• Title/Summary/Keyword: Sequential therapy

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Neurotropism and Invasiveness of $\alpha-Herpes$ Virus in the Rodent (설치류에서 알파 Herpes 바이러스의 신경친화성과 침습)

  • KIM Jin-Sang;Yi Seong-Joon;Card J. Patrick
    • The Journal of Korean Physical Therapy
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    • v.9 no.1
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    • pp.59-70
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    • 1997
  • The ability of neurotropic alpha herpesviruses to replicate within synaptically linked neurons has made these pathogens valuable tools for transneuronal analysis. Recent studies suggest that unique gene products expressed by genetically engineered strains of virus may permit the use of multiple strains in complex tracing paradigms. In the present study we have examined the invasiveness of two genetically engineered strains of the swine pathogen known as pseudorabies virus(PRV). The two strains were isogenic with the attenuated Bartha strain of PRV; in one strain a lacZ reporter gene was inserted into the gC locus (PRV-BaBlu; $4.75\times10^8pfu/ml$) contrained a PRV envelope glycoprotein gene that was absent in PRV-BaBlu. Simultaneous or temporally separated sequential injection of $4\mu\ell$ of each strain into the ventral wall of the stomach produced a predictale course of retrograde synaptic infection. The results were as follows: 1. PRV-BaBlu and PRV-D infected the dorsal motor nucleus of vagus nerve(DMV) and paraventricular nucleus(PVN). 2. Invasion and replication of PRV-D occured at a faster rate than the parental strain or PRV-BaBlu. 3. PRV-D was much more virulent than PRV-BaBlu or the parental strain. 4. Co-injection of PRV-D and PRV-BaBlu produced an infection that was more virulent than that produced by the parental strain (PRV-Bartha), 5. Neurons in DMV were permissive to co-infection with PRV-D and PRV-BaBlu when they were injected simultaneously into the same site. 6. Replication of PRV-BaBlu was compromised by prior infection of the same circuit with PRV-D. 7. Prior infection of neurons with PRV-D maked them resistant to infection with PRV-BaBlu.

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Protein Expression Analysis in Hematopoietic Stem Cells during Osteopontin-Induced Differentiation of Natural Killer Cells

  • Kim, Mi-Sun;Bae, Kil-Soo;Kim, Hye-Jin;Yoon, Suk-Ran;Oh, Doo-Byung;Hwang, Kwang-Woo;Jun, Woo-Jin;Shim, Sang-In;Kim, Kwang-Dong;Jung, Yong-Woo;Park, So-Young;Kwon, Ki-Sun;Choi, In-Pyo;Chung, Jin-Woong
    • Biomolecules & Therapeutics
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    • v.19 no.2
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    • pp.206-210
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    • 2011
  • Natural Killer (NK) cells are the lymphocytes that are derived from hematopoietic stem cells, developed in the bone marrow from hematopoietic stem cells (HSC) by sequential acquisition of functional surface receptors, and express the repertoire of inhibitory and activating receptors. Recently, Osteopontin (OPN) has been identified as a critical factor for differentiation of natural killer cells. However, the detailed mechanism of OPN-induced NK differentiation has been still to be elucidated. Here, we determined the signaling pathway and possible receptor for OPN in NK differentiation. OPN induced expression of Bcl-2 and activation of Erk kinase. Inhibition of Erk pathway decreased the effect of OPN on NK differentiation. In addition, the expression of integrin ${\alpha}9$ was significantly increased by OPN during NK differentiation, suggesting the possible role of a major signaling molecule for OPN- induced NK differentiation.

Multimodal Therapy for Patients with Acute Ischemic Stroke : Outcomes and Related Prognostic Factors

  • Jeong, Seung-Young;Park, Seung-Soo;Koh, Eun-Jeong;Eun, Jong-Pil;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • v.45 no.6
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    • pp.360-368
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    • 2009
  • Objective : The objectives of this study were to analyze the recanalization rates and outcomes of multimodal therapy that consisted of sequential intravenous (IV)/intra-arterial (IA) thrombolysis, mechanical thrombolysis including mechanical clot disruption using microcatheters and microwires, balloon angioplasty, and stenting for acute ischemic stroke, and to evaluate the prognostic factors related to the outcome. Methods : Fifty patients who were admitted to the hospital within 8 hours from ischemic symptom onset were retrospectively analyzed. Initial IV thrombolysis and subsequent cerebral angiography were performed in all patients. If successful recanalization was not achieved by IV thrombolysis, additional IA thrombolysis with mechanical thrombolysis, including balloon angioplasty and stenting, were performed. The outcomes were assessed by the National Institute of Health Stroke Scale (NIHSS) change and modified Rankin scale (mRS) and prognostic factors were analyzed. Results : Successful recanalization was achieved in 42 (84%) of 50 patients, which consisted of 8 patients after IV thrombolysis, 19 patients after IA thrombolysis with mechanical clot disruption, and 15 patients after balloon angioplasty or stenting. Symptomatic hemorrhage occurred in 4 (8%) patients. Good outcomes were achieved in 76% and 70% of patients upon discharge, and 93% and 84% of patients after 3 months according to the NIHSS change and mRS. The initial clinical status, recanalization achievement, and presence of symptomatic hemorrhage were statistically related to the outcomes. Conclusion : Multimodal therapy may be an effective and safe treatment modality for acute ischemic stroke. Balloon angioplasty and stenting is effective for acute thrombolysis, and produce higher recanalization rates with better outcomes.

Breast Conserving Therapy and Quality of Life in Thai Females: a Mixed Methods Study

  • Peerawong, Thanarpan;Phenwan, Tharin;Supanitwatthana, Sojirat;Mahattanobon, Somrit;Kongkamol, Chanon
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2917-2921
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    • 2016
  • Background: To explore factors that influence quality of life (QOL) in patients receiving breast conserving therapy (BCT). Materials and Methods: In this sequential mixed methods study, 118 women from Songklanagarind Hospital were included. We used participants' characteristics, Body Image Scale (BIS), and Functional Assessment of Cancer Therapy with the Breast Cancer Subscale (FACT-B) for analysis. The BIS transformed into presence of body image disturbance (BID). Factors that influenced QOL were determined by stepwise multiple linear regression. Forty-one participants were selected for qualitative analysis. Our female researcher performed the semi-structured interviews with questions based on the symbolic interaction theory. Final codes were analysed using thematic analysis along with investigator triangulation methods. Results: Ninety percent had early stage breast cancer with post-completed BCT, for an average of 2.7 years. The median BIS score and FACT-B score were 2 (IQR=10) and 130 (IQR=39). In the regression analysis, an age of more than 50 years and BID were significant factors. As for the value of conserved breasts, two themes emerged: a conserved breast is an essential part of a participant's life and also the representation of her womanhood; the importance of a breast is related to age. Conclusions: Body image influenced QOL in post BCT participants. The conserved breasts also lead to positive and better impact on their body image as an essential part of their life.

Strategy to Overcome Drug Resistance That Develops during Treatment of Chronic Hepatitis B in Children

  • Hong, Suk Jin;Choe, Byung-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.15 no.2
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    • pp.63-73
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    • 2012
  • Development of antiviral resistance to lamivudine is the most important factor for the treatment failure. It is necessary to establish proper guidelines to overcome drug resistance for children with chronic hepatitis B. Primary treatment with lamivudine should be considered if patients are in immune-clearance phase and have persistently elevated ALT levels more than twice the upper limit of normal value. Before initiating the therapy, careful consideration of the patient's status is required to exclude abnormal liver function tests due to other causes. The treatment option should be carefully decided to suppress the viral replication effectively. To obtain good compliance, clinicians should educate patients and their parents. Appropriate monitoring for virologic breakthrough and genotypic resistance is important in deciding to change the treatment plan. Sequential monotherapy should be avoided and a combination of drugs in other categories is recommended. New antiviral agents, such as entecavir and tenofovir, which have high potency and high genetic barrier, are soon expected to be available for use with children.

Effective Management of Acute Necrotizing Ulcerative Gingivitis with Proper Diagnosis and Immediate Treatment

  • Kwon, Eun-Young;Choi, Youn-Kyung;Choi, Jeomil;Lee, Ju-Youn;Joo, Ji-Young
    • Journal of Korean Dental Science
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    • v.9 no.2
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    • pp.81-89
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    • 2016
  • Necrotizing periodontal diseases, especially acute necrotizing ulcerative gingivitis (ANUG), it should be noted, occur abruptly and progress rapidly, eventually causing severe soft-tissue and alveolar bone loss. This report presents the cases of two ANUG patients and provides a brief treatment protocol for easy and effective clinical management. After proper diagnosis, sequential treatment with cessation of mechanical brushing, along with a prescription of systemic antibiotics and chlorhexidine as a mouth rinse, scaling, root planing, and supportive periodontal therapy, was utilized. In all cases discussed in this report, there was marked improvement in a few days. ANUG, though an uncommon disease, can be efficiently managed with proper diagnosis and immediate treatment.

Surgical Treatment of Coronary Artery Occlusive Disease (관상동맥협착증의 외과적 치료 -6례 보고-)

  • 이재동
    • Journal of Chest Surgery
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    • v.21 no.5
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    • pp.842-849
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    • 1988
  • Between July, 1987, and September, 1988, 6 patients with coronary occlusive disease received coronary artery bypass surgery at Kyungpook University Hospital. There were five males and one female whose age ranged from 39 to 64 years[mean 54*8.0 years]. Of the 6 patients, 5 suffered from unstable angina, 1 suffered from stable angina. Selective coronary angiography revealed a significant stenosis of the left anterior descending artery in 6 cases, of its diagonal branch in 1 case, of the right coronary artery in 1 case, the circumflex artery in 1 case, and of its obtuse marginal branch in 1 case. The mode of anastomosis were single saphenous vein graft in 3 cases, single left internal mammary artery graft in 1 case, double saphenous vein graft with sequential anastomosis in 1 case, and left internal mammary artery plus saphenous vein graft in 1 case. Of these, 6 grafts to left anterior descending artery were done. There was no operative death, but perioperative myocardial infarction was happened in 1 case. All survivors were free of angina and discontinuing medical therapy during the follow up period[mean 7.8*5.15 months].

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Surgical treatment of unstable angina -Experience in 6 patients- (불안정형 협심증의 외과적 치료 -6예 경험-)

  • 조형곤
    • Journal of Chest Surgery
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    • v.19 no.4
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    • pp.595-605
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    • 1986
  • From February 1986 through September 1986, the authors have experienced 6 cases of coronary artery bypass graft for patients with unstable angina. There were five males and one female who ranged from 39 to 65 years [mean, 53.3 years]. The extent of coronary disease was as follows: one-, two- and three-vessel diseases, all 2 cases respectively, and among them, 1 case had left main disease. Distal anastomoses were performed first with using saphenous vein grafts as conduits in all cases and sequential bypass methods were employed in 5 cases. Numbers of vein grafts were two in 2 cases and one in 4 cases. The mean time wasted for one distal anastomosis was 36 minutes. Post operative complications were leg-wound disruption [2 cases], transient psychosis [1 case] and perioperative myocardial infarction [MI] [1 case]. Sixty three year-old male patient associated with cardiomegaly, prior MI, ventricular arrhythmia, cardiac dysfunction and endocrinologic diseases preoperatively was expired in the operating room due to perioperative Ml. All survivors were asymptomatic and on discontinuing medical therapy on follow-up varying from 1 to 8 months.

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Advanced Technologies and Mechanisms for Yeast Evolutionary Engineering

  • Ryu, Hong-Yeoul
    • Microbiology and Biotechnology Letters
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    • v.48 no.4
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    • pp.423-428
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    • 2020
  • In vitro evolution is a powerful technique for the engineering of yeast strains to study cellular mechanisms associated with evolutionary adaptation; strains with desirable traits for industrial processes can also be generated. There are two distinct approaches to generate evolved strains in vitro: the sequential transfer of cells in the stationary phase into fresh medium or the continuous growth of cells in a chemostat bioreactor via the constant supply of fresh medium. In culture, evolutionary forces drive diverse adaptive mechanisms within the cell to overcome environmental or intracellular stressors. Especially, this engineering strategy has expanded to the field of human cell lines; the understanding of such adaptive mechanisms provides promising targets for the treatment of human genetic diseases and cancer. Therefore, this technology has the potential to generate numerous industrial, medical, and academic applications.

Favorable Outcome in Elderly Asian Patients with Metastatic Renal Cell Carcinoma Treated with Everolimus: The Osaka Urologic Oncology Group

  • Inamoto, Teruo;Azuma, Haruhito;Nonomura, Norio;Nakatani, Tatsuya;Matsuda, Tadashi;Nozawa, Masahiro;Ueda, Takeshi;Kinoshita, Hidefumi;Nishimura, Kazuo;Kanayama, Hiro-Omi;Miki, Tsuneharu;Tomita, Yoshihiko;Yoshioka, Toshiaki;Tsujihata, Masao;Uemura, Hirotsugu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1811-1815
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    • 2014
  • Background: In clinical trials with no upper age limit, the proportion of older patients is usually small, probably reflecting the more conservative approach adopted by clinicians when treating the elderly. An exploratory analysis of elderly patients in the RECORD-1 Trial showed that patients ${\geq}$ 65 y.o. had superior median PFS than overall RECORD-1 population (5.4 months and 4.9 months, respectively). We investigated the efficacy, relative benefit and safety of Everolimus (EVE) as sequential therapy after failure of VEGFr-TKI therapy for older patients with metastatic renal cell cancer (mRCC), in daily practice. Materials and Methods: 172 consecutive IRB approved patients with mRCC (median age 65, M:F 135/37, 78% clear cell) who received salvage EVE at 39 tertiary institutions between October 2009 and August 2011 were included in this analysis. Some 31% had progressed on sunitinib, 22% on sorafenib, 1% on axitinib, 41% on sequential therapy, and 5% had received other therapy. Patients with brain metastases were not included and 95% of the patients had a ECOG (Eastern Cooperative Oncology Group) performance status (PS) of 0 or 1. Previous radiotherapy was an exclusion criterion, but prior chemotherapy was permitted. Adequate organ function and hematologic parameters were mandatory. EVE administration was approved by the institutional review board at each participating institution and signed informed consent was obtained from all patients. Results: Median time of the whole cohort to last follow-up was 3.5 months (range 0.4-15.2 months). Forty four percent were continuing to take EVE at last followup. There were 86 (50%) patients ${\geq}$ 65 y.o. and 86 (50%) <65 y.o. The percentage of patients who showed PR/SD was higher in the older group than in the younger one (5.9%/61.2% vs 1.2%/46.5%, respectively). Median survival of older patients was also significantly longer (3.5 +/- 0.31 vs 3.1 +/- 0.34, hazard ratio=0.45, CI; 0.255-0.802). Analysis using Cox regression model adjusted for gender, PS, number of metastases, site of metastases, histology, smoking history and age detected an association between age and PFS (p=0.011). The frequency of adverse events in elderly patients treated with EVE was no greater than that in younger patients, although such toxicity may have had a greater impact on their quality of life. Conclusions: Older patients should not generally be excluded from accepted therapies (mTOR inhibitors after failure of VEGFr-TKI therapy) for mRCC.