• Title/Summary/Keyword: Early-stage treatment

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Modern Treatment of Early Gastric Cancer: Comparison between Laparoscope Assisted vs Hand-Assisted Laparoscopic Distal Gastrectomy vs Open Distal Gastrectomy (조기 위암의 최신 치료 방법 : 복강경 원위부 위절제술, Hand-Assisted 복강경 원위부 위절제술과 소개복 원위부 위절제술의 비교)

  • Yoon, Ki-Young;Gagner, Michel;Lee, Sang-Ho
    • Journal of Gastric Cancer
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    • v.4 no.2
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    • pp.75-81
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    • 2004
  • Recently detection of early gastric cancer (EGC) has been increasing and the treatment strategies for gastric cancer have been changing. The purpose of this study was to compare clinical outcomes between laparoscopically assisted (LADG) and hand-assisted laparoscopic gastrectomy (HALDG) and open distal gastrectomy for early gastric cancer. This review is directed toward providing gastric surgeons with recent advances in the treatment of EGC. We investigated the English language literature for the past 12 years through computer searches which focused on : 1) Patient demographics, 2) Operation time, 3) Intra-operative blood loss, 4) Depth of invasion, 5) CBC, 6)Weight loss, 7) Analgesic requirement, 8)Time NPO, 9) Length of hospital stay, 10) Tumor stage, 11) Lymph node (LN) dissection, 12) Position of LN resected, 13) Complications. Improved operative techniques and surgical instrumentation have facilitated the development of minimally invasive gastric cancer surgery. The short-term benefits of laparoscopic gastrectomy included less surgical trauma, less pain, rapid return of gastrointestinal function, and shorter hospital stay, with no change in operative outcome. Laparoscopic gastrectomy was better accepted by the patients as a good procedure and promptly brought the patients back to their previous lifestyle and activities of daily living. But the advantages of HALDG for gastric cancer, extended lymph node dissection and intracorporeal anastomosis are feasible and easier with the presence of the internal hand. The hand-assisted laparoscopic (HALDG) method reported the best results in lymph node dissection.This method is an alternative to total laparoscopic radical gastrectomy. LADG and HALDG, when compared with conventional open gastrectomy, have several advantages. When performed by a skilled surgeon, LADG and HALDG are safe and useful techniques for patients with early-stage gastric cancer. Their appropriateness for gastric cancer surgery require further study.

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A Case report of Soyangin patient with early-stage Parkinson's disease treated with Hyeongbangjihwhang-tang (형방지황탕(荊防地黃湯)으로 호전된 초기 파킨슨병환자의 두통(頭痛) 변비(便秘) 치험례)

  • Lee, In-Sung;Won, Jin-Hee
    • Journal of Sasang Constitutional Medicine
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    • v.28 no.2
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    • pp.184-192
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    • 2016
  • Objectives The purpose of this case study is to report significant improvement of headache, constipation and a slight improvement of tremor after treatment with Hyeongbangjihwhang-tang in a Soyangin patient with Parkinson's disease.Methods This Soyangin patient is treated by Hyeongbangjihwhang-tang and acupuncture therapy. The progress was evaluated using the Unified Parkinson Disease Rating Scale before and after treatment. Secondary results assessments include Global Assessment Scale, change of patient's omniloquilism, Xerostomia and Cold hands & Feet Syndrome.Results and Conclusions The patient's symptoms of headache, constipation and tremor were improved after using Hyeongbangjihwhang-tang. and UDPRS score decreased in Part Ⅰ, Part Ⅱ, and Part Ⅲ. In conclusion, this study shows that Hyeongbangjihwhang-tang can be effective treatment for Soyangin patient with early-stage Parkinson''s disease. Overall, Sasang medicine can be a solution of the symptoms caused by Parkinson's disease. Through Sasang medicine we can contribute Parkinson's disease Patient's quality of life get better.

Current Status of Robotic-assisted Surgery in Gastric Cancer

  • Eli Kakiashvili
    • Journal of Digestive Cancer Research
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    • v.4 no.2
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    • pp.99-106
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    • 2016
  • Minimally invasive surgery for gastric cancer has increased in popularity during the last two decades mainly in the Asia for patients with early-stage cancer. Nevertheless, the development of laparoscopic surgery for gastric cancers in the Western world has been slow because of the advanced stage at diagnosis for which LG is not yet considered an acceptable alternative to standard open surgery. RAG has been reported as a safe alternative to conventional surgery for treating of early gastric carcinoma. We assess the current status of robotic surgery in the treatment of gastric cancer focusing on the technical details, postoperative outcome, oncological considerations and future perspectives. In gastrectomy the biggest advantage of the robotic approach is the ease and reproducibility of lymphadenectomy. Reports also show that even the intra corporeal digestive restoration is facilitated by use of the robotic approach, particularly following TG. Additionally, the accuracy of robotic dissection is confirmed by decreased blood loss in comparison to conventional laparoscopy. The learning curve and technical reproducibility also appear to be shorter with robotic surgery and, consequently, robotics can help to standardize and diffuse minimally invasive surgery in the treatment of gastric cancer. While published reports have shown no significant differences in surgical morbidity, mortality, or oncological adequacy between robot-assisted and conventional gastrectomy. There are some advantages in terms of postoperative recovery of patients after robotic surgery. More studies are needed to assess the true indications and oncological effectiveness of robotic use in the treatment of gastric carcinoma.

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Effects of Shading at Heading Stage on Yield Components in Rice (출수기 차광이 벼 수량 관련형질에 미치는 영향)

  • 김기식;김승경;허범량;윤경민
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.36 no.2
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    • pp.127-133
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    • 1991
  • Experiments were conducted to investigate the effect of light shading around the heading stage on grain yield and its components of rice. Early, medium, and late-maturing varieties were trected with the light shading of 50% and 75% from the reduction division stage to 20 days after heading date. Heading date were delayed 2-3 days, whereas the mid -late varieties, Sangpung- byeo, and Bongkwang- byeo were no significantly affected. Culm length was increased and panicle exsersion was reduced as the shading treatments become higher, and the degree of the shading effect was more intensive at 75% of shading. The rate of spikllet degeneration was higher at the secondary rachis branches than the primary rachis branch. The early maturing varieties showed the higher rate of spikelet degeneration. Spikelet number was reduced 12-15, spikelet sterility was increased and ripening rate was declined by the shading treatments. Grain yield was decreased by 30-40% at the shading treatment of 50%, and 50% at the shade treatment of 75%.

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A novel schedule of accelerated partial breast radiation using intensity-modulated radiation therapy in elderly patients: survival and toxicity analysis of a prospective clinical trial

  • Sayan, Mutlay;Wilson, Karen;Nelson, Carl;Gagne, Havaleh;Rubin, Deborah;Heimann, Ruth
    • Radiation Oncology Journal
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    • v.35 no.1
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    • pp.32-38
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    • 2017
  • Purpose: Several accelerated partial breast radiation (APBR) techniques have been investigated in patients with early-stage breast cancer (BC); however, the optimal treatment delivery techniques remain unclear. We evaluated the feasibility and toxicity of APBR delivered using intensity-modulated radiation therapy (IMRT) in elderly patients with stage I BC, using a novel fractionation schedule. Materials and Methods: Forty-two patients aged ${\geq}65$ years, with stage I BC who underwent breast conserving surgery were enrolled in a phase I/II study evaluating APBR using IMRT. Forty eligible patients received 40 Gy in 4 Gy daily fractions. Patients were assessed for treatment related toxicities, and cosmesis, before APBR, during, and after completion of the treatment. Results: The median age was 73 years, median tumor size 0.8 cm and the median follow-up was 54 months. The 5-year locoregional control was 97.5% and overall survival 90%. Erythema and skin pigmentation was the most common acute adverse event, reported by 27 patients (69%). Twenty-six patients (65%) reported mild pain, rated 1-4/10. This improved at last follow-up to only 2 (15%). Overall the patient and physician reported worst late toxicities were lower than the baseline and at last follow-up, patients and physicians rated cosmesis as excellent/good in 93% and 86 %, respectively. Conclusion: In this prospective trial, we observed an excellent rate of tumor control with daily APBR. The acceptable toxicity profile and cosmetic results of this study support the use of IMRT planned APBR with daily schedule in elderly patients with early stage BC.

Consideration of Cardia Preserving Proximal Gastrectomy in Early Gastric Cancer of Upper Body for Prevention of Gastroesophageal Reflux Disease and Stenosis of Anastomosis Site

  • Kim, Jihoon;Kim, Sungsoo;Min, Young-Don
    • Journal of Gastric Cancer
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    • v.12 no.3
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    • pp.187-193
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    • 2012
  • Purpose: The aim of this study is to evaluate the feasibility and safety of cardia preserving proximal gastrectomy, in early gastric cancer of the upper third. Materials and Methods: A total of 10 patients were diagnosed with early gastric cancer of the upper third through endoscopic biopsy. The operation time, length of resection free margin, number of resected lymph nodes and postoperative complications, gastrointestinal symptoms, nutritional status, anastomotic stricture, and recurrence were examined. Results: There were 5 males and 5 females. The mean age was $56.5{\pm}0.5$ years. The mean operation time was $188.5{\pm}0.5$ minutes (laparoscopic operation was 270 minutes). Nine patients were T1 stage (T2 : 1), and N stage was all N0. The mean number of resected lymph nodes was $25.2{\pm}0.5$. The length of proximal resection free margin was $3.1{\pm}0.1$ cm and distal was $3.7{\pm}0.1$ cm. Early complications were surgical site infection (1), bleeding (1), and gastro-esophageal reflux disease (1) (this symptom was improved with medication). Late complications were dyspepsia (3) (this symptom was improved without any treatment), and others were nonspecific results of endoscopy or symptom. Conclusions: Cardia preserving proximal gastrectomy was feasible for early gastric cancer of the upper third. Further evaluation and prospective research will be required.

Endobronchial Ultrasound in Early Lung Cancer (초기 폐암에서 기관지 초음파 내시경의 임상적 유용성)

  • Park, Jinkyeong;Hwangbo, Bin
    • Korean Journal of Bronchoesophagology
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    • v.17 no.1
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    • pp.9-13
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    • 2011
  • Endobronchial ultrasound (EBUS), which enables visualization of lesions beyond the bronchus, broadens the fields of bronchoscopy. Two types of ultrasound, radial and linear, are used for bronchoscopy. Radial EBUS is performed by inserting an ultrasound mini-probe through the working channel of a flexible bronchoscope. Evaluation of the depth of invasion of early endobronchial lung cancers using radial EBUS is useful in deciding endobronchial treatment. A central tumor limited to within the cartilaginous layer is a good indication for endobronchial photodynamic therapy. EBUS-guide sheath (GS) technique is a sampling method assisted by localization of peripheral lesions using EBUS. The diagnostic yield of EBUS-GS method is higher than that of conventional transbronchial biopsy. High diagnostic values of EBSU-GS method are reported even in small (${\leq}2cm$) peripheral tumors. Linear EBUS is used for endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA). EBUS-TBNA has high diagnostic yields in mediastinal staging of lung cancer even in patients having radiologically early stage lung cancers with normal CT or PET findings in the mediastinum. EBUS is a valuable method in evaluating early endobronchial tumors and peripheral small lung cancers and as well as in mediastinal staging.

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Report on the Case of Treatment of Child Guillain-Barre Syndrome (소아(小兒) Guillain-Barre 증후군(症候群) 치험례(治驗例) 보고(報告))

  • Lee, Jae-Won;Koo, Eun-Jeong
    • The Journal of Korean Medicine
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    • v.18 no.2
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    • pp.137-147
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    • 1997
  • The writers have treated in hospital a two-year and 4 month boy child with Guillain-Barre syndrome whose chief complaints are flaccid tetraparalysis and hypesthesia for about three months from December 2, 1996. In the early stage, the principles and methods of treatment such as wind expelling and removal of dampness(?風濕) and obstruction in meridians and collaterals(通經活絡) were used and in the late stage the principles and methods of treatment to invigorate the spleen, replenish Ki(健脾益氣), and nourish the liver and kidneys(滋補肝腎) were applied, together with acupuncture, indirect moxibustion and massotheraphy. Since then, the symptom has gradually improved. Six months after onset, the boy child was recovered to a nearly normal condition. Therefore, this case of treatment is reported, together with consideration of literature.

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Clinical Diagnosis of Oral Cancer (구강암의 임상적 진단)

  • Choi, Sung Weon
    • The Journal of the Korean dental association
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    • v.49 no.3
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    • pp.136-145
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    • 2011
  • Oral cavity cancer accounts for approximately 3-4% of all malignancies and is a significant worldwide health problem. The Korea Central Cancer Registry estimates that there will be approximately 1500 new cases of oral cancer in Korea. Oral cancer occurs most commonly in middle-aged and elderly individuals. The majority of oral malignancies occur as squamous cell carcinomas and despite remarkable advances in treatment modalities, the 5-year survival rate has not significantly improved over the past several decades, hovering at about 50% to 60%. The unfavorable 5-year survival rate may be attributable to several factors. First, oral cancer is often diagnosed at a late stage, with late stage 5-year survival rates as low as 22%. Additionally, the development of secondary primary tumors in patients with early stage disease has a major impact on survival. The early detection of oral cancer and premalignant lesions offers the promise to cure chance of oral cancer. The major diagnostics moddalities for oral cancer include oral cavity examination, supravital staining, oral cytology, and optical detection systems. But the clinical finding of oral mucosa is the most important key to confirm the oral cancer until now. The traditional clinical examination of oral cavity can be performed quickly, is without additional diagnostic expense to patients, and may be performed by health care professionals. Therefore, clinicians must be well-acquainted with clinical characteristics of oral cancer and practice routine screening for oral cancer in dental clinic to decrease the morbidity and mortality of disease.

Patients with HER2-positive Early Breast Cancer Receiving Adjuvant Trastuzumab: Clinicopathological Features, Efficacy, and Factors Affecting Survival

  • Ulas, Arife;Kos, Tugba;Avci, Nilufer;Cubukcu, Erdem;Olmez, Omer Fatih;Bulut, Nilufer;Degirmenci, Mustafa
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1643-1649
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    • 2015
  • Background: The aim of the present study was to evaluate clinicopathological characteristics of our early stage breast cancer patients who are epidermal growth factor receptor 2 (HER2) overexpressed/amplified (HER2+), the efficacy of trastuzumab treatment and survival results. Materials and Methods: Patients with HER2-positive early stage breast cancer receiving adjuvant trastuzumab were investigated retrospectively. Clinicopathological features of 210 patients and treatment outcome were analysed. To evaluate survival rates, the Kaplan-Meier method was used. Univariate and multivariate analyses were conducted with the Cox regression model. Results: Mean age of the patients was 51.8, 71.9% being postmenopausal. Some 37.6% of patients were node negative, and 31% had T1 tumor size and 52.4% were positive for estrogen receptor. Of 210 patients, 89.5% completed planned 52 weeks adjuvant trastuzumab treatment. The median follow up was 27.5 months (6.0-86.0). Relapse free survival (RFS) was 68.0 months (95% CI: 62.1-74.0) and overall survival (OS) was 74.8 months (95% CI: 69.5-80.1). The 3 year OS for all patients was 92.0% and RFS was 79.6%. During follow up, relapse was detected at the rate of 14.3%. Trastuzumab associated cardiotoxicity was found at the rate of 3.3%. In univariate analyses, larger tumor size and grade III were significantly associated (p<0.05) with RFS. Multivariate analyses of covariates displaying p<0.05 identified grade III as an independent prognostic factor. Conclusions: In the present study, it was established that trastuzumab had a satisfactory safety profile and treatment efficacy as in other clinical studies and that among clinicopathological factors evaluated, only being grade 3 had a significant effect on RFS. The occurrence of relapse with adjuvant trastuzumab makes it necessary to identify molecular predictors, which will define this group better and help explain resistance to anti HER2 based therapies.