• Journal of Korean Neurosurgical Society
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• 제30권8호
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• pp.998-1003
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• 2001

Objective : The maintenance of the correction of kyphotic deformity is one of the difficult problem in tuberculous spondylitis after anterior debriment and fusion with tricortical bone graft. The goal of this study is to find out the efficacy of titanium mesh cage impacted with autogenous bone chip in tuberculous spondylitis treated with anterior intervertebral fusion. Materials and Method : Twelve patients were treated with anterior intervertebral fusion using titanium mesh cage for tuberculous spondylitis from January 1996 to June 1999. We analized the changes in the correction of kyphotic deformity, changes of ESR and CRP, fusion state and recurrence after anterior intervertebral fusion with titanium mesh cage. Results : Clinical symptoms were improved in all twelve patients without any neurologic complications. The mean kyphotic angle corrected was 7.3 degrees immediately after operation, but the loss of correction of kyphotic angle was 2.2 degrees after 3 months and 2.6 degrees after 6 months. We found that the loss of correction of kyphotic deformity occurred mainly within the first 3 months after surgery. Only one patient, suffered from acute hepatic failure after first operation and had an insufficient anti-tuberculous medication therapy, showed recurrence of tuberculous spondylitis after 6 months. The patient underwent a second operation with posterior fixation procedure with good outcome. The changes of ESR and CRP were not specifically important factor to reveal recurrence of tuberculosis of the spine in our series. Conclusion : The surgical procedure of tuberculous spondylitis using titanium mesh cage with bone chip seems to be an effective procedure to minimize loss of the correction of kyphotic deformity without any aggravating inflammatory change and recurrence with titanium mesh cage, when sufficient debridement and anti-tuberculous chemotherapy are achieved.

• Journal of Gastric Cancer
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• 제15권2호
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• pp.139-142
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• 2015

Hepatic metastasis of early gastric cancer (EGC) following subtotal gastrectomy with lymphadenectomy is rare. We report the case of a 61-year-old male patient who was diagnosed with EGC that was initially treated using endoscopic submucosal dissection (ESD) and subsequently underwent laparoscopic subtotal gastrectomy. Histopathological examination of the patient's ESD specimen showed a moderately differentiated tubular adenocarcinoma invading the submucosa without lymphatic invasion. The deep margin of the specimen was positive for adenocarcinoma, and he subsequently underwent laparoscopic distal gastrectomy. The patient developed liver metastasis 15 months after the operation and then underwent liver resection. Histology of the resected specimen confirmed the diagnosis of two foci of metastatic adenocarcinoma originating from stomach cancer. Immunohistochemical analysis of the specimen demonstrated overexpression of human epidermal growth factor receptor 2. The patient was treated with trastuzumab in combination with chemotherapy consisting of capecitabine and cisplatin. Twenty-four months after the operation, the patient remained free of recurrence.

• Journal of Digestive Cancer Research
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• 제5권1호
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• pp.55-57
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• 2017

A 64-year-old man was admitted due to jaundice for 2 weeks. Radiologic findings revealed biliary stricture at the hepatic hilum with intrahepatic duct dilation suggesting Bismuth type IV Klatskin tumor. Jaundice improved spontaneously several days after hospitalization. Surgical treatment was considered but he only wanted to observe without specific treatment. Ten months later, he was re-admitted due to the recurrence of jaundice. Computed tomography (CT) showed no significant difference compared to previous results. Serum cancer antigen 19-9 and Immunoglobulin G4 were normal. Endoscopic forcep biopsy during endoscopic retrograde cholagiopancreatography (ERCP) revealed chronic inflammation. After steroid use under possible diagnosis of IgG4 related cholangiopathy, biliary stricture improved slightly. Four years later, he was hospitalized with the occurrence of acute cholangitis. Endoscopic retrograde biliary drainage was performed following endobiliary forcep biopsy. Pathology revealed well-differentiated adenocarcinoma at this time. Combined chemotherapy based on gemcitabine and cisplatin was performed. Six months later, CT revealed partial response.

• 대한영상의학회지
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• 제79권5호
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• pp.264-270
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• 2018

목적: 간기능이 보존된 간세포암 환자에서 간문맥 고혈압이 고주파열치료 후 종양 재발에 미치는 영향을 평가한다. 대상과 방법: 2010년 1월에서 2017년 3월 사이에 Milan criteria 및 Child-Pugh class A를 가진 신규 간세포암 환자 중 본원에서 고주파열치료를 시행한 환자가 본 연구에 포함되었다. 종양 재발에 대한 예측인자를 찾기 위해 Cox proportional hazard model을 이용한 단변량 및 다변량 분석을 수행하였다. 결과: 모두 178명의 환자가 본 연구에 포함되었다. 추적 관찰 기간의 중앙값은 42.8개월이었다. 국소 재발률은 문맥고혈압 여부에 따라 뚜렷한 차이를 유발하지 않았다(p = 0.195). 3년 및 5년 원위부 간내 종양 재발률은 문맥고혈압이 없는 환자의 경우 각각 29.5%와 53.7%, 그리고 문맥고혈압이 있는 환자의 경우 51.9%와 63.6%였으며 두 군 사이의 차이는 통계적으로 유의하였다(p = 0.011). 단변량 및 다변량 분석에서 문맥압항진은 원위부 간내 종양 재발에 대한 독립적인 예측 인자이었다(p = 0.008). 결론: Child-Pugh class A를 가진 간세포암 환자의 경우, 문맥고혈압은 종양 재발에 불량 예후인자로 작용하였다.

• Parasites, Hosts and Diseases
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• 제33권2호
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• pp.125-130
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• 1995

소화불량을 주소로 내원한 38세 남자의 초음파 촬영과 전산화단층촬영 소견에서 간의 낭종이 발 견되어 낭종적출술을 시행하였다. 낭종은 성공적으로 적출되었으며, 현미경 하에서 낭액 내에 살아 움직이는 단방조충(Echinococcus granulosus)의 protoscolek가 다수 관찰되었다. 그러나, 수술중 낭종이 터져 낭액의 유출이 있었다. 술후 환자는 albendazole을 투약받았으며, 아나필락시스 등 합병증은 관찰되지 않았다 환자는 1982년부터 3년간 사우디아라비아에서 근무한 적이 있었다. 이 환자는 국내에서 확진된 단방포충 낭종증의 제16례로, 수술 중 낭종이 터졌으나 아나필락시스를 일으키지 않은 1례이었다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2541-2546
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• 2014

Background: Primary hepatic neuroendocrine carcinoma (PHNEC) is rarer than extrahepatic gastrointestinal neuroendocrine carcinoma (NEC). It is difficult to make a correct diagnosis and poses a challenge for management. Materials and Methods: Ten PHNEC patients were admitted to our hospital from June 2006 to June 2011. Laboratory tests and imaging scans were performed for diagnosis and exclusion of extrahepatic NEC. All patients were AFP - and CA199-. Seven patients had solid tumors with cystic changes on ultrasonography, CT and/or MRI. For the initial treatment, four patients received combined-therapy and six monotherapy. Considering overall treatment, six patients received combined-therapy and four patients monotherapy. Staging criteria of primary hepatocellular carcinoma (PHC, AJCC 7th edition) were used to differentiate the stage of all patients: 3 patients were stage I, 2 stageII, 4 patients stageIII and 1 stageIV. All patients were followed up and clinical data were gathered. Results: The median follow-up duration was 38.5 months. The 1-year, 2-year, 3-year and 6-year disease-free survival was 80.0%, 46.2% and 46.2% and 0% respectively. The overall survival rates were 100%, 67.1%, 67.1% and 33.6% respectively. Patients in early-stages (I/II) had similar disease-free and overall survival as those in advanced-stages (III/IV). Patients with monotherapy had significant shorter disease-free and overall survival than the patients with combination-therapy. Conclusions: PHNEC has a unique specificity during its occurrence and development. The staging criteria of PHC might not be suitable for the PHENT. More convenient and effective features need to be found in imaging and laboratory detection. Surgical resection, TACE, chemotherapy and radiofrequency ablation should be performed in combination and actively for patients with PHNEC or recurrence to get the best effectiveness; they might extend the disease-free and overall survival.

• 한국간담췌외과학회지
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• 제28권2호
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• pp.134-143
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• 2024

Backgrounds/Aims: The hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is classified as the advanced stage (BCLC stage C) with extremely poor prognosis, and in current guidelines is recommended for systemic therapy. This study aimed to evaluate the surgical outcomes and long-term prognosis after hepatic resection (HR) for patients who have HCC combined with PVTT. Methods: We retrospectively analyzed 332 patients who underwent HR for HCC with PVTT at ten tertiary referral hospitals in South Korea. Results: The median overall and recurrence-free survival after HR were 32.4 and 8.6 months, while the 1-, 3-, and 5-year overall survival rates were 75%, 48%, and 39%, respectively. In multivariate analysis, tumor number, tumor size, AFP, PIVKA-II, neutrophil-to-lymphocyte ratio, and albumin-bilirubin (ALBI) grade were significant prognostic factors. The risk scoring was developed using these seven factors-tumor, inflammation and hepatic function (TIF), to predict patient prognosis. The prognosis of the patients was well stratified according to the scores (log-rank test, p < 0.001). Conclusions: HR for patients who have HCC combined with PVTT provided favorable survival outcomes. The risk scoring was useful in predicting prognosis, and determining the appropriate treatment strategy for those patients who have HCC with PVTT.

• Radiation Oncology Journal
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• 제9권2호
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• pp.293-301
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• 1991

CEA 측정으로 부인과 영역 악성종양의 치료결과나 재발 여부의 조기 진단을 할 수 있나를 연구한 결과이다. 1985년 1월부터 1989년 12월까지 239명의 자궁경부암 환자를 대상으로 치료전과 치료후 CEA치를 체계적으로 측정했고 이를 비교하기 위하여 정상군으로 아무런 증상이 없는 건강한 부인 65명과 양성종양을 가진 18명의 부인을 상대로 CEA치를 측정하였다. 혈장내 CEA치는 종양의 진행정도와 기의 직접관계가 있는 것을 알 수 있고 종양의 기가 진행되면 될수록 CEA치가 비정상인 경우가 높아지고 있다. 또한 CEA치가 비정상인 경우 편평상피종 환자보다는 선세포나 선세포와 편평세포가 혼합된 경우 더욱 증가되는 것을 볼 수 있었다. 결론으로 혈장내 CEA을 체계적으로 측정함으로써 치료 끝난 후 추적검사시 재발의 조기발견 및 치료결과를 확인할 수 있는 좋은 방법이라는 결론을 얻었다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권16호
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• pp.6587-6590
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• 2014

Objective: To further observe the efficacy and safety of pemetrexed, combined with Irinotecan or oxaliplatin or cisplatin in treating patients with advanced gastric cancer as second-line or third-line chemotherapy. Methods: From September 2013 to February 2014 we recruited 50 patients with advanced gastric cancer, with stage IV disease or postoperative recurrence, or unresectable. Then treated with pemetrexed based chemotherapy. After two cycles of treatment, efficacy and toxicity were evaluated. Results: Pemetrexed based chemotherapy was used as second-line in 33 patients, RR(CR+PR) is 41.2%. And achieved 36.4% when used as third-line. Overall response rate of 50 patients treated with Pemetrexed based treatment was 38% (CR+PR). Treatment related side effects were bone marrow suppression, vomiting, hepatic dysfunction and malaise.No treatment related death occurred. Conclusions: Treatment with pemetrexed based chemotherapy is active and is well tolerated in patients with advanced gastric cancer.

• Parasites, Hosts and Diseases
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• 제51권2호
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• pp.255-258
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• 2013

Spillage of cyst contents during surgical operation is the major cause of recurrence after hydatid cyst surgery. Instillation of a scolicidal agent into a hepatic hydatid cyst is the most commonly employed measure to prevent this complication. SB202190 is a pyridinyl imidazole derivative and is known to be a specific inhibitor of p38 MAPK. In the present study, the scolicidal effect of SB202190 was investigated. Freshly isolated Echinococcus granulosus protoscolices were subjected to SB202190 treatment (10, 20, 40, and $80{\mu}M$), and the effects on parasite viability were monitored by trypan blue staining. Corresponding effects were visualized by scanning and transmission electron microscopy. Dose-dependent protoscolex death within a few days of SB202190 treatment was observed. Although the in vitro scolicidal effect of SB202190 was satisfactory, the in vivo efficacy of this drug and also possible side effects remain to be further investigated.