• Title/Summary/Keyword: 췌장전이

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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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Anti-Oxidative Effect of Seungyangikki-tang Decoction in Spleen, Pancreas and Stomach Cells of SD Rats (승양익기탕(升陽益氣湯) 전탕액이 노화쥐의 비장, 췌장, 위장 세포의 항산화능에 미치는 영향)

  • Lee, Joo-Yong;Ahn, Taek-Won
    • Journal of Sasang Constitutional Medicine
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    • v.22 no.2
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    • pp.82-92
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    • 2010
  • 1. Objectives: The purpose of this study is to investigate the anti-aging and anti-oxidative effects of Seungyangikki-tang decoction(SY) in spleen, pancreas and stomach cells of Sprague-Dawley(SD) rats. 2. Methods: This experiment was used by the tissue of spleen, pancreas and stomach cells of 6, 52 and 68 weeks old SD rats. We devided each group by three. One group as normal group was non-treated cells, another group as control group was saline-treated cells, and the other group as experimental group was SY treated cells. After culture for 48 hours, each groups measured the level of SOD, GSH, MDA and NO in the tissue of kidney, bladder and spleen cells. 3. Results and Conclusions: SOD activity was significantly increased in spleen cell of 6, 68w-SY group, pancreas cell of 52,68w-SY group and in stomach cell of 52w-SY group compared with those of the control groups. GSH concentration was significantly increased in spleen cell of 6,68w-SY group and in pancreas cell of 6w-SY group compared with those of the control groups. MDA concentration was significantly decreased in spleen cell of 68w-SY group and in stomach cell of 68w-SY group compared with those of the control groups. NO concentration was significantly decreased in spleen cell of 68w-SY group, stomach cell of 68w-SY group compared with those of the control groups.

Anti-oxidant Effect of Hyangsayangyi-tang Decoction in Stomach, Spleen and Pancreas Cell of SD Rats (향사양위탕(香砂養胃湯) 전탕액이 노화주의 비장, 췌장, 위장 세포의 항산화능에 미치는 영향)

  • Choi, Byoung-Chol;Ahn, Taek-Won
    • Journal of Sasang Constitutional Medicine
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    • v.20 no.2
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    • pp.72-84
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    • 2008
  • 1. Objectives The purpose of this study was to observe the anti-oxidant effects of Hyangsayangyi-tang(HY) in SD rats. 2. Methods This experiment was used the tissue of stomach, spleen and pancreas cells of 6, 52 and 68 weeks old SD rats. Each age group was again divided into three groups. One group, as normal group, was not-treated cells, another group, as control group, was saline-treated cells, and the last group, as experimental group, was HY-treated cells. After culture for 48 hours, each groups measured the level of SOD, GSH, MDA and NO in the tissue of stomach, spleen and pancreas cells. 3. Results and Conclusions The activity of SOD were significantly increased in spleen cell of 52, 68 w-HY group, pancreas cell of 68 w-HY group and in stomach cell of 52, 68 w-HY group compared with those of the normal and the control groups. The level of GSH were significantly increased in spleen cell of 52, 68w-HY group and in pancreas cell of 68w-HY group compared with those of the normal and the control groups. The level of MDA were significantly decreased in pancreas cell of 68 w-HY group compared with those of the normal and the control groups. The level of NO were significantly decreased in spleen cell of 68 w-HY group, pancreas cell of 52, 68w-HGD groups compared with those of the control groups. According to results, HY showed anti-oxidant effect. Investigation into the clinical use of the HY is suggested for future research.

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A Case Report of Patient with Metastatic Pancreatic Cancer Treated with modified Bangam-tang and Gunchil-dan in conjunction with Gemcitabine (전이 췌장암 환자의 Gemcitabine과 방암탕 가감방 및 건칠단 병용투여 치험 1례)

  • Kim, Eun Hye;Yoon, Sung Soo;Lee, Jee Young;Yoon, Seong Woo
    • Journal of Korean Traditional Oncology
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    • v.23 no.2
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    • pp.1-9
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    • 2018
  • Objectives: This study was aimed to report a patient with metastatic pancreatic cancer treated with modified Bangam-tang and Gunchil-dan in conjunction with gemcitabine. There were better survival-related outcomes compared to gemcitabine alone. Methods: The patient with metastatic pancreatic cancer received gemcitabine as palliative chemotherapy since June 2016 concurrent with modified Bangam-tang and Gunchil-dan since October 2016 to October 2017. To evaluate the effect of treatment, tumor markers (carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA)), Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, and overall survival were checked. Adverse events were evaluated according to the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Results: After 12 months with the combination treatment, levels of CA19-9 were decreased from 8747 to 265.7 ng/ml and CEA from 42.2 to 6.5 U/ml. Clinical partial response state was shown until May 2, 2017 and stable disease state was maintained from August 4, 2017. In March 2018, the patient got an operation including pancreatectomy and diagnosed with no evidence of disease state in September, 2018. In conclusion, it showed the overall survival of 29 months from June, 2016 to November, 2018. Serious adverse events were not identified. Conclusions: This study suggested that combined treatment with modified Bangam-tang and Gunchil-dan may show better outcome in patient with metastatic pancreatic cancer than gemcitabine alone.

Membrane Technology for Artificial Lungs and Blood Oxygenators (혈액산화용 인공폐 분리막 기술 연구동향)

  • Donghyun Park;Bao Tran Duy Nguyen;Bich Phuong Nguyen Thi;Jeong F. Kim
    • Membrane Journal
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    • v.33 no.2
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    • pp.61-69
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    • 2023
  • The technical importance of membrane-based artificial lung technology has been re-emphasized after the recent breakout of COVID-19 to treat acute lung-failure patients. The world population, particularly in Korea, is aging at an unprecedented rate, which can increase the demand for better artificial organs (AO) in the near future. Membrane technology plays a key role in artificial organ markets. Among them, membrane-based artificial lung (AL) technology has improved significantly in the past 50 years, but the survival rate of lung-failure patients is still very low. Most AL works focus on the clinical application of the AL device, not on the development of the AL membrane itself. This review summarizes the challenges and recent progress of membrane-based AL technology.

Nomenclature and Lymphatic Drainage Patterns of Abdominal Lymph Nodes (복부 림프절의 명명법 및 림프 배액 패턴)

  • Hyun Seok Cho;Jhii-Hyun Ahn
    • Journal of the Korean Society of Radiology
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    • v.83 no.6
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    • pp.1240-1258
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    • 2022
  • The lymphatic system provides a route for the spread of inflammation and malignancies. The identification of nodal stations and lymphatic pathways of tumor spread is important for tumor staging, choice of therapy, and the prediction of the prognosis of patients with malignant diseases. Because lymph node metastasis is common in primary intra-abdominal malignant tumors, its detection is essential for radiologists to understand the pattern of disease spread. Using schematic pictures and color-coded CT images, this pictorial essay describes the locations and nomenclature of the abdominal lymph nodes. Furthermore, the lymphatic drainage pathways of the upper and lower gastrointestinal tracts, liver, gallbladder, bile duct, and pancreas have been highlighted. In addition, lymph nodes belonging to the regional lymph nodes in malignant tumors arising from each organ are described, and certain cases are presented with images from patients.

Delayed Hemorrhage of the Hepatic Artery Caused by Biliary Stenting after Concurrent Chemoradiotherapy (동시항암화학방사선요법 후 담도 스텐트에 의해 발생한 지연성 간동맥 출혈)

  • Joon Ho Cho;Hyoung Nam Lee
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1216-1221
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    • 2020
  • Neoadjuvant concurrent chemoradiotherapy has been increasingly used to obtain secondary resectability for locally advanced pancreatic cancers. Although most patients require biliary decompression, only a few studies have investigated the safety of biliary stenting with chemoradiotherapy. Herein, we report a rare case of delayed hemorrhage of the hepatic artery caused by biliary stenting after chemoradiotherapy. The serial follow-up CT demonstrated that the biliary stent was approaching the right hepatic artery and eventually caused acute angulation and indentation. Diagnostic catheter angiography revealed contrast extravasation at the right hepatic artery, and endovascular embolization was performed. This report highlights the relevance of anatomical deformation after chemoradiotherapy, which can result in fatal complications. Indentation of the hepatic artery caused by biliary stents should be recognized as a warning sign of vascular injury.

Malrotation and Midgut Volvulus in Children: Diagnostic Approach, Imaging Findings, and Pitfalls (소아의 장회전이상과 중장염전: 진단적 접근, 영상 소견 및 함정들)

  • Jeongju Kim;So-Young Yoo;Tae Yeon Jeon;Ji Hye Kim
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.124-137
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    • 2024
  • Malrotation and midgut volvulus are surgical emergencies that commonly occur within the first month of life. The classic symptom is acute bilious vomiting, while nonspecific symptoms such as recurrent abdominal pain may be present in older children. Malrotation can be associated with duodenal obstruction caused by an abnormal peritoneal fibrous band or congenital anomalies, such as an annular pancreas or a preduodenal portal vein. Volvulus can lead to bowel ischemia and a life-threatening condition, thus prompt and accurate diagnosis is crucial. Diagnosis can be made through upper gastrointestinal series, ultrasonography, and CT, with ultrasonography being preferred as a screening tool due to its rapid and accurate diagnosis, without radiation exposure, in children. This pictorial essay discusses the key imaging findings and diagnostic approaches for malrotation and midgut volvulus, as well as diagnostic pitfalls based on actual cases.

Clinical Application Analysis of 3D-CRT Methods Using Tomotherapy (토모테라피를 이용한 3차원 입체 조형 치료의 임상적 적용 분석)

  • Cho, Kang-Chul;Kim, Joo-Ho;Kim, Hun-Kyum;Ahn, Seung-Kwon;Lee, Sang-Kyoo;Yoon, Jong-Won;Cho, Jeong-Hee;Lee, Jong-Seok;Yoo, Beong-Gyu
    • Journal of radiological science and technology
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    • v.36 no.4
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    • pp.327-335
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    • 2013
  • This study investigates the case of clinical application for TomoDirect 3D-CRT(TD-3D) and TomoHelical 3D-CRT(TH-3D) with evaluating dose distribution for clinical application in each case. Treatment plans were created for 8 patients who had 3 dimensional conformal radiation therapy using TD-3D and TH-3D mode. Each patients were treated for sarcoma, CSI(craniospinal irradiaion), breast, brain, pancreas, spine metastasis, SVC syndrome and esophagus. DVH(dose volume histogram) and isodose curve were used for comparison of each treatment modality. TD-3D shows better dose distribution over the irradiation field without junction effect because TD-3D was not influenced by target length for sarcoma and CSI case. In breast case, dosimetric results of CTV, the average value of D 99%, D 95% were $49.2{\pm}0.4$ Gy, $49.9{\pm}0.4$ Gy and V 105%, V 110% were 0%, respectively. TH-3D with the dosimetric block decreased dose of normal organ in brain, pancreas, spine metastasis case. SCV syndrome also effectively decreased dose of normal organ by using dose block to the critical organs(spinal cord <38 Gy). TH-3D combined with other treatment modalities was possible to boost irradiation and was total dose was reduced to spinal cord in esophagus case(spinal cord <45 Gy, lung V 20 <20%). 3D-CRT using Tomotherapy could overcomes some dosimetric limitations, when we faced Conventional Linac based CRT and shows clinically proper dose distribution. In conclusion, 3D-CRT using Tomotherapy will be one of the effective 3D-CRT techniques.

Effectiveness of Positron Emission Tomography in the Pre-operative Staging of Gastric Cancer (위암환자의 술 전 병기 결정에서 PET-CT의 유용성)

  • Park, Shin-Young;Bae, Jung-Min;Kim, Se-Won;Kim, Sang-Woon;Song, Sun-Kyo
    • Journal of Gastric Cancer
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    • v.9 no.3
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    • pp.110-116
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    • 2009
  • Purpose: The aim of this study was to examine the usefulness of positron emission tomography (PET)-computed tomography (CT) in the pre-operative staging of gastric cancer. Materials and Methods: Between February 2006 and August 2008, PET-CT and CT were performed on 70 patients diagnosed with gastric cancer by gastrofiberscopic biopsy. The sensitivities, specificities, Positive predictive value (PPV), and negative predictive value (NPV) of PET-CT and CT imaging for the detection of gastric cancer TNM staging were compared. Results: The detection rates for the primary tumor were as follows: PET-CT, 81.4% (57/70); and CT, 42.9% (30/70). For both early gastric cancer (EGC) and advanced gastric cancer (AGC), PET-CT was more accurate than CT in detecting the lesions. As the size of the tumor exceeded 3 cm, the detection rate increased. The sensitivities, specificities, PPV, and NPV of PET-CT for lymph node staging were 55.6%, 81%, 86.2%, and 45.9%, while the sensitivities, specificities, PPV, and NPV of CT were 40.0%, 85.7%, 85.7% and 40%, respectively. One case of multiple liver metastasis and two cases of dual primary cancer (rectal and pancreatic cancers) were detected by PET-CT. PET-CT also had a higher detection rate for all histologic types of primary tumors. PET-CT was more accurate than CT in detecting primary gastric cancer lesions. The detection of nodal metastasis by PET-CT was similar to CT; small-sized tumors or EGC detection rates were not high. However, PET-CT provided additional information to detect distant metastases and dual primary cancers and reduced unnecessary laparotomies to detect peritoneal seeding or carcinomatosis. Conclusion: It would be useful to make a pre-operative diagnosis of gastric cancer and determine treatment if PET-CT were added to other routine pre-operative studies.

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