• 제목/요약/키워드: Lung failure

검색결과 366건 처리시간 0.034초

Establishment of Paclitaxel-resistant Breast Cancer Cell Line and Nude Mice Models, and Underlying Multidrug Resistance Mechanisms in Vitro and in Vivo

  • Chen, Si-Ying;Hu, Sa-Sa;Dong, Qian;Cai, Jiang-Xia;Zhang, Wei-Peng;Sun, Jin-Yao;Wang, Tao-Tao;Xie, Jiao;He, Hai-Rong;Xing, Jian-Feng;Lu, Jun;Dong, Ya-Lin
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권10호
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    • pp.6135-6140
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    • 2013
  • Background: Breast cancer is a common malignant tumor which affects health of women and multidrug resistance (MDR) is one of the main factors leading to failure of chemotherapy. This study was conducted to establish paclitaxel-resistant breast cancer cell line and nude mice models to explore underlying mechanisms of MDR. Methods: The breast cancer drug-sensitive cell line MCF-7 (MCF-7/S) was exposed in stepwise escalating paclitaxel (TAX) to induce a resistant cell line MCF-7/TAX. Cell sensitivity to drugs and growth curves were measured by MTT assay. Changes of cell morphology and ultrastructure were examined by optical and electron microscopy. The cell cycle distribution was determined by flow cytometry. Furthermore, expression of proteins related to breast cancer occurrence and MDR was tested by immunocytochemistry. In Vivo, nude mice were injected with MCF-7/S and MCF-7/TAX cells and weights and tumor sizes were observed after paclitaxel treatment. In addition, proteins involved breast cancer and MDR were detected by immunohistochemistry. Results: Compared to MCF-7/S, MCF-7/TAX cells had a higher resistance to paclitaxel, cross-resistance and prolonged doubling time. Moreover, MCF-7/TAX showed obvious alterations of ultrastructure. Estrogen receptor (ER) expression was low in drug resistant cells and tumors while expression of human epidermal growth factor receptor 2 (HER2) and Ki-67 was up-regulated. P-glycoprotein (P-gp), lung resistance-related protein (LRP) and glutathione-S-transferase-${\pi}$ (GST-${\pi}$) involved in the MDR phenotype of resistant cells and tumors were all overexpressed. Conclusion: The underlying MDR mechanism of breast cancer may involve increased expression of P-gp, LRP and GST-${\pi}$.

체간부 장기 손상을 동반한 외상성 체간부 동맥 손상 환자의 치료 방침 (Therapeutic Plan for Traumatic Truncal Arterial Injury Associated with Truncal Organ Injury)

  • 조충현;정용식;김욱환;조영신;안정환;민영기;정윤석;김성희;이국종
    • Journal of Trauma and Injury
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    • 제22권1호
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    • pp.77-86
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    • 2009
  • Purpose: The appropriate management of traumatic truncal arterial injury is often difficult to determine, particularly if the injury is associated with severe additional truncal lesions. The timing of repair is controversial when patients arrive alive at the hospital. Also, there is an argument about surgery versus stent-graft repair. This study's objective was to evaluate the appropriate method and the timing for treatment in cases of truncal abdominal injury associated with other abdominal lesions. Methods: The medical records at Ajou University Medical Center were reviewed for an 8-year period from January 1, 2001, to December 31, 2008. Twelve consecutive patients, who were diagnosed as having had a traumatic truncal arterial injury, were enrolled in our study. Patients who were dead before arriving at the hospital or were not associated with abdominal organ injury, were excluded. All patients involved were managed by using the ATLS (Advanced Trauma Life Support) guideline. Data on injury site, the timing and treatment method of repair, the overall complications, and the survival rate were collected and analyzed. Results: Every case showed a severe injury of more than 15 point on the ISS (injury severity score) scale. The male-to-female ratio was 9:3, and patients were 41 years old on the average. Sites of associated organ injury were the lung, spleen, bowel, liver, pelvic bone, kidney, heart, vertebra, pancreas, and diaphragm ordered from high frequency to lower frequency. There were 11 cases of surgery, and one case of conservative treatment. Two of the patients died after surgery for truncal organ injury: one from excessive bleeding after surgery and the other from multiple organ failure. Arterial injuries were diagnosed by using computed tomography in every case and 9 patients were treated by using an angiographic stent-graft repair. There were 3 patients whose vessels were normal on admission. Several weeks later, they were diagnosed as having a truncal arterial injury. Conclusion: In stable rupture of the truncal artery, initial conservative management is safe and allows management of the major associated lesions. Stent grafting of the truncal artery is a valuable therapeutic alternative to surgical repair, especially in patients considered to be a high risk for a conventional thoracotomy.

비인강암의 방사선치료 성적 (Results of Radiation Therapy in Nasopharyngeal Cancer)

  • 조문준;장지영;김준상;김병국;송창준;김재성
    • Radiation Oncology Journal
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    • 제19권1호
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    • pp.10-15
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    • 2001
  • 목적 : 비인강암 환자의 방사선치료 성적을 후향적으로 분석하여 방사선치료의 효과와 예후인자를 분석하고자 하였다. 대사 및 방법 : 1989년 9월부터 1996년 10월까지 비인강암으로 진단받고 방사선치료를 받은 19명을 대상으로 하였다. 병기별로 보면 I 병기가 2명, II 병기가 6명, III 병기가 2명, IV 병기가 9명이었다. 병리조직학적으로 편평세포암이 5명, 미분화세포암이 14명이었다. 14명은 방사선치료만을 받았다. 5명은 항암제치료를 받았다. 추적 기간은 5개월에서 115개월이였으며 중앙값은 33개월이었다. 모든 환자에게서 추적이 가능하였다. 결과 : 방사선치료 후 15명$(79\%)$에서 완전관해를 보였고 2명$(10.5\%)$에서 부분관해를 보였으며 2명$(10.5\%)$에서는 무반응을 보였다. 치료실패 양상은 국소 실패가 6명이었으며 원격전이가 4명에서 나타났다. 원격전이는 뼈, 간, 폐 등에서 관찰되었다. 전체 환자의 5년 생존율은 $47.4\%$이었고 5년 무병 생존율은 $48.1\%$였다. 병기, T 병기, N 병기, 뇌신경침윤 여부, 병리학적 유형, 활동지수, 반응도, 방사선량, 항암제 치료여부 등에 의한 생존율의 의미 있는 통계적 차이는 없었다. 결론 : 전체 환자의 5년 생존율은 $47.4\%$이었고 5년 무병 생존율은 $48.1\%$이었다. 치료 효과를 증가시키기 위하여 방사선치료 방법의 개선 및 항암제치료 방법에 대한 연구가 필요할 것으로 사료된다.

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미분화 갑상선암의 치료 (Treatment of Anaplastic Thyroid Cancer)

  • 장항석;윤종호;정웅윤;이미경;박정수
    • 대한두경부종양학회지
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    • 제14권2호
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    • pp.220-227
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    • 1998
  • The clinical and pathological features of 35 cases of anaplastic thyroid cancer were studied. These tumors occurred in 12 men and 23 women ranging in age from 19 to 83 years(mean age; 61.7 years). A rapidly enlarging thyroid mass was the most common presentation. The duration of the presence of mass varied from 20 days to 12 months with an average of 2.7 months. Systemic metastasis at the time of initial examination was found in 14 patients(40.0%) and the lung was the most common site of involvement. The overall rate of distant metastasis was about 65.7%. The tumors were subdivided morphologically into giant cell type of 10 cases, spindle cell type of 7 cases, epidermoid cell type of 1 cases, and mixed giant cell and spindle cell type of 5 cases. The mean survival period of 6 among 35 patients who had biopsy alone was 1.4 months. The 22 patients underwent the incomplete combined treatment modalities (palliative surgery with or without chemotherpy or radiation therapy) survived for a mean period of 3.0 months, among them, 7 patients who had surgery combined with chemotherapy and radiation therapy showed mean survival period of 3.7 months. The mean survival of 7 patients who had complete combined treatment modality(curative surgery combined with chemotherapy and hyperfractionated radiation therapy) was 6.6 months, only one patient survived for 21 months and one patient has been alive for 1 month after operation, and the others survived for a mean period of 4.8 months. So far, as of July 31, 1998, 34 patients among 35 were died(one has been survived for 1 month) despite the various treatment modalities, and the main cause of death were failure of local control and systemic metastasis. None of the various treatment modalities gave consistently favourable results. However, a combination of surgery, radiation therapy and chemotherapy seemed to have a slight positive effect on survival. Furthermore, the aggressive treatment modalities will be indicated only in the early diagnosed and minimal cases.

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Bronchial compression in an infant with isolated secundum atrial septal defect associated with severe pulmonary arterial hypertension

  • Park, Sung-Hee;Park, So-Young;Kim, Nam-Kyun;Park, Su-Jin;Park, Han-Ki;Park, Young-Hwan;Choi, Jae-Young
    • Clinical and Experimental Pediatrics
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    • 제55권8호
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    • pp.297-300
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    • 2012
  • Symptomatic pulmonary arterial hypertension (PAH) in patients with isolated atrial septal defect (ASD) is rare during infancy. We report a case of isolated ASD with severe PAH in an infant who developed airway obstruction as cardiomegaly progressed. The patient presented with recurrent severe respiratory insufficiency and failure to thrive before the repair of the ASD. Echocardiography confirmed volume overload on the right side of heart and severe PAH (tricuspid regurgitation [TR] with a peak pressure gradient of 55 to 60 mmHg). The chest radiographs demonstrated severe collapse of both lung fields, and a computed tomography scan showed narrowing of the main bronchus because of an intrinsic cause, as well as a dilated pulmonary artery compressing the main bronchus on the left and the intermediate bronchus on the right. ASD patch closure was performed when the infant was 8 months old. After the repair of the ASD, echocardiography showed improvement of PAH (TR with a peak pressure gradient of 22 to 26 mmHg), and the patient has not developed recurrent respiratory infections while showing successful catch-up growth. In infants with symptomatic isolated ASD, especially in those with respiratory insufficiency associated with severe PAH, extrinsic airway compression should be considered. Correcting any congenital heart diseases in these patients may improve their symptoms.

Cyclophosphamide에 의해 유발된 미만성 폐포 손상 1예 (A Case of Diffuse Alveolar Damage Induced by Cyclophosphamide)

  • 배상수;배문희;박형석;박정웅;서지영;정만표;한정호;권오정;이경수;이종헌
    • Tuberculosis and Respiratory Diseases
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    • 제45권2호
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    • pp.429-436
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    • 1998
  • 저지들은 이전의 문헌과 비슷하게 만성 특발성 혈소판 감소증 환자에서 cyclophosphamide와 스테로이드 치료도중 cyclo-phosphamide 최초 투여 시작일로부터 1~2개월이내에 발생한 조기 발현형 폐독성으로 개흉폐생검을 통하여 진단한 후 조기에 cyclophosphamide의 투여 중단과 함께 스테로이드 사용에도 불구하고 진행성 호흡부전으로 사망한 환자를 경험하였기에 이틀 문헌고찰과 함께 보고하는 바이다.

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내과적 치료와 함께 폐절제술을 시행하여 균음전에 성공한 Mycobacterium avium 폐질환 1례 (Successful Pulmonary Resection Combined with Chemotherapy for the Treatment of Mycobacterium avium Pulmonary Disease : A Case Report)

  • 고원중;권오정;강은해;서지영;정만표;김호중;김관민;이남용;한정호;김태성;이경수
    • Tuberculosis and Respiratory Diseases
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    • 제54권6호
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    • pp.621-627
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    • 2003
  • MAC는 NTM 폐질환의 가장 흔한 원인균이다. Clarithromycin과 같은 새로운 항생제의 사용에도 불구하고, 아직까지 MAC 폐질환의 내과적 치료성적은 만족스럽지 않으며, 따라서 내과적 치료만으로 균음전에 성공하지 못하였을 때, 폐병변이 국한되어 있다면 폐절제술을 고려하여야 한다. 국내에서는 아직까지 MAC 폐질환의 치료를 위하여 폐절제술을 시행한 증례가 보고되지 않았다. 저자들은 MAC 폐질환을 진단하고 clarithromycin을 포함한 내과적 치료에 실패한 환자에서 폐절제술을 시행 후 균음전에 성공한 환자를 경험하여 이를 보고하는 바이다.

무선 디지털청진기를 이용한 동물 진단시스템 (Animal Diagnosis System Using Wireless Digital Stethoscope)

  • 박기영;홍수미;이종하;박진호;정의붕
    • 한국통신학회논문지
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    • 제38B권9호
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    • pp.722-727
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    • 2013
  • 동물 의료는 병의 정도나 치료의 필요성에 관계없이 보호자의 의향이 앞서는 어려운 의료행위이다. 특히, 동물치료 중 심장 질환은 필요한 치료법의 결정이나 치료 효과의 확인에 대해서 동물 환자로부터 직접적인 답을 얻기가 어렵다. 그래서 동물 환자의 경우, 심장질환은 증상의 악화로 급변하거나 돌연사 등의 응급사태를 예측하고 그것에 대처하는 것은 거의 불가능하다. 심장 및 몸 안의 질환을 확인하는 1차 진단 방법은 청진이다. CT나 X-ray, 초음파 등의 최첨단 영상장비들을 이용하여 정확하게 측정할 수 있지만 장비가 비싸고, 이를 활용할 수 있는 전문인력이 요구되는 등 경제성으로 인해 2차 진단장비로 활용되어질 뿐 1차 진단을 위한 가장 좋은 진단도구로 여전히 청진기가 이용되어지고 있다. 본 논문에서는 수의사가 귀에 대지 않고 청진음을 분석하고 무선으로 어디서나 진단 할 수 있는 무선디지털 진단시스템에 대해 자세하게 서술하고, 이 시스템을 통해 진단되는 청진음에 대한 레벨교차율(LCR)과 에너지레벨을 통해 질병의 관계에 대해 새로운 개념의 진단시스템 환경을 제시한다.

Effect of severe acute respiratory syndrome coronavirus 2 infection during pregnancy in K18-hACE2 transgenic mice

  • Byeongseok, Kim;Ki Hoon, Park;Ok-Hee, Lee;Giwan, Lee;Hyukjung, Kim;Siyoung, Lee;Semi, Hwang;Young Bong, Kim;Youngsok, Choi
    • Animal Bioscience
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    • 제36권1호
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    • pp.43-52
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    • 2023
  • Objective: This study aimed to examine the influence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on pregnancy in cytokeratin-18 (K18)-hACE2 transgenic mice. Methods: To determine the expression of hACE2 mRNA in the female reproductive tract of K18-hACE2 mice, real-time polymerase chain reaction (RT-PCR) was performed using the ovary, oviduct, uterus, umbilical cord, and placenta. SARS-CoV-2 was inoculated intranasally (30 μL/mouse, 1×104 TCID50/mL) to plug-checked K18-hACE2 homozygous female mice at the pre-and post-implantation stages at 2.5 days post-coitum (dpc) and 15.5 dpc, respectively. The number of implantation sites was checked at 7.5 dpc, and the number of normally born pups was investigated at 20.5 dpc. Pregnancy outcomes, including implantation and childbirth, were confirmed by comparison with the non-infected group. Tissues of infected mice were collected at 7.5 dpc and 19.5 dpc to confirm the SARS-CoV-2 infection. The infection was identified by performing RT-PCR on the infected tissues and comparing them to the non-infected tissues. Results: hACE2 mRNA expression was confirmed in the female reproductive tract of the K18-hACE2 mice. Compared to the non-infected group, no significant difference in the number of implantation sites or normally born pups was found in the infected group. SARS-CoV-2 infection was detected in the lungs but not in the female reproductive system of infected K18-hACE2 mice. Conclusion: In K18-hACE2 mice, intranasal infection with SARS-CoV-2 did not induce implantation failure, preterm labor, or miscarriage. Although the viral infection was not detected in the uterus, placenta, or fetus, the infection of the lungs could induce problems in the reproductive system. However, lung infections were not related to pregnancy outcomes.

자궁내막암의 수술 후 보조적 방사선치료 (Postoperative Adiuvant Radiation Therapy in Endometrial Carcinoma)

  • 신경환;최은경;안승도;장혜숙;목정은;남주현;김영탁;김용만;김종헉
    • Radiation Oncology Journal
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    • 제18권1호
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    • pp.40-45
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    • 2000
  • 목적 : 수술 및 수술 후 보조적 방사선치료를 시행한 자궁내막암 환자의 예후인자, 재발 장소 및 생존율 등을 분석해 보고자 하였다. 대상 및 방법: 1991년 9월부터 1997년 12월까지 서을중앙병원에서 수술 및 방사선치료를 받은 27예의 자궁내막암환자를 대상으로 하였다. 수술은 단순자궁적출술이 6예, 단순자궁적출술 및 림프절 절제술이 8예, 근치적 자궁적출 술이 13예에서 시행되었다. 모든 환자에서 외부 방사선치료가 시행되었으며 이 중 16예에서 ovoid를 이용한 질내조사가 추가되었다. 조사선량은 외부 방사선치료는 총 50.4 Gy를 조사하는 것을 원칙으로 하였고, 질내조사는 1회 분할선량 4$\~$5 Gy씩 4내지 5회 시행하였다. 추적기간은 6개월에서 95개월로서 중앙추적기간은 30개월이었다. 결과:FIGO 병기는 I-18예(67$\%$), II-1(4$\%$), III-8예(29$\%$)이었고, 조직분화도는 1$\~$14예(52$\%$), 2$\~$6예(9$\%$), 3$\~$7예(26$\%$)이었다. 수술 후 조직 소견상 조직분화도가 나쁠수록, 자궁근층의 침범 정도가 심할수록, 자궁부속기의 침범이있는 경우, 림프-혈관 침범이 있는 경우 골반내 림프절이 양성을 보이는 경우가 많았으나 통계적인 의미는 없었다. 추적이 종료된 시점에서 사망한 환자가 한 예도 없어 전체 생존율은 100$\%$이었으나 3예에서 병이 재발되어 3년 및 5년 무병생존율이 각각 89.6$\%$,, 76.8$\%$이었다. 재발 장소는 골반내, 대동맥방림프절, 폐를 포함한 다발성 등이 각각 I예 이었고 질 재발은 관찰되지 않았다. FIGO 병기(p=0.01), 림프-혈관 침범(p=0.03), 골반내 림프절 침범(p=0.0001)등이 무병생존을에 영향을 미치는 것으로 나타났고 조직분화도가 나쁠수록 무병생존율이 저조한 경향을 보였다(p=0.1). 치료부작용으로는 1예에서만 Grade 1의 직장출혈이 나타났으나 중등도 이상의 합병증을 보인 경우는 없었다. 결론 : 수술후 조직학적 소견에 따른 외부방사선치료 및 추가 질내조사는 국소재발을 억제하는데 효과적인 것으로 판단되며 결과적으로 생존율을 향상시키는데 기여하는 것으로 생각된다. 다만, 병기 및 조직분화도에 따라 질내조사를 추가하지 않는 경우 질 재발이 호발하는 환자군에 대한 연구가 더 진행되어야 할 것으로 판단된다.

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