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Purpose@#The aim of this study was to compare the diameter and volume of liver metastases on CT images in relation to overall survival and tumor response in patients with gastric cancer liver metastases (GCLM) treated with chemotherapy. @*Materials and Methods@#We recruited 43 patients with GCLM who underwent chemotherapy as a first-line treatment. We performed a three-dimensional quantification of the metastases for each patient. An independent survival analysis using the Response Evaluation Criteria in Solid Tumors (RECIST) was performed and compared to volumetric measurements. Overall survival was evaluated using Kaplan-Meier analysis and compared using Cox proportional hazard ratios following univariate analyses. @*Results@#When patients were classified as responders or non-responders based on volumetric criteria, the median overall survival was 23.6 months [95% confidence interval (CI), 8.63–38.57] and 7.6 months (95% CI, 3.78–11.42), respectively (p = 0.039). The volumetric analysis and RECIST of the non-progressing and progressing groups showed similar results based on the Kaplan-Meier method (p = 0.006) and the Cox proportional hazard model (p = 0.008). @*Conclusion@#Volumetric assessment of liver metastases could be an alternative predictor of overall survival for patients with GCLM treated with chemotherapy.
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Purpose@#The aim of this study was to compare the diameter and volume of liver metastases on CT images in relation to overall survival and tumor response in patients with gastric cancer liver metastases (GCLM) treated with chemotherapy. @*Materials and Methods@#We recruited 43 patients with GCLM who underwent chemotherapy as a first-line treatment. We performed a three-dimensional quantification of the metastases for each patient. An independent survival analysis using the Response Evaluation Criteria in Solid Tumors (RECIST) was performed and compared to volumetric measurements. Overall survival was evaluated using Kaplan-Meier analysis and compared using Cox proportional hazard ratios following univariate analyses. @*Results@#When patients were classified as responders or non-responders based on volumetric criteria, the median overall survival was 23.6 months [95% confidence interval (CI), 8.63–38.57] and 7.6 months (95% CI, 3.78–11.42), respectively (p = 0.039). The volumetric analysis and RECIST of the non-progressing and progressing groups showed similar results based on the Kaplan-Meier method (p = 0.006) and the Cox proportional hazard model (p = 0.008). @*Conclusion@#Volumetric assessment of liver metastases could be an alternative predictor of overall survival for patients with GCLM treated with chemotherapy.
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In a study of the fungal diversity on Ulleung Island in Korea, three novel strains of Penicillium were isolated. Different sites on Ulleung Island were selected for collecting endophytic fungi, and three endophytic fungal strains showed unique morphological characteristics. DNA sequence of the internal transcribed spacer, β-tubulin, calmodulin, and RNA polymerase II second largest subunit regions of the strains were analyzed and they showed unique taxonomic position from the other species of Penicillium section Sclerotiora. The new strains were named Penicillium ulleungdoense sp. nov. As the novel endophytic Penicillium taxa were discovered in a unique environment, the data could be meaningful for understanding the geographical distribution of Ascomycetes on Ulleung Island.
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PURPOSE: The purpose of this study was to examine effects of music intervention on environmental stress and sleep quality in liver transplant patients who are receiving care in one-person isolation rooms of an ICU. METHODS: The study was a quasi-experimental design pre-and-post nonequivalent control group. Participants were 37 patients (18 in the experimental group and 19 in the control group) who, after receiving liver transplant, were hospitalized in one-person isolation rooms of the ICU. The study covered patients admitted between August 2016 and December 2017. Earplugs and sleep shades were provided as ordinary care to both experimental and control groups, and music intervention was provided to the experimental group three times a day for 30 minutes each from the first day of hospitalization. RESULTS: The first hypothesis, “The experimental group who received music intervention will experience a lower environmental stress level than the control group” was supported (Z=−3.212, p<.001). The second hypothesis, “The experimental group who received music intervention will experience a higher sleep quality than the control group” was also supported (t=3.715, p=.001). CONCLUSION: Findings show that music intervention is an effective nursing intervention to reduce environmental stress and improve sleep quality in liver transplant patients in the ICU.
Subject(s)
Humans , Ear Protective Devices , Hospitalization , Intensive Care Units , Liver Transplantation , Liver , Music Therapy , Music , NursingABSTRACT
PURPOSE@#The aim of this study was to compare the measurements of diameter and volume of hepatic metastases from CT images with the overall survival and tumor response, in patients with unresectable liver metastases of colorectal cancer treated with a targeted agent.@*MATERIALS AND METHODS@#We recruited 43 patients with unresectable liver metastases of colorectal cancer, in whom targeted therapy was used as the first-line treatment. Three-dimensional quantification of the volume of hepatic metastases was performed for each patient. An independent survival analysis using the Response Evaluation Criteria in Solid Tumors guidelines was performed and compared to the volumetric measurement. Overall survival was evaluated using the Kaplan-Meier analysis and compared to the Cox proportional hazard ratios (HRs) following univariate and multivariate analyses.@*RESULTS@#In patients classified as non-progressing and progressing by the volumetric criteria, the median overall survival time was 21 months [95% confidence interval (CI): 491.25–768.75] and 11 months (95% CI: 0–949.42), respectively (p = 0.001). Using a multivariate analysis, we found that volumetric response (HR: 3.467; p = 0.002) was a significant factor affecting the overall survival in patients with liver metastases of colorectal cancer.@*CONCLUSION@#Volumetric assessment of liver metastases could be an alternative predictor of the overall survival of patients with liver metastases of colorectal cancer treated with a targeted agent.
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Functional neuroimaging studies have revealed the importance of the role of cognitive and psychological factors and the dysregulation of the brain-gut axis in functional gastrointestinal disorder patients. Although only a small number of neuroimaging studies have been conducted in functional gastrointestinal disorder patients, and despite the fact that the neuroimaging technique requires a high level of knowledge, the technique still has a great deal of potential. The application of functional magnetic resonance imaging (fMRI) technique in functional gastrointestinal disorders should provide novel methods of diagnosing and treating patients. In this review, basic knowledge and technical/practical issues of fMRI will be introduced to clinicians.
Subject(s)
Humans , Brain , Functional Neuroimaging , Gastrointestinal Diseases , Magnetic Resonance Imaging , Neuroimaging , PsychologyABSTRACT
To systematically review the effects of probiotics on central nervous system function in animals and humans, to summarize effective interventions (species of probiotic, dose, duration), and to analyze the possibility of translating preclinical studies. Literature searches were conducted in Pubmed, Medline, Embase, and the Cochrane Library. Only randomized controlled trials were included. In total, 38 studies were included: 25 in animals and 15 in humans (2 studies were conducted in both). Most studies used Bifidobacterium (eg, B. longum, B. breve, and B. infantis) and Lactobacillus (eg, L. helveticus, and L. rhamnosus), with doses between 10⁹ and 10¹⁰ colony-forming units for 2 weeks in animals and 4 weeks in humans. These probiotics showed efficacy in improving psychiatric disorder-related behaviors including anxiety, depression, autism spectrum disorder (ASD), obsessive-compulsive disorder, and memory abilities, including spatial and non-spatial memory. Because many of the basic science studies showed some efficacy of probiotics on central nervous system function, this background may guide and promote further preclinical and clinical studies. Translating animal studies to human studies has obvious limitations but also suggests possibilities. Here, we provide several suggestions for the translation of animal studies. More experimental designs with both behavioral and neuroimaging measures in healthy volunteers and patients are needed in the future.
Subject(s)
Animals , Humans , Anxiety , Autism Spectrum Disorder , Bifidobacterium , Central Nervous System , Depression , Healthy Volunteers , Lactobacillus , Memory , Neuroimaging , Obsessive-Compulsive Disorder , Probiotics , Research Design , Stem Cells , Sulfalene , TranslatingABSTRACT
BACKGROUND/AIMS: Osteoporosis is common in chronic obstructive pulmonary disease (COPD) patients. The relationship between osteoporosis and COPD has been primarily reported in patients with moderate to severe COPD, but there is no report in the general population. The aim of this study is to investigate the relationship between bone mineral density (BMD) and lung function in the general Korean population. METHODS: This study was based on data acquired from the Fourth and Fifth Korea National Health and Nutrition Examination Surveys (KNHANES IV and V), conducted from 2008 to 2010. The study population included 4,501 subjects (aged ≥ 50 years) who underwent both spirometry and BMD. The study populations were divided into two groups by sex to correct for the effects of gender on BMD. All female participants were postmenopausal women. RESULTS: The BMD values of the femur neck, total femur, and L-spine tended to decrease with degree of airflow limitation in both genders. To correct confounding factors, data were analyzed and adjusted for age, body mass index, fat free mass index, body fat percentage, smoking amount, parathyroid hormone levels, daily calcium and phosphorus intake, and alkaline phosphatase (ALP) levels. While the BMD of the femur neck, total femur, and L-spine was reduced significantly as age and ALP increased, the correlation between airway obstruction and BMD of all regions disappeared in both genders. CONCLUSIONS: In the general population aged 50 years and older, diminution of BMD is not associated with airway obstruction. Further investigation along other factors is needed to determine the possible role of pulmonary function and BMD.
Subject(s)
Female , Humans , Adipose Tissue , Airway Obstruction , Alkaline Phosphatase , Body Mass Index , Bone Density , Calcium , Femur , Femur Neck , Korea , Lung , Nutrition Surveys , Osteoporosis , Parathyroid Hormone , Phosphorus , Pulmonary Disease, Chronic Obstructive , Respiratory Function Tests , Smoke , Smoking , SpirometryABSTRACT
A 43-year-old woman with breast cancer who was on neoadjuvant chemotherapy presented with cough, sputum and mild fever. High-resolution computed tomography showed diffuse ground glass opacities in bilateral lungs and subpleural patchy consolidations. Initially, she was thought to have pneumonia or interstitial lung diseases such as drug-induced pneumonitis and treated with antibiotics and steroids. She subsequently got breast cancer surgery because of disease progression, and concurrent thoracoscopic lung biopsy revealed metastatic carcinoma of the lung from breast cancer. The diagnosis of suspected interstitial lung disease can be made without lung biopsy, but malignancy should always be considered and lung biopsy should be performed in the absence of a definitive clinical diagnosis.
Subject(s)
Female , Humans , Anti-Bacterial Agents , Biopsy , Breast , Breast Neoplasms , Cough , Diagnostic Imaging , Disease Progression , Fever , Glass , Lung , Lung Diseases, Interstitial , Neoplasm Metastasis , Pneumonia , Sputum , SteroidsABSTRACT
A 55-year-old woman was admitted for an elevated serum carbohydrate antigen-125 (CA-125) level, and a left pleural effusion, which were detected at a routine health examination. Computed tomography of the chest was performed upon admission, revealing extensive bilateral paratracheal and mediastinal lymph node enlargement with a massive left-sided pleural effusion. Subsequent analysis of the pleural fluid demonstrated consistency with an exudate, no evidence of malignant cells, and a normal adenosine deaminase. However, the pleural fluid and serum CA-125 levels were 2,846.8 U/mL and 229.5 U/mL, respectively. A positron emission tomography did not reveal any primary focus of malignancy. Finally, a surgical mediastinoscopic biopsy of several mediastinal lymph nodes was performed, revealing non-necrotizing granulomas, consistent with sarcoidosis. After a month of treatment of prednisolone, the left pleural effusion had resolved, and after 2 months the serum CA-125 level was normalized.
Subject(s)
Female , Humans , Adenosine Deaminase , Biopsy , CA-125 Antigen , Exudates and Transudates , Granuloma , Lymph Nodes , Pleural Effusion , Positron-Emission Tomography , Prednisolone , Sarcoidosis , ThoraxABSTRACT
BACKGROUND: Cigarette smoke induced release of iron could alter iron metabolism in the lungs of chronic smokers and contribute to the increase in the total oxidative burden on the lungs of smokers. In previous studies, ferritin levels of bronchoalveolar lavage fluid in smokers were elevated. The aim of the present study was to investigate the relationship between serum ferritin concentration, smoking and lung function in Korean people. METHODS: This study was based on the data acquired in the second year (2008) of the Forth National Health and Nutrition Examination Survey that was conducted from 2007 to 2009. The analysis included 2,244 subjects who were older than 20 years and had complete data from both lung function test and serum ferritin concentration. Among participants, 1,076 were male and 1,168 were female. RESULTS: Mean serum ferritin concentrations in males were 120.3+/-80.1 microg/L and 47.9+/-39.8 microg/L in females. There were no differences in serum ferritin concentrations between non-smokers and smokers after adjusting for age, body mass index, and amounts of alcohol. Serum ferritin concentrations were associated with smoking amounts by simple linear regression but not associated with smoking amounts after adjustment with age, body mass index, and amounts of alcohol in both males and females. Lung function was not associated with serum ferritin concentrations. CONCLUSION: Our data suggested that serum ferritin concentrations are not related with smoking and lung function.
Subject(s)
Female , Humans , Male , Body Mass Index , Bronchoalveolar Lavage Fluid , Ferritins , Iron , Linear Models , Lung , Nutrition Surveys , Respiratory Function Tests , Smoke , Smoking , Tobacco ProductsABSTRACT
BACKGROUND: The level of urine cotinine is an indicator of tobacco smoke exposure. The purpose of this study is to investigate urine cotinine for the purpose of assessing the smoking status of Korean smokers and non-smokers exposed to tobacco smoke. METHODS: The subjects were identified from the 2007-2009 and the 2010 data sets of the Korea National Health and Nutrition Examination Survey (KNHANES). They were assigned as non-smokers, current smokers and ex-smokers. Non-smokers were also divided into three subset groups according to the duration of smoke exposure. Each group was stratified by gender prior to analysis. RESULTS: The median value of urine cotinine in the male current smokers was 1,221.93 ng/mL which was the highest among all groups. The difference between levels of urine cotinine for male and the female groups was statistically significant (p<0.01). In the female group, passive smoke exposure groups reported higher urine cotinine levels than non-exposure groups (p=0.01). The cutoff point for the discrimination of current smokers from non-smokers was 95.6 ng/mL in males and 96.8 ng/mL in females. The sensitivity and specificity were 95.2% and 97.1%, respectively, in males, 96.1% and 96.5% in females. However, the determination of urine cotinine level was not useful in distinguishing between passive smoke exposure groups and non-exposure groups. CONCLUSION: Urine cotinine concentration is a useful biomarker for discriminating non-smokers from current smokers. However, careful interpretation is necessary for assessing passive smoke exposure by urine cotinine concentration.