• 제목/요약/키워드: Nausea & vomiting

검색결과 702건 처리시간 0.027초

Comparative Study on Transcatheter Arterial Chemoembolization, Portal Vein Embolization and High Intensity Focused Ultrasound Sequential Therapy for Patients

  • Cui, Lin;Liu, Xing-Xiang;Jiang, Yong;Wu, Xing-Jun;Liu, Jian-Jun;Zhou, Xiang-Rong;He, Xue-Jun;Huang, Xin-En
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제13권12호
    • /
    • pp.6257-6261
    • /
    • 2012
  • Objective: To investigate the safety and efficacy of transcatheter arterial chemoembolization (TACE), combined with portal vein embolization (PVE), and high intensity focused ultrasound (HIFU) sequential therapy in treating patients with hepatocellular carcinoma (HCC). Methods: Patients with inoperative HCC were treated by two methods: in the study group with TACE first, then PVE a week later, and then TACE+PVE every two months as a cycle, after 2~3 cycles finally HIFU was given; in the control group only TACE+PVE was given. Response (CR+PR), and disease control rate (CR+PR+SD), side effects, overall survival and time to progress were calculated. Results: Main side effects of both groups were nausea and vomiting. No treatment related death occurred. In the study group, 32 patients received TACE for overall 67 times, PVE 64 times, and HIFU 99 times; on average 2.1, 2 and 3.1 times for each patient, respectively. In the control group, 36 patients were given TACE 78 times and PVE 74 times, averaging 2.2 and 2.1 times per patient. Effective rate: 25.0% in study group and 8.3% in control group (p>0.05). Disease control rates were 71.9% and 44.4%, respectively (p<0.05). In patients with portal vein tumor thrombus, the rate reduced over 1/2 after treatment was 69.2%(9/13) in the study and 21.4%(3/14) in the control group (p<0.05). Rate of AFP reversion or decrease over 1/2 was 66.7%(16/24) in study and 37%(10/27) (p<0.05) in control group. Median survival time: 16 months in study and 10 months in control group. PFS was 7months in study and 3 months in control group. Log-rank test suggested that statistically significant difference exists between two groups (p=0.024). 1-, 2- and 3-year survival rates were 56.3%, 18.8% and 9.3% in study, while 30.6%, 5.6% and 0 in control group, respectively, with statistically significant difference between two groups (by Log-rank, p = 0.014). Conclusions: The treatment of TACE+PVE+HIFU sequential therapy for HCC increases response rate, prolong survival, and could thus be a safe and effective treatment for advanced cases.

Second-Line Capecitabine and Oxaliplatin Combination for Gemcitabine-Resistant Advanced Pancreatic Cancer

  • Bayoglu, Ibrahim Vedat;Varol, Umut;Yildiz, Ibrahim;Muslu, Ugur;Alacacioglu, Ahmet;Kucukzeybek, Yuksel;Akyol, Murat;Demir, Lutfiye;Dirican, Ahmet;Cokmert, Suna;Yildiz, Yasar;Karabulut, Bulent;Uslu, Ruchan;Tarhan, Mustafa Oktay
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제15권17호
    • /
    • pp.7119-7123
    • /
    • 2014
  • Background: The role of second-line therapy in metastatic pancreatic cancer is not clear. In this study, we aimed to explore the second-line efficiency of capecitabine and oxaliplatin (XELOX) in patients with advanced pancreatic cancer who have received gemcitabine-based first-line therapy. Materials and Methods: We retrospectively evaluated 47 patients with locally advanced or metastatic pancreatic cancer previously treated with gemcitabine-based first-line regimens. Treatment consisted of oxaliplatin $130mg/m^2$ and capecitabine $1000mg/m^2$ twice daily with a 3 week interval, until unacceptable toxicity or disease progression. Results: Median number of cycles was 4 (range, 2-10). The overall disease control rate was 38.3%. The median overall survival and progression-free survival from the start of second-line therapy were 23 weeks (95%CI: 16.6-29.5 weeks) and 12 weeks (95%CI: 9.8-14.4 weeks), respectively. The most common grade 3-4 toxicities were nausea, vomiting and hematologic side effects. Conclusions: Our result suggests that the combination of capecitabine and oxaliplatin was tolerated with manageable toxicity and showed encouraging activity as second-line treatment of advanced or metastatic pancreatic cancer patients with ECOG performance status 0-2.

Expression of ERCC1, RRM1 and LRP in Non-small Cell Lung Cancers and their Influence on Chemotherapeutic Efficacy of Gemcitabine Concomitant with Nedaplatin

  • Qiu, Zhen-Qin;Zhao, Kun
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제15권17호
    • /
    • pp.7303-7307
    • /
    • 2014
  • Objective: To explore the clinical efficacy of gemcitabine concomitant with nedaplatin and drug resistance in the treatment of non-small cell lung cancer (NSCLC) and associated molecular predicators. Materials and Methods: A total of 68 patients diagnosed with NSCLC by histology served as the study objects and were randomly divided into an observation group treated with gemcitabine concomitant with nedaplatin and a control group with cisplatin concomitant with gemcitabine, 34 cases for each group. Short-term and long-term efficacies, adverse responses as well as the expression of nucleotide excision repair cross complementing 1 (ERCC1), ribonucleotide reductase subunit M1 (RRM1) and lung resistance-related protein (LRP) in NSCLC tissues in both groups were assessed. Results: The short-term objective response rate (ORR) and disease control rate (DCR) were 35.3% (12/34) and 76.5% (26/34) in the observation group and 38.2% (13/34) and 85.3% (29/34) in the control group, respectively, the differences not being statistically significant. The time to progression (TTP) in both groups were 1~12 months, while the median TTP was 135 d and 144 d, respectively. Though the survival was slightly higher in the control group, there were no significant differences in TTP and survival time. The rates of decreased hemoglobin, vomiting and nausea as well as renal toxicity were evidently lower in the observation group, while other adverse responses demonstrated no significant difference. The positive expression rates of ERCC1, RRM1 and LRP were 47.1% (16/34), 61.8% (21/34) and 64.7% (22/34) in the observation group, respectively. Compared with negative ERCC1 expression, ORR had decreasing trend and the overall survival time (OS) decreased significantly in patients with positive ERCC1 expression, which were markedly decreased by the positive expressions of RRM1 and LRP. Conclusions: Gemcitabine concomitant with nedaplatin has significant effects in the treatment of NSCLC, with an adverse response rate obviously lower than for cisplatin concomitant with gemcitabine, suggesting that wider use in the clinic is warranted. Additionally, the positive expressions of ERCC1, RRM1 and LRP may increase patient drug resistance, so they can be applied as the chemotherapeutic predicators to guide individualized therapy of NSCLC patients.

비인두암 토모테라피 시 체중 감소에 따른 피부선량 변화 분석 (Analysis of Changes in Skin Dose During Weight Loss when Tomotherapyof Nasopharynx Cancer)

  • 장준영;김대현;최천웅;김보희;박철수
    • 한국자기학회지
    • /
    • 제26권3호
    • /
    • pp.99-104
    • /
    • 2016
  • 항암요법과 방사선치료를 병행하여 두경부암을 치료하는 환자의 경우 항암요법과 방사선치료를 거듭할수록 구토, 메스꺼움, 식욕부진 등의 이유로 환자의 체중 감소가 생기게 된다. 체중 감소는 목의 두께 변화로 나타날 수 있으며 이로 인해 치료하고자 하는 t 타겟과 주위 정상조직의 선량 전달에도 영향을 미치며 방사선이 전달되는 방향에 위치한 피부선량의 변화가 나타날 것으로 사료된다. 특히 비인두암 환자의 경우 비인두 구조가 다른 장기보다 복잡한 구조를 지니고 있고 치료방법인 토모테라피는 수 mm 차이로 급격한 선량 변화가 발생하므로 이러한 체중 감소의 변화에 주의 깊은 관찰이 필요하다. 현재 토모테라피의 경우 매 회 치료 전 정확한 자세 재현을 위한 영상 검증을 통해 이러한 움직임을 확인하고 그 값을 보정하여 치료를 수행한다. 그러나 환자의 체중 감소로 인하여 피부선량에 전달되는 선량 변화의 검증은 되지 않고 있다. 환자의 피부선량이 증가함으로써 나타나는 부작용은 환자의 삶의 질에 영향을 미칠 뿐 만 아니라 2차 암 발생률을 높일 수 있다. 이에 환자의 체중 감소로 인하여 나타나는 환자의 목 두께를 휴먼 팬톰에 볼루스를 올리고 두께를 조절해가며 변화시켜 필름을 이용하여 피부선량의 변화가 어떻게 나타나는지 분석해보고자 한다.

Neonicotinoid 살충제 중독환자의 임상양상 (Clinical Characteristics of Patients with Neonicotinoid Insecticide Poisoning)

  • 김진철;소병학;김한준;김형민;박정호;최세민;박규남;최경호
    • 대한임상독성학회지
    • /
    • 제8권1호
    • /
    • pp.24-29
    • /
    • 2010
  • Purpose: Neonicotinoid insecticides are widely used as they have been proven by experimental studies to have low toxicity to mammals, including humans. As the use of neonicotioids increases, the number of patients with neonicotinoid poisoning has also increased. We conducted a study to investigate the clinical manifestations of neonicotinid poisoning. Methods: We retrospectively analyzed the patients who ingested neonicotinids and who visited the emergency department located in Korea from March 2002 to February 2010. We reviewed the patients' age, gender, the amount of exposure, the elapsed time to presentation, the treatment and the outcome. According to the poisoning severity score, we divided the patients with a Poisoning severity score (PSS) of 0 or 1 into the mild/moderate toxicity group and the patients with a PSS of 2 or 3 into the severe/fatal toxicity group. Results: A total of 24 patients were analyzed. The most common clinical manifestations of neonicotinoid insecticide toxicity were gastrointestinal symptoms (66.7%) such as nausea, vomiting and abdominal pain and the others are respiratory symptoms (16.7%), cardiovascular symptoms (12.5%), metabolic imbalance (12.5%), renal dysfunction (8.3%), CNS symptoms (8.3%), and asymptomatic (29.2%). Twenty patients (83.3%) showed mild/moderate toxicity and 4 patients (16.7%) showed fatal conditions such as shock and mutiorgan failure. The mortality rate was 4.2%. In these fatal cases, the patients developed respiratory failure, hypotension, altered mentality and renal failure at the acute stage and they deteriorated to a more serious condition. This severe toxicity was caused by decreased renal excretion of neonicotinid metabolite, and this was improved after hemodialysis. Conclusion: Most patients with neonicotinoid poisoning and who showed mild toxicity usually improved after symptomatic treatment. However, some patients showed significant toxicity with respiratory failure and renal function deterioration, and intensive care needed, including mechanical ventilation and hemodialysis.

  • PDF

전환장애(轉換障碍)로 입원(入院)한 환자(患者) 41례(例)에 대(對)한 임상적(臨床的) 고찰(考察) (Clinical Study for Conversion Disorder in 41 Admission Cases)

  • 김명진;최병만;이상룡
    • 동의신경정신과학회지
    • /
    • 제11권2호
    • /
    • pp.131-140
    • /
    • 2000
  • The clinical study was carried out the 41 patients with conversion disorder who were treated in Dae Jeon University Oriental Hospital from 26 september 1998 to 21 september 2000.The results were summarized as follows.1. The ratio of male and female was 4:37 and in the age distribution, the highest frequence was 40s, in descending order over 50s, 30s, 20s, 10s and mental attack was the most inducing factor.2. In distribution of the period of the clinical history. within one day was the highest percentage and in admission period most of the patients were from four days to seven days.3. In symptoms and signs, physical symptoms were more than mental symptoms, physical symptoms had many muscle-skeleton-system symptoms and they were in descending order general body weakness. headache, anorexia, chest discomfort, dyspepsia, dizziness, four extremities numbness, insomnia, dysarthria, anxiety, four extremities tremor. palpitation. nausea, vomiting, facial numbness.4. In classification of Four Human coporeal constitution the number of patients, Sho-Eum-In(少陰人) was remarked mostly and most of female patients had no past history of the conversion disorder.5. In distribution of the prescription, drugs of regulating gi such as BUNSIMGIEUM(分心氣飮) were many, in descending order drugs of growing heart and warming gall bladder such as ONDAMTANGGAMI(溫膽湯加味), drugs of maintaining patency for the flow of gi such as CHUNGGANSOYOSAN(淸肝逍遙散), drugs of decomposing food and asending gi such as PYUNGJINGUNBITANG(平陳健脾湯), drugs of storing blood and relaxing the mind such as SAMULGUIBITANG(四物歸脾湯). drugs of removing sputum and cooling heart such as CHUNGSIMDODAMTANG 淸心導痰湯).6. In distribution of the treatments, the group of drug and acupuncture and aroma-therapy was many, in acup uncture TAEGUKCHIMBUP(太極針法) was mainly used. in therapy inhalation type of Lavender and Rosewood was many and the type of Peppermint and Rosemary massaging epigastric-chest, and neck was many.7. In distribution of the treatment result, in 15 patients(36.6%) symptoms were eliminated from four to seven days, in 13 patients(31.7%) symptoms were not changed. in 12 patients(29.3%) symptoms were eliminated from two to three days. in 1 patients(2.4%) symptoms were eliminated whin one day.

  • PDF

단일기관에서 조사한 소아 뇌농양의 임상양상(1997-2006) (Clinical Features of Brain Abscesses in Neonates and Children: A Single Center Experience from 1997 to 2006)

  • 이택진;전진경;김기환;김기주;김동수
    • Pediatric Infection and Vaccine
    • /
    • 제15권1호
    • /
    • pp.30-35
    • /
    • 2008
  • 목 적 : 소아에서 치명적인 뇌농양의 선행요인 및 사망률 등 임상 양상에 대하여 알아보고자 하였다. 방 법 : 1997년부터 2006년까지 세브란스병원에서 뇌농양으로 진단된 만 18세 미만의 소아 및 청소년을 대상으로 임상 소견, 검사 결과 및 치료 경과 등을 후향적으로 조사하였다. 결 과 : 최근 10년간 뇌농양으로 진단된 환아는 총 27명이었으며, 이 중 6명(22%)이 치료 중 사망하였고 생존자 중 8명(38%)은 신경학적 후유증이 남았다. 전체 뇌농양 환아 중 1세 미만의 영아가 총 8명(30%)이었으며 영아의 사망률은 38%였다. 뇌농양의 발생부위는 다발성 7례(26%), 전두엽과 두정엽이 각각 6례, 측두엽 5례 순이었으며, 원인균이 분리된 15례 중 사슬알균 5례(33%), 포두알균 4례, 그람음성 장내간균 3례, 진균 2례, 결핵균 1례 등이 포함되었다. 선행요인에는 신경외과술 8례(30%), 선천성 심질환 4례, 중이염과 부비동염 각각 1례, 면역억제치료 1례 등이 있었다. 증상으로는 발열(74%), 두통(37%), 오심/구토, 의식저하 순이었으며 발열, 두통 및 국소적 신경증상의 주요 3증상을 보이는 환아는 2례(7%)에 불과하였다. 전체 뇌농양 환아 중 1세미만의 영아에서 다발성 발생(63%, P=0.011) 및 신경학적 후유증이나 사망의 비율(88%, P=0.033)이 더 높았다. 결 론 : 비교적 증상이 뚜렷하지 않은 영아에서 뇌농양에 의한 신경학적 후유증과 사망률이 더 높으며 따라서 영아에 대한 보다 적극적인 진단과 조기치료가 필요할 것으로 사료된다.

  • PDF

Niacin의 상한섭취량 제안 및 식품과 복합비타민제 섭취를 통한 인체 노출평가 (Niacin Upper Level Recommendation and Exposure Assessment of Foods and Multivitamin drugs)

  • 박신희;이효민;윤은경;민충식;김현정;전은아;제금련
    • 한국식품위생안전성학회지
    • /
    • 제20권2호
    • /
    • pp.77-82
    • /
    • 2005
  • 본 연구에서는 식품 단일섭취 또는 식품과 일반의약품으로서의 복합비타민제의 병용섭취를 통해 niacin을 섭취한다는 노출시나리오를 설정하여 우리나라 성인의 niacin 1일 평균섭취량을 산출하였으며, 인체독성자료를 근거로 niacin의 상한섭취량(UL)을 제안하였고 그 값을 비교하여 niacin에 대한 위해지수를 산출하였다. 그 결과 식품 단일섭취 시 위해지수는 0.53,식품과 복합비타민제의 병용섭취 시 위해지수는 0.81-6.24라는 값이 얻어졌다. 일반적으로 위해지수가 1이상이면 건강한 인구집단에서 부작용 발생이 우려됨을 나타낸다 그러므로, 복합비타민제를 병용섭취 하는 일부경우에서는 악영향이 발생할 가능성이 있다고 할 수 있다. 식품을 통한 자연적인 niacin의 섭취로는 악영향이 보고되고 있지 않으나$^{3), 12),}$ 복합비타민제 또는 최근 소비량이 급증하고 있는 비타민 강화 건강기능식품 및 영양보조제 등의 섭취를 통해 niacin으로 인한 악영향의 발생이 우려되므로 지속적이고 세심한 위해성평가와 함께 민감그룹 및 임산부, 수유부 등 특정그룹에 대한 UL설정연구가 이루어져야 할 것으로 생각된다.

시상출혈(視床出血)의 임상적(臨床的) 관찰(觀察) (Clinical Studies on Thalamic Hemorrhage)

  • 박창국
    • 대한한의학회지
    • /
    • 제15권2호
    • /
    • pp.28-39
    • /
    • 1994
  • Clinical studies were made on 79 cases with thalamic hemorrhage diagnosed by computed tomographic scan and only localized on the thalamic area, were admitted to the Kyung San University Taegu Oriental Medical Hospital from August 1990 to March 1994. The age and sex distribution, sites of hematoma, recurrence rate, incidence of hypertension, inducing factor, prodromal syndroms, symptoms and neurologic signs on admission, relationship between the hospital course and many factors affecting the prognosis such as age, side of hematoma, level of consciousness, volume of the hematoma. ventricular hemorrhage were analysed. The results were summarized as follows; 1. The most prevalent age group was above 60 years of age with 50-59 years, 70-79 years, 40-49 years and 80-89 years of age in the order of frequency. Male to female ratio was 1:1.55. 2. The ratio of left hematoma to the right was 1.32:1. The recurrence rate of cerebrovascular accident was 17.7% 3. The incidence of hypertension was 69.6% and inducing factors of thalamic hemorrhage in the order of frequency were physical work(29.1%), drinking or eating(13.9%), walking(12.7%) and rest(12.7%), The prodromal syndroms were numbness of extremities(5.1%), headache(2.5%), fatigue(2.5%), dizziness(1.3%), insomnia(1.3%), but prodromal syndrom was not found in 89.9% of thalamic hemorrhage. 4. The symptoms and neurologic signs on admission in the order of frequency were motor disturbance(98.7%), dysarthria(82.3%), positive Babinski sign(78.5%), headache(69.6%), dizziness(62.0%). hemisensory deficit(48.1%). nausea or vomiting(39.2%), absent or sluggish light reflex(35.4%), changes of consciousness (35.4%), dysphagia (20.3%), voiding difficulty.(13.9%), facial palsy(6.3%), aphasia(3.8%), seizure(38%), 6th N. palsy(3.8%) and small pupil(1.3%). 5. The rate of improvement was found almost equally in the 4th, 5th and 6th decades, but it was shown with dramatic decrease in the over 7th decades. The hospital course had no relationship with the side of hematoma but the level of consciousness had influence upon the prognosis. 6, The small hematoma had better outcome than large in the volume of hematoma under 15cc, but volume of the hematoma had no influence upon the prognosis because the rate of improvement was 75.0% in the volume of hematoma over 15cc. The hospital course had no relationship with ventricular hemorrhage.

  • PDF

전기방사에 의한 PAN/FA 나노 복합재의 제조 및 휘발성 유기 화합물에 대한 흡착효과 (Fabrication of Electrospun PAN/FA Nanocomposites and Their Adsorption Effects for Reducing Volatile Organic Compounds)

  • 갈준총;왕자건;윤삼기;최낙정
    • 한국산학기술학회논문지
    • /
    • 제19권6호
    • /
    • pp.702-708
    • /
    • 2018
  • 휘발성 유기 화합물(VOCs: volatile organic compounds)은 대기 오염 물질 중 하나로 주로 화석연료 연소, 도료를 사용하는 건축물 자재 등에서 발생한다. VOCs를 흡입하면 두통, 메스꺼움, 구토 등을 발생시켜 인체에 유해하며 심한 경우에는 기억상실을 유발하고, 백혈병의 발병율을 증가시킨다. 따라서 대기 중의 VOCs를 저감하기 위한 방법의 하나로 우리는 전기방사를 이용하여 폴리아크릴로니트릴과 플라이 애쉬 (PAN/FA: polyacrylonitrile/fly ash) 나노복합재를 성공적으로 제조하였다. 또한 이 복합재의 VOCs에 대한 흡착능력을 관찰하기 위해서 주사형 전자현미경(FE-SEM)을 통해 PAN/FA 나노 매트들의 형태학적 구조 관찰과 클로로폼, 벤젠, 톨루엔, 자일렌 (chloroform, benzene, toluene and xylene) 등 VOCs 성분에 대한 흡착력 실험을 수행한 후 정성 및 정량 (chromatography/mass spectrometry: GC/MS)적으로 분석하였다. 그 결과 40wt%의 FA가 들어있는 PAN 나노섬유가 가장 작은 섬유 지름을 가지고 있었으며, 그 크기는 약 283nm인 것을 확인할 수 있었고, 다른 복합 멤브레인들과 비교하여 VOCs에 대한 흡착력이 우수하다는 것을 실험적으로 규명하였다.