• Title/Summary/Keyword: early remission

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Surgical Results of Growth Hormone-Secreting Pituitary Adenoma

  • Kim, Min-Su;Jang, Hyun-Dong;Kim, Oh-Lyong
    • Journal of Korean Neurosurgical Society
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    • v.45 no.5
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    • pp.271-274
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    • 2009
  • Objective: We retrospectively analyzed the surgical outcomes of 42 patients with growth hormone (GH)-secreting pituitary adenoma to evaluate the clinical manifestations and to determine which preoperative factors that significantly influence the remission. Methods: Forty-two patients with GH-secreting pituitary adenoma underwent transsphenoidal surgery (TSS) between 1995 and 2007. The patient group included 23 women and 19 men, with a mean age of 40.2 (range 13-61) years, and a mean follow-up duration of 49.4 (range 3-178) months after the operation. For comparable radiological criteria, we classified parasellar growth into five grades according to the Knosp classification. We analyzed the surgical results of the patients according to the most recent stringent criteria for cure. Results: The overall rate of endocrinological remission in the group of 42 patients after primary TSS was 64% (26 of 42). The remission rate was 67% (8 of 12) for microadenoma and 60% (18 of 30) for macroadenoma. The remission rate was 30%(3 of 10) for the group with cavernous sinus invasion and 72% (23 of 32) for the group with intact cavernous sinus. Cavernous sinus invasion in Knosp grade III and IV was significantly correlated with the remission rate. There was a significant relationship between preoperative mean GH concentration and early postoperative outcome, with most patients in remission having a lower preoperative GH concentration. Conclusion: TSS is thought to be an effective primary treatment for GH-secreting pituitary adenomas according to the most recent criteria of cure. Because the remission rate in cases with cavernous sinus invasion is very low, early detection of the tumor before it extends into the cavernous sinus and a long-term endocrinological and radiological follow-up are necessary in order to improve the remission rate of acromegaly.

Early Efficacy of Taxotere and Cisplatin Chemo-Radiotherapy for Advanced Cervical Cancer

  • Ke, Qing-Hua;Zhou, Shi-Qiong;Du, Wei;Lei, Yong;Huang, Min;Luo, Fei;Yang, Ji-Yuan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.2
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    • pp.617-619
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    • 2012
  • The aim of this study was to investigate the early outcome of the taxotere and cisplatin chemoradiotherapy for advanced cervical cancer. Fifty-six cases (FIGO II b to IVa) were divided randomly into two groups: radiotherapy alone (28 cases) and radiation plus chemotherapy (TP) group. There was no difference in radiotherapy between the two groups. The RT+C cases who received TP regimen during the radiation, and DDP once weekly injection of vain, according to 20$mg/m^2$ and taxotere once weekly iv according to 35 $mg/m^2$. These regimens were given for 4~5weeks, and some medicines to control vomiting were available for the RT+C cases. The two groups received an oral medicine MA 160mg every day during the treatment. Regarding early outcome, the complete remission rate was 64.3% and partial remission rate was 35.7% in RT+C. The complete remission rate was 32.1% and partial remission rate was 39.3% in RT. The total response rate and complete remission in the RT+C group were higher than that in the RT group. We conclude that taxotere and cisplatin chemoradiotherapy can improve the early outcome of the advanced cervical cancer, the adverse effects being endurable.

Medical Therapeutic Effect of Hyperthyroidism - Comparison of antithyroid therapy and $^{131}I$ Therapy - (갑상선기능항진증(甲狀腺機能亢進症)의 내과적(內科的) 치료효과(治療效果) - 방사성동위원소(放射性同位元素) ($^{131}I$)치료(治療)와 항갑상선제(抗甲狀腺劑) 치료(治療)의 비교검토(比較檢討) -)

  • Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.14 no.2
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    • pp.35-40
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    • 1980
  • In order to compare the therapeutic effect as well as side effects between antithyroid therapy and radioiodine therapy in hyperthyroidism, the author evaluated 111 cases of hyperthyroidism which were composed of 57 patients with antithyroid treatment, 23 patients with combined treatment comprising of antithyroid and radioactive iodine ($^{131}I$) and 31 patients with treatment of $^{131}I$ alone. The $^{131}I$ treatment was limited to older age, above 20 years of age, and not employed in patients with pregnancy and lactation. The patients treated with antithyroid belonged to relatively younger age, and also milder in symptoms and thyroid function tests. The remission rate of antithyroid therapy group was 97.8% within 16 months. Among them the early remission rate occured within 4 months was found to be 21.7%. The combined therapy group, having prescribed more severe cases, showed the remission rate to be 75% within 16 months. The remission rate of $^{131}I$ therapy group revealed 90.9% within 16 months. Among them the early remission rate taking place within 4 months disclosed 16.7%. The side effects of antithyroid drug, propylthiouracil, were noted as follows: itching (2.7%) skin rashes (1.3%), and adverse enlargement of goiter (10.7%). The side effects $^{131}I$ therapy were transient hypothyroidism(3.9%) permanent hypothyroidism (7.8%) and itching (2.0%).

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Fecal Calprotectin Assay at an Early Stage of Treatment Can Be Used as a Surrogate Marker to Predict Clinical Remission and Mucosal Healing in Pediatric Crohn's Disease

  • Lee, Yeoun Joo;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.5
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    • pp.396-405
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    • 2022
  • Purpose: This study evaluated the predictive role of fecal calprotectin (FC) measured at an early stage of treatment for monitoring clinical remission (CR) after six months and endoscopic remission (ER) after one year of treatment in pediatric Crohn's disease (CD). Methods: This retrospective study included 45 patients who simultaneously underwent ileocolonoscopy and FC testing during follow-up. FC levels were measured before and after six weeks of treatment. CR was assessed after six months of treatment using Pediatric Crohn' s Disease Activity Index and acute-phase reactants. ER was assessed after one year using the Simple Endoscopic Score for Crohn's Disease. Results: Twenty-nine (64.4%) patients used oral prednisolone for remission induction and 16 (35.6%) patients used anti-tumor necrosis factor-alpha. Thirty (66.7%) patients achieved CR, while 24 (53.3%) achieved ER. The FC level measured after six weeks of treatment could predict CR (χ2=9.15, p=0.0025) and ER (χ2=12.31, p=0.0004). The δFC could predict CR (χ2=7.91, p=0.0049), but not ER (χ2=1.85, p=0.1738). With a threshold of ≤950.4 ㎍/g, FC at week six could predict CR with 76.7% sensitivity and 73.3% specificity. The area under the curve (AUC) was 0.769 (standard error 0.0773, p=0.0005). The same threshold predicted ER with 87.5% sensitivity and 71.4% specificity. The AUC was 0.774 (standard error 0.074, p=0.0002). Conclusion: FC assay at an early stage of treatment can be used as a surrogate marker to predict CR and mucosal healing in pediatric CD.

Fecal Microbiota Transplantation to Patients with Refractory Very Early Onset Ulcerative Colitis

  • Yodoshi, Toshifumi;Hurt, Thomas L.
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.4
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    • pp.355-360
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    • 2018
  • Recently, fecal microbiota transplantation (FMT) has been attracting attention as a possible medical treatment of ulcerative colitis (UC). A randomized controlled trial of FMT for children with UC is currently underway. Therapeutic effects of FMT for adults with UC remain controversial. We report two cases of early-onset UC in children. A patient was diagnosed with UC at age 1-year 9-month and underwent FMT at age 2-year 3-month. He attained clinical remission for three weeks after FMT, but then relapsed at four weeks, ultimately undergoing a total colectomy. Another child was diagnosed with UC at 2-year 10-month and she underwent FMT at age 5 years. She has remained in clinical remission following FMT for 24 months and her UC has been maintained without complications with tacrolimus and azathioprine. We report that FMT for early-onset UC appears to be safe and potentially effective.

Initial steroid regimen in idiopathic nephrotic syndrome can be shortened based on duration to first remission

  • Baek, Hee Sun;Park, Ki-Soo;Kang, Hee Gyung;Ko, Cheol Woo;Cho, Min Hyun
    • Clinical and Experimental Pediatrics
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    • v.58 no.6
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    • pp.206-210
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    • 2015
  • Purpose: The use of a 12-week steroid regimen (long-term therapy, LT) for the first episode of idiopathic nephrotic syndrome (NS) reportedly induces a more sustained remission and lower relapse rate than previous regimens, including an 8-week steroid regimen (short-term therapy, ST). Here, we assessed the potential for selective application of 2 steroid regimens (LT vs. ST) based on the days to remission (early responders [ER] vs. late responders [LR]) for the first idiopathic NS episode in children. Methods: Patients were divided into 4 subgroups (ST+ER, ST+LR, LT+ER, and LT+LR) according to the initial steroid regimen used and rapidity of response; the baseline characteristics, relapse rates, and cumulative percentage of children with sustained remission were then compared among the 4 subgroups. Results: Fifty-four children received ST, and the remaining 45 children received LT. As observed in previous studies, children receiving LT showed significantly lower relapse rates during the first year after the first NS episode than those receiving ST. The ST+ER group showed significantly lower relapse rates during the first one year and two years after the first NS episode than the the ST+LR group, whereas there were no significant differences of the relapse rates and duration to the first relapse between the ST+ER and LT+ER groups. Conclusion: We suggest that the initial steroid regimen in idiopathic NS patients can be shortened according to the duration to remission i.e., LT in patients achieving remission after the first week of steroid therapy, and ST in those achieving remission within the first week of steroid therapy.

Treatment of steroid-resistant pediatric nephrotic syndrome

  • Kang, Hee-Gyung
    • Clinical and Experimental Pediatrics
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    • v.54 no.8
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    • pp.317-321
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    • 2011
  • Children who suffer from steroid-resistant nephrotic syndrome (SRNS) require aggressive treatment to achieve remission. When intravenous high-dose methylprednisolone fails, calcineurin inhibitors, such as cyclosporine and tacrolimus, are used as the first line of treatment. A significant number of patients with SRNS progress to end-stage renal disease if remission is not achieved. For these children, renal replacement therapy can also be problematic; peritoneal dialysis may be accompanied by significant protein loss through the peritoneal membrane, and kidney allograft transplantation may be complicated by recurrence of SRNS. Plasmapheresis and rituximab were initially used for treatment of recurrent SRNS after transplantation; these are now under consideration as rescue therapies for refractory SRNS. Although the prognosis of SRNS is complicated and unfavorable, intensive treatment in the early stages of the disease may achieve remission in more than half of the patients. Therefore, timely referral of pediatric SRNS patients to pediatric nephrology specialists for histological and genetic diagnosis and treatment is highly recommended.

Early Efficacy of Endostar Combined with Chemoradiotherapy for Advanced Cervical Cancers

  • Ke, Qing-Hua;Zhou, Shi-Qiong;Huang, Min;Lei, Yong;Du, Wei;Yang, Ji-Yuan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.3
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    • pp.923-926
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    • 2012
  • The aim of this study was to investigate the early outcome of Endostar combined with chemoradiotherapy for advanced cervical cancer. Fifty-two cases (FIGO IIb to IVa) were divided randomly into two groups, receiving chemoradiotherapy alone (CRT group) and Endostar combined with chemoradiotherapy (CRT+E group). For the patients in the CRT+E group, Endostar was administered daily with the dosage of 7.5 $mg/m^2$, and cisplatin was administered weekly with the dosage of 20 $mg/m^2$ during the radiation. The regimens lasted for 4 weeks with no difference in chemoradiotherapy between the two groups. The early outcome complete remission rate was 73.1%, partial remission rate was 23.1% and the total response rate was 96.2% in CRT+E group, a significant improvement on the 34.6%, 42.3% and 76.9%, respectively, in the CRT group. One year survive rates were 100% and 84.6% in the CRT+E group and CRT groups, the difference being significant. Endostar combined with chemoradiotherapy can improve the early outcome of the advanced cervical cancer, and adverse effects were not encountered.

Low Frequency of ETV6-RUNX1 (t 12; 21) in Saudi Arabian Pediatric Acute Lymphoblastic Leukemia Patients: Association with Clinical Parameters and Early Remission

  • Aljamaan, Khaled;Aljumah, Talal khalid;Aloraibi, Saleh;Absar, Muhammad;Iqbal, Zafar
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7523-7527
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    • 2015
  • Background: Pediatric acute lymphoblastic leukemia (pALL) patients at King Abdulaziz Medical City represent a pure Saudi Arabian population. ETV6-RUNX1 positive pALL patients have good prognosis as compared to ETV6-RUNX1 negative counterparts. Therefore, frequencies of these two patient groups have a huge consideration in treatment strategies of pALL in a given population. Different geographical locations have been reported to have different frequencies of ETV6-RUNX1 ranging from 10% in Southeast Asia to 30% in Australia. Aim: Therefore, the objective of this study was to establish the ETV6-RUNX1 status of Saudi Arabian pALL patients and its association with clinical parameters and early remission. Materials and Methods: Clinical parameters and ETV6-RUNX1 status (using FISH technique) of pALL patients attending the Pediatric Oncology Clinic, King Abdulaziz Medical City, Riyadh from 2006 to 2011 were studied. Comparisons between ETV6-RUNX1 positive and negative groups were accomplished using chi-square test or Fisher's exact test. All statistical analyses were performed using SAS version 9.2 (SAS Institute, Inc., Cary, NC). Results: Out of 54 patients, 33 were male and 21 were females (ratio 1.57:1). B- and T-cell lineages were found in 47 (87%) and 7 (13%) patients respectively. Only 5 (9.3%) patients were ETV6-RUNX1 positive while 49(80.7%) were ETV6-RUNX1 negative. All ETV6-RUNX1 patients (100%) were of B-cell lineage and 80% (4/5) were in the 3-7 year age group. None of the ETV6-RUNX11 patients had ${\geq}5%$ blasts (no remission) at day 14 as compared with 9% in the ETV6-RUNX1 negative group (Figure 1). Conclusions: Frequency of ETV6-RUNX1 positive patients (less than 10%) in our pALL patients is much lower than reported for most European countries, North America, Australia and Japan while it is in accordance with ETV6-RUNX1 frequencies from Egypt (11.6%), Pakistan (10%), Spain (2%) and India (5-7%). This shows ethnic differences in genetics of pALL as well as higher frequencies of ETV6-RUNX1 positive pALL mostly in more industrialized countries, probably due to some industrial pollutants or westernized lifestyle.

An Unusual Case of Acute Lymphocytic Leukemia with Extramedullary Relapse Presenting as Parotid Enlargement (급성 림프구성 백혈병 환자에서 이하선 비대로 나타난 골수외 재발 1례)

  • Lee, Dong-Hee;Cho, Kwang-Jae
    • Korean Journal of Bronchoesophagology
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    • v.11 no.1
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    • pp.21-24
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    • 2005
  • Acute lymphocytic leukemia(ALL) is a malignant disease of the bone marrow in which early lymphoid precursors proliferate and replace the normal hematopoietic cells of the marrow. Currently, only $20-30\%$ of adults with ALL are cured with standard chemotherapy regimens. It is very important risk factor whether to failure to achieve complete remission within 4 weeks or not. The relapse of leukemia is usually classified as hematologic and extramedullary relapse, and extramedullary leukemic infiltration is rarely observed in patients with ALL. In October 2004, a 23-year-old man presented with painless enlargement of both parotid glands. He was diagnosed as ALL(L2 subtype) one month ago, and he gained complete remission with induction chemotherapy. Fine needle aspiration cytology and bone marrow biopsy revealed extramedullary and hemtologic remission. To our knowledge this is the first report of extramedullary relapse in the parotid in ALL.

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