• Title/Summary/Keyword: 치료 저항성

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Effect of Delayed Clozapine Initiation on Acute Treatment Response in Treatment-Resistant Schizophrenia (클로자핀의 지연된 사용이 치료저항성 조현병 환자의 급성기 약물 반응에 미치는 영향)

  • Yang, So Yung;Choi, Jung-Kyu;Park, Sunyoung;Park, Jaesub
    • Korean Journal of Schizophrenia Research
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    • v.24 no.2
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    • pp.52-59
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    • 2021
  • Objectives: Recent studies have reported that delayed initiation of clozapine can affect clinical response in patients with treatment-resistant schizophrenia (TRS). This study aimed to explore the relationship between delayed initiation of clozapine and acute treatment response. Methods: Sixty-five inpatients with TRS who started clozapine for the first time were included through a retrospective chart review. Acute treatment response was defined as a 30% reduction in the Positive and Negative Syndrome Scale score or a Clinical Global Impression of Improvement score of 1 (very much improved) or 2 (much improved) at 4 weeks after initiating clozapine. Results: After meeting the TRS criteria, the mean delay for initiating clozapine was approximately 13.8 months. The delay was shorter in patients who showed a better response to clozapine in logistic regression analysis (p=0.037). Conclusion: Our findings suggest that reducing the delay in initiating clozapine increases the effectiveness of clozapine in patients with TRS.

Development of the Gene Therapy Vector for Targeting Ovarian Cancer Cells through ErbB Receptors (ErbB 수용체를 이용한 난소암세포 표적 유전자치료 벡터의 개발)

  • Joung, In-Sil;Bang, Seong-Ho
    • Korean Journal of Microbiology
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    • v.47 no.1
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    • pp.1-6
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    • 2011
  • Inefficiency of in vivo gene transfer using currently available vectors reflects a major hurdle in cancer gene therapy. Both viral and non-viral approaches have been described to improve gene transfer efficiency but suffer from a number of limitations. Here we tested an adenovirus carrying the small peptide ligand derived from heregulin${\beta}$ EGF-like domain onto fiber, the adenoviral capsid protein, to deliver transgene to ovarian cancer cells which overexpress ErbB, the cognate receptors for heregulin. The attachement of 53 amino acids to fiber didn't affect on the fiber's trimer structure that is critical for the viral entry to cells. The fiber-modified adenovirus can mediate entry and expression of a ${\beta}$-galactosidase into cancer cells in an increased efficiency compared the unmodified adenovirus. Particularly, the gene transfer efficiency was improved up to 5 times in OVCAR3 cells, an ovarian cancer cell line. Such transduction systems hold promise for delivering genes to ErbB receptor overexpressing cancer cells, and could be used for future cancer gene therapy.

Successful Treatment of Vancomycin-Resistant Enterococcus Bacteremia With a Combination of Daptomycin and Tigecycline in an Infant who Underwent Heart-Lung Transplantation

  • Kang, Jeong Eun;Byun, Joung-Hee;Kim, Younga;Park, Su Eun
    • Pediatric Infection and Vaccine
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    • v.29 no.2
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    • pp.105-109
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    • 2022
  • The treatment of invasive infections caused by multidrug-resistant vancomycin-resistant enterococci (VRE) is challenging, particularly in pediatric patients with underlying medical conditions. Newer antibiotics used to treat VRE infections in pediatric patients are insufficiently studied. This report presents the case of a 6-month-old infant who underwent heart-lung transplantation and was successfully treated with a combination of daptomycin and tigecycline for recurrent VRE bacteremia shortly after the discontinuation of linezolid.

Research on the Correlationship between the Stress Resistant Ability of Obese and their Level of Obesity Based on Brainwave (뇌파기반 비만인의 스트레스 저항능력과 비만도와의 상관성 연구)

  • Bak, Ki-Ja
    • Proceedings of the KAIS Fall Conference
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    • 2012.05a
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    • pp.312-314
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    • 2012
  • 본 연구는 2011년 6월부터 2012년 2월까지 S시 I병원과 B센터에 비만치료를 위하여 방문한 내담자 초중고등학생 51명의 뇌파를 검사하여 스트레스저항 능력과의 상관성을 보고자 하였다. 뇌파측정을 통한 뇌기능은 시계열 선형분석 방법을 사용하였으며 비만도는 Body Composition Analysis으로 측정 비교하였다. 연구의 결과로는 체성분 측정결과가 높을 수록 스트레스 저항 능력이 낮았으며 유의미한 결과를 나타냈다. 이 결과는 스트레스 저항 능력을 조절함으로써 비만과 관련된 긍정적인 효과를 유도 할 수 있는 방법을 도출함에 의의가 있다고 본다.

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Effect of submerged culture of Ceriporia lacerata mycelium on GLUT4 protein in db/db mouse (db/db 마우스에서 Ceriporia lacerata 균사체 배양액이 GLUT4 발현에 미치는 영향)

  • Shin, Eun Ji;Kim, Ji-Eun;Kim, Ji-Hye;Park, Yong Man;Yoon, Sung Kyoon;Jang, Byeong-Churl;Lee, Sam-Pin;Kim, Byoung-Cheon
    • Food Science and Preservation
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    • v.22 no.6
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    • pp.893-900
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    • 2015
  • In this study, we evaluated the antidiabetic effect of a submerged culture of Ceriporia lacerata mycelium (CL01) on hematological indices, as well as protein and mRNA expression of the insulin-signaling pathway, in db/db mice. After CL01 was administrated for 4 weeks, blood glucose levels decreased consistently, and plasma insulin and c-peptide levels each decreased by roughly 55.8%, 40% of those in the negative control (p<0.05). With regard to HOMA-IR, an insulin resistance index, insulin resistance of the CL01-fed group improved over that of the negative control group by about 62% (p<0.05). In addition, we demonstrated that the protein expression levels of pIR, pAkt, pAMPK, and GLUT4 and the mRNA expression levels of Akt2, IRS1, and GLUT4 in the muscle cells of db/db mice increased in the CL01-fed group compared to the corresponding levels in the control group. These results demonstrate that CL01 affects glucose metabolism, upregulates protein and gene expression in the insulin-signaling pathway, and decreases blood glucose levels effectively by improving insulin sensitivity. More than 90% of those who suffer from type 2 diabetes are more likely to suffer from hyperinsulinemia, hypertension, obesity, and other comorbidities because of insulin resistance. Therefore, it is possible that CL01 intake could be used as a fundamental treatment for type 2 diabetes by lowering insulin resistance, and these results may prove be useful as basic evidence for further research into the mechanisms of a cure for type 2 diabetes.

Analysis of vertical root fracture in endodontically versus nonendodontically treated teeth on patients with periodontitis (치주질환자에서 근관치료의 유무에 따른 수직 치근 파절의 실태분석)

  • Kim, Myung-Jun;Jang, Hyun-Seon;Kim, Dong-Kie;Kim, Byung-Ock
    • Journal of Periodontal and Implant Science
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    • v.35 no.2
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    • pp.413-426
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    • 2005
  • 수직 치근파절은 특이성을 나타내지 않기 때문에 치과의사가 정확한 진단을 하기 어렵다. 따라서 수직 치근파절의 임상적 특징, 진단적 증상을 파악하여 향후 근관치료된 치아나 치료되지 않은 치아에서 수직 치근파절의 유발인자와의 관련성 및 고찰을 통해 수직 치근파절의 예방 및 치료에 응용할 수 있을 것으로 생각된다. 연구대상은 조선대학교 부속치과병원 치주과에 내원한 환자 중 최근 2년간 144명의 환자에서 근관치료를 받았거나 받지 않았던 치아 중 임상적 및 방사선학적으로 수직 치근파절로 진단된 156개의 증례를 대상으로 하였다. 모든 불확실한 증례에서 수직 지근파절의 최종 진단은 외과적 탐지를 통해 이루어졌고, 금이 간 치아와 관련될 수 있는 치근파절의 증례의 경우는 제외되었다. 근관치료된 치아와 치료되지 않은 치아, 환자의 나이와 성별, 치아종류 및 파절된 치근부위, 자각증상의 유무를 기준으로 각각의 수치와 백분율로 분류하였다. 수직 치근파절의 증상과 증후별로 분류하였으며, 진단방법에 의한 분류, 치료방법에 따른 분류, 근관 치료 후 수직 치근파절이 발생한 기간에 따른 분류를 시행하고 통계분석을 하여 다음과 같은 결과를 얻었다. 1. 근관치료를 받지 않았던 치아의 수직 치근파절의 발생율은 58%였다. 2. 성별에 따른 발생률에 있어서 남성의 호발양상을 나타내었다. 3. 근관치료된 치아에 있어서 치료되지 않은 치아에 비해 호발연령이 낮았다. 4. 전치부의 수직 치근파절은 관찰되지 않았으며 특히, 강한 교합력을 필요로 히는 구치부에서의 높은 발생율을 나타냈다. 5. 수직 치근파절의 가장 주된 증상 및 증후는 깊은 치주낭 깊이였다. 6. 근관 치료 후 수직 치근파절이 발생한 기간은 평균 5.7년이었다. 7. 다수 증례에 있어서 3개 이하의 결손치를 가졌고, 자각증상이 나타났다. 이상의 결괴에서 한국인에 있어서 근관치료를 받지 않은 치아의 수직 치근파절은 드문 현상이 아님을 알 수 있었고 남성과 구치부에 있어서의 높은 발생율을 알 수 있었다. 그 이유로는 강한 교합력, 딱딱한 음식의 저작습관, 치조골 흡수에 따른 낮은 저항성, 골 유연성의 저하 등으로 여겨진다. 그러나, 수직 치근파절은 아직까지 정확한 진단을 내리기는 여전히 어려운 상태이며, 이를 위한 다양한 진단방법 및 더 나은 연구가 필수적이라 하겠다. 그리고, 향후 보다 많은 증례에 대한 분석, 치주질환에 이환되지 않은 경우의 분석, 치료 후 생존 기간에 대한 고찰 등도 필요하리라 사료된다.

Effects of growth hormone treatment on glucose metabolism in idiopathic short stature (특발성 저신장증 환자에서 성장 호르몬 투여가 당 대사에 미치는 영향)

  • Kwon, Seung Yeon;Kim, Duk-Hee;Kim, Ho-Seong
    • Clinical and Experimental Pediatrics
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    • v.49 no.6
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    • pp.665-671
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    • 2006
  • Purpose : To study the effects of growth hormone(GH) treatment on glucose metabolism and insulin resistance in children with idiopathic short stature(ISS). Methods : Glucose and insulin concentrations were measured during oral glucose tolerance test (OGTT) before and after GH treatment(0.6-0.7 IU/kg/week) in 20 patients with ISS. Insulin resistance was assessed by homeostasis model assessment(HOMA). Results : During OGTT, the mean blood glucose level did not show any significant changes after GH treatment. However, mean blood insulin levels of fasting and 30 minutes of OGTT showed significant increases after GH treatment, accompanying significant increases of insulin resistance. There was no difference in change of glucose, insulin levels and insulin resistance before and after GH treatment between two groups of body mass indices(BMI) of 25< and >25. There also was no significant difference between two groups of with and without family histories of diabetes mellitus (DM). There was no case of newly developed impaired glucose tolerance, fasting glucose tolerance, nor newly developed DM. Conclusion : GH treatment with doses of 0.6-0.7 IU/kg/week for mean 9.6 months in patients with ISS did not show any significant changes in blood glucose levels during OGTT. However, GH treatments induced considerably higher fasting insulin levels compared to pretreatment, resulting in statistically higher insulin resistance. Higher BMI and family history of DM did not induce any significant changes in glucose, insulin level and insulin resistance after GH treatment than the other groups.

Thrombolytic Therapy for Repeated Prosthetic Valvular Thrombosis That's Associated with Pregnancy under Heparin Anticoagulation (임신과 연관된 헤파린 항응고요법 중 반복적으로 발생한 인공판막 혈전증의 혈전용해치료)

  • Choe, Ju-Won;Kim, Yong-In L.
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.484-488
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    • 2008
  • During long-term anticoagulation treatment with using heparin in a pregnant patient with a mechanical mitral prosthesis, we observed several anticoagulation-related complications, including repeated prosthetic valve thrombosis. This was found to be caused by heparin resistance due to an anti-thrombin III deficiency. Thrombolytic therapy using urokinase or tissue plasminogen activator (tPA) was successful and safe for her as well as her baby.

Type 2 Diabetes Pathogenesis: Impairment of Insulin/IGF-1 Signaling (제2형 당뇨병 병인: 인슐린/IGF-1 신호전달 장애)

  • Park, Sun-Min
    • Food Industry And Nutrition
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    • v.10 no.3
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    • pp.10-18
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    • 2005
  • 제2형 당뇨병은 인슐린 저항성과 인슐린 분비능의 장애에 의해서 복합적으로 나타나는 대사성 증후군 중 하나이다. 인슐린 저항성은 용어에서도 알 수 있듯이 인슐린 신호전달의 저하로 인한 인슐린 작용 감소가 나타나고 이는 인슐린 분비가 증가하더라도 포도당 이용은 감소된 상태이다. 인슐린 분비능은 직접적으로 인슐린 작용과는 무관한 것처럼 보이지만 자세히 살펴보면 인슐린 분비능의 중요한 역할을 하는 췌장 베타세포의 성장과 생존은 인슐린/IGF-1 신호 전달과 밀접한 관계가 있으므로 인슐린 분비능도 인슐린/IGF-1 신호전달과 관련이 있다. 그러므로 인슐린/IGF기 신호전달의 장애는 제2형 당뇨병의 병인에 매우 중요한 요인이다. 그러므로 제2형 당뇨병을 효과적으로 예방 또는 치료하기 위해서는 근육, 지방세포와 간등에서 인슐린 신호전달을 향상시켜 포도당 이용을 증가시키고, 시상하부에서 인슐린 신호전달을 향상시켜 식욕을 적절하게 조절할 수 있도록 하여 과체중이나 비만의 발생을 방지하고 췌장의 베타세포에서 인슐린/IGF-1 신호전달을 향상시켜 베타세포의 성장과 생존을 향상시켜 포도당에 대한 인슐린 분비 능을 촉진시키는 것이다. 최근에 FDA에서 승인받은 Exenatide는 glucagons like peptide-1 receptor agonist로 시상하부에 작용하여 식욕조절도 하고 췌장의 베타세포에서 IRS2의 발현을 증가시켜 인슐린/IGF-1 신호전달을 향상시켜 insulinotropic 작용을 가지는 것으로 알려졌다. 이 Exenatide는 도마뱀의 독침에서 분리한 peptide로 천연물로부터 유래된 약물이므로 천연물로부터 제2형 당뇨병을 치료할 수 있는 약물을 발견할 가능성은 매우 높으므로 이에 대한 연구는 체계적으로 이루어져야 하겠다.

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Effects of Pranlukast on Ovalbumin Induced Early-Phase Bronchoconstriction in Guinea Pigs (기니픽에서 Ovalbumin으로 유발된 즉시형 기관지 수축반응에 대한 Pranlukast의 효과)

  • Lee, Sin-Hyung;Shim, Jae-Jeong;Kim, Kyung-Kyu;Jeong, Hye-Cheol;Kwon, Young-Hwan;Kim, Je-Hyeong;Lee, Sung-Yong;Lee, So-Ra;Lee, Sang-Youb;Cho, Jae-Youn;In, Kwang-Ho;Yoo, Se-Hwa;Kang, Kyung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.697-708
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    • 1999
  • Background : Leukotriene (LT) $C_4$, $D_4$, and $E_4$, the main components of slow-reacting substance of anaphylaxis (SRS-A), have been suggested to play an important role in bronchial asthma such as antigen-induced bronchoconstriction, airway hyperreactivity, and pulmonary eosinophil accumulation. The purpose of this study was to evaluate the effects of treatment with the cysteinyl-LTs (cys-LTs) antagonist, pranlukast on allergen-induced guinea pig asthma model. Methods : Guinea pigs of treatment and placebo groups were sensitized by subcutaneous injection of ovalbumin(OVA) and challenged by inhalation of aerosolized OVA (1% weight/volume OVA). Normal control group did not sensitize with OVA. Oral ingestion of pranlukast and normal saline to the treatment and placebo groups was performed. In the treatment and placebo groups, airway resistance was measured before and after oral ingestion. Serum $LTC_4$ and eosinophilic infiltration of the bronchiolar and peribronchiolar tissues were measured after ingestion in the treatment and placebo groups. Results : Allergen-induced airway constriction developed in 20 (8 in treatment group, 12 in placebo group) among 35 guinea pigs. Airway resistance was significantly decreased at 3 and 6 minutes after OVA challenge in the pranlukast treatment group. In the placebo group, there was no difference of airway resistance between before and after saline ingestion. Serum $LTC_4$ levels showed 348.4 pg/ml in the treatment group, 373.9 pg/ml in the placebo group, and 364.4 pg/ml in the control group. There were no statistically significant difference between treatment and placebo group (p=0.232), and treatment and control group (p=0.501). Eosinophilic infiltrations in the peribronchiolar region per one-microscopic field ($\times$400 high power fields) demonstrated 7.06 in the treatment group, 19.2 in the placebo group, and 4.50 in the control group. There was significant decrement of eosinophilic infiltration in the treatment group which was compared with placebo group (p=0.001). Conclusion : These results demonstrate that pranlukast, a cys-LTs receptor antagonist, can attenuate allergen induced early-phase bronchoconstriction and eosinophilic infiltration in the bronchiolar tissues.

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