ABSTRACT
BACKGROUND: As the importance of the quality of life is emphasiged in our society, efforts to improve the quality of life in the field of medicine have intensified. Terminal cancer patients, facing death, need not only biomedical therapy, but also systematic and continuous treatments such as mental or psycho-social intervention. The purpose of this study was to investigate the family caregiver's depression level and the associated factors. METHODS: The survey was conducted with 52 family caregivers of the terminal cancer patients who had been hospitalized at Chungnam National University Hospital from October 2003 to June 2004. The questionnaire consisted of the general characteristics of the subjects, BDI (Beck's Depression Inventory) evaluating the depression level and family APGAR score evaluating the family function. RESULTS: The mean age of the subjects was 50.4 years. The relationship with patients as 'spouse' accounted for 30 individuals (57.7%). The mean (+/-SD) BDI score was 24.0 (+/-10.9) points and 57.7 percent of the subjects were suggested to have depression tendency (> or =21 point). There was no relationship between the caregiver's depression level and their gender, religion, household income and family APGAR score. However, the depression level was significant related to the total caregiving duration (P=0.001), visiting frequency of visitors (P=0.004) and caregiving hours per day (P= 0.005). CONCLUSION: More than half of the family caregivers were suggested to have depression tendency. The depression level as influenced by the burden of caregiving and the visiting frequency of visitors. There is a need to activate social resources to share the burden of caregiving and to develop continuous and comprehensive care for terminal cancer patients and their families.
Subject(s)
Humans , Apgar Score , Caregivers , Depression , Family Characteristics , Quality of Life , Surveys and QuestionnairesABSTRACT
BACKGROUND: There has been contradictory reports regarding the homing potential of hematopoietic cells briefly exposed to hematopoietic growth factors in vitro. To get a resolution to this controversy, we investigated the effects of short-term growth factor treatment of hematopoietic cells on the expression of CXCR4 and adhesion molecules, and the chemotaxis in response to stromal cell-derived factor-1 (SDF-1), which is widely accepted to play a critical role in bone marrow (BM) homing of hematopoietic stem cells. METHODS: BM and cord blood(CB) CD34+ cells were incubated with various hematopoietic growth factors including IL-1beta, IL-3, IL-6, G-CSF, GM-CSF, stem cell factor (SCF), flk-2 ligand, and thrombopoietin, alone or in combination for up to 48 hours. Before and after the incubation, the expression of CXCR4 and adhesion molecules of CD34+ cells was analyzed using flow cytometry. SDF-1-mediated transmembrane or transendothelial migration of CD34+ cells, cobblestone area-forming cells (CAFCs), and/or long-term culture-initiating cells (LTC-ICs) was measured using Transwell(TM) system. RESULTS: VLA-4 was moderately up-regulated by the incubation of the cells with IL-3 and SCF, and ICAM-1 was slightly up-regulated by IL-1 and IL-3. The expression of L-selectin, PECAM-1 or LFA-1 was not altered by any growth factors. With the incubation of the cells in the absence of growth factors or SDF-1, CXCR4 expression of CD34+ cells was rapidly increased, reaching a plateau at 24 hours. The spontaneous up-regulation was abrogated with the addition of SDF-1. In agreement with the up-regulation of CXCR4, CD34+ cells incubated for 40 hours showed much enhanced chemotaxis in response to SDF-1 compared to non-incubated cells (24.7 3.5% vs. 7.0 1.6%, P=0.01). Any growth factors examined in this study did not alter the CXCR4 expression of CD34+ cells. Neither did growth factors affect the transendothelial migration of LTC-ICs toward bone marrow stromal cells as well as the SDF-1-induced transmembrane chemotaxis of CD34+ cells and CAFCs. CONCLUSION: Short-term treatment of hemo-topoietic cells with hematopoietic growth factors does not alter the expression of CXCR4 or SDF-1-mediated transendothelial chemotaxis.
Subject(s)
Platelet Endothelial Cell Adhesion Molecule-1 , Bone Marrow , Chemotaxis , Flow Cytometry , Granulocyte Colony-Stimulating Factor , Granulocyte-Macrophage Colony-Stimulating Factor , Hematopoietic Stem Cells , Integrin alpha4beta1 , Intercellular Adhesion Molecule-1 , Intercellular Signaling Peptides and Proteins , Interleukin-1 , Interleukin-3 , Interleukin-6 , L-Selectin , Lymphocyte Function-Associated Antigen-1 , Mesenchymal Stem Cells , Stem Cell Factor , Thrombopoietin , Transendothelial and Transepithelial Migration , Up-RegulationABSTRACT
PURPOSE: The aim of this study was to investigate treatment results, toxicity and efficacy of hyperfractionated radiation therapy combined with paclitaxel for paraaortic node recurrence in cervix cancer. MATERIALS AND METHODS: Between September 1997 to March 1999, 12 patients with paraaortic node recurrence in cervix cancer who previously received radical or postoperative radiotherapy were treated with hyperfractionated radiation therapy combined with paclitaxel. Of these, 2 patients who irradiated less than 30 Gy were excluded, 10 patients were eligible for this study. Median age was 5 1 years. Initial FlGO stage was 1 stage IB1, 2 stage IIA, 7 stage IIB. For initial treatment, 7 patients received radical radiotherapy and 3 received postoperative radiotherapy. The paraaortic field encompassed the gross recur rent disease with superior margin at T 12, and inferior margin was between L5 and S 1 with gap for previously pelvic radiation field. The radiation field was initially anterior and posterior opposed field followed by both lateral field. The daily dose was 1.2 Gy, twice daily fractions, and total radiotherapy dose was between 50.4 and 60 Gy(median, 58.8 Gy). Concurrent chemotherapy was done with paclitaxel as a radiosensitizer. Dose range was from 20 mg/m to 30 mg/m (median, 25 mg/m'), and cycle of chemotherapy was from 3 to 6 (median, 4.5 cycle). Follow-up period ranged from 3 to 21 months. RESULTS: Interval between initial diagnosis and paraaortic node recurrence was range from 2 to 63 months (median, 8 months). The 1 year overall survival rate and median survival were 75% and 9.5 months, respectively. The 1 year disease free survival rate and median disease free survival were 30% and 3 7 months, respectively. At 1 month after treatment, 4 (40%) achieved a complete response and 6 (63%) experienced a partial response and all patients showed response above the partial response. There was distant metastasis in 6 patients and pelvic node recurrence in 2 patients after paraaortic node irradialion. There was 2 patients with grade 3 to 4 leukopenia and 8 patients with grade 1 to 2 nausea/ vom ting which was usually tolerable with antiemetic drug. There was no chronic complication in abdomen and pelvis during follow up period. CONCLUSION: Hyperfractionated radiation therapy combined with paclitaxel as a radiosensitizer showed high response rate and few complication rate in paraaortic node recurrence in cervix cancer. Therefore, present results suggest that hyperfractionated radiation therapy combined with paclitaxel chemotherapy can be used as optimal treatment modality in this patients.
Subject(s)
Female , Humans , Abdomen , Cervix Uteri , Diagnosis , Disease-Free Survival , Drug Therapy , Follow-Up Studies , Leukopenia , Neoplasm Metastasis , Paclitaxel , Pelvis , Radiotherapy , Recurrence , Survival Rate , Tolnaftate , Uterine Cervical NeoplasmsABSTRACT
BACKGROUND: THP-adriamycin ia a tetrahydropyranyl derivative of adriamycin with compatible anti-lymphoma effect but fewer side effects, especially cardiac, nausea/vomiting and alopecia. So we performed a multicenter study of 4-drug combination chemotherapy, THP-COP regimen for patients with non-Hodgkin's lymphoma to evaluate the response rate, survival time and toxicity by Malignant Lymphoma Study Group in Korea. METHODS: Between June 1996 and Feb. 1997, previously untreated stage II/III/IV intermediate and high-grade non-Hodgkin's lymphoma patients were treated with a THP-COP regimen including THP-adriamycin 40 mg/m2 on day 1, cyclophosphamide 750 mg/m2 on day 1, oncovin 1.4 mg/m2 on day 1, and prednisolone 100 mg PO on day 1-5 with 3 weeks interval. RESULTS: Twenty six patients (89.7%) were evaluable. Patient characteritics include: median age 54.8 years (16-76) and 13 patients were 60 years or old; clinical stage II in 9 patients (34.6%), stage III in 7 patients (26.9%), and stage IV in 10 patients (38.5%). Objective response were 13 CR, 7 PR, 6 PD with 76.9% response rate. Six months and 1 year survival rates and progression-free survival rates were 87.8%, 70.4%, and 85.0%, 60.5% respectively. Grade 3/4 toxicities were anemia in 7.7%, neutropenia in 53.8%, thrombocytopenia in 3.8%, vomiting in 7.7%, alopecia in 7.7% and increased SGOT in 3.8%. Prognostic significance of age and International Prognostic Index were not demonstrated. CONCLUSION: THP-COP combination chemotherapy is active in advanced stage, non-Hodgkin's lymphoma with low incidence of vomiting and alopecia.
Subject(s)
Humans , Alopecia , Anemia , Aspartate Aminotransferases , Cyclophosphamide , Disease-Free Survival , Doxorubicin , Drug Therapy , Drug Therapy, Combination , Incidence , Korea , Lymphoma , Lymphoma, Non-Hodgkin , Neutropenia , Prednisolone , Survival Rate , Thrombocytopenia , Vincristine , VomitingABSTRACT
No abstract available.
Subject(s)
Cell Proliferation , Interleukin-1 , Leukemia, Myelogenous, Chronic, BCR-ABL PositiveABSTRACT
No abstract available.
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No abstract available.
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Two cases of familial asymmetric septal hypertrophy diagnosed by myocardial biopsy and clinical studies are reported with literature reviewed. Myocardial biopsy was done at right ventricular septal wall, and pedigree of family members was observed clinically and examined by noninvasive methods including chest X-ray and echocardiography.