• Structural Engineering and Mechanics
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• 제5권1호
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• pp.21-32
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• 1997

A new torsional analysis method for multiple cell box based on the Softened Truss Model Theory was developed. This softened truss model unifies shear and torsion to address the problem associated with a torque applied on a box. The model should be very useful for the analysis of a reinforced concrete box under torque, especially for the bridge superstructure with multiple cell box sections.

• 대한두경부종양학회지
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• 제6권1호
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• pp.11-23
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• 1990

Systemic chemotherapy is usually regarded as the standard treatment for palliation in patients with recurrent or metastatic cancer who have failed the definite local treatment with surgery and/or radiotherapy. Recently, with the introduction of more active chemotherapeutic agents and combinations, systemic chemotherapy is being increasingly used before or after local therapy in patients with previously untreated locally advanced head and neck cancer. The most active agents for the head and neck caner are methotrexate, 5-fluorouracil (5-FU), cisplatin and bleomycin. The overall response rates to each of these four drugs are 15-30% expecially when used as first line therapy. But most of these responses are partial with a mean duration of 3-5 months. Various combinations with methotrexate, 5-FU, cisplatin, and bleomycin have been tried with overall response rates of 50-90%, and 10-20% of complete responses. The introduction of chemotherapy prior to local therapy, induction chemotherapy, has been investigated with improved survivals in patients with complete response, especially pathologic, though improvement in overall survival has not been proved yet after the induction chemotherapy. Other therapeutic modalities, such as 'Sandwich' chemotherapy between surgery and radiotherapy, concomittent chemo-radiotherapy and post local treatment adjuvant chemotherapy have been pursued with some hopeful results but these trials should be compared with prospective randomized Phase III trials. To increase the response rates and enhance the survival, important work still remains; 1. Identification of better prognostic factors, 2. Improvement in staging, 3. Development of more active and safter chemotherapeutic agents, 4. Identification of the proper sequence for the addition of chemotherapy to multimodality treatment, and 5. Testing the value of such chemotherapy in locally advanced cancer patients.

• Journal of Ginseng Research
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• 제8권2호
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• pp.153-166
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• 1984

The anticancer activities of petroleum ether extract of Panax ginseng root(crude GX) and its partially purified fraction from silicic acid column chromatography (7:3 GX) were studied with Sarcoma 180(S-180) or Walker carcinosarcoma 256 (Walker 256) in vivo and with L1210 leukemic lympocyte in vitro. Potential cytotoxic activities of the crude GX and against L1210 cells were compared with those of 5-Fluorouracil (5-FU) and saponin derivatives (Panax-diol, Panax-triol, Diol saponin, Triol saponin) in vitro. In order to observe the physiological effects of the crude GX and 7:3 GX on the animals with cancer, hemoglobin(Hb), red blood cell(R.B.C) and white blood cell after treatment with each GX in comparison with corresponding control groups, respectively. The anticancer effects of the crude GX and 7:3 GX were estimated by measuring the survival time of S-180 bearing mice after treatment with them. The experimental results obtained are summarized as follows; 1. The one unit of cytotoxic activity against L1210 cells was equivalent to 2.54$\mu\textrm{g}$ and 0.88$\mu\textrm{g}$of the crude GX and 7:3 GX per ml of culture medium, respectively. 2. The cytotoxic activities of Panax-diol, Panax=triol, Diol saponin and triol saponin against L1210 cells were not detected. 3. The anticancer activities of 5-FU against L1210, S-180 and Walker 256 were very effective in vivo and vitro tests. 4. The significantly increased W.B.C values of mice after inoculation with S-180 cells were reduced to normal range by the crude GX treatment. 5. The significantly decreased Hb values of rats after inoculation with Walker 256 were recovered to normal range by oral administration of the crude GX. 6. The survival times of mice inoculated with S-180 cells were extended about 1.5 to 2 times by the 7:3 GX treatment compared with their control group.

• Radiation Oncology Journal
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• 제27권2호
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• pp.78-83
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• 2009

목 적: 직장암에서 수술 전 항암화학방사선치료는 수술 후 항암화학방사선치료에 비하여 치료 성적은 비슷하며 독성은 낮아 최근에 많이 시행되고 있다. 본 연구에서는 수술 전 항암화학방사선치료 시 병행한 항암화학요법 중 적정 요법과 적정 이하의 비적정 요법에 따른 치료 결과를 알아보고자 하였다. 대상 및 방법: 2003년 4월부터 2006년 4월까지 수술 전 항암화학방사선치료와 수술을 시행한 환자 중 수술 병리결과 확보가 가능하고 단일 제제 화학요법을 시행한 환자 43명을 대상으로 하였다. 방사선치료는 전 골반에 41.4~50.4 Gy (중앙값, 45 Gy), 종양에 추가조사 0~5.4 Gy (중앙값, 5.4 Gy), 총 41.4~50.4 Gy (중앙값, 50.4 Gy)를 시행하였다. 적정군은 5-fluorouracil (5-FU) 500 mg/$m^2$/day를 방사선치료 첫 3일 동안과 5주 후 3일 동안에 반복 급속 정주 한 6명과 경구 capecitabine을 방사선 치료일에 사용한 6명으로 총 12명이었다. 비적정군은 동일량의 5-FU를 방사선치료 첫 3일에만 급속 정주한 31명이었다. 수술은 방사선치료가 끝난 뒤 40~71일(중앙값, 58일)에 시행하였고 36명은 하전방절제술을, 7명은 복회음절제술을 시행하였다. 결 과: 적정군과 비적정군 사이에, 치료반응 등급 3 이상의 치료반응(83.3% vs. 67.7%, p=0.456), 수술 전과 비교한 수술 후의 병기하강(75.0% vs. 67.7%, p=0.727), 주변절제연 2 mm 초과의 획득(66.7% vs. 83.9%, p=0.237) 등에서 통계적으로 유의하게 차이를 보이지는 않았으나, 병변의 위치가 항문에서 5 cm 이내에 위치한 경우 비적정군에서 괄약근 보존 수술을 시행한 비율이 적정군에 비하여 더 낮은 경향을 보였다(75% vs. 100%, p=0.068). 모든 환자에서 3도 이상의 독성은 관찰되지 않았다. 결 론: 비적정군에서 치료에 수반되는 독성은 낮았으나 모두 2도 이하였고, 항문에서 5 cm 이내에 위치한 직장암의 수술 시 괄약근 보존 수술률이 더 낮은 경향을 보여 적정 화학요법의 병행을 시행하는 것이 바람직하겠다.

• Radiation Oncology Journal
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• 제20권3호
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• pp.206-214
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• 2002

목적 : 하인두암 환자에서 방사선단독치료와 항암화학요법 병용치료시의 반응과 생존율, 그리고 합병증에 영향을 미치는 요소를 알아보고자 하였다. 대상 및 방법 : 1984년 1월부터 1999년 12월까지 고신대학교 복음병원 치료방사선과에서 치료를 받았던 환자 중 근치적 목적으로 방사선치료 단독 또는 항암화학요법과 병용치료를 받았던 56명을 대상으로 후향적 조사를 하였다. 방사선 단독치료(Group I)가 24명$(42.9\%)$, 항암화학방사선치료(Group II)가 32명$(57.1\%)$이었다. 방사선치료는 정규분할 조사법으로 9명$(16.4\%)$, 과분할조사로 분할선량이 $1.15\~1.2\;Gy$인 경우가 26명$(47.2\%)$, 1.35 Gy인 경우가 18명$(32.7\%)$, 가속과분할조사로 2명$(3.6\%)$이 치료받았으며 총 방사선량은 $40.5\~83.5\;Gy$ (평균선량 68.3 Gy)이었다. 항암화학요법은 cisplatin $100\;mg/m^2$을 day 1에, 5-FU $1,000\;mg/m^2$를 day $2\~6$에 방사선치료에 선행해서 사용하였으며 3주 간격으로 시행하였고 환자에 따라 1회에서 3회까지 시행하였다(평균 2.3회). 추적관찰기간은 1개월에서 195개월 이었고 중앙값은 28개월이었다. 결과 : 전체 대상 환자들의 3년 및 5년 생존율은 $40.6\%,\;27.6\%$였고, Group I은 $50.0\%,\;30.0\%$, II는 $36.4\%,\;26.3\%$였다. 국소제어율은 Group I에서 완전관해율이 $70.0\%$, Group II에서는 완전관해율이 $67.7\%$였다. 생존율에 영향을 미치는 예후인자로는 방사선치료에 대한 반응과 림프절 병기로 나타났다. 항암화학요법을 병용한 군에서 합병증 발생율이 높았으나 다분할 조사군에서는 정규분할조사군보다 적게 나타났다. 결론 : 하인두암의 방사선치료 결과는 방사선치료에 대한 반응과 경부 림프절 병기에 따라 좌우되었다. Cisplatin, 5-FU를 방사선치료 전 선행하여 $1\~3$회 사용하는 것은 하인두암의 국소제어율과 생존율에 가치가 없는 것으로 증명되었으며 오히려 합병증을 높이는 것으로 판명되었다. 다분할 방사선치료는 후기 합병증을 저하시키는 것으로 판명되었다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권6호
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• pp.2771-2774
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• 2012

Aim: Tumors of upper gastrointestinal tract are among the cancers that have a quite lethal course. Cytotoxic chemotherapy is the most efficient therapeutic modality for metastatic gastric cancer. In patients who do not respond to first-line treatment, the response rate to second-line therapies is generally low and the toxicity rates high. This study concerned the efficacy and the side effect profile of second-line therapy with irinotecan in the patients who were being followed-up with the diagnosis of metastatic gastric cancer in $\dot{I}$zmir, Turkey. Materials and Methods: We retrospectively evaluated the efficacy and toxicity in 31 patients with metastatic gastric adenocarcinoma who presented to the polyclinic of Medical Oncology of Izmir Ataturk Education and Research Hospital between May 2008 and July 2011. All received chemotherapy regimens containing cisplatin, fluoropyrimidine (5-FU) and docetaxel as the first-line therapy for late stage disease. Irinotecan as a single agent was given at a dose of 210 mg/$m^2$ on each 21 days. Irinotecan (180 mg/$m^2$ on day 1), 5-FU (500 mg/$m^2$ on days 1-2) and leucovorin (LV; 60 mg/$m^2$ on days 1-2) as a combined regimen were given over a 14 day period. Results: Median age was 54 (range, 31-70). Irinotecan was given as a combined regimen for median 6 cycles (range, 3-12) and as a single agent for median 3 cycles (range, 1-10). Metastases were detected in one site in six patients (19%), in two different sites in 17 patients (55%) and in three or more sites in eight patients (26%). Four patients (12.9%) showed partial response and six patients (19.3%) showed stable disease. Progression-free survival (PFS) was found to be 3.26 months (95% CI, 2.3-4.2). Median overall survival (OS) was found to be 8.76 months (95% CI, 4.5-12.9). The most commonly seen grade 3/4 side effect was neutropenia but the the therapy was generally well-tolerated. Conclusions: In this study, it was demonstrated that second-line therapy with irinotecan given following the first-line therapy with cisplatin, fluoropyrimidine (5-FU) and docetaxel was efficient and safe. Further studies are needed for confirmation.

• Asian Pacific Journal of Cancer Prevention
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• 제16권8호
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• pp.3447-3450
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• 2015

Objective: To explore the sensitivity of gastric cancer cells to chemotherapy drugs in elderly patients and its correlation with cyclooxygenase-2 (COX-2) expression in cancer tissue. Materials and Methods: Forty-three elderly patients with gastric cancer (observation group) and 31 young patients with gastrointestinal tumors (control group) who were all diagnosed by pathology and underwent surgery in the 89th Hospital of Chinese People's Liberation Army were selected. Drug sensitivity testing of tumor cells in primary culture was carried out in both groups using a methyl thiazolyl tetrazolium (MTT) method, and the expression of COX-2 and the factors related to multi-drug resistance (MDR) in cancer tissue were assessed by immunohistochemistry. Results: The inhibition rates (IR) of vincristine (VCR), 5-fluorouracil (5-FU), oxaliplatin (L-OHP), mitomycin (MMC) and epirubicin (eADM) on tumor cells in the observation group were dramatically lower than in the control group, with statistical significance (P<0.05 or P<0.01). The positive rates of COX-2, glutathione s-transferase-${\pi}$ (GST-${\pi}$) and P glycoprotein (P-gp) expression in cancer tissue in the observation group were all higher than in control group (P<0.05), while that of DNA topoisomerase $II{\alpha}$ ($TopoII{\alpha}$) expression lower than in the control group (P<0.01). In the observation group, COX-2 expression in cancer tissue had a significantly-positive correlation with GST-${\pi}$ and P-gp (r=0.855, P=0.000; r=0.240, P=0.026), but a negative correlation with $TopoII{\alpha}$ (r=-0.328, P=0.002). In the control group, COX-2 expression in cancer tissue was only correlated with P-gp positively (r=0.320, P=0.011). Bivariate correlation analysis displayed that COX-2 expression in cancer tissue in the observation group had a significantly-negative correlation with the IRs of 5-FU, L-OHP, paclitaxel (PTX) and eADM in tumor cells (r=-0.723, P=0.000; r=-0.570, P=0.000; r=-0.919, P=0.000; r=-0.781, P=0.000), but with hydroxycamptothecine (HCPT), VCR and 5-FU in the control group (r=-0.915, P=0.000; r=-0.890, P=0.000; r=-0.949, P=0.000). Conclusions: Gastric cancer cells in elderly patients feature stronger MDR, which may be related to high COX-2 expression.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제13권4호
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• pp.391-404
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• 1991

Three anticncer agents which are different in time or dosage dependence as well as in phase specificity, namely mitomycin and adriamycin from natural products, and widely different cancer cell lines_Four epidermoid carcinomas originated from larynx, cervix, skin and gut were used toghether with one osteosarcoma as the target cell of single and combined administration of anticancer drugs. Semiautomated tetrazolium dye assay(MTT) appears to offer an attractive option for chemosensitivity of head and neck cancers since it is a simple, valid and inexpensive method of assessing chemosensitivity for large samples in a short time. The results obtained form this study were as follows. 1. Good correlations were obtained with the results of the MTT test and those of $^3H$ thymidine uptake assay. 2. $LD_{50}$ values of HIST and St.Ca. which showed relatively high doubling time on adriamycin were $30{\mu}g/ml$ and $15{\mu}g/ml$ while those of HeLa, Hep-2 and KHOS/NP were $2.1{\mu}g/ml$, $4.8{\mu}g/ml$, and $6.8{\mu}g/ml$ respectively. 3. The $LD_{50}$ value of 5-FU on five cancer cells were very high ranging from 15mg/ml to almost indefinite number, which means 5-FU is very resistant to epidermoid carcinomas or osteosarcoma examined in this study. 4. Mitomycin was relatively effective showing 80% cancer killing effect on HeLa, 70% on St. Ca. and 50% on Hep-2 at the high concentrations used. 5. Adriamycin was the most effective showing 90% cancer cell killing effect on KHOS/NP, 98% on HeLa, 80% both on Hep-2 and St. Ca. The least susceptible cancer cells toward adriamycin was HIST having only 55% cell killing effect at the high cincentration. 6. Combined therapy of adriamycin and 5-FU was more effective than single administration in all the cases examined. Most effective synergism was observed on St. Ca. at the low concentration, showing 21 times higher than each single administration.

• Journal of Gastric Cancer
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• 제7권3호
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• pp.160-166
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• 2007

목적: 진행성위암의 경우 근치적 수술 후 보조항암요법에도 불구하고 5년 생존율이 그리 높지 않은 것으로 보고되고 있다. 이에 항암제 감수성 검사를 기초로 한 항암요법은 최소한 환자들에게 효과가 없는 약제 투여를 막을 수 있는 기회를 제공할 수 있다는 측면에서는 고무적이라 할 수 있다. 본 연구에서는 보조항암요법의 효과를 높이기 위한 유효약제 선정을 위하여 항암제 감수성검사를 실시하였으며 그 결과를 분석하여 항암제 선택에 이용하고자 임상병리학적 요인에 따른 항암제 감수성을 비교하였다. 대상 및 방법: 2005년 8월부터 2006년 8월까지 영남대학교 병원 외과에서 위절제술을 받은 위암환자 81명의 위암절제조직을 이용하여 항암제 감수성 검사를 실시하였다. 검사방법은 ATP (Adenosine Triphosphate) based chemotherapy response assay였다. 항암제 감수성과 임상병리학적 요인과의 상관관계를 보기 위하여 성별, 연령, 종양표지자(CEA 치, CA19-9 치), 암의 위치, 진행암 형태, 조직학적 형태, 분화 유무, 침윤도, Lauren 분류, Ming 분류, 림프관 침윤 유무, 맥관 침윤 유무, 신경 침윤 유무, 림프절 전이 유무, 병리학적 병기를 선정 비교하였다. 결과: 위암 환자를 대상으로 한 항암제 감수성 순위를 보면 5-FU, Epirubicin, Irinotecan, Oxaliplatin 순이었으며 통계학적으로 유의했다(P=0.000). 성별, 연령, 종양표지자(CEA 치, CA19-9치), 암의 위치, 진행암 형태, 조직학적 형태, 분화 유무, 침윤도, Lauren 분류, Ming 분류, 림프관 침윤 유무, 맥관 침윤 유무, 신경 침윤 유무, 림프절 전이 유무, 병리학적 병기 모두에서 유의하게 감수성의 차이를 보였다. 결론: 위암절제조직에서 시행한 항암제 감수성 순위는 5-FU, Epirubicin, Irinotecan, Oxaliplatin의 순이었으며 위절제술을 받은 위암환자의 절제조직을 이용 항암제 감수성검사를 시행한 결과 약제별 임상병리학적 인자에 따라 감수성의 차이가 있으므로 획일적인 항암화학요법을 실시하는 것보다 항암제 감수성 검사를 통하여 감수성 높은 약제들을 조합하여 사용하는 것이 바람직할 것으로 보인다.

• Radiation Oncology Journal
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• 제13권3호
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• pp.233-241
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• 1995

Purpose : To analyse clinical outcome and prognostic factors according to treatment modality, this paper report our experience of retrospective study of patients with esophageal cancer Materials and Methods : One hundred and ten patients with primary esophageal cancer who were treated in Presbyterian Medical Center from May 1985 to December 1992. We analysed these patients retrospectively with median follow up time of 28 months, one hundred and four patients($95{\%}$) were followed up from 15 to 69 months. In methods, twenty-eight patients were treated with median radiation dose irradiated 54.3Gy only. Fifty-six patients were treated with combined chemoradiotherapy. Sixteen cases of these patients were treated with concurrent chemoradiation and the other patients(forty cases) were treated sequential chemoradiotherapy. In concurrent chemoradiotherapy group, patients received 5-FU continuous IV infusion for 4 days. Cisplatin IV bolus. and concurrent esophageal irradiation to 30 Gy. After that patients received 5-FU continuous IV, Cisplatin bolus injection and Mitomycin-C bolus IV, Bleomycin continuous IV, and irradiation to 20 Gy. In sequential chemoradiotherapy group, the chemotherapy consisted of 5-FU 1,000mg/$m^2$ administered as a continuous 24 hour intravenous infusion during five days and Cisplatin 80-100mg/$m^2$ bolus injected, or Bleomycin, Vinblastine, Cisplatin, Methotrexate were used of 1 or 2 cycles. After preoperative concurrentm chemoradiation twenty-six patients underwent radical esophagectomy. Results : Ninety-three patients could be examined for response assessment, By treatment modality, response rates were $85.1{\%}$ for radiation alone group and $86.3{\%}$ for combined chemoradiation group. But in operation group, after one cycle of concurrent chemoradiation treatment, response rate was $61.9{\%}$. The pathologic complete response were $15.4{\%}$ in operation group. Overall median survival was II months and actuarial 5-year survival rate was $8{\%}$. The median survival interval was 6 months for radiation alone group, 11 months for combined chemoradiation group and 19 months for operation group. And also median survival was 19 months for complete responder group that 8 months for noncomplete responder group. In univariative analysis, statistically significant prognostic factors were tumor size, clinical stage, tumor response, and operation. In multivariative analysis, significantly better survival was associated with clinical stage, tumor response, radiation dose, and operation. Conclusion : Compared with radiotherapy alone, combined multimodality may improve the median survival in patients with localized carcinoma of the esophagus and toxicity is acceptable.