• Title/Summary/Keyword: therapeutic factors

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Radiation Therapy for Operable Breast Cancer after Conservative Surgery (유방암환자의 유방보존수술 후 방사선 치료 성적)

  • Lee, Myung-Za;Chun, Ha-Chung
    • Radiation Oncology Journal
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    • v.20 no.4
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    • pp.309-315
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    • 2002
  • Purpose : To evaluate the result of conservative management on recurrence, survival and prognostic factors of patient with operable breast cancer. Materials and Methods : Fifty three patients, treated for localized breast cancer by lumpectomy or quadrantectomy followed by radiotherapy between January 1985 and December 1996, were retrospectively studied. All patients followed up for at least five years. Their median age was 43 years $(range\;24\~72)$. The tumor stages were as follows : T1 in 30 patients, T2 in 21, Tis in 2. Thirty-eight patients had negative and 15 had positive axillary nodes. The histological types were 42 infiltrating ductal, 2 infiltrating lobular, and 2 intraductal carcinomas with 7 other histologies. The tumor locations were the outer quadrant in 38 breasts, the inner quadrant in 13 and central in 2. Radiation doses of $46\~50\;Gy$ were given to the entire breast areas with additional doses of 14-18 Gy delivered to the tumor bed areas. Results : The overall five and 10 yea actuarial and disease free survivals were $94.3\%\;and\;92.4\%,\;91.2\%\;and\;81\%$, respectively. The overall five year survivals were $100\%$ in stage I and IIa, and $66.7\%$ in stage IIb and IIIa tumors. Seven patients failed either locally or distantly. Incidence of local failure and distant metastasis for the first failure were $7.5\%\;and\;5.7\%$, respectively. Local recurrence appeared within 2 years of treatment at the primary site and after more than 8 years outside of primary lesion, whereas distant metastasis appeared between 2 and 6 years following treatment. The overall recurrences were high at a young age (< or = 35 years), with 5 out of 12 (2 local, 3 distant), and in T2 lesions with 5 out of 21 (1 local, 3 distant, and 1 in both). Distant metastasis was high in the positive axillary lymph node group with 4 out of 15 $(26.6\%)$. A high incidence in the axillary node was noted at a young age with 7 out of 12 $(58.3\%)$ and in T2 lesions with 8 out of 21 $(38.4\%)$. A young age, positive axillary node and large tumor size were all related with poor survival. Conclusion : Based on this study, lumpectomy or quadrantectomy, followed by radiation appears to be an adequate therapeutic method in operable breast cancer. A long term follow-up is necessary because a recurrence of breast can occur long time after treatment. The poor prognostic group, especially young patients with an aggressive biological behavior needs more effective treatment modalities to improve their survival.

Analysis of Surgical Results for the Patients with Pulmonary Metastasis from Colorectal Carcinoma (대장암의 전이성 폐암의 수술 결과에 대한 분석)

  • Sim, Hyung-Tae;Kim, Yong-Hee;Shin, Hong-Ju;Chun, Mi-Sun;Bae, Chi-Hoon;Lee, Eung-Sirk;Park, Seung-Il;Kim, Dong-Kwan
    • Journal of Chest Surgery
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    • v.39 no.11 s.268
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    • pp.838-843
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    • 2006
  • Background: The lung is the most common site of metastatic colorectal cancer comprising 10% of all curative resection of colorectal cancer. The reported 5 year survival rate varies among institutions. The purpose of the present study was to present the retrospective analysis of colorectal metastatic lung cancer surgery at our institution. Material and Method: A total of 61 patients undergoing surgery for metastatic colorectal lung cancer between July 1996 and December 2003 were included in the present study. The stage of the primary colorectal cancer, site of pulmonary metastasis, method of lung resection, the number and size of the metastatic nodules, the recurrence rate, and survival were assessed. Result: The 3 and 5 year survival rates were 66% and 41%, respectively. No significant risk factors were identified among the studied variables by either univariate or multivariate analysis. The mean disease free survival rate was 17 months. The most common recurrent site was lung, and among these patients, 3 underwent a second operation and two are still alive. Conclusion: The results of the above data suggest that pulmonary resection of metastatic lung cancer in select patients after curative resection of colon cancer may be a good therapeutic option with the potential for excellent results.

Utility of Bone SPECT in Temporomandibular Joint Pain (악관절 동통 환자에서 Bone SPECT의 유용성)

  • Yang, Dong-Hunn;Sung, Mi-Sook;Lee, Jung-Whee;Chung, Soo-Kyo;Shinn, Kyung-Sub
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.3
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    • pp.388-394
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    • 1997
  • Temporomandibular (TM) joint Pain results from many etiologic factors. The aim of this study was to evaluate the utility of Bone SPECT in patients with TM joint pain. The subjects were 34 patients with TM joint pain. All patients underwent plain radiography, planar bone scan, and Bone SPECT The intensity of radioisotope uptake at TM joint was graded into three; no increased uptake above the background activity as grade 0, uptake similar to occipital bone as grade I, and uptake similar to maxillary sinus as grade II. Clinical findings and therapeutic methods were reviewed. Twenty-seven patients (80%) out of 34 patients with TM joint pain had increased uptake in bone SPECT. Twenty-one (78%) out of 27 patients had increased uptake in the mandibular condyle and remaining six patients (22%) had uptake in the mandibular and maxillary arch, which proved to be dental problem. Seven patients (21%) out of 34 were grade as 0, four (12%) were grade I, 23 (68%) were grade II. Four patients with grade I had clicking sound and symptoms which were subsided with medication in all cases. Among 23 patients with grade II, 7 patients had clicking sound and 14 patients underwent medication and decompression therapy. With Planar bone scan, 11 cases (32%) had increased uptake in TM joint area. Plain radiography revealed narrowing, distension, erosion and limitation of TM joint in 16 cases (47%). Bone SPECT can be valuable for screening and managing the patients with TM joint pain. Patients with grade II needed intensive treatment such as joint aspiration. However degree of the radioisotope uptake did not well correlated with clinical symptoms.

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Clinical Observation on C.V.A with Diabetes Mellitus (당뇨병(糖尿病) 환자(患者)에 병발(倂發)된 뇌졸중(腦卒中)의 임상적(臨床的) 고찰(考察))

  • Yoon, Cheol-Ho;Seo, Un-Kyo;Jeong, Ji-Cheon
    • The Journal of Internal Korean Medicine
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    • v.15 no.1
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    • pp.22-44
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    • 1994
  • Clinical observations were done on 67 cases with Diabetes Mellitus in CVA patients who were confirmed by CT scan and observed for over 1 week, admitted to the Dept. of Internal Medicine in Oriental Medical Hospital of Dongguk University from January 1992 to December 1993. The results were as follows; 1. 86 patients (15.3%) with Diabetes Mellitus were found in 561 CVA patients, the 6th decade of age was 40.2%, the ratio of male to female was 0.72:1. 2. The local distribution of CVA was similar to common CVA, and occlusive CVD was 83.6%, cerebral hemorrhage was 16.4% in this study. 3. The association between blood glucose and years were not significant. The largest ratio of fasting blood glucose were 140-199 mg/dl (44.6%) in admission, below 139 mg/dl (51.8%) in discharge in case of occlusive CVD. In cerebral hemorrhage, that were 140-199 mg/dl(45.5%) in dmission, below 139 mg/dl (45.5%) in discharge. The largest ratio of pp2hrs blood glucose were 200-299mg/dl in admission and discharge both occlusive CVD and cerebral hemorrhage. 4. The total sensitivity of urine glucose was 71.6%, and sensitivity of urine glucose in cerebral hemorrhage (81.8%) was more higher than that of occlusive CVD (69.6%). 5. Below 4 years had the highest prevalence(44.8%) in duration of diabetes mellitus. Patients usually used oral hypoglycemic agents(41.8%), insulin injection(23.9%) treatment and non-therapeutic was 17.9% in this study. 6. Predisposing factors and symptoms in admissin were similar to common CVA. The conscious disturbance on attacck was 41.1% in occlusive CVD, and that was 63.7% in cerebral hemorrhage. 7. The most common ratio of the season's attack was spring (44.8%), 8. The frequency of post history was as follows, hypertension (44.8%), heart disease (10.4%), and they were in below 199 mg/dl (83.3%) of fasting blood glucose. 9. The family history of CVA was 46.3%, and they was higher than nondiabetic patients. 10. The recurrence rate of CVA was 28.4%, and that of occlusive CVD(28.6%) was higer than cerebral hemorrhage's (18.2%). 11. The smoker was 52.2%, the drinker was 38.9%. 12. The complications was occured in 10 cases (14.9%) after admission, and they frequently occured than common CVA. 13. In admission, the ratio of systolic blood pressure in over l60mmHg was 42.9%, that of diastolic blood pressure in over l00mmHg was 12.5% in occlusive CVD. In cerebral hemorrhage, the ratio of systolic blood pressure in over l60mmHg was 54.5%, that of diastolic blood pressure in over l00mmHg was 27.3%. 14. The average beginned time of physical theraphy was, generally lated, 8.3 days in occlusive CVD, 11.2 days in cerebral hemorrhage. Average admitted period was longer than common CVA, and was 29.2 days in occlusive CVD, 11.2 days in cerebral hemorrhage. 15. The degree of recovery were 82.1% in occlusive CVD, 72.7% in cerebral hemorrhage. 16. The herb medications were various Sunghyanggeonggisans, Sopungtang, Ganghwalyupungtang, Yanggyuksan etc. were used most frequently, and Yukmijihwangtang, Gamidaebotang, Mangeumtang etc. were used as discharge.

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Antioxidant and Inhibition on Angiotensin Converting Enzyme Activity of Colored Potato Extracts (유색감자 추출물의 항산화 및 항고혈압 활성)

  • Park, Young-Eun;Cho, Huyn-Mook;Lee, Hyeon-Jin;Hwang, Young-Sun;Choi, Su-San-Na;Lee, Su-Jin;Park, Eun-Sun;Lim, Jung-Dae;Choung, Myoung-Gun
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.52 no.4
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    • pp.447-452
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    • 2007
  • This experiment was conducted to enhance the colored potatoes utilization and to determine the biological activity of colored potato extracts. In order to understand the factors responsible for the potent antioxidant and antihypertensive ability of colored potatoes, it has been evaluated for anti-oxidative activity using Fenton's reagent/ethyl linoleate system and for free radical scavenging activity using the 1,1-diphenyl-2-picryl hydrazyl free radical generating system. There were significant differences of antioxidant activities in $50{\mu}g/mL$ extracts treatment among different colored potatoes. About two-fold higher radical scavenging activity was found in 'Daegwan 1-102', 'Daegwan 1-104' and 'Jasim' compared to that in 'Superior'. Based on the flesh color tested, potatoes with purple tuber showed higher radical scavenging activity than red potatoes, while white potato showed the lowest radical scavenging activity. The ability of 80% ethanol extracts from colored potatoes to influence the inhibitory activity of angiotensin converting enzyme(ACE) and xanthine oxidase(XOase) has also been investigated. Expect 'Jasim', the high levels of inhibition activity of xanthine oxidase in two colored potatoes such as 'Daegwan 1-102' and 'Daegwan 1-104' were highly correlated to $IC_{50}$ values of ACE inhibition activity. The various therapeutic benefit claims in the new functional medicinal usage of colored potatoes ascribed to the phenolic compounds and anthocyanin. This result revealed that the extracts of colored potatoes are expected to be good candidate for development into source of free radical scavengers and anti-hypertentive agent.

Induction of Midbrain Dopaminergic Phenotype in Nurr 1-Over expressing Human Neural Stem Cells (사람 신경 간세포에서 도파민 신경세포 분화유도에 대한 Nurr 1 유전자의 역할 규명)

  • Kim, Han-Jip;Lee, Haksup;Kim, Hyon-Chang;Min, Churl-Ki;Lee, Myung-Ae;Kim, Seung-Up;Han, Jin;Youm, Jae-Boum;Kim, Nari;Park, Won, Sun;Kim, Taeho;Kim, Euiyong;Han, Il-Yong
    • KSBB Journal
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    • v.20 no.5 s.94
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    • pp.363-370
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    • 2005
  • Neural stem cells (NSCs) of the central nervous system (CNS) have raised a great interest not only for their importance in basic neural development but also for their therapeutic potentials in neurologically degenerative diseases such as Parkinson's, Alzheimer and stroke. During the CNS development, two molecular cascades determine specification of midbrain dopamine system. In one pathway, FGF-8, sonic hedgehog and transcription factor Nurr1 specify dopamine neurotransmitter phenotype. In the other, transcription factors $Lm{\times}lb\;and\;Pt{\times}3$ are required for induction of dopaminergic neurons. In Nurr1 knockout mouse, tyrosine hydroxylase (TH) positive cells fail to appear in substantia nigra, indicating that Nurr1 is essential in specification of dopaminergic cell phenotype. In this study, we used the immortalized human NSCs retrovirally transduced with Nurr1 gene to probe the Nurr1 mediated mechanism to induce dopamine phenotype. While Nurr1 over-expression alone did not generate dopamine phenotype in NSCs, applications of retinoid and forskolin induced expression of TH and AADC mRNAs. In addition, co-cultures of Nurr1 expressing NSCs with human astrocytes induced a marked increase of TH expression. In this co-culture system, the addition of retinoid and forskolin dramatically increased expression of TH. These results indicate that the immortalized human NSCs with Nurr1 gene could have a clinical utility for cell replacement for the Parkinson patients.

Ethanol Extract of Schisandra chinensis (Turcz.) Baill. Reduces AICAR-induced Muscle Atrophy in C2C12 Myotubes (마우스 C2C12 근관세포에서 AICAR로 유도된 근위축에 미치는 오미자 추출물의 영향)

  • Kang, Young-Soon;Park, Cheol;Han, Min-Ho;Hong, Su-Hyun;Hwang, Hye-Jin;Kim, Byung Woo;Kim, Cheol Min;Choi, Yung Hyun
    • Journal of Life Science
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    • v.25 no.3
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    • pp.293-298
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    • 2015
  • Muscle atrophy, known as a sarcopenia, is defined as a loss of muscle mass resulting from a reduction in the muscle fiber area or density due to a decrease in muscle protein synthesis and an increase in protein breakdown. Schisandrae fructus (SF) extract of the fruits of Schisandra chinensis (Turcz) Baillon has been used as a tonic in traditional medicine for thousands of years. Although a great deal of work has been carried out on the therapeutic potential of SF, its pharmacological mechanisms of action in muscle diseases actions remain unclear. In the present study, we investigated the inhibitory effects of SF ethanol extracts on the production of muscle atrophy factors in C2C12 myotubes stimulated with 5-aminoimidazole-4-carboxamide-ribonucleotide (AICAR), an AMP-activated kinase (AMPK) activator, and sought to determine the underlying mechanisms of action. AICAR upregulated atrophy-related ubiquitin ligase muscle RING finger-1 (MuRF-1) and stimulated the levels of the forkhead box O3a (FoxO3a) transcription factor in the C2C12 myotubes. SF supplementation effectively and concentration- dependently counteracted AICAR-induced muscle cell atrophy and reversed the increased expression of MuRF-1 and FoxO3a. Our study demonstrates that SF can reverse the muscle cell atrophy caused by AICAR through regulation of the AMPK and FoxO3a signaling pathways, followed by inhibition of MuRF-1.

Radiotherapy for Locoregional Recurrent Cervix Cancer after Surgery (수술후 국소 재발된 자궁경부암의 방사선 치료)

  • Yang, Mi-Gyoung
    • Radiation Oncology Journal
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    • v.12 no.3
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    • pp.377-386
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    • 1994
  • Purpose: The role of radiotherapy in the management of patients with locoregional recurrent cervix cancer after radical surgery were retrospectively analyzed. Methods and materials: Twenty-eight patients treated with radiotherapy for locoregional recurrence after primary surgery for carcinoma of the cervix between 1989 and 1993 were analyzed. The median follow-up of survivors was 15 months (ranged 7-43 months). Eight patients had their disease confined to the vagina and 19 patients($68\%$) had pelvic mass as part of their locoregional recurrent disease. Within 24 months after the initial surgery, $82\%$ of recurrences manifested themselves. All patients had whole pelvic irradiation with or without intracavitary radiotherapy(ICR). Results: Complete response(CR) was achieved in 18 patients($54\%$). Five of eighteen patients($28\%$) with initial CR developed second locoregional recurrence. Response to radiotherapy correlated strongly with tumor volume, site of recurrence and total radiation dose. The overall 2 year survival rate was $43\%$ and the disease free survival was $31\%$. Survival rate was significantly influenced by the factors of interval from operation to recurrence, size and site of recurrent tumor, radiation dose, response of radiotherapy, lymph node status as initial presentation, The principal cause of death was lung metastasis($36\%$). Conclusion: Radiotherapy is an excellent modality for control of locoregional recurrent cervix cancer. To improve local control and survival rate, whole pelvic external radiotherapy in addition to ICR with more than 75.0Gy at the depth of 1.0cm from vaginal mucosa is needed and frequent follow up and early detection of recurrence is suggested as well.

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The Role of Radiotherapy in the Management of Supratentorial Low Grade Astrocytoma (천막 상부 저분화 성상세포종의 치료에 있어 방사선 치료의 역할)

  • Lee, Kyung-Ja;Chang, Hye-Sook;Song, Mi-Hee
    • Radiation Oncology Journal
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    • v.15 no.1
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    • pp.1-10
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    • 1997
  • Purpose : To evaluate the role of radiotherapy in the management of incompletely resected supratentorial low grade astrocytoma with the analysis of the survival, the Pattern of failure, and the prognostic variables affecting survival. Material and methods : Between January 1990 and December 1995, fifty-one patients with supratentorial low grade astrocytoma received radiotherapy after subtotal resection(16 patients) or stereotactic biopsy(35 patients) at Asan Medical Center, External radiotherapy was done by conventional fractionation with the total dose of 4820cGy to 6000cGy(median 5580cGy) and partial brain volume. The follow-up was done from 6 to 79 months(median 48 months) Result : Overall actuarial survival rate at 2 and 5 years were $83.4\%\;and\;54.8\%$, respectively. Progression free survival at 2 and 5 years were $67.4\%\;and\;48.7\%$, respectively The significant prognostic factors affecting overall survival rate were the performance status, 1 stage, histologic subtype, radiation field and radiation response. The major pattern of failure was local failure, such as Progressive disease and primary site recurrence in 23 patients $(45.1\%)$. Progression free survivors excluding 2 patients were physically and intellectually intact without major neurologic deficit. Conclusion : Although the follow-up period of this study was relatively short, overall actuarial and progression free survival rate were encouraging. Patients with good performance status, lower T stage, pilocytic subtype, patients treated with small radiation field and radiation responder showed better survival. As the local failure was the major pattern of failure, the various efforts to decrease the local failure is necessary.

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Recent Advancement in the Stem Cell Biology (Stem Cell Biology, 최근의 진보)

  • Harn, Chang-Yawl
    • Journal of Plant Biotechnology
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    • v.33 no.3
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    • pp.195-207
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    • 2006
  • Stem cells are the primordial, initial cells which usually divide asymmetrically giving rise to on the one hand self-renewals and on the other hand progenitor cells with potential for differentiation. Zygote (fertilized egg), with totipotency, deserves the top-ranking stem cell - he totipotent stem cell (TSC). Both the ICM (inner cell mass) taken from the 6 days-old human blastocyst and ESC (embryonic stem cell) derived from the in vitro cultured ICM have slightly less potency for differentiation than the zygote, and are termed pluripotent stem cells. Stem cells in the tissues and organs of fetus, infant, and adult have highly reduced potency and committed to produce only progenitor cells for particular tissues. These tissue-specific stem cells are called multipotent stem cells. These tissue-specific/committed multipotent stem cells, when placed in altered environment other than their original niche, can yield cells characteristic of the altered environment. These findings are certainly of potential interest from the clinical, therapeutic perspective. The controversial terminology 'somatic stem cell plasticity' coined by the stem cell community seems to have been proved true. Followings are some of the recent knowledges related to the stem cell. Just as the tissues of our body have their own multipotent stem cells, cancerous tumor has undifferentiated cells known as cancer stem cell (CSC). Each time CSC cleaves, it makes two daughter cells with different fate. One is endowed with immortality, the remarkable ability to divide indefinitely, while the other progeny cell divides occasionally but lives forever. In the cancer tumor, CSC is minority being as few as 3-5% of the tumor mass but it is the culprit behind the tumor-malignancy, metastasis, and recurrence of cancer. CSC is like a master print. As long as the original exists, copies can be made and the disease can persist. If the CSC is destroyed, cancer tumor can't grow. In the decades-long cancer therapy, efforts were focused on the reducing of the bulk of cancerous growth. How cancer therapy is changing to destroy the origin of tumor, the CSC. The next generation of treatments should be to recognize and target the root cause of cancerous growth, the CSC, rather than the reducing of the bulk of tumor, Now the strategy is to find a way to identify and isolate the stem cells. The surfaces of normal as well as the cancer stem cells are studded with proteins. In leukaemia stem cell, for example, protein CD 34 is identified. In the new treatment of cancer disease it is needed to look for protein unique to the CSC. Blocking the stem cell's source of nutrients might be another effective strategy. The mystery of sternness of stem cells has begun to be deciphered. ESC can replicate indefinitely and yet retains the potential to turn into any kind of differentiated cells. Polycomb group protein such as Suz 12 repress most of the regulatory genes which, activated, are turned to be developmental genes. These protein molecules keep the ESC in an undifferentiated state. Many of the regulator genes silenced by polycomb proteins are also occupied by such ESC transcription factors as Oct 4, Sox 2, and Nanog. Both polycomb and transcription factor proteins seem to cooperate to keep the ESC in an undifferentiated state, pluripotent, and self-renewable. A normal prion protein (PrP) is found throughout the body from blood to the brain. Prion diseases such as mad cow disease (bovine spongiform encephalopathy) are caused when a normal prion protein misfolds to give rise to PrP$^{SC}$ and assault brain tissue. Why has human body kept such a deadly and enigmatic protein? Although our body has preserved the prion protein, prion diseases are of rare occurrence. Deadly prion diseases have been intensively studied, but normal prion problems are not. Very few facts on the benefit of prion proteins have been known so far. It was found that PrP was hugely expressed on the stem cell surface of bone marrow and on the cells of neural progenitor, PrP seems to have some function in cell maturation and facilitate the division of stem cells and their self-renewal. PrP also might help guide the decision of neural progenitor cell to become a neuron.