• Title/Summary/Keyword: 국소적 반응

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ORAL FINDINGS AND TREATMENT OF A PATIENT WITH CYCLIC NEUTROPENIA (주기성 호중구 감소증 환자의 구강 내 소견과 치료에 대한 증례 보고)

  • Kang, Eun-Joo;Choi, Nam-Ki;Kim, Seon-Mi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.2
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    • pp.133-140
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    • 2013
  • Cyclic neutropenia is a hematologic disorder characterized by a marked decrease in the number of circulating neutrophils occurring at regular intervals and after this period, the level of neutrophils usually recovers to a normal range. The clinical symptoms of cyclic neutropenia include fever, malaise, headaches and oral findings associated with painful soft tissue ulceration where lips, tongue and gingiva are typically involved. A 4 year 1 month old boy was presented to the hospital. His chief complaint was mobility of his teeth and swollen gums. The patient had suffered from cyclic neutropenia. Clinical examination revealed evident decay on all primary teeth except for the mandibular anterior teeth and localized alveolar bone loss around mandibullar right and left first primary molars which have mobility was notable. The patient was diagnosed with multiple dental caries, gingivitis and localized periodontitis associated with cyclic neutropenia and treated based on it. The dental treatment, including regular tooth care and appropriate treatment of dental caries or gingivitis, is essential for patients suffering cyclic neutropenia. Especially, proper care at an early stage is needed for young patients to minimize the unwanted consequences for permanent teeth development.

Palliative Irradiation Using Helical Tomotherapy in Recurrent Pelvic Tumors with Prior Radiotherapy (방사선치료 후 재발한 골반암에서 토모테라피를 이용한 고식적 재치료)

  • Kay, Chul-Seung;Yoo, Eun-Jung;Kim, Ji-Hoon;Ro, Duck-Young;Kim, Ki-Jun
    • Radiation Oncology Journal
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    • v.28 no.3
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    • pp.133-140
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    • 2010
  • Purpose: We retrospectively investigated the effect of irradiation using helical tomotherapy in recurrent pelvic tumors that underwent prior irradiation. Materials and Methods: Fourteen patients with recurrent pelvic tumors consisting of rectal cancer (57.1%), cervical cancer (35.7%) and cancer with an unknown origin (7.1%) were treated with tomotherapy. At the time of irradiation, median tumor size was 3.5 cm and 7 patients complained of pain originating from a recurrent tumor. The median radiation dose delivered to the gross tumor volume, clinical target volume, and planning target volume was 50 Gy, 47.8 Gy and 45 Gy, respectively and delivered at 5 fractions per week over the course of 4 to 5 weeks. Treatment response and duration of local disease control were evaluated using the Response Evaluation Criteria in Solid Tumors (ver. 1.0) and the Kaplan-Meyer method. Treatment-related toxicities were assessed through Common Terminology Criteria for Adverse Events (ver. 3.0). Results: The median follow-up time was 17.3 months, while the response rate was 64.3%. Symptomatic improvement appeared in 6 patients (85.7%). The median duration time of local disease control was 25.8 months. The rates of local failure, distant failure, and synchronous local and distant failure were 57.1%, 21.4%, and 7.1%, respectively. Acute toxicities were limited in grade I or II toxicities, except for one patient. No treatment related death or late toxicity was observed. Conclusion: Helical tomotherapy could be suggested as a feasible palliative option in recurrent pelvic tumors with prior radiotherapy. However, to increase treatment effect and overcome the limitation of this outcome, a large clinical study should be performed.

Induction Chemotherapy with S-1 and Cisplatin in Patients with Locally Advanced Squamous Cell Carcinoma of the Head and Neck : A Single Center Experience (국소진행성 두경부편평상피암 환자를 대상으로 한 S1과 시스플라틴 병용 유도항암화학요법에 관한 연구)

  • Yoon, Dok-Hyun;Cho, Yoo-Jin;Kim, Ji-Youn;Kim, Sang-Yoon;Nam, Soon-Yuhl;Choi, Seung-Ho;Roh, Jong-Lyel;Lee, Sang-Wook;Lee, Jeong-Hyun;Kim, Jae-Seung;Cho, Kyung-Ja;Kim, Sung-Bae
    • Korean Journal of Head & Neck Oncology
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    • v.27 no.2
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    • pp.183-189
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    • 2011
  • 서 론: 5-FU와 cisplatin 병용항암화학요법은 국소진행성 두경부편평상피암의 유도화학요법으로 널리 사용되고 있는 요법이다. 저자들은 5-FU 대신 경구제재인 S-1을 cisplatin과 병용하는 복합항암요법의 효과와 안전성에 대해 연구하였다. 대상 및 방법: 저자들은 2007년 2월부터 2008년 12월까지 S1과 cisplatin의 복합유도화학요법을 시행받은 3/4기 구인두, 하인두, 후두, 구강 편평상피세포암 환자 52명의 치료결과를 후향적으로 분석하였다. 유도항암화학요법은 제 1일에 cisplatin(75 또는 60mg/$m^2$), 제1일부터 14일까지 S-1(40mg/$m^2$)을 1일 2회, 21일 간격으로 투여하였고 가능한 경우에는 항암방사선동시요법 또는 수술을 뒤이어 시행하였다. 결 과: 전체 52명 중 37명(71.2%)에서 부분반응을 보였으나 완전반응은 관찰되지 않았다. 2년 무진행생존율은 56.9%, 2년 전체생존율은 68.2%였다. 유도항암요법과 관련된 유해반응으로는 호중구감소증(71.2%) 및 빈혈(63.5%) 등과 같은 혈액학적 부작용이 가장 흔했다. 결 론: S-1과 cisplatin의 복합항암화학요법은 국소진행성 두경부편평상피암 환자를 대상으로 한 유도화학요법으로 적용이 가능한 것으로 판단된다.

Radiotherapy Results of Stage I Glottic Cancer (조기 성문암의 방사선 치료 결과)

  • Kim, Jae-Chul;Park, In-Kyu
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.245-250
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    • 1998
  • Purpose : This study was to evaluate survival, failure patterns, and prognostic factors of stage I squamous cell carcinoma of the glottic larynx after curative radiation therapy. Materials and Methods : A retrospective analysis was done for 57 patients with glottic cancer who were treated with curative radiation therapy from June 1985 to November 1992. There were 55 male and two female patients. Patients' age ranged from 17 to 71 years(median 39 years). Radiation therapy was delivered five times a week, 2 Gy daily, total 66 Gy using 6 MV X-ray. Results : Complete response(CR) was noted in 51 out of 57 patients (89.5%) and persistent disease (PER) in six out of 57 patients(10.5%). The disease-free survival rates at 3 and 5 years were 72.9% and 63.8%, respectively. Seven failures were observed among 51 CR patients during follow-up. Salvage total laryngectomy for six recurred patients and partial laryngectomy for one recurred patient were done with successful results, i.e., all of them were actually salvaged. Among six PER patients, salvage total laryngectomy for two patients and partial laryngectomy for two patients were done and two patients refused operation. Following salvage surgery for the four PER patients, three were salvaged and one failed locoregionally. Among the 13 failures 10(76.9%) were salvaged with surgery. The ultimate local control rate at 5 years was 92.3% and overall 47 out of 57 (82.5%) patients were able to preserve their larynx. The 5-year disease-free survival rates were 85.5% for posterior lesions, and 61.6% for anterior lesions(P<0.05). Cord mobility, involvement of anterior commissure, field size, and T stage did not impact on disease-free survival. Conclusion : Considering the high percentage of voice preservation with initial radiotherapy, radiotherapy should be the first choice in the treatment of stage 1 glottic carcinoma.

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Clinical Significance of Maspin Expression in Osteosarcoma (골육종에서 Maspin 발현의 임상적 의의)

  • Choi, Jay-Rim;Han, Il-Kyu;Lee, Mi-Ra;Cho, Hwan-Seong;Oh, Joo-Han;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.1
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    • pp.26-33
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    • 2009
  • Purpose: This study was performed to investigate the maspin gene expression from osteosarcoma and to determine whether its expression correlates with clinical course of the cancer. Materials and Methods: Between 2001 and 2006, 39 patients who were diagnosed and treated surgically for osteosarcoma were included in the present study. We estimated the maspin gene expression from osteosarcoma tissue samples using RT-PCR. And we examined the correlations between the maspin expression and clinical data (post-chemotherapeutic response, local relapse or metastases). Results: Maspin was over expressed in 21 cases of 39 osteosarcoma tissues. There were significant correlations between maspin expression and the response to neoadjuvant chemotherapy, distant metastases & metastasis-free survival. In multivariate analysis, maspin low-expression was significant risk factor for distant metastases. Also, there was significant difference in metastasis-free survivals between maspin hi- expression group ($69.0{\pm}10.5%$) and low-expression group ($25.4{\pm}13.0%$). Conclusion: The degree of maspin expression in osteosarcoma was significant risk factor for distant metastases and predictive factor for metastasis-free of overall survivals. Maspin may be a useful biologic marker in evaluating the prognosis in patients with osteosarcoma and could be used as a therapeutic target clinically.

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Stimulatory Effect of Staphylococcal Protein A on Inflammatory Response in Human HaCaT Keratinocytes (사람의 피부상피세포에서 황색포도상구균의 독소인자인 Staphylococcal Protein A의 염증반응 촉진효과)

  • Kwon, Hyun-Jin;Kim, Yeon-Jung;Jang, Sung-Hee;Bae, Bo-Kyoung;Youn, Hwa-Young;Lee, Hee-Woo
    • Korean Journal of Microbiology
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    • v.47 no.4
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    • pp.348-355
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    • 2011
  • Staphylococcus aureus is a major human pathogen that is associated with various types of local and systemic infection. Staphylococcal protin A (SPA), a highly expressed surface component of S. aureus, may have a role in virulence such as activating inflammation and interfering with immune clearance. We examined the effect of recombinant SPA on inflammatory response in human HaCaT keratinocytes. The recombinant SPA protein was prepared using the pET-28a Vector System in Escherichia coli. The expression of pro-inflammatory related adhesion molecules and cytokines in HaCaT cells incubated for 6, 12, and 24 h with SPA (2 ${\mu}g$/ml) was analyzed by comparative RT-PCR or ELISA. The expression of E-selectin, ICAM-1, MCP-1, IL-6 and IL-8 was significantly increased in HaCaT from 6 to 24 h after treatment with SPA. SPA showed the effect on the adhesion-promoting ability of U937 monocytes to HaCaT cells. Our data demonstrate that SPA stimulates inflammatory response of HaCaT cells, implicating an important factor for exacerbation of skin inflammation of immunologic disease.

Bioluminescence Imaging of Chondrocytes in Rabbits by Intraarticular Injection of D-Luciferin (토끼에서 D-luciferin의 관절강 주입에 의한 연골세포의 자연발광 영상)

  • Moon, Sung-Min;Min, Jung-Joon;Oh, Suk-Jung;Kang, Han-Saem;Kim, Young-Ho;Kim, Sung-Mi;Kim, Kwang-Yoon;Bom, Hee-Seung
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.1
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    • pp.54-58
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    • 2007
  • Purpose: Luciferase is one of the most commonly used reporter enzymes in the field of in vivo optical imaging. D-luciferin, the substrate for firefly luciferase has very high cost that allows this kind of experiment limited to small animals such as mice and rats. In this current study, we validated local injection of D-luciferin in the articular capsule for bioluminescence imaging in rabbits. Materials and Methods: Chondrocytes were cultured and infected by replication-defective adenoviral vector encoding firefly luciferase (Fluc). Chondrocytes expressing Fluc were injected or implanted in the left knee joint. The rabbits underwent optical imaging studies after local injection of D-luciferin at 1, 5, 7, 9 days after cellular administration. We sought whether optimal imaging signals was could be by a cooled CCD camera after local injection of D-luciferin. Results: Imaging signal was not observed from the left knee joint after intraperitoneal injection of D-luciferin (15 mg/kg), whereas it was observed after intraarticular injection. Photon intensity from the left knee joint of rabbits was compared between cell injected and implanted groups after intraarticular injection of D-luciferin. During the period of imaging studies, photon intensity of the cell implanted group was 5-10 times higher than that of the cell injected group. Conclusion: We successfully imaged chondrocytes expressing Fluc after intraarticular injection of D-luciferin. This technique may be further applied to develop new drugs for knee joint disease.

Intestinal mastocytosis and goblet cell hyperplasia in BALB/e and C3H mice infected with Neodiplostomum seoulLense (서울주걱흡충 감염 BALB/c 및 C3H 마우스에서 장점막 비만세포 및 배세포의 증식)

  • 채종일;김태규
    • Parasites, Hosts and Diseases
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    • v.36 no.2
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    • pp.109-120
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    • 1998
  • Mucosal mast cell (MMC) and goblet cell (GC) responses were observed in the small intestine of two strains of mice (BALBfc and C3H) infected with Weodiplostomum seouLehTe, and their roles in the host defense and worm expulsion were studied. From day 3 to 28 post-infection (Pl) with 200 metacercariae, the worm recovery rate from BALB/c mice was consistently and remarkably higher than that from C3H mice. In the duodenum of both strains of mice, the main habitat of the flukes, mastocytosis was pronounced on day 7 Pl but quickly diminished thereafter. Similar kinetics were observed in the jejunum and ileum, although the extent of mastocytosis was lesser in the ileum than other two areas. These MMC kinetics were not different between the ko strains of mice. Moreover, the extent of mastocytosis was stronger in BALB/C mice than in C3H mice. GC hyperplasia was remarkable in the duodenum of BALBlc mice throughout the course of infection except day 14 Pl, whereas it was recognizable only in the jejunum and ileum of C3H mice on day 7 Pl. Mucin activation was evidently demonstrated in both strains of mice throughout the course of infection, but more marked in BALB/c than in C3H mice. The results strongly suggest that mastocytosis and GC hyperplasia are local immune responses against N. seoulense, however, they play a minor role in the host defense and worm expulsion.

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Immunogenicity and Safety of Inactivated Influenza Vaccine in Healthy Korean Children and Adolescent (한국의 건강한 소아청소년을 대상으로 한 인플루엔자 사백신의 면역원성과 안전성 연구)

  • Ri, Soohyun;Kim, Mi Jeong;Kim, Yun-Kyung
    • Pediatric Infection and Vaccine
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    • v.25 no.1
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    • pp.35-44
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    • 2018
  • Purpose: This study aimed to evaluate the immunogenicity and safety of a trivalent inactivated influenza vaccine (TIV) among healthy Korean children and adolescents. Methods: From October to December 2008, 65 healthy patients aged 6 months to 18 years who visited Korea University Ansan Hospital for influenza vaccination were enrolled in this study. We measured the hemagglutinin inhibition antibody titers at baseline and 30 days after vaccinating enrollees with split influenza vaccine and calculated the seroprotection rates, geometric mean titers, and seroconversion rates. Local and systemic adverse events were assessed after vaccination. Results: The seroprotection rates against all three viral strains (A/H1N1, A/H3N2, B) were 87.7%, 89.2%, and 89.2% (${\geq}70%$), respectively; seroconversion rates were 44.6%, 73.8%, and 63.1% (${\geq}40%$), respectively; and seroconversion factors were 4.5, 8.4, and 10.5 (>2.5), respectively. The TIV immunogenicity was acceptable according to the CPMP (Committee for Proprietary Medicinal Products) criteria. Although 48 patients (73.8%) reported one or more adverse events, no severe adverse events such as anaphylaxis and convulsion were observed. Forty-two patients (64.6%) reported a local skin reaction, including redness (29.2%), pain (43.1%), or swelling (41.5%) of the injected site, and 26 (40.0%) reported a systemic reaction: fatigue (23.1%), myalgia (20.0%), headache (10.8%), arthralgia (10.8%), chills (9.2%), or fever (7.7%). Conclusions: This study shows that the immunogenicity of the TIV vaccine is acceptable. As there were no serious adverse events aside from local reactions and mild systemic reactions, this vaccine can be safely used among healthy Korean children and adolescents.

Radiotherapy in Supraglottic Carcinoma - With Respect to Locoregional Control and Survival - (성문상부암의 방사선치료 -국소종양 제어율과 생존율을 중심으로-)

  • Nam Taek-Keun;Chung Woong-Ki;Cho Jae-Shik;Ahn Sung-Ja;Nah Byung-Sik;Oh Yoon-Kyeong
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.108-115
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    • 2002
  • Purpose : A retrospective study was undertaken to determine the role of conventional radiotherapy with or without surgery for treating a supraglottic carcinoma in terms of the local control and survival. Materials and Methods : From Jan. 1986 to Oct. 1996, a total of 134 patients were treated for a supraglottic carcinoma by radiotherapy with or without surgery. Of them, 117 patients who had completed the radiotherapy formed the base of this study. The patients were redistributed according to the revised AJCC staging system (1997). The number of patients of stage I, II, III, IVA, IVB were $6\;(5\%),\;16\;(14\%),\;53\;(45\%),\;32\;(27\%),\;10\;(9\%)$, respectively. Eighty patients were treated by radical radiotherapy in the range of $61.2\~79.2\;Gy$ (mean : 69.2 Gy) to the primary tumor and $45.0\~93.6\;Gy$ (mean : 54.0 Gy) to regional lymphatics. All patients with stage I and IVB were treated by radiotherapy alone. Thirty-seven patients underwent surgery plus postoperative radiotherapy in the range of $45.0\~68.4\;Gy$ (mean : 56.1 Gy) to the primary tumor bed and $45.0\~59.4\;Gy$ (mean : 47.2 Gy) to the regional lymphatics. Of them, 33 patients received a total laryngectomy (${\pm}lymph$ node dissection), three had a supraglottic horizontal laryngectomy (${\pm}lymph$ node dissection), and one had a primary excision alone. Results : The 5-year survival rate (5YSR) of all patients was $43\%$. The 5YSRs of the patients with stage I+II, III+IV were $49.9\%,\;41.2\%$, respectively (p=0.27). However, the disease-specific survival rate of the patients with stage I (n=6) was $100\%$. The 5YSRs of patients who underwent surgery plus radiotherapy (S+RT) vs radiotherapy alone (RT) in stage II, III, IVA were $100\%\;vs\;43\%$ (p=0.17), $62\%\;vs\;52\%$ (p=0.32), $58\%\;vs\;6\%$ (p<0.001), respectively. The 5-year actuarial locoregional control rate (5YLCR) of all the patients was $57\%$. The 5YLCR of the patients with stage I, II, III, IVA, IVB was $100\%,\;74\%,\;60\%,\;44\%,\;30\%$, respectively (p=0.008). The 5YLCR of the patients with S+RT vs RT in stage II, III, IVA was $100\%\;vs\;68\%$ (p=0.29), $67\%\;vs\;55\%$ (p=0.23), $81\%\;vs\;20\%$ (p<0.001), respectively. In the radiotherapy alone group, the 5YLCR of the patients with a complete, partial, and minimal response were $76\%,\;20\%,\;0\%$, respectively (p<0.001). In all patients, multivariate analysis showed that the N-stage, surgery or not, and age were significant factors affecting the survival rate and that the N-stage, surgery or not, and the ECOG performance index were significant factors affecting the locoregional control. In the radiotherapy alone group, multivariate analysis showed that the radiation response and N-stage were significant factors affecting the overall survival rate as well as locoregional control. Conclusion : In early stage supraglottic carcinoma, conventional radiotherapy alone is an equally effective modality compared to surgery plus radiotherapy and could preserve the laryngeal function. However, in the advanced stages, radiotherapy combined with concurrent chemotherapy for laryngeal preservation or surgery should be considered. In bulky neck disease, all the possible planned neck dissections after induction chemotherapy or before radiotherapy should be attempted.