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1.  A Promising Treatment for Broncholith Removal Using Cryotherapy during Flexible Bronchosopy: Two Case Reports 
Broncholiths are defined as calcified materials that occur in a tracheobronchial tree or in a cavity communicating with that. Broncholith has variable clinical features. The therapeutic options to remove broncholiths are so variable that clinicians need to select the most safe and effective methods by mass size, mobility, and location. As yet, there is no consistent guideline removing a broncholith. We report 2 successful cases of removing a fixed broncholith by flexible bronchoscopy guided cryoadhesion. With repeated technique of thawing and freezing with ryoprobe, we could extract the fixed broncholith safely. This method is promising as a way to remove broncholith in the future.
doi:10.4046/trd.2012.73.5.282
PMCID: PMC3517948  PMID: 23236321
Bronchial Diseases; Calculi; Cryotherapy; Bronchoscopy
2.  Hemophagocytic Lymphohistiocytosis (HLH) Associated with Plasmodium vivax Infection: Case Report and Review of the Literature 
Chonnam Medical Journal  2011;47(3):173-176.
Hemophagocytic lymphohistiocytosis (HLH) is an unusual syndrome characterized by fever, hepatosplenomegaly, cytopenias, hypertriglyceridemia, hypofibrinogenemia, and pathologic findings of hemophagocytosis in the bone marrow and other tissues. HLH may be familial or associated with different types of infections, autoimmune disorders, or malignancies. Infection-associated HLH has been reported in various viral, bacterial, fungal, and parasitic infections, and case reports of parasitic infections implicated in HLH include rare cases from Plasmodium vivax infection, which occasionally affects both military personnel and civilians in Korea. We describe an unusual case of HLH resulting from Plasmodium vivax infection and review the literature. This case suggests that clinical suspicion of HLH is important when P. vivax infection is accompanied by cytopenias. Administration of antimalarial drugs may prevent irreversible end organ damage resulting from P. vivax-associated HLH.
doi:10.4068/cmj.2011.47.3.173
PMCID: PMC3252507  PMID: 22247919
Hemophagocytic lymphohistiocytosis; Plasmodium vivax
3.  Early Gastric Cancer with Signet Ring Cell Histology Remained Unresected for 53 Months 
Journal of Gastric Cancer  2011;11(3):189-193.
The natural course of untreated patients with signet ring cell carcinoma of the stomach remains poorly understood while assumptions have been made to distinguish it from other types of gastric cancer. A 74-year-old Korean woman was diagnosed with early gastric cancer with signet ring cell histology and refused surgery. A satellite lesion was identified 46 months after the initial diagnosis. The patient finally agreed to undergo distal subtotal gastrectomy 53 months following the initial diagnosis. Postoperative histological examination of both lesions confirmed signet ring cell carcinoma associated with submucosal invasion. There was no evidence of lymph node metastasis.
doi:10.5230/jgc.2011.11.3.189
PMCID: PMC3204463  PMID: 22076226
Disease progression; Gastrectomy; Carcinoma, signet ring cell; Stomach neoplasms
4.  Korean Guidelines for the Prevention of Venous Thromboembolism 
Journal of Korean Medical Science  2010;25(11):1553-1559.
This guideline focuses on the primary prevention of venous thromboembolism (VTE) in Korea. The guidelines should be individualized and aim at patients scheduled for major surgery, as well as patients with a history of trauma, high-risk pregnancy, cancer, or other severe medical illnesses. Currently, no nation-wide data on the incidence of VTE exist, and randomized controlled trials aiming at the prevention of VTE in Korea have yielded few results. Therefore, these guidelines were based on the second edition of the Japanese Guidelines for the Prevention of VTE and the eighth edition of the American College of Chest Physicians (ACCP) Evidenced-Based Clinical Practice Guidelines. These guidelines establish low-, moderate-, and high-risk groups, and recommend appropriate thromboprophylaxis for each group.
doi:10.3346/jkms.2010.25.11.1553
PMCID: PMC2966990  PMID: 21060742
Guideline; Prevention; Venous Thromboembolism
5.  Comparison of different nutritional assessments in detecting malnutrition among gastric cancer patients 
AIM: To evaluate the prevalence of preoperative and postoperative malnutrition and the relationships between objective and subjective nutritional assessment of gastric cancer patients.
METHODS: From October 2005 to July 2006, we studied 80 patients with no evidence of recurrent disease and no loss to follow-up after curative surgery for gastric cancer. In this group, 9 patients underwent total gastrectomy and 71 patients subtotal gastrectomy. At admission, 6 and 12 mo after surgery, the patients were assessed on the subjective global assessment (SGA), nutritional risk screening (NRS-2002), nutritional risk index (NRI) and by anthropometric measurements and laboratory data. Differences between the independent groups were assessed with the Student’s t test and one-way analysis of variance. Spearman’s rank correlation coefficients were calculated to evaluate the association between the scores and variables.
RESULTS: The prevalence of malnutrition at admission was 31% by SGA and 43% by NRS-2002. At admission, the anthropometric data were lower in the malnourished groups defined by the SGA and NRS-2002 assessments, but did not differ between the groups using the NRI assessment. Body weight (BW), body mass index (BMI), triceps skin fold and midarm circumference were significantly reduced, but the total lymphocyte count, albumin, protein, cholesterol and serum iron levels did not decrease during the postoperative period. Six months after surgery, there was a good correlation between the nutritional assessment tools (SGA and NRS-2002) and the other nutritional measurement tools (BW, BMI, and anthropometric measurements). However, 12 mo after surgery, most patients who were assessed as malnourished by SGA and NRS-2002 had returned to their preoperative status, although their BW, BMI, and anthropometric measurements still indicated a malnourished status.
CONCLUSION: A combination of objective and subjective assessments is needed for the early detection of the nutritional status in case of gastric cancer patients after gastrectomy.
doi:10.3748/wjg.v16.i26.3310
PMCID: PMC2900724  PMID: 20614488
Gastrectomy; Malnutrition; Nutritional assessment; Nutritional risk screening; Postoperative follow up; Subjective global assessment
6.  Evaluation of fat sources (lecithin, mono-glyceride and mono-diglyceride) in weaned pigs: Apparent total tract and ileal nutrient digestibilities 
Nutrition Research and Practice  2008;2(2):130-133.
This study was conducted to investigate the effects of lecithin, mono-glyceride and mono-diglyceride on apparent total tract and ileal nutrient digestibilities in nursery pigs. Twenty [(Landrace × Yorkshire) × Duroc] barrows were surgically fitted with simple T-cannulas. Dietary treatments included 1) CON (basal diet: soy oil), 2) LO (lecithin 0.5%), 3) MO (mono-glyceride 0.5%), 4) MG (mono-glyceride 1.0%) and 5) MDG (mono-diglyceride 1.0%). In apparent total tract nutrient digestibility, dry matter (DM) and gross energy (GE) digestibilities of MDG treatments were higher than LO and MG treatments (p<0.05). In nitrogen (N) digestibility, LO treatment showed the lowest compared to others (p<0.05). The digestibility of crude fat was higher in MDG treatment than CON and LO treatments (p<0.05). In apparent ileal nutrient digestibility, DM digestibility was higher in MDG treatment than LO and MG treatments (p<0.05). GE digestibility was higher in MDG treatment than LO, MO and MG treatments (p<0.05). N digestibility of MDG treatment was greater than LO treatment (p<0.05). Also, the digestibility of crude fat was higher in MDG treatment than CON and LO treatments (p<0.05). In conclusion, mono-diglyceride can increase apparent total tract nutrient and apparent ileal nutrient digestibilities of DM, GE, N and crude fat.
doi:10.4162/nrp.2008.2.2.130
PMCID: PMC2815320  PMID: 20126377
Lecithin; monoglyceride; ileal digestibility; weanling pigs
7.  Adrenalectomy for Metastatic Disease to the Adrenal Gland from Gastric Cancer: Report of a Case 
Metastases to the adrenal glands are frequently found at autopsy. In practice, adrenal metastases have generally been accepted as evidence of blood-borne systemic disease. So, clinically curable adrenal metastases is a rare malady. The role for surgical resection in adrenal metastases has not been clearly defined. A 45-year-old man initially underwent total gastrectomy with D2 lymph node dissection for treating his advanced gastric cancer. A solitary adrenal metastases was resected 1 year later. The patient has survived for 3 years and no further evidence of disease was found on his last follow-up examination. We report here on this case to show that for selected cases, surgical resection of adrenal metastases is feasible and this procedure may extend survival for metastatic gastric cancer patients.
doi:10.3904/kjim.2007.22.1.18
PMCID: PMC2687596  PMID: 17427640
Gastric cancer; Metastases; Adrenalectomy
8.  Prognostic Significance of Immunohistochemical Expression of p53 and Retinoblastoma Gene Protein (pRB) in Curatively Resected Gastric Cancer 
Background
The aim of this study was to determine the prognostic significance of the expression of p53 and retinoblastoma (Rb) gene products in cases of curatively resected gastric adenocarcinoma, by immunohistochemical analysis.
Methods
Between January 1996 and December 2001, 736 curatively resected gastric cancer patients underwent immunohistochemical staining for p53 or Rb proteins (pRb), and we retrospectively analyzed the correlation of our results with the clinical outcomes of these cases.
Results
High levels of expression of p53 (>25% p53-positive cells) and Rb (>50% Rb-positive cells) proteins were detected in 40.1% and 43.7% of cases, respectively. Tubular type was found to frequently exhibit higher levels of p53 expression (high expression in 44.2%) than signet ring cell type (high expression in 26.0%) (p=0.042). The incidence of vascular invasion was lower in the high pRb expressors (43.2%) than in the pRb low expressors (56.8%), but this was not a statistically significant discrepancy (p=0.063). Preoperative CEA levels were found to be low in high pRb expressors: initial CEA level in the high pRb expressors was 2.31±3.30 ng/mL, and was 5.18±24.80 ng/mL in the low pRb expressors (p=0.033). Tumor depth and node metastasis were both independent of the levels of expression of p53 and Rb proteins. The seven-year overall survival rate and relapse-free survival rates of patients were 87.2% and 75.7%, respectively. Multivariate Cox regression analysis indicated that tumor stage, tumor size, patient age and pRb expression were the significant prognostic factors with regard to overall survival, and tumor stage and age were both significant factors with regard to relapse-free survival.
Conclusion
Immunohistochemical staining of retinoblastoma gene products was an independent prognostic factor for the prediction of overall survival in curatively resected gastric cancer patients.
doi:10.3904/kjim.2005.20.1.1
PMCID: PMC3891404  PMID: 15906946
Gastric cancer; Prognosis; p53; Rb gene; Immunohistochemistry
9.  Prognostic Significance of Immunohistochemical Expression of EGFR and C-erbB-2 Oncoprotein in Curatively Resected Gastric Cancer 
Purpose
The purpose of this study was to investigate the prognostic significance of the expression of EGFR and C-erbB-2 gene products by immunohistochemical analysis for curatively resected gastric adenocarcinoma.
Materials and Methods
Between January 1996 and December 2001, 739 patients with curatively resected gastric cancer patients underwent immunohistochemical staining for EGFR and C-erbB-2 proteins, and we retrospectively analyzed their correlation with the clinical outcome.
Results
The overexpressions of EGFR and C-erbB-2 were 25.4% and 26.2%, respectively. The overexpressions of EGFR was associated with the more poorly differentiated tumor (p=0.000) and with neuronal invasion (p=0.03). Overexpression of C-erbB-2 was associated with less vascular invasion (p=0.001). Tumor depth or node metastasis was not related to the overexpression of EGFR or C-erbB-2. The seven-year overall survival and relapse-free survival rates were 87.2% and 75.8%, respectively. Upon multivariate Cox regression analysis, the tumor stage, tumor size and patient age were important prognostic factors for overall survival, and tumor stage was the important factor for relapse-free survival. Overexpressions of EGFR or c-erbB-2 were not significant prognostic factors.
Conclusion
Immunohistochemical staining of EGFR and C-erbB-2 gene products were not independent prognostic factors for predicting the overall survival and the relapse-free survival in curatively resected gastric cancer.
doi:10.4143/crt.2004.36.4.240
PMCID: PMC2843891  PMID: 20368841
Gastric cancer; Prognosis; Immunohistochemistry; EGFR; C-erbB-2

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