• Title/Summary/Keyword: Pancreatic Cancer

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Evaluation and Prediction of Post-Hepatectomy Liver Failure Using Imaging Techniques: Value of Gadoxetic Acid-Enhanced Magnetic Resonance Imaging

  • Keitaro Sofue;Ryuji Shimada;Eisuke Ueshima;Shohei Komatsu;Takeru Yamaguchi;Shinji Yabe;Yoshiko Ueno;Masatoshi Hori;Takamichi Murakami
    • Korean Journal of Radiology
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    • v.25 no.1
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    • pp.24-32
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    • 2024
  • Despite improvements in operative techniques and perioperative care, post-hepatectomy liver failure (PHLF) remains the most serious cause of morbidity and mortality after surgery, and several risk factors have been identified to predict PHLF. Although volumetric assessment using imaging contributes to surgical simulation by estimating the function of future liver remnants in predicting PHLF, liver function is assumed to be homogeneous throughout the liver. The combination of volumetric and functional analyses may be more useful for an accurate evaluation of liver function and prediction of PHLF than only volumetric analysis. Gadoxetic acid is a hepatocyte-specific magnetic resonance (MR) contrast agent that is taken up by hepatocytes via the OATP1 transporter after intravenous administration. Gadoxetic acid-enhanced MR imaging (MRI) offers information regarding both global and regional functions, leading to a more precise evaluation even in cases with heterogeneous liver function. Various indices, including signal intensity-based methods and MR relaxometry, have been proposed for the estimation of liver function and prediction of PHLF using gadoxetic acid-enhanced MRI. Recent developments in MR techniques, including high-resolution hepatobiliary phase images using deep learning image reconstruction and whole-liver T1 map acquisition, have enabled a more detailed and accurate estimation of liver function in gadoxetic acid-enhanced MRI.

Study on Sanitary Management of Deceased Bodies through Categorical Analysis of Cause of Death (사망 원인별 유형 분석을 통한 사망자의 위생 관리에 대한 연구)

  • Choi, Jeungmok
    • The Journal of the Korea Contents Association
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    • v.17 no.7
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    • pp.265-275
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    • 2017
  • The aim of this study was to examine fluid excretions and changes in deceased bodies depending on type, location of, and causes of death for hygienic management of funeral homes. Based on the 858 cadavers studied, the average age at the time of death is 68.6 years, 83.0% had illness as the cause of death, and 79.5% passed away in a medical facility. Fluid excretion was observed in 46.2% of the cadavers. In manner of death, 78.8% of deaths -highest percentage- was due to an accident and 10.8% of deaths - lowest percentage- was due to age. Fluid excretion was observed in 46.3% of cadavers from medical facilities, 38.6% of cadavers from homes and 77.4% of cadavers from miscellaneous locations. There were various number of cadavers with recorded immediate, secondary and underlying cause of death; however, the fluid excretion rate was similar. In analyzing the immediate, secondary and underlying cause of death, respiratory and heart disease were the most common causes of death in categories of body organ and system. In terms of fluid excretion, liver disease followed by digestive and circulatory diseases were most common in immediate cause of death. Accidents and miscellaneous circumstances were most common amongst secondary and underlying causes of death for cadavers with fluid excretion. Based on the recorded illnesses of the cadavers, cardiopulmonary failure was most common as evident in 96 cadavers followed by pneumonia and sepsis. Cholangiocarcinoma (73.3%) had the highest rate of fluid excretion followed by pancreatic cancer, severe brain injury and liver cancer amongst categories of illnesses with more than 15 cadavers.

EphB1 and Ephrin-B, New Potential Biomarkers for Squamous Cell/adenosquamous Carcinomas and Adenocarcinomas of the Gallbladder

  • Yuan, Yuan;Yang, Zhu-Lin;Miao, Xiong-Ying;Liu, Zi-Ru;Li, Dai-Qiang;Zou, Qiong;Li, Jing-He;Liang, Lu-Feng;Zeng, Gui-Xiang;Chen, Sen-Lin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.3
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    • pp.1441-1446
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    • 2014
  • Squamous cell/adenosquamous carcinoma (SC/ASC) of the gallbladder are rare tumors and there are few clinical reports in the literature. Herein we report our clinical experience with 46 patients with SC/ASC and 80 with adenocarcinoma (AC). Expression of EphB1 and Ephrin-B in each tumor was determined using immunohistochemical methods for determination of correlations with prognosis. There was no difference in EphB1 and Ephrin-B expression between SC/ASC and AC tumors (P>0.05), but greater expression in those less than 3 cm in diameter, stage I or II (TNM stage), with no lymph node metastases, with no local invasion and treated with radical resection was apparent. Expression of EphB1 (P<0.05) and Ephrin-B (P<0.01) was higher in well differentiated than in poorly differentiated AC tumors. Kaplan-Meier survival analysis indicated that degree of differentiation, tumor diameter, lymph node metastases, local invasion, surgical approach and expression rate of EphB1 and Ephrin-B were closely related to the survival of SC/ASC (P<0.05) and AC patients (P<0.01). Patients with tumors that positive expressed EphB1 and Ephrin-B, whether it is SC/ASC ($P_{SC/ASC}$ =0.000) or AC ($P_{AC}$ =0.000 or $P_{AC}$ =0.002) had longer survival than those negative expression. Cox multivariate analysis indicated a negative correlation between expression of EphB1 or Ephrin-B and overall survival. Hence, EphB1 and Ephrin-B could be regarded as independent good prognostic factorsand important biological markers for SC/ASC and AC of gallbladder.

Anti-proliferative Effects of Celastrol, A Quinine Methide Triterpene Extracted from the Perennial Vine Tripterygium wilfordii, on Obesity-related Cancers (미역줄나무 뿌리 추출물인 셀라스트롤의 비만관련 암증식 억제효과)

  • Park, Sunmi;Moon, Hyun-Seuk
    • Journal of Food Hygiene and Safety
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    • v.31 no.1
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    • pp.59-66
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    • 2016
  • It has been generally accepted that obesity and overweight are associated with metabolic diseases and cancer incidence. In fact, obesity increased risks of cancers i.e. breast, liver, pancreatic and prostate. Celastrol is a pentacyclic triterpenoid isolated from Thunder god vine, was used as a Chinese traditional medicine for treatment of inflammatory disorders such as arthritis, lupus erythematosus and Alzheimer's disease. Also, celastrol has various biological properties of chemo-preventive, neuro-protective, and anti-oxidant effects. Recent studies demonstrated that celastrol has anti-proliferation effects in different type of obesity-related cancers and suppresses tumor progression and metastasis. Anticancer effects of celastrol include regulation of $NF-{\kappa}B$, heat shock protein, JNK, VEGF, CXCR4, Akt/mTOR, MMP-9 and so on. For these reasons, celastrol has shown to be a promising anti-tumor agent. In this review, we will address the anticancer activities and multiple mechanisms of celastrol in obesity-related cancers.

A Case of Bronchiectasis with High Serum CA19-9 (혈중 CA19-9이 지속적으로 상승되었던 기관지 확장증 환자 1예)

  • Huh, Jung Hun;Lee, Su Mi;Koo, Tae Hyoung;Shin, Bong Chul;Um, Soo Jung;Yang, Doo Kyung;Lee, Soo-Keol;Son, Choonhee;Rho, Mee Sook;Kim, Ki Nam;Lee, Ki Nam;Choi, Pil Jo
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.5
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    • pp.383-386
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    • 2008
  • An elevated serum CA19-9 level is an indication of pancreatic and biliary tract cancer. However, it has recently become known that nonmalignant gastrointestinal diseases and a variety of nonmalignant respiratory diseases, such as idiopathic interstial pneumonia, collagen vascular disease associated lung diseases, diffuse panbronchiolitis and bronchiectasis, can also show an elevated serum CA19-9 level. We recently encountered a case of bronchiectasis with persistently elevated serum CA19-9, but without any evidence of malignant disease in endoscopic retrograde pancreatocholangiography, abdominal computed tomography, and positron emission tomography. After serial follow-up of 3 years and 10 months, there was still no evidence of cancer. It is believed that the elevated serum CA19-9 level was due to bronchiectasis. An elevated serum CA19-9 level should be interpreted carefully with the patients' clinical condition.

Added Value of the Sliding Sign on Right Down Decubitus CT for Determining Adjacent Organ Invasion in Patients with Advanced Gastric Cancer (진행성 위암 환자에서 인접 장기 침범을 결정하기 위한 우측와위 CT에서의 미끄러짐 징후의 추가적 가치)

  • Kyutae Jeon;Se Hyung Kim;Jeongin Yoo;Se Woo Kim
    • Journal of the Korean Society of Radiology
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    • v.83 no.6
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    • pp.1312-1326
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    • 2022
  • Purpose To investigate the added value of right down decubitus (RDD) CT when determining adjacent organ invasion in cases of advanced gastric cancer (AGC). Materials and Methods A total of 728 patients with pathologically confirmed T4a (pT4a), surgically confirmed T4b (sT4b), or pathologically confirmed T4b (pT4b) AGCs who underwent dedicated stomach-protocol CT, including imaging of the left posterior oblique (LPO) and RDD positions, were included in this study. Two radiologists scored the T stage of AGCs using a 5-point scale on LPO CT with and without RDD CT at 2-week intervals and recorded the presence of "sliding sign" in the tumors and adjacent organs and compared its incidence of appearance. Results A total of 564 patients (77.4%) were diagnosed with pT4a, whereas 65 (8.9%) and 99 (13.6%) patients were diagnosed with pT4b and sT4b, respectively. When RDD CT was performed additionally, both reviewers deemed that the area under the curve (AUC) for differentiating T4b from T4a increased (p < 0.001). According to both reviewers, the AUC for differentiating T4b with pancreatic invasion from T4a increased in the subgroup analysis (p < 0.050). Interobserver agreement improved from fair to moderate (weighted kappa value, 0.296-0.444). Conclusion RDD CT provides additional value compared to LPO CT images alone for determining adjacent organ invasion in patients with AGC due to their increased AUC values and improved interobserver agreement.

A Study on The Effect of The Tobacco Price Raise on The Smoking Rate and Smoking Attributable Death (담배 가격인상이 흡연률과 흡연귀속사망에 미칠 영향에 대한 연구 -대도시 일부 사무직 근로자를 대상으로-)

  • Kang, Jonw-Won;Kim, Joung-Soon
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.4 s.59
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    • pp.697-707
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    • 1997
  • This study was performed to estimate the quantity of the effects of tobacco price raise on the smoking rate, and the smoking attributable deaths in Korea. The data were collected by questionnaire survey from 538 male of male workers. The questionnaire contained items on age, sex, living place, status of education, smoking history, the intention to quit smoking when the tobacco price be raised. The questionnaire, were distributed to the offices of enterprises, hospitals, research centers, and public agencies and then collected. Data were analyzed by using the age specific smoking rate, relative risks of eight major smoking related diseases, vital statistics, and the population attributable risk of deaths of smoking males. On the other hand, the impact of the tobacco price raise on the population attributable risk of death due to smoking in Korea was estimated by applying the presumed smoking rate after the price raise. The results obtained were as follows: 1. The smoking rate of male white color workers in large cities was 59.5%. 2. The proportion of male smokers who has the intention to quit smoking when the tobacco price be raised was 61.5%. 3. The proportion of male smokers who has the intention to quit smoking if the price of tobacco be raised was proportional to the degree of increasing tobacco price. It is estimated that if the tobacco price were raised more than four times as now, the presumed smoking rate goes down as low as 26.7%. If the tobacco price be raised 20% each year, presumed smoking rate is 46.2%. 4. The number of attributable male death of smoking estimated by using 8 major smoking related diseases(lung cancer, laryngeal cancer, esophageal cancer, stomach cancer, pancreatic cancer, cerebrovascular disease, ischemic heart disease, chronic obstructive pulmonary disease) was 25,863 death each year. That is 20.1% of total age over 20 male deaths. 5. f the tobacco price were raised more than four times as now and all smokers who has intention to quit smoking quits smoking, 12,336 lives, or 47.7% of smoking related deaths could be saved. 6. IF the actual practice rate of quitting smoking among male smokers with intention to stop smoking when the price of tobacco be raised is 10%, 25%, or 50%, then the expected decrease of death numbers when the tobacco price were raised more than four times as now can be 1,112, 3,483, 5,796 respectively.

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Biological Activities of Pharbitis nil and Partial Purification of Anticancer Agent from Its Extract (견우자의 생리활성 분석과 추출물로부터 항암 활성물질의 분리)

  • Choi, Hyeun Deok;Yu, Sun Nyoung;Park, Sul-Gi;Kim, Young Wook;Nam, Hyo Won;An, Hyun Hee;Kim, Sang Hun;Kim, Kwang-Youn;Ahn, Soon Cheol
    • Journal of Life Science
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    • v.27 no.2
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    • pp.225-232
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    • 2017
  • This study aimed to evaluate several biological activities of Pharbitis nil and to isolate an anticancer agent from its methanol extract. Pharbitis nil seeds were extracted with methanol (PNM). Then, PNM was fractionated into solvent layers such as ethyl acetate fraction (PNE), butanol fraction (PNB), and water fraction (PNW). The biological activities of the fractions were analyzed for tyrosinase inhibition, lipase inhibition, DPPH-free radical scavenging, and cell growth inhibition. PNM showed strong growth inhibition of prostate cancer PC-3 cells. PNM was subjected to Diaion HP-20 and eluted stepwise with 50%, 80%, and 100% methanol. Then, for activity-guided fraction, each fraction was analyzed for growth inhibition of prostate cancer PC-3 cells by using an MTT assay. Because the 100% fraction showed significantly strong inhibitory activity, the fraction was further separated in the reverse phase C18, which was eluted with 80% and 90% methanol. The 90% fraction was further subjected to Sephadex LH-20 using a mobile solvent of 100% methanol. Finally, the compound PN was partially purified for HPLC analysis. PN showed cell growth inhibitory activity and induced the apoptosis and cell cycle arrest of prostate cancer PC-3 cells, as measured by flow cytometry. The results together suggest that Pharbitis nil possesses various biological activities, especially the inhibitory activity for the proliferation of prostate cancer PC-3 cells, suggesting the possibility of its use as an anticancer agent.

A Clinical Evaluation of Splanchnic Nerve Block with Absolute Ethanol (무수 알코올에 의한 내장신경차단에 관한 임상적 연구)

  • Lee, Hyo-Keun;Yoon, Duck-Mi;Oh, Hung-Kun
    • The Korean Journal of Pain
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    • v.4 no.2
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    • pp.111-121
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    • 1991
  • It has been well known that the splanchnic nerve block is effective for patients who suffer from intractable upper abdominal pain. However, it is unclear whether the effect of the splanchnic nerve block depends on varied alcoholic concentration. In this study, an attempt was made to use absolute ethanol on patients who recieved a splanchnic nerve block at Severance Hospital during the period from September l990 to April l991. The results are as follows; 1) Among the 33 patients, including 22 males and 1l females, the fifties and sixties were the major age groups. 2) Stomach cancer was the most common underlying disease(13 cases), with pancreatic can- cer next(9 cases). 3) The main locations of pain were the upper abdomen, epigastrium, and entire abdomen in decreasing order. 4) There were 17 cases who had had chemotherapy, and 1l cases of whom had had surgery before the splanchnic nerve block. 5) The volume of alcohol used was 12 ml bilaterally. 6) Among the 33 patients, 15.2% required a second block within two weeks of the first block. One case required a third block. 7) The most common complications of splanchnic nerve block were hypotension(33.3%), occasional transient sharp burning pain, flushing of face, pain on injection site, nausea, vomiting, dyspnea, chest discomfort and diarrhea. 8) The supplemental block most commonly used was a continuous epidural block. It was used both as a diagnostic block and to afford relief from pain before the splanchnic nerve block was done. 9) The interval between the receiving the absolute ethanol block and discharge was within 2 weeks in l5 cases. But, in the patients with poor general health, the interval between the splanchnic nerve block and discharge prolonged. The above results suggest that bilateral splanchnic nerve block done with absolute ethanol after an effective test block with 1% lidocaine under C-arm fluroscopic control is satisfactory and reliable. Still, 26.6% of the patients received a repeat block within 2 weeks. Insufficient spread of ethanol due to its small volume seems to be a major factor in the repeat block. Minimizing the incidence of repeat block remains a problem to be solved.

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Models for Predicting Five Jang Biological Ages with Clinical Biomarkers (임상 생체지표를 이용한 오장생체나이 추정 모델)

  • Kim, Tae-Hee;Kim, Seok;Bae, Chul-Young;Kang, Young-Gon;Cho, Kyung-Hee;Kwon, Su-Kyung;Park, Mei-Hua
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.15 no.2
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    • pp.175-190
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    • 2011
  • Objectives: Even though there has been no consensus on the concept of viscera organ between the oriental and western medicine, we tried to investigate the correlation between clinical biomarkers of five Jang and chronological age and develop the models for predicting five Jang biological ages by statistical analysis. Methods: We obtained data from about 120,000 subjects who visited health promotion centers for health promotion and disease prevention from January 2004 to June 2009. Participants were included if they were over 20 years old, and excluded if reported to have cardiovascular disease or other serious medical illness such as cancer, malignant hypertension, uncontrolled diabetes, cardiopulmonary insufficiency, liver disease, pancreatic disease or renal disease. Among the clinical biomarkers obtained, we selected the biomarkers which were associated with the function of 5 Jang in previous studies, or showed statistically significant correlation with age. Multiple regression models were used for building prediction models of biological age after adjusting for potential confounders for men and women, respectively. Pearson correlation coefficient was calculated to examine the linear relationship between age and various biomarkers, and multiple regression analysis was used for building the prediction models of five Jang biological ages for men and women, respectively. All statistical data analysis was performed by using SPSS Version 12.0 software and statistical significance was obtained if p<0.05. Results: For males, the best models were developed using 12, 2, 8, 3, and 4 biomarkers for predicting biological ages of heart, lung, liver, pancreas, and kidney, respectively (R2 = 0.57, 0.43, 0.11, 0.24, and 0.93, respectively). Similar to males, for the females, 10, 2, 8, 3, and 4 biomarkers were selected as the models respectively (R2 = 0.76, 0.44, 0.14, 0.38, and 0.89, respectively). Conclusions: As we have developed for the first time the models for predicting five Jang biological ages with common clinical biomarkers, it is expected that these models may be used as clinical supplementary tools in the evaluation of aging status and functional decline of five Jang according to age in health promotion centers and private clinics. At the same time, it is considered that the use as objective tools to evaluate aging status and functional decline of each Jang.