• 제목/요약/키워드: Clinical response

검색결과 2,706건 처리시간 0.027초

Diagnosis and Treatment of Extrapulmonary Tuberculosis

  • Lee, Ji Yeon
    • Tuberculosis and Respiratory Diseases
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    • 제78권2호
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    • pp.47-55
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    • 2015
  • Extrapulmonary tuberculosis (EPTB) constitutes about 20% of all cases of tuberculosis (TB) in Korea. Diagnosing EPTB remains challenging because clinical samples obtained from relatively inaccessible sites may be paucibacillary, thus decreasing the sensitivity of diagnostic tests. Whenever practical, every effort should be made to obtain appropriate specimens for both mycobacteriologic and histopathologic examinations. The measurement of biochemical markers in TB-affected serosal fluids (adenosine deaminase or gamma interferon) and molecular biology techniques such as polymerase chain reaction may be useful adjuncts in the diagnosis of EPTB. Although the disease usually responds to standard anti-TB drug therapy, the ideal regimen and duration of treatment have not yet been established. A paradoxical response frequently occurs during anti-TB therapy. It should be distinguished from other causes of clinical deterioration. Surgery is required mainly to obtain valid diagnostic specimens and to manage complications. Because smear microscopy or culture is not available to monitor patients with EPTB, clinical monitoring is the usual way to assess the response to treatment.

Genetic variations affecting response of radiotherapy

  • Choi, Eun Kyung
    • Journal of Genetic Medicine
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    • 제19권1호
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    • pp.1-6
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    • 2022
  • Radiation therapy (RT) is a very important treatment for cancer that irradiates a large amount of radiation to lead cancer cells and tissues to death. The progression of RT in the aspect of personalized medicine has greatly advanced over the past few decades in the field of technical precision responding anatomical characteristics of each patient. However, the consideration of biological heterogeneity that makes different effect in individual patients has not actually applied to clinical practice. There have been numerous discovery and validation of biomarkers that can be applied to improve the efficiency of radiotherapy, among which those related to genomic information are very promising developments. These genome-based biomarkers can be applied to identify patients who can benefit most from altering their therapeutic dose and to select the best chemotherapy improving sensitivity to radiotherapy. The genomics-based biomarkers in radiation oncology focus on mutational changes, particularly oncogenes and DNA damage response pathways. Although few have translated into clinically viable tools, there are many promising candidates in this field. In this review the prominent mutation-based biomarkers and their potential for clinical translation will be discussed.

Dihydroartemisinin inhibits HepG2.2.15 proliferation by inducing cellular senescence and autophagy

  • Zou, Jiang;Ma, Qiang;Sun, Ru;Cai, Jiajing;Liao, Hebin;Xu, Lei;Xia, Jingruo;Huang, Guangcheng;Yao, Lihua;Cai, Yan;Zhong, Xiaowu;Guo, Xiaolan
    • BMB Reports
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    • 제52권8호
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    • pp.520-525
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    • 2019
  • Dihydroartemisinin (DHA) has been reported to possess anti-cancer activity against many cancers. However, the pharmacologic effect of DHA on HBV-positive hepatocellular carcinoma (HCC) remains unknown. Thus, the objective of the present study was to determine whether DHA could inhibit the proliferation of HepG2.2.15 cells and uncover the underlying mechanisms involved in the effect of DHA on HepG2.2.15 cells. We found that DHA effectively inhibited HepG2.2.15 HCC cell proliferation both in vivo and in vitro. DHA also reduced the migration and tumorigenicity capacity of HepG2.2.15 cells. Regarding the underlying mechanisms, results showed that DHA induced cellular senescence by up-regulating expression levels of proteins such as p-ATM, p-ATR, ${\gamma}-H_2AX$, P53, and P21 involved in DNA damage response. DHA also induced autophagy (green LC3 puncta gathered together and LC3II/LC3I ratio increased through AKT-mTOR pathway suppression). Results also revealed that DHA-induced autophagy was not linked to senescence or cell death. TPP1 (telomere shelterin) overexpression could not rescue DHA-induced anticancer activity (cell proliferation). Moreover, DHA down-regulated TPP1 expression. Gene knockdown of TPP1 caused similar phenotypes and mechanisms as DHA induced phenotypes and mechanisms in HepG2.2.15 cells. These results demonstrate that DHA might inhibit HepG2.2.15 cells proliferation through inducing cellular senescence and autophagy.

Anti-inflammatory Effects of Low-frequency Stimulator using Superposition of Alternating Microcurrent Wave in the Animal Models

  • Kim, Yoo-Jeong;Lee, Seong gwang;Go, Shin Jee;An, Suyeon;Kim, Ye eun;Kim, Ye in;Hyun, Kyung-Yae;Cho, Dong Shik;Choi, Go-Eun
    • 대한의생명과학회지
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    • 제27권2호
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    • pp.99-104
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    • 2021
  • Treatment techniques that affect homeostasis by non-invasive regulation in peripheral organs will advance disease research. Here, we demonstrate a non-invasive method of conditioning within an organ using a low-frequency stimulator superposition of alternating microcurrent wave in stages. It is first applied to the inflammatory response in H3N2-infected sinusitis mice. To check the progress of the treatment, mice were sacrificed every week for 3 weeks, nasal tissue was removed, and the inflammatory response was investigated through H & E staining. The low-frequency stimulation treatment group was found to alleviate the proliferation of epithelial cells and invasion of inflammatory cells compared to the control group as the passage of treatment time. The reduction of inflammatory cytokines in the nasal lavage fluid was observed in H3N2-infected sinusitis mice treated with of low-frequency stimulation using superposition of alternating microcurrent wave compared to H3N2-infected sinusitis mice after 3 weeks. These data demonstrate that low-frequency stimulation device in the form of using alternating current wave superposition on within organs provides a new method to regulate specific physiological functions. Therefore, it is necessary to prove the inhibitory effect of low-frequency stimulation using alternating current wave superposition on inflammatory diseases by various methods through further studies and clinical studies.

Response Evaluation of Chemotherapy for Lung Cancer

  • Hwang, Ki-Eun;Kim, Hak-Ryul
    • Tuberculosis and Respiratory Diseases
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    • 제80권2호
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    • pp.136-142
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    • 2017
  • Assessing response to therapy allows for prospective end point evaluation in clinical trials and serves as a guide to clinicians for making decisions. Recent prospective and randomized trials suggest the development of imaging techniques and introduction of new anti-cancer drugs. However, the revision of methods, or proposal of new methods to evaluate chemotherapeutic response, is not enough. This paper discusses the characteristics of the Response Evaluation Criteria In Solid Tumor (RECIST) version 1.1 suggested in 2009 and used widely by experts. It also contains information about possible dilemmas arising from the application of response assessment by the latest version of the response evaluation method, or recently introduced chemotherapeutic agents. Further data reveals the problems and limitations caused by applying the existing RECIST criteria to anti-cancer immune therapy, and the application of a new technique, immune related response criteria, for the response assessment of immune therapy. Lastly, the paper includes a newly developing response evaluation method and suggests its developmental direction.

만성두통환자(慢性頭痛患者)의 생체전기자율반응검사에 의(依)한 임상적(臨床的) 고찰(考察) (The Clinical Study of Autonomic Bioelectric Response Recorder on Patients with Chronic Headache)

  • 황선미;이승진;정대규
    • 동의신경정신과학회지
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    • 제11권2호
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    • pp.63-78
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    • 2000
  • Headache is one of the most common medical complaints. It is not so easy to manage headache. especially if it is chronic although it seldom cause serious problem. There are many psychological factor known to induce, maintain an aggravate symptom in patients with chronic headache. The purpose of this study is to investigate clinical characteristics with ABR-2000 was carried out for 57 patients who had been suffered from headache for 6 months from march to August 2000.The results were as follows:1. According to the statics, on the whole woman's rate was higher than man's, and the mean duration of the headache was 8.06 years.2. Common associated symptoms were nausea. dyspepsia, dizziness, palpitation, fatigue, depression, etc.3. According to oriental medical differentiation of symptoms and signs, the rate of stagnation of the liver-qi's fire-transmission(肝變化火), deficiency of blood(血虛) and plegm syncope (痰厥), these three types were hghest.4. Result of analyzing ABR-2000 is that the rate of low response is higher than high response's on each item. But result of Graph A is that the rate of high response in higher than that of low response only in deficiency of Yin(陰虛) and the rate of high response in stagnation of the liver-qi's fire-transmission(肝變化火) and deficiency of blood (血虛) is comparatively high. Result of Graph R is that the rate of high response in wind-heat(風熱), deficiency of blood(血虛) and plegm syncope(痰厥) is comparatively higher than in others.

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바이오휘드백을 이용한 점진적 근육이완훈련이 스트레스반응과 면역반응에 미치는 효과 (The Effect of Progressive Muscle Relaxation using Biofeedback on Stress Response and Natural Killer Cell in first Clinical Practice of Nursing Students)

  • 김금순
    • 기본간호학회지
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    • 제7권1호
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    • pp.109-121
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    • 2000
  • Increasingly nursing science is embracing the concepts and methodology derived from psycho-neuroimmunology. It has been previously shown that stress increases and immune function declines in students undergoing examinations. To date, however, no many studies have been reported on stress levels, immune function and interventions in Korean students undergoing their first clinical nursing rotation. It was proposed that nursing students during their first clinical rotation experience increase in stress because of the novelty of the situation and their lack of clinical knowledge. It was also hypothesized that biofeedback and progressive relaxation, methods of self-regulation of involuntary autonomic nervous system responses, would reduce the stress response. The purpose of this study is to test the effectiveness of progressive muscle laxation using biofeedback The effectiveness of the experimental methods was tested by measuring the degree of symptoms of stress (SOS) and the values of ephinephrine, pulse rate, blood pressure and natural killer cells. The subjects of this study were thirty nursing students divided into two groups: experimental group was progressive muscle relaxation group using biofeedback and control group. This study was conducted for 8 weeks of clinical practice. Biofeedback training was done by software developed by J&J company (1-410 form for progressive muscle training). Progressive muscle relaxation training according to Jacobson's Theory was done by messaged word from biofeedback. The data was analyzed using Chronbach' ${\alpha}$ and t-test of the SPSS program and the significance level of statistics was 5%. The results of the study were : 1) The progressive muscle relaxation training using biofeedback was effective for the reduction of symptoms of stress(t=-4.248, p<.001) under clinical practice stress conditions. 2) The progressive muscle relaxation training using biofeedback was not effective for the values of epinephrine(t=-1.294, p=.206). 3) The progressive muscle relaxation training using biofeedback was effective for the reduction of systolic blood pressure (t=-2.757, p=.01). 4) The progressive muscle relaxation training using biofeedback was effective for the reduction of diastolic blood pressure (p=-2.032, 0=.05). 5) The progressive muscle relaxation training using biofeedback was not effective for the reduction of pulse rate(t=-15, p=.988). 6) The progressive muscle relaxation training using biofeedback was effective for the maintenance of natural killer cells (t=2.381, p=02). The first clinical rotation for student nurses is a stressful experience as seen by the rise in the SOS in the control group. Biofeedback using progressive muscle relaxation were effective in preventing the rise of symptoms of stress and the blood pressure means when comparing the pre to post clinical experience, The mean natural killer cell count was depressed in the control group but not significantly different in the experimental groups, It is proposed here that stress via the hypothalamic - pituitary - adrenal axis suppressed the NK cell count whereas the relaxation methods prevented the rise in stress and the resulting immune depression. We recommend relaxation techniques using biofeedback as a health promotion technique to reduce psychological stress. In summary. the progressive muscle relaxation training using biofeedback was effective for the reduction of symptoms of stress under clinical practice stress conditions.

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통풍의 한의임상진료현황 - 온라인(웹기반) 설문조사 (Current Status of Clinical Practice for Gout in Korean Medicine - On-line (Web-Based) Survey)

  • 황지혜;이광호;남동우;육태한;송호섭
    • Korean Journal of Acupuncture
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    • 제38권1호
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    • pp.16-31
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    • 2021
  • Objectives : The purpose of this study was to investigate the current status of clinical practice for gout in Korean Medicine (KM). Methods : On-line survey was adopted for this study, targeted at KM Doctors who were registered in the Association of Korean Medicine. The questionnaire included the general status of treatment, pattern identification and treatment method according to three stages given: acute, chronic and asymptomatic hyperuricemia stage. Results : Data from a total of 384 respondents was analyzed. Participants who responded most were in their 40s, working in KM clinics located in Seoul. Acupuncture and herbal medicines were the top priority treatments in preparing recommendations in clinical practice guidelines for gout, and where clinical trials were considered essential. As of the past year, the average number of first visits per month was 86.7%, and the average treatment duration was less than 1 month, accounting for 72.9%. As for the diagnostic method used for gout patients, the "diagnosed by clinical pattern" response was the highest, and the "blood and urine test" response was the highest as the diagnostic equipment used. As for the evaluation scale being used, the "VAS/NRS" response was the highest. Regardless of the gout stage, acupuncture was the most commonly used treatment method for gout patients, and bee venom pharmacopuncture was the highest for the pharmacopuncture used. In the case of herbal medicine, it was found that a wider variety of herbal medication uninsured in health insurance and herbal prescription were used for the staged treatment of gout than herbal medication in national health insurance coverage. In clinical practice, "acupuncture treatment three times a week" was the most common, and the "acupoints in the limb" were the most frequently used; LR3 and SP3 were the most frequently used acupoints. Conclusions : It is suggested that this survey should be helpful to develop clinical practice guideline for gout that reflects actual clinical practice.

항결핵제 사용 중 폐병변의 일시적 악화를 보인 환자의 임상상 (Clinical Characteristics of Paradoxical Response to Chemotherapy in Pulmonary Tuberculosis)

  • 김수희;정효영;이기동;신민기;정태식;진병철;김현정;유진종;이종덕;황영실
    • Tuberculosis and Respiratory Diseases
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    • 제53권1호
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    • pp.27-35
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    • 2002
  • 목 적 : 결핵 치료 중 폐병변이 일시적으로 악화를 보이는 경우가 있는데 이것은 적절한 항결핵제의 사용에도 불구하고 이전의 병변이 커지거나 새로운 병변이 생기는 것으로, 폐암과 약제 내성 결핵 또는 비결핵 마이코 박테리움증 등에 의한 치료 실패와 감별을 요한다. 결핵 치료 중 생기는 일시적 악화의 임상 양상과 경과를 관찰하고 이것의 예측 인자를 찾음으로써 다른 질환과의 감별에 도움되고 사망률을 줄일 수 있을 것으로 사료되어 본 연구를 시행하였다. 방 법 : 1998년 3월부터 2000년 7월까지 경상대학병원에서 폐결핵과 결핵성 흉막염으로 진단 받고 6개월 이상 항 결핵 약제를 복용한 환자 205명을 대상으로 하여, 투약 시작 후 약 1개월 간격으로 촬영한 흉부 방사선의 변화를 비교하여 일시적 악화를 판단하였다. 결 과 : 대상환자 205명 종 일시 적 악화틀 보인 환자는 29명(14.1%)이었다. 항 결핵 약제 투여 후 일시적 악화를 보이는 시기는 평균 32일이었고, (폐결핵:평균 35일, 흉수 결핵:평균 25일), 대부분 1개월 째에 일시적 악화를 보였다. 일시적 악화 후에 치료전의 병변보다 줄어드는 데 걸려는 기간은 평균 116일이었고 (폐결해 :114일, 흉수 절핵 :124일), 3 개월 째에 호전 (29%)되는 환자가 가장 많았다. 일시적 악화를 보인 환자 29명중 남녀 비율은 4.8 : 1 (24명:5명)로서 남자 환자가 많았다. 항 결핵제를 사용하기 전의 초기 백혈구 수는 일시적 악화를 보인 군에서 평균 8610/$mm^3$로 그렇지 않은 군의 7308.6/$mm^3$보다 유의하게 높았다(p=0.022). 평균 LDH 농도는 일시적 악화군에서 850.6 IU/L으로 그렇지 않은 군의 594.6 IU/L보다 통계적으로 유의하지는 않았으나 높은 경향을 보였다(p=0.085). 결 론: 항결핵제 사용 중인 환자에서 일시적 악화의 빈도는 14.1%였고, 1 개월 이내외 환자가 가장 많았고, 대부분 4개월 경에 호전되는 양상이었다. 남자인 경우와 혈액의 백혈구 수치가 높은 경우가 일시적 악화를 보인 군에서 유의하게 높았다(P<0.05). 혈액의 백혈구 수치는 일시적 악화의 예측 인자로 사용 될 수 있을 것으로 생각되며, 흉수 내 총 LDH 농도는 일시적 악화군에서 통계적으로 의미는 없었으나 높은 경향을 보였다(p=0.085).

Evidence Based Analysis of Cisplatin for Treating Patients with Cutaneous Squamous Cell Carcinoma

  • Shao, Xiao-Hong;Xu, Yun-Sheng;Zhang, Xue-Qi;Li, Wen-Feng
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권22호
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    • pp.9813-9815
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    • 2014
  • Background: This analysis was conducted to evaluate the efficacy and safety of cisplatin based chemotherapy for treating patients with cutaneous squamous cell carcinoma. Methods: Clinical studies evaluating the efficacy and safety of cisplatin based regimens on response and safety for patients with cutaneous squamous cell carcinoma were identified using a predefined search strategy. Pooled response rates (RR) of treatment were calculated. Results: In cisplatin based regimens, 4 clinical studies which including 50 patients with advanced cutaneous squamous cell carcinoma were considered eligible for inclusion. Regimens included cisplatin, doxorubicin, or vindesine. Pooled analysis suggested that, in all patients, the pooled RR was 60% (30/50) in cisplatin based regimens. Nausea and vomiting were the main side effects. No grade III or IV renal or liver toxicity were observed. No treatment related death occurred with the cisplatin based treatments. Conclusion: Evidence based analysis suggests that cisplatin based regimens are associated with a good response rate and acceptable toxicity for treating patients with cutaneous squamous cell carcinoma.