• Title/Summary/Keyword: Solid Cancer

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Risk Factors of Predicting Intensive Care unit Transfer in Deteriorating Ward Patients (병동 급성악화 환자의 중환자실 전동 위험요인 분석)

  • Lee, Ju-Ry
    • Journal of Digital Convergence
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    • v.19 no.4
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    • pp.467-475
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    • 2021
  • Purpose: When a patient with acute deterioration occurs in a ward, the decision to transfer to intensive care unit (ICU) is critical to improve the patient's outcomes. However, when available ICU resources limited, it is difficult to determine which of the deteriorating ward patients to transfer to the ICU. Therefore the purpose of this study was to identify risk factors in predicting deteriorating ward patients transferred to intensive care unit (ICU). Methods: We reviewed retrospectively clinical data of 2,945 deteriorating ward patients who referred medical emergency team. Data were analyzed with multivariate logistic regression. Results: The solid cancer that diagnosed at hospitalization (odds ratio[OR] 0.39; 95% confidence interval [CI] 0.32-0.47), when the cause of deterioration was respiratory problem (1.51; 95% CI 1.17-1.95), high MEWS (1.22; 1.17-1.28) and SpO2/FiO2 score (2.41; 2.23-2.60) were predictive of ICU transfer. Conclusion: These findings suggest that early prediction and treatment of patients with high risk of ICU transfer may improve the prognosis of patients.

Development of a polystyrene phantom for quality assurance of a Gamma Knife®

  • Yona Choi;Kook Jin Chun;Jungbae Bahng;Sang Hyoun Choi;Gyu Seok Cho;Tae Hoon Kim;Hye Jeong Yang;Yeong Chan Seo;Hyun-Tai Chung
    • Nuclear Engineering and Technology
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    • v.55 no.8
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    • pp.2935-2940
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    • 2023
  • A polystyrene phantom was developed following the guidance of the International Atomic Energy Association (IAEA) for gamma knife (GK) quality assurance. Its performance was assessed by measuring the absorbed dose rate to water and dose distributions. The phantom was made of polystyrene, which has an electron density (1.0156) similar to that of water. The phantom included one outer phantom and four inner phantoms. Two inner phantoms held PTW T31010 and Exradin A16 ion chambers. One inner phantom held a film in the XY plane of the Leksell coordinate system, and another inner phantom held a film in the YZ or ZX planes. The absorbed dose rate to water and beam profiles of the machine-specific reference (msr) field, namely, the 16 mm collimator field of a GK PerfexionTM or IconTM, were measured at seven GK sites. The measured results were compared to those of an IAEA-recommended solid water (SW) phantom. The radius of the polystyrene phantom was determined to be 7.88 cm by converting the electron density of the plastic, considering a water depth of 8 g/cm2. The absorbed dose rates to water measured in both phantoms differed from the treatment planning program by less than 1.1%. Before msr correction, the PTW T31010 dose rates (PTW Freiberg GmbH, New York, NY, USA) in the polystyrene phantom were 0.70 (0.29)% higher on average than those in the SW phantom. The Exradin A16 (Standard Imaging, Middleton, WI, USA) dose rates were 0.76 (0.32)% higher in the polystyrene phantom. After msr correction factors were applied, there were no statistically significant differences in the A16 dose rates measured in the two phantoms; however, the T31010 dose rates were 0.72 (0.29)% higher in the polystyrene phantom. When the full widths at half maximum and penumbras of the msr field were compared, no significant differences between the two phantoms were observed, except for the penumbra in the Y-axis. However, the difference in the penumbra was smaller than variations among different sites. A polystyrene phantom developed for gamma knife dosimetry showed dosimetric performance comparable to that of a commercial SW phantom. In addition to its cost effectiveness, the polystyrene phantom removes air space around the detector. Additional simulations of the msr correction factors of the polystyrene phantom should be performed.

Analysis and risk assessment of formaldehyde in water from water purification plant in korea (국내 정수장 먹는 물 중 폼알데히드 함유실태 조사 및 위해성 평가 연구)

  • Chae, Hyojin;Kim, Hyun Ku;Kim, Seungki;Pyo, Heesoo;Hong, Jongki
    • Analytical Science and Technology
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    • v.22 no.5
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    • pp.386-394
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    • 2009
  • Formaldehyde is used in lether manufacture, a dry plate and an explosive. It is by-product of ozonizing process in filtration plant. The effects of exposure are eye pruritus, tickle, runing nose, blocking nasal passages and headache. It also makes a dried throat and causes inflammation. It is classified as B1 group for inhalation by US. EPA, which can cause cancer in human. For analysis of formaldehyde, formaldehydes-DNPH derivative was extracted with solid cartridge and was analyzed by High Performance Liquid Chromatography/Diode Array Detector (HPLC/DAD). The detection limit was $3{\mu}g/L$ and the recoveries were 72.3~109.1% (RSD 2.9~11.5%). Water samples were collected in four Korean rivers, four times per year seasonally for 10 years from 1998 to 2007. The monitoring results were 48.8% (630/1291), $5.15{\sim}101.9{\mu}g/L$ in purified water. Because of non-carcinogen in drinking water, hazard index is calculated with RfD. Results of excess cnacer risk was below 1 and was considered as safe value.

The Role of Radiotherapy in Patients with Brain Metastasis (고형암의 뇌전이시 방사선치료 효과)

  • Lee Soon Nam;Choo Mi-Soon;Lee Kyung-Ja;Nam Eunmi
    • Radiation Oncology Journal
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    • v.17 no.4
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    • pp.281-286
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    • 1999
  • Purpose : Brain metastases are the most frequent metastatic neurologic complication of systemic cancer. Even if the prognosis of brain metastases is grave, with available treatments, most patients experience effective palliation of neurologic symptoms and meaningful extension of life. We evaluated the clinical features and prognostic factors of the patients who were diagnosed as solid tumors with brain metastasis and received radiotherapy for brain metastases. Materials and Methods: Between January 1987 and January 1998, 71 patients with brain metastases from solid malignancy were included. We reviewed neurologic symptoms and signs of patients and evaluated improvememt of neurologic symptoms and signs. Survival durations after brain metastasis were ana lysed according to several factors such as age, performance status, primary malignancies, the pre-sence of brain metastasis at initial diagnosis of primary tumor, multiplicity of brain metastass, the presence of metastases other than brain, and treatment method. Results: Frequent symptoms associated with brain metastasis were headache (47.9$\%$), motor weakness (40.8$\%$), nausea and vomiting (19.7$\%$) and mental change (19.7%). Palliation of these symptoms was accomplished in 64.9$\%$ of cases. The overall median survival time was 16 weeks and 1- and 2-year survival rates were 15.0$\%$ and 5.1$\%$ respectively. Patients without extracranial metastases (n=27) had longer median survival than patients with extracranial metastases (33 weeks vs 10 weeks, p=0.0018). In patients with single brain metastasis (n=37), the median survival time was longer in patients treated with surgery plus radiotherapy than in patients treated with radiotherapy alone (40 weeks vs 16 weeks, p=0.0438). Conclusion: Patients who has brain metastases only constitute a prognostically favorable group and they may be benefited from radiotherapy and surgery if indicated.

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Immunohistochemical and Immunogold Electron Microscopic Studies on Effects of Cis-platin on the Ciliogenesis of Rat Oviducts (Cis-Platin이 흰쥐 난관의 섬모형성에 미치는 영향에 대한 면역조직학적 및 면역도금법에 의한 전자현미경적 연구)

  • Kim, Jin-Kook;Kim, Won-Kyu;Paik, Doo-Jin;Chung, Ho-Sam
    • Applied Microscopy
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    • v.30 no.1
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    • pp.45-59
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    • 2000
  • Cis-platin is a widely used anticancer drug against certain solid tumors such as malignant ovarian tumor, malignant carcinoma of head and neck, bladder cancer and cervical cancer of uterus, and its major mechanism of action is inhibition of DNA synthesis of the tumor cell. To investigate the inhibitory effects of cis-platin on the ciliogensis of the ciliated cells in the mucosa of oviduct, the author pursued the alterations of $\alpha-tubulin$, which is the main constituent of the microtubles in cilia, after cis-platin treatment. To eliminate the possible variations due to ovarian cycle, female Spargue-Dawley rats ($150\sim200gm$ in B.W.) were pretreated with estradiol benzoate (20 mg/kg, once a day, for 4 consecutive days). Animals were administrated with cis-platin (6 mg/kg, i.p.) and sacrificed at 1day, 3days, 5days and 7days after treatment, respectively. Immunohistochemistry for $\alpha-tubulin$ using mouse anti-rat $\alpha-tubulin$ monoclonal antibody as primary antibody was done. Immunogold electronmicroscopy for intracellular distributions of $\alpha-tubulin$ was also performed with same primary antibody and Goat anti- mouse IgM which is preconjugated with gold particles of 15 nm as secondary antibody. The results obtained were as follows; 1. Strong immunoreactivity of $\alpha-tubulin$ was observed in ciliated cells of oviducts at 1, 3 and 5 days after estradiol pretreatment. 2. Weak immunoreactivity of $\alpha-tubulin$ was observed in ciliated cells of oviducts at 1 and 3 days after cis-platin treatment but it was recovered to strong immunoreactivity in 5 days 3. In immunogold electronmicroscopy, density of gold particles for $\alpha-tubulin$ reactions was decreased in apical cytoplasm, but few changes were observed in basal body or cilia at 1 and 3 days after cis-platin treatment. From these above results, it is indicated that synthesis of $\alpha-tubulin$ in ciliated cells of rat oviduct is inhibited by cis-platin treatment.

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A Web-based 'Patterns of Care Study' System for Clinical Radiation Oncology in Korea: Development, Launching, and Characteristics (우리나라 임상방사선종양을 위한 웹 기반 PCS 시스템의 개발과 특성)

  • Kim, Il Han;Chie, Eui Kyu;Oh, Do Hoon;Suh Chang-Ok;Kim, Jong Hoon;Ahn, Yong Chan;Hur, Won-Joo;Chung, Woong Ki;Choi, Doo Ho;Lee, Jae Won
    • Radiation Oncology Journal
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    • v.21 no.4
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    • pp.291-298
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    • 2003
  • Purpose: We report upon a web-based system for Patterns of Care Study (PCS) devised for Korean radiation oncology. This PCS was designed to establish standard tools for clinical quality assurance, to determine basic parameters for radiation oncology processes, to offer a solid system for cooperative clinical studies and a useful standard database for comparisons with other national databases. Materials and Methods: The system consisted of a main server with two back-ups in other locations. The program uses a Linux operating system and a MySQL database. Cancers with high frequencies in radiotherapy departments in Korea from 1998 to 1999 were chosen to have a developmental priority. Results: The web-based clinical PCS .system for radiotherapy in www.pcs.re.kr was developed in early 2003 for cancers of the breast, rectum, esophagus, larynx and lung, and for brain metastasis. The total number of PCS study items exceeded one thousand. Our PCS system features user-friendliness, double entry checking, data security, encryption, hard disc mirroring, double back-up, and statistical analysis. Alphanumeric data can be input as well as image data. In addition, programs were constructed for IRB submission, random sampling of data, and departmental structure. Conclusion: For the first time in the field of PCS, we have developed a web-based system and associated working programs. With this system, we can gather sample data in a short period and thus save, cost, effort and time. Data audits should be peformed to validate input data. We propose that this system should be considered as a standard method for PCS or similar types of data collection systems.

GENETIC ALTERATIONS OF HUMAN ORAL CANCERS USING COMPARATIVE GENOMIC HYBRIDIZATION (Comparative genomic hybridization 기법을 이용한 인체 구강암의 유전자 변화에 대한 연구)

  • Lee, Myeong-Reoyl;Shim, Kwang-Sup;Lee, Young-Soo;Woo, Soon-Seop;Kong, Gu
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.3
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    • pp.245-253
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    • 2000
  • The development and progression of oral cancer is associated with an accumulation of multiple genetic alterations through the multistep processes. Comparative genomic hybridization(CGH), newly developed cytogenetic and molecular biologic technique, has been widely accepted as a useful method to allow the detection of genetic imbalance in solid tumors and the screening for chromosome sites frequently affected by gains or losses in DNA copy number. The authors examined 19 primary oral squamous cell carcinomas using CGH to identify altered chromosome regions that might contain novel oncogenes and tumor suppressor genes. Interrelationship between these genetic aberrations detected and major oncogenes and tumor suppressor genes previously recognized in carcinogenesis of oral cancers was studied. 1. Changes in DNA copy number were detected in 14 of 19 oral cancers (78.9%, mean: 5.58, range: $3{\sim}13$). High level amplification was present in 4 cases at 9p23, $12p21.1{\sim}q13.1$, 3q and $8q24{\sim}24.3$. Fourteen cases(78.9%, mean: 3.00, range: $1{\sim}8$) showed gains of DNA copy number and 12 cases(70.5%, mean: 2.58, range: $1{\sim}9$) revealed losses of DNA copy number. 2. The most common gains were detected on 3q(52.6%), 5p(21.0%), 8q(21.0%), 9p(21.0%), and 11q(21.0%). The losses of DNA copy number were frequently occurred at 9p(36.8%), 17q(36.8%), 13q(26.3%), 4p(21.0%) and 9p(21.0%). 3. The minimal common regions of gains were repeatedly observed at $3q24{\sim}26.7$, $3q27{\sim}29$, $1q22{\sim}31$, $5p12{\sim}13.3$, $8q23{\sim}24$, and 11q13.1-13.3. The minimal common regions of losses were detected at $9q11{\sim}21.3$, 17p31, $13q22{\sim}34$, and 14p16. 4. In comparison of CGH results with tumor stages, the lower stage group showed more frequent gain at 3q, 5q, 9p, and 14q, whereas gains at 1q($1q22{\sim}31$) and 11q($11q13.1{\sim}13.3$) were mainly detected in higher stage group. The loss at $13q22{\sim}34$ was exclusively detected in higher stage. The results indicate that the most frequent genetic alterations in the development of oral cancers were gains at $3q24{\sim}26.3$, $1q22{\sim}31$, and $5p12{\sim}13.3$ and losses at $9q11{\sim}21.3$, 17p31, and 13q. It is suggested that genetic alterations manifested as gains at $3q24{\sim}26.3$, $3q27{\sim}29$, $5p12{\sim}13.3$ and 5p are associated with the early progression of oral cancer. Gains at $1q22{\sim}31$ and $11q13.1{\sim}13.3$ and loss at 13q22-34 could be involved in the late progression of oral cancers.

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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.

Factors Related to Serum Level of Carbohydrate Antigen 19-9 and Cancer Antigen 125 in Healthy Rural Populations in Korea (일부 농촌지역 주민에서 혈청 CA19-9 및 CA125 농도에 영향을 미치는 인자에 관한 연구)

  • Lee, SK;Yoo, KY;Park, SK;Kang, DH;Kim, JQ;Chung, JK;Lee, MC
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.1
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    • pp.71-80
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    • 1998
  • This study examines the levels of carbohydrate antigen 19-9(CA19-9) and cancer antigen 125(CA125) in serum and its related factors in healthy Korean population. Although CA19-9 and CA125 have been widely used tumor markers for gastroenteric cancers and ovarian cancer in Western countries, there are no information available on the serum levels of CA19-9 and CA125 in healthy population and the factors affecting the levels of these tumor markers in Korea. A cross-sectional study was performed to measure CA19-9 and CA125 among 76 healthy males and 95 healthy females in Korea. CA19-9 and CA125 were quantitated using solid-phase radioimmunoassay kits. Informations on the factors which might be related to the levels of these markers were collected by questionnaire(e.g., smoking, alcohol consumption, menstruation, oral pill use, breast-feeding history, etc.). There was no statistically significant difference in the mean of CA19-9 concentration between men(10.4 u/ml) and women(10.1 u/ml), whereas the mean of CA125 levels(11.2 u/ml) was higher in women than that(2.5 u/ml) in men. Although there was a statistically significant association between CA19-9 and average number of cigarette consumed per day(r=0.59, p=0.026) and total number of cigarettes consumed in women(r=0.74, p=0.003), the significance disappeared by multiple regression analysis after adjusting age and body mass index. Later age of menopause(p=0.035) and longer duration of breast-feeding(p=0.050) were significant predictors for CA125 levels in women by multiple regression analysis after adjusting age and body mass index. In conclusion, CA19-9 can be used as a stable tumor marker in clinical practices, however, menstruation and breast-feeding should be considered when CA125 is used in women.

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Comparison of Virtual Wedge versus Physical Wedge Affecting on Dose Distribution of Treated Breast and Adjacent Normal Tissue for Tangential Breast Irradiation (유방암의 방사선치료에서 Virtual Wedge와 Physical Wedge사용에 따른 유방선량 및 주변조직선량의 차이)

  • Kim Yeon-Sil;Kim Sung-Whan;Yoon Sel-Chul;Lee Jung-Seok;Son Seok-Hyun;Choi Ihl-Bong
    • Radiation Oncology Journal
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    • v.22 no.3
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    • pp.225-233
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    • 2004
  • Purpose: The Ideal breast irradiation method should provide an optimal dose distribution In the treated breast volume and a minimum scatter dose to the nearby normal tissue. Physical wedges have been used to Improve the dose distribution In the treated breast, but unfortunately Introduce an Increased scatter dose outside the treatment yield, pavllculariy to the contralateral breast. The typical physical wedge (FW) was compared with 4he virtual wedge (VW) to do)ermine the difference In the dose distribution affecting on the treated breast and the contralateral breast, lung, heart and surrounding perlpheral soft tissue. Methods and Materials: The data collected consisted of a measurement taken with solid water, a Humanoid Alderson Rando phantom and patients. The radiation doses at the ipsllateral breast and skin, contralateral breast and skin, surrounding peripheral soft tissue, and Ipsllateral lung and heart were compared using the physical wedge and virtual wedge and the radiation dose distribution and DVH of the treated breast were compared. The beam-on time of each treatment technique was also compared Furthermore, the doses at treated breast skin, contralateral breast skin and skin 1.5 cm away from 4he field margin were also measured using TLD in 7 patients of tangential breast Irradiation and compared the results with phantom measurements. Results: The virtual wedge showed a decreased peripheral dose than those of a typical physical wedge at 15$^{\circ}$, 30$^{\circ}$, 45$^{\circ}$, and 60$^{\circ}$. According to the TLD measurements with 15$^{\circ}$ and 30$^{\circ}$ virtual wedge, the Irradiation dose decreased by 1.35$\%$ and 2.55$\%$ In the contralateral breast and by 0.87$\%$ and 1.9$\%$ In the skin of the contralateral breast respectively. Furthermore, the Irradiation dose decreased by 2.7$\%$ and 6.0$\%$ in the Ipsllateral lung and by 0.96$\%$ and 2.5$\%$ in the heart. The VW fields had lower peripheral doses than those of the PW fields by 1.8$\%$ and 2.33$\%$. However the skin dose Increased by 2.4$\%$ and 4.58$\%$ In the Ipsliateral breast. VW fields, In general, use less monitor units than PW fields and shoriened beam-on time about half of PW. The DVH analysis showed that each delivery technique results In comparable dose distribution in treated breast. Conclusion: A modest dose reduction to the surrounding normal tissue and uniform target homogeneity were observed using the VW technique compare to the PW beam in tangential breast Irradiation The VW field is dosmetrically superlor to the PW beam and can be an efficient method for minimizing acute, late radiation morbidity and reduce 4he linear accelerator loading bV decreasing the radiation delivery time.