Journal of Yeungnam Medical Science

Original article

The clinical outcomes of second-line chemotherapy in patients with advanced pancreatic cancer: a retrospective study: Hyun yeb Jung, Eun Mi Lee; J Yeungnam Med Sci. 2022;39(2):124-132. Published online October 19, 2021; DOI: https://doi.org/10.12701/yujm.2021.01347

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Background
Despite recent advances in first-line chemotherapy for advanced pancreatic cancer, standard treatment after the failure of initial chemotherapy has not been established. Hence, we aimed to retrospectively analyze the clinical characteristics and outcomes of second-line chemotherapy in patients with advanced pancreatic cancer.
Methods
We reviewed the clinical data of patients with advanced pancreatic cancer who underwent palliative chemotherapy at Kosin University Gospel Hospital between January 2013 and October 2020.
Results
Among 366 patients with advanced pancreatic cancer who had received palliative chemotherapy, 104 (28.4%) underwent at least one cycle of second-line chemotherapy. The median age of the patients at the time of initiating second-line treatment was 62 years (interquartile range, 57–62 years), and 58.7% (61 patients) of them were male. The common second-line chemotherapy regimens were 5-fluorouracil (FU) plus leucovorin, irinotecan, and oxaliplatin (33 patients, 31.7%); gemcitabine/nab-paclitaxel (29, 27.9%), gemcitabine±erlotinib (13, 12.5%); and oxaliplatin and 5-FU/leucovorin (12, 11.5%). The median overall survival (OS) and progression-free survival were 6.4 months (95% confidence interval [CI], 4.5–8.6 months) and 4.5 months (95% CI, 2.7–6.3 months), respectively. In a multivariate analysis, poor performance status (PS) (hazard ratio [HR], 2.247; p=0.021), metastatic disease (HR, 2.745; p=0.011), and elevated carcinoembryonic antigen (CEA) levels (HR, 1.939; p=0.030) at the beginning of second-line chemotherapy were associated with poor OS.
Conclusion
The survival outcome of second-line chemotherapy for advanced pancreatic cancer remains poor. However, PS, disease extent (locally advanced or metastatic), and CEA level may help determine patients who could benefit from second-line treatment.

Citations

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Efficacy and tolerance of LV5FU2-carboplatin chemotherapy in patients with advanced pancreatic ductal adenocarcinoma after failure of standard regimens
Thomas Chaigneau, Lina Aguilera Munoz, Caroline Oger, Clémence Gourdeau, Olivia Hentic, Lucie Laurent, Nelly Muller, Marco Dioguardi Burgio, Marie-Pauline Gagaille, Philippe Lévy, Vinciane Rebours, Pascal Hammel, Louis de Mestier
Therapeutic Advances in Medical Oncology.2023; 15: 175883592311637. CrossRef
Real-Life Results of Palliative Chemotherapy in Metastatic Pancreatic Ductal Adenocarcinoma
Bianca Varzaru, Razvan A. Iacob, Adina E. Croitoru, Speranta M. Iacob, Cristina E. Radu, Stefania M. Dumitrescu, Cristian Gheorghe
Cancers.2023; 15(13): 3500. CrossRef

Original Articles

Chronic Fatigue Syndrome.: Seung Pil Jung, Keun Mi Lee; Yeungnam Univ J Med. 2007;24(1):1-10. Published online June 30, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.1.1

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Abstract PDF

The chronic fatigue immune dysfunction syndrome (abbreviated CFIDS or CFS) is a disorder characterized by debilitating fatigue(over 6 months), along with cognitive, musculoskeletal, and sleep abnormalities. The etiology of this illness is unlikely to be a single agent. Findings to date suggest that physiological and psychological factors work together to predispose and perpetuate the illness. Diagnosis is made difficult by the nonspecific clinical findings and no available diagnostic testing. With no known cause or cure for the chronic fatigue and immune dysfunction syndrome, treatment is based on relieving symptoms and improving the quality of life of affected patients. There is emerging evidence that chronic fatigue syndrome may be familial. In the future, studies will examine the extent to which genetic and environmental factors play a role in the development of chronic fatigue syndrome. Most patients with CFS have psychiatric problems such as a generalized anxiety disorder, or major or minor depression, therefore, these mental health disorders may be correlated with the pathophysiology of the CFS. The treatment for CFS must be individualized, due to the heterogeneity of the CFS population. Also the treatment of CFS is built on a foundation of patient-physician relationship, respect and advocacy.

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Consumptive Disease and Chronic Fatigue Improved by Nokyonggunbi-tang and Other Korean Medical Treatments: A Case Report
Mu-jin Park, So-ri Jin, Eun-jae Oh, Woo-sub Song, Hyun-seok Lee, Kyu-hyun Hwang, Seung-ju Oh, Ah-ra Ju, Su-in Baek
The Journal of Internal Korean Medicine.2021; 42(5): 738. CrossRef

The Relationship Between Adiposity and Risk factors for Cadiovascular Disease at Normal Body Weight Male.: Woo Sung Kwon, Jun Su Kim, Jin Wook Chae, Keun Mi Lee, Seung Pil Jung, Yong Moon; Yeungnam Univ J Med. 2003;20(1):62-70. Published online June 30, 2003; DOI: https://doi.org/10.12701/yujm.2003.20.1.62

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Abstract PDF: BACKGROUND
Most of all studies about the relation between the health risk and obesity are based on the European and American data. The purpose of this study is to examine the relation between adiposity and risk factors for cardio vacular disease (CVD) in normal weight individuals. MATERIALS AND METHODS: Normal weight subjects with a body mass index (BMI) between 18.5 and 23 kg/m2 (76 subjects) and overweight subjects with a BMI between 23 and 25 kg/m2 (53 subjects) were retained for this study. Normal weight subjects were divided into three group of each adiposity variable, then three group and the overweight group were evaluated for the presence of CVD risk factors and analyze the correlation coefficients between adiposity variables and risk factors controlled for age in normal weight, overweight groups. Using logistic regression analysis, the odds ratio (OR) for the prevalence of risk factors for each group of adiposity variables and the overweight group was estimated relative to the first group in normal weight subjects. RESULTS: Systolic BP, diastolic BP, LDL cholestrol, HDL cholesterol, triglycerides in normal weight subjects were significantly correlated with all adiposity variables (P<0.01). Third group (3.7 for %fat and 4.7 for fat mass)of adiposity variables in the normal weight group and the overweight group (6.6 for %fat and 11.5 for fat mass) tended to have higher ORs compared to first group for risk factor variables. CONCLUSION: Normal weight subjects with elevated adiposity had higher prevalence of risk factors than normal weights subjects with less adiposity. Measuring of adiposity added additional information of cardiovascular disease risk factors in normal weight subjects.

The Relationship Between Body Composition and Bone Mineral Density in Postmenopausal Women.: Jin Wook Chae, Il Hoe Kim, Woo Sung Kwon, Keun Mi Lee, Seung Pil Jung, Yong Moon; Yeungnam Univ J Med. 2003;20(1):53-61. Published online June 30, 2003; DOI: https://doi.org/10.12701/yujm.2003.20.1.53

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Abstract PDF

BACKGROUND
Body weight is an important factor that influence the bone density in postmenopausal women except estrogen dificiency. However, different results are reported about the relationship between body composition and bone density in the postmenopausal women. We have studied the relationship between age, body weight, body mass index (BMI), waist hip ratio (WHR), muscle mass, fat mass, fat free mass and bone density. MATERIALS AND METHODS: We have studied 127 persons of postmenopausal women who visited university medical center and examined the inbody 3.0 and Dual Energy X-ray Absorptiometry (DEXA) from Jan, 2001 to Jun, 2002. they didn't have any disease and didn't received hormone therapy, osteoporosis therapy or other medication that influence the bone density. RESULTS: The numbers of study subjects is total 127 persons. Mean age is 56.9+/-5.14, mean weight is 59.3+/-8.7 kg, mean BMI is 25.37+/-3.16 (kg/m2), mean fat mass is 20.02+/-5.05 kg, mean muscle mass is 37.49+/-4.50 kg, mean fat free mass is 39.80+/-4.70, mean BMD is 0.828+/-0.148 (g/cm2). In the result of linear regression analysis, age, height, weight, muscle mass, fat free mass, fat mass, BMI are significant determinants of BMD. In stepwise multiple regression analysis, age is the most significant determinant of BMD and besides age, fat free mass is the most significant determinant of BMD among body composition. CONCLUSION: In postmenopausal women, age, height, weight, BMI, muscle mass, fat free mass, fat mass are significant determinants of BMD and besides age, fat free mass is the most significant determinant of BMD among the body composition. So, diet and exercise that increase fat free mass will contribute to bone density increment.

Citations

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Problems with Bone Health and the Influencing Factors of Bone Mineral Density in Women across the Life Cycle
Nami Chun, Hyunju Chae
Korean Journal of Women Health Nursing.2015; 21(1): 43. CrossRef
Association between bone mineral density and remaining teeth in postmenopausal women
Kyeong-Soo Lee, Chang-Suk Kim
Journal of Korean society of Dental Hygiene.2014; 14(3): 319. CrossRef
Association of Anthropometric and Biochemical Factors with Bone Mineral Density in Korean Adult Women Data from the Fourth (2008~2009) and Fifth (2010~2011) Korea National Health and Nutrition Examination Surveys (KNHANES IV & V)
Soon-Nam Choi, Kwang-Hyun Jho, Nam-Yong Chung
Journal of the Korean Dietetic Association.2014; 20(3): 157. CrossRef
A Study of Factors Influencing the Bone Mineral Density on Premenopausal Women: Using the 2011 Korean National Health and Nutrition Examination Survey Data
Young-Mi Chun, Sun-Hee Lee
Journal of the Korea Academia-Industrial cooperation Society.2013; 14(12): 6246. CrossRef
Factors Associated with Bone Mineral Density in Korean Postmenopausal Women Aged 50 Years and Above: Using 2008-2010 Korean National Health and Nutrition Examination Survey
Son-Ok Mun, Jihye Kim, Yoon Jung Yang
Korean Journal of Community Nutrition.2013; 18(2): 177. CrossRef

Differences in Clinical Laboratory Data between the Elderly and the Young Adults.: Kun A Lee, Keun Mi Lee, Seung Pil Jung, Seong Wook Bae; Yeungnam Univ J Med. 1997;14(2):430-442. Published online December 31, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.2.430

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Abstract PDF: Due to the lowering of biological functions resulted from old age, the elderly is known to have many different clinical laboratory data compared with the young adults. But, in korea, such study is lacking. This research is to find the differences between the elderly and the young adults, and also to know the sexual differences, by comparing the outcomes of the clinical laboratory data. Along with that, it is to help clinical usage of the data in the future. The age of the elderly was between 60 and 83(average age 63.8), and that of the young controls was between 20 and 35. In both sexes, MCV, MCH, ESR, CRP,AST, ALT, gamma GTP, ALP, BUN, total cholesterol were significantly higher in the elderly than in the controls. And lymphocyte count(%), total bilirubin, direct bilirubin, total protein, albumin, T3 were significantly lower in the elderly than in the controls(P<0.05). Hemoglobin, Hct, platelet count, T4 were significantly lower only in the male elderly, and eosinophil count(%), creatinine were significantly higher only in the female elderly(P<0.05). HDLcholesterol was significantly higher only in the male elderly(P<0.01). There were no significant difference between two groups regarding WBCcount, segment neutrophil count(%), monocyte count(%), TSH. Many clinical laboratory data are different between the elderly and the young adults, and some clinical laboratory data also have sexual differences.

Factors Affecting to Bone Mineral Density in Postmenopausal Women.: Seung Pil Jung, Keun Mi Lee, Suk Hwan Lee; Yeungnam Univ J Med. 1996;13(2):261-271. Published online December 31, 1996; DOI: https://doi.org/10.12701/yujm.1996.13.2.261

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Abstract PDF

INTRODUCTION: Osteoporosis, the most common metabolic bone disorder, is a condition of reduced bone density and increased susceptibility to fractures. Osteoporosis is a major public health problem and a significant cause of morbidity in postmenopausal women. Therefore family physicians as primary care physicians are in a key position for preventing and treating this disorder. So we studied the factors affecting to bone mineral density in postmenopausal women. MATERIALS AND METHODS: A total of 136 spontaneous postmenopausal women were participated in the study. They have measured spinal bone mineral density by dual energy x-ray absorptiometry from January 1992 to June 1995 at Yeungnam University Hospital. Age, height, weight, age at menarche and menopause, number of child and breast feeding child, history of oral pill ingestion, family history of osteoporosis, amount of milk and coffee ingestion, consumption of tobacco and alcohol and physical activity were assessed by qustionnaire and medical records. RESULTS: physical activity and weight were significant contributors. Physical activity is most the largest contributor. CONCLUSIONS: Among factors affecting to BMD in postmenopausal women, physical activity and weight were more important factors. Therefore continuous physical activity is significant factor to prevent osteoporosis in postmenopausal women.

Citations

Citations to this article as recorded by

The Bone Mineral Density Impact Factors of Adult Women before the Menopause - based on the National Health and Nutrition Examination Survey -
Kyung-Hee Kim, Jung-Hee Lee, Jin-Dong Yeo
Journal of the Korean Society of Radiology.2015; 9(3): 147. CrossRef
The association of dietary quality and food group intake patterns with bone health status among Korean postmenopausal women: a study using the 2010 Korean National Health and Nutrition Examination Survey Data
Gyeongah Go, Zuunnast Tserendejid, Youngsook Lim, Soyeon Jung, Younghee Min, Haeryun Park
Nutrition Research and Practice.2014; 8(6): 662. CrossRef
Association of Bone Mineral Density and Blood Pressure, Calcium Intake among Adult Women in Seoul · Kyunggi Area - Based on 2011 KNHANES -
Jae Ok Koo
Korean Journal of Community Nutrition.2013; 18(3): 269. CrossRef

Effect of Baclofen on the Cholinergic Nerve Stimulation in Isolated Rat Detrusor: Kwang Youn Lee, Keun Mi Lee, Eun Mee Choi, Hyoung Chul Choi, Jeoung Hee Ha, Won Joon Kim; Yeungnam Univ J Med. 1995;12(2):246-259. Published online December 31, 1995; DOI: https://doi.org/10.12701/yujm.1995.12.2.246

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Abstract PDF: This study aimed to investigate the mechanism of action of baclofen on the detrusor muscle isolated from rat. Rats (Sprague-Dawley) were sacrificed by decapitation and exsanguination. Horizontal muscle strips of 2 mm × 15 mm were prepared for isometric myography in isolated muscle chamber bubbled with 95% / 5%-OZ / CO2 at 371C, and the pH was maintained at 7.4. Detrusor strips contracted responding to the electrical field stimulation (EFS) by 2 Hz, 20 msec, monophasic square wave of 60 VDC. The initial peak of EFS-Induced contraction was tended to be suppresed by α,β-methylene-adenosine 5'-triphosphate (mATP), a partial agonist of purinergic receptor, and baclofen, a GABAB receptor agonist (statistically nonsignificant). The late sustained contraction by EFS was suppressed significantly (p<0.05) by additions of atropine, a cholinergic muscarinic receptor antagonist and baclofen. The adenosine 5'-triphosphate-induced contraction was completely abolished by mA TP but not by baclofen. In the presence of atropine, the subsequent addition of acetylcholine could not contract the muscle strips: but the addition of acetylcholine in the presence of baclofen evoked a contraction to a remarkable extent. These results suggest that in the condition of present study, the cholinergic innervation may play a more important role than the purinergic one, and baclofen suppresses the contractility of rat detrusor by the stimulation of the GABA receptors to inhibit the release of neurotransmitter from the cholinergic nerve ending

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