• Title/Summary/Keyword: 동시성 폐암

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Surgical Treatment for Metastatic Spinal Tumor (전이성 척추 종양의 수술적 치료)

  • Han, Chung-Soo;Kim, Ki-Tack;Soh, Jae-Ho;Lee, Jung-Hee;Shin, Dong-Jun
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.1
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    • pp.1-9
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    • 2000
  • Purpose : Spine is one of the most common sites of the metastatic bone tumors. Conservative management such as chemotherapy or radiotherapy has been preferred in most cases. However, the neurologic deficit has not been usually improved, and the quality of life was poor. The purpose of this study was to show the efficacy of the surgical treatments for metastatic spinal tumors in terms of postoperative improvements of neurologic deficit and survival time. Materials and Methods : Authors have reviewed the literatures and analyzed 14 patients of metastatic spinal tumors who were received operative treatments between August 1991 and June 1999 at the our department of orthopaedic surgery. Results : The most frequent primary tumor was breast cancer in women and lung cancer in men. The thoracic region was the most common site. There was a preponderance of females over males, and the age ranged between 4th and 8th decade. The indications of surgical treatment comprised instability, progressive neurologic findings, resistance to radiotherapy, pathological fracture, long life expectancy( >6weeks), isolated metastasis and need for pathological diagnosis. The degree of preoperative neurological deficit might influence on the improvement of clinical symptoms after surgery. Conclusion : The surgical treatment reduced the neurological deficit and pain regardless of the operative methods. In the early stage of neurological deficit, the surgical treatment was important for better prognosis. Recently early active operative treatment was performed for metastatic spinal tumor to minimize the intractable pain and to prevent the progression of the neurologic deficit. Early intervention can improve the quality of life and long term survival.

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Measuring Intracellular Mycobacterial Killing Using a Human Whole Blood Assay (인체 전혈 모델을 이용한 세포내 결핵균 살균력에 관한 연구)

  • Cheon, Seon-Hee;Song, Ho-Yeon;Lee, Eun-Hee;Oh, Hee-Jung;Kang, In-Sook;Cho, Ji-Yoon;Hong, Young-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.5
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    • pp.497-509
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    • 2002
  • Background : The mechanisms through which cellular activation results in intracellular mycobacterial killing is only partially understood. However, in vitro studies of human immunity to Mycobacterium tuberculosis have been largely modeled on the work reported by Crowle, which is complicated by several factors. The whole blood culture is simple and allows the simultaneous analysis of the relationship between bacterial killing and the effect of effector cells and humoral factors. In this study, we attempted to determine the extent to which M. tuberculosis is killed in a human whole blood culture and to explore the role of the host and microbial factor in this process. Methods : The PPD positive subject were compared to the umbilical cord blood and patients with tuberculosis, diabetes and lung cancer. The culture is performed using heparinized whole blood diluted with a culture medium and infected with a low number of M. avium or M. tuberculosis $H_{37}Ra$ for 4 days by rotating the culture in a $37^{\circ}C$, 5% $CO_2$ incubator. In some experiments, methlprednisolone- or pentoxifyline were used to inhibit the immune response. To assess the role of the T-cell subsets, CD4+, CD8+ T-cells or both were removed from the blood using magnetic beads. The ${\Delta}$ log killing ratio was defined using a CFU assay as the difference in the log number of viable organisms in the completed culture compared to the inoculum. Results : 1. A trend was noted toward the improved killing of mycobacteria in PPD+ subjects comparing to the umbilical cord blood but there was no specific difference in the patients with tuberculosis, diabetes and lung cancer. 2. Methylprednisolone and pentoxifyline adversely affected the killing in the PPD+ subjects umbilical cord blood and patients with tuberculosis. 3. The deletion of CD4+ or CD8+ T-lymphocytes adversely affected the killing of M. avium and M. tuberculosis $H_{37}Ra$ by PPD+ subjects. Deletion of both cell types had an additive effect, particularly in M. tuberculosis $H_{37}Ra$. 4. A significantly improved mycobacterial killing was noted after chemotherapy in patients with tuberculosis and the ${\Delta}$ logKR continuously decreased in a 3 and 4 days of whole blood culture. Conclusion : The in vitro bactericidal assay by human whole blood culture model was settled using a CFU assay. However, the host immunity to M. tuberculosis was not apparent in the human whole blood culture bactericidal assay, and patients with tuberculosis showed markedly improved bacterial killing after anti-tuberculous chemotherapy compared to before. The simplicity of a whole blood culture facilitates its inclusion in a clinical trial and it may have a potential role as a surrogate marker in a TB vaccine trial.

Assessment of the Usefulness of an IMRT Plan Using a Shell-Type Pseudo Target with Patients in Stage III or IV of NSCLC (비소세포폐암 III, IV기 환자에 있어서 Shell-Type Pseudo Target을 이용한 세기 조절 방사선치료계획기법의 유용성 평가)

  • Lee, Sang-Bong;Park, Ki-Ju;Park, Du-Chan;Kim, Man-Wo;Kim, Jun-Gon;Noh, Sung-Hwan
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.95-106
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    • 2012
  • Purpose: The objective of this study was to investigate the usefulness of an IMRT treatment plan according to whether there was a shell-type pseudo target during radiation therapy for patients in Stage III or IV of non-small cell lung cancer (NSCLC). Materials and Methods: After setting an IMRT (Intensity-Modulated Radiation Therapy, IMRT) plan for when there was a shell-type pseudo target (SPT) and when there was none (WSPT) with 22 patients in Stage III or IV of NSCLC, the investigator analyzed dose-volume histograms (DVHs) and made assessment with dosimetric comparisons such as homogeneity index (HI) inside the tumor target, conformity index (CI) of the tumor target, spinal cord maximum dose, Esophagus $V_{50%}$, mean lung dose (MLD), and $V_{40%}$, $V_{30%}$, $V_{20%}$, $V_{10%}$, $V_{5%}$. Results: The mean CI of WSPT and SPT was $1.22{\pm}0.04$ and $1.16{\pm}0.032$ ($.000^*$), respectively, and the mean HI of WSPT and SPT was $1.06{\pm}0.015$ and $1.07{\pm}0.014$ ($.000^*$), respectively. In SPT, the mean of each CI difference decreased by $-5.16{\pm}2.54%$, while HI increased by average $0.81{\pm}0.47%$. Esophagus $V_{50%}$ recorded $14.54{\pm}12.01%$ (WSPT) and $12.14{\pm}11.09%$ ($.000^*$, SPT) with the mean of SPT differences dropping by $-26.37{\pm}25.05%$. Mean spinal cord maximum dose was $3,898.44{\pm}1,075.0$ cGy (WSPT) and $3,810.8{\pm}1,134.9$ cGy ($.004^*$, SPT) with SPT dropping by average $-3.36{\pm}5.81%$. As for lung $V_{X%}$, the mean of $V_{5%}$ and $V_{10%}$ differences was $-1.62{\pm}2.29%$ ($.006^*$) and $-1.98{\pm}5.02%$ ($.005^*$), respectively with SPT making a decrease. The mean of V20%, V30%, and V40% differences was $-3.51{\pm}3.07%$ ($.000^*$), $-4.84{\pm}6.01%$ ($.000^*$), and $-6.16{\pm}8.46%$ ($.001^*$), respectively, with SPT making a decrease with statistical significance. In MLD assessment, SPT also dropped by average $-2.83{\pm}2.41%$ ($.000^*$). Those results show that SPT allows for mean 169 cGy (Max: 547 cGy, Min: 6.4 cGy) prescription dose. Conclusion: An IMRT treatment plan with SPT during radiation therapy for patients in Stage III or IV of NSCLC will help to reduce the risk of lung toxicity and radiation-induced pneumonia by cutting down radiation doses entering the normal lung, reduce the local control failure rate during radiation therapy due to increasing prescription doses to a certain degree, and increase treatment effects.

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Combined Treatment of Nonsteroidal Anti-inflammatory Drugs and Genistein Synergistically Induces Apoptosis via Induction of NAG-1 in Human Lung Adenocarcinoma A549 Cells (인간 A549 폐암세포에서 비스테로이드성 항염증제와 genistein의 복합처리에 의한 NAG-1 의존적 세포사멸 증진 효과)

  • Kim, Cho-Hee;Kim, Min-Young;Lee, Su-Yeon;Moon, Ji-Young;Han, Song-Iy;Park, Hye-Gyeong;Kang, Ho-Sung
    • Journal of Life Science
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    • v.19 no.8
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    • pp.1073-1080
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    • 2009
  • A number of studies have demonstrated that the regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce the risks of colorectal, oesophageal and lung cancers. NSAIDs have been shown to exert their anti-cancer effects through inducing apoptosis in cancer cells. The susceptibility of tumor cells to anti-tumor drug-induced apoptosis appears to depend on the balance between pro-apoptotic and anti-apoptotic programs such as nuclear factor kB (NF-kB), phosphatidylinositol 3-kinase (PI3K)-Akt/protein kinase B (PKB) and MEK1/2-ERK1/2 pathways. We examined the effects of pro-survival PI3K and ERK1/2 signal pathways on cell cycle arrest and apoptosis in response to NSAIDs including sulindac sulfide and NS398. We show that simultaneous inhibition of the Akt/PKB and ERK1/2 signal cascades could synergistically enhance the potential pro-apoptotic activities of sulindac sulfide and NS398. Similar enhancement was observed in cells treated with sulindac sulfide or NS398 and 100 ${\mu}$M genistein, an inhibitor of receptor tyrosine kinases (RTKs) that are upstream of PI3K and MEK1/2 signaling. We further demonstrate that NAG-1 is induced and plays a critical role(s) in apoptosis by NSAIDs-based combined treatment. In sum, our results show that combinatorialtreatment of sulindac sulfide or NS398 and genistein results in a highlysynergistic induction of apoptotic cell death to increase the chemopreventive effects of the NSAIDs, sulindac sulfide and NS398.

Interventional radiology of Bronchial artery embolization due to massive hemoptysis (대량객혈로 인한 기관지 동맥 색전의 중재적 방사선시술)

  • Min, Byoung-Yun;Lee, Sang-Bock
    • Journal of the Korean Society of Radiology
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    • v.4 no.4
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    • pp.17-24
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    • 2010
  • Hemoptysis which is comparatively common symptom in respiratory disease patients is a clinical symptom which has high risk of death in spite of many curative means. Bronchial tube embolization is a very useful medical procedure when hemoptysis does not stop for treatment of internal medicine or surgery and in addition to the purpose of instant hemostasis, for patients for whom surgical operation is impossible or for the purpose of gaining time to improve the state of the patient before surgical operation. In relation to this, this study is to know of the usefulness of bronchial tube artery embolization. The objects were 60 persons for whom bronchial tube artery embolizations are conducted because of large hemoptysis occurred from March 2007 to December 2009 in J hospital. They had large hemoptysis of 400ml or more per day and 200ml or more at a time or though the quantity of hemoptysis was less than 400ml they did not respond to the treatment of internal medicine for 10 days or longer. The average age was 60.5 years and cause diseases were tuberculosis, bronchiectasis, and pneumonia and lung cancer. Embolus parts were Rt bronchial artery 19 examples, Lt bronchial artery, both bronchial artery, Rt Intercostobronchial artery, and they were the case where embolization for many blood vessels were simultaneously carried out. As embolus materials, PVA (conteour) and microcoil were used. In 76.6% of 60 persons of patients hemorrhage stopped with the lapse of time after the procedure and in 4 examples (6.6) re-embolization was carried out due to re-bleeding after the procedure. Bronchial tube artery embolization has high early success rate and effectively controls hemoptysis in the treatment of hemoptysis and is an effective emergency remedy for hemorrhage due to large hemoptysis and will be a good medical procedure which reduces death rate. In addition, primarily if it is conducted together with the treatment of internal medicine it will be, as an effective curative means for hemorrhage due to large hemoptysis, a good mediate radial rays medical procedure which reduces death rate.

Clinical Observation for the 161 Cases of CVA (뇌졸중환자(腦卒中患者) 161례(例)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Kang, Myeong-Seog;Jun, Chan-Yong;Park, Chong-Hyeong
    • The Journal of Korean Medicine
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    • v.16 no.2 s.30
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    • pp.17-35
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    • 1995
  • Clinical observation was made on 161 cases of CVA that were confirmed through brain CT, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from January to December in 1994. 1. The CVA cases were classified into the following kinds: cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage(SAH), transient ischemic attack, hypertensive encephalopathy, and the greatest in number among them were the cases of cerebral infarction. 2. The frequency of strokes was much the same between male and female cases and most cases were over 50 of age. 3. In the case of cerebral infarction the place of the most frequent occurrences was in the MCA territory, and as for cerebral hemorrhage, in the basal ganglia area. 4. The most ordinary preceding disease was hypertension. The next was diabetes mellitus. 5. Generally it is thought that CVA occurs frequently in winter. But on the contrary this study of observation confirmed that it occurs mostly in summer. 6. The predisposing factors of cerebral infarction were usually initiated during the time of resting and sleeping and those of cerebral hemorrhage chiefly during the time of exercising. 7. As concerns the course of hospitalization, most patients passed through western medical hospitals or oriental medical hospitals. 8. For the patients the condition of whose consciousness was bad at the time of admission, the prognosis in most cases was bad. 9. The common symptoms were motor disability and verbal disturbance. 10. With regard to cerebral infarction, the average time to start physical theraphy was 11.4 days and with cerebral hemorrhage 22.7 days after stroke. 11. The duration of hospitalization was in most cases more than one month. 12. The main complication was urinary tract infection. The next was pneumonia. 13. At the time of admission to hospital, the blood pressure in most cases was high, but it well controlled at the time of discharge. 14. Most cases were given simultaneous treatment in both ways of western and oriental medicine.

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Comparison of PCR-RFLP and Real-Time PCR for Allelotyping of Single Nucleotide Polymorphisms of RRM1, a Lung Cancer Suppressor Gene (폐암 억제유전자 RRM1의 단일염기다형성 검사를 위한 PCR-RFLP법과 Real-Time PCR법의 유용성 비교)

  • Jeong, Ju-Yeon;Kim, Mi-Ran;Son, Jun-Gwang;Jung, Jong-Pil;Oh, In-Jae;Kim, Kyu-Sik;Kim, Young-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.5
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    • pp.406-416
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    • 2007
  • Background: Single nucleotide polymorphisms (SNPs), which consist of a substitution of a single nucleotide pair, are the most abundant form of genetic variations occurring with a frequency of approximately 1 per 1000 base pairs. SNPs by themselves do not cause disease but can predispose humans to disease, modify the extent or severity of the disease or influence the drug response and treatment efficacy. Single nucleotide polymorphisms (SNPs), particularly those within the regulatory regions of the genes often influence the expression levels and can modify the disease. Studies examining the associations between SNP and the disease outcome have provided valuable insight into the disease etiology and potential therapeutic intervention. Traditionally, the genotyping of SNPs has been carried out using polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP), which is a low throughput technique not amenable for use in large-scale SNP studies. Recently, TaqMan real-time PCR chemistry was adapted for use in allelic discrimination assays. This study validated the accuracy and utility of real-time PCR technology for SNPs genotyping Methods: The SNPs in promoter sequence (-37 and -524) of lung cancer suppressor gene, RRM1 (ribonucleotide reductase M1 subunit) with the genomic DNA samples of 89 subjects were genotyped using both real-time PCR and PCR-RFLP. Results: The discordance rates were 2.2% (2 mismatches) in -37 and 16.3% (15 mismatches) in -524. Auto-direct sequencing of all the mismatched samples(17 cases) were in accord with the genotypes read by real-time PCR. In addition, 138 genomic DNAs were genotyped using real-time PCR in a duplicate manner (two separated assays). Ninety-eight percent of the samples showed concordance between the two assays. Conclusion: Real-time PCR allelic discrimination assays are amenable to high-throughput genotyping and overcome many of the problematic features associated with PCR-RFLP.

The Enhancement of Radiosensitivity by Celecoxib, Selective Cyclooxygenase-2 Inhibitor, on Human Cancer Cells Expressing Differential Levels of Cyclooxygenase-2 (선택적 Cyclooxygenase-2 억제제인 Celecoxib가 상이한 Cyclooxygenase-2 발현량을 가진 인간 암세포주들에 대하여 유도하는 방사선 감수성 증진 작용)

  • Pyo Hongryull;Shin You Keun;Kim Hyun Seok;Seong Jinsil;Suh Chang Ok;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.21 no.3
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    • pp.216-221
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    • 2003
  • Purpose: To investigate the modulation of radiosensitivity by celecoxib, a selective cyclooxygenase-2 (COX-2) inhibitor, on cancer cells over- and under-expressing COX-2. Materials and Methods: A clonogenic radiation survival analysis was performed on A549 human lung and MCF-7 human breast cancer cell lines incubated in both 1 and $10\%$ fetal bovine serum (FBS) containing media. The apoptosis in both cell lines was measured after treatment with radiation and/or celecoxib. Results: Celecoxib enhanced the radiation sensitivity of the A549 cells in the medium containing the $10\%$ FBS, with radiation enhancement ratios of 1.58 and 1.81 respectively, at surviving fractions of 0.1, with $30\muM\;and\;50\muM$ celecoxib. This enhanced radiosensitivity disappeared in the medium containing the $1\%$ FBS. Celecoxib did not change the radiation sensitivity of the MCF-7 cells in either media. The induction of apoptosis by celecoxib and radiation was not synergistic in either cell line. Conclwsion: Celecoxib, a selective COX-2 inhibitor, preferentially enhanced the effect of radiation on COX-2 over-expressing cancer cells compared to the cells with a low expression, and this effect disappeared on incubation of the cells during drug treatment in the medium with suboptimal serum concentration. Apoptosis did not appear to be the underlying mechanism of this radiation enhancement effect due to celecoxib on the A549 cells. These findings suggest radiosensitization by a selective COX-2 inhibitor is COX-2 dependent.

Quality Characteristics of Kochujang Prepared with Paecilomyces japonica from Silkworm (누에 동충하초(Paecilomyces japonica)를 첨가하여 제조한 고추장의 품질특성 변화에 관한 연구)

  • Bang, Hye-Yeol;Park, Moo-Hyun;Kim, Gun-Hee
    • Korean Journal of Food Science and Technology
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    • v.36 no.1
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    • pp.44-49
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    • 2004
  • Changes in quality properties of Kochujang prepared with Paecilomyces japonica powder and extract using different solvents were investigated during 90 days of fermentation at $20^{\circ}C$. Although moisture contents were not significantly different, pH of P. japonica-added Kochujang was lower than that of control group without P. japonica, and decreased with increasing fermentation time. Amino nitrogen content increased up to 60 days of fermentation and decreased slightly after 90 days, with that of P. japonica-added Kochujang showing highest on 30 and 60 days at 179.2 and 282.2 mg%, respectively, higher than control gruup. L, a, and b values decreased in proportion to fermentation period, with P. japonica-added Kochujang, particularly P. japonica powder-added Kochujang, lower than those of control g개up. Sensory evaluation test showed color of control group was 'clear red', whereas that of P. japonica powder-added Kochujang was 'dark reddish brown' and P. japonica extract-added Kochujang was darker than control group; consumer preference for dark color was low, Textures of all samples were 'glossy and smooth', showing high consumer preference. Salt content of P. japonica-added Kochujang was higher than that of control group, with P. japonica extract-added Kochujang higher than that made with powder Hot taste or P. japonica-added Kochujang was weaker, whereas its flavor higher, than control group, with P. japonica powder-added Kochujang showing highest flavor score. Overall preference was higher for P. japonica-added Kochujang than control group, with P. japonica water extract-added Kochujang showing the highest score.

Comparison of Inhalation Scan and Perfusion Scan for the Prediction of Postoperative Pulmonary Function (수술후 폐기능 변화의 예측에 대한 연무 흡입스캔과 관류스캔의 비교)

  • Cheon, Young-Kug;Kwak, Young-Im;Yun, Jong-Gil;Zo, Jae-Ill;Shim, Young-Mog;Lim, Sang-Moo;Hong, Sung-Woon;Lee, Choon-Taek
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.2
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    • pp.111-119
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    • 1994
  • Background: Because of the common etiologic factor, such as smoking, lung cancer and chronic obstructive pulmonary disease are often present in the same patient. The preoperative prediction of remaining pulmonary function after the resectional surgery is very important to prevent serious complication and postoperative respiratory failure. $^{99m}Tc$-MAA perfusion scan has been used for the prediction of postoperative pulmonary function, but it may be inaccurate in case of large V/Q mismatching. We compared $^{99m}Tc$-DTPA radioaerosol inhalation scan with $^{99m}Tc$-MAA perfusion scan in predicting postoperative lung function. Method: Preoperative inhalation scan and/or perfusion scan were performed and pulmonary function test were performed preoperatively and 2 month after operation. We predicted the postoperative pulmonary functions using the following equations. Postpneurnonectomy $FEV_1$=Preop $FEV_1x%$ of total function of lung to remain Postlobectomy $FEV_1$=Preop $FEV_1{\times}$(% of total 1-function of affected lung${\times}$$\frac{Number\;of\;segments\;to\;be\;resected}{Number\;of\;segments\;of\;affected\;lung})$ Results: 1) The inhalation scan showed good correlations between measured and predicted $FEV_1$, FVC and $FEF_{25-75%}$. (correlation coefficiency; 0.94, 0.91, 0.87 respectively). 2) The perfusion scan also showed good correlations between measured and predicted $FEV_1$, FVC and $FEF_{25-75%}$. (correlation coefficiency; 0.86, 0.72, 0.87 respectively). 3) Among three parameters, $FEV_1$ showed the best correlations in the prediction by lung scans. 4) Comparison between inhalation scan and perfusion scan in predicting pulmonary function did not show any significant differneces except FVC. Conclusion: The inhalation scan and perfusion scan are very useful in the prediction of postoperative lung function and don't make a difference in the prediction of pulmonary function a1though the former showed a better correlation in FVC.

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