• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.1759-1767
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• 2016

Background: Uterine sarcoma is a group of rare gynecologic tumors with various natures, and different lines of treatment. Most have a poor treatment outcome. This study targeted clinical characteristics, treatment, overall survival (OS), progression-free survival (PFS), and prognostic factors in uterine sarcoma patients in one tertiary center for cancer care. Materials and Methods: Uterine sarcoma patients who were treated at the Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital between January 1994 and December 2014 were identified. Clinico-pathological data were analyzed. Prognostic outcomes were examined by Kaplan-Meier curves and Cox regression analysis. Results: We identified 46 uterine sarcoma patients: 25 carcinosarcoma (CS) (54.3%), 15 leiomyosarcoma (LMS) (32.6%), and 6 undifferentiated uterine sarcoma (UUS) (13.1%) cases. Mean age was $54.0{\pm}11.9years$ (range 25-82 years). Abnormal uterine bleeding was the most common presenting symptom (63.0%). Among 33 patients (71.7%) who had pre-operative tissue collected, diagnosis of malignancy was correct in 29 (87.9%). All patients received primary surgery and retroperitoneal lymph nodes were resected in 34 (73.9%). After surgery, 5 (10.9%) had gross residual tumors. Stage I disease was most commonly found (56.5%). Adjuvant treatment was given to 27 (58.7%), most commonly chemotherapy. After a median follow-up of 16.0 months (range 0.8-187.4 months), recurrence was encountered in 22 patients (47.8%). Median time to recurrence was 5.8 months (range1.0-105.5 months). Distant metastasis was more common than local or locoregional failure. The 2-year PFS was 45.2% (95% confidence interval [CI], 30.6%-59.7%) and the 2-year OS was 48.3% (95% CI, 33.3%-60.7%). Multivariable analyses found residual disease after surgery as a significant factor only for PFS. Conclusions: Uterine sarcoma is a rare tumor entity. Even with multimodalities of treatment, the prognosis is still poor. Successful cytoreductive surgery is a key factor for a good survival outcome.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.1887-1893
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• 2012

The aim of this study was to detail characteristics of mammary Paget's disease (PD) representing the whole population in China. A total of 4211 female breast cancer inpatients at seven tertiary hospitals from seven representative geographical regions of China were collected randomly during 1999 to 2008. Data for demography, risk factors, diagnostic imaging test, physical examination and pathologic characters were surveyed and biomarker status was tested by immunohistochemistry. The differences of demography and risk factors between PD with breast cancer and other lesions were compared using Chi-square test or t-test, with attention to physical examination and pathological characters. The percentage of PD was 1.6% (68/4211) in all breast cancers. The mean age at diagnosis was 48.1, and 63.2% (43/68) patients were premenopausal. There is no difference in demography and risk factors between PD with breast cancer and other breast cancer (P > 0.05). The main pattern of PD in physical exam and pathologic pattern were patients presenting with a palpable mass in breast (65/68, 95.6%) and PD with underlying invasive cancer (82.4%, 56/68) respectively. The rate of multifocal disease was 7.4% (5/68). PD with invasive breast cancer showed larger tumor size, more multifocal disease, lower ER and PR expression and higher HER2 overexpression than those in other invasive breast cancer (P < 0.05). These results suggested that PD in China is a concomitant disease of breast cancer, and that PD with underlying invasive cancer has more multiple foci and more aggressive behavior compared with other breast invasive cancer. We address the urgent needs for establishing diagnostic and therapeutic guidelines for mammary PD in China.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5355-5360
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• 2013

Background: Clarifying the prognostic impact of histological type is an essential issue that may influence the treatment and follow-up planning of newly diagnosed cervical cancer cases. This study aimed to evaluate the prognostic impact of histological type on survival and mortality in patients with cervical squamous cell carcinoma (SCC), adenocarcinoma (ADC) and small cell neuroendocrine carcinoma (SNEC). Materials and Methods: All patients with cervical cancer diagnosed and treated at Chiang Mai University Hospital between January 1995 and October 2011 were eligible. We included all patients with SNEC and a random weighted sample of patients with SCC and ADC. We used competing-risks regression analysis to evaluate the association between histological type and cancer-specific survival and mortality. Results: Of all 2,108 patients, 1,632 (77.4%) had SCC, 346 (16.4%) had ADC and 130 (6.2%) had SNEC. Overall, five-year cancer-specific survival was 60.0%, 54.7%, and 48.4% in patients with SCC, ADC and SNEC, respectively. After adjusting for other clinical and pathological factors, patients with SNEC and ADC had higher risk of cancer-related death compared with SCC patients (hazard ratio [HR] 2.6; 95% CI, 1.9-3.5 and HR 1.3; 95% CI, 1.1-1.5, respectively). Patients with SNEC were younger and had higher risk of cancer-related death in both early and advanced stages compared with SCC patients (HR 4.9; 95% CI, 2.7-9.1 and HR 2.5; 95% CI, 1.7-3.5, respectively). Those with advanced-stage ADC had a greater risk of cancer-related death (HR 1.4; 95% CI, 1.2-1.7) compared with those with advanced-stage SCC, while no significant difference was observed in patients with early stage lesions. Conclusion: Histological type is an important prognostic factor among patients with cervical cancer in Thailand. Though patients with SNEC were younger and more often had a diagnosis of early stage compared with ADC and SCC, SNEC was associated with poorest survival. ADC was associated with poorer survival compared with SCC in advanced stages, while no difference was observed at early stages. Further tailored treatment-strategies and follow-up planning among patients with different histological types should be considered.

• IMMUNE NETWORK
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• 제6권1호
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• pp.43-51
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• 2006

Background: The DR-$70^{TM}$ immunoassay is a newly developed cancer diagnostic test which quantifies the serum fibrin degradation products (FDP), produced during fibrinolysis, by antibody reaction. The purpose of this study was to evaluate the potential of DR-$70^{TM}$ Immunoassay in screening malignant tumor. Methods: Sample subjects were 4,169 adults, both male and female, who visited the health promotion center of a general hospital from March 2004 to April 2005 and underwent the DR-$70^{TM}$ immunoassay test and other tests for cancer diagnosis. The patient group was defined as 42 adults out of the sample subjects who were newly diagnosed with cancer during the same time period when the DR-$70^{TM}$ immunoassay test was performed. Final confirmation of a malignant tumor was made by pathological analysis. Results: The mean DR-$70^{TM}$ level was $0.83{\pm}0.65{\mu}g/ml$ (range: 0.00 (0.0001)${\sim}7.42{\mu}g/ml)$ in the control group (n=4,127) as opposed to $2.70{\pm}2.33{\mu}g/ml$ (range: $0.12{\sim}9.30{\mu}g/ml)$ in the cancer group (n=42), and statistical significance was established (p<0.0001, Student t-test). When categorized by the type of malignant tumor, all cancer patients with the exception of the subgroups of colon and rectal cancer showed significantly higher mean DR-$70^{TM}$ levels compared with the control group (p<0.0001, Kruscal-Wallis test). The receiver operating characteristic (ROC) curve analysis revealed ${\geq}1.091{\mu}g/ml$ as the best cut-off value. Using this cut-off value, the DR-$70^{TM}$ immunoassay produced a sensitivity of 71.4%, a specificity of 70.1%, a positive predictability of 69.4%, and a negative predictability of 69.2% (1). Conclusion: A significant increase in the mean DR-$70^{TM}$ value was observed in the cancer group (thyroidal, gastric, breast, hepatic and ovarian) com pared with the control group. In particular, the specificity and sensitivity of the DR-$70^{TM}$ immunoassay was relatively high in the subgroups of breast, gastric, and thyroidal cancer patients. There is need for further studies on a large number of malignant tumor patients to see how the DR-$70^{TM}$ level might be changed according to the differentiation grade and postoperative prognosis of the malignant tumor.

• 동의생리병리학회지
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• 제22권1호
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• pp.13-24
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• 2008

This Chapter mentioned Terror and Palpitation due to Fright(驚悸) and Hemorrhagic disease(血證). Terror and Palpitation due to FrightAcctually Terror(驚) is different from Palpitation(悸). Terror(驚) is one of the seven emotions. But in this case, It refer to the Palpitation and the uneasiness of mind due to one's hearing a strange sound of seeing a strange. Tremulous Pulse can be appear. So Terror(驚) is caused by Exopathic Factors(外因) and belongs to Excess syndrome(實證). Palpitaion(悸) is the sensation of plamus, palpitation and unrest not because of being frightened. It is usurally caused by the deficiency of Ki(氣) and blood(血). So Deep, Thready and weak pulse can be appear. So Palpitaion(悸) is caused by Endopathic Factors and belongs to Deficiency Syndrome. In this Chapter, Terror and Palpitation due to Fright(驚悸) treat with the Kyeji-ke-jakyak-ka-chokchil-moryu-yongkol-kuyuk-tang(桂枝去芍藥加蜀漆牡蠣龍骨救逆湯) and Banha-mahwang-hwan(半夏麻黃丸). There are two type in Hemorrhagic disease(血證). One is bleeding(出血) and another is blood stasis(瘀血). The contents which relate with the Hemorrhagic disease(血證) are Hematemisis(吐血), Rhinorrhagia, Hemafecia(下血). In hemorrhage pathological mechanisms, there are two mechanisms. One is that Fire and Heat(火熱) pressure blood. Another is that cold and deficiency(虛寒) disable Ki(氣) from keeping blood flowing within vessels. Blood stasis(瘀血) can be called Extravasated Blood(惡血), Coagulated Blood, Blood retention(蓄血,積血), Dead Blood(死血) and Emaciation due to Blood disorder(乾血). It refer to a morbid state of unsmooth circulation and blood stagnancy often resulting from Ki(氣) stagnation, Ki(氣) deficiency and accumulation of pathogenic coldness. The symptom of Blood stasis are 'Fullness sensation in the chest, Lip Flaccidity, Cyonotic Tongue and Dryness of Mouth'. And the man who have Blood stasis, want to rinse his mouth with the water, but he can't drink the water because there isn't interior Heat of Excess Type. The symptom of Cyonotic Tongue(舌靑) had influence on diagnosing Blood stasis(瘀血) in offspring.

• 대한핵의학회지
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• 제12권2호
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• pp.33-40
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• 1978

Clinical features of 147 patients with biopsy-proven thyroid carcinomas were investigated from January, 1972 to April, 1978 at the Seoul National University Hospital with the following results. 1) The incidence of thyroid carcinomas according to their histopathological classification revealed 76.2% of papillary carcinoma, 19.0% of follicular carcinoma, and 3 cases of occult sclerozing carcinoma, 1 case of giant cell carcinoma and 1 case of metastatic melanoma. 2) The ratio of male to femle patients was 1:8.3 and showed no difference between papillary and follicular carcinomas. 3) The age distribution showed the peak incidence in the fourth decade (29.3%) followed by the fifth and sixth decades. 4) The average duration of illness from the onset of symptoms was about 5 years while it was 4.4 years and 7.6 years in the papillary and follicular carcinomas respectively. 5) The diameter of the thyroid masses was smaller than 5 cm in 53.6% of the patients, from 5 cm to 10 cm in 40.0% and larger than 10 cm in 6.4%. 6) In 36.4% of the patients with thyroid carcinomas the thyroid masses were fixed to adjacent tissues. 7) Metastasis to the regional lymph nodes was noted in 40.0% of the total cases, and in 45.2% and 17.6% of the papillary and follicular carcinomas respectively, while the lung and bone metastases were found in 10.0% and 4.4% in each type respectively. 8) 88.9% of the patients showed cold areas in the thyroid scans using $^{131}I$. 9) Typical psammoma bodies were observed in 21.3% of the cases in the microscopic examination of the pathological specimens. 10) The initial diagnosis of thyroid malignancy could be made before histological confirmation in 64.5% of the patients. 11) The clinical staging slightly modified from Schulz method revealed 43.6% of the patients in stage I, 26.4% in stage II, 20.9% in stags III and 9.1 % in stage IV. 12) The association with Hashimoto's thyroiditis was noted in 4 cases, with nodular goiter in 3 cases, and with follicular adenoma in 1 case.

• 대한한방내과학회지
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• 제15권2호
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• pp.383-417
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• 1994

By making use of the EAV(Electroacupuncture acc. Voll) combined meridian theory of oriental medicine with electronics which was contrived to recognize the physiological and pathological changes of human body, the following conclusions were made in comparison with EAV measurements and types of symptoms(anxiety & headache, fatigue, palpitation, dizzness, abdominal distension. nausea, gastric disturbance. constipation & diarrhea, fatty liver, cva), QSCC, and blood type test. 367 patients including 124 with nervous gastrointestinal problems were selected for this research. 1. From the point of variance of the tested patients 124 nervous gastrointestinal patients, Liver meridian and Spleen meridian showed hyperenergia and Large intestine meridian, Circulation meridian, Triple warmer meridian showed hypoergia 2. In each symptom as the nervous gastrointestinal symptom Liver meridian showed hyperenergia, Large intestine meridian, Circulation meridian and Triple warmer meridian showed hypoergia . 3. In an objective comparison with other symptoms, firstly among the headache & anxiety group left Gall Bladder, Triple warmer and Stomach meridian showed remarkable hypoergia, secondly among fatigue group showed hypoergia in Triple warmer meidian and hyperenergia of Stomach meridian. and thirdly among palpitation group showed hypoergia of Kidney meridian, and lastly among dizzness group showed hypoergia of Gall Bladder, Stomach, Circulation and Small intestine meridian. 4. All of gastric disturbance, nausea, abdominal distention, constipation and diarrhea group showed hyperenergia in Stomach meridian and Spleen meridian. gastric disturbance group showed remarkably hypoergia in Circulation. Small intestine, Lung and Large intestine meridian. Nausea group showed hypoergia in Gall bladder and Urinary bladder meridian. Abdominal distenton group showed hypoergia of Large intestine. Constipation and diarrhea group showed hypoergia of Kidney and left Circulation meridian. 5. Fatty liver group showed hyperenergia of Liver meridian of 83.3%, Gall Bladder, Stomach and Spleen meridian. Urinary bladder and Kidney meridian showed hypoergia 6. CVA group showed hyperenergia in Liver and Circulation meridian. 7. Blood type in typical classification had no significant bearings on each other. 8. QSCC for the attempt of objective materials of constitutional diagnosis had no correlativity in comparison with EAV measurements. In conclusion EAV is thought be used as a diagnostic method in oriental medicine and further research is needed regarding it can be used as a useful method for verifying the characteristics and early finding of symptoms.

• 대한두경부종양학회지
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• 제14권2호
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• pp.228-235
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• 1998

Objectives: Papillary microcarcinoma of the thyroid was evaluated as to the effectiveness of diagnostic modalities, lymphatic spread pattern, and therapeutic decision according to tumor size. Material and Methods: We retrospectively analyzed a clinicopathologic findings of 72 papillary microcarcinoma patients who were treated at the over 11 years between 1985 and 1995. The authors divided papillary microcarcinoma of the thyroid into two subgroups according to tumor size: $0{\leqq}5mm$ and $5<0{\leqq}10mm$. An analysis including age and gender distribution, diagnostic tools(thyroid sonogram, thyroid scan, thyroid function test, fine needle aspiration cytology, frozen section), pathological examination of lymphnode, and surgical procedures was carried out in each subgroups. Results: The carcinoma of smaller than 5mm were found in 32 patients, and of 6 -10mm were in 40 patients. The average age of patients was 45years and all of them were female. Cold nodules on thyroid scan were noticed in 53 patientss and normal findings were in 15 patients. Suspicious malignant lesions(fine calcification, solid mass, irregular margin) on thyroid sonography were detected in 23 patients and the sonography was more useful in detecting $0{\leqq}5mm$ small sized lesions than other diagnostic methods. FNAC were performed in 17 patients, and 7 patients were diagnosed as having thyroid papillary cancer. But diagnotic rate in $0{\leqq}5mm$ small sized lesions was very low(one of eights).Frozen section were performed in all patients, among these 15 patients were diagnosed as being benign diseases and false negative rates were higher in $0{\leqq}5mm$ small sized lesions than in $5<0{\leqq}10mm$ sized lesions(p-value<0.006). Only thyroidectomies were performed in 24 patients and thyroidectomy with node dissections in 48 patients. The lymphnode metastatic rates were much higher in multifocal lesions(61.5%) than in single lesion. The incidence of cervical lymphnode metastasis was 19.4% in $0{\leqq}5mm$ sized lesions and 47.9% in $5<0{\leqq}10mm$ sized lesions. Postoperative management were performed with TSH suppression therapy(T4, synthroid) in all patients and RI therapy in 29 patients. Conclusion: On the basis of our study, improved preoperative diagnostic tools for papillary microcarcinoma of the thyroid was helpful in the choice of surgical treatment. As a result of techninological progress(ultrasonography, FNAC), the pencentage of the discovery of papillary microcarcinoma has been increased. The thyroid ultrasonography was useful in detecting small sized lesions($0{\leqq}5mm$), but FNAC may not be beneficial in detecting small sized lesions($0{\leqq}5mm$). In the surgical procedure, thyroid lobectomy alone should be avoided because of the high rate of bilaterality and multifocality.

• 생명과학회지
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• 제30권7호
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• pp.630-633
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• 2020

야생 포유류의 신부전 증후군은 거의 보고가 없다. Muskrat (Ondatra zibethicus)는 중간 크기의 설치류이며 많은 질병을 가지고 있으나, 신부전 증후군은 보고된 바가 없으며, 본 케이스는 병리학적 진단을 위해 6개월령 암컷 사향쥐의 다른 임상증후군 없는 상태로 부검을 실시하였다. 요관, 신장결석과 수진증을 관찰하였고, 결석에 의한 심각한 신장 손상과, 뇌 손상을 포함한 전신 출혈과 석회화가 관찰되었고, 이는 신장 손상으로 인한 요로결석과 장기 손상에 기인한 것이다. 괴사 및 미세석회화는 신장 피질 및 수질에서, 특히 근위 곡 세뇨관 및 신장의 수집관에서 검출되었다. 사구체의 초자양변성이 크게 관찰되었으며 이는 만성 신염을 나타내며. 이러한 소견은 특히 신장에 대한 진균성 독성 효과를 나타내는 것으로 사료된다. 또한, 폐에서 호중구 및 단핵 세포의 침윤이 관찰되었고, 비장에서도 만성 염증세포인 형질세포의 침윤이 관찰되었다. 본 소견에서는 사향쥐 신부전에 따른 사인은 오염된 사료섭취로 의심되는 것으로 판단된다.

• Advances in pediatric surgery
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• 제20권2호
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• pp.53-57
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• 2014

Purpose: Neonatal neuroblastoma (NBL) is the most common malignant tumor in neonates, but there have been few studies about it. The purpose of this study was to investigate the clinical features of NBL and to compare prenatal and postnatal diagnosed groups. Methods: Nineteen patients who were diagnosed with NBL prenatally or within 28 days after birth from February 1986 to February 2013 in Seoul National University Hospital were enrolled in the study. The patients were categorized according to the International Neuroblastoma Staging System (INSS) and Children's Oncology Group (COG). Retrospective medical-record reviews were performed on these patients. The operative date, complication, pathological stage, and overall survival of the prenatally diagnosed group and the postpartum diagnosed group were compared. Results: Tumor was detected via prenatal ultrasonography in 8 patients (42.1%), and 11 patients (57.9%) were diagnosed within 28 days after birth. Based on INSS, the patients were divided into the stage I (n=8), stage II (n=1), stage III (n=3), stage IV (n=4), and stage IVs (n=3) groups, respectively. Based on COG, on the other hand, the patients were divided into the low-risk (n=8), intermediate-risk (n=8), and high-risk (n=3) groups. The postoperative complication rate was 29%. One patient died from complications from chemotherapy. The other 18 patients' mean follow-up period was 77.7 months. The differences between the postoperative complication rate, proportion of early-stage tumor, and overall survival of the prenatal and postnatal groups were not statistically significant (p=0.446, p=0.607, p=0.414). Conclusion: NBL showed favorable outcomes but relatively higher postoperative complications. There seem to be no significant statistical differences in the postoperative complications, proportion of early-stage tumor, and overall survival between the prenatally diagnosed group and the postpartum diagnosed group.