• 대한종양외과학회지
• /
• 제14권2호
• /
• pp.120-127
• /
• 2018

Purpose: The purpose of this study was to determine the immunologic role of lymph node (LN) and stage migration by assessing LN count and metastatic LN count. Methods: A total of 2,117 patients with gastric adenocarcinoma located in the body and antrum who underwent distal/subtotal gastrectomy with D2 LN dissection between January 1, 1998 and December 31, 2008 were enrolled. LN count and number of metastases were determined in the N1 tier (area of D1 dissection) and N2 tier (area of D2 dissection). The lower and upper quartiles of LN counts in the same pN stage were grouped to compare the prognosis and LN positivity according to the LN tier. Results: Stage migration from N1 tier to N2 tier occurred in 3.2% of cases. The 5-year disease-specific survival rates of the upper and lower LN count groups within the N1 tier were 91.0% and 86.7% (P=0.01), respectively. LN positivity in the N2 tier of the lower LN count group was higher than that of the upper LN count group (14.1% vs. 8.2%, P<0.01). Stage migration in the N2 tier of the lower LN count group was also higher than that of the upper LN count group (4.6% vs. 1.8%, P<0.01). Conclusion: The lower LN count group had a decreased survival rate compared to that of the upper LN count group, suggesting that perigastric LN has an immunological defense role in weakening the disseminating power of metastatic tumor cells, as indicated by the LN count.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권19호
• /
• pp.8483-8488
• /
• 2014

Background: Breast cancer is the most common cancer and the second most common cause of cancer-induced mortalities in Iranian women, following gastric carcinoma. The survival of these patients depends on several factors, which are very important to identify in order to understand the natural history of the disease. Materials and Methods: In this retrospective study, 313 consecutive women with pathologically-proven diagnosis of breast cancer who had been treated during a seven-year period (January 2006 until March 2014) at Towhid hospital, Sanandaj city, Kurdistan province of Iran, were recruited. The Kaplan-Meier method was used for data analysis, and finally those factors that showed significant association on univariate analysis were entered in a Cox regression model. Results: the mean age of patients was $46.10{\pm}10.81$ years. Based on Kaplan-Meier method median of survival time was 81 months and 5 year survival rate was $75%{\pm}0.43$. Tumor metastasis (HR=9.06, p=0.0001), relapse (HR=3.20, p=0.001), clinical stage of cancer (HR=2.30, p=0.03) and place of metastasis (p=0.0001) had significant associations with the survival rate variation. Patients with tumor metastasis had the lowest five-year survival rate (37%)and among them patients who had brain metastasis were in the worst condition (5 year survival rate= $11%{\pm}0.10$). Conclusions: Our findings support the observation that those women with higher stages of breast malignancies (especially with metastatic cancer) have less chance of surviving the disease. Furthermore, screening programs and early detection of breast cancer may help to increase the survival of those women who are at risk of breast cancer.

• Journal of Gastric Cancer
• /
• 제8권1호
• /
• pp.47-52
• /
• 2008

융모막암은 임신과 연관되어 발생하는 악성 종양으로 주로 자궁에서 발생한다. 위장관에서도 융모막암이 발생할 수 있는데 매우 드물고 다른 장기의 융모암과 다른 발생 기전을 가진다. 원발성 위융모암은 치료 성적이 나쁘고 전이 속도가 빨라서 예후가 매우 나쁘다. 저자들은 혈변, 상복부 통증을 주소로 내원한 69세 여자 환자에서 수술전 진행성 저분화형 위선암으로 진단되어 위아전절제술을 시행하였으나 수술 후 위 전정부의 원발성 융모막암으로 진단된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. 융모막암 치료 원칙은 수술적 절제술과 보조적 항암 화학치료이지만 생존율 증가가 입증된 치료 방법은 아직 없는 실정이다. 그러므로 저분화도를 보이거나 출혈 경향을 보이는 위암인 경우에는 융모막암의 가능성도 염두에 두고 적극적인 검사가 이루어져야 할 것으로 생각된다.

• Clinical Endoscopy
• /
• 제57권2호
• /
• pp.209-216
• /
• 2024

Background/Aims: Endoscopic ultrasonography-guided gastrojejunostomy is a minimally invasive method for the management of gastric outlet obstruction. Conventionally, a lumen-apposing metal stent (LAMS) is used to create an anastomosis. However, LAMS is expensive and not widely available. In this report, we described a tubular fully covered self-expandable metallic stent (T-FCSEMS) for this purpose. Methods: Twenty-one patients (15 men [71.4%]; median age, 66 years; range, 40-87 years) were included in this study. A total of 19 malignant (12 pancreatic, 6 gastric, and 1 metastatic rectal cancer) and 2 benign cases were observed. The proximal jejunum was punctured with a 19 G needle. The stomach and jejunum walls were dilated with a 6 F cystotome, and a 20×80 mm polytetrafluoroethylene T-FCSEMS (Hilzo) was deployed. Oral feeding was initiated after 12 to 18 hours and solid foods after 48 hours. Results: The median procedure time was 33 minutes (range, 23-55 minutes). After two weeks, 19 patients tolerated oral feeding. In patients with malignancy, the median survival time was 118 days (range, 41-194 days). No serious complications or deaths occurred. All patients with malignancy tolerated oral food intake until they expired. Conclusions: T-FCSEMS is safe and effective. This stent should be considered as an alternative to LAMS for gastric outlet obstruction.

• 대한약침학회지
• /
• 제13권1호
• /
• pp.37-43
• /
• 2010

Objective : Ginseng is one of most widely used herbal medicine. Ginseng showed anti-metastasis activities. However, its molecular mechanisms of action are unknown. So we want to report the wild ginseng repress which plays key roles in neoplastic epithelial-mesenchymal transition process. Methods : Treatment of the human colorectal carcinoma LOVO cells and human gastric carcinoma SNU601 cells with the increased concentrations of cultivated wild ginseng extracts resulted in a gradual decrease in the AXIN2 gene expression. Results : Metastasis-suppressor genes, maspin and nm23 was not affected by the treatment of ginseng extracts in LOVO cells. Moreover, the mountain cultivated wild ginseng or mountain wild ginseng are similar in their inhibitory effects on the expression of AXIN2 gene, but are substantially stronger than cultivated ginseng. Conclusion : We described the novel mechanism of wild ginseng-induced anti-metastasis activity by repressing the expression of AXIN2 gene that plays key roles in epithelial-mesenchymal transition process.

• 한국응용약물학회:학술대회논문집
• /
• 한국응용약물학회 2002년도 창립10주년기념 및 국립독성연구원 의약품동등성평가부서 신설기념 국재학술대회:생물학적 동등성과 의약품 개발 전략을 위한 국제심포지움
• /
• pp.97-102
• /
• 2002

Life Science Research Center of SK Chemicals has developed a 3rd-generation anticancer platinum drug for the first time in the nation′s 100-year-old pharmaceutical industry. The Korea Food and Drug Administration (KFDA) approved the sale of "Sunpla" (code name SKI 2053R, general name : Heptaplatin) on July 14, 1999 for the treatment of advance, metastatic gastric cancer. Cisplatin, the 1 st-generation anticancer drug, which was developed by Bristol-Myers of the United States in 1976, is one of the most potent anticancer drugs and is a major component of combination chemotherapy for a variety of human cancers. However its clinical usefulness has frequently been limited not only by undesirable side effects such as severe renal toxicity, nausea, vomiting, ototoxicity, and neurotoxicity but also by the development of resistance. Carboplatin, the 2nd-generation anticancer platinum drug, which was also developed by Bristol-Myers in 1986, has modified the problems of the renal and gastrointestinal toxicities of cisplatin. Carboplatin, however, has no enhanced therapeutic efficacy over cisplatin and does not possess the property to overcome cross-resistance to cisplatin.

• Radiation Oncology Journal
• /
• 제10권2호
• /
• pp.187-192
• /
• 1992

영남대학교 의료원 치료방사선과에서 1988년 6월 15일에 위암 환자의 수술중 방사선치료를 시작한 이래 1992년 8월 30일까지 총 58예에서 시도하여 그중 53예에서 IORT를 실시하였으며, 정기적인 추적 검사에서 한명의 국소재발 환자도 보고되지 않고 있다. 출혈(3예), 장관폐쇄(3예), 폐혈증(2예), 골수기능저하(1예)를 포함한 총 9예($17\%$)의 합병증이 보고되었고, 이중 6예 ($13\%$)가 사망하였다. IORT(1500 cGy), 외부 방사선치료(-4500 cGy)와 강한 항암제를 병합치료 하였음에도 불구하고 주등(수술과 항암제 치료)의 $25.2\%$, 김등(수술 불가능한 환자에서 항암제 투여)의 $18\%$, 리등(수술)의 $18.5\%$, Kramling등(IORT 2800-3500 cGy)의 $35.3\%$에 비해 낮은 합병증을 보여 IORT가 위암의 치료에 공헌할 수 있음을 시사하였다. 그러나 비교적 높은 치사율($11.3\%$)은 더욱 세심한 수술수기 및 수술 후 환자의 치료가 필요하며 외부 방사선치료와 항암제치료의 적절한 시기 조절 및 치료선량의 가감이 필요할 것으로 생각된다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권5호
• /
• pp.2679-2681
• /
• 2016

Background: Gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NEN) are relatively rare tumors, not equally distributed in gastro-intestinal system. In 2010, a revised version of the WHO classification of GEP-NENs was published. This study reports for the first time the distribution and characteristics of GEP-NEN in a Lebanese population. Materials and Methods: This descriptive retrospective study concerns all the digestive neuroendocrine tumors with their characteristics diagnosed in $H\hat{o}tel$ Dieu de France in Beirut, Lebanon from 2001 to 2012, all the pathology reports being reanalyzed according to the latest WHO 2010 classification. The characteristics and features of GEP-NEN analyzed in this study were age, gender, grade and site. Results: A total of 89 GEP-NENs were diagnosed, representing 28.2% of all neuroendocrine tumors. The mean age of GEP-NEN patients was 58.7 years and the M/F sex ratio was 1.2. The primary localization was as follows: 21.3%(19) pancreatic, 18% (16) gastric, 15.7% (14) duodenal, 11.2% (10) appendix, 10.1% (9) intestinal, 10.1% (9) colorectal (7.9% colonic and 2.2% rectal), 5.6% (4) hepatic, 2.2% (2) ampulla, 1.1% (1) esophageal and 7.9%(5) NOS digestive (metastatic with unknown primary). Of the 89 patients with GEP-NEN, 56.2% (50) were diagnosed as grade I, 11.2% (10) as grade II, 20.2% (18) as grade III and 12.4% (11) were considered as mixed adeno-neuroendocrine carcinomas (MANEC). Conclusions: This study, one of the rare examples based on the 2010 WHO classification of neuroendocrine tumors in the literature, indicates that in the Lebanese population, all duodenal and appendicular tumors are G1 and the majority of MANEC tumors are gastric and pancreatic tumors. Moreover, more duodenal tumors and fewer rectal tumors were encountered in our study compared to European reports.

• Clinical Pain
• /
• 제19권1호
• /
• pp.54-58
• /
• 2020

Skeletal muscle metastasis of gastric cancer is extremely rare and is associated with various symptoms. Here, we report on a 60-year-old woman with right hip pain after excessive walking. Two years earlier, the patient had been treated for advanced gastric cancer (surgery, adjuvant chemotherapy). Upon magnetic resonance imaging, diffuse muscle swelling and high signal intensity were observed in T2-weighted images of the right hip muscle. However, the FDG uptake in the right gluteal muscles was not obviously increased. Pathological examination of muscle biopsy revealed metastatic adenocarcinoma of stomach origin. The patient was treated with chemotherapy, and the swelling and pain in the right hip are progressively improving.

• Journal of Gastric Cancer
• /
• 제5권4호
• /
• pp.288-294
• /
• 2005

목적: 표층 확대형 조기위암은 위벽 내로의 깊은 침윤은 없으면서 위의 표층부를 넓게 퍼져 나가는 성장형태가 특징이다. 이는 조기 위암 가운데 드문 형태로서 이들의 임상병리학적 특성은 아직 널리 알려져 있지 않다. 이에 이의 임상병리학적 특성을 규명 해 보고자 본 연구를 시행하였다. 대상 및 방법: 본원에서 위암으로 수술 받고 조기위암이 확인된 385예를 대상으로 하였다. 이들 가운데 종양의 최대 직경이 6 cm 이상이거나 종양의 면적이 $5{\times}5cm\;(25cm^2)$ 이상이었던 69명을 표층 확대형, 그 이하인 319명은 일반 형으로 정의하고 두 그룹 사이의 임상병리학적 특성을 비교 분석하였다. 결과: 표층 확대형의 경우 일반형에 비하여 림프절 전이, 미만형, 림프관 침윤이 의미 있게 많았다. 표층 확대형에서 림프절 전이 위치는 위 주위와 총간동맥 주위, 좌위동맥 주위에 국한되었다. 종양의 변연부와 절제선까지의 거리가 10 mm 이하이나 절제선 내 암침윤은 음성이었던 6예는 추적관찰 기간($4 {\sim}13$년)동안 재발 없이 생존 중이다. 단 변량 생존 분석에서 58세 이상의 연령, 위 상부1/3 위치 암, 림프절 전이 예, 점막하층 침윤 예 등이 의미 있는 불량예후인자였다. 다변량 생존분석에서는 연령 및 림프절 전이 여부만이 독립적인 예후관련 인자였다. 그러나 표층 확대형 여부는 의미 있는 예 후인자가 아니었다. 결론: 표층 확대형 조기 위암은 조직학적으로 특징적인 면모를 보이고 있으나 이의 치료 시 절제선 음성을 확인하며 위절제술을 시행하고 림프절은 $D1+{\beta}$범위에서 곽청하면 좋은 예후를 기대 할 수 있겠다. 수치는 체내 그렐린 생성량을 반영하지 못한다. 위는 그렐린 생성의 주요 장소이며 위 절제 범위에 따라 혈중 그렐린 농도에 유의한 차이가 없는 것으로 보아 위전절술 후 다른 장기에서 그렐린이 대상성으로 더욱 증가하였음을 알 수 있다. 그렐린의 생성에 영향을 미치는 다른 인자들에 대한 추가적인 연구가 필요할 것으로 생각한다.배 이상 강력한 미백활성을 나타낸 반면, $100{\mu}M$ 농도에서도 비교적 안전한 화합물로 확인되었으며, 작용기전은 MITF 단백질을 조절함으로 활성을 나타내는 것으로 확인되었다.이 바람직할 것으로 생각된다. 얻었으며 두 군 사이에 임상적 결과의 차이는 없었다.건측 보다 10도의 굴곡 제한이 있었다. 결론: 자가 슬괵 건을 이용한 전방 십자 재건술 시, 경골 부의 고정 시 슬관절의 굴곡 각도 따른 슬관절의 전방 안정성에 차이는 없었으나, 신전 위에서 고정하는 것이 과도한 이식 건의 장력으로 인한 슬관절 굴곡 구축을 예방하는데 도움이 될 것으로 사료된다.라 증가할 것으로 추정되었으며 이에 대한 연근 추출물 경구 투여가 간 조직을 보호할 수 있는지를 확인하기 위해 분리한 혈청으로부터 ALT 함량을 측정한 결과 대조군에 비하여 유의한 감소를 나타내었다. 또한 연근 추출물이 혈청 내 지질 과산화물의 생성을 억제할 수 있다면 질병의 예방과 치료에 효과적일 것으로 추정할 수 있으므로 그 생성량을 측정하여 보았으나 대조군과의 차이가 나타나지 않았다. 이상의 결과들을 종합하여 보면 스트레스가 부하된 5일 동안 연근(蓮根) 추출물을 함께 투여한 결과 혈청 corticosterone 함량을 유의하게 감소시켰고 뇌 조직내 noradrenaline 함량을 증가시키는 경향을 나타내어 스트레스