• 제목/요약/키워드: Terminal Cancer

검색결과 513건 처리시간 0.031초

간세포암 환자의 호스피스 완화 의료 (Hospice and palliative care for the terminal patients with hepatocellular carcinoma)

  • 길현자;문도호
    • 호스피스학술지
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    • 제7권2호
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    • pp.6-14
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    • 2007
  • Purpose: Hepatocellular carcinoma is the 3rd leading cause of cancer death in Korea and its prognosis is very poor. We aimed to investigate the clinical characteristics of terminal patients with hepatocellular carcinoma on admission into a hospice unit, and to know if they had received appropriate hospice and palliative care. Methods: We retrospectively reviewed the medical records in 62 patients with hepatocellular carcinoma who had admitted, received palliative care, and died in a hospice unit between January 2003 and December 2005. Results: The median age of patients was 56.5 years with 50 men(80.65%) and 12 women(19.35%) and gender ratio(male to female) was 417. Child-Pugh class A, B, and C were 6(9.68%), 22(35.38%), and 34(58.84%) respectively. We divided the patients into two groups and compared, the terminal HCC patients with class C as group I and those with class A & B as group 2. The median time from hospice referral to death was significantly short in group 1 with 15.5 days compared to group 2 with 53 days. Statistically more prevalent symptoms in group I were ascites, dyspnea, peripheral edema, and hepatic encephalopathy with abnormal laboratory findings (jaundice, hypoalbuminemia, or renal insufficiency). There, however, was no significant difference in complications and managements during admission between group 1 and 2. Conclusion: Most terminal HCC patients were often accompanied with chronic liver disease. The length of hospice and palliative care for above patients was not enough to attend them. Therefore, we suggest that proper education and information should be provided to physicians, patients, and their family members for effective hospice and palliative care.

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호스피스 병동의 암환자에서 경막외 모르핀 주입을 이용한 통증 조절 (Epidural Morphine for Pain Control in Patients with Terminal Cancer in Hospice Ward)

  • 이장은;허기훈;강유진;전연수;이옥경;심병용;김훈교
    • Journal of Hospice and Palliative Care
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    • 제11권3호
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    • pp.136-139
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    • 2008
  • 목적: 경막외 모르핀 주입을 시행 받은 호스피스 병동의 암환자에서 통증 조절의 효율성과 안전성, 합병증에 대해 알아보고자 하였다. 방법: 2001년 3월부터 2004년 3월까지 3년간 성빈센트병원 호스피스 병동에 입원한 환자 중 경막외 모르핀 주입을 시행한 24명에 대해 환자의 일반 특성과 모르핀 등가용량, 기저 질환, 도관의 거치기간 등에 대해 후향 적으로 자료 분석하였다. 결과: 환자들은 위암, 췌장암이 각각 5명으로 가장 많았으며 경막외 모르핀 주입 부위는 흉추가 15명으로 가장 많았다. 시행 당시의 기저 모르핀 등가 용량(morphine equivalent daily dose, MEDD)은 615 mg이었다. 경막외 모르핀 주입을 시행 받고 1주일 뒤의 MEDD는 274 mg으로 효과적인 통증 조절이 가능하였다(P-value=0.000). 경막외 도관을 제거한 환자는 6명으로 이중 3명은 재 삽입하였다. 도관의 감염으로 인하여 제거한 환자는 2명이었다. 결론: 호스피스 병동에서 시행한 경막외 지속적 모르핀 주입은 진행한 암 환자의 통증 조절에 효율적이었으며 도관의 위치 변동, 감염으로 인하여 제거한 경우가 있었으나 조절 가능한 합병증이었다. 다만 1일 주사용 모르핀 요구량이 100 mg일 때 경막하 모르핀 주입법을 통한 통증 조절을 권하더라도 동의를 얻는데 걸리는 기간 중 기저 질환의 악화 등으로 인한 투여 모르핀 용량의 증량으로 경막외 모르핀 주입 당시 평균 MEDD는 615 mg이었다. 향후 환자 및 보호자들에게 경막외 모르핀 주입의 효율성과 안전성에 대한 정보 제공이 필요할 것으로 생각한다.

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암의 비대칭적 성장, 혈관생성 및 혈류역학에 대한 수치적 연구 (Numerical Research about Asymmetric Growth of Cancer, Angiogenesis and Hemodynamics)

  • 김유석;심은보
    • 대한기계학회:학술대회논문집
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    • 대한기계학회 2007년도 춘계학술대회B
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    • pp.2951-2954
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    • 2007
  • Tumor hemodynamics in vascular state is numerically simulated using pressure node solution. The tumor angiogenesis pattern in our previous study is used for the geometry of vessel networks. For tumor angiogenesis, the equation that governed angiogenesis comprises a tumor angiogenesis factor (TAF) conservation equation in time and space, which is solved numerically using the Galerkin finite element method. A stochastic process model is used to simulate vessel formation and vessel. In this study, we use a two-dimensional model with planar vessel structure. Hemodynamics in vessel is assumed as incompressible steady flow with Newtonian fluid properties. In parent vessel, arterial pressure is assigned as a boundary condition whereas a constant terminal pressure is specified in tumor inside. Kirchhoff's law is applied to each pressure node to simulate the pressure distribution in vessel networks. Transient pressure distribution along with angiogenesis pattern is presented to investigate the effect of tumor growth in tumor hemodynamics.

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Design, Synthesis, and Preliminary Cytotoxicity Evaluation of New Diarylureas and Diarylamides Possessing 1,3,4-Triarylpyrazole Scaffold

  • Choi, Won-Kyoung;El-Gamal, Mohammed I.;Choi, Hong-Seok;Hong, Jun-Hee;Baek, Dae-Jin;Choi, Ki-Hang;Oh, Chang-Hyun
    • Bulletin of the Korean Chemical Society
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    • 제33권9호
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    • pp.2991-2998
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    • 2012
  • A series of new diarylureas and diarylamides possessing 1,3,4-triarylpyrazole scaffold was synthesized and their in vitro antiproliferative activities against A375P human melanoma cell line and NCI-60 cell line panel were tested. Compounds 9, 11, 12, 14, and 17-21 showed superior potency against A375P to Sorafenib. Over the NCI-60 cancer cell line panel, compound 14 possessing a methoxy group, amide linker, and 4-chloro-3-(trifluoromethyl)phenyl terminal ring showed the highest potency and broad-spectrum anticancer activity. Compound 13 showed high selectivity towards leukemia subpanel over other cancer types.

말기 암성통증을 위한 Totally Implanted Port System; 문제점과 합병증 (Totally Implanted Port System for Terminal Cancer Pain; Problems and Complications)

  • 홍기혁
    • The Korean Journal of Pain
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    • 제5권1호
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    • pp.23-28
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    • 1992
  • The use of epidural narcotics to treat cancer pain was first described by Behar et al in 1979. More recently, a variety of implantable INDSs have been described for long-term intraspinal narcotic administration. Especially, among these systems INDS typeIII which is designed by Poletti et al is relatively low cost and less risk of infection, therefore this system has been widely accepted but the clinical experience is insufficient yet. 1, Problems, 1) thorough education of patients and care-givers about this system the method of drug delivery and the situations could be happen in using this system. 2) high cost of continuous drug delivery system 3) legal problems about morphine carry-out in the case of bolus infusion by syringe 1. Complications; 1) by morphine; Significant respiratory depression was not found in all 21cases. other morphine-related complications were occurred occasionally but improved within a few days by appropriate treatment. 2) by system, Blockage or leakage of catheter was occurred in 2cases and wound infection was occurred in 2cases and so reimplantation was done.

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암성통증에 대한 척추내 신경 파괴제요법 (Intraspinal Neurolytic Block for the Treatment of Cancer Pain)

  • 최훈;최현규;김동찬;한영진
    • The Korean Journal of Pain
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    • 제4권1호
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    • pp.31-36
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    • 1991
  • Intraspinal alcohol or phenol administration has been used for the treatment of intractable pain due to terminal cancer. It has been alleged to produce good pain relief with minimal complication if performed carefully. We analysed 35 patients who received epidural or subarachnoid neurolytic block out of 83 patients with malignancy who were referrecl to our pain clinic. Most of the patients needed additional treatment modalities including epidural catheterization or systemic narcotic administration. The incidence of complication was high, especially when the neurolytic agents were administered in the lumbar region. This suggest that intraspinal neurolytic block is unreliable and unsafe, although it may temporarily reduce the analgesic requirement.

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Effect of Snake Venom Toxin on Inhibition of Colorectal Cancer HT29 Cells Growth via Death Receptors Mediated Apoptosis

  • Shim, Yoon Seop;Song, Ho Sueb
    • Journal of Acupuncture Research
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    • 제31권2호
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    • pp.87-98
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    • 2014
  • Objectives : We investigated whether snake venom toxin(SVT) from Vipera lebetina turanica sensitizes HT29 human epithelial colorectal cancer cells to tumor necrosis factor(TNF)-related apoptosis-inducing ligand(TRAIL) induced apoptosis in cancer cells. Methods : Cell viability assay was used to assess the inhibitory effect of TRAIL on cell growth of HT29 human colorectal cancer cells. And 6-diamidino-2-phenylindole(DAPI), terminal deoxynucleotidyl transferase mediated dUTP nick end labeling assay(TUNEL) staining assay were used to evaluate cell-apoptosis. Western blot analysis were conducted to observe apoptosis related proteins and death receptor. To assess whether the synergized inhibitory effect of SVT and TRAIL on reactive oxygen species(ROS) generation was reversed by strong anti-oxidative agent. Results : SVT with TRAIL inhibited HT29 cell growth different from TRAIL alone. Consistent with cell growth inhibition, the expression of TRAIL receptors; Expression of death receptor(DR)4 and DR5 was significantly increased and intrinsic pro-apoptotic cleaved caspase-3, -9 was subsequently increased together with increase of Bax/Bcl-2 ratio and extrinsic pro-apototic caspase-8 was also activated. In addition, the expression of anti-apoptotic survival proteins, a marker of TRAIL resistance(eg, cFLIP, survivin, X-linked inhibitor of apoptosis protein(XIAP) and Bcl-2) was suppressed by the combination treatment of SVT and TRAIL. Pretreatment with the ROS scavenger N-acetylcysteine abolished the SVT and TRAIL-induced upregulation of DR4 and DR5 expression and expression of the intrinsic pro-apoptotic caspase-3 and-9. Conclusion : The collective results suggest that SVT facilitates TRAIL-induced apoptosis in $HT_{29}$ human epithelial colorectal cancer cells through up-regulation of the TRAIL receptors; DR4 and DR5 and consecutive induction of bilateral apoptosis via regulating apoptosis related proteins.

Vanillin oxime inhibits lung cancer cell proliferation and activates apoptosis through JNK/ERK-CHOP pathway

  • Shen, Jie;Su, Zhixiang
    • The Korean Journal of Physiology and Pharmacology
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    • 제25권4호
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    • pp.273-280
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    • 2021
  • Lung cancer despite advancement in the medical field continues to be a major threat to human lives and accounts for a high proportion of fatalities caused by cancers globally. The current study investigated vanillin oxime, a derivative of vanillin, against lung cancer cells for development of treatment and explored the mechanism. Cell viability changes by vanillin oxime were measured using MTT assay. Vanillin oxime-mediated apoptosis was detected in A549 and NCI-H2170 cells at 48 h of exposure by flow cytometry. The CEBP homologous protein (CHOP) and death receptor 5 (DR5) levels were analysed by RT-PCR and protein levels by Western blotting. Vanillin oxime in concentration-dependent way suppressed A549 and NCI-H2170 cell viabilities. On exposure to 12.5 and 15 μM concentrations of vanillin oxime elevated Bax, caspase-3, and -9 levels in A549 and NCI-H2170 cells were observed. Vanillin oxime exposure suppressed levels of Bcl-2, survivin, Bcl-xL, cFLIP, and IAPs proteins in A549 and NCI-H2170 cells. It stimulated significant elevation in DR4 and DR5 levels in A549 and NCI-H2170 cells. In A549 and NCI-H2170 cells vanillin oxime exposure caused significant (p < 0.05) enhancement in CHOP and DR5 mRNA expression. Vanillin oxime exposure of A549 and NCI-H2170 cells led to significant (p < 0.05) enhancement in levels of phosphorylated extracellular-signal-regulated kinase and c-Jun N-terminal kinase. Thus, vanillin oxime inhibits pulmonary cell proliferation via induction of apoptosis through tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) mediated pathway. Therefore, vanillin oxime may be studied further to develop a treatment for lung cancer.

Microtubule Acetylation-Specific Inhibitors Induce Cell Death and Mitotic Arrest via JNK/AP-1 Activation in Triple-Negative Breast Cancer Cells

  • Suyeon Ahn;Ahreum Kwon;Youngsoo Oh;Sangmyung Rhee;Woo Keun Song
    • Molecules and Cells
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    • 제46권6호
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    • pp.387-398
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    • 2023
  • Microtubule acetylation has been proposed as a marker of highly heterogeneous and aggressive triple-negative breast cancer (TNBC). The novel microtubule acetylation inhibitors GM-90257 and GM-90631 (GM compounds) cause TNBC cancer cell death but the underlying mechanisms are currently unknown. In this study, we demonstrated that GM compounds function as anti-TNBC agents through activation of the JNK/AP-1 pathway. RNA-seq and biochemical analyses of GM compound-treated cells revealed that c-Jun N-terminal kinase (JNK) and members of its downstream signaling pathway are potential targets for GM compounds. Mechanistically, JNK activation by GM compounds induced an increase in c-Jun phosphorylation and c-Fos protein levels, thereby activating the activator protein-1 (AP-1) transcription factor. Notably, direct suppression of JNK with a pharmacological inhibitor alleviated Bcl2 reduction and cell death caused by GM compounds. TNBC cell death and mitotic arrest were induced by GM compounds through AP-1 activation in vitro. These results were reproduced in vivo, validating the significance of microtubule acetylation/JNK/AP-1 axis activation in the anti-cancer activity of GM compounds. Moreover, GM compounds significantly attenuated tumor growth, metastasis, and cancer-related death in mice, demonstrating strong potential as therapeutic agents for TNBC.

켑스트럼 파라미터를 이용한 후두암 검진 (Laryngeal Cancer Screening using Cepstral Parameters)

  • 이원범;전경명;권순복;전계록;김수미;김형순;양병곤;조철우;왕수건
    • 대한후두음성언어의학회지
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    • 제14권2호
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    • pp.110-116
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    • 2003
  • Background and Objectives : Laryngeal cancer discrimination using voice signals is a non-invasive method that can carry out the examination rapidly and simply without giving discomfort to the patients. n appropriate analysis parameters and classifiers are developed, this method can be used effectively in various applications including telemedicine. This study examines voice analysis parameters used for laryngeal disease discrimination to help discriminate laryngeal diseases by voice signal analysis. The study also estimates the laryngeal cancer discrimination activity of the Gaussian mixture model (GMM) classifier based on the statistical modelling of voice analysis parameters. Materials and Methods : The Multi-dimensional voice program (MDVP) parameters, which have been widely used for the analysis of laryngeal cancer voice, sometimes fail to analyze the voice of a laryngeal cancer patient whose cycle is seriously damaged. Accordingly, it is necessary to develop a new method that enables an analysis of high reliability for the voice signals that cannot be analyzed by the MDVP. To conduct the experiments of laryngeal cancer discrimination, the authors used three types of voices collected at the Department of Otorhinorlaryngology, Pusan National University Hospital. 50 normal males voice data, 50 voices of males with benign laryngeal diseases and 105 voices of males laryngeal cancer. In addition, the experiment also included 11 voices data of males with laryngeal cancer that cannot be analyzed by the MDVP, Only monosyllabic vowel /a/ was used as voice data. Since there were only 11 voices of laryngeal cancer patients that cannot be analyzed by the MDVP, those voices were used only for discrimination. This study examined the linear predictive cepstral coefficients (LPCC) and the met-frequency cepstral coefficients (MFCC) that are the two major cepstrum analysis methods in the area of acoustic recognition. Results : The results showed that this met frequency scaling process was effective in acoustic recognition but not useful for laryngeal cancer discrimination. Accordingly, the linear frequency cepstral coefficients (LFCC) that excluded the met frequency scaling from the MFCC was introduced. The LFCC showed more excellent discrimination activity rather than the MFCC in predictability of laryngeal cancer. Conclusion : In conclusion, the parameters applied in this study could discriminate accurately even the terminal laryngeal cancer whose periodicity is disturbed. Also it is thought that future studies on various classification algorithms and parameters representing pathophysiology of vocal cords will make it possible to discriminate benign laryngeal diseases as well, in addition to laryngeal cancer.

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