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이한홍,송교영,전해명,박조현 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.77 No.6
Paraesophageal hernias are rare, accounting only for about 5% of all hiatal hernias but can sometimes lead to life-threatening complications such as bleeding, obstruction, incarceration, and strangulation. Accordingly, the surgical repair of paraesophageal hernia must be performed irrespectively of symptoms. Laparoscopic techniques of paraesophageal hernia offer several advantages compared with open techniques, including smaller incision, less traumatic handling of tissues, less postoperative pain. In this report, we describe a case of paraesophageal hernia complicated with gastric volvulus, which has been successfully repaired by the laparoscopic approach. A 79-year-old female was suffering from dysphagia, abdominal pain and intermittent vomiting for several months, and a paraesophageal hernia with partial gastric outlet obstruction due to gastric volvulus was diagnosed. The patient underwent the reduction of the hernia, dissection of the sac, crural repair and fundoplication via a laparoscopic approach. She recovered early and has been doing well on follow up with no recurrence.
절제 불가능한 국소 진행성 위암 환자에서 Taxotere 및 Cisplatin을 이용한 선행 화학 요법제의 투여 후 근치적 절제가 가능했던 2예
이한홍,허훈,채병주,김욱,전해명,Lee, Han-Hong,Hur, Hoon,Chae, Byung-Joo,Kim, Wook,Jeon, Hae-Myung 대한위암학회 2005 대한위암학회지 Vol.5 No.1
위암의 치료에 있어서 근치적 절제는 완치를 위한 유일한 방법이나 불행이도 많은 환자들이 국소적이나 혹은 타 장기로 전이된 상태로 발견된다. 이런 경우에는 근치적 절제술의 시행이 매우 어렵고 선행 화학요법을 시행하여 병기를 낮추려는 시도가 고려되어야 한다. Docetaxel은 반합성 택산으로 튜불린의 중합 반응을 유도하고 미세관의 해중합 반을을 방해함으로서 그 작용을 나타낸다. 현재 전이성 위암의 신행화학요법에서 docetaxel의 사용이 많이 시도되고 있고 그 반응률이 보고되고 있다. 본 교실에서는 docetsxel과 cisplatin 병용요법을 시행하여 전이성 위암의 부분 관해로 근치적 절제가 가응하였던 2예를 보고하는 바이다. At diagnosis, the majority of patients with gastric cancer are found to have local invasion or distant organ metastasis, even though the sole measure for a complete cure is a curative resection. A curative resection is hardly applicable for those with invasion and metastasis; thus, trials with neoadjuvant chemotherapy for downstaging the cancer should be considered. Docetaxel is a semisynthetic taxane that promotes tubulin polymerization and inhibits microtubule depolymerization. In recent studies, many metastatic gastric cancers were treated using neoadjuvant chemotherapy with docetaxel, and the response rates were reported. We report here two cases of locally advanced, non-resectable gastric cancer that were candidates for a curative resection after induction chemotherapy with docetaxel and cisplatin.
Mixed Exocrine and Endocrine Carcinoma in the Stomach: A Case Report
이한홍,정찬권,정은선,송교영,전해명,박조현 대한위암학회 2011 Journal of gastric cancer Vol.11 No.2
We report a rare case of the coexistence of a gastric small cell neuroendocrine carcinoma with a gastric adenocarcinoma. A 62-year-old man presented with epigastric soreness for 1 month. Esophagogastroduodenoscopy revealed a Borrmann type I tumor at the lesser curvature of the lower body of the stomach. The patient underwent a distal gastrectomy with D2 lymph node dissection and the resected specimen exhibited a 3.5x3.5 cm sized, fungating lesion. Two separated, not intermingling, lesions with non-adenocarcinoma components encircled by well differentiated adenocarcinoma components were identified microscopically. The non-adenocarcinoma component showed neuroendocrine features, such as a solid and trabecular pattern, and the tumor cells showed a high nuclear grade with minimal cytoplasm, indistinct nucleoli, and positive response for synaptophysin, CD56. The final pathological diagnosis was a gastric mixed exocrine-endocrine carcinoma (MEEC) composed of an adenocarcinoma and small cell neuroendocrine carcinoma of the collision type.
이한홍,허훈,김수홍,박애령,김욱,전해명 대한암학회 2010 Cancer Research and Treatment Vol.42 No.1
Purpose :Treatment options for patients with advanced gastric cancer remain limited. Few studies have investigated the efficacy and tolerability of the combination regimen of oxaliplatin and 5-fluorouracil with leucovorin for patients with advanced gastric cancer. The goal of this study was to examine the efficacy and toxicity of a modified FOLFOX-6 (mFOLFOX-6) regimen as a first-line chemotherapy regimen for patients with advanced gastric cancer. Materials and Methods :From March, 2006, to December, 2007, 82 patients with advanced gastric cancer received 100 mg/m2 oxaliplatin and 100 mg/m2 leucovorin on the first day of treatment, followed by 2,400 mg/m2 of 5-fluorouracil on the first and second days of treatment every 2 weeks as a first-line treatment. Results :The median age of the enrolled patients was 62 years (range; 30∼75). Out of 82 patients, 34 cases (41.5%) were recurrent cases after curative resection, and the other 48 cases were unresectable or non-curative resectable cases. Their response was evaluated every 6 weeks. The overall response rate was 40.2%, with 2 (2.4%) complete response and 31 (37.8%) partial responses. The median time to progression (TTP) and overall survival (OS) time were 6.0 months (95% confidence interval [CI]: 4.69∼7.31) and 13.0 months (7.99∼18.0), respectively. The grade 3∼4 hematologic toxicities observed included neutropenia (34.1%), thrombocytopenia (7.3%), and anemia (1.2%). The gastrointestinal toxicities observed included grade 3∼4 nausea (9.8%) and vomiting (7.3%). Six patients (7.3%) experienced grade 3 neuropathy. No treatment-related deaths were recorded. Conclusion :The modified FOLFOX-6 regimen is effective and well tolerated as a first-line chemotherapy regimen for patients with advanced gastric cancer.