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내시경역행담췌관조영술과 간동맥내 화학요법 후 소실된 담관내 간세포암 1예
조영윤 ( Young Youn Cho ),이상협 ( Sang Hyub Lee ),이재우 ( Jae Woo Lee ),박진명 ( Jin Myung Park ),류지곤 ( Ji Kon Ryu ),김용태 ( Yong Tae Kim ),윤창진 ( Chang Jin Yoon ),김혜령 ( Haer Young Kim ) 대한소화기학회 2014 대한소화기학회지 Vol.63 No.5
Invasion of the bile duct by hepatocellular carcinoma (HCC), which is called intrahepatic bile duct HCC, is rare and has a poor prognosis. Early diagnosis and surgical resection is important for treatment. A 58-year-old man who underwent hepatic resection for HCC 4 years ago and received transarterial chemoembolization (TACE) 2 years after the operation for recurred HCC presented with jaundice. CT scan revealed a tumor in the common bile duct without intrahepatic lesion. Therefore, ERCP was done to perform biopsy and biliary drainage. Histological examination was compatible with hepatocellular carcinoma. However, the tumor could not be visualized at angiography and thus, only transarterial chemoinfusion was performed without embolization. The tumor had disappeared on follow-up CT scan, and the patient has been disease free for 23 months without evidence of recurrence. Herein, we report a case of intrahepatic bile duct HCC which disappeared after ERCP.
근치적인 수술 이후 조기 재발하였으나 서로 다른 예후를 보인 간세포암종 2예
조영윤 ( Young Youn Cho ),이정훈 ( Jeong Hoon Lee ),이남준 ( Nam Joon Yi ),이광웅 ( Kwang Woong Lee ),서경석 ( Kyung Suk Suh ),김윤준 ( Yoon Jun Kim ),윤정환 ( Jung Hwan Yoon ) 대한간암학회 2015 대한간암학회지 Vol.15 No.2
Hepatocellular carcinoma (HCC) has poor prognosis, even after curative resection. Earlyrecurrence after curative treatment is a major cause of the poor prognosis. Pathologic factors such as vessel invasion, satellite nodule, size of tumor and pathologic grade are prognostic factors predicting early recurrence and poor prognosis. We share our experience of two cases which both showed early recurrence after curative hepatic resection, but eventually demonstrated different prognosis. Since the most common cause of death after potentially curative treatment is tumor recurrence, suppression of tumor recurrence might be linked to survival gain. Currently, there is no adjuvant therapy for HCC endorsed by international guidelines. However, recent studies have shown that antiviral treatment for hepatitis B virusrelated HCC and immunotherapy using autologous cytokine-induced killer cell reduced HCC recurrence. Further study is needed to select patients who will benefit from adjuvant treatments. (J Liver Cancer 2015;15:126-131)
동적 CT와 MRI에서 진단이 엇갈리는 간암의 치료로서 고주파열치료와 경동맥화학색전술의 효과 비교
조영윤 ( Young Youn Cho ),권정희 ( Jung Hee Kwon ),이정훈 ( Jeong Hoon Lee ),이정민 ( Jeong Min Lee ),이재영 ( Jae Young Lee ),김효철 ( Hyo Cheol Kim ),정진욱 ( Jin Wook Chung ),최원묵 ( Won Mook Choi ),조은주 ( Eun Ju Cho ),유수 대한간암학회 2015 대한간암학회지 Vol.15 No.1
Background/Aims: This study compared the outcomes of patients with small hepatocellular carcinomas (HCCs) who were treated using transarterial chemoembolization (TACE) or radiofrequency ablation (RFA). Methods: This was a post-hoc analysis of a prospective study that evaluated the diagnostic efficacy of magnetic resonance imaging (MRI) and computed tomography (CT). We analyzed 41 small hepatic nodules in 32 patients that showed typical radiologic hallmarks on both CT and gadoxate-enhanced MRI (typical nodules) and 25 small hepatic nodules from 22 patients that showed atypical radiologic hallmarks on CT and typical radiologic hallmarks on MRI (discrepant nodules). Results: There were no significant differences in the baseline characteristics of the patients with typical and discrepant nodules. Complete response rates 1 month after TACE or RFA were 75.0% (18/24) and 94.1% (16/17; P=0.20), respectively, for the patients with typical nodules and 58.8% (10/17) and 100% (8/8; P=0.05), respectively, for the patients with discrepant nodules. Treatment failure rates after TACE or RFA were 33.3% (8/24) and 5.8% (1/17; P=0.15), respectively, for the patients with typical nodules and 47.0% (8/17) and 0.0% (0/8; P=0.02), respectively, for the patients with discrepant nodules. Among patients achieving complete response, there were no significant differences in the risk of marginal recurrence.
간 절제술 후 반복적인 복막 재발을 보인 간세포암종 환자에서 수술 절제로 완치된 1예
이효영 ( Hyo Young Lee ),이정훈 ( Jeong-hoon Lee ),남준열 ( Joon Yeul Nam ),장영 ( Young Chang ),조혜기 ( Hyeki Cho ),조영윤 ( Young Youn Cho ),조은주 ( Eun Ju Cho ),유수종 ( Su Jong Yu ),김윤준 ( Yoon Jun Kim ),윤정환 ( Jung-hwa 대한간암학회 2017 대한간암학회지 Vol.17 No.2
Recurrence of hepatocellular carcinoma (HCC) after hepatic resection is quite common. Peritoneal recurrence has been considered incurable status and related to poor prognosis. Although peritoneal metastasectomy is a therapeutic option for some selected patients with a few peritoneal metastasis, the indication and therapeutic effect has not been clear. We report a case of a 61-year-old man achieving complete remission of recurrent peritoneal metastasis after repeated surgical resection by a multidisciplinary approach. Peritoneal metastasectomy might be a therapeutic option for selected patients with localized oligonodular peritoneal metastasis. (J Liver Cancer 2017;17:153-157)
증례 : 소화기 ; 크론병 환자에서 발생한 간세포암 1예
장승현 ( Seung Hyeon Jang ),김지현 ( Jee Hyun Kim ),이재우 ( Jae Woo Lee ),이준영 ( June Young Lee ),조영윤 ( Young Youn Cho ),최원묵 ( Won Mook Choi ),정현채 ( Hyun Chae Jung ) 대한내과학회 2015 대한내과학회지 Vol.88 No.4
간세포암은 주로 간경화증이나 바이러스 간염 등의 만성간 질환을 가진 환자에서 발생하며 기저에 만성 간 질환이 없는 크론병 환자에서 간세포암이 발생하는 경우는 극히 드물다. 지금까지 보고된 몇몇 국외의 증례들을 살펴보면 비교적 젊은 나이에 크론병이 발생하여 크론병의 유병 기간이 길고 azathioprine을 포함한 면역억제제를 장기간 사용하였다. 만성 간 질환이 없던 34세 남자 크론병 환자가 14년간아자티오프린 치료 및 반복적인 수술을 받았다. 추적 관찰하던 중 결장 천공과 결장 주위 농양으로 입원하였고 당시 시행한 전산화 단층촬영에서 결장 천공과 간의 종양이 발견되었다. 간의 종양은 간 조직 검사에서 기저에 간경화증 등의 특별한 병리학적 소견 없이 간세포암이 확인되었다. 결장 주위 농양과 결장 천공에 대해 우측 결장 절제술을 시행하였고 간세포암에 대해 간동맥 화학색전술 및 고주파 열치료를 시행하였다. 본 증례는 국내에서는 처음 보고되는 증례로 이전 보고되었던 증례와는 달리 원발성 경화성담관염이나 국소적 간 글리코겐증 등의 병리학적 소견을 보이지 않았다. 저자들은 만성 간 질환이 없는 크론병 환자에서 간세포암이 발생한 드문 증례를 문헌고찰과 함께 보고하는 바이다. Hepatocellular carcinomas (HCCs) in patients with Crohn`s disease (CD) without underlying chronic hepatitis or liver cirrhosis are extremely rare. Previously reported cases occurred in patients who had developed CD at a young age and had been treated with immunosuppressive agents long-term. We herein report the first case of HCC in a 34-year-old patient with CD in Korea. The patient was treated with azathioprine for 14 years and had undergone repeated surgeries for CD. During the follow-up period, the patient was hospitalized for colon perforation and pericolic abscess formation. Computed tomography showed a liver mass, and HCC was diagnosed based on liver biopsy. The patient underwent right hemicolectomy for colon perforation and transcatheter arterial chemoembolization followed by radiofrequency ablation for the HCC. The present case is similar to previously reported cases with the exception of the liver pathology findings, which exhibited neither primary sclerosing cholangitis nor focal hepatic glycogenolysis.
曺永允 新羅大學校 1983 論文集 Vol.14 No.-
Webern has expanded the basic principals of series in the various types of music field. He has intended to make his abridgment form to the ability of his own concept, and such concept is reaching to the minute sellection of extreme sound. In seeing it through such view points, all of the musical language have been separated from the ability of traditional tonal system, and it was started according to his own intentional music design. The works of Webern, for the structure, looks Complicative by external forms but the basic structure which is forming the structure is involving the nature of clearness and conciseness which are actualized in the schemetizing and transparenting forms. It can be said that the musical specifics are appeared from the driving out method according to re-organization of rich sound resources which is based on the traditional music rather than being called as his optional originality. Webern has made progress the experience of sound to the utmost to the basic condensed condition, and so we can call him as a camposer who has created the up-to-date sound which was certified the new possibility of tone-row music which can develope by type of the significant expression that can spred the common 12 tone row technical without problem, and also was based on the aesthetic thought.