• Title/Summary/Keyword: Disease Location

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A Comparative Study of Survivor Outcomes between Preoperative Evaluation Using CT Alone and Combined CT and MRI in Patients with Pancreatic Ductal Adenocarcinoma (췌장선암 환자의 수술 전 CT 단독 평가와 추가적 MRI 평가에 따른 생존 결과 비교 분석)

  • Ji Eun Lee;Seong Hyun Kim;Soon Jin Lee;Seo-Youn Choi;Sunyoung Lee;Bo Ra Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.638-653
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    • 2021
  • Purpose To compare the recurrence pattern, disease-free survival (DFS), and overall survival (OS) after curative surgery for pancreatic ductal adenocarcinoma (PDAC) in patients who underwent preoperative evaluation with CT alone or in combination with MRI, and to compare the prognosis according to the first recurrence site. Materials and Methods We retrospectively evaluated 152 patients who underwent R0 resection of PDAC. Preoperative CT or combined CT and MRI were performed for 103 and 49 patients, respectively. Two radiologists recorded the location and date of the first recurrence in consensus. The recurrence pattern, DFS, and OS were compared between the two groups. OS was analyzed according to the first recurrence site. Results In both groups, liver metastasis was the most common recurrence pattern. DFS (p = 0.247) or OS (p = 0.067) showed no significant difference between the two groups. OS according to the first recurrence site was the lowest for liver metastasis, followed by locoregional recurrence (p < 0.001). Conclusion There were no significant differences in the recurrence pattern, DFS, or OS between patients evaluated with preoperative CT alone or with CT and MRI after curative resection of PDAC. Liver metastasis was the most common tumor recurrence pattern with the lowest OS.

Mediastinal Lymph Node Metastasis from Head and Neck Cancer: Predictive Factors and Imaging Features (두경부암의 종격동 림프절 전이: 예측인자 및 영상 소견)

  • Il Kwon Ko;Dae Young Yoon;Sora Baek;Ji Hyun Hong;Eun Joo Yun;In Jae Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1246-1257
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    • 2021
  • Purpose To assess the predictive factors and describe the imaging features of mediastinal lymph node (MLN) metastases in patients with head and neck cancer. Materials and Methods We compared the clinical features and disease characteristics (sex, age, site of primary tumor, histologic type, history of prior treatments, TNM stages, and metastasis in cervical LNs) of patients with head and neck cancers between the MLN metastasis and no MLN metastasis groups. We also evaluated the chest CT (distribution and maximum dimension of the largest LN) and PET/CT (maximum standardized uptake value) features of MLN metastases based on the MLN classification. Results Of the 470 patients with head and neck cancer, 55 (11.7%) had MLN metastasis, involving 150 mediastinal stations. Hypopharynx cancer, recurrent tumor, T4 stage, N2/N3 stages, and M1 stage were found to be significant predicting factors for MLN metastasis. The most common location of MLN metastasis was ipsilateral station 2 (upper paratracheal LNs, 36.4%), followed by ipsilateral station 11 (interlobar LNs, 27.3%) and ipsilateral station 10 (hilar LNs, 25.5%). Conclusion Metastasis to MLNs should be considered in patients with head and neck cancer, especially in cases that are associated with a hypopharyngeal cancer, recurrent tumor, and high TNM stages.

Surgical Treatment of Pulmonary Aspergillosis (III) (폐 국균증의 외과적 치료(제 3보))

  • 정성철;김우식;배윤숙;유환국;정승혁;이정호;김병열
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.497-503
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    • 2003
  • Pulmonary aspergillosis usually results from the colonization of the existing lung lesions by chronic pulmonary diseases, such as tuberculosis. Most cases of pulmonary aspergilloma have been treated surgically for many years because it is a potentially life-threatening disease causing massive hemoptysis. Here we reviewed our results from the last 10 years. Material and Method: We reviewed 31 cases surgically treated from Aug. 1992 to Jul. 2002. retrospectively. This investigation is designed to illustrate the peak age incidence, sex ratio, chief complaints, preoperative study, anatomic location of operative site, postoperative pathologic finding and postoperative complications. Result: The peak age Incidence laid in the 3rd and 4th decade of 20 cases (64.5%). The most common complaint was hemoptysis in 27 cases (87.1%). The 31 cases had a history of treatment with anti-tuberculous drugs under impression of pulmonary tuberculosis. The 19 cases (61.3%) showed the so-called “Air-meniscus sign” on the preoperative chest X-ray. In the 31 cases (100%) on the chest computed tomography. as a preoperative diagnostic modality, positivity was shown in 37.9%, 83.3% was shown on the fungus culture of sputum for Aspergillus, serum immunodiffusion test for A. fumigatus, respectively. The anatomical location of aspergilloma was mainly in the upper lobe in 19 cases (61.3%) and the majority of cases were managed by lobectomy. The postoperative pathologic findings showed that 31 cases (100%) were combined with tuberculosis. The postoperative complications include empyema, prolonged air leakage, remained dead space, postoperative bleeding and these numbers of cases is 3 cases (9.7%), 2 cases (6.45%), 2 cases (6.45%), 1 case (3.23%), respectively. one case was died postoperatively due to massive beeding, and asphyxia. Conclusion: Compared with the previous study, there is no significant difference in results. Preoperative chest computed tomography and immunodiffusion test were more commonly available and showed high positivity. Operations often became technically difficult because of pleural space obliteration, indurated hilar structures, and poor expansion of the remaining lung, which were more prominent in the patients with complex aspergillosis. In such cases, medical treatments and interventional procedures like bronchial artery embolization are preferred. However, cavernostomy is also recommanded with few additional morbidity because of its relatively less invassiveness. Early surgical intervention is the recommended management for patients with simple aspergilloma considering the Row surgical mortality and morbidity in recent days.

Clinical Analysis of Ectopic Kidney in Children (소아 이소성 신장의 임상적 고찰)

  • Yook Jin-Won;Kim Ji-Hong;Kim Myung-Joon;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.196-202
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    • 1999
  • Purpose : When the mature kidney fails to reach its norml location in the renal fossa, the condition is known as ectopic kidney. Presenting symtoms can be various and it generally depend on the associated anomaly. Beside urologic anomalies such as hydronephrosis and vesicoureteral reflux, various anomalous vascular net work, skeletal anomaly or genital anomaly can be observed in this condition. Methods : Sixteen children with ectopic kidney was studied retrospectively to analyse initial presentation, accompanied anomaly and prognosis. Results : 56% of the children were accompanied with other urologic anomalies such as true incontinence and vesicoureteral reflux that required surgical treatment. 31% of children were either diagnosed incidentally during evaluation of other non-urologic disease or during follow-up evaluation of abnormal antenatal renal sonogram. Conclusion : Ectopic kidney can be often misdiagnosed as tumorous condition or as a surgical condition depend on the abnormal location of the kidney. Careful evaluation using abdominal sonogram, DMSA, VCUG and abdominal CT scan should be performed in order to search for associated anomalous condition and for proper management.

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Analysis of Prognostic Factors in 1,435 Surgically Treated Patients with Gastric Cancer (위암 수술 1,435에의 예후 인자 분석)

  • Seo, Won-Hong;Seo, Byoung-Jo;Yu, Hang-Jong;Lee, Woo-Yong;Lee, Hea-Kyoung
    • Journal of Gastric Cancer
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    • v.9 no.3
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    • pp.143-151
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    • 2009
  • Purpose: Gastric cancer is prevalent in Korea, therefore the purpose of this study was to determine the clinicopathologic characteristics, 5-year survival rate, and prognostic factors for gastric patients who underwent gastrectomy by a single surgeon. Materials and Methods: A total of 1,435 patients diagnosed with gastric cancer who underwent gastrectomy in the Department of Korean Gastric Cancer Center at Seoul Paik Hospital between September 1998 and August 2003, and the gender, age, location and size of the tumor, visual and histologic analysis, depth of invasion, lymph node metastasis, invasion (perineural, venous, and lymphatic), and surgical method were examined retrospectively. Results: The ratio between males and females was 2.29 : 1, and the average age was 56.7 years. Based on the UICC TNM classification, the patients were distributed as follows: IA 35.4%, IB 14.1%, II 12.6%, IIIA 12.3%, IIIB 8.3% and IV 17.3%. The 5-year survival rate was 69.6%. The results of univariate analysis showed that there were significant differences in the survival rate by age, location and size of tumor, Borrmann type, level of differentiation, Lauren's classification, depth of invasion, metastasis in lymph nodes, UICC TNM stage, invasion (perineural, venous, and lymphatic), and surgical method. Based on multivariate analysis, only the depth of invasion and lymph node metastasis were independent prognostic factors. Conclusion: Although various clinicopathologic characteristics affect the prognostic factors of the patients with gastric cancer, the results of this study showed that the stage of disease, such as depth of invasion and metastasis in lymph nodes, are the most critical factors. There is a need to establish the diagnosis of gastric cancer early and to study and develop various treatment methods based on the diagnostic factors in order to improve the survival of patients with gastric cancer.

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A Study of Image Quality Improvement Through Changes in Posture and Kernel Value in Neck CT Scanning (경부 CT검사 시 Kernel 값과 검사자세 변화를 통한 화질개선에 관한 연구)

  • Kim, Hyeon-Ju;Chung, Woo-Jun;Cho, Jae-Hwan
    • Journal of the Korean Society of Radiology
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    • v.5 no.2
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    • pp.59-66
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    • 2011
  • There is a difficulty because of classifying the anatomical structure in the neck CT scan by the beam hardening artifact no more than disease and it including the 6, 7 number cervical spine and intervertebral disk. In case of enforcing the neck CT scan cause of the inner diameter of beam artifact tried to be inquired by the image evaluation according to the change of the image evaluation according to the direction of the shoulder joint applying the variation method of a posture and location and Kernel value and it was most appropriate, the lion tax and Kernel value try to be searched for through an experiment. Somatom Sensation 16 (Siemens, Enlarge, Germany) equipment was used in a patient 30 people coming to the hospital for the neck CT scan. A workstation used the AW 4.4 version (GE, USA). According to a direction and location of the shoulder joint, the patient posture gave a change to the direction of the shoulder joint as the group S it gave a change as three postures and placed the both arms comfortably and helps a group N and augmented unipolar left in the wealthy merchant and group P it memorized the both hands and ordered the eversion and drops below to the utmost and enforced a scan. By using a reconstructing method as the second opinion, it gave and reconstructed the Kernel value a change based on scan data with B 10 (very smooth), B 20 (smooth), B 30 (medium smooth), B 40 (medium), B 50 (medium sharp), B 60 (sharp), and B 70 (very sharp). By using image data which gave the change of the examination posture and change of the Kernel value and are obtained, we analyzed through the noise value measurement and image evaluation of. The outside wire eversion orders the both hands and the examination posture is cost in the neck CT scan with the group P it drops below to the utmost. And in case of when reconstructing with B 40 (medium) or B 50 (medium sharp) being most analyzed into the inappropriate posture and Kernel value and applying the Kernel value to a clinical, it is considered to be very useful.

A Statistical Survey of Foreign Bodies in Air and Food Passage (Report V) (식도 및 기도이물의 통계적 고찰(제5보))

  • 김기령;홍원표;이춘근;이정권;박기현;김상기
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1979.05a
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    • pp.6.2-6
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    • 1979
  • Foreing bodies of the esophagus and tracheobronchus are likely to occur whenever a child places an inedible object in the mouth and are common in the older age group particularily in edentulous individuals or preexisting disease. Our department had already reported the statistical survey at first in 1954, successively in 1962, 1963 and 1968, respectively according to the age, sex, variety of foreign bodies, location and duration of the lodgement. Now, we have experienced the new 186 cases during the consecutive 5 year period from January 1973 to December 1977 and reported as a 5th report comparing with previous report. The results were as follows. 1. In the incidence of foreign bodies, coins were the most common and pointed metal, disc, bony fragment were followed in order in the esophagus while the peanut and corn were common in the air passage. 2) 79 cases (56.4%) were males and 61 cases (43.6%) were females in the esophagus, which was not a significant difference to note. But in the air passage, males accounted for 33 cases (71.7%) compared to 13 cases (28.3%) of females. 3) In the aspect of age incidence, child 10 years or under accounted for almost all cases in the esophagus as well as in the air passage. 4) In the location of foreign bodies in the esophagus, the first narrowing was the most common, while in the air passage right bronchus had a high incidence but the difference of incidence between right bronchus and left bronchus was not remarkable. 5) The duration of lodgement was 24 hours or less in more than half of the all cases. 6) In the aspect of kind of coin, 10 won coins accounted for majority of the cases (67.0%) but the incidence of 100 won coins were tend to increase gradually in these years.

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Treatment and Prognosis of Chondroblastoma (연골모세포종의 치료 결과)

  • Lee, Young-Kyun;Han, Il-kyu;Oh, Joo-Han;Lee, Sang-Hoon;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.81-87
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    • 2007
  • Purpose: Chondroblastoma of bone is rare with the potential for local recurrence and metastasis. A retrospective review of 30 patients with chondroblastoma of bone treated at a single institution during a 24-year period was conducted to determine the clinical outcome and relevant prognostic factors. Materials and Methods: Thirty patients with biopsy-proven chondroblastoma of bone, treated between September of 1981 and September of 2005, were retrospectively reviewed. There were 16 men and 14 women with an average follow-up period of 7.2 years (range, 1.6~21.2). The most common sites were the distal femur (n=7), proximal humerus (n=6), proximal tibia (n=6) and proximal femur (n=4). The average age of the patients was 20 years (range, 12~47) with closed physes in 20 patients(67%.) Twenty-seven patients(90%) were treated by curettage of the tumor with or without bone grafting or cementing. Three patients(10%) were treated with en bloc resection. Clinical and pathological factors reported to be associated with poor outcome were analyzed. Results: Four local recurrences(13%) developed in postoperative 4, 6, 7 and 16 months. These patients underwent further curettage (once in 2 patients and twice 2) and had no further recurrence. All patients showed no evidence of disease at the final follow-up. Local recurrence developed in the two cases which removal of the tumor was incomplete. Curettage and bone-grafting (1) and cementing (1) were performed in the two other cases with local recurrences. In contrast, no local recurrences were observed in the 3 cases treated with en-bloc resection. The status of physes or the histologic presence of aneurysmal bone cyst, the anatomic location of the tumor did not affect local recurrence. Conclusion: Adequate removal of the tumor with aggressive curettage or en bloc resection seems to be necessary to prevent local recurrence in chondroblastoma. The status of physes, the histologic presence of aneurysmal bone cyst or the anatomic location of the tumor was not related with local recurrence.

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Clinicopathological Features and Prognostic Factors for Patients with Clinical T4 Gastric Cancer that Underwent Combined Resection of Invaded Organs (위암의 주위 장기 침윤으로 합병 절제를 실시한 환자의 병리학적 병기 및 예후)

  • Byun, Gun-Young;Park, Joong-Min;Kim, He-Il;Kim, Jong-Han;Park, Sung-Soo;Kim, Seong-Ju;Mok, Young-Jae;Kim, Chong-Suk
    • Journal of Gastric Cancer
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    • v.7 no.3
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    • pp.117-123
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    • 2007
  • Purpose: The surgical treatment of gastric cancer that invades adjacent organs is a radical gastrectomy with combined resection including the adjacent organs or a palliative operation by performing either a gastrojejunostomy or gastrectomy. However, since it is impossible to determine the exact stage of the cancer, either T or N, in the case of palliative surgery, it is inappropriate to predict patient prognosis. This study analyzes the prognoses for patients whose final TNM stages are determined by a combined resection performed due to macroscopical infiltration into the adjacent organs. Materials and Methods: Of 2,452 patients that underwent surgery for gastric cancer at our hospital from 1983 to 2002, we evaluated 102 patients where a combined resection was performed because direct infiltration into the adjacent organs was discovered. Results: Univariate analysis showed that the survival rate differed by the depth of invasion into the gastric walls, the degree of lymph node metastasis, distant metastasis, pathological TNM stage, surgical curability, the location of tumor, and histological differentiation. By multivariate analysis, it was found that the surgical curability, the location of the tumor and the degree of lymph node metastasis were independent prognostic factors. Conclusion: It is suggested that even when infiltration into adjacent organs is suspected, radical surgery should be performed as to allow a prediction of prognosis through an exact determination of disease stage, and to improve the survival rate.

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Diagnosis of Real Condition and Distribution of Protected Trees in Changwon-si, Korea (창원시 보호수의 분포현황과 실태진단)

  • You, Ju-Han;Park, Kyung-Hun;Lee, Young-Han
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.29 no.1
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    • pp.59-70
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    • 2011
  • The purpose of this study is to present raw data to systematically and rationally manage the protected trees located in Changwon-si, Korea. This study investigated about the present condition and the information of location, individual, management, health and soil. The results are as follows. The protected trees were located in 26 spots, and species of trees were 9 taxa; Zelkova serrata, Celtis sinensis, Aphananthe aspera, Ginkgo biloba, Carpinus tschonoskii, Pinus densiflora for. multicaulis, Quercus variabilis, Pinus densiflora and Salix glandulosa. In protected tree types, shade trees were the most, and the majority of theirs were 200 years or more in age. The range of altitude was 14~173m, and the number of trees located in flat fields was the most. For location types, village and field and mountain were presented in the order and, in land use, land for building was the most. The range of height was 8.0~30.0m, 0.6~5.1m in crown height, 240~700cm in diameter of breast and 210~800cm in diameter of root. In case of crown area, Zelkova serrata of No.5 was most large. The status boards were mostly installed except No.23 and No.26. The sites with fence were 9 spots, and the site with stonework were 14 spots. The sites with the support beam were 5 spots, and most sites were not covered up with soil. The materials of bottom were soil, gravel and vegetation in the order. The range of withering branch rate was 0~40%, and peeled bark rate was 0~60%. The sites made holes were 23 spots, and the hole size of Aphananthe aspera of No.12 was the largest. The sites disturbed by human trampling were 7 spots, the sites by disease and insects of 2 spots, the sites by injury of 23 spots and the sites by exposed roots of 13 spots. In the results of soil analysis, there showed that acidity was pH 4.5~8.0, organic matter content of 3.5~69.8g/kg, electrical conductivity(EC) of 0.11~2.87dS/m, available $P_2O_5$ of 3.0~490.6mg/kg, exchangeable K of 0.10~1.05cmol+/kg, exchangeable Ca of 1.41~16.45cmol+/kg, exchangeable Mg of 0.37~1.96cmol+/kg, exchangeable Na of 0.25~2.41cmol+/kg and cation exchange capacity(C.E.C) of 8.35~26.55cmol+/kg.