• Title/Summary/Keyword: 위 선암

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A Study of the Adjustment and Treatment Depending on the Change of Prostate Location Using DIPS in Proton Beam Therapy for Prostate Gland in which a Fiducial Gold Marker was Inserted (Fiducial Gold Marker가 삽입된 전립선암 양성자 치료 시 Digital Image Positioning System (DIPS)을 이용한 전립선의 위치변화에 따른 보정에 관한 연구)

  • Park, June-Ki;Kim, Sun-Young;Kim, Tae-Yoon;Choi, Kye-Sook;Yeom, Doo-Suk;Kang, Dong-Yoon;Choi, Seung-O;Park, Ji-Youn
    • The Journal of Korean Society for Radiation Therapy
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    • v.20 no.1
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    • pp.25-29
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    • 2008
  • Purpose: To monitor the changes of location of prostate gland using DIPS and to examine the adjustment and proton beam therapy depending on the movement of prostate gland in proton beam therapy for prostate gland in which a fiducial gold marker was inserted. Materials and Methods: This study was conducted in ten patients with prostate cancer who received proton beam therapy since April of 2008. To monitor the change of prostate location, three fiducial gold markers were inserted prior to the treatment. To minimize the movement of prostate gland, patients were recommended to urinate prior to the treatment, to intake a certain amount of water and to concomitantly undergo rectal balloon. In these patients, the set-up position was identical to that for a CT-simulation. The PA (posterior-anterior) and lateral images were obtained using both DIPS (digital image positioning system) and a plain radiography, and they were compared between the two imaging modalities. Thus, the changes of the location of fiducial gold marker were assessed based on three coordinates (x, y, z) and then adjusted. This was followed by proton beam therapy. Results: Images which were taken using a plain radiography were compared with those which were taken using DIPS. In ten patients, according to a reference bony marker, the mean changes of the location of fiducial gold marker based on an iso-center were X-axis: $\pm$0.116 cm, Y-axis: $\pm$0.19 cm and Z-axis: $\pm$0.176 cm. These ten patients showed a difference in the changes of location of prostate gland and it ranged between RT: 0.04 cm and RT: 0.24 cm on the X-axis; between Inf: 0.03 cm and Sup: 0.42 cm on the Y-axis; and Post: 0.05 cm and Ant: 0.35 cm on the Z-axis. Conclusion: To minimize the movement of prostate gland, as the pre-treatment prior to the treatment. In all the patients, however, three fiducial gold markers showed a daily variation which were inserted in the prostate gland. Based on the above data, Thus, the requirement of gold marker matching system depending on the daily variation in the proton beam therapy for which more accurate establishment of target was confirmed. It is assumed that an accurate effect of proton beam therapy would be enhanced by adjusting the target-center depending on the location change of prostate gland using DIPS which was used in the current study.

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Clinical Charicteristics of Primary Lung Cancer Patients in a Tertiary Hospital (3차 의료기관에서 진단된 원발성 폐암의 임상적 특성)

  • Ryu, Jeong-Seon;Lee, Hun-Jae;Leem, Jong-Han;Kim, Lucia;Lee, Kyung-Hee;Cho, Jae-Hwa;Yoon, Young-Han;Kwak, Seung-Min;Lee, Hong-Lyeol;Kim, Kwang-Ho;Loh, John-Kyu;Jung, Soo-Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.3
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    • pp.321-329
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    • 2006
  • Background : To evaluate the clinical characteristics of lung cancer patients in Korea, where there is a higher number of smokers than in Western countries. Methods : A retrospective study was performed on 1655 lung cancer patients, who were diagnosed at a university hospital between September 1996 and August 2005. Age, gender, cell types and clinical stage were analysed. Of 941 patients, who responded to a questionnaire at the time of diagnosis, the smoking habits, occupational history, family history of lung cancer in the first-degree relatives, coexisting diseases (diabetes mellitus and cardiovascular disease), body weight loss, ECOG performance status and presenting symptoms, were examined prospectively. In addition, coexisting diseases including chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis and active pulmonary tuberculosis were evaluated. Results : Of the 1655 patients, the male to females ratio was 3.6. Squamous cell carcinoma was the most common cancer whereas adenocarcinoma was more common in lifetime nonsmokers or women. 19.9% of the patients were non smokers and 80.1% ever smokers. Since 2000, there was an increase in the incidence of adenocarcinoma with a corresponding decrease in the incidence of squamous cell carcinoma. 6.2% of patients were asymptomatic. A coincident diagnosis of chronic obstructive pulmonary disease, cardiovascular disease, diabetes mellitus, active pulmonary tuberculosis, and idiopathic pulmonary fibrosis was made in: 44.1%, 22.2%, 10.7%, 3.9%, and 1.6% of patients, respectively. A positive family history of lung cancer in the first-degree relatives was identified in 4.4% of patients. An occupational history relevant to lung cancer was identified in 12.2% of patients. Conclusion : There is a high proportion of cigarette smokers in Korean lung cancer patients. The most common cell type was squamous cell carcinoma. However, a more detailed, prospective study of the clinical characteristics will be needed to better characterize lung cancer in Korea.

Gastric Metastasis of Primary Lung Adenocarcinoma Mistaken for Primary Gastric Cancer (원발성 위암으로 오인된 전이성 비소세포 폐암 1예)

  • Park, Young Sik;Lee, Jin Woo;Lim, Hyo-Jeong;Lee, Geon Kook;Hwangbo, Bin;Lee, Hee Seok
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.1
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    • pp.52-57
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    • 2009
  • The stomach is a rare site for metastasis, with autopsy incidence rates of 0.2% to 1.7%. This low rate makes diagnosis of metastatic gastric cancer challenging for clinicians. The authors report a case of a 64-year-old man diagnosed with gastric metastasis of primary lung adenocarcinoma that was initially mistaken for primary gastric cancer, as well as a review of the medical literature.

Simultaneous Off-pump Coronary Artery Bypass Surgery and Total Gastrectomy (동시에 시행한 체외순환 없이 시행하는 관상동맥우회수술과 위전절제술)

  • Park, Jeong-Ok;Ryu, Jae-Wook;Seo, Pil-Won
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.56-59
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    • 2007
  • A 65 year-old male had chest pain which was diagnosed as unstable angina needing urgent coronary artery bypass surgery. Physical examination demonstrated signs of severe anemia and hemoglobin level was 5.7 g/dL. Gastrofiberscopy showed a 4 cm sized fungating mass at the lesser curvature with active bleeding. The mass was adenocarcinoma by pathologic examination. Simultaneous coronary artery bypass surgery and total gastrectomy were planned due to bleeding of the mass. Off-pump coronary bypass grafting was done first, followed by total gastrectomy. The postoperative course was smooth. He was discharged from the hospital after 12 days and was on surveillance for 9 months. We report a rare case of simultaneous surgery for angina and gastric cancer.

Gastric Adenocarcinoma of Fundic-gland Type Diagnosed and Treated by Endoscopic Mucosal Resection (내시경 점막 절제술로 진단 및 치료했던 위바닥샘형 선암)

  • Sung Eun Kim;Seun Ja Park;Moo In Park;Won Moon;Jae Hyun Kim;Kyoungwon Jung;Bang Ju Kim;Hee Kyung Chang
    • Journal of Digestive Cancer Research
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    • v.11 no.3
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    • pp.165-170
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    • 2023
  • Gastric cancer is histologically classified into two types. One is the intestinal and diffuse type according to Lauren's classification, and the other is the differentiated and undifferentiated type based on Nakamura's classification. In 2007, Japanese groups proposed a new type of well-differentiated gastric adenocarcinoma in the gastric fundic glands with distinct endoscopic and clinicopathologic features. This is gastric adenocarcinoma of the fundic-gland type (GA-FG), a rare variant of gastric cancer. In a 2012 Korean study, of 6,000 cases of gastric cancer tissues, only three cases of GA-FG were identified. GA-FG is usually located in the upper third of the stomach and not known to be associated with the Helicobacter pylori infection. We herein report a case of GA-FG diagnosed in a 63-year-old man. A gastric polyp was incidentally detected during an upper endoscopy screening while conducting a health check-up, and he was diagnosed with GA-FG after an endoscopic mucosal resection (EMR) was conducted for diagnostic and therapeutic purposes. Our case suggests that for both diagnostic and therapeutic purposes, EMR may be beneficial in case of gastric polyps with suspected GA-FG.

Expression Pattern of the Trefoil Factor Family 1 in Gastric Adenoma and Carcinoma (위 선종 및 선암에서 Trefoil Factor Family 1 단백의 발현 양상)

  • Park Won Sang;Kim Young Sil;Yoo Nam Jin;Park Cho Hyun;Yoo Jin Young;Lee Youn Soo;Lee Jung Young
    • Journal of Gastric Cancer
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    • v.1 no.1
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    • pp.4-9
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    • 2001
  • Purpose: The trefoil factor family 1 (TFF1) has a protective effect against gastric mucosal damage induced by nonsteroidal anti-inflammatory drugs or ethanol. In addition, a TFF1 knockout mouse model has exhibited circumferential adenomas with high-grade dysplasia, of which $30\%$ progressed into frankly invasive carcinomas. We tried to determine whether the expression pattern of the TFF1 could be involved in the development of sporadic gastric carcinomas. Materials and Methods: We examined TFF1 expression in a series of 43 sporadic gastric carcinomas and 18 gastric adenomas by immunohistochemistry. Results: Strong positive TFF1 staining was identified primarily in the normal gastric mucosa, mainly in the cytoplasm of the superficial and foveolar epithelium. We found TFF1 expression in $55.8\%$ (24 out of 43) of the gastric carcinomas and in $16.7\%$ (3 out of 18) of the gastric adenomas. Statistically, TFF1 immunoreactivity was significantly higher in diffuse-type ($82.4\%$) than in intestinal-type ($38.5\%$) carcinomas(p=0.0058, Fisher's exact test). Conclusion: Our findings provide sufficient evidence that the expression of TFF1 in gastric cancer may simply disclose gastric-type differentiation of neoplastic cells and provide further support for the existence of at least two pathways of malignant transformation of the gastric mucosa: one via intestinal metaplasia and adenomatous dysplasia, leading to glandular carcinomas with intestinal-type differentiation, and the other via hyperplastic changes or de novo changes, leading to diffuse carcinomas and to a subset of glandular carcinomas displaying gastric-type differentiation.

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Design and Implementation of Open GIS OLE DB Component Using RDBMS (RDBMS를 이용한 개방형 GIS OLE DB 제공자 컴포넌트의 설계 및 구현)

  • Kim, Min-Soo;Lee, Ki-Won;Lee, Jong-Hun
    • Annual Conference of KIPS
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    • 2000.10a
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    • pp.67-70
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    • 2000
  • 최근 네트워크 서비스 및 분산 컴퓨팅 환경의 급격한 발전과 더불어 인터넷 기반 지리정보 시스템과 이 기종 시스템간에 상호 운용성을 지원하는 분산 지리정보시스템의 기술이 혁신적으로 발전하게 되었다. 현재 이러한 상호 운용성과 더불어 기 구축된 시스템의 재 사용성을 극대화하기 위하여 개방형 컴포넌트 소프트웨어 기술이 발표[1]되었으며, 최근 발표되는 지리정보시스템들도 이러한 개방화와 컴포넌트화 기술을 채택하여 개발되고 있다. 이러한 개방형 컴포넌트 소프트웨어 기술은 컴퓨터 소프트웨어 산업 전반에 커다란 파급 효과를 끼치고 있다. 지리정보시스템 분야에서는 OpenGIS Consortium(OGC)을 주축으로 하여 개방형 컴포넌트 지리정보시스템을 위한 표준 구현 사양을 발표하고 있으며, 이러한 표준 사양을 수용한 제품들이 개발되고 있는 실정이다. 본 논문에서는 분산 환경에서 다양한 관계형 데이터베이스시스템을 이용하여 OGC가 제시한 OLE/COM 기반의 데이터 제공자 컴포넌트의 설계 및 구현에 중점을 두고 있다. 본 시스템의 데이터 제공자 컴포넌트는 순수한 관계형 데이터베이스시스템 기반 위에서 구성되므로, 우선 OGC에서 요구하는 GIS 관련 핵심 기능들을 제공하기 위해서 우선 관계형 데이터베이스와 ODBC를 이용하여 공간엔진을 구성하고 있다. 본 공간 엔진은 OGC 사양을 충족하기 위해서 이용되는 최소한의 기능-공간데이터 관리 기능, 공간 연산 처리, 공간 색인 기능 그리고 클라이언트와 통신하기 위한 기능-들을 포함하고 있다. 그러므로 본 논문에서는 이러한 공간 엔진의 기반 위에서 OGC OLE DB 제공자 컴포넌트의 설계 및 구현 방법에 대해서 자세히 살펴보고 실제 SQL Server 7.0 환경에서 구축된 공간 엔진 및 OLE DB 제공자 컴포넌트의 구현 예에 대하여 살펴볼 것이다. 혈액내방사선 조사량이 안전용량 범위(200rad)에 속하며 48시간 후 체내잔류량은 서양인과 큰 차이가 없었다.비출현의 소견을 보이는 악성종양 환자의 골 신티그람 53개중 44개 (83.0%)에서 척추 및 늑골에 미만성, 또는 다발성 침습이 관찰되었다. 또 골전이 부위를 두개골, 척추, 견대부, 늑골, 골반, 사지의 근위부 장골의 6개 부위로 나누어 분석할 경우 49개(92.5%)에서 3부위 이상에 전이가 발견되었고, 35개(66.0%)에서 4부위 이상에 전이가 발견되었으며, 5부위 이상, 6개 부위에 모두 전이가 발견된 것은 각각 20개 (37 7%), 11개(20.8%)이었다. 이상의 성적으로 보아 악성종양 환자의 골 신피그라피에서 신장 영상의 비출현은 종양의 광범위한 골전이를 간접적으로 시사하는 소견으로 생각된다. 여러 악성종양중 전립선암에서 신장 영상 비출현의 빈도가 가장 높았으며, 특히 위암에서 골전이 및 신장 영상 비출현의 빈도가 높음은 주목할 만한 것이라 하겠다.출한 결과 인,규소 증가와 자가영양성 미소플랑크톤(ANP)증가에 미치는 요인이 해안과 외해에서 동일하게 가장 큰 설명력을 보였다. N:P 비도 해안에서 36.4, 외해에서 32.6을 보이고 있어 인이 상당히 부족한 것으로 나타났다. 따라서 조사해역은 인이 식물플랑크톤 성장에 중요한 제한요인으로 작용하고 있다고 판단된다.의 회전. 전위력의 강도, 적용시점, 그리고 키, 체중등의 신체적 요인 등이 있으나 능숙한 기계사용과 정확한 슬관절 위치에서 검사할 때 전방 십자 인대 파열에 대한 진단에 유용한 기구이다.태라고 하였다. 본 연구에서는 이러한 근거를 바탕으로 개방형 문제의 유형을 다양한 답이 존재하는 문제, 다양한 해결 전략이 가능한 문제, 답이 없는 문제, 문제 만들기, 일반화가 가능한 문제 등으로 보고, 수학적 창의성 중

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Clinicopathologic Characteristics of Stage IV Early Gastric Cancer (IV기 조기위암의 임상병리학적 특성)

  • Kim, Min Kuk;An, Ji Yeong;Choi, Min Gew;Noh, Jae Hyung;Sohn, Tae Sung;Kim, Sung
    • Journal of Gastric Cancer
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    • v.8 no.3
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    • pp.136-140
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    • 2008
  • Purpose: Stage IV early gastric carcinoma (EGC) is a rare disease. We report here on 10 cases of EGC that showed metastasis in more than 15 lymph nodes. Materials and Methods: A total of 8354 cases of gastric carcinoma in patients who underwent surgical procedures between January 2001 and January 2007 at Samsung Medical Center were studied, and 10 cases were classified as stage IV EGC. We investigated their clinicopathologic characteristics. Results: There were 5 males and 5 females. Their ages at operation ranged from 46 to 76 years with a mean age of 61. All of the 10 patients had undergone curative resection for gastric cancer. The pathological diagnosis confirmed that all of the patients had tumor confined to the submucosa. The median size of the tumors was 5.3cm and the mean number of dissected nodes was 45.5 with a mean number of 22.2 involved nodes. Six cases were classified as the diffuse type and 4 were classified as the intestinal type by Lauren's classification. Histologically, 3 cases were signet ring cell carcinoma, 3 were poorly differentiated, 2 were moderately differentiated and 2 were well differentiated adenocarcinoma. Endolymphatic invasion was found in 9 cases. The median follow-up was 31 months. Adjuvant chemotherapy was done in 9 patients, and the patient who did not receive chemotherapy died by cerebrovascular accident. 2 patient had recurrence of gastric cancer and 7 survived without recurrence. Conclusion: More cases should be collected and further studies on the molecular and cellular tumor characteristics are required to characterize these tumors that show aggressive lymphatic spread.

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우유투여가 N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) 유발 위십이지장 암 발생에 미치는 영향에 관한 실험적 연구

  • Han, Deok-Jong;Kim, Jin-Bok
    • Journal of the Korean Society of Food Culture
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    • v.5 no.1
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    • pp.169-180
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    • 1990
  • An experimental study on the effect of milk diet on carcinogenesis induced by N-methyl-N-nitro-N-nitrosoguanidine (MNNG) was designed in rats to elucidate its mechanism. A total of 136 Sprague-Dawley rats were divided into 6 groups according to the milk dosagnes in each diet. The entire group of 136 rats was fed the MNNG (100 g/ml) and milk for the initial 28 weeks. Thereafter for the next 12 weeks the group was fed a normal diet only. After this 40 week experiment 109 rats survived. These rats were then dissected with the results being summarized as follows: Suppression of gastroduodenal malignancy was evidenced by the increase of milk concentration in the diet except for the group given MNNG and the lowest concentration of milk (6% milk). Significant differences in the rate of cancer association were present between the regenerative hyperplasia (22.2%) and adenomatous hyperplasia (57.9%). The incidence of benign lesions increased proportionally with the concentration of milk in the diet, especially in regenerative hyperplasia. In the group which had been given the lowest concentration of milk there was a significant increase of the serum gastrin level in the rats with gastric cancer or precancerous benign lesions like regenerative hyperplasia or adenomatous hyperplasia.

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Surgical Option for Sufficient Safety Margine in Locally Advanced Type II Cardia Cancer - Left Colon Interposition (국소 진행된 Type II 분문부 선암의 절제연 확보를 위한 수술 방법: 좌측 대장 간치술)

  • Yoon, Ho Young;Kim, Hyoung-Il;Lee, Sang Hoon;Kim, Choong Bai
    • Journal of Gastric Cancer
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    • v.8 no.2
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    • pp.97-103
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    • 2008
  • Purpose: Radical surgery is the standard therapy for patients with resectable cardia cancer. In the case of type II disease with esophageal invasion, a transhiatal extended radical total gastrectomy is needed or a gastroesophagectomy through an abdomino-thoracotomy, depending on the extent of the esophageal invasion. We analyzed the indications and outcome of left colon interposition as an esophageal substitution. Materials and Methods: Between 1 January 1994 and 31 December 2006, 10 patients underwent left colon interposition after gastroesophagectomy through an abdomino-thoracotomy or the tanshiatal approach for type II cardia cancer at the Department of surgery, Yonsei University College of Medicine. The outcomes of these patients were reviewed and compared, with those who underwent a Roux-en-Y, by gender and age matched analysis, retrospectively. Results: There were nine males and one female with a mean age of 52.5 (range, 16~72). The operation time was $449.00{\pm}87.39minutes$. The mean distance between the proximal resection margin and the cancer was $6.56{\pm}3.65cm$; the maximum size of the tumor was $9.90{\pm}3.97cm$. These measures differed significantly from patients who underwent Roux-en-Y. The patients had a double primary cancer in the cardia and esophagus. There were no events of colon necrosis. However, a pneumothorax occurred in one patient (10%) and a proximal anastomotic stricture occurred in one patient. There were no reports of heartburn, regurgitation, thoracic or epigastric fullness, and one patient even gained weight, 16 kg. Conclusion: Colon interposition after esophagogastrectomy was safe and effective and should be considered as an additional surgical option for locally advanced type II cardia cancer patients with esophageal invasion.

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