1.A Case of Common Bile Duct Cancer with Mucosal and Submucosal Spread to Gallbladder and Common Hepatic Duct.
Seok Tae LIM ; Hyeon Woo KOH ; Heok Soo AHN ; Kyu Hee HAN ; Dae Ghon KIM ; Deuk Soo AHN ; Myoung Ja CHUNG ; Back Hwan CHO
Korean Journal of Gastrointestinal Endoscopy 1997;17(6):872-877
Cholangiocarcinoma is a form of adenocarcinoma arising from the intrahepatic or extrahepatic biliary epithelium. Apparent predisposing factors include some chronic hepatobiliary parasitic infsttations, congenital anomalies with ectatic ducts, sclerosing cholangitis and chronic ulcerative colitis and occupational exposure to possible biliary tract carcinogens. Patients with cholangiocarcinoma usually present with biliary obstruction, painless jaundice, pruritus, weight loss and acholic stools. Because the obstructing process is gradua1, the cholangiocarcinoma is often far advanced by the time it presents clinically. The diagnosis is most frequently made by cholangiography following ultrasound demonstration of dilated intrahepatic bile ducts. We report a case of common bile duct cancer spreading to gallbladder and common hepatic duct along the biliary mucosal epitherium and submucosal tissue in 68-year-old female patient along with a review of literature.
Adenocarcinoma
;
Aged
;
Bile Ducts, Intrahepatic
;
Biliary Tract
;
Carcinogens
;
Causality
;
Cholangiocarcinoma
;
Cholangiography
;
Cholangitis, Sclerosing
;
Colitis, Ulcerative
;
Common Bile Duct*
;
Diagnosis
;
Epithelium
;
Female
;
Gallbladder*
;
Hepatic Duct, Common*
;
Humans
;
Jaundice
;
Occupational Exposure
;
Pruritus
;
Ultrasonography
;
Weight Loss
2.Mn-DPDP-enhanced MR Imaging: the Optimal Pulse Sequence for Detection of Focal Hepatic Tumor.
Ji Hyun YOUK ; Jeong Min LEE ; In Hwan KIM ; Gyung Ho CHUNG ; Seung Ok LEE ; Dae Kon KIM ; Hee Cheol YOU ; Back Hwan CHO ; Chong Soo KIM
Journal of the Korean Radiological Society 2002;46(4):367-375
PURPOSE: To assess the diagnostic value of Mn-DPDP for the detection of focal hepatic tumors on MR images and to determine the optimal pulse sequence to maximize its effect. MATERIALS AND METHODS: Twenty-three patients with 32 focal hepatic tumors were examined by means of 1.5-T MRI. Before and after the intravenous administration of Mn-DPDP, five pulse sequences were used to obtain T1-weighted images: two-dimensional fast low-angle shot (2D FLASH) with/without fat saturation (FS), spinecho (SE), and three-dimensional fast low angle shot reconstruction (3D FLASH) with/without FS. Quantitative assessment involved determination of the signal-to-noise ratio (SNR) of the liver and the tumor, the percentage signal enhancement ratio (PSER) of the liver, and tumor-to-liver contrast to noise ratio (CNR). Pulse sequences were also evaluated subjectively for tumor conspicuity, delineation, and image artifact. In addition, two experienced radiologists compared tumor detection rates between precontrast and postcontrast images. RESULTS: Mn-DPDP had a marked effect on liver SNR and absolute CNR at all pulse sequences (p<0.05). On postcontrast images, PSER and absolute CNR of the liver were highest at 3D FLASH and 2D FLASH FS, respectively, and significantly higher at GRE than at SE (p<0.05). On postcontrast images, the CNR of focal nodular hyperplasia and hepatocellular carcinoma was positive, while that of hemangioma, metastasis and cholangiocarcinoma was negative. The postcontrast CNR of all tumors except hepatocellular carcinoma increased more than 100%. Qualitative studies showed that tumor conspicuity increased significantly at all sequences except SE, and delineation increased significantly except at SE and postcontrast 2D GRE FS. After Mn-DPDP, GRE more effectively demonstrated tumor conspicuity and image artifact than did SE, and GRE other than 2D FLASH FS was also better than SE for tumor dilineation (p<0.05). The sensitivity of all postcontrast images increased and the tumor detection rate at GRE was significantly higher than at SE. CONCLUSION: Mn-DPDP favorably affects tumor-to-liver contrast, and may be useful in the imaging of focal hepatic tumors, more so with 2D or 3D FLASH pulse sequences than with SE.
Administration, Intravenous
;
Artifacts
;
Carcinoma, Hepatocellular
;
Cholangiocarcinoma
;
Dyphylline
;
Focal Nodular Hyperplasia
;
Hemangioma
;
Humans
;
Liver
;
Magnetic Resonance Imaging*
;
Manganese
;
Neoplasm Metastasis
;
Noise
;
Signal-To-Noise Ratio
3.The Retrospective Research of the 119 Emergency Medical Services(EMS)System using the new Standardized Record of the 119 EMS system.
Kyung Ho LEE ; Young Chul YOON ; Sung Hun AHN ; Won Yul KIM ; Kyung Hwan KIM ; Hong Yong KIM ; Back Moon SUNG ; Young Seek CHO ; Hyeng Dae CHON ; Bon Kwan KU
Journal of the Korean Society of Emergency Medicine 1998;9(2):220-230
Regulation for new standardized rescue record from of the 119 EMS system was established by law from February 1, 1998. We have recently evaluated the effectiveness of the record from. Records of 192 patients who visited the Emergency department of Sangggye Paik Hospital. Inje University by the 119 EMS system from February 1 to February 28, 1998 were analyzed statistically according to the contents of record form. In conclusion, the new standardized rescue record form of the 119 EMS system was effective in giving information of patients' history and analysing of the 119 EMS system. But, Detailed modification of the record form about disease entities is needed for proper initial evaluation of emergency patient.
Emergencies*
;
Emergency Service, Hospital
;
Humans
;
Jurisprudence
;
Retrospective Studies*
4.Autoradiographic Investigation for 3H-Thymidine Labeling Indicies of gamma-Glutamyl Transpeptidase Positive Foci during the Rat Liver Carcinogenesis.
Kee Woon KWEON ; Hong Joo KIM ; Soong Hwan LEE ; Yeong Jung CHO ; Jong Cheol KIM ; Sung Woo KIM ; Hee Soo KIM ; In Gyu BACK ; Cheol Hun JUNG ; Yong Hyeon JO ; Chang Woo GHAM ; Dong Hoo LEE
The Korean Journal of Hepatology 1998;4(2):162-178
No abstract available.
Animals
;
Autoradiography
;
Carcinogenesis*
;
Diethylnitrosamine
;
gamma-Glutamyltransferase*
;
Liver*
;
Rats*
5.Autoradiographic Investigation for 3H-Thymidine Labeling Indicies of gamma-Glutamyl Transpeptidase Positive Foci during the Rat Liver Carcinogenesis.
Kee Woon KWEON ; Hong Joo KIM ; Soong Hwan LEE ; Yeong Jung CHO ; Jong Cheol KIM ; Sung Woo KIM ; Hee Soo KIM ; In Gyu BACK ; Cheol Hun JUNG ; Yong Hyeon JO ; Chang Woo GHAM ; Dong Hoo LEE
The Korean Journal of Hepatology 1998;4(2):162-178
No abstract available.
Animals
;
Autoradiography
;
Carcinogenesis*
;
Diethylnitrosamine
;
gamma-Glutamyltransferase*
;
Liver*
;
Rats*
6.A Case of Hepatocellular Carcinoma with Pulmonary Metastasis Who Showed Complete Response by Cytotoxic Chemotherapy after Sorafenib Failure.
Hwa Sun PARK ; Jae Young JANG ; Min Young BAEK ; Yong Kwon KIM ; Hyun Jin YOUN ; Su Young BACK ; Soung Won JEONG ; Sae Hwan LEE ; Sang Gyune KIM ; Sang Woo CHA ; Young Seok KIM ; Young Deok CHO ; Hong Soo KIM ; Boo Sung KIM
Journal of Liver Cancer 2017;17(1):72-76
Hepatocellular carcinoma (HCC) is the 2nd most common cause of cancer related death in Korea and well-known malignancy with poor prognosis. Sorafenib is the first-line molecular targeted agent in patients with extra-hepatic spread of HCC. However, complete response is extremely rare in patients treated with sorafenib and the disease control rate is only 43%. We report a 53-year-old man with advanced HCC with pulmonary metastasis who showed complete response by cytotoxic chemotherapy with doxorubicin and cisplatin with relatively tolerable adverse effects after failure of treatment with sorafenib.
Carcinoma, Hepatocellular*
;
Cisplatin
;
Doxorubicin
;
Drug Therapy*
;
Humans
;
Korea
;
Middle Aged
;
Neoplasm Metastasis*
;
Prognosis
7.Nitric Oxide Synthase (NOS) Expression in Breast Cancer.
Hae Kyung LEE ; Back Hyun CHO ; Min Hee HUR ; Sung Soo KANG ; Jee Hyun LEE ; Sung Kong LEE ; Hye Sun KIM ; Yee Jeong KIM ; Byoung San MOON ; Sei Joong KIM ; Hae Seung HAN ; Young Chae CHU ; Seck Hwan SHIN
Journal of the Korean Surgical Society 2002;63(2):105-111
PURPOSE: NO, a diatomic free radical, plays a diverse physiological and pathophysiological roles in the vascular, neuronal and immune systems. It is produced by nitric oxide synthase (NOS) which consists of three different isoforms. In this study we investigated NOS expression in 84 human breast carcinomas and its associations to other clinicopathological factors. METHODS: The immunohistochemical staining for NOS expression in 84 human breast carcinomas were performed and their medical records were reviewed retrospectively. RESULTS: iNOS expression in tumor cells was observed in 48.2% and eNOS expression was detected in 51.9%. iNOS expression in tumor cells has positive correlation with eNOS expression in tumor and is associated with iNOS expression in stroma and endothelial cells. Although iNOS expression in tumor cells has negative correlation with tumor size (P=0.047) and lymph node metastasis (P=0.002), it has no effects on 5 year overall and disease free survivals. iNOS expression in stroma also has negative correlation with tumor size (P=0.016) and nuclear grade (P=0.025). No significant correlation between eNOS expression and clinicopathological factors was observed but eNOS expression in tumor cells contributed to worse 5 year overall survivals (92.1% vs 77.0%) in marginal significance (P=0.053). CONCLUSION: These data suggest that iNOS expression in tumor may have an inhibitory effect in tumor growth and lymph node metastasis. These results may be further investigated.
Breast Neoplasms*
;
Breast*
;
Diatoms
;
Endothelial Cells
;
Humans
;
Immune System
;
Lymph Nodes
;
Medical Records
;
Neoplasm Metastasis
;
Neurons
;
Nitric Oxide Synthase*
;
Nitric Oxide*
;
Protein Isoforms
;
Retrospective Studies
8.A Case of Cimetidine-induced Immune Hemolytic Anemia.
Ye Rim LEE ; Hee Jin SO ; Yoon Hwan CHANG ; Su Yeon CHO ; Dae Hyun BACK ; Kyung Ah LIM ; Jungwon HYUN ; Kyou Sup HAN ; Hye Jin KANG
Korean Journal of Blood Transfusion 2011;22(1):65-69
There have been 5 case reports about immune hemolytic anemia related with cimetidine, but there has been no such report in Korea. A sixty-four-year-old woman was admitted to the emergency department in a coma. She was diagnosed with diffuse large B-cell lymphoma 5 years ago and she achieved a complete remission after treatment. She was in a state of shock, and her blood pressure was 70/40 mmHg. The laboratory test results were consistent with hemolytic anemia (HA) as follows: hemoglobin: 1.9 g/dL, corrected reticulocyte count: 2%, total/conjugated bilirubin: 6.4/2.1 mg/dL, lactate dehydrogenase: 1,083 U/L and haptoglobin <10 mg/dL. She had a history of taking the drugs including cimetidine, acetaminophen and etizolam for two days. She urgently received transfusion of 3 units of packed red blood cells and then she regained consciousness. To investigate the relation between cimetidine and HA, we subsequently performed a drug-induced immune complex test and an antibody test by using cimetidine, AB serum and phosphate-buffered saline. The results proved that cimetidine was the cause of the HA. Patient was treated with steroid, and the following laboratory tests showed rapid improvement. This is the first case report from Korea that shows the causal relationship between cimetidine and immune HA.
Acetaminophen
;
Anemia, Hemolytic
;
Antigen-Antibody Complex
;
Blood Pressure
;
Cimetidine
;
Coma
;
Consciousness
;
Diazepam
;
Emergencies
;
Erythrocytes
;
Female
;
Haptoglobins
;
Humans
;
Korea
;
Lactic Acid
;
Lymphoma, B-Cell
;
Reticulocytes
;
Shock
9.Korean Thyroid Association Guidelines on the Management of Differentiated Thyroid Cancers; Part III. Management of Advanced Differentiated Thyroid Cancers - Chapter 1-2. Locally Recurred/Persistent Thyroid Cancer Management Strategies 2024
Ho-Ryun WON ; Min Kyoung LEE ; Ho-Cheol KANG ; Bon Seok KOO ; Hyungju KWON ; Sun Wook KIM ; Won Woong KIM ; Jung-Han KIM ; Young Joo PARK ; Jun-Ook PARK ; Young Shin SONG ; Seung Hoon WOO ; Chang Hwan RYU ; Eun Kyung LEE ; Joon-Hyop LEE ; Ji Ye LEE ; Cho Rok LEE ; Dong-Jun LIM ; Jae-Yol LIM ; Yun Jae CHUNG ; Kyorim BACK ; Dong Gyu NA ;
International Journal of Thyroidology 2024;17(1):147-152
These guidelines aim to establish the standard practice for diagnosing and treating patients with differentiated thyroid cancer (DTC). Based on the Korean Thyroid Association (KTA) Guidelines on DTC management, the “Treatment of Advanced DTC” section was revised in 2024 and has been provided through this chapter. Especially, this chapter covers surgical and nonsurgical treatments for the local (previous surgery site) or regional (cervical lymph node metastasis) recurrences. After drafting the guidelines, it was finalized by collecting opinions from KTA members and related societies. Surgical resection is the preferred treatment for local or regional recurrence of advanced DTC. If surgical resection is not possible, nonsurgical resection treatment under ultrasonography guidance may be considered as an alternative treatment for local or regional recurrence of DTC. Furthermore, if residual lesions are suspected even after surgical resection or respiratory-digestive organ invasion, additional radioactive iodine and external radiation treatments are considered.
10.Korean Thyroid Association Guidelines on the Management of Differentiated Thyroid Cancers; Part I. Initial Management of Differentiated Thyroid Cancers - Chapter 2. Surgical Management of Thyroid Cancer 2024
Yoon Young CHO ; Cho Rok LEE ; Ho-Cheol KANG ; Bon Seok KOO ; Hyungju KWON ; Sun Wook KIM ; Won Woong KIM ; Jung-Han KIM ; Dong Gyu NA ; Young Joo PARK ; Kyorim BACK ; Young Shin SONG ; Seung Hoon WOO ; Ho-Ryun WON ; Chang Hwan RYU ; Jee Hee YOON ; Min Kyoung LEE ; Eun Kyung LEE ; Joon-Hyop LEE ; Ji Ye LEE ; Dong-Jun LIM ; Jae-Yol LIM ; Yun Jae CHUNG ; Chan Kwon JUNG ; Jun-Ook PARK ; Hee Kyung KIM ;
International Journal of Thyroidology 2024;17(1):30-52
The primary objective of initial treatment for thyroid cancer is minimizing treatment-related side effects and unnecessary interventions while improving patients’ overall and disease-specific survival rates, reducing the risk of disease persistence or recurrence, and conducting accurate staging and recurrence risk analysis. Appropriate surgical treatment is the most important requirement for this purpose, and additional treatments including radioactive iodine therapy and thyroid-stimulating hormone suppression therapy are performed depending on the patients’ staging and recurrence risk. Diagnostic surgery may be considered when repeated pathologic tests yield nondiagnostic results (Bethesda category 1) or atypia of unknown significance (Bethesda category 3), depending on clinical risk factors, nodule size, ultrasound findings, and patient preference. If a follicular neoplasm (Bethesda category 4) is diagnosed pathologically, surgery is the preferred option. For suspicious papillary carcinoma (suspicious for malignancy, Bethesda category 5), surgery is considered similar to a diagnosis of malignancy (Bethesda category 6). As for the extent of surgery, if the cancer is ≤1 cm in size and clinically free of extrathyroidal extension (ETE) (cT1a), without evidence of cervical lymph node (LN) metastasis (cN0), and without obvious reason to resect the contralateral lobe, a lobectomy can be performed. If the cancer is 1-2 cm in size, clinically free of ETE (cT1b), and without evidence of cervical LN metastasis (cN0), lobectomy is the preferred option. For patients with clinically evident ETE to major organs (cT4) or with cervical LN metastasis (cN1) or distant metastasis (M1), regardless of the cancer size, total thyroidectomy and complete cancer removal should be performed at the time of initial surgery. Active surveillance may be considered for adult patients diagnosed with low-risk thyroid papillary microcarcinoma. Endoscopic and robotic thyroidectomy may be performed for low-risk differentiated thyroid cancer when indicated, based on patient preference.