Background & Method : Bronchiolitis obliterans organizing pneumonia(BOOP) is a specific clinicopathologic condition characterized by chronic inflammatory interstitial infiltrates. Cryptogenic form of BOOP presents subacute clinical course of flu-like illness, such as cough, fever, dyspnea with exertion and other constitutional symptoms. Pathologically it shows the presence of granulation tissue filling the lumen of terminal and respiratory bronchioles, extending into distal airspaces. Recently, we reviewed 24 cases of idiopathic type of BOOP, 5 cases of our hospital and another 19 cases on Korean literatures, and compared with reviewed data from foreign literatures. Results : Mean age was 54 years old and there was female preponderance in domestic reports. Their common presenting symptoms were dyspnea and cough, and mean duration of illness was 41 days. On chest examination, inspiratory crackle was a common finding. The laboratory findings were nonspecific except hypoxemia. Lung function studies revealed restrictive defect or combined obstructive and restrictive pattern in most patients. Bilateral patchy and nonsegmental alveolar opacities constituted characterized radiographic finding, highlighted on high resolution computed tomogram. It showed a favorable prognosis with an excellent responsiveness to corticosteroid therapy. The clinical features and laboratory findings were similar between domestic and foreign cases except female preponderance in Korean cases. Conclusion : If the clinical course is atypical or pregressive under proper treatment, clinicians should reevaluate clinical features and radiographic findings under the consideration of BOOP. Tissue confirmation would be recommended for the definitive diagnosis of BOOP.
Kim, Da-Hyun;Lee, Seul;Kang, Hyeok Gu;Park, Hyun-Woo;Lee, Han-Woong;Kim, Dongin;Yoem, Dong-Hoon;Ahn, Jin-Hyung;Ha, Eunsin;You, Weon-Kyoo;Lee, Sang Hoon;Kim, Seok-Jun;Chun, Kyung-Hee
BMB Reports
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v.53
no.10
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pp.533-538
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2020
Notch signaling has been identified as a critical pathway in gastric cancer (GC) progression and metastasis, and inhibition of Delta-like ligand 4 (DLL4), a Notch ligand, is suggested as a potent therapeutic approach for GC. Expression of both DLL4 and vascular endothelial growth factor receptor 2 (VEGFR2) was similar in the malignant tissues of GC patients. We focused on vascular endothelial growth factor (VEGF), a known angiogenesis regulator and activator of DLL4. Here, we used ABL001, a DLL4/VEGF bispecific therapeutic antibody, and investigated its therapeutic effect in GC. Treatment with human DLL4 therapeutic antibody (anti-hDLL4) or ABL001 slightly reduced GC cell growth in monolayer culture; however, they significantly inhibited cell growth in 3D-culture, suggesting a reduction in the cancer stem cell population. Treatment with anti-hDLL4 or ABL001 also decreased GC cell migration and invasion. Moreover, the combined treatment of irinotecan with anti-hDLL4 or ABL001 showed synergistic antitumor activity. Both combination treatments further reduced cell growth in 3D-culture as well as cell invasion. Interestingly, the combination treatment of ABL001 with irinotecan synergistically reduced the GC burden in both xenograft and orthotopic mouse models. Collectively, DLL4 inhibition significantly decreased cell motility and stem-like phenotype and the combination treatment of DLL4/VEGF bispecific therapeutic antibody with irinotecan synergistically reduced the GC burden in mouse models. Our data suggest that ABL001 potentially represents a potent agent in GC therapy. Further biochemical and pre-clinical studies are needed for its application in the clinic.
Patients with chronic disease have various treatment patterns because it shows a progressive degenerative feature. Especially various physical and emotional problems of the rheumatoid arthritis patients leave them shopping around various types of treatment. According to previous studies, over 70% of patients with arthritis experienced the traditional oriental medicine or folk remedies simultaneously with medical treatment within one year after the onset of disease. The purposes of this study are 1) to compare the patterns of treatment-seeking behaviors between Korean arthritis patients and Americans ; and 2) test two models of treatment-seeking behaviors by path analysis, one for early treatment-seeking behavior model(ETBM) and the other is chronic treatment-seeking behavior model (CTBM) in Korean sample. The interview survey was performed to 133 RA patients with structured questionnaire at out-patient clinic or public health center. Patients characteristics such as age, duration of disease were similar in two countries except higher educational background in Americans. There were no patients using only alternative therapies or no medical treatment in the US. Most of the American patients have chosen both medical treatment and alternative therapy, while the Koreans less than American. In Korea, combined treatment group usually consists of the people who are younger, more educated and higher economic status than the characters of other groups in early or chronic stages. In early stage, they tend to have strong belief of curing from the disease, satisfy the relationship with their physicians and comply with direction of the medical professional. The paths of two models were explained by 70% in ETBM and 33% in CTBM. When the models were modified, almost all paths of the CTBM were the same as the previous one, but direct determinant factor was changed from the relationship with physicians to the lay referral system in chronic model. These two models' explanation powers became 94% and 88%, respectively. The attitude or perception of disease, lay referral system and the relationship with medical personnel are the main determinants of treatment-seeking behaviors.
Jo, Hyo Sang;Eum, Won Sik;Park, Eun Young;Ko, Je Young;Kim, Do Yeon;Kim, Dae Won;Shin, Min Jea;Son, Ora;Cho, Su Bin;Park, Jung Hwan;Lee, Chi Hern;Yeo, Eun Ji;Yeo, Hyeon Ji;Choi, Yeon Joo;Youn, Jong Kyu;Cho, Sung-Woo;Park, Jinseu;Park, Jong Hoon;Choi, Soo Young
BMB Reports
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v.50
no.9
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pp.460-465
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2017
Polycystic kidney disease (PKD) is one of the most common inherited disorders, involving progressive cyst formation in the kidney that leads to renal failure. FK506 binding protein 12 (FK506BP) is an immunophilin protein that performs multiple functions, including regulation of cell signaling pathways and survival. In this study, we determined the roles of PEP-1-FK506BP on cell proliferation and cyst formation in PKD cells. Purified PEP-1-FK506BP transduced into PKD cells markedly inhibited cell proliferation. Also, PEP-1-FK506BP drastically inhibited the expression levels of p-Akt, p-p70S6K, p-mTOR, and p-ERK in PKD cells. In a 3D-culture system, PEP-1-FK506BP significantly reduced cyst formation. Furthermore, the combined effects of rapamycin and PEP-1-FK506BP on cyst formation were markedly higher than the effects of individual treatments. These results suggest that PEP-1-FK506BP delayed cyst formation and could be a new therapeutic strategy for renal cyst formation in PKD.
Background: Preclinical studies have shown that the combination of an aromatase inhibitor (AI) and capecitabine in estrogen receptor (ER)- positive cell lines enhance antitumor efficacy. This retrospective analysis of a group of patients with metastatic breast cancer (MBC) evaluated the efficacy and safety of combined AI with capecitabine. Materials and Methods: Patients with hormone receptor-positive metastatic breast cancer treated between 1st January 2005 and 31st December 2010 with a combination of capecitabine and AI were evaluated and outcomes were compared with those of women treated with capecitabine in conventional dose or AI as a monotherapy. Results: Of 72 patients evaluated, 31 received the combination treatment, 22 AI and 19 capecitabine. The combination was used in 20 patients as first-line and 11 as second-line treatment. Mean age was 46.2 years with a range of 28-72 years. At the time of progression, 97% had a performance status of <2 and 55% had visceral disease. No significant difference was observed between the three groups according to clinical and pathological features. Mean follow up was 38 months with a range of 16-66 months. The median PFS of first-line treatment was significantly better for the combination (PFS 21 months vs 8.0 months for capecitabine and 15.0 months for AI). For second-line treatment, the PFS was longer in the combination compared with capecitabine and Al groups (18 months vs. 5.0 months vs. 11.0 months, respectively). Median 2 year and 5 year survival did not show any significant differences among combination and monotherapy groups. The most common adverse events for the combination group were grade 1 and 2 hand-for syndrome (69%), grade 1 fatigue (64%) and grade 1 diarrhoea (29%). Three grade 3 hand-foot syndrome events were reported. Conclusions: Combination treatment with capecitabine and AI used as a first line or second line treatment was safe with much lowered toxicity. Prospective randomized clinical trials should evaluate the use of combination therapy in advanced breast cancer to confirm these findings.
The extranodal natural killer/T-cell lymphoma (ENKTL) shows high local or systemic failure rates when radiotherapy (RT) is taken as the primary treatment, suggesting a role for chemotherapy (CT) added to RT for this disease. However, the appropriate mode of combined modality therapy (CMT) has not been fully defined. A total of one hundred and twenty-one patients with ENKTL receiving sandwich CT with RT were reviewed between January 2003 and August 2012. The primary endpoints were the response rate, progression-free survival (PFS), overall survival (OS), and the relapse rate. After the initial CT, there were 84 (69.4%) patients in CR, 22 (18.2%) patients in PR, 9 (7.4%) patients in SD, and 6 (5%) patients in PD, respectively. At the end of RT, the CR, PR, SD, and PD rates for all patients were 90.9% (n=110), 1.7% (n=2), 4.1% (n=5), and 3.3% (n=4), respectively. After a median follow-up of 42.3 months (3.5~112.3 months), the 5-year PFS was 74.7% (95% CI 70.4%~79.0%), and 5-year OS was 77.3% (95% CI 67.9%~86.7%). Disease progression was documented in 25 (20.7%) patients. The rates of systemic failure, local failure, and regional failure were 18.2%, 5.8%, 1.7%, respectively. Twenty death events (16.5%) were observed for the entire group of patients (18 deaths related to PD). Furthermore, CR to the initial CT and low Korean Prognostic Index (KPI) can independently predict long PFS and OS. The sandwich CMT achieved an excellent outcome for localized ENKTL with acceptable toxicity. We recommend it can be applied as the optimal choice for localized ENKTL.
Background: About 3% of all cancer patients suffer from cancer of unknown primary origin. Generally, carcinoma of unknown primary (CUP) carries a grave prognosis, but primary tumor presented to the neck is exception to this. The aims of study are to determine the role of chemotherapy and to find the prognostic factors in unknown primary tumor presented to the neck. Method and Material: Eighty-four patients were diagnosed with unknown primary tumor presented to the neck between January 1996 and June 2002. Among 84 patients, 43 patients (52%) received chemotherapy, radiation or surgery were performed in 20 patients (23%), 21 patients (25%) had no treatment. Results: The response rates to chemotherapy were 87.5% in CUP only localized to the neck and 44.0% in CUP systemically involved (p=0.012). A median follow-up duration was 6.4 years and overall median survival time was 9 months. The median overall survival time of patients treated with chemotherapy were 17 months and that of patients who received surgery or radiation were 20 months (p=0.3548). The important prognostic factors were performance status and the number of involved organ. Conclusion: The prognosis of patients with CUP presented to the neck is more favorable than that of patients with CUP of other localization. The effectiveness of chemotherapy for CUP only localized to the neck was similar to that of surgery or radiation. The important prognostic factors were performance status and the number of involved organ.
The purpose of this study is to find out problems in obesity management through survey and analysis of the actual conditions from the view of a elementary schools school-nurses and to establish fundamental data for efficient obesity management. The subjects for this study were 313 numbers of elementary school-nurses in Kyung-Sang-Pook-Do. The data were collected through mail questionaries from November 1 to November 30, 1997. The major findings in this survey were as follows: 49.8% of the school-nurses who responded in the survey were in their 30s. The average career was 7.3years. The average service duration in their present school was 2.3 years, 55.6% of them were serving at schools which have less than ten classes total 77.2% of them were serving rural areas, 79.6% of them were serving at schools with fewer than 100 obese students. The total obesity prevalence rate was 11.4%, 13.3% were girls, 9.3% were boys. The measurement of height and weight is performed once a year for all surveyed students (91.7%), but obese students were measured as much five times (51.1%). The rate of obesity management planning was 74.1%, however the rates of evaluation and role assignment were 41. 2%, and 24.3%. 79.6% of the surveyed schools have health education classes for obesity, the rate compared (8.0 periods per year) to the whole of health education (79.1 periods per year) is 10.1%. 99.9% of the schools had counseling rooms for obesity (combined with nursing rooms) but they were used. The roote of individual counseling was 84.3%. The frequency counseling was six times a year for about 15 minutes. Obesity counseling records were kept 93.6% of the time and individual information cards were kept 98.7% of the time. The frequency of parents counseling was 42.8% and the survey shows that the main problem here was insufficient counseling facilities. The frequency of dietary guidance and exercise therapy was 84.3% and the dietary instructor was usually the school nurse at 51.7%. The frequency of obesity student exercise was 1-2 times a week and more-than-10-minutes at a time. They skip rope during the morning self-study class. The number on problem of exercise guidance at 56.2% was students' non-cooperativeness. School-nurses, 87.9%, answered that obesity management at school is necessary and 86.9% mentioned the shortage of obesity related information in present physical exercise books. From the plural responses of executing the obesity management, there are many similar problems: lack of knowledge and non-cooperation in parents at 41.9%, is predominant followed by of knowledge and non-cooperation in the children. The third problem is the lack of funds and facilities.
Lee, Ju Young;Moon, Duk-Soo;Shin, Suk-Ho;Yoo, Hee-Jung;Byun, Hee-Jung;Suh, Dong-Soo
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.28
no.4
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pp.213-219
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2017
Objectives: Early intensive interventions are very important for children with autism spectrum disorder. We examined the actual conditions of hospital-based early intensive interventions for autism spectrum disorder in Seoul, in order to help develop and implement an evidence-based early intensive intervention model for use in Korea. Methods: Nine hospital-based institutes running an early intensive intervention program for children with autism spectrum disorder responded to a questionnaire in September 2014. They provided a brief introduction to their program, explained its theoretical bases, and reported the number of children, their age, intervention time, duration and so on. Results: In the majority of the institutions, the intervention was provided for over 20 hours every week, and the theoretical bases included various applied behavioral analysis (ABA) methods and other therapies (language and occupational therapy). The therapist-child ratio ranged from 1:1 to 5:3. Various types of therapists were involved, including behavioral analysts, special education teachers and (or) language pathologists. There was only one clinic where the behavioral analyst was the main therapist. Usually, the intervention was terminated just before the child entered elementary school. The main merit of the hospital-based intervention in our survey was the effectiveness of the multi-disciplinary intervention plan and its other merits were the accuracy of the diagnosis, its ability to be combined with medicine, and so on. Conclusion: The current hospital-based early intensive intervention programs provide interventions for over 20 hours per week and employ multidisciplinary approaches. However, there are very few institutes for children with autism and very few intervention specialists and specialist education courses in the country. We need more educational programs for intervention therapists and have to try to develop policies which encourage the implementation of an evidence-based early intensive intervention program nationwide.
Purpose: Alendronate has been proposed as a local and systemic drug treatment used as an adjunct to scaling and root planing (SRP) for the treatment of periodontitis. However, its effectiveness has yet to be conclusively established. The purpose of the present meta-analysis was to assess the effectiveness of SRP with alendronate on periodontitis compared to SRP alone. Methods: Five electronic databases were used by 2 independent reviewers to identify relevant articles from the earliest records up to September 2016. Randomized controlled trials (RCTs) comparing SRP with alendronate to SRP with placebo in the treatment of periodontitis were included. The outcome measures were changes in bone defect fill, probing depth (PD), and clinical attachment level (CAL) from baseline to 6 months. A fixed-effect or random-effect model was used to pool the extracted data, as appropriate. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated. Heterogeneity was assessed using the Cochrane ${\chi}^2$ and $I^2$ tests. Results: After the selection process, 8 articles were included in the meta-analysis. Compared with SRP alone, the adjunctive mean benefits of locally delivered alendronate were 38.25% for bone defect fill increase (95% CI=33.05%-43.45%; P<0.001; $I^2=94.0%$), 2.29 mm for PD reduction (95% CI=2.07-2.52 mm; P<0.001; $I^2=0.0%$) and 1.92 mm for CAL gain (95% CI=1.55-2.30 mm; P<0.001; $I^2=66.0%$). In addition, systemically administered alendronate with SRP significantly reduced PD by 0.36 mm (95% CI=0.18-0.55 mm; P<0.001; $I^2=0.0%$) and increased CAL by 0.39 mm (95% CI=0.11-0.68 mm; P=0.006; $I^2=6.0%$). Conclusions: The collective evidence regarding the adjunctive use of alendronate locally and systemically with SRP indicates that the combined treatment can improve the efficacy of non-surgical periodontal therapy on increasing CAL and bone defect fill and reducing PD. However, precautions must be exercised in interpreting these results, and multicenter studies evaluating this specific application should be carried out.
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