• Title/Summary/Keyword: 혈액암

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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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The Changing Patterns and Predisposing Factors of Delirium at End of Life in Palliative Care Unit (완화 병동에서 임종기 섬망의 변화 양상과 선행 요인)

  • Rim, Mi-Roo;Kang, Sang-Gu;Choi, Seo-Hyeon;Cho, Jinhyun;Lee, Moon-Hee;Kim, Hye-Young;Bae, Jae-Nam;Lee, Jeong-Seop;Kim, Won-Hyoung
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.94-101
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    • 2018
  • Objectives : The purpose of this study is to investigate the change pattern and the leading factors of delirium in the palliative ward from 2 weeks before to the end of life. Methods : From October 2015 to August 2017, a retrospective chart review was conducted on the final 180 patients of 207 patients with terminal cancer patients at the Inha University Hospital. Clinical records were collected during palliative care hospitalization. Patients were diagnosed with three subtypes of delirium through the Richmond Agitation Sedation Scale and the Nursing Delirium Screening Scale, which were evaluated daily. Results : The prevalence of delirium 13 days before death was 46%, of which 18.3% were hyperactive subtypes, 13.8% were hypoactive subtypes, and mixed subtypes were 13.8%. And hyperactive delirium gradually decreased with the approach to the end of the day, and the mixed subtype gradually increased until 4 days before the end of life. Of the patients, the day before death, 86.9% were diagnosed with delirium. In multivariate analysis, hematologic malignancy was associated with a lower rate of delirium at the end of life than gastrointestinal cancer. Overweight was associated with hyperactive, mixed, and hypoactive delirium. Conclusions : Most palliative care patients experienced delirium at the end of life. Overweight was considered as a protective factor that reduced the all subtypes of delirium at the end of life. Further prospective studies are needed to reveal the prevalence of terminal delirium, and their risk factors.

Comparison of Serum Cytokines($IL-1{\beta}$, IL-6, and $TNF-{\alpha}$) between Terminal Cancer Patients Treated with Vitamin C and Them without Vitamin C Therapy (Anorexia-Cachexia Syndrome을 가진 말기 암 환자에서 비타민 C 사용여부에 따른 사이토카인 변화 비교)

  • Yeom, Chang-Hwan;Suh, Sang-Youn;Cho, Kyung-Hee;Sun, Young-Gyu;Park, Yong-Gyu;Lee, Hye-Ree
    • Journal of Hospice and Palliative Care
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    • v.6 no.1
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    • pp.51-57
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    • 2003
  • Purpose : Anorexia-cachexia syndrome is one of the most common symptoms and main cause of death in terminal cancer patients. This symptom is due to the enlarged cancer mass as well as tumor released cytokines. Some doctors have suggested that vitamin C was preferentially toxic to tumor cells in vitro and in vivo, and improved clinical symptoms in terminal cancer patients. Therefore, we measured cytokines in serum of terminal cancer patients to determine whether vitamin C treatment improved the anorexia-cachexia syndrome. Methods : We investigated that 49 terminal cancer patients admitted to the department of family medicine, National Health Insurance Corporation Ilsan hospital from March 1, 2002 to August 31, 2002. The study was done on 22 patients who were given 10 g/day of vitamin C infusions during 1 week and 27 patients who were not infused. We measured the cytokines levels ($IL-1{\beta}$, IL-6, and $TNF-{\alpha}$) before and after 1 week between terminal cancer patients treated vitamin C and without vitamin C. Results : Out of 49 patients, patents treated with vitamin C infusions were 22 (12 male, 10 female), and these without vitamin C were 27 (18 male, 9 female). In patients treated with vitamin C, $IL-1{\beta}\;were\;6.19{\pm}5.17$ before day and $8.76{\pm}5.72$ after 1 week, IL-6 were $3.07{\pm}8.09$ before day and $1.31{\pm}2.36$ after 1 week, and $TNF-{\alpha}\;were\;2.74{\pm}14.24$ before day and $0.50{\pm}2.00$ after 1 week. In patients treated without vitamin C, $IL-1{\beta}\;were\;2.50{\pm}3.58$ before day and $6.49{\pm}12.01$ after 1 week, IL-6 were $1.00{\pm}2.19$ before day and $17.16{\pm}81.55$ after 1 week, and $TNF-{\alpha}\;were\;1.19{\pm}2.98$ before day and $1.27{\pm}1.52$ after 1 week. The level of cytokines in patients treated with vitamin C decreased more than those without vitamin C. However, this represented no statistical value (P=0.0598 in $IL-1{\beta}$, P=0.1664 in IL-6, and P=0.5395 in $TNF-{\alpha}$). Conclusion : In terminal cancer, even if there was no statistical difference in the cytokines levels between patients treated with vitamin C and those not treated, those who were treated had a decrease all cytokines levels. Vitamin C is very safe with almost no side effects. Therefore, vitamin C treatment in terminal cancer patients can be seen as beneficial and helpful for clinical symptoms.

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Effects of Dietary Acidifier($Lactacid^(R)$) and Essential Oil($Immunocin^(R)$) on the Performance, Nutrient Metabolizability, Small Intestinal Microflora and Immune Response in Broiler Chicks (유기산제제 ($Lactacid^(R)$)와 Essential Oil($Immunocin^(R)$)이 육계의 생산성과 영양소 이용율, 소장내 미생물 균총 및 면역 체계에 미치는 영향)

  • Woo K.C.;Lee M.K.;Jung B.Y.;Paik I.K.
    • Korean Journal of Poultry Science
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    • v.33 no.2
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    • pp.141-149
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    • 2006
  • An experiment was conducted to investigate the effects of dietary acidifier($Lactacid^(R)$) and essential oil($Immunocin^(R)$) on the performance, nutrient metabolizability, small intestinal microflora, IgG level and leukocytes and erythrocytes in broiler chickens. Five hundred males and 500 females broiler chickens($Ross^(R)$) were divided into 20 pens of 50 chickens(25 birds in each sex). Five pens were assigned to each of four dietary treatments: control, diets containing antibiotics(Bacitracin methylene disalicilate), acidifier($Lactacid^(R)$) and essential oil($Immunocin^(R)$) dietary treatments. Birds were fed experimental diets ad libitum 5 wks. Weight gain, feed intake, and feed conversion rate were significantly affected by dietary treatment(P<0.05). Overall weight gain($0{\sim}5$ wks) of $Lactacid^(R)$ treatment was significantly lower than the others. Feed intake was highest(P<0.05) in the control followed by antibiotics, $Lactacid^(R)\;and\;Immunocin^(R)$ treatment. Feed conversion rate of $Immunocin^(R)$ treatment was lowest(P<0.05) followed by antibiotics, $Lactacid^(R)$ treatment and the control. Production indices of $Immunocin^(R)$ and antibiotics treatments were significantly higher than those of the control and $Lactacid^(R)$ treatment(P<0.05). $Immunocin^(R)$ treatment was the highest and antibiotics was lowest in serum IgG level. The number of leukocytes and stress index(neutrophil/lymphocytes) tended to be lower in $Immunocin^(R)$ treatment than others. There were no significant differences in erythrocytes among the treatments. The cfu of E. coli was significantly lower in $Immunocin^(R)$ and antibiotics treatments than $Lactacid^(R)$ treatment and the control. Metabolizability of crude protein was significantly lower in the control than $Lactacid^(R)\;and\;Immunocin^(R)$ treatment while that of NFE was significantly lower in $Immunocin^(R)\;than\;Lactacid^(R)$ and antibiotics treatments. It was concluded that essential oil product $Immunocin^(R)$ is as effective as antibiotics in improving feed conversion efficiency and production index while $Lactacid^(R)$ is not.

Effect of Boxing Aerobic Dance on Body Composition, Blood Component and Vascular Compliance in Obese Middle Aged Women (복싱에어로빅 참여가 비만 중년여성의 신체조성, 혈액성분 및 혈관탄성에 미치는 영향)

  • Zhang, Seok-Am;Kim, Seung-Suk
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.9
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    • pp.4009-4017
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    • 2012
  • This study was conducted to test the effects of participation in 12-week program of boxing aerobics by obese middle-aged women on their body composition, blood constituents, and vascular compliance The samples are the middle-aged women in their forties or more, who has 30% or more body fat percentage, but has no medical history in cardiovascular disorders or metabolic diseases. The samples are divided into 8 of exercising group, and 8 of control group by random assignment. The intensity of boxing aerobics was HRmax 50% for the initial 4 weeks, HRmax 60% for the 5th to 8th week, and HRmax 70% for the 9th to 12th week. Each session took 60 minutes. The result is as follows. First, as a result of participating in the boxing aerobics program, body weight, body fat percentage, and muscle showed significant differences depending on the measuring period and the interacting term of the group and measuring period(p<.001), and the result of t-test on the sample matched to each group's measuring time also showed the significant increase or decrease in the exercising group(p<.001). Second, as a result of participating in the boxing aerobics program, the exercising group's TC, TG, HDL-C, and LDL-C, all showed significant differences in accordance with each group, measuring time, and the interaction term between groups and measuring time(p<.01, p<.001), and the result of t-test on each group's samples matched to the measuring time also shows significant increase or decrease in the exercising group(p<.01). Third, as a result of participating in the boxing aerobics programs, the vascular compliance of right hand, left hand, right hand, and left hand showed significant differences in accordance with each group, measuring time, and the interacting term between the measuring time and the group(p<.001), the t-test results of the samples matched to the each group's measuring time also showed significant differences in the exercising group(p<.001). To summarize the results above, it is suggested that the 12-week boxing aerobics program can improve body composition, blood constituents, and the blood circulation, which may prevent or enhance relevant diseases such as cardiovascular disorders.

Observation on The Frequency of Chromosomal Aberration and Changes in Number of Peripheral Lymphocytes in Radioactive Iodine Treatment (방사성옥소 투여에 따른 말초혈액 림프구 수의 변화 및 염색체이상 빈도의 관찰)

  • Koo, Chun-Hee;Shin, Min-Ho;Park, Young-Ju;Lee, Jung-Yim;Park, Tae-Yong;Lee, Jae-Yong;Kim, Chong-Soon;Han, Seung-Soo;Kim, Kwang-Hoe;Kim, Hee-Geun;Kang, Duck-Won;Song, Myung-Jae
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.3
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    • pp.343-349
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    • 1995
  • Background : For biological dosimetry of radiation exposure, both observing hematologic change and calculating Ydr by chromosomal analysis as biological indicators are widely used. However, due to the lack of studies on biological dosimetry of radiation dose absorbed in the body such as in the cases of radioactive iodine therapy, the maximal and safe dose is not well known, nor is the extent to which the body can safely endure radiation exposure. Purpose : To investegate the practical applicability of hematologic changes and Ydr as an indicator for estimating radiation exposure, to patients with thyroid diseases after doses of radioactive iodine. Material and Methods : 5 patients with hyperthyroidism and 35 patients who have had thyroid cancer operation were under treatment with radioactive iodine, changes in number of lymphocytes were tracked and Ydr was calculated for more than 2 months by chromosomal analysis in peripheral lymphocytes. Results ; 1) The number of lymphocytes began to decrease 2 weeks after doses of radioactive iodine, and reached the nadir after 6 and 8 weeks, then gradually recovered. 2) The nadir count of lymphocytes was reversely correlated with the administered dosage of radioactive iodine. 3) Ydr was generally stable between 2 and 8 weeks. 4) The maximal value of Ydr was correlated with the administered dosage of radioactive iodine. 5) Ydr value at the 2nd week increased with augmented dosage of radioactive iodine. 6) Ydr value at the 2nd week was correlated with fall of lymphocyte count. Conclusion : Patients must be closely observed, because temporary bone marrow suppression and slight chromosomal aberration can be produced by even generally used dosages of radioactive iodine for diagnosis and therapy. Maximal percent fall of lymphocyte count, Ydr at the 2 week interval and maximal Ydr can be used as the biological predictor of administered dosage of radioactive iodine.

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Effect of Feeding Prunus mume By-products on Productivity and Blood Composition in Semi-Broiler Chicks (매실 부산물 급여가 준육용계의 생산 능력과 혈액 성상에 미치는 영향)

  • Jeong, Y.D.;Cho, I.K.
    • Korean Journal of Poultry Science
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    • v.34 no.4
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    • pp.237-243
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    • 2007
  • The objective of this experiment was to investigate the feeding influence of Prunus memu by-products (PMB) on productivity, blood composition, meat quality and intestinal microflora in semi-broiler chicks. Four hundred one day old chicks(Hanhyup 3) were raised in the floor pen with five treatments(0, 0.5, 1.0 2.0 3.0%) of four replicate for ten weeks. Basal diets contained 3,000, 3,100, 3,100, 3,200 kcal/kg ME and 22, 21, 19, 17% CP, respectively. There were no different performance for the first two weeks, but showed significantly different weight gain, feed intake in PMB 2.0, 3.0% addition treatments compared with control from three to five weeks of age. Weight gain of birds fed 2.0% PMB was significantly higher from nine to 10 weeks of age than control(P<0.05). Total weight gain tended to increase in PMB 1.0, 2.0, 3.0% addition treatments. Feed intake also showed increase in PMB 2.0, 3.0% addition treatments, but there were no different feed conversion. Total protein, albumin, cholesterol, neutral fat, glucose was significantly decreased in PMB 0.5% addition treatments compared with control. There were no different physico-chemical characteristics in breast meat. The number of yeast was significantly improved in PMB 3.0% compared with control(P<0.05), but found no difference in number of E. coli between control and PMB treatments. ND titer of birds fed PMB was not statistically different, but tended to decrease as dietary PMB increased. As the result of this experiment, PMB would be available as a feed additives in semi-broiler chicks.

Comparative Evaluation of 25-OH-VitD and 25-OH-VitD3 by Radioimmunoassay (방사면역 측정법에 의한 25-OH-VitD와 25-OH-VitD3의 비교 평가)

  • Lee, Young-ji;Park, Ji-hye;Lim, Soo-yeon;Cheon, Jun-hong;Lee, Sun-ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.24 no.1
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    • pp.33-38
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    • 2020
  • Purpose Vitamin D is essential for maintaining bone health, controling cell proliferation or differentiation, strengthening immune function by controlling calcium metabolism in the body. Vitamin D deficiency can lead to increase the risk of rickets, osteoporosis, cardiovascular disease, diabetes and cancer. Especially, South Korea is one of the highest population proportion of vitamin D deficiency. Accurate determination of levels of 25-OH-VitD or 25-OH-VitD3 in blood serum is required for the diagnosis and treatment of vitamin D deficiency. In this study, radioimmunoassay of 25-OH-VitD and 25-OH-VitD3 was performed and compared to evaluate the effectiveness of Vitamin D radioimmunoassay. Materials and Methods Serum 25-OH-VitD and 25-OH-VitD3 levels were measured using radioimmunoassay. The interrelationship, reproducibility and population distribution rate were evaluated. In addition, the internal quality control was performed at Asan Medical Center from April 2017 to June 2019 and the result of external quality control (Interagency proficiency evaluation) of first and second half of 2018 hosted by the Korean Society of Nuclear Medicine Technology (KSNMT). Both tests were measured by same manufacturer's reagent. Results 25-OH-VitD showed a strong positive correlation on 97 samples, as 25-OH-VitD3 x 0.9 + 0.3 (R>0.9). In repeated measurement, the average Diff(%) value of the reproducibility evaluation of 25-OH-VitD and 25-OH-VitD3 were 7.7% and 7.4%, respectively. Population distribution results showed no statistically significant differences(p>0.05). The resultant value of internal quality control, which measured from April, 2017 to June 2019 in Blood test room of Nuclear Medicine at Asan Medical Center, showed average (CV%) 6.2% and 6.8%, respectively. As a result of the external quality control (interagency proficiency evaluation) Z value obtained under 2.0, as shown below; Conclusion The interrelationship, reproducibility, population distribution rate, internal quality control and external quality control between 25-OH-VitD and 25-OH-VitD3 radioimmunoassay shows superior outcome. Radioimmunoassay, which can be alone measured in the blood as 25-OH-VitD or 25-OH-VitD3, is considered suitable screening tests for the diagnosis of vitamin D deficiency.

Effects of Adjuvant Radiation Therapy and Chemotherapy Following Curative Surgery in Locally Advanced Rectal Cancer (국소 진행된 직장암에서 근치적 절제술 후 방사선치료와 항암화학요법과의 병용치료에 대한 효과)

  • Kang, Ki-Mun;Choi, Ihl-Bohng;Kim, In-Ah;Jang, Jee-Young;Shin, Kyung-Sub;Jang, Suck-Kyun;Lee, Jae-Hak;Kim, Young-Ha;Won, Chong-Man;Choi, Dong-Hwan;Kim, Jin-Seung;Park, Shinn-Hee
    • Radiation Oncology Journal
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    • v.15 no.2
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    • pp.121-128
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    • 1997
  • Purpose : To evaluate the effect of postoperative adjuvant radiation therapy and chemotherapy on the survival, pattern of failure and complication for locally advanced rectal carcinoma Materials and Methods : From October 1992 to September 1995, twenty eight patients with rectal carcinoma were treated by postoperative adjuvant radiation therapy and chemotherapy Radiation therapy was delivered with 6MV and 15MV linear accelerator, 180c0y fractions 5 day per week. Total radiation doses were 5040cGy in $B_{2+3}$ and 5580cGy in $C_{2+3}$. Within 4 weeks after radical surgery. 5-FU$(400mg/m^2/day)\;and\;Leucovorin(20mg/m^2/day)$ were administered by intravenous injection for 4 days during the first and fifth week of radiation therapy. The median follow up was 19 months with a range 2 to 47 months. Results : The 2 year overall survival and disease free survival rates were $78.6\%\;and\;70.8\%$, respectively. The 2 year overall survival was $93.0\%\;in\;B_{2+3}$ and $76.2\%\;in\;C_{2+3}$(p=0.11) The 2 year disease free survival was $79.4\%\;in\;B_{2+3}\;and\;69.2\%\;in\;C_{2+3}(p=0.13)$. The overall failure rate was $21.42\%$(6/28) including $10.72\%$(3/28) locoregional recurrence, $3.62\%$(1/28) distant metastasis and $7.12\%$(2/28) locoregional recurrence with distant metastasis. The overall locoregional recurrence rate was $17.92\%$(5/28). The 2 year locoregional recurrence rates were $13.32\%(2/15)\;and\;23.12\%$(3/13) for respectively for $B_{2+3}\;and\;C_{2+3}$ The difference between the locoregional recurrence of $B_{2+3}\;and\;C_{2+3}$ patients was not significant(p=0.07). Complications developed in 13 patients$(46.42\%)$, including 8 dermatitis, 7 loose stool, 6 leukopenia, 4 tenesmus, 2 diarrhea. In Univariate analysis, there was no statistically significant factor except for tumor grade in locoregional recurrence, disease free survival and overall survival rate(p=0.04, 0.05, 0.04). Conclusion : This study sugges1s that postoperative adjuvant radiation therapy and chemotherapy is effective in patients with locally advanced rectal cancer. Therefore these results need to be confirmed with a long term follow-up and larger number of patients with the further clinical trials including prospective controlled studies.

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A Phase I/II Trial of $DCVac/IR^{(R)}$ Dendritic Cell Immunotherapy Combined with Irradiation in Cases of Refractory Colorectal Cancer with Multiple Liver Metastases (기존의 치료에 반응하지 않는 다발성 간전이 대장암 환자에서 방사선조사와 병합한 수지상세포 면역치료의 1, 2상 임상시험)

  • Choi, Young-Min;Lee, Hyung-Sik;Kwon, Hyuk-Chan;Han, Sang-Young;Choi, Jong-Cheol;Chung, Ju-Seop;Kim, Chang-Won;Kim, Dong-Won;Kang, Chi-Duk
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.104-112
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    • 2008
  • Purpose: To assess the toxicity and tumor response induced by $DCVac/IR^{(R)}$ dendritic cell(DC) immunotherapy combined with irradiation for refractory colorectal cancer patients with multiple liver metastases. Materials and Methods: Between May 2004 and November 2006, applicants from a pool of refractory colorectal cancer patients with multiple liver metastases were enrolled. The patients were registered after having signed the informed consent form, which had been approved by the Institutional Review Board from the Dong-A University and Busan National University Hospital. DCs were obtained from peripheral blood of each patient, and then cultured in vitro. A total of $6{\times}10^6$ DCs were packed into a vial($DCVac/IR^{(R)}$, 0.5 ml) at the convenience of each patient's schedule. On the day before and on the day of each vaccination, each patient received a 4 Gy radiation dose to the target tumor. On the day of vaccination, the indicated dose of autologous DCs was injected into the irradiated tumor using ultrasound-guided needle injection procedures. A total of four vaccinations were scheduled at three 2-week intervals and one 4 week interval at the Dong-A University and Busan National University Hospital. If the tumor status was deemed to be stable or responding to therapy, an additional vaccination dose or two was approved at 4 week intervals beyond the fourth immunization. A tolerance test for DCs was conducted by injecting a range of doses($3{\times}10^6\;to\;12{\times}10^6$ DCs) after the 3rd injection. Moreover, the maximal tolerable dose was applied to additional patients. Treatment safety was evaluated in all patients who had at least one injection. Treatment feasibility was evaluated by the 10th week by assessing the response of patients having at least 4 injections. For systemic toxicities, the evaluation was performed using the National Cancer Institute Common Toxicity Criteria, whereas adverse effects were recorded using common WHO toxicity criteria. Results: Of the 24 registered patients, 22 received the DCs injections. Moreover, of the 14 patients that applied for the tolerance test, only 11 patients completed it because 3 patients withdrew their testing agreement. A grade 3 or more side effect, which was possibly related to the DC injection, did not occur in additional patients. The $12{\times}10^6$ DC injection was identified as the maximum tolerable dose, and was then injected in an additional 8 patients. Patients tolerated the injection fairly well, with no fatal side effects. In order to assess the feasibility of DC immunotherapy, the response was evaluated in other hepatic lesions outside of the targeted hepatic lesion. The response evaluation was performed in 15 of the 17 patients who received at least 4 injections. Stable and progressive disease was found in 4 and 11 patients, respectively. Conclusion: The DC-based immunotherapy and radiotherapy is theoretically synergistic for the local control and systemic control. The $DCVac/IR^{(R)}$ immunotherapy combined with irradiation was tolerable and safe in the evaluated cases of refractory colorectal cancer with multiple liver metastases. Future work should include well designed a phase II clinical trials.