Purpose: The best treatment for advanced esophageal cancer is chemoradiotherapy followed by surgery. In spite of the advance of multimodality therapy, most patients with esophageal cancer are treated with radiation therapy alone. This study reports the outcome of the use of conventional external beam radiotherapy alone for the treatment of esophageal cancer. Materials and Methods: Between January 1998 and December 2005, 30 patients with squamous cell carcinoma of the esophagus were treated with external beam radiotherapy using a total dose exceeding 40 Gy. Radiotherapy was delivered with a total dose of 44-60 Gy(median dose, 57.2 Gy) over $36{\sim}115$ days(median time, 45 days). Thirteen patients(43.3%) had a history of disorders such as diabetes, hypertension, tuberculosis, lye stricture, asthma, cerebral infarct, and cancers. Four patients metachronously had double primary cancers. The most common location of a tumor was the mid-thoracic portion of the esophagus(56.7%). Tumor lengths ranged from 2 cm to 11 cm, with a median length of 6 cm. For AJCC staging, stage III was the most common (63.3%). Five patients had metastases at diagnosis. Results: The median overall survival was 8.3 months. The survival rates at 1-year and 2-years were 33.3% and 18.7%, respectively. The complete response rate $1{\sim}3$ months after radiotherapy was 20%(6/30) and the partial response rate was 70%(21/30). Sixteen patients(53.3%) had an improved symptom of dysphagia. Significant prognostic factors were age, tumor length, stage, degree of dysphagia at the time of diagnosis and tumor response. Cox regression analysis revealed the aim of treatment, clinical tumor response and tumor length as independent prognostic factors for overall survival. Twenty-eight patients had local failure and another four patients had metastases. Three patients were detected with double primary cancers in this analysis. A complication of esophageal stricture was observed in three patients(10%), and radiation pneumonitis occurred in two patients(6.7%). Conclusion: The prognosis of esophageal cancer remains poor, in spite of advances in radiotherapy techniques. Radiotherapy is one of the main treatment modalities for the relief of dysphagia and treatment related complications are minimal. It is expected that the addition of chemotherapy or another systemic modality to radiotherapy will improve tumor control and increase the survival rate in advanced esophageal cancer.
Kim, Yeung-Jin;Chun, Churl-Hong;Lee, Ji-Wan;Choo, Ji-Woong
Journal of Korean Orthopaedic Sports Medicine
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v.9
no.1
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pp.7-15
/
2010
Anterior knee pain syndrome would best be defined as a painful condition that arises in or around the patellofemoral joint and is insidious in onset and bilateral, with an enigmatic entity with multiple causes. Although its etiology is uncertain, the cause is often considered to be abnormal lower limb biomechanics, pathology of extensor mechanism, disorder of patellofemoral joint, malalignment or lateral tracking of the patella, soft tissue tightness, muscle weakness. The measurement of patellar alignment has come to be accepted as an integral part of the examination of anterior knee pain syndrome. Various measurement techniques exist, both clinical and radiological, and these have been frequently used in the diagnosis and treatment of the condition.?Treatment depends on the underlying cause of anterior knee pain and should be directed to the cause rather than to the results. Most often, this involves non-surgical measures, such as anti-inflammatory medications, quadriceps exercises, and hamstring stretching. Shin splint, or medial tibial stress syndrome refers a syndrome of pain running along the inner distal 2/3 of tibia shaft. Shin splint is a common problem for athletes whose sport involves a repeated, jarring impact to the leg. A major factor determining the efficacy of the treatment is that correct diagnosis be made of the problem. The varied etiology has led to the development of several theories as to the cause, treatment, rehabilitation and prevention of shin splint. The management is rest, ice massages, pain relief by medication, and muscle strengthening exercise. Proper rehabilitation and preventative measures can ensure that there is no further recurrence.
Journal of the Korea Academia-Industrial cooperation Society
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v.16
no.1
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pp.490-497
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2015
The aim of this study was to examine the quality of life (QOL) and its related factors in veterans with physical dysfunction. The survey data was collected from 412 patients with physical dysfunction managed at five veterans' hospitals in Seoul, Pusan, Daegu, Gwangju, and Daejeon city. The baseline for the quality of life was measured using the SF-36 (Short-Form 36), activities of daily living was measured using a Modified Barthel Index (MBI), pain level was determined using Quadruple Visual Analogue Scale (QVAS), and the depression level was assessed using Korean version of the Geriatric Depression Scale: Short-Form (SGDS-K). The SF-36 scores showed a significant correlation with age (r=-0.132), self-rated current health status (r=-0.545), active daily living (r=0.514), pain level (r=-0.243), and depression level (r=-0.565) (p<0.05). The most influential variables on the QOL were the depression level (B=-.969, p<0.001), QVAS (B=-0.163, p<0.001), and MBI (B=0.140, p<0.001). The results of this study showed that that depression, pain and activities of daily living are significant predictors of the QOL in veterans with a physical dysfunction. Therefore, healthcare providers need to consider these parameters for interventions to improve the QOL in veterans with a physical dysfunction.
Pain is one of the most common and painful symptoms that cancer patients suffer from. Pain seriously affects 30-50% of the patients at the early cancer diagnosis stage or who receive active anticancer treatments, 60-70% of the patients with progressive cancer, and 80-90% of the patients at the late stage of cancer. However, there is no systematic and easy pain control program for the cancer patients. In this study, an algorithm is proposed to provide quick pain relief service upon the occurrence of sudden pain, for the purpose of controlling the sudden pain that cancer operation survivors experience. In developing the algorithm, questionnaires, evaluation forms and National Comprehensive Cancer Network (NCCN) guideline were considered, and a trial service was provided to a group of 20 cancer patients for a month to evaluate the designed algorithm. The results of the trial service were examined by expert medical workers to evaluate the proposed algorithm, and a 90% compatibility decision was derived, which verified the effectiveness of the proposed algorithm. In the case of incompatibility decision, the management of the pain diary did not have compatible results. Therefore, the further study will additionally address the customized pain diary algorithm.
This study was intended to evaluate the anti-atopic effect of Sargassum fulvellum water extract (SFWE). Atopic dermatitis (AD) was induced in BALB/c mice by spreading 2,4-dinitrochlorobenzene (DNCB) to the dorsal skin area. The production of IL-4 and total IgE of the SFWE treated group was significantly less than the DNCB only group. On the other hand, the production of the IFN-γ of SFWE treated group was greater than that of the DNCB only group. In addition, SFWE alleviated the AD symptoms when compared to the DNCB only group and reduced the epidermal thickness and the number of mast cells in histological analysis. In conclusion, these results suggest that the application of SFWE has an anti-atopic activity through the modulation of IL-4 and IFN-γ cytokines, and the total IgE in DNCB-induced BALB/c mice. Therefore, SFWE can be utilized with atopic disease therapies.
Ha, Su jeong;Song, Si yeon;Park, So-jung;Jeon, Hyung-joon;Lee, Yeon-weol;Cho, Chong-kwan;Yoo, Hwa-seung
Journal of Korean Traditional Oncology
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v.23
no.1
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pp.23-32
/
2018
Objective: The purpose of this study is to report the case of a patient with non-small cell lung adenocarcinoma (NSCLC) with anaplastic lymphoma kinase (ALK) mutation treated by Samchilchoongcho-Jung in conjunction with Crizotinib. Methods: An NSCLC patient diagnosed with multiple pleural and lymph nodes metastasis has been taking Crizotinib (500 mg/day) since January 2014. The patient has been treated with Samchilchoongcho-Jung (1,500 mg/day) since June 2014. The tumor size was measured by computed tomography (CT) and laboratory analysis was conducted. Adverse events were evaluated by the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0. Results: After combining treatment, stable disease was shown on CT. The tumor marker (CEA, Cyfra 21-1) levels were maintained. NCI-CTCAE 5.0 showed no adverse events. Conclusion: This case study suggests that Samchilchoongcho-Jung may contribute to tumor response, in conjunction with Crizotinib on the treatment of patients with NSCLC.
Purpose : The purpose of this study was to describe a total pain model in patients with terminal cancer and to identify factors relating to total pain using the Twycross Pain Management Model, which included physical, psycho-social and spiritual pain. Method : The study was a retrospective descriptive study. The first stage included 87 patients who received hospice service at Y hospital in 1997. The second stage included five model patients who suffer severe pain as selected by the four hospice nurses. Data collection was from 1) chart analysis and 2) in-depth interviews with the hospice nurses about their selected patients. Data analysis was performed using SPSS-WIN and content analysis. Result : 1) The main problems of 3 patient with terminal cancer were pain(77%), constipation (25.3%), family coping(35.6%), psycho-spiritual distress(17.2%)and other symptoms. 2. The Twycross model was a useful model. However, new items were added; loneliness, depression, and no improvement in condition as depression factors. In anger, new items were anger due to family neglect, at God and in relationships. The case studies identified the followsing; 1) Patient suffer from physical pain as well as multiple other symptoms when cancer is advanced. 2) Body concept, role change, threat to self concept, fear of pain, fear of death, anxiety, family conflict, financial burden, spiritual distress, hope for a cure, are all affected. Conclusion : 1) It is believed that the Twycross model is useful but further tests and revisions are necessary for deciding priorities in the care plan. 2) Pain management must improve culturally appropriate and family support, psychological, spiritual care are imperative for patient with terminal cancer. 3) Further study is recommended to test correlations of depression, anxiety, spiritual distress and family coping using valid instruments. A qualitative study on the spiritual journey of the patient with terminal cancer is also recommended.
Codonopsis lanceolata (Campanulaceae) has been widely used in traditional medicine and is considered to have medicinal properties to treat diseases and symptoms such as bronchitis, coughs, spasm, edema, hepatitis, colitis, and lung injury. In order to investigate whether native Codonopsis lanceolata extract alleviates ashmatic symptoms in vivo, we first carried out various antioxidant activities by 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging, ferric reducing antioxidant power (FRAP), and cupric reducing antioxidant capacity (CUPRAC) assays. The antioxidant activities were increased by adding Codonopsis lanceolata extract in a concentration-dependent manner which compared to ascorbic acid as a positive control. Histological studies using an ovalbumin-induced animal model exhibited potent anti-inflammatory potential by decreasing immuno-responsive cells in the lung by the extract by confirming H&E and PAS staining. It is revelaed that further immunihistochemical analysis showed anti-ashmatic capabilities by assessing histamine, IL-31, and MMP-9 expressions. The level of IL-13 expression in Codonopsis lanceolata extract-treated group was decreased upto 73.7% compared to control, whereas that of total cells and eosinophil counting in Codonopsis lanceolata extract-treated group was diminished to 73.5% and 80.9%, respectively. These results collectively indicate that the C. lanceolata extract ameliorates asthmatic symptoms effectively in an ovalbumin-challenged mice model, in that the extract can be used for the development of an anti-asthmatic food ingredient.
For establishing the efficacy against breast cancer occurrence, women's mammographic breast density and hot flush remission related to pre and post-menopausal symptoms were selected as biomarkers. Meta analysis applied the final selection of 40 papers from Medline to assess the efficacy of isoflavone-rich soy or supplements versus placebo under randomized controlled trials. Interestingly, the exposure to the purified isoflavones was more effective than the exposure to the crude extract of soy isoflavones for hot flush suppression. The length and the amount of dosage dependency is the most appropriately suggested to be one year long with 50~100 mg/day of isoflavone-rich soy or supplements. Funnel plots was used to interpret the results, overall effect of isoflavones on breast density in post-menopausal women was revealed to be less effect [effect size: 0.062, 95% confidence interval (CI): 0.005 to 0.12], than that of pre-menopausal women (effect size: 0.101, CI: -0.003 to 0.205). The reason why breast density was found higher among the pre-menopausal than the post-menopausal women is that the phytoestrogens of dietary isoflavones were antagonized against estrogen by the basis of estrogen receptor binding affinity. Overall, the Meta analysis reported that isoflavone had limited influence on breast density by suppressing the expansion by only 2%, while it was more effective to suppressing the hot flush, showing a dramatic decrease of 23%.
Lee, So Jin;Lee, Joon Yong;Choi, Youn Seon;Lee, June Young
Journal of Hospice and Palliative Care
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v.17
no.1
/
pp.18-26
/
2014
Purpose: Anorexia is a common symptom in terminal cancer patients. Some data have suggested a role of visfatin in regulating feeding behavior. We studied the relationship of a serum visfatin level and anorexia in cancer patients provided with hospice care. Methods: After informed consent was obtained, 69 cancer patients over 20 years old at a hospice center were enrolled in the study from July 2009 to July 2010. We characterized patients by age, sex, body mass index, primary cancer site, and Eastern Cooperative Oncology Group (ECOG) performance status, etc. Also, blood tests were performed to measure the level of hemoglobin, white blood cell (WBC), C-reactive protein (CRP), total cholesterol, albumin, lymphocyte count, glucose, blood urea nitrogen (BUN), creatinine, tumor necrosis factor-alpha (TNF-${\alpha}$), interukin-6, leptin and visfatin. Results: The mean age of subjects was 65.5 years old, According to univariate analysis, pulse, ECOG performance scale, opioid use and visfatin level were different between the anorexia and non-anorexic group (P<0.05). The median visfatin level was higher in the anorexia group than the good appetite group (P=0.0323). Serum visfatin concentrations were not related with either body mass index or serum leptin or total cholesterol levels, but it was negatively correlated with serum albumin levels (P=0.0198) and lymphocyte counts (P=0.0013). Conclusion: This study did not identify a novel link between visfatin levels and anorexia in cancer patients at a hospice.
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