• Journal of Korean Traditional Oncology
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• v.10 no.1
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• pp.93-98
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• 2005

Angiocentric T-cell lymphoma is a rare form of peripheral T-cell lymphoma. The disease typically manifests clinically as an aggressive, progressively destructive disorder often with a fatal outcome. It is the aim of the present paper to derive further studies evaluating the effectiveness of Korean traditional medicine on angiocentric T-cell lymphoma with intra-abdominal metastasis. A patient with high fever, weight loss, night sweat and general weakness(B symptoms) was diagnosed as angiocentric T-cell lymphoma and chemotherapy was done more than 10 times. But the response to chemotherapy was poor, finally the lymphoma involved liver and spleen. The abdominal CT showed the hepatosplenomegaly, diffuse lymphoma of liver and spleen, massive ascites, minimal pleural effusion. Then the patient gave up the chemotherapy and only herb medications (Bohyunsoamtang-A,B) were administered. The ascites, high fever and hepatosplenomegaly gradually reduced to normal. He survived for 7 years after first diagnosis, which is much longer than average survival time in angiocentric T-cell lymphoma with B symptoms. This case may give us a possibility of that Korean traditional herb medications offer potential benefits for patients with angiocentric T-cell lymphoma, and more researches are needed.

• Journal of Digestive Cancer Research
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• v.12 no.1
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• pp.44-47
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• 2024

Malignant melanomas, which are rarely found in the Asian population, are malignant tumors or melanocytes that manifest in the skin mucosa. Malignant melanomas of the anorectum are very rare and account for approximately 1% of all malignant melanomas in the Asian population. Here, we present a rare case presenting a malignant melanoma of the anorectum. An 85-year-old woman visited the hospital with bloody stools and an anal mass. Sigmoidoscopy revealed a black mass protruding from the anus, and the scope was able to penetrate the anorectal mass. Close-up endoscopy revealed black moles of different sizes scattered across the rectal mucosa. PET-CT indicated multiple FDG uptakes in the liver, indicating multiple metastases. Pathologic examination led to the detection of malignant melanocytes with dark brown deposits. The patient's immunohistochemical markers were positive for melanin-A antibodies and HMB-45, indicating a malignant melanoma. As there was no evidence of malignant melanomas on the skin, the patient was diagnosed with primary malignant anorectal melanoma with liver metastases.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.1
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• pp.91-102
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• 2009

Objectives : The present study was carried out investigate the anti-cancer effect of Salvia miltiorrhiza, Carydalis turtschaminovii and Reynoutria elliptica herbal acupuncture on solid tumor of rats induced by injection of RK3E-ras cells. Methods : RK3E-ras cells were injected on the right lumbar region of rats. After 1 weeks, the experimental rats were divided into four groups : Control group, Salvia miltiorrhiza herbal acupuncture group(SM), Carydalis turtschaminovii herbal acupuncture group(CT), Reynoutria elliptica herbal acupuncture group(RE). And we investigated the weight and size of tumor tissue, gross anatomy, histological and PCNA immunohistochemical study, hepatic and renal metastasis for tumor of each group. Results : 1. In the weight of tumor tissue assessment, SM and CT's weight of tumor tissue was decreased. 2. In the size of tumor tissue assessment, SM was smaller than any other group. 3. In the histological observation, SM's formation of tunica fibrosa that surround the tumor cell was obvious and vasculature that developes circumference of tumor cell was not observed, and density of tumor cell was very low. 4. In the PCNA immunohistochemical study, Control group, SM, RE showed strong immune response in the central site of tumor tissue. 5. In observation of liver and kidney tissue, we were not able to observe tumor cell in the SM. Conclusions : Consequently, SM and CT showed a inhibition of growth and metastasis.

• Journal of Digestive Cancer Research
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• v.4 no.2
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• pp.122-126
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• 2016

Leptomeningeal carcinomatosis occurs in approximately 5% of patients with cancer. The most common cancers involving the leptomeninges are breast, lung cancer and melanoma. However, gastric adenocarcinoma has been rarely reported with leptomeningeal carcinomatosis. The presenting manifestations are usually headache, visual disturbances and seizures. We report a case of leptomeningeal metastasis that presented as a gastric cancer. A 75-year old man was transferred to our hospital for further evaluation and treatment after being diagnosed with adenocarcinoma through endoscopic biopsy during a regular health examination. An abdominal computed tomography (CT) showed AGC, stage IA (cT1N0M0), while an endoscopic examination showed AGC, Borrmann type 2. The patient is currently under observation after undergoing radical subtotal gastrectomy with gastroduodenostomy and subsequent administration of oral chemotherapeutic agents. As an abdominal CT response assessment performed after surgery revealed new metastasis to the liver, the patient received palliative chemotherapy as recurrence was suspected. After receiving chemotherapy in the order of DP (Cisplatin + Docetaxel), FOLFIRI (5-FU + Leucovorin + Irinotecan), an abdominal CT response assessment showed complete response. Since decreased mentality maintained throughout the follow up period based on outpatient clinic, brain MRI was performed and revealed multiple leptomeningeal metastasis. The Patient died 2 days after the diagnosis.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.2
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• pp.13-20
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• 2011

Purpose: The limited FOV(Field of View) of CT (Computed Tomography) can cause truncation artifact at external DFOV (Display Field of View) in PET/CT image. In our study, we measured the difference of SUV and compared the influence affecting to the image reconstructed with the extended DFOV. Materials and Methods: NEMA 1994 PET Phantom was filled with $^{18}F$(FDG) of 5.3 kBq/mL and placed at the center of FOV. Phantom images were acquired through emission scan. Shift the phantom's location to the external edge of DFOV and images were acquired with same method. All of acquired data through each experiment were reconstructed with same method, DFOV was applied 50 cm and 70 cm respectively. Then ROI was set up on the emission image, performed the comparative analysis SUV. In the clinical test, patient group shown truncation artifact was selected. ROI was set up at the liver of patient's image and performed the comparative analysis SUV according to the change of DFOV. Results: The pixel size was increase from 3.91 mm to 5.47 mm according to the DFOV increment in the centered location phantom study. When extended DFOV was applied, $_{max}SUV$ of ROI was decreased from 1.49 to 1.35. In case of shifted the center of phantom location study, $_{max}SUV$ was decreased from 1.30 to 1.20. The $_{max}SUV$ was 1.51 at the truncated region in the extended DFOV. The difference of the $_{max}SUV$ was 25.9% higher at the outside of the truncated region than inside. When the extended DFOV was applied, $_{max}SUV$ was decreased from 3.38 to 3.13. Conclusion: When the extended DFOV was applied, $_{max}SUV$ decreasing phenomenon can cause pixel to pixel noise by increasing of pixel size. In this reason, $_{max}SUV$ was underestimated. Therefore, We should consider the underestimation of quantitative result in the whole image plane in case of patient study applied extended DFOV protocol. Consequently, the result of the quantitative analysis may show more higher than inside at the truncated region.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.2137-2140
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• 2016

Background: Gall bladder cancer (GBC) usually presents as unresectable or metastatic disease. We conducted a feasibility study to evaluate the effect of neoadjuvant therapy (NAT) on radiologic downstaging and resectability in unresectable GBC cases. Materials and Methods: Patients with locally advanced disease were treated with chemoradiotherapy [CTRT] ( external radiotherapy (45Gy) along with weekly concurrent cisplatin $35mg/m^2$ and 5-FU 500 mg) and those with positive paraaortic nodes were treated with neoadjuvant chemotherapy [NACT (cisplatin $25mg/m^2$ and gemcitabine $1gm/m^2$ day 1 and 8, 3 weekly for 3 cycles). Radiological assessment was according to RECIST criteria by evaluating downstaging of liver involvement and lymphadenopathy into complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). Results: A total of 40 patients were evaluated from January 2012 to December 2014 (CTRT=25, NACT=15). Pretreatment CT scans revealed involvement of hilum (19), liver infiltration (38), duodenum involvement (n=22), colon involvement (n=11), N1 involvement (n=11), N2 disease (n=8), paraaortic LN (n=15), and no lymphadenopathy (n=6). After neoadjuvant therapy, liver involvement showed CR in 11(30%), PR in 4 (10.5%), SD in 15 (39.4%) and lymph node involvement showed CR in 17 (50%), PR in 6 (17.6%), SD in 4 (11.7 %). Six patients (CTRT=2, NACT=4) with 66.6 % and 83% downstaging of liver and lymphnodes respectively underwent extended cholecystectomy. There was 16.6 % and 83.3% rates of histopathological CR of liver and lymph nodes. All resections were R0. Conclusions: Neoadjuvant therapy in unresectable gall bladder cancer results in a 15% resectability rate. This approach has a strong potential in achieving R0 and node negative disease. Radiologic downstaging (CR+PR) of liver involvement is 40.5% and lymphadenopathy is 67.5%. Nodal regression could serve as a predictor of response to neoadjuvant therapy.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.2019-2025
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• 2016

Hepatocellular carcinoma (HCC) is major health problem with high mortality rates, especially in patients with hepatitis B virus (HBV) infection. Telomerase function is one of common mechanisms affecting genome stability and cancer development. Recent studies demonstrated that genetic polymorphisms of telomerase associated genes such as telomerase associated protein 1 (TEP1) rs1713449 and PIN2/TERF1-interacting telomerase inhibitor 1 (PINX1) rs1469557 may be associated with risk of HCC and other cancers. In this study, 325 patients with HCC and 539 non-HCC groups [193 healthy controls, 80 patients with HBV-related liver cirrhosis (LC) and 266 patients with HBV-related chronic hepatitis (CH)] were enrolled to explore genetic polymorphisms of both SNPs using the allelic discrimination method based on MGB probe TaqMan real time PCR. We demonstrated that all genotypes of both genes were in Hardy-Wienberg equilibrium (P>0.05). Moreover, there was no significant association between rs1713449 genotypes and HCC risk, HCC progression and overall survival (P>0.05). Interestingly, we observed positive association of rs1469557 with risk of HCC when compared with the LC group under dominant (CC versus CT+TT, OR=1.89, 95% CI= 1.06-3.40, P=0.031) and allelic (C versus T alleles, OR=1.75, 95% CI=1.04-2.94, P=0.033) models, respectively. Moreover, overall survival of HCC patients with CC genotype of rs1469557 was significantly higher than non-CC genotype (Log-rank P=0.015). These findings suggest that PINX1 rs1469557 but not TEP1 rs1469557 might play a role in HCC progression in Thai patients with LC and be used as the prognosis marker to predict overall survival in HCC patients.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.2
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• pp.21-25
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• 2011

Purpose: $^{18}F$-FDG Fusion Whole Body PET scan is performed approximately 1 hour after injecting $^{18}F$-FDG. At this point in the injection procedure, as a tool of the criteria of time input, time of clocks or computers can be used and in the scan procedure, time of workstation can be used. In case that synchronized time input is not done in the injection and scan procedures for PET scan, time error from injection to scan can occur. This time error may affect Standard Uptake Value (SUV) being used as quantitative assessment. Therefore, in this study, we analyzed the change of SUV according to time input difference and necessity of time synchronization. Materials and Methods: The analysis was performed to 30 patients ($54.8{\pm}15.5$ years old) who examined $^{18}F$-FDG Fusion Whole Body PET scan in Department of nuclear medicine, Asan Medical Center from December 2009 to February 2010. To observe the change of SUV according to time input difference, the image was reconstructed and analyzed by artificially changing time difference of 1, 2, 3, 5, 10, 20 min against the same patients based on 60 minutes. Result: SUV of the image that reconstructed the images of 30 patients by giving intervals of 1, 2, 3, 5, 10, 20 min respectively and the image that entered original time was compared and analyzed through paired t-test. Based on 0 minute, mean SUV of aorta was changed by 0.3, 1.1, 1.4, 3.2, 4.7, 12.5% respectively and there was no statistically significant difference in 1, 2 minutes (p>0.05) but there was significant difference in 3, 5, 10, 20 min (p<0.05). The changes of $SUV_{avg}$ of liver were 1.6, 2.5, 3.0, 4.2, 6.6, 12.8% in 1, 2, 3, 5, 10, 20 min respectively and the changes of $SUV_{max}$ of primary lesion were 1.0, 1.5, 2.2, 3.5, 6.6, 12.8% respectively (p<0.05). Conclusion: Errors may occur in the process of measuring or recording variables affecting SUV such as height and weight of patients, $^{18}F$-FDG dose, Emission scan start time etc. and as these errors are more, the accurate assessment of SUV is interfered. Therefore, in order to assess SUV more accurately, it is thought that efforts to minimize these errors should be made. Of these efforts, time synchronization will be a cornerstone for accurate scanning.

• The Journal of Korean Society for Radiation Therapy
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• v.22 no.1
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• pp.11-18
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• 2010

Purpose: In every time radiation therapy set up errors occur because internal anatomical organs move due to breathing and change of patient's position. These errors may affect the change of dose distribution between target area and normal structure. This study investigates the usefulness of body-fix in clinical treatment. Materials and Methods: Among 55~60 aged male patients who has hepatocellular carcinoma in area of liver's couinaud classification, we chose 10 patients and divided two groups by using body-fix or not. When applying body-fix, we maintained a vacuum of 80 mbar pressure by using vacuum pump (Medical intelligence, Germany). Patients had free breathing with supine position. After working to fuse and consist MV-CT (megavoltage computed tomography) with KV-CT (kilovoltage computed tomography) obtained by 5 times treatments, we compared and analyzed set up errors occurred to (Right to Left, RL) of X axis, (Anterioposterio, AP) of Z axis, (Cranicoudal, CC) of Y axis. Results: Average Set up errors through image fusion showed that group A moved $0.3{\pm}1.1\;mm$ (Cranicoudal, CC), $-1.1{\pm}0.7\;mm$ (Right to Left, RL), $-0.2{\pm}0.7\;mm$ (Anterioposterio, AP) and group B moved $0.62{\pm}1.94\;mm$ (Cranicoudal, CC), $-3.62{\pm}1.5\;mm$ (Right to Left, RL), $-0.22{\pm}1.2\;mm$ (Anterioposterio, AP). Deviations of X, Y and Z axis directions by applying body-fix indicated that maximum X axis was 5.5 mm, Y axis was 19.8 mm and Z axis was 3.2 mm. In relation to analysis of error directions, consistency doesn't exist for every patient but by using body-fix showed that the result of stable aspect in spite of changes of everyday's patient position and breathing. Conclusion: Using body-fix for liver cancer patient is considered effectively for tomotherapy. Because deviations between group A and B exist but they were stable and regular.

• The Korean Journal of Nuclear Medicine
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• v.30 no.4
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• pp.516-523
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• 1996

The purpose of this study was to evaluate the clinical usefulness of I-123 MIBG scintigraphy with early planar and SPECT image in the diagnosis of neuroendocrine tumors. We reviewed I-123 MIBG scintigraphies of 21 patients who had been suspected to have neuroendocrine tumors by CT or MRI findings. Early 4 hour planar and SPECT images were obtained in all patients and delayed (13-24 hour) planar images were performed in 17 patients. Final diagnoses were made by surgery, biopsy, or clinical follow up. Twelve patients were confirmed to have neuroendocrine tumors. With 4 hour planar and SPECT images, there were 9 true positives(6 pheochromocytomas, 1 paraganglioma, 1 neuroblastoma, and 1 medullary cancer of the thyroid), 8 true negatives(1 adrenal cortical adenoma, 1 malignant fibrous histiocytoma, 1 adenoma in colon and 5 benign nonfunctioning adrenal tumors), 1 false positive(hepatocellular carcinoma) and 3 false negatives(1 recurred medullary cancer of the thyroid, 1 liver metastasis of carcinoid tumor and 1 ganglioneuroma). The sensitivity and specificity of I-123 MIBG scintigraphy were 75% and 89%, respectively. SPECT images provided good anatomical correlation with CT or MRI. Delayed images showed increased tumor to background ratio in 5 out of 8 true positive patients, but did not change the diagnosis. In conclusion, early 4 hour images with I-123 MIBG is clinically convenient and useful method in the detection of neuroendocrine tumors, and SPECT images can provide good anatomical correlation with CT or MRI.