• Title/Summary/Keyword: Multi-therapy

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The Retrospective Review of 410 Shoulder Pain Inpatients in Korean Medicine Hospital (어깨 통증으로 한방병원에 입원한 환자 410명을 대상으로 한 후향적 연구)

  • Lee, Jae-Eun;Oh, Min-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.25 no.2
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    • pp.155-173
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    • 2015
  • Objectives The purpose of this study is to investigate the characteristics of inpatients who were admitted to Korean medicine hospital due to shoulder pain. Methods Characteristics of four hundred ten shoulder pain inpatients of single institution from 2011 to 2013 were retrospectively reviewed through medical charts. Results Patients showed different characteristics in sex, age, motives, interval between onset and admission day, first occurrence or not, related medical history before admission, usage of west medication, admission days, treatment results, radiological examinations by shoulder pain disease groups. Accordingly, Korean medical treatment such as acupuncture, moxibustion, external treatment, cupping therapy, physiotherapy, herb-medication varied with the characteristics of shoulder pain disease groups. Conclusions Through retrospective medical charts review, characteristics of 410 single institution shoulder pain inpatients showed distinctive features and versatile Korean medicine treatments by disease groups. It is expected that this study would accelerate multi-institutional and large scale characteristic review of shoulder pain patients, which would raise reconsideration and expand boundary of Korean medicine.

Application of Cancer Genomics to Solve Unmet Clinical Needs

  • Lee, Se-Hoon;Sim, Sung Hoon;Kim, Ji-Yeon;Cha, SooJin;Song, Ahnah
    • Genomics & Informatics
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    • v.11 no.4
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    • pp.174-179
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    • 2013
  • The large amount of data on cancer genome research has contributed to our understanding of cancer biology. Indeed, the genomics approach has a strong advantage for analyzing multi-factorial and complicated problems, such as cancer. It is time to think about the actual usage of cancer genomics in the clinical field. The clinical cancer field has lots of unmet needs in the management of cancer patients, which has been defined in the pre-genomic era. Unmet clinical needs are not well known to bioinformaticians and even non-clinician cancer scientists. A personalized approach in the clinical field will bring potential additional challenges to cancer genomics, because most data to now have been population-based rather than individualbased. We can maximize the use of cancer genomics in the clinical field if cancer scientists, bioinformaticians, and clinicians think and work together in solving unmet clinical needs. In this review, we present one imaginary case of a cancer patient, with which we can think about unmet clinical needs to solve with cancer genomics in the diagnosis, prediction of prognosis, monitoring the status of cancer, and personalized treatment decision.

Aesthetic soft tissue management in facial trauma (안면 외상에서 연부조직 치료에 있어 미용적 재건)

  • Chung, Kyu Jin;Kim, Tae Gon;Lee, Jin Ho
    • Journal of the Korean Medical Association
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    • v.61 no.12
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    • pp.715-723
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    • 2018
  • Facial soft tissue injury due to trauma is common. Severe damage of soft tissue causes functional and cosmetic problems. In the initial evaluation of patients with facial trauma, airway maintenance and respiratory maintenance are the most important. The principles of treatment include adequate irrigation and debridement, primary closure, or secondary wound healing. Postoperative care such as taping, silicone gel sheeting, and sun screening is important to prevent scarring. The scalp and forehead are abundant in blood and can cause severe bleeding. The eyelid is very thin and has a multi-layered structure, requiring accurate suturing and reconstruction of the layers. It is advisable to determine the presence of hematoma in the ear and treat it. When the cheek area is damaged, it is necessary to identify and treat the damage of the parotid gland and the facial nerve branch. The lips should be sewn with the white roll of lip and vermillion.

The Correlation between Speech Intelligibility and Acoustic Measurements in Children with Speech Sound Disorders (말소리장애 아동의 말명료도와 음향학적 측정치 간 상관관계)

  • Kang, Eunyeong
    • Journal of The Korean Society of Integrative Medicine
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    • v.6 no.4
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    • pp.191-206
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    • 2018
  • Purpose : This study investigated the correlation between speech intelligibility and acoustic measurements of speech sounds produced by the children with speech sound disorders and children without any diagnosed speech sound disorder. Methods : A total of 60 children with and without speech sound disorders were the subjects of this study. Speech samples were obtained by having the subjects? speak meaningful words. Acoustic measurements were analyzed on a spectrogram using the Multi-speech 3700 program. Speech intelligibility was determined according to a listener's perceptual judgment. Results : Children with speech sound disorders had significantly lower speech intelligibility than those without speech sound disorders. The intensity of the vowel /u/, the duration of the vowel /${\omega}$/, and the second formant of the vowel /${\omega}$/ were significantly different between both groups. There was no difference in voice onset time between the groups. There was a correlation between acoustic measurements and speech intelligibility. Conclusion : The results of this study showed that the speech intelligibility of children with speech sound disorders was affected by intensity, word duration, and formant frequency. It is necessary to complement clinical setting results using acoustic measurements in addition to evaluation of speech intelligibility.

Management of Hypertension and Proteinuria after Treatment with Lenvatinib for Radioiodine Refractory Papillary Thyroid Carcinoma: a Case Report (렌바티닙 사용과 관련된 고혈압과 단백뇨의 관리: 증례 보고)

  • Song, Eyun;Kim, Won Gu
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.78-81
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    • 2018
  • Lenvatinib, an oral multi-kinase inhibitor, is a valuable treatment option for advanced differentiated thyroid carcinoma. However, severe treatment-related adverse events occur up to 30% of the patients receiving lenvatinib, making it a challenge for clinicians to maintain this drug and therefore affecting the outcome of therapy. Blood vessel related events, such as hypertension or proteinuria, are among the most frequent adverse events. We present a case of 65-year-old man with radioactive iodine refractory papillary thyroid carcinoma with cervical lymph node metastasis and tracheal invasion receiving lenvatinib who developed proteinuria and worsening of hypertension. Management with repeated dose reductions and using supportive medications allowed this patient to continue lenvatinib with his disease stably controlled. Early detection of patients at risk for these adverse events and cautious administration of lenvatinib at appropriate level are crucial in managing patients receiving lenvatinib.

Stereotactic Radiosurgery

  • Chung, Hyun-Tai;Lee, Dong-Joon
    • Progress in Medical Physics
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    • v.31 no.3
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    • pp.63-70
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    • 2020
  • Stereotactic radiosurgery is one of the most sophisticated forms of modern advanced radiation therapy. Unlike conventional fractionated radiotherapy, stereotactic radiosurgery uses a high dose of radiation with steep gradient precisely delivered to target lesions. Lars Leksell presented the principle of radiosurgery in 1951. Gamma Knife® (GK) is the first radiosurgery device used in clinics, and the first patient was treated in the winter of 1967. The first GK unit had 179 cobalt 60 sources distributed on a hemispherical surface. A patient could move only in a single direction. Treatment planning was performed manually and took more than a day. The latest model, Gamma Knife® IconTM, shares the same principle but has many new dazzling characteristics. In this article, first, a brief history of radiosurgery was described. Then, the physical properties of modern radiosurgery machines and physicists' endeavors to assure the quality of radiosurgery were described. Intrinsic characteristics of modern radiosurgery devices such as small fields, steep dose distribution producing sharp penumbra, and multi-directionality of the beam were reviewed together with the techniques to assess the accuracy of these devices. The reference conditions and principles of GK dosimetry given in the most recent international standard protocol, International Atomic Energy Agency TRS 483, were shortly reviewed, and several points needing careful revisions were highlighted. Understanding the principles and physics of radiosurgery will be helpful for modern medical physicists.

Comparison of plan dosimetry on multi-targeted lung radiotherapy: A phantom-based computational study using IMRT and VMAT

  • Khan, Muhammad Isa;Rehman, Jalil ur;Afzal, Muhammad;Chow, James C.L.
    • Nuclear Engineering and Technology
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    • v.54 no.10
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    • pp.3816-3823
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    • 2022
  • This work analyzed the dosimetric difference between the intensity modulated radiotherapy (IMRT), partial/single/double-arc volumetric modulated arc therapy (PA/SA/DA-VMAT) techniques in treatment planning for treating more than one target of lung cancer at different isocenters. IMRT and VMAT plans at different isocenters were created systematically using a Harold heterogeneous lung phantom. The conformity index (CI), homogeneity index (HI), gradient index (GI), dose-volume histogram and mean and maximum dose of the PTV were calculated and analyzed. Furthermore, the dose-volume histogram and mean and maximum doses of the OARs such as right lung, contralateral lung and non GTV were determined from the plans. The IMRT plans showed the superior target dose coverage, higher mean and maximum values than other VMAT techniques. PA-VMAT technique shows more lung sparing and DA-VMAT increases the V5/10/20 values of contralateral lung than other VMAT and IMRT techniques. The IMRT technique achieves highly conformal dose distribution to the target than other VMAT techniques. Comparing to the IMRT plans, the higher V5/10/20 and mean lung dose were observed in the contralateral lung in the DA-VMAT.

Ginseng-derived compounds as potential anticancer agents targeting cancer stem cells

  • Ji-Sun Lee;Ho-Young Lee
    • Journal of Ginseng Research
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    • v.48 no.3
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    • pp.266-275
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    • 2024
  • Cancer stem cells (CSCs) are a rare subpopulation of cancer cells that exhibit stem cell-like characteristics, including self-renewal and differentiation in a multi-stage lineage state via symmetric or asymmetric division, causing tumor initiation, heterogeneity, progression, and recurrence and posing a major challenge to current anticancer therapy. Despite the importance of CSCs in carcinogenesis and cancer progression, currently available anticancer therapeutics have limitations for eradicating CSCs. Moreover, the efficacy and therapeutic windows of currently available anti-CSC agents are limited, suggesting the necessity to optimize and develop a novel anticancer agent targeting CSCs. Ginseng has been traditionally used for enhancing immunity and relieving fatigue. As ginseng's long history of use has demonstrated its safety, it has gained attention for its potential pharmacological properties, including anticancer effects. Several studies have identified the bioactive principles of ginseng, such as ginseng saponin (ginsenosides) and non-saponin compounds (e.g., polysaccharides, polyacetylenes, and phenolic compounds), and their pharmacological activities, including antioxidant, anticancer, antidiabetic, antifatigue, and neuroprotective effects. Notably, recent reports have shown the potential of ginseng-derived compounds as anti-CSC agents. This review investigates the biology of CSCs and efforts to utilize ginseng-derived components for cancer treatment targeting CSCs, highlighting their role in overcoming current therapeutic limitations.

Advancements of Common Gamma-Chain Family Cytokines in Cancer Immunotherapy

  • Alexandra A. Wolfarth;Swati Dhar;Jack B. Goon;Ugonna I. Ezeanya;Sara Ferrando-Martínez;Byung Ha Lee
    • IMMUNE NETWORK
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    • v.22 no.1
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    • pp.5.1-5.22
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    • 2022
  • The approval of immunotherapies such as checkpoint inhibitors (CPIs), adoptive cell therapies and cancer vaccines has revolutionized the way cancer treatment is approached. While immunotherapies have improved clinical outcome in a variety of tumor types, some cancers have proven harder to combat using single agents, underscoring the need for multi-targeted immunotherapy approaches. Efficacy of CPIs and cancer vaccines requires patients to have a competent immune system with adequate cell numbers while the efficacy of adoptive cellular therapy is limited by the expansion and persistence of cells after infusion. A promising strategy to overcome these challenges is combination treatment with common gamma-chain cytokines. Gamma-chain cytokines play a critical role in the survival, proliferation, differentiation and function of multiple immune cell types, including CD8 T-cells and NK cells, which are at the center of the anti-tumor response. While the short halflife of recombinant cytokines initially limited their application in the clinic, advancements in protein engineering have led to the development of several next-generation drug candidates with dramatically increased half-life and bioactivity. When combining these cytokines with other immunotherapies, strong evidence of synergy has been observed in preclinical and clinical cancer settings. This promising data has led to the initiation of 70 ongoing clinical trials including IL-2, IL-7, IL-15 and IL-21. This review summarizes the recent advancements of common gamma-chain cytokines and their potential as a cancer immunotherapy.

Endoscopic ultrasound-guided intervention for inaccessible papilla in advanced malignant hilar biliary obstruction

  • Partha Pal;Sundeep Lakhtakia
    • Clinical Endoscopy
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    • v.56 no.2
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    • pp.143-154
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    • 2023
  • Advanced malignant hilar biliary obstruction (MHBO) with inaccessible papilla poses a significant challenge to endoscopists, as drainage of multiple liver segments may be warranted. Transpapillary drainage may not be feasible in patients with surgically altered anatomy, duodenal stenosis, prior duodenal self-expanding metal stent, and after initial transpapillary drainage, but require re-intervention for draining separated liver segments. Endoscopic ultrasound-guided biliary drainage (EUS-BD) and percutaneous trans-hepatic biliary drainage are the feasible options in this scenario. The major advantages of EUS-BD over percutaneous trans-hepatic biliary drainage include a reduction in patient discomfort and internal drainage away from the tumor, thus reducing the possibility of tissue or tumor ingrowth. With innovations, EUS-BD is helpful not only for bilateral communicating MHBO but also for non-communicating systems with bridging hilar stents or isolated right intra-hepatic duct drainage by hepatico-duodenostomy. EUS-guided multi-stent drainage with specially designed cannulas and guidewires has become a reality. A combined approach with endoscopic retrograde cholangiopancreatography for re-intervention, interventional radiology, and intraductal tumor ablative therapies has been reported. Stent migration and bile leakage can be minimized with proper stent selection and technique, and stent blocks can be managed with EUS-guided interventions in a majority of cases. Future comparative studies are required to establish the role of EUS-guided interventions in MHBO as rescue or primary therapy.