• Tuberculosis and Respiratory Diseases
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• 제81권1호
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• pp.19-28
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• 2018

Cancer is the leading cause of death in the Republic of Korea and cancer death accounts for 27.8% of the total deaths, which is not only a social issue but also a concern for the public. Among the cancer death rates, lung cancer mortality account for 34 deaths per 100,000 populations, making it the number one cancer death rate. In a preliminary report on cancer death in 2012, the lung cancer mortality ratio showed the regional variation indicating that there were differences in the qualitative level and the structure among the medical care benefit agency and in the assessment of the treatment process. Therefore, the Health Insurance Review and Assessment Service (HIRA) had begun evaluation of the assessment of lung cancer treatment since 2014 to improve the quality of lung cancer care through evaluation and feeds back the results of lung cancer care process. In this report, authors described the current Indicators for the lung cancer adequacy assessment proposed by HIRA and results of the evaluation reported in 2017.

• Journal of Chest Surgery
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• 제38권6호
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• pp.441-444
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• 2005

복강내 종양이 혈관을 통해 전이될 수는 있으나 우심장까지 침범되는 경우는 드물다. 자궁에서 기원하는 정맥내 평활근종증은 매우 드물며 조직학적으로는 양성이지만 임상적으로는 하대 정맥, 우심장 또는 폐동맥의 폐쇄를 동반함으로써 치명적인 결과를 초래할 수 있는 질환이다. 치료 방법은 심폐 순환기를 통한 완전 순환정지하에 종괴를 완전절제하는 것이다. 자궁에서 기원한 정맥내 평활근종증을 개복술과 개심술을 이용해 일차 수술로 성공적으로 치유하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제39권4호
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• pp.332-334
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• 2006

폐에서 발생하는 염증성 근섬유아세포종은 원인은 정확히 밝혀져 있지 않은 매우 드문 종양이다. 소아에서 발생한 이 종양은 양성종양으로 분류되어 있으나 드물게 국소침윤이나 재발, 원격전이 및 악성변이가 나타날 수 있다. 외과적 완전 절제술이 가장 적절한 치료 방법으로 되어 있다. 12세 남자가 단순흉부엑스선 사진에서 우연히 발견된 좌측 폐 상부의 4 cm크기의 응어리소견을 주소로 내원하였다. 환아는 좌상엽 절제수술을 받은 후 진단병리학적으로 염증성 근섬유아세포종으로 확진되었다. 환아는 술 후 3개월째 재발 소견없이 외래 추적 관찰 중이다.

• Journal of Chest Surgery
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• 제52권1호
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• pp.25-31
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• 2019

Background: The primary goal of this study was to characterize the clinical outcomes of adult patients with hematologic malignancies (HM) who were treated with extracorporeal membrane oxygenation (ECMO) support when conventional treatments failed. Methods: In this retrospective, observational study at a tertiary medical center, we reviewed the clinical course of 23 consecutive patients with HM requiring ECMO who were admitted to the intensive care unit at Asan Medical Center from March 2010 to April 2015. Results: A total of 23 patients (8 female; median age, 44 years; range, 29-51 years) with HM and severe acute circulatory and/or respiratory failure received ECMO therapy during the study period. Fourteen patients received veno-arterial ECMO, while 9 patients received veno-venous ECMO. The median ECMO duration was 104.7 hours (range, 37.1-221 hours). Nine patients were successfully weaned from ECMO. The in-hospital mortality rate was 91.1% (21 of 23). There were complications in 3 patients (cannulation site bleeding, limb ischemia, and gastrointestinal bleeding). Conclusion: ECMO is a useful treatment for patients with circulatory and/or pulmonary failure. However, in patients with HM, the outcomes of ECMO treatment results were very poor, so it is advisable to carefully decide whether to apply ECMO to these patients.

• Journal of Preventive Medicine and Public Health
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• 제52권2호
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• pp.140-144
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• 2019

Objectives: Investigating the survival of patients with cancer is vitally necessary for controlling the disease and for assessing treatment methods. This study aimed to compare various statistical models of survival and to determine the survival rate and its related factors among patients suffering from lung cancer. Methods: In this retrospective cohort, the cumulative survival rate, median survival time, and factors associated with the survival of lung cancer patients were estimated using Cox, Weibull, exponential, and Gompertz regression models. Kaplan-Meier tables and the log-rank test were also used to analyze the survival of patients in different subgroups. Results: Of 102 patients with lung cancer, 74.5% were male. During the follow-up period, 80.4% died. The incidence rate of death among patients was estimated as 3.9 (95% confidence [CI], 3.1 to 4.8) per 100 person-months. The 5-year survival rate for all patients, males, females, patients with non-small cell lung carcinoma (NSCLC), and patients with small cell lung carcinoma (SCLC) was 17%, 13%, 29%, 21%, and 0%, respectively. The median survival time for all patients, males, females, those with NSCLC, and those with SCLC was 12.7 months, 12.0 months, 16.0 months, 16.0 months, and 6.0 months, respectively. Multivariate analyses indicated that the hazard ratios (95% CIs) for male sex, age, and SCLC were 0.56 (0.33 to 0.93), 1.03 (1.01 to 1.05), and 2.91 (1.71 to 4.95), respectively. Conclusions: Our results showed that the exponential model was the most precise. This model identified age, sex, and type of cancer as factors that predicted survival in patients with lung cancer.

• Journal of Chest Surgery
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• 제55권2호
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• pp.108-117
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• 2022

Background: The efficacy of telemedicine among cancer survivors is uncertain. The Smart After-Care Program (SAP), which is an interactive, smartphone-based remote health monitoring system, was developed to help patients manage their health after leaving the hospital. This study was designed to evaluate the efficacy of our remote health care program for lung cancer patients. Methods: We enrolled 50 patients with lung cancer. Self-monitoring devices were supplied to all patients, who were instructed to enter their daily vital signs and subjective symptoms to the Smart After-Care app. The app also provided information about rehabilitation exercises and a healthy diet for lung cancer patients. All patients received health counseling via telephone once a week and visited an outpatient clinic during weeks 6 and 12 to assess satisfaction with the SAP and changes in quality of life and physical performance. Results: Overall satisfaction with the SAP was very high (very good, 61.9%; good, 26.2%). In the multivariate analysis to identify factors affecting satisfaction, the distance between the patient's residence and the hospital was the only significant independent factor (p=0.013). Quality of life improved along all functional scales (p<0.05). Muscle strength significantly improved in the lower limbs (p=0.012). Two-minute walk distance also significantly improved (p=0.028). Conclusion: This study demonstrated that the SAP was acceptable for and supportive of patients with reduced pulmonary function after lung cancer treatment. The SAP was found to be particularly useful for patients living far from the hospital.

• Journal of Gastric Cancer
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• 제23권3호
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• pp.487-498
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• 2023

Purpose: Reduced port surgery (RPS) for gastric cancer has been frequently reported in distal gastrectomies but rarely in total gastrectomies. This study aimed to determine the feasibility of 3-port totally laparoscopic total gastrectomy (TLTG) with overlapping esophagojejunal (EJ) anastomosis. Materials and Methods: A total of 81 patients who underwent curative TLTG for gastric cancer (36 and 45 patients with 3-port and 5-port TLTG, respectively) were evaluated. All 3-port TLTG procedures were performed with the same method as 5-port TLTG, including EJ anastomosis with the intracorporeal overlap method using a linear stapler, except for the number of ports and assistants. Short-term outcomes, including the number of lymph nodes (LNs) harvested by station and postoperative complications, were analyzed retrospectively. Results: Clinical characteristics were not significantly different among the groups, except that the 3-port TLTG group was younger and had a lower rate of pulmonary comorbidity. There were no cases of open conversion or additional port placement. All operative details and the number of harvested LNs did not differ between the groups, but the rate of suprapancreatic LN harvest was higher in the 3-port TLTG group. No significant differences were observed in the overall complication rates between the 2 groups. Conclusions: Three-port TLTG with overlapping EJ anastomoses using a linear stapler is a feasible RPS procedure for total gastrectomy to treat gastric cancer.

• 대한영상의학회지
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• 제81권1호
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• pp.219-224
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• 2020

염증성 근섬유모세포 종양은 전체 폐 종양의 0.04~1%를 차지하는 드문 양성 종양이며 대개 고립성 폐결절이나 종괴로 보인다. 우리는 21세 남자 환자에서의 기관지 내 염증성 근섬유모세포 종양 증례를 영상소견을 중심으로 보고하고 관련된 문헌을 고찰하고자 한다.

• 대한영상의학회지
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• 제84권1호
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• pp.34-50
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• 2023

미국방사선의학회는 효과적인 국가 폐암 검진 시행을 위해 2019년도에 Lung CT Screening Reporting & Data System (이하 Lung-RADS) 1.0보다 폐암의 위양성을 줄이기 위해 개편된 Lung-RADS 1.1을 발표하였고, 2022년 12월에 새로운 Lung-RADS 1.1 개선안 Lung-RADS^Ⓡ 2022를 발표하였다. Lung-RADS^Ⓡ 2022은 Lung-RADS 1.0과 비교했을 때 결절의 크기는 소수점 첫째 자리까지 측정하고, 늑막근처 결절의 크기가 10 mm 미만인 경우까지 범주 2로 하며, 범주 2에서 간유리 결절의 크기 기준을 30 mm로 높이고, 범주 4B와 4X는 매우 의심으로 변경하며, 기도 결절의 위치와 비정형 폐 낭종의 형태와 벽 두께에 따라 범위를 나누었다. 이에 영상의학과 의사들의 개선된 Lung-RADS^Ⓡ 2022에 대한 이해를 돕고자, 이 종설에서는 Lung-RADS^Ⓡ 2022의 장점, 단점, 그리고 향후 개선점에 대해서 기술하고자 한다.

• 대한영상의학회지
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• 제82권3호
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• pp.670-681
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• 2021

목적 병리학적 침습성 병소를 기준으로 폐 아고형결절의 고형 부분을 진단하기 위한 최적의 CT 임계값을 알아보고자 하였다. 대상과 방법 병리적으로 최소 침습성 선암이 확진된 25명의 환자에 대해 비조영증강 흉부 CT 영상을 후향적으로 분석하였다. CT 영상에서 고형 부분은 -600부터 -100 Hounsfield units (이하 HU) 단위 사이에서 50 HU 간격의 다양한 임계치보다 높은 감쇠를 나타내는 영역으로 정의되었다. 각 임계치에서 고형부분의 축상 영상 최대 직경과 다면재구성 영상 최대 직경을 각각 측정한 후, 선형 혼합 모델을 이용하여 병리적 침습성 병소 크기와 비교하였다. 결과 -400 HU 단위의 임계값에서 아고형결절의 고형 부분의 크기와 침습성 병소의 크기는 통계학적으로 유의미한 차이를 보이지 않았으며(축상 영상: p = 0.2682, 다면재구성 영상: p = 0.963) 오차가 가장 적었다(축상 영상: 0.388, 다면재구성 영상: -0.0176). 결론 아고형결절의 침습성 병소를 진단하기 위해, -400 HU 단위가 고형 부분을 정의하는 최적의 정량 분석 임계값일 수 있다.