• Journal of Life Science
• /
• v.30 no.6
• /
• pp.501-512
• /
• 2020

Sasa quelpaertensis Nakai leaf has been used as a folk medicine for the treatment of gastric ulcer, dipsosis, and hematemesis based on its anti-inflammatory, antipyretic, and diuretic characteristics. We have previously reported the procedure for deriving a phytochemical-rich extract (PRE) from S. quelpaertensis and how PRE and its ethyl acetate fraction (EPRE) exhibits an anticancer effect by inducing apoptosis in various gastric cancer cells. To explore the molecular targets involved in this apoptosis, we investigated the mRNA and microRNA profiles of EPRE-treated SNU-16 human gastric cancer cells. In total, 2,875 differentially expressed genes were identified by RNA sequencing, and gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses indicated that the EPRE-modulated genes are associated with apoptosis, mitogen-activated protein kinase, inflammatory response, tumor necrosis factor signaling, and cancer pathways. Subsequently, protein-protein interaction network analysis confirmed interactions among genes associated with cell death and apoptosis, and 27 differentially expressed microRNAs were identified by further sequencing. Here, GO and KEGG pathway analysis revealed that EPRE modified the expression of microRNAs associated with the cell cycle and cell death, as well as signaling of tropomyosin-receptor-kinase receptor, transforming growth factor-b, nuclear factor kB, and cancer pathways. Taken together, these results provide insight into the mechanisms underlying the anticancer effect of EPRE.

• Journal of Hospice and Palliative Care
• /
• v.20 no.2
• /
• pp.93-99
• /
• 2017

Purpose: This study investigated changes in life-sustaining treatments in terminally ill cancer patients after consenting to a do-not-resuscitate (DNR) order. Methods: Electronic medical records were reviewed to select terminally ill cancer patients who were treated at the oncology unit of the Asan Medical Center, a tertiary hospital in South Korea and died between January 1, 2013 and December 31, 2013. Results: The median (range) age of the 200 patients was 59 (22~89) years, and 62% (124 persons) were male. Among all patients, 83.5% were aware of their medical condition, and 47.0% of the patients had their DNR order signed by their spouses. The median of the patients' hospital stay was 15 days, and time from admission to DNR decision was 10 days. After signing a DNR order, 35.7~100% of the life-sustaining treatments that had been provided at the time of the DNR decision making were administered. The most commonly discontinued interventions were transfusion (13.5%), blood test (11.5%) and parenteral nutrition (8.5%). Conclusion: It is necessary to define the scope of life-sustaining treatments for DNR patients. Treatment guidelines should be established as well to secure terminal patients' death with dignity after their consent to a DNR order, thereby avoiding meaningless life-sustaining treatments and allowing administration of active terminal care interventions.

• Radiation Oncology Journal
• /
• v.4 no.1
• /
• pp.45-50
• /
• 1986

RTOG proposed a multivariate modelling system predicting the response of head and neck cancers to radiation therapy in 1984. The aim of this study was to veri(y whether PPC (Probaility of primary clearance calculated by a multivariate modelling system) had any correlation with the survival in the patients with carcinoma of the nasopharynx following radiation therapy Analysing 81 patients with carcinoma of the nasopharynx treated with radiotherapy between January 1, 1971 and December 31, 1983 at Yonsei University College of Medicine, Yonsei Cancer Center the actuarial 5 year survival rate was $36\%$ and median survival was 39 months. The survivals for Group 1 (27 who had more than $80\%$ of PPC), Group 2 (20 who had between 71 and $80\%$ of PPC), and Group 3 (29 who had less than $71\%$ of PPC) were $66\%$ (median survival months : more than 72), $27\%$ (31), and $4\%$ (12) respectively. There was a definite correlation between PPC and survival among the three groups.

• Journal of the korean veterinary medical association
• /
• v.25 no.10
• /
• pp.595-606
• /
• 1989

항원제시세포(APC)와 보조T세포 간의 협력작용에 의하여 활성화된 작동세포(NK세포, CTL, K세포, 대식세포, 과립구 등)의 종양세포, 이식장기 및 세포내기생세균에 감염된 각종 세포에 대한 세포독성작용은 생체방어를 위한 중요한 세포성면역기전이다. 지난 몇 년간 세포성면역기전에 관한 많은 연구에도 불구하고 T림파구매개성 세포독성작용의 면역생물학적기전은 확실히 밝혀있지 않다. 지금까지 알려진 중요한 연구내용을 요약하면 다음과 같다. 1. 세포독성작용을 나타내는 작동세포로는 NK세포, CTL, K세포, 대식세포/단핵구 및 과립구가 있다. 2. T세포의 세포표면항원분자군(CD)으로는 $CD_{2},\;CD_{3},\;CD_{4}[Ly_{3}T_{4}],\;CD_{5}[=Ly_{1}],\;CD_{7},\;CD_{8}[Ly_{2,3}]$가 있으며 $CD_{4}$는 보조Ttpvhdml 특이마커이고 $CD_{8}$는 세포독성 T세포 및 억압T세포의 특이마커이다. 주요 T세포수용체(TCR)는 $CD_{4}$ 또는 $CD_{8}$ 분자와 가까이 연합된 이향체($TCR-{\alpha}{\beta}/TCR-{\gamma}{\delta}$이며 보조 T세포 $CD_{4}$(마우스 $L_{3}T_{4}$)는 수용체와 연합되어 있는반면 억압 T세포 $CD_{8}(Ly+_{2,3})$는 항원수용체와 연합되어 있다. 3. T세포는 Ti-$CD_{3}$(항원/MHC) 복합체를 통한 '항원가교'에 의한 자극(항원인식)과 $CD_{2}$를 통한 비특이경로에 의하여 활성화(분화증식)된다. 비특이경로를 통한 활성경로에서 T세포($CD_{4}$ 및 $CD_{8}$)가 활성화되기 위하여는 보조T세포가 생산하는 IL-2을 요구하며 IL-2의 자극으로 분화증식된 $CD_{8}$는 세포독성능을 나타내지만 $CD_{4}^{+}$는 여전히 세포독성능을 나타내지 못한다. 4. 보조T세포는 class II MHC분자와 연합된 항원을 식별하는 반면 세포독성T세포는 class I MHC 분자와 연합된 항원을 식별한다. 5. 림파구 매개성 세포독성은 접촉(conjugati-on), 탈분극(depolarization), 용해계획(progra-mming), 용해(lysis) 및 재순환(recycling)의 단계를 거쳐 진행된다. 6. 표적세포살해매체로는 perforin / PFP / cy-tolysin, lymphopores, lymphotoxins, protone, cytolytic enzymes가 알려졌으며 세포독성작용은 이들 이외에도 여러 가지 매체를 통한 복합작용으로 추정된다. 7. CTL 매개성 표적세포의 주요 대사변화는 actomyocin ATPase의 증가, phosphocreatine과 ATPase의 소모, ATP 의존성 $Na^{+}/K^{+}$ 펌프작용의 중지, ATP 의존성 $Ca^{2+}$ 유출감소 및 세포내 축적이 관찰된다. 8. $Ca^{2+}$의 축적으로 세포막 교질 침투손상을 주어 수분의 유입을 증가시킴으로써 수포형성, 핵붕괴, 사립체팽화 및 정상세포 구조상실(Zeiosis)이 있다. 결론적으로 CTL 매개성 세포독성작용은 PFP, LT, TNF, 유사 TNF / LT 및 기타 매체를 통한 복합작용이며 세포살해기전은 지속적 대사소모와 정형적 세포구조(핵 및 세포질)의 파괴에 의한 것이다.

• Radiation Oncology Journal
• /
• v.19 no.1
• /
• pp.10-15
• /
• 2001

Purpose : This is a retrospective study to evaluate the results of radiation therapy in nasopharyngeal carcinoma. Materials and Methods : From September 1989 to October 1996, 19 patients with nasopharyngeal carcinoma completed planned radiation therapy course. Stages were 1 in 2 patients, II in 6, III in 2 IV in 9 patients, respectively. Pathology was squamous cell carcinoma in 5 patients, undifferentiated cell carcinoma in 14 patients. Fourteen patients were treated with radiation therapy only. Five patients received chemotherapy. The follow-up period ranged from 5 months to 115 months with a median of 33 months. Follow-up was possible in all patients. Results : Responses to radiation therapy were complete response in 15 patients, partial response in 2, and no response in 2, respectively. Patterns of failure were as follows : locoregional recurrence in 6 patients and distant metastasis in 4 patients. The sites of distant metastasis were bone, liver and lung. Five year survival rate was $47.8\%$ and five year disease free survival rate was $48.1\%$. Stage, T-stage, N-stage, central nervous system involvement, pathology type, performance status, response, radiation dose, chemotherapy were not significant prognostic factors. Conclusion : 5-year survival rate was $47.8\%$ and 5-year disease free survival rate was $48.1\%$. The advances in radiation therapy techniques and chemotherapy are needed.

• Radiation Oncology Journal
• /
• v.12 no.1
• /
• pp.109-115
• /
• 1994

The purpose of this paper is to develop an efficient method for the quick determination of multiple isocenters plans to provide optimal dose distribution in sterotactic radiosurgery. A Spherical dose model was developed through the use of fit to the exact dose data calculated in a 18cm diameter of spherical head phantom. It computes dose quickly for each spherical part and is useful to estimate dose distribution for multiple isocenters. An automatic computer search algorithm was developed using the relationship between the isocenter move and the change of dose shape, and adapted with a spherical dose model to determine isocenter separation and cellimator sizes quickly and automatically. A spheric81 dose model shows a comparable isodose distribution with exact dose data and permits rapid calculations of 3-D isodoses. the computer search can provide reasonable isocenter settings more quickly than trial and error types of plans, while producing steep dose gradient around target boundary. A spherical dose model can be used for the quick determination of the multiple isocenter plans with 3 computer automatic search. Our guideline is useful to determine the initial multiple isocenter plans.

• Radiation Oncology Journal
• /
• v.11 no.1
• /
• pp.103-108
• /
• 1993

Among the patients with rectal cancer who entered Yonsei University Hospital for management from Jan. 1980 to Dec. 1990, we selected 23 subjects who were received surgical resection of tumor in rectum, and who proved to have liver metastasis during the diagnostic work-up, at the time of the operation, or within 3 months after starting definitive treatment. With those subjects, we investigated the role of radiation therapy by comparison of the treatment results of the patients without radiation therapy (S group) with those of the patients with radiation therapy to the primary site (S+R group). The local control rates of S group and S+R group were $64{\%}$ and $89{\%}$, and 2-year survival rates were $50{\%}$ and $78{\%}$, respectively. Although there was not statistically meaningful difference, local control rate and 2-year survival rate were higher in the group with radiation therapy to primary site than that without radiation therapy. The 2-year survival rates of the case with resection of the liver and the case without it were $63.6{\%}$ and $58.3{\%}$ respectively, which was not statistically significant. Also, the 2-year survival rate of the case with sustained local control was higher than that of the case with local failure, which was statistically significant ($76.5{\%}$ and $16.7{\%}$, p<0.005). From the above results, it is thought that radiation therapy to the primary site might improve the local control rate even in the patients with liver metastasis, which seems to be correlated to the higher survival rate.

• Radiation Oncology Journal
• /
• v.11 no.1
• /
• pp.109-117
• /
• 1993

To analyze biochemical changes of liver function following combined radiotherapy and hyperthermia, we reviewed retrospectively 37 patients with hepatocellular carcinoma treated with radiotherapy and hyperthermia between July 1988 and December 1990 at Department of Radiation Oncology, Yonsei University College of Medicine. Mean age was 52.7 years and male to female ratio was 11:1. The patients were classified as follows; to A and B group by Child's classification, to M and L group by irradiated volume, and subclassified into BM, BL, AM and AL group according to the combination of Child's classification and irradiated volume. Radiation dose to the primary tumor was 3060 cGy with daily 180 cGy, 5 fraction per week using 10 MV or 4 MV linear accelerator. Hyperthermia (Thermotron RF-8) was performed more than 4 times in all patients. Biochemical parameters including albumin (Alb), total bilirubin (T. Bil), aspartate aminotransferase (AST or SGOT), alanine aminotransferase (ALT or SGPT), and alkaline phosphatase (ALP) were regularly followed from 1 week before the treatment to 3 months after the treatment. The results are summerized as follows; 1) In all the patient, mean ALP level peaked at 1 month, decreased at 2 months, slightly increased at 3 months after the treatment. Mean SGOT and SGPT levels peaked at 1 month after the treatment. Mean T. Bil level increased continuously and highest at 3 months after the treatment. Mean Alb level did not show significant changes.; 2) Mean ALP level retured to normal level at 3 month after the treatment in A but increased in B group and the differences were statistically significant (p<0.01). Mean SGOT and SGPT levels peaked 1 month in A and 2 months after the treatment in B group. All the biochemical parameters did not show significant difference between M and L group. Mean ALP level increased at 3 months after the treatment in BM and BL groups and decreased in AM and AL groups. Mean SGOT level increased at 3 months after the treatment in BL groups.; 3) Hepatic failure occurred within 3 months after the treatment in 4 patients, all of whom were in BL group. It is suggested that pre-treatment liver function and irradiated volume influence biochemical changes of liver in patients with hepatocellular carcinoma following combined radiotherapy and hyperthermia, and this treatment modality appears generally to be safe but might cause hepatic failure particularly in patient with poor liver function and large treatment volume.

• Radiation Oncology Journal
• /
• v.5 no.2
• /
• pp.131-136
• /
• 1987

Forty seven patients with locally recurrent uterine cerival cancer after surgery were treated with radiation during the 6 year period from 1979 through 1984 at the Department of Therapeutic Radiology of Seoul National University Hospital. In 30 out of the 47 patients, recurrence was diagnosed within 2 years after surgery. Site of recurrence was vagina in 19 patients, vagina and parametrium in 21 patients and parametrium only in 7 patients. Complete tumor control was achieved in 35 patients $(74.5\%)$; the complete response rates were $94.7\%(18/19)$ in vaginal recurrences, $57.1\%(12/21)$ in combined vaginal and parametrial recurrences and $71.4\%(5/7)$ in parametrial recurrences. Overall and disease free survival rates at 4 years were 55.2 and 50.1 percent, respectively, for entire group. Overall 4 year survival rates were $77.0\%$ for vaginal recurrences, $44.1\%$ for vaginal and parametrial recurrences and $42.9\%$ for parametrial recrrences. When the disease extent was classified in the same way as the staging system of FIGO, the 4 year survival was 80.4, 73.0, 25.0 and 0 percent for stage IIa, IIb, IIIb and IVa, respectively.

• Radiation Oncology Journal
• /
• v.20 no.4
• /
• pp.391-395
• /
• 2002

Purpose : To confirm the accuracy of the radiation dose at the isocenter by the standard linear accelerator-based stereotactic radiosurgery technique which was developed at Seoul National University Hospital. Materials and Methods : Radiation dosimetry was undertaken during standard 5-arc radiosurgery using 6 MV X-ray beam from CL2100C linac. The treatment head was attached with circular tertiary collimators of 10 and 20 mm diameter. We measured the absorbed dose at the isocenter of a multi-purpose phantom using two kinds of detector : a 0.125 co ionization chamber and a silicon diode detector. Results : The dose differences at each arc plane between the planned dose and the measured dose at the isocenter raged from $-0.73\%\;to\;-2.69\%$ with the 0.125 cc ion chamber, and from $-1.29\%\;to\;-2.91\%$ with the diode detector during radiosurgery with the tertiary collimator of 20 mm diameter. Those with the 10-mm tertiary collimator ranged from $-2.39\%\;to\;-4.25\%$ with the diode. Conclusion : The dose accuracy at the isocenter was ${\pm}3\%$. Therefore, further efforts such ws modification in processing of the archived image through DICOM3.0 format are required to lessen the dose difference.