• Title/Summary/Keyword: Treatment Efficacy

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Efficacy of the pocket-creation method with a traction device in endoscopic submucosal dissection for residual or recurrent colorectal lesions

  • Daisuke Ide;Tomohiko Richard Ohya;Mitsuaki Ishioka;Yuri Enomoto;Eisuke Nakao;Yuki Mitsuyoshi;Junki Tokura;Keigo Suzuki;Seiichi Yakabi;Chihiro Yasue;Akiko Chino;Masahiro Igarashi;Akio Nakashima;Masayuki Saruta;Shoichi Saito;Junko Fujisaki
    • Clinical Endoscopy
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    • v.55 no.5
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    • pp.655-664
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    • 2022
  • Background/Aims: Endoscopic submucosal dissection (ESD) for residual or recurrent colorectal lesions after incomplete resection is challenging because of severe fibrosis. This study aimed to compare the efficacy of the pocket-creation method (PCM) with a traction device (TD) with that of conventional ESD for residual or recurrent colorectal lesions. Methods: We retrospectively studied 72 patients with residual or recurrent colorectal lesions resected using ESD. Overall, 31 and 41 lesions were resected using PCM with TD and conventional ESD methods, respectively. We compared patient background and treatment outcomes between the PCM with TD and conventional ESD groups, respectively. The primary endpoints were en bloc resection and R0 resection rates. The secondary endpoints were the dissection speed and incidence of adverse events. Results: En bloc resection was feasible in all cases with PCM with TD, but failed in 22% of cases of conventional ESD. The R0 resection rates for PCM with TD and conventional ESD were 97% and 66%, respectively. Dissection was significantly faster in the PCM with TD group (13.0 vs. 7.9 mm2/min). Perforation and postoperative bleeding were observed in one patient in each group. Conclusions: PCM with TD is an effective method for treating residual or recurrent colorectal lesions after incomplete resection.

Ten-Year Outcomes of Radiofrequency Ablation for Locally Recurrent Papillary Thyroid Cancer

  • Sae Rom Chung;Jung Hwan Baek;Young Jun Choi;Jeong Hyun Lee
    • Korean Journal of Radiology
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    • v.25 no.9
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    • pp.851-858
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    • 2024
  • Objective: This study investigates the long-term efficacy and safety of ultrasound (US)-guided radiofrequency ablation (RFA) for treating locally recurrent papillary thyroid cancer (PTC). Materials and Methods: We retrospectively analyzed 39 consecutive patients with 61 locally recurrent PTCs (14 males, 25 females; mean ± standard deviation age, 52.8 ± 16.7 years; range 21-92 years) who underwent US-guided RFA with curative intent between September 2008 and April 2012. A subgroup of 24 patients with 37 recurrent PTCs who had a follow-up of at least 10 years were analyzed separately. All patients were followed for changes in lesion size on US and thyroglobulin (Tg) levels at 1, 3, 6, and 12 months after RFA, with follow-up every 6-12 months thereafter. Any complications were documented during the follow-up period. Recurrence-free survival (RFS) rates were assessed using Kaplan-Meier estimates. Long-term outcomes were evaluated in patients with follow-up of at least 10 years. Results: The follow-up period ranged from 7 to 180 months (median 133 months). The RFS rates for the 39 patients at 3, 5, and 10 years were 86.8%, 75.5%, and 60.6%, respectively. Among the 24 patients with 37 recurrent PTCs followed for more than 10 years, the volume reduction rate was 99.9% (range 96%-100%), and the complete tumor disappearance rate was 91.9%. The mean serum Tg level also decreased significantly, from 2.66 ± 86.5 mIU/L before ablation to 0.43 ± 0.73 mIU/L (P < 0.001) at the final follow-up. In 14 (58.3%) of the 24 patients, Tg levels were undetectable (below 0.08 mIU/L) at the last follow-up. No life-threatening or delayed complications were observed during the 10-year follow-up period. Conclusion: The high RFS throughout the follow-up period, with efficacy and safety lasting beyond 10 years, supports US-guided RFA as a valuable option for local control of recurrent PTCs.

Improvement of Virus Safety of a Human Intravenous Immunoglobulin by Low pH Incubation

  • Kim, In-Seop;Choi, Yong-Woon;Lee, Sung-Rae;Cho, Hang-Bok;Eo, Ho-Gueon;Han, Sang-Woo;Chang, Chong-Eun;Lee, Soung-Min
    • Journal of Microbiology and Biotechnology
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    • v.11 no.4
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    • pp.619-627
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    • 2001
  • n order to increase the virus safety of a human intravenous immunoglobulin (IVIg) that was manufactured by a successive process of cold ethanol fractionation, polyethylene glycol precipitation, and pasteurization ($60^{\circ}C$ heat treatment for 10h), a low pH incubation process (pH 3.9 at $25{\circ}C$ for 14 days) was employed as the final step. The efficacy and mechanism of the fraction III cold ethanol fractionation, pasteurization, and low pH treatment steps in the removal and/or inactivation of blood-borne viruses were closely examined. A variety of experimental model viruses for human pathogenic viruses, including the Bovine herpes virus (BHV), Bovine viral diarrhoea virus (BVDV), Murine encephalomyocarditis virus (EMCV), and Porcine parvovirus (PPV), were selected for this study. The mechanism of reduction for the enveloped viruses (BHV and BVDV) during fraction III fractionation was both inactivation and partitioning, however, it was partitioning in the case of the nonenveloped viruses (EMCV and PPV). The log reduction factors achieved during fraction III fractionation were ${\geqq}$6.7 for BHV, ${\geqq}4.7$ for BVDV, 4.5 for EMCV, and 4.4 for PPV. Pasteurization was found to be a robust and effective step in inactivating all the viruses tested. The log reduction factors achieved during the pasteurization process were ${\geqq}7.5$ for BHV, ${\geqq}4.8$ for BVDV, 3.0 for EMCV, and 3.3 for PPV. A low pH incubation was very effective in inactivating the enveloped viruses as well as EMCV. The log reduction factors achieved during low pH incubation were ${\geqq}7.4$ for BHV, ${\geqq}3.9$ for BVDV, 5.2 for EMCV, and 2.0 for PPV. These results indicate that the low pH treatment successfully improved the viral safety of the final products.

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Efficacy of Foliar Herbicide Treatment by Unmanned Helicopter under Water-Seeded Rice Cultivation (벼 담수표면산파 재배에서 무인헬기를 이용한 제초제 경엽처리 효과)

  • Seong, Deok-Gyeong;Bea, Sung-Mun;Kim, Young-Gwang;Cho, Yong-Cho;Lee, Sang-Dae;Shim, Sang-In;Chung, Jung-Sung
    • Weed & Turfgrass Science
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    • v.3 no.4
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    • pp.323-328
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    • 2014
  • This study was conducted to find out the effects of aerial application by unmanned helicopter (AAUH) on controlling weeds under water-seeded rice cultivation. Foliar herbicide (bentazone sodium + fenoxaprop-P-ethyl) was applied with diluted 8-times (standard concentration pest control) as AAUH. Foliar herbicide treatment with standard and two times amount were little damage, but with more than three times amount showed great damage in rice growth. Six annual and two perennial weeds were major weeds occurred in the experimental paddy field. On foliar herbicide treatment 25 days after direct seeding, AAUH showed high control values against weeds (96.3% for annual weeds and 99.8% for perennial weeds). There was no significant difference in weed control values between AAUH and conventional application. There was no spray injury against rice plants with aerial application. In the experiment for good spray timing (15, 20 and 25 days after direct seeding) 15 days showed highest weed control values with 98.5% to annual weeds and 99.8% to perennial weeds and no spray injury.

The Effects of Yacon (Smallanthus sonchifolius) Extract on Pancreatic Fibrosis in the Rat (야콘(Smallanthus sonchifolius) 추출물이 흰쥐의 췌장 섬유화에 미치는 영향)

  • Choi, Nan-Hee;Kim, Jong-Bong;Kim, Jin-Teak;Park, In-Sick
    • Journal of Life Science
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    • v.22 no.7
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    • pp.904-911
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    • 2012
  • Yacon has been used in folk medicines as a medicinal tea for hypoglycemia treatment. In a recent study described herein, antioxidative, antibacterial, antifungal activities, and cell-protective functions of yacon leaves have been reported. To evaluate the effects on fibrosis on pancreatitis, the efficacy of 1% of yacon extract (YE) on dibutyltin dichloride (DBTC) (8 mg/kg)-induced pancreatitis in rats was examined. On the 21st day after the DBTC treatment, a large increase in collagen was observed in the pancreas in the DBTC-treatment group (DT). But this was noticeably decreased with YE. In relation to the expression of COX-2, there was no response or a very weak response in the pancreas of the control group (CON). However, in DT, strong expression of COX-2 was observed in the pancreas on the 14th day, and COX-2 was present in inflammatory cells in the pancreas of the DT, especially on the 21st day. The expression was decreased for YE compared with DT. A remarkable increase in TGF-${\beta}1$ expression was observed in inflammatory cells in the pancreas in DT on the 21st day, whereas the expression was not found in YE after 21 days. However, on the 21th day, TGF-${\beta}1$ expression was increased in acinar cells of YE compared with DT. VEGF expression was very similar to the expression of in the pancreas. These results suggest that YE has an inhibitory effect on DBTC-induced pancreatic fibrosis.

Role of the HPV DNA Test in Follow-up of Treated Cervical Intraepithelial Neoplasia in Bangladesh

  • Nessa, Ashrafun;Rashid, Mohammad Harun Ur;Jahan, Munira;Ferdous, Noor-E;Nahar, Pervin Akhter Shamsun;Chowdhury, Afroza
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8063-8067
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    • 2014
  • Background: Cervical cancer is a major public health problem in Bangladesh. Persistence of high risk human papillomavirus (HRHPV) influences the progression of the disease, with an important role in followup for cervical intraepithelial neoplasia (CIN). Objective: To establish application of high risk HPV DNA test in the follow-up of women after treatment of CIN. Materials and Methods: This cross-sectional and hospital based study was carried out among 145 CIN treated women during the previous six months to three years at the colposcopy clinic of Bangabandhu Sheikh Mujib Medical University, Dhaka, between January 2011 and June 2012. Pap smear and HPV samples were collected and colposcopy was performed to find out the persistence of the disease. Cervical samples obtained were tested for HPV DNA using the Hybrid Capture II (HC-II) test. A cervical biopsy was collected whenever necessary. The results were compared to assess the efficacy of different methods during follow up such as Pap smear, HPV test and colposcopy. Results: Mean age of the recruited women (n=145) was 33.6 (${\pm}7.6$), mean age of marriage was 16.8 (${\pm}2.9$) and mean age of 1st delivery was 18.8 (${\pm}3.5$) years. More than half had high grade CIN before treatment and 115 (79.3%) women were managed by LEEP and 20.7% were managed by cold coagulation. Among the 145 treated women, 139 were negative for HPV DNA and six of them (4.1%) were HPV positive. Sensitivity of Pap smear (40.0) and HPV DNA test (40.0) was poor, but specificity was quite satisfactory (>93.0) for all the tests. Conclusions: The high risk HPV DNA test can be an effective method of identifying residual disease. It can be added to colposcopy and this should be applied to all treated women attending for their first or second post-treatment follow-up visit at 6 months to one year, irrespective of the grade of treated CIN.

Development of bombesin peptide kit for prostate cancer diagnosis and treatment using 64Cu/177Lu.

  • Kim, Mi Hyun;Kim, Min Hwan;Kim, Kwang Il;Kim, Jung Young;Lee, Tae Sup;Kang, Joo Hyun;Lee, Kyo Chul;Lee, Yong Jin
    • Journal of Radiopharmaceuticals and Molecular Probes
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    • v.3 no.2
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    • pp.59-64
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    • 2017
  • It has been reported that $^{64}Cu$ was radiolabeled with bombesin (BBN) peptide binding to the gastrin releasing peptide receptor expressed in human prostate cancer cells (PC3), confirming tumor target efficacy in mouse model. In this study, we developed the kit for the diagnosis and treatment of prostate cancer that can be used clinically using bombesin peptide available of $^{64}Cu$ and $^{177}Lu$ radioisotope labeling. The NODAGA-galacto-BBN peptide containing the NODAGA chelator and galactose was dispensed into a sterilized glass vial and lyophilized to prepare a kit. The stability of the kit after long-term storage in the $4^{\circ}C$ cold chamber and the radiolabeling efficiency after $^{64}Cu$ or $^{177}Lu$ labeling were confirmed by thin layer chromatography. When labeling with $^{64}Cu$ at the initial stage of storage, labeling efficiency of NODAGA-galacto-BBN peptide kit was over 96%, labeling efficiency was over 90% when $^{177}Lu$ was labeled. At 11 months after storage, the radiolabeling efficiency of kit against $^{64}Cu$ and $^{177}Lu$ was each over 95% and 90%. The cell viability was significantly reduced in the $^{177}Lu$-NODAGA-galacto-BBN treated group compared with the control and $^{177}Lu$ alone treated group in clonogenic assay. In conclusion, the NODAGA-galacto-BBN kit prepared by the lyophilization showed high stability over time and high yield of radioisotope labeling. Also $^{177}Lu$-NODAGA-galacto-BBN confirmed high cytotoxicity to prostate cancer cells. Therefore, the NODAGA-galacto-bombesin kit is expected to be useful for the diagnosis and treatment of prostate cancer patients.

Treatment outcome of hepatic re-irradiation in patients with hepatocellular carcinoma

  • Seol, Seung Won;Yu, Jeong Il;Park, Hee Chul;Lim, Do Hoon;Oh, Dongryul;Noh, Jae Myoung;Cho, Won Kyung;Paik, Seung Woon
    • Radiation Oncology Journal
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    • v.33 no.4
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    • pp.276-283
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    • 2015
  • Purpose: We evaluated the efficacy and toxicity of repeated high dose 3-dimensional conformal radiation therapy (3D-CRT) for patients with unresectable hepatocellular carcinoma. Materials and Methods: Between 1998 and 2011, 45 patients received hepatic re-irradiation with high dose 3D-CRT in Samsung Medical Center. After excluding two ineligible patients, 43 patients were retrospectively reviewed. RT was delivered with palliative or salvage intent, and equivalent dose of 2 Gy fractions for ${\alpha}/{\beta}=10Gy$ ranged from $31.25Gy_{10}$ to $93.75Gy_{10}$ (median, $44Gy_{10}$). Tumor response and toxicity were evaluated based on the modified Response Evaluation Criteria in Solid Tumors criteria and the Common Terminology Criteria for Adverse Events (CTCAE) ver. 4.0. Results: The median follow-up duration was 11.2 months (range, 4.1 to 58.3 months). An objective tumor response rate was 62.8%. The tumor response rates were 81.0% and 45.5% in patients receiving ${\geq}45Gy_{10}$ and $<45Gy_{10}$, respectively (p = 0.016). The median overall survival (OS) of all patients was 11.2 months. The OS was significantly affected by the Child-Pugh class as 14.2 months vs. 6.1 months (Child-Pugh A vs. B, p < 0.001), and modified Union for International Cancer Control (UICC) T stage as 15.6 months vs. 8.3 months (T1-3 vs. T4, p = 0.004), respectively. Grade III toxicities were developed in two patients, both of whom received ${\geq}50Gy_{10}$. Conclusion: Hepatic re-irradiation may be an effective and tolerable treatment for patients who are not eligible for further local treatment modalities, especially in patients with Child-Pugh A and T1-3.

A Comparison of Salmeterol with Salbutamol Inhalation in Treatment of Mild to Moderate Asthma (기관지 천식 환자에 있어서 살메테롤과 살부타몰 흡입제의 치료효과비교)

  • Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.815-821
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    • 1997
  • Background : Salmeterol, a new ${\beta}_2$-adrenergic receptor agonist, is a long-acting bronchodilator and benefits patients with asthma who have nocturnal symptoms. We wished to assess the efficacy of inhaled salmeterol ($50{\mu}g$ bid) compared to inhaled salbutamol ($200{\mu}g$ qid) for the treatment of bronchial asthma, particularly nocturnal asthma. Method : We randomly assigned 35 patients (25 female and 10 male patients, 15 to 50 years old) to one of two treatment groups : one group received $50{\mu}g$ of salmeterol twice daily and another did $200{\mu}g$ salbutamol four times per day. And this study was performed as an open-label and the 6 weeks inhalation period. Results : Analysis of symptam score ; Day and night time symptom score showed significant difference between salmeterol and salbutamol Group (p<0.05). Number of days for additional bronchodilator requirements; The number of days and puffs for additional bronchodilator were lower in the salmeterol group in either day and night time (p<0.05). Pulmonary function test ; $FEV_1$ showed significant increase in salmeterol group compared to salbutamol group after 2 and 4 weeks inhalation period. Adverse effects ; We found no evidence of tolerance to the bronchodilating effects of salmeterol, and adverse reactions to all the treatments were infrequent and mild. Conclusion : For the management of bronchial asthma, salmeterol given twice daily is superior to salbutamol given four times daily.

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The Current Status of Complementary-Alternative Medicine for Asthmatics in Korea : Experience in One Tertiary Care Hospital (한 대학병원에서의 천식환자의 대체-보완의료의 실태와 경향)

  • Hwang, Bo Young;Park, Mi Na;Choi, Hye Sook;Choi, Cheon Woong;Yoo, Ji Hong;Kang, Hong Mo;Park, Myung Jae
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.4
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    • pp.339-346
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    • 2006
  • Background: There has no known epidemiologic survey on the frequency of complementary-alternative medicine (CAM) use in the treatment of adult asthma in Korea. This study examined the current use of CAM by asthma patients in Korea. Methods: One hundred adults with asthma, who had been admitted to Kyunghee university hospital between January 2000 and December 2003, were enrolled in this survey. They received a structured questionnaire interview and a clinical assessment of prevalence and pattern of CAM use. Results: 53% patients had an experience of at least one type of CAM during their asthma management. Users of CAM had more hospital visits than those who had never used CAM($1.46{\pm}0.68$ vs. $2.11{\pm}1.20$, p=0.001). Those in their $50^{th}$ decades had more experience of CAM (80%) than the other age groups. The methods of CAM used by our patients are as follows: Diet/nutritional therapy in 35 patients(69%), herbal therapy in 28 patients(53%), acupuncture in 9 patients(17%), moxa treatment in 6 patients(11%), breathing exercises in 1 patient(2%). Conclusions: More than 50% of patients with bronchial asthma have used CAM. A more detailed and large scaled study will be needed to define the actual status of the use of CAM in the treatment for asthma. Inaddition, further research on the scientific validation of the clinical efficacy of CAM in asthma management should be followed.