• Title/Summary/Keyword: 완전 관해

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Surgical Results for Myasthenia Gravis (중증근무력증의 수술적 치료 결과)

  • 장인석;김성호
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.72-76
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    • 1997
  • Myasthenia gravis is relatively rare disease which is related autoimmune response. There are various methods of management for myasthenia gravis, but nowaday radical thymectomy is the treatment of choice in the aspect of bringing out complete remission and clinical improvement. Sixteen patients of myasthenia gratis underwent radical thymectomy during last eight years, and its result was analysed. Complete rem ssion was achieved in five patients (31 %) and pharmacological or symptomatic improvement in seven patients (44%), thus giving a total remission in 12 patients (75%). Postoperative result was not correlated with age, sex, degree of preoperative symptom, surgical approach, pathologic diagnosis.

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Concurrent Weekly Cisplatin and Radiation Therapy for High risk group of Uterine Cervical Cancer (국소적으로 진행된 자궁경부암에 대한 방사선 치료와 Cisplatin의 동시 병행요법의 치료 결과)

  • Suh Hyun Suk;Kang Seung Hee;Kim Ju Ree;Lee Eung Soo;Kim Yong Bong;Park Sung Kwan
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.213-217
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    • 1992
  • Locally advanced cervical carcinoma has shown high rate of local failure and poor survival rate despite the advances in modern radiation therapy techniques. Combination of chemotherapy and radiation therapy demonstrated benefit in improving local control and possibly the overall survival. Twelve patients with advanced stages (Figo stage III, IV) or 11b with bulky tumors (>5 cm in diameter) were treated with combination of radiation therapy and concurrent weekly cisplatin between May of 1988 and September of 1991 at Inje University Paik Hospital. Cisplatin was administered in bolus injections of 50 mg at weekly intervals during the courses of radiation therapy. Median follow-up period was 34 months with ranges from 3 to 53 months. Eleven patients were evaluable for the estimation of response. Response was noted in all the 11 patients: complete response (CR) in 7 ($64\%$), partial response (PR) in 4 ($36\%$). Of the 7 patients with CR, all maintained local control, whereas only 1 of 4 with PR showed local control. Six of 7 with CR are alive disease free on the completion of follow-up. Eight of 11 patients ($73\%$) maintained local control in the pelvis. The median survival for CR patient is 27 months and 9 months for the PR patients. Analysis of survival by stage shows 11 b 4/5, III 2/3 and IV 1/3. Overall survival rate was $61\%$. Three patients recurred: 1 at local, 1 in distant site and 1 with local and distant site. Toxicity for the combination therapy was not excessive. These results are preliminary, but definitely encouraging in view of markedly improved response rate compared with the results of historical control group.

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Clinical Factors Predicting the Pathologic Tumor Response after Preoperative Concurrent Chemoradiotherapy for Rectal Cancer (직장암에 수술 전 항암화학방사선 동시 병용요법 후 종양의 병리학적 반응에 영향을 주는 임상적 예측 인자)

  • Lee, Ji-Hae;Lee, Kyung-Ja
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.213-221
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    • 2008
  • Purpose: The objective of this retrospective study was to identify predictive factors for the complete pathologic response and tumor downstaging after preoperative concurrent chemoradiotherapy for locally advanced rectal cancer. Materials and Methods: Between the years 2000 and 2008, 39 patients with newly diagnosed rectal cancer without prior evidence of distant metastasis received preoperative concurrent chemoradiotherapy followed by surgery. The median radiation dose was 50.4 Gy (range, $45{\sim}59.4\;Gy$)). Thirty-eight patients received concurrent infusional 5-fluorouracil and leucovorin, while one patient received oral capecitabine twice daily during radiotherapy. Results: A complete pathologic response (CR) was demonstrated in 12 of 39 patients (31%), while T-downstaging was observed in 24 of 39 patients (63%). N-downstaging was observed in 18 of 28 patients (64%), with a positive node in the CT scan or ultrasound. Two patients with clinical negative nodes were observed in surgical specimens. The results from a univariate analysis indicated that the tumor circumferential extent was less than 50% (p=0.031). Moreover, the length of the tumor was less than 5 cm (p=0.004), while the post-treatment carcinoembryonic antigen (CEA) levels were less than or equal to 3.0 ng/mL (p=0.015) and were significantly associated with high pathologic CR rates. The univariate analysis also indicated that the adenocarcinoma (p=0.045) and radiation dose greater than or equal to 50 Gy (p=0.021) were significantly associated with high T-downstaging, while a radiotherapy duration of less than or equal to 42 days (p=0.018) was significantly associated with N-downstaging. The results from the multivariate analysis indicated that the lesser circumferential extent of the tumor (hazard ratio [HR] 0.150; p=0.028) and shorter tumor length (HR, 0.084; p=0.005) independently predicted a higher pathologic CR. The multivariate analysis also indicated that a higher radiation dose was significantly associated with higher T-downstaging (HR, 0.115; p=0.025), while the shorter duration of radiotherapy was significantly associated with higher N-downstaging (HR, 0.028; p=0.010). Conclusion: The circumferential extent of the tumor and its length was a predictor for the pathologic CR, while radiation dose and duration of radiotherapy were predictors for tumor downstaging. Hence, these factors may be used to predict outcomes for patients and to develop further treatment guidelines for high-risk patients.

Response Evaluation after Stereotactic Ablative Radiotherapy for Lung Cancer (초기 폐암의 정위방사선치료후 반응평가 분석)

  • Choi, Ji Hoon
    • Progress in Medical Physics
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    • v.26 no.4
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    • pp.229-233
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    • 2015
  • We retrospectively reviewed lung cancer patients who were treated with stereotactic ablative radiotherapy (SABR). We investigated the value of response evaluation after treatment by measuring the volume change of tumors on serial chest computed tomography (CT) examinations. The study included 11 consecutive patients with early-stage (T1-T2aN0M0) non-small cell lung cancer (NSCLC) who were treated with SABR. The median dose of SABR was 6,000 cGy (range 5,000~6,400) in five fractions. Sequential follow-up was performed with chest CT scans. Median follow-up time was 28 months. Radiologic measurement was performed on 51 CT scans with a median of 3 CT scans per patient. The median time to partial response ($T_{PR}$) was 3 months and median time to complete remission ($T_{CR}$) was 5 months. Overall response rate was 90.9% (10/11). Five patients had complete remission, five had partial response, and one patient developed progressive disease without response. On follow-up, three patients (27.2%) developed progressive disease after treatment. We evaluated the the response after SABR. Our data also showed the timing of response after SABR.

Clinical experience with amitriptyline for management of children with cyclic vomiting syndrome (주기성 구토 증후군 소아에서 구토 예방을 위한 amitriptyline의 임상 경험)

  • Sim, Ye-Jee;Kim, Jung-Mi;Kwon, Soonhak;Choe, Byung-Ho
    • Clinical and Experimental Pediatrics
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    • v.52 no.5
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    • pp.538-543
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    • 2009
  • Purpose : To report the clinical experience with amitriptyline for managing children with cyclic vomiting syndrome (CVS). Methods : Totally, eleven children (eight males) were diagnosed with CVS. Of these, medical records were reviewed for eight children treated with amitriptyline; three children were not treated because one was not followed up and two were kept under observation to study the natural course without medication, because the frequency of vomiting had recently decreased to less than one episode per year. The eight amitriptyline-treated children were divided into three groups by the therapeutic response: (1) complete remission (CR), with no recurrence of symptoms after treatment; 2) partial remission (PR), in which the frequency of symptoms decreased by almost 50% after treatment; and (3) no response. Results : For the eight amitriptyline-treated children, the mean age of symptom onset was 4.7 (0.3-7) yr and mean age at diagnosis was 8.9 (6.0-11.3) yr. The mean number of vomiting episodes was 8.8 (2-25) per year, and the duration of vomiting in each episode ranged from 3 hours to 5 days. CR was achieved in five (62.5%) of the eight amitriptyline-treated children (0.2-0.8 mg/kg/day orally, at night) and PR was achieved in three children (37.5%). Two children relapsed on discontinuation of amitriptyline by their parents decision but showed improvement on remedication. No adverse effects were noted throughout the study period. Conclusion : Amitriptyline can be used in long-term prophylaxis for the management of children with CVS aged over 6 yr. However, a large-scale study is needed to ascertain its effects.

Radiation Therapy of Nasopharyngeal Cancers (비인강암의 방사선치료성적)

  • Shin, Sei-One;Kim, Sung-Kyu;Kim, Myung-Se
    • Journal of Yeungnam Medical Science
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    • v.9 no.2
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    • pp.312-320
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    • 1992
  • Radiotherapeutically, nasopharyngeal cancer is an important disease in korea. Because of its blind anatomic location, early detection is relatively uncommon. Clinically, most of cases are locally advanced and nodal involvement are common. Recently better understanding of nature of the disease and improvement of radio-therapy technique permit better treatment results, including locoregional control and survival rate, and minimal normal tissue damages comparing with previously published data. We analyzed 31 patients of pathologically proven and previously untreated naso-pharyngeal carcinoma with different treatment techniques, retrospectively. Minimal and maximal follow up period of the survuor is 6 months and 68 months, respectively. Thirteen patients with squamous cell carcinoma are included in this analysis. The median age is 49 years(range from 20 to 64 years). Twenty two patients are stage III. Eleven patients are treated with radiotherapy alone and 20 are treated with comblined modalities treatment. The degree of responses after radiotherapy are categorized by 3-classes, i.e. complete response, partial response. In spite of simioarities of complete response rate and 1-year survival rate between two different treatment techniques, those patients with undifferentiated carcinoma appear to benefit from the adjuvant chemotherapy. In addition, systemic failure is more prominant in radiotherapy alone group than in combined modalities treatment group. These results suggest that adjuvant therapy in the radiotherapeutic management of nasopharyngeal cancers needs additional research according to histologic types and future extensive clinical trials.

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The Result of Combined Modality Treatment for Limited Stage Small Cell Lung Cancer (국소성 소세포 폐암에 대한 복합화학요법 및 방사선 병용치료의 효과)

  • Kim Jae Cheol;Jang Yang Suk;Ryu Samuel;Park In Kyu
    • Radiation Oncology Journal
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    • v.7 no.2
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    • pp.205-211
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    • 1989
  • From July 1984 to September 1988, 27 patients with limited stage small cell lung cancer were treated with combined modality (combination chemotherapy Plus radiotherapy) at the Department of Therapeutic Radiology in Kyungpook National University Hospital. Of the 27 patients, 19$(70\%)$ achieved a complete response, 6$(22\%)$ a partial response, and 2$(8\%)$ no response. Female, performance status HO, serum enolase level below 30ng/ml, radiation dose over 4500 cGy, and 4 or more cycles of chemotherapy had a favorable effect on the rates of complete response, although there were no statistical differences according to the variables. Median survival time was 10 months and overall 1- and 2-year survival rates were $40,7\%$ and $12.2\%$, respectively. Complete response (p<0.05), performance status HO (p<0.05), 4 or more cycles of chemotherapy (p<0.05), and radiation dose over 4500 cGy had a significantly favorable effect on 2-year survival rate. Prophylactic cranial irradiation or sex had no effect on survival. The results of this study suggest that radiation treatment should be combined with combination chemotherapy in the therapeutic strategy of SCLC of limited stage.

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A Case of Membranous Glomerulonephritis Associated with Small Cell Lung Cancer Being Complete Remmission with Chemotherapy (항암치료 후 완전관해된 소세포암과 동반된 막성사구체신염 1예)

  • Pack, Jong-Hae;Park, Ji-Young;Yu, Sung-Keun;Park, Hye-Jung;Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Kwan-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.6
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    • pp.633-639
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    • 2002
  • Paraneoplastic nephrotic syndrome can be diagnosed from its clinical and immunological features. The development of several types of glomerular injury in patients with cancer have been recognized, and are considered as paraneoplastic syndrome. Most prominent are the occurrence of membranous glomerulonephritis in patients with carcinomas. We report a case of a 60-year-old-man with small cell lung cancer presenting as nephrotic syndrome. A renal biopsy revealed membranous glomerulonephritis. Six lots of chemotherapy were administered, which led to a complete tumor response with total resolution of the nephrotic syndrome following treatment.

Radiation Therapy of Head and Neck Cancer with CO-60 HDR Transcatheteric Irradiation (고선량율 강내 조사를 이용한 두경부암의 방사선 치료)

  • Shin, Sei-One;Kim, Sung-Kyu;Kim, Myung-Se
    • Journal of Yeungnam Medical Science
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    • v.7 no.2
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    • pp.109-114
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    • 1990
  • The basic strategy of irradiation is to deliver a dose to the cancer that is high enough to make cancer cells incapable of reproduction, while keeping the doses to the various healthy tissues below tolerable levels. In order to improve local control and survival, as a boost therapy after external radiotherapy, high dose rate transcatheteric irradiation using remote control afterloading system(RALSTRON-20B) was used for twelve patients with head and neck cancers. Present results showed complete remission of cancer in 9 out of 12 patients without treatment related complications. Although this procedure is easy to operate, well trained skillful hand is essential for good results. Furthermore our experience suggested that meticulous treatment planning should be developed for better results.

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A Case of Hypertrophic Osteoarthropathy Resolved After Resection of Lung Cancer (폐암절제술 후 완전관해된 비후성 골관절병증 1예)

  • Park, Ki-Soo;Park, Jae-Yong;Kim, Yeon-Jae;Kang, Tae-Kyung;Kim, Chang-Ho;Kweon, Sam;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1403-1407
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    • 1997
  • Hypertrophic osteoarthropathy(HOA) is a systemic disorder characterized by proliferative periostitis of long bone and polysynovitis. Clubbing of the fingers and toes usually accompanies HOA. This syndrome is most frequently with lung cancer. Although disappearance of HOA with removal of the tumor is well known, very few typical cases are reported in Korea We report case of lung cancer with HOA, which was dramatically relieved after the surgical resection of the tumor.

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