• Title/Summary/Keyword: Treatment Efficacy

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Predictors of Success of Selective Laser Trabeculoplasty Adjusted for Intraocular Pressure Variations (단안 선택적 레이저섬유주성형술에서 안압 변동을 보정한 성공예측인자의 분석)

  • Lee, Jun Seok;Lee, Chong Eun;Seo, Sam;Lee, Kyoo Won
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.12
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    • pp.1166-1172
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    • 2018
  • Purpose: To investigate the efficacy, and identify predictors of success of selective laser trabeculoplasty (SLT) in open-angle glaucoma (OAG) patients after adjusting for intraocular pressure (IOP) changes in the untreated fellow eye. Methods: This retrospective chart review included 52 eyes of 52 OAG patients who underwent SLT in one eye and were followed-up for at least 1 year after the procedure. The IOP was measured before the treatment, at 1, 2, and 3 months posttreatment, and every 3 months thereafter. To account for the possible influence of IOP fluctuations on laser outcomes, post-laser IOP values of the treated eye of each patient were also analyzed, after adjusting for IOP changes in the untreated fellow eye. Success was defined as an IOP decrease ${\geq}20%$ of the pretreatment IOP. The success rate was determined based on Kaplan-Meier survival analysis and factors predictive of success were analyzed using the Cox proportional hazard model. Results: The mean pretreatment IOP was $23.17{\pm}6.96mmHg$. The mean IOP reduction was $5.59{\pm}4.78mmHg$ (29.7%) and the success rate was 65.4% at 1 year. The adjusted mean IOP reduction was $4.70{\pm}4.67mmHg$ (23.9%) and the adjusted success rate was 53.9%. Pretreatment IOP was associated with SLT success; the higher the pretreatment IOP, the greater the post-laser IOP reduction (p = 0.025). Age and mean deviation index did not show a significant association with SLT success (p = 0.066 and p = 0.464, respectively). Conclusions: SLT is a safe and effective alternative method of IOP reduction in OAG patients. Herein, pretreatment IOP was the only factor significantly associated with SLT success. IOP fluctuations of the untreated eye should be considered for a better understanding of the impact of treatment.

The Tumor Control According to Radiation Dose of Gamma Knife Radiosurgery for Small and Medium-Sized Brain Metastases from Non-Small Cell Lung Cancer

  • Park, Sue Jee;Lim, Sa-Hoe;Kim, Young-Jin;Moon, Kyung-Sub;Kim, In-Young;Jung, Shin;Kim, Seul-Kee;Oh, In-Jae;Hong, Jong-Hwan;Jung, Tae-Young
    • Journal of Korean Neurosurgical Society
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    • v.64 no.6
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    • pp.983-994
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    • 2021
  • Objective : The effectiveness of gamma knife radiosurgery (GKR) in the treatment of brain metastases is well established. The aim of this study was to evaluate the efficacy and safety of maximizing the radiation dose in GKR and the factors influencing tumor control in cases of small and medium-sized brain metastases from non-small cell lung cancer (NSCLC). Methods : We analyzed 230 metastatic brain tumors less than 5 mL in volume in 146 patients with NSCLC who underwent GKR. The patients had no previous radiation therapy for brain metastases. The pathologies of the tumors were adenocarcinoma (n=207), squamous cell carcinoma (n=18), and others (n=5). The radiation doses were classified as 18, 20, 22, and 24 Gy, and based on the tumor volume, the tumors were categorized as follows : small-sized (less than 1 mL) and medium-sized (1-3 and 3-5 mL). The progression-free survival (PFS) of the individual 230 tumors and 146 brain metastases was evaluated after GKR depending on the pathology, Eastern Cooperative Oncology Group (ECOG) performance score (PS), tumor volume, radiation dose, and anti-cancer regimens. The radiotoxicity after GKR was also evaluated. Results : After GKR, the restricted mean PFS of individual 230 tumors at 24 months was 15.6 months (14.0-17.1). In small-sized tumors, as the dose of radiation increased, the tumor control rates tended to increase (p=0.072). In medium-sized tumors, there was no statistically difference in PFS with an increase of radiation dose (p=0.783). On univariate analyses, a statistically significant increase in PFS was associated with adenocarcinomas (p=0.001), tumors with ECOG PS 0 (p=0.005), small-sized tumors (p=0.003), radiation dose of 24 Gy (p=0.014), synchronous lesions (p=0.002), and targeted therapy (p=0.004). On multivariate analyses, an improved PFS was seen with targeted therapy (hazard ratio, 0.356; 95% confidence interval, 0.150-0.842; p=0.019). After GKR, the restricted mean PFS of brain at 24 months was 9.8 months (8.5-11.1) in 146 patients, and the pattern of recurrence was mostly distant within the brain (66.4%). The small and medium-sized tumors treated with GKR showed radiotoxicitiy in five out of 230 tumors (2.2%), which were controlled with medical treatment. Conclusion : The small-sized tumors were effectively controlled without symptomatic radiation necrosis as the radiation dose was increased up to 24 Gy. The medium-sized tumors showed potential for symptomatic radiation necrosis without signifcant tumor control rate, when greater than 18 Gy. GKR combined targeted therapy improved the tumor control of GKR-treated tumors.

Prognostic Analysis of Drug-Eluting Balloon Catheter and Drug-Eluting Stent for In-Stent Restenosis of Drug-Eluting Stent (스텐트 재협착 병변에서 약물코팅 풍선카테터과 약물용출 스텐트의 예후 분석)

  • Lee, Doo Hwan;Song, Jong Nam;Park, Sin eui;Choi, Nam Gil;Han, Jae Bok;Kim, In Soo
    • Journal of the Korean Society of Radiology
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    • v.13 no.3
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    • pp.381-389
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    • 2019
  • Although the development of Drug-eluting stent (DES) improved the ISR significantly more than the Bare metal stent (BMS), the coronary stent restenosis (ISR) treatment still has a high recurrence rate. This study is compared the efficacy of DEB with that of DES implantation in patients with ISR. Among 4,316 patients who underwent coronary stent implantation at the Chonnam National University Hospital between November 2012 and December 2016, 187 patients developed ISR on follow-up coronary angiography ($66.3{\pm}11.0years$, 123 males) were enrolled and divided into two groups according to revascularization method as group I (DEB group; n=127) and group II (DES group; n=60). Primary end point was defined as major adverse cardiac events (MACEs), composite of cardiac death (CD), myocardial infaction (MI), target lesion revascularization (TLR) and stent thrombosis (ST) during two-year follow-up between the two groups. There were no differences in the baseline characteristics and angiographic findings except that prevalence of device length was shorter ($21.1{\pm}5.3$ vs. $25.3{\pm}9.6 mm$, p<0.002) in group I.Two-year MACE were not different in the two groups (8.7%vs.10.0%, p=0.789). The incidences of cardiac death (0%vs.0%, p=1.000), MI (1.6%vs.6.7%, p=0.085), TLR(8.7% vs. 10.0%, p=0.789) and ST (0% vs. 0%, p=1000). DEB demonstrated comparable risk reduction for MACEs compared with DES in patients with ISR during two-year follow-up. DEB might be good alternative for the treatment of ISR in patients with ISR.

Effect of Chlorine Dioxide (ClO2) on the Malodor Suppression of Chicken Feces (이산화염소(ClO2) 처리가 계분의 악취 억제에 미치는 영향)

  • Ji Woo, Park;Gyeongjin, Kim;Tabita Dameria, Marbun;Duhak, Yoon;Changsu, Kong;Sang Moo, Lee;Eun Joong, Kim
    • Korean Journal of Poultry Science
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    • v.49 no.4
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    • pp.287-298
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    • 2022
  • This study evaluated the efficacy of chlorine dioxide (ClO2) as an oxidant to reduce malodor emission from chicken feces. Two experiments were performed with the following four treatments in parallel: 1) fresh chicken feces with only distilled water added as a control, 2) a commercial germicide as a positive control, and 3) 2,000 or 4) 3,000 ppm of ClO2 supplementation. Aluminum gas bags containing chicken feces sealed with a silicone plug were used in both experiments, and each treatment was tested in triplicate. In Experiment 1, 10 mL of each additive was added on the first day of incubation, and malodor emissions were then assessed after 10 days of incubation. In Experiment 2, 1 mL of each additive was added daily during a 14-day incubation period. At the end of the incubation, gas production, malodor-causing substances (H2S and NH3 gases), dry matter, pH, volatile fatty acids (VFAs), and microbial enumeration were analyzed. Supplementing ClO2 at 2,000 and 3,000 ppm significantly reduced the pH and the ammonia-N, total VFA, H2S, and ammonia gas concentrations in chicken feces compared with the control feces (P<0.05). Additionally, microbial analysis indicated that the number of coliform bacteria was decrease after ClO2 treatment (P<0.05). In conclusion, ClO2 at 2,000 and 3,000 ppm was effective at reducing malodor emission from chicken feces. However, further studies are warranted to examine the effects of ClO2 at various concentrations and the effects on malodor emission from a poultry farm.

Clinical Results of Anterolateral Thigh Perforator Flap for Soft Tissue Reconstruction of the Foot and Ankle (족부 및 족관절부 연부조직 재건을 위한 전외측 대퇴 천공지 피판술의 임상결과)

  • Han, Soo-Hong;Hong, In Tae;Lee, Yohan;Jo, Yong-Gil;Kwon, Young Woo
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.40-48
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    • 2017
  • Purpose: Soft tissue reconstruction of a defect around the foot and ankle is a particularly challenging procedure due to the anatomical and functional characteristics of this area. Hence, only a limited number of treatment options are available. Moreover, if patients wish to avoid additional scars on the ipsilateral lower leg for cosmetic reasons, even fewer options are available for treatment. The authors used an anterolateral thigh perforator flap for soft tissue defects in this area, when other surgical options were inadequate. The aim of this study was to report the clinical results and the efficacy of this procedure. Materials and Methods: Sixteen cases of soft tissue defects around the foot and ankle were included. Participants included 12 male and 4 female subjects, and the mean age was 34 years. The most common cause of defect was acute trauma, and the average follow-up period was 33 months. Flap survival time, surgical complications, and ambulation status at the final follow-up stage were evaluated. Results: All 16 flaps successfully survived, except for one case with partial flap necrosis that was thought to be due to weight bearing earlier than scheduled. All patients were able to walk independently without any aid at the final follow-up stage. No patients showed other significant surgical complications. Conclusion: The anterolateral thigh perforator flap is a good alternative for soft tissue defects of the foot and ankle, when other options are not applicable. This study also demonstrated that surgery using an anterolateral thigh perforator flap is safe and highly reliable.

Viability Test and Bulk Harvest of Marine Phytoplankton Communities to Verify the Efficacy of a Ship's Ballast Water Management System Based on USCG Phase II (USCG Phase II 선박평형수 성능 평가를 위한 해양 식물플랑크톤군집 대량 확보 및 생물사멸시험)

  • Hyun, Bonggil;Baek, Seung Ho;Lee, Woo Jin;Shin, Kyoungsoon
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.22 no.5
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    • pp.483-489
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    • 2016
  • The type approval test for USCG Phase II must be satisfied such that living natural biota occupy more than 75 % of whole biota in a test tank. Thus, we harvested a community of natural organisms using a net at Masan Bay (eutrophic) and Jangmok Bay (mesotrophic) during winter season to meet this guideline. Furthermore, cell viability was measured to determine the mortality rate. Based on the organism concentration volume (1 ton) at Masan and Jangmok Bay, abundance of ${\geq}10$ and $<50{\mu}m$ sized organisms was observed to be $4.7{\times}10^4cells\;mL^{-1}$and $0.8{\times}10^4cells\;mL^{-1}$, and their survival rates were 90.4 % and 88.0 %, respectively. In particular, chain-forming small diatoms such as Skeletonema costatum-like species were abundant at Jangmok Bay, while small flagellate ($<10{\mu}m$) and non chain-forming large dinoflagellates, such as Akashiwo sanguinea and Heterocapsa triquetra, were abundant at Masan Bay. Due to the size-difference of the dominant species, concentration efficiency was higher at Jangmok Bay than at Masan Bay. The mortality rate in samples treated by Ballast Water Treatment System (BWMS) (Day 0) was a little lower for samples from Jangmok Bay than from Masan Bay, with values of 90.4% and 93%, respectively. After 5 days, the mortality rates in control and treatment group were found to be 6.7% and >99%, respectively. Consequently, the phytoplankton concentration method alone did not easily satisfy the type approval standards of USCG Phase II ($>1.0{\times}10^3cells\;mL^{-1}$ in 500-ton tank) during winter season, and alternative options such as mass culture and/or harvesting system using natural phytoplankton communities may be helpful in meeting USCG Phase II biological criteria.

Herbal Medicines for the Improvement of Immune Function in Patients with Cancer: A Protocol for Systematic Review and Meta-Analysis (한약의 암 환자에 대한 면역기능 개선 효과 : 체계적 문헌고찰과 메타분석 프로토콜)

  • Young-Min Cho;Soobin Jang;Mi Mi Ko;Han-eum Joo;Hwa-Seung Yoo;Mi-Kyung Jeong
    • The Journal of Internal Korean Medicine
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    • v.45 no.3
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    • pp.335-341
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    • 2024
  • Objectives: Patients with cancer eventually fail to respond to therapy when malignant cells develop effective ways to evade immunosurveillance. Conventional cancer treatments, such as radiation therapy and chemotherapy, aim to cure the disease or prolong the patient's life. However, the toxicity and side effects of conventional treatments limit their efficacy. Herbal medicine is a typical complementary and integrative form of medicine for cancer treatment in Asia. This protocol evaluates the effectiveness of herbal medicines in improving the immune function of patients with cancer. Methods: The following electronic databases will be searched: MEDLINE via PubMed, EMBASE via Elsevier, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure (CNKI), and Korean databases including Regional Information Sharing Systems (RISS), National Digital Science Library (NDSL), and Oriental Medicine Advanced Searching Integrated System (OASIS). Additionally, prospective randomized controlled trials that evaluate the effectiveness of herbal medicines on immune function in patients with cancer will be included in this review. All outcomes related to the immune function of patients with cancer (e.g., CD3, CD4, CD8, CD4/CD8 ratio, CD19 (B cells), dendritic cells (CD11), CD56 (NK cells), and macrophages) will be included in this review. Results: This review is expected to provide data on the effectiveness of herbal medicines on improving immune functions in patients with cancers. Conclusion: This systematic review will help patients and clinicians establish new management options for cancer treatment.

LINAC-based Stereotactic Radiosurgery for Meningiomas (수막종에 대한 선형가속기형 정위방사선수술)

  • Shin Seong Soo;Kim Dae Yong;Ahn Yong Chan;Lee Jung Il;Nam Do-Hyun;Lim Do Hoon;Huh Seung Jae;Yeo Inhwan J;Shin Hyung Jin;Park Kwan;Kim BoKyoung;Kim Jong Hyun
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.87-94
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    • 2001
  • Purpose : To evaluate the role of LINAC-based stereotactic radiosurgery (SRS) in the management of meningiomas, we reviewed clinical response, image response, neurological deficits for patients treated at our institution. Methods and materials : Between February 1995 and December 1999, twenty-six patients were treated with SRS. Seven patients had undergone prior resection. Nineteen patients received SRS as the initial treatment. There were 7 male and 19 female patients. The median age was 51 years (range, $14\~67\;years$). At least one clinical symptom presented at the time of SRS in 17 patients and cranial neuropathy was seen in 7 patients. The median tumor volume was $4.7\;cm^3\;(range,\;0.7\~16.5\;m^3)$. The mean marginal dose was 15 Gy (range, $10\~20\;Gy$), delivered to the $80\%$ isodose surface (range, $46\~90\%$). The median clinical and imaging follow-up periods were 27 months (range, 1-71 months) and 25 months (range, $1\~52\;months$), respectively. Results : Of 14 patients who had clinical follow-up of one year or longer, thirteen patients $(93\%)$ were improved clinically at follow-up examination. Clinical symptom worsened in one patient at 4 months after SRS as a result of intratumoral edema, who underwent surgical resection at 7 months. OF 14 patients who had radiologic follow-up of one year or longer, tumor volume decreased in 7 patients $(50\%)$ at a median of 11 months (range, $6\~25\;months$), remained stable in 6 patients $(43\%)$, and increased in one patient $(7\%)$, who underwent surgical resection at 44 months. New radiation-induced neurological deficits developed in six patients $(23\%)$. Five patients $(19\%)$ had transient neurological deficits, completely resolved by conservative treatment including steroid therapy. Radiation-induced brain necrosis developed in one patient $(3.8\%)$ at 9 months after SRS who followed by surgical resection of tumor and necrotic tissue. Conclusions : LINAC-based SRS proves to be an effective and safe management strategy for small to moderate sized meningiomas, inoperable, residual, and recurrent, but long-term follow-up will be necessary to fully evaluate its efficacy. To reduce the radiation-induced neurological deficit for large size meningioma and/or in the proximity of critical and neural structure, more delicate treatment planning and optimal decision of radiation dose will be necessary.

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Phase II Study of Gemcitabine and Vinorelbine as a Combination Chemotherapy for the Second-Line Treatment of Nonsmall Cell Lung Carcinoma (비소세포 폐암 환자의 2차 치료로서 Gemcitabine과 Vinorelbine의 병합 요법의 효과)

  • Lee, EunJoo;Ha, EunSil;Park, SangHoon;Hur, GyuYoung;Jung, KiHwan;Jeong, HyeCheol;Lee, SungYong;Kim, JeHyeong;Lee, SangYeub;Sin, Chol;Shim, JaeJeong;In, KwangHo;Kang, KyungHo;Yoo, SeHwa
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.510-516
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    • 2005
  • Backgroud : Lung cancer is the leading cause of cancer deaths in Korea and the number of lung cancer deaths is increasing. The higher response rates, decreased toxicity and improved performance status of the first-line treatments have resulted in an increased number of patients becoming candidates for second-line therapy. Several new antineoplastic agents, including gemcitabine, docetaxel and paclitaxel, have recently demonstrated second-line activity. This phase II study evaluated the efficacy and toxicity of gemcitabine and vinorelbine as combination chemotherapy for Korean patients with NSCLC as a second-line treatment. Methods : Sixty response-evaluable patients were enrolled from December 2000 to July 2003. We conducted a phase II study of a combination gemcitabine and vinorelbine chemotherapy for patients with histologically confirmed NSCLC that was stage IIIB and IV disease at the time of diagnosis, and the disease had progressed onward or the patients had relapsed after first-line platinum-based chemotherapy. They were treated with intravenous gemcitabine $1000mg/m^2$ and intravenous vinorelbine $25mg/m^2$ on days 1 and 8. This chemotherapy regimen was repeated every 3 weeks. Results : A total of 215 cycles of treatment were given and the mean number of cycles was 3.6 cycles. All the patients were evaluable for the toxicity profile. The response rate was 10% according to the WHO criteria. The median progression free survival was 3.8 months and the median survival time was 10.1 months. The 1-year survival rate was 32.9%. Grade III and IV neutropenia were seen in 20 (33.3%) and 7 (11.7%) patients, respectively. Conclusion : The combination of gemcitabine and vinorelbine is active and well tolerated as a second-line therapy for patients with advanced nonsmall cell lung carcinoma.