• Title/Summary/Keyword: 진행성 암

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PECTORALIS MAJOR MYOCUTANEOUS FLAP FOR THE COMPLICATIONS OF POSTIRRADIATION HEAD & NECK CANCER SURGERY (방사선 치료후 두경부암 수술의 합병증에 대한 Pectoralis Major Myocutaneous Flap의 이용)

  • 송달원;백재한;김중강
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1987.05a
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    • pp.19.2-19
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    • 1987
  • 방사선치료후 재발성 또는 잔존성 두경부암의 수술후에 피부판의 괴사 및 slough, 감염, 누공, 부종과 경동맥 노출 심지어는 경동맥 파열 등의 술후 합병증이 빈발함으로 수술에 큰 어려움을 겪게 된다. Pectoralis major myocutaneous flap은 진행된 두경부암의 광범위한 절제후에 그 결손부를 보충해 주는 데 좋은 방법으로 사용할 수 있을 뿐아니라 방사선치료후에 생긴 합병증에도 이 flap을 이용하여 좋은 치료결과를 얻을 수 있다. 저자들은 수술 전에 방사선치료를 받고 심한 부종으로 후두조직의 괴사 및 기능이 손실된 환자와 방사선 치료후 재발된 상인두암환자의 경우에서 수술 후 생긴 pharyngocutaneous fistula와 피부판감염 및 경동맥노출 등으로 치유가 곤란하여 여기에 pectoralis major myocutaneous flap을 사용하여 pharyngostoma를 재건하고 노출된 경동맥부위를 보호하여 좋은 치료효과를 얻었기에 문헌을 고찰하여 보고하는 바이다.

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Change in Palliative Performance Scale (PPS) Predicts Survival in Patients with Terminal Cancer

  • Oh, Jee Hye;Lee, Yong Joo;Seo, Min Seok;Yoon, Jo Hi;Kim, Chul Min;Kang, Chung
    • Journal of Hospice and Palliative Care
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    • v.20 no.4
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    • pp.235-241
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    • 2017
  • Purpose: The Palliative Performance Scale (PPS) is a widely used prognostic tool in patients with advanced cancer. This study examines the association between changes in PPS score and survival in patients with advanced cancer. Methods: We identified a cohort of 606 inpatients who died at a Korean university hospital's hospice/palliative care center. For each patient, the PPS score was measured twice according to a standard procedure: 1) upon admission, and 2) three days after admission (D3). "Change on D3" was defined as a difference between initial PPS and PPS on D3. We used a Cox regression modeling approach to explore the association between this score change and survival. Results: The changes in scores were associated with survival. A score change of >30% yielded a hazard ratio for death of 2.66 (95% CI 2.19~3.22), compared to a score change of ${\leq}30%$. PPS of ${\leq}30$ on D3 also independently predicted survival, with a hazard ratio of 1.67 (95% CI 1.38~2.02) compared to PPS of >30. Conclusion: A change of over 30% in PPS appears to predict survival in hospitalized patients with terminal cancer, even after adjustment for confounders. Changes in PPS may be a more sensitive indicator of impending death than a single PPS measured on the day of admission in terminal cancer patients. Further prospective study is needed to examine this important finding in other populations.

Analysis System of Endoscopic Image of Early Gastric Cancer (조기 위암의 내시경 영상 분석 시스템)

  • Lim Eun-Kyung;Kim Gwang-Ha;Kim Kwang-Baek
    • Proceedings of the Korean Institute of Intelligent Systems Conference
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    • 2005.04a
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    • pp.255-260
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    • 2005
  • 위암은 국내 암발생 및 사망률의 상당 부분을 차지하고 있으며, 이러한 조기 위암의 발견은 치료 및 예후에 있어서 아주 중요하다. 본 논문에서는 조기 위암의 진단을 위해 위 내시경 영상에서 색상 변화를 이용해 이상 부위를 검출하여 검사자에게 조직적인 정보를 제공하는 시스템을 제안한다. 어느 정도의 진행이 이루어진 염증과 암은 쉽게 판단할 수 있지만, 조기의 염증이나 암의 경우에는 주의 깊게 보지 않는 경우에는 병변의 진단이 쉽지 않다. 본 논문에서는 위 내시경 영상을 IHB 채널로 변환시키고 조명에 의해 발생하는 잡음을 제거하며 자동으로 암 의심 영역을 검출하여 검사자에게 제공하거나 검사자에 의해 설정된 영역에 대한 조직적인 표면 정보를 제공한다. 본 논문의 연구는 추출된 이상 부위가 암을 확진할 수 없지만, 인간이 쉽게 인지하기 어려운 이상부위(암 의심 영역)를 추출하여 검사자에게 주의를 요구함으로써 일 처리를 줄이고 부과적인 정보를 제공한다. 그리고 검사추가 지정한 영역에 대해서도 조직적인 정보를 제공한다. 제안된 위 내시경 영상 분석 방법의 효율성을 확인하기 위해서 실제 내시경 영상들을 대상으로 실험한 결과, 제안된 방법이 위 내시경 영상 분석에 효율적임을 확인하였다.

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A Case of Papillary Thyroid Cancer Presenting as Pleural Effusion (흉수로 발현한 유두모양 갑상샘암)

  • Jung, Ki Hwan;Seo, Ji A;Lee, Ju-Han;Jo, Won Min;Kim, Je Hyeong;Shin, Chol
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.4
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    • pp.314-317
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    • 2008
  • We report the patient presented with a left-sided pleural effusion. Pleural fluid analysis revealed lymphocyte-dominant exudates with lower level of adenosine deaminase and negative cytologic malignancy. Thoracoscopic examination and histologic examination revealed metastatic nodules on pleurae, proven to be from the papillary thyroid cancer. There were no other sites of distant metastases. Though papillary thyroid cancer is characterized with slow progression and relatively good prognosis, metastatic pleural effusion as an initial manifestation of undiagnosed papillary thyroid cancer can be considered.

The Influence of the Sympathetic Nervous System on the Development and Progression of Cancer (교감신경계가 암의 발전과 진행에 미치는 영향)

  • Park, Shin-Hyung;Chi, Gyoo-Yong;Choi, Yung Hyun
    • Journal of Life Science
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    • v.28 no.1
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    • pp.116-129
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    • 2018
  • Living creatures possess long-conserved mechanisms to maintain homeostasis in response to various stresses. However, chronic and continuous exposure to stress can result in the excessive production of stress hormones, including catecholamines, which have harmful effects on health. Studies on the relationship between the sympathetic nervous system (SNS) and cancer have been conducted based on the traditional hypothesis that stress can promote cancer progression. Many preclinical and epidemiological studies have suggested that the regulation of ${\beta}$-adrenergic signaling, which mediates SNS activity, can suppress the progression of solid tumors. SNS activation has highly pleiotropic effects on tumor biology, as it stimulates oncogenes, survival pathways, the epithelial - mesenchymal transition, and invasion. Moreover, it inhibits DNA repair and programmed cell death and regulates the tumor microenvironment, including immune cells, endothelial cells, the extracellular matrix, mesenchymal cells, and adipocytes. Although targeted therapies on the molecular basis of tumor proliferation are currently receiving increased attention, they have clinical limitations, such as the compensatory activation of other signaling pathways, emergence of drug resistance, and various side effects, which raise the need for pleiotropic cancer regulation. This review summarizes the effects of the SNS on the development and progression of cancer and discusses the clinical perspectives of ${\beta}$-blockade as a novel therapeutic strategy for this disease.

$^{131}I-MIBG$ Therapy in Malignant Pheochromocytoma and Medullary Thyroid Carcinoma (악성 갈색세포종 및 갑상선수질암의 $^{131}I-MIBG$을 이용한 치료)

  • Yoon, Jong-Kil;Ryoo, Baek-Yeol;Lee, Chang-Hee;Jeong, Sang-Hoon;Cheon, Young-Kug;Choi, Chang-Woon;Lim, Sang-Moo;Hong, Sung-Woon
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.3
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    • pp.319-327
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    • 1995
  • $^{131}I$-metaiodobenzylguanidine(MIBG) has been used for the diagnosis and treatment of neural crest tumors. We report our experience with this agent in 8 patients[1 multiple endocrine neoplasia(MEN) type IIb; 2 malignant pheochromocytoma; 5 medullary thyroid carcinoma(MTC)]. The therapeutic procedure consisted of 30-200 mCi of $^{131}I-MIBG$ administered by slow I.V. infusion, given at 3-6 months intervals. Commutative activity ranged from 150 mCi to 410 mCi, in 1 to 4 courses. $^{131}I-MIBG$ therapy resulted in significant disease free interval in 1 malignant pheochromocytoma(no measurable lesion) after surgery; complete hormonal and tumoral response in 2 MTC(1 MEN IIb): stable disease in 1 recurred pheochromocytoma(MEN IIb): stable disease but symptomatic improvement in 1 MTC, progressive disease in 1 malignant pheochromocytoma and 2 MTC. The patients who showed progression appeared to have large inoperable tumors or postoperative remnant tumors.

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Postoperative Complications after Preoperative Chemoradiotherapy Combined with Hyperthermia in Locally Advanced Rectal Cancer (국소 진행성 직장암의 수술전 동시 화학방사선치료와 온열치료병합시 수술후 부작용)

  • Yea, Ji Woon
    • Progress in Medical Physics
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    • v.25 no.2
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    • pp.89-94
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    • 2014
  • We investigated whether regional hyperthermia (HT) increased post-surgical complications in patients with locally advanced rectal cancer treated with preoperative concurrent chemoradiotherapy (CCRT). Between 1996 and 2007, 205 patients treated with preoperative CCRT and curative surgery were evaluable for the analysis of acute and late toxicities. A total dose of 39.6 Gy or 45 Gy was delivered concurrently with one or two cycles of chemotherapy (5-fluorouracil, leucovorin). Eighty-eight patients received regional HT twice a week using an 8-MHz radiofrequency capacitive heating device. Surgery was performed 4~6 weeks after the completion of preoperative CCRT. The median age was 59 years (range, 18~83) and the median follow-up period was 61months (range, 2~191). The 5-year overall survival and complication-free survival rate of all patients was 77.4% and 73.7%, respectively. Early leakage, delayed leakage, anastomotic stricture, fistula, and small bowel obstruction occurred in 1.0%, 2.9%, 1.5%, 5.9%, and 17.1%, respectively. HT did not increase all kinds of complications. The 5-year complication-free survival rate was 71.8% in the non-HT group and 76.3% in the HT group (p=0.293). Regional HT did not increase postoperative complications in patients with locally advanced rectal cancer treated with preoperative CCRT followed by curative surgery.

Adverse Events of Tyrosine Kinase Inhibitors in Patients with Advanced Thyroid Cancer (진행성 갑상선암 환자에서 발생하는 Tyrosine Kinase Inhibitor의 이상반응)

  • Kim, Min Joo;Park, Young Joo
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.61-70
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    • 2018
  • Tyrosine kinase inhibitors (TKIs) are widely used for the treatment of advanced radioiodine-refractory thyroid cancer. Although the previous studies including large-scale randomized controlled trials have demonstrated the effects of TKIs in advanced thyroid cancers, it has been found that most patients experienced adverse events (AEs). Unlike other cancers, even patients with advanced thyroid cancers are often asymptomatic. Rather, TKI use can make patients suffer adverse events. Therefore, the use of TKI should be decided after the full consideration of AEs as well as its efficacies. While using TKI, AEs should be monitored, evaluated, and managed appropriately, if AEs develop. In this review, the occurrence, evaluation, and management of AEs of sorafenib, lenvatinib, and vandetanib will be described, which TKIs are most commonly used for the treatment of advanced thyroid cancer. Some suggestions for the management of AEs in the real life are also provided.

Case of Remission of Progressive Breast Cancer Treated by Capecitabine with Integrative Medicine Therapy (카페시타빈과 통합의학 프로그램 치료 병용을 통해 호전된 진행성 유방암 1례)

  • Jin, Yong Jae;Shin, Kwang Soon;Ha, Jee Yong
    • Journal of Korean Traditional Oncology
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    • v.19 no.1
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    • pp.43-51
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    • 2014
  • This report is aimed to investigate the effect of Integrative Medicine Therapy (IMT) in treating breast cancer metastasized to several portion. A 55-year-old woman who was diagnosed breast cancer and treated by breast conservation surgery (BCS) IN 2002. (pT2M0N0), adjuvant chemotherapy and radiotherapy till Jan. in 2013. But cancer had metastasized to sacrum (2009), liver (2012) and ribs (2013). Finally cause of several side effects of Xeloda(neuralgia and vommiting), she gave up to be treated by Xeloda and started to receive IMT including Abnoba Viscum, Vitamin C therapy Xeloda again, Korean herbal medicine and pharmacopuncture from Jul. in 2013. The effect was evaluated with Positron Emission Tomography and Computed Tomography (PET-CT) and Abdomen Computed Tomography (CT). The metastatic tumor in liver was disappeared and cancers to ribs, their size decreased after 12 months and pain of sacrum maintained VAS 2 continually. These results suggest that IMT is a therapeutic method to treat metastatic tumor originated from breast cancer.

Mammography-Adaptive Threshold Method Based Microcalcification Segmentation (마모그래피 적응적 임계화 방법 기반 미세석회화 분할)

  • Jeon, Jae-Hyun;Eom, Won-Yong;Ro, Yong-Man
    • Proceedings of the Korea Multimedia Society Conference
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    • 2012.05a
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    • pp.14-17
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    • 2012
  • 현재 유방암으로 인한 사망률이 급증하고 있다. 이러한 유방암의 위험성을 줄일 수 있는 치료 방법으로 수년간 많은 연구가 진행되어 왔다. 특히 마모그래피의 연장 선상이라 할 수 있는 CAD 시스템의 개발에 대한 연구가 진행 중에 있다. 미세석회화 검출에 적합한 CAD 시스템의 구현을 위해서 미세석회화를 분할하는 다양한 방법들이 연구되어 왔다. 기존의 미세석회화 분할 방법들 중에서 마모그램 영상에서 그레이 레벨 또는 컨트라스트를 임계화하는 방법을 많이 사용하고 있다. 이 방법은 간단하고 빠르다는 장점을 가지지만, 관찰하는 사람에 따라 변동성이 높다. 변동성이 크다는 단점으로 인해 다양한 마모그램 영상들에서 최적의 성능을 얻어내는 데는 한계가 있다. 본 논문에서는 관찰자에 의해서 컨트라스트 임계값을 정하는 방법이 아닌, 마모그램 영상에 따라 적응적으로 임계값을 자동적으로 설정하는 방법을 제안한다. 실험 결과를 보면 기존의 임계화 방법은 마모그램 영상마다 적합한 컨트라스트 임계값 변동이 크다. 그러나 제안된 방법은 마모그램 영상에 적합한 임계값을 찾아준다.

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