• Title/Summary/Keyword: Advanced disease

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Fulvestrant 250mg versus Anastrozole 1 mg in the Treatment of Advanced Breast Cancer: a Meta-Analysis of Randomized Controlled Trials

  • Gong, Dan-Dan;Man, Chang-Feng;Xu, Juan;Fan, Yu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2095-2100
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    • 2014
  • Objective: Most patients with advanced breast cancer experience resistance to endocrine treatment and eventual disease progression. This meta-analysis was designed to compare the efficacy and tolerability of fulvestrant 250mg with anastrozole 1mg in postmenopausal women with advanced breast cancer. Methods: Electronic literature databases (Cochrane Library, Medline, and Embase) were searched for randomized controlled trials (RCTs) published prior to August 2013. Only RCTs that compared fulvestrant 250mg to anastrozole 1mg in postmenopausal women with advanced breast cancer were selected. The main outcomes were time to treatment failure (TTF), time to progression (TTP), duration of response (DOR), clinical benefit rate, and tolerability. Results: Four RCTs covering 1,226 patients (fulvestrant, n=621; anastrozole, n=605) were included in the meta-analysis. Fulvestrant increased the DOR compared to anastrozole (HR =1.31, 95% confidence interval [CI] 1.13-1.51). There was no statistically significant difference between fulvestrant and anastrozole in terms of TTF (HR=1.02, 95%CI 0.89-1.17), complete response (RR=1.79, 95%CI, 0.93-3.43), and partial response (RR=0.91, 95%CI 0.69-1.21). As for safety, there was no statistical significance between the two groups for common adverse events. Conclusion: Fulvestrant 250mg is as effective and well-tolerated as anastrozole 1mg treatment for advanced breast cancer in postmenopausal women whose disease progressed after prior endocrine treatment. Thus, fulvestrant may serve as a reasonable alternative to anastrozole when resistance is experienced in breast cancer cases.

Pharmacological potential of ginseng and ginsenosides in nonalcoholic fatty liver disease and nonalcoholic steatohepatitis

  • Young-Su Yi
    • Journal of Ginseng Research
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    • v.48 no.2
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    • pp.122-128
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    • 2024
  • Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease characterized by hepatic fat accumulation, while nonalcoholic steatohepatitis (NASH) is an advanced form of NAFLD characterized by hepatic inflammation, fibrosis, and liver injury, resulting in liver cirrhosis and hepatocellular carcinoma (HCC). Given the evidence that ginseng and its major bioactive components, ginsenosides, have potent anti-adipogenic, anti-inflammatory, anti-oxidative, and anti-fibrogenic effects, the pharmacological effect of ginseng and ginsenosides on NAFLD and NASH is noteworthy. Furthermore, numerous studies have successfully demonstrated the protective effect of ginseng on these diseases, as well as the underlying mechanisms in animal disease models and cells, such as hepatocytes and macrophages. This review discusses recent studies that explore the pharmacological roles of ginseng and ginsenosides in NAFLD and NASH and highlights their potential as agents to prevent and treat NAFLD, NASH, and liver diseases caused by hepatic steatosis and inflammation.

Modified Docetaxel and Cisplatin in Combination with Capecitabine (DCX) as a First-Line Treatment in HER2-Negative Advanced Gastric Cancer

  • Bilici, Ahmet;Selcukbiricik, Fatih;Demir, Nazan;Ustaalioglu, Bala Basak Oven;Dikilitas, Mustafa;Yildiz, Ozcan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8661-8666
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    • 2014
  • Background: Docetaxel and cisplatin in combination with fluorouracil (DCF) regimen is accepted to be one of the standard regimens in the treatment of advanced gastric cancer. However, substantial toxicity has limited its use in daily clinical practice. Therefore, modification of DCF regimens, including introduction of capecitabine has been investigated to improve the safety profiles. In the present study, the efficacy and toxicity of a regimen with a modified dose of docetaxel and cisplatin in combination with oral capecitabine (DCX) was evaluated in untreated patients with HER2-negative advanced gastric cancer. Materials and Methods: Fifty-four patients with HER2-negative locally advanced or metastatic gastric cancer were included in this cohort. Patients received docetaxel $60mg/m^2$ plus cisplatin $60mg/m^2$ (day 1) combined with capecitabine $1650mg/m^2$ (days 1-14) every 3 weeks. Treatment response, survival, and toxicity were retrospectively analyzed. Results: The median age was 54 years (range: 24-76). The majority of patients (70%) had metastatic disease, while 11 patients (21%) had recurrent disease and underwent curative gastrectomy, and 5 patients (9%) had locally advanced disease (LAD). The median number of DCX cycles was 4. There were 28 partial responses and 11 complete responses, with an overall response rate of 72%. Curative surgery could be performed in four patients among five with LAD. At the median follow-up of 10 months, the median progression-free survival (PFS) and overall survival (OS) of the entire cohort of patients were 7.4 and 12.1 months, respectively. Dose modification was done in 12 patients due to toxicity in 8 and noncompliance in 4 patients. The most common hematological toxicity was neutropenia, which occurred at grade 3-4 intensity in 10 of 54 patients (27.7%). Febrile neutropenia was diagnosed only in two cases. Conclusions: DCX regimen offers prominent anti-tumor activity and considered to be effective first-line treatment with manageable toxicity for patients with HER2-negative advanced gastric cancer.

Chronic suppuraive osteomyelitis of the mandible caused by periodontal disease;a case report (치주질환으로 인해 유발된 하악의 만성 화농성 골수염의 치험 일례)

  • Lim, Yo-Han;Pyo, Sung-Woon;Han, Eun-Young
    • Journal of Periodontal and Implant Science
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    • v.32 no.4
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    • pp.745-752
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    • 2002
  • Osteomyelitis is an exhaustive disease whose main feature is an inflammation of inner part of bone, bone marrow. In oral and maxillofacial area, we have maxillary and mandibular osteomyelitis and the latter is dominant because of its impaired blood supply. The main cause of osteomyelitis is a bacterial infection and the ways of infections are by periapical odontogenic infection, fracture, post-operative complication, and periodontal disease. The predominant etiologic factor is periapical odontogenic infection mostly caused by advanced dental caries. It is generally believed that periodontal disease could be a cause of osteomyelitis. But periodontal disease is usually confined to the alveolar bone area and not extends to the underlying bone marrow. Accordingly periodontal infection per se rarely cause produce oseomyelitis. Even though osteomyeltis could be occurred by periodontal disease, its virulence of infection is milder than periapical odontogenic infection. So it usually provokes sclerosing or hyperplastic osteomyelitis rather than suppurative type. We had a case of suppurative osteomyelitis caused by periodontal disease and treated it with periodontal and oral and maxillofacial surgical method.

Development of a Clinical Nursing Practice Training Simulation Program using Standardized Patient for Nursing Students Focused on Infectious Respiratory

  • Hur, Jung
    • International Journal of Advanced Culture Technology
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    • v.9 no.4
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    • pp.169-179
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    • 2021
  • This study was conducted to develop and apply clinical nursing practice training simulation program using Standardized Patient for Nursing Students focused on infectious respiratory disease. This study is descriptive methodological study. Through prior consideration of documents and educational task of infectious respiratory disease was conducted with interview of clinical specialists of infection control managers. Development of educational task for infectious respiratory disease for Nursing Students went through the content validity. Finally, 10 educational tasks are developed 'knowledge of respiratory infections disease', 'hand washing', 'put on mask', 'lead to put on mask to patients and caregiver', 'intravenous injection via 3way', 'surgical aseptic technique', 'sterilization medical instrument', 'management of contaminated linen', 'infected personnel management manual'. The infectious respiratory disease simulation program was developed based on the ADDIE model and proceeded to 4 steps of analysis, design, development, implementation. The infection control education program included lectures (20 min), skill training (20 min), simulation using standardized patient (20 min), and debriefing (40 min), The collected data were analyzed by descriptive statistics with SPSS program for version 23.0. The results of this study confirmed that the clinical nursing practice training simulation program using standardized patients was effective in infectious respiratory disease of the nursing college students in knowledge of infectious respiratory disease and clinical nursing performance. we found this practical training program for nursing college students to improve knowledge and clinical competency of infection control. we expected that this developed program could be applied to practical training for various infectious control.

Exome and genome sequencing for diagnosing patients with suspected rare genetic disease

  • Go Hun Seo;Hane Lee
    • Journal of Genetic Medicine
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    • v.20 no.2
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    • pp.31-38
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    • 2023
  • Rare diseases, even though defined as fewer than 20,000 in South Korea, with over 8,000 rare Mendelian disorders having been identified, they collectively impact 6-8% of the global population. Many of the rare diseases pose significant challenges to patients, patients' families, and the healthcare system. The diagnostic journey for rare disease patients is often lengthy and arduous, hampered by the genetic diversity and phenotypic complexity of these conditions. With the advent of next-generation sequencing technology and clinical implementation of exome sequencing (ES) and genome sequencing (GS), the diagnostic rate for rare diseases is 25-50% depending on the disease category. It is also allowing more rapid new gene-disease association discovery and equipping us to practice precision medicine by offering tailored medical management plans, early intervention, family planning options. However, a substantial number of patients remain undiagnosed, and it could be due to several factors. Some may not have genetic disorders. Some may have disease-causing variants that are not detectable or interpretable by ES and GS. It's also possible that some patient might have a disease-causing variant in a gene that hasn't yet been linked to a disease. For patients who remain undiagnosed, reanalysis of existing data has shown promises in providing new molecular diagnoses achieved by new gene-disease associations, new variant discovery, and variant reclassification, leading to a 5-10% increase in the diagnostic rate. More advanced approach such as long-read sequencing, transcriptome sequencing and integration of multi-omics data may provide potential values in uncovering elusive genetic causes.

Clinical Practice Guideline for Soyangin Disease of Sasang Constitutional Medicine: Yin-Depletion (Mangeum) Symptomatology (소양인체질병증 임상진료지침: 망음병)

  • Shin, Mi-Ran;Joo, Jong-Cheon;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.26 no.3
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    • pp.251-261
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    • 2014
  • Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Soyangin Disease of Sasang Constitutional Medicine(SCM): Yin-Depletion (Mangeum) Symptomatology. The CPG was developed by the national-wide experts committee consisting of SCM professors. Methods The CPG was developed by the national-wide experts committee considering of the society of Sasang Constitutional Medicine. It was performed by search and collection of literature related SCM, opinion of SCM experts and journal search and it was followed by CPG's guideline. Results & Conclusions The CPG of Yin-Depletion (Mangeum) Symptomatology in Soyangin Disease include classification, definition and standard symptoms of each pattern. Yin-Depletion (Mangeum) Symptomatology is classified into severe and critical pattern by severity. The severe pattern of Yin-Depletion (Mangeum) Symptomatology is classified into the pattern of Heat-related diarrhea accompanied by headache (Sinyeol-dutong Mangeum) and the advanced pattern of Heat-related diarrhea accompanied by headache (Sinyeol-dutong Mangeum). The critical pattern of Yin-Depletion (Mangeum) Symptomatology is classified into the pattern of Cold-related diarrhea accompanied by the abdominal pain (Sinhan-bocktong Mangeum) and the advanced pattern of Cold-related diarrhea accompanied by abdominal pain (Sinhan-bocktong Mangeum).

Palliative Treatment with Celestin`s tube in Advanced Esophageal Cancer (진행성 식도암의 Celestin`s tube 를 이용한 고식적 치료)

  • 백광제
    • Journal of Chest Surgery
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    • v.18 no.3
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    • pp.529-533
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    • 1985
  • Though esophageal cancer was not a common disease, early metastasis and direct extension to adjacent organ were important on the treatment of disease. Therefore, palliative operation was often useful in advanced esophageal cancer. Between June 1985 through July 1985, we treated three cases of inoperable esophageal cancer with Celestin`s endo-esophageal tube by esophageal intubation. Three operations were done under general anesthesia. Celestin`s tube were inserted via oral cavity and additional traction on stomach were applied. After complete insertion of tube was done, the distal end of Celestin`s tube was modified in length. Also stay suture was applied between tube and stomach wall was applied. Postoperative esophagogram revealed good esophageal patency through Celestin`s tube. Clinically, swallowing difficulty was much improved after operation.

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Extraordinary radiation super-sensitivity accompanying with sorafenib combination therapy: what lies beneath?

  • Lee, Jayoung;Lee, Ju Hye;Yoon, Hanbin;Lee, Ho Jeong;Jeon, Hosang;Nam, Jiho
    • Radiation Oncology Journal
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    • v.35 no.2
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    • pp.185-188
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    • 2017
  • Primary liver tumor, especially hepatocellular carcinoma (HCC), is a common cause of cancer death worldwide. The incidence is generally higher in Asian countries than in western countries. Carcinogenesis of HCC is often associated with hepatitis viral infections. Current standard treatment of HCC is surgical resection or transplantation in patients with early stage disease. However, the patient with advanced stage disease, surgical resection is often limited. Sorafenib or other treatment modalities are not so effective as well. We report a case of unusual radiation super-sensitivity in advanced stage HCC, and review the literature.

Considerations during dental implant treatment for patients under bisphosphonate therapy (Bisphosphonate를 복용하는 환자에게 임프란트 치료시 고려사항)

  • Park, Won-Se;Chung, Won-Yoon;Kim, Hyung-Jun;Kim, Kee-Deog
    • The Journal of the Korean dental association
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    • v.49 no.7
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    • pp.389-397
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    • 2011
  • Bisphosphonate inhibits the function of osteoclast, so they are widely used for multiple myeloma, Paget's disease, metastatic malignant bone disease, and severe osteoporosis. This drug is very effective for preventing severe complication of osteoporosis, some unpredictable complication occurred such as esophageal malignancy, atypical fracture of femur, and osteonecrosis of the jaw. Bisphosphonate related osteonecrosis of the jaw (BRONJ) is closely related with invasive, open bone surgery like tooth extraction. BRONJ associated with dental implant is rare, however, as the use of bisphosphonate increase, BRONJ cases with dental implant are increasing. In this article, we will describe the considerations during dental implant treatment for patient under bisphosphonate therapy.