• Title/Summary/Keyword: Response efficacy

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Light Therapy : Basic Principle and Clinical Practice (광치료의 기본원리와 임상 실제)

  • Joe, Sook-Haeng
    • Sleep Medicine and Psychophysiology
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    • v.5 no.2
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    • pp.170-176
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    • 1998
  • Nowadays light therapy is accepted practice in the treatment for Seasonal Affective Disorder. The author reviewed the practical aspects of light therapy, latest treatment research on optimal parameters of light therapy and the mechanisms of action of light therapy. Therapeutic efficacy of light therapy using light visors & dawn simulators has been suggested but further studies are needed to clarify the efficacy. The treatment most strongly supported by research studies is light therapy using a light box to administer bright white light (2500 lux for 2 hours or 10000 lux for 30 minutes). Although some patients may be selective responders to morning light exposure, the optimal timing of light exposure still remains controversial. In practice, generally the duration of exposure can be increased or decreased as necessary and also the timing of exposure can be splitted (e.g. AM/PM usage) if optimal response is obtained. For most, a positive response of light therapy is usually noted within $4{\sim}5\;days$ and optimal response is obtained within 2 weeks. Generally the relapse of symptom occurs within days of discontinuation of light therapy, so to prevent relapse, light therapy should be continued throughout the winter season for typical seasonal affective disorder. Side effects of light therapy appear to be mild and well tolerated. Several theories for the mechanisms of action of light therapy at the basis of seasonal affective disorder had been suggested but remain still controversial. Further studies on the optimal parameters and the mechanisms of light therapy help us to better understand and treat not only seasonal affective disorders but also chronobiological disorders and nonseasonal affective disorders.

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Evaluation of efficacy of Valsalva maneuver for attenuating propofol injection pain: a prospective, randomized, single blind, placebo controlled study

  • Kumar, Sanjay;Khuba, Sandeep;Agarwal, Anil;Gautam, Sujeet;Yadav, Madhulika;Dixit, Aanchal
    • Korean Journal of Anesthesiology
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    • v.71 no.6
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    • pp.453-458
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    • 2018
  • Background: Pain on injection is a limitation with propofol use. The effect of the Valsalva maneuver on pain during propofol injection has not been studied. This maneuver reduces pain through the sinoaortic baroreceptor reflex arc and by distraction. We aimed to assess the efficacy of the Valsalva maneuver in reducing pain during propofol injection. Methods: Eighty American Society of Anesthesiologists class I adult patients undergoing general anesthesia were enrolled and divided into two groups of 40 each. Group I (Valsalva) patients blew into a sphygmomanometer tube raising the mercury column up to 30 mmHg for 20 seconds, while Group II (Control) patients did not. Anesthesia was induced with 1% propofol immediately afterwards. Pain was assessed on a 10-point visual analog scale (VAS), where 0 represented no pain, and 10, the worst imaginable pain, and a 4-point withdrawal response score, where 0 represented no pain, and 3, the worst imaginable pain. Scores were presented as median (interquartile range). Results: We analyzed the data of 70 patients. The incidence of pain was significantly lower in the Valsalva than in the control group (53% vs. 78%, P = 0.029). The withdrawal response score was significantly lower in the Valsalva group (1.00 [0.00-1.00] vs. 2.00 [2.00-3.00], P < 0.001). The VAS score was significantly lower in the Valsalva group (1.00 [0.00-4.00] vs. 7.00 [6.25-8.00], P < 0.001). Conclusions: A prior Valsalva maneuver is effective in attenuating injection pain due to propofol; it is advantageous in being a non-pharmacological, safe, easy, and time-effective technique.

Comparison of WHO and RECIST Criteria for Evaluation of Clinical Response to Chemotherapy in Patients with Advanced Breast Cancer

  • Khokher, Samina;Qureshi, Muhammad Usman;Chaudhry, Naseer Ahmad
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3213-3218
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    • 2012
  • When patients with advanced breast cancer (ABC) are treated with neoadjuvant chemotherapy (NACT), efficacy is monitored by the extent of tumor shrinkage. Since their publication in 1981, World Health Organization (WHO) guidelines have been widely practiced in clinical trials and oncologic practice, for standardized tumor response evaluation. With advances in cancer treatment and tumor imaging, a simpler criterion based on one-dimensional rather than bi-dimensional (WHO) tumor measurement, named Response Evaluation Criteria in Solid Tumors (RECIST) was introduced in 2000. Both approaches have four response categories: complete response, partial response, stable disease and progressive disease (PD). Bi-dimensional measurement data of 151 patients with ABC were analysed with WHO and RECIST criteria to compare their response categories and inter criteria reproducibility by Kappa statistics. There was 94% concordance and 9/151 patients were recategorized with RECIST including 6/12 PD cases. RECIST therefore under-estimates and delays diagnosis of PD. This is undesirable because it may delay or negate switch over to alternate therapy. Analysis was repeated with a new criteria named RECIST-Breast (RECIST-B), with a lower threshold for PD (${\geq}10%$ rather than ${\geq}20%$ increase of RECIST). This showed higher concordance of 97% with WHO criteria and re-categorization of only 4/151 patients (1/12 PD cases). RECIST-B criteria therefore have advantages of both ease of measurement and calculations combined with excellent concordance with WHO criteria, providing a practical clinical tool for response evaluation and offering good comparison with past and current clinical trials of NACT using WHO guidelines.

Efficacy of Oral Korean Red-ginseng on sCRP and Soreness after Muscle Damage

  • NA, Hyun-Jong
    • The Journal of Korean Medicine
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    • v.26 no.4
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    • pp.39-45
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    • 2005
  • Objectives: The study investigated the efficacy of oral Korean red-ginseng (RG) on sCRP response mediated by eccentric contraction-induced muscle damage and discussed its mechanism. Methods: Nineteen healthy young subjects (aged 24.4$\pm$2.07 yr) volunteered for this double blind test. They were classified into either the RG group (N=10) or placebo (P) group (N=9) during the 10-d experimental protocol. Blood samples were collected on T1 (baseline), T1 (1h), T2 (1d), T3 (2d) and T4 (3d) after eccentric contraction-induced injury on the seventh day. Statistical analyses were conducted using nonparametric methods (p<0.05). Results: The RG group increased sCRP more than P group and didn't increase soreness peak at T2, not significant. There were no correlations between soreness intensity and sCRP. Oral RG had little efficacy for reducing sCRP at the muscle damage-mediated acute phase; rather, it increased because of its proinflammatory cytokine production. Conclusions: Oral RG could stimulate proinflammatory cytokine production, and occasionally bal-pyo-beob could be helpful for the efficient recovery of muscle injury.

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Further Study on Pemetrexed based chemotherapy in Treating Patients with Advanced Gastric Cancer (AGC)

  • Liu, Jin;Huang, Xin-En;Feng, Ji-Feng
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6587-6590
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    • 2014
  • Objective: To further observe the efficacy and safety of pemetrexed, combined with Irinotecan or oxaliplatin or cisplatin in treating patients with advanced gastric cancer as second-line or third-line chemotherapy. Methods: From September 2013 to February 2014 we recruited 50 patients with advanced gastric cancer, with stage IV disease or postoperative recurrence, or unresectable. Then treated with pemetrexed based chemotherapy. After two cycles of treatment, efficacy and toxicity were evaluated. Results: Pemetrexed based chemotherapy was used as second-line in 33 patients, RR(CR+PR) is 41.2%. And achieved 36.4% when used as third-line. Overall response rate of 50 patients treated with Pemetrexed based treatment was 38% (CR+PR). Treatment related side effects were bone marrow suppression, vomiting, hepatic dysfunction and malaise.No treatment related death occurred. Conclusions: Treatment with pemetrexed based chemotherapy is active and is well tolerated in patients with advanced gastric cancer.

Efficacy of pushover analysis methodologies: A critical evaluation

  • Dutta, Sekhar Chandra;Chakroborty, Suvonkar;Raychaudhuri, Anusrita
    • Structural Engineering and Mechanics
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    • v.31 no.3
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    • pp.265-276
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    • 2009
  • Various Pushover analysis methodologies have evolved as an easy as well as designers-friendly alternative of nonlinear dynamic analysis for estimation of the inelastic demands of structures under seismic loading for performance based design. In fact, the established nonlinear dynamic analysis to assess the same, demands considerable analytical and computational background and rigor as well as intuitive insight into inelastic behavior for judging suitability of the results and its interpretation and hence may not be used in design office for frequent practice. In this context, the simple and viable alternative of Pushover analysis methodologies can be accepted if its efficacy is thoroughly judged over all possible varieties of the problems. Though this burning issue has invited some research efforts in this direction, still a complete picture evolving very clear guidelines for use of these alternate methodologies require much more detailed studies, providing idea about how the accuracy is influenced due to various combinations of basic parameters regulating inelastic dynamic response of the structures. The limited study presented in the paper aims to achieve this end to the extent possible. The study intends to identify the range of applicability of the technique and compares the efficacy of various alternative Pushover analysis schemes to general class of problems. Thus, the paper may prove useful in judicial use of Pushover analysis methodologies for performance based design with reasonable accuracy and relative ease.

The Effects of Emotional Factors on Environment Behaviors - Comparing the Protective Motivation Theory with the ERB-Based Tentative Model - (환경행동에 미치는 정서적 요인의 영향: -보호동기이론과 환경 책임성 행위모형에 근거한 잠정적 모형의 비교-)

  • 이태연
    • Hwankyungkyoyuk
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    • v.15 no.1
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    • pp.18-30
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    • 2002
  • So far, the environmentally responsible behavior(ERB) model has been applied successfully to explain environment behaviors. But the ERB model has several limitations such as underestimation of social factors on environment behaviors. This study planned to point out that the emotional aspects should be considered seriously for explaining human's behaviors to conserve the environment in the ERB model. In this study, the effects of emotional aspects, such as perceived severity or perceived danger, on environment behaviors were investigated and the protective motivation theory(Rogers, 1983) and the ERB-based tentative model were compared Results showed that teenagers in urban areas realized clearly the severity and danger of environmental threats and do environmentally responsible behaviors more than ones in rural areas. Two model's goodness of fit to explain observed environment behaviors were analyzed through the regression analysis and the AMOS analysis. In the regression analysis, self-efficacy, confirmity toward social norm, and knowledge were involved in the regression equation as statistically meaningful variables in the ERB-based tentative model and self-efficacy and perceived severity were involved in the protective motivation theory. Especially, the AMOS analysis showed that the protective motivation theory was more valid model lot explaining environment behaviors than the ERB-based tentative model. In conclusion, it is reasonable that emotional aspects should be considered as meaningful variables for explaining environment behaviors.

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Comparison of Gefitinib and Erlotinib for Patients with Advanced Non-Small-Cell Lung Cancer (진행성 비소세포폐암 환자에서 Gefitinib와 Erlotinib의 비교)

  • Lee, Jin Hwa;Lee, Kyoung Eun;Ryu, Yon Ju;Chun, Eun Mi;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.4
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    • pp.280-287
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    • 2009
  • Background: The epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), became an attractive therapeutic option for advanced non-small-cell lung cancer (NSCLC). Several studies suggested that there might be some different efficacy or response predictors between gefitinib and erlotinib. We compared the efficacy and toxicity of gefitinib and erlotinib in Korean patients with advanced NSCLC and evaluated specific predictors of response for both gefitinib and erlotinib. Methods: We collected the clinical information on patients with advanced NSCLC, who were treated with gefitinib or erlotinib at the Ewha Womans University Hospital, between July 2003 and February 2009. Median survival times were calculated using the Kaplan-Meier method. Results: Eighty-six patients (52 gefitinib vs. 34 erlotinib) were enrolled. Patient median age was 64 years; 53 (62%) subjects were male. Out of the 86 patients treated, 83 received response evaluation. Of the 83 patients, 35 achieved a response and 12 experienced stable disease while 36 experienced progressive disease, resulting in a response rate of 42% and a disease control rate of 57%. After a median follow-up of 502 days, the median progression-free and overall survival time was 129 and 259 days, respectively. Comparing patients by treatment (gefitinib vs erlotinib), there were no significant differences in the overall response rate (44% vs. 39%, p=0.678), median survival time (301 days vs. 202 days, p=0.151), or time to progression (136 days vs. 92 days, p=0.672). Both EGFR-TKIs showed similar toxicity. In a multivariate analysis using Cox regression model, adenocarcinoma was an independent predictor of survival (p=0.006; hazard ratio [HR], 0.487; 95% confidence interval [CI], 0.292-0.811). Analyses of subgroups did not show any difference in response predictors between gefitinib and erlotinib. Conclusion: Comparing gefitinib to erlotinib, there were no differences in the response rate, overall survival, progression-free survival, or toxicity. No specific predictor of response to each EGFR-TKI was identified.

Modelling the capture of spray droplets by barley

  • Cox, S.J.;Salt, D.W.;Lee, B.E.;Ford, M.G.
    • Wind and Structures
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    • v.5 no.2_3_4
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    • pp.127-140
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    • 2002
  • This paper presents some of the results of a project whose aim has been to produce a full simulation model which would determine the efficacy of pesticides for use by both farmers and the bio-chemical industry. The work presented here describes how crop architecture can be mathematically modelled and how the mechanics of pesticide droplet capture can be simulated so that if a wind assisted droplet-trajectory model is assumed then droplet deposition patterns on crop surfaces can be predicted. This achievement, when combined with biological response models, will then enable the efficacy of pesticide use to be predicted.

Animal Models of Arthritis: Pharmacological Intervention

  • Ryn, Joanne van
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 2001.11a
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    • pp.41-76
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    • 2001
  • Rheumatoid arthritis is an incurable chronic inflammatory and destructive arthopathy that affects 1% of the population world-wide. It has substantial personal, social and economic costs. The long-term prognosis is poor: 80 percent of affected patients will become disabled within 20 years after onset of disease. Medical costs of rheumatoid arthritis average ∼$ 6000 (US) per patient (1), Current antirheumatic drugs have limited efficacy and many side effects and more importantly they do not improve the long-term prognosis of rheumatoid arthritis (2). After a decade of few notable advances in therapy, several biological response modifiers that target pathophysiological processes in the disease have now emerged in the clinic. These new drugs are termed biological agents, and although information about their use in the clinic is still limited to short term treatment, they appear to have the ability to modify disease progress. In addition, COX-2 selective agents have now been approved that have comparable efficacy with standard NSAIDs, but fewer gastrointestinal side effects (3). Thus today many more therapeutic options are suddenly open to patients that even five years ago had little hope of relief from chronic pain and inflammation.

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