• Radiation Oncology Journal
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• v.14 no.4
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• pp.291-297
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• 1996

Purpose : This study was performed to evaluate survival, failure patterns, and prognostic factors of MMR patients after radiation therapy. We also discussed the need for chemotherapy. Materials and Methods : A retrospective analysis was done for 23 patients with MMR who were treated with radiation therapy from June 1985 to November 1992. There were 19 male and 4 female patients, The patients' age ranged from 17 to 71 years (median 39 years). Systemic symptoms including fever, weight loss, or malaise were found in $30\%$ of the patients. The nasal cavity was most frequently involved No patients had nodal involvement at diagnosis. There were 2 patients with distant metastasis at presentation. Radiation therapy was delivered five times a week, 1.8 Gy daily, total $45\~54$ Gy (median 50.4 Gy) using 6 MV X-ray No patients received chemotherapy as initial treatment. Results : Overall 5-year and 10-year survival rates were $52.4\%$ and $44.1\%$, respectively. Seventy Percent(12/17) of the patients achieved complete response to radiotherapy, and $29.4\%$ (5/17) achieved partial response. The Patients with complete response showed a better 5-year survival rate than those with partial response ($66.9\%$ vs. $20\%$. p=0.004). Symptom duration before diagnosis, the presence of systemic symptom, and the number of primary sites had no influence on survival. The patterns of failure were as follows: local failure(1), failure in adjacent site(1), local and distant failure(1) distant metastasis(2). and conversion to malignant lymphoma(1). We could not find factors associated with the patterns of failure. Conclusion : The most important facto associated with survival was the response to radiotherapy. Seventeen percent of the patients had distant metastasis, and the salvage after distant metastasis was not successful. However. about $50\%$ of the patients could achieve long-term survival with local radiation therapy alone. Therefore, chemotherapy of MMR should be done after a prospective randomized study for the factors associated with distant metastasis.

• Radiation Oncology Journal
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• v.15 no.4
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• pp.321-329
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• 1997

Purpose : It is well known that the risk of lymph nodes metastases to head and neck cancers are influenced by the location and size of the Primary tumor. as well as the degree and types of histological differentiation. However, data on the statistical analyses of lymph node metastases from the head and neck cancers among Korean Population are not available at present. In order to obtain current status of such data, we have analyzed cancer patients at the department of radiation oncology, korea universityhospital for radiation treatment. Materials and Methods : We have evaluated nine-hundred and ninetyseven (997) head and neck cancer Patients who visited to the Department of radiation oncology, between November 1981 to December 1995. After careful physical examinations and CAT scan, Patients were divided into two groups, those with positive lymph node metastases and with negative lymph node metastases. The nodal status were classified according to the TNM system of American Joint Committee on Cancer (AJCC) Besults : Four-hundred and sixteen Patients out of the 997 patients were lymph node positive $(42\%)$ and 581 patients were lymph node negative $(58\%)$ when they were first presented at the department of radiation oncelogy. According to the AJCC classification, the distribution of positive lymph node is as follow: Nl:106 $(25.5\%),\;N2a:100\;(24\%),\;N2b:68\;(16.4\%),\;N2c:69\;(16.6\%),\;3:73\;(15\%).$ respectively. The frequency of lymph node metastases according to the primary sites is as follow : larynx 283 $(28.5\%)$, paranasal sinuses: 182 $(18\%),\;oropharynx:144\;(14.5\%)\;nasopharynx:122(12\%),\;oral\;cavity\;92\;(9\%),\;hypopharynx:71\;(7\%),\;falivary\;gland:58\;(6\%)$ unknown primary:31 $(3\%),\;skin:\;14(2\%)$,. The most frequent Primary site for the positive Iymph node metastases was nasopharynx $(71\%)$ followed by hypopharynx $(69\%),\;oropharynx\;(64\%),\;oral\;cavity\;(39\%)$ The most common histologic type was squamous cell carcinoma (652/997: $65.4\%$). followed by malignant lymphoma $(109/997:11\%)$. Conclusion : Statistical results of lymph node metastases from head and neck cancer at our department were very similar to those obtained from other countries. It is concluded that the location of Primary cancer influences sites of metastases on head and neck, and stage of the primary cancer also influences the development of metastatic lesions. Since the present study is limited on the data collected from one institute. further statistical analyses on Korean cancer Patients are warrented.

• The Korean Journal of Nuclear Medicine
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• v.28 no.3
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• pp.384-390
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• 1994

Authors retrospectively compared the 99mTc MDP bone scans and corresponding MR imagings in 20 patients with histologically proven malignancy, Mean interval of the two studies was 16.6 days, Cancer diagnosis Included 8 lung, 2 each of colon, breast, stomach, 1 each of prostate, thyroid, malignant lymphoma and 3 adenocarcinoma of unknown primary site. Of the 105 regions compared, :t6 regions were positive for metastases in bone scans or MR imagings. 30 regions(65.2%) were positive by bone scan and 44 regions(95.7%) by MR imaging. 87 regions(82.9%) were concordantly positive or negative by bone scan and MR imaging, but 18 regions(17.1%) were discordant. In the discordant regions, 16 regions positive in MR imaging were negative in bone scan. The greatest number of discordant findings occured in the cervical region and in the patient with stomach cancer. Our results suggest that the sensitivity of MR Imaging is greater than that of bone scan in detecting spinal metastases. And bone scan is useful screening test of metastasis for evaluating entire skeleton including spine.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.5
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• pp.402-410
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• 2009

Purpose: The aim of this study was to determine the incidence and malignant rate of incidental asymmetric palatine tonsillar uptake (ATU) on $^{18}F$-FDG PET/CT in various clinical indications and to evaluate the clinical and PET/CT findings suggesting malignancy. Materials and Methods: We retrospectively reviewed a total of 2,901 patients ($58.4{\pm}12.3$ yrs, range 20~88 yrs, M:F = 1,841:1,060) who underwent $^{18}F$-FDG PET/CT during an 1-year period with various indications except primary tonsillar cancer and lymphoma evaluation. On $^{18}F$-FDG PET/CT, metabolic abnormality of the palatine tonsil and cervical lymph node were visually assessed. ATU was defined as increased palatine tonsillar uptake with diffuse, focal, or irregular pattern compared to contralateral side. The incidence and malignant ratio of ATU were evaluated according to clinical and PET/CT findings. Results: Of 2,901 cases, 290(10,0%) showed ATU. The incidence of ATU showed seasonal variation and was high in the winter (12.1%). Of 209 cases with ATU confirmed pathologically and/or clinically, five (2.4%) were malignant lesions. ATU with irregular uptake pattern (2/2) and in cases referred for cervical lymph node metastasis of unknown origin (3/5) were frequently associated with malignant lesion (p<0.05). Conclusion: ATU was not infrequently observed on $^{18}F$-FDG PET/CT, and the malignant risk of ATU was low. However, ATU with cervical lymph node metastasis or with irregular pattern on PET/CT would be further evaluated by the histopathologic examination.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.1
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• pp.31-40
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• 2005

Purpose: This study aimed to provide, as a basic material, the experiences of endoscopy in diagnosis and treatment of tumorous conditions in the upper gastrointestinal tract in children. Methods: The objects were 26 patients diagnosed as having tumorous conditions in the upper gastrointestinal tract among 1,283 patients who underwent upper gastrointestinal endoscopic examination at the Department of Pediatrics, Pusan National University Hospital, from January 1994 to July 2004 retrospectively. The characteristics of patients, the chief complaints for endoscopic examination, the sorts of tumors diagnosed, the endoscopic findings of tumors, and the treatment of tumors were analysed. Results: 1) Eleven male and fifteen female were included, whose mean age was $6.93{\pm}4.02years$. 2) The chief complaints for endoscopic examination were abdominal pain (80.7%), vomiting or nausea (30.8%), and gastrointestinal beeding (30.7%) in order. 3) Six cases of ectopic pancreas, five cases of sentinel polyp, three cases of papilloma and vallecular cyst, two cases of Brunner's gland hyperplasia and gastric submucosal tumor, one case of gastrointestinal stromal tumor, duodenal intramural hematoma, T cell lymphoma, lipoma, and Peutz-Jeghers syndrome were diagnosed by endoscopy with or without biopsy. 4) The location of tumors was in the pharynx (19.2%), esophagus (7.7%), gastro-esophageal junction (23.0%), stomach (30.7%) and duodeneum (26.9%). 5) The size of tumors was less than 10 mm in 53.8%, 10~20 mm in 26.9%, more than 20 mm 19.2%. 6) Treatments for tumors included resection by laser, surgical resection, endoscopic polypectomy with a forcep or snare, and observation 7) There was no significant complication. Conclusion: Various and not a few tumors were found in the upper gastrointestinal tract. The endoscopy was accurate, effective, and safe means for diagnosis and treatment of those lesions in children.

• Korean Journal of Head & Neck Oncology
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• v.14 no.2
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• pp.244-252
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• 1998

The thyroid nodules are the most common endocrine disease requiring surgical management. We perfomed a clinical study of 298 cases with thyroid nodules, who were admitted to and operated at the Department of Surgery, College of Medicine, Gyeong sang National University from January 1987 to April 1997 and the results were summarized as follows: 1) Patients were composed of 214 cases(71.8%) of benign nodule and 84 cases(28.2%) of malignant nodule. Benign and malignant nodules were prevalent in fifth decade. 2) The sex distribution showed a preponderance of females with ratio of 5.88:1 in benign nodule and 11:1 in malignant nodule. 3) The nodules were located in the right lobe(134 cases, 44.9%), the left lobe(121 cases, 40.6%), both lobes(34 cases, 11.4%), and isthmus(8 cases, 2.7%). The possibility of malignancy was higher in the solid rather than cystic lesions. 4) Radioactive iodine scintiscans were perfomed in 273 cases and revealed cold nodules in 237 cases(86.8%), 58 of these cases(24.4%) were malignant. 5) According to the histopathologic classification, benign nodules included follicular adenomas 136 cases(63.5%), adenomatous goiters 67 cases(31.3%), Hurthle cell adenomas 4 cases(1.9%), cysts 3 cases(1.4%) and thyroiditis 4 cases(1.4%). In malignant nodules, papillary carcinomas 72 cases(85.7%), follicular carcinoma 8 cases(9.5%), undifferentiated carcinoma 2 cases(2.4%), medullary carcinoma 1 case(1.2%) and malignant lymphoma 1 case(1.2%). 6) The most commonly performed operative procedure was a lobectomy with isthmusectomy(85.5%) for bengn nodules and a total thyroidectomy(51.2%) for malignant nodules. 7) The rate of complications was higher in the cases with malignant nodules(20.2%) than in the benign cases(0.5%). The recurrence rate was 8.3%(7 cases).

• Journal of Hospice and Palliative Care
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• v.12 no.4
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• pp.228-233
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• 2009

Purpose: The purpose of this study was to retrospectively examine the factors and characteristics of cancer patients who visited the emergency room, as well as to offer some educational materials for to manage acute symptoms. Methods: Data for this study were selected from the period of January to December, 2006. A total of 564 patients were examined using the tool which we developed by ourselves for the study. The collected data were analyzed using the SAS program for frequencies and percentage. Results: As for disease-related characteristics of the subjects, 28.9% of them had gastric and colorectal cancer; 66.9% were in stage 4; 51.6% had been in chemotherapy prior to visiting the emergency room; and 82.5% had their anticancer drug administrated average 1~5 times. As for the characteristics in regard to visit the emergency room, 62.9% were admitted to hospital within 2 weeks of being treated. As for chief complaints for visiting the emergency room, the worst symptom was pain, followed by symptoms such as gastro-intestinal symptoms, respiratory symptoms, high fever, and weakness. As for the disease-related symptoms, the worst symptom that gastric, colorectal, pancreatic, liver and gallbladder cancer patients complained of was pain, high fever for lymphoma patients was respiratory symptoms for lung cancer patients, and gastrointestinal symptoms for head and neck cancer and other patients. Conclusion: Therefore, according to their need and background, an individualized consultation and teaching program should be provided to cancer patients.

• Journal of Hospice and Palliative Care
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• v.7 no.2
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• pp.169-178
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• 2004

Purpose: The aim of the study was to assess changes of the attitudes and opinions about disclosure of cancer diagnosis to patients. Methods: We analyzed the attitudes and opinions of in-patients with metastatic cancer, their families, physicians, nurses, medical students, nursing students. Three questionnaires were used for in-patients, families, and surroundings in hospital. Data was collected in the St. Mary hospital for 3 months from October, 2002. We investigated the preference of disclosure, the reason the patients should be informed of disclosure, when, how and who to tell the cancer diagnosis to patients. 242 persons participated in these questionnaires (50 in-patients, 50 their families, 51 physicians and nurses, 41 medical students, 50 nursing students). Only 34 in-patients with metastatic cancer were enrolled, and so 16 in-patients with lymphoma were added. All in-patients were undergoing anticancer chemotherapy. Results: 89.3% of the participants wanted to be told about disclosure of cancer and terminal illness (in-patients 98.0%, their families 88.0%, physicians and nurses 90.2%, medical students 73.2%, nursing students 94.0%, in-patients with metastatic cancer 97.1%). 79.8% of the respondents hoped that the moment to tell the truth was immediately when the disease was diagnosed (in-patients 94.0%, their families 80.0%, physicians and nurses 68.6%, medical students 68.3%, nursing students 86.0%). 64.4% of all prefered to be told the truth once for alt including patients' diagnosis, present status and prognosis (in-patients 81.6%, their families 66.0%, physicians and nurses 56.0%, medical students 48.8%, nursing students 70.0%). Most indicated the first reason to be told the truth was the possibility to participate in treatment design. 86.4% responded that physicians were the proper persons to disclose the diagnosis. Conclusion: Not only in-patients, families but also physicians, nurses, medical students and nursing students all preferred the disclosure of cancer diagnosis. This preference was increased compared with the previous papers. The first reason to be told the truth was the possibility to participate in treatment design. Most of the participants wanted to be told the truth once for all.

• Tuberculosis and Respiratory Diseases
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• v.44 no.2
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• pp.264-279
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• 1997

Background : To analyze the morphologic characteristics of low density lymph node in etiologic differentiation of lymphadenopathy, emphasizing the different features between tuberculosis and lung cancer, on contrast enhanced CT scan. Method : A total of 64 patients who showed low density lymph nodes on chest CT scan were analyzed. Primary causes were tuberculosis (n=28), lung cancer (n=27), malignant lymphoma (n=5) and metastasis from extrathoracic malignancies (n=4). CT scan was performed with 10mm slice thickness and 7 characteristic features were evaluated : location, size, presence or absence of the nonnecrotic lymph node, calcification, perinodal fat obliteration, thickness and evenness of the enhancing rim. Results : In patients with tuberculous lymphadenopathy, lymph nodes with uneven (68.0%) and thick (62.1%) enhancing rim were more common than lung cancer (p<0.05). Low density lymph nodes with less than 1 cm in size were found only in tuberculous lymphadenopathy(n=10). In 48.2% of patients with lung cancer, more than 1 nonnecrotic enlarged lymph node were coexisted, whereas 21.4% in patients with tuberculous lymphadenopathy(p=0.06). However, the size, location and calcification were not statistically significant between tuberculous lymphadenopathy and lung cancer. Conclusion : Tuberculous lymphadenopathy is strongly suggested when enhancing rim of enlarged lymph nodes is uneven and thick, when the coexisting nonnecrotic lymph nodes are few in number and when central low density is encountered in normal sized lymph nodes.

• Tuberculosis and Respiratory Diseases
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• v.46 no.3
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• pp.327-337
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• 1999

Background: Reactive oxygen species are involved in multi-stage process of carcinogenesis. The moot of cancer cell lines and cancer cells in tumor tissue produce reactive oxygen species and on the other hand, the activities of catalase, Mn- and CuZn-superoxide dismutase in tumor cells are usually low. These persistent oxidative stress in tumor tissue facilitates tumor invasion and metastasis. 12-kDa thioredoxin, which regulates the intracellular redox potential with glutathione and glutaredoxin is involved in cell activation, proliferation, differentiation and redox-mediated apoptosis. It is also purified as 14-kDa and 10-kDa eooinophilic cytotoxic enhancing factor(ECEF) from human histiocytic cell(U937) and 10-kDa ECEF has more than 20 times eosinophilic stimulation activity than 14-kDa ECEF. It has been reported that adult T-cell leukemia, squamous cell carcinoma of uterine cervix, and hepatocellular carcinoma show increased amounts of human thioredoxin and thioredoxin mRNA is increased in lung cancer. In this study, we investigated the expression of conventional antioxidant enzymes such as catalase, CuZn-SOD, and glutathione peroxidase and thioredoxin in lung cancer tissue compared to adjacent normal lung tissue and the induction of thioredoxin in macrophage cells after treatment of oxidative stress and endotoxin Methods: We measured the amount of conventional antioxidant enzymes such as catalase, CuZn-SOD, and glutathione peroxidase and thioredoxin in lung cancer tissue compared to adjacent normal lung tissue by immunoblot analysis and the induction of thioredoxin in mouse monocyte-macrophage cells(RAW 264.7) by treatment of 5 ${\mu}M$ menadione and 1 ${\mu}g/ml$ endotoxin Results: On immunoblot analysis, the expression of 12-kDa thioredoxin was increased in lung cancer tissue compared to paired normal lung tissue. but the expression of catalase and CuZn-SOD were decreased in lung cancer tissue compared to paired normal tissue and the expression of glutathione peroxidase in lung cancer was variable. The expression of truncated thioredoxin was also increased in lung cancer. When mouse monocyte-macrophage cells were treated with 5 ${\mu}M$ menadione and 1 ${\mu}g/ml$ endotoxin, the expression of thioredoxin was peaked at 12 hrs and sustained to 48 hrs. Conclusion: In contrast with other conventional antioxidants, the expression of 12-kDa and truncated thioredoxin in lung cancer were increased and it is closely associated with persistent oxidative stress in tumor microenvironment. Considering especially the biological functions of truncated thioredoxin, the increased amount of truncated thioredoxin has significant role in tumor growth through cell proliferation.