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S-479 : Cervical spine and pelvic bone metastases from unknown primary hepatocellular carcinoma
( Sea Won Hwang ),( Ji Eun Lee ),( Jung Min Lee ),( Young Min Kim ),( Sook Hee Hong ),( Myung Ah Lee ),( Ho Jong Chun ),( Sung Hak Lee ),( Eun Sun Jung ),( Hoo Geun Chun ) 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1
Hepatocellular carcinoma (HCC) is the fifth most common cancer in Korea. We report a case of hepatocellular carcinoma of unknown primary origin, presented with cervical spine and pelvic bone metastases. A 61-year-old male was admitted to oncology department for the evaluation of 3 cm sized mass located at C5 spine. He experienced left upper extremity weakness and tingling sensation for 2 months before visiting oncology department. For primary mass evaluation, abdomen CT scan was done. Besides of cervical mass, 7.6 cm sized hypervascular mass was found at right iliac bone, detected by abdomen CT scan. Both masses were suspected for metastatic cancer, but primary lesion was not detected. This patient showed positive results on hepatitis B screening. On blood chemistry, serum α-fetoprotein (AFP) was 5013.1 ng/mL (reference range <10 ng/mL), and protein induced by vitamin K absence or antagonist-II (PIVKA-II) was 13891 mAU/mL (reference range <40 mAU/mL). MRI showed cirrhotic configuration of liver, but no definite hepatic mass was detected. Percutaneous bone biopsy for iliac mass was done for pathologic confirmation, and C5 corpectomy with sub-total tumor removal was done for symptomatic relief. Histopathological examination showed eosinophilic cytoplasm-rich cells, positive with hepatocyte surface antigen (HSA) and CD10 on both specimens. This was consistent with HCC. Pelvic and right iliac angiography revealed hypervascular tumor located at right iliac bone, and transarterial embolization (TACE) was performed. This patient underwent localized radiation therapy to control pelvic mass and remnant C5 mass, and received sorafenib 400 mg bid thereafter. On imaging findings, iliac mass showed partial regression, and serum AFP was decreased to 47.3 ng/mL and PIVKA-II was decreased to 6344 mAU/mL. He was readmitted to orthopedic surgery department for the management of right pelvic pain. Right iliac bone fracture was confirmed on plain x-ray, and he received wide resection and reconstruction of iliac bone. He is currently taking sorafenib, and tumor is still on partial regression state.
간세포암의 근치적 치료 후 발생한 단독 뼈 전이에 대해 다학제적 치료로 완전반응을 얻은 1예
황세원 ( Sea Won Hwang ),양현 ( Hyun Yang ),이해림 ( Hae Lim Lee ),장정원 ( Jeong Won Jang ),배시현 ( Si Hyun Bae ),최종영 ( Jong Young Choi ),윤승규 ( Seung Kew Yoon ) 대한간암학회 2016 대한간암학회지 Vol.16 No.1
Despite recent advances in the treatment of hepatocellular carcinoma (HCC), the prognosis of patients with extrahepatic metastasis from HCC still remains dismal. The current study presents a case of HCC that was metastatic to the pelvis and describes successful treatment with multidisciplinary approach to the skeletal metastasis. The patient was a 67-year-old male who presented with right pelvic pain 28 months following right hepatectomy for HCC. Computed tomography and magnetic resonance imaging indicated a solitary bone metastasis without intrahepatic recurrence. Complete response was achieved with multidisciplinary management including sorafenib, transarterial embolization, surgery to remove the metastatic mass and radiotherapy after surgery. A post-operative follow-up 15 months later found that the patient remained in good health with maintained complete response. This case suggests that a multidisciplinary approach can achieve long-term cancer-free survival and prolonged life expectancy beyond palliative care for patients with solitary bone metastasis after curative surgery for HCC. (J Liver Cancer 2016;16:52-56)
원발병소불명암 형태로 내원한 경추 및 골반뼈에 전이된 간세포암종
황세원 ( Sea Won Hwang ),이지은 ( Ji Eun Lee ),이정민 ( Jung Min Lee ),홍숙희 ( Sook Hee Hong ),이명아 ( Myung Ah Lee ),전후근 ( Hoo Geun Chun ),천호종 ( Ho Jong Chun ),이성학 ( Sung Hak Lee ),정은선 ( Eun Sun Jung ) 대한소화기학회 2015 대한소화기학회지 Vol.66 No.1
The occurrence of hepatocellular carcinoma (HCC) is closely associated with viral hepatitis or alcoholic hepatitis. Although active surveillance is ongoing in Korea, advanced or metastatic HCC is found at initial presentation in many patients. Metastatic HCC presents with a hypervascular intrahepatic tumor and extrahepatic lesions such as lung or lymph node metastases. Cases of HCC presenting as carcinoma of unknown primary have been rarely reported. The authors experienced a case of metastatic HCC in a patient who presented with a metastatic bone lesion but no primary intrahepatic tumor. This case suggests that HCC should be considered as a differential diagnosis when evaluating the primary origin of metastatic carcinoma. (Korean J Gastroenterol 2015;66:50-54)
Sea-Won Lee,MD,Tae-Kon Hwang,MD,Sung-Hoo Hong,MD,Ji-Youl Lee,MD,Mi Joo Chung,MD,Song Mi Jeong,MD,Sung Hwan Kim,MD,Jong Hoon Lee,MD,Hong Seok Jang,MD,Sei Chul Yoon,MD 대한방사선종양학회 2014 Radiation Oncology Journal Vol.32 No.3
Purpose: This single institutional study is aimed to observe the outcome of patients who received postoperative radiotherapy after radical prostatectomy. Materials and Methods: A total of 59 men with histologically identified prostate adenocarcinoma who had received postoperative radiation after radical prostatectomy from August 2005 to July 2011 in Seoul St. Mary’s Hospital of the Catholic University of Korea, was included. They received 45–50 Gy to the pelvis and boost on the prostate bed was given up to total dose of 63–72 Gy (median, 64.8 Gy) in conventional fractionation. The proportion of patients given hormonal therapy and the pattern in which it was given were analyzed. Primary endpoint was biochemical relapse-free survival (bRFS) after radiotherapy completion. Secondary endpoint was overall survival (OS). Biochemical relapse was defined as a prostate-specific antigen level above 0.2 ng/mL. Results: After median follow-up of 53 months (range, 0 to 104 months), the 5-year bRFS of all patients was estimated 80.4%. The 5-year OS was estimated 96.6%. Patients who were given androgen deprivation therapy had a 5-year bRFS of 95.1% while the ones who were not given any had that of 40.0% (p < 0.01). However, the statistical significance in survival difference did not persist in multivariate analysis. The 3-year actuarial grade 3 chronic toxicity was 1.7% and no grade 3 acute toxicity was observed. Conclusion: The biochemical and toxicity outcome of post-radical prostatectomy radiotherapy in our institution is favorable and comparable to those of other studies.
Lee, Sea-Won,Hwang, Tae-Kon,Hong, Sung-Hoo,Lee, Ji-Youl,Chung, Mi Joo,Jeong, Song Mi,Kim, Sung Hwan,Lee, Jong Hoon,Jang, Hong Seok,Yoon, Sei Chul The Korean Society for Radiation Oncology 2014 Radiation Oncology Journal Vol.32 No.3
Purpose: This single institutional study is aimed to observe the outcome of patients who received postoperative radiotherapy after radical prostatectomy. Materials and Methods: A total of 59 men with histologically identified prostate adenocarcinoma who had received postoperative radiation after radical prostatectomy from August 2005 to July 2011 in Seoul St. Mary's Hospital of the Catholic University of Korea, was included. They received 45-50 Gy to the pelvis and boost on the prostate bed was given up to total dose of 63-72 Gy (median, 64.8 Gy) in conventional fractionation. The proportion of patients given hormonal therapy and the pattern in which it was given were analyzed. Primary endpoint was biochemical relapse-free survival (bRFS) after radiotherapy completion. Secondary endpoint was overall survival (OS). Biochemical relapse was defined as a prostate-specific antigen level above 0.2 ng/mL. Results: After median follow-up of 53 months (range, 0 to 104 months), the 5-year bRFS of all patients was estimated 80.4%. The 5-year OS was estimated 96.6%. Patients who were given androgen deprivation therapy had a 5-year bRFS of 95.1% while the ones who were not given any had that of 40.0% (p < 0.01). However, the statistical significance in survival difference did not persist in multivariate analysis. The 3-year actuarial grade 3 chronic toxicity was 1.7% and no grade 3 acute toxicity was observed. Conclusion: The biochemical and toxicity outcome of post-radical prostatectomy radiotherapy in our institution is favorable and comparable to those of other studies.
황원효(Won Hyo Hwang),박정제(Jung Je Park),전시영(Sea Yuong Jeon),김진평(Jin Pyeong Kim) 대한두경부종양학회 2004 대한두경부 종양학회지 Vol.20 No.1
Ectopic cervical thymic tissue is rarely reported in medical literature, but it should be included in the differential diagnosis of neck masses, especially in children. It occurs in the line of descent of the thymus from the angle of the mandible to the superior mediastinum. A preoperative diagnosis is seldom considered and is often misdiagnosed as a possible tumor or a lymph node. We present a case of a 2-month-old infant with an asymptomatic enlarging right neck mass. Patient underwent complete excision of the mass.
황은섭(Eun-Seob Hwang),이경룡(Kyung-Ryong Lee),이지연(Ji-Yeon Lee),김새롬(Sea-Rom Kim),주문원(Moon-Won Choo),노웅기(Woong-Gee Noh) 한국멀티미디어학회 2010 한국멀티미디어학회 학술발표논문집 Vol.2010 No.2
국내 토종 휴대용 게임기 제조사인 GPH사에서 출시하고 있는 GP2X WIZ 를 기반으로 한 슈팅게임 개발사례를 소개한다. 게임의 난이도 레벨 선정함에 있어 유연성을 향상시키고 웜홀시스템이란 새로운 게임적 요소를 제안하고 있다. 이 시스템은 플레이 중간에 다른 공간 으로 이동할 수 있는 포탈이 랜덤으로 생성되고 다른 공간으로 이동하며 공간의 속성이 동적으로 변화함으로써 매니아적 특성을 진행시킬 수 있는 요소이며, 캐릭터 자체가 변하는 기존의 슈팅게임에 비해 주인공 캐릭터에게 직업을 부여해 선택한 직업에 따라 캐릭터 스프라이트와 공격기술을 다르게 적용하는 또 다른 새로운 요소도 구현하고 있다.