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A Phase I/II Trial of $DCVac/IR^{(R)}$ Dendritic Cell Immunotherapy Combined with Irradiation in Cases of Refractory Colorectal Cancer with Multiple Liver Metastases (기존의 치료에 반응하지 않는 다발성 간전이 대장암 환자에서 방사선조사와 병합한 수지상세포 면역치료의 1, 2상 임상시험)

  • Choi, Young-Min;Lee, Hyung-Sik;Kwon, Hyuk-Chan;Han, Sang-Young;Choi, Jong-Cheol;Chung, Ju-Seop;Kim, Chang-Won;Kim, Dong-Won;Kang, Chi-Duk
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.104-112
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    • 2008
  • Purpose: To assess the toxicity and tumor response induced by $DCVac/IR^{(R)}$ dendritic cell(DC) immunotherapy combined with irradiation for refractory colorectal cancer patients with multiple liver metastases. Materials and Methods: Between May 2004 and November 2006, applicants from a pool of refractory colorectal cancer patients with multiple liver metastases were enrolled. The patients were registered after having signed the informed consent form, which had been approved by the Institutional Review Board from the Dong-A University and Busan National University Hospital. DCs were obtained from peripheral blood of each patient, and then cultured in vitro. A total of $6{\times}10^6$ DCs were packed into a vial($DCVac/IR^{(R)}$, 0.5 ml) at the convenience of each patient's schedule. On the day before and on the day of each vaccination, each patient received a 4 Gy radiation dose to the target tumor. On the day of vaccination, the indicated dose of autologous DCs was injected into the irradiated tumor using ultrasound-guided needle injection procedures. A total of four vaccinations were scheduled at three 2-week intervals and one 4 week interval at the Dong-A University and Busan National University Hospital. If the tumor status was deemed to be stable or responding to therapy, an additional vaccination dose or two was approved at 4 week intervals beyond the fourth immunization. A tolerance test for DCs was conducted by injecting a range of doses($3{\times}10^6\;to\;12{\times}10^6$ DCs) after the 3rd injection. Moreover, the maximal tolerable dose was applied to additional patients. Treatment safety was evaluated in all patients who had at least one injection. Treatment feasibility was evaluated by the 10th week by assessing the response of patients having at least 4 injections. For systemic toxicities, the evaluation was performed using the National Cancer Institute Common Toxicity Criteria, whereas adverse effects were recorded using common WHO toxicity criteria. Results: Of the 24 registered patients, 22 received the DCs injections. Moreover, of the 14 patients that applied for the tolerance test, only 11 patients completed it because 3 patients withdrew their testing agreement. A grade 3 or more side effect, which was possibly related to the DC injection, did not occur in additional patients. The $12{\times}10^6$ DC injection was identified as the maximum tolerable dose, and was then injected in an additional 8 patients. Patients tolerated the injection fairly well, with no fatal side effects. In order to assess the feasibility of DC immunotherapy, the response was evaluated in other hepatic lesions outside of the targeted hepatic lesion. The response evaluation was performed in 15 of the 17 patients who received at least 4 injections. Stable and progressive disease was found in 4 and 11 patients, respectively. Conclusion: The DC-based immunotherapy and radiotherapy is theoretically synergistic for the local control and systemic control. The $DCVac/IR^{(R)}$ immunotherapy combined with irradiation was tolerable and safe in the evaluated cases of refractory colorectal cancer with multiple liver metastases. Future work should include well designed a phase II clinical trials.

The Effects of Water-Based Exercise on Muscle activity and Gait Ability in Stroke Patients

  • Park, Seung-Kyu;Yang, Dae-Jung;Kang, Jung-Il;Kim, Je-Ho;Park, Sam-Heon
    • The Journal of Korean Physical Therapy
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    • v.27 no.5
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    • pp.369-374
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    • 2015
  • Purpose: This study attempts to determine the effects of water-based exercise performed on stroke patients in their muscle activity of lower extremity and gait ability tests. Methods: The subjects were 20 stroke patients, who were randomly divided into a water-based exercise group and a land-based exercise group, each including 10 patients. Both exercises were performed 3 days per week, for 40 minutes a day, for a period of eight weeks. Results: The water-based exercise group showed a greater increase in muscle activity of lower extremity compared to the land-based exercise group. The water-based exercise group showed a greater increase in gait ability than the land-based group, showing a significant difference and better efficiency of water-based exercise when compared to land-based exercise. Conclusion: From the result of this study, we found that water-based exercises are more effective in improving muscle activity of lower extremity and gait ability. The patient is considered to be used by itself to involve the treatment and the risk of falling from the lowered state into the treatment method for the intensive treatment of stroke patients to be useful in improving the strength and ability to walk.

The Effects of Two Motor Dual Task Training on Balance and Gait in Patients with Chronic Stroke (이중운동과제 훈련이 만성 뇌졸중 환자의 균형 및 보행에 미치는 효과)

  • Cho, Ki-Hun;Lee, Wan-Hee
    • The Journal of Korean Physical Therapy
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    • v.22 no.4
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    • pp.7-14
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    • 2010
  • Purpose: The goal of this study was to investigate the effect of balance and gait ability through two motor dual task training in chronic stroke subjects. Methods: A group of twenty-five subjects who were six months post stroke participated in this study, where they were designated into pretest-posttest control The subjects were randomly allocated into two groups: experimental (n=13) and control (n=12). Both groups received physical therapy for 5 session 30 minutes per week during 6 weeks. Experimental group practiced additional two motor dual task training programs for thirty minutes a day, three days a week during six weeks. Evaluation of results was obtained through analyzing static balance, dynamic balance and gait function. Results: There was significant improvement among the group that practiced the additional two motor dual task training in that the postural sway area with open eye and close eye on the foam surface, the dynamic balance (p<0.05), and the gait function (p<0.05). Conclusion: Two motor dual task training improved static balance on the foam, dynamic balance, gait function. These results suggest that two motor dual task training is a feasible and suitable treatment for individuals with chronic stroke.

Physical Therapy Following Arthroscopic Rotator Cuff Repair with Graft Augmentation: A Case Report with Magnetic Resonance Imaging

  • Kim, Hyun-Joong;Lee, Seungwon
    • Physical Therapy Rehabilitation Science
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    • v.10 no.4
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    • pp.463-469
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    • 2021
  • Objective: If non-surgical treatment fails, arthroscopic rotator cuff repair (ARCR) is recommended, and ARCR considers graft augmentation in consideration of size, direction, and re-tear. It is reported to have potential benefits by improving the healing rate as it can fill the gaps that have been left behind. The purpose of this study is to investigate the effect of structural changes observed after ARCR on muscle action through magnetic resonance imaging and to investigate the effect of appropriate physical therapy required for graft augmentation in the general ARCR rehabilitation protocol. Case presentation: A 47-year-old male hospitalized for postoperative rehabilitation following ARCR participated in a 5-week physical therapy intervention. The postoperative day was 6 months, but due to shooting pain and shoulder dysfunction,and the movement of the shoulder was compensatory motion, not normal motion. Physical agents, manual therapy, and supervised exercise for 110 minutes per session were performed 3 times a week, and pain intensity, range of motion, function, and strength were evaluated. Results: As a result of the study, the patient showed positive improvement in pain intensity, range of motion, function, and strength. In addition, normal scapulohumeral rhythm movement was observed. Conclusions: According to the results of this case, appropriate physical therapy according to the compensatory motion shown in the structural changes after ARCR can positively improve the pain intensity, range of motion, function, and strength of ARCR patients.

The Effects of Ginsenoside Re on High-Fat Diet induced Insulin Resistance in Muscle (Ginsenoside Re가 골격근의 고지방식 유도 인슐린 저항성에 미치는 영향)

  • Jung, Su-Ryun
    • Korean Journal of Exercise Nutrition
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    • v.14 no.2
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    • pp.75-80
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    • 2010
  • We evaluated the effect of the ginsenoside Re on insulin resistance of glucose transport in muscles of rats made insulin resistant with a high fat diet. After a week of adaptation period to the laboratory environment, 40 male wistar rats were randomly assigned into 2 groups (Chow diet group; CD, n = 20, High fat diet group; HFD, n = 20). After 5-week of high fat diet, Food was removed after 6:00 PM the day before the experiment. The following morning, rats were anesthetized by an intraperitoneal injection of pentobarbital sodium (50 mg/kg body wt), and the soleus muscles were removed. Before incubation, the soleus muscle was split longitudinally into strips with an average weight of 15~20 mg. After the muscle dissection was completed, the abdominal cavity was opened, and the epididymal, mesenteric, and retroperitoneal fat pads were removed and weighed. Treatment of muscles with ginsenoside Re alone had no effect on glucose transport. The high fat diet resulted in ~50% decreases glucose transport rate in soleus muscles. Treatment of muscles with ginsenoside Re in vitro for 90 min completely reversed the high fat diet-induced insulin resistance of glucose transport in soleus muscles. This effect of ginsenoside Re is specific for insulin stimulated glucose transport, as Re treatment did not reverse the high fat diet-induced resistance of skeletal muscle glucose transport to stimulation by contraction. Our results show that the ginsenoside Re induces a remarkably rapid reversal of high fat diet-induced insulin resistance of muscle glucose transport.

Development of a mouse model for pulp-dentin complex regeneration research: a preliminary study

  • Kim, Sunil;Lee, Sukjoon;Jung, Han-Sung;Kim, Sun-Young;Kim, Euiseong
    • Restorative Dentistry and Endodontics
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    • v.44 no.2
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    • pp.20.1-20.8
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    • 2019
  • Objectives: To achieve pulp-dentin complex regeneration with tissue engineering, treatment efficacies and safeties should be evaluated using in vivo orthotopic transplantation in a sufficient number of animals. Mice have been a species of choice in which to study stem cell biology in mammals. However, most pulp-dentin complex regeneration studies have used large animals because the mouse tooth is too small. The purpose of this study was to demonstrate the utility of the mouse tooth as a transplantation model for pulp-dentin complex regeneration research. Materials and Methods: Experiments were performed using 7-week-old male Institute of Cancer Research (ICR) mice; a total of 35 mice had their pulp exposed, and 5 mice each were sacrificed at 1, 2, 4, 7, 9, 12 and 14 days after pulp exposure. After decalcification in 5% ethylenediaminetetraacetic acid, the samples were embedded and cut with a microtome and then stained with hematoxylin and eosin. Slides were observed under a high-magnification light microscope. Results: Until 1 week postoperatively, the tissue below the pulp chamber orifice appeared normal. The remaining coronal portion of the pulp tissue was inflammatory and necrotic. After 1 week postoperatively, inflammation and necrosis were apparent in the root canals inferior to the orifices. The specimens obtained after experimental day 14 showed necrosis of all tissue in the root canals. Conclusions: This study could provide opportunities for researchers performing in vivo orthotopic transplantation experiments with mice.

The efficacy and safety of Dendropanax morbifera leaf extract on the metabolic syndrome: a 12-week, placebo controlled, double blind, and randomized controlled trial

  • Jun, Ji Eun;Hwang, You-Cheol;Ahn, Kyu Jeung;Chung, Ho Yeon;Choung, Se Young;Jeong, In-Kyung
    • Nutrition Research and Practice
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    • v.16 no.1
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    • pp.60-73
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    • 2022
  • BACKGROUND/OBJECTIVES: The extract from Dendropanax morbifera exhibited diverse therapeutic potentials. We aimed to evaluate the efficacy and safety of D. morbifera leaf extract for improving metabolic parameters in human. SUBJECTS/METHODS: A 12-week, double blind, placebo-controlled and randomized trial included a total of 74 adults, and they were assigned to the placebo group (n = 38) or 700 mg/day of D. morbifera group (n = 36). The efficacy endpoints were changes in glycemic, lipid, obesity, and blood pressure (BP) parameters, in addition to the prevalence of metabolic syndrome (MetS) and the numbers of MetS components. Safety was assessed by monitoring adverse events (AEs). RESULTS: After 12 weeks of treatment, the hemoglobin A1c (HbA1c) level significantly decreased in the D. morbifera group compared to that of the placebo group (difference: -0.13 ± 0.20% vs. 0.00 ± 0.28%, P = 0.031; % of change: -2.27 ± 3.63% vs. 0.10 ± 5.10%, P = 0.025). The homeostatic model assessment for insulin resistance level also decreased significantly from its baseline in the D. morbifera group. The systolic BP of D. morbifera group decreased significantly than that of placebo group (difference: -3.9 ± 9.8 mmHg vs. 3.3 ± 11.7 mmHg, P = 0.005; % of change: -2.8 ± 7.7% vs. 3.3 ± 10.2%, P = 0.005). However, the lipid parameters and body composition including body weight did not differ between the groups. The prevalence of MetS (36.8% vs. 13.9%, P = 0.022) and the incidence of MetS (10.5% vs. 13.9%, P = 0.027) at 12 weeks was significantly lower in the D. morbifera group than it was in the placebo group. No serious AEs occurred in either group. CONCLUSIONS: Supplementation with D. morbifera extracts over a 12-week period improved metabolic parameters such as HbA1c and BP and reduced the prevalence of MetS.

Effect of regional climatic conditions, air pollutants, and season on the occurrence and severity of injury in trauma patients

  • Kim, Young-Min;Yu, Gyeong-Gyu;Shin, Hyun-Jo;Lee, Suk-Woo;Park, Jung-Soo;Kim, Hoon
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.6
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    • pp.603-615
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    • 2018
  • Objective: We analyzed the association between regional weather and temporal changes on the daily occurrence of trauma emergencies and their severity. Methods: In this cross-sectional prospective study, we investigated daily atmospheric patterns in trauma episodes in 1,344 patients in Cheongju city, South Korea, from January 2016 to December 2016 and analyzed the association of trauma occurrence and Injury Severity Scores (ISS) with weather conditions on a daily scale. Results: The mean age of trauma patients was $53.0{\pm}23.8years$ and average ISS was $9.0{\pm}2.0$. Incidence of trauma was positively correlated with average temperature (r=0.512, P<0.001) and atmospheric pressure (r=0.332, P=0.010) and negatively correlated with air pollutants (particulate matter less than $2.5{\mu}m^3$ [PM2.5], r=-0.629, P<0.001; particulate matter less than $10{\mu}m^3$ [PM10], r=-0.679, P<0.001). ISS was not significantly correlated with climate parameters and air pollutants, and variability was observed in the frequency and severity of trauma by time of day (highest occurrence, 16-20 pm; highest ISS, 4-8 am), day of the week (highest occurrence and highest ISS, Saturday), month of the year (highest occurrence, July; highest ISS, November), and season (highest incidence, summer; highest ISS, autumn). Conclusion: The study shows a positive relationship between trauma occurrence and specific weather conditions, such as atmospheric temperature and pressure. There was a negative relationship between concentrations of PM2.5 or PM10, and trauma occurrence. However, no correlation was observed between weather conditions or the concentrations of air pollutants and ISS. In addition, seasonal, circaseptan, and circadian variations exist in trauma occurrence and severity. Thus, we suggest that evaluation of a larger, population-based data set is needed to further investigate and confirm these relationships.

The Effects of Lumbar Vertebrae Mobilization and Lumbar Stabilizing Exercise on Lumbar Muscle Strength (요추가동술과 요부안정화운동이 요부근력에 미치는 효과)

  • Gong, Won-Tae;Lee, Sang-Yong
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.13 no.2
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    • pp.21-30
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    • 2007
  • Purpose: The purpose of this study was to evaluate effects of lumbar vertebrae mobilization and lumbar stabilizing exercises on the muscle strength. Methods: The subject were sixty healthy adult(30 females. 30 males) two decade from 21 to 35. All subjects randomly assigned the control group, lumbar vertebrae mobilization group, lumbar stabilizing exercises group. lumbar stabilizing exercises group received lumbar stabilizing exercises for 30 minutes, lumbar vertbrae mobilization group received lumbar vertbrae mobilization for 4-5 minutes per day and three times a week during 3 weeks period. BIODEX was used to measure muscle strength. All measurements of each subjects were measured at pre-experiment, after 10 day, and post-experiment. Results: The results of this study were summarized as follows; 1. The flexion strength test of control group, lumbar vertebrae mobilization group, lumbar stabilizing exercises group were no significantly differences at pre-experiment and after 10 days(p> .05), however significantly increased post-experiment(p <.05). The result of analyzed effects of flexion strength test was significantly increased accordining to experiment type(p <.05). 2. The extension strength test of control group, lumbar vertebrae mobilization group, lumbar stabilizing exercises group were no significantly differences at pre-experiment and after 10 days(p> .05), however significantly increased post-experiment(p <.05). The result of analyzed effects of extension strength test was significantly increased accordining to experiment type(p <.05). Conclusion: conclusionally these data suggest that a 3-week lumbar stabilizing exercises improved muscle strength. Additional randomized controlled trials to more fully investigate trement effects and factors that may mediate these effect are needed.

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The Effects of Respiratory Muscle Strengthening Training on Pulmonary Function and Gait Ability in Subacute Stroke Patients (호흡근 강화 훈련이 아급성 뇌졸중 환자의 폐기능과 보행 능력에 미치는 영향)

  • Kim, Jin-Seok;Shin, Won-Seob
    • Journal of the Korean Society of Physical Medicine
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    • v.8 no.4
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    • pp.489-496
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    • 2013
  • PURPOSE: The aim of this study was to investigate the effect of respiratory muscle strengthening training on pulmonary function and gait ability in patients with subacute stroke. METHODS: Eighteen inpatients with subacute stroke were recruited for this study. The subjects were randomized into two group. All study groups participated in a conventional stroke rehabilitation intervention 30minutes a day 5 times a week for 4 weeks. For subjects from the experimental group, respiratory muscle strengthening training was performed: 30minutes a day 3 times a week for 4 weeks. Outcomes such as the pulmonary function(Forced Vital Capacity, Forced Expiratory Volume in one second, Maximal Voluntary Ventilation) and gait ability(10m walk test, 6 minute walk test) were measured before and after training. RESULT: There were significant differences of pulmonary function(FVC, FEV1 and MVV) and gait ability(10m walk test, 6minute walk test) between pre and post in the experimental group. In comparison of two group, experimental group was significant different pulmonary function(FVC, FEV1, MVV) and gait ability(6minute walk test) than control group. but, There was no significant difference of the gait ability(10m walk test). CONCLUSION: This study showed experimental group can be used to improve pulmonary function and gait ability than control group. These findings suggest that the respiratory muscle strengthening training effect on pulmonary function and gait ability for rehabilitation in patients with subacute stroke.