• Radiation Oncology Journal
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• 제10권1호
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• pp.49-58
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• 1992

1986년 1월부터 1990년 9월까지 7예의 간외담도계 암 환자를 대상으로 외부 방사선치료와 온열치료를 병행하였다. 7예중 3예는 간외담도암으로 이중 2예는 원발성 담도암 이었고 1예는 위암에서 담도주위로 전이된 암이었다. 7예중 나머지 4예는 담낭암으로 이중 2예는 담낭 절제후 국소적으로 재발된 암이었고 나머지 2예는 원발성 담낭암 이었다. 그리고 7예는 모두 선암으로 확인 되었다. 조사된 방사선의 양은 3000 cGy/2주 조사한 1예를 제외하고 6예에서는 $4500\~5040\;cGY/6\~7$주 조사되었다. 온열치료는 모든 환자에서 방사선치료후 30분 이내에 시행되었으며 방사선치료 기간동안 주 1회 내지 2회씩 총 4회에서 12회까지 시행되었다. 치료효과의 판정은 T-관 T-관 담도촬영술. PTC, 그리고 CT등의 소견으로 하였으며 7예중 6예($86\%$)에서 부분관해를 보였으며 완전관해는 없었다. 7예중 6예는 4개월에서 11개월 애내 사망하였으며 나머지 1예는 현재 11개월째 생존하고 있으나 치료부위 밖에서 국소전이가 관찰되었다. 그리고 7예환자의 정중생존기간은 7개월이었다. 사망환자 6예의 사망원인으로는 원발성 담도암환자 1예에서 폐혈증, 전이성 담도암환자에서 원격 전이, 나머지 4예에서는 원발병소의 진행이 확인되었다. 관찰기간이 짧았으나 모든 환자에서 치료에 잘 적응하였으며 간, 십이지장, 위내의 합병증은 없었고 전이성 담도암 환자에서 일과성 카보닐산혈증이 관찰되었다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권2호
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• pp.575-578
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• 2012

Objective: To study the incidence, types and distribution pattern of malignant tumors in renal transplant recipients at a single center in Pakistan. Materials and methods: This retrospective study was conducted at Sindh Institute of Urology and Transplantation (SIUT) and included all transplant patients on regular follow-up from November 1986 to December 2008. The original biopsy reports and case files of all patients who developed posttransplant malignancies were reviewed and relevant demographic, clinical, radiological, and histopathological data were retrieved and analyzed. SPSS version 10.0 was used for statistical analysis. Results: Over 22 years of study period, 1816 renal transplants were carried out at our center. Among these, 44 patients developed malignancies constituting an overall incidence rate of 2.4%. All patients in this study were males with a mean age of $34.9{\pm}9.5$ years (range: 9 to 60 years). The most common type of malignancy was lymphoma (27 patients, 61.4%), followed by Kaposi's sarcoma (11 patients, 25%) and skin malignancies (3 patients, 6.8%). One case each of adenocarcinoma of the gallbladder, acute myeloid leukemia (AML), conjunctival carcinoma-in-situ and seminoma were also diagnosed. Conclusion: Posttransplant malignancies occurring in our renal transplant recipients show different incidence rates and patterns as compared with western studies.

• Clinical Endoscopy
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• 제56권2호
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• pp.155-163
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• 2023

Malignant hilar biliary obstruction (MHO), an aggressive perihilar biliary obstruction caused by cholangiocarcinoma, gallbladder cancer, or other metastatic malignancies, has a poor prognosis. Surgical resection is the only curative treatment for biliary malignancies. However, the majority of patients with MHO cannot undergo surgery on presentation because of an advanced inoperable state or a poor performance state due to old age or comorbid diseases. Therefore, palliative biliary drainage is mandatory to improve symptomatic jaundice and the quality of life. Among the drainage methods, endoscopic biliary drainage is the current standard for palliation of unresectable advanced MHO. In addition, combined with endoscopic drainage, additional local ablation therapies, such as photodynamic therapy or radiofrequency ablation (RFA), have been introduced to prolong stent patency and survival. Currently, RFA is commonly used as palliative therapy, even for advanced MHO. This literature review summarizes recent studies on RFA for advanced MHO.

• Journal of Gastric Cancer
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• 제12권1호
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• pp.43-45
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• 2012

Mesenteric pseudocyst is rare. This term is used to describe the abdominal cystic mass, without the origin of abdominal organ. We presented a case of mesenteric pseudocyst of the small bowel in a 70-year-old man. Esophago-gastro-duodenoscopy showed a 3.5 cm sized excavated lesion on the posterior wall of angle. Endocopic biopsy confirmed a histologic diagnosis of the poorly differentiated adenocarcinoma, which includes the signet ring cell component. Abdominal computed tomography scan showed a focal mucosal enhancement in the posterior wall of angle of the stomach, a 2.4 cm sized enhancing mass on the distal small bowel loop, without distant metastases or ascites in rectal shelf, and multiple gallbladder stones. The patient underwent subtotal gastrectomy with gastroduodenostomy, segmental resection of the small bowel, and cholecystectomy. The final pathological diagnosis was mesenteric pseudocyst. This is the first case report describing incidentally detected mesenteric pseudocyst of the small bowel in gastric cancer patients.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1485-1488
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• 2016

Background: Chile is one of the countries with the highest prevalence of cholelithiasis worldwide, considering the Mapuche ethnicity as a risk factor for developing this pathology. Moreover, cholelithiasis is the main risk factor for developing gallbladder cancer, being the fifth cause of cancer death in Chile. The purpose of this study was to compare the frequency of cholelithiasis and biliary pathology among the population belonging to Rapanui ethnicity and non-Rapanui population living on Easter Island. Materials and Methods: In this retrospective case-control study, a total of 609 abdominal ultrasonographs performed consecutively in Hanga Roa Hospital during the period August 2012 to January 2015 were analyzed. Multiple logistic regression was used to obtain odds ratio (OR) and 95% confidence intervals (95% CI) of cholelithiasis and biliary pathology, adjusting for age, gender and referral diagnostic hypothesis. Results: In the Rapanui population the frequency for cholelithiasis and biliary pathology was 6.4% and 13%, meanwhile for the non-Rapanui population it was 13% and 22% respectively. Compared to the non-Rapanui Chilean population, the Rapanui ethnicity presented an OR of 0.53 (95% CI: 0.29-0.95) for cholelithiasis and OR of 0.52 (95% CI: 0.33-0.82) for biliary pathology. Conclusions: We found statistically significant ethnic differences in the frequency of cholelithiasis and biliary disease among the population of Rapanui and non-Rapanui ethnicity, so that this could be a protective factor for the development of biliary pathology, given the Chilean population context. Other studies including community population to determine the real prevalence of cholelithiasis and analyze the protective role of Rapanui ethnicity on this disease are necessary.

• Radiation Oncology Journal
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• 제31권3호
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• pp.125-130
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• 2013

Purpose: We investigated the role of radiotherapy (RT) for pancreatobiliary neuroendocrine tumors (PB-NETs). Materials and Methods: We identified 9 patients with PB-NETs who received RT between January 2005 and March 2012. Of these 9 patients, 4 were diagnosed with NETs in the pancreas and 5 were diagnosed with NETs in the gallbladder. All patients received RT to the primary tumor or resection bed with a median total irradiation dose of 50.4 Gy, with or without chemotherapy. Results: The tumor response rate and tumor control rate in the RT field were 60% and 100 %, respectively. All 4 patients who underwent surgery had no evidence of disease in the RT field. Of the 5 patients who received RT to the primary gross tumor, 1 had complete response, 2 had partial response, and 2 had stable disease in the RT field. The median time to progression was 11 months. Of the 9 patients, four patients had no progression, and 5 patients had progression of disease (locoregional, 2; distant, 2; locoregional/distant, 1). Of the 4 patients without progression, 3 were treated with RT in adjuvant or neoadjuvant setting, and one received RT to primary tumor. One patient experienced radiation-induced duodenitis at 3 months after concurrent chemoradiation without treatment-related mortality. Conclusion: RT can yield local control for advanced PB-NETs. RT should be considered an essential part of multimodality treatment in management of advanced PB-NETs.

• 한국환경보건학회지
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• 제39권4호
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• pp.335-345
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• 2013

Objectives: As the suspicion was raised that 'Agent Orange' was reclaimed 30 years ago at Camp Carol, located in Waegwan, Gyeongsangbuk-do, the government conducted an investigation of the influence of environmental and health effects around Camp Carol through a public-private joint investigation team. As part of the investigation of population health effects, this study was carried out in order to observe changes and regional differences in diseases, particularly cancer, by year. Methods: We authors conducted an analysis of secondary health data, such as cancer registration data, mortality data, and health insurance data. We drew an age standardized incidence ratio (SIR), death rate (SDR), mortality ratio (SMR), and health care utilization rate using these data. Results: For gastric cancer in women, and other cancers in men, a significant increase in incidence was observed compared to the control area. For biliary tract cancer, gallbladder cancer, and thyroid cancer in women, and prostate cancer in men, a significant decrease in incidence was observed compared to the control area. In the national statistical analysis of data, such as health insurance data and mortality data, we did not observe a significant increase at the Waegwan region compared to other regions. Conclusions: We must consider the limitations of this study. Because thirty years have passed from the time of the estimated landfill of 'Agent Orange', recent national statistical data may not reflect the past real situation. Therefore, the monitoring of secondary data for health effects at the municipal level should be carried out continuously.

• 대한방사선기술학회지:방사선기술과학
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• 제24권1호
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• pp.33-41
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• 2001

This study is to get preliminary data for an effectiveness evaluation of abdominal examination and improvement of it. Abnormal cases of abdominal ultrasonography are classified by sex, frequency, diagnosis and age. 4,924 examinees were included at a university hospital of health promotion center from January to December in 1999. The results are as follows. 1. According to the distribution of sex, there are more male patients(55.0%) than females patients(48.0%). For men, 40's showed the highest percentage among examinees. For women, 50's were the highest. 2. The reason that they visited the health promotion center was that 'they wanted to check their health status'. This answers were reported the highest(59.3%). 3. Patients that had abnormal cases of abdominal ultrasonography were 48.3%. Liver, kidney, gallbladder showed the highest percentage of abnormal cases in order of organs. Additionally, abnormal cases were discovered in liver cases. 4. According to the frequency of abnormal cases among examinees, the slight fatty liver were the highest regardless of sex. Men had the slight fatty liver, kidney simple cyst, liver calcification and liver simple cyst in order of abnormal cases. Women showed the slight fatty liver kidney simple cyst, kidney calcification, liver simple cyst, and blood vessel tumor in order of abnormal cases. 5. For the abnormal cases of liver by sex and age, the 50's reported the highest number of abnormal cases in men(299 patients). In addition, 60's had the highest of disease rata 47.8%. For women, 50's reported the highest number of abnormal cases(361 patients). Over 70's patients had the highest of disease rata 52.6%. For kidney, men and women showed the highest number of abnormal cases -62 vs 44 respectively. Over 70's patients had the highest percentage of disease rata-23.2% vs 14.0% respectively. For gallbladder, the number of abnormal cases were the most in men's 60's (31 patients) and in women's in the same age group (32patients). Disease showed the highest percentage in men's 60's(7.6%) and in women's 70's (14.0%). 6. According to malignant tumor, 17patients were liver cancer, 2patients stomach ca and 1pt kidney cancer. 7. The relationship between the malignant tumor and the examination motive was that 'they wanted to check their health status(41.0%)' and 'regular checkup (24.0%)'.

• Korean Journal of Radiology
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• 제22권5호
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• pp.714-724
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• 2021

Objective: To evaluate the value of ¹⁸F-fluorodeoxyglucose PET/MRI added to contrast-enhanced CT (CECT) in initial staging, assessment of resectability, and postoperative follow-up of biliary tract cancer. Materials and Methods: This retrospective study included 100 patients (initial workup [n = 65] and postoperative follow-up [n = 35]) who had undergone PET/MRI and CECT for bile duct or gallbladder lesions between January 2013 and March 2020. Two radiologists independently reviewed the CECT imaging set and CECT plus PET/MRI set to determine the likelihood of malignancy, local and overall resectability, and distant metastasis in the initial workup group, and local recurrence and distant metastasis in the follow-up group. Diagnostic performances of the two imaging sets were compared using clinical-surgical-pathologic findings as standards of reference. Results: The diagnostic performance of CECT significantly improved after the addition of PET/MRI for liver metastasis (area under the receiver operating characteristic curve [A_z]: 0.77 vs. 0.91 [p = 0.027] for reviewer 1; 0.76 vs. 0.92 [p = 0.021] for reviewer 2), lymph node metastasis (0.73 vs. 0.92 [p = 0.004]; 0.81 vs. 0.92 [p = 0.023]), and overall resectability (0.79 vs. 0.92 [p = 0.007]; 0.82 vs. 0.94 [p = 0.021]) in the initial workup group. In the follow-up group, the diagnostic performance of CECT plus PET/MRI was significantly higher than that of CECT imaging for local recurrence (0.81 vs. 1.00 [p = 0.029]; 0.82 vs. 0.94 [p = 0.045]). Conclusion: PET/MRI may add value to CECT in patients with biliary tract cancer both in the initial workup for staging and determination of overall resectability and in follow-up for local recurrence.

• Journal of Minimally Invasive Surgery
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• 제21권4호
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• pp.168-176
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• 2018

Purpose: Robotic-associated minimally invasive surgery is a novel method for overcoming some limitations of laparoscopic surgery. This study aimed to evaluate the outcomes (postoperative pain, cosmesis, surgeon's workload) of single-incision robotic cholecystectomy (SIRC) vs. single-incision laparoscopic cholecystectomy (SILC) vs. conventional three-port laparoscopic cholecystectomy (3PLC). Methods: 134 patients who underwent laparoscopic or robotic cholecystectomy at a single center during 2016~2017 were enrolled. Prospectively collected data included demographics, operative outcomes, questionnaire regarding pain and cosmesis, and NASA-Task Load Index (NASA-TLX) scores for surgeon's workload. Results: 55 patients underwent SIRC, 29 SILC, and 50 3PLC during the same period. 3PLC patient group was older than the others (SIRC vs. SILC vs. 3PLC: 48.1 vs. 42.2 vs. 54.1 years, p<0.001). Operative time was shortest with 3PLC (44.1 vs. 38.8 vs. 25.4 min, p<0.001). Estimated blood loss, postoperative complications, and postoperative stay were similar among the groups. Pain control was lowest in the 3PLC group (98.2% vs. 100% vs. 84.0%, p=0.004), however, at 2 weeks postoperatively there were no differences among the groups (p=0.374). Cosmesis scores were also worst after 3PLC (17.5 vs. 18.4 vs. 13.3, p<0.001). NASA-TLX score was highest in the SILC group (21.9 vs. 44.3 vs. 25.2, p<0.001). Conclusion: Although SIRC and SILC take longer than 3PLC, they produce superior cosmetic outcomes. Compared with SILC, SIRC is more ergonomic, lowering the surgeon's workload. Despite of higher cost, SIRC could be an alternative for treating gallbladder disease in selected patients.