• Title/Summary/Keyword: Integrated therapy

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A Patterns of Care Study of the Various Radiation Therapies for Prostate Cancer among Korean Radiation Oncologists in 2006 (Patterns of Care Study를 위한 2006년 한국 방사선종양학과 전문의들의 전립선암 방사선치료원칙 조사연구)

  • Kim, Jin-Hee;Kim, Jae-Sung;Ha, Sung-Whan;Shin, Seong-Soo;Park, Won;Cho, Jae-Ho;Suh, Chang-Ok;Oh, Young-Taek;Shin, Sei-Won;Kim, Jae-Chul;Jang, Ji-Young;Nam, Taek-Keun;Choi, Young-Min;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.96-103
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    • 2008
  • Purpose: To conduct a nationwide academic hospital patterns of the practice status and principles of radiotherapy for prostate cancer. The survey will help develop the framework of a database of Korean in Patterns of Case Study. Materials and Methods: A questionnaire about radiation treatment status and principles was sent to radiation oncologists in charge of prostate cancer treatment at thirteen academic hospitals in Korea. The data was analyzed to find treatment principles among the radiation oncologists when treating prostate cancer. Results: The number of patients with prostate cancer and treated with radiation ranged from 60 to 150 per academic hospital in Seoul City and 10 to 15 outside of Seoul City in 2006. The primary diagnostic methods of prostate cancer included the ultrasound guided biopsy on 6 to 12 prostate sites(mean=9), followed by magnetic resonance imaging and a whole body bone scan. Internal and external immobilizations were used in 61.5% and 76.9%, respectively, with diverse radiation targets. Whole pelvis radiation therapy(dose ranging from 45.0 to 50.4 Gy) was performed in 76.9%, followed by the irradiation of seminal vesicles($54.0{\sim}73.8$ Gy) in 92.3%. The definitive radiotherapy doses were increased as a function of risk group, but the range of radiation doses was wide(60.0 to 78.5 Gy). Intensity modulated radiation therapy using doses greater than 70 Gy, were performed in 53.8% of academic hospitals. In addition, the simultaneous intra-factional boost(SIB) technique was used in three hospitals; however, the target volume and radiation dose were diverse. Radiation therapy to biochemical recurrence after a radical prostatectomy was performed in 84.6%; however, the radiation dose was variable and the radiation field ranged from whole pelvis to prostate bed. Conclusion: The results of this study suggest that a nationwide Korean Patterns of Care Study is necessary for the recommendation of radiation therapy guidelines of prostate cancer.

Development of Indocyanine Green and 5-Aminolevulinic Acid Detection System for Surgical Microscope (수술현미경용 다중형광 관측 시스템 연구)

  • Kim, Hong Rae;Lee, Hyun Min;Yoon, Woong Bae;Kim, Young Jae;Kim, Seok Ki;Yoo, Heon;Joo, Jae Young;Kim, Kwang Gi;Lee, Seung-Hoon
    • Journal of Biomedical Engineering Research
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    • v.36 no.1
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    • pp.16-21
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    • 2015
  • Indocyanine green(ICG) and 5-aminolevulinic acid(5-ALA) have been widely used to mark blood vessels or tumors. However, fluorescent dye detection systems were designed to use one type of dyes only. In this study, we proposed a detection system capable of detecting Indocyanine green and 5-aminolevulinic acid. Multiple filters and light sources are integrated into a single system. In this study, we performed analysis of fluorescent dyes and configured a detection system. During the analysis, it was found that Indocyanine green and 5-aminolevulinic acid have the maximum intensity at $40{\mu}M$. We designed light source for fluorescent dyes and conducted compatibility test using a commercial surgical microscope. The fluorescent dye detection system was configured based on the experimental results. The developed system successfully detects Indocyanine green and 5-aminolevulinic acid. Therefore, more efficient surgical operations can be achieved using both fluorescent dyes at the same time. We expect that the developed system can increase the survival rate of patients.

A Historical Study on the Treatments of 鼻鼽(bí qiú) ('비구(鼻鼽)'에 대한 의사학적 연구)

  • Oh, Byung-Gun;Maeng, Woong-Jae;Kim, Hoon
    • The Journal of Korean Medical History
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    • v.24 no.1
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    • pp.97-110
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    • 2011
  • Rhinitis, inflammation of the nasal cavity caused by the disease in our country that a recent trend is the rapidly increasing number of patients. It causes multiple complications and interfere with daily life and social life in case of being viewed as a mild cold. The rhinitis treatment for symptomatic therapy in modern medicine is staying because the situation is exposing the limitations. so traditional medicine is trying to find a solution but that is not easy. In modern medicine, rhinitis is defined as a set of histological lesions and clinical symptoms, but traditional medicine has developed in dealing with each symptoms in disease. The treatment that doesn't distinguish any treatment in growing numbers of patients does not seem to validate, because doctors treat without considering the difference of recognition. Looking at the symptoms for each, I found that each symptoms and causes are varied according to doctors and era. In spite of considering all of that in treatment, it was ignored or underestimated in modern medicine. Furthermore, in traditional medicine, they just conjugated certain period theory and only had limited treatment by a lack of integrated awareness about definition and mechanism. In addition, in case of mentioning about the causes of prescription in each medical books, there were not enough explain about pathological states. Therefore, these causes should be made to further the research about the validity, pathogenesis and treatment. We can see that theory could be established and modified by the accumulation of clinical experience, observations through classification by each of the causes, prescription and treatment. In traditional medicine simply does not pay attention only to nasal inflammation, such as the impact of Meridian and organs considered to have focused on the fundamental treatment. This increased immune resistance to the modern rhinitis patients may offer new therapeutic approaches. I hope this paper would be helpful to find the treatment with uncovered theory in modern medicine.

One Case of Systemic Lupus Erythematosus treated by Integrated Therapy of Western Medicine with Oriental Differential Diagnosis of Symptoms and Signs (한방 변증과 양방 협진에 의한 전신성 홍반성 낭창(Systemic Lupus Erythematosus) 치료 1예)

  • Jung, Dae-Young;Baek, Dong-Gi;Hwang, Sang-Il;Shin, Sun-Ho;Kim, Dong-Woung;Han, Myoung-Ah
    • The Journal of Internal Korean Medicine
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    • v.23 no.2
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    • pp.306-312
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    • 2002
  • Systemic Lupus Erythematosus(SLE) is a autoimmune disease characterized by combined symtoms of malar rash, discoid rash, neuropsychiatric disorder, renal disorder, hematologic disorder, photosensitivity immunologic disorder, oral ulcer, anti-nuclear antibody, arthritis, pleuritis and pericarditis, etc. Multiple genetic or environmental causes are supposed to facilitate antiboby production to autoantigen such as ds-DNA, histone, phospholipid, red blood cell, platelet, etc. And defective complementary system fail to remove autoantigen-antibody complex, which deposit in multiple organs and result in inflammatory damages. SLE does not correctly correspond to any specific category of oriental medicine. But, accoring to previous reports, it can be controlled by herb medications used differently patients-to-patients. So we are to report this one SLE case being successfully controlled by classic corticosteroids with herb medications based on oriental diffrential diagnosis of symptoms and signs.

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Review of Research Topics on Consumptive Disease and Chronic Fatigue (허로에 대한 국내 연구동향 분석 및 연구방향 제안)

  • Kim, Ji Hye;Kim, Jae Uk;Kim, Keun Ho
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.5
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    • pp.587-593
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    • 2013
  • Exhaustion syndrome(虛勞) became broadly experienced symptoms in Korean population. In this work, we carried out a systematic literature review on exhaustion syndrome(ES) and chronic fatigue. We searched through the databases Koreanstudies Information Service System, Oriental Medicine Advanced Searching Integrated System, DataBase Periodical Information Academic for the articles published between 1994 and 2013, with the keywords 'exhaustion syndrome(虛勞)', 'consumption(虛損)', 'overexertion syndrome(勞倦)', 'fatigue', 'chronic fatigue' and 'degree of fatigue'. Among the first-run rough-searched 602 articles, we narrowed down the scope within the field of Oriental medicine (126 articles), and finally selected 28 articles appropriate to the intended research field; the selected articles were categorized by literature study(7 papers), clinical treatment (7), clinical diagnosis (5), treatment effects of herbal medicine (2), diagnosis in Sasang medicine and treatment effect of dry cupping therapy (2), and questionnaire-based diagnosis (5). We found that the overall research level on ES remained in the preliminary stages, and more efforts are needed in the field of terminology definition and standardization of diagnosis, and treatment efficacy validation beyond muscle fatigue. Finally, to develop reliable diagnostic devices on ES, we proposed a study design that included the development of objective ES diagnostic indicators and a clinical validation procedure.

Study of Experimentations and Clinical Trials' Trends for Obesity Treatment using Pharmacupuncture (약침을 활용한 비만연구의 실험실적 및 임상적 연구동향 고찰)

  • Kim, Min-Woo;Song, Yun-Kyung;Lim, Hyung-Ho
    • Journal of Korean Medicine for Obesity Research
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    • v.11 no.1
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    • pp.47-60
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    • 2011
  • Objectives The objective of this study was to contribute to the development of pharmacupuncture for obesity treatment by reviewing the studies of pharmacupuncture experimentations and clinical trials. Methods We searched the papers with keywords of 'obesity' and 'pharmacupuncture' in the search site, RISS, Oriental medicine advanced searching integrated system(OASIS), Korean traditional knowledge portal, the society of Korean medicine for obesity research, Korean pharmacupuncture institute, the Korean academy of oriental rehabitation medicine and Korean acupuncture & moxibustion society. Results 1. We reviewed 37 articles searched. 27 articles(73.0%) were animal experimentations, 5 articles(13.5%) were cell experimentations, 4 articles(10.8%) were clinical trials and 1 article(2.7%) was study analysis. 2. The herbs, using for animal experimentations, were atratylodes japonica, coix lachrymajobi, ephedra sinica, crataegus pinnatifida, wild ginseng and etc. Acupucture points were joksamni(ST36), zhongwan(CV12), gansoo(BL18), pungnyung(ST40), umnungchon(SP9), bisu(BL20), gokji (LI11), cheun-chu(ST25) and etc. 3. For cell experimentations, preadipocytes and adipocytes performed on cell cultures with using rats, 3T3-L1 preadipocytes and porcine skin including fat tissue were treated with fel ursi, bovis calculus, ephedrae herba, spirodelae herba, wild ginseng. 4. For clinical trials, Sangsik no.1, Bigiheo, ephedra, green tea and sweet bee venom were injected at the region where a lot of fat like zhongwan(CV12), xiawan(CV10), kwanwon(CV4), cheun-chu(ST25) and thigh. Conclusion Through animal and cell experimentations and clinical trials, the treatment of obesity using local acupuncture therapy was effective. For clinical use, however, it is considered that animal and cell experimentation and clinical trial's connection using one kind of herb and studies about more clinical trials and associated side effects are needed.

Situation of HPV16 E2 Gene Status During Radiotherapy Treatment of Cervical Carcinoma

  • Kahla, Saloua;Kochbati, Lotfi;Maalej, Mongi;Oueslati, Ridha
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2869-2873
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    • 2014
  • Background: Human papillomavirus (HPV) integration within the E2 gene has been proposed as a critical event in cervical carcinogenesis. This study concerned whether HPV16 status and E2 gene intactness are predictive of radiation response in patients with cervical cancer. Materials and Methods: Biopsies of 44 patients with cervical cancer were collected before or after radiotherapy. The presence of HPV16 was assessed by polymerase chain reaction (PCR) using specific primers for the L1 region. E2 disruption was detected by amplifying the entire E2 gene. Results: HPV16 DNA was found in 54.5% of the clinical samples. Overall, 62.5% of the HPV16 positive tumors had integrated viral genome and 37.5% had episomal genome. There was a tendency of increase of HPV16 E2 negative tumors compared with HPV16 L1 ones in advanced stages (75% versus 20% in stage III respectively). Detection of E2 gene appeared influenced by the radiotherapy treatment, as the percentage of samples containing an intact HPV16 E2 was more frequent in pretreated patients compared to radiotherapy treated patients (66.6% versus 20%). The radiation therapy caused an eight-fold [OR= 8; CI=1.22-52.25; p=0.03] increase in the risk of HPV16 genome disruption. The integration status is influenced by the irradiation modalities, interestingly E2 disruption being found widely after radiotherapy treatment (75%) with a total fractioned dose of 50Gy. Conclusions: This study reveals that the status of the viral DNA may be used as a marker to optimize the radiation treatment.

Socio-demographic factors and diet-related characteristics of community-dwelling elderly individuals with dysphagia risk in South Korea

  • Lim, Youngsuk;Kim, Chorong;Park, Haeryun;Kwon, Sooyoun;Kim, Oksun;Kim, Heeyoung;Lee, Youngmi
    • Nutrition Research and Practice
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    • v.12 no.5
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    • pp.406-414
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    • 2018
  • BACKGROUND/OBJECTIVES: The objective of this study was to determine dysphagia risk among community-dwelling elderly people living at home. We also examined the impact of socio-demographic variables on dysphagia risk as well as the relationship between dysphagia risk and dietary characteristics. SUBJECTS/METHODS: The study sample included 568 community-dwelling individuals, aged 65 years and above, who were living independently in their own home in Seoul, Gyeonggi, or Gwangju in South Korea. We used a dysphagia risk assessment scale to screen for dysphagia risk and the Mini nutritional assessment to evaluate the nutritional status. Associations between dysphagia risk and other variables were assessed using logistic regression analysis. RESULTS: Of the 568 subjects, 350 (61.6%) were classified into the dysphagia risk group (DR) and 218 (38.4%) were classified into the normal group (non-DR). Being female (odds ratio (OR) = 1.82, 95% confidence interval (CI) = 1.28-2.59), being 75 years and older (OR = 2.40, 95% CI = 1.69-3.42), having a lower education level (OR = 2.29, 95% CI = 1.33-3.97), and having a lower perceived economic status (OR = 2.18, 95% CI = 1.32-3.60) were more frequently observed with dysphagia risk compared to those who did not have such characteristics. Lowered mastication ability (OR = 14.40, 95% CI = 4.43-46.95), being at risk of malnutrition or malnourished (OR = 2.72, 95% CI = 1.75-4.23), lowered appetite (OR = 3.27, 95% CI = 2.16-4.93), and decreased food intake (OR = 2.95, 95% CI = 1.83-4.78) were observed more frequently in the DR group than in the non-DR group when adjusting for potential confounding factors. CONCLUSIONS: It is necessary to develop and apply integrated programs to improve the dietary habits and nutritional status of elderly individuals at risk for dysphagia, especially for women aged 75 years or older with lower educational and economic levels.

Role of Cerebrospinal Fluid Biomarkers in Clinical Trials for Alzheimer's Disease Modifying Therapies

  • Kang, Ju-Hee;Ryoo, Na-Young;Shin, Dong Wun;Trojanowski, John Q.;Shaw, Leslie M.
    • The Korean Journal of Physiology and Pharmacology
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    • v.18 no.6
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    • pp.447-456
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    • 2014
  • Until now, a disease-modifying therapy (DMT) that has an ability to slow or arrest Alzheimer's disease (AD) progression has not been developed, and all clinical trials involving AD patients enrolled by clinical assessment alone also have not been successful. Given the growing consensus that the DMT is likely to require treatment initiation well before full-blown dementia emerges, the early detection of AD will provide opportunities to successfully identify new drugs that slow the course of AD pathology. Recent advances in early detection of AD and prediction of progression of the disease using various biomarkers, including cerebrospinal fluid (CSF) $A{\beta}_{1-42}$, total tau and p-tau181 levels, and imagining biomarkers, are now being actively integrated into the designs of AD clinical trials. In terms of therapeutic mechanisms, monitoring these markers may be helpful for go/no-go decision making as well as surrogate markers for disease severity or progression. Furthermore, CSF biomarkers can be used as a tool to enrich patients for clinical trials with prospect of increasing statistical power and reducing costs in drug development. However, the standardization of technical aspects of analysis of these biomarkers is an essential prerequisite to the clinical uses. To accomplish this, global efforts are underway to standardize CSF biomarker measurements and a quality control program supported by the Alzheimer's Association. The current review summarizes therapeutic targets of developing drugs in AD pathophysiology, and provides the most recent advances in the clinical utility of CSF biomarkers and the integration of CSF biomarkers in current clinical trials.

Integrative Meta-Analysis of Multiple Gene Expression Profiles in Acquired Gemcitabine-Resistant Cancer Cell Lines to Identify Novel Therapeutic Biomarkers

  • Lee, Young Seok;Kim, Jin Ki;Ryu, Seoung Won;Bae, Se Jong;Kwon, Kang;Noh, Yun Hee;Kim, Sung Young
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.7
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    • pp.2793-2800
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    • 2015
  • In molecular-targeted cancer therapy, acquired resistance to gemcitabine is a major clinical problem that reduces its effectiveness, resulting in recurrence and metastasis of cancers. In spite of great efforts to reveal the overall mechanism of acquired gemcitabine resistance, no definitive genetic factors have been identified that are absolutely responsible for the resistance process. Therefore, we performed a cross-platform meta-analysis of three publically available microarray datasets for cancer cell lines with acquired gemcitabine resistance, using the R-based RankProd algorithm, and were able to identify a total of 158 differentially expressed genes (DEGs; 76 up- and 82 down-regulated) that are potentially involved in acquired resistance to gemcitabine. Indeed, the top 20 up- and down-regulated DEGs are largely associated with a common process of carcinogenesis in many cells. For the top 50 up- and down-regulated DEGs, we conducted integrated analyses of a gene regulatory network, a gene co-expression network, and a protein-protein interaction network. The identified DEGs were functionally enriched via Gene Ontology hierarchy and Kyoto Encyclopedia of Genes and Genomes pathway analyses. By systemic combinational analysis of the three molecular networks, we could condense the total number of DEGs to final seven genes. Notably, GJA1, LEF1, and CCND2 were contained within the lists of the top 20 up- or down-regulated DEGs. Our study represents a comprehensive overview of the gene expression patterns associated with acquired gemcitabine resistance and theoretical support for further clinical therapeutic studies.