• Journal of Chest Surgery
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• v.34 no.12
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• pp.930-936
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• 2001

Background: The origin site of carcinoma invading esophagogastric junction is variable. It may arise from squamous cell carcinoma of low esophagus, adenocarcinoma arising from Barrett's esophagus, adenocarcinoma of gastric cardia, or extension from proximal stomach cancer. In Korea, the majority of adenocarcinoma invading esophago-gastric junction seems to arise from proximal gastric carcinoma. Material and Method: We reviewed the data of surgically-resected gastric adenocarcinoma involving esophagogastric junction in KCCH between 1988 and 1999. Result: There were 212 cases. Male to female ratio was 156 to 56. Age distribution was between 22 and 78. Variable surgical approaches including median laparotomy, laparotomy with left or right thoracotomy, left thoracotomy, and thoracoabdominal approach were used. Postoperative pathologic stages were : Stage IA-7, IB-11, Ⅱ-25, ⅢA-73, ⅢB-34, and Ⅳ-57. Curative resection was performed in 199 patients, and total gastrectomy was performed in 200 patients. There were 77.4%(164 cases) with esophageal involvement, 74.1％(157 cases) with tumor involvement in the abdominal LN, and 8%(17 cases) with mediastinal LN metastasis. Operative mortality was 3.3%, and over-all 5 year survival rate was 35%. Conclusion: There are various surgical approaches and many things to consider for surgical resection, thoracic and abdominal approach may need for obtain proper resection margin and adequate lymph node dissection in stomach cancer invading esophagogastric junction.

• Journal of Chest Surgery
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• v.42 no.3
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• pp.355-360
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• 2009

Background: Benign teratoma is mostly asymptomatic, but this tumor rarely ruptures into the adjacent structure such as the pleural space, pericardium, lung parenchyma or tracheobronchial tree. Thus, it is important to differentiate ruptured teratoma from unruptured teratoma. This study evaluated the difference between ruptured and unruptured benign teratoma. Material and Method: Twenty-four cases of surgically resected benign teratomas were reviewed retrospectively. The clinical symptoms, chest CT findings and operative findings of the ruptured teratoma were compared with those of the unruptured teratoma. Especially, the tumor size, wall thickness, location of the mass, internal septation, homogeneity, calcification and ancillary findings were evaluated on CT. Result: Of the 24 patients, 7 patients were diagnosed with ruptured teratoma. Severe symptoms were more commonly found for ruptured teratoma than for unruptured teratoma. The ruptured teratoma had a tendency to display calcification and such ancillary findings as collapse or consolidation of the lung parenchyma. For the ruptured teratoma, the resection was performed by sternotomy or thoracotomy, and more lung resection was included. Conclusion: Calcification within the mass and changes in the lung parenchyma on the preoperative CT findings can be diagnostic signs of a ruptured teratoma. The demonstration of ruptured teratoma is important not only for making the early diagnosis, but also for the surgical planning.

• Journal of Chest Surgery
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• v.31 no.10
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• pp.982-987
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• 1998

Background: Surgical resection is the standad therapy for the stage I lung cancer. We analysed the risk facturs of stage I lung cancer patent and tryed to establish more effective and aggressive treatment modality. Materials and methods: A detailed analysis was undertaken to evaluate the surgical results and to define the risk factors associated with the recurrence and the survival time in 146 consecutive patients with stage I lung cancer who were diagnosed, and resected at Yonsei Medical Center from January 1990 to December 1996. Results: There were 115 males and 31 females. Their ages ranged from 27 to 79 years(mean age:58.9$\pm$9.3 years). The histologic types were squamous carcinoma in 72 cases(49.3%) and adenocarcinoma in 45 cases(30.8%). A pulmonary resection and mediastinal lymph node dissection were done in all cases. A lobectomy was performed in 96 cases(65.7%) and a pneumonectomy in 48 cases(32.9%). There were 5 operative mortalities(3.4%) and complications occured in 24 cases(16.5%). The overall 5-year survival was 64.1%, and survival time did not depend on the type of operation or histologic type. Significant predictors of decreased survival were visceral pleural invasion(p=0.0079), T2 lesion(p=0.0462), and tumor size($\geq$5 cm) in adenocarcinoma(p=0.0472). The overall incidence of recurrence was 33.3%(47 cases; local or regional 6.4%, distant 26.9%). Almost all recurrences(44cases) occurred in T2 lesions. The distant organs that failed were the contralateral lung in 13 patients, the brain in 12, the bone in 10, and other organs in 3. Conclusions: even in stage I lung cancer, we suggest that postoperative adjuvant therapy is recommended in patients with poor prognostic factors such as visceral pleural invasion, T2 lesions, and a tumor size($\geq$5 cm) in the adenocarcinoma.

• Journal of Chest Surgery
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• v.31 no.12
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• pp.1200-1205
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• 1998

Background: Lung cancer formation is a multistage process involving activation of protooncogene and inactivation of tumor suppressor genes. We evaluate the significance of cyclin D1, p53, bcl-2 gene mutations in patients with curatively resected stage IIIA non-small cell lung cancer(NSCLC). Material and Method: One hundred consecutive cases of stage IIIA lung cancers from patients operated on curatvely between 1990 and 1995 for which adequate paraffin blocks and clinical history were available. Immunohistochemical studies were performed on the representative tissue sections from each case by the labelled streptovidin- biotin method. Sections for cyclin D1, p53, Bcl-2 immunostaining were pretreated in a microwave oven for 10 to 20 minutes in citrate buffer before immunostaining. The overnight incubation with NCL-cyclin D1-GM for cyclin D1, with clone DO-7 for p53, with clone 124 for bcl-2 was done. Mean follow-up was 24.1 months (range 2-84 months) after operation. Result: One hundred cases of lung cancers were composed of 56 cases of squamous cell carcinoma, 37 cases of adenocarcinoma, 5 cases of adenosquamous cell carcinoma, and 2 cases of large cell carcinoma. The 5-year survival was 32.1%. The positive expression rate of cyclin D1 was 35%, p53 was 56%, and bcl-2 was 17%. But there were no correlation between cyclin D1, p53, Bcl-2 protein expression and survival. Conclusion: These observation indicate that cyclin D1, p53, bcl-2 protein overexpression might be implicated in the oncogenesis of non-small cell lung carcinomas but they have no usefulness as a prognostic marker.

• Radiation Oncology Journal
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• v.33 no.1
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• pp.12-20
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• 2015

Purpose: To evaluate treatment outcomes and determine prognostic factors in patients with esophageal cancer treated with esophagectomy after neoadjuvant chemoradiotherapy (NCRT) Materials and Methods: We retrospectively evaluated 39 patients with esophageal cancer who underwent concurrent chemoradiotherapy followed by esophagectomy between 2002 and 2012. Initial clinical stages of patients were stage IB in 1 patient (2.6%), stage II in 5 patients (12.9%), and stage III in 33 patients (84.6%). Results: The median age of all the patients was 62 years, and the median follow-up period was 17 months. The 3-year overall survival (OS) rate was 33.6% in all the patients. The 3-year locoregional recurrence-free survival (LRFS) rate was 33.7%. In multivariate analysis with covariates of age, the Eastern Cooperative Oncology Group performance status, hypertension, diabetes mellitus, tumor length, clinical response, clinical stage, pathological response, pathological stage, lymphovascular invasion, surgical type, and radiotherapy to surgery interval, only pathological stage was an independent significant prognostic factor affecting both OS and LRFS. The complications in postoperative day 90 were pneumonia in 9 patients, anastomotic site leakage in 3 patients, and anastomotic site stricture in 2 patients. Postoperative 30-day mortality rate was 10.3% (4/39); the cause of death among these 4 patients was respiratory failure in 3 patients and myocardial infarction in one patient. Conclusion: Only pathological stage was an independent prognostic factor for both OS and LRFS in patients with esophageal cancer treated with esophagectomy after NCRT. We could confirm the significant role of NCRT in downstaging the initial tumor bulk and thus resulting in better survival of patients who gained earlier pathological stage after NCRT.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.7
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• pp.3035-3042
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• 2015

Background: Isorhamnetin (Iso), a novel and essential monomer derived from total flavones of Hippophae rhamnoides that has long been used as a traditional Chinese medicine for angina pectoris and acute myocardial infarction, has also shown a spectrum of antitumor activity. However, little is known about the mechanisms of action Iso on cancer cells. Objectives: To investigate the effects of Iso on A549 lung cancer cells and underlying mechanisms. Materials and Methods: A549 cells were treated with $10{\sim}320{\mu}g/ml$ Iso. Their morphological and cellular characteristics were assessed by light and electronic microscopy. Growth inhibition was analyzed by MTT, clonogenic and growth curve assays. Apoptotic characteristics of cells were determined by flow cytometry (FCM), DNA fragmentation, single cell gel electrophoresis (comet) assay, immunocytochemistry and terminal deoxynucleotidyl transferase nick end labeling (TUNEL). Tumor models were setup by transplanting Lewis lung carcinoma cells into C57BL/6 mice, and the weights and sizes of tumors were measured. Results: Iso markedly inhibited the growth of A549 cells with induction of apoptotic changes. Iso at $20{\mu}g/ml$, could induce A549 cell apoptosis, up-regulate the expression of apoptosis genes Bax, Caspase-3 and P53, and down-regulate the expression of Bcl-2, cyclinD1 and PCNA protein. The tumors in tumor-bearing mice treated with Iso were significantly smaller than in the control group. The results of apoptosis-related genes, PCNA, cyclinD1 and other protein expression levels of transplanted Lewis cells were the same as those of A549 cells in vitro. Conclusions: Iso, a natural single compound isolated from total flavones, has antiproliferative activity against lung cancer in vitro and in vivo. Its mechanisms of action may involve apoptosis of cells induced by down-regulation of oncogenes and up-regulation of apoptotic genes.

• Tuberculosis and Respiratory Diseases
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• v.65 no.2
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• pp.105-109
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• 2008

Background: Fascin is an actin-bundling protein that plays an important role in cellular motility. Fascin is normally expressed in the neuronal and mesenchymal cells and its expression is low or absent in the epithelia. However, an overexpression of fascin has been linked to the invasive behavior of some neoplasms such as breast, stomach and ovarian tumors. In this study, we evaluated the expression of fascin and its prognostic significance in stage I non-small cell lung cancer (NSCLC). Methods: Immunohistochemical staining for fascin was performed on the paraffin-embeded tissue sections of 81 cases of resected NSCLC. Staining of more than 5% of the tumor cells was recorded as positive immunoreactivity. Results: Fascin expression was seen in 73% (59/81) of the cases and this was more frequently seen in squamous cell carcinoma than in adenocarcinoma (93% vs 42%). There were no significant correlations of fascin immunoreactivity with tumor recurrence and overall survival. Conclusion: The expression rate of fascin was relatively high in NSCLC, but this was without prognostic significance. The exact clinical role of fascin should be defined through further investigations.

• The Journal of Internal Korean Medicine
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• v.15 no.2
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• pp.318-346
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• 1994

A Bibliographical study was done about lumbago in oriental internal Medicine. The results are as follows. 1. Shenxu,sexual active, senile, Feng, Han, Shi, shiji, Tanyin and Qi lumbago are applicable to internal medical lumbago in oriental medicine, and Shenxu is essential pathogenesis. 2. Shenxu lumbago is characterized by continous pain, improved after chiropsia, deep pulse in Chi pulse, and used QingeWan, LiuweiDihuangWan and AnshenWan in herb-medicine. and Cortex Eucommiae, Radix Rehmanniae Praeparata and Fructus Psoraleae in drugs for the purpose of ZishenYijing, and related to lumbago caused by chronic prostatitis, calculus or tumor in kidney and diabetes mellitus. 3. Sexual active lumbago is dim-aching and weak pain in or after sexual life at low back and knee joint, and classified to Shenyang Buzu, ShenjingKuisun. GanshenYinxu and XinshenBujiao ; Liuwei Dihuang Wan, ZuoguiWan In herb-medicine. Cornu Cervi Pantotrichum, Fructus Lycii and Fructus Corni in drug were used for treatment. 4. Senile Lumbago is a kind of consumptive disease due to exhaused essential energy and caused by lack of Shenjing, Yangqi ; and described as repeated mild dim pain and ErzhiWan, QingeWan and MoyaoGao were used frequently, supposed to connected with osteoporosis, osteomalacia and osteoarthropathy deformons caused by aging. 5. Feng lumbago is attacked by Liuyin, and characterized by chilling and fever. stabbing pain from thoracic and lumbar vertebrae to pedes, and used WujiXan, XiaoxumingTang for treatment. Han lumbago is caused by cold's attacking Shenjing, distinguished for chilling,icing sense improved by heat on low back, and used WujiXan, JiangfuTang. Shi lumbago is caused by damp's inflowing Shenjing, described as stone-like lumbago which was subsided low back pain growing worse by gloomy rain, and used ShenshiTang. ShenzhuTang for the purpose of ZaoshiXingqi. And it is supposed that lumbago occured in the initial of urinary track infection was belong to those of Feng,Han and Sill's. 6. Sillji lumbago is caused by pathogen being in the spleen and the stomach, and used ChenxiangJiangqiTang, PingweiSan for treatment. And it is supposed that it belong to lumbago caused by gastrointerstinal disease such as peptic ulcer. gastroduodenal tumor and colonic inflammatory disease. 7. Tanyin lumbago is caused by Tanyin's flowing meridian, characterized by thoracolumbar verterber's heaviness, covered sense with something on low back and painless massage. Kuaiqi-drug are added to ErchenTang, DaotanTang for treatment, and it supposed that Tanyin lumbago's belong to that accompanied with metabolic disease such as obesity and gout. 8. Qi lumbago is caused by excessive stress such as melancholy and fury, described as multiple stabbing pain, an unexpected on and improvement, ranging back pain until flank and abdomine. Tiaoqi-drugs were added to RenshenShunqiSan, WuyaoShunqiSan for treatment, and it supposed to connecting with emotional lumbago such as hysteria, feigned illness and anxiety psychosis.

• Journal of Gastric Cancer
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• v.15 no.4
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• pp.238-245
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• 2015

Purpose: This study aimed to identify time-dependent prognostic factors and demonstrate the time-dependent effects of important prognostic factors in patients with advanced gastric cancer (AGC). Materials and Methods: We retrospectively evaluated 3,653 patients with AGC who underwent curative standard gastrectomy between 1991 and 2005 at the Korea Cancer Center Hospital. Multivariate survival analysis with Cox proportional hazards regression was used in the analysis. A non-proportionality test based on the Schoenfeld residuals (also known as partial residuals) was performed, and scaled Schoenfeld residuals were plotted over time for each covariate. Results: The multivariate analysis revealed that sex, depth of invasion, metastatic lymph node (LN) ratio, tumor size, and chemotherapy were time-dependent covariates violating the proportional hazards assumption. The prognostic effects (i.e., log of hazard ratio [LHR]) of the time-dependent covariates changed over time during follow-up, and the effects generally diminished with low slope (e.g., depth of invasion and tumor size), with gentle slope (e.g., metastatic LN ratio), or with steep slope (e.g., chemotherapy). Meanwhile, the LHR functions of some covariates (e.g., sex) crossed the zero reference line from positive (i.e., bad prognosis) to negative (i.e., good prognosis). Conclusions: The time-dependent effects of the prognostic factors of AGC are clearly demonstrated in this study. We can suggest that time-dependent effects are not an uncommon phenomenon among prognostic factors of AGC.

• Tuberculosis and Respiratory Diseases
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• v.55 no.4
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• pp.402-407
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• 2003

Mesoblastic nephroma is a neoplasm of the kidney which is characterized by interlacing bundles of spindle mesenchymal cells. It is usually diagnosed during the first six months of life and is mostly benign. Incidence in adults is exceedingly rare. In most cases, only total excision is required without postoperative adjuvant therapy, and the rare cases of local recurrence have usually been related to incomplete removal. However, mesoblastic nephroma may behave aggressively, in contrast to a congenital mesoblastic nephroma. Several cases of metastatic mesoblastic nephroma have been previously described. We report herein a case of a 42-year-old woman with mesoblastic nephroma which recurred as a large metastatic lung mass seven years after the nephrectomy. The patient presented with chest wall discomfort for four days. Seven years previously, total nephrectomy had been performed because of a right renal tumor which had been diagnosed as a mesoblastic nephroma. There had been no evidence of recurrence for five years, after which she discontinued follow-up. On readmission two years later, chest X-ray and CT scan revealed a large lung mass in the left upper lobe. It was completely excised and the pathologic examination was identical with that of the original renal tumor. Synovial sarcoma was excluded because the fusion transcripts of the SYT-SSX fusion gene associated with the t(X;18) translocation were negative. The final diagnosis was a lung metastasis of mesoblastic nephroma and the patient remained free of disease for 7 months postoperatively.