPYL2 destabilization.

• Clinics in Shoulder and Elbow
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• v.25 no.4
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• pp.274-281
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• 2022

Background: In the present study, the age- and sex-adjusted Constant score (CS) in a normal Indian population was calculated and any differences with other population cohorts assessed. Methods: The study participants were patients who visited the outpatient department for problems other than shoulder and healthy volunteers from the local population. Patients without shoulder pain/discomfort during activity were included in the study. Subjects with any problem that might affect shoulder function (e.g., cervical, thoracic spine, rib cage deformity, inflammatory arthritis) were excluded. Constant scoring of all participants was performed by trained senior residents under the supervision of the senior faculty. Shoulder range of movement and strength were measured following recommendations given by the research and Development Committee of the European Society for Shoulder and Elbow Surgery (2008). A fixed spring balance was used for strength measurement; one end was fixed on the floor and the other end tied with a strap to the wrist of the participant, arm in 90° abduction in scapular plane with palm facing down. Results: Among the 248 subjects (496 shoulders), the average age was 37 years (range, 18-78 years), 65.7% were males (326 shoulders) and 34.3% females (170 shoulders). The mean CS was 84.6±2.9 (males, 86.1±3.0; females, 81.8±2.9). CS decreased significantly after 50 years of age in males and 40 years of age in females (p<0.05). The mean CS was lower than in previous studies for both males and females. Heavy occupation workers had higher mean CS (p<0.05). A linear standardized equation was estimated for calculating the adjusted CS for any age. Conclusions: Mean CS and its change with age differed from previous studies among various population cohorts.

• Journal of Yeungnam Medical Science
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• v.40 no.2
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• pp.146-155
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• 2023

Background: Despite the recent increasing trend in the prevalence of type 2 diabetes among older individuals, the relationship between diabetic retinopathy (DR) and chronic kidney disease (CKD) in these patients remains unclear. This study investigated the severity of renal dysfunction according to the degree of DR in older patients with type 2 diabetes. Methods: A total of 116 patients with diabetes and CKD stage ≥3 who visited both the nephrology and ophthalmology outpatient departments between July 2021 and January 2022 were screened. There were 53 patients in the no DR group, 20 in the nonproliferative DR (NPDR) group, and 43 in the proliferative DR (PDR) group. Results: DR severity was related to the deterioration of renal function. The proportion of patients with advanced CKD significantly increased with DR severity (p for trend <0.001). In the multivariate regression model adjusted for age of ≥80 years, male sex, poorly controlled diabetes, macroalbuminuria, insulin use, diabetes duration of ≥10 years, cerebrovascular accident, hypertension, hyperlipidemia, and cardiovascular disease history, the odds ratio compared with the no DR group was approximately 4.6 for the NPDR group and approximately 11.8 for the PDR group, which were both statistically significant (p=0.025 and p<0.001, respectively). Conclusion: DR severity in older patients with diabetes may be associated with deterioration of renal function and high prevalence of advanced CKD. Therefore, periodic examination for DR in older patients with diabetes is important for predicting renal function deterioration and CKD progression.

• Journal of Digestive Cancer Research
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• v.4 no.2
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• pp.122-126
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• 2016

Leptomeningeal carcinomatosis occurs in approximately 5% of patients with cancer. The most common cancers involving the leptomeninges are breast, lung cancer and melanoma. However, gastric adenocarcinoma has been rarely reported with leptomeningeal carcinomatosis. The presenting manifestations are usually headache, visual disturbances and seizures. We report a case of leptomeningeal metastasis that presented as a gastric cancer. A 75-year old man was transferred to our hospital for further evaluation and treatment after being diagnosed with adenocarcinoma through endoscopic biopsy during a regular health examination. An abdominal computed tomography (CT) showed AGC, stage IA (cT1N0M0), while an endoscopic examination showed AGC, Borrmann type 2. The patient is currently under observation after undergoing radical subtotal gastrectomy with gastroduodenostomy and subsequent administration of oral chemotherapeutic agents. As an abdominal CT response assessment performed after surgery revealed new metastasis to the liver, the patient received palliative chemotherapy as recurrence was suspected. After receiving chemotherapy in the order of DP (Cisplatin + Docetaxel), FOLFIRI (5-FU + Leucovorin + Irinotecan), an abdominal CT response assessment showed complete response. Since decreased mentality maintained throughout the follow up period based on outpatient clinic, brain MRI was performed and revealed multiple leptomeningeal metastasis. The Patient died 2 days after the diagnosis.

• Journal of Chest Surgery
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• v.41 no.5
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• pp.610-618
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• 2008

Background: There are various treatment modalities for atherosclerotic arterial obstructive disease at the lower limbs, for example, conservative physical therapy, medication, operation etc. Yet it has been established that an arterial bypass operation is the most effective treatment. The aim of this study is to evaluate the effect of arterial bypass operation within our experience and to determine the indicators of treatment. Material and Method: Ninety six patients received arterial bypass operation for atherosclerotic arterial obstructive disease from June 2002 to April 2006. We evaluated the feasibility of arterial bypass operation based on the improvement of symptoms and the ankle-brachial index (ABI) and the surgical outcomes, as based on the complications, the amputation rates and the patency rates. We also assessed the possible risk factors such as gender, age, a smoking history, co-morbidities, the anastomotic sites, the graft size and the graft type. We retrospectively reviewed the medical records of the patients. The total mean follow-up period was $29.4{\pm}13.1$ months. Result: The mean age was $65.95{\pm}9.61$ and there were 88 male patients. The most common clinical manifestation was ischemic resting pain in the lower extremities. The underlying combined diseases were hypertension (61%), diabetes (43%), cardiac problems (35%) and smoking (91.7%). The most frequent site of arterial obstruction was the superficial femoral artery (44 cases, 40%). A femoropopliteal artery bypass operation with a Polytetrafluoroethylene(PTFE) synthetic graft was done in 44 cases (40%) and the great saphenous vein graft was used in 11 cases. The postoperative ABI increased significantly from $0.30{\pm}0.11$ preoperatively to $0.63{\pm}0.11$ (p<0.001) postoperatively. In 8 cases, amputations above the ankle level were necessary. The graft patency rates were 86.4% and 68.0% after 1 and 3 years, respectively. There were 29 cases (30.21%) of patency failure; the male gender, smokers and hypertension were significantly more frequent in the failure group. Of these, hypertension was the most powerful risk factor (p=0.042). Conclusion: The arterial bypass operation is an effective treatment modality for controlling the symptoms such as pain and claudication, and for preventing major amputations for the patients with atherosclerotic arterial obstructive disease. This study suggests quitting smoking, strict blood pressure control, selection of an appropriate graft, regular outpatient follow up and proper medication would offer higher patency rates and more favorable outcomes.

• Journal of Chest Surgery
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• v.31 no.12
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• pp.1172-1182
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• 1998

Background: Primary goal of anticoagulation treatment in patients with mechanical heart valve is the effective prevention of thromboembolism and safe avoidance of bleeding as well. Material and Method: Two-hundred and nine patients with the St. Jude Medical prosthesis operated on between 1984 and 1995, for mitral(MVR 122), aortic(AVR 39) and double mitral and aortic valve replacement(DVR 48) respectively, were studied on the practically achieved levels of anticoagulation and the clinical outcomes. Patients were on Coumadin and followed up by monthly visit to outpatient clinic for examination and prothrombin time measurement to adjust the International Normalized Ratios(INRs) within the low-intensity target range between 1.5 and 2.5. Result: A total anticoagulation follow-up period was 1082.0 patient- years(mean 62.1 months) and INRs of 10,205 measurements were available for evaluation. The accomplished INRs among the replacement groups were not significantly different and only 65% of INRs were within the target range. And, in individual patients, only 37% of patients had INRs included within the target range in more than 70% of tests during follow-up period. The levels of INRs in patients with atrial fibrillation, which was found in 57% of patients, were definitely higher than the ones measured in patients with regular rhythm(p<0.001). Thromboembolisms were experienced by 15 patients with the incidence of 1.265%/patient- year(MVR 1.412%, AVR 0.462% and DVR 1.531%/patient-year) and major bleeding by 4 patients with the incidence of 0.337%/patient-year(MVR 0.424%, AVR none and DVR 0.383%/patient-year). Frequent as well as prolonged missing of prothrombin time tests was the main risk factor strongly associated with the thromboembolic complications(odds ratio 1.99). The proportion of INRs within target range of less than 60% in individual patient was the highly significant risk factor of both thromboembolic and overall embolic and bleeding complications(p<0.004 and p<0.002 respectively). Conclusion: In conclusion, the low-intensity therapeutic target range of INRs was adequate in patients with AVR and in sinus rhythm. However, the patients with replacement of the mitral valve were more likely to require higher target range of INRs, especially in the presence of atrial fibrillation, to achieve the practical levels of anticoagulation enough to prevent thromboembolic complications effectively. For the higher therapeutic target range of INRs between 2.0∼3.0, further accumulation of clinical evidences are required. It is highly desirable to improve the patients' compliance under continuous instructions in visiting outpatient clinic and in taking daily Coumadin without omission and to keep INRs consistently within optimal range with tight control for minimization of chances and of periods of exposure to the risk of complications. And, particularly, patients with high risk of complications and with wide fluctuation of INRs should be better managed with frequent monitoring anticoagulation levels.