• Title/Summary/Keyword: Therapeutic index

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Evidence-based approach for herbal medicine-safety classification : Human equivalent dose-based the margin of safety (한약의 안전성 등급화를 위한 evidence-based approach : Human equivalent dose-based the margin of safety)

  • Park, Yeong-Chul;Lee, Sundong
    • Journal of Society of Preventive Korean Medicine
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    • v.17 no.3
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    • pp.19-30
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    • 2013
  • This study was aimed to develop a new formula for herbal medicine-safety classification in terms of evidence-based medicine. Recently, human equivalent dose(HED)-based therapeutic index was developed for herbal medicine-safety classification by transforming $LD_{50}$ to HED. However, the use of the $ED_{50}$ and $LD_{50}$ to derive the therapeutic index may be misleading as to safety, depending on the slope of the dose-response curves for therapeutic and lethal effects. To overcome this deficiency, HED-based MOS(Margin of Safety)was developed and suggested in this study. The HED-based MOS developed by using $LD_1$, changing to ALD(approximate lethal dose), and $ED_{99}$. The HED-based MOS seems to be more useful and safer than HED-based therapeutic index since its values for several herbal medicines are basically two times less than the values from HED-based therapeutic index. Thus, HED-based MOS can be a good example of Evidence-based approach for herbal medicine-safety classification.

Development of human tumor necrosis factor-α muteins with improved therapeutic potential

  • Jang, Seung-Hwan;Kim, Hyo-Jin;Cho, Kwang-Hwi;Shin, Hang-Cheol
    • BMB Reports
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    • v.42 no.5
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    • pp.260-264
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    • 2009
  • Tumor necrosis factor-$\alpha$ (TNF-$\alpha$) exhibits cytotoxicity towards various tumor cells in vitro and induces apoptotic necrosis in transplanted tumors in vivo. It also shows severe toxicity when used systemically for the treatment of cancer patients, hampering the development of TNF-$\alpha$ as a potential anticancer drug. In order to understand the structure-function relation of TNF-$\alpha$ with respect to receptor binding, we selected four regions on the bottom of the TNF-$\alpha$ trimer that are in close contact with the receptor and carried out mutagenesis studies and computational modeling. From the study, various TNF-$\alpha$ muteins with a high therapeutic index were identified. These results will provide a structural basis for the design of highly potent TNF-$\alpha$ for therapeutic purposes. By conjugating TNF-$\alpha$ muteins with a high therapeutic index to a fusion partner, which targets a marker of angiogenesis, it could be possible to develop TNF-$\alpha$ based anticancer drugs.

The Effect of Combined Suboccipitalis Release Exercise and Therapeutic Ultrasound on Mechanical Properties of Cervical Muscles and Neck Disability Index, Headache Impact Test in Tension-Type Headache Patients (초음파치료를 동반한 뒤통수밑근 이완운동이 긴장성 두통 환자의 근육의 기계적인 특성과 목 장애 지수, 두통 영향 검사에 미치는 영향)

  • Park, Seung-Kyu;Park, Sam-Heon
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.4
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    • pp.271-281
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    • 2021
  • Purpose : This study aimed to apply muscle relaxation exercise and ultrasound therapy as an effective treatment method for tension headache patients by comparatively analyzing the muscle mechanical properties, neck disorder index, and headache impact test. Method : The subjects were classified into three groups based on the intervention received: the therapeutic ultrasound (n=15, group I), placebo therapeutic ultrasound combined with the suboccipital release (n=15, group II), and therapeutic ultrasound combined with suboccipital release (n=15, group III) groups. The intragroup and intergroup differences in muscle mechanical properties, neck disability index, and headache impact test were compared and analyzed. Result : The comparison and analyses of the changes in muscle tone and post hoc analysis revealed statistically significant intragroup decreases in the suboccipitalis and upper trapezius in groups I and III. Furthermore, statistically significant intergroup differences in the upper trapezius with a greater change in group III than in group II and suboccipitalis with greater changes in group III than in groups I and II were observed. The comparison and analyses of the changes in muscle stiffness and post hoc analysis revealed statistically significant intragroup decreases in the upper trapezius in group I and suboccipitalis in group III. Moreover, statistically significant intergroup differences in both muscles with greater changes in group III than in group II for both cases were observed. The comparison and analyses of the changes in the neck disability index and post hoc analysis revealed statistically significant intragroup decreases in all three groups and statistically significant intergroup differences with greater changes in group III than in groups I and II. The comparison and analyses of the changes in the headache impact test and post hoc analysis revealed statistically significant intragroup decreases in all three groups and a statistically significant intergroup difference with greater changes in group III than in groups I and II. Conclusion : The therapeutic ultrasound and suboccipital muscle release exercise effectively increased the flexibility of the muscles around the cervical vertebrae and reduced muscle tension and stiffness in tension-type headache patients.

Comparison of Sensorimotor Training using Chin-Tuck Exercise with Therapeutic Stretching Training on Neck Pain and Mobility in Individuals with Chronic Non-Specific Neck Pain: A pilot randomized controlled trial

  • Kim, Chang-Yong;Kim, Hyeong-Dong
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.2
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    • pp.29-40
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    • 2019
  • PURPOSE: Despite the widespread occurrence in the general population, few studies have directly evaluated the effects of shingles on non-specific neck pain (NSNP). This study investigated whether sensory training or therapeutic stretching exercises are more effective in increasing neck mobility and reducing neck pain in chronic NSNP patients. METHODS: Eighty-one subjects aged between 20 and 32 years with chronic neck pain (> six months), were allocated randomly to three groups: sensorimotor training group (STG), therapeutic stretching group (TSG), and home exercise group (HEG). All participants received a half-hour training session, three times weekly for six weeks. The outcomes were evaluated using the neck disability index for measuring neck pain, and a universal goniometer to measure the cervical passive range of motion before and after the six-week intervention. RESULTS: The post-test neck disability index scores in the STG (t = 4.86) and TSG (t = 3.24) were decreased significantly (p < .05). The passive range of motion changes in all cervical movements in the STG was increased significantly (p < .05) after intervention compared to those in the other two groups. CONCLUSION: Sensorimotor training using chin tuck exercises may improve neck pain and mobility in subjects with chronic NSNP.

Longitudinal Motor Function Recovery in Stroke Patients with Focal Pons Infarction: Report of 4 cases (국소 교뇌 경색으로 인한 뇌졸중 환자에서 장기적인 운동기능 회복에 관한 사례보고)

  • Park, Ji-Won
    • The Journal of Korean Physical Therapy
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    • v.21 no.4
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    • pp.111-115
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    • 2009
  • Purpose: The aim of this study was to present fundamental information regarding clinical prognosis and clinical criteria for therapeutic intervention in stroke patients with focal pons infarction. Methods: Four stroke patients (male: 2, female: 2) who were diagnosed with pons infarction were recruited. All subjects had motor functions evaluated using methods such as the Motricity Index (MI), the Modified Brunnstrom Classification (MBC), Functional Ambulatory Category (FAC), and the Bathel Index (BI). Evaluations were done at least 4 times over a period that was approximately 8~11 months from stroke onset. We compared the final evaluation with the first evaluation. Results: All patients with focal pons infarction showed improvement with time in motor function. The physical strength of all patients was improved to normal or good grades from zero or trace grades in the Motricity Index test. Also, other motor functions such as ambulatory capacity and activities of daily living (ADL) improved with time. Conclusion: Aspects of functional recovery and clinical prognosis are clearly predictable for specific patients with focal pons infarction. In addition, adequate therapeutic interventions can be provided clinical criterion to patients, according to aspect of functional recovery. Accordingly, patients with pons infarction change for the better over time.

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A Daylighting Design Indicator for Korean Dementia Nursing Homes Based on the Therapeutic Effects of Light - Focusing on maximizing daylight availability, optimizing therapeutic views, and minimizing glare (빛에 의한 치료적 효과 기반의 한국형 치매요양시설의 자연채광 계획지표 개발 - 주광 가용성 최대화, 치료적 조망 최적화 및 현휘 최소화 지표 중심으로)

  • Jee, Soo In
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.29 no.1
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    • pp.29-42
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    • 2023
  • Purpose: This study aimed to develop a daylighting design indicator for Korean dementia nursing homes based on the therapeutic effects of light, focusing on the serious aging index facing Korea and the importance of natural light that occupies the most important position in the therapeutic environments for the elderly with dementia. Methods: A wide range of literature-oriented research methods were mobilized to develop the daylighting design indicator of Korean dementia nursing homes. Results: The daylighting design indicator of Korean dementia nursing homes was derived from three perspectives: maximizing daylight availability, optimizing therapeutic view, and minimizing glare. In addition, eighteen basic indicators were derived within seven indicator items in the range of building layout, windows, glazing, shading devices, spaces, interior finishings, and daylight factor. Implications: The daylighting design indicator of Korean dementia nursing homes revealed in this study will contribute to realizing Korean dementia nursing homes as a therapeutic environment for the elderly with dementia.

The Effects of Manual Therapy and Therapeutic Exercise in Patient with Acute Lumbar Sprain: Case Study (급성 요추염좌에 대한 도수치료와 치료적 운동이 미치는 효과 : 단일사례연구)

  • Lee, Nam-Yung;Song, Hyun-Seung;Kwon, Chun-Suk
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.20 no.2
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    • pp.35-42
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    • 2014
  • Background: The purpose of this study was to effect of the manual therapy and pelvic floor muscle exercise interventions in patient with acute lumbar sprain. Based on this, proceed to present an effective physical treatments. Methods: Subject was 55 year old female patient with acute lumbar sprain. Subject was damaged, wash in the morning. Subject was hoping to return to work and Activity daily living (ADL) without pain. I proceed in order screening, evaluation, diagnosis, prognosis, treatment planning and intervention, re-screening. To solving problem, was conducted in parallel to a manual therapy and therapeutic exercise. Results: To investigate changes in body functions and activities was measured, Visual analog scale (VAS) and Oswestry disability index (ODI), changes in posture, maintain in posture, 10m walk test. The improved results were compared before and three weeks after mediation interventions. Conclusions: Frequency manual therapy and pelvic floor muscle exercise is thought to be an efficient way of patients with acute lumbar sprain.

The Effects of Group Rehabilitation Exercise and Physical Education Program on Local Community Stroke Patient's Walking Function, Balance Index and Muscle Strength in the Knee Joint (그룹 재활운동 및 체육 프로그램이 지역사회 뇌졸중 장애인의 보행기능, 균형지수 및 무릎관절 근력에 미치는 영향)

  • Lee, Hyongsoo;Kim, Yoonhwan
    • Journal of The Korean Society of Integrative Medicine
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    • v.6 no.4
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    • pp.15-27
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    • 2018
  • Purpose : This study aims to present a rehabilitation exercise and physical education program (REPEP) for local community stroke patients by examining an exercise program provided from traditional physical therapeutic perspectives. Methods : The subjects were 40 stroke patients residing in a local community and managed by a public health center (the group-exercise group: 20, the individual-exercise group: 20). In the case of the group-exercise group (GEG), the subjects were divided into small groups composed of five members each to participate in the program. The individual-exercise group (IEG) took part in the program individually. The subjects received a REPEP that included a warm-up exercise, an elastic band exercise, a leg exercise, a balance and gait exercise, an arm and trunk exercise, and a cool-down exercise twice per week for 20 weeks. They had their gait function, balance index, and muscle strength in the bilateral knee joints tested before and after the experiment. Results : Compared to before the experiment, both groups' gait function, balance index, and muscle strength in the knee joints increased after the experiment. After the experiment, the GEG experienced more improvement in their gait function, balance index, and muscle strength in the bilateral knee joints, excluding their gait velocity and $300^{\circ}/sec$ flexion and extension, than the IEG (p<.05). Conclusion : An exercise program provided from the traditional physical therapeutic perspectives may be applied to stroke patients as their REPEP. In addition, a REPEP was more effective in improving their gait function, balance index, and muscle strength in the knee joints when the subjects formed a group and took part in the program than when they partook in it individually.

A Case Study of a Serious Antibiotics-associated diarrhea Patient Treated with Modified Hyangsayukgunja-tang (중증 항생제 유발 설사 환자에 대한 향사육군자탕(香砂六君子湯) 가감방(加減方) 투여 1예)

  • Park, Soim;Kang, Da-Hyun;Seo, Ho-Seok;Kim, Jin-Won
    • Herbal Formula Science
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    • v.22 no.2
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    • pp.121-131
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    • 2014
  • Objectives : The purpose of this study is to report a therapeutic effects of a Korean herbal prescription for antibiotics-associated diarrhea. Methods : Modified Hyangsayukgunja-tang was prescribed once or twice a day to a antibiotics-associated diarrhea patient. To observe the therapeutic effects, the frequency of defecation was counted and Bristol Stool Form Index was used. Laboratory tests were conducted periodically. Results : The frequency of defecation was decreased from 9 times a day to once a day. According to Bristol Stool Form Index, stool form was improved from Type 7 to Type 5. The level of red blood cell, hemoglobin and albumin increased slightly from the day of admission to discharge. Conclusions : Hyangsayukgunja-tang can be a choosable treatment option for a serious antibiotics-associated diarrhea.

Changes in Gait Patterns after Physical Therapy in Patients with Non-specific Chronic Low Back Pain: a Pilot Study

  • Song, Seonghyeok;Cho, Namjeong;Kim, Hyun-Joong
    • Physical Therapy Rehabilitation Science
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    • v.11 no.1
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    • pp.105-112
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    • 2022
  • Objective: Nonspecific low back pain (NS-LBP) causes pain and disability, affecting the neuromuscular system and altering gait patterns. The purpose of this study is to investigate the effect of improvement of low back pain symptoms through physical therapy on foot pressure and spatiotemporal gait parameters. Design: A pilot study. Methods: Participants received manual therapy and supervised therapeutic exercise, which consisted of 12 sessions for 6 weeks. Participants were assessed for pain intensity (a numeric pain rating scale), disability index (oswestry disability index), and spatiotemporal gait parameters before and after intervention. Wilcoxon signed rank test was used to analyze the before-and-after differences in a single group. Results: All seven NS-LBP patients completed the study without dropout. After six weeks of physical therapy, the numeric pain rating scale and oswestry disability index showed significant improvement (Z= -2.388, P=0.017). There was no significant improvement in both static and dynamic conditions in foot pressure (P>0.05). However, in the spatiotemporal gait parameters, there were significant differences in all variables except the right stance phase and left mid stance (P<0.05). Conclusions: In our pilot study, 12 sessions of physical therapy in NS-LBP patients improved gait quilty in spatiotemporal gait parameters. Similarly, it has resulted in clinically positive improvements in pain and disability.