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The Role of Surgery for the Treatment of Upper Esophageal Cancer (상부 식도암에서 수술적 치료의 유용성)

  • Park, Jae-Kil;Sa, Young-Jo;Nam, Sang-Yong;Park, Kuhn
    • Journal of Chest Surgery
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    • v.40 no.10
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    • pp.685-690
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    • 2007
  • Background: In the past, radiotherapy was the gold standard for the treatment of upper esophageal cancer, but the long-term follow-up was disappointing. There is still ongoing debate on the surgical management of these patients. This study was undertaker to update our experience with upper esophageal carcinoma and to evaluate the effectiveness of surgery. Material and Method: From May 1995 to December 2005, 147 patients with esophageal cancer underwent surgery at our hospital. They were divided into two groups: one group consisted of 23 patients with upper esophageal (cervical and upper thoracic) cancer and another group consisted of 424 patients with lower esophageal (middle thoracic, lower thoracic and abdominal) cancer. We evaluated the effectiveness of surgical treatment between the 2 groups by measuring the rate of complete surgical resection, the postoperative complications, the postoperative mortality, tumor recurrence, the average life expectancy and the long-term survival. Result: On comparing both groups, there was no significant difference in the distribution of the pathological stage and no significant difference in the percentage of performing complete surgical resection. The percentage of post-operative complications was 39.1% (9 out of 23 patients) in the upper esophageal cancer group, and this was significantly higher than 16.9% (21 out of 124 patients) in the lower esophageal cancer group (p<0.05). However, there was no significant statistical difference between the groups for the percentages of postoperative mortality, tumor recurrence or the postoperative average life expectancy. Conclusion: There was no significant difference in operative mortality or surgical effectiveness between the 2 groups. Therefore, we thought that surgical treatment is also effective for treating upper esophageal cancer, but further investigation with large patient populations will be required.

Cancer Stem Cells and the Tumor Microenvironment (암줄기세포와 종양 미세환경에 대한 고찰)

  • Soo-Yeon Woo;Hee-Seon Choi;Kanghee Yoo;Junseo Kim;Yeolhee Yoon;Seungyeon Lee;Jaehyuk Choi;Kyeongho Kim;Kangjun Lee;Seunghyeon Hwang;Dongjun Lee
    • Journal of Life Science
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    • v.34 no.6
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    • pp.418-425
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    • 2024
  • Solid tumors are heterogeneous populations of multiple cell types. While the majority of the cells that comprise cancer are unable to divide, cancer stem cells have self-renewal and differentiation properties. Normal stem cell pathways that control self-renewal are overactivated in cancer stem cells, making cancer stem cells important for cancer cell expansion and progression. Dick first proposed the definition of cancer stem cells in acute myeloid leukemia, according to which cancer stem cells can be classified based on the expression of cell surface markers. Cancer stem cells maintain their potential in the tumor microenvironment. Multiple cell types in the tumor microenvironment maintain quiescent cancer stem cells and serve as regulators of cancer growth. Since current cancer treatments target proliferative cells, quiescent state cancer stem cells that are resistant to treatment increase the risk of recurrence or metastasis. Various signals of the tumor microenvironment induce changes to become a tumor-supportive environment by remodeling the vasculature and extracellular matrix. To effectively treat cancer, cancer stem cells and the tumor microenvironment must be targeted. Therefore, it is important to understand how the tumor microenvironment induces reprogramming of the immune response to promote cancer growth, immune resistance, and metastasis. In this review, we discuss the cellular and molecular mechanisms that can enhance immunosuppression in the tumor microenvironment.

A case study on a metastatic adrenocortical carcinoma patient treated by Wheel Balanced Cancer Therapy with improvement of quality of life and related symptoms (수레바퀴 암치료법을 시행한 전이성 부신피질암 환자의 증상 개선 및 삶의 질 향상에 대한 증례보고)

  • Ha, Su-jeong;Song, Si-yeon;Park, So-jung;Jeon, Hyung-joon;Lee, Yeon-weol;Cho, Chong-kwan;Yoo, Hwa-seung
    • Journal of Korean Traditional Oncology
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    • v.23 no.2
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    • pp.35-41
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    • 2018
  • Objective: The purpose of this study is to report a metastatic adrenocortical carcinoma patient treated with wheel balanced cancer therapy (WBCT) regimen. Methods: A 52-year-old female patient diagnosed and incised with metastatic adrenocortical carcinoma visited the East West Cancer Center (EWCC) on Sep. 1st, 2018 for WBCT. The patient was treated with WBCT for an approximately 2 months, from Sep. 1st to Nov. 9th. Computed tomography (CT) was used to follow-up the tumor site. Laboratory analysis and National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0 were used to evaluate the safety of WBCT. Results: The surgical beds after surgery (Lt. Laparoscopic adrenalectomy) were maintained without recurrence at follow up chest CT, and related symptoms and quality of life (QOL) were improved during the WBCT. Conclusion: This case study suggests that WBCT may help to improve QOL of adrenocortical carcinoma patient.

Nodal Status of the Head and Neck Cancer Patients (두경부 암 환자의 경부 림프절 전이 분석)

  • Yang, Dae-Sik;Choi, Myung-Sun;Choi, Jong-Ouck
    • 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.

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Docetaxel-cisplatin-fluorouracil Induction Chemotherapy Followed by Concurrent Chemoradiotherapy Versus Concurrent Chemoradiotherapy for Locally Advanced Head and Neck Cancer : A Meta-analysis (국소진행성 두경부암에서 Docetaxel, Cisplatin, Fluorouracil 선행항암요법의 효과 및 부작용에 대한 메타분석)

  • Hwang, Ilseon;Park, Keon Uk
    • Korean Journal of Head & Neck Oncology
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    • v.31 no.2
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    • pp.21-28
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    • 2015
  • 서론: 국소 진행성 두경부암 환자에서 선행 항암요법 후 동시 항암화학방사선요법은 원격 전이를 줄이고, 국소병변을 줄여 방사선 치료의 효과를 높이거나, 기관의 기능을 보존할 목적으로 시도된다. 선행 항암요법의 약제로 는 docetaxel, cisplatin, fluorouracil (DPF) 삼제요법이 가장 효과적인 것으로 알려져 있다. 선행 항암요법 후 동시 항암화학방사선요법과 표준치료인 동시화학방사선요법을 비교한 3상 연구들이 모두 선행 항암요법이 더 낫다는 결과를 보여 주지 못하였지만, 이 연구들은 충분한 환자를 모집하지 못하고 조기 종료된 불완전한 연구라는 한계가 있었다. 이에 저자들은 DPF 선행 항암요법 후 동시 화학방사선요법과 표준치료인 동시 화학방사선요법을 비교하는 메타분석을 시행하였다. 대상 및 방법: 체계적 문헌고찰을 통해 국소진행성 두경부암 환자를 대상으로 시행된 DPF 선행 항암요법 후 동시화학방사선요법과 현재 표준치료인 동시화학방사선요법을 비교한 5개의 3상 연구 결과를 분석하였다. 대상환자는 862 명이었고, 분석 결과 DPF 선행 항암요법 후 동시화학방사선요법은 표준치료와 비교하였을 때 반응률, 2년 및 3년 생존율, 2년 및 3년 무진행 생존율, 점막염 및 빈혈 발생 빈도에서 통계적으로 유의한 차이가 없었다. 하지만, 완전관해율과 3~4도의 백혈구감소증 및 혈소판 감소증의 빈도는 선행 항암요법 시행군에서 더 높았다. 결론: 국소진행성 두경부암의 치료에서 DPF 선행 항암요법 후 동시 항암화학방사선요법을 시행하는 것은 표준치료인 항암화학방사선요법에 비해 생존율 개선을 보이지 못하였다. 선행항암치료를 추가하는 것이 특정 환자군에서 효과가 있을지에 대해서는 추가적인 연구가 필요하다.

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K-Ar ages and Geochemistry for Granitic and Volcanic Rocks in the Euiseong and Shinryeong Area, Korea (의성-신령지역의 화강암류 및 화산암류에 대한 K-Ar 연대)

  • Kim, Sang Jung;Lee, Hyun Koo;Itaya, Tetsumaru
    • Economic and Environmental Geology
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    • v.30 no.6
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    • pp.603-612
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    • 1997
  • Cretaceous sedimentary-volcanoclastic formations of the Kyeongsang Supergroup were intruded by granitic rocks in the late Cretaceous and early Tertiary. In the Euiseong and Shinryeong area, these intrusives have various compositions including gabbro, diorite,biotite granite and feldspar porphyry. Associated volcanic rocks consist of two chemically distinct types: the bimodal suite of basalt and rhyolite in the Keumseongsan caldera, and the felsic suite of andesite and rhyolite in the Sunamsan-Hwasan calderas. Most rocks are subalkaline, and follow a typical differentiation path of the calc-alkaline magma. The granitic rocks can be distinguished chemically from the volcanics by high Zr/Y ratios. Differences in Zr/Y and K/Y ratios between the two volcanic suites can be accounted for by mantle source and fractionation. Chondrite-normalized trace element abundances of granitic rocks are depleted in Th and K, whereas those of the Keumseongsan rhyolites are depleted in Sr and Ti. Rb, La and Ce is enriched in rhyolites of the Sunamsan-Hwasan calderas. $Rb-SiO_2$ and Rb-Y+Nb discrimination diagrams suggest that the intrusives and volcanics have a volcanic arc setting. K-Ar ages indicate four plutonic episodes : diorite (89 Ma), granite (66~62 Ma), granite and porphyry (55~52 Ma) and gabbro (52~45 Ma), and two volcanisms : bimodal basaltic and rhyolitic volcanism (71~66 Ma) in the Keumseongsan caldera, and felsic andesitic and rhyolitic volcanism (61~54 Ma) in the Sunamsan-Hwasan calderas. Geochemical and age data thus suggest that the igneous rocks are related to several geologic episodes during the late Cretaceous to early Tertiary.

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Mineral Carbonation of Serpentinite: Extraction, pH swing, and Carbonation (사문암(Serpentinite)을 이용한 광물탄산화: Mg 추출과 pH swing 및 탄산화)

  • LEE, Seung-Woo;Won, Hyein;Choi, Byoung-Young;Chae, Soochun;Bang, Jun-Hwan;Park, Kwon Gyu
    • Journal of the Mineralogical Society of Korea
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    • v.30 no.4
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    • pp.205-217
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    • 2017
  • Mineral carbonation by indirect method has been studied by serpentinite as cation source. Through the carbonation of $CO_2$ and alkaline earth ions (calcium and magnesium) from serpentinite, the pure carbonates including $MgCO_3$ and $CaCO_3$ were synthesized. The extraction solvent used to extract magnesium (Mg) was ammonium sulfate ($(NH_4)_2SO_4$), and the investigated experimental factors were the concentration of $(NH_4)_2SO_4$, reaction temperature, and ratio of serpentinite to the extraction solvent. From this study, the Mg extraction efficiency of approximately 80 wt% was obtained under the conditions of 2 M $(NH_4)_2SO_4$, $300^{\circ}C$, and a ratio of 5 g of serpentinite/75 mL of extraction solvent. The Mg extraction efficiency was proportional to the concentration and reaction temperature. $NH_3$ produced from the Mg extraction of serpentinite was used as a pH swing agent for carbonation to increase the pH value. About 1.78 M of $NH_3$ as the form of $NH_4{^+}$ was recovered after Mg extraction from serpentinite. And, the main step in Mg extraction process of serpentinite was estimated by geochemical modeling.

An Exploration of the Experience of Compassion Fatigue in Nurses Working with Oncology Patients (암환자를 돌보는 병동 간호사의 공감피로 경험 탐색)

  • Kim, Soo Hyun;Kim, Min Ah
    • Journal of Digital Convergence
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    • v.18 no.11
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    • pp.581-593
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    • 2020
  • This study aimed to understand experiences of compassion fatigue reported by nurses providing services to oncology patients and families. We conducted in-depth interviews with 8 nurses currently working in oncology. Three main themes and 13 subthemes were extracted from the thematic analysis suggested by Braun and Clarke. Participants experienced compassion fatigue while feeling the sufferings transferred from patients and caregivers. The stress resulted from unique nature of oncology work added to their compassion fatigue. Participants became running low on empathy towards oncology patients and caregivers because of external work environments and negative perceptions on compassion. The results of the study inform health care professionals about increasing awareness of compassion fatigue of nurses working with oncology patients and families and the importance of providing interventions to promote their individual and professional quality of life.

Expression of Sodium-Iodide Symporter (NIS) in Thyroid Nodules: Comparison of RT-PCR and Immunohistochemical Staining Methods (갑상선 결절에서 Sodium Iodide Symporter (NIS)의 발현: RT-PCR방법과 면역조직화학염색법의 비교)

  • Bae, Sang-Kyun;Lee, Kang-Dae;Chang, Hee-Kyung
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.6
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    • pp.511-515
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    • 2004
  • Purpose: The sodium-iodide symporter (NIS) expression is an important factor in determining the sensitivity of radioiodine therapy in well-differentiated thyroid cancers. Several previous studies for the expression of NIS in thyroid tissues show diverse results. To investigate whether there is difference between methods in determining the expression of NIS in thyroid tissues of patients with thyroid nodules, we measured the expression ot NIS using two different methods (RT-PCR and immunoshistochemical staining) and compared the results. Materials & Methods: We measured the expression of NIS by reverse transcriptase-polymerase chain reaction (RT-PCR) and also by immunohistochemical staining using anti-NIS antibody in thyroid cancers and other benign thyroid diseases. We compared the results of each method. We included 19 papillary carcinomas, 1 follicular carcinoma, 7 medullary carcinoma, 4 adenomas and 7 nodular hyperplasias. Results: By RT-PCR analysis, 10 of 19 papillary carcinomas expressed NIS, but 1 follicular cancer didn't express NIS. By immunohistochemical staining, 15 of 19 papaillary carcinomas express NIS, but 1 follicular lancer didn't express NIS. There was a significant correlation between the semiquautitative results of RT-PCR and immunohistochemical staining of NIS expression. (p<0.01) Conclusion: Our data demonstrated that the expression of NIS in thyroid cancers and other benign diseases investigated by RT-PCR and immunohistochemical staining correlated well each other. However, by immunohistochemical staining, more NIS expression was found.

Earthquake Engineering Bedrock Based on the Shear Wave Velocities of Rock Strata in Korea (국내 암반지층의 전단파속도에 근거한 지진공학적 기반암 결정)

  • Sun, Chang-Guk
    • The Journal of Engineering Geology
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    • v.24 no.2
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    • pp.273-281
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    • 2014
  • In most current seismic design codes, design earthquake ground motions are defined by a reference spectrum, based on bedrock and site amplification factors that quantify the geotechnical dynamic conditions. Earthquake engineering bedrock is the fundamental geotechnical formation where the seismic waves are attenuated without amplification. To better define bedrock in an earthquake engineering context, shear wave velocity ($V_S$ ) data obtained from in-situ seismic tests were examined for several rock strata in Korea; these data were categorized by borehole drilling investigations. The $V_S$ values for most soft rock data in Korea are > 750 m/s, which is the threshold $V_S$ value for identifying engineering bedrock from a strong motion station. Conversely, VS values are < 750 m/s for 60% of $V_S$ data in weathered rock in Korea. Thus, the soft (or harder) rock strata below the weathered rock layer in Korea can be regarded as earthquake engineering bedrock.