• 한국임상수의학회지
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• 제38권4호
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• pp.179-183
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• 2021

A 12-year-old male American Cocker Spaniel was diagnosed with a type of chronic hepatits (CH) called cholangioheaptits. Routine supportive medication was administered to the patient, and ex vivo boosted immune cell (EBI-C) therapy was used for the treatment. A histopathologic examination of the liver 19 months later revealed that the cholangiohepatitis had progressed to cholangiocarcinoma. The medication and immune cell therapy was maintained. Two months after the new diagnosis, the patient's state worsened, and the dog died 635 days after the first visit. EBI-C therapy is a type of immunotherapy, where immune cells are isolated from the patient's peripheral blood mononuclear cells, expanded ex vivo, and then infused into the patient intravenously every two weeks. EBI-Cs (mean: 2.78 × 10⁸ cells) were obtained 38 times and infused every two weeks. Most EBI-C were T-lymphocytes (99.24% of total EBI cells). T-lymphocytes produce large interferon (IFN)-γ, and IFN-γ inhibits liver fibrosis in dogs with CH. Moreover, in bile duct cancer, an increase in T-lymphocytes correlates with decreasing tumor invasion and metastasis. Thus, we propose that EBI-C therapy is applicable as a new supportive therapy for canine liver disease if other treatments like drug medication, surgery, or radiation are unavailable.

• Journal of Hospice and Palliative Care
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• 제19권4호
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• pp.331-334
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• 2016

목적: 진행성 암 환자에서 발열이 동반되지 않은, 암성 발한에서 NSAID (non-steroid anti-inflammatory drug) 치료 효과를 알아보고자 함이 목적이다. 방법: 다음과 같은 조건을 만족하는 환자를 대상으로 후향적으로 의무 기록을 조사하였다. 1) 수술적 절제나 항암방사선 치료로 완치가 불가능한 진행성 암 환자 2) 숫자평가등급 4점 이상의 식은 땀을 호소하며 발열이 동반되지 않은 환자 3) 식은 땀의 원인이 될 만한 감염이 없고, 마약성 진통 및 호르몬 차단제를 현재 최근 1개월 이내 새롭게 사용하지 않는 환자 4) 식은 땀 치료를 위해 NSAID를 사용하고, NRS 평가가 치료 전 후 시행한 환자. 결과: 총 13명의 환자가 등록되었다. 남자가 9명(69%)이었고, 평균 59세(범위: 50~71)였다. 암종별 빈도는 담도암, 췌장암, 위암, 전립선암 순이었다. 치료 전 환자들의 식은 땀은 평균 NRS 6.5 (최소값: 4, 최대값: 10) 이었고, 치료 후에는 NRS 1.9 (최소값: 0, 최대값: 5)이었다. 평균 추적 관찰 기간은 9.1일이었다. 결론: 진행성 암 환자에서 열이 동반되지 않은 중등도 이상의 식은 땀 환자에서 NSAID는 효과적인 치료방법이다.

• 동의생리병리학회지
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• 제23권5호
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• pp.1041-1048
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• 2009

The development of skin metastasis is usually a morbid prognostic feature although they occur infrequently. Adenocarcinomas account for up to about 70% of all metastatic skin cancer. In general, adenocarcinomas are the most difficult metastatic tumor to accurately identify the primary site because they don't have distinctive histological features. For this reason, immunohistochemistry have been used to help identify the origin of metastatic adenocarcinomas. This study performed immunohistochemical staining with metastatic adenocarcinomas of the skin using a variety of antisera to find out characteristic immunohistochemical findings of them. This study was made upon the 29 cases of metastatic adenocarcinomas of the skin, which had been confirmed histopathologically in Chonbuk National University Hospital from January, 1986 to April, 2006, Paraffin blocks were colledted and homemade tissue arrays were made. We performed immunohistochemical staning using 12 antibodies (MUC1, 2, 5AC, 6, cytokeratin (CK) 7, 20, thyroid transcription factor-1 (TTF-1), estrogen receptor (ER), progesterone receptor (PR), beta-catenin, cox-2, claudin-1). The mean age at the time of diagnosis was 60.7 years and the male to female ratio was 1.2:1.0. The most common primary site was lung, followed by stomach and colorectum. MUC1 was expressed by most colorectal, breast and lung adenocarcinoma. MUC2 was expressed infrequently. MUCSAC was expressed by most gastric and colorectal cancer MUC6 was not specific of any primary site in this series. CK7+/CK20+immunophenotype was observed in gastric, lung, colorectal adenocarcinoma. CK7+/CK20- immunophenotype was observed in breast, lung, endometrial, uterine cervical, bile duct adenocarcinoma, while CK7-/CK20+ immunophenotype was observed only in colorectal adenocarcinoma. This results show the utility of TTF-1 to confirm the pulmonary origin. On the other hand ER and PR were not useful markers to assess the origin of primary tumor in this series.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6257-6260
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• 2013

Gallstone disease is a major surgical problem in many populations; it is probably related to diet, especially excessive consumption of meat. The objective of this study was to determine the chemical composition of gallstones and their association with neoplastic changes including cholangiocarcinomas in cholecystectomised patients. The chemical composition of gallstones from 40 patients (8 males and 32 females) was analyzed. This is a prospective study performed in Baquba teaching hospital in the period from 1/10/2012 to 1/1/2013 in which we collected the gallstones for the patients who underwent cholecystectomy, whether open or laparoscopic. The stones were classified according to their chemical composition as a mixed stones (MS), and examined using a stone analysis set (chemical qualitative method) for calcium, magnesium, phosphate, uric acid and oxalate which was used reagent for qualitative determination of main individual components of stones. The results of this study showed the highest incidence of gallstones in the age group 40-49 was 13 cases followed by 11, 8 and 4 cases for age groups 30-39, 50-59, 20-29 and 60 and above, respectively. The chemical analysis showed the majority of gallstones were mixed, 38 containing calcium followed by 37 cases with uric acid, 28 with magnesium, and 25 and 22 stones with oxalate and phosphate, respectively. Microscopically, we confirmed neoplastic changes (17.5%) as cholangiocarcinomas (CCCs) (7.55%) and dysplastic cells of carcinoma in situ in 4 (10%), 31 (77.5%) cases were chronic cholecystitis and 2 (5%) cases were acute cholecystitis with empyema out of bile duct disorders patients. In conclusion, majority of cases had mixed gallstones that involved five and four of inorganic chemicals of calcium, magnesium and phosphate, the highest incidence of gallstones in age group 40-49 years old was 13 cases, and neoplastic changes were confirmed (17.5%) including CCCs, (7.5%) and dysplastic cells of carcinoma in situ (10%), while 31 (77.5%) cases were chronic cholecystitis.

• Parasites, Hosts and Diseases
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• 제58권6호
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• pp.647-652
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• 2020

Clonorchis sinensis is the most common fish-borne intestinal parasite in Korea. The aim of the present investigation was to survey the status of C. sinensis infection and analyze associated risk factors in residents of Haman-gun, Gyeongsangnam-do. A total of 5,114 residents from 10 administrative towns/villages voluntarily agreed to participate in the study, which comprised fecal examination, a questionnaire survey for risk factors, ultrasonography, and enzyme-linked immunosorbent assay for cancer biomarker detection in the blood. We detected C. sinensis eggs in 5.3% of the subjects. By region, Gunbuk-myeon had the highest number of residents with C. sinensis eggs. The infection rate and intensity were higher in male than in female residents. Based on the risk factor questionnaire, infection was highly associated with drinking, a history of C. sinensis infection, and the practice of eating of raw freshwater fish. Extension of the bile duct, infection intensity, and cancer biomarker detection significantly correlated with the presence of eggs in the study population. In conclusion, the development of feasible, long-term control policies and strategies for the elimination of C. sinensis in Korea is still required.

• Asian Pacific Journal of Cancer Prevention
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• 제17권1호
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• pp.37-44
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• 2016

Several infectious agents are considered to be causes of cancer in human, mainly hepatitis B and C viruses, high-risk human pailloma viruses, Helicobacter pylori, Clonorchis sinensis, and Opisthorchis viverrini. Here we described the evident research and the association between Helicobacter spp. and biliary tract cancer particularly cholangiocarcinoma (CCA). Global epidemiological studies have suggested that Helicobacter spp. are possible risk factors for biliary tract diseases. Molecular studies support a linkage of Helicobacter spp. with CCA development. H. pylori, H. bilis, and H. hepaticus, are found in CCA, but the most common species are H. pylori and H. bilis. The type of CCA are associated with Helicobacter spp. include extrahepatic CCA, and common bile duct cancer. Up to the present, however, the results from different regions, materials and methods, sub-sites of cancer, and controls have not been consistent, thus introducing heterogeneity. Therefore, a comparison between co-Helicobacter spp.-CCA in the countries with low and high incident of CCA is required to settle the question. Furthermore, clarifying variation in the role of Helicobacter species in this CCA, including pathogenesis of CCA through enhanced biliary cell inflammation and proliferation, is necessary.

• Asian Pacific Journal of Cancer Prevention
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• 제15권21호
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• pp.9511-9515
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• 2014

Cholangiocarcinoma (CCA) is a cancer of the bile duct epithelial cells. The highest incidence rate of CCA with a poor prognosis and poor response to chemotherapy is found in Southeast Asian countries, especially in northeastern Thailand and Lao PDR. Cathepsin B is a lysosomal cysteine protease which is regulated by cysteine proteinase inhibitors such as cystatin C. Elevation of cathepsin B levels in biological fluid has been observed in patients with inflammatory diseases and many cancers. We aimed to investigate the serum cathepsin B and cystatin C levels of CCA patients to evaluate the feasibility of using cathepsin B and cystatin C as markers for the diagnosis of CCA. Fifty-six sera from CCA patients, 17 with benign biliary diseases (BBD) and 13 from controls were collected and the cathepsin B and cystatin C levels were determined. In addition, cathepsin B expression was investigated immunohistochemically for 9 matched-pairs of cancerous and adjacent tissues of CCA patients. Serum cathepsin B, but not cystatin C, was significantly higher in CCA and BBD patient groups compared to that in the control group. Consistently, all cancerous tissues strongly expressed cathepsin B while adjacent tissues were negative in 7 out of 9 cases. In contrast, serum cystatin C levels were comparable between CCA and control groups, although serum cystatin C levels in the BBD group was higher than that in the control or CCA groups. When the serum cathepsin B to cystatin C ratio was calculated, that of the CCA group was significantly higher than that of the control group, and, although statistically not significant, the ratio of CCA group showed a trend to be higher than that of the BBD group. Thus, the cathepsin B to cystatin C ratio might be used as an alternative marker for aiding diagnosis of CCA.

• Parasites, Hosts and Diseases
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• 제51권6호
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• pp.711-717
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• 2013

Opisthorchis viverrini (O. viverrini) is a well-known causative agent of cholangiocarcinoma (CCA) in humans. CCA is very resistant to chemotherapy and is frequently fatal. To understand the pathogenesis of CCA in humans, a rodent model was developed. However, the development of CCA in rodents is time-consuming and the xenograft-transplantation model of human CCA in immunodeficient mice is costly. Therefore, the establishment of an in vivo screening model for O. viverrini-associated CCA treatment was of interest. We developed a hamster CCA cell line, Ham-1, derived from the CCA tissue of O. viverrini-infected and N-nitrosodimethylamine-treated Syrian golden hamsters. Ham-1 has been maintained in Dulbecco's Modified Essential Medium supplemented with 10% fetal bovine serum for more than 30 subcultures. These cells are mostly diploid (2n=44) with some being polyploid. Tumorigenic properties of Ham-1 were demonstrated by allograft transplantation in hamsters. The transplanted tissues were highly proliferative and exhibited a glandular-like structure retaining a bile duct marker, cytokeratin 19. The usefulness of this for in vivo model was demonstrated by berberine treatment, a traditional medicine that is active against various cancers. Growth inhibitory effects of berberine, mainly by an induction of G1 cell cycle arrest, were observed in vitro and in vivo. In summary, we developed the allo-transplantable hamster CCA cell line, which can be used for chemotherapeutic drug testing in vitro and in vivo.

• Radiation Oncology Journal
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• 제14권2호
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• pp.129-136
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• 1996

목적 : 담낭과 간외 담도를 포함한 간외 담도계암에 대한 방사선치료의 효과를 평가하고 방사선치료의 역할에 관하여 알아보고자 함이 본 연구의 목적이다. 대상 및 방법 : 1986년 4월에서 1994년 7월까지 본원 치료방사선과에서 외부 방사선치료를 받은 43명의 담낭 및 간외 담도계암 환자를 후향적으로 분석하였다. 23명은 담낭암이었고 20명은 간외 담도암이었다. 23명의 담낭암 환자중에서 제 2병기는 2명, 제 3 병기는 12명, 제 4병기는 9명이었다. 남녀비는 11명대 12명이었다. 15명은 근치적 절제술을 시행하였고, 8명은 조직생검과 우회수술만을 시행하였다. 3명을 제외한 모든 환자에서 수술후 4500 cGy 이상의 방사선을 조사하였으며, 추적기간은 11-82개월 이었다. 20명의 간외 담도암 환자중에서 제 1병기는 1명, 제 2병기는 2명, 제 3병기는 10명, 제 4병기는 7명이었다. 남녀비는 16명대 4명이었다. 16명이 근치적 목적으로 위플씨 수술 또는 절제와 배액술을 시행하였고, 나머지 4명은 우회수술만을 시행하였다. 16명은 수술후 방사선 치료로 4500 cGy 이상 조사하였고, 4명은 3180-4140cGy를 조사하였다. 추적기간은 8-34개월 이었다. 결과 : 담낭암 환자의 전체 중앙 생존기간은 11개월이었다. 제 3병기와 제 4병기의 중앙생존기간은 14개월과 5개월이었으며, 2년 생존율은 각각 $36\%$(4/11)와 $13\%$(1/8) 이었다. 근치적 목적으로 수술을 받은 환자들이 우회수술 만으로 치료받은 환자들보다 통계적으로 유의하게 생존율이 높았다. ($67\%$ : $13\%$ 12개월) 치료와 연관된 합병증으로 사망한 환자는 없었다. 20명의 간외 담도암 환자의 전체 중앙 생존기간은 10개월이었다. 제 3병기 10명과 제 4병기 7명의 중앙 생존기간은 각각 10개월과 8개월이었다. 위플씨 수술을 시행한 2명은 각각 11개월과 14개월간 생존하였으며, 절제와 배액술로 치료한 환자들의 중앙 생존기간은 10개월이었다. 결론 : 간외 담도계암 환자에서 수술후 외부 방사선치료에 의한 합병증은 미미하였으며, 특히 수술후 현미경적 또는 육안적 잔여병변이 있는 환자에서 방사선 치료에 의해 생존율이 증가하는 양상을 나타내었다.

• Radiation Oncology Journal
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• 제18권4호
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• pp.277-282
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• 2000

목적 : 방사선간염(radiation hepatitis)의 발생에는 방사선 조사량, 조사체적 등의 요인이 작용하는 것으로 알려져 왔으나 이러한 요인들의 관계를 양적으로 나타내지는 못하였다. 그러나 최근 3차원 입체조형 치료계획체계의 발전으로 간암의 방사선조사시 간의 선량-체적에 대한 분석이 가능하게 되었고 나아가 이를 이용한 수학적 변수인 정상조직손상확률을 계산할 수 있게 되었다. 이에 저자들은 정상조직손상확률값을 연계시켜서 방사선간염의 예측 가능성을 평가하고자 본 연구를 진행하였다. 대상 및 방법 : 1992년 3월부터 1994년 12월 사이에 방사선 치료를 받은 환자중에서 간암 환자 10명, 담도암 환자 10명을 대상으로 하였다. 치료 전 혈청학적 검사에서 간암 환자 2명에서 간경화가 있었고 (각각의 prothrombin time 73$\%$, 68$\%$) 다른 18명의 간기능은 정상이었다. 조사된 방사선량은 1일 1.8$\~$2.0 Gy씩 22회에서 30회를 시행하여 39.6$\~$60.0 Gy (중앙값은 50.4 Gy)였으며, 조사면수는 2$\~$6 ports (중앙값은 4 ports)였다. 이 환자들의 치료 전 전산화단층촬영을 이용하여 간의 선량체적분석 및 Lyman의 공식을 적용하여 정상조직손상확률값을 구하였다. 방사선간염은 alkaline phosphatase의 값이 2배이상 증가 되고 비암성 복수가 동반된 경우로 정의하였으며 환자의 병력 기록을 이용하여 방사선간염 발생여부를 파악하여 정상조직손상확률값과 상관 관계를 분석하였다. 결과 :정상조직손상확률값은 0.001$\~$0.840까지 분포하였고 중앙값은 0.05였다. 방사선간염은 방사선 치료후 약1주에서 5주사이에 20명중 3명에서 발생하였으며, 이들의 정상조직손상확를값은 각각 0.390, 0.528, 0.844 (평균값 0.58$\pm$0.23)이었고, 방사선간염이 생기지 않은 환자의 정상조직손상확률값은 0.00l$\~$0.308 (평균값 0.09$\pm$0.09) 사이에 분포하였다. 정상조직손상확률을 체적인자가 0.32로 계산한 경우에는 비교적 높은 값인 0.39이상에서 방사선 간염이 발생한 것을 알 수 있으나, n 을 0.69로 하여 계산한 경우에는 비교적 낮은 정상조직손상확률(0.03, 0.18)에서도 방사선 간염이 발생하는 것을 보여 체적인자 0.32가 비교적 임상적 결과와 일치하는 값이었다. 결론: 정상조직손상확률값이 일정값 이상의 환자에서 방사선간염이 발생하는 것으로 보아 정상조직손 상확률값으로 방사선간염의 발생을 예측할 수 있을 것이다.