• Journal of Yeungnam Medical Science
• /
• 제31권1호
• /
• pp.33-37
• /
• 2014

Acinic cell carcinoma (ACC) is an uncommon malignant tumor of the salivary glands that is difficult to diagnose. It grows slowly and shows distant metastasis rarely. We experienced a case of recurrent ACC in the parotid gland with cardiac metastasis and hypertrophic osteoarthropathy. The 29-year-old man had been suffering from severe multiple bones and joints pain for 2 months. Ten years earlier, he underwent superficial parotidectomy due to a right subauricular mass. The mass was diagnosed with ACC. After surgery, the tumor recurred twice. Then the patient was diagnosed with cardiac metastasis via positron emission tomography-computed tomography and trans-thoracic echocardiography. He also had hypertrophic osteoarthropathy with multiple bone metastasis. He was given palliative radiotherapy and conservative treatment. ACC in the parotid gland with cardiac metastasis and hypertrophic osteoarthropathy has not yet been reported in literature. From this case, it is recommended to evaluate multiple distant metastasis in the ACC of the parotid gland when joint and bone pain are present.

• 셀메드
• /
• 제2권4호
• /
• pp.35.1-35.11
• /
• 2012

The homeopathic remedy Chelidonium majus 200C (Chel-200) is traditionally used by homeopathic practitioners in liver ailments arising out of hepatotoxicity. The present investigation was aimed at examining whether vitamin C (L-ascorbic acid or AA), used in both traditional and orthodox medicines, can show better effects when used in combination with Chel-200, in favorably modifying the toxicological effects induced by the chronic feeding of p-dimethylaminoazobenzene (p-DAB, initiator) and phenobarbital (PB, promoter) in mice for 7 days through 120 days to induce hepatotoxicity and liver tumors. Mice were euthanized at 7, 15, 30, 60, 90, and 120 days of carcinogen feeding to assess various cytogenetical, biochemical and histological changes occurring in them. In a placebo controlled study, Chel-200 or the respective placebo (Alcohol-200C or Alc, "vehicle" of homeopathic drug), was orally administered to toxicant-fed mice. Sub-groups of the mice receiving Chel-200 were also fed either AA or an Alc placebo and their individual and conjoint effects were studied against the respective controls, to evaluate if the combination therapy of Chel-200 with AA can be of additional help in the amelioration of the toxicities generated by the toxicants. The combined feeding of Chel-200 and AA appeared to reduce the cytotoxic and genotoxic effects significantly, when compared to either only the Chel-200 or AA fed group. A similar trend was also obtained in the results of scanning and transmission electron microscopic studies of the livers. Experiments in other mammalian models are warranted to confirm if these drugs in combination could be used in palliative care of human patients with liver diseases including cancer.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권1호
• /
• pp.171-176
• /
• 2016

Background: Much has been done to examine the psychological impact of cancer treatment, but it remains unclear to what extent anxiety and depression is related to symptom prevalence. The present study concerned the characteristics and frequency of distress as related to symptom prevalence in cancer patients undergoing chemotherapy in Malaysia. Materials and Methods: Participants were 303 consecutive adult cancer patients undergoing chemotherapy in an academic medical center. The short form Memorial Symptom Assessment Scale (MSAS-SF), which covers three domains of symptoms (global distress, physical- and psychological symptoms) was used to cross-sectionally measure symptom frequency and associated distress via self-reporting. One-way ANOVA and t-tests were used to test mean differences among MSAS-SF subscale scores. Results: Complete data were available for 303 patients. The mean number of symptoms was 14.5. The five most prevalent were fatigue, dry mouth, hair loss, drowsiness and lack of appetite. Overall, symptom burden and frequency were higher than in other published MSAS-SF studies. Higher symptom frequency was also found to be significantly related to greater distress in cancer patients undergoing chemotherapy. Conclusions: Patients undergoing chemotherapy suffer from multiple physical and psychological symptoms. Better symptom control or palliative care is needed. Greater frequency of reported symptoms may also indicate a subconscious bid by patients for care and reassurance - thus tailored intervention to manage distress should be offered.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권20호
• /
• pp.8753-8757
• /
• 2014

Background: Glioma is a heterogeneous central nervous system (CNS) tumor group that encompasses different histological subtypes with high variability in prognosis. The lesions account for almost 80% of primary malignant brain tumors. The aim of this study is to extend our understanding of the glioma epidemiology in the central Tunisian region. Materials and Methods: We analyzed 393 gliomas recorded in cancer registry of central Tunisia from 1993 to 2012. Crude incidence rates (CR) and world age-standardized rates (ASR) were estimated using annual population data size and age structure. Statistic correlations were established using Chi-square and Kaplan-Meier test. Results: Tunisian glioma patients were identified with a mean age at diagnosis of 48 years and 1.5 sex ratio (male/female). During the 19 years period of study the highest incidence value was observed in male group between 1998 and 2002 (CR: 0.28, ASR: 0.3). Incidence results underline increasing high grade glioma occurring in the adulthood in the last period (2007-2012). Median survival was 27 months, with 1-, 2- and 5-year survival rates of 42%, 30% and 26%, respectively. Survival was greater in patients with younger age, lower tumor grade, infratentrial tumor location and undergoing a palliative treatment. Conclusions: This central Tunisia gliomas registry study provides important information that could improve glioma management and healthcare practice.

• Journal of Chest Surgery
• /
• 제30권1호
• /
• pp.40-47
• /
• 1997

본 교실에서는 1990년 1월부터 1994년 3월까지 61명의 식도암 환자를 치험하였으며 이들의 의무기록을 조사하여 식도암 수술의 위험 인자를 조사하였다. 평균연령은 58.3세로 36세부터 74세까지였으며 성비는 남자에서 14:1로 호발하였다. 연하곤란은 평균 3.8개월간 있었으며, 연하곤란의 정도는 4등급이 제일 많았다. 술후 종양의 병기는 I기 2명, II기 23 명, III기 27명, 그리고 IV기 9명이었으며 49명의 환자가 완전한 종양절제가 가능하여 종양절제율은 78.7%이 었다. 5명은 불완전 종양절제와 고식적 식도위문합술을 시행하였으며 5명에서는 위루술을 시행하였고 2명은 Celestin관 삽입을 하였다. 가장 흔한 수술합병증은 폐 허탈과 폐렴이었으며 조기 사망율은 5.6%이었다. 9명의 환자에서 수술후 국소재발이나 원격전이가 발견되었다. 장기 생존율은 1년 73.4%, 2년 54.7%, 4년 23.1%이었다 식도암의 외과적 치료의 조기성적에 나쁜 영향을 미치는 인자로는 종양 의 병 기 (p = 0.02)이었다.

• Radiation Oncology Journal
• /
• 제30권1호
• /
• pp.20-26
• /
• 2012

Purpose: To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy. Materials and Methods: The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy. Results: Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications. Conclusion: Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.

• Journal of Chest Surgery
• /
• 제30권8호
• /
• pp.827-832
• /
• 1997

폐용적 감축술(Lung volume reduction surgery : Lns)은 최근들어 활동이 어려운 심한 폐기종 환자에서 폐이식의 대체요법이나 폐이식의 전단계 시술로 추천되고 있다. 이 시술은 폐기종 환자의 호흡곤란을 감소 시키고 일상생활의 수행을 개선시키기 위한 고식적인 치료방법이다. 범발성 폐기종 환자에 대한 폐용적 감축술(LVRS)의 개념은 병변이 심한 기능이 없는 폐를 절제함으로써 남아있는 병변이 적은 폐의 기능을 개선 시킨다는 것이다. 폐용적 감축술UnS)의 성공에 결정적인 영향을 미치는 요소들로는 철저한 환자의 선택 (patient selection), 정확한 수술부위의 위치선정, 신중한 마취 및 수술기법, 그리고 집중적인 술후 처치 등이 있다. 본 병원에서는 심한 폐기종으로 입원한 59세 남자환자에서 철저한 선택과정patient selection)과 호흡기재활 (pulmonary rehabilitation)을 거쳐 흉강내시경을 이용하여 폐용적 감축술InnS)을 시행하였으며 술후 경과 양 호하녀 퇴원 후 현재 외래 추적관찰 중이다.

• 대한핵의학회지
• /
• 제24권2호
• /
• pp.267-273
• /
• 1990

Serum carcinoembryonic antigen (CEA) levels were measured by radioimmunoassay in 82 patients with stomach cancer and were related to their clinical status and to the response to therapeutic modalities. Serum CEA in patients over 40 years of age was higher (p < 0.05) than that of younger age group and was higher (p 앞 0.0025) in patients with advanced stages (IIII and IV) than in patients with earlier stages (EGC and stage II). No significant differences in serum CEA levels were seen between the tumor cell types. In 9 patients who underwent successful radical resection of the cancer, serum CEA decreased significantly (p < 0.05) after surgery, whereas the changes in serum CEA levels after palliative surgery in other 7 patients were statistically insignificant (p > 0.01). Eleven patients who were given chemotherapy were followed up until death, the changes in their serum CEA levels were significant reverse-correlation (r=-0.72) with duration of survival.

• Journal of Gastric Cancer
• /
• 제4권2호
• /
• pp.89-94
• /
• 2004

Purpose: There is no established treatment-related prognostic factor for gastric cancer except a curative tumor resection. This study was done to clarify the prognostic value of early postoperative intraperitoneal chemotherapy (EPIC) in patients with serosa-positive gastric cancer. Materials and Methods: We analyzed retrospectively the postoperative survival data of 209 patients with serosapositive gastric cancer treated by surgery and chemotherapy. The survival period for patients was calculated from the date of resection until cancer-related death or the last date of follow-up; Kaplan-Meier survival curves were plotted and compared by using the log-rank test. A multivariate analysis was done by using the Cox proportional hazards model. Results: Statistically significant differences in survival rates were noted based on gender, depth of invasion, lymph node metastasis, distant metastasis, stage, location of tumor, macroscopic type, extent of gastric resection, curability of surgery, and adjuvant chemotherapy. Five-year survival rates of patients who received EPIC and systemic chemotherapy were 49 per cent and 25 per cent, respectively (P=0.009). A multivariate analysis revealed that invasion of an adjacent organ, lymph node metastasis, total gastrectomy, and palliative surgery were poor independent prognostic factors. Also, EPIC had a marginal prognostic value (P=0.056). Conclusion: Perioperative intraperitoneal chemotherapy can possibly be one of the independent prognostic indicators in case of serosa-positive gastric cancer. (J Korean Gastric Cancer Assoc 2004;4:89-94)

• Journal of Gastric Cancer
• /
• 제17권4호
• /
• pp.319-330
• /
• 2017

Introduction: The extent of lymphadenectomy in the surgical treatment of gastric cancer is a topic of controversy among surgeons. This study was conducted to analyze the American National Cancer Database (NCDB) and conclude the optimal extent of lymphadenectomy for gastric adenocarcinoma. Methods: The NCDB for gastric cancer was utilized. Patients who received at least a partial gastrectomy were included. Patients with metastatic disease, unknown TNM stages, R1/R2 resection, or treated with a palliative intent were excluded. Joinpoint regression was used to identify the extent of lymphadenectomy that reflects the optimal survival. Cox regression analysis and Bayesian information criterion were used to identify significant survival predictors. Kaplan-Meier was applied to study overall survival and stage migration. Results: 40,281 patients of 168,377 met the inclusion criteria. Joinpoint analysis showed that dissection of 29 nodes provides the optimal median survival for the overall population. Regression analysis reported the cutoff ${\geq}29$ to have a better fit in the prognostic model than that of ${\geq}15$. Dissection of ${\geq}29$ nodes in the higher stages provides a comparable overall survival to the immediately lower stage. Nonetheless, the retrieval of ${\geq}15$ nodes proved to be adequate for staging without a significant stage migration compared to ${\geq}29$ nodes. Conclusion: The extent of lymphadenectomy in gastric adenocarcinoma is a marker of improved resection which reflects in a longer overall survival. Our analysis concludes that the dissection of ${\geq}15$ nodes is adequate for staging. However, the dissection of 29 nodes might be needed to provide a significantly improved survival.