• Title/Summary/Keyword: Hormone Therapy

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Efficacy of Exemestane After Nonsteroidal Aromatase inhibitor Use in Metastatic Breast Cancer Patients

  • Kim, Sun-Hye;Park, In-Hae;Lee, Hye-Won;Lee, Keun-Seok;Nam, Byung-Ho;Ro, Jung-Sil
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.3
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    • pp.979-983
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    • 2012
  • Background : Previous studies have suggested a lack of complete cross-resistance between steroidal (exemestane) and non-steroidal aromatase inhibitors (nSAI). Methods : Eighty-eight metastatic breast cancer (MBC) patients who received 25 mg of exemestane orally once a day at the National Cancer Center, Korea, between 2003 and 2009, were reviewed retrospectively. All patients had received nSAI for metastatic disease prior to exemestane therapy. Results : The median age was 52 years (range, 33-79), and 13 (14.8%) patients were premenopausal who concomitantly received GnRH agonist. Exemestane was given as a second- (80.7%) or third-line (19.3%) hormone therapy. The clinical benefit (CB) rate (complete response + partial response + stable disease ${\geq}$ 24 weeks) was 30.7%, with a median CB duration of 10.0 months (range, 6.3-78.7). The median progression-free survival (PFS) was 3.0 months (95% confidence interval [CI], 1.99-4.01) and the overall survival (OS) 21.5 months (95% CI, 17.96-25.04), with a median followup of 50.3 months. Patients who achieved CB had longer OS than those patients who did not (29.6 vs 17.9 months; P=0.002). On univariate analysis of predictive factors, patients who had achieved CB from previous nSAI tended to show lower CB rate (24.6% vs 44.4%, respectively; P=0.063) and shorter PFS (2.8 vs 4.8 months, respectively; p=0.233) than patients who had not. Achieving CB from previous nSAI became independent predictive factor for CBR to exemestane on multivariable analysis (Odds ratio = 2.852, P = 0.040). Conclusions : Exemestane after nSAI failure was effective in prolonging CB duration. The drug's efficacy seemed to be inferior in patients who had benefit from previous nSAI use.

The effect of relax therapy on the change of facial temperature by D.I.T.I. (이완요법(弛緩療法)이 안면(顔面) 체열(體熱) 변화(變化)에 미치는 영향(影響))

  • Cho, Jung-Hoon;Lee, Kyung-Sub
    • Journal of Oriental Medical Thermology
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    • v.3 no.1
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    • pp.27-35
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    • 2004
  • Today, everybody lives in the stress. So 50% to 80% or 60% to 80% of the modern diseases are estimated what is caused by the stress. And one of the most important point of the stress is a too serious and continuos tension state. Therefore the best way to promotion, persistence, prevention and treatment of the modern man's health will be the relaxion from the tension state. The relax therapy as known as am effective method to the disease which as concerned with stress. that can be adapted to the treatment of anxiety-related diseases, insomnia, hypertension, tension headache, migraine, asthma, preparation of delivery, G-I disorders and menstrual disorders. Until now we guess the change of a relaxed state by the observation to the change of autonomic nervous system(ANS) and EEG. From the point of the ANS, sympathetic nervous system progresses slowly but parasympathetic nervous system increases the activity. In the EEG, both the alpha-wave concerned with the deep physical relaxed state and emotional stability and the theta-wave appeared in the state of meditation are increased. Current studies show that among the biochemical changes, especially serotinin like body hormone is increased by the feeling of the stability or the happiness. So, to see the change of the relaxed state in the image of the D.I.T.I., we used the deviational differences between the pre-relaxed state and the post-relaxed state of 70 people. As a result, the portional deviation of the face is decreased in the image of the D.I.T.I. So it can be thaught that we can determine the changes of the relaxed state by the D.I.T.I.

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Mesenteric Fibromatosis Mimicking Recurrence after Distal Gastrectomy for Gastric Cancer

  • Kim, Dae-Hoon;Oh, Seung-Jong;Oh, Jeong-A;Bae, Young-Sik;Choi, Min-Gew;Noh, Jae-Hyung;Sohn, Tae-Sung;Kim, Kyoung-Mee;Kim, Sung;Bae, Jae-Moon
    • Journal of Gastric Cancer
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    • v.10 no.2
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    • pp.79-83
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    • 2010
  • Mesenteric fibromatosis is a monoclonal, fibroblastic proliferation arising from musculoaponeurotic structure, and it is distinctive lesions defined as a group of non-metastasizing fibroblastic tumors which has local invasion and has a high recurrence rate after the surgical excision. The main treatment modality is the surgical excision. Radiation therapy, chemotherapy, and hormone therapy are also known as useful treatments. We report our experience of a recent case of Mesenteric fibromatosis. A 62-year old female patient had undergone gastrectomy due to gastric cancer. 18 months after gastrectomy, we detected an abdominal mass. The preoperative radiologic findings were suggestive of recurrence. Exploratory laparotomy was performed and post-operative pathologic diagnosis was confirmed as fibromatosis. We report a patient with mesenteric fibromatosis that mimic recurrence after gastrectomy for gastric cancer.

Review of Herbs Used as Treatment for Menopausal Patients in Alternative Medicine (대체의학에서 갱년기 증후군에 사용되는 약물에 대한 고찰)

  • Kim, Seung-Hyun;Lee, Jin-Moo;Lee, Chang-Hoon;Cho, Jung-Hoon;Jang, Jun-Bock;Lee, Kyung-Sub
    • The Journal of Korean Obstetrics and Gynecology
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    • v.21 no.3
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    • pp.90-98
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    • 2008
  • Purpose: Menopausal syndrome is caused by urgent changes of sex hormone in women. The hormonal therapy can soothe the problems of menopausal patients, but it can increase the probability of another disease, such as breast cancer, heart attack, etc. So the demand of alternative herb therapy is increasing in Western countries. In Korea, herbal medicine is imported and used by Western doctors. To know and use the alternative herbal medicine, Korean Medical doctors should know their efficacy and safety. Methods: We researched the Medline(Pubmed) with the key word such as 'CAM', 'herb' and 'menopause'. We selected the herbs known as treating the menopausal syndrome and researched the similar or same herbs that are used in Korean medicine by the scientific name and efficient ingredients. To evaluate the efficacy of the herbs, we compared the herbs that were differently defined in alternative and Korean medicine Results: Balm, black cohosh, chaste berry, dong quai. evening primrose oil. ginkgo, St. John's wort, valerian root, and sarsaparilla were chosen as prevalent herbs used in alternative medicine. The pharmacologic effect of Black cohosh, licorice root, St. John's wort were recognized. But these three herbs are not usually prescripted for menopausal patients in Korean medicine. So we could apply these three herbs as one of Korean medical treatments. The efficacy of other herbs cannot be surely prescripted for menopausal patients. Conclusion: The efficacy and safety of alternative medicine is not proved yet. But to diversify the treatmental methods of Korean medicine, we need to prove and use these medicine as one of Korean medical treatment.

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Fertility-sparing treatment in women with endometrial cancer

  • Won, Seyeon;Kim, Mi Kyoung;Seong, Seok Ju
    • Clinical and Experimental Reproductive Medicine
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    • v.47 no.4
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    • pp.237-244
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    • 2020
  • Endometrial cancer (EC) in young women tends to be early-stage and low-grade; therefore, such cases have good prognoses. Fertility-sparing treatment with progestin is a potential alternative to definitive treatment (i.e., total hysterectomy, bilateral salpingo-oophorectomy, pelvic washing, and/or lymphadenectomy) for selected patients. However, no evidence-based consensus or guidelines yet exist, and this topic is subject to much debate. Generally, the ideal candidates for fertility-sparing treatment have been suggested to be young women with grade 1 endometrioid adenocarcinoma confined to the endometrium. Magnetic resonance imaging should be performed to rule out myometrial invasion and extrauterine disease before initiating fertility-sparing treatment. Although various fertility-sparing treatment methods exist, including the levonorgestrel-intrauterine system, metformin, gonadotropin-releasing hormone agonists, photodynamic therapy, and hysteroscopic resection, the most common method is high-dose oral progestin (medroxyprogesterone acetate at 500-600 mg daily or megestrol acetate at 160 mg daily). During treatment, re-evaluation of the endometrium with dilation and curettage at 3 months is recommended. Although no consensus exists regarding the ideal duration of maintenance treatment after achieving regression, it is reasonable to consider maintaining the progestin therapy until pregnancy with individualization. According to the literature, the ovarian stimulation drugs used for fertility treatments appear safe. Hysterectomy should be performed after childbearing, and hysterectomy without oophorectomy can also be considered for young women. The available evidence suggests that fertility-sparing treatment is effective and does not appear to worsen the prognosis. If an eligible patient strongly desires fertility despite the risk of recurrence, the clinician should consider fertility-sparing treatment with close follow-up.

Adipose tissue-derived mesenchymal stem cells reduce endometriosis cellular proliferation through their anti-inflammatory effects

  • Meligy, Fatma Y.;Elgamal, Dalia A.;Abdelzaher, Lobna A.;Khashbah, Maha Y.;El-Mokhtar, Mohamed A.;Sayed, Ayat A.;Refaiy, Abeer M.;Othman, Essam R.
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.4
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    • pp.322-336
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    • 2021
  • Objective: Endometriosis is a chronic debilitating inflammatory condition characterized by the presence of endometrial tissues outside the uterine cavity. Pelvic soreness and infertility are the usual association. Due to the poor effectiveness of the hormone therapy and the high incidence of recurrence following surgical excision, there is no single effective option for management of endometriosis. Mesenchymal stem cells (MSCs) are multipotent stromal cells studied for their broad immunoregulatory and anti-inflammatory properties; however, their efficiency in endometriosis cases is still a controversial issue. Our study aim was to evaluate whether adipose tissue-derived MSCs (AD-MSCs) could help with endometriosis through their studied anti-inflammatory role. Methods: Female Wistar rats weighting 180 to 250 g were randomly divided into two groups: group 1, endometriosis group; established by transplanting autologous uterine tissue into rats' peritoneal cavities and group 2, stem cell treated group; treated with AD-MSCs on the 5th day after induction of endometriosis. The proliferative activity of the endometriosis lesions was evaluated through Ki67 staining. Quantitative estimation of interferon γ, tumor necrosis factor-α, interleukin (IL)-6, IL-1β, IL-10, and transforming growth factor β expression, as well as immunohistochemical detection of CD68 positive macrophages, were used to assess the inflammatory status. Results: The size and proliferative activity of endometriosis lesions were significantly reduced in the stem cell treated group. Stem cells efficiently mitigated endometriosis associated chronic inflammatory reactions estimated through reduction of CD68 positive macrophages and the expression of the proinflammatory cytokines. Conclusion: Stem cell therapy can be considered a novel remedy in endometriosis possibly through its anti-inflammatory and antiproliferative properties.

Effects of Methadone Maintenance Therapy on Thyroid Function of Adult Men

  • Bozchelou, Shahrzad;Delirrad, Mohammad
    • Toxicological Research
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    • v.35 no.1
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    • pp.9-12
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    • 2019
  • One of the major challenges in methadone maintenance therapy (MMT) for drug dependence is the physiological side effects on endocrine hormones. Because of the key role of the thyroid gland in the normal functioning of the human body and brain, this study examined the effect of MMT on thyroid function. Thyroid hormones (T3, T4, and thyroid-stimulating hormone (TSH)) were evaluated in normal and user treated with MMT who were referred to the Province Clinical & Pathology Center of Urmia, Iran. The study was conducted for three months using the Case Series method. A total of 270 samples were collected, 215 were from individuals who were not treated, whereas 55 were from men treated with methadone. Average levels of T3 and T4 in non-treated sample of men are $1.34{\pm}0.02ng/mL$ and $90.96{\pm}1.38ng/mL$ while the corresponding values for patients treated with methadone are $1.39{\pm}0.04ng/mL$ for T3 and $94.57{\pm}2.72ng/mL$ for T4. Mean TSH levels of the non-treated group and the methadone consuming group were $1.75{\pm}0.08{\mu}IU/mL$ and $3.17{\pm}0.45{\mu}IU/mL$, respectively. These results indicate that although men treated with methadone had higher levels of T3, T4, and TSH than normal individuals, only the difference in TSH level was significant. The importance of this difference among individuals on methadone maintenance programs should be investigated in larger samples over long periods of time. Additionally, the effects of methadone treatment on women should be examined.

Novel nomogram-based integrated gonadotropin therapy individualization in in vitro fertilization/intracytoplasmic sperm injection: A modeling approach

  • Ebid, Abdel Hameed IM;Motaleb, Sara M Abdel;Mostafa, Mahmoud I;Soliman, Mahmoud MA
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.2
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    • pp.163-173
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    • 2021
  • Objective: This study aimed to characterize a validated model for predicting oocyte retrieval in controlled ovarian stimulation (COS) and to construct model-based nomograms for assistance in clinical decision-making regarding the gonadotropin protocol and dose. Methods: This observational, retrospective, cohort study included 636 women with primary unexplained infertility and a normal menstrual cycle who were attempting assisted reproductive therapy for the first time. The enrolled women were split into an index group (n=497) for model building and a validation group (n=139). The primary outcome was absolute oocyte count. The dose-response relationship was tested using modified Poisson, negative binomial, hybrid Poisson-Emax, and linear models. The validation group was similarly analyzed, and its results were compared to that of the index group. Results: The Poisson model with the log-link function demonstrated superior predictive performance and precision (Akaike information criterion, 2,704; λ=8.27; relative standard error (λ)=2.02%). The covariate analysis included women's age (p<0.001), antral follicle count (p<0.001), basal follicle-stimulating hormone level (p<0.001), gonadotropin dose (p=0.042), and protocol type (p=0.002 and p<0.001 for short and antagonist protocols, respectively). The estimates from 500 bootstrap samples were close to those of the original model. The validation group showed model assessment metrics comparable to the index model. Based on the fitted model, a static nomogram was built to improve visualization. In addition, a dynamic electronic tool was created for convenience of use. Conclusion: Based on our validated model, nomograms were constructed to help clinicians individualize the stimulation protocol and gonadotropin doses in COS cycles.

A Case Report of Korean Medicine Treatment for Pleural Effusion due to Metastasis of Breast Cancer (유방암의 폐전이로 인한 흉막 삼출의 한의치료에 대한 증례보고)

  • Moon, Jiseong;Kim, Hakkyeom;Kim, Yeseul;Min, Seonwoo;Park, Jiyoon;Ahn, Lib
    • The Journal of Internal Korean Medicine
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    • v.42 no.3
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    • pp.420-430
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    • 2021
  • The survival time of breast cancer patients with lung metastasis has been prolonged as treatment methods have improved. However, there is yet no definitive therapy for the additional symptoms of lung metastasis to improve the quality of life of these patients. We report a patient who was suffering from pleural effusion due to metastasized breast cancer. She was treated with Korean medicine, including herbal medicine (Bojungikgi-tang-gami), combined with hormone therapy, for two months. We assessed her other symptoms, such as shortness of breath, generalized weakness, and lower extremity swelling, using a numeric rating scale (NRS). We also evaluated pleural effusion with chest X-rays. Shortness of breath was maintained at NRS 5, generalized weakness was slightly improved from NRS 6~7 to NRS 7~8 (10=healthy condition), and lower extremity edema was improved from NRS 3 to NRS 2 (10=highest score of discomfort). Malignant pleural effusion was maintained during the admission period. This report suggests that Korean medicine can help to maintain malignant pleural effusion and improve additional symptoms of lung metastasis.

From diagnosis to treatment of mucopolysaccharidosis type VI: A case report with a novel variant, c.1157C>T (p.Ser386Phe), in ARSB gene

  • Yoo, Sukdong;Lee, Jun;Kim, Minji;Yoon, Ju Young;Cheon, Chong Kun
    • Journal of Genetic Medicine
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    • v.19 no.1
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    • pp.32-37
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    • 2022
  • Mucopolysaccharidosis type VI (MPS VI) is an autosomal recessive lysosomal disorder caused by the deficiency of arylsulfatase B due to mutations in the ARSB gene. Here, we report the case of a Korean female with a novel variant of MPS VI. A Korean female aged 5 years and 8 months, who is the only child of a healthy non-consanguineous Korean couple, presented at our hospital for severe short stature. She had a medical history of umbilical hernia and recurrent otitis media. Her symptoms included snoring and mouth breathing. Subtle dysmorphic features, including mild coarse face, joint contracture, hepatomegaly, and limited range of joint motion, were identified. Radiography revealed deformities, suggesting skeletal dysplasia. Growth hormone (GH) provocation tests revealed complete GH deficiency. Targeted exome sequencing revealed compound heterozygous mutations in the ARSB genes c.512G>A (p.Gly171Asp; a pathogenic variant inherited from her father) and c.1157C>T (p.Ser386Phe; a novel variant inherited from her mother in familial genetic testing). Quantitative tests revealed increased urine glycosaminoglycan (GAG) levels and decreased enzyme activity of arylsulfatase B. While on enzyme replacement therapy and GH therapy, her height increased drastically; her coarse face, joint contracture, snoring, and obstructive sleep apnea improved; urine GAG decreased; and left ventricular mass index was remarkably decreased. We report a novel variant-c.1157C>T (p.Ser386Phe)-of the ARSB gene in a patient with MPS VI; these findings will expand our knowledge of its clinical spectrum and molecular mechanisms.