Background: The serum carcinoembryonic antigen (CEA) level can reflect tumor growth, recurrence and metastasis. It has been reported that epidermal growth factor receptor (EGFR) mutations in exons 19 and 21may have an important relationship with tumor cell sensitivity to EGFR-TKI therapy. In this study, we investigated the clinical value of EGFR mutations and serum CEA in patients with non-small cell lung cancer (NSCLC). Materials and Methods: The presence of mutations in EGFR exons 19 and 21 in the tissue samples of 315 patients with NSCLC was detected with real-time fluorescent PCR technology, while the serum CEA level in cases who had not yet undergone surgery, radiotherapy, chemotherapy and targeted therapy were assessed by electrochemical luminescence. Results: The mutation rates in EGFR exons 19 and 21 were 23.2% and 14.9%, respectively, with the two combined in 3.81%. Measured prior to the start of surgery, radiotherapy, chemotherapy and targeted treatment, serum CEA levels were abnormally high in 54.3% of the patients. In those with a serum CEA level <5 ng/mL, the EGFR mutation rate was 18.8%, while with 5~19 ng/mL and ${\geq}20ng/mL$, the rates were 36.4% and 62.5%. In addition, in the cohort of patients with the CEA level being 20~49 ng/mL, the EGFR mutation rate was 85.7%, while in those with the CEA level ${\geq}50ng/mL$, the EGFR mutation rate was only 20.0%, approximately the same as in cases with the CEA level<5 ng/mL. Conclusions: There is a positive correlation between serum CEA expression level and EGFR mutation status in NSCLC patients, namely the EGFR mutation-positive rate increases as the serum CEA expression level rises within a certain range (${\geq}20ng/mL$, especially 20~49 ng/mL). If patient samples are not suitable for EGFR mutation testing, or cannot be obtained at all, testing serum CEA levels might be a simple and easy screening method. Hence, for the NSCLC patients with high serum CEA level (${\geq}20ng/mL$, especially 20~49 ng/mL), it is worthy of attempting EGFR-TKI treatment, which may achieve better clinical efficacy and quality of life.
Background : The safety and efficacy of trabeculectomy with Mitomycin C (MMC) for surgical treatment in aphakic and pseudophaic eyes were retrospectively evaluated. Materials and Methods : The authors reviewed 51 eyes of 45 patients who had been followed up for at least 6 months after trabeculectomy using MMC for aphakic and pseudophakic eyes. The success rate and complications were analyzed. The success criteria included intraocular pressures of 21 mmHg or less with or without glaucoma medications and no loss of light perception. Surgical failure was defined as a postoperative loss of light perception in patients with preoperative vision better than light perception, additional glaucoma surgery, or phthisis bulbi in patients with preoperative vision of no light perception. Results : The average follow up period was 27.7 months and the intraocular pressure was controlled under 21 mmHg in 36 eyes of 51 (70.6%) after the procedure with or without medication for glaucoma. Using the Kaplan-Meier survival analysis, the cumulative success rate at the 3-, 6-, 12-, 24- and 36-month intervals were 98.0%, 94.1%, 91.9%, 83.4% and 75.5%, respectively. The complications observed were hyphema (4 eyes), serous choroidal detachment (4 eyes), hypotony (3 eyes), and endophthalmitis (1 eye). Conclusion : Trabeculectomy using Mitomycin C for the treatment of aphakic and pseudophaic eyes was safe and effective.
Background: Studies of effects of IL-1 polymorphisms, CYP2C19 genotype together with antibiotic resistance for H. pylori eradication are rare worldwide. The present study was designed to evaluate efficacy of 10-day sequential therapy (SQT) and 14-day standard triple therapy (STT) with four- times-daily dosing of amoxicillin for H. pylori eradication related to these important host and bacterial factors in Thailand. Materials and Methods: This prospective randomized study was performed during March 2015 to January 2016. H. pylori infected gastritis patients were randomized to receive 10-day sequential therapy and 14-day standard triple therapy. CYP2C19 genotyping, IL1 polymorphism (IL-1B and IL-1RN genotypes) and antibiotic susceptibility tests were performed in all patients. 13C-UBT was conducted to confirm H. pylori eradication at least 4 weeks after treatment. Results: A total of 100 patients (33 males and 67 females, mean age=51.1 years) were enrolled. Eradication rate by PP analysis was 97.9% (47/48) with the 10-day SQT regimen and 87.8% (43/49) with 14-day STT regimen (97.9% vs 87.8%; p-value=0.053). Antibiotic susceptibility testing demonstrated 45% resistance to metronidazole, 14.8% to clarithromycin, and 24.1% to levofloxacin. CYP2C19 genotyping revealed 44.9% RM, 49% IM and 6.1% PM. IL-1B and IL-1RN genotypes were demonstrated as 21.4% for CC, 48.1% for TC, 36.8% for TT, 72.7% for 1/1, and 21.2% for 1/2 genotypes, respectively. The 10-day SQT regimen provided 100% eradication in patients with clarithromycin or dual clarithromycin and levofloxacin H. pylori resistant strains. Moreover, the 10-day SQT regimen resulted in a 100% eradication rate in all patients with CYP2C19 genotype RM and almost type of IL-1B (TC and TT) and IL1-RN genotypes ( 1/2 and other). Conclusions: Treatment with 10-day sequential therapy is highly effective for H. pylori eradication regardless of the effects of clarithromycin resistance, dual clarithromycin and levofloxacin resistance, CYP2C19 genotype, IL-1B and IL1-RN genetic polymorphisms and can be used as effective first line therapy in Thailand.
Susilawati, Dwi;Sitaresmi, Mei;Handayani, Krisna;Ven, Peter van de;Sutaryo, Sutaryo;Kaspers, Gertjan;Mostert, Saskia
Asian Pacific Journal of Cancer Prevention
/
v.17
no.7
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pp.3235-3242
/
2016
Background: Complementary alternative medicine (CAM) use in children with cancer is widespread. Health-care providers (HCP) need to acknowledge and address this need. This study explored and compared perspectives on CAM of HCP and parents of young patients with cancer in Indonesia. Materials and Methods: We conducted a cross-sectional study using semi-structured questionnaires in HCP and parents of childhood cancer patients at an Indonesian academic hospital. Results: A total of 351 respondents participated: 175 HCP (response rate 80%) and 176 parents (response rate 80%). Parents were more likely than HCP to think that chemotherapy can cure cancer (80% compared to 69%, P=0.013). Nearly half of all parents (46%) and HCP (45%) doubted whether CAM can cure cancer. Parents were more likely than HCP to think that CAM can be helpful in childhood cancer treatment (54% compared to 35%, P=0.003). The most recommended CAM by HCP was self-prayer (93%). Reasons for recommending CAM were: hope for improvement of the child's condition (48%), patient wants to stop treatment (42%). Most discouraged CAM by HCP was by old-smart people (70%), the reasons being: lack of evidence for usefulness (77%), lack of CAM knowledge (75%). The proportion thinking that patients were unlikely to raise the CAM topic if they perceived that doctors were skeptical was higher in parents than in HCP (52% versus 1%) (P<0.001). Most HCP (71%) and parents (77%) acknowledged that their knowledge about safety and efficacy of CAM was inadequate (P=ns). The proportion that wanted to learn or read more about CAM was higher among parents than HCP (48% compared to 31%, P=0.002). Conclusions: HCP and parents have different perspectives on CAM use in children with cancer. HCP should enhance their CAM knowledge and encourage open communication about CAM with parents. If doctors' skepticism is perceived, parents are unlikely to raise CAM as a topic.
In this study, we selected some herbal formulation about a series of Chijasi-tang in Dongeuibogam by using web-based open program;Prescription Lineage Graph (http://164.125.206.43/PrescriptionLineageGraph.aspx). And we compared and analyzed the changes of efficacy, major target symptoms of each herbal formulation according to compositional variation of each herbal formulation. Chijasi-tang, first appeared in Sanghanlun, consists of Capejasmine and Fermented soybean, and it is mainly used to treat insomnia due to vexation, heartburn and yellow greasy tongue fur. Capejasmine can clear away irritable feverish sensation in chest by flowing downward the heat, and Fermented soybean can disperse stagnated heat throughout the chest by expelling stagnated heat from the exterior In the case of the heat stagnation caused by relapsing of disease due to overstain, Chisijisil-tang can be used. And if symptom appear more on the upper or exterior than a case of Chisijisil-tang, Seosisi-tang could be more suitable, if half exterior and half interior, Omae-tang could be for it. In addition, if symptom caused by relapsing due to improper diet, Chisijihwang-tang could be proper formulation. In the case of the heat stagnation body inside and jaundice, if it is caused by alcohol, Chijadaehwang-tang could be used for the purpose of urgent purgation, Galchul-tang would be suitable for helping the function of the spleen and the stomach and for treatment of damp-heat of the spleen and the stomach. And if it is caused by pandemic infection, Jangdal-hwan would be good formulation for it. Samhwangseokgo-tang and Yangdokchija-tang could be appropriate formulation for the raging of noxious heat and pathogenic fire caused by febrile disease with toxic yang. Daehwangeum-ja is for severe constipation due to heat-dryness with stagnated fever, Haebaek-tang is appropriate for severe diarrhea due to heat type change of Soeum. According to the result of our investigation, although there are various target causes and symptoms of each herbal formulations, whatever pathogenetic cause is, the stagnated heat in interior side is the basis of symptoms. Therefore, the purpose of including Chijasi-tang in composition of each herbal formulation is treatment of the stagnated heat. For such reason, on the fundamental or ancillary basis of Chijasi-tang plus some herbs for each therapeutic purpose.
Journal of the Korean Society of Food Science and Nutrition
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v.44
no.12
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pp.1912-1917
/
2015
Pancreatic lipase is a potential therapeutic target for the treatment of diet-induced obesity in humans. As part of our continuing search for novel bioactive compounds, the convenient enzymatic transformation of caffeic acid into neolignans as well as related oxidized-products enhanced pancreatic lipase inhibitory activity. Enzymatic transformation of caffeic acid (1) using polyphenol oxidase originating from Korean pear yielded four oxidized metabolites, which were identified by different spectroscopic techniques ($^1H$,$^{13}C$ NMR, DEP/T, $^1H-^1H$ COSY, HMBC, HMQC, and NOESY). The anti-obesity efficacy of caffeic acid reactant was tested by in vitro porcine pancreatic lipase assay. All tested samples showed dose-dependent pancreatic lipase inhibitory activities. Four oxidative products including phellinsin A (2), caffeicinic acid (3), isocaffeicinic acid (4), and 7,8-erythro-caffeicin (5) were isolated and identified. The major metabolites (2~5) were evaluated for their pancreatic lipase inhibitory activity, and oxidized-products (2~3) improved potency against pancreatic lipase when compared to original caffeic acid. This result suggested that the neolignans isolated from oxidative transformation of caffeic acid might be beneficial in the treatment of obesity and relevant diseases, and the convenient enzymatic transformation by polyphenol oxidase may be a valuable method for structural modification and enhancement of activity.
A comparative experiment was conducted to investigate the persistence of chlorfenapyr residue and its biological activity to two spotted spider mite, Tetranychus urticae, after treatment of chlorfenapyr suspension concentrate (10% SC) on paprika plants at recommended (2000 times dilution) and double dosage. Biological half-lives of chlorpfenapyr were estimated as 8 and 5 days in leaves and fruits of paprika plants, respectively. While initial deposits of chlorfenapyr residues in leaves at recommended and double dosages were 22.22 and 37.75 ${\mu}g\;g^{-1}$ at the time of application, its residue decreased to 1.56 ${\mu}g\;g^{-1}$ and 3.62 ${\mu}g\;g^{-1}$ at 29 days after treatment, respectively. Residual biological activity of chlorfenapyr SC to T. urticae at recommended dosage lasted for 7 or 15 days on the basis of 24 or 48-hrs mortality test assayed with feeding on excised leaf chlorfenapyr-treated. The control efficacy to the mite showed a good agreement with the persistence of chlorfenapyr residues in leaves.
This study evaluated the efficacy of topical eprinomectin (0.5% pour-on solution, $Eprinex^{(R)}$, Merial) against Chorioptes texanus (C texanus) infestation in dairy cows reared in Korea. Dairy cows naturally infected with C texanus showed skin lesions as alopecia, erythema, excoriations and crusts on the tail head, the caudal folds, the back of udder and the rump area. Fourteen adult Holstein dairy cows with chorioptic mange at National Institute of Animal Science were selected on the basis of gross lesion and microscopic examination. Experimental dairy cows infected with chorioptic mange were treated with eprinomectin ($Eprinex^{(R)}$, Merial, France) at the rate of 1 ml /10 kg/BW. Evaluation of therapeutic effect is based on mite counts and gross lesion at weekly interval for 6 weeks. Milk yields were measured every day and calculate at the mean of milk yield at weekly interval. Mange mites absolutely removed after 1 week of topical eprinomectin against C. texanus infestation on dairy cows. The skin lesion of dairy cows infested with C. texanus recovered normal status after 6 weeks of eprinomectin treatment. After eprinomectin treatment, return to the normal level of milk yields in diary cows infested with C. texanus has indirectly indicated that C. texanus infestation have negative effect on productivity of dairy farm. However, it would be suggested that the investigation of actual condition and the effective control method of C. texanus infestation of dairy farms in Korea should be studied in the future.
Purpose: To describe the effectiveness of traditional Korean medicine (TKM) on the patients with secondary dementia (case 1: Rt. MCA infarction; case 2: traumatic subacute subdural hemorrhage and traumatic intracranial hemorrhage; case 3: delayed encephalopathy after carbon monoxide poisoning). Methods: We used a complete TKM treatment. The acupoints used were as follows: acupoints frequently used in hemiparesis (GV20, GV24, ST4, LI11, LI14, ST36, GB34, SP9, and LR3), and we used herbal medicine (補腎益腦湯加味, Boshiniknoe-tang-gami). The efficacy was evaluated using the Mini-Mental State Examination for Dementia Screening (MMSE-DS) and the Modified Barthel Index (MBI). Results: After treatment, the total MMSE-DS score was increased from 14 to 24 (case 1), 14 to 19 (case 2), and 0 to 17 (case 3). The total K-MBI was increased from 30 to 44 (case 1), 82 to 86 (case 2), and 30 to 86 (case 3) Conclusions: We suggest that TKM could positively influence cognition and improve activity of daily living (ADL). This study has limitations, so further studies are needed.
Dyslipidemia is the multiple lipid metabolic disorders which is one of the high risk factors for the atherosclerotic diseases. It increases the morbidity and mortality and therefore, must be treated with antilipidemic agents. HMG-Co A reductase inhibitors (statins), one of many antidyslipidemic agents, have shown to be significant improvement from the various cholesterol levels. Especially, data from many comparative trials suggest that rosuvastatin is more effective than atorvastatin among many other statins. The aims of this study were to evaluate the efficacy and safety between rosuvastatin and atorvastatin in the treatment of Korean patients with dyslipidemia. Currently the Korean Society of Lipidology and Atherosclerosis based on the Korean health screening data suggests that Korean patients with dyslipidemia should be treated by the target cholesterol levels according to the Adult Treatment Panel III guidelines of the US National Cholesterol Education Program (NCEP-ATP III). We reviewed retrospectively all medical histories of the total 392 dyslipidemic patients with atorvastatin or rosuvastatin from June 1st, 2004 to August 31st, 2006 in Chungbuk National University Medical Center. Patients were classified as total 4 groups by the NCEP-ATP III Guidelines. The numbers of enrolled patients were each 5 mg atorvastatin (n=34), 10 mg atorvastatin (n=148), 5 mg rosuvastatin (n=94) and 10 mg rosuvastatin (n=82). In comparison between groups, rosuvastatin groups in the lowering LDL-C had better efficacies, and the results were each 22% (5 mg atorvastatin), 33.3% (10 mg atorvastatin), 35% (5 mg rosuvastatin) and 41.3% (10 mg rosuvastatin) with the dose relationship (P=0.000). Rosuvastatin groups also have shown to be more significantly reducing Total Cholesterol levels compared to atorvastatin groups with the no dose relationship (P=0.000). In the lowering of non-HDL cholesteroles, rosuvastatin groups showed significantly better efficacies than atorvastatin with the dose-relationship (P=0.000). Each medication groups did not demonstrate the differences in the changing of HDL cholesterol and triglyceride levels (P=0.096, 0.309, respectively). In conclusion, rosuvastatin was better efficacious than atrovastatin in reducing LDL-C Total Chol, and Tg. Therefore, rosuvastatin is a good antilipidemic agents for Korean patients with dyslipidemia and it can use to minimize the morbidity and mortality related to the cardiovascular diseases in Korean.
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