Purpose: The purpose of this study was to identify the changes of chemotherapy induced peripheral neuropathy (CIPN), sleep quality, and quality of life and their interrelationships following chemotherapy. Methods: A sample of 52 patients who had been diagnosed with stomach cancer receiving oxaliplatin containing chemotherapy were included in a prospective longitudinal study. The assessment tools were Chemotherapy-induced Peripheral Neuropathy 20, Pittsburgh Sleep Quality Index, and EORTC Quality of Life- Cancer. The data were collected at three time points: pre-chemotherapy, post-chemotherapy, and three months after the completion of chemotherapy, using questionnaires given between June 2017 and March 2019. Data were analyzed using descriptive statistics, repeated measures analysis of variance, and multiple regression analysis. Results: Post-chemotherapy, 19.2% of patients complained of CIPN and 21.2% exhibited CIPN at three-month follow-up. Repeated measures ANOVA showed a significant increase in CIPN after chemotherapy and it remained high at three-month follow-up (F = 39.90, p< .001). Functional quality of life (F = 8.23, p< .001) and symptom quality of life (F = 7.88, p= .001) also showed significant decreases after chemotherapy, and symptom quality of life remained low at three-month follow-up. However, for sleep quality, no significant main effect of time point was shown. CIPN and sleep quality were a factor influencing quality of life with an explanatory power of 48.3% at post-chemotherapy and 65.3% at three-month follow up. Conclusion These results suggest that chemotherapy is highly associated with CIPN and symptoms affecting quality of life in cancer patients. Nursing intervention is needed to monitor and relieve these symptoms of patients during the cancer care trajectory.

BACKGROUND: To meet the need for a subspecialized skin type system, the Baumann skin type (BST) system was proposed. OBJECTIVE: To evaluate the distribution of BST types and influencing factors among Korean women. METHODS: BST questionnaires were administered to 1,000 Korean women. The possible responses were as follows: oily (O) or dry (D), sensitive (S) or resistant (R), pigmented (P) or non-pigmented (N), and wrinkled (W) or tight (T). The correlations of the BST with the subjects' age, location, ultraviolet (UV) ray exposure, drinking and smoking habits, and blood type were assessed. RESULTS: The OSNT, DSNT, DRNT, and OSNW skin types were the most common skin types (55.3%). The O, S, P, and W types accounted for 46.6%, 68.8%, 23.2%, and 31.9%, respectively. The proportion of the O and S type was the highest in Gyeongsangbuk-do (55.0%) and Seoul (77.2%). The proportion of the P and W type was the highest in Gyeongsangbuk-do (33.0%) and Chungcheong-do (39.0%). The O type decreased in the higher age group, whereas the P and W type showed a reversed tendency. In smokers, the proportion of W type was significantly higher than in the non-smokers (66.3% vs. 24.1%, p<0.05). CONCLUSION: The 4 most common BST types were OSNT, DSNT, DRNT, and OSNW. In the comparison across the 4 BST parameters according to the age, region, smoking and drinking habits, occupation, blood type, and UV exposure, significant differences were observed. Individualized and customized skin care is required according to the personal skin type.
Drinking ; Female* ; Gyeongsangbuk-do ; Humans ; Occupations ; Seoul ; Skin Care ; Skin* ; Smoke ; Smoking ; Surveys and Questionnaires

BACKGROUND: The utilization of botulinum toxin has rapidly expanded into various aesthetic applications. Achieving success with the aesthetic use of neurotoxins depends on several factors, including an understanding of the anatomy, the methods of dilution and the injection technique. Any guidelines representing a consensus for aesthetic treatments using botulinum toxin type A (BTA) have not been published in Korea. OBJECTIVE: We wanted to provide consensus recommendations on the treatment of facial wrinkles and benign masseter hypertrophy using BTA in Korean patients. METHODS: A panel of experienced Korean dermatologists was convened to develop a clinical consensus. The clinical consensus was comprised of the recommendations of the panel and the guidelines on general issues, such as the reconstitution and handling of the BTA, the procedural considerations, the dosing and injection-site standardizations, and the prevention and treatment of unwanted effects. Specific recommendations were provided according to the area of treatment, including glabellar lines, horizontal forehead lines, lateral periorbital wrinkles and benign masseter hypertrophy. RESULTS: The recommended final concentration of BTA was 50 units/ml (5 units/0.1 ml) after reconstitution with physiologic saline. For glabellar lines, the members recommend three injection points (a total of 8 units). For forehead wrinkles, the members recommend nine injections in two rows into the frontalis with 1 unit/point. For crow's feet, the members recommend three injections per side (7 units/side) at the lateral part of the orbicularis oculi. For benign masseter hypertrophy, three injections per side (24~30 units/side) were recommended. CONCLUSION: These consensus recommendations will provide a framework for Korean dermatologists who wish to perform safe and efficacious injection of BTA for facial rejuvenation.
Botulinum Toxins ; Botulinum Toxins, Type A ; Consensus ; Foot ; Forehead ; Handling (Psychology) ; Humans ; Hypertrophy ; Korea ; Neurotoxins ; Rejuvenation

PURPOSE: Gastric cancer is prevalent in Korea, therefore the purpose of this study was to determine the clinicopathologic characteristics, 5-year survival rate, and prognostic factors for gastric patients who underwent gastrectomy by a single surgeon. MATERIALS AND METHODS: A total of 1,435 patients diagnosed with gastric cancer who underwent gastrectomy in the Department of Korean Gastric Cancer Center at Seoul Paik Hospital between September 1998 and August 2003, and the gender, age, location and size of the tumor, visual and histologic analysis, depth of invasion, lymph node metastasis, invasion (perineural, venous, and lymphatic), and surgical method were examined retrospectively. RESULTS: The ratio between males and females was 2.29:1, and the average age was 56.7 years. Based on the UICC TNM classification, the patients were distributed as follows: IA 35.4%, IB 14.1%, II 12.6%, IIIA 12.3%, IIIB 8.3% and IV 17.3%. The 5-year survival rate was 69.6%. The results of univariate analysis showed that there were significant differences in the survival rate by age, location and size of tumor, Borrmann type, level of differentiation, Lauren's classification, depth of invasion, metastasis in lymph nodes, UICC TNM stage, invasion (perineural, venous, and lymphatic), and surgical method. Based on multivariate analysis, only the depth of invasion and lymph node metastasis were independent prognostic factors. CONCLUSION: Although various clinicopathologic characteristics affect the prognostic factors of the patients with gastric cancer, the results of this study showed that the stage of disease, such as depth of invasion and metastasis in lymph nodes, are the most critical factors. There is a need to establish the diagnosis of gastric cancer early and to study and develop various treatment methods based on the diagnostic factors in order to improve the survival of patients with gastric cancer.
Female ; Gastrectomy ; Humans ; Korea ; Lymph Nodes ; Male ; Multivariate Analysis ; Neoplasm Metastasis ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate

PURPOSE: Docetaxel (Taxotere(R)) and capecitabine are used in combination to treat advanced gastric cancer. Thymidine phosphorylase (TP) is an essential enzyme for the activation of capecitabine in tumors. This study sought to identify the best combination therapy with capecitabine and using two different schedules for docetaxel, a TP up-regulator, to enhance capecitabine's efficacy. METHODS: The human gastric cancer cell line SNU-484 was cultured and docetaxel (2 microgram/ml) was added to the 24-well plates that contained 5 x 10(5) cells/well. The total RNA was isolated and RT-PCR was done to identify the TP expression. Four- or five-week-old BALB/c-nu/nu mice were subcutaneously inoculated with the SNU-484 cells. The nude mice were divided into two groups and they were given capecitabine 539 mg/m2 p.o. from days 1 to 14: Group 1 was given docetaxel 15 mg/m2 i.v. on day 1; Group 2 was given docetaxel 7.5mg/m2 on days 1 and 8. Tumor tissues were excised on days 1, 8 and 15 to measure the TP and bcl-2 levels. RESULTS: TP was expressed 2 hours after docetaxel administration. Group 2 had a higher TP concentration in the tumor tissues and a better antitumor effect than did Group 1. There was no difference in the bcl-2 concentration in the two groups. CONCLUSION: These results suggest that docetaxel stimulates the TP expression in tumor tissues and it enhances the antitumor activity of capecitabine. A weekly docetaxel injection with capecitabine administration can be used to treat gastric cancer more effectively than when docetaxel is injected once per cycle. Capecitabine had no bcl-2 suppressive effect in this study.
Animals ; Appointments and Schedules* ; Capecitabine ; Cell Line* ; Heterografts* ; Humans ; Mice ; Mice, Nude* ; RNA ; Stomach Neoplasms* ; Thymidine Phosphorylase* ; Thymidine*

Eosinophilic gastroenteritis is a rare clinicopathologic entity of unknown etiology with a variety of digestive symptoms. The pathogenesis is poorly understood. Diagnostic criteria include demonstration of eosinophilic infiltration of the affected bowel wall, lack of evidence of extraintestinal disease, and exclusion of various disorders that could mimic similar conditions. The disease might involve any area of the gastrointestinal tract from the esophagus to the rectum, but the stomach and the proximal small bowel are most commonly affected. The clinical features depend on which layer and site are involved. We report the case of a 59-year-old male patient with a 3-week history of post-prandial vomiting with malnutrition and weight loss. An abdominopelvic CT showed a gastric outlet obstruction with diffuse wall thickening, as with linitis plastica. Three gastrofiberscopic biopsies showed chronic gastritis. We carried out a radical total gastrectomy with D2 lymph node dissection. The pathologic report revealed a mural type eosinophilic gastritis with a marked hypertrophic scar formation at the proper muscle layer. We report this case with a brief review of the literature.
Biopsy ; Cicatrix, Hypertrophic ; Eosinophils* ; Esophagus ; Gastrectomy ; Gastric Outlet Obstruction ; Gastritis* ; Gastroenteritis ; Gastrointestinal Tract ; Humans ; Linitis Plastica ; Lymph Node Excision ; Male ; Malnutrition ; Middle Aged ; Rectum ; Stomach ; Stomach Neoplasms* ; Vomiting ; Weight Loss

Despite improvements in the surgical treatment of gastric adenocarcinomas, the recurrence rates remain high in patients with advanced-stage disease. Most of the recurrence occurs within 3 years of the surgical resection, and nearly 90% of the patients with recurrence die within 2 years of the diagnosis of recurrence. A recent study analyzed recurrence patterns for patients who had undergone a potentially curative gastrectomy. For those patients, 33% of the recurrences involved locoregional sites, 44% the peritoneum, and 38% distant sites. A 51-year-old female patient was diagnosed with stomach cancer and underwent a total gastrectomy with D2 lymph node dissection during Oct. 1999. The pathologic report indicated a T3N1M0 tumor. We performed immunochemotherapy for 2 years with regular follow up. A gastrofiberscopic examination done during Sep. 2004, cancer recurrence was found at the *Kim's tie site of the jejunual loop. We did an abdominal exploration and a segmental resection of cancer site with pathologically negative resection margins. After the operation, we started secondary chemotherapy with TS-1.
Adenocarcinoma ; Diagnosis ; Drug Therapy ; Female ; Follow-Up Studies ; Gastrectomy* ; Humans ; Jejunum* ; Lymph Node Excision ; Middle Aged ; Peritoneum ; Recurrence ; Stomach Neoplasms*

We report a case of gastrointestinal anisakiasis which was misinterpreted as a gastrointestinal stromal tumor until an operation and pathological report. A 44-year-old female was diagnosed as having a gastrointestinal stromal tumor on esophagogastroduodenoscopy during a routine medical examination. The esophagogastroduodenoscopy revealed a 1 cm sized submucosal tumor at the gastric mid-body. Endoscopic ultrasonography showed a low echoic tumor, with an irregular margin, in the submucosal layer. The patient underwent a wedge resection of the gastric lesion. A histological examination revealed chronic granulomatous inflammation, with abscess formation and a parasitic organism, morphologically consistent with anisakiasis.
Abscess ; Adult ; Anisakiasis* ; Endoscopy, Digestive System ; Endosonography ; Female ; Gastrointestinal Stromal Tumors ; Humans ; Inflammation

PUPOSE: Anastomosis site stricture is a common complication after a total gastrectomy. End-to-end anastomosis (EEA) stapler devices are preferred to a hand-sewn esophagojejunostomy these days. However, stapling devices have been reported not to reduce the incidence of esophagojejunostomy site stricture considerably. MATERIALS AND METHODS: From Sep. 1998 to Dec. 2000, at Korea Gastic Cancer Center, Seoul Paik Hospital, Inje University, we experienced 228 total gastrectomies in which EEA stapling devices had been used. We investigated the correlation of the stricture with the size of the EEA stapling device, the type of esophagojejunal reconstruction, reflux esophagitis, and duration of stricture development. RESULTS: Among the 228 cases, as far as the patient's age was concerned, the 7th decade was the most common 64 cases, followed by the 5th decades. The Male-to-female ratio was 2.3 : 1. A loop esophagojejunostomy was used in 223 cases, and the Roux-en-Y method was used in 5 cases. The 32 patients with anastomosis site stricture were patients with loop esophagojejunal anastomosis. Anastomosis site stricture occurred in 14% (32/228) of the total gastrectomy cases, in15.9% (11/69) of the total gastrectomies involving stapler devices with a 25-mm diameter, and in 13.2% (21/159) of the total gastrectomies involving staper devices with a 28-mm diameter. There was no correlation between the incidence of stricture and EEA- stapling device size (P>0.05). Reflux esophagitis occurred in 56 of the 228 cases, with 7 of those 56 cases (12.5%) and 25 of the remaining 172 cases (14.5%) having strictures. There was no considerable difference in the stricture incidence rate according to the presence of reflux esophagitis (P>0.05). The onset of stricture development, occurred within 6 months in 16 cases, including 4 cases of reflux esophagitis, between 7 and 18 months in 14 cases, including 3 cases of reflux eshophagitis, and after 19 months in 2 cases. CONCLUSION: An esophagojejunostomy site stricture after a total gastrectomy was not correlated with the esophagojejunal reconstruction type, the size of the stapling device, or the presence of reflux esophagitis. General anastomosis technical factors (e.g., adequate blood supply, tension-free manner, adequate hemostasis) may be more important to prevent anastomosis site stricture after an esophagojejunostomy during a total gastrectomy.
Constriction, Pathologic* ; Esophagitis, Peptic ; Gastrectomy* ; Humans ; Incidence ; Korea ; Seoul

We report a case of giant malignant gastrointestinal stromal tumor (GIST) accompanying an advanced gastric adenocarcinoma. A 73-year-old male patient was admitted to our hospital due to epigastric discomfort. In gastrofiberscopic examination, a localized Borrmann III gastric cancer at the lower body and antrum was noted. In endoscopic ultrasonographic examination, T3 hyperechoic advanced gastric cancer lesion and a relatively well-marginated heterogenous hypoechoic huge mass with a size of 10 cm were noted. In abdomen CT findings, localized wall thickening in the gastric antrum and the anterior wall, and a 11-cm-sized large heterogeneously enhancing mass in gastric body, posterior wall were noted. We did a radical subtotal gastrectomy, including a huge mass, with D2 lymph node dissection. Pathologic findings revealed double primary gastric neoplasms (synchronous occurrence of an adenocarcinoma and a huge GIST). Although closely juxtaposed, these two tumors had not merged and were separated by the thin rim of the muscularis propria.
Abdomen ; Adenocarcinoma ; Aged ; Gastrectomy ; Gastrointestinal Stromal Tumors* ; Humans ; Lymph Node Excision ; Male ; Pyloric Antrum ; Stomach Neoplasms* ; Stomach*