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장흥문 ( Heung Moon Chang ) 대한내과학회 2011 대한내과학회지 Vol.80 No.4
The goals of medical treatment for advanced pancreatic neuroendocrine tumor (PNET) are to control hormone-related symptoms and to prolong overall survival. Somatostatin analogues have been used for decreasing the secretion of peptides and relieving symptoms. Recent studies showed that these agents also have an anti-tumor effect and could prolong the survival of patients with advanced PNET. For well-differentiated PNET, streptozocin-based combination chemotherapy has been used for a long time and recent several studies showed survival benefit of targeted agents including angiogenesis inhibitor and mTOR inhibitor. For poorly-differentiated tumors, the number of clinical studies is very limited and the combination of etoposide and cisplatin is widely used. Based on the recent progress in the understanding of tumor biology, newer targeted agents are tested and some of these agents showed promising activity. (Korean J Med 2011;80:393-396)
김명환,장흥문,김태원,이성구,이태윤,장세진,서철원,이태석,김상희,이승규,박정선,김영훈 대한의학회 2009 Journal of Korean medical science Vol.24 No.3
EC-18 (monoacetyldiacylglyceride) stimulates T cell production of IL-2, IL-4, IL-12, IFN-γ, and GM-CSF in vitro. To study the effects of these cytokines stimulated by EC-18 on cancer cells, we applied hamster biliary cancer model, a difficult cancer to treat. Cancer (KIGB-5) cells were given intravenously to produce hematogenous metastatic lung lesions which were treated with EC-18 at 10, 25, and 50 mg/kg/day respectively. The fourth group was untreated control. At 4th, 8th, and 12th week the lungs were examined. EC-18 treated groups showed only a few microscopic lung lesions and no evidence of metastatic lesion with highest dose whereas widespread gross lung lesions were observed in untreated control. To investigate whether the anti-tumor effect of EC-18 is associated with suppression of tumor cell Toll-like receptor 4 (TLR-4) expression in addition to stimulation of the immune cells, KIGB-5 cells were exposed to LPS with or without EC-18. TLR-4 mRNA and protein expression, measured by reverse transcriptase PCR (RT-PCR), real-time quantitative PCR and western blot analysis, showed suppression of TLR-4 expression in KIGB-5 cells treated with EC-18 compared with control. In conclusion, EC-18 has a significant anti-tumor effect in this experimental model of biliary cancer suggesting potential for clinical application to this difficult cancer.
고형암 환자에서 항암화학요법 후 호중구감소증에 대한 류코업(R) (Filgrastim, rhG-CSF)의 안전성 및 유효성: 그라신(R)과의 다기관 비교 임상시험
이소영 ( So Young Lee ),장흥문 ( Heung Moon Chang ),허대석 ( Dae Seog Heo ),류백렬 ( Baek Yeol Ryoo ),김태원 ( Tae Won Kim ),류민희 ( Min Hee Ryu ),김태유 ( Tae You Kim ),박연희 ( Yeon Hee Park ),이재훈 ( Jae Hoon Lee ),박근칠 ( K 대한내과학회 2005 대한내과학회지 Vol.69 No.1
우인숙,김노경,방영주,김원석,장흥문,정흠,정경해,허대석,심영수 대한내과학회 1995 대한내과학회지 Vol.48 No.3
The cancer-associated retinopathy (CAR) is a very rare paraneoplastic syndrome. Most of the cases are associated with the lung cancer, especially small cell lung cancer. The triad of CAR is described as photosensitivity, scotomatous peripheral visual field loss, and attenuated retinal arterial caliver. The pathogenesis is suggested that anti-retinal antibody induced by malignat tumors causes the degeneration of photoreceptors in the retina through the cross reaction. The titer of these antibodies can be used as an index of disease activity and treatment response. The CAR antigen is not clearly determined yet, but 26 kD proteins located in cone and rod photoreceptor cells are considered as that antigen. Consequently, the destructioon of the photoreceptors by immune mechanism results in visual changes even complete blindness. If no treatment is done, the visual loss progresses to complete blindness. Many authors recommanded prednisone as a treatment. This can reduce the antibody titer even to normal range, and stop the disease progress through the immunosuppression. With a brief review of literature, we report a case of cancer-associated retinopathy in 54-year old female patient who has a small cell lung cancer in the stage of limited disease, Her initial symptomes were peritpheral visual loss and sparkling in front of her eys. We treated her with the combination chemotherapy of cisplatin and etoposide (VP-16) and radiation therapy. The gastrointestinal symptom made her stop prednisone medication. The outcome of teatments was complete remission and her visual symptoms were not progressed. We have a good result in this patient. So we report this case.