• Title/Summary/Keyword: Selective-Medical Treatment

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Current Management for Pregnancy-related Low Back Pain by Korean Physical Therapists: A National Cross-sectional Survey Using the Vignette Method (비네트를 활용한 한국 물리치료사의 임신 관련 허리통증 환자에 대한 치료실태 조사연구)

  • Han, Hee-ju;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.27 no.1
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    • pp.53-62
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    • 2020
  • Background: Pregnancy-related low back pain (PLBP) has fewer systematic guidelines than pregnancy-related pelvic girdle pain, previous studies have not evaluated physical therapy for this ailment in Korea. Objects: We aimed to provide a detailed account of clinical decision making by Korean physiotherapists while treating PLBP. Methods: In total, 955 questionnaires were distributed mainly in places of continuing education held by the Korean Physical Therapy Association from April to July 2019. The same questionnaire was posted on a website used by physiotherapists. We collected subject information, a specific Vignette typically represent symptoms of PLBP, and responses to multiple questions about decision making, subjective recognition and interest level in the field of women's health physiotherapy (WHPT). Results: The overall response rate was 56% (n = 537); of these, responses to 520 questionnaires were analyzed. Most respondents chose various combinations of physical therapy methods. There were significant differences in subjective recognition levels of WHPT according to gender (p < 0.05), age (p < 0.01), education level (p < 0.01), and clinical experience (p < 0.05). There were significant differences in interest according to gender (p < 0.01) and education level (p < 0.01). With respect to the types of treatment, significant differences were noted in selective rates for "manual therapy", "pain control", and "supportive devices" based on gender. Manual therapy tended to be chosen more with increasing age and clinical experience. With increased education level, there were fewer choices for the use of pain control. Conclusion: This is the first data on how Korean physiotherapists manage PLBP patients using the vignette method. We were able to recognize the Korean physical therapist's decision on PLBP patients, and observed statistically significant correlations. This may aid in developing future research and education plans in the WHPT field.

The Determination of 5-Fluorourasil in Human Plasma by a Gas Chromatography-Mass Spectrometry (GC-MS에 의한 혈중 5-fluorouracil의 정량법)

  • Shin, Ho-Sang;Seo, Bae-Seck;Oh, Yun-Suk;Park, Sung-Woo
    • Analytical Science and Technology
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    • v.11 no.1
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    • pp.36-41
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    • 1998
  • A gas chromatography-mass spectrometry method for the determination of 5-fluorourasil in human plasma is described. The method involves a single extraction procedure with 10 ml of isopropanol-ether(20:80) solution and pentafluoro-benzylation. Samples were injected using an automatic injector, followed by separation on a nonpolar capillary column and detection with a mass selective detector(MSD). No endogeneous compounds were found to interfere. The detection limit, based upon an assayed plasma volume of 0.5, was 3 ng/ml. The extraction yield was found to be above 80%. Plasma 5-FU concentrations were determined by this method in about 500 plasma samples from cancer patients undergoing treatment with 5-FU. This method is suitable for monitoring of 5-FU in plasma of cancer patients.

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Chitosan/hydroxyapatite composite coatings on porous Ti6Al4V titanium implants: in vitro and in vivo studies

  • Zhang, Ting;Zhang, Xinwei;Mao, Mengyun;Li, Jiayi;Wei, Ting;Sun, Huiqiang
    • Journal of Periodontal and Implant Science
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    • v.50 no.6
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    • pp.392-405
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    • 2020
  • Purpose: Titanium implants are widely used in the treatment of dentition defects; however, due to problems such as osseointegration failure, peri-implant bone resorption, and periimplant inflammation, their application is subject to certain restrictions. The surface modification of titanium implants can improve the implant success rate and meet the needs of clinical applications. The goal of this study was to evaluate the effect of the use of porous titanium with a chitosan/hydroxyapatite coating on osseointegration. Methods: Titanium implants with a dense core and a porous outer structure were prepared using a computer-aided design model and selective laser sintering technology, with a fabricated chitosan/hydroxyapatite composite coating on their surfaces. In vivo and in vitro experiments were used to assess osteogenesis. Results: The quasi-elastic gradient and compressive strength of porous titanium implants were observed to decrease as the porosity increased. The in vitro experiments demonstrated that, the porous titanium implants had no biological toxicity; additionally, the porous structure was shown to be superior to dense titanium with regard to facilitating the adhesion and proliferation of osteoblast-like MC3T3-E1 cells. The in vivo experimental results also showed that the porous structure was beneficial, as bone tissue could grow into the pores, thereby exhibiting good osseointegration. Conclusions: Porous titanium with a chitosan/hydroxyapatite coating promoted MC3T3-E1 cell proliferation and differentiation, and also improved osseointegration in vitro. This study has meaningful implications for research into ways of improving the surface structures of implants and promoting implant osseointegration.

Chronicles of EGFR Tyrosine Kinase Inhibitors: Targeting EGFR C797S Containing Triple Mutations

  • Duggirala, Krishna Babu;Lee, Yujin;Lee, Kwangho
    • Biomolecules & Therapeutics
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    • v.30 no.1
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    • pp.19-27
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    • 2022
  • Epidermal growth factor receptor (EGFR) is a receptor tyrosine kinase widely expressed in many cancers such as non-small cell lung cancer (NSCLC), pancreatic cancer, breast cancer, and head and neck cancer. Mutations such as L858R in exon 21, exon 19 truncation (Del19), exon 20 insertions, and others are responsible for aberrant activation of EGFR in NSCLC. First-generation EGFR tyrosine kinase inhibitors (TKIs) such as gefitinib and erlotinib have clinical benefits for EGFR-sensitive (L858R and Del19) NSCLC patients. However, after 10-12 months of treatment with these inhibitors, a secondary T790M mutation at the gatekeeper position in the kinase domain of EGFR was identified, which limited the clinical benefits. Second-generation EGFR irreversible inhibitors (afatinib and dacomitinib) were developed to overcome this T790M mutation. However, their lack of selectivity toward wild-type EGFR compromised their clinical benefits due to serious adverse events. Recently developed third-generation irreversible EGFR TKIs (osimertinib and lazertinib) are selective toward driving mutations and the T790M mutation, while sparing wild-type EGFR activity. The latest studies have concluded that their efficacy was also compromised by additional acquired mutations, including C797S, the key residue cysteine that forms covalent bonds with irreversible inhibitors. Because second- and third-generation EGFR TKIs are irreversible inhibitors, they are not effective against C797S containing EGFR triple mutations (Del19/T790M/C797S and L858R/T790M/C797S). Therefore, there is an urgent unmet medical need to develop next-generation EGFR TKIs that selectively inhibit EGFR triple mutations via a non-irreversible mechanism.

ROS Scavenger, Ebselen, Has No Preventive Effect in New Hearing Loss Model Using a Cholesterol-Chelating Agent

  • Lee, Min Young;Kabara, Lisa L.;Swiderski, Donald L.;Raphael, Yehoash;Duncan, R. Keith;Kim, Young Ho
    • Journal of Audiology & Otology
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    • v.23 no.2
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    • pp.69-75
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    • 2019
  • Background and Objectives: The antioxidant ebselen will be able to limit or prevent the ototoxicity arising from 2-hydroxypropyl-β-cyclodextrin (HPβCD). Niemann-Pick Type C (NPC) disease is a disorder of lysosomal storage manifested in sphingolipidosis. Recently, it was noted that experimental use of HPβCD could partially resolve the symptoms in both animals and human patients. Despite its desirable effect, HPβCD can induce hearing loss, which is the only major side effect noted to date. Understanding of the pathophysiology of hearing impairment after administration of HPβCD and further development of preventive methods are essential to reduce the ototoxic side effect. The mechanisms of HPβCD-induced ototoxicity remain unknown, but the resulting pathology bears some resemblance to other ototoxic agents, which involves oxidative stress pathways. To indirectly determine the involvement of oxidative stress in HPβCD-induced ototoxicity, we tested the efficacy of an antioxidant reagent, ebselen, on the extent of inner ear side effects caused by HPβCD. Materials and Methods: Ebselen was applied prior to administration of HPβCD in mice. Auditory brainstem response thresholds and otopathology were assessed one week later. Bilateral effects of the drug treatments also were examined. Results: HPβCD-alone resulted in bilateral, severe, and selective loss of outer hair cells from base to apex with an abrupt transition between lesions and intact areas. Ebselen co-treatment did not ameliorate HPβCD-induced hearing loss or alter the resulting histopathology. Conclusions: The results indirectly suggest that cochlear damage by HPβCD is unrelated to reactive oxygen species formation. However, further research into the mechanism(s) of HPβCD otopathology is necessary.

ROS Scavenger, Ebselen, Has No Preventive Effect in New Hearing Loss Model Using a Cholesterol-Chelating Agent

  • Lee, Min Young;Kabara, Lisa L.;Swiderski, Donald L.;Raphael, Yehoash;Duncan, R. Keith;Kim, Young Ho
    • Korean Journal of Audiology
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    • v.23 no.2
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    • pp.69-75
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    • 2019
  • Background and Objectives: The antioxidant ebselen will be able to limit or prevent the ototoxicity arising from 2-hydroxypropyl-β-cyclodextrin (HPβCD). Niemann-Pick Type C (NPC) disease is a disorder of lysosomal storage manifested in sphingolipidosis. Recently, it was noted that experimental use of HPβCD could partially resolve the symptoms in both animals and human patients. Despite its desirable effect, HPβCD can induce hearing loss, which is the only major side effect noted to date. Understanding of the pathophysiology of hearing impairment after administration of HPβCD and further development of preventive methods are essential to reduce the ototoxic side effect. The mechanisms of HPβCD-induced ototoxicity remain unknown, but the resulting pathology bears some resemblance to other ototoxic agents, which involves oxidative stress pathways. To indirectly determine the involvement of oxidative stress in HPβCD-induced ototoxicity, we tested the efficacy of an antioxidant reagent, ebselen, on the extent of inner ear side effects caused by HPβCD. Materials and Methods: Ebselen was applied prior to administration of HPβCD in mice. Auditory brainstem response thresholds and otopathology were assessed one week later. Bilateral effects of the drug treatments also were examined. Results: HPβCD-alone resulted in bilateral, severe, and selective loss of outer hair cells from base to apex with an abrupt transition between lesions and intact areas. Ebselen co-treatment did not ameliorate HPβCD-induced hearing loss or alter the resulting histopathology. Conclusions: The results indirectly suggest that cochlear damage by HPβCD is unrelated to reactive oxygen species formation. However, further research into the mechanism(s) of HPβCD otopathology is necessary.

Fabrication of an ultra-fine ginsenoside particle atomizer for drug delivery through respiratory tract (호흡기를 통한 약액 전달을 위한 진세노사이드 초미세입자 분무장치 제작)

  • Byung Chul Lee;Jin Soo Park;Woong Mo Yang
    • Journal of Convergence Korean Medicine
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    • v.2 no.1
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    • pp.5-12
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    • 2021
  • Objectives: The purpose of this study is to fabricate an ultra-fine ginsenoside particle atomizer that can provide a new treatment method by delivering ginsenoside components that have a therapeutic effect on respiratory diseases directly to the lungs. Methods: We fabricated the AAO vibrating mesh by using the micromachining process. The starting substrate of an AAO wafer has a 350nm pore diameter with 50㎛ thickness. A photomask having several 5㎛ opening holes with a 100㎛ pitch was used to separate each nanopore nozzle. The photoresist structure was optimized to pattern the nozzle area during the lift-off process precisely. The commercial vibrating mesh was removed from OMRON's NE-U100 product, and the fabricated AAO vibrating mesh was installed. A diluted sample of 20mL with 30% red ginseng concentrate was prepared to atomize from the device. Results: As a result of liquid chromatography analysis before spraying the ginsenoside solution, ginsenoside components such as 20S-Rg3, 20R-Rg3, and Rg5 were detected. After spraying through the AAO vibrating mesh, ginsenosides of the same component could be detected. Conclusion: A nutrient solution containing ginsenosides was successfully sprayed through the AAO vibrating mesh with 350 nm selective pores. In particular, during the atomizing experiment of ginsenoside drug solution having excellent efficacy in respiratory diseases, it was confirmed that atomizing through the AAO vibrating mesh while maintaining most of the active ingredients was carried out.

A DOUBLE BLIND CROSS-OVER COMPARISON OF ANTIDEPRESSANT AND ANTIANXIETY EFFECTS OF PAROXETINE AND PLACEBO IN CHILD-ADOLESCENT AND ADULT DEPRESSIVE NEUROSIS (소아 ${\cdot}$ 청소년 및 성인 우울신경증 환자에 대한 Paroxetine의 항우울 및 항불안 효과 검증 : 위약과의 이중맹 교차 비교실험)

  • Kim, S. Peter;Hong, Kyung-Sue
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.5 no.1
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    • pp.83-92
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    • 1994
  • Paroxetine is a potent and selective serotoin re-uptake inhibitor. It is well known as an effective and safe antidepressant and increasingly used for neurotic or non-psychotic depression with anxiety symptoms. The present study assessed antidepressant and antianxiety efficacy and tolerability of paroxetine against placebo in child-adolescent and adult depressive neurosis patients. 232 subjects aged 8-55 years and meeting DSM-III-R criteria for depressive neurosis or dysthymia were divided into 8 subgroups according to their sex and age(8-11 yeard old, 12-17 years old, 18-35 years old and 36-55 years old subgroup in each male and female group). In each subgroup, the randomly assigned half of the patients were treated with paroxetine(10-30mg/day) and the others with placebo for the first 2 weeks in double blind fashion. After 1 week of drug-washout period, paroxetine and placebo groups were crossed over. The depression and anxiety symptoms were assessed with Hamilton Depression Scale(HDS) and Hamilton Anxiety Scale(HAS) at baseline and every 1 week during the trial periods. The levels of reduction in HDS and HAS scores from baseline after 2-week trial were compared between paroxetine- and placebo- treated periods by paired t-test. In all the 8 subgroups, statistically significant differences between paroxetine and placebo were found on the antidepressant efficacy after 2-week treatment. The antidepressant efficacy of paroxetine compared to placebo was most prominent in child and adolescent female groups. On anxiety symptoms, paroxetine was also significantly more effective than placebo. The antianxiety efficacy of paroxetine compared to placebo was most prominent in male and female child groups and young adult female group aged 18-35 years. As for the adverse effects of paroxetine, 3 out of 232 subjects reported mild indigestion and abdominal pain. however, in all the 3 cases, the symptoms improved without reduction of dosage or discontinuation of the drug. In conclusion, paroxetine showed significantly higher antidepressant and antianxiety efficacy compared to placebo in child-adolescent and adult depressive neurosis patients after 2-week treatment. Further trials of paroxetine in depressive neurosis are warranted to elucidate the long-term antidepressant and antianxiety efficacy of paroxetine.

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Signal Transduction Factors on the Modulation of Radiosusceptibility in K562 Cells (K562 세포의 방사선 감수성 변화에 영향을 미치는 신호전달인자)

  • Yang Kwang Mo;Youn Seon-Min;Jeong Soo-Jin;Jang Ji-Yeon;Jo Wol-Soom;Do Chang-Ho;Yoo Y대-Jin;Shin Young-Cheol;Lee Hyung Sik;Hur Won Joo;Lim Young-Jin;Jeong Min-Ho
    • Radiation Oncology Journal
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    • v.21 no.3
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    • pp.227-237
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    • 2003
  • Purpose: The human chronic myelogenous leukemia cell line, K562, expresses the chimeric bcr-abl oncoprotein, whose deregulated protein tyrosine kinase activity antagonizes via DNA damaging agents. Previous experiments have shown that nanomolar concentrations of herbimycin A (HWA) coupled with X-irradiation have a synergistic effect in inducing apoptosis in the Ph-positive K562 leukemia cell line, but genistein, a PTK inhibitor, is non selective for the radiation-induced apoptosils on $p210^{bcr/abl}$ protected K562 cells. In these experiments, the cytoplasmic signal transduction pathways, the Induction on a number of transcription factors and the differential gene expression in this model were investigated. Materials and Methids: K562 cells in the exponential growth phase were used in this study. The cells were irradiated with 0.5-12 Gy, using a 6 Mev Linac (Clinac 1800, Varian, USA). Immediately after irradiation, the cells were treated with $0.25/muM$ of HMA and $25/muM$ of genistein, and the expressions and the activities of abl kinase, MAPK family, NF- kB, c-fos, c-myc, and thymidine kinase1 (TK1) were examined. The differential gene expressions induced by PTK inhibitors were also investigated. Results: The modulating effects of herbimycin A and genistein on the radiosensitivity of K562 cells were not related to the bcr-abl kinase activity. The signaling responses through the MAPK family of proteins, were not involved either in association with the radiation-induced apoptosis, which is accelerated by HMA, the expression of c-myc was increased. The combined treatment of genistein, with irradiation, enhanced NF- kB activity and the TK1 expression and activity. Conclusion: The effects of HMA and genistein on the radiosensitivity on the K562 cells were not related to the bcr-abl kinase activity in this study, another signaling pathway, besides the WAPK family responses to radiation to K562 cells, was found. Further evaluation using this model will provide valuable information for the optional radiosensitization or radioprotection.