Journal of Korean medical science
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J. Korean Med. Sci. · Aug 2004
Identification of factors that influence conscious sedation in gastrointestinal endoscopy.
Although several studies examined factors that influence conscious sedation, investigation was limited into the gender and age. The aim of this prospective study is to identify the clinical variables of successful conscious sedation during gastrointestinal endoscopy. A total of 300 subjects who underwent gastrointestinal endoscopy were enrolled in a prospective fashion. ⋯ This anxiety level was also related to increased pain (p=0.0026) and alertness (p=0.0003) during the procedure. Lower dose of midazolam is needed for sedation in older subjects. Subjects with a high level of preprocedural anxiety such as women, younger subjects, slender subjects, and those without previous experience of conscious sedation should be sedated with great caution because generally, they complain of much more severe pain and alertness during the procedure.
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J. Korean Med. Sci. · Aug 2004
Clinical TrialCapecitabine and vinorelbine in patients with metastatic breast cancer previously treated with anthracycline and taxane.
We have evaluated the efficacy and safety of the combination of capecitabine and vinorelbine in metastatic breast cancer (MBC) patients previously treated with anthracycline-and taxane-containing regimens. Between April 2000 and September 2002, 44 female MBC patients received oral capecitabine (1,250 mg/m2 twice daily on days 114), and intravenous vinorelbine (25 mg/m2 on days 1 and 8) during each 3 week-chemotherapy cycle (median, 5 cycles/patient; total, 235 cycles). One patient achieved a complete response and 21 patients had partial responses, giving an overall response rate of 50% in the intention-to-treat analysis (95% CI, 35.0-65.0%). ⋯ Toxicities included grades III and IV neutropenia in 63 (26.8%) and 4 (1.7%) cycles, respectively, and grades II and III hand-foot syndrome in 12 (5.1%) and 4 (1.7%) cycles, respectively. Other nonhematologic toxicities were minimal and manageable. In conclusion, the combination of capecitabine and vinorelbine was effective and well tolerated in MBC patients even after treatment with anthracyclines and taxanes.
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J. Korean Med. Sci. · Aug 2004
Decreasing incidence of chronic lung disease despite the gradual reduction of postnatal dexamethasone use in very low birth weight infants.
Dexamethasone has been widely used in very low birth weight infants (VLBWI) weighing less than 1,500 g at birth for the prevention or treatment of chronic lung disease (CLD). Recently, however the use of dexamethasone is being reduced, as its association with abnormal neurodevelopmental outcome is known. On the other hand, there have been persistent concerns about the increased risk of CLD according to the reduction of postnatal dexamethasone use. ⋯ The day when postnatal dexamethasone therapy was begun has also been significantly delayed. The incidence of CLD has significantly decreased over the same period. In conclusion, the incidence of CLD has not increased despite the decreased use of postnatal dexamethasone.
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J. Korean Med. Sci. · Aug 2004
Case ReportsDuodenal duplicated cyst manifested by acute pancreatitis and obstructive jaundice in an elderly man.
A duodenal duplication cyst is an uncommon congenital anomaly that is usually encountered during infancy or in early childhood. Duodenal duplication cysts generally appear on the first or second portion of the duodenum and may cause duodenal obstruction, hemorrhage or pancreatitis. Here, we report a case of a duodenal duplication cyst on the second and third portion of the duodenum in an old aged man with obstructive jaundice and acute pancreatitis, which was treated successfully by a surgical excision.
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During the past decade, major breakthroughs have been achieved in treatment of chronic hepatitis B. Currently, three therapeutic agents are approved for chronic hepatitis B: interferon-alpha, lamivudine and adefovir dipivoxil. In patients with HBeAgpositive chronic hepatitis B, all of these drugs achieve HBeAg loss (24-33%) and anti-HBe seroconversion (12-30%) rates that are superior to those observed in untreated controls. ⋯ The main advantage of adefovir dipivoxil is the rare emergence of resistance, which has been identified in less than 2% of patients at 2 yr of treatment. Adefovir is also effective against lamivudine-resistant strains. This review will focus on the natural history and recently gained knowledge on the treatment of chronic hepatitis B.