• Journal of Gastric Cancer
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• v.5 no.2
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• pp.127-132
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• 2005

A hepatoid adenocarcinoma of stomach, a subtype of gastric cancr, is characterized by a histologic resemblance to a hepatocellular carcinoma and $\alpha$-feto protein production. Another feature is early metastasis to the liver and lymph nodes, thus revealing a poor prognosis. We report a case of a hepatoid adenocarcinoma of the stomach with liver metastasis. A 52-year-old male visited our hospital with a chief complaint of indigestion. Gastroscopic examination showed a Borrmann type-II lesion on the lesser curvature of the antrum. The CT scan showed a suspected advanced gastric cancer with liver metastasis. The serum AFP level was 123 ng/ml. A radical subtotal gastrectomy and a right hemihepatectomy were performed simultaneously. Pathologic examination confirmed the lesion to be confined to the submucosa. The gastric lesion was a hepatoid adenocarcinoma, and the hepatic lesion was a metastatic adenocarcinoma from the stomach. Therefore, he was classified as having stage IV (T1N1M1) gastric cancer. In cases of a hepatoid adenocarcinoma of the stomach, even patients with early gastric cancer can be staged into the poor prognostic group.

• Korean Journal of Digital Imaging in Medicine
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• v.17 no.1
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• pp.19-31
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• 2015

최근 우리나라의 암 발생률은 꾸준히 증가추세에 있고 그 중에서도 전립선암은 갑상선암을 제외했을 때 남성에서 가장 높은 증가 추세를 보이고 있는 암이다. 전립선암은 그 동안 선진국에서 주로 발병하는 것으로 알려진 암 종이지만 서구화된 식습관과 생활 행태 변화로 인하여 국내에서도 발생률이 증가하는 것으로 추정하고 있다. 따라서 국내 환경에 맞는 내장 지방 분포와 같은 정확한 비만도 측정을 통해 우리나라에서 증가율 1위를 보이고 있는 전립선암 발생의 원인 관계를 찾고자 한다. 본 연구는 환자와 정상군 비교를 하는 환자-대조군 연구이고 본 연구를 위하여 임상시험 윤리위원회 (IRB) 승인을 받았다 (NCC2014-0124). 환자군은 2014년 8월 1일부터 2015년 1월 6일 까지 국립암센터를 방문하여 전립선암을 진단받고 수술과 항암치료 그리고 방사선 치료를 시작하지 않은 초진을 대상으로 하였고, 정상군은 2009년 11월부터 2014년 9월 30일까지 공단검진을 목적으로 국립암센터를 방문한 정상인을 대상으로 하였다. 전립선암 연구는 환자 총 52명에 평균 66세 (51 - 82세)이고 정상군은 총 50명에 평균 64세 (59 - 75세) 이다. 모든 연구 대상자들의 생활 요인 평가를 위하여 암 가족력, 흡연, 음주 상태, 운동, 등을 추가적으로 설문 조사하였다. MRI 영상의 배꼽 주위에서의 내장 지방과 피하지방을 전용 분석 컴퓨터를 활용하여 측정 하였다. 복부비만율은 환자군과 정상군에서뿐만 아니라 (p = 0.03), 전립선암 악성도와 (Gleasonscore; p = 0.001)도 통계적 차이를 나타냈다. 하지만 BMI 결과와는 전립선암 발생과 악성도에서 무관함을 보인 것에 반해 허리둘레는 전립선암의 발생에 영향을 미치는 결과를 나타났다. 한편 전립선암의 또 다른 악성도 지표인 PSA는 비만 측정치와의 상관성이 Gleason score와 보다 대체적으로 낮게 나타났다. 학력, 운동량, 흡연, 음주 상태와 같은 생활 특성에 따른 전립선암 발생의 영향 관계는 뚜렷하지 않았다. 결론적으로 본 연구를 통해서 전립선암의 발생 위험도와 악성도 지표로 복부 비만도가 유용함을 나타냈고 간단한 신체 계측 지표 활용으로는 BMI보다 허리둘레 측정치가 더 암 발생의 연관성이 높음을 보였다.

• 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 Gastric Cancer
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• v.7 no.2
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• pp.107-112
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• 2007

Rhabdoid tumor has been considered to be a rare subtype of Wilm's tumor with Rhabdomyoma features. Since rhabdoid tumor that developed in the kidney was described for the first time in 1989, it has been reported in the gastrointestinal tract, although this is rare. The appropriate treatment is radical resection, and the effect of adjuvant chemotherapy has not yet been reported on. The outcome of extra-renal rhabdoid tumor is different from renal rhabdoid tumor and the former shows a poor prognosis. Among extra-renal rhabdoid tumors, undifferentiated gastric adenocarcinoma with rhabdoid features is very rare and its prognosis is poor. A 63 years old male patient underwent total gastrectomy for a tumor that developed in the greater curvature of the gastric body and this was diagnosed as undifferentiated gastric adenocarcinoma with rhabdoid features, according to the histopathology. We experienced an undifferentiated gastric adenocarcinoma with rhabdoid features that was diagnosed by immunohistochemical staining and we report here on this case.

• Journal of Chest Surgery
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• v.41 no.6
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• pp.787-790
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• 2008

Barrett's esophagus is precancerous lesion of esophageal adenocarcinoma, but this has been rarely reported in Korea. A 81-year-old man with esophageal adenocarcinoma was admitted to our hospital, and we performed a distal esophagectomy and end-to-end esophagogastrostomy. The microscopic examination of the resected tissue revealed the intestinal metaplasia with goblet cells around the esophageal adenocarcinoma, which indicates this was a Barrett's esophagus. We report here on this case along with a review of the relevant literature.

• KIPS Transactions on Software and Data Engineering
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• v.3 no.5
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• pp.187-194
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• 2014

Prostate cancer is a malignant tumor occurring in the prostate. Recently, the repetition rate is increasing. Image inspection method which we can check the prostate structure the most correctly is MRI(Magnetic Resonance Imaging), but it is hard to apply it to all the patients because of the cost. So, they use mostly TRUS(Transrectal Ultrasound) images acquired from prostate ultrasound inspection and which are cheap and easy to inspect the prostate in the process of treating and diagnosing the prostate cancer. Traditionally, in the hospital the doctors saw the TRUS images by their eyes and manually segmented the boundary between the prostate and nonprostate. But the manually segmenting process not only needed too much time but also had different boundaries according to the doctor. To cope the problems, some automatic segmentations of the prostate have been studied to generate the constant segmentation results and get the belief from patients. In this study, we propose an average shape model to segment the prostate boundary in TRUS prostate image. The method has 3 steps. First, it finds the probe using edge distribution. Next, it finds two straight lines connected with the probe. Finally it puts the shape model to the image using the position of the probe and straight lines.

• Journal of Hospice and Palliative Care
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• v.17 no.4
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• pp.207-215
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• 2014

Multiple bone metastases are common manifestation of many malignant tumors such as lung cancer, breast cancer, prostate cancer and renal cell carcinoma. Bone metastasis is secondary cancer in the bone, and it can lead to bone pain, fracture, and instability of the weight bearing bones, all of which may profoundly reduce physical activity and life quality. Treatment for bone metastasis is determined by multiple factors including pathology, performance status, involved site, and neurologic status. Treatment strategies for bone metastasis are analgesics, surgery, chemotherapy and radiotherapy. External beam radiotherapy has traditionally been an effective palliative treatment for localized painful bone metastasis. However, in some cases such as multiple bone metastases, especially osteoblastic bone metastasis originated from breast or prostate cancer, the radiopharmaceutical therapy using $^{89}Sr$, $^{186}Re$, $^{188}Re$, $^{153}Sm$ and $^{117m}Sn$ are also useful treatment option because of administrative simplicity (injection), few side effects, low risk of radiation exposure and high response rate. This article offers a concise explanation of the radiopharmaceutical therapy for multiple bone metastases.

• The Korean Chronic Disease News
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• no.320
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• pp.1-17
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• 2007

전국 지자체 보건사업 종합평가/"생활습관병 퇴치 정책도입 필요"/고혈압.당뇨병환자 직접 등록관리/'방문건강관리'로 고혈압 관리율 향상/세계폐암학회, 담배 판매 금지 촉구/"폐암 진단 기준 세분화된다"/세계폐암학회 2007년 담배규제선언문/서울대병원, 브랜드 경쟁력 1위/세브란스병원 국제적으로 인증/충남도청 이전지에 '건양대학병원' 설립/55세 이상 남성... 5%가 전립선암/"순한 담배가 선암성 폐암 일으킨다"/골다공증 척추골절, 직접성형 96% 만족/건강투자전략의이해/"살기 좋은 웰빙 도봉"-도봉구보건소/"생각이 바뀌면 운명이 달라진다"

• Journal of Digestive Cancer Research
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• v.1 no.1
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• pp.48-51
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• 2013

We report an unusual case of postoperative early gastric cancer with liver metastasis mimicking pancreaticobiliary carcinoma. A 73-year-old man with early gastric cancer was transferred for endoscopic treatment. The patient underwent endoscopic submucosal dissection for the treatment of the early gastric cancer. The pathological diagnosis was adenocarcinoma with extension to the deep submucosa and some lymphatic invasion. Therefore, subsequent a subtotal gastrectomy was performed. The histological results demonstrated residual adenocarcinoma confined to the mucosa. The resection margin and lymph node metastasis were negative. Thus, he was closely monitored for recurrence every 6 months. After 2 years, he was suddenly suspected of developing liver metastasis and local recurrence. He received a liver biopsy, and the pathological result was poorly differentiated adenocarcinoma. Immunohistochemical staining suggested pancreaticobiliary carcinoma rather than metastatic adenocarcinoma from the stomach or colon, but primary focus was not found. We were sure that the recurrent stomach cancer metastasized to the liver because stomach cancer can show heterogeneous cytokeratin (CK) expression pattern with various histological features. Therefore, no single CK expression pattern has diagnostic value for distinguishing gastric carcinoma. The patient underwent chemotherapy for metastatic stomach cancer.

• Journal of Chest Surgery
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• v.34 no.2
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• pp.156-161
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• 2001

배경: 식도암의 절제술에 있어 식도 위 문합술은 중대한 합병증, 즉 문합부 누출, 양성협착, 종양의 재발 등을 유발한다. 수술 후 재원기간동안 환자가 느끼는 주관적인 증상과 합병증이 식도와 위장관의 문합부 위치에 따라 달라질 수 있으므로 서로간에 비교분석할 필요가 있겠다. 대상 및 방법: 1995년 1월부터 1999년 5월까지 식도암 근치술로 식도 위 문합술을 시행 받은 55명의 환자를 대상으로 문합위치에 따라 경부문합한 23명의 환자와 흉부문합을 한 32명의 환자를 비교 분석하였다. 절제술 후 AJCC분류에 따라 I기 5명, II기 27명, III기 23명으로 판정되었으며, 종양이 상흉부에 위치한 경우 3명, 중흉부 34명, 하흉부 18명이었다. 조직학적으로 55명의 환자 2명의 선암을 제외하고 53명이 편평상피세포암이었다. 55명 전원이 남자였으며 평균연령은 경부문합의 경우 59세였고, 흉부문합은 55세였다. 경부 문합의 경우 1명의 staple봉합을 제외하고 나머지 22명이 수봉합을 하였으며, 흉부문합술의 경우는 9명이 수봉합, 23명이 staple봉합을 하였다. 결과: 수술 후 사망자는 경부문합 1명, 흉부문합 2명이었다. 경부 문합환자의 경우 23명 중 15명에서 호흡기, 소화기등의 합병증 46례가 발생하였고, 흉부 문합환자의 경우 32명중 13명에서 합병증 37례가 발생하였다. 경부문합환자는 중등도 혹은 심한 연하곤란을 나타내는 경우가 11명에서 있었으며, 흉부문합환자는 2명에서 나타났다. 또한 수술 후 20일 이후까지 재원한 경우는 경부문합환자 18명, 흉부문합환자는 13명이었다. 결론: 식도암에서 식도 위 문합술의 경우 호흡기, 소화기, 감염등의 합병증이 발생하였으며, 특히 호흡기 합병증에 의한 사망률이 높았다. 문합부 누출은 staple봉합보다 수봉합에서, 흉부문합보다 경부문합에서 빈도가 높았다. 경부문합의 경우 문합부 누출률이 높고, 연하곤란을 많이 호소하며 재원기간이 의미있게 길었다.