• 한국식품과학회지
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• 제37권3호
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• pp.456-464
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• 2005

본 연구에서는 최근 전세계적으로 문제가 되고 있는 항생제 내성균에 대해 그 항균효과를 천연의 약용식물을 이용하여 분자생물학적 수준에서 비교해보고 천연항균제의 개발에 우선하여 직접 식품에 첨가하여 그 효과를 검색하고자 하였다. 병원내감염의 주된 원인균으로 알려진 황색포도상구균(Staphylococcusaureus)은 여러 항균제에 대하여 내성을 획득함으로써 질병의 치료를 어렵게 한다는 점에서 매우 심각한 문제이다. 이러한 내성균은 다양한 방법으로 동 식물에 빠르게 전파되고 있으므로 소비자가 내성균을 지닌 식품을 섭취해 잠재적인 내성균을 보유하게 되는 결과를 낳게 된다. 이러한 항생제 내성 황색포도상구균(Methicillin Resistant S. aureus, MRSA)에 대해 천연 약용 식물 중 우수한 항균력을 가지는 감초를 순차 분획하여 각 분획물을 이용한 MRSA에 대한 항균 활성을 알아본 결과 hexane, chloroform 분획물에서 항균활성을 나타냈으며, 동일농도의 생육저해비교 실험에서 대부분의 내성균주에 대해 대조군과 유사한 효과를 나타낸 penicillin에 비해 감초분획물이 대수기를 넘는 억제효과를 나타내었으며 이 중 chloroform 분획물이 가장 높은 저해활성을 나타내었다. 또한 RT-PCR을 통하여 표준균주와 내성균주의 내성 정도와 내성 유전자를 관찰해본 결과 KCCM 40510은 내성획득유전자인 mecA, mecRI, mecI, femA에 발현이 높게 나타나 고도내성균임을 알 수 있었으며, 고도내성을 나타내는 균주를 이용하여 감초의 chloroform 분획물을 농도별로($50,\;100,\;250\;{\mu}/mL$) 처리한 결과 농도 의존적으로 유전자 발현이 억제됨을 볼 수 있었다. 특히 고도내성균주인 KCCM 40510은 메티실린 내성을 상승시키는 mecA 유전자의 발현을 억제시키는 mecRI 유전자의 pathway와 상응하는 것으로 보여지므로 감초가 이러한 고도내성균에 효과가 있음을 알 수 있었다. 또한 SEM을 통한 형태학적 관찰을 통해 분획물 처리 시 세포벽이 파괴되는 것을 확인할 수 있었다. 한편 이러한 감초추출물을 직접 식품에 첨가하여 내성 균주에 대한 억제 효과도 확인한 결과 추출물 200mg/100mL 농도에서 포도상구균에 대해 항균효과를 나타내는 것을 볼 수 있었다.

• Radiation Oncology Journal
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• 제35권3호
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• pp.208-216
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• 2017

Purpose: To evaluate the feasibility of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) for preoperative concurrent chemoradiotherapy (PCRT) in locally advanced rectal cancer (LARC), by comparing with 3-dimensional conformal radiotherapy (3D-CRT). Materials and Methods: Patients who were treated with PCRT for LARC from 2015 January to 2016 December were retrospectively enrolled. Total doses of 45 Gy to 50.4 Gy with 3D-CRT or SIB-IMRT were administered concomitantly with 5-fluorouracil plus leucovorin or capecitabine. Surgery was performed 8 weeks after PCRT. Between PCRT and surgery, one cycle of additional chemotherapy was administered. Pathologic tumor responses were compared between SIB-IMRT and 3D-CRT groups. Acute gastrointestinal, genitourinary, hematologic, and skin toxicities were compared between the two groups based on the RTOG toxicity criteria. Results: SIB-IMRT was used in 53 patients, and 3D-CRT in 41 patients. After PCRT, no significant differences were noted in tumor responses, pathologic complete response (9% vs. 7%; p = 1.000), pathologic tumor regression Grade 3 or higher (85% vs. 71%; p = 0.096), and R0 resection (87% vs. 85%; p = 0.843). Grade 2 genitourinary toxicities were significantly lesser in the SIB-IMRT group (8% vs. 24%; p = 0.023), but gastrointestinal toxicities were not different across the two groups. Conclusion: SIB-IMRT showed lower GU toxicity and similar tumor responses when compared with 3D-CRT in PCRT for LARC.

• 대한골관절종양학회지
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• 제2권1호
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• pp.1-7
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• 1996

PURPOSE : The purpose of this study is to know the ability of detecting malignant tumor tissue by Tl-201 scan, and to compare with that of Tc-99m-MIBI and Tc-99m-MDP scan. MATERIAL AND METHODS : Between February 1994 and December 1995,38 unselected patients with various bone pathologies were studied prospectively. Eighteen had malignant bone and soft tissue pathologies, while twenty had benign. All patients were studied with Tl-201, Tc-99mMIBI and Tc-99m-MDP scan prior to surgical biopsy. PICKER Prism 2000 gamma camera with high resolution parallel hole collimator was used for scanning. To avoid the interaction of isotope, the early(30min.) and delayed phase(3hrs.) of Tl-20l scan was performed first and Tc-99m-MIBI scan was performed after 30 minutes, and then Tc-99m-MDP scan 48 hours later. The scan images were visually evaluated by a blinded nuclear medicine physician. We could find true positive, true negative, false positive and false negative by the comparison of results with those of biopsy. We calculated positive and negative predictive value(%), sensitivity(%), specificity(%) and diagnostic accuracy(%) of each scan. RESULT : The results of each scan were 85.7, 100, 100, 85, 92.1% in Tl-201, 81, 94.1, 94.4, 80, 86.8% in Tc-99m-MIBI and 50, 66.7, 88.9, 20, 52.6% in Tc-99m-MDP scan. As a conclusion, Tl-201 scan was the most specific and accurate method for detecting malignant tumor tissue. Tc-99m-MIBI scan was also good for malignant tumor searching. CONCLUSION : With our results, we can use Tl-201 scan to differentiate benign from malignant tumor, and to evaluate the response of preoperative chemotherapy or radiotherapy, and to determine the residual tumor or local recurrence. For the better result, we need to have a more detail information about false positive cases and a more objective and quantitative reading technique.

• Radiation Oncology Journal
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• 제8권2호
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• pp.183-188
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• 1990

비인강암은 해부학적으로 두개저부 및 중추신경계와 인접하고 있어 수술적 접근이 어렵고, 또 최근 항암제요법의 발달로 복합항암제를 이용한 항암제요법으로 반응율을 높이기 위한 여러 연구들이 진행되고 있지만, 아직까지 비인강암에 대한 치료는 방사선치료가 그 근간을 이루고 있다. 비인강암의 연령분포곡선은 30세 이후에 급격히 증가하여 45세에서 54세까지에서 수평을 이룬후 서서히 감소하는 곡선을 그리는데, 10대 내지 20대에서도 작은 증가곡선을 나타내어 bimodal curve를 그리게 된다. 30세 이전에 생긴 비인강암은 그 빈도가 매우 적어서 이에 대한 연구보고가 많지 않지만 일반적으로는 30세 이후에 생긴 비인강암과는 다른 임상양상을 보이는 것으로 보고되어 있다. 이에 저자들은 1971년부터 1987년까지 연세대학교 의과대학 치료방사선과에서 치료받았던 113명의 비인강암 환자들을 30세 이전과 30세 이후 환자군으로 구별하여, 임상적 특성 및 치료에 대한 관해율, 이에 따른 생존율 및 생존에 영향을 미치는 인자들, 그리고 치료실패양상 등을 분석 비교하여 향후 30세 이전의 비인강암 환자의 치료에 지침을 마련하고자 본 연구를 시행하여 다음과 같은 결과를 얻었다. 1. 30세 이전의 비인강암 환자에서 치료에 대한 초기반응율이 높았다 2. 30세 이전의 비인강암 환자에서 통계적 의의는 없었으나 원격전이가 많았다. 3. 두 연령군간에 생존율의 차이는 없었다.

• Radiation Oncology Journal
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• 제12권2호
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• pp.191-199
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• 1994

Purpose : This study was undertaken to show the clinical results of combined radiotherapy and hyperthermia in primary hepatoma Materials and Methods : Between December 1989 and March 1993, 50 patients with hepatomas were treated by combined radiotherapy and hyperthermia. Among them, we analyzed retrospectively 33 patients who received the complete course of treatment. The ages of the patients ranged from 36 to 75(mean age: 55.5 years). Twenty-six patients ($78.8\%$) were men, and 7 ($21.2\%$ were women. According to Child's classification, nine patients ($27.3{\%}$) were A group, 9 ($27.3\%$) were B group, 15 ($45.4\%$) were C group. Radiation therapy was done by a 6 MV and 15 MV linear accelerator. Patients were treated with daily fractions of 150-180 cCy to doses of 2550 cGy -4950 cGy (median : 3000 cGy). Local hyperthermia was done by 8 MHZ RF capacitive heating device (Cancermia. Green Cross Co., Korea), 50-60 min/session, 1-2 sessions/wk, and 8.5 sessions (median number)/patient. We analyzed the prognostic factors including age, sex, tumor type, Child's classification, $\alpha$-fetoprotein, liver cirrhosis, ascites, portal vein invasion, esophageal varix, number of hyperthermia, chemotherapy, total bilirubin level, Karnofsky perfomance status. Results : The overall 1-year survival was $24.2\%$, with a mean survival of 10months. Of 33 patients, tumor regression (PR+MR) was seen in $30.4\%$, no response was seen in $52.2\%,\;17.4\%$ patient was progressed. In patients who had tumor regression, the overall 1-year survival was $42.1\%$ with a mean survival of 14 months. Factors influencing the survival were sex (p=0.05), tumor type (p=0.0248), Child's classification (p=0.0001), liver cirrhosis (p=0.0108), ascites (p=0.0009), and Karnofsky perfomance status (p=0.0028). Complications developed in 28 patients, including 18 hot pain,5 fat necrosis, 3 transient fever, 2 nausea and vomiting. Conclusion : In this study, the results suggests that combined radiotherauy and hyperthermia may improve the survival rate of hepatoma.

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

• Asian Pacific Journal of Cancer Prevention
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• 제16권6호
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• pp.2355-2359
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• 2015

Background: Combination chemotherapy of 5 fluorouracil (5-FU) and leucovorin (LV) with oxaliplatin, mainly FOLFOX regimens, has shown considerable antitumor activity and a tolerable toxicity profile in gastric cancer. The goal of this study was to retrospectively compare the efficacy and toxicity of modified FOLFOX-6 (mFOLFOX6) regimen in advanced gastric cancer (AGC) patients with good and poor performance status (PS). Materials and Methods: AGC patients receiving the mFOLFOX6 regimen including oxaliplatin $85mg/m^2$, bolus of 5-FU $400mg/m^2$ and LV $400mg/m^2$ on the first day, followed by $2400mg/m^2$ of 5- FU as a continious infusion over 46 hour for first-line treatment were eligible for the study. Results: A total 58 patients with a median age of 59.5 (32-81) were included. The median follow up of the study was 9.2 months. Thirty patients (51.7%) with an ECOG PS 0-1 were assigned to the good PS arm, while 28 patients (48.3%) with ECOG PS 2 were in the poor PS arm. Overall response rates were 36.6 and 28.8%, respectively (p=0.91). Median PFS was 6.7 and 6.3 months in good PS and poor PS arms (p=0.50) and median OS was 9.6 and 10.4 months (p=0.55). As compared with good PS arm, poor PS arm was associated with more grade 3-4 neutropenia and anemia. Dose reduction and dose delays were also significantly higher. Conclusions: In this study, mFOLFOX6 was similarly effective in both arms. Although hematologic toxicity was significantly higher in patients with poor PS, it remained manageable. Our results suggest that this regimen may be an effective treatment option for AGC patients with poor PS.

• Asian Pacific Journal of Cancer Prevention
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• 제15권12호
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• pp.4781-4786
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• 2014

Background: The purpose of this study was to analyze the predictive value of neutrophil/lymphocyte ratio (NLR) to better clarify which patient groups will benefit the most from particular treatments like bevacizumab. Materials and Methods: A total of 245 treatment-naive metastatic colorectal cancern (mCRC) patients were retrospectively enrolled and divided into 2 groups: 145 group A patients were treated with chemotherapy in combination with bevacizumab, and 100 group B patients were treated as above without bevacizumab. Results: Group A patients had better median overall survival (OS) and progression-free survival (PFS) (24.0 and 9.0 months) than group B patients (20 and 6.0 months) (p=0.033; p=0.015). In patients with low NLR, OS and PFS were significantly longer in group A patients (27 vs 18 months, p=0.001; 11 vs 7 months, p=0.017). Conclusions: We conclude that NLR, a basal cancer related inflammation marker, is associated with the resistance to bevacizumab-based treatments in mCRC patients.

• Radiation Oncology Journal
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• 제37권2호
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• pp.91-100
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• 2019

Purpose: Internal mammary lymph node (IMN) involvement is associated with poor prognosis in breast cancer. This study investigated the treatment outcomes of initial clinically IMN-positive breast cancer patients who received adjuvant radiotherapy (RT), including IMN irradiation, following primary breast surgery. Materials and Methods: We retrospectively reviewed data of 95 breast cancer patients with clinically detected IMNs at diagnosis treated with surgery and RT between June 2009 and December 2015. Patients received adjuvant RT to the whole breast/chest wall and regional lymph node (axillary, internal mammary, and supraclavicular) areas. Twelve patients received an additional boost to the IMN area. Results: The median follow-up was 43.2 months (range, 4.5 to 100.5 months). Among 77 patients who received neoadjuvant chemotherapy, 52 (67.5%) showed IMN normalization and 19 (24.6%) showed a partial response to IMN. There were 3 and 24 cases of IMN failure and any recurrence, respectively. The 5-year IMN failure-free survival, disease-free survival (DFS), and overall survival (OS) were 96%, 70%, and 84%, respectively. IMN failure-free survival was significantly affected by resection margin status (97.7% if negative, 87.5% for close or positive margins; p = 0.009). All three patients with IMN failure had initial IMN size ≥1 cm and did not receive IMN boost irradiation. The median age of the three patients was 31 years, and all had hormone receptor-negative tumors. Conclusion: RT provides excellent IMN control without the support of IMN surgery. Intensity-modulated radiotherapy, including IMN boost for breast cancer patients, is a safe and effective technique for regional lymph node irradiation.

• Asian Pacific Journal of Cancer Prevention
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• 제16권7호
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• pp.3015-3021
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• 2015

Background: Colorectal cancer (CRC) is a major cause of mortality in developed countries, and it is the third most frequent malignancy in Turkey. There are many biological, genetic, molecular, and tissue-derived prognostic factors for CRCs. In this study, we evaluated prognostic factors in patients who were metastatic at diagnosis or progressed to metastatic disease during follow-up. Patients and Methods: This study included 116 patients with malignancies either in the colon or rectum. Of these, 65 had metastatic disease at diagnosis, and 51 progressed to metastatic disease during the course of the disease. The parameters evaluated were age, gender, comorbidity, performance status and stage of the disease at the beginning, localization, history of surgery, chemotherapy regimen, response to first-line treatment, K-RAS status, site and number of metastases, expression of tumor predictors (CEA, CA19-9), and survival times. A multivariate analysis conducted with factors that considered statistically significant in the univariate analysis. Findings: Median age was 56 (32-82) years and the male/female ratio was 80/36. Eleven patients were at stage II, 40 at stage III, and 65 at stage IV at diagnosis. Twenty three patients had tumor in the right colon, 48 in the left colon, and 45 in the rectum. Ninety seven patients were operated, and 27 had surgical metastasectomy. Ninety three patients received targeted therapy. At the end of follow-up, 61 patients had died, and 55 survived. Metastatic period survival times were longer in the adjuvant group, but the difference did not reach the level of statistical significance (adjuvant group: median 29 months, metastatic group: median 22 months; p=0.285). In the adjuvant group before the metastatic first-line therapy, CEA and CA 19-9 levels were significiantly lower compared to the metastatic group (p<0.005). We also found that patients with elevated tumor predictor (CEA, CA 19-9) levels before the first-line therapy had significiantly poorer prognosis and shorter survival time. Survival was significiantly better with the patients who were younger than 65 years of age, had better initial performance status, a history of primary surgery and metastatectomy, and single site of metastasis. Those who benefitted from the first-line therapy were K-RAS wild type and whose tumor markers (CEA, CA 19-9) were not elevated before the first line therapy. Conclusions: Among the patients with metastatic CRC, those who benefited from first-line therapy, had history of metastasectomy, were K-RAS wild type and had low CA 19-9 levels before the first-line therapy, showed better prognosis independent of other factors.