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TACE와 Sorafenib 치료 후 수술을 시행한 간세포암종
노금엽 ( Geum Youb Noh ),한철주 ( Chul Ju Han ),김연주 ( Youn Joo Kim ),양기영 ( Ki Young Yang ),박수철 ( Su Cheol Park ),김진 ( Jin Kim ),김유철 ( Yu Cheol Kim ),최윤희 ( Yoon Hee Choi ),이효락 ( Hyo Rak Lee ) 대한간암학회 2011 대한간암학회지 Vol.11 No.1
Surgical resection for hepatocellular carcinoma (HCC) is one of the managements, showing improved long term survival. Nowadays, it is being accepted as the main curative treatment. However, the biggest problem we used to face is that surgery cannot be applied at the point of presentation in many patients due to advanced stage. Here we present a case of 54 years old female, who had transarterial chemoembolization (TACE) and sorafenib due to advanced stage of HCC, and later underwent curative surgery due to remarkable response. She had a CT scan of abdomen, which showed multiple huge masses. HCC was confirmed by ultrasonography-guided liver biopsy. TACE was performed once. After TACE, the size of masses increased. Therefore, sorafenib was administered and then continued for 9 months. As partial response was obtained at that time, surgical resection was successfully done. In the pathological report of removed tumor, we could confirm total necrosis of tumor. Now, it`s been 6 months and she is followed up without any recurrence.
간외 전이로 처음 발견된 간세포암종 간외 전이가 있는 간세포암종에 대한 systemic doxorubicin-cisplatin (AP) 감량요법 후 완전 관해에 도달한 2예
남승범 ( Seung Bum Nam ),한철주 ( Chul Ju Han ),이호진 ( Ho Jin Lee ),김연주 ( Youn Joo Kim ),양기영 ( Ki Young Yang ),박수철 ( Su Cheol Park ),김진 ( Jin Kim ),김유철 ( Yu Cheol Kim ) 대한간암학회 2010 대한간암학회지 Vol.10 No.-
The effect of systemic chemotherapy in patients with advanced HCC is very limited, not only in regard to poor response to cytotoxic chemotherapeutic agents but also poor tolerance to therapy and related adverse effects. Herein, we report two cases of hepatocellular carcinoma (HCC) with extrahepatic metastasis who achieved complete remission following administration of doxorubicin and cisplatin in reduced dosage. The first case was a 41-year-old male who had HCC with multiple lung and intraabdominal lymph nodes metastasis. After 9 cycles of chemotherapy with 50% reduced dosage, he achieved a complete remission of both primary and metastatic lesions. He showed no evidence of disease for 11 more months during follow-up and still lives without recurrence. The second case was a 61-year-old female who had HCC with inferior vena cava thrombosis and multiple lung metastasis. After one cycle of treatment with 25% reduced dosage, she underwent life-threatening toxicities and poor tolerance to chemotherapy and further treatment was discontinued. However, she achieved a complete remission of both primary and metastatic lesions. Following 26 months of recurrence free period, she suffered from a recurrent tumor near previously treated lesion, which was successfully treated by TACE and radiation therapy. This modified doxorubicin and cisplatin regimen in reduced dosage could be used as means of evading life threatening toxicity and selecting out responders to systemic chemotherapy with reduced risk.
협심증과 구별하기 어려운 흉통을 호소하는 환자중 관상동맥 조영술상 정상인, 비심인성 흉통 환자에서의 식도 운동성 질환에 대한 연구
김용태 ( Kim Yong Tae ),한철주 ( Han Cheol Ju ),김영호 ( Kim Yeong Ho ),정현채 ( Jeong Hyeon Chae ),이명묵 ( Lee Myeong Mug ),박영배 ( Park Yeong Bae ),윤용법 ( Yun Yong Beob ),송인성 ( Song In Seong ),최규완 ( Choe Gyu Wan ),김 대한내과학회 1992 대한내과학회지 Vol.42 No.4
이상의 결과로 협심증과 구별하기 어려운 흉통을 호소하는 환자들에게서 관상동맥 조영술이 정상인 경우, 이들에서 흉통이 원인이 식도질환에서 유래되는지를 알아보기 위하여 이들에게 식도운동검사, Bernstein 검사, edrophonium 유발검사, 24시간 식도 pH측정 들을 실시한 결과 이들의 흉통의 원인으로서 위 식도 역류나 식도의 운동성 질환 등이 중요한 비중을 차지함을 알 수 있다. 그리고 식도 내압 검사 결과 하부식도 괄약근압이 현저히 저하되어 있거나 Bernstein 검사 결과 양성인 경우에는 역류의 확인만을 위해서라면 반드시 24시간 pH검사를 실시할 필요는 없으리라 여겨진다. To assess the frequency of esophageal disease in patients with angina-like chest pain and normal coronary arteriograms, twenty-eight patients underwent esophageal manometric studies, acid perfusion (Bernstein) tests, edrophonium provocation tests, and 24 hr esophageal pH monitorings, and were compaired with the records of 32 normal controls. In the chest pain group, seventeen patients (61%) had abnormal esophageal motility and eleven (39%) had normal motility in the esophageal manometry tests. Two of the 17 (12%) patients with abnormal motility had nutcracker esopohaus, four (24%) had hypotensive lower esophageal sphincter (LES), six (35%) had hypertensive LES, and five (29%) had nonspecific esophageal motility disorder (NEMD). Bernstein test provoked chest pain in 5 patients (18%). Edrophonium injection elicited chest pain in 4 patients, but in only 2 (7%) of the 4 patients the pain was accompanied with abnormal esophageal motility changes. Twenty patients of the chest pain group underwent 24 hour esophageal pH monitorings. Four of the 20 patients (20%) had pathological esophageal refluxes. Twelve patients experienced a total of 70 spontaneous chest pain episodes but only 23 chest pain episodes (43%) in 8 patients were associated with acid refluxes (pH<4.0). Overall, of the 28 patients with non-cardiac chest pain, ten patients (36%) (8 GERD and 2 nutcracker esophagus) had esophageal disease which could be associated definitely with that pain. If manometric study revealed significantly lowered LES pressure or acid perfusion test provocated the identical pain in a patient with chest pain, no further study seemed to be necessary only for the diagnosis of gastroesophageal reflux disease, because the specificity of these tests` results was high.
간세포암종에 대한 Cyberknife 치료 후 완전관해가 왔던 환자에서 하반신 마비가 발생한
노금엽 ( Geum Youb Noh ),한철주 ( Chul Ju Han ),김연주 ( Youn Joo Kim ),양기영 ( Ki Young Yang ),박수철 ( Su Cheol Park ),김진 ( Jin Kim ),김유철 ( Yu Cheol Kim ),김미숙 ( Mi Sook Kim ) 대한간암학회 2011 대한간암학회지 Vol.11 No.2
Radiation therapy (RT) is one of the managements for unresectable hepatocellular carcinoma (HCC). Traditionally, RT has played only a limited role in HCC treatment because of its low efficacy and the low tolerance of the liver for this modality. However, as the technology of RT grows rapidly in recent years, indication of RT for HCC has been extended remarkably. Stereotactic body radiation therapy (SBRT) is a technique that allows precise delivery of a large ablative radiation dose to the tumor while sparing normal surrounding tissue in 1 to 5 fractions. As RT becomes useful therapeutic strategy, the important problem is that there could be serious complication after RT. Here we present a case of 54 years old male with advanced stage of HCC, who underwent a serious neurologic complication of paraplegia following Cyberknife (CK) treatment. He had a huge HCC in right lobe of the liver, and initially transarterial chemoembolization (TACE) was performed with an unsatisfactory response. Therefore, CK was performed, and another TACE was done for a new lesion, which was followed by remarkable complete remission of the tumor. However, paraplegia developed in both of his lower extremities a year after CK. Investigation has shown radiation myelitis as the cause of paralysis. Three and a half years have passed since CK treatment, and HCC is still in complete remission state, however, paraplegia is persistent now. Radiation myelitis should be considered as a complication, when CK is applied to treatment of HCC.
대한간학회지 제6차 춘계학술대회 초록집 : 구연 ; 각종 간 병변에 대한 PET 영상의 분석
손현배 ( Son Hyeon Bae ),조상형 ( Jo Sang Hyeong ),한철주 ( Han Cheol Ju ),정숙향 ( Jeong Sug Hyang ),김유철 ( Kim Yu Cheol ),김창민 ( Kim Chang Min ),이진오 ( Lee Jin O ),김병일 ( Kim Byeong Il ),양원일 ( Yang Won Il ),최창운 ( C 대한간학회 2000 Clinical and Molecular Hepatology(대한간학회지) Vol.6 No.1(S)