• 제목/요약/키워드: digestive cancer

검색결과 393건 처리시간 0.02초

내시경초음파 세침흡인술을 통한 전이성 미분화육종의 진단 (Diagnosis of Metastatic Undifferentiated Sarcoma by Endoscopic Ultrasound Guided Fine Needle Aspiration (EUS-FNA))

  • 김시영;이희승;정문재;박정엽;방승민;박승우;송시영
    • Journal of Digestive Cancer Research
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    • 제5권2호
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    • pp.120-124
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    • 2017
  • A-49-year-old male patient with no specific medical history was admitted to the clinic because of persistent epigastric pain radiating to back for 4 months. He had multiple parenchymal tumors in body and tail of pancreas, para-spinal muscle, and mediastinum on abdomen CT image. Cytologic examination of the pancreas which was done by endoscopic ultrasound guided fine needle aspiration (EUS-FNA) showed adenocarcinoma, whereas histological examination of the para-spinal mass showed undifferentiated sarcoma. Histologic examination of the pancreatic mass was made through endoscopic ultrasound guided fine needle biopsy (EUS-FNB) for accurate diagnosis, and the histologic examination of both the pancreas and posterior mediastinal mass showed the same undifferentiated sarcoma. Therefore, we reviewed the cytopathic tissue obtained from the pancreas for the first time, and it was confirmed to be similar to histologic findings in the mediastinal mass.

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Unexpected Complications and Safe Management in Laparoscopic Pancreaticoduodenectomy

  • Yuichi Nagakawa;Yatsuka Sahara;Yuichi Hosokawa;Chie Takishita;Tetsushi Nakajima;Yousuke Hijikata;Kazuhiko Kasuya;Kenji Katsumata;Akihiko Tsuchida
    • Journal of Digestive Cancer Research
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    • 제5권1호
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    • pp.23-27
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    • 2017
  • Although laparoscopic pancreaticoduodenectomy (LPD) is considered as minimally invasive surgery, an advanced level of laparoscopic skill is still required. LPD comprises various procedures including reconstruction. Therefore, establishment of a safe approach at each step is needed. Prevention of intraoperative bleeding is the most important factor in safe completion of LPD. The establishment of effective retraction methods is also important at each site to prevent vascular injury. I also recommend the "uncinate process first" approach during initial cases of LPD, in which the branches of the inferior pancreaticoduodenal artery are dissected first, at points where they enter the uncinate process. This approach is performed at the left side of the superior mesenteric artery (SMA) before isolating the pancreatic head from the right aspect of the SMA, which allows safe dissection without bleeding. Safe and reliable reconstruction is also important to prevent postoperative complications. Laparoscopic pancreatojejunostomy requires highly skilled suturing technique. Pancreatojejunostomy through a small abdominal incision, as in hybrid-LPD, facilitates reconstruction. In LPD, the surgical view is limited. Therefore, we must carefully verify the position of the pancreaticobiliary limb. A twisted mesentery may cause severe congestion of the pancreaticobiliary limb following reconstruction, resulting in severe complications. We must secure the appropriate position of the pancreaticobiliary limb before starting reconstruction. We describe the incidence of intraoperative and postoperative complications and appropriate technique for safe performance of LPD.

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The Maximum Standardized Uptake Value of 18F-FDG PET/CT in Diabetic Patients with Metastatic Pancreatic Ductal Adenocarcinoma

  • Kyu-hyun Paik;Hyoung Woo Kim;Jong-chan Lee;Jingu Kang;Yoon Suk Lee;Jaihwan Kim;Jin-Hyeok Hwang
    • Journal of Digestive Cancer Research
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    • 제5권2호
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    • pp.91-96
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    • 2017
  • Background: To evaluate whether DM affects the SUVmax of metastatic lesions on 18F-FDG PET/CT and whether the SUVmax can influence the prognosis of metastatic PDAC patients. Methods: We conducted a retrospective study of 86 patients with metastatic PDAC who underwent PET/CT before treatment. The SUVmax of primary and metastatic lesions and the ratios of the SUVmax were measured. Long-term survival was evaluated using clinical parameters. Results: The mean SUVmax of primary lesion was lower in the DM group than in the non-DM group (4.74 vs. 5.96, p=0.009). The SUVmax for all metastatic lesions, except those in the lung, were lower in the DM group than in the non-DM group, and these differences were statistically significant in the lymph nodes and peritoneum. In the 35 patients with hepatic metastasis, higher ratios of the liver SUVmax significantly correlated with shorter OS (HR, 2.625; p=0.013). Conclusion: DM can influence the lower SUVmax of metastatic lesions as well as primary lesions. The SUVmax ratio of hepatic metastasis could influence on prognosis in metastatic PDAC patients.

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수술과 항암치료 후 종양표지자 검사의 상승으로 복막 가성점액종의 재발을 확인한 1례 (A Case of Recurred Pseudomyxoma Peritonei Identified by Serially Elevated Serum CEA Levels after Cytoreductive Surgery and Intraperitoneal Chemotherapy)

  • 한인섭;송근암;김광하;이봉은;백동훈;이성준;이문원;한성용
    • Journal of Digestive Cancer Research
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    • 제4권1호
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    • pp.32-35
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    • 2016
  • 복막 가성점액종은 표준치료인 종양감축수술과 함께 복강 내 고온열 항암요법과의 병합치료로 생존율의 향상을 기대할 수 있다. 재발성 병변에 대해서는 추가적인 종양감축 수술이 권고되고 있지만, 치료시기에 따른 이환율과 사망률의 차이가 있어 조기발견이 중요하다. 수술 전 혈청 종양표지자 검사의 수치 이상 여부에 따른 재발과 생존율의 상관관계를 알아보고자 하는 연구들은 있지만, 추적관찰 중 수치 이상에 따른 재발여부에 관한 연구는 거의 없다. 저자들은 CSR과 HIPEC, 그리고 전신 항암화학요법을 시행받은 환자에서 CEA의 수치 상승이 질병의 재발과 상관관계가 있었음을 경험하였기에 보고하는 바이다.

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Endoscopic Intervention for Anastomotic Leakage After Gastrectomy

  • Ji Yoon Kim;Hyunsoo Chung
    • Journal of Gastric Cancer
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    • 제24권1호
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    • pp.108-121
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    • 2024
  • Anastomotic leaks and fistulas are significant complications of gastric surgery that potentially lead to increased postoperative morbidity and mortality. Surgical intervention is reserved for cases with severe symptoms or hemodynamic instability; however, surgery carries a higher risk of complications. With advancements in endoscopic treatment options, endoscopic approaches have emerged as the primary choice for managing these complications. Endoscopic clipping is a traditional method comprising 2 main categories: through-the-scope clips and over-the-scope clips. Through-the-scope clips are user friendly and adaptable to various clinical scenarios, whereas over-the-scope clips can close larger defects. Another promising approach is endoscopic stent insertion, which has shown a high success rate for leak closure, although vigilant monitoring is required to monitor stent migration. Infection control is essential in post-surgical leakage cases, and endoscopic internal drainage provides a relatively safe and noninvasive means to manage fluids, contributing to infection control and wound healing promotion. Endoscopic suturing offers full-thickness wound closure, but requires additional training and endoscopic versatility. As a promising tool, endoscopic vacuum therapy potentially surpasses stent therapy by draining inflammatory materials and closing defects. Furthermore, the use of tissue sealants, such as fibrin glue and cyanoacrylate, has been reported to be effective in selected situations. The choice of endoscopic device should be tailored to individual cases and specific patient conditions, with careful consideration of the nature of the defect. Further extensive studies involving larger patient populations are required to provide more robust evidence on the efficacy of endoscopic approach in managing post-gastric anastomotic leaks.

약제의 신규등재 절차와 급여기준 관리 (New Drug Listing Process and Reimbursement Standard Management)

  • 배윤경;유미영
    • Journal of Digestive Cancer Research
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    • 제11권2호
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    • pp.104-107
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    • 2023
  • The Ministry of Health and Welfare of Korea has implemented various social security programs to ensure a basic standard of living and raise overall quality of life for all citizens. The Korean social security system provides social insurance, public assistance, and social welfare services. To achieve adequate drug benefits, the Drug Management Department of Health Insurance Review and Assessment Service (HIRA) implement drug management duties including drug listing, upper price limit setting, scope of benefits, and post-factum management. When a manufacturer or an importer wants to apply for National Health Insurance (NHI) coverage of the drug that has obtained safety and efficacy approval, the pharmaceutical benefit assessment committee of HIRA evaluates the drug's clinical efficacy and cost-effectiveness to determine whether or not to include the drug into the benefit package. The benefit standards for a listed drug (ingredient) are set either for the whole permitted range or a part of range with conditions. To increase the coverage rate for new drugs, the listed drugs are regularly reviewed for their value. The status of listed drugs can be adjusted or eliminated from the benefit package if the clinical efficacy turns out to be insignificant. Therefore, through these pharmaceutical management procedures, high-quality drugs are provided at reasonable prices, which save healthcare expenditure by price determination and selective coverage in consideration of economic evaluation.

원발미상암으로 오인된 이하선 림프상피암종 (Lymphoepithelial Carcinoma of the Parotid Gland, Mimicking Malignancy of Unknown Origin(MUO) in the Head and Neck)

  • 박준오;장전엽;고영혜;정한신
    • 대한두경부종양학회지
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    • 제29권2호
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    • pp.71-74
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    • 2013
  • Neck mass is a common manifestation from head and neck malignancy, most of which come from mucosal squamous cell carcinomas in the upper aero-digestive tract. However, once aspiration cytology suggests atypical malignant cells in the neck mass rather than metastatic squamous cell carcinomas, it is confusing to decide the adequate diagnostic work-ups and treatment planning. Here, we report a 29-year-old woman presenting with a growing neck mass mimicking malignancy of unknown origin, which was finally diagnosed as primary lymphoepithelial carcinoma in the parotid gland with multiple metastases to the lymph nodes. The patient underwent comprehensive neck dissection and total parotidectomy and the adjuvant radiation treatment was given. Our report highlight that the primary salivary gland cancer should be considered as the potential tumor origin in case of malignancy of unknown origin in the head and neck region and neck mass suggestive of atypical carcinomas.

청심연자탕의 연구 동향 (Review of experimental and clinical studies on Cheongsimyeonja-tang in Korea)

  • 안다영;한수지;유준상
    • 사상체질의학회지
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    • 제30권3호
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    • pp.1-24
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    • 2018
  • Objective This study was aimed to provide the information about Cheongsimyeonja-tang by domestic papers and theses. Method 50 Domestic papers related to Cheongsimyeonja-tang were selected according to the criteria. These papers were classified and analyzed by research designs, methods and results. Result The following results were obtained in this study. 1. 19 experimental studies on the effect of Cheongsimyeonja-tang were mainly focused on anti-aging, followed by anti-allergy, anti-inflammation, improvement of immune system. And there were 4 experimental studies on the safety of Cheongsimyeonja-tang, proving safety by acute toxicity test, nephrotoxicity test, drug interaction, and test of residual ingredients after decoction. 2. 25 clinical studies on the effect of Cheongsimyeonja-tang were mainly focused on cardiovascular and cerebral vascular diseases, followed by psychiatric and otologic disorder, dermatologic and musculoskeletal diseases. Also, there were 2 studies on the effect of Cheongsimyeonja-tang for diabetes insipidus, macular degeneration, digestive disorder in terminal cancer, drug-induced hepatitis. 3. More evidenced studies on Cheongsimyeonja-tang are needed and it is recommended that psychiatric questionnaire should be used for assessing the effects of Cheongsimyeonja-tang.

Reducing Power Consumption of Wireless Capsule Endoscopy Utilizing Compressive Sensing Under Channel Constraint

  • Saputra, Oka Danil;Murti, Fahri Wisnu;Irfan, Mohammad;Putri, Nadea Nabilla;Shin, Soo Young
    • Journal of information and communication convergence engineering
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    • 제16권2호
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    • pp.130-134
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    • 2018
  • Wireless capsule endoscopy (WCE) is considered as recent technology for the detection cancer cells in the human digestive system. WCE sends the captured information from inside the body to a sensor on the skin surface through a wireless medium. In WCE, the design of low-power consumption devices is a challenging topic. In the Shannon-Nyquist sampling theorem, the number of samples should be at least twice the highest transmission frequency to reconstruct precise signals. The number of samples is proportional to the power consumption in wireless communication. This paper proposes compressive sensing as a method to reduce power consumption in WCE, by means of a trade-off between samples and reconstruction accuracy. The proposed scheme is validated under channel constraints, expressed as the realistic human body path loss. The results show that the proposed scheme achieves a significant reduction in WCE power consumption and achieves a faster computation time with low signal error reconstruction.

Sea cucumber as a therapeutic aquatic resource for human health

  • Siddiqui, Ruqaiyyah;Boghossian, Anania;Khan, Naveed Ahmed
    • Fisheries and Aquatic Sciences
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    • 제25권5호
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    • pp.251-263
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    • 2022
  • Sea cucumbers are worm-like, leathery bodied, benthic, marine organisms with a branched gonad. There are over 900 species, and these organisms are capable of changing their mechanical state, regenerating their small appendages, and digestive tract. Additionally, sea cucumbers possess both commercial and therapeutical value. Furthermore, it is thought that the metabolites these organisms possess may give rise to their therapeutical value. The use of sea cucumbers in therapy can be traced back to the Ming dynasty, where they were eaten for their tonic properties against constipation, hypertension, and rheumatism. A plethora of studies have been conducted, whereby different metabolites were extracted from sea cucumbers and tested for different therapeutic properties. Herein, we review and discuss the anti-cancer, anti-microbial, anti-coagulant, anti-diabetic, antioxidant, and anti-inflammatory properties of the sea cucumber by assessing literature on PubMed and Google Scholar. Furthermore, the genome and epigenome of these remarkable species is discussed. With the immense data supporting the therapeutic properties of sea cucumbers, further studies are warranted, in order to develop novel and innovative therapeutic compounds for the benefit of human health from these fascinating marine organisms.