• Title/Summary/Keyword: 진행성 암

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Palliative Treatment with Celestin`s tube in Advanced Esophageal Cancer (진행성 식도암의 Celestin`s tube 를 이용한 고식적 치료)

  • 백광제
    • Journal of Chest Surgery
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    • v.18 no.3
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    • pp.529-533
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    • 1985
  • Though esophageal cancer was not a common disease, early metastasis and direct extension to adjacent organ were important on the treatment of disease. Therefore, palliative operation was often useful in advanced esophageal cancer. Between June 1985 through July 1985, we treated three cases of inoperable esophageal cancer with Celestin`s endo-esophageal tube by esophageal intubation. Three operations were done under general anesthesia. Celestin`s tube were inserted via oral cavity and additional traction on stomach were applied. After complete insertion of tube was done, the distal end of Celestin`s tube was modified in length. Also stay suture was applied between tube and stomach wall was applied. Postoperative esophagogram revealed good esophageal patency through Celestin`s tube. Clinically, swallowing difficulty was much improved after operation.

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Transsternal Resection in Advanced Thyroid cancer -A Report of 8 Cases- (진행성 갑상선암의 흉골절개를 통한 근치적 절제술 -8례 보고-)

  • 임수빈
    • Journal of Chest Surgery
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    • v.28 no.12
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    • pp.1155-1159
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    • 1995
  • Differentiated thyroid carcinoma is a slow growing tumor with relative good prognosis. But locally advanced thyroid cancer with T4 or N1b is difficult to manage. Between June 1988 and April 1995, we resected 8 advanced thyroid cancers trans-sternally. All patients had direct mediastinal extension [T4 or mediastinal lymph node metastasis [N1b with airway obstruction or dysphagia. We operated all the patients by partial or total sternotomy for mediastinal dissection along with thyroidectomy and radical neck dissection. There were some acceptable morbidities but no operative mortality. Postoperative radioactive iodine therapy was followed without side effects. Follow-up survival period was between 11 months to 81 months with 2 late mortalities [17 month, 30 month . Although definite benefit for routine mediastinal dissection in thyroid cancer has not been established, in locally advanced cases impending airway obstruction or dysphagia who have questionable effect by radioactive iodine therapy alone, aggressive mediastinal mass dissection including lymph node metastasis has the significant role to prevent the patients from suffocation & dysphagia, and to enhance the effect of followed radioactive iodine tharapy.

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암 사망 위해도 변화에 대한 지역별 지불의사금액 차이에 관한 연구 - 서울과 울산을 대상으로 -

  • 김예신;이용진;신동천;신영철
    • Proceedings of the Korea Society of Environmental Toocicology Conference
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    • 2003.10a
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    • pp.164-165
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    • 2003
  • 환경 중 오염물질 중에는 발암물질로 판명된 물질이 수 종 포함되어 있으며, 여러 선진국에서는 방대한 연구를 통하여 오염수준을 파악하고, 위해성 평가에 근거한 관리대책을 펴가고 있다. 하지만 여러 선진국에서는 이러한 인체 위해성 평가결과만을 사용하여 환경 정책을 결정하기에는 그 결과가 반영하는 시야(scope)가 협소함을 느끼고, 다양한 측면(생태, 사회ㆍ경제, 삶의 질 등)을 함께 고려해야한다고 강조하고 있다. 이 중 인체 위해성 평가 결과를 경제성 평가와 더불어 화폐가치화 하는 연구는 정책 결정자들과 일반인들에게 위해성 평가 결과를 쉽게 인지시키고, 비교를 더욱 편이하게 할 수 있다는 장점이 있으며, 현재 많은 연구가 진행되고 있다.

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식도 천공의 외과적 치료

  • 이재익
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 2003.09a
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    • pp.108-108
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    • 2003
  • 식도 천공의 치료는 최근 치료법의 발전에도 불구하고 여전히 난해한 문제이다. 이 환자들은 천공의 원인이나 위치, 심한 정도가 다양한 이질적인 군이며, 반수 이상이 이미 식도에 기존의 질환을 가지고 있어 문제를 더욱 복잡하게 한다. 따라서 절대적이고 획일적인 치료방법은 아직 확립되어 있지 않으며 많은 다양한 방법들이 제시되고 있다. 2002년 11월부터 2003년 7월까지 총 8명의 환자가 식도 천공으로 동아대학교병원 흥부외과에서 치료를 받았으며, 원인별로는 의인성(iatrogenic) 손상이 6례, 자발성(spontaneous) 손상이 2례였고 부위별로는 경부가 3례, 흥부가 5례였다. 의인성 손상에는 내시경 검사중 정상 경부 식도에 발생한 1례, 부식성 식도협착 환자의 풍선 확장술과 스텐트 삽입시 흉부 식도에 발생한 경우가 각각 1례씩, 외상성 경추손상의 수술시 정상 경부 식도에 발생한 경우가 2례, 선천성 식도폐쇄증(esophageal atresia)의 술후 문합부 누출이 생긴 경우가 1례 있었으며, 자발성 손상에는 하부식도에 발생한 기압성(barogenic) 손상 1례와 상흉부 식도암 천공 1례가 있었다. 경부 식도 천공 3례는 모두 경부 배액(drainage)과 식이용 장루술(feeding jejunostomy)을 시행하였고, 부식성 식도협착이 있던 환자 2례는 식도절제술과 흉부내 식도-위 문합을 시행하였으며, Boerhaave씨 증후군 환자는 1차 봉합술, 술후 문합부 유출이 있었던 환자와 식도암 천공이 있었던 환자는 식도절제 및 경부 식도루(esophagostomy), 배액용 위루(gastrostomy), 식이용 장루술을 시행하였다. 모든 환자는 패혈증 등의 심각한 합병증으로의 진행 없이 회복되었다. 현재 위장관의 연속성이 유지 혹은 복원된 환자는 경구식이 중이며 그 외의 환자들은 장루를 통해 영양을 공급하며 식도재건술을 기다리고 있다. 식도 천공은 최근 항생제의 사용, 과영양요법(hyperalimentation), 술후 환자관리의 개선 등으로 치료에 많은 발전이 있었으나, 치료 방침에 있어서는 여전히 논란이 있으며 높은 사망률을 보이는 난제로 남아있다. 비록 일반적인 지침이 도움이 되겠지만, 치료 방침은 환자 개개인의 상황에 따라 적절하게 선택해야 하며, 임상경과에 따라 언제라도 방침을 변경할 수 있는 유연함이 필요하리라 생각한다.

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Apoptosis and Cell Proliferation in Gastric Adenoma and Adenocarcinoma (위샘종과 위샘암종에서의 세포자멸사와 세포증식)

  • Lee, Dong-Soo;Kang, Sang-Bum;Lee, Seung-Woo;Nam, Soon-Woo;Yoo, Young-Kyung;Han, Sok-Won
    • Journal of Gastric Cancer
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    • v.6 no.2
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    • pp.91-96
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    • 2006
  • Purpose: Cancer is a genetic disease caused by alterations in key regulators of cell growth and cell turnover, We investigated apoptotic cell death and cell proliferation in gastric adenomas and adenocarcinomas. Materials and Methods: The TdT-mediated dUTP-biotin nick end labelling (TUNEL) method and immunohistochemistry for Ki-67 were peformed, using paraffin-embedded tissues of 41 gastric adenomas and 100 gastric adenocarcinomas. These results were compared with histopathologic parameters. Results: The Ki-67 labelling index was higher in adenocarcinomas than in adenomas and the apoptotic index was higher in adenomas than in adenocarcinomas. There were no significant difference between the apoptotic index/Ki-67 labelling index and clinicopathological parameters. Conclusion: We propose that cell proliferation is more closely associated with gastric adenocarcinomas than apoptosis is, but that neither has any clinical significance as a prognostic factor in gastric adenocarcinomas. (J Korean Gastric Cancer Assoc 2006;6:91-96)

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Comparison of Immunohistochemical Expression of CBP(cAMP-responsive Element Binding Protein) Transcriptional Co-activator between Premalignant Lesions and Squamous Cell Carcinomas in the Lungs (전암성 폐병변 및 편평상피세포폐암 조직에서 CBP(cAMP-responsive Ele-ment Binding Protein) 전사 공동 활성인자의 면역조직화학적 발현양상의 비교)

  • Shin, Jong Wook;Kim, Jin Soo;Kim, Mi Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.2
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    • pp.165-172
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    • 2007
  • Background: The pathogenesis of lung cancer includes the accumulation of multiple genetic abnormalities. The CREB-binding protein(CBP) is one of several transcriptional co-activators among various sequence-specific DNA-binding transcription factors. CBP is involved in a wide range of cellular activities, such as DNA repair, cell growth, differentiation, and apoptosis that are suspected of contributing to tumorigenesis. The goal of this study was to evaluate CBP expression in a series of human lung tissues containing normal epithelium, premalignant lesions(hyperplasia and dysplasia) and squamous cell carcinomas. Materials and Methods: Immunohistochemical staining was performed on formalin-fixed paraffin-embedded sections by use of a monoclonal anti-CBP antibody. CBP expression was compared in samples from 120 patients with premalignant and malignant histological types including 20 metaplastic specimens, 40 dysplastic specimens, and 60 squamous cell carcinomas in the lung. Results: CBP expression was seen in 35% (7/20) of the metaplastic specimens. 65% (26/40) of the dysplastic specimens, and 70% (42/60) of the squamous cell carcinomas (p<0.05). According to celluar atypism, CBP expression was 50% (10/20) of the low-grade dysplastic specimens and 80% (16/20) of the high-grade dysplastic specimens(p <0.01). By cellular differentiation, CBP expression was seen in 95% (19/20) of the well differentiated squamous cell carcinomas, 85% (17/20) of the moderately differentiated carcinomas and 30% (6/20) of the poorly differentiated lesions (p <0.05). Conclusion: These results suggest that CBP may have an important role in malignant transformation of precancerous lung lesions and may be a marker for malignancy.

Expression of bcl-2, p53 Protein and Aggressiveness in Thymic Epithelial Tumor (흉선상피종에서 bcl-2, p53 단백의 발현과 악성도)

  • 조성래;전도환
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.726-731
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    • 1999
  • Background: The distinction between non-invasive and invasive or thymic carcinoma has been severely compromised by lack of objective morphological criteria. A reliable biological marker of tumor aggressiveness is, therefore, mandatory for predicting tumor behavior. Material and Method: Thirty thymic epithelial tumors, including 7 non-invasive thymoma, 10 invasive thymoma, and 13 thymic carcinoma of the Rosai's classification; and 5 stage I, 7 stage II, 2 stage III, and 3 stage IVa of the Masaoka stage of thymoma were investigated for expression of bcl-2 and p53 proteins by immunohistochemistry. Result: The thymic epithelial cells showed positive immunostain for bcl-2 in 0 (0%), 3 (30%), 8 (61.5%) of categories in the Rosai's classification respectively and in 0 (0%), 1 (14.3%), 2 (100%), 0 (0%) of stage I, II, III, IVa of the Masaoka stage respectively. Thymic carcinoma, and high stage thymoma had significantly higher proportion of bcl-2 expression than thymoma (p=0.021) and low stage thymoma (p=0.011). However, p53 showed no correlation with the histological subtypes nor with clinical aggressiveness. Bcl-2 expression appeared to be positively correlated with p53 immunoactivity (p=0.007, kappa=0.525). Conclusion: These date indicate that bcl-2 expression correlates with aggressiveness in thymic epithelial tumors, but further studies on mutation of p53 protein is necessary because bcl-2 expression appeared to be positively correlated with p53 immunoactivity.

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Adenoid Cystic Carcinoma of the Submandible in a 56-Year-Old Woman (56세된 여자의 하악 선양낭성암 환자 증례보고)

  • Park, Hee-Yong;Cho, Jung-Hyo;Son, Chang-Gue;Cho, Chong-Kwan
    • The Journal of Internal Korean Medicine
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    • v.26 no.4
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    • pp.941-945
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    • 2005
  • 연구목적 : 선양낭성암은 모든 두경부 종양에서 불과 1% 미만의 희소암으로, 본 논문에서는 하악 선양낭성암 기원의 간에 전이성 거대 종양을 가진 증례를 통해 선양낭성암에서의 한방 치료의 유효성평가와 함께 이에 대한 계속적인 연구를 유도해내는 계기로 삼고자 한다. 연구방법 : 본 연구에서는 한약물치료, 침치료, CT검사 및 혈액학적 검사를 포함한 모든 치료와 검사결과를 추적 조사하였다. 치료로 청간탕과 화침법을 사용하였으며, 청간탕은 1일 3회 복용, 화침은 월 1회 시술하였다. 또한, 혈액학적 검사는 월 1회 하였으며, CT검사는 19개월간의 치료기간 중 2회에 걸쳐 수행되어졌다. 연구결과 : 재검사시의 CT소견과 내원당시의 CT소견을 비교하였을 때, 큰 변화가 없이 잘 유지하였으며, 비록 일부의 혈액학적 검사소견이 약간 악화되었지만, 환자의 주증상은 빠르게 경감되었다. 결론 : 본 증례는 진행성 선양낭성암 환자에게서 한방치료가 삶의 질 개선과 생존을 향상을 위한 고식적 목적의 치료에 유용하게 사용되어질 수 있는 가능성을 제시해 준다.

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Development of Photoacoustic System for Breast Cancer Detection (유방암 진단용 광음향 영상 시스템 개발)

  • Lee, Soonhyouk;Ji, Yun-Seo;Lee, Rena
    • Progress in Medical Physics
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    • v.24 no.3
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    • pp.183-190
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    • 2013
  • Recently, the photoacoustic imaging system has been widely and intensively developed, and has been shown the possibility of diagnosis for early stage cancer. In this study, we developed a photoacoustic tomography imaging system with a commercial ultra sound device and a linear array probe. A tube phantom and a chicken breast phantom was made for the possibility of a system as a breast cancer detection. A moving average filter and a band pass filter with 3~6 MHz bandwidth were developed for background noise elimination before delay-and-sum beamforming algorithm was used for image reconstruction. As a result, we showed that some signal processing procedure before beamforming was effective for the photoacoustic image reconstruction.

Diffusion-Weighted Imaging as a Stand-Alone Breast Imaging Modality (독립적 검사 방법으로서의 확산강조 자기공명영상검사)

  • Hee Jung Shin;Su Hyun Lee;Woo Kyung Moon
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.29-48
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    • 2021
  • Diffusion-weighted magnetic resonance imaging (DW MRI) is a fast unenhanced technique that shows promise as a stand-alone modality for cancer screening and characterization. Currently, DW MRI may have lower sensitivity than that of dynamic contrast-enhanced MRI as a standalone modality for breast cancer detection but superior to that of mammography, which may provide a useful alternative for supplemental screening. Standardized acquisition and interpretation of DW MRI can improve the image quality and reduce the variability of the results. Furthermore, high-resolution DW MRI, with advanced techniques and postprocessing, will facilitate better detection and characterization of subcentimeter cancers and reduce false-negatives and false-positives. Future results from ongoing prospective multicenter clinical trials using standardized and optimized protocols will facilitate the use of DW MRI as a stand-alone modality.