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Value of KRAS, BRAF, and PIK3CA Mutations and Survival Benefit from Systemic Chemotherapy in Colorectal Peritoneal Carcinomatosis

  • Sasaki, Yusuke;Hamaguchi, Tetsuya;Yamada, Yasuhide;Takahashi, Naoki;Shoji, Hirokazu;Honma, Yoshitaka;Iwasa, Satoru;Okita, Natsuko;Takashima, Atsuo;Kato, Ken;Nagai, Yushi;Taniguchi, Hirokazu;Boku, Narikazu;Ushijima, Toshikazu;Shimada, Yasuhiro
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.539-543
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    • 2016
  • Background: It is well known that peritoneal carcinomatosis (PC) from colorectal cancer (CRC) is associated with a poor prognosis. However, data on the prognostic significance of modern chemotherapy containing bevacizumab, cetuximab or panitumumab are not available. Materials and Methods: This retrospective review concerned 526 patients with metastatic CRC who were classified into two groups according to the presence or absence of PC, and were treated with systemic chemotherapy, with or without bevacizumab or anti-EGFR antibodies. The genetic background, in particular KRAS, BRAF, and PIK3CA gene mutations, and overall survival (OS) were compared between the two groups. Results: The median OS values were 23.3 and 29.1 months for PC and non-PC patients, respectively (hazard ratio [HR]=1.20; p=0.17). Among all patients, tumor location, number of metastatic sites and BRAF mutation status were significant prognostic factors, whereas the presence of PC was not. In the PC group, chemotherapy with bevacizumab resulted in a significantly longer OS than forchemotherapy without bevacizumab (HR=0.38, p<0.01), but this was not the case in the non-PC group (HR=0.80, p=0.10). Furthermore, the incidence of the BRAF V600E mutation was significantly higher in PC than in non-PC patients (27.7% versus 7.3%, p<0.01). BRAF mutations displayed a strong correlation with shorter OS in non-PC (HR=2.26), but not PC patients (HR=1.04). Conclusions: Systemic chemotherapy, especially when combined with bevacizumab, improved survival in patients with PC from CRC as well as non-PC patients. While BRAF mutation demonstrated a high frequency in PC patients, but it was not associated with prognosis.

Case Report: A Case of Conversion Disorder Treated by Ganyanghwapung(肝陽化風) Comprehensive Diagnosis (전환장애를 간양화풍(肝陽化風)으로 변증(辨證)한 치험 1례(例))

  • Kim, Jin-Won;Jeong, Byeong-Ju;Woo, Sung-Ho;Kim, Byung-Chul;Son, Ji-Hyung;Lim, Ho-Jae;Hwang, Gyu-Dong;Seo, Ho-Seok;Kim, Yong-Ho;Han, Seung-Hea
    • The Journal of Internal Korean Medicine
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    • v.26 no.2
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    • pp.489-497
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    • 2005
  • Conversion disorder lacks temperamental grounds and is a type of somatoform disorder that includes alteration or loss of physical functions implicated in physical deficit suggestive psychological conflict. There is high incidence of return of conversion disorder and difficulty in producing exact approaches of cure and apparent effects of remedy with symptomatic treatment alone because of its complex clinical symptoms. The approach of Oriental Medicine in treatment of conversion disorder is to apprehend relative symptoms from the syndrome combined with several annexational symptoms centering around sequential symptoms. Thereupon, author made a Ganyanghwapung comprehensive diagnosis was conducted using Oriental Medicine measures by differential diagnostic methods in psychosomatic patients whose cases are diagnosed as conversion disorder. Then, Cheonmagudeungeum Gagambang was prescribed for them and it brought on satisfactory effects from the first or second treatment. There have been many cases reporting the application of Oriental Medicine treatment to conversion disorder to date and outcomes have also been favorable. Results of this study likewise suggest that this Oriental Medicine treatment for conversion disorder is effective.

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A Case Study of Tremor Patient diagnosed as Cerebellar infarction (소뇌경색(小腦梗塞)으로 인한 진전환자(振顫患者)의 치험(治驗) 1례(例))

  • Hwang, Jin-Woo;Kang, Rae-Yeop;Shim, Hyo-Ju;Na, Yu-Jin;Kim, Byung-Chul;Song, Soo-Cheol;Lee, Won-Hui;Kim, Jin-Won;Seo, Ho-Seok;Kim, Yong-Ho
    • The Journal of Internal Korean Medicine
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    • v.28 no.4
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    • pp.929-936
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    • 2007
  • Tremor is a rhythmic, involuntary muscular contraction characterized by oscillations of a part of the body and is the most common movement disorder. Clinically, tremor isclassified into postural tremor, resting tremor, action tremor, or other kinds of tremor, and treated according to the causes. The appropriate treatment of tremor depends on accurate diagnosis of its cause. We have recently examined a number of tremor-patients diagnosed as cerebellar infarction. Based on traditional Korean medicine curative way, we diagnosed this patient as deficiency of Qi and blood(氣血兩虛). On this account, suitable treatment had been provided. Our results show the clinical symptoms had improved through treatment with herbal medicine (Palmultang-gamibang) and acupuncture, so we report it for better treatment.

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Magnetic Resonance Findings of a Canine Benign Uveal Melanocytoma

  • Yoon, Hyounglok;Yu, Jin;An, Taegeon;Lee, Hanbin;Kim, Hakhyun;Kim, Dongwook;Chang, Jinhwa;Kang, Ji-Houn;Kim, Gonhyung;Chang, Dongwoo
    • Journal of Veterinary Clinics
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    • v.35 no.5
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    • pp.233-236
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    • 2018
  • A 13-year-old spayed female Beagle dog was referred with high intraocular pressure, hyperemia, and exophthalmos of the left eye and underwent ultrasound, which revealed a mass in the ciliary body of the left eye. Magnetic resonance (MR) imaging was ordered to evaluate invasion of surrounding structures and metastasis to the brain via the optic nerve. On MR imaging, a single, well-defined, smoothly marginated, triangular-to-oval-shaped mass was found. The mass was hyperintense on T1-weighted images and hypointense on T2-weighted images, similar to a previous case of ocular melanoma. The mass originated from the ciliary body and extended from the anterior chamber to the posterior chamber. Slight enhancement was observed in the mass. There was no evidence of invasion into surrounding structures or the optic nerve, and no sign of metastasis to the brain. The mass was histopathologically diagnosed as benign uveal melanocytoma.

Evaluation of Airborne Bacteria and Fungi in Surgical Areas at the Animal Hospital

  • Jeong, Seongsoo;Kang, Yuntae;Hwang, Yawon;Yoo, Seungwon;Jang, Hyejin;Oh, Hyejong;Kang, Jihoon;Chang, Dongwoo;Na, Kijeong;Kim, Gonhyung
    • Journal of Veterinary Clinics
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    • v.34 no.2
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    • pp.76-81
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    • 2017
  • Studies on the concentration of airborne microorganisms in human medicine as a part of a study on the nosocomial infections have been conducted properly, but in veterinary medicine, there has been rarely performed in Korea to the best of study's knowledge. The purpose of this study was to evaluate the distribution of airborne microorganisms and to identify their species in different places in the animal hospital to alert the necessity of thorough cleanliness management. This study evaluated the concentrations of airborne bacteria and fungi in hospital areas, such as patient waiting room, internal medicine ward, surgical ward and radiological diagnostic ward. The concentration of bacteria and fungi was significantly lower (p < 0.05) in two operating rooms and higher in the patient waiting room. The dominant species of bacteria were Micrococcus spp., Staphylococcus spp., and fungi were Penicillium spp., Dermatophyte mold. Animal hospitals need to perform proper procedures for disinfection, sterilization, and environmental cleaning as well as appropriate employee training and monitoring in order to the maximum prevention of the risk of nosocomial and surgical infections.

A clinical Case Report of Spastic Patient After Stroke Treated with Gagamyounjo-tang (뇌경색 후유증으로 발생한 주관절 경직 환자의 가감윤조탕(加減潤燥湯) 치험1례)

  • Shim, Hyo-ju;Kim, Byung-chul;Woo, Sung-ho;Na, Eu-jin;Hwang, Jin-woo;Kang, Rae-yeop;Kim, Yong-ho;Seo, Ho-seok;Kim, Jin-won;Song, Su-chul
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.8 no.1
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    • pp.40-47
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    • 2007
  • Many patients have difficulties after stroke. Spasticity is an important one of that difficulties. So in these days, its management is becoming a major issue in rehabilitation. Gagamyounjo-tang was administered to a patient have had spasticity after stroke include Hyulhu(血虛) symptoms. And check the modified Ashworth Scale, Motor grade and VAS for being in the hospital. After treated with Gagamyounjo-tang, Modified Ashworth Scale, Motor grade and VAS have improved, and most of all symptoms about hyulhu(血虛) was disappeared. Based on this result, this study shows that Gagamyounjo-tang was effective in spasticity after stroke especially included Hyulhu(血虛) symptoms.

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A Case of Asymptomatic, Localized, and Idiopathic Diffuse Alveolar Damage

  • Jeon, Young-Do;Hong, Christian;Joh, Joon-Sung;Jung, Ja-Young;Min, Ji-Won;Park, Seon-Young;Lee, Ga-Ram
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.4
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    • pp.386-389
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    • 2012
  • Diffuse alveolar damage (DAD) is a histological change in lung tissue, and is generally caused by an acute lung injury, which is characterized by bilateral and widespread damages. Localized DAD occurs very rarely. The causes for DAD are numerous, but the chief cause is acute interstitial pneumonia or acute exacerbation of idiopathic interstitial pneumonia, in cases of idiopathic manifestation. The 82-year-old patient, in this case study, showed a DAD lesion in only 1 lobe. The patient was otherwise healthy, with no previous symptoms of DAD. He was admitted to our medical center owing to localized infiltration, observed on his chest radiograph. Laboratory studies showed no signs of infections. DAD was confirmed by a surgical lung biopsy. The patient received corticosteroid treatment and had gradually improved. We report the case of a patient with localized, idiopathic DAD that cannot be classified as acute interstitial pneumonia or acute exacerbation of idiopathic interstitial pneumonia.

Differences in the Survival of Gastric Cancer Patients after Gastrectomy according to the Medical Insurance Status

  • Jang, Jae Seong;Shin, Dong Gue;Cho, Hye Min;Kwon, Yujin;Cho, Dong Hui;Lee, Kyung Bok;Park, Sang Soo;Yoon, Jin;Jang, Yong Seog;Kim, Il Myung
    • Journal of Gastric Cancer
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    • v.13 no.4
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    • pp.247-254
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    • 2013
  • Purpose: In Korea, the entire population must enroll in the national health insurance system, and those who are classified as having a lower socioeconomic status are supported by the medical aid system. The aim of this study was to evaluate the association of the medical insurance status of gastric cancer patients with their survival after gastrectomy. Materials and Methods: A total of 247 patients who underwent surgical treatment for gastric cancer between January 1999 and December 2010 at the Seoul Medical Center were evaluated. Based on their medical insurance status, the patients were classified into two groups: the national health insurance registered group (n=183), and the medical aid covered group (n=64). The survival rates were calculated using the Kaplan-Meier method. Results: The median postoperative duration of hospitalization was longer in the medical aid covered group and postoperative morbidity and mortality were higher in the medical aid group than in the national health insurance registered group (P<0.05). The overall 5-year survival rate was 43.9% in the medical aid covered group and 64.3% in the national health insurance registered group (P=0.001). Conclusions: The medical insurance status reflects the socioeconomic status of a patient and can influence the overall survival of gastric cancer patients. A more sophisticated analysis of the difference in the survival time between gastric cancer patients based on their socioeconomic status is necessary.