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Clinical Study of Thalidomide Combined with Dexamethasone for the Treatment of Elderly Patients with Newly Diagnosed Multiple Myeloma

  • Chen, Hai-Fei;Li, Zheng-Yang;Tang, Jie-Qing;Shen, Hong-Shi;Cui, Qing-Ya;Ren, Yong-Ya;Qin, Long-Mei;Jin, Ling-Juan;Zhu, Jing-Jing;Wang, Jing;Ding, Jie;Wang, Ke-Yuan;Yu, Zi-Qiang;Wang, Zhao-Yue;Wu, Tian-Qin
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4777-4781
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    • 2012
  • Objective: To investigate the relationship between the efficacy and safety of different doses of thalidomide (Thal) plus dexamethasone (Dex) as the initial therapy in elderly patients with newly diagnosed multiple myeloma (MM). Methods: Clinical data of 28 elderly patients with newly diagnosed MM who underwent the TD regimen as the initial therapy were analyzed retrospectively. The patients were divided into two groups according to the maximal sustained dose of Thal: lower dose (group A) and higher dose (group B). The overall response rate (ORR), progression free survival (PFS), overall survival (OS), and adverse events (AES) were compared between the two groups. Results: A total of 28 patients were followed up with a median of 18 months. The ORR was 60.1%. The median response time and PFS were 2.0 and 17.0 months, respectively. The mean sustained dose of Thal in group B was significantly higher than group A (292.9 mg v 180.4 mg, P=0.01). There was no significantly difference in ORR (57.1% v 64.3%, P=1.00) and PFS (9.63months v 17.66 months, P=0.73) between groups A and B. During the follow up, only five patients died (<40%) and, therefore, median OS values were not available. It is estimated, however, that the mean survival time in the two groups was 35.6 and 33.4 months (P>0.05), respectively. All of the patients tolerated the treatment well. The incidence of AES in patients with a grading above 3 in group B was significantly higher than in group A (P=0.033). Conclusions: The TD regimen results in a high response rate and manageable AES as the initial therapy in elderly patients with MM. TD should be considered as the front line regimen for the treatment of elderly patients with MM in areas with financial constraints. The clinical response can be achieved at a low dose Thal with minimal toxicity.

Questions and Answers about the Humidifier Disinfectant Disaster as of February 2017 (가습기살균제 참사의 진행과 교훈(Q&A))

  • Choi, Yeyong
    • Journal of Environmental Health Sciences
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    • v.43 no.1
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    • pp.1-22
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    • 2017
  • 'The worstest environment disaster', 'World's first biocide massacre', 'Home-based Sewol ferry disaster' are all phrases attached to the recent humidifier disinfectant disaster. In the spring of 2011, four of 8 pregnant women including 1 adult man passed away at a university hospital in Seoul due to breathing failure. Epidemiologic investigation conducted by the Korean CDC soon revealed the inhalation of humidifier disinfectant, which had been widely used in Korea during the winter, to be responsible for the disease. As well as lung fibrosis hardening of the lungs, other diseases including asthma, rhinitis, skin disease, liver disease, fetal disease or cancers have been researched for their relation with exposure to the products. By February 9, 2017, 5,342 cases had registered for health problems and 1,131 of them were already dead (20.8% mortality rate). Based on studies by government agencies and a telephone survey of the general population by Seoul National University and civic groups, around 20% of the general public of Korea has used these products. Since the market release of the first product by SK Chemical in 1994, over 7.1 million items from around 20 brands were sold up to 2011. Most of the products were manufactured by well-known large conglomerates such as SK, Lotte, Samsung, Shinsegye, LG, and GS, as well as some European companies including UK-based Reckitt Benckiser and TESCO, the German firm Henkel, the Danish firm KeTox, and an Irish company. Even though this disaster was unveiled in 2011 by the Korean government, the issue of the victims was neglected for over five years. In 2016, an unexpected but intensive investigation by prosecutors found that Reckitt Benckiser manipulated and concealed animal tests for its own brand and brought several university experts and company employees to court. The matter was an intense social issue in Korea from May to June with a surge in media coverage. The prosecutor's investigation and a nationwide boycott campaign organized by victims and environmental groups against Reckitt Benckiser, whose product had been used by more than 70% of victims, led to the producer's official apology and a compensation scheme. A legislative investigation organized after the April 2016 national election revealed the producers' faults and the government's responsibility, but failed to meet expectations. A special law for the victims passed the National Assembly in January 2017 and a punitive system together with a massive environmental epidemiology investigation are expected to be the only solutions for this tragedy. Sciences of medicine, toxicology and environmental health have provided decisive evidence so far, but for the remaining problems the perspectives of social sciences such as sociology and jurisprudence are highly necessary, similar to with the Minamata disease and Wonjin Rayon events. It may not be easy to follow this issue using unfamiliar terminology from medical and chemical science and the long, complicated history of the event. For these reasons the author has attempted to write this article in a question and answer format to render it easier to follow. The 17 questions are: Q1 What is humidifier disinfectant? Q2 What kind of health problems are caused by humidifier disinfectant? Q3 How many victims are there? Q4 What is the analysis of the 1,112 cases of death? Q5 What is the problem with the government's diagnostic criteria and the solution? Q6 Who made what brands? Q7 Has there been a recall? What is still on sale? Q8 Was safety not checked by any producers? Q9 What are the government's responsibilities? Q10 Is it true that these products were sold only in Korea? Q11 Why and how was it unveiled only in 2011 after 17 years of sales? Q12 What delayed the resolution of the victim issue? Q13 What is the background of the prosecutor's investigation in early 2016? Q14 Is it possible to report new victim cases without evidence of product purchase? Q15 What is happening with the victim issue? Q16 How does it compare with the cases of Minamata disease and Wonjin Rayon? Q17 Are there prevention measures and lessons?

Changes in Cordycepin and Liquiritigenin Content and Inhibitory Effect on NO Production in Fermented Licorice and Dongchunghacho (동충하초균주로 발효한 감초의 주요성분 함량 변화 및 NO 생성 억제 효과)

  • Wang, Ziyu;Li, Mei;Li, Ke;Son, Beung Gu;Kang, Jum Soon;Park, Young Hoon;Lee, Yong Jae;Kim, Sun Tae;Jung, Jae-Chul;Lee, Young Guen;Choi, Young Whan
    • Journal of Life Science
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    • v.27 no.1
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    • pp.57-66
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    • 2017
  • Traditional Korean fermented herbal plants are potential sources of new food that promote health, but they are still produced by yeast, fungi or bacteria fermentation. In the present work, mushroom (Paecilomyces tenuipes and Cordyceps militaris) fungal dongchunghacho were used to fermented Glycyrrhiza uralensis Fischer (licorice) or mixed with pupa. The pupa were tested as solid substrates for the production of corcycepin, liquiritin, and liquiritigenin. The fermented substrates were analyzed the content of cordycepin, liquiritin, liquiritigenin, and glycirrhizin productivity and inhibitory activity of NO. The cordycepin content of 70% EtOH extract from the fermented mixture of licorice and 50% pupa with C. militaris increased maximum at 33 times. Pupa was very excellent for the production of cordycepin. The liquiritin content was decreased in all the assays inoculated with P. tenuipes and C. militaris dongchunghachos. The liquiritigenin content was higher when fermented with P. tenuipes than C. militaris. The addition of pupa significantly reduced the liquiritin content and glycyrrhizin production. As a result, the liquiritigenin content increased in fermented P. tenuipes and C. militaris, and liquiritin and glycyrrhizin decreased. The inhibition of NO production in the different ethanolic extracts fermented with licorice and pupa was also significantly increased and higher than that of a nonfermented extract in higher polar solvent extracts. The contents of cordycepin and biological active compounds were altered in accordance with the concentration of pupa and fungi. This study provides basic data for use in developing dongchunghacho fungi as a functional food resource.

Quantitative Comparisons between CT and $^{68}Ge$ Transmission Attenuation Corrected $^{18}F-FDG$ PET Images: Measured Attenuation Correction vs. Segmented Attenuation Correction (CT와 $^{68}Ge$ 감쇠보정 $^{18}F-FDG$ PET 영상의 정량적 비교: 측정감쇠보정대 분할감쇠보정)

  • Choi, Joon-Young;Woo, Sang-Keun;Choi, Yong;Choe, Yearn-Seong;Lee, Kyung-Han;Kim, Byung-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.1
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    • pp.49-53
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    • 2007
  • Purpose: It was reported that CT-based measured attenuation correction (CT-MAC) produced radioactivity concentration values significantly higher than $^{68}Ge$-based segmented attenuation correction (Ge-SAC) in PET images. However, it was unknown whether the radioactivity concentration difference resulted from different sources (CT vs. Ge) or types (MAC vs. SAC) of attenuation correction (AC). We evaluated the influences of the source and type of AC on the radioactivity concentration differences between reconstructed PET images in normal subjects and patients. Material and Methods: Five normal subjects and 35 patients with a known or suspected cancer underwent $^{18}F-FDG$ PET/CT. In each subject, attenuation corrected PET images using OSEM algorithm (28 subsets, 2 iterations) were reconstructed by 4 methods: CT-MAC, CT-SAC, Ge-MAC, and Ge-SAC. The physiological uptake in normal subjects and pathological uptake in patients were quantitatively compared between the PET images according to the source and type of AC. Results: The SUVs of physiological uptake measured in CT-MAC PET images were significantly higher than other 3 differently corrected PET images. Maximum SUVs of the 145 foci with abnormal FDG uptake in CT-MAC images were significantly highest among 4 differently corrected PET images with a difference of 2.4% to 5.1% (p<0.001). The SUVs of pathological uptake in Ge-MAC images were significantly higher than those in CT-SAC and Ge-MAC PET images (p<0.001). Conclusion: Quantitative radioactivity values were highest in CT-MAC PET images. The adoption of MAC may make a more contribution than the adoption of CT attenuation map to such differences.

Effect of Reperfusion after 20 min Ligation of the Left Coronary Artery in Open-chest Bovine Heart: An Ultrastructural Study (재관류가 허혈 심근세포의 미세구조에 미치는 영향 : 재관류 손상에 관한 연구)

  • 이종욱;조대윤;손동섭;양기민;라봉진;김호덕
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.739-748
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    • 1998
  • Background: It has been well documented that transient occlusion of the coronary artery causes myocardial ischemia and finally cell death when ischemia is sustained for more than 20 minutes. Extensive studies have revealed that ischemic myocardium cannot recover without reperfusion by adequate restoration of blood flow, however, reperfusion can cause long-lasting cardiac dysfunction and aggravation of structural damage. The author therefore attempted to examine the effect of postischemic reperfusion on myocardial ultrastructure and to determine the rationales for recanalization therapy to salvage ischemic myocardium. Materials and methods: Young Holstein-Friesian cows(130∼140 Kg body weight; n=40) of both sexes, maintained with nutritionally balanced diet and under constant conditions, were used. The left anterior descending coronary artery(LAD) was occluded by ligation with 4-0 silk snare for 20 minutes and recanalized by release of the ligation under continuous intravenous drip anesthesia with sodium pentobarbital(0.15 mg/Kg/min). Drill biopsies of the risk area (antero-lateral wall) were performed at just on reperfusion(5 minutes), 1-, 2-, 3-, 6-, 12-hours after recanalization, and at 1-hour assist(only with mechanical respiration and fluid replacement) after 12-hour recanalization. The materials were subdivided into subepicardial and subendocardial tissues. Tissue samples were examined with a transmission electron microscope (Philips EM 300) at the accelerating voltage of 60 KeV. Results: After a 20-minute ligation of the LAD, myocytes showed slight to moderate degree of ultrastructural changes including subsarcolemmal bleb formation, loss of nuclear matrix, clumping of chromatin and margination, mitochondrial destruction, and contracture of sarcomeres. However, microvascular structures were relatively well preserved. After 1-hour reperfusion, nuclear and mitochondrial matrices reappeared and intravascular plugging by polymorphonuclear leukocytes or platelets was observed. However, nucleoli and intramitochondrial granules reappeared within 3 hours of reperfusion and a large number of myocytes were recovered progressively within 6 hours of reperfusion. Recovery was apparent in the subepicardial myocytes and there were no distinct changes in the ultrastructure except narrowed lumen of the microvessels in the later period of reperfusion. Conclusions: It is likely that the ischemic myocardium could not be salvaged without adequate restoration of coronary flow and that the microvasculature is more resistant to reversible period of ischemia than subendocardium and subepicardium. Therefore, thrombolysis and/or angioplasty may be a rational method of therapy for coronarogenic myocardial ischemia. However, it may take a relatively longer period of time to recover from ischemic insult and reperfusion injury should be considered.

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Studies on Production of Heteropolysaccharide by Mutant of Xanthomonas malvacearum (Xanthomonas malvacearum 돌연변이주(突然變異株)의 Heteropolysaccharide 생산성(生産性)에 관(關)하여)

  • Lee, Ke-Ho;Kim, Mi-Sun;Park, Chan-Yung
    • Applied Biological Chemistry
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    • v.30 no.1
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    • pp.77-87
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    • 1987
  • The mutant with high productivity, X. malvacearum SNUF 560-6, was acquired from the X. malvacearum SNUF 560 with low productivity by UV-light irradiation. It was preserved is lyophilized stock culture and it was transferred to PDA slant to maintain viability fortnightly. Fermentations were started by retransfering to MY agar slant from PDA stok culture. The experiments for optimal xanthan gum production were studied in a chemically defined medium. Of the carbon and nitrogen sources tested, 0.4% sucrose medium and 10mM glutamic acid medium yielded the highest xanthan gun production respectively. The addition of 10g/l succinic acid stimulated xanthan gum production. Also 65mM $PO_4\;^{-3}\;(12.6g/l\;KH_2PO_4)$ was effective on xanthan gum production. Finally, medium 1 and medium 2 which have high xanthan gum production potencies were achieved in this stud. The components of medium 1 and medium 2 were as follows: Medium 1 : sucrose 40g/l glutamate 10mM $PO_4\;^{-3}\;54mM\;(KH_2PO_4\;12.65g/l)$ Citrate 2g/l $MgSO_4{\cdot}7H_2O\;0.2g/l$ $H_3BO_3\;0.005/l$ ZnO 0.006/l $FeCl_2{\cdot}6H_2O\;0.0024g/l$ $CaCO_3\;0.02g/l$ Medium 2 : $Sucrose\;40g/l\;(NH_4)_2SO_4\;2g/l$ $PO_4\;^{-3}\;65mM\;(KH_2PO_4\;12.65g/l)$ Succinate 10g/l $MgSO_4{\cdot}7H_2O\;0.02g/l$ $H_3BO_3\;0.06g/l$ ZnO 0.006g/l $FeCl_2{\cdot}6H_2O\;0.0024g/l$ $CaCO_3\;0.02g/l$.

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Tephra Origin of Goryeri Archaeological Site, Milyang Area, Korea (밀양 고례리 화산 유리물질 기원 해석)

  • 김주용;양동윤;박영철
    • The Korean Journal of Quaternary Research
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    • v.13 no.1
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    • pp.35-43
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    • 1999
  • Goryeri archaeological site is located in the upstream valley of the Danjang River. The basement rocks of the area are composed of the Cretaceous to Palaeogene biotite granite (KbGr), acidic dyke (Kad), Milyang Andesite (Kma) and Jyunggagsan Formation. Among them Milyang Andesite and Jyunggagsan Formation are prevailed in archaeological site and they are composed of reddish brown tuffaceous shale, sandstone and conglomerate, with intercalations of acidic tuffs and lapilli tuffs. The purpose of this research is not only to compare REE pattern of the soil-sedimentary deposits with those of surrounding rocks, but also to identify vitric tephra in the soil-sedimentary deposits derived from the andesite, acidic tuff and lapilii tuff, in order to illucidate the provenance of the vitric tephra. The rare earth element(REE) of the soils and sedimentary deposits results in the same REE pattern with those analyzed from the surrounding basement rocks. This indicates that the soils and sedimentary deposits are originated from the surrounding basement rocks, most probably from the andesite and lapilli tuff. In addition, vitric tephra were identified both in the Quaternary in-situ weathered soils and sedimentary deposits (PMU-13 and PMU-17), and in the weathered surrounding lapilli tuff. These vitric tephra are considered to be different from those of Japanese AT(Aira Tanzawa) -tephra. The latter is predominant with clean, platty, bubble-walled and Y-shaped vitrics, while the former is conspicuous with those shapes of large and diverse size and devitrified, as well as having secondarily bubbled-surfaces reflecting surface weathering. The size of vitric fragments in the Goryeri site is about 300${\mu}{\textrm}{m}$ and large in size in compasion to 150${\mu}{\textrm}{m}$ of Japanese AT-Tephra. The interim results of the research are contradictary to the explanations based on a series of AT-tephra researches carried by Japanese scholar. In short, the vitric materials of the Goryeri archaeological site are most probably originated from the weathering products of the surrounding basement rocks, and are different from the AT-tephra in their size, shape and devitrification properties. Thus it is highly recommended to have a further comprehensive research which is more emphasized the magmatic genesis of these vitric tephra in addition to the external shape and morphology.

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Association between Dietary Factors and Breast Cancer Risk among Chinese Females: Systematic Review and Meta-analysis

  • Liu, Xue-Ou;Huang, Yu-Bei;Gao, Ying;Chen, Chuan;Yan, Ye;Dai, Hong-Ji;Song, Feng-Ju;Wang, Yao-Gang;Wang, Pei-Shan;Chen, Ke-Xin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.3
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    • pp.1291-1298
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    • 2014
  • Background: Evidence for associations between dietary factors and breast cancer risk is inconclusive among Chinese females. To evaluate this question, we conducted a systematic review of relevant case-control and cohort studies. Methods: Studies were systematically searched among 5 English databases (PudMed, ScienceDirect, Wiley, Clinicaltrials.gov, and Cochrane) and 3 Chinese databases (CNKI, WanFang, and VIP) until November 2012. Random effects models were used to estimate summary odds ratios (ORs) and the corresponding 95% confidence intervals (CIs). Results: Thirty one case-control studies and two cohort studies involving 9,299 cases and 11,413 controls were included. Consumption of both soy and fruit was significantly associated with decreased risk of breast cancer, with summary ORs of 0.65 (95% CIs: 0.43-0.99; I2=88.9%, P<0.001; N=13) and 0.66 (95% CIs: 0.47-0.91; $I^2$=76.7%, P<0.001; N=7), respectively. Consumption of fat was significantly associated with increased risk of breast cancer (OR=1.36; 95% CIs: 1.13-1.63; $I^2$=47.9%, P=0.088; N=6). There was nonsignificant association between consumption of vegetables and breast cancer risk (OR=0.72; 95% CIs: 0.51-1.02; $I^2$= 74.4%, P<0.001; N=9). However, sensitivity analysis based on adjusted ORs showed decreased risk of breast cancer was also associated with consumption of vegetables (OR=0.49; 95% CIs: 0.30-0.67). Conclusion: Both soy food and fruit are significantly associated with decreased risk of breast cancer among Chinese females, and vegetables also seems to be protective while dietary fatexerts a promoting influence.

Tea Consumption, Alcohol Drinking and Physical Activity Associations with Breast Cancer Risk among Chinese Females: a Systematic Review and Meta-analysis

  • Gao, Ying;Huang, Yu-Bei;Liu, Xue-Ou;Chen, Chuan;Dai, Hong-Ji;Song, Feng-Ju;Wang, Jing;Chen, Ke-Xin;Wang, Yao-Gang
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7543-7550
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    • 2013
  • Objective: To evaluate associations between tea consumption, alcohol drinking and physical activity and breast cancer risk among Chinese females. Methods: Three English databases (PubMed, ScienceDirect and Wiley) and three Chinese databases (CNKI, WanFang and VIP) were independently searched by 2 reviewers up to December 2012, complemented by manual searches. The quality of included studies was assessed with the Newcastle-Ottawa Scale items. Random-effects models were used to estimate the pooled odds ratios (ORs) and 95% confidence intervals (CIs). Potential publication bias was estimated through Egger's and Begg's tests. Heterogeneity between studies was evaluated with $I^2$ statistics. Results: Thirty-nine studies involving 13,204 breast cancer cases and 87,248 controls were identified. Compared with non-drinkers, regular tea drinkers had decreased risk (OR=0.79, 95%CIs: 0.65-0.95; $I^2$=84.9%; N=16). An inverse association was also found between regular physical activity and breast cancer risk (OR=0.73, 95%CIs: 0.63-0.85; $I^2$=77.3%; N=15). However, there was no significant association between alcohol drinking and breast cancer risk (OR=0.85, 95%CIs: 0.72-1.02; $I^2$=63.8%; N=26). Most of the results from the subgroup analysis were consistent with the main results. Conclusion: Tea consumption and physical activity are significantly associated with a decreased risk of breast cancer in Chinese females. However, alcohol drinking may not be associated with any elevation of risk.

The Prediction of Ambient Temperature and the Correlation Analysis for Carbon Dioxide, Carbon Monoxide and Relative Humidity in Gwangju (광주지역 기온변화 예측과 $CO_2$, CO, 상대습도와의 상관성분석)

  • Lee, Dae-Haeng;Jeong, Won-Sam;Lee, Se-Haeng;Park, Kang-Soo;Kim, Nan-Hee;Kim, Do-Sool;Paik, Ke-Jin;Park, Jong-Tae
    • Journal of Korean Society of Environmental Engineers
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    • v.31 no.11
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    • pp.1041-1050
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    • 2009
  • The ambient temperature and concentration of carbon dioxide in Gwangju and the reducing method of temperature, air pollutants were investigated using the atmospheric data in Gwangju. Average ambient temperature ($T_{a-ave}$ was $13.5^{\circ}C$ during 1961 to 2008. The temperature was predicted as increasing of about $2.7^{\circ}C$ in 2108 after 100 years using the trend line of regression equation. Carbon dioxide was 370.7 and 391.4 ppm at Anmyundo, in 1999 and 2008, respectively, showing proportionally increased as ambient temperature. The temperature at Gwangju, $14.2^{\circ}C$ during 1997 to 2008, was a little higher than at neighboring counties as Naju, Damyang, Hwasoon, and Jangsung. In Gwangju, Spring will start in mid-January of 2108, Summer in mid-May, Autumn in mid-October, and Winter in last-December. The average relative humidity in the air ($RH_{a-ave}$) was gradually decreased as the temperature inversely increased. The average $CO_2$ was 457 ppm, which is 65.6 ppm higher than that in Anmyundo, korean background area of $CO_2$ in 2008. Carbon dioxide showed positive correlation, both of them, with carbon monoxide (0.87) and relative humidity (0.48).