Purpose: Studies on the efficacy of infliximab (IFX) in a large population of pediatric patients with Crohn's disease (CD) are limited, and prognostic factors are not well-known. The aim of this study was to evaluate outcomes of IFX in pediatric patients with CD and to identify factors associated with poor prognosis. Methods: We retrospectively analyzed medical data of 594 pediatric patients with CD between 1987 and 2013 in a tertiary center. Of these, 156 children treated with IFX were enrolled and were followed up for at least a year with intact data. Outcomes of induction and maintenance, classified as failure or clinical response, were evaluated on the tenth and 54th week of IFX therapy. Results: We treated 156 pediatric patients with CD with IFX, and the median duration of IFX therapy was 47 months. For IFX induction therapy, 134 (85.9%) patients experienced clinical response on the 10th week. Among the 134 patients who showed response to induction, 111 (82.8%) patients maintained the clinical response on the 54th week. In multivariate analysis, low hematocrit (p=0.046) at the time of IFX initiation was associated with the failure of IFX induction. For IFX maintenance therapy, longer duration from the initial diagnosis to IFX therapy (p=0.017) was associated with maintenance failure on the 54th week. Conclusion: We have shown the acceptable outcomes of IFX in a large cohort of pediatric CD patients in Korea. Hematocrit and early introduction of IFX may be prognostic factors for the outcomes of IFX.
Purpose: This study was designed to evaluate the effectiveness and prognostic factors for patients treated with postoperative radiation therapy following surgery or with radiation therapy alone for squamous cell carcinoma of the esophagus. Materials and Methods: We retrospectively analyzed 132 esophageal cancer patients treated with postoperative radiation therapy following surgery or patients who were treated with radiation therapy alone at our institution from 1989 to 2006. Thirty-five patients had stage II disease, 88 patients had stage III disease and nine patients had stage IV disease. Tumors were located at the upper esophagus in 18 patients, the mid esophagus in 81 patients and the distal esophagus in 33 patients. Sixty patients were treated with radiation therapy alone and 72 patients were treated with postoperative radiation therapy following surgery. Eight patients received a dose less than 40 Gy and 78 patients received a dose of 40 to 50 Gy. The remaining 46 patients received a dose of 50 to 60 Gy. The majority of patients who underwent postoperative radiation therapy received a dose of 45 Gy. Results: Actuarial survival rates for all of the patients at two years and five years were 24% and 5%, respectively. The median survival time was 11 months. Survival rates for patients who underwent postoperative RT at two years and five years were 29% and 8%, respectively. The corresponding survival rates for patients who received radiation alone were 18% and 2%, respectively. Survival rates at two years and five years were 43% and 15% for stage II disease, 22% and 2% for stage III disease and 0% and 0% for stage IV disease, respectively; these findings were statistically significant. Two-year survival rates for patients with upper, middle and distal esophageal cancer were 19, 29% and 22%, respectively. Although there was a trend of slightly better survival for middle esophageal tumors, this finding was not statistically significant. Complete response to radiation was achieved in 13 patients (22%) and partial response to radiation was achieved in 40 patients (67%) who received radiation alone. No response to radiation was noted in seven patients (12%). A statistically significant difference in survival rates was seen between patients that had a complete response and patients that had a partial response. Two-year survival rates for patients that had a complete response versus patients that had a partial response were 31% and 17%, respectively. There were no survivors for patients with no response as determined at two-year follow-up. Conclusion: We conclude that radiation therapy is an effective treatment for esophageal cancer. Stage and response to radiation therapy were noted to be prognostic factors. A more effective treatment modality is needed to improve long term survival because of the relatively dismal prognosis for this tumor.
Bingjie Zheng;Ji Hoon Shin;Hailiang Li;Yanqiong Chen;Yuan Guo;Meiyun Wang
Korean Journal of Radiology
/
v.22
no.3
/
pp.366-375
/
2021
Objective: To evaluate the radiological tumor response patterns and compare the response assessments based on immune-based therapeutics Response Evaluation Criteria in Solid Tumors (iRECIST) and RECIST 1.1 in metastatic clear-cell renal cell carcinoma (mccRCC) patients treated with programmed cell death-1 (PD-1) inhibitors. Materials and Methods: All mccRCC patients treated with PD-1 inhibitors at Henan Cancer Hospital, China, between January 2018 and April 2019, were retrospectively studied. A total of 30 mccRCC patients (20 males and 10 females; mean age, 55.6 years; age range, 37-79 years) were analyzed. The target lesions were quantified on consecutive CT scans during therapy using iRECIST and RECIST 1.1. The tumor growth rate was calculated before and after therapy initiation. The response patterns were analyzed, and the differences in tumor response assessments of the two criteria were compared. The intra- and inter-observer variabilities of iRECIST and RECIST 1.1 were also analyzed. Results: The objective response rate throughout therapy was 50% (95% confidence interval [CI]: 32.1-67.9) based on iRECIST and 30% (95% CI: 13.6-46.4) based on RECIST 1.1. The time-to-progression (TTP) based on iRECIST was longer than that based on RECIST 1.1 (median TTP: not reached vs. 170 days, p = 0.04). iRECIST and RECIST 1.1 were discordant in 8 cases, which were evaluated as immune-unconfirmed PD based on iRECIST and PD based on RECIST 1.1. Six patients (20%, 6/30) had pseudoprogression based on iRECIST, of which four demonstrated early pseudoprogression and two had delayed pseudoprogression. Significant differences in the tumor response assessments based on the two criteria were observed (p < 0.001). No patients demonstrated hyperprogression during the study period. Conclusion: Our study confirmed that the iRECIST criteria are more capable of capturing immune-related atypical responses during immunotherapy, whereas conventional RECIST 1.1 may underestimate the benefit of PD-1 inhibitors. Pseudoprogression is not rare in mccRCC patients during PD-1 inhibitor therapy, and it may last for more than the recommended maximum of 8 weeks, indicating a limitation of the current strategy for immune response monitoring.
The Journal of Korean Academy of Sensory Integration
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v.2
no.1
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pp.53-64
/
2004
Objective : To identify the effect of intensive sensory integration therapy through 5 days camp programs for children with dyspraxia Methods : A comparison of quantitative date and qualitative description between before and after sensory integration therapy camp described adaptative response of children and individual home-based program was designed and therapist educated parents about it. Results : The problem of control and apraxia which children have was improved rather than before camp and adaptive response increased. Conclusion : Follow-up study is needed to observe and investigate the effect of continuous treatment after camp participation.
This review focuses on the clinical use of $^{18}F-FDG$ PET to evaluate solitary pulmonary nodule (SPN) and non-small cell lung cancer (NSCLC). When SPN or mass without calcification is found on chest X-ray or CT, $^{18}F-FDG$ PET is an effective modality to differentiate benign from malignant lesions. For initial staging of NSCLC, $^{18}F-FDG$ PET is useful, and proved to be cost-effective in several countries. $^{18}F-FDG$ is useful for detecting recurrence, restaging and evaluating residual tumor after curative therapy in NSCLC. For therapy response assessment, $^{18}F-FDG$ PET may be effective after chemotherapy or radiation therapy. $^{18}F-FDG$ PET is useful to predict pathological response after neoadjuvant therapy in NSCLC. For radiation therapy planning, $^{18}F-FDG$ PET may be helpful, but requires further investigations. PET/CT is better for evaluating NSCLC than conventional PET.
Cellular senescence, a permanent state of cell cycle arrest, is believed to have originally evolved to limit the proliferation of old or damaged cells. However, it has been recently shown that cellular senescence is a physiological and pathological program contributing to embryogenesis, immune response, and wound repair, as well as aging and age-related diseases. Unlike replicative senescence associated with telomere attrition, premature senescence rapidly occurs in response to various intrinsic and extrinsic insults. Thus, cellular senescence has also been considered suppressive mechanism of tumorigenesis. Current studies have revealed that therapy-induced senescence (TIS), a type of senescence caused by traditional cancer therapy, could play a critical role in cancer treatment. In this review, we outline the key features and the molecular pathways of cellular senescence. Better understanding of cellular senescence will provide insights into the development of powerful strategies to control cellular senescence for therapeutic benefit. Lastly, we discuss existing strategies for the induction of cancer cell senescence to improve efficacy of anticancer therapy.
Most of physical therapists has thought be exposed themselves to risk of hospital infection but it is reported that have been low concern about infection management. Above like this haven t done systematical education on hospital infection, also physical therapist's information management of infection disease is found very low. It is lack of driving information about disease condition of the patients. Physical therapists has thought their working room may be polluted a lots of micro-organism(%). The control situation of infection waste articles, only 53% responded that the controller has managed very intensive so we can feel to need more intensive It's reported that air culture investigation of physical therapy room has never initiated. To wash the hand, before, after treatment of the patients of physical therapist, is very low frequency. And 73% have responded that the time to wash the hand stays 15-45 second. It is examined that 70% physical therapy room is equipped with washing system, a response of 58% disinfects physical therapy room 1-2times per one month. 36% responded disinfection of treatment modality have done everyday, 25% responded have never done. The location physical therapy room is above one floor - 65%. A response of 57% is ventilation system sufficiency, it is considered that physical therapists needs more efforts on management of hospital infection.
Objectives : The purpose of this study is to report the effect of Korean Medicine Treatment (KMT) on the advanced gastric carcinoma (AGC) patient. Method : One advanced gastric carcinoma patient was treated by Korean Medicine Treatment composed of pharmacopuncture, acupuncture and herbal medicine. At the same time, he received chemotherapy (S-1 and Cisplatin) and radiotherapy. The effect of KMT was measured by scanning with Computed tomography (CT) and Esophagogastroduodenoscopy (EGD). Response was evaluated using the Response Evaluation Criteria in Solid Tumors (RECIST) Committee classification. Result : The tumor was disappeared after the treatment during 13 months (Complete Response (CR)). As treatment was performed, chemoradiation therapy induced complication was alleviated. Conclusion : This case provides us a possibility that Korean Medicine Treatment offers potential benefits for advanced gastric carcinoma patient.
Purpose: This study examined whether 1) the motor inhibition response as cognitive-behavioral component is learning though a stop signal task using stop-signal paradigm, and 2) whether there is a difference in the learning degree according to imagery training and actual practice training. Methods: Twenty young adults (males: 9, females: 11) volunteered to participate in this study, and were divided randomly into motor imagery training (IT, n=10) and practice training (PT, n=10) groups. The PT group performed an actual practice stop-signal task, while the IT group performed imagery training, which showed a stop-signal task on a monitor of a personal computer. The non-signal reaction time and stop-signal reaction time of both groups were assessed during the stop-signal task. Results: In the non-signal reaction time, there were no significant intra-group and inter-group differences between pre- and post-intervention in both groups (p>0.05). The stop-signal reaction time showed a significant difference in the PT group in the intra-group analysis (p<0.05). On the other hand, there was no significant intra-group difference in the IT group and inter-group difference between pre- and post-intervention (p>0.05). Conclusion: These results showed that the motor inhibition response could be learned through a stop-signal task. Moreover, these findings suggest that actual practice is a more effective method for learning the motor inhibition response.
The purpose of this study is to provide the fundamental information fer the rehabilitation of hand injury and to emphasize the point of early treatment of hand injury after operation. The subjects are composed with the physical therapists who care hand injury and are engaged in 76 university hospitals,59 general hospitals and 88 semi and local clinics respectively. Investigator take the research form chart with 41 questionnaire and use the cross tabulation frequencies and one-way ANOVA of SPSS WIN(ver 10.0) for the statistic analysis. The results of this research are as follows :1. The number of physical therapists who care hand injury are 110 men and 113 women. 2. The beginning period of active assistive exorcise on the various type of injuries are as follows: At the case of flexor tendon injury, the most part of physical therapists make response to the period that is above 4 weeks in the rate of 29.1%. At the case of fracture, the most part of physical therapists make response to the period those are from 3 weeks to less than 4 weeks and from 4 weeks to less than 5 weeks in the rate of 28.7% respectively. At the case of crushing injury, the most part of physical therapists response to the period that is above 4 weeks in the rate of 32.2%. At the case of amputation injury, the most part of physical therapists response to the period that is above 4 weeks in the rate of 40.4%. 3. In the physical therapy request, treatment period are mentioned in 22.0%. 4. The most difficult factors in the hand treatment is to contracture soft tissue and joint to physical therapist in the rate of 59.6%. 5. Among the reasons of the intervention between physical therapy request and actual treatment, the case of wrong physical therapy request is examined in 69.4%.
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