• 제목/요약/키워드: Advanced Treatment

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폐암에서 광역동치료술의 효과 (Effect of Photodynamic Therapy in Lung Cancer)

  • 윤성호;한경택;김경남;이승일
    • Tuberculosis and Respiratory Diseases
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    • 제57권4호
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    • pp.358-363
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    • 2004
  • 연구배경 : 폐암에서 광역동치료는 미세침습성 비소세포폐암 및 기관지폐쇄를 일으키는 악성종양에 대한 기관지내 치료를 미국식품의약국(FDA)에서 승인한 상태이다. 국내에서는 폐암세포주에 대한 보고 외에 폐암에 대한 광역동치료 연구가 많지 않아 임상 성적에 대한 보고가 없어 이에 저자들은 폐암에서 시행된 광역동치료에 대한 결과를 문헌고찰과 함께 보고하고자 한다. 방 법 : 2002년 8월부터 2003년 5월까지 조선대학교 병원에서 기관지 내시경을 통해 조직학적으로 진단된 폐암환자 중 10명을 대상으로 하여 광역동치료 48시간 전에 광과민제(Photogem$^{(R)}$, Lomonosov institute of Fine Chemical, Russia)를 2.0mg/Kg을 정맥 주사한 후 48시간, 72시간에 Diode LASER system(Biolitec Inc., Germany, wavelength; 633nm)을 사용하여 광역 동치료를 시행하였다. 결 과 : 10명 중 9예에서 부분관해와 함께 기관지 개통을 보였으며, 1예에서는 변화를 보이지 않았다. 결 론 : 저자들은 광역동치료를 통해 기관지폐쇄로 인한 호흡곤란 및 기관지 폐쇄와 관련된 폐렴이 개선됨을 확인 하였으며, 합병증이 적어 안전한 기관지내 치료법으로 생각된다. 앞으로 광역동 치료에 대한 장기적인 결과 및 적절한 치료 적응증 및 조기 폐암에서 치료효과 등에 대한 연구가 필요할 것으로 생각된다.

119 소방헬기 이용 활성화를 위한 발전방안 (The Developmental Device for 119 fire fighting helicopter use activations)

  • 고재문;김태민;김효식;이영아
    • 한국응급구조학회지
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    • 제11권3호
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    • pp.93-109
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    • 2007
  • The pre-hospital care in site transportation care and site care will be divided, it will follow in site or evacuation it will enforce it will can evacuate in condition of the emergency patient of like this at the initial stage and emergency care from inside fire fighting helicopter back transfer means and the manpower security of the specialty emergency necessary personnel(nursing and 1st EMT's) as the medical treatment agency and modernization of first aid equipment necessity inside American securing and fire fighting helicopter and specialty first aid packet won about lower the emergency care which is appropriate cannot become accomplished are the actual condition in total lack of emergency care equipment. Consequently craving augmentation, in order to be adapted with the handling kind transfer whose specialty and is appropriate and present time of rapid increase and the citizen of emergency demand by fire fighting helicopter simplicity transfer compared to it is a condition where the countermeasure preparation is earnest. Must expand emergency care equipment first even in fire fighting helicopter and 1st EMT's which it follows in him become arrangement and quickly the execution and specialty temporary disposal(ALS) must be enforced a temporary disposal and must buy the life which is. Also it gets by experience a helicopter induction outline, a radio communication method and the patient helicopter on-board hour attention point back various attention fact back with the body and when where it stands but accurately there must be it will be able to induce the helicopter. Also every manuals anger it does a helicopter transfer method and the emergency care method back and that all processes must do fixed form anger, it becomes feed. Also it related with a helicopter transfer even from the relationship agency many research to lead, difference of the advanced foreign nation and the maximum it is the actual condition where the medical emergency system construction which it reduces is earnestly demanded. Also with emergency structure(crane) it confronts to an aviation transfer even from the establishment college and education it leads intensively and 1st EMT's of the good quality which relates with an aviation structure expects is cultivate at all.

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At Which Stage of Gastric Cancer Progression Do Levels of Carcinoembryonic Antigen and Carbohydrate Antigen 19-9 Increase? Application in Advanced Gastric Cancer Treatment

  • Han, Eui Soo;Lee, Han Hong;Lee, Jun Suh;Song, Kyo Young;Park, Cho Hyun;Jeon, Hae Myung
    • Journal of Gastric Cancer
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    • 제14권2호
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    • pp.123-128
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    • 2014
  • Purpose: Since there are no proven tumor markers that reflect the course of gastric cancer, carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) are commonly used alternatives. However, the degree of progression that corresponds to an increase in these markers, and the values of these markers at different cancer stages, remains unclear. Materials and Methods: This study enrolled 1,733 gastric cancer patients who underwent surgery and whose pre-operative CEA and CA19-9 levels were known. Survival curves and mean values of the two markers were compared according to the degree of cancer progression: serosa-unexposed (SU), serosa-exposed (SE), direct invasion (DI), localized seeding (P1), and extensive seeding (P2). Results: The 5-year overall survival rates at each stage differed significantly, except between DI and P1 patients (17.1% vs. 10.5%, P=0.344). The mean CEA values in SU, SE, DI, P1, and P2 patients were 5.80, 5.48, 13.36, 8.06, and 22.82, respectively. The CA19-9 values for these patients were 49.40, 38.97, 101.67, 73.77, and 98.57, respectively. The increase in CEA in P2 patients was statistically significant (P=0.002), and the increases in CA19-9 in DI and P2 patients were significant (P=0.025, 0.007, respectively). There was a fair correlation between the two markers in P2 patients (r=0.494, P<0.001). Conclusions: CA19-9 can be used to assess DI of gastric cancer into adjacent organs. Both markers are useful for predicting the presence of extensive peritoneal seeding.

단감 탄저병 방제법 개선을 위한 살균제 선발 및 효과 (Improvement and Effectiveness for Chemical Control Protocol of Sweet Persimmon Anthracnose Disease)

  • 전창욱;권영호;이정한;곽연식
    • 농약과학회지
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    • 제19권3호
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    • pp.312-316
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    • 2015
  • 본 연구에서 단감 탄저병 방제력을 수립하기 위하여 단제 6종류와 복합제 6종류 총 12종류의 약제를 시중에서 구입하여 시험에 공시하였다. EC50 값 결과에 의해서 Quinone계의 Dithianon, Triazole계의 Metconazole, Dithiocarbamate계의 Propineb을 사용하였다. 최종적으로 사용한 세 가지 약제의 약제 처리 횟수에 따른 단감 탄저병 방제효과는 신초와 과실에서 Quinone계 약제인 Dithianon 약제가 가장효과가 좋은 것으로 나타났으며 Triazole계 약제인 Metconazole와 Dithiocarbamate계 약제인 Propineb약제는 효과가 유사하게 나타났다. 또한 2회 처리구에서는 과일과 신초에 탄저병이 발생하였고 8회 처리구와 4회 처리구에 비하여 효과가 낮은 것으로 나타났다. 8회 처리구와 4회 처리구에서는 두 처리 구 모두 탄저병 발생이 유사하게 나타났으며 앞에서 언급한 바와 같이 하였듯이 경제적 비용, 노동력 및 농약의 오남용을 줄이기 위해서는 4회 처리하는 것이 효율적이라고 본 연구 결과로 도출되었다.

Relationship of Amplification and Expression of the C-MYC Gene with Survival among Gastric Cancer Patients

  • Khaleghian, Malihea;Shakoori, Abbas;Razavi, Amirnader Emami;Azimi, Cyrus
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권16호
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    • pp.7061-7069
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    • 2015
  • Background: During the past decades, the incidence and mortality rate of stomach cancer has demonstrated a great decrease in the world, but it is still one of the most common and fatal cancers especially among men worldwide, including Iran. The MYC proto-oncogene, which is located at 8q24.1, regulates 15% of genes and is activated in 20% of all human tumors. MYC amplification and overexpression of its protein product has been reported in 15-30% of gastric neoplasias. The aim of this investigation was to find the relative efficacy of CISH (chromogenic in situ hybridization) or IHC (immunohistochemistry) in diagnosis and prognosis of gastric cancer, as well as the relationship of amplification and expression of C-MYC gene with patient survival. Materials and Methods: In this cross-sectional study, 102 samples of gastric cancer were collected from patients who had undergone primary surgical resection at the Cancer Institute Hospital, Tehran University of Medical Sciences, from July 2009 to March 2014. All samples were randomly selected from those who were diagnosed with gastric adenocarcinomas. CISH and IHC methods were performed on all of them. Results: Patients were classified into two groups. The first consisted of stage I and II cases, and the second of stage III and IV. Survival tests for both groups was carried out with referrnce to CISH test reults. Group II (stage III & IV) with CISH+ featured lower survival than those with CISH- (p=0.233), but group I (stage I & II) patients demonstrated no significant variation with CISH+ or CISH- (p=0.630). Kaplan-Meier for both groups was carried out with IHC test findings and showed similar results. This data revealed that both diffuse and intestinal types of gastric cancer occurred significantly more in men than women. Our data also showed that CISH+ patients (43%) were more frequent in comparison with IHC+ patients (14.7%). Conclusions: For planning treatment of gastric cancer patients, by focusing on expanding tumors, which is the greatest concern of the surgeons and patients, CISH is a better and more feasible test than IHC, in regard to sensitivity and specificity. Therefore, CISH can be used as a feasible test for tumor growth and prognosis in stage III and IV lesions. This study also indicated that C-MYC amplification in gastric cancer is correlated with survival in advanced stages.

Crosstalk between EGFR and p53 in Hepatocellular Carcinoma

  • Cioca, Andreea;Cimpean, Anca;Ceausu, Raluca;Fit, Ana-Maria;Zaharie, Teodor;Al-Hajjar, Nadim;Puia, Vlad;Raica, Marius
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권19호
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    • pp.8069-8073
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    • 2014
  • Background: Hepatocellular carcinoma (HCC) is one of the most frequent cancers worldwide, with a high mortality. Most patients present with late stage disease, when the treatment options are limited to systemic chemotherapy. The purpose of our study was to evaluate the significance of p53 and EGFR expression in HCC, and to determine whether these two markers correlate with conventional parameters of prognosis. Materials and Methods: Our study included a total of 45 patients, diagnosed histopathologically with HCC. Clinicopathological data including sex, age, tumor necrosis, tumor size, histologic grading, tumor stage, the presence of cirrhosis and chronic hepatitis, were recorded from the Institute database. Three independent microscopic fields were selected for each sample and all the tumor cells within each microscopic field were counted, and then the positive percent of p53 cells were calculated. Three staining patterns were recognized: diffuse, heterogenous and focal. The intensity of EGFR staining was scored on a scale of 0-3+: 0 no staining; 1+ when a weak membrane staining was observed; 2+ when membrane staining is more intense than in 1+, but less than 3+, and 3+ when intense dark brown staining delineated the membrane. To determine the relationship between EGFR expression and p53, we performed double staining in the same HCC specimens. Results: By immunohistochemical staining, p53 protein was detected in tumor cell nuclei in 20 HCCs (44%). We found a significant correlation between the intensity of p53 expression and the histological grade (p=0.008). EGFR expression was detected in 17 (38%) cases, linked to histological grade (p=0.039). Moreover, the intensity of p53 expression was significantly correlated with EGFR intensity (p=0.014). Conclusions: Our results suggest that overexpression of p53 and EGFR plays an important role in hepatocarcinogenesis and contributes to more advanced disease. These markers are not only valuable predictors of prognosis in HCC, but they are also rational targets for new anti-tumor strategies.

Statistical Estimates from Black Non-Hispanic Female Breast Cancer Data

  • Khan, Hafiz Mohammad Rafiqullah;Ibrahimou, Boubakari;Saxena, Anshul;Gabbidon, Kemesha;Abdool-Ghany, Faheema;Ramamoorthy, Venkataraghavan;Ullah, Duff;Stewart, Tiffanie Shauna-Jeanne
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권19호
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    • pp.8371-8376
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    • 2014
  • Background: The use of statistical methods has become an imperative tool in breast cancer survival data analysis. The purpose of this study was to develop the best statistical probability model using the Bayesian method to predict future survival times for the black non-Hispanic female breast cancer patients diagnosed during 1973-2009 in the U.S. Materials and Methods: We used a stratified random sample of black non-Hispanic female breast cancer patient data from the Surveillance Epidemiology and End Results (SEER) database. Survival analysis was performed using Kaplan-Meier and Cox proportional regression methods. Four advanced types of statistical models, Exponentiated Exponential (EE), Beta Generalized Exponential (BGE), Exponentiated Weibull (EW), and Beta Inverse Weibull (BIW) were utilized for data analysis. The statistical model building criteria, Akaike Information Criteria (AIC), Bayesian Information Criteria (BIC), and Deviance Information Criteria (DIC) were used to measure the goodness of fit tests. Furthermore, we used the Bayesian approach to obtain the predictive survival inferences from the best-fit data based on the exponentiated Weibull model. Results: We identified the highest number of black non-Hispanic female breast cancer patients in Michigan and the lowest in Hawaii. The mean (SD), of age at diagnosis (years) was 58.3 (14.43). The mean (SD), of survival time (months) for black non-Hispanic females was 66.8 (30.20). Non-Hispanic blacks had a significantly increased risk of death compared to Black Hispanics (Hazard ratio: 1.96, 95%CI: 1.51-2.54). Compared to other statistical probability models, we found that the exponentiated Weibull model better fits for the survival times. By making use of the Bayesian method predictive inferences for future survival times were obtained. Conclusions: These findings will be of great significance in determining appropriate treatment plans and health-care cost allocation. Furthermore, the same approach should contribute to build future predictive models for any health related diseases.

Preoperative Long Course Chemoirradiation in a Developing Country for Rectal Carcinoma: Kuala Lumpur Hospital Experience

  • Lee, Wei Ching;Yusof, Mastura Md.;Lau, Fen Nee;Ee Phua, Vincent Chee
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권6호
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    • pp.3941-3944
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    • 2013
  • Background: The use of preoperative chemoirradiation is the commonest treatment strategy employed in Malaysia for locally advanced rectal cancer. We need to determine the local control and survival rates for comparison with established rates in the literature. Materials and Methods: This retrospective study analyzed all newly diagnosed patients with rectal adenocarcinoma who underwent long course preoperative radiotherapy (RT) at the Department of Radiotherapy and Oncology, Kuala Lumpur Hospital (HKL) between $1^{st}$ January 2004 and $31^{st}$ December 2010. The aim of the study was to determine the radiological response post radiotherapy, pathological response including circumferential resection margin (CRM) status, 3 years local control, 3 years overall survival (OS) and 3 years disease free survival (DFS). Statistical analysis was performed using the SPSS software. Kaplan-Meier and log rank analysis were used to determine survival outcomes. Results: A total of 507 patients with rectal cancer underwent RT at HKL. Sixty seven who underwent long course preoperative RT were eligible for this study. The median age at diagnosis was 60 years old with a range of 26-78 years. The median tumour location was 6 cm from the anal verge. Most patients had suspicion of mesorectum involvement (95.5%) while 28.4% of patients had enlarged pelvic nodes on staging CT scan. All patients underwent preoperative chemo-irradiation except for five who had preoperative RT alone. Only 38 patients underwent definitive surgery (56.7%). Five patients were deemed to be inoperable radiologically and 3 patients were found to have unresectable disease intraoperatively. The remaining 21 patients defaulted surgery (31.3%). The median time from completion of RT to surgery was 8 weeks (range 5.6 to 29.4 weeks). Fifteen patients (39.5%) had surgery more than 8 weeks after completion of RT. Complete pathological response was noted in 4 patients (10.5%). The pathological CRM positive rate after RT was 18.4%. With a median follow-up of 38.8 months, the 3 year local control rate was 67%. The 3 years rate for CRM positive (<2 mm), CRM clear (>2 mm) and pCR groups were 0%, 88.1% and 100% respectively (p-value of 0.007). The 3 year OS and DFS were 57.3% and 44.8% respectively. Conclusions: In conclusion, the approach of long course preoperative chemoirradiation for rectal cancer needs to be re-examined in our local setting. The high rate of local recurrence is worrying and is mainly due to patient defaulting post-preoperative chemoirradiation or delayed definitive surgery.

An evaluation of heat on protein oxidation of soy protein isolate or soy protein isolate mixed with soybean oil in vitro and its consequences on redox status of broilers at early age

  • Zhang, Xianglun;Lu, Peng;Xue, Wenyue;Wu, Dawei;Wen, Chao;Zhou, Yanmin
    • Asian-Australasian Journal of Animal Sciences
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    • 제30권8호
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    • pp.1135-1142
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    • 2017
  • Objective: The objective of this study was to evaluate effects of heat treatment and soybean oil inclusion on protein oxidation of soy protein isolate (SPI) and of oxidized protein on redox status of broilers at an early age. Methods: SPI mixed with soybean oil (SPIO) heated at $100^{\circ}C$ for 8 h was used to evaluate protein oxidation of SPI. A total of two hundred and sixteen 1-day-old Arbor Acres chicks were divided into 3 groups with 6 replicates of 12 birds, receiving basal diet (CON), heat-oxidized SPI diet (HSPI) or mixture of SPI and 2% soybean oil diet (HSPIO) for 21 d, respectively. Results: Increased protein carbonyl, decreased protein sulfhydryl of SPI were observed as heating time increased in all treatments (p<0.05). Addition of 2% soybean oil increased protein carbonyl of SPI at 8 h heating (p<0.05). Dietary HSPI and HSPIO decreased the average daily gain of broilers as compared with the CON (p<0.05). Broilers fed HSPI and HSPIO exhibited decreased glutathione (GSH) in serum, catalase activity and total sulfhydryl in liver and increased malondialdehyde (MDA) and protein carbonyl in serum, advanced oxidation protein products (AOPPs) in liver and protein carbonyl in jejunal mucosa as compared with that of the CON (p<0.05). Additionally, broilers receiving HSPIO showed decreased glutathione peroxidase activity (GSH-Px) in serum, GSH and hydroxyl radical scavenging capacity in liver, GSH-Px activity in duodenal mucosa, GSH-Px activity and superoxide anion radical scavenging capacity in jejunal mucosa and increased AOPPs in serum, MDA and protein carbonyl in liver, MDA and AOPPs in jejunal mucosa (p<0.05). Conclusion: Protein oxidation of SPI can be induced by heat and soybean oil and oxidized protein resulted in redox imbalance in broilers at an early age.

행동유도법에 대한 보호자의 인식도 조사 (A Survey of Guardian's Attitudes toward Behavior Guidance Techniques)

  • 임현수;김미선;이효설;최성철;김광철
    • 대한소아치과학회지
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    • 제44권4호
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    • pp.427-436
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    • 2017
  • 본 연구의 목적은 국내 실정에 맞는 행동유도법에 대한 보호자의 인식도를 조사하여 어린이 환자와 보호자, 그리고 치과 의사간의 긍정적인 관계를 설정하는데 기초 자료를 제공하는 것이다. 117명의 보호자에게 소아치과에서 사용되는 행동유도법에 대해 구두로 설명한 후 설문지를 작성하게 하였다. 설문지에 포함된 행동유도법은 다음과 같다: 말-시범-시행법, 음성조절법, 기구에 의한 보호안정법, 의료진에 의한 보호안정법, 아산화질소-산소 흡입진정법, 의식하 진정법, 전신마취법. 106명의 보호자의 설문지가 분석을 위해 채택되었다. 말-시범-행동법에 대한 인식도가 가장 높았다. 그 뒤로 음성조절법, 의료진에 의한 보호안정법, 아산화질소-산소 흡입진정법, 기구에 의한 보호안정법, 의식하 진정법, 전신마취법 순으로 낮아졌다. 보호자의 연령, 성별, 환자의 나이, 환자의 성별, 환자의 치과 경험 유무, 치과 방문의 종류, 의료진의 직위는 보호자의 행동유도법에 대한 인식에 영향을 미치지 않았다. 보호자들은 의사소통을 통한 행동유도법(말-시범-시행법, 음성조절법)을 가장 긍정적으로 생각하며, 전신마취법에 의한 행동유도법을 가장 부정적으로 생각하는 것으로 나타났다.