• Title/Summary/Keyword: 진행성 암

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A Study of Influence of Filgrastim on PET/CT In Diffuse Large B cell Lymphoma (미만성 거대 B 세포 림프종 환자에서 Filgrastim 사용이 PET/CT 영상에 미치는 영향에 대한 고찰)

  • NamKoong, Hyuk;Park, Hoon-Hee;Ban, Yung-Gak;Kang, Sin-Chang;Kim, Sang-Kyoo;Lim, Han-Sang;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.17-23
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    • 2009
  • Purpose: It has been known that PET/CT is very valuable in follow-up study of diffuse large B cell lymphoma (DLBCL). Generally, in DLBCL, radiotherapy and chemotherapy has been progressed, because the lesion hasn‘t been limited to one site. And, it has lead to the decrease of leukocyte like neutropenia, due to myelosuppression of chemotherapy. So, in that case, administration of Filgrastim (Granulocyte colony-stimulating factor; G-CSF) is universal. However, in short time after administration, PET/CT has limitation to offer accurate images, through the uptake of $^{18}F$-FDG is increased in the region that is activated bone marrow by hematopoietic growth. Therefore, the aim of this study is that PET/CT in a certain period of time after administration of Filgrastim is able to show normal degree of $^{18}F$-FDG uptake. Materials and Methods: 10 patients under follow-up study of diffuse large B cell lymphoma were examined in this study from January, 2007 to January, 2009 (Male: 4 persons; Female: 6 persons; The mean age: 53.8 years old; The mean weight: 57.3 Kg). Using PET/CT (Discovery STe; GE Healthcare, Milwaukee, WI, USA), whole body images were acquired in 1 hour after $^{18}F$-FDG injection. For image analysis, each ROI ($120\;mm^2$) was drawn on $C^6$ (the sixth C-spine), $L_4$ (the forth L-spine), liver, spleen, and lung, then SUV (Standard Uptake Value)s were measured. We compared with each uptake between in 1-day and 5~7 days after administration of Filgrastim at same patient, so confirmed significance about these by SPSS version 12. Results: In case of $C_6$, $L_4$, spleen, every SUV of 1 day later was remarkably higher than that of 5~7 days later, but liver and lung were similar. Also, the images acquired after 5~7 days distinct remarkably and show normal degree of $^{18}F$-FDG uptake, because uptake of bone was almost disappeared. Conclusions: In this study, each SUV was prominent difference as a period of time after Filgrastim’s administration. And Filgrastim makes concentrate uptake of $^{18}F$-FDG in bone, but, after 5~7 days, bone‘s uptake was greatly decreased. Therefore, we are able to infer a certain period of time that shows normal degree of uptake, by numerical value proven. Also, we consider that this study contribute to advanced study about the other agent like Pegfilgrastim, Lenograstim besides Filgrastim, afterwards.

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Treatment Results of Ovarian Dysgerminoma (난소 미분화세포종의 치료 결과)

  • Chung, Eun-Ji;Suh, Chang-Ok;Seong, Jin-Sil;Keum, Ki-Chang;Kim, Gwi-Eon
    • Radiation Oncology Journal
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    • v.14 no.3
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    • pp.221-228
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    • 1996
  • Purpose : We tried to evaluate the clinical characteristics, the treatment methods, the results of treatments, and the Patterns of failure in ovarian dysgerminoma retrospectively According to the results we would like to suggest the proper management guideline of stage la ovarian dysgerminoma patients who want to maintain fertility. Materials and Methods : Between 1975 and 1990, 34 patients with ovarian dysgerminoma were treated at the Yonsei University Hospital. The case records of these patients have been reviewed for presenting symptoms, treatment methods, local control and survival following treatment. Excluded from analysis were five patients with mixed ovarian germ cell tumors and gonadoblastomas (46,XY) Treatment results of the twenty nine patients were analysed by each treatment modality. Twenty one patients were treated with surgery and postoperative adjuvant radiotherapy (group 2). The other eight patients were treated with operation alone (group 2). The median age of twenty-nine patients was 23 years with a range of 8 to 39 years. Presenting symptoms were abdominal mass (20) pelvic discomfort or pain (5) et al. Radiotherapy was performed by 10MV LINAC or Co-60 teletherapy unit. The total radiation dose of the whole abdomen was 20-25 Gy/3weeks, 1-1.5 Gy/fraction with a boost to the whole pelvis 10-15 Gy/l-2weeks 1.8-2.0 Gy/fraction. Advanced stage disease (stage II or stage III) patients received prophylactic mediastinal and supraclavicular irradiation to a dose of 16-26 Gy. Median duration of follow-up of living patients was 80 months (range 13-201 months). Results : All of the twenty one patients of group 1 were alive without disease ($100\%$). Among the eight patients who were not treated with radiotherapy (group 2), six patients developed local recurrence. Four Patients referred with recurrent disease were treated with salvage radiotherapy. Three of four patients were salvaged and one Patient who had recurrent intra-abdominal disease died of progressed carcinomatosis at 11 months after salvage radiotherapy. The other two patients with recurrence were salvaged with chemotherapy (1 patient) or re-operation (1 Patient). Twenty eight patients remained alive without disease at last follow up, so the 5 year local control rate and 5 year overall survival rate for all groups were $96.6\%$ (28/29), respectively. Among thirteen patients with stage la unilateral tumors seven patients were treated with postoperative radiotherapy and the other six patients were treated with unilateral salpingo-oophorectomy alone. Five patients who did not received radiotherapy developed local failure but all of the recurrent ovarian dysgerminomas were salvaged with radiotherapy, chemotherapy or re-operation. So all the 13 patients with stage la ovarian dysgerminoma were free of disease from 20-201 months (median 80 months). Conclusion : The authors consider external irradiation to be an effective treatment as a complement to surgery in ovarian dysgerminoma. For those patients with disease presenting in stage la tumors who wish to maintain fertility, unilateral salpingo-oophorectomy alone may be curative and spare ovarian function considering excellent salvage rate of recurrent ovarian dysgerminoma in present study.

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Evaluate the Change of Body Shape and the Patient Alignment State During Image-Guided Volumetric Modulated Arc Therapy in Head and Neck Cancer Patients (두경부 환자의 VMAT 시 체형변화와 환자 정렬과의 상관관계 고찰)

  • Seo, Se Jeong;Kim, Tae Woo;Choi, Min Ho;Son, Jong Gi
    • The Journal of Korean Society for Radiation Therapy
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    • v.29 no.2
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    • pp.109-117
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    • 2017
  • Objectives: The purpose of this study was to evaluate the change of body shape and the patient alignment state during image-guided volumetric modulated arc therapy in head and neck cancer patients, Materials and Methods: We performed a image-guided volumetric modulated arc therapy plan for 89 patients with head and neck cancer who underwent curative radiotherapy. Ten of them were evaluated for set up error. The landmarks of the ramus, chin, posterior neck, and clavicle were specified using ARIA software (Offline review), and the positional difference was analyzed. Results: The re-CT simulation therapy was performed in 60 men with $17{\pm}4$ cycles of treatment. The weight loss rate was $-6.47{\pm}3.5%$. 29 women performed re-CT simulation at $17{\pm}5$ cycles As a result, weight loss rate was $-5.73{\pm}2.7%$. The distance from skin to C1, C3, and C5 was measured, and both clavicle levels were observed to measure the skin shrinkage changes. The skin shrinkage standard deviations were C1 (${\pm}0.44cm$), C3 (${\pm}0.83cm$), and C5 (${\pm}1.35cm$), which is about 1 mm shrinkage per 0.5 kg reduction. Skin shrinkage according to the number of treatments was 1 ~ 4 fractions (no change), 5 ~ 13 fractions (-2 mm), 14 ~ 22 fractions (-4 mm) and 23 ~ 30 fractions (-6 mm). Conclusion: When the body shape changes about 5 mm, the central dose starts to differ about 3 % or more. Therefore, the CT simulation treatment for the adaptive therapy should be additionally performed. In addition, it is necessary to actively study the CT simulation therapy method and set up method of the lower neck and to examine the use of a new immobilization device.

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Inhibitory Effect of Steviol and Its Derivatives on Cell Migration via Regulation of Tight Junction-related Protein Claudin 8 (스테비올 및 그 유도체의 세포연접 관련 클라우딘 8 발현 조절을 통한 세포이동 저해효과)

  • Choi, Sun Kyung;Cho, Nam Joon;Cho, Uk Min;Shim, Joong Hyun;Kim, Kee K.;Hwang, Hyung Seo
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.42 no.4
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    • pp.403-412
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    • 2016
  • The tight junction, one of Intercellular junctions, performs a variety of biological functions by bonding adjacent cells, including the barrier function to control the movement of the electrolyte and water. Recent studies have revealed that unusual expression of tight junction-related genes have been shown to be related in cancer development and progression. Recently, there are many reports that control of tight junction proteins expression is closely related to the skin moisture. In this study, we are focusing on the regulating mechanism of tight junction-associated genes by the steviol and its derivatives. Steviol, used as a sweetner, is known to chemical compound isolated from stevia plant. The MTS (3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium, inner salt) assay was carried out in HaCaT cells (human keratinocyte cell line) in order to determine the cytotoxicity. As a result, while steviol showing cytotoxicity from $250{\mu}M$, steviol derivatives are not cytotoxic more than $250{\mu}M$ concentration. We have observed a change in the tight junction protein via quantitative real-time PCR. Claudin 8 among tight junction proteins is only significantly reduced up to 30% in the presence of steviol. In addition, cell migration was inhibited by steviol, not by stevioside and rebaudioside. Finally, we could observe that steviol, not stevioside and rebaudioside, is able to increase the skin barrier permeability through the transepithelial electric resistance (TEER) measurements. These results suggest that the steviol and its derivatives are specifically acts on the tight junction related gene expression, but steviol derivatives are more suitable as a cosmetic material.

Independent Verification Program for High-Dose-Rate Brachytherapy Treatment Plans (고선량률 근접치료계획의 정도보증 프로그램)

  • Han Youngyih;Chu Sung Sil;Huh Seung Jae;Suh Chang-Ok
    • Radiation Oncology Journal
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    • v.21 no.3
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    • pp.238-244
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    • 2003
  • Purpose: The Planning of High-Dose-Rate (HDR) brachytherapy treatments are becoming individualized and more dependent on the treatment planning system. Therefore, computer software has been developed to perform independent point dose calculations with the integration of an isodose distribution curve display into the patient anatomy images. Meterials and Methods: As primary input data, the program takes patients'planning data including the source dwell positions, dwell times and the doses at reference points, computed by an HDR treatment planning system (TPS). Dosimetric calculations were peformed in a $10\times12\times10\;Cm^3$ grid space using the Interstitial Collaborative Working Group (ICWG) formalism and an anisotropy table for the HDR Iridium-192 source. The computed doses at the reference points were automatically compared with the relevant results of the TPS. The MR and simulation film images were then imported and the isodose distributions on the axial, sagittal and coronal planes intersecting the point selected by a user were superimposed on the imported images and then displayed. The accuracy of the software was tested in three benchmark plans peformed by Gamma-Med 12i TPS (MDS Nordion, Germany). Nine patients'plans generated by Plato (Nucletron Corporation, The Netherlands) were verified by the developed software. Results: The absolute doses computed by the developed software agreed with the commercial TPS results within an accuracy of $2.8\%$ in the benchmark plans. The isodose distribution plots showed excellent agreements with the exception of the tip legion of the source's longitudinal axis where a slight deviation was observed. In clinical plans, the secondary dose calculations had, on average, about a $3.4\%$ deviation from the TPS plans. Conclusion: The accurate validation of complicate treatment plans is possible with the developed software and the qualify of the HDR treatment plan can be improved with the isodose display integrated into the patient anatomy information.

Fractionation and Rare-Element Mineralization of Kenticha Pegmatite, Southern Ethiopia (에티오피아 남부 켄티차 페그마타이트의 분화양상과 희유원소 광화작용)

  • Kim, Eui-Jun;Kim, Soo-Young;Moon, Dong-Hyeok;Koh, Sang-Mo
    • Economic and Environmental Geology
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    • v.46 no.5
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    • pp.375-390
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    • 2013
  • The Kenticha rare-element (Ta-Li-Nb-Be) mineralized zone is located in ophiolitic fold and thrust complex of southern Ethiopia and was firstly discovered by joint exploration program of Ethiopia-Soviet in 1980s. It includes Dermidama, Kilkele, Shuni Hill, Kenticha, and Bupo pegmatites from south to north. The Kenticha pegmatite intruded parallel to NS-striking serpentinite and talc-chlorite schist, and is exposed approximately 2 km length and 400-700 m width. The Kenticha pegmatite is internally zoned and subdivided into lower quartz-muscovite-albite granite, intermediate muscovite-quartz-albite-microcline pegmatite, and upper spodumene-quartz-albite pegmatite, based on their mineral assemblage. The major, trace elements (e.g., Rb, Li, Nb, Ta, and Ga), and element ratios (e.g., K/Rb, Nb/Ta, Mg/Li, and Al/Ga) suggest that the fractionation and solidification of pegmatite have progressed from the lower towards upper pegmatite. In contrast, unlike general magmatic fractionation, Mg/Li ratios of the Kenticha pegmatite tend to be increased towards the upper pegmatite. It may result from post-magmatic hydrothermal alteration and/or interaction with upper ultramafic rock. Rare-element mineralization in Kenticha pegmatite concentrates on the upper pegmatite, which contains up to 3.0 wt % $Li_2O$, 3,780 ppm Rb, 111 ppm Cs, 1,320 ppm Ta, and 332 ppm Nb. Ore minerals in Kenticha pegmatite mostly include tantalite, spodumene, and lepidolite, and tantalite has an association with coarser quartz-spodumene and relatively fine sacchroidal albite. The tantalite is classified into Mn-tantalite as a function of $Mn^*[Mn/(Mn+Fe)]$ and $Ta^*[Ta/(Ta+Nb)]$ values. Its compositions ($Mn^*$, $Ta^*$, and Nb/Ta) between coarse and fine tantalites are different and the former is strongly enriched in Ta and depleted in Nb compared to latter one. In conclusion, rare-element mineralization in the Kenticha pegmatite may has occurred in the latest stage of magmatic fractionation.

A Study on Music Summarization (음악요약 생성에 관한 연구)

  • Kim Sung-Tak;Kim Sang-Ho;Kim Hoi-Rin;Choi Ji-Hoon;Lee Han-Kyu;Hong Jin-Woo
    • Journal of Broadcast Engineering
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    • v.11 no.1 s.30
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    • pp.3-14
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    • 2006
  • Music summarization means a technique which automatically generates the most importantand representative a part or parts ill music content. The techniques of music summarization have been studied with two categories according to summary characteristics. The first one is that the repeated part is provided as music summary and the second provides the combined segments which consist of segments with different characteristics as music summary in music content In this paper, we propose and evaluate two kinds of music summarization techniques. The algorithm using multi-level vector quantization which provides a repeated part as music summary gives fixed-length music summary is evaluated by overlapping ration between hand-made repeated parts and automatically generated summary. As results, the overlapping ratios of conventional methods are 42.2% and 47.4%, but that of proposed method with fixed-length summary is 67.1%. Optimal length music summary is evaluated by the portion of overlapping between summary and repeated part which is different length according to music content and the result shows that automatically-generated summary expresses more effective part than fixed-length summary with optimal length. The cluster-based algorithm using 2-D similarity matrix and k-means algorithm provides the combined segments as music summary. In order to evaluate this algorithm, we use MOS test consisting of two questions(How many similar segments are in summarized music? How many segments are included in same structure?) and the results show good performance.

Comparison of Outcomes after Curative Resection of Primary Lung Cancer between 50 Year or Younger and 70 Year or Older Patients (50세 이하와 70세 이상 원발성 폐암 환자에서의 근치적 수술 후 성적 비교)

  • Lee, Jae-Ik;Kim, Keun-Woo;Park, Kook-Yang;Park, Chul-Hyun;Jeon, Yang-Bin;Choi, Chang-Hyu
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.206-213
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    • 2009
  • Background: Previous series have suggested that younger patients with primary lung cancer exhibit a more aggressive disease course with a worse prognosis, as compared to older patients, although this issue is still debatable. Material and Method: We reviewed the medical records of 79 patients (32 patients 50 years and younger (Group I) and 47 patients 70 years and older (Group II)) who underwent curative resection for primary lung cancer between July 2000 and June 2008. Result: The median age of the patients was 46.5 years in Group I and this was 73 years in Group II. The older patients were more likely to have major comorbidities (44% versus 77%, respectively; p=0.003). Histological examinations identified that the minor histological types (excluding non-small cell lung cancer (NSCLC)) were predominantly found in the Group I patients (16% versus 2%, respectively; p=0.037). For the TNM staging of the NSCLC, with excluding the minor histologic types, a higher proportion of patients had stage III disease in Group I (33% versus 13%, respectively; p=0.038). There was no significant difference in major morbidity (16% versus 30%, respectively; p=0.148) and operative mortality (0% versus 4.3%; p=0.512) between the groups. The mean follow-up interval was 33 months (range: $1{\sim}98$ months) for patients in both groups. For the patients with NSCLC, the five-year overall survival rate was 52.3% for Group I and 53.7% for Group II (p=0.955). The rate of freedom from recurrence at five years was significantly lower for the Group I patients than for the Group II patients (39.4% versus 70.4%, respectively; p=0.027), and only being a member of Group I impacted recurrence, based on the Cox proportional hazard analysis (p=0.034). Of the patients who had recurrence, four patients in Group I underwent aggressive surgical treatment. All of these patients exhibited long-term survival (range: $46{\sim}87$ months). Conclusion: In our study, the early outcome and long-term survival were similar for the younger and older patients after curative resection of primary lung cancer. However, we think that younger patients require meticulous follow-up as they had a tendency to proceed to surgery with advanced stage disease, a higher recurrence rate than did the older patients and the survival rates were improved, even for the recurred cases, with early aggressive treatment.

Bee Venom Inhibits Angiogenesis by Decreasing HIF-1α Expression in HCT116 Cells (봉독의 HIF-1α 발현감소를 통한 혈관신생 억제효과)

  • Shin, Jae-Moon;Jeong, Yun-Jeong;Park, Kwan-Kyu;Choe, Jung-Yoon;Han, Sang-Mi;Lee, Kwang-Gill;Yeo, Joo-Hong;Chung, Il-Kyung;Chang, Young-Chae
    • Journal of Life Science
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    • v.22 no.1
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    • pp.41-48
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    • 2012
  • Bee venom (BV) has been used in medicine to treat a variety of diseases including arthritis, rheumatism, and various cancers. Recent reports indicate that BV has anti-angiogenic effects, but the precise molecular mechanism underlying the effects of BV against colorectal cancer remains to be elucidated. We examined the effects of BV and its major components (melittin and apamin) on tumor angiogenesis and found that BV significantly decreased protein levels of hypoxia-inducible factor-$1{\alpha}$ (HIF-$1{\alpha}$), an important factor involved in angiogenesis and tumor progression, in human colorectal carcinoma HCT116 cells. BV also suppressed the transcription of HIF-$1{\alpha}$ under hypoxia, leading to a decrease in the expression of vascular endothelial growth factor (VEGF), a major target gene of HIF-$1{\alpha}$. We also found that these effects were mainly elicited by apamin, but not melittin. BV specifically inhibited the phosphorylation of ERK1/2 without changing the total levels of this protein, but had no effect on kinases of p38/JNK and AKT. Our results suggest that BV may inhibit human colorectal cancer progression and angiogenesis by inhibiting HIF-$1{\alpha}$ and VEGF expression, thereby providing a novel potential mechanism for the anticancer action of BV.

The Radiotherapeutic Significance of Serum NSE Level in Non-Small Cell Lung Cancers(NSCLC) (비 소세포성 폐암의 방사선 치료에서 혈청내 NSE 치의 중요성)

  • Yun Sang Mo;Kim Sang Bo;Park In Kyu;Jung Tae Hoon
    • Radiation Oncology Journal
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    • v.12 no.1
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    • pp.73-80
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    • 1994
  • From December 1989 to February 1993, 108 patients with Non-Small Cell Lung Cancers(NSCLC) were studied retrospectively to evaluate radiotherapeutic significance of serum levels of NSE. We considered elevated serum neuron specific enolase(S-NSE) level as one of the neuroendocrine features in NSCLC. Histopathologic evaluation revealed 86 squamous cell carcinomas, 11 adenocarcinomas.3 large cell carcinomas, 3 mucoepidermoid carcinomas, and 5 unknown pathology. Eight Patients had stage 1,40 stage IlIA, and 60 stage lIIB.S-NSE level greater than 15 ng/ml was considered as elevated, and below this considered as normal. All patients recieved radiotherapy as primary treatment modality. The responders to radiotherapy had significantly higher mean S-NSE level than non-responders (28.5 ng/ml vs 20 ng/ml, p=0.01). Overall 2-year survival rate(YSR) was 23.6$ \% $. According to radiotherapy response, 2 YSR for Patients with CR, PR, and NR were 39.2$ \% $, 28.6$ \% $, and 6.2$ \% $ respectively(p=0.001). 2 YSR for patients with elevated and normal S-NSE were 14.6$ \% $ and 31.7$ \% $(p=0.02). The patients with NR showed no difference in survival according to S-NSE level. When we considered all patients, S-NSE level showed no significant impact on response. But for squamous cell carcinomas alone, patients with elevated S-NSE had more responders(80$ \% $ vs 61$ \% $, p=0.05). There was no correlation between tumor characteristics and S-NSE level. But the patients with elevated S-NSE had more patients with higher nodal stage, Based on our and other datas, NSCLC with neuroendocrine features have different response to treatment and clinical behavior compared to other NSCLC. Thus, this subgroup may need different treatment modality, and S-NSE level may have prognostic significance.

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