• Title/Summary/Keyword: regimen

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Bilateral Triple Negative Invasive Ductal Breast Carcinoma in a BRCA1 Mutation Carrier with Discrepant Pathologic Response to Neoadjuvant Chemotherapy (BRCA 유전자 변형 환자의 양측 삼중음성 유방암의 선행화학요법에 대한 상이한 반응)

  • Gi Won Shin;Young Mi Park;Tae Hyun Kim;Anbok Lee;Ha Young Park;Hye Kyoung Yoon;Young Jin Heo;Jin Wook Baek;Yoo Jin Lee
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.428-435
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    • 2020
  • Herein, we report a case of synchronous bilateral triple negative invasive ductal breast carcinoma in a patient with discrepant pathologic response to neoadjuvant chemotherapy. Right and left breast cancer stages at the initial diagnosis were T1cN0M0 and T4dN3aM0, respectively. The patient was identified as a BRCA1 mutation carrier and treated with four cycles of adriamycin and cyclophosphamide, followed by four cycles of docetaxel. Bilateral breast cancer stages decreased with the first regimen. However, the bilateral breast cancers showed discrepant responses to chemotherapy with docetaxel. The right breast cancer showed a continuous tumor volume reduction while the left breast cancer showed marked progression. Finally, the tumor size was 0.3 cm and 12 cm in the right and left mastectomy specimens, respectively. As bilateral breast cancers of the same subtype may show discrepant responses to neoadjuvant chemotherapy, close monitoring and follow-up imaging are required to avoid delayed surgery.

Case Report: Quantitative Evaluation of Gait Function Following Treatment Progression in a Patient with Central Pontine Myelinolysis (중심성 교뇌수초용해 환자의 치료 경과에 따른 보행 기능의 정량적 평가)

  • Sangho Ji;Sunny Kang;Jiwoo Kim;Youngjo So;Sangkwan Lee;Cheol-Hyun Kim
    • The Journal of Internal Korean Medicine
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    • v.45 no.2
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    • pp.190-198
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    • 2024
  • Introduction: Central pontine myelinolysis (CPM) is a rare neurological disorder marked by symmetric nerve fiber damage, commonly following rapid hyponatremia correction, with no established treatment and a poor prognosis. The condition, often linked to alcoholism, malnutrition, and various diseases, lacks comprehensive studies on its impact on gait. This research aims to quantitatively analyze gait changes in CPM patients receiving both traditional Korean and conventional rehabilitation treatments, addressing a gap in current understanding of CPM management. Case presentation: A 56-year-old male diagnosed with CPM following an initial misdiagnosis underwent combined electoracupuncture and rehabilitative treatment at ○○ university Korean medical center, resulting in significant gait improvements. A treadmill gait analysis system was used to measure changes in key gait parameters at 2-week intervals, and the patient's progress was documented. Conclusions: The quantitative analysis revealed significant gait improvements. Foot rotation decreased from 8.9° to 6.4° (right) and from 11.1° to 7.2° (left); lateral symmetry improved from -7.8 to 0.8; step length increased from 21 cm to 44 cm (right) and from 19 cm to 44 cm (left); and velocity increased from 1.2 m/s to 2.7 m/s. These findings highlight decreased foot rotation and lateral symmetry, along with increased step length and velocity, suggesting a positive outcome of the treatment regimen. Notably, the patient experienced no adverse effects related to the treatments. Despite limitations, including the singe case focus and lack of prior gait-focused CPM research, this case report provides valuable insights into effective CPM management strategies, paving the way for future research in this domain.

Combined Effect of Ganciclovir and Vidarabine on the Replication, DNA Synthesis, and Gene Expression of Acyclovir-resistant Herpes Simplex Virus (Acyclovir저항성 Herpes Simplex Virus의 복제, DNA합성 및 형질 발현에 미치는 Ganciclovir 및 Vidarabine의 병용효과에 관한 연구)

  • Yang, Young-Tai;Cheong, Dong-Kyun;Mori, Masakazu
    • The Korean Journal of Pharmacology
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    • v.25 no.1
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    • pp.115-134
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    • 1989
  • Combined effects of ganciclovir (GCV) and vidarabine (ara-A) on the replication, DNA synthesis, and gene expression of wild type-1 herpes simplex virus (HSV-1) and three acyclovir (ACV)-resistant HSV-1 mutants were studied. These mutants include a virus expressing no thymidine kinase $(ACV^r)$, a virus expressing thymidine kinase with altered substrate specificity $(IUdR^r)$, and a mutant expressing altered DNA polymerase $(PAA^r5)$. GCV, an agent activated by herpesvirus specific thymidine kinase, showed potent antiviral activity against the wild type HSV-1(KOS) and DNA polymerase mutant $(PAA^r5)$. The ACV-resistant mutants with thymidine kinase gene $(ACV^r\;and\;IUdR^r)$ were resistant to GCV. All tested wild type HSV-1 or ACV-resistant HSV-1 mutants did not display resistance to vidarabine (are-A). Combined GCV and ara-A showed potentiating synergistic antiviral activity against wild type KOS and $PAA^r5$, and showed subadditive combnined ativiral activity against thymidine kinase mutants. Combined GCV and ara-A more significantly inhibited the viral DNA synthesis in wild type KOS and $PAA^r5-infected$ cells to a greater extent than either agent alone, but the synergism was not determined in $ACV^r$ or $IUdR^r-infected$ cells. These data clearly indicate that combined GCV and ara-A therapy might be useful for the treatment of infections caused by wild type HSV-1 or ACV-resistant HSV-1 with DNA polymerase mutation. ACV-resistant viruses with the mutation in thymidine kinase gene are also, resistant to GCV, but susecptible to ara-A, indicating that ara-A would the drug of choice for the treatment of ACV-resistant HSV-1 which does not express thymidine kinase or expresses thymidine kinase with altered substrate specificity. While the synthesis of viral ${\alpha}-proteins$ of wild type HSV-1 was not affected by ACV, GCV, ara-A, or combined GCV and ara-A, the synthesis of ${\beta}-proteins$ was slightly but significantly increased at the later stage of viral infection by the antiviral agents. The synthesis of ${\gamma}-proteins$ of wild type HSV- 1 was significantly inhibited by ACV, GCV, ara-A, and combined GCV and ara-A. Combined GCV $(5-{\mu}M)$ and ara-A $(100-{\mu}M)$ also significantly altered the expression of viral ${\beta}-and$ ${\gamma}-proteins$, of which efffct was similar to that of GCV $(10-{\mu}M)$ alone. Although ACV at the concentration of $10-{\mu}M$ did not alter the expression of ${\alpha}-$, ${\beta}-$, and ${\gamma}-proteins$ of ACV-resistant $PAA^r5$, GCV and ara-A significantly alter the epression of ${\beta}-and$ ${\gamma}-proteins$, not ${\alpha}-protein$, as same manner as they altered the expression of those proteins in cells inffcted with wild type HSV-1. Combined GCV $(5-{\mu}M)$ and ara-A $(100-{\mu}M)$ altered the expression ${\beta}-and$ ${\gamma}-proteins$ in $PAA^r5$ infected cells, and the effect of combined regimen was comparable of that of GCV $(10-{\mu}M)$. These data indicate that the alteration in the expression of ${\beta}-and$ ${\gamma}-proteins$ in wild type HSV-1 or $PAA^r5$ infected cells could be more significantly affected by combined GCV and are-A than individual GCV or ara-A. In view of the fact that (a) viral ${\alpha}-$, ${\beta}-$, and ${\gamma}-proteins$ are synthesized in a cascade manner; (b) ${\beta}-proteins$ are essential for the synthesis of viral DNA; (c) the synthesis of ${\beta}-proteins$ are inhibited by ${\gamma}-proteins$; and (d) most ${\gamma}-proteins$ are made from the newly synthesized progeny virus, it is suggested that GCV and ara-A, alone or in combination, primarily inhibit the synthesis of viral DNA, and by doing so might exhibit their antiherpetic activity. The alteration in viral protein synthesis in the presence of tested antiviral agents could result from the alteration in viral DNA synthesis. From the present study, it can be concluded that (a) combined GCV and ara-A therapy would be beneficial for the control of inffctions caused by wild type HSV-1 or ACV-resistant DNA polymerase mutants; (b) the combined synergistic activity of GCV and ara-A is due to further decrease in the viral DNA by the combined regimen; (c) ara-A is the drug of choice for the infection caused by ACV-resistant HSV-1 with thymidine kinase mutation; and (d) the alteration in viral protein synthesis by GCV and ars-A, alone or in combination, is mostly due to the decreased synthesis of viral DAN.

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The effect of Lantus on glycemic control in children and adolescents with type 1 diabetes mellitus (1형 당뇨병을 가진 소아와 청소년에서 란투스 치료의 혈당 조절에 대한 효과)

  • Rhie, Young Jun;Chae, Hyun Wook;Kim, Ho Seong;Kim, Duk Hee
    • Clinical and Experimental Pediatrics
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    • v.50 no.6
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    • pp.565-569
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    • 2007
  • Purpose : With a duration of action of approximately 24 hours and peakless levels, Lantus is a more physiologic basal insulin analogue compared with NPH. The aim of this study was to compare the glycemic control of Lantus plus Humalog with that of premixed insulin in children and adolescents with type 1 diabetes mellitus. Methods : The subjects consisted of 25 patients with type 1 diabetes mellitus, aged 12-19 years, who changed their insulin regimen from premixed insulin to Lantus plus Humalog. Daily insulin doses, frequency of hypoglycemia, fasting blood glucose, C-peptide concentration and HbA1c before and 6 months after Lantus treatment were compared. 24 hour blood glucose of 11 patients among Lantus treatment group (n=25) and premixed insulin treatment group (n=10) were self-monitored and compared. Results : 6 months after Lantus treatment, the episodes of hypoglycemia were reduced by 50%(15.1 vs. 7.6 events/month), especially nocturnal hypoglycemia by 67%(6.7 vs. 2.5 events/month). HbA1c was reduced from 9.3% to 8.7% after Lantus treatment. Self-monitored blood glucose of Lantus treatment group at postbreakfast 30, 60, 90 and 120 minutes were 171.1, 169.5, 171.0 and 154.1 mg/dL respectively and lower than those of premixed insulin treatment group (259.7, 282.7, 280.0 and 250.9 mg/dL respectively). Conclusion : Compared with premixed insulin, Lantus plus Humalog is more effective in glycemic control and reduction in nocturnal hypoglycemia in children and adolescents with type 1 diabetes mellitus.

Nutritional Characteristics and Stability in Cell of the Yac-Sun Tea for Caronary Heart Disease (관상동맥 질환의 예방을 위한 약선차의 식품영양학적 구성 및 안전성 평가)

  • Kim, Woon-Ju;Cho, Hwa-Eun;Park, Sung-Hye
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.1
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    • pp.219-225
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    • 2007
  • This study was performed to provide basic ideas as understanding and application for oriental medicinal cuisine (Yak-Sun). To develop medicinal cuisine, it is necessary to grasp the theoretical system. And to develop medicinal cuisine for health enhancement, it is also required not only to consider constitutions but also to suggest the need of knowledge for moderation in terms of regimen along with the theory of oriental medicine. Also to develop medicinal cuisine according to the perspective of oriental medicinal theory, what should be taken into account is not only the understanding of the characteristics of food materials, but also the properties of them that the theory of oriental medicine. Lastly the scientific effect of the medicinal cuisine which is developed according to the oriental medicinal theory. And it is believed to De essential for the government to make effects to set a standard and laws to validate the medicinal effects and the process of assessment so that the systematic development can be encouraged, and to prepare guidance to food development for national health improvement. This research was planned and executed to evaluate how the composition of Yak-sun(oriental diet therapy) can effect health conditions of people who are suffering from diet-related diseases like cardiovascular related disease. by taking Yak-sun in a form of nutritional supplement with our daily meals. We produced Yak-sun tea with Mansam, Hwanggi, Tanggi and Paekchak and observed nutritional composition. We concluded that we could apply the components not only in a form of tea, but also in other forms of various food. The information we received from this conclusion will be a basic information on how we can apply oriental medicinal resources into other food and will also be a steppingstone for medicinal herbs to step foot in the field of functional food research, which already draws sizable attention world-wide.

Treatment of Skin Diseases in Hyungsang Medicine (피부병의 형상의학적 치료)

  • Suk Min He;Hwang Won Duek;Jung Haeng Gyu;Lee Yong Tae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.3
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    • pp.646-669
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    • 2004
  • By treating skin diseases with Hyungsang medicine and reviewing the clinical cases of them through classifying skin diseases into general care and into Hyungsang medical care, the writer came to the conclusion as followings. The skin is a house of Kyungnak, and it' s a place which Ki comes in and out, which human body controls conditions of his physiological function and which doctors can make a diagnosis from seeing it. The skin is subject to lung and large intestine in the point of organ, but in the point of movement, to spleen and stomach. Skin diseases come from unbalance of Ki and Hyul, mostly from fever in blood and also from Dam, Wind, Dampness and Dryness because of including fire. Generally skin diseases are treated according to classifying into distinctive symptoms, region, cause or time being occurred, and concomitant symptoms. After being divided into man and woman, age and youth, fatness and leanness, Jung Ki Shin Hyul type, visceral figures, Yukkyung shapes on Hyungsang medicine method, the remedy of skin diseases which is combined common meditation with Hyungsang medical method is efficacious. In distinguishing into man and woman, age and youth, man gets sick mainly by drinking liquor and exhausting Jung, woman is taken ill generally by indigestion and Damwha, especially by drinking liquor. Young child gets ill mostly from inherent weakness, but in many cases he is occurred by disturbed digestion, so he must be taken care of ingesting food. The aged becomes ill from weakening, so he must be treated according to reasons of diseases. To fatness and leanness, skin diseases are showed symptoms by weakened Yang, insufficient Yin or excess fever on the theory of upper and lower parts, by unbalance of Ki and Hyul on the theory of left and right, by Dryness and Dampness on the theory of front and rear and by insufficiency of vitality and combined fever on the theory of inside and outside. Therefore doctors must cure the symptoms according to the theory of upper and lower, left and right, front and rear and inside and outside. In type of Jung Ki Shin Hyul, the balances between Jung-Hyul and Shin-Ki are important points. Concretely Jung type comes to easily shortage of Jung or gathering abnormally Dampness and Dam, Ki type is easy to make a mass with Ki or to be deficient of Ki, Shin type comes to press seven emotions togather or to be insufficient of Yin and fever inside, and Hyul type is inclined to be deficient of Hyul and to become feverish or to be deficient of Ki. Therefore on the ground of the above reasons skin diseases come into existence. Inclusively in Jung-Hyul type , Ki must be moved on the base of full Jung-Hyul, so Wukmijiwhangtang or Samultang is prescribed basically. In Shin-Ki type , Jung-Hyul is saved on the base of moving Ki, so Hyangsosan or Yijintang is the proper prescription. Considering the visceral figures, doctors judge for diagnosis and remedy by putting together the elements, that is, great and small sizes of a set of features (eye, ear, mouth, nose), color and temper. The yukkyung types are classified according to many or few of Ki-Hyul, and then skin diseases appear by being inclined toward one side between Ki and hyul, or among the six atmospheric elements(wind, cold, heat, dampness, dryness, and fire). Especially because Yangmyung type is full of much Ki and Hyul, and also has much fever in stomach, he gets skin symptoms frequently. So his prescription is based on taking off fever in stomach, and also he must be careful about regimen certainly.

Evaluation of Steroid Therapy in Tuberculous Pleurisy - A prospective, randomized study - (결핵성 흉막염에서 스테로이드의 치료 효과 - 전향적, 임의추출법에 의한 비교 -)

  • Bang, Jei So;Kim, Myong Sik;Kwak, Seung Min;Cho, Chul Ho
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.52-58
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    • 1997
  • Background : Tuberculous pleurisy has been treated With a combined regimen of corticosteroids- antimicrobial therapy. But whether such combination therapy add to benefits is unknown. We evaluate the effects of corticosteroid and its routine application in relief of clinical symptoms, absorption of pleural effusion, and pleural adhesions. Methods : A prospective, randomized study of the role of corticosteroid in the treatment of tuberculous pleurisy was performed in 83 patients(nonsteroid group: 50 patients, steroid group: 33 patients) from June, 1991 to September, 1994. Results : 1) The mean duration from symptoms(fever, chest pain, dyspnea) to relief was 3.8 days in the steroid group, and 7.4 days in the nonsteroid group(P<0.05). Clinical symptoms including fever, chest pain, sputum and weight loss were relieved more rapidly in the steroid group than other symptoms(weakness, night sweating and dyspnea). 2) Pleural effusion was taken an averge of 88 days in the steroid group and 101 days in the nonsteroid group 10 be absorbed completely(p>0.05) 3) The incidence of pleural adhesions was 17/33(5l.5%) in the steroid group and 32/50(64%) in the nonsteroid group(p>0.05) 4) Side effects of corticosteroids were observed in only one patient causing epigastric pain and discontinuation of drug. Conclusion : Corticosteroid exert benefitial role in the more rapid relief of clinical symptoms to patients with tuberculous pleurisy, but absortion of pleural effusion and occurrence of pleural adhesions was not influenced significantly Therefore, its routine application should be reevaluated.

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Short-term Clinical Experience on Interferon gamma-1b Therapy for Idiopathic Pulmonary Fibrosis (특발성 폐섬유화증에서 Interferon gamma-1b 치료의 단기 임상경험)

  • Hwang, Jung Hye;Chung, Man Pyo;Kang, Eun Hae;Kim, Kyung Chan;Lee, Byoung-Hoon;Koh, Won-Jung;Suh, Gee Young;Kim, Hojoong;Lee, Kyung Soo;Han, Joungho;Kwon, O Jung
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.6
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    • pp.619-627
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    • 2004
  • Background : Corticosteroids in combination with cytotoxic drugs are the mainstays of therapy for idiopathic pulmonary fibrosis (IPF). However, there has been no regimen showing any survival benefit. The aim of this study was to describe a short-term clinical experience on interferon gamma-1b (IFN-${\gamma}1b$) therapy for IPF, as an antifibrotic agent. Methods : Medical records of 27 patients who were treated with IFN-${\gamma}1b$ (2 million IU, 3 times a week, subcutaneous injection) were retrospectively reviewed. Treatment response was assessed using ATS/ERS criteria in 17 patients who received IFN-${\gamma}1b$ for more than 6 months. In addition, we compared the efficacy of IFN-${\gamma}1b$ therapy with that of cyclophosphamide${\pm}$prednisolone therapy (n=26). Results : The median age of IFN-${\gamma}$ treated group (M:F=19:8) was 59 years (44-74 years). Compared to the patients who showed a stable response at 6 months (n=12), the deteriorated group (n=5) had worse baseline lung function (FVC, $55.4{\pm}11.3%$ vs. $70.7{\pm}10.9%$, p=0.019; DLco, $50.3{\pm}7.3%$ vs. $76.9{\pm}19.6%$, p=0.014). Lower baseline $PaO_2$ on room air breathing was observed in the deteriorated group ($68.6{\pm}7.8mmHg$ vs. $91.4{\pm}6.6mmHg$ p=0.001). Subcutaneous IFN-${\gamma}1b$ did not show better efficacy than prednisolone. Five patients discontinued IFN-${\gamma}$ because of severe side effects. ARDS developed in one patient, who eventually died. Conclusion : The administration of IFN-${\gamma}1b$ is not desirable for patients diagnosed with IPF with poor lung function. Long-term and large-scaled clinical studies are needed for its efficacy in IPF.

Concurrent Chemoradiation with Weekly Paclitaxel in Locally Advanced Non-small Cell Lung Cancer (국소진행성 비소세포폐암에서 Paclitaxel 매주투여 및 방사선치료 동시요법)

  • Bae, Kang Woo;Song, Tak Ho;Yang, Joo Yeon;Kim, Yun Seup;Park, Jae Seok;Jee, Young Koo;Lee, Kye Young
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.4
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    • pp.351-357
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    • 2004
  • Background : Paclitaxel is highly beneficial anticancer drug for the treatment of non-small cell lung cancer and has shown remarkable radiosensitizing effect in vitro. We evaluated whether concurrent chemoradiation therapy with weekly paclitaxel (60 $mg/m^2$) could be tolerated and effective in the treatment of locally advanced non-small cell lung cancer (NSCLC). Methods : Twenty-two stage III (IIIA:6, IIIB:16) NSCLC patients were treated with weekly administration of paclitaxel (60 $mg/m^2$) on days 1, 8, 15, 22, 29, and 36 in addition to concurrent radiation therapy of 54 Gy. After the initial phase of concurrent chemoradiation, patients received additional two cycles of consolidation chemotherapy with paclitaxel (175 $mg/m^2$)/cisplatin (75 $mg/m^2$) or paclitaxel (175 $mg/m^2$)/carboplatin (6AUC) every 3 weeks. Results : Overall response rate was 81.8% (18/22) with 9.1% (2/22) of complete response and 72.7% (16/22) of partial response rate. Two patients (9.1%) died of chemoradiation-induced pneumonitis after completion of therapy. In total, grade 3 toxicities included pneumonitis (22.7%), esophagitis (22.7%), neuropathy (13.6%), and neutropenia (13.6%). The median survival time was 15 months and 2-year overall survival were 31.8%. Conclusion : Concurrent chemoradiation therapy with weekly paclitaxel in locally advanced NSCLC showed good local response, but survival rate was not completely satisfactory due to potentially fatal chemoradiation-induced pneumonitis.

The Actual Management State of Trial Contact Lenses and Lens Care Products in Local Optical Shops (안경원의 시험착용 콘택트렌즈 및 관리용품 관리 실태)

  • Park, Mijung;Lee, Unjung;Kim, So Ra
    • Journal of Korean Ophthalmic Optics Society
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    • v.16 no.4
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    • pp.391-401
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    • 2011
  • Purpose: In the present study, the actual management state of trial contact lenses and lens care products in local optical shops was surveyed and analyzed to reduce the risk of lens complication possibly induced by neglecting lens care. Methods: The feeling of contact lens wearers during the wear of trial contact lenses was surveyed. Futhermore, the actual management state of trial contact lenses such as cosmetic lens and RGP lens and lens care products was also investigated by surveying opticians who trade contact lenses in local optical shops. Results: It was found that consumers trusted the sanitary conditions of the lens since trial cosmetic contact lens and RGP lens were cleaned before and after trails by over 98% of opticians in local optical shops. For trial cosmetic lens, cleaning with normal saline, multipurpose solution for soft lens and combination of saline and multipurpose solution were 38.5%, 40.5% and 21%, respectively, before trials. After trials, cosmetic lenses were cleaned with normal saline, multipurpose solution for soft lens and a combination of saline and multipurpose solution were 13%, 75%, and 12%, respectively. On the other hand, cleaning with normal saline, multipurpose solution for RGP lens and combination of saline and multipurpose solution were 28.5%, 38.5% and 33%, respectively, before trying trial RGP lens. After trials, RGP lenses were cleaned with normal saline, multipurpose solution for RGP lens and a combination of saline and multipurpose solution were 2.5%, 70%, and 27.5%, respectively, indicating that relatively many opticians followed the lens cleaning regimen. In local optical shops, the cleaning trial cosmetic lens was mainly conducted at every 10 days or a month and the washing cycle of cosmetic lens case was in a month or 2~3 months. The cleaning interval of trial RGP lens was primarily in a month or 2~3 months. For those lens cases, more than 75% of opticians washed them with a surfactant and then rinsed with cold water. The storing periods of lens care products were primarily in a week for saline and in a month and 2~3 months indicating that storing period of lens care products was relatively well-kept in local optical shops. Conclusions: It is thought that the concern about any microbial infection is not that high since trial contact lenses and lens care products were generally well-managed by opticians in local optical shops from the results above. However, better public eye health and better public confidence in opticians may be possible if further strengthen in avoidance of lens cleaning with saline, keep of cleaning cycles within 2 weeks and rinsing of lens cases with hot water happens.