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Analysis of Existing Guidelines and Controlled Clinical Trials for Development of [Guideline of Clinical Trials with Herbal Medicinal Products for Colorectal Cancer] (결장직장암 한약제제 임상시험 가이드라인 개발을 위한 한약제제 대조군 임상시험 고찰)

  • Park, Eunjoo;Seong, Sin;Kim, Sungsu;Kim, Jinsung;Park, Jae-Woo;Ko, Seok-Jae;Han, Gajin
    • The Journal of Korean Medicine
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    • v.40 no.1
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    • pp.124-152
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    • 2019
  • Objectives: This study aimed to ascertain what should be considered in the "Guideline for Clinical Trials with Herbal Medicinal Products for Colorectal Cancer" by analyzing the existing guidelines and clinical trials. Methods: The development committee searched guidelines for herbal medicinal products for colorectal cancer that have already been developed. Then, clinical trials for colorectal cancer using herbal medicine were searched. The searched trials were analyzed in terms of inclusion and exclusion of participants, intervention, comparator, outcomes and trial design. Then, we compared the results of our analysis with the regulations and guidelines of the Ministry of Food and Drug Safety in order to identify the issues we will have to consider when making the "Guideline for Clinical Trials with Herbal Medicinal Products for Colorectal Cancer". Several guidelines for anti-tumor agents and clinical trials with herbal medicinal products were searched on the national institution homepage. In addition, 12 articles were searched using a combination of the following search terms: 'colorectal neoplasms', 'herbal medicine', 'Medicine, Korean traditional', 'Medicine, Chinese Traditional', 'medicine, East Asian medicine', 'medicine, Kampo', etc. Results: The characteristics of participants were various, such as people with medical histories of surgeries or recurrent cancers or who complained of chemotherapy-induced side effects. The types of interventions were also various and included decoctions, powders, intravenous fluids, intraperitoneal injections and gargles. Comparators used included placebos and conventional treatments. The outcome measurements used in the studies were quality of life, symptom score, tumor response, and survival duration, etc. Safety was evaluated by recording adverse events. Conclusions: Findings were made by reviewing existing guidelines and comparing them with clinical trials for colorectal cancer and herbal medicinal products. These results will be utilized in the development of the "Guideline for Clinical Trials with Herbal Medicinal Products for Colorectal Cancer".

Recent Studies on Anorexia and Tissue Wasting Induced by Cancer Cachexia (암 악액질의 주요 병인 기전 및 최근 연구 동향)

  • Yeom, Eunbyul
    • Journal of Life Science
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    • v.32 no.3
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    • pp.263-269
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    • 2022
  • Cancer cachexia-anorexia is a multi-organ metabolic syndrome characterized by anorexia and weight loss. Generally, such symptoms are a serious problem in cancer patients, adversely affecting chemotherapy success and survival rate. Cachexia has been reported to accompany up to 80% of gastrointestinal cancers, such as pancreatic, lung, and colon cancer, though it is relatively rare in lymphoma or breast cancer patients. It is also known that cancer-induced anorexia occurs independently of chemotherapy, although decreased appetite due to chemotherapy is well reported. In terms of pathoflammatory cytokines that are excessively increased by tumor tissues. Since the mechanism of cancer cachexia is not yet fully understood, there are currently no therapeutic agents or diagnostic markers to treat it. A recently published study identified a substance secreted from cancer cells that induces cancer anorexia, and the molecular mechanism causing the eating disorder was discovered. An increase in the expression of this substance has been shown to be statistically correlated with the symptoms of cachexia in cancer patients, and it is therefore expected to be applicable in the diagnosis and development of therapeutic agents for cancer cachexia. This review article aims to provide an overview of the key molecular mechanisms of the anorexia and tissue wasting caused by cancer cachexia.

Anti-inflammation and Anti-cancer Activity of Methanol Extract of Antarctic Lichen, Usnea Aurantiaco-atra (남극 지의류 Usnea Aurantiaco-atra의 메탄올 추출물의 항염증 및 항암 활성)

  • Sung-Suk Suh
    • Journal of Life Science
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    • v.33 no.12
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    • pp.978-986
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    • 2023
  • Inflammation by the innate immune system is a protective mechanism of the organism against infection-mediated environmental factors. It is also responsible for the pathogenesis of various human diseases, including the progression of cancer. Lichens are receiving increasing attention as a source of bioactive molecules with therapeutic potential for a variety of diseases. Additionally, the antioxidant, anti-inflammatory, and anticancer potential of lichen and its secondary metabolites have been widely reported. However, the underlying mechanism is still unknown. In the present study, to investigate molecular mechanisms of anti-inflammation and anti-cancer activity in the Antarctic lichen, Usnea aurantiaco-atra, methanol extract of Usnea aurantiaco-atra (MEUS) was used in vitro assays in RAW 264.7 macrophages cell and HCT116 colon cancer cells. Based on our data, MEUS had the anti-inflammatory activity through the modulation of main inflammatory indicators such as COX-2, IL-6, iNOS, TNF-α and NO production in a concentration-dependent manner. In addition, we observed that MEUS had cytotoxic activity against HCT116 colon cancer cells in a concentration-dependent manner, leading to a significantly reduced proliferation of the cancer cells through apoptotic induction by activating caspase-3. Taken together, this work firstly reported the anti-inflammatory and anti-cancer activities of an Antarctic lichen, Usnea aurantiaco-atra, and MEUS may provide a new insight into the molecular mechanisms underlying a link between inflammation and cancer.

Primary Colonic Epithelioid Angiosarcoma with Hepatic Metastasis: A Case Report (간전이를 동반한 대장 상피모양혈관육종: 증례 보고)

  • Jiyun Lim;Seong Sook Hong;Jiyoung Hwang;Hyun-joo Kim;So-Young Jin
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.432-438
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    • 2022
  • Colonic angiosarcoma is an extremely rare and aggressive malignant tumor with poor prognosis. We report a case of colonic epithelioid angiosarcoma with colonic obstruction and rapidly progressive hepatic metastasis in a 44-year-old female. Abdominal CT revealed a heterogeneously enhancing irregular mass in the ascending colon, causing proximal bowel distension. The patient underwent surgery, and histopathological examination revealed a poorly differentiated carcinoma. A follow-up liver dynamic MRI after 4 months revealed newly developed diffusely scattered numerous small nodules in both hepatic lobes with peripheral and nodular marked arterial hyperenhancement, raising the suspicion of hepatic angiosarcoma. A pathologic second opinion was obtained, and additional immunohistochemistry revealed colonic epithelioid angiosarcoma. The patient showed progressive hepatic metastasis on follow-up abdominal CT after 6 months and died 8 months after initial diagnosis. We describe an educational case of colonic angiosarcoma, a rare malignant tumor, with rapidly progressive hepatic metastasis that showed radiologic findings suggestive of angiosarcoma and enabled a re-diagnosis for proper treatment and prognosis prediction.

Human Immunodeficiency Virus-Associated Gastrointestinal Kaposi's Sarcoma: A Case Report (후천성 면역 결핍 바이러스와 연관된 위장관 카포시 육종: 증례 보고)

  • Hee Joong Lim;So Hyun Park;Seung Joon Choi;Suyoung Park;Hee Young Lee;Jun Won Chung;Dong Hae Chung
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1260-1265
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    • 2020
  • Kaposi's sarcoma (KS) is a multicentric human immunodeficiency virus-associated neoplasm characterized by multiple vascular nodules in the skin, mucous membranes, and viscera. Gastrointestinal acquired immunodeficiency syndrome (AIDS)-related KS is the most common visceral involvement reported in disseminated disease. Here, we present the findings of a rare case of KS involving multiple organs with abdominal pain and active bleeding in the colon. Multiple intraluminal lesions were found in the terminal ileum, sigmoid colon, and rectum by ileocolonoscopy, and in the jejunum and ileum by fluoroscopy. Abdominopelvic CT revealed multiple enhanced flat lesions in the ileum and enlarged lymph nodes. The diagnosis was confirmed by histopathology, and antiretroviral therapy was initiated as the treatment of choice for KS. Owing to the increasing number of AIDS patients, it is essential for radiologists and clinicians to be aware of the imaging characteristics of KS to protect physicians from indiscriminate exposure to AIDS.

Imaging and Clinical Findings of Xanthogranulomatous Inflammatory Disease of Various Abdominal and Pelvic Organs: A Pictorial Essay (복부와 골반의 다양한 장기에서 발생한 황색육아종성 염증 질환의 영상 및 임상 소견: 임상화보)

  • Se Jin Lee;Dal Mo Yang;Hyun Cheol Kim;Sang Won Kim;Kyu Yeoun Won;So Hyun Park;Woo Kyoung Jeong
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.109-123
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    • 2024
  • Xanthogranulomatous (XG) inflammatory disease is a rare benign disease involving various organs, including the gallbladder, bile duct, pancreas, spleen, stomach, small bowel, colon, appendix, kidney, adrenal gland, urachus, urinary bladder, retroperitoneum, and female genital organs. The imaging features of XG inflammatory disease are nonspecific, usually presenting as a heterogeneous solid or cystic mass. The disease may also extend to adjacent structures. Due to its aggressive nature, it is occasionally misdiagnosed as a malignant neoplasm. Herein, we review the radiological features and clinical manifestations of XG inflammatory diseases in various organs of the abdomen and pelvis.

Studies on the digestive gland structures of domestic and experimental animals I. Glandular tubule structures in the cecum and colon of piglets (가축 및 실험동물 소화선의 구조에 관한 연구 I. 돼지 맹장 및 결장 장선의 구조에 관하여)

  • Kwak, Soo-dong;Lee, Soon-sun;Moon, Oun-gyeong
    • Korean Journal of Veterinary Research
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    • v.30 no.1
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    • pp.1-8
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    • 1990
  • The present study was focussed mainly on the morphological changes of the glandular tubules in the large intestine according to age of piglets. Samples were taken from large intesine of 1-, 10-, 20-, 35- and 45-day-old piglets, 2 to 3 piglets in each age group. The intestinal samples were fixed in 10% neutral formalin solution, dehydrated, and then paraffin sections were stained with H-E. The results observed were summarized as follows: 1. The mucosal glands in the cecum and colon tend to be unbranched simple straight tubular glands, or often two or more branched simple stright tubular glands. 2. The number of the longitudinal folds and the number of the crypts per cross section of piglet colons, respectively, were 1-day-old piglets-$3.8{\pm}0.8$, $92.1{\pm}6.9$; 10-day-old piglets-$7.1{\pm}1.1$, $164.2{\pm}10.3$; 20-day-old piglets-$15.2{\pm}0.8$, $178.5{\pm}6.8$; 35-day-old piglets-$19.3{\pm}3.0$, $454.9{\pm}25.3$; 45-day-old piglets-$20.6{\pm}3.1$, $524.6{\pm}37.2$, and the regression equation between age and these two number were $\hat{Y}=0.40X+4.32$ and $\hat{Y}=10.4X+51.52$, respectively. 3. The length and cell number per single side wall of a glandular tubule in the colon section were 1-day-old piglets-$196.3{\pm}7.1{\mu}m$, $40.0{\pm}3.3$; 10-day-old piglets-$236.0{\pm}34.5{\mu}m$, $47.9{\pm}5.3$; 20-day-old piglets-$262.8{\pm}39.6{\mu}m$, $54.3{\pm}9.0$; 35-day-old piglets-$291.75{\pm}48.3{\mu}m$, $56.9{\pm}4.9$; 45-day-old piglets-$364.8{\pm}61.5{\mu}m$, $67.7{\pm}7.4$, respectively, and the regression equation between age and these two data were $\hat{Y}=3.45X+193.8$ and $\hat{Y}=0.56X+41.0$, respectively. 4. The overall percentages of the cell number and length of glandular tubules in piglet colons were the pit and isthmus-$75.3{\pm}11.1%$, $78.8{\pm}12.3%$; gland-$24.7{\pm}5.4%$, $21.2{\pm}5.3%$, respectively. 5. The length and cell number of single side wall of glandular tubules in cecal sections were 1-day-old piglets-$190.3{\pm}31.1{\mu}m$, $37.6{\pm}4.8$; 10-day-old piglets-$235.6{\pm}25.3{\mu}m$, $46.2{\pm}3.6$; 20-day-old piglets-$295.3{\pm}45.6{\mu}m$, $52.0{\pm}6.2$; 35-day-old piglets-$351.3{\pm}28.3{\mu}m$, $60.4{\pm}8.5$; 45-day-old piglets-$366.3{\pm}48.5{\mu}m$, $64.7{\pm}8.2$, respectively, and the regression equation between age and these two data were $\hat{Y}=4.11X+196.6$ and $\hat{Y}=0.60X+38.9$, respectively.

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A Clinical Analysis of Neonatal Surgical Gastrointestinal Diseases in Daegu·Busan Area (대구·부산 지역에서 수술을 요하는 신생아 소화기 질환의 임상적 고찰)

  • Son, Seung Kook;Park, Jae Hong;Choi, Byung Ho;Choi, Kwang Hae;Lee, Kyoung Hoon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.2
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    • pp.179-185
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    • 2004
  • Purpose: Perinatal mortality rates have been used as a summary statistic for evaluating child health and medical status. Neonatal mortality rates have decreased over the past 30 years in Korea. To understand the current status of neonatal surgical gastrointestinal diseases in Daegu Busan area, we have studied about neonatal gastrointestinal diseases with their clinical features, postoperative outcome, and mortality rates. Methods: A clinical analysis on 202 neonates who underwent neonatal surgery from January 1996 to July 2003 at Pusan National University, Kyungpook National University, Youngnam University, and Daegu Catholic University was carried out. Results: The main diseases of surgical conditions were anorectal malformation (23.8%), atresia/stenosis of midgut (13.4%) and pyloric stenosis (13.4%). The male to female ratio was 2.8 : 1. Thirty-five cases (17.0%) had one or more associated anomalies including congenital heart disease, cryptoorchidism, hydronephrosis, and chromosomal anomaly. Twenty cases (10.0%) were diagnosed by antenatal ultrasound. Patients with esophageal atresia had the longest hospitalization for 54.6 days. Postoperative complications occurred in 18 cases (8.9%). The main postoperative complications were wound infection (3.5%) and anastomotic leakage (2.5%). Overall mortality was 5.9%. Diaphragmatic hernia showed the highest mortality rate (37.5%), and esophageal atresia (28.6%) and omphalocele (20.0%) were followed. Conclusion: The current status of neonatal surgical gastrointestinal diseases in Daegu Busan area has improved because the disease categories are various, postoperative complications and mortality rates are decreased.

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결장루형성술 환자 간호를 위한 일 연구

  • 모경빈
    • Journal of Korean Academy of Nursing
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    • v.1 no.1
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    • pp.27-43
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    • 1970
  • This study is designed to find out proper nursing activities for the needs of the colostomy patients, i.e., mental and psychological as well as physical needs for rapid recovery, and to help them build up the follow-up care for proper social adjustment. The study is based on 268 cases out of 381 colostomy patient's records kept in Ewha Womans University Hospital, Yonsei Medical Center, and National Medical Center in between the period from Jan. 1953 to Jan. 1970. The items of study are mainly on etiology, sex, age, duration of hospitalization, mortality rate, seasonal frequency, time from the onset of illness to the admission of the hospital, signs and symptoms. 1. Frequency of onset by etiology: Neoplastic disease 112 cases (42%), Inflammatory disease 33 cases (12%), Congenital malformation 30 cases (11%), Intussusception 25 cases (9.3%), Trauma 24 cases (9%), Volvulus 17 cases (6.3%), and Crohn's disease 6 cases (2.2%). 2. By sex: male 167 cases (62.9%), and female 101 cases (37.1%). So the ratio of portion of male and female 2:1. 3. By age: under 1·year·old 27 cases (10.1%) highest, 41-50 yrs 54 cases (20.2%), 51-60 yrs 42 cases (15.5%), above 71 yrs 5 cases (1.9%). 4. Duration of hospitalization: the shortest is 2-days and the longest is 470 days. 1-20-days 52%, 40-60 days 14%. 5. Mortality rate: Under the 10-days-admission 19.5%, and the beyond 30-days-admission 3.9%. 6. Seasonal frequency: Higher in summer (32% ). 7. Signs and symptoms: abdominal pain (56%), abdominal distention (54%), vomiting (40%), bloody mucoid diarrhea (38%) , pain of anal region (18%), abdominal tenderness, anorexia, indigestion, constipation, disuria, tenesmus, high fever and chilling sensation, bile tingled vomiting. Nursing activities for the patient's physical needs are as follows: Skin care for colostomy region, Prevention of colostomy constriction and depression, Removal of an offensive odor, The use of colostomy bag-selection for, and demonstration of the use of inexpensive colostomy irrigation equipment, Personal hygiene, general skin care, care of hair, finger nails and toe-nails, Oral hygiene, sleep and rest, aquate, Daily activities, etc. Measures for regulation of bowl movement. Keeping the instruction of taking food, Preparing the meal and help for anorexia, Constipation and it's solution, Prevention of diarrhea, helping the removal of mucous, and stretch constricted steam as needed. Nursing activities for pt's socio-psychological needs are as follows; Help the patient to make decision for the operation, Remove pt's anxiety toward operation and anesthesia, To meet the pt's spiritual needs at his death bed, Help to establish family and friends cooperation, Help to reduce anxiety at the time of admission and it's solution, Help to meet religious need, Help to remove pt's anxiety for loosing his job and family maintenance, Follow-up studies for 7 cases have been done to implement the present thesis. The items of the personal interviews with the patients are as follows: Acceptability for artificial anus, The most anxious thing they had in mind at the time of discharge, The most anxious thing they hat·e in mind at present, Their friends and family's attitudes toward the patient after operation, Relations with other colostomy patients, Emotional damage from the operation, Physical problem of enema, irrigation, Control of diet, Skin care, Control of offensive odor, Patient's suggestions to nurses during hospital stay and after discharge. In conclusion, the follow-up care for colostomy patients shares equal weight or perhaps more than the post-operative care. The follow-up care should include the spiritual care for moral support of the patient, to drag him out of isolation and estrangement, and make him fully participate in social activities. It is suggested that the following measures would help to rehabilitate the colostomy patients (1) mutual acquaintance with other colostomy patients if possible form a sort of club for the colostomy patient to exchange their experiences in care (2) through the team work of doctor, nurse and rehabilitation specialists, to have a sort of concerted effort for betterment of the patient.

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A Study on Shaker's Free Design from Fashion (유행(流行)으로부터 자유로운 세이커(Shaker) 디자인에 대한 고찰)

  • Choi, Sung-Woon;Huh, Jin
    • Archives of design research
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    • v.20 no.3 s.71
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    • pp.279-288
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    • 2007
  • Today, design is not free from fashion, which emerges and vanishes temporarily, and aims at equalization. As a result, products quickly become obsolete because of fashion. This means that the span of products is determined by a social concept, which is not clarified, regardless of their functions. Usable products will gradually disappear from us and it will cause serious environmental problems, unless we can find out measures against fashion. As such, it is important to study the characteristics of the shaker's design in this circumstance. The Shaker's community has a distinguishable difference from other general societies. Temporary fashion and misled information cannot interfere with their consciousness. Religion, the life and the principle of design have developed on the same level in their community. Especially, any decoration or the difference of materials is not allowed in shaker's design. It reflects their thinking that all people are equal in the sight of God. Therefore, any decoration for social and economical superiority can not be used. Through this consciousness, they can be free from fashion or decoration. They, also, believe that they can reach perfection through practicality and simplicity. The reason why shaker's design is not disturbed by fashion is that their belief is involved in their design. Consequently, if religious or conscious contents are primarily set up, design can be free from fashion and products can be used for a long time.

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