• Title/Summary/Keyword: Selective-Medical Treatment

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Treatment outcome of postoperative radiotherapy for retroperitoneal sarcoma

  • Lee, Hyun-Jin;Song, Si-Yeol;Kwon, Tae-Won;Yook, Jeong-Hwan;Kim, Song-Cheol;Han, Duck-Jong;Kim, Choung-Soo;Ahn, Han-Jong;Chang, Heung-Moon;Ahn, Jin-Hee;Jwa, Eun-Jin;Lee, Sang-Wook;Kim, Jong-Hoon;Choi, Eun-Kyung;Shin, Seong-Soo;Ahn, Seung-Do
    • Radiation Oncology Journal
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    • v.29 no.4
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    • pp.260-268
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    • 2011
  • Purpose: To evaluate the treatment outcome and prognostic factor after postoperative radiotherapy in retroperitoneal sarcoma. Materials and Methods: Forty patients were treated with surgical resection and postoperative radiotherapy for retroperitoneal sarcoma from August 1990 to August 2008. Treatment volume was judged by the location of initial tumor and surgical field, and 45-50 Gy of radiation was basically delivered and additional dose was considered to the high-risk area. Results: The median follow-up period was 41.4 months (range, 3.9 to 140.6 months). The 5-year overall survival (OS) was 51.8% and disease free survival was 31.5%. The 5-year locoregional recurrence free survival was 61.9% and distant metastasis free survival was 50.6%. In univariate analysis, histologic type (p = 0.006) was the strongest prognostic factor for the OS and histologic grade (p = 0.044) or resection margin (p = 0.032) had also effect on the OS. Histologic type (p = 0.004) was unique significant prognostic factor for the actuarial local control. Conclusion: Retroperitoneal sarcoma still remains as a poor prognostic disease despite the combined modality treatment including surgery and postoperative radiotherapy. Selective dose-escalation of radiotherapy or combination of effective chemotherapeutic agent must be considered to improve the treatment result especially for the histopathologic type showing poor prognosls.

Risk of Lymph Node Metastases from Early Gastric Cancer in Relation to Depth of Invasion: Experience in a Single Institution

  • Wang, Zheng;Ma, Li;Zhang, Xing-Mao;Zhou, Zhi-Xiang
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5371-5375
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    • 2014
  • Background: An accurate assessment of potential lymph node metastasis is important for the appropriate treatment of early gastric cancers. Therefore, this study analyzed predictive factors associated with lymph node metastasis and identified differences between mucosal and submucosal gastric cancers. Materials and Methods: A total of 518 early gastric cancer patients who underwent radical gastrectomy were reviewed in this study. Clinicopathological features were analyzed to identify predictive factors for lymph node metastasis. Results: The rate of lymph node metastasis in early gastric cancer was 15.3% overall, 3.3% for mucosal cancer, and 23.5% for submucosal cancer. Using univariate analysis, risk factors for lymph node metastasis were identified as tumor location, tumor size, depth of tumor invasion, histological type and lymphovascular invasion. Multivariate analysis revealed that tumor size >2 cm, submucosal invasion, undifferentiated tumors and lymphovascular invasion were independent risk factors for lymph node metastasis. When the carcinomas were confined to the mucosal layer, tumor size showed a significant correlation with lymph node metastasis. On the other hand, histological type and lymphovascular invasion were associated with lymph node metastasis in submucosal carcinomas. Conclusions: Tumor size >2 cm, submucosal tumor, undifferentiated tumor and lymphovascular invasion are predictive factors for lymph node metastasis in early gastric cancer. Risk factors are quite different depending on depth of tumor invasion. Endoscopic treatment might be possible in highly selective cases.

Effects of Glutamate Receptor Antagonists and Protein Synthesis Inhibitor on Delayed Neuronal Death Induced by Transient Global Ischemia in Rat Brain

  • Ko, Jun-Seog;Bae, Choon-Sang;Kim, Jong-Keun
    • The Korean Journal of Physiology and Pharmacology
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    • v.2 no.3
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    • pp.279-286
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    • 1998
  • It has been well documented that transient forebrain global ischemia causes selective neuronal degeneration in hippocampal CA1 pyramidal neurons with a delay of a few days. The mechanism of this delayed hippocampal CA1 pyramidal neuronal death (DND) is still controversial. To delineate the mechanisms of the DND, the effects of treatment with MK-801, an NMDA receptor antagonist, kynurenic acid, a NMDA/non-NMDA receptor antagonist, and/or cycloheximide, a protein synthesis inhibitor, on the DND were investigated in male Wistar rats. To examine the participation of apoptotic neuronal death in the DND, TUNEL staining was performed in ischemic brain section. Global ischemia was induced by 4-vessel occlusion for 20 min. All animals in this study showed the DND 3 and 7 days after the ischemic insult. The DND that occured 3 days and 7 days after the ischemia were not affected by pretreatment with MK-801 (1 mg/kg), but markedly attenuated by the pretreatment with kynurenic acid (500 mg/kg). Treatment with cycloheximide (1 mg/kg) also markedly inhibited the DND. The magnitudes of attenuation by the two drugs were similar. The magnitude of attenuation by co-treatments with kynurenic acid and cycloheximide was not greater than that with any single treatment. TUNEL staining was negative in the sections obtained 1 or 2 days after the ischemic insults, but it was positive at hippocampal CA1 pyramidal cells in sections collected 3 days after the ischemia. These results suggested that the DND should be mediated by the activation of non-NMDA receptor, not by the activation of NMDA receptor and that the activation of AMPA receptor should induce the apoptotic process in the DND.

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RNA Metabolism in T Lymphocytes

  • Jin Ouk Choi;Jeong Hyeon Ham;Soo Seok Hwang
    • IMMUNE NETWORK
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    • v.22 no.5
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    • pp.39.1-39.18
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    • 2022
  • RNA metabolism plays a central role in regulating of T cell-mediated immunity. RNA processing, modifications, and regulations of RNA decay influence the tight and rapid regulation of gene expression during T cell phase transition. Thymic selection, quiescence maintenance, activation, differentiation, and effector functions of T cells are dependent on selective RNA modulations. Recent technical improvements have unveiled the complex crosstalk between RNAs and T cells. Moreover, resting T cells contain large amounts of untranslated mRNAs, implying that the regulation of RNA metabolism might be a key step in controlling gene expression. Considering the immunological significance of T cells for disease treatment, an understanding of RNA metabolism in T cells could provide new directions in harnessing T cells for therapeutic implications.

Surgical Management of Pyoderma Gangrenosum: A Case Report (괴저성 농피증의 수술적 치험례)

  • Seul, Chul Hwan;Kim, Bom Jin;Lee, Sung Joon;Kim, Sug Won;Chung, Yoon Kyu
    • Archives of Plastic Surgery
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    • v.32 no.1
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    • pp.135-138
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    • 2005
  • Pyoderma gangrenosum(PG) is an uncommon cutaneous vascular disease that typically presents as a painful and destructive ulceration on the anterior surface of the legs. The etiology of PG is currently unknown. But, the association with many immunologic disorders and its clinical response to immunomodulating agents suggest an immune etiology. A common feature of patients with PG is the presence of pathergy(the induction of lesion following injury of the skin). The trauma of surgery can be sufficient to induce pathergy, thus paradoxically limiting the usefulness of surgical treatment of PG. For that reason, medical treatments have been commonly used, while surgical treatments have been regarded not suitable. However, the use of the classic systemic agents is limited by their side effects and contraindications. Moreover, the large, problematic ulcers take too long to heal with medical management only. We present our experience in closing large wounds with the goal of decreasing morbidity, drug side effects and hospital stay by combination of medical and surgical therapy(split thickness skin graft). And authors advocate that surgical management is not a contraindication and may be considered as a selective modality in treatment of PG.

Mitophagy stimulation as a novel strategy for the treatment of mitochondrial diseases

  • Kang-Min Lee;Jeanho Yun
    • Journal of Genetic Medicine
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    • v.19 no.2
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    • pp.49-56
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    • 2022
  • Mitophagy, the selective degradation of damaged or surplus mitochondria using core autophagy machinery, plays an essential role in maintaining cellular mitochondrial function. Impaired mitophagy is closely linked to various human diseases, including neurodegenerative diseases, cardiovascular diseases, cancers and kidney disease. Defective mitophagy induces the accumulation of damaged mitochondria and thereby results in a decline in cellular survival and tissue function. Accordingly, enhancement of mitophagy has been proposed as a novel strategy for the treatment of human diseases closely linked to mitochondrial dysfunction. Recent studies showing that the stimulation of mitophagy has a therapeutic effect on several disease models highlight the possibility of disease treatment using mitophagy. The development of mitophagy inducers with toxicity and the identification of molecular mechanisms will enable the clinical application of mitophagy-based treatments.

The Clinical Pathology Characteristics and Tetanus Quick Stick Evaluation for Tetanus Patients in Daegu Emergency Medical Center

  • Lee, Seung Jin;Lim, Soon Ok;Jeong, Jae Yeop;Park, Min Jeong;Park, Ju Eun
    • Korean Journal of Clinical Laboratory Science
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    • v.46 no.1
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    • pp.12-16
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    • 2014
  • Tetanus has high lethality and can cause serious complication, so it is very important to have a quick and exact checkup and treatment. In this study, we conducted a study about clinical characteristics and types of tetanus patients in Daegu Emergency Medical Center and we studied possibility of Tetanos Quick Stick (TQS) as a selective check up to treat tentanus by comparing the results of local checkup kit measured from tetanus quick stick developed to check up tetanus antibody titer and results measured from ELISA (Enzyme-Linked Immunosorbent Assay). The result of the study showed that tetanus happens more to males, and by looking at season, tetanus happened most in summer (from June-August) as 19 cases (45.3%), and when patients come to the emergency medical center, the diagnosis name was electrolyte imbalance 14 cases (33.3%), peripheral nerve 11 cases (26.2%), Meningitis 8 cases (19.0%), drug addiction 7 cases (16.7%), and the patients who are diagnosed as tetanus at the beginning of hospitalization was 2 cases (4.8%). The result of TQS usefulness by comparing with ELISA, in TQS, 42 people was positive and 478 people was negative. it was positive when the result was over 0.1 IU/mL, 48 people was ELISA positive while 472 people was negative. TQS checkup has accuracy of 98%, sensitivity of 83.3%, specificity of 99.5%, positive predictability of 95.2% and negative predictability of 98.3%. The evaluation of current immunity statuses of tetanus patients is available for TQS checkup, and it has an advantage of preventing side effects coming from the injection of unnecessary vaccine and immunoglobulin, and it is thought that it can give help to emergency checkup and treatment at the beginning.

Myoepithelioma of the Parotid Gland: A Case Report (이하선에서 발생한 근상피종 치험례)

  • Chang, Cheol Ho;Lim, So Young;Hyon, Won Sok;Bang, Sa Ik;Oh, Kap Sung;Mun, Goo Hyun
    • Archives of Plastic Surgery
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    • v.34 no.2
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    • pp.258-260
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    • 2007
  • Purpose: Myoepithelioma is a rare tumor that originates exclusively from myoepithelial cells of the salivary glands, breast and the prostate. Myoepithelioma accounts for less than 1% of all salivary gland tumors. The objective of our study is to present our experience of the infra-auricular mass which was finally diagnosed as a myoepithelioma. Methods: A 54-year-old woman was presented with a firm, movable, slow-growing infra-auricular mass with 3 cm in diameter. MRI scans and fine needle biopsy was performed for preoperative diagnostic study. A superficial parotidectomy was preceded and removed tumor successfully. Results: Histopathological study revealed a myoepithelioma of plasmacytoid type. Patient's postoperative course was uneventful without any complication and had no evidence of recurrence of tumor for 9 months follow-up period. Conclusion: Myoepithelioma in the parotid gland shows similar clinical courses and intraoperative finding to the pleomorphic adenoma and superficial parotidectomy was selective choice for treatment.

Update on Transarterial Chemoembolization with Drug-Eluting Microspheres for Hepatocellular Carcinoma

  • Yasir M. Nouri;Jin Hyoung Kim;Hyun-Ki Yoon;Heung-Kyu Ko;Ji Hoon Shin;Dong Il Gwon
    • Korean Journal of Radiology
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    • v.20 no.1
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    • pp.34-49
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    • 2019
  • Conventional transcatheter arterial chemoembolization (c-TACE) is a widely used first-line palliative treatment for patients with unresectable hepatocellular carcinoma (HCC). Despite the effectiveness of c-TACE, to date, technique and procedure scheduling has not yet been standardized. Drug-eluting microspheres (DEMs) were therefore introduced to ensure more sustained and tumor-selective drug delivery for permanent embolization. These DEMs can load various drugs and release them in a sustained manner over a prolonged period. This approach ensures the delivery of high concentrations of chemotherapeutic agents to tumors, without increasing systemic concentrations, and promote tumor ischemia and necrosis. This review summarizes the recent advances in the use of DEM-TACE to treat HCC.

A Qualitative Study on the Treatment Process Experiences of Patients with Whiplash Associated Disorder Treated with Traditional Korean Medicine - Based on the Grounded Theory Approach - (교통사고 상해 증후군 환자들에 대한 한의치료 경험의 질적 연구 -근거이론 접근방법으로 -)

  • Im, Se Hoon;Lee, Seung Hoon;Lee, Seung Min;Nam, Dong Woo;Kim, Yong Suk
    • Journal of Acupuncture Research
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    • v.33 no.4
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    • pp.73-92
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    • 2016
  • Objectives : The purpose of this study is to understand the treatment process experiences of patients with whiplash associated disorder treated with Traditional Korean Medicine. Methods : This study was based on grounded theory. We recruited a total of 10 participants between the ages of 19 and 65, who were hospitalized at Kyung Hee University Korean Medicine Hospital and received treatment after traffic accidents from January to October 2014. Data was collected from in-depth interviews and notes, and was analyzed using open coding, axial coding and selective coding. Results : The core category of the phenomenon: 'The experiences of the treatment process for patients with whiplash associated disorder treated with Traditional Korean Medicine', was elicited as 'The selection of Traditional Korean Medicine treatment over other treatments for holistic healing that supplement for the deficiencies of Western medical treatment'. Conclusion :' The experiences of treatment process for patients with whiplash associated disorder treated with Traditional Korean Medicine', was elicited as 'The selection of the Traditional Korean Medicine treatment over other treatments for holistic healing that complements deficiency of the Western medical treatment'.