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Multidisciplinary Management of the Locally Advanced Unresectable Non-Small Cell Lung Cancer (수술 불가능한 국소 진행 비소세포성 폐암의 집합적 요법)

  • Cho, Kwan-Ho
    • Radiation Oncology Journal
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    • v.22 no.1
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    • pp.1-10
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    • 2004
  • Locally advanced (Stage III) non-small cell lung cancer (NSCLC) accounts for approximately one third of all cases of NSCLC. Few patients with locally advanced NSCLC present with disease amenable to curative surgical resection. Historically, these patients were treated with primary thoracic radiation therapy (RT) and had poor long term survival rates, due to both progression of local disease and development on distant metastases. Over the last two decades, the use of multidisciplinary approach has improved the outcome for patients with locally advanced NSCLC. Combined chemoradiotherapy is the most favored approach for treatment of locally advanced unresectable NSCLC. There are two basic treatment protocols for administering combined chemotherapy and radiation, sequential versus concurrent. The rationale for using chemotherapy is to eliminate subclinical metastatic disease while improving local control. Sequential use of chemotherapy followed by radiotherapy has improved median and long term survival compared to radiation therapy alone. This approach appears to decrease the risk of distant metastases,, but local failure rates remain the same as radiation alone. Concurrent chemoradiotherapy has been studied extensively. The potential advantages of this approach may include sensitization of tumor cells to radiation by the administration of chemotherapy, and reduced overall treatment time compared to sequential therapy; which is known to be important for improving local control in radiation biology. This approach Improves survival primarily as a result of improved local control. However, it doesn't seem to decrease the risk of distant metastases probably because concurrent chemoradiation requires dose reductions in chemotherapy due to increased risks of acute morbidity such as acute esophageal toxicity. Although multidisciplinary therapy has led to improved survival rates compared to radiation therapy alone and has become the new standard of care, the optimal therapy of locally advanced NSCLC continues to evolve. The current issues in the multidisciplinary management of locally advanced NSCLC will be reviewed in this report.

The Results of Curative Concurrent Chemoradiotherapy for Anal Carcinoma (항문암 환자에서 근치적 목적의 동시 항암화학 방사선치료의 결과)

  • Jeong, Jae-Uk;Yoon, Mee-Sun;Song, Ju-Young;Ahn, Sung-Ja;Chung, Woong-Ki;Nah, Byung-Sik;Nam, Taek-Keun
    • Radiation Oncology Journal
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    • v.28 no.4
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    • pp.205-210
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    • 2010
  • Purpose: To evaluate the predictive factors for treatment response and prognostic factors affecting survival outcomes after concurrent chemoradiotherapy (CCRT) for patients with anal squamous cell carcinoma. Materials and Methods: Medical records of forty two patients with histologically confirmed analsquamous cell carcinoma, who had complete CCRT between 1993 and 2008, were reviewed retrospectively. Median age was 61.5 years (39~89 years), and median radiotherapy (RT) dose was 50.4 Gy (30.0~64.0 Gy). A total of 36 patients had equal to or less than T2 stage (85.7%). Fourteen patients (33.3%) showed regional nodal metastasis, 36 patients (85.7%) were treated with 5-fluorouracil (5-FU) plus mitomycin, and the remaining patients were treated by 5-FU plus cisplatinum. Results: The median follow-up time was 62 months (2~202 months). The 5-year overall survival, loco regional relapse-free survival, disease-free survival, and colostomy-free survival rates were 86.0%, 71.7%, 71.7%, 78.2%, respectively. Regarding overall survival, the Eastern Cooperative Oncology Group (ECOG) performance status and complete response were found to be significant prognostic factors on univariate analysis. For multivariate analysis, only the ECOG performance status was significant. No significant factor was found for locoregional relapse-free survival or disease-free survival and similarly for treatment response, no significant factor was determined on logistic regression analysis. There were 7 patients who had local or regional recurrences and one patient with distant metastasis. The only evaluable toxicity in all patients was radiation dermatitis of perianal skin (grade 3), which developed in 4 patients (9.5%) and grade 2 in 22 patients (52.4%). Conclusion: This study revealed that patients with a performance score of ECOG 0-1 survived significantly longer than those with a poorer score. Finally, there was no significant predicting factors tested for treatment response.

Perineal Skin Toxicity according to Irradiation Technique in Radiotherapy of Anal Cancer (항문암의 방사선치료 시 방사선 조사 기법에 따른 회음부 피부 독성)

  • You, Sei-Hwan;Seong, Jin-Sil;Koom, Woong-Sub
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.222-228
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    • 2008
  • Purpose: Various treatment techniques have been attempted for the radiotherapy of anal cancer because of acute side effects such as perineal skin reactions. This study was performed to investigate an optimal radiotherapy technique in anal cancer. Materials and Methods: The study subjects included 35 patients who underwent definitive concurrent chemoradiotherapy for anal cancer in Yonsei Cancer Center between 1990 and 2007. The patients' clinical data, including irradiation technique, were reviewed retrospectively. The primary lesion, regional lymph nodes, and both inguinal lymph nodes were irradiated by $41.4{\sim}45\;Gy$ with a conventional schedule, followed by a boost does to the primary lesion or metastatic lymph nodes. The radiotherapy technique was classified into four categories according to the irradiation field and number of portals. In turn, acute skin reactions associated with the treatment interruption period were investigated according to each of the four techniques. Results: 28 patients (80.0%) had grade 2 radiation dermatitis or greater, whereas 10 patients (28.6%) had grade 3 radiation dermatitis or greater during radiotherapy. Radiation dermatitis and the treatment interruption period were relatively lower in patients belonging to the posterior-right-left 3 x-ray field with inguinal electron boost and in patients belonging to electron thunderbird techniques. The interruption periods were $8.2{\pm}10.2$ and $5.7{\pm}7.7$ for the two technique groups, respectively. Twenty-seven patients (77.1%) went into complete remission at 1 month after radiotherapy and the overall 5 year survival rates were 67.7%. Conclusion: Field size and beam arrangement can affect patients' compliance in anal cancer radiotherapy, whereas a small x-ray field for the perineum seems to be helpful by decreasing severe radiation dermatitis.

Establishment of Food Processing Methods for Larvae of Allomyrina dichotoma, Korean Horn Beetle (식약용으로의 장수풍뎅이 유충 전처리 방법에 대한 연구)

  • Chung, Mi Yeon;Kwon, Eun-Young;Hwang, Jae-Sam;Goo, Tae-Won;Yun, Eun-Young
    • Journal of Life Science
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    • v.23 no.3
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    • pp.426-431
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    • 2013
  • With the objective of developing a functional food source, we established optimal processing conditions for the larvae of Allomyrina dichotoma, which have been used in traditional medicine to treat hepatic disorders in Korea. Without suitable processing, the larvae are difficult to consume as a food because of their disgusting taste and smell; moreover, in this form they might be a potential microbial hazard. In this study, we investigated the effect of feeding material, sterilization, and powdering after freeze-drying on the food quality of the larvae of A. dichotoma and on cytotoxicity against Raw 264.7 cells. Three to five days feeding with the sawdust from discarded oak-trees is sufficient for the breeding process. The sawdust was sterilized by vapor for five minutes. Sterilization of the larvae at a high temperature ($115^{\circ}C$ for 5 min, 0.9 $kgf/cm^2$) is necessary to eliminate pathogenic bacteria and fungi. The results of the cytotoxicity assay showed no toxicity in the prepared extract from larvae of A. dichotoma. In addition, to prepare the larvae for human consumption, various feeds were used and the smell, color, and taste were evaluated. Our results suggested that larvae of A. dichotoma could be developed as food source when a suitable processing method is established.

Prevention of Photoaging and Wrinkle Formation in Hairless Mice Dorsal Skin by APB-03 (Hairless mice에서의 대두 홍삼 혼합 분말(APB-03)의 경구 반복 투여 시 피부 주름 생성 예방 효과)

  • Lee, Ji-Hae;Lee, Byoung-Seok;Yang, Mi-Suk;Byun, Bum-Sun;Kim, Wan-Gi;Kim, Bae-Hwan;Lee, Sang-Jun
    • Korean Journal of Food Science and Technology
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    • v.37 no.6
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    • pp.989-996
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    • 2005
  • Ultraviolet (UV) induces photo aging, erythema, sunburn, photo-toxicity, photo-allergy, and skin tumor, To investigate photo-protective effects of AmorePacific Beauty-03 (APB-03; mixture of red ginseng extract powder and soybean extract powder) on UV-induced damaged skins, 40 SKH hairless female mice were orally administered APB-03 or saline five times a week and irradiated with UV three times per week far up to 12 weeks. Visible skin changes and skin damage in dermis and epidermis by replica image analysis and histological analysis. In APB-03-treated group, better skin, negative replica appearance and less wrinkle formation were observed compared to the UV control group. These results demonstrate oral administration of APB-03 have photo-protective effects on UV-damaged hairless mouse skin.

Primer Evaluation for the Detection of Toxigenic Microcystis by PCR (독소 생성 Microcystis 검출을 위한 PCR primer의 평가)

  • 이현경;김준호;유순애;안태석;김치경;이동훈
    • Korean Journal of Microbiology
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    • v.39 no.3
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    • pp.166-174
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    • 2003
  • Microcystin produced by cyanobacteria in surface waters, such as eutrophic lake and river, is a kind of serious environmental problems due to its toxicity to human and wild animals. Microcystin is synthesized nonribosomally by the large modular multi-functional enzyme complex known as microcystin synthetase encoded by the mcy gene cluster. Amplification of mcy genes by PCR from cultures and environmental samples is a simple and efficient method to detect the toxigenic Microcystis. In order to evaluate primers designed to detect toxic microcystin-producing strains, 17 cyanobacterial strains and 20 environmental samples were examined by PCR with 7 pairs of primers. Some microcystin-producing cyanobacteria were not detected with FAA-RAA, TOX4F-TOX4R and FP-RP primers. The fragment of unexpected size was amplified with NSZW2-NSZW1 primers in Microcystis strains isolated from the lakes in Korea. TOX1P-TOX1F primers failed in amplification of toxin-producing strains. Only MSF-MSR and TOX2P- TOX2F primers amplified the fragments of mcy genes from 11 strains of microcystin-producing Microcystis. The water samples taken from 20 lakes in Korea were analyzed by PCR using each of the primers. In all the water samples, cyanobacteria capable of producing microcystin were detected by the PCR with TOX2P-TOX2F primers. These results indicate that TOX2P-TOX2F primers are better than the other primers for detection of microcystin-producing Microcystis strains in Korea. The nucleotide sequences of mcy gene in Microcystis aeruginosa NIER10010 suggest genetic diversity of Korean isolates.

Effects of Nitrogen Sources on RNA, DNA and other Phosphorus Fractions of Soybean Cultivars Different in Phosphorus Sensitivity (인산감수성(燐酸感受性)이 다른 대두품종(大豆品種)의 RNA, DNA 및 기타 인산형태(燐酸形態)에 대(對)한 질소원(窒素源)의 영향(影響)에 관한 연구(硏究))

  • Park, Hoon;Stutte, Charls A.
    • Applied Biological Chemistry
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    • v.19 no.3
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    • pp.172-183
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    • 1976
  • RNA, DNA and other phosphorus fractions were determined in the leaf and root of soybean plants different in phosphorus sensitivity grown in $NH_4-N,\;NO_3-N$ and urea medium. The phosphorus sensitive cultivars contained higher ASIP (acid soluble inorganic phosphorus) than the tolerant cultivars with all nitrogen sources. ASIP was highest in the urea treated plants and lowest in the nitrate treated plants. Total phosphorus content was mostly affected with increase in ASIP. When ASIP increased, acid solsuble organic phosphorus(ASOP), phospholipids (L-P), RNA-P, residual phosphorus (R-P) tended to increase, while DNA-P showed little change. The percent RNA-P or DNA-P of total phosphorus in the nitrate treated plant was twice that in the ammonium treated plant, which were also higher in tolerant cultivars regardless of nitrogen sources. The percent ASOP in total acid soluble phosphorus $(ASOP/ASP{\times}100)$ decreased as phosphorus sensitivity decreased. Indications are that phosphorus sensitivity depends on the relative sizes of phosphorus metabolic pools. Total dry matter yield was negatively correlated with total phosphorus (r=0.84 significant at 0.01P), ASIP (0.84 significant at 0.01P) and residual phosphorus (0.69 significant at 0.05P). ASOP showed positive correlation with L-P, RNA-P and DNA-P but negative with R-P. RNA-P was significanly correlated only with L-P (0.63 at P=0.01). There was significant interaction (0.01) among nitrogen sources, cultivars and phosphorus metabolic pools. Phosphorus sensitivity and ammonium toxicity appear to be same in view of energy metabolism, that is, the former inhibits the conversion of ATP to ADP (energy releasing) through phosphate potential while the latter inhibits ATP formation (energy storing).

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Whitening effect of extracts from Matricaria chamomilla L. with B16F10 melanoma cells (B16F10 melanoma cell을 이용한 캐모마일(Matricaria chamomilla L.) 추출물의 미백 효과)

  • Jo, Jae-Bum;Kim, Myung-Uk;Lee, Eun-Ho;Kim, Ye-Jin;Cho, Eun-Bi;Kang, In-Kyu;Cho, Young-Je
    • Journal of Applied Biological Chemistry
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    • v.61 no.3
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    • pp.267-273
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    • 2018
  • Matricaria chamomilla L. has been used as a bath agent in Europe because of its sterilization effect on the skin. Flowers contain terpenes, flavonoids are effective in relieving inflammation. Matricaria chamomilla L. has been reported to have various drug efficacies such as sedation, anti-diabetic effect and anti-arthritic effect, but there is little research on the scientific efficacy of whitening effect. The purpose of this study was to examine the whitening effect of Matricaria chamomilla L. extract and to investigate the mechanism of inhibition of melanogenesis. The extracts were used to determine tyrosinase inhibitory activity. The tyrosinase inhibitory activity of extracts was ineffective for water extract but in 60% ethanol extract was shown in a concentration-dependent manner. B16F10 melanoma cell was measured using a powder obtained by lyophilization of 60% ethanol extract. The toxicity was observed at a concentration of $75{\mu}g/mL$. And concentration range was selected to be at most $50{\mu}g/mL$. The effect of tyrosinase, MITF, TRP-1 and TRP-2 on the expression of melanin protein was investigated in melanoma cells of B16F10 melanoma cells. As a result, it was confirmed that as the concentration of the extract increased, the melanogenesis level decreased and the protein expression level also decreased in a concentration dependent manner. Therefore, it was concluded that Matricaria chamomilla L. extract inhibited melanogenesis in cells. Based on the above results, it is expected that it will be used as a useful basic data for industrialization of whitening functional food of Matricaria chamomilla L.

Packing effects on the intracavitary radiation therapy of the utaine lervix cancer ($^{192}Ir$source를 이용할 자궁경부암 강내치료시 사용하는 packing의 효과에 대한 고찰)

  • Cho, Jung-Kun;Lee, Du-Hyun;Si, Chang-Kun;Choi, Yoon-Kyung;Kim, Tae-Yoon
    • The Journal of Korean Society for Radiation Therapy
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    • v.16 no.1
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    • pp.73-77
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    • 2004
  • Purpose of the radio-therapy is maximize the radiation dose to the tumor while minimizing the dose to the critical organ. Carcinoma of the uterine cervix treatment are external irradiation or an interstitial brachtheraphy make use of isotope. Brachytherapy is a method of radiotherapy in advantage to achieve better local control with minimum radiation toxicity in comparison with external irradiation because radiation dose is distributed according to the inverse square low of gamma-ray emitted from the implanted sources. Authors make use of the patients data which 192Ir gives medical treatment intrcavity. Intracavitary radiation of the uterine cervix cancer, critical organ take $20\%$ below than exposure dose of A point in the ICRU report. None the less of the advice, Radiation proctitis and radiation cystitis are frequent and problematic early complications in patients treated with radiation for the uterine cervix cancer. In brachytherapy of uterine cervical cancer using a high dose rate remote afterloading system, it is of prime importance to deliver a accurate dose in each fractionated treatment by minimizing the difference between the pre-treatment planned and post-treatment calculated doses. Use of packing to reduce late complications intracavitary radiation of the uterine cervix cancer. Bladder and rectum changes exposure dose rate by radiotherphy make use of packing.

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Effects of C/N Ratio on Removal of Organic Matter and Nitrogen in Alternately Intermittently Aerated Nonwoven Fabric Filter Bioreactor (교대로 간헐 포기되는 부직포 여과막 생물반응조에서 C/N비가 유기물 및 질소 제거효율에 미치는 영향)

  • Ahn, Yun-Chan;Bae, Min-Su;Lee, Jong-Ho;Cho, Yun-Kyung;Cho, Kwang-Myeung
    • Journal of Korean Society of Environmental Engineers
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    • v.27 no.5
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    • pp.499-506
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    • 2005
  • This study was performed to investigate the effects of influent C/N ratio on the removal of organic and nitrogenous compounds by two nonwoven fabric filter bioreactors. The reactors were alternately aerated at an aeration/nonaeration period ratio of 60 min/60 min, and fed with wastewater only during nonaeration period. The influent C/N ratio (COD/TKN) was gradually reduced from 10 to 2. The influent was prepared by diluting the leachate from a foodwaste treatment facility in I city so that the COD concentration could be about 2,500 mg/L. The C/N ratio of the wastewater was adjusted by adding ammonium chloride. The results of the experiment showed that the COD and BOD concentration of the effluent was $40{\sim}54\;mg/L$ and $1{\sim}4\;mg/L$, respectively at the C/N ratios of $10{\sim}3$, and the effluent SS concentration was always below 2.0 mg/L. The T-N removal efficiencies were 96% or higher at C/N ratios of $10{\sim}5$, but decreased to 83% and 81%, respectively at the C/N ratios of 3 and 2.8. At the C/N ratios of 2.6 and 2, the effluent quality deteriorated due to ammonia toxicity. The fraction of nitrifying microorganism in the reactors increased from 10% to 20% as the C/N ratio decreased from 5 to 2.6. Alkalinity consumed were $3.12{\sim}3.49\;g$ alkalinity/g T-N removed at the C/N ratios of $10{\sim}5$, which are lower than the theoretical value of 3.57. However, the ratio increased to 4.63 and 4.87 g alkalinity/g T-N removed, respectively at the C/N ratios of 3 and 2.8.