• Title/Summary/Keyword: toxicity grading scale

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Suggestion for a New Grading Scale for Radiation Induced Pneumonitis Based on Radiological Findings of Computerized Tomography: Correlation with Clinical and Radiotherapeutic Parameters in Lung Cancer Patients

  • Kouloulias, Vassilios;Zygogianni, Anna;Efstathopoulos, Efstathios;Victoria, Oikonomopoulou;Christos, Antypas;Pantelis, Karaiskos;Koutoulidis, Vassilios;Kouvaris, John;Sandilos, Panagiotis;Varela, Maria;Aytas, Ilknur;Gouliamos, Athanasios;Kelekis, Nikolaos
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.2717-2722
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    • 2013
  • Background: The objective of this research is the computed axial tomography (CT) imaging grading of radiation induced pneumonitis (RP) and its correlation with clinical and radiotherapeutic parameters. Materials and Methods: The chest CT films of 20 patients with non-small cell lung cancer who have undergone threedimensional conformal radiation therapy were reviewed. The proposed CT grading of RP is supported on solely radiological diagnosis criteria and distinguishes five grades. The manifestation of RP was also correlated with any positive pre-existing chronic obstructive pulmonary disease (COPD) history, smoking history, the FEV1 value, and the dosimetric variable V20. Results: The CT grading of RP was as follows: 3 patients (15%) presented with ground glass opacity (grade 1), 9 patients (45%) were classified as grade 2, 7 patients (35%) presented with focal consolidation, with or without elements of fibrosis (grade 3), and only one patient (5%) presented with opacity with accompanying atelectasis and loss of pulmonary volume (grade 4). Both univariate and multivariate analysis revealed as prognostic factors for the radiological grading of RP the reduction of FEV1 and the V20 (P=0.026 and P=0.003, respectively). There was also a significant (P<0.001) correlation of radiological grading of RP with FEV1 and V20 (spearman rho 0.92 and 0.93, respectively). Conclusions: The high correlation of the proposed radiological grading with the FEV1 and the V20 is giving a satisfactory clinical validity. Although the proposed grading scale seems relevant to clinical practice, further studies are needed for the confirmation of its validity and reliability.

Long-term Colchicine Prophylaxis on Operative Adhesion Formation in Embryo Transfer Donor Ewes and the Cytogenetic Evalution of Therapy (Embryo Transfer Donor Ewe에 생기는 수술상의 Adhesion 형성에 대한 장기간의 Colchicine 치료와 그에 따른 세포유전학적 분석)

  • 박석천
    • Korean Journal of Animal Reproduction
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    • v.18 no.1
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    • pp.63-70
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    • 1994
  • Thirty ewes received typical trauma to their oviducts and uterine horns from surgical embryo collection procedures. Ten percent Dexamethasone was used as an irrigant on the exposed abdominal tissue prior to closing the incision. The treatment group received 17mg colchicine Om! lewe) and the control group was administered a 1.0ml placebo(PSS). Fifteen ewes that were initially treated with 17mg /im colchicine showed acute colchicine toxicity within 2-5 days after initial treatment and were removed from the study. Due to acute colchicine toxicity at 17mg, the colchicine level was lowered to 8, 4 and 2mg(4 ewes/group). Treatments consisted of daily injections of colchicine. One ewe in the 8mg group developed toxicity on day 5. Therefore, ewes were then administered colchicine every other day from day 6 to day 14 postsurgeryat 4 and 2 mg. the second laparotomy was performed 9 weeks after first treatment. Following second laparotomy, the treatment group(n=5) received 4 mg colchicine every day for 14 days and there was no clinical symptoms of colchicine toxicity. The third laparotomy was performed by the same operators 5 weeks after final treatment and the adhesions scored. Adhesion grading was based on a scale of 0-4, with 4 being the most severe. The results of adhesion grading(> 3) at second laparotomy were not significantly different(P>0.05)between the two groups. Adhesion formation observed at third laparotomy showed a reduced, but not significant reduction (P>0.05) in the colchicine-treated ewes when compared with the controls. Ten ewes(5 control and 5 treatment)were examined cytogenetically by bone marrow analysis five days post-treatment. There was no difference(P>0.05)in the incidence of numerical or structural aberrations between the two groups.

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A Case Report of Long-term Acupuncture Treatment in Bortezomib Induced Peripheral Neuropathy (보르테조밉으로 유발된 말초신경병증에 대한 장기간의 침치료 증례 보고)

  • Kim, So Yeon;Choi, Jun Yong;Yun, Young Ju;Park, Seong Ha;Han, Chang Woo
    • Korean Journal of Acupuncture
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    • v.32 no.4
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    • pp.208-212
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    • 2015
  • Objectives : We present a successful administration of acupuncture in alleviating persistant peripheral neuropathy due to bortezomib, a potent therapeutic agent of mutlple myeloma. Methods : A patient, experiencing numbness, coldness, tingling and weakness in her feet and hands after bortezomib treatment, was administered acupuncture for 32 weeks, 3 times/week for first 4 weeks and 2 times/week the last 28 weeks, in bilateral acupuncture points, ST36, ST40, EX-LE10, LI11, TE5, and EX-UE9. Responses were assessed at the end of every 4 weeks with Eastern Cooperative Oncology Group(ECOG) grading system, National Cancer Institute - Common Toxicity Criteria(NCIC-CTC) v4.0, Numeric Rating Scale(NRS) 0-10, and Neuropathy Pain Scale (NPS). Results : ECOG was improved from 2 to 1, NCIC-CTC from 2 to 1, NRS from 8 to 1, and NPS from 41 to 5 through 32 weeks of acupuncture treatment. Conclusions : It is conceivable that acupuncture can be a help to relieve bortezomib induced peripheral neuropathy.

The Protective Effect of Green Tea Extract on Alpha-amanitin Induced Hepatotoxicity (알파 아마니틴에 의한 간독성에 대한 녹차 추출물의 보호 효과)

  • An, Su Hwan;Sun, Kyung Hoon;Hong, Ran;Lee, Byoung Rai;Park, Yongjin
    • Journal of The Korean Society of Clinical Toxicology
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    • v.17 no.2
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    • pp.58-65
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    • 2019
  • Purpose: Alpha-amanitin induces potent oxidative stress and apoptosis, and may play a significant role in the pathogenesis of hepatotoxicity. This study examined the mechanisms of α-amanitin-induced apoptosis in vitro, and whether green tea extract (GTE) offers protection against hepatic damage caused by α-amanitin (AMA) induced apoptosis in vivo. Methods: The effects of GTE and SIL on the cell viability of cultured murine hepatocytes induced by AMA were evaluated using an MTT assay. Apoptosis was assessed by an analysis of DNA fragmentation and caspase-3. In the in vivo protocol, mice were divided into the following four groups: control group (0.9% saline injection), AMA group (α-amanitin 0.6 mg/kg), AMA+SIL group (α-amanitin and silibinin 50 mg/kg), and AMA+GTE group (α-amanitin and green tea extract 25 mg/kg). After 48 hours of treatment, the hepatic aminotransferase and the extent of hepatonecrosis of each subject was evaluated. Results: In the hepatocytes exposed to AMA and the tested antidotes, the cell viability was significantly lower than the AMA only group. An analysis of DNA fragmentation showed distinctive cleavage of hepatocyte nuclear DNA in the cells exposed to AMA. In addition, the AMA and GTE or SIL groups showed more relief of the cleavage of the nuclear DNA ladder. Similarly, values of caspase-3 in the AMA+GTE and AMA+SIL groups were significantly lower than in the AMA group. The serum AST and ALT levels were significantly higher in the AMA group than in the control and significantly lower in the AMA+GTE group. In addition, AMA+GTE induced a significant decrease in hepatonecrosis compared to the controls when a histologic grading scale was used. Conclusion: GTE is effective against AMA-induced hepatotoxicity with its apoptosis regulatory properties under in vitro and in vivo conditions.