Yeo, Hyeonjung;Lee, Dongkyu;Kim, Jin Soo;Eo, Pil Seon;Kim, Dong Kyu;Lee, Joon Seok;Kwon, Ki Tae;Lee, Jeeyeon;Park, Ho Yong;Yang, Jung Dug
Archives of Plastic Surgery
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v.48
no.2
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pp.165-174
/
2021
Background In recent years, implant-based breast reconstruction has been performed because of its simplicity, short operation time, and rapid recovery of patients. Several studies have reported treatment methods for implant surgery-related infection, which is a serious complication. The aim of this study was to introduce our strategy for salvaging infected implants and to evaluate its effectiveness. Methods The authors performed a retrospective study of 145 cases from 132 patients who underwent implant-based breast reconstruction from January 2012 to December 2018. Empirical antibiotics were immediately administered to patients with suspected infections. The patients then underwent salvage treatment including appropriate antibiotics, ultrasonography-guided aspiration, debridement, antibiotic lavage, and implant exchange through a multidisciplinary approach. Patient demographics, operative data, duration until drain removal, adjuvant treatment, and complications were analyzed. Results The total infection rate was 5.5% (8/145). A longer indwelling catheter period and adjuvant treatment were significantly associated with infection. The salvage treatment showed a success rate of 87.5% (7/8). Seven patients who received early aggressive salvage treatment recovered from infection. One patient with methicillin-resistant Staphylococcus aureus, who received salvage treatment 11 days after symptom onset, did not respond to drainage and antibiotic treatment. That patient subsequently underwent explantation. Conclusions In implant-based breast reconstruction, prevention of infection is of the utmost importance. However, if an infection is suspected, proactive empirical antibiotic therapy and collaboration with the necessary departments are required. Through a multidisciplinary approach and proactive early management, swift and appropriate salvage should be performed.
Background: Adjuvant androgen deprivation therapy (ADT) is a treatment option for prostate cancer (PC) patients after radical prostatectomy (RP). Although it can achieve a good progression-free survival rate, some patients still develop clinical metastasis. We here investigated risk factors of clinical metastasis in post-prostatectomy patients who received immediate adjuvant ADT. Materials and Methods: We identified 197 patients with non-metastatic PC who underwent RP at our institution between 2000 and 2012, followed by adjuvant ADT. The associations of various clinicopathologic factors with clinical metastasis (primary endpoint) and cancer-specific survival (secondary endpoint) were assessed. Multivariate analysis was conducted using a Cox proportional hazards model. Median follow-up was 87 months after RP. Results: Nine (4.6%) patients developed clinical metastasis and six (3.0%) died from PC. Eight of nine metastatic patients had a pathologic Gleason score (GS) 9 and developed bone metastasis, while the remaining one had pathologic GS 7 and developed metastasis only to para-aortic lymph nodes. On multivariate analyses, pathologic GS ${\geq}9$ and regional lymph node metastasis (pN1) were independent predictors of clinical metastasis and pathologic GS ${\geq}9$ was an independent predictor of cancer-specific death. Conclusions: Pathologic GS ${\geq}9$ and pN1 were independent predictors of clinical metastasis in post-prostatectomy patients who received immediate adjuvant ADT. Furthermore, pathologic GS ${\geq}9$ was an indispensable condition for bone metastasis, which may imply that patients with GS ${\leq}8$ on adjuvant ADT are unlikely to develop bone metastasis.
Objectives This study was carried out to investigate the experimental effects of Lonicerae Caulis and Bee-venom Acupuncture in Yanglingquan (陽陵泉, GB34) that have clinical efficacy in the Rheumatoid Arthritis. Methods Materials of present study are Lonicerae Caulis Extracts (LCE), Bee-Venom Acupuncture (BVP), Sprague-dawley rats (250 g or so, ♂), and various kinds of needing experimental studies. We measured several experimental items of the rats with the arthritis induced by Freund's complete adjuvant (0.2 ml/kg), such as body weight, rate of paw edema, analgesic effect by hot plate method, WBC, TNF-${\alpha}$ cytokine and IL-10 cytokine. Rats were divided into four groups; Normal group that was treated with normal saline 1.0 ml (o.p) and $15{\mu}l/kg$ (GB34) to normal rats, Control group that was treated with normal saline 1.0 ml (o.p) and $15{\mu}l/kg$ (GB34) to pathologic model rats induced by Freund's complete adjuvant 0.2 ml/kg, Experimental group A that was treated with LCE 1.0 ml (o.p) and normal saline $15{\mu}l/kg$ (GB34) to pathologic model rats induced by Freund's complete adjuvant 0.2 ml/kg and Experimental group B that was treated with LCE 1.0 ml (o.p) and BVP $15{\mu}l/kg$ (GB34) to pathologic model rats induced by Freund's complete adjuvant 0.2 ml/kg, and the experiment took over after 28 days. The results were analysed using SPSS for windows 12.0. Results Experimental group A showed the increase in body weight, paw licking times and IL-10 cytokine compared to Control group. Also it was decreased in rate of paw edema, WBC, and TNF-${\alpha}$ cytokine compared with Control group. Experimental group B showed the increase in body weight, paw licking times, and IL-10 cytokine compared to Control group, and showed the decrease in rate of paw edema, WBC and TNF-${\alpha}$ cytokine compared to Control group. Especially TNF-${\alpha}$ cytokine and rate of paw edema were accepted statistical significance compared with Control group. Conclusions It is suggested that Lonicerae Caulis (o.p) and Bee-venom Acupuncture (GB34) can be used in the treatment of rheumatoid arthritis.
Artemisia princeps Pampanini is an herbal medicine widely used to immune function-related diseases, such as anti-oxidative, anti-inflammatory, and antibacterial agents. In this study, we investigated the anti-inflammatory effects of AP extract and underlying mechanisms were evaluated in RAW 264.7 cells. The effects of AP extract were also studied in a complete Freund's adjuvant (CFA)-induced arthritis and lipopolysaccharide (LPS)-induced inflammation mouse model. In RAW 264.7 cells, AP extracts significantly inhibited the LPS-induced nitric oxide (NO) production and inducible NO synthase and cyclooxygenase-2 protein expression. The LPS-induced phosphorylation of mitogen-activated protein kinases and nuclear factor-κB was also significantly blocked by AP extract in RAW 264.7 cells. Oral administration of AP extract suppressed the increase in mouse paw edema and spleen index compared to CFA-treated mice group. Histologically, the infiltration of inflammatory cells was increased in cartilage and synovium in the CFA-treated mouse group, whereas it was suppressed in the AP extract-administered group. Furthermore, AP extract treatment significantly reduced the inflammatory cytokine, tumor necrosis factor-α, levels in CFA and LPS-treated mouse. In conclusion, the anti-inflammatory and anti-arthritis effect of AP extract was confirmed in both in vitro and in vivo models, suggesting that Artemisia princeps Pampanini may be a candidate material for arthritis treatment.
Background: Breast conservation treatment (BCT) has long been recognised to provide survival outcomes equivalent to mastectomy for the treatment of breast cancer. However, published reports of BCT rates in Asian communities are lower than those from Western countries. This study sought to investigate the eligibility and utilisation of BCT in a predominantly Asian population. Materials and Methods: All patients treated surgically by a single surgeon at a private medical facility between 2009 and 2011 were included in the study. Patients were deemed to have successful BCT if they underwent breast conserving surgery with pathologic clear margins and completed all recommended adjuvant treatment. Those who did not complete adjuvant treatment were excluded from the analysis. Results: Data from a total of 161 patients who underwent treatment during the study period were analysed. The mean age was 48.8 years. One hundred and six patients (65.8%) were of Chinese ethnicity, 12 were Indian (7.5%), 11 were Malay (6.8%), 18 were Caucasian (11.2%) and 14 (8.7%) were of other Asian ethnicity. One hundred and thirty-eight women (85.7%) underwent BCT. Of the 23 (14.3%) who underwent mastectomy, 8 (5.4%) elected to undergo a mastectomy despite being eligible for BCT. In total, it was assessed that 146 of 161 patients (90.7%) were eligible for BCT and utilisation was 94.5%. Conclusions: In this study, eligibility, utilisation of BCT and eventual successful breast conservation rates are similar to published rates in Western communities. Additional research is needed to investigate the reasons for the lower published BCT rates in Asian countries and determine ways to improve them.
Despite optimal local therapy such as surgery and/or radiotherapy, the long term outcome is poor for patients with advanced squamous cell carcinomma of head and neck, due to frequent loco-regional recurrence and distant metastases. We studied to determine whether the combination chemotherapy, especially as an adjuvant chemotherapy, would improve the survival of these patients. Between January, 1986 and December, 1992, 57 patients with previously untreated, locally advanced squamous cell arcinoma of head and neck were assigned to receive 2-3 cycles of induction chemotherapy consisting of 5-fluorouracil(F) and cisplatin(P) every 3 weeks and standard local therapy such as surgery and/or radiotherapy followed by adjuvant chemotherapy with the same FP regimens. Of the 57 enroled patients, 45 patients were evaluable. The obtained results were as following: 1) Among 45 evaluable patients, 18 patients finished all treatment protocol including adjuvant chemotherapy and 27 patients had no adjuvant chemotherapy. The difference of age, sex, performance status, disease stage, and tumor differentiation was not significant statistically between adjuvant chemotherapy group and no-adjuvant chemotherapy group. 2) After induction chemotherapy, 7/45(15.4%), 30/45(67%) achieved complete remission and partial remission respectively with 82.4% overall response rates in entire patients. 3) The 4year progression free survival was 43.3% in adjuvant chemotherapy group and 24.1% in no-adjuvant chemotherapy group(p>0.05). The 4year overall survival was 56.9% and 25.5% respectively(p>0.05). There was no significant different in the patterns of local recurrence and distant metastasis between the two groups. 4) Adverse reactions from combination chemotherapy included nausea, vomiting, mucositis, diarrhea and hematologic bone marrow depression. These were mild and tolerated by patients, and these was no episode of any life threatening toxicities. In conclusion, adjuvant chemotherapy after induction chemotherapy and local therapy did not show statistically significant survival improvement, but there was trend of prolongation of survival when compared to no adjuvant chemotherapy. Thus, large scale phase III randomized controlled studies are strongly recommended.
Kim, Kyung-Hae;Chung, Bok-Yae;Kim, Gyung-Duck;Byun, Hye-Sun;Choi, Eun-Hee;Cho, Eun-Jung
Asian Oncology Nursing
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v.12
no.1
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pp.1-11
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2012
Purpose: This study reviewed articles related to breast cancer, cognitive function and chemotherapy available in 4 databases. Methods: The researcher reviewed 32 pieces of literature that were published between January 2001 and November 2011. Results: Within the last decade, several studies have investigated whether adjuvant treatment of breast cancer affects cognitive function. A number of prospective studies have reported inconsistent results regarding whether chemotherapy affects cognitive function. Approximately half of the studies reported subtle cognitive decline in a wide range of domains among some breast cancer patients following chemotherapy, and others did not. Conclusion: Breast cancer patients receiving adjuvant chemotherapy showed the most deterioration and the most persistent decline in cognitive function. Since cognitive impairment is subtle, if evident at all, discrepant findings are due to hormonal, physiological, psychological or temporal confounding variables and differences in study design. Especially, that chemotherapy may impair memory, executive function, attention and visuospatial function in women with breast cancer.
Chang-Back-San and Chil-Mi-Chang-Back-San have been used for the treatment of neuralgia and arthritis in traditional medicine. The anti-inflammatory activities of Chang-Back-San and Chil-Mi-Chang-Back-San water extract (CBSE and CCBSE) on the carrageenin induced edema, Corton oil induced granuloma pouch, and adjuvant arthritis in rats were examined. The analgesic effects of the CBSE and CCBSE were also investigated utilizing acetic acid induced writhing syndrome in mice. The oral administration of CBSE and CCBSE showed to have the anti-inflammatory activities in 1% carrageenin induced edema in rats. They also showed significant inhibitory effects on granuloma and exudate formation in rats. In the method of adjuvant arthritis, they orally administered for 19 days, inhibited the hind paw edema in rats from 3rd day to 19th day, especially CCBSE has the efficacy more than CBSE. They significantly decreased the number of writhing syndromes induced by acetic acid in mice. In the present study, CBSE and CCBSE were indicated to have the anti-inflammatory and analgesic activities.
Objectives: This study was to investigate the effect of high frequency electro-acupuncture (EA) at $ST_{36}$ acupoint on the Freund's Complete Adjuvant (FCA)-induced arthritis in rats. Methods : Arthritis was induced by intradermal injection of FCA into base of tail. Experimental groups were divided into 4 groups; Normal, Control, $ST_{36}$ and Non-Acupoint (NA). $ST_{36}$ group was treated by 120Hz EA at $ST_{36}$ acupoint. Body weight, paw edema volume and ankle joint thickness were measured after treatment. And we investigated the effects of 120Hz EA via WBC count, segmen neurophil, lymphocyte, PGE2 assay and NADPH-d histochemistry. Results and Conclusions : The mean of body weight and ankle joint thickness of $ST_{36}$ group was increased compared with control group. The mean of paw edema volume, WBC count, segment neutrophil and lymphocyte of were not decreased with control group. The mean of PGE2 concentration ($1,851.00{\pm}160.11$) and NADPH-d positive neurons ($13.12{\pm}1.23$) were changed significantly (p
To examine the potentiation of Macrolepiota procera extracts (MPE-4) to act as adjuvant enhancing the tumor specific anti-tumor immune response, tumor vaccine prepared by boiling (HK vaccine) admixed with MPE-4 and immunized in mice. Vaccination of mice with HK vaccine in combination with MPE-4 resulted in higher inhibition in tumor metastasis compared with the mice of HK vaccine alone treatment against live syngeneic tumor cell challenge. The splenocytes from mice immunized HK vaccine mixed with MPE-4 was able to elicit a stronger cytotoxic T lymphocyte (CTL) response as compared with HK vaccine alone. In addition, the splenocytes from MPE-4 admixed HK vaccine immunized mice secreted a higher concentration of Th1 type cytokine such as IFN-${\gamma}$, and GM-CSF. Furthermore, the adoptive transfer of splenocytes from mice immunized HK vaccine and MPE-4 led to a more robust anti-tumour response than the HK vaccine alone. Overall, these results indicate that MPE-4 is a good candidate adjuvant of anti-tumor immune response.
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