• Title/Summary/Keyword: cancer care

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A Case of Complete Remission after Concurrent Chemoradiotherapy for Esophageal Squamous cell Carcinoma with Solitary Bone Metastasis (고립성 골 전이를 동반한 식도편평세포암에서 동시 항암화학방사선 요법 후 완전관해를 보인 1례)

  • Woo Jin Lee;Hoon Jai Chun;Ye Ji Kim;Sun Young Kim;Min Ho Seo;Hyuk Soon Choi;Eun Sun Kim;Bora Keum;Yoon Tae Jeen;Hong Sik Lee;Soon Ho Um;Chang Duck Kim;Ho Sang Ryu
    • Journal of Digestive Cancer Research
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    • v.1 no.1
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    • pp.53-57
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    • 2013
  • There is no established treatment for esophageal carcinoma with metastasis. For the metastatic esophageal squamous cell carcinoma, chemotherapy or best supportive care according to patient's performance status are accepted as an available treatment. We report a case of complete remission after concurrent chemoradiotherapy for esophageal squamous cell carcinoma with metastatic lesion in 5th thoracic vertebrae. A 57-year-old man with ongoing dysphagia and weight loss was admitted to our hospital. On the endoscopic and radiologic imaging evaluation,the patient was diagnosed as a squamous cell carcinoma of esophagus with solitary metastatic lesion in 5th thoracic vertebrae. The patient was treated with combination chemotherapy (5-fluorouracil (5-FU) and cisplatin) and concurrent radiotherapy for two months to relieve dysphagia. Because metastatic lesion in thoracic vertebrae was located near the primary esophageal tumor, the metastatic lesion could be included within the radiation field. After concurrent chemoradiotherapy, consecutive 4 cycles of chemotherapy had been carried out. Primary esophageal tumor with metastatic lymph nodes and metastatic lesion in 5th thoracic vertebrae disappeared on follow up computed tomography (CT) and positron emission tomography-CT (PET-CT). Follow up endoscopic biopsy revealed no remnant malignant cells at previous primary cancer lesion.

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Optimal Scheme of Postoperative Chemoradiotherapy in Rectal Cancer : Phase III Prospective Randomized Trial (직장암의 근치적 수술 후 화학요법과 방사선치료의 순서)

  • Kim Young Seok;Kim Jong Hoon;Choi Eun Kyung;Ahn Seung Do;Lee Sang-Wook;Kim Kyoung-Ju;Lee Je Hwan;Kim Jin Cheon;You Chang Sik;Kim Hee Cheol
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.53-61
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    • 2002
  • Purpose : To determine the optimal scheme of postoperative chemoradiotherapy in rectal cancer by comparing survival, Patterns of failure, toxicities in early and late radiotherapy groups using a Phase III randomized prospective clinical trial. Materials and Methods : From January 1996 to March 1999, 307 patients with curatively resected AJCC stage II and III rectal cancer were assigned randomly to an 'early (151 patients, arm 1)' or a 'late (156 patients, arm II)' and were administered combined chemotherapy (5-FU $375\;mg/m^2/day$, leucovorin $20\;mg/m^2$, IV bolus daily, for 3 days with RT, 5 days without RT, 8 cycles with 4 weeks interval) and radiation therapy (whole pelvis with 45 Gy/25 fractions/5 weeks). Patients of arm I received radiation therapy from day 1 of the first cycle of chemotherapy and those of arm II from day 57 with a third cycle of chemotherapy. The median follow-up period of living patients was 40 months. Results : Of the 307 patients enrolled, fifty patients did not receive scheduled radiation therapy or chemotherapy. The overall survival rate and disease free survival rate at 5 years were $78.3\%\;and\;68.7\%$ in arm I, and $78.4\%\;and\;67.5\%$ in arm II. The local recurrence rate was $6.6\%\;and\;6.4\%$ (p=0.46) in arms I and II, respectively, no significant difference was observed between the distant metastasis rates of the two arms ($23.8\%\;and\;29.5\%$, p=0.16). During radiation therapy, grade 3 diarrhea or more, by the NCI common toxicity criteria, was observed in $63.0\%\;and\;58.2\%$ of the respective arms (p=N.S.), but most were controlled with supportive care. Hematologic toxicity (leukopenia) greater than RTOG grade 2 was found in only $1.3\%\;and\;2.6\%$ of patients in each respective arm. Conclusion : There was no significant difference in survival, patterns of failure or toxicities between the early and late radiation therapy arms. Postoperative adjuvant chemoradiation was found to be a relatively safe treatment but higher compliance is needed.

Hyperfractionated Radiotherapy and Concurrent Chemotherapy for Stage III Unresectable Non Small Cell Lung Cancer : Preliminary Report for Response and Toxicity (절제 불가능한 제 3기 비소세포성 페암의 다분할 방사선 치료와 MVP 복합 항암요법의 동시 치료에 대한 예비적 결과)

  • Choi, Eun-Kyung;Kim, Jong-Hoon;Chang, Hye-Sook;Kim, Sang-We;Suh, Cheol-Won;Lee, Kyoo-Hyung;Lee, Jung, Shin;Kim, Sang-Hee;Ko, Youn-Suk;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Song, Koun-Sik
    • Radiation Oncology Journal
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    • v.13 no.2
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    • pp.157-162
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    • 1995
  • Lung cancer study group at Asan Medical Center has conducted the second prospective study to determine the efficacy and feasibility of MVP chemotherapy with concurrent hyperfractionated radiotherapy for Patients with stage III unresectable non-small cell lung cancer(NSCLC). All eligible Patients with stage III unresectable NSCLC were treated with hyperfractionated radiotherapy(120 cGy/fx BID. 6480 cGy/54fx) and concurrent 2 cycles of MVP(Mitomycin C $6mg/m^2,$ d2 & d29.Vinblastine $6mg/m^2,$ d2 & d29, Cisplatin $60mg/m^2,$ dl & d28) chemotherapy. Between Aug. 1993 and Nov. 1994, 62 patients entered this study; $6(10\%)$ had advanced stage IIIa and $56(90\%)$ had IIIb disease including 11 with pleural effusion and 10 with supraclavicular metastases. Among 62 patients, $48(77\%)$ completed planned therapy. Fourteen patients refused further treatment during chemoradiotherapy. Of 46 patients evaluable for response, $34(74\%)$ showed major response including $10(22\%)$ with complete and $24(52\%)$ with partial responses. Of 48 patients evaluable for toxicity, $13(27\%)$ showed grade IV hematologic toxicity but treatment delay did not exceed 5 days Two patients died of sepsis during chemoradiotherapy. Severe weight loss(more than $10\%)$ occurred in 9 patients$(19\%)$ during treatment. Nine patients$(19\%)$ developed radiation pneumonitis Six of these patients had grade 1 (mild) Pneumonitis with radiographic changes within the treatment fields Three other patients had grade 11 Pneumonitis, but none of these patients had continuous symptoms after steroid treatment. Concurrent chemoradiotherapy for patients with advanced NSCLC was well tolerated with acceptable toxicity and achieved higher response rates than the first study, but rather low compliance $rate(77\%)$ in this study is worrisome. We need to improve nutritional support during treatment and to use G-CSF to improve leukopenia and if necessary. supportive care will be given as in patients, Longer follow-up and larger sample size is needed to observe survival advantage.

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A Study on the Treatment of Combine Electron Beam in the Treatment of Breast Cancer Tumor Bed (유방암 Tumor bed 치료 시 혼합 전자선 치료 방법에 대한 고찰)

  • Lee, Geon Ho;Kang, Hyo Seok;Choi, Byoung Joon;Park, Sang Jun;Jung, Da Ee;Lee, Du Sang;Ahn, Min Woo;Jeon, Myeong Soo
    • The Journal of Korean Society for Radiation Therapy
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    • v.31 no.1
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    • pp.51-56
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    • 2019
  • Purpose: The usefulness of using single-electron radiation for secondary radiotherapy of breast cancer patients after surgery is assessed and the use of a combine of different energy. Methods and materials : In this study, 40 patients (group A) using energy 6 MeV and 9 MeV, and 19 patients (group B) using a combine of 9 MeV and 12 MeV were studied among 59 patients who performed secondary care using combine electronic radiation. Each patient in each group, 6 MeV, 9 MeV, Combine(6 MeV / 9 MeV) and 9 MeV, 12 MeV, Combine (9 MeV / 12 MeV) were developed in different ways, and the maximum doses delivered to the original hospital, D95, D5, and $V_3$, $V_5$, $V_{10}$ were compared. Result: The D95 mean value of Group A treatment plan was $785.33{\pm}225.37cGy$, $1121.79{\pm}87.02cGy$ at 9 MeV, and $1010.98{\pm}111.17cGy$ at 6 MeV / 9 MeV, and the mean value at 6 MeV / 9 MeV was most appropriate for the dose. The mean values of the low dose area $V_3$ and $V_5$ in the lung of the breast direction being treated were $3.24{\pm}3.49%$ and $0.72{\pm}1.55%$ at 6 MeV, the highest 9 MeV at $7.25{\pm}4.59%$, $3.07{\pm}2.64%$, the lowest at 6 MeV. Maximum and average lung dose was $727.78{\pm}137.27cGy$ at 6 MeV / 9 MeV, $49.16{\pm}24.44cGy$, highest 9 MeV at $998.97{\pm}114.35cGy$, $85.33{\pm}41.18cGy$, and lowest 6 MeV at $387.78{\pm}208.88cGy$, $9.27{\pm}6.60cGy$. The value of $V_{10}$ was all close to zero. Group B appeared in the pattern of Group A. Conclusion: Relative differences in low-dose areas of the lungs $V_3$ and $V_5$ were seen and were most effective in the dose transfer of tumor bed in the application of combined energy. It is thought that the method of using electronic energy in further radiation treatments for breast cancer is a more effective way to use the energy effect of limiting energy resources, and that if you think about it again, it could be a little more beneficial radiation treatment for patients.

Oestrogenic Activity of Parabens In Vitro Estrogen Assays (에틸, 프로필, 이소프로필, 부틸, 이소부틸 파라벤의 In Vitro 검색시험 연구에서의 내분비독성)

  • Lee Sung-Hoon;Kim Sun-Jung;Park Jung-Ran;Jo Eun-Hye;Ahn Nam-Shik;Park Joon-Suk;Hwang Jae-Woong;Jung Ji-Youn;Lee Yong-Soon;Kang Kyung-Sun
    • Journal of Food Hygiene and Safety
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    • v.21 no.2
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    • pp.100-106
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    • 2006
  • The use of underarm and body care cosmetics with oestrogenic chemical excipients (particularly the parabens) and the hypothesized association with breast cancer incidence, particularly in women. It is noted that the type of cosmetic product is irrelevant (e.g. antiperspirant/deodorant versus body lotion, moisturizers or sprays versus creams) and attention must focus on issues of actual exposure to chemicals through continued dermal application of body care products and the endocrine/hormonal activity and toxicity of the chemicals in the formulations. To evaluate the estrogenic activities of parabens such as ethylparaben, butylparaben, propylparaben, isobutylparaben and isopropylparaben, we used recombinant yeasts containing the human estrogen receptor [Saccharomyces cerevisiae ER+LYS 8127], human breast cancer MCF-7 cell lines and human estrogen receptor ${\alpha}\;and\;{\beta}$. In E-screen assays, isopropylparaben is the most estrogenic paraben, and in ER competition assay, isobutylparaben is the most estrogenic paraben. We evaluated isopropylparaben was most active in the recombinant yeast assay, followed by propylparaben, ethylparaben, isobutylparaben and butylparaben. Results from this study demonstrate that parabens are observed in human endocrine system. Therefore, we have shown that the parabens is induced the estrogenic activities similar to $17{\beta}$-estradiol and Bisphenol-A.

Molecular Cloning and Characterization of the Yew Gene Encoding Squalene Synthase from Taxus cuspidata

  • Huang, Zhuoshi;Jiang, Keji;Pi, Yan;Hou, Rong;Liao, Zhihua;Cao, Ying;Han, Xu;Wang, Qian;Sun, Xiaofen;Tang, Kexuan
    • BMB Reports
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    • v.40 no.5
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    • pp.625-635
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    • 2007
  • The enzyme squalene synthase (EC 2.5.1.21) catalyzes a reductive dimerization of two farnesyl diphosphate (FPP) molecules into squalene, a key precursor for the sterol and triterpene biosynthesis. A full-length cDNA encoding squalene synthase (designated as TcSqS) was isolated from Taxus cuspidata, a kind of important medicinal plants producing potent anti-cancer drug, taxol. The full-length cDNA of TcSqS was 1765 bp and contained a 1230 bp open reading frame (ORF) encoding a polypeptide of 409 amino acids. Bioinformatic analysis revealed that the deduced TcSqS protein had high similarity with other plant squalene synthases and a predicted crystal structure similar to other class I isoprenoid biosynthetic enzymes. Southern blot analysis revealed that there was one copy of TcSqS gene in the genome of T. cuspidata. Semi-quantitative RT-PCR analysis and northern blotting analysis showed that TcSqS expressed constitutively in all tested tissues, with the highest expression in roots. The promoter region of TcSqS was also isolated by genomic walking and analysis showed that several cis-acting elements were present in the promoter region. The results of treatment experiments by different signaling components including methyl-jasmonate, salicylic acid and gibberellin revealed that the TcSqS expression level of treated cells had a prominent diversity to that of control, which was consistent with the prediction results of TcSqS promoter region in the PlantCARE database.

Clinical Evaluation of Pneumonectomy (전폐절제술의 임상적 연구)

  • Park, Jin-Gyu;Kim, Min-Ho;Jo, Jung-Gu;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.29 no.9
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    • pp.996-1002
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    • 1996
  • From August 1979 to August 1995, 73 consecutive patients with various pulmonary diseases underwent pneumonectomy Underlying diseases were lung cancer(53 cases), pulmonary tuberculosis(10 cases), bronchiectasis(4 cases) and others(6 cases). Operative mortality and complication rate for 73 patients and respiratory capacity for 53 patients at postoperative 6 months were measured, and statistically analysed for the influencing factors. The influencing factors on prognosis included age, sex, pathologic finding (benign or malignant), associated diseases, preoperative pulmonary function test and operation time. The statistically significant factors for operative mortality were preoperative MW(% prep)(P=0.013) and operation time(P=0.009). The factors influencing operative complication was infectious disease (P=0. 015), and for respiratory capacity a postoperative 6 months, preoperative FVC(%. prod) (PED.0018), FEVI(%. prod)(P=0.0024), and MW(%. prod) (P=0.004)) were statistically significant factors. The preoperative FVC(%. tyred), FEVI(% . prod) and MW(%. prod) should be measured exactly. We conclude that preoperative lung function, cardiovascular and nutritional status, postoperative care and infection prevention were important factors to decrease the operative mortality and complication as well as to increase respiratory capacity.

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Gated Conductivity Imaging using KHU Mark2 EIT System with Nano-web Fabric Electrode Interface (나노웹 섬유형 전극 인터페이스와 KHU Mark2 EIT 시스템을 이용한 생체신호 동기 도전율 영상법)

  • Kim, Tae-Eui;Kim, Hyun-Ji;Wi, Hun;Oh, Tong-In;Woo, Eung-Je
    • Journal of Biomedical Engineering Research
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    • v.33 no.1
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    • pp.39-46
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    • 2012
  • Electrical impedance tomography(EIT) can produce functional images with conductivity distributions associated with physiological events such as cardiac and respiratory cycles. EIT has been proposed as a clinical imaging tool for the detection of stroke and breast cancer, pulmonary function monitoring, cardiac imaging and other clinical applications. However EIT still suffers from technical challenges such as the electrode interface, hardware limitations, lack of animal or human trials, and interpretation of conductivity variations in reconstructed images. We improved the KHU Mark2 EIT system by introducing an EIT electrode interface consisting of nano-web fabric electrodes and by adding a synchronized biosignal measurement system for gated conductivity imaging. ECG and respiration signals are collected to analyze the relationship between the changes in conductivity images and cardiac activity or respiration. The biosignal measurement system provides a trigger to the EIT system to commence imaging and the EIT system produces an output trigger. This EIT acquisition time trigger signal will also allow us to operate the EIT system synchronously with other clinical devices. This type of biosignal gated conductivity imaging enables capture of fast cardiac events and may also improve images and the signal-to-noise ratio (SNR) by using signal averaging methods at the same point in cardiac or respiration cycles. As an example we monitored the beat by beat cardiac-related change of conductivity in the EIT images obtained at a common state over multiple respiration cycles. We showed that the gated conductivity imaging method reveals cardiac perfusion changes in the heart region of the EIT images on a canine animal model. These changes appear to have the expected timing relationship to the ECG and ventilator settings that were used to control respiration. As EIT is radiation free and displays high timing resolution its ability to reveal perfusion changes may be of use in intensive care units for continuous monitoring of cardiopulmonary function.

The Current State and Implementation of Music Therapy for Adults With Intellectual Disabilities (국내 성인지적장애인 음악치료 중재 현황)

  • Oh, Ji Eun
    • Journal of Music and Human Behavior
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    • v.13 no.2
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    • pp.17-30
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    • 2016
  • This study aimed to examine the current state of music therapy for adults with intellectual disabilities (ID) by conducting a survey of music therapists. Completed surveys from 32 certified music therapists were included for analysis. The questionnaire was composed of 38 items that asked about the participants' background, work environment and music therapy implementation experience (including assessment, goal establishment, intervention strategy and difficulties). The results of the study showed that music therapy for adults with ID was practiced in diverse facilities. Enhancing social interaction was the most frequently set goal by music therapists, whereas facilities mostly required the music therapy services for emotional stability. Also, instrument playing was used most among music activities, and musical structure was considered most when choosing music for therapy. Among the influential institutional factors, characteristics of the facility were considered most frequently, and the level of functioning was the most considered in terms of client-related factors. To advance the effective use of music therapy interventions with adults with ID, development of music therapy assessment tools and more active communication with facility staff were also suggested when working with this population.

Effects of Aquatic Exercise Program on the Shoulder Joint Function, Physical Symptom and Quality of Life in Postmastectomy Patients (수중운동 프로그램이 유방절제술 환자의 어깨관절 기능, 신체적 자각증상 및 삶의 질에 미치는 효과)

  • Yoo Yang-Sook
    • Journal of Korean Public Health Nursing
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    • v.13 no.2
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    • pp.101-114
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    • 1999
  • This study was designed to investigate the effects of an aquatic exercise program on the shoulder joint function. physical symptom. quality of life and stress among the patients who received modified radical mastectomy between 6 to 12 months prior to their visits. The subjects were 31 women aged between 40 and 60 who visited the out-patient department at Kang Nam St. Mary's Hospital for follow-up care. and were not under the treatment of intravenous cancer chemotherapy or radiation therapy. and had no complications. Twelve of them were assigned to the control group. while nineteen subjects to the experimental group. The aquatic exercise program was developed by the author with the assistance of exercise specialists. The program includes warming uP. aerobic and cooling down exercises in water. The aquatic exercise program for the experimental group was carried out 3 times a week with 60 minutes in each time for 8 weeks from September 20th to November 15th. 1995 in a regular swimming pool in Seoul. Changes in the range of motion of the shoulder joint. muscle strength. physical symptom. quality of life. and stress were examined after the completion of treatment. The data were collected through isokinetic muscle strength evaluation and questionnaire survey before and after the treatment. Paired and unpaired t-test were adopted to analyze the data. The results were as follows ; 1. The increment in the range of motion of the shoulder joint in the experimental group after the exercise was significantly greater than those in the control group. 2. The peak torque of shoulder girdle muscles increased significantly after the exercise in the experimental group only. 3. The physical symptom score decreased significantly after the exercise in the experimental group only. 4. The experimental group revealed significantly higher level of quality of life and lower level of stress after the exercise compared with those before the exercise. whereas the control group showed no significant changes in those levels. These findings may indicate that the aquatic exercise program is effective in increasing the range of motion of the shoulder joint and muscle strength and quality of life. and also effective in decreasing physical symptoms. and the level of stress in postmastectomy patients. Accordingly. the acquatic exercise program' can be adopted as an effective nursing intervention for postmastectomy rehabilitation.

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