• Title/Summary/Keyword: 골수암

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Tumor Prosthetic Arthroplasty and Arthroplasty with Bone Cement for the Metastatic Malignant Bone Tumor in the lower Extremity (하지 관절 부위에 발생한 전이성 종양 환자의 종양 대치물 및 골시멘트와 인공관절 삽입술)

  • Yang, Jun-Young;Lee, June-Kyu;Hwang, Deuk-Soo;Shin, Hyun-Dae;Kwak, Sang-Koo;Kim, Kyung-Cheon;Nam, Dae-Cheul
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.12-17
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    • 2003
  • Purpose: In this report we are going to discuss about the functional evaluation and the outcome of treatment of metastatic tumor in the lower extremities treated with tumor prosthetic arthroplasty. Materials and Methods: This report is based on nine patients diagnosed as a metastatic tumor and treated by tumor prosthetic arthroplasty, from June 1998 to December 2001. Age of the patients ranged from 49 to 63 with the average of 56.3. The average follow up period was 23.4 months. Two patients had lung cancer, three had breast cancer, two had renal cancer, one colon cancer, and one had multiple myeloma. All these were primary cancers. The site of metastasis were six in proximal femur, two in distal femur, and one in proximal tibia. Tumor excision was performed after biopsy in following the principle of primary tumor management. Excision with wide surgical margin was tried as possible could. Six cases were treated with tumor prosthesis, and the other three cases were reconstructed with bone cement and arthroplasty. Results: The functional evaluation in the extremities at the last follow up was performed on Enneking evaluation score with 6 categories. The highest scored 26, and the lowest scored 10, with an average of 19.5. A case in which the patient died 15 days after the operation was excluded from the evaluation. Among the categories, emotional acceptance to postoperative function and pain relief were highly scored. At the final follow up, seven patients survived, and one colon cancer patient died 68 days after operation. Conclusion: Metastatic tumor occurring in joints of lower extremities could be treated in accordance to the treatment principle of primary tumor. By insertion of tumor prosthesis, we can get satisfactory results of function in the lower extremity and pain relief especially. So, this aspect of medical favor must be considered in treating patients.

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Immune Stimulation and Anti-Metastasis of Crude Polysaccharide from Submerged Culture of Hericium erinaceum in the Medium Supplemented with Korean Ginseng Extracts (수삼추출물 첨가 배지에서 배양된 노루궁뎅이버섯 균사체 심부발효물 조다당획분의 면역 및 암전이 억제활성)

  • Kim, Hoon;Park, Chang-Kyu;Jeong, Jae-Hyun;Jeong, Heon-Sang;Lee, Hyeon-Yong;Yu, Kwang-Won
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.11
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    • pp.1535-1542
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    • 2009
  • To find the new use of Korean ginseng and mushroom, crude polysaccharides were prepared from submerged cultures of Hericium erinaceum in the medium supplemented with Korean ginseng extracts. When we fractionated crude polysaccharides (HE-GE-CP-1, 3, and 5) from hot-water extracts of submerged cultures of H. erinaceum with ginseng extracts (1%, 3%, and 5% addition of total medium), the yields of HE-GE-CP-1, 3, and 5 were identified at 5.7, 5.1, and 4.8%, respectively. Among crude polysaccharide fractions, HE-GE-CP-5 was significantly higher (1.89-fold of the saline control) than those of HE-GE-CP-1 (1.64-fold) or HE-GE-CP-3 (1.76-fold) on mitogenic activity of splenocytes. HE-GE-CP-5 also had the more potent bone marrow cell proliferation (1.83-fold) rather than HE-CP or HE-GE-CP-1 or HE-GE-CP-3 (1.59- or 1.44- or 1.69-fold, respectively), and anti-metastatic activity as anti-cancer effect showed the highest prophylactic value (72.4% inhibition of tumor control) in 5% supplementation of ginseng extract. However, the lysosomal phosphatase of macrophage was significantly stimulated after HE-GE-CP-3 treatment (2.03-fold). In addition, the immunostimulating and anti-metastatic crude polysaccharide, HE-GE-CP-5, contained mainly neutral sugars (63.2%) with considerable amounts of uronic acid (19.3%) and a small amount of proteins (8.8%). HE-GE-CP-5 can stimulate immune system to inhibit tumor metastasis, and its anti-tumor metastasis may be associated with macrophages, splenocytes and Peyer's patch cells activation.

Surgical Treatment of Metastatic Tumor in Pelvis (골반부 전이성 종양의 수술적 치료)

  • Kim, Jae-Do;Park, Woong;Jo, Myung-Rae;Son, Jung-Whan;Lee, Young-Gu
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.2
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    • pp.61-70
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    • 2004
  • Purpose: We studied to decide the operative indication of the metastatic tumor in pelvis according to the oncologic results, the Eastern Cooperative Oncologic Group (ECOG) performance status and complication. Materials and methods: From May 1994 to May 2003, 9 patients who were performed on palliative treatment and 10 paitents on operative treatment due to metastatic tumor of pelvic bone were investigated. On palliative/operative group, the mean age of patients was 57.6/48.0 years old and the ratio of male to female was 5:4/7:3. Primary origins were 3 cases from kidney, 3 from cervix and 2 of lung, 2 of myeloma, 2 of Non-Hodgkin's Lymphoma, and 1 from breast, bladder, testis, prostate, stomach, liver and retroperitoneal leimyosarcoma respectively. The palliative treatment was performed in 5 cases with radiotherapy, 1 with chemotherapy, 2 with combined chemo-radiotherapy and 1 with percutaneous cementation. The operative methods were 1 case of bone cement insertion after curettage, 2 of Girdlestone with internal hemipelvectomy and 7 of reconstruction after wide excision. Reconstructions were done.: 1 case of bone cementation, 5 of autograft prosthesis composite with irradiation or pastuerization and 1 of saddle prosthesis. We have observed the oncologic results, the ECOG performance status and complication. Results: The oncologic results of palliative/operative groups are NED 0/1, AWD 2/6, DOC 1/2 and DOD 6/1. The ECOG performance status was changed from 1.5 into 4.3 in palliative group and from 2.6 into 2.2 in operative group. The complications were 3 cases of the prosthesis failure and 2 of infection. Conclusion: The indication of operation of metastatic pelvic tumor is decided in consideration of the patient's condition, the grade of malignancy in primary tumor and the life expectancy.

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Analysis of the Factors Relating Nutritional Status in Discharging of Leukemia Patients Receiving Chemotherapy (항암화학요법을 받고 있는 혈액암 환자의 퇴원시 영양 상태와 관련한 요인 분석)

  • So, Eun-Jin;Kim, Jee-Yeon;Jung, Su-Jin;Park, Sook
    • Journal of Nutrition and Health
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    • v.43 no.1
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    • pp.26-33
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    • 2010
  • This study was performed to investigate the changes of oral diet intake during the admission period and identify the factors related with nutritional status in discharging of leukemia patients. This is a retrospective cross sectional study on 46 leukemia patients receiving chemotherapy at the Catholic University of Korea Seoul St. Mary's Hospital from July to September 2009. The patients' charts were surveyed on the general characteristics and factors relating chemotherapy. The calorie count method was used to investigate diet intake during admission period. Multivariate logistic regression analysis was used to identify possible confounding factors. A p < 0.05 was considered statistically significant. The mean age was $42.8\;{\pm}\;14.6$ years and the average length of stay was $30.4\;{\pm}\;7.0$ days. The incidence of malnourished patients was 60.9% in discharging. There was a significant difference in chemotherapy sessions and chemotherapy period between well-nourished and malnourished patients. The average energy intake was 1,525.9 kcal in well-nourished patients and 1,143 kcal in malnourished patients, which was significant different. From repeated measures ANOVA test, the changes of oral intake during admission period were significant by groups. In addition, there were significant differences in oral intake according to each period between well-nourished and malnourished patients. In multivariate logistic regression analysis, both the ratio of total oral energy intake to recommended energy intake and chemotherapy sessions were significantly associated with nutritional status in discharging. The results of this study could be used to establish a protocol of nutritional management for leukemia patients receiving chemotherapy.

Physical Dosimetry in Radioactive Iodine Treatment in the Patients with Thyroid Cancer (갑상선암 환자에 대한 방사성옥소 치료시 물리적 선량 측정)

  • Kim, Myung-Seon;Jeong, Nae-In;Lee, Jai-Yong;Kim, Chong-Soon;Kim, Chong-Ho;Lee, Myung-Chul;Koh, Channg-Soon;Kim, Hee-Geun;Kang, Duck-Won;Song, Myung-Jae
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.1
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    • pp.124-132
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    • 1994
  • Radioactive iodine has been widely used in patients with thyroid cancer combined with surgical treatment. However, due to individual variations in absorption and excretion and uptake by tumor tissue of radioactive iodine, there are differences in therapeutic effect and adverse effects even if the same doses are administrated. So this study compared the therapeutic effect and radiation hazard by measuring internal radiation dose. Of total 27 patients with well differentiated thyroid cancer who had been thyroidectomized, we administered radioactive iodine 100 mCi, 150 mCi, 200 mCi. According to BEL DOSIMETRY PROTO-COL, beta and gamma ray dose were estimated from a pelt of the logarithm of the percent of dose per liter of whole blood versus day, and percent dose retained versus day using somilogarithmic paper, respectively. 1) Physical dose to whole blood averaged $56.54{\pm}13.02$ rad in 100 mCi administered group, $76.83{\pm}19.97$ rad in 150 mCi administered group, $95.08{\pm}25.51$ rad in 200 mCi administered group and there has been a significant correlation among the groups. 2) Mean percent dose retained 48 hours later was 26.34%. 3) There was no significant correlation of physical dose between absence and presence of metastasis. 4) 17 of 19 patients who has been followed up with TSH and serum throglobulin, Thallium scan were successfully ablated by radioactive iodine. 5) Leukocyte, lymphocyte, neutrophil, platelet counts all deelined in 4.6 weeks and most of all were restored 3 months later. 6) There was no significant correlation between physical dosimetry and biologic dosimetry. Generally administered doses of radioactive iodine (100-200 mCi) to patients with thyroid cancer postoperatively had developed transient bone marrow suppression and minimal chromosomal aberration, but they were within safety dose to blood (200 rad). And there has been no significant differences in residual dose 48 hours later between Korean and western people.

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항암화학요법후 골수억제가 수반된 진행암환자에서 rh GM-CSF(LBD-005)의 제1b 상 및 약동태학 연구

  • 라선영;이경희;이혜란;최진혁;정현철;노형근;김범수;노재경;한지숙
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1994.04a
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    • pp.314-314
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    • 1994
  • 대상환자는 15예로, 14예에서 평가 가능하였으며 남녀비는 8:6, 중앙연령 32세(10-70세) 이었고, 대상질환은 악성골옥종 7예, 악성임파종 2예, 위암 2예, 폐암 2예, 그리고 자궁평활근육종 1예였다. rhGM-CSF 50 $\mu\textrm{g}$/$m^2$ 3예, 100 $\mu\textrm{g}$/$m^2$ 3예, 150 $\mu\textrm{g}$/$m^2$ 3예, 250 $\mu\textrm{g}$/$m^2$ 3예, 350 $\mu\textrm{g}$/$m^2$ 3예, 500 $\mu\textrm{g}$/$m^2$ 6예, 700 $\mu\textrm{g}$/$m^2$ 용량 3예에서 시행되었다. 1주기 시행한 환자는 7예, 2주기 5예, 3주기, 4주기 각각 1예씩 있다. 부작용은 50-150 $\mu\textrm{g}$/$m^2$에서 WHO grade I의 발열, 전신쇠약, 식용부진등이 관찰되었으나 grade II이상의 부작용은 없었다. 250 $\mu\textrm{g}$/$m^2$이상의 용량에서도 grade II의 발열이 관찰되었을 뿐 다른 중증의 부작용은 관찰되지 않았다. 최고용량인 700 $\mu\textrm{g}$/$m^2$ 에서도 grade II의 발열외의 중한 부작용은 관찰되지 않았다. 각 용량에 따른 백혈구 증가율(%투여제2일/투여제1일)은 130-500% 이었다. rhGM-CSF는 투여 2-4 시간후 혈중최고치 (0.42-15.4 ng/ml)가 관찰되었으며 투여 12시간까지 0.2-2 ng/ml 의 농도가 지속되었다. 소변내 rh GM-CSF 배설량은 총투여량의 1% 미만이었다.

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Percutaneous Vertebroplasty in Spinal Metastasis and Myeloma : 25 Cases Experience (척추 전이암 및 골수종 환자를 대상으로 시행한 경피적 척추체 성형술)

  • Park, Woo-Min;Jang, Jee-Soo;Rhee, Chang-Hun;Gwak, Ho-Shin;Lee, Seung-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1484-1490
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    • 2000
  • Objectives : In spinal metastasis and myeloma, percutaneous vertebroplasty could be an effective treatment method to provide spinal stabilization and to relief pain for early rehabilitation. The authors report twenty-five cases the clinical results of percutaneous vertebroplasty for twenty-five cases of spinal metastasis and myeloma. Materials and Methods : From September 1998 to December 1999, seventy percutaneous vertebroplasties(PVP) were performed for spinal metastases and myeloma in 25 patients, sixteen women and nine men ranging in age from 34 to 74. The primary malignancies were 6 multiple myelomas, and in metastatic tumore from various origin. All patients complained of severe pain and had osteolytic vertebral body destructions without spinal cord compression. To evaluate clinical improvement, suObjective verbal analogue pain score(VAS) and Karnofsky performance scale(KPS) were used. Thin sliced(2mm-thickness) sectional computed tomography(CT) was performed before and after PVP. Plain X-ray film was followed up every 1 month to assess the vertebral column stability. Results : In 25 patients, a total of seventy PVPS were performed successfully : 6 cervical, 33 thoracic and 31 lumbar vertebrae. Most patients had clear improvement of pain after PVP ; mean as score was 8.1 and 2.9 before and after PVP, respectively. Improvement was maintained in most patients. No further collapse of treated vertebrae was observed(mean follow-up, 7 months). Leakage of PMMA was notod in the spinal canal(13 levels), neural foramen (2 levels), adjacent disk(15 levels), paravertebral soft tissue(14 levels) and vein(8 levels). Pulmonary embolism was detected in three patients after the procedure, but was not associated with clinical symptoms. Conclusion : These results indicate that percutaneous vertebroplasty can be valuable treatment method in osteolytic spinal metastasis and myeloma, providing immediate pain relief and spinal stabilization and contributing to early rehabilitation.

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1-β-D-Arabinofuranosyl-cytosine Induces Chromosomal Breaks in vitro (In vitro에서 1-β-D-arabinofuranosyl-cytosine의 염색체 파열 유도)

  • Jeon, In-sang
    • Clinical and Experimental Pediatrics
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    • v.46 no.12
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    • pp.1186-1193
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    • 2003
  • Purpose : Fragile sites are points on chromosomes which tend to break non-randomly when exposed to specific chemical agents or conditions of tissue culture. The chromosomal break induced by the antineoplastic drug, 1-${\beta}$-D-arabinofuranosyl-cytosine(Ara-c), was investigated to study the laboratory conditions in which the incidence of chromosomal break could be enhanced. Besides, the fragile sites induced by Ara-C were investigated and compared to the already known locations of the specific chromosomal alterations observed in specific neoplasms. Methods : T-lymphocytes from theree normal males and three females were cultured for 48 hours. Cells from each individual were exposed to the Ara-C for an additional 24 hours. After the caffeine was added during the last six hours culture, the metaphase chromosomes were prepared following the conventional method. A site was considered fragile if it was found to break two or more per 100 chromosomal breaks in more than four of six individuals tested. Results : Ara-C induced 252.1 chromosomal breaks per 100 mitotic cells and this result was significantly higher than that of the control, which induced 25.2 breaks(P<0.05). The incidence of the chromosomal break by Ara-C was higher, if cultured in the MEM-FA, which has no folic acid, than in the RPMI 1640 which contains enough folic acid(P<0.05). The most common break site by Ara-C was 3p14.2(FRA3B). There were 20 fragile sites induced by Ara-C. Among these 20 fragile sites, seven coincided with the locations of the mapped oncogenes, JUN, SKI, REL, N-MYC, FHIT, MET, ETS-1, and FOS. Conclusion : S phase specific chemotherapeutic agent, Ara-C, induced the expression of the chromosomal fragile sites effectively using the T-lymphocyte in vitro. Some of the fragile sites by Ara-C highly coincided with the oncogenes and neoplasm specific chromosome breakpoints. In this regard, the fragile sites reported here could provide the unknown neoplasm related chromosomal alternation points.

Vertebral Compression Fractures: Distinction Between Benign and Malignant Causes with Tc-99m Labeled Antigranulocyte Antibody Immunoscintigraphy (Tc-99m 표지 항과립구항체 면역신티그라피(Tc-99m labeled antigranulocyte antibody immunoscintigraphy)를 이용한 척추압박골절의 원인질환 감별)

  • Cho, Ihn-Ho;Lee, Hyong-Woo;An, Sang-Ho;Won, Kyu-Chang;Bae, Jang-Ho;Cho, Soo-Ho
    • Journal of Yeungnam Medical Science
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    • v.15 no.2
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    • pp.254-262
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    • 1998
  • We evaluated the effectiveness of Tc-99m labeled antigranulocyte antibody immunoscintigraphy in differentiating the causes of vertebral compression fracture. This study involved 16 patients with vertebral compression fracture; 8 were due to trauma or osteoporosis, 3 were due to metastasis and 5 were due to tuberculous spondylitis. We retrospectively analyzed the location and the extent of decreased tracer uptake in tomographic images of Tc-99m labeled antigranulocyte antibody immunoscintigraphy. Eight patients had a 16 vertebral compression fractures due to trauma or osteoporosis, three patients had 3 vertebral compression fractures due to metastasis and 5 patients had 6 vertebral compression fractures due to tuberculous spondylitis. Sixteen vertebral compression fractures by trauma or osteoporosis showed a normal tracer uptake in pedicle, laminar and spinous process, but there was noted with 6 decreased uptake, 8 absence of tracer uptake and 2 normal tracer uptake in the vertebral body. Two vertebral compression fractures by metastasis showed the absence of uptake in vertebral body, pedicle, laminar and spinous process, and one showed an absence of vertebral body and spinous process. Six vertebral compression fractures by tuberculous spondylitis showed the absence of uptake in six compression fractures, the absence of pedicle in five compression fractures. We concluded Tc-99m labeled antigranulocyte antibody immunoscintigraphy may be helpful to differentiate the causes of vertebral compression fractures.

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SAPHO Syndrome in a Patient with Breast Cancer Mimicking Bone Metastasis: A Case Report (유방암 환자에서 골전이와 유사한 소견을 보였던 SAPHO 증후군: 증례보고)

  • Ko, Kyungran;Suh, Hee Jung;You, Ji Young;Jung, So-Youn;Kwon, Youngmee;Koh, Young Whan
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.1
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    • pp.59-63
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    • 2014
  • A 66-year-old woman was transferred to our hospital due to her right breast cancer. Preoperative breast MRI shows 1.9 cm malignancy on her right breast (cT1N0M0) and incidentally found osteosclerotic change of left coststernoclavicular region. Bone scintigraphy showed hot uptake and the possibility of bone metastasis was not excluded. However, because the bone metastasis is not common in early stage cancer and the costosternoclavicular region is not common site, other possibility should be considered. SAPHO syndrome can be diagnosed even in the absence of dermatosis when there is an axial or appendicular osteitis and hyperostosis, especially in costosternoclavicular region. Though breast imaging specialists are not accustomed to this disease entity, awareness and diagnosis of the SAPHO syndrome can help differentiate bone metastasis.