• Journal of Korean Neurosurgical Society
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• 제61권5호
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• pp.592-599
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• 2018

Objective : Metastatic brain tumors (MBTs) often present with intracerebral hemorrhage. Although Gamma Knife surgery (GKS) is a valid treatment option for hemorrhagic MBTs, its efficacy is unclear. To achieve oncologic control and reduce radiation toxicity, we used a radiosurgical targeting technique that confines the tumor core within the hematoma when performing GKS in patients with such tumors. We reviewed our experience in this endeavor, focusing on local tumor control and treatment-associated morbidities. Methods : From 2007 to 2014, 13 patients with hemorrhagic MBTs were treated via GKS using our targeting technique. The median marginal dose prescribed was 23 Gy (range, 20-25). GKS was performed approximately 2 weeks after tumor bleeding to allow the patient's condition to stabilize. Results : The primary sites of the MBTs included the liver (n=7), lung (n=2), kidney (n=1), and stomach (n=1); in two cases, the primary tumor was a melanoma. The mean tumor volume was $4.00cm^3$ (range, 0.74-11.0). The mean overall survival duration after GKS was 12.5 months (range, 3-29), and three patients are still alive at the time of the review. The local tumor control rate was 92% (tumor disappearance 23%, tumor regression 46%, and stable disease 23%). There was one (8%) instance of local recurrence, which occurred 11 months after GKS in the solid portion of the tumor. No GKS-related complications were observed. Conclusion : Our experience shows that GKS performed in conjunction with our targeting technique safely and effectively treats hemorrhagic MBTs. The success of this technique may reflect the presence of scattered metastatic tumor cells in the hematoma that do not proliferate owing to the inadequate microenvironment of the hematoma. We suggest that GKS can be a useful treatment option for patients with hemorrhagic MBTs that are not amenable to surgery.

• Journal of Chest Surgery
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• 제31권12호
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• pp.1226-1229
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• 1998

환아는 생후 50일된 체중 4.5kg의 남아로 선천성 심장질환 및 울혈성 심부전증으로 본원에 내원하여 시행한 심초음파상 막주위형 심실중격결손으로 진단되어 수술하였다. 수술후 중환자실에서 치료하던 중 방실접합부 이소성 빈맥이 발생하면서 혈역학적으로 불안정한 상태가 되었고 요량이 감소하여 강심제 및 이뇨제등의 약물 치료를 하였으나 호전되지 않아서 경도의 저체온(34℃)치료를 병행하였다. 술후 2일 동안 4차례의 저체온 치료로 방실접합부 이소성 빈맥은 정상 동율동으로 전환 되었고 혈역학적으로도 안정되었으며 요량도 증가 되어 수술후 8일에 정상 퇴원하였다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권7호
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• pp.2833-2838
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• 2015

Background: Repeating a prior chemotherapy (rechallenge therapy) is an option for selected patients with metastatic colorectal cancer, but there is very little evidence in the literature for this approach. Thus, we reviewed our registry to evaluate prognostic factors and survival of patients who received irinotecan and oxaliplatin-based regimens as rechallenge third and fourth-line therapy. Materials and Methods: Patients who received irinotecan-based or oxaliplatin-base regimen as first-line had been rechallenged with third-line or fourth-line therapy. These patients were selected from the database of Turkish mCRC registry archives between October 2006 and June 2013 and evaluated retrospectively for factors effecting progression free survival (PFS) and overall survival (OS) by the Kaplan-Meire and Cox-regression methods. Results: Thirty-nine patients were enrolled. The median duration of follow-up was 36 months (14-68 months). Thirty-one patients (76%) died during follow-up. In terms of rechallenge treatments, 29 patients had received third-line and 10 patients had received fourth-line. Response rate (RR) was found to be 12.9%, with stable disease in 19 (48.7%) patients. The median PFS was 6 months (95%CI=4.64-7.35 months) and the median OS was 11 months (95%CI=8.31-13.68 months). The factors effecting survival (PFS and OS) were only being PFS after first-line chemotherapy ${\geq}12months$ (p=0.007, 95% CI=1.75-35.22 and p=0.004, 95%CI=1.44-7.11), both in univariate and multivariate analyses. Conclusions: This study indicates that rechallenge treatment could be a good option as a third or later line therapy in patients who had ${\geq}12months$ PFS onreceiving first line therapy.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.423-427
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• 2013

Background: Phase II and III trials of docetaxel, cisplatin and fluorouracil (DCF) have shown superior efficacy versus cisplatin and fluorouracil alone but with high rates of hematologic toxicity in metastatic gastric cancer cases. To reduce toxicity while maintaining the efficacy of DCF, we investigated low dose docetaxel (D), cispatin (C) - leucovorin and fluorouracil (De Gramont regimen). Patient and methods: Chemotherapy-naïve patients with metastatic gastric cancer (MGC) received D 60 mg/$m^2$ on day 1 and cisplatin 30 mg/$m^2$ on day 1-2 and the De Gramont regimen (Folinic acid 400 mg/m2 on day 1 and 5-FU 2400 mg/$m^2$/46h continuous infusion) every 3 weeks. The primary endpoint was response rate. Results: One hundred twenty patients with a median age of 52.5 years (range, 32-78) received a median of 6 cycles (range, 2-12 cycles). Of the 120 evaluable patients, 4 showed complete remission and 36 achieved a partial response. The overall response rate was 56.6%. Twenty eight patients (23.3%) showed stable disease and 52 (43.3%) progression. The median time to progression was 7 months (95%CI 6-7.9). The median overall survival was 15 months (95%CI 13.7-16.2). The most frequent hematological toxicity was leucopenia, which occurred at grade 3/4 intensity in 24 patients (20%). Conclusions: Low-dose DC-De Gramont regimen is active in MGC with a tolerable toxicity profile.

• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.7867-7869
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• 2015

Objective: To assess the safety and effectiveness of thalidomide (produced by CHANGZHOU PHARMACEUTICAL FACTORY CO.LTD) combined with chemotherapy in treating patients with advanced colorectal cancer. Method: A consecutive cohort of pretreated patients with advanced colorectal cancer were treated with thalidomide combined with chemotherapy. And chemotherapy for patients with advanced colorectal cancer were administered according to the condition of patients. Thalidomide was orally administered at a dosage of 50mg/day to 150mg/day before sleeping for at least 14 days. After at least 14 days of treatment, safety and side effects were evaluated. Results: There were 12 female and 3 male patients with advanced cancer recruited into this study, including 9 patients with colon, 6 patients with rectal cancer. The median age of patients was 57(41-82) years. Partial response was observed in 2 patients (2/15), and stable disease in 3 patients(3/15). Incidences of Grade 1 to 2 myelosuppression was observed in 1/15 patients, and Grade 1 to 2 elevation of hepatic enzyme was recorded in 1/15 patients. Adverse effects on the gastrointestinal tract were documented in 1/15 patients, and were Grade 1. No Grade 3-4 toxicities were diagnosed. No treatment related death was found. Conclusions: Thalidomide combined with chemotherapy was safe and mildly effective in treating patients with advanced colorectal cancer. However, further study should be conducted to clarify the effectiveness of this combination.

• 한국수정란이식학회:학술대회논문집
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• 한국수정란이식학회 2002년도 국제심포지엄
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• pp.97-97
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• 2002

Human eryhropoietin (EPO) is acidic glycoprotein hormone that plays key role in hematopoiesis by facilitating differentiation of erythrocyte and formation of hemoglobin (Hb) and is used for the treatment of anemia. Human EPO is consist of 166 amino acids which is modified by three N-glycosylations (24, 38, 83) and single O-glycosylation (126). N-glycosylation is reported to be related to the cellular secretion and activity of EPO. In this study, we examined effects of mutagenesis in glycosylation site of recombinat hEPO for the cellular secretion during production from cultured CHO cell. We produced rhEpo which was cloned by PCR from human liver cDNA (TaKaRa) in cultured CHO cell. Using supernatant of the culture, ELISA assay and western analysis were performed. To estimate biological activity, 20IU of rhuEpo was subcutaneously injected into four ICR mice. After 8 days, HCT level was increased average 13 per cent, RBC was increased ca. 2${\times}$10$\^$6//${\mu}\ell$. In disease model Rat (anemia c-kit, WSRC-WS/WS), HCT was increased ca. 12%, RBC was increased ca. 1.6${\times}$10$\^$6//${\mu}\ell$. These results suggests that rhEpo we produced has biological activity. To remove glycosylation site by substituting 24, 38, 83, and 126th asparagine (or serine) with glutamic acid, overlapping -extension site-directed mutagenesis was performed. To add novel glycosylation sites, 69, 105th leucine was mutated to asparagine. Mutant EPO construct was transfected into CHO cell. Supernatant of the cell culture was analyzed using ELISA assay with monoclonal anti-EPO antibody (Medac, Germany). Since, several reports for mutagenesis of glycosylation sites showed case-by-case results, we examined both transient expression and stable expression. Addition of novel glycosylation sites resulted no secretion while deletion mutants had little effect except some double deletion mutants (24/83 and 38/83) and triple mutant. We suggest that not single but combination of glycosyl group affect secretion of EPO.

• 식물병연구
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• 제16권1호
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• pp.74-80
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• 2010

2009년 6월에서 7월까지 경남 농업술원 ATEC 센터의 시설 하우스 내에서 파프리카에 발생한 흰가루병에 대하여 실험한 결과이다. 난황유 제조시 물 첨가량에 따른 유화 및 과일표면을 비교한 결과 50 ml과 100 ml의 물을 첨가하였을 때는 응집력이 강하지 않아 물에 균일하게 잘 분산되었다. 식용유가 완전히 유화되지 못한 것과 유화된 것을 살포하여 1주일 후 파프리차 과일의 표면을 비교한 결과 완전히 유화되지 못한 난황유의 경우 과일표면에 기름성분으로 덮여있는 것이 관찰되었다. 난황유 및 혼합제의 처리는 난황유 단독 처리구와 혼합제 처리구에서 병재발생이 억제되는 것으로 관찰되었으며, 혼합제 1,000배 와 5,000배를 처리한 구에서 난황유를 단독처리한구보다 병 재발생이 더 억제되어 유의차가 인정되었다. 난황유 및 혼합제의 처리에 의한 흰가루병 발병억제 지속효과는 난황유와 혼합제 처리구에서 병 재발생 면적 증가율이 다른 물처리와 유황수화제처리보다 낮은 것으로 나타났으며, 3주가 경과하여도 재발생 억제효과가 지속되었으나 4주차에서는 난황유와 혼합제(1,000, 5,000, 10,000배)가 각의 처리구 모두 재발생 면적이 조금씩 나타났다.

• 한국방사선학회논문지
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• 제11권2호
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• pp.123-130
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• 2017

암(caner)라는 중증의 질환을 가지고 있는 환자의 경우, 방사선 치료시 받을 수 있는 불안감, 폐쇄적 공포심을 알아보려 하였다. 연구의 대상은 각각 선형가속기의 치료, 토모테라피 치료를 받는 환자를 대상으로 하였으며 연구의 방법은 설문조사의 방법으로 시행을 하였다. 설문의 내용은 치료시간별로 조사 하였고, (5분 이내의 치료시, 10분이내, 20분 이상, 30분 이상), 장비의 고장으로 인한 치료실 및 치료기기 변경의 경험에 대한 설문조사를 시행하였다. 설문에 성실히 응답한 200개의 설문지를 연구한 결과 방사선치료의 경험이 없을수록 불안감이 많았으며 그 이유로는 치료시 고틍이 있을 것 같다는 의견이 지배적이었다. 치료기로는 선형가속기가 가장 불안감이 높았으며 이유는 환자의 테이블의 개방감 때문인 것으로 나타났다. 가장 안정적인 상태는 토모테라피 치료를 20분 이상 30분 미만 시행한 경우였으며 치료시 토모테라피 치료장비의 아늑함이 원인이었다. 30분이 초과된 경우는 외부와 분리에 대한 불안감으로 불안한 심리상태를 보였다. 본 논문을 통하여 임상에서는 환자의 만족도를 높이는 양질의 의료서비스를 제공하기 위한 제반 자료로 활용되길 기대해 본다.

• Radiation Oncology Journal
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• 제32권4호
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• pp.231-237
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• 2014

Purpose: To evaluate the predictive value of the early response of $^{18}F$-flurodeoxyglucose positron emission tomography (FDG PET) during concurrent chemoradiotherapy (CCRT) for locally advanced non-small cell lung cancer (NSCLC). Materials and Methods: FDG PET was performed before and during CCRT for 13 NSCLC patients. Maximum standardized uptake value ($SUV_{max}$), mean standardized uptake value ($SUV_{mean}$), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured and the changes were calculated. These early metabolic changes were compared with the standard tumor response by computed tomograms (CT) one month after CCRT. Results: One month after the completion of CCRT, 9 patients had partial response (PR) of tumor and 4 patients had stable disease. The percent changes of $SUV_{max}$ ($%{\Delta}SUV_{max}$) were larger in responder group than in non-responder group ($55.7%{\pm}15.6%$ vs. $23.1%{\pm}19.0%$, p = 0.01). The percent changes of $SUV_{mean}$ ($%{\Delta}SUV_{mean}$) were also larger in responder group than in non-responder group ($54.4%{\pm}15.9%$ vs. $22.3%{\pm}23.0%$, p = 0.01). The percent changes of MTV ($%{\Delta}MTV$) or TLG ($%{\Delta}TLG$) had no correlation with the tumor response after treatment. All the 7 patients (100%) with $%{\Delta}SUV_{max}{\geq}50%$ had PR, but only 2 out of 6 patients (33%) with $%{\Delta}SUV_{max}$ < 50% had PR after CCRT (p = 0.009). Likewise, all the 6 patients (100%) with $%{\Delta}SUV_{mean}{\geq}50%$ had PR, but only 3 out of 7 patients (43%) with $%{\Delta}SUV_{mean}$ < 50% had PR after CCRT (p = 0.026). Conclusion: The degree of metabolic changes measured by PET-CT during CCRT was predictive for NSCLC tumor response after CCRT.

• 한국사회복지학
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• 제57권2호
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• pp.41-70
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• 2005

본 연구는 사회경제적 구조변화에 따른 빈곤형태의 변화를 고찰하고 신빈곤층의 탈빈곤을 위한 정책을 모색하는데 목적이 있다. 그동안 빈곤정책은 노령, 실업, 장애, 질병 등 노동능력 상실과 관련된 절대빈곤층에 초점을 두어 왔다. 그러나 경제위기 후 증가하는 빈곤의 특성은 노동시장 참여가 더 이상 탈빈곤의 요인으로 작용하지 않게 되었다. 본 연구는 근로빈민을 대상으로 경제위기이후 경제상황변화, 복지상황, 사회적 위험에 대한 경험 및 대응방식에 대해 경험적으로 조사하고 이를 기반으로 탈빈곤정책을 모색하고자 하였다. 연구결과 근로빈민층은 경제위기이후 실업, 소득감소 등 다양한 형태의 사회적 위험을 경험했으며 불안정한 고용상황, 취약한 복지상황을 보여주고 있으며 이를 기반으로 탈빈곤정책으로 소득안정정책, 직업훈련 및 기술교육정책, 적극적인 사회복지정책 등을 제시하였다.