• 제목/요약/키워드: 경구 요법

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Concurrent Chemoradiation for Unresectable Pancreatic Cancer (절제 불가능한 췌장암의 동시항암화학방사선요법)

  • Kim, Yong-Bae;Seong, Jin-Sil;Song, Si-Young;Park, Seung-Woo;Suh, Chang-Ok
    • Radiation Oncology Journal
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    • v.20 no.4
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    • pp.328-333
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    • 2002
  • Purpose : To analyze the treatment results of concurrent chemoradiation with oral 5-FU plus Gemcitabine or Paclitaxel for unresectable pancreatic cancer. Materials & Methods : The patients, who were diagnosed by imaging modalities or by explo-laparotomy, were treated with concurrent chemoradiation. Radiotherapy was delivered to primary tumor and regional lymph nodes, and the total dose was 45 Gy. Patients received Gemcitabine $1,000\;mg/m^2$ or Paclitaxel $50\;mg/m^2$ weekly and oral 5-FU daily The total number of cycles of chemotherapy ranged from 1 to 39 (median, 11 cycles). The follow-up period ranged from 6 to 36 months, Survival was analyzed using the Kaplan-Meier method. Results : Fifty-four patients between Jan. 1999 to Nov. 2001 were included in this study. Forty-two patients who completed the planned treatment were included in this analysis. The patients' age ranged from 37 to 73 years (median, 50 years) and the male to female ratio was 30:12. Treatment was interrupted for 12 patients due to: disease progression for 6 $(50\%)$, poor performance status for 4 $(33.3\%)$, intercurrent disease for 1 $(8.3\%)$, and refusal for 1 $(8.3\%)$. Response evaluation was possible for 40 patients. One patient gained complete remission and 24 patients gained partial remission, hence the response rate was $59\%$. The survival rates were $46.7\%\;and\;17.0\%$ at 1 year and 2 years, respectively with a median survival time of 12 months. Patients treated with Paclitaxel showed superior outcomes compared to those patients treated with Gemcitabine, in terms of both response rate and survival rate although this difference was not statistically significant. Grade III or IV hematologic toxicity was shown in 8 patients $(19\%)$, while grade III or IV non-hematologic toxicity was shown in 5 patients $(12\%)$. Conclusion : Concurrent chemoradiation with oral 5-FU and Gemcitabine or Paclitaxel improves both the response rate and survival rate in patients with unresectable pancreatic cancer. A prospective study should be investigated in order to improve both the patient selection and the treatment outcome as well as to reduce the toxicity.

Impact of Postoperative Oral Administration of UFT for Completely Resected pT2N0 Non-Small Cell Lung Cancer (완전 절제된 비소세포폐암 병기 IB (pT2N0) 환자에서 수술 후 UFT의 효과)

  • Lee, Jin-Gu;Park, In-Kyu;Kim, Dae-Joon;Kim, Kil-Dong;Cho, Sang-Ho;Chung, Kyung-Young
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.428-434
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    • 2007
  • Background: Recent studies have suggested that UFT may be an effective adjuvant therapy for completely resected IB (pT2N0) non-small cell lung cancer (NSCLC). We designed this study to clarify the feasibility of performing adjuvant chemotherapy with UFT for completely resected IB nor-small cell lung cancer, Material and Method: We randomly assigned patients suffering with completely resected IB non-small cell lung cancer to receive either UFT 3g for 2 year or they received no treatment. All patients had to be followed until death or the cut-off date (December 31 2006). Result: From June 2002 through December 2004, 64 patients were enrolled. Thirty five patients were assigned to receive UFT (the UFT group) and 29 patients were assigned to observation (the control group). A follow-up surrey on the 3 year survival rate was successfully completed for all the patients. The median follow-up time for all the patients was 32.8 months. In the UFT group, the median time of administration was 98 weeks (range: $2{\sim}129$ weeks). The rate of compliance was 88.2% at 6 months, 87.5% at 12 months, 80.6% at 18 month and 66.7% at 24 months. Seven recurrences (24.1%) occurred in the control group and six (17.1%) occurred in the UFT group (p=0,489). The three-year disease free survival rate was 71.3% for the control group and 82.0% for the UFT group (p=0.331). On the subgroup analysis, the three-year disease free survival rate for the patients with adenocacinoma was 45.0% for the control group and 75.2% for the UFT group (p=0.121). The three-year disease free survival rate for the patients with non-adenocarcinoma was 88.1% for the control group and 88.9% for the UFT group (p=0.964), Conclusion: Postoperative oral administration of UFT was well-tolerated. Adjuvant chemotherapy with UFT for completely resected pT2N0 adenocarcinoma of the lung could be expected to improve the disease free survival, but this failed to achieve statistical significance. A prospective randomized study for a large number of patients will be necessary.

DENTAL MANAGEMENT OF A PATIENT WITH MOYAMOYA DISEASE UNDER GENERAL ANESTHESIA (모야모야병(moyamoya disease) 환자의 전신마취 하 치과 치료)

  • Sang, Eun Jung;Song, Ji-Soo;Shin, Teo Jeon;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Hyun, Hong-Keun
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.13 no.2
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    • pp.108-113
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    • 2017
  • Moyamoya disease is a disorder in which certain arteries in the brain are constricted. Blood flow can be blocked by the constriction and blood clots. The patients frequently experience transient ischemic attacks (TIA), cerebral hemorrhage, or may not experience any symptoms at all. It is reported that they have a higher risk of recurrent stroke and a distinct underlying pathophysiology. A 3-year-8-month old boy with moyamoya disease experienced cerebral infarctions five times, and he underwent a cerebrovascular anastomosis surgery four years ago. He showed swallow disturbance, general delayed development, hemiplegia, and strabismus. Also he had hypocalcified teeth with or without multiple caries lesions in all dentitions. Dental treatment under general anesthesia using sevoflurane was performed due to his lack of cooperation. Moyamoya disease is associated with various medical conditions requiring a thoughtful deliberation and a careful examination before and during dental treatment. Pain and anxiety control during dental treatment is important because hyperventilation induced by crying has been seen to trigger TIA. Both isoflurane and sevoflurane are commonly used in patients with MMD, but dynamic autoregulation is better preserved during sevoflurane than isoflurane anesthesia. So sevoflurance general anesthesia may be recommendable to manage dental patients having multiple caries with moyamoya disease.

The Efficacy and Safety of High Dose Amino Acid Administration to Preterm Infants in the Early Neonatal Period (미숙아의 출생초기에 고용량 아미노산 투여의 유효성 및 안전성 평가)

  • Yoon, Ji-Hye;Park, Hyo-Jung;Han, Chae-Won;Chang, Hyo-In;Chung, Seon-Young;In, Yong-Won;Lee, Young-Mi;Sohn, Kie-Ho
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.4
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    • pp.316-323
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    • 2012
  • 미숙아는 단백질 대사 속도가 빠르기 때문에 성장이 충분히 이루어질 수 있도록 ASPEN 가이드라인에서는 아미노산 초기용량을 1-2 g/kg/day로 투여하도록 권장하고 있다. 또한 최근 여러 연구에서 출생초기 고용량 (1.5-4 g/kg/day) 아미노산 투여에 대해 보고하고 있다. 이를 근거로 하여 삼성서울병원 신생아 중환자실에서도 2009년 6월부터 아미노산 초기용량을 0.5 g/kg/day에서 1.5~2 g/kg/day으로 증량하여 투여하고 있다. 본 연구에서는 신생아 중환자실에서 정맥영양요법을 받은 미숙아를 대상으로 고용량 아미노산 공급 효과를 평가하고자 하였다. 2009년 6월 기준으로 출생 후 48시간 이내에 0.5 g/kg/day로 아미노산을 투여 받은 저용량 환아군(38명: 대조군)과 1.5~2 g/kg/day로 투여 받은 고용량 환아군(38명: 시험군)의 전자의무기록을 후향적으로 검토하였다. 고용량 아미노산 공급 효과를 체중증가량 및 총 정맥영양기간, 경구 및 경장 영양 시작 시기, 재원기간으로 평가하였고, 안전성 평가를 위해 혈액화학검사 및 합병증을 조사하였다. 또한 두 군의 인구학적 및 주산기 인자, 영양 공급량 등에 대해 조사하였다. 두 군의 인구학적 및 주산기 인자는 재태기간에서만 차이를 보였으며, 시험군에서 재태기간이 길었다(p < 0.05). 초기 아미노산 용량만이 생후 28일간 일평균 체중증가량에 영향을 미치는 인자였으며 시험군의 일평균 체중증가량이 대조군보다 유의하게 큰 것으로 나타났다($12.6{\pm}4.5$ g/day vs $9.8{\pm}4.5$ g/day, p < 0.05). 목표 체중증가량에 도달한 비율도 시험군이 높았다(65.8% vs 47.4%). 총 공급열량, 총 정맥영양 공급 기간과 경구 및 경장 영양 시작 시기는 두 군간 차이가 없었으나 시험군에서 목표열량 도달시간, 신생아 중환자실 재원기간이 단축되었다(p < 0.05). 혈액화학검사 결과 및 대사성 산증, 호흡곤란증후군, 괴사성장염 발생은 두 군간 차이가 없었으며 고혈당 및 감염, 기관지폐이형증, 뇌실내출혈 발생률은 대조군에서 유의하게 높았다(p < 0.05). 연구 결과, 미숙아에서 출생 초기 고용량 아미노산 공급은 혈액화학검사 이상이나 합병증 없이 체중증가와 재원기간 감소에 효과가 있음을 확인하였다. 따라서 미숙아에 대한 출생초기 영양지원으로 1.5~2 g/kg/day 아미노산 공급은 안전하고 효과적이라고 사료된다.

Effect of Short-Term Feeding of Dietary Fiber Supplements on Glucose Metabolism in Subjects with Non-Insulin-Dependent Diabetes Mellitus (단기간의 식이섬유 첨가물의 섭취가 인슐린 비의존성 당뇨병 환자의 당질대사에 미치는 영향)

  • 이연경;이혜성;김보완
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.25 no.5
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    • pp.846-854
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    • 1996
  • High dietary fiber(DF) diets lower blood glucose and insulin requirements in diabetics. In this study we evaluated the effects of high dietary fiber(DF) food supplements on glucose metabolism in thirty-four subjects with non-insulin-dependent diabetes mellitus(NIDDM). The subjects were divided into three test groups. Each group's prescribed hospital diets were augmented by one of the three following DF supplements for two weeks: Soybean biscuits containing 5g of total DF-the control group(n=15); Biji biscuits containing 20g of total DF-the high insoluble DF group(n=9); and sea tangle biscuits containing 25g of total DF-the high soluble DF group(n=10). The mean daily DF intake of the subjects during the period were: $19.1\pm4.3g$ for the soybean control group; $32.5\pm4.1g$ for the Bijl group; and $38.1\pm5.5g$ for the sea tangle group. The supplementation of the Biji or sea tangle biscuits singnificantly lowered fasting serum glucose levels(p < 0.05) and resulted in the improvement of glucose tolerance. However, the secretions of insulin, C-peptide, and glucagon and Hb $A_{lc}$ concentration were not affected by the high fiber supplementary feeding for two weeks. The urinary excretion of glucose decreased remarkably after the addition of the DF supplements in all three groups(p<0.05). The results indicate that the supplementation of Biji or sea tangle bascuits possesses a beneficial effect on the improvement of glucose metabolism in subjects with NIDDM.

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The Preventive Effect of Angelica gigas Nakai Extract and Green Coffee BeanExtract on Bone Marrow Toxicity Induced by Benzene (Benzene으로 유도한 골수독성에 대한 참당귀 추출물과 커피 생두 추출물의 예방효과 연구)

  • Eun-Bi Lee;Seo-Kyung Lee;Ye-Jin Hwang;Hyun-Woo Kim;Jae-Seon Kang
    • Journal of Life Science
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    • v.34 no.9
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    • pp.620-631
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    • 2024
  • Bone marrow toxicity is a side effect of chemotherapy with anticancer drugs or the exposure to chemicals, such as benzene. When myelotoxicity occurs, the number of white blood cells decreases, which reduces immune functioning and increases the risk of infection or the development of tumors. Angelica gigas Nakai extract (AGNEX) and green coffee bean extract (GCBE) have many effects, such as anti-cancer and antioxidant effects, as well as effects on the immune functioning. In this experiment, the preventive effect of AGNEX and GCBE against benzene-induced bone marrow toxicity was confirmed in Sprague Dawley rats (SD rats) in vivo. Benzene (1 ml/kg mixed with corn oil 1:1) was intraperitoneally administered to SD rats (six weeks, N = 9/group) once a day, and AGNEX (12 mg/kg) and GCBE (6, 12, and 24 mg/kg) were administered orally daily for five weeks. To determine the preventive effect, AGNEX (12 mg/kg) and GCBE (6, 12, and 24 mg/kg) were administered orally before the administration of benzene. Consequently, AGNEX 12 mg/kg and GCBE 12 mg/kg were effective at reducing leukocytes and lymphocytes, specifically granulocyte. Additionally, the treatment also showed protective effects specifically on spleen and liver weight changes and spleen damage. Through this protective effect, AGNEX and GCBE were confirmed to prevent bone marrow toxicity by enhancing the functioning of the immune system.

Case Report : Treatment of Burning mouth Syndrome Using a Removable Anti-Nociceptive Appliance (가철성 유해자극차단장치를 이용한 구강작열감증후군의 치료 증례)

  • Roh, Byung-Yoon;Ahn, Jong-Mo;Yoon, Chang-Lyuk;Ryu, Ji-Won
    • Journal of Oral Medicine and Pain
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    • v.37 no.1
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    • pp.1-7
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    • 2012
  • Burning mouth syndrome(BMS) refers to a chronic orofacial pain disorder usually unaccompanied by mucosal lesions or other clinical signs. Tongue(anterior and lateral border) is found to be the most common site for the burning sensations in the oral cavity, and various oral sites may be affected including hard palate and lips. The etiology of this disorder remains poorly understood, but the various factors might be related with the pathogenesis of the BMS. These factors have been devided into local, systemic and psychological. Recently, there have been increasing reports that the pain of BMS may be neuropathic in origin. The complex and multifactorial etiology of BMS necessitates multidisciplinary approach for the management of these patients. Recently, several studies have reported that oral parafunctional habits could be related the pathogenesis of BMS, and tried to control the symptom of BMS with various methods. We reported the cases who had the symptom of burning mouth syndrome with removable anti-nociceptive appliance in the lower dentition.

Pre-operative Concurrent Chemoradiotherapy for Stage IlIA (N2) Non-Small Cell Lung Cancer (N2 병기 비소세포 폐암의 수술 전 동시화학방사선요법)

  • Lee, Kyu-Chan;Ahn, Yong-Chan;Park, Keunchil;Kim, Kwhan-Mien;Kim, Jhin-Gook;Shim, Young-Mog;Lim, Do-Hoon;Kim, Moon-Kyung;Shin, Kyung-Hwan;Kim, Dae-Yong;Huh, Seung-Jae;Rhee, Chong-Heon;Lee, Kyung-Soo
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.100-107
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    • 1999
  • Purpose: This is to evaluate the acute complication, resection rate, and tumor down-staging after pre-operative concurrent chemoradiotherapy for stage IIIA (N2) non-small cell lung cancer. Materials and Methods Fifteen patients with non-small cell lung cancer were enrolled in this study from May 1997 to June 1998 in Samsung Medical Center. The median age of the patients was 61 (range, 45~67) years and male to female ratio was 12:3. Pathologic types were squamous cell carcinoma (11) and adenocarcinoma (4). Pre-operative clinical tumor stages were cT1 in 2 patients, cT2 in T2, and cT3 in 1 and all were N2. Ten patients were proved to be N2 with mediastinoscopic biopsy and five had clinically evident mediastinal Iymph node metastases on the chest CT scans. Pre-operative radiation therapy field included the primary tumor, the ipsilateral hilum, and the mediastinum. Total radiation dose was 45 Gy over 5 weeks with daily dose of 1.8 Gy. Pre-operative concurrent chemotherapy consisted of two cycles of intravenous cis-Platin (100 mg/m$^{2}$) on day 1 and oral Etoposide (50 mg/m$^{2}$/day) on days 1 through 14 with 4 weeks' interval. Surgery was followed after the pre-operative re-evaluation including chest CT scan in 3 weeks of the completion of the concurrent chemoradiotherapy if there was no evidence of disease progression. Results : Full dose radiation therapy was administered to all the 15 patients. Planned two cycles of chemotherapy was completed in 11 patients and one cycle was given to four. One treatment related death of acute respiratory distress syndrome occurred In 15 days of surgery. Hospital admission was required in three patients including one with radiation pneumonitis and two with neutropenic fever. Hematologic complications and other acute complications including esophagitis were tolerable. Resection rate was 92.3% (12/l3) in 13 patients excluding two patients who refused surgery. Pleural seeding was found in one patient after thoracotomy and tumor resection was not feasible. Post-operative tumor stagings were pT0 in 3 patients, pTl in 6, and pT2 in 3. Lymph node status findings were pN0 in 8 patients, pN1 in 1, and pN2 in 3. Pathologic tumor down-staging was 61.5% (8/13) including complete response in three patients ($23.7%). Tumor stage was unchanged in four patients (30.8%) and progression was in one (7.7%). Conclusions : Pre-operative concurrent chemoradiotherapy for Stage IIIA (N2) non-small cell lung cancer demonstrated satisfactory results with no increased severe acute complications. This treatment shceme deserves more patinet accrual with long-term follow-up.

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The Effect of Steroid Therapy for Idiopathic Unilateral Vocal Cord Palsy (특발성 일측성 성대마비에서 경구 스테로이드 요법의 효과)

  • Bae, Jong-Won;Lee, GilJoon
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.2
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    • pp.107-111
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    • 2019
  • Background and Objectives Idiopathic unilateral vocal fold paralysis (IVFP) is believed to be due to inflammation and edema of the recurrent laryngeal nerve caused by viral diseases such as upper respiratory tract infections. Corticosteroid has a potent anti-inflammatory action which should minimize nerve damage. The purpose of this study was to investigate the effect of oral steroid therapy on IVFP. Materials and Method Study was performed for the IVFP patient from January 2012 to August 2017. Patient's dermography, direction and location of paralyzed vocal cords, history of hypertension, diabetes, cerebrovascular disease, and other underlying disease, smoking history, alcohol consumption and upper respiratory tract infection, and symptoms were investigated. Treatment was divided into three groups: the observation group, low-dose group, and high-dose group, and the recovery rate and time of vocal cord paralysis were analyzed in each group. Results Thirty-seven patients were enrolled in this study. There was no relationship between oral steroid use, dosage and recovery of vocal cord paralysis. Oral steroids showed a rapid recovery of vocal cord paralysis, but there was no statistically significant difference in the time of recovery of vocal palsy with or without steroids (p=0.673). In addition, there was no statistically significant difference in recovery rate between the period to start of treatment, presence of diabetes mellitus, and treatment modality, but the recovery rate was high in the group with upper respiratory tract infection history (p=0.041). Conclusion In IVFP, oral steroid therapy has no significant difference in time and extent of recovery compared to the case of spontaneous recovery.

A Convergence Study on the Effects of Core Nursing Skills Improvement Program on Nursing Skills Competence in Nursing Students (핵심간호술 강화프로그램이 간호학생의 간호술 수행능력에 미치는 효과에 관한 융합연구)

  • Ha, Young-ok;An, Ji-Yoen
    • Journal of the Korea Convergence Society
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    • v.8 no.5
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    • pp.223-231
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    • 2017
  • This convergence study was done to identify the effectiveness of core nursing skills improvement program on nursing skills competence in nursing students. The design of research was one group pretest-posttest and the participants were 158 nursing students. The core nursing skills improvement program was composed of 7 fundamental nursing skills(vital sign, intramuscular injection, oral medication, subcutaneous injection, enema, oxygen therapy and nelaton). The data were collected using self-report questionnaires from January 19 to 23, 2015 and analyzed using paired t-test. The mean score of nursing skills competence in posttest was significantly higher than those in pretest (t=-4.71 ~ -8.00, p<.001). The score for self-confidence(t=-11.61, p<.001) and that for problem solving skills(t=-2.04, p=.043) increased significantly after core nursing skills improvement program. The results indicate that core nursing skills improvement program was effective in improving nursing skills competence.