• The Korean Journal of Pain
• /
• 제4권2호
• /
• pp.111-121
• /
• 1991

It has been well known that the splanchnic nerve block is effective for patients who suffer from intractable upper abdominal pain. However, it is unclear whether the effect of the splanchnic nerve block depends on varied alcoholic concentration. In this study, an attempt was made to use absolute ethanol on patients who recieved a splanchnic nerve block at Severance Hospital during the period from September l990 to April l991. The results are as follows; 1) Among the 33 patients, including 22 males and 1l females, the fifties and sixties were the major age groups. 2) Stomach cancer was the most common underlying disease(13 cases), with pancreatic can- cer next(9 cases). 3) The main locations of pain were the upper abdomen, epigastrium, and entire abdomen in decreasing order. 4) There were 17 cases who had had chemotherapy, and 1l cases of whom had had surgery before the splanchnic nerve block. 5) The volume of alcohol used was 12 ml bilaterally. 6) Among the 33 patients, 15.2% required a second block within two weeks of the first block. One case required a third block. 7) The most common complications of splanchnic nerve block were hypotension(33.3%), occasional transient sharp burning pain, flushing of face, pain on injection site, nausea, vomiting, dyspnea, chest discomfort and diarrhea. 8) The supplemental block most commonly used was a continuous epidural block. It was used both as a diagnostic block and to afford relief from pain before the splanchnic nerve block was done. 9) The interval between the receiving the absolute ethanol block and discharge was within 2 weeks in l5 cases. But, in the patients with poor general health, the interval between the splanchnic nerve block and discharge prolonged. The above results suggest that bilateral splanchnic nerve block done with absolute ethanol after an effective test block with 1% lidocaine under C-arm fluroscopic control is satisfactory and reliable. Still, 26.6% of the patients received a repeat block within 2 weeks. Insufficient spread of ethanol due to its small volume seems to be a major factor in the repeat block. Minimizing the incidence of repeat block remains a problem to be solved.

• Journal of Chest Surgery
• /
• 제29권4호
• /
• pp.397-402
• /
• 1996

전북대 학교병 원 흉부외과에서는 1979년 1월부터 1992년 12월까지 폐결핵으로 폐절제술을 실시한 44 명중 자료가 충실하였던 36명을 연구대상으로 하였다. 연령분포는 20, 30대가 55 %를 차지하여 가장 많 았고, 남녀비는 3.5 : 1이 었다. 증상은 흥통과 객혈 또는 혈액 이 약간 섞인 객담이 27예 (74.9 %)로 가장 많 았다. 병 력기간은 1년 미만이 12예 (33.3 %), 1~5년이 17예 (47.2 %), 5~10년이 4예 (11.1 %), 10년이상이 3예 (8.3 %)이 었다. 술전 객담도말검사상 균음성예는 77.8 %였고 화학요법에도 불구하고 균양성 예는 8 %이었다. 수술 적응은 공동을 동반한 폐구역 및 폐엽의 심한 파괴가 58.3 %로 가장 많았으며, 결핵병소는 우상 엽이 27.8 %로 가장 많았다. 술식은 폐 엽 절제가 50 %였고, 폐구역 절제가 27.8%, 전폐 절제가 16.7 %이 었다. 폐기능 검사는술식에 관계없이 술전에 비해 술후에 모두 향상되었으나 통계학적 유의 수준에는 미치지 못하였다. 술후 주요 합병증으로는 기관지늑막루가 동반된 농흥이 2예 (5.5 %), 사강이 4예 (11.1 %), 결핵균의 확산이 2예 (5.5 %)이 었다. 1예 에서 좌상엽 절제후 합병한 약제과민성으로 인한 궤양\ulcorner 대장염으로 인공항 문성형술을 시행후 2일째 호흡부전으로 사망하여 술후 사망율은 2.7 %이었다.

• 한국식품영양학회:학술대회논문집
• /
• 한국식품영양학회 2000년도 춘계학술심포지엄
• /
• pp.1-3
• /
• 2000

A kind of traditional herbal prescription, Sip-Jeon-Dae-Bo-Tang (TJ-48), has been reported to improve the general condition of cancer patients receiving chemotherapy and /or radiation therapy, and to accelerate hematopoietic recovery from bone marrow injury by mitomycin C. In the present studies, we found that hot-water extract from Atractylodes lancea DC. rhizomes contributed mainly to intestinal immune modulating activity of TJ-48 on Peyer's patch cells mediated-hematopoietic response. After the fractionation, ALR-5 II a-1-1, 5 II b-2-2 and 5 II c-3-1 were further purified from crude polysaccharide fraction. Chemical analyses of each fraction indicated that ALR-5 II a-1-1 mainly contained arabinogalactan fraction whereas ALR-5 II b-2-2 and 5 II c-3-1 mostly comprised pectic polysaccharide fractions as the active polysaccharide ingredients. In order to analyze the essential structure of the activity, ALR-5 II a-1-1 was treated by sequential enzymatic digestion using exo-${\alpha}$-L-arabinofuranosidase and exo-${\beta}$-D-(1\longrightarrow3)-galactanase. Based upon the results of chemical and MALDI-TOF-MS analyses and activity on the digested fractions, the galactosyl side chains consisting of 6-linked Galf and Galp over tetrasaccharide in ALR-5 II a-1-1 might be responsible for the potent intestinal immune modulating activity. To characterize moiety of ALR-5 II c-3-1 for the expression of activity, endo-${\alpha}$-D-(1\longrightarrow4)-polygal acturonase (GL-PGase) purified from dried leaves of Panax ginseng digested ALR-5 II c-3-1. The results of structural analyses and activity on the digested fractions showed that PG-2, which structurally resembles to rhamnogalacturonan II (RG II), and PG-3 (galacturono-oligosaccharides) contained potent intestinal immune modulating activity. Further purification of the other acidic fraction (ALR-5 II b-2-2) indicated that ALR-5 II b-2-2Bb showed that the most potent activity. ALR-5 II b-2-2Bb also contained the unusual component sugars characteristics in RG- II as well as PG-2 derived from ALR-5 II c-3-1, but it could not be digested with GL-PGase. The present studies of relationship between structures and intestinal immune modulating activity of the active polysaccharides purified from A. lancea DC. rhizomes suggested that neutral galactosyl chains consisting mainly of (1\longrightarrow6)-linked Galf and Galp, and RG- II -like moiety with unique component sugars, such as 2-Me-Xyl, 2-Me-Fuc, Api, AceA, Kdo and Dha should play an important role in the potent intestinal immune modulating action of A. lancea DC. rhizomes.

• 대한한방종양학회지
• /
• 제3권1호
• /
• pp.29-48
• /
• 1997

Astragalus membranaceus Bunge (黃?), Atractylodes macrocephala Loidz (白朮), Angelica sinensis(Oliv) Kiels (當歸), Lycium chinense Mill (枸杞子), Ligustrum lucidum Ail (女貞子) are Herbs that are frequently used in a lot of prescriptions to reduce the side effects of anti-cancer therapies, especially like chemotherapy and radiotherapy. The radioprotective and hemopoietic effects of these Herbs on BALB/c splenocytes and bone marrow cells are measured. In order to evaluate the Hemopoietic effects, Thymidine uptakes and secretion of colony stimulating factors(CSFs) of splenocytes and myelocytes treated with herbs were measured. Radioprotective effects were accessed by the method of immunocompetence of murine lymphocytes cultured with herbs before irradiation and with LPS, ConA after irradiation. The results are as follows. 1. The orders of Proliferative effects of herbs on splenocytes were Atractylodes macrocephala Loidz (白朮), the higest of all, Astragalus membranaceus Bunge (黃?), Angelica sinensis(Oliv) Kiels (當歸). Lycium chinense Mill (枸杞子) and Ligustrum lucidum Ait (女貞子), the lowest of all. At Optimal concentration, the proliferation ratios of herb-treated splenocytes compared to non-treated ones were like these. Atractylodes macrocephala Loidz (白朮) 44.3, Astragalus membranaceus Bunge (黃?) 17.7, Angelica sinensis(Oliv) Kiels (當歸) 10, Lycium chinense Mill (枸杞子) 6.4, Ligustrum lucidum Ait (女貞子) 2.0.(p<0.05) 2. When splenocytes were cultured during different periods, Atractylodes. macrocephala Loidz (白朮) and Astragalus membranaceus Bunge (黃?) showed the higest proliferation on 3th day, Angelica sinensis(Oliv) Kiels (當歸), Lycium chinense Mill (枸杞子) on 4th day,(p<0.05) and Ligustrum lucidum Ait (女貞子) until 5th day but with no significant increase. 3. The orders of Proliferative effects of herbs on Bone Marrow(BM) cells were Atractylodes macrocephala Loidz (白朮), the higest of all, Astragalus memhranaceus Bunge (黃?), Angelica sinensis(Oliv) Kiels (當歸), Lycium chinense Mill (枸杞子) and Ligustrum lucidum Ait (女貞子), the lowest of all too. At Optimal concentration, the proliferation ratios of herb-treated BM cells compared to non-treated ones were like these. Atractylodes macrocephala Loidz (白朮) 21.7, Astragalus membranaceus Bunge (黃?) 9.9, Angelica sinensis(Oliv) Kiels (當歸) 4.9, Lycium chinense Mill (枸杞子) 2.3, Ligustrum lucidum Ait (女貞子) 1.4(p<0.05). 4. The secretion ratio of colony stimulating factors(CSFs) of each herb-treated group, compared to control, was Atractylodes macrocephala Loidz (白朮) 9.4, Astragalus membranaceus Bunge (黃?) 9.0, Angelica sinensis(Oliv) Kiels (當歸) 4.4, Lycium chinense Mill (枸杞子) 3.8 (p<0.05) but no significant increase in Ligustrum lucidum Ait (女貞子). 5. The mitogen(ConA, LPS) stimulated-lymphocytes cultured with each herb before irradiation of 1-3 Gy showed more enhanced proliferation than control(p<0.05). When compared to each non-irradiated group of all groups, the orders of percentage increase of irradiated group were Atractylodes macrocephala Loidz (白朮), the higest of all, Astragalus membranaceus Bunge (黃?), Angelica sinensis(Oliv) Kiels (當歸), Ligustrum lucidum Ait (女貞子), Lycium chinense Mill (枸杞子). Each percentage showed significant enhancement compared to control group(p<0.05). According to the results, Atractylcdes macrocephala Loidz (白朮), Astragalus membranaceus Bunge (黃?) are suggested to be the most effective hemopoietic and radioprotective herbs, and Angelica sinensis(Oliv) Kiels (當歸), Lycium chinense Mill (枸杞子) the next, but Ligustrum lucidum Ait (女貞子) showed lower effects than expected.

• Journal of Yeungnam Medical Science
• /
• 제9권2호
• /
• pp.312-320
• /
• 1992

1986년 4월부터 1992년 3월까지 6년간 영남대학교 의과대학 부속병원 치료방사선과에 내원하여 근치적인 방사선치료를 시행한 후 6개월 이상 추적조사가 가능하였던 31명의 치료성적은 다음과 같다. 대상환자 31명중 남자가 22명으로 여자보다 2.4배 많았으며 30세미만 3명을 제외하면 30대에서 60대까지 고른분포를 보였다. 병리조직학적 분류상 편평세포암이 13명, 미분화세포암이 18명이었다. 임상적병기는 I기 1명, II기 2명, III기 6명, IV기 22명이었다. 31명중 방사선치료만 시행된 경우가 11명, 항암제등과 병합치료를 시행한 경우가 20명이었다. 편평세포암 환자 11명중 6명에서 방사선치료만을 시행하였고 5명에서 병합치료를 시행하였으나, 미분화세포암에서는 18명중 5명은 방사선치료만을 시행하였고 13명은 병합치료를 실시하였다. 치료에 대항 반응은 치료방법에 따른 차이가 없었으나, 방사선치료만 시행한 경우에 편평세포암 6명중 3명이 완전관해를 보인 반면에, 미분화세포암 5명 모두 완전관해를 보여 큰 차이를 보였으나 병합치료에서는 세포형태에 따른 차이가 소실되었다. 치료 후 1년 생존율은 치료방법에 따른 차이가 없었다. 완전관해를 보인 환자 22명중에서 방사선치료만 시행한 8명중 6명에서 재발을 보였으며 그중 3명은 원격전이를 동반하였으나, 병합치료를 시행한 14명중에서 3명만이 재발을 보였으며 그중2명은 원격전이를 보였다. 이상의 결과에서 치료방법에 따른 관해율은 비슷하였으나 치료 후 추적과정에서 발생하는 재발은 방사선치료만 시행한 경우보다 병합치료를 실시한 경우에 현저히 줄어듬을 보여주어 비인강암에 대한병합치료가 국소재발의 감소 및 원격전이의 감소를 통하여 생존율의 향상에도 기여하리라 사료된다.

• Nutrition Research and Practice
• /
• 제9권2호
• /
• pp.129-136
• /
• 2015

BACKGROUND/OBJECTIVES: A variety of immunomodulators can improve the efficacy of low-dose chemotherapeutics. Active hexose correlated compound (AHCC), a mushroom mycelia extract, has been shown to be a strong immunomodulator. Whether AHCC could enhance the antitumor effect of low-dose 5-fluorouracil (5-FU) via regulation of host immunity is unknown. MATERIALS/METHODS: In the current study Hepatoma 22 (H22) tumor-bearing mice were treated with PBS, 5-FU ($10mg{\cdot}kg^{-1}{\cdot}d^{-1}$, i.p), or AHCC ($360mg{\cdot}kg^{-1}{\cdot}d^{-1}$, i.g) plus 5-FU, respectively, for 5 d. $CD^{3+}$, $CD^{4+}$, $CD^{8+}$, and NK in peripheral blood were detected by flow cytometry. ALT, AST, BUN, and Cr levels were measured by biochemical assay. IL-2 and $TNF{\alpha}$ in serum were measured using the RIA kit and apoptosis of tumor was detected by TUNEL staining. Bax, Bcl-2, and TS protein levels were measured by immunohistochemical staining and mRNA level was evaluated by RT-PCR. RESULTS: Diet consumption and body weight showed that AHCC had no apparent toxicity. AHCC could reverse liver injury and myelosuppression induced by 5-FU (P < 0.05). Compared to mice treated with 5-FU, mice treated with AHCC plus 5-FU had higher thymus index, percentages of $CD^{3+}$, $CD^{4+}$, and NK cells (P < 0.01), and ratio of $CD^{4+}$/$CD^{8+}$ (P < 0.01) in peripheral blood. Radioimmunoassay showed that mice treated with AHCC plus 5-FU had the highest serum levels of IL-2 and $TNF{\alpha}$ compared with the vehicle group and 5-FU group. More importantly, the combination of AHCC and 5-FU produced a more potent antitumor effect (P < 0.05) and caused more severe apoptosis in tumor tissue (P < 0.05) compared with the 5-FU group. In addition, the combination of AHCC and 5-FU further up-regulated the expression of Bcl-2 associated X protein (Bax) (P < 0.01), while it down-regulated the expression of B cell lymphoma 2 (Bcl-2) (P < 0.01). CONCLUSIONS: These results support the claim that AHCC might be beneficial for cancer patients receiving chemotherapy.

• Journal of Microbiology and Biotechnology
• /
• 제20권2호
• /
• pp.438-445
• /
• 2010

The immunomodulatory effects of Aureohasidium pullulans SM-2001 exopolymers containing $\beta$-1,3/1,6-glucan were evaluated in cyclophosphamide (CPA)-treated mice. To induce immunosuppression, 150 and 110 mg/kg of CPA were intraperitoneally injected 3 days and 1 day, respectively, before beginning administration of the test material. Exopolymers were delivered subcutaneously or orally, four times, in a volume of 10 ml/kg at 12-h intervals beginning 24 h after the second CPA treatment. Changes in thymus and spleen weights, splenic amounts of tumor necrosis factor (TNF)-$\alpha$, interleukin (IL)-$1{\beta}$, and IL-10, and numbers of CD3+, CD4+, CD8+, and TNF-$\alpha+$ thymus and spleen cells were monitored in CPA-treated mice. As a result of CPA treatment, dramatic decreases in the number of CD3+, CD4+, CD8+, and TNF-$\alpha+$ cells were detected in the thymus and spleen, along with decreases in thymus and spleen weights. In addition, splenic TNF-$\alpha$, IL-$1{\beta}$, and IL-10 contents were also decreased on observation with flow cytometry. However, oral and subcutaneous treatments with exopolymers effectively reduced the immunosuppressive changes induced by CPA. Therefore, it is concluded that exopolymers of A. pullulans SM-2001 can effectively prevent immunosuppression through, at least partially, the recruitment of T cells and TNF-$\alpha+$ cells or enhancement of their activity, and can provide an effective component of prevention or treatment regimens for immunosuppression related to cancer, sepsis, and high-dose chemotherapy or radiotherapy.

• 대한한방내과학회지
• /
• 제37권3호
• /
• pp.539-547
• /
• 2016

본 증례에서는 한방치료를 받은 두 명의 골수이형성증후군 환자를 통하여 골수이형성증후군에 대한 한방치료의 효과를 보여주고자 하였다. 골수이형성증후군은 골수의 증식과 구성 세포들의 이형성, 비효율적인 조혈을 특징으로 하는 골수의 악성 종양이다. 현재까지 골수이형성증후군에 대한 완벽한 치료법은 없으며 골수이형성증후군의 증상을 경감시키거나 급성 골수성 백혈병으로의 진행을 막는 목적으로 치료가 이뤄지고 있다. 첫 번째 환자는 1차성 골수이형성증후군 환자로 2011년 1월부터 2016년 현재까지 꾸준히 침 치료 및 한약치료를 받고 있다. 두 번째 환자는 난소암 치료를 위한 항암화학요법의 부작용으로 생긴 2차성 골수이형성증후군 환자로 2010년 10월부터 4년간 꾸준한 한약 복용 및 3번의 입원치료를 받은 환자이다. 침 치료, 한약 치료와 함께 환자들의 상태를 평가하기 위해 정기적인 혈액검사가 이루어졌다. 골수이형성증후군 진단 후 두 달에 한 번씩 수혈을 받으며 수혈 의존 경향을 보이던 첫 번째 환자는 한방치료 후 단 두 번의 수혈밖에 받지 않았고 급성골수성백혈병으로 진행하지도 않았으며 건강한 몸 상태를 유지하고 있다. 두 번째 환자 역시 꾸준한 한방치료를 통해 비교적 좋은 삶의 질을 유지하며 기본 체력 또한 많이 상승되면서 골수 이식을 받을 정도까지 몸 상태가 개선되었다. 본 증례보고는 마땅한 치료법이 없는 골수이형성증후군 환자들에게 한방 치료가 특별한 부작용 없이 환자들이 호소하는 증상을 개선하고 기본적인 체력 증진에 도움이 되며 급성 골수성 백혈병으로의 진행을 예방하는 동시에 기존의 보존적 치료법의 효과를 극대화 시키는 효과가 있음을 보여주는 증례라고 하겠다.

• Radiation Oncology Journal
• /
• 제29권4호
• /
• pp.243-251
• /
• 2011

Purpose: To evaluate the prognostic value of metabolic tumor volume (MTV) and maximum standardized uptake value (SUVmax) on initial positron emission tomography-computed tomography (PET-CT) and investigate the clinical value of SUVmax for early detection of locoregional recurrent disease after postoperative radiotherapy in patients with locally advanced head and neck squamous cell carcinoma (HNSCC). Materials and Methods: A total of 100 patients with locally advanced HNSCC received primary tumor excision and neck dissection followed by adjuvant radiotherapy with or without chemotherapy. The MTV and SUVmax were measured from primary sites and neck nodes. The prognostic value of MTV and SUVmax were assessed using initial staging PET/CT (study A). Follow-up PET/CT scan available after postoperative concurrent chemoradiotherapy or radiotherapy were evaluated for the SUVmax value and correlated with locoregional recurrence (study B). A receiver operating characteristic (ROC) curve analysis was used to define a threshold value of SUVmax with the highest accuracy for recurrent disease assessment. Results: High MTV (>41 mL) is negative prognostic factor for disease free survival (p = 0.041). Postradiation SUVmax was significantly correlated with locoregional recurrence (hazard ratio, 1.812; 95% confidence interval, 1.361 to 2.413; P < 0.001). A cutoff value of 5.38 from follow-up PET/CT was identified as having maximal accuracy for detecting locoregional recurrence by ROC analysis. Conclusion: MTV at staging work-up was significantly associated with disease free survival. The SUVmax value from follow-up PET/CT showed high diagnostic accuracy for the detection of locoregional recurrence in postoperatively irradiated HNSCC.

• Journal of Yeungnam Medical Science
• /
• 제28권1호
• /
• pp.31-44
• /
• 2011

Background: The optimal timing of treatment with EGFR-tyrosine kinase inhibitors (EGFR-TKI) in NSCLC patients has not yet been determined. Methods: We separated 228 patients with advanced /metastatic NSCLC treated with gefitinib into an early gefitinib group (patients who received gefitinib as first- or second-line treatment) and a delayed gefitinib group (patients who received gefitinib as third or fourth-line treatment) and attempted to determine whether the timing of gefitinib treatment affected clinical outcomes. Results: Median overall survival (OS), progression free survival (PFS), and median OS from first-line treatment of advanced/metastatic disease (OSt) for 111 patients in the early gefitinib group were 6.2 months, 3.3 months, and 11.6 months. However, median OS, PFS, and OSt for 84 patients in the delayed gefitinib group were 7.8 months, 2.3 months, and 22.7 months. No differences in OS and PFS were observed between the 2 groups. However, OSt was significantly longer in the delayed gefitnib group. Timing of gefitinib therapy was one of the independent predictors of OSt. Hb ${\geq}$ 10 g/dl, and having never smoked, and ECOG performance status ${\leq}1$ were independent predictors of better PFS. Conclusion：Deferral of gefitinib therapy in patientswith advanced ormetastatic NSCLC may be preferable if they are able to tolerate chemotherapy.