• Title/Summary/Keyword: Cancer surgery

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A Clinical Evaluation of Splanchnic Nerve Block with Absolute Ethanol (무수 알코올에 의한 내장신경차단에 관한 임상적 연구)

  • Lee, Hyo-Keun;Yoon, Duck-Mi;Oh, Hung-Kun
    • The Korean Journal of Pain
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    • v.4 no.2
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    • pp.111-121
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    • 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.

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Effect of Jaeumkanghwatang (JEKHT), a Polyherbal Formula on the Pharmacokinetics Profiles of Tamoxifen in Male SD Rats (2) - Oral Combination Treatment of Tamoxifen 50 mg/kg with JEKHT 100 mg/kg on JEKHT 6-day Repeated Pretreated Rats with 8-day Repeated Co-administration -

  • Park, Soo Jin;Kwak, Min A;Park, Sung Hwan;Lee, Young Joon;Ku, Sae Kwang
    • Journal of Society of Preventive Korean Medicine
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    • v.20 no.2
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    • pp.97-109
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    • 2016
  • Objectives : The effects of Jaeumkanghwatang (JEKHT) co-administration on the pharmacokinetics of tamoxifen were observed after oral combination treatment of tamoxifen 50 mg/kg with JEKHT 100 mg/kg on JEKHT 6-day repeated oral pretreated rats with 8-day repeated co-administration to confirm the effects of JEKHT co-administration on the pharmacokinetics of tamoxifen. Methods : Six days after pretreatment of JEKHT 100 mg/kg, tamoxifen 50 mg/kg was co-administered with JEKHT 100 mg/kg, once a day for 8 days within 5 min. The blood were collected at 30 min before administration, 30 min, 1, 2, 3, 4, 6, 8 and 24 hrs after end of first and last 8th tamoxifen treatment, and plasma concentrations of tamoxifen were analyzed using LC-MS/MS methods. PK parameters of tamoxifen ($T_{max}$, $C_{max}$, AUC, $t_{1/2}$ and $MRT_{inf}$) were analysis as compared with tamoxifen single administered. Results : Six-day repeated oral pretreatment of JEKHT and 8-day repeated oral co-administration of tamoxifen within 5 min did not influenced on the plasma concentrations and pharmacokinetic parameters of tamoxifen, oral bioavailability, as compared with tamoxifen single treated rats, except for some negligible effects. Conclusions : It is concluded that JEKHT did not influenced on the plasma concentrations and pharmacokinetic parameters, the oral bioavailability of tamoxifen. Therefore, it is considered that co-administration of JEKHT and tamoxifen will be provide an effective novel treatment regimen on the comprehensive and integrative medicine for breast cancer patients, if they showed favorable synergic effects on the pharmacodynamics or reduce the tamoxifen treatment related toxicity and side effects in future studies.

Overexpression of EFGR as Prognostic Factor and Effect of EGF in the Progression of Hypopharyngeal Cancer (하인두암에서 예후인자로서의 표피성장인자수용체(EGFR) 과발현과 하인두암의 진행에 있어 표피성장인자(EGF)의 역할 분석)

  • Lim, Young Chang;Choi, Eun Chang;Kim, Yoon Tae;Kim, Jang Hee;Hwang, Hye Sook;Kang, Sung Un;Chang, Jae Won;Shin, Yoo Seob;Kim, Chul-Ho
    • Korean Journal of Head & Neck Oncology
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    • v.29 no.1
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    • pp.1-10
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    • 2013
  • 연구배경 및 목적 표피성장인자수용체(EGFR)는 HER2/neu(erbB2), HER3(erbB3), HER4(erbB4)를 포함하는 receptor tyrosine ki-nase의 erbB 그룹에 속하는 수용체이다. 표피성장인자수용체의 과발현은 다양한 종류의 암, 특히 두경부편평세포암에서 예후를 악화시킨다고 알려져 있다. 이에 저자들은 하인두편평세포암에서 표피성장인자수용체의 발현 및 분포를 확인하고, 하인두암에서 표피성장인자(EGF)가 암세포의 증식과 침습에 미치는 영향에 대해 알아보고자 하였다. 대상 및 방법 57명의 하인두편평세포암 환자의 조직에서 표피성장인자수용체의 발현을 면역화학적염색을 통해 확인하고, 이에 대해 임상병리학적 요인과 생존율에 대한 분석을 시행하고, 일부 환자의 정상 및 암조직에서 Western blot을 시행하였다. 하인두편평세포암 세포주인 FaDu에서 proliferative assay, colony dispersion, wound healing assay, invasion assay를 시행하여, 하인두암의 진행에서 표피성장인자의 역할에 대하여 분석하였다. 또한 RT-PCR과 Zymography를 통하여 Matrix metalloproteinase(MMP)-2, 9의 발현을 확인하였다. 결 과 63.2%의 하인두편평세포암 조직에서 표피성장인자수용체의 발현이 확인되었다. 표피성장인자수용체의 발현은 정상조직에서 비하여 하인두암 조직에서 유의하게 증가되어 있었으며, 병리학적 병기(p=0.022)가 올라갈수록 유의하게 증가하였으나, 증례수의 제한으로 생존율에서는 통계적 유의성을 얻지는 못했다(p=0.053). in vitro의 결과로 표피성장인자를 FaDu 세포주에 처리하였을 때, FaDu 세포주의 증식이 유의하게 증가되었으며(p<0.05), Transwell invasion chamber상 침습의 증가가 확인되었다(p<0.05). RT-PCR과 zymogram 실험상 표피성장인자처리시 FaDu 세포주의 MMP-2, 9이 발현이 증가되고 활성화되는 것이 확인하였다. 결 론 본 연구에서 표피성장인자수용체의 과발현이 하인두암의 예후 인자로서의 가능성을 확인하였고, 표피성장인자가 하인두편평세포암의 증식과 침습에 관여하는 것을 확인하였다.

Association between interstitial cells of Cajal and anti-vinculin antibody in human stomach

  • Kim, Ji Hyun;Nam, Seung-Joo;Park, Sung Chul;Lee, Sang Hoon;Kim, Tae Suk;Lee, Minjong;Park, Jin Myung;Choi, Dae Hee;Kang, Chang Don;Lee, Sung Joon;Ryu, Young Joon;Lee, Kyungyul;Park, So Young
    • The Korean Journal of Physiology and Pharmacology
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    • v.24 no.2
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    • pp.185-191
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    • 2020
  • Interstitial cells of Cajal (ICC) are known as the pacemaker cells of gastrointestinal tract, and it has been reported that acute gastroenteritis induces intestinal dysmotility through antibody to vinculin, a cytoskeletal protein in gut, resulting in small intestinal bacterial overgrowth, so that anti-vinculin antibody can be used as a biomarker for irritable bowel syndrome. This study aimed to determine correlation between serum anti-vinculin antibody and ICC density in human stomach. Gastric specimens from 45 patients with gastric cancer who received gastric surgery at Kangwon National University Hospital from 2013 to 2017 were used. ICC in inner circular muscle, and myenteric plexus were counted. Corresponding patient's blood samples were used to determine the amount of anti-vinculin antibody by enzyme-linked immunosorbent assay. Analysis was done to determine correlation between anti-vinculin antibody and ICC numbers. Patients with elevated anti-vinculin antibody titer (above median value) had significantly lower number of ICC in inner circular muscle (71.0 vs. 240.5, p = 0.047), and myenteric plexus (12.0 vs. 68.5, p < 0.01) compared to patients with lower anti-vinculin antibody titer. Level of serum anti-vinculin antibody correlated significantly with density of ICC in myenteric plexus (r = -0.379, p = 0.01; Spearman correlation). Increased level of circulating anti-vinculin antibody was significantly correlated with decreased density of ICC in myenteric plexus of human stomach.

Immunomodulatory Effects of Aureobasidium pullulans SM-2001 Exopolymers on Cyclophosphamide-Treated Mice

  • Yoon, Hyun-Soo;Kim, Joo-Wan;Cho, Hyung-Rae;Moon, Seung-Bae;Shin, Hyun-Dong;Yang, Kun-Ju;Lee, Hyeung-Sik;Kwon, Young-Sam;Ku, Sae-Kwang
    • Journal of Microbiology and Biotechnology
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    • v.20 no.2
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    • pp.438-445
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    • 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.

Radiation-induced Apoptosis, Necrosis and G2 Arrest in Fadu and Hep2 Cells

  • Lee Sam-Sun;Kang Beom-Hyun;Choi Hang-Moon;Jeon In-Seong;Heo Min-Suk;Choi Soon-Chul
    • Imaging Science in Dentistry
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    • v.30 no.4
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    • pp.275-279
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    • 2000
  • Purpose: Radiation damage is produced and viable cell number is reduced. We need to know the type of cell death by the ionizing radiation and the amount and duration of cell cycle arrest. In this study, we want to identified the main cause of the cellular damage in the oral cancer cells and normal keratinocytes with clinically useful radiation dosage. Materials and Methods: Human gingival tissue specimens obtained from healthy volunteers were used for primary culture of the normal human oral keratinocytes (NHOK). Primary NHOK were prepared from separated epithelial tissue and maintained in keratinocyte growth medium containing 0.15 mM calcium and a supplementary growth factor bullet kit. Fadu and Hep-2 cell lines were obtained from KCLB. Cells were irradiated in a /sup 137/Cs γ-irradiator at the dose of 10 Gy. The dose rate was 5.38 Gy/min. The necrotic cell death was examined with Lactate Dehydrogenase (LDH) activity in the culture medium. Every 4 day after irradiation, LDH activities were read and compared control group. Cell cycle phase distribution and preG1-incidence after radiation were analyzed by flow cytometry using Propidium Iodine staining. Cell cycle analysis were carried out with a FAC Star plus flowcytometry (FACS, Becton Dickinson, USA) and DNA histograms were processed with CELLFIT software (Becton Dickinson, USA). Results: LDH activity increased in all of the experimental cells by the times. This pattern could be seen in the non-irradiated cells, and there was no difference between the non-irradiated cells and irradiated cells. We detected an induction of apoptosis after irradiation with a single dose of 10 Gy. The maximal rate of apoptosis ranged from 4.0% to 8.0% 4 days after irradiation. In all experimental cells, we detected G2/M arrest after irradiation with a single dose of 10 Gy. Yet there were differences in the number of G2/M arrested cells. The maximal rate of the G2/M ranges from 60.0% to 80.0% 24h after irradiation. There is no significant changes on the rate of the G0/G1 phase. Conclusion: Radiation sensitivity was not related with necrosis but cell cycle arrest and apoptosis. These data suggested that more arrested cell is correlated with more apoptosis.

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Evaluation of Automatic Image Segmentation for 3D Volume Measurement of Liver and Spleen Based on 3D Region-growing Algorithm using Animal Phantom (간과 비장의 체적을 구하기 위한 3차원 영역 확장 기반 자동 영상 분할 알고리즘의 동물팬텀을 이용한 성능검증)

  • Kim, Jin-Sung;Cho, June-Sik;Shin, Kyung-Sook;Kim, Jin-Hwan;Jeon, Ho-Sang;Cho, Gyu-Seong
    • Progress in Medical Physics
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    • v.19 no.3
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    • pp.178-185
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    • 2008
  • Living donor liver transplantation is increasingly performed as an alternative to cadaveric transplantation. Preoperative screening of the donor candidates is very important. The quality, size, and vascular and biliary anatomy of the liver are best assessed with magnetic resonance (MR) imaging or computed tomography (CT). In particular, the volume of the potential graft must be measured to ensure sufficient liver function after surgery. Preoperative liver segmentation has proved useful for measuring the graft volume before living donor liver transplantations in previous studies. In these studies, the liver segments were manually delineated on each image section. The delineated areas were multiplied by the section thickness to obtain volumes and summed to obtain the total volume of the liver segments. This process is tedious and time consuming. To compensate for this problem, automatic segmentation techniques have been proposed with multiplanar CT images. These methods involve the use of sequences of thresholding, morphologic operations (ie, mathematic operations, such as image dilation, erosion, opening, and closing, that are based on shape), and 3D region growing methods. These techniques are complex but require a few computation times. We made a phantom for volume measurement with pig and evaluated actual volume of spleen and liver of phantom. The results represent that our semiautomatic volume measurement algorithm shows a good accuracy and repeatability with actual volume of phantom and possibility for clinical use to assist physician as a measuring tool.

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Postoperative irradiation after implant placement: A pilot study for prosthetic reconstruction

  • Doh, Re-Mee;Kim, Sungtae;Keum, Ki Chang;Kim, Jun Won;Shim, June-Sung;Jung, Han-Sung;Park, Kyeong-Mee;Chung, Moon-Kyu
    • The Journal of Advanced Prosthodontics
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    • v.8 no.5
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    • pp.363-371
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    • 2016
  • PURPOSE. On maxillofacial tumor patients, oral implant placement prior to postoperative radiotherapy can shorten the period of prosthetic reconstruction. There is still lack of research on effects of post-implant radiotherapy such as healing process or loading time, which is important for prosthodontic treatment planning. Therefore, this study evaluated the effects of post-implant local irradiation on the osseointegration of implants during different healing stages. MATERIALS AND METHODS. Custom-made implants were placed bilaterally on maxillary posterior edentulous area 4 weeks after extraction of the maxillary first molars in Forty-eight Sprague-Dawley rats. Experimental group (exp.) received radiation after implant surgery and the other group (control) didn't. Each group was divided into three sub-groups according to the healing time (2, 4, and 8 week) from implant placement. The exp. group 1, 2 received 15-Gy radiation 1 day after implant placement (immediate irradiation). The exp. group 3 received 15-Gy radiation 4 weeks after implant placement (delayed irradiation). RESULTS. The bone mineral density (BMD) was significantly lower in the immediate irradiation groups. BMD was similar in the delayed irradiation group and the control group. The irradiated groups exhibited a lower bone-to-implant contact ratio, although the difference was not statistically significant. The irradiated groups also exhibited a significantly lower bone volume and higher empty lacuna count than the control groups. No implant failure due to local irradiation was found in this study. CONCLUSION. Within the limits of this study, the timing of local irradiation critically influences the bone healing mechanism, which is related to loading time of prostheses.

Normalization of Elevated CA 19-9 Level after Treatment in a Patient with the Nodular Bronchiectatic Form of Mycobacterium abscessus Lung Disease

  • Chang, Boksoon;Han, Seo Goo;Kim, Wooyoul;Ko, Yousang;Song, Junwhi;Hong, Goohyeon;Eom, Jung Seop;Lee, Ji Hyun;Jhun, Byung Woo;Koh, Won-Jung
    • Tuberculosis and Respiratory Diseases
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    • v.75 no.1
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    • pp.25-27
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    • 2013
  • Carbohydrate antigen 19-9 (CA 19-9) is a widely-used tumor marker in patients with pancreatic cancer. However, some patients with respiratory disease also exhibit elevated serum CA 19-9 levels. We report a case of normalization of elevated serum CA 19-9 levels after treatment of the nodular bronchiectatic form of Mycobacterium abscessus lung disease. A 40-year-old man visited our hospital because of chronic cough and sputum. A computed tomography scan revealed severe bronchiectasis in the right upper and right middle lobes. Nontuberculous mycobacteria were repeatedly isolated and identified as M. abscessus. The serum CA 19-9 level was elevated to 142.35 U/mL (normal range, <37 U/mL). Surgical resection was performed because of failure of sputum conversion after antibiotic treatment. The serum CA 19-9 level returned to the normal range after surgery. This case suggested that serum CA 19-9 levels could be elevated in patients with the nodular bronchiectatic form of M. abscessus lung disease.

Assessment of Damages for Non-pecuniary Loss and Compensation for Damages in Medical Accidents - Overview for Cases of Medical Injury Relief in Korea Comsumer Agency - (의료사고의 손해배상과 위자료 산정 -한국소비자원 의료피해구제 사례들의 일별-)

  • Kim, Kyoung Reay;Ahn, Bup-Young
    • The Korean Society of Law and Medicine
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    • v.13 no.2
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    • pp.179-214
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    • 2012
  • There are two opinions on the legal characteristics of damages for non-pecuniary loss, a private sanctions theory and complementary function of damages for non-pecuniary loss, briefly. There is a close connection between the legal characteristics and the function of damages for non-pecuniary loss. The functions of damages for non-pecuniary loss are consist of satisfaction, prevention( sanctions) and complementation. Several cases of medical injury relief reported to Korea Comsumer Agency are categorized as follows, 1) cases of death after having an operation, 2) diagnosed with disability after a medical accident, 3) extended damages happening related to delayed diagnosis, 4) et cetera(a plastic surgery, a treatment with oriental medicine), and the damages for non-pecuniary loss in respect to each cases are examined. In the case of occurring death or disability, Korea Comsumer Agency has set up guidelines for assessment of damages for non-pecuniary loss by classifying into major and collateral violation for a duty of care. Furthermore, the damages for non-pecuniary loss in the case of all sorts of cancers, are assessed in accordance with the degree of responsibility subsequent to dividing cancer into good and poor prognosis. When it comes to a complementary function of damages for non-pecuniary loss in the actual work, it is hard to assess the damages as it is difficult to objectify non-pecuniary loss, such as emotional distress. Though compensation for damages is major legal characteristics of consolation money, preventing a damage(private sanctions) through consolation for a victim or sanctions against an assailant also has great significance. Therefore, it is necessary to approach flexibly for mutual agreement by considering specialty( concrete facts) of individual issue thoroughly. If considering this aging society that limits the possible age for work to 60 years old, it is needed to have a complementary function of consolation money in mind not to make it less meaningful for victims due to small sum of consolation money.

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