검색용 MeSH 필터와 단어인접탐색 기법을 활용한 KoreaMed 검색 효율성 향상 연구

정소나(So-Na Jeong),정지나(Ji-Na Jeong) 한국산학기술학회 2017 한국산학기술학회논문지 Vol.18 No.5

의학학술문헌에는 해부학적 조직이나 기관명이 종양, 질환 또는 감염 용어들과 서로 조합하여 사용되는 언어적 특성을 가지고 있다. 의학학술문헌을 검색할 때 데이터베이스가 제공하는 통제어휘도구인 Medical Subject Headings (MeSH)를 활용하면 합성어, 동의어, 그리고 관련어를 추가로 검색할 수 있어 검색효율이 높다. 본 연구에서는 위암(Stomach Neoplasms) 어휘군을 검색용 필터로 추가하는 방법과 동시출현용어의 거리를 측정하여 단어인접탐색 기법으로 검색효율성을 향상시키는 연구를 수행하였다. 검색용 MeSH에 추가할 어휘군을 결정하기 위해 실험데이터로 PubMed에서 중심주제어가 “Stomach Neoplasms”인 2007년∼2016년 논문 8,625편을 내려 받아 논문제목으로부터 Stomach와 Neoplasms 관련 용어의 동시출현여부를 분석하였다. 검색효율성은 KoreaMed에서 검색되는 MEDLINE 학술지를 대상으로 “Stomach Neoplasms”가 MeSH로 색인되어 있는 277편으로 검증하였는데 MEDLINE MeSH, MeSH on Demand, 그리고 KoreaMed MeSH Indexer의 “Stomach Neoplasms” 색인어 추출여부와 검색용 필터로 어휘군을 적용했을 때, 그리고 동시출현 용어의 단어인접검색 기법을 적용했을 때 “Stomach Neoplasms”의 매칭여부를 비교하였다. 가장 출현빈도가 높은 용어는 “Gastric Cancer”로 2,780회 출현하였다. “Gastric Adenocarcinoma”, “Gastric MALT Lymphoma” 등과 같이 “Stomach” 용어와 “Neoplasms" 관련 조직학적 용어가 조합된 경우는 7,376개(88.51%)였다. 동시출현 거리가 2단어인 용어는 “Stomach”와 “Neoplasms”의 합성어로 5,234개(70.95%)였다. 연구 결과 MeSH용어를 제외하고 973개의 용어를 후보어휘군으로 선정하였다. MEDLINE MeSH와 KoreaMed MeSH Indexer의 MeSH 매칭률은 209편(75.5%)이었는데 검색필터를 적용한 결과 263편(94.9%)으로, 동시출현 용어의 13단어 단어인접탐색 기법을 적용한 경우 268편(96.7%)으로 매칭률이 향상되었다. 본 연구를 통해 자연어 검색에 있어서 검색효율을 향상시키는 수단으로 검색용 시소러스를 사용하면 색인비용에 대한 부담이 적고, 통제어의 망라적 장점과 자연어가 가지는 용어의 특정성을 유지할 수 있음을 증명하였다. 또한 불리안 검색보다는 단어인접탐색 기법을 활용하면 정확률을 높일 수 있어 검색 효율성이 향상됨을 알 수 있었다. This study examined the method for adding related to “stomach neoplasms” as filters to the Medical Subject Headings (MeSH) for search as well as a method for improving the search efficiency through a word-proximity search by measuring the distance of co-occurring terms. A total of 8,625 articles published between 2007 and 2016 with the major topic terms “stomach neoplasms” were downloaded from PubMed article titles. The vocabulary to be added to the MeSH for search were analyzed. The search efficiency was verified by 277 articles that had “Stomach Neoplasms” indexed as MEDLINE MeSH in KoreaMed. As a result, 973 terms were selected as the candidate vocabulary. “Gastric Cancer” (2,780 appearances) was the most frequent term and 7,376 compound words (88.51%) combined the histological terms of “stomach” and “neoplasm”, such as “gastric adenocarcinoma” and “gastric MALT lymphoma”. A total of 5,234 compounds words (70.95%), in which the co-occurring distance was two words, were found. The matching rate through the MEDLINE MeSH and KoreaMed MeSH Indexer was 209 articles (75.5%). The search efficiency improved to 263 articles (94.9%) when the search filters were added, and to 268 articles (96.7%) when the 13 word-proximity search technique of the co-occurring terms was applied. This study showed that the use of a thesaurus as a means of improving the search efficiency in a natural language search could maintain the advantages of controlled vocabulary. The search accuracy can be improved using the word-proximity search instead of a Boolean search.

Risk Factors for Metachronous Gastric Neoplasms in Patients Who Underwent Endoscopic Resection of a Gastric Neoplasm

( Hyuk Yoon ),( Nayoung Kim ),( Cheol Min Shin ),( Hye Seung Lee ),( Bo Kyoung Kim ),( Gyeong Hoon Kang ),( Jung Mogg Kim ),( Joo Sung Kim ),( Dong Ho Lee ),( Hyun Chae Jung ) 대한소화기학회 2016 Gut and Liver Vol.10 No.2

Background/Aims: To identify the risk factors for metachronous gastric neoplasms in patients who underwent an endoscopic resection of a gastric neoplasm. Methods: We prospectively collected clinicopathologic data and measured the methylation levels of HAND1, THBD, APC, and MOS in the gastric mucosa by methylation-specific real-time polymerase chain reaction in patients who underwent endoscopic resection of gastric neoplasms. Results: A total of 257 patients with gastric neoplasms (113 low-grade dysplasias, 25 highgrade dysplasias, and 119 early gastric cancers) were enrolled. Metachronous gastric neoplasm developed in 7.4% of patients during a mean follow-up of 52 months. The 5-year cumulative incidence of metachronous gastric neoplasm was 4.8%. Multivariate analysis showed that moderate/severe corpus intestinal metaplasia and family history of gastric cancer were independent risk factors for metachronous gastric neoplasm development; the hazard ratios were 4.12 (95% confidence interval [CI], 1.23 to 13.87; p=0.022) and 3.52 (95% CI, 1.09 to 11.40; p=0.036), respectively. The methylation level of MOS was significantly elevated in patients with metachronous gastric neoplasms compared age- and sexmatched patients without metachronous gastric neoplasms (p=0.020). Conclusions: In patients who underwent endoscopic resection of gastric neoplasms, moderate/severe corpus intestinal metaplasia and a family history of gastric cancer were independent risk factors for metachronous gastric neoplasm, and MOS was significantly hypermethylated in patients with metachronous gastric neoplasms. (Gut Liver 2016;10:228-236)

레빈튜브 삽입후 물 점적 주입 나선식 CT의 유용성 : 위아전절제 환자의 추적 CT 검사로서 기존 방법과의 비교

박영진 대한영상의학회 1998 대한영상의학회지 Vol.38 No.4

Purpose : To access the usefulness of newly designed Leven tube inserted drip infusion spiral CT for the evaluation of remnant stomach and anastomosis site in patients who have undergone subtotal gastrectomy for stomach cancer. Material and Methods : A new technique named Levin tube inserted drip infusion spiral CT was used to prospectively study 23 patients. A 16Fr Levin tube was inserted into the remnant stomach ; 500ml of tap water was drip infused just before CT scanning and an additional 500ml of water was infused during IV contrast injection. Water was infused by gravity, using a water bottle suspended at a height of 90cm(Group A). The 31 patients who underwent conventional spiral CT scanning immediately after the divided ingestion of 900ml diluted gastrografin were selected as a control group(Group B). The anatomic delineation of the anastomosis site was graded by two radiologists as excellent(3), good(2), fair(1) or poor(0). To evaluate the degree of distension, the maximal diameters of remnant stomach and the anastomosis site, and the thickness of the stomach wall, were also measured. Results : In group A, anatomic delineation of the anastomosis site was excellent, compared to group B(mean score: 2.91 vs 1.19, p<0.01). In addition, the maximum diameters of remnant stomach and anastomosis site were significantly larger in group A than in group B(transverse A-P remnant stomach and anastomosis site: 92.4$\pm$16.0mm, 97.6$\pm$26.5mm, 29.7$\pm$7.3mm vs 50.6$\pm$12.9mm, 53.5$\pm$14.4mm, 7.7$\pm$4.4mm, p<0.01). The mean thickness of distended stomach wall in group A was 3.2$\pm$1.7mm ; in group B, measurement was possible in only a few cases, but their number was too smallfor comparison. Conclusion : In patients who had undergone subtobal gastrectomy, Levin tube inserted drip infusion spiral CT showed excellent anatomic delineation of the site of anastomosis and remnant stomach. We found that because it increases the distension of remnant stomach and the anastomosis site, this technique is effective for the evaluation of postoperative stomach.

Clinicopathological characteristics of synchronous and metachronous gastric neoplasms after endoscopic submucosal dissection

장미영,조진웅,오왕국,고성준,한상훈,백훈기,이영재,김지웅,정금모,조용근 대한내과학회 2013 The Korean Journal of Internal Medicine Vol.28 No.6

Background/Aims: Endoscopic submucosal dissection (ESD) has become accepted as a minimally invasive treatment for gastric neoplasms. However, the development of synchronous or metachronous gastric lesions after endoscopic resection has become a major problem. We investigated the characteristics of multiple gastric neoplasms in patients with early gastric cancer (EGC) or gastric adenoma after ESD. Methods: In total, 512 patients with EGC or gastric adenoma who had undergone ESD between January 2008 and December 2011 participated in this study. The incidence of and factors associated with synchronous and metachronous gastric tumors were investigated in this retrospective study. Results: In total, 66 patients (12.9%) had synchronous lesions, and 13 patients (2.5%) had metachronous lesions. Older (> 65 years) subjects had an increased risk of multiple gastric neoplasms (p = 0.012). About two-thirds of the multiple lesions were similar in macroscopic and histological type to the primary lesions. The median interval from the initial lesions to the diagnosis of metachronous lesions was 31 months. The annual incidence rate of metachronous lesions was approximately 3%. Conclusions: We recommend careful follow-up in patients of advanced age (> 65 years) after initial ESD because multiple lesions could be detected in the remnant stomach. Annual surveillance might aid in the detection of metachronous lesions. Large-scale, multicenter, and longer prospective studies of appropriate surveillance programs are needed.

Clinicopathological characteristics of synchronous and metachronous gastric neoplasms after endoscopic submucosal dissection

( Mi Young Jang ),( Jin Woong Cho ),( Wang Guk Oh ),( Sung Jun Ko ),( Shang Hoon Han ),( Hoon Ki Baek ),( Young Jae Lee ),( Ji Woong Kim ),( Gum Mo Jung ),( Yong Keun Cho ) 대한내과학회 2013 The Korean Journal of Internal Medicine Vol.28 No.6

Background/Aims: Endoscopic submucosal dissection (ESD) has become accepted as a minimally invasive treatment for gastric neoplasms. However, the development of synchronous or metachronous gastric lesions after endoscopic resection has become a major problem. We investigated the characteristics of multiple gastric neoplasms in patients with early gastric cancer (EGC) or gastric adenoma after ESD. Methods: In total, 512 patients with EGC or gastric adenoma who had undergone ESD between January 2008 and December 2011 participated in this study. The incidence of and factors associated with synchronous and metachronous gastric tumors were investigated in this retrospective study. Results: In total, 66 patients (12.9%) had synchronous lesions, and 13 patients (2.5%) had metachronous lesions. Older (> 65 years) subjects had an increased risk of multiple gastric neoplasms (p = 0.012). About two-thirds of the multiple lesions were similar in macroscopic and histological type to the primary lesions. The median interval from the initial lesions to the diagnosis of metachronous lesions was 31 months. The annual incidence rate of metachronous lesions was approximately 3%. Conclusions: We recommend careful follow-up in patients of advanced age (> 65 years) after initial ESD because multiple lesions could be detected in the remnant stomach. Annual surveillance might aid in the detection of metachronous lesions. Large-scale, multicenter, and longer prospective studies of appropriate surveillance programs are needed.

위에서 발생한 신경초종 : 1예 보고

이미숙 대한영상의학회 1995 대한영상의학회지 Vol.33 No.5

저자들은 41세된 남자의 위에서 발생한 신경초종을 보고한다. 환자는 좌상복부에서 촉지되는 종괴를 주소로 내원하여 위투시에서는 위 대만곡측이 외부에서 눌리는 모양으로 보였고, 복부 CT 촬영에서는 저음영의 종괴가 위의 외벽에 연하여 좌상복부에서 관찰되었 다. 수술소견상 위의 대만곡을 따라 위체부의 외병에 붙어 있는 낭성종괴로 보였고, 병리 소 견상 신경초종으로 확진되었다. We report a case of exogastric schwannoma of the stomach in 41-years-old male patient with papable mass inleft upper abdomen. Upper GI series revealed extrinsic compression on the greater curvature of the stomach. CTscan showed a low density mass attached to greater curvature of the stomach with inhomogeneous contrastenhancement in the mass lesion. The mass was removed by surgery, and confirmed pathologically as schwannomaarising form the stomach.

Proximal Anterior-Antrum Posterior (PAAP) Overlapping Anastomosis in Minimally Invasive Pylorus-Preserving Gastrectomy for Early Gastric Cancer Located in the High Body and Posterior Wall of the Stomach

박지현,공성호,최종호,박신후,서윤석,박도중,이혁준,양한광 대한위암학회 2020 Journal of gastric cancer Vol.20 No.3

Purpose: To evaluate the feasibility and safety of intracorporeal overlapping gastrogastrostomy between the proximal anterior wall and antrum posterior wall (PAAP; PAAP anastomosis) of the stomach in minimally invasive pylorus-preserving gastrectomy (PPG) for early gastric cancer (EGC). Materials and Methods: From December 2016 to December 2019, 17 patients underwent minimally invasive PPG with PAAP anastomosis for EGC in the high body and posterior wall of the stomach. Intraoperative gastroscopy was performed with the rotation maneuver during proximal transection. A longer antral cuff (>4–5 cm) was created for PAAP than for conventional PPG (≤3 cm) at the point where a safe distal margin and good vascular perfusion were secured. Because the posterior wall of the proximal remnant stomach was insufficient for intracorporeal anastomosis, the anterior wall was used to create an overlapping anastomosis with the posterior wall of the remnant antrum. The surgical and oncological outcomes were analyzed, and the stomach volume was measured in patients who completed the 6-month follow-up. The results were compared to those after conventional PPG (n=11 each). Results: PAAP anastomosis was successfully performed in 17 patients. The proximal and distal resection margins were 2.4±1.9 cm and 4.0±2.6 cm, respectively. No postoperative complications were observed during the 1-year follow-up esophagogastroduodenoscopy (n=10). The postoperative remnant stomach (n=11) was significantly larger with PAAP than with conventional PPG (225.6±118.3 vs. 99.1±63.2 mL; P=0.001). The stomach length from the anastomosis to the pylorus was 4.9±2.4 cm after PAAP. Conclusions: PAAP anastomosis is a feasible alternative for intracorporeal anastomosis in minimally invasive PPG for highly posteriorly located EGC.

위에 생긴 선암종과 신경내분비종의 충돌종양의 CT 위장조영술 소견: 증례 보고

김형수,홍성숙,김정훈,진소영,최득린,김용재,권귀향 대한영상의학회 2007 대한영상의학회지 Vol.57 No.5

Concurrent occurrence of an adenocarcinoma and carcinoid tumor in the stomach has been observed infrequently; moreover, a gastric collision tumor of both tumor types has rarely been seen. We describe a case of a gastric collision tumor following the differential diagnosis from observing the morphological patterns more closely using CT gastrography. The patient presented with a gastric collision tumor that consisted of an adenocarcinoma and carcinoid tumor in the antrum of the stomach. 위의 종양으로 신경내분비종과 선암종의 동반은 매우 드물고, 더욱이 충돌종양으로 발생한 증례는 더 드물다. 본 저자들은 위 전정부에서 발생한 매우 드문 신경내분비종과 선암종의 충돌종양 증례에서, 가상내시경술을 포함한 CT 위장조영술을 이용하여 종양의 형태학적 특성을 보다 자세히 관찰하여, 감별진단에 도움을 받은 증례를 경험하였기에 보고하고자 한다.

위의 간양선암:1예 보고

정은아 대한영상의학회 1995 대한영상의학회지 Vol.32 No.1

Hepatoid adenocarcinoma of the stomach is a gastric carcinoma with both adenocarcinomatous and hepatocellularcarcinomatous differentiation. It usually produces large amount of serum alpha-fetoprotein. It often occurs inaged person, commonly located in the gastric antrum. Because of early lymph node and liver metastasis, prognosisis poor. A case of hepatoid adenocarcinoma of the stomach in a 49-year-old man is reported. The patient's serumalpha-fetoprotein level was high (3380 ng/ml). Liver function test was normal, otherwise. A mass was observed inritht lobe of the liver on US and CT. It was hypervascular with increased uptake of lipiodol on hepaticarteriography. A large ulcerative tumor involving the gastric antrum and body was also found at barium study ofthe stomach. Subtotal gastrectomy and right lobectomy of the liver resulted in rapid decrease in serumalpha-fetoprotein. Histopathologically the diagnosis was hepatoid adenocarcinoma of the stomach with livermetastasis.

위의 간양 선암의 방사선학적소견

구자홍,임현철,송순영,백정환,김용수,고병희,조온구,박충기,박문향 대한영상의학회 1996 대한영상의학회지 Vol.35 No.1

Purpose : Hepatoid adenocarcinoma of the stomach is a variant of gastric carcinoma with both adenocarcinoma and hepatocellular carcinomatous differentiations. Until recently, few reports had been published. The purpose of this study was to evaluate the radiologic characteristics of eleven hepatoid adenocarcinomas of the stomach as well as patterns of metastasis. Materials and Methods : Eleven pathologically proven cases of hepatoidadenocarcinoma of the stomach were retrospectively reviewed. Radiologic studies available were CT in eightpatients, abdominal ultrasonography in ten, upper GI series in seven, and hepatic angiography in two. Pathologicand radiologic characteristics of these lesions, patterns of metastasis, if present, and labolatory data(AFP and CEA) were evaluated. Results : Tumors were seen in the antrum and body in five patients, in the antrum in five, and in the body of the stomach in one. Six tumors were classified as Borrmann type 3, four as Borrmann type 2, and one as Borrmann type 4. Nine cases showed hepatic metastasis. Portal vein thrombosis was present in three cases ;two were accompanied by multiple liver metastasis and the other had portal venous thrombosis. Lymph nodemetastasis was identified in 11 cases ; N1 in five, N2 in five, and extensive retroperitoneal paraaortic and leftsupraclavicular lymphadenopathy in one. Angiography showed hypervascular metastatic liver masses in two cases. There was no evidence of metastasis to the mesentery, omentum, and peritoneum. Serum AFP was elevated in tencases(mean:24752.2 ; median:4230ng/ml). Conclusion : Radiologic findings of hepatoid adenocarcinoma of the stomach appear similar to those of non-hepatoid adenocarcinoma. However, elevation of AFP and early liver metastasis without peritoneal metastasis is suggestive of hepatoid adenocarcinoma of the stomach.