The Clinical Efficacy and Safety of Four-Weekly Docetaxel as First-Line Therapy in Elderly Lung Cancer Patients with Squamous Cell Carcinoma.

BACKGROUND: Docetaxel is one of the standard treatments for advanced non-small cell lung cancer. Docetaxel is usually administered in a 3-week schedule, but there is significant toxicity. In this phase II clinical study, we investigated the efficacy and safety of a 4-weekly schedule of docetaxel monotherapy, as first-line chemotherapy for advanced squamous cell carcinoma in elderly lung cancer patients. METHODS: Patients with stage IIIB/ IV lung squamous-cell carcinoma age 70 or older, that had not undergone cytotoxic chemotherapy were enrolled. Patients received docetaxel 25 mg/m² on days 1, 8, and 15, every 4 weeks. Primary endpoint was the objective response rate (ORR). Secondary endpoints were progression-free survival (PFS), overall survival (OS), and toxicity profiles. RESULTS: A total of 19 patients were enrolled. Among 19 patients, 17 were for evaluated efficacy and safety. In the intent-to-treat population, ORR and disease control rate (DCR) were 11.8% and 47.1%, respectively. In the response evaluable population, ORR was 16.7% and DCR was 66.7%. Median PFS and OS were 3.1 months and 3.3 months, respectively. There were three adverse grade 3/4 events. Grade 1 neutropenia was reported in one patient. CONCLUSION: Our data failed to demonstrate efficacy of a 4-weekly docetaxel regimen, in elderly patients with a poor performance status. However, incidence of side effects, including neutropenia, was lower than with a 3-week docetaxel regimen, as previously reported.

Clinical Effectiveness of High-Flow Nasal Cannula in Hypoxaemic Patients during Bronchoscopic Procedures.

BACKGROUND: Bronchoscopy is a useful diagnostic and therapeutic tool. However, the clinical use of high-flow nasal cannula (HFNC) in adults with acute respiratory failure for diagnostic and invasive procedures has not been well evaluated. We present our experiences of well-tolerated diagnostic bronchoscopy as well as cases of improved saturation in hypoxaemic patients after a therapeutic bronchoscopic procedure. METHODS: We retrospectively reviewed data of hypoxaemic patients who had undergone bronchoscopy for diagnostic or therapeutic purposes from October 2015 to February 2017. RESULTS: Ten patients (44-75 years of age) were enrolled. The clinical purposes of bronchoscopy were for diagnosis in seven patients and for intervention in three patients. For the diagnoses, we performed bronchoalveolar lavage in six patients. One patient underwent endobronchial ultrasonography with transbronchial needle aspiration of a lymph node to investigate tumour involvement. Patients who underwent bronchoscopy for therapeutic interventions had endobronchial mass or blood clot removal with cryotherapy for bleeding control. The mean saturation (SpO2) of pre-bronchoscopy in room air was 84.1%. The lowest and highest mean saturation with HFNC during the procedure was 95% and 99.4, respectively. The mean saturation in room air post-bronchoscopy was 87.4%, which was 3.3% higher than the mean room air SpO2 pre-bronchoscopy. Seven patients with diagnostic bronchoscopy had no hypoxic event. Three patients with interventional bronchoscopy showed improvement in saturation after the procedure. Bronchoscopy was well tolerated in all 10 cases. CONCLUSION: This study suggests that the use of HFNC in hypoxaemic patients during diagnostic and therapeutic bronchoscopy procedures has clinical effectiveness.

Clinical and molecular characteristics of pulmonary sarcomatoid carcinoma.

Background/Aims: Pulmonary sarcomatoid carcinoma (PSC) is a poorly differentiated non-small cell lung cancer (NSCLC) that contains components of spindle or giant cells. Owing to its low prevalence, there are insufficient data regarding its clinical features, therapeutic strategies and prognosis. METHODS: The medical records of 26 patients diagnosed with PSC from January 2009 to June 2015 were reviewed and analyzed for clinicopathological characteristics, treatment modality, and outcomes. RESULTS: The median age was 69.5 years. Twenty-three patients (88%) were male. Twenty-four patients (92%) were smokers. The median time from symptom onset to diagnosis was one month. Eighteen patients (69%) were diagnosed at an advanced stage. Pleomorphic carcinoma was the most common subtype, and epidermal growth factor receptor (EGFR) mutation was positive in two of 11 patients. Among 13 patients tested for programmed death ligand 1 (PD-L1) immunohistochemistry assay, eight showed high expression of PD-L1. The median overall survival (OS) of all patients was 9.5 months. In total, 12 patients were treated with chemotherapy: nine with platinum-based doublet therapy, two with tyrosine kinase inhibitor, and one with docetaxel. Seven patients showed partial response or stable disease. The median OS and progression-free survival of patients who received chemotherapy were 8.7 and 2.8 months, respectively. Conclusions: PSC was more common in males, smokers, and the elderly, with worse prognosis than ordinary NSCLC; chemotherapy response was favorable, and EGFR mutation status and PD-L1 expression may offer more therapeutic options.

Evaluation of Appropriate Management of Chronic Obstructive Pulmonary Disease in Korea: Based on Health Insurance Review and Assessment Service (HIRA) Claims.

Chronic obstructive pulmonary disease (COPD) is an ambulatory care-sensitive condition, and effective treatment of outpatients can prevent worsening of the illness and hospitalization. Current COPD guidelines provide appropriate guidance for the diagnosis and treatment of patients with COPD. In fact, it has been shown that when appropriate guidance and treatment are performed, the morbidity and mortality rates of COPD patients are reduced. However, there is a gap between the clinical guidelines and the actual clinical treatment. Therefore, the Health Insurance Review and Assessment Service (HIRA) conducted an evaluation of the adequacy of COPD diagnosis and treatment using the Claims Database of HIRA. This review provides a summary of the COPD adequacy assessment results reported by the HIRA and some brief comments on the results.

Dengue-associated hemophagocytic lymphohistiocytosis in an adult: A case report and literature review.

BACKGROUND: Infection-associated hemophagocytic syndrome (IAHS) is potentially a fatal disease caused by systemic infection complicated by hemophagocyticlymphohistiocytosis (HLH). Here, we report a case of HLH associated with dengue hemorrhagic fever (DHF) after a trip to Thailand. CASE SUMMARY: A 33-year-old healthy female patient presented with 3 days of fever, myalgia, and skin rash. Serotype 3 dengue virus was isolated. Clinical and laboratory findings fulfilled the criteria of HLH. After the initiation of corticosteroid therapy, the patient recovered and laboratory findings were normalized. CONCLUSION: It would be important to differentially diagnose dengue-associated HLH from severe DHF. Early recognition and initiation of steroid treatment would be crucial for the successful treatment of dengue fever complicated by HLH.

Evaluation of sensory processing abilities following stroke using the adolescent/adult sensory profile: implications for individualized intervention.

[Purpose] The present study aimed to understand characteristics of sensory processing in patients who have experienced a stroke using the previously established, self-diagnostic Adolescent/Adult Sensory Profile (AASP). [Subjects and Methods] Data from 180 total Korean patients who had been diagnosed as having experienced a stroke were collected and analyzed between May and August of 2015. [Results] Average scores for each sensory processing domain were as follows: low registration (32.1), sensation seeking (34.3), sensory sensitivity (36.7), and sensation avoiding (34.0). Study participants exhibited similar scores to healthy controls (data obtained from previous studies) with the following frequencies: low registration (65%), sensation seeking (77.2%), sensory sensitivity (65%), and sensation avoiding (62.2%). Significant differences were observed between control data and scores obtained for study participants in all domains except that of sensory sensitivity. [Conclusion] The results of the present study indicate that therapeutic intervention following the experience of a stroke should account for individual differences in sensory processing abilities to provide the environment most conducive to the patient's overall cognitive and physical improvement.

Effects of shoulder reaching exercise on the balance of patients with hemiplegia after stroke.

[Purpose] This study investigated whether a shoulder reaching exercise was beneficial for restoring the standing balance of patients with hemiplegia after stroke. [Subjects and Methods] There were 13 subjects in the experimental group (EG) and 14 subjects in the control group (CG), all with hemiplegia following stroke. The shoulder reaching exercise intervention was performed by the EG and conventional physical therapy was administered to the CG for 30 minutes, 3 times a week for 4 weeks. Virtual reality (RM, BioRescue -AP 1153, France) was used as an assessment tool. All data were analyzed using SPSS version 18 (Statistical Package for the Social Science). [Results] After the intervention, the EG showed significant differences in the distances moved in the anteroposterior and mediolateral directions. The length and velocity were reduced after the intervention in both the EG and the CG. There were significant differences in the distances moved in the north, south and west directions between the groups. The sway path lengths of the subjects in the Romberg test were reduced under both the eyes open and closed conditions in the EG. There was no significant variation in sway velocity in the EG and the CG. [Conclusion] The shoulder reaching exercise had beneficial effects on the distances moved in the anteroposterior and mediolateral directions.

Positive response of a primary malignant pericardial mesothelioma to pemetrexed plus cisplatin followed by pemetrexed maintenance chemotherapy: A case report.

Primary malignant pericardial mesothelioma (PMPM) is a rare tumor with poor prognosis. Surgery is the treatment of choice, but numerous cases are inoperable. For the treatment of inoperable or metastatic cases, systemic chemotherapy is required. However, a standard chemotherapeutic regimen for the treatment of pericardial mesothelioma has not yet been established. Chemotherapy involving pemetrexed and cisplatin has been actively used in the treatment of pleural or peritoneal mesothelioma, and may be considered for the treatment of PMPM. The present study reports the case of a patient with PMPM with lung metastasis who demonstrated a positive response to treatment with pemetrexed and cisplatin followed by pemetrexed maintenance chemotherapy, leading to prolonged progression-free survival for 21 months.

The Effect of Walking Exercise on Physical Fitness and Serum Lipids in Obese Middle-aged Women: Pilot Study.

[Purpose] This study was conducted to identify the effects of walking on the body composition, health-related physical fitness, and serum lipids as part of efforts to encourage middle-aged people to participate in walking as a regular and sustainable exercise. [Methods] This study was conducted as a pretest-posttest control group study. The study period was for 12 weeks from January to March 2010. The participants were 43 middle-aged women (age range: 40-55 years) with body fat rates over 30%. Subjects in the experiment group participated in the walking exercise (n = 38), the control group did not participate in the exercise (n = 23). [Results] In the exercise group, statistically significant reductions in weight and body fat were observed among the body composition measurement variables, and statistically significant increases in flexibility and cardiopulmonary endurance were observed among the physical fitness measurement variables. TC, TG, and LDL-C levels in the serum lipid measurement variables showed a statistically significant reduction in the exercise group. [Conclusion] The results of this study showed that 12 weeks of walking exercise influenced middle-aged women in a positive way by effecting changes in their body composition, physical fitness, and serum lipids. We believe that these positive changes result in positive effects on the factors for prevention of various adult diseases that can occur in middle-aged women.

Induction of unfolded protein response during neuronal induction of rat bone marrow stromal cells and mouse embryonic stem cells.

When we treated rat bone marrow stromal cells (rBMSCs) with neuronal differentiation induction media, typical unfolded protein response (UPR) was observed. BIP/GRP78 protein expression was time-dependently increased, and three branches of UPR were all activated. ATF6 increased the transcription of XBP1 which was successfully spliced by IRE1. PERK was phosphorylated and it was followed by eIF2alpha phosphorylation. Transcription of two downstream targets of eIF2alpha, ATF4 and CHOP/GADD153, were transiently up-regulated with the peak level at 24 h. Immunocytochemical study showed clear coexpression of BIP and ATF4 with NeuN and Map2, respectively. UPR was also observed during the neuronal differentiation of mouse embryonic stem (mES) cells. Finally, chemical endoplasmic reticulum (ER) stress inducers, thapsigargin, tunicamycin, and brefeldin A, dose-dependently increased both mRNA and protein expressions of NF-L, and, its expression was specific to BIP-positive rBMSCs. Our results showing the induction of UPR during neuronal differentiations of rBMSCs and mES cells as well as NF-L expression by ER stress inducers strongly suggest the potential role of UPR in neuronal differentiation.