Background: Bone metastasis is a single condition but presents with various patterns and severities. Skeletal-related events (SREs) deteriorate overall performance status and reduce quality of life. However, guidelines for early detection and management are limited. This study includes a survey of the prevalence of bone metastasis in cases with common cancers in Thailand as well as a focus on survival patterns and SREs. Materials and Methods: A retrospective cohort analysis was conducted using a database of the Chiang Mai Cancer Registry and the Musculoskeletal Tumor Registry of the OLARN Center, Chiang Mai University. The prevalence of bone metastasis from each type of primary cancer was noted and time-to-event analysis was performed to estimate cancer survival rates after bone metastasis. Results: There were 29,447 cases of the ten most common cancers in Thailand, accounting for 82.2% of the entire cancer registry entries during the study period. Among those cases, there were 2,263 with bone metastases, accounting for 7.68% of entries. Bone metastasis from lung, liver, breast, cervix and prostate are common in the Thai population, accounting for 83.4% of all positive cases. The median survival time of all was 6 months. Of the bone metastases, 48.9% required therapeutic intervention, including treatment of spinal cord and nerve root compression, pathological fractures, and bone pain. Conclusions: The frequency of the top five types of bone metastasis in Thailand were different from the frequencies in other countries, but corresponded to the relative prevalence of the cancers in Thailand and osteophilic properties of each cancer. The results of this study support the establishment of country specific guidelines for primary cancer identification with skeletal lesions of unknown origin. In addition, further clinical studies of the top five bone metastases should be performed to develop guidelines for optimal patient management during palliative care.
To establish an appropriate policy for robotic surgery in Korea, the National Evidence-based Collaborating Agency (NECA) and the Korean Society of Health Policy and Administration held a round-table conference (RTC) to gather opinions through a comprehensive discussion of scientific information in gastric cancer. The NECA RTC is a public discussion forum wherein experts from diverse fields and members of the lay public conduct in-depth discussions on a selected social issue in the health and medical field. For this study, representatives from the medical field, patient groups, industry, the press, and policy makers participated in a discussion focused on the medical and scientific evidence for the use of robotic surgery in gastric cancer. According to the RTC results, robotic surgery showed more favorable results in safety and efficacy than open surgery and it is similar to laparoscopy. When the cost-effectiveness of robotic surgery and laparoscopy is compared, robotic surgery costs are higher but there was no difference between the two of them in terms of effectiveness (pain, quality of life, complications, etc.). In order to resolve the high cost issue of the robotic surgery, a proper policy should be implemented to facilitate the development of a cost-effective model of the robotic surgery equipment. The higher cost of robotic surgery require more evidence of its safety and efficacy as well as the cost-effectiveness issues of this method. Discussions on the national insurance coverage of robotic surgery seems to be necessary in the near future.
Background: As of now, the impact of low back pain (LBP) and its chronic state, chronic low back pain (CLBP), on mental health-related quality of life (HRQOL) has never been investigated among police officers. The present investigation aims at studying this relationship using a biopsychosocial model. Methods: Between May and October 2014, a Web-based cross-sectional study was conducted among Quebec police officers (Quebec, Canada). Mental HRQOL was measured using the role emotional (RE) and the mental health (MH) domains of the SF-12v2 Health Survey. The impact of CLBP on mental HRQOL (as opposed to acute/subacute LBP or no LBP) was studied with a multivariate linear regression model. Results: Of the 3,589 police officers who participated in the study, 1,013 (28.4%) reported CLBP. The mean age of respondents was $38.5{\pm}8.7years$, and 32.0% were females. The RE (44.1/100) and MH (49.0/100) mean scores of the CLBP group were comparable with the scores found in populations suffering from cancer or heart diseases. Compared to officers without LBP, the presence of CLBP was significantly associated with lower RE (${\beta}$: -0.068; p = 0.003) and MH (${\beta}$: -0.062; p = 0.002) scores. These relationships were not found in the acute/subacute LBP group. Conclusion: Our results underscore how frequent CLBP is among police officers and how burdensome it is. Considering the importance of good physical and mental health for this occupational population, police organizations should be aware of this issue and contribute to the efforts toward CLBP prevention and management in the workplace.
Yap, Ning Yi;Ng, Keng Lim;Ong, Teng Aik;Pailoor, Jayalakshmi;Gobe, Glenda Carolyn;Ooi, Chong Chien;Razack, Azed Hassan;Dublin, Norman;Morais, Christudas;Rajandram, Retnagowri
Asian Pacific Journal of Cancer Prevention
/
v.14
no.12
/
pp.7497-7500
/
2013
Background: This study concerns clinical characteristics and survival of renal cell carcinoma (RCC) patients in University Malaya Medical Centre (UMMC), as well as the prognostic significance of presenting symptoms. Materials and Methods: The clinical characteristics, presenting symptoms and survival of RCC patients (n=151) treated at UMMC from 2003-2012 were analysed. Symptoms evaluated were macrohaematuria, flank pain, palpable abdominal mass, fever, lethargy, loss of weight, anaemia, elevated ALP, hypoalbuminemia and thrombocytosis. Univariate and multivariate Cox regression analyses were performed to determine the prognostic significance of these presenting symptoms. Kaplan Meier and log rank tests were employed for survival analysis. Results: The 2002 TNM staging was a prognostic factor (p<0.001) but Fuhrman grading was not significantly correlated with survival (p=0.088). At presentation, 76.8% of the patients were symptomatic. Generally, symptomatic tumours had a worse survival prognosis compared to asymptomatic cases (p=0.009; HR 4.74). All symptoms significantly affect disease specific survival except frank haematuria and loin pain on univariate Cox regression analysis. On multivariate analysis adjusted for stage, only clinically palpable abdominal mass remained statistically significant (p=0.027). The mean tumour size of palpable abdominal masses, $9.5{\pm}4.3cm$, was larger than non palpable masses, $5.3{\pm}2.7cm$ (p<0.001). Conclusions: This is the first report which includes survival information of RCC patients from Malaysia. Here the TNM stage and a palpable abdominal mass were independent predictors for survival. Further investigations using a multicentre cohort to analyse mortality and survival rates may aid in improving management of these patients.
Kim, Sang-Chan;Lee, Sang-Tae;Kim, Dae-Jun;Byun, Joon-Seok
Herbal Formula Science
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v.13
no.1
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pp.71-83
/
2005
Chelidonii Herba (Baekgulchae in Korean: CHE), a commonly used herb in Korea, Japan and China, is widely used in the treatment of stomach cancer, jaundice, gastric ulcer, edema and pain of stomach. In the present study, we demonstrated that CHE induces apoptosis in AGS cells, human stomach adenocarcinoma cell line. One of the most important recent advances in cancer research is the recognition that apoptosis plays a major role in both tumor formation and treatment response, In this study, CHE caused a decrease of viability in AGC cells. When AGS cells were treated with CHE, cells showed dose-dependent manner apoptotic cell death. Increased apoptotic cell death, exposured to CHE, resulted from induction of Bad translocation to mitochondria, cytochrome-c release from mitochondria to cytosol, activation of caspase-3, 8, 9, and PARP cleavage. These results suggest that CHE may be potential therapeutic approach in the clinical management of stomach adenocarcinoma.
Hemophilia A is a hemorrhagic disease caused by coagulation factor VIII deficiency. In head and neck cancer surgery, especially during a reconstructive one, complications can occur. These include hematomas due to bleeding which can then lead to flap ischemia, necrosis, and impaired wound healing. There are fewer cases of reconstructive surgery in patients with hemophilia A. Here in we report, a reconstructive surgery that involved mass resection, partial glossectomy (right), selective neck dissection (right, Levels I, II, III, IV), and reconstruction at the lateral arm free flap (left) in a 25-year-old man with hemophilia A. The surgery was successfully performed without any complications after pretreatment with Factor VIII concentrate, which has not been reported earlier.
A clinical study of selected patients with intraoral squamous cell carcinoma which were managed in the Department of Oral Oncology of Korea Cancer Center Hospital from January 1982 to August 1989 was done. And following results were obtained. 1. Males were involved more than females by intraoral squamous cell carcinoma in a ratio of 4:1. and most of the cases occurred in the 7th and 6th decades (69%). 79% of total patients and 92.5% of males were. 2. The mean duration of symptomatic period was 5.9 months. 3. The common symptoms were swelling (63%), pain (40%), ulceration (33%), and trismus (23%) 4. In the histologic findings, well differentiation comprised 58.0%. 5. The primary sites were the upper alveolar mucosa (32%), the floor of the mouth (21%), the lower alveolar mucosa (19%), tongue (14%), retromolar trigone (8%), palate (7%) and buccal mucosa (3%). 6. According to TNM system, Stage I, Stage II, Stage III, and Stage IV comprised 4%, 15%, 32%, and 49% respectively. 7. In the management of intraoral squamous cell carcinoma, surgeries were done in the 32 cases, 23 cases of which were managed by radiation therapy or chemotherapy concurrently. And radiation therapy alone was received in 35 cases. 8. Overall 3 and 5-year survival rates without regarding to stage were 27.6% and 21.4%. 9. 3-year survival rate of female patients was 47.2% and that of male patients was 22.6%. 10. 5-year survival rate was 53.9% for "early" cancer (stage I and II) and 15.6% for "advanced"cancer (stage III and IV). Survival rate of patients in the early stages of cancer appeared to be higher than that of patients with stage III and IV(p<0.05).
Yadav, Budhi Singh;Bansal, Anshuma;Kuttikat, Philip George;Das, Deepak;Gupta, Ankita;Dahiya, Divya
Radiation Oncology Journal
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v.38
no.2
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pp.109-118
/
2020
Purpose: Hypofractionated radiotherapy (RT) is becoming a new standard in postoperative treatment of patients with early stage breast cancer after breast conservation surgery. However, data on hypofractionation in patients with advanced stage disease who undergo mastectomy followed by local and regional nodal irradiation (RNI) is lacking. In this retrospective study, we report late-term effects of 3 weeks post-mastectomy hypofractionated local and RNI with two-dimensional (2D) technique in patients with stage II and III breast cancer. Methods: Between January 1990 and December 2007, 1,770 women with breast cancer who were given radical treatment with mastectomy, systemic therapy and RT at least 10 years ago were included. RT dose was 35 Gy/15 fractions/3 weeks to chest wall by two tangential fields and 40 Gy in same fractions to supraclavicular fossa (SCF) and internal mammary nodes (IMNs). SCF and IMNs dose was prescribed at dmax and 3 cm depth, respectively. Chemotherapy and hormonal therapy was given in 64% and 74% patients, respectively. Late-term toxicities were assessed with the Radiation Therapy Oncology Group (RTOG) scores and LENT-SOMA scales (the Late Effects Normal Tissue Task Force-Subjective, Objective, Management, Analytic scales). Results: Mean age was 48 years (range, 19 to 75 years). Median follow-up was 12 years (range, 10 to 27 years). Moderate/marked arm/shoulder pain was reported by 254 (14.3%) patients. Moderate/marked shoulder stiffness was reported by 219 (12.3%) patients. Moderate/marked arm edema was seen in 131 (7.4%) patients. Brachial plexopathy was not seen in any patient. Rib fractures were noted in 6 (0.3%) patients. Late cardiac and lung toxicity was seen in 29 (1.6%) and 23 (1.3%) patients, respectively. Second malignancy developed in 105 (5.9%) patients. Conclusion: RNI with 40 Gy/15 fractions/3 weeks hypofractionation with 2D technique seems safe and comparable to historical data of conventional fractionation (ClinicalTrial.gov Registration No. NCT04175821).
The purpose of this study was to investigate the feasibility of developing transdermal drug delivery system (TDDS) for fentanyl used for the management of chronic cancer pain. The effect of type of pressure sensitive adhesive on the permeation of fentanyl from polyisobutylene (PIB), silicone and acrylic adhesive was evaluated. Due to the good adhesive force and relatively steady flux for 3 days, both acrylic and PIB adhesives were chosen for further study. The permeation rate of fentanyl was the highest from acrylic adhesive with hydroxyl functional group. Permeation rate increased linearly as the concentration of fentanyl in acrylic adhesive was increased from 2.5% to 10%. In case of PIB adhesive, crystals of fentanyl were developed above 5% drug load. $Crovol^{(R)}$ A40, $Crovol^{(R)}$ PK40 and Plurol $oleique^{(R)}$ provided higher flux of fentanyl.
Yu, Seonhye;Chun, Eunho;Ji, Yeounjung;Lee, Young Joo;Jin, Mirim
Journal of Ginseng Research
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v.45
no.6
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pp.706-716
/
2021
Background: Irritable bowel syndrome (IBS), the most common functional gastrointestinal disorder, is characterized by chronic abdominal pain and bowel habit changes. Although diverse complicated etiologies are involved in its pathogenesis, a dysregulated gut-brain axis may be an important factor. Red ginseng (RG), a traditional herbal medicine, is proven to have anti-inflammatory effects and improve brain function; however, these effects have not been investigated in IBS. Methods: Three-day intracolonic zymosan injections were used to induce post-infectious human IBS-like symptoms in mice. The animals were randomized to receive either phosphate-buffered saline (CG) or RG (30/100/300 mg/kg) for 10 days. Amitriptyline and sulfasalazine were used as positive controls. Macroscopic scoring was performed on day 4. Visceral pain and anxiety-like behaviors were assessed by colorectal distension and elevated plus maze and open field tests, respectively, on day 10. Next-generation sequencing of gut microbiota was performed, and biomarkers involved in gut-brain axis responses were analyzed. Results: Compared to CG, RG significantly decreased the macroscopic score, frequency of visceral pain, and anxiety-like behavior in the IBS mice. These effects were comparable to those after sulfasalazine and amitriptyline treatments. Moreover, RG significantly increased the proliferation of beneficial microbes, including Lactobacillus johnsonii, Lactobacillus reuteri, and Parabacteroides goldsteinii. RG significantly suppressed expression of IL-1β and c-fos in the gut and prefrontal cortex, respectively. Further, it restored the plasma levels of corticosterone to within the normal range, accompanied by an increase in adrenocorticotropic hormone. Conclusion: RG may be a potential therapeutic option for the management of human IBS.
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