• Asian Pacific Journal of Cancer Prevention
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• 제16권7호
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• pp.2833-2838
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• 2015

Background: Repeating a prior chemotherapy (rechallenge therapy) is an option for selected patients with metastatic colorectal cancer, but there is very little evidence in the literature for this approach. Thus, we reviewed our registry to evaluate prognostic factors and survival of patients who received irinotecan and oxaliplatin-based regimens as rechallenge third and fourth-line therapy. Materials and Methods: Patients who received irinotecan-based or oxaliplatin-base regimen as first-line had been rechallenged with third-line or fourth-line therapy. These patients were selected from the database of Turkish mCRC registry archives between October 2006 and June 2013 and evaluated retrospectively for factors effecting progression free survival (PFS) and overall survival (OS) by the Kaplan-Meire and Cox-regression methods. Results: Thirty-nine patients were enrolled. The median duration of follow-up was 36 months (14-68 months). Thirty-one patients (76%) died during follow-up. In terms of rechallenge treatments, 29 patients had received third-line and 10 patients had received fourth-line. Response rate (RR) was found to be 12.9%, with stable disease in 19 (48.7%) patients. The median PFS was 6 months (95%CI=4.64-7.35 months) and the median OS was 11 months (95%CI=8.31-13.68 months). The factors effecting survival (PFS and OS) were only being PFS after first-line chemotherapy ${\geq}12months$ (p=0.007, 95% CI=1.75-35.22 and p=0.004, 95%CI=1.44-7.11), both in univariate and multivariate analyses. Conclusions: This study indicates that rechallenge treatment could be a good option as a third or later line therapy in patients who had ${\geq}12months$ PFS onreceiving first line therapy.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.1637-1641
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• 2016

Oxaliplatin, a third generation novel platinum compound is the most effective first line chemotherapeutic agent for colorectal cancer (CRC) in combination with 5FU and leucovorin. It is indicated for pancreatic, gastric and testicular cancers combined with bevacuzimab, capecitabine, irinotecan and other cytotoxic agents. However, moderate to severe hypersensitivity reactions (HSR) during or after oxaliplatin infusion usually require cessation of chemotherapy or substitution of the key therapeutic drug which largely interferes with improved patient prognosis. This mini- review showcases recent and accepted opinions/approaches in oxaliplatin induced HSR management. Physicians and oncologists have varying attitudes regarding the decision to rechallenge the patient after an HSR experience, efficacy of desensitization protocols, effectiveness and selection of drugs for premedication and possibilities of cross sensitivity to other platinum agents (e.g. carboplatin). A brief insight into underlying molecular mechanisms and clinical manifestations of oxaliplatin induced HSR is offered. We have also discussed the management of oxaliplatin induced HSR and risk stratification for a successful and complete chemotherapeutic plan.

• Tuberculosis and Respiratory Diseases
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• 제75권6호
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• pp.256-259
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• 2013

Imatinib mesylate is a targeted therapy that acts by inhibiting tyrosine kinase of the bcr-abl fusion oncoprotein, which is specific to chronic myeloid leukemia (CML), and the c-transmembrane receptor, which is specific to gastrointestinal stromal tumors. Interstitial pneumonitis is a rare adverse event of imatinib therapy. It is clinically difficult to distinguish from infectious pneumonia, which can frequently occur due to the underlying disease. The standard treatment for imatinib-induced pneumonitis is to discontinue the medication and optionally administer corticosteroids. However, there are a few cases of successful retrial with imatinib. We describe a case of successful rechallenge of imatinib in a patient with imatinib-induced interstitial pneumonitis and CML without a recurrence of the underlying disease after 3 months of follow-up.

• 벤처창업연구
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• 제13권6호
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• pp.39-48
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• 2018

대전지역은 정부출연연구소, 대덕특구, KAIST 등 우량한 기술인프라를 보유하고 있음에도 불구하고, 기술창업을 위한 초기투자 및 성장지원 하부구조가 열악한 실정이다. 특히 대전지역의 벤처 자금공급 규모는 다른 혁신 인프라에 비해 상대적으로 부족한 것으로 평가받고 있다. 이에 본 연구는 대전지역 벤처 자금생태계는 어떤 진화 과정을 겪었으며 향후 개선 보완할 점이 무엇인지를 분석함으로써, 벤처창업 활성화에 대한 시사점을 제시하고자 하였다. 첫째, 창업 초기기업에 대한 엔젤투자 활성화 및 민간자금 유입을 견인하는 정책금융의 역할이 강화되어야 한다. 둘째, 투자전문인력의 지역 내 육성을 위해 지역에서 조성한 펀드를 지역 내 기관에 부여하고, 수도권 투자자의 지역 내 정착을 지원하며, 대학에서 투자전문가 양성과정 운영이 필요하다. 셋째, 기존 창업보육센터에 액셀러레이터 기능을 추가하고 신규 액셀러레이터를 육성하기 위해 유관기관 간 협력이 필요하다. 넷째, 지방정부의 역할 확대를 위해 펀드조성 및 공무원의 개방혁신 마인드, 중앙정부와의 효과적 의사소통이 필요하다. 다섯째, 우수인력 유입, 기술탈취 방지, 재도전 환경 개선 등 기본적인 벤처생태계 하부구조를 확충해야 한다. 여섯째, '창업-성장-회수-재도전'의 단계별 창업자금 지원정책을 재정비할 필요가 있다. 본 연구는 최근 급변하고 있는 대전지역 벤처창업 자금생태계의 현황을 파악했다는 점에서 의의가 있다. 특히 대전지역 벤처기업의 성장 단계별 부족자금의 형태가 무엇인지를 파악하고, 기존 자금생태계의 효율적 활용 방안을 찾은 점에서 차별성이 있다고 하겠다.

• 대한간호학회지
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• 제28권2호
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• pp.414-430
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• 1998

The main purpose of this study was to provide understanding of the meaning of post menopausal womens' lived body changing experience. The methodological approach was guided by Van Manen's hermeneutic phenomenological methodology : inquiring and investigating experience as it was lived rather than as conceptualized : reflecting and analyzing the essential themes which characterize the phenomenon : and describing the phenomenon through the art of writing and rewriting. Multiple strategies for data collecting were used ; in depth face-to-face interview ; analysis of womens' writings : artistic work : and analysis of examples of phenomenon in art, literature, and drama. Although the experience was different for all of the women interviewed, essential themes of experience emerged ; Drifting through the years (solitude, in the twilight of life, loneliness, change of taste, forgetfulness, the sense of missing something), A walking weather forecast, Standing on the threshold of losing ki energy, Lately taking care of my body, Seized with fear all of a sudden, Keenly feeling the preciousness of life, Preferring comfortableness to prettiness, Wanting to recall my past years, A strong impulse to rechallenge life, Becoming more fond of friends. Findings from the artistic and creative inquiry further validated the interview findings and the meaning discovered. The study illuminated meaning and simultaneously validated the phenomenological research process. Essential themes for understanding women's experience, implications for education, research, and practice, direction and need for continuing inquiry were identified.

• Tuberculosis and Respiratory Diseases
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• 제71권4호
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• pp.286-290
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• 2011

Although failure of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKI) is generally believed to be associated with cross-resistance to other EGFR TKI, the benefit of administering erlotinib as a second EGFR TKI after resistance of gefitinib as the first TKI has been well known. However, good response to gefitinib after an initial response to erlotinib has been rare. We report that a 45-year-old woman (never smoked), with lung adenocarcinoma and EGFR mutation, showed an initial response to erlotinib, and then responded to gefitinib again.

• Tuberculosis and Respiratory Diseases
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• 제73권3호
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• pp.143-150
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• 2012

Background: The release of interferon-gamma (IFN-${\gamma}$) by T lymphocytes increases after rechallenge with Mycobacterium tuberculosis antigen, especially, at a localized site of tuberculosis (TB) infection. We aimed to compare the clincial efficacy of two commercial IFN-${\gamma}$ release assays from pleural fluid for the diagnosis in tuberculous pleurisy. Methods: We performed T-SPOT.TB and QuantiFERON-TB Gold tests simultaneously on pleural fluid and peripheral blood samples from patients with pleural effusion, in South Korea, an area with intermediate TB burden. Results: Thirty-six patients were enrolled prospectively, and tuberculous pleurisy was found in 21 patients. Both the numbers of IFN-${\gamma}$ secreting T cells and the concentration of IFN-${\gamma}$ were greater in the pleural tuberculous group, comparing with the non-tuberculous group. Moreover, in the tuberculous group, there was a significant difference in IFN-${\gamma}$ producing spot-forming cells using the T-SPOT.TB method between pleural fluid and peripheral blood. The receiver operating characteristic (ROC) curve, was the greatest for pleural fluid T-SPOT.TB test, followed by peripheral blood T-SPOT.TB test, peripheral blood QuantiFERON-TB Gold test, and pleural fluid QuantiFERON-TB Gold test (area under the ROC curve of 0.956, 0.890, 0.743, and 0.721, respectively). The T-SPOT.TB assay produced less indeterminate results than did QuantiFERON-TB Gold assay in both pleural fluid and peripheral blood. Conclusion: These findings suggest that the pleural fluid T-SPOT.TB test could be the most useful test among the IFN-${\gamma}$ release assays for diagnosing tuberculous pleurisy in an area with an intermediate prevalence of TB infection.

• Tuberculosis and Respiratory Diseases
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• 제56권4호
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• pp.411-414
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• 2004

본 증례는 결핵 치료 중 급성 췌장염이 발생하였고, 재투여 검사를 통하여 그 원인으로 isoniazid임을 확인하였다. 결핵 치료 중인 환자에서 위장관장애 증상이 있을 때, 그 원인으로서 간염이외에 급성 췌장염을 고려해 봐야 할 것이다.

• Journal of Gastric Cancer
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• 제23권1호
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• pp.207-223
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• 2023

Gastric cancer (GC) is the fourth leading cause of cancer-related deaths worldwide. Under the standard of care, patients with advanced GC (AGC) have a median survival time of approximately 12-15 months. With the emergence of immunotherapy as a key therapeutic strategy in medical oncology, relevant changes are expected in the systemic treatment of GC. In the phase III ATTRACTION-2 trial, nivolumab, a monoclonal anti-programmed cell death 1 (PD-1) antibody, as a third- or later-line treatment improved overall survival (OS) compared with placebo in patients with AGC. Furthermore, nivolumab in combination with 5-fluorouracil and platinum as a first-line treatment improved OS in patients with human epidermal growth factor receptor-2 (HER2)-negative AGC in the global phase III CheckMate-649 study. Another anti-PD-1 antibody, pembrolizumab, in combination with trastuzumab and cytotoxic chemotherapy as a first-line treatment, significantly improved the overall response rate in patients with HER2-positive AGC. Therefore, immune checkpoint inhibitors (ICIs) are essential components of the current treatment of GC. Subsequent treatments after ICI combination therapy, such as ICI rechallenge or combination therapy with agents having other modes of action, are being actively investigated to date. On the basis of the success of immunotherapy in the treatment of AGC, various clinical trials are underway to apply this therapeutic strategy in the perioperative and postoperative settings for patients with early GC. This review describes recent progress in immunotherapy and potential immunotherapy biomarkers for GC.

• Tuberculosis and Respiratory Diseases
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• 제65권5호
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• pp.416-420
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• 2008

한약은 폐 질환을 일으키는 드문 원인이나 현재 동, 서양을 막론하고 한약의 사용 증가를 고려하면 향후 더 많은 경우에서 본 사례와 같은 한약 유발성 폐 질환을 경험할 것으로 생각된다. 보중익기탕으로 인한 간질성 폐렴은 국내에서 아직 보고된 바가 없고 이런 경우에서 가능성을 의심하고 초기에 진단하여 더 이상의 복용을 회피하고 적절하게 치료한다면 좋은 예후를 보일 것으로 예상된다. 이에 문헌 고찰과 함께 본 증례를 보고하는 바이다.