No abstract available.
Adult* ; Cerebrospinal Fluid* ; Humans

BACKGROUND: The epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), became an attractive therapeutic option for advanced non-small-cell lung cancer (NSCLC). Several studies suggested that there might be some different efficacy or response predictors between gefitinib and erlotinib. We compared the efficacy and toxicity of gefitinib and erlotinib in Korean patients with advanced NSCLC and evaluated specific predictors of response for both gefitinib and erlotinib. METHODS: We collected the clinical information on patients with advanced NSCLC, who were treated with gefitinib or erlotinib at the Ewha Womans University Hospital, between July 2003 and February 2009. Median survival times were calculated using the Kaplan-Meier method. RESULTS: Eighty-six patients (52 gefitinib vs. 34 erlotinib) were enrolled. Patient median age was 64 years; 53 (62%) subjects were male. Out of the 86 patients treated, 83 received response evaluation. Of the 83 patients, 35 achieved a response and 12 experienced stable disease while 36 experienced progressive disease, resulting in a response rate of 42% and a disease control rate of 57%. After a median follow-up of 502 days, the median progression-free and overall survival time was 129 and 259 days, respectively. Comparing patients by treatment (gefitinib vs erlotinib), there were no significant differences in the overall response rate (44% vs. 39%, p=0.678), median survival time (301 days vs. 202 days, p=0.151), or time to progression (136 days vs. 92 days, p=0.672). Both EGFR-TKIs showed similar toxicity. In a multivariate analysis using Cox regression model, adenocarcinoma was an independent predictor of survival (p=0.006; hazard ratio [HR], 0.487; 95% confidence interval [CI], 0.292-0.811). Analyses of subgroups did not show any difference in response predictors between gefitinib and erlotinib. CONCLUSION: Comparing gefitinib to erlotinib, there were no differences in the response rate, overall survival, progression-free survival, or toxicity. No specific predictor of response to each EGFR-TKI was identified.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Lung ; Lung Neoplasms ; Male ; Multivariate Analysis ; Protein-Tyrosine Kinases ; Quinazolines ; Receptor, Epidermal Growth Factor ; Erlotinib Hydrochloride

The relationship between the level of testosterone and the incidence of coronary heart disease is still controversial in the view of the results of clinical and epidemiologic studies. This uncertainty might be partly due to relatively small number of experimental studies undertaken to investigate the cellular mechanism underlying the vascular responses to testosterone. To further investigate the cellular mechanisms of testosterone with respect to vascular response, we investigated the effect of testosterone on contractility and intracellular Ca2+ regulation in a rabbit coronary artery and evaluated the underlying mechanism of testosterone-induced changes of coronary vascular tone by using various pharmacological blockers. Testosterone was found to relax rabbit coronary arteries in a dose-dependent manner, and no significant difference was found in the relaxation response to testosterone with or without endothelium. Similar results were obtained in male and non-pregnant female rabbit coronary arteries. The relaxation response of rabbit coronary arteries to testosterone was greater for PGF2alpha-contracted rings than for KCl contracted rings, which suggest the involvement of K+ channels. Furthermore, the relaxation response to testosterone was significantly reduced by 4-aminopyridine, a sensitive blocker of voltage dependent K+ channels, but not by low doses of tetraethylammonium or iberiotoxin, a Ca2+ activated K+ channel blocker. Testosterone simultaneously reduced the intracellular Ca2+ concentration ([Ca2+]i) and tension, and 4-AP effectively antagonized the testosterone-induced change of [Ca2+]i and tension. Therefore, it may be concluded that the stimulation of voltage dependent K channels is responsible, at least in part, for the testosterone-induced relaxation of rabbit coronary arteries.
Androgens/*pharmacology ; Animals ; Arteries/drug effects ; Calcium/*metabolism ; Coronary Vessels/*drug effects ; Female ; Intracellular Membranes/*metabolism ; Male ; Osmolar Concentration ; Potassium Channels, Voltage-Gated/drug effects/*metabolism ; Rabbits ; Support, Non-U.S. Gov't ; Testosterone/*pharmacology ; *Vasodilation

BACKGROUND: Although abnormal serum alanine aminotranferase(ALT) and aspartate aminotransferase (AST) clearly indicates certain disease in the liver, normal reversion of serum ALT and AST during the disease process, after the histologic diagnosis of chronic hepatitis, does not ensure that the patients liver would be normal. We considered a partial remission of chronic hepatitis as the levels of serum ALT and AST were persistently normal over 6 months or more, and studied how the histologic findings in the partial-remitted patients of chronic hepatitis would change. MATERIALS: Twenty-three agreed to rebiopsy in the patients of chronic hepatitis with normal level of serum ALT and AST over 6 months. The histologic findings between the first and second liver-biopsied specimens were compared, and the classification of their morpholgy was translated with Batts and Ludwigs new scoring system of chronic hepatitis divided into grade and stage. RESULTS: The grading scores of the first and second biopsy were 2.70 +/- 0.16 and 1.48 +/- 0.14, respectively, and the grading scores of the second biopsy decreased significantly than of the first biopsy (p=0.000); 18 cases(78.1%) were improved, but none was aggravated. The staging scores of the first and second biopsy were 1.870.19 and 1.430.22, respectively, and the staging scores of the secand biapsy also decreased significantly than of the first biopsy (p=0,020); 14 cases (61.2%) were unchanged, 8 cases (34.5%) were improved, but 1 case (4.3%) was aggravated. The stage-improved cases were 7 in the patients of chronic viral hepatitis B, and 1 in the patient of chronic viral hepatitis C, and viral loads of them disappeared. Three cases (13.0%) of them changed into no fibrosis, and 2 cases of them (8.7%) with severe fibrosis improved to mild fibrosis. But, although the levels of serum ALT and AST were persistently normal over average 16 months, grading and staging scores decreased over 2 points in 21.0% and 13.0%, respectively, and the case of which both grading and staging scores improved to normal was only 4.3%. CONCLUSION: Serum ALT and AST level were well correlated with grading. However, the correlation between serum ALT and AST level and staging was poor, even though the triggering factors of chronic hepatitis had been disappeared. Then, we recommand close follow-up and treatment to lessen the fibrogenic reaction of the liver in them.
Alanine* ; Aspartate Aminotransferases ; Aspartic Acid* ; Biopsy ; Classification ; Diagnosis ; Fibrosis ; Follow-Up Studies ; Hepatitis B ; Hepatitis C ; Hepatitis, Chronic ; Humans ; Liver Diseases* ; Liver* ; Viral Load

We have evaluated the performance of a recently developed immunoassay analyzer, ADVIA Centaur XPT (Siemens, Germany). Precision, linearity, and comparison studies were performed according to the CLSI guidelines. The test items evaluated were ferritin, folate, human epidermal growth factor receptor 2/neu, homocysteine, vitamin B₁₂, B-type natriuretic peptide, creatine kinase–myocardial band, myoglobin, procalcitonin, troponin I. Bio-Rad control materials, linearity materials, and patients' samples were used for the evaluation. For the correlation study, ADVIA Centaur XP (Siemens) were used as comparative methods. The total coefficients of variations (CVs) of the analytes were between 2.5% and 7.0%. The results of linearity evaluation were also acceptable for the range tested. Correlations with comparative methods were good. The overall analytical performance of ADVIA Centaur XPT is acceptable for the immunology analyzer. Therefore, ADVIA Centaur XPT is expected to be widely used.
Allergy and Immunology ; Creatine ; Ferritins ; Folic Acid ; Homocysteine ; Humans ; Immunoassay ; Myoglobin ; Natriuretic Peptide, Brain ; Receptor, Epidermal Growth Factor ; Statistics as Topic ; Troponin I ; Vitamins

The purposes of this study were 1) to investigate eating behaviors and patterns in breast cancer patients using a newly developed food frequency questionnaire and 2) to examine perception and use of nutritional information about breast cancer treatment among cancer patients treated with radiation therapy. Sixty breast cancer patients (case group) undergoing radiation therapy in Ajou University Hospital, Suwon, South Korea and 79 healthy women (control group) participated in this study. Mean age of subjects in the control group was 46.00 +/- 7.88 years and BMI was 23.12 +/- 2.85 kg/m2, and that of the case group was 50.06 +/- 11.64 years and 22.32 +/- 3.24 kg/m2. The results of eating behaviors showed several significant differences between control and case groups. Breast cancer patients ate meals on a more regular basis, on time, and more frequently compared to control subjects. In addition, they preferred more salty or spicy and bland food compared to healthy women. According to answers from the food frequency questionnaire, breast cancer patients consumed significantly lower amounts of boiled white rice, meats and processed food, fish and shellfish, coffee, milk, and cheese, whereas they consumed a significantly large amount of boiled multigrain rice, vegetable, seaweeds, soybean and processed food, and yoghurt compared to healthy women. This study also observed the way in which cancer patients and healthy control subjects obtain information about breast cancer treatment and its reliabilities. Results showed that healthy women did not hesitate to obtain information from mass media, while breast cancer patients would obtain nutritional information from specialists rather than mass media. Results of this survey confirmed that breast cancer patients avoided intake of red meat protein, even though they already recognized the importance of dietary protein intake for recuperation and treatment of the disease. These results could be used for future diet and nutrition guidelines for breast cancer patients.
Breast ; Breast Neoplasms ; Cheese ; Coffee ; Diet ; Dietary Proteins ; Eating ; Feeding Behavior ; Female ; Humans ; Mass Media ; Meals ; Meat ; Milk ; Surveys and Questionnaires ; Republic of Korea ; Shellfish ; Soybeans ; Specialization ; Survivors ; Vegetables ; Yogurt

Objective: Early identification of dysphagia after stroke helps in preventing aspiration pneumonia. However, data are limited regarding the effectiveness of formal dysphagia screening for reducing the risk of aspiration pneumonia.The current study evaluates the effectiveness of formal dysphagia screening in stroke patients, to prevent future episodes of aspiration pneumonia. Methods: The stroke registry of a tertiary hospital was retrospectively reviewed. We compared clinical variables and the incidence of aspiration pneumonia of patients hospitalized between 2014 and 2015 after formal screening was implemented, and patients hospitalized in 2011 when no established dysphagia screening protocol was in place.Additionally, we identified the incidence of pneumonia according to stroke severity, and evaluated the association with results obtained for incidence of pneumonia and dysphagia screening. Results: A total of 2,902 patients were identified to have suffered acute stroke (2,018 who underwent formal dysphagia screening; 884 without screening). Patients with formal dysphagia screening developed pneumonia less frequently than patients not administered screening (1.3% with formal screening vs. 3.4% no formal screening, P＜0.001).Pneumonia was significantly lower in patients with moderate and severe stroke who underwent formal dysphagia screening. Furthermore, failure of the dysphagia screening test, presentation with severe dysarthria, and conditions where dysarthria could not be evaluated, were independent predictors of pneumonia among patients who underwent formal screening. Conclusion Our findings demonstrate the association of formal dysphagia screening with reduced risk of poststroke aspiration pneumonia, and indicates the efficacy of the procedure in identifying patients at higher risk of contracting pneumonia.

The purpose of the present study was to evaluate cardiovascular regulation during passive standing (PS) after ethanol ingestion by spectral analysis of heart rate variability (HRV) in flushed and nonflushed subjects. Of 24 young male subjects, 8 belonged to flushed group (F) and 16 to nonflushed group (NF). Two sessions of 10-min PS were performed before and after ethanol (0.5 g/kg) ingestion. Powers of R-R interval variability in very low frequency (VLF, 0~0.05 Hz), low frequency (LF, 0.05~0.15 Hz) and high frequency (HF, 0.15~0.50 Hz) bands, normalized powers (LFn and HFn) and LF/HF ratio were obtained. After ethanol ingestion, F showed higher heart rate than NF. PS increased LFn (+ 22.9+/-3.6 in NF, + 12.8+/-4.7 in F, in normalized units) and LF/HF (+ 3.10+/-0.57 in NF, + 3.00+/-1.08 in F) and decreased HFn powers. Ethanol ingestion increased LFn and LF/HF and decreased HFn. PS after ethanol resulted in higher LFn and LF/HF and lower HFn than the prior PS. F showed a greater and more sustained HRV change than NF after ethanol. In conclusion, PS or ethanol ingestion increased LFn and LF/HF and decreased HFn. Flushed subjects showed an accentuated HRV response to ethanol.
Arterial Pressure ; Dizziness ; Eating* ; Ethanol* ; Flushing ; Heart Rate* ; Heart* ; Humans ; Male

Natural infections with influenza A viruses have been reported in a variety of animal species including humans, pigs, horses, sea mammals, and birds. Although viruses of relatively few haemagglutinin(HA) and neuraminidase(NA) subtype combinations have been isolated from mammalian species, all subtypes, in most combinations, have been isolated from birds. During the past few years, several subtypes of avian influenza A have been shown to cross the species barrier and infect humans. During an outbreak of a highly pathogenic influenza A(H5N1) virus among poultry in Hong Kong in 1997, 6 of 18 people with confirmed infection died. And a total of 89 human infections with influenza A(H7N7), including 1 resulting in the death of a Dutch veterinarian, occurred during the extensive outbreak in 2003. During late 2003 and early 2004, there were reports of large outbreaks of H5N1 among poultry throughout Asia (including Korea, Japan, Indonesia, Vietnam, Thailand, Laos, Cambodia, and China). In Korea, we had also highly pathogenic avian influenza(HPAI) outbreak in 2003~2004 with a first suspected case reported on 10 December 2003. The case was reported at a parent stock farm for broilers, which was located in Chungbuk province, and the farm was immediately placed under movement restrictions. Laboratory tests confirmed the outbreak of HPAI on 12 December 2003. Up to 20 March 2004, a total of 19 farms were confirmed as having been infected with HPAI virus. No further outbreaks occurred after that date. Fortunately there were no human cases founded in this epidemic in Korea. In January 2004, there was confirmation that influenza A(H5N1) virus had been isolated from patients who had died of a respiratory illness in Vietnam. Total 107 human confirmed cases were reported until June 2005 to WHO, threatening new pandemic outbreak. We reviewed our prevention and control strategies of avian influenza and preparedness to the pandemic outbreak.
Animals ; Asia ; Birds ; Cambodia ; Chungcheongbuk-do ; Communicable Diseases, Emerging ; Disease Outbreaks ; Epidemiology* ; Hong Kong ; Horses ; Humans ; Indonesia ; Influenza A virus ; Influenza in Birds* ; Influenza, Human ; Japan ; Korea ; Laos ; Mammals ; Pandemics ; Parents ; Poultry ; Swine ; Thailand ; Veterinarians ; Vietnam

OBJECTIVE: To provide more useful guidelines for methotrexate (MTX) treatment in ectopic pregnancy, including patient selection, therapeutic dose, and reproductive outcome. METHODS: Retrospectively, records of 54 patients treated for ectopic pregnancy with systemic MTX were reviewed. MTX was administered 1.0 mg/kg intramuscularly, alternatively with leucovorin 0.1 mg/kg intramuscularly for up to four daily doses of each drug. Samples for beta-hCG detection were obtained on days +3, +7 after beginning of the therapy and then weekly until values were undetectable. RESULTS: 50 patients (92.6%) were treated successfully. 4 patients (7.4%) for whom MTX therapy failed, were treated surgically. The endometrial thickness significantly increased in the failed group, compared to the successful group (14.3+/-4.0 mm vs 7.0+/-2.8 mm, P=0.0001). The serum hemoglobin levels significantly changed in the failed group, compared to the successful group (2.1+/-0.9 g/dL vs 1.0+/-0.8 g/dL, P=0.044). Patients were divided into increasing group and decreasing group according to beta-hCG levels on day 0, that were higher or lower than day -2 level. The resolution time of beta-hCG between increasing group and decreasing group was significantly different (27.6+/-14.0 days vs 17.7+/-8.6 days, p=0.016). In 8 patients (15.1%), an immediate rise of beta-hCG was recorded on day 3 after MTX treatment, but on day 7, a rapid decrease was recorded. Women were treated with significantly different therapeutic dose of MTX according to initial level of serum beta-hCG (p=0.021). There were mild complications (12%). MTX treatment preserved the fallopian tube and thus preserved fertility (70%). CONCLUSION: Systemic MTX use with the dose according to initial level of serum beta-hCG is a safe and highly effective treatment in clinically stable ectopic pregnancy.
Fallopian Tubes ; Female ; Fertility ; Humans ; Leucovorin ; Methotrexate* ; Patient Selection ; Pregnancy ; Pregnancy, Ectopic* ; Retrospective Studies