• Title/Summary/Keyword: Primary Medical Center

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An Epidemiologic Study of Metastatic Bone Tumor (전이성 골종양의 역학적 연구)

  • Kim, Jae-Do;Lee, Duk-Hee;Park, Jeong-Ho;Son, Young-Chan;Hong, Yonng-Gi;Son, Jeong-Hwan
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.38-44
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    • 1995
  • Metastatic bone tumor is the most common bone tumor and 32.5% of all primary malignant tumors are eventually metastasize to bone. Metastatic bone tumor has been more frequently encountered disease in the orthopedic fields due to the greater longevity of life of the patients with primary visceral cancers by major advances in early detection, diagnosis, and surgical/radiotherapeutic/chemotherapeutic treatment of primary and metastatic lesions. Therefore, the epidemiologic data about the incidences and the patterns of bone metastasis is important. We reviewed 417 patients who were diagnosed and treated for metastatic bone tumor at Kosin University Medical Center from 1985 to 1993 to analyse the primary lesion, age and sex distributions, location of bone metastasis, patterns of metastasis according to the primary. The results were as follows : 1. The common origin of bone metastasis were lung(29.5%), stomach(15.3%), breast(11.3%), unknown(7.7%), cervix(5.3%), liver(4.8%) in order of frequency. 2. There were 251 men and 166 women and their mean age was 54.8 years and the peak age incidence was in 6th decades. Most cases(85.3%) were occured beyond 5th decades. 3. The preferred sites of metastatic deposits were spine(64.0%), pelvis(40.5%), rib(38.8%), femur(36.7%), skull(21.1%), humerus(13.9%), scapula(13.0%) in order of frequency. In the spine, thoracic(42.1%), lumbar(39.1%), cervical(13.2%), sacral(5.6%) vertebrae were involved in order of frequency. 4. Multiple bone metastases were more common(73.1%) than single metastasis(26.9%). 5. In the lung cancer, the peak age incidence was 6th decades, and the preferred sites of bone metastasis were spine, pelvis, femur. 6. In the stomach cancer, the peak age incidence was 6th decades, and the preferred sites of bone metastasis were spine, femur, pelvis. 7. In the breast cancer, the peak age incidence was 5th decades, and the preferred sites of bone metastasis were spine, rib, pelvis. 8. In the bone metastasis with unknown primary site, the peak age incidence was 7th decades, the preferred sites of bone metastasis were spine, femur, pelvis, and the common histologic types were adenocarcinoma and squamous cell carcinoma.

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Paclitaxel-Coated Balloon versus Plain Balloon Angioplasty for Dysfunctional Autogenous Radiocephalic Arteriovenous Fistulas: A Prospective Randomized Controlled Trial

  • Jong Woo Kim;Jeong Ho Kim;Sung Su Byun;Jin Mo Kang;Ji Hoon Shin
    • Korean Journal of Radiology
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    • v.21 no.11
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    • pp.1239-1247
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    • 2020
  • Objective: To report the mid-term results of a single-center randomized controlled trial comparing drug-coated balloon angioplasty (DBA) and plain balloon angioplasty (PBA) for the treatment of dysfunctional radiocephalic arteriovenous fistulas (RCAVFs). Materials and Methods: In this prospective study, 39 patients (mean age, 62.2 years; 21 males, 18 females) with RCAVFs failing due to juxta-anastomotic stenosis were randomly assigned to undergo either both DBA and PBA (n = 20, DBA group) or PBA alone (n = 19, PBA group) between June 2016 and June 2018. Primary endpoints were technical and clinical success and target lesion primary patency (TLPP); secondary outcomes were target lesion secondary patency (TLSP) and complication rates. Statistical analysis was performed using the Kaplan-Meier product limit estimator. Results: Demographic data and baseline clinical characteristics were comparable between the groups. Technical and clinical success rates were 100% in both groups. There was no significant difference between the groups in the mean duration of TLPP (DBA group: 26.7 ± 3.6 months; PBA group: 27.0 ± 3.8 months; p = 0.902) and TLSP (DBA group: 37.3 ± 2.6 months; PBA group: 40.4 ± 1.5 months; p = 0.585). No procedural or post-procedural complications were identified. Conclusion: Paclitaxel-coated balloon use did not significantly improve TLPP or TLSP in the treatment of juxta-anastomotic stenosis of dysfunctional RCAVFs.

Immunohistochemical Expressions of Sodium/Iodide Symporter (NIS) and Thyroid Transcription Factor-l (TTF-1) and Their Relationship in Primary Pulmonary Adenocarcinoma

  • Lee Kyung-Eun;Kang Do-Young;Choi Phil-Jo;Hong Young-Seoub;Roh Mee-Sook;Shon Jae-Jeong;Lee Jung-Min;Hwang Soo-Myoung
    • Biomedical Science Letters
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    • v.12 no.3
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    • pp.171-176
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    • 2006
  • Sodium iodide symporter (NIS) plays a key role in thyroid hormone production by efficiently accumulating iodide from the circulating blood into the thyocytes, and this is done against an electrochemical gradient. Thyroid transcription factor-l (TTF-l) is a homeodomain-containing protein expressed in embryonic diencephalons, thyroid, and lung and has been found to bind to thyroid specific promoters and to activate their transcriptional activity. TTF-l may be one of the factors capable of activating NIS gene expression in the thyroid gland, thus it accounts for the lower levels of NIS gene expression that are seen in the extrathyroidal tissues. However, a high frequency of TTF-l expression has been observed, especially in primary lung adenocarcinoma. The present study was undertaken in order to elucidate the relationship between the expression of NIS and TTF-l in primary lung adenocarcinoma. Immunohistochemical studies for NIS and TTF-l were performed in 64 primary lung adenocarcinomas. Immunoreactivities for NIS and TTF-l were found in 49 (76.6%) and 45 (70.3%) out of 64 cases, respectively. Forty-one (83.7%) of the 49 cases with positive NIS immunoreactivity showed positive TTF-l expression, whereas 11 (73.3%) of the 15 cases with negative NIS immunoreactivity showed negative TTF-l expression (P<0.05). So the NIS expression was significantly associated with the TTF-l expression. These findings suggest that TTF-l may be one of the factors capable of activating NIS gene expression in primary lung adenocarcinoma. Further studies are needed to define the relation between NIS and TTF-l for examining the mechanisms of tissue-specific NIS expression.

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Clinical Features and Prognostic Factors in 41 Patients of Primary Nasal/Nasopharyngeal Non-Hodgkin's Lymphoma: Prognostic Significance of Immunophenotype (비/비인강 비호즈킨 림프종의 임상양상과 예후 인자 : 면역 표현형의 임상적 의의)

  • Park Soon-Seo;Park Jong-Beom;Suh Cheol-Won;Park Ji-Woon;Lim Soo-Duk;Huh Joo-Ryung;Nam Soon-Yuhl;Kim Sang-Yoon;Lee Ho-Gyu;Chang Hye-Sook;Kim Tae-Won;Lee Je-Hwan;Kim Sung-Bae
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.2
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    • pp.149-155
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    • 1999
  • Objectives: To study the clinical features of the primary nasal/nasopharyngeal non-Hodgkin's lymphomas and to evaluate the implication of immunophenotyping as a prognostic factor. Patients and Methods: From January 1990 to December 1997,41 patients(median age, 41 years) of primary nasal/nasopharyngeal non-Hodgkin's lymphoma were studied. The clinical records and paraffin-embedded tissue blocks were reviewed retrospectively. The histologic features, immunophenotypic findings(pan-T, pan-B, CD3, CD56) and Epstein-Barr virus in situ hybridizatios were examined. The prognostic factors for clinical outcome were evaluated in these patients. According to Ann-Arbor system, there were 30 patiets(73%) with stage IE, 4(10%) with stage IIE, 3(7%) with stage IIIE, 4(10%) with stage IVE lymphoma. Among the patients with stage IE/IIE, 4 patients received local radiation alone, 4 received chemotherapy alone, 25 received combination chemotherapy and radiotherapy and 1 refused treatment. The patients with stage IIIE/IVE were given combination chemotherapy and radiotherapy. Results: Immunophenotyping were performed in 40 patients and staining results were as follows: 3(7%) patients with B cell, 17(42%) with T cell, 18(44%) with NK/T cell(CD56 positive), and two patients with unclassifiable result. Epstein-Barr(EB) virus in situ hybridization were performed in 28 patients and 23(82%) patients had positive EBV-encoded RNAs(EBERs). 21(55%) patients achieved a complete remission. There was no difference in complete remission between radiation alone and combination therapy. With median follow-up of 30 months, 5-years disease free survival of complete responders was 60% and 5-years overall survival rate was 36%. Multivariate analysis showed that better overall survival was related with absence of B symptoms, ECOG performance${\leq}1$ and non-NK cells. Conclusion: Most of all cases were positive for EBER. Since NK/T phenotype carried the worst prognosis, analysis for CD56 expression should be done. Further prospective studies were warranted to evaluate the role of chemotherapy in stage IE/IIE.

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Multiple Primary Brain Tumors - Case Report - (원발성, 다발성 뇌종양 - 증례보고 -)

  • Lyo, In Uk;Suh, Jae Hee;Kwon, Yang
    • Journal of Korean Neurosurgical Society
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    • v.30 no.7
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    • pp.925-927
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    • 2001
  • Multiple intracranial tumors of different cell types are rare. We report a case of double primary intracranial tumors of different histologic types : oligodendroglioma, and pituitary adenoma. Von Recklinghausen's disease or other etiologic factors supposedly associated with multiple brain tumors were not recognized in this 36-year-old male patient.

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Long-term outcomes after stent insertion in patients with early and late hepatic vein outflow obstruction after living donor liver transplantation

  • Kim, Kyeong Sik;Lee, Ji Soo;Choi, Gyu Sung;Kwon, Choon Hyuck David;Cho, Jae-Won;Lee, Suk-Koo;Park, Kwang Bo;Cho, Sung Ki;Shin, Sung Wook;Kim, Jong Man
    • Annals of Surgical Treatment and Research
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    • v.95 no.6
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    • pp.333-339
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    • 2018
  • Purpose: The purpose of this study was to describe the long-term effects of stenting in patients with hepatic venous outflow obstruction (HVOO), who underwent living donor liver transplantation (LDLT). Methods: Between January 2000 and December 2009, 622 adult patients underwent LDLT at our hospital, and of these patients, 21 (3.3%) were diagnosed with HVOO; among these patients, 17 underwent stenting. The patients were divided into early or late groups according to the time of their HVOO diagnoses (cutoff: 60 days after liver transplantation). Results: The median follow-up period was 54.2 months (range, 0.5-192.4 months). Stent insertion was successful in 8 of 10 patients in the early group and 6 of 7 in the late group. The 5-year primary patency rates were 46% and 20%, respectively. In both groups, patients with recurrent HVOO at the beginning showed kinking confirmed by venography. Patients who carried their stents for more than 3 years maintained long-term patency. There was no significant difference in spleen size between groups; however, when the groups were compared according to whether they maintained patency, spleens tended to be smaller in the patency-maintained group. Conclusion: Unlike stenosis, if kinking is confirmed on venography, stenting is not feasible in the long term for patients with LDLT.

Current Evidence for a Paradigm Shift in Gastric Cancer Prevention From Endoscopic Screening to Helicobacter pylori Eradication in Korea

  • Kim, Young-Il;Choi, Il Ju
    • Journal of Gastric Cancer
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    • v.22 no.3
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    • pp.169-183
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    • 2022
  • Gastric cancer is prevalent in Korea and ranked as the third most common cancer in 2019, followed by lung and thyroid cancers. The National Cancer Screening Program (NCSP) for gastric cancer has been implemented in adults aged ≥ 40 since 1999 and involves endoscopic screening every 2 years. The beneficial effects of the current NCSP on early cancer detection, cost-effectiveness, and mortality reduction are evident. However, the screening program results in a large socioeconomic burden and the consumption of medical resources, as it focuses solely on secondary prevention (early detection) rather than primary prevention of cancer. Helicobacter pylori is defined as a group I carcinogen by the International Agency for Research on Cancer. Hence, its eradication has been suggested as an important primary gastric cancer prevention strategy. Well-designed randomized controlled trials involving high-risk groups (post-endoscopic resection of early gastric cancer and family history of gastric cancer) and long-term follow-up studies in the general population have provided high-quality evidence regarding the effects of H. pylori eradication on gastric cancer prevention. In this review, we discussed the evidences for a possible modification of the current gastric cancer secondary prevention strategy by introducing primary prevention through H. pylori eradication. Areas for future research to optimize primary prevention strategies were also suggested.

Long-term Surgical Outcomes in Oligometastatic Non-small Cell Lung Cancer: A Single-Center Study

  • Seungmo Yoo;Won Chul Cho;Geun Dong Lee;Sehoon Choi;Hyeong Ryul Kim;Yong-Hee Kim;Dong Kwan Kim;Seung-Il Park;Jae Kwang Yun
    • Journal of Chest Surgery
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    • v.56 no.1
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    • pp.25-32
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    • 2023
  • Background: We reviewed the clinical outcomes of patients with oligometastatic (OM) non-small cell lung cancer (NSCLC) who received multimodal therapy including lung surgery. Methods: We retrospectively analyzed 117 patients with OM NSCLC who underwent complete resection of the primary tumor from 2014 to 2017. Results: The median follow-up duration was 2.91 years (95% confidence interval, 1.48-5.84 years). The patients included 73 men (62.4%), and 76 patients (64.9%) were under the age of 65 years. Based on histology, 97 adenocarcinomas and 14 squamous cell carcinomas were included. Biomarker analysis revealed that 53 patients tested positive for epidermal growth factor receptor, anaplastic lymphoma kinase, or ROS1 mutations, while 36 patients tested negative. Metastases were detected in the brain in 74 patients, the adrenal glands in 12 patients, bone in 5 patients, vertebrae in 4 patients, and other locations in 12 patients. Radiation therapy for organ metastasis was performed in 81 patients and surgical resection in 27 patients. The 1-year overall survival (OS) rate in these patients was 82.8%, and the 3- and 5-year OS rates were 52.6% and 37.2%, respectively. Patients with positive biomarker test results had 1-, 3-, and 5-year OS rates of 98%, 64%, and 42.7%, respectively. These patients had better OS than those with negative biomarker test results (p=0.031). Patients aged ≤65 years and those with pT1-2 cancers also showed better survival (both p=0.008). Conclusion: Surgical resection of primary lung cancer is a viable treatment option for selected patients with OM NSCLC in the context of multimodal therapy.

Roles of Korean Medicine in Restructuring Public Health Service of Korea ((참여)정부의 보건의료 Infra개편과정에서 한의학의 참여방안 -공공의료를 중심으로-)

  • Lee, Sun-Dong
    • Journal of Society of Preventive Korean Medicine
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    • v.9 no.2
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    • pp.17-41
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    • 2005
  • Current Korean medical system is evaluated as inefficient and the government is planning a new medical development plan to provide guaranteed life-long medical service and more efficient medical system Korean medicine also needs to participate as the primary medical provider and strengthen public recognition. The needs for active participation are essential to prevent irrational medical policies and Korean medicine can exercise medical merits. When the doctors of Korean medicine are recognized as the primary medical provider, not only social rights are served but also provide medical service to less privileged sector of the society. This calls for the establishment of system for attending physician and public health doctor from Korean medicine. Another important issue is the establishment of public medical service at the government level. Doctors of Korean medicine should be posted at the national health center and other public hospitals. Revision of the current policies on Korean medicine must be made to yield concrete outcome of the public Korean medicine service as well as cooperation between the conventional allopathic medical community and the Korean medical community

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