• Title/Summary/Keyword: Adjuvant treatment

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The Structural Equation Model on Resilience of Breast Cancer Patients Receiving Chemotherapy (항암화학요법을 받는 유방암 환자의 극복력 구조모형)

  • Yang, Jeong Ha;Kim, Ok Soo
    • Journal of Korean Academy of Nursing
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    • v.46 no.3
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    • pp.327-337
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    • 2016
  • Purpose: The purpose of this study was to construct and test a structural equation model on resilience of breast cancer patients receiving chemotherapy. Methods: Participants were 204 patients with breast cancer who received chemotherapy treatment. They participated in a structured interview, which included social support, depression, symptom experience, self-efficacy, hope, resilience, and infection prevention behaviors. Data were analyzed using SPSS/WIN 20.0 and AMOS 18.0. Results: Lower depression (${\gamma}=-.33$, p=.020) and symptom experience (${\gamma}=-.31$, p=.012) and higher self-efficacy (${\gamma}=.32$, p=.005) and hope (${\gamma}=.48$, p=.016) were influenced by higher social support. Greater resilience was influenced by lower symptom experience (${\beta}=-.18$, p=.016), higher self-efficacy (${\beta}=.49$, p=.023), and higher hope (${\beta}=.46$, p=.012), and these predictors explained 66.7% of variance in resilience. Greater resilience (${\beta}=.54$, p =.009) made an impact on greater infection prevention behaviors. Resilience mediated the relations of symptom experience (${\beta}=-.10$ p=.013), self-efficacy (${\beta}=.27$, p=.006) and hope (${\beta}=.25$, p=.009) with infection prevention behaviors. These predictors explained 24.9% of variance in infection prevention behaviors. Conclusion: The findings of the study suggest that breast cancer patients with greater resilience who are receiving chemotherapy participate in increased infection prevention behaviors. Further research should be conducted to seek intervention strategies that improve breast cancer patients' resilience.

Prognostic Value of Early Postoperative Intraperitoneal Chemotherapy for Gastric Cancer with Serosal Invasion (장막 침윤이 있는 위암환자에서 수술 후 조기 복강 내 화학요법의 예후인자로서의 가치)

  • Yu, Wan-Sik;Kim, Tae-Bong
    • Journal of Gastric Cancer
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    • v.4 no.2
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    • pp.89-94
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    • 2004
  • Purpose: There is no established treatment-related prognostic factor for gastric cancer except a curative tumor resection. This study was done to clarify the prognostic value of early postoperative intraperitoneal chemotherapy (EPIC) in patients with serosa-positive gastric cancer. Materials and Methods: We analyzed retrospectively the postoperative survival data of 209 patients with serosapositive gastric cancer treated by surgery and chemotherapy. The survival period for patients was calculated from the date of resection until cancer-related death or the last date of follow-up; Kaplan-Meier survival curves were plotted and compared by using the log-rank test. A multivariate analysis was done by using the Cox proportional hazards model. Results: Statistically significant differences in survival rates were noted based on gender, depth of invasion, lymph node metastasis, distant metastasis, stage, location of tumor, macroscopic type, extent of gastric resection, curability of surgery, and adjuvant chemotherapy. Five-year survival rates of patients who received EPIC and systemic chemotherapy were 49 per cent and 25 per cent, respectively (P=0.009). A multivariate analysis revealed that invasion of an adjacent organ, lymph node metastasis, total gastrectomy, and palliative surgery were poor independent prognostic factors. Also, EPIC had a marginal prognostic value (P=0.056). Conclusion: Perioperative intraperitoneal chemotherapy can possibly be one of the independent prognostic indicators in case of serosa-positive gastric cancer. (J Korean Gastric Cancer Assoc 2004;4:89-94)

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Five-year Survival Associated with Stage I Gastric Cancer after Resection of Early Recurrence at Nodal Station No. 14v: a Case Report

  • Abe, Iku;Kinoshita, Takahiro;Kaito, Akio;Sunagawa, Hideki;Watanabe, Masahiro;Sugita, Shizuki;Tonouchi, Akiko;Sato, Reo
    • Journal of Gastric Cancer
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    • v.17 no.2
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    • pp.186-191
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    • 2017
  • The role of nodal station No. 14v (along the superior mesenteric vein) in lymphadenectomy for distal gastric cancer remains elusive. A 73-year-old woman underwent endoscopic submucosal dissection for gastric cancer, and was referred to our division for additional surgery because of pathologically non-curative resection. A laparoscopic distal gastrectomy with D1+ dissection was performed, with a final diagnosis of pT1bN1M0, Stage IB (2 nodal metastases to No. 6). Four months post-surgery, abdominal computed tomography revealed a 14-mm solitary nodule along the superior mesenteric vein. The lesion was excised and pathologically identified as a lymph node metastasis. Adjuvant chemotherapy with tegafur-gimeracil-oteracil potassium (S-1) was administered for the metastasis. Presently the patient survives without recurrence, 5.5 years after the second operation. Our findings suggest that there is lymphatic flow from the No. 6 to the No. 14v nodal station. Some patients with a No. 6 metastasis may benefit from a No. 14v lymphadenectomy, even in early-staged disease.

Clinical Experiences of Pancreatic Tumors in Children (소아 췌장종양의 임상적 고찰)

  • Im, Ra-Joo;Kim, Hae-Sol;Kim, Tae-Seok;Lee, Cheol-Gu;Seo, Jeong-Meen;Lee, Suk-Koo
    • Advances in pediatric surgery
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    • v.13 no.2
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    • pp.155-161
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    • 2007
  • Pancreatic tumors in children are very rare but have a better prognosis compared with that in adult. Pediatric pancreatic tumors are more often benign and easier to resect. To evaluate the characteristics and prognosis, the records of 13 patients who underwent pancreatic resection, from June 1997 to May 2005, at Samsung Medical Center were reviewed. The mean follow up period was 48 months. The male to female ratio was 1: 1.6. Mean age was 10.3 years. Signs and symptoms included abdominal pain (7), abdominal palpable mass (5), jaundice (1), hypoglycemic (1), and non-specific GI symptoms (4). The commonly used diagnostic tools were CT and abdominal sonography. In addition, MRI, ERCP, EEG, and hormone test were also done when indicated. Surgical procedures included distal pancreatectomy (5), pylorus preserving pancreaticoduodenectomy (4), tumor excision (3), and subtotal pancreatectomy (1). Locations of lesions in pancreas were head (4), tail (5), and body and tail (4). Postoperative complications developed in 3 cases; postoperative ileus (1), wound problem (1), and pancreatitis (1). The pathologic diagnosis included solid-pseudopapillary tumor (6), congenital simple cyst (1), pancreatic duplication cyst (1), serous oligocystic adenoma (1), mucinous cystadenocarcinoma (1), rhabdomyosarcoma (1), insulinoma (1), and pancreatoblastoma (1). Three cases received adjuvant chemotherapy and radiotherapy. Overall survival rate was 81 %. One patient with a mucinous cystadenocarcinoma died. In this study, pancreatic tumors in children were resectable in all patients and had good survival. Surgery of pancreatic tumors should be regarded as the gold standard of treatment and a good prognosis can be anticipated in most cases of benign and malignant tumors.

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Anti-inflammatory Effect of Paeoniflorigenone Isolated from Paeoniae Radix (Paeoniflorigenone 작약성분의 항염효과)

  • Kim, Ha-Yan;Han, Yong-Moon
    • YAKHAK HOEJI
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    • v.56 no.1
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    • pp.20-25
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    • 2012
  • In Northeast Asia, Paeoniae Radix has been used in treatments of inflammation-causing diseases such as arthritis for many centuries. Paeoniflorin, one of the principle bioactive monoterpene glucosides from the paeony root, is reported to be mostly responsible for the effectiveness of the treatments. However, the anti-inflammatory effect of a monoterpene, paeoniflorigenone (PFG) which partially has the moiety of paeoniflorin minus a glucose structure is unknown. Thus, the aim of this work was to investigate anti-inflammatory activity of PFG. For the investigation, PFG activity on the NO (nitric oxide) production from LPS-stimulated macrophages, and the anti-inflammatory effect was tested in the animal model of septic arthritis caused by Candida albicans, a major etiological agent for septic arthritis. For induction of the arthritis, mice were administered with an emulsion of C. albicans cell wall (CACW) mixed with Complete Freund's Adjuvant (CFA) via footpad-injection (Day 0); PFG at a dose of 0.5 or 1 mg/mouse (25 or 50 mg/kg of body-weight) was given to the animals on Day 3, 6, and 9; footpads were scored for arthritis. Moreover, the PFG effect on proliferation of T-lymphocyte that causes aggravation of arthritis was additionally tested. Data resulting from those tests showed that PFG inhibited the NO production from the stimulated macrophage in a dose dependent manner (P<0.05), indicating that PFG is an anti-inflammatory. To confirm the in-vitro results, anti-inflammatory activity of PFG was determined against C. albicans-caused septic arthritis. Data showed that PFG-treatment reduced footpad-swelling which indicates that PFG has anti-arthritic effect (P<0.05), which is therapeutic. The anti-arthritic effect appeared to be mediated by PFG suppression of T-cell proliferation. Ultimately, PFG, a monoterpene component, has anti-inflammatory activity analogous to paeoniflorin. The anti-inflammatory activity treats the septic arthritis due to a pathogenic fungus C. albicans.

Effect of Ulmus davidiana Planch (Ulmaceae) on T-lymphocyte-producing cytokines such as IL-2, IL-6, and $IFN-{\gamma}$ production in collagen-induced arthritis of rats

  • Kang, Han-Ju;Kim, Kyung-Ho;Jo, Hyun-Seog;Hwang, Min-Seob;Kim, Kap-Sung
    • Journal of Acupuncture Research
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    • v.22 no.2
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    • pp.33-41
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    • 2005
  • Objective : The effect of Ulmus davidiana Planch(UD), which has long been known to have anti-inflammation and protective effects on damaged tissue, inflammation and bone among other functions, on the development of type II collagen (CII)-induced arthritis (CIA) in rats was studied. Methods : Male rats were immunized with an emulsion of $200\;{\mu}g$ of CII and complete Freund's adjuvant (CFA). The rats were then given intraperitoneal stimulation of Ulmus davidiana Planch herbal acupuncture(UDHA)or saline during the experiment. When compared with rats treated with saline as control, UDHA at doses of more than $20{\mu}g/100\;g$ rat once a day for 7 days inhibited the ability of inguinal lymph node cells to produce T cell cytokines interleukin-2, interleukin-6, $IFN-{\gamma}$ when the cells were obtained from rats 14 days after immunization and cultured in vitro with CII. Results : When rats were injected intraperitoneally, UD -treated group and control group rats did not differ significantly when low doses of UD was given to rats. Conclusion : The recommended dose of UD in the management and treatment of rat CIA will be more than $20{\mu}g/100\;g$, which is two-firth of human therapeutic dose. From the results, it was concluded that the effect of UDHA is dependent of dosage.

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Folk Remedies used by Patients with Breast Cancer (유방암 환자의 민간요법)

  • 박진미;정복례
    • Journal of Korean Academy of Nursing
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    • v.25 no.3
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    • pp.419-430
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    • 1995
  • There is a need to investigate folk remedies used by patients with breast cancer because there is little information about the subject, even though many Korean women with breast cancer have used folk remedies during and after their treatment. The purpose of this study was to investigate and describe the phenomena and the meaning of folk remedies in order to better understand patients with breast cancer and to suggest directions for comprehensive nursing care. The Questions for the study were as follows What kinds of folk remedies do patients with breast cancer use\ulcorner What are the routes of knowing about folk remedies in patients with breast cancer\ulcorner What are the patterns of the usage of the folk remedies\ulcorner Why do patients with breast cancer use folk remedies\ulcorner What are the meanings of folk remedies to patients with breast cancer\ulcorner To answer these questions, a qualitative research method was used. Thirty-nine patients were recruited from university teaching hospitals from March, 1993 to November 1994. Many of them underwent either modified radical mastectomy or received various adjuvant therapy including chemotherapy, radiation therapy, and hormonal therapy. Data were collected by in-depth interviews, observations, medical records, and analyzed step-by-step using qualitative analysis. The results were as follows : 1. Patients with breast cancer have used many different kinds of folk remedies. 2. Patients with breast cancer did not know the exact effects of the folk remedies. Also the effects could not be exactly proven by the patients. 3. Patients with breast cancer received information about many kinds of folk remedies through various communication systems, such as other patients, their families and relatives, friends, and many types of mass media. 4. To use the folk remedies was one kind of illness behavior that was used by these patients. 5. Folk remedies were used to deal with not only anxiety by the patients themselves but also as the expression of affection and concern by families and relatives. 6. The use of folk remedies was one of the adaptation behaviors in patients with breast cancer whose disease was in the terminal stage. Based on the above findings, one suggestion was made : To continue further studies on folk remedies used by other patients with cancer in order to further explain health and illness behavior of Korean people.

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Effectiveness of Non-Pharmacologic Interventions in Chemotherapy Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis (항암화학요법 관련 말초신경병증에 적용한 비약물적 중재의 효과: 체계적 문헌고찰 및 메타분석)

  • Oh, Pok-Ja;Kim, You Lim
    • Journal of Korean Academy of Nursing
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    • v.48 no.2
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    • pp.123-142
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    • 2018
  • Purpose: This study was conducted to evaluate the effectiveness of non-pharmacologic interventions in chemotherapy-induced peripheral neuropathy (CIPN). Methods: PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL, and several Korean databases (Until August 2017) were searched. The main search strategy combined terms for peripheral neuropathy and presence of neoplasms. The risk of bias was assessed using the Cochrane's Risk of Bias tool for randomized studies and the Risk of Bias Assessment tool for non-randomized studies. To estimate the effect size, a meta-analysis of the studies was performed using the Rev Man 5.3 program of the Cochrane Library random-effects models were used in the analyses. Results: Twenty-two studies with a total of 954 participants met the inclusion criteria. Of the 22 studies, 12 were used to estimate the effect size of the non-pharmacologic interventions. The non-pharmacologic interventions used in patients with CIPN were exercise, acupuncture, massage, and foot bath. The acupuncture significantly reduced CIPN symptoms and signs (d=-0.71) and CIPN pain (d=-0.73) (p<.001). Massage and foot bath were also effective in reducing CIPN symptoms (d=-0.68; 95% CI=-1.05, -0.30; p<.001; $I^2=19%$).Exercises were effective in improving muscle strength and endurance(d=-0.55) and quality of life (d=-2.96), but they were not significantly effective in improving CIPN. Conclusion: Although these results provide little evidence of the effectiveness of acupuncture, massage, and foot bath in the treatment of CIPN, they suggest that these interventions can reduce CIPN symptoms in patients with cancer. However, the findings of this study should be interpreted with caution as there is a relative lack of data in this field, and additional well-designed studies are needed. PROSPERO registration: CRD42017076278.

Botulinum Toxin Type A Attenuates Activation of Glial Cells in Rat Medullary Dorsal Horn with CFA-induced Inflammatory Pain

  • Kim, Min-Ji;Cho, Jin-Ho;Kim, Hye-Jin;Yang, Kui-Ye;Ju, Jin-Sook;Lee, Min-Kyung;Park, Min-Kyoung;Ahn, Dong-Kuk
    • International Journal of Oral Biology
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    • v.40 no.2
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    • pp.71-77
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    • 2015
  • The activation of glial cells in the spinal cord has been contribute to the initiation and maintenance of pain facilitation induced by peripheral inflammation and nerve injury. The present study investigated effects of botulinum toxin type A (BoNT-A), injected subcutaneously or intracisternally, on the expression of microglia and astrocytes in rats. Complete Freund's Adjuvant (CFA)-induced inflammation was employed as an orofacial chronic inflammatory pain model. A subcutaneous injection of $40{\mu}L$ CFA into the vibrissa pad was performed under 3% isoflurane anesthesia in SD rats. Immunohistochemical analysis for changes in Iba1 (a microglia marker) and GFAP (an astrocyte marker), were performed 5 days after CFA injection. Subcutaneous injection of CFA produced increases in Iba1 and GFAP expression, in the ipsilateral superficial lamia I and II in the medullary dorsal horn of rats. Subcutaneous treatment with BoNT-A attenuated the up-regulation of Iba1 and GFAP expressions induced by CFA injection. Moreover, intracisternal injection of BoNT-A also attenuated the up-regulated Iba1 and GFAP expressions. These results suggest that the anti-nociceptive action of BoNT-A is mediated by modulation activation of glial cells, including microglia and astrocyte.

A Case of Inflammatory Pseudotumor Completely Resolved by Steroid Therapy (스테로이드 요법으로 완치된 염증성 가종양 1예)

  • Bang, Seung-Ho;Kim, Chi-Hong;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.709-713
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    • 1993
  • Inflammatory pseudotumor, also known as plasma cell granuloma, is a rare, benign tumor that affects at all ages and frequently involves the lung, gastrointestinal tract, and salivary gland. They are the most common, isolated, primary lesion of the lung in children less than 16 years of age, and usually present as circumscribed, peripheral, parenchymal tumors, which may be static or increase slowly in size without causing symptoms. Surgical excision is the treatment of choice bacause of the location and benign nature of this lesion. The prognosis after resection is excellent. Adjuvant therapeutic modalities include radiation and steroid therapy. Recently, we experienced a case of inflammatory pseudotumor of the lung, the diagnosis of which was made by percutaneous fine needle aspiration cytology examination. We tried steroid and the lesions of the lung was completely resolved. We report this case with a review of literatures.

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