• Title/Summary/Keyword: 암 전이

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Point Prevalence of Anxiety and Depression among Cancer Inpatients in a General Hospital : A Preliminary Study for the Development of Distress Management Strategies in Cancer Patients (일 종합병원 입원 암환자의 불안과 우울증상의 시점 유병률 : 암 환자 디스트레스 중재 전략을 위한 예비 연구)

  • Lee, Min-A;Huh, Hyu-Jung;Min, Jung-Ah;Lee, Chang-Uk;Lee, Chul;Kim, Tae-Suk
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.2
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    • pp.122-131
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    • 2013
  • Objectives: This study aimed to examine the point prevalence of anxiety, depression and the associated risk factors in hospitalized patients with cancer. Methods: A total of 114 patients with cancer who admitted to the Cancer Center in St. Mary's Hospital were enrolled for a day. The patients were asked to complete Hospital Anxiety and Depression Scale(HADS). Sociodemographic and cancer related clinical variables were also evaluated. Results: The point prevalence of anxiety and depression was 10.5% and 34.2%, respectively, as assessed with HADS. Logistic regression models revealed that distant metastasis was significantly associated with anxiety in patients with cancer and previous chemotherapy and Low socioeconomic status were significantly associated with depression. Conclusions: Our results indicate that more than one third of patients with cancer suffer from either anxiety or depression. In addition, previous chemotherapy as well as low socioeconomic status and distant metastasis were associated risk factors of anxiety and depression, respectively. These findings suggest the need for screening and systematized psychosocial intervention for psychological distress in hospitalized patients with cancer.

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Factors Affecting Quality of Sleep in Breast Cancer Patients Receiving Chemotherapy in the Outpatient Settings (외래에서 항암화학요법을 받는 유방암 환자의 수면의 질 영향요인)

  • Choi, Yooun-Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.2
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    • pp.562-570
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    • 2019
  • The purpose of this study was to identify the factors influencing the quality of sleep in breast cancer patients receiving chemotherapy in the outpatient settings. The data were collected from 203 patients with breast cancer receiving chemotherapy in the outpatient settings at one tertiary hospital in B City. Stress, fatigue and depression were negatively correlated with quality of sleep (r=-.369, p=.001; r=-.565, p=.001; r=-.526, p=.001, respectively). Fatigue(${\beta}=-.387$, p<.001) was one of the biggest impact factors on quality of sleep which explained 31.6% of the variance of the sleep quality, followed by the experience of sleep disturbances prior to the diagnosis of breast cancer(${\beta}=-.178$, p<.002) and depression(${\beta}=-.231$, p<.004). In total, all of the antecedent variables explained significantly 37.4% of the variance of the sleep quality. Thus, in order to improve the quality of sleep, integrative nursing interventions need to be developed to reduce fatigue and depression among them, including an proactive system to screen out the patients with the experience of sleep disturbances prior to the diagnosis with breast cancer and to provide adequate pharmacological and/or non-pharmacological sleep interventions prior to the chemotherapy.

Recent Research Trend in Biomaterials for Effective Cancer Immunotherapy (효과적인 암 면역치료를 위한 생체재료 연구동향)

  • Han, Jun-Hyeok;Go, Eun-Jin;Kim, Joon-Kyu;Park, Wooram
    • Prospectives of Industrial Chemistry
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    • v.22 no.6
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    • pp.2-12
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    • 2019
  • 최근 암 면역치료는 임상연구에서 긍정적인 결과를 보이고 있으며 암 질환의 표준치료법으로 자리 잡아가고 있다. 암 면역치료는 암의 재발과 전이를 획기적으로 개선시킬 수 있다는 이점이 있다. 하지만 전체 암 환자의 15~20%에서만 치료 효과를 보이고 심각한 부작용을 유발할 수 있다는 임상적 한계가 있다. 이러한 문제점들을 개선하기 위해서 기존에 약물전달 또는 조직공학 분야에서 활용되었던 생체재료를 도입하여 면역치료의 효과를 개선하고 부작용은 줄이려는 시도가 활발하다. 본 기고문에서는 효율적인 암 면역치료를 위한 생체재료(나노입자, 리포좀, 미립구, 및 하이드로젤)에 관한 최신 연구동향을 다루고자 한다. 고기능성 생체재료 개발과 종양 면역학 분야의 깊은 이해는 효과적인 암 면역치료제를 개발하는데 있어서 매우 중요하다.

Metastasizing Pleomorphic Adenoma in Right Lung -A case report - (우측 폐로 전이된 전이성 다형태 선종 -증례 보고-)

  • Chung, Won-Sang;Nam, Seung-Hyuk;Kang, Jeong-Ho;Kim, Young-Hak;Kim, Eung-Soo;Kim, Hyuck
    • Journal of Chest Surgery
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    • v.40 no.2 s.271
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    • pp.143-146
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    • 2007
  • A metastasizing pleomorphic adenoma originating from the parotid gland is a rare form of neoplasm. The neoplasm is a histologically benign, but clinically controversial entity. Herein, a case report of a pleuro-pneumonectomy of a metastasizing pleomorphic adenoma in the right lung is described. A 57-year-old man, who underwent resection of parotid gland due to a pleomorphic adenoma, presented with multiple metastases on the right lung, mediastinum, pericardium and intercostal muscle. The metastatic lesions were composed of a benign pleomorphic structure.

Expression of DNA-dependent Protein Kinase and Its Relationship with Epidermal Growth Factor Receptor Signaling in Metastatic Cancer Cell Lines (DNA-PK 및 표피성장인자수용체의 신호전달이 암전이에 미치는 영향)

  • Hwang Jee Young;Kim Sun Hee;Kang Chi Dug;Yoon Man Soo
    • Journal of Life Science
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    • v.15 no.3 s.70
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    • pp.406-414
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    • 2005
  • The genetic instability of cancer cells may be related to inappropriately activated DNA repair pathways. In present study, the modulated expression of DNA-dependent protein kinase (DNA-PK), a major DNA repair protein, in human cancer metastatic cells was tested. The expressions of Ku70/80, regulatory subunit of DNA-PK, and the Ku DNA-binding activity in various highly metastatic cell lines were higher than those in each parental cell line. Also, the expression of DNA-PKcs, catalytic subunit of DNA-PK, and the kinase activity of the whole DNA-PK complex in highly metastatic cells were significantly increased as compared to those of parental cells, suggesting that the enhanced DNA repair capacity of metastatic cells could be associated with aberrant use of DNA repair, which may mediate tumor progression and metastatic potential. Increased EGFR (epidermal growth factor receptor) signaling has been associated with tumor invasion and metastasis, and the linkage between EGFR-mediated signaling and DNA-PK has been suggested. This study showed that PKI166, the new EGFR tyrosine kinase inhibitor, modulated the expressions of Ku70/80 and DNA-PKcs and also revealed the chemosensitization effect of PKI166 against metastatic cells may be in part due to inhibition of Ku70/80. These results suggest that interference in EGFR signaling by EGFR inhibitor resulted in the impairment of DNA repair activity, and thus DNA-PK could be possible molecular targets for therapy against metastatic cancer cells.

Results of Radioiodine Treatment for Distant Metastases of Differentiated Thyroid Carcinoma (분화성 갑상선암의 원격 전이에서 방사성옥소 치료 성적)

  • Kim, Yu-Kyeong;Chung, June-Key;Kim, Seok-Ki;Yeo, Jung-Seok;Park, Do-Joon;Jeong, Jae-Min;Lee, Dong-Soo;Cho, Bo-Youn;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.2
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    • pp.107-118
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    • 2000
  • Purpose: To evaluate the effectiveness of radioiodine treatment for metastatic thyroid carcinoma, we reviewed results of radioactive iodine treatment in patients with functional lung or bone metastases. Materials and Methods: Of 760 patients who were treated for differentiated thyroid cancer between 1984 and 1998, we detected pulmonary metastases and bone metastases in 76 patients (10.0%) and 20 patients (2.6%), respectively. Among them, we could evaluate the effectiveness of I-131 therapy in 53 patients with lung metastases and 15 patients with bone metastases. Results: Of 53 patients who received I-131 therapy with a mean cumulative dose of 26.2 GBq (1.1-84.4 GBq) for pulmonary metastases, metastatic lung lesions completely resolved in 19 patients (35.8%) and improved in 22 patients (41.5%). In 13 of 19 patients with complete remission of pulmonary metastases, the total accumulated dose of I-131 was less than 18.5 GBq. We found 43 sites of metastatic bone lesions in 15 patients with bone metastases. Of 29 lesions which received I-131 therapy, metastatic lesions improved in 14 sites (48.3%), but did not change or progress in 15 sites (51.7%) despite the I-131 therapy. Three lesions were completely cured with a combination treatment of surgery(${\pm}$ external radiotherapy) and I-131 therapy, and the other 11 lesions improved. Conclusion: Radioactive iodine treatment gives favorable results for pulmonary metastases. However, for bone metastases, there might be a need to use combination therapy including I-131 and surgery or external irradiation.

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Recurrent Early Gastric Cancer with Liver Metastasis Mimicking Pancreaticobiliary Cancer (조기위암으로 위 절제술 후 갑자기 발생한 췌담도암으로 오인되었던 재발성 위암 1례)

  • Byung Hoo Lee;Joo Young Cho
    • Journal of Digestive Cancer Research
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    • v.1 no.1
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    • pp.48-51
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    • 2013
  • We report an unusual case of postoperative early gastric cancer with liver metastasis mimicking pancreaticobiliary carcinoma. A 73-year-old man with early gastric cancer was transferred for endoscopic treatment. The patient underwent endoscopic submucosal dissection for the treatment of the early gastric cancer. The pathological diagnosis was adenocarcinoma with extension to the deep submucosa and some lymphatic invasion. Therefore, subsequent a subtotal gastrectomy was performed. The histological results demonstrated residual adenocarcinoma confined to the mucosa. The resection margin and lymph node metastasis were negative. Thus, he was closely monitored for recurrence every 6 months. After 2 years, he was suddenly suspected of developing liver metastasis and local recurrence. He received a liver biopsy, and the pathological result was poorly differentiated adenocarcinoma. Immunohistochemical staining suggested pancreaticobiliary carcinoma rather than metastatic adenocarcinoma from the stomach or colon, but primary focus was not found. We were sure that the recurrent stomach cancer metastasized to the liver because stomach cancer can show heterogeneous cytokeratin (CK) expression pattern with various histological features. Therefore, no single CK expression pattern has diagnostic value for distinguishing gastric carcinoma. The patient underwent chemotherapy for metastatic stomach cancer.

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The Treatment Choice for Patients with Papillary Thyroid Carcinoma (유두상 갑상선암의 치료 방법 선택에 대한 고찰)

  • Park Cheong-Soo;Choi Jin-Sup;Park Byeong-Woo
    • Korean Journal of Head & Neck Oncology
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    • v.9 no.2
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    • pp.175-182
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    • 1993
  • 유두상 갑상선암의 대부분은 서서히 진행하는 양호한 임상경과를 보이나, 일부는 저등급 혹은 미분화 갑상선암으로 전환되는 생물학적 특성을 보인다. 저자는 유두상 갑상선암 환자 358예를 적용된 치료방법과 치료결과를 분석하여 논란이 되고 있는 치료방법들 중에서 적절한 치료방법을 찾고자 본 연구를 시도하였다.% 568예중 동측엽절제술 및 협부 절제술 혹은 갑상선 아전 절제술 220예, 갑상선 전 절제술 혹은 근전절제술 143예, 종양적출술 5예였고, 이중 115예는 여러가지 형태의 경부 곽청술이 추가되었고, 150예는 수술후 방사성 동위원소 치료까지 추가되었다. 또 전 환자에서 TSH 억제를 위한 갑상선 호르몬 투여를 하였다. 추적 기간은 5년에서 12년까지 평균 8.5년이었다. Cady와 Rossia AMES Scoring system에 따라 저위험군과 고위험군으로 나누어 재발율과 사망율을 산출한 결과 저위험군 255예중 재발율 11.0%, 사망율 0.4%, 고위험군 65예중 재발율 36.9%, 사망율 20.0%을 보여 고위험군에서 현격히 불량한 예후를 나타내었다. 따라서 저자들은 유두상 갑상선암의 치료방법 선택은 일률적인 치료방법 보다는 환자 개인의 임상적 특성, 병기 등을 고려하여 저위험군에서는 소극적 수술을, 고위험군에서는 적극적인 수술과 수술후 보조치료를 시행하는 것이 바람직하다고 사료되었다.

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Closed Interlocking Intrmedullary Nailing of Metastatic Diaphyseal Fractures of the Humerus (상완골 간부 악성 병적골절의 비관혈적 고합성 골수강내 금속정 고정술)

  • Bahk, Won-Jong;Rhee, Seung-Koo;Kang, Yong-Koo
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.1-11
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    • 2003
  • Purpose: To analysis of the result of the treatment of metastatic diaphyseal fracture of the humerus with closed interlocking intrameduallry nailing. Materials and Methods: Among surgically treated 29 patients with pathologic or impending fracture of diaphysis of the humeurs, 13 patients (16 cases) treated with closed intramedullary interlocking nail were selected for the study. The final result of pain relief and functional recovery was evaluated by modified rating system of Perez et al. Results: Primary cancer was diagnosed after fracture was developed in 2 patients and pathologic or impending fracture was occurred average period of 28.9 months after primary cancer was diagnosed. The main primary malignancies were multiple myeloma, lung cancer and breast cancer. Mean survival after humeral metastasis was 11.7 months. The final result was superior to fair in 13 of 16 cases, and poor in 3 cases with progression of tumor spread or distant dissemination to the ipsilateral fingers. Except the latter 3 patients and other 3 patients, who died before 3 months postoperatively, bony union was achieved in 10 cases. There were no complications related to surgery. Conclusion: Closed interlocking intrameduallry nailing is accomplished with brief operative time, small amount of bleeding and provides immediate stability with resultant early return of function to the arm. Additionally it allows early postoperative irradiation. However, some of our cases shows that intramedullary nailing can accelerate tumor spread and metastases elsewhere, so that serious consideration must be given in planning this treatment. In conclusion, the functional status before fracture, life expectancy, type of tumor and extent of involvement should be carefully considered to decide operative treatment of metastatic disease.

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Significance of Supraclavicular Lymph Node Involvement on Determination of Clinical Staging for Thoracic Esophageal Carcinoma (흉부 식도암의 병기 결정에 있어서 채골상 림프절 전이의 의미)

  • Wu Hong-Gyun;Park Chan Il;Ha Sung Whan;Kim Il Han
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.108-112
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    • 1999
  • Background and Purpose : Involvement of supraclavicular Iymph nodes (SCL) is considered distant metastasis for thoracic esophageal carcinoma in AJCC staging system revised in 1997. We investigated significance of SCL involvement compared to other regional Iymph node involvement. Materials and Methods : Two-hundred eighty-nine patients with unresectable esophageal carcinoma were treated with radiation therapy from June of 1979 through December 1992. Of these patients, 25 were identified having SCL involvement. Survival rate and relapse patterns were compared with that of mediastinal and perigastric Iymph node positive patients to evaluate prognostic significance of SCL involvement. Results : Median survival for patients with SCL involvement was 7 months and 2- and 5-year overall survival rates were 12.0$\%$ and 4.0$\%$ respectably. Corresponding features for regional node positive patients were 9 month, 17.0$\%$ and 3.8$\%$. There was no significant difference between two groups. There was also no difference in patterns of recurrence. Conclusions : Results of this analysis showed that SCL involvement should be staged as nodal disease in contrast to present classification of metastatic disease.

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