• Journal of Gastric Cancer
• /
• v.20 no.2
• /
• pp.115-126
• /
• 2020

Peritoneal metastasis (PM) frequently occurs in patients with gastric cancer (GC) and confers a dismal prognosis despite advances in systemic chemotherapy. While systemic chemotherapy has poor peritoneal penetration, intraperitoneal (IP) chemotherapy remains sequestered, resulting in high peritoneal drug concentrations with less systemic side-effects. The first application of IP treatment was hyperthermic intraperitoneal chemotherapy (HIPEC) with cytoreductive surgery (CRS) for gastric cancer peritoneal metastasis (GCPM); but was associated with an increased morbidity and mortality rate without significantly improving overall survival (OS). While CRS confers limited benefit, the potential role of prophylactic HIPEC and laparoscopic neoadjuvant HIPEC are currently being evaluated. Combination systemic and IP chemotherapy (SIPC) gained popularity in the 1990s, since it provided the benefits of IP treatment while reducing surgical morbidity, demonstrating promising early results in multiple Phase II trials. Unfortunately, these findings were not confirmed in the recent PHOENIX-GC randomized controlled trial; therefore, the appropriate treatment for GCPM remains controversial. Small observational studies from Japan and Singapore have reported successful downstaging of PM in GC patients receiving SIPC who subsequently underwent conversion gastrectomy with a median OS of 21.6-34.6 months. Recently, the most significant development in IP-directed therapy is pressurized IP aerosol chemotherapy (PIPAC). Given that aerosol chemotherapy achieves a wider distribution and deeper penetration, the outcomes of multiple ongoing trials assessing its efficacy are eagerly awaited. Indeed, IP-directed therapy has evolved rapidly in the last 3 decades, with an encouraging trend toward improved outcomes in GCPM, and may offer some hope for an otherwise fatal disease.

• Journal of Acupuncture Research
• /
• v.26 no.6
• /
• pp.1-9
• /
• 2009

Objectives : For evaluation of preventive and anti-diabetic activities of Cinnamomi ramulus(CR) herbal acupuncture on pancreatic islet damage in streptozotocin(STZ)-induced diabetic rat. Methods : CR herbal acupuncture was performed at Bisu($BL_{20}$) for 3 weeks subcutaneously starting1 week before STZ i.p. injection. SD rats were divided into four groups(n=10 for each group); 1) NC group, non-treated normal control group, 2) STZ group, STZ administered control group, 3) CR125 group, CR(125mg/kg) + STZ administered group, and 4) CR250 group, CR(250mg/kg) + STZ administered group. Results : Both of CR250 and CR125 groups showed increase in insulin secretion and decrease in the level of serum triglyceride and non-esterified fatty acid in a dose-dependent manner compared to the STZ group. Only CR250 group showed decrease in the levels of glucose and total cholesterol compared to the STZ group. CR herbal acupuncture prevents $\beta$-cell damage of pancreatic islet, showing round figure on the sections of the pancreas. In the pancreatic cells, expressions of iNOS, JNK-2, P-JNK-1/2 and ERK-1/2 were decreased compared to the STZ group. CR herbal acupuncture solution did not show any cytotoxicity by MTS assay and inhibited expressions of iNOS and COX-2 in the STZ-induced diabetic rats. Conclusions : Therefore, we suggest that CR herbal acupuncture may act as a prophylactic as well as a therapeutic modality for diabetes mellitus.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.9
• /
• pp.4651-4654
• /
• 2012

Organized introduction of prophylactic human papillomavirus (HPV) vaccination can reduce the burden of cervical cancer in developing countries. One of the most effective ways is through a national school-based program. Information on teachers is therefore important since this group may have a disproportionate influence in the success of any implementation. Objective: To assess teachers' knowledge and perception of HPV, cervical cancer and HPV vaccine prior to commencing a school-based HPV vaccination program in a multiethnic, predominantly Muslim country. Factors associated with acceptability of the vaccine were identified. Method: A bilingual questionnaire was applied to 1,500 secondary school teachers from 20 urban schools in Malaysia. Data collected were analyzed using SPSS version 17. Results: 1,166 questionnaires were returned. From this group, 46.1% had never heard of HPV while 50.9% had never had a pap smear. However, 73.8% have heard of the HPV vaccine with 75% agreeing to have it. 96% considered themselves religious with 79.8% agreeing to have the vaccine. Conclusions: A national school-based HPV immunization program can be implemented effectively in a multiethnic, cultural and religious country despite limited knowledge of HPV-related pathology among teachers. In addition, the perception that religion has a negative influence on such a program is unwarranted.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.9
• /
• pp.4623-4626
• /
• 2012

Background: The risk of treatment-related death (TRD) and febrile neutropaenia (FN) with adjuvant taxane-based chemotherapy for early breast cancer is unknown in Malaysia despite its widespread usage in recent years. This study aims to determine these rates in patients treated in University Malaya Medical Centre (UMMC). Patients and Methods: Patients who were treated with adjuvant taxane-based chemotherapy for early breast cancer stages I, II or III from 2007-2011 in UMMC were identified from our UMMC Breast Cancer Registry. The TRD and FN rates were then determined retrospectively from medical records. TRD was defined as death occurring during or within 30 days of completing chemotherapy as a consequence of the chemotherapy treatment. FN was defined as an oral temperature > $38.5^{\circ}C$ or two consecutive readings of > $38.0^{\circ}C$ for 2 hours and an absolute neutrophil count < $0.5{\times}10^9/L$, or expected to fall below $0.5{\times}10^9/L$. Results: A total of 622 patients received adjuvant chemotherapy during this period. Of these patients 209 (33.6%) received taxane-based chemotherapy. 4 taxane-based regimens were used namely the FEC-D, TC, TAC and AC-PCX regimens. The commonest regimen employed was the FEC-D regimen accounting for 79.9% of the patients. The FN rate was 10% and there was no TRD. Conclusion: Adjuvant taxane-based chemotherapy in UMMC for early breast cancer has a FN rate of 10%. Primary prophylactic G-CSF should be considered for patients with any additional risk factor for FN.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.20 no.3
• /
• pp.178-185
• /
• 2017

Purpose: To evaluate the outcomes of a hybrid prophylactic strategy to prevent cytomegalovirus (CMV) disease in pediatric liver transplantation (LT) patients. Methods: CMV DNAemia was regularly monitored by quantitative nucleic acid amplification test (QNAT) and was quantified in all children. CMV infection and disease were defined according to the International Consensus Guidelines. The hybrid strategy against CMV infection consisted of universal 3-week prophylaxis and preemptive treatment of intravenous ganciclovir regardless of the recipient's serostatus. Results: A total of 143 children who underwent living donor LT were managed using the hybrid strategy. The overall incidence of CMV infection by QNAT was 48.3% (n=69/143). The highest CMV DNAemia positivity was observed in 49.2% (n=60/122) of children in the D+/R+ group, followed by 46.7% (n=7/15) in the D+/R- group. CMV disease was noted in 26.1% (n=18/69) patients. Forty-three (62.3%) children had undergone preemptive therapy consisting of intravenous ganciclovir. No symptomatic patients developed tissue-invasive disease, resulting in no CMV-associated mortality. Conclusion: The incidence of CMV infection was high in pediatric LT patients despite the hybrid strategy. However, tissue-invasive disease in pediatric LT did not occur.

• Biomedical Science Letters
• /
• v.23 no.2
• /
• pp.80-88
• /
• 2017

Ginkgo biloba extract (EGb 761) is a standardized extract of Ginkgo biloba leaves and has anti- atherosclerosis properties. Many patients with atherosclerosis disorders take Ginkgo biloba extracts to supplement current therapy. In addition, normal healthy individuals also take Ginkgo biloba extracts for prophylactic purposes. However, it is unknown whether supplementation of Gingko biloba extracts in healthy individuals offer a benefit. In this study, we assessed whether EGb 761 could provide beneficial effects on serum cholesterol levels in normal mice. Wild-type C56Bl/6 mice were orally administered EGb 761 at 25 mg/kg (Group 3) or 50 mg/kg (Group 4) every other day for 40 days. We found that the serum levels of HDL-cholesterol (HDL-C) were significantly increased in EGb 761 and lovastatin treated groups. Treatment with EGb 761 and lovastatin resulted in reduced serum total cholesterol and LDL-cholesterol (LDL-C) compared to control group. Serum lecithin cholesterol acyltransferase (LCAT) levels were higher in EGb 761 and lovastatin treated group compared to the control group. However, no difference was observed in serum APO A-I levels between the control group and treatment group. These results suggest that EGb 761 can increase HDL-C resulting in increased serum LCAT levels.

• Archives of Plastic Surgery
• /
• v.43 no.6
• /
• pp.590-594
• /
• 2016

Recently, the number of cases of animal bite wounds has increased significantly in concordance with an increase in the pet population around the world. The authors report two rare cases of osteomyelitis of the phalanx following cat and dog bites. On initial physical examination, signs of a severe infection were observed. Radiographs of both patients showed the presence of osteomyelitis, and in one of the patients, the diagnosis was confirmed with a bone biopsy. After use of empirical antibiotics, intravenous antibiotic therapy that matched the identified bacterium's sensitivity was initiated, and at the same time, secure dressing including debridement was performed to induce secondary healing. In addition, the patients were closely monitored with serial X-rays, and culture and blood test follow-up. One patient fully recovered without sequelae, but the other patient suffered a loss of distal interphalangeal joint motion. When dealing with bite wounds located on the hand, it is important to visit the hospital as soon as possible and receive the appropriate treatment early. Moreover, to prevent severe complications such as osteomyelitis, it is important to administer antibiotic therapy to which the cultured bacteria are sensitive, along with proper wound management and prophylactic antibiotic treatment.

• The Journal of the Korean dental association
• /
• v.54 no.8
• /
• pp.604-612
• /
• 2016

The aim of this study was to evaluate the effect of national health insurance coverage of periodontal scaling using the National Health Insurance Service-National Sample Cohort for 2009-2013. After the enforcement of periodontal scaling covered by national health insurance, the number of patients diagnosed with periodontal disease and received treatment, has increased from 35,234 to 99,576 people in the last 4 years. Further, the number of patients who received the treatment of periodontal disease more than once, have also increased to around 69% in 2013 when compared to 2012. Moreover, the number of patients receiving periodontal scaling has been steadily increasing every year. Among the patients who visited hospital for periodontal disease, there has been an increase of 280%. As a result, continuous public relations and long-term research on the effect of periodontal scaling as a prophylactic treatment is necessary.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.34 no.3
• /
• pp.461-467
• /
• 2007

Infective endocarditis is a life-threatening disease, although it is relatively uncommon. Substantial morbidity and mortality result from this infection. Therefore, primary prevention of endocarditis whenever possible is very important. The American Heart Association updated recommendations for the prevention of infective endocarditis in individuals at risk for this disease in 1997. But, utilization of antibiotic prophylaxis for patients at risk does not provide absolute immunity from infection. This report presents the case of infective endocarditis that occurred in spite of appropriate antibiotic prophylaxis in the ventricular septal defect(VSD) patient.

• Tuberculosis and Respiratory Diseases
• /
• v.79 no.4
• /
• pp.274-281
• /
• 2016

Background: Factors associated with the prognosis of patients with small cell lung cancer (SCLC) is relatively unknown, than of those with non-small cell lung cancer. This study was undertaken to identify the prognostic factors of SCLC. Methods: The medical records of 333 patients diagnosed with SCLC at tertiary hospital from January 1, 2008, to December 31, 2012 were retrospectively reviewed. Patients were categorized by age (${\leq}65$ years vs. >65 years) and by extent of disease (limited disease [LD] vs extensive disease [ED]). Overall survival and progression free survival rates were determined. Factors associated with prognosis were calculated using Cox's proportional hazard regression model. Results: Most baseline characteristics were similar in the LD and ED groups. Eastern Cooperative Oncology Group (ECOG) performance status (PS), first chemotherapy regimen, and prophylactic cranial irradiation (PCI) differed significantly in patients with LD and ED. Mean ECOG PS was significantly lower (p<0.001), first-line chemotherapy with etoposide-cisplatin was more frequent than with etoposide-carboplatin (p<0.001), and PCI was performed more frequently (p=0.019) in LD-SCLC than in ED-SCLC. Prognosis in the LD group was better in younger (${\leq}65$ years) than in older (>65 years) patients, but prognosis in the ED group was unrelated to age. Conclusion: This study showed that overall survival (OS) was significantly improved in younger than in older patients with LD-SCLC. Univariate and multivariate analyses showed that age, PCI and the sum of cycles were significant predictors of OS in patients with LD-SCLC. However, prognosis in the ED group was unrelated to age.