• Radiation Oncology Journal
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• v.26 no.4
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• pp.213-221
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• 2008

Purpose: The objective of this retrospective study was to identify predictive factors for the complete pathologic response and tumor downstaging after preoperative concurrent chemoradiotherapy for locally advanced rectal cancer. Materials and Methods: Between the years 2000 and 2008, 39 patients with newly diagnosed rectal cancer without prior evidence of distant metastasis received preoperative concurrent chemoradiotherapy followed by surgery. The median radiation dose was 50.4 Gy (range, $45{\sim}59.4\;Gy$)). Thirty-eight patients received concurrent infusional 5-fluorouracil and leucovorin, while one patient received oral capecitabine twice daily during radiotherapy. Results: A complete pathologic response (CR) was demonstrated in 12 of 39 patients (31%), while T-downstaging was observed in 24 of 39 patients (63%). N-downstaging was observed in 18 of 28 patients (64%), with a positive node in the CT scan or ultrasound. Two patients with clinical negative nodes were observed in surgical specimens. The results from a univariate analysis indicated that the tumor circumferential extent was less than 50% (p=0.031). Moreover, the length of the tumor was less than 5 cm (p=0.004), while the post-treatment carcinoembryonic antigen (CEA) levels were less than or equal to 3.0 ng/mL (p=0.015) and were significantly associated with high pathologic CR rates. The univariate analysis also indicated that the adenocarcinoma (p=0.045) and radiation dose greater than or equal to 50 Gy (p=0.021) were significantly associated with high T-downstaging, while a radiotherapy duration of less than or equal to 42 days (p=0.018) was significantly associated with N-downstaging. The results from the multivariate analysis indicated that the lesser circumferential extent of the tumor (hazard ratio [HR] 0.150; p=0.028) and shorter tumor length (HR, 0.084; p=0.005) independently predicted a higher pathologic CR. The multivariate analysis also indicated that a higher radiation dose was significantly associated with higher T-downstaging (HR, 0.115; p=0.025), while the shorter duration of radiotherapy was significantly associated with higher N-downstaging (HR, 0.028; p=0.010). Conclusion: The circumferential extent of the tumor and its length was a predictor for the pathologic CR, while radiation dose and duration of radiotherapy were predictors for tumor downstaging. Hence, these factors may be used to predict outcomes for patients and to develop further treatment guidelines for high-risk patients.

• Radiation Oncology Journal
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• v.20 no.3
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• pp.206-214
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• 2002

Purpose : The aim of this study was to assess the effectiveness, survival rate and complications of radiation therapy and chemoradiation treatment in hypopharyngeal cancer. Methods and Materials : From January 1984 to December 1999, 56 patients who had hypopharyngeal carcinoma treated with curative radiation therapy were retrospectively studied. Twenty four patients $(42.9\%)$ were treated with radiation therapy alone (Group I) and $32\;(57.1\%)$ treated with a combination of chemotherapy and radiation (Group II). Total radiation dose ranged from 40.5 to 83. 5 Gy (median 67.9 Gy). Radiotherapy was given with conventional technique in 9 patients $(16.4\%)$, with hyperfractionation I ($1.15\~1.2$ Gy/fr., BID) in 26 $(47.2\%)$, hyperfractionation II (1.35 Gy/fr., BID) in 18 $(32.7\%)$, and accelerated fractionation (1.6 Gy/fr., BID) in 2 $(3.6\%)$. In chemotherapy, 5-FU ($1,000\;mg/m^2$ daily for 5 consecutive days) and cisplatin ($100\;mg/m^2$ on day 1) were administered in a cycle of 3 weeks interval, and a total of 1 to 3 cycles (average 2..3 cycles) were given prior to radiation therapy. Follow up duration was $1\~195$ months (median 28 months). Results : Overall 2 and 5 year survival rates were $40.6\%\;and\;27.6\%;\;50.0\%\;and\;30.0\%$ in Group I, and $36.4\%\;and\;26.3\%$ in Group II, respectively. Complete local control rates in Group I and II were $70.0\%\;and\;67.7\%$, respectively. The response to radiotherapy and nodal stage were statistically significant prognostic factors. The complication rate was increased in Group II and was decreased in hyperfractionation. Conclusion : The response to radiotherapy and nodal stage were valid factors to indicate the degree of control over the hypopharyngeal cancer. The induction cisplatin, 5-Fu chemotherapy was not valid in terms of local control rate and survival rate, but did contribute to an increased complication rate. The use of hyperfractionation was valid to reduce the late radiation complications.

• Korean Journal of Head & Neck Oncology
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• v.11 no.2
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• pp.137-144
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• 1995

Malignant lymphoma affecting the larynx is uncommon, probably accounts for less than 1 percent of malignant lesion of the larynx. Malignant lymphoma of the larynx is predominantly localized to supraglottis such as epiglottis, aryepiglottic fold. Laryngoscopy reveals a irregular submucosal mass with a smooth surface and no ulceration. Most of which belongs to non­Hodgkin's lymphoma. After it has been determined that the disease is localized, radiation therapy is the choice of the treatment. Chemotherapy with or without irradiation is reserved for more advanced tumor. Then life-long follow-up is essential. This paper deals with 5 cases malignant lymphoma of the larynx to review our clinical experience and to suggest the optimum treatment in the course of the disease.

• The Journal of Internal Korean Medicine
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• v.30 no.3
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• pp.632-638
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• 2009

The patient was hospitalized for treatment of cerebral infarction (Lt. BG). He was a 61-year-old man who was diagnosed with membranous nephropathy (MN) in 2000. Before admission, he was admitted for treatment for cerebral infarction at another hospital. During that admission, his MN symptoms went from bad to worse, and medication for MN was started (steroid and cyclophosphamide therapy). In our hospital, we started herbal medicine and western medicine combination therapy as well as oriental rehabilitation therapy. Our main herbal medicine was Magsungsinyeom-bang(Moxingshenyanfang). After 5 months, levels of 24 hrs proteinuria, total cholesterol, LDL-cholesterol and triglyceride decreased, levels of serum albumin, total protein increased, and clinical symptoms (lower limb edema, general body weakness) improved.

• The Journal of Internal Korean Medicine
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• v.41 no.4
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• pp.644-657
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• 2020

Objectives: The aim of this study was to systematically evaluate the clinical therapeutic effects and safety of the Zeo lyung tang (ZLT) on primary glomerulonephritis (PGN). Methods: The MEDLINE, EMBASE, PubMed, CENTRAL, CNKI, RISS, NDSL, KISS, and OASIS databases were searched for randomized controlled trials (RCTs) testing the effects of ZLT on PGN. The Cochrane collaboration bias risk assessment scale was used to evaluate the methodological quality of the included studies. RevMan 5.3 software was used for data analysis. Results: Ten RCTs involving 781 patients were included in the review. Compared with conventional Western medicine (WM) therapy alone, a combination treatment of ZLT and WM improved the total effective rate (RR=1.24; 95%CI [1.16, 1.33]; p<0.00001), reduce the blood urea nitrogen (BUN; MD=-1.05; 95%CI [-1.32, -0.78]; p<0.00001) and the 24-hour urinary protein (MD=-0.38; 95%CI [-0.46, -0.29]; p<0.00001). Conclusions: The combination of ZLT with WM has therapeutic effects on PGN, and it has advantages over WM treatment alone in reducing BUN and 24-hour urinary protein. However, due to the low quality of the included studies and the small sample sizes, additional research is needed in this area.

• Journal of Yeungnam Medical Science
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• v.30 no.2
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• pp.109-111
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• 2013

Continuous ambulatory peritoneal dialysis (CAPD) peritonitis is a major complication of peritoneal dialysis (PD) and leads to the discontinuation of PD. Despite its limited pathogenicity, CAPD peritonitis caused by Stenotrophomonas maltophilia (S. maltophilia), an important nosocomial pathogen that is present in nature and is usually associated with plastic indwelling devices. Infection of S. maltophilia is associated with a poor prognosis, including inability to maintain the CAPD catheter, because of its resistance to multiple antibiotics. We report a case of CAPD peritonitis due to S. maltophilia that was treated successfully using oral Trimethoprim-sulfamethoxazole and intraperitoneal Ticarcillin/clavulanate without removing the dialysis catheter.

• Journal of Acupuncture Research
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• v.20 no.1
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• pp.244-253
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• 2003

Objective : Interferon-alpha and Rivabirin are much used at the same time to treat Chronical C viral hepatitis. But interferon caused lots of unexpected side effects, Acupuncture Treatment for them will be an alternative plan. Methods : We first posed questions to a 4 year-old man who ha skin flare, fatigue, itching, insomnia, pronounced a diagnosis based on overall of symptoms and signs and then treated Acupuncture, Moxibustion and Electroacupuncture. We acupunctured a BL17, BL18, BL20 and removed it at once. We electroacupunctured at GV20, Yin tang(Ex-HN3) form 20 minutes, acupunctured at Bi yi(鼻翼, Extra-point), S36, P6. Pizhengge(脾定格) was acupunctured for 10 minutes. Results : The symptoms of fatigue, insomnia, itching are reduced after acupuncture treatments and they made a person keep interferon treatment on. Conclusions : We confirmed that acupuncture treatments make a patient of chronic C viral hepatitis reduce and improve side effects of interferon treatment. We should keep on studying the various and efficient method of acupuncture treatment to improve living quality and treatment efficiency of patients.

• Journal of Society of Preventive Korean Medicine
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• v.28 no.1
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• pp.131-157
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• 2024

목적 : 본 연구는 감기에 대한 한약제제 임상시험을 수행하고 평가하는 데 보편적인 원칙을 제공하는 가이드라인 개발과정 및 내용을 소개하여 가이드라인 활용성 및 접근성을 높이고자 한다. 방법 : 임상시험 가이드라인 개발을 위해 총 9인으로 이루어진 위원회를 구성하고, 전반적인 절차를 수립하였다. 먼저, 가이드라인 집필위원회에서 관련된 국내외 가이드라인을 고찰하고, 감기에 대한 최신 임상시험 논문을 분석하여 초안을 완성하였다. 이후 대한한방내과학회 소속 전문가 자문위원회 검토 및 8인의 전문가로 구성된 협의회 자문을 통해 최종 가이드라인을 도출하였다. 결과 : 본 가이드라인은 (1) 일반적 사항 (2) 유효성 평가 기준 (3) 유효성 평가 방법 (4) 시험 대상자 선정 (5) 임상시험 설계 (6) 안전성 평가 (7) 감기 치료에서의 병용요법 (8) 한의학적 고려 사항의 8가지 범주로 나뉘어진다. 최종 개발된 가이드라인은 한의약임상시험센터 협의회와 대한한방내과학회의 인증을 득하였다. 결론 : 본 가이드라인은 감기 치료를 위한 임상시험을 수행하고 평가하는 데 유용하게 사용될 것이며, 이를 통해 신뢰할 수 있는 결과를 이끌어내고 정확한 해석을 용이하게 할 수 있을 것이라 기대된다. 또한 추후 해당 가이드라인 개정 및 관련된 호흡기질환 가이드라인 개발 과정에 도움을 줄 수 있을 것으로 사료된다.

• Korean Journal of Clinical Pharmacy
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• v.15 no.2
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• pp.165-172
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• 2005

엑세나타이드는 2005년 4월에 미국 FDA로부터 허가된 새로운 계열의 당뇨병치료제로서 적응증은 멧포르민이나 설포닐유레아계열의 당뇨병치료제로서 치료를 받고 있음에도 불구하고 혈당이 목표치로 저하되지 않는 제2형 당뇨병환자에게 기존의 치료법에 부가적으로 사용하는 것으로 제한되어 있다. 엑세나타이드는 39개의 아미노산으로 구성되어 있으며 미국 캘리포니아주에 자생하는 도마뱀의 타액에서 유래된 물질과 조성과 기능이 유사하도록 합성된 펩타이드 약물이다. 이 약물은 혈중포도당의 농도에 의존적으로 인슐린분비를 촉진하며, 비정상적으로 높은 혈중 글루카곤농도를 저하시키며, 음식물의 위통과시간을 연장하며, 식욕을 저하시키는 등의 여러 가지 기전을 통하여 혈당을 조절하는 것으로 알려져 있다. 멧포르민으로 1일 1500 mg을 사용하고 있는데도 불구하고 당화혈색소가 7%를 초과하는 제2형 당뇨병환자 336명을 대상으로 부가적으로 30주간 엑세나타이드 $5{\mu}g$또는 $10{\mu}g$을 1일 2회 피하주사 한 임상시험결과에 의하면, 당화혈색소가 7% 미만인 환자의 비율은 intent-to-treat 로서 각각 27%와 40%로 나타났다. 이는 기존의 치료법과 위약으로 치료받은 군에서의 13%에 비하여 통계적으로 매우 유의성 있는 결과인 것으로 분석되었다(p<0.01). 또 다른 임상시험에서는 상기 임상시험과 유사한 임상시험계획을 바탕으로 하여 설포닐유레아로 치료받고 있었지만 당화혈색소가 7%를 초과하는 제2형 당뇨병환자를 대상으로 임상시험을 실시하였으며, 그 결과에 의하면 엑세나타이드와 설포닐유레아의 병용치료 시 혈당조절에 매우 유리한 것으로 나타났다. 멧포르민과 설포닐유레아의 병용요법으로 치료받고 있던 당뇨병환자를 대상으로 실시한 임상시험에서도 동일한 결과가 나타났다. 이 약의 부작용은 치료개시 후 나타나는 메스꺼움이 문제로 지적되었으며 저 혈당현상은 큰 문제가 되지 않는 것으로 나타났다. 이 약은 인슐린 대용약물이 될 수 없으며 당뇨병성 케토산증의 치료에 사용할 수 없다. 또한 이 약물은 심한 신부전이 있거나 말기신장질환 환자에게 사용해서는 안 된다.

• Radiation Oncology Journal
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• v.8 no.1
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• pp.45-50
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• 1990

One hundred-ten patients with squamous cell carcinoma of the maxillary antrum treated at the Department of Therapeutic Radiology, Seoul National Unviersity Hospital between February 1979 and September 1986 were retrospectively analyzed. Of these, only 73 patients were eligible for analysis. Forty-one patients were treated with combination of surgery and radiation therapy and 32 patients were treated with radiation therapy alone. The majority of patients had advanced stage (including $47\%\;T_4$ tumor). Overall 5 year survival rate was $40.0\%$. In the radiotherapy alone group,5 year survival rate was $22.1\%$, and in the combined surgery and radiotherapy group,5 year survival rate was $65.3\%$. Of 31 patients who had failures,22 patients ($71.0\%$) had local failures, 6 patients ($19.3\%$) had regional failures and 3 patients ($9.7\%$) had distant metastasis. Planned combined treatment with surgery followed by radiation therapy is an effective modality for carcinoma of the maxillary antrum.