• Journal of Chest Surgery
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• v.32 no.6
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• pp.536-542
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• 1999

Background: The purpose of this study is to improve the quality of the diagnostic procedures in the preoperative evaluation so as to reduce the unnecessary thoracotomy and to ensure resectability in non-small cell lung cancer. Material and Method: Of 616 patients who underwent thoracotomy for primary lung cancer from January 1990 to December 1996, 59 patients(9.6%) turned out to have inoperable lesions after the thoracotomy. We reprospectively reviewed the bronchoscopic findings, methods of tissue diagnosis, CT scans, pulmonary function test and lung perfusion scan, reasons for nonresectability, and adjuvant therapy, and then followed up on the survival rate after exploratory thoracotomy. Result: The cell types were squamous cell carcinoma in 38, adenocarcinoma in 15, large cell carcinoma in 3 and others in 3. Primary loci were RUL in 20, RML in 6, RLL in 8, LUL in 13, LLL in 4 and others in 8. The reasons for non-resectability were various; direct tumor invaison to mediastinal structures(n=41), seeding on pleural cavity(n=8), poor pulmonary function(n=2), invasions to extranodal mediastinal lymph node(n=2), technical non- resectability due to extensive chest wall invasion (n=3), small cell carcinoma (n=1), malignant lymphoma(n=1), and multiple rib metastases(n=1). In the follow-up of 58 patients, 1-year survival rate was 55.2% and 2-year survival rate was 17.2% and the mean survival time was 14 months. When compared according to cell types or postoperative adjuvant therapeutic modalities, no significant difference in the survival rates were found. The squamous cell carcinoma was frequently accompanied by local extension to contiguous structures and was the main cause of non-resectability. In adenocarcinoma, pleural seeding with malignant effusion was frequently encountered, and was the major reason for non-resectability. Conclusion: These data revealed that if appropriate preoperative diagnostic tools had been available, many unnecessary thoracotomies could have been avoided. Both the use of thoracoscopy in selected cases of adenocarcinoma and the more aggressive surgical approach to the locally advanced tumor could reduce the incidence of unnecessary thoracotomies for non-small cell lung cancers.

• Tuberculosis and Respiratory Diseases
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• v.67 no.2
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• pp.95-104
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• 2009

Background: The pathophysiologic mechanisms of early acute lung injury (ALI) differ according to the type of primary insult. It is important to differentiate between direct and indirect pathophysiologic pathways, and this may influence the approach to treatment strategies. NF-$\kappa$B decoy oligodeoxynucleotide (ODN) is a useful tool for the blockade of the expression of NF-$\kappa$B-dependent proinflammatory mediators and has been reported to be effective in indirect ALI. The purpose of this study was to investigate the effect of NF-$\kappa$B decoy ODN in the lipopolysaccharide (LPS)-induced direct ALI model. Methods: Five-week-old specific pathogen-free male BALB/c mice were used for the experiment. In the preliminary studies, tumor necrosis factor (TNF)-$\alpha$, interleukine (IL)-6 and NF-$\kappa$B activity peaked at 6 hours after LPS administration. Myeloperoxidase (MPO) activity and ALI score were highest at 36 and 48 hours, respectively. Therefore, it was decided to measure each parameter at the time of its highest level. The study mice were randomly divided into three experimental groups: (1) control group which was administered 50 ${\mu}L$ of saline and treated with intratracheal administration of 200 ${\mu}L$ DW containing only hemagglutinating virus of Japan (HVJ) vector (n=24); (2) LPS group in which LPS-induced ALI mice were treated with intratracheal administration of 200 ${\mu}L$ DW containing only HVJ vector (n=24); (3) LPS+ODN group in which LPS-induced ALI mice were treated with intratracheal administration of 200 ${\mu}L$ DW containing 160 ${\mu}g$ of NF-$\kappa$B decoy ODN and HVJ vector (n=24). Each group was subdivided into four experimental subgroups: (1) tissue subgroup for histopathological examination for ALI at 48 hours (n=6); (2) 6-hour bronchoalveolar lavage (BAL) subgroup for measurement of TNF-$\alpha$ and IL-6 in BAL fluid (BALF) (n=6); (3) 36-hour BAL subgroup for MPO activity assays in BALF (n=6); and (4) tissue homogenate subgroup for measurement of NF-$\kappa$B activity in lung tissue homogenates at 6 hours (n=6). Results: NF-$\kappa$B decoy ODN treatment significantly decreased NF-$\kappa$B activity in lung tissues. However, it failed to improve the parameters of LPS-induced direct ALI, including the concentrations of tumor necrosis factor-$\alpha$ and interleukin-6 in BALF, myeloperoxidase activity in BALF and histopathologic changes measured by the ALI score. Conclusion: NF-$\kappa$B decoy ODN, which has been proven to be effective in indirect models, had no effect in the direct ALI model.

• Journal of Gastric Cancer
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• v.9 no.3
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• pp.143-151
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• 2009

Purpose: Gastric cancer is prevalent in Korea, therefore the purpose of this study was to determine the clinicopathologic characteristics, 5-year survival rate, and prognostic factors for gastric patients who underwent gastrectomy by a single surgeon. Materials and Methods: A total of 1,435 patients diagnosed with gastric cancer who underwent gastrectomy in the Department of Korean Gastric Cancer Center at Seoul Paik Hospital between September 1998 and August 2003, and the gender, age, location and size of the tumor, visual and histologic analysis, depth of invasion, lymph node metastasis, invasion (perineural, venous, and lymphatic), and surgical method were examined retrospectively. Results: The ratio between males and females was 2.29 : 1, and the average age was 56.7 years. Based on the UICC TNM classification, the patients were distributed as follows: IA 35.4%, IB 14.1%, II 12.6%, IIIA 12.3%, IIIB 8.3% and IV 17.3%. The 5-year survival rate was 69.6%. The results of univariate analysis showed that there were significant differences in the survival rate by age, location and size of tumor, Borrmann type, level of differentiation, Lauren's classification, depth of invasion, metastasis in lymph nodes, UICC TNM stage, invasion (perineural, venous, and lymphatic), and surgical method. Based on multivariate analysis, only the depth of invasion and lymph node metastasis were independent prognostic factors. Conclusion: Although various clinicopathologic characteristics affect the prognostic factors of the patients with gastric cancer, the results of this study showed that the stage of disease, such as depth of invasion and metastasis in lymph nodes, are the most critical factors. There is a need to establish the diagnosis of gastric cancer early and to study and develop various treatment methods based on the diagnostic factors in order to improve the survival of patients with gastric cancer.

• Progress in Medical Physics
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• v.25 no.1
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• pp.15-22
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• 2014

The IMRT is proper implement to get high dose deliver to tumor as its shape and selective approach in radiation therapy. Since the IMRT is performed as modulated the radiation fluence by the MLC created the open shapes and its irradiation time, the dose of segment of radiation field effects on the cumulated portal dose. The accurate output factor of small and step shape of segment is important to improve the determination of deliver tumor dose as it is directly proportional to dose. This experiment performed with the 6 MV photon beam of Clinac Ex(Varian) from $3{\times}3cm^2$ to $0.5{\times}0.5cm^2$ small field size for collimator jaw in MLC free and/or for MLC open field in fixed collimator jaw $10{\times}10cm^2$ using the CC01 ion chamber, SFD diode, diamond detector and X-Omat film dosimetry. As results of normalized to the reference field of $10{\times}10cm^2$ of MLC, the output factor of $3{\times}3cm^2$ showed $0.899{\pm}0.0106$, $0.855{\pm}0.0106$ for $2{\times}2cm^2$, $0.764{\pm}0.0082$ for $1{\times}1cm^2$ and $0.602{\pm}0.0399$ for $0.5{\times}0.5cm^2$. The output factor of MLC open field has shown a maximum 3.8% higher than that of the collimator jaw open field.

• Journal of Yeungnam Medical Science
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• v.17 no.2
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• pp.137-145
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• 2000

Background: Hepatocellular carcinomal(HCC) has been considered to be relatively radioresistant. The role of radiotherapy(RT) in the treatment of HCC is controversial. But RT has a role in the treatment of hepatocellular carcinoma as a single or combination modalities. The effect of radiotherapy on HCC was evaluated. Patients and Methods: From January 1984 through January 2000, a total of 18 patients with unresectable HCC underwent radiotherapy alone or in conjunction with transarterial embolization(TAE). We reviewed the medical ecords of patients treated with RT and measured the tumor size using measured the tumor size using planimetry method. The Kaplan-Meier method was used to calculate the survival rate. Results: The RT patients were 15 men and 3 women. The mean age was 51 years. four(22.2%) of them were accompanied with ascites. Eleven(61.1%) of them were accompanied with liver cirrhosis and their functions were 6, 3, 2 in each Child-Pugh A, B, C, respectively. A partial response(PR) was observed in 2 patients(11.1%), minimal response(MR) in 4 patients (22.2%) and no change(NC), in 11 patients(61.1%), whereas progressive disease(PD) was seen in 1 patients(6%), respectively. Conclusions: Although the radiotherapy in HCC did not improve the survival rate. it decreased the tmor size. Radiotherapy strengthens the therapeutic efficacy when combined with TAE, but more studies are needed.

• The Journal of Korean Society for Radiation Therapy
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• v.20 no.2
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• pp.69-81
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• 2008

Purpose: To reduce side effects in image guided radiation therapy (IGRT) and to improve the quality of life of patients, also to meet accurate SETUP condition for patients, the various SETUP correction conditions were compared and evaluated by using on board imager (OBI) during the SETUP. Materials and Methods: Each 30 cases of the head, the neck, the chest, the belly, and the pelvis in 150 cases of IGRT patients was corrected after confirmation by using OBI at every 2∼3 day. Also, the difference of the SETUP through the skin-marker and the anatomic SETUP through the OBI was evaluated. Results: General SETUP errors (Transverse, Coronal, Sagittal) through the OBI at original SETUP position were Head & Neck: 1.3 mm, Brain: 2 mm, Chest: 3 mm, Abdoman: 3.7 mm, Pelvis: 4 mm. The patients with more that 3 mm in the error range were observed in the correction devices and the patient motions by confirming in treatment room. Moreover, in the case of female patients, the result came from the position of hairs during the Head & Neck, Brain tumor. Therefore, after another SETUP in each cases of over 3 mm in the error range, the treatment was carried out. Mean error values of each parts estimated after the correction were 1 mm for the head, 1.2 mm for the neck, 2.5 mm for the chest, 2.5 mm for the belly, and 2.6 mm for the pelvis. Conclusion: The result showed the correction of SETUP for each treatment through OBI is extremely difficult because of the importance of SETUP in radiation treatment. However, by establishing the average standard of the patients from this research result, the better patient satisfaction and treatment results could be obtained.

• Applied Microscopy
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• v.40 no.4
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• pp.193-200
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• 2010

This experiment was performed to evaluate the morphological responses of the duodenal epithelial cells of the mouse, inoculated with Ehrlich carcinoma cells in the inguinal area, following administration of Bacillus Calmette-Guerin (BCG). In the experimental groups, each mouse was inoculated with $1{\times}10^7$ Ehrlich carcinoma cells subcutaneously in the inguinal area. From next day after inoculations, 0.2 mL of saline or BCG (0.5 mL/25 g B.W.: $0.03{\times}10^8\sim0.32{\times}10^8$ CFU) were injected subcutaneously to the animals every other day, respectively. The day following the 7th injection of saline or BCG, each mouse was injected with a single dose of $0.7{\mu}Ci$/g of methyl-$^3H$-thymidine (25 Ci/mmol, Amersham Lab, England) through tail vein. Seventy minutes after the thymidine injection, animals were sacrificed, and duodenal tissues were taken and fixed in 10% neutral formalin. Deparaffinized sections were coated with autoradiographic emulsion EM-1 (Amersham Lab, England) in a dark room and dried and were placed in a light-tight box. The number of labeled epithelial cells in the duodenal mucosae (mean number of labeled epithelial cells per 3.5 mm length of mucosa) were observed and calculated. On the light microscopic study, duodenal mucosae had no severe morphological changes following the injection of BCG. In the tumor control and BCG treated groups, a number of small lymphocytes and eosinophile leucocytes are slightly increased as compared with those of the normal control ones. On the autoradiographic study, number of the labeled cells of normal control, tumor control and BCG-treated mice were 632.3 (${\pm}14.47$), 761.7 (${\pm}27.65$) and 505.0 (${\pm}17.09$) respectively. From the above results, BCG may suppress the DNA synthesis of the duodenal epithelial cells, but does not results severe structural defect on the duodenal mucosae. And it is suggested that BCG may greatly improve the anticancer therapy on certain kind of cancer.

• Radiation Oncology Journal
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• v.11 no.2
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• pp.369-376
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• 1993

226 patients with carcinoma of the uterine cervix treated with curative radiation therapy at the Department of Therapeutic Radiology, Dongsan hospital, Keimyung university, School of medicine, from July,1988 to May,1991 were evaluated. The patients with all stages of the disease were included in this study. The maximum and mean follow up durations were 60 and 43 months. The radiation therapy consisted of external irradiation to the whole pelvis (2700~4500 cGy) and boost parametrial doses (for a total of 4500~6300 cGy)with midline shild $(4{\times}10\;cm),$ and combined with intracavitary irradiation (5700~7500 cGy to point A). The distribution of patients according to the stage was as follows: stage IB 37 $(16.4\%),$ stage IIA 91 $(40.3\%),$ stage IIB 58 $(25.7\%),$ stage III 32 $(13.8\%),$ stage IV 8 $(3.5\%).$ The overall failure rate was $23.9\%$ (54 patients). The failure rate increased as a function of stage from $13.5\%$ in stage IB to $15.4\%$ in stage IIA, $25.9\%$ in stage IIB, $46.9\%$ in stage III, and $62.5\%$ in stage UV. The pelvic failure alone were 32 patients and 11 patients were as a components of other failure, and remaining 11 patients had distant metastasis only. Among the 43 patients of locoregional failure,28 patients were not controlled initially and in other words nearly half of total failures were due to residual tumor. The mean medial paracervical (point A) doses were 6700 cGy in stage IIB,7200 cGy in stage IIA,7450 cGy in stage IIB,7600 cGy in stage III and 8100 cGy in stage IV. The medial paracervical doses showed some correlation with tumor control rate in early stage of disease (stage Ib, IIA), but there were higher central failure rate in advanced stage in spite of higher paracervical doses. In advanced stage, failure were not reduced by simple increment of paracervical doses. To improve a locoregional control rate in advanced stages, it is necessary to give additional treatment such as concomitant chemoradiation.

• Journal of Applied Biological Chemistry
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• v.63 no.1
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• pp.95-101
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• 2020

Psoriasis is an autoimmune skin disease that is accompanied by hyper proliferation of the epidermis, erythema of various sizes, and ulceration. However, the mechanism of the development of psoriasis dermatitis is unclear. Recently, it is known that the inflammatory cytokines and Th17 cells as well as chemokine (CC motif) ligand 20 (CCL20) are involved in the process of keratinocytes hyper-differentiation, which is common in psoriasis dermatitis. Therefore, we studied the effects of yakuchinone-A, an active ingredient of Alpinia oxyphylla Miquel known for its anti-inflammatory activity, to improve psoriasis dermatitis. First, cytotoxicity of yakuchinone-A was observed in cell counting kit-8 assay and not observed in 10 ㎍/mL concentration on the human keratinocyte HaCaT cells. Yakuchinone-A in the presence of tumor necrosis factor-alpha (TNF-α) on HaCaT cells inhibited mRNA expression of IL-6, IL-8, and TNF-α by up to 61.4±7.5, 23.6±1.5, 46.0±4.8%. CCL20, a chemokine that attracts immune cells such Th17 cells to the inflammation location, was also significantly suppressed by yakuchinone-A. In addition, IκB and STAT3 phosphorylation involved in the CCL20 expression was inhibited by yakuchinone-A in a concentration-dependent manner up to the level of 79.1±5.0, 80.8±2.3%. Furthermore, yakuchinone-A downregulated CCL20 mRNA expression level on IL-17A-activated HaCaT cells as a concentration-dependent manner. Based on these results, yakuchinone-A is expected to be developed as a new material for improving psoriasis dermatitis in the future.

• Radiation Oncology Journal
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• v.23 no.1
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• pp.51-60
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• 2005

Purpose : Selective inhibition of multiple molecular targets may improve the antitumor activity of radiation. Two specific inhibitors of selective cyclooxygenase-2 (COX-2) and epidermal growth factor receptor (EGFR) were combined with radiation on the HeLa cell line. To investigate cooperative mechanism with selective COX-2 inhibitor and EGFR blocker, in vitro experiments were done. Materials and Methods : Antitumor effect was obtained by growth inhibition and apoptosis analysis by annexin V-Flous method. Radiation modulation effects were determined by the clonogenic cell survival assay. Surviving fractions at 2 Gy ($SF_2$) and dose enhancement ratio at a surviving fraction of 0.25 were evaluated. To investigate the mechanism of the modulation of radiosensitivity, the cell cycle analyses were done by flow cytometry. The bcl-2 and bax expressions were analyzed by western blot. Results : A cooperative effect were observed on the apoptosis of the HeLa ceil line when combination of the two drugs, AG 1478 and NS 398 with radiation at the lowest doses, apoptosis of $22.70\%$ compare with combination of the one drug with radiation, apoptosis of $8.49\%$. In cell cycle analysis, accumulation of cell on $G_0/G_l$ phase and decrement of S phase fraction was observed from 24 hours to 72 hours after treatment with radiation, AG 1478 and NS 398. The combination of NS 398 and AG 1478 enhanced radiosensitivity on a concentration-dependent manner in HeLa cells with dose enhancement ratios of 3.00 and $SF_2$ of 0.12 but the combination of one drug with radiation was not enhanced radlosensitivity with dose enhancement ratios of 1.12 and SF2 of 0.68 (p=0.005). The expression levels of bcl-2 and bax were reduced when combined with AG 1478 and NS 398. Conclusion : Our results indicate that the selective COX-2 inhibitor and EGFR blocker combined with radiation have potential additive or cooperative effects on radiation treatment and may act through various mechanisms including direct inhibition of tumor cell proliferation, suppression of tumor cell cycle progression and inhibition of anti-apoptotic proteins.