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Bae HR, Kim EJ, Ahn YC, Cho JH, Son CG, Lee NH. Efficacy of Moxibustion for Cancer-Related Fatigue in Patients with Breast Cancer: A Systematic Review and Meta-Analysis. Integr Cancer Ther 2024; 23:15347354241233226. [PMID: 38372234 PMCID: PMC10878217 DOI: 10.1177/15347354241233226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/30/2023] [Accepted: 02/01/2024] [Indexed: 02/20/2024] Open
Abstract
INTRODUCTION Breast cancer is the most commonly diagnosed cancer worldwide, and most patients experience fatigue. However, there are no effective treatments for cancer-related fatigue (CRF). Several randomized controlled trials (RCTs) have suggested that moxibustion improves CRF. We conducted a systematic review and meta-analysis to compare the differences in fatigue scale scores, quality of life, and clinical efficacy in patients with breast cancer who developed CRF and did versus did not receive moxibustion. METHODS RCTs were searched in 7 databases using a standardized search method from database inception to March 2023, and RCTs that met the inclusion criteria were selected. RESULTS Among 1337 initially identified RCTs, 10 RCTs involving 744 participants were selected for this study. The meta-analysis involved assessment of the revised Piper Fatigue Scale scores, Cancer Fatigue Scale scores, Karnofsky Performance Scale scores, Athens Insomnia Scale scores, clinical efficacy, and Qi deficiency syndrome scale scores. Compared with the control, moxibustion was associated with significantly better Piper Fatigue Scale scores (P < 0.0001), quality of life [Karnofsky Performance Scale scores (P < 0.0001)], clinical efficacy (P = 0.0007), and Qi deficiency syndrome scale scores (P = 0.02). CONCLUSIONS Moxibustion improves CRF in patients with breast cancer. The efficacy of moxibustion should be further examined by high-quality studies in various countries with patients subdivided by their breast cancer treatment status. REGISTRATION PROSPERO ID: CRD42023451292.
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Affiliation(s)
- Hye-Ri Bae
- East-West Cancer Center, Cheonan Korean Medical Hospital, Daejeon University, Cheonan, Republic of Korea
| | - Eun-Ji Kim
- East-West Cancer Center, Cheonan Korean Medical Hospital, Daejeon University, Cheonan, Republic of Korea
| | - Yo-Chan Ahn
- Department of Health Service Management, Daejeon University, Daejeon, Republic of Korea
| | - Jung-Hyo Cho
- East-West Cancer Center, Daejeon Korean Medicine Hospital of Daejeon University, Daejeon, Republic of Korea
| | - Chang-Gue Son
- East-West Cancer Center, Daejeon Korean Medicine Hospital of Daejeon University, Daejeon, Republic of Korea
| | - Nam-Hun Lee
- East-West Cancer Center, Cheonan Korean Medical Hospital, Daejeon University, Cheonan, Republic of Korea
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Lee NH, Jeong SJ, Wang JH, Choi YJ, Oh HM, Cho JH, Ahn YC, Son CG. The Clinical Diagnosis-Based Nationwide Epidemiology of Metabolic Dysfunction-Associated Liver Disease in Korea. J Clin Med 2023; 12:7634. [PMID: 38137703 PMCID: PMC10744038 DOI: 10.3390/jcm12247634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/11/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Although most epidemiological studies have been conducted using a relatively small population or subjects who had medical screenings, the present study aimed to investigate the incidence and prevalence of MASLD (formerly NAFLD) in Korea using nationwide registry data provided by the Health Insurance Review and Assessment Service (HIRA). METHODS Using nationwide medical records provided by HIRA, we analyzed the entire dataset of patients with MASL (KCD10-K76.0) and MASH (KCD10-K75.8) from 2010 to 2021 and calculated the incidence and prevalence by year, age, and gender. The prevalence and incidence rates were calculated by analyzing the HIRA data covering almost the entire population of Korea for 12 years, from 2010 to 2021, with an average population of 50,856,244 during this period. Statistical analyses included calculating confidence intervals using Ulm's formula and conducting sex- and age-specific analyses with a Cochran-Armitage test for trends. RESULTS The annual incidence of MASL/MASH increased significantly from 9.71/0.37 in 2010 to 13.95/5.52 per 1000 persons in 2021 (p < 0.01). The annual prevalence of MASL increased from 15.69 in 2010 to 34.23 per 1000 persons in 2021, while the annual prevalence of MASH increased from 0.49 to 9.79 per 1000 persons between 2010 and 2021 (p < 0.01). Regarding the sex-dimorphic feature of MASLD, there was a male predominance in those < 50 years old but a female predominance in those ≥ 50 years old for the incidence and prevalence of MASL and the incidence of MASH. CONCLUSION The incidence of MASL increased by 3% to 4% every year, while the incidence of MASH increased 14.91-fold from 2010 to 2021. The increasing trend is noteworthy compared with previous reports.
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Affiliation(s)
- Nam-Hun Lee
- East-West Cancer Center, Cheonan Korean Medical Hospital, Daejeon University, 4 Notaesan-ro, Seobuk-gu, Cheonan-si 31099, Republic of Korea;
| | - Seok-Ju Jeong
- Health Insurance Review & Assessment Service, Dunsanbuk-ro 121, Seo-gu, Daejeon 35236, Republic of Korea;
| | - Jing-Hua Wang
- Liver-Immunology Research Center, Daejeon University, 176 Daedeok-daero, Seo-gu, Daejeon 35235, Republic of Korea; (J.-H.W.); (Y.-J.C.); (H.-M.O.); (J.-H.C.)
| | - Yu-Jin Choi
- Liver-Immunology Research Center, Daejeon University, 176 Daedeok-daero, Seo-gu, Daejeon 35235, Republic of Korea; (J.-H.W.); (Y.-J.C.); (H.-M.O.); (J.-H.C.)
| | - Hyeon-Muk Oh
- Liver-Immunology Research Center, Daejeon University, 176 Daedeok-daero, Seo-gu, Daejeon 35235, Republic of Korea; (J.-H.W.); (Y.-J.C.); (H.-M.O.); (J.-H.C.)
| | - Jung-Hyo Cho
- Liver-Immunology Research Center, Daejeon University, 176 Daedeok-daero, Seo-gu, Daejeon 35235, Republic of Korea; (J.-H.W.); (Y.-J.C.); (H.-M.O.); (J.-H.C.)
| | - Yo-Chan Ahn
- Department of Health Service Management, Daejeon University, 62 Daehak-ro, Dong-gu, Daejeon 35620, Republic of Korea;
| | - Chang-Gue Son
- Liver-Immunology Research Center, Daejeon University, 176 Daedeok-daero, Seo-gu, Daejeon 35235, Republic of Korea; (J.-H.W.); (Y.-J.C.); (H.-M.O.); (J.-H.C.)
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Kang YE, Yoon JH, Park NH, Ahn YC, Lee EJ, Son CG. Prevalence of cancer-related fatigue based on severity: a systematic review and meta-analysis. Sci Rep 2023; 13:12815. [PMID: 37550326 PMCID: PMC10406927 DOI: 10.1038/s41598-023-39046-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/19/2023] [Indexed: 08/09/2023] Open
Abstract
Cancer-related fatigue (CRF) affects therapeutic compliance and clinical outcomes including recurrence and mortality. This study aimed to comprehensively and comparatively assess the severity-based prevalence of CRF. From two public databases (PubMed and Cochrane Library), we extracted data containing information on both prevalence and severity of fatigue in cancer patients through December 2021. We conducted a meta-analysis to produce point estimates using random effects models. Subgroup analyses were used to assess the prevalence and severity by the organ/system tumor development, treatment phase, therapeutic type, sex and assessment method. A total of 151 data (57 studies, 34,310 participants, 11,805 males and 22,505 females) were selected, which indicated 43.0% (95% CI 39.2-47.2) of fatigue prevalence. The total CRF prevalence including 'mild' level of fatigue was 70.7% (95% CI 60.6-83.3 from 37 data). The prevalence of 'severe' fatigue significantly varied by organ/system types of cancer origin (highest in brain tumors 39.7% vs. lowest in gynecologic tumors 3.9%) and treatment phase likely 15.9% (95% CI 8.1-31.3) before treatment, 33.8% (95% CI 27.7-41.2) ongoing treatment, and 24.1% (95% CI 18.6-31.2) after treatment. Chemotherapy (33.1%) induced approximately 1.5-fold higher prevalence for 'severe' CRF than surgery (22.0%) and radiotherapy (24.2%). The self-reported data for 'severe' CRF was 20-fold higher than those assessed by physicians (23.6% vs. 1.6%). Female patients exhibited a 1.4-fold higher prevalence of 'severe' fatigue compared to males. The present data showed quantitative feature of the prevalence and severity of CRF based on the cancer- or treatment-related factors, sex, and perspective of patient versus physician. In the context of the medical impact of CRF, our results provide a comparative reference to oncologists or health care providers making patient-specific decision.
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Affiliation(s)
- Ye-Eun Kang
- Research Center for CFS/ME, Daejeon Oriental Hospital of Daejeon University, Daejeon, Republic of Korea
| | - Ji-Hae Yoon
- Research Center for CFS/ME, Daejeon Oriental Hospital of Daejeon University, Daejeon, Republic of Korea
| | - Na-Hyun Park
- Research Center for CFS/ME, Daejeon Oriental Hospital of Daejeon University, Daejeon, Republic of Korea
| | - Yo-Chan Ahn
- Department of Health Service Management, Daejeon University, Daejeon, Republic of Korea
| | - Eun-Jung Lee
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Chang-Gue Son
- Research Center for CFS/ME, Daejeon Oriental Hospital of Daejeon University, Daejeon, Republic of Korea.
- East-West Cancer Center of Daejeon Hospital, Daejeon University, Daejeon, Republic of Korea.
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Yoon JH, Park NH, Kang YE, Ahn YC, Lee EJ, Son CG. The demographic features of fatigue in the general population worldwide: a systematic review and meta-analysis. Front Public Health 2023; 11:1192121. [PMID: 37575103 PMCID: PMC10416797 DOI: 10.3389/fpubh.2023.1192121] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/13/2023] [Indexed: 08/15/2023] Open
Abstract
Background Fatigue is one of the most common subjective symptoms that impairs daily life and predict health-related events. This study aimed to estimate the prevalence of fatigue in the global population. Methods PubMed and the Cochrane Library were used to search for relevant articles from inception to December 31, 2021. Studies with prevalence data of fatigue in the general population were selected and reviewed by three authors independently and cross-checked. Regarding subgroups, adults (≥18 years), minors (<18 years), and specific occupation population (participants in each study being limited to a specific occupational group), and fatigue types and severity, meta-analysis was conducted to produce point estimates and 95% confidence intervals (95% CI). Results From the initial 3,432 studies, 91 studies accounting for 115 prevalence data points (623,624 participants) were finally selected. The prevalence of general fatigue (fatigue lasting < 6 months, or fatigue of unspecified duration) was 20.4% (95% CI, 16.7-25.0) in adults, 11.7% (95% CI, 5.2-26.6) in minors, and 42.3% (95% CI, 33.0-54.2) in specific occupations. Chronic fatigue (fatigue lasting more than 6 months) affected 10.1% (95% CI, 8.2-12.5) of adults, 1.5% (95% CI, 0.5-4.7) of minors, and 5.5% (95% CI, 1.4-21.6) of subjects in specific occupations. There was an overall female-predominant prevalence for all subgroup analyses, with a total odds ratio of 1.4 (95% CI, 1.3-1.6). Regarding the severity and presence of medical causes, the total prevalence of moderate fatigue [14.6% (95% CI, 9.8-21.8)] was 2.4-fold that of severe fatigue [6.1% (95% CI, 3.4-11.0)], while unexplained fatigue (fatigue experienced by individuals without any underlying medical condition that can explain the fatigue) was ~2.7-fold that of explained fatigue (fatigue experienced by individuals with a medical condition that can explain the fatigue); as proportion of 40.0% of physical, 8.6% of mental, and 28.4% of mixed cause. Conclusions This study has produced the first comprehensive picture of global fatigue prevalence in the general population, which will provide vital reference data contributing to fatigue-related research, including the prevention of diseases. Systematic review registration Identifier: CRD42021270498.
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Affiliation(s)
- Ji-Hae Yoon
- Research Center for CFS/ME, Daejeon Oriental Hospital of Daejeon University, Daejeon, Republic of Korea
| | - Na-Hyun Park
- Research Center for CFS/ME, Daejeon Oriental Hospital of Daejeon University, Daejeon, Republic of Korea
| | - Ye-Eun Kang
- Research Center for CFS/ME, Daejeon Oriental Hospital of Daejeon University, Daejeon, Republic of Korea
| | - Yo-Chan Ahn
- Department of Health Service Management, Daejeon University, Daejeon, Republic of Korea
| | - Eun-Jung Lee
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Chang-Gue Son
- Research Center for CFS/ME, Daejeon Oriental Hospital of Daejeon University, Daejeon, Republic of Korea
- Institute of Bioscience and Integrative Medicine, Daejeon University, Daejeon, Republic of Korea
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Lim EJ, Lee JS, Lee EJ, Jeong SJ, Park HY, Ahn YC, Son CG. Nationwide epidemiological characteristics of chronic fatigue syndrome in South Korea. J Transl Med 2021; 19:502. [PMID: 34876158 PMCID: PMC8650266 DOI: 10.1186/s12967-021-03170-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/20/2021] [Indexed: 12/21/2022] Open
Abstract
Background Chronic fatigue syndrome (CFS) is a long-term disabling illness accompanied by medically unexplained fatigue. This study aimed to explore the epidemiological characteristics of CFS in South Korea. Methods Using the nationwide medical records provided by the Korean Health Insurance Review & Assessment Service (HIRA), we analyzed the entire dataset for CFS patients diagnosed by physicians in South Korea from January 2010 to December 2020. Results The annual mean incidence of CFS was estimated to be 44.71 ± 6.10 cases per 100,000 individuals [95% CI: 40.57, 48.76], and the prevalence rate was 57.70 ± 12.20 cases per 100,000 individuals [95% CI: 49.40, 65.79]. These two rates increased by 1.53- and 1.94-fold from 2010 to 2020, respectively, and showed an increasing trend with aging and an approximately 1.5-fold female predominance. Conclusions This study is the first to report the nationwide epidemiological features of CFS, which reflects the clinical reality of CFS diagnosis and care in South Korea. This study will be a valuable reference for studies of CFS in the future.
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Affiliation(s)
- Eun-Jin Lim
- Department of Integrative Medicine, Graduate School of Integrative Medicine, CHA University, 120 Haeryong-Ro, Kyeong-Gi, Pocheon, 11160, Republic of Korea
| | - Jin-Seok Lee
- Institute of Bioscience & Integrative Medicine, College of Korean Medicine, Daejeon Oriental Hospital of Daejeon University, Daedeok-Daero 176, Seo-Gu, Daejeon, 35235, Republic of Korea
| | - Eun-Jung Lee
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Daejeon University, Daedeok-Daero 176, Seo-Gu, Daejeon, 35235, Republic of Korea
| | - Seok-Ju Jeong
- Health Insurance Review & Assessment Service, Dunsanbuk-ro 121, Seo-Gu, Daejeon, 35236, Republic of Korea
| | - Ho-Young Park
- Health Insurance Review & Assessment Service, Dunsanbuk-ro 121, Seo-Gu, Daejeon, 35236, Republic of Korea
| | - Yo-Chan Ahn
- Department of Health Service Management, Daejeon University, 96-3 Yongun-Dong, Dong-Gu, 300-716, Daejeon, 34520, Republic of Korea
| | - Chang-Gue Son
- Institute of Bioscience & Integrative Medicine, College of Korean Medicine, Daejeon Oriental Hospital of Daejeon University, Daedeok-Daero 176, Seo-Gu, Daejeon, 35235, Republic of Korea.
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Kim SK, Joung JY, Ahn YC, Jung IC, Son CG. Beneficial Potential of Banha-Sasim-Tang for Stress-Sensitive Functional Dyspepsia via Modulation of Ghrelin: A Randomized Controlled Trial. Front Pharmacol 2021; 12:636752. [PMID: 33959008 PMCID: PMC8093827 DOI: 10.3389/fphar.2021.636752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 03/15/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Functional dyspepsia (FD) is a highly complex pathophysiologic disease, which shows low recovery and high relapse rates. Therefore, a growing number of clinicians and patients are looking for alternative herbal medicine. Banha-Sasim-Tang (BST) is an herbal prescription for treating a wide range of dyspepsia in traditional Korean medicine (TKM). Aim of the study: This study aimed to evaluate the efficacy of BST on FD in patients with psychological stress-related symptoms and to investigate the involvement of ghrelin. This study is registered at https://cris.nih.go.kr/with the identification number KCT 0002811. Materials and methods: A total of 31 participants with FD who met the Rome IV criteria and the psychological stress-related pattern were enrolled in a double-blind, randomized, and controlled study. Participants were randomly assigned to the BST group (10 g twice daily for 4 weeks) or placebo group. The primary endpoint was a change in the Nepean Dyspepsia Index-Korean (NDI-K) score. The secondary endpoints were changes in the Visual Analog Scale (VAS) scores and plasma ghrelin level. Results: All participants completed the study (n = 15 for BST, n = 16 for placebo). BST decreased NDI-K scores compared with placebo, but the difference was not statistically significant (37.40 ± 27.40 vs 22.50 ± 23.85, p = 0.12). VAS scores and plasma total ghrelin levels were significantly improved in patients who were treated with BST (3.19 ± 1.60 vs 1.38 ± 2.85, p = 0.03 for VAS and 105.69 ± 287.89 vs -142.31 ± 314.32, p = 0.03 for total ghrelin). No BST-related adverse effects were observed during the trial. Conclusion: Our results indicate the clinical potential of BST for FD patients and are the first study to show the modulation of plasma ghrelin as one of its corresponding mechanisms. Clinical Trial Registration: https://cris.nih.go.kr/, identifier KCT 0002811.
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Affiliation(s)
- Sul-Ki Kim
- Liver and Immunology Research Center, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Jin-Yong Joung
- Liver and Immunology Research Center, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Yo-Chan Ahn
- Department of Health Service Management, Daejeon University, Daejeon, Republic of Korea
| | - In-Chul Jung
- Departments of Neuropsychiatry, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Chang-Gue Son
- Liver and Immunology Research Center, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
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Lee NH, Lee GY, Park CR, Kim SK, Ahn YC, Cho JH, Son CG. Risk levels of herb-induced liver injury in Korea: from a meta-analysis. Integr Med Res 2020; 10:100705. [PMID: 33665093 PMCID: PMC7903345 DOI: 10.1016/j.imr.2020.100705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/23/2020] [Accepted: 11/30/2020] [Indexed: 01/16/2023] Open
Abstract
Background As the use of herbal medicines increased worldwide, there has been concern about the risk of herb-induced liver injury (HILI). Many clinical studies have assessed the risk of HILI in Korea. Methods Therefore, we conducted a meta-analysis of the incidence of HILI in Korea, by analyzing nine clinical studies. These involved 8625 participants (3274 males; 5351 females), including 436 outpatients (three studies) and 8189 inpatients (six studies). Results As a result, the overall incidence of HILI in Korea was 0.49% (95% CI 0.33–0.74%), and it was 0.57% in males and 0.30% in females. We found a similar incidence of HILI in prospective (0.51%) and retrospective (0.50%) studies. The incidence of HILI was higher in inpatients (0.62%) than outpatients (0.03%). Conclusion Although there are limitations regarding study quality and the number of participants, we systematically estimated the risk of HILI in Korea. We anticipate this study would be a helpful information for prescribing herbal medicines and researching the safety of herbs.
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Affiliation(s)
- Nam-Hun Lee
- Department of Hepatology & Hematology, Cheonan Korean Medicine Hospital of Daejeon University, Cheonan, Republic of Korea
| | - Ga-Young Lee
- Department of Hepatology & Hematology, Cheonan Korean Medicine Hospital of Daejeon University, Cheonan, Republic of Korea
| | - Chan-Ran Park
- Department of Hepatology & Hematology, Cheonan Korean Medicine Hospital of Daejeon University, Cheonan, Republic of Korea
| | - Sul-Ki Kim
- Liver & Immunology Research Center, Daejeon Korean Medicine Hospital of Daejeon University, Daejeon, Republic of Korea
| | - Yo-Chan Ahn
- Department of Health Service Management, Daejeon University, Daejeon, Republic of Korea
| | - Jung-Hyo Cho
- Liver & Immunology Research Center, Daejeon Korean Medicine Hospital of Daejeon University, Daejeon, Republic of Korea
| | - Chang-Gue Son
- Liver & Immunology Research Center, Daejeon Korean Medicine Hospital of Daejeon University, Daejeon, Republic of Korea
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Lee EJ, Ahn YC, Kim YI, Oh MS, Park YC, Son CG. Incidence Rate of Hypersensitivity Reactions to Bee-Venom Acupuncture. Front Pharmacol 2020; 11:545555. [PMID: 33117156 PMCID: PMC7577189 DOI: 10.3389/fphar.2020.545555] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 09/11/2020] [Indexed: 12/15/2022] Open
Abstract
Introduction Bee-venom acupuncture (BVA) has been widely applied to various disorders including pain-related diseases; however, patients are often warned of adverse reactions such as anaphylaxis. This study aimed to estimate the risk of hypersensitivity reactions to BVA and to determine their clinical features. Methods We retrospectively surveyed the medical records of patients treated by BVA between January 2010 and April 2019 in Dunsan Hospital of Daejeon University, and all cases of allergic reactions and their clinical symptoms were analyzed. Results A total of 8,580 patients (males 4,081 and females 4,499) were treated with BVA which amounts to a total of 60,654 treatments (average 7.1 ± 14.8 times). A total of fifteen patients (7 males and 8 females) reported an allergic reaction (0.175%, 95% CI, 0.086–0.263) of type 1 hypersensitivity, indicating a rate of allergic reaction in 0.025% (95% CI, 0.012–0.037) of the total BVA treatments. The average number of BVA treatments in those patients was 6.9 ± 6.5 (males: 4.1 ± 3.4 and females: 9.3 ± 7.9). Among the cases of hypersensitivity reactions, 4 involved anaphylactic shock; therefore, the incidence rate of anaphylaxis was 0.047% (95% CI, 0.001–0.092) for the 8,580 subjects and 0.007% (95% CI, 0.000–0.013) for the 60,654 treatments. All grade 1 cases were recovered within 1 day, whereas others took up to 30 days for complete recovery. Conclusion Our results may emphasize paying attention to unforeseeable risks of anaphylaxis after bee-venom acupuncture. This study could be essential reference data for the guidelines of appropriate use of bee-venom acupuncture and bee-venom-derived interventions in clinical applications.
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Affiliation(s)
- Eun-Jung Lee
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Daejeon University, Daejeon, South Korea
| | - Yo-Chan Ahn
- Department of Health Service Management, Daejeon University, Daejeon, South Korea
| | - Young-Il Kim
- Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Daejeon University, Daejeon, South Korea
| | - Min-Seok Oh
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Daejeon University, Daejeon, South Korea
| | - Yang-Chun Park
- Division of Respiratory System, Department of Internal Medicine, College of Korean Medicine, Daejeon University, Daejeon, South Korea
| | - Chang-Gue Son
- Department of Gastrobilliary System, Dunsan Hospital of Daejeon University, Daejeon, South Korea
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Ahn YC, Lee JS, Son CG. Reliability and Validity of the Modified Korean Version of the Chalder Fatigue Scale (mKCFQ11). Healthcare (Basel) 2020; 8:healthcare8040427. [PMID: 33114401 PMCID: PMC7712859 DOI: 10.3390/healthcare8040427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/21/2020] [Accepted: 10/22/2020] [Indexed: 12/20/2022] Open
Abstract
Fatigue can accompany various diseases; however, fatigue itself is a key symptom for patients with chronic fatigue syndrome (CFS). Due to the absence of biological parameters for the diagnosis and severity of CFS, the assessment tool for the degree of fatigue is very important. This study aims to verify the reliability and validity of the modified Korean version of the Chalder Fatigue Scale (mKCFQ11). This study was performed using data from 97 participants (Male: 37, Female: 60) enrolled in a clinical trial for an intervention of CFS. The analyses of the coefficient between the mKCFQ11 score and the Fatigue Severity Scale (FSS), the Visual Analogue Scale (VAS) or the 36-item Short-Form Health Survey (SF-36) at two time points (baseline and 12 weeks) as well as their changed values were conducted. The mKCFQ11 showed strong reliability, as evidenced by the Cronbach’s alpha coefficient of 0.967 for the whole item and two subclasses (0.963 for physical and 0.958 for mental fatigue) along with the suitable validity of the mKCFQ11 structure shown by the principal component analysis. The mKCFQ11 scores also strongly correlated (higher than 0.7) with the VAS, FSS and SF-36 on all data from baseline and 12 weeks and changed values. This study demonstrated the clinical usefulness of the mKCFQ11 instrument, particularly in assessing the severity of fatigue and the evaluation of treatments for patients suffering from CFS.
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Affiliation(s)
- Yo-Chan Ahn
- Department of Health Service Management, Daejeon University, Daejeon 300-716, Korea;
| | - Jin-Seok Lee
- Department of Korean Medicine, Institute of Bioscience and Integrative Medicine, Daejeon University, Daejeon 300-716, Korea;
| | - Chang-Gue Son
- Department of Korean Medicine, Institute of Bioscience and Integrative Medicine, Daejeon University, Daejeon 300-716, Korea;
- Correspondence: ; Tel.: +82-42-257-6397; Fax: +82-42-257-6398
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Joung JY, Kim HG, Lee JS, Cho JH, Ahn YC, Lee DS, Son CG. Anti-hepatofibrotic effects of CGX, a standardized herbal formula: A multicenter randomized clinical trial. Biomed Pharmacother 2020; 126:110105. [PMID: 32203892 DOI: 10.1016/j.biopha.2020.110105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/10/2020] [Accepted: 03/11/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Chunggan extract (CGX) is an herbal formula used for the treatment of chronic liver disease in traditional Korean medicine. Many preclinical studies have suggested its therapeutic or preventive effects on liver fibrosis. To evaluate the efficacy and safety of CGX, we conducted a randomized controlled clinical trial of CGX in patients with liver fibrosis diagnosed by Fibroscan. METHODS We enrolled 67 subjects at two hospitals with chronic liver disorders with a 5.5 ≤ liver stiffness measurement (LSM) score ≤ 16 kPa. Subjects were randomly assigned at a 1:1:1 ratio with stratification (with/without concomitant use of antivirals) and orally administered CGX (1 g or 2 g) or placebo twice daily for 24 weeks. The end point was the change in instantaneous elasticity of the liver assessed by Fibroscan before and after treatment. RESULTS LSM scores were significantly decreased in both the CGX1 g (2.5 ± 1.7 kPa, p < 0.01) and CGX2 g (1.9 ± 2.0 kPa, p < 0.05) groups compared to the placebo (0.6 ± 1.6 kPa) group. The change was also significant in 35 subjects without concomitant use of antiviral agents in the CGX1 g group (placebo 0.1 ± 1.4 kPa vs. 2.7 ± 1.6 kPa, p < 0.01) but not in those with concomitant antiviral use (p > 0.05). No notable adverse events were present. CONCLUSION CGX appeared to have a pharmacological effect against liver fibrosis. Further studies to confirm the results are needed in the future using a larger sample size.
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Affiliation(s)
- Jin-Yong Joung
- Liver and Immunology Research Center, Dunsan Oriental Hospital of Daejeon University, 35353, Daedukdae-ro 176 bun-gil 75, Seo-gu, Daejeon, Republic of Korea
| | - Hyeong-Geug Kim
- Liver and Immunology Research Center, Dunsan Oriental Hospital of Daejeon University, 35353, Daedukdae-ro 176 bun-gil 75, Seo-gu, Daejeon, Republic of Korea
| | - Jin-Seok Lee
- Liver and Immunology Research Center, Dunsan Oriental Hospital of Daejeon University, 35353, Daedukdae-ro 176 bun-gil 75, Seo-gu, Daejeon, Republic of Korea
| | - Jung-Hyo Cho
- Liver and Immunology Research Center, Dunsan Oriental Hospital of Daejeon University, 35353, Daedukdae-ro 176 bun-gil 75, Seo-gu, Daejeon, Republic of Korea
| | - Yo-Chan Ahn
- Department of Health Service Management, Daejeon University, 96-3 Yongun-dong, Dong-gu, Daejeon, 34520, Republic of Korea
| | - Dong-Soo Lee
- Department of Internal Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 64, Daeheung-ro, Jung-gu, Daejeon, 34943, Republic of Korea.
| | - Chang-Gue Son
- Liver and Immunology Research Center, Dunsan Oriental Hospital of Daejeon University, 35353, Daedukdae-ro 176 bun-gil 75, Seo-gu, Daejeon, Republic of Korea.
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Lim EJ, Ahn YC, Jang ES, Lee SW, Lee SH, Son CG. Systematic review and meta-analysis of the prevalence of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). J Transl Med 2020; 18:100. [PMID: 32093722 PMCID: PMC7038594 DOI: 10.1186/s12967-020-02269-0] [Citation(s) in RCA: 173] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 02/14/2020] [Indexed: 01/31/2023] Open
Abstract
Background Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) has been emerging as a significant health issue worldwide. This study aimed to systemically assess the prevalence of CFS/ME in various aspects of analyses for precise assessment. Methods We systematically searched prevalence of CFS/ME from public databases from 1980 to December 2018. Data were extracted according to 7 categories for analysis: study participants, gender and age of the participants, case definition, diagnostic method, publication year, and country of the study conducted. Prevalence data were collected and counted individually for studies adopted various case definitions. We analyzed and estimated prevalence rates in various angles: average prevalence, pooled prevalence and meta-analysis of all studies. Results A total of 1291 articles were initially identified, and 45 articles (46 studies, 56 prevalence data) were selected for this study. Total 1085,976 participants were enrolled from community-based survey (540,901) and primary care sites (545,075). The total average prevalence was 1.40 ± 1.57%, pooled prevalence 0.39%, and meta-analysis 0.68% [95% CI 0.48–0.97]. The prevalence rates were varied by enrolled participants (gender, study participants, and population group), case definitions and diagnostic methods. For example, in the meta-analysis; women (1.36% [95% CI 0.48–0.97]) vs. men (0.86% [95% CI 0.48–0.97]), community-based samples (0.76% [95% CI 0.53–1.10]) vs. primary care sites (0.63% [95% CI 0.37–1.10]), adults ≥ 18 years (0.65% [95% CI 0.43–0.99]) vs. children and adolescents < 18 years (0.55% [95% CI 0.22–1.35]), CDC-1994 (0.89% [95% CI 0.60–1.33]) vs. Holmes (0.17% [95% CI 0.06–0.49]), and interviews (1.14% [95% CI 0.76–1.72]) vs. physician diagnosis (0.09% [95% CI 0.05–0.13]), respectively. Conclusions This study comprehensively estimated the prevalence of CFS/ME; 0.89% according to the most commonly used case definition CDC-1994, with women approximately 1.5 to 2 folds higher than men in all categories. However, we observed the prevalence rates are widely varied particularly by case definitions and diagnostic methods. An objective diagnostic tool is urgently required for rigorous assessment of the prevalence of CFS/ME.
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Affiliation(s)
- Eun-Jin Lim
- Institute of Bioscience and Integrative Medicine, Department of Korean Medicine, Daejeon University, 62 Daehak-ro, Dong-gu, Daejeon, Republic of Korea
| | - Yo-Chan Ahn
- Department of Health Service Management, Daejeon University, 96-3 Yongun-dong, Dong-gu, Daejeon, 300-716, Republic of Korea
| | - Eun-Su Jang
- Institute of Bioscience and Integrative Medicine, Department of Korean Medicine, Daejeon University, 62 Daehak-ro, Dong-gu, Daejeon, Republic of Korea
| | - Si-Woo Lee
- Division of Future Medicine, Korean Institute of Oriental Medicine, Yuseong-daero, 1672, Daejeon, Republic of Korea
| | - Su-Hwa Lee
- The Catholic University of Korea, Daejeon St. Mary Hospital, 64, Daeheung-ro, Jung-gu, Daejeon, Republic of Korea
| | - Chang-Gue Son
- Institute of Bioscience and Integrative Medicine, Department of Korean Medicine, Daejeon University, 62 Daehak-ro, Dong-gu, Daejeon, Republic of Korea.
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Joung JY, Lee JS, Cho JH, Lee DS, Ahn YC, Son CG. The Efficacy and Safety of Myelophil, an Ethanol Extract Mixture of Astragali Radix and Salviae Radix, for Chronic Fatigue Syndrome: A Randomized Clinical Trial. Front Pharmacol 2019; 10:991. [PMID: 31551788 PMCID: PMC6746924 DOI: 10.3389/fphar.2019.00991] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 08/05/2019] [Indexed: 12/12/2022] Open
Abstract
Background: There is a strong demand for therapeutics to treat chronic fatigue syndrome (CFS), although there are limitations. Myelophil, which is a combination of extracts from Astragali Radix and Salviae Miltiorrhizae Radix, has been clinically used to treat fatigue-related disorders in South Korea. We conducted a randomized controlled clinical trial of Myelophil in patients with CFS and evaluated its efficacy and safety in two hospitals. Methods: We enrolled 98 participants (M: 38, F: 60) with CFS in a phase 2 trial of oral Myelophil (2 g daily) or placebo for 12 weeks. The primary end point was a change in the Chalder fatigue scale, as scored by a numeric rating scale (NRS). The secondary end points included changes in the visual analogue scale, fatigue severity scale (FSS), and 36-item short-form health survey (SF-36). Biomarkers of oxidative stress and cytokines were evaluated by blood tests. Results: Ninety-seven participants (48 in the Myelophil group and 49 in the placebo group) completed the trial. An analysis of all participants showed that Myelophil slightly improved fatigue symptoms compared with those of the placebo, but this effect was not statistically significant (p > 0.05 for the NRS, VAS, FSS, and SF-36). By contrast, an analysis of the subpopulation (53 participants, M: 24, F: 29) with severe symptoms (≥63, median NRS value of total participants) showed a statistically significant improvement in fatigue symptoms in the Myelophil group compared with the placebo (p < 0.05 for NRS, FSS, and SF-36). There were no significant changes in the biomarkers for oxidative stress and cytokines before or after the treatment. No Myelophil-related adverse response was observed during the trial. Conclusion: These results support the hypothesis that Myelophil can be a therapeutic candidate to manage CFS and provide the rationale for its progression to a phase 3 clinical trial. Clinical Trial Registration:www.ClinicalTrials.gov, identifier KCT0002317.
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Affiliation(s)
- Jin-Yong Joung
- Liver and Immunology Research Center, Oriental Medical Collage of Daejeon University, Daejeon, South Korea
| | - Jin-Seok Lee
- Liver and Immunology Research Center, Oriental Medical Collage of Daejeon University, Daejeon, South Korea
| | - Jung-Hyo Cho
- Liver and Immunology Research Center, Oriental Medical Collage of Daejeon University, Daejeon, South Korea
| | - Dong-Soo Lee
- Department of Internal Medicine, Daejeon St. Mary's Hospital of Catholic University, Daejeon, South Korea
| | - Yo-Chan Ahn
- Department of Health Service Management, Daejeon University, Daejeon, South Korea
| | - Chang-Gue Son
- Liver and Immunology Research Center, Oriental Medical Collage of Daejeon University, Daejeon, South Korea
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Byeon JH, Kil JH, Ahn YC, Son CG. Systematic review of published data on herb induced liver injury. J Ethnopharmacol 2019; 233:190-196. [PMID: 30639232 DOI: 10.1016/j.jep.2019.01.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 05/13/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Herbal products have been widely used as a means of ethnomedicine worldwide. Recently, the potential hepatotoxicity of herbs has become a medical issue but comprehensive studies are limited. AIM OF THE STUDY This study aims to determine the clinical features of herb induced liver injury (HILI) including its constituent ratio among liver injury case cohorts that included both HILI and drug induced liver injury (DILI). MATERIALS AND METHODS A systematic review was conducted using a literature search for DILI/HILI in seven electric databases including PubMed, Cochrane and Embase. We analyzed the DILI/HILI cases and clinical characteristics in terms of herbs, conventional drugs, concomitant, or others. RESULTS Thirty-one studies met the necessary criteria and included 9 prospective and 22 retrospective studies. Among total number of overall DILI/HILI cases (7511, male 2819, female 3669 and unknown 1023), 25.0% (1874 cases) were implicated in herbs. HILI was relatively higher in females (69.8% vs. 30.2% male), compared to conventional drugs (57.3% female vs. 42.7% male, p < 0.01), while it was prone to induce hepatocellular injury (hepatocellular 78.8%, cholestatic 8.9%, mixed type 12.3%), contrary to conventional drugs (hepatocellular 56.7% vs. cholestatic 22.1% vs. mixed 21.2%), respectively (p < 0.01). The main herbs causing HILI included Polygonum multiflorum, Psoralea corylifolia, Corydalis yanhusuo, and Rheum officinale. CONCLUSIONS This review created the comparative and comprehensive feature of hepatotoxicity by herbal products, which provides reference data for the clinical applications and establishing pharmacovigilance system of herbs.
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Affiliation(s)
- Jung-Hwan Byeon
- Korean Medical College of Daejeon University, 62, Daehak-ro Dong-gu, Daejeon 301-716, Republic of Korea.
| | - Ji-Hye Kil
- Korean Medical College of Daejeon University, 62, Daehak-ro Dong-gu, Daejeon 301-716, Republic of Korea.
| | - Yo-Chan Ahn
- Department of Health Service Management, Daejeon University, 62, Daehak-ro Dong-gu, Daejeon 301-716, Republic of Korea.
| | - Chang-Gue Son
- Liver and Immunology Research Center, Dunsan Oriental Hospital of Daejeon University, 75, Daedeok-daero 176, Seo-gu, Daejeon 35253, Republic of Korea.
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Lee JS, Kim HG, Lee HW, Kim WY, Ahn YC, Son CG. Pine needle extract prevents hippocampal memory impairment in acute restraint stress mouse model. Journal of Ethnopharmacology 2017; 207:226-236. [PMID: 28642096 DOI: 10.1016/j.jep.2017.06.024] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
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Lee HY, Lee WJ, Kim HW, Jang ES, Ahn YC, Ku BC, Kang W, Lee SW, Son CG. A Systematic Review on Sasang Constitutional Type-Associated Susceptibility to Disorders in Korea. J Altern Complement Med 2016; 22:950-956. [PMID: 27754711 DOI: 10.1089/acm.2016.0177] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND/OBJECTIVE Sasang constitutional medicine is a component of traditional Korean medicine that classifies individuals into four Sasang constitutional types (SCTs) by their physical and psychological traits. Each SCT is known to show different susceptibilities to disorders. This systematic review investigated the effect of SCT as a risk factor for various disorders. METHODS A systematic literature survey was conducted by searching seven databases for all articles on the prevalence rates of disorders according to SCT and sex. RESULTS From 14,272 relevant articles, 15 studies (13 disorders) were ultimately identified to verify different prevalence rates by SCT. Of the 13 disorders, 6 (prehypertension, general obesity, abdominal obesity, metabolic syndrome, diabetes mellitus, and irritable bowel syndrome [IBS]) had a significantly different prevalence by SCT. Metabolic syndrome and its associated disorders showed the highest prevalence in Taeumin-type individuals, whereas IBS was most prevalent in Soeumin-type individuals. In general, these findings were consistent with the results obtained in an analysis of male and female participants. CONCLUSIONS This study revealed that susceptibility to disorders was affected by SCT to some extent. Further studies are needed to determine the concrete features of SCT-related susceptibility, which may be helpful in preventive medicine with Sasang constitutional practice.
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Affiliation(s)
- Hyun-Yong Lee
- 1 College of Korean Medicine, Daejeon University , Daejeon, Republic of Korea
| | - Woo-Jin Lee
- 1 College of Korean Medicine, Daejeon University , Daejeon, Republic of Korea
| | - Hae-Won Kim
- 1 College of Korean Medicine, Daejeon University , Daejeon, Republic of Korea
| | - Eun-Su Jang
- 1 College of Korean Medicine, Daejeon University , Daejeon, Republic of Korea
| | - Yo-Chan Ahn
- 2 Department of Health Service Management, Daejeon University , Daejeon, Republic of Korea
| | - Bon-Cho Ku
- 3 KM Fundamental Research Division, Korea Institute of Oriental Medicine , Daejeon, Republic of Korea
| | - Weechang Kang
- 4 Department of Statistics, Daejeon University, Daejeon, Republic of Korea
| | - Si-Woo Lee
- 5 Mibyeong Research Center, Korea Institute of Oriental Medicine , Daejeon, Republic of Korea
| | - Chang-Gue Son
- 1 College of Korean Medicine, Daejeon University , Daejeon, Republic of Korea
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Abstract
Non-Hodgkin lymphoma involving the esophagus is very rare. Only a few cases have been reported in the English literature to date, and it accounts for less than 1% of all cases of gastrointestinal lymphoma. As this malignancy manifests as a submucosal tumor, pathological diagnosis by using a simple endoscopic biopsy alone is difficult. Therefore, surgical biopsy, endoscopic mucosal resection, and endoscopic ultrasound-guided fine-needle aspiration have been used in most cases. Herein, we report a case of esophageal mucosa-associated lymphoid tissue lymphoma in a 49-year-old man, which involved the use of a stacked forceps biopsy to obtain adequate samples for pathological analysis; the use of the stacked forceps biopsy method is unlike those used in previous cases. The patient received cyclophosphamide, vincristine, and prednisolone chemotherapy; he achieved a complete response. In addition, we review the literature relevant to this case.
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Affiliation(s)
- D S Lee
- Department of Internal Medicine, Gangneung Asan Medical Center, University of Ulsan College of Medicine, Gangneung, South Korea
| | - Y C Ahn
- Department of Internal Medicine, Gangneung Asan Medical Center, University of Ulsan College of Medicine, Gangneung, South Korea
| | - D W Eom
- Department of Pathology, Gangneung Asan Medical Center, University of Ulsan College of Medicine, Gangneung, South Korea
| | - S J Lee
- Department of Internal Medicine, Gangneung Asan Medical Center, University of Ulsan College of Medicine, Gangneung, South Korea.
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Son SW, Lee JS, Kim HG, Kim DW, Ahn YC, Son CG. Testosterone depletion increases the susceptibility of brain tissue to oxidative damage in a restraint stress mouse model. J Neurochem 2015; 136:106-17. [PMID: 26385432 DOI: 10.1111/jnc.13371] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 09/01/2015] [Accepted: 09/02/2015] [Indexed: 12/31/2022]
Affiliation(s)
- Seung-Wan Son
- Department of Biomedical Engineering; College of Health Science; Korea University; Seongbuk-Gu Seoul Korea
| | - Jin-Seok Lee
- Liver and Immunology Research Center; Daejeon Oriental Hospital of Oriental Medical Collage of Daejeon University; Jung-gu Daejeon South Korea
| | - Hyeong-Geug Kim
- Liver and Immunology Research Center; Daejeon Oriental Hospital of Oriental Medical Collage of Daejeon University; Jung-gu Daejeon South Korea
| | - Dong-Woon Kim
- Department of Anatomy; Brain Research Institute; Chungnam National University School of Medicine; Daejeon South Korea
| | - Yo-Chan Ahn
- Department of Health Service Management; Daejeon University; Dong-gu Daejeon Korea
| | - Chang-Gue Son
- Department of Biomedical Engineering; College of Health Science; Korea University; Seongbuk-Gu Seoul Korea
- Liver and Immunology Research Center; Daejeon Oriental Hospital of Oriental Medical Collage of Daejeon University; Jung-gu Daejeon South Korea
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Ahn YC, Son CG. Prevalence of functional supplement use among Korean adolescents. Afr J Tradit Complement Altern Med 2013; 11:28-29. [PMID: 24653550 PMCID: PMC3957238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Yo-Chan Ahn
- Dep. of Health Service Management, Daejeon Univ., Daejeon 300-716, South Korea
| | - Chang-Gue Son
- Dept. of Oriental Internal Medicine, Daejeon Oriental Hospital of Daejeon Univ., Daejeon 301-724, South Korea
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Kim HG, Cho JH, Yoo SR, Lee JS, Han JM, Lee NH, Ahn YC, Son CG. Antifatigue effects of Panax ginseng C.A. Meyer: a randomised, double-blind, placebo-controlled trial. PLoS One 2013; 8:e61271. [PMID: 23613825 PMCID: PMC3629193 DOI: 10.1371/journal.pone.0061271] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Accepted: 03/04/2013] [Indexed: 11/19/2022] Open
Abstract
UNLABELLED The present study investigated the antifatigue effects of Panax ginseng C.A. Meyer in 90 subjects (21 men and 69 women) with idiopathic chronic fatigue (ICF) in a randomised, double-blind, placebo-controlled and parallel designed trial. A bespoke 20% ethanol extract of P. ginseng (1 g or 2 g day(-1)) or a placebo was administered to each group for 4 weeks, and then fatigue severity was monitored using a self-rating numeric scale (NRS) and a visual analogue scale (VAS) as a primary endpoint. Serum levels of reactive oxygen species (ROS), malondialdehyde (MDA), total glutathione (GSH) contents and glutathione reductase (GSH-Rd) activity were determined. After 4-week, P. ginseng administration decreased the total NRS score, but they were not statistically significant compared with placebo (P>0.05). Mental NRS score was significantly improved by P. ginseng administrations as 20.4 ± 5.0 to 15.1 ± 6.5 [95% CI 2.3 ~ 8.2] for 1 g and 20.7 ± 6.3 to 13.8 ± 6.2 [95% CI -0.1 ~ 4.2] for 2 g compared with placebo 20.9 ± 4.5 to 18.8 ± 2.9 [95% CI 4.1 ~ 9.9, P<0.01]. Only 2 g P. ginseng significantly reduced the VAS score from 7.3 ± 1.3 to 4.4 ± 1.8 [95% CI 0.7∼1.8] compared with the placebo 7.1 ± 1.0 to 5.8 ± 1.3 [95% CI 2.2 ~ 3.7, P<0.01]. ROS and MDA levels were lowered by P. ginseng compared to placebo. P. ginseng 1 g increased GSH concentration and GSH-Rd activity. Our results provide the first evidence of the antifatigue effects of P. ginseng in patients with ICF, and we submit that these changes in antioxidant properties contribute in part to its mechanism. TRIAL REGISTRATION Clinical Research Information Service (CRIS) KCT0000048.
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Affiliation(s)
- Hyeong-Geug Kim
- Liver and Immunology Research Center, Daejeon Oriental Hospital of Daejeon University, Jung-gu, Daejeon, South Korea
| | - Jung-Hyo Cho
- Liver and Immunology Research Center, Daejeon Oriental Hospital of Daejeon University, Jung-gu, Daejeon, South Korea
| | - Sa-Ra Yoo
- Liver and Immunology Research Center, Daejeon Oriental Hospital of Daejeon University, Jung-gu, Daejeon, South Korea
| | - Jin-Seok Lee
- Liver and Immunology Research Center, Daejeon Oriental Hospital of Daejeon University, Jung-gu, Daejeon, South Korea
| | - Jong-Min Han
- Liver and Immunology Research Center, Daejeon Oriental Hospital of Daejeon University, Jung-gu, Daejeon, South Korea
| | - Nam-Hun Lee
- Liver and Immunology Research Center, Daejeon Oriental Hospital of Daejeon University, Jung-gu, Daejeon, South Korea
| | - Yo-Chan Ahn
- Department of Health Service Management Daejeon University, Dong-gu, Daejeon, South Korea
| | - Chang-Gue Son
- Liver and Immunology Research Center, Daejeon Oriental Hospital of Daejeon University, Jung-gu, Daejeon, South Korea
- * E-mail:
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Sun JM, Ahn YC, Choi EK, Ahn MJ, Ahn JS, Lee SH, Lee DH, Pyo H, Song SY, Jung SH, Jo JS, Jo J, Sohn HJ, Suh C, Lee JS, Kim SW, Park K. Phase III trial of concurrent thoracic radiotherapy with either first- or third-cycle chemotherapy for limited-disease small-cell lung cancer. Ann Oncol 2013; 24:2088-92. [PMID: 23592701 DOI: 10.1093/annonc/mdt140] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND We compared late thoracic radiotherapy (TRT) with early TRT in the treatment of limited-disease small-cell lung cancer (LD-SCLC). PATIENTS AND METHODS Patients with LD-SCLC received four cycles of etoposide plus cisplatin every 21 days. Patients were randomly assigned to receive either TRT administered concurrently with the first cycle (early TRT) or the third cycle (late TRT) of chemotherapy. The primary end point was complete response rate. RESULTS Two hundred twenty-two patients were randomly assigned.Late TRT was not inferior to early TRT in terms of the complete response rate (early v late; 36.0% v 38.0%). Other efficacy measures including overall survival [median, 24.1 v 26.8 months;hazard ratio (HR) 0.93; 95% CI = 0.67–1.29] and progression free survival (median, 12.4 v 11.2 months; HR 1.09; 95%CI = 0.80–1.48) were not different between two arms. No statistical difference was noted in the pattern of treatment failures.However, neutropenic fever occurred more commonly in the early TRT arm than the late TRT arm (21.6% v 10.2%; P = 0.02) [corrected]. CONCLUSION In LD-SCLC treatment, TRT starting in the third cycle of chemotherapy seemed to be noninferior to early TRT, and had a more favorable profile with regard to neutropenic fever.
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Affiliation(s)
- J-M Sun
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lee JS, Kim HG, Han JM, Lee JS, Son SW, Ahn YC, Son CG. Myelophil ameliorates brain oxidative stress in mice subjected to restraint stress. Prog Neuropsychopharmacol Biol Psychiatry 2012; 39:339-47. [PMID: 22813841 DOI: 10.1016/j.pnpbp.2012.07.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2012] [Revised: 06/29/2012] [Accepted: 07/06/2012] [Indexed: 12/22/2022]
Abstract
We evaluated the pharmacological effects of Myelophil, a 30% ethanol extract of a mix of Astragali Radix and Salviae Radix, on oxidative stress-induced brain damage in mice caused by restraint stress. C57BL/6 male mice (eight weeks old) underwent daily oral administration of distilled water, Myelophil (25, 50, or 100mg/kg), or ascorbic acid (100mg/kg) 1h before induction of restraint stress, which involved 3h of immobilization per day for 21days. Nitric oxide levels, lipid peroxidation, activities of antioxidant enzymes (superoxide dismutase, catalase, and glutathione redox system enzymes), and concentrations of adrenaline, corticosterone, and interferon-γ, were measured in brain tissues and/or sera. Restraint stress-induced increases in nitric oxide levels (serum and brain tissues) and lipid peroxidation (brain tissues) were significantly attenuated by Myelophil treatment. Restraint stress moderately lowered total antioxidant capacity, catalase activity, glutathione content, and the activities of glutathione reductase, glutathione peroxidase, and glutathione S-transferase; all these responses were reversed by Myelophil. Myelophil significantly attenuated the elevated serum concentrations of adrenaline and corticosterone and restored serum and brain interferon-γ levels. Moreover, Myelophil normalized expression of the genes encoding monoamine oxidase A, catechol-O-methyltransferase, and phenylethanolamine N-methyltransferase, which was up-regulated by restraint stress in brain tissues. These results suggest that Myelophil has pharmacological properties protects brain tissues against stress-associated oxidative stress damage, perhaps in part through regulation of stress hormones.
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Affiliation(s)
- Jin-Seok Lee
- Liver and Immunology Research Center, Oriental Medical Collage of Daejeon University, 22-5 Daehung-dong, Jung-gu, Daejeon, 301-724, Republic of Korea
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Jeong TY, Park BK, Cho JH, Kim YI, Ahn YC, Son CG. A prospective study on the safety of herbal medicines, used alone or with conventional medicines. J Ethnopharmacol 2012; 143:884-888. [PMID: 22940254 DOI: 10.1016/j.jep.2012.08.016] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Revised: 07/14/2012] [Accepted: 08/15/2012] [Indexed: 06/01/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Along with increase of herbal medicine use worldwide, the safety of traditional herbal medicines frequently becomes a medical issue. AIM OF THE STUDY This study aimed to investigate the incidence of herbal medicine-induced adverse effects on liver functions. SUBJECTS AND METHODS A prospective study was performed with 313 inpatients (87 male and 226 female) receiving herbal prescriptions during hospitalization. The patients were classified into two groups based on their treatments: one group received herbal medicines only (57 patients), and another received herbal and conventional medicines concurrently (256 patients). All patients were given liver and renal function tests at the start of hospitalization (baseline) and at approximately 2-week intervals thereafter, until discharge. RESULTS Six of the 313 patients showed abnormal liver function without related clinical symptoms (1.9%, 95% CI 0.38-3.41); none of the patients in the herbal group had abnormal result in liver function tests (0% of 57 patients) while all six had received a combination of herbal and conventional medicines (2.3% of 256 patients, 95% CI 0.46-4.14). CONCLUSION Our findings indicate that herbal drugs used alone are relatively safe, but the risk for adverse reactions may increase when herbal and conventional drugs are taken concurrently.
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Affiliation(s)
- Tae-Young Jeong
- Liver and Immunology Research Center, Daejeon Oriental Hospital of Daejeon University, 22-5 Daeheung-dong, Jung-gu, Daejeon 301-704, Republic of Korea
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Yi JH, Kim JH, Baek KK, Lim T, Lee DJ, Ahn YC, Kim K, Kim SJ, Ko YH, Kim WS. Elevated LDH and paranasal sinus involvement are risk factors for central nervous system involvement in patients with peripheral T-cell lymphoma. Ann Oncol 2011; 22:1636-1643. [PMID: 21220520 PMCID: PMC3121968 DOI: 10.1093/annonc/mdq645] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background: The incidence and risk factors of central nervous system (CNS) involvement in peripheral T-cell lymphomas (PTCLs) are still unclear. Patients and methods: We analyzed 228 patients with PTCLs, excluding cases of extranodal natural killer/T-cell lymphoma and primary cutaneous T-cell lymphoma, by retrospectively collecting the clinical features and outcomes of the patients. Results: Twenty events (8.77%, 20/228) of CNS involvement were observed during a median follow-up period of 13.9 months (range 0.03–159.43). Based on univariate analysis, elevated serum lactate dehydrogenase (LDH) level [P = 0.019, relative risk (RR) 5.904, 95% confidence interval (CI) 1.334–26.123] and involvement of the paranasal sinus (P = 0.032, RR 3.137, 95% CI 1.105–8.908) adversely affect CNS involvement. In multivariate analysis, both were independently poor prognostic factors for CNS relapse [elevated LDH level: P = 0.011, hazard ratio (HR) 6.716, 95% CI 1.548–29.131; involvement of the paranasal sinus: P = 0.008, HR 3.784, 95% CI 1.420–10.083]. The survival duration of patients with CNS involvement was significantly shorter than that of the patients without CNS involvement (P = 0.009), with median overall survival of 7.60 months (95% CI of 4.92–10.28) versus 27.43 months (95% CI of 0.00–57.38), respectively. Conclusions: Elevated LDH level and involvement of the paranasal sinus are two risk factors for CNS involvement in patients with PTCLs. Considering the poor prognoses after CNS relapse, prophylaxis should be considered with the presence of any risk factor.
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Affiliation(s)
- J H Yi
- Division of Hematology-Oncology, Department of Medicine
| | - J H Kim
- Division of Hematology-Oncology, Department of Medicine
| | - K K Baek
- Division of Hematology-Oncology, Department of Medicine
| | - T Lim
- Division of Hematology-Oncology, Department of Medicine
| | - D J Lee
- Division of Hematology-Oncology, Department of Medicine
| | - Y C Ahn
- Department of Radiation Oncology
| | - K Kim
- Division of Hematology-Oncology, Department of Medicine
| | - S J Kim
- Division of Hematology-Oncology, Department of Medicine
| | - Y H Ko
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - W S Kim
- Division of Hematology-Oncology, Department of Medicine.
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Kim SJ, Oh SY, Hong JY, Chang MH, Lee DH, Huh J, Ko YH, Ahn YC, Kim HJ, Suh C, Kim K, Kim WS. When do we need central nervous system prophylaxis in patients with extranodal NK/T-cell lymphoma, nasal type? Ann Oncol 2009; 21:1058-63. [PMID: 19850636 DOI: 10.1093/annonc/mdp412] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The incidence and risk factors of central nervous system (CNS) invasion is still unclear in extranodal natural killer (NK)/T-cell lymphoma, nasal type. PATIENTS AND METHODS We analyzed 208 patients to study the clinical features and outcomes of CNS disease in extranodal NK/T-cell lymphoma. RESULTS Twelve patients (5.76%, 12/208) experienced CNS disease during treatment or follow-up period (median 11.62 months, range 0.2-123.2 months). The clinical variables associated with CNS disease were Ann Arbor stage III/IV (15.87%, P <0.001), regional lymph node involvement (10.41%, P = 0.006), group III/IV of NK/T-cell lymphoma prognostic index (NKPI; 10.20%, P = 0.003), high/high-intermediate international prognostic index (9.30%, P = 0.072) and extra-upper aerodigestive primary sites (9.75%, P = 0.008). In multivariate analysis, NKPI retained the strongest statistical power to predict CNS disease (P = 0.007, relative risk 9.289, 95% confidence interval 1.828-47.212) in extranodal NK/T-cell lymphoma. CONCLUSIONS Despite extranodal NK/T-cell lymphoma frequently involves paranasal sinus, a routine CNS evaluation and prophylaxis do not seem to be necessary in NKPI group I or II patients due to a very low incidence. Nevertheless, CNS prophylaxis should be considered in NKPI groups III and IV.
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Affiliation(s)
- S J Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Shin JS, Han Y, Ju SG, Shin EH, Ahn YC. SU-GG-J-32: Analysis of Imaging Doses for Optimal Management of 4D-IGRT Treatments. Med Phys 2008. [DOI: 10.1118/1.2961589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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26
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Han Y, Shin EH, Yoon MK, Lee SB, Ju SG, Lim CI, Park SH, Kang SK, Lah JE, Cho SH, Ibbott G, Ahn YC. SU-FF-T-186: Dosimetry in An IMRT Phantom Designed for a Remote Auditing Program. Med Phys 2007. [DOI: 10.1118/1.2760846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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27
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Ju SG, Shin EH, Han Y, Ahn YC. SU-FF-T-124: Comparison of Radiographic Film with Lead Filter and GAFchromic EBT Film for IMRT Dose Verification. Med Phys 2007. [DOI: 10.1118/1.2760782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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28
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Lee J, Kim WS, Park YH, Park SH, Park KW, Kang JH, Lee SS, Lee SI, Lee SH, Kim K, Jung CW, Ahn YC, Ko YH, Park K. Nasal-type NK/T cell lymphoma: clinical features and treatment outcome. Br J Cancer 2005; 92:1226-30. [PMID: 15798768 PMCID: PMC2361983 DOI: 10.1038/sj.bjc.6602502] [Citation(s) in RCA: 138] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Nasal-type NK/T cell lymphoma is an increasingly recognised disease entity of aggressive clinical behaviour. The objective of this study was to investigate clinical features and treatment outcomes in patients with nasal-type NK/T cell lymphoma. From January 1991 to December 2003, 26 patients diagnosed as nasal-type NK/T cell lymphoma were included in the analysis. One half of patients presented with poor performance status (ECOG ⩾2); 46% of patients were categorised as high intermediate or high-risk group according to IPI; and 46% of patients were diagnosed at advanced stage. The median survival for 26 patients with nasal-type NK/T cell lymphoma was 7.4 months (95% CI, 0.1, 16.9). The treatment outcome of primary anthracycline-based chemotherapy was poor: 60% CR rate in localised disease and 0% CR rate in advanced disease. After a median follow-up of 24.4 months (range 3.1–99.0) in patients with localised disease who had achieved a CR (range 29.6–165.7), three patients (50.0%) developed disease recurrence at 6.1, 21.8, and 52.1 months, respectively, and all patients presented with locoregional failure. The predictive factors for poor survival were of age greater than 60, advanced stage and poor performance in multivariate analysis. In conclusion, Nasal-type NK/T cell lymphomas showed a poor response to the conventional anthracycline-based chemotherapy, and thus an investigation for an innovative therapy is urgently needed to improve survival in these patients.
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Affiliation(s)
- J Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong Kangnam-ku, Seoul 135-710, Korea
| | - W S Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong Kangnam-ku, Seoul 135-710, Korea
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong Kangnam-ku, Seoul 135-710, Korea. E-mail:
| | - Y H Park
- Department of Hematology-Oncology, Korea Cancer Center Hospital, Seoul, Korea
| | - S H Park
- Department of Hematology-Oncology, Gachun Medical School Gil Medical Center, Incheon, Korea
| | - K W Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong Kangnam-ku, Seoul 135-710, Korea
| | - J H Kang
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong Kangnam-ku, Seoul 135-710, Korea
| | - S S Lee
- Department of Pathology, Korea Cancer Center Hospital, Seoul, Korea
| | - S I Lee
- Department of Hematology-Oncology, Dankook University School of Medicine, Seoul, Korea
| | - S-H Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong Kangnam-ku, Seoul 135-710, Korea
| | - K Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong Kangnam-ku, Seoul 135-710, Korea
| | - C W Jung
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong Kangnam-ku, Seoul 135-710, Korea
| | - Y C Ahn
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y H Ko
- Department of Pathology, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - K Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong Kangnam-ku, Seoul 135-710, Korea
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Lim DH, Kim DY, Kang MK, Kim YI, Kang WK, Park CK, Kim S, Noh JH, Joh JW, Choi SH, Sohn TS, Heo JS, Park CH, Park JO, Lee JE, Park YJ, Nam HR, Park W, Ahn YC, Huh SJ. Patterns of failure in gastric carcinoma after D2 gastrectomy and chemoradiotherapy: a radiation oncologist's view. Br J Cancer 2004; 91:11-7. [PMID: 15162146 PMCID: PMC2364765 DOI: 10.1038/sj.bjc.6601896] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The risk of locoregional recurrence in resected gastric adenocarcinoma is high, but the benefit of adjuvant treatment remains controversial. In particular, after extended lymph node dissection, the role of radiotherapy is questionable. Since 1995, we started a clinical protocol of adjuvant chemoradiotherapy after D2 gastrectomy and analysed the patterns of failure for 291 patients. Adjuvant chemotherapy consisted of five cycles of fluorouracil and leucovorin, and concurrent radiotherapy was given with 4500 cGy from the second cycle of chemotherapy. With a median follow-up of 48 months, 114 patients (39%) showed any type of failure, and the local and regional failures were seen in 7% (20 out of 291) and 12% (35 out of 291), respectively. When the recurrent site was analysed with respect to the radiation field, in-field recurrence was 16% and represented 35% of all recurrences. Our results suggest that adjuvant chemoradiotherapy has a potential effect on reducing locoregional recurrence. Moreover, low locoregional recurrence rates could give a clue as to which subset of patients could be helped by radiotherapy after D2 gastrectomy. However, in order to draw a conclusion on the role of adjuvant radiotherapy, a randomised study is needed.
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Affiliation(s)
- D H Lim
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Korea
| | - D Y Kim
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Korea
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Korea. E-mail:
| | - M K Kang
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Korea
| | - Y I Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Korea
| | - W K Kang
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Korea
| | - C K Park
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Korea
| | - S Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Korea
| | - J H Noh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Korea
| | - J W Joh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Korea
| | - S H Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Korea
| | - T S Sohn
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Korea
| | - J S Heo
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Korea
| | - C H Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Korea
| | - J O Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Korea
| | - J E Lee
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Korea
| | - Y J Park
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Korea
| | - H R Nam
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Korea
| | - W Park
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Korea
| | - Y C Ahn
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Korea
| | - S J Huh
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Korea
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Abstract
Fractionated stereotactic radiotherapy (FSRT) offers a technique to minimize the absorbed dose to normal tissues; therefore, quality assurance is essential for these procedures. In this study, quality assurance for FSRT of 58 cases, between August 1995 and August 1997 are described, and the errors for each step and overall accuracy were estimated. Some of the important items for FSRT procedures are: accuracy in CT localization, transferred image distortion, laser alignment, isocentric accuracy of linear accelerator, head frame movement, portal verification, and various human errors. A geometric phantom, that has known coordinates was used to estimate the accuracy of CT localization. A treatment planning computer was used for checking the transferred image distortion. The mechanical isocenter standard (MIS), rectilinear phantom pointer: (RLPP), and laser target localizer frame (LTLF) were used for laser alignment and target coordinates setting. Head-frame stability check was performed by a depth confirmation helmet (DCH). A film test was done to check isocentric accuracy and portal verification. All measured data for the 58 patients were recorded and analyzed for each item. 4-MV x-rays from a linear accelerator, were used for FSRT, along with homemade circular cones with diameters from 20 to 70 mm (interval: 5 mm). The accuracy in CT localization was 1.2+/-0.5 mm. The isocentric accuracy of the linear accelerator, including laser alignment, was 0.5+/-0.2 mm. The reproducibility of the head frame was 1.1+/-0.6 mm. The overall accuracy was 1.7+/-0.7 mm, excluding human errors.
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Affiliation(s)
- D R Choi
- Department of Medical Physics, Tom Baker Cancer Centre, University of Calgary, Alberta, Canada
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Ahn YC, Park K, Kim DY, Kim KM, Kim J, Shim YM, Lee KS, Han J, Kim HJ, Kwon J, Lim DH, Noh YJ, Lee JE, Huh SJ. Preoperative concurrent chemoradiotherapy for stage IIIA non-small cell lung cancer. Acta Oncol 2002; 40:588-92. [PMID: 11669330 DOI: 10.1080/028418601750444123] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Thirty-one patients with stage IIIA non-small cell lung cancer (NSCLC) were treated with preoperative concurrent chemoradiotherapy (CCRT) followed by surgery. The treatment protocol could not be completed in eight patients. The acute hematologic toxicities of grade III or IV occurred in 48.4%, (15/31) after the first chemotherapy cycle, and in 39.1% (9/23) after the second cycle. The most common non-hematologic toxicity was radiation esophagitis. Surgery was attempted in 23 patients and successful in 22 patients (resection rate = 71.0%. Pathologic complete response and down-staging were achieved in 13.6% (3/22) and 68.2% (15/22). The median survival period, 2-year overall survival, local control and disease-free survival rates of all 31 patients and of 22 patients who underwent surgery were 19 months, 37.2%, 49.1%, 35.5%, and 19 months, 43.2%, 51.8%, 25.6%, respectively. On the basis of our observations, preoperative CCRT followed by surgery for stage IIIA NSCLC has resulted in outcomes comparable with those in previous reports.
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Affiliation(s)
- Y C Ahn
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Huh SJ, Choi DR, Yeo IJ, Ahn YC, Lim DH. Development of an expert system for automatic chart checking combined with departmental digital chart system. Nihon Igaku Hoshasen Gakkai Zasshi 2001; 61:683-5. [PMID: 11729678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Affiliation(s)
- S J Huh
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-Gu, Seoul 135-710, Korea
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Lee JE, Kim DY, Ahn YC, Lim DH, Huh SJ, Shin SS, Kim WS, Kang WK, Nam DH, Lee JI, Kim JH. Combined Chemotherapy and Radiotherapy for Primary CNS Lymphoma. Cancer Res Treat 2001; 33:398-403. [PMID: 26680814 DOI: 10.4143/crt.2001.33.5.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
PURPOSE This study was performed in order to evaluate the effectiveness of combined chemotherapy and radiotherapy (RT) in primary central nervous system lymphoma (PCNSL). MATERIALS AND METHODS From January 1995 to August 1999, 21 patients with a diagnosis of PCNSL were treated with combined chemotherapy and radiotherapy. Their median age was 47 years with range of 19 to 78 years. Twelve patients were male and nine patients were female. All patients were immunocompetent and they had no evidence of systemic lymphoma. All patients underwent placement of an Ommaya reservoir and recieved a combination regimen using pre-RT systemic and intra-Ommaya methotrexate (MTX), 40 Gy whole-brain RT with a 14.4 Gy boost, and 2 courses of post-RT high-dose cytarabine. The median follow-up period of all patients and survived patients were 22 months and 36 months, respectively. RESULTS The median overall survival duration was 21 months and the overall two- and four-year survival rates were 51% and 43%, respectively. Complete response (CR), partial response, stable disease, and progressive disease were achieved in 12, 3, 1, and 5 patients, respectively. All nine patients without CR expired within 1-31 months (median 6 months). Two patients among the patients with CR developed recurrence after 13 and 14 months, respectively. The location of recurrent disease was within the port of radiation boost. Survival was influenced by age, performance status, and CR. There was one episode of MTX neurotoxicity and hepatotoxicity,respectively. CONCLUSION Combined chemotherapy and radiotherapy was an effective treatment for PCNSL, and was associated with a minimum toxicity. However, we must pay attention to the recurrence and late toxicity, particularly within two years following treatment.
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Kang WK, Park C, Yoon HL, Kim WS, Yoon SS, Lee MH, Park K, Kim K, Jeong HS, Kim JA, Nam SJ, Yang JH, Son YI, Baek CH, Han J, Ree HJ, Lee ES, Kim SH, Kim DW, Ahn YC, Huh SJ, Choe YH, Lee JH, Park MH, Kong GS, Park EY, Kang YK, Bang YJ, Paik NS, Lee SN, Kim SH, Kim S, Robbins PD, Tahara H, Lotze MT, Park CH. Interleukin 12 gene therapy of cancer by peritumoral injection of transduced autologous fibroblasts: outcome of a phase I study. Hum Gene Ther 2001; 12:671-84. [PMID: 11426466 DOI: 10.1089/104303401300057388] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
A phase I dose-escalation clinical trial of peritumoral injections of interleukin 12 (IL-12)-transduced autologous fibroblasts was performed in patients with disseminated cancer for whom effective treatment does not exist. The goals of this study were to assess the safety and toxicities as well as the efficacy, and ancillarily the immunomodulatory effects, of peritumoral IL-12 gene transfer. Primary dermal fibroblasts cultured from the patients were transduced with retroviral vector carrying human IL-12 genes (p35 and p40) as well as the neomycin phosphotransferase gene (TFG-hIL-12-Neo). Patients received four injections at intervals of 7 days. Nine patients were enrolled in this dose-escalation study, with secreted IL-12 doses ranging from 300 ng/24 hr for the first three patients to 1000, 3000, and 5000 ng/24 hr for two patients in each subsequent dosage level. Although a definite statement cannot be made, there appears to be perturbation of systemic immunity. Also, the locoregional effects mediated by tumor necrosis factor alpha (TNF-alpha) and CD8+ T cells were observed with tumor regression. Treatment-related adverse events were limited to mild to moderate pain at the injection site; clinically significant toxicities were not encountered. Transient but clear reductions of tumor sizes were observed at the injected sites in four of nine cases, and at noninjected distant sites in one melanoma patient. Hemorrhagic necrosis of tumors was observed in two melanoma patients. These data indicate that gene therapy by peritumoral injection of IL-12-producing autologous fibroblasts is feasible, and promising in patients with advanced cancer.
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Affiliation(s)
- W K Kang
- Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim WS, Song SY, Ahn YC, Ko YH, Baek CH, Kim DY, Yoon SS, Lee HG, Kang WK, Lee HJ, Park CH, Park K. CHOP followed by involved field radiation: is it optimal for localized nasal natural killer/T-cell lymphoma? Ann Oncol 2001; 12:349-52. [PMID: 11332147 DOI: 10.1023/a:1011144911781] [Citation(s) in RCA: 227] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The present study aimed to analyse the treatment outcome of four cycles of CHOP (cyclophosphamide-vincristine-doxorubicin-prednisolone) followed by involved field radiation therapy (IF RT) for the treatment of stage I-II nasal natural killer (NK)/T-cell lymphoma. From March 1995 to December 1999, 17 patients (median age 41 years; range 30-66) with localized nasal NK/T-cell lymphoma were enrolled. B symptoms were noted in five patients (31%). Sixteen of seventeen patients (94%) were of low risk when classified according to the International Prognostic Index (IPI). The treatment plan consisted of four cycles of CHOP chemotherapy followed by IF RT of 45 Gy. Two patients received radiation during the first or second cycle of CHOP because of bleeding from the primary tumour site. Both patients achieved complete responses (CRs). In the remaining 15 patients, after 4 cycles of CHOP, 6 CRs and 3 partial responses (PRs) were achieved (53% of response rate). IF RT was given to six patients (four in CR, one in PR and one in PD), and all six patients achieved CR. Overall, CR was achieved in 10 of 17 patients (58%). The planned sequential chemoradiotherapy was completed in only 6 of 17 patients (35%) because of the progression during chemotherapy. None of the patients who achieved CR experienced relapse of lymphoma during follow-up. The estimated overall three-year survival rate was 59%. In univariate analysis, B symptoms and stage were significant prognostic factors for response and overall survival (P < 0.05). The present study suggests that four cycles of CHOP followed by IF RT is not satisfactory for treating patients with localized nasal NK/T-cell lymphoma, and that further exploration for improved therapy is needed.
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Affiliation(s)
- W S Kim
- Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Kangnam-Ku, Seoul, Korea
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Woo IS, Park YS, Kwon SH, Park YL, Lee JA, Park MJ, Hyun IG, Jung KS, Bae HS, Oh DH, Kim WS, Park K, Park CH, Kim HJ, Ahn YC. A phase II study of VP-16-fosfamide-cisplatin combination chemotherapy plus early concurrent thoracic irradiation for previously untreated limited small cell lung cancer. Jpn J Clin Oncol 2000; 30:542-6. [PMID: 11210163 DOI: 10.1093/jjco/hyd135] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND At present the addition of thoracic irradiation to combination chemotherapy is a standard treatment for limited staged small cell lung cancer. However, there is still controversy about the optimum timing of chest irradiation. We conducted a phase II study of etoposide (VP-16)-ifosfamide-cisplatin (VIP) combination chemotherapy plus early concurrent thoracic irradiation for the patients with previously untreated limited small cell lung cancer in order to assess if the treatment modality could improve the response rate and the toxicity. METHODS Forty-four patients with limited small cell lung cancer were treated with etoposide-ifosfamide-cisplatin and concurrent thoracic irradiation. Combination chemotherapy consisted of etoposide 100 mg/m2 (on days 1-3), ifosfamide 1000 mg/m2 (on days 1 and 2) and cisplatin 100 mg/m2 (on day 1). Concurrent thoracic irradiation consisted of a total of 4000 cGy over 4 weeks starting on the first day of the first chemotherapy. All patients who showed a complete response were given prophylactic cranial irradiation for 2.5 weeks. RESULTS Forty-four of the 49 patients who entered the study from May 1994 to August 1998 were evaluable. The median age was 59 years and 40 patients had a performance status of 0 or 1. The median survival time was 22.5 months. Twenty-eight patients (62%) showed a complete response and 16 (38%) a partial response. Twenty-four patients (54%) developed grade 3 or 4 neutropenia; there was a 9% RTOG score 3 or 4 esophagitis. CONCLUSION VIP combination chemotherapy and early concurrent thoracic irradiation for patients with limited stage small cell lung cancer revealed excellent antitumor response with tolerable toxicity.
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Affiliation(s)
- I S Woo
- Department of lnternal Medicine, College of Medicine, Hallym University, Seoul, Korea
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Hwang JH, Lee KS, Song KS, Kim H, Kwon OJ, Lim TH, Ahn YC, Choo IW. Extensive acute lung injury following limited thoracic irradiation: radiologic findings in three patients. J Korean Med Sci 2000; 15:712-7. [PMID: 11194201 PMCID: PMC3054705 DOI: 10.3346/jkms.2000.15.6.712] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The aim of our study was to describe the radiologic findings of extensive acute lung injury associated with limited thoracic irradiation. Limited thoracic irradiation occasionally results in acute lung injury. In this condition, chest radiograph shows diffuse ground-glass appearance in both lungs and thin-section CT scans show diffuse bilateral ground-glass attenuation with traction bronchiectasis, interlobular septal thickening and intralobular smooth linear opacities.
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Affiliation(s)
- J H Hwang
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim DY, Ahn YC, Oh DG, Choi DR, Ju SG, Yeo IH, Huh SJ. Physical properties of new collimator cone system for stereotactic radiation therapy developed in samsung medical center. Int J Radiat Oncol Biol Phys 2000; 48:541-4. [PMID: 10974474 DOI: 10.1016/s0360-3016(00)00611-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE A new collimator cone system has been developed at the Samsung Medical Center that overcomes some of the limitations of present commercially supplied collimator cones. The physical properties of the newly developed cone system are described in this report. METHODS AND MATERIALS The new cones have relatively larger aperture sizes (3.0-7.0 cm in diameter) and are 16 cm in length. Each new cone is fabricated with cerrobend alloy melted and poured into a stainless steel housing that is permanently fixed to a mounting plate. The mounting plate of the new cone is designed to insert into the wedge mount slot of the gantry head. The mechanical accuracy of the central axis of the cone pointing to the isocenter was tested using film, a steel ball positioned at the isocenter by the mechanical isocenter device. For the evaluation of beam flatness and penumbra, off-axis ratios at 5 cm depth were measured by film dosimetry using polystyrene phantom. RESULTS The average error of the mechanical isocenter was 0.27 mm (+/- 0.16 mm). The beam flatness was excellent in the central region of the beam, and the average penumbra width was 3.35 mm (+/- 0.25 mm). The new cone design has more clearance between the patient's head and the gantry, and can more easily be removed from the gantry head because it slides in and out of the wedge slot. This facilitates changing cone sizes during one treatment session, and makes the process of double exposure port films easier. CONCLUSIONS A new collimator cone system for stereotactic radiation therapy has been developed. The mechanical accuracy and physical properties are satisfactory for clinical use, and the new design permits a wider range of clinical applications for stereotactic radiation therapy.
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Affiliation(s)
- D Y Kim
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, South Korea.
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Ahn YC, Lee KC, Kim DY, Huh SJ, Yeo IH, Lim DH, Kim MK, Shin KH, Park S, Chang SH. Fractionated stereotactic radiation therapy for extracranial head and neck tumors. Int J Radiat Oncol Biol Phys 2000; 48:501-5. [PMID: 10974468 DOI: 10.1016/s0360-3016(00)00612-x] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND This study is to report the clinical experiences of fractionated stereotactic radiation therapy (FSRT) for extracranial head and neck tumors. METHODS AND MATERIALS Between the period of July 1995 and November 1998, 48 patients with extracranial head and neck tumors were given FSRT as a boost and sole modality. Individualized treatment planning was performed using XKnife-3 system with relocatable Gill-Thomas-Cosman frame. In 24 patients, FSRT was applied as a boost technique following the 2-dimensional conventional external radiation therapy (ERT); in 24 patients FSRT was the sole radiotherapy modality. The primary diseases in the boost group consisted of nasopharynx cancer (19), lacrimal gland adenoid cystic carcinoma (3), orbital lymphoma (1), and skull-base recurrence of maxillary sinus adenoid cystic carcinoma (1). The primary diseases in the sole modality group consisted of recurrent nasopharynx cancer (12), orbital pseudotumor (4), skull-base recurrence of maxillary sinus, submandibular gland, and hypopharynx cancers (3), orbital rhabdomyosarcoma (2), orbital lymphoma (1), orbital metastasis of neuroblastoma (1), and nasal cavity melanoma (1). The fractionation schedule was to give 5 treatments per one week and the fractional doses were 2.0-3 Gy depending on the treatment aim and the FSRT volume. The FSRT doses varied depending on the nature of the primary diseases. RESULTS The local tumor response in nasopharynx cancer patients was excellent compared to retrospective data without occurrence of unexpectedly severe complication. FSRT to other regions was well tolerated by the patients and resulted in good to excellent local tumor responses with no unacceptable side effects as expected by the authors. CONCLUSION Based on the current observations, FSRT is a very effective and safe modality in the treatment of extracranial head and neck tumors.
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Affiliation(s)
- Y C Ahn
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, South Korea.
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Huh SJ, Ahn YC, Kim DY, Lim DH, Yeo IJ, Choi D, Kim MK, Lee KC, Shin KH. Prompt radiation oncology record access by patient centered digital image chart system. Radiother Oncol 2000; 56:117-20. [PMID: 10869762 DOI: 10.1016/s0167-8140(00)00187-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The authors have developed and evaluated a radiation oncology digital image chart system (RODICS). With this system we could achieve paperless and filmless practice, and thus improved operational efficiency within the department. In this paper, we describe characteristics and clinical usage of RODICS.
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Affiliation(s)
- S J Huh
- Department of Radiation Oncology, Samsung Medical Center and the Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, 135-710, Seoul, South Korea
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Huh SJ, Shirato H, Hashimoto S, Shimizu S, Kim DY, Ahn YC, Choi D, Miyasaka K, Mizuno J. An integrated service digital network (ISDN)-based international telecommunication between Samsung Medical Center and Hokkaido University using telecommunication helped radiotherapy planning and information system (THERAPIS). Radiother Oncol 2000; 56:121-3. [PMID: 10869763 DOI: 10.1016/s0167-8140(00)00179-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study introduces the integrated service digital network (ISDN)-based international teleradiotherapy system (THERAPIS) in radiation oncology between hospitals in Seoul, South Korea and in Sapporo, Japan. THERAPIS has the following functions: (1) exchange of patient's image data, (2) real-time teleconference, and (3) communication of the treatment planning, dose calculation and distribution, and of portal verification images between the remote hospitals. Our preliminary results of applications on eight patients demonstrated that the international telecommunication using THERAPIS was clinically useful and satisfactory with sufficient bandwidth for the transfer of patient data for clinical use in radiation oncology.
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Affiliation(s)
- S J Huh
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon Dong, Kangnam Ku, 135-710, Seoul, South Korea
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Ju SG, Huh SJ, Lee KC, Yeo IJ, Ahn YC, Kim DY, Kim JS, Kim MK, Lim DH, Park YH. A glass compensator filter to improve breast image quality in radiation therapy simulation. Int J Radiat Oncol Biol Phys 2000; 46:1061-4. [PMID: 10705030 DOI: 10.1016/s0360-3016(99)00510-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To improve the image quality of simulation films in tangential radiotherapy for breast cancer, we have designed a new compensator filter for the variation of breast contour using high-density-glass material. METHODS AND MATERIALS The measurements and analyses of the body contour were done using CT scans, taken in the treatment position, of 20 breast cancer patients. The maximum tissue deficit that needed to be compensated for was 8 cm, and the authors fabricated the compensator system using high-density-glass material to maintain transparency. The glass compensator can be attached to the accessory mount of the simulator head and its position can be easily adjusted according to breast shape and position. The image qualities of simulation films taken with and without the glass compensator in tangential breast radiotherapy field were compared and the film densitometry was performed using the humanoid phantom. RESULTS Using this compensator system, the overall image quality improved, resulting in enhanced contrast and resolution of the breast simulation image. The delineator wires for the beam margins were also well depicted, and the surgical clips within the breast tissue can be easily demonstrated. The film densitometry resulted in much less saturation over the breast tissue when using the glass compensator. CONCLUSION Using the glass compensator system, the geographical miss may be reduced with the virtue of the improved image quality.
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Affiliation(s)
- S G Ju
- Department of Radiation Oncology, Samsung Medical Center, College of Medicine, Sungkyunkwan University, Seoul, Korea, South Korea
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Lee KS, Shim YM, Han J, Kim J, Ahn YC, Park K, Jung KJ. Primary tumors and mediastinal lymph nodes after neoadjuvant concurrent chemoradiotherapy of lung cancer: serial CT findings with pathologic correlation. J Comput Assist Tomogr 2000; 24:35-40. [PMID: 10667655 DOI: 10.1097/00004728-200001000-00007] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this work was to describe the changes of primary tumor and mediastinal lymph nodes on CT after neoadjuvant concurrent chemoradiotherapy and to correlate the CT findings with pathology. METHOD Twenty-one consecutive patients [N2 disease (n = 19) or resectable T4 and N2 disease (n = 2)] with non-small cell lung cancer underwent neoadjuvant concurrent chemoradiotherapy. Changes of primary tumor and mediastinal nodes before and after the therapy were assessed using CT. The CT findings were correlated with pathologic findings. RESULTS With neoadjuvant therapy, decrease in T stage was achieved in 9 of 21 (43%) patients on CT. On pathology, the remaining tumor consisted mostly of fibrosis and necrosis with little proportion of viable tumor cells (mean volume 17%, range 0-55%). Decrease in nodal stage was achieved in 14 of 21 (67%) patients on pathologic examination. Seven patients had cancer cells in mediastinal lymph nodes: in 6 of 9 (67%) patients with adenocarcinoma and 1 of 12 (8%) patients with squamous cell carcinoma (p = 0.016). CONCLUSION With neoadjuvant concurrent chemoradiotherapy, the remaining tumor consists mostly of fibrosis or necrosis. Decreased nodal stage on pathology is achieved especially in patients with N2 disease of squamous cell carcinoma. The CT findings of the tumor and mediastinal nodes are not helpful in predicting the pathology after the therapy.
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Affiliation(s)
- K S Lee
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Kangnam-Ku, Korea
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Abstract
BACKGROUND This article reports on experience with fractionated stereotactic radiation therapy (FSRT) for locally recurrent nasopharynx cancer. METHODS Three patients with locally recurrent nasopharynx cancer were given FSRT as reirradiation between September 1995 and August 1996. Application of FSRT was the third radiation therapy in two patients. Authors used the individually made relocatable Gill-Thomas-Cosman (GTC) stereotactic frame, and the radiation dose planning was performed using XKnife-3. The total doses to the recurrent tumor were 45 Gy/18 fractions in two patients, who were given concurrent chemotherapy as a radiosensitizer, and 50 Gy/20 fractions in the other patient. In all three patients the dose per fraction was 2.5 Gy, and the fraction schedule was to give five daily treatments per week. RESULTS Authors observed satisfactory symptomatic improvement and remarkable objective tumor size decrease through the magnetic resonance (MR) images taken one month post-FSRT in all three patients. No neurological side effect was observed. All three patients died with regional and distant seeding outside the FSRT field at seven, nine, and nine months, respectively. CONCLUSION FSRT as reirradiation for locally recurrent nasopharynx cancer seemed to be effective and safe.
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Affiliation(s)
- Y C Ahn
- Department of Radiation Oncology, Samsung Medical Center, College of Medicine, Sungkyunkwan University, Seoul, Korea.
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Shin KH, Huh SJ, Chie EK, Choi DR, Lim DH, Kim MK, Lee KC, Kim DY, Ahn YC. Analysis of correlation between rectal complications and rectal dose following high dose rate intracavitary radiotherapy in patients with uterine cervix cancer: in vivo dosimetric analysis. Radiat Med 1999; 17:289-93. [PMID: 10510902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
PURPOSE To investigate the correlation between late rectal complications and rectal dose in uterine cervix cancer patients treated with high dose rate intracavitary radiotherapy (HDR ICR) and to analyze dose factors reducing complications. METHODS A retrospective analysis was done of 74 patients treated with external beam RT and HDR ICR between 1995 and 1997. Radiotherapy (RT) consisted of a median 50.4 Gy external beam plus six fractions of HDR ICR given two times per week, concurrent with the last three weeks of external beam therapy, to a total dose of median 24 Gy to point A or the reference point. Rectal doses were calculated at rectal reference points using barium contrast criteria. In vivo measurement of rectal dose was performed with thermoluminescent dosimeters (TLD) immediately prior to the first fraction of HDR ICR. RESULTS Eight patients developed rectal complications (11%). There was a significant difference between measured rectal doses for patients with rectal complications and those without (p < 0.05), and the doses were higher in complicated patients. A significant increase in the probability of development of complications was found for patients receiving measured rectal doses of ICR fractional dose 320 cGy or more, ICR total dose 2000 cGy or more, and ICR% to point A 80% or more. CONCLUSIONS This study showed that in vivo dosimetry using TLD during HDR ICR could have a useful role as a predictor of late rectal complications. Dose limitation to the rectum could possibly be achieved by thorough vaginal packing or use of an applicator with proper shielding while maintaining a high dose to the tumor.
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Affiliation(s)
- K H Shin
- Department of Radiation Oncology, Sumsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Ahn YC, Ju SG, Kim DY, Choi DR, Huh SJ, Park YH, Lim DH, Kim MK. Design and development of new collimator cones for fractionated stereotactic radiation therapy in Samsung Medical Center. Int J Radiat Oncol Biol Phys 1999; 44:435-8. [PMID: 10760440 DOI: 10.1016/s0360-3016(99)00005-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE In stereotactic radiotherapy using X-Knife system, the commercially supplied collimator cone system had a few mechanical limitations. The authors have developed new collimator cones to overcome these limitations and named them "SMC type" collimator cones. METHODS We made use of cadmium-free cerrobend alloy within the stainless steel cylinder housing. We made nine cones of relatively larger sizes (3.0 cm to 7.0 cm in diameter) and of shorter length with bigger clearance from the isocenter than the commercial cones. The cone housing and the collimator cones were designed to insert into the wedge mount of the gantry head to enable double-exposure linac-gram taking. RESULTS The mechanical accuracy of pointing to the isocenter was tested by ball test and cone rotation test, and the dosimetric measurements were performed, all of which were with satisfactory results. A new innovative quality assurance procedure using linac-grams on the patients at the actual treatment setup was attempted after taking 10 sets of AP and lateral linac-grams and the overall mechanical isocenter accuracy was excellent (average error = 0.4 +/- 0.2 mm). CONCLUSIONS We have developed the SMC type collimator cone system mainly for fractionated stereotactic radiation therapy use with our innovative ideas. The new cones' mechanical accuracy and physical properties were satisfactory for clinical use, and the verification of the isocenter accuracy on the actual treatment setup has become possible.
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Affiliation(s)
- Y C Ahn
- Department of Radiation Oncology, Samsung Medical Center, College of Medicine, Sungkyunkwan University, Seoul, South Korea
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Huh SJ, Ahn YC. Radiation oncology digital image chart system (RO-DICS) at Samsung Medical Center. Nihon Igaku Hoshasen Gakkai Zasshi 1998; 58:712-5. [PMID: 9844408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- S J Huh
- Department of Radiation Oncology, Samsung Medical Center, Seoul, Korea
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Abstract
PURPOSE Authors designed a customized small bowel displacement system (SBDS) to displace the small bowel out of the pelvic radiation fields and to minimize treatment related bowel morbidity. METHODS AND MATERIALS From August 1995 to May 1996, 55 consecutive patients who received pelvic radiation therapy with the SBDS were included in this study. The SBDS consists of a customized Styrofoam compression device that can displace the small bowel out of the radiation fields and an individualized immobilization abdominal board for easy daily setup of the patient in prone position. After opacifying the small bowel with barium, the patients were laid prone and posterior-anterior (PA) and lateral (LAT) simulation films were taken with and without the SBDS. The volume of the small bowel included in the radiation fields with and without the SBDS were compared. RESULTS Using the SBDS, the mean small bowel volume was reduced by 59% on PA and 51% on LAT films (p = 0.0001). In six patients (6 of 55, 11%), it was possible that no small bowel was included within the treatment fields. The mean upward displacement of the most caudal small bowel was 4.8 cm using the SBDS. Patients treated with the SBDS manifested a significantly lower incidence of diarrhea requiring medication (8 of 55, 15%) vs. those without the SBDS (24 of 39, 62%) (p < 0.05). CONCLUSION The SBDS is a novel method that can be used to displace the small bowel away from the treatment portal effectively and to reduce the radiation therapy morbidity. Compliance with setup is excellent.
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Affiliation(s)
- S J Huh
- Department of Radiation Oncology, Samsung Medical Center, College of Medicine, Sung Kyun Kwan University, Seoul, Korea
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Kim MK, Huh SJ, Kim DY, Yang JH, Han J, Ahn YC, Lim DH. Secondary angiosarcoma following irradiation--case report and review of the literature. Radiat Med 1998; 16:55-60. [PMID: 9568635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Angiosarcoma is a rare malignant tumor that accounts for 1% to 2% of all soft tissue sarcomas. This paper reports a case of radiation-associated angiosarcoma with a literature review of 66 cases. Twenty-nine years after transabdominal hysterectomy and adjuvant radiation therapy for uterine cervix cancer, cutaneous angiosarcoma developed in the abdominal wall of a 63-year-old woman. She underwent wide excision of the abdominal wall mass, radiation therapy, and chemotherapy, and has been alive and well without any evidence of metastasis for 23 months since the initial diagnosis of angiosarcoma. After an intensive literature review, we found 66 cases of radiation-associated angiosarcoma. The most common primary disease was breast cancer (44%), with gynecologic cancer (21%) next. Eighty-five percent of radiation-associated angiosarcomas developed in the cutaneous area. The median age at diagnosis was 65 years, and the median latency period from irradiation to diagnosis was 96 months. The median survival period of 48 patients whose survival lengths could be reviewed was 12 months.
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Affiliation(s)
- M K Kim
- Department of Radiation Oncology, Samsung Medical Center, Seoul, Korea
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Abstract
The accuracy in target localization of CT, MRI, and digital angiography and the isocentric deviation of linear accelerator were investigated for stereotactic radiosurgery. Twenty-five slice images using CT and MRI were obtained out of geometrical phantom which was designed to produce exact 3-dimensional coordinates of several points within a 0.1 mm error range. These diagnostic images were transferred to a 3-D treatment planning system through ethernet. Measured 3-D coordinates of these images from the planning system were compared to known values by geometrical phantom. Anterior-posterior and lateral films were taken by digital angiography for measurement of spatial accuracy. The accuracy of gantry isocenter aligned by laser localizer was also measured. Lead ball was located at the isocenter of linear accelerator and x-ray films were taken by 4-MV photon beam with gantry angles of 0, 90, 180 and 270 degrees, Overall procedure from CT scanning to treatment was carried out using the geometrical phantom. The target accuracy was verified by high energy x-ray portal film. The accuracy of diagnostic machines were within 2.1 mm except MR-axial images. In case of linear accelerator, the deviation of isocenter was within 0.7 mm. Finally, the total isocentric deviation of overall procedure was 1.3 +/- 0.5 mm (using CT localization).
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Affiliation(s)
- D R Choi
- Department of Radiation Oncology, Samsung Medical Center, Kangnam-Ku, Seoul, Korea. drchoi@smc.-samsung.co.kr
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