[show abstract][hide abstract] ABSTRACT: We describe here a patient who obtained a good analgesic effect with high-dose fentanyl patches for controlling cancer pain. A 52-year-old man was referred to our hospital because of severe cancer pain that was 7/10 on a numeric rating scale (NRS). He had been diagnosed with locally advanced cholangiocarcinoma 3 months previously. We prescribed weak opioids and an antidepressant, but his pain was not relieved. We introduced strong opioids (transdermal fentanyl patches for the background pain and a short-acting opioid for the breakthrough pain) and his pain was tolerable on 250 µg/hr of fentanyl patches for 3 months. With time, however, his pain intensity became worse and this reached up to 8/10 to 9/10 on the NRS. Percutaneous transhepatic biliary drainage was performed, which did not relieve his pain. We increased gradually the dose of transdermal fentanyl to 1,050 µg/hr (20 patches). At this dose, the patient was mentally alert, with good pain control (NRS 2/10 to 3/10) and no exacerbation of side effects. To the best of our knowledge, we report here on the highest dose of transdermal fentanyl that has been successfully used for treating a patient suffering from visceral cancer pain.
The Korean Journal of Internal Medicine 09/2010; 25(3):337-40.
[show abstract][hide abstract] ABSTRACT: Abstract
Constipation is a significant problem in the elderly, specifically nursing home and/or extended-care facility residents are reported to suffer from constipation. Lactic acid bacteria (LAB) are beneficial probiotic organisms that contribute to improved nutrition, microbial balance, and immuno-enhancement of the intestinal tract, as well as diarrhea and constipation effect. The objective of this study was to investigate the efficacy of this LAB supplement in the management of nursing home residents.
Nineteen subjects (8M, 11F; mean age 77.1 ± 10.1) suffering with chronic constipation were assigned to receive LAB (3.0 × 10<sup>11 </sup>CFU/g) twice (to be taken 30 minutes after breakfast and dinner) a day for 2 weeks in November 2008. Subjects draw up a questionnaire on defecation habits (frequency of defecation, amount and state of stool), and we collected fecal samples from the subjects both before entering and after ending the trial, to investigate LAB levels and inhibition of harmful enzyme activities. Results were tested with SAS and Student's t-test.
Analysis of questionnaire showed that there was an increase in the frequency of defecation and amount of stool excreted in defecation habit after LAB treatment, but there were no significant changes. And it also affects the intestinal environment, through significantly increase ( p < 0.05) fecal LAB levels. In addition, tryptophanase and urease among harmful enzyme activities of intestinal microflora were significantly decreased ( p < 0.05) after LAB treatment.
LAB, when added to the standard treatment regimen for nursing home residents with chronic constipation, increased defecation habit such as frequency of defecation, amount and state of stool. So, it may be used as functional probiotics to improve human health by helping to prevent constipation.
[show abstract][hide abstract] ABSTRACT: Fibrous dysplasia (FD) is a common benign bone disorder of an unclear etiology. It is known that FD can appear without an increased FDG uptake on F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT). However, there are also several reports that FD showed increased FDG uptake and this mimicked malignant bone involvement on FDG-PET. Herein we describe a case of biopsy-proven FDG-PET positive FD in a patient with intestinal non-Hodgkin's lymphoma (NHL). A 45-year-old woman was diagnosed with intestinal NHL, which was removed by right hemicolectomy. After the operation, the FDG-PET/CT scan showed hypermetabolic activity in the right transverse process of the T10 vertebra. The patient then received a total of 6 cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) chemotherapy every 3 weeks. After completion of the planned chemotherapy, the 2(nd) FDG-PET/CT showed increased FDG uptake (SUVmax=6.0 g/mL) of the previous bone lesion. The MR images revealed a T1-hypointense lesion with sharp borders in the same region, and this showed homogenous contrast enhancement on the fat-suppressed T1-weighted images. After the radiologic studies were carefully reviewed, the bone lesion was assumed to be benign such as FD. We performed bone biopsy and the histological examination confirmed the diagnosis of FD. In conclusion, bone lesions with FDG uptake need to be carefully interpreted when evaluating patients with known malignancy.
Cancer Research and Treatment 09/2009; 41(3):171-4. · 1.96 Impact Factor
[show abstract][hide abstract] ABSTRACT: Suspension laryngoscopy under general anaesthesia with a tracheal tube has been widely used for laryngeal microsurgery, but it has some limitations such as intense cardiovascular stimulation during anaesthesia of short duration, occasionally a poor surgical field, and the possibility of a mass being hampered by the tracheal tube. The aim of this study was to compare the usefulness of the laryngeal mask airway (LMA) Fastrach and fibreoptic bronchoscope with a conventional suspension laryngoscope in laryngeal microsurgery.
Forty patients scheduled for laryngeal microsurgery were enrolled in this prospective randomized study consecutively. After general anaesthesia was induced, laryngeal microsurgery was performed with a fibreoptic bronchoscope through the LMA Fastrach or conventional suspension laryngoscope. The best view of the surgical field, evaluated by percentage of glottic opening score, was obtained by the up-down manipulations of the LMA Fastrach or repositioning the suspension laryngoscope. Blood pressure and heart rate changes at the baseline, preinsertion, and postinsertion were recorded.
Percentage of glottic opening score of the LMA Fastrach group was 100 and that of the suspension laryngoscope group was 80 (P < 0.05). The LMA Fastrach insertion was performed without remarkable systolic or diastolic blood pressure or heart rate changes, but systolic, diastolic blood pressure or heart rate were increased after intubation in the suspension laryngoscope group.
The LMA Fastrach during fibreoptic bronchoscope-guided laryngeal surgery provided a good surgical field and haemodynamic stability without additional risk compared with the conventional suspension laryngoscope.
European Journal of Anaesthesiology 09/2009; 27(1):20-3. · 2.79 Impact Factor
[show abstract][hide abstract] ABSTRACT: Sclerosing stromal tumor (SST) is a rare benign ovarian neoplasm classified as a type of sex cord stromal tumor that occurs predominantly in young patients. Several reports have described the US, CT and MR features of SST, but there have been no reports of a bilateral calcified SST in a child. We present a case of a bilateral SST of the ovary with calcification in a 12-year-old premenarchal girl and describe the US, CT, MR and pathological findings.
[show abstract][hide abstract] ABSTRACT: This study was performed to evaluate the compatibility of the Digene media when performing the Roche linear array human papillomavirus (HPV) genotyping test.
A total of 258 samples from 166 women were tested using the Hybrid Capture 2 (HC2) assay, the Cytyc media-based linear array test, and the Digene media-based linear array test.
The results between the HC2 assay and the Digene media-based linear array test were highly concordant (kappa = 0.78). The Cytyc media-based linear array test and Digene media-based linear array test exhibited substantial agreement in 207/249 cervical samples (kappa = 0.62). The two genotyping test also showed substantial agreement for the detection of HPV genotypes 16, 18, 52, 58 and for 18 HPV genotypes including both high-risk, and possible high-risk genotypes (kappa = 0.74, 0.69, respectively).
We found Digene media to be interchangeable with Cytyc media when performing the Roche linear array genotyping test. This may be clinically meaningful in that we could perform the Roche linear array genotyping test with the same Digene media among women, positive for HC2 assay without the need for a return visit.
Archives of Gynecology 03/2009; 280(4):613-8. · 0.91 Impact Factor
[show abstract][hide abstract] ABSTRACT: We routinely have performed arthroscopic shoulder surgery under general anesthesia in the beach chair position using epinephrine (0.33 mg/L) saline irrigation. At a 2-week interval, two patients, a 19-year-old man scheduled to undergo an arthroscopic Bankart repair for left traumatic anterior instability and a 49-year-old woman scheduled for an arthroscopic rotator cuff repair for a left rotator cuff tear, were resuscitated by chest compression and defibrillation due to a sudden developed cardiogenic shock following ventricular tachycardia at the time of arthroscopic shoulder surgery. They were transferred to the intensive care unit because their emergent echocardiogram showed significantly decreased cardiac functions. They were fully recovered and then discharged. Epinephrine was considered to be the cause of ventricular tachycardia because the two patients showed no anaphylactic reaction to drugs or symptoms of air embolism related to the beach chair position. In addition, according to our observation of epinephrine flow patterns, it was more likely that highly concentrated epinephrine was rapidly infused into the body. This complication is very rare. However, thorough understanding of the side effects and their development of epinephrine during arthroscopic shoulder surgery should neither be overemphasized nor disregarded.
Archives of Orthopaedic and Trauma Surgery 02/2009; 130(3):353-6. · 1.36 Impact Factor
[show abstract][hide abstract] ABSTRACT: Abstract
Deletion of large blocks of nonessential genes that are not needed for metabolic pathways of interest can reduce the production of unwanted by-products, increase genome stability, and streamline metabolism without physiological compromise. Researchers have recently constructed a reduced-genome Escherichia coli strain MDS42 that lacks 14.3% of its chromosome.
Here we describe the reengineering of the MDS42 genome to increase the production of the essential amino acid L-threonine. To this end, we over-expressed a feedback-resistant threonine operon ( thrA*BC ), deleted the genes that encode threonine dehydrogenase ( tdh ) and threonine transporters ( tdcC and sstT ), and introduced a mutant threonine exporter ( rhtA23 ) in MDS42. The resulting strain, MDS-205, shows an ~83% increase in L-threonine production when cells are grown by flask fermentation, compared to a wild-type E. coli strain MG1655 engineered with the same threonine-specific modifications described above. And transcriptional analysis revealed the effect of the deletion of non-essential genes on the central metabolism and threonine pathways in MDS-205.
This result demonstrates that the elimination of genes unnecessary for cell growth can increase the productivity of an industrial strain, most likely by reducing the metabolic burden and improving the metabolic efficiency of cells.
[show abstract][hide abstract] ABSTRACT: We investigated early postoperative morbidity, mortality, and long-term outcomes in patients with liver cirrhosis (LC) who had undergone curative surgery for gastric cancer. The medical records of patients with LC who had undergone radical gastrectomy for gastric adenocarcinoma between January 1996 and September 2006 were retrospectively reviewed. A total of 57 patients were enrolled in this study. Forty-six patients (81%) were classified into Child's class A. In 22 patients (39%) postoperative complications developed, the most common being ascites (23%), followed by wound infection and hepatic encephalopathy. Postoperative ascites occurred more frequently in patients with Child's class B or C than in those with class A (63.6% vs 13%, P = 0.001). Massive ascites developed in 4 patients, 3 of whom had Child's class B and underwent D2 lymph node (LN) dissection, and 1 of whom had Child's class C and a D1 LN dissection. Postoperative mortality occurred in 5 patients (9%), with a significantly higher mortality rate for patients with Child's class B or C than for those with class A (27.2% vs 4.3%, P = 0.045). With a median follow-up of 32 months, the estimated 5-year survival rate for all patients was 54%. Regardless of the tumor depth, overall survival was longer for patients with Child's class A than for those with Child's class B or C. These results demonstrated that radical gastrectomy with extended LN dissection is feasible in patients with compensated LC. For patients with moderate to severe hepatic dysfunction, however, D1 or less extensive LN dissection may be the more reasonable surgical procedure.
Digestive Diseases and Sciences 03/2008; 53(2):399-404. · 2.26 Impact Factor
[show abstract][hide abstract] ABSTRACT: Abstract
Lactic acid bacteria (LAB) are beneficial probiotic organisms that contribute to improved nutrition, microbial balance, and immuno-enhancement of the intestinal tract, as well as anti-tumor activity. The aim of the present work was to study the growth inhibition of tumor cells by butanol extract of Bifidobacterium adolescentis isolated from healthy young Koreans.
The anti-proliferative activity of B. adolescentis isolates was assessed by XTT assays on three human colon cancer cell lines (Caco-2, HT-29, and SW480). The effects of B. adolescentis SPM0212 butanol extract on tumor necrosis factor-α (TNF-α) and nitric oxide (NO) production were tested using the murine macrophage RAW 264.7 cell line.
The butanol extract of B. adolescentis SPM0212 dose-dependently inhibited the growth of Caco-2, HT-29, and SW480 cells by 70%, 30%, and 40%, respectively, at 200 μg/mL. Additionally, the butanol extract of B. adolescentis SPM0212 induced macrophage activation and significantly increased the production of TNF-α and NO, which regulate immune modulation and are cytotoxic to tumor cells.
The butanol extract of B. adolescentis SPM0212 increased activity of the host immune system and may improve human health by helping to prevent colon cancer as a biological response modifier.