• Title/Summary/Keyword: Treatment Grade

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Reirradiation with Robotic Stereotactic Body Radiotherapy for Recurrent Nasopharyngeal Carcinoma

  • Dizman, Aysen;Coskun-Breuneval, Mehtap;Altinisik-Inan, Gonca;Olcay, Gokce Kaan;Cetindag, Mehmet Faik;Guney, Yildiz
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3561-3566
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    • 2014
  • Background: Recurrent nasopharyngeal carcinoma (NPC) after previous radiotherapy is challenging. There is no standard approach for salvage treatment. Here we present toxicity and treatment results for recurrent NFC patients who underwent fractionated stereotactic radiotherapy (FSRT) as second line radiotherapy (RT). Materials and Methods: Between April 2009 and July 2012, 24 patients, with a male to female ratio of 3:1, were treated with CykerKnife$^{(R)}$ FSRT for recurrent NFC in our institution. Seven out of 24 patients had metastatic recurrent disease. Median age was 53 years (range, 20-70 years). Initial RT dose was 70Gy. The time period between initial RT and FSRT was a median of 33.2 months. The median prescription dose for FSRT was 30Gy (range, 24-30 Gy) in a median of 5 fractions (range, 4-6). Results: The median follow-up for all patients was 19.5 months (IQR: 12.2.-29.2 months). The locoregional control; progression free survival and overall survival (OS) rates for 1-, 2- and 3-year were 64%, 38%, 21%; 60%, 30%, 17% and 83%, 43%, 31%, respectively. Median OS for the entire cohort was 22 months (95% CI: 16.5-27.5). On multivariate analysis recurrent tumor stage was the only prognostic factor for OS (p=0.004). One patient exhibited grade III temporal lobe necrosis. One died because of grade IV mucositis and overlapping infection. Conclusions: The treatment of recurrent NPC is controversial. Fractionated stereotactic radiotherapy is promising. However, the published trials are heterogeneous with respect to the selection criteria and treatment details. Prospective studies with long term follow-up data are warranted.

The Effects of Korean medicine treatment on Foot drop with common peroneal neuropathy patient: A Case Report (족관절 염좌에 따른 비골신경 신전 손상 환자에 대한 근에너지기법과 한의종합치료 병행 증례보고)

  • Ryu, Won-Hyung;Kim, Doo-Ri;Lee, Jiyun;Lee, Yunha;Chai, Jiwon;Chung, Jai-Hyeon;Moon, Hee-Young;Park, Ji-Won
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.14 no.2
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    • pp.67-76
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    • 2019
  • Objectives : The purpose of this study was to explore the effectiveness of Korean medicine treatment and the Muscle Energy Technique on foot drop through a case study with a patient with common peroneal neuropathy. Methods : A patient with severe foot drop after an ankle sprain was hospitalized and treated with acupuncture and traditional medicine and the Muscle Energy Technique. The effect of the treatment was evaluated with the Numeric Rate Scale(NRS), dorsiflexion angle evaluation, and the Manual Muscle Test (MMT). Results : The results of the NRS, dorsiflexion angle evaluation and MMT showed greatly improvementwith results changing from 8 to 2, 0 to 15, and Grade 2 to Grade 4, respectively. Conclusions : This study suggests that Korean medicine treatment and the Muscle Energy Technique could be effective treatments for foot drop with common peroneal neuropathy. However further clinical studies are needed to establish a definite conclusion.

Long-Term Follow-Up Result of Hydroxyurea Chemotherapy for Recurrent Meningiomas

  • Kim, Min-Su;Yu, Dong-Woo;Jung, Young-Jin;Kim, Sang Woo;Chang, Chul-Hoon;Kim, Oh-Lyong
    • Journal of Korean Neurosurgical Society
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    • v.52 no.6
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    • pp.517-522
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    • 2012
  • Objective : Meningiomas represent 18-20% of all intracranial tumors and have a 20-50% 10-year recurrence rate, despite aggressive surgery and irradiation. Hydroxyurea, an inhibitor of ribonucleotide reductase, is known to inhibit meningioma cells by induction of apoptosis. We report the long-term follow-up result of hydroxyurea therapy in the patients with recurrent meningiomas. Methods : Thirteen patients with recurrent WHO grade I or II meningioma were treated with hydroxyurea (1000 $mg/m^2/day$ orally divided twice per day) from June 1998 to February 2012. Nine female and 4 male, ranging in age from 32 to 83 years (median age 61.7 years), were included. Follow-up assessment included physical examination, computed tomography, and magnetic resonance imaging (MRI). Standard neuro-oncological response criteria (Macdonald criteria) were used to evaluate the follow-up MRI scans. The treatment was continued until there was objective disease progression or onset of unmanageable toxicity. Results : Ten of the 13 patients (76.9%) showed stable disease after treatment, with time to progression ranging from 8 to 128 months (median 72.4 months; 6 patients still accruing time). However, there was no complete response or partial response in any patients. Three patients had progressive disease after 88, 89, 36 months, respectively. There was no severe (Grade III-IV) blood systemic disorders and no episodes of non-hematological side effects. Conclusion : This study showed that hydroxyurea is a modestly active agent against recurrent meningiomas and can induce long-term stabilization of disease in some patients. We think that hydroxyurea treatment is well tolerated and convenient, and could be considered as an alternative treatment option in patients with recurrent meningiomas prior to reoperation or radiotherapy.

Allogeneic clonal mesenchymal stem cell therapy for refractory graft-versus-host disease to standard treatment: a phase I study

  • Yi, Hyeon Gyu;Yahng, Seung-Ah;Kim, Inho;Lee, Je-Hwan;Min, Chang-Ki;Kim, Jun Hyung;Kim, Chul Soo;Song, Sun U.
    • The Korean Journal of Physiology and Pharmacology
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    • v.20 no.1
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    • pp.63-67
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    • 2016
  • Severe graft-versus-host disease (GVHD) is an often lethal complication of allogeneic hematopoietic stem cell transplantation (HSCT). The safety of clinical-grade mesenchymal stem cells (MSCs) has been validated, but mixed results have been obtained due to heterogeneity of the MSCs. In this phase I study, the safety of bone marrow-derived homogeneous clonal MSCs (cMSCs) isolated by a new subfractionation culturing method was evaluated. cMSCs were produced in a GMP facility and intravenously administered to patients who had refractory GVHD to standard treatment resulting after allogeneic HSCT for hematologic malignancies. After administration of a single dose ($1{\times}10^6cells/kg$), 11 patients were evaluated for cMSC treatment safety and efficacy. During the trial, nine patients had 85 total adverse events and the rate of serious adverse events was 27.3% (3/11 patients). The only one adverse drug reaction related to cMSC administration was grade 2 myalgia in one patient. Treatment response was observed in four patients: one with acute GVHD (partial response) and three with chronic GVHD. The other chronic patients maintained stable disease during the observation period. This study demonstrates single cMSC infusion to have an acceptable safety profile and promising efficacy, suggesting that we can proceed with the next stage of the clinical trial.

Concurrent treatment with ursolic acid and low-intensity treadmill exercise improves muscle atrophy and related outcomes in rats

  • Kim, Jae Cheol;Kang, Yun Seok;Noh, Eun Bi;Seo, Baek Woon;Seo, Dae Yun;Park, Gi Duck;Kim, Sang Hyun
    • The Korean Journal of Physiology and Pharmacology
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    • v.22 no.4
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    • pp.427-436
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    • 2018
  • The objective of this study was to analyze the concurrent treatment effects of ursolic acid (UA) and low-intensity treadmill exercise and to confirm the effectiveness of UA as an exercise mimetic to safely improve muscle atrophy-related diseases using Sprague-Dawley (SD) rats with skeletal muscle atrophy. Significant muscle atrophy was induced in male SD rats through hind limb immobilization using casting for 10 days. The muscle atrophy-induced SD rats were group into four: SED, sedentary; UA, daily intraperitoneal UA injection, 5 mg/kg; EX, low-intensity (10-12 m/min, $0^{\circ}$ grade) treadmill exercise; and UEX, daily intraperitoneal UA injection, 5 mg/kg, and low-intensity (10-12 m/min, $0^{\circ}$ grade) treadmill exercise. After 8 weeks of treatment, endurance capacity was analyzed using a treadmill, and tissues were extracted for analysis of visceral fat mass, body weight, muscle mass, expression of muscle atrophy- and hypertrophy-related genes, and endurance capacity. Although the effects of body weight gain control, muscle mass increase, and endurance capacity improvement were inadequate in the UA group, significant results were confirmed in the UEX group. The UEX group had significantly reduced body weight and visceral fat, significantly improved mass of tibialis anterior and gastrocnemius muscles, and significantly decreased atrophy-related gene expression of MuRF1 and atrogin-1, but did not have significant change in hypertrophy-related gene expression of Akt and mTOR. The endurance capacity was significantly improved in the EX and UEX groups. These data suggest that concurrent treatment with low-intensity exercise and UA is effective for atrophy-related physical dysfunctions.

Effects of Lotus (Nelumbo nucifera) Leaf Hot Water Extracts on the Quality and Stability of Eggs using Ultrasonication Treatment during Storage

  • Lee, Jihye;Seo, Han Geuk;Lee, Chi-Ho
    • Food Science of Animal Resources
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    • v.40 no.6
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    • pp.1044-1054
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    • 2020
  • This study was performed to investigate the effects of lotus leaf hot water extracts treatment on the quality and stability of eggs using impregnation treatment through ultrasonication during storage. A total of 480 eggs were categorized into four treatment groups (n=30 each)-non-treated (CON), soaked for 30 min in lotus leaf hot water extracts without ultrasonication (T1), sonicated in distilled water (T2), and sonicated in lotus leaf hot water extracts (T3)-and stored for 15 d at 30℃. The egg weight, Haugh unit (HU), egg grade, albumen height, yolk color, eggshell thickness, eggshell breaking strength, and weight loss were measured for egg quality assessment. 2-Thiobarbituric acid reactive substance (TBARS) and volatile basic nitrogen (VBN) contents were measured as stability indicators. Additionally, total phenolic contents (TPC), total flavonoid contents (TFC), and 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging activity were evaluated. The HU, egg grade, albumen height, and yolk color of T3 were significantly higher than those of CON (p<0.05). No significant differences in eggshell thickness and eggshell breaking strength are observed among the groups. The weight loss of T3 was significantly lower than that of the other groups during storage (p<0.05). The application of lotus leaf hot water extracts also significantly reduced TBARS and VBN (p<0.05). The TPC, TFC, and DPPH radical scavenging activity of T3 were significantly higher than those of the other groups (p<0.05). These results suggest that lotus leaf hot water extracts may be useful as a natural ingredient for improving the quality and stability of eggs during storage.

Prevalence and treatment of gastric ulcers in Thoroughbred racehorses of Korea

  • Hwang, Hyeshin;Dong, Hee-Jin;Han, Janet;Cho, Seongbeom;Kim, Yongbaek;Lee, Inhyung
    • Journal of Veterinary Science
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    • v.23 no.2
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    • pp.19.1-19.9
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    • 2022
  • Background: Gastric ulcer is one of the prevalent diseases in racehorses. However, it has not been recognized as important in Korea, and drugs used to treat gastric ulcers are included in the doping test list, so they are not allowed to be administered to racehorses in training. Objectives: This study was performed 1) to investigate the prevalence and the severity of gastric ulcers in Thoroughbred racehorses in Korea, 2) to confirm the therapeutic effect of ranitidine and omeprazole, and 3) to compare the efficacy between ranitidine and omeprazole. Methods: Forty-nine horses were randomly recruited, and gastroscopy was performed within two days after racing. Twelve horses with a sum grade of five or higher were randomly assigned to two treatment groups. Seven horses were administered ranitidine, and five horses were administered omeprazole. Follow-up gastroscopy was scheduled within one to five days after finishing the treatment. Results: The prevalence of gastric ulcer in Korean Thoroughbred racehorses after racing was 100%, and the grade was more severe in the non-glandular region than in the pyloric region. There was no correlation between the severity of gastric ulcer in the two regions. Omeprazole had a greater therapeutic effect than ranitidine. Conclusions: This study shows the importance of recognizing gastric ulcers as an important factor, and omeprazole as a possible treatment option in Korea, as it has been removed from the list of prohibited substances for racehorses. Thus, the use of omeprazole is currently recommended until one day before the race.

A Case Report on the Improvement of Cancer Pain in a Patient with Metastatic Non-Small Cell Lung Cancer Through Herbal Medicine-based Integrative Cancer Treatment with Chemotherapy (항암화학요법과 병행한 한의기반 통합암치료를 통한 전이성 비소세포폐암 환자의 암성 통증 호전 증례보고)

  • Young-min Cho;Jae-ho Yang;Han-eum Joo;So-jeong Park;Ji-hye Park;Hwa-seung Yoo
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.594-601
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    • 2023
  • Objective: To demonstrate an improvement in metastatic cancer pain and a decrease in tumor size in a patient with non-small cell lung cancer. Method: A 53-year-old female patient diagnosed with metastatic non-small cell lung cancer in August 2022 underwent integrative cancer treatment (ICT) for two months to decrease the tumor size and improve back pain from bone metastasis. The patient underwent chemotherapy with ICT. Radiologic outcomes were assessed by chest, abdomen, and pelvis computed tomography based on the Response Evaluation Criteria in Solid Tumors (RECIST) protocol. Clinical outcomes were assessed using National Cancer Institute Common Terminology Criteria for Adverse Event (NCI-CTCAE), Eastern Cooperative Oncology Group (ECOG), and a numeric rating scale (NRS). Result: During the two months of treatment, the NRS scores for back pain were improved, and the ECOG score improved from grade 2 to 1. The size and metabolic activity of the primary lung tumor decreased and underwent partial remission based on RECIST. No serious side effects of grade 3 or higher were noted on the NCI-CTCAE test. Conclusion: This case suggests that ICT may have a therapeutic effect for cancer pain and a synergetic effect with chemotherapy for metastatic non-small cell lung cancer.

A Case Report on Right Hemiparesis after Left Thalamus Infarction Treated with Boyanghwanoh-tang-gagam and Complex Korean Medicine Treatment (보양환오탕가감방 및 복합한의치료로 호전된 시상 부위 뇌경색 후 우측 편마비 환자 치험 1례)

  • Eun-soo Park;Hyun-seo Park;Seong-hyun Jeon;Jin-won Kim
    • The Journal of Internal Korean Medicine
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    • v.44 no.5
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    • pp.823-829
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    • 2023
  • Objectives: This study reports the case of a patient with right hemiparesis after a left thalamic infarction, in which the patient experienced improved clinical symptoms (hemiparesis, constipation) after treatment with a complex Korean medicine treatment. Methods: A 81-year-old male patient diagnosed with acute left thalamic infarction was treated with daily acupuncture and herbal medicine (Boyanghwanoh-tang-gagam) three times a day. Jowiseunggi-tang extract granules were administered to treat constipation by adjusting the dosage according to the reported symptoms. The patient's clinical course was assessed using changes in Modified Barthel Index (MBI) score, Manual Muscle Testing (MMT) grade, and defecation frequency . Results: The patient's MBI score improved from 35 to 69 and was discharged with the ability to walk under supervision. The MMT grade also improved from 3/4 to 5/5 in the upper/lower extremities. Other clinical symptoms, including constipation, also improved, leading to the discontinuation of magnesium medication. Conclusion: These findings suggest that complex Korean medicine treatments, including herbal medicine and acupuncture, may be an effective treatment for post-stroke hemiplegic patients.

Study on Clinical Effects of Homnis Placenta Herbal Acupuncture on Osteoarthritis of Knee Joint (자하거(紫河車) 약침(藥針)의 퇴행성(退行性) 슬관절염(膝關節炎) 치료(治療)에 대한 임상적 고찰(考察))

  • Song, Kye-Hwa;Lee, Jin-Seok;Jo, Jin-Hyung;Park, Ki-Bum
    • Journal of Acupuncture Research
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    • v.23 no.4
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    • pp.163-173
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    • 2006
  • Objectives : The study was peformed to evaluate the effect of treatment for Osteoarthritis of knee joint by using Homnis Placenta Herbal Acupuncture. Methods : We investigated 60 cases of patient with Osteoarthritis of knee joint from 1st February 2005 to 31st January 2005, 60 cases of patient with Osteoarthritis in knee joint treated at the department of acupuncture & moxibustion of Kwang-Dong Oriental Medicine Hospital were randomly selected for two group. One group was treated by Homnis Placenta Herbal Acupuncture therapy, the other group was treated by Filiform Acupuncture therapy. We studied Lyshoim score, Ahlaback Grade, Nine-point scale and improvement degree of the grade of Ahlaback. Results : 1. In the Lyshoim score, Homnis Filiform Acupuncture was more effective than Filiform Acupuncture. But, there was no significance between two groups statistically in the Lyshoim score. 2. In the Nine point score, Homnis Placenta Herbal Acupuncture was more effective than Filiform Acupuncture. 3.In the improvement degree of the grade of Ahlaback., Homnis Placenta Herbal Acupuncture was as effective as Filiform Acupuncture. Conclusion : In the treatment of Osteoarthritis of knee joint, Homnis Placenta Herabl Acupuncture was not more effective than Filiform Acupuncture statistically. But both Homnis Placenta Herbal Acupuncture and Piliform Acupuncture was effective in Osteoarthritis of knee joint.

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