• Title/Summary/Keyword: 폐암(肺癌)

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Efficacy and Safety of $Ultracet^{(R)}$ in Ambulatory Patients with Cancer Pain (암환자의 통증치료에 대한 $Ultracet^{(R)}$의 유효성과 안전성)

  • Lee, Hyo-Jin;Jin, Sun-Ah;Yun, Gak-Won;Yang, Yung-Joon;Park, Nam-Whan;Chun, Jae-Min;Park, Nam-Sook;Yun, Hwan-Jung;Jo, Deog-Yeon;Kim, Sam-Yong
    • Journal of Hospice and Palliative Care
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    • v.9 no.2
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    • pp.101-105
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    • 2006
  • Purpose: We aimed to investigate the efficacy and side effects of $Ultracet^{(R)}$ in relieving cancer pain in setting. Methods: Sixty-one cancer patients over 18 years old, who had cancer pain with or without medication, were enrolled. Pain and other variables were evaluated before and after treatment with $Ultracet^{(R)}$ for 2 weeks, using Korean version of Brief Pain Inventory. Results: Of 61 patients with assessable efficacy data, the maximum pain intensity(PI) experienced in a day were $5.18{\pm}1.41\;and\;4.82{\pm}1.94$, before and after treatment with$Ultracet^{(R)}$ respectively (P=0.113). The minimum PI experienced in a day were $1.2{\pm}1.05\;and\;0.87{\pm}1.35$, before and after treatment with $Ultracet^{(R)}$, respectively (P=0.038). The average PI experienced in a day were $3.61{\pm}1.01\;and\;3.15{\pm}1.73$, before and after treatment with $Ultracet^{(R)}$, respectively (P=0.022). The current PI were $3.63{\pm}1.25\;and\;2.85{\pm}1.94$, before and after treatment with $Ultracet^{(R)}$, respectively (P=0.003). Regarding the quality of life, only mood changed for the better in 49 patients who were treated with $Ultracet^{(R)}$ alone ($1.98{\pm}1.73\;and\;1.35{\pm}1.15$, before and after treatment respectively; P=0.046). There were five (8.2%) adverse events associated with $Ultracet^{(R)}$ treatment. Conclusion: $Ultracet^{(R)}$ seems effective and safe in ambulatory patients with cancer pain.

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Expression of Caspase 3, Survivin, and p53 Protein in Urethane Induced Mouse Lung Carcinogenesis (Urethane으로 유발된 생쥐 폐샘암종 발생과정에서 Caspase 3, Survivin과 p53 단백 발현)

  • Shin, Jong Wook;Lee, Soo Hwan;Park, Eon Sub
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.3
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    • pp.251-260
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    • 2007
  • Purpose: An imbalance of cell proliferation and cell apoptosis is an important mechanism in carcinogenesis. Capase 3, survivin and p53 have been identified as important members of the apoptotic related proteins. This study evaluated the proliferating cell nuclear antigen(PCNA), apoptosis, apoptotic related protein such as capase 3, survivin and p53 using urethane-induced mouse lung carcinogenesis, which provides reproducible steps from hyperplasia to adenocarcinoma. Methods: Urethane was administered to the ICR mice through an intra-peritoneal injection, The mice were sacrificed at 5, 15, and 25 weeks after urethane intervention. The sequential morphological changes and immunohistochemical expression of PCNA, apoptosis, capase 3, survivin, and p53 were examined during mouse lung carcinogenesis. Results: During carcinogenesis, the sequential histological changes were observed from hyperplasia of type II pneumocytes, to anadenoma, and ultimately to an overt adenocarcinoma. The PCNA Labeling index (LI) was 9.6% in hyperplasia, 23.2% in adenoma, and 55.7% in adenocarcinoma, respectively. The apoptotic LI was 0.24% in hyperplasia, 1.25% in adenoma, and 5.27% in adenocarcinoma. A good correlation was observed between the PCNA LI and apoptotic LI. The expression of caspase 3 was remarkable- i.e., 46.7% in adenocarcinoma, in contrast to 15% in hyperplasia and 16% in adenoma. Survivin was detected weakly in the alveolar hyperplasia and showed an increasing expressional pattern in adenoma and adenocarcinoma. p53 expression was detected only in the adenocarcinoma lesions with an expression rate of 13.3%. The level of caspase 3 expression correlated with the increase in the apoptotic index. The positive expression of caspase 3 was associated with an increased apoptotic index. Conclusions: These results suggest that the PCNA LI and apoptotic LI might be useful markers for evaluating the risk of a malignant transformation. In addition, caspase, survivin and p53 might play a role in the early and late steges of urethane-induced mouse lung carcinogenesis.

Quality Assurance of Leaf Speed for Dynamic Multileaf Collimator (MLC) Using Dynalog Files (Dynalog file을 이용한 동적다엽조준기의 Leaf 속도 정도관리 평가)

  • Kim, Joo Seob;Ahn, Woo Sang;Lee, Woo Suk;Park, Sung Ho;Choi, Wonsik;Shin, Seong Soo
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.305-312
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    • 2014
  • Purpose : The purpose of this study is to analyze the mechanical and leaf speed accuracy of the dynamic multileaf collimator (DMLC) and determine the appropriate period of quality assurance (QA). Materials and Methods : The quality assurance of the DMLC equipped with Millennium 120 leaves has been performed total 92 times from January 2012 to June 2014. The the accuracy of leaf position and isocenter coincidence for MLC were checked using the graph paper and Gafchromic EBT film, respectively. The stability of leaf speed was verified using a test file requiring the leaves to reach maximum leaf speed during the gantry rotation. At the end of every leaf speed QA, dynamic dynalog files created by MLC controller were analyzed using dynalog file viewer software. This file concludes the information about the planned versus actual position for all leaves and provides error RMS (root-mean square) for individual leaf deviations and error histogram for all leaf deviations. In this study, the data obtained from the leaf speed QA were used to screen the performance degradation of leaf speed and determine the need for motor replacement. Results : The leaf position accuracy and isocenteric coincidence of MLC was observed within a tolerance range recommanded from TG-142 reports. Total number of motor replacement were 56 motors over whole QA period. For all motors replaced from QA, gradually increased patterns of error RMS values were much more than suddenly increased patterns of error RMS values. Average error RMS values of gradually and suddenly increased patterns were 0.298 cm and 0.273 cm, respectively. However, The average error RMS values were within 0.35 cm recommended by the vendor, motors were replaced according to the criteria of no counts with misplacement > 1 cm. On average, motor replacement for gradually increased patterns of error RMS values 22 days. 28 motors were replaced regardless of the leaf speed QA. Conclusion : This study performed the periodic MLC QA for analyzing the mechanical and leaf speed accuracy of the dynamic multileaf collimator (DMLC). The leaf position accuracy and isocenteric coincidence showed whthin of MLC evaluation is observed within the tolerance value recommanded by TG-142 report. Based on the result obtained from leaf speed QA, we have concluded that QA protocol of leaf speed for DMLC was performed at least bimonthly in order to screen the performance of leaf speed. The periodic QA protocol can help to ensure for delivering accurate IMRT treatment to patients maintaining the performance of leaf speed.

Evaluation of Planning Dose Accuracy in Case of Radiation Treatment on Inhomogeneous Organ Structure (불균질부 방사선치료 시 계획 선량의 정확성 평가)

  • Kim, Chan Yong;Lee, Jae Hee;Kwak, Yong Kook;Ha, Min Yong
    • The Journal of Korean Society for Radiation Therapy
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    • v.25 no.2
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    • pp.137-143
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    • 2013
  • Purpose: We are to find out the difference of calculated dose of treatment planning system (TPS) and measured dose in case of inhomogeneous organ structure. Materials and Methods: Inhomogeneous phantom is made with solid water phantom and cork plate. CT image of inhomogeneous phantom is acquired. Treatment plan is made with TPS (Pinnacle3 9.2. Royal Philips Electronics, Netherlands) and calculated dose of point of interest is acquired. Treatment plan was delivered in the inhomogeneous phantom by ARTISTE (Siemens AG, Germany) measured dose of each point of interest is obtained with Gafchromic EBT2 film (International Specialty Products, US) in the gap between solid water phantom or cork plate. To simulate lung cancer radiation treatment, artificial tumor target of paraffin is inserted in the cork volume of inhomogeneous phantom. Calculated dose and measured dose are acquired as above. Results: In case of inhomogeneous phantom experiment, dose difference of calculated dose and measured dose is about -8.5% at solid water phantom-cork gap and about -7% lower in measured dose at cork-solid water phantom gap. In case of inhomogeneous phantom inserted paraffin target experiment, dose difference is about 5% lower in measured dose at cork-paraffin gap. There is no significant difference at same material gap in both experiments. Conclusion: Radiation dose at the gap between two organs with different electron density is significantly lower than calculated dose with TPS. Therefore, we must be aware of dose calculation error in TPS and great care is suggested in case of radiation treatment planning on inhomogeneous organ structure.

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Lung Biopsy after Localization of Pulmonary Nodules with Hook Wire (Hook Wire를 이용한 폐결절의 위치선정 및 생검)

  • Kim, Jin-Sik;Hwang, Jae-Joon;Lee, Song-Am;Lee, Woo-Surng;Kim, Yo-Han;Kim, Jun-Seok;Chee, Hyun-Keun;Yi, Jeong-Geun
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.681-686
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    • 2010
  • Background: A chest computed-tomography has become more prevalent so that it is more common to detect small sized pulmonary nodules that have not been found in previous simple chest x-ray. If those detected nodules are undersized or located in pulmonary parenchyma, it is difficult to accomplish a biopsy since it is vulnerable to explore them either grossly or digitally. Thus, in our hospital, a thoracoscopic pulmonary wedge resection was performed after locating a lesion by means of hook wire with CT-guided. Material and Method: 31 patients (17 males and 14 female patients) from December in 2006 to June in 2010 became our subjects; their 34 pulmonary nodules were subjected to the thoracoscopic pulmonary wedge resection after locating a lesion by means of hook wire with CT-guided. Also we analyzed a possibility of hook wire dislocation, a frequency of conversion to open thoracotomy, time consumed to operation after location of a lesion, operation time, post operation complication, and histological diagnosis of the lesion. Result: 12 of 34 cases were ground glass lesion, whereas 22 cases of them were solitary pulmonary lesion. The median value of the lesion was 8mm in size (range: 3 to 23 mm), while the median value was 12.5 mm in depth (range: 1 to 34 mm). The median value of time consumed from location of the lesion to anesthetic induction was 86.5 minutes (41~473 minutes); furthermore the mean value of operation time was 103 minutes (25~345 minutes). Intrathoracic wire dislocation was found in one case, but a target lesion was successfully excised. Open thoracotomy was performed in four cases due to pleural adhesion. However, there was no case of conversion to open thoracotomy due to failure to detect a target lesion. In histological diagnosis, metastatic cancer were found in 15 cases, which were the most common, primary lung cancer were in 9 cases, non-specific inflammation were in 3 cases, tuberculosis inflammation were in 2 cases, lymph nodes were in 2 cases, active tuberculosis were in 1 case, atypical adenomatous hyperplasia was in 1 case and normal lung parenchymal finding was in 1 case, respectively. Conclusion: In our hospital, in order to accomplish a precise histological diagnosis of ground-glass lesion and pulmonary nodules in lung parenchyma, location of pulmonary nodules were exactly located with hook wire under chest computed-tomography, which was followed by lung biopsy. We concluded that this was an accurate, minimally invasive and valuable method to minimize the complications and increase of cost of medical service provided.

A Study of Radon Reduction using Panel-type Activated Carbon (판재형 활성탄을 이용한 라돈 저감 연구)

  • Choi, Il-Hong;Kang, Sang-Sik;Jun, Jae-Hoon;Yang, Seung-Woo;Park, Ji-Koon
    • Journal of the Korean Society of Radiology
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    • v.11 no.5
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    • pp.297-302
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    • 2017
  • Recently, building materials and air purification filters with eco-friendly charcoal are actively studying to reduce the concentration of radon gas in indoor air. In this study, radon reduction performance was assessed by designing and producing new panel-type activated carbon filter that can be handled more efficiently than conventional charcoal filters, which can reduce radon gas. For the fabrication of our panel-type activated carbon filter, first the pressed molding product after mixing activated carbon powder and polyurethane. Then, through diamond cutting, the activated carbon filter of 2 mm, 4 mm and 6 mm thickness were fabricated. To investigate the physical characteristics of the fabricated activated carbon filter, a surface area and flexural strength measurement was performed. In addition, to evaluate the reduction performance of radon gas in indoor, the radon concentration of before and after the filter passes from a constant amount of air flow using three acrylic chambers was measured, respectively. As a result, the surface area of the fabricated activated carbon was approximately $1,008m^2/g$ showing similar value to conventional products. Also, the flexural load was found to have three times higher value than the gypsum board with 435 N. Finally, the radon reduction efficiency from indoor gas improved as the thickness of the activated carbon increases, resulting in an excellent radon removal rate of more than 90 % in the 6 mm thick filter. From the experimental results, the panel-type activated carbon is considered to be available as an eco-friendly building material to reduce radon gas in an enclosed indoor environment.

Biological Activity of Oenothera Biennis Seed Extracts (달맞이꽃 종자 추출물의 생리활성)

  • Cho, Hyun-Dong;Kim, Du-Hyun;Kim, Min-Geun;Lee, Yong-Suk;Seo, Kwon-Il
    • Journal of Life Science
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    • v.28 no.9
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    • pp.1048-1055
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    • 2018
  • In the current study, comparisons of Oenothera Biennis seed extracts with water, ethanol, methanol, and 70% ethanol in their total polyphenolics contents, anti-oxidant, anti-neurotoxicity, anti-cancer, and immune-modulatory activities were investigated. Compared with other extracts, those concentrations of total phenolics and flavonoids were the highest in MeOH extract (31.90 mg GAE/g and 20.66 mg QE/g). The radical scavenging and reducing power activities were dose-dependently increased by treatment of O. Biennis seed water, EtOH, MeOH, and 70% EtOH extracts. Furthermore, pretreatment of water, EtOH, and MeOH extracts significantly reduced glutamate-induced cytotoxicity in HT22 hipocampal neuron cells. In the case of cancer cells, MeOH extracts showed lower $IC_{50}$ values in HepG2 ($74.21{\mu}g/ml$), A549 ($188.24{\mu}g/ml$), MCF-7 ($186.42{\mu}g/ml$), and B16 ($101.80{\mu}g/ml$) than other extracts, where those water ($101.96{\mu}g/ml$) and EtOH ($788.39{\mu}g/ml$) extracts showed the lowest $IC_{50}$ activity in HT-29 and PC-3 cells, respectively. O. Biennis seed extracts did not show any cytotoxicity in RAW 264.7 macrophages at the concentration of $1-10{\mu}g/ml$, whereas 70% EtOH extract dose-dependently enhanced nitric oxide (NO) production in RAW 264.7 cells. Overall, we evaluated that various bioactive potentials of O. Biennis seed extracts which would relate with phenolic compounds abundance, thus these can be useful to future developments as functional food ingredients and natural medicines.

Transformation of Asbestos-Containing Slate Using Exothermic Reaction Catalysts and Heat Treatment (발열반응 촉매제와 열처리를 이용한 석면함유 슬레이트의 무해화 연구)

  • Yoon, Sungjun;Jeong, Hyeonyi;Park, Byungno;Kim, Yongun;Kim, Hyesu;Park, Jaebong;Roh, Yul
    • Economic and Environmental Geology
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    • v.52 no.6
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    • pp.627-635
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    • 2019
  • Cement-asbestos slate is the main asbestos containing material. It is a product made by combining 10~20% of asbestos and cement components. Man- and weathering-induced degradation of the cement-asbestos slates makes them a source of dispersion of asbestos fibres and represents a priority cause of concern. When the asbestos enters the human body, it causes cellular damage or deformation, and is not discharged well in vitro, and has been proven to cause diseases such as lung cancer, asbestos, malignant mesothelioma and pleural thickening. The International Agency for Research on Cancer (IARC) has designated asbestos as a group 1 carcinogen. Currently, most of these slats are disposed in a designated landfill, but the landfill capacity is approaching its limit, and there is a potential risk of exposure to the external environment even if it is land-filled. Therefore, this study aimed to exam the possibility of detoxification of asbestos-containing slate by using exothermic reaction and heat treatment. Cement-asbestos slate from the asbestos removal site was used for this experiment. Exothermic catalysts such as calcium chloride(CaCl2), magnesium chloride(MgCl2), sodium hydroxide(NaOH), sodium silicate(Na2SiO3), kaolin[Al2Si2O5(OH)4)], and talc[Mg3Si4O10(OH)2] were used. Six catalysts were applied to the cement-asbestos slate, respectively and then analyzed using TG-DTA. Based on the TG-DTA results, the heat treatment temperature for cement-asbestos slate transformation was determined at 750℃. XRD, SEM-EDS and TEM-EDS analyses were performed on the samples after the six catalysts applied to the slate and heat-treated at 750℃ for 2 hours. It was confirmed that chrysotile[Mg3Si2O5(OH5)] in the cement-asbestos slate was transformed into forsterite (Mg2SiO4) by catalysts and heat treatment. In addition, the change in the shape of minerals was observed by applying a physical force to the slate and the heat treated slate after coating catalysts. As a result, the chrysotile in the cement-asbestos slate maintained fibrous form, but the cement-asbestos slate after heat treatment of applying catalyst was broken into non-fibrous form. Therefore, this study shows the possibility to safely verify the complete transformation of asbestos minerals in this catalyst- and temperature-induced process.

Cause of Death in COPD Patients of a Referral Hospital (만성폐쇄성폐질환 환자 사망 원인 - 한 3차 병원 연구)

  • Kim, Beom Jun;Hong, Sang Bum;Shim, Tae Sun;Lim, Chae Man;Lee, Sang Do;Koh, Younsuck;Kim, Woo Sung;Kim, Dong-Soon;Kim, Won Dong;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.5
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    • pp.510-515
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    • 2006
  • Background : Although 17% of Korean adults over the age of 45 years have chronic obstructive pulmonary disease (COPD), there is only limited data on the cause of death in COPD patients in Korea. Therefore, this retrospective study was performed to examine the cause of death in COPD patients at a referral hospital in Korea. Methods : The medical records of 28 deceased patients diagnosed as COPD in Asan Medical Center from January to December 2003 were reviewed patients had died in Asan Medical Center and 16 patients had died outside the hospital. The Korean National Statistical Office confirmed 88 deceased patients out of 1,078 patients diagnosed as COPD in Asan Medical Center in 2003. After excluding those with tuberculous destroyed lung, bronchiectasis, and lung cancer, 28 COPD patients were evaluated. Results : The causes of death were pulmonary disease including pneumonia in 16 patients (57%), cardiac disease in 5 patients (18%), sudden death in 3 patients (11%), and other causes in 4 patients (14%). The cause of death was pulmonary disease in 83% (10 out of 12 patients) and 38% (6 out of 16 patients) of patients who died in Asan Medical Center and outside the center, respectively (P=0.05). The cause of death was pulmonary disease in 43% of patients with $FEV_1$ more than 50 % of the predicted value and in 55% of patients with $FEV_1$ less than 50 % of the predicted value (P=0.89). Conclusion : Pulmonary disease is the leading cause of death in COPD patients in Korea.

Causes of Right Middle Lobe Syndrome -Recent Experience in Local Tertiary Hospital for Several Years- (우중엽증후군의 원인 -최근 수년간 지역 3차 병원의 경험-)

  • Kim, Hyun Ok;Ma, Jeong Eun;Lee, Seung Jun;Cho, Yu Ji;Jeong, Yi Yeong;Jeon, Kyoung-Nyeo;Kim, Ho Cheol;Lee, Jong Deok;Hwang, Young Sil
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.3
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    • pp.192-196
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    • 2007
  • Background: Right middle lobe syndrome (RMLS) is defined as transient or chronic and recurrent atelectasis of the right middle lobe. Although numerous conditions are associated with RMLS, there are very few recent reports in Korea. This study evaluated the causes of RMLS in a local tertiary hospitalover a period of 42 months. Method: Eighty-eight patients (M:F=64:22, mean age: $67.2{\pm}10.3years$), who had consistent chest radiography findings and underwent bronchoscopy in Gyeongsang University Hospital from January 2003 to July 2006, were enrolled in this study. The clinical characteristics and causes of RMLS in these patients were retrospectively reviewed. Results: The most common symptoms fo RMLS were cough, dyspnea and sputum. Tuberculosis was the most common cause (endobronchial tuberculosis in 22 and pulmonary tuberculosis in 1) The other causes were bronchial stenosis by benign fibrotic changes in 22 cases (25%), anthracofibrosis in 13 cases (14.8%), pneumonia in 11 cases (12.5%), lung cancer in 10 cases (11.4%), mucus impaction in 3 cases (3.4%), bronchiectasis in 2 cases (2.3%) and no demonstrable causes in 7 cases (8%). The bronchoscopy findings were mucosal edema with hyperemic changes in 38 cases (43.2%), mucosal edema with anthracotic pigmentation in 16 cases (18.2%), mucus impaction in 13 cases (14.8%), fibrotic stenosis in 13 cases (14.8%), a mass like lesion in 8 cases (9.1%), exudative necrotic material in 4 cases (4.5%), narrowing as a result of extrinsic compression in 2 cases (2.3%) and no demonstrable abnormalities in 12 cases (13.6%). Conclusion: Right middle lobe syndrome was observed more frequently in patients over the age of 65. The causes were mainly benign diseases with endobronchial tuberculosis being the most common.