• Title/Summary/Keyword: Inoperable

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$^{131}I-MIBG$ Therapy in Malignant Pheochromocytoma and Medullary Thyroid Carcinoma (악성 갈색세포종 및 갑상선수질암의 $^{131}I-MIBG$을 이용한 치료)

  • Yoon, Jong-Kil;Ryoo, Baek-Yeol;Lee, Chang-Hee;Jeong, Sang-Hoon;Cheon, Young-Kug;Choi, Chang-Woon;Lim, Sang-Moo;Hong, Sung-Woon
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.3
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    • pp.319-327
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    • 1995
  • $^{131}I$-metaiodobenzylguanidine(MIBG) has been used for the diagnosis and treatment of neural crest tumors. We report our experience with this agent in 8 patients[1 multiple endocrine neoplasia(MEN) type IIb; 2 malignant pheochromocytoma; 5 medullary thyroid carcinoma(MTC)]. The therapeutic procedure consisted of 30-200 mCi of $^{131}I-MIBG$ administered by slow I.V. infusion, given at 3-6 months intervals. Commutative activity ranged from 150 mCi to 410 mCi, in 1 to 4 courses. $^{131}I-MIBG$ therapy resulted in significant disease free interval in 1 malignant pheochromocytoma(no measurable lesion) after surgery; complete hormonal and tumoral response in 2 MTC(1 MEN IIb): stable disease in 1 recurred pheochromocytoma(MEN IIb): stable disease but symptomatic improvement in 1 MTC, progressive disease in 1 malignant pheochromocytoma and 2 MTC. The patients who showed progression appeared to have large inoperable tumors or postoperative remnant tumors.

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Clinical Experience of Photodynamic Therapy in Five Patients with Advanced Lung Cancer (진행성 폐암에서 광역동 치료로 호전된 5례에 관한 임상적 경험)

  • Kim, Yang-Ki;Lee, Young-Mok;Kim, Ki-Up;Uh, Soo-Taek;Kim, Yong-Hoon;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.1
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    • pp.72-77
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    • 2004
  • Background : A tracheobronchial obstruction in lung cancer is associated with significant morbidity and mortality due to dyspnea, cough, hemoptysis, and recurrent respiratory infection. It is well known that one of standard treatments is photodynamic therapy (PDT) in tracheobronchial obstruction after radiotherapy, chemotherapy, and/or surgery. We reported here the role of PDT in airway obstruction in patients advanced lung cancer. Method : Pre-treatment protocol consisted of clinical, radiologic, and bronchoscopic examination, pulmonary function test, and assessment of Karnofsky performance status. A 2 mg/kg of porfimer sodium was injected intravenously, and then followed by cylindrical and/or interstitial irradiation with 630 nm of laser after 48 hours. The repeated bronchoscopy for debridement of necrotic tissue and re-illumination was performed after 48 hours. Result : Improved airway obstruction and selective tumor necrosis were achieved by photodynamic therapy in all cases. Dyspnea and performance status were improved in three cases. A purulent sputum, fever and hemoptysis were improved in one of five cases. After PDT, all patients showed temporarily aggravation of dyspnea, two of five showed febrile reaction for a few days and nobody presented photosensitivity reaction, hemoptysis and respiratory failure. Conclusion : Our experiences of PDT are effective in palliation of inoperable advanced lung cancer in terms of tracheobronchial obstruction.

Risk Assessment for Contact Accident of Buoy - Focusing on Busan New Port - (등부표 접촉사고 발생의 위험성 평가에 관한 기초 연구 - 부산항신항 해역을 중심으로 -)

  • Lee, Myoung-ki;Park, Young-Soo;Jeong, Hae-Sang;Gug, Seung-Gi
    • Journal of Navigation and Port Research
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    • v.44 no.3
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    • pp.158-165
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    • 2020
  • Buoys are a necessary component for the safety of vessel traffic. However, if the buoy becomes inoperable from damage and loss, it can have significant impact on vessel traffic safety as well as unexpected budget spending. The purpose of this study was to evaluate the risk of accidental contact by applying the marine traffic assessment index that can reflect the traffic flow in the sea area. First, Busan Port No. 5 fairway, with a high number of buoys and many contact accidents, was set as the sea area for assessment. to investigate the status of accidental contact and evaluate risk of contact accidents based on the IALA Waterway Risk Assessment Programme (IWRAP MkII) and Potential Assessment of Risk Model (PARK Model). As a result, buoys are near the P recautionary Area wherein the traffic flow was complicated by the Masan port vessel and Busan new port vessel, and buoys are near the entrance of the Gadeok waterway, wherein vessels show a pattern of navigation across the fairway and buoys are near the breakwater in the inner fairway were considered as high risk for contact accidents. This study can be used as basic data for establishing an integrated model to evaluate the risk of buoy contact accidents.

A Clinicopathologic Analysis of Neck Masses (경부 종괴의 임상 및 병리학적 고찰)

  • Km Jeong-Ho;Oh Sang-Hoon;Kim Sang-Hyo
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.1
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    • pp.51-57
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    • 1997
  • A mass appearing in the anterior or lateral side of neck often can be a diagnostic challenge. Differential diagnosis of the neck mass covers a broad spectrum of diseases and the proper evaluation and management of a neck mass requires an impressive amount of anatomic and pathologic information. Because improper diagnosis and management may convert a potentially curable malignant metastasis into incurable disease, a differential diagnosis must be considered in all patients who present with a neck mass. Authors reviewed 2,148 cases of neck mass who were diagnosed by surgical resection, biopsy or aspiration during the period between October 1982 to December 1993, excluding those with thyroid and parathyroid disease. The evaluated characteristics were age, sex, site of lesion, and pathologic diagnosis. The results were as follows: Of 2,148 cases of neck mass, the overall ratio of benign to malignant tumor was 3 : 1. In 1,603 cases of benign mass lesion, the most common disease was lymphadenitis(non-specific and tuberculosis) showing 53% incidence, the second was salivary gland tumor(13%), and the third was congenital lesion(12%). The minor problems such as lipoma and sebaceous cyst were 21 %. In the age distribution of benign lesion, tuberculous lymphadenitis showed peak incidence in second decade, non-specific lymphadenitis was main disease of childhood, salivary gland tumor was peak in fourth decade, and most of congenital lesions were diagnosed at the age below 15. In 545 malignant tumors, the most common lesion was metastatic cancer to cervical lymph nodes yielding 71 % incidence(head and neck primary 52%, infraclavicular primary 42%, unknown primary 5%), the second common disease was lymphoma(19%), and the third was salivary gland cancer(9%). In the age incidence of malignant tumor, 60% of them developed in the fifth and sixth decade, head and neck primary was more common in the fifth decade than sixth, however lymphoma showed higher incidence in sixth decade. In the analysis of mass location according to lymph node level grouping(I - V), lymphadenitis developed mostly in level V nodes, the next common occurring site was level IV in tuberculous lymphadenitis and level II in non-specific lymphadenitis. The majority of metastatic cancers were found in level IV and III, and common occurring site of lymphoma was in level II and IV. Pathologic diagnosis of neck masses were made by fine needle aspiration cytology 80 cases, incisional biopsy 533 cases, excisional surgery 1,399 cases, and neck dissection 116 cases. For the proper management of neck mass, a proper diagnostic modality should be selected from imaging techniques, cytology, biopsy or neck dissection, with the consideration of patient's age, history and clinical findings. The scapel biopsy could be used freely in the inflammatory disease or inoperable metastatic cancer, but it should be reserved in the curable metastatic cancer or clinically possible malignancy.

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A Study on the Life-time Prediction for the Rubber O-ring applied to decoy through the Accelerated Life Test (기만기 적용 고무 O-ring의 온도에 따른 가속수명시험을 통한 수명예측에 관한 연구)

  • Jo, Hee-Jin;Kim, Minwoo;Gwak, Hyerim
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.10
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    • pp.182-188
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    • 2016
  • A decoy is a weapon system that can protect vessels from an enemy's torpedo. Thus, the decoy should be able to operate in the field without any failure. Because the decoy can be inoperable once its sealing is broken and water permeates inside the system, the hermetic sealing capability considering the operational environment is mandatory. To be hermetically sealed, a rubber-type O-ring is generally used in a decoy system. The sealed performance of rubber-type products, however, tends to age and deteriorate with time. Therefore, the O-ring needs to be maintained or changed periodically. This paper proposes a method to estimate the proper maintenance period using the hardness and elongation percentage, which represents the performance of the O-ring product and test data from Accelerated Life Test (ALT) of the product. The O-ring used in this paper is a NBR type, and the temperature was chosen to be the main accelerating factor as referenced in many studies. The criteria for the failure of the O-ring was set for the product to be 50% degraded compared to the initial performance. In addition, the Korean standard KS M 6518 was adopted and referenced for the preparation of test samples and the calculation of estimates. The O-ring's predicted life was simulated by analyzing the test results from a computer program, and the optimized maintenance period for the product was determined.

FOLFIRI Regimen as a Second-line Chemotherapy after Failure of First-line Chemotherapy in Advanced Gastric Cancer (진행성 위암에서 1차 항암화학요법에 실패한 환자에서 2차 항암화학요법으로 FOLFIRI요법의 효용성에 대한 연구)

  • Yong Kang Lee;Jae Hyun Kim;Jun Chul Park;Hee Seok Moon;Sung Eun Kim;Jin Seok Jang;Joo Young Cho;Eun Sun Kim;Si Hyung Lee;Sang Kil Lee
    • Journal of Digestive Cancer Research
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    • v.5 no.2
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    • pp.113-119
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    • 2017
  • Background: Second line chemotherapy is often considered in advanced gastric cancers. We assessed irinotecan in combination with fluorouracil in patients experienced diseases progression after first line chemotherapy. Methods: Prospective trial was done at 7 centers in republic of Korea. Patients aged 18 years or older with advanced gastric adenocarcinoma and disease progression on or within 4 months after first-line chemotherapy were assigned to receive irinotecan 180 mg/m2 and 5-fluorouraicl 400 mg/m2 intravenously bolus injection on days 1 and leucovorin 200 mg/m2 for 2 hours and 5-fluorouracil 600 mg/m2 for 22 hours intravenously infusion on day 2 of a 14-day cycle (FOLFIRI group). The primary endpoint was objective tumor response (OR). Efficacy analysis was by per-protocol, and safety analysis included all patients who received at least one treatment with study drug. Results: Between January 1, 2014 and December 31, 2016, 28 patients were assigned to FOLFIRI treatment. Of those 20 patients were completed the study protocol. Per-protocol analysis, two patients among 20 subjects (10.0%) showed partial response. Overall survivals of FOLFIRI group; median 10.1 months [95% CI 4.9-15.3] Grade 3 and higher adverse event that occurred about 5%, but grade 3 or higher febrile neutropenia or life threatening complication was not reported. Conclusion: Combination chemotherapy with irinotecan, 5-FU, and LV is feasible in gastric cancer patients previously treated with platinum-based chemotherapy

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A Case of Complete Remission to Advanced Esophageal Cancer by a Palliative Chemotherapy (고식적 항암화학요법으로 완치가 된 진행성 식도암 환자 1예)

  • Dae Hyun Tak;Hee Seok Moon;Hyun Yong Jeong;Jae Kyu Sung;Sun Hyung Kang
    • Journal of Digestive Cancer Research
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    • v.2 no.2
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    • pp.64-67
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    • 2014
  • Esophageal cancer has a poor prognosis, because the progression rate is faster compared to that of other cancers, Up to 30-40% of cases are inoperable at diagnosis, and most cases occur in the elderly. By this time, surgery has been regarded as the treatment of choice in patients suffering esophageal cancer and recent improvements in surgical techniques and perioperative management have significantly increased the resection rate and reduced the operative mortality. And Although the combination of chemotherapy and radiation therapy has been reported to be an effective treatment for esophageal cancer, most cases show only partial remission. Moreover, radiation therapy alone or chemotherapy alone has limited efficacy. We report a rare case of an 80-year-old man who presented with a chief complaint of dysphasia and was diagnosed with advanced esophageal cancer, with a review of the literature. Considering his advanced age, generally poor performance status, and the risk of fistula development after radiation therapy due to indentation of esophageal cancer into the main bronchus, palliative, rather than therapeutic, chemotherapy was performed, and complete remission was obtained.

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Transcatheter Arterial Embolization for Palliation of Uterine Body Cancer Bleeding (자궁체부암 출혈에 대한 보존적 치료로써의 경카테터 동맥 색전술)

  • Jaeyeon Choi;Ji Hoon Shin;Hee Ho Chu
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.606-614
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    • 2023
  • Purpose This study aimed to evaluate the efficacy and safety of transcatheter arterial embolization (TAE) for bleeding due to uterine body cancer. Materials and Methods In this retrospective study, six patients with varying types of uterine body cancer who underwent TAE for bleeding control were investigated. Angiographic findings, cross-sectional images, TAE details, and clinical outcomes were studied. Technical and clinical success rates were calculated. Results The identified patients had endometrioid adenocarcinoma, sarcoma, and gestational trophoblastic neoplasia, and most were patients with advanced-stage cancer. In four patients, tumor bleeding presented as vaginal bleeding. Technical success was achieved in all seven TAE procedures in six patients. Two patients with recurrent masses who had undergone hysterectomy presented with hematochezia, and TAE was able to provide technical success in these patients as well. The clinical success rate was 50%, indicating bleeding control for > 1 week. Rebleeding was directly associated with death in one patient. On the following day, mild fever was observed in one patient. Conclusion TAE can be considered an effective and safe method of bleeding control for uterine body cancer, especially during critical periods throughout the disease course of patients with inoperable, advanced-stage cancer.

The Effect of External Radiation Therapy for Intracrania1 Arteriovenous Malformation - Conventional Radiation Therapy vs Stereotactic Radiosurgery - (뇌동정맥성 기형의 외부방사선 치료 효과)

  • Kim In Ah;Jang Hong Suk;You Mi Ryung;Yoon Sei Chul;Kim Moon Chan;Shinn Kyung Sub;Bahk Yong Whee
    • Radiation Oncology Journal
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    • v.9 no.1
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    • pp.53-58
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    • 1991
  • From February 1987 through July 1990, the seventeen cases of inoperable intracranial arteriovenous malformation (AVM) were treated using 6 MV linear accelerator at the Division of Therapautic Radiology, Kang Nam 51. Mary's Hospital. Of seventeen cases, fourteen were male and three were female. Ages ranged from 10 to 51 years (median age of 25 years). The main symtoms were headache, epilepsy and hemiparesis in decreasing order of frequency. The middle cerebral artery is the most common origin of the feeding vessel $(41.2\%)$. Four were treated by conventionally fractionated radiation therapy (CRT, thirteen were treated by stereotactic radiosurgery (RS). duration or follow-up in CRT and RS group were 4 to 43 months (median 33 months) and 3 to 12 months (median 13 months), respectively. When the response was assessed by radiologic follow-up study, two of four CRT group showed minimal response. Of thirteen cases of RS group, two $(15.4\%)$ showed complete response, five $(38\%)$ partial response, two $(15.4\%)$ minimal response and four $(30.7\%)$ no response by the same assessment. There was no statistical significance in terms of follow-up period (p=0.22), size of lesion (p=0.82) and treated dose (p=0.05). Further accumulation of experience is recommended with proper case selection and sufficient follow-up period.

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The Usefulness of Ultrasound-Guided Fine Needle Aspiration Cytology of Impalpable Neck Nodes in Patients with Lung Cancer (폐암 환자에서 촉진되지 않는 경부 림프절에 대한 초음파 유도 하 세침흡인 세포검사의 유용성)

  • Kim, Hee Kyoo;Ha, Seung In;Kim, Yu Ri;Park, Chan Bog;Oak, Chul Ho;Jang, Tae Won;Jung, Maan Hong;Oh, Kyung Seung;Chun, Bong Kwon;Lee, Min Ki;Park, Soon Kew
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.5
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    • pp.505-513
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    • 2004
  • Background : In lung cancer patients, the presence of metastatic neck nodes is a crucial indicator of inoperabilty. So thorough physical examination of neck is always mandatory, but sometimes those are hardly palpable even by the skillful hand. Ultrasonography is a useful diagnostic method in detection of small impalpable lymph nodes and in guidance of fine needle aspiration biopsy. In this study we evaluated the clinical usefulness of ultrasonography(USG) and ultrasound-guided fine needle aspiration cytology(US-FNA) in lung cancer patients without palpable neck nodes. Methods and Materials : From Sep 2002 to Sep 2003, 36 non-small cell lung cancer patients (20 adenocarcinoma, 16 squamous cell cancer) and 10 small cell lung cancer patients without palpable neck nodes on physical examiation were enrolled. patients who had contralateral mediastinal nodal enlargement(>1cm) on chest CT were excluded. After the routine check of USG on the neck, US-FNA was done in cases with enlarged neck nodes (${\geq}5mm$ in the short axis). The presence of enlarged lymph node on USG, and of malignant cells on cytology were evaluated by the histological type and the patients' clinical stage of lung cancer. Results : Among 36 non-small lung cell cancer patients, 14 (38.8%) had enlarged neck nodes on USG, and 5 of 10 small cell lung carcinoma patients. The mean diameter of the neck nodes was 9.8 mm (range, 7-12 mm). US-FNA of 14 non-small cell lung cancer patients revealed tumor cells in eight patients (57.1%). In 5 small cell lung cancer pateints, tumor cells were found in all cases. By the result of US-FNA, the clinical stage of 8 out of 36 (22.2%) non-small cell lung cancer patients had changed, including two cases of shift from the operable IIIa to the inoperable IIIb. In small cell lung cancer patients their clinical stage was not changed after US-FNA, but their pathological diagnosis was easily done in two cases, in whom endobronchial lesions were not found on bronchoscopy. Conclusions : USG and US-FNA of neck node seem to be safe, sensitive and cost-effective diagnostic tools in the evaluation of lung cancer patients without palpable neck nodes.