• 제목, 요약, 키워드: 10-day sequential therapy

검색결과 13건 처리시간 0.029초

Effect of IL-1 Polymorphisms, CYP2C19 Genotype and Antibiotic Resistance on Helicobacter pylori Eradication Comparing Between 10-day Sequential Therapy and 14-day Standard Triple Therapy with Four-Times-Daily-Dosing of Amoxicillin in Thailand: a Prospective Randomized Study

  • Phiphatpatthamaamphan, Kittichet;Vilaichone, Ratha-korn;Siramolpiwat, Sith;Tangaroonsanti, Anupong;Chonprasertsuk, Soonthorn;Bhanthumkomol, Patommatat;Pornthisarn, Bubpha;Mahachai, Varocha
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1903-1907
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    • 2016
  • Background: Studies of effects of IL-1 polymorphisms, CYP2C19 genotype together with antibiotic resistance for H. pylori eradication are rare worldwide. The present study was designed to evaluate efficacy of 10-day sequential therapy (SQT) and 14-day standard triple therapy (STT) with four- times-daily dosing of amoxicillin for H. pylori eradication related to these important host and bacterial factors in Thailand. Materials and Methods: This prospective randomized study was performed during March 2015 to January 2016. H. pylori infected gastritis patients were randomized to receive 10-day sequential therapy and 14-day standard triple therapy. CYP2C19 genotyping, IL1 polymorphism (IL-1B and IL-1RN genotypes) and antibiotic susceptibility tests were performed in all patients. 13C-UBT was conducted to confirm H. pylori eradication at least 4 weeks after treatment. Results: A total of 100 patients (33 males and 67 females, mean age=51.1 years) were enrolled. Eradication rate by PP analysis was 97.9% (47/48) with the 10-day SQT regimen and 87.8% (43/49) with 14-day STT regimen (97.9% vs 87.8%; p-value=0.053). Antibiotic susceptibility testing demonstrated 45% resistance to metronidazole, 14.8% to clarithromycin, and 24.1% to levofloxacin. CYP2C19 genotyping revealed 44.9% RM, 49% IM and 6.1% PM. IL-1B and IL-1RN genotypes were demonstrated as 21.4% for CC, 48.1% for TC, 36.8% for TT, 72.7% for 1/1, and 21.2% for 1/2 genotypes, respectively. The 10-day SQT regimen provided 100% eradication in patients with clarithromycin or dual clarithromycin and levofloxacin H. pylori resistant strains. Moreover, the 10-day SQT regimen resulted in a 100% eradication rate in all patients with CYP2C19 genotype RM and almost type of IL-1B (TC and TT) and IL1-RN genotypes ( 1/2 and other). Conclusions: Treatment with 10-day sequential therapy is highly effective for H. pylori eradication regardless of the effects of clarithromycin resistance, dual clarithromycin and levofloxacin resistance, CYP2C19 genotype, IL-1B and IL1-RN genetic polymorphisms and can be used as effective first line therapy in Thailand.

연속요법의 Helicobacter pylori 제균율 - 3차 기관에서의 8년간의 전향적 연구 (Eradication Rates of 10-day Sequential Therapy for Helicobacter pylori: Results of an 8-year Prospective Study Conducted at a Tertiary Korean Hospital)

  • 윤기철;김나영
    • 대한소화기학회지
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    • v.73 no.2
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    • pp.99-104
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    • 2019
  • 목적: 한국에서 표준 3제요법에 의한 H. pylori의 제균율은 낮은 실정이다. 일차 제균 치료로서의 연속요법(sequential therapy)은 현실적인 대안으로 제시되어 왔다. 본 전향적 연구에서는 연속요법의 연도별 제균율 변화 양상을 확인하고자 하였다. 대상 및 방법: 2010년부터 2018년까지 983명의 환자가 치료의도자 분석(intention to treat) 및 복용순응자 분석 대상이 되었다. 10일 연속요법은 최초 5일간 esomeprazole 40 mg b.i.d, amoxicillin 1 g b.i.d 투약 후 esomeprazole 40 mg b.i.d, clarithromycin 500 mg b.i.d, metronidazole 500 mg t.i.d를 5일간 추가 투약하였다. 추적 시 요소호기 검사, 요소분해 검사, 또는 조직학적 검사로 제균 여부를 확인하였으며 약물 순응도와 부작용 발생 여부 또한 조사하였다. 결과: 치료의도자 분석과 복용순응자 분석의 제균율은 각각 69.9% (687명/983명) 및 87.1% (657명/754명)였다. 2010년부터 2018년까지 각 연도별 치료의도자 제균율은 시간에 따른 유의한 변화 양상 없이 유사하게 유지되었으며(p for trend=0.167), 복용순응자 제균율은 증가하는 경향을 보였다(p for trend=0.042). 약물 부작용은 41.7% (410명)의 환자에서 보고되었다. 결론: 한국에서의 높은 항생제 내성률에도 불구하고 연속요법의 제균율은 8년간 감소하지 않고 유지되었다.

임파부종 환자의 간헐적 공기압박 치료의 효과 (Effect of Sequential Intermittent Pneumatic Compression for Lymphedema)

  • 김성중;이현숙;김순희
    • 대한물리치료과학회지
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    • v.5 no.2
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    • pp.595-602
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    • 1998
  • The purpose of this study was to investigate the effect of sequential intermittent pneumatic compression in patients with lymphedema who were hospitalized for three days at Samsung Medical Center. Thirty-three subjects with lymphedema was selected by physician referral. A selection of the patients was made according to the following criteria : 1) no known metastases, 2) no infection after the a difference of at least 10% in the volumes of edematous limb. All patients were treated with the Lympha-Press(Model 103-A). Circumferential limb mesurements was done before and after a 3-day treatment period. As a result of sequential intermittent pneumatic compression therapy. All extremity showed a decrease in circumferential measurements with the maximal reduction occurring at the wrist(55.75 %) for the upper extremities and at the lower 1/3 of calf (40.61%) for the lower extremities. Upper extremity arm was reduced by 42.1% and lower extremity leg by 33.61%. In contrast with this, the proximal levels of arm patients and leg showed comparatively poor reduction than distal levels. Almost 44.44% of arm patients and 5.26% of leg patients experienced significant reduction(> 50%) after compression therapy. These data clearly indicates that Sequential Intermittent Pneumatic Compression Therapy was effective treatment for reducing of extremity volume in patients with lymphedema. but this was variable degree and dependent on the amount of pre-existing lymphedema. Other factors such as duration of edema, etiology, previous history of radiology, age did not appear to influence the extend of improvement. Further sutdies will be necessary to determine long term benefit of this therapy.

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Comparison of Motor Skill Acquisition according to Types of Sensory-Stimuli Cue in Serial Reaction Time Task

  • Kwon, Yong Hyun;Lee, Myoung Hee
    • The Journal of Korean Physical Therapy
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    • v.26 no.3
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    • pp.191-195
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    • 2014
  • Purpose: The purpose of this study is to investigate whether types of sensory-stimuli cues in terms of visual, auditory, and visuoauditory cues can be affected to motor sequential learning in healthy adults, using serial reaction time task. Methods: Twenty four healthy subjects participated in this study, who were randomly allocated into three groups, in terms of visual-stimuli (VS) group, auditory-stimuli (AS) group, and visuoauditory-stimuli (VAS) group. In SRT task, eight Arabic numbers were adopted as presentational stimulus, which were composed of three different types of presentational modules, in terms of visual, auditory, and visuoauditory stimuli. On an experiment, all subjects performed total 3 sessions relevant to each stimulus module with a pause of 10 minutes for training and pre-/post-tests. At the pre- and post-tests, reaction time and accuracy were calculated. Results: In reaction time, significant differences were founded in terms of between-subjects, within-subjects, and interaction effect for group ${\times}$ repeated factor. In accuracy, no significant differences were observed in between-group and interaction effect for groups ${\times}$ repeated factor. However, a significant main effect of within-subjects was observed. In addition, a significant difference was showed in comparison of differences of changes between the pre- and post-test only in the reaction time among three groups. Conclusion: This study suggest that short-term sequential motor training on one day induced behavioral modification, such as speed and accuracy of motor response. In addition, we found that motor training using visual-stimuli cue showed better effect of motor skill acquisition, compared to auditory and visuoauditory-stimuli cues.

순차치료에 병합 투여된 Ecabet Sodium이 Helicobacter pylori 제균에 미치는 효과 (Efficacy of Ecabet Sodium for Helicobacter pylori Eradication with Sequential Therapy)

  • 소설;안지용;나희경;정기욱;이정훈;김도훈;최기돈;송호준;이진혁;정훈용
    • 대한상부위장관⦁헬리코박터학회지
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    • v.18 no.3
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    • pp.180-185
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    • 2018
  • Background/Aims: We aimed to compare the outcomes of Helicobacter pylori eradication in patients receiving sequential therapy (ST) depending on the use of ecabet sodium (ES). Materials and Methods: Between January to December 2015, 176 patients randomly received either ST alone (n=72) or 10-day ES therapy combined with ST (n=104). After applying the exclusion criteria, 56 patients were finally assigned to the ST-only group and 84 to the ST with ES group. We retrospectively reviewed and analyzed the H. pylori eradication rate and adverse events between the two groups. Results: Among the 140 patients, 121 (86.4%) achieved successful H. pylori eradication and 24 (17.1%) had adverse events. Eradication was achieved in 50 patients (89.3%) in the ST-only group and in 71 patients (84.5%) in the ST with ES group (P=0.420). No significant difference in the incidence of adverse events was found between the ST-only and ST with ES groups (12.5% vs. 20.2%, respectively; P=0.234). However, the ST with ES group tended to have a higher prevalence of nausea or vomiting than the ST-only group (11.9% vs. 1.8%; P=0.050). Conclusions: ST showed a good H. pylori eradication rate without deteriorating the adverse events regardless of adding ES.

PNF 구강안면 운동 프로그램이 마비말장애가 있는 아급성 뇌졸중 환자의 교대운동속도와 연속운동속도에 미치는 효과 (The Effect of an Orofacial Exercise Program using PNF on Diadochokinesis in Subacute Stroke Patients with Dysarthria)

  • 원영식;이순현;김계호;문종훈
    • PNF and Movement
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    • v.16 no.3
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    • pp.475-484
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    • 2018
  • Purpose: The aim of the present study was to investigate the effect of a PNF orofacial exercise program on diadochokinesis in subacute stroke patients with dysarthria. Methods: Thirteen subacute stroke inpatients with dysarthria were recruited for the study. All participants were randomly assigned to two groups: an experimental group (n=7) and a control group (n=6). The experimental group performed a PNF orofacial exercise program, and the control group carried out an orofacial self-exercise. Both groups received the treatments 30 minutes per day, 5 days per week, for 4 weeks. The outcome measures were assessed before and after the intervention, including an alternating motion rate (AMR) and sequential motion rate for diadochokinesis. Results: After the intervention, both groups showed significant improvement in diadochokinesis (p<0.05). In the change values for both groups, the experimental group showed a more significant improvement than the control group did in /pə/ of AMR (p<0.05). Conclusion: These findings suggest that PNF orofacial exercise programs may have positive effects on the improvement of diadochokinesis in subacute stroke patients with dysarthria.

반복적 경두부 자기자극이 운동학습과 뇌 운동영역 활성화에 미치는 영향 : 예비연구 (Effect of rTMS on Motor Sequence Learning and Brain Activation : A Preliminary Study)

  • 박지원;김종만;김연희
    • 한국전문물리치료학회지
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    • v.10 no.3
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    • pp.17-27
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    • 2003
  • Repetitive transcranial magnetic stimulation (rTMS) modulates cortical excitability beyond the duration of the rTMS trains themselves. Depending on rTMS parameters, a lasting inhibition or facilitation of cortical excitability can be induced. Therefore, rTMS of high or low frequency over motor cortex may change certain aspects of motor learning performance and cortical activation. This study investigated the effect of high and low frequency subthreshold rTMS applied to the motor cortex on motor learning of sequential finger movements and brain activation using functional MRI (fMRI). Three healthy right-handed subjects (mean age 23.3) were enrolled. All subjects were trained with sequences of seven-digit rapid sequential finger movements, 30 minutes per day for 5 consecutive days using their left hand. 10 Hz (high frequency) and 1 Hz (low frequency) trains of rTMS with 80% of resting motor threshold and sham stimulation were applied for each subject during the period of motor learning. rTMS was delivered on the scalp over the right primary motor cortex using a figure-eight shaped coil and a Rapid(R) stimulator with two Booster Modules (Magstim Co. Ltd, UK). Functional MRI (fMRI) was performed on a 3T ISOL Forte scanner before and after training in all subjects (35 slices per one brain volume TR/TE = 3000/30 ms, Flip angle $60^{\circ}$, FOV 220 mm, $64{\times}64$ matrix, slice thickness 4 mm). Response time (RT) and target scores (TS) of sequential finger movements were monitored during the training period and fMRl scanning. All subjects showed decreased RT and increased TS which reflecting learning effects over the training session. The subject who received high frequency rTMS showed better performance in TS and RT than those of the subjects with low frequency or sham stimulation of rTMS. In fMRI, the subject who received high frequency rTMS showed increased activation of primary motor cortex, premotor, and medial cerebellar areas after the motor sequence learning after the training, but the subject with low frequency rTMS showed decreased activation in above areas. High frequency subthreshold rTMS on the motor cortex may facilitate the excitability of motor cortex and improve the performance of motor sequence learning in normal subject.

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Critically Ill Patients with Pandemic Influenza A/H1N1 2009 at a Medical Center in Korea

  • Choi, Eun-Young;Huh, Jin-Won;Lim, Chae-Man;Koh, Youn-Suck;Kim, Sung-Han;Choi, Sang-Ho;Kim, Won-Young;Kim, Won;Kim, Mi-Na;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.1
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    • pp.28-35
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    • 2011
  • Background: The aim of the study was to describe the characteristics, treatments, and outcomes of critically ill patients with pandemic Influenza A/H1N1 2009 at a major medical center in Korea. Methods: This retrospective observational study examined critically ill adult patients with pandemic Influenza A/H1N1 2009, who were admitted to the AMC between August and December 2009. Results: 27 patients with confirmed pandemic Influenza A/H1N1 2009 were admitted to the intensive care unit (ICU) at the Asan Medical Center (AMC). The median age (IQR) was 59 years (41~67), and 66.7% of the patients were older than 51 years. A total of 81.5% of the patients had 2 or more co-morbidities. The median time (IQR) from symptom onset to presentation was 2 days (1~4), and the median time from presentation to ICU admission was 0 days (0~1.5). All patients received oseltamivir (300 mg/day) and 13 patients received triple combination therapy (oseltamivir, amantadine, ribavirin). Twelve patients required mechanical ventilation on the first day of ICU admission. A total of 6 patients (22.2%) died within 28 days of admission. The patients who died had significantly higher acute physiology and chronic health evaluation (APACHE) II and sequential organ failure assessment (SOFA) scores at presentation. There were no significant differences in age, co-morbidities, or antiviral regimens between survivors and non-survivors. Conclusion: Critical illness related to pandemic Influenza A/H1N1 2009 was common in elderly patients with chronic co-morbidities. All patients were given high-dose oseltamivir or triple combination antiviral therapy. Nonetheless, patients with critical illnesses associated with pandemic Influenza A/H1N1 2009 had a death rate of 22.2%.

제한병기 소세포암 환자의 항암화학방사선요법에 대한 후향적 분석 (Retrospective Analysis of Chemoradiotherapy for Limited-Stage Small-Cell Lung Cancer)

  • 이종훈;김성환;김수지;이주환;김훈교;심병용
    • Radiation Oncology Journal
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    • v.27 no.3
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    • pp.133-139
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    • 2009
  • 목 적: 제한병기 소세포암 환자의 흉부방사선치료 및 항암치료의 성적과 부작용을 분석하고자 연구를 진행하였다. 대상 및 방법: 제한병기 소세포암으로 진단받고 동시항암화학방사선요법 혹은 순차적항암화학방사선요법을 받은 35명의 환자를 후향적으로 조사하였다. 방사선치료선량은 하루 1.8~2 Gy 분할선량으로 원발병소에 총 50~66 Gy 조사하였다. 환자군은 4주기 시스플라틴 및 에토포사이드 복합 항암치료를 받았다. 동시항암화학방사선요법군은 항암 제 1주기 첫 날에 흉부방사선치료를 시작하였고 순차적항암화학방사선요법군은 항암 제 4주기를 마친 후 에 흉부방사선치료를 시작하였다. 결 과: 순차적항암화학방사선요법군의 무진행생존시간의 중앙값은 16.5개월이었고 동시항암화학방사선요법군의 무진행생존시간의 중앙값은 26.3개월이었다. 동시항암화학방사선요법군의 2년 무진행생존율은 50.0%이었고 순차적항암화학방사선요법군의 2년 무진행생존율은 16.0%이었다(p=0.0950). 백혈구감소증의 정도와 빈도는 동시 항암화학방사선요법군에서 유의하게 높았다. 하지만, 심한 식도염의 빈도는 양군에서 모두 높지 않았다. 동시항암화학방사선요법군은 순차적항암화학방사선요법군에 비하여 빈번하게 혈액학적독성으로 치료가 중단되었다(p=0.001). 결 론: 본 연구에서는 동시항암화학방사선요법이 제한병기 소세포암 치료에서 순차적항암화학방사선요법보다 효과적이었다. 하지만, 동시항암화학방사선요법은 부작용을 유의하게 증가시켰다.