Introduction : Diffuse interstitial lung diseases (DILD) comprise of a large group of lung diseases with diverse etiologies. They are classified into four categories based on the etiology and pathological findings. In Korea, epidemiological data on DILD has never been reported in a prospective manner. Method : From May 2002 to April 2004, total 487 patients with DILD were prospectively registered at Samsung Medical Center. The prospective observational analysis of the etiologies, its classification based on 2002 ATS/ERS (American Thoracic Society/European Respiratory Society) guidelines, as well as diagnostic tests and the retrospective analysis of the treatment modalities were carried out. Any infectious and malignant causes were excluded. Results : 1) The patients were classified into idiopathic interstitial pneumonia (IIP) in 269 patients (55.2%), known causes of DILD in 168 patients (34.5%), sarcoidosis in 27 patients (5.5%), other forms of DILD in 14 patients (2.9%), and undetermined DILD in 9 patients (1.9%). 2) The diagnostic test showed that most patients had undergone chest high resolution computed tomography (HRCT) and pulmonary function test (PFT) (97%, 89%). Transbronchial lung biopsy (TBLB) and surgical lung biopsy (SLB) were performed in limited patients (38%, 29%). 3) Among 269 patients with IIP, 220 (82%) had idiopathic pulmonary fibrosis (IPF) while 23 (9%) had nonspecific interstitial pneumonia. SLB was carried out in 36% of patients with IIP. 4) Symptomatic supportive care was given to 67% of IPF, but specific medical treatment including corticosteroids was administered to 89% of non-IPF patients. Conclusion : A nationwide registry of DILD patients is required to determine the annual incidence, etiology, and practice pattern of diagnosis and treatment in Korea.
Park, So-Yung;Kim, Yun-Min;Lee, Hyun-Bok;Cho, Nam-Soo;Yoon, Joon
Journal of radiological science and technology
/
v.36
no.2
/
pp.149-155
/
2013
The Korean Thyroid Association recommends fine-needle aspiration biopsy (FNAB) for nodules more than 0.5 cm in diameter. But nodules, smaller than 0.5 cm have been found in papillary carcinomas of the thyroid (PTC) at the health promotion center at SMC. We wanted to evaluate the ultrasonographic findings according to size of nodule in proven PTCs by FNAB, especially less than 0.5 cm. All nodules were classified into three groups by their longest diameter : less than 0.5 cm, more than 0.5 cm but less than 1 cm, and more than 1 cm. Sonographic findings suggesting malignancy were analyzed according to their size groups. Of 288 malignant nodules, 21.5 % (62/288) were less than 0.5 cm, 54.9 % (158/288) were more than 0.5 cm but less than 1 cm, 23.6 % (68/288) exceeded 1 cm. A taller-than-wide shape was observed in 90.3 % (56/62) of nodules less than 0.5 cm, and 48.5 % (33/68) of nodules exceeding 1 cm (p<0.001). There were no well-defined smooth nodules among nodules less than 0.5 cm, and spiculated or irregular margin nodules increased as the size increased (p=0.024). Nodules of size less than 0.5 cm did not showed hyper or isoechogenicity. Hypoechogenicity was greater than the marked hypoechogenicity in each group (p=0.034). Micro- or macro-calcifications were not founded in 77.4 % (48/62) of the nodule group sized less than 0.5 cm. From the small size of the group, micro- or macrocalcifications were observed 21.0 % (13/62), 48.1 % (76/158), 64.7 % (44/68), so the number of nodules containing micro- or macro-calcification increased as size increased (p<0.001). PTCs less than 0.5 cm in size on ultrasonography had taller than-wide shape, spiculated or irregular and ill-defined margins, and exhibited hypo and markedly hypoechogenicity, but microor macro-calcifications were not common. These ultrasonographic features of nodules less than 0.5 cm can be useful in reporting and guiding FNABs or follow-up exams.
Purpose: The studied the effect of such variables as the symptom improvement rate, survival and prognostic factors on the treatment results of radiation therapy for Superior Vena Cava Syndrome (SVCS). Materials and Methods: From 1988 to 2003, seventy two patients with SVCS were treated with radiation therapy at the Department of Radiation Oncology, Keimyung University Dongsan Medical Center. The patients' ages ranged from 10 to 83 years old with the median age being 61, and sixty four patients were male. For the causes of the SVCS, 64 patients had lung cancer, four had metastatic lung cancer, two had malignant lymphoma and two had thymoma. The radiotherapy was delivered with 6-MV X-rays and all patients received above 900 cGy up to 6,600 cGy, with the median dose being 4,000 cGy The follow-up periods were from 1 to 180 months with a median of 5.6 months. Results: The main clinical manifestations were dyspnea ($84.7\%$), facial edema ($81.9\%$), arm edema ($22.2\%$), neck vein distension ($25\%$), hoarseness ($12.5\%$) and facial plethora ($5.6\%$). Eighty percent of patients achieved excellent to good symptom improvement and $19.4\%$ experienced minimal improvement. The median survival period was 5.1 months, and overall survival rates were $17.7\%$ at 2 years (2YOS) and $14.8\%$ at five years (5YOS) for all the patients. The median survival period, the two and five year disease free survival rates were 4.3 months, $16.7\%$ and $13.4\%$ for the lung cancer patients, respectively. The total tumor dose was a statistically significant survival factor on the univariate analysis for the patients with lung cancer (2YSR; > 30 Gy, $25.6\%$, $\leq$ 30 Gy $6.7\%$, p<0.01). On the multivariated analysis, a higher total tumor dose (p<0.01) and younger age (p<0.05) were statistically significant factors of survival for the lung cancer patients. Patients with NSCLC showed better survival than did the patients with SCLC, but this was not statistically significant (p > 0.05), Conclusion: Radiation therapy for the patients with SVCS due to malignancy could be an effective treatment. We considered that radiation therapy above 30 Gy of the total tumor dose may improve survival for SVCS due to lung cancer.
Purpose : Conservative management of multicystic dysplastic kidney(MCDK) without nephrectomy has recently been advocated. The purpose of this study was to determine the clinical course of conservatively managed MCDK and to find out possible predictive factors for involution of MCDK by ultrasonography(US). Methods : A retrospective analysis was made on 45 patients(26 boys and 20 girls) in whom MCDK was detected and had been traced by US between Dec. 1993 and Aug. 2005 at Severance Hospital. Results : Median follow-up time was 30 months(range 2-102 months). All patients under-went radionuclide scans and voiding eystourethrograms. The serial follow-up US showed complete involution in 11(24%), partial involution in 19(41%), and no interval change or increased in cyst size in 13(28%) patients. Nephrectomy was done in 3 patients(7%) due to relapsing urinary tract infection(UTI) and severe abdominal distension. The mean age of complete involution of MCDK was 37 months(range 12-84 months). Episodes of UTI were present in 17 patients(37%) and additional genitourinary(GU) abnormalities were found in 22 patients(44%). Hypertension and renal insufficiency was complicated in one patient. No child developed malignant tumor. Univariate analysis showed that five variables were associated with complete involution of the MCDK; gender, site, UTI episode, additional GU abnormalities, and renal length on initial US. After adjusting using the Pearson model, the presence of additional GU abnormalities was exclusively associated with complete involution among the 5 variables(P=0.034). Conclusion : In our review of 46 cases of MCDK, non-surgical approach for patients with MCDK was advisable and we could predict poor prognosis when MCDK is associated with other GU anomalies.
Osteosarcoma (OS) is the most common and malignant bone tumors. Although many types of resection surgery and experimental agents were developed, median survival and clinical prognosis are poorly investigated. Recently, several researches have reported that Eucheuma cottonii has potent as protective effects of coal dust-induced lung damage via inhibition of malondialdehyde (MDA) and oxidative stress in bronchoalveolar lavage fluids (BALF). However, anti-cancer effects and specific molecular mechanism of extract from Eucheuma cottonii (EE) has not been clearly studied yet. This study evaluated that anti-cancer potential of EE in human osteosarcoma Saos-2 cells. EE indicated cytotoxicity on Saos-2 cells in a dose-dependent manner. Morphological degradation and nucleic condensation were also observed under the EE treatment. However, it did not significantly affect on non-cancerous kidney HEK-293 cells under the same concentration which is shown cytotoxicity on Saos-2 cells. The phosphorylation of Fas-Associated Death Domain (FADD) and expression of cleaved caspase-8, -7 and -3 were upregulated in a dose-dependent manner. In immunofluorescence staining, expression level of Fas and cleaved PARP were upregulated by EE treatment. Furthermore, treatment of EE induces upregulation of sub G1 phase by flow cytometry analysis. The results demonstrated that EE has a therapeutic potential against osteosarcoma via FADD mediated caspase cascade apoptosis signal pathway.
Purpose: The measurement of radiation absorbed dose is useful to predict the response after I-131 labeled metaiodobenzylguanidine (MIBG) therapy and determine therapy dose in patients with unresectable or malignant pheochromocytoma. We estimated the absorbed dose in tumor tissue after high dose I-131 MIBG in a patient with pheochromocytoma using a gamma camera and Medical Internal Radiation Dose (MIRD) formula. Materials and Methods: A 64-year old female patient with pheochromocytoma who had multiple metastases of mediastinum, right kidney and periaortic lymph nodes, received 74 GBq (200 mCi) of I-131 MIBG. We obtained anterior and posterior images at 0.5, 16, 24, 64 and 145 hours after treatment. Two standard sources of 37 and 74 MBq of I-131 were imaged simultaneously. Cummulated I-131 MIBG uptake in tumor tissue was calculated after the correction of background activity, attenuation, system sensitivity and count loss at a high count rate. Results: The calculated absorbed radiation dose was 32-63 Gy/ 74 GBq, which was lower than the known dose for tumor remission (150-200 Gy). follow-up studies at 1 month showed minimally reduced tumor size on computed tomography, and mildly reduced I-131 MIBG uptake. Conclusion: We estimated radiation absorbed dose after therapeutic I-131 MIBG using a gamma camera and MIRD formula, which can be peformed in a clinical nuclear medicine laboratory. Our results suggest that the measurement of radiation absorbed dose in I-131 MIBG therapy is feasible as a routine clinical practice that can guide further treatment plan. The accuracy of dose measurement and correlation with clinical outcome should be evaluated further.
Woo, Hye Kyung;Cho, Kyung-Keun;Rha, Hyung Kyun;Lee, Kyung Jin;Park, Sung Chan;Cho, Jung Ki;Park, Hea Kwan;Kang, Joon Ki;Choi, Chang Rak
Journal of Korean Neurosurgical Society
/
v.30
no.sup2
/
pp.189-196
/
2001
Objective : We tested the hypothesis that photodynamic therapy(PDT) with Photofrin inhibits tumor invasion of U87 human glioma cells using several in vitro assay to measure tumor invasiveness. The effects of PDT on cell growth, directional migration and cell invasion were investigated. Material and Method : Tumor cells were treated with Photofrin at various doses and at a fixed optical(632nm) dose of $100mJ/cm^2$. Cytotoxicity was tested using the MTT method. Invasion assays including the matrigelartificial basement membrane barrier migration and spheroid confrontation with confocal microscopic analysis were used to study the relationship between PDT and invasiveness. Result : U87 cells showed a dose dependent cytotoxic response to increasing Photofrin dose. Data from the matrigel artificial basement membrane assay indicate that PDT inhibits the U87 cell migration dose dependently. Low doses of subcytotoxic PDT treatment, such as 2.5ug/ml Photofrin dose, also appeared to significantly inhibit migration of U87 cells(p<0.05). In co-cultures between U87 cell spheroids and brain aggregates, progressive invasion with destruction of the brain aggregate occurs. The extent of tumor cell infiltration and proportion or intact brain aggregate remaining after 24h differs in Photofrin PDT treated versus Photofrin only control, with changes suggestive of a dose-response effect. Conclusion : our data indicate that PDT with Photofrin significantly inhibits the invasiveness of U87 cells, and this inhibition is dose dependent.
The purposes of this study is to calculate the gender-based Life Expectancy and Disability Free Life Expectancy of 65-year-olds in accordance with the regions of 16 in Korea based on the years 2005 and 2010 by using the Sullivan method. We used the Census in 2005, 2010, the Korea National Statistical Office(10% sample). We also reviewed examining the changes in LE and DFLE and understanding the relevance between the DFLE of 65-year-olds of the year 2010 and related factors. As a result of this study, it was shown that the LE of the group of all 65-year-old in Korea increased from 18.15 years in 2005 to 19.75 years in 2010 and DFLE increased from 11.41 years in 2005 to 11.64 years in 2010. Regionally, the highest LE for total of 65-year-olds was found to be the entire Jeju area and DFLE was the highest in the city of Seoul. And the highest LE and the highest DFLE for 65-year-old male were found to be in the city of Seoul. Regarding the regional LE of 65-year-old female, both in 2005 and 2010 Jeju area was seen to be the highest. The results of a correlation analysis showed that the DFLE of 65-year-olds in 2010 was found to be increasing with high LE and high population density and in regions with low average temperatures, low number of beds and low age standardized death rates of malignant neoplasms and circulatory disease.
The purpose of this study was to compare the FA(faractional anisotropy) and ADC(apparent diffusion coefficient) values, which were derived from diffusion tensor imaging in breast cancer patients. The diffusion gradient used in this study was derived from quantitative diffusion indices using 20 directions(b-value, 0 and $1,000s/mm^2$). Quantitative analysis was analyzed using Pearson's correction and qualitative analysis using for correction coefficients. As a result, $FA_{min}$, $FA_{mean}$ and $FA_{max}$ were $0.098{\pm}0.065$, $0.302{\pm}0.142$ and $0.634{\pm}0.236$, respectively(p > 0.05). The $ADC_{min}$, $ADC_{mean}$ and $ADC_{max}$ were $0.741{\pm}0.403$, $1.095{\pm}0.394$ and $1.530{\pm}0.447$, respectively(p > 0.05). The $FA_{min}$, $FA_{mean}$, and $FA_{max}$ mean values were $0.132{\pm}0.050$, $0.418{\pm}0.094$, and $0.770{\pm}0.164$ for Category 6 and Kinetic Curve Pattern III, respectively. $ADC_{min}$, $ADC_{mean}$, and $ADC_{max}$ were $0.753{\pm}0.189$, $1.120{\pm}0.236$, and $1.615{\pm}0.372$, respectively. Quantitative analysis showed negative correlation between $ADC_{mean}-FA_{mean}$ and $ADC_{max}-FA_{max}$(p = 0.001, 0.003). The qalitative analysis showed ADC 0.628(p = 0.001), FA 0.620(p = 0.001) in the internal evaluations, ADC 0.677(p = 0.001), FA 0.695(p = 0.001) in external evaluations. In conclusion, based on the morphological examination, time to signal intensity graph is the form of wash-out(pattern III) in the dynamic contrast enhance examination, As a result, the $ADC_{mean}$$1.120{\pm}0.236$ and $FA_{mean}$ values were $0.032{\pm}0.142$ with a negative correlation (Y=1.44-1.12X). Therefore, If we understand the shape of time to signal intensity graph and the relationship between ADC and FA, It will be a criterion for distinguishing malignant diseases in breast cancer.
Cervical cancer is the fourth most common malignant neoplasm in women worldwide. Most cases of cervical cancer are caused by an infection by the human papillomavirus. Molecular diagnostic methods have emerged to detect the HPV for sensitivity, specificity, and objectivity. In particular, real-time PCR has been introduced to acquire a more sensitive target DNA or RNA. RNA extraction and complementary DNA synthesis are proceeded before performing real-time PCR targeting RNA. To identify an adequate and sensitive cDNA synthesis kit, this study evaluated the two commonly used kits for cDNA synthesis. The results show that the $R^2$ and efficiency (%) of the two cDNA synthesis kits were similar in the cervical cancer cell lines. On the other hand, the Takara kit compared to Invitrogen kit showed P<0.001 in the $10^2$ and $10^3$ SiHa cell count. The Takara kit compared to the Invitrogen kit showed P<0.001 in the $10^1$ and $10^2$ HeLa cell count. Furthermore, 8, 4, 2, 1, and 0.5 ml of forty exfoliated cell samples were used to compare the cDNA synthesis kits. The Takara kit compared to the Invitrogen kit showed P<0.01 in 8, 4, and 1 ml and P<0.05 in 0.5 mL. The study was performed to identify the most appropriate cDNA synthesis kit and suggests that a cDNA synthesis kit could affect the real-time PCR results.
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