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Background@#While treatment strategies for mantle cell lymphoma (MCL) have evolved, patients often experience disease progression and require additional treatment therapies. Ibrutinib presents a promising option for relapsed or refractory MCL (RR-MCL). This study investigated real-world treatment outcomes of ibrutinib in patients with RR-MCL. @*Methods@#A single-center retrospective analysis investigated clinical characteristics and survival outcomes of patients with RR-MCL, treated with ibrutinib. @*Results@#Forty-two patients were included, with 16 received rituximab and bendamustine, and 26 receiving anthracycline-based regimens as front-line treatment. During a median follow-up of 46.0 months, the response rate to ibrutinib was 69%, with 12 CRs and 8 partial responses. Disease progression (54.8%) and adverse events (11.9%) were the primary reasons for discontinuation. Median progression-free survival (PFS) and overall survival (OS) were approximately 16.4 and 50.1 months, respectively. Patients older than 70 years (P =0.044 and P =0.006), those with splenomegaly (P =0.022 and P=0.006), and those with a high-risk simplified Mantle Cell Lymphoma International Prognostic Index (sMIPI) (P<0.001 and P<0.001) exhibited siginificantly inferior PFS and OS. Notably, patients with a high-risk sMIPI relapsed earlier. Post-ibrutinib treatment yilded an OS of 12.2 months, while clinical trial participants demonstrated superior survival compared to those receiving chemotherapy alone. @*Conclusion@#This study underscores the importance of considering patient characteristics before administering ibrutinib as salvage therapy. Early relapse was associated with poor outcomes, highlighting the need for novel therapeutic strategies.
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Objectives@#In 2021, the effectiveness of the COVID-19 vaccine was analyzed among people living in the Honam region (Gwangju, Jeollanam-do, Jeollabuk-do, and Jeju) of the Republic of Korea. And we investigated changes in the dominant virus strain. @*Methods@#This study used the data provided by the Korean Ministry of the Interior and Safety for individuals ≥12 years old in the Honam region, and the Integrated Disease and Health Management System of the Korea Centers for Disease Control and Prevention for COVID-19-vaccinated individuals as of December 31, 2021. Statistical analyzes were performed using IBM SPSS ver. 23.0. The occurrence of confirmed cases by vaccination status, the relative risk, and vaccine effectiveness by vaccine type were calculated. @*Results@#In 2021, the COVID-19 vaccination rate in Honam was 88.6%. The overall vaccine effectiveness (after 2 and 3 doses) was 98.7% (p98%, and the effect among persons who received 2 doses was >90% regardless of the vaccine type. Although vaccine effectiveness decreased because of reduced antibody levels over time (as observed in breakthrough infections), receiving a booster dose restored the neutralizing antibody levels.
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OBJECTIVES: Human rhinoviruses (HRVs) are the major cause of the common cold. Currently there is no registered, clinically effective, antiviral chemotherapeutic agent to treat diseases caused by HRVs. In this study, the antiviral activity of dexamethasone (DEX) against HRV1B was examined. METHODS: The anti–HRV1B activity of DEX was assessed by sulforhodamine B assay in HeLa cells, and by RT-PCR in the lungs of HRV1B-infected mice. Histological evaluation of HRV1B-infected lungs was performed and a histological score was given. Anti-HRV1B activity of DEX via the glucocorticoid receptor (GCR)-dependent autophagy activation was assessed by blocking with chloroquine diphosphate salt or bafilomycin A1 treatment. RESULTS: In HRV1B-infected HeLa cells, treatment with DEX in a dose-dependent manner, resulted in a cell viability of > 70% indicating that HRV1B viral replication was reduced by DEX treatment. HRV1B infected mice treated with DEX, had evidence of reduced inflammation and a moderate histological score. DEX treatment showed antiviral activity against HRV1B via GCR-dependent autophagy activation. CONCLUSION: This study demonstrated that DEX treatment showed anti-HRV1B activity via GCR-dependent autophagy activation in HeLa cells and HRV1B infected mice. Further investigation assessing the development of topical formulations may enable the development of improved DEX effectiveness.
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Animais , Humanos , Camundongos , Autofagia , Sobrevivência Celular , Cloroquina , Resfriado Comum , Dexametasona , Células HeLa , Inflamação , Pulmão , Receptores de Glucocorticoides , RhinovirusRESUMO
PURPOSE: The present study was designed to evaluate the efficacy and the outcome when using the Starion(TM) and the Harmonic Scalpel(TM) vessel sealing systems for a sutureless hemorrhoidectomy. METHODS: This study is a randomized, controlled trial. Patients with Grade 3 and 4 hemorrhoids were categorized into two groups: the Starion(TM) hemorrhoidectomy (30 patients) group and the Harmonic Scalpel(TM) hemorrhoidectomy (30 patients) group. The measures of the primary outcomes were the operating time, the postoperative pain score, and the patient satisfaction score. Secondary outcome criteria included early and delayed complications: postoperative bleeding, anal stenosis, urinary difficulty, and skin tag. RESULTS: The satisfaction scores 4 wk postoperatively were not significantly different between the two groups (P=0.186). However, the operating time was reduced (P=0.019), the pain score was lower (P=0.009), and the satisfaction score 1 wk postoperatively (P=0.001) was lower in the Starion(TM) hemorrhoidectomy group. In addition, there were no differences in early and delayed postoperative complications between the two groups (all P>0.05). CONCLUSION: Both methods were found to be surprisingly equivalent in all major aspects analyzed. A Starion(TM) hemorrhoidectomy with submucosal dissection can provide a safe, fast, bloodless, reduced-pain, and low-priced surgical alternative to hemorrhoidal surgery. More studies are needed to determine whether similar favorable results can be attained in patients with more severe, strangulated hemorrhoids.
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Humanos , Constrição Patológica , Glicosaminoglicanos , Hemorragia , Hemorroidectomia , Hemorroidas , Dor Pós-Operatória , Satisfação do Paciente , Complicações Pós-Operatórias , PeleRESUMO
PURPOSE: Idiopathic pruritus ani is a common and embarrassing proctological condition which can be very difficult to treat. In this study, we documented our results with methylene blue intra-dermal injection in patients with intractable idiopathic pruritus ani. METHODS: 5-ml 1% methylene blue, 100-mg hydrocortisone, and 15-ml 1% lidocaine were injected into the perianal skin of 21 patients with idiopathic pruritus ani which had proved refractory to standard care. Clinical follow-up was undertaken. RESULTS: After one injection of the above solution, 15 (71.4%) of the patients were rendered symptom free. Repeat injection in the initial non- responders ultimately rendered another four. 19 (total: 90.5 %) of the patrents symptom free. Morbidity was 0%. CONCLUSION: This study has shown that intra-dermal methylene blue injection is a safe, simple, and efficient method of treating intractable, idiopathic pruritus ani.
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Humanos , Seguimentos , Hidrocortisona , Lidocaína , Azul de Metileno , Prurido Anal , Prurido , PeleRESUMO
PURPOSE: Rectoceles are often associated with anorectal symptoms. Various surgical techniques have been described to repair rectoceles, but the surgical results vary. The aim of this study was to compare transanal repair (TAR) and transanal repair with posterior colporrhaphy (TAR+PC). METHODS: The records of 58 patients operated on during a 56-month period were reviewed. Of those 26 patients had a TAR, and 32 patients had a TAR+PC. Interviews and anorectal physiologic studies were performed preoperatively and postoperatively. RESULTS: The recurrence rate after a TAR+PC was lower than the recurrence rate after a TAR (TAR 19.2% vs. TAR+PC 3.1%). The rectal sensation (sensory threshold: TAR 64.8+/-18.9 ml vs. TAR+PC 56.1+/-23.67 ml; earliest defecation urge: TAR 116.4+/-29.5 ml vs. TAR+PC 104.8+/-31.2 ml) was more improved after a TAR+PC. CONCLUSIONS: A TAR+PC for treatment of a rectocele is safe and effectively corrects obstructed defecation. The improvement probably relates, at least in part, to rectal sensational factors other than the dimensions of the rectocele.
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Humanos , Defecação , Retocele , Recidiva , SensaçãoRESUMO
PURPOSE: Generally, the constipation is a medical disease, but recently, there are many reports showing the good results after correction of rectocele in constipated patients. The authors try to show the effect of surgery in rectocele cases and also analyse the relationship between the anatomical distortion and clinical symptoms by using anorectal physiologic study before and after operation. METHODS: 31 cases of rectocele are surgically corrected from June 1998 to August 2001. 31 cases of them could be followed up and with them, pre- and post-operative anal ultrasonography, anorectal manommetry and defecography were tried. Personal interview was also done to each patient. RESULTS: After trasanal rectocele repair, the rectocele size decreased and clinical symptoms improved remarkably. In defecography, anorectal angle (pre-op; 105.9+/-6.0 degrees vs. post-op; 109.5+/-3.7 degees) and perineal descent (1.6+/-0.7 cm vs. 2.4+/-1.2 cm) increase in pushing state after operation. In anorectal manometry, mean resting anal pressure (29.2+/- 3.4 mmHg vs. 17.9+/-4.6 mmHg) and maximal squeeze pressure (84.5+/-20.8 mmHg vs. 47.6+/-12.1 mmHg) decreased and rectal sensation improved after operation. CONCLUSIONS: Current results suggest that the surgical correction aims not only the decrement of the rectocele size but changing the vector power on pushing more physiologically and also improving the rectal sensibility.