진행성 위암과 동반된 후복막 섬유화증 7예의 임상적 고찰

장재영,천영국,최우봉,김진오,조주영,이준성,이문성,심찬섭 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Background/Aims: Retroperitoneal fibrosis is a fibrosing disease process which frequently develops ureteral obstruction. Malignant retroperitoneal fibrosis has been reported that various types of cancer including cancer of the breast, stomach, prostate, lung, cervix, uteri, colon, pancreas, ovary, and even Hodgkin's disease. While the pathogenesis remains obscure, small foci of metastatic neoplasm in the retroperitoneal space can elicit a desmoplastic reaction in secondary form to malignancy. Methods: Recently we experienced 7 cases of retroperitoneal fibrosis with advanced gastric cancer. So, we report 7 cases of retroperitoneal fibrosis with clinical and radiologic characteristics. Results: The most common signs and symptoms were related irreversible renal dysfunction. The urologic finding noted medial deviation of the involved ureters and hydronephrosis Conclusions: Clinical manifestations are abdominal pain, back pain, hydronephrosis, and uremia. When sudden back pain and hydronephrosis develop in advanced malignancy, physicians should be considerd for retroperitoneal fibrosis.

Borrmann 4형으로 진단된 진행성 위암환자의 임상적 검토

천영국,김영태,홍수진,김진오,조주영,이문성,심찬섭 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Background/Aim: It is difficult to dignosis of Borrmann type 4 gastric cancer at the early stage, because of its special morphology. Most of the cases have been detected at the advanced stage with poor survival rate. We reviewed patients with advanced gastric cancer, to define clinicopathologic characteristics of Borrmann type 4 gastric cancer comparing other types of gastric cancer. Methods: 1033 patients with advanced gastric cancer were divided into two groups, consisting of 50 patients with Borrmann type 4 gastric cancer, and the remaining 983 patients with all other types of gastric cancer, which were then compared clinicopatologically. Results: The proportion of Borrmann type 4 gastric cancer to advanced gastric cancer was 4.48%(50/1,033). The patients with Borrmann type 4 gastric cancer to advanced gastric cancer was 4.48%(50/1,033). The patients with Borrmann type 4 gastric cancer were composed 20 males and 30 males and revealed the highest frequency 3rd decade (24.0%) in age (range 26-78). In giant folds group (n=27), the number of poorly differentiated cell type, lymph node metastasis, peritoneal seeding were 20 (74.1%), 17 (63,0%), 12 (44.4%). In non-giant folds group (n=23), the number of poorly differentiated type, lymph node metastasis, peritoneal seeding were 17 (73.9%), 15 (65.2%), 6 (26.1%). Rate of tumor invasion in serosa and beyound serosa was 88.9% in giant fold group, 63.0% in non-giant fold group. Surgery was performed in only 32% as a modality of treatment (vs. 82.5%). Characteristics findings of Borrmann type 4 gastric cancer in EUS showed a thickening of the third (submucosa) and fourth (muscularis propria) layers in 72% of 50 patients, and a well preserved five-layered gastric wall structure in 33 patients. Conclusions: We concluded that Borrmann type 4 gastric cancer was diagnosed more in females, as a more advanced disease, early detection was needed. And endoscopic ultrasonography is useful for diagnosis of Borrmann type 4 gastric cancer in the cases of suspicious results of gastroscopy.

폐쇄성 식도암에서 고식적 목적의 방사선치료와 병행한 광역동 치료의 효과

천영국 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

진행성 폐쇄성 식도암에서 증상 완화를 위한 고식적 치료법으로는 인공관 삽관술, 방사선 치료, 레이저 소작술 또는 광역동 치료 등의 다양한 방법이 보고되고 있다. 이에 대해 저자는 폐쇄성 식도암 환자에서 광역동 치료를 시행하여 그 효과 및 경험을 보고하고자 한다. 2001년에서 2003년 사이에 진행성 폐쇄성 식도암으로 진단받은 20명의 환자를 대상으로 하였다. 광역동 치료 48시간 전에 Photogem (2mg/Kg body weight)을 정맥 주사한 후 광역동 치료를 하였다. 연하곤란 정도를 1단계 연하 곤란이 없는 경우에서 4단계 침조차 삼킬 수 없는 경우로 4단계로 하여 치료 전후의 연하곤란의 완화 정도 및 완화 지속기간을 측정하였다. 20명의 환자에서 총 43회의 광역동 치료를 시행하였고 10명은 광역동 치료 후 방사선 치료를 병행하였다. 광역동 치료 후 4주 뒤의 연하 곤란의 완화는 환자의 90%에서 관찰되었고 점수는 2.75 ± 0.91에서 1.05 ± 0.83으로 향상되었다. (p<0.05). 평균 연하곤란 완화 지속기간은 63.1 ± 81.4 일이었다. 광역동 치료 후 연하 곤란 정도의 향상이 없었던 환자는 6명으로서 치료 후 자가 팽창성 금속관을 삽입하였다. 시술과 관련된 합병증으로는 식도 협착증이 2예, 피부 착색증이 3예, 안면 부종이 1예, 기관식도루가 1예에서 있었다. 결론적으로 진행성 폐쇄성 식도암 환자에서 광역동 치료는 비교적 안전하고 효과적으로 완화의 정도를 향상시킬 수 있었다. 그러나 일부 중대한 합병증이 발생되어 향후 종양에 대한 선택성이 높은 광과민제을 사용한 광역동 치료의 연구가 필요하겠다.

Intraductal ultrasonography for biliary strictures

Young Koog Cheon 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.2

When diagnosing the nature of biliary strictures, it is sometimes difficult to perform non-invasive methods such as ultrasound, spiral computed imaging, magnetic resonance imaging, or endoscopic ultrasonography. Thus, treatment decisions are usually based on biopsy results. However, brush cytology or biopsy, which is widely used for biliary stenosis, has limitations owing to its low sensitivity and negative predictive value for malignancy. Currently, the most accurate method is bile duct tissue biopsy under direct cholangioscopy. On the other hand, intraductal ultrasonography administered under the guidance of a guidewire has the advantages of easy administration and being less invasive, allowing for adequate examination of the biliary tract and surrounding organs. This review discusses the usefulness and drawbacks of intraductal ultrasonography for biliary strictures.

Recent advances of photodynamic therapy for biliary tract cancer

Young Koog Cheon 소화기인터벤션의학회 2021 International journal of gastrointestinal interven Vol.10 No.3

The prognosis of bile duct cancer (BDC) is limited due to tumor spread along the biliary tree leading to refractory obstructive cholestasis, cholangitis, and liver failure. Palliation with biliary endoprostheses yields median survival times between 4 and 6 months for advanced BDC. Photodynamic therapy (PDT) is a local photochemical tumor treatment that consists of a photosensitizing agent combined with laser irradiation of a distinct wavelength. Tumor ablation with PDT combined with biliary stenting reduces cholestasis and significantly improves the median survival time. However, the treatment is not widely available, and the photosensitizer used for PDT causes prolonged photosensitivity. Optimal control of tumor spread along the bile ducts and control of cholestasis and cholangitis will prolong survival in 33% to 66% of patients and render them suitable for other antitumor therapies.

Photodynamic Therapy in Patients with Advanced Hilar Cholangiocarcinomas

( Young Koog Cheon ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Recent advances of photodynamic therapy for biliary tract cancer

Young Koog Cheon 소화기인터벤션의학회 2021 Gastrointestinal Intervention Vol.10 No.3

The prognosis of bile duct cancer (BDC) is limited due to tumor spread along the biliary tree leading to refractory obstructive cholestasis, cholangitis, and liver failure. Palliation with biliary endoprostheses yields median survival times between 4 and 6 months for advanced BDC. Photodynamic therapy (PDT) is a local photochemical tumor treatment that consists of a photosensitizing agent combined with laser irradiation of a distinct wavelength. Tumor ablation with PDT combined with biliary stenting reduces cholestasis and significantly improves the median survival time. However, the treatment is not widely available, and the photosensitizer used for PDT causes prolonged photosensitivity. Optimal control of tumor spread along the bile ducts and control of cholestasis and cholangitis will prolong survival in 33% to 66% of patients and render them suitable for other antitumor therapies.

Longstanding postoperative fluid collection influences recurrence of pancreatic malignancy

( Young Jung Kim ),( Young Koog Cheon ),( Tae Yoon Lee ),( Seong-Hwan Chang ),( Mi-Hye Yu ) 대한내과학회 2021 The Korean Journal of Internal Medicine Vol.36 No.6

Background/Aims: Postoperative abdominal fluid collection (PAFC) is a frequent complication of pancreatobiliary cancer surgery. The effects of the existence and duration of PAFC are not well known. This study aimed to assess the effects of PAFC on patient prognosis after surgery for pancreatobiliary adenocarcinoma and the association of longstanding PAFC with the recurrence of pancreatic cancer. Methods: We retrospectively analyzed the data of 194 consecutive patients with pancreatobiliary adenocarcinoma who underwent curative operations from August 2005 to December 2019. The presence of PAFC was assessed using computed tomography within a week of surgery; PAFC lasting > 4 weeks was defined as longstanding PAFC. Results: Among 194 patients, PAFC occurred in 165 (85.1%), and 74 of these had longstanding PAFC. The recurrence rate of pancreatobiliary adenocarcinoma was significantly higher in patients with longstanding PAFC than in patients with non-longstanding PAFC (p = 0.025). Recurrence was also significantly associated with high T stage (T3, T4; p = 0.040), lymph node involvement (p < 0.001), perineural invasion (p < 0.006), and non-receipt of adjuvant chemotherapy (p = 0.025). Longstanding PAFC was significantly associated with the recurrence of pancreatic adenocarcinoma (p = 0.016). However, cancer-specific survival was related to neither the presence nor the duration of PAFC. Conclusions: The presence of longstanding PAFC was associated with the recurrence of pancreatic adenocarcinoma. However, a larger prospective study is necessary to confirm the findings.

Case Reports : Biliary Metal Stent as a Nidus for Bile Duct Stone

Young Koog Cheon,Jong Ho Moon,Young Deok Cho,Yun Soo Kim,Moon Sung Lee,Chan Sup Shim 대한내과학회 2002 The Korean Journal of Internal Medicine Vol.17 No.1

Several cases of recurrent stone formation caused by a surgical materiel as a nidus have been reported. Recently, we experienced one case in which a migrated metal stent might have been served as a nidus for common duct stone formation. The diagnosis was c

In-Situ Magneto-Optical Kerr Effect Studies of Exchange-Bias Formations in Ferromagnetic/Antiferromagnetic Thin Film Systems

( Young Sang Yu ),( Ki Suk Lee ),( Dong Ju Jeon ),( Sang Koog Kim ),( Kwang Youn Kim ),( Seong Ho Jang ),( Young Woon Kim ),( Jeong Woon Lee ),( Sung Chul Shin ) 대한금속재료학회 ( 구 대한금속학회 ) 2005 ELECTRONIC MATERIALS LETTERS Vol.1 No.1

We report on experimental investigations of exchange-bias formations in different layered structures of Ta/NiFe/CoFe/Cu/CoFe/FeMn/Ta and Ta/NiFe/FeMn/Co by in-situ visible light magneto-optical Kerr effect. It is found that exchange bias (a kind of unidirectional anisotropy) can be controlled by aligning the magnetization orientations of ferromagnetic layers during cooling through the blocking temperatures, as well as by applying a suffcient magnetic field during the film growth. For the structure of a magnetic NiFe/FeMn/Co trilayer, oppositely oriented exchange bias of the two ferromagnetic NiFe and Co layers is found to be set with the single antiferromagnetic FeMn layer through the oppositely oriented remnant magnetizations of the two ferromagnetic layers while cooling. These results reveal that the exchange bias and its unidirectional orientation can be determined by interfacial uncompensated antiferromagnetic spins in contact with ferromagnets, which are locked in by the magnetization orientations of ferromagnets during the film growth or subsequent cooling.