• Title/Summary/Keyword: Secondary cancer

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A Case of Paraneoplastic Limbic Encephalitis Associated with Primary Adenocarcinoma of Lung (비소세포 폐암과 동반된 부수종양성 변연계뇌염 1예)

  • Shin, Hyun Jong;Kim, Hyun Soo;Lim, Keum Nam;Noh, U Seok;Choi, Jung Hye;Kim, In Soon;Lee, Young Yeul;Park, Byeong Bae;Park, Dong Woo
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.4
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    • pp.382-386
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    • 2007
  • Paraneoplastic limbic encephalitis is a rare disorder that is characterized by personality changes, irritability, depression, seizures, memory loss and dementia, and is commonly associated with small cell lung cancer. The cause is unknown but it is believed to be an autoimmune disorder that develops secondary to a carcinomatous process. We report a patient with the clinical feature consistent with limbic encephalitis. A 64-year-old women developed disorientation, memory loss and general weakness. She was diagnosed with NSCLC (adenocarcinoma) with a brain metastasis 1 year earlier and was treated with radiation and chemotherapy. Although the lung mass and brain metastatic lesions had improved, the brain T2-weighted MRI showed high signal intensity in the right temporal region. This lesion consisted of with limbic encephalitis and was negative to the other viral and immune markers. The patient's symptoms did not improve after steroid treatment. Our case demonstrated that a NSCLC (adenocarcinoma) also can be associated with paraneoplastic limbic encephalitis.

Experimental Study for Construction of Mouth Care in Chemotherapy Patients (화학요법을 받는 암환자의 구강간호전략을 위한 연구)

  • 변영순;김애경
    • Journal of Korean Academy of Nursing
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    • v.26 no.2
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    • pp.428-442
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    • 1996
  • Stomatitis is a common toxicity associated with the administration of certain cancer chemotherapeutic agents used in the treatment of malignant tumors. It represents one of the most distressing side effects of cancer chemotherapy and can interfere with the patient's ability to eat, be the cause of much pain and discomfort, and require the use of potent analgesics. The situation also creates favorable conditions for local infection which may lead to septicemia. Several authors have identified the need to establish protocols for the control and treatment of the oral discomfort associated with oral mucositis as a result of chemotherapy. Thus this study attempted to development of oral care protocol for chemotherapy patients. The effects of the mouth care using sterile normal saline, nystatine solution on oral stomatitis were investigated in 30 patients on chemotherapy. The subsect were divided into three groups : control group : not gargling experimental group A : normal saline gargling (4 times a day) experimental group B : nystatine solution gargling(4 times a day) The Oral Assessment Guide (OAG) was used to assess oral status three times(once in the prechemotherapy period, on 5th, 10th day of post chemotherapy) Oral culture was used to assess oral infection on 5th day of postchemotherapy. Data was analyzed on SAS program which used repeated ANOVA, t-test, X/sup²test. The results are as follows : 1. The incidence of stomatitis was higher in the control group and experimental group A than in experimental group B.(X/sup²=0.002 P=0.001). The grade of stomatitis(mean of total score) for patients in the experimental group B were significantly lower than in the experimental group A F=1.96 P=0.0024). In incidence of tongue change, control group, experimental group B were significantly higher than experimental group B(F=6.84 P=0.0039). In control group and experimental group A. oral infection due to pathogenic bacteria were identified. In conclusion, mouth care with nystatine solution four times a day could reduce the incidence of stomatitis and secondary oral infection due to stomatitis. Thus active mouth care protocol which used to nystatine solution gargling need to prevention of stomatitis in chemotherapy patients.

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Reconstruction of Velopharyngeal Function after Resection of Lateral and Superior Oropharyngeal Cancer (상외측 구인두암 절제술 후 구개인두기능의 재건)

  • Lee, Hyoung Gyo;Tark, Min Soong;Kim, Cheol Hann;Shin, Ho Sung;Kang, Sang Gue;Lee, Young Man
    • Archives of Plastic Surgery
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    • v.33 no.5
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    • pp.546-551
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    • 2006
  • Purpose: The reconstruction of oropharyngeal defect after cancer surgery is very difficult because of their complicated structure and the functional importance to prevent velopharyngeal incompetence. In this article we investigated affecting factors of velopharyngeal function after reconstruction and a fundamental rule of reconstruction for saving their functions such as swallowing, speeching and breathing. Methods: We classified 18 patients into three group under Kimata's grouping. Type I defect(6 patients) was healed by primary closure or secondary intention. In Type II or III defect, two operation methods were used - the folded flap(8 patients) and modified Gehanno method(4 patients), which include a lateral-posterior pharyngeal rotation-advancement flap. We evaluated wound dehiscence between the flap and the soft palate, speech intelligibility using Hirose's method, regurgitation during oral feeding, and hypernasality. Results: Most of type I or II defects patients recovered satisfactory velopharyngeal function. But, in patients with type III defects we found wound dehiscence, worse speech function, and common velopharyngeal incompetence. Conclusion: The large defect size and presence of wound dehiscence are major factors of postoperative velopharyngeal function. We conclude that folded flap or modified Gehanno method is a good reconstructive operation method for broad contact between the flap and defect site, preventing wound problem.

Retroangular Flap for Midface Reconstruction (역행안각동맥 피판을 이용한 중안면부 결손의 재건)

  • Kang, Nak Heon;Song, Seung Han;Lee, Seung Ryul;Oh, Sang Ha;Seo, Young Joon
    • Archives of Plastic Surgery
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    • v.33 no.5
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    • pp.531-535
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    • 2006
  • Purpose: To report our experience of retro-angular flap for reconstruction of the midface defect. The midface, including nose, lower eyelid, and intercanthal area, is the very prominent area of face. Also midface is more vulnerable to trauma and skin cancer and defect of mid face of highly perceptible. Reconstruction of mid face is difficult because of complexity of anatomy and functions. Following factors should be considered in reconstructive prcedure of midface. First, multiple procedure may need for complete the reconstruction of mid face defect. Second, secondary reconstructive surgeries such as flap rotation or skin graft may need for donor site morbidity. Third, the color, texture and thickness of the skin used are not always complacency. Methods: 8 cases of the midface defects (3 cases of lower eyelid, 1 case of intercanthal area, and 4 cases of nose) from skin cancer were reconstructed with retroangular flap from March 2004 to August 2005. Results: Satisfactory result were obtained in color, texture and donor site scar. There was no major complication such as wound disruption, hematoma, and atrophy of flap. But partial necrosis of flap and bulkiness were observed one case in each. Retroangular flap is simple procedure that can be preceded in one stage under local anesthesia closing primary wound closure. It will leave less visible donor scar, acceptable color, texture and thickness of the skin. Conclusions: The retro-angular flap could be suggested as a safe and effective method for midface reconstruction.

Purification of Caudal-Related Homeodomain Transcription Factor and Its Binding Characterization

  • Jeong, Mi-Suk;Hwang, Eun-Young;Kim, Hyun-Tae;Yoo, Mi-Ae;Jang, Se-Bok
    • Journal of Microbiology and Biotechnology
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    • v.19 no.12
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    • pp.1557-1564
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    • 2009
  • Human CDX2 is known as a caudal-related homeodomain transcription factor that is expressed in the intestinal epithelium and is important in differentiation and maintenance of the intestinal epithelial cells. The caudal-related homeobox proteins bind DNA according to a helix-turn-helix structure, thereby increasing the structural stability of DNA. A cancer-tumor suppressor role for Cdx2 has been shown by a decrease in the level of the expression of Cdx2 in colorectal cancer, but the mechanism of transcriptional regulation has not been examined at the molecular level. We developed a large-scale system for expression of the recombinant, novel CDX2, in Escherichia coli. A highly purified and soluble CDX2 protein was obtained in E. coli strain BL21(DE3)RIL and a hexahistidine fusion system using Ni-NTA affinity column, anion exchange, and gel filtration chromatographies. The identity and secondary structure of the purified CDX2 protein were confirmed by MALDI-TOF MS, Western blot, and a circular dichroism analyses. In addition, we studied the DNA-binding activity of recombinant CDX2 by ELISA experiment and isolated human CDX2-binding proteins derived from rat cells by an immobilized GST-fusion method. Three CDX2-binding proteins were found in the gastric tissue, and those proteins were identified to the homeobox protein Hox-D8, LIM homeobox protein 6, and SMC1L1 protein.

Analysis of Fracture Risk due to Alterations of Bone Quality by Metastatic Bone Tumor (전이성 골암으로 인한 골질 변화와 이로 인한 골절 위험성 분석)

  • Lim, Dohyung
    • Journal of Biomedical Engineering Research
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    • v.33 no.4
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    • pp.213-222
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    • 2012
  • While much has been learned about the mechanisms of metastatic spread of cancer to bone, there has been little headway in establishing guidelines for monitoring the alteration in bone quality and estimating fracture risk. The aims of this study are, therefore, 1) to evaluate bone quality induced by metastatic bone tumor by analyzing the characteristics on bone microarchitecture and degree of bone mineralization and 2) analyze fracture risk increased secondary to the bone quality changes by metastatic bone tumor through calculating mechanical rigidities based on in-vivo micro CT images. For this study, eighteen female SD rats (12 weeks old, approximate 250 g) were randomly allocated in Sham and Tumor groups. W256 (Walker carcinosarcoma 256 malignant breast cancer cell) was inoculated in the right femur (intraosseous injection) in Tumor group, while 0.9% NaCl (saline solution) was injected in Sham group. The right hind limbs of all rats were scanned by in-vivo micro-CT to acquire structural parameters and degree of bone mineralization at 0 week, 4 weeks, 8 weeks, and 12 weeks after surgery. At the same time, urine was collected by metabolic cages for a biochemical marker test in order to evaluate bone resorption. Then, bone metastasis had been directly identified by positron emission tomography. Finally, axial, bending and torsional rigidities had been calculated based on in-vivo micro CT images for predict fracture risk. The results of this study showed that metastatic bone tumor might induce significant decrease in bone quality and increase of fracture risk. This study may be helpful to monitoring a degree of bone metastasis and predicting fracture risk due to metastatic bone tumor. In addition, this noninvasive diagnostic methodology may be utilized for evaluating other bone metabolic diseases such as osteoporosis.

Smoking among Secondary School Students in Kota Tinggi, Johor, Malaysia - Findings from a Cross-Sectional Study

  • Lim, Hock Kuang;Teh, Huey Chien;Lim, Li Hui;Lau, Joo Keng;Kee, Cheong Chee;Ghazali, Sumarni Mohd;Chan, Ying Ying;Sabtu, Mohd Yusoff;Ismail, Hasimah;Zaki, Nor Azian Mohd;Thomas, Leni Tupang;Lim, Kuay Kuang;Cheong, SM;ibrahim, Normala;Yusoff, Muhammad Fadhli Mohd
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.11
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    • pp.4563-4570
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    • 2015
  • Background: Smoking is a learnt behavior during adolescence and understanding the factor/s associated with smoking will assist in identifying suitable measures in combating the rising prevalence of smoking among adolescents. This research aimed to identify the factor/s associated with smoking among form four students in Kota Tinggi, Johor. Multistage sampling was used to select a representative sample of students in 2008 and data were collected using a self-administered validated questionnaire. This study revealed that the overall smoking prevalence was 19.0% with a significantly higher proportion of male smokers (35.8%) as compared to females (3.15%). Adolescents who were male (aOR 6.6, 95%CI 2.61-16.4), those who had peer/s who smoked (aOR 4.03, 95% CI 1.31-12.4), and those who studied in rural areas and Felda Settlements ( aOR 4.59, 95 CI 1.11-18.0; aOR 9.42, 95%CI 3.91-29.1) were more likely to smoke in the past one week. On the other hand, adolescents with better knowledge on the hazards of smoking and negative attitudes towards smoking were less likely to smoke (aOR 0.51, 95%CI 0.37-0.72; aOR 0.67, 95%CI 0.46-0.99). Future promotional and interventional programmes on smoking should be considered and the above identified risk factors integrated to reduce smoking prevalence among students of school-going ages in Kota Tinggi. Johor.

Is Exposure to Tobacco Advertising, Promotion and Sponsorship Associated with Initiation of Tobacco Use among Current Tobacco Users in Youth in India?

  • Sardana, Mohini;Goel, Sonu;Gupta, Madhu;Sardana, Veera;Singh, BS
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6299-6302
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    • 2015
  • Background: The rise in consumption of tobacco products among youth is a public health concern in India. Several studies have shown that advertisements promoting tobacco products influence decisions and behaviour of youth towards smoking. Objective: To ascertain which method of Tobacco Advertising, Promotion and Sponsorship (TAPS) was more influential for initiating tobacco use in youth in India. Materials and Methods: The secondary data of youth (15-24 years) from nationally representative Global Adult Tobacco Survey (GATS) conducted in 2009-2010 was analyzed. Odds ratio and p-value were used to know the association between TAPS and initiation of use of tobacco products among youth. Logistic regression was used to determine the most significant means of TAPS altering the youth's behaviour towards tobacco products. Results: Out of 13,383 youths, 1,982 (14.7%) used smokeless forms of tobacco and 860 (6.38%) used smoke forms. Logistic regression reveals that promotional activities mainly through cinemas (p<0.05) and providing free samples of tobacco products (p < = .001) were most influential means of initiating consumption of tobacco products among youth. Conclusions: The smoking in youth is associated with watching advertisements particularly in cinema and promotional activities like distribution of free samples, coupons and sales on the price of tobacco products. Stronger legislative measures should be enforced to curb promotional advertisements in cinemas and distribution of free samples.

131I-Labeled-Metuximab Plus Transarterial Chemoembolization in Combination Therapy for Unresectable Hepatocellular Carcinoma: Results from a Multicenter Phase IV Clinical Study

  • Ma, Jun;Wang, Jian-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7441-7447
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    • 2015
  • Objective: This study evaluated the safety and objective response of combining $^{131}I$-labeled-metuximab (Licartin) with transarterial chemoembolization (TACE) in the treatment of unresectable hepatocellular carcinoma (HCC). Materials and Methods: In a multicenter open-label clinical trial, 341 enrolled patients with stage III/IV HCC according to TNM criteria were nonrandomly assigned to a trial group (n=167) and a control group (n=174), undergoing TACE following hepatic intra-arterial injection of licartin or TACE alone from July 2007 to July 2009. Radiopharmaceutical distribution was evaluated. The primary endpoint was overall survival; secondary endpoints included time-to-progression (TTP), toxicity and adverse events (AEs). Results: The radiobiological distribution demonstrated better localization of licartin in liver tumors than other tissues (P<0.01). The organ absorbed doses to liver and red marrow were $3.19{\pm}1.01Gy$ and $0.55{\pm}0.22Gy$, respectively. The 1-year survival rate was significantly higher [79.47% vs. 65.59%, hazard ratio (HR), 0.598, P=0.041] and TTP significantly improved ($6.82{\pm}1.28$ vs. $4.7{\pm}1.14months$, P=0.037) compared with the control group. Patients at stage III achieved more benefit of one year survival than stage IV in the trial group (86.9% vs. 53.8%, P<0.001). There were significant different toxicities in leukocytopenia, thrombocytopenia and increased total bilirubin level [P<0.001, P=0.013, P<0.01, relative risk (RR) 1.63, 1.33, 1.43], but no differences in severe AEs of upper GI hemorrhage and severe liver dysfunction between the groups (5.39% vs. 2.3%, P=0.136). Conclusions: Owing to excellent tumor-targeting, promised efficacy and favourable toxicity profile, the novel combination therapy of licartin and TACE could be applied in patients with unresectable HCC.

Predictors of Tobacco Use among Youth in India: GATS 2009-2010 Survey

  • Sharma, Shailja;Singh, Mitasha;Lal, Pranay;Goel, Sonu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7535-7540
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    • 2015
  • Background: Early initiation of smoking and chewing of diverse forms of tobacco among youth in India is a significant driver for tobacco epidemic in India. Several socio-demographic factors are predictors of tobacco use in populations, especially among youth. Interventions which address these socio-demographic factors can help policy makers to curb new initiations and avert morbidity and mortality due to tobacco use. Objective: To study the various sociodemographic variables associated with tobacco use among youth in India. Materials and Methods: Secondary analysis of data from the Global Adult Tobacco Survey-India 2009-10 for the age group of 15-24 years was performed and predictors of smoking and smokeless tobacco were analyzed using data on occupation, education, and other sociodemographic factors. Results: In India there are a total of 51.3 million (22.1%) youth (15-24 years) tobacco users. Of these 35.1 million consumes chewable tobacco (15.1%), 16.2 million smoke (7%) and 1.6 million are dual users (3.1%). Males, urban, less educated, un-employed and those belonging to middle class preferred smoking over chewing; whereas, females, rural, students and those belonging to low socio-economic class are predictors of smokeless tobacco use. The major determinants of dual users are male sex, poor socio-economic strata and student class. The overall tobacco use was higher among males, rural populations, lower socioeconomic strata and un-employed class. Conclusions: India's youth is more susceptible to the tobacco addiction, especially of smokeless tobacco. Youth from rural India especially students, girls and those from poor socio-economic strata prefer to use smokeless tobacco products whereas urban, male and those less educated prefer smoking tobacco products. More population-based and region-focused research is needed to understand initiation patterns into tobacco use among youth so as to inform policymakers to devise new policy measures to curb the growing epidemic.