• Title/Summary/Keyword: Non-responders

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Physiological Predictors of Treatment Response to Biofeedback in Patients With Panic Disorder

  • Seongje Cho;In-Young Yoon;Ji Soo Kim;Minji Lee;Hye Youn Park
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.1
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    • pp.19-24
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    • 2023
  • Objectives : Biofeedback is a useful non-pharmacological treatment for panic disorder (PD), but no studies have identified physiological markers related to the treatment response. This study investigated predictors of the treatment response for biofeedback in patients with PD. Methods : A retrospective study based on the electronic medical records of 372 adult patients with PD was performed. Patients received biofeedback treatment at least once, and physiological markers including heart rate, heart rate variability, respiratory rate, skin conductance, skin temperature, and electromyography were collected before the treatment began. The patients were classified as responders or non-responders based on the change in Clinical Global Impression-Severity (CGI-S) score. Results : The response rate to biofeedback treatment was 30.4%. Multivariable logistic regression analysis revealed that a higher CGI-S score at baseline and fewer benzodiazepine prescriptions were associated with a better response to biofeedback treatment. According to subgroup analyses, the baseline CGI-S score, dose of benzodiazepines, and skin conductance are candidate predictors of the response to biofeedback treatment in men, while only baseline disease severity was associated with the treatment response in women. Conclusions : The present results suggest that skin conductance may be target marker and predictor for biofeedback in male patients with PD.

Effect of Bevacizumab Treatment in Cerebral Radiation Necrosis : Investigation of Response Predictors in a Single-Center Experience

  • Shin Heon Lee;Jung Won Choi;Doo-Sik Kong;Ho Jun Seol;Do-Hyun Nam;Jung-Il Lee
    • Journal of Korean Neurosurgical Society
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    • v.66 no.5
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    • pp.562-572
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    • 2023
  • Objective : Bevacizumab is a feasible option for treating cerebral radiation necrosis (RN). We investigated the clinical outcome of RN after treatment with bevacizumab and factors related to the initial response and the sustained effect. Methods : Clinical data of 45 patients treated for symptomatic RN between September 2019 and February 2021 were retrospectively collected. Bevacizumab (7.5 mg/kg) was administered at 3-week intervals with a maximum four-cycle schedule. Changes in the lesions magnetic resonance image (MRI) scans were examined for the response evaluation. The subgroup analysis was performed based on the initial response and the long-term maintenance of the effect. Results : Of the 45 patients, 36 patients (80.0%) showed an initial response, and eight patients (17.8%) showed delayed worsening of the corresponding lesion. The non-responders showed a significantly higher incidence of diffusion restriction on MRI than the responders (100.0% vs. 25.0%, p<0.001). The delayed worsening group showed a significantly higher proportion of glioma pathology than the maintenance group (87.5% vs. 28.6%, p=0.005). Cumulative survival rates with sustained effect were significantly higher in the groups with non-glioma pathology (p=0.019) and the absence of diffusion restriction (p<0.001). Pathology of glioma and diffusion restriction in MRI were the independent risk factors for non-response or delayed worsening after initial response. Conclusion : The initial response of RN to bevacizumab was favorable, with improvement in four-fifths of the patients. However, a certain proportion of patients showed non-responsiveness or delayed exacerbations. Bevacizumab may be more effective in treating RN in patients with non-glioma pathology and without diffusion restriction in the MRI.

A Review of Korean Medicine Treatment for Managing the Thoracolumbar Compression Fractures: A Retrospective Observational Study (흉요추 압박골절 치료에 대한 한의복합치료 고찰: 후향적 관찰 연구)

  • Min-Jin Cho;Jiyun Lee;Myeong-Jong Lee;Hojun Kim;Kyungsun Han
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.4
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    • pp.109-124
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    • 2023
  • Objectives This study aims to find out effect of Korean medicine treatment on managing thoracolumbar compression fractures through retrospective observational study. Methods Among hospitalized patients at the Department of Korean Medicine Rehabilitation from January 1st, 2018 to February 28th, 2023, a total of 24 inpatients who were diagnosed with thoracolumbar compression fractures and received Korean medicine treatment were included in this study. Numeric rating scale (NRS) was used for pain assessment and clinical variables such as sex, symptoms, age, thoracolumbar injury classification and severity (TLICS) scores were collected. For subgroup analysis to analyze factors affecting treatment response, we divided patients into responders and non-responders according to NRS change. For statistical analysis, we compared before/after hospitalization and analyzed distinct features between two groups. Results Most of the patients were in their 70s and 83.33% were female. Average hospitalization period was 24.54±11.91 days. All patients had back pain as their chief complaint and only 2 patients received surgeries. In TLICS, only 1 patient got score 6, which represented surgery indication. After Korean medicine treatment, NRS of almost every patient got lower significantly at the time of discharge (3.02±1.93) than admission (5.52±1.95). Comparing two groups, responders had lower NRS at the time of discharge and TLICS score of them were lower than non-responders. Conclusions Our results show that Korean medicine treatment for thoracolumbar compression fractures was effective in reducing pain. There were distinct clinical features such as age, past history, surgeries between those with significant improvement in pain scores and those who did not.

Earlier treatment improves the chances of complete relief from postherpetic neuralgia

  • Kang, Dong Hee;Kim, Su Young;Kim, Hyuck Goo;Park, Jung Hyun;Kim, Tae Kyun;Kim, Kyung Hoon
    • The Korean Journal of Pain
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    • v.30 no.3
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    • pp.214-219
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    • 2017
  • Background: As herpes zoster progresses via postherpetic neuralgia (PHN) to well-established PHN, it presents its recalcitrant nature to the treatment. At this point, the well-established PHN is fixed as a non-treatable, but manageable chronic painful neuropathic disorder. This study evaluated the incidence of complete relief from PHN according to PHN duration at their first visit, and the other factors influencing it. Methods: A retrospective chart review was performed on patients with PHN at a university-based pain clinic over 7 years. The responders were defined as patients who had complete relief from pain after 1 year of active treatment. Age, sex, PHN duration at their first visit, dermatomal distribution, and underlying disorders were compared in the responder and non-responder groups. Responders were also compared according to these factors. Results: Among 117 PHN patients (M/F = 48/69), 35 patients (29.9%) had complete relief from PHN. Mean ages were $64.3{\pm}10.6$ and $66.9{\pm}10.7$ years, numbers of male to female patients were 11/24 and 37/45, and mean durations of PHN at their first visit were $8.5{\pm}6.3$ and $15.3{\pm}10.7$ months in the responder and non- responder groups, respectively. In addition, PHN patients who visited the clinic before 9 months showed a better result. Dermatomal distribution and underlying disorders did not show significant differences. Conclusions: Almost 30% of PHN patients received complete relief. Those who sought treatment in a pain clinic before 9 months received a better result.

Genotypes of Hepatitis C Virus in Relapsed and Non-respondent Patients and their Response to Anti-Viral Therapy in District Mardan, Khyber Pakhtunkhawa, Pakistan

  • Akhtar, Noreen;Bilal, Muhammad;Rizwan, Muhammad;Khan, Muhammad Asif;Khan, Aurangzeb
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.1037-1040
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    • 2015
  • Hepatitis C is a blood-borne infectious disease of liver, caused by a small enveloped, positive-single stranded RNA virus, called the hepatitis C virus (HCV). HCV belongs to the Flaviviridae family and has 6 genotypes and more than 100 subtypes. It is estimated that 185 million people are infected with HCV worldwide and 5% of these are in Pakistan. The study was designed to evaluate different genotypes of HCV circulating in District Mardan and to know about the behavior of these genotypes to different anti-viral regimes. In this study 3,800 patients were exposed to interferon alfa-2a plus Ribavirin treatment for 6-months and subjected to real-time PCR to check the viral response. Among these 3,677 (97%) patients showed no detectable HCV RNA while 123 (3%) patients (non-responders) remained positive for HCV RNA. Genotypes of their analyzed showed that most of them belonged to the 3a genotype. Non-responders (123) and relapsed (5) patients were subjected to PEG-interferon and Ribavirin therapy for next 6 months, which resulted into elimination of HCV RNA from 110 patients. The genotypes of the persisting resistant samples to anti-viral treatment were 3b, 2a, 1a and 1b. Furthermore, viral RNA from 6 patients remained un-typed while 4 patients showed mixed infections. HCV was found more resistant to antiviral therapy in females as compared to mals. The age group 36-45 in both females and males was found most affected by infection. In general 3a is the most prevalent genotype circulating in district Mardan and the best anti-viral therapy is PEG-interferon plus Ribavirin but it is common practice that due to the high cost patients receive interferon alfa-2a plus Ribavirin with consequent resistance in 3% patients given this treatment regime.

Prediction of Treatment Outcome of Chemotherapy Using Perfusion Computed Tomography in Patients with Unresectable Advanced Gastric Cancer

  • Dong Ho Lee;Se Hyung Kim;Sang Min Lee;Joon Koo Han
    • Korean Journal of Radiology
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    • v.20 no.4
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    • pp.589-598
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    • 2019
  • Objective: To evaluate whether data acquired from perfusion computed tomography (PCT) parameters can aid in the prediction of treatment outcome after palliative chemotherapy in patients with unresectable advanced gastric cancer (AGC). Materials and Methods: Twenty-one patients with unresectable AGCs, who underwent both PCT and palliative chemotherapy, were prospectively included. Treatment response was assessed according to Response Evaluation Criteria in Solid Tumors version 1.1 (i.e., patients who achieved complete or partial response were classified as responders). The relationship between tumor response and PCT parameters was evaluated using the Mann-Whitney test and receiver operating characteristic analysis. One-year survival was estimated using the Kaplan-Meier method. Results: After chemotherapy, six patients exhibited partial response and were allocated to the responder group while the remaining 15 patients were allocated to the non-responder group. Permeability surface (PS) value was shown to be significantly different between the responder and non-responder groups (51.0 mL/100 g/min vs. 23.4 mL/100 g/min, respectively; p = 0.002), whereas other PCT parameters did not demonstrate a significant difference. The area under the curve for prediction in responders was 0.911 (p = 0.004) for PS value, with a sensitivity of 100% (6/6) and specificity of 80% (12/15) at a cut-off value of 29.7 mL/100 g/min. One-year survival in nine patients with PS value > 29.7 mL/100 g/min was 66.7%, which was significantly higher than that in the 12 patients (33.3%) with PS value ≤ 29.7 mL/100 g/min (p = 0.019). Conclusion: Perfusion parameter data acquired from PCT demonstrated predictive value for treatment outcome after palliative chemotherapy, reflected by the significantly higher PS value in the responder group compared with the non-responder group.

The Association between the Dopamine $D_1$ Receptor Genotype and Treatment Response in Korean Schizophrenic Patients (정신분열병 환자의 도파민 $D_1$ 수용체 유전자형과 치료반응간의 연관)

  • Paik, Jong Woo;Lee, Min Soo;Rhee, Choong Soon;Lim, Dong Ju;Ham, Won Hun
    • Korean Journal of Biological Psychiatry
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    • v.8 no.1
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    • pp.106-110
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    • 2001
  • Background : Dopamine receptors have been regarded as a strong candidate involved in etiology of schizophrenia and a target for various antipsychotic drugs. The purpose of our study was to investigate whether dopamine $D_1$ receptor(DRD1) gene polymorphisms would predict the treatment response to antipsychotics in schizophrenia. Method : One hundred thirty-four schizophrenic patients, who met DSM-IV criteria for schizophrenia were entered into a 48 -week study. The psychopathology of the patients was assessed at baseline, 12th, 24th 48th weeks of treatment by PANSS. Responders were defined by a 20% of the reduction in total PANSS score at end point. The genomic DNA fragment corresponding to nucleotides of dopamine $D_1$ receptor gene was amplified by polymerase chain reaction(PCR). Result: Neither allelic frequencies nor genotypes for dopamine $D_1$ receptor differed significantly between responders and non-responders. Also, there was no difference of changes of PANSS scores among three genotype groups of the dopamine $D_1$ receptor. Conclusion : Allelic variation in the dopamine $D_1$ gene is not associated with individual differences in antipsychotic response.

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Efficacy of Pancreatic Kallikrein on Semen Parameters of Men with Varicocele (정계정맥류로 인한 불임증에 대한 췌장성 Kallikrein의 효능)

  • Lee, Hee-Yong;Lee, Sang-Kon;Kim, Choung-Soo;Lee, Seung-Won
    • Clinical and Experimental Reproductive Medicine
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    • v.13 no.2
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    • pp.175-180
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    • 1986
  • It has been reported that oral kallikrein therapy exerts a favourable effect on sperm motility in asthenozoospermic patients. In order to evaluate the efficacy of kallikrein on asthenozoospermia, a total of 20 subfertile male patients with varicocele, whose sperm counts were less than $40{\times}10^6/ml$ and sperm motility was less than 30%, was subjected to this clinical study (Table 1). They were divided into 2 study groups: 1) Varicocelectomy group consisted of 10 patients with varicocele (grade II-III) who underwent varicocelectomy. 2) Kallikrein group was composed of 10 patients with varicocele (grade I) who were given kallikrein orally 600 KU (kallikrein unit) daily divided 3 times after meal for 3 to 9 months. Semen analyses were repeated twice before the study, once a month during the study and twice after the study. Effective results designate that sperm parameters improved more than 30% from the basical levels after varicocelectomy or kallikrein exposure. Sperm counts increased from $32.5{\times}10^5/ml$ to $45.5{\times}10^6/ml$ after varicocelectomy in 3 patients and sperm motility increased from 25% to 38.5% after varicocelectomy in 3 patients. Pregnancy occurred in 2 patients of 3 responders and 1 patient of 7 non-responders 3 to 6 months after varicocelectomy in Varicocelectomy group. Sperm motility increased from 28% to 40.2% after kallikrein treatment in 3 patients. Pregnancy occurred in 2 patients of the 3 responders in Kallikrein group (Tables 2-3). There were no significant changes in volume and morphology in Varicocelectomy group before after varicocelectomy and no significant changes in volume, counts, and morphology before and after kallikrein exposure. No remarkable side effects were noted with kallikrein treatment.

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Clinical and Neuropsychological Factors Associated with Treatment Response and Adverse Events of Atomoxetine in Children with Attention-Deficit/Hyperactivity Disorder

  • Park, Kee Jeong;Kim, Hyo-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.30 no.2
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    • pp.74-82
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    • 2019
  • Objectives: The objective of this study was to investigate clinical and neuropsychological factors associated with treatment response and adverse events of atomoxetine in children with attention-deficit/hyperactivity disorder (ADHD) in Korea. Methods: Children with ADHD were recruited at the Department of Psychiatry of Asan Medical Center from April 2015 to April 2018. Diagnoses of ADHD and comorbid psychiatric disorders were confirmed with the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. The subjects were subsequently treated with atomoxetine for 12 weeks and illness severity was scored using the ADHD Rating Scale, Clinical Global Impression-Severity scale (CGI-S) and/or Improvement scale (CGI-I), at pre- and post-treatment. They also completed the Advanced Test of Attention (ATA), while their caregivers completed the Korean Personality Rating Scale for Children (KPRC) at pre- and post-treatment. Independent t-test, Fisher's exact test, ${\chi}^2$ test, mixed between-within analysis of variance and correlation analysis were used for statistical analysis. Results: Sixty-five children with ADHD (mean age: $7.9{\pm}1.4years$, 57 boys) were enrolled, of which, 33 (50.8%) were treatment responders. Scores on the social dysfunction subscale of the KPRC (p=0.021) and commission errors on the visual ATA (p=0.036) at baseline were higher in treatment non-responders than in responders; however, the statistical significances disappeared after adjusting for multiple comparisons. Mood changes were also observed in 13 subjects (20.0%), and three of them discontinued atomoxetine due to this. Additionally, atomoxetine-emergent mood change was observed more frequently in girls (p=0.006), while the intelligence quotient (p=0.040) was higher in those subjects with mood changes than in those without. Conclusion: The results of our study suggest that clinical and neuropsychological factors could be associated with treatment response or adverse events of atomoxetine in children with ADHD. Further long-term studies with larger samples are needed.

Genetic and Epigenetic Biomarkers on the Personalized Nutrition

  • An Sung-Whan
    • Proceedings of the Korean Society of Food Science and Nutrition Conference
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    • 2004.11a
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    • pp.271-274
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    • 2004
  • Nutritional genomics is a new field of study of how nutrition interacts with an individual's genome or individual responds to individual diets. Systematic approach of nutritional genomics will likely provide important clues about responders and non-responders. The current interest in personalizing health stems from the breakthroughs emerging in integrative technologies of genomics and epigenomics and the identification of genetic and epigentic diversity in individual's genetic make-up that are associated with variations in many aspects of health, including diet-related diseases. Microarray is a powerful screen system that is being also currently employed in nutritional research. Monitoring of gene expression at genome level is now possible with this technology, which allows the simultaneous assessment of the transcription of tens of thousands of genes and of their relative expression of pathological cells such tumor cells compared with that of normal cells. Epigenetic events such as DNA methylation can result in change of gene expression without involving changes in gene sequence. Recent developed technology of DNAarray-based methylation assay will facilitate wide study of epigenetic process in nutrigenomics. Some of the areas that would benefitfrom these technologies include identifying molecular targets (Biomarkers) for the risk and benefit assessment. These characterized biomarkers can reflect expose, response, and susceptibility to foods and their components. Furthermore the identified new biomarker perhaps can be utilized as a indicator of delivery system fur optimizing health.

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