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증례 : 소화기 ; 간세포암의 복강경하 고주파 소작술 후 천자침 경로를 통한 흉벽 전이 1예
김의식 ( Eui Sik Kim ),김윤정 ( Yun Jeung Kim ),이수윤 ( Su Youn Lee ),이엄석 ( Eaum Seok Lee ),김석현 ( Seok Hyun Kim ),이병석 ( Byung Seok Lee ),이헌영 ( Heon Young Lee ) 대한내과학회 2012 대한내과학회지 Vol.82 No.3
Radiofrequency ablation (RFA) is a popular technique and shows excellent local tumor control and acceptable morbidity. Although RFA is considered much safer than surgical treatment, it is not a complication-free procedure. The most common complications of percutaneous RFA areabdominal hemorrhage, abdominal infection (abscess), biliary tract damage, and ground-pad burns. Laparoscopic RFA (LRFA) is a safe, feasible treatment modality to achieve tumor destruction. LRFA has proven superior to the percutaneous approach for lesions that are difficult or impossible to treat percutaneously. Needle-track implantationafter LRFA is a rare complication in HCCs. We report a case of needle-tract implantation of HCC found in the chest wall, ribs,and diaphragm 11 months after LRFA in a 49-year-old man. Although treatment for needle-track implantation is not well established, the metastatic mass was surgically removed. (Korean J Med 2012;82:326-330)
김의식 ( Eui Sik Kim ),고평곤 ( Pyung Gohn Goh ),김윤정 ( Yun Jeung Kim ),이수윤 ( Su Youn Lee ),문희석 ( Hee Seok Moon ),성재규 ( Jae Kyu Sung ),이병석 ( Byung Seok Lee ),정현용 ( Hyun Yong Jeong ) 대한소화기학회 2012 대한소화기학회지 Vol.60 No.1
Mantle cell lymphoma (MCL) is an uncommon type of gastrointestinal lymphoma. MCL is a distinct subtype of B-cell non-Hodgkin lymphomas. The major subtype of MCL is characterized by the presence of multiple lymphomatous polyposis (MLP), in which multiple polyps are observed along the gastrointestinal tract. The malignant cells express pan B-cell marker and the T-cell marker cluster of differentiation 5. The chromosomal translocation t(11;14)(q13;q32) that causes cyclin D1 overexpression is commonly observed on the cytogenetic analysis of MCL. Survival improvement has recently been achieved for patient with MCL by the successful introduction of monoclonal antibodies and dose-intensified approaches for treatment, including autologous stem cell transplantation strategies. Some reports suggest that there is an increased incidence of second malignancies in patients with MCL or lymphoma. We report a case of MCL involving the colon; the patient was a 60-year-old man who complained of low abdominal discomfort during defecation. During the workup, a meningioma was unexpectedly discovered. On analysis, the tumor was found to be a t(11;14)-negative and non-MLP-type MCL. (Korean J Gastroenterol 2012;60:56-60)
위장관 ; 진행성 위암에서 항암 화학 치료로 완전 반응을 보인 환자들의 복합항암 화학요법의 독성과 효능의 비교 분석
김윤정 ( Yun Jeung Kim ),고평곤 ( Pyung Gohn Goh ),김의식 ( Eui Sik Kim ),이수윤 ( Su Youn Lee ),문희석 ( Hee Seok Moon ),이엄석 ( Eaum Seok Lee ),성재규 ( Jae Kyu Sung ),김석현 ( Seok Hyun Kim ),이병석 ( Byung Seok Lee ),정현용 ( 대한소화기학회 2011 대한소화기학회지 Vol.58 No.6
Background/Aims: We retrospectively analyzed comparative toxicities and efficacies of chemotherapy regimens in advanced gastric cancer (AGC) patients who achieved complete response (CR) after chemotherapy. Methods: We reviewed the medical records of 1,203 patients, who were pathologically diagnosed as AGC in a single center between January 2001 and October 2007. On the basis of the Response Evaluation Criteria in Solid Tumors, CR was evaluated with abdominal computed tomography. Toxicities were evaluated using the National Cancer Institute`s common toxicity criteria before each chemotherapy cycle. Results: Among the 1,203 AGC patients enrolled in this study, 568 received chemotherapy and 635 received best supportive care. The major chemotherapy regimens were 5-fluorouracil, leucovorin and oxaliplatin (FOLFOX), docetaxel, cisplatin and 5-fluorouracil (DCF) and 5-fluorouracil, leucovorin and irinotecan (FOLFIRI). Among the 568 patients, 51 (9.0%) achieved CR (49 [8.6%] with FOLFOX [n=12], DCF [n=26], or FOLFIRI [n=11] and 2 [0.3%] with etoposide, leucovorin and 5-fluorouracil). For patients administered FOLFOX, DCF, and FOLFIRI, the median time to disease progression was 4 months (range, 1.8-59.5), 15 months (range, 2.9-31.2) and 10 months (range, 2.0-39.5), and the median survival times were 48 months (range, 5.9-74.0), 37 months (range, 14.0-86.0), and 30 months (range, 6.0-50.0), respectively. Grades 3-4 mucositis occurred mostly in patients administered DCF (n=8, 30.8%). Grades 3-4 leucopenia were observed in 1 (8.3%), 11 (42.3%), and 4 (36.4%) patients administered FOLFOX, DCF and FOLFIRI, respectively. No statistically significant differences were observed in the 3 regimens. Conclusions: All 3 regimens (FOLFOX, DCF and FOLFIRI) were active and tolerable. Their efficacies and toxicities were not significantly different. (Korean J Gastroenterol 2011;58:311-317)