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1.
Clin Oncol (R Coll Radiol) ; 35(6): e384-e394, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37003842

RESUMO

AIMS: To compare the local control rate of pulmonary metastatic lesions in colorectal adenocarcinoma treated with stereotactic body radiation therapy (SBRT) using a biologically effective dose with an α/ß ratio of 10 (BED10) of 150 Gy. MATERIALS AND METHODS: We analysed 231 pulmonary metastatic lesions from colorectal adenocarcinoma treated with SBRT in 135 patients. The patients were referred for the control of oligometastatic or oligoprogressive disease in the lungs. A dose of 40-60 Gy in three to eight fractions was delivered. The local control per tumour (LCpT) by BED10 was evaluated. The local control per patient (LCpP), pulmonary progression-free survival (PPFS), any progression-free survival (APFS) and overall survival were also reported as clinical outcomes. RESULTS: A significant difference was observed in the LCpT between the BED10 groups (P < 0.001). The 1-, 2- and 3-year LCpT were 38.9%, 25.9% and 25.9% in BED10 < 100 group; 84.1%, 62.6% and 60.4% in 100 ≤ BED10 < 150 Gy group; and 97.3%, 94.9% and 85.2% in BED10 ≥ 150 Gy group, respectively. BED10 ≥ 150 Gy remained significant in the multivariate analysis of LCpT. The 3-year LCpP, PPFS, APFS and overall survival rates were 62.7%, 26.5%, 24.8% and 67.7%, respectively. Oligoprogression (versus oligometastasis), multiple pulmonary nodules and extrapulmonary metastasis were associated with a poor prognosis. CONCLUSION: A BED10 ≥ 150 Gy may be required to achieve sufficient local control. The indications for SBRT and the extent of metastatic disease should be assessed for proper estimation of the clinical outcomes.


Assuntos
Adenocarcinoma , Neoplasias Colorretais , Neoplasias Pulmonares , Radiocirurgia , Humanos , Dosagem Radioterapêutica , Neoplasias Pulmonares/patologia , Adenocarcinoma/radioterapia , Neoplasias Colorretais/radioterapia , Estudos Retrospectivos
2.
Zhonghua Yi Xue Za Zhi ; 102: 76-79, 2022 May 30.
Artigo em Chinês | MEDLINE | ID: mdl-35701087

RESUMO

Investigate theclinical practice of seizure prophylaxis after aneurysmal subarachnoid hemorrhage in Chinese neurosurgeons.Aquestionnaire for this theme was designed and was sent to respondents through the internet.From July 2021 to October 2021, atotal of forty-three eligible questionnaires were collected. All responders come from affiliated hospitals of medical schools in China. Each of these hospitals admitted more than one hundred patients with aneurysmal subarachnoid hemorrhage per year. Only 9.3% (4/43) of responders disagree with the prophylactic use of anticonvulsants. 86.04% (37/43) of responders perform seizure prophylaxis in clinical practice. Sodium valproate is the most commonly used regimen; 94.59% (35/37) of responders who perform prophylaxis chose this drug. The medication period differs sharply fromlessthan 3 daystolongerthan 14 daysamong different hospitals. The use of EEG was insufficient in Chinese patients. A low seizure rate was reported according to the feedback from Chinese neurosurgeons.In China, seizure prophylaxis after subarachnoid hemorrhage was not yet standardized. Clinicians' mastery of relevant knowledge is still not enough. Carrying out high-quality clinical research can help justify the use of anticonvulsants, which could also positively impact rational drug use.

3.
Eur Rev Med Pharmacol Sci ; 22(6): 1782-1786, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29630127

RESUMO

OBJECTIVE: We aimed at investigating the clinical and bacteriological features and drug resistance of bloodstream infection of Acinetobacter baumannii, so as to provide new evidence for treatment of bloodstream infection of Acinetobacter baumannii. PATIENTS AND METHODS: Statistical analysis was carried out for the clinical and bacteriological features and drug sensitivity of 74 bloodstream infection cases of Acinetobacter baumannii who were admitted to this hospital between July 2016 and June 2017. RESULTS: Among 74 patients, about 72.0% of them were admitted to the ICU and Respiratory Department; the average age of these patients was 63 years old. Among 74 patients, 62 patients stayed in the hospital for over 2 weeks (83.8%), and 35 for over 1 month (47.3%); 72.0% of patients experienced intrusive operation, in which 28.0% of patients dead. The experiment of drug sensitivity showed that tigecycline had the highest sensitivity (100%), sequentially followed by amikacin (over 90.0%) and other anti-bacterial drugs (less than 40.0%). Pan-drug resistance was identified in 42 patients, accounting for 56.8%. Comparison between the pan-drug resistant and non-pan-drug resistant patients showed that in the first two weeks before the positive blood culture, there were statistically significant differences in administration of carbapenem antibiotics and intrusive operation (p<0.05). Among the patients, the lowest resistance to carbapenem antibiotics was 8.16%, while the rate of resistance to other 12 antibiotics was more than 40.00%. Multiple-resistant strain mainly originated from the ICU and the burn center. CONCLUSIONS: In patients with bloodstream infection of Acinetobacter baumannii, the pan-drug resistant strains account for a vast majority with a high mortality rate. Age, intrusive operation and length of stay in hospital longer than 2 weeks are the common susceptible factors, while the administration of carbapenem antibiotics and intrusive operations might be the high-risk factors leading to pan-drug resistant cases.


Assuntos
Infecções por Acinetobacter/tratamento farmacológico , Acinetobacter baumannii/efeitos dos fármacos , Antibacterianos/uso terapêutico , Bacteriemia/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carbapenêmicos/uso terapêutico , Criança , Pré-Escolar , Farmacorresistência Bacteriana , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Adulto Jovem
4.
Artigo em Inglês | MEDLINE | ID: mdl-27200098

RESUMO

Visceral hypersensitivity is enhanced in irritable bowel syndrome (IBS) patients. Treatment of IBS visceral pain by moxibustion methods has a long history and rich clinical experience. In the clinic, moxibustion on the Tianshu (ST25) and Shangjuxu (ST37) acupoints can effectively treat bowel disease with visceral pain and diarrhea symptoms. To investigate the regulatory function of moxibustion on the Tianshu (ST25) and Shangjuxu (ST37) acupoints on spinal cord NR1, NR2B, and PKCε protein and mRNA expression in irritable bowel syndrome (IBS) visceral hypersensitivity rats, we did some research. In the study, we found that moxibustion effectively relieved the IBS visceral hyperalgesia status of rats. Analgesic effect of moxibustion was similar to intrathecal injection of Ro 25-6981. The expression of NR1, NR2B, and PKCε in the spinal dorsal horns of IBS visceral hyperalgesia rats increased. Moxibustion on the Tianshu and Shangjuxu acupoints might inhibit the visceral hypersensitivity, simultaneously decreasing the expression of NR1, NR2B, and PKCε in spinal cord of IBS visceral hyperalgesia rats. Based on the above experimental results, we hypothesized NR1, NR2B, and PKCε of spinal cord could play an important role in moxibustion inhibiting the process of central sensitization and visceral hyperalgesia state.

5.
Ann Oncol ; 26(9): 1974-1980, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26116430

RESUMO

BACKGROUND: In this study, we aimed to identify demographic and clinical variables that correlate with perceived information provision among cancer patients and determine the association of information provision with decisional conflict (DC). PATIENTS AND METHODS: We enrolled a total of 625 patients with cancer from two Korean hospitals in 2012. We used the European Organization for Research and Treatment of Cancer (EORTC) quality-of-life questionnaire (QLQ-INFO26) to assess patients' perception of the information received from their doctors and the Decisional Conflict Scale (DCS) to assess DC. To identify predictive sociodemographic and clinical variables for adequate information provision, backward selective logistic regression analyses were conducted. In addition, adjusted multivariate logistic regression analyses were carried out to identify clinically meaningful differences of perceived level of information subscales associated with high DC. RESULTS: More than half of patients with cancer showed insufficient satisfaction with medical information about disease (56%), treatment (73%), other services (83%), and global score (80%). In multiple logistic regression analyses, lower income and education, female, unmarried status, type of cancer with good prognosis, and early stage of treatment process were associated with patients' perception of inadequate information provision. In addition, Information about the medical tests with high DCS values clarity [adjusted odds ratio (aOR), 0.54; 95% confidence interval (CI) 0.30-0.97] and support (aOR, 0.53; 95% CI 0.33-0.85) showed negative significance. For inadequate information perception about treatments and other services, all 5 DCS scales (uncertainty, informed, values clarity, support, and effective decision) were negatively related. Global score of inadequate information provision also showed negative association with high DCS effective decision (aOR, 0.43; 95% CI 0.26-0.71) and DCS uncertainty (aOR, 0.46; 95% CI 0.27-0.77). CONCLUSION: This study found that inadequate levels of perceived information correlated with several demographic and clinical characteristics. In addition, sufficient perceived information levels may be related to low levels of DC.


Assuntos
Comunicação , Conflito Psicológico , Tomada de Decisões , Relações Médico-Paciente , Escolaridade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/terapia , Educação de Pacientes como Assunto , Qualidade de Vida , Fatores Socioeconômicos , Inquéritos e Questionários
6.
Br J Radiol ; 88(1052): 20140536, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25993487

RESUMO

OBJECTIVE: To assess the image quality and dosimetric effects of the Philips orthopaedic metal artefact reduction (OMAR) (Philips Healthcare System, Cleveland, OH) function for reducing metal artefacts on CT images of head and neck (H&N) patients. METHODS: 11 patients and a custom-built phantom with metal bead inserts (alumina, titanium, zirconia and chrome) were scanned. The image was reconstructed in two ways: with and without OMAR (OMAR and non-OMAR image). The mean and standard deviation values of CT Hounsfield unit (HU) for selected regions of interest of each case were investigated for both images. Volumetric modulated arc therapy plans were generated for all cases. Gamma analysis of each dose distribution pair in the patient (1%/1 mm criteria) and phantom (2%/2 mm and 3%/3 mm criteria) images was performed. The film measurements in phantom for two metal beads were conducted for evaluating the calculated dose on both OMAR and non-OMAR images. RESULTS: In the OMAR images, noise values were generally reduced, and the mean HU became closer to the reference value (measured from patients without metal implants) in both patient and phantom cases. Although dosimetric difference was insignificant for the eight closed-mouth patients (γ = 99.4 ± 0.5%), there was a large discrepancy in dosimetric calculation between OMAR and non-OMAR images for the three opened-mouth patients (γ = 91.1%, 94.8% and 96.6%). Moreover, the calculated dose on the OMAR image is closer to the real delivered dose on a radiochromic film than was the dose from the non-OMAR image. CONCLUSION: The OMAR algorithm increases the accuracy of CT HU and reduces the noise such that the entire radiation treatment planning process can be improved, especially for contouring and segmentation. ADVANCES IN KNOWLEDGE: OMAR reconstruction is appropriate for the radiotherapy planning process of H&N patients, particularly of patients who use a bite block.


Assuntos
Algoritmos , Artefatos , Neoplasias de Cabeça e Pescoço/radioterapia , Metais , Equipamentos Ortopédicos , Implantes Dentários , Humanos , Imagens de Fantasmas , Radiometria , Estudos Retrospectivos
7.
Purinergic Signal ; 11(3): 321-9, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25809868

RESUMO

The aim of this study is to investigate the role of the purinergic receptor P2X3 in the peripheral and central nervous systems during acupuncture treatment for the visceral pain of irritable bowel syndrome (IBS). A total of 24 8-day-old Sprague-Dawley (SD) neonatal male rats (SPF grade) were stimulated using colorectal distention (CRD) when the rats were awake. The modeling lasted for 2 weeks with one stimulation per day. After 6 weeks, the rats were randomly divided into three groups of eight each: (1) the normal group (NG, n = 8); (2) the model group (MG, n = 8); and (3) the model + electroacupuncture group (EA, n = 8) that received electroacupuncture at a needling depth of 5 mm at the Shangjuxu (ST37, bilateral) and Tianshu (ST25, bilateral) acupoints. The parameters of the Han's acupoint nerve stimulator (HANS) were as follows: sparse-dense wave with a frequency of 2/100 Hz, current of 2 mA, 20 min/stimulation, and one stimulation per day; the treatment was provided for seven consecutive days. At the sixth week after the treatment, the abdominal withdrawal reflex (AWR) score was determined; immunofluorescence and immunohistochemistry were used to measure the expression of the P2X3 receptor in myenteric plexus neurons, prefrontal cortex, and anterior cingulate cortex; and, a real-time PCR assay was performed to measure the expression of P2X3 messenger RNA (mRNA) in the dorsal root ganglion (DRG) and spinal cord. After stimulation with CRD, the expression levels of the P2X3 receptor in the inter-colonic myenteric plexus, DRG, spinal cord, prefrontal cortex, and anterior cingulate cortex were upregulated, and the sensitivity of the rats to IBS visceral pain was increased. Electroacupuncture (EA) could downregulate the expression of the P2X3 receptor and ease the sensitivity to visceral pain. The P2X3 receptor plays an important role in IBS visceral pain. The different levels of P2X3 in the peripheral enteric nervous system and central nervous system mediate the effects of the EA treatment of the visceral hyperalgesia of IBS.


Assuntos
Sistema Nervoso Central/fisiopatologia , Eletroacupuntura , Síndrome do Intestino Irritável/complicações , Síndrome do Intestino Irritável/fisiopatologia , Sistema Nervoso Periférico/fisiopatologia , Receptores Purinérgicos P2X3 , Dor Visceral/fisiopatologia , Dor Visceral/terapia , Pontos de Acupuntura , Animais , Animais Recém-Nascidos , Regulação para Baixo , Sistema Nervoso Entérico/fisiopatologia , Masculino , Medição da Dor , RNA Mensageiro/biossíntese , Ratos , Ratos Sprague-Dawley , Receptores Purinérgicos P2X3/biossíntese , Receptores Purinérgicos P2X3/genética , Dor Visceral/etiologia
8.
Br J Radiol ; 88(1049): 20140698, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25734490

RESUMO

OBJECTIVE: To determine a new metric utilizing multileaf collimator (MLC) speeds and accelerations to predict plan delivery accuracy of volumetric modulated arc therapy (VMAT). METHODS: To verify VMAT delivery accuracy, gamma evaluations, analysis of mechanical parameter difference between plans and log files, and analysis of changes in dose-volumetric parameters between plans and plans reconstructed with log files were performed with 40 VMAT plans. The average proportion of leaf speeds ranging from l to h cm s(-1) (Sl-h and l-h = 0-0.4, 0.4-0.8, 0.8-1.2, 1.2-1.6 and 1.6-2.0), mean and standard deviation of MLC speeds were calculated for each VMAT plan. The same was carried out for accelerations in centimetre per second squared (Al-h and l-h = 0-4, 4-8, 8-12, 12-16 and 16-20). The correlations of those indicators to plan delivery accuracy were analysed with Spearman's correlation coefficient (rs). RESULTS: The S1.2-1.6 and mean acceleration of MLCs showed generally higher correlations to plan delivery accuracy than did others. The highest rs values were observed between S1.2-1.6 and global 1%/2 mm (rs = -0.698 with p < 0.001) as well as mean acceleration and global 1%/2 mm (rs = -0.650 with p < 0.001). As the proportion of MLC speeds and accelerations >0.4 and 4 cm s(-2) increased, the plan delivery accuracy of VMAT decreased. CONCLUSION: The variations in MLC speeds and accelerations showed considerable correlations to VMAT delivery accuracy. ADVANCES IN KNOWLEDGE: As the MLC speeds and accelerations increased, VMAT delivery accuracy reduced.


Assuntos
Neoplasias de Cabeça e Pescoço/radioterapia , Neoplasias da Próstata/radioterapia , Radioterapia de Intensidade Modulada/métodos , Algoritmos , Raios gama , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Aceleradores de Partículas , Imagens de Fantasmas , Neoplasias da Próstata/diagnóstico por imagem , Controle de Qualidade , Doses de Radiação , Radiografia , Radiometria , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador , República da Coreia , Sensibilidade e Especificidade
9.
Br J Radiol ; 87(1043): 20140342, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25225915

RESUMO

OBJECTIVE: To present conformity indices (CIs) based on the distance differences between the target volume (TV) and the volume of reference isodose (VRI). METHODS: The points on the three-dimensional surfaces of the TV and the VRI were generated. Then, the averaged distances between the points on the TV and the VRI were calculated (CIdistance). The performance of the presented CIs were evaluated by analysing six situations, which were a perfect match, an expansion and a reduction of the distance from the centroid to the VRI compared with the distance from the centroid to the TV by 10%, a lateral shift of the VRI by 3 cm, a rotation of the VRI by 45° and a spherical-shaped VRI having the same volume as the TV. The presented CIs were applied to the clinical prostate and head and neck (H&N) plans. RESULTS: For the perfect match, CIdistance was 0 with 0 as the standard deviation (SD). When expanding and reducing, CIdistance was 10 and -10 with SDs <1.3, respectively. With shifting and rotating of the VRI, the CIdistance was almost 0 with SDs >11. The average value of the CIdistance in the prostate and H&N plans was 0.13 ± 7.44 and 6.04 ± 23.27, respectively. CONCLUSION: The performance of the CIdistance was equal or better than those of the conventional CIs. ADVANCES IN KNOWLEDGE: The evaluation of target conformity by the distances between the surface of the TV and the VRI could be more accurate than evaluation with volume information.


Assuntos
Simulação por Computador , Próstata/diagnóstico por imagem , Neoplasias da Próstata/radioterapia , Planejamento da Radioterapia Assistida por Computador/métodos , Radioterapia Conformacional/métodos , Humanos , Masculino , Tamanho do Órgão , Neoplasias da Próstata/diagnóstico por imagem , Dosagem Radioterapêutica , Tomografia Computadorizada por Raios X
10.
Ann Oncol ; 20(8): 1414-9, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19468031

RESUMO

BACKGROUND: Recent researches revealed that class III beta-tubulin (TUBB3) is a prognostic marker in various tumors and role of TUBB3 in head and neck squamous cell carcinoma (HNSCC) is not defined yet. We analyzed the significance of TUBB3 expression along with p53 and ERCC1 in locally advanced HNSCC patients receiving cisplatin-based induction chemotherapy. MATERIALS AND METHODS: Retrospective review of medical records at Seoul National University Hospital between 1998 and 2007 was carried out. Immunohistochemical stain of TUBB3, p53, and ERCC1 was done in paraffin-embedded tumor tissue. We assessed response to treatment, progression-free survival (PFS), overall survival (OS), and cancer-specific survival (CSS). RESULTS: Eighty-five patients with oropharyngeal, hypopharyngeal, and laryngeal cancers received induction chemotherapy with 5-fluorouracil (5-FU) and cisplatin (n = 55), or 5-FU, cisplatin, and docetaxel (Taxotere) (n = 30). Eighty-three received definitive treatment after induction chemotherapy, where 62 received radiotherapy and 21 received surgery. TUBB3-positive patients showed lower response rate than TUBB3-negative patients (69% versus 88%, P = 0.039). Shorter median PFS was observed in TUBB3-positive group (12 versus 47 months, P = 0.001). Shorter median OS was observed in TUBB-positive group not reaching statistical significance (30 versus 59 months, P = 0.072). TUBB3 status significantly influenced CSS (35 months versus not reached, P = 0.017). Positive p53 status was related to poorer OS and CSS. ERCC1 showed no influence on chemotherapy response, PFS, OS, and CSS. CONCLUSION: TUBB3 is a predictive and prognostic marker along with well-known p53 in HNSCC patients receiving cisplatin-based induction chemotherapy. Clinical impact of ERCC1 is not evident in this setting.


Assuntos
Carcinoma de Células Escamosas/metabolismo , Proteínas de Ligação a DNA/biossíntese , Endonucleases/biossíntese , Neoplasias de Cabeça e Pescoço/metabolismo , Tubulina (Proteína)/biossíntese , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/biossíntese , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/enzimologia , Cisplatino/administração & dosagem , Intervalo Livre de Doença , Docetaxel , Feminino , Fluoruracila/administração & dosagem , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Neoplasias de Cabeça e Pescoço/enzimologia , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxa de Sobrevida , Taxoides/administração & dosagem , Proteína Supressora de Tumor p53/biossíntese
11.
Head Neck ; 23(9): 713-7, 2001 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11505479

RESUMO

BACKGROUND: The purpose of this retrospective study is to compare the treatment results of locally advanced hypopharyngeal carcinoma according to treatment modalities. METHODS: Seventy-three patients with locally advanced hypopharyngeal carcinoma treated at the Department of Therapeutic Radiology, Seoul National University Hospital, between August 1979 and July 1997 were retrospectively analyzed. Twenty-three patients were treated with radiotherapy (RT) alone, 18 patients were treated with surgery and postoperative RT, and 32 patients were treated with neoadjuvant chemotherapy (CTx) and RT. Median follow-up period was 28 months. RESULTS: The overall 5-year survival rates were 15.7% for the RT alone group, 46.8% for surgery and postoperative RT group, and 43.0% for neoadjuvant CTx and RT group. The 5-year disease-free survival rates were 13.9%, 47.4%, and 30.7%, respectively. Surgery and postoperative RT or neoadjuvant CTx and RT showed superiority over RT alone in terms of both overall survival and disease-free survival rates. No significant differences were found in overall and disease-free survival rates between the surgery and postoperative RT group and neoadjuvant CTx and RT group (p =.15, p =.13). In the neoadjuvant CTx and RT group, 12 patients (38%) retained their larynx more than 5 years. CONCLUSION: Neoadjuvant CTx and RT is an effective strategy to achieve organ preservation without compromising the survival of patients with locally advanced hypopharyngeal carcinoma.


Assuntos
Carcinoma de Células Escamosas/terapia , Neoplasias Hipofaríngeas/terapia , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Intervalo Livre de Doença , Feminino , Humanos , Neoplasias Hipofaríngeas/mortalidade , Neoplasias Hipofaríngeas/patologia , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Indução de Remissão , Estudos Retrospectivos , Estatística como Assunto , Taxa de Sobrevida , Falha de Tratamento , Resultado do Tratamento
12.
Int J Radiat Oncol Biol Phys ; 45(4): 901-5, 1999 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-10571196

RESUMO

PURPOSE: To analyze the impact of neoadjuvant chemotherapy on the treatment of locoregionally advanced nasopharyngeal carcinoma and to assess the outcomes of patients receiving such treatment. METHODS AND MATERIALS: We analyzed 137 previously untreated and histologically confirmed advanced stage nasopharyngeal carcinoma patients treated with either radiation therapy only or combined radiation therapy and chemotherapy at the Seoul National University Hospital between 1984 and 1996. The stage distribution was as follows: AJCC Stage III-21, Stage IV-61 in the radiation therapy group (RT group); AJCC Stage III-1, Stage IV-54 in neoadjuvant chemotherapy and radiation therapy group (CT/RT group). The median follow-up for surviving patients was 48 months. RESULTS: The 5-year overall survival (OS) rates were 71% for the CT/RT group and 59% for the RT group (p = 0.04). The 5-year actuarial disease-free survival (DFS) rates were 63% for the CT/RT group and 52% for the RT group (p = 0.04). Distant metastasis (DM) incidence was significantly lower in the CT/RT group. The 5-year freedom from distant metastasis rates were 84% for the CT/RT group and 66% for the RT group (p = 0.01). The incidence of locoregional failures was also lower in the CT/RT group, although this difference did not reach statistical significance (69% vs. 56%, p = 0.09) CONCLUSION: While not providing conclusive evidence, historical evidence from this institution suggests that neoadjuvant chemotherapy significantly improves both overall and the disease-free survival of patients with advanced stage nasopharyngeal carcinoma.


Assuntos
Carcinoma/tratamento farmacológico , Carcinoma/radioterapia , Neoplasias Nasofaríngeas/tratamento farmacológico , Neoplasias Nasofaríngeas/radioterapia , Adolescente , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carboplatina/administração & dosagem , Carcinoma/patologia , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/radioterapia , Quimioterapia Adjuvante , Cisplatino/administração & dosagem , Feminino , Fluoruracila/administração & dosagem , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Neoplasias Nasofaríngeas/patologia , Estadiamento de Neoplasias , Estudos Retrospectivos , Falha de Tratamento
13.
J Korean Med Sci ; 14(5): 565-70, 1999 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-10576154

RESUMO

The benefits of radio-chemotherapy in HIV-negative primary central nervous system (CNS) lymphomas were analyzed in 40 patients, who received radiotherapy to the brain or craniospinal axis with the total dose of 4460-5940 cGy to the primary tumor. Radiotherapy was followed by systemic chemotherapy, mainly with the cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP) regimen, in 16 of the patients. Follow-up ranged from four to 95 months with a median of 15 months. The relapse rate was 72.5%, and 83% of the relapses occurred within the radiation field. Median survival was 19 months and the two-year survival rate was 41%. Survival was significantly influenced by treatment method and radiation dose when measured by univariate analysis; median survival and the two-year survival rate was 29 months and 63% after radio-chemotherapy, while 13.5 month and 29% after radiotherapy alone (p= 0.027), and 22 months and 49% with doses of 50 Gy or more, but 12.5 months and 13% with doses less than 50 Gy (p=0.009). However, statistical significance was lost in multivariate analysis. These results might suggest the short-term efficacy of radio-chemotherapy, however, cautious observation is needed to confirm long-term effects.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias do Sistema Nervoso Central/terapia , Linfoma/terapia , Adolescente , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Bleomicina/administração & dosagem , Neoplasias do Sistema Nervoso Central/mortalidade , Ciclofosfamida/administração & dosagem , Intervalo Livre de Doença , Doxorrubicina/administração & dosagem , Epirubicina/administração & dosagem , Feminino , Humanos , Linfoma/mortalidade , Masculino , Mecloretamina/administração & dosagem , Metotrexato/administração & dosagem , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Prednisolona/administração & dosagem , Procarbazina/administração & dosagem , Dosagem Radioterapêutica , Radioterapia Adjuvante/efeitos adversos , Taxa de Sobrevida , Falha de Tratamento , Vincristina/administração & dosagem
14.
J Korean Med Sci ; 14(2): 217-9, 1999 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10331572

RESUMO

Endometriosis of a surgical scar is rare and occurs mainly when a hysterectomy or Cesarean section was performed. We describe a 54-year-old woman with a large suprapubic mass as a definite case of a endomerioid carcinoma developing within the scar endometriosis following Cesarean section. Scar endometriosis, as well as endometriosis at other sites, can turn malignant. Endometrioid carcinoma is the most common histological pattern of malignant tumor arising in endometriosis. But clear cell carcinoma is very unusual. A case of primary clear cell carcinoma in endometriosis of a Cesarean section scar is described. To the best of our knowledge, this is the first documented case of endomerioid carcinoma developing within the scar endometriosis in Korea.


Assuntos
Adenocarcinoma de Células Claras/etiologia , Carcinoma Endometrioide/etiologia , Cesárea/efeitos adversos , Cicatriz , Adenocarcinoma de Células Claras/patologia , Adenocarcinoma de Células Claras/cirurgia , Carcinoma Endometrioide/patologia , Carcinoma Endometrioide/cirurgia , Endometriose/fisiopatologia , Feminino , Humanos , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X/métodos
15.
Planta Med ; 64(1): 54-7, 1998 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-9491767

RESUMO

A series of mono- and dimeric natural and structurally modified carbazoles has been tested for activity against Plasmodium falciparum. One of the monomers, the synthetic compound 1,4-diacetoxy-3-methylcarbazole (17), displays the highest activity, with an IC50 value of 1.79 micrograms/ml. It is distinctly more active than the as yet best natural compound, 1-hydroxy-3-methylcarbazole (4) (4).


Assuntos
Antimaláricos/farmacologia , Carbazóis/farmacologia , Plasmodium falciparum/efeitos dos fármacos , Animais , Antimaláricos/química , Carbazóis/química , Estrutura Molecular , Análise Espectral
16.
Int J Radiat Oncol Biol Phys ; 40(3): 623-7, 1998 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-9486612

RESUMO

PURPOSE: Authors designed a customized small bowel displacement system (SBDS) to displace the small bowel out of the pelvic radiation fields and to minimize treatment related bowel morbidity. METHODS AND MATERIALS: From August 1995 to May 1996, 55 consecutive patients who received pelvic radiation therapy with the SBDS were included in this study. The SBDS consists of a customized Styrofoam compression device that can displace the small bowel out of the radiation fields and an individualized immobilization abdominal board for easy daily setup of the patient in prone position. After opacifying the small bowel with barium, the patients were laid prone and posterior-anterior (PA) and lateral (LAT) simulation films were taken with and without the SBDS. The volume of the small bowel included in the radiation fields with and without the SBDS were compared. RESULTS: Using the SBDS, the mean small bowel volume was reduced by 59% on PA and 51% on LAT films (p = 0.0001). In six patients (6 of 55, 11%), it was possible that no small bowel was included within the treatment fields. The mean upward displacement of the most caudal small bowel was 4.8 cm using the SBDS. Patients treated with the SBDS manifested a significantly lower incidence of diarrhea requiring medication (8 of 55, 15%) vs. those without the SBDS (24 of 39, 62%) (p < 0.05). CONCLUSION: The SBDS is a novel method that can be used to displace the small bowel away from the treatment portal effectively and to reduce the radiation therapy morbidity. Compliance with setup is excellent.


Assuntos
Intestino Delgado , Pelve , Radioterapia (Especialidade)/instrumentação , Adulto , Idoso , Neoplasias do Endométrio/radioterapia , Desenho de Equipamento , Feminino , Humanos , Intestino Delgado/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Decúbito Ventral , Radiografia , Neoplasias Retais/radioterapia , Neoplasias do Colo do Útero/radioterapia
17.
Theor Appl Genet ; 92(6): 702-8, 1996 May.
Artigo em Inglês | MEDLINE | ID: mdl-24166394

RESUMO

A tandemly repeated DNA sequence (RRS7) was isolated from Oryza alta (CCDD). RRS7-related sequences were also found tandemly arrayed in genomes AA, BB, BBCC, CC, and EE, and a small amount of RRS7-related sequences were detected in genome FF and the Oryza species with unknown genomes. DNA sequence analysis of the 1844-bp insert of RRS7 revealed that it contained six tandemly repeated units, of which five were 155 bp in length and one was 194 bp in length and contained an imperfect internal 39-bp duplication. Southern blot analysis showed that the boundary sequence contained in RRS7 is a single-copy sequence. A 155-bp consensus sequence derived from the six monomeric repeats contained no internal repeat and showed no significant homology to other currently known sequences. The results of Southern blot and sequence analysis revealed that there are at least two subfamilies present in the RRS7 family; these are represented by the DraI site and the MspI site, respectively. Restriction digestion with two pairs of isoschizomers MboI/Sau3A and MspI/HpaII demonstrated that most of the C residues in the GATC sites and the internal C in the CCGG sites of the RRS7 family in O. Alta were methylated. The usefulness of the RRS7 family in determining the evolutionary relationship of the genome DD and other Oryza genomes is discussed.

18.
Chin Med J (Engl) ; 107(2): 137-41, 1994 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-8194381

RESUMO

It is postulated the pulmonary injury in acute necrotizing pancreatitis could be due to oxygen-derived free radicals released during the attack of acute pancreatitis. To elucidate the relationship between oxygen-derived free-radicals and the degree of pulmonary injury in acute necrotizing pancreatitis, lipid peroxide (LPO) in lung tissues, bronchoalveolar lavage fluid and serum were measured in 10 adult Mongrel dogs with acute necrotizing pancreatitis induced by injection of 5% sodium taurocholate into the pancreatic duct. Compared with the controls (n = 10), the weight of lung was increased (241.2 +/- 33.7 g vs 121.2 +/- 51.4 g, P < 0.05). LPO of bronchoalveolar lavage fluid (BALF) was higher (3.56 +/- 1.64 mumol/L vs 0.75 +/- 0.31 mumol/L, P < 0.05), LPO in peripheral and portal vein 10 hours after induction of acute pancreatitis was also significantly increased. The LPO content of lung tissue was not higher than that of the control group, but hemorrhage within alveolar space and infiltration by polymorphonuclear and phagocytic cells was seen on histological examination. In conclusion, lipid peroxidation could be an important cause of pulmonary injury in acute necrotising pancreatitis.


Assuntos
Peróxidos Lipídicos/metabolismo , Pulmão/patologia , Oxigênio/metabolismo , Pancreatite/metabolismo , Doença Aguda , Animais , Líquido da Lavagem Broncoalveolar , Cães , Radicais Livres , Pulmão/metabolismo , Pancreatite/induzido quimicamente , Pancreatite/patologia , Ácido Taurocólico
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