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Prognostic Value of a Single Center Nutrition Screening Tool in Patients with Metastatic Cancer (전이암 환자에서 단일기관 영양검색 도구의 예후 가치)

  • Yoon, Sung Soo;Kim, Min Jin;Kim, Eun Hye;Lee, Jee Young;Yoon, Seong Woo
    • Journal of Korean Traditional Oncology
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    • v.24 no.2
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    • pp.1-11
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    • 2019
  • Objectives : We investigated whether a single center nutrition screening tool (Kyunghee Neo Nutrition Risk Screening, KNNRS) can predict survival in patients with metastatic cancer. Methods : We retrospectively reviewed data of inpatients with metastatic cancer from April 2016 to August 2019. Data on demographic and clinical parameters were collected from electronic medical records, and overall survival was estimated using the Kaplan-Meier method. Stepwise Cox regression analysis was used to determine factors associated with survival. Patients with a KNNRS score of 0 to 3 were classified as "no-risk", 4 to 10 as "low-risk", and 11 to 20 as "high-risk". Results : Total 105 patients were included in the study. According to nutritional screening at baseline, 25 patients (23.8%, median age 57.0) were classified as ""no risk"" group; 80 patients (76.2%, median age 68.5) as "low risk" group; No patients as "high risk" group. Predictors of survival were Eastern Cooperative Oncology Group Performance Status score of 3 or 4 (hazard ratio [HR] = 1.93; 95% confidence interval [CI] = 1.21-3.10), hemoglobin less than 10 g/dL (HR = 1.97; 95% CI = 1.25-3.10) and C-reactive protein more than 1.0 mg/dL (HR = 1.95; 95% CI = 1.21-3.13). Kaplan-Meier survival analysis showed significant differences in the survival between KNNRS groups: ""no risk"" group: 6.1 ± 1.4 months (95% CI = 3.37-8.83); ""low risk"" group: 3.4 ± 0.9 months (95% CI = 1.5-5.37). Conclusions : Nutritional status according to KNNRS wasn't significant predictor of survival for patients with metastatic cancer. Improvement of KNNRS score thresholds is needed.

Immunohistochemical Expression and Prognostic Value of VEGF, HIF-$1{\alpha}$, EGFR in Non-Small Cell Lung Cancer (비소세포 폐암에서 VEGF, HIF-$1{\alpha}$, EGFR의 면역조직화학적 발현과 예후 인자로서의 역할)

  • Kim, Myung-Sook;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.1
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    • pp.22-28
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    • 2010
  • Background: Vascular endothelial growth factor (VEGF) is a potent mediator of angiogenesis. VEGF production is regulated by HIF-$1{\alpha}$ and EGFR. This study examined the relationship between the clinicopathological factors and VEGF, HIF-$1{\alpha}$ and EGFR protein overexpression, and evaluated their prognostic value in patients with a surgically resected non-small cell lung cancer (NSCLC). Methods: Patients who underwent a surgical resection at Kangnam St. Mary's hospital were reviewed retrospectively. The core biopsy samples from 54 patients with NSCLC were assembled on a tissue microarray (TMA), and immunohistochemical staining for the VEGF, HIF-$1{\alpha}$ and EGFR proteins was performed. The overexpression of these proteins was evaluated in relation to age, gender, histology and staging by univariate analysis. The clinicopathological prognostic factors were analyzed. Results: Multivariate analysis performed by Cox regression (odds ratio 2.8, 95% CI 1.0~8.2, p=0.046) revealed HIF-$1{\alpha}$ overexpression to be an unfavorable factor. There was no correlation between the overexpression of these proteins and the clinicopathological factors. VEGF showed a positive relationship with EGFR, but there was no statistical significance [$p(x^2)=0.06$]. Conclusion: HIF-$1{\alpha}$ overexpression predicts shorter survival in patients with a surgically resected NSCLC. Therefore, HIF-$1{\alpha}$ may be a poor prognostic factor in NSCLC.

Triggers and Outcomes of Falls in Hematology Patients: Analysis of Electronic Health Records (혈액내과 입원 환자의 낙상 위험 요인과 환자 결과: 전자의무기록 분석)

  • Jung, Min Kyung;Lee, Sun-Mi
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.26 no.1
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    • pp.1-11
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    • 2019
  • Purpose: The goal was to use electronic health records to identify factors and outcomes associated with falls among patients admitted to hematology units. Methods: This retrospective case-control study included data from a tertiary university hospital. Analysis was done of records from 117 patients with a history of falls and 201 patients with no history of falls who were admitted to the hematology unit from January 1, 2013 to December 31, 2014. Risk factors were analyzed using hierarchical logistic regression; patient outcomes were analyzed using multiple logistic regression, Cox proportional hazards regression, and multiple linear regression. Results: Clinical factors such as self-care nursing (OR=4.47, CI=1.64~12.11), leukopenia (OR=6.03; CI=2.51~14.50), and hypoalbuminemia (OR=2.79, CI=1.31~5.96); treatment factors such as use of narcotics (OR=2.06, CI=1.01~4.19), antipsychotics (OR=3.05, CI=1.20~7.75), and steroids (OR=4.51, CI=1.92~10.58); and patient factors such as low education (OR=3.16, CI=1.44~6.94) were significant risk factors. Falls were also associated with increased length of hospital stay to 21.58 days (p<.001), and healthcare costs of 17,052,784 Won (p<.001). Conclusion: These findings can be a resource for fall prevention education and to help develop fall risk assessment tools for adults admitted to hematology units.

Prediction of Life-expectancy for Patients with Hepatocellular Carcinoma Based on Prognostic Factors (간암 환자에서 예후인자를 통한 생존기간의 예측)

  • Yeom, Chang-Hwan;Shim, Jae-Yong;Lee, Hye-Ree;Hong, Young-Sun
    • Journal of Hospice and Palliative Care
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    • v.1 no.1
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    • pp.30-38
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    • 1998
  • Background : Hepatocellular carcinomoma is the 3rd most common malignancy and the 2nd most common cause of death in Korea. The prediction of life-expectancy in terminal cancer patients is a major problem for patients, families, and physicians. We would like to investigate the prognostic factors of hepatocellular carcinoma, and therefore contribute to the prediction of the survival time of patients with hepatocellular carcinoma. Methods : A total of 91 patients(male 73, female 18) with hepatocellular carcinoma who were admitted to the hospital between January and lune 1995 were entered into the study, and data were collected prospectively on 28 clinical parameters through medical obligation record. We surveyed an obligation and local district office records, and confirmed the surivival of patients till July, 1996. Using Cox-proportional hazard model, give the significant variables related to survival. These determined prognostic factors. Life regressional analysis was used, there were calculated predicted survival day based on combinations of the significant prognostic factors. Results : 1) Out of 91 patients, 73 were male, and 18 were female. The mean age was $56.7{\pm}10.6$ ears. During the study, except for 16 patients who could not follow up, out of 75 patients, the number of deaths was 57(76%) and the number of survivals was 18(24%). 2) Out of the 28 clinical parameters, the prognostic factors related to reduced survival rate were prothrombin time<40%(relative risk:10.8), weight loss(RR:4.4), past history of hypertension (RR:3.2), ascites(RR:2.8), hypocalcemia(RR:2.5)(P<0.001). 3) Out of five factors, the survival day is 1.7 in all of five, $4.2{\sim}10.0$ in four, $10.4{\sim}41.9$ in three, $29.5{\sim}118.1$ in two, $124.0{\sim}296.6$ in one, 724.0 in none. Conclusion : In hepatocellular carcinoma we found that the prognostic factors related to reduce survival rate were prolonged prothrombin time(<40%), weight loss, past history of hypertension, ascites, and hypocalcemia(<8.7mg/dl). The five prognostic factors enabled the prediction of life-expectancy in patients with hepatocellular carcinoma and may assist in managing patients with hepatocellular carcinomal.

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Protective Effects of Cinnamomi Ramulus Herbal Acupuncture on $\beta$-cell Damage of Streptozotocin-induced Diabetic Rat (계지약침(桂枝藥鍼)이 Streptozotocin 유도 당뇨 흰쥐의 췌장세포 손상에 미치는 보호 효과)

  • Seo, Chang-Wan;Lee, Sang-Hoon;Park, Dong-Suk;Kang, Sung-Keel
    • Journal of Acupuncture Research
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    • v.26 no.6
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    • pp.1-9
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    • 2009
  • Objectives : For evaluation of preventive and anti-diabetic activities of Cinnamomi ramulus(CR) herbal acupuncture on pancreatic islet damage in streptozotocin(STZ)-induced diabetic rat. Methods : CR herbal acupuncture was performed at Bisu($BL_{20}$) for 3 weeks subcutaneously starting1 week before STZ i.p. injection. SD rats were divided into four groups(n=10 for each group); 1) NC group, non-treated normal control group, 2) STZ group, STZ administered control group, 3) CR125 group, CR(125mg/kg) + STZ administered group, and 4) CR250 group, CR(250mg/kg) + STZ administered group. Results : Both of CR250 and CR125 groups showed increase in insulin secretion and decrease in the level of serum triglyceride and non-esterified fatty acid in a dose-dependent manner compared to the STZ group. Only CR250 group showed decrease in the levels of glucose and total cholesterol compared to the STZ group. CR herbal acupuncture prevents $\beta$-cell damage of pancreatic islet, showing round figure on the sections of the pancreas. In the pancreatic cells, expressions of iNOS, JNK-2, P-JNK-1/2 and ERK-1/2 were decreased compared to the STZ group. CR herbal acupuncture solution did not show any cytotoxicity by MTS assay and inhibited expressions of iNOS and COX-2 in the STZ-induced diabetic rats. Conclusions : Therefore, we suggest that CR herbal acupuncture may act as a prophylactic as well as a therapeutic modality for diabetes mellitus.

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Effects and molecular mechanisms of Noemyeong-san, a novel herbal prescription for treating Alzheimer's disease on microglia (미세아교세포에서 알츠하이머형 치매 치료 처방인 뇌명산(腦明散)의 효능 및 기전연구)

  • Han, Sangtae;Jeong, Ji-Cheon
    • Herbal Formula Science
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    • v.25 no.4
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    • pp.471-481
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    • 2017
  • Objectives : Noemyeong-san (NMS) is a novel herbal prescription composed of five oriental medicinal herbs including Prunellae Spica, Betulae Cortex, Foeniculi Fructus, Asiasari Radix, and Clematidis Radix for treating Alzheimer's disease. In the present study, we investigated the effects and molecular mechanisms of NMS on BV2 microglia to evaluate the potential action of this formula for preventing or treating neurodegenerative disease such as Alzheimer's disease. Methods : To determine the cytotoxicity of NMS on BV2 microglia, the MTT assay was performed. The effects of NMS on lipopolysaccharide (LPS)-stimulated BV2 microglia were determined with a nitric oxide (NO) assay and western blots for inflammatory mediator-related proteins, mitogen activated protein kinases (MAPKs), nuclear factor kappa B (NF-${\kappa}B$) pathway-related proteins, and heme oxygenase-1 (HO-1). Result : NMS inhibited induction of iNOS and COX-2 as well as NO production without affecting the cell viability in LPS-stimulated BV2 microglia. NMS also suppressed activation of ERK and p38 MAPK among main kinases of MAPKs as well as NF-${\kappa}B$ by LPS stimulation. Furthermore, NMS dose-dependently induced the expression of HO-1 and the inhibitory effect of NMS on the production of NO were blocked by pretreatment with an HO-1 inhibitor, Snpp. Conclusions : These results demonstrate that NMS has potent anti-neuroinflammatory effect on the LPS-stimulated microglia. These findings provide evidences for NMS to be considered as a new prescription for preventing or treating neurodegenerative disease such as Alzheimer's disease.

The Experimental Studies of YangHyulEum Gami-Bang Extracts on the Hair Growth Effect (양혈음가미방(養血飮加味方) 추출물의 발모효과에 대한 실험적 연구)

  • Hong, Jee-Hee;Jung, Hyun-A
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.29 no.3
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    • pp.74-94
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    • 2016
  • Objectives : YangHyulEum Gami-Bang(YHEG) is a hair care extracts which is composed of fourteen plant extracts used in oriental medicine. The purpose of this study is to investigate the effect of YangHyulEum Gami-Bang(YHEG) on the alopecia and hair growth.Methods & Results : The herbal extracts from YangHyulEum Gami-Bang(YHEG) was tested using in vivo and in vitro test models. 1. The YHEG extracts showed effect on the DNA proliferation of the hair dermal papilla cells measured by [3H]thymidine incorporation. 2. YHEG showed promoting on the expression of growth factors such as IGF-1, KGF-1 and inhibiting on the expression of inhibitory hair growth factor such as TGF-β1, BMP-2 estimated by qPCR. 3. The YHEG extracts showed effect on the activation of β-catenin in the dermal papilla cells. 4. YHEG showed inhibitory effects of NO synthesis at 0.2% concentrations. 5. YHEG showed effects in the expression of IL-1β, TNF-α, IL-6, COX-2 and iNOS gene in the LPS stimulated RAW 264.7 cells. 6. The hair growth index of the YHEG extracts ranked at over 2 when compared to control group which was ranked at 0. 7. The hair follicle number, length and size of the experimental group were remarkably higher than the control group in the histological observation.Conclusions : These results suggest that YangHyulEum Gami-Bang(YHEG) has hair growth promoting activity and it can be used as a potent treatment agent for preventing hair loss and stimulating hair growth for treatment of alopecia.

Antiplatelet Effects of Cordycepin-Enriched WIB-801CE from Cordyceps militaris: Involvement of Thromboxane A2, Serotonin, Cyclooxygenase-1, Thromboxane A2 Synthase, Cytosolic Phospholipase A2

  • Ok, Woo Jeong;Nam, Gi Suk;Kim, Min Ji;Kwon, Hyuk-Woo;Kim, Hyun-Hong;Shin, Jung-Hae;Lim, Deok Hwi;Kwon, Ho-Kyun;Lee, Chang-Hwan;Chung, Soo-Hak;Kim, Jong-Lae;Park, Hwa-Jin
    • Biomedical Science Letters
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    • v.22 no.4
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    • pp.127-139
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    • 2016
  • A species of the fungal genus Cordyceps has been used as an ingredient of traditional Chinese medicine. In this study, we prepared cordycepin-enriched WIB-801CE, an ethanol extract from culture solution of Cordyceps militaris-hypha, and evaluated its antiplatelet effects on human platelet aggregation. WIB-801CE dose-dependently inhibited ADP-, collagen-, and thrombin-induced platelet aggregation. These antiplatelet effects by WIB-801CE were associated with the attenuation of thromboxane $A_2$ ($TXA_2$) production and serotonin release by ADP, collagen, and thrombin. The inhibition of $TXA_2$ production by WIB-801CE was due to the inhibition of cyclooxygenase-1, $TXA_2$ synthase, and cytosolic phospholipase $A_2$ activity. Therefore, these data suggest that WIB-801CE may be a beneficial component against protection from platelet aggregation-mediated thrombotic disease.

Comparative Study of the Biological Activity Effects of Manjakani (Quercus infectoria Olivier) Extract using Water and 80% Ethanol (열수 및 80% 에탄올로 추출한 만자카니(Quercus infectoria Olivier)의 생리활성 비교연구)

  • Lee, Hea-Jin;Kim, Dong-Han;Lee, Eun-Jin;Lim, Mi-Hye
    • Journal of the Korean Applied Science and Technology
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    • v.37 no.1
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    • pp.124-132
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    • 2020
  • The purpose of this study was to investigate the biological activities such as cytotoxicity and anti-inflammation using Manjakani (Quercus infectoria Olivier) extract. Manjakani was extracted from hot DW and 80% ethanol. Cell viability was assessed using MTT assay on RAW 264.7 cells. Also, anti-inflammatory activities were measured through changes in the levels of nitric oxide (NO), prostaglandin E2 (PGE2), leukotrien B4 (LTB4), pro-inflammatory cytokines (IL-1β, IL-6 and tumor necrosis factor (TNF)-α) and transcription factor on LPS-induced RAW264.7 cells. The results confirmed that significant cytotoxicity does not appear in the concentration range of 1, 5, and 10 ㎍/㎖ of both extracts of this study. The production of NO was slowed by approximately MDE 37.2% and MEE 43.7% at 10 ㎍/㎖ concentration. Also, level of PGE2 and LTB4 was decreased MDE 30.9%/MEE 43.7% and MDE 37.1%/MEE 43.7%. In the case of inflammatory cytokine was reduced to MDE 38.8%/MEE 50.8% for IL-1β, MDE 35.0%/MEE 44.2% for IL-6 and MDE 31.9%/MEE 36.6% for TNF-α at 10 ㎍/㎖ concentration. The mRNA expression of NF-κB, iNOS and COX-2 significantly decreased by MDE 44.0%/MEE 16.0%, MDE 44.0%/MEE 55.0% and MDE 45.0%/MEE 40.0%, respectively, following the 10 ㎍/mL sample treatment when compared to the control. Both extracts were effective in anti-inflammatory activity. In addition, both extracts showed efficient changes of production of NO, PGE2, LTB4, pro-inflammatory cytokines and transcription factor. But MEE was found to have a higher inhibitory effect than MDE. In other words, Manjakani was showed significant biological activities showing anti-inflammation without cytotoxicity. These results will be provided as fundamental data for further development of the new health food and therapeutics related to the results above.

Long-Term Outcome of Posterior Cervical Inclinatory Foraminotomy

  • Heo, Juneyoung;Chang, Jae Chil;Park, Hyung-Ki
    • Journal of Korean Neurosurgical Society
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    • v.59 no.4
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    • pp.374-378
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    • 2016
  • Objective : A modified surgical technique of posterior cervical foramintomy called posterior cervical inclinatory foraminotomy (PCIF) was introduced in previous preliminary article. PCIF allows better preservation of facet joint and capsule than conventional techniques. The authors conducted a study to investigate long-term outcomes of PCIF. Methods : We retrospectively reviewed demographic, radiologic, and clinical data from the patients who underwent PCIFs at our institution. Criteria included a minimum of 48 month follow-up and PCIFs for patients with radiculopathy from foraminal stenosis (C2-T1; single or multilevel) with persistent or recurrent root symptoms despite conservative treatment for more than 3 months. Patients who had undergone previous cervical operation were excluded. The visual analogue scale (VAS) score was used for clinical follow-up, and radiologic follow-up was performed to compare the changes of cervical sagittal alignment, focal angle and disc-space height of treated segment. Results : The PCIFs were performed between April 2007 and March 2011 on 46 patients (32 males and 14 females) with a total of 73 levels affected. The average duration of follow-up was 74.4 months. Improvements in radiculopathic pain were seen in 39 patients (84.7%), and VAS score decreased from $6.82{\pm}1.9$ to $2.19{\pm}1.9$. Posterior neck pain also improved in 25 patients (71.4%) among 35 patients, and VAS score decreased from $4.97{\pm}2.0$ to $2.71{\pm}1.9$. The mean disc-space heights of treated segment were $5.41{\pm}1.03mm$ preoperatively and decreased to $5.17{\pm}1.12mm$ postoperatively. No statistically significant changes in cervical sagittal alignment, focal angle were seen during the follow-up period (Cox proportional hazards analysis and Student t-test, p>0.05). Conclusion : The PCIF is highly effective in treating patients with cervical spondylotic radiculopathy, leading to long-lasting relief in pain. Long-term radiologic follow-up showed no significant spinal angular imbalance.