• Journal of Gastric Cancer
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• v.7 no.2
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• pp.74-81
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• 2007

Purpose: Routine pancreatico-splenectomy with total gastrectomy should no longer be considered as the standard surgical procedure for gastric cancer because of the lack of proven surgical benefit for survival. The aim of this study is to evaluate the clinicopathologic factors and the survival of patients with locally advanced gastric cancer and they had undergone combined pancreatico-splenectomy with a curative intent. Material and Methods: We retrospectively reviewed a total of 118 patients who had undergone total gastrectomy with distal pancreatico-splenectomy from 1990 to 2001. The patients were divided into 2 groups: 90 patients who were free from cancer invasion (group I), and 28 patients with histologically proven cancer invasion into the pancreas (group II). The various clinicopathologic factors that were presumed to influence survival and the survival rates were analyzed. Results: The rate of pathological pancreatic invasion was 23.7%. The tumor stage, depth of invasion, pancreas invasion, lymph node metastasis, lymph node ratio, curability and the hepatic and peritoneal metastasis were statistically significance on univariate analysis. Among these factors, the tumor stage, lymph node ratio and curability were found to be independent prognostic factor on multivariate analysis. The 5-years survival rates were 36.2% for group I and 13.9% for group II. The morbidity rate was 22.1%, and this included pancreatic fistula (5.1%), intra-abdominal abscess (4.2%) and bleeding (4.2%). The overall mortality rate was 0.8%. Conclusion: Combined distal pancreatico-splenectomy with total gastrectomy with a curative intent was selectively indicated for those patients with visible tumor invasion to the pancreas, a difficult complete lymph node dissection around the distal pancreas and spleen, and no evidence of liver metastasis or peritoneal dissemination.

• Investigative Magnetic Resonance Imaging
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• v.18 no.4
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• pp.323-331
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• 2014

Purpose : To assess the usefulness of rectal filling using ultrasonographic gel in patients with lower rectal cancer. Materials and Methods: Twenty five patients with lower rectal cancer were enrolled. High resolution pelvic MR was performed twice before and after gel filling. Independently and retrospectively, two radiologists reviewed each set of MR images using five-grade scales for sphincter involvement, CRM (circumferential resection margin) involvement and depiction of the tumor. Same two radiologists retrospectively performed consensus review of each set of MR images for tumor distance from the anal verge and T&N staging. Results: Tumor depiction scores from MR with gel filling were significantly higher than those of MR without distention (p<0.001). Compared to MR without distension, MR with gel filling had no significant differences in prediction of CRM or sphincter involvement (p>0.05). Distance from the anal verge was significantly different between MR with gel filling and rigid endoscopy ($6.8{\pm}1.6cm$ vs. $5.8{\pm}1.6cm$, p=0.001). There were no significant differences between pathological staging and MR staging with or without gel filling. Conclusion: MR with gel filling improved tumor depiction. And also MR with gel filling revealed same ability for the predictions of CRM or sphincter invasion in patients with lower rectal cancer, comparing with MR without gel filling.

• Korean Journal of Biological Psychiatry
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• v.5 no.2
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• pp.253-262
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• 1998

Objectives : Risperidone, an atypical antipsychitics which blocks both dopaminergic and serotonergic receptors, have a good response to the negative symptoms as well as positive symptoms, and improve cognitive dysfunction of schizophrenic patients. Furthermore, it has few extrapyramidal side effects and tardive dyskinesia. Although it had been reported that the atypical antipsychotics have less effect on prolactin(PRL) than the classical antipsychotics, we could experience PRL-associated symptoms such as amenorrhea, galactorrhea and hyperprolactinemia in practice. Therefore, we tried to identify the sex differences of risperidone-induced hyperprolactinemia, to evaluate factors affecting PRL levels, and to know the association between cognitive disorders and PRL. Methods : The baseline levels of PRL and TSH prior to risperidone administration were measured by enzyme immunoassay method for 50 patients(25 ma-les and 25 females) admitted with schizophrenia, schizoaffective disorder or schizophreniform disorder according to the DSM-IV classification, and the measurements of PRL were repeated on the 2nd and the 4th wks of risperidone administration. Concomitantly, the severity of psychotic symptoms using CGI, BPRS and PANSS, and the cognitive dysfunction using PANSS-CF were assessed prior to, on the 2nd and the 4th wks of risperidone administration. The PRL and TSH levels of 54 healthy controls(29 males and 25 females) who had no medical, neurological and psychiatric illnesses were also evaluated. Furthermore, the correlation with the psychiatric diagnosis, education, age, sex, duration of illnesses, risperidone dosage, duration of risperdone administration, TSH concentration, cognitive function, severity of psychotic symptoms were also identified. Results : 1) The baseline PRL levels of female schizophrenics($74.3{\pm}49.6ng/ml$) were significantly(p<0.005) higher than those of males($36.3{\pm}24.6ng/ml$), which were significantly(p<0.0001 respectively) higher than those of controls(females $16.9{\pm}6.1ng/ml$, males $13.3{\pm}4.9ng/ml$). The PRL levels measured on the 2nd wks(females $133.7{\pm}47.8ng/ml$, males $56.9{\pm}23.6ng/ml$) and on the 4th wks(females $146.1{\pm}45.9ng/ml$, males $70.0{\pm}31.5ng/ml$) after risperidone administration were significantly(p<0.0001 respectively) higher in females. The mean dosages of risperidone on the 2nd wks were $3.8{\pm}1.7mg$(2-6mg) for the females and $4.0{\pm}1.6mg$(2-6mg) for the males, and on the 4th wks were $4.5{\pm}2.1mg$(2-8mg) for the females and $5.4{\pm}2.2mg$(2-8mg) for the males. 2) The rise of PRL levels were positively correlated with increased risperidone dosage in males(${\gamma}$=0.307 on the 2nd wks and ${\gamma}$=0.280 on the 4th wks), while they were not correlated with dosages in females. For the females, the PRL levels were negatively correlated(${\gamma}$=-0.320) with decrease of TSH concentration. The baseline PRL levels were not correlated with age, education, duration of illnesses, psychopathology, cognitive disorders in both males and females, while it was negatively correlated with TSH levels only in females(${\gamma}$=-0.320). 3) The cognitive dysfunction was not correlated with PRL levels in males, while PANSS-CF scores were negatively correlated with PRL levels(${\gamma}$=-0.220 on the 2nd wks and ${\gamma}$=-0.366 on the 4th wks) in females. The psychopathology was positively correlated with cognitive dysfunction in both males and females. Therefore, the risperidone-induced cognitive improvement seemed to be correlated with improvement of psychopathology in both males and females, and with increase in PRL levels only in females. Conclusions : The fact that the serum PRL levels of schizophrenics were higher than those of controls, especially in females suggested that it could be related with risperidone dosage in males and with primary pathological process in females. The risperidone-associated cognitive improvement seemed to be related with general improvement of psychopathology as well as the rise of PRL levels especially in females. The facts that the effect of risperidoneinduced hyperprolactinemia and the cognitive function were more in females suggested that somewhat different mechanisms could be exerted on them.

• Journal of Society of Preventive Korean Medicine
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• v.8 no.2
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• pp.141-156
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• 2004

Objectives : JianTeng-Yuan(交藤圓) is said to be a prescription for preservation of health in ${\ulcorner}$HuaTuo ZhongZangJing(華陀 中藏經)${\lrcorner}$. It is known to have the effect of Bu-Shen(補腎: strengthening kidney) and Yi-Shou(益壽: prolonging the span of one's life). This study investigates whether JTY is effective on inhibition of oxidation stress. Methods : Sprague-Dawley Rats(12-week-old, weight $300{\pm}20g$) were divided into 3 groups. Normal group(n=8) was injected PBS(1ml/body, s.c) at the back neck's skin. Control group(n=8) was injected D-galactose(50mg/kg, 1ml PBS/body, s.c) to induce pathological animals. JTY group was injected the same treatment for the Control group, and fed containing JTY(10%). The whole groups were treated 1 time per day for 6 weeks. After rats were sacrificed and anti-oxidant enzyme(SOD, CAT, G-px) activity, GSH quantity of RBC and tissue(heart, liver and kidney), plasma Vit-C quantity were examined. Besides, the MDA levels of liver and kidney, lipofuscin of heart and endurance of erythrocyte membrane were measured. Results : In the JTY group, RBC's SOD activity decline was halted by 21% of the normal level, compared to the control group ; G-px activity(unit/g of Hb) increased significantly, compared to the normal group ; and the level of Vit-C in plasma increased by 16%. Heart's SOD activity was kept at the same level as that of the normal group ; and CAT activity decline was halted by 26%. Kidney's CAT and G-px activities were kept at the same level as that shown in the normal group, implying the existence of halting effect. Liver also showed a slight halting effect against the decline of anti-oxidant ability, but the effect was not significant(a=0.05). A comparison between the levels of peroxide in SD rats showed that the level of TBARS in plasma increased significantly in the control group and that it was normal in the JTY group. The livers in the JTY group, compared to those in the control group, showed 36% halting effect of the normal level while their kidney's indicated the level significantly lower than the normal level. Heart's lipofuscin increased significantly in the control group, but was alike in both the JTY and the normal groups. Endurance of erythrocyte membrane(%) decreased significantly in the control group while it was kept at the similar level in both the JTY and the normal groups, indicating the halting effect. Conclusions : This study suggests that JTY is effective to defend oxidation stress caused by D-galactose in the animals. It showed that the anti-oxidant ability was maintained and strengthened. On the other hand, it reduced the level of peroxide in animals. In sum, JTY appeared to have the equilibrium normal physiological function in SD rat.

• Journal of Food Hygiene and Safety
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• v.28 no.2
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• pp.146-151
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• 2013

Perilla frutescens usually dieted in East Asian country such as Korea and Japan. Antioxidant, antiinflammatory and anticancer activities of perilla leaves have been founded. In previous study, we confirmed that caffeic acid, major compound of perilla, was accumulation by sucrose aqueous solution and thus antioxidant effect of perilla was enhanced. In this study, we investigated the protective effect of functional perilla leaves extract (PLE) against tert-butyl hydroperoxide(t-BHP) induced-oxidative hepatotoxicity. The pretreatment with PLE (250, 500 and 1000 mg/kg b.w.) for 5 days before a single dose of t-BHP (i.p.; 0.5 mmol/kg) significantly lowered the serum levels of aspartate aminotransferase, alanine aminotransferase and lactate dehydrogenase dose-dependently. And we confirmed that the indicators of oxidative stress were remarkably reduced in the liver, such as the glutathione contents and malondialdehyde, marker of lipid peroxidation. Pathological histology of the rat livers tissues showed that PLE reduced the hepatocyte degeneration and neutrophilic infiltration of liver induced by t-BHP. These results suggest that functional perilla frutescens has the protective effect of liver against t-BHP-induced oxidative hepatic stress in rats.

• Journal of fish pathology
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• v.8 no.2
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• pp.119-134
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• 1995

To induce an overpopulated melanomacrophage centers(MMCs) within spleen and kidney in tilapias, two methods were applied through the intraperitoneal inoculation of V. anguillarum FKC with a repeated dose of saline(the 1st induction group), and of colloidal carbon (the 2nd induction group). In the 1st group, both number and size of MMCs were slightly increased in spleen and head kidney. However in the 2nd group the two hemopoietic tissues were nearly occupied with quite a large number of MMCs. Regardless of induction groups, many of MMCs were confined within the walls of blood vessels in the spleen. Especially in the 2nd group, the MMCs without fibrous capsules often had concentrically or eccentrically located, thin-walled lumens of vessels, which strongly suggests to be ellipsoids. In head kidney, nearly all MMCs were located within or just around the lymphocytic areas but the precise relationship to blood vessel wall was not obvious. Despite of such overpopulated MMCs, no histopathological degenerative findings in hemopoetic parenchymas of both organs were recognized. To evaluate the effect on defensive function, tilapias of the 2nd group were challenged with E. tarda. Susceptabilities to E. tarda were never increased but rather significantly decreased compared to control. Weekly antibody titres in sera were determined for all induction groups, in which the titres in the 1st and 2nd groups were 4 or 8 times higher than in the control, and then remained high until the 4th week. Also with the hemopoietic function, cellular compositions of peripheral blood were analyzed at weekly intervals but no significant changes resulted. From those results, it is suggested that overcrowding of MMCs would not lead to any morphological as well as functional deteriorations of spleen and head kidney but have an intimate association with enhancement of protective immune system in tilapias.

• Childhood Kidney Diseases
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• v.7 no.1
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• pp.23-29
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• 2003

Purpose : This study was performed to determine the natural history of histologically confirmed IgA nephropathy in pediatric patients who presented with hematuria and proteinuria. Patients and Methods : We reviewed the clinical course of 57 patients diagnosed with IgA nephropathy at the age of 15 years or younger from 1981 to 2000. All patients presented with hematuria or minimal proteinuria($<40\;mg/m^2/day$) and had normal renal function and blood pressure at the time of renal biopsy. Based on the clinical and pathological findings at the time of diagnosis, we sought for complications of IgA nephropathy such as heavy proteinuria(${\ge}40\;mg/m^2/day$), hypertension, and chronic renal failure. Results : The mean age at presentation was $9.5{\pm}2.8$ years(4 to 15 years) and 42(74%) were male. Isolated gross hematuria was observed in 20 patients(35%), microscopic hematuria in 3(5%), minimal proteinuria in 4(7%), both gross hematuria and minimal proteinuria in 15(26%), and both microscopic hematuria and minimal proteinuria in 15(26%). During a median follow-up of $7.0{\pm}3.5$ years, 38(67%) had complete resolution of hematuria and proteinuria, 12(21%) had persistently abnormal urinalysis without development of adverse events. Only 7(12%) developed adverse events : 4(7%) developed severe proteinuria, 1(2%) became hypertensive, and 2(3%) developed Impaired renal function. By univariate analysis using the chisquare test, the age at presentation(>10 years)(P<0.01) and poor histological classes of the Lee or Haas classification at onset(P<0.05) were significantly correlated with adverse events, whereas sex and clinical signs at onset were less concordant. Conclusion : We can conclude that the prognosis of IgA nephropathy diagnosed in early childhood is better and a good correlation exists between the clinical manifestations of this disease and the histological classes.

• Radiation Oncology Journal
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• v.13 no.4
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• pp.377-383
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• 1995

Purpose : To obtain the optimal treatement method in patients with endometrial carcinoma(clinical stage FIGO I, II) by comparative analysis between preoperative radiotherapy (pre-op RT) and postoperative radiotherapy (post-op RT). Material and Methods : A retrospective review of 62 endometrial carcinoma patients referred to the Yonsei Cancer Center for radiotherapy between 1985 and 1991 was undertaken. Of 62 patients, 19 patients(Stagel : 12 patients. Stagell;7 patients) received pre-op RT before TAH(Total Abdominal Hysterectomy) and BSO (Bilateral Salphingoophorectomy) (Group 1) and 43 patients(Stage 1;32 patients, Stage 2; 11 patients) received post-op RT after TAH and BSO (Group 2). Pre-op irradiation was given 4-6 weeks prior to surgery and post-op RT administered on 4-5 weeks following surgery. All patients except 1 patient(Group 2: ICR alone) received external irradiation. Seventy percent(13/19) of pre-op RT group and 54 percent(23/42) of post-op RT group received external pelvic irradiation and intracavitary radiation therapy(ICR). External radiation dose was 39.6-55 Gy(median 45 Gy) in 5-6. 5weeks through opposed AP/PA fields or 4-field box technique treating daily, five days per week, 180 cGy per fraction. ICR doses were prescribed to point A(20-39.6 Gy, median 39 Gy) in Group 1 and 0.5cm depth from vaginal surface (18-30 Gy,median 21 Gy) in Group 2. Results : The overall 5 year survival rate was $95{\%}$. No survival difference between pre-op and post-op RT group.($89.3{\%}$ vs $97.7{\%}$, p>0.1) There was no survival difference by stage, grade and histology between two groups. The survival rate was not affected by presence of residual tumor of surgical specimen after pre-op RT in Group 1 (p>0.1), but affected by presence of lymph node metastasis in post-op RT group(P<0.5). The complication rate of pre-op RT group was higher than post-op RT. ($16{\%}$ vs $5{\%}$) Conclusion : Post-op radiotherapy offers the advantages of accurate surgical-pathological staging and low complication rate.

• Radiation Oncology Journal
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• v.21 no.2
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• pp.118-124
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• 2003

Purpose: The goal of this study was to determine the role of postoperative radiation therapy in extrahepatic bile duct cancers. Materials and Methods: Between 1997 and 2001, 41 patients with extrahepatic bile duct cancer having undergone surgical resection were retrospectively analyzed. Of the 41 patients, 22 were treated by surgery alone (Group I) with remaining 19 treated by surgery and postoperative radiation therapy (Group II). A gross total surgical resection with pathologically negative margins was peformed in 11 of the patients (50$\%$) in Group 1, and in 7 of the patients (36.8$\%$) in Group II. There were no significant differences in the disease stage, surgical procedure or pathological characteristics of the two groups. The patients in group II received 45$\~$54 Gy (median: 50.4 Gy) of external beam radiation therapy to the tumor bed and draining nodal area. Results: The local failure rate was significantly higher In group I (54.5$\%$) than in group II (15.8$\%$)(p=0.01). Of the 12 failed patients in Group I and the 3 failed patients in group II, 7 and 3 had a positive resection margin. The overall 3-year survival rates were 38.3 and 38.9$\%$ and the 3-year disease free survival rates were 18.8 and 26.3$\%$ in groups I and II, respectively. However, the patients with positive resection margins who received adjuvant radiation therapy had higher 3-year overall survival rates than those with surgery alone (36.4$\%$ vs. 24.2$\%$, p=0.06), and 3-year disease free survival rate was significantly higher in the group II patients who had positive margins compared with those in group I (25.0$\%$ vs. 18.2$\%$, p=0.04). Conclusion: Postoperative adjuvant radiation therapy appeared to reduce the incidence of local failure in patients with extrahepatic bile duct cancer, and might improve the survival rate in the patients with positive resection margins.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.5
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• pp.395-401
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• 2009

Purpose: We evaluated $^{18}F$-FDG PET/CT findings in initially diagnosed adenoid cystic carcinoma (ACC) of the head and neck in association with pathological subtype, staging, uptake comparison with squamous cell carcinoma (SqCC) and prognosis. Materials and Methods: The subjects were 16 patients with initially diagnosed ACC of head and neck who underwent pretreatment $^{18}F$-FDG PET/CT. Histological subtype (solid pattern vs. tubular/cribriform pattern), $SUV_{max}$ of size-matched SqCC of the head and neck as control group, disease-free survival (DFS) were compared with the $SUV_{max}$ of ACC of the head and neck. Results: Of total 16 patients, 6 had solid pattern and the remaining 10 had tubular/cribriform pattern. The $SUV_{max}$ were significantly higher in solid pattern group than in tubular/cribriform pattern group ($6.7{\pm}3.2$ vs. $4.2{\pm}0.9$, p=0.03). PET/CT found unexpected distant metastasis in 18.7% of patients (3/16) and changed the therapeutic plan in those patients. The $SUV_{max}$ of ACC was significantly lower than that of size-matched SqCC ($5.1{\pm}2.4$ vs. $13.6{\pm}6.0$, p<0.001). DFS was not significantly different according to the histological subtype. In contrast, patients with high $^{18}F$-FDG uptake ($SUV_{max}$ ${\geq}$6.0) had significantly shorter DFS than those with low $^{18}F$-FDG uptake ($SUV_{max}$ <6.0). Conclusion: $^{18}F$-FDG uptake of ACC of the head and neck is significantly associated with histological subtype and DFS. $^{18}F$-FDG PET/CT may be useful for detecting unexpected metastasis. Since $^{18}F$-FDG uptake of tubular/cribriform ACC compared with SqCC is relatively low, it is necessary to interpret PET images carefully in patients without alleged ACC.