• 제목/요약/키워드: anticancer chemotherapy

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암 환자 병명통고 (The Disclosure of Cancer Diagnosis and its Prognosis)

  • 박진노;최소은;최경미;홍영선;이경식;양수
    • Journal of Hospice and Palliative Care
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    • 제7권2호
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    • pp.169-178
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    • 2004
  • 목적: 환자, 가족, 의료진(의사, 간호사), 의과대학생, 간호대학생들의 시간의 흐름에 따른 병명통고에 대한 태도 변화를 알아보는 것이다. 방법: 2002년 10월부터 3 개월 간 가톨릭대학교 의과대학 부속 성모병원에서 전이성 암 환자, 조사대상 암 환자의 주 보호자, 암 환자의 간호 및 치료에 관련된 의료진(의사 및 간호사), 임상 실습 중인 의과 대학생, 간호대학생을 대상으로 각 군 50명씩 등록하여 암 환자의 병명통고에 관한 설문 조사를 실시하였다. 설문자료 평가 항목은 병명통고에 대한 찬성여부, 시기여부, 통고방법, 통고를 받기를 원하는 이유, 적합한 병명통고자가 누구인지였다. 환자 50명, 주 보호자 50명, 의료진 51명, 의과대학생 41명과 간호대학생 50명을 대상으로 하였다. 전이성 암환자 50명을 대상으로 하기로 하였으나, 전이성 암환자 34명만이 등록되었으며, 이외에 림프종 환자 16명을 포함하여 총 50명의 환자에게 설문조사를 진행하였다. 결과: 모든 설문 응답자들 가운데 89.3%가 병명통고에 찬성하였다(환자 98.0%, 주 보호자 88.0%, 의료진 90.2%, 의과대학생 73.2%, 간호대학생 94.0%). 림프종 환자를 제외한 진행성 암환자 34명을 대상으로 97.1%가 동의하였다. 병명통고 시기는 79.8%에서 진단 즉시 해주는 것을 선호하였다(환자 94.0%, 주 보호자 80.0%, 의료진 68.6%, 의과대학생 68.3%, 간호대학생 86.0%). 병명통고 방법은 64.4%에서 모든 내용을 한 번에 정확히 설명해주는 것을 선호하였다(환자 81.6%, 주 보호자 66.0%, 의료진 56%, 의과대학생 48.8%, 간호대학생 70.0%). 병명통고에 동의하는 이유에 대해서 모든 군에서 치료 참여가 가능한 것을 가장 큰 이유로 들었다. 병명통고를 누가하느냐는 문제에 대해서는 86.4%에서 의사가 병명통고를 하는 것이 적합하다고 응답하였다. 결론: 환자, 주 보호자, 의료진, 의과대학생 및 간호대학생의 병명통고에 대한 찬성률은 증가하였다. 병명통고 찬성 이유로 치료에 참여가 가능하다는 것을 가장 많이 선택하였다. 통고시기와 방법은 진단 즉시 모든 내용을 한 번에 정확히 알려주기를 원하였다.

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구강 편평세포암종 세포주에서 Cyclosporin A와 Taxol 투여시 PI-3 kinase/Akt1 Pathway에 의한 세포사멸 병용효과 (APOPTOTIC EFFECT IN COMBINATION OF CYCLOSPORIN A AND TAXOL ON ORAL SQUAMOUS CELL CARCINOMA CELL LINE THROUGH THE PI-3 KINASE/AKT1 PATHWAY)

  • 김규영;이재훈
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제33권5호
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    • pp.426-436
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    • 2007
  • Oral cancer take up 2-6% of all carcinomas and squamous cell carcinoma, which is the most common type in oral cancer, has a poor prognosis due to its high metastasis and recurrence rates. In treating oral cancer, chemotherapy to the primary, metastasized and recurrent lesion is a very important and useful treatment, even though its widespread usage is limited due to high general toxicity and local toxicity to other organs. Taxol, a microtubule stabilizing agent, is an anticancer drug that induces cell apoptosis by inhibiting depolymerization of microtubules in between the metaphase and anaphase of the cell mitosis. Recently, its effectiveness and mechanism on various tumor has been reported. However, not much research has been done on the application of Taxol to oral squamous cell carcinoma. Cyclosporin A, which is an immunosuppressant, is being used on cancers and when co-administered with Taxol, effectiveness of Taxol is enhanced by inhibition of Taxol induced multidrug resistance. In this study, Cyclosporin A with different concentration of Taxol was co-administered to HN22, the oral squamous cell carcinomacell line. To observe the cell apoptosis and the mechanisms that take part in this process, mortality evaluation of tumor cell using wortmannin, c-DNA microarray, RT-PCR analysis, cytometry analysis and western blotting were used, and based upon the observation on the effect and mechanism of the agent, the following results were obtained: 1. The HN22 cell line viability was lowest when $100{\mu}M$ of Wortmannin and $5{\mu}g/ml$ of Taxol were co-administered, showing that Taxol participates in P13K-AKT1 pathway. 2. In c-DNA microarray, where $1{\mu}g/ml$ of cyclosporine A and 3mg/ml of Taxol were co-administered, no up regulation of AKT1, PTEN and BAD c-DNA that participate in cell apoptosis was observed. 3. When $1{\mu}g/ml$ of Cyclosporin A was applied alone to HN22 cell line, no difference was found in AKT1, PTEN and BAD mRNA expression. 4. Increased AKT1, mRNA expression was observed when $3{\mu}g/ml$ of Taxol was applied alone to HN22 cell line. 5. When $1{\mu}g/ml$ of Cyclosporin A and Taxol($3{\mu}g/ml\;and\;5{\mu}g/ml$) were co-administered to HN22 cell line, PTEN mRNA expression increased, whereas AKT1 and BAD mRNA decreased. 6. As a result of cytometry analysis, in the group of Cyclosporin A($1{\mu}g/ml$) and Taxol($3{\mu}g/ml$) co-administration, increased Annxin V was observed, which shows that apoptosis occurred by deformation of plasma membrane. However, no significant difference was observed with vary ing concentration. 7. In western blot analysis, no caspase 3 was observed in the group of Cyclosporin A($1{\mu}g/ml$) and Taxol($3{\mu}g/ml$) co-administration. From the results of this study, it can be concluded that synergistic effect can be observed in combination therapy of Taxol and Cyclosporin A on oral squamous cell carcinoma cell line, where decreased activity of the cell line was observed. This resulted in decreased AKT1 and BAD mRNA and increased PTEN mRNA expression and when wortmannin and Taxol were co-administered, the viability decreased which confirms that Taxol decreases the viability of tumor cell line. Hence, when Taxol and cyclosporine A are co-administered, it can be assumed that cell apoptosis occurs through AKt1 pathway.