• Title/Summary/Keyword: 진행성 간암

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특이성 떨어지는 진단시약의 문제점 해결

  • Korea Invention Promotion Association
    • 발명특허
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    • v.31 no.4 s.358
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    • pp.54-56
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    • 2006
  • 현재 병원 및 의원에서는 GOT, GPT 등의 간 질환 진단시약을 사용하고 있다. 하지만 이것들은 특이성이 떨어진다는 문제점을 가지고 있다. 또한 초기 염증 및 급성간염 진단에 있어서는 유용할 지 모르나 만성간염, 간경변, 간암에 있어서는 수치가 정상으로 나타나는 경우도 있어 오진 및 의료분쟁의 원인이 되기도 하 는 등의 치명적인 오류를 안고 있다. 이렇듯 간의 초기 염증 및 급성간염 진단만 가능하던 현재의 간질환 진단시약이 가지고 있는 문제점을 해결하여 만성간염, 간경변, 간암 등까지도 확실하게 구별할 수 있음은 물론 간질환의 진행상태까지도 판단할 수 있는 세계 유일의 제품을 개발하게 되었다. 이는 간경변, 간암의 경우 9 6 %의 높은 판정비율을 나타낸다.

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Detecting liver lesion using Object detection (객체 탐지를 통한 간 종양 검출)

  • Rhyou, Se-Yeol;Yoo, Jae-Chern
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2022.07a
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    • pp.343-344
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    • 2022
  • 간암에는 크게 두 종류가 있는데 하나는 간에서 생긴 종양이 악성종양으로 진행된 것이고 다른 하나는 다른 장기에서 생긴 암이 간으로 전이되는 것이다. 본 논문에서는 간에서 생긴 종양이 악성종양으로 진행되는 것을 조기 발견하고 막고자 Object Detect 모델인 YOLO v5의 다섯 가지 모델을 비교하여 악성 종양으로의 발전 가능성이 있는 간의 lesion을 찾아보았다.

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최신의학상식 - 비알코올성 지방간

  • Kim, Yong-Seok
    • KOREAN ASSOCIATION OF OCCUPATIONAL HEALTH NURSES
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    • v.19 no.1
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    • pp.18-24
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    • 2012
  • 동서양을 망라하여 전 세계적으로 비알코올성 지방간(Nonalcoholic fatty liver disease[NAFLD])의 발생률은 증가추세에 있다. NAFLD는 간에 중성지방(triacylglyceride)이 비정상적으로 축적되어 발생하지만, 사람에 따라서는 간조직에 염증반응이 초래되고, 심지어 간경화, 간암으로까지 진행되기도 한다. NAFLD의 원인이 비만, 인슐린내성과 같은 대사증후군과 연관되기는 하지만, 정확한 병리기전은 아직 규명되지 않았다. 따라서, 치료방법도 충분히 개발되지 못하고 있다. 그럼에도 불구하고, NAFLD에 있어 분명한 점은, 예방과 악화방지가 가능하다는 사실이다.

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Combined Transcatheter Arterial Chemoembolization and Local Radiotherapy for Unresectable Hepatocellular Carcinoma (절제불가능 원발성 간암에서 경간동맥 항암 색전술과 국소 방사선의 병용요법)

  • Seong Jinsil;Keum Ki Chang;Han Kwang Hyub;Lee Do Yun;Lee Jong Tae;Chon Chae Yoon;Moon Young Myoung;Kim Gwi Eon;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.16 no.2
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    • pp.159-165
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    • 1998
  • Purpose : The best prognosis for hepatocellular carcinoma can be achieved with surgical resection. However, the number of resected cases is limited due to the advanced lesion or associated liver disease. A trial of combined transcatheter arterial chemoembolization(TACE) and local radiotherapy(RT) for unresectable hepatocellular carcinoma(HCC) was prospectively conducted and its efficacy and toxicity were investigated. Materials and Methods : From 1992 to 1994, 30 Patients with unresectable HCC due either to advanced lesion or to associated cirrhosis were entered in the study Exclusion criteria included the presence of extrahepatic metastasis, liver cirrhosis of Child's class C, tumors occupying more than two-thirds of the whole liver, and an ECOG scale of more than 3. Patient cHaracteristics were : mean tumor size $8.95\pm3.4cm$, serum AFP+ in all patients, portal vein thrombosis in all patients, liver cirrhosis in 22 patients, and UICC stage III and IVA in 10 and 20 patients, respectively. TACE was performed with the mixture of Lipiodol(5ml) and Adriamycin(50mg) and Gelfoam embolizatin. RT(mean dose $44.0\pm9.3Gy$) 10 days with conventional fractionation. Results : An objective response was observed in 19 patients($63.3\%$). Survival rates at 1 2, and 3 years were $67\%,\;33.3\%$ and $22.2\%$, respectively. Median survival was 17 months. There were 6 patients surviving more than 3 years. Distant metastasis occurred in 10 patients, with 8 in the lung only and 2 in both lung and bone, Toxicity included transient elevation of liver function test in all patients, fever in 20, thrombocytopenia in 4, and nausea and vomiting in 1. There was no treatment-related death. Conclusion : Combined TACE and RT appear to produce a favorable response and survival results with minimal toxicity.

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Preliminary Results of 3-Dimensional Conformal Radiotherapy for Primary Unresectable Hepatocellular Carcinoma (절제 불가능한 원발성 간암의 입체조형 방사선치료의 초기 임상 결과)

  • Keum Ki Chang;Park Hee Chul;Seong Jinsil;Chang Sei Kyoung;Han Kwang Hyub;Chon Chae Yoon;Moon Young Myoung;Kim Gwi Eon;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.123-129
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    • 2002
  • Purpose : The purpose of this study 띤as to determine the potential role of three-dimensional conformal radiotherapy (3D-CRT) in the treatment of primary unresectable hepatocellular carcinoma. The preliminary results on the efficacy and the toxicity of 3D-CRT are reported. Materials and Methods : Seventeen patients were enrolled in this study, which was conducted prospectively from January 1995 to June 1997. The exclusion criteria included the presence of extrahepatic metastasis, liver cirrhosis of Child-Pugh classification C, tumors occupying more than two thirds of the entire liver, and a performance status of more than 3 on the ECOG scale. Two patients were treated with radiotherapy only while the remaining 15 were treated with combined transcatheter arterial chemoembolization. Radiotherapy was given to the field including the tumor plus a 1.5 cm margin using a 3D-CRT technique. The radiation dose ranged from $36\~60\;Gy$ (median; 59.4 Gy). Tumor response was based on a radiological examination such as the CT scan, MR imaging, and hepatic artery angiography at $4\~8$ weeks following the completion of treatment. The acute and subacute toxicities were monitored. Results : An objective response was observed in 11 out of 17 patients, giving a response rate of $64.7\%$. The actuarial survival rate at 2 years was $21.2\%$ from the start of radiotherapy (median survival; 19 months). Six patients developed a distant metastasis consisting of a lung metastasis in 5 patients and bone metastasis in one. The complications related to 30-CRT were gastro-duodenitis $(\geq\;grade\;2)$ in 2 patients. There were no treatment related deaths and radiation induced hepatitis. Conclusion : The preliminary results show that 3D-CRT is a reliable and effective treatment modality for primary unresectable hepatocellular carcinoma compared to other conventional modalities. Further studies to evaluate the definitive role of the 3D-CRT technique in the treatment of primary unresectable hepatocellular carcinoma are needed.

A Case of Metastatic Tonsillar Lesion Showing Increased FDG Uptake in the Patient with Advanced Hepatocellular Carcinoma (진행성 간암 환자에서 편도 전이에 FDG 섭취증가를 보인 예)

  • Park, Jung-Mi;Kim, Hee-Kyung;Kim, Sang-Gyune;Kim, Young-Seok
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.1
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    • pp.70-73
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    • 2008
  • A 65 year-old man with hepatocellulcar carcinoma (HCC) admitted to treat left lower leg swelling and pus discharge suspecting osteomyelitis. MRI of his lower leg revealed the bone metastasis. Whole body FDG PET/CT additionally detected left shoulder and right ilium metastasis. Hematemesis suddenly developed in this patient after 3 weeks. Metastasis of right tonsil was histologically proven. When we reviewed his FDG PET/CT, there was asymmetric mild hypermetabolism in the right tonsil. When focal hypermetabolism is shown in the organ physiologically taking glucose up such as tonsil, we should cautiously assess whole body PET/CT in the examination of distant metastasis. We present a patient with multiple distant metastasis including tonsil from HCC showing increased FDG uptake with the literature review.

The Use of Normal Tissue Complication Probability to Predict Radiation Hepatitis (간암의 정상조직손상확률을 이용한 방사선간염의 발생여부 예측가능성에 관한 연구)

  • Keum Ki Chang;Seong Jinsil;Suh Chang Ok;Lee Sang-wook;Chung Eun Ji;Shin Hyun Soo;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.277-282
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    • 2000
  • Purpose : Though It has been known that the to tolerance of the liver to external beam irradiation depends on the irradiated volume and dose, few data exist which Quantify this dependence. However, recently, with the development of three dimensional (3-D) treatment planning, have the tools to Quantify the relationships between dose, volume, and normal tissue complications become available. The objective of this study is to investigate the relationships between normal tissue complication probabili쇼 (WCP) and the risk of radiation hepatitis for patients who received variant dose partial liver irradiation. Materials and Methods : From March 1992 to December 1994, 10 patients with hepatoma and 10 patients with bile duct cancer were included in this study. Eighteen patients had normal hepatic function, but 2 patients (prothrombin time 73$\%$, 68$\%$) had mild liver cirrhosis before irradiation. Radiation therapy was delivered with 10MV linear accelerator, 180$\~$200 cGy fraction per day. The total dose ranged from 3,960 cGy to 6,000 cGy (median dose 5,040 cGy). The normal tissue complication probability was calculated by using Lyman's model. Radiation hepatitis was defined as the development of anicteric elevation of alkaline phosphatase of at least two fold and non-malignant ascites in the absence of documented progressive. Results: The calculated NTCP ranged from 0.001 to 0.840 (median 0.05). Three of the 20 patients developed radiation hepatitis. The NTCP of the patients with radiation hepatitis were 0.390, 0.528, 0.844(median : 0.58$\pm$0.23), but that of the patients without radiation hepatitis ranged fro 0.001 to 0.308 (median .0.09$\pm$0.09). When the NTCP was calculated by using the volume factor of 0.32, a radiation hepatitis was observed only in patients with the NTCP value more than 0.39. By contrast, clinical results of evolving radiation hepatitis were not well correlated with NTCP value calculated when the volume factor of 0.69 was applied. On the basis of these observations, the volume factor of 0.32 was more correlated to predict a radiation hepatitis. Conclusion : The risk of radiation hepatitis was increased above the cut-off value. Therefore the NTCP seems to be used for predicting the radiation hepatitis.

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Dose Response Relationship in Local Radiotherapy for Hepatocellular Carcinoma (원발성 간암의 국소 방사선치료 시 선량반응 관계)

  • Park Hee Chul;Seong Jinsil;Han Kwang Hyub;Chon Chae Yoon;Moon Young Myoung;Song Jae Seok;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.118-126
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    • 2001
  • Purpose : In this study, it was investigated whether dose response relation existed or not in local radiotherapy for primary hepatocellular carcinoma. Materials and Methods : From January 1992 to March 2000, 158 patients were included in present study. Exclusion criteria included the presence of extrahepatic metastasis, liver cirrhosis of Child's class C, tumors occupying more than two thirds of the entire liver, and performance status on the ECOG scale of more than 3. Radiotherapy was given to the field including tumor with generous margin using 6, 10-MV X-ray. Mean tumor dose was $48.2{\pm}7.9\;Gy$ in daily 1.8 Gy fractions. Tumor response was based on diagnostic radiologic examinations such as CT scan, MR imaging, hepatic artery angiography at $4\~8$ weeks following completion of treatment. Statistical analysis was done to investigate the existence of dose response relationship of local radiotherapy when it was applied to the treatment of primary hepatocellular carcinoma. Results : An objective response was observed in 106 of 158 patients, giving a response rate of $67.1\%$. Statistical analysis revealed that total dose was the most significant factor in relation to tumor response when local radiotherapy was applied to the treatment of primary hepatocellular carcinoma. Only $29.2\%$ showed objective response in patients treated with dose less than 40 Gy, while $68.6\%\;and\;77.1\%$ showed major response in patients with $40\~50\;Gy$ and more than 50 Gy, respectively. Child-Pugh classification was significant factor in the development of ascites, overt radiation induced liver disease and gastroenteritis. Radiation dose was an important factor for development of radiation induced gastroduodenal ulcer. Conclusion : Present study showed the existence of dose response relationship in local radiotherapy for primary hepatocellular carcinoma. Only radiotherapy dose was a significant factor to predict the objective response. Further study is required to predict the maximal tolerance dose in consideration of liver function and non-irradiated liver volume.

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Combined Radiotherapy and Hyperthermia for Nonresectable Hepatocellular Carcinoma (절제 불가능한 원발성 간암의 온열 및 방사선 병용 요법)

  • Seong Jin Sil;Juhn Juhn Kyu;Suh Chang Ok;Kim Gwi Eon;Han Kwang Hyub;Lee Sang In;Roh Jae Kyung;Choi Heung Jai;Kim Byung Soo
    • Radiation Oncology Journal
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    • v.7 no.2
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    • pp.247-257
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    • 1989
  • Thirty patients with nonresectable hepatocellular carcinoma (HCC) due to either locally advanced lesion or association with liver cirrhosis, treated with combined radiotherapy and hyperthermia between April 1988 and July 1988, at Dept. of Radiation Oncology, Yonsei university College of medicine, were analysed. External radiotherapy of a total dose of 3060cGy/3.5 wks was given. Hyperthermia was given twice a week with a total of 6 treatment sessions using 8MHz radiofrequency capacitive type heating device, i.e., Thermotron RF-8 and Cancermia. In all cases hyperthermia was given within 30 minutes after radiotherapy for 30~60min. Temperature was measured by inserting thermocouple into the tumor mass under the ultrasonographic guidance only for those who had not bleeding tendency. As a result, partial response (PR) was achieved in 12 patients (40%), and symptomatic improvement was observed in 22 patients (78.6%) among 28 patients who had suffered from abdominal pain. The most significant factor affecting the tumor response rate was the type of tumor (single massive: 10/14, 71.4%; diffuse infiltrative: 2/10, 20%; multinodular:0/6, 0%; p<0.005). There were not any significant side effects relating to combined treatment. The overall 1 year survival rate was 34%, with 50% in the PR group and 22% in the no response group (NR), respectively. Median survival was 6.5 months and longer for those of PR than of NR (11 mos. vs 5, p<0.05). In conclusion, combined radiotherapy and hyperthermia appeared to be effective in local control and symptomatic palliation of HCC. Further study including a larger number of the patients to confirm its effect in survival and detrimental side effect should be urged.

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