• Title/Summary/Keyword: 폐암 분할

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Comparison of Stereotactic Radiosurgery and Whole Brain Radiotherapy in Patients with Four or More Brain Metastases (4개 이상의 다발성 전이성 뇌종양의 정위적 방사선수술과 전뇌 방사선조사의 비교)

  • Kim, Cheol-Jin;Baek, Mi-Young;Park, Sung-Kwang;Ahn, Ki-Jung;Cho, Heung-Lae
    • Radiation Oncology Journal
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    • v.27 no.3
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    • pp.163-168
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    • 2009
  • Purpose: This study was a retrospective evaluation of the efficacy of stereotactic radiosurgery (SRS) in patients with >4 metastases to the brain. Materials and Methods: Between January 2004 and December 2006, 68 patients with $\geq$4 multiple brain metastases were included and reviewed retrospectively. Twenty-nine patients received SRS and 39 patients received whole brain radiotherapy (WBRT). Patients with small cell lung cancers and melanomas were excluded. The primary lesions were non-small cell lung cancer (69.0%) and breast cancer (13.8%) in the SRS group and non-small cell lung cancer (64.1%), breast cancer (15.4%), colorectal cancer (12.8%), esophageal cancer (5.1%) in the WBRT group. SRS involved gamma-knife radiosurgery and delivered 10~20 Gy (median, 16 Gy) in a single fraction with a 50% marginal dose. WBRT was delivered daily in 3 Gy fractions, for a total of 30 Gy. After completion of treatment, a follow-up brain MRI or a contrast-enhanced brain CT was reviewed. The overall survival and intracranial progression-free survival were compared in each group. Results: The median follow-up period was 5 months (range, 2~19 months) in the SRS group and 6 months (range, 4~23 months) in the WBRT group. The mean number of metastatic lesions in the SRS and WBRT groups was 6 and 5, respectively. The intracranial progression-free survival and overall survival in the SRS group was 5.1 and 5.6 months, respectively, in comparison to 6.1 and 7.2 months, respectively, in the WBRT group. Conclusion: SRS was less effective than WBRT in the treatment of patients with >4 metastases to the brain.

The Physical and Chemical Properties and Cytotoxic Effects of Acer tegmentosum Maxim. Extracts (산겨릅나무 추출물의 이화학적 특성과 암세포 성장 억제 효과)

  • Shin, In-Cheol;Sa, Jae-Hoon;Shim, Tae-Heum;Lee, Jin-Ha
    • Applied Biological Chemistry
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    • v.49 no.4
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    • pp.322-327
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    • 2006
  • Food constituents analysis of Acer tegmentosum. Maxim.(Acer TM) stem was carried out according to AOAC method, and the antiradical activity on DPPH and cytotoxicity on human cell lines (AGS, HepG2, A549, MCF-7 and Chang) for the 80% ethylalcohol(EtOH) extracts of Acer TM stem were studied. The antiradical activity on DPPH radical of the ethylacetate(EtOAc) fraction of the bark showed a higher activity than that of $\alpha$-tocopherol, ascorbic acid and BHT. The inhibition activity of the 80% EtOH extracts from Acer TM stem on human cancer cell lines by SRB assay indicated a dose-dependent growth inhibition on most human carcinoma cells. The growth inhibition rate of each human cancer cell line showed 91.3% to AGS, 75.0% to A549, 74.1% to HepG2, and 70.2% to MCF-7 cells, respectively, when the 80% EtOH extract(1 mg/ml) of Acer TM stem was added.

A Case of Fatal Hyperinfective Strongyloidiasis with Acute Respiratory Failure and Intestinal Perforation in Lung Cancer Patient (폐암환자에서 급성호흡부전과 장천공을 동반한 분선충 감염증 1예)

  • Kim, Hyeon-Sik;Kim, Yu-Eun;Yun, Eun-Young;Ju, Ji-Hyun;Ma, Jeong-Eun;Lee, Gi-Dong;Cho, Yu-Ji;Kim, Ho-Cheol;Lee, Jong-Deok;Hwang, Young-Sil;Jeong, Yi-Yeong
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.1
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    • pp.29-33
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    • 2010
  • Strongyloides stercoralis is an intestinal nematode that is a parasite to humans. The infecting filariform larvae of S. stercoralis enters the host body via the bloodstream, passes through the lungs, penetrates the alveoli, and then ascends the airway to transit down the esophagus into the small bowel. The infection can persist for decades without causing major symptoms and can elicit eosinophilia of varying magnitudes. Of note, this infection can also develop into a disseminated, often fatal, disease (hyperinfection) in patients receiving immunosuppressive corticosteroids. A 65-year-old man who was receiving corticosteroid therapy for the treatment of spinal stenosis was admitted to the emergency room with complaints of abdominal pain and severe dyspnea. We detected many S. stercoralis larvae in the sputum and in the bronchoalveolar-lavage sample collected by bronchoscopy. Here, we report a fatal case of strongyloidiasis with acute respiratory failure and intestinal perforation. In addition, we provide a brief review of the relevant medical literature.

Differences in Medical Care Utilization by Regional Economic Status (지역 소득수준에 따른 의료이용의 차이)

  • Lim, Nam Gu
    • Journal of Digital Convergence
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    • v.11 no.10
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    • pp.459-467
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    • 2013
  • The purpose of this study was to identify the differences in medical care utilization by regional economic status using the National Hospital Discharge Patients Injury Survey. In order to determine economic status of each region, 234 cities and counties were categorized 5 quintiles according to their financial self-reliance ratio. The main results are as follows. First, low economic region has high age-standardized admission rate and standardized mortality rate. Second, of 16 major diseases, cerebrovascular and heart diseases, lung cancer, and stomach cancer reported greater changes in standardized mortality rate by regional economic status. Third, the rate of admission via emergency room in low economic region is higher than that of high economic region. Lastly, in the major illnesses, lower economic status led to an increase in average length of stay. Therefore, In order to bridge the gap in health inequality across regions, a regional medical policy tailored for each region and characteristics of the economic status should be established.

Analysis of Lymphocyte Subsets in Peripheral Blood after Radiotherapy (악성 종양 환자에서 방사선 치료 전, 후의 림프구 아형 분석)

  • Choi, Young-Min;Kim, Jeung-Kee;Lee, Hyun-Sik;Hur, Won-Joo;Kim, Jung-Man
    • Radiation Oncology Journal
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    • v.14 no.3
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    • pp.229-236
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    • 1996
  • Purpose : To evaluate the changes of differential counts and lymphocyte subsets in cancer patients' leukocyte before and after radiotherapy. Materials and Methods : From Dec. 1994 to Mar 1995, the changes of leukocyte and its subsets in 16 patients who received radiotherapy in the Dept. of Radiation Oncology of Dong-A University Hospital were investigated. Radiation was delivered from 2700 cGy to 6660 cGy with median dose of 5400 cGy. The results of pre- and Post-radiotherapy were analyzed by paired T-test. The results of patients Who received < 50 Gy and $\geq$ 50 Gy were analyzed by Wilcoxon test. Results : Before and after radiotherapy, there was not any significant differences in the counts of leukocyte, granulocyte and monocyte. A remarkable decrease was noted in lymphocyte counts after radiotherapy(p=0.015). T cells, B cells and natural killer cells were also decreased in number after radiotherapy but it was not significant statistically. 1 helper cells and T suppressor cells were also decreased in number(p>0.05). The ratio of T helper/suppressor cell was decreased from 1.52 to 1, 11 and it was significant statistically(p=0.016). The portion of T suppressor cell among all T cells was increased after radiotherapy (p=0.0195). No significant difference was observed in the analysis of leukocyte and its subsets between patients who received < 50 Gy and $\geq$ 50 Gy, Conclusion : Radiotherapy caused remarkable decrease in lymphocyte count and its subsets. Among all lymphocyte subsets, T helper cell might be the most vulnerable to radiation, considering decreased ratio of T helper/suppressor cell count after radiotherapy.

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Radiotherapy in Medically Inoperable Early Stage Non-small Cell Lung Cancer (내과적 문제로 수술이 불가능한 조기 비소세포성 폐암에서의 방사선치료)

  • Kim, Bo-Kyoung;Park, Charn-Il
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.257-264
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    • 2000
  • Purpose: For early stage non-small-cell lung cancer, surgical resection is the treatment of choice. But when the patients are not able to tolerate it because of medical problem and when refuse surgery, radiation therapy is considered an acceptable alternative. We report on the treatment results and the effect of achieving local control of primary tumors on survival end points, and analyze factors that may influence survival and local control. Materials and Method : We reviewed the medical records of 32 patients with medically inoperable non-small cell lung cancer treated at our institution from June, 1987 through June, 1997. All patients had a pathologic diagnosis of non-small cell lung cancer and were not candidate for surgical resection because of either patients refusal (4), old age (2), lung problem (21), chest wail invasion (3) and heart problems (3). In 8 patients, there were more than 2 problems. The median age of the patients was 68 years (ranging from 60 to 86 years). Histologic cell type included souamous (24), adenocarcinoma (6) and unclassiried squamous cell (2). The clinical stages of the patients were 71 in 5, 72 in 25, 73 in 2 patients. Initial tumor size was 3.0 cm in 11, between 3.0 cm and 5.0 cm in 13 and more than 5.0 cm in 8 patients. Ail patients had taken chest x-rays, chest CT, abdomen USG and bone scan. Radiotherapy was delivered using 6 MV or 10 MV linear accelerators. The doses of primary tumor were the ranging from 54.0 Gy to 68.8 Gy (median; 61.2 Gy). The duration of treatment was from 37 days through 64 days (median; 0.5 days) and there was no treatment interruption except 1 patient due to poor general status. In 12 patients, concomitant boost technique was used. There were no neoadjuvant or adjuvant treatments such as surgery or chemotherapy. The period of follow-up was ranging from 2 months through 93 months (median; 23 months). Survival was measured from the date radiation therapy was initiated. Results : The overall survival rate was 44.6$\%$ at 2 years and 24.5$\%$ at 5 years, with the median survival time of 23 months. of the 25 deaths, 7 patients died of intercurrent illness, and cause-specific survival rate was 61.0$\%$ at 2 years and 33.5$\%$ at 5 years. The disease-free survival rate was 38.9$\%$ at 2 years and 28.3$\%$ at 5 years. The local-relapse-free survival rate was 35.1$\%$, 28.1$\%$, respectively. On univariate analysis, tumor size was significant variable of overall survival (p=0.0015, 95$\%$ C.1.; 1.4814-5.2815), disease-free survival (P=0.0022, 95$\%$ C.1., 1.4707-5.7780) and local-relapse-free survival (p=0.0015, 95$\%$ C.1., 1.2910- 4.1197). 7 stage was significant variable of overall survival (p=0.0395, 95$\%$ C.1.; 1.1084-55.9112) and had borderline significance on disease-free survival (p=0.0649, 95$\%$ C.1.; 0.8888-50.7123) and local-relapse-free survival (p=0.0582, 95$\%$ C,1.; 0.9342-52.7755). On multivariate analysis, tumor size had borderline significance on overall survival (p=0.6919, 955 C.1., 0.9610-5.1277) and local-relapse-free survival ( p=0.0585, 95$\%$ C.1.; 0.9720-4.9657). Tumor size was also significant variable of disease-free survival (p=0.0317, 95% C.1.; 1.1028-8.4968). Conclusion : Radical radiotherapy is an effective treatment for small (71 or f3 cm) tumors and can be offered as alternative to surgery in elderly or infirmed patients. But when the size of tumor is larger than 5 cm, there were few long-term survivors treated with radiotherapy alone. The use of hypefractionated radiotherapy, endobronchial boost, radisensitizer and conformal or IMRT should be consider to improve the local control rate and disease-specific survival rate.

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A Study on a Comparative Analysis of 2D and 3D Planning Using CT Simulator for Transbronchial Brachytherapy (전산화단층모의치료기를 이용한 경기관지 근접치료환자의 치료계획에 관한 고찰)

  • Seo, Dong Rin;Kim, Dae Sup;Back, Geum Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.25 no.1
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    • pp.69-75
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    • 2013
  • Purpose: Transbronchial brachytherapy used in the two-dimensional treatment planning difficult to identify the location of the tumor in the affected area to determine the process analysis. In this study, we have done a comparative analysis for the patient's treatment planning using a CT simulator. Materials and Methods: The analysis was performed by the patients who visited the hospital to June 2012. The patient carried out CT-image by CT simulator, and we were plan to compare with a two-dimensional and threedimensional treatment planning using a Oncentra Brachy planning system (Nucletron, Netherland). Results: The location of the catheter was confirmed the each time on a treatment planning for fractionated transbronchial brachytherapy. GTV volumes were $3.5cm^3$ and $3.3cm^3$. Also easy to determine the dose distribution of the tumor, the errors of a dose delivery were confirmed dose distribution of the prescibed dose for GTV. In the first treatment was 92% and the second was 88%. Conclusion: In order to compensate for the problem through a two-dimensional treatment planning, it is necessary to be tested process for the accurate identification and analysis of the treatment volume and dose distribution. Quantitatively determine the dose delivery error process that is reflected to the treatment planning is required.

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Weekly irinotecan and carboplatin for patients with small cell lung cancer (소세포 폐암 환자에서 이리노테칸, 카보플라틴 주별 분할 항암요법의 효과)

  • Lee, Hye-Won;Jeong, Eu Gene;Kim, Dong Hyun;Lee, Hyuk;Kang, Bo Hyoung;Um, Soo-Jung;Roh, Meesook;Son, Choonhee
    • Journal of Yeungnam Medical Science
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    • v.31 no.2
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    • pp.82-88
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    • 2014
  • Background: Lung cancer is the most common cause of cancer-related death worldwide and in Korea, and small cell lung cancer (SCLC) is the most deadly tumor type in the different lung cancer histology. Chemotherapy is the main strategy of the treatment for SCLC, and etoposide and platinum regimen has been the only standard chemotherapy for about 30 years. To test feasibility of weekly divided dose irinotecan and carboplatin for Korean patients is the aim of this study. Methods: Patients with histologically or cytologically confirmed extensive stage SCLC were included. Patients with limited stage (LD), who could not tolerate concurrent chemoradiotherapy were also included. All the patients received irinotecan $60mg/m^2$, carboplatin 2 area under the curve at day 1, 8, and 15 every 4 weeks. Study regimen was discontinued when the disease progressed or intolerable side effects occurred. No more than 6 cycles of chemotherapy were given. Results: Total 47 patients were enrolled, among them 9 patients were LD. Overall response rate was 74.5% (complete response, 14.9%; partial response, 59.6%). Side effects greater than grade 3 were neutropenia (25.5%), fatigue (12.8%), thrombocytopenia (8.5%), sepsis (4.3%), and pancytopenia (2.1%). There was no treatment related death. Conclusion: Weekly divided irinotecan and carboplatin regimen is effective, and safe as a first line therapy for both stage of SCLC. Large scaled, controlled study is feasible.

Anti-Cancer Activity of the Leave Extracts of Rodgersia podophylla through β-catenin Proteasomal Degradation in Human Cancer Cells (도깨비부채(Rodgersia podophylla) 잎 추출물의 인간 암세포의 β-catenin 분해 유도 활성)

  • Kim, Ha Na;Kim, Jeong Dong;Son, Ho-Jun;Park, Gwang Hun;Eo, Hyun Ji;Jeong, Jin Boo
    • Korean Journal of Plant Resources
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    • v.32 no.5
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    • pp.442-447
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    • 2019
  • In this study, we evaluated the effect of Rodgersia podophylla leave extracts (RPL) on ${\beta}-catenin$ level in human cancer cells. RPL dose-dependently inhibited cell proliferation in SW480, A549, MDA-MB-231, PC-3 and AsPC-1 cells. RPL dramatically decreased ${\beta}-catenin$ protein level in all cancer cells. However, decreased level of ${\beta}-catenin$ mRNA expression was observed in A549 and AsPC-1 cells. In addition, RPL dramatically attenuated cyclin D1 mRNA expression in all cancer cells. MG132 decreased the downregulation of ${\beta}-catenin$ protein level induced by RPL in all cancer cells, while RPL-induced downregulation of ${\beta}-catenin$ was inhibited by the inhibition of $GSK-3{\beta}$ by LiCl in MDA-MB-231 cells. RPL phosphorylated ${\beta}-catenin$ and $GSK-3{\beta}$. In addition, the inhibition of $GSK-3{\beta}$ by LiCl attenuated RPL-induced ${\beta}-catenin$ phosphorylation. Based on these findings, RPL may be a potential candidate for the development of chemopreventive or therapeutic agents for human cancer.

Lung Biopsy after Localization of Pulmonary Nodules with Hook Wire (Hook Wire를 이용한 폐결절의 위치선정 및 생검)

  • Kim, Jin-Sik;Hwang, Jae-Joon;Lee, Song-Am;Lee, Woo-Surng;Kim, Yo-Han;Kim, Jun-Seok;Chee, Hyun-Keun;Yi, Jeong-Geun
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.681-686
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    • 2010
  • Background: A chest computed-tomography has become more prevalent so that it is more common to detect small sized pulmonary nodules that have not been found in previous simple chest x-ray. If those detected nodules are undersized or located in pulmonary parenchyma, it is difficult to accomplish a biopsy since it is vulnerable to explore them either grossly or digitally. Thus, in our hospital, a thoracoscopic pulmonary wedge resection was performed after locating a lesion by means of hook wire with CT-guided. Material and Method: 31 patients (17 males and 14 female patients) from December in 2006 to June in 2010 became our subjects; their 34 pulmonary nodules were subjected to the thoracoscopic pulmonary wedge resection after locating a lesion by means of hook wire with CT-guided. Also we analyzed a possibility of hook wire dislocation, a frequency of conversion to open thoracotomy, time consumed to operation after location of a lesion, operation time, post operation complication, and histological diagnosis of the lesion. Result: 12 of 34 cases were ground glass lesion, whereas 22 cases of them were solitary pulmonary lesion. The median value of the lesion was 8mm in size (range: 3 to 23 mm), while the median value was 12.5 mm in depth (range: 1 to 34 mm). The median value of time consumed from location of the lesion to anesthetic induction was 86.5 minutes (41~473 minutes); furthermore the mean value of operation time was 103 minutes (25~345 minutes). Intrathoracic wire dislocation was found in one case, but a target lesion was successfully excised. Open thoracotomy was performed in four cases due to pleural adhesion. However, there was no case of conversion to open thoracotomy due to failure to detect a target lesion. In histological diagnosis, metastatic cancer were found in 15 cases, which were the most common, primary lung cancer were in 9 cases, non-specific inflammation were in 3 cases, tuberculosis inflammation were in 2 cases, lymph nodes were in 2 cases, active tuberculosis were in 1 case, atypical adenomatous hyperplasia was in 1 case and normal lung parenchymal finding was in 1 case, respectively. Conclusion: In our hospital, in order to accomplish a precise histological diagnosis of ground-glass lesion and pulmonary nodules in lung parenchyma, location of pulmonary nodules were exactly located with hook wire under chest computed-tomography, which was followed by lung biopsy. We concluded that this was an accurate, minimally invasive and valuable method to minimize the complications and increase of cost of medical service provided.