• Journal of Korean Neurosurgical Society
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• v.62 no.1
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• pp.106-113
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• 2019

Objective : The efficacy of preoperative embolization for hypervascular metastatic spine disease (MSD) such as renal cell and thyroid cancers has been reported. However, the debate on the efficacy of preoperative embolization for non-hypervascular MSD still remains unsettled. The purpose of this study is to determine whether preoperative embolization for non-hypervascular MSD decreases perioperative blood loss. Methods : A total of 79 patients (36 cases of preoperative embolization and 43 cases of non-embolization) who underwent surgery for metastatic spine lesions were included. Representative hypervascular tumors such as renal cell and thyroid cancers were excluded. Intraoperative and perioperative estimated blood losses (EBL), total number of transfusion and calibrated EBL were recorded in the embolization and non-embolization groups. The differences in EBL were also compared along with the type of surgery. In addition, the incidence of Adamkiewicz artery and complications of embolization were assessed. Results : The average age of 50 males and 29 females was $57.6{\pm}13.5$ years. Lung (30), hepatocellular (14), gastrointestinal (nine) and others (26) were the primary cancers. The demographic data was not significantly different between the embolization and the non-embolization groups. There were no significant differences in intraoperative EBL, perioperative EBL, total transfusion and calibrated EBL between two groups. However, intraoperative EBL and total transfusion in patients with preoperative embolization were significantly lower than in non-embolization in the corpectomy group (1645.5 vs. 892.6 mL, p=0.017 for intraoperative EBL and 6.1 vs. 3.9, p=0.018 for number of transfusion). In addition, the presence of Adamkiewicz artery at the index level was noted in two patients. Disruption of this major feeder artery resulted in significant changes in intraoperative neuromonitoring. Conclusion : Preoperative embolization for non-hypervascular MSD did not reduce perioperative blood loss. However, the embolization significantly reduced intraoperative bleeding and total transfusion in corpectomy group. Moreover, the procedure provided insights into the anatomy of tumor and spinal cord vasculature.

• Tuberculosis and Respiratory Diseases
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• v.40 no.5
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• pp.495-500
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• 1993

Background: For the relief of the occlusion of major bronchi, laser therapy, radiation therapy or combined therapy is generally used. But the effect of radiation therapy is very slow and not consistent and laser therapy requires expensive equipments and technical expertise with occasional serious side effects. Direct ethanol injection has been widely used for the control of bleeding in gastrointestinal lesion, esophageal varices or renal cell carcinoma with good results. So we tried direct injection of ethanol into the tumor to relieve the obstruction of major bronchus in 11 patients. Method: All procedures were done under the fiberoptic bronchoscopy with continuous oxygen supplement and aliquoted 0.5-1.0 ml of absolute ethanol directly into the tumor through the endobronchial aspiration needle. The tumor was endoscopically removed with a biopsy forceps immediately after ethanol injection. The whole procedure was repeated 3-4 days interval until the lumen opens. Usually after 2-3 trials of ethanol injection, the lumen opened up. Results: The immediate effect of ethanol injection was whitening of the mucosa and prompt cessation of bleeding. The late effect was necrosis of the tumor. The final results of this procedure were improvement of symptoms and reexpnasion of the lung in all patients. $FEV_{1.0}$ and FVC were improved and $PaO_2$ was increased from $68.1{\pm}9.2$ mmHg to $83.9{\pm}8.1$ mmHg, $SaO_2$: from $94{\pm}8.5%$ to $96.6{\pm}1.1%$, and $AaDO_2$ was reduced from $26.5{\pm}8.5$ mmHg to $10.9{\pm}9.1$ mmHg. Conclusion: Direct ethanol injection into the tumor tissue is a rapid, cheap and relatively safe method of relieving the complete occlusion of major bronchus.

• Archives of Plastic Surgery
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• v.34 no.5
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• pp.659-662
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• 2007

Purpose: Multiple skin leiomyoma and uterine myoma bearing autosomal dominant traits are benign smooth muscle tumors which originate in skin or female uterus. Skin leiomyoma occurs after gene mutation originating from arrector pili muscle of hair follicle where its clinical manifestations vary significantly from person to person. Our department hereby reports the histological findings and genetic evaluations of this very rare disease. Methods: A 57-year-old woman presented in our institute with multiple tumors in the left and central parts of her back that started to appear since 19 years ago. The patient was diagnosed as having uterine myoma 15 years ago and underwent hysterectomy. Biopsy has been done on the specimen, and genomic DNA was separated from Fumarate hydratase gene for it to go through PCR amplification. The results of PCR amplification were aligned by sequencer. Results: According to the results of biopsy, tumor cells were spindle-shaped and were aligned in a bundle where there was no dysplasia or mitosis. Moreover, these cells had abundant eosinophilic cytoplasm with elongated nucleus, and benign leiomyoma that showed positive reactions to SMA stain were found. In genetic examination, mutations such as heterozygous single nucleotide substitutions were found in alignments of amplified DNA. Conclusion: Multiple skin leiomyoma and uterine myoma are relatively uncommon diseases that are transmitted through autosomally dominant traits from genetic mutations. When a patient's chief complaint lies upon skin-colored or brown masses that occur in multiples appearing in the trunk or extremities with characteristic clinical symptoms and histological findings, and when the patient's family history is acknowledged such as skin or uterine leiomyoma or renal tumor, necessary genetic examination on multiple skin leiomyoma and uterine myoma could be done, and thereby precise diagnosis could also be made.

• Journal of Veterinary Clinics
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• v.32 no.5
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• pp.459-463
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• 2015

A 14-year-old, castrated male mixed-breed dog weighing 9 kg was presented for hematuria and dysuria. Abdominal ultrasound showed unilateral hydronephrosis and hydroureter with focal thickening of the ureteral wall. Surgical exploration revealed an intraluminal mass arising from the proximal left ureter. Mass resection was performed. Histopathology of the ureteral mass was consistent with a papillary transitional cell carcinoma. The patient recovered well post-operatively, but was diagnosed with another tumor three months later, this time in the right kidney. Fine-needle aspiration cytology of the renal mass revealed an epithelial cell tumor with mesenchymal features.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.1
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• pp.44-51
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• 2009

Purpose: We evaluated the results of surgical treatment for metastatic pathologic or impending pathologic fractures. Materials and Methods: From January 2004 to December 2007, 18 patients 19 cases were included. Male were 6 and female were 12. The mean age was 65.1. Mean follow up period was 15.2 months. Pathologic fractures were 14 and impending pathologic fractures were 5. MSTS score, periodic radiologic follow up and postoperative complications were evaluated. Results: The primary malignancies were 6 cases of multiple myeloma, 4 cases of renal cell carcinoma, 2 cases of cholangiocarcinoma, 2 cases of colon cancer, 2 cases of breast cancer and 2 cases of leiomyosarcoma. Metastatic lesions were 10 cases of femur, 4 cases of clavicle, 2 cases of humerus, 2 cases of tibia and 1 case of radius. Surgical options were curettage, cementation, internal fixation and arthroplasty. Mean MSTS score was 15.9. Postoperative complications were 1 case of infection, 1 case of local recurrence and 1 case of implant loosening. Ten patients were alive with disease, 8 patients died of disease. Conclusion: Surgical treatment of metastatic skeletal lesions allowed early ambulation and improving dexterity. It improved pain and emotional acceptance. Surgery is necessary for improving qualities of remaining lives.

• IMMUNE NETWORK
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• v.7 no.1
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• pp.31-38
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• 2007

Background: Mizoribine (MZR) is an imidazole nucleoside isolated from Eupenicillium brefeldianum. MZR is currendy in clinical use for patients who have undergone renal transplantation. Therapeutic efficacy of MZR has also been demonstrated in rheumatoid arthritis and lupus nephritis. MZR has been shown to inhibit the proliferation or lymphocytes by interfering with inosine monophosphate dehydrogenase. Since the exact mechanism by which MZR benefits rheumatoid arthritis (RA) is not clear, we investigated the ability of MZR to direct its immunosuppressive influences on other antigen presenting cells, such as macrophages. Methods: Mouse macrophage RAW264.7 cells were stimulated with lipopolysaccharide in the presence of MZR. To elucidate the mechanism of the therapeutic efficacy in chronic inflammatory diseases, we examined the effects of MZR on the production of pro-inflammatory cytokines, nitric oxide (NO) and prostaglandin $E_2\;(PGE_2)$ in macrophages. Results: MZR dose-dependendy decreased the production of nitric oxide and pro- inflammatory cytokines such as tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), interleukins $1{\beta}$ (IL-${\beta}$ and IL-6 $PGE_2$. Examination of gene expression levels showed that the anti-inflammatory effect correlated with the down-regulation of inducible nitiric oxide synthase expression, cycloxygenase-2 expression and TNF-${\alpha}$ gene expression. Conclusion: In this work, we resulted whether MZR $(1.25{\sim}10{\mu}g/ml)$ inhibited macrophage activation by inhibiting secretion of pro-inflammatory cytokines, NO and $PGE_2$. These findings provide an explanation for the therapeutic efficacy of MZR in chronic inflammation-associated diseases.

• Childhood Kidney Diseases
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• v.21 no.1
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• pp.21-25
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• 2017

Severe hypercalcemia is rarely encountered in children, even though serum calcium concentrations above 15-16 mg/dL could be life-threatening. We present a patient having severe hypercalcemia and azotemia. A 14-year-old boy with no significant past medical history was referred to our hospital with hypercalcemia and azotemia. Laboratory and imaging studies excluded hyperparathyroidism and solid tumor. Other laboratory findings including a peripheral blood profile were unremarkable. His hypercalcemia was not improved with massive hydration, diuretics, or even hemodialysis, but noticeably reversed with administration of calcitonin. A bone marrow biopsy performed to rule out the possibility of hematological malignancy revealed acute lymphoblastic leukemia. His hypercalcemia and azotemia resolved shortly after initiation of induction chemotherapy. Results in this patient indicate that a hematological malignancy could present with severe hypercalcemia even though blast cells have not appeared in the peripheral blood. Therefore, extensive evaluation to determine the cause of hypercalcemia is necessary. Additionally, appropriate treatment, viz., hydration or administration of calcitonin is important to prevent complications of severe hypercalcemia, including renal failure and nephrocalcinosis.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.5
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• pp.2475-2478
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• 2016

Background: Laparoscopic partial nephrectomy is one of the major surgical techniques for small renal masses. However, it is difficult to manage cutting and suturing procedures within acceptable time periods. To overcome this difficulty, we applied a three-dimensional (3D) video system with laparoscopic partial nephrectomy, and evaluated its utility. Materials and Methods: We retrospectively enrolled 31 patients who underwent laparoscopic partial nephrectomy between November 2009 and June 2014. A conventional two-dimensional (2D) video system was used in 20 patients, and a 3D video system in 11. Patient characteristics and video system type (2D or 3D) were recorded, and correlations with perioperative outcomes were analyzed. Results: Mean age of the patients was $55.8{\pm}12.4$, mean body mass index was $25.7{\pm}3.9kg/m^2$, mean tumor size was $2.0{\pm}0.8cm$, mean R.E.N.A.L nephrometry score was $6.9{\pm}1.9$, and clinical stage was T1a in all patients. There were no significant differences in operative time (p=0.348), pneumoperitoneum time (p=0.322), cutting time (p=0.493), estimated blood loss (p=0.335), and Clavien grade of >II complication rate (p=0.719) between the two groups. However, warm ischemic time was significantly shorter in the 3D group than the 2D group (16.1 min vs. 21.2min, p=0.021), which resulted from short suturing time (9.1 min vs. 15.2 min, p=0.008). No open conversion occurred in either group. Conclusions: A 3D video system allows the shortening of warm ischemic time in laparoscopic partial nephrectomy and thus may be useful in improving the procedure.

• Journal of Chest Surgery
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• v.10 no.2
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• pp.337-342
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• 1977

A clinical analysis was performed on 383 cases of chest injurjes experienced at Department of Thoracic Surgery, Seoul National University Hospital during 21 year period from 1957 to 1977. Of 383 patients of chest injuries, 209 cases were result from nonpenetrating injuries whereas 175 were from penetrating injuries, and there were 258 cases of hemothorax or/and pneumothorax, 162 of rib fracture, 33 of foreign body, 26 of clavicle fracture, 26 of lung contusion, 17 of diaphragmatic laceration, 14 of hemopericardium, 14 of flail chest and others. Stab wound was the most common in penetrating injuries and followed by gunshot and shell fragments. The majority of nonpenetrating chest injury patients were traffic accident victims. and fails accounted for the next largest group of accidents. Chest injuries were frequently encountered in the age group between 16 and 50 years, and 321 patients were male comparing to 62 of female. In blunt chest injuries the patients with five or more rib fractures had a 85 per cent incidence-of intrathoracic injury and 19 per cent had an intraabdominal organ damage, whereas those with four or less rib fractures had a 69 per cent and a 6 per cent incidence respectively. The principal associated injuries were cerebral contusion on 19 cases, renal contusion on 10, liver laceration on 7, peripheral vessel laceration on 5, spleen laceration on 3 and extremity fracture on 18 patients. The principles of therapy for early complications of chest trauma were rapid reexpansion of the lungs by thoracentesis [46 cases] and closed thoracotomy [125 cases] but open thoracotomy .had to be done on 90 cases [23-5%] because of massive bleeding or intrapleural hematoma, foreign body, cardiac injury, diaphragmatic laceration and bronchial rupture. The over all mortality was 2.87 per cent [11 among 383 cases], 8 cases were from penetrating injuries and 3 from nonpenetrating injuries.

• Journal of Microbiology and Biotechnology
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• v.10 no.4
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• pp.514-517
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• 2000

Abstracts Six shikonin metabolites were obtained from human intestinal bacteria, Bacteriodes fragilis subsp. thetaotus. following biotransformation. The transformation of shikonin (1) was performed anaerobically for 3 day at $37^{\circ}C$ in thc bacterial suspension of B. Fagilis which was cultured overnight in GAM broth. The incubation mixture \vas extracted with EtGAc Lo give a dark-brown residue. The residue was apphed to a silica gel column, which was eluted successively with hexane (Fr. A), $CHCl_3$ (Fr. B), and $CHCl_3$:MeOH (9:I) (Fr. C). Six metabolites. Fr.A (2 and 3), Fr. B (6 and 7), and Fr. C (4 and 5) were isolated by repeated silica gel column chromatography, preparatlVe TLC, followed by Sephadex LH-20. In vitro cytotoxicities were tested against human tumor cell lines; PC-3 (prostate), ACHN (renal), A549 (lung), SW620 (colon), KS62 (leukemia), and Du145 (prostate). The shikonin metabolites 2. 4, 5, and 6 showed weaker cytotoxicity than the parenL shikonin (1). whereas shikonin monomenc metabolite 3 ($ED_{50}{\;}O.44-{\;}1.22{\;}\mu\textrm{g}/ml$) and dimeric metabolite 7 ($ED_{50}{\;}O.48-{\;}2.35{\;}\mu\textrm{g}/ml$) exhibited stronger activities compared with adriamycin, which was used as the positive control.ontrol.