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Phase II Study of Pemetrexed as Second or Third Line Combined Chemotherapy in Patients with Colorectal Cancer

  • Wu, Xue-Yan;Huang, Xin-En;You, Shan-Xi;Lu, Yan-Yan;Cao, Jie;Liu, Jin;Xiang, Jin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.2019-2022
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    • 2013
  • Purpose: To investigate the safety and efficacy of pemetrexed combined with chemotherapy as second or third line in patients with stage IV colorectal cancer (CRC). Patients and Methods: This trial was conducted to evaluate the effectiveness and safety of pemetrexed given to patients with recurrent or metastatic colorectal carcinoma who previously received 5-FU-based chemotherapy. All patients were required to have a histological diagnosis of colorectal adenocarcinoma with measurable metastatic disease and prior chemotherapy. Patients received pemetrexed at a dose of 500 $mg/m^2$ by 10 minute infusion on day 1, repeated every 21 days. Doses were modified depending on nadir counts. Combined chemotherapy included Oxaliplatin, Irinotecan and cis-platinum. Results: Thirty patients were enrolled and twenty-nine were evaluable for response. One patient did not have repeat radiological testing to determine response because he went off study after only one cycle of treatment for economic reasons. For 29 evaluable patients, 1 partial response, 6 stable disease and 22 progressive disease were recorded. Response rate was 3.45% (1/29). All responses occurred in patients receiving a starting dose of pemetrexed 500 $mg/m^2$. Median time to progression for all eligible patients was 2.5 months. The most common toxicities experienced were mild to moderate fever, hepatic damage, myelosuppression, nausea, vomiting, constipation, abdominal pain, diarrhea, and skin rash. Conclusion: Pemetrexed at 500 $mg/m^2$ given every three weeks combined with chemotherapy is associated with moderate response and good tolerability in patients with stage IV CRC.

Hyperhidrosis Treated by Thoracoscopic Sympathicotomy (다한증 환자에서의 T2 Sympathicotomy의 효과)

  • 윤용한;이두연;김해균;이교준;신화균;강정신
    • Journal of Chest Surgery
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    • v.32 no.2
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    • pp.171-174
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    • 1999
  • Background: Hyperhidrosis of the palms, axillae and face has a strong negative impact on social and professional life. The present existing non-operative therapeutic options seldom give sufficient relief and have a transient effect. A definitive cure can be obtained by upper thoracic sympathectomy. However, this is offset by the occurrence of a high rate of side effects, such as embarrassing compensatory sweating. Material and Method: From Sep. 1997 to Feb. 1998, 89 cases of the needle(2 mm) thoracoscopic thoracic sympathicotomy were performed. The second thoracic ganglion was resected by cutting with a endoscissors. Result: A bilateral procedure takes less than 25 min and requires just one night in hospital. There have been no mortality or life-threatening complications. One patient(<2%) required intercostal drainage because of pneumothorax. Primary failure occurred in one cases(<2%) and recurrent hyperhidrosis occurred in no cases. The patients with failure was successfully re-sympathicotomy. At the end of postoperative follow-up(median 3 months), 96.6% of the patients were satisfied. Compensatory sweating occurred in 57 cases(64.0%) with fourteen of those cases classified as either embarrassing in 10 cases(11.2%) or disabling in 4 cases(4.5%). Conclusion: Endoscopic transthoracic sympathicotomy is an efficient, safe and minimally invasive surgical method for the treatment of palmar and craniofacial hyperhidrosis.

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NEVOID BASAL CELL CARCINOMA SYNDROME : A REPORT OF CASE (기저세포모반 증후군 환아의 증례보고)

  • Heo, Su-Kyung;Choi, Nam-Ki;Kim, Seon-Mi;Yang, Kyu-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.4
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    • pp.725-730
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    • 2008
  • Nevoid basal cell carcinoma syndrome is an ecto-mesodermal polydysplasia with numerous manifestations that affect multiple organs. The syndrome is an autosomal dominant inherited, with a high penetration and visible expression. The syndrome is characterized by a series of associated anomalies such as cutaneous, dentofacial, skeletal, ophthalmologic, neurological, and genital anomalies. Generally, the jaw cysts are multiple odontogenic keratocysts, affecting any area of maxilla and mandible. Multiple odontogenic keratocysts of this syndrome are more recurrent than the keratocysts of non-syndrome, thus they are treated aggressively for complete removal. We report a case of multiple jaw cysts associated with nevoid basal cell carcinoma syndrome. In clinical and radiological examinations, frontal bossing, hypertelorism, mild mental retardation and two odontogenic keratocysts in both the maxilla and mandible were observed. Two cysts were treated by marsupialization. For the management of eruption of unerupted teeth, periodic recall check and orthodontic treatment are required.

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Endobronchial Metastasis of Epithelioid Sarcoma

  • Kim, Seo-Yun;Lee, Ji-Yeon;Lee, Yeon-Joo;Park, Sung-Soo;Koo, Hyeon-Kyoung;Lee, Sang-Min;Yim, Jae-Joon;Yang, Seok-Chul;Yoo, Chul-Gyu;Han, Sung-Koo;Shim, Young-Soo;Kim, Young-Whan
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.5
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    • pp.423-427
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    • 2011
  • Epithelioid sarcomas are rare soft tissue sarcomas with a high tumor grade and high local recurrence and metastasis rates. Although the lung is the most common site of metastasis, endobronchial metastasis hasn't been reported yet. We now report a case of epithelioid sarcoma with endobronchial metastasis. A 28-year-old man had recurrent pneumothorax and underwent wedge resection. He presented at our hospital with hemoptysis, dyspnea, and chest pain. Chest computed tomography revealed left pneumothorax, multiple lung nodules and endobronchial lesions at the right lower basal lobe. Bronchoscopy showed a hemorrhagic mass obstructing the bronchus of the right lower basal lobe. Magnetic resonance imaging revealed multiple nodular lesions in the left thigh muscles. The bronchoscopic biopsy of the endobronchial lesion and the muscle biopsy of the thigh showed the same feature epithelioid sarcoma. This is the first case report of an epithelioid sarcoma with endobronchial metastasis that was diagnosed by bronchoscopic biopsy.

Non-tuberculous Mycobacterial Lung Disease Presenting as a Solitary Pulmonary Nodule (고립성 폐결절로 발현된 비결핵성 마이코박테리움 폐질환 1예)

  • Kim, Song-Yee;Lee, Kyung-Jong;Lee, Sang-Hoon;Lee, Sang-Kook;Park, Byung-Hoon;Jung, Ji-Ye;Son, Ji-Young;Yoon, Yoe-Wun;Shim, Hyo-Sup;Kang, Young-Ae;Park, Moo-Suk;Kim, Young-Sam;Chang, Joon;Kim, Se-Kyu;Moon, Jin-Wook
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.1
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    • pp.43-47
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    • 2010
  • We report a case of Mycobacterium intracellulare pulmonary infection presenting as a solitary pulmonary nodule (SPN). A 35-year-old male was admitted due to a SPN in the right upper lobe which was detected on the chest radiography being examed due to recurrent cough for 1 year. The computed tomography (CT) revealed a spiculated nodule containing air-bronchogram, which was suspicious of malignancy. We performed transbronchial biopsy and the pathology showed granulomatous inflammation with caseous necrosis. Under the presumptive diagnosis of pulmonary tuberculosis, we started anti-tuberculous medication including isoniazid, rifampin, ethambutol, and pyrazinamide. In one month, however, the sputum culture was positive for Mycobacterium intracellulare. The follow-up chest CT showed slight aggravation of the previous lesions. Under the final diagnosis of Mycobacterium intracellulare pulmonary infection presenting as a solitary pulmonary nodule, we changed the regimen to rifampin, ethambutol, and clarithromycin. The follow-up chest CT after the completion of treatment, revealed resolution of the previous lesions.

Progressive Transformation of Germinal Centers in Submandibular Area: Case Report (악하부에 발생한 Progressive Transformation of Germinal Centers: 증례보고)

  • Park, Su-Won;Jang, Soo-Mi;Kim, Dong-Yul;Son, Jang-Ho;Cho, Yeong-Cheol;Sung, Iel-Yong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.4
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    • pp.368-372
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    • 2011
  • Progressive transformation of germinal centers (PTGC) is mostly a disease of young adults and it presents as unexplained, asymptomatic, localized or generalized lymphadenopathy that is usually persistent or recurrent over a period of many years. PTGCs are larger than regular germinal centers and they contain a variable proportion of small mantle zone lymphocytes and so they become progressively transformed and they may result in the loss of clear demarcation between them and the mantle zone. PTGC may resemble the nodules of nodular lymphocyte predominant Hodgkin's disease (NLPHD) and it may be mistaken for NLPHD. Histological and immunohistochemical studies are helpful in differentiating these diseases. Because of the relatively frequent recurrences of PTGC, follow-up and repeat biopsy are indicated. Although PTGC is not considered to be a premalignant condition, PTGC may occur prior to, concurrent with or following NLPHD. This emphasizes the need for ongoing follow-up and repeat biopsy. Although PTGC is reported in 3.5% to 10% of the cases of chronic nonspecific lymphadenopathy, oral & maxillofacial surgeons are not widely aware of this condition and its clinical implications. Herein, we present a case of PTGC. A 24-year-old male without any history of immunodeficiency or autoimmune disease was admitted to the Department of Oral & Maxillofacial surgery at Ulsan University Hospital for evaluation of a right submandibular swelling. He had another mass on the right thigh that was noticed about 1 year ago. The submandibular lesion was completely resected and biopsied. The histological findings and immunohistochemical stains (CD3, CD15, CD20, CD30, CD57, BCL-2, EMA) were consistent with PTGC. He was followed up without any other complaints for 9 months.

Motion Study of Treatment Robot for Autistic Children Using Speech Data Classification Based on Artificial Neural Network (음성 분류 인공신경망을 활용한 자폐아 치료용 로봇의 지능화 동작 연구)

  • Lee, Jin-Gyu;Lee, Bo-Hee
    • Journal of IKEEE
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    • v.23 no.4
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    • pp.1440-1447
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    • 2019
  • Currently, the prevalence of autism spectrum disorders in children is reported to be higher and shows various types of disorders. In particular, they are having difficulty in communication due to communication impairment in the area of social communication and need to be improved through training. Thus, this study proposes a method of acquiring voice information through a microphone mounted on a robot designed through preliminary research and using this information to make intelligent motions. An ANN(Artificial Neural Network) was used to classify the speech data into robot motions, and we tried to improve the accuracy by combining the Recurrent Neural Network based on Convolutional Neural Network. The preprocessing of input speech data was analyzed using MFCC(Mel-Frequency Cepstral Coefficient), and the motion of the robot was estimated using various data normalization and neural network optimization techniques. In addition, the designed ANN showed a high accuracy by conducting an experiment comparing the accuracy with the existing architecture and the method of human intervention. In order to design robot motions with higher accuracy in the future and to apply them in the treatment and education environment of children with autism.

The impact factors on 5-year survival rate in patients operated with oral cancer

  • Geum, Dong-Ho;Roh, Young-Chea;Yoon, Sang-Yong;Kim, Hyo-Geon;Lee, Jung-Han;Song, Jae-Min;Lee, Jae-Yeol;Hwang, Dae-Seok;Kim, Yong-Deok;Shin, Sang-Hun;Chung, In-Kyo;Kim, Uk-Kyu
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.5
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    • pp.207-216
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    • 2013
  • Objectives: The purpose of this study is to analyze clinical impact factors on the survival rate, and to acquire basic clinical data for the diagnosis of oral cancer, for a determination of the treatment plan with long-term survival in oral cancer patients. Materials and Methods: Through a retrospective review of the medical records, the factors for long-term survival rate were analyzed. Thirty-seven patients, among patient database with oral cancer treated in the Department of Oral and Maxillofacial Surgery at Pusan National University Hospital within a period from March 1998 to March 2008, were selected within the study criteria and were followed-up for more than 5 years. The analyzed factors were gender, age, drinking, smoking, primary tumor site, type of cancer, TNM stage, recurrence of affected region, and metastasis of cervical lymph node. The 5-year survival rate on the impact factors was calculated statistically using the Kaplan-Meier method. Results: By classification of clinical TNM at the 1st visit, there were 11 (29.7%) cases for stage I, 11 (29.7%) cases for stage II, 3 (8.1%) cases for stage III, and 12 (32.5%) cases for stage IV. The 5-year survival rate of total oral cancer patients after the operation were 75.7%, pathological TNM stage related 5-year survival rate were as follows: stage I 90.0%, stage II 81.8%, stage III 100% and stage IV 45.5%; in which the survival rate difference by each stage was significantly observed. The recurrence of cervical lymph node was the significant impact factor for the survival rate, because only 30.0% the survival rate in recurrent cases existed. During the follow-up, there were 15 (40.5%) patients with confirmed recurrence, and the 5-year survival rate of these patients was decreased as 46.7%. Conclusion: The classification of clinical and pathological TNM stage, local recurrence after surgery, and metastasis of cervical lymph node after surgery were analyzed as the 3 most significant factors.

Recurrence of Early Gastric Cancer (조기위암의 재발)

  • Ahn Jung-Sik;Bang Ho-Yoon;Lee Jong-Inn;Noh Woo-Chul;Hwang Dae-Yong;Choi Dong-Wook;Paik Nam-Sun;Moon Nan-Mo;Choi Tae-Inn
    • Journal of Gastric Cancer
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    • v.1 no.3
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    • pp.180-186
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    • 2001
  • Purpose: The prognosis for early gastric cancer (EGC) is favorable, and the 10-year disease-specific survival rate is reported to be around $90\%$. The absolute number of recurred EGC is too small to assess the risk factors, so recruitment of a large number of cases for statistical analysis is very difficult. We carried out this study to analyze the incidence and the patterns of recurrence of EGC and to identify the clinicopathological risk factors for recurrence of EGC. Materials and Methods: The authors retrospectively investigated the follow-up records of 1418 patients who underwent a curative resection for EGC from Jan. 1984 to Dec. 1999 at the Korea Cancer Center Hospital and analyzed them with special reference to cancer recurrence. Results: In this retrospective study of 1418 cases, 43 patients died of a recurrence of gastric cancer, and 105 patients died of unrelated causes. The five-year and the ten-year overall survival rates were $89.6\%$ and $81.7\%$, respectively, while the five-year and the ten-year diseasespecific survival rates were $96.5\%$ and $94.3\%$, respectively. The recurrence patterns of the 45 recurred EGC were hematogenous metastasis (19 cases), lymph node (L/N) metastasis (8 cases), locoregional recurrence (2 cases), peritoneal seeding (3 cases), and combined form (13 cases). The mean time interval to recurrence was 38.6 months, and the number of delayed recurred cases after 5 years was 10 ($22.2\%$). Of the clinicopathologic factors, depth of invasion, L/N metastasis, macroscopic type, lymphatic invasion, and vessel invasion, were significant risk factors in the univariate analysis. However, in the multivariate analysis, only L/N metastasis was an independent prognostic factor. Conclusion: Based on the results of this study, L/N metastasis is an independent prognostic factor. Thus, in patients with node-positive disease, adjuvant therapy might be considered, and long-term close follow-up might facilitate early detection and treatment of recurrent disease due to delayed recurrence.

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Teratoma Presenting as An Unilateral Mediastinal Mass with Contralateral Pleural Effusion (편측성 종격동 종괴와 반대측 흉수로 발현된 기형종 1예)

  • Ha, Eun Sil;Hur, Gyu Young;Jung, Ki Hwan;Lee, Sung Yong;Jo, Won Min;Lee, Sang Yeub;Kim, Je-Hyeong;Lee, Eung Seok;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.3
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    • pp.347-352
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    • 2006
  • A teratoma is the most common benign germ cell tumor that develops in the mediastinum. Patients with a mediastinal teratoma are usually asymptomatic. However, a spontaneous rupture of a mediastinal teratoma into the pleural cavity or adjacent organs can cause severe chest pain, hemoptysis, acute dyspnea, etc. Complications such as recurrent pneumonia, pericardial effusion, pleural effusion and great vessel invasion can sometimes occur. We encountered a case of a patient with an abrupt onset of dyspnea after persistent shoulder pain for one month. The X-ray examinations revealed a unilateral mediastinal mass with contralateral pleural effusion. Subsequent evaluations confirmed a spontaneous rupture of the teratoma into the contralateral pleural cavity.