• The Journal of the Korean bone and joint tumor society
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• v.10 no.2
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• pp.61-70
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• 2004

Purpose: We studied to decide the operative indication of the metastatic tumor in pelvis according to the oncologic results, the Eastern Cooperative Oncologic Group (ECOG) performance status and complication. Materials and methods: From May 1994 to May 2003, 9 patients who were performed on palliative treatment and 10 paitents on operative treatment due to metastatic tumor of pelvic bone were investigated. On palliative/operative group, the mean age of patients was 57.6/48.0 years old and the ratio of male to female was 5:4/7:3. Primary origins were 3 cases from kidney, 3 from cervix and 2 of lung, 2 of myeloma, 2 of Non-Hodgkin's Lymphoma, and 1 from breast, bladder, testis, prostate, stomach, liver and retroperitoneal leimyosarcoma respectively. The palliative treatment was performed in 5 cases with radiotherapy, 1 with chemotherapy, 2 with combined chemo-radiotherapy and 1 with percutaneous cementation. The operative methods were 1 case of bone cement insertion after curettage, 2 of Girdlestone with internal hemipelvectomy and 7 of reconstruction after wide excision. Reconstructions were done.: 1 case of bone cementation, 5 of autograft prosthesis composite with irradiation or pastuerization and 1 of saddle prosthesis. We have observed the oncologic results, the ECOG performance status and complication. Results: The oncologic results of palliative/operative groups are NED 0/1, AWD 2/6, DOC 1/2 and DOD 6/1. The ECOG performance status was changed from 1.5 into 4.3 in palliative group and from 2.6 into 2.2 in operative group. The complications were 3 cases of the prosthesis failure and 2 of infection. Conclusion: The indication of operation of metastatic pelvic tumor is decided in consideration of the patient's condition, the grade of malignancy in primary tumor and the life expectancy.

• Journal of Chest Surgery
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• v.41 no.5
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• pp.591-597
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• 2008

Background: Pulmonary endarterectomy is widely accepted as a treatment for chronic thromboembolic pulmonary hypertension. Based on our experiences, we sought to find ways to reduce perioperative complications and to improve surgical outcomes in patients undergoing pulmonary endarterectomy. Material and Method: This study was designed as a retrospective analysis of 20 patients with pulmonary hypertension who underwent pulmonary endarterectomy between January 1998 and March 2008. All patients presented with chronic dyspnea. Deep vein thrombosis (DVT) was the major cause of chronic pulmonary thromboembolism (55%). Seventeen patients (85%) underwent inferior vena cava (IVC) filter placement. Thirteen patients underwent surgery under total circulatory arrest, while the others underwent surgery while on low flow cardiopulmonary bypass. Concomitant tricuspid annuloplasty was done in 6 patients (66%) whose tricuspid regurgitation was as severe as grade IV/IV. The mean follow-up duration was $45{\pm}32$ months. Result: Using of University of California, San Diego (UCSD), thromboembolism classification, 4 patients (20%) were type 1, 8 patients (40%) were type II, and 8 patients (40%) were type III. Right ventricular systolic pressure was reduced significantly from $77{\pm}29$ mmHg to $37{\pm}19$ mmHg after pulmonary endarterectomy (p<0.001). The degree of tricuspid regurgitation and the NYHA functional class were all improved postoperatively. Reperfusion edema occurred in 7 cases (35%). The incidence of reperfusion edema was higher in the UCSD type III group than in the other group (25% vs 50%, p=0.25) and the length of postoperative intensive care unit stay was longer in type III group ($5{\pm}2$ days vs $9{\pm}7$ days, p=0.07). The early mortality rate was 10%, and the late mortality rate was 15% (n=3); one death was due to progression of underlying non-Hodgkin's lymphoma, and the other deaths were related to recurrent thromboembolism and persistent pulmonary hypertension, respectively. Conclusion: Pulmonary endarterectomy, as a curative surgical method for treating chronic thromboernbolic pulmonary hypertension, should be performed aggressively in patients diagnosed with chronic thromboembolic pulmonary hypertension, and an effort should be made to reduce the frequency of perioperative complications and to improve surgical outcomes.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.1
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• pp.60-71
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• 2009

Purpose: We assessed the absorbed dose to the tumor ($Dose_{tumor}$) by using pretreatment FDG-PET and whole-body (WB) planar images in repeated radioimmunotherapy (RIT) with $^{131}I$ rituximab for NHL. Materials and Methods: Patients with NHL (n=4) were administered a therapeutic dose of $^{131}I$ rituximab. Serial WB planar images alter RIT were acquired and overlaid to the coronal maximum intensity projection (MIP) PET image before RIT. On registered MIP PET and WB planar images, 2D-ROls were drawn on the region of tumor (n=7) and left medial thigh as background, and $Dose_{tumor}$ was calculated. The correlation between $Dose_{tumor}$ and the CT-based tumor volume change alter RIT was analyzed. The differences of $Dose_{tumor}$ and the tumor volume change according to the number of RIT were also assessed. Results: The values of absorbed dose were $397.7{\pm}646.2cGy$ ($53.0{\sim}2853.0cGy$). The values of CT-based tumor volume were $11.3{\pm}9.1\;cc$ ($2.9{\sim}34.2cc$), and the % changes of tumor volume before and alter RIT were $-29.8{\pm}44.3%$ ($-100.0%{\sim}+42.5%$), respectively. $Dose_{tumor}$ and the tumor volume change did not show the linear relationship (p>0.05). $Dose_{tumor}$ and the tumor volume change did not correlate with the number of repeated administration (p>0.05). Conclusion: We could determine the position and contour of viable tumor by MIP PET image. And, registration of PET and gamma camera images was possible to estimate the quantitative values of absorbed dose to tumor.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.5
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• pp.369-374
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• 2008

Purpose: F-18 FDG PET/CT has excellent sensitivity and specificity for staging non-Hodgkin lymphomas, but to the author's knowledge few studies to date have evaluated FDG PET/CT in peripheral T cell lymphoma. We evaluated the usefulness of F-18 FDG PET/CT in staging of patients with peripheral T cell lymphoma, especially indolent cutaneous T cell lymphomas. Materials and Methods: Twenty five patients (M:F=17:8, age $53.7{\pm}14.8$ yrs) with biopsy-proven indolent cutaneous T cell (CL) or noncutaneous T cell lymphomas (NCL) underwent PET/CT scans for staging at baseline. Peak standardized uptake values (p-SUV) of all abnormal foci were measured and compared between cutaneous and noncutaneous lesions. F-18 FDG PET/CT was performed on 6 patients with indolent CL and on 19 patients with NCL. Results: All 6 patients with indolent CL had no significant FDG avidity in the skin despite histologically positive cutaneous lesions. However, FDG avidity appeared in extracutaneous lesions (lymph nodes) in two patients with CL where CT imaging suggested lymphoma involvement (mean p-SUV $4.26{\pm}0.37$ in noncutaneous lesions in CL). In NCL, FDG avidity was demonstrated in all lesions where CT imaging suggested lymphoma involvement (mean p-SUV, $8.52{\pm}5.00$ in noncutaneous lesions in NCL). Conclusion: F-18 FDG PET/CT has the limitation of usefulness for the evaluation of the skin in indolent CL. In contrast, F-18 FDG PET/CT is sensitive in staging evaluation of extracutaneous lesions regardless of CL or NCL.

• Journal of Life Science
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• v.27 no.2
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• pp.149-154
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• 2017

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-hodgkin lymphoma. Advances in the chemotherapeutic treatment of this disease have improved the outcomes of DLBCL; nonetheless, many patients still die of DLBCL, and therefore, a better understanding of this disease and identification of novel therapeutic targets are urgently required. In a recent gene expression profiling study, PDE (phosphodiesterase) 4B was found to be overexpressed in chemotherapy-resistant tumors. The major function of PDE4B is to inactivate the second messenger cyclic 3',5' monophosphate (cAMP) by catalyzing the hydrolysis of cAMP to 5'AMP. It is known that cAMP induces cell cycle arrest and/or apoptosis in B cells, and PDE4B abolishes cAMP's effect on B cells. However, the mechanism by which PDE4B is overexpressed remains unclear. Here, we show that the aberrant expression of miRNA may be associated with the overexpression of this gene. The PDE4B 3' untranslated region (UTR) has three functional binding sites of miR-23b, as confirmed by luciferase reporter assays. Interestingly, miR-23b-binding sites were evolutionarily conserved from humans to lizards, implying the critical role of PDE4B-miR-23b interaction in cellular physiology. The ectopic expression of miR-2 3b repressed PDE4B mRNA levels and enhanced intracellular cAMP concentrations. Additionally, miR-23b expression inhibited cell proliferation and survival of DLBCL cells only in the presence of forskolin, an activator of adenylyl cyclase, suggesting that miR-23b's effect is via the downregulation of PDE4B. These results together suggest that miR-23b could be a therapeutic target for overcoming drug resistance by repressing PDE4B in DLBCL.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.2 no.2
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• pp.204-210
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• 1999

Purpose: We assessed the nutritional status and the alterations of oral diets during anti-cancer chemotherapy in pediatric oncology patients. Methods: Twenty children with malignancy were evaluated from day 0 until day 21 of post-chemotherapy. Nutritional status was assessed by body weight and biochemical parameters. The amount and calories of oral diets were assessed and food preference before and during chemotherapy were analysed by questionnelle. Results: 1) The underlying diseases of 20 patients were 11 acute lymphoblastic lekemia, 2 non-Hodgkin's lymphoma, 2 Langerhans cell histiocytosis, 2 Wilm's tumor, 2 brain tumor, 1 rhabdomyosarcoma. 2) There were weight loss during chemotherapy in 8 patients (40.0%), weigt gain in 5 patients (25.0%), and no significant changes in 7 patients (35.0%). 3) Biochemical parameters showed no significant interval changes during chemotherapy except elevation of serum ALT level. 4) The daily caloric intakes of oral diets during chemotherapy were 310~600 Kcal which was much lower than average of daily recommended calory for Korean children. 5) The most favorate food was altered by chemotherapy, from meats to carbonated beverages and unfavorate food was not altered as vegetables. Conclusion: The periodic assessment of nutritional status and dietary supplements according to preferred foods of patients will be required for the optimal nutrition care in cancer patients.

• The Korean Journal of Medicine
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• v.99 no.1
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• pp.37-49
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• 2024

Background/Aims: In Korea, the incidence of primary diffuse large B-cell lymphoma of the central nervous system (PCNSL) is increasing and autologous stem cell transplantation (ASCT) has improved the survival of younger patients. We explored our real-world experience with PCNSL at Asan Medical Center (AMC). Methods: We used the AMC lymphoma registry to collect patient data prospectively. We analyzed 279 patients diagnosed from 2002 until August 2019. Results: The PCNSL incidence at AMC increased progressively and comprised 7.4-8.9% of new non-Hodgkin lymphoma patients annually during the most recent 4 years. The median age was 60 years (range, 17-85) and males comprised 55%. Patients under 65 years of age (n = 183) had no significant differences in characteristics compared to those aged 65 years or over, with the exception of less occipital lobe involvement and lower beta-2 microglobulin levels. Rituximab, methotrexate, procarbazine, and vincristine (R-MPV) combination induction had the best overall response, of 95%. The median overall survival was 3.8 years with 5- and 10-year survival rates of 41.5% and 30.2%, respectively. Survival was better in younger patients and those treated with ASCT. Thiotepa, busulfan, and cytoxan (TBC) conditioning chemotherapy had better survival than other combinations. The International Extranodal Lymphoma Study Group and Memorial Sloan Kettering Cancer Center prognostic score systems were valid in this cohort. Age and performance status were independent prognostic factors. Exclusive extra-central nervous system failure occurred in six patients (5.6%) among 107 failures. Conclusions: The incidence of PCNSL is rising. R-MPV induction therapy followed by ASCT with TBC has improved the survival of young, fit PCNSL patients.