• Title/Summary/Keyword: Systemic therapy

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Study on the Meaning of Four Subjects and Four Species as a Disease-Prediction Data and Diagnostic Value on Ante-Disease (질병예측자료로서 사과(四科) . 사류형상(四類形象)의 의의와 미병진단적 가치 연구)

  • Kim, Jong-Won;Jeon, Soo-Hyung;Lee, In-Seon;Kim, Kyu-Kon;Lee, Yong-Tae;Kim, Kyung-Chul;Eom, Hyun-Sup;Chi, Gyoo-Yong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.2
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    • pp.325-330
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    • 2009
  • In Korea, medical diagnostic equipments and biochemical examination can not be used in order for diagnosing sub-healthy state or ante-disease state in oriental medicine clinic. So morphic analogical method used in oriental medicine can be a good tool as a disease-predictable signs in order to enable preventive diagnosis and therapy. Therefore the four geometrical subjects; Essence, Pneuma, Spirit, Blood(四科;精氣紳血) and the four taxonomical species; Pisces, Quadruped, Aves, Carapaces(四類;魚走鳥甲) are chosen as morphic models in this paper. The differences of two classifying methods with four subjects and four species were as follows. The diagnostic category was meta-medical and synthetic against medical specific. The diagnostic object was body in contrast with face. They were able to be applicant in psychology and classification of characteristics against diagnostics and therapeutics directly in oriental medicine. The theoretical basis was basic diagrams of four unit-fluids of body and morphological analogy with four animal species respectively. And the therapeutic aims were systemic pathogenesis following five phase theory against congestion and deficiency of Essence, Pneuma, Spirit, Blood. The four subjects and four species are mixed each other practically in clinic. But it should be used limitedly because of the above reasons described and must divide the principal and secondary factors and follow the pathology of principal shape factor. In order to improve the diagnostic value of ante-disease state, the discriminable standards, measurement methods, limit of interrelating interpretation and the criteria of abnormal disproportion were needed to be defined more clearly in advance.

Conservative Surgery and Definitive Radiotherapy in Early Breast Cancer (보존적 유방 절제술과 근치적 방사선치료가 초기 유방암의 치료 성적에 미치는 효과)

  • Shin, Sei-One;Hong, Jung-Sook;Kim, Myung-Se;Lee, Young-Do;Kim, Sung-Kyu;Lee, Soo-Jung
    • Journal of Yeungnam Medical Science
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    • v.10 no.2
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    • pp.380-387
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    • 1993
  • Local excision and axillary dissection followed by radiation therapy to the breast has been shown to achieve equivalent local control and survival as mastectomy in an prospective randomized trials. We analyzed 28 cases of early breast cancer in order to evaluate the therapeutic effects of conservative surgery and definitive radiotherapy in the management of early breast cancer as possible alternative of simple mastectomy, retrospectively. Obtained results were as follows : 1. Treatment related acute side reactions are more prominant in the case of chemoradiotherapy group than radiotherapy alone group. 2. There were no cases of primary, regional or systemic failures on the last follow up examination. 3. Cosmetic results after treatment were satisfactory in 26 cases out of 28 cases on the last follow up examination. 4. There were no demonstrable differences of tumor control and cosmetic results between the treatment groups. Although, these results suggested that definitive radiotherapy after local excision would be a possible and desirable alternative instead of total mastectomy in the management of early breast cancers, analyzed cases were too small and follow up period was too short to evaluate the therapeutic effect of primary radiotherapy after local excision, exactly.

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Recurred Thyroid Carcinoma (재발성 갑상선 암)

  • Park Kyue-Il;Yoon Jung-Han;JeGal Young-Jong
    • Korean Journal of Head & Neck Oncology
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    • v.8 no.2
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    • pp.72-81
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    • 1992
  • Thyroid cancer, the most common cancer of endocrine neoplasms, has tremendous variation in tumor biologic behavior. There is no consensus about treatment mode to prevent recurrences despite of recent advance in understanding characteristics of thyroid cancer. So, we have made a clinical analysis and follow-up study of recurred 27 cases among 189 cases treated under the diagnosis of thyroid carcinoma in the department of surgery, Chonnam University Hospital from February, 1982 to February, 1992 to clarify our experience about the characteristics of recurred thyroid cancer. The results were as follow: According to the pathological classification of recurred thyroid cancer, recurrence rate was 11.6% in papillary carcinoma, 15.6% in follicular carcinoma, 37.5% in medullary carcinoma, 66.7% in undifferentiated carcinoma, respectively, and the mean recurrence rate of thyroid cancer was 14.3%. The recurrence rate according to age was 28.6% in 8th decade and 17.9% in 4th decade. The recurrence rate according to sex was not singificant(15.6% in male: 14% in female). The mean period to relapse was 4 years 6 months in papillary carcinoma, 2 years 5 months in follicular carcinoma, 2 years 1 months in medullary carcinoma, 2 years 6 months in undifferentiated carcinoma. The recurrence rate according to previous operating methods, such as performing lymph node dissection or not, mode of thyridectomy, type of lymph node dissection was statisfically non-specific. Common recurrent sites of papillary and follicular carcinoma was cervical lymph node and remained thyroid tissue. Medullary and undifferentiated carcinoma was noted in multiregional or systemic involvement Reoperation was performed with complete resection of recurred or metastatic mass, such as radical neck dissection or mass extirpation from involved organs as possible. The postoperative complications were 2 cases of horseness, and 1 case with hematoma, transient hypocalcemia, wound infection, and pulmonary insufficency, respectively. 5-year survival rate was 85.5% in papillary carcinoma, 66.7% in follicular carcinoma. 50% in medullary carcinoma, and 50% in undifferentiated carcinoma. We concluded that recurrence in thyroid cancer give a reconsideration to previous conservative therapy and more extensive surgical procedures for thyroid cancer including lymphatic dissection are recommanded to prevent recurrences in selected cases if possible.

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The Local Effect after Surgery in Non-small Cell Lung Cancer (비소세포성 폐암에서 수술 후의 국소 제어효과)

  • Sa, Young-Jo;Jeon, Hyun-Woo;Lee, Sun-Hee;Wang, Young-Pil;Park, Jae-Kil
    • Journal of Chest Surgery
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    • v.40 no.5 s.274
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    • pp.356-361
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    • 2007
  • Background: Recent progress in the surgical therapy for lung cancer is one of the best examples of the successful evolution of clinical medicine. We reviewed our experience to evaluate the surgical outcomes in patients with non-small cell lung cancer. Material and Method: We reviewed clinical records of 432 consecutive patients with proven non-small cell lung cancer who underwent complete removal of the primary tumor together with hilar and mediastinal lymph nodes from 1995 to 2005. The clinical characteristics, surgical methods, and recurrence patterns were analyzed. Result: Lobectomy was the most common procedure (66.7%) performed and sleeve lobectomy was the least (5.6%). In 179 patients (42.6%) the recurrence was noted and the regional recurrence (67 cases, 16.0%) was less than systemic recurrence (112 cases, 26.7%). The main sites of regional recurrence were hilum (25 cases, 37.3%) and ipsilateral mediastinum (54/432 cases, 25.4%). The hospital mortality rate was 2.8% (12/432 cases) and resection-morbidity rate was 12.5% (54/432 cases). Conclusion: The low recurrence rate, especially regional recurrence rate indicated that our surgical procedures with preoperative measures were considered useful and effective.

A Case of Bronchilolitis Obliterans Organizing Pneumonia in a Patient with Ulcerative Colitis (궤양성 대장염에서 나타난 폐쇄성 세기관지염 기질화 폐렴 1예)

  • Lee, Hyun-Jung;Park, Byung-Hoon;Son, Ji-Young;Jung, Ji-Ye;Hwang, Se-Na;Chon, Young-Eun;Kim, Eun-Young;Lim, Ju-Eun;Lee, Kyung-Jong;Yoon, Yoe-Wun;Kim, Young-Sam;Kim, Se-Kyu;Chang, Joon;Shim, Hyo-Sub;Cho, Sang-Ho;Park, Moo-Suk
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.3
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    • pp.175-179
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    • 2010
  • The ulcerative colitis is a chronic inflammatory bowel disease with an unknown etiology. The major symptoms of ulcerative colitis are diarrhea, abdominal pain and hematochezia. However, arthritis, skin disorders, hepatobiliary inflammation and uveitis are occasionally recognized as systemic complications. Although there are few reports of coexistent pulmonary and inflammatory bowel disease, the lung is not generally considered to be a target organ in ulcerative colitis. We report a patient with ulcerative colitis-related bronchilolitis obliterans organizing pneumonia confirmed by video-assisted thoracoscopic surgery, who responded to corticosteroid therapy.

Effectiveness of alendronate as an adjunct to scaling and root planing in the treatment of periodontitis: a meta-analysis of randomized controlled clinical trials

  • Chen, Jin;Chen, Qian;Hu, Bo;Wang, Yunji;Song, Jinlin
    • Journal of Periodontal and Implant Science
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    • v.46 no.6
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    • pp.382-395
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    • 2016
  • Purpose: Alendronate has been proposed as a local and systemic drug treatment used as an adjunct to scaling and root planing (SRP) for the treatment of periodontitis. However, its effectiveness has yet to be conclusively established. The purpose of the present meta-analysis was to assess the effectiveness of SRP with alendronate on periodontitis compared to SRP alone. Methods: Five electronic databases were used by 2 independent reviewers to identify relevant articles from the earliest records up to September 2016. Randomized controlled trials (RCTs) comparing SRP with alendronate to SRP with placebo in the treatment of periodontitis were included. The outcome measures were changes in bone defect fill, probing depth (PD), and clinical attachment level (CAL) from baseline to 6 months. A fixed-effect or random-effect model was used to pool the extracted data, as appropriate. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated. Heterogeneity was assessed using the Cochrane ${\chi}^2$ and $I^2$ tests. Results: After the selection process, 8 articles were included in the meta-analysis. Compared with SRP alone, the adjunctive mean benefits of locally delivered alendronate were 38.25% for bone defect fill increase (95% CI=33.05%-43.45%; P<0.001; $I^2=94.0%$), 2.29 mm for PD reduction (95% CI=2.07-2.52 mm; P<0.001; $I^2=0.0%$) and 1.92 mm for CAL gain (95% CI=1.55-2.30 mm; P<0.001; $I^2=66.0%$). In addition, systemically administered alendronate with SRP significantly reduced PD by 0.36 mm (95% CI=0.18-0.55 mm; P<0.001; $I^2=0.0%$) and increased CAL by 0.39 mm (95% CI=0.11-0.68 mm; P=0.006; $I^2=6.0%$). Conclusions: The collective evidence regarding the adjunctive use of alendronate locally and systemically with SRP indicates that the combined treatment can improve the efficacy of non-surgical periodontal therapy on increasing CAL and bone defect fill and reducing PD. However, precautions must be exercised in interpreting these results, and multicenter studies evaluating this specific application should be carried out.

TREATMENT OF BRUXISM USING THE OCCLUSAL SPLINT (교합안정장치를 이용한 이갈이의 치료)

  • Baik, Byeoung-Ju;Lee, Sun-Young;Yang, Yeon-Mi;Kim, Jae-Gon;Jeon, Young-Mi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.4
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    • pp.586-591
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    • 2002
  • Bruxism can be generally regarded as a diurnal clenching or nocturnal teeth grinding or a combination of both. Clenching of the teeth is forceful closure of the opposing dentition in a static relationship of the mandible to the maxilla, whereas grinding of the dentition is forceful closure of the opposing dentition in a dynamic maxillo-mandibular relationship as the mandibular arch moves through various excursive positions. The causes of bruxism are not yet discovered clearly, but most consistently mentioned cause is psychological stress. Bruxism can be also associated with sleep disorders, medication, and disturbances of the central nervous system. There is no permanent treatment method of bruxism, so the objectives for management of bruxism are reduction of psychological stress and treatment of signs and symptoms of bruxism by occlusal adjustment, occlusal splint, systemic medication and physical therapy. These cases report present three cases of children with bruxism. The bruxism was reduced in these patients wearing occlusal splint.

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Clinical Efficacy and Prognosis Factors for Advanced Hepatoblastoma in Children: A 6-year Retrospective Study

  • Zhang, Yi;Zhang, Wei-Ling;Huang, Dong-Sheng;Hong, Liang;Wang, Yi-Zhuo;Zhu, Xia;Hu, Hui-Min;Zhang, Pin-Wei;Yi, You;Han, Tao
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4583-4589
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    • 2013
  • Objective: This study aimed to investigate the effect of multimodality treatment of advanced paediatric hepatoblastoma (HB) and the factors affecting prognosis. Methods: A total of 35 children underwent multimodality treatments consisting of chemotherapy, surgery, interventional therapy, and autologous peripheral blood stem cell transplantation. The patients were followed up every month. Results: Serum AFP levels in 33 out of 35 patients in this study were significantly increased (P = 0.0002). According to the statistical scatter plot, the values of serum AFP on the 25th, 50th, and 75th percentages were 1,210, 1,210 and 28,318 ng/dl, respectively. Of the 35 cases, 21 were stage IV. 18 cases were treated with systemic chemotherapy before surgery, and 3 cases with locally interventional chemotherapy before surgery. Statistical analysis showed that the preferred interventional treatment affected prognosis, and that there was a statistically significant difference (P = 0.024). Some 33 patients completed the follow-up, of which 17 were in complete remission (CR), 5 were in partial remission (PR), 1 became disease progressive (DP), and 10 died. The remission and overall survival rates were 66.7% (22/33) and 69.7% (23/33), respectively. Patients with the mixed HB phenotypes had worse prognoses than the epithelial phenotype (P < 0.001), and patients in stage IV had a lower survival rate than those in stage III (P < 0.001). Conclusion: Multimodality treatment can effectively improve remission rate and prolong the survival of children with advanced HB. In addition, alpha-fetoprotein (AFP), a tumor marker of liver malignant tumors, HB pathological classification, and staging are highly useful in predicting prognosis.

Evaluation of MiR-34 Family and DNA Methyltransferases 1, 3A, 3B Gene Expression Levels in Hepatocellular Carcinoma Following Treatment with Dendrosomal Nanocurcumin

  • Chamani, Fatemeh;Sadeghizadeh, Majid;Masoumi, Mahbobeh;Babashah, Sadegh
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.sup3
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    • pp.219-224
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    • 2016
  • Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver making up more than 80 percent of cases. It is known to be the sixth most prevalent cancer and the third most frequent cause of cancer related death worldwide. Epigenetic regulation constitutes an important mechanism by which dietary components can selectively activate or inactivate target gene expression. The miR-34 family members including mir-34a, mir-34b and mir-34c are tumor suppressor micro RNAs, which are expressed in the majority of normal tissues. Several studies have indicated silencing of miR-34 expression via DNA methylation in multiple types of cancers. Bioactive nutrients like curcumin (Cur) have excellent anticarcinogenic activity and minimal toxic manifestations in biological systems. This compound has recently been determined to induce epigenetic changes. However, Cur is lipophilic and has a poor systemic bioavailability and poor absorption. Its bioavailability is increased through employing dendrosome nanoparticles. The aim of the current study was to investigate the effect of dendrosomal nanocurcumin (DNC) on expression of mir-34 family members in two HCC cell lines, HepG2 and Huh7. We performed the MTT assay to evaluate DNC and dendrosome effects on cell viability. The ability of DNC to alter expression of the mir-34 family and DNA methyltransferases (DNMT1, DNMT3A and 3B) was evaluated using semi-quantitative and quantitative PCR. We observed the entrance of DNC into HepG2 and Huh7 cells. Gene expression assays indicated that DNC treatment upregulated mir34a, mir34b and mir34c expression (P<0.05) as well as downregulated DNMT1, DNMT3A and DNMT3B expression (P<0.05) in both HepG2 and Huh7 cell lines. DNC also reduced viability of Huh7 and HepG2 cells through restoration of miR-34s expression. We showed that DNC could awaken the epigenetically silenced miR-34 family by downregulation of DNMTs. Our findings suggest that DNC has potential in epigenetic therapy of HCC.

The Blood Neutrophil-to-lymphocyte Ratio Predicts Survival in Patients with Advanced Hepatocellular Carcinoma Receiving Sorafenib

  • Zheng, You-Bing;Zhao, Wei;Liu, Bing;Lu, Li-Gong;He, Xu;Huang, Jian-Wen;Li, Yong;Hu, Bao-Shan
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5527-5531
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    • 2013
  • Background and Aim: Increasing evidence correlates the presence of systemic inflammation with poor survival in patients with hepatocellular carcinoma (HCC). The aim of this study was to investigate the prognostic significance of the blood neutrophil-to-lymphocyte ratio (NLR) in patients with advanced HCC who received sorafenib monotherapy. Methods: A total of sixty-five patients with advanced HCC, not eligible for locoregional therapy, treated with sorafenib were enrolled. Potential prognostic factors such as age, gender, tumoral characteristics, performance status and NLR were analyzed. Results: Median OS and TTP for the entire cohort were 10.0 months (95%CI, 7.6-12.3 months) and 4.5 months (95% CI, 4.0-4.9 months). The mean NLR at baseline was 2.89. The median OS of patients with a high NLR (>4) was 6.5 months (95%CI, 5.2-7.7 months) compared with 12.5 months (95%CI, 9.9-15.0) for patients with a normal NLR (${\leq}4$) (P=0.01). Age ${\leq}65$, NLR>4, extrahepatic metastases and vascular invasion were all predictors of poorer overall survival. Multivariate analysis showed that NLR > 4, vascular invasion and extrahepatic metastases were independent predictors of poorer overall survival. The median TTP of patients with a high NLR was 2.5 months (95%CI, 1.4-3.6 months) compared with 4.5 months (95%CI, 3.9-5.1 months) for patients with a normal NLR (P=0.012). Conclusions: High baseline NLR was associated with worse OS and TTP for patients with advanced HCC treated with sorafenib.