• Title/Summary/Keyword: early treatment

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Treatment outcome in patients with triple negative early stage breast cancers compared with other molecular subtypes

  • Kim, Ja Young;Chang, Sei-Kyung;Park, Heily;Lee, Bo-Mi;Shin, Hyun Soo
    • Radiation Oncology Journal
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    • v.30 no.3
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    • pp.124-131
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    • 2012
  • Purpose: To determine whether triple negative (TN) early stage breast cancers have poorer survival rates compared with other molecular types. Materials and Methods: Between August 2000 and July 2006, patients diagnosed with stage I, II early stage breast cancers, in whom all three markers (estrogen receptor, progesterone receptor, and human epidermal growth factor receptor [HER]-2) were available and treated with modified radical mastectomy or breast conserving surgery followed by radiotherapy, were retrospectively reviewed. Results: Of 446 patients, 94 (21.1%) were classified as TN, 57 (12.8%) as HER-2 type, and 295 (66.1%) as luminal. TN was more frequently associated with young patients younger than 35 years old (p = 0.002), higher histologic grade (p < 0.0001), and nuclear (p < 0.0001). The median follow-up period was 78 months (range, 4 to 130 months). There were 9 local relapses (2.0%), 15 nodal (3.4%), 40 distant metastases (9.0%), and 33 deaths (7.4%) for all patients. The rates of 5-year OS, DFS, LFS, and DMFS for all patients were 95.5%, 89.9%, 95.4%, and 91.7%, respectively. There were no significant differences in OS, DFS, LFS, and DMFS between triple negative and other subtypes (p > 0.05). Conclusion: We found that patients with TN early stage breast cancers had no difference in survival rates compared with other molecular subtypes. Prospective study in homogeneous treatment group will need for a prognosis of TN early stage breast cancer.

BioMEMS-EARLY DISEASE DETECTION (BioMEMS 기반의 조기 질병 진단 기술에 관한 연구)

  • Singh, Kanika;Kim, Kyung-Chun
    • Proceedings of the KSME Conference
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    • 2007.05b
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    • pp.2781-2784
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    • 2007
  • Early detection of a disease is important to tackle treatment issues in a better manner. Several diagnostic techniques are in use, these days; for such purpose and tremendous research is going on to develop newer and newer methods. However, more work is required to be done to develop cheap and reliable early detection techniques. Micro-fluidic chips are also playing key role to deliver new devices for better health care. The present study focuses on a review of recent developments in the interrogation of different techniques and present state-of-the-art of microfluidic sensor for better, quick, easy, rapid, early, inexpensive and portable POCT (Point of Care testing device) device for a particular study, in this case, bone disease called osteoporosis. Some simulations of the microchip are also made to enable feasibility of the development of a blood-chip-based system. The proposed device will assist in early detection of diseases in an effective and successful manner.

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Controversies on the Usefulness of Nerve Conduction Study in the Early Diagnosis of Diabetic Polyneuropathy: Cons (당뇨병성 다발신경병증의 조기 진단에 있어서 신경전도검사의 유용성에 관한 논란: 부정적인 관점에서)

  • Sohn, Eun Hee
    • Annals of Clinical Neurophysiology
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    • v.10 no.1
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    • pp.33-37
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    • 2008
  • Diabetic polyneuropathy (DPN) is the most common form of diabetic neuropathy, and causes a significant morbidity with an impact on the quality of life in the patients with diabetes. Since DPN frequently induces foot deformity and ulceration, which finally leads to foot amputation, the early detection and treatment is very important for the prevention of a permanent structural change. In the early stage of DPN, the diagnostic methods which can evaluate the function or structure of small nerve fibers should be employed because small nerve fibers are first involved in the course of DPN. However, the nerve conduction study cannot reflect the function of the small nerve fibers, and thus, has a definite limitation in the early diagnosis of DPN. For the early detection of DPN, electrodiagnostic data should be interpreted on a clinical context, along with the careful evaluation of the small nerve fiber functions using the tests such as the analysis of intraepidermal nerve fiber density.

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The Relationship between Early-onset Androgenetic Alopecia and Metabolic Syndrome: Systematic Review and Meta-Analysis (조발성 탈모증과 대사증후군과의 관계: 체계적 문헌고찰 및 메타분석)

  • Jang, Jin-Young;Yoon, Young-Joon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.30 no.3
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    • pp.166-181
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    • 2017
  • Objectives : The study was done to verify the relation between early-onset androgenetic alopecia(AGA) and metabolic syndrome(MetS). Methods : Data were collected through electronic database including KoreaMed, National Assembly Library, KMBASE, NDSL, KCI, KERIS, Google Scholar, Pubmed, Cochrane CENTRAL and EBSCO MEDLINE. A total of 13 case-control studies related to the MetS of early-onset alopecia patients were used for the systematic review and meta-analysis. Risk of bias of included studies were assessed by RoBANS tool. RevMan5.3, CMA3 were used for the meta-analysis. Results : In 13 evaluated articles, most frequent bias was the participant selection bias that was found in 10 articles. Significant association between early-onset AGA and MetS was found in 10(76.9%) out of 13 articles in the systematic review. In meta-analysis, early-onset male AGA was associated with increased risk of metabolic syndrome(OR: 3.73, 95% CI:2.49 -5.61). Conclusions : AGA, particularly early -onset male AGA, is significantly associated with MetS. Therefore all patients with early onset male AGA should be suggested to take preventive treatment to reduce the risk of MetS and various problems associated with it.

Prevention of thiopurine-induced early leukopenia in a Korean pediatric patient with Crohn's disease who turned out to possess homozygous mutations in NUDT15 R139C

  • Bae, Jaewoan;Choe, Byung-Ho;Kang, Ben
    • Journal of Yeungnam Medical Science
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    • v.37 no.4
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    • pp.332-336
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    • 2020
  • Homozygous mutations in NUDT15 R139C are known as the major factor associated with thiopurine-induced early leukopenia, particularly in Asian patients. Therefore, NUDT15 genotyping is currently recommended before thiopurine treatment to identify patients who are NUDT15 poor metabolizers and consider the use of an alternative immunomodulatory therapy. We report a case of a 12-year-old Korean girl with Crohn's disease (CD), in whom thiopurine-induced leukopenia was prevented by initiation of azathioprine (AZA) therapy at a low dose (0.5 mg/kg/day) and early detection of significant hair loss and white blood cell (WBC) count decrease at 17 days from the start of AZA treatment. The WBC count dropped from 8,970/μL to 3,370/μL in 2 weeks, and AZA treatment was stopped because of concerns of potential leukopenia in the near future. Her WBC count recovered to 5,120/μL after 3 weeks. Gene analysis later revealed that she had a homozygous mutation in NUDT15 R139C, resulting in a poor metabolizing activity of NUDT15. In situations when NUDT15 genotyping is unavailable, initiation of AZA therapy at 0.5 mg/kg/day with close observation of hair loss and WBC counts within 2 weeks may be an alternative way to prevent thiopurine-induced early leukopenia in Asian children with CD.

Monitoring microRNAs Using a Molecular Beacon in CD133+/CD338+ Human Lung Adenocarcinoma-initiating A549 Cells

  • Yao, Quan;Sun, Jian-Guo;Ma, Hu;Zhang, An-Mei;Lin, Sheng;Zhu, Cong-Hui;Zhang, Tao;Chen, Zheng-Tang
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.161-166
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    • 2014
  • Lung cancer is the most common causes of cancer-related deaths worldwide, and a lack of effective methods for early diagnosis has greatly impacted the prognosis and survival rates of the affected patients. Tumor-initiating cells (TICs) are considered to be largely responsible for tumor genesis, resistance to tumor therapy, metastasis, and recurrence. In addition to representing a good potential treatment target, TICs can provide clues for the early diagnosis of cancer. MicroRNA (miRNA) alterations are known to be involved in the initiation and progression of human cancer, and the detection of related miRNAs in TICs is an important strategy for lung cancer early diagnosis. As Hsa-miR-155 (miR-155) can be used as a diagnostic marker for non-small cell lung cancer (NSCLC), a smart molecular beacon of miR-155 was designed to image the expression of miR-155 in NSCLC cases. TICs expressing CD133 and CD338 were obtained from A549 cells by applying an immune magnetic bead isolation system, and miR-155 was detected using laser-scanning confocal microscopy. We found that intracellular miR-155 could be successfully detected using smart miR-155 molecular beacons. Expression was higher in TICs than in A549 cells, indicating that miR-155 may play an important role in regulating bio-behavior of TICs. As a non-invasive approach, molecular beacons could be implemented with molecular imaging to diagnose lung cancer at early stages.

Endoscopic Submucosal Dissection Versus Endoscopic Mucosal Resection for the Treatment of Early Esophageal Carcinoma: a Meta-analysis

  • Wang, Jing;Ge, Jian;Zhang, Xiao-Hua;Liu, Ji-Yong;Yang, Chong-Mei;Zhao, Shu-Lei
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1803-1806
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    • 2014
  • Endoscopic submucosal dissection (ESD) was originally developed for en bloc resection of large, flat gastrointestinal lesions. Compared with endoscopic mucosal resection (EMR), ESD is considered to be more time consuming and have more complications for treatment of early esophageal carcinoma, such as bleeding, stenosis and perforation. The objective of this study was to compare the efficacy and safety of ESD and EMR for such lesions. We searched databases, such as PubMed, EMBASE, Cochrane Library and Science Citation Index updated to 2013 for related trials. In the meta-analysis, the main outcome measurements were the en bloc resection rate, the histologically resection rate and the local recurrence rate. We also compared the operation time and the incidences of procedure-related complications. Five trials were identified, and a total of 710 patients and 795 lesions were included. The en bloc and histologically complete resection rates were higher in the ESD group compared with the EMR group (odds ratio (OR) 27.3; 95% CI, 11.5-64.8; OR 18.4; 95% CI, 8.82-38.59). The local recurrence rate was lower in the ESD group (OR 0.13, 95 % CI 0.04-0.43). The meta-analysis also showed ESD was more time consuming, but did not increase the complication rate (P=0.76). The results implied that compared with EMR, ESD showed better en bloc and histologically resection rates, and lower local recurrence, without increasing the incidence of procedure-related complications in the treatment of early esophageal carcinoma.

The Effect of Thoracoscopic Sympathicotomy at the Fourth Rib (R4) for the Treatment of Palmar and Axillary Hyperhidrosis

  • Kim, Jae-Bum;Park, Chang-Kwon;Kum, Dong-Yoon
    • Journal of Chest Surgery
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    • v.44 no.2
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    • pp.154-158
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    • 2011
  • Background: Video-assisted thoracic sympathicotomy plays an important for the treatment of essential hyperhidrosis. Patients are usually satisfied with the surgical outcome at the early post-operative period, but suffer recurrence and compensatory sweating in the late post-operative period. There are many sympathicotomy methods to minimize recurrence and compensatory sweating. We compared the outcome of sympathicotomy methods above the third rib (R3) and the fourth rib (R4) with regards to symptoms, satisfaction, recurrence, and compensatory palmar and axillary hyperhydrosis. Materials and Methods: From January 1999 to April 2009, 39 cases of thoracoscopic sympathicotomy at the third rib (R3), and 94 cases of thoracoscopic sympathicotomy at the fourth rib (R4) for palmar and axillary hyperhidrosis were compared for early and late post-operative satisfaction, compensatory sweating and recurrence. Results: There was no sex or age difference between groups. Early satisfaction was 94.9% and 98.9% in the R3 group and R4 group, respectively. There was no difference in early satisfaction (94.9% in R3 and 98.9% in R4), late satisfaction (84.6% in R3 and 89.4% in R4), or recurrence (17.9% in R3 and 17.0% in R4) between groups. There was significant difference in compensatory sweating (71.8% in R3 and 33% in R4, p=0.002). Conclusion: R4 sympathicotomy demonstrated superior efficacy in the treatment of compensatory sweating compared to R3 in palmar and/or axillary hyperhidrosis.

Modern Treatment of Early Gastric Cancer: Comparison between Laparoscope Assisted vs Hand-Assisted Laparoscopic Distal Gastrectomy vs Open Distal Gastrectomy (조기 위암의 최신 치료 방법 : 복강경 원위부 위절제술, Hand-Assisted 복강경 원위부 위절제술과 소개복 원위부 위절제술의 비교)

  • Yoon, Ki-Young;Gagner, Michel;Lee, Sang-Ho
    • Journal of Gastric Cancer
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    • v.4 no.2
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    • pp.75-81
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    • 2004
  • Recently detection of early gastric cancer (EGC) has been increasing and the treatment strategies for gastric cancer have been changing. The purpose of this study was to compare clinical outcomes between laparoscopically assisted (LADG) and hand-assisted laparoscopic gastrectomy (HALDG) and open distal gastrectomy for early gastric cancer. This review is directed toward providing gastric surgeons with recent advances in the treatment of EGC. We investigated the English language literature for the past 12 years through computer searches which focused on : 1) Patient demographics, 2) Operation time, 3) Intra-operative blood loss, 4) Depth of invasion, 5) CBC, 6)Weight loss, 7) Analgesic requirement, 8)Time NPO, 9) Length of hospital stay, 10) Tumor stage, 11) Lymph node (LN) dissection, 12) Position of LN resected, 13) Complications. Improved operative techniques and surgical instrumentation have facilitated the development of minimally invasive gastric cancer surgery. The short-term benefits of laparoscopic gastrectomy included less surgical trauma, less pain, rapid return of gastrointestinal function, and shorter hospital stay, with no change in operative outcome. Laparoscopic gastrectomy was better accepted by the patients as a good procedure and promptly brought the patients back to their previous lifestyle and activities of daily living. But the advantages of HALDG for gastric cancer, extended lymph node dissection and intracorporeal anastomosis are feasible and easier with the presence of the internal hand. The hand-assisted laparoscopic (HALDG) method reported the best results in lymph node dissection.This method is an alternative to total laparoscopic radical gastrectomy. LADG and HALDG, when compared with conventional open gastrectomy, have several advantages. When performed by a skilled surgeon, LADG and HALDG are safe and useful techniques for patients with early-stage gastric cancer. Their appropriateness for gastric cancer surgery require further study.

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Impact of an Early Hospital Arrival on Treatment Outcomes in Acute Ischemic Stroke Patients (급성 뇌경색 환자의 증상 발현 후 응급실 도착까지의 시간이 치료 결과에 미치는 영향)

  • Kwon, Young-Dae;Yoon, Sung-Sang;Chang, Hye-Jung
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.2
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    • pp.130-136
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    • 2007
  • Objectives : Recent educational efforts have concentrated on patient's early hospital arrival after symptom onset. The purpose of this study was to evaluate the time interval between symptom onset and hospital arrival and to investigate its relation with clinical outcomes for patients with acute ischemic stroke. Methods : A prospective registry of patients with signs or symptoms of acute ischemic stroke, admitted to the OO Medical Center through emergency room, was established from September 2003 to December 2004. The interval between symptom onset and hospital arrival was recorded for each eligible patient and analyzed together with clinical characteristics, medication type, severity of neurologic deficits, and functional outcomes. Results : Based on the data of 256 patients, the median interval between symptom onset and hospital arrival was 13 hours, and 22% of patients were admitted to the hospital within 3 hours after symptom onset. Patients of not-mild initial severity and functional status showed significant differences between arrival hours of 0-3 and later than 3 in terms of their functional outcomes on discharge. Logistic regression models also showed that arrival within 3 hours was a significant factor influencing functional outcome (OR=5.6; 95% CI=2.1, 15.0), in addition to patient's initial severity, old age, cardioembolism subtype, and referral to another hospital. Conclusions : The time interval between symptom onset and hospital arrival significantly influenced treatment outcome for patients with acute ischemic stroke, even after controlling for other significant clinical characteristics. The findings provided initiatives for early hospital arrival of patients and improvement of emergency medical system.