• Journal of Hospice and Palliative Care
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• v.16 no.4
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• pp.205-215
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• 2013

Most terminally ill cancer patients experience various physical and psychological symptoms during their illness. In addition to pain, they commonly suffer from fatigue, anorexia-cachexia syndrome, nausea, vomiting and dyspnea. In this paper, I reviewed some of the common non-pain symptoms in terminally ill cancer patients, based on the National Comprehensive Cancer Network (NCCN) guidelines to better understand and treat cancer patients. Cancer-related fatigue (CRF) is a common symptom in terminally ill cancer patients. There are reversible causes of fatigue, which include anemia, sleep disturbance, malnutrition, pain, depression and anxiety, medical comorbidities, hyperthyroidism and hypogonadism. Energy conservation and education are recommended as central management for CRF. Corticosteroid and psychostimulants can be used as well. The anorexia and cachexia syndrome has reversible causes and should be managed. It includes stomatitis, constipation and uncontrolled severe symptoms such as pain or dyspnea, delirium, nausea/vomiting, depression and gastroparesis. To manage the syndrome, it is important to provide emotional support and inform the patient and family of the natural history of the disease. Megesteol acetate, dronabinol and corticosteroid can be helpful. Nausea and vomiting will occur by potentially reversible causes including drug consumption, uremia, infection, anxiety, constipation, gastric irritation and proximal gastrointestinal obstruction. Metoclopramide, haloperidol, olanzapine and ondansetron can be used to manage nausea and vomiting. Dyspnea is common even in terminally ill cancer patients without lung disease. Opioids are effective for symptomatic management of dyspnea. To improve the quality of life for terminally ill cancer patients, we should try to ameliorate these symptoms by paying more attention to patients and understanding of management principles.

• The Journal of Korean Obstetrics and Gynecology
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• v.25 no.3
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• pp.40-60
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• 2012

Objectives: The object of this study was to observe antitumor, anticachexia and immunomodulatory effects of Shipyeukmiyeugi-eum(SYM) on human breast cancer cell, MCF-7, xenograft Balb/c nu-nu nude mice. Methods: Three different dosages of SYM-125, 250 and 500 mg/kg were orally administered once a day for 28 days from 11 days after tumor cell inoculation, and the changes on the body weights, tumor volume and weights, weights of spleen and popliteal lymph node and epididymal fat, serum IL-6 and IFN-${\gamma}$ levels, NK cell and peritoneal macrophage activities, splenic TNF-${\alpha}$, IL-$1{\beta}$ and IL-10 contents were observed. In addition, histopathological observations of apoptotic cell, spleen, popliteal lymph node and cervical brown adipose were also detected. The results were compared with a potent cytotoxic estrogen receptor antagonist, Tamoxifen 20 mg/kg treated mice. Results: Tumor volumes and weights were decreased without cytotoxic effects on the both MCF-7 and MCF-10A cells as results of all three different dosages of SYM treatment. And weights of body, spleen, popliteal lymph node, epididymal fat, serum IFN-${\gamma}$, NK cell, peritoneal macrophage activities, splenic TNF-${\alpha}$, IL-$1{\beta}$ and IL-10 contents were increased with decrease of serum IL-6. At histopathological observations, apoptotic tumor cells, spleen, popliteal lymph node and cervical brown adipose tissue were increased. That means tumor-related immunosuppress and cachexia were markedly inhibited by SYM treatment as compared with tumor-bearing mice. On the other hand, Tamoxifen showed marked cytotoxic effects against MCF-7 and MCF-10A, decreases of tumor volume and weights, and increases of apoptotic tumor cells and related decreases of tumor cell volumes, but tamoxifen markedly deteriorated the tumor-related immune-suppress and cachexia. Conclusions: The results obtained in this study suggest that SYM showed favorable anticancer effects and anticachexic effects on the MCF-7 cell xenograft through immunomodulatory effects. SYM did not induce any cytotoxic effects against both normal and cancer cells.

• Journal of Physiology & Pathology in Korean Medicine
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• v.32 no.4
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• pp.261-270
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• 2018

The aim of this study was to evaluate the antitumor activities of Typhae pollen (TP) by confirming in vitro cytotoxicity and in vivo anti-tumor and immune-modulatory effect with anti-cachexia effect. The MTT assay is used in HepG2 cell to detect potential cytotoxic activities of aqueous extract of Typhae pollen (TPe). After HepG2 tumor cell implantation, eight mice per groups were assigned to six groups. Three different dosages of TPe (500, 250 and 125 mg/kg) were orally administered in the amount of $10m{\ell}/kg$ and sorafenib also administered 20mg/kg, every day for 35 days from 28 days after the tumor cell implantation. We observed the changes on body weights, tumor volume and weights, lymphatic organ, serum interferon $(IFN)-{\gamma}$ levels, splenocytes and peritoneal NK cell activity, splenic tumor necrosis factor $(TNF)-{\alpha}$, interleukin $(IL)-1{\beta}$, IL-10 contents. Periovarian fat weights, serum IL-6 levels, thicknesses of deposited periovarian adipose tissue and mean diameters were also detected to monitor the tumor-related anticachexic effects. In tumor masses, the immunoreactivities of cleaved caspase-3 and cleaved poly (ADP-ribose) polymerase (cleaved PARP) - apoptotic marks, cyclooxygenase-2 (COX-2), inducible nitric oxide synthases (iNOS) and tumor necrosis factor $(TNF)-{\alpha}$ were additionally observed by immunohistochemistry. The results were compared with sorafenib. Decreases of COX-2 were demonstrated in sorafenib and TPe treated mice and also increases of iNOS in tumor masses were observed in TPe, not in sorafenib. TPe increased periovarian fat pad weights compared with tumor-bearing controls and sorafenib treated mice. TPe showed increases of splenic $TNF-{\alpha}$, IL-10 and $IL-1{\beta}$, serum $IFN-{\gamma}$ and NK cell activities corresponding to increases of spleen weights, lymph node weights and non-atrophic changes of lymph nodes. Our results show oral treatment of TPe 500, 250 and 125 mg/kg has potent in vitro and in vivo antitumor activities through modest cytotoxic effects, immunomodulatory effects and apoptotic activities in HepG2 tumor cells. In addition, TPe can prevent cancer related cachexia.

• Journal of Veterinary Clinics
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• v.35 no.2
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• pp.53-56
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• 2018

Computed tomography (CT) findings of hepatic adenoma in veterinary medicine are variable and unlike in human medicine, not defined clearly. A 12-year-old neutered male Shih Tzu presented after a seizure, with weight loss, salivation, and cachexia. An abdominal mass was identified on radiography, and ultrasonographic images showed a mixed echo pattern with marked vascularity. CT showed that the mass originated from caudate lobe, was heterogeneously hypoattenuated compared with the hepatic parenchyma, and had irregular margins. Contrast enhanced CT showed that the mass enhanced like the surrounding liver parenchyma. However, it contained unenhanced areas and enhanced vessels were observed in the arterial phase at the periphery of the mass. The margins of mass were more enhanced in the venous phase than the arterial phase and the hypoattenuating regions within the mass were not enhanced. Greater enhancing in the venous phase is seen with adenomas; however, the heterogeneous enhancement pattern, especially the marginal vascular enhancement and internal hypoattenuating regions, is seen with malignancy. Although this is a single case of hepatic adenoma, the atypical enhanced pattern of this case can provide useful information to predict the malignancy of primary liver tumor.

• Korean Journal of Biological Psychiatry
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• v.5 no.2
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• pp.197-209
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• 1998

In mordern society, nutritional and appetite disorders occur in epidemic proportions and are serious health harzards. Obesity and diabetes affect over 30% of American population, while eating disorders, such as anorexia nervosa and bulimia nervosa occur in a growing number of adolescences and young adults. The changes in various sociocultural aspects with the introduction of Westernized culture have had the effect of increasing the risk of same problems in Korea. Disorderd eating patterns are a primary symptom of numerous psychiatric disorders and loss of appetite and cachexia, during illness or in the elderly, preclude proper medical treatment for restoring good health or preserving life. Increased understanding of the systems of the body and brain, related to energy and nutrient balance, may help us to treatment and ultimately prevent these commom disorders. In this review, the author highlights the psychobiological mechanisms or factors which are associated with eating behavior, especially in the view of intake psychobiology. This review would be concentrated on 1) the theoretical concepts and theories of eating behavior ; 2) the psychobiological determinants of food intake ; and 3) the psychobiological control of eating behavior.

• Korean Journal of Veterinary Research
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• v.25 no.2
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• pp.175-181
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• 1985

An eighteen months old, female, Great Dane dog which had shown signs of severe cachexia, dehydration, hematuria, vomiting and the palpable cervical mass during three weeks was examined clinically and necropsied after death. Diagnosis of this tumor case was made by gross pathology, cytology of the aspirate, radiography of the abdomen and the tumor tissse as multicentric, histiocytic lymphosarcoma. Cytologic findings of the needle aspirate of the cervical lesion were typical of macrophage origin cell. The tnmor was encountered predominantly in the lymph nodes, tonsils and spleen. The predominant cell type of these tumor masses manifested characteristics of histiocytic cells.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.3
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• pp.242-248
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• 2019

Purpose: Severe acute malnutrition (SAM) is an important public health problem which contributes to significant number of under five deaths. Protocol based management significantly decreases risk of deaths in children with medical complications. Methods: Outcome of children aged 2 months-5 years admitted and fulfilling definition of SAM having diarrhea (group A) was compared to children with SAM having medical complications other than diarrhea (group B). Both groups were managed according to standard recommended protocols and monitored and followed up for 12 weeks after discharge. Results: The average weight gain, defaulter rate, primary failure, secondary relapse rate and readmission rate were similar in both groups. Length of stay in group A was three days longer (p-value=0.039). Discharge rate was comparable with overall 68% of children successfully discharged and 50% of children reaching weight/height > -2 standard deviation at follow-up of 12 weeks. Conclusion: The current management protocol is equally effective for managing children with SAM having diarrhea. Good adherence to management protocol of dehydration and timely modification of therapeutic feeds in children with persistent diarrhea results in satisfactory weight gain.

• Korean Journal of Veterinary Service
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• v.44 no.2
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• pp.119-124
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• 2021

The report describes an avian mycobacteriosis in a captive wild bird. A 7-year-old female Indian peafowl (Pavo cristatus) maintained in a zoo of Korea presented a gradual cachexia and eventually was found dead. At necropsy, severely atrophied pectoral muscles exposing the keel bone were noticed. Yellowish thick nodules in varying sizes were scattered in all lobes of lungs, liver and spleen, suggesting mycobacteriosis. Histopathologically, multifocal to coalescing granulomas surrounded by multinucleated giant cells were observed. Numbers of acid-fast bacilli were revealed in granulomas. Then, a series of molecular diagnostic techniques were followed: a nested PCR, DNA sequencing and bioinformatics analysis. It resulted as Mycobacterium genavense. The identification of M. genavense as an etiological agent suggested that it might serve as a risk factor for other captive wild animals, and for a potential zoonotic risk since M. genavense have been a definite cause of disseminated mycobacterial infection in immunocompromised people. To the authors' knowledge, this is the first report of avian mycobacteriosis with M. genavense in a captive Indian peafowl.

• Journal of Veterinary Clinics
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• v.39 no.5
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• pp.253-257
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• 2022

A 5-year-old castrated male Golden Retriever dog weighing 15 kg presented with evidence of intestinal intussusception. The patient had cachexia and severe dehydration before being referred to our department. Ultrasound imaging revealed a target sign indicative of intestinal intussusception. Emergency surgery was performed shortly after diagnosis. After a successful surgery, the patient was hospitalised for postoperative care. Initial treatment was aimed at the reversion of dehydration and the provision of adequate nutrition. Fluid therapy and central parenteral nutrition were administered via the peripheral and central venous catheters, respectively. Ten days postoperatively, swelling and edema were observed in the head and neck. Ultrasound and computed tomography confirmed complete blockage of the cranial vena cava due to thrombosis, which consequently obstructed both the left and right jugular veins. For treatment, dalteparin and tissue plasminogen activator were administered. However, the patient lost all of its vital function on the daybreak of postoperative day 11. Venous thrombus formation secondary to central parenteral nutrition application via the central line is a rare but possible complication. Veterinarians who are concerned about taking care of patients receiving CPN through the central line should keep the possibility of venous thrombus formation in mind.

• Journal of Society of Preventive Korean Medicine
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• v.17 no.3
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• pp.129-141
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• 2013

Objectives : Anorexia is the primary symptom impinging cancer patients' Quality of Life. It is usually accompanied by gastrointestinal symptoms(GI symptoms). Thus, to measure anorexia symptom precisely, assessing anorexia and GI symptoms together is recommended. This study was designed to analyze cancer-related anorexia assessment tools, extract GI symptoms included in these tools and investigate usefulness of instruments in clinical trials. Methods : Instruments were selected by searching PubMed, PROQOLID database. We analyzed instruments by number of items, assessment method, type of question, GI symptoms. Results : 9 instruments were selected to assess cancer-related anorexia symptom. Most tools adopt Likert scale as response scale and 'during past week' as recall period. Assessment method of all 9 instruments is the self-administration. Questions measuring anorexia are able to be sorted into 3 forms (frequency, severeness, distress of anorexia symptom). Among the GI symptoms, nausea is included in all 9 instruments. In clinical trials of cancer-related anorexia, Edmonton Symptom Assessment Scale(ESAS) and Functional Assessment of Anorexia/Cachexia Therapy Questionnaire(FAACT) were selected as endpoint measure. Conclusions : The result showed that FAACT is the only specialized tool to assess cancer-related anorexia. To measure cancer-related anorexia precisely, the need to develop new instrument exists.