• Journal of Chest Surgery
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• 제16권4호
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• pp.563-570
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• 1983

For the purpose of evaluation of clinical characteristics and histopathological properties in mediastinal tumors, 130 patients with mediastinal tumors treated during the period from 1958 to 1982 were reviewed. Cancers of unidentified primary site of origin, nonneoplastic lesions and the cases with clinical diagnosis only were excluded from this report. There were 69 males and 61 females, and their ages ranged from 2 months to 66 years, with the average age of 31.3 years. 19.2% of patients were younger than 15 years of age. The most frequently encountered tumors were teratodermoids, followed by neurogenic tumors, thymic tumors, benign cysts, malignant lymphomas and miscellaneous tumors in order of decreasing frequency. 75.4% of the mediastinal tumors were benign and 24.6% were malignant. 16.6% of the patients were asymptomatic at admission. There were 2 postoperative deaths with 1.7% of operative mortality rate, and 2 other deaths who were not operated upon, showing overall hospital mortality rate of 3.1%. Postoperative follow up was possible in 84 cases, and there were 4 late deaths.

• Journal of Korean Neurosurgical Society
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• 제61권2호
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• pp.267-276
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• 2018

Objective : The beneficial effect of hypothermia after hemicraniectomy in malignant middle cerebral artery (MCA) infarction has been controversial. We aim to investigate the safety and clinical efficacy of hypothermia after hemicraniectomy in malignant MCA infarction. Methods : From October 2012 to February 2016, 20 patients underwent hypothermia (Blanketrol III, Cincinnati Sub-Zero, Cincinnati, OH, USA) at $34^{\circ}C$ after hemicraniectomy in malignant MCA infarction (hypothermia group). The indication of hypothermia included acute cerebral infarction >2/3 of MCA territory and a Glasgow coma scale (GCS) score <11 with a midline shift >10 mm or transtentorial herniation sign (a fixed and dilated pupil). We retrospectively collected 27 patients, as the control group, who had undergone hemicraniectomy alone and simultaneously met the inclusion criteria of hypothermia between January 2010 and September 2012, before hypothermia was implemented as a treatment strategy in Dong-A University Hospital. We compared the mortality rate between the two groups and investigated hypothermia-related complications, such as postoperative bleeding, pneumonia, sepsis and arrhythmia. Results : The age, preoperative infarct volume, GCS score, National institutes of Health Stroke Scale score, and degree of midline shift were not significantly different between the two groups. Of the 20 patients in the hypothermia group, 11 patients were induced with hypothermia immediately after hemicraniectomy and hypothermia was initiated in 9 patients after the decision of hypothermia during postoperative care. The duration of hypothermia was $4{\pm}2days$ (range, 1 to 7 days). The side effects of hypothermia included two patients with arrhythmia, one with sepsis, one with pneumonia, and one with hypotension. Three cases of hypothermia were discontinued due to these side effects (one sepsis, one hypotension, and one bradycardia). The mortality rate of the hypothermia group was 15.0% and that of the control group was 40.7% (p=0.056). On the basis of the logistic regression analysis, hypothermia was considered to contribute to the decrease in mortality rate (odds ratio, 6.21; 95% confidence interval, 1.04 to 37.05; p=0.045). Conclusion : This study suggests that hypothermia after hemicraniectomy is a viable option when the progression of patients with malignant MCA infarction indicate poor prognosis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권5호
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• pp.462-469
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• 2000

Positron Emission Tomography(PET) is a new diagnostic method that can create functional images of the distribution of positron emitting radionuclides, which when administered intravenously in the body, makes possible anatomical and functional analysis by quantity of biochemical and physiological process. After genetic and biochemical changes in initial stage, malignant tumor undergoes functional changes before undergoing anatomical changes. So, early diagnosis of malignant tumors by functional analysis with PET can be achieved, replacing traditional anatomical analysis, such as computed tomography(CT) and magnetic resonance image(MRI), etc. Similarly, PET can identify malignant tumor without confusion with scar and fibrosis in follow up check. In the Korea Cancer Center Hospital(KCCH) from October 1997 to September 1999, clinical study was performed in 79 cases that underwent 89 times PET evaluation with [18F]-Fluorodeoxyglucose for diagnosis of oral and maxillofacial tumors, and the data was analysed by Bayesian $2{\times}2$ Classification Table. The results were as follows : Evaluation for initial diagnosis with FDG-PET (P<0.005) 1. Agreement rate or accuracy rate is 88.9%. 2. Sensitivity is 95.2%, and specificity 66.7%. 3. Positive predictive rate is 90.9%, and negative predictive rate 80.0%. 4. In consideration of tumor stage, diagnostic rate in less than stage II was 90% and in greater than stage III 100%. 5. In consideration of tumor size, diagnostic rate in less than T2 was 92.3% and in greater than T3 100%. After primary treatment, evaluation for follow up check with FDG-PET (P < 0.001) 1. Agreement rate or accuracy rate is 85.4%. 2. Sensitivity is 87.5%, and specificity 82.4%. 3. Positive predictive rate is 87.5%, and negative predictive rate 82.4%. 4. In 24 recurred cases, 6 had distant metastasis, and 5 of them were diagnosed with FDG-PET, resulting in diagnostic rate of FDG-PET of 83.3%. From the above results, Positron Emission Tomography with [18F]- Fluorodeoxyglucose appears to be more sensitive and accurate for detecting the presence of oral and maxillofacial tumors, and has various clinical applications such as early diagnosis of tumor in initial and follow up check and detection of distant metastasis.

• 동의생리병리학회지
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• 제23권3호
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• pp.710-714
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• 2009

Several studies showed that the survival rate of stage IIIB disease with malignant pleural effusion is worse than stage IIIB disease without malignant effusion. But, malignant pleural effusion was considered T4. To analyze changes the survival time for malignant pleural effusion, in the seventh revision of TNM classification for lung cancer. The records of all patients had to have either a histological or cytological diagnosis of non-small cell lung cancer (NSCLC), who were admitted to Wonkwang university hospital between January 2004 and December 2006 were reviewed retrospectively. We evaluated the survival time of 187 patients with advanced lung cancer with and without malignant pleural effusion. This included the pleural effusion or nodule M1 a (pleural dissemination, currently classified as T4), nodule(s) in the other lung M1 a (contralateral lung nodule, currently classified as M1), nodule(s) with the same lobe as the primary tumor T3 (currently classified as T4), other T4 factors T4 (T4 MO anyN), and extrathoracic sites of disease M1b (distant metastasis, currently classified M1). Among the 187 patients, T4anyNMO was 57 patients in the current TNM classification. In the next edition of the TNM classification, T4MOanyN-T4 (excluding same lobe nodules) was 12 patients, pleural dissemiantion-M1a was 45 patients, contralateral lung nodule(s)-M1a was 7 patients, and metastatic disease-M1b was 55 patients. We compared the survival time for these groups. Survival time was 11 months, 8 months, 11 months, and 4 months. The survival time of malignant pleural effusion was shorter than other T4 factors without pleural effusion. But, there was no remarkable difference in statistics due to small cases (p=0.23). We strongly suggest that malignant pleural effusion in advanced NSCLC will be categorized with metastatic disease.

• 대한골관절종양학회지
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• 제17권1호
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• pp.30-35
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• 2011

목적: 악성 흑색종의 치료 결과를 분석하고 예후 인자에 대해 알아보고자 하였다. 대상 및 방법: 1996년 1월부터 2005년 12월까지 악성 흑색종으로 진단 받고 외과적 절제술 시행 후 추시가 가능하였던 31예를 대상으로 하였다. 평균 추시 기간은 46.5개월이었고 평균 연령은 56.9세였다. 나이, 성별, 발생 부위, 종양의 두께, 림프절 전이유무, 면역화학 요법의 시행 유무에 따른 5년 생존율을 비교하였다. 결과: 전체 환자의 5년 생존율은 80.6%였고 발병 연령이 65세 미만인 경우 5년 생존율은 89.7%였고 65세 이상에서는 66.7%였다. 남자의 5년 생존율은 75%였으며 여자는 90.9%였다. 발생 부위에 따라 상지에 발생한 경우 66.7%, 하지에 발생한 경우 89.5%, 기타 부위에 발생한 경우 66.7%의 5년 생존율을 보였다. Clark level IV 이상에서는 62.5%의 5년 생존율을 보였고 III 이하에서는 100% 였다. 림프절 전이가 있었던 경우 5년 생존율은 53.8% 였고, 없었던 경우는 100%였다. 결론: 악성 흑생종 치료에 있어 조기 발견 및 광범위 절제술이 가장 효과적인 치료 방법으로 생각되며, 예후 인자에 있어서 나이, Clark level, 림프절 전이가 통계적 유의성이 있는 것으로 나타났다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8637-8644
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• 2016

Background: Malignant serous effusions (MSE) are one complication in patients with advanced cancer. Endostar is a new anti-tumor drug targeting vessels which exerts potent inhibition of neovascularization. This study aimed to systematically evaluate the efficacy and safety of intraperitoneal perfusion therapy of Endostar combined with platinum chemotherapy for malignant serous effusions (MSE). Materials and Methods: Randomized controlled trials (RCTs) on intraperitoneal perfusion therapy of Endostar combined with platinum chemotherapy for malignant serous effusions were searched in the electronic data of PubMed, EMBASE, Web of Science, CNKI, VIP, CBM and WanFang. The quality of RCTs was evaluated by two independent researchers and a meta-analysis was performed using RevMan 5.3 software. Results: The total of 25 RCTs included in the meta-analysis covered 1,253 patients, and all literature quality was evaluated as "B" grade. The meta-analysis showed that Endostar combined with platinum had an advantage over platinum alone in terms of response rate of effusions (76% vs 48%, RR=1.63, 95%CI: 1.50-1.78, P<0.00001) and improvement rate in quality of life (69% vs 44%, RR=1.57, 95%CI: 1.42-1.74, P<0.00001). As for safety, there was no significant difference between the two groups in the incidences of nausea and vomiting (35% vs 34%, RR=1.01, 95%CI: 0.87-1.18, P=0.88), leucopenia (38% vs 38%, RR=1, 95%CI: 0.87-1.15, P=0.99), and renal impairment (18% vs 20%, RR=0.86, 95%CI: 0.43-1.74, P=0.68). Conclusions: Endostar combined with platinum by intraperitoneal perfusion is effective for malignant serous effusions, and patient quality of life is significantly improved without the incidence of adverse reactions being obviously increased.

• Journal of Gastric Cancer
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• 제8권3호
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• pp.148-153
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• 2008

목적: 위암의 재발로 발생한 악성 장폐쇄증은 치료의 효과와 생존율을 향상시키기 위하여 적합하게 치료되어야 한다. 본 연구에서는 위암으로 수술 후 재발되어 악성 장폐쇄증이 발생한 경우 수술 방법에 따른 치료 효과와 생존율의 차이를 알아보았다. 대상 및 방법: 1998년 1월부터 2008년 3월까지 위암의 재발로 악성 장폐쇄증이 발생하여 수술적 치료를 받은 환자들의 의무 기록을 후향적으로 분석하였다. 수술 방법은 절제술, 장루술, 우회술로 나누었고 치료의 성공은 유동식 이상의 경구 섭취가 가능한 것으로 보았다. 결과: 42명의 환자에 대해 46회의 수술이 시행되었으며 절제술이 12회, 장루술이 24회, 위회술이 10회이었다. 입원기간과 유동식 이상의 경구 섭취까지의 기간은 장루술이 가장 짧았다. 수술 후 합병증은 10예(21.7%)에서 있었고 수술 후 30일 이내에 사망한 경우는 4예(8.7%)이었다. 수술 방법에 따른 생존율의 차이는 없었다. 결론: 위암의 재발로 발생한 악성 장폐쇄증의 수술적 치료로 장루술은 입원일과 경구 섭취까지의 기간이 다른 수술법에 비해 짧기 때문에 일부 환자들에서 좋은 선택이 될 수 있다. 수술 방법에 따른 생존율의 차이는 없었으며 이는 악성 장폐쇄증의 경우 근치적 수술이 어려운 경우가 대부분이기 때문으로 생각된다.

• Journal of Gastric Cancer
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• 제1권1호
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• pp.50-54
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• 2001

Purpose: The aim of this study was to analyze the outcomes of patients with gastrointestinal stromal tumors(GISTs) of the stomach who were treated in our hospital. Materials and Methods: We retrospectively studied 31 patients who were treated for primary gastrointestinal stromal tumors of the stomach from 1990 to 1999 at Korea University Guro Hospital. Clinical characteristics, including age, sex and tumor size were analyzed. In addition, the relation between the 5-year survival rate and tumor size, operative procedure, and malignancy were analyzed to identify the factors that predict survival. Results: The malignant GISTs were 11 cases, borderline GISTs were 2 cases, and benign GISTs were 18 cases. The overall 5-year cumulative survival rate of the patients was $84.6\%$, and the 5-year survival rates according to malignancy were $100\%$ for benign and borderline GISTs and $78.1\%$ for malignant GISTs, p=0.1119. The 5-year survival rates according to tumor size were $100\%$ for tumor sizes smaller than 5 cm and $78.4\%$ for tumor sizes larger than 5 cm, p=0.0453. The 5-year survival rate according to lymph node dissection during operative procedure of malignant GISTs was not significant statistically. Conclusions: GISTs of the stomach are infrequently encountered tumors. Tumor size was the most important factor for predicting survival in a clinical situation, and performing a complete resection of the tumor, especially tumors larger than 5 cm, will improve the outcome of treatment.

• 대한방사선기술학회지:방사선기술과학
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• 제40권2호
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• pp.237-243
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• 2017

본 연구는 갑상샘 초음파 영상에서 정상 및 악성결절의 세포병리 진단결과를 바탕으로 GLCM 알고리즘분석을 통한 후향적 연구를 시행하여 컴퓨터보조진단의 적용 가능성을 평가하였다. GLCM 알고리즘의 6가지 파라미터를 이용한 갑상샘 악성결절의 인식률 평가와 ROC 곡선을 분석하였다. 실험 결과는 에너지 97%, 대조도 93%, 상관관계 92%, 동질성 92%, 엔트로피 100%, 분산 100%의 높은 질환인식률을 나타내었다. ROC 곡선 분석에서 각 파라미터의 곡선아래면적이 0.947(p=0.001) 이상을 나타내어 갑상샘 악성결절의 인식에 의미가 있는 결과로 나타났다. 또한 GLCM에서 각 파라미터의 cut-off값 결정으로 정량적인 컴퓨터보조진단의 분석을 통한 질환예측이 가능할 것으로 판단된다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권21호
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• pp.9391-9394
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• 2014

Purpose: To evaluate the effect of internal-external percutaneous transhepatic biliary drainage (IEPTBD) for patients with malignant obstructive jaundice. Methods: During the period of January 2008 and July 2013, internal-external drainage was performed in 42 patients with malignant obstructive jaundice. During the procedure, if the guide wire could pass through the occlusion and into the duodenum, IEPTBD was performed. External drainage biliary catheter was placed if the occlusion was not crossed. Newly onset of infection, degree of bilirubin decrease and the survival time of patients were selected as parameters to evaluate the effect of IEPTBD. Results: Twenty newly onset of infection were recorded after procedure and new infectious rate was 47.6%. Sixteen patients with infection (3 before, 13 after drainage) were uncontrolled after procedure, 12 of them (3 before, 9 after drainage) died within 1 month. The mean TBIL levels declined from 299.53 umol/L before drainage to 257.62 umol/L after drainage, while uninfected group decline from 274.86 umol/L to 132.34 umol/Lp (P < 0.5). The median survival time for uninfected group was 107 days, and for infection group was 43 days (P < 0.05). Conclusions: The IEPTBD drainage may increase the chance of biliary infection, reduce bile drainage efficiency and decrease the long-term prognosis, and the external drainage is a better choice for patients with malignant obstructive jaundice need to biliary drainage.