• The Korean Journal of Physiology and Pharmacology
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• 제16권4호
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• pp.273-279
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• 2012

Busulfan is an antineoplastic agent with a narrow therapeutic window. A post-hoc population pharmacokinetic analysis of a prospective randomized trial for comparison of four-times daily versus once-daily intravenous busulfan was carried out to search for predictive factors of intravenous busulfan (iBu) pharmacokinetics (PK). In this study the population PK of iBu was characterized to provide suitable dosing recommendations. Patients were randomized to receive iBu, either as 0.8 mg/kg every 6 h or 3.2 mg/kg daily over 4 days prior to hematopoietic stem cell transplantation. In total, 295 busulfan concentrations were analyzed with NONMEM. Actual body weight and sex were significant covariates affecting the PK of iBu. Sixty patients were included in the study (all Korean; 23 women, 37 men; mean [SD] age, 36.5 [10.9] years; weight, 66.5 [11.3] kg). Population estimates for a typical patient weighing 65 kg were: clearance (CL) 7.6 l/h and volume of distribution (Vd) 32.2 l for men and 29.1 L for women. Inter-individual random variabilities of CL and $V_d$ were 16% and 9%. Based on a CL estimate from the final PK model, a simple dosage scheme to achieve the target $AUC_{0-inf}$ (defined as median AUC0-inf with a once-daily dosage) of 26.18 $mg/l{\cdot}hr$, was proposed: $24.79{\cdot}ABW^{0.5}mg$ q24h, where ABW represents the actual body weight in kilograms. The dosing scheme reduced the unexplained interindividual variabilities of CL and Vd of iBu with ABW being a significant covariate affecting clearance of iBU. We propose a new simple dosing scheme for iBu based only on ABW.

• Clinical and Experimental Reproductive Medicine
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• 제47권4호
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• pp.237-244
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• 2020

Endometrial cancer (EC) in young women tends to be early-stage and low-grade; therefore, such cases have good prognoses. Fertility-sparing treatment with progestin is a potential alternative to definitive treatment (i.e., total hysterectomy, bilateral salpingo-oophorectomy, pelvic washing, and/or lymphadenectomy) for selected patients. However, no evidence-based consensus or guidelines yet exist, and this topic is subject to much debate. Generally, the ideal candidates for fertility-sparing treatment have been suggested to be young women with grade 1 endometrioid adenocarcinoma confined to the endometrium. Magnetic resonance imaging should be performed to rule out myometrial invasion and extrauterine disease before initiating fertility-sparing treatment. Although various fertility-sparing treatment methods exist, including the levonorgestrel-intrauterine system, metformin, gonadotropin-releasing hormone agonists, photodynamic therapy, and hysteroscopic resection, the most common method is high-dose oral progestin (medroxyprogesterone acetate at 500-600 mg daily or megestrol acetate at 160 mg daily). During treatment, re-evaluation of the endometrium with dilation and curettage at 3 months is recommended. Although no consensus exists regarding the ideal duration of maintenance treatment after achieving regression, it is reasonable to consider maintaining the progestin therapy until pregnancy with individualization. According to the literature, the ovarian stimulation drugs used for fertility treatments appear safe. Hysterectomy should be performed after childbearing, and hysterectomy without oophorectomy can also be considered for young women. The available evidence suggests that fertility-sparing treatment is effective and does not appear to worsen the prognosis. If an eligible patient strongly desires fertility despite the risk of recurrence, the clinician should consider fertility-sparing treatment with close follow-up.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.10021-10025
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• 2014

Background: The study aimed to describe the age distribution of breast cancer diagnosis among Chinese females for comparison with the United States and the European Union, and provide evidence for the screening target population in China. Materials and Methods: Median age was estimated from hospital databases from 7 tertiary hospitals in China. Population-based data in China, United States and European Union was extracted from the National Central Cancer Registry, SEER program and GLOBOCAN 2008, respectively. Age-standardized distribution of breast cancer at diagnosis in the 3 areas was estimated based on the World Standard Population 2000. Results: The median age of breast cancer at diagnosis was around 50 in China, nearly 10 years earlier than United States and European Union. The diagnosis age in China did not vary between subgroups of calendar year, region and pathological characteristics. With adjustment for population structure, median age of breast cancer at diagnosis was 50~54 in China, but 55~59 in United States and European Union. Conclusions: The median diagnosis age of female breast cancer is much earlier in China than in the United States and the European Union pointing to racial differences in genetics and lifestyle. Screening programs should start at an earlier age for Chinese women and age disparities between Chinese and Western women warrant further studies.

• Asian Pacific Journal of Cancer Prevention
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• 제14권6호
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• pp.3465-3467
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• 2013

Background: Breast cancer is the most frequent malignant disease amongst young women. If we review local data in Pakistan then breast cancer represents approximately a third of all cancers in females. The age standardized incidence rate (ASR) world per 100,000 is 53.8 and crude incidence rate is 30.9. We have observed during our surgical pathology practice and it is also reported by other Asian studies that breast carcinoma is amongst the leading malignancies in the region and the patients are at least a decade younger than counterparts in developed nations. Age is an important issue in effective screening, diagnosis and management of breast cancer, especially in this geographical region where late presentation and poor prognosis are a hallmark of the disease. Objective: The aim of this study is to determine the frequency of malignant breast lesions in symptomatic young females presenting with breast lumps. Materials and Methods: This is a retrospective study conducted at the Pathology Department, Liaquat National Hospital and Medical College, Karachi. Descriptive and pathology data of malignant breast tumors 1st January 2004 to 31st December 2009 were reviewed, using the departmental archived data. It included both male and female patients up to the age of 25 years. Results: A total of 714 surgical specimens from/of symptomatic breast lesions were received at the pathology department of Liaquat National Medical, in the five years study period, in young females. There were 575 (80%) benign, 119 (16%) inflammatory and 20 (2.8%) malignant lumps. Conclusions: The obtained data for females only up to 25 years of age suggest a massive burden which requires urgent attention. Early assessment of lesions is essential in order to avoid mortality from malignancies.

• 대한후두음성언어의학회지
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• 제17권1호
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• pp.53-55
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• 2006

Background and Objectives: The purposes of this study are to find out clinical causes, clinical characteristics and treatment outcomes in relation to anatomical location of laryngeal cyst. Subjects and Method: A retrospective study of medical records was carried out for 170 patients with cysts on vocal cord, epiglottis, vallecula, arytenoid and aryepiglottic fold. Results: There were 83 cases of epiglottic cysts, 41 cases of vallecular cysts, 35 cases of intracordal cysts, 3 cases of arytenoid cysts and 2 cases of aryepiglottic cysts. Laryngeal cysts were more common in men than in women, and the ratio between men and women was 2:1. The age of patients ranged from 7 to 90 years, with their average age being 52 years. The most common symptom was voice change at intracordal cysts and globus sensation at vallecular and epiglottic cysts. The most common cause of intracordal cysts were voice abuse. But other location of laryngeal cysts doesn't have common causes. The average size of cysts was 0.3cm at vocal cord, 1.43cm at epiglottis, 1.4cm at vallecula, 0.9cm at arytenoid and 1cm at aryepiglottis. Recurrence was observed in 7 cases from 1 months to 18 months following the operation. Size of all recurred cysts was over the average. Conclusion: Physicians should be aware of changes in clinical patterns of laryngeal cysts according to location and have long follow-up period at large cysts after operation.

• 여성건강간호학회지
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• 제18권1호
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• pp.17-27
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• 2012

Purpose: This study aimed to identify sexuality for women with gynecological cancer. Methods: A total of seven women with gynecological cancer agreed to participate in this study. The data were collected utilizing in-depth semi-structured interviews style. A descriptive study design was used in this study. The interviews were analyzed using inductive content analysis methodology. Results: Three themes identified were: 'women with gynecological cancer who give up their sexual life due to misunderstanding and fear', 'women with gynecological cancer who control their body and mind for recovery', 'women with gynecological cancer resume their sexual life with their partner's will'. Conclusion: To improve sexual health and quality of life for women with gynecological cancer, we need to develop programs related to sexual health. An adjusted sexual health program will contribute to increased sexual health and quality of life for women with gynecological cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제15권4호
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• pp.1671-1674
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• 2014

Background: To study the clinical presentation of cervical carcinoma correlating with histopathological findings in a tertiary hospital situated in the southern part of India catering to rural and semi-urban populations Materials and Methods: 199 cases histopathologically diagnosed as cervical cancer over a period of one year were considered for the study. Clinical details of the patients were noted with the help of semi-structured proforma. The data was analysed by descriptive analysis using SPSS software. Results: Out of 199 patients, 109 had moderately differentiated squamous cell carcinoma, 51 poorly differentiated and 35 well differentiated. Adenocarcinomas numbered only four. 121 cases were in the age group of 40-59 years, 59 in 60-80 years and 19 in 20-39 years. All four cases of adenocarcinoma were seen between 40-59 years. 95 (47.7%) cases were in women who had 4 or more children, 120 presented with white discharge, 89 with bleeding per vagina and 68 had constitutional symptoms. Most of the patients with adenocarcinoma presented with bleeding per vagina. 151 was in stage IIIB, 29 in stage IIB, 14 in stage IVA and 5 in stage IB. Conclusions: Screening of cervical cancer should be emphasised in women with white discharge especially in rural areas for early detection of dysplastic cells and reduce mortality and morbidity in productive age. In addition health education has to be given to women regarding the awareness of hygiene, risk factors and symptoms of cervical cancer.

• 한국보건간호학회지
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• 제21권2호
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• pp.193-205
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• 2007

Purpose: To evaluate the current status of utilization and implementation of health promotion programs for Korean middle-aged women in public health centers. Methods: Three-phase stratified sampling was done to select 1304 middle-aged women (aged 40-64 years) from all regions of Korea. The data were collected by face-to-face interviews using a structured questionnaire for individual responses and mailed surveys to 126 public health centers. Descriptive statistics and $x^2$-test were done for data analysis. Results: Only 12 of the 126 public health centers (9.9%) implemented health promotion programs for middle-aged women, with the lack of manpower being cited as the main reason for the absence of programs. From individual responses, 11.3% had participated in health promotion programs offered by public health centers. The main reasons for not participating were inconvenient times and lack of information. Significant differences were found in the frequency of participation in programs, exercise programs and diabetes management according to the size of region. The majority of the respondents cited the need for medical services, followed by programs focused on stroke prevention and leisure time management. The responses on the willingness to participate followed a similar pattern. Conclusion: There are gaps between the utilization of health promotion programs by middle-aged women and what is offered by public health centers. The results of this study support the need to develop more health promotion programs focusing specifically on the needs of middle-aged women.

• Clinical and Experimental Reproductive Medicine
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• 제43권4호
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• pp.215-220
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• 2016

Objective: To evaluate the efficacy and safety of dienogest treatment in patients who had received dienogest for 12 months or more to treat endometriosis. Methods: We analyzed the clinical data of 188 women with endometriosis who had been treated with 2 mg of dienogest once a day for 12 months or more at a single institute. We evaluated changes in endometriosis-associated pain and endometrioma size, recurrence rate, and adverse events following dienogest administration. Bone mineral density (BMD) was measured in patients who were prescribed dienogest for more than 18 months. Results: Pain was significantly reduced at 12 months after dienogest medication. In those treated with dienogest due to recurrent endometrioma, the size of the endometrioma was significantly decreased at the 12-month and 18-month follow-ups. We found only one case of sonographic recurrence during dienogest administration among those who were treated postoperatively to prevent recurrence (1 of 114, 0.9%). The most common adverse drug reaction was uterine bleeding (3.2%), and other adverse events were generally tolerable and associated with low discontinuation rates (5.2%). Among the 50 patients in whom BMD was measured, 10 patients (20%) had a Z-score below the expected range for age. Conclusion: The administration of dienogest for a year or more seems to be highly effective in preventing recurrence after surgery, reducing endometriosis-associated pain, and decreasing the size of recurrent endometrioma, with a favorable safety and tolerability profile. However, BMD should be checked in patients on long-term medication due to possible bone loss in some women.

• Tuberculosis and Respiratory Diseases
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• 제60권2호
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• pp.215-220
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• 2006

연구 배경: 폐활량측정법 정상예측식이 한국인을 대상으로 개발되었다. 한국인 정상예측식을 실제 진료에 사용하기 위해서 그 동안 많이 사용하던 정상 예측식 중 하나인 Morris 예측식을 적용하였을 때와 한국인 예측식을 적용하였을 때 장애 양상 해석 및 질병 중증도 평가가 어떻게 달라지나 비교하고자 하였다. 방 법: 서울아산병원의 호흡기검사실에서 2004년도 11월 한 달간 폐활량측정법을 시행한 남자 926명과 여자 694명을 대상으로 하였다. 나이, 성, 키, 몸무게, 그리고 폐활량측정법으로 $FEV_1$ [forced expiratory volume in one second], FVC [forced vital capacity], $FEV_1/FVC$ 등을 구하였다. 한국인 예측식과 Morris 예측식을 사용하여 장애 양상 해석과 질병 중증도 평가를 하였고 그 차이를 비교하였다. 폐활량측정법 장애 양상은 $FEV_1/FVC$과 FVC 값에 따라서 정상, 제한성, 폐쇄성, 양상 미정 등으로 정의하였고 질병 중증도는 기류제한이 있는 환자는 $FEV_1$ 값에 따라서 기류제한이 없는 환자는 FVC값에 따라서 정의하였다. 결 과: Morris 예측식에서 한국인 예측식으로 바꾸어 적용하면 장애 양상 해석이 남자 환자의 경우 22.5% (208/926) 달라졌고 여자의 경우 24.8% (172/694) 달라졌다. 한국인 예측식을 적용하였을 때, 기류제한이 있는 환자의 경우 질병의 중증도가 남자에서 30.2% (114/378) 바뀌었고 여자에서 39.4% (37/94) 바뀌었다. 기류제한이 없는 환자의 경우는 질병의 중증도가 남자에서 27.9% (153/548) 바뀌었고 여자에서 30.2% (181/600) 바뀌었다. 결 론: 폐활량측정법 정상예측식이 바뀌면 장애 양상 해석과 질병 중증도 평가에 유의한 영향을 미칠 수 있다.