• Title/Summary/Keyword: 면역화학수술요법

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Analysis of Risk and Benefit of Open Lung Biopsy in Severe Immunocompromised Patients with Pulmonary Complications (폐합병증을 동반한 심한 면역저하 환자에서 폐생검술의 유효성 및 위험성에 대한 분석)

  • 이호석;이성호;김관민;심영목;한정호
    • Journal of Chest Surgery
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    • v.34 no.7
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    • pp.539-546
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    • 2001
  • Background: Pulmonary complications in immunocompromised patients are often fatal. Empirical treatment is usually applied based on the clinical and radiological findings because of the risk of the aggressive diagnostic procedures such as open lung biopsy. However, recent advancements in operative procedures and perioperative management has decreased the procedure-related risks. We have prospectively analyzed the risks and benefits of the early application of open lung biopsy in such patients. Material and Method: Forty-two consecutive immunocompromised patients with critical pulmonary complications were included from June, 1996 to December, 1999. The definition of the immunocompromised is as those with chemotherapy and/or other modality for hematologic disorders, with usage of immunosuppressive drug after transplantation, with usage of steroid for more than 1 month, and with primary immunodeficiency disorders. The indication of open lung biopsy was those with no significant improvement after a week of aggressive application of empirical treatment or with rapidly aggressive process. The underlying disease included hematologic disorder(31 patients), post-transplantation(3 patients), chemotherapy for solid tumor(2 patients), and others(6 patients). Operations were done through thoracotomy(conventional or mini-) or VATS.

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EFFECTS OF MULTIMODAL TREATMENT FOR THE MAXILLARY CANCER (상악암에 대한 병용요법의 효과)

  • Kim, Yong-Gak;Ryu, Sun-Youl
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.1
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    • pp.54-60
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    • 2001
  • The treatment of maxillary cancer has been commonly performed by the surgery and radiation therapy, alone or in combination. Multimodal treatment has been introduced with improvement of chemotherapy and immunotherapy. Multimodal treatment for the maxillary cancer is composed of surgery, radiation therapy, and regional intra-arterial chemotherapy. The present study was performed to evaluate the effectiveness of the multimodal treatment with Morita's method, with a slight modification, for the maxillary cancer. Twenty-four cases of the maxillary cancer were analyzed. The multimodal treatment increased the 5-year-survival rate up to 66% and reduced the need for maxillectomy. This method made the morphological and funtional preservation possible. This method may be recommended for the treatment of maxillary cancer.

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Immunochemosurgery for Gastric Carcinoma (위암의 면역화학수술요법)

  • Kim Jin-Pok;Yu Hang-Jong;Suh Byoung-Jo;Joo-Ho Lee
    • Journal of Gastric Cancer
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    • v.1 no.1
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    • pp.17-23
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    • 2001
  • Purpose: The purpose of this study is to analyze the clinicopathologic characteristics of gastric cancer patients and to evaluate the survival and prognostic factors and effect of immunochemosurgery for gastric cancer patients. Materials and Methods: The clinicopathologic characteristics were analyzed for 12,277 consecutive patients who underwent operation for gastric cancer from 1970 to 1999. We also evaluated the survival and prognostic factors for 9,262 consecutive patients from 1981 to 1996. The prognostic significance of treatment modality [surgery alone, surgery+chemotherapy, surgery+immunotherapy+chemotherapy (immunochemosurgery)] were evaluated in stage III gastric cancer. Results: The 5-year survival rate (5-YSR) of overall patients was $55.8\%$, and that of patients who received curative resection was $64.8\%$. The 5-YSRs according to TNM stage were $92.9\%$ for Ia, $84.2\%$ for Ib, $69.3\%$ for II, $45.8\%$ for IIIa, $29.6\%$ for IIIb and $9.2\%$ for IV. Regarding adjuvant treatment modality, significant survival difference was observed in stage III patients. The 5-year survival rates were $44.8\%$ for immunochemosurgery group, $36.8\%$ for surgery+chemotherapy group and $27.2\%$ for surgery alone group. Curative resection, depth of invasion and lymph node metastasis were the most significant prognostic factors in gastric cancer. Conclusion: Consequently, early detection and curative resection with radical lymph node dissection, followed by immunochemotherapy especially in patients with stage III gastric cancer should be recommended as a standard treatment principle for patients with gastric cancer.

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A Case of Locally Recurrent Gastric Cancer at Kim's Tie Site of the Jejunum after a Total Gastrectomy (위전절제술 후 Kim 's Tie 부근 공장에 국소 재발한 위암환자 1예)

  • Bae Byung-Gu;Suh Byoung-Jo;Yu Hang-Jong;Kang Yun-Kyung;Kim Jin-Pok
    • Journal of Gastric Cancer
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    • v.5 no.1
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    • pp.52-56
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    • 2005
  • Despite improvements in the surgical treatment of gastric adenocarcinomas, the recurrence rates remain high in patients with advanced-stage disease. Most of the recurrence occurs within 3 years of the surgical resection, and nearly $90\%$ of the patients with recurrence die within 2 years of the diagnosis of recurrence. A recent study analyzed recurrence patterns for patients who had undergone a potentially curative gastrectomy. For those patients, $33\%$ of the recurrences involved locoregional sites, $44\%$ the peritoneum, and $38\%$ distant sites. A 51-year-old female patient was diagnosed with stomach cancer and underwent a total gastrectomy with D2 lymph node dissection during Oct. 1999. The pathologic report indicated a T3N1M0 tumor. We performed immunochemotherapy for 2 years with regular follow up. A gastrofiberscopic examination done during sep. 2004, cancer recurrence was found at the Kim's tie site of the jejunual loop. We did an abdominal exploration and a segmental resection of cancer site with pathologically negative resection margins. After the operation, we started secondary chemotherapy with TS-1.

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The effect of Asparagi Tuber on Anti-cancer and Immunocytes (천문동(天門冬)이 항암(抗癌) 및 면역세포(免疫細胞)에 미치는 영향(影響))

  • Jeong, Hyun Woo;Cho, Young-Lim
    • Herbal Formula Science
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    • v.5 no.1
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    • pp.169-178
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    • 1997
  • To investigate effect of water extract of Asparagi Tuber(天門冬) on human cancer cell-lines and immunocytes, this research estimated proliferation of A431 cell line, KHOS-NP cell line, mouse thymocytes and mouse splenocytes, Nitric Oxide(NO) from macrophage, apoptosis and subpopulation of the mouse thymocytes. The result were obtained as follows ; 1. Asparagi Tuber inhibited the proliferation of A431 cell line. 2. Asparagi Tuber inhibited the proliferation of KHOS-NP cell line. 3. Asparagi Tuber accelerated the proliferation of mouse thymocytes. 4. Asparagi Tuber inhibited the proliferation of mouse splenocytes. 5. Asparagi Tuber $100{\mu}g/m{\ell}$ inhibited the production of NO from macrophages in vitro, being compared NPS+IFN treated group. 6. Asparagi Tuber inhibited the production of NO from macrophages in vivo, being compared LPS+IFN treated group. 7. Asparagi Tuber accelerated the induction of apoptosis of the mouse thymocytes. 8. In subpopulation Asparagi Tuber increased $T_H$ of the mouse thymocytes, but decreased $T_C/T_S$ of the mouse thymocytes.

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Prospective Study for Korean Red Ginseng Extract as an Immune Modulator Following a Curative Gastric Resection in Patients with Advanced Gastric Cancer (진행성 위암 환자에서 수술 후 홈삼엑기스에 의한 면역 조절자 역할에 관한 전향적 연구)

  • Suh, Sung-Ock;Kim, Jin;Cho, Min-Young
    • Journal of Ginseng Research
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    • v.28 no.2
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    • pp.104-110
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    • 2004
  • The aim of this study was to evaluate prospectively the impact of the red ginseng extract on circulating interleukin (IL) 2 and 10 in advanced gastric cancer during chemotherapy after operative treatment. Analysis of circulating IL-2 and 10 was performed in 50 patients with advanced gastric adenocarcinoma who underwent a curative surgery or with an unresectable gastric adenocarcinoma by using ELISA and monoclonal antibodies at preoperative day 1, postoperative months 1, and 3. Twenty-five patients as the control group, twenty-six patients as the non-ginseng (NG) group, and twenty-four patients as the ginseng (G) group were eligible in this study. All plasma IL-2 of the NG and G groups was significantly lower an that of the control group on preoperative 1 day. These values of the G group were more increase than these of the NG group during the postoperative chemotherapy. The mean value of serum IL-10 of the control group (0.608pg/ml) was significantly lower than that of the advanced gastric cancer patients including the NG (12.015 pg/ml) and G group (9.409 pg/ml) (p<0.001). These values of the G group were reduced progressively during the postoperative chemotherapy. The mesh value of the G group were only close to that of the control group on postoperative months 3 (p=0.003). The number of patients who were enrolled in this study was relatively small to fully evaluate the immunologic effects of the red ginseng extract on circulating IL-2 and 10. Despite this limitation, these results suggest that the post-operative intake of the red ginseng extract have potential to improve earlier anti-cancer immunity with recovering IL-2 and reducing IL-10 from the depressed IL-2 and elevated IL-10 by gastric cancer during the postoperative chemotherapy. This study will be based on the future study to evaluate the anti-immunity of the red ginseng extract.

Analysis of Treatment and Prognosis in Malignant Melanoma (악성 흑색종의 치료와 예후에 대한 분석)

  • Kwon, Young-Ho;Kim, Jeong-Ryoul;Lee, Young-Gu;Kim, Jae-Do
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.141-147
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    • 2005
  • Purpose: The most important thing in curing Malignant melanoma is surgical excision, operating method is wide excision. The author et al. studied 5-year survival rate of each stage and appropriate surgical margin after operating wide excision and immuno-chemotherapy. Materials and methods: From March 1995 to August 2003, wide excision and immunochemotherapy were operated to 35 patients (17 males and 18 females) who were diagnosed as malignant melanoma and followed up. Excision was done around 2 cm from edge of tumor regardless of the size or effected degree of the skin, and flap or full thickness skin graft was used for skin deficit that was not covered after excision. As for immuno-chemotherapy, method that prescribes 400 mg of dacarbazine (DTIC) and 3 million IU of interferone-${\alpha}$ in combination was used. Immuno-chemotherapy was operated to patients in over stage III. We used AJCC stage that was revised in 2002. Local recurrence, local metastasis and distant metastasis were investigated for these patients as well as the 5-year survival rate of each stage. Results: Most frequently 15 cases(42.8%) occurred in foot, 5 cases(14.2%) occured in ankle, 2 cases(5.7%) in leg, 2 cases(5.7%) in thigh and 5 cases(14.2%) in hand. The incidence of each stage were 8 cases(22.8%) in IA, 9 cases(25.7 %) in IB, 4 cases(11.4%) in IIA, 2 cases(5.7%) in IIB, 1 cases(2.8%) in IIIA, 2 cases(5.7%) in IIIB, 2 cases(5.7%) in IIIC and 7 cases(20.0%) in stage IV. 5-year survival rate of each stage were 94.1% in stage I, 66.8% in stage II, 40% in stage III and 14.3% in stage IV. Conclusion: 5-year survival rate of stage IV was low in malignant melanoma. In treatment of malignant melanoma, staging before operation is important as operation methods are different from each stage. We recommend wide excision which remove around 1~3 cm from margin of tumor up to each thickness.

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Diagnosis and Treatment of Gastric Cancer (위암의 진단과 치료)

  • Song, S.K.
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.173-181
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    • 1996
  • 위암 환자의 수술후 5년 생존율은 조기암의 경우 90%이상으로 매우 좋으나 진행암의 경우 20~30%를 넘지 못한다. 위암의 예후에 영향을 주는 요인 중 조기 발견보다 더 중요한 것은 없으며, 조기암의 진단율에 노력을 기울이는 것이 현실적 타개책이라 하겠다. 현재 우리나라의 조기암 진단율은 16~22%로 일본의 40~45%보다 극히 저조하므로 소화기계 증상이 있는 경우 위내시경 검사를 적극 권고함이 바람직하다. 위암은 외과적 절제술이 유일한 근치치료법임은 주지의 사실이며 근래에는 위내시경 및 복강경을 이용하여 위장관 기능을 보존하는 술식도 시도되고 있어 바람직한 발전이라 사료되나, 림프절 곽청의 원칙을 훼손하지 않는 범위내에서 이루어져야할 것이다. 근치적 절제술의 정의에 합당한 외과적 치료법만이 5년 생존율 향상을 기대할 수 있으며, 보조적 항암화학요법과 면역요법은 대상 환자의 엄선으로 부분적 치료효과를 기대할 수 있다. 절제불능 위암이나 국소진행암에서 절제율을 높이기 위한 술전치료방법들의 적극적 도입이 바람직하다. 그러나 대상 환자의 선정에 있어 객관적 타당성이 있는 병기 결정 방법과 치료효과를 판정하는 방법의 혁신이 있어야 할 것으로 사료되며 현재의 부정확한 검사방법들의 대안으로 복강경의 이용이 바람직하리라 사료된다.

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Outcome of patients with neuroblastoma aged less than 1 year at diagnosis (진단 시 1세 이하인 신경모세포종 환자의 치료성적)

  • Suh, Jung Min;Lee, Sang Goo;Yoo, Keon Hee;Sung, Ki Woong;Koo, Hong Hoe;Kim, Ju Youn;Cho, Eun Joo;Lee, Suk Koo;Kim, Jhingook;Lim, Do Hoon
    • Clinical and Experimental Pediatrics
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    • v.52 no.1
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    • pp.93-98
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    • 2009
  • Purpose : The purpose of this study was to evaluate the clinical characteristics and outcomes of patients with neuroblastoma aged less than 1 year. Methods : From January 1997 to December 2007, 41 patients aged less than 1 year were diagnosed with neuroblastoma. Patients were divided into 3 risk groups according to the stage of the disease and N-myc amplification. Low-risk patients underwent surgery with (stage 2) or without (stage 1) short-term chemotherapy. Intermediate-risk patients underwent chemotherapy and surgery with or without local radiation therapy. High-risk patients underwent chemotherapy, surgery, radiation therapy, and high-dose chemotherapy/autologous stem cell rescue (HDCT/ASCR). Results : While tumor relapse occurred in only 1 patient, 7 patients died of treatment-related toxicities. Causes of treatment- related death included infection during conventional chemotherapy in 5 patients and acute myocarditis during HDCT/ASCR in 2 patients. The overall 5-year survival (${\pm}$ standard error) and 5-year event-free survival (EFS) rates after diagnosis for all 41 patients were $82.8{\pm}5.9%$ and $80.0{\pm}$6.3%$, respectively, with a median follow-up of 58 (9-137) months. The 5-year EFS rates for low-risk, intermediate-risk, and high-risk patients were 100%, $68.4{\pm}10.8%$, and $66.7{\pm}19.3%$, respectively. Conclusion : Increased efforts to reduce infection-associated toxicity deaths during conventional chemotherapy are needed to further improve the survival of patients with neuroblastoma aged less than 1 year.

Primary Melanoma of the Stomach at Cardia (위 분문부에 발생한 원발성 흑색종)

  • Park, Jong-Ik;Kang, Sung-Gu;Park, Sang-Su;Yoon, Jin;Kim, Il-Myung;Shin, Dong-Gue
    • Journal of Gastric Cancer
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    • v.6 no.3
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    • pp.193-197
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    • 2006
  • Melanoma is a malignant neoplasm of melanocytes most frequently arising from the skin, but primary melanoma can also arise from the mucosa of the gastrointestinal tract. Gastrointestinal melanomas are most commonly metastases from a cutaneous melanoma. Primary melanoma of the stomach is rare and carries a poor prognosis. Reported here is the case of a 75-year-old man with a primary gastric melanoma who presented with a melena, abdominal pain, and weight loss. Most cases of melanoma are treated by excision of the primary tumor. Patients with melanoma have been treated with adjuvant chemotherapy, radiation therapy, and immunotherapy. None of these modalities has been demonstrated to prolong the survival rate. To improve long-term disease-free survival, early diagnosis and surgical intervention are very important.

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