• Title/Summary/Keyword: 보조요법

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An Imported Case of Kala-azar in Korea (중동에서 유입된 Kala-azar 1예)

  • 지제근;송영기
    • Parasites, Hosts and Diseases
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    • v.21 no.1
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    • pp.87-94
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    • 1983
  • Kala-azar는 우리나라에는 분포하지 않는 것으로 인정되고 있으나 과거 중국에서 감염되어 국내에서 관찰된 보고가 있는 질병이다. 최근에 중동 지방에서 감염되어 귀국하고 발병하였다고 생각되는 예를 보고한다. 서울에 주소를 둔 26세의 한국인 남자가 1년간 사우디 아라비아에서 건설기능공으로 근무하고 1981년 9월 귀국하여 약 8개월 후인 1982년 5월 경부터 심한 피로감, 전신쇠약, 복부의 수물등을 느끼기 시작하였다. 환자가 국립서울병원을 거쳐 서울대학교병원에 1982년 9월 17일 입원할 당시에는 간과 비장이 모두 14cm정도 만져질 만큼 부어있었고, 심한 체중 감소(4개월간 14kg의 감소), 적혈구, 백혈구, 혈소판등 모든 혈구의 감소등이 관찰되었다. 간생검을 통해 amastigote가 관찰되고 이는 투사전자현미경을 통해서 전형적인 amastigote형으로 확인되었다. 환자는 국외에서 구한 약제인 sodium antimony gluconate(Pentostam )와 각종 보조요법에 의해 치료를 받았다. 퇴원 직전에 시행한 간생검에서 괴사된 간 조직이 섬유화로 대치된 것이 확인되었고 충체는 관찰되지 않았다. 이 Kala-azar 에는 1952년 만주에 유입되어 보고된 3예 이후로는 처음 관찰된 것으로 중동에서 유입된 것으로는 첫번째 보고례이다. 최근 급격히 늘어난 해외 인력진출을 감안하면 해당 지역의 열대 풍토병에 대한 다각적인 대책이 절실히 요청된다.

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Primary Malignant Melanoma of the Esopahgus -A Case Report- (원발성 식도 악성 흑색종 -1례 보고-)

  • 이응배;김대현;박태인
    • Journal of Chest Surgery
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    • v.35 no.4
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    • pp.322-324
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    • 2002
  • Herein we report a rare case of primary esophageal malignant melanoma in a 56-year-old gentleman who presented with a 2-month dysphagea. Esophagoscopy reveals a polypoid tumor and a total thoracic esophagectomy was performed through a right thoracotomy and esophageal replacement with stomach. The tumor was proven to be a primary esophageal malignant melanoma by histological and immunohistochemical studies. The pathologic stage was IIa. He received no postoperative adjuvant therapy. He died of liver metastasis at 8 months postoperatively.

A CASE OF LARYNGEAL STENOSIS TREATED WITH $CO_2$ LASER ($CO_2$ Laser에 의한 후두협착증의 치험예)

  • 김영숙;이종욱;강경화;김춘길;주양자
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1987.05a
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    • pp.19.3-20
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    • 1987
  • 후두협착증은 그동안 여러 치료방법에도 불구하고 이비인후과영역에서 가장 어려운 문제 중의 하나로 남아 있다. 1979년 McGee등이 후두 및 기관협착증에 처음으로 $CO_2$ laser를 사용한 이래 미세현미경술과 조화되어 후두의 상흔 및 육아조직을 제거하는 정교하고, 쉽고, 지혈이 우수한 방법으로 대두되고 있다. 또한, 주기적인 후두 및 기관확장술, 국소 steroid주입법, stenting등의 보조요법과 병행하여 사용될 때 개방성형술의 빈도를 훨씬 줄일 수 있다. 최근 저자들의 상흔성 비후에 의한 후두협착 환자에서 $CO_2$ laser를 사용하여 협착을 제거하여 좋은 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다.

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Efficacy of a Preoperative Concurrent Chemoradiotherapy for the Locally Advanced Unresectable Rectal Cancer (국소진행성 직장암에서 수술 전 방사선 및 항암화학 동시요법의 효과)

  • Cho Jae Ho;Seong Jinsil;Keum Ki Chang;Kim Gwi Eon;Suh Chang Ok;Roh Jae Kyung;Chung Hyun Cheol;Min Jin Sik;Kim Nam Kyu
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.293-299
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    • 2000
  • Purpose :We conducted a prospective non-randomized clinical study to evaluate the efficacy and toxic of the preoperative concurrent chemoradiotherapy for locally advanced unresectable rectal cancer. Materials and Methods: Between January 1995 and June 1998, 37 conecutive patients with locally unresectable advanced rectal cancer were entered into the study. With 3- or 4- fields technique, a total of 45 Gy radiation was delivered on whole pelvis, followed by 5.4 Gy boost to the primary tumor in some cases. Chemotherapy was done at the first and fifth week of radiation with bolus i.v. 5-Fluorouracil (FU) 370$\~$450 mg/m$^{2}$, days 1$\~$5, plus Leucovorin 20 mg/m$^{2}$, days 1$\~$5. OF 37 patients, 6 patients did not receive all planned treatment course (refusal in 4, disease progression in 1, metastasis to lung in 1). Surgical resection was undergone 4$\~$6 weeks after preoperative concurrent chemoradiotherapy. Results :Complete resection rate with negative margins was 94$\%$ (29/31). Complete response was seen in 7 patients (23$\%$) clinically and 2 patients (6$\%$) pathologically. Down staging of tumor occured in 21 patients (68$\%$). Treatment related toxicity was minimal except grade III & IV leukopenia in 2 patients, respectively. Conclusion : Preoperative concurrent chemoradiotherapy in locally advanced rectal cancer was effective in inducing down staging and complete resection rate. Treatment related toxicity was minimal. Further follow up is on-going to determine long term survival following this treatment.

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Small Cell Carcinoma of the Trachea - 1 case report - (기관에 발생한 소세포암 - 1례 보고 -)

  • 신제균;정종필;류상완;서재희;박재후
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.757-760
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    • 1999
  • A rare small cell carcinoma of the trachea was managed in a 59 year old female patient. The diagnosis was confirmed by histopathological and immunohistochemical studies. Surgical resection and adjuvant chemotherapy were done. The patient died 6 months later due to multiple metastasis.

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Visceral Pleural Invasion as a Prognostic Factor for Recurrence in Resected IB Non-small Cell Lung Cancer (완전 절제된 IB 비소세포암에서 재발의 예후인자로의 장측늑막 침범)

  • Kim, Seok;Park, Ki-Sung;Kum, Yoon-Seup;Lee, Sub;Bae, Chi-Hoon;Hyun, Dae-Sung
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.610-614
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    • 2009
  • Background: Several trials have reported on whether adjuvant chemotherapy for resected stage IB non-small cell lung cancer is needed. The aim of our study was to investigate prognostic factors for recurrence to help identify patients who should receive adjuvant chemotherapy. Material and Method: We reviewed the cases of 48 stage IB non-small cell lung cancer patients between 1997 and 2006. Disease-free survival and overall survival rates were calculated by the Kaplan-Meier method. Univariate analysis was performed with the log rank test and multivariate analysis was done using Cox's proportional hazard model. Result: The median follow-up time was 48 months. The overall survival rate was 55.9%, and the disease-free survival rate was 48.6%. Of 8 variables, two factors, visceral pleural invasion and Iymphovascular invasion, were prognostic factors of disease-free survival (univariate analysis). Visceral pleural invasion was a significant prognostic factor in multivariate analysis, and overall survival in com-pared one or more variable such as visceral pleural invasion or, and lymphovascular invasion with the other variables. Conclusion: Visceral pleural invasion was identified as a poor prognostic factor and it may help select which patients will benefit from adjuvant chemotherapy in addition to more comprehensive follow-up.

The Results of the ATP Based Chemotherapy Response Assay in Gastric Cancer Tissues (ATP-CRA 방법을 이용한 위암조직의 항암제 감수성 검사결과)

  • Lee, Je-Hyung
    • Journal of Gastric Cancer
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    • v.7 no.3
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    • pp.160-166
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    • 2007
  • Purpose: Recently, chemosensitivity tests have become widely used for the selection of effective drugs in gastric cancer patients. In this study, a chemosensitivity test was performed to select agents to increase the effectiveness of adjuvant chemotherapy. Materials and Methods: Chemosensitivity testing was performed in 81 gastric cancer patients that received a gastrectomy at the Yeungnam University Hospital. An ATP (adenosine triphosphate) based chemotherapy response assay was used. Clinicopatholgical factors such as sex, age, expression of tumor markers (CEA and CA19-9 levels), location of the tumor, morphology of advanced cancer, histological type, cell differentiation, depth of invasion, Lauren classification, Ming classification, lymphatic invasion, vascular invasion, neural invasion, lymph node metastasis and TNM stage were used to correlate the chemosensitivity and clinicopathological factors. Results: The most effective antitumor agents in gastric cancer patients were (in order of effectiveness) 5-FU, Epirubicin, lrinotecan and Oxaliplatin in our series. The chemosensitivity test showed a significant difference in susceptibility according to clinicopathological factors. Conclusion: Further studies on multidrug therapy are needed to evaluate synergistic effects of drugs. Therefore, for effective chemotherapy, it is more efficacious to select a chemosensitive drug than continue to use the same drug regimen.

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Optimal Scheme of Postoperative Chemoradiotherapy in Rectal Cancer : Phase III Prospective Randomized Trial (직장암의 근치적 수술 후 화학요법과 방사선치료의 순서)

  • Kim Young Seok;Kim Jong Hoon;Choi Eun Kyung;Ahn Seung Do;Lee Sang-Wook;Kim Kyoung-Ju;Lee Je Hwan;Kim Jin Cheon;You Chang Sik;Kim Hee Cheol
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.53-61
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    • 2002
  • Purpose : To determine the optimal scheme of postoperative chemoradiotherapy in rectal cancer by comparing survival, Patterns of failure, toxicities in early and late radiotherapy groups using a Phase III randomized prospective clinical trial. Materials and Methods : From January 1996 to March 1999, 307 patients with curatively resected AJCC stage II and III rectal cancer were assigned randomly to an 'early (151 patients, arm 1)' or a 'late (156 patients, arm II)' and were administered combined chemotherapy (5-FU $375\;mg/m^2/day$, leucovorin $20\;mg/m^2$, IV bolus daily, for 3 days with RT, 5 days without RT, 8 cycles with 4 weeks interval) and radiation therapy (whole pelvis with 45 Gy/25 fractions/5 weeks). Patients of arm I received radiation therapy from day 1 of the first cycle of chemotherapy and those of arm II from day 57 with a third cycle of chemotherapy. The median follow-up period of living patients was 40 months. Results : Of the 307 patients enrolled, fifty patients did not receive scheduled radiation therapy or chemotherapy. The overall survival rate and disease free survival rate at 5 years were $78.3\%\;and\;68.7\%$ in arm I, and $78.4\%\;and\;67.5\%$ in arm II. The local recurrence rate was $6.6\%\;and\;6.4\%$ (p=0.46) in arms I and II, respectively, no significant difference was observed between the distant metastasis rates of the two arms ($23.8\%\;and\;29.5\%$, p=0.16). During radiation therapy, grade 3 diarrhea or more, by the NCI common toxicity criteria, was observed in $63.0\%\;and\;58.2\%$ of the respective arms (p=N.S.), but most were controlled with supportive care. Hematologic toxicity (leukopenia) greater than RTOG grade 2 was found in only $1.3\%\;and\;2.6\%$ of patients in each respective arm. Conclusion : There was no significant difference in survival, patterns of failure or toxicities between the early and late radiation therapy arms. Postoperative adjuvant chemoradiation was found to be a relatively safe treatment but higher compliance is needed.

Adjuvant Metronomic Chemotherapy in a Dog with Nasal Transitional Carcinoma (개의 비강 이행암종에서 메트로노믹항암 요법)

  • Park, Hyung-Jin;Kim, Ja-Won;Jeong, Seong-Mok;Choi, Ho-Jung;Son, Hwa-Young;Song, Kun-Ho;Seo, Kyoung-Won
    • Journal of Veterinary Clinics
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    • v.32 no.2
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    • pp.183-186
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    • 2015
  • A four-year-old spayed female Maltese dog weighing 3 kg was referred with reverse sneezing and fourmonth history of unilateral nasal discharge. She was diagnosed as nasal transitional carcinoma which in bilateral nasal cavity and extending into the frontal sinus by biopsy with rhinoscopy. Metronomic chemotherapy with cyclophosphamide ($12.5mg/m^2$) and toceranib phosphate (2.5 mg/kg) was initiated following after surgical treatment of nasal mass debulking. Clinical response was good and had no side effects during the chemotherapy period (11 months after diagnosis). This is a case report describing adjuvant metronomic chemotherapy in nasal transitional carcinoma in Korea.