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간장 및 담도 : Lipiodol - I - 131 의 간동맥 주입에 의한 간암치료
최흥재(Heung Jai Choi),문영명(Young Myoung Moon),전재윤(Chae Yoon Chon),이경식(Kyung Sik Lee),김병수(Byung Soo Kim),김병로(Byung Ro Kim),이종태(Jong Tae lee),유형식(Hyung Sik Yoo),서정호(Jung Ho Suh),김동익(Dong Ik Kim),박창윤(chang 대한소화기학회 1986 대한소화기학회지 Vol.18 No.1
N/A An iodized oil such as Ethiodol or Lipiodol was selectively retained in the tumor vessls of the large hepatomas as well as in the small daughter hepatomas for long periods following the intraarterial hepatic injection of such contrast material. The specific aim of the study is to deliver a high internal radiation dose to hepatocellular carcinoma(HCC) in an atempt to control the disease. We were able to replace a small fraction of the stable iodine (I-127) of the 37% iodine in Lipiodol by the I-131 with 100% exchange efficiency. I-131 labeled Lipiodol was injected through the superselected tumor feeding artery under superselection or into the proper hepatic arterial level of patients who have malignant hep- atomas confirmed by aspiration cytology. I-131-Lipiodol was stable in vivo and no significant activity was noted in the thyroid, stomach, blood and urine after the injection. Only small fraction of radioisotope activity was noticed in the both side of lungs. Tumor to normal liver ratio was very high. Therefore, I-131-Lipiodol (or p-32-Lipiodol) will be effective delivering high internal radiation dose to the tumor while delivering small radiation doses to normal tissues. Labeling, tumor dose calculation and preliminary findings will be presented.
김기황(Ki Whang Kim),이종태(Jong Tae lee),유형식(Hyung Sik Yoon),이도연(Do Yun Lee) 대한소화기학회 1988 대한소화기학회지 Vol.20 No.2
N/A The recent development of various imaging modalities has simplified the diagnosis of hepatocellular carcinoma (HCC). 38 patients with a total of 40 small HCC less than 5 cm were studied with ultrasonography, Computed tomography, Gallium 67 scan, and selective celiac angiography. The characteristic findings on each imaging modalities were analysed and the detection rate of small HCCs by the modalities were assessed. The results as follows; 1) Ultrasonography revealed low leveled internal echo in less than 3 cm tumor without definite halo or lateral shadow, however halo was seen in 73% of masses larger than 3 cm in size. 2) Post contrast enhancement CT demonstrated low attenuation mass lesions in 87.5% of cases and central necrotic components were seen in 18.7% of 5 cm sized HCCs. Extrahepatic extensions or the portal vein thrombus were not observed. 3) Gallium-67 SPECT was more useful to detect small peripheral tumors which were not detected on US or CT. 4) Angiography failed to depict small tumors less than 2 cm in 33%, and A-P shunt was not demonstrated in less than 3 cm tumor and nodular venous staining was one of the characteristic findings of angiography. 5) The detection rate of 16 small HCCs performed all the imaging modalities as follows, ultrasonography, 68.8%, CT, 87.5%, Ga-67 planar, 56.3% SPECT, 81.3% selective celiac angiography, 93.8% respectively. 6) To detect small hepatocellular carcinoma, imaging modalities should be combined not only ultrasonography as well as Ga-67 SPECT and CT as noninvaseve procedures.
간장 ( 肝臟 ) 및 담도 ( 膽道 ) : 비수술적 치료에 의한 원발성 간암 장기 생존예의 검토
최흥재(Heung Jai Choi),이상인(Sang In Lee),한광협(Kwang Hyub Han),전재윤(Chae Yoon Chon),김기황(Ki Whang Kim),김병수(Byung Soo Kim),이종태(Jong Tae lee),유형식(Hyung Sik Yoo),노재경(Jae Kyung Roh),김귀언(Gui En Kim) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.4
N/A l2 patients who have survived more than 3 years after transarterial embolization with and without I-131 Lipiodol or chemotherapeutic agents from Feb. 1985 were analyzed:in terms of factors of tumor size, type, treatment method and cause of death. The tumors were less than 6.0 cm, nodular or multinodular presentitions. 10 patients were in criteria of Child class A and partal vein thrombosis was not identified at initial treatment. Five patients died due to hepatic failure and longest survival was 4 year and 6 months. Recurrent tumors were identified in nine patients within one year and multiple TAE proeedures were perfvrmed. Karly rercognition of recurrent tumors with perioidic serum AFP and uItrasound examinatiene artd prompt TAE should be performed to get lorg term survival.
간장 ( 肝腸 ) 및 담도 ( 膽道 ) : I - 131 - Lipiodol의 간동맥주입과 간동맥 색전술에 의한 원발성 간암 치료 효과
강진경(Jin Kyung Kang),최흥재(Heung Jai Choi),박인서(In Suh Park),이상인(Sang In Lee),한광협(Kwang Hyub Han),전재윤(Chae Yoon Chon),이종태(Jong Tae lee),유형식(Hyung Sik Yoo),한승희(Seung Hee Han),노재경(Jae Kyung Roh) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.3
N/A Lipiodol (iodized oil) is known to be selectively retained for an extended duration in hepatocellular carcinoma (HCC), so a number of therapeutic trials using Lipiodol in patients with HCC have been performed. Hepatic arterial infusion of radiolabelled iodized oil (I-131-Lipiodol) has potential as a radiotherapeutic agent in patiens with HCC. This study was undertaken to assess the therapeutic efficacy of hepatic arterial infusion of I-131-Lipiodol alone or I-131-Lipiodol combined with transcath- eter arterial embolization (TAE) in comparison with conventional TAE in patients with HCC. From March 1985 to December 1988, 136 patients with HCC were given eithep an hepatic arterial infusion of I-131-Lipiodol alone (Group 1, n=83), TAE with Ivalon or GelfoaO (Group 2, n=23) or infusion of I-131-Lipiodol combined with TAE (Group 3, n=30). There was no significant difference in sex, age, tumor size and type, biochemical tests, and Child classification among the 3 groups. We analyzed the response rate and survival rate according to the therapeutic modality and tumor size. 1) The response rates were 32.5, 43.5, and 73.3% in groups 1,2, and 3 respectively and the response rate in group 3 was significantly higher than group 1 (p<0.05). (response was defined as a decrease more than 2.5% in tumor size 3 months after treatment). 2) There was no significant difference in response rate among the 3 groups in tumors smaller than 5 cm, but the response rate of group 3 (71.4%) was significantly higher than group 1 (27.9%) in tumors larger than 5 cm (p<0.05). 3) The survival rate among tumors smaller than 5 cm was significantly highter than among tumors larger than 5 cm (p<0.05).