• Title/Summary/Keyword: 초기 유방암

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Is $^{99m}Tc$-MDP Mammoscintigraphy Useful in Patients with Breast Mass Lesions? ($^{99m}Tc$-MDP 유방 스캔은 유방 종괴의 감별진단에 임상적인 유용성이 있는가?)

  • Park, Seok-Gun;Lee, Yeon-Hee;Rhyu, Jin-Woo;You, Sun-Mee
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.2
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    • pp.151-160
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    • 1998
  • Purpose: Piccolo et al. advocated the usefulness of $^{99m}Tc$-MDP breast scan in differential diagnosis of breast mass with high accuracy. But there are little or no follow-up studies about it as we know. We studied $^{99m}Tc$-MDP uptake pattern and lesion/background ratio in patients complaining palpable breast lesions to evaluate the clinical usefulness of $^{99m}Tc$-MDP scan. Materials and Methods: Total 34 patients were studied with physical examination, mammo-gram and $^{99m}Tc$-MDP scan prospectively. Anteroposterior and both lateral view of breast were obtained 5 minutes after iv injection of 740 MBq $^{99m}Tc$-MDP. Breast uptake pattern of $^{99m}Tc$-MDP was analyzed by a grade system: 0=no uptake, grade 1=bilateral diffuse uptake, grade 2=asymmetric faint uptake, grade 3=focal hot uptake. 20 cases were pathologically confirmed by excision biopsy or aspiration biopsy. 14 cases were normal in physical examination and mammogram. Results: Pathologic results showed 7 carcinomas, 6 benign solid tumors, and 7 fibrocystic changes. Grade 3 pattern of $^{99m}Tc$-MDP uptake was noted in 4/7 carcinomas, 3/6 benign solid tumors, and 1/7 fibrocystic changes. Grade 2 pattern was 217, 0/7, 3/7 respectively. The average L/B ratio was 1.66 in carcinomas, 1.68 in benign solid masses, 1.20 in fibrocystic diseases, 1.05 in normal patients. L/B ratio was higher in carcinoma and benign mass groups than in fibrocystic change and normal control groups(p=0.005). But there was no statistical difference between L/B ratio of malignant mass group and benign mass group. Conclusion: $^{99m}Tc$-MDP scan is not suitable to routine clinical use for breast mass diagnosis. It might be used in limited conditions when whole body bone scan is planned.

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Surgical Treatment of Metastatic Pathologic or Impending Pathologic Fractures (전이성 병적 골절 또는 병적 임박 골절의 수술적 치료)

  • Kim, Kap-Jung;Lee, Sang-Ki;Choy, Won-Sik;Seo, Dong-Wook
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.1
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    • pp.44-51
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    • 2009
  • Purpose: We evaluated the results of surgical treatment for metastatic pathologic or impending pathologic fractures. Materials and Methods: From January 2004 to December 2007, 18 patients 19 cases were included. Male were 6 and female were 12. The mean age was 65.1. Mean follow up period was 15.2 months. Pathologic fractures were 14 and impending pathologic fractures were 5. MSTS score, periodic radiologic follow up and postoperative complications were evaluated. Results: The primary malignancies were 6 cases of multiple myeloma, 4 cases of renal cell carcinoma, 2 cases of cholangiocarcinoma, 2 cases of colon cancer, 2 cases of breast cancer and 2 cases of leiomyosarcoma. Metastatic lesions were 10 cases of femur, 4 cases of clavicle, 2 cases of humerus, 2 cases of tibia and 1 case of radius. Surgical options were curettage, cementation, internal fixation and arthroplasty. Mean MSTS score was 15.9. Postoperative complications were 1 case of infection, 1 case of local recurrence and 1 case of implant loosening. Ten patients were alive with disease, 8 patients died of disease. Conclusion: Surgical treatment of metastatic skeletal lesions allowed early ambulation and improving dexterity. It improved pain and emotional acceptance. Surgery is necessary for improving qualities of remaining lives.

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Treatment Outcome and Analysis of the Prognostic Factors of Ductal Carcinoma in situ Treated with Breast Conserving Surgery and Radiotherapy (유방 관상피내암의 유방 보존술 후 방사선 치료의 성적과 예후 인자 분석)

  • Kim, Kyoung-Ju;Huh, Seung-Jae;Park, Won;Yang, Jeong-Hyeon;Nam, Seog-Jin;Kim, Jeong-Han;Lee, Sung-Kong;Lee, Jee-Hyun;Kang, Sung-Soo;Lee, Jeong-Eun;Kang, Min-Kyu;Park, Young-Je;Nam, Hee-Rim
    • Radiation Oncology Journal
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    • v.22 no.1
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    • pp.11-16
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    • 2004
  • Purpose: To evaluate the survival rate, local failure rate and patterns of failure, and analyze the prognostic factors affecting local relapse of ductal carcinoma in situ treated with breast conserving surgery and radiotherapy Materials and Methods: From June 1995 to December 2001, 96 patients with ductal carcinoma in situ treated with breast conserving surgery and radiotherapy were retrospectively analyzed. The operations were either local or wide excision in all patients, with an axillary lymph node dissection performed in some patients. Radiation dose to the whole breast was 50.4 Gy, over 5 weeks, with 1.8 Gy daily fractions, with additional doses ($10\~14$ Gy) administered to the primary tumor bed in some patients with close ($\leq$2 mm) or positive resection margin. The median follow-up period was 43 months (range $10\~102$ months). Results: The 5-year local relapse free survival and overall survival rates were 91 and $100\%$ respectively. Local relapse occurred in 6 patients ($6.3\%$). Of the 6 recurrences, one was invasive ductal cell carcinoma. With the exception of one, all patients recurred 2 years after surgery. There was no regional recurrence or distant metastasis. Five patients with local recurrence were salvaged with total mastectomy, and are alive with no evidence of disease. One patient with recurrent invasive ductal cell carcinoma will receive salvage treatment. On analysis of the prognostic factors affecting local relapse, none of the factors among the age, status of resection margin, comedo type and nuclear grade affected local relapse. Operation extent also did not affect local control (p=0.30). In the patients with close resection margin, boost irradiation to the primary tumor bed did not affect local control (p=1.0). Conclusions: The survival rate and local control of the patients with ductal carcinoma in situ treated with breast conserving surgery and radiotherapy were excellent. Close resection margin and boost irradiation to the primary tumor bed did not affect local relapse, but further follow-up with much more patients is needed.

Usefulness of Three-Dimensional Maximal Intensity Projection (MIP) Reconstruction Image in Breast MRI (유방자기공명영상에서 3 차원 최대 강도 투사 재건 영상의 유용성)

  • Kim, Hyun-Sung;Kang, Bong-Joo;Kim, Sung-Hun;Choi, Jae-Jeong;Lee, Ji-Hye
    • Investigative Magnetic Resonance Imaging
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    • v.13 no.2
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    • pp.183-189
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    • 2009
  • Purpose : To evaluate the usefulness of three-dimensional (3D) maximal intensity projection (MIP) reconstruction method in breast MRI. Materials and Methods : Total 54 breasts of consecutive 27 patients were examined by breast MRI. Breast MRI was performed using GE Signa Excite Twin speed (GE medical system, Wisconsin, USA) 1.5T. We obtained routine breast MR images including axial T2WI, T1WI, sagittal T1FS, dynamic contrast-enhanced T1FS, and subtraction images. 3D MIP reconstruction images were obtained as follows; subtraction images were obtained using TIPS and early stage of contrast-enhanced TIPS images. And then 3D MIP images were obtained using the subtraction images through advantage workstation (GE Medical system). We detected and analyzed the lesions in the 3D MIP and routine MRI images according to ACR $BIRADS^{(R)}$ MRI lexicon. And then we compared the findings of 3D MIP and those of routine breast MR images and evaluated whether 3D MIP had additional information comparing to routine MR images. Results : 3D MIP images detect the 43 of 56 masses found on routine MR images (76.8%). In non-mass like enhancement, 3D MIP detected 17 of 20 lesions (85 %). And there were one hundred sixty nine foci at 3D MIP images and one hundred nine foci at routine MR images. 3D MIP images detected 14 of 23 category 3 lesions (60.9%), 11 of 16 category 4 lesions (68.87%), 28 of 28 Category 5 lesions (100%). In analyzing the enhancing lesions at 3D MIP images, assessment categories of the lesions were correlated as the results at routine MR images (p-value < 0.0001). 3D MIP detected additional two daughter nodules that were descriped foci at routine MR images and additional one nodule that was not detected at routine MR images. Conclusion : 3D MIP image has some limitations but is useful as additional image of routine breast MR Images.

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MD로써 기대하는 PhD의 역할과 현실

  • 정태섭
    • Proceedings of the KSMRM Conference
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    • 1999.11a
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    • pp.69-71
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    • 1999
  • 최근 한국 의학의 발전은 전체 한국의 선진화를 선도하다고 보기에는 힘드리만 최소한 국제무대에의 진출은 괄목할만한 발전을 보이고 있다. 최근에 들어 국내 방사선영상과련 학회의 발전은 날로 비약적인 추세를 보이고 있다. 일례로 대한방사선의학회는 본 저자가 전공의 하던 1980년도 초기만 해도 호텔의 큰 홀 한 개만 빌려서 하루만 해도 넉넉하게 진행되었다. 그러나 최근의 학회사정은 대형호텔 1개층 통째로 빌리고 3일간 진행해도 여유가 없을 정도이며 더욱이 추계학회는 지방에서 유치할만한 공간이 부족하여 이제는 없어져야할 지경에 이러렀다. 그뿐 아니라 대한 자기공명의과학회를 포함한 각종 학회가 이제 그 규모를 더해가고 있어. 대한민국에 있어서 진단 방사선영역의 의학은 급속히 발전하여 RSNA, ISMRM등에서도 세계 발표순위가 4-5위권을 다투게 되었다. 이러한 발전은 양적인 발전이 우세하여 주로 임상연구에 기반을 두고 있는데 이 자체로는 장기적인 발전에 한계점이 있으므로 앞으로는 기초과학연구에 기초한 질적 발전을 같이 추구하여야만 균형있는 성장을 기대할 수 있겠다. 이러한 기존의 구성에 최근 급격한 변화를 주도하는 학문이 MRI부분이 되며 이 분야를 연구하는 PhD 들의 역할이 크게 대두되고 있다. 현재 국내에도 초기 단계이지만 MRI를 생산하고 있으며 PhD들의 활동이 성장단계에 접어들었다고 할수 있다. 과거 우리의 NRI역사에서는 금성사 MR기계처럼 육성되기 전에 시들며 노력하던 기술진이 흩어져야 했던 어두운 기억이 있다. 이러한 시점에서 우리의 힘들었던 과거를 돌이켜보며 또 하나의 기초부분이 육성되 수 있도록 서로가 격려하며 협조하여야 될 것으로 생각되어 다음과 같이 요약을 하였다. 소기관으로는 세포 막, 미토콘드리아 (mitochondria), endoplasmic reticulum, Golgi 체, lysosome, peroxisome 그리고 세포질등이 있으며, 이들중에서 lysosomes, peroxisomes, 그리고 미토콘드리아가 특정한 유전성 백질질환에 중요한 역할을 하는 것이 밝혀졌다. 이러한 질환들은 최소한 각 소기관에 의한 질환군으로 분류될 수 있다.SXR이 ER의 transactivation 효과를 약간 촉진한 반면 MDA-MB-231세포는 SXR을 제외한 CAR와 PPAR${\gamma}$에 의해 ER의 transactivation 효과가 약간 증가되는 경향을 보였다. 이러한 결과는 유방암세포에서는 CAR, SXR, PPAR${\gamma}$과 같은 xenobiotic nuclear receptor에 의한 ER transactivation 효과가 간암세포와는 다르게 나타나며, 유방암의 종류에 따라서 endogenous CAR, SXR, PPAR${\gamma}$수용체가 다르게 발현됨으로써 이들에 대한 반응이 서로 상이한 특징을 나타낼 수 있을 것으로 사료된다. 따라서 estrogen receptor에 의해 매개되는 estrogn의 전사활성조절기전이 표적세포에 따라 다른 경로를 포함 할 수 있음을 시사한다.서 흡착 능력이 우수하게 나타났으며, 황화수소는 펄라이트, 왕겨, 소나무수피에서 상대적으로 우수한 것으로 나타났으며, 혼합충전재는 암모니아의 경우 코코넛과 펄라이트의 비율이 7:3인 혼합 재료 3번과 소나무수피와 펄라이트의 비율이 7:3인 혼합 재료 6번에서 다른 혼합 재료에 비하여 우수한 것으

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Venlafaxine for Management of Hot Flashes: A Review of Randomized Controlled Trials in Human (Venlafaxine의 안면홍조 증상개선효과에 대한 최근 연구 고찰)

  • Lee, Yu-Jeung
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.2
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    • pp.138-144
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    • 2010
  • The results from eight randomized controlled studies demonstrate that venlafaxine is effective in the treatment of hot flashes with tolerable adverse effects. Based on the results of the above studies, venlafaxine can be recommended for the treatment of hot flashes. However, there are limitations in the above studies. The inclusion criteria of 5 studies reviewed in this paper was breast cancer patients, so it's hard to apply the results to the general population in clinical practice. Also 5 studies had less than 100 subjects included, and 18-week study was the longest one among studies reviewed in this paper. Therefore, large and long-term clinical studies with the general population should be conducted to use venlafaxine for the treatment of hot flashes in clinical practice.

A Study on the Image Enhancement Method of Digital Mammogram in the Wavelet Domain (웨이블렛 영역에서 디지털 맘모그램의 영상향상 방법에 관한 연구)

  • Jeon, Geum-Sang;Jang, Boo-Hwan;Kim, Sang-Hee
    • Journal of the Institute of Convergence Signal Processing
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    • v.13 no.1
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    • pp.6-11
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    • 2012
  • Digital mammogram is effective for detecting the micro-calcification that is early symptom of breast cancer. In the digital mammogram, many image processing techniques have been studied for accurate diagnosis and efficient treatment of micro-calcification lesion. The wavelet based multi-scale method was mainly used to enhance the image contrast. This paper presents an advanced mammography enhancement method which is based both on the brightness and the contrast enhancement in the wavelet domain. The proposed method normalizes a dynamic range using histogram of the image. The brightness is enhanced by modifying coefficients of low frequency components, and the contrast is enhanced by coefficients of high frequency component based on the multi-scale contrast measure. The experiment results show that the proposed method yields better performance of the image enhancement over the existing methods.

Cloning and Expression of Lactadherin Gene from Korean Women (한국 여성의 Lactadherin 유전자 Cloning과 발현 연구)

  • Yom, Heng-Cherl
    • Development and Reproduction
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    • v.11 no.3
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    • pp.253-261
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    • 2007
  • Lactadherin is a glycoprotein of human milk fat globule membrane that binds to mucin and butyrophilin forming the protein complex. Especially, mucin and lactadherin in human milk efficiently protect infants with poor immune functions right after birth from infections by microorganisms and play important roles for their early survival, growth and development. Lactadherin inhibits the propagation and growth of rotavirus that is a global pathogen causing infants' diarrhea. Recently this protein was known to promote neovascularization and its deficiency related to develop Alzheimer's disease. In this study, the basic biochemical and physiological aspects of lactadherin were investigated. Messenger RNAs were isolated from mammary tissues from Korean women patients to clone a 1.2 kb cDNA and sequenced its DNA to determine its amino acid sequences. The cDNA was cloned to express its 43 kD protein in E. coli, which was confirmed by Western blot. The recombinant protein was purified and injected to 2 rabbits to raise antibodies against it. The semi-purified milk fat globule membrane proteins from Korean women was analyzed by Western blot using the rabbit antibody to give 70, 55, 46, 30 kD bands. Also several polymorphism and SNPs of lactadherin gene from Korean women were observed compared with those of Caucasian women.

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Citalopram and Escitalopram for Management of Hot Flashes: A Review of Recent Clinical Trials in Humans (Citalopram과 Escitalopram의 안면홍조 증상개선효과에 대한 최근 연구 고찰)

  • Lee, Yu-Jeung
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.4
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    • pp.376-382
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    • 2011
  • The results from eight clinical studies demonstrate that citalopram and escitalopram could be an effective option in the treatment of hot flashes with tolerable adverse effects. However, there are limitations in the above studies. The inclusion criteria of 2 studies reviewed in this paper was breast cancer patients, so it's hard to apply the results to the general population in clinical practice. Also 4 studies had less than 50 subjects included, and the duration of study was 8 weeks or less in 7 studies reviewed in this paper. Moreover, only 4 studies were randomized, placebo-controlled trials (3 for citalopram and 1 for escitalopram). Therefore, further randomized, double-blind, placebo-controlled studies with the general population should be needed to use citalopram and escitalopram for the treatment of hot flashes in clinical practice.

Effects of Ixeris dentata Extract on Radical Oxygen Species and Bcl-2 Family in Human Breast Cancer Cells (씀바귀 추출물이 인체유방암세포의 활성 산소 및 Bcl-2 Family에 미치는 영향)

  • Kim, Hee-Jung;Kang, Keum-Jee
    • Journal of the East Asian Society of Dietary Life
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    • v.24 no.6
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    • pp.739-747
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    • 2014
  • The aim of the study was to determine the effects of Ixeris dentata extract (IDE) on anticancer activity in human breast cancer MDA-MB-231 cells at both cellular and molecular levels. The cells were cultured in the presence of 0, 20, 30 and $40{\mu}g/mL$ Ixeris dentata extract for 24 hours, respectively. At the end of culture, cytochemical analyses for MTT activity, trypan blue dye exclusion, Annexin V-FITC Apoptosis, and radical oxygen species (ROS) were conducted. RT-PCR was also performed to determine whether or not alterations in cell viability affect the Bax/Bcl-2 ratio. MTT assay showed that relative cell viability decreased in a dose-dependent manner (p<0.05). Reduction of cell viability matched well with increased cell membrane permeability as determined by trypan blue dye exclusion test (p<0.05). The rates of intracellular ROS also increased in a similar manner to those of TB-stained cells. There was an associated shift of apoptotic cells from early to late apoptosis between the 30 and $40{\mu}g/mL$. Bax/Bcl-2 ratio significantly increased along with significant decreases in Bcl-2 expression between 30 and $40{\mu}g/mL$ groups (p<0.05). In conclusion, anticancer activity of Ixeris dentata extract is modulated by a reduction in cell viability along with increased membrane permeability, leading to ROS accumulation within cells, and subsequently cell death through an apoptotic pathway that involves Bax and Bcl-2 in human breast cancer MDA-MB-231 cells.