• 제목/요약/키워드: pre-malignant

검색결과 89건 처리시간 0.025초

대퇴골 근위부 악성 골종양 환자에서 종양 대치물을 이용한 사지 구제술 (Limb Salvage Surgery with Tumor Prosthesis for the Malignant Bone Tumors Involving the Proximal Femur)

  • 전영수;백종훈;이승혁;이충환;한정수
    • 대한골관절종양학회지
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    • 제20권1호
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    • pp.7-13
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    • 2014
  • 목적: 대퇴골 근위부에 발생한 악성 골 종양의 치료로 사지 구제술을 시행하는 경우 환자의 생존과 더불어 술 후 보행 등의 기능회복이 중요하다. 대퇴골 근위부의 악성 골 종양에 의한 통증 또는 병적 골절이 발생한 환자에 대하여 종양 대치물을 이용한 사지 구제술 시행 후 임상 결과에 대해서 분석하였다. 대상 및 방법: 2005년 2월부터 2014년 1월까지 대퇴골 근위부 악성 골 종양을 진단 받고 통증 또는 병적 골절이 발생하여 대퇴골 근위부 절제술 및 종양 대치물을 이용한 사지 구제술을 시행한 20예(19명)를 대상으로 하였다. 평균 연령은 63.1세(범위 35-86세)였으며 남자가 14예, 여자가 6예였다. 평균 추시 기간은 20개월(1-94개월)이었고, 전이성 골 종양 15예, 골육종 4예, 다발성 골수종 1예였으며, 전이성 병변의 원발 암은 폐암 4예, 간암 3예, 신장암 3예였고, 유방암, 갑상선암, 대장암, 전립선암, 악성 방추 세포암이 각각 1예씩 이었다. 사용된 종양 대치물은 모두 조립형 종양 대치물로 Kotz's$^{(R)}$ Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey)가 3예에서 사용되었고, MUTARS$^{(R)}$ proximal femur system (Implantcast, Munster, Germany)이 17예에서 사용되었다. 수술 전 후의 동통 정도를 Visual Analogue Scales(VAS)로 평가하였으며, 술 후 하지의 기능적 평가를 위해 Musculoskeletal Tumor Society score(MSTS) grading system 을 이용하였다. 결과: 최종 추시 시 20예(19명) 중 11예(10명)가 생존하고 9예(9명)가 사망하였으며 사망한 환자의 술 후 평균 생존기간은 10.1개월(1-38개월) 이었다. VAS 점수는 술 전 평균 8.40점(5-10점)에서 술 후 평균 1.35점(0-3점)으로 호전 되었고, 수술 후 MSTS 기능적 평가는 평균 19.65점(65.50%) (7-28점)이었다. 수술과 관련된 합병증으로는 국소 재발 2예, 혈종 3예, 감염 3예, 음낭 종창 2예, 탈구 1예였고 치환물 주위 골절이나 해리는 없었다. 결론: 대퇴골 근위부에 발생한 악성 골 종양에 의한 통증 또는 병적 골절이 발생한 경우 종양 대치물을 이용한 사지 구제술은 조기의 통증 감소 및 기능 회복을 위한 적절한 치료로 생각된다.

Ileo-uterine fistula in a degenerated posterior wall fibroid after Caesarean section

  • Shehata, Ayman;Hussein, Naglaa;El Halwagy, Ahmed;El Gergawy, Adel;Khairallah, Mohamed
    • Clinical and Experimental Reproductive Medicine
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    • 제43권1호
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    • pp.51-53
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    • 2016
  • Uterine fibroids are benign tumors of the myometrium with a diverse range of manifestations. Fibroids can dramatically increase in size during pregnancy due to the increase in estrogen levels. After delivery, the fibroids usually shrink back to their pre-pregnancy size. Uterine myomas may have many complications, including abnormal uterine bleeding, infertility, pressure on nearby organs, degeneration, and malignant transformation. No previous reports have indicated that a fistula may develop between a uterine fibroid and the bowel loops, although previous studies have documented the occurrence of fistulas from the uterus to the bowel following myomectomy or uterine artery embolization performed to treat a myoma. In our case report, we document the rare complication of a fistula occurring between a degenerated myoma in the posterior wall and the ileum 1 week postoperatively in a patient who underwent a Caesarean section but did not have a history of uterine artery embolization.

인트라넷 기반의 웹 메일 시스템 구현 (A Implement of Web-Mail System based on Intranet)

  • 신승수;한군희
    • 한국산학기술학회논문지
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    • 제12권5호
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    • pp.2346-2352
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    • 2011
  • 인트라넷을 사용하는 메일 시스템은 악의적인 서버 관리자 또는 제 3자가 메일을 해킹할 경우 모든 메일 내용이 그대로 노출 된다. 이를 해결하기 위해서 대칭키 암호 알고리즘을 이용한 안전한 인트라넷 메일 암호 프로토콜에 대해서 제안한다. 제안한 프로토콜은 메일 내용을 송 수신하는 쌍방 간의 합의된 세션 키로 암 복호화하기 때문에 악의적인 의도로 메일에 접근했을 경우에도 세션 키가 노출되지 않는 한 메일 내용을 알 수 없다.

Characterization of focal hepatic lesions with ferucarbotran (Resovist)-enhanced T2 and T2*-weighted MR imaging

  • 조은석;유정식
    • 대한자기공명의과학회:학술대회논문집
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    • 대한자기공명의과학회 2003년도 제8차 학술대회 초록집
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    • pp.40-40
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    • 2003
  • The purpose of this study was to characterize focal hepatic lesions through pre and post ferucarbotran-enhanced T2 and T2*-weighted imaging and to help differentiate benign and malignant lesions 대상 및 방법: Consecutive 34 patients with 52 hepatic lesions underwent MRI before and after intravenous bolus injection of ferucarbotran (Resovist Sobering, Berlin, Germany) for evaluation of focal hepatic lesions. Lesions included hemangiomas (n=17), metastases (n=12), cysts (n=10), hepatocellular carcinomas (n=8), dysplastic nodules (n=4), and focal fat deposit (n=1). T2-weighted fast spin echo (TR/TE: 4060/138) and gradient echo T2*-weighted images(TR/TE: 140/5.3, FA = 90) were obtained according to the institutional routine imaging protocol. Lesional signal-intensity and lesion-to-liver contrast changes were measured by contrast-to-noise ratio (CNR) from region of interest.

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The Long-Term Safety and Efficacy of Intrathecal Therapy Using Sufentanil in Chronic Intractable Non-Malignant Pain

  • Monsivais, Jose Jesus;Monsivais, Diane Burn
    • The Korean Journal of Pain
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    • 제27권3호
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    • pp.297-300
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    • 2014
  • This report describes the long term safety and efficacy of intrathecal therapy using Sufentanil for the management of chronic intractable neuropathic pain in 12 chronic pain patients. Standardized psychological screening was used to determine treatment suitability. Evaluation data included the Visual Analog Scale (VAS), Wong-Baker Faces Scale, Brief Pain Inventory (BPI), Disability of Arm, Shoulder, and Hand (DASH), McGill Quality of Life Questionnaire, and complications (granulomas, toxicity, withdrawal, or deaths). SPSS version 18 was used for data analysis. Pre- and post- treatment BPI measures and pain scale scores showed a statistically significant difference. There were no complications directly related to drug toxicity, nor drug withdrawals, granulomas, or deaths. Intrathecal therapy with Sufentanil therapy offers a good treatment alternative for those cases that have failed both surgery and standard pain treatment. Strict patient selection based on psychological screening, control of co-morbidities, a proper pain management may contribute to successful outcome.

자궁경부 세포진검사 및 자궁경부 확대촬영술의 비교연구 (A Comparative Study of Cytology & Cervicography for Cervical Cancer Screening)

  • 하중규;윤달식;이준기;최창근;우양례;이진수;이윤희;박재영;이영임
    • 한국건강관리협회지
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    • 제2권1호
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    • pp.27-37
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    • 2004
  • Background 'For many years, the Papanicolaou smear has been used to detect pre-malignant and malignant disease of the cervix. Although cervical cytology screening programmes have result in the reduction of cervical cancer incidence and mortality, Pap smear have been subjected to intense scrutiny and criticism in recent years. So cervicography is introduced. Cervicography is an adjunct method of cervical cancer screening intended to complement Papanicolaou smear. Cervicography involve obtaining and evaluating a photographic image of the cervix. The purpose of this investigation was to evaluate the efficacy of Papanicolaou smear and cervicography in cervical cancer screening. Materials & Methods : This study population was of 74 women, who visited department of obstetrics & Gynecology, Korea association of Health Promotion Chung-nam branch from January, 20O2 to October, 2003. All patients were taken Pap smear before cervicography, and then two cervicography was obtained with applying5% acetic acid. Those women in whom abnormalities were detected by either test subsequently obtained histologic specimen. Results : 1. The sensitivity and the specificity of Papanicolaou smear was 92.1% and 72.7%respectively.2. The sensitivity and the specificity of cervicography was 88.9% and 54.5% respectively. The false negative rate, and false positive rate of Papanicolaou smear were 7.9%, 27.2% respectively. The false negative rate, and false positive rate of cervicography were 11.1%,45.5% respectively. Conclusions . Papanicolaou smear is a useful method and an important tool for detecting cervical cancer. However when Papanicolaou smear and Cervicograpy is used together, the sensitivity is higher than for Papanicolaou smear used alone.

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Autophagy Inhibition Promotes Gambogic Acid-induced Suppression of Growth and Apoptosis in Glioblastoma Cells

  • Luo, Guo-Xuan;Cai, Jun;Lin, Jing-Zhi;Luo, Wei-Shi;Luo, Heng-Shan;Jiang, Yu-Yang;Zhang, Yong
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권12호
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    • pp.6211-6216
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    • 2012
  • Objective: To investigate the effects of gambogic acid (GA) on the growth of human malignant glioma cells. Methods: U251MG and U87MG human glioma cell lines were treated with GA and growth and proliferation were investigated by MTT and colony formation assays. Cell apoptosis was analyzed by annexin V FITC/PI flow cytometry, mitochondrial membrane potential assays and DAPI nuclear staining. Monodansylcadaverine (MDC) staining and GFP-LC3 localisation were used to detect autophagy. Western blotting was used to investigate the molecular changes that occurred in the course of GA treatment. Results: GA treatment significantly suppressed cell proliferation and colony formation, induced apoptosis in U251 and U87MG glioblastoma cells in a time- and dose-dependent manner. GA treatment also lead to the accumulation of monodansylcadaverine (MDC) in autophagic vacuoles, upregulated expressions of Atg5, Beclin 1 and LC3-II, and the increase of punctate fluorescent signals in glioblastoma cells pre-transfected with GFP-tagged LC3 plasmid. After the combination treatment of autophagy inhitors and GA, GA mediated growth inhibition and apoptotic cell death was further potentiated. Conclusion: Our results suggested that autophagic responses play roles as a self-protective mechanism in GA-treated glioblastoma cells, and autophagy inhibition could be a novel adjunctive strategy for enhancing chemotherapeutic effect of GA as an anti-malignant glioma agent.

간 전이환자에서 최적의 펄스시퀀스에 따른 SPIO 특이성 조영제의 국소병변검출: Case review (Focal Lesion Detection of SPIO-specific agent Compared with Optimized Pulse Sequences in the Hepatic Metastases: Case Review)

  • 구은회
    • 대한디지털의료영상학회논문지
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    • 제14권2호
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    • pp.57-61
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    • 2012
  • To compare the accuracy of breath-hold magnetic resonance imaging sequences to establish the most effective superparamagnetic iron oxide-enhanced sequence for detection of hepatic metastases. A total of 100 patients(50men and 50women, mean age: 60years) with liver disease(including malignant and benign liver lesions) were investigated at 3.0T machine (GE, General Electric Medical System, Excite HD) with 8Ch body coil. Pulse sequence for MR imaging decided to the FS-T2-FSE-RT(TR/TE/Thick./Freq./Phase=12857ms/100ms/7mm/512/384), MGRE(TR/TE/Thick./Freq./Phase=100ms/9.7ms/7mm/384/288), in-out of phase echo(TR/$TE_1$, $TE_2$/Thick./Freq./Phase=140ms/2.4, 5.8ms/7mm/352/300), Images obtained before the injection of SPIO. Six sequences were optimized for lesion detection: FS-T2-FSE-RT, multigradient recalled echo data image(MGRE), T2-weighted MGRE with an 9.7msec echo time. Images were reviewed independently by five blinded observers. The accuracy of each sequence was measured by using picture archiving communication system analysis. All results were correlated with findings at multidectator computed tomography examination. Differences between the mean results of the six observers were measured by using paired student t-test analysis. Postcontrast T2-weighted MGRE sequences were the most accurate and were significantly superior to postcontrast FS-T2-FSE-RT, T2-weighted MGRE, in-out of phase MR sequences(p < .05). For all lesions that were malignant or smaller than 1 cm, respectively, contrast to noise ratio of pre and postcontrast sequences were -1and -0.3 for T2-weighted FSE, 0.53 and 4.5 in-out of phase, 7, 7.08, 5.08, 3.32, 1.7, 1.16, 0.79, 0.68 for GRE with 2.9, 7.5, 12.1, 16.6, 21.2, 25.8, 30.4, 35.0 TE values. Breath-hold various TE precontrast sequences offer improvement in sensitivity compared with fixed multigradient recalled echo sequences alone.

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A Hybrid Optimized Deep Learning Techniques for Analyzing Mammograms

  • Bandaru, Satish Babu;Deivarajan, Natarajasivan;Gatram, Rama Mohan Babu
    • International Journal of Computer Science & Network Security
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    • 제22권10호
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    • pp.73-82
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    • 2022
  • Early detection continues to be the mainstay of breast cancer control as well as the improvement of its treatment. Even so, the absence of cancer symptoms at the onset has early detection quite challenging. Therefore, various researchers continue to focus on cancer as a topic of health to try and make improvements from the perspectives of diagnosis, prevention, and treatment. This research's chief goal is development of a system with deep learning for classification of the breast cancer as non-malignant and malignant using mammogram images. The following two distinct approaches: the first one with the utilization of patches of the Region of Interest (ROI), and the second one with the utilization of the overall images is used. The proposed system is composed of the following two distinct stages: the pre-processing stage and the Convolution Neural Network (CNN) building stage. Of late, the use of meta-heuristic optimization algorithms has accomplished a lot of progress in resolving these problems. Teaching-Learning Based Optimization algorithm (TIBO) meta-heuristic was originally employed for resolving problems of continuous optimization. This work has offered the proposals of novel methods for training the Residual Network (ResNet) as well as the CNN based on the TLBO and the Genetic Algorithm (GA). The classification of breast cancer can be enhanced with direct application of the hybrid TLBO- GA. For this hybrid algorithm, the TLBO, i.e., a core component, will combine the following three distinct operators of the GA: coding, crossover, and mutation. In the TLBO, there is a representation of the optimization solutions as students. On the other hand, the hybrid TLBO-GA will have further division of the students as follows: the top students, the ordinary students, and the poor students. The experiments demonstrated that the proposed hybrid TLBO-GA is more effective than TLBO and GA.

고립성 폐결절의 감별에 있어서 나선형 흉부 전산화 단층촬영시 조영증강의 의의 (Evaluation of the Solitary Pulmonary Nodule by Spiral Computed Topography with Contrast Enhancement)

  • 송광선;신계철;용석중;류정선;강신구;김정주;성기준
    • Tuberculosis and Respiratory Diseases
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    • 제43권4호
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    • pp.519-526
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    • 1996
  • 연구배경 : 양성종양과 악성종양은 혈관분포의 차이와 임파선 발달이 차이로 혈관조영시 조영증강의 정도가 다르다. 이에 연구자는 고립성 폐결절 환자에서 SRCT을 시행하여 조영증강의 정도를 관찰하였다. 방법 : 대상은 1995년에 원주의과대학 호흡기내과에 내원하여 고립성 폐결절로 진단받고 조직검사를 시행받은 환자 16예였다. 고립성 폐결절 환자에서 조영제 주입후 SRCT를 시행하여 조영증강의 정도를 45초, 2분, 5분에 측정하여, 조직학적 및 임상적으로 진단된 양성결절 8예와 수술후 악성결절로 확진된 8예 사이에 그 차이를 관찰하였다. 결과 : 1. 대상 환자의 평균연령은 52세로, 남녀는 11:5 예였다. 2. 질환별로는 결핵성 결절이 8예, 선암이 6예, 상피세포암이 2예였다. 3. 폐결절의 평균 크기는 $2.86{\pm}1.11cm$(1.8-5cm)이었으며 양성결절은 $2.98{\pm}1.4cm$, 악성결절은 $2.76{\pm}0.84cm$으로 차이는 없었다(p=0.75). 조영제 투여전 평균 CT numbed (hounsfield unit)는 $36.8{\pm}17.2$ HU 이며, 양성 결절 $38.1{\pm}23$ HU 과 악성결절 $35.1{\pm}15.3$ HU 으로 두군 간의 차이는 없었다(p=0.52). 조영제 투여 시작후 45초에 조영증강(조영전과 비교한)은 평균 $12.1{\pm}1.3$ HU 이며, 양성결절 $6.22{\pm}10$ HU 과 악성결절 $19.6{\pm}7.9$ HU으로 두군간의 유의한 차이가 있었다 (p=0.008). 조영제 투여 시작후 2분의 조영증강은 평균 $21.1{\pm}20.8$ HU 이며, 양성 결절 $6.75{\pm}15$ HU 과 악성결절 $34.0{\pm}19.2$ HU 으로 악성결절에서 더 높은 경향을 보였다 (p=0.007). 조영제 투여 시작후 5분의 조영증강은 평균 $21.8{\pm}1.9.7$ HU 이며, 양성 결절 $7.75{\pm}17$ HU 과 악성결절 $34.0{\pm}15.4$ HU 으로 악성결절에서 더 높았다(p=0.011). 조영증강의 시판별 변화는 조영제 투여전과 투여시작후 45초, 2분, 5분의 CT number는 악성결절의 경우는 $35.1{\pm}15.3$ HU, $54.7{\pm}15.6$ HU, $69.1{\pm}24.2$ HU, $69.1{\pm}16.4$ HU 으로 계속적인 증가를 유지하였으나 양성 결절에서는 각각 $38.1{\pm}23$ HU, $44.3{\pm}34$ HU, $44.8{\pm}24$ HU, $44.8{\pm}32$ HU 으로 큰 변화가 없었다. 4. 조영증강과 다른 요인간의 상관관계 : 결절의 크기와 조영증강 사이의 상관관계는 없었으며(r=0.21, p=0.43) 환자의 나이와 조영증강 사이에도 상관관계는 없었다(r=0.21, p=0.42). 결론 : 이상의 결과로 고립성 폐결절에서 SRCT상 시간에 따른 조영증가는 악성결절에서 단시간내 더 현저하여 양성결절과 악성결절을 감별하는데 도움이 될 것으로 생각된다.

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