• Title/Summary/Keyword: Cyclophosphamide

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Local and regional recurrence following mastectomy in breast cancer patients with 1-3 positive nodes: implications for postmastectomy radiotherapy volume

  • Park, Shin-Hyung;Lee, Jeeyeon;Lee, Jeong Eun;Kang, Min Kyu;Kim, Mi Young;Park, Ho Yong;Jung, Jin Hyang;Chae, Yee Soo;Lee, Soo Jung;Kim, Jae-Chul
    • Radiation Oncology Journal
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    • v.36 no.4
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    • pp.285-294
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    • 2018
  • Purpose: To determine the necessity of postmastectomy radiotherapy (PMRT) and which regions would be at risk for recurrence, we evaluated local and regional recurrence in breast cancer patients with 1-3 positive nodes and a tumor size of <5 cm. Materials and Methods: We retrospectively analyzed data of 133 female breast cancer patients with 1-3 positive nodes, and a tumor size of <5 cm who were treated with mastectomy followed by adjuvant systemic therapy between 2007 and 2016. The median follow-up period was 57 months (range, 12 to 115 months). Most patients (82.7%) were treated with axillary lymph node dissection. Adjuvant chemotherapy, endocrine therapy, and trastuzumab therapy were administered to 124 patients (93.2%), 112 (84.2%), and 33 (24.8%), respectively. The most common chemotherapy regimen was anthracycline and cyclophosphamide followed by taxane (71.4%). Results: Three patients (2.3%), 8 (6.0%), and 12 (9.0%) experienced local, regional, and distant failures, respectively. The 5-year cumulative risk of local recurrence, regional recurrence, distant metastasis, and disease-free survival was 3.1%, 8.0%, 11.7%, and 83.4%, respectively. There were no statistically significant clinicopathologic factors associated with local recurrence. Lymphovascular invasion (univariate p = 0.015 and multivariate p = 0.054) was associated with an increased risk of regional recurrence. Conclusion: Our study showed a very low local recurrence in patients with 1-3 positive nodes and tumor size of <5 cm who were treated with mastectomy and modern adjuvant systemic treatment. The PMRT volume need to be tailored for each patient's given risk for local and regional recurrence, and possible radiation-related toxicities.

Treatment of Malignant Peripheral Nerve Sheath Tumor Using Surgery and Metronomic Chemotherapy in a Dog (개에서 발생한 악성 말초 신경집 종양의 외과적 절제와 메트로놈 화학요법을 이용한 치료 증례)

  • Son, Jin-Na;Park, Seong-Kyu;Choi, Seok-Hwa;Kim, Gon-Hyung
    • Journal of Veterinary Clinics
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    • v.28 no.3
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    • pp.310-313
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    • 2011
  • A 6-year-old female Shih-tzu dog was referred with left elbow joint mass associated with weight bearing lameness. Ultrasonography demonstrated an encapsulated hyperechoic mass at the left elbow joint. Radiography was performed on elbow joint, chest, and abdomen, but there was no evidence of metastasis. Clinicopathologic examination revealed the existence of neoplastic cells with anisocytosis, pleomorphism and increased nuclear-cytoplasmic ratio. The left forelimb was amputated for cure. Histopathological examination diagnosed the mass as a malignant peripheral nerve sheath tumor. During the 4 weeks follow-up, the patient showed full remission and adopted to walk with remaining three legs. Thereafter, the tumor recurred after 5 months of first surgery at the operation site and other two cutaneuos regions. Cytology test revealed the mesenchymal originated tumor cells with malignancy. These tumors were surgically removed and histopathological examination of the resected tissue revealed the recurrence of primary tumor and metastasis. Metronomic therapy with cyclophophamide (10 mg/$m^2$, PO, sid) and piroxicam (0.3 mg/kg, PO, sid) had been adopted for 5 months. At 26 months of follow up after the first surgery, the dog alive with satisfactory quality of life. Aggressive surgical resection with metronomic chemotherapy should be the most effective treatment for malignant peripheral nerve sheath tumor.

Wnt7b is Upregulated in Macrophages during Thymic Regeneration and Negatively Regulated by RANKL (흰쥐 가슴샘 재생과정 동안 대식세포에서 Wnt 7b의 발현증가 및 RANKL에 의한 발현조절)

  • Kim, Jong-Gab;Kim, Sung-Min;Kim, Bong-Seon;Kim, Jae-Bong;Yoon, Sik;Bae, Soo-Kyung
    • Journal of Life Science
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    • v.17 no.7 s.87
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    • pp.923-930
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    • 2007
  • Thymus can regenerate to its normal mass within 14 days after acute involution induced by cyclophosphamide (CY) in adult rat. Despite the established role of Wnt pathways in the process of thymus development, they have not yet been associated with the regeneration of adult thymus. The purpose of this study was to investigate whether Wnt7b, which is expressed in developing thymic epithelial cells rather than in thymocytes, is modulated during thymic regeneration in adult rat. Here, we show that Wnt7b expression was up-regulated in the regenerating thymus. Cells immunolabeled for the Wnt7b were identified as macrophages. Furthermore, Wnt7b gene expression was decreased by the treatment of receptor activator of NF-kappaB ligand (RANKL). Taken together, our results demonstrate that Wnt7b gene expression was increased in macrophages during thymic regeneration and negatively regulated by RANKL.

A Case of Erdheim-Chester Disease Who Has Policythemia Vera (진성 적혈구증다증 환자에서 발현한 Erdheim-Chester Disease 1예)

  • Kim, Ji Eun;Lee, Hyun Jeong;Rhee, Chin Kook;Yoon, Hyung Kyu;Song, Jeong Sup
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.3
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    • pp.224-229
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    • 2008
  • Erdheim-Chester disease (ECD) is a rare disease that is characterized by multi-organ involvement of foamy histiocytes. It causes systemic inflammation, and also demonstrates various clinical manifestations and has a poor prognosis. We encountered a case of ECD in a patient that had been treated for underlying polycythemia vera. As far as we know, this is the first reported case worldwide where ECD developed in association with polycythemia vera. A 59-year-old man visited our hospital due to pleuric pain at the right side of the chest. Pleural tissue that was obtained following a thoracoscopic biopsy showed non-Langerhan's cell histiocytosis, suggesting the presence of ECD. The histiocytes stained positively for CD68, but were negative for S-100 and CD1a. The patient also complained of pain at both hips and the right shoulder area. An X-ray and magnetic resonance image demonstrated that the lesion showed sclerosis and osteolysis in both the proximal femur and right humerus. Treatment was started with predinisolone, and subsequently cyclophosphamide was added. ECD is a very rare multi-systemic disease, and its cause and therapeutic options have not yet been defined. ECD has a poor prognosis. Therefore, we believe that additional case studies are needed prior to the determination of a novel therapy for ECD.

Effects of Patriniae Radix Extract on The Membranous Nephropathy Induced by Cationic Bovine Serum Albumin in Mice (패장초(敗醬草)가 Cationic Bovine Serum Albumin 투여로 유발된 Membranous Nephropathy Mouse Model에 미치는 영향)

  • Chang, Sun-Kyu;Cho, Chung-Sik;Kim, Cheol-Jung
    • The Journal of Internal Korean Medicine
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    • v.30 no.1
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    • pp.212-227
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    • 2009
  • Objective : Membranous nephropathy (MN) is one of the most commonest forms of glomerular disease in man and the most frequent cause of the adult idiopathic nephrotic syndrome. Some investigators recommend no treatment, while others propose aggressive therapy, including prednisolone plus an immunosupressant such as chlorambucil or cyclophosphamide. But a more effective way to treat MN is not defined yet. This study was to evaluate the effects of Patriniae Radix extract (PRE) on the MN induced by cBSA in mice. Methods : Mice were divided into 4 groups. The first group (normal) was injected with saline. The second group (control) was treated with cBSA (10 mg/kg i.p) only. The third group, named PRE-2S0, was treated with cBSA (10 mg/kg i.p) and PRE (250 mg/kg, p.o). The fourth group, PRE-500, was treated with cBSA (10mg/kg i.p) and PRE (500mg/kg, p.o). After cBSA and PRE treatment for 4 weeks, we measured change of body weight, 24hrs proteinuria, serum albumin, total cholesterol, triglyceride, BUN, creatinine, IgG, IgA, IgM, $TNF-\alpha$, $IL-1\beta$, and $IFN-\gamma$ levels and the mRNA expression of $IFN-\gamma$, IL-6, and IL-10. The morphologic changes of renal glomeruli were also observed with a light microscope and an electron microscope. Results : The levels of 24 hrs proteinuria and serum triglyceride. BUN. IgG. $TNF-\alpha$, and $IL-1\beta$ significantly decreased in both PRE groups, while the level of serum albumin significantly increased in both PRE groups. The mRNA expression of IL-10 in splenocytes considerably increased in both PRE groups. The mRNA expression of $IFN-\gamma$ and IL-6 in splenocytes considerably increased in both PRE group. In histological findings of kidney tissue, thickening of GBM decreased in both PRE groups. Conclusions : The present study suggests that PRE is effective when treating mice with MN induced by cBSA. More clinical data and studies are to be done for efficient application.

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Enhanced γ-aminobutyric acid and sialic acid in fermented deer antler velvet and immune promoting effects

  • Yoo, Jiseon;Lee, Juyeon;Zhang, Ming;Mun, Daye;Kang, Minkyoung;Yun, Bohyun;Kim, Yong-An;Kim, Sooah;Oh, Sangnam
    • Journal of Animal Science and Technology
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    • v.64 no.1
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    • pp.166-182
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    • 2022
  • Deer antler velvet is widely used in traditional medicine for its anti-aging, antioxidant, and immunity-enhancing effects. However, few studies have reported on the discovery of probiotic strains for deer antler fermentation to increase functional ingredient absorption. This study evaluated the ability of probiotic lactic acid bacteria to enhance the concentrations of bioactive molecules (e.g., sialic acid and gamma-aminobutyric acid [GABA]) in extracts of deer antler velvet. Seventeen strains of Lactobacillus spp. that were isolated from kimchi and infant feces, including L. sakei, L. rhamnosus, L. brevis, and L. plantarum, and those that improved the life span of Caenorhabditis elegans were selected for evaluation. Of the 17 strains, 2 (L. rhamnosus LFR20-004 and L. sakei LFR20-007) were selected based on data showing that these strains increased both the sialic acid and GABA contents of deer antler extract after fermentation for 2 d and significantly improved the life span of C. elegans. Co-fermentation with both strains further increased the concentrations of sialic acid, GABA, and metabolites such as short-chain fatty acids and amino acids. We evaluated the biological effects of the fermented antler velvet (FAV) on the antibacterial immune response in C. elegans by assessing worm survival after pathogen infection. The survival of the C. elegans conditioned with FAV for 24h was significantly higher compared with that of the control worm group fed only normal feed (non-pathogenic E. coli OP50) exposed to E. coli O157:H7, Salmonella typhi, and Listeria monocytogenes. To evaluate the protective effects of FAV on immune response, cyclophosphamide (Cy), an immune-suppressing agent was treated to in vitro and in vivo. We found that FAV significantly restored viability of mice splenocytes and immune promoting-related cytokines (interleukin [IL]-6, IL-10, inducible nitric oxide synthase [iNOS], interferon [IFN]-γ, and tumor necrosis factor [TNF]-α) were activated compared to non-fermented deer antlers. This finding indicated the protective effect of FAV against Cy-induced cell death and immunosuppressed mice. Taken together, our study suggests that immune-promoting antler velvet can be produced through fermentation using L. rhamnosus LFR20-004 and L. sakei LFR20-007.

Screening and prevention of the mutagenicity for fishes accordind to cookery and storage (어류의 가열조리 및 보존에 의해 생성되는 변이원성 물질의 정량적 해석과 제어법)

  • 홍이진;이준경;구성자
    • Korean journal of food and cookery science
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    • v.16 no.6
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    • pp.652-662
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    • 2000
  • This study was performed to measure the mutagenicity of fish by cooking and storage. Mutagenicity of the fish extract was measured by Ames test(Salmonella typhimurium reversion assay with TA 100) in vitro and by micro-nucleus test in vivo. The fish samples screened in this study were white fish(Trichiurus, Croaker, Salted Croaker) and red fish(Saury pike, Mackerel, Yellowtail, Salmon). The number of revertants of red fish were significantly higher than that of white fish. And the mutagenicity of mackerel was higher than other red fish, so followed experiment was made by using the extract of mackerel. Mutagenicity of the samples cooked on microwave oven was the lowest, whereas there was no significant difference between the samples cooked on gas grill and the ones on electric grill. In the presence of S9 mixture, the methanol extract of mackerel showed 2∼4 times high values of mutagenicity in comparison with the extract without S9. The extract of mackerel cooked with various vegetable juices showed inhibitory effects on the mutagenicity in the order of green tea, ginger, and radish. Also, the number of revertants was increased in the stored samples. Mutagenicity of the samples stored in the refrigerator was higher than that of the freezer. In micronucleus test, the methanol extract treated with vegetable juice inhibited micro-nucleus formation in bone marrow by cyclophosphamide in the order of ginger, green tea, and radish. In TBA test, there was a tendency that TBA values were increased as the storage time increased. Also, the rancidity of sample were stored in the refrigerator was higher value than sample stored in the freezer. Samples cooked on microwave oven showed the highest value in rancidity. When the antioxidant effect of vegetable juice was measured by electron donating ability(EDA) of mackerel cooked with vegetable juice to DPPH, the samples treated with onion showed the highest value of EDA(%), and the samples treated with green tea, ginger and cabbage also showed the antioxidant effect.

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Breast Conserving Operation and Radiation Therapy in Early Breast Cancer : Interim Analysis (초기유방암에서 유방보존수술 후 방사선치료 : 중간분석)

  • Kim, Jin-Hee;Kim, Ok-Bae;Kim, You-Sah
    • Radiation Oncology Journal
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    • v.19 no.1
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    • pp.27-33
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    • 2001
  • Purpose : To evaluate interim results in terms of failure, cosmetic results and survival after breast conserving operation and radiation therapy in early breast cancer. Material and Methods : From January 1992 through December 1997, seventy two patients with early stage 0, I and II breast cancer were treated with conservative surgery plus radiotherapy at Keimyung University Dongsan Medical Center. Age distribution was 25 to 77 years old with median age of 43. According to TNM stage, five patients had stage 0, thirty three were stage I, twenty five were IIa, and nine were IIb. Most patients underwent excision of all gross tumor and ipsilateral axillary dissection. Breast was irradiated through medial and lateral tangential fields of 6 MV photons to 50.4 Gy in 28 fractions over 5.5 weeks. We delivered a boost irradiation dose of 10 to 16 Gy in 1 to 2 weeks to excision site. Adjuvant chemotherapy was administered in forty one patients with CMF (cyclophosphamide, methotrexate, 5-fluorouracil) regimens of 6 cycles concurrently or before radiation. Cosmetic results were assessed by questionnaire to patients grading of excellent, good, fair, poor. Follow-up periods were 22 to 91 months with median 40 months. Results : Five year disease free survival rate (5YDFS) was $95.8\%$. According to stage, 5YDFS was $100\%,\;96.9\%,\;96\%\;and\;88.9\%$ in stage 0, I, IIa and IIb, respectively. Two patients had distant metastasis and one had local and distant failure. One patient with distant failure had bone and liver metastasis at 14 months after treatment and the other had lung and both supraclavicular metastasis at 21 months after treatment. Patient with local and distant failure had local recurrence on other quadrant in same breast and then salvaged with total mastectomy and chemotherapy but she died due to brain metastasis at 55 months. Complications were radiation pneumonitis in five patients (four patients of asymptomatic, one patients of symptomatic) and hand or arm edema(4 patients). Fifty nine patients answered our cosmetic result questionnaire and cosmetic results were good to excellent in fifty one patients $(86\%)$. Conclusion : We considered that conservative surgery and radiation for the treatment of early stage invasive breast cancer was safe and had excellent survival and cosmetic results. We need to assess about prognostic factors with longer follow up and with large number of patients.

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Clinicopathological evaluation of Childhood Henoch-$Sch{\ddot{o}}nlein$ Purpura(HSP) Nephritis with Nephrotic Syndrome (신증후군을 동반한 Henoch-$Sch{\ddot{o}}nlein$ 신염 환아의 임상병리 적 고찰)

  • Kang Hyeon-Ho;Yoon Kyung-Leem;Cho Byoung-Soo
    • Childhood Kidney Diseases
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    • v.4 no.2
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    • pp.111-119
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    • 2000
  • Purpose : Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP) is a common pediatric discase presenting most frequently with skin, gastrointestinal, joint and renal manifestations. The prognosis of HSP is mainly determined by the involvement of the kidney, but prognostic markers have not been established. We evaluated the patients who have HSP nephritis with nephrotic syndrome. Method : Clinical manifestations and laboratory findings were observed and analyzed in 34 cases with HSP which were manifested by nephrotic syndrome hospitalized at Kyung Hee university Hospital during the period from Jan. 1990 to Dec. 1998. Results : 1) Male to female ratio was 1.3:1, and mean age at onset was 8.3 year. 2) Mean duration from symptom onset to renal biopsy was 10.5 weeks. 3) Proportion of patients presenting with acute nephritis was 32.4$\%$, gross hematuria 17.6$\%$, microscopic hematuria 50$\%$. 4) The findings of renal biopsy were 20 cases of grade II, 11 cases of grade III, 2 cases of grade I, 1 case of grade IV according to classification by ISKDC. 5) Patients with grade I were recovered with no residual defect, but patients with grade IV shows active renal disease(states C). Conclusion : Among the 디le patients with Henoch-$Sch{\ddot{o}}nlein$ purpura accompanying nephrotic syndrome, more aggressive treatment might be needed in patients showing crescents formation on renal biopsy. A prospective study will be needed to explore the progression of this disease.

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Effect of Panax ginseng on the Graft-versus-Host Reaction, Production of Leucocyte Migration Inhibitory Factor and Expulsion of Adult Trichinella spiralis in Mice (인삼이 이식편대숙주반응, 대식세포유주저지반응 및 Trichinella spiralis의 expulsion에 미치는 영향)

  • Ha, Tai-You;Lee, Jeong-Ho;Kim, Sang-Hyung
    • The Journal of the Korean Society for Microbiology
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    • v.21 no.1
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    • pp.133-144
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    • 1986
  • This study was undertaken to assess the effect of ginseng administration on T lymphocyte induced local xenogenic graft-versus-host(GVM) reactions which were induced with thymocyte, spleen cell and lymph node cell of ICR mice. Mice received daily 10mg of 70% alcohol ginseng extract oral1y for 100days and control mice remained untreated for the same period of time. The cells from donor mice were injected intradermally into the closely shaven abdominal skin of Sprague-Dawley rats for GVH tests. The thymocyte from control(ginseng-untreated) mice showed a negative local GVH reaction, whereas thymocyte from experimental(ginseng-treated) mice showed a positive reaction with the rate of 17.4%. When spleen cells were injected, the incidence of positive local GVH reaction was 66.7% among ginseng-treated mice, as opposed to incidence of 45.5% of positive local GVH reaction among control mice. The incidence of positive local GVH reaction of the lymph node cells when injected into a recipient was 71.4% among ginseng-treated mice as compared with that of 18.9% among control mice. The relationship between spleen cell inoculum and intensity of the local GVH reaction was assessed in ginseng-untreated mice. The intensity of GVH reaction clearly appears to be dose related. In ginseng-treated mice, a minimum of $1{\times}10^7$ spleen cell was required for production of positive local GVH reaction with almost linear relationship up to an inoculum of $5{\times}10^8$ cells. In control mice, however, a minimum of $1{\times}10^8$ spleen cells was required for positive GVH reaction. These results strongly suggest that the ginseng administration augments significantly the local xenogenic GVH reaction which was used to assess T lymphocyte function and immunocompetence of mice and in addition to this, these results appear to support previous suggestions that the local GVH reaction consitutes a qualitative test of the functional activity of T lymphocytes. These results may be the first to induce local GVH reaction, employing rats as recipient and mice as donor. This study was also desingned to investigate some of the effects of ginseng extract on lymphocyte-macrophage interactions. This was accomplished by in vitro quantification of 1) migratory inhibitory factor(MIF) synthetic capacity of splenic lymphocytes in mice previously primed with ginseng 2) MIF responsiveness of mouse peritoneal macrophages or chicken peripheral leucocytes under the presence of ginseng extract 3) migration ability of chicken peripheral leucocytes by direct stimulation of ginseng extract or ginseng saponin and 4) immunosuppressive effects of immunosuppressants such as cyclophosphamide, cyclosporin A or dexamethasone. Mice divided equally into the ginseng and the saline groups, which received intraperitoneally daily 0.2ml of ginseng absolute alcohol-extract(5mg/ml) and same amount of saline for 15 days, respectively. The cellular immune responsiveness of these mice was assayed 15 days after ginseng pretreatment. Splenic lymphocytes of mice treated with ginseng, when stimulated with sensitized specific-antigen such as sheep red blood cells or toxoplasmin, or with polyclonal activator concanavalin A, produced significantly more MIF than those of control saline group. MIF responsiveness of normal mouse macrophages was significantly augmented when assayed under the presence of ginseng extract (1mg/ml). The migratory ability of normal chicken leucocytes in the absence of MIF was significantly decreased by the stimulation of ginseng extract alone. MIF response was significantly decreased by immunosuppressants and this impaired response was not restored by ginseng pretreatment. This study was additionally performed to evaluate the effect of ginseng on the expulsion of adult Trichinella spiralis in mice. ICR mice were infected experimentally by esophageal incubation of 300 T. spiralis infective muscle larvae prepared by acid-pepsin digestion of infected mice. and received oral administration of 70% alcohol ginseng extract(10mg/mouse/day) for the indicated days plus 4 days before infection. At various times after infection, the number of adult T. spiralis worms in small intestines was determined. Interestingly, ginseng-treatment was accompanied by accelerated expulson of T. spiralis. These results led to the conclusion that Panax ginseng caused some enhancing effect on GVH reaction, macrophage migration inhibition reaction and expulsion of T. spiralis. In addition these results suggested that the mechanisms responsible for this enhancement of ginseng may be chiefly or partially due to nonspecific stimulation of cell-mediated immune response.

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