• Title/Summary/Keyword: Concurrent Treatment

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Giant Brain Abscess in a Neonate: Good Outcome with Single Transfontanelle Aspiration and Antibiotic Therapy

  • Ko, Jin-Hee;Choi, Yu-Mi;Shim, Kye-Shik;Bae, Chong-Woo;Chung, Sa-Jun;Bang, Jae-Seung;Yoon, Kyung-Lim
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.399-403
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    • 2011
  • Brain abscesses in neonates are extremely rare and usually occur in patients with certain risk factors. A 1-month-old boy presented at the hospital with fever and irritability. As a result of preterm delivery and low birth weight, he had a history of admission to the neonatal intensive care unit. Neuroimaging revealed a large, space-occupying lesion in both frontal lobes, which was suspected to be an abscess with the midline shifting to the right. With a single aspiration and abscess drainage along with concurrent prolonged parenteral antibiotic therapy, the patient showed an excellent treatment outcome with normal development. The focus will be placed on minimally invasive surgical management as well as positive outcomes.

Can we omit prophylactic inguinal nodal irradiation in anal cancer patients?

  • Kim, Hakyoung;Park, Hee Chul;Yu, Jeong Il;Choi, Doo Ho;Ahn, Yong Chan;Kim, Seung Tae;Park, Joon Oh;Park, Young Suk;Kim, Hee Cheol
    • Radiation Oncology Journal
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    • v.33 no.2
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    • pp.83-88
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    • 2015
  • Purpose: To evaluate the appropriateness of prophylactic inguinal nodal irradiation (PINI), we analyzed patterns of failure in anal cancer patients who were inguinal node-negative at presentation and did not receive PINI. Materials and Methods: We retrospectively reviewed the records of 33 anal cancer patients treated by definitive concurrent chemoradiation therapy (CCRT) between 1994 and 2013. Radiotherapy consisted of a total dose of 44-45 Gy (22-25 fractions in 5 weeks) on the whole pelvis, anus, and perineum. Except inguinal lymphadenopathy was present at initial diagnosis, the entire inguinal chain was not included in the radiation field. In other words, there was no PINI. Results: The median follow-up duration was 50 months (range, 4 to 218 months). Median survival and progression-free survival (PFS) were 57 months (range, 10 to 218 months) and 50 months (range, 4 to 218 months), respectively. Among the survival, the median follow-up duration was 51 months (range, 12 to 218 months). The 5-year overall survival and PFS rates were 93.4% and 88.8%, respectively. Although none of the patients received inguinal node irradiation for prophylactic purposes, there was no inguinal recurrence. Conclusion: Treatment of anal cancer by omitting PINI might be considered in selected patients with clinically uninvolved inguinal nodes.

Successful Management of Hepatic Lipidosis Accompanied by a Feline Skin Fragility Syndrome-like Lesion in a Cat (고양이 피부유약증 유사병변을 동반한 지방간에 이환된 한 마리 고양이의 성공적인 치료증례)

  • Park, Hyoung-Jin;Hong, Eun-Ji;Kwon, Hyo-Jung;Park, Seong-Jun;Park, Joo Min;Song, Kun-Ho;Seo, Kyoung-Won
    • Journal of Veterinary Clinics
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    • v.32 no.5
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    • pp.449-453
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    • 2015
  • A 7-year-old spayed female Somali-cross cat was admitted with a 4-week history of anorexia, vomiting, weight loss, and lethargy. The cat was diagnosed with hepatic lipidosis. With intensive care and nutritional support via a nasogastric feeding tube for 3 weeks, the clinical signs of hepatic lipidosis were improved. However, skin lesions were found in the left and right scapular regions during the treatment that were suspected to be due to feline skin fragility syndrome (FSFS). Intensive wound healing therapy with granulated sugar, laser therapy, and a surgical flap was conducted. Skin lesions improved uneventfully without other clinical signs or recurrence of any skin lesion for a year. To our knowledge, this is the first report of a good prognosis in a hepatic disorder and concurrent FSFS.

Noise Phobia-Induced Relative Polycythemia in a Dog (개에서 소리공포증에 의해 발생한 상대적 적혈구증가증 증례)

  • Kang, Min-Hee;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.29 no.6
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    • pp.494-497
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    • 2012
  • A 6-year-old castrated male Miniature Pinscher dog was referred due to shaking, panting and inappropriate elimination during thunderstorms. The dog had noise phobia after a car accident two years ago. The intensity of the fear of noise, especially with thunderstorms, worsened during the past 3 months (thunderstorm season). Physical examination revealed hyperthermia, tachypnea (panting), mild tachycardia, and an elevated systolic blood pressure. Laboratory examination revealed mild polycythemia with a lower oxygen pressure and saturation. Based on the history, physical examination, and laboratory tests, the dog was diagnosed as a noise phobia concurrent with relative polycythemia. Treatment was initiated with behavior modification with desensitization, counter-conditioning, and medication. Music therapy was also used and appeared to be beneficial. Clinical signs including polycythemia are improved. This case indicates that relative polycythemia can be occurred by chronic mental stress, such as noise phobia in a dog.

A Case of Functional Upper Airway Obstruction Due to Vocal Cord Dysfunction in Obstructive Pulmonary Disease (폐쇄성 폐질환에 동반된 성대 운동이상에 의한 기능성 상기도폐색 1예)

  • Oh, Myoung;Kim, Sang-Cheol;Baik, Jae-Joong;Chung, Yeon-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.3
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    • pp.270-274
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    • 2001
  • A functional upper airway obstruction due to a vocal cord dysfunction(VCD) is characterized by a paradoxical adduction of the vocal cords throughout the respiratory cycle with no obvious organic cause for the obstruction. It commonly occurs paroxysmally and imitates acute asthmatic attacks, often in patients with coexisting asthma. They present with episodes of dyspnea associated with inspiratory wheezing that persists despite conventional asthma treatment and a flattening of the inspiratory limb of the flow-volume curve ; an adduction of the vocal cord during inspiration. Failure to recognize concurrent vocal cord dysfunction and asthma has led not only to the excessive use of bronchodilators and corticosteroids, but also to intubation and tracheostomy. Here, we report a case of coexistent obstructive pulmonary disease and functional upper airway obstruction due to a vocal cord dysfunction where a bronchoscopy showed a paradoxical vocal cord motion and typical features of a variable extrathoracic obstruction and a lower airway obstruction on the Flow-volume loop during a symptomatic period.

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Use of Anti-Phosphohistone H3 (PHH3) as a Mitosis Marker for Classifying Pulmonary Carcinoid Tumors

  • Seo, Bo-Ram;Hong, Young-Seob;Choi, Phil-Jo;Um, Soo-Jung;Seo, Jeong-Wook;Roh, Mee-Sook
    • Biomedical Science Letters
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    • v.17 no.3
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    • pp.197-202
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    • 2011
  • Mitosis count is one of the most helpful morphologic features for distinguishing pulmonary typical carcinoid (TC) from atypical carcinoid (AC). However, identifying areas of highest mitotic activity is tedious and time-consuming, and mitosis count may vary substantially among pathologists. Anti-phosphohistone H3 (PHH3) is an antibody that specifically detects histone H3 only when phosphorylated at serine 10 or serine 28, an event that is concurrent with mitotic chromatin condensation and not observed during apoptosis. In this study, immunohistochemical staining for PHH3 was performed to determine whether PHH3 was a reliable and objective mitosis-specific marker for pulmonary carcinoid tumors. Seventeen cases of surgically resected pulmonary carcinoid tumors (12 TCs and 5 ACs) were obtained and classified according to the 2004 World Health Organization classification. Mitotic counts determined by PHH3 correlated to ones determined by hematoxylin and eosin (H&E) staining; however, PHH3 mitotic counts (mean mitotic counts: 1 in TCs and 3.2 in ACs) were slightly higher than H&E mitotic counts (mean mitotic counts: 0.25 in TCs and 1.8 in ACs). The mitotic counts determined by experienced observer were more correlated to those determined by inexperienced observer with the PHH3-based method (R=0.968, P<0.001) rather than H&E staining (R=0.658, P<0.001). These results suggest that the PHH3 mitotic counting method was more sensitive and simple for detecting mitoses compared to traditional H&E staining. Therefore, PHH3 immunohistochemistry may contribute to more accurate and reproducible diagnosis of pulmonary carcinoid tumors and may be a valuable aid for administrating appropriate clinical treatment.

Therapeutic Results of Postoperative Radiation Therapy for Uterine Cervical Cancer (자궁경부암의 수술후 방사선치료 결과)

  • Choi, Doo-Ho;Hong, Seong-Eon
    • Radiation Oncology Journal
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    • v.12 no.3
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    • pp.369-376
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    • 1994
  • This is a retrospective analysis of 64 patients who was treated with postoperative radiation therapy after radical hysterectomy and bilateral pelvic lymphadenectomy (53 patients) or total abdominal hysterectomy(11 patients) for uterine cervix cancer between May 1980 and September 1991 at the Department of Radiation Oncology, Kyung Hee University Hospital. Most patients were FIGO IB (31 Patients) and IIA (25 patients), and median period of follow-up was 5.1 years. Of these patients,24 received adjuvant whole pelvis irradiation of 6000 cGy and 40 received 5000-5500 cGy whole pelvis irradiation and/or intracavitary radiation (7 Patients). The actuarial overall and relapse free 5 year survival rate were $71.0\%$, $68.3\%$ respectively. The survival rates by stage were $79.1\%$ in stage I, and $61.2\%$ in stage II. Treatment failure was noted in 18 of 64 patients ($28.1\%$), Iocoregional failure in 8 ($12.5\%$), distant metastasis in 8 ($12.5\%$), paraaortic node metastasis in 1 and one patient and concurrent locoregional and distant metastasis. The univariate analysis of prognostic factors affecting to overall survival rate represented lymph node status, the number and site of metastatic lymph node, parametrial invasion, the thichness of cervical wall invasion, and size of cancer mass. Histology, vessel invasion, endometrial extension, hemoglobin level. resection margin status, age, radiation dose were not significant prognostic factors. Complication relating to operation and postoperative radiation were variable according to radiation therapy method: 6000 cGy RT group 8/24($33.3\%$), 5000-5500 cGy+ICR 3/7 ($42.9\%$), 5000-5500 cGy external RT only group 3/33 ($9.1\%$). In conclusion, the results suggest that postoperative radiotherapy is necessary in high risk patients for locoregional control and improving survival rate, and higher dose does not improve results but only increases complication.

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Alteration in Pyridine Nucleotide Status in Cells as an Adaptive Response to Water Stress in Rice (Oryza sativa L.) Seedlings

  • Boo, Yong-Chool;Jung, Jin
    • Applied Biological Chemistry
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    • v.41 no.4
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    • pp.228-234
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    • 1998
  • An adaptive measure of photosynthetic cells to a condition identified with a reduction of cellular energy charge, caused by water deficit-induced impairment of photosynthetic ATP production, was investigated using hydroponically cultured rice seedlings. Water stress treatment of the seedlings resulted in a marked decrease in cellular ATP level, a significant increase in the content of NAD(H) and concurrent decrease in that of NADP(H) in shoots, which accompanied a decrease in the activity of NAD kinase (EC 2.7.1.23) that specifically converts NAD(H) to NADP(H). The decline in the enzyme activity was particularly evident in the $Ca^{2+}/calmodulin-dependent$ kinase, the major form of NAD kinase in plants, whereas the level of active calmodulin remained unchanged during water deficit. The ratio of $NADP^+$ to NADPH was maintained nearly constant and no increases were seen in the level of $H_2O_2$ and the activities of $superoxide/H_2O_2-detoxifying$ enzymes in shoots stress-treated for two days. Based on these results, it may be suggested that rice plants take a strategy to cope with an adverse situation of limited photophosphorylation created by water deficit in that cells facilitate ATP production through glycolysis and oxidative phosphorylation; in doing so, rice cells suppress NAD kinase activity, consequently up-sizing the NAD(H) pool at the expense of the NADP(H) pool. Several parameters associated with the stress symptoms are also of implicative that there is no overproduction of superoxide radical or the related active oxygen at least in rice seedlings.

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Rapidly resolved IgG4-related retroperitoneal fibrosis after steroid pulse therapy

  • Jeung, Soomin;Kim, Hyosang;Seo, Yuri;Yoon, Hee-Young;Lee, Nah Kyum;Park, Shinhee;Seo, Bomi;Park, Su-Yeon;Park, Su-Kil
    • Journal of Yeungnam Medical Science
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    • v.33 no.1
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    • pp.40-43
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    • 2016
  • Retroperitoneal fibrosis (RF) is a disorder characterized by the presence of a retroperitoneal mass and concurrent systemic inflammation. Some cases of RF are recognized as belonging to the spectrum of immunoglobulin G4-related disease (IgG4-RD). Glucocorticoids are highly effective for treatment of retroperitoneal fibrosis, although the optimal dose and duration of therapy have not been established. An initial dose of prednisone (40-60 mg) daily is usually administered with a tapering scheme. We report on a 55-year-old man diagnosed with IgG4-related RF and successfully treated with a 3-day course of daily 250 mg (4 mg/kg) intravenous methylprednisolone, which resulted in the prompt resolution of urinary obstruction and systemic symptoms.

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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    • v.15 no.23
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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.