• Title/Summary/Keyword: Concurrent Treatment

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Percutaneous Ultrasound-Guided Cholecystocentesis for Treatment of Extrahepatic Biliary Tract Obstruction Concurrent with Pancreatitis in Two Dogs (개에서 췌장염이 병발한 간외성 담관계 페쇄 치료를 위한 경피적 초음파 유도하 담낭 천자술 2예)

  • Cho, Hang-Myo;Chun, Haeng-Bok;Kim, Ju-Hyung;Chun, Hye-Young;Kim, Tae-Hun;Kang, Ji-Houn;Han, Tae-Sung;Na, Ki-Jeong;Yang, Mhan-Pyo;Kim, Gon-Hyung;Chang, Dong-Woo
    • Journal of Veterinary Clinics
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    • v.25 no.4
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    • pp.295-302
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    • 2008
  • Two dogs were referred to Veterinary Medical Center, Chungbuk National University with the clinical signs of vomiting, diarrhea, anorexia, and jaundice. Both dogs were diagnosed as extrahepatic biliary tract obstruction(EHBO) with concurrent pancreatitis based on dilated common bile duct and hyperechoic or mixed-echoic pancreas in abdominal ultrasonographic examination and serum biochemical abnormalities, such as high serum bilirubin, cholesterol, and increased cholestatic enzyme activity. Percutaneous ultrasound-guided cholecytocentesis(PUCC) was performed to examine bile and decompress the gall bladder. After PUCC with medical therapy, both dogs were steadily improved clinical signs of jaundice and anorexia. Also, cholestatic enzyme activity and serum bilirubin concentration decreased. Any complications that have been described in previous studies, such as peritonitis resulting from bile leakage and hemorrhage, were not identified. It is assumed that percutaneous ultrasound guided cholecystocentesis may be an useful diagnostic and therapeutic tool in canine gallbladder disease and can be used easily and safely to gain bile for diagnosis of bacterial cholecytitis.

Factors predicting radiation pneumonitis in locally advanced non-small cell lung cancer

  • Kim, Myung-Soo;Lee, Ji-Hae;Ha, Bo-Ram;Lee, Re-Na;Lee, Kyung-Ja;Suh, Hyun-Suk
    • Radiation Oncology Journal
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    • v.29 no.3
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    • pp.181-190
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    • 2011
  • Purpose: Thoracic radiotherapy is a major treatment modality of stage III non-small cell lung cancer. The normal lung tissue is sensitive to radiation and radiation pneumonitis is the most important dose-limiting complication of thoracic radiation therapy. This study was performed to identify the clinical and dosimetric parameters related to the risk of radiation pneumonitis after definitive radiotherapy in stage III non-small cell cancer patients. Materials and Methods: The medical records were reviewed for 49 patients who completed definitive radiation therapy for locally advanced non-small cell lung cancer from August 2000 to February 2010. Radiation therapy was delivered with the daily dose of 1.8 Gy to 2.0 Gy and the total radiation dose ranged from 50.0 Gy to 70.2 Gy (median, 61.2 Gy). Elective nodal irradiation was delivered at a dose of 45.0 Gy to 50.0 Gy. Seven patients (14.3%) were treated with radiation therapy alone and forty two patients (85.7%) were treated with chemotherapy either sequentially or concurrently. Results: Twenty-five cases (51.0%) out of 49 cases experienced radiation pneumonitis. According to the radiation pneumonitis grade, 10 (20.4%) were grade 1, 9 (18.4%) were grade 2, 4 (8.2%) were grade 3, and 2 (4.1%) were grade 4. In the univariate analyses, no clinical factors including age, sex, performance status, smoking history, underlying lung disease, tumor location, total radiation dose and chemotherapy were associated with grade ${\geq}2$ radiation pneumonitis. In the subgroup analysis of the chemotherapy group, concurrent rather than sequential chemotherapy was significantly related to grade ${\geq}2$ radiation pneumonitis comparing sequential chemotherapy. In the univariate analysis with dosimetric factors, mean lung dose (MLD), $V_{20}$, $V_{30}$, $V_{40}$, MLDipsi, $V_{20}$ipsi, $V_{30}$ipsi, and $V_{40}$ipsi were associated with grade ${\geq}2$ radiation pneumonitis. In addition, multivariate analysis showed that MLD and V30 were independent predicting factors for grade ${\geq}2$ radiation pneumonitis. Conclusion: Concurrent chemotherapy, MLD and $V_{30}$ were statistically significant predictors of grade ${\geq}2$ radiation pneumonitis in patients with stage III non-small cell lung cancer undergoing definitive radiotherapy. The cutoff values for MLD and $V_{30}$ were 16 Gy and 18%, respectively.

Analysis of Renal Adverse Reaction Caused by Amphotericin B (Amphotericin B 투여에 의한 신장 유해반응 분석)

  • Lee, Song Bin;Kim, Tae Kyung;Ko, Jong Hee;Ahn, Ji Hyune;Kim, Sung Eun;Seok, Hyun Ju;Kim, Hyunah
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.4
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    • pp.340-346
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    • 2012
  • Background: Amphotericin B is a mainstay in the treatment of many systemic fungal infections due to its wide antifungal spectrum and low incidence of resistance. However, the use of amphotericin B is limited by its nephrotoxicity. Objectives: The objective of this study was to evaluate the incidence and risk factors of renal adverse drug reactions (ADRs) of conventional amphotericin B (Fungizone$^{(R)}$). In addition, we compared the changes of serum creatinine (SCr) between patients who remained conventional amphotericin B and patients who were switched to liposomal amphotericin B after occurrence of renal adverse reactions. Methods: Adult hospitalized patients who reported renal adverse reactions caused by conventional amphotericin B from January 2011 to July 2012 at pharmacovigilance center in Yonsei University Healthcare System included in this study. ADRs scored as 'doubtful' in Naranjo probability ADR scale were excluded. We retrospectively analyzed patients' basic clinical characteristics, concurrent diseases or nephrotoxic drugs in order to find variables that can correlate with occurrence of renal ADRs. Changes in SCr were compared between conventional amphotericin B group and liposomal amphotericin B group. Results: A total of 231 ADRs after administration of conventional amphotericin B in 75 patients were reported to pharmacovigilance center and assessed their severities as 'possible', 'probable', or 'definite'. Renal adverse reaction was the most common ADR with incidence rate of 42% (96 of 231 ADRs). Mean change in SCr from baseline was 0.26 mg/dL (change % 37.8) and statistically significant (p=0.000). Simple correlations analysis revealed that the number of concurrent diseases and number of nephrotoxic drugs were positively correlated with changes in SCr, but these results were not statistically significant. Among 43 patients who remained amphotericin B after occurrence of renal ADRs, 27 patients was administered conventional amphotericin B and 16 patients changed to liposomal amphotericin B. Mean change in SCr in amphotericin B group was 0.23 mg/dL (32.75%), whereas mean change in SCr in liposomal amphotericin B group were -0.28 mg/dL (19.38%) and difference between two groups was statistically significant (p=0.003). The numbers of patient with SCr elevation more than 30% were 9 (33.3%) in amphotericin B group and 2 (12.5%) in liposomal amphotericin B group (Odd Ratio=3.50, 95% Confidence Interval 0.65-18.85; p=0.130). Conclusion: An analysis of ADRs due to amphotericin B administration revealed significant mean changes in SCr from baseline. Switching to liposomal amphotericin B showed significant decrease in SCr compared with conventional amphotericin B.

Prediction of response by FDG PET early during concurrent chemoradiotherapy for locally advanced non-small cell lung cancer

  • Kim, Suzy;Oh, So Won;Kim, Jin Soo;Kim, Ki Hwan;Kim, Yu Kyeong
    • Radiation Oncology Journal
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    • v.32 no.4
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    • pp.231-237
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    • 2014
  • Purpose: To evaluate the predictive value of the early response of $^{18}F$-flurodeoxyglucose positron emission tomography (FDG PET) during concurrent chemoradiotherapy (CCRT) for locally advanced non-small cell lung cancer (NSCLC). Materials and Methods: FDG PET was performed before and during CCRT for 13 NSCLC patients. Maximum standardized uptake value ($SUV_{max}$), mean standardized uptake value ($SUV_{mean}$), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured and the changes were calculated. These early metabolic changes were compared with the standard tumor response by computed tomograms (CT) one month after CCRT. Results: One month after the completion of CCRT, 9 patients had partial response (PR) of tumor and 4 patients had stable disease. The percent changes of $SUV_{max}$ ($%{\Delta}SUV_{max}$) were larger in responder group than in non-responder group ($55.7%{\pm}15.6%$ vs. $23.1%{\pm}19.0%$, p = 0.01). The percent changes of $SUV_{mean}$ ($%{\Delta}SUV_{mean}$) were also larger in responder group than in non-responder group ($54.4%{\pm}15.9%$ vs. $22.3%{\pm}23.0%$, p = 0.01). The percent changes of MTV ($%{\Delta}MTV$) or TLG ($%{\Delta}TLG$) had no correlation with the tumor response after treatment. All the 7 patients (100%) with $%{\Delta}SUV_{max}{\geq}50%$ had PR, but only 2 out of 6 patients (33%) with $%{\Delta}SUV_{max}$ < 50% had PR after CCRT (p = 0.009). Likewise, all the 6 patients (100%) with $%{\Delta}SUV_{mean}{\geq}50%$ had PR, but only 3 out of 7 patients (43%) with $%{\Delta}SUV_{mean}$ < 50% had PR after CCRT (p = 0.026). Conclusion: The degree of metabolic changes measured by PET-CT during CCRT was predictive for NSCLC tumor response after CCRT.

Development of Korean Adult ADHD Rating Scale (한국형 성인 ADHD 평가척도 개발 연구)

  • Kang, Taewoong;Kim, Jae-Won;Bahn, Geon Ho;Song, Sook Hyung;Kim, Junwon;Kim, Ji-Hoon;Kim, Yoon-Jung;Kim, Eui-Jung;Kim, Tae-Ho;Yang, Su-Jin;Yang, Jaewon;Lee, Soyoung Irene;Park, Joon-Ho;Choi, Jeewook;Han, Doug-Hyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.26 no.4
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    • pp.295-310
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    • 2015
  • Objectives : Symptoms of attention-deficit hyperactivity disorder (ADHD) during childhood may persist into adulthood. This study included the development and validation process of the Korean Adult ADHD Rating Scale (K-AARS), which was developed for screening and monitoring treatment of adults with ADHD. Methods : Preliminary questionnaires of the K-AARS were based on the reviews of previous adult ADHD scales and clinical experiences of the board certified child and adolescent psychiatrists in Korea. For this study, 136 adults (18-50 years old) with inattention, hyperactivity and/or impulsivity symptoms were enrolled as ADHD subjects, and compared with 406 control subjects (18-50 years old) without ADHD symptoms. Construct validity was examined using explorative factor analysis and Cronbach's alpha to obtain internal reliability coefficients. Concurrent validity was evaluated by comparison with the Conners' Adult ADHD Rating Scale (CAARS). Results : An explorative factor analysis showed that the K-AARS had 8 factors (inattention, hyperactivity, impulsivity, antisocial personality disorder/conduct disorder/oppositional defiant disorder, impairment, driving, emotional dysregulation, disorganization). K-AARS was highly reliable in terms of internal consistency (Cronbach's alpha 0.77-0.95) and correlation between factors (0.57-0.86). Concurrent validity with the CAARS and discriminant validity were statistically significant. Conclusion : The K-AARS is a valid and reliable measure for assessment of Korean adults with ADHD.

Prognostic Value of SPARC Expression in Unresectable NSCLC Treated with Concurrent Chemoradiotherapy

  • Kurtul, Neslihan;Eroglu, Celalettin;Unal, Dilek;Tasdemir, Erdem Arzu;Orhan, Okan;Zararsiz, Gokmen;Baran, Munevver;Kaplan, Bunyamin;Kontas, Olgun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8911-8916
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    • 2014
  • Background: The aim of the present study was to determine the predictive/prognostic value of the secreted protein, acidic and rich in cysteine (SPARC) in cases of unresectable, locally advanced, non-small cell lung cancer. Materials and Methods: The study included 84 patients with Stage IIIA-B non-small cell lung cancer, undergoing simultaneous chemoradiotherapy including radiotherapy at a dose of 66 Gy and weekly docataxel ($20mg/m^2$) and cisplatin ($20mg/m^2$). SPARC expression was studied in biopsy material by immunohistochemical methods and correlations with treatment responses or survival were evaluated. Results: Median overall survival was $16{\pm}2.73$ (11.55-20.46) months for low expression vs $7{\pm}1.79$ months (7.92-16.08) months for high expression (p=0.039), while median local control was $13{\pm}2.31$ (8.48-17.5) months for low expression vs $6{\pm}0.85$ (4.34-7.66) months for high expression (p=0.045) and median progression-free survival was $10{\pm}2.31$ (5.48-14.5) months for low expression vs $6{\pm}1.10$ (3.85-8.15) months for high expression (p=0.022). In both univariate and multivariate analyses, high SPARC expression was associated with significantly shorter overall survival (p=0.003, p=0.007, respectively), local control (p=0.008, p=0.036) and progression-free survival (p=0.004, p=0.029) when compared to low SPARC expression. No significant difference was detected between high and low SPARC expression groups regarding age, sex, T stage, N stage, histopathology and stage-related patient characteristics. Conclusions: High SPARC expression was identified as a poor prognostic factor in cases with locally advanced NSCLC treated with concurrent chemoradiotherapy.

Spay-Related Urethral Sphincter Mechanism Incompetence Concurrent with Pituitary-Dependent Hyperadrenocorticism in a Bitch (암캐에서 부신피질기능 항진증 및 난소제거 이후 발생한 요도 괄약근 기능부전 증례)

  • Kang, Min-Hee;Kim, Ju-Won;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.28 no.2
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    • pp.258-261
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    • 2011
  • An 8-year-old spayed female, Yorkshire terrier dog was presented with a urinary incontinence. Unaware urine dribbling during sleeping was observed eight months after spaying. Polyuria and polydipsia were also reported. Physical examination revealed obesity and hypertension. Characteristic laboratory findings in this dog were polycythemia, hyperlipidemia and elevated hepatic enzyme. Other causes of the urinary incontinence were ruled out through further diagnostic tests and spay-related urethral sphincter mechanism incompetence (USMI) was made as a presumptive diagnosis. In addition, the dog was also diagnosed with pituitary-dependent hyperadrenocorticism. Both conditions can cause urinary incontinence in dogs; therefore, definite diagnosis was made through a therapeutic approach. The synthetic estrogen, diethylstilbesterol, was initially administered and successfully managed the urinary incontinence in this dog. To the best of the author's knowledge, this is the first case report describing the clinical and laboratory features of spay-related USMI concurrent with hyperadrenocorticism and treatment outcomes in our country.

Efficacy of combination of endo-xylanase and xylan-debranching enzymes in improving cereal bran utilization in piglet diet

  • Wang, Weiwei;Zheng, Dawen;Zhang, Zhenzhen;Ye, Hui;Cao, Qingyun;Zhang, Changming;Dong, Zemin;Feng, Dingyuan;Zuo, Jianjun
    • Animal Bioscience
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    • v.35 no.11
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    • pp.1733-1743
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    • 2022
  • Objective: This study was aimed to explore the efficacy of combination of endo-xylanase (Xyn) and xylan-debranching enzymes (arabinofuranosidase, Afd and feruloyl esterase, FE) in improving utilization of bran in piglet diet. Methods: In vitro experiments were firstly conducted to examine the enzymological properties of Xyn, Afd, and FE, concurrent with their effect on degradation of arabinoxylan (Abx) in bran. In vivo experiment was then implemented by allocating two hundred and seventy 35-d-old postweaning piglets into 3 groups (6 replicates/group), which received bran-containing diet supplemented with Xyn (1,600 U/kg) or its combination with Afd (0.8 U/kg) and FE (4 U/kg) or without enzyme. Results: Both Xyn, Afd, and FE are relatively stable against the changes in temperature and pH value. Combining Xyn with Afd and FE had a superiority (p<0.05) over Xyn alone and its combination with Afd or FE in promoting (p<0.05) degradation of Abx in different brans. Combined treatment with Xyn, Afd, and FE was more beneficial than Xyn alone to induce increasing trends (p<0.10) of average daily gain, final body weight and feed efficiency of piglets fed bran-containing diet. Moreover, combination of Xyn, Afd, and FE showed advantages (p<0.05) over Xyn alone in causing reductions (p<0.05) in diarrhea rate and cecal pH value, concurrent with increases (p<0.05) in cecal and colonic acetic acid and total volatile fatty acid concentrations, as well as cecal butyric acid concentration of piglets fed bran-containing diet. Conclusion: Combining Xyn with Afd and FE was more beneficial than Xyn alone in promoting degradation of Abx in bran, along with growth performance and intestinal volatile fatty acid profile of piglets received bran-containing diet. Thereby, combination of Xyn, Afd, and FE had a superior efficacy relative to Xyn alone in improving application of cereal bran in piglet diet.

Study of Validity and Reliability of the Korean Translation Version of the Sensory Processing and Self-Regulation Checklist (SPSRC) (한글판 감각처리 및 자기조절 체크리스트(SPSRC)의 타당도와 신뢰도 연구)

  • Kim, Ye-Eun;Lee, Hye-Rim;Lee, Sun-Min
    • The Journal of Korean Academy of Sensory Integration
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    • v.21 no.3
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    • pp.27-38
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    • 2023
  • Objective : This study aims to verify the validity and reliability of the Korean version of the Sensory Processing and Self-Regulation Checklist (SPSRC) for children with and without autism spectrum disorder. Methods : The Pearson product-moment correlation coefficient was calculated using Short Sensory Profile (SSP) to verify concurrent validity. Construct validity was verified by comparing the sensory processing ability and self-regulation ability of the two groups. Cronbach's α was calculated in the case of internal consistency for reliability verification, and the test-retest reliability was verified through the Pearson correlation coefficient. Results : Based on the verification of the concurrent validity, the Korean version of SPSRC and SSP showed a statistically significant correlation (p < 0.01). The construct validity was found to have a statistically significant difference between the two groups in the area and sub-items of the Korean version of SPSRC (p < 0.001). For the internal consistency, Cronbach's α ranged from 0.700 to 0.975. The test-retest reliability showed that the correlation coefficient ranged from 0.937 to 0.997. Conclusion : The Korean version of SPSRC was confirmed to be an evaluation tool with high validity and reliability. It is expected to be used as an evaluation tool for planning treatment goals in clinical trials and as a meaningful basis for future research.

Treatment outcomes of curative radiotherapy in patients with vulvar cancer: results of the retrospective KROG 1203 study

  • Kim, Youngkyong;Kim, Joo-Young;Kim, Ja Young;Lee, Nam Kwon;Kim, Jin Hee;Kim, Yong Bae;Kim, Young Seok;Kim, Juree;Kim, Yeon-Sil;Yang, Dae Sik;Kim, Yeon-Joo
    • Radiation Oncology Journal
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    • v.33 no.3
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    • pp.198-206
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    • 2015
  • Purpose: We evaluated the prognostic factors and clinical outcomes of 56 patients with vulvar cancer treated with curative radiotherapy (RT) or concurrent chemoradiotherapy. Materials and Methods: Overall survival (OS) and disease-free survival (DFS) were assessed retrospectively. Prognostic factors evaluated included age, International Federation of Gynecology and Obstetrics (FIGO) stage, TNM classification, tumor size, treatment modality, RT duration, and RT field. The association between the tumor human papillomavirus (HPV) status and survival was analyzed in 35 patients. Results: During the median follow-up of 2.8 years (range, 0.3 to 18.9 years), 21 patients (37.5%) experienced treatment failure. Fifteen patients (27%) had local failure: nine (16%) local failure only, three (5%) locoregional failure, two (4%) local and distant failure, and one (2%) locoregional and distant failure. Of 56 patients, seven (13%) had persistent disease at the first follow-up at 2 months and all but one died within a year after completing RT. The 5-year OS and DFS were 51.6% and 44.0%, respectively. In multivariate analysis, clinical size ${\geq}3$ cm predicted a poor prognostic factor for DFS (p = 0.040) and age (${\geq}70years$) was poor prognostic for DFS (p = 0.032) and OS (p = 0.048). Patients with HPV-positive tumors tended to have better 5-year OS and DFS, but the differences were not significant statistically. Conclusion: Clinical size ${\geq}3$ cm was a significant prognostic factor for DFS. However, age was the most important prognostic factor for DFS and OS in patients treated with curative RT. Further studies are needed to determine which treatment should be considered for old age ${\geq}70years$.