Approximately 100 drugs have been reported to affect the lungs adversely. Among these, pulmonary toxicity caused by antieneoplastic agent. is being recognized more frequently. Cyclophosphamide is an immunosuppressive alkylating agent used for the treatment of a wide variety of malignant and nonmalignant diseases. The incidence of pulmonary toxicity is probably less than 1 percent The first case was reported in 1967. Since then, more than 20 well-documented cases of pulmonary toxicity associated with cyclophosphamide have been reported in the literature. In Korea, three patients were identified with cyclophosphamide-induced lung disease. The typical features of toxicity include dyspnea, fever, cough, new parenchymal infiltrates, gas exchangs abnormalities on pulmonary function tests, and pleural thickening on chest roentgenogram. The best approach to management is early diagnosis, discontinuation of the offending drug and administration of corticosteroid therapy. Recently, we experienced a case of diffuse alveolar damage induced by cyclophosphamide. The patient presented with early-onset pulmonary toxicity and died of repiratory failure despite early use of corticosteroid.
Background: Breast cancer is the leading cause of cancer-related death among women in Malaysia. A diagnosis is very stressful for women, affecting all aspects of their being and quality of life. As such, there is little information on quality of life of women with breast cancer across the different ethnic groups in Malaysia. The purpose of this study was to examine the quality of life in Malay and Chinese women newly diagnosed with breast cancer in Kelantan. Materials and Methods: A descriptive study involved 58 Malays and 15 Chinese women newly diagnosed with breast cancer prior to treatment. Quality of life was measured using the Malay version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its breast-specific module (QLQ-BR23). Socio-demographic and clinical data were also collected. All the data were analyzed using SPSS version 20.0. Results: Most of the women were married with at least a secondary education and were in late stages of breast cancer. The Malay women had lower incomes (p=0.046) and more children (p=0.001) when compared to the Chinese women. Generally, both the Malay and Chinese women had good functioning quality-of-life scores [mean score range: 60.3-84.8 (Malays); 65.0-91.1 (Chinese)] and global quality of life [mean score 60.3, SD 22.2 (Malays); mean score 65.0, SD 26.6 (Chinese)]. The Malay women experienced more symptoms such as nausea and vomiting (p=0.002), dyspnoea (p=0.004), constipation (p<0.001) and breast-specific symptoms (p=0.041) when compared to the Chinese. Conclusions: Quality of life was satisfactory in both Malays and Chinese women newly diagnosed with breast cancer in Kelantan. However, Malay women had a lower quality of life due to high general as well as breast-specific symptoms. This study finding underlined the importance of measuring quality of life in the newly diagnosed breast cancer patient, as it will provide a broader picture on how a cancer diagnosis impacts multi-ethnic patients. Once health care professionals understand this, they might then be able to determine how to best support and improve the quality of life of these women during the difficult times of their disease and on-going cancer treatments.
In recent years, explosive increase in population has been damaging mankind in terms of deprivation of natural resources and more of economical demands. Therefore, we have thought about problems as to counter-balance the increasing population, and reached a resolution of artificial methods of controlling birth. In the past, though now used in some of contraceptive methods, extravaginal ejaculation, condom were commonly used. But recently, pills, IUD and several kinds of operative procedures are quite popular. Though the recent methods are known to be effective compared with the traditional methods, a certain unwanted side effects as well as limited value of usages now must be discussed. On this aspect, we are trying to research for a ideal methods such as symptom free, more of natural way of family planning and try to zero the failure rate. And also it has been suggested that only if those scientific methods of controlling birth can be base on religious concepts of moral being, it will be enlightened. At the Happy Family Planning Clinic of St. Mary's Hospital, we apply Billing's ovulation method to out-patients who want contraception and usually advise them to use it on a self-care basis. For a retrospective study of the presurvey data analysis and use-effectiveness of the ovulation method from April 1, 1975 to Nov., 30, 1975, we have dealt with a total of 1,383 women (urban areas 465, rural areas 918). The results of preliminary survey were as follows; 1) Among 465 women in Seoul areas, the failure rate was 10.3, which signified unplanned pregnancies of 32 women. 27 of the 32 women were pregnant due to the users own failure and the remaing 5 due to the failure of the method. Therefore, the failure of the method accounted for 1.6. 2) Among 918 women in rural areas, the failure rate was 15.2 signifing unplanned pregnancies in 93 women. The cause of the failure in 81 of the 93 women was attributable to the user's own mistake and that in the remaing 12 to the default of the method. Therefore, the failure attributable to the method accounted for 2.0.
A retinal prosthesis is being developed for the restoration of vision in patients with retinitis pigmentosa (RP) and age-related macular degeneration (AMD). Determining optimal electrical stimulation parameters for the prosthesis is one of the most important elements for the development of a viable retinal prosthesis. Here, we investigated the effects of different charge-balanced biphasic pulses with regard to their effectiveness in evoking retinal ganglion cell (RGC) responses. Retinal degeneration (rd1) mice were used (n=17). From the ex-vivo retinal preparation, retinal patches were placed ganglion cell layer down onto an $8{\times}8$ multielectrode array (MEA) and RGC responses were recorded while applying electrical stimuli. For asymmetric pulses, 1st phase of the pulse is the same with symmetric pulse but the amplitude of 2nd phase of the pulse is less than $10{\mu}A$ and charge balanced condition is satisfied by lengthening the duration of the pulse. For intensities (or duration) modulation, duration (or amplitude) of the pulse was fixed to $500{\mu}s$($30{\mu}A$), changing the intensities (or duration) from 2 to $60{\mu}A$(60 to $1000{\mu}s$). RGCs were classified as response-positive when PSTH showed multiple (3~4) peaks within 400 ms post stimulus and the number of spikes was at least 30% more than that for the immediate pre-stimulus 400 ms period. RGC responses were well modulated both with anodic and cathodic phase-1st biphasic pulses. Cathodic phase-1st pulses produced significantly better modulation of RGC activity than anodic phase-1st pulses regardless of symmetry of the pulse.
Improvements in therapy have resulted in increasing numbers of children being successfully treated for cancer. However the agrressiveness of therapy & uncertainty about prognosis are associated with many adverse effects, psychological as well as physical for both the child & family. The purpose of this study were to measure the degree of perceived uncertainty, self-efficacy & coping, and then to examine the relationship between the perceived uncertainty, self-efficacy & coping in parents of children cancer patients. The subjects of this study consist of 140 parents with pediatric cancer, registered at pediatric cancer ward & Out Patient Department. Data was collected from July 1st to August 15th 1998. The tools used in this study were Mishel's the Parents' Perception of Uncertainty Scale (28 item, 4 likert scale), Shere's Self-Efficacy Scale (17 item, 5 likert scale) & Folkman & Lazarus Ways of Coping Checklist(34 items, 4 likert scale). Data was analyzed by t-test, Anova, Pearson Correlation coefficient. Results of this study are summerized as follows 1. Parents perceived their uncertainty to be slightly high(Mn 2.41). The degree of perceived uncertainty by the four components were followed as lack of clarity (2.60), unpredictability(2.59), ambiguity(2.51) & lack of information(1.90). The degree of perceived uncertainty of parents with pediatric cancer revealed to be influenced significantly by the family outcome, reliability about health care provider & perceived severity of illness. 2. The range of parents' self-efficacy was measured iron 35 to 85 point, so revealed slightly high. The degree of self-efficacy related to be Influenced signiicantly by the sequency of child birth, family religion & degree of perceived support. 3. The degree of parents' coping was measured slightly high (Mn 2.78). The degree of coping related to be influnced significantly by the sequency of child birth, number of sible & degree of perceived support. 4. parents' uncertainty was related inversely to the parents' self-efficacy(r=-.38, p<.001) & coping(r=-.26, p<.001). And also parents' self-efficacy was positively related to coping(r=.56, p<.001) From the above results, it can be concluded that predicting & controlling parents' uncertainty with children cancer are necessary to improve positive coping strategies. This information may be used as a foundation for developing nursing interventions to decrease perceived uncertainty & to foster self-efficacy & coping for parents with children cancer.
Background: Faced with highly prevalent and recalcitrant cancer-related fatigue (CRF), together with the absence of any official guidelines on management, numerous groups have been striving to seek and test alternative therapies including acupuncture and moxibustion. However, different patients have various feedbacks, and the many clinical trials have given rise to varied conclusions. In terms of the therapeutic effect of acupuncture and moxibustion, there exist vast inconsistencies. Objective: The aim of the study was to evaluate the auxiliary effectiveness of acupuncture and moxibustion in the treatment of CRF, and to provide more reliable evidence to guide clinical practice. Methods: Randomized controlled trials (RCTs) published before December 2012 were all aggregated, focusing on evaluation of acupuncture or moxibustion for CRF. The quality of the included studies was assessed basing on Cochrane handbook 5.1.0, and the available data were analyzed with RevMan software (version 5.2.0). Descriptive techniques were performed when no available data could be used. Results: A total of 7 studies involving 804 participants were eligible. With real acupuncture versus sham acupuncture, subjects receiving true acupuncture benefited more in the reduction of fatigue. With real acupuncture versus acupressure or sham acupressure, fatigue level appeared 36% improved in the acupuncture group, but 19% in the acupressure group and only 0.6% with sham acupressure. When real acupuncture plus enhanced routine care was compared with enhanced routine care, the combination group improved mean scores for general fatigue, together with physical and mental fatigue. With real acupuncture versus sham acupuncture or wait list controls, the real acupuncture group displayed significant advantages over the wait list controls at 2 weeks for fatigue improvement and better well-being effects at 6 weeks. When moxibustion plus routine care was compared with routine care alone, the meta-analyses demonstrated the combination had a relatively significant benefit in improving severe fatigue and QLQ-C30. Conclusion: Up to the search date, there exist few high quality RCTs to evaluate the effect of acupuncture and moxibustion, especially moxibustion in English. Yet acupuncture and moxibustion still appeared to be efficacious auxiliary therapeutic methods for CRF, in spite of several inherent defects of the included studies. Much more high-quality studies are urgently needed.
Kim, Hee-Joung;Kim, Wan-Seop;Shin, Kyeong-Cheol;Lee, Gwan-Ho;Kim, Mi-Jin;Lee, Jeong-Eun;Song, Kyu-Sang;Kim, Sun-Young;Lee, Kye-Young
Tuberculosis and Respiratory Diseases
/
v.70
no.1
/
pp.21-27
/
2011
Background: Although the gold standard method for research trials on epidermal growth factor receptor (EGFR) mutations has been direct sequencing, this approach has the limitations of low sensitivity and of being time-consuming. Peptide nucleic acid (PNA)-mediated polymerase chain reaction (PCR) clamping is known to be a more sensitive detection tool. The aim of this study was to compare the detection rate of $EGFR$ mutation and EGFR-tyrosine kinase inhibitor (TKI) responsiveness according to $EGFR$ mutation status using both methodologies. Methods: Clinical specimens from 112 NSCLC patients were analyzed for $EGFR$ mutations in exons 18, 19, 20, and 21. All clinical data and tumor specimens were obtained from 3 university hospitals in Korea. After genomic DNA was extracted from paraffin-embedded tissue specimens, both PNA-mediated PCR clamping and direct-sequencing were performed. The results and clinical response to $EGFR$-TKIs were compared. Results: Sequencing revealed a total of 35 (22.9%) mutations: 8 missense mutations in exon 21 and 26 deletion mutations in exon 19. PNA-mediated PCR clamping showed the presence of genomic alterations in 45 (28.3%) samples, including the 32 identified by sequencing plus 13 additional samples (6 in exon 19 and 7 in exon 21). Conclusion: PNA-mediated PCR clamping is simple and rapid, as well as a more sensitive method for screening of genomic alterations in $EGFR$ gene compared to direct sequencing. This data suggests that PNA-mediated PCR clamping should be implemented as a useful screening tool for detection of $EGFR$ mutations in clinical setting.
Canine babesiosis has been scarcely investigated in the Republic of Korea (ROK). Although it is known that Babesia gibsoni is its primary causative agent, its clinical presentation has not been completely clarified in the ROK. Consequently, the aim of this study was to evaluate the clinical appearance of this parasitic infection based on the anamnesis of the patient and compare of hematological and biochemical test results. Four hundred whole blood samples from patients with a presumptive diagnosis of tick-borne disease were analyzed by polymerase chain reaction (PCR) to amplify the Babesia spp. 18S rRNA gene and by a rapid diagnostic test kit (VetAll Laboratories®) to detect B. gibsoni seroreactive animals. Thirty-six (9.0%) dogs were PCR-positive but only 24 (6.0%) were seropositive. The investigation revealed that all the courses of the disease are present in the ROK, with the acute course being predominant. The acute course tends to consist of inappetence, lethargy, pyrexia, gastrointestinal symptoms, and occasionally hematuria. It also occurs with common hematological abnormalities, such as thrombocytopenia and anemia, and to a lesser extent biochemical abnormalities, such as hyperbilirubinemia, hypoalbuminemia, and elevated liver enzymes. This research shows that B. gibsoni is an endemic hemoparasite capable of producing a variety of clinical manifestations in dogs. For its accurate diagnosis, a descriptive history of the clinical signs, hematology, and biochemical profile of the patient, along with a well-performing PCR assay, are essential. These findings will help in planning pragmatic preventive strategies against this potent threat in the ROK.
Do Kyung Han;Jee Won Shon;Eui Suk Sung;Youn Sook Kim;Won G. An
Journal of Life Science
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v.33
no.11
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pp.876-886
/
2023
In some cases of head and neck cancers (HNC), surgical interventions may result in the loss of organs and/or changes to their functions, thereby significantly affecting the patient's quality of life. As a result, the surgical treatment of HNC patients is often limited to specific cases, and alternative treatment modalities, such as chemotherapy, are considered. However, serious adverse effects caused by chemotherapy, such as severe nausea and vomiting, necessitate the need for the development of adjunctive methods to minimize patient suffering. Chuanxiong, Ligusticum chuanxiong (L. chuanxiong), is a natural herb used in Eastern medicine to treat cerebrovascular disorders and headaches. This study aimed to predict the effect and potential of L. chuanxiong as an auxiliary anticancer drug through network-based pharmacology and molecular docking analysis. The study results showed that 40 out of 41 genes of L. chuanxiong shared common targets of HNC and their proteins could be used to target HNC cells to prevent cancer progression. The results of the functional enrichment analysis confirmed that L. chuanxiong is associated with the neuroactive-ligand metabolism and neurotransmitter pathways, indicating its potential medicinal value as an adjuvant in HNC treatment. Lastly, our findings demonstrated that the active ingredient of L. chuanxiong, (Z)-Ligustilide, has the ATP binding site of heat shock protein 90, a protein known to promote the activation of cancer cells. These results suggest that L. chuanxiong is a promising candidate for developing auxiliary anticancer drugs, and further research could potentially lead to the discovery of newer and safer anti-cancer agents.
Ko, Gyoung Min;Moon, Sung Je;Sohn, Min Sung;Lee, Sol;Go, Dun sol;Yoon, Seok Jun
Korea Journal of Hospital Management
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v.25
no.2
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pp.1-13
/
2020
Purpose: The purpose of this study is to identify the effect of the disease duration on depression change in cancer survivors between the middle and old age groups. Methodology: To that end, we analyzed 275 patients using the Korea welfare panel survey from 2011 to 2016 jointly developed by the Korea Institute for Health and Social Affairs and Seoul National University. The duration of the elapsed and the experienced was measured as a independent variable. CES-D was used as a dependent variable. Frequency, paired t-test, ANOVA, and logistic regression analysis were conducted using Stata 14.0 for statistical analysis. Findings: Studies have shown that as the duration of the elapsed and the experienced increases, people under 65 are 1.17 times and 1.84 times each more likely to be included in depression-increase group than in depression-reduction group. The group that has been maintaining economic activities continuously since 2011 was significantly less likely to belong to the depression-increase group than the group that did not have economic activities in 2016. For those aged 65 and older, there was no significant difference in the duration of the elapsed and the experienced. The higher the likelihood of low-income households being included in the family of depression was 2.58 times higher than for ordinary households. Practical Implications: It is suggested that close policy management of the employment and working environment of cancer survivors is necessary, as both cancer survivors of productive age as well as older cancer survivors are analyzed to be beneficial to depression management. In addition, a systematic management program related to the mental health of cancer survivors is believed to be necessary for normal social recovery in the future.
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