• Radiation Oncology Journal
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• 제32권3호
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• pp.163-169
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• 2014

Purpose: To report the results of stereotactic body radiotherapy (SBRT) for unresectable primary or recurrent cholangiocarcinoma. Materials and Methods: From January 2005 through August 2013, 58 patients with unresectable primary (n = 28) or recurrent (n = 30) cholangiocarcinoma treated by SBRT were retrospectively analyzed. The median prescribed dose was 45 Gy in 3 fractions (range, 15 to 60 Gy in 1-5 fractions). Patients were treated by SBRT only (n = 53) or EBRT + SBRT boost (n = 5). The median tumor volume was 40 mL (range, 5 to 1,287 mL). Results: The median follow-up duration was 10 months (range, 1 to 97 months). The 1-year, 2-year overall survival rates, and median survival were 45%, 20%, and 10 months, respectively. The median survival for primary group and recurrent group were 5 and 13 months, respectively. Local control rate at 1-year and 2-year were 85% and 72%, respectively. Disease progression-free survival rates at 1-year and 2-year were 26% and 23%, respectively. In univariate analysis, ECOG performance score (0-1 vs. 2-3), treatment volume (<50 vs. ${\geq}50mL$), and pre-SBRT CEA level (<5 vs. ${\geq}5ng/mL$) were significant in overall survival rate. In multivariate analysis, ECOG score (p = 0.037) and tumor volume (p = 0.030) were statistically significant. In the recurrent tumor group, patients with >12 months interval from surgery to recurrence showed statistically significant higher overall survival rate than those with ${\leq}12$ months (p = 0.026). Six patients (10%) experienced ${\geq}$grade 3 complications. Conclusion: SBRT can be considered as an effective local modality for unresectable primary or recurrent cholangiocarcinoma.

• Journal of Radiation Protection and Research
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• 제24권3호
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• pp.131-142
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• 1999

통계청에서 최근에 발표한 한국인 인구통계 자료와 미국 학술원 산하 '방사선의 생물학적 영향 위원회'의 최근 보고서(BEIR-V)의 수정 상대위험 투사모델을 적용하여 한국인의 방사선 피폭에 의한 초과 암발생 위험도를 평가하였다. 인구통계 자료로부터 유도한 사소위험도(trivial risk) 및 계산된 방사선유발 초과 암 위험도를 비교한 후 사소위험도의 수준으로 개인의 피폭선량을 유지하기 위한 국내 원전의 안전운영 목표치를 유도하였다. 방사선 피폭 유발 초과 암 위험도는 0.1 Gy의 단일피폭의 경우에는 $5.5{\times}10^{-3}$, 1.0 mGy/y로 생애연속 피폭 시엔 $3.7{\times}10^{-3}$인 것으로 평가되었다. 한국인의 모든 원인에 의한 기저사망 위험도 및 사소위험도는 각각 $5.2{\times}10^{-3}$ 및 $5.2{\times}10^{-6}$인 것으로 예상되었다. 한국인의 사소위험도 및 방사선 위험도 평가 결과로부터 유도한 국내 원전운영의 안전목표치는 대략 0.05 mSv/y로, 이 값은 미국 원자력규제위원회(USNRC)가 연방규제법 10CFR50 부록 I에서 제시하고 있는 ALARA 지침값과 거의 동일한 값으로 밝혀졌다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권12호
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• pp.6129-6132
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• 2012

Objectives: To evaluate the feasibility and efficacy of simultaneous accelerated radiation therapy (SMART) and concurrent weekly paclitaxel in the treatment of locally advanced nasopharyngeal carcinoma. Methods: Forty-one patients with pathologically confirmed nasopharyngeal carcinoma were treated by SMART with concurrent weekly paclitaxel. Daily fraction doses of 2.5 Gy and 2.0 Gy were prescribed to the gross tumor volume (GTV) and clinical target volume (CTV) to a total dose of 70 Gy and 56 Gy, respectively. Paclitaxel of $45mg/m^2$ was administered concurrently with radiation therapy every week. Adjuvant chemotherapy was given four weeks after the completion of the radiotherapy (RT) if the tumor demonstrated only a partial response (PR). Results: All patients completed the radiotherapy (RT) course. Adjuvant chemotherapy was administered to 12 patients due to PR. The CR (complete remission) rate was 82.9% three months after RT. Thirty-nine (95.1%) patients completed the concurrent weekly chemotherapy with paclitaxel, and two patients skipped their sixth course. Seven patients had a 15% dosage reduction at the fifth and sixth course due to grade 3 mucositis. The median follow-up was 30 (range, 14-42) months. The three-year overall survival (OS), metastases-free survival (MFS), and local control rates were 77.0%, 64.4%, and 97.6%, respectively. No correlation between survival rate and T or N stage was observed. Grade 3 acute mucositis and xerostomia were present in 17.1% and 7.1%, respectively. Conclusion: SMART with concurrent weekly paclitaxel is a potentially effective and toxicity tolerable approach in the treatment of locally advanced NPC.

• Journal of Hospice and Palliative Care
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• 제20권2호
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• pp.131-135
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• 2017

목적: 경구 oxycodone/naloxone 복합제는 아편유사제에 의해 유발되는 변비를 완화시키거나 예방하는 목적으로 사용되고 있다. Naloxone에 의해 oxycodone의 진통 효과가 상쇄되거나 금단증상이 나타난다는 보고는 거의 없었으나 저자는 실제 임상에서 몇몇 금단증상 예를 경험하였기에 이 환자들에 대한 조사 연구를 수행하였다. 방법: 2012년 1월 1일부터 2016년 12월 31일까지 경남 지역 암센터에 방문했던 진행성 암환자들로 oxycodone/naloxone extended-release tablets를 투약 받고 마약 금단증상이 나타났던 환자들의 의무기록을 후향적으로 조사하였다. 결과: 연구 기간 중 경구 oxycodone/naloxone을 처방 받은 1,641명의 암 환자 중, 총 10예(0.6%) 에서 마약 금단 증상을 겪었다. 금단증상 관련 통증 강도의 변화는 oxycodone/naloxone 투여 전 NRS 3에서 평균 NRS 6점으로 증가하였다. 금단증상 중 오한이 10예 중 7예에서 나타나 가장 많이 나타난 증상이었으며 그 외에 식은땀, 전신 쇠약감, 근육경련, 복부경련(각 5예), 불안(4예), 열, 어지럼증, 의식혼란, 하품(각 2예)의 순으로 빈번하게 관찰되었다. 결론: Oxycodone/naloxone extended-release 복합제에 의한 마약 금단증상은 흔하지는 않아도 적은 수의 환자에서라도 나타날 수 있다. 향후 이에 대한 다기관, 전향적 연구가 필요하다.

• 대한의생명과학회지
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• 제13권3호
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• pp.161-168
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• 2007

Salicornia herbacea L. (Chenopodiaceae: S. herbacea) is a salt marsh plant, which has long been prescribed in traditional medicines for the treatment of intestinal ailments, nephropathy, and hepatitis in Oriental countries. In order to elucidate the mechanisms of this herb, we conducted an anti-oxidative activity, the inhibition of nitric oxide (NO) production, and the suppression of the pro-inflammatory cytokine genes, with the solvent-extracts of S. herbacea. We found that both ethyl acetate and n-butanol tractions showed potent anti-oxidative effects in comparison to other fractions using xanthine oxidase assay with $IC_{50}$ values of $66.0{\pm}0.5\;{\mu}g/ml$ and $82.5{\pm}3.8\;{\mu}g/ml$, respectively. In addition, both ethyl acetate and n-butanol fractions showed more electron donating activity (EDA) than other tractions, according to DPPH (2, 2-Diphenyl-lpicrylhydrazyl radical) assay. The EDA of ethyl acetate fraction ($IC_{50}$ values of $117.5{\pm}3.8\;{\mu}g/ml$) is more significant than that of n-butanol fraction ($IC_{50}$ values of $375.0{\pm}12.5\;{\mu}g/ml$). Among potential anti-oxidative tractions, ethyl acetate traction dose-dependently suppressed lipopolysaccharide (LPS, $0.1\;{\mu}g/ml$)-induced nitric oxide (NO) production in RAW264.7 cell, while n-butanol did not. As expected, ethyl acetate fraction suppressed the expression of inducible NO synthase (iNOS) in RAW264.7 cell stimulated by $0.1\;{\mu}g/ml$ of LPS. Moreover, the ethyl acetate traction suppressed the expression of interleukin-1 $(IL)-1{\beta}$ and granulocyte/macrophage colony-stimulating factor (GM-CSF) mRNA in LPS-stimulated RAW264.7 cells. Therefore, these results suggest that S. herbacea may have anti-oxidative and anti-inflammatory activities by modulating radical-induced toxicity and various pro-inflammatory responses.

• Advances in Traditional Medicine
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• 제7권5호
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• pp.494-500
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• 2008

Ginseng has been traditionally used to recover vital energy from Qi deficiency in oriental countries. Recent reports suggested that ginseng could regulate blood pressure (BP), but much controversy still remain. Therefore, we intended to assess the anti-hypertensive effect of some ginseng species on Koreans and Chinese. This is a randomized, double blinded controlled clinical trial. The study subjects were recruited from the mild hypertensive patients who belonged prehypertension(120/80 to 139/89 mmHg) and stage I hypertension (140/90 to 159/99 mmHg) in Korea and China. After assigning the subjects into a Korean, a Chinese, and an American ginseng group by randomization, we prescribed ginseng with the dose of 4.5 g per a day for 4 w. To assess the anti-hypertensive effect, we compared the mean of systolic and diastolic BP between before and after ginseng medication by 24 h Ambulatory Blood Pressure Monitor (24 h ABPM). We also monitored adverse effect and laboratory findings to secure the subjects' safety. There were 64 subjects treated with Korean ginseng, 58 treated with Chinese ginseng, and 64 treated with American ginseng. All of the ginseng species reduced subjects' BP. Especially, Korean and Chinese ginseng showed more excellent effects. The secondary analysis on the subjects' nationality revealed that all of the ginseng species showed more significant anti-hypertensive effect in Chinese than in Koreans. We suggest ginseng could be useful for mild hypertension regardless of its species. And it would be safe within the dosage of 4.5 g per a day.

• Journal of Radiation Protection and Research
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• 제34권3호
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• pp.137-143
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• 2009

본 연구는 호흡에 따라 움직임이 큰 흉부나 복부 장기의 방사선 수술에 적용되는 사이버나이프 $Synchrony^{TM}$ 호흡 추적장치의 정확성을 평가하였다. $Synchrony^{TM}$ 호흡 추적장치의 정확성 평가를 위해 금침이 삽입된 움직임 Phantom을 이용하였고, Phantom은 아크릴 볼이 들어 있는 정육면체에 Radiochromic 필름을 삽입하여 가상의 치료용적인 아크릴 볼에 21 Gy, 70% 등선량곡선으로 처방하였다. 고정된 Phantom의 금침추적방법과 움직임 Phantom의 $Synchrony^{TM}$ 호흡추적 방법으로 나누어 각각 5회 측정한 정확성 평가는 고정된 Phantom 추적 시 총 에러는 $0.0195{\sim}0.652mm$, 총 에러 평균은 0.3926 mm로 나타났으며, 움직임 Phantom을 이용한 $Synchrony^{TM}$ 호흡 추적 방법의 결과로 총 에러는 $0.4405{\sim}0.7665mm$, 총 에러 평균은 0.5673 mm로 나타나 두 방법에 유의한 차이가 없었다. 본 연구를 통해 사이버나이프 $Synchrony^{TM}$ 호흡 추적 장치의 정확성을 평가하였으며 체부의 방사선 수술 적용 시 그 유용성을 확인할수 있었다.

• Tuberculosis and Respiratory Diseases
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• 제73권2호
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• pp.93-99
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• 2012

Background: Local adverse events associated with inhaled corticosteroid use, including dysphonia, pharyngitis and oral candidiasis, can affect adherence for treatment. 'Mouth rinsing method' has been used for reducing local adverse events, but it cannot ensure complete prevention. The goal of this pilot study was to identify whether the 'immediate diet method' can reduce local adverse events in a limited number of patients. Methods: The study was conducted in a total of 98 patients, who had been prescribed a medium-dose fluticasone propionate for the first time, from January to October in 2010. One training nurse had performed the education on how to use the inhaler, including the mouth rinsing method. And with follow-ups at one month intervals, any patient who experienced such adverse events were educated on the immediate diet method, having a meal within 5 minutes after using an inhaler and they were checked on any incurrence of adverse events with one month intervals for 2 months. Results: The mean age of patients was 65.9 years old. The local adverse events had incurred from 18.4% of the study subjects. When performed the follow-up observation in 18 patients with local adverse events after education on the immediate diet method, 14 patients (77.8%) had shown symptomatic improvements. Three of 4 patients did not show any improvement, in spite of implementing the immediate diet method. The other 1 patient did not practice the immediate diet method properly. Conclusion: The immediate diet method may be useful in reducing the local adverse events, caused by the use of inhaled corticosteroid.

• 대한수의학회지
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• 제45권2호
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• pp.255-261
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• 2005

The purpose of this study is to compare hepatotoxicity of each treatment for dermatophytosis; one is the administration of the ketoconazole only and the other, ketoconazole with diphenyl-dimeththyl-dicarboxylate. Have chosen the range of 14-24 months of healthy dogs divided by two groups (group 1 and group 2) for the experiment of which test proved positive in dermatophytosis diagnosis and showed normal reaction in terms of physical examination, blood chemistry and especially of liver function. Group 1 was administrated ketoconazole orally at 10 mg/kg/day and of same dose of ketoconazole with diphenyl-dimethyl-dicarboxylate for group 2. After administering, we have tested two groups by blood collecting every one week in order to check the differences of hepatotoxicity state through AST, ALT and r-GTP, the barometers of liver function which lasted for 12 weeks. Moreover, tested Indocyanine Green (ICG), known as susceptible gauge of function of excretion before starting the experiment and tested ICG as well after 12 weeks. The experiment of result the value of group 1 in AST, ALT and r-GTP has been highly rised after administering ketoconazole for 10 weeks meanwhile, of group 2 has shown a steady state troughout the whole experiment. For ICG test, we injected 0.5 mg/kg of ICG into a vein for both groups and tested the retention rate at regular interval of 15, 30, 45 minutes. The results of retention rate in two groups were similar to before the drug administration. However, after 12 weeks the retention rate of group 1 has been delayed, on the other hand, retention rate of group 2 were a steady state. In conclusion, the administration of ketoconazole only for a long period of time induced hepatotoxicity where as, the administration of ketoconazole with diphenyl-dimethyl-dicarboxylate didn't induce hepatotoxicity. Therefore, when doctors prescribes for a dog with dermatophytosis should not administrate ketoconnazole itself but with diphenyl-dimethyl-dicarboxylate and one who has abnormal condition of liver function should not be prescribed ketoconazole treatment. If there is a case needed to prescribe ketoconazole treatment, the regular monitoring should be accompanied by at the same time.

• 한국임상약학회지
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• 제19권1호
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• pp.18-22
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• 2009

Oxaliplatin is a tolerable and effective drug of choice in the treatment of advanced or metastatic gastric cancer. However, it has many dose-limiting neurotoxicities. This study was performed to assess the incidence and types of oxaliplatin-related neurotoxicities. Sixty-four patients receiving oxaliplatin-involved regimen as salvage therapy on metastatic gastric cancer or as the first-line therapy on advanced gastric cancer were evaluated during the period between September 1, 2006 and February 29, 2008. The patients were treated with oxaliplatin 100 $mg/m^2$ and leucovorin 100 $mg/m^2$ simultaneously as 2-hour-lasting infusion on Day-1 followed by 5-FU 1200 $mg/m^2$ as a 22-hour-lasting continuous infusion both on Day-1 and Day-2 by every other week. We developed questionnaires to evaluate patient-recognized neurotoxic symptoms rather than the observer-described events. Surveys were completed at bedside or via telephone interview. Acute and chronic neurotoxicities were graded according to the National Cancer Institute Common Toxicity Criteria (NCI-CTC, version 3) as well as the Oxaliplatin-specific Neurotoxicity Scale. The Grade-3 neuropathy was reported in 19% of the patients (n=12) and grade-1/2 neuropathy occurred in 70% (n=45). The most common symptom was cold-related dysesthesia (83%) regarded as nociperception by the patients. Some patients (19%) experienced functional impairment affecting activities of daily living such as writing, buttoning, and walking. Even though 74% of the patients (42/57) were prescribed with gabapentin to reduce these peripheral symptoms, it did not appear to derive any benefit from this medication. It is suggested that notify the patients about their oxaliplatin-associated, debilitating symptoms, and educate them any self-care strategy at the initiating phase of the chemotherapy. Moreover, it needs to design the intervention studies regarding the prevention and management of the peripheral neuropathy.