• The Korean Journal of Nuclear Medicine
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• v.24 no.2
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• pp.299-306
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• 1990

골 신티그라피에서 신장이 희미하게 보이거나 전혀 안보이게 되는(이하 신장 영상 비출현이라 함) 원인 질환을 파악하고, 또 골 신티그라피에서 골전이가 발견된 여러 악성종양에서 신장 영상 비출현의 빈도 및 신장 영상 비출현의 소견을 보이는 여러 악성종양의 골전이 범위를 관찰하기 위하여, 서울대학교 병원에서 최근 6년간 시행한 골 신티그람 중 신장 영상 비출현의 소견을 보이는 889개를 재검토하였다. 신장영상 비출현의 원인 질환으로는 신부전이 대부분을 차지하였으나(816/889 : 91.8%), 신장 질환이 없는 경우에서는 광범위한 골전이가 가장 많았으며 (53/889 : 6.0%), 그 원발부위는 전립선암 (19/53 : 35.8%), 위암(14/53 : 26.4%), 유방암(5/53 : 9.4%), 폐암(4/53 : 7.5%) 신세포암(2/53 : 3.8%), 방광암(1/53 : 1.9%), 원발부위 미상(8/53 : 15.1%)으로 전립선암과 위암이 가장 많았다. 특히 강직성 척추염 4예, 류마토이드 관절염 3예, 성인형의 골화석증 1예에서 신장 영상 비출현의 소견을 보여 이채로왔으며, 이 밖에 원발성 부갑상선 기능항진증 및 그레이브스병이 각 1예씩 있었으며 원인을 알 수 없는 경우가 10예 있었다. 전립선암 140예중 골 신티그라피에서 골전이가 발견된 예는 108예(77.1%), 이중 신장 영상 비출현의 소견을 보이는 예는 19예(19/108, 17 6%)이었으며, 위암에서는 각각 328예, 162예(49.4%), 14예 (8.6%), 유방암에서는 각각 1754예, 730예 (41.6%), 5예(0.7%), 폐암에서는 각각 1105예, 596예(53.9%), 4예(0.7%), 방광암에서는 각각 247예, 110예(44.5%), 1예(0.9%)로 전립선암에서 신장 영상 비출현의 빈도가 가장 높았으며, 특히 위암에서 골전이 및 신장 영상 비출현의 빈도가 높아 주목되었다. 골전이 및 신장 영상 비출현의 소견을 보이는 악성종양 환자의 골 신티그람 53개중 44개 (83.0%)에서 척추 및 늑골에 미만성, 또는 다발성 침습이 관찰되었다. 또 골전이 부위를 두개골, 척추, 견대부, 늑골, 골반, 사지의 근위부 장골의 6개 부위로 나누어 분석할 경우 49개(92.5%)에서 3부위 이상에 전이가 발견되었고, 35개(66.0%)에서 4부위 이상에 전이가 발견되었으며, 5부위 이상, 6개 부위에 모두 전이가 발견된 것은 각각 20개 (37 7%), 11개(20.8%)이었다. 이상의 성적으로 보아 악성종양 환자의 골 신피그라피에서 신장 영상의 비출현은 종양의 광범위한 골전이를 간접적으로 시사하는 소견으로 생각된다. 여러 악성종양중 전립선암에서 신장 영상 비출현의 빈도가 가장 높았으며, 특히 위암에서 골전이 및 신장 영상 비출현의 빈도가 높음은 주목할 만한 것이라 하겠다.

• Journal of Haehwa Medicine
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• v.5 no.2
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• pp.497-497
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• 1997

간질성폐질변(間質性肺疾變)은 결체조직질병(結締組織疾病)의 상견(常見)되는 병발증(倂發證)이지만, 지금까지는 이상적(理想的)인 치료법(治療法)이 없었다. 본(本) 연구(硏究)는 본병(本病)의 병리기전(病理機轉)이 중의(中醫)에서의 "어혈(瘀血)"증(證) 상호(相互) 유사(類似)한 것으로부터 시작(始作)하여, 중의(中醫)의 "활혈화어법(活血化瘀法)"과 결합(結合)하여 치료(治療)하면서 환자(患者)의 폐기능(肺氣能) 검사결과(檢査結果)의 변화(變化)를 추적(追跡)해, 그 치료효과(治療效果)에 대(對)한 평가(評價)를 내리는 작업(作業)으로 이루어졌다. 먼저 풍습과(風濕科)에 의뢰(依賴)하여 결체조직질병(結締組織疾病)에 간질성폐병(間質性肺病)이 병발(倂發)한 환자(患者)를 선별(選別)한 후(後)에, 서의치료(西醫治療) 통(通)해서 그 원발성(原發性) 질병(疾病)이 은정(隱靜)한 상태(狀態)에까지 이르도록 한 후(後), 필요(必要)한 최저량(最低量)의 서의약(西醫藥)만을 유지(維持)케 하였다. 환자(患者)의 의사(意舍)에 따라서 두 개의 조(組)로 나누어, 실험군(實驗群)은 중의(中醫)에서 회진(會診)하고, Raynaud 증후군(症候群)의 유무(有無)에 따라서, 당귀사역탕(當歸四逆湯) 혹(或)은 혈부축어탕(血府逐瘀湯)을 농축분제(濃縮粉劑)로 투여(投與)하며 연속(連續)하여 6개월간(個月間) 치료(治療)하였다. 대조군(對照群)의 경우(境遇)에는 중의(中醫)가 회진(會診)하지 않았다. 14개월(個月)동안 모두 실험군(實驗群) 23례(例)와 대조군(對照群) 16례(例)를 대상(對象)으로 연구(硏究)를 하였는데, 모두 여성환자(女性患者)였다. 압축성폐용량(壓軸性肺用量)(FVC), 폐총용량(肺總用量)(TCL), carbon monoxide에 대(對)한 폐(肺)의 확산능력(擴散能力)(DLCO), 그리고 폐포공기량(肺泡空氣量)(VA)에 대(對) DCLO의 비(比)를 지표(指標)로 삼아, 폐기능(肺氣能)의 손상정도(損傷程度)에 따라서 box plot으로 분석(分析)하고, 폐기능(肺氣能)의 손상(損傷)을 측정(測定)하는 시스템을 만들었다. 실험결과(實驗結果), 실험군(實驗群)이 대조군(對照群)에 비(比)해서 치료(治療) 전(前)보다 명현(明顯)한 개선(改善)이 있었다. 폐기능(肺氣能)을 검사(檢査)한 수치(數値)들을 일반적(一般的)으로 통계처리(統計處理)한 것을 응용(應用)하고, TCL과 FVC의 모형식(模型式)을 만든 결과(結果), 실험군(實驗群)에서 FVC가 치료과정(治療過程)의 기간(其間)과 정비례(正比例)하여 향상(向上)되고, 또한 치료효과(治療效果)가 명현(明顯)하게 나타나기 시작(始作)하는 시기(時期)가 중의(中醫) 치료과정(治療過程)을 거친 실험군(實驗群)의 제(第)12개(個)에서 DLCO와 DLCO/VA의 향상(向上)이 나타나는 시기(時期)와 거의 일치(一致)하는 것을 발견(發見)하였다.

• Tuberculosis and Respiratory Diseases
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• v.43 no.2
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• pp.228-235
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• 1996

Idiopathic bronchiolitis obliterans with organizing pneumonia(BOOP) is a specific clinicopathologic syndrome characterized by a pneumonia-like illness, with excessive proliferation of granulation tissue within bronchioles, alveolar ducts and alveoli. The changes are most numerous in alveolar ducts. The presence of intraluminal tufts of organizing connective tissue in alveolar ducts and more distal airspaces has been termed organizing pneumonia. The radiologic manifestations are distinctive with bilateral, diffuse alveolar opacities predominantly in the subpleural and lower lung zone. Patchy migratory pneumonic foci or solely nodular infiltrates are rarely present in BOOP. BOOP is a diagnosis of importance because of its dramatic response to steroids.

• Journal of radiological science and technology
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• v.35 no.2
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• pp.151-156
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• 2012

$^{18}F$-fluorodeoxyglucose ($^{18}F$-FDG) causes a significant amount of radioactivity retention in kidneys and urinary tract and degrades image quality and diagnostic performance. Diuretics are used to perform tests and prevent the urinary tract retention of $^{18}F$-FDG. The purpose of the study is to investigate how the diuretics affect images and excretion rates of $^{18}F$-FDG. The study consists of a group using diuretics for patients with no primary tumors or transfer lesions in kidneys according to PET/CT images, a group using physiological saline and the control group injecting only $^{18}F$-FDG and SUVs are measured by configuring interested areas for each group. Also, SUVs are compared and evaluated depending on the lasix injection after basic inspection and injecting $^{18}F$-FDG for quantitative analysis. The study shows that images with decreased background radioactivity and increased urine excretion due to using diuretics. However, an opposite result that there is no change in the amount of radioactivity in urine appears. The study concludes that the diuretics may decrease background radioactivity in the images but may not affect the $^{18}F$-FDG excretion.

• Journal of Chest Surgery
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• v.31 no.4
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• pp.380-387
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• 1998

We evaluated CT findings of bronchial carcinoid and accuracy of preoperative pathological diagnosis according to two subtypes. The subjects were 10 cases(typical;5, atypical;5), confirmed by surgery and tissue pathology. Sputum cytology(n=10), percutaneous aspiration(n=1) and bronchoscopic biopsy (n=8) were performed, preoperatively. The CT findings were analysed according to two subtypes. Typical carcinoid shows central location in all, and bronchial lumens just proximal to tumor were widened in two, whereas atypical carcinoid presented as peripheral leison in two. Among central atypical carcinoid, two cases showed flat meniscus appearance of lumen. Remaining one showed diffuse wall thickening. Intratumoral low density by necrosis was noted in one. Both subtypes show contrast enhancement. For preoperative diagnosis, sputum cytology & percutaneous aspiration were not conclusive at all. As for bronchoscopic biopsy, only 3 cases were accurately diagnosed as typical carcinoid. Typical carcinoid presented as endobronchial mass in all, whereas atypical carcinoid presented in various appearance. In all atypical & some typical carcinoid were misdiagnosed as primary lung cancer, preoperatively. However, in typical carcinoid, conservative surgery was possible. In conclusion, if there is discrepancy between CT findings & preoperative pathological diagnosis, full understanding of CT findings of bronchial carcinoid is imperative to choose appropriate surgical modality.

• Journal of Digestive Cancer Research
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• v.2 no.2
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• pp.72-74
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• 2014

Pancreatic cancer is well known to have a poor prognosis and poor responses to both of chemotherapy and radiation therapy. We report a metastatic pancreatic cancer treated successfully with chemotherapy and radiation therapy. A 71-year-old female with epigastric pain and weight loss was diagnosed as advanced pancreatic cancer with main vessels invasion and multiple mesenteric lymph node's metastasis. She was taken chemotherapy of gemcitabine single regimen and radiation therapy. Although she experienced one recurrence and concomitant primary lung cancer, she has survived for over 7 years with no symptoms. The authors report this case of long term survival in metastatic pancreatic cancer after chemoradiation therapy.

• Journal of Chest Surgery
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• v.30 no.2
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• pp.179-186
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• 1997

The frequency of primary lung cancer is increasing compared to other cancer. Complete surgical resection is the most effective method of treatment, but it is limited to only 25 to 30 percent of patients after initial clinical presentation. The survival rate is different by the subtypes of carcinoma, stages, and general condition of patients. The author investigated the survival rate of 87 patients with squamous cell carcinoma of the lung after surgery. Age ranged from 31 to 73 years, with Lean 57.1) $\pm$ 7.15 and 80.5% (70 cases) was initially diagnosed at sixth and seventh decades. Male to female ratio was 8.9'1. Initial complaints were cough with sputum in 78.1%, weight loss in 31.0%, chest pain and discomfort in 29.9%, and hemoptysis in 24.1%. The location of the tumor was right side in 44.8% and left slde in 55.2% ; LUL in 39.1%, RLL in 20.7%, LLL in'16. 1%, RUL in 14.9% and RML in 9.2%. Stage I was 19.5%, stage II 25.3%, stage olla 54.1% and stage lIIb 1.1%. Operative procedures were as follow : pneumonectomy in 52.9%, lobectomy in 47.1%, sleeve upper lobectomy in 4 cases. Single mediastinal Iymph node involvement was observed in 17 cases, and multi-level mediastinal Iymph node involvement in 23 cases. Lower paratracheal Iymph node and subcarinal Lymph node were more frequently involved in right side lung cancer, with 8 and 10 cases, respectively and subaortic Iymph node was most frequently involved in left side lung cancer with 9 cases. Operative complications were hoarseness, wound infection and chylothorax in 7, 5 and 4 cases, respectively. The operative mortality was 2.2% and the cause of death was pulmonary edema. Postoperative follow-up period ranged from 1 month to 99 months with a mean of 29.95 $\pm$ 17.21 months. Overall one-year survival rate was 75.1 % and five-year survival rate was 29.8%. One-year and five-year survival rates were 93.7% and 52.4% for stage 1, 92.2% and 30.5% for st ge ll, and 61.2% and 17.4% for stage llla, respectively. These findings correlate survival rate with tumor size, mediastinal Iymph node metastasis and surgical resectability, and long-term survival can be expected with small sized tumor, absent mediastinal Iymph node metastasis and complete surgical resection.

• Radiation Oncology Journal
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• v.21 no.4
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• pp.283-290
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• 2003

Purpose: To evaluate the long term significance of the squamous cell carcinoma (SCC) antigen (Ag) as a tumor marker in uterine cervix carcinoma. Materials and Methods: The SCC antigen levels of pre-radiotherapy and serial post-radiotherapy serum were analyzed in 48 patients who received radiotherapy with histologically proven primary SCC of the uterine cervix. Results: Pre-radiotherapy SCC Ag level was high ($\geq$2 ng/ml) at 79.2$\%$. After the treatment, the SCC Ag level was significantly decreased. The SCC Ag level measured at about 3 months after radiotherapy was high at 23.0$\%$. In further follow up measurements, a rise of the SCC Ag to a high level was well associated with clinical relapse. The specificity of the elevated SCC Ag level in association with recurrent or persistent disease was 100$\%$, and the sensitivity was 85.7$\%$. In 3 of 4 lung metastasis cases, lung lesions were detected in chest PA before elevation of the SCC Ag level. The median lead time of the high SCC Ag level to clinical recurrence was 4 months. Conclusion: SCC Ag was a good tumor marker for monitoring treatment effect in patients with increased pre-treatment levels except in case of early lung metastasis. Elevation of the SCC Ag level after radiotherapy accurately predicted the treatment failure with lead time of 4 months. But, in early lung metastasis cases, the SCC level may be normal temporarily. Thus, chest PA should be checked to evaluate the presence of lung metastasis.

• Journal of Chest Surgery
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• v.34 no.8
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• pp.615-620
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• 2001

The new stage of metastatic lung cancer based upon resectability, disease-free interval, and the number of pulmonary metastases was proposed in 1998 by Ginsberg, et al. We evaluated the validity of the new staging proposal for pulmonary metastases through the analysis of experiences at Severance Hospital. Material and Method: The cases of 111 patients who underwent resection of metastatic lung cancer during the eleven-year period (1990-2000) were reviewed. Of these patients, 103(92.8%) underwent compete surgical resection. The primary tumor was carcinoma in 60 cases, sarcoma in 46, and others in 5. The disease-free interval(DFI) was 0 to 35 months in 79 cases adn more than 36 months in 32 cases. Single metastasis accounted for 53 cases and multiple lesions for 58 cases. Mean follow-up was 49 months. Result: The actuarial survival after complete metastasectomy was 48.2% at 3 years and 32.6% at 5 years; the corresponding values for incomplete resection were 21.9% at 3 years. The 3-year survival rate(3-YSR) for complete resction was 40.5% and 5-year survival rate(5-YSR) was 30.4% for patients with a DFI less than 36 months, the 3-YSR, 75.8% and 5-YSR, 39.0% for those with a DFI equal or more than 36 moths; 45.8% and 30.5% for single lesions, 50.0% and 34.4% for multiple lesions. The 3-YSR and 5-YSR were 58.5% and 43.8% for stage I patients, 54.0% and 37.4% for stage II, 38.2% and 27.9% for stage III and 21.9% for stage IV. Conclusion: The result of the analysis of new stage of pulmonary metastases showed that the survival rate was different according to stage and there was no statistical significance. We need more experiences and long-term follow up to determine the prognostic factor of metastatic lung cancer surgery.

• The Korean Journal of Nuclear Medicine
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• v.39 no.4
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• pp.252-256
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• 2005

Purpose: Thyroglobulin (Tg) is a valuable and sensitive tool as a marker for diagnosis and follow-up for several thyroid disorders, especially, in the follow-up of patients with differentiated thyroid cancer (DTC). Often, clinical decisions rely entirely on the serum Tg concentration. But the Tg assay is one of the most challenging laboratory measurements to perform accurately owing to antithyroglobulin antibody (Anti-Tg). In this study, we have compared the degree of Anti-Tg effects on the measurement of Tg between availale Tg measuring kits. Materials and Methods: Measurement of Tg levels for standard Tg solution was performed with two different kits commercially available (A/B kits) using immunoradiometric assay technique either with absence or presence of three different concentrations of Anti-Tg. Measurement of Tg for patient's serum was also performed with the same kits. Patient's serum samples were prepared with mixtures of a serum containing high Tg levels and a serum containg high Anti-Tg concentrations. Results: In the measurements of standard Tg solution, presence of Anti-Tg resulted in falsely lower Tg level by both A and B kits. Degree of Tg underestimation by h kit was more prominent than B kit. The degree of underestimation by B kit was trivial therefore clinically insignificant, but statistically significant. Addition of Anti-Tg to patient serum resulted in falsely lower Tg levels with only A kit. Conclusion: Tg level could be underestimated in the presence of anti-Tg. Anti-Tg effect on Tg measurement was variable according to assay kit used. Therefore, accuracy test must be performed for individual Tg-assay kit.