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Efficacy and Safety of Neurokinin-1 Receptor Antagonists for Prevention of Chemotherapy-Induced Nausea and Vomiting: Systematic Review and Meta-analysis of Randomized Controlled Trials

  • Yuan, Dong-Mei;Li, Qian;Zhang, Qin;Xiao, Xin-Wu;Yao, Yan-Wen;Zhang, Yan;Lv, Yan-Ling;Liu, Hong-Bin;Lv, Tang-Feng;Song, Yong
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1661-1675
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    • 2016
  • Objectives: Can addition of neurokinin-1 receptor antagonists (NK1-RAs) be considered as an ideal strategy for the prevention of chemotherapy-induced nausea and vomiting (CINV)? Researchers differ on this question. Materials and Methods: Electronic databases were searched for randomized control trials (RCTs) that evaluated the effectiveness and safety of NK1-RAs in preventing CINV. The primary end point was complete response (CR) in the acute, delayed, and overall phases after chemotherapy. Subgroup analyses evaluated the types of NK1-RAs, routines of administration, types of malignancies, regimens used in combination with NK1-RAs, and age of patients included in the studies. The incidences of different types of adverse events were also extracted to estimate the safety of NK1-RAs. Results: A total of 38 RCTs involving 13,923 patients were identified. The CR rate of patients receiving NK-RAs was significantly higher than patients in the control groups during overall phase (70.8% vs 56.0%, P<0.001), acute phase (85.1% vs 79.6%, P<0.001), and delayed phase (71.4% vs 58.2%, P<0.001). There were three studies including patients of children or adolescents, the CR rate was also significantly higher in the treatment group (overall phase: OR=2.807, P<0.001; acute phase: OR=2.863, P =0.012; delayed phase: OR=2.417, P<0.001). For all the other outcomes, patients in the NK1-RAs groups showed improvements compared to the control groups (incidence of nausea: 45.2% vs 45.9%, P<0.001; occurrence of vomiting: 22.6% vs 38.9%, P<0.001; usage of rescue drugs: 23.5% vs 34.1%, P<0.001). The pooled side effects from NK1-RAs did not significantly differ from previous reports and the toxicity rates in patients less than eighteen years old also did not diff between the two groups (P=0.497). However, we found that constipation and insomnia were more common in the patients of control groups, whereas diarrhea and hiccups were more frequently detected in patients receiving NK1-RAs. Conclusions: NK1-RAs improved the CR rate of CINV. They are effective for both adults and children. The use of NK1-RAs might be associated with the appearance of diarrhea and hiccups, while decreasing the possibility of constipation and insomnia.

Treatment of Extremely High Risk and Resistant Gestational Trophoblastic Neoplasia Patients in King Chulalongkorn Memorial Hospital

  • Oranratanaphan, Shina;Lertkhachonsuk, Ruangsak
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.925-928
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    • 2014
  • Background: Gestational trophoblastic neoplasia (GTN) is a spectrum of disease with abnormal trophoblastic proliferation. Treatment is based on FIGO stage and WHO risk factor scores. Patients whose score is 12 or more are considered as at extremely high risk with a high likelihood of resistance to first line treatment. Optimal therapy is therefore controversial. Objective: This study was conducted in order to summarize the regimen used for extremely high risk or resistant GTN patients in our institution the in past 10 years. Materials and Methods: All the charts of GTN patients classified as extremely high risk, recurrent or resistant during 1 January 2002 to 31 December 2011 were reviewed. Criteria for diagnosis of GTN were also assessed to confirm the diagnosis. FIGO stage and WHO risk prognostic score were also re-calculated to ensure the accuracy of the information. Patient characteristics were reviewed in the aspects of age, weight, height, BMI, presenting symptoms, metastatic area, lesions, FIGO stage, WHO risk factor score, serum hCG level, treatment regimen, adjuvant treatments, side effects and response to treatment, including disease free survival. Results: Eight patients meeting the criteria of extremely high risk or resistant GTN were included in this review. Mean age was 33.6 years (SD=13.5, range 17-53). Of the total, 3 were stage III (37.5%) and 5 were stage IV (62.5%). Mean duration from previous pregnancies to GTN was 17.6 months (SD 9.9). Mean serum hCG level was 864,589 mIU/ml (SD 98,151). Presenting symptoms of the patients were various such as hemoptysis, abdominal pain, headache, heavy vaginal bleeding and stroke. The most commonly used first line chemotherapeutic regimen in our institution was the VAC regimen which was given to 4 of 8 patients in this study. The most common second line chemotherapy was EMACO. Adjuvant radiation was given to most of the patients who had brain metastasis. Most of the patients have to delay chemotherapy for 1-2 weeks due to grade 2-3 leukopenia and require G-CSF to rescue from neutropenia. Five form 8 patients were still survived. Mean of disease free survival was 20.4 months. Two patients died of the disease, while another one patient died from sepsis of pressure sore wound. None of surviving patients developed recurrence of disease after complete treatment. Conclusions: In extremely high risk GTN patients, main treatment is multi-agent chemotherapy. In our institution, we usually use VAC as a first line treatment of high risk GTN, but since resistance is quite common, this may not suitable for extremely high risk GTN patients. The most commonly used second line multi-agent chemotherapy in our institution is EMA-CO. Adjuvant brain radiation was administered to most of the patients with brain metastasis in our institution. The survival rate is comparable to previous reviews. Our treatment demonstrated differences from other institutions but the survival is comparable. The limitation of this review is the number of cases is small due to rarity of the disease. Further trials or multicenter analyses may be considered.

Uses of Music by People with Adventitious Visual Impairments (중도시각장애인의 음악 활용)

  • Yang, Ji Hye;Park, Hye Young
    • Journal of Music and Human Behavior
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    • v.13 no.1
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    • pp.41-60
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    • 2016
  • This study investigated how people who became blind midway through life used music and how these uses differed according to individual factors. Sixty-one late-blind adults aged 40 to 60 years attending six welfare centers for the blind in Seoul and Gyeonggi region participated in this research. Participants were asked to complete a 25-question survey in Braille on music utilization and preference, as well as the purpose of music utilization. The response rate was 87.1%. The results were as follows. First, with regard to listening preference, they reported preferring to listen to upbeat popular music on the radio when resting at home. They liked to sing along to lyrics reminiscent of personal memories. String instruments were preferred when playing an instrument. With regard to the reason for using music, inducing mood change was found to be the biggest reason, followed by seeking enjoyment, comfort, sense of achievement, and sense of belonging. Third, for people with adventitious visual impairments, individual factors, such as gender, level of disability, and period without eyesight, did not reveal any significant differences. Last, participants were found to obtain a higher sense of belonging through music compared to those having low vision. Regarding time without eyesight, it appeared that the shorter the period, the higher the sense of belonging participants had from utilizing music, and vice versa. This study provides fundamental information for organizing an effective music program that can meet the needs and demands of people with adventitious visual impairments.

Effects of Dietary Selenium Supplementation on Growth Performance, Selenium Retention in Tissues and Nutrient Digestibility in Growing-finishing Pigs

  • Tian, J.Z.;Yun, M.S.;Ju, W.S.;Long, H.F.;Kim, J.H.;Kil, D.Y.;Chang, J.S.;Cho, S.B.;Kim, Y.Y.;Han, In K.
    • Asian-Australasian Journal of Animal Sciences
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    • v.19 no.1
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    • pp.55-60
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    • 2006
  • This experiment was conducted to investigate the effects of selenium (Se) sources and levels on growth performance, nutrient digestibility and Se retention in growing-finishing pigs. A total of 56 crossbred pigs ([$Landrace{\times}Yorkshire$]${\times}$Large White) with average $28.5{\pm}0.2kg$ BW were allotted to 7 treatments on the basis of sex and weight in two replicates and four pigs per pen. A $2{\times}3$ factorial arrangement of treatments was used in a randomized complete block (RCB) design. Two sources of Se (selenite Se or Se-enriched yeast) were added at 0.1, 0.3 and 0.5 mg/kg to each treatment diet. A basal diet without Se supplementation was the seventh treatment group. Three pigs per treatment were randomly selected and samples of loin, liver, pancreas and a kidney were collected, frozen and later analyzed for Se. The digestibility trial was conducted to evaluate the apparent absorption and retention of Se and availability of other nutrients. Growth performance was not affected by dietary sources and levels of Se. No growth retardation was observed in the 0.5 mg/kg dietary Se treatment group regardless of Se sources. The Se concentration of serum in Se supplemented groups was increased compared with the control group (p<0.01). During the growing and finishing phase, Se in serum was clearly increased when organic Se was provided (p<0.01). Interaction of Se source ${\times}$ Se level was observed in Se concentration of loin, liver and pancreas of the pigs at the end of experiment. Selenium retention in the liver, kidney, pancreas and loin of pigs was increased as dietary Se level increased and was higher when pigs were fed organic Se resulting in an interaction response (p<0.01). Nutrient digestibilities were not affected by dietary Se sources or levels. No dietary Se source ${\times}$ Se level interaction was observed in nutrient digestibility. The results from this experiment indicated that dietary Se sources and levels affected the distribution of Se in the body of growing-finishing pigs. Organic source of Se, such as Se-enriched yeast resulted in higher serum and tissue Se concentration compared to inorganic form, while no beneficial effects on nutrient digestibility were observed from dietary Se supplementation in growing-finishing pigs.

Effects of different space allowances on growth performance, blood profile and pork quality in a grow-to-finish production system

  • Jang, J.C.;Jin, X.H.;Hong, J.S.;Kim, Y.Y.
    • Asian-Australasian Journal of Animal Sciences
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    • v.30 no.12
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    • pp.1796-1802
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    • 2017
  • Objective: This experiment was conducted to evaluate the optimal space allowance on growth performance, blood profile and pork quality of growing-finishing pigs. Methods: A total of ninety crossbred pigs [$(Yorkshire{\times}Landrace){\times}Duroc$, $30.25{\pm}1.13kg$] were allocated into three treatments (0.96: four pigs/pen, $0.96m^2/pig$; 0.80: five pigs/pen, $0.80m^2/pig$; 0.69: six pigs/pen, $0.69m^2/pig$) in a randomized complete block design. Pigs were housed in balanced sex and had free access to feed in all phases for 14 weeks (growing phase I, growing phase II, finishing phase I, and finishing phase II). Results: There was no statistical difference in growing phase, but a linear decrease was observed on average daily gain (ADG, p<0.01), average daily feed intake (ADFI, p<0.01), and body weight (BW, p<0.01) with decreasing space allowance in late finishing phase. On the other hand, a quadratic effect was observed on gain to feed ratio in early finishing phase (p<0.03). Consequently, overall ADG, ADFI, and final BW linearly declined in response to decreased space allowance (p<0.01). The pH of pork had no significant difference in 1 hour after slaughter, whereas there was a linear decrease in 24 h after slaughter with decreasing space allowance. Floor area allowance did not affect pork colors, but shear force linearly increased as floor space decreased (p<0.01). There was a linear increase in serum cortisol concentration on 14 week (p<0.05) with decreased space allocation. Serum IgG was linearly ameliorated as space allowance increased on 10 week (p<0.05) and 14 week (p<0.01). Conclusion: Data from current study indicated that stress derived from reduced space allowance deteriorates the immune system as well as growth performance of pigs, resulting in poor pork quality. Recommended adequate space allowance in a grow-to-finish production system is more than $0.80m^2/pig$ for maximizing growth performance and production efficiency.

Transcription Factor for Gene Function Analysis in Maize (옥수수 유전자 기능 분석을 위한 전사인자의 이해)

  • Moon, Jun-Cheol;Kim, Jae Yoon;Baek, Seong-Bum;Kwon, Young-Up;Song, Kitae;Lee, Byung-Moo
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.59 no.3
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    • pp.263-281
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    • 2014
  • Transcription factors are essential for the regulation of gene expression in plant. They are binding to either enhancer or promoter region of DNA adjacent to the gene and are related to basal transcription regulation, differential enhancement of transcription, development, response to intercellular signals or environment, and cell cycle control. The mechanism in controlling gene expression of transcription can be understood through the assessment of the complete sequence for the maize genome. It is possible that the maize genome encodes 4,000 or more transcription factors because it has undergone whole duplication in the past. Previously, several transcription factors of maize have been characterized. In this review article, the transcription factors were selected using Pfam database, including many family members in comparison with other family and listed as follows: ABI3/VP1, AP2/EREBP, ARF, ARID, AS2, AUX/IAA, BES1, bHLH, bZIP, C2C2-CO-like, C2C2-Dof, C2C2-GATA, C2C2-YABBY, C2H2, E2F/DP, FHA, GARP-ARR-B, GeBP, GRAS, HMG, HSF, MADS, MYB, MYB-related, NAC, PHD, and WRKY family. For analyzing motifs, each amino acid sequence has been aligned with ClustalW and the conserved sequence was shown by sequence logo. This review article will contribute to further study of molecular biological analysis and breeding using the transcription factor of maize as a strategy for selecting target gene.

Effect of Dietary sugar beet pulp supplementation on growth performance, nutrient digestibility, fecal Microflora, blood profiles and Diarrhea incidence in weaning pigs

  • Yan, C.L.;Kim, H.S.;Hong, J.S.;Lee, J.H.;Han, Y.G.;Jin, Y.H.;Son, S.W.;Ha, S.H.;Kim, Y.Y.
    • Journal of Animal Science and Technology
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    • v.59 no.8
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    • pp.18.1-18.8
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    • 2017
  • Background: In 2006, the European Union (EU) has decided to forbid use of antibiotics as growth promoters. Although many researches had been conducted about fiber source as alternatives of antibiotics, there are still lack of reports in the literature about the optimum level of sugar beet pulp supplementation, affecting growth performance and nutrient digestibility in weaning pigs. Therefore, different level of sugar beet pulp was added to diets to determine the effects of sugar beet pulp supplementation on growth performance, nutrient digestibility, fecal microflora, blood profile and incidence of diarrhea in weaning pigs. Methods: A total of 200 weaning pigs [$(Yorkshire{\times}Landrace){\times}Duroc$], averaging $9.01{\pm}1.389kg$ of initial body weight were, allotted to 5 treatments in a randomized complete block (RCB) design. Each treatment was composed of 4 replicates with 10 pigs per pen. The treatments were control treatment: Corn-SBM basal diet + ZnO (phase 1: 0.05%; phase 2; 0.03%) and four different levels of sugar beet pulp were supplemented in Corn-SBM basal diet (3, 6, 9 or 12%). Two phase feeding programs (phase 1: 1-2 weeks; phase 2: 3-5 weeks) were used for 5 week of growth trial. Results: In feeding trial, there were no significant differences in growth performance and incidence of diarrhea among treatments. The E.coli counts were not significantly different among dietary treatments but linear response was observed in Lactobacillus counts as sugar beet pulp supplementation increased (P < 0.05). In addition, IGF-1, IgA and IgG were not affected by dietary treatments. However, the BUN concentration was decreased when pigs were fed the treatments of diets with SBP compared to that of control treatment (P < 0.05). In nutrient digestibility, crude fiber and NDF digestibilities were improved as the sugar beet pulp increased (P < 0.05). However, digestibilities of crude ash, crude fat, crude fiber and nitrogen retention were not affected by dietary sugar beet pulp levels. Conclusion: This experiment demonstrated that sugar beet pulp can be supplemented in weaning pigs' diet instead of ZnO to prevent postweaning diarrhea without any detrimental effect on growth performance.

Diamond-Blackfan anemia: long-term follow-up of six cases (Diamond-Blackfan 빈혈: 6예 장기간 추적관찰보고)

  • Son, Young Jun;Baek, Hee Jo;Kook, Hoon
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1211-1216
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    • 2008
  • Purpose : Diamond-Blackfan anemia (DBA) is a rare heterogeneous genetic disorder of infancy and early childhood. It is characterized by red cell aplasia, congenital anomalies, and a predisposition to cancer. Corticosteroids and red cell transfusions are the mainstays of therapy. We describe our experience of 6 cases of DBA that were encountered over a period of 16 years. Methods : Medical records of 6 patients diagnosed to have DBA and admitted to the Chonnam National University Hospital between 1992 and 2008 were retrospectively reviewed. Results : Three patients were males. The age at diagnosis ranged from 3 to 18 months (median, 5.5 months). Heart defects were observed in 4, polydactyly in 2, and strabismus in 1 patient. The median number of transfusions was 3 (range, 2-8). All patients responded to initial treatment with steroids and had a hemoglobin level ${\geq}9g/dL$ with a median of 12.5 days (range, 7-22 days). Three patients are currently not receiving steroid therapy. A minimum dose of oral prednisolone (<5 mg per day) was required to maintain hemoglobin ${\geq}9mg/dL$ in 3 cases. Red cell transfusion was infrequently required in 1 patient. In the median follow-up of 14 years, there was no development of malignancy. No significant side effects of steroids were found, except for short stature in 2. Conclusion : The majority of DBA patients achieved complete response and under maintenance therapy with low dose of steroids. Close observation is needed to monitor steroid side effects, cardiac function, and development of malignancy. A nation-wide survey is necessary to further characterize this rare disease in Korean children.

In-depth Review of IPCC 5th Assessment Report (IPCC 제5차 과학평가보고서 고찰)

  • Park, Il-Soo;Woon, Yu;Chung, Kyung-Won;Lee, Gangwoong;Owen, Jeffrey S.;Kwon, Won-Tae;Yun, Won-Tae
    • Journal of Korean Society for Atmospheric Environment
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    • v.30 no.2
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    • pp.188-200
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    • 2014
  • The IPCC 5th Assessment Report (Climate Change 2013: The Physical Science Basis) was accepted at the 36th Session of the IPCC on 26 September 2013 in Stockholm, Sweden. It consists of the full scientific and technical assessment undertaken by Working Group I. This comprehensive assessment of the physical aspects of climate change puts a focus on those elements that are relevant to understand past, document current, and project future of climate change. The assessment builds on the IPCC Fourth Assessment Report and the recent Special Report on Managing the Risk of Extreme Events and Disasters to Advance Climate Change Adaptation. The assessment covers the current knowledge of various processes within, and interactions among, climate system components, which determine the sensitivity and response of the system to changes in forcing, and they quantify the link between the changes in atmospheric constituents, and hence radiative forcing, and the consequent detection and attribution of climate change. Projections of changes in all climate system components are based on model simulations forced by a new set of scenarios. The report also provides a comprehensive assessment of past and future sea level change in a dedicated chapter. The primary purpose of this Technical Summary is to provide the link between the complete assessment of the multiple lines of independent evidence presented in the main report and the highly condensed summary prepared as Policy makers Summary. The Technical Summary thus serves as a starting point for those readers who seek the full information on more specific topics covered by this assessment. Warming of the climate system is unequivocal, and since the 1950s, many of the observed changes are unprecedented over decades to millennia. The atmosphere and ocean have warmed, the amounts of snow and ice have diminished, sea level has risen, and the concentrations of greenhouse gases have increased. Total radiative forcing is positive, and has led to an uptake of energy by the climate system. The largest contribution to total radiative forcing is caused by the increase in the atmospheric concentration of $CO_2$ since 1750. Human influence on the climate system is clear. This is evident from the increasing greenhouse gas concentrations in the atmosphere, positive radiative forcing, observed warming, and understanding of the climate system. Continued emissions of greenhouse gases will cause further warming and changes in all components of the climate system. Limiting climate change will require substantial and sustained reductions of greenhouse gas emissions. The in-depth review for past, present and future of climate change is carried out on the basis of the IPCC 5th Assessment Report.

The Effects of Pulsed Electromagnetic Energy and Microcurrent on Wound Healing in Rabbits. (맥동전자장에너지의 미세전류가 가토의 상처치유에 미치는 영향)

  • Kwon Won-An;Park Rae-Joon;Park Youn-Ki;Hwang Tae-Yeun
    • The Journal of Korean Physical Therapy
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    • v.12 no.3
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    • pp.319-329
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    • 2000
  • The purpose of this study w8s to evaluate the effects of pulsed electromagnetic energy(Diapulse) and microcurrent on the wound healing in rabbits. 15 domestic rabbits were randomly assigned to the PRME(n=5). MC(n=5) and CON(n=91 group. Each rabbits were anesthetized with lidocaine HCL $2\%$. Skin wounds were created laterally on the back of IS domestic rabbits(33cm). From 24 hours after being injured, the rabbits of the PEME group were irradiated with an intensity of 3 at a 300 pulses per second, which were applied for 15 minutes every day during the 12 days. The MC group were stimulated with an intensity of $50{\mu}A$ at frequency of40 pulses per second, which were applied for 15 minutes every day during the 12 days. The CON group were not stimulated. The rabbits were sacrificed and the incised wound pans were processed appropriately for the light microscopic examination on the 3rd day, 6th day and 12th day before the beginning of wound treatment. The areas of wound were measured with metric graph paper. The results were as tallows. 1 The PRME and MC group compared with control group showed that wound closure rate increased on 6th, 12th day. 2. It was found that the CON group did not show a complete maturation and had a chronic inflammatory response. Judging from the irregularity of intercellular space and the loose alignment of connective tissue. these findings showed that wound healing was delayed. 3. It showed that inflammatory cells. fibroblasts and epithelial cells activity rapidly processed in the PEME group compared with the CON group. It was found that the PEMI; group showed a advanced remodeling of epithelial layer and a positive repair of connective tissue. 4. It showed that fibroblasts, epithelial cells and inflammatory cells activity rapidly processed in the MC group compared with the CON group. It was found that the MC group showed a improved remodeling of epithelial layer and a dense connective tissue.

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