• 제목/요약/키워드: clinical stage

검색결과 2,594건 처리시간 0.035초

횡경막상부에 국한된 임상적 병기 1-2기 호지킨병에서 치료 결과와 예후 인자의 분석 (The Analyses of Treatment Results and Prognostic Factors in Supradiaphragmatic CS I-II Hodgkin's Disease)

  • 박원;서창옥;정은지;조재호;정현철;김주항;노재경;한지숙;김귀언
    • Radiation Oncology Journal
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    • 제16권2호
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    • pp.147-157
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    • 1998
  • 목적 : 시험개복술을 시행하지 않은 임상적 병기 1기, 2기 횡경막상부 호지킨병에서 후향적으로 치료 결과를 분석함으로써 시험개복술의 필요성을 재검토하였고 예후 인자를 분석하고, 예후 인자군의 유용성을 평가하고자 하였다. 대상 및 방법 : 1985년에서 1995년까지 연세의료원에서 횡경막 상부에 국한된 임상적 병기 1-2기 호지킨병으로 진단받고 치료를 받았던 51례를 대상으로 하였다. 연령은 4-67세까지 였으며 중앙값은 30세였고 병기별로는 IA, IIA, IIB가 각각 16례, 25례, 10례였다. 방사선치료는 4, 6MV 광자선으로 매일 1.5-1.8Gy씩 19.5Gy에서 55.6Gy(중앙값:45Gy)가 조사되었으며, 항암화학 요법은 방사선치료 전후에 2-12회(중앙값: 6회) 시행되었다. 방사선치료 단독, 항암화학방사선병용요법, 항암화학요법 단독이 각 각 31례, 16례, 4례에 시행되었고 방사선치료는 Involved field 방사선치료가 3례, 맨틀방사선치료가 26례, 부분적림프절방사선치료가 18례에서 시행되었다. 생존을 분석은 Kaplan-Meier method, 유의성 검증은 log-rank test를 이용하였다. 결과 : 5년 전체 생존율은 $87.6\%$, 무병 생존율은 $78.0\%$였다. 완전 관해된 50례 중 림프절만 재발한 경우가 4례, 간이나 폐 또는 비장에서 재발한 경우가 3례, 림프절과 간에 동시에 재발된 경우가 1례 있었다. 재발한 8례중 구제 치료가 항암화학요법 단독, 방사선치료 단독, 항암화학방사선병용요법이 각 각 4례, 1례, 2례에서 시행되어 이중 2례만 구제되었다. 여성이거나 거대 종격동 림프선비대가 있는 경우에 재발이 의미있게 많았고 전체 생존율은 B 증상이 있거나 임상적 .병기가 높을수록 의미있게 낮았다. EORTC 예후 인자군에 따른 5년 무병 생존율은 very favorable군 (VF관), favorable군(F군), unfavorable군(U군)이 각각 100, 100, $55.8\%$, 5년 전체 생존율은 100, 100, $75.1\%$로 통계적으로 의미있는 차이를 보여주었다. VF군과 F은 방사선치료만으로도 $100%$의 생존율을 보였으나 U군에서는 항암화학방사선병용요법시 방사선치료 단독보다 적은 재발율을 보였으나 생존율은 비슷하였다. 방사선치료를 받았던 경우에 맨틀방사선치료보다 부분적림프절방사선치료를 받은 경우에 무병 생존율이 높았다. 결론 : 횡경막상부에 국한된 호지킨병에서 시험개복술을 시행하지 않고도 좋은 치료 결과를 보여 주었다 성별, 거대 종격동 림프선비대가 무병 생존율에 의미있는 영향을 주었고 B 증상, 임상적 병기는 전체 생존율에 영향을 주는 중요한 예후 인자였다. 그리고 EORTC 예후 인자군에 따른 분류가 예후 예측과 치료 방법을 결정하는데 유용함을 확인할 수 있었다.

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사람 난포액의 처리 방법과 Sample이 생쥐 수정란의 체외 발달율에 미치는 영향 (Effect of Treatment and Samples of Human Follicular Fluid on Development In Vitro of Mouse Embryos)

  • 전병균;최연희;조은정;송건호;곽대오;문진수;김광철
    • Clinical and Experimental Reproductive Medicine
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    • 제27권4호
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    • pp.359-366
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    • 2000
  • The present studt was performed to investigate the effect of treatment and samples of human follicular fluid (hFF) on the development in vitro of mouse embryos. The two cell stage embryos collected at 40 h post-hCG injection were cultured in the modified human tubal fluid (m-RTF) containing 15% synthetic serum substitute (SSS) or human tubal fluid (hFF) for up to 3 days at $37^{\circ}C$ in 5% $CO_2$ incubator. Also the composition of hormone, total protein and protein pattern of hFF samples were analyzed. The developmental rate of mouse embryos developed to blastocyst were not significant difference in the m-RTF containing 15% hFF filtered with 0.22 or 0.8 ${\mu}m$ syringe filter, however, the embryos cultured in the m-RTF containing inactivated hFF were significantly (p<0.05) developed at the high rate to blastocyst than those containing fresh hFF and SSS. The in vitro developmental rate to blastocyst and hatched blastocyst in the m-RTF containing 15% hFF sample A (90.5 and 85.4%, respectively) and SSS (79.4 and 75.3, respectively) were significantly (p<0.05) increased, compared with hFF sample B (64.2 and 54.1 %, respectively). The hFF sample A tended to be higher concentration of LH, FSR, total protein and the ratio of progesterone/$E_2$ and lower concentration of $E_2$ and progesterone than the hFF sample B, but there were no differences in the protein pattern between the two hFF samples. The results of these study suggest that the addition of hFF to the culture medium enhances the development in vitro to blastocyst and hatched blastocyst, but the in vitro developmental rate of mouse embryos is different between hFF samples.

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고용량의 Dexamethasone 존재하에서 골막기원세포에서 발현되는 혈관신생인자의 평가 (EVALUATION OF ANGIOGENIC PHENOTYPES IN CULTURED HUMAN PERIOSTEAL-DERIVED CELLS UNDER HIGH-DOSE DEXAMETHASONE)

  • 박봉욱;최문정;류영모;이성균;하영술;김덕룡;조영철;김종렬;변준호
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제30권3호
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    • pp.217-224
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    • 2008
  • Angiogenesis plays an important role in bone development and postnatal bone fracture repair. Vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptors (VEGFRs) have been thought to be primarily involved in promoting angiogenesis. It is well known that VEGF and its receptors have been reported to play an important role in the regulation of the interaction between angiogenesis and osteogenesis during bone repair processes. Dexamethasone, a potent synthetic glucocorticoid, promotes phenotype markers of osteoblast differentiation, such as ALP and osteocalcin. It stimulates in vitro osteogenesis of human bone marrow osteogenic stromal cells. Dexamethasone has been reported to suppress VEGF gene expression in some cells. However, our previous study demonstrated VEGF quantification increased in a time-dependent manner in periosteal-derived osteogenesis under dexamethasone. So, the purpose of this study was to examine the angiogenic phenotypes in cultured human periosteal-derived cells under high-dose dexamethasone. Periosteal-derived cells were cultured using a technique previously described. After passage 3, the periosteal-derived cells were further cultured for 28 days in an osteogenic inductive culture medium containing ascorbic acid, ${\beta}$-glycerophosphate and high-dose dexamethasone, We evaluated the expression of VEGF isoforms, VEGFR-1, VEGFR-2, and neuropilin-1, ALL VEGF isoforms ($VEGF_{121},\;VEGF_{165},\;VEGF_{189}$, and $VEGF_{206}$) expression was observed by RT-PCR analysis. VEGFR-1, VEGFR-2 and neuropilin-1 expression increased up to day 14, particularly during the early stage of mineralization. Our results suggest the involvement of direct VEGFs/VEGFRs system on periosteal-derived cells during early mineralization phase under high-dose of dexamethasone. These also suggest that VEGF might act as an autocrine growth molecule during osteoblastic differentiation of cultured human periosteal-derived cells.

식도암 조직에시 p53 및 nm23 유전자 발현의 임상적 의의 (Clinical Significance of p53 Gene and nm23 Gene Expression in Esophageal Cancer)

  • 박건;이종호;사영조;진웅;권종범;박재길;이선희;곽문섭
    • Journal of Chest Surgery
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    • 제37권3호
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    • pp.261-266
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    • 2004
  • 식도암 환자에서 조기진단 및 수술적 치료 방법의 상당한 진전에도 불구하고 환자의 예후는 여전히 좋지 않다. p53 종양 억제유전자는 세포의 성장과 증식을 조절하는 것으로 알려져 있고 nm23 유전자는 설치류 흑색종에서 종양의 전이억제 효과가 있다고 알려져 있다. 이 실험은 p53과 nm23유전자 발현과 식도암 환자의 임상병리학적인 특징상의 관련성을 알아보고자 하였다. 가톨릭대학교 의과대학 부속 성모병원에서 수술한 식도암 환자 40명의 조직을 대상으로 하였고, p53 변이형 단백질과 nm23단백질을 면역화학적 염색을 시행하여 <10% 양성 종양세포 : negative ; 10∼30% 양성 종양세포: +; 30∼50% 양성 종양세포 : ++; >50% 양성 종양세포: +++의 4개의 군으로 분류하였고, 또한 종양의 침습 정도는 none, mild, moderate, severe로 분류하여 평가하였다. p53 변이형 단백질과 nm23 단백질의 과발현은 생존율 및 임상병리학적 특징과 연관성이 없었고, 또한 p53 및 nm23유전자 발현의 조합 분석에서도 유의한 상관관계를 발견하지 못하였다.

Ovarian Masses: Is Multi-detector Computed Tomography a Reliable Imaging Modality?

  • Khattak, Yasir Jamil;Hafeez, Saima;Alam, Tariq;Beg, Madiha;Awais, Mohammad;Masroor, Imrana
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권4호
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    • pp.2627-2630
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    • 2013
  • Background: Ovarian cancer continues to pose a major challenge to physicians and radiologists. It is the third most common gynecologic malignancy and estimated to be fifth leading cancer cause of death in women, constituting 23% of all gynecological malignancies. Multi-detector computed tomography (MDCT) appears to offer an excellent modality in diagnosing ovarian cancer based on combination of its availability, meticulous technique, efficacy and familiarity of radiologists and physicians. The aim of this study was to compute sensitivity, specificity, positive and negative predictive values and diagnostic accuracy of 64-slice MDCT in classifying ovarian masses; 95% confidence intervals were reported. Materials and Methods: We prospectively designed a cross-sectional analytical study to collect data from July 2010 to August 2011 from a tertiary care hospital in Karachi, Pakistan. A sample of 105 women aged between 15-80 years referred for 64-MDCT of abdomen and pelvis with clinical suspicion of malignant ovarian cancer, irrespective of stage of disease, were enrolled by non-probability purposive sampling. All patients who were already known cases of histologically proven ovarian carcinoma and having some contraindication to radiation or iodinated contrast media were excluded. Results: Our prospective study reports sensitivity, specificity; positive and negative predictive values with 95%CI and accuracy were computed. Kappa was calculated to report agreement among the two radiologists. For reader A, MDCT was found to have 92% (0.83, 0.97) sensitivity and 86.7% (0.68, 0.96) specificity, while PPV and NPV were 94.5% (0.86, 0.98) and 86.7% (0.63, 0.92), respectively. Accuracy reported by reader A was 90.5%. For reader B, sensitivity, specificity, PPV and NPV were 94.6% (0.86, 0.98) 90% (0.72, 0.97) 96% (0.88, 0.99) and 87.1% (0.69, 0.95) respectively. Accuracy computed by reader B was 93.3%. Excellent agreement was found between the two radiologists with a significant kappa value of 0.887. Conclusion: Based on our study results, we conclude MDCT is a reliable imaging modality in diagnosis of ovarian masses accurately with insignificant interobserver variability.

Advantages of Restoring miR-205-3p Expression for Better Prognosis of Gastric Cancer via Prevention of Epithelial-mesenchymal Transition

  • Zhang, Zhen;He, Xujun;Xu, Ji;Zhang, Genhua;Yang, Yue;Ma, Jie;Sun, Yuanshui;Ni, Haibin;Wang, Fengyong
    • Journal of Gastric Cancer
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    • 제20권2호
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    • pp.212-224
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    • 2020
  • Purpose: miR-205 is a tumor suppressor and plays an important role in tumor invasiveness. However, the role of miR-205 in human gastric cancer (GC) epithelial-mesenchymal transition (EMT) remains unclear. The aim of this study was to investigate the molecular mechanism of miR-205 in the regulation of EMT in GC invasion. Materials and Methods: Quantitative polymerase chain reaction (qPCR) was used to detect the expression of miR-205 in GC. Further, the correlation between the pathological parameters and prognosis of GC was statistically analyzed. A transwell model was used to evaluate the effect of miR-205-3p on the invasion and migration of GC cells. qPCR, western blotting, and luciferase assay were performed to analyze the relationship and target effects between miR-205-3p and the expression of zinc finger electron box binding homologous box 1 (ZEB1) and 2 (ZEB2). Results: We found that the levels of miR-205-3p were significantly lower (P<0.05) in GC tissues than in matched normal tissues. Additionally, the expression of miR-205-3p was related to the tumor invasion depth, lymph node metastasis, lymph node invasion, and tumor, node, metastasis stage. Patients with lower miR-205-3p expression levels in the tumors had a poorer prognosis. The in vitro assays indicated that miR-205-3p could affect the invasion ability and EMT of GC cells by targeting the expression of both ZEB1 and ZEB2. Conclusions: miR-205-3p promotes GC progression and affects the prognosis of patients by targeting both ZEB1 and ZEB2 to directly influence EMT.

Nitric oxide-induced immune switching in experimental inflammatory autoimmune diseases

  • Kwak, Hyun-Jeong;Kim, Hyung-Jin;Park, Jae-Sung;Jun, Chang-Duk;Lee, Mun-Young;Shin, Tae-Kyun;Chung, Hun-Taeg
    • IMMUNE NETWORK
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    • 제1권2호
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    • pp.116-125
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    • 2001
  • Background: Nitric oxide (NO) production has been described as a double-edged sword eliciting both pro- and anti-inflammatory effects in different immune reactions. This work was undertaken to investigate the immunoregulatory role of NO in experimental allergic encephalomyelitis (EAE) and experimental allergic uveitis (EAU). Method: We examined whether molsidomine (MSDM), a NO donor, administration to the myelin basic protein (MBP)- or interphotoreceptor retinoid binding protein (IRBP)-immunized rats could suppress EAE development by shifting toward the Th2 cytokine response. In the EAE experiments, the rats were treated orally with MSDM (10 mg/kg/day) at the early stage (-1~4 days) or throughout the experimental period (-1~15 days). Results: This resulted in significant amelioration of the disease and mild clinical symptoms, while MBP-immunization without MSDM administration showed severe EAE development. A marked reduction in inflammation was also observed in the spinal cord, indicating the crucial role of NO in the pathogenesis of EAE in in vivo. In the EAU experiments, a 24 h pre-treatment with MSDM prior to IRBP immunization resulted in significant inhibition of the disease. Furthermore, MSDM administration for 2 1 days completely reduced the incidence and severity of EAU. To investigate whether MSDM could modulate cytokine switching from Th 1 to Th2, culture supernatants of MBP- or IRBP-stimulated inguinal lymphocytes were analyzed. MSDM treatment enhanced IL-10 secretion but decreased IFN-${\gamma}$. IL-4 was undetectable in all groups. In contrast, the MBP-or IRBP-immunized rats without MSDM secreted high concentrations of IFN-${\gamma}$, but low concentrations of IL-10. Conclusion: In conclusion, NO administation suppresses EAE and EAU by modulating the Th1/Th2 balance during inflammatory immune responses. This work further suggests that NO may be useful in the therapeutic control of autoimmune disease.

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경추 추간판 탈출증 입원 환자 102례에 관한 한의학적 복합치료 효과의 관찰 연구 (Effects of Korean Medical Combination Treatment for 102 Cases of Cervical Disc Herniation : An Observational Study)

  • 최지훈;이순호;김상민;김현중;구자성;이현호;정성현;윤덕원
    • Journal of Acupuncture Research
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    • 제33권2호
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    • pp.11-20
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    • 2016
  • Objectives : The purpose of this study is to investigate the clinical effectiveness of Korean medical combination treatment for cervical disc herniation. Methods : This is an observational study. 102 patients diagnosed with cervical disc herniation by MRI (Magnetic Resonance Imaging) were investigated from January, 2015 through to December, 2015 at Daejeon Jaseng Hospital of Korean Medicine. They were sorted according to the distribution of sex, age, causing factor, the period of disease, admission day and pain area. All patients were treated with acupuncture, Chuna treatment, and herbal therapy and physical therapy during the admission period. After treatment, NRS (Numeric Rating Scale), NDI (Neck Disability Index) and EQ-5D were assessed to evaluate the treatment efficacy. Results : There were more females than Males with a ratio of 1 : 1.37, the age of fifty was the most with 35.29 %, reason unknown was the most with 72.55 % and the subacute stage was the most with 38.24 %. According to disc herniation types, patients with protruded disc types were the most with 66.67 % and a lesion of C5/6 was the most with 41.18 %. For patients diagnosed with cervical disc herniation, neck and shoulder pain NRS decreased from $6.43{\pm}1.77$ to $3.96{\pm}1.96$(p<0.001) and radiating pain NRS decreased from $5.64{\pm}1.96$ to $3.57{\pm}1.88$ (p<0.001). NDI decreased from $41.72{\pm}14.04$ to $30.84{\pm}15.34$(p<0.001), and the EQ-5D index increased from $0.68{\pm}0.17$ to $0.79{\pm}0.14$(p<0.001) after treating cervical disc patients. Conclusion : Korean medical combination treatment might be effective in decreasing pain and raising the life quality of patients with cervical disc herniation.

가토 탈회 동종골편 이식시 조직반응에 관한 연구 (HISTOLOGICAL TISSUE RESPONSES OF DEMINERALIZED ALLOGENEIC BONE BLOCK GRAFT IN RABBITS)

  • 전영환;김영조;민승기;엄인웅;이동근
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제15권1호
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    • pp.63-79
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    • 1993
  • To repair bony defects with tansplanted bone in the body, fresh autogenous bone is undoubtly, the most effective bone graft for clinical applications. But the demineralized bone has the matrix-induced bone formation which was suggested by Urist in 1965. Many authors assisted that demineralized bone powder induces phenotypic conversion of mesenchymal cells into osteoblasts, with high-density bone formation. The process of inducing differentiated cells becomes osteogenic properties. The purpose of this study was to evaluate the osteoinductive capacity of allogenic freeze-dried demineralized bone block (FDD, $7{\times}7mm$) and to compare FDD with the same sue of deep-frozen allogenic bone(DF), fresh autogenous bone (A) after implantation. The histological and ultrastructural features of tissue responses were examined after 1, 2, 4, 6, 8 weeks implantation of each experimental groups in the operative site of the New Zealand white rabbits. The results were as follows : 1. Inflammatory cell infiltration generally has appeared at 1 week, but reduced at 4 weeks in each group, but most severe in DF group. 2. Osteoblastic activity has increased for 4 weeks, but decreased at 6 weeks in each group and there was no significant difference among experimental groups. 3. New bone formation has begun at 1week, least activations in A groups, and showed the revesal line of bone formation among each group at 6 to 8 weeks. 4. Bone resorption has appeared at 1 week, but disappeared at 4 weeks in both A and DF groups, but more severe in DF than A groups. 5. In ultrastructural changs, the DF group have showed the most remarkable osteoclastic activities among experimental groups. 6. Osteoid or tangled collagen fibrils near the implanted sites were replaced by more mature, lamellated bony trabeculae during bone remodeling. There was little difference among each experimental groups. 7. During the convertion osteoblasts to osteocytes which embedded within the bone matrix, there was organ-less-poor cytoplasm, increased nuclear chromatin, abundant rough endothelial reticulum (RER) in each groups. From the above the findings, the DF group shored more bone resorption and foreign body reaction than FDD and A groups, and FDD group showed more new bone formation or osteoblastic activity than DF and A groups in early stage. There was no significant difference of cellular activities among the FDD DF, and A groups according to the time.

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Efficacy and Toxicity of Gemcitabine Plus Docetaxel Combination as a Second Line Therapy for Patients with Advanced Stage Soft Tissue Sarcoma

  • Ali Osman, Kaya;Suleyman, Buyukberber;Metin, Ozkan;Necati, Alkis;Alper, Sevinc;Nuriye Yildirim, Ozdemir;Suleyman, Alici;Onur, Esbah;Veli, Berk;Celalettin, Camci;Arife, Ulas;Ugur, Coskun;Mustafa, Benekli
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권2호
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    • pp.463-467
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    • 2012
  • Purpose: To assess the safety and efficacy of a gemcitabine plus docetaxel regimen as a second line therapy for patients with advanced soft tissue sarcoma (STS) resistant to doxorubicin and ifosfamide-based therapy. Patients and Methods: Medical records of 64 patients with advanced STS who received gemcitabine plus docetaxel regimen as a second line treatment between May 2006 and June 2011 were examined. All patients had been previously treated with doxorubicin plus ifosfamide-based regimen at first line setting. Patients received gemcitabine 900 $mg/m^2$ on days one and eight intravenously over 90 minutes, followed by docetaxel 75 $mg/m^2$ on day eight intravenously over one hour. Cycles were repeated every 3 weeks. Results: The male-to-female ratio was 37/27 and the median age was 44 years (range; 19-67 years). Objective responses were observed in 13 (20.3 %) patients (2 CR, 11 PR) and stable disease in 21 (32.8 %). Total clinical benefit (CR+PR+SD) was observed in 34 (53.1 %). Median overall survival (OS) was 18 months (95% confidence interval (CI):12.1-23.9) and Median time to progression (TTP) was 4.8 months (95% CI: 3.6-6). A total of 243 cycles of chemotherapy were administered. The median number of cycle was 3 (range;1-11). The most common grade 3-4 hematologic toxicity was neutropenia (35.9 %). The most common nonhematologic toxicities consisted of nausea/vomiting (37.5 %), mucositis (32.8 %), peripheral neuropathy (29.7%), and fatigue (26 %). There was no toxicity-related death. Conclusion: The combination of gemcitabine plus docetaxel is an active and tolerable regimen as a second line therapy for patients with advanced soft tissue sarcoma who have failed doxorubicin and ifosfamide-based therapy.