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1.
PLoS One ; 18(10): e0292884, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37903150

RESUMEN

This research introduces a deep learning method for ocean wave height estimation utilizing a Convolutional Neural Network (CNN) based on the VGGNet. The model is trained on a dataset comprising buoy wave heights and radar images, both critical for marine engineering. The dataset features X-band radar images sourced from Sokcho, Republic of Korea, spanning from June 1, 2021, to August 13, 2021. This collection amounts to 72,180 three-dimensional images, gathered at intervals of approximately 1.43 seconds. The data collected was highly unbalanced in terms of wave heights, with images of lower wave heights being more common. To deal with data imbalances in the wave height datasets, we categorized the data into three groups based on wave heights and applied stratified random sampling at each level. This approach balances the data patches for each training iteration, reducing the risk of overfitting and promoting learning from diverse data. We also implemented a system to protect data in groups with fewer instances, ensuring fair representation across all categories. This study presents a deep learning regression model for predicting wave height values from radar images. The model extracts features from sequences of 64 radar images using three-dimensional convolutions for both temporal and spatial learning. Using three-dimensional convolutions, the model captures temporal features in radar image sequences and provides accurate wave height estimates with an RMSE of 0.3576 m. The study derived results using radar images under different wave height conditions for 74 days to ensure reliability.


Asunto(s)
Aprendizaje Profundo , Radar , Reproducibilidad de los Resultados , Redes Neurales de la Computación , Imagenología Tridimensional
2.
Thorac Cancer ; 12(24): 3310-3318, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34689429

RESUMEN

BACKGROUND: To evaluate the lung dose differences between three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiation therapy (IMRT) techniques for lung stereotactic body radiation therapy (SBRT) and the correlations with tumor characteristics, such as size and location. METHODS: Dosimetric comparisons between the two SBRT techniques in high- and low- to intermediate-dose regions were retrospectively performed using four planning indices and lung-dose parameters in 31 lung tumors. The magnitude of differences in these parameters was analyzed with relation to the planning target volume (PTV) and location-related parameters. RESULTS: The absolute differences between the two techniques in lung-dose parameters were small in both ipsilateral and bilateral lungs. The dosimetric differences were mainly correlated with the PTV rather than location-related parameters, with positive and negative correlations with the high-dose and intermediate-dose parameters, respectively. The distances from the ipsilateral lung centroid to the PTV center were not correlated with the differences in any of the lung-dose parameters. Additionally, the negative correlations with the MLD and V20 differences disappeared after applying a more rapid dose fall-off in the IMRT plans for tumors with small PTVs of ≤15 cc. CONCLUSIONS: Lung dose differences between the 3D-CRT and IMRT techniques for lung SBRT were mainly correlated with the PTV rather than location-related parameters. Together with the dosimetric benefit in high-dose lung regions of IMRT for larger tumors, the relative increases in the MLD and V20 for small-sized tumors could be reduced by applying a more rapid dose fall-off outside the PTV.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/patología , Carcinoma de Pulmón de Células no Pequeñas/radioterapia , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/radioterapia , Radioterapia Conformacional/métodos , Radioterapia de Intensidad Modulada/métodos , Anciano , Anciano de 80 o más Años , Humanos , Persona de Mediana Edad , Dosificación Radioterapéutica
3.
Thorac Cancer ; 11(2): 311-319, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31802637

RESUMEN

BACKGROUND: To evaluate the correction differences between vertebra and tumor matching as cone-beam computed tomography (CBCT)-guided setup strategies in lung stereotactic body radiation therapy (SBRT), and the correlations with tumor characteristics such as size, mobility, and location. METHODS: The manual registrations for 33 lung tumors treated with SBRT were retrospectively performed by matching thoracic vertebrae for vertebra matching and then by matching CBCT-visualized tumors within the internal target volume obtained from a four-dimensional CT dataset for tumor matching. RESULTS: The mean correction difference between the two matching methods during the SBRT fractions was larger in the anterior-posterior direction (2.7 mm) than in the superior-inferior (2.1 mm) and left-right (1.4 mm) directions, with differences of less than 5 mm in 90% of the total 134 CBCT fractions. The X-axis and direct distances from the central axis to the tumor had significant correlations with the correction differences in all three directions, while the mobility-related parameters were correlated only in the superior-inferior direction. The absolute differences in lung-dose parameters after applying the margins (3.4-6.5 mm) required for the setup errors from vertebra matching relative to tumor matching were mild, with values of 1.95 Gy for the mean lung dose and 3.9% for V20. CONCLUSION: The setup differences between vertebra and tumor matching in the CBCT-guided setup without rotation correction were increased in tumors located long distances from the central axis. The additional safety margins of 3.4-6.5 mm were required for the setup errors from vertebra matching. KEY POINTS: Significant findings of the study The correction difference between the vertebra and tumor matching as CBCT-guided setup strategies was the largest in the anterior-posterior direction and significantly correlated with the X-axis and direct distances from the central axis to the tumor. What this study adds Setup differences between vertebra and tumor matching in the CBCT-guided setup were increased in tumors located long distances from the central axis. The additional safety margins of 3.4-6.5 mm were required for the setup errors from vertebra matching.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/patología , Carcinoma de Pulmón de Células no Pequeñas/cirugía , Tomografía Computarizada de Haz Cónico/métodos , Tomografía Computarizada Cuatridimensional/métodos , Radiocirugia/métodos , Errores de Configuración en Radioterapia/prevención & control , Cirugía Asistida por Computador/métodos , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/cirugía , Masculino , Persona de Mediana Edad , Pronóstico , Planificación de la Radioterapia Asistida por Computador/métodos , Estudios Retrospectivos
4.
Medicine (Baltimore) ; 97(21): e10778, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29794758

RESUMEN

Standard treatment for locally advanced (stage III-IV) head and neck squamous cell cancer (LA-HNSCC) is concurrent chemoradiation therapy (CCRT) with cisplatin 100 mg/m every 3 weeks. For medically unfit patients susceptible to treatment-related adverse events, low-dose weekly cisplatin (30-40 mg/m) can be used as an alternative. In this study, we retrospectively compared the therapeutic outcomes of low-dose weekly cisplatin regimen and standard regimen in CCRT for LA-HNSCC.The medical records of histologically confirmed LA-HNSCC patients were retrospectively reviewed from January 1, 2007 to December 31, 2012. Patients who were treated with CCRT as initial treatment were included.Among 220 patients eligible, 65 (29.5%) were treated with cisplatin dosing schedule of 100 mg/m every 3 weeks and 155 (70.5%) with 30 to 40 mg/m weekly. The overall response rate in 3-weekly group was 92.3% and did not differ from that in weekly group (91.0%). The median progression-free survival of the weekly group was not attained but was not significantly different from that of 3-weekly group (50.7 months, 95% confidence interval [CI] 42.2-59.1 months) (P = .81). Also, the median overcall survival did not differ significantly between 2 groups (P = .34).In the present study, low-dose weekly cisplatin showed therapeutic outcomes comparable to standard-dose cisplatin in CCRT for LA-HNSCC. Prospective comparison of standard-dose three-weekly and low-dose weekly cisplatin is warranted.


Asunto(s)
Antineoplásicos/administración & dosificación , Carcinoma de Células Escamosas/tratamiento farmacológico , Cisplatino/administración & dosificación , Neoplasias de Cabeza y Cuello/tratamiento farmacológico , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/mortalidad , Quimioradioterapia/métodos , Terapia Combinada , Esquema de Medicación , Femenino , Neoplasias de Cabeza y Cuello/mortalidad , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Carcinoma de Células Escamosas de Cabeza y Cuello , Tasa de Supervivencia , Resultado del Tratamiento , Adulto Joven
5.
Medicine (Baltimore) ; 97(3): e9677, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-29505016

RESUMEN

RATIONALE: Hereditary spherocytosis (HS) is an inherited disorder characterized by the presence of spherical-shaped red blood cells (RBCs) on the peripheral blood (PB) smear. To date, a number of mutations in 5 genes have been identified and the mutations in SPTB gene account for about 20% patients. PATIENT CONCERNS: A 65-year-old female had been diagnosed as hemolytic anemia 30 years ago, based on a history of persistent anemia and hyperbilirubinemia for several years. She received RBC transfusion several times and a cholecystectomy roughly 20 years ago before. Round, densely staining spherical-shaped erythrocytes (spherocytes) were frequently found on the PB smear. Numerous spherocytes were frequently found in the PB smears of symptomatic family members, her 3rd son and his 2 grandchildren. DIAGNOSIS: One heterozygous mutation of SPTB was identified by targeted next-generation sequencing (NGS). The nonsense mutation, c.1956G>A (p.Trp652*), in exon 13 was confirmed by Sanger sequencing and thus the proband was diagnosed with HS. INTERVENTIONS: The proband underwent a splenectomy due to transfusion-refractory anemia and splenomegaly. OUTCOMES: After the splenectomy, her hemoglobin level improved to normal range (14.1 g/dL) and her bilirubin levels decreased dramatically (total bilirubin 1.9 mg/dL; direct bilirubin 0.6 mg/dL). LESSONS: We suggest that NGS of causative genes could be a useful diagnostic tool for the genetically heterogeneous RBC membrane disorders, especially in cases with a mild or atypical clinical manifestation.


Asunto(s)
Codón sin Sentido , Espectrina/genética , Esferocitosis Hereditaria/genética , Anciano , Pueblo Asiatico , Femenino , Humanos , Linaje
6.
Korean J Fam Med ; 37(6): 351-355, 2016 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-27900074

RESUMEN

Afatinib is an oral tyrosine kinase inhibitor (TKI) that inhibit Endothelial Growth Factor Receptor (EGFR), Human Epidermal Growth Factor Receptor 2 (HER2), and HER4. The common side effects of EGFR TKI are rash, acne, diarrhea, stomatitis, pruritus, nausea, and loss of appetite. Drug induced pneumonitis is the less common adverse effects of EGFR TKI. Afatinib, 2nd generation EGFR TKI is anticipated to overcome drug resistance from 1st generation EGFR TKI according to preclinical study, and several studies are being conducted to compare clinical efficacy between 1st and 2nd EGFR TKI. Several cases of rug induced acute fatal pneumonitis were reported after use of erlotinib or gefitinib. However, a case of acute fatal pneumonitis associated with afatinib was note reported except drug induced pneumonitis in other clinical study. Here, we present a cases of acute severe pneumonitis related with afatinib in metastatic lung adenocarcinoma with literature review.

7.
Nucl Med Commun ; 36(12): 1187-94, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26375438

RESUMEN

OBJECTIVE: We aimed to evaluate the prognostic value of early response assessment using a volumetric fluorine-18-fluorodeoxyglucose (F-FDG) PET analysis in chemotherapy-treated patients with non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS: We retrospectively reviewed 33 patients with NSCLC who received first-line chemotherapy and performed F-FDG PET/computed tomography before (baseline PET) and after two cycles of chemotherapy (interim PET). The maximum standardized uptake value (SUVmax) and metabolic tumor volume (MTV) of the total malignant lesion were measured in baseline (SUV1 and MTV1) and interim (SUV2 and MTV2) PET images, and percentage changes in SUVmax (ΔSUV) and MTV (ΔMTV) were calculated between the two images. We compared PET parameters and clinicopathologic variables in terms of the 2-year overall survival (OS). RESULTS: The median follow-up period was 14.3 months and the 2-year OS was 31%. In PET images, the mean SUV1, MTV1, SUV2, MTV2, ΔSUV, and ΔMTV were 13.1±4.5, 307.9±340.0 cm, 9.5±5.1, 180.4±29.6 cm, 27±28%, and 42±65%, respectively. In univariable analysis, M stage, TNM stage, and all six PET parameters associated significantly with OS. Both the MTV1 and the ΔMTV were tested against OS controlling for M stage, one at time, and the effect remained significant in multivariable analyses. CONCLUSION: A smaller baseline MTV and greater decrease in MTV between baseline and interim PET images are associated with a significantly prolonged OS. A volume-based F-FDG PET analysis would facilitate prediction of clinical outcome and identification of treatment-resistant patients early during chemotherapy and could thus be used in personalized treatment approaches for patients with NSCLC.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/diagnóstico , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Fluorodesoxiglucosa F18 , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/tratamiento farmacológico , Tomografía de Emisión de Positrones , Tomografía Computarizada por Rayos X , Anciano , Anciano de 80 o más Años , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico por imagen , Femenino , Humanos , Neoplasias Pulmonares/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Imagen Multimodal , Pronóstico , Estudios Retrospectivos , Análisis de Supervivencia , Factores de Tiempo , Resultado del Tratamiento
8.
Cancer Res Treat ; 47(4): 638-44, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25761490

RESUMEN

PURPOSE: There is no regimen that is strongly recommended for more than second-line treatment. We investigated the efficacy and safety of platinum/vinorelbine as more than second-line treatment. MATERIALS AND METHODS: We selected patients with advanced non-small cell lung cancer (NSCLC) who received treatment with platinum/vinorelbine at Chungnam National University Hospital from August 2001 to December 2013. The primary end point was the response rate, and secondary end points were progression-free survival (PFS), overall survival (OS), and toxicity. RESULTS: Thirty-five patients were enrolled. Response rate was 22.9% (complete response, 0 patients [0%]; partial response, eight patients [22.9%]; stable disease, 10 patients [28.6%]; progressive disease, 14 patients [40.0%]). A significantly higher response rate was observed for patients who had responded to previous chemotherapy than for those who did not (34.8% [8/23] vs. 0% [0/12], p=0.020). The median PFS was 4 months (range, 1 to 21 months). Patients with adenocarcinoma and non-smokers had a significantly longer PFS than patients with non-adenocarcinoma and smokers (5 months vs. 2 months, p=0.007; 4.5 months vs. 2 months, p=0.046, respectively). The median OS was 10 months (range, 1 to 41 months). Patients with good performance status and non-smokers had a significantly longer OS than patients with poor performance status and smokers (14 months vs. 4 months, p=0.02; 18.5 months vs. 6 months, p=0.049, respectively). The main serious adverse event (grade 3 or 4) was neutropenia (15 events, 13.3%) in a total of 113 cycles. CONCLUSION: Platinum/vinorelbine was effective as more than second-line chemotherapy, and the toxicity was tolerable, in patients with advanced NSCLC.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Carcinoma de Pulmón de Células no Pequeñas/patología , Neoplasias Pulmonares/tratamiento farmacológico , Platino (Metal)/efectos adversos , Platino (Metal)/farmacología , Vinblastina/análogos & derivados , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica , Supervivencia sin Enfermedad , Femenino , Humanos , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Platino (Metal)/administración & dosificación , Estudios Retrospectivos , Vinblastina/administración & dosificación , Vinblastina/efectos adversos , Vinblastina/farmacología , Vinorelbina
9.
Int J Hematol ; 101(6): 612-9, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25491494

RESUMEN

We present two cases of concurrent development of essential thrombocythemia (ET) with chronic lymphocytic leukemia (CLL) and one related to clonal B-cell lymphocytosis (CBL). Both patients were referred for lymphocytosis and thrombocytosis. A bone marrow biopsy revealed infiltration of small, mature lymphocytes and megakaryocytic hyperplasia. Flow cytometric immunophenotyping and immunoglobulin (IG) gene clonality tests revealed clonal B lymphocytes. Both patients were positive for the JAK2 V617F mutation in whole bone marrow aspirate. The JAK2 V617F mutation was present in isolated B lymphocytes of patient 1, but not patient 2. Cytogenetics were normal in both patients. An array comparative genomic hybridization (CGH) analyses of B cells revealed a gain of 4q28.3, which is reported in non-Hodgkin's lymphoma, in patient 1, and deletion 22q11.22, which is associated with CLL, and a gain of Xp22.31 in patient 2. In both patients, B cells showed no myeloproliferative neoplasm (MPN)-specific genetic abnormalities. These results suggest that different oncogenic mechanisms in each cell lineage may underlie the concurrent development of ET and CLL (or CBL). Array CGH may be helpful in identifying the pathogenic mechanism in cases of concurrent development of lymphoid neoplasm and MPN.


Asunto(s)
Leucemia Linfocítica Crónica de Células B/complicaciones , Linfocitosis/complicaciones , Trombocitemia Esencial/complicaciones , Anciano , Linfocitos B/metabolismo , Linfocitos B/patología , Plaquetas/metabolismo , Plaquetas/patología , Médula Ósea/patología , Hibridación Genómica Comparativa , Femenino , Reordenamiento Génico de Linfocito B , Humanos , Subunidades de Inmunoglobulinas/genética , Janus Quinasa 2/genética , Leucemia Linfocítica Crónica de Células B/genética , Leucemia Linfocítica Crónica de Células B/patología , Linfocitosis/genética , Linfocitosis/patología , Masculino , Mutación Puntual , Trombocitemia Esencial/genética , Trombocitemia Esencial/patología
10.
Radiat Oncol ; 9: 106, 2014 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-24885768

RESUMEN

BACKGROUND: To evaluate the volumetric and geometric differences in the ITVs generated by four-dimensional (4D) computed tomography (CT), a modified slow CT scan, and a combination of these CT methods in lung cancer patients treated with stereotactic body radiotherapy (SBRT). METHODS: Both 4D CT and modified slow CT using a multi-slice CT scanner were performed for SBRT planning in 14 patients with 15 pulmonary targets. Volumetric and geometric analyses were performed for (1) ITVall, generated by combining the gross tumor volumes (GTVs) from all 8 phases of the 4D CT; (2) ITV2, generated by combining the GTVs from 2 extreme phases of the 4D CT; (3) ITVslow, derived from the GTV on the modified slow CT scan; (4) ITVall+slow, generated by combining ITVall and ITVslow; and (5) ITV2+slow, generated by combining ITV2 and ITVslow. Three SBRT plans were performed using 3 ITVs to assess the dosimetric effects on normal lung caused by the various target volumes. RESULTS: ITVall (11.8 ± 8.3 cm3) was significantly smaller than ITVall+slow (12.5 ± 8.9 cm3), with mean values of 5.8% for the percentage volume difference, and a mean of 7.5% of ITVslow was not encompassed in ITVall. The geometric coverages of ITV2 and ITVslow for ITVall were 84.7 ± 6.6% and 76.2 ± 9.3%, respectively, but the coverage for ITVall increased to 90.9 ± 5.9% by using the composite of these two ITVs. There were statistically significant increases in the lung-dose parameters of the plans based on ITVall+slow compared to the plans based on ITVall or ITV2+slow. However, the magnitudes of these differences were relatively small, with a value of less than 3% in all dosimetric parameters. CONCLUSIONS: Due to its ability to provides additional motion information, the combination of 4D CT and a modified slow CT scan in SBRT planning for lung cancer can be used to reduce possible errors in true target delineation caused by breathing pattern variations.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/radioterapia , Tomografía Computarizada Cuatridimensional/métodos , Neoplasias Pulmonares/radioterapia , Radiocirugia/métodos , Planificación de la Radioterapia Asistida por Computador , Tomografía Computarizada por Rayos X/métodos , Anciano , Anciano de 80 o más Años , Carcinoma de Pulmón de Células no Pequeñas/secundario , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Pronóstico , Dosificación Radioterapéutica , Radioterapia de Intensidad Modulada , Estudios Retrospectivos , Carga Tumoral
11.
Thorac Cancer ; 5(4): 281-8, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-26767014

RESUMEN

BACKGROUND: To evaluate the efficacy and toxicity of reirradiation using three-dimensional conformal radiotherapy (3D-CRT) in symptomatic patients with locoregionally recurrent lung cancer. METHODS: Between 2005 and 2012, 15 patients with locoregionally recurrent lung cancer were retreated with 3D-CRT after previously receiving thoracic radiotherapy. The median interval between the initial irradiation and reirradiation was 12 months (range, five to 41 months). The median initial radiotherapy dose was 63 Gy (range, 45-70 Gy), and reirradiation doses ranged from 25.2 to 45.2 Gy (median, 36 Gy), with daily fractions of 1.8-4 Gy (median, 2 Gy). RESULTS: After reirradiation, 80% of the patients experienced resolved or diminished symptoms for one or more of their symptoms, with an 83% improvement in a total of 24 symptoms. The overall tumor response rate to reirradiation was 46.7%, with progressive disease occurring in only one patient. The median overall survival (OS) time was 11 months (range, one to 27 months), and the one-year OS rate was 47%. The progression-free survival time ranged from one to 10 months (median, five months). In univariate analysis, the use of combined chemotherapy and a higher reirradiation dose showed a trend toward improved survival after reirradiation. Treatment-induced toxicity included grade 2 radiation pneumonitis in only one patient, and there were no other complications, such as radiation esophagitis or myelopathy. CONCLUSIONS: Reirradiation using 3D-CRT with moderate doses for locoregionally recurrent lung cancer can provide palliative benefits without severe complications to the majority of selected patients with symptoms as a result of a regrowing tumor.

12.
Korean J Gastroenterol ; 61(6): 347-50, 2013 Jun.
Artículo en Coreano | MEDLINE | ID: mdl-23877217

RESUMEN

Sunitinib as a multitarget tyrosine kinase inhibitor is one of the anti-tumor agents, approved by the United States Food and Drug Administration to use treat gastrointestinal stromal tumor and metastatic renal cell carcinoma. The agent is known to commonly induce adverse reactions such as fatigue, nausea, diarrhea, stomatitis, esophagitis, hypertension, skin toxicity, reduciton in cardiac output of left ventricle, and hypothyroidism. However, it has been reported to rarely induce adverse reactions such as nephrotic syndrome and irreversible reduction in renal functions, and cases of intestinal perforation or pneumatosis interstinalis as such reactions have been consistently reported. In this report, a 66-year old man showing abdominal pain had renal cell carcinoma and history of sunitinib at a dosage of 50 mg/day on a 4-weeks-on, 2-weeks-off schedule. Seven days after the third cycle he was referred to the hospital because of abdominal pain. Computed tomography showed pneumoperitoneum with linear pneumatosis intestinalis in his small bowel. The patient underwent surgical exploration that confirmed the pneumatosis intestinalis at 100 cm distal to Treitz's ligament. We report a rare case of intestinal perforation with pneumatosis intestinalis after administration of sunitinib to a patient with metastatic renal cell carcinoma.


Asunto(s)
Antineoplásicos/uso terapéutico , Carcinoma de Células Renales/tratamiento farmacológico , Indoles/uso terapéutico , Perforación Intestinal/diagnóstico , Neoplasias Renales/tratamiento farmacológico , Neumatosis Cistoide Intestinal/diagnóstico , Pirroles/uso terapéutico , Anciano , Antineoplásicos/efectos adversos , Esquema de Medicación , Humanos , Indoles/efectos adversos , Perforación Intestinal/etiología , Perforación Intestinal/cirugía , Pulmón/diagnóstico por imagen , Masculino , Neumatosis Cistoide Intestinal/etiología , Tomografía de Emisión de Positrones , Pirroles/efectos adversos , Sunitinib , Tomografía Computarizada por Rayos X
13.
Anticancer Res ; 33(5): 2115-22, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-23645763

RESUMEN

BACKGROUND: New strategies are still needed to enhance the treatment outcome for advanced non-small cell lung cancer, in spite of recent remarkable developments. Cancer immunotherapy has been attractive since a long time, with diverse clinical attempts and results. In particular, natural killer (NK) cells have received considerable attention because of their potential role in immune surveillance in vivo by destroying infected or transformed cells. Major histocompatibility complex class I-related chain A/B (MICA/B) on tumor cells, known as the representative ligand for NKG2D receptor on NK cells, has been reported to be modulated by a variety of stress factors, including some chemotherapeutic agents, and it is anticipated that enhancing MICA/B expression will be contributory to anticancer treatment. With recent development of expanding autologous ex vivo NK cell-enriched lymphocytes (NKL), we designed a trial to augment the anticancer effect by co-administering NKL and docetaxel, one of the second-line agents used for treatment of patients with advanced non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: Eligible patients were between the age of 20 and 75 years, with an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 to 2, and previously received one chemotherapy or two regimens including one epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, stage IIIB/IV, histologically- or cytologically-proven NSCLC with measurable lesions. NKL were kindly prepared and provided from NKBIO Co. (Seongnam City, Korea). Feasibility, adverse effects, progression-free survival (PFS) were evaluated and compared with the historical control of weekly docetaxel regimen. RESULTS: Nineteen patients were enrolled before early closure. NKL production and administration were feasible in all cases, even in those with disseminated disease. No additional adverse events were observed in addition to those reported for docetaxel-alone. PFS of 3 months and 10.5% response rate (RR), with two cases of partial response, were observed and were similar to the historical control (PFS=2.9 months, RR=8.0%). CONCLUSION: To our knowledge, this is the first report on the combination of NKL with docetaxel in patients with advanced NSCLC. Autologous NKL production and co-administration with docetaxel were feasible without further toxicity or complication. Benefit in PFS and RR, as compared with the historical control, was not detected in this study population with advanced NSCLC. In order to determine whether the combination of NKL and chemotherapy has any anticancer effect, an additional study should be performed in patients with low tumor burden, such as those with less advanced disease or those in remission.


Asunto(s)
Antineoplásicos/uso terapéutico , Carcinoma de Pulmón de Células no Pequeñas/terapia , Células Asesinas Naturales/inmunología , Neoplasias Pulmonares/terapia , Linfocitos/inmunología , Taxoides/uso terapéutico , Adenocarcinoma/inmunología , Adenocarcinoma/mortalidad , Adenocarcinoma/terapia , Adulto , Carcinoma de Pulmón de Células no Pequeñas/inmunología , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Carcinoma de Células Escamosas/inmunología , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/terapia , Terapia Combinada , Docetaxel , Femenino , Estudios de Seguimiento , Humanos , Células Asesinas Naturales/trasplante , Neoplasias Pulmonares/inmunología , Neoplasias Pulmonares/mortalidad , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Estudios Retrospectivos , Terapia Recuperativa , Tasa de Supervivencia , Trasplante Autólogo
14.
J Korean Med Sci ; 28(2): 200-4, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-23400269

RESUMEN

To determine the approximate incidence and clinical features of pernicious anemia in a Korean population, we retrospectively analyzed clinical data for patients with pernicious anemia who were diagnosed between 1995 and 2010 at five hospitals in Chungnam province. Ninety-seven patients were enrolled, who accounted for 24% of patients with vitamin B(12) deficiency anemia. The approximate annual incidence of pernicious anemia was 0.3 per 100,000. The median age was 66 (range, 32-98) yr, and the male/female ratio was 1.25. Anemia-associated discomfort was the most common symptom (79.4%), followed by gastrointestinal and neurological symptoms (78.4% and 38.1%, respectively). Pancytopenia was found in 36 patients (37.1%), and autoimmune disorders were found in 15 patients (15.5%). Antibody to intrinsic factor was detected in 62 (77.5%) of 80 patients examined, and antibody to parietal cells was detected in 35 (43.2%) of 81 patients examined. Of the 34 patients who underwent tests for Helicobacter pylori, 7 (12.5%) were positive. The anemia-associated and gastrointestinal symptoms resolved completely in all patients after intramuscular injection of cobalamin, whereas neurological symptoms remained in some. In conclusion, pernicious anemia is less frequent in Koreans than in Western populations; however, the clinical features of this disorder in Koreans do not differ from those of Western cases.


Asunto(s)
Anemia Perniciosa/diagnóstico , Adulto , Anciano , Anemia Perniciosa/complicaciones , Anemia Perniciosa/epidemiología , Pueblo Asiatico , Enfermedades Autoinmunes/complicaciones , Enfermedades Autoinmunes/epidemiología , Femenino , Enfermedades Gastrointestinales/complicaciones , Enfermedades Gastrointestinales/tratamiento farmacológico , Enfermedades Gastrointestinales/epidemiología , Infecciones por Helicobacter/diagnóstico , Helicobacter pylori , Humanos , Isoanticuerpos/sangre , Masculino , Persona de Mediana Edad , Enfermedades del Sistema Nervioso/complicaciones , Enfermedades del Sistema Nervioso/epidemiología , Células Parietales Gástricas/inmunología , República de Corea/epidemiología , Estudios Retrospectivos , Vitamina B 12/sangre , Vitamina B 12/uso terapéutico
15.
Korean J Hematol ; 46(2): 128-34, 2011 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-21747886

RESUMEN

BACKGROUND: Hypocellularity of bone marrow (BM), not associated with significant dyshematopoiesis, is often found in patients with isolated thrombocytopenia, but its clinical implications have not been studied. We prospectively studied the clinical features and natural history of these patients. METHODS: Adults with isolated thrombocytopenia (platelet counts <100×10(9)/L) in the absence of dyshematopoiesis, cytogenetic abnormalities, or megakaryocytic hyperplasia and who had BM hypocellularity (below 30% in patients aged less than 60 years; below 20% in patients aged 60 years or more) were enrolled at Chungnam National University Hospital between January 2002 and December 2006. They were monitored regularly for changes in platelet counts or development of additional cytopenia. RESULTS: Twenty patients (17 men and 3 women) were enrolled in the study. The median age was 29 years (range, 18-70 years). At initial presentation, the platelet counts ranged from 12×10(9)/L to 99×10(9)/L (median, 63×10(9)/L) and were >50×10(9)/L in 16 patients (80%). BM cellularity ranged from 5% to 25% (median, 15%) and was ≤10% in 6 patients (30%). During the median 48-month follow-up (range, 12-90 months), platelet counts of 3 of the 20 patients recovered to normal levels (>150×10(9)/L) after 12, 56 and 66 months. Three patients developed pancytopenia after 11, 70 and 90 months. Two patients were consistent with moderate aplastic anemia, and 1 was confirmed as having refractory cytopenia with multilineage dysplasia. In the remainder of the patients, platelet counts remained unchanged. CONCLUSION: Isolated thrombocytopenia accompanied by hypocellular marrow encompasses a group of heterogeneous conditions.

16.
Korean J Hematol ; 46(4): 244-52, 2011 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22259630

RESUMEN

BACKGROUND: Antagonists of CXC chemokine receptor 4 (CXCR4), including AMD3100, induce peripheral mobilization of hematopoietic stem cells and have been approved for clinical use. We explored whether the CXCR4 antagonists affected the survival and proliferation of myeloid leukemia cells in vitro. METHODS: The effects of CXCR4 antagonists AMD3100 and T140 on the survival and proliferation of myeloid leukemia cell lines (U937, HL-60, MO7e, KG1a, and K562) as well as CD34(+) cells obtained from patients with AML and CML were analyzed by flow cytometry by using annexin V and a colorimetric cell proliferation assay. RESULTS: AMD3100, but not T140, stimulated the proliferation of leukemia cells in vitro in a dose-dependent manner for up to 5 days (~2-fold increase at a concentration of 10(-5) M), which was not abrogated by pretreatment of the cells with pertussis toxin, but was attenuated by RNAi knockdown of CXCR7 transcripts. In contrast, AMD3100 induced a marked decrease in the cell numbers after 5-7 days. AMD3100, but not T140, induced phosphorylation of MAPK p44/p42. AMD3100 increased the number and size of leukemia cell colonies and reduced cell apoptosis during the first 5-7 days of incubation, but the phenomena were reversed during the later period of incubation. CONCLUSION: The effects of CXCR4 antagonists on the proliferation of myeloid leukemia cells are not uniform. AMD3100, but not T140, exerts dual effects, initially enhancing and subsequently inhibiting the survival and proliferation of the cells in vitro.

17.
Colloids Surf B Biointerfaces ; 38(1-2): 35-40, 2004 Oct 10.
Artículo en Inglés | MEDLINE | ID: mdl-15465302

RESUMEN

In this work, the biodegradable poly(epsilon-caprolactone) (PCL)/poly(ethylene glycol) (PEG) microcapsules were prepared in the presence of SiO(2) and fragrant oil using emulsion solvent evaporation method. And SiO(2) was chemically treated in 30 wt.% hydrochloric acid and sodium hydroxide. The effect of chemical treatment on SiO(2) surfaces was studied in terms of pH, acid-base value, and N(2)/77 K gas adsorption. Image analyzer and scanning electron microscope (SEM) were used to observe the shape and surface change of the prepared microcapsules. And the variation of surface free energy of microcapsules was characterized by contact angles. The results showed that the average diameter, surface free energy, and fragrant oil release rate of microcapsules were increased with increasing the PEG ratio. Also, it was found that in the case of basic treated SiO(2), the fragrant oil adsorption capacity and release rate were decreased due to the decrease of specific surface area or the increase of acid-base interactions between basic SiO(2) and acidic fragrant oil.


Asunto(s)
Cápsulas/química , Aceites/química , Poliésteres/química , Polietilenglicoles/química , Dióxido de Silicio/química , Adsorción , Emulsiones , Solventes/química , Propiedades de Superficie
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