• Title/Summary/Keyword: cancer patient

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Analysis of Intrafractional Mass Variabilities Using Deformable Image Registration Program (영상변조 프로그램을 이용한 호흡 위상 간 종양의 움직임 특성 분석)

  • Cho, Jeong-Hee;Kim, Joo-Hoo;Seo, Sun-Youl;Han, Dong-Kyoon
    • Journal of radiological science and technology
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    • v.35 no.2
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    • pp.173-181
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    • 2012
  • The aim of this study is to compare the geometric characteristics of the lung tumor, such as tumor centroid, HU change relative to breath phase, depending on tumor location and adhesion using 4DCT and deformable image registration program (MIMVista). The Y axis change was most significant and the mean Y axis centroid fluctuation was $7.32{\pm}6.88mm$ in lower lung tumor. The mean HU variation in lower lung mass has changed more than other locations, and its mean HU variation was $7.7{\pm}4.97%$ and non-adhered mass was more changed. Correlation for the mass volume between 3DCT and MIP was very high and its coefficient was 0.998. The effect of tumor location, adhesion and diaphragm excursion to geometric uncertainties was analyzed by linear regression model, it was influenced to mass deformation and geometrical variation so much except diaphragm excursion. but intra-fractional and inter-patient's uncertainties were great, so it couldn't find any exact deformation trend.

'Simultaneous Modulated Accelerated Radiation Therapy' (SMART) Intensity-Modulated Radiotherapy in the Treatment of Nasopharyngeal Carcinoma : the Asan Medical Center (비인강암의 세기조절방사선치료기술을 이용한 동시차등조사가속치료의 예비성적)

  • Lee Sang-Wook;Back Geum-Mun;Yi Byong-Yong;Choi Eun-Kyung;Kim Jong-Hoon;Ahn Seung-Do;Shin Seong-Soo;Kim Sang-Yoon;Nam Soon-Yuhl;Choi Seung-Ho;Kim Sung-Bae;Song Si-Yeol
    • Korean Journal of Head & Neck Oncology
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    • v.19 no.1
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    • pp.9-15
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    • 2003
  • Purpose: To introduce our early experience with intensity-modulated radiotherapy (IMRT) in the treatment of nasopharyngeal carcinoma. Methods and Materials: Eight patients who underwent IMRT for no disseminated nasopharyngeal carcinoma at the Asan Medical Center between September 2001 and November 2002 were evaluate by prospective analysis. According to the 1997 American Joint Committee on Cancer staging classification, 5 had Stage III, and 3 had Stage IVB disease. The IMRT plans were designed to be delivered as a 'Simultaneous Modulated Accelerated Radiation Therapy' (SMART) using the 'step and shoot' technique with a MLC (multileaf collimator). Daily fractions of 2.2-2.5Gy and 1.9-2Gy were prescribed and delivered to the GTV and CTV and clinically negative neck node, respectively. The prescribed dose was 70A-79.0Gy to the gross tumor volume (GTV), 60Gy to the clinical target volume (CTV) and metastatic nodal station, and 46Gy to the clinically negative neck. All patients also received weekly cisplatin during radiotherapy. Acute and late normal tissue effects were graded according to the Radiation Therapy Oncology Group (RTOG) radiation morbidity scoring criteria. Results: Follow-up period was ranging from 5 to 18 months. All patients showed complete response and loco-regional control rate was 100% but one patient died of malnutrition due to treatment related toxicity. There were no Grade 3 or 4 xerostomia and all patients had experienced improvement of salivary gland function. Conclusion: 'Simultaneous Modulated Accelerated Radiation Therapy' (SMART) boost intensity-modulated radiotherapy technique allows parotid sparing as evidenced both clinically and by dosimetry. Initial tumor response and loco-regional control was promising. It is clinically feasible. A larger population of patients and a long-term follow-up are needed to evaluate ultimate tumor control and late toxicity.

A Pychoeducational Group Intervention for Women with Primary Breast Carcinoma (유방암 환자에 대한 심리교육 집단개입의 효과)

  • Hwang, Sook-Yeon;Lee, In-Soo;Park, Byeong-Woo
    • Korean Journal of Social Welfare
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    • v.51
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    • pp.93-118
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    • 2002
  • The objective of this study was to determine the effect of a psycho-educational group intervention in reducing psychologic distress and enhancing coping in Korean breast cancer patients. The patient selection criteria were age younger than 70 years, having any postoperative adjuvant therapy, and surgery undergone within the previous 12 months as of the start of the study and there were 70 patients eligible for this criteria. They were randomized into three groups; experimental group(24 patients), wait-list control group(24 patients) and wait-list group(36 patients). We conducted a 8-week, structured, psychosocial group intervention, which used psycho-educational strategies combining education and psychological support. Subjects were assessed for psychological distress and coping by administering the Beck Depression Inventory(BDI) and the Ways of Coping Checklist-Revised(WCCL-R) at the baseline and after 8 weeks. Forty eight patients were participated and thirty five patients completed the study. The experimental group had significantly lower scores than the controls for depression on the BDI(p=.012) after 8-week intervention. However, coping did not show a significant difference on WCCL-R after the intervention. Despite of some limitations, the results of this study suggest that a short term psychosocial group intervention produces a significant improvement in the quality of life of patients with primary breast carcinoma in Korea in terms of managing depression.

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Clinical Evaluation of Dose Distribution in High Dose Rate Intracavitary Irradiation in the Treatment of Cervical Cancer (고선량 강내 조사법을 이용한 자궁 경부암의 방사선 치료 계획에 대한 임상적 고찰)

  • Shin, Sei-One;Kim, Myung-Se
    • Journal of Yeungnam Medical Science
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    • v.6 no.1
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    • pp.87-98
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    • 1989
  • Clinical estimation of bladder and rectal doses from high dose rate intracavitary irradiation in carcinoma of the cervix uteri has been initiated on a routine basis in an effort to obtain the optimum radiotherapeutic dose. Simulation films with contrast media are used to image the bladder and rectum, and dose rates are estimated at various interesting points with the aid of treatment planning computer, NEC Therac-2300. Fifty-three patients have been reviewed in order to ascertain the correlation between radiation dose at interesting points in the bladder and rectum and the dose at Point A and B. The dose ratio between doses at Point A 'and interesting points is an important clinical factor in evaluating the treatment planning. This also serves as documentation of the dose to normal structures within the treatment volume. Authors conclude that obtained data are within acceptable ranges and routine simulation films of the bladder and rectum after administration of contrast media with dose calculations at interesting points provide important information for optimizing radiotherapy planning in the treatment of cervical carcinoma without increased time and effort or patient's discomfort.

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Two Cases of Anti-Jka Whose Reactivity Was Disappeared after Enzyme Treatment (효소 처리 후 항체반응이 사라진 항-Jka 2예)

  • Choi, Moon Suk;Cho, Yong Gon;Lee, Jaehyeon;Kim, Dal Sik;Lee, Hye Soo;Choi, Sam Im
    • The Korean Journal of Blood Transfusion
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    • v.23 no.2
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    • pp.173-179
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    • 2012
  • We report on two cases of anti-$Jk^a$, whose reactivity disappeared on an antibody identification test using enzyme-treated red cells. One of two patients was a 72-year-old female with cirrhosis of the liver and colon cancer, and the other was a 55-year-old female with known MDS and incomplete Behcet's disease. Results of an antibody identification test using a LISS/Coombs gel card (DiaMed AG) showed negative to one positive with red cells having the $Jk^a$ antigen; however, all reactions using the enzyme-treated cells showed negative results, which was unexpected. The patients' RBC phenotype was Jk(a-b+). We obtained positive results in reactions of enzyme-treated $Jk^a+$ cells and EDTA using a patient's serum and proved that the cause of the negative reaction might be complement-related.

A Study on the Practice Model for Practical Education for Health and Medical Information Management (보건의료정보관리 실습교육을 위한 실습모델 연구)

  • Choi, Joon-Young
    • Journal of the Health Care and Life Science
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    • v.8 no.2
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    • pp.83-93
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    • 2020
  • In this study, a practical model for health information management education using the EMR education system at universities for nurturing health care information managers was studied. Currently, there is no practical training course for health care information management in the standards for evaluation and certification of health care information management education introduced to strengthen the job competency of health care information managers. Accordingly, the program was constructed so that the practice program suggested as an educational environment in the Health and Medical Information Management Education Evaluation and Certification Manual can be practiced in the EMR education system. In addition, a practical model that can be performed according to the on-site practice guidelines for health and medical information management for each program was studied. Using the health care information management education EMR system, master data management, patient registration, doctor prescription, medical cost calculation, health insurance claim management, form management, discharge registration, cancer registration, unrecorded management, health care data management, health care statistics, A practice model was studied so that practice on information protection/security management can be performed. It will be possible to play a role as a health care information management expert by raising the quality level of health care information management education through systematic and standardized health care information management practice courses at universities. Accordingly, it is necessary to cultivate health care information management experts who develop and manage medical services based on medical data analysis through practical training of health care information managers.

EID3 Promotes Glioma Cell Proliferation and Survival by Inactivating AMPKα1

  • Xiang, Yaoxian;Zhu, Lei;He, Zijian;Xu, Lei;Mao, Yuhang;Jiang, Junjian;Xu, Jianguang
    • Journal of Korean Neurosurgical Society
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    • v.65 no.6
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    • pp.790-800
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    • 2022
  • Objective : EID3 (EP300-interacting inhibitor of differentiation) was identified as a novel member of EID family and plays a pivotal role in colorectal cancer development. However, its role in glioma remained elusive. In current study, we identified EID3 as a novel oncogenic molecule in human glioma and is critical for glioma cell survival, proliferation and invasion. Methods : A total of five patients with glioma were recruited in present study and fresh glioma samples were removed from patients. Four weeks old male non-obese diabetic severe combined immune deficiency (NOD/SCID) mice were used as transplant recipient models. The subcutaneous tumor size was calculated and recorded every week with vernier caliper. EID3 and AMP-activated protein kinase α1 (AMPKα1) expression levels were confirmed by real-time polymerase chain reaction and Western blot assays. Colony formation assays were performed to evaluate cell proliferation. Methyl thiazolyl tetrazolium (MTT) assays were performed for cell viability assessment. Trypan blue staining approach was applied for cell death assessment. Cell Apoptosis DNA ELISA Detection Kit was used for apoptosis assessment. Results : EID3 was preferentially expressed in glioma tissues/cells, while undetectable in astrocytes, neuronal cells, or normal brain tissues. EID3 knocking down significantly hindered glioma cell proliferation and invasion, as well as induced reduction of cell viability, apoptosis and cell death. EID3 knocking down also greatly inhibited tumor growth in SCID mice. Knocking down of AMPKα1 could effectively rescue glioma cells from apoptosis and cell death caused by EID3 absence, indicating that AMPKα1 acted as a key downstream regulator of EID3 and mediated suppression effects caused by EID3 knocking down inhibition. These findings were confirmed in glioma cells generated patient-derived xenograft models. AMPKα1 protein levels were affected by MG132 treatment in glioma, which suggested EID3 might down regulate AMPKα1 through protein degradation. Conclusion : Collectively, our study demonstrated that EID3 promoted glioma cell proliferation and survival by inhibiting AMPKα1 expression. Targeting EID3 might represent a promising strategy for treating glioma.

Adjuvant Chemotherapy in Patients with Node-Negative Non-Small Cell Lung Cancer with Satellite Pulmonary Nodules in the Same Lobe

  • Park, Jiyoun;Lee, Junghee;Jeon, Yeong Jeong;Shin, Sumin;Cho, Jong Ho;Kim, Hong-Kwan;Choi, Yong Soo;Kim, Jhingook;Zo, Jae Ill;Shim, Young Mog
    • Journal of Chest Surgery
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    • v.55 no.1
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    • pp.10-19
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    • 2022
  • Background: According to the eighth TNM (tumor-node-metastasis) staging system, the presence of separate tumor nodules in the same lobe is designated as a T3 descriptor. However, it remains unclear whether adjuvant chemotherapy confers survival advantages in this setting. Methods: We retrospectively identified 142 pathologic T3N0M0 patients with additional pulmonary nodules in the same lobe from a single-institutional database from 2004 to 2019. The main outcomes were overall survival and recurrence-free survival. Multivariable Cox regression was used to identify the benefit of adjuvant chemotherapy while adjusting for other variables. Results: Sixty-one patients received adjuvant chemotherapy (adjuvant group) and 81 patients did not receive adjuvant therapy after surgery (surgery-only group). There were no demonstrable differences between the 2 groups regarding hospital mortality and postoperative complications, indicating that treatment selection had not significantly occurred. However, the use of adjuvant chemotherapy was associated with improved 5-year overall survival (70% vs. 59%, p=0.006) and disease-free survival (60% vs. 46%, p=0.040). A multivariable Cox model demonstrated that adjuvant chemotherapy was associated with a survival advantage (adjusted hazard ratio, 0.54; p<0.001). In exploratory analyses of subgroups, the effect of adjuvant chemotherapy seemed to be insufficient in those with small main tumors (<4 cm). Conclusion: Adjuvant chemotherapy was associated with better survival in T3 cancers with an additional tumor nodule in the same lobe. However, the role of adjuvant chemotherapy in patient subgroups with small tumors or those without risk factors should be determined via large studies.

The Age and Sex-specific Quality of Life by Chronic Disease Using the EQ-5D Index : Based on the 2017-2019 Korea National Health and Nutrition Examination Survey (EQ-5D 지수를 활용한 만성질환별 삶의 질의 성별 및 연령에 따른 변화: 2017~2019년 국민건강영양조사 자료를 이용하여)

  • Gyung-Jun Chae;Se-Ho Park;Seung-A Song;Jun-Kyu Lee;Jong-min Hong;Jae Seok Song;Nam Jun Kim
    • Journal of agricultural medicine and community health
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    • v.48 no.2
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    • pp.81-90
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    • 2023
  • Objectives: This study analyzed the decline in quality of life according to age in the chronic disease patient group, quantified it as a quantitative index, and compared it by sex and chronic disease. Methods: In the 2017-2019 Korea National Health and Nutrition Examination Survey database, 11,473 adults aged 19 years or older, excluding cancer patients, were analyzed for age-specific changes in the EQ-5D Index by chronic disease. The decline in quality of life according to age in patients with chronic diseases was analyzed by linear regression analysis while controlling for general characteristics. Then, linear regression analysis was performed according to sex. Results: In the case of the control group, the quality of life decreased by 0.0004 for every 1-year increase in age(P<0.001). By chronic disease, asthma(β=0.0019, P<0.001), arthritis(β=0.0017, P=0.002), thyroid dis- ease(β=0.0016, P=0.015), dyslipidemia(β=0.0011, P=0.020), and hypertension(β=0.0009, P=0.027) mostly showed a greater decrease in quality of life than the control group. In addition, when divided into two groups by sex, hypertension(β=0.0012, P=0.029), thyroid disease(β=0.0041, P=0.038), and arthritis(β=0.0022, P<0.001) showed a significant decrease in quality of life only in male. Diabetes(β=0.0056, P=0.038), dyslipi- demia(β=0.0022, P=0.001) significantly decreased quality of life only in female. Conclusions: Chronic disease had a negative impact on patients perception of quality of life, and the more severe the pain and activity limitation due to the chronic disease, the more severe it was. It also showed different patterns according to sex. Therefore, it is necessary to allocate more medical resources and provide policy support to prevent chronic diseases, which are serious social problems.

99mTc-3PRGD2 SPECT/CT Imaging for Diagnosing Lymph Node Metastasis of Primary Malignant Lung Tumors

  • Liming Xiao;Shupeng Yu;Weina Xu;Yishan Sun;Jun Xin
    • Korean Journal of Radiology
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    • v.24 no.11
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    • pp.1142-1150
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    • 2023
  • Objective: To evaluate 99mtechnetium-three polyethylene glycol spacers-arginine-glycine-aspartic acid (99mTc-3PRGD2) single-photon emission computed tomography (SPECT)/computed tomography (CT) imaging for diagnosing lymph node metastasis of primary malignant lung neoplasms. Materials and Methods: We prospectively enrolled 26 patients with primary malignant lung tumors who underwent 99mTc-3PRGD2 SPECT/CT and 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT imaging. Both imaging methods were analyzed in qualitative (visual dichotomous and 5-point grades for lymph nodes and lung tumors, respectively) and semiquantitative (maximum tissue-to-background radioactive count) manners for the lymph nodes and lung tumors. The performance of the differentiation of lymph nodes with and without metastasis was determined at the per-lymph node station and per-patient levels using histopathological results as the reference standard. Results: Total 42 stations had metastatic lymph nodes and 136 stations had benign lymph nodes. The differences between metastatic and benign lymph nodes in the visual qualitative and semiquantitative analyses of 99mTc-3PRGD2 SPECT/CT and 18F-FDG PET/CT were statistically significant (all P < 0.001). The area under the receiver operating characteristic curve (AUC) in the semi-quantitative analysis of 99mTc-3PRGD2 SPECT/CT was 0.908 (95% confidence interval [CI], 0.851-0.966), and the sensitivity, specificity, positive predictive value, and negative predictive value were 0.86 (36/42), 0.88 (120/136), 0.69 (36/52), and 0.95 (120/126), respectively. Among the 26 patients (including two patients each with two lung tumors), 15 had pathologically confirmed lymph node metastasis. The difference between primary lung lesions in patients with and without lymph node metastasis was statistically significant only in the semi-quantitative analysis of 99mTc-3PRGD2 SPECT/CT (P = 0.007), with an AUC of 0.807 (95% CI, 0.641-0.974). Conclusion: 99mTc-3PRGD2 SPECT/CT imaging may notably perform in the direct diagnosis of lymph node metastasis of primary malignant lung tumors and indirectly predict the presence of lymph node metastasis through uptake in the primary lesions.