• 제목/요약/키워드: Cachexia

검색결과 63건 처리시간 0.026초

중증 심부전 또는 심인성 악액질을 동반한 미숙아및 영아기 동맥관개존증에 대한 수술요법 (Surgical Treatment of Patent Ductus Arteriosus in Preterm and Infants with Severe Heart Failure and Cardiac Cachexia)

  • 이석재
    • Journal of Chest Surgery
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    • 제26권12호
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    • pp.915-919
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    • 1993
  • The management of Patent Ductus Arteriosus[PDA] with heart failure and cardiac cachexia in premature infants have been a disturbing and controversial problem in the field of pediatric cardiovascular surgery.We analysed our experiences to determine the rationale of surgical closure of PDA in infants . During a period of 7 years from January 1986 to December 1992, 12 infants under 2 months of age underwent operations for "hemodynamically significant" PDA which had caused severe heart failure.There were 6 male and 6 female patients. Their mean gestational age was 33.8 weeks and their mean body weight was 1990 g. ranged from 710 g. to 2900 g. Mean age at operation was 28.5days. Seven patients had history of Indomethacin trial. All patients were operated with double ligation technique under general anesthesia.There was no mortality and blood transfusion was not necessary in any patient during the operation.In all cases, we could confirm the complete closure of PDA after operation by follow-up echocardiography.Two patients died during their hospital stay and 1 patient died at 6 months after operation. The causes of death were sepsis with congestive heart failure, necrotizing entero colitis and pneumonia respectively.We can not detect any operation related complication which resulted in permanent sequelae as well as delayed complications related to nerve damage. These results indicate that surgical ligation of PDA in infants with severe heart failure is relatively safe and effective.effective.

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Anorexia-Cachexia Syndrome을 가진 말기 암 환자에서 비타민 C 사용여부에 따른 사이토카인 변화 비교 (Comparison of Serum Cytokines($IL-1{\beta}$, IL-6, and $TNF-{\alpha}$) between Terminal Cancer Patients Treated with Vitamin C and Them without Vitamin C Therapy)

  • 염창환;서상연;조경희;선영규;박용규;이혜리
    • Journal of Hospice and Palliative Care
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    • 제6권1호
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    • pp.51-57
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    • 2003
  • 배경 : Anorexia-cachexia syndrome은 말기 암 환자에서 흔한 증상이며, 암 환자의 주린 사망 원인이 되기도 한다. 이들 증상들은 주로 암 세포 성장과 암세포에서 분비되는 cytokines이 중요한 역할을 한다고 한다. 일부 의사들은 비타민 C가 선택적인 항암 효과를 가지고 있을 뿐만 아니라 여러 가지 말기 암 환자에서 임상 증상을 호전시키는 데 도움이 된다고 보고하였다. 이에 저자 등은 비타민 C가 anorexia-cachexia syndrome을 유발시키는 기전 중의 하나인 사이토카인에 어떤 영향을 주는 지를 알아보고자 한다. 방법 : 2002년 3월 1일부터 2002년 8월 31일까지 국민건강보험공단 일산병원 가정의학과에 입원한 환자 49명을 대상으로 22명은 비타민 C를 1주일동안 지속적으로 10 g을 정맥 주사하였고, 나머지 27명은 비타민 C를 주사하지 않았다. 대상이 된 환자의 비타민 C를 주기 전과 주고 1주일 지난 후의 혈액을 채취하여 cytokine의 변화가 있는 지를 wilcoxon rank sum test를 이용하여 비교분석하였다. 결과 : 대상이 된 총 49명의 환자 중 22명(남자 12명, 여자 10명)이 비타민 C를 사용하였고, 27명(남자18명, 여자 9명)이 비타민 C를 사용하지 않았다. 비타민 C를 사용한 환자에서 $IL-1{\beta}$는 사용 전에는 $6.19{\pm}5.47$이고, 사용 1주일 후에는 $8.76{\pm}5.72$$2.94{\pm}7.29$만큼 증가하였고, IL-6는 사용 전에는 $3.07{\pm}8.09$이고 사용 1주일 후라는 $1.31{\pm}2.36$$-1.57{\pm}7.96$만큼 감소하였으며, $TNF-{\alpha}$는 사용 전에는 $2.74{\pm}14.24$이고 사용 1주일 후에는 $0.50{\pm}2.00$$-4.13{\pm}18.74$만큼 감소하였다. 비타민 C를 사용하지 않은 환자에서는 $IL-1{\beta}$는 사용 전에는 $1.00{\pm}2.19$이고, 사용 1주일 전에는 $17.16{\pm}81.55$$16.50{\pm}81.71$만큼 증가하였고, IL-6는 사용 전에는 $2.50{\pm}3.58$이고, 사용 1주일 후에는 $6.49{\pm}12.01$$4.11{\pm}12.14$만큼 증가하였으며, $TNF-{\alpha}$는 사용 전에는 $1.19{\pm}2.98$이고, 사용 1주일 후에는 $1.27{\pm}1.52$$-0.07{\pm}4.36$만큼 감소하였다. 비타민 C를 사용한 환자와 사용하지 않은 환자에서 사이토카인 변화는 모두 비타민 C를 사용한 환자가 사용하지 않은 환자보다 감소하거나 더 적게 증가하였지만 각각 통계학적인 의미는 없었다($IL-1{\beta}$에서는 P=0.06, IL-6에서는 P=0.166, $TNF-{\alpha}$에서는 P=0.54). 결론 : 비타민 C 사용여부에 따른 cytokines의 변화는 비록 통계학적인 차이는 없지만 비타민 C를 사용한 환자의 cytokines이 모두 사용하지 않은 환자에 비해 감소하였음을 보였다. 비타민 C는 부작용이 거의 없는 안전한 약으로서 말기 암 환자에서 비타민 C사용은 임상 증상을 호전시키는 데 도움이 될 것이라 생각된다.

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Sarcopenia in Cancer Patients

  • Chindapasirt, Jarin
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권18호
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    • pp.8075-8077
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    • 2016
  • Sarcopenia, characterized by a decline of skeletal muscle plus low muscle strength and/or physical performance, has emerged to be an important prognostic factor for advanced cancer patients. It is associated with poor performance status, toxicity from chemotherapy, and shorter time of tumor control. There is limited data about sarcopenia in cancer patients and associated factors. Moreover, the knowledge about the changes of muscle mass during chemotherapy and its impact to response and toxicity to chemotherapy is still lacking. This review aimed to provide understanding about sarcopenia and to emphasize its importance to cancer treatment.

5/6 NTX로 유발된 만성 신부전 랫트에 대한 형방지황탕(荊防地黃湯)의 효과 (Efficacy of Hyeongbangjihwhang-tang on the 5/6 Nephrectomy(NTX) induced Chronic Renal Failure(CRF) Rats)

  • 하진호;최애련
    • 사상체질의학회지
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    • 제25권4호
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    • pp.359-372
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    • 2013
  • Objectives The object of this study was to observe the effects of Hyeongbangjihwhang-tang (HB; Soyangin prescription) on the 5/6 NTX induced CRF rats. Methods Each of Hyeongbangjihwhang-tang aqueous extracts 200mg/kg were orally administered once a day for 35 days from 4 weeks after 5/6 NTX surgery. Four groups, each of 8 rats per group were used in this study, were sham group, CRF group, ${\alpha}$-Tocoperol group and HB group. Changes on the left remnant kidney weights, serum BUN, creatinine levels, caspase-3, PARP immunoreactivities were observed to nephroprotective effects, and relative immunomodulatory effects were monitored based on the changes of lymphatic organ weights and splenic cytokine contents. In addition, the changes on the kidney MDA, GSH contents and SOD, CAT activities were also calculated for antioxidant effects, and the effects on the CRF related cachexia were demonstrated based on the changes of body and epididymal fat pad weights, serum TG, TC, LDL and HDL levels. Results and Conclusions 1) HB was significantly decreased the left remnant kidney weights, serum BUN, creatinine levels and caspase-3, PARP immunoreactivities. 2) HB was significantly increased lymphatic organ weights and splenic cytokine contents. 3) HB was significantly increased body and epididymal fat pad weights, and was significantly decreased serum TG, TC, LDL and HDL levels. 4) HB was significantly decreased MDA contents, and was significantly increased GSH contents and SOD, CAT activities. The results obtained in this study suggest that HB significantly retarded immunosuppressions and cachexia related to the 5/6 NTX induced CRF through modulations of oxidative defense systems. Especially HB showed the highest favorable effects more than those of ${\alpha}$-tocoperol.

Can Megestrol Acetate Induce Thrombosis in Advanced Oncology Patients Receiving Chemotherapy?

  • Ordu, Cetin;Pilanci, Kezban Nur;Koksal, Ulkuhan Iner;Okutur, Kerem;Saglam, Sezer;Tecimer, Coskun;Demir, Gokhan
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권23호
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    • pp.10165-10169
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    • 2015
  • Background: Megestrol acetate (MA) is a steroid origin medicine often used for control of cachexia in oncologic palliative care. Thrombosis is a common problem in oncology patients. One question is whether MA can cause thrombosis. This retrospective, registry-based analysis was therefore conducted to assess thrombotic processes in oncology patients using MA concurrent with chemotherapy. Materials and Methods: Data on oncology patients at the metastatic stage using MA were obtained from the archives of our center. Outcomes of patients were evaluated for thromboembolic events (VTEs) during treatment. Results: Ninety-seven oncology patients with a median age of 62 (33-84) years were included. During the median follow-up of 17 months, 58 (59.8%) died leaving 39 (31.2%) still alive. Median overall survival (OS) was 19 months (6-180). Mean time of MA use was 8.69 months(${\pm}3.53$), with a median dose of 160mg (range 160-480mg). Eleven VTEs were detected after MA use, 4 of these in pancreatic cancer cases. The patients with thrombosis non-significantly had worse OS, than those without thrombosis (p=0.106). Conclusions: This trial revealed that the 11.3% of all patients developed thrombosis,who had been treated with MA and chemotherapy concomittantly. There was no statistically significant difference regarding to occurrence of thrombotic process, among the patients receiving different chemotherapy regimens with MA concomittantly. Pancreatic cancer seemed to be related to thrombosis rather than MA use.

항암치료 후 발생한 식욕부진, 오심에 대하여 독활지황탕 투여 후 삶의 질 개선 증례 보고 1례 (A Cancer Patient Suffering from Chemotherapy-Induced Anorexia and Nausea Treated by Herbal Medicine (Dokhwaljihwang-tang-gamibang) Resulted in Improved Quality of Life: A Case Report)

  • 김은지;김혜진;장승원;김현호;한양희;임정태
    • 대한한방내과학회지
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    • 제39권5호
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    • pp.1032-1041
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    • 2018
  • Despite a considerable improvement in antiemetic chemotherapy and the use of antiemetic prophylaxis for decades, there are still numerous cancer patients suffering from anorexia and nausea after chemotherapy, which forces them to postpone or refuse treatment. This case report is about a 66-year-old female patient diagnosed with malignant lymphoma of the small intestine who underwent right hemicolectomy. After the tumor and the colon adjacent to it were surgically removed, the patient continued to undergo chemotherapy. Chemotherapy-induced anorexia and nausea appeared but were well treated with administration of Dokhwaljihwang-tang-gamibang. During the treatment, no adverse effect related to this Korean medicine was reported. The outcome was evaluated by the functional assessment of anorexia/cachexia therapy (FAACT); the total score increased from 85 to 130 within 12 days, and the symptoms were alleviated. This improvement might suggest the feasibility of Dokhwaljihwang-tang-gamibang to help cancer patients suffering from chemotherapy-induced anorexia and nausea.

Bojungikgi-tang for Anorexia in Lung Cancer Patients with Treated with Chemotherapy: A Single-arm, Open-label, Single-center Trial

  • Im-Hak Cho;Seong-Hoon Yoon;So-Yeon Kim;Byoung-Kab Kang;Chang-Seob Seo;Young-Eun Choi;Hyeun Kyoo Shin;Jun-Yong Choi
    • 대한한의학회지
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    • 제44권4호
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    • pp.26-40
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    • 2023
  • Objectives: This study was to evaluate the effectiveness and safety of Bojungikgi-tang for lung cancer patients with anorexia. Methods: This was a single-arm, open-label, and single-center trial, and suitable participants took Bojungikgi-tang (Buzhongyiqi-tang in Chinese, Hochuekki-to in Japanese) three times a day before or between meals for six weeks (42 days). After registration of clinical trials (visit 2), they visited the hospital every three weeks (visits 3 and 4) and measured or tested the effectiveness or safety evaluation variables to analyze the results. The primary outcome was the anorexia/cachexia subscale (A/CS) of functional assessment of anorexia/cachexia therapy (FAACT) score. Results: Seventeen lung cancer patients were included in the intention-to-treat (ITT) analysis. Lung cancer patients had higher A/CS of FAACT scores after six weeks of Bojungikgi-tang administration compared to that at the baseline. This was not significant four lung cancer (p=0.1668). In the secondary outcomes, the visual analog scale (VAS) score of anorexia decreased significantly (p=0.0009), and the CD4/CD8 ratio (p=0.0396) and CD4 levels (p=0.0345) significantly increased after six weeks of treatment. No serious adverse events were reported with Bojungikgi-tang in lung cancer patients. Conclusions: Bojungikgi-tang can be an effective and safe treatment for anorexia in lung cancer patients undergoing chemotherapy.

The contribution of the nervous system in the cancer progression

  • Hongryeol Park;Chan Hee Lee
    • BMB Reports
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    • 제57권4호
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    • pp.167-175
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    • 2024
  • Cancer progression is driven by genetic mutations, environmental factors, and intricate interactions within the tumor microenvironment (TME). The TME comprises of diverse cell types, such as cancer cells, immune cells, stromal cells, and neuronal cells. These cells mutually influence each other through various factors, including cytokines, vascular perfusion, and matrix stiffness. In the initial or developmental stage of cancer, neurotrophic factors such as nerve growth factor, brain-derived neurotrophic factor, and glial cell line-derived neurotrophic factor are associated with poor prognosis of various cancers by communicating with cancer cells, immune cells, and peripheral nerves within the TME. Over the past decade, research has been conducted to prevent cancer growth by controlling the activation of neurotrophic factors within tumors, exhibiting a novel attemt in cancer treatment with promising results. More recently, research focusing on controlling cancer growth through regulation of the autonomic nervous system, including the sympathetic and parasympathetic nervous systems, has gained significant attention. Sympathetic signaling predominantly promotes tumor progression, while the role of parasympathetic signaling varies among different cancer types. Neurotransmitters released from these signalings can directly or indirectly affect tumor cells or immune cells within the TME. Additionally, sensory nerve significantly promotes cancer progression. In the advanced stage of cancer, cancer-associated cachexia occurs, characterized by tissue wasting and reduced quality of life. This process involves the pathways via brainstem growth and differentiation factor 15-glial cell line-derived neurotrophic factor receptor alpha-like signaling and hypothalamic proopiomelanocortin neurons. Our review highlights the critical role of neurotrophic factors as well as central nervous system on the progression of cancer, offering promising avenues for targeted therapeutic strategies.

Visceral Leishmaniasis Mimicking Autoimmune Hepatitis, Primary Biliary Cirrhosis, and Systemic Lupus Erythematosus Overlap

  • Tunccan, Ozlem Guzel;Tufan, Abdurrahman;Telli, Gulcin;Akyurek, Nalan;Pamukcuoglu, Merve;Yilmaz, Guldal;Hizel, Kenan
    • Parasites, Hosts and Diseases
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    • 제50권2호
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    • pp.133-136
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    • 2012
  • Visceral leishmaniasis (VL) is a life-threatening infection caused by Leishmania species. In addition to typical clinical findings as fever, hepatosplenomegaly, and cachexia, VL is associated with autoimmune phenomena. To date, VL mimicking or exacerbating various autoimmune diseases have been described, including systemic lupus erythematosus (SLE), rheumatoid arthritis, and autoimmune hepatitis (AIH). Herein, we presented a patient with VL who had overlapping clinical features with SLE, AIH, as well as antimitochondrial antibody (AMA-M2) positive primary biliary cirrhosis.

Radiological assessment of pectus excavatum in a Pekingese dog

  • Cho, Sung-Jin;Hong, Sun-Hwa;Chung, Yung-Ho;Kim, Ok-Jin
    • 한국동물위생학회지
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    • 제35권3호
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    • pp.251-254
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    • 2012
  • Pectus excavatum (PE) is a ventral chest wall deformity, also known as funnel chest, sunken chest, chondrosternal depression or koilosternia. The 4 months old, 1.3 kg intact-female Pekingese dog was evaluated for acute semicoma and convulsion. The client reported that this patient have had chronic loss of appetite, intermittent dyspnea and palpable sunken breast. The other littermates did not show any abnormalities. On physical examination, cachexia (BCS 1/5), concave sternum, flatten thoracic cavity and cardiac murmur were observed. On radiographic study, the caudal sternum cave to vertebrae and narrowing thoracic cavity. The severities of thoracic deformity were evaluated by deformation indices such as-Frontosagittal index (FSI) and vertebral index (VI). Moderate to severe PE was founded by the radiological measurements.