• Title/Summary/Keyword: Leukemia-lymphoma

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A Study on the Dose Distribution for Total Body Irradiation using Co-60 Teletherapy Unit (Co-60 Teletherapy Unit를 이용한 전신조사의 선량분포에 관한 고찰)

  • Kim, Sung-Kyu;Shin, Sei-One;Kim, Myung-Se
    • Journal of Yeungnam Medical Science
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    • v.6 no.2
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    • pp.113-119
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    • 1989
  • In recent years there has been a growing interest in total body, hemibody, total lymphoid irradiation. For refractory leukemia or lymphoma patients, various techniques and dose regimens were introduced, including high dose total body irradiation for destruction of leukemic or bone marrow cells and immunosuppression prior to bone marrow transplantation, and low dose total body irradiation for treatment of lymphocytic leukemia or lymphomas. Accurate provision for specified dose and the desired homogeneity are essential before clinical total body irradiation. Purposes of this paper are to discuss calibrating Cobalt Unit in 3m distance using Rando Phantom, to compare calculated dose, calibrated dose, and compensating filters for homogeneous dose distribution in the head and neck, the lung, and the pelvis. Results were following. 1. Measured dose on the lung was 6% higher than on the abdomen. Measured dose on the head (10%) and neck (18%) were higher than the abdomen because of thinness. Pelvic dose was measured 12% less than the abdomen. Those data suggest that compensating filter was essential. 2. Measured dose according to distance was 3% less than calculated dose which suggest that all doses in clinical use should be compared with calculated dose for minimizing error.

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Dose Distribution of Total Body Irradiation for Bone Marrow Transplantation in Leukemia (백혈병에서 골수이식을 위한 전신방사선조사시 선량분포 특성)

  • 김성규;김명세;신세원
    • Progress in Medical Physics
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    • v.7 no.2
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    • pp.47-55
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    • 1996
  • Total Body Irradiation(TBI) is one of the essential treatment modalities in bone marrow transplantation for leukemia and lymphoma. Various techniques and dose regimens were introduced with sevelal advantages and disadvantages. In TBI, lung block could reduce lung dose to 75% of original beam for decreasing lung dose with homogenous total body irradiation. Accurate provision for specified dose and the desired homogeneity are essential before clinical total body irradiation. When performed in total body irradiation, the problem obtain uniform dose distribution in brain, neck, lung, umbilicus, pelvis and leg. Authors compared to dose distribution with method 1 and method 2. The method 1 used compensating filters for homogeneous dose distribution(Minesota University Method). The method 2 used fixing frame made in aeryl developing authors. Results were following. 1. Method 1 was showed dose distribution from 95.6% to 100%, method 2 showed dose distribution from 95.4% to 100%. 2. Method 2 was showed different to 3.4% at skin region and midline in the brain. In the neck, showed different to 1.5%. In the umbilicus. showed different to 2.3%.

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Medical Expenses by Site of Cancer and Survival Time among Cancer Patients in the Last One Year of Life (암환자에서 암발생부위와 생존기간에 따른 사망전 1년간의 의료비용)

  • Yi, Jee-Jeon;Yoo, Won-Kon;Kim, So-Yoon;Kim, Kwang-Ki;Yi, Sang-Wook
    • Journal of Preventive Medicine and Public Health
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    • v.38 no.1
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    • pp.9-15
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    • 2005
  • Objectives : To analyze medical expenses by cancer site and survival time among cancer patients in their last year of life. Method : The study subjects were 45,394 people that had died of cancers in 2002, were registered by the Korea Central Cancer Registry and received National Health Insurance benefit in the last year (360 days) of life. Personal identification data, general characteristics, dates of death and cancer incidence, and site of cancer were collected from the National Statistical Office and the Korea Central Cancer Registry, and merged with the data of the individual medical expenses of the Health Insurance Review Agency. Results : Average monthly cost curves were U-shaped with high costs near the time of diagnosis and death, and lower costs in between. Medical expenses in the last year of life were around 30.3, 16.7, 13.0, and 12.1 million won among leukemia, lymphoma, ovarian cancer, and breast cancer patients, respectively. Digestive organ cancers including stomach, esophagus, liver, pancreas, and colorectal cancers had relatively low medical expenses. Medical expenses in the last year of life were inverse U-shaped with high expenses near one year of survival. Average monthly cost in the 12 months before death among the patients who had survived $10{\sim}15$ years were more than two-fold greater than the cost before diagnosis among those who had survived for less than one year. Conclusions : Leukemia was the most expensive cancer. It is possible that once diagnosed as cancer, medical expenses do not return to the level before diagnosis. Further research will be needed to understand the magnitude and change of the medical expenses among cancer patients with long term follow up data.

Surgical Roles for Spinal Involvement of Hematological Malignancies

  • Kim, Sang-Il;Kim, Young-Hoon;Ha, Kee-Yong;Lee, Jae-Won;Lee, Jin-Woo
    • Journal of Korean Neurosurgical Society
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    • v.60 no.5
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    • pp.534-539
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    • 2017
  • Objective : Patients with hematological malignancies frequently encounter spine-related symptoms, which are caused by disease itself or process of treatment. However, there is still lack of knowledge on their epidemiology and clinical courses. The purpose of this article is to review clinical presentations and surgical results for spinal involvement of hematologic malignancies. Methods : From January 2011 to September 2014, 195 patients (98 males and 97 females) suffering from hematological malignancies combined with spinal problems were retrospectively analyzed for clinical and radiological characteristics and their clinical results. Results : The most common diagnosis of hematological malignancy was multiple myeloma (96 patients, 49.7%), followed by chronic myeloid leukemia (30, 15.2%), acute myeloid leukemia (22, 11.2%), and lymphoma (15, 7.56%). The major presenting symptoms were mechanical axial pain (132, 67.7%) resulting from pathologic fractures, and followed by radiating pain (49, 25.1%). Progressive neurologic deficits were noted in 15 patients (7.7%), which revealed as cord compression by epidural mass or compressive myelopathy combined with pathologic fractures. Reconstructive surgery for neurologic compromise was done in 16 patients. Even though surgical intervention was useful for early paralysis (Frankel grade D or E), neurologic recovery was not satisfactory for the progressed paralysis (Frankel grade A or B). Conclusion : Hematological malignancies may cause various spinal problems related to disease progression or consequences of treatments. Conservative and palliative treatments are mainstay for these lesions. However, timely surgical interventions should be considered for the cases of pathologic fractures with progressive neurologic compromise.

1, 25(OH)$_2$-23ene-$D_3$ : Effects on Proliferation and Differentiation of U937 Cells in vitro and on Clcium Metabolism of Rat in vivo (1, 25(OH)$_2$-23ene-$D_3$ : in vitro에서 U937 세포의 증식과 분화 및 in vivo에서 쥐의 칼슘대사에 미치는 영향)

  • 정수자;서명자
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.24 no.1
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    • pp.1-9
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    • 1995
  • 1, 25(OH)2-23ene-D3 is a novel vitamine D3 analog which has a double bond between C-23 and C-24. We describe the effects of this analog on cell differentiation and cell proliferation in vitro using the human histiocytic lymphoma cell line U937, and on calcium metabolism in rats in vivo. In the present investigation 1, 25(OH)2-23ene-D3 was compared to the natural metabolite of vitamin D3, 1$\alpha$, 25-dihydroxycholecalciferol[1, 25(OH)2-23ene-D3 was more potent than 1, 25(OH)2-23ene-D3 for inhibition of proliferation and induction of differentiation of U937 cells. Especially, its effect on induction of differentiation, as measured by superoxide production and nonspecific esterase(NSE) activity, was about 20-fold more potent that 1, 25(OH)2-23ene-D3. This analog morphologically and functionally differentiated U937 cells to monocyte-macrophage phenotype showing a decrease of N/C ratio in Giemsa staining and the increase of adherence ability to surface. Intraperitoneal administration of 1, 25(OH)2-23ene-D3 to rats showed that the compound had at least 50 times less activity than 1, 25(OH)2-23ene-D3 in causing hypercalcemia and hypercalciuria. The strong direct effects of 1, 25(OH)2-23ene-D3 on cell proliferation and cell differentiation, coupled with its decreased activity of calcium metabolism make this compound an interesting candidate for clinical studies including patients with leukemia, as well as several skin disorders, such as psoriasis.

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Central and Peripheral Distribution of Bone Marrow on Bone Marrow Scintigraphy with Antigranulocytic Antibody in Hematologic Malignancy (혈액 종양 질환에서 항과립구항체 골수 스캔을 이용한 중심 골수와 말초 골수 분포의 분석)

  • Kang, Do-Young;Lee, Jae-Tae;Sohn, Sang-Kyun;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.5
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    • pp.298-305
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    • 2002
  • Purpose: Bone marrow scintigraphy has been used to evaluate the status of bone marrow in various hematologic disorders. We have analyzed the peripheral distribution pattern and central uptake ratio of bone marrow using anti-NCA-95 monoclonal antibody and the their correlation in patients with various hematologic malignancy. Materials and Methods: Bone marrow immunoscintigraphy was performed using Tc-99m anti-granulocyte monoclonal mouse antibody BW 250/183. Fifty patients were classified into four groups; 11 with acute myelogenous leukemia, 12 with acute lymphocytic leukemia, 15 with lymphoma and 12 with myelodysplastic syndrome. The extension of peripheral bone marrow was categorized into four grades: I, II, III and IV. The activity of central bene marrow was expressed as sacroiliac uptake ratio. Results: The patient's number was 4 in grade I, 27 in grade II, 15 in grade III and 4 in grade IV according to extension of peripheral bone marrow. The extension of peripheral bone marrow was marked (58% in grade III and IV) in myelodysplastic syndrome and acute lymphocytic leukemia and mild (93% in grade I and II) in lymphoma. Sacroiliac uptake ratio was highest ($8.5{\pm}4.0$) in myelodysplastic syndrome and lowest ($5.9{\pm}3.6$) in acute myelogenous leukemia, but not significantly different among four patient groups (p>0.05). Sacroiliac uptake ratio of whole patients was significantly different among four grades (p=0.003), but there was not correlated between grade of peripheral bone marrow and sacroiliac uptake ratio (r=0.05). Conclusion: The pattern of peripheral bone marrow extension and activity of central hemopoietic marrow were not specific to the disease entities. Response of hemopoietic bone marrow may be evaluated on both peripheral and central bone marrow in patients with hematologic malignancy.

Antioxidant Activity and Inhibitive Effects on Human Leukemia Cells of Edible Mushrooms Extracts (식용버섯 추출물의 항산화 활성 및 혈액암세포에 대한 저해효과)

  • Kim Hyun Jeong;Bae Joon-Tae;Lee Ji-Won;Hwang Bo Mi-Hyang;Im Hyo Gwon;Lee In-Seon
    • Food Science and Preservation
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    • v.12 no.1
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    • pp.80-85
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    • 2005
  • The effect of 12 edible mushroom species on the antioxidant and cytotoxicity on cancer cells were studied Methanol extract of Lyophyllum ulmarium, Cordyceps militaris and Sarcodon aspratus showed $30\~60\%$ DPPH radical scavenging activity and $39\~53\%$ protective effects against the cytotoxicity of $B_2O_2$. Methanol extracts of Sarcodon aspratus, Lyophyllum ulmarium, Cordyceps militaris, Agaricus blazei and Ganoderma lucidum revealed high inhibitive activities in cytotoxicity on human leukemia tells such as promyelocytic leukemia cell (HL60) and histiocytic lymphoma cell (U937). Highest toxicity was observed against HL60 cells in Sarcodon aspratus methanol extract showing $70.5\%$ inhibition at 1mg/mL whereas Cordyceps militaris methanol extract showed $81.5\%$ inhibition against U937 cells. Most water extracts of edible mushrooms exhibited the lowest effect against HL60 and U937 cells compared to methanol extract. These extract did not show cytotoxic effects against human lymphocyte. Results revealed 5 kinds of edible murshroom (Cordyceps militaris, Agaricus blaxei, Lyophyllum ulmarium, Ganoderma lucidum and Sarcodon aspratus) have strong antioxidative and in vitro anticancer efforts.

Quantitative Analysis of Methotrexate using Hitach-7600 P-module (Hitach-7600 P-module을 이용한 Methotrexate 정량분석 평가)

  • Kim, Min-Eui;Cha, Kyong-Ho;Kim, Seung-Hee;Kim, Nam-Joo;Chae, Hyo-Jin
    • Korean Journal of Clinical Laboratory Science
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    • v.41 no.4
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    • pp.167-172
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    • 2009
  • Methotrexate (MTX) in one of the antineoplastic drug and it is known to effective to management of acute lymphoblastic leukemia in children, management of choriocarcinoma and related trophoblastic tumors in women, management of carcinomas of the breast, tongue, pharynx, and tests, maintenance of remission in leukemia and treatment of serve, debilitating psoriasis. Intermediate to high-dose methotrexate administration followed by leucovorin rescue is effective in treatment of carcinoma of the lung and osteogenic sarcoma. Intrathecal administration is effective in treating meningeal leukemia or lymphoma. There are FPIA (Fluorescence polarization immunoassay) and EMIT (Enzyme multiplied immunotechique) methods that measure for MTX. We evaluated the FPIA and EMIT methods. MTX were measured by Hitachi-7600 P-module using EMIT and FPIA using TDX in the sera 60 patients. The performance characteristics evaluated were, light influence, linearity, comparison with FPIA. Also, precision evaluated were three level controls through put following CLSI evaluation protocols (EP10-A). When the MTX value of $4.16{\pm}5.78{\mu}{\mu}mol/L$ (mean, SD) by the Hitachi-7600 P-module was compared with that of $4.05{\pm}5.47{\mu}{\mu}mol/L$ by FPIA, coefficients of correlation of 0.988 was obtained. The regression equation was Y (Hitachi-7600 P-module) = 0.9408 x (FPIA) + 0.1316 (r=0.9885, n=60). CVs of MTX measured by Hitachi 7600 P-module was 6.78% at $0.33{\mu}{\mu}mol/L$, 0.96% at $1.16{\mu}{\mu}mol/L$, and 0.96% at $8.04{\mu}{\mu}mol/L$. The precision was excellent in each group. The linearity was acceptable. We evaluated that MTX is light-sensitive on prolonged exposure to direct sunlight. Comparing with the FPIA using TDX, the Hitachi-7600 P-module using EMIT showed good coefficient of correlation and precision. Therefore the Hitachi-7600 P-module can replace the FPIA for quantitative analysis of MTX.

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Immunotherapeutic Approach for Better Management of Cancer - Role of IL-18

  • Kuppala, Manohar Babu;Syed, Sunayana Begum;Bandaru, Srinivas;Varre, Sreedevi;Akka, Jyothy;Mundulru, Hema Prasad
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5353-5361
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    • 2012
  • Interleukin-18 (IL-18) is an immune-stimulatory cytokine with antitumor activity in preclinical models. It plays pivotal roles in linking inflammatory immune responses and tumor progression and is a useful candidate in gene therapy of lymphoma or lymphoid leukemia. A phase I study of recombinant human IL-18 (rhIL-18) in patients with advanced cancer concluded that rhIL-18 can be safely given in biologically active doses to patients with advanced cancer. Some viruses can induce the secretion of IL-18 for immune evasion. The individual cytokine activity might be potentiated or inhibited by combinations of cytokines. Here we focus on combinational effects of cytokines with IL-18 in cancer progression. IL-18 is an important non-invasive marker suspected of contributing to metastasis. Serum IL-18 may a useful biological marker as independent prognostic factor of survival. In this review we cover roles of IL-18 in immune evasion, metastasis and angiogenesis, applications for chemotherapy and prognostic or diagnostic significance.

Interactive Visualization for Patient-to-Patient Comparison

  • Nguyen, Quang Vinh;Nelmes, Guy;Huang, Mao Lin;Simoff, Simeon;Catchpoole, Daniel
    • Genomics & Informatics
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    • v.12 no.1
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    • pp.21-34
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    • 2014
  • A visual analysis approach and the developed supporting technology provide a comprehensive solution for analyzing large and complex integrated genomic and biomedical data. This paper presents a methodology that is implemented as an interactive visual analysis technology for extracting knowledge from complex genetic and clinical data and then visualizing it in a meaningful and interpretable way. By synergizing the domain knowledge into development and analysis processes, we have developed a comprehensive tool that supports a seamless patient-to-patient analysis, from an overview of the patient population in the similarity space to the detailed views of genes. The system consists of multiple components enabling the complete analysis process, including data mining, interactive visualization, analytical views, and gene comparison. We demonstrate our approach with medical scientists on a case study of childhood cancer patients on how they use the tool to confirm existing hypotheses and to discover new scientific insights.