The Effect of Neuromuscular Electrical Stimulation on Pulmonary Function, Gait Ability, and Quality of Life in Patients with Chronic Obstructive Pulmonary Disease

PURPOSE: This study aims to investigate the changes in pulmonary function, gait ability, and quality of life when NMES is applied along with CBE and to provide basic clinical data to be used in pulmonary rehabilitation guidelines for patients with COPD to treat patients with severe COPD. METHODS: For this study, CBE and NMES of quadriceps femoris on both sides were applied to the experimental group (n=10), and only CBE was applied to the control group (n=10). For a pre-test, a 6-minute walk test was performed, and pulmonary function and health-related quality of life were measured. Moreover, an exercise program was applied to each group for 30 minutes per session, 5 times a week, for 6 weeks. After that, a post-test was conducted the same way as the pre-test. RESULTS: In the within-group comparison, there were significant differences in forced expiratory volume in one second, 6-minute walk test and health-related quality of life between the experimental group and the control group (p < 0.01)(p < 0.05). In the between-group comparison, the experimental group showed an increase in forced expiratory volume in one second and 6-minute walk test (p < 0.05) and showed a decline in health-related quality of life (p < 0.05). CONCLUSION: The 6-weeks NMES program improved health-related quality in patients with severe COPD by increasing expiratory volume by reinforcing the function of quadriceps femoris. This finding implies that NMES could be an alternative mode for improving physical functions of patients with severe COPD, who cannot participate in a breathing exercise program or are reluctant to participate.

Prospective phase II trial of regional hyperthermia and whole liver irradiation for numerous chemorefractory liver metastases from colorectal cancer

PURPOSE: A prospective phase II trial was conducted to evaluate the effectiveness and toxicity of regional hyperthermia and whole liver irradiation (WLI) for numerous chemorefractory liver metastases from colorectal cancer. MATERIALS AND METHODS: Enrolled patients had numerous chemorefractory hepatic metastases from colorectal cancer. Five sessions of hyperthermia and seven fractions of 3-gray WLI were planned. Health-related quality of life (HRQoL) was determined using the Korean version of the European Organization for Research and Treatment of Cancer quality of life questionnaire C-30 and the Functional Assessment of Cancer Therapy-Hepatobiliary version 4.0. Objective and pain response was evaluated. RESULTS: A total of 12 patients consented to the study and the 10 who received WLI and hyperthermia were analyzed. WLI was completed as planned in nine patients and hyperthermia in eight. Pain response was partial in four patients and stable in four. Partial objective response was achieved in three patients (30.0%) and stable disease was seen in four patients at the 1-month follow-up. One patient died 1 month after treatment because of respiratory failure related to pleural metastasis progression. Other grade III or higher toxicities were detected in three patients; however, all severe toxicities were related to disease progression rather than treatment. No significant difference in HRQoL was noted at the time of assessment for patients who were available for questionnaires. CONCLUSION: Combined WLI and hyperthermia were well tolerated without severe treatment-related toxicity with a promising response from numerous chemorefractory hepatic metastases from colorectal cancer.

ERRATUM: Role of Chemotherapy in Stage II Nasopharyngeal Carcinoma Treated with Curative Radiotherapy / Journal of the Korean Cancer Association, 대한암학회지

In this article, an protocol number error was found in the last paragraph of the introduction part, page 872.

Comparison of Clinicopathological Features and Treatment Results between Invasive Lobular Carcinoma and Ductal Carcinoma of the Breast / 한국유방암학회지

PURPOSE: The purpose of this study was to assess the incidence of invasive lobular carcinoma (ILC) and to compare the clinicopathological features and treatment results after breast conserving surgery (BCS) followed by radiotherapy between ILC and invasive ductal carcinoma (IDC). METHODS: A total of 1,071 patients who underwent BCS followed by radiotherapy were included in the study. Medical records and pathological reports were retrospectively reviewed. RESULTS: The incidence of ILC was 5.2% (n=56). Bilateral breast cancer, lower nuclear grade, and hormone receptor-positive breast cancer were more frequent in patients with ILC than in those with IDC. There were no cases of lymphovascular invasion or the basal-like subtype in patients with ILC. There were no statistically significant differences in patterns of failure or treatment outcomes between patients with ILC and those with IDC. The development of metachronous contralateral breast cancer was more frequent in patients with IDC (n=27). Only one patient with ILC developed contralateral breast cancer, with a case of ductal carcinoma in situ. CONCLUSION: The incidence of ILC was slightly higher in our study than in previous Korean studies, but was lower than the incidences reported in Western studies. The differences we observed in clinico pathological features between ILC and IDC were similar to those described elsewhere in the literature. Although there were no statistically significant differences, there was a trend toward better disease-specific survival and disease-free survival rates in patients with ILC than in those with IDC.

Role of Chemotherapy in Stage II Nasopharyngeal Carcinoma Treated with Curative Radiotherapy / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: To define the role of neoadjuvant and concurrent chemotherapy in stage II nasopharyngeal carcinoma, we compared the treatment outcomes of patients treated with curative radiotherapy with or without chemotherapy. MATERIALS AND METHODS: From 2004 to 2011, 138 patients with American Joint Committee on Cancer (AJCC) 2002 stage II nasopharyngeal carcinoma were treated with curative radiotherapy in 12 hospitals in South Korea. Treatment methods included radiotherapy alone in 34 patients, neoadjuvant chemotherapy followed by radiotherapy alone in seven, concurrent chemoradiotherapy in 80, and neoadjuvant chemotherapy followed by concurrent chemoradiotherapy in 17. Adjuvant chemotherapy was used in 42 patients. Total radiation dose ranged from 64 Gy to 74.2 Gy (median, 70 Gy). RESULTS: Median follow-up was 48 months (range, 7 to 97 months) for all patients. At the last follow-up, 13 patients had died and 32 had experienced treatment failure; locoregional failure occurred in 14, distant failure in 16, and both in two. Five-year locoregional relapse-free survival, distant metastasis-free survival, progression-free survival, and overall survival were 86.2%, 85.5%, 74.4%, and 88.2%, respectively. Multivariate analyses showed that the significant prognostic factors were concurrent chemotherapy and N stage for locoregional relapse-free survival, concurrent chemotherapy for progression-free survival, and age and N stage for overall survival. Neither neoadjuvant nor concurrent chemotherapy improved distant metastasis-free survival. CONCLUSION: Concurrent chemotherapy significantly improved 5-year locoregional relapse-free survival and progression-free survival in stage II nasopharyngeal carcinoma. However, neoadjuvant chemotherapy failed to improve either.

Prognostic and predictive value of liver volume in colorectal cancer patients with unresectable liver metastases

PURPOSE: To determine the prognostic and predictive value of liver volume in colorectal cancer patients with unresectable liver metastases. MATERIALS AND METHODS: Sixteen patients received whole liver radiotherapy (WLRT) between January 1997 and June 2013. A total dose of 21 Gy was delivered in 7 fractions. RESULTS: The median survival time after WLRT was 9 weeks. In univariate analysis, performance status, serum albumin and total bilirubin level, liver volume and extrahepatic metastases were associated with survival. The mean liver volume was significantly different between subgroups with and without pain relief (3,097 and 4,739 mL, respectively; p = 0.002). CONCLUSION: A larger liver volume is a poor prognostic factor for survival and also a negative predictive factor for response to WLRT. If patients who are referred for WLRT have large liver volume, they should be informed of the poor prognosis and should be closely observed during and after WLRT.

Scleroderma-like Manifestation in a Patient with Primary Systemic Amyloidosis: Response to High-dose Intravenous Immunoglobulin and Plasma Exchange

A 54-year-old Korean male with scleroderma-like manifestation of primary systemic amyloidosis presented with firm cutaneous induration of face and distal extremities, subcutaneous induration of the trunk and proximal extremities, limited range of motion in all joints, hoarseness, and dysphagia. Monthly high-dose intravenous immunoglobulin (hdIVIg) was given (three treatments, each time administering 0.4 g/kg per day for five days), and both signs and symptoms began to improve. However, the quantitative analyses of serum protein did not improve. Therapeutic plasma exchange (TPE) was performed monthly to clear the elevated serum immunoglobulin, and after several treatments, their levels normalized and symptoms were maintained in the improved state for more than two years. To summarize, hdIVIg and TPE combination therapy may be used as a safe first-line treatment for patients with primary systemic amyloidosis presenting with symptomatic monoclonal gammopathy.

Weber-Christian Disease Treated with Steroid Pulse Therapy / 대한피부과학회지

Weber-Christian disease is an inflammatory disease of subcutaneous fat tissue which is characterized by relapsing, febrile tender nodules and histologically lobular panniculitis. Many cases originally considered as examples of Weber-Christian disease were later found to be other diseases when lobular panniculitis was reclassified, and some authors believe that Weber-Christian disease should no longer be considered as a distinctive entity. However, there are still occasional cases which cannot be diagnosed as other specific diseases but have the characteristic manifestations of Weber-Christian disease, and they attest to the fact that Weber-Christian disease could be a distinctive disease entity. We report here a case of Weber-Christian disease in a 22-year-old female who was treated successfully with steroid pulse therapy.