• 대한영상의학회지
• /
• 제84권6호
• /
• pp.1403-1407
• /
• 2023

방광암의 림프절 전이는 방광의 림프순환에서 처음과 두 번째로 거쳐 가는 외/내 장골, 폐쇄림프절과 총장골림프절에서 주로 일어난다. 방광암에서 횡격막을 넘어서 일어나는 전이는 드물고, 두경부로의 전이는 예후가 좋지 않으며 생존율도 낮다. 방광요로상피암 환자에서 뼈나 그 외에 고형장기로의 전이 없이 목 피부의 염증성 변화와 함께 림프절전이를 동반하는 것은 드문 증례이므로 이에 보고하고자 한다.

• Radiation Oncology Journal
• /
• 제28권3호
• /
• pp.125-132
• /
• 2010

목 적: 자궁경부암에서 근치적 절제술 후 림프절 침범은 중요한 예후인자 중 하나이다. 본 연구에서는 총장골동맥림프절 침범 시 대동맥주위림프절에 대한 예방적 방사선조사의 효과를 알아보고자 하였다. 대상 및 방법: 1985년 5월부터 2004년 10월까지 총 909명의 환자가 서울대병원에서 자궁경부암으로 근치적 절제술 후 방사선치료를 시행받았다. 골반 내 림프절 침범이 있는 환자는 375명이었고 총장골동맥림프절 침범이 있는 환자는 69명이었다. 이 중 총장골동맥림프절 침범이 있으면서 대동맥주위림프절 침범은 없었던 54명의 환자를 대상으로 후향적 분석을 시행하였다. 대상환자의 FIGO 병기는 IB, IIA, IIB가 각각 22명, 21명, 11명이었다. 이 중 10명은 전골반과 대동맥주위림프절을 포함하는 확장조사야로 방사선치료를 받았고 모두 항암화학치료를 병용하였으며, 나머지 44명은 전골반 만을 포함하는 표준조사야로 방사선치료를 받았고 이 중 16명이 항암화학치료를 병용하였다. 확장조사군과 표준조사군의 추적관찰기간은 각각 21~58개월(중간값, 47개월)과 6~201개월(중간값, 58개월)이었다. 결 과: 전체 환자의 4년 생존율, 4년 무병생존율, 4년 무전이생존율은 각각 70.0%, 61.1%, 71.7%였다. 단변량 분석 시 절제연 침범(p<0.001), 림프관내 종양 침범(p=0.041)이 있는 경우 유의하게 생존율이 낮았고, 양측 림프절침범(p=0.001), 5개 이상의 림프절 전이(p=0.006)가 있는 경우 유의하게 낮은 무병생존율을 보여주었다. 낮은 무전이생존율과 관련 있는 인자는 양측 림프절 침범(p=0.009), 5개 이상의 림프절 전이(p=0.003), 자궁경부 전층 침범(p=0.013), 절제연 침범(p=0.014), 림프관내 종양 침범(p=0.041)이었다. 확장조사군과 표준조사군의 4년 생존율은 90.0%와 67.2% (p=0291), 4년 무병생존율은 70.0%와 59.0% (p=0.568), 4년 무전이생존율은 90.0%와 67.5% (p=0.196), 4년 대동맥주위림프절 전이율은 0%와 14.3% (p=0.249)로 통계적으로 유의한 차이가 없었다. 3등급 이상의 중등도 급성합병증은 확장조사군 10명 중 4명(40%; 조혈계 2명, 위장관계 2명)에서 발생하였고, 표준조사군 44명 중에서는 11명(25%; 조혈계 2명, 위장관계 6명, 비뇨생식계 3명)에서 발생하였다. 결론: 자궁경부암의 근치적 절제술 후 총장골동맥림프절 침범이 있는 경우 예방적 대동맥주위림프절 방사선조사의 생존율에 대한 통계적 유용성은 확인할 수 없었다. 그러나 확장조사야로 치료받은 환자수가 적고 추적관찰기관이 짧았던 점을 고려하면 추가적인 추적관찰이 필요할 것으로 생각한다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권11호
• /
• pp.5505-5510
• /
• 2012

Objective: The aim of this retrospective study is to analyze the clinical and pathological factors related to the prognosis of Chinese patients with stage Ib to IIb cervical cancer. Methods and Results: 13 clinical pathological factors in 255 patients with stage Ib to IIb cervical cancer undergoing radical hysterectomy and systematic lymphadenectomy were analyzed to screen for factors related to prognosis. The cumulative 5-year survival of the 255 patients was 75.7%. The result of the univariate analysis suggested that clinical stage, cell differentiation, depth of cervical stromal invasion, parametrial tissue involvement, and lymph node metastasis were prognostic factors for patients with stage Ib to IIb cervical cancer (P<0.05). Compared with cases with involvement of iliac nodes, obturator nodes, or inguinal lymph nodes, cases with metastasis to the common iliac lymph nodes had a poorer prognosis (P<0.05). Cases with involvement of four or more lymph nodes had a poorer prognosis than those with involvement of three or fewer lymph nodes (P<0.05). Using multivariate Cox proportional hazards model regression analysis, non-squamous histological type, poor differentiation, parametrial tissue involvement, and outer 1/3 stromal invasion were found to be independently related to patients poor prognosis (P<0.05). Conclusion: Non-squamous histological type, poor cell differentiation, parametrial tissue involvement, and outer 1/3 stromal invasion are the independent poor prognostic factors for patients with stage Ib to IIb cervical cancer.

• Journal of Acupuncture Research
• /
• 제18권1호
• /
• pp.113-128
• /
• 2001

Objective : To investigate the effect of BUM aqua-acupuncture in treating the RA, the immunosis to logical analysis of LPS induced arthritis in mice to study this. For 14th day after the injection of LPS & BUM injection, the distribution of fibroblast, collagen, CD54(ICAM-1), CD106(VCAM-1), IL-$1{\beta}$, IL-2 receptor, CDl lb(macrophage) were examined on synovial capsule of mice knee joint. For 14th day after the injection of LPS & BUM injection, the distribucion of CD4(TH cell), CD8(TC cell), CD40(B cell) were examined on common iliac lymph node in mice. Methods : The experimental model of arthritis was induced by injection of 300${\mu}g$/kg LPS in BALB/c mice weighing 30g. The 100${\mu}l$ BUM aqua-acupuncture which compounded calculus bovis, fel ursi and moschus was injected into GB34 of mice every other day for 12 days. For 3rd, 7th, 14th day after the injection of LPS, the neutrophil, lymphocyte and monocytc counts in WBC were measured using hemacytometer. Results : The obstain results are summarized as follows ; 1. In sample group, the neutrophils counts were increased and the lympnocytes counts were decreased compared with control group. 2. The distribution of fibrosis & fibroblast on synovial membrane were decreased compared with control group. 3. The distribution of collagen fiber on synovial membrane were decreased compared' with control group. 4. The distribution of CD54(ICAM-1) & CD106(VCAM-1) on synovial membrane were decreased compared with control group. 5. The distribution of IL-$1{\beta}$ & IL-2 receptor on synovial membrane were decreased compared with control group. 6. The distribution of CDb(macrophage) on synovial membrane were decreased compared with control group. 7. The distribution of CD4(TH cell), CD8(TC cell) and CD40(B cell) in common iliac lymph nodes were decreased compared with control group. Conclusions : BUM aqua-acupuncture stimulation decreased inflammatory responses LPS induced arthritis in mice.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권16호
• /
• pp.6519-6524
• /
• 2014

The aim of this study was to evaluate the clinical outcomes of radical cystectomy (RC) and concurrent chemoradiotherapy (CRT) with methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) in patients with locally advanced bladder cancer (BC). From December 2000 to February 2012, 72 patients with locally advanced BC (T3-4a, N0 or N+, M0) received either RC or CRT. RC with bilateral pelvic lymph node dissection including the common iliac region as the standard procedure. Patients in the CRT group received one cycle of MVAC followed by radiotherapy with a half dose of MVAC and then two more cycles of MVAC. Standard fractionation at a daily dose of 1.8-2.0 Gy was used, with a median total dose of 50 Gy (range, 45-60 Gy). The 3-year progression-free survival (PFS) rates in the RC and CRT groups were 56.2% and 25.6%, respectively (p=-0.015) and the 3-year overall survival (OS) rates were 63.5% and 48.1% (p=0.272). Multivariate Cox proportional hazards regression analysis with application of a propensity score indicated that RC was a significant predictor of PFS (p=0.033) but not of OS (p=0.291). Among patients with locally advanced BC, PFS was significantly prolonged in the RC group compared with the CRT group. However, RC was not a significant predictor of OS. Although the sample size in this study was small, the results suggest that patient background and postoperative quality of life should be considered when choosing treatment strategy for locally advanced BC.

• 사상체질의학회지
• /
• 제14권3호
• /
• pp.114-131
• /
• 2002

1. PURPOSE : The purpose of this study is to investigate the effect of Chungpyesagantang on LPS induced Arthritis in Mice. 2. METHOD : All the BALB/C Mice used in this study were 4wks of age at the start of the experiment. The experimental model of Arthritis was induced by injectection of $300{\mu}g/kg$ LPS in mice knee joint. The experiment was compare daily CS treatment group after Arthritis elicitation with Arthritis elicitated group at day 4, 7, 14 after Arthritis elicitation. 3. RESULTS 1) The hyperplasia of synoviocytes of CS treatment group after Arthritis elicitation is soften than Arthritis elicitated group. 2) The aggregation of collagen fibers CS treatment group after Arthritis elicitation is decreased than Arthritis elicitated group. 3) The distribution of TUNEL positive cells(apoptotic cell) of CS treatment group was remarkably increased than Arthritis elicitated group. 4) The distribution of $TNF-{\alpha}$, $NF-{\kappa}B\;p50$, COX-2 positive cells of CS treatment group after Arthritis elicitation in synovial membrane was decreased than Arthritis elicitated group. 5) The distribution of $IL-2R-{\alpha}$, ICAM-1 positive cells of CS treatment group after Arthritis elicitation in apical surface of synovial membrane was decreased than Arthritis elicitated group. 6) The distribution of $NF-{\kappa}B\;p50$, $IL-2R-{\alpha}$ in common iliac lymph node of CS treatment group after Arthritis elicitation positive cells was decreased than Arthritis elicitated group. 4. CONCLUSION : As a result of these experimental results, it may be concluded that Chungpyesagantang used for treatment of LPS induced Arthritis in Mice. Inflamation activity in CS treatment group after Arthritis elicitation was decreased than Arthritis elicitated group.