• Korean Journal of Radiology
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• 제22권6호
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• pp.912-921
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• 2021

Objective: To compare the performance of the deep learning-based lesion detection algorithm (DLLD) in detecting liver metastasis with that of radiologists. Materials and Methods: This clinical retrospective study used 4386-slice computed tomography (CT) images and labels from a training cohort (502 patients with colorectal cancer [CRC] from November 2005 to December 2010) to train the DLLD for detecting liver metastasis, and used CT images of a validation cohort (40 patients with 99 liver metastatic lesions and 45 patients without liver metastasis from January 2011 to December 2011) for comparing the performance of the DLLD with that of readers (three abdominal radiologists and three radiology residents). For per-lesion binary classification, the sensitivity and false positives per patient were measured. Results: A total of 85 patients with CRC were included in the validation cohort. In the comparison based on per-lesion binary classification, the sensitivity of DLLD (81.82%, [81/99]) was comparable to that of abdominal radiologists (80.81%, p = 0.80) and radiology residents (79.46%, p = 0.57). However, the false positives per patient with DLLD (1.330) was higher than that of abdominal radiologists (0.357, p < 0.001) and radiology residents (0.667, p < 0.001). Conclusion: DLLD showed a sensitivity comparable to that of radiologists when detecting liver metastasis in patients initially diagnosed with CRC. However, the false positives of DLLD were higher than those of radiologists. Therefore, DLLD could serve as an assistant tool for detecting liver metastasis instead of a standalone diagnostic tool.

• 대한영상의학회지
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• 제84권1호
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• pp.15-33
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• 2023

간영상 보고 및 자료체계(liver imaging reporting and data system; 이하 LI-RADS)는 간세포암종 고위험군에서 간세포암종의 진단과 치료반응평가 등을 표준화하기 위해 미국영상의 학회의 후원을 받아 개발되었다. CT/MRI LI-RADS는 2018년 버전이 가장 최근에 개정된 것인데, 미국간학회 가이드라인에 간세포암종 진단기준으로서 통합되었다. 이 종설에서는 CT/MRI LI-RADS가 간영상의 표준화된 보고에 미친 영향을 살펴보고, CT/MRI LI-RADS를 이용한 간세포암종 진단과 국소치료 후의 치료반응평가에 있어 현시점에서 축적된 근거 및 다른 간세포암종 진단가이드라인들과의 비교 결과를 살펴볼 것이며, 추후 발전방향에 대해 기술하고자 한다.

• 보건행정학회지
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• 제33권2호
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• pp.129-140
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• 2023

Background: This study aims to compare the burden of disease in Korea with other Organization for Economic Cooperation and Development (OECD) countries using the OECD health statistics from 1985 to 2020. Methods: We analyzed potential years of life lost (YLL) per 100,000 population using the Positive value for relative comparison (PARC) index, trend test, and average annual percentage change (AAPC) with logistic regression analysis. Results: The relative disease burden was good for many diseases, but the disease burden was severe for a few diseases in Korea. Diseases with a high relative burden of disease in Korea are as follows; intentional self-harm (YLL2020 575.6, AAPCYLL 2.6%; PARC2020 -1.000, AAPCPARC -15.8%), malignant neoplasms of the liver (YLL2020 136.6, AAPCYLL -3.9%; PARC2020 -1.000, AAPCPARC 0.0%), malignant neoplasms of the stomach (YLL2020 9.0, AAPCYLL 3.2%; PARC2020 -0.556, AAPCPARC -22.9%), Parkinson's disease (YLL2020 575.6, AAPCYLL 2.6%; PARC2020 -1.000, AAPCPARC -15.8%). Conclusion: Diseases with a high burden of disease are needed to be prioritized in the planning and execution of healthcare policies that can contribute to the efficient use of healthcare resources.

• 대한영상의학회지
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• 제81권2호
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• pp.418-422
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• 2020

췌장의 장액성 낭성 종양은 일반적으로 양성 질환으로 알려져 있으나 드물게 악성화를 보이는 사례들이 보고되고 있다. 영운에서 췌장 미부에 발생한 장액성 낭성 종양을 수술로 제거한 후 추적 관찰 중 국소 재발과 함께 간으로의 원격전이가 발생한 증례를 경험하여 보고하고자 한다.

• 한국간담췌외과학회지
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• 제26권1호
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• pp.40-46
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• 2022

Backgrounds/Aims: The role of inflammation in malignant cell proliferation has been well described. High values of platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) as markers of systemic inflammation have shown associations with unfavorable long-term outcomes. The purpose of this study was to determine values of NLR and PLR evaluated prior to and after surgery and their associations with mortality and recurrence rates of liver transplant patients with hepatocellular carcinoma (HCC). Methods: A total of 105 patients with HCC who underwent orthotopic liver transplantation (OLT) were retrospectively reviewed. NLR and PLR values were obtained from complete blood counts prior to and after surgery. Overall survival (OS) and recurrence-free survival (RFS) in relation with delta NLR and PLR were estimated. Results: Serum alpha-fetoprotein levels > 100 ng/mL (p = 0.014) and lymphovascular emboli in the specimen (p = 0.048) were identified to be significant predictors of RFS. Child-Pugh score (p = 0.016) was found to be an independent factor associated with poorer OS. An increasing delta PLR was associated with worse RFS, although it showed no significant association with OS. Conclusions: The analysis of PLR as a continuous variable may predict recurrence outcomes in patients undergoing OLT for HCC. It is more representative than isolated values.

• Radiation Oncology Journal
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• 제4권2호
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• pp.129-133
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• 1986

한 환자에서 두개 이상의 중복암이 발생하는 경우는 매우 드물게 알려져 왔으나 근래에 들어와 치료법의 발달로 환자의 수명이 연장되고 진단법이 발달되면서 그 보고가 증가되고 또한 관심도 높아지고 있는 상태이다. 따라서 이런 중복암을 가진 환자의 특성을 분석함으로써 발생할 수 있는 2차 3차 암의 조기 발견 및 나아가서는 발암 물질과 유전적 요인 등을 찾아 암의 치료 및 예방에 이응 할 수 있겠다. 이에 $1978.7\~1986.8$까지 8년간 서울 대학교 병원에서 중복암으로 진단되어 치료받은 121예를 대상으로 하여 다음과 같은 결과를 얻었다. 전체 발생율은$0.7\%$이 있으며 이중 2중복암이 119례, 3중복암이 2례 있었다. 동시성은 (6개월 이내) 51례, 속발성은 (6개월 이상) 70례이었으며 속발성의 경우 $70\%$이상에서 3년내에 2차 암이 발생했다. Moertel분류에 의한 mvlticentriz은 $11.6\%$로 다소 낮은 빈도를 보였으며 다른 장기에 발생한 중복암 중에서는 위암과 간암, 위암과 직장암의 빈도가 가장 높았다.

• 한국인구학
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• 제24권2호
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• pp.207-234
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• 2001

지난 20 여년간 미주 한인의 수는 급속도로 증가하였다. 하지만 이들의 건강에 관한 연구는 거의 이루어지지 않았다. 본 연구는 기대여명(期待餘命), 연령별 사망률, 그리고 사망의 주요원인 등을 통한 본국 거주 한국인과 미주 한인의 건강 수준 비교를 그 목적으로 한다. 분석결과 전반적으로 미주 한인이 같은 연령의 한국인에 비해 기대여명은 더 높고, 연령별 사망률은 더 낮게 나타났다. 사망의 주요 원인에 관한 분석 결과, 미주 한인에게 있어서 신생물 (Neoplasms)로 인한 사망이 빈번하게 발견되었으나 소화기계 질환 (Diseases of the digestive system), 특히 간질환으로 인한 사망률은 동일연령의 본국 거주 한국인에 비해 크게 낮은 것으로 나타났다. 두 인구 집단간 큰 차이를 보이는 신생물과 소화기계 질환에 대해 인구 사회 경제적 요소들을 통제하여 회귀 분석을 실시한 결과 신생물로 인한 사망 비율의 차이는 변함이 없었다. 결론적으로 미주 한인이 본국 거주 한국인에 비해 상대적으로 양호한 건강상태를 유지하고 있다고 볼 수 있고, 이는 미주 한인의 교육수준이 상대적으로 높고, 이민 후 보다 건강한 생활습관을 습득하기 때문이라고 여겨진다. 그러나 미주 한인의 경우 이질적인 문화와 언어 사용에 의한 정신적 스트레스와 소수민족이기 때문에 보건정책의 혜택에서 쉽게 소외된다는 사실 등을 고려할 때 본 연구 결과는 보다 지속적고 심도있는 연구의 필요성을 시사한다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9773-9779
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• 2014

Background: Colorectal cancer (CRC) is one of the prime causes of mortality around the globe, with a significantly rising incidence in the Middle East region in recent decades. Since detection of CRC in the early stages is an important issue, and also since to date there are no comprehensive epidemiologic studies depicting the Middle East region with special attention to the average risk group, further investigation is of significant necessity in this regard. Aim: Our aim was to investigate the prevalence of preneoplastic and neoplastic lesions of the colon in an average risk population. Materials and Methods: A total of 1,208 eligible asymptomatic, average- risk adults older than 40 years of age, referred to Firuzgar Hospotal in the years 2008-2012, were enrolled. They underwent colonoscopy screening and all polypoid lesions were removed and examined by an expert gastrointestinal pathologist. The lesions were classified by size, location, numbers and pathologic findings. Size of lesions was measured objectively by endoscopists. Results: The mean age of participants was $56.5{\pm}9.59$ and 51.6% were male. The overall polyp detection rate was 199/1208 (16.5 %), 26 subjects having non-neoplastic polyps, including hyperplastic lesions, and 173/1208 (14.3%) having neoplastic polyps, of which 26 (2.15%) were advanced neoplasms. The prevalence of colorectal neoplasia was more common among the 50-59 age group. Advanced adenoma was more frequent among the 60-69 age group. The majority of adenomas were detected in the distal colon, but a quarter of advanced adenomas were found in the proximal colon; advance age and male gender was associated with the presence of adenoma. Conclusions: It seems that CRC screening among average-risk population might be recommended in countries such as Iran. However, sigmioidoscopy alone would miss many colorectal adenomas. Furthermore, the 50-59 age group could be considered as an appropriate target population for this purpose in Iran.

• Journal of Gastric Cancer
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• 제13권2호
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• pp.126-128
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• 2013

Pyogenic liver abscess in patients with malignant disease is a fatal state and is easily diagnosed. We presented a rare case of sudden fatal septicemia following anticancer treatment for recurred gastric cancer due to multiple liver abscesses which could not be diagnosed. A 72-year-old male with recurred gastric cancer received anticancer agents. He had a history of distal gastrectomy with right hepatic lobectomy for hepatic metastasis. He received anticancer treatment in the outpatient's service center periodically, and his performance status was preserved with nothing in particular. After administrating docetaxel, he suddenly developed septicemia and multiple organ failure and died 5 days after strong medical supports. Pathological autopsy revealed that multiple minute abscesses of the liver which could not be detected macroscopically were the causes of fatal septicemia. The etiology, therapies and prognosis of rare entity are being discussed.

• Journal of Gastric Cancer
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• 제22권4호
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• pp.339-347
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• 2022

Purpose: Lymphovascular invasion is a criterion for non-curative resection in patients who have undergone endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). We aimed to determine the rate of extragastric metastasis (EGM) and identify the predictors of EGM in patients with negative resection margins (R0 resection) and lymphovascular invasion in post-ESD pathology. Materials and Methods: A total of 2,983 patients underwent ESD for EGC. Among them, 110 had a pathology of R0 resection and positive lymphovascular invasion. Patients underwent additional gastrectomy (n=63) or further follow-up without gastrectomy (n=47). Results: The 110 patients were assigned to one of the 3 groups according to ESD indications based on post-ESD pathology. The first group satisfied the absolute indication for ESD (n=18), the second group satisfied the expanded indications for ESD (n=34), and the last group satisfied the beyond indication (n=58). The number of occurrences of EGM in each group was 1 (5.6%), 3 (8.8%), and 3 (5.2%), respectively. The logistic regression analysis adjusted for age, sex, tumor size, and indication for ESD, showed that larger tumor size was associated with EGM (odds ratio, 1.76; 95% confidence interval, 1.00-3.10; P=0.048). In contrast, ESD indication criteria did not affect EGM (P=0.349). Conclusions: Tumor size was the only predictive indicator for EGM in patients who underwent R0 resection and lymphovascular invasion on post-ESD pathology. Even patients with pathology corresponding to the absolute indication criteria of ESD had lymphovascular invasion, which means that they require additional gastrectomy due to the risk of EGM.