Precision and Future Medicine最新文献

{"title":"Responses against infectious disease pandemics: a narrative review on COVID-19 A narrative review","authors":"D. Chung","doi":"10.23838/pfm.2021.00156","DOIUrl":"https://doi.org/10.23838/pfm.2021.00156","url":null,"abstract":"Currently, the world is facing the coronavirus disease 2019 (COVID-19) pandemic. With this, an emerging infectious disease pandemic in the absence of effective antiviral agents and vaccines for a novel virus is no different from the 1918 influenza pandemic, which became a great disaster for humankind. We also experienced a global lockdown with a stringent implementation of social distancing, which is a first for mankind living in the present day, and has led to enormous economic damage and restrictions on individual freedom. The microorganism that will cause the next pandemic may be a highly fatal avian influenza virus, another coronavirus, or a completely different microorganism. This COVID-19 pandemic is an enormous lesson for humankind and is tantamount to a vaccine in preparation for the next pandemic. Important and urgent undertakings were given to each country in terms of complementing laws and regulations for a stronger and more resilient healthcare system, such as investment in research and development for new rapid diagnostic technologies, vaccines, new therapeutic agents, among others.","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42171777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional outcomes after sphincter-preserving surgeries for low-lying rectal cancer A review","authors":"E. Park, S. Baik","doi":"10.23838/pfm.2021.00142","DOIUrl":"https://doi.org/10.23838/pfm.2021.00142","url":null,"abstract":"Sphincter preservation and organ restoration during rectal cancer surgery avoids permanent stoma creation and diminishes psychosocial damages. However, decreased rectal volumes and sphincter dysfunction—including pelvic nerve damage—results in low anterior resection syndrome, as well as urinary and sexual dysfunction after rectal resection. Bowel habit changes such as fecal incontinence, fecal urgency, frequent bowel movements, clustered stools, and difficulties in bowel emptying can be treated using medications, pelvic floor rehabilitation, sacral neuromodulation, or neorectal reservoir reconstruction. Pelvic nerve damage resulting from superior and inferior hypogastric plexi during sphincter-preserving rectal cancer surgery can induce urologic and sexual dysfunctions. Preoperative voiding difficulty, perioperative blood loss, and autonomic nerve injury are considered independent risk factors for postoperative urinary dysfunction. Retrograde ejaculation and erectile dysfunction, female dyspareunia, and vaginal dryness are manifestations of sexual dysfunction resulting from autonomic nerve injury during rectal cancer surgery. Multifactorial causes for functional outcomes after sphincter-preserving surgeries are considered to improve patient’s quality of life with acceptable oncologic outcomes in the treatment of rectal cancer patients.","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46126680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Widening role of multidisciplinary treatment for rectal cancer: toward diversity of cancer care","authors":"Y. Cho","doi":"10.23838/pfm.2021.00191","DOIUrl":"https://doi.org/10.23838/pfm.2021.00191","url":null,"abstract":"Advances in treatment modalities, including systemic therapy, local therapy, and technical development, have substantially improved survival rates in patients with colorectal cancer [1]. In addition, the rate of colorectal cancer diagnosis before 50 years of age has been increasing over the past two decades [2]. The number of cancer survivors who suffer from chronic morbidities that impair their quality of life has also increased and will continue growing. Therefore, precision medicine in the era of rectal cancer management aims to provide curative-intent treatment based on tumor characteristics and preserve the quality of life, especially bowel function with sphincter preservation or rectum sparing. Functional derangement was considerably significant after radical resection of rectal cancer. Abdominoperineal resection results in a colossal lifestyle change, and surgeons have attempted to preserve the sphincter. However, several patients experience bowel dysfunction even after sphincter preservation, which constitutes a series of symptoms. Although researchers have suggested various methods for evaluating and managing bowel dysfunction after rectal cancer surgery, treatment strategies need to be established. Therefore, endoscopic removal or local excision has been widely accepted for early rectal cancer treatment, as oncologic outcomes are comparable to those after radical resection. Even in patients with advanced rectal cancer, neoadjuvant chemoradiotherapy resulted in complete tumor regression in a subset of patients, which led us to consider deferral surgery. Watch-andwait (WW) strategies have continuously gained approval in the Asia-Pacific region and Western countries [3]. Proper patient selection is critical for the organ-preserving strategies mentioned above. In this issue of Precision and Future Medicine, three review articles have been published on rectal cancer management, in which interest has increased. Park and Baik [4] reviewed functional assessment methods and various treatments for bowel dysfunction. A series of symptoms associated with postoperative bowel dysfunction was typically called “low anterior resection syndrome (LARS).” Although different scoring systems have been proposed, each affords advantages and drawbacks. The LARS score questionnaire is a widely used tool. Young age, low anastomosis level, anastomotic leakage, and radiotherapy were related to the occurrence of LARS. Medical management, pelvic floor rehabilitation, and sacral nerve stimulation have been suggested for treating LARS. The authors also documented urinary and sexual dysfunctions, as reported in 20% to 40% of patients who undergo rectal cancer surgery. The authors concluded that surgeons should carefully perform sphincter-preserving rectal cancer surgery to ensure functional recovery of the remnant bowel and improve urologic and sexual Received: December 22, 2021 Revised: December 24, 2021 Accepted: December 24, 2021","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48000038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Watch and wait strategies for rectal cancer A systematic review","authors":"I. Park","doi":"10.23838/pfm.2021.00177","DOIUrl":"https://doi.org/10.23838/pfm.2021.00177","url":null,"abstract":"Watch and wait (WW) strategies have been suggested for patients with clinical complete regression (cCR). The WW approach was first introduced by Habr–Gama in patients with cCR after neoadjuvant treatment. Actually, it is not “no surgery” but “deferral of surgery;” therefore, the WW approach or non-operative management is a representative term currently. The number of publications regarding WW for rectal cancer has increased abruptly. We conducted a systematic review of PubMed for literature published on WW. It is now one of the most interesting issues in rectal cancer treatment. Many studies have reported comparable overall survival with WW and radical resection. However, a high local regrowth rate is a problem, and proper salvage management is the main concern in the WW approach. Adequate patient selection is necessary to achieve favorable oncologic outcomes. However, the appropriate definition and diagnostic method for cCR have not yet been clearly defined. Indeed, advances in local control have not translated into overall survival improvement, and many efforts have been made to improve distant metastasis control and overall survival and improve clinical response to preoperative chemoradiotherapy. In this review, oncologic outcomes, ongoing efforts to improve oncologic outcomes, and limitations for clinical practice were evaluated and described.","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44719440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monogenic diabetes mellitus and clinical implications of genetic diagnosis","authors":"Eungu Kang, Lindsey Yoojin Chung, Yu Jin Kim, Kyung Eun Oh, Y. Rhie","doi":"10.23838/pfm.2021.00100","DOIUrl":"https://doi.org/10.23838/pfm.2021.00100","url":null,"abstract":"Monogenic diabetes mellitus, which is diabetes caused by a defect in a single gene that is associated with β cell function or insulin action, accounts for 1% to 6% of all pediatric diabetes cases. Accurate diagnosis is important, as the effective treatment differs according to genetic etiology in some types of monogenic diabetes: high-dose sulfonylurea treatment in neonatal diabetes caused by activating mutations in KCNJ11 or ABCC8; low-dose sulfonylurea treatment in HNF1A/HNF4A-diabetes; and no treatment in GCK diabetes. Monogenic diabetes should be suspected by clinicians for certain combinations of clinical features and laboratory results, and approximately 80% of monogenic diabetes cases are misdiagnosed as type 1 diabetes or type 2 diabetes. Here, we outline the types of monogenic diabetes and the clinical implications of genetic diagnosis.","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46219756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic etiologies of central precocious puberty","authors":"Hae-sang Lee","doi":"10.23838/pfm.2021.00107","DOIUrl":"https://doi.org/10.23838/pfm.2021.00107","url":null,"abstract":"Pubertal onset is a complex process, which is influenced by genetic and environmental factors, such as obesity and endocrine-disrupting chemicals. In addition, the timing of normal puberty varies between individuals and is a highly polygenic trait with both rare and common variants. Central precocious puberty (CPP) is defined as the early activation of the hypothalamic-pituitary-gonadal axis. Genetic factors are suggested to account for 50% to 80% of the variation in puberty initiation, as indicated by the greater concordance of pubertal timing observed in monozygotic twins than in dizygotic twins. Although genetic factors play a crucial role in CPP development, only few associated genes have been identified. To date, four monogenic genes have been identified: KISS1, KISS1R, MKRN3, and DLK1. Moreover, mutation prevalence in these genes varies considerably depending on the ethnicity of patients with CPP. This article reviews the current knowledge on the normal pubertal timing and physiology and discusses the CPP-causing genes.","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42657506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do we need more genetic counselling in pediatric endocrine diseases?","authors":"E. Rhee","doi":"10.23838/pfm.2021.00121","DOIUrl":"https://doi.org/10.23838/pfm.2021.00121","url":null,"abstract":"","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":"138 2","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41247554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital hypogonadotropic hypogonadism: from clinical characteristics to genetic aspects","authors":"A. Kwon, Ho-Seong Kim","doi":"10.23838/pfm.2021.00093","DOIUrl":"https://doi.org/10.23838/pfm.2021.00093","url":null,"abstract":"Congenital hypogonadotropic hypogonadism (CHH) is a rare disorder caused by a deficiency in gonadotropin-releasing hormone (GnRH). CHH is characterized by delayed puberty and/or infertility; this is because GnRH is the main component of the hypothalamic-pituitary-gonadal (HPG) axis, which is a key factor in pubertal development and reproductive function completion. However, since the development of sexual characteristics and reproduction begins in the prenatal period and is very complex and delicate, the clinical characteristics and involved genes are very diverse. In particular, the HPG axis is activated three times in a lifetime, and the symptoms and biochemical findings of CHH vary by period. In addition, related genes also vary according to the formation and activation process of the HPG axis. In this review, the clinical characteristics and treatment of CHH according to HPG axis activation and different developmental periods are reviewed, and the related genes are summarized according to their pathological mechanisms.","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47652638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infiltrative invasion of the diaphragm: an uncommon manifestation of recurrent hepatocellular carcinoma","authors":"C. Kim, K. D. Song, Jung Han Woo","doi":"10.23838/pfm.2021.00086","DOIUrl":"https://doi.org/10.23838/pfm.2021.00086","url":null,"abstract":"Purpose: To report on infiltrative invasion of the diaphragm, an uncommon manifestation of recurrent hepatocellular carcinoma (HCC), and evaluate its clinical significance. Methods: Using the term “diaphragm” or “diaphragmatic” and “invasion” or “involvement,” we searched for patients in the database of radiologic reports of liver computed tomography or magnetic resonance imaging performed between 2012 and 2016 at our institution. Nine patients with infiltrative invasion of the diaphragm due to recurrent HCC were included. Their clinical and imaging findings were evaluated. Results: The median age of patients at the time of diagnosis was 68 years (range, 40 to 73). There were eight men and one woman. Imaging findings of infiltrative invasion of the diaphragm revealed diffuse thickening with enhancement involving a part of the diaphragm. The median interval between initial manifestation on imaging and radiologic diagnosis of infiltrative invasion of the diaphragm was 6.8 months (range, 3.4 to 18.6). In two of three patients who underwent surgical resection, tumors of the diaphragm were controlled without recurrence. In six patients except for one patient who was not followed up, tumors recurred at the resection site or diaphragm tumors showed a partial response or disease progression. Conclusion: Infiltrative invasion of the diaphragm by recurrent HCC manifested with diffuse thickening and diaphragm enhancement on radiologic imaging. A good prognosis can be expected only in patients who are diagnosed early and undergo surgical resection.","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45267629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The therapeutic approaches in children and adolescent with Tourette’s disorder","authors":"Y. Joung, Moon-Soo Lee","doi":"10.23838/PFM.2020.00191","DOIUrl":"https://doi.org/10.23838/PFM.2020.00191","url":null,"abstract":"A tic is a sudden, rapid, recurrent, and nonrhythmic motor movement and vocalization. In Tourette’s disorder (TD), the tics may wax and wane in frequency and severity but persist for more than one year since the first tic onset. TD may have a high spontaneous remission rate. However, in some patients, tic symptoms persist even after adulthood. Since tic symptoms develop from a very young age and have wax and wane patterns during the development period, uncontrolled symptoms can cause both subjective dis-tress and functional disability in activities of daily living. Even if psychoeducation and behavioral therapy are considered first, the treatment is determined by considering various factors such as severity of symptoms, subjective distress, physical pain, and functional impairment caused by symptoms. In addition to the antipsychotics that have been used so far, several drugs have recently been tried based on the pathogenesis hy-pothesis, and the evidence for treatment effects is increasing. This article reviewed pos-sible interventions with proven evidence of TD, including psychopharmacologic treatment.","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49103187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}