• Title/Summary/Keyword: 1st line therapy

Search Result 27, Processing Time 0.022 seconds

Effect of Treadmill Walking Training using the Metronome on Gait Pattern (메트로놈을 이용한 트레드밀 보행훈련이 보행패턴에 미치는 영향)

  • Yoon, Won-Chan;Park, Sun-Wook
    • Journal of the Korean Society of Physical Medicine
    • /
    • v.15 no.2
    • /
    • pp.101-108
    • /
    • 2020
  • PURPOSE: The purpose of this study was to investigate the effect of treadmill walking training using the metronome on the gait pattern. METHODS: A total of 33 healthy persons were studied consisting of 17 female and 16 male in the 20-30 age group. A gait analysis program was installed on a treadmill with a built - in gait analysis sensor and laptop. After 9 minutes of treadmill walking, gait analysis was performed for 1 minute. The mean values of the differences in the step length, angle of COP, separation line standard deviation and step force of the lower legs affecting walking symmetry were calculated for treadmill walking and treadmill walking using the metronome. The Shapiro-Wilk test was used to test the normality of the collected data and a paired t-test was performed to analyze the difference in walking before and after using the metronome. RESULTS: As a result of the analysis, the mean of difference between the measured values of the bilateral lower extremity for step length, angle of COP, separation line standard deviation and step force were statistically significant before and after treadmill walking using the metronome. CONCLUSION: Therefore, the treadmill walking training using the metronome is effective in decreasing the difference in the foot width, gait angle, gait distribution, and foot pressure. Because of this, the treadmill walking training using the metronome has a significant effect on walking symmetry among the elements for correct walking, which is a means for enabling efficient and continuous walking.

Emerging Targets for Systemic Treatment of Gastric Cancer: HER2 and Beyond

  • In-Ho Kim
    • Journal of Gastric Cancer
    • /
    • v.24 no.1
    • /
    • pp.29-56
    • /
    • 2024
  • In recent years, remarkable progress has been made in the molecular profiling of gastric cancer. This progress has led to the development of various molecular classifications to uncover subtype-specific dependencies that can be targeted for therapeutic interventions. Human epidermal growth factor receptor 2 (HER2) is a crucial biomarker for advanced gastric cancer. The recent promising results of novel approaches, including combination therapies or newer potent agents such as antibody-drug conjugates, have once again brought attention to anti-HER2 targeted treatments. In HER2-negative diseases, the combination of cytotoxic chemotherapy and programmed cell death-1/programmed cell death ligand-1 (PD-1/PD-L1) inhibitors has become the established standard of care in first-line settings. In the context of gastric cancer, potential biomarkers such as PD-L1 expression, Epstein-Barr virus, microsatellite instability, and tumor mutational burden are being considered for immunotherapy. Recently, promising results have been reported in studies on anti-Claudin18.2 and fibroblast growth factor receptor 2 treatments. Currently, many ongoing trials are aimed at identifying potential targets using novel approaches. Further investigations will be conducted to enhance the progress of these therapies, addressing challenges such as primary and acquired resistance, tumor heterogeneity, and clonal evolution. We believe that these efforts will improve patient prognoses. Herein, we discuss the current evidence of potential targets for systemic treatment, clinical considerations, and future perspectives.

Thyroid Transcription Factor-1 Expression in Advanced Non-Small Cell Lung Cancer: Impact on Survival Outcome

  • Elsamany, Shereef Ahmed;Al-Fayea, Turki M;Alzahrani, Abdullah Said;Abozeed, Waleed Nabeel;Darwish, Waseem;Farooq, Mian Usman;Almadani, Ahmed Salahuddin;Bukhari, Esraa Ahmed
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.16 no.7
    • /
    • pp.2987-2991
    • /
    • 2015
  • Background: The prognostic role of thyroid transcription factor-1 (TTF-1) expression in lung cancer has been assessed but with inconsistent results. The present study aimed to evaluate the prognostic value of TTF1 expression in advanced non-squamous non-small cell lung cancer (NSCLC). Materials and Methods: In this retrospective study, patients with stage IIIB-IV non-squamous NSCLC were enrolled. Progression free survival (PFS) and overall survival (OS) were assessed according to TTF1 expression status, age categories (${\leq}60$ vs >60 years), gender, performance status (PS) (0-2 vs 3-4), type of 1st line chemotherapy (pemetrexed containing vs others) and EGFR status. Results: A total of 120 patients were included. In univariate analysis, PFS was improved in patients with PS 0-2 (7.0 vs 2.0 months, p=0.002) and those who received pemetrexed-containing chemotherapy (9.2 vs 5.8 months, p=0.004). OS was improved in female patients (23.0 vs 8.7 months, p<0.0001), PS 0-2 (14.4 vs 2.0 months, p<0.0001), those with pemetrexed-containing chemotherapy (17.0 vs 11.0 months, p=0.019), TTF1-positive (12.8 vs 5.8 months, p=0.011) and EGFR- mutant patients (23.0 vs 11.7 months, p=0.006). In multivariate analysis, male gender (HR=2.34, p=0.025) and non-pemetrexed containing therapy (HR=2.24, p=0.022) were independent predictors of worse PFS. Wild EGFR status (HR=2.49, p=0.015) and male gender (HR=2.78, p=0.008) were predictors of worse OS. Conclusions: Pemetrexed-containing therapy significantly improved PFS while OS was improved in EGFR mutant patients. Female patients had better PFS and OS. TTF1 expression was not a prognostic marker in advanced non-squamous NSCLC.

Dramatic Tumor Response to 2nd-line Pemetrexed/Cisplatin Combination Chemotherapy in Patient with Malignant Pleural Mesothelioma (Pemetrexed/cisplatin 병합 2차 항암화학요법에 극적 반응을 보인 악성 흉막 중피종 1예)

  • Lee, Seung Min;Ko, Soon Young;Seo, Tae Ho;Lee, Jung Hyun;Choi, Seung Oh;Lee, Jeong Geun;Kim, Wan Seop;Lee, Tae Hoon;Yoo, Gwang Ha;Lee, Kye Young
    • Tuberculosis and Respiratory Diseases
    • /
    • v.62 no.5
    • /
    • pp.432-436
    • /
    • 2007
  • Malignant pleural mesothelioma (MPM) is a rare tumor that is difficult to clearly distinguish from an adenocarcinoma but usually has a poor prognosis. Numerous cytotoxic agents have been used in the primary treatment of MPM with limited success. A complete response is unusual and a partial response occurs in less than one-third of patients. Recently, a phase III trial showed that a combination of pemetrexed with cisplatin resulted in a significantly higher response rate and median survival time than with cisplatin alone. We encountered a case of a dramatic tumor response to pemetrexed/cisplatin combination chemotherapy in patients with MPM, which was resistant to the 1st-line gemcitabine/cisplatin therapy. After six cycles of pemetrexed/cisplatin combination chemotherapy, the tumor volume had decreased dramatically with complete symptom relief. There was no chemotherapy-related toxicity or scheduled violation. The patient is under maintenance chemotherapy with the same regimen.

Method Development for the Profiling Analysis of Urine Globotriaosylceramide (Gb3) for the Screening of Fabry Disease by Tandem Mass Spectrometry (ESI-MS/MS를 이용한 소변 중 Globotriaosylceramide(Gb3)의 정량 및 임상 응용; 패브리병(Fabry) 진단)

  • Yoon, Hye-Ran;Cho, Kyung-Hee;Kang, Seung-Woo;Kwon, Young-Joo;Jeong, Choon-Sik;Lee, Yong-Soo
    • YAKHAK HOEJI
    • /
    • v.51 no.2
    • /
    • pp.96-102
    • /
    • 2007
  • Measurement of globotriaosylceramide (Gb3, ceramide trihexoside) in urine has clinical importance for monitoring after enzyme replacement therapy in Fabry disease patients. The disease is an X-linked lipid storage disorder that results from a deficiency of the enzyme ${\alpha}$-galactosidase A (${\alpha}$-Gal A). The lack of ${\alpha}$-Gal A causes an intracellular accumulation of glycosphingolipids, mainly Gb3. A simple, rapid, and highly sensitive analytical method for Gb3 in urine was developed without labor-extensive pre-treatment by electrospray ionization MS/MS (ESI-MS/MS). Only simple 5-fold dilution of urine is necessary for the extraction and isolation of Gb3 in urine. Gb3 in diluted urine was dissolved in dioxane containing C17:0 Gb3 as an internal standard. After centrifugation it was directly injected and analyzed through guard column by in combination with multiple reaction monitoring mode of ESI-MS/MS. Eight isoforms of Gb3 were completely resolved from urine matrix. C24:0 Gb3 occupied 50% of total Gb3 as a major component in urine. Linear relationship for Gb3 isoforms was found in the range of 0.005${\sim}$5.0 ${\mu}$g/ml. The limit of detection (S/N=5) was 0.005 ${\mu}$g/ml and limit of quantification was 0.05 ${\mu}$g/ml for C24:0 Gb3 with acceptable precision and accuracy. Correlation coefficient of calibration curves for 8 Gb3 isoforms ranged from 0.9598 to 0.9975. This method could be useful for rapid and sensitive 1st line Fabry disease screening, monitoring and/or diagnostic tool for Fabry disease.

Determination of plasma C16-C24 globotriaosylceramide (Gb3) isoforms by tandem mass spectrometry for diagnosis of Fabry disease (패브리병(Fabry) 진단을 위한 혈장 중 Globotriaosylceramide (Gb3)의 탠덤매스 분석법 개발과 임상 응용)

  • Yoon, Hye-Ran;Cho, Kyung-Hee;Yoo, Han-Wook;Choi, Jin-Ho;Lee, Dong-Hwan;Zhang, Kate;Keutzer, Joan
    • Journal of Genetic Medicine
    • /
    • v.4 no.1
    • /
    • pp.45-52
    • /
    • 2007
  • Purpose : A simple, rapid, and highly sensitive analytical method for Gb3 in plasma was developed without labor-ex tensive pre-treatment by electrospray ionization MS/ MS (ESI-MS/MS). Measurement of globotriaosy lceramide (Gb3, ceramide trihex oside) in plasma has clinical importance for monitoring after enzyme replacement therapy in Fabry disease patients. The disease is an X-linked lipid storage disorder that results from a deficiency of the enzyme ${\alpha}$-galactosidase A (${\alpha}$-Gal A). The lack of ${\alpha}$-Gal A causes an intracellular accumulation of glycosphingolipids, mainly Gb3. Methods : Only simple 50-fold dilution of plasma is necessary for the extraction and isolation of Gb3 in plasma. Gb3 in diluted plasma was dissolved in dioxane containing C17:0 Gb3 as an internal standard. After centrifugation it was directly injected and analyzed through guard column by in combination with multiple reaction monitoring mode of ESI-MS/MS. Results : Eight isoforms of Gb3 were completely resolved from plasma matrix. C16:0 Gb3 occupied 50% of total Gb3 as a major component in plasma. Linear relationship for Gb3 isoforms w as found in the range of 0.001-1.0 ${\mu}g$/mL. The limit of detection (S/N=3) was 0.001 ${\mu}g$/mL and limit of quantification was 0.01 ${\mu}g$/mL for C16:0 Gb3 with acceptable precision and accuracy. Correlation coefficient of calibration curves for 8 Gb3 isoforms ranged from 0.9678 to 0.9982. Conclusion : This quantitative method developed could be useful for rapid and sensitive 1st line Fabry disease screening, monitoring and/or diagnostic tool for Fabry disease.

  • PDF

Clinical Features of Oromandibular Dystonia (하악운동이상증의 임상양태)

  • Kang, Shin-Woong;Choi, Hee-Hoon;Kim, Ki-Suk;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
    • /
    • v.36 no.3
    • /
    • pp.169-176
    • /
    • 2011
  • Oromandibular dystonia (OMD) is a form of focal dystonia that affects the masticatory, facial and lingual muscles in any variety of combinations, which results in repetitive involuntary and possibly painful jaw opening, closing, deviation or a combination of these movements. This study aimed to investigate clinical features and treatment type of OMD patients. By retrospective chart review, the study was conducted to consecutive OMD patients who visited a department of Oral Medicine and Orofacial Pain Clinic in a university dental hospital during Aug 2007 to Apr 2010. 78 OMD patients were identified with female preponderance (M:F=1:3.6) and a mean age of 72 years. Their mean duration of OMD was about 10 months. The most common chief complaints at the first visit was jaw ache, followed by uncontrolled, repetitive movement of the jaw and/or oral tissues, pain in the oral region(p=0.000). The most common subtype of OMD was lateral jaw-deviation dystonia, followed by combination and jaw-closing dystonia(p=0.001). While no apparent cause was recognized in over 60% of the OMD patients, peripheral trauma including dental treatment such as prosthetic treatment and extraction was the most frequently reported as precipitating factor(p=0.000). Medication was the 1st line therapy for our patients and anxiolytics such as clonazepam was given to most of them. Based on the results of this study, OMD is the disease of the elderly, particularly of women and causes orofacial pain and compromises function of orofacial region. Some patients considered dental treatment a precipitating factor. Dentists, therefore, should have knowledge of symptoms and treatment of OMD.