• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.9
• /
• pp.4531-4536
• /
• 2012

Objective: To study synergistic effects of nedaplatin and cisplatin on three human carcinoma cell lines (esophageal carcinoma cell line Eca-109, ovarian carcinoma Skov-3 and cervical carcinoma Hela). Methods: Inhibition effects were evaluated by MTT assay and cell apoptosis was detected by flow cytometry. In addition, changes of Ki-67, Bax and Bcl-2 at mRNA and protein levels were quantified by RT-PCR and Western blotting. Results: Growth inhibition in each cell lines was dose-dependent after exposure to nedaplatin or cisplatin alone. The interaction of the two drugs was synergistic at higher concentrations according to the median-effect principle. The inhibition rates with nedaplatin, cisplatin and combined treatment were $41.9{\pm}4.1%$, $47.4{\pm}2.9%$, $52.5{\pm}0.9%$(Eca-109), $39.0{\pm}1.26%$, $45.0{\pm}1.45%$, $56.2{\pm}1.44%$ (Skov-3) and $44.8{\pm}2.11%$, $46.9{\pm}0.99%$, $56.6{\pm}1.83%$ (Hela) respectively, with increase in apoptosis. Compared with the nedaplatin or cisplatin alone treatment group, the combinative treatment group's Ki-67 and bcl-2 mRNA (protein) expression was decreased while that of Bax mRNA (protein) was increased. Conclusion: Compared to the effects of nedaplatin or cisplatin alone at high concentrations, combination of nedaplatin and cisplatin at low concentrations proved to be much more effective for inhibition of proliferation and the induction of apoptosis in the Eca-109, Skov-3 and Hela cell lines.

• Journal of Chest Surgery
• /
• v.22 no.6
• /
• pp.914-920
• /
• 1989

Bleomycin and cyclophosphamide are widely used and effective anti-cancer agents for treatment of various forms of cancer. Bleomycin has no myelotoxicity, but because of potential risk of pulmonary complications including interstitial pneumonitis and idiopathic interstitial pulmonary fibrosis, it has been limited in use. Some investigator has also suggested that cyclophosphamide can induce pulmonary toxicity like bleomycin. Recently, The combination chemotherapy including bleomycin and cyclophosphamide has been adopted effectively in some types of cancer. But there are no available literatures for synergistic effect of pulmonary toxicity in combination chemotherapy including these two drugs. We tried this study to observe synergism of pulmonary toxicity using these two drugs in rats. The animals were divided into five groups: group 1 received intra-peritoneal injection of saline, group 2-a received only bleomycin 0.1 mg [0.4 mg/kg] by intra-peritoneal injection twice a week, group 2-b received only bleomycin 0.5 mg [2 mg/kg] by intra-peritoneal injection twice a week, group 3-a received bleomycin 0.1 mg [0.4 mg/kg] twice a week +cyclophosphamide 5 mg [20 mg/kg] two weeks interval by intra-peritoneal injection, group 3-b received bleomycin 0.5 mg [2 mg/kg] twice a week + cyclophosphamide 5 mg[20 mg/kg] two weeks interval by intra-peritoneal injection. The animals were sacrificed at 2 and 4 weeks later. Lung tissues were obtained and observed by light microscope. The results are as follows: 1. The pathologic findings of group 1 were normal without change. 2. There was no difference between group 2-a and group 3-a at 2 weeks later, group 3-a, however, revealed more severe change in lung tissue at 4 weeks later compared with group 2-a. 3. In group 3-b there was more severe pulmonary injury compared with group 2-b at 2 and 4 weeks later. We conclude that the combined administration of bleomycin and cyclophosphamide induce more severe pulmonary toxic effect than bleomycin administration alone and the combination chemotherapy including these two drugs will be require special attention to selection of the dose of each drug.

• The Journal of Korean Society for Radiation Therapy
• /
• v.33
• /
• pp.79-88
• /
• 2021

Objectives: Bolus, which combines 3D-bolus and Step-bolus, was produced and its usefulness is evaluated. Materials and Methods: A Bolus was manufactured with a thickness of 10mm and 5mm using a 3D printer (3D printer, USA), and a Step Bolus of 5mm was bonded to a 5mm thick bolus. In order to understand the characteristics of Step bolus and 3D bolus, the differences in relative electron density, HU value, and mass density of the two bolus were investigated. These two Bolus were applied to anthropomorpic phantom to confirm its effectiveness. After all contouring of the phantom, a treatment plan was established using the computed treatment planning system (Eclipse 16.1, Varian medical system, USA). Treatment plan was performed using electron beam 6MeV, nine dose measurement points were designated on the phantom chest, air-gap was measured at that point, and dose evaluation was performed at the same point for each bolus applied using a glass dosimeter (PLD). Results: Bolus, which combines 3D-bolus 5mm and Step-bolus 5mm, was manufactured and evaluated compared with 3D-bolus 1cm. The relative electron density of 3D Bolus was 1.0559 g/cm2 and the step Bolus was 1.0590 g/cm2, which was different by 0.01%, so the relative electron density was almost the same. In the lightweight measurement of air-gap, the combined bolus was reduced to 54.32% for all designated points compared to 3D-bolus. In the dose measurement using a glass dose meter (PLD), the consistency was high in phantom using combined bolus at most points except the slope point. Conclusion: Combined bolus made by combining 3D-bolus and Step-bolus has all the advantages of 3D-bolus and Step-bolus. In addition, by dose inaccuracy due to Air-gap, more improved dose distribution can be shown, and effective radiation therapy can be performed.

• Radiation Oncology Journal
• /
• v.18 no.4
• /
• pp.251-256
• /
• 2000

Purpose : To evaluate efficacy and complication of stereotactic radiosurgery using stereotactic body frame. Methods and Materials :From December 1997 to June 1999, 11 patients with primary and metastatic tumors were treated with stereotactic radiosurgery using stereotactic body frame(Precision TherapyTu). Three patients were treated with primary hepatoma and seven with metastatic tumor from liver, lung, breast, trachea and one with arteriovenous malformation on neck. We used vacuum pillow for immobilization and made skin marker on sternum and tibia area with chest marker and leg marker. Diaphragm control was used for reducing movement by respiration. CT-simulation and treatment planning were peformed. Set-up error was checked by CT-Simulator before each treatment. Dose were calculated on the 80$\~$90$\%$ isodose of isocenter dose and given consecutive 3 fractions for total dose of 30 Gy (10 Gy/fraction). Results :Median follow-up was 12 months. One patient (9$\%$) showed complete response and four Patients (36$\%$) showed partial response and others showed stable disease. Planning target volumes (PTV) ranged from 3 to 111 cc (mean 18.4 n). Set-up error was within 5 mm in all directions (X, Y, Z axis). There was no complication in all patients. Conclusion :In Primary and metastatic tumors, stereotactic body frame is very safe, accurate and effective treatment modality.

• Tuberculosis and Respiratory Diseases
• /
• v.48 no.3
• /
• pp.357-364
• /
• 2000

Background : Complicated exudative pleural fluid collections have traditionally been treated by either closed tube thoracostomy drainage or by open surgical drainage. Complete drainage is important in order to control pleural sepsis, restore pulmonary function, and entrapment. Recently intracavitary fibrinolytic therapy has been advocated as a method to facillitate drainage of complicated exudative pleural effusion and to allow enzymatic debridemant of the restrictive fibrinous sheets covering the pleural surface. The purpose of this study is to prospectively evaluate the effects of image-guided catheter drainage with high dose urokinase(UK) instillation in the treatment of complicated pleural effusions. Patients : Twenty complicated pleural effusion patients that poorly respond to image-guided drainage were allocated to receive UK. There were 8 pneumonia and 12 tuberculosis. Methods : Drugs were diluted in 250 mL normal saline and were infused intrapleurally through the chest tube or pig-tail catheter in a daily dose of 250,000 IU of UK. Response was assessed by clinical outcome, fluid drainage, chest radiography, pleural ultrasound and/or computed tomography. Results : The mean UK instillation time was $1.63{\pm}0.10$. The mean volume drained UK instillation was $381.3{\pm}314.4\;mL$, and post-UK was $321.6{\pm}489.5\;mL$. The follow up duration after UK therapy was mean $212.9{\pm}194.5$ days. We had successful results in 19 cases (95.0%). There were 12 pleural thickenings (60.0%), 2 markedly decreased effusions (10.0%) and 5 cases of no thickening or effusion. There was recurrence after treatment in only one patient(5%) with complicated pleural effusiondue to tuberculosis. Conclusions : Image-guided drainage with high dose UK instillation (250,000 U/day) in complicated pleural effusion is a safe and more effective method than closed thoracostomy drainage. And this management, in turn, can obviate surgery in most cases.

• Journal of radiological science and technology
• /
• v.38 no.3
• /
• pp.187-197
• /
• 2015

This study analysed the effectiveness of aluminium(Al) filter in the added compound filtration for the removal of characteristic radiation by energy spectrum and image evaluation. 0.1, 0.2, 0.3 mm copper with and without 1 mm Al were evaluated. The energy spectrum was measured using the GATE and evaluated separately by each energy. Image quality was evaluated by PSNR, MAE, MSE, CNR, SNR and qualitative analysis was performed by seven items for resolution and contrast from chest x-ray criteria of National Cancer Screening and Cardiovascular evaluation table. In the analysis of the quality of the energy per photon spectrum with the exception of a low energy region, without Al were superior in all area. PSNR MAE, MSE, CNR, SNR and qualitative analysis were the same or slightly better. PSNR was over 30 dB and all significant and the p>0.05 in the T-test of qualitative analysis. The energy spectrum and image quality have little difference between before and after use of Al filter. Therefore, it is effective to use the Al filter for the radiation dose management with the compensation capability of DR system.

• The Journal of the Korea Contents Association
• /
• v.15 no.10
• /
• pp.362-373
• /
• 2015

This study analysed the effectiveness of aluminium(Al) filter in the added compound filtration for the removal of characteristic radiation from high atomic number material by DQE and image evaluation. 1mm Al was applied to each 0.1, 0.2, 0.3 mm copper and befere and after use were evaluated. Beam quality and DQE were tested by IEC regulations and image quality was evaluated by PSNR, MAE, MSE, CNR, SNR and qualitative analysis was performed by 7 items for resolution and contrast from chest x-ray criteria of national cancer checkup. MTF 10 and 50% were the same by 4.6, 2.54 cycle/mm and NPS, DQE, PSNR MAE, MSE, CNR, SNR and qualitative analysis were all the same or slightly better when Al was not used. PSNR is over 30dB and all significant and at the qualitative analysis, the p-value of t-test was over 0.05. The DQE and image quality evaluation have little difference between before and after use of Al filter and it is effective to use the Al filter for the reduction of skin dose by removal of characteristic radiation.

• Tuberculosis and Respiratory Diseases
• /
• v.40 no.4
• /
• pp.390-394
• /
• 1993

Background: Bronchiectasis is characterized by chronic sputum production and complications such as hemoptysis and repeated infections. Even though some patients are cured by surgical resection of bronchiectatic lesions, most bronchiectasis patients can not be treated surgically because of multiple site involvement, and they are treated by medical measures such as postura1 drainage and antibiotics when indicated. Recently there have been some reports that low-dose longterm erythromycin treatment is effective on bronchiectsis, and it is well known that low-dose longterm erythromycin treatment is the treatment of choice in diffuse panbronchiolitis which is characterized by chronic sputum production and dyspnea. To evaluate the efficacy of erythromycin, we tried erythromycin on twenty five stable bronchiectasis patients for more than six months. Methods: We tried erythromycin 250 mg b.i.d. for more than 6 months. We checked respiratory symptoms, chest PA, spirometry, and side effects before treatment and after 3 and 6 months of treatment. Results: 1) 32% of the patients showed marked improvement of symptoms and PFT. 32% showed slight improvement of symptoms with little change of PFT, and 36% showed no change of symptoms and signs. 2) Analysis of the patients showing marked improvement revealed that most of them had diffuse bronchiectasis and paranasal sinus involvement. Conclusion: These results suggest that low-dose longterm erythromycin treatment can be tried on diffuse bronchiectasis patients with sinus involvement. And further studies will be followed on the mechanism of erythromycin in bronchiectasis.

• Journal of Chest Surgery
• /
• v.33 no.9
• /
• pp.697-706
• /
• 2000

Background: Isolated lung perfusion(ILP) was developed as a new treatment approach to non-resectable primary or metastatic lung cancer, because of its ability to reduce systemic toxicity while delivering high-dose chemotherapeutic agents to the target organs. This research was planned to evaluate the direct toxic effect of high-dose cisplatin to the lung tissue during isolated lung perfusion. Material and Method: Fifteen mongrel dogs were divided in the perfusate for 40 minutes. The second group was composed of 5 mongrel dogs which underwent ILP with cisplatin 2.5 mg/Kg added to the perfusate for 30 minutes and 10 minutes with washing solution without cisplatin. The third group underwent the same procedure as the second group except cisplatin 5.0 mg/Kg in the perfusate. Activities of serum angiotensin converting enzyme(ACE), tumor necrosis factor-$\alpha$(TNF-$\alpha$), and concentration of serum lactate dehydrogenase(LDH) and blood urea nitrogen/creatinine (BUN/Cr) were analyzed in each groups at the time of pre-perfusion, 1 hour, 1 day, 1 week, and 2 weeks after ILP. Result: Serum ACE activities before and 1 hour, 1 day, 1 week, and 2 weeks after ILP in control group were 45.1$\pm$6.3, 44.6$\pm$9.3, 46.7$\pm$9.5, 50.8$\pm$9.1, 46.1$\pm$4.3 U/L. Those in cisplatin 2.5 and 5.0 mg/Kg groups were 49.4$\pm$12.6, 39.0$\pm$8.6, 42.3$\pm$15.9, 50.0$\pm$2.6, 53.8$\pm$8.3 and 55.5$\pm$12.3, 47.0$\pm$6.3, 45.1$\pm$6.9, 74.8$\pm$19.5, 60.2$\pm$12.0 U/L, respectively. Serum TNF-$\alpha$ activities in each group before and after ILP were 5.0$\pm$1.5 / 7.7$\pm$2.2 / 6.6$\pm$2.5 / 4.3$\pm$1.3 / 5.2$\pm$1.1(control), 8.7$\pm$1.6 / 9.9$\pm$2.2 / 7.9$\pm$1.5 / 6.3$\pm$2.2 / 7.4$\pm$2.4 (cisplatin 2.5 mg/Kg), and 6.9$\pm$0.7 / 8.9$\pm$3.4 / 7.9$\pm$4.0 / 3.3$\pm$0.9 / 5.8$\pm$1.3 pg/ml(cisplatin 5.0 mg/Kg). Mean LDH levels of each group were 225.7 / 271.3 / 328.9 / 350.8 / 255.7(control), 235.7 / 265.7 / 336.0 / 379.5 / 299.2 (cisplatin 2.5 mg/Kg), and 259.6 / 285.2 / 340.6 / 433.4 / 292.4 IU/L(cisplatin 5.0 mg/Kg). So there was no significant difference in serum ACE, TNF-$\alpha$, and LDH activity changes after ILP between the 3 groups. And, there was no significant changes in BUN/Cr in each groups, which was independent of ILP and perfused concentration of cisplatin. In addition, all dogs survived the ILP and there was no significant evidence of pulmonary vascular injury after 2 weeks of ILP with cisplatin. Conclusion: There was no harmful effect of cisplatin to the lund tissue of the mongrel dog up to 5.0 mg/Kg in perfusate. Therefore, it is perceived to be safe and effective to deliver high-dose cisplatin to the lung without pulmonary toxicity and renal damage with ILP.

• Tuberculosis and Respiratory Diseases
• /
• v.60 no.4
• /
• pp.419-425
• /
• 2006

Background : Severe community-acquired pneumonia (CAP) can develop into respiratory failure that requires mechanical ventilation (MV), which is associated with a higher rate of mortality. It was recently reported that a hydrocortisone infusion in severe CAP patients was associated with a significant reduction in the length of the hospital stay and mortality. This study evaluated efficacy of a hydrocortisone infusion for patients with severe CAP requiring MV. Methods : From February 2005 to July 2005, 13 patients (M : F = 10 : 3, mean age: $68.6{\pm}14.1years$), who were diagnosed with severe CAP and required MV, were enrolled in this study. Hydrocortisone was administered as an intravenous 200mg loading bolus, which was followed by an infusion at a rate of 10mg/hour for 7 days. The control group was comprised of patients with severe CAP requiring MV but in whom corticosteroid was not used before study period. The clinical and physiologic parameters on or by day 8 and the outcome in the hydrocortisone infusion group were compared with those in the control group. Results : 1) There was no significant difference in age, gender ratio, SAPS II, SOFA score, temperature, leukocyte count, PaO2/FiO2 (P/F) ratio, the number of patients with P/F ratio < 200, chest radiograph score, lung injury score and catecholamine-dependent septic shock between the hydrocortisone infusion group and control group at day 1. 2) At day 8, the proportion of patients with an improvement in the P/F ratio ${\geq}100$ and the chest radiograph score was significantly higher in the hydrocortisone infusion group than in the control group (61.5% vs. 15.4%, 76.9% vs. 23.1%, p< 0.05). However, there was no significant difference in the other clinical and physiologic parameters. 3). There was no significant difference in the duration of the MV, ICU stay, hospital stay and 10th and 30th day mortality between the two groups. Conclusion : Hydrocortisone infusion for patients with severe CAP requiring invasive mechanical ventilation may be effective in improving the level of oxygenation and the chest radiograph score.