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Multidisciplinary Management of the Locally Advanced Unresectable Non-Small Cell Lung Cancer (수술 불가능한 국소 진행 비소세포성 폐암의 집합적 요법)

  • Cho, Kwan-Ho
    • Radiation Oncology Journal
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    • v.22 no.1
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    • pp.1-10
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    • 2004
  • Locally advanced (Stage III) non-small cell lung cancer (NSCLC) accounts for approximately one third of all cases of NSCLC. Few patients with locally advanced NSCLC present with disease amenable to curative surgical resection. Historically, these patients were treated with primary thoracic radiation therapy (RT) and had poor long term survival rates, due to both progression of local disease and development on distant metastases. Over the last two decades, the use of multidisciplinary approach has improved the outcome for patients with locally advanced NSCLC. Combined chemoradiotherapy is the most favored approach for treatment of locally advanced unresectable NSCLC. There are two basic treatment protocols for administering combined chemotherapy and radiation, sequential versus concurrent. The rationale for using chemotherapy is to eliminate subclinical metastatic disease while improving local control. Sequential use of chemotherapy followed by radiotherapy has improved median and long term survival compared to radiation therapy alone. This approach appears to decrease the risk of distant metastases,, but local failure rates remain the same as radiation alone. Concurrent chemoradiotherapy has been studied extensively. The potential advantages of this approach may include sensitization of tumor cells to radiation by the administration of chemotherapy, and reduced overall treatment time compared to sequential therapy; which is known to be important for improving local control in radiation biology. This approach Improves survival primarily as a result of improved local control. However, it doesn't seem to decrease the risk of distant metastases probably because concurrent chemoradiation requires dose reductions in chemotherapy due to increased risks of acute morbidity such as acute esophageal toxicity. Although multidisciplinary therapy has led to improved survival rates compared to radiation therapy alone and has become the new standard of care, the optimal therapy of locally advanced NSCLC continues to evolve. The current issues in the multidisciplinary management of locally advanced NSCLC will be reviewed in this report.

Attenuation of Renal Ischemia-Reperfusion (I/R) Injury by Ascorbic Acid in the Canine Nephrotomy (개의 신장에 있어서 Ascorbic Acid에 의한 허혈/재관류 손상의 감소에 관한 연구)

  • Kim, Jong-Man;Lee, Jae-Yeon;Jeong, Seong-Mok;Park, Chang-Sik;Kim, Myung-Cheol
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.553-558
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    • 2010
  • The purpose of this study was to investigate the effects of premedicated ascorbic acid and hepa-saline irrigation/aspiration on attenuation of ischemia-reperfusion (I/R) injury and recovery of renal function in canine nephrotomy model. In the canine model, nine mixed dogs were subjected to renal nephrotomy with premedicated ascorbic acid and hepa-saline irrigation-aspiration (treatment group 2), and only hepa-saline irrigation-aspiration (treatment group 1). The level of renal function and antioxidant enzymes after nephrotomy were measured. And the expression pattern of TNF-${\alpha}$ and INF-${\gamma}$ was examined in the renal tissue at $7^{th}$ day after nephrotomy. BUN and creatinine levels significantly decreased in the treatment group 1 and 2 compared to that of control group at the $3^{rd}$, 5th and $7^{th}$ day after reperfusion (p < 0.05). And, there was significant difference between treatment group 1 and 2 at the $3^{rd}$ day after reperfusion (p < 0.05). The activities of antioxidant enzymes in plasma was significantly increased in the treatment group 1 and 2 compared to that of control group at the $3^{rd}$, $5^{th}$ and $7^{th}$ day after reperfusion (p < 0.05). And, there was significant difference between treatment group 1 and 2 at the $3^{rd}$ day after reperfusion (p < 0.05). TNF-${\alpha}$ was decreased and INF-${\gamma}$ was increased in treatment groups. The result of this study suggested that irrigation-aspiration has effects on attenuation of renal ischemia-reperfusion injury, and the exogenous ascorbic acid has a role in the attenuation of renal ischemia-reperfusion injury and recovery of renal function in canine nephrotomy model.

The apoptotic fragment assay in rat peripheral lymphocytes and crypt cells with whole body irradiation with 60Co ϒ-rays and 50 MeV cyclotron fast neutrons (코발트-60 감마선과 50 MeV 싸이크로트론 고속 중성자선에 전신조사된 랫드의 말초 임파구와 음와 세포의 아포토시스 유도를 이용한 생물학적 선량 측정 모델 개발 연구)

  • Kim, Tae-hwan
    • Korean Journal of Veterinary Research
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    • v.41 no.2
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    • pp.203-210
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    • 2001
  • Here, we compared the effectiveness of 50 MeV($p{\to}RBe^+$) cyclotron fast neutrons versus $^{60}Co$ ${\gamma}$-rays by the apoptotic fragment frequency in both rat peripheral lymphocytes and crypt cells to check a radiobiological endpoint. The incidence of apoptotic cell death was increased in all irradiated groups, and radiation at all doses trigger rapid changes in both crypt cells and peripheral lymphocytes. These data suggest that apoptosis may play an important role in homeostasis of damaged radiosensitive target organ by removing damaged cells. The curve of dose-effect relationship for these data of apoptotic fragments frequencies was $y=0.3+(6.512{\pm}0.279)D(r^2=0.975)$ after neutrons, while $y=0.3+(4.435{\pm}0.473)D+(-1.300{\pm}0.551)D^2(r^2=0.988)$ after ${\gamma}$-rays. In addition, $y=3.5+(118.410{\pm}10.325)D+(-33.548{\pm}12.023)D^2(r^2=0.992)$ after ${\gamma}$-rays in rat lymphocytes. A significant dose-response relationship was found between the frequency of apoptotic cell and dose. These data show a trend towards increase of the numbers of apoptotic cells with increasing dose. Dose-response curves for high and low linear energy transfer (LET) radiation modalities in these studies were different. The relative biological effectiveness (RBE) value for crypt cells was 1.919. In addition, there were significant peaks on apoptosis induction at 4 and 6h after irradiation, and the morphological findings of the irradiated groups were typical apoptotic fragments in crypt cells that were hardly observed in the control group. Thus, apoptosis induction in both crypt cells and peripheral lymphocytes could be a useful endpoint of rat model for studying screening test and microdosimetic indicator to evaluate the biological effects of radiation-induced cell damage.

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Antioxidant Effect of Mul-kimchi on Hepatic Tissue of Rats Fed with High Cholesterol Diet (키토산-아스코베이트 첨가 물김치의 고콜레스테롤 식이 흰쥐 간 조직에 대한 항산화효과)

  • Beik, Kyung-Yeun;Kim, Mee-Jung;Kim, So-Ja;Yang, Jae-Ho;Kim, Soon-Dong
    • Journal of Marine Bioscience and Biotechnology
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    • v.1 no.3
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    • pp.178-185
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    • 2006
  • This study was to investigate the effect of 0.1% chitosan-ascorbate (CA) prepared with different molecular weight (223, 746, 1,110 and 2,025 kDa) of chitosan on the changes in antioxidant activity of mul-kimchi during storage at $10^{\circ}C$ for 20 days. Animal experiments were divided to 5 groups; normal control group (NC), high cholesterol diet group (HC), high cholesterol diet mul-kimchi diet group (HCKC), high cholesterol diet and CA2025 containing mul-kimchi administrated group (HCCA), and high cholesterol diet and 1/2 concentrated CA containing mul-kimchi administrated group (HC2CA). Mul-kimchi juice was administered 0.5 mL per 100 g body weight once a day and fed for 5 weeks. Electron donating activity of the 20 days-stored mul-kimchi with 0.1% CA showed higher activity (84.74~89.13%) than those of control and ascorbic acid mul-kimchi (35.04 and 75.04%). Superoxide dismutase activities of the kimchijuice with CA were higher in the higher molecular of chitosan. In the animal experiments, the average body weight of the HCCA and HC2CA group were lower 6.9% and 8.4% than that of HC control group, respectively. Hepatic glutathione content in HCCA and HC2CA group was increased 22.5% and 9.1% as compared to HC group. Hepatic glutathione S-transferase activities were significantly increased in the HCCA (219.9%) and HC2CA group (153.8%) compared to NC group. Hepatic superoxide dismutase activity was highest in the HCCA group, and the activities in CA groups were higher than those of NC and HC group.

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The Anti-angiogenic Potential of a Phellodendron amurense Hot Water Extract in Vitro and ex Vivo (in Vitro와 ex vivo에서 황백 온수추출물의 신생혈관 억제효과)

  • Kim, Eok-Cheon;Kim, Seo Ho;Bae, Kiho;Kim, Han Sung;Gelinsky, Michael;Kim, Tack-Joong
    • Journal of Life Science
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    • v.25 no.6
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    • pp.693-702
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    • 2015
  • Blocking new blood-vessel formation (angiogenesis) is now recognized as a useful approach to the therapeutic treatment of many solid tumors. The best validated approach to date is to target the vascular endothelial growth-factor (VEGF) pathway, a key regulator of angiogenesis. Many natural products and extracts that contain a variety of chemopreventive compounds have been shown to suppress the development of malignancies through their anti-angiogenic properties. Phellodendron amurense, which is widely used in Korean traditional medicine, has been shown to possess antitumor, antimicrobial, and anti-inflammatory properties, among others. The present study investigated the effects of P. amurense hot-water extract (PAHWE) on angiogenesis, a key process in tumor growth, invasion, and metastasis. To investigate PAHWE’s anti-angiogenic properties, this study’s authors performed an analysis of angiogenesis and endothelial-cell proliferation, migration, invasion, and tube formation, as well as zymogram assays and the rat aortic ring-sprouting assay. PAHWE inhibited cell growth, mobility, and vessel formation in response to VEGF in vitro and ex vivo. Furthermore, it reduced VEGF-induced intracellular signaling events, such as the activation of matrix metalloproteinases (MMPs) -2 and -9. These results indicate that PAHWE’s anti-angiogenic properties might lead to the development of potential drugs for treating angiogenesis-associated diseases such as cancer.

Changes of the Breeding State of Little Tern (Sterna albifrons) in the Nakdong Estuary, Busan, Republic of Korea (낙동강하구에서 쇠제비갈매기의 번식 상황의 변화)

  • Lee, In-Sup;Hong, Soon-Bok
    • Journal of Life Science
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    • v.19 no.11
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    • pp.1611-1616
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    • 2009
  • This study was conducted to determine the characteristics in breeding of the little tern Sterna albifrons in Shinja-do and Doyo-Deung in Nakdong estuary. The data was obtained in the middle and late 1990's and in the mid 2000's, which were analysed for the breeding information of the little tern. In Shinja-Do, a total of 638 nests were observed in 1995, and the average numbers of eggs laid per nest were 2.48. In 2004 and 2005, 94 and 456 nests were observed, and the average number of eggs laid per nest was 2.16 and 2.53, respectively. There was a significant difference between the average numbers of eggs laid per nest for the 3 respective years. In Doyo-Deung, a total of 269 nests were observed in 1998, and the average number of eggs laid per nest was 2.16. In 2004 and 2005, 1,023 and 1,123 nests were observed, and the average numbers of eggs laid per nest were 2.33 and 2.52, respectively. There was a significant difference (p<0.001) between the average number of eggs laid per nest as well. Hatching success rate by nesting site in Shinja-Do was calculated in 1995. Type A nest (nest located on dry sand land) showed a 56.8% success rate, and type B nest (nest located on the land with dwarf grass), type C nest (nest located on moist land) and type D nest (nest located on the land with shells) showed 55.3%, 36.6% and 59.3% success rates, respectively. The average hatching success rate in Shinja-Do was 54.5%. The most crucial factor for hatching failure was flood, especially, for the type C nests. The hatching success rate by the nesting site in Doyo-Deung showed an average of 73.2%. It was high in type D nest (83.8%) and type A nest (75.9%), and low in type C nest (59.7%). Again, the most crucial factor for hatching failure was flood, especially, for the type C nests. Nakdong estuary has been through many changes over time, particularly in recent. Therefore, continuous efforts to keep it a breeding place for the little tern are urgently required, including overall management of land, protection of reef and sand, etc.

Changes in the in vitro Antioxidant and Antithrombosis Activities of Salicornia europaea According to Harvest Time (수확시기에 따른 함초의 항산화 및 항혈전 활성의 변화)

  • Kim, Mi-Sun;Lee, Jung-Nam;Seong, Ha-Jung;Kim, Deuk Hoi;Sohn, Ho-Yong
    • Journal of Life Science
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    • v.26 no.9
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    • pp.1033-1040
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    • 2016
  • In Korea, the aerial parts of the halophyte Salicornia europaea, known as hamcho, are used in salads in April–June and in oriental medicine in September–October In this study, with the aim of developing functional foods to aid blood circulation, hot water extract (HWE) and ethanol extract (EE) were prepared using hamcho harvested from the fields of Shinan, Jeonnam, Korea on 5th April (HWE-04, EE-04), 5th July (HWE-06, EE-06), 5th August (HWE-08, EE-08), 5th September (HWE-09, EE-09), and 5th October (HWE-10, EE-10), and their antioxidant and antithrombosis activities were evaluated. Among the HWEs, HWE-10 showed the highest concentration of total polyphenols and total flavonoids (22.4 and 17.6 mg/ml, respectively), and EE-09 had the highest concentration among the EEs (20.1 and 19.3 mg/ml, respectively). Among the HWEs and EEs, HWE-08 and EE-08 had the highest total sugar and reducing sugar content. In the antioxidation assay, HWE-10 and EE-09 showed strong reducing power, as well as DPPH, ABTS, and nitrite scavenging activities. The calculated RC50s of EE-09 against DPPH, ABTS, and nitrite were 578, 277, and 68.8 μg/ml, respectively. The antithrombosis activity assay revealed that HWE-04, HWE-06, EE-04, and EE-06 had anticoagulation activity against coagulation factors and that HWE-08, HWE-09, EE-08, and EE-09 expressed strong thrombin inhibitory activity, which was comparable to the antithrombosis activity of aspirin. In addition, EE-06 and HWE-08 exhibited strong aggregation inhibitory activities against human platelets. The results suggest that extract from hamcho harvested in particular periods and prepared using a defined solvent has strong potential as a novel food ingredient and an antioxidant and antithrombosis agent.

A Case Study of Angular Momentum of Trunk and Lower extremity when Performing Uchimata by Posture and Voluntary Resistance Levels of Uke in Korean Judo Olympian[III] (유도 올림피언 허벅다리걸기 기술발휘 시 받기의 자세와 저항수준에 따른 몸통과 하지의 각운동량 분석 사례연구[III])

  • Kim, Eui-hwan;Kim, Sung-sup;Chung, Chae-Wook
    • Korean Journal of Applied Biomechanics
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    • v.15 no.4
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    • pp.191-203
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    • 2005
  • It was to study a following research of "A Kinematical Traits Analysis when Performing Uchimata(inner thigh reaping throw) by Posture and Voluntary Resistance Levels(VRL) of Uke in Judo[1]" and. "A Case Study of Center of Gravity(COG) when Performing Uchimata(inner thigh reaping throw) by Posture and Voluntary Resistance Levels(VRL) of Uke in Judo[II]". The purpose of this study was to analyze an angular momentum of trunk and lower extremity when performing uchimata by two postures and voluntary resistance levels(VRL) of uke(reciver) in Judo. The subjects, who were one male judoka(YH) for 1992 Barcelona Olympic Games Olympian(silver medalist), was filmed on two S-VHS 16mm video cameras(60fields/sec.) through 3-dimensional motion analysis methods, that postures of uke were shizenhontai (straight natural posture:NP) and jigohontai (straight defensive posture:DP), VRL of uke were 0% and 100%, respectively. The variables were angular momentum of trunk, lower extremity of attacking leg and supporting leg of tori(the thrower). The data of this study collection were digitized by SIMI Motion Program computed the mean values and the standard deviation calculated for each variables. When performing uchimata according to each posture and VRL of uke and classifying. From the data analysis and discussion, the conclusions were as follows : Angular momentum of trunk when performing uchimata was showed the largest among another angular momenta, and the posture displayed more different than resistant of uke(reciver), but the pattern similar in judo. Angular momentum of trunk of X axis was the largest and Y, Z axis order. Angular momentum of attacking the thigh-leg when performing uchimata was showed the largest among another angular momenta, and the posture displayed more different than resistant of uke(reciver), X axis and Y axis similar, but angular momentum of Z axis of thigh-leg the largest, in kake(application) event in 0% resistance of DP than other variables. Angular momentum in X,Y axis of attacking the lower-leg when performing uchimata was showed that the resistance level displayed more different than posture, but Z axis the largest, in kake(E3) phase in 0% resistance of DP than other variables as same thigh-leg, and the largest from tsukuri(set-up:E2) to kake(E3) phase. X and Z axis Angular momentum of supporting the thigh-leg were similar, regardless of posture and resistance of uke, but Y axis was resistance level. Angular momentum of supporting the thigh-leg was showed the largest in X axis, increased from EO event to E2, and decreased in E3, and angular momenta of Y, X axis were showed the largest in kuzushi(balance breaking) phase when performing uchimata. Angular momentum of supporting the lower leg were similar pattern, regardless of posture and resistance of uke, in Y axis, resistance displayed more difficult the position in NP, and showed opposite angular momentum in tsukuri phase. In conclusion, angular momentum of trunk when performing uchimata was showed the largest, and pattern was similar, regardless of posture than resistant of uke(reciver), magnitude and direction were different each other, and uchimata was Ashi -waza(foot and leg techniques) division but important of trunk action.

Neoadjuvant Chemotherapy and Radiotherapy in Locally Advanced Hypopharyngeal Cancer (국소 진행된 하인두암의 선행 항암화학요법 후 방사선치료)

  • Kim Suzy;Wu Hong-Gyun;Heo Dae-Seog;Park Charn I1
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.244-250
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    • 2000
  • Purpose : To see the relationship between the response to chemotherapy and the final outcome of neoadiuvant chemotherapy and radiotherapy in patients with mocanry advanced hypopharyngeal cancer. Methods and Materials :A retrospective analysis was done for thirty-two patients with locally advanced hypopharyngeal cancer treated in the Seoul National University Hospital with neoadiuvant chemotherapy and radiotherapy from August 1979 to July 1997. The patients were treated with Co-60 teletherapy unit or 4MV or 6MV photon beam produced by linear accelerator. Daily fractionation was 1.75 to 2 Gy, delivered five times a week. Total dose ranged from 60.8 Gy to 73.8 Gy. Twenty-nine patients received continuous infusion of cisplatin and 5-FU. Other patients were treated with cisplatin combined with bleomycin or vinblastin. Twenty-four (75$\%$) patients received all three prescribed cycles of chemotherapy delivered three weeks apart. Six patients received two cycles, and two patients received only one cycle. Results :The overall 2-year and 5-year survival rates are 65.6$\%$ and 43.0$\%$, respectively. 5-year local control rate is 34$\%$. Organ preservation for more than five years is achieved in 12 patients (38$\%$). After neoadjuvant chemotherapy, 24 patients achieved more than partial remission (PR): the response rate was 75$\%$ (24/32). Five patients had complete remission (CR), 19 patients PR, and 8 patients no response (NR). Among the 19 patients who had PR to chemotherapy, 8 patients achieved CR after radiotherapy. Among the 8 non-responders to chemotherapy, 2 patients achieved CR, and 6 patients achieved PR after radiotherapy. There was no non-responder after radiotherapy. The overall survival rates were 60$\%$ for CR to chemotherapy group, 35.1$\%$ for PR to chemotherapy group, and 50$\%$ for NR to chemotherapy group, respectively (p=0.93). There were significant difference in five-year overall survival rates between the patients with CR and PR after neoadjuvant chemotherapy and radiotherapy (73.3$\%$ vs. 14.7$\%$, p<0.01). The prognostic factor affecting overall survival was the response to overall treatment (CR vs. PR, p<0.01). Conclusion :In this study, there were only five patients who achieved CR after neoadiuvant chemotherapy. Therefore the difference of overall survival rates between CR and PR to chemotherapy group was not statistically significant. Only the response to chemo-radiotherapy was the most important prognostic factor. There needs to be more effort to improve CR rate of neoadjuvant chemotherapy and consideration for future use of concurrent chemoradiotherapy.

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The Characteristics of Sediment and Organic Content in the Dalpo Wetland (달포늪의 퇴적물과 유기물함량 특성 연구)

  • Kang, Dong Hwan;Kim, Sung Soo;Jung, Hwee Je;Kwon, Byung Hyuk;Kim, Il Kyu
    • Journal of Wetlands Research
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    • v.9 no.3
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    • pp.1-12
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    • 2007
  • In this study, the correlation of organic content with particle size and type of sediment was found out.Particle size, stratigraphic section and organic content of sediments sampled from Dalpo wetland was analyzed. Dalpo wetland consists of three wetlands, and the area of Dalpo wetland is about $31,295m^2$. The particle size analyses for sampled sediments of 7 points (3 points in wetland A, 3 points in wetland B and 1 point in wetland C) were tested. As results of the particle size analyses, the sediment particle size becomes larger as to the edge of the wetland. It is revealed in order of wetland A > wetland C > wetland B. Borehole surveys with horizontal distance in the major and minor axes of wetland A, the major and minor axes of wetland B and the major axis of wetland C were accomplished. Clayey peat deposit is distributed at 10~90 cm depth below ground surface in the major axis of wetland A. The clayey peat deposit was the most thick at the center of wetland A that horizontal distance is 100 m. As the depth below ground surface of clayey peat deposit is less than 27 cm in the wetland B, we can infer that the life for the wetland B is being finished. Sediment composition of wetland C is simple because wetland C is small scale, and clayey peat deposit is distributed at 10~34 cm depth below ground surface. Sediment sampled by borehole survey in the Dalpo wetland was cut at interval of 10 cm, then organic content was analyzed. Organic content of wetland A sediment showed more than 40% until 70 cm depth below ground surface, also sediment of wetland B is similar to wetland A until 10 cm depth below ground surface, but is showed within 20 % above 30 cm depth below ground surface. Organic content of wetland B is showed the lowest as organic content near the ground surface is about 40%. All of the three wetlands, organic content is showed higher at clayey peat deposit near to ground surface. This is caused by finer particles of the clayey peat deposit, also organic materials were supplied from dead vegetation. Organic content of the Dalpo wetland showed in order of wetland A > wetland C > wetland B. This result is caused by thickness of clayey peat deposit in sediment. Through this study, it was verified that organic content of the Dalpo wetland sediment was dominated by particle size of sediment and vegetation of the upper part.

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