• Clinical Endoscopy
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• 제56권6호
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• pp.744-753
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• 2023

Background/Aims: This study aimed to evaluate the prevalence and natural progression of subepithelial lesions (SELs) in the upper gastrointestinal (UGI) tract. Methods: The medical records of patients with UGI SELs who underwent endoscopic screening at eight university hospitals between January and December 2010 were retrospectively investigated. The follow-up evaluations were performed until December 2016. Results: UGI SELs were found in 1,044 of the 65,233 participants screened (endoscopic prevalence, 1.60%; the total number of lesions, 1,062; mean age, 55.1±11.2 years; men, 53.6%). The median follow-up period was 48 (range, 8-74) months. SELs were most frequently found in the stomach (63.8%) and had a mean size of 9.9±6.1 mm. Endoscopic ultrasonography (EUS) was performed in 293 patients (28.1%). The most common lesions were leiomyomas, followed by gastrointestinal stromal tumors (GISTs), and ectopic pancreas. The proportions of SELs with malignant potential according to size were 3% (<1 cm), 22% (1-2 cm), 27% (2-3 cm), and 38% (≥3 cm). In gastric SELs larger than 1 cm, resections were performed in 20 patients because of an increase in size, of which 12 were found to be GISTs. Conclusions: The prevalence of UGI SELs was 1.60%. Further, 23% of gastric SELs ≥1 cm were precancerous lesions, most followed by EUS and clinical decisions without initial pathological confirmation.

• 대한한의학방제학회지
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• 제31권4호
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• pp.361-371
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• 2023

Objectives : Gastric cancer is a malignant tumor of the digestive tract that not only has a high mortality rate, but also affects quality of life. In Traditional Korean Medicine, acupuncture and herbal medicines can increase the survival rate for Gastric cancer and improve the quality of life. Traditional Korean Medicine treatment played an important role when used alone or in combination with chemotherapy. However, there is still insufficient evidence to support the efficacy and safety of Traditional Korean Medicine in patients undergoing chemotherapy after surgery. Therefore, the purpose of this study is to systematically evaluate the effect of oriental medicine treatment on patients as a complementary therapy for Gastric cancer. Methods : 2 researchers will search using EMBASE, Pubmed, CNKI, Cochrane Library, CiNii, KMBASE, KISS, OASIS, RISS, ScienceON. The search period of the database is from inception until June 2022. This study will include a randomized controlled trial of GC for acupuncture and herbal treatment. Primary outcomes include anti-cancer effects. Secondary outcomes evaluate survival rates and improvements in quality of life. The data uses Review Manager Software 5.4. Results : This study will provide a systematic evaluation by synthesizing the anti-cancer effect, survival rate and quality of life of Gastric cancer when Traditional Korean Medicine is combined with chemotherapy. Conclusion : The conclusion of this study will provide a basis for determining whether Traditional Korean Medicine treatment for Gastric cancer treatment is an effective and safe treatment method in clinical practice.

• 대한임상검사과학회지
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• 제56권1호
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• pp.43-51
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• 2024

[⁶⁸Ga]Ga-FAPI-04는 암세포에 과발현 되어 있는 fibroblast activation protein (FAP)에 특이적으로 결합하는 FAP 저해제(FAP inhibitor, FAPI)에 방사성동위원소 ⁶⁸Ga을 표지한 방사성의약품이다. 본 연구에서는 국내에서 제작된 카세트기반 자동합성장치를 사용하여 [⁶⁸Ga]Ga-FAPI-04를 제조하는 방법을 개발하였다. [⁶⁸Ga]Ga-FAPI-04의 합법을 개발하기 위해 완충액 HEPES의 농도, 반응시간, FAPI-04 전구체 양, 반응온도에 따른 표지효율을 확인하였다. [⁶⁸Ga]Ga-FAPI-04는 2 M HEPES를 사용하여 pH 3.85에서 반응할 경우 가장 높은 표지효율을 획득할 수 있었고, 반응시간이 10분일 경우와 25 ㎍의 FAPI-04 전구체를 사용할 경우 및 100℃에서 반응할 경우 가장 높은 표지효율을 획득할 수 있었다. 또한 최종 합성된 [⁶⁸Ga]Ga-FAPI-04는 모든 품질기준을 만족하여 본 연구를 통해 개발된 [⁶⁸Ga]Ga-FAPI-04의 합성법은 FAPI 기반 방사성의 약품생산에 활용도가 높을 것으로 예상된다.

• 대한영상의학회지
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• 제85권1호
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• pp.109-123
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• 2024

황색육아종성 염증 질환은 담낭, 담관, 췌장, 비장, 위, 소장, 결장, 충수, 신장, 부신, 요막관, 방광, 후복막, 여성 생식기 등 다양한 장기를 침범하는 드문 양성 질환이다. 황색육아종성 염증 질환의 영상학적 소견은 비특이적이고 대개 비균질한 고형 또는 낭성 종괴로 나타나며 인접한 장기를 침범할 수 있다. 황색육아종성 염증 질환은 공격적인 양상으로 인해 때때로 악성 종양으로 오인될 수 있다. 본 임상화보에서는 복부와 골반의 다양한 장기에서 발생한 황색육아종성 염증 질환의 영상 소견 및 임상양상을 고찰하고자 한다.

• 대한영상의학회지
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• 제84권1호
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• pp.150-169
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• 2023

다발성 골수종은 골수에서 클론 형질 세포의 증식으로 인한 악성 혈액 질환으로 최근 우리나라에서도 발병률이 증가하고 있다. 다발성 골수종의 치료법이 발전하면서 질환의 조기 진단과 조기 치료의 필요성이 대두되었고 International Myeloma Working Group (이하 IMWG) 중심으로 질병의 진단의학적, 영상의학적 진단 기준이 여러 차례 개정되고 있다. 또한 다발성 골수종 환자의 진단과 치료 반응 평가에 전신 자기공명영상(whole body MR; 이하 WBMR)의 사용량이 증가하면서 WBMR의 영상 획득 기법이나 영상 결과 해석, 반응평가법을 표준화하기 위해 Myeloma Response Assessment and Diagnosis System (이하 MYRADS)가 만들어졌다. 이 종설에서는 다발성 골수종의 정확한 진단을 위해 영상의학과 의사로서 알아야 할 최신 지견으로 IMWG의 최신 가이드라인에 따른 다발성 골수종의 영상검사법 및 MY-RADS에 따른 WBMR에서의 영상 획득 기법 및 반응 평가 기법에 대해 설명하였다.

• 한국간담췌외과학회지
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• 제26권1호
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• pp.91-97
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• 2022

Backgrounds/Aims: Metastatic lesions of the pancreas (PMET) account for 1%-5% of all malignant solid pancreatic lesions (SPL). In this study we evaluated the utility of endoscopic ultrasonography with fine needle aspiration (EUS-FNA) in diagnosing PMET. Methods: Patients who underwent EUS-FNA at a community referral center between 2011-2017 for SPL were identified. Clinical, radiologic, and EUS-FNA features of those with PMET were compared to those with primary solid tumors of the pancreas: pancreatic adenocarcinoma (PDAC) and neuroendocrine tumors (PNET). Results: A total of 191 patients were diagnosed with solid pancreatic malignancy using EUS-FNA: 156 PDAC, 27 PNET, and eight (4.2%) had PMET. Patients with PMET were less likely to have abdominal pain (25.0% vs. 76.3% vs. 48.2%; p < 0.01) or obstructive jaundice (37.5% vs. 58.3% vs. 0%; p < 0.01) compared to PDAC and PNET. Those with PMET were more likely to have mass lesions with/without biliary or pancreatic ductal dilatations (100% vs. 86.5% vs. 85.2%; p < 0.01) and lower CA19-9 (82.5 ± 43.21 U/mL vs. 4,639.30 ± 11,489.68 U/mL vs. 10.50 ± 10.89 U/mL; p < 0.01) compared to PDAC and PNET. Endosonographic features were similar among all groups. Seven (87.5%) patients with PMET had a personal history of malignancy prior to PMET diagnosis. The primary malignancy was renal cell carcinoma in five PMET. Conclusions: PMET are exceedingly rare, comprising less than 5% of SLP. Patients with PMET are less likely to present with symptoms and mostly identified by surveillance imaging for the primary malignancy.

• 한국간담췌외과학회지
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• 제26권1호
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• pp.40-46
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• 2022

Backgrounds/Aims: The role of inflammation in malignant cell proliferation has been well described. High values of platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) as markers of systemic inflammation have shown associations with unfavorable long-term outcomes. The purpose of this study was to determine values of NLR and PLR evaluated prior to and after surgery and their associations with mortality and recurrence rates of liver transplant patients with hepatocellular carcinoma (HCC). Methods: A total of 105 patients with HCC who underwent orthotopic liver transplantation (OLT) were retrospectively reviewed. NLR and PLR values were obtained from complete blood counts prior to and after surgery. Overall survival (OS) and recurrence-free survival (RFS) in relation with delta NLR and PLR were estimated. Results: Serum alpha-fetoprotein levels > 100 ng/mL (p = 0.014) and lymphovascular emboli in the specimen (p = 0.048) were identified to be significant predictors of RFS. Child-Pugh score (p = 0.016) was found to be an independent factor associated with poorer OS. An increasing delta PLR was associated with worse RFS, although it showed no significant association with OS. Conclusions: The analysis of PLR as a continuous variable may predict recurrence outcomes in patients undergoing OLT for HCC. It is more representative than isolated values.

• Korean Journal of Radiology
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• 제25권8호
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• pp.706-714
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• 2024

Objective: This study aimed to evaluate the diagnostic performance and procedural characteristics of fluoroscopy-guided percutaneous transthoracic pleural forceps biopsy (PTPFB) in patients with exudative pleural effusion. Materials and Methods: Patients with exudative pleural effusion who underwent PTPFB between May 1, 2014, and February 28, 2023, were included in this retrospective study. The interval between percutaneous catheter drainage (PCD) and PTPFB, number of biopsies, procedural time, and procedure-related complications were evaluated. The sensitivity, specificity, and accuracy of diagnosing malignancy were computed for pleural cytology using PCD drainage, PTPFB, and combined PTPFB and pleural cytology. Results: Seventy-one patients, comprising 50 male and 21 female (mean age, 69.5 ± 15.3 years), were included in this study. The final diagnoses were benign lesions in 48 patients (67.6%) and malignant in 23 patients (32.4%). The overall interval between PCD and biopsy was 2.4 ± 3.7 days. The interval between PCD and biopsy in the group that underwent delayed PTPFB was 5.2 ± 3.9 days. The mean number of biopsies was 4.5 ± 1.3. The mean procedural time was 4.4 ± 2.1 minutes. Minor bleeding complications were reported in one patient (1.4%). The sensitivity, specificity, and accuracy for pleural cytology, PTPFB, and combined PTPFB and pleural cytology were 47.8% (11/23), 100% (48/48), and 83.1% (59/71), respectively; 65.2% (15/23), 100% (48/48), and 88.7% (63/71), respectively; and 78.3% (18/23), 100% (48/48), and 93.0% (66/71), respectively. The sensitivity and accuracy of cytology combined with PTPFB were significantly higher than those of cytological testing alone (P = 0.008 and 0.001, respectively). Conclusion: Fluoroscopy-guided PTPFB is an accurate and safe diagnostic technique for patients with exudative pleural effusion, with acceptable diagnostic performance, low complication rates, and reasonable procedural times.

• Korean Journal of Radiology
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• 제25권8호
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• pp.742-748
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• 2024

Objective: ¹⁸F-N-(2-(Diethylamino)ethyl)-5-(2-(2-(2-fluoroethoxy)ethoxy)ethoxy) picolinamide (¹⁸F-PFPN) is a novel positron emission tomography (PET) probe designed to specifically targets melanin. This study aimed to evaluate the diagnostic feasibility of ¹⁸F-PFPN in patients with ocular or orbital melanoma. Materials and Methods: Three patients with pathologically confirmed ocular or orbital melanoma (one male, two females; age 41-59 years) were retrospectively reviewed. Each patient underwent comprehensive ¹⁸F-PFPN and ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) PET scans. The maximum standardized uptake value (SUV_max) of the lesion and the interference caused by background tissue were compared between ¹⁸F-PFPN and ¹⁸F-FDG PET imaging. In addition, the effect of intrinsic pigments in the uvea and retina on the interpretation of the results was examined. The contralateral non-tumorous eye of each patient served as a control. Results: All primary tumors (3/3) were detected using ¹⁸F-PFPN PET, while only two primary tumors were detected using ¹⁸F-FDG PET. Within each lesion, the SUV_max of ¹⁸F-PFPN was 2.6 to 8.3 times higher than that of ¹⁸F-FDG. Regarding the quality of PET imaging, the physiological uptake of ¹⁸F-FDG PET in the brain and periocular tissues limited the imaging of tumors. However, ¹⁸F-PFPN PET minimized this interference. Notably, intrinsic pigments in the uvea and retina did not cause abnormal concentrations of ¹⁸F-PFPN, as no anomalous uptake of ¹⁸F-PFPN was detected in the healthy contralateral eyes. Conclusion: Compared to ¹⁸F-FDG, ¹⁸F-PFPN demonstrated higher detection rates for ocular and orbital melanomas with minimal interference from surrounding tissues. This suggests that ¹⁸F-PFPN could be a promising clinical diagnostic tool for distinguishing malignant melanoma from benign pigmentation in ocular and orbital melanomas.

• Journal of Digestive Cancer Research
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• 제9권1호
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• pp.1-7
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• 2021

췌관 내 유두상 점액종양은 매우 다양한 자연경과와 예후를 가지고 있어 추적 검사방법, 간격, 기간 등이 아직도 논란이 되고 있다. 이 종양에 대한 진료지침들에서는 추적 검사를 받을 환자군과 수술적 치료가 필요한 군으로 분류하기 위하여 악성화 고위험 특징 또는 절대적 수술 적응증과 걱정스러운 특징 또는 상대적 수술 적응증으로 분류하였다. 걱정스러운 특징이나 고위험 특징이 없는 분지형 유두상 점액종양은 혼합형이나 주췌관 종양에 비하여 악성화 위험성이 매우 낮다고 보고되고 있다. 그러나 저위험 특징을 가진 환자들을 장기간 추적한 연구에서 시간이 지남에 따라서 췌장암 발생이 점점 높아지고 있다고 보고하고 있어 지속적인 장기간 추적 검사가 필요하다. 혼합형과 주췌관형 유두상 점액종양은 악성화 가능성이 매우 높아 수술적 치료가 필요하다고 알려져 있다. 무결절이고 주췌관 직경이 10 mm 미만으로 분절형 주췌관 확장을 가진 환자들은 악성화 가능성이 낮아서 즉각적인 수술보다는 주의 깊은 추적관찰을 고려해볼 수 있다. 고령이나 기저질환을 동반한 환자의 치료 방향을 결정할 때는 췌장암 발생의 위험도와 수술의 위험성을 균형있게 평가해야 한다.