Background: Symptomatic multiple myeloma (MM) is an acquired B-cell malignant proliferation of antibody secreting plasma cells, characterized by end organ damage due to monoclonal immunoglobulin secretion. The aim of this study wa to determine the stage stratification according to an international scoring system in adult Pakistani MM patients at presentation. Materials and Methods: This single centre retrospective study extendedfrom January 2012 to December 2015. Data were retrieved from the departmental maintained records. Results: A total of 39 patients were diagnosed at our center with MM during the period of the study, 25 males and 14 females. Age ranged between 36 and 81 with a mean of $54.5{\pm}14.8$ and a median of 57 years. Common presenting complaints included fatigue (80.9%), backache (79.3%) and bone pain (66.2%). Overall, 9 patients were in ISS stage I (23%), 12 were in stage II (30.7%) and 18 were in stage III (46.1%). Out of the total, 29 (74.3%) had kappa immunoglobulin andthe remaining 10 (25.6%) had lambda type myelomas. IgG myeloma was commonest, seen in 26 (66.6%) followed by IgA in 11 (28.2%) with non secretory myeloma in one (2.5%) and light chain disease also in one patient (2.5%). Conclusions: MM in Pakistani patients is seen in a relatively young population with male predominance. Primarily patients are symptomatic and risk stratification revealed a predominance of advanced stage III disease in our setting.
International Journal of Advanced Culture Technology
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v.6
no.4
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pp.275-283
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2018
Cancer show distinct pattern of gene expression when it is compared to normal. This difference results malignant characteristic of cancer. Many cancer drugs are targeting this difference so that it can selectively kill cancer cells. One of the recent demand for personalized treating cancer is retrieving normal tissue from a patient so that the gene expression difference between cancer and normal be assessed. However, in most clinical situation it is hard to retrieve normal tissue from a patient. This is because biopsy of normal tissues may cause damage to the organ function or a risk of infection or side effect what a patient to take. Thus, there is a challenge to estimate normal cell's gene expression where cancers are originated from without taking additional biopsy. In this paper, we propose in-silico based prediction of normal cell's gene expression from gene expression data of a tumor sample. We call this challenge as reverting the cancer into normal. We divided this challenge into two parts. The first part is making a generator that is able to fool a pretrained discriminator. Pretrained discriminator is from the training of public data (9,601 cancers, 7,240 normals) which shows 0.997 of accuracy to discriminate if a given gene expression pattern is cancer or normal. Deceiving this pretrained discriminator means our method is capable of generating very normal-like gene expression data. The second part of the challenge is to address whether generated normal is similar to true reverse form of the input cancer data. We used, cycle-consistent adversarial networks to approach our challenges, since this network is capable of translating one domain to the other while maintaining original domain's feature and at the same time adding the new domain's feature. We evaluated that, if we put cancer data into a cycle-consistent adversarial network, it could retain most of the information from the input (cancer) and at the same time change the data into normal. We also evaluated if this generated gene expression of normal tissue would be the biological reverse form of the gene expression of cancer used as an input.
Objectives : Hypertension (high blood pressure), one of the world's major chronic diseases, has a high mortality rate due to its high prevalence and complications, but its control rate is low. The proper management and control through appropriate exercise, diet management, and optimal drug choice can reduce the risk of death from hypertension. Although various antihypertensive drugs are used to treat hypertension, they also have numerous adverse effects. Alongside increased interest in the use of Traditional Herbal Formulas (THF) for hypertension treatment, the purpose of this study was to examine the vasodilative effects of 10 THF in the rat thoracic artery pre-contracted by potassiumchloride (KCl). Methods : THF were extracted with distilled water for 2 hours. The rat thoracic artery was suspended and contracted by KCl in the organ bath which contained 10 ml Krebs Henseleit (KH) buffer. THF extracts were added in a dose-dependent increase (10-1,000 ㎍/mL) to examine vasodilative effects. The vasodilative effects produced by THF were expressed as the percentage in response to KCl-induced contraction. Results : Among the 10 THF, Banhasasim-tang, Buhnsimgieum, Sagunja-tang, and Samul-tang showed vasodilative effects. And, Sipjeondaebo-tang, Ssanghwa-tang, Ojeok-san, Onkyung-tang, Yongdamsagan-tang, and Hyangsayukgunja-tang showed no significant vasodilative effects. Also, in co-administration with amlodipine, Banhasasim-tang showed higher vasodilative effects than amlodipine alone, and Buhnsimgieum showed greater vasodilative effects at low concentrations, but inhibited amlodipine's vasodilative effects at high concentrations. Conclusion : As a result of these studies, they will be expected to provide useful data to establish guidelines of combined administration of THF and western antihypertensive drugs for the treatment of hypertension.
Ajay Sharma;Anand Nagar;Peeyush Varshney;Maunil Tomar;Shashwat Sarin;Rajendra Prasad Choubey;V. K. Kapoor
Annals of Hepato-Biliary-Pancreatic Surgery
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v.26
no.2
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pp.149-158
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2022
Backgrounds/Aims: Pancreaticoduodenectomy is the most common procedure for the management of duodenal pathologies. However, it is associated with substantial morbidity and a low risk of mortality. Pancreas-preserving limited duodenal resection (PPLDR) can be performed under specific scenarios. We share our experience with PPLDR and its outcome. Methods: We retrospectively analyzed a prospectively maintained database of patients undergoing limited duodenal resection in the form of wedge (sleeve) resection or segmental resection of one or more duodenal segments from March 2016 to March 2021 at a tertiary care center in North India. Results: During the study period, 10 patients (including 9 males) underwent PPLDR. Five of these 10 patients showed primary duodenal or proximal jejunal pathology, while the remaining five had duodenal pathology involving an adjacent organ tumor. Four patients underwent wedge (sleeve) resection, while the remaining six underwent segmental duodenal resection of one or more duodenal segments. Mean hospital stay was 6 days (range, 3-11 days) without 30-day mortality. Morbidity occurred in 4 patients (Grade I-II, n = 3; Grade III, n = 1). All patients were alive and disease-free at the time of last follow-up. The mean follow-up duration was 23 months (range, 2-48 months). Conclusions: PPLDR is a safe and effective alternative for pancreaticoduodenectomy when selected carefully for specific tumor types and location.
It is known that aggressive treatment of chemotherapy, radiation and autogenous stem cell transplantation is effective for prevention of recurrence in the high-risk breast cancer patients. It was assumed that this procedure takes a longer time and decreases the quality of life more than the standard adjuvant chemotherapy. However, there are few studies comparing the quality of life of patients having bone marrow transplantation and adjuvant chemotherapy. Most of the studies were focused on the quality of life in one point of time, such as only during the early treatment stage, only overall quality of life rather than specific dimensions of the quality of life. The purposes of this study are 1) to identify the difference of the quality of life between two different treatment patterns, adjuvant chemotherapy and autogenous stem cell transplantation: 2) to identify the mostly affected dimension and the periods of time affected by the treatment patterns; and 3) to identify the trajectories of quality of life in each treatment pattern. This is a time series design that measures 4 different points of times. At the beginning of the study, 19 patients were placed in the chemotherapy group and 12 in the group of auto-peripheral blood stem cell transplantation. The inclusion criterion was the advanced disease stage of 3 or over with metastasis of more than 5 lymph nodes. The exclusion criteria were 1) anyone who has metastasis to other organ; 2) anyone who had psychological problems. Ferrell's Quality of Life Scale for Cancer Survivors 41 items on a 10 point scale was used. The QOL-CS includes 4 dimensions, which were labeled physical, psychological, social, and spiritual. The Cronbach‘s alpha of this scale was 0.89. Mann-Whitney U test and Friedman test were used to test each hypothesis. In comparison of the two groups, the quality of life of the bone marrow transplantation group dramatically increased at the 3rd and 6th month after transplantation, while the chemotherapy groups results stayed lower. The most affected dimension of the quality of life at the end of the treatment was the physical dimension. However, it and increased along with time, while the psychological dimension values remained low over the long-term period. Intensive nursing care is needed during the entire period of chemotherapy in all patients having chemotherapy, and is also required for right after cases of bone marrow transplantation.
Osaki, Yoneatsu;Ino, Aro;Matsushita, Sachio;Higuchi, Susumu;Kondo, Yoko;Kinjo, Aya
Asian Pacific Journal of Cancer Prevention
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v.15
no.16
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pp.6571-6574
/
2014
Background: Alcohol is well established as a risk factor for cancer development in many organ sites. To assess the reliability and validity of the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) for detecting alcohol use disorders or risky drinking in Japanese adults the present study was conducted. Materials and Methods: A test-retest method was applied with a 2-week interval with 113 health care employees. The k coefficient, Cronbach's coefficient alpha, Spearman's correlation coefficient, and intraclass correlation coefficient (ICC) were determined and the validity of the AUDIT-C was analyzed using the data from a nationwide survey on adult alcohol use conducted in 2008 (n=4,123). Results: The reliability of the AUDIT-C score was high (${\kappa}$ coefficient=0.63, Cronbach's alpha=0.98, correlation coefficient=0.95, and ICC=0.95). According to the likelihood ratio and Youden index, appropriate cutoffs for the AUDIT-C were ${\geq}5points$ in men and ${\geq}4$ points in women. The sensitivity and specificity of these cutoffs for identifying ${\geq}8$ points on the AUDIT were 0.88 and 0.80, respectively, for men (positive likelihood ratio [LR+]=4.5) and 0.96 and 0.87, respectively, for women (LR+=7.7). The sensitivity and specificity of the cutoffs for identifying ${\geq}12$ points on the AUDIT were 0.90 and 0.84, respectively, for men (LR+=5.8) and 0.93 and 0.94, respectively, for women (LR+=15.8). The sensitivity and specificity of the cutoffs for identifying ${\geq}16$ points on the AUDIT were 0.93 and 0.80, respectively, for men (LR+=4.7) and 0.92 and 0.98, respectively, for women (LR+=55.6). With higher scores on the AUDIT, the specificity decreased and false-positives increased. The appropriate cutoffs for identifying risky drinking were the same for both genders. Conclusions: The reliability and validity of the AUDIT-C are high, indicating that it is useful for identifying alcohol use disorders or risky drinking among the general population in Japan, a group at high risk of cancer development.
Choi, Hoon Sik;Jeong, Bae Kwon;Jeong, Hojin;Song, Jin Ho;Kim, Jin Pyeong;Park, Jung Je;Woo, Seung Hoon;Kang, Ki Mun
Radiation Oncology Journal
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v.34
no.1
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pp.26-33
/
2016
Purpose: To compare the dose distribution between carotid sparing intensity modulated radiotherapy (IMRT) and opposed lateral field technique (LAFT), and to determine the effects of carotid sparing IMRT in early glottic cancer patients who have risk factors for atherosclerosis. Materials and Methods: Ten early glottic cancer patients were treated with carotid sparing IMRT. For each patient, the conventional LAFT plan was developed for comparison. IMRT and LAFT plans were compared in terms of planning target volume (PTV) coverage, conformity index, homogeneity index, and the doses to planning organ at risk volume (PRV) for carotid arteries, spinal cord and pharyngeal constrictor muscle. Results: Recurrence was not observed in any patients during the follow-up period. $V_{95%}$ for PTV showed no significant difference between IMRT and LAFT plans, while $V_{100%}$ was significantly higher in the IMRT plan (95.5% vs. 94.6%, p = 0.005). The homogeneity index (11.6%) and conformity index (1.4) in the IMRT plan were significantly better than those in the LAFT plans (8.5% and 5.1, respectively) (p = 0.005). The median $V_{5Gy}$ (90.0%), $V_{25Gy}$ (13.5%), and $V_{50Gy}$ (0%) for carotid artery PRV in the IMRT plan were significantly lower than those in the LAFT plan (99.1%, 89.0%, and 77.3%, respectively) (p = 0.005). Conclusion: Our study suggests that carotid sparing IMRT can significantly decrease the dose to carotid arteries compared to LAFT, and it would be considered for early glottic cancer patient with high risk of atherosclerosis.
Tae-Seok Kim;Kwangho Yang;Gi Hong Choi;Hye Yeon Yang;Dong-Sik Kim;Hye-Sung Jo;Gyu-Seong Choi;Kwan Woo Kim;Young Chul Yoon;Jaryung Han;Doo Jin Kim;Shin Hwang;Koo Jeong Kang
Annals of Hepato-Biliary-Pancreatic Surgery
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v.28
no.2
/
pp.134-143
/
2024
Backgrounds/Aims: The hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is classified as the advanced stage (BCLC stage C) with extremely poor prognosis, and in current guidelines is recommended for systemic therapy. This study aimed to evaluate the surgical outcomes and long-term prognosis after hepatic resection (HR) for patients who have HCC combined with PVTT. Methods: We retrospectively analyzed 332 patients who underwent HR for HCC with PVTT at ten tertiary referral hospitals in South Korea. Results: The median overall and recurrence-free survival after HR were 32.4 and 8.6 months, while the 1-, 3-, and 5-year overall survival rates were 75%, 48%, and 39%, respectively. In multivariate analysis, tumor number, tumor size, AFP, PIVKA-II, neutrophil-to-lymphocyte ratio, and albumin-bilirubin (ALBI) grade were significant prognostic factors. The risk scoring was developed using these seven factors-tumor, inflammation and hepatic function (TIF), to predict patient prognosis. The prognosis of the patients was well stratified according to the scores (log-rank test, p < 0.001). Conclusions: HR for patients who have HCC combined with PVTT provided favorable survival outcomes. The risk scoring was useful in predicting prognosis, and determining the appropriate treatment strategy for those patients who have HCC with PVTT.
Kim, Dong Sun;Yang, Se-Ran;Park, Sung Min;Choi, Seong Wook
Journal of Biomedical Engineering Research
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v.38
no.2
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pp.62-73
/
2017
To identify a solution for the restricted availability of healthy lungs and the high risk of immune rejections following organ transplantation, tissue engineering techniques for culturing lungs have been studied by many research groups. The most promising method for culturing lungs is the utilization of a bio-scaffold that was prepared using harvested organs from human donors or other animals by removing their original cells. In this study, a pulsatile perfusion pump was used to alleviate the cell removal effect with the high fluid-dynamic power of the perfusion stream during the decellularization process, while other conventional studies focused on chemical methods to identify efficient detergents. The purpose of this study was to analyze the developed device by using energy equivalent pressure (EEP), which is an indicator of pulsatility, to understand the characteristics of pulsatile energy transmitted according to the load size by using the artificial model and compare it with the measured EEP. The pulsatility of the device can be estimated with the concept of fluid-dynamic energy during a particular constant time period or fluid-dynamic power represented as EEP and EEP increment. Because the measured EEP of perfusion flow during decellularization can be changed by the amount of fluid leakage and the degree of clogging in the capillary vessels, EEP should be measured to determine whether the decellularization is progressing without problems. The decrement of EEP caused by the high perfusion resistance was observed from some experimental results that were obtained with artificial models. EEP can be used to monitor the decellularization process after analyzing the varying EEP according to the amount of load. It was confirmed that the EEP was maintained at a high level in the experiment using the harvested lungs from 12-13-week-old rats. In addition, it was confirmed that the cell removal time was faster than when continuous perfusion was performed. In this study, pulsatile power delivered to the lungs was measured to monitor the process of cell removal, and it serve as the evidence for efficient decellularization.
The purpose of this study is to reconstruct the treatment plan by applying CBCT and DIR to dose changes according to the change of the patient's motion and breast shape in the large breast cancer patients and to compare the doses using TWF, FIF and IMRT. CT and CBCT were performed with MIM6 to create DIRCT and each treatment plan was made. The patient underwent computed tomography simulation in both prone and supine position. The homogeneity index (HI), conformity index (CI), coverage index (CVI) to the left breast as planning target volume (PTV) were determined and the doses to the lung, heart, and right breast as organ at risk (OAR) were compared by using dose-volume histogram and the unique property of each organ. The value of HI of the PTV breast increased in all treatment planning methods using DIRCT, and CVI and CI were decreased in the treatment planning methods using DIRCT.
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