• Journal of Life Science
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• v.26 no.3
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• pp.376-386
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• 2016

Apoptosis induction has been proposed as an efficient mechanism by which malignant tumor cells can be removed following chemotherapy. The intrinsic mitochondria-dependent apoptotic pathway is frequently implicated in chemotherapy-induced tumor cell apoptosis. Since DNA-damaging agent (DDA)-induced apoptosis is mainly regulated by the tumor suppressor protein p53, and since more than half of clinical cancers possess inactive p53 mutants, microtubule-damaging agents (MDAs), of which apoptotic effect is mainly exerted via p53-independent routes, can be promising choice for cancer chemotherapy. Recently, we found that the apoptotic signaling pathway induced by MDAs (nocodazole, 17α-estradiol, or 2-methoxyestradiol) commonly proceeded through mitotic spindle defect-mediated prometaphase arrest, prolonged Cdk1 activation, and subsequent phosphorylation of Bcl-2, Mcl-1, and Bim in human acute leukemia Jurkat T cells. These microtubule damage-mediated alterations could render the cellular context susceptible to the onset of mitochondria-dependent apoptosis by triggering Bak activation, Δψm loss, and resultant caspase cascade activation. In contrast, when the MDA-induced Bak activation was inhibited by overexpression of anti-apoptotic Bcl-2 family proteins (Bcl-2 or Bcl-xL), the cells in prometaphase arrest failed to induce apoptosis, and instead underwent mitotic slippage and endoreduplication cycle, leading to formation of populations with 8N and 16N DNA content. These data indicate that cellular apoptogenic mechanism is critical for preventing polyploid formation following MDA treatment. Since the formation of polyploid cells, which are genetically unstable, may cause acquisition of therapy resistance and disease relapse, there is a growing interest in developing new combination chemotherapies to prevent polyploidization in tumors after MDA treatment.

• Journal of Life Science
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• v.33 no.9
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• pp.713-723
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• 2023

Lung cancer is a type of cancer that has the highest mortality rate. It is mainly classified into small-cell lung cancer (SCLC) and non-small-cell lung cancer (NSCLC). Chemotherapy is used to treat lung cancer, but long-term treatment causes side effects and drug resistances. Curcumin is a bright yellow polyphenol extracted from the root of turmeric. It has biological activities, such as anti-oxidant, anti-cancer, and anti-inflammatory effects. In this study, we observed differential cell death in human lung cancer cells. Based on the results, curcumin at 10, 30, and 50 μM exhibited a dose-dependent inhibition on the cell survival of several lung cancer cells, with minor differential phenotypes. In addition, apoptosis, autophagy, and reactive oxygen species (ROS) regeneration were observed through flow cytometry. Curcumin dose-dependently increased these phenotypes in A549 (NSCLC) and DMS53 (SCLC), which were restored by corresponding inhibitors. Western blotting was performed to measure the level of expression of apoptosis- and autophagy-related proteins. The results indicate that Bax, PARP, pro-caspase-3, and Bcl-2 were dose-dependently regulated by curcumin, with seemingly higher Bax/Bcl-2 ratios in DMS53. In addition, autophagic proteins, p-AKT, p62, and LC3B, were dose-dependently regulated by curcumin. ROS inhibition by diphenyleneiodonium reduced the induction of apoptosis and autophagy generated by curcumin. Taken together, it is suggested that curcumin induces apoptosis and autophagy via ROS generation, leading to cell death, with minor differences between human lung cancer cells.

• Tuberculosis and Respiratory Diseases
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• v.54 no.4
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• pp.415-428
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• 2003

Background : This study assessed the efficacy and toxicity of etoposide and carboplatin(EC) combination regimen as a first line therapy for small cell lung cancer(SCLC), and determined the efficacy and toxicity of topotecan for relapsed SCLC. Methods : One hundred and ten patients with previously untreated SCLC received etoposide($100mg/m^2$ i.v., day 1 to 3) and carboplatin($300mg/m^2$ i.v., day 1) combination chemotherapy every 3 weeks. For patients with relapsed SCLC after EC therapy, topotecan($1.5mg/m^2$) was administered for 5 consecutive days every 3 weeks. Response rate, survival and toxicity profiles were assessed. Response was recorded as CR(complete remission), PR(partial remission), SD(stable disease) and PD(progressive disease). Results : One hundred and one patients were assessed for response to EC. Overall response rate to EC was 57.4%(CR 15.8%, PR 41.6%) with a time to progression of 10.3 months(median). The toxicity was tolerable and there was no treatment-related death. Twenty one relapsed SCLC patients were treated with topotecan. Of those who relapsed within 3 months of EC(refractory relapse, RR), 15.4%(2/13) showed PR, while of those who relapsed after 3 months(sensitive relapse, SR), 25%(2/8) exhibited PR. Grade 4 neutropenia was noted in 9.5% and 14.3% showed thrombocytopenia(G4). Conclusion : The EC regimen showed a moderate response rate for SCLC with minimal toxicity. The use of topotecan for relapsed SCLC warrants further investigation.

• Journal of Korean Academy of Nursing
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• v.36 no.6
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• pp.942-949
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• 2006

Purpose: This study was to investigate the knowledge and learning needs of chemotherapy in gynecological cancer patients. Method: The subjects consisted of 103 gynecological cancer patients receiving chemotherapy from April 2005 to August 2005. Data was collected using a questionnaire about knowledge and learning needs of chemotherapy. The data was analyzed by t-test, ANOVA, Scheffe test, and Pearson's correlation coefficient using SAS. Result: Average scores of knowledge and learning needs of general treatment and care were 2.74, and 3.30 respectively. Average score of knowledge and learning needs of chemotherapy were 2.54 and 3.23 respectively. Learning needs of general treatment and care and of chemotherapy were significantly different in relation to marital status, educational level, family support, the operation, and the amount of chemotherapy received. Items with the highest level of learning needs were the symptoms of recurring illness of general treatment, and minimizing side effects of chemotherapy. There were a negative correlation between knowledge and learning needs on general treatment and a positive correlation between knowledge and learning needs on chemothearpy but there were not significant statistically. Conclusion: The level of learning needs related to cancer treatment was high, whereas, that of knowledge was low. Therefore, when designing an educational program for gynecological cancer patients, understanding of learning needs is necessary. Also, consideration of a patient's characteristics, and a systematic and detailed educational program should be provided.

• Journal of Korean Biological Nursing Science
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• v.6 no.1
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• pp.5-15
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• 2004

목적 : 이 연구는 항암제를 투여받는 여성암환자에서 발반사마사지가 스트레스반응(활력징후, 코티졸)과 면역반응에 미치는 효과를 평가하기 위함이다. 방법 : 11명의 여성암 환자를 임의로 표출한 후 단일군 전후실험설계로 진행하였다. 종속변수는 스트레스 반응으로 활력징후(수축기 혈압, 이완기 혈압, 맥박수, 호흡수)와 혈중 코티졸, 면역반응으로 림프구 아군(CD3, CD4, CD8, CD19)과 자연살세포(NK cells)이며, 독립변수는 발반사마사지이었다. 중재 전후 종속변수의 변화를 보기 위해 Wilcoxon signed rank test를 실시하였다. 결과 : 중재 전에 비해 중재 후 수축기 혈압, 이완기 혈압, 맥박수, 혈중 코티졸치, CD4와 CD19는 유의한 변화를 보였으나 호흡수, CD3, CD8, 그리고 자연살세포는 유의한 변화를 보이지 않았다. 결론 : 이러한 연구결과는 발반사마사지가 항암화학요법을 받는 여성암 환자의 스트레스 호르몬과 면역관련세포에 영향을 보였지만 표본수가 작고 중재가 1회에 그쳤기 때문에 이러한 단점을 보완한 추후연구를 통해 발반사마사지의 효과를 좀더 잘 규명할 수 있을 것이다.

• Journal of Chest Surgery
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• v.41 no.6
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• pp.791-794
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• 2008

Pneumomediastinum is a rare, but well recognized complication of bleomycin-induced lung toxicity. Spontaneous pneumomediastinum has to be considered as one of the causes when the dyspnea becomes aggravated in patients with bleomycin induced lung toxicity. We describe here two patients who suffered with germ cell tumor and they developed spontaneous pneumomediastinum without pneumothorax, and this was caused by bleomycin-induced lung toxicity.

• Journal of Korean Clinical Nursing Research
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• v.20 no.1
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• pp.75-89
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• 2014

Purpose: This study was done to identify conditions of cancer patients who visited an emergency department (ED) with the side effects of chemotherapy. Methods: Data were collected retrospectively from medical records of 294 cancer patients who visited a tertiary hospital in 2009 for treatment of side effects of chemotherapy. Records were reviewed for characteristics of participants and side effects of chemotherapy. Data were analyzed using SPSS software. Results: ED Triage grade 3 was 81.6%. The hospitalization ratio was 72.8%, and 6.5% died during the admission. Most frequent side effects were thrombocytopenia (80.6%), anemia (74.5%), pain (52.0%), neutropenia (50.7%), and leucopenia (46.3%). The hospitalization group showed more severe leucopenia than the discharge group (p=.020). Patients in the group who died had higher scores for dyspnea compared to patients discharged or hospitalized (p<.05). Conclusion: Results of the study suggest that there is a special need to develop a system to manage side effects of chemotherapy. Also it is necessary to provide appropriate care and treatment with prompt initial evaluation when cancer patients with side effects of chemotherapy present in the ED. More effective educational discharge programs should also be developed to help these patients cope with various side effects of chemotherapy.

• The Journal of Korean Academic Society of Nursing Education
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• v.29 no.2
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• pp.115-123
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• 2023

Purpose: This study aimed to identify the factors affecting the chemotherapy medication errors made by new nurses and to use the results as basic data for the development of a chemotherapy medication nursing education program for new nurses. Methods: This cross-sectional study was conducted with 189 new nurses working at a general hospital and a tertiary general hospital in Korea. The data collection period was from January 11 to February 7, 2021. The data collected during this study were analyzed using the IBM SPSS statistics version 25.0 program. Data analysis included descriptive statistics, independent t-test, ANOVA, and logistic regression analysis. Results: One factor influencing chemotherapy medication errors was new nurses' educational needs (odds ratio=.18, p=.005). As educational needs increased, the probability of making errors in medication was reduced by .18. Conclusion: It is necessary to develop a chemotherapy medication education program tailored to the educational needs of new nurses by considering the education period, method, and content, with a focus on the content with high demand from new nurses.

• Tuberculosis and Respiratory Diseases
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• v.42 no.3
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• pp.302-313
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• 1995

Background: Tumor necrosis factor(TNF) showed antitumor cytolytic effects on sensitive tumor cells in numerous in vivo and in vitro studies. But it could not be administered systemically to human because of severe systemic adverse effects at effective concentrations against tumor cells. Many studies showed that a high concentrations of TNF in the local milieu may evoke in vivo TNF-responsive mechanisms sufficient to suppress tumor growth. Recently developed technique of TNF gene transfer to tumor cells using retrovirus vector could be a good candidate for local TNF administration. TNF is also known to synergistically enhance in vitro cytotoxicity of chemotherapeutic drugs targeted to DNA topoisomerase II against TNF-sensitive tumor cell lines. In this study the in vitro chemosensitivity against DNA topoisomerase II targeted chemotherapeutic drugs was evaluated using some respiratory cancer cell lines to which TNF gene had been transferred. Method: NCI-H2058, a human mesothelioma cell line, A549, a human lung adenocarcinoma cell line and WEHI 164 cell line, a murine fibrosarcoma cell line were treated with etoposide and doxorubicin, which are typical topoisomerase II - targeted chemotherapeutic agents, at different concentration. The resultant cytotoxicity was measured by MIT assay. Then the cytotoxicity of the same chemotherapeutic agents was measured after TNF-$\alpha$ gene-transfer and the two results were compared. Results: The cytotoxicity was not increased significantly in WEHI164 cell line and A549 cell line but statistically significant increase was observed in H2058 cell line when TNF-$\alpha$ gene was transferred(p<0.05). Conclusion: These findings show that TNF-$\alpha$ gene transfer to respiratory cancer cell lines results in variable effects on chemosensitivity against topoisomerase II inhibitor among different cell lines in vitro and can be additively cytotoxic in certain selective tumor cell lines.

• Radiation Oncology Journal
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• v.16 no.1
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• pp.43-49
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• 1998

Purpose : Carcinomas arising in the gall bladder(GB) or extrahepatic biliary ducts are uncommon and generally have a poor prognosis. The overall 5-year survival rates are less than $10\%$. Early experiences with the external radiation therapy demonstrated a good palliation with occasional long-term survival. The present report describes our experience over the past decade with irradiation of primary carcinomas of the gallbladder and extrahepatic biliary duct. Materials and Methods : From Feb. 1984 to Nov. 1995, thirty-three patients with carcinoma of the GB and extrahepatic biliary duct were treated with external beam radiotherapy with curative intent at our institution. All patients were treated with 4-MV linear accelerator and radiation dose ranged from 31.44Gy to 54.87Gy(median 44.25Gy), and three Patients received additional intraluminal brachytherapy(range, 25Gy to 30Gy). Twenty-seven Patients received postoperative radiation. Among 27 patients, Sixteen patients underwent radical operation with curative aim and the rest of the patients either had bypass surgery or biopsy alone. In seventeen patients, adjuvant chemotherapy was used and eleven patients were treated with 5-FU, mitomycin and leucovorin. Results : Median follow up period was 8.5 months(range 2-97 months). The overall 2-year and 5-year survival rates in all patients were $29.9\%$ and $13.3\%$ respectively. In patients with GB and extrahepatic biliary duct carcinomas, the 2-year survival rates were $34.5\%$ and $27.8\%$ respectively. Patients who underwent radical operation showed better 2-year survival rates than those who underwent palliative operation($43.8\%\;vs.\;20.7\%$), albeit statistically insignificant(p>0.05). The 2-year survival rates in Stage I and II were higher than in Stage III and IV with statistical significance(p<0.05). Patients with good performance status in the beginning showed significantly better survival rates than those with worse status(p<0.05). The 2-year survival rates in combined chemotherapy group and radiation group were $40.5\%$ and $22.0\%$ respectively. There was no statistical differences in two groups (p>0.05). Conclusion : The survival of patients with relatively lower stage and/or initial good performance was significantly superior to that of others. We found an statistically insignificant trend toward better survival in patients with radical operation and/or chemotherapy, More radical treatment strategies, such as total resection with intensive radiation and/or chemotherapy may offer a better chance for cure in selective patients with carcinoma of gall bladder and extrahepatic biliary ducts.