• Clinical and Experimental Pediatrics
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• v.48 no.4
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• pp.416-424
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• 2005

Purpose : To find the risk factors associated with coronory artery lesions, non-responsiveness to intravenous immunoglobulin(IVIG) treatment, and recurrences in Kawasaki disease patients. Methods : We retrospectively analyzed 1,000 Kawasaki disease patients who were admitted to Yonsei University Medical Center from September 1990 to December 2003. We compared between responder and non-responder groups to IVIG treatment as well as between relapsed and non-relapsed groups, and as to the relapsed group, we also compared variables between patients in their first and second attack states. Finally, factors associated with longer-fever duration from disease onset were evaluated. Results : Longer fever durations before and after IVIG treatment, male sex, lower Hgb and Hct level, higher WBC count and segmented WBC proportion, and higher CRP and Harada's score were related with coronary artery lesions. Non-responsiveness was related to higher WBC count, segmented WBC proportion, CRP, SGPT, Harada's score, and pyuria. Moderate-to-severe coronary artery dilatations and recurrences were more commonly seen among the non-responder group. No significant predictive factors for recurrence were found. In the relapsed group, lower WBC count, CRP, and shorter fever duration from disease onset were observed in their second attack state. Fever duration from disease onset showed positive correlation with WBC count, CRP, and Harada's score and negative correlation with Hgb levels. Conclusion : Higher WBC count, CRP, and higher Harada's score were related to both higher incidences of coronary artery lesions and non-responsiveness to IVIG treatment, and these factors were also related with longer fever duration. Non-responders to IVIG treatment showed higher recurrence rate and more moderate-to-severe coronary artery dilatations than responders.

• Radiation Oncology Journal
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• v.6 no.2
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• pp.211-226
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• 1988

Among 165 patients of esophagus cancer treated by either radiation alone or postoperative radiation, median survival period was 6.6 months, $16\%$ 3 years and $8\%$ 5years crude survival. In biphasic plotting of survival curve semilogarithmically all nonresponder died within one year regardless of treatments and in responder each 1, 2, 3 years survival rate was $80\%,\;70\%,\;60\%$ in the group of postoperative radiation among 20 patients ($54\%$ of 37 patients) respectively and $62\%,\;38\%,\; 23\%$ each in the group of radiation alone among 61 patients ($48\%$ of 128 patients) respectively, better survival rate of postoperative radiation vs radiation alone in 3 year (P<0.01). The most common cause of death was dysphagia $55\%$, and majority of patients died by failure to control the disease locally $62\%,\;88\%$ of stricture were associated with persistenece of cancer in esophagus. $50\%$ of patients was found to have locoregional metastatc nodes. Preoperative diagnostic failure rate was for metastatic locoregional nodes was $54\%$, for grossly metastatic nodes $29.7\%$, for blood borne organ metastasis $13.5\%$, and for local extent of the disease $14\%$. The residual cancer at surgical margin o. postitive node was not effectively killed by either 5000 to 5500 cGy conventional radiation or 5290 to 5750 cGy with 115 cGy fraction in 2 times daily; hyperfractionated radiation. However hyperfractionation schedule decreased the both acute and late complications in this study.

• The Journal of the Korean bone and joint tumor society
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• v.5 no.4
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• pp.221-228
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• 1999

The purpose of this study was to verify the importance of apoptosis in genesis of osteosarcoma and whether apoptosis may play an important role as a predictive factor for the response to chemotherapy. Of the patients who were diagnosed osteosarcoma between January 1995 and June 1999, ten patients were selected. All specimens were obtained before and after preoperative chemotherapy and examined for the occurrence of apoptosis. Apoptosis was investigated by in situ end-labeling technique on paraffin-embedded sections and apoptotic indices were calculated before and after chemotherapy. The ages of ten patients ranged from 15 to 59 with equal sex ratio. All patients completed the planned pre-operative chemotherapy. Apoptosis occurs in osteosarcoma and apoptotic indices are increased after chemotherapy. Mean apoptotic index (AI) before and after chemotherapy were 17.2 (range 6-28.9) and 26.3 (9.6-46.2), respectively. Apoptotic cells were usually present around the necrotic area. The AI was increased as the progression of stage and in responder group more than in non-responder. Apoptosis is induced by pre-operative chemotherapy and the response is variable. Changes in AI levels before and after chemotherapy may possibly predict an individual patient's overall response.

• Journal of Yeungnam Medical Science
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• v.32 no.2
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• pp.85-89
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• 2015

Background: We examined the usefulness of urine osmolality, as a predictive factor in the treatment of monosymptomatic nocturnal enuresis (NE) with combination therapy of imipramine and desmopressin. Methods: From May 2014 to April 2015, 59 monosymptomatic NE patients participated in this study. Early morning urine osmolality was measured at 1 week and 1 day before combination therapy of imipramine and desmopressin, and at 1 week and 2 weeks after therapy. The response to combination therapy was evaluated at 3 months after treatment. The mean period of combination therapy was $6.4{\pm}4.2weeks$. Therapeutic response was classified as complete (0-1 wet night/week), partial (over 50% reduction of night) and non-responders (less than 50% reduction of night). Results: The cumulative rate of the complete and partial responders was 76.3%. Among the 3 groups, the statistically lowest value of pre-treatment urine osmolality was observed in the complete responder group (p<0.001). Urine osmolality increased in all groups after treatment, however, statistically the greatest difference between pre and post-treatment urine osmolality was observed in the complete responder group (p=0.024). No serious side effects were observed. Conclusion: Early morning urine osmolality and change of urine osmolality between pre and post-treatment have predictive values in the response to combined imipramine and desmopressin for treatment of monosymptomatic NE.

• Journal of Korean Neurosurgical Society
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• v.59 no.4
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• pp.379-384
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• 2016

Objective : Mechanical thrombectomy (MT) for acute intracranial internal carotid artery (ICA) occlusion is often complicated by difficult revascularization and non-involved territory embolization possibly related with larger clot-burden. This study aims to evaluate the efficacy of proximal aspiration thrombectomy (PAT) using a balloon-tipped guide catheter for clot-burden reduction in such cases with period-to-period analysis (period 1 : standard MT without PAT; period 2 : PAT first, then standard MT for the remaining occlusion). Methods : Eighty-six patients who underwent MT for acute intracranial ICA occlusion were included in this analysis from the prospectively maintained stroke registry (33 patients in period 1 and 53 in period 2). In period 2, 'responder' was defined as a case where some amount of clot was retrieved by PAT and the following angiography showed partial or full recanalization. Results : Fifteen of fifty-three patients in period 2 (28.3%) were 'responders' to PAT. There was a significantly higher incidence of atrial fibrillation in the 'responder' subgroup. Period 2 showed a significantly shorter puncture-to-reperfusion time (94.5 minutes vs. 56.0 minutes; p=0.002), a significantly higher Thrombolysis in Cerebral Infarction of 2b-3 reperfusion (45.5% vs. 73.6%; p=0.009), but only a trend for better 3-month favorable outcome (mRS 0-2; 36.4% vs. 54.7%; p=0.097). There was no increase in the incidence of procedure-related complications or intracranial hemorrhage in period 2. Conclusion : A strategy of PAT before standard MT may result in shorter puncture-to-reperfusion time and better angiographic outcome than a strategy of standard MT for acute intracranial ICA occlusion.

• The Korean Journal of Pain
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• v.34 no.4
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• pp.479-486
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• 2021

Background: Prior studies have reported that 40%-90% of the patients with celiac plexus-mediated visceral pain benefit from the neurolytic celiac plexus block (NCPB), but the predictive factors of response to NCPB have not been evaluated extensively. This study aimed to identify the factors associated with the immediate analgesic effectiveness of NCPB in patients with intractable upper abdominal cancer-related pain. Methods: A retrospective review was performed of 513 patients who underwent NCPB for upper abdominal cancer-related pain. Response to the procedure was defined as (1) a decrease of ≥ 50% or ≥ 4 points on the numerical rating scale (NRS) in pain intensity from the baseline without an increase in opioid requirement, or (2) a decrease of ≥ 30% or ≥ 2 points on the NRS from the baseline with simultaneously reduced opioid consumption after NCPB. Logistic regression analysis was performed to determine the factors associated with successful responses to NCPB. Results: Among the 513 patients included in the analysis, 255 (49.8%) and 258 (50.2%) patients were in the non-responder and responder group after NCPB, respectively. Multivariable logistic regression analysis showed that diabetes (odds ratio [OR] = 0.644, P = 0.035), history of upper abdominal surgery (OR = 0.691, P = 0.040), and celiac metastasis (OR = 1.496, P = 0.039) were the independent factors associated with response to NCPB. Conclusions: Celiac plexus metastases, absence of diabetes, and absence of prior upper abdominal surgery may be independently associated with better response to NCPB for upper abdominal cancer-related pain.

• Journal of Hospice and Palliative Care
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• v.4 no.2
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• pp.130-136
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• 2001

Purpose : It is very important to endow the cancer patients underwent chemotherapy with satisfactory quality of life (QOL). However, little is known about the factors influencing QOL during chemotherapy. Therefore, we designed this study to find out the factors influencing QOL in the cancer patients who underwent chemotherapy. Methods : Ninety-seven cancer patients were studied, prospectively. The patients' characteristics were as follows; median age(range): 48(19{\sim}83) years, male:female; 57:40, PS:0,1/2,3;55/42 patients, diagnosis(number): lymphoma (28), lung cancer (22), gastrointestinal cancer (18), sarcoma (12), breast cancer (12), gynecological cancer (5), Stage: I,II/III.IV;37/60 patients. We used EORTC QLQ-C30 questionnaires to evaluate QOL. EORTC QLQ-C30 scores were performed before the onset of chemotherapy and after the end of 3 cycles of chemotherapy. The correlation of these scores with performance status (PS), diagnosis, disease stage, response to chemotherapy, and regimen related toxicity was evaluated. Results : The responder group (CR, PR) demonstrated marked improvement of social functional and emotional scales to non-responder group (SD,PD) (P=0.024, 0.045). Non-hematologic regimen related toxicity such as mucositis, nausea and vomiting was significantly correlated with pain scale change (P=0.043). Other factors had no notable correlation with QOL changes. Conclusion : Our preliminary study results may suggest as follows. The response to chemotherapy is associated with the change of social functional and emotional scales and the severity of non-hematologic regimen related toxicity is associated with pain scale change.

• Radiation Oncology Journal
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• v.32 no.3
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• pp.170-178
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• 2014

Purpose: We sought to evaluate the clinical outcomes of 3-dimensional conformal radiation therapy (3D-CRT) for portal vein tumor thrombosis (PVTT) alone in patients with advanced hepatocellular carcinoma. Materials and Methods: We retrospectively analyzed data on 46 patients who received 3D-CRT for PVTT alone between June 2002 and December 2011. Response was evaluated following the Response Evaluation Criteria in Solid Tumors. Prognostic factors and 1-year survival rates were compared between responders and non-responders. Results: Thirty-seven patients (80.4%) had category B Child-Pugh scores. The Eastern Cooperative Oncology Group performance status score was 2 in 20 patients. Thirty patients (65.2%) had main or bilateral PVTT. The median irradiation dose was 50 Gy (range, 35 to 60 Gy) and the daily median dose was 2 Gy (range, 2.0 to 2.5 Gy). PVTT response was classified as complete response in 3 patients (6.5%), partial response in 12 (26.1%), stable disease in 19 (41.3%), and progressive disease in 12 (26.1%). There were 2 cases of grade 3 toxicities during or 3 months after radiotherapy. Twelve patients in the responder group (15 patients) received at least 50 Gy irradiation, but about 84% of patients in the non-responder group received less than 50 Gy. The 1-year survival rate was 66.8% in responders and 27.4% in non-responders constituting a statistically significant difference (p = 0.008). Conclusion: Conformal radiotherapy for PVTT alone could be chosen as a palliative treatment modality in patients with unfavorable conditions (liver, patient, or tumor factors). However, more than 50 Gy of radiation may be required.

• Proceedings of the Korean Society of Applied Pharmacology
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• 2001.11a
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• pp.35-36
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• 2001

According to the recent epidemiological data, the numbers of patients of Reumatoid Arthritis(RA) in the world are reported to be 350mi11ion and 700,000 in the world and in Japan, respectively For the treatment of RA, NASIDs as the first choice drug have been widely used worldwide, and more than 50 NSAIDs have been in market up to today in Japan. Early 1990s, DMARDs as the new drug for RA treatment came into market, and the number of DMARDs has been increased every year. These drugs are recognized to have several advantages in treatment of RA, however, disadvantages are also reported, i.e., (1) high incidence of side effects, (2) high non-responder population, (3) decreased efficacy in chronic treatment, and (4) slow starting of the efficacy. For example, Methotrexate which has been widely used as the immunosuppressant has been recently used for treatment of Reumatoid. However, this drug has several disadvantages such as 60-70% improvement of the disease, 80% incidence of side effects, and 2-4 weeks to recognize the efficacy after treatment. In addition to these two.

• Tuberculosis and Respiratory Diseases
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• v.42 no.1
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• pp.76-83
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• 1995

Background: Despite advances in chemotherapy, the treatment of inoperable non-small cell carcinoma of the lung remains poor. According to the recent reports, the response rates of mitomycin, vinblastine, and cisplatin(MVP) chemotherapy are higher than those of other cisplatin based polychemotherapy and MVP chemotherapy can be used as neoadjuvant chemotherapeutic regimen. But the overall response rates of MVP chemotherapy range from 17 to 53 percent, so we studied the effect of MVP chemotherapy in advanced non-small cell lung cancer. Method: We treated forty patients with stage III or IV non-small cell lung cancer with two courses of MVP chemotherapy($8mg/m^2$ of mitomycin on day 1, $6mg/m^2$ of vinblastine on day 2 & day 14, and $100mg/m^2$ of cisplastin on day 1) at 4 weeks interval. Then all patients were evaluated the response of chemotherapy 4 weeks later, and received further chemotherapy, palliative radiotherapy or supportive therapy according to the patient's condition. We also determined the median survival time and prognostic factors. Results: 1) Nine patients(23%) had a partial reponse, 23 patients(57%) had a stable disease, and disease progressed in 8 patients(20%). There were no patients with complete response. 2) The overall median survival time was 36 weeks(range, 9 to 119+ weeks). The median survival time of responder(partial response) and non-responder(stable and progressed) groups were 60 weeks(range, 36 to 82+ weeks) and 31 weeks(range, 9 to 119+ weeks) respectively(p=0.03). 3) The median survival time of the female group was 71 weeks and significantly prolonged in comparision with 35 weeks of the male group(p=0.01). But, the other prognostic factors didn't affect the survival time and response rate. 4) The median survival times of chemotherapy group and chemotherapy with palliative radiotherapy group were not significantly different. Conclusion: MVP combined chemotherapy is unsatisfactory in improving survival in advanced non-small cell lung cancer. Therefore, further studies are needed to find more active new agents and to estabilish the efficacy of the combined treatment with radiotherapy and/or surgery.