Rugved Kulkarni;Irfan Kabir;James Hodson;Syed Raza;Tahir Shah;Sanjay Pandanaboyana;Bobby V. M. Dasari
한국간담췌외과학회지
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제26권1호
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pp.31-39
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2022
In patients with neuroendocrine tumors with liver metastases (NETLMs), complete resection of both the primary and liver metastases is a potentially curative option. When complete resection is not possible, debulking of the tumour burden has been proposed to prolong survival. The objective of this systematic review was to evaluate the effect of curative surgery (R0-R1) and debulking surgery (R2) on overall survival (OS) in NETLMs. For the subgroup of R2 resections, outcomes were compared by the degree of hepatic debulking (≥ 90% or ≥ 70%). A systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines using PubMed, Medline, CINAHL, Cochrane, and Embase databases. Hazard ratios (HRs) were estimated for each study and pooled using a random-effects inverse-variance meta-analysis model. Of 538 articles retrieved, 11 studies (1,729 patients) reported comparisons between curative and debulking surgeries. After pooling these studies, OS was found to be significantly shorter in debulking resections, with an HR of 3.49 (95% confidence interval, 2.70-4.51; p < 0.001). Five studies (654 patients) compared outcomes between ≥ 90% and ≥ 70% hepatic debulking approaches. Whilst these studies reported a tendency for OS and progression-free survival to be shorter in those with a lower degree of debulking, they did not report sufficient data for this to be assessed in a formal meta-analysis. In patients with NETLM, OS following surgical resection is the best to achieve R0-R1 resection. There is also evidence for a progressive reduction in survival benefit with lesser debulking of tumour load.
In order to find out the status of health care of the old aged people (age of 65 and over) in a rural area, a study was carried out, through analyzing the data of health care clinic for 207 old aged people with geriatric diseases, and of questionnired survey for 84 old aged people with geriatric diseases in a rural community. Su Dong-Myun. Nam Yang Zu-Gun, Kyung Gi-Do, Korea, during the year of 1989. The following results were obtained. 1) The composition rate of population of age of 65 and over was 9.8% in total, and sex-specific composition rate was 9.3% in male and 10.4% in female. 2) Utilization rate of health care clinic for old aged people with geriatric diseases was the highest rate with 37.9%, through individual letters at the first time, and showed gradually decreasing tendency afterward. 3) In the means of utilization advices to health care clinic for the old aged people. the individual letters(37.9%) at the first time were more effective than public information of the old aged hall or/and Myun office(18.4%). 4) In opinion on utilization of health subcenter-health care clinic for the old aged people "will utilize"(59.5%) was the highest and "do not know"(26.2%) "be difficult to utilize" (9.5%) and "will not utilize"(4.8%) were in the next order. 5) Out of 84 respondents, the old aged people With geriatric diseases, 73.8%(about three-fourths) of them answered "their diseases to the aggravated" (29.8%) "not to be changed"(25.0%) and "to be unknown"(19.0%), and the others(26.2% of them) "to be changed for the better". 6) Out of 62 respondents(the old aged people), answered their geriatric diseases not to be changed for the better, "no curative effect" was the highest with 43.5% of them. "could not know" (33.9%), "would not treat"(19.4%) and "could not be treated"(4.8%) were in decreasing order. 7) The old aged people, responded their diseases to be changed for the better, answered that they(patients) should make themselves(68.2%) responsible for basic effort of health care. However the old aged people responded their diseases not to be changed for the better answered that they should impute the responsibility of basic effort for health care to medical facilities or other conditions(63.0%). 8) In the reason of failure that the old aged people responded their geriatric diseases not to have curative effect, mis-control of regular habits of daily life was the highest(57.1%), and failure of taking selected medicine steadily(28.6%), and abuse of medicines(14.3%) were in decreasing order. 9) The reason order of being changed for the better that the old aged people responded their diseases to have curative effect, was keeping and control of regular habits of daily life (46.7%), taking selected medicines steadily(33.3%) and others (20.2%) respectively. 10) The courses of geriatric diseases itself are so chronic, duplicate and uncertain, and the old aged people activities for disease control are so slow, various and uncertain that continuous health education in home or/and community unit must be essential factors for effective geriatric health care.
Herbal medicines have an accurate effect on atopic dermatitis, and at the same time, they hardly have adverse reactions. However, herbal medicines are difficult to be quantitatively analyzed due to low-quality preparation and types. In addition, herbal medicines have raised many problems as they have not been standardized and their active components have not been analyzed. Patients with atopic dermatitis began to recognize the effectivity and safety of herbal medicines. Accordingly, standardization, biological analyses, animal experiments and clinical trials should be generally performed in order that herbal medicines may be recognized all over the world. A standard, which is to objectively judge the curative effect of atopic dermatitis, should be established as soon as possible. Case studies and RCTs (Randomized Controlled Trials) should be actively performed on the basis of rigid clinical trial design to the end that the curative effect of herbal medicines is recognized all the world over.
Objectives : This study aimed to find the curative effect of Gamitongkyutang distillate in mice with allergic rhinitis. Metbods : Forty mice were divided into four groups: the normal group, the control group (allergic rhinitis elicited group), the sample I group (Gamitongkyutang treated group after allergic rhinitis elicitation) and the sample II group (distillate of Gamitongkyutang treated group after allergic rhinitis elicitation). Indexes of AR were investigated such as the histological changes of the nasal mucosa, the changes of eosinophil count, the changes of interleukin-4(IL-4) secretion in the intranasal mucosa, the alteration of inducible nitric oxide synthase(iNOS) mRNA expression and the distribution of the nuclear factor kappa B (NF-kB). ANOVA test was used for statistical analysis (p<0.05). Results : Loss of the cilium and the mucous secretion in the sample I and II groups was rare when compared to the control group. The segment of eosinophil was significantly decreased in the sample I and II groups when compared to the control group (p<0.05). A significant decrease of IL-4 mRNA expression was observed in the sample I and II groups when compared with the control group (p<0.05). Inhibition of iNOS induced by NF-kB p50 in the sample I and II groups was significantly superior to that in the control group (p<0.05). DGT and GT didn't affect AST and ALT. Conclusions : GT was superior to DGT in the IL-4 secretion, eosinophil levels and iNOS production. However, considering the difficulty in taking herbal medicine, the DGT has a meaningful curative effect in mice with allergic rhinitis.
The conclusions after studying the rules and the principles of the six-drugs mixing forming the prescription of Yukmijihwanghuan(六味地黃丸) are as follows: 1. Yukmijihwanghuan cares for the three viscera; the liver, the spleen and the kidney and the three entrails; the urinary bladder, the gall bladder, and the stomach and it strengthens them as well. The drug can be used mainly for the cure of the Three Yang Channels of Foot and the Three Yin Channels of Foot. 2. The three drugs of Yukmijihwanghuan; Rehmanniae Radix, Dioscoreae Rhizoma, Corni Fructus altogether has the tonifying effect and the other three; Alismatis Rhizoma, Moutan Cortex, Poria has the purging effect. The first three kinds of drugs tonifies and the last three kinds of drugs purges. While these two groups of drugs are pitted against each other, they also balance each other harmoniously increasing the curative effect(remedial[curative] value). 3. Yukmijihwanghuan cools off the lung which is under metal category, helps the spleen, an earth category to be strong. It also adds the Water Qi to the kidney so that it stabilizes the Fire Qi. 4. Yukmijihwanghuan helps the kidney strongly, helps the urine to be excreted well, cools down the Fire Qi and makes dry things wet. 5. Rehmanniae Radix, the principal drug of Yukmijihwanghuan and Corni Fructus, the minister drug of the medicine have a taste of thick and are materially heavy. The two drugs do the descending action that it tonifies Yin Qi and adds Essence of Life. The other ingredients of Yukmijihwanghuan; Moutan Cortex, Poria, Alismatis Rhizoma have effects on lowering the Fire Qi. If Fire Qi descends, then Water Qi ascends. Yukmijihwanghuan has an efficacy of lowering Fire Qi and increasing Water Qi.
Objectives The purpose of the study is to review the trend of clinical trials conducted in China with oral herbal medicine treatment on childhood primary hyperhidrosis. Methods We searched the randomized controlled trials (RCTs) with oral herbal medicine treatment on childhood primary hyperhidrosis from the China National Knowledge Infrastructure (CNKI). The demographic data, duration of illness, intervention, treatment period, outcome and composition of herbal medicine were analyzed for this study. Results A total of five RCTs were selected and analyzed. The effectiveness of the oral administration of herbal medicines on childhood primary hyperhidrosis was found to be significant. In one study, there was no statistical difference between the treatment group and the control group when curative effect was evaluated two weeks after the intervention; however, the treatment group showed a statistically higher curative effect than the control group at one and two months after intervention, and also one month after the intervention was terminated. Conclusions Oral herbal medicine has been shown to be an effective treatment for childhood primary hyperhidrosis, and it takes at least one month for the administered oral herbal medicines to take effect. However, further well-designed large-scale randomized controlled trials are needed to confirm the efficacy and safety of oral herbal medicines in childhood primary hyperhidrosis.
This study aimed to verify the nutritional and curative effects of protein hydrolysate in rats with cysteamine-induced duodenal uncer. Duodenal ulcer rat model was established by intraperitoneal injections of cysteamine. Sprague-Dawley, female rats weighing approximately 200g were intraperitoneally injected twice cysteamine(13mg/100g BW) at intervals of 3h per day. This procedure was repeated 3$\times$at intervals of 3d. Animals fed on 10% casein diet for infection periods. After last injection, 4 kinds of diets(10% casein, 20% casein, 10% casein hydrolysate, 20% casein hydrolysate) were given. Gastric montility, trypsin activity in gastrointestinal content, retention rate of nitrogen, plasma total protein, albumin, amino-N, urinary urea nitrogen, creatinine and hydroxyproline were analyzed for nutritional effects of dietary nitrogen levels(10%, 20%) and sources(casein, casein hydrolysate). In duodenal ulcer rat model, there was no differences between 20% casein diet and 20% casein hydrolysate in the view of severeness of ulcer, gastric emptying rate, serum total protein, serum albumin, plasma $\alpha$-amino-N, UUN, creatinine excretion, GFR, nitrogen retention. On the other hand, rats on 10% casein hydrolysate diet group had more curative effect of the ulcer, higher plasma albumin concentration and nitrogen retention than 10% casein diet group. The casein hydrolysate diet group was lower trypsin activity in small intestinal content than the casein diet group, at both nitrogen levels(10%, 20%). The results suggest that protein hydrolysate be applied in diet therapy for the patients with gastrointestinal ulcer.
Internal deficiency of vital Qi is origination of cancer and root cause of its development from the viewpoint of traditional Chinese medicine(TCM). For about 40 years, China has developed a combined system of TCM and Western medical system in treatment of cancers, laying stress on the therapeutic principle of strengthening the body resistance and restoring normal functioning of the body to consolidate the constitution (Fu Zheng Pei Ben). According to the results of the latest clinical and experimental studies, Chinese medicine not only increases curative effectiveness, but also reduces the side effect caused by the toxic, radio and chemical treatment of cancer cases in the western medical system as well as various complications. Long-term taking Chinese herbal medicine prevents recurrence and metastasis of tumor, and heightens long-term curative effectiveness after western medical treatments. It also helps to relieve symptoms, improve the quality of life, and prolong life of terminal cancer patients who have already lost opportunities of western medical treatments. In addition, it can prevent and cure premonitory symptoms of cancer.
Purpose: The significance of hospital volume remains inconsistent and controversial. In particular, few studies have examined whether hospital volume is associated with the outcome of gastrectomy for gastric cancer in East Asia. This study examined the effect of hospital volume on the short-term surgical and long-term oncological outcomes of patients undergoing curative gastrectomy for gastric cancer. Materials and Methods: Between 2009 and 2011, 1,561 patients underwent curative gastrectomy for gastric cancer at Seoul St. Mary's Hospital (n=1,322) and Bucheon St. Mary's Hospital (n=239). We defined Seoul St. Mary's Hospital as a high-volume center and Bucheon St. Mary's Hospital as a low-volume center. Results: The extent of resection, rate of combined resection, tumor stage, operating time, and hospital stay did not differ significantly between the 2 hospitals. In addition, the hospital volume was not significantly associated with the 30-day morbidity and mortality. When the overall and disease-free survival rates of the patients were stratified according to stage, hospital volume was not significantly associated with prognosis at any stage. Conclusions: Hospital volume might not be a decisive factor with respect to the surgical and oncological outcomes of patients if well-trained surgeons perform gastrectomy for gastric cancer.
(Backgrounds) This study was performed to evaluate the usefulness of red ginseng ex rant as adjuvant therapeutic agent improving immune function in immune compromizing gas-trointestinal carcinoma patient. (Material and Methods) We were treated 72 patients with two groups after we were undertaken the curative resection for gastrointestinal carcinoma; 1) only chemotherapy and immunotherapy (control group) 2) chemotherapy and immunotherapy with 4500 mg (15 tablets) red ginseng for 6 months (study group). For investigating the immunologic alternations alongside the numerical changes in peripheral blood Iymphocyte and their subsets in the gastrolntestinal carcinoma patients, Iymphocyte surface markers were determined by monoclonal antibodies on the preoperative day, postoperative 1 months, 3 months, 6 months, 12 months and 18 months in 40 controls and 32 red ginseng groups In gastrointestinal carcinoma patients which was recruited at Korea diversity Hospital from March, 1995 to January, 1997. The patient was measured and compared in both groups with the body weight, total protein and albumin, blood hematocrit and hemoglobin, total leukocyte, lymphocyte and lymphocyte subsets count in peripheral blood through planed schedules. (Couclusion) This data suggests that red ginseng may be useful as a adjuvant therapeutic agent for improving the immune function after curative operation for immune compromizing gastrointestinal carcinoma patients. Key words : Ginseng, Immunity, Gastrointestlnal carcinoma patients.
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