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1.
Rev. argent. mastología ; 40(147): 16-24, sept. 2021. tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1400932

ABSTRACT

Introducción: El subtipo luminal de cáncer de mama es sensible a la terapia antiestrógenica y muestra un mejor pronóstico que el del cáncer de mama con receptor del factor de crecimiento epidérmico humano 2 enriquecido (HER2) o triple negativo. Sin embargo, el cáncer de mama tipo luminal es heterogéneo y puede tener características clínicas agresivas. Investigamos las implicaciones clínicas y pronósticas de la baja expresión del receptor de estrógeno en un grupo de carcinomas luminales HER2 negativos. Material y método: Recolectamos los datos de un grupo de 367 cánceres de mama luminales HER2 negativo que eran receptor de estrógeno (RE) positivos y receptor de progesterona (RP) positivos o negativos y los dividimos en RE+ alto (RE) y RE+ bajo (REB). Se definió REB de acuerdo a la úl- tima actualización ASCO /CAP de las recomendaciones del testeo de de RH en cáncer de mama como aquellos con expresión entre 1 y 10%. Analizamos los datos clínico-patológicos y la supervivencia según los grupos de RE y REB. Resultados: Edad media 63,9+12.8 años. Tamaño tumoral: 1,9 +0.9 cm. Se realizó Mastectomía radical modificada en 61% de los pacientes. Tipo histológico más frecuente: Ductal Infiltrante en 89,5% de los casos. Hallazgos que concuerdan con publicaciones de otros centros. Discusión: Los tumores REB resultaron en 1,6%. No hubo diferencias estadísticas en el estadio TNM y tipo histológico. Sin embargo, el grupo REB se asoció con menor edad (47 vs 57 años), tipo luminal B, mayor grado histológico y Ki 67 alto (>30%). Si bien las diferencias en supervivencia global (SG) no fueron significativas (p=0,279), observamos que a partir de los 60 meses de seguimiento la SG fue menor en el grupo REB que en el grupo RE. Conclusiones: La baja expresión del RE se asoció peor pronóstico. Podríamos considerar la baja expresión del RE como marcador pronóstico en el subtipo luminal HER2 negativo de cáncer de mama. Debido a la baja incidencia de casos REB consideramos necesario estudios adicionales con mayor número de pacientes que podrían revelar su papel negativo en el cáncer de mama.


Introduction: The luminal subtype of breast cancer is sensitive to antiestrogenic therapy and shows a better prognosis than human epidermal grow- th factor receptor 2 (HER2) enriched or triple negative breast cancer. However, luminal type breast cancer is heterogeneous and can have aggressive clinical features. We investigated the clinical and prognostic implications of low estrogen receptor expression in a group of HER2-negative luminal carcinomas. Material and method: We collected data from a group of 367 HER2 negative luminal breast cancers that were estrogen receptor (ER) positive and progesterone receptor (PR) positive or negative and divided them into ER + high (ER) and ER + low (ERL). ERL was defined when RE expression was < 10%. We analyzed the clinical-pathological data and survival accor- ding to the ER and ERL groups. Results: ERL tumors resulted in 1.6%. There were no statistical differences in TNM stage and histological type. However, the ERL group was as- sociated with younger age (47 vs 57 years), luminal type B, higher histological grade, and high Ki 67 (> 30% ). Although the differences in overall survival (OS) were not significant (p = 0.279), we observed that after 60 months of follow-up the OS was lower in the ERL group than in the ER group. Conclusions: Low ER expression was associated with a worse prognosis. We could consider low ER expression as a prognostic marker in the HER2-ne- gative luminal subtype of breast cancer. Due to the low incidence of ERL cases, we consider necessary additional studies with a larger number of patients that could reveal its negative role in breast cancer.


Subject(s)
Female , Breast Neoplasms , Phenobarbital , Prognosis , Breast , Receptors, Estrogen
2.
Braz. dent. sci ; 24(1): 1-9, 2021. tab, ilus
Article in English | BBO, LILACS | ID: biblio-1141391

ABSTRACT

Objective: Gingival hyperplasia (GH) is one of the side effects of anticonvulsant drugs. The aim of this study was to verify the prevalence of GH associated with the use of anticonvulsant, through a systematic review. Material and Methods: Systematic search was done at databases Pubmed and Embase between January 1984 and March of 2020 for identification of articles addressing the prevalence of GH associated with the use of anticonvulsant drugs. The methodological index for non-randomized studies (MINORS) was independently assessed for quality in the selected papers. Results: The search identified 4.471 references. Nine articles were selected and evaluated 632 participants. All of the studies included in the systematic review showed a low risk of bias. The anticonvulsants used by patients were carbamazepine, ethosuximide, phenytoin, primidone, phenobarbital, sodium valproate. The studies showed a correlation between different types of anticonvulsants and GH prevalence, with a range from 0% to 73%. Among the anticonvulsants used, phenytoin showed the greatest incidence of GH, varying between 15.61% and 73% in patients. Conclusion: In the analysis of the results obtained in the literature, it is possible to notice that the great majority of studies presented incidence of GH associated with anticonvulsant use. However, further studies are necessary to understand the anticonvulsant action mechanism inducing GH, as well as the prevention forms, given that GH is a significant side effect. (AU)


Objetivo: Hiperplasia gengival (HG) é um dos efeitos colaterais das drogas anticonvulsivantes. O objetivo deste estudo foi verificar a prevalência de HG associada ao uso de anticonvulsivantes, por meio de uma revisão sistemática. Material e Métodos: A busca sistemática foi realizada nas bases de dados Pubmed e Embase entre janeiro de 1984 e março de 2020 para identificação de artigos que abordassem a prevalência de HG associada ao uso de drogas anticonvulsivantes. Foi avaliado independentemente, o risco de viés através do "Methodological index for non-randomized studies" (MINORS), para análise da qualidade dos trabalhos selecionados. Resultados: A pesquisa identificou 4.471 referências. Nove artigos foram selecionados e avaliaram 632 participantes. Todos os estudos incluídos na revisão sistemática mostraram baixo risco de viés. Os anticonvulsivantes utilizados pelos pacientes foram carbamazepina, etossuximida, fenitoína, primidona, fenobarbital e valproato de sódio. Os estudos mostraram correlação entre os diferentes tipos de anticonvulsivantes e a prevalência de HG, com variação entre 0% a 73%. Entre os anticonvulsivantes utilizados, a fenitoína apresentou a maior incidência de HG, variando entre 15,61% e 73% em pacientes. Conclusão: Na análise dos resultados obtidos na literatura, é possível notar que a grande maioria dos estudos apresentou incidência de HG associada ao uso de anticonvulsivantes. No entanto, estudos adicionais são necessários para compreender o mecanismo de ação do anticonvulsivante para a indução da HG, bem como as formas de prevenção, dado que a HG é um efeito colateral significativo (AU)


Subject(s)
Humans , Phenobarbital , Phenytoin , Primidone , Carbamazepine , Prevalence , Valproic Acid , Ethosuximide , Gingival Hyperplasia , Anticonvulsants
3.
Rev. argent. mastología ; 39(142): 52-90, jun. 2020. graf
Article in Spanish | LILACS | ID: biblio-1104088

ABSTRACT

El cáncer de mama Estadio IV se define como la diseminación de células tumorales más allá de la mama, la pared torácica y los ganglios linfáticos regionales. Globalmente, 5-10% de las mujeres tienen metástasis al momento del diagnóstico y hasta un 30% de aquellas con estadios tempranos al inicio desarrollará metástasis en algún momento. Se estima una mediana de sobrevida global en cáncer de mama metastásico de 3 años, con un intervalo que va desde pocos meses hasta muchos años, y una sobrevida a 5 años que ronda el 25%. Continúa siendo una enfermedad tratable pero no curable. Los objetivos terapéuticos en enfermedad metastásica principalmente son: prolongación de la sobrevida global y libre de enfermedad, disminución de síntomas y complicaciones asociadas al cáncer y mejoras en la calidad de vida de las pacientes. En la actualidad, estas metas son alcanzadas principalmente con la utilización de terapias sistémicas como la quimioterapia, la hormonoterapia o el uso de agentes biológicos. En algunas circunstancias, el tratamiento locorregional también contribuye a lograr estos objetivos. La elección del tratamiento sistémico está principalmente determinada por la biología tumoral, ya que esto permite el empleo de terapias dirigidas. En los tumores Luminales, deberá emplearse hormonoterapia, sola o en asociación con otros esquemas. En tumores her2+, se indicará, de ser posible, como primera línea de tratamiento doble bloqueo anti-her más quimioterapia. El subgrupo de peor pronóstico está representado por los tumores Triple Negativos, para los cuales no existen blancos terapéuticos dirigidos. En este caso, se utilizará quimioterapia. Se deberá usar terapia de mantenimiento luego de lograr el control de la enfermedad en tumores Luminales y her2+. El rol del tratamiento locorregional en cáncer de mama metastásico continúa siendo un tema de debate. Actualmente, algunos estudios sugieren que podrían obtenerse algunos beneficios, aunque aún hacen falta más datos para sostener su indicación. Deberá garantizarse un abordaje multidisciplinario y un seguimiento cercano de estas pacientes, con el fin de valorar la respuesta al tratamiento, la aparición de toxicidad inaceptable y las condiciones de calidad de vida


Stage IV breast cancer is defined as the spread of tumor cells beyond the breast, chest wall, and regional lymph nodes. Globally, 5-10% of women have metastases at diagnosis, and up to 30% of those with early stages of onset will develop metastases at some point. A median overall survival in metastatic breast cancer of 3 years is estimated, with an interval ranging from a few months to many years, and a 5-year survival of around 25%. It remains a treatable but not curable disease. The therapeutic goals in metastatic disease are mainly: prolongation of global and disease-free survival, decrease in symptoms and complications associated with cancer, and improvements in the quality of life of patients. At present, these goals are mainly achieved with the use of systemic therapies such as chemotherapy, hormonal therapy or the use of biological agents. In some circumstances locoregional treatment also contributes to achieving these goals. The choice of systemic treatment is mainly determined by tumor biology, since this allows the use of targeted therapies. In Luminal tumors, hormone therapy should be used, alone or in association with other schemes. In her2+ tumors, double blocking anti-her plus chemotherapy will be indicated if possible as the first line of treatment. The worst prognosis subgroup is represented by Triple Negative tumors for which there are no targeted therapeutic targets. In this case chemotherapy will be used. Maintenance therapy should be used after achieving control of the disease in Luminal tumors and her2+. The role of locoregional treatment in metastatic breast cancer continues to be a matter of debate. Currently some studies suggest that some benefits could be obtained although more data are still needed to support its indication. A multidisciplinary approach and close monitoring of these patients should be guaranteed in order to assess the response to treatment, the appearance of unacceptable toxicity and quality of life conditions


Subject(s)
Phenobarbital , Breast Neoplasms , Drug Therapy
4.
Rev. ciênc. farm. básica apl ; 41: [13], 01/01/2020. tab, ilus
Article in English | LILACS | ID: biblio-1128572

ABSTRACT

The therapeutic drug monitoring (TDM) is an important strategy for the effectiveness and safety of long-term pharmacotherapy, such as the use of phenobarbital as an anticonvulsant drug in epilepsy. In this sense, HLPC has been presented as a technique for the measurement of phenobarbital in serum. However, the ideal conditions for carrying out the method must be established for each laboratory reality. An analytical method using HPLC was developed and validated in order to identify and quantify Phenobarbital in blood. The chromatographic conditions were C-18 column (Shimpack XR-ODS 50L x 3.0), acetonitrile-water mobile phase (30:70, v v-1), 0.2 mL min-1 flow and reading wavelength of 210 nm. Linearity was established in the range of 2.5 to 80 µg mL-1, the linear correlation coefficient was 0.9981. The average of the coefficient of variation of the precision was 5.30%. The relative standard error of the accuracy was -2.17% and of the recovery coefficient was 97.83%. In all eleven patients, phenobarbital concentrations were below the therapeutic range. The tested method was selective, linear, precise, accurate and showed good recovery.(AU)


Subject(s)
Humans , Male , Female , Phenobarbital/blood , Drug Monitoring/methods , Anticonvulsants/pharmacokinetics , Phenobarbital/adverse effects , Chromatography, High Pressure Liquid/methods , Drug Combinations , Validation Studies as Topic
5.
Pediatric Gastroenterology, Hepatology & Nutrition ; : 121-131, 2020.
Article in English | WPRIM | ID: wpr-811419

ABSTRACT

PURPOSE: To determine the long-term efficacy of the anti-tumor necrosis factor (TNF) agents, infliximab (IFX) and adalimumab (ADA), in pediatric luminal Crohn's disease (CD) by performing a systematic literature review.METHODS: An electronic search was performed in Medline, Embase, and the Cochrane Library from inception to September 26, 2019. Eligible studies were cohort studies with observation periods that exceeded 1 year. Studies that reported time-to-event analyses were included. Events were defined as discontinuation of anti-TNF therapy for secondary loss of response. We extracted the probabilities of continuing anti-TNF therapy 1, 2, and 3 years after initiation.RESULTS: In total, 2,464 papers were screened, 94 were selected for full text review, and 13 studies (11 on IFX, 2 on ADA) met our eligibility criteria for inclusion. After 1 year, 83–97% of patients were still receiving IFX therapy. After 2 and 3 years the probability of continuing IFX therapy decreased to 67–91% and 61–85%, respectively. In total, 5 of the 11 studies subgrouped by concomitant medication consistently showed that the probabilities of continuing IFX therapy in patients with prolonged immunomodulator use were higher than those in patients on IFX monotherapy.CONCLUSION: This review of real-world evidence studies confirms the long-term therapeutic benefit of IFX therapy in diverse cohorts of children with luminal CD. Moreover, it supports the view that combination therapy with an immunomodulator prolongs the durability of IFX therapy in patients who previously failed to recover following first-line therapy. The limited number of time-to-event studies in patients on ADA prevented us from drawing definite conclusions about its long-term efficacy.


Subject(s)
Child , Humans , Adalimumab , Cohort Studies , Crohn Disease , Infliximab , Necrosis , Pediatrics , Phenobarbital , Survival Analysis , Treatment Outcome
6.
Journal of Breast Cancer ; : 47-58, 2020.
Article in English | WPRIM | ID: wpr-811197

ABSTRACT

PURPOSE: Tau is a microtubule-associated protein that can be found in both normal and abnormal breast cells. Whether the expression of Tau protein can predict the response to neoadjuvant chemotherapy (NACT) is still unclear. In this study, we assessed the role of Tau protein expression in predicting a pathological complete response (pCR) to NACT for different subtypes of breast cancer.METHODS: Four hundred and sixty-eight eligible patients were retrospectively recruited in our study. The relationship between clinicopathologic factors, including Tau protein expression, and pCR in different subtypes was evaluated using logistic regression analysis. Correlation between Tau and disease-free survival (DFS) and overall survival (OS) was performed using Kaplan–Meier analysis.RESULTS: The expression of Tau protein was negatively correlated with pCR, especially in triple-negative breast cancer (TNBC). No significant difference was observed in the luminal human epidermal growth factor receptor-2 (HER2)-negative subtype and HER2-positive subtype. Patients with pCR were associated with better DFS and OS (p < 0.05). However, Tau protein expression had no association with either DFS or OS (p > 0.05).CONCLUSION: Tau protein expression can predict pCR before NACT in TNBC, but there was no correlation between Tau expression and DFS or OS.


Subject(s)
Humans , Breast Neoplasms , Breast , Disease-Free Survival , Drug Therapy , Epidermal Growth Factor , Logistic Models , Neoadjuvant Therapy , Phenobarbital , Polymerase Chain Reaction , Retrospective Studies , tau Proteins , Triple Negative Breast Neoplasms
9.
Actual. osteol ; 15(3): 192-204, Sept-Dic. 2019. graf, ilus, tab
Article in English | LILACS | ID: biblio-1104327

ABSTRACT

Blocking of the growth plate (GP) using plates with screws (tension band plating) is a modern method used to correct deformities and moderate leg length discrepancy in growing children. Determining the duration of temporary bilateral blocking without the occurrence of irreversible changes of GP is of paramount importance important. Methods: Two-month-old Californian breed male rabbits (n=30) were exposed to bilateral blocking of the distal GP of the right femur locking plates with screws for 3, 5, and 7 weeks. The fixators were removed after 5 and 7 weeks in 18 rabbits and 3 weeks after that, animals were sacri!ced. The contralateral limb was used as a control. Histological, histomorphometric, and X-ray analyses were performed. Results: During GP blocking, its height gradually decreased. This decreased was more pronounced after 7 weeks. Destructive changes progressed with an increase in the blocking duration. Three weeks after discontinuation of the bilateral blocking that lasted 5 weeks, the height of the GP signi!cantly increased 1.2 times on the lateral side and 1.9 times on the medial side (p<0.001) compared to the control. When blocking was discontinued after 7 weeks, the structure of the GP was partially restored after 3 weeks, the height of GP signi!cantly increased 1.2 times on the lateral side, and 1.07 times on the medial side (p<0.01) compared to the control. Conclusion: Restoration of the structuralfunctional features of the GP after the removal of the plates depends on the duration of temporary bilateral blocking, which must be taken into account in the clinical setting. (AU)


El bloqueo de la placa de crecimiento (PC) utilizando placas con tornillos (banda de tensión) es un método moderno utilizado para corregir deformidades y alteraciones moderadas en la longitud de las piernas en niños en crecimiento. Es de suma importancia determinar cuál debe ser la duración del bloqueo bilateral temporal sin que ocurran cambios irreversibles en la PC. Métodos: Conejos machos de raza californiana de dos meses de edad (n = 30) fueron expuestos al bloqueo bilateral de la PC distal colocando placas del fémur derecho con tornillos durante 3, 5 y 7 semanas. Los fijadores fueron retirados después de 5 y 7 semanas en 18 de los conejos, y 3 semanas después los animales fueron sacrificados. La extremidad contralateral se utilizó como control. Se realizaron análisis histológicos, histomorfométricos y de rayos X. Resultados: Durante el bloqueo de la PC, su altura disminuyó gradualmente. Esta disminución fue más pronunciada después de 7 semanas. Los cambios destructivos se incrementaron a medida aumentaba la duración del bloqueo. Tres semanas después de la interrupción del bloqueo bilateral que duró 5 semanas, la altura de la PC aumentó significativamente 1.2 veces en el lado lateral y 1.9 veces en el lado medial (p <0.001) en comparación con el control. Conclusión: La restauración de las características funcionales estructurales de la PC después de la extracción de las placas depende de la duración del bloqueo bilateral temporal, lo que debería tenerse en cuenta en el tratamiento clínico de estas alteraciones. (AU)


Subject(s)
Humans , Animals , Child , Rabbits , Limb Deformities, Congenital/therapy , Growth Plate/growth & development , Phenobarbital/administration & dosage , Rabbits/surgery , Xylazine/administration & dosage , Bone Plates , Cefazolin/administration & dosage , Child Development , Harm Reduction , Femur/cytology , Femur/growth & development , Femur/diagnostic imaging , Fixatives/analysis , Growth Plate/abnormalities , Ketamine/administration & dosage , Leg/abnormalities
10.
Article in English | LILACS | ID: biblio-1003818

ABSTRACT

ABSTRACT: Anticonvulsants are drugs that can modify the gingival tissues response to inflammatory processes in the presence of dental plaque, inducing gingival overgrowth. Preexisting gingival inflammation induced by dental plaque seems to be a favorable condition to the development and/or expression of gingival overgrowth. This study describes a case in which the use of phenytoin and phenobarbital anticonvulsant associated with the presence of dental plaque provided a large and severe extent of gingival alteration. We concluded that it was possible to achieve a good result in the patient with an intensive mechanical control of dental plaque, oral hygiene orientations and substitution of the drug for other alternative medication.


Subject(s)
Humans , Female , Adult , Phenobarbital , Therapeutics , Gingival Hyperplasia , Anticonvulsants
11.
Archives of Plastic Surgery ; : 214-220, 2019.
Article in English | WPRIM | ID: wpr-762830

ABSTRACT

BACKGROUND: Microvascular anastomosis patency is adversely affected by local and systemic factors. Impaired intimal recovery and endothelial mechanisms promoting thrombus formation at the anastomotic site are common etiological factors of reduced anastomosis patency. Epigallocatechin gallate (EGCG) is a catechin derivative belonging to the flavonoid subgroup and is present in green tea (Camellia sinensis). This study investigated the effects of EGCG on the structure of vessel tips used in microvascular anastomoses and evaluated its effects on thrombus formation at an anastomotic site. METHODS: Thirty-six adult male Wistar albino rats were used in the study. The right femoral artery was cut and reanastomosed. The rats were divided into two groups (18 per group) and were systemically administered either EGCG or saline. Each group were then subdivided into three groups, each with six rats. Axial histological sections were taken from segments 1 cm proximal and 1 cm distal to the microvascular anastomosis site on days 5, 10, and 14. RESULTS: Thrombus formation was significantly different between the EGCG and control groups on day 5 (P=0.015) but not on days 10 or 14. The mean luminal diameter was significantly greater in the EGCG group on days 5 (P=0.002), 10 (P=0.026), and 14 (P=0.002). Intimal thickening was significantly higher on days 5 (P=0.041) and 10 (P=0.02). CONCLUSIONS: EGCG showed vasodilatory effects and led to reduced early thrombus formation after microvascular repair. Similar studies on venous anastomoses and random or axial pedunculated skin flaps would also contribute valuable findings relevant to this topic.


Subject(s)
Adult , Animals , Humans , Male , Rats , Catechin , Femoral Artery , Microsurgery , Oxidants , Phenobarbital , Skin , Tea , Thrombosis , Vasodilation
12.
Annals of Surgical Treatment and Research ; : 49-57, 2019.
Article in English | WPRIM | ID: wpr-762691

ABSTRACT

PURPOSE: Sentinel lymph node (SLN) biopsy (SLNB) is widely performed for axillary staging in patients with breast cancer. Based on the results of frozen section examination (FSE), surgeons can decide to continue further axillary dissections. This study aimed to verify the accuracy of FSE for SLNs. METHODS: We reviewed the records of 4,219 patients who underwent SLNB for primary invasive breast cancer between 2007 and 2016 at the Severance Hospital. We evaluated factors associated with the false-negative results of FSE for SLNs using the Generalized Estimating Equations model. RESULTS: A total of 1,397 SLNs from 908 patients were confirmed to be metastatic. Seventy-one patients (1.7%) had confirmed pathologic N2 or N3 stage. Among metastatic SLNs, micrometastasis was found in 234 (16.8%). The overall accuracy of SLNB was 98.5%. The sensitivity and false-negative rate of FSE were 86.4% and 13.6%, respectively. Several clinicopathological factors, including the size of SLN metastases, suspicious preoperative axillary lymph nodes, and luminal B subtype, were associated with a higher rate of false-negative results. CONCLUSION: Most patients were not indicated for axillary lymph node dissection. Some patients may show transition in their permanent pathology due to the size of the metastatic node. However, the false-negative results of FSE for SLNs based on the size of the metastatic node did not change our practice. Therefore, intraoperative FSE for SLN should not be routinely performed for all breast cancer patients.


Subject(s)
Humans , Biopsy , Breast Neoplasms , Breast , False Negative Reactions , Frozen Sections , Lymph Node Excision , Lymph Nodes , Neoplasm Metastasis , Neoplasm Micrometastasis , Pathology , Phenobarbital , Sentinel Lymph Node Biopsy , Surgeons
13.
Korean Circulation Journal ; : 1022-1032, 2019.
Article in English | WPRIM | ID: wpr-759411

ABSTRACT

BACKGROUND AND OBJECTIVES: Intermediate coronary lesion that can be under- or over-estimated by visual estimation frequently results in stenting of functionally nonsignificant lesions or deferral of percutaneous coronary intervention (PCI) of significant lesions inappropriately. We evaluated current status of PCI for intermediate lesions from a standardized database in Korea. METHODS: We analyzed the Korean percutaneous coronary intervention (K-PCI) registry data which collected a standardized PCI database of the participating hospitals throughout the country from January 1, 2014, through December 31, 2014. Intermediate lesion was defined as a luminal narrowing between 50% and 70% by visual estimation and then compared whether the invasive physiologic or imaging study was performed or not. RESULTS: Physiology-guided PCI for intermediate lesions was performed in 16.8% for left anterior descending artery (LAD), 9.8% for left circumflex artery (LCX), 13.2% for right coronary artery (RCA). PCI was more frequently performed using intravascular ultrasound (IVUS) than using fractional flow reserve (FFR) for coronary artery segments (27.7% vs. 13.9% for LAD, 32.9% vs. 8.1% for LCX, and 33.8% vs. 10.8% for RCA). In accordance with or without FFR, PCI for intermediate lesions was more frequently performed in the hospitals with available FFR device than without FFR, especially in left main artery (LM), proximal LAD lesion (40.9% vs. 5.9% for LM, 24.6% vs 7.6% for proximal LAD). CONCLUSIONS: These data provide the current PCI practice pattern with the use of FFR and IVUS in intermediate lesion. More common use of FFR for intermediate lesion should be encouraged.


Subject(s)
Arteries , Coronary Artery Disease , Coronary Stenosis , Coronary Vessels , Fractional Flow Reserve, Myocardial , Korea , Percutaneous Coronary Intervention , Phenobarbital , Stents , Ultrasonography
15.
Korean Journal of Radiology ; : 94-101, 2019.
Article in English | WPRIM | ID: wpr-719594

ABSTRACT

OBJECTIVE: To investigate the efficacy of motion-correction algorithm (MCA) in improving coronary artery image quality and measurement accuracy using an anthropomorphic dynamic heart phantom and 256-detector row computed tomography (CT) scanner. MATERIALS AND METHODS: An anthropomorphic dynamic heart phantom was scanned under a static condition and under heart rate (HR) simulation of 50–120 beats per minute (bpm), and the obtained images were reconstructed using conventional algorithm (CA) and MCA. We compared the subjective image quality of coronary arteries using a four-point scale (1, excellent; 2, good; 3, fair; 4, poor) and measurement accuracy using measurement errors of the minimal luminal diameter (MLD) and minimal luminal area (MLA). RESULTS: Compared with CA, MCA significantly improved the subjective image quality at HRs of 110 bpm (1.3 ± 0.3 vs. 1.9 ± 0.8, p = 0.003) and 120 bpm (1.7 ± 0.7 vs. 2.3 ± 0.6, p = 0.006). The measurement error of MLD significantly decreased on using MCA at 110 bpm (11.7 ± 5.9% vs. 18.4 ± 9.4%, p = 0.013) and 120 bpm (10.0 ± 7.3% vs. 25.0 ± 16.5%, p = 0.013). The measurement error of the MLA was also reduced using MCA at 110 bpm (19.2 ± 28.1% vs. 26.4 ± 21.6%, p = 0.028) and 120 bpm (17.9 ± 17.7% vs. 34.8 ± 19.6%, p = 0.018). CONCLUSION: Motion-correction algorithm can improve the coronary artery image quality and measurement accuracy at a high HR using an anthropomorphic dynamic heart phantom and 256-detector row CT scanner.


Subject(s)
Coronary Vessels , Heart Rate , Heart , Phenobarbital
16.
Journal of Cancer Prevention ; : 20-25, 2019.
Article in English | WPRIM | ID: wpr-764299

ABSTRACT

BACKGROUND: High-fat diet is known to be implicated in the pathogenesis of various metabolic disorders related to an inflammatory response. The aim of this study was to investigate the influence of high-fat diet for intestinal acetic acid and butyric acid concentrations which are related to inflammation-associated colon cancer risk. METHODS: Both male and female rats of 6, 31, 74 and 104-week of age were fed chow diet or high-fat diet for 8 weeks. Body weight and food intake were measured weekly during the feeding period. Intestinal acetic acid and butyric acid levels were measured by high-performance liquid chromatography from luminal contents of ileum and cecum. RESULTS: Male rats showed greater weight change than female rats in every age. Calorie-adjusted food intake was also higher in male rats compared to female rats. Male rats showed similar intake of food in every age while 31-week old female rats showed increased intake, which was decreased at 74-week and 104-week of age. The ileal acetic acid concentration was increased in male rats fed high-fat diet, while female rats fed high-fat diet showed no significant change in the ileal acetic acid level. On the other hand, butyric acid almost disappeared in high-fat diet fed rats regardless of sex. CONCLUSIONS: High-fat diet increases the intestinal acetic acid concentration while reducing the butyric acid concentration which may account for increased risk of inflammation-associated colon cancer.


Subject(s)
Animals , Female , Humans , Male , Rats , Acetic Acid , Body Weight , Butyric Acid , Cecum , Chromatography, Liquid , Colonic Neoplasms , Diet , Diet, High-Fat , Eating , Hand , Ileum , Phenobarbital
17.
Journal of Breast Disease ; (2): 23-29, 2019.
Article in English | WPRIM | ID: wpr-764287

ABSTRACT

PURPOSE: Neoadjuvant chemotherapy (NAC) has become the standard treatment for patients with locally advanced breast cancer. The purpose of this study was to evaluate prognosis according to molecular subtype and clinicopathologic factors in patients with locally advanced breast cancer treated by NAC. METHODS: We retrospectively analyzed the medical records of 91 patients with breast cancer who underwent NAC followed by surgery between January 2005 and January 2010. The patients were classified into four molecular subtype groups: luminal A, luminal B, HER2 enriched, and triple negative (TN). RESULTS: Thirty-five (38%) patients had luminal A, 13 (14%) patients luminal B, 22 (24%) patients HER2 enriched and 21 (21%) patients TN breast cancer. Patients with TN breast cancer tended to be more than 50 years of age and to have a higher histologic grade. There were statistically significant differences according to ypN stage (ypN0 vs. ypN1–3; p=0.019, 5-year disease-free survival [DFS]; p=0.005, 5-year overall survival [OS]) and lymphovascular invasion (LVI) (p=0.003, 5-year DFS; p=0.006, 5-year OS) in the univariate analysis. In the multivariate analysis, LVI was a significant factor in 5-year DFS (odds ratio 2.145, 95% confidence interval 1.064–4.324, p=0.033). There was no significant difference among molecular subtypes in DFS (p=0.161) or OS (p=0.084). CONCLUSION: LVI was associated with prognosis in patients with locally advanced breast cancer treated by NAC and surgery. However, molecular subtype had no effect on 5-year DFS or OS.


Subject(s)
Humans , Breast Neoplasms , Breast , Disease-Free Survival , Drug Therapy , Medical Records , Multivariate Analysis , Neoadjuvant Therapy , Phenobarbital , Prognosis , Retrospective Studies
18.
Journal of Breast Disease ; (2): 30-37, 2019.
Article in English | WPRIM | ID: wpr-764286

ABSTRACT

PURPOSE: We aimed to investigate organ-specific recurrence or the metastatic pattern of breast cancer according to biological subtypes and clinical characteristics. METHODS: We retrospectively analyzed the medical records of 168 patients with recurrent breast cancer who were diagnosed between January 1, 2000 and April 30, 2017. Four biological subtypes were classified according to estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67 expression: luminal A, luminal B, HER2-enriched, and triple negative breast cancer (TNBC). To analyze recurrence patterns according to biological subtypes, we accessed clinical variables including age at diagnosis, TNM stage, type of surgery in the breast and axilla, histologic grade, nuclear grade, lymphatic, vascular, and neural invasion, Ki-67 expression and recurrence to distant organs. RESULTS: The biological subtypes of recurrent breast cancer comprised the following luminal A (n=33, 19.6%), luminal B (n=95, 56.5%), HER2 enriched (n=19, 11.3%), and TNBC (n=21, 12.5%). Luminal A (7.7%) and B (6.5%) subtypes were associated with the increased rate of local recurrence compared to HER2-enriched (2.4%) and TNBC subtypes (1.8%) (p=0.005). The bone (53.6%) was the most common metastatic organ, followed by the lung (34.5%), liver (29.8%), brain (17.9%), and other visceral organ (7.7%). Bone metastasis was commonly observed in individuals with luminal B (63.2%), HER2-enriched (57.9%), and luminal A (42.4%) subtypes (p=0.005). Most liver metastases occur in individuals with luminal B (40.0%) and HER2-enriched subtypes (31.6%) (p=0.002). CONCLUSION: Luminal B subtype was commonly observed in individuals with recurrent breast cancer, and the bone is the most common target organ for breast cancer metastasis, followed by the lungs and liver.


Subject(s)
Humans , Axilla , Brain , Breast Neoplasms , Breast , Diagnosis , Estrogens , Liver , Lung , Medical Records , Neoplasm Metastasis , Organ Specificity , Phenobarbital , ErbB Receptors , Receptors, Progesterone , Recurrence , Retrospective Studies , Triple Negative Breast Neoplasms
19.
Journal of Breast Cancer ; : 412-424, 2019.
Article in English | WPRIM | ID: wpr-764280

ABSTRACT

PURPOSE: Neoadjuvant chemotherapy (NAC) is less effective for luminal breast cancer because luminal breast cancer has a lower rate of pathological complete response (pCR) after NAC than human epidermal growth factor receptor 2 (HER2)-type and triple-negative breast cancer (TNBC). We investigated the efficacy of NAC and the predictive factors of a better response in luminal breast cancer. METHODS: Between 2010 and 2016, we retrieved data of 244 patients with clinically node-positive breast cancer who were treated with NAC followed by surgery from a prospectively collected database. We classified breast cancer into luminal HER2⁻ and non-luminal HER2⁻ breast cancer (luminal HER2⁺, HER2⁺, and TNBC types). We analyzed each subtype with respect to surgical outcomes, response to NAC, and determined variables associated with surgical outcomes and response in patients with luminal HER2⁻ breast cancer. RESULTS: The total, breast, and axillary pCR rates were significantly lower in 114 patients with luminal HER2⁻ breast cancer than in those with other subtypes (7.9%, 12.3%, and 22.8%, respectively). However, breast-conserving surgery (BCS) conversion and tumor response rates did not significantly differ between patients with luminal HER2⁻ and those with non-luminal HER2⁻ breast cancer (p = 0.836 and p = 0.180, respectively). In the multivariate analysis, high tumor response rate (≥ 46.4%) was significantly associated with an increased BCS conversion rate. In the subgroup analysis of luminal HER2⁻ breast cancer, the multivariate analysis showed that higher Ki67 expression and axilla pCR and BCS conversion rates were significantly associated with tumor response to NAC. CONCLUSION: Despite the low pCR rate, the tumor response and BCS conversion rates after NAC of luminal HER2⁻ breast cancer were similar to those of other subtypes. NAC has the potential benefit of reducing the size of breast cancer, thereby increasing the BCS conversion rate in luminal HER2⁻ breast cancer.


Subject(s)
Humans , Axilla , Breast Neoplasms , Breast , Drug Therapy , Mastectomy, Segmental , Multivariate Analysis , Neoadjuvant Therapy , Phenobarbital , Polymerase Chain Reaction , Prospective Studies , ErbB Receptors , Triple Negative Breast Neoplasms
20.
Journal of Breast Cancer ; : 285-296, 2019.
Article in English | WPRIM | ID: wpr-764262

ABSTRACT

PURPOSE: The benefit of post-mastectomy radiation therapy (PMRT) in patients with breast cancer who achieve ypN0 following neoadjuvant chemotherapy (NAC) has not yet been established. This study aimed to identify the role of PMRT in patients who achieve ypN0 according to molecular subtype. METHODS: We identified patients initially suspected with axillary disease who achieved ypN0 following NAC. From 13 institutions of the Korean Radiation Oncology Group between 2005 and 2011, a total of 189 patients were included in the analysis. Effects of PMRT on loco-regional control (LRC), disease-free survival (DFS), and overall survival (OS) were evaluated for different molecular subtypes. RESULTS: In all patients, the prognostic effect of PMRT on LRC, DFS, or OS was not significant. Subgroups analysis showed that the effect of PMRT on LRC was different according to molecular subtype (p for interaction = 0.019). PMRT was associated with greater LRC in the luminal subtype (p = 0.046), but not in other subtypes. CONCLUSION: In patients who achieve ypN0 following NAC and mastectomy, PMRT shows no additional survival benefits for any molecular subtype.


Subject(s)
Humans , Breast Neoplasms , Disease-Free Survival , Drug Therapy , Mastectomy , Neoadjuvant Therapy , Phenobarbital , Radiation Oncology , Radiotherapy
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