• Title/Summary/Keyword: early cancer

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Allogeneic Hematopoietic Stem Cell Transplantation in Juvenile Myelomonocytic Leukemia (연소형 골수단구성 백혈병에서의 동종 조혈 모세포 이식)

  • Yoo, Keon Hee;You, Dong Kil;Lee, Soo Hyun;Sung, Ki Woong;Cho, Eun Joo;Koo, Hong Hoe
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.178-185
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    • 2005
  • Purpose : The purpose of this study was to evaluate the outcome of children with juvenile myelomonocytic leukemia(JMML) treated with allogeneic hematopoietic stem cell transplantation(allo-HSCT). Methods : Eleven JMML patients aged 8-39 months underwent allo-HSCT. The sources of grafts were unrelated donors(n=7), HLA-matched siblings(n=3) and an HLA 1-antigen mismatched familial donor. All patients had received chemotherapy ${\pm}13$-cis-retinoic acid(CRA) before transplant, and CRA was used, posttransplant, in six patients. Results : Only three patients were in complete remission(CR) at the time of transplantation. Initial chimeric status revealed complete donor chimerism(CC) in five patients, mixed chimerism(MC) in five and autologous recovery(AR) in one. One patient with MC having persistent splenomegaly eventually turned to CC and CR after rapid tapering of cyclosporine, combined with daily use of CRA. An AR case relapsed shortly after transplant but was rescued with second, unrelated cord blood transplantation. Ultimately, six patients are alive, event-free, with a median follow-up of 15.5 months posttransplant. All three deaths occurred in patients who failed to achieve CC, leading to disease progression. Conclusion : We suggest that graft-versus-leukemia effect play an important role and CRA a possible role in posttransplant leukemic involution in JMML. In patients whose leukemic burden is still high with MC after transplant, early tapering of immunosuppressants and introduction of CRA might provide a chance of a cure for some patients.

How to Determine the Moving Target Exactly Considering Target Size and Respiratory Motion: A Phantom Study (종양의 움직임과 호흡주기에 따른 체적 변화에 대한 연구: 팬텀 Study)

  • Kim, Min-Su;Back, Geum-Mun;Kim, Dae-Sup;Kang, Tae-Yeong;Hong, Dong-Ki;Kwon, Kyung-Tae
    • The Journal of Korean Society for Radiation Therapy
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    • v.22 no.2
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    • pp.145-153
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    • 2010
  • Purpose: To accurately define internal target volume (ITV) for treatment of moving target considering tumor size and respiratory motion, we quantitatively investigated volume of target volume delineated on CT images from helical CT and 4D CT scans. Materials and Methods: CT images for a 1D moving phantom with diameters of 1.5, 3, and 6 cm, acryl spheres were acquired using a LightSpeed $RT^{16}CT$ simulator. To analyze effect of tumor motion on target delineation, the CT image of the phantoms with various moving distances of 1~4 cm, and respiratory periods of 3~6 seconds, were acquired. For investigating the accuracy of the target trajectory, volume ratio of the target volumes delineated on CT images to expected volumes calculated with diameters of spherical phantom and moving distance were compared. Results: Ratio$_{helical}$ for the diameter of 1, 5, 3, and 6 cm targets were $32{\pm}14%$, $45{\pm}14%$, and $58{\pm}13%$, respectively, in the all cases. As to 4DCT, RatioMIP were $98{\pm}8%$, $97{\pm}5%$, and $95{\pm}1%$, respectively. Conclusion: The target volumes delineated on MIP images well represented the target trajectory, in comparison to those from helical CT. Target volume delineation on MIP images might be reasonable especially for treatment of early stage lung cancer, with meticulous attention to small size target, large respiratory motion, and fast breathing.

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Result of Tracheal Resection and End-to-end Anastomosis (기관 절제 및 단단문합술의 성적 고찰)

  • 유양기;박승일;박순익;김용희;박기성;김동관;최인철
    • Journal of Chest Surgery
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    • v.36 no.4
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    • pp.267-272
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    • 2003
  • Background: Common treatment modalities for tracheal stenosis include conservative methods such as repeated balloon dilatation, removal of obstructive material through bronchoscopy and T-tube insertion as well as operative treatment methods. Recent advances in surgical approaches through tracheal resection and end-to-end anastomosis have been reported to give better functional and anatomical results. Material and Method: Between March 1990 and July 2002, 41 patients who received tracheal resection and end-to-end anastomosis at Asan Medical Center, University of Ulsan were studied retrospectively. Result: The causes for tracheal resection and end-to-end anastomosis included 26 cases of postintubation stenosis, 10 cases of primary tracheal tumors (3 benign, 7 malignant), 1 case of endobronchial tuberculosis, 2 cases of traumatic rupture, and 2 cases of tracheal invasion of a thyroid cancer, Of the 41 patients who received tracheal resection and reconstruction, 29 received tracheal resection and end-to-end anastomosis, and 12 received laryngotracheal anastomosis with cricoid or thyroid cartilage resection. Four of these patients received supralaryngeal release. The average length of the resected trachea was $3.6{\pm}1.0$cm. Of the 41 patients who received tracheal resection and end-to-end anastomosis, 30 (73.2%) experienced no postoperative complications, and 8 (19.5%) experienced granulation tissue growth and/or minor infections which improved after conservative management. Good or satisfactory results were therefore achieved in 92.7%. Complications included repeated granulation tissue growth in 7, wound infection in 2, anastomotic site dehiscence in 2, restenosis resulting in dyspnea on exertion in 1, and repeated postoperative aspiration requiring retracheostomy in 1. There was no early postoperative mortality. There were 3 cases of hospital death. Conclusion: In cases of proper length of tracheal lesion, excellent results were obtained after tracheal resection and end-to-end anastomosis. But, granulation tissue growth is so serious complication, it is necessary for continuous study and efforts to prevent it.

Expression of Hypoxia-inducible Factor-1 $\alpha$ in Esophageal Squamous Cell Carcinoma: Relationship to Prognosis and Tumor Biomarkers (식도 편평세포암에시 Hypoxia-inducible Factor-1 $\alpha$의 발현: 예후와 종양표지자와의 상관성)

  • 양일종;김종인;이해영;천봉권;조성래
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.691-701
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    • 2004
  • Background: Tissue hypoxia is a characteristic of many human malignant neoplasms, and hypoxia inducible factor-1 (HIF-1) plays a pivotal role in essential adaptive response to hypoxia, and activates a signal pathway for the expression of the hypoxia-regulated genes, resulting in increased oxygen delivery or facilitating metabolic adaptation to hypoxia. Increased level of HIF-1 a has been reported in many human malignancies, but in esophageal squamous cell carcinoma, the influence of HIF-1 a on tumor biology, including neovascularization, is not still defined. Material and Method: The influence of HIF-1 a expression on angiogenic factors, correlation between the tumor proliferation and HIF-1 a expression, interaction of HIF-1 a expression and p53, and correlation between HIF-1 a expression and clinicopathological prognostic parameters were investigated, using immunohistochemical stains for HIF-1 a, VEGF, CD34, p53, and Ki-67 on 77 cases of resected esophageal squamous cell carcinoma. Result: HIF-1 a expression in cancer cells was found in 33 of 77 esophageal squamous cell carcinoma cases. The 33 cases (42.9%) showed positive stain for HIF-1 a. High HIF-1 a expression was significantly associated with several pathological parameters, such as histologic grade (p=0.032), pathological TMN stage (p=0.002), the depth of tumor invasion (p=0.022), regional lymph node metastasis (p=0.002), distant metastasis (p=0.049), and lymphatic invasion (p=0.004). High HIF-1 a expression had significant VEGF immunoreactivity (p=0.008) and Ki-67 labeling index (p<0.001), but was not correlated with microvascular density within tumors (p=0.088). The high HIF-1 a expression was correlated with aberrant p53 accumulation with a marginal significance (p=0.056). The overall 5-year survival rate was 34.9%. The survival rate of patients with a high HIF-1 a expression was worse than that of patients with low-expression tumors (log-rank test, p=0.0001). High HIF-1 a expression was independent unfavorable factors although statistical significance is marginal in multivariate analysis. Conclusion: It is suggested that (1) high HIF-1 a expression in esophageal squamous cell carcinoma is associated with tumor hypoxia, or with genetic alteration in early carcinogenesis and progressive stages, (2) high HIF-1 a expression may be associated with intratumoral neovascularization through HIF-VEGF pathway, and (3) high HIF-1 a expression is associated with poor prognosis in patients with esophageal squamous cell carcinoma and may playa role as biomarker for regional lymph node metastasis.

Variation of Growth Characteristics and Quality Related Components in Korean Indigenous Tea (Camellia sinensis) Germplasms (한국 재래종 차나무(Camellia sinensis)의 작물학적 특성 및 품질관련 성분 변이)

  • Lee, Min-Seuk;Lee, Jin-Ho;Lee, Jeong-Dae;Hyun, Jin-Wuk;Kim, Young-Gul;Hwang, Young-Sun;Lee, Hyeon-Jin;Choi, Su-San-Na;Lee, Su-Jin;Choung, Myoung-Gun
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.53 no.3
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    • pp.333-338
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    • 2008
  • The tea has traditionally been used as a foodstuff by unique flavor, however recently not only the diversity of consumer demands but also the public interest in unique favorite and functional aspects have increased. It has been also reported that the main components contained in the leaves of tea (Camellia sinensis) include total nitrogen, free amino acids, polyphenols, and fiber, of which catechin has powerful bioactive effect such as anti-cancer, anti-aging, and anti-diabetic. (-)-Epigallocatechin gallate (EGCG) which is a major phenolic constituent of green tea extract has received considerable attention for a variety of important bioactivities. This study was carried out to obtain useful information for tea breeding programs, and to investigate the concentration of quality and functional related components in Korean indigenous tea germplasms. Korean indigenous tea lines were classified into three groups of sprout time, i.e, early, medium and late sprout time, and the ratio were 20%, 43% and 37%, respectively. There was a difference in characteristics among these Korean indigenous tea lines, leaf width of those ranged from 19.8 to 75 mm, leaf length was 35.5-160.0 mm, and leaf area was $660-8,400\;mm^2$. Experimental data on chlorophyll content (SPAD value) of Korean indigenous tea genetic resources ranged from 51.3 to 82.3. The concentrations of the total nitrogen, total free amino acids, and theanine were ranged 4.18-6.07%, 2.87-4.58%, and 1.64-2.66%, respectively. Also, catechin concentration showed from 11.54 to 15.07%, and concentration of caffeine was 2.82-4.23%. These results indicated indicated that it is possible to select elite lines with high concentration of quality related components and low concentration of caffeine from Korean domestic tea germplasms.

Establishment of a Single Dose Radiation Model of Oral Mucositis in Mice (일회 방사선조사를 이용한 마우스 구강점막염 모델의 확립)

  • Ryu, Seung-Hee;Moon, Soo-Young;Choi, Eun-Kyung;Kim, Jong-Hoon;Ahn, Seung-Do;Song, Si-Yeol;Park, Jin-Hong;Noh, Young-Ju;Lee, Sang-Wook
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.257-262
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    • 2008
  • Purpose: Oral mucositis induced by radiotherapy to the head and neck area, is a common acute complication and is considered as the most severe symptom for cancer patients in the early stages of treatment. This study was proposed to establish the oral mucositis mouse model induced by a single dose of radiation for the facility of testing therapeutic candidates which can be used for the oral mucositis treatments. Materials and Methods: Fifty-five BALB/c mice were divided into four groups: control, 16 Gy, 18 Gy, and 20 Gy. Oral mucositis was induced by a single dose of radiation to the head and neck using 6 MV x-Ray from linear accelerator. After irradiation, body weight and physical abnormalities were checked daily. Tongue tissues from all groups were taken on days 1, 2, 3, 5, 7, 9, and 14, respectively and H&E staining was conducted to examine morphological changes. Results: Body weight dramatically decreased after day 5 in all irradiated mice. In the 16 Gy treatment group, body weight was recovered on day 14. The histology data showed that the thickness of the epithelial cell layer was decreased by the accumulated time after radiation treatment, up to day 9. Severe ulceration was revealed on day 9. Conclusion: A single dose of 16 Gy is sufficient dose to induce oral mucositis in Balb/C mice. Significant changes were observed in the Balb/C mice on days 7 and 9 after radiation. It is suggested that this mouse model might be a useful standard tool for studying oral mucositis induced by radiation.

A Study on the Gene Expression in Shikonin-Induced Inhibition of Adipogenesis (Shikonin에 의한 지방세포형성 억제과정에서의 유전자 발현 연구)

  • Lee, Hae-Yong;Kang, Ryun-Hwa;Chung, Sang-In;Cho, Soo-Hyun;Oh, Dong-Jin;Yoon, Yoo-Sik
    • Journal of Life Science
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    • v.19 no.11
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    • pp.1637-1643
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    • 2009
  • Shikonin, a component of Lithospermum erythrorhizon Sieb. et Zucc, exerts various characteristics such as anti-inflammatory, anti-cancer and anti-obesity functions. To elucidate the molecular mechanism of shikonin-induced inhibition of adipogenesis, we analyzed the mRNA expression level of various adipogenesis-related factors including C/EBPs (CCAAT/enhancerbinding proteins) and $PPAR{\gamma}$ (peroxisome proliferator-activated receptor $\gamma$). The data showed that mRNA expressions of C/$EBP{\beta}$ and C/$EPB{\delta}$ were only slightly changed by shikonin treatment, but mRNA expressions of $PPAR{\gamma}$ and C/$EPB{\alpha}$ were significantly down-regulated. Then, we tested whether upstream regulators of C/$EBP{\beta}$ and $PPAR{\gamma}$ were involved in anti-adipogenesis of shikonin. C/$EBP{\gamma}$ and CHOP (C/EBP homologous protein), which are upstream regulators of C/$EBP{\beta}$, were not affected by shikonin treatment. On the contrary, the mRNA level of KROX20 was markedly down-regulated by shikonin treatment. These results suggest that KROX20 might regulate downstream factors of adipogenesis through C/$EBP{\beta}$-independent pathway. The expression of KLF15 (Kruppel-like factor15), which is a member of KLF family and is a upstream regulator of $PPAR{\gamma}$, was dramatically decreased by shikonin treatment, but KLF2 was not changed. Shikonin had no impact on the expression of KLF5 in the early stage of adipogenesis, but shikonin increased expression of KLF5 in the late stage of adipogenesis. Even though mRNA expression of KLF5 was moderately changed by shikonin treatment, its effect may be small compared with the effect of KLF15, which was markedly inhibited. Taken together, these results suggest that shikonin inhibits adipogenesis through the down-regulation of $PPAR{\gamma}$ and C/$EPB{\alpha}$, which is mediated by the down-regulation of two pro-adipogenic factors, KROX20 and KLF15.

Evaluation of Neoadjuvant Chemotherapy Effect in Osteosarcoma (골육종에서 술전 항암화학요법의 효과 판정)

  • Joo, Min Wook;Kang, Yong-Koo;Yoo, Ie Ryung;Choi, Woo Hee;Chung, Yang-Guk;Kim, Dong-Hyun;Kang, Jin-Woo
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.2
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    • pp.66-73
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    • 2014
  • Purpose: Various diagnostic imaging modalities have been used to evaluate the effect of neoadjuvant chemotherapy for osteosarcoma early and noninvasively. We evaluated the effectiveness of imaging studies of plain radiographs and positron-emission tomography/computed tomography (PET/CT) in predicting neoadjuvant chemotherapy effect for osteosarcoma and tried to establish a general principle in interpretation of PET/CT parameters. Materials and Methods: Eighteen patients who underwent two cycles of neoadjuvant chemotherapy and surgical excision for osteosarcoma were enrolled. There were 13 males and 5 females, with a median age of 19 (11-63) years. Fifteen patients of 18 had the American Joint Committe on Cancer (AJCC) stage IIB. They had plain radiographs and PET/CT before and after neoadjuvant chemotherapy. The resected tumor specimens were pathologically examined to determine histological response grade using a conventional mapping method. Statistical analysis was performed to evaluate the correlation between histopathological necrosis rate, and radiographic finding category, post-chemotherapy maximum standardized uptake value (SUVmax), average standardized uptake value and metabolic tumor volume (MTV) as well as reduction rates of them. Results: Eight patients were good responders to neoadjuvant chemotherapy based on histological evaluation. Median SUVmax reduction rate was 73 (23-77) % in good responders and 42 (-32-76) % in poor responders. Median MTV reduction rate was 93.5 (62-99) % in good responders and 46 (-81-100) % in poor responders. While radiographic finding category was not different according to histological response (p=1.0), SUVmax reduction rate was significantly different (p=0.041). Difference in MTV reduction rates approached statistical significance as well (p=0.071). Conclusion: While radiographic finding category was not reliable to assess neoadjuvant chemotherapy effect for osteosarcoma, reduction rate of SUVmax was a useful indicator in this study. As parameters of PET/CT can be influenced by various factors of settings, different centers have to make an effort to establish their own standard of judgement with reference of previous studies.

Study on Image Quality Assessment in Whole Body Bone Scan (전신 뼈검사에서의 영상 평가 연구)

  • Kwon, Oh Jun;Hur, Jae;Lee, Han Wool;Kim, Joo Yeon;Park, Min Soo;Roo, Dong Ook;Kang, Chun Goo;Kim, Jae Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.19 no.1
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    • pp.30-36
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    • 2015
  • Purpose Whole body bone scan, which makes up a largest percentage of nuclear medicine tests, has high sensitivity and resolution about bone lesion like osteomyelitis, fracture and the early detection of primary cancer. However, any standard for valuation has not yet been created except minimum factor. Therefore, in this study, we will analysis the method which show a quantitative evaluation index in whole body bone scan. Materials and Methods This study is conducted among 30 call patients, who visited the hospital from April to September 2014 with no special point of view about bone lesion, using GE INFINIA equipment. Enumerated data is measured mainly with patient's whole body count and lumbar vertabrae, and the things which include CNR (Contrast to Noise ratio), SNR (Signal to Noise ratio) are calculated according to the mean value signal and standard deviation of each lumbar vertabrae. In addition, the numerical value with the abdominal thickness is compared to each value by the change of scan speed and tissue equivalent material throughout the phantom examination, and compared with 1hours deleyed value. Completely, on the scale of ten, 2 reading doctors and 5 skilled radiologists with 5-years experience analysis the correlation between visual analysis with blind test and quantitative calculation. Results The whole body count and interest region count of patients have no significant correlation with visual analysis value throughout the blind test(P<0.05). There is definite correlation among CNR and SNR. In phantom examination, Value of the change was caused by the thickness of the abdomen and the scan speed. And The poor value of the image in the subject as a delay test patient could be confirmed that the increase tendency. Conclusion Now, a standard for valuation has not been created in whole body bone scan except minimum factor. In this study, we can verify the significant correlation with blind test using CNR and SNR and also assure that the scan speed is a important factor to influence the imagine quality from the value. It is possible to be some limit depending on the physiology function and fluid intake of patient even if we progress the evaluation in same condition include same injection amount, same scan speed and so on. However, that we prove the significant evaluation index by presenting quantitative calculation objectively could be considered academic value.

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Effects of Seeding Date on Growth, Yield, and Fatty Acid Content of Perilla Inter-cropped with Sesame in Central Korea (중부지역 참깨 간작 들깨 재배시 파종기가 수량 및 품질에 미치는 영향)

  • Kim, Young Sang;Kim, Ki Hyeon;Yun, Cheol Gu;Heo, Yun Seon;Kim, Ik Jei;Kim, Young-Ho;Song, Yong-Sup;Lee, Myoung Hee
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.66 no.2
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    • pp.138-145
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    • 2021
  • Perilla contains more than 60% of fatty acids. Linolenic acid is effective in preventing heart disease, improving learning ability, treating allergies, and preventing cancer. This study was carried out to improve the cultivation method to aid the stable production of perilla by developing a suitable inter-cropping system with sesame in the central region as well as to report a suitable planting time. The test results are summarized as follows. As the planting time of perilla in the inter-cropping system with sesame was delayed, the number of clusters and capsules decreased. The perilla yields in this system showed significant differences compared to that with the previous crops (sesame varieties) and planting period. The yield of perilla was significantly lower in the characteristic-Type B variety than in the characteristic-Type A variety and decreased significantly as the planting time was delayed. With regards to the quality characteristics of perilla, such as crude protein, crude fat, etc., there were no differences between previous perilla crops and those inter-cropped with sesame. The perilla composition did not show any difference during the planting period; however, with delay in the planting time, crude protein content increased but crude fat content decreased. Yield of perilla was 38% higher in a two-row (40 x 40 cm) system, compared to a single-row cultivation (110 x 20 cm) of perilla inter-cropped with sesame. These results suggest that the suitable method for inter-cropping perilla with sesame in the central region is to sow the characteristic-Type A variety in early May, and cultivate the perilla in two lines (40 x 40 cm) in mid-June. This was judged to be the best cultivation method in the central region.