• Nuclear Medicine and Molecular Imaging
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• 제42권1호
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• pp.29-38
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• 2008

목적: 최근에 세포증식성 PET 방사성의약품으로 소개되고 있는 FLT를 이용하여 국소진행성 유방암 환자에서 FLT-PET 영상을 시행하여 종양 영상으로서의 향후 적용 가능성을 살펴보고, FDG와 FLT의 섭취양상에 대한 비교 및 정상 장기에 대한 섭취분포 양상을 알아보고자 하였다. 대상 및 방법: 본 연구는 2005년 8월부터 2006년 11월까지 총 22명(모두 여성, 평균나이; 42세)의 국소진행성 유방암 진단 받은 환자들을 대상으로 하였으며, 모든 종양의 조직형은 침윤성관상피암이었다. 모든 환자를 대상으로 하여 conventional imaging workup, FLT PET/CT, FDG-PET를 시행하였다. MRI로 측정 한 종양 장경의 평균은 $7.2{\pm}3.4$ cm 이었다. 원발 병소와 림프절 섭취에 대한 육안적인 분석과 반정량적인 분석(SUVmax, $SUV_{75}$, TB ratio)을 하였고, 림프절 섭취에 대한 FDG-PET와 FLT-PET의 일치도를 살펴보았다. 정상장기에서의 FLT와 FDG 분포양상을 비교하기 위해 간과 골수의 SUVmax와 $SUV_{75}$을 측정하였다. 결과: 모든 원발 종양근 FLT-PET와 FDG-PET에서 섭취 증가를 나타냈다. MR로 측정한 종양 장경과 FLT-PET 또는 FDG-PET의 SUVmax간에 유의한 상관관계는 없었다(p>0.05). 종양의 SUVmax (FLT $6.5{\pm}5.2$ vs FDG $8.3{\pm}4.9$, p=0.02)와 $SUV_{75}$ (FLT $5.3{\pm}4.3$ vs FDG $6.9{\pm}4.2$, p=0.02)에서는 FDG가 FLT보다 유의하게 높았으며, 중등도의 유의한 상관관계를 보였다(SUVmax; rho=0.450, p=0.04 / $SUV_{75}$; rho=0.472, p=0.03). 반면, TB 섭취비는 FLT가 FDG보다 현저히 높았다(FLT $11.7{\pm}7.7$ vs FDG $6.3{\pm}3.8$, p=0.001). 림프절 섭취 분포에 대한 비교에서는 FDG와 FLT-PET는 34개 구역에서 33개가 일치하였다. FLT와 FDG의 정상 장기의 섭취분포를 보았을 때 FLT는 간(FLT $4.2{\pm}1.2$ vs FDG $1.8{\pm}0.4$)과 골수(FLT $7.4{\pm}1.2$ vs FDG $1.6{\pm}0.4$)의 섭취가 FDG보다 높고 환자마다 다양하였다. 결론: 국소진행성 유방암에서 FTLT는 FDG보다 종양 섭취도는 낮지만 종양과 전이 림프절 섭취가 PET에서 잘 관찰되었다. FLT-PET는 종양 대 주변섭취의 비가 FDG-PET보다 높았으며, 전이 림프절의 진단에서도 FDG-PET와 높은 일치율을 보여 종양 진단 영상으로 유용할 것으로 생각된다. FLT는 정상 간과 골수 조직의 섭취가 높고 개인차가 커서 이들 장기의 전이를 진단하는 데는 제한적일 것으로 생각된다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권4호
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• pp.1419-1424
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• 2012

Objectives: To investigate in depth the use of complementary and alternative medicines (CAMs) by cancer patients at the end-of-life (EOL) and how they communicate with physicians about them. Design and location: In 17 hospitals in Korea between January and December 2004 we identified 4,042 families of cancer patients. Results: The prevalence of CAM use among cancer patients at the EOL was 37.0%, and 93.1% had used pharmacologic types of agents. The most frequent motive for CAM use was the recommendation of friends or a close relative (53.4%) or a physician (1.6%). Only 42.5% discussed CAM use with their physicians. Satisfaction with CAMS was recalled for 37.1%. The most common reason given for that satisfaction was improvement of emotional or physical well-being, while ineffectiveness was the most common reason given for dissatisfaction. The average cost of CAM during the last month of life was $US 900. CAM use was associated with longer disease periods, primary cancers other than liver, biliary, and pancreatic, and need of support from physicians or religion. Conclusions: CAM use among cancer patients at the EOL was common, not discussed with physicians, and associated with expectation of cure. Expectations were generally unmet while the treatments were a financial burden. Further studies evaluating the effects of CAM at the EOL and factors that enhance communication with the physician are needed.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.263-268
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• 2016

Cervical cancer is the fourth common cancer among women worldwide. Pap smear screening has resulted in deceasing incidence of cervical cancer in developed countries but low uptake of Pap smear screening among women in developing countries is still a public health challenge. The aim of this cross-sectional study was to assess the relationship between self-efficacy and timely uptake of Pap smear among Iranian women. A total of 580 married women referred to primary health care centers covered administratively by Shahid Beheshti University of Medical Sciences in Tehran were administered a questionnaire by trained staff. Data were analyzed with SPSS (version 16) software, using univariate and multivariate logistic regression. The mean age for participants was $33.1{\pm}8.8years$. There was a significant association between self-efficacy and Pap smear screening (P<0.01). There was also a positive correlation between duration of marriage and husband's education with Pap smear uptake (P<0.01). In univariate analysis, there was a significant association between Pap smear uptake and level of selfefficacy (OR = 15.3 for intermediate and OR=7.4 for good level), duration of marriage (OR = 5.7 for 5-14 years and OR=10.4 for more than 15), age (OR =2.7 for 27-34 years and OR=7.4 for more than 35 years) and husband education level (OR=2.3 for more than 12 years of education). In multivariate analysis, significant associations persisted between Pap smear uptake and self-efficacy (OR = 23.8; 95% CI: 8.7, 65.5), duration of marriage (OR = 5.9; 95% CI: 2.8, 12.2), age (OR = 3.9; 95% CI: 1.2, 12.9) and husband's education (OR = 2.5; 95% CI: 2.0, 10.3). Efforts are needed to increase women's knowledge about cervical cancer and improve their self-efficacy and perceptions of the Pap smear screening in order to reduce cervical cancer incidence and mortality rates.

• Journal of Yeungnam Medical Science
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• 제14권2호
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• pp.459-466
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• 1997

저자들은 원발성 부갑상선 기능 항진증과 함께 전신성 석회증을 동반한 부갑상선암 환자에서 부갑상선암 제거후 골 스캔상 폐와 위장의 전신성 석회화가 사라진 증례를 경험하여 보고하는 바이다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권3호
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• pp.1039-1042
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• 2012

Aim: Tanscatheter arterial embolization irrespective of with or without an anticancer agent and lipiodol has been controversial with regard to survival benefit. Therefore, we conducted a prospective study to analyze the effect of transcatheter arterial lipiodol chemoembolization (TACE) on the survival of HCC. Methods: A prospective study was conducted, and a total of 326 patients with primary liver cancer who were newly diagnosed were collected from January 2004 to January 2005 in Zhejiang Provincial People's Hospital of China. A univariate Cox's regression analysis was used to assess the survival of the HCC cases receiving TACE. Results: The duration of follow-up for the HCC patients treated with TACE ranged from 3 months to 60 months. For the overall patients, survival rate at 5 years was 42%. Both HBV Ag and HCV Ab positive patients showed significantly low survival rate at 5 years. The multivariate analysis revealed The IV TNM stage was related to an heavy increased risk of death of HCC patients, and Child C grade group showed a significant moderate increased risk. Conclusion: Our study showed TACE is associated with a better prognosis of HCC patients, and the HBV infection, TNM stage, Child-Pugh grade and number of TACE may influence the survival probability. Further TACE studies should be assess the quality of life of HCC patients, so as to provide more information for treatment of HCC.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.1107-1110
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• 2013

Intrahepatic cholangiocarcinoma (ICC), one of the primary liver cancers, is frequent in the northeastern part of Thailand. Surgical resection remains the best method of treatment, but patients suffering from ICC usually present at a late stage of the disease. Studies of survival and prognostic factors after surgery remain rare. The aim here was to evaluate the survival rate and factors affecting the survival of patients with intrahepatic cholangiocarcinoma after surgery. The study used a retrospective cohort design. The subjects were 73 consecutive patients with ICC, who were admitted for surgery to Srinagarind Hospital, Khon Kaen University, during the period 2005-2009. The censoring date was 31 December, 2011, data being evaluated using uni- and multivariate analyses. Postoperative survival analysis was performed by the Kaplan-Meier method, and the Cox proportional hazard model was used to identify independent prognostic factors. The total follow-up time was 99 person-years. The total number of deaths was 59, giving a mortality rate of 59 per 100 person-years. The cumulative 1-, 3-, and 5-year survival rates were 52.1%, 21.7%, and 11.2%, respectively. The median duration of survival after resection was 12.4 months. Univariate analysis revealed stage of disease, lymph node metastasis, histological type, histological grade and macroscopic classification to be statistically significant (p-value<0.05) prognostic factors. In the multivariate analysis, only macroscopic classification was statistically significant (p-value<0.05). In conclusion, macroscopic classification was the only independent factor found to be significantly associated with survival following surgical treatment of ICC.

• 대한본초학회지
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• 제22권3호
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• pp.27-37
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• 2007

Objectives: Hepatocellular carcinoma is the most common primary malignant tumor of the liver worldwide. In-Jin-Ho-Tang(IJHT) has been used as a traditional Chinese herbal medicine since ancient time. and today it is widely applied as a medication for jaundice which is associated with inflammation in liver. In this study, I investigated whether methanol extract of IJHT induced HepG2 cancer cell death. Methods: Cytotoxic activity of IJHT on HepG2 cells was using XTT assay. Apoptosis induction by Ros A in HCT116 cells was verified by the induction of cleavage of poly ADP-ribose polymerase (PARP). and activation of caspase-3, -8 and -9. The release of cytochrome c from mitochondria to cytosol. the level of Bcl-2 and Bax and the expression of p53 and p21 were examined by western blotting analysis. Furthermore, MAPKs activation was analyzed by western blotting analysis. Results: IJHT induced apoptosis in HepG2 cells. And treatment of IJHT resulted in the release of cytochrome c into cytosol, decreased anti-apoptotic Bcl-2, and increased pri-apoptotic Bax expression. IJHT markedly inactivated extracellular signal-regulated kinase (ERK1/2), and activated p38 mitogen-activated protein (MAP) kinase. Sodium orthovanadate (SOV), a phosphatase inhibitor, to reverse IJHT-induced ERK1/2 inactivation and SB203580, a specific p38 MAP Kinase inhibitor efficiently blocked apoptosis of HepG2. Thus, IJHT induces apoptosis in HepG2 cells via MAP kinase modulation. Conclusion: These results indicated that IJHT has some potential for use as an anti-cancer agent.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5951-5957
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• 2014

Background: Traditional Chinese Medicine (TCM) possesses several advantages for treating patients with hepatocellular carcinoma (HCC). The theory of 'Jianpi Huayu Therapy' rooted from 'Jin Kui Yao Lue'is one of the most important therapies in this respect. This study was conducted to investigate the clinical effect and safety of hepatectomy combining with 'Jianpi Huayu Therapy' in the treatment of HCC. Materials and Methods: One hundred and twenty patients with HCC were randomized allocated into hepatectomy combined with 'Jianpi Huayu Therapy' group (treatment group, n=60) and hepatectomy alone group (control group, n=60). Disease- free survival (DFS) and overall survival (OS) were the primary end-points. Liver function at the end of one week after surgery, complications, average days of hospitalization as well as performance status (PS) at the end of one month post operation were also compared. Results: No significant differences existed between two groups on baseline analysis (p>0.05). No treatment related mortality occurred in either group. Post-operative complications were detected among 14 patients (23.3%) in the treatment group, and 12 (20.0%) in the control group (p=0.658). Alanine aminotransferase (ALT) at the end of one week after operation was lower in the treatment than control groups (p=0.042). No significant differences in other indexes of liver function were discovered between two groups. Average days of hospitalization reduced by 0.9 day in treatment group than in control (p=0.034). During follow-up, 104 patients (86.6%) developed recurrence. The rates of 1-, 3-, and 5-year DFS and median DFS for all patients were 77.4%, 26.3%, 9.0% and 25.6 months (range, 6.0~68.0), respectively (78.2%, 29.2%, 14.3% and 28.7 months for the 48 patients in the treatment group and 75.0%, 23.3%, 6.4%, and 22.6 months for the 56 patients in the control group (p=0.045)). 101 patients had died at the time of censor, with 1-, 3-, and 5-year overall survival rates and median survival for all patients of 97.5%, 76.4%, 40.5% and 51.2 months (range, 10.0~72.0), respectively (98.3%, 78.0%, 43.6% and 52.6 months, for treatment and 96.7%, 74.7%, 37.4%, and 49.8 months, for controls, respectively (p=0.048)). Conclusions: Hepatectomy combined with 'Jianpi Huayu therapy'was effective in the treatment of HCC, and reduced post-operative recurrence and metastasis and improved DFS and OS of HCC patients.

• 대한두경부종양학회지
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• 제27권2호
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• pp.177-182
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• 2011

Backgrounds : Head and neck cancer is one of the most prevalent cancers in the world. It tends to remain localized at the primary site and regional lymph nodes, but if distant metastasis occurs, it has a poor prognosis. This study was performed to evaluate the prevalence of distant metastasis and to determine the risk factor in locally advanced head and neck cancer after induction chemotherapy followed locoregional control therapy. Methods : A retrospective review was performed in 420 patients with locally advanced head and neck cancer who treated with induction chemotherapy followed locoregional control therapy from January 2001 to December 2010. Among them, 31 patients who had distant metastasis as first relapse within 2 years after termination of therapy were analyzed for clinical features and the risk factors of distant metastasis. Results : The overall incidence of distant metastasis was 7.3%. The bone, lung, and liver were the most frequent metastatic organs. In univariate analysis, nodal stage, nasopharyngeal cancer, laryngeal cancer, G3/G4 neutropenia during induction chemotherapy, and concurrent chemoradiotherapy were the influencing factors for distant metastasis. In multivariate analysis, advanced N stage and nasopharynx were the risk factors of distant metastasis, and grade 3/4 neutropenia during induction chemotherapy was considered to decrease distant metastasis. Conclusion : This study suggests that the advanced N stage is the risk factor of distant metastasis and Grade 3/4 neutropenia during induction chemotherapy can be beneficial against distant metastasis in locally advanced head and neck cancer patients treated with induction chemotherapy followed locoregional control therapy.

• Radiation Oncology Journal
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• 제10권1호
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• pp.49-58
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• 1992

1986년 1월부터 1990년 9월까지 7예의 간외담도계 암 환자를 대상으로 외부 방사선치료와 온열치료를 병행하였다. 7예중 3예는 간외담도암으로 이중 2예는 원발성 담도암 이었고 1예는 위암에서 담도주위로 전이된 암이었다. 7예중 나머지 4예는 담낭암으로 이중 2예는 담낭 절제후 국소적으로 재발된 암이었고 나머지 2예는 원발성 담낭암 이었다. 그리고 7예는 모두 선암으로 확인 되었다. 조사된 방사선의 양은 3000 cGy/2주 조사한 1예를 제외하고 6예에서는 $4500\~5040\;cGY/6\~7$주 조사되었다. 온열치료는 모든 환자에서 방사선치료후 30분 이내에 시행되었으며 방사선치료 기간동안 주 1회 내지 2회씩 총 4회에서 12회까지 시행되었다. 치료효과의 판정은 T-관 T-관 담도촬영술. PTC, 그리고 CT등의 소견으로 하였으며 7예중 6예($86\%$)에서 부분관해를 보였으며 완전관해는 없었다. 7예중 6예는 4개월에서 11개월 애내 사망하였으며 나머지 1예는 현재 11개월째 생존하고 있으나 치료부위 밖에서 국소전이가 관찰되었다. 그리고 7예환자의 정중생존기간은 7개월이었다. 사망환자 6예의 사망원인으로는 원발성 담도암환자 1예에서 폐혈증, 전이성 담도암환자에서 원격 전이, 나머지 4예에서는 원발병소의 진행이 확인되었다. 관찰기간이 짧았으나 모든 환자에서 치료에 잘 적응하였으며 간, 십이지장, 위내의 합병증은 없었고 전이성 담도암 환자에서 일과성 카보닐산혈증이 관찰되었다.