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The safety, immunological benefits, and efficacy of ginseng in organ transplantation

  • Lim, Sun Woo;Luo, Kang;Quan, Yi;Cui, Sheng;Shin, Yoo Jin;Ko, Eun Jeong;Chung, Byung Ha;Yang, Chul Woo
    • Journal of Ginseng Research
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    • v.44 no.3
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    • pp.399-404
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    • 2020
  • Korean ginseng (Panax ginseng) is associated with a variety of therapeutic effects, including antioxidative, anti-inflammatory, vasorelaxative, antiallergic, antidiabetic, and anticancer effects. Accordingly, the use of ginseng has reached an all-time high among members of the general public. However, the safety and efficacy of ginseng in transplant recipients receiving immunosuppressant drugs have still not been elucidated. Transplantation is the most challenging and complex of surgical procedures and may require causation for the use of ginseng. In this regard, we have previously examined the safety, immunological benefits, and protective mechanisms of ginseng with respect to calcineurin inhibitor-based immunosuppression, which is the most widely used regimen in organ transplantation. Using an experimental model of calcineurin inhibitor-induced organ injury, we found that ginseng does not affect drug levels in the peripheral blood and tissue, favorably regulates immune response, and protects against calcineurin inhibitor-induced nephrotoxicity and pancreatic islet injury. On the basis of our experimental studies and a review of the related literature, we propose that ginseng may provide benefits in organ transplant recipients administered calcineurin inhibitors. Through the present review, we aimed to briefly discuss our current understanding of the therapeutic benefits of ginseng related to transplant patient survival.

Treatment Outcomes and Survival Study of Gastric Cancer Patients: A Retrospective Analysis in an Endemic Region

  • Basaran, Hamit;Koca, Timur;Cerkesli, Arda Kaymak;Arslan, Deniz;Karaca, Sibel
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.2055-2060
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    • 2015
  • Purpose: To present information about prognostic factors of gastric cancer patients treated in our Erzurum center including age, gender, tumour location, pathological grade, stage and the effect of treatment on survival. Materials and Methods: This retrospective study was performed on patients who applied to our clinic and diagnosed as gastric cancer. Age and gender of the patients, primary location, histopathological characteristics, TNM stage of the gastric cancers (GCs), treatment applied, oncological treatment modalities and survival outcomes were studied. A univariate analysis of potential prognostic factors was performed with the log-rank test for categorical factors and parameters with a p value < 0.05 at the univariate step were included in the multivariate regression. Results: A total of 228 patients with a confirmed diagnosis of gastric cancer were included in the study with a male/female ratio of 1.47. Median follow-up period was estimated as 22.3 (range, 3 to 96) months. When diagnosis of the patients at admission was analysed, stage III patients were most frequently encountered (n=147; 64.5%). One hundred and twenty-six (55.3%) underwent surgical treatment, while 117 (51.3%) were given adjuvant chemotherapy. Median overall survival time was 18.0 (${\pm}1.19$) months. Mean overall survival rates for 1, 2, 3 and 5 years were $68{\pm}0.031%$, $36{\pm}0.033%$, $24{\pm}0.031%$and $15.5{\pm}0.036%$, respectively. Univariate variables found to be significant for median OS in the multivariate analysis were evaluated with Cox regression analysis. A significant difference was found among TNM stage groups, location of the tumour and postoperative adjuvant treatment receivers (p values were 0.011, 0.025 and 0.001, respectively). Conclusions: This study revealed that it is possible to achieve long-term survival of gastric cancer with early diagnosis. Besides, in locally advanced GC patients, curative resection followed by adjuvant concomitant chemoradiotherapy based on the McDonald regimen was an independent prognostic factor for survival.

Dietary Effects of Herbal Mixture on the Laying Performance, Blood Parameters and Immune Response in Laying Hens (사료 내 생약물질의 첨가 급여가 산란계의 생산성, 혈액성상 및 면역반응에 미치는 영향)

  • Kim, Chan Ho;Kang, Hwan Ku;Hwangbo, Jong;Kim, Ji-Hyuk
    • Korean Journal of Poultry Science
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    • v.42 no.1
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    • pp.61-67
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    • 2015
  • The objective of this experiment was to investigate the effect of dietary supplementation of herbal medication (HM) on laying performance, blood parameter, and immune response in laying hens. A total of 800 Hy-Line Brown laying hens of 60 weeks of age were randomly allotted to one of four dietary treatments with four replicates per treatment. Three additional diets were prepared by adding 0.5, 1.0 or 1.5 % of HM to the basal diet. Feeding trial lasted 7 weeks under 16L:8D lighting regimen. The diet and water were available ad libitum. Hen-day egg production in groups fed diets with 0.5% and 1.5% HM was significantly (P<0.05) higher than that of control. Feed conversion ratio in group fed diet with 0.5% HM showed the lowest value (P<0.05). Egg weight, feed intake, broken and shell-less egg production were not affected HM supplementation levels. Egg yolk color was significantly greater in all HM supplemented groups than basal treatment. However, eggshell strength, eggshell thickness, eggshell color, and Haugh units were not affected by HM supplementation level. There were no differences in leukocyte counts among the treatments. Plamsa IgM concentration was (P<0.05) higher in all HM treated groups. In conclusion, dietary HM improved egg production, and IgM of laying hens.

Dramatic Tumor Response to 2nd-line Pemetrexed/Cisplatin Combination Chemotherapy in Patient with Malignant Pleural Mesothelioma (Pemetrexed/cisplatin 병합 2차 항암화학요법에 극적 반응을 보인 악성 흉막 중피종 1예)

  • Lee, Seung Min;Ko, Soon Young;Seo, Tae Ho;Lee, Jung Hyun;Choi, Seung Oh;Lee, Jeong Geun;Kim, Wan Seop;Lee, Tae Hoon;Yoo, Gwang Ha;Lee, Kye Young
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.5
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    • pp.432-436
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    • 2007
  • Malignant pleural mesothelioma (MPM) is a rare tumor that is difficult to clearly distinguish from an adenocarcinoma but usually has a poor prognosis. Numerous cytotoxic agents have been used in the primary treatment of MPM with limited success. A complete response is unusual and a partial response occurs in less than one-third of patients. Recently, a phase III trial showed that a combination of pemetrexed with cisplatin resulted in a significantly higher response rate and median survival time than with cisplatin alone. We encountered a case of a dramatic tumor response to pemetrexed/cisplatin combination chemotherapy in patients with MPM, which was resistant to the 1st-line gemcitabine/cisplatin therapy. After six cycles of pemetrexed/cisplatin combination chemotherapy, the tumor volume had decreased dramatically with complete symptom relief. There was no chemotherapy-related toxicity or scheduled violation. The patient is under maintenance chemotherapy with the same regimen.

Chest Wall Tuberculosis: Clinical Features and Treatment Outcomes

  • Kim, Young Joo;Jeon, Hee Jung;Kim, Chang Ho;Park, Jae Yong;Jung, Tae Hoon;Lee, Eung Bae;Park, Tae In;Jeon, Kyung Nyeo;Jung, Chi Young;Cha, Seung Ick
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.4
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    • pp.318-324
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    • 2009
  • Background: A diagnosis and treatment of chest wall tuberculosis (CWTB) is both difficult and controversial. The aim of this study was to collect information on the optimal treatment for CWTB. Methods: The clinical features, radiographic findings, and treatment outcomes of 26 patients, who underwent surgery and were diagnosed histopathologically, were retrospectively analyzed. Results: The most common presenting symptom was a palpable mass found in 24 patients (92.3%). In all patients, CT revealed a soft tissue mass that was accompanied by a central low density, with or without peripheral rim enhancement. The sensitivity and specificity of the bone scintigram for bone involvement were 87.5% and 100%, respectively. CWTB was diagnosed preoperatively by aspiration cytology and smear for acid-fast bacilli in five out of 11 patients. Twenty-three patients (88.5%) underwent a radical excision and three underwent incision/drainage or an incisional biopsy. The duration of antituberculous medication was 7.5${\pm}$3.98 months with a follow-up period of 28.2${\pm}$26.74 months. Among the 20 patients who completed their treatment, nine received chemotherapy for six months or less and 11 received chemotherapy for nine months or more. Two patients had a recurrence four and seven months after starting their medication. Conclusion: A 6 month regimen may be appropriate for CWTB patients who have undergone a complete excision.

Definitive radiotherapy with or without chemotherapy for clinical stage T4N0-1 non-small cell lung cancer

  • Kim, Yeon Joo;Song, Si Yeol;Jeong, Seong-Yun;Kim, Sang We;Lee, Jung-Shin;Kim, Su Ssan;Choi, Wonsik;Choi, Eun Kyung
    • Radiation Oncology Journal
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    • v.33 no.4
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    • pp.284-293
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    • 2015
  • Purpose: To determine failure patterns and survival outcomes of T4N0-1 non-small cell lung cancer (NSCLC) treated with definitive radiotherapy. Materials and Methods: Ninety-five patients with T4N0-1 NSCLC who received definitive radiotherapy with or without chemotherapy from May 2003 to October 2014 were retrospectively reviewed. The standard radiotherapy scheme was 66 Gy in 30 fractions. The main concurrent chemotherapy regimen was $50mg/m^2$ weekly paclitaxel combined with $20mg/m^2$ cisplatin or AUC 2 carboplatin. The primary outcome was overall survival (OS). Secondary outcomes were failure patterns and toxicities. Results: The median age was 64 years (range, 34 to 90 years). Eighty-eight percent of patients (n = 84) had an Eastern Cooperative Oncology Group performance status of 0-1, and 42% (n = 40) experienced pretreatment weight loss. Sixty percent of patients (n = 57) had no metastatic regional lymph nodes. The median radiation dose was EQD2 67.1 Gy (range, 56.9 to 83.3 Gy). Seventy-one patients (75%) were treated with concurrent chemotherapy; of these, 13 were also administered neoadjuvant chemotherapy. At a median follow-up of 21 months (range, 1 to 102 months), 3-year OS was 44%. The 3-year cumulative incidences of local recurrence and distant recurrence were 48.8% and 36.3%, respectively. Pretreatment weight loss and combined chemotherapy were significant factors for OS. Acute esophagitis over grade 3 occurred in three patients and grade 3 chronic esophagitis occurred in one patient. There was no grade 3-4 radiation pneumonitis. Conclusion: Definitive radiotherapy for T4N0-1 NSCLC results in favorable survival with acceptable toxicity rates. Local recurrence is the major recurrence pattern. Intensity modulated radiotherapy and radio-sensitizing agents would be needed to improve local tumor control.

Uncertainty, Anxiety and Coping with Mastectomy for Breast Cancer (유방절제술 환자의 불확실성, 불안 및 대처방식)

  • Cho, Ok-Hee
    • Journal of Korean Academy of Nursing
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    • v.30 no.4
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    • pp.1006-1017
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    • 2000
  • The purpose of this study was to provide basic information for developing a nursing intervention that helps patients learn how to acquire coping to reduce post operation uncertainty and anxiety by investigating the level of uncertainty and anxiety experienced by mastectomy patients. The subjects were 134 patients selected from St. Mary's Kangnam and St. Mary's hospital, and the data collection period was from October to December of 1998. Uncertainty was measured by using Mishel Uncertainty in Illness Scale (MUIS), anxiety measured by using State-Trait Anxiety Inventory(STAI), and coping by using a questionnaire developed by Kim & Yoo (1996). Data were analyzed with SAS program by t-test, ANOVA, Duncan's multiple range test, Pearson correlation coefficients, and stepwise multiple regression. The results were as follows : 1. The mean uncertainty score was 57.6. The results of the correlation between the compliance of medical regimen and demographic characteristics were as follows ; Those who monthly income over 2,010,000 won had lower than above 1,000,000 won, and those with the experience of chemotherapy had higher than those without, and the patient who has 7∼12 months(1 yr.) post operation period had higher than the one below 6months, 25∼36 months(3 yrs.), 37∼60 months(5 yrs.), and over 61 months. 2. The mean anxiety score was 45.9. Anxiety tended to be increased slightly in subjects with low educational background, poor monthly income, experience of chemotherapy, and 7∼12 months(1 yr.) post operation period, but there was no significant difference by general characteristics 3. The mean value of the coping score was 100.7. The study revealed higher score in problem-focused coping than emotion-focused coping. In regard to coping by demographic characteristics were as follows ; those who had monthly income over 2,010,000 won had higher level of coping than those whose monthly income was between 1,010,000 and 2,000,000 won. In terms of problem- focused coping, those who had 25∼36 months of post operation period showed significantly lower level of coping than those below 6 months or 37∼60 months(5 yrs.) or over 61 months of post operation period. Regarding the emotion-focused coping, those with the christianity had significantly lower level of coping than those without it. Also, those whose monthly income over 2,010,000 won had significantly higher coping level than those with income of between 1,010,000 and 2,000,000 won. 4. A positive relationship was found between uncertainty and anxiety. Patients who experienced more uncertainty also showed more anxiety. Problem-focused coping was inversely related to uncertainty and anxiety. 5. The major variable that affected uncertainty was anxiety, explaining 63.3% of the uncertainty. In addition to this, it would explain 66.4% in total when experience of chemotherapy was added.

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Self-Efficacy as a Predictor of Self-Care in Persons with Diabetes Mellitus: Meta-Analysis

  • Lee, Hyang-Yeon
    • Journal of Korean Academy of Nursing
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    • v.29 no.5
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    • pp.1087-1102
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    • 1999
  • Diabetes mellitus, a universal and prevalent chronic disease, is projected to be one of the most formidable worldwide health problems in the 21st century. For those living with diabetes, there is a need for self-care skills to manage a complex medical regimen. Self-efficacy which refers to one's belief in his/her capability to monitor and perform the daily activities required to manage diabetes has be found to be related to self-care. The concept of self-efficacy comes from social cognitive theory which maintains that cognitive mechanism mediate the performance of behavior. The literature cites several research studies which show a strong relationship between self-efficacy and self-care behavior. Meta-analysis is a technique that enables systematic review and quantitative integration of the results from multiple primary studies that are relevant to a particular research question. Therefore, this study was done using meta-analysis to quantitatively integrate the results of independent research studies to obtain numerical estimates of the overall effect of a self-efficacy with diabetic patient on self-care behaviors. The research proceeded in three stages : 1) literature search and retrieval of studies in which self-efficacy was related to self-care, 2) coding, and 3) calculation of mean effect size and data analysis. Seventeen studies which met the research criteria included study population of adults with diabetes, measures of self-care and measures of self-efficacy as a predictive variable. Computation of effect size was done on DSTAT which is a statistical computer program specifically designed for meta-analysis. To determine the effect of self-efficacy on self-care practice homogeneity tests were conducted. Pooled effect size estimates, to determine the best subvariable for composite variables, metabolic control variables and component of self-efficacy and self-care, indicated that the effect of self-efficacy composite on self-care composite was moderate to large. The weighted mean effect size of self-efficacy composite and self-care composite were +.76 and the confidence interval was from +.66 to +.86 with the number of subjects being 1,545. The total for this meta-analysis result showed that the weighted mean effect sizes ranged from +.70 to +1.81 which indicates a large effect. But since reliabilities of the instruments in the primary studies were low or not stated, caution must be applied in unconditionally accepting the results from these effect sizes. Meta-analysis is a useful took for clarifying the status of knowledge development and guiding decision making about future research and this study confirmed that there is a relationship between self-efficacy and self-care in patients with diabetes. It, thus, provides support for nurses to promote self-efficacy in their patients. While most of the studies included in this meta-analysis used social cognitive theory as a framework for the study, some studies use Fishbein & Ajzen's attitude model as a model for active self-care. Future research is needed to more fully define the concept of self-care and to determine what it is that makes patients feel competent in their self-care activities. The results of this study showed that self-efficacy can promote self-care. Future research is needed with experimental design to determine nursing interventions that will increase self-efficacy.

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Primary Radiation Therapy of Polymorhic Reticulosis (다형성 세망증의 방사선 치료성적)

  • Kim Jae Sung;Yun Hyoung Geun;Ahn Yong Chan;Park Charn Il
    • Radiation Oncology Journal
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    • v.9 no.1
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    • pp.111-116
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    • 1991
  • From 1979 to 1987, 33 patients with polymorphic reticulosis (PMR) limited in the upper airway were treated with primary radiation therapy and the analysis of treatment results was undertaken. Systemic symptoms such as fever, night sweats, and weight ioss were noted in $48\%$. The nasal cavity was most frequently involved $(85\%)$, although involvement of PNS $(33\%)$ and palate $(30\%)$ was not uncommon. The 5 and 10 year actuarial survival rates were $47\%\;and\;40\%$, respectively. The difference in NSD between patients with in-field failure and those without it was significant statistically. Also, field size was significantly smaller in patients with marginal failure than those without it. During the follow-up period, systemic failure was found in S patients (diffuse histiocytic Iymphoma in 4, histiocytic medullary reticulosis in 1). In this study, we can suggest that total radiation dose of at least 4500 cGy with generous treatment volume should be delivered to achieve better local control and that the developement of an effective systemic chemotherapeutic regimen is required to improve the survival after systemic relapse.

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USE OF ENFLURANE FOR CHILDREN WHO FAIL TO RESPOND PROPERLY TO ORAL CHLORAL HYDRATE (Chloral Hydrate 경구투여 후 진정 효과가 나타나지 않은 소아환자에 대한 Enflurane의 사용)

  • Lee, Sang-Min;Yoon, Hyng-Bae;Kim, Jong-Soo;Kim, Yong-Kee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.3
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    • pp.513-519
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    • 1999
  • Chloral hydrate is one of the most widely used sedative agents to control the difficult to treat young age group in the dental clinic. We are often frustrated to see the patient still awake and cry with agitation even after far more than the normal onset time. In such a case, the patient has to be rescheduled for another sedation visit with different agents and/or routes which greatly disappoints the guardians. This case report presents a sedative regimen that can possibly help the clinician complete scheduled treatment without postponement. We have tried sleep induction with Enflurane (1-1.5vol%) for 60 seconds to 37 patients of those who failed to respond properly to the dose(70mg/kg)of oral Chloral hydrate. The average age and weight of the patients was 34.3 months(22-43mo.) and 14.9kg(11-21kg) respectively. It is suggested that sleep induction with low dose Eflurane produced a stable state during dental treatment with respect to vital sign and behavior. Evidence of adverse effect was not detected or reported during and/or after the procedures.

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