• Title/Summary/Keyword: 신생물 전이

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Surgery of Esophageal Cancer with Metastasis to Distant Abdominal Lymph Nodes(M1LYN) (원격 복부 림프절의 전이(M1LYN)를 동반한 식도암의 수술)

  • 이종목;임수빈;이현석;박종호;조재일;심영목;백희종
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1248-1256
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    • 1996
  • From June 1987 to December 1994, 372 patients underwent operation for resection of esophageal cancer, and 48 patients with metastasis to distant abdominal lymph nodes were analyzed.. The primary tumors were located predominantly in lower thoracic esophagus(n=29). The location of involved lymph nodes were celiac L/N(n=45), common hepatic L/N(n=4), paraaortic L/N(n=l), and retropancreatic L/N(n=l). Most tumors penetrated the esophageal wall(T3,T4, n=43), metastased to regional L/N(N1, n=41), but a few tumors were limited to the esophageal wall(T1,T2, n=5), metastased to distant abdominal L/N without metastasis to regional L/N(NO, n=7). Resectability rate was 87.5%(42/48), and complete resection was possible in 31 patients(64.6%). The most frequent cause of incomplete resection and unresectability was unresectable T4 lesions(n=8), extranodal invasion(n=7). Overall operative mortality and morbidity was 4.2%, 22.9%, and resection mortality was 4.8%. Adjuvant therapy was given to 27 patients, and postoperative follow-up was possible in all patients(median follow-up, 32 months). The 1 year and 3 year survival for resection group was 54.0%, 18.1%(median, 386 days) including operative deaths. Our results suggest that resection of the esophageal cancer with metastasis to distant abdominal lymph nodes(M1LYN) can be done with acceptable mortality and morbidity, and may playa role in long-term survival in carefully selected patients because prognosis is dismal in unresectable esophageal cancer. We recommend that lymph nodes around celiac axis be dissected thoroughly for exact staging and possible prolongation of survival, and multimodality therapy as necessary because most patients with M1(LYN) esophageal cancer do poorly with only primay surgical treatment.

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Surgical Experience of Pathological Stage IIIB Non-Small Cell Lung Cancer (병리학적 병기 IIIB폐암의 외과적 체험)

  • 백희종;이종목
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.517-523
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    • 1996
  • From May 1988 to June 1994, )73 patients underwent exploratory thoracotomy for resection of non- small cell lung cancer, and 48 patients staged pathologically as lIIB were analyzed. 74 lesions were involvement of great vessel (n=26), heart (n=5), ipsilateral lung metastasis(n=4), esophagus (n=4), carina(n=3), mediastinum (n=2), trachea(n=1), spine (n=1) and 13lourO seeding(A=15). N3 lesions were involved in 6 patients. Extended pulmonary resection with radical mediastinal node dissection was possible in 25 patients, and exploration only was performed in 23 patients. The most frequent cause of unresectability was pleural seeding. Postoperative morbidity was )2 % (8125) and mortality was 16 % (41 25) in resected group. The adjutant therapy was given to 37 patients. The 1 year and 3 year survival for resected group ncluding operative deaths was 57.2%, and 2).8 % (median 15 months), but 48.4%, and 0 % (median 7 months) for exploration only group (Log-Rank test, p : 0.17). Our results suggest that extended pulmonary resection might be helpful for carefully selected patients with 74 non-small cell lung cancer, but meticulous preoperative work-up for staging, especially to detect pleural seeding and Invasion to the irlediastinal structures is a prerequisite to avoid unnecessary thoracotomy.

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The Anti-angiogenic Potential of a Phellodendron amurense Hot Water Extract in Vitro and ex Vivo (in Vitro와 ex vivo에서 황백 온수추출물의 신생혈관 억제효과)

  • Kim, Eok-Cheon;Kim, Seo Ho;Bae, Kiho;Kim, Han Sung;Gelinsky, Michael;Kim, Tack-Joong
    • Journal of Life Science
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    • v.25 no.6
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    • pp.693-702
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    • 2015
  • Blocking new blood-vessel formation (angiogenesis) is now recognized as a useful approach to the therapeutic treatment of many solid tumors. The best validated approach to date is to target the vascular endothelial growth-factor (VEGF) pathway, a key regulator of angiogenesis. Many natural products and extracts that contain a variety of chemopreventive compounds have been shown to suppress the development of malignancies through their anti-angiogenic properties. Phellodendron amurense, which is widely used in Korean traditional medicine, has been shown to possess antitumor, antimicrobial, and anti-inflammatory properties, among others. The present study investigated the effects of P. amurense hot-water extract (PAHWE) on angiogenesis, a key process in tumor growth, invasion, and metastasis. To investigate PAHWE’s anti-angiogenic properties, this study’s authors performed an analysis of angiogenesis and endothelial-cell proliferation, migration, invasion, and tube formation, as well as zymogram assays and the rat aortic ring-sprouting assay. PAHWE inhibited cell growth, mobility, and vessel formation in response to VEGF in vitro and ex vivo. Furthermore, it reduced VEGF-induced intracellular signaling events, such as the activation of matrix metalloproteinases (MMPs) -2 and -9. These results indicate that PAHWE’s anti-angiogenic properties might lead to the development of potential drugs for treating angiogenesis-associated diseases such as cancer.

Smart Baby Bottle Using the Arduino (아두이노를 이용한 스마트 젖병)

  • Park, Dong-Hyun;Han, Sang-Wook;Jeon, Eun-Kwang;Lee, HwaMin
    • Annual Conference of KIPS
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    • 2016.04a
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    • pp.962-964
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    • 2016
  • 아이를 처음 낳는 부모님들은 신생아의 분유를 타는 방법을 모르거나 넣어야 하는 분유의 양을 잘못 넣는 경우가 많다. 분유를 타는 방법은 신생아의 개월 수 마다 물의 양과 분유의 양도 다를 뿐더러 신생아에게 먹일 수 있는 적당한 온도도 맞춰야 하는 어려움이 발생한다. 하지만 분유 타기에 미숙한 부모나 외출을 하는 경우 물의 온도를 맞추는 것은 번거로움과 어려움을 발생시킨다. 이러한 문제점들을 해결하기 위해서 본 논문에서는 아두이노(Arduino)와 소프트웨어를 결합하여서 신생아들에게 분유를 타줄 때 편리하게 사용할 수 있는 스마트 젖병을 설계하고 구현하였다.

Primary Hemangiopericytoma of the Lung -1 Case Report - (폐에 발생한 원발성 혈관주위세포종 -1례 보고-)

  • 최광민;김건일;신호승;박희철;홍기우
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.315-318
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    • 1998
  • Primary hemangioperiycytoma is quite rare tumor of the lung and arising from pericyte in external layer of capillaries. Most cases are developed in 4th and 5th decade, are asymptomatic, and have malignant otential. On chest radiography, primary pulmonary hemangiopericytoma shows lobulated, well demarcated, homogeneous soft tissue density. Microscopically, it consisits of numerous vascular spaces of variable size and shape separated by aggregates of tightly packed oval to spindle-shaped cells. Treatment of choice is surgical excision. We report a case of primary pulmonary hemangiopericytoma in a 16-year-old man who had well demarcated homogeneous mass in the superior segment of left lower lobe, but had no symptom. He had undergone left lower lobectomy. He has been followed up for 8 months but has no sign of relapse or metastasis yet.

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An Outbreak of Epidemic Keratoconjunctivitis by Adenovirus Type 8 in a Neonatal Intensive Care Unit (신생아 중환자실에서의 아데노바이러스 8형에 의한 유행성 각결막염의 발생)

  • Park, Na-Ri-Mi;Na, Ji-Youn;Joung, Kyoung-Eun;Lee, Ji-Na;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Seong-Joon;Song, Jung-Suk;Oh, Hyang-Soon;Lee, Hoan-Jong;Choi, Jung-Hwan
    • Neonatal Medicine
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    • v.15 no.1
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    • pp.44-53
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    • 2008
  • Purpose : Epidemic keratoconjunctivitis (EKC) caused by adenovirus is a highly contagious disease, which has been reported as outbreaks involving adults in the community. However, there has been no report on EKC outbreak by adenovirus in a neonatal intensive care unit (NICU) in Korea. Aims of this study were to investigate the EKC outbreak by adenovirus type 8 in NICU and to confirm an effectiveness of polymerase chain reaction (PCR) for diagnosis. Methods : Conjunctival swab or nasopharyngeal aspirate specimens were taken from all patients and tested by viral culture and PCR. Adenovirus serotype was determined by sequencing of PCR product of selected region of hexon gene using the virus isolates or specimens. Results : An outbreak of EKC occurred which was involving 12 preterm infants in the NICU of the Seoul National University Children's Hospital between July 12th and August 1st, 2005. Three hospital staffs and one family member of the neonate were also affected. Adenovirus was detected in 12/12 (100%), 6/11 (54.5%) by PCR and virus culture, respectively. Eleven PCR-positive neonates were identified as serotype 8 by sequencing. The first affected 4 babies have had routine ROP (retinopathy of prematurity) examinations one week ago. While previous outbreaks were sustained for a few months, the event in our unit was controlled without complications in 3 weeks. Conclusion : We analyzed the EKC outbreak by adenovirus type 8 in NICU. Adenovirus serotype was identified by PCR and sequencing with high sensitivity for the first time in Korea, so we suggest this method can be very useful for rapid diagnosis and infection control.

Retroperitoneal Bronchogenic Cyst -A case report- (후복막강내 기관지 낭종 - 1예 보고 -)

  • Shin, Kyung-Wook;Kang, Jeong-Ho;Chung, Won-Sang;Kim, Hyuck;Kim, Young-Hak;Jeon, Seok-Chol
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.221-223
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    • 2010
  • Bronchogenic cysts are usually located in the pulmonary parenchyma or in the mediastinum. When bronchogenic cysts are located in the mediastinum, they are usually near the bronchus or esophagus, and rarely located in the retroperitoneal space. It is difficult to differentiate between bronchogenic cysts and benign cysts prior to surgert. We report here on a patient for who had a mass in the retroperitoneum, with the preoperative diagnosis being a benign neurogenic tumor. Via left open thoracotomy, pathologic reports revealed that the mass was a bronchogenic cyst. We report here on the case of a bronchogenic cyst that was located in the retroperitoneal space of the diaphragm.

Biosynthesis of the extracellular enzymes in de novo during the differentiation of Aspergillus niger (검정곰팡이의 형태분화에 따른 세포외성효소의 신생적생합성에 관한 연구)

  • Kim, Jong-Hyup
    • The Korean Journal of Mycology
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    • v.6 no.2
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    • pp.1-10
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    • 1978
  • In de novo biosynthesis of the extracellulor enzymes-proteinsaes, alpha and gluc-amylases during the synchronized differentiation of Aspergillus niger in submerged culture and surface liquid culture were investigated. Gluc-amylase was synthesized in the stage of presporulation in which phialide formation is involved. Proteinase was synthesized both in the stages of conidiophore formation and presporulation. Alpha-amylase was synthesized during presporulation and sporulation stages, the activity of enzyme lasted for seven days on surface liquid culture. It seemed that the synthesis was occured in de novo partly repressed by the catabolite, and its nature was found to be constitutive since it is produced in non-starch medium. Polyacrylamide gel electrophoresis have shown that presporulating and sporulating body produced diverse types of the proteins whereas the earlier stages of vegetative body showed simpler profiles. The uptake of C-14 uracil into RNA and C-14 glutamate into protein were shown to be vigorous in presporulating body rather than those in sporulating body. Coincidence of alpha-amylase biosynthesis in de novo and sporulation may be significant in the study of differentiation in which gene expression is involved.

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Langerhans Cell Histiocytosis of Thyroid Gland : A Case Report (갑상선에 생긴 랑게르한스 세포 조직구증 1예)

  • Jang, Chul Soon;Yeon, Je Yeob;Park, Soo Kyoung;Lee, Dong Wook
    • Korean Journal of Head & Neck Oncology
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    • v.29 no.1
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    • pp.18-21
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    • 2013
  • 랑게르한스 세포 조직구증은 골수에서 유래하는 랑게르한스 세포 조직구의 이상 증식에 의해 발병하는 희귀한 질병으로 알려져 있다. 비록 모든 장기에서 발생 할 수 있으나 갑상선을 침범하는 경우는 매우 드물다. 18세 남자가 5달전부터 점점 커지는 갑상선 종괴를 주소로 내원하여 세침흡인 세포검사, 총샘검, 경부 전산화단층촬영을 시행하였다. 세침흡인 세포검사에서 악성신생물이 의심되었고, 총생검에서 랑게르한스 세포 조직구증으로 나타났다. 경부 전산화단층촬영에서는 우측 갑상선에서 윤곽이 잘 구분되는 저음영의 종괴와 우측 기관 주위 림프절의 종대가 관찰되었다. 갑상선 전절제술과 우측 중앙 선택적 경부 림프절 청소술이 시행되었다. 랑게르한스 세포 조직구증이 갑상선을 침범하는 경우는 드물지만 갑상선 비대가 있는 환자가 뇌하수체 기능부전의 증상이나 뼈와 폐의 침범과 관련된 증상을 호소한다면 갑상선의 랑게르한스 세포 조직구증 침범을 고려해야 한다. 또한, 다른 장기의 랑게르한스 세포 조직구증을 치료한 과거력이 있는 경우는 갑상선 종괴를 감별 진단하는데 있어 랑게르한스 세포 조직구증을 고려해야 한다.

A Comparative Study on the Pattern of Outpatient Department Utilization at a Tertiary Level Hospital before and after Implementation of the Patient Referral System (의료전달체계 실시 전후의 3차 진료기관 외래환자 이용양상 비교)

  • Lee, Kyeong-Soo;Kim, Chang-Yoon;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.25 no.1 s.37
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    • pp.88-100
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    • 1992
  • This study was conducted to assess the effects of implementation of the patient referral system started July 1st, 1989. A comparison on the pattern of outpatient services of the Departments of Internal Medicine, General Surgery, and Pediatrics at the Yeungnam University Hospital was conducted for each one year period before and after implementation of the patient referral system. The pre-implementation period was from July 1, 1988 to June 30, 1989 and the post-implementation period was from July 1, 1989 to June 30, 1990. The information used for this study was obtained from official forms, prepared by the Yeungnam University Hospital, and submitted to the Korean Medical Insurance Cooperatives. After implementation of the patient referral system, the number of outpatient cases in the Department of Internal Medicine decreased 36.1% from 9,669 cases to 6,181 cases a year. Cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of Pediatrics decreased 36.9% from 3,372 cases to 2,128 cases a year. After implementation of the patient referral system, the average age of cases in the Departments of Internal Medicine and General Surgery was 52.5 and 49.7 years old, respectively. This was a significant increase in comparison with the pre-implementation period. After implementation of patient referral system, the proportion of new outpatients in the Department of Internal Medicine decreased from 24.1% to 14.6%, the Department of General Surgery from 36.0% to 23.4%, and the Department of Pediatrics from 15.5% to 8.3%. The number of visits per case decreased significantly in the Department of Internal Medicine(from 1.74 to 1.61), but there was no significant change in the Departments of General Surgery and Pediatrics. The length of treatment per case increased significantly in all three departments(from 16.1 days to 19.3 days in the Department of Internal Medicine, from 12.0 days to 15.2 days in the Department General Surgery, and 8.9 days to 11.2 days in the Department of Pediatrics). The number of clinical tests per case increased significantly in the Department of Internal Medicine (from 2.2 to 2.5), in the Department of Pediatrics(from 0.8 to 1.1) and increased in the Department of General Surgery(from 6.4 to 6.6). The average medical cost per case decreased from 43,900 Won to 42,500 Won in the Department of Internal Medicine, while the cost increased from 75,900 Won to 78,500 Won in the Department of General Surgery and from 12,700 Won to 13,500 Won in the Department of Pediatrics. In case-mix, the chronic degenerative disease(i. e. hypertension, diabetes mellitus, angina pectoris, malignant neoplasm, and pulmonary tuberculosis) ranked higher and acute infectious diseases and simple cases(i. e. gastritis and duodenitis, haemorrhoids, anal fissure, carbuncle, acute URI, and bronchitis) ranked lower after implementation of the patient referral system compared to before implementation.

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