• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.10
• /
• pp.5699-5703
• /
• 2013

Objective: To investigate the clinical effects of whole brain radiotherapy concomitant with targeted therapy for brain metastasis in non-small cell lung cancer (NSCLC) patients with chemotherapy failure. Materials and Methods: Of the 157 NSCLC patients with chemotherapy failure followed by brain metastasis admitted in our hospital from January 2009 to August 2012, the combination group (65 cases) were treated with EGFR-TKI combined with whole brain radiotherapy while the radiotherapy group (92 cases) were given whole brain radiotherapy only. Short-term effects were evaluated based on the increased MRI in brain 1 month after whole brain radiotherapy. Intracranial hypertension responses, hematological toxicity reactions and clinical effects of both groups were observed. Results: There were more adverse reactions in the combination group than in radiotherapy group, but no significant differences were observed between the two groups in response rate (RR) and disease control rate (DCR) (P>0.05). Medium progression free survival (PFS), medium overall survival (OS) and 1-year survival rate in combination group were 6.0 months, 10.6 months and 42.3%, while in the radiotherapy group they were 3.4 months, 7.7 months and 28.0%, respectively, which indicated that there were significant differences in PFS and OS between the two groups (P<0.05). Additionally, RPA grading of each factor in the combination group was a risk factor closely related with survival, with medium PFS in EGFR and KRAS mutation patients being 8.2 months and 11.2 months, and OS being 3.6 months and 6.3 months, respectively. Conclusions: Whole brain radiotherapy concomitant with target therapy is favorable for adverse reaction tolerance and clinical effects, being superior in treating brain metastasis in NSCLC patients with chemotherapy failure and thus deserves to be widely applied in the clinic.

• International Journal of Oral Biology
• /
• v.41 no.1
• /
• pp.17-23
• /
• 2016

Chronic/cyclic neutropenia, leukocyte adhesion deficiency syndrome, Papillon-$Lef{\grave{e}}vre$ syndrome, and $Ch{\grave{e}}diak$-Higashi syndrome are associated with severe periodontitis, suggesting the importance of neutrophils in the maintenance of periodontal health. Various Toll-like receptor (TLR) ligands are known to stimulate neutrophil function, including FcR-mediated phagocytosis. In the present study, the effect of TLR2 activation on the non-opsonic phagocytosis of oral bacteria and concomitant production of reactive oxygen species (ROS) by human neutrophils was evaluated. Neutrophils isolated from peripheral blood were incubated with Streptococcus sanguinis or Porphyromonas gingivalis in the presence of various concentrations of $Pam_3CSK_4$, a synthetic TLR2 ligand, and analyzed for phagocytosis and ROS production by flow cytometry and chemiluminescence, respectively. $Pam_3CSK_4$ significantly increased the phagocytosis of both bacterial species in a dose-dependent manner. However, the enhancing effect was greater for S. sanguinis than for P. gingivalis. $Pam_3CSK_4$ alone induced ROS production in neutrophils and also increased concomitant ROS production induced by bacteria. Interestingly, incubation with P. gingivalis and $Pam_3CSK_4$ decreased the amounts of ROS, as compared to $Pam_3CSK_4$ alone, indicating the possibility that P. gingivalis survives within neutrophils. However, neutrophils efficiently killed phagocytosed bacteria of both species despite the absence of $Pam_3CSK_4$. Although P. gingivalis is poorly phagocytosed even by the TLR2-activated neutrophils, TLR2 activation of neutrophils may help to reduce the colonization of P. gingivalis by efficiently eliminating S. sanguinis, an early colonizer, in subgingival biofilm.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.19 no.3
• /
• pp.684-689
• /
• 2005

In order to evaluate the in vitro synergic effect of Mahwangyounpae-tang which was a traditional poly-herbal formula has been used in the treatment of respiratory diseases in oriental medicine, and quinolone antibiotics, ciprofloxacin (CPFX), the minimal inhibitory concentration (MIC), $MIC_{50}$ and MIC90 of single use of quinolones and concomitant treatment with Mahwangyounpae-tang against 5 strains of aerobic gram negative bacteria, Escherichia coli, Klebsiella peumoniae, Hemophilus influenzae, Citrobacter freundii and Pseudomonas aeruginosae. The obtained results were as follows : In the case of aerobic gram negative bacteria, the MIC, $MIC_{50}$ and $MIC_{90}$ against Klebsiella peumoniae and Pseudomonas aeruginosae was significantly decreased in concomitant treated groups with Mahwangyounpae-tang compared to those of single treated groups of CPFX, respectively. However, no significant changes were demonstrated against Echerichia coli, Hemophilus influenzae and Citrobacter freundii. According to these results, it is considered as the in vitro antibacterial activity of CPFX was dramatically increased by concomitant use of Mahwangyounpae-tang against some strains of aerobic gram negative bacteria and the increase and selectivity of antibacterial activities against strains were chosen by the selectivity of Mahwangyounpae-tang not CPFX activity.

• Journal of Chest Surgery
• /
• v.44 no.2
• /
• pp.131-136
• /
• 2011

Background: We evaluated the surgical results and predictors of long-term survival in patients who underwent coronary artery bypass grafting (CABG) at the time of an aortic valve replacement (AVR) due to aortic stenosis. Materials and Methods: Between January 1990 and December 2009, 183 consecutive patients underwent CABG and concomitant aortic valve replacement for aortic stenosis. The mean follow-up period was $59.8{\pm}3.3$ months and follow-up was possible in 98.3% of cases. Predictors of mortality were determined by Cox regression analysis. Results: There were 5 (2.7%) in-hospital deaths. Follow-up of the in-hospital survivors documented late survival rates of 91.5%, 74.8%, and 59.6% at 1, 5, and 10 postoperative years, respectively. Age (p<0.001), a glomerular filtration rate (GFR) less than 60 mL/min (p=0.006), and left ventricular (LV) mass (p<0.001) were significant predictors of mortality in the multivariate analysis. Conclusion: The surgical results and long-term survival of aortic valve replacement with concomitant CABG in patients with aortic stenosis and coronary artery disease were acceptable. Age, a GFR less than 60 mL/min, and LV mass were significant predictors of mortality.

• The Journal of Korean Medicine
• /
• v.26 no.1 s.61
• /
• pp.195-205
• /
• 2005

Objective & Methods: To evaluate the in vitro synergic effect of Eunkyo-san, a traditional poly-herbal formula used in the treatment of respiratory diseases in oriental medicine with quinolone antibiotics, represented by ciprofloxacin (CPFX), which was used in the minimal concentration (MIC), $MIC_{50}$ and $MIC_{90}$. of single use of quinolones in concomitant treatment with Eunkyo-san against 9 strain$ of gram positive bacteria. Results: In. the case of aerobic gram positive bacteria, the MIC, $MIC_{50}$ and $MIC_{90}$ against Staphylococcus aureus, Staphylococcus aureus smith, Staphylococcus epidermidis, Streptococcus pyogenes, Streptococcus pneumoniae Type I, Type II and Type III were significantly decreased in concomitant treated groups with Eunkyo-san compared to those of single treated groups of CPFX, respectively. However, no significant changes were demonstrated against Bacillus subtilis and Enterococcus faecalis. Conclusion: The in vitro antibacterial activity of CPFX were increased against some strains of gram positive strains, especially, pneumococcus such as Staphylococcus and Streptococcus, by concomitant use of Eunkyo-san.

• Korean Journal of Clinical Pharmacy
• /
• v.32 no.3
• /
• pp.204-214
• /
• 2022

Objective: This study aimed to investigate the occurrence and types of the adverse events (AEs) associated with oral fluconazole and itraconazole and factors associated with specific types of AEs. Methods: We analyzed AEs reported by community pharmacies nationwide over 10 years using the Korea Adverse Event Reporting System database. Various AE terms were categorized into 18 types, and concomitant medications were classified by drug-drug interaction (DDI) severity. The relationship between the specific type of AE and age, sex, and number of concomitant medications was investigated using multiple logistic regression analysis. Results: A total of 879 AE reports of fluconazole and 401 reports of itraconazole were analyzed; of these reports, 321 and 83 reports of fluconazole and itraconazole, respectively, described concomitant drug administration categorized as DDI severity of contraindicated or major. Women had a higher risk of psychiatric AEs associated with fluconazole use (OR, 1.587; p=0.042). Polypharmacy increased the risk for psychiatric AEs (OR, 3.598; p<0.001 for fluconazole and OR, 2.308; p=0.046 for itraconazole). In dermatologic AEs, the mean age of patients who received itraconazole was lower than that of patients who received fluconazole (46.3±16.8 vs. 54.9±15.4; p<0.001). Co-administration of fluconazole with 1-3 drugs increased the risk of neurological AEs (OR, 1.764; p=0.028). Conclusion: When using fluconazole and itraconazole, psychiatric AEs should be noted, particularly in women and in case of polypharmacy; moreover, when fluconazole is co-administered with other drugs, attention should be paid to the occurrence of neurological AEs.

• Journal of the Korea Society for Simulation
• /
• v.19 no.1
• /
• pp.133-141
• /
• 2010

This research suggests a unified scheme for using stratified sampling and control variates method to improve the efficiency of estimation for parameters in simulation experiments. We utilize standardized concomitant variables defined during the course of simulation runs. We first use these concomitant variables to counteract the unknown error of response by the method of control variates, then use a concomitant variable not used in the controlled response and stratify the response into appropriate strata to reduce the variation of controlled response additionally. In case that the covariance between the response and a set of control variates is known, we identify the simulation efficiency of suggested method using control variates and stratified sampling. We conjecture the simulation efficiency of this method is better than that achieved by separated application of either control variates or stratified sampling in a simulation experiments. We investigate such an efficiency gain through simulation on a selected model.

• Clinics in Shoulder and Elbow
• /
• v.26 no.1
• /
• pp.49-54
• /
• 2023

Background: Lateral epicondylitis is an increasingly debilitating condition in working population. Evidence for conservative treatment modalities has been inconclusive. Percutaneous pie crusting of the common extensor origin at the lateral epicondyle at the time of local corticosteroid injection (CSI) has been proposed sparsely. The objective of this study was to analyze if concomitant CSI and pie-crusting of the common extensor origin provides better outcome than CSI alone in lateral epicondylitis. Methods: This case-control study on 236 patients was conducted at a single center between January 1, 2020, and May 31, 2022. Patients were divided into two groups (n=118 each) based on their preference. Group A underwent CSI alone and group B underwent pie crusting along with CSI. The clinical and functional outcomes of all patients were evaluated at 2, 4, 6, and 12-week post-procedure using the visual analog scale (VAS) and Nirschl score. The mean time for return to daily activities was also compared. Results: Both groups showed significant improvement in post-procedure outcome at successive follow-ups on intragroup longitudinal analysis (VAS: F=558.384 vs. F=1,529.618, Nirschl: F=791.468 vs. F=1,284.951). On intergroup analysis, VAS of group B was superior to that of group A; however, it was statistically significant (P<0.05) only from the 6-week follow-up onwards. Nirschl score of group B was significantly better throughout the period of follow-up (P<0.05). Group B returned to daily activities faster than Group A (6.2±0.44 weeks vs. 7.18±0.76 weeks). Conclusions: Concomitant pie crusting with CSI is recommended for lateral epicondylitis as it provides significantly better results than CSI alone.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.24 no.2
• /
• pp.129-135
• /
• 2024

Concomitant chemoradiotherapy (CCRT) treated patients experience various complications. We present a rare case of post-CCRT Bell's palsy and describe its various possible causes, so as to increase awareness among clinicians about Bell's palsy being a CCRT-associated adverse effect. The patient was a 48-year-old man diagnosed with squamous cell carcinoma who presented with post-CCRT Bell's palsy. After radiotherapy for 6 weeks (overall 67.5 Gy) and four rounds of cisplatin chemotherapy, he complained of paralysis of the entire left face. A test was performed 33 days after the last CCRT session to differentiate Bell's palsy from other causative factors. Based on magnetic resonance imaging findings, facial nerve invasion due to tumor size increase was determined to not cause Bell's palsy. Inflammation of the left Eustachian tube was observed. Hence, steroids and famciclovir were administered, which markedly improved the facial paralysis symptoms within 56 days after facial paralysis development. In conclusion, patients can develop Bell's palsy owing to complex effects of various CCRT mechanisms. Although the exact cause of Bell's palsy has not been identified and the effectiveness of drug treatment was questionable in this case, unlikely causative factors should be excluded through various tests and appropriate and timely measures must be adopted.

• The Korean journal of internal medicine
• /
• v.39 no.2
• /
• pp.261-271
• /
• 2024

Background/Aims: Mucoprotective agents, such as eupatilin, are often prescribed to prevent gastrointestinal (GI) bleeding in addition to an acid suppressant despite the absence of a large-scale study. We evaluated the additional effect of eupatilin on the prevention of GI bleeding in both the upper and lower GI tract in concomitant aspirin and acid suppressant users using the nationwide database of national claims data from the Korean National Health Insurance Service (NHIS). Methods: An aspirin cohort was constructed using the NHIS claims data from 2013 to 2020. Patients who manifested with hematemesis, melena, or hematochezia were considered to have GI bleeding. A Cox proportional hazards regression model was used to determine the risk factors for GI bleeding associated with the concomitant use of GI drugs and other covariates among aspirin users. Results: Overall, a total of 432,208 aspirin users were included. The concurrent use of an acid suppressant and eupatilin (hazard ratio [HR] = 0.85, p = 0.016, vs. acid suppressant only) was a statistically significant preventive factor for GI bleeding. Moreover, a more than 3-month duration (HR = 0.88, p = 0.030) of acid suppressant and eupatilin prescription (vs. acid suppressant only) was a statistically significant preventive factor for GI bleeding. Conclusions: Eupatilin administration for ≥ 3 months showed additional preventive effect on GI bleeding in concomitant aspirin and acid suppressant users. Thus, cotreatment with eupatilin with a duration of 3 months or longer is recommended for reducing GI bleeding among aspirin plus acid suppressant users.