• Title/Summary/Keyword: Treatment Efficacy

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Endoscopic Balloon Dilatation in Children with Congenital and Acquired Esophageal Anomalies (소아의 선천성 및 후천성 식도 질환에서 내시경적 풍선 확장술)

  • Kwak, Ju Yuong;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.137-142
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    • 2005
  • Purpose: To evaluate the safety, efficacy and technical problems of the endoscopic balloon dilatation of esophageal anomalies in children. Methods: The medical records of 8 children treated by endoscopic balloon dilatation for esophageal anomalies over a 10-year period at Pusan National University Hospital were reviewed retrospectively. The balloon catheter (Maxforce TTS or CRE, Boston Scientific Co., USA) was positioned across the area of narrowing by direct visualization. The balloon was slowly inflated with normal saline to specified pressures for each balloon and maintained for 60 seconds and then deflated. After 60 seconds pause, the procedure was repeated with a larger sized balloon (increments of 1 mm for each subsequent dilation) till effective dilatation was confirmed by direct visualization without complications. Results: Three male and five female were included and their mean age was 4.2 years. A total of 27 (average of 3.2 per patient) dilatation were performed. Underlying diseases of patients are postoperative stricture of esophageal atresia in 3 cases, esophageal ring in 2 cases, achalasia, corrosive esophagitis and hypertensive LES in one case respectively. The size of initial dilating balloon was chosen on the basis of the diameter of the narrowing determined by endoscopy. The first dilation in patients with severe esophageal stricture was made with a 6 mm sized balloon. Complications observed were esophageal perforation and respiratory holding during the procedure in one case respectively. Successful outcome was seen in 6 patients (75%). Conclusion: Endoscopic balloon dilatation can provide a safe and effective mean of treating esophageal anomalies in children and should be considered the treatment of choice in the initial management of those cases.

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Serological and Histological Changes after Interferon Alfa Therapy in Children with Chronic Hepatitis B (소아 만성 B형 간염의 Interferon Alfa 치료 후 혈청학적, 조직학적 소견의 변화)

  • Ko, Jae-Sung;Chung, Ju-Young;Jang, Ja-Joon;Seo, Jeong-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.56-62
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    • 2000
  • Purpose: The aim of this study was to evaluate the efficacy and histologic changes of interferon-alfa therapy on chronic hepatitis B virus infection in children. Patients and Methods: Thirty five children aged 3~16 years who were seropositive for HBV DNA, HBsAg and HBeAg were enrolled. Interferon-alfa 2a ($3.4\;MU/m^2$) were given for 6 months. Serologic markers of viral replication was evaluated 1 year after therapy. Post treatment liver biopsy was performed in 18 patients who showed serologic response. Results: Serum HBeAg and viral DNA became negative in 22 (63%) of treated children at 12 months after therapy. Serum aminotransferase levels normalized in all of the responders and HBsAg became negative in one responder. Horizontal transmission, serum aminotransferase levels more than twice normal, and active inflammation on liver biopsy were predictive factors for response to interferon therapy. Periportal piecemeal necrosis, lobular activity, portal inflammation, fibrosis, and total histologic activity index were reduced in responders. Conclusion: In children with chronic hepatitis B, interferon alfa promotes loss of viral replication and improves aminotransferase. Serologic response is associated with improvement in hepatic histology.

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Control Effect on Dollar Spot Disease Caused by Sclerotinia homoeocarpa under Different Application Rates and Intervals with Two Mixed Fungicides (혼용된 2종의 살균제 살포 농도 및 간격에 따른 잔디 동전마름병 방제효과)

  • Chang, Seog-Won;Jung, Suk-Woo;Kim, Sehun;Park, Jong-Hyun;Lee, Ji-Young
    • Weed & Turfgrass Science
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    • v.2 no.4
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    • pp.408-412
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    • 2013
  • Dollar spot caused by Sclerotinia homoeocarpa F.T. Benn. is a common and economically important turfgrass disease in South Korea. Fungicides mixture (propiconazole 25% + boscalid 47%) treatments, showing synergistic interaction, with three application rates (low: 50.3 ml $10a^{-1}$ and 97.5 g $10a^{-1}$, intermediate: 67.0 ml $10a^{-1}$ and 130.0 g $10a^{-1}$, and high: 100.5 ml $10a^{-1}$ and 195.0 g $10a^{-1}$) and two application intervals (10 and 15 days) were evaluated for control of dollar spot in creeping bentgrass golf course putting green. In both nontreated plots of field A and B, the disease has severed as 48.3 and 60.0% after the pathogen inoculation. Two fungicide mixture treatments showed significantly higher the disease control effect than a single fungicide treatment (propiconazole). Field A which showed more the disease severity but the fungicide still showed acceptable level of the disease efficacy (89.0%), significant differences in control value were not detected among treatments. The results suggest that the lower application rate of two fungicides mixture treatments may reduce the dollar spot disease severity in creeping bentgrass golf course putting green.

Clinical Study of Extra-anatomic Bypass (해부외 회로 조성술에 관한 임상적 고찰)

  • Kim Jong Won;Chung Sung Woon
    • Journal of Chest Surgery
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    • v.38 no.5 s.250
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    • pp.377-381
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    • 2005
  • Background: Extra-anatomic bypass was performed in the patient who could not use anatomic bypass due to many causes. The purpose of this study is to evaluate the efficacy of extra-anatomic bypass surgery. Material and Method: We reviewed 31 patients who underwent extra-anatomic bypass surgery at Pusan national university hospital. We analysed the combined diseases, etiologic diseases, symptoms, patency rate and the factors affecting patency rate retrospectively. Result: There were 26 cases of femoro-femoral bypass and 5 cases of axillo-bifemoral bypass among 31 patients. The mean age was 70.23 years. Combined disease were hypertension, hyperlipidemia, and ischemic heart disease in order of frequency. The indications for surgery were disabled claudication, tissue necrosis, rest pain, and a cute ischemia. We analysed the ages, smoking history, hypertension, ischemic heart disease, severity of limb ischemia, and hyperlipidemia as factors affecting patency rate. We could not find any statistical differences between these factors. The primary graft patency rates were $73.65\%$ one year, $73.65\%$ two year, and $65.46\%$ three year respectively according to the Kaplan-Meier method. Conclusion: Nevertheless extra-anatomic bypass has a relatively low patency rate, it has good merits that is less dangerous, simple and easy re-do surgery compared to anatomic bypass. We think that extra-anatomic bypass is one of the good treatment modalities for the high risk vascular patients.

Nodal Outcomes of Uniportal versus Multiportal Video-Assisted Thoracoscopic Surgery for Clinical Stage I Lung Cancer

  • Choi, Jung Suk;Lee, Jiyun;Moon, Young Kyu;Moon, Seok Whan;Park, Jae Kil;Moon, Mi Hyoung
    • Journal of Chest Surgery
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    • v.53 no.3
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    • pp.104-113
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    • 2020
  • Background: Accurate intraoperative assessment of mediastinal lymph nodes is a critical aspect of lung cancer surgery. The efficacy and potential for upstaging implicit in these dissections must therefore be revisited in the current era of uniportal video-assisted thoracoscopic surgery (VATS). Methods: A retrospective study was conducted in which 544 patients with stage I (T1abc-T2a, N0, M0) primary lung cancer were analyzed. To assess risk factors for nodal upstaging and to limit any imbalance imposed by surgical choices, we constructed an inverse probability of treatment-weighted (IPTW) logistic regression model (in addition to non-weighted logistic models). We also evaluated risk factors for early locoregional recurrence using IPTW logistic regression analysis. Results: In the comparison of uniportal and multiportal VATS, the resected lymph node count (14.03±8.02 vs. 14.41±7.41, respectively; p=0.48) and rate of nodal upstaging (6.5% vs. 8.7%, respectively; p=0.51) appeared similar. Predictors of nodal upstaging included tumor size (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.12-2.70), carcinoembryonic antigen level (OR, 1.11; 95% CI, 1.04-1.18), and histologically confirmed pleural invasion (OR, 3.97; 95% CI, 1.89-8.34). The risk factors for locoregional recurrence within 1 year were found to be number of resected N2 nodes, age, and nodal upstaging. Conclusion: Uniportal and multiportal VATS appear similar with regard to accuracy and thoroughness, showing no significant difference in the extent of nodal dissection.

Phase II Study of Irinotecan Plus Cisplatin as First Line therapy in Extensive Small-Cell Lung Cancer (확장기 소세포폐암에서 1차 치료로서 Irinotecan + Cisplatin 복합요법의 임상적 결과)

  • Hwang, Ki Eun;Kim, So Young;Jung, Jong Hoon;Park, Seong Hoon;Park, Jung Hyun;Kim, Hwi Jung;Kim, Hak Ryul;Yang, Sei Hoon;Jeong, Eun Taik
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.2
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    • pp.143-149
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    • 2006
  • Background: Irinotecan (topoisomerase I inhibitor) is effective as a monotherapy against small-cell lung cancer(SCLC). Cisplatin is also an important drug against SCLC. A phase II study of irinotecan combined with cisplatin was carried out to evaluate the efficacy and toxicity of this combined regimen as a first line treatment in patients with extensive SCLC. Methods: Thirty-nine patients with previously untreated extensive SCLC were enrolled in this study. Irinotecan $60mg/m^2$ was administered intravenously on days 1, 8 and 15, and in combination with cisplatin $60mg/m^2$ on day 1 and every 28 days thereafter. Four cycles of chemotherapy were given to the patients. Results: The overall response rate was 77% with a complete response (CR) rate of 8%. The median survival time, 1- and 2-year survival rate were 14.8 months, 60.9% and 27.6%, respectively. The median progression free survival time, 6-and 12-month progression free survival rate were 8.4 months, 75% and 18.8%, respectively. The WHO grade 3 or more toxicity encountered were leukopenia (23%), diarrhea (26%). Two patients changed their chemotherapeutic regimen and one patient died from severe diarrhea. Conclusion: The combination of irinotecan and cisplatin is effective as a first line therapy in extensive SCLC is effective, but has severe or fatal diarrhea as toxicity.

Antibiotic Resistant Pattern of Helicobacter Pylori Infection Based on Molecular Tests in Laos

  • Vannarath, Sengdao;Vilaichone, Ratha-korn;Rasachak, Bouachanh;Mairiang, Pisaln;Yamaoka, Yoshio;Mahachai, Varocha
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.1
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    • pp.285-287
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    • 2016
  • Background: The efficacy of standard treatment of Helicobacter pylori (H. pylori) is declining because of antibiotic resistance. Clarithromycin resistance is also increasing in many Asian countries. The aim of this study was to determine the antibiotic susceptibility patterns of H. pylori infection and clinical association in Laos. Materials and Methods: A total of 329 Lao dyspeptic patients who underwent gastroscopy at Mahosot Hospital, Vientiane, Laos during December 2010-March 2012 were enrolled in this study. During gastroscopy, 4 biopsies were collected (2 each from the antrum and body) for CLO-test and histopathology. Only the positive CLO-test gastric tissues was stored at $-80^{\circ}C$ in a freezer until DNA was extracted and a GenoType$^{(R)}$HelicoDR test was conducted for detecting mutations in the rrl gene encoding 23S rRNA (clarithromycin resistance) and mutations in gyrA gene (fluoroquinolone resistance). Results: Of the total, 119 Lao patients (36.2%) were infected with H. pylori including 59 males (49.6%) and 60 females (50.4%) with a mean age of 46 years. Clarithromycin and fluoroquinolone resistance of H. pylori infection was demonstrated in 15 (12.6%) and 16 strains (13.4%) respectively. In clarithromycin resistance, the number of patients who had education above primary school and $BMI{\geq}25kg/m^2$ were significantly higher than those who had education below primary school and BMI<$25kg/m^2$ (23.1% vs 7.5%, P-value= 0.036 and 20.5% vs 8%, P-value= 0.048, respectively). In fluoroquinolone resistance, the number of lowland Lao was significantly higher than those of non-lowland (highland and midland) Lao ethnic groups (16.7% vs 0%, P-value= 0.039). Conclusions: H. pylori infections remain common in Laos. Clarithromycin and fluoroquinolone resistance with H. pylori infection are growing problems. Education above primary school and $BMI{\geq}25kg/m^2$ might be predictors for clarithromycin resistance and lowland Lao ethnicity might be predictors for fluoroquinolone resistance with H. pylori infection in Laos.

Selective Radiotherapy after Distant Metastasis of Nasopharyngeal Carcinoma Treated with Dose-Dense Cisplatin plus Fluorouracil

  • Liang, Yong;Bu, Jun-Guo;Cheng, Jin-ling;Gao, Wei-Wei;Xu, Yao-Can;Feng, Jian;Chen, Bo-Yu;Liang, Wei-Chao;Chen, Ke-Quan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.6011-6017
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    • 2015
  • Purpose: To investigate the efficacy and safety of selective radiotherapy after distant metastasis of nasopharyngeal carcinoma (NPC) treated with dose-dense cisplatin plus fluorouracil. Materials and Methods: Eligible patients were randomly assigned to a study group treated with dose-dense cisplatin plus fluorouracil following selective radiotherapy and a control group receiving traditional cisplatin plus fluorouracil following selective radiotherapy according to a 1:1 distribution using a digital random table method. The primary endpoint was overall survival (OS). Secondary endpoints were progression-free survival (PFS), objective response rate, relapse or progression rate in the radiation field and treatment toxicity. Results: Of 52 patients in the study group, 20 cases underwent radiotherapy., while in the control group of 51 patients, 16 underwent radiotherapy. The median PFS, median OS, survival rates in 1, 2 and 3 years in study and control group were 20.9 vs 12.7months, 28.3 vs 18.8months, 85.2%vs 65.9%, 62.2% vs 18.3%, and 36.6%vs 5.2% (p values of 0.00, 0.00, 0.04, 0.00 and 0.00, respectively). Subgroup analysis showed that the median OS and survival rates of 1, 2, 3 years for patients undergoing radiotherapy in the study group better than that in control group( 43.2vs24.1 months, 94.1% vs 86.7%, 82.4% vs 43.3%, 64.7% vs 17.3%, (p=0.00, 0.57, 0.04 and 0.01, respectively). The complete response rate, objective response rate after chemotherapy and three months after radiotherapy, relapse or progression rate in radiation field in study group and in control group were 19.2% vs 3.9%, 86.5% vs 56.9%, 85% vs 50%, 95% vs 81.3% and 41.3% vs 66.7% (p =0.03, 0.00, 0.03,0.30, 0.01 respectively). The grade 3-4 acute adverse reactions in the study group were significantly higher than in the control group (53.8% vs 9.8%, p=0.00). Conclusions: The survival of patients benefits from selective radiotherapy after distant metastasis of NPC treated with dose-dense cisplatin plus fluorouracil.

Insulin Resistance Reduces Sensitivity to Cis-Platinum and Promotes Adhesion, Migration and Invasion in HepG2 Cells

  • Li, Lin-Jing;Li, Guang-Di;Wei, Hu-Lai;Chen, Jing;Liu, Yu-Mei;Li, Fei;Xie, Bei;Wang, Bei;Li, Cai-Li
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.7
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    • pp.3123-3128
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    • 2014
  • The liver is normally the major site of glucose metabolism in intact organisms and the most important target organ for the action of insulin. It has been widely accepted that insulin resistance (IR) is closely associated with postoperative recurrence of hepatocellular carcinoma (HCC). However, the relationship between IR and drug resistance in liver cancer cells is unclear. In the present study, IR was induced in HepG2 cells via incubation with a high concentration of insulin. Once the insulin-resistant cell line was established, the stability of HepG2/IR cells was further tested via incubation in insulin-free medium for another 72h. Afterwards, the biological effects of insulin resistance on adhesion, migration, invasion and sensitivity to cis-platinum (DDP) of cells were determined. The results indicated that glucose consumption was reduced in insulin-resistant cells. In addition, the expression of the insulin receptor and glucose transportor-2 was downregulated. Furthermore, HepG2/IR cells displayed markedly enhanced adhesion, migration, and invasion. Most importantly, these cells exhibited a lower sensitivity to DDP. By contrast, HepG2/IR cells exhibited decreased adhesion and invasion after treatment with the insulin sensitizer pioglitazone hydrochloride. The results suggest that IR is closely related to drug resistance as well as adhesion, migration, and invasion in HepG2 cells. These findings may help explain the clinical observation of limited efficacy for chemotherapy on a background of IR, which promotes the invasion and migration of cancer cells.

Predictive Efficacy of Radioisotope Voiding Cystography for Renal Outcome (방사성동위원소 배뇨방광촬영술의 신장예후 예측성능)

  • Kim, Seok-Ki;Lee, Dong-Soo;Kim, Kwang-Myeung;Choi, Whang;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.2
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    • pp.135-143
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    • 2000
  • Purpose: As vesicoureteral reflux (VUR) could lead to renal functional deterioration when combined with urinary tract infection, we need to decide whether operative anti-reflux treatment should be performed at the time of diagnosis of VUR. Predictive value of radioisotope voiding cystography (RIVCG) for renal outcome was tested. Materials and Methods: In 35 children (18 males, 17 females), radiologic voiding cystoure-thrography (VCU), RIVCG and DMSA scan were performed. Change in renal function was evaluated using the follow-up DMSA scan, ultrasonography, and clinical information. Discriminant analysis was performed using individual or integrated variables such as reflux amount and extent at each phase of voiding on RIVCG, in addition to age, gender and cortical defect on DMSA scan at the time of diagnosis. Discriminant function was composed and its performance was examined. Results: Reflux extent at the filling phase and reflux amount and extent at postvoiding phase had a significant prognostic value. Total reflux amount was a composite variable to predict prognosis. Discriminant function composed of reflux extent at the filling phase and reflux amount and extent at postvoiding phase showed better positive predictive value and specificity than conventional reflux grading. Conclusion: RIVCG could predict renal outcome by disclosing characteristic reflux pattern during various voiding phases.

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