• Title/Summary/Keyword: Treatment Efficacy

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The Evaluation of Teicoplanin Usage in a University Hospital (대학병원에서의 Teicoplanin의 사용 현황 조사 및 실태 평가)

  • Kim, Eun A;Oh, Jung Mi
    • Korean Journal of Clinical Pharmacy
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    • v.11 no.1
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    • pp.19-29
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    • 2001
  • Teicoplanin, a glycopeptide antibiotic, has potential for use as an alternative to vancomycin in the treatment of gram-positive bacterial infections. However, unlike vancomycin, there is a lack of study on teicoplanin's efficacy and safety and the guideline for its use is not available, yet. The objective of this study was to investigate and evaluate the pattern of teicoplanin usage in a university hospital. A retrospective study was performed on 72 adult patients, who took teicoplanin for 3 continuous days at D. University hospital from 1 January 1999 to 30 June 2000. The microorganisms treated with teicoplanin were methicillin-resistant Staphylocorcus aureus $(69\%)$, coagulase-negative Staphylococci $(12\%)$, Enterococcus $(4\%)$, vancomycin-resistant Enterococci $(2\%)$, Streptococci $(2\%)$, and Bacillus $(1\%)$. The types of infection treated with teicoplanin were surgical wound infection $(58\%)$, lower respiratory infection $(11\%)$, bactremia $(7\%)$, urinary tract infection $(5\%)$, pleural fluid infection $(4\%)$, and peritoneal fluid infection $(2\%)$. The mean duration of teicoplanin usage was 16.5 days and teicoplanin was used with 1.4 other antibiotics, which were aminoglycosides (isepamicin, amikacin, netilmicin, astromicin) or quinolones (ciprofloxacin, tosufloxacin) or the third generation cephalosporin (ceftazidime). Only 24 cases $(28.6\%)$ met with the criteria for the justification of use, and the rest of 60 cases $(71.4\%)$ did not meet the criteria. In 84 cases $(100\%)$, blood culture tests were performed prior to the initial dose of teicoplanin. In 83 cases $(99\%)$, serum creatinine were conducted before the initial doses. In 45 cases $(53.6\%)$, serum creatinine was monitored at least twice weekly. In 55 cases $(65.5\%)$, WBC was tested at least twice weekly. In 84 cases $(100\%)$, body temperature was monitored at least once per nursing shift. In 15 cases out of 56 cases, maximum temperature decreased at least 1 degree within 3 days of teicoplanin use. In 15 case out of 35 cases, WBC values were within the normal range after treatment. In 23 cases $(27.4\%)$, dosage regimen was appropriate. Drug-related adverse effects were reported in 13 cases. Nephrotoxicity (progressively increasing SCr. or sustained SCr increase of $\geq$0.5 mg/dl from baseline) was noted in five cases. Neutropenia (absolute neutrophil count <1,500 $cells/mm^3$) was noted in one case and eosinophilia (total eosinophil count >350 $cells/mm^3$) was noted in seven cases. A more strict control on use of teicoplanin is required, considering that teicoplanin is categorized as one of restricted antibiotics.

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Promotion Directions of Spa Industry Using Local Resources in Jeju Island, Korea (제주도 향토자원을 활용한 스파산업 육성방향)

  • Yoon, Hye Yung
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.8 no.1
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    • pp.69-78
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    • 2013
  • Settled lifestyle as important to health and healing to medical tourism and wellness tourism in the 21st century has emerged as the best promising service industry. Jeju Island has a variety of local resources, and the directions was considered to spa industry promotion application it. Jeju Island has a variety of local resources which can be used for spa industry promotion. Jeju Island's beautiful natural environment, mineral resources, water resources, biological resources, agricultural products, traditional folk remedies available in Jeju's spa treatments. Using the local resources of Jeju, 'Jeju specialized spa treatments' can develop of 12 kinds of spa treatments. Namely, thalssotherapy, stone therapy, black sand poultice, hot-floored therapy using volcanic soil, thalassotherapy, drinking therapy, hydrotherapy, herbal/medicinal plants poultice, forest therapy, Spa cuisine, facial beauty, diet therapy. 12 kinds of Jeju specialized spa treatments development and service to the local resources of basic research on the physical and chemical characteristics, product development, clinical trials, efficacy studies should precede. In addition, customized spa services programs should be developed considering the propensity of customers, customer needs, and a spa type. And standardized program of spa services and need a manual painter. Medical tourism and wellness tourism in conjunction with efforts to be considered in order to increase the competitiveness of the spa industry in Jeju.

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Effects of Ibuprofen and Indomethacin for Prophylaxis of Patent Ductus Arteriosus in Premature Infants (미숙아 동맥관 개존증의 예방적 치료로서 Indomethacin과 Ibuprofen의 효과)

  • Jeon, Bok-Seon;Kwon, Kyung-Ah;Park, Kyung-Hee;Byun, Shin-Yun;Kim, Myo-Jing
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.228-233
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    • 2011
  • Purpose: The aim of our study was to compare the efficacy and safety of ibuprofen and indomethacin in the prophylaxis of patent ductus arteriosus (PDA) in preterm infants and to determine whether ibuprofen could be an alternative agent in prophylactic use. Methods: A retrospective study including 37 preterm infants <1,500 g of birth weight, <34 weeks of gestation, whom were administrated indomethacin (n=17; January 2009-December 2009) or ibuprofen (n=20; January 2010-February 2011) within 24 hr after birth was conducted. The rate of ductal closure, need for surgical ligation, clinical outcomes such as necrotizing enterocolitis, intraventricular hemorrhage, bronchopulmonary dysplasia, retinopathy of prematurity (ROP) and death rate were compared. Results: There were no statistically significant differences between the two groups in mean gestational age, mean birth weight, Apgar score, sex, type of delivery, maternal dexamethasone treatment, frequency and duration of ventilator and surfactant treatment. The closure of PDA on day 7 of life was in 19 of 20 infants of the ibuprofen group and 13 of 17 infants of the indomethacin group (P=0.159). Between the two groups, there were no significant differences with respect to clinical outcomes. Conclusion: Ibuprofen has similar effects to indomethacin in the rate of PDA closure. Our study demonstrates that prophylactic ibuprofen is relatively effective without significant differences with respect to clinical outcomes compared with indomethacin. Therefore, ibuprofen may be used as an alternative agent in the prophylaxis of PDA in preterm infants.

Mineral Medicine Described in the Oriental Medicine Book and Mineral Medicines Applicable to Atopic Dermatitis Treatment (한의서에 기재된 광물(鑛物) 약재 및 아토피피부염 활용 외용성 광물(鑛物) 약재)

  • Bak, Jiwon;Kim, Donghee
    • Economic and Environmental Geology
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    • v.48 no.3
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    • pp.231-240
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    • 2015
  • A total of 93 mineral medicines are mentioned in the Chinese Bonchodogam(本草圖鑑). In Donguibogam(東醫寶鑑), 77 mineral medicines are listed, where 18 are from soil origin, 4 from gem origin, and 55 mineral medicines were originated from stone. In the Herblogy(本草學), which is the textbook used in most oriental medicine colleges in Korea, a total of 23 mineral medicines are listed. Of those, Cinnabaris, Alumen, Melanteritum, Realgar, Orpimentum, Sulfur, Lime from Donguibogam, additional eight which are Talcum, Calomelas, Minium, Calamina, Stannum, Hydrargyrum, Lithargyrum, Hydrargyrum Chloratum from Bonchodogam and Gypsum, Natrii Sulfas, Talcum, Cinnabaris, Sulfur, Arsenicum Sublimatum, Realgar, Calomelas, Minium, Calamina, Borax, Aurum, Glauberitum from Herblogy were selected as the mineral medicine applicable as external atopic dermatitis treatment. Most of the mineral medicines were generally regarded as toxic materials, and therefore, they were elaborately processed to remove toxicity before use. In accordance, it is necessary to discuss how to effectively remove toxicity from toxic mineral medicines. In addition, detoxification can be applied to those mineral medicines classified based on the index material or high content compounds, and if efficacy can be evaluated through various analytical methods, this can be applied to diverse inflammatory diseases as well as atopic dermatitis.

Therapeutic Effect of Oncolytic Herpes Simplex Virus on Induced Radioresistant Head and Neck Squamous Cell Carcinoma (방사선 치료에 내성이 유도된 두경부 편평세포암에 대한 종양살상 헤르페스 바이러스의 유전자 치료 효과)

  • Kim, Se-Heon;Choi, Eun-Chang;Lee, Jin-Seok;Chun, Je-Young;Byun, Hyung-Kwon;Song, Ki-Jae;Kim, Kwang-Moon
    • Korean Journal of Head & Neck Oncology
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    • v.22 no.2
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    • pp.130-136
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    • 2006
  • Introduction : The sensitivity of tumor cells to radiotherapy is a critical determinant of local control and potential cure in advanced head and neck squamous cell carcinoma(HNSCC). The emergence of radioresistant tumor cells is an obstacle to cancer therapy. Most radioresistant cells have a higher proportion of cells in the Sphase of the cell cycle and a lower apoptotic fraction than radiosensitive cells. HSV replication is increased in cells that have higher S-phase fractions. NV1066 is an oncolytic herpes simplex virus type-1 mutant. We hypothesized that NV1066 replication and cytotoxicity are increased in radioresistant cells. The purpose of this study is to evaluate the antitumor efficacy of NV1066 to treat radioresistant HNSCC. Methods : Radioresistant cells were selected by treating five HNSCC cell lines with repeated conventional fractionated doses of radiation(2Gy/day), using a Cs-137 irradiator, up to a cumulative dose of 70Gy. Clonogenic cell survival and S-phase fractions were compared between radioresistant and parental radiosensitive cells. The two cell populations were then treated with NV1066 to examine viral replication, by the viral plaque assay and viral cytotoxicity. Results : Fractionated irradiation resulted in the selection of radioresistant cells. Radioresistant cells had a higher S-phase fraction(42.9%) compared to parental cells(26.2%). NV1066 replication in radioresistant cells was 7.4 times higher than in parental cells(p<0.01). Treatment with NV1066 resulted in increased cytotoxicity of 24.5% in radioresistant cells compared to parental cells(p<0.05). Conclusion : NV1066 showed increased viral replication and cytotoxicity in radioresistant HNSCC cell lines. These findings suggest a potential clinical application for this oncolytic viral therapy as treatment for radioresistant head and neck cancers.

Radiation Therapy Combined with Cisplatin Based Chemotherapy for the Patients with Locally Advanced Nasopharyngeal Cancer (국소 진행된 비인강암의 방사선-항암제 병용요법)

  • Son, Seok-Hyun;Kim, Ji-Yoon;Kim, Sung-Whan;Mun, Seong-Kwon;Cho, Seung-Ho;Park, Young-Hak;Hong, Young-Seon;Kim, Yeon-Sil
    • Korean Journal of Head & Neck Oncology
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    • v.22 no.2
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    • pp.123-129
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    • 2006
  • Objective : This retrospective study was designed to evaluate the anti-tumor efficacy and toxicities of the radiation therapy(RT) combined with cisplatin-based chemotherapy in locally advanced nasopharyngeal cancer(NPC). Materials and Methods : Fifty three patients with locally advanced NPCs(AJCC stage II, III, IV) received curative RT and cisplatin-based chemotherapy. Duration of follow-up ranged from 5.5 to 201 months(median 50.8 months). Nineteen patients(35.8%) were treated with induction chemotherapy including cisplatin $100mg/m^2$ for 1 day and 5-fluorouracil $1g/m^2$ for 5 days followed by RT(Induction CTx-RT). Another 34 patients (64.2%) were treated with concurrent chemoradiation(CCRT) using cisplatin $100mg/m^2$(D1, 22, 43). Results : Thirty-six(67.9%) and 11(20.8%) patients achieved clinical complete response and partial response, respectively. The pattern of failure was as follows:14 locoregional recurrence(26.4%) and 7 distant metastasis(13.2%). Among them, two patients(3.8%) had both locoregional and distant failure. Median overall survival(OS) and progression-free survival(PFS) were 85.5 months and 87.5 months, respectively. Five-year OS rate was 57.1%. The stage(AJCC), tumor response to chemoradiation and T stage were significant prognostic factors for OS(p=0.0113, p=0.0362 and p=0.0469). The stage(AJCC), tumor response to chemoradiation were also significant prognostic factors for PFS(p=0.0329, p=0.0424). Compared to each treatment group(Induction CTx-RT vs. CCRT), there were no significant differences in OS and PFS(p=0.7000, p=0.8261). Grade 3-4 mucositis, nausea/vomiting and hematological toxicities were noticed in 35.8%, 11.3% and 13.2%, respectively. Delayed RT over 2 weeks was inevitable in 26.5%. Seventeen patients(50%) successfully completed planned 3 courses of cisplatin in CCRT group. Conclusions : RT combined with cisplatin-based chemotherapy in locally advanced NPC showed high response rate, good locoregional control, and survival rate. As expected, frequency of acute toxicities increased, and the patient's compliance to treatment was need to be improved. Although our data could not show additional survival benefit of CCRT compare to that of induction chemotherapy followed by RT, patients' accrual and further follow-up are required due to limitation of retrospective study.

The Effects of Occupational Therapy Intervention Using Fully Immersive Virtual Reality Device on Upper Extremity Function of Patients With Chronic Stoke: Case Study (완전 몰입형 가상현실 기기를 이용한 작업치료 중재가 만성 뇌졸중 환자의 상지기능에 미치는 영향: 사례연구)

  • Han, Soul;Yoo, Eun-Young
    • Therapeutic Science for Rehabilitation
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    • v.7 no.2
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    • pp.17-27
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    • 2018
  • Objective : The purpose of this study was to investigate the effect of occupational therapy intervention using a fully immersive virtual reality device on the upper extremity function of patients with chronic stroke. Methods : This study used a single subject (ABA) design. The study subjects was a chronic stroke patient with left lateral deviation. Four baseline periods, 12 intervention periods, and 4 baseline regression periods were performed for a total of 20 sessions for 10 weeks. OT intervention with a fully immersive virtual reality device was used every 30 minutes. BBT and WMFT evaluations were performed at each session and the results were displayed in a line graph. Results : The patient's upper limb function has improved. During baseline recurrence, efficacy of treatment was confirmed after removal of intervention, but no significant changes were observed. Conclusion : It has been found that OT intervention with a fully immersive virtual reality device for upper limb function in chronic stroke patients is an effective intervention. However, the effectiveness of maintaining treatment is not important, so we need to develop an easy-to-use home intervention program.

Prospective Observation Study on Hyperthyroidism Patients Treated with Korean Medicine (한의치료를 받은 갑상선 기능 항진증 환자에 대한 전향적 관찰연구)

  • Choi, Yu-jin;Shin, Seon-mi;Han, Yang-hee;Ahn, Se-young;Cho, Chung-sik
    • The Journal of Internal Korean Medicine
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    • v.39 no.1
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    • pp.84-96
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    • 2018
  • Objective: This is aprospective clinical case study that includes the administration of Ahnjeonbaekho-tang (AJBHT) to patients who have suffered from Graves' disease for the 8 weeks of the clinical research. Methods: Without administration of an antithyroid drug, AJBHT was administered 3 times a day for 8 weeks. In Case 1, AJBHT without modification was administered and in Case 2, in accordance with the patients' symptoms, a dose of Gypsum Fibrosum was increased by 4g from the beginning of week 2, and further increased by 16 g, for a total of 20 g between week 6 and week 8. Body mass index (BMI), thyroid function test (TFT), thyroid autoantibody test, complete blood cell count (CBC), and blood chemistry (BC) tests were conducted at an interval of 4 weeks, for a total of 3 times during the study. The clinical manifestations, a spectrum of symptoms of the patients, was observed by Wayne's Index, Euro-QOL-5 Dimension (EQ-5D), and Perceived Stress Scale (PSS). Results: In both cases, an acceptable significance of reduction of value in T3, fT4, Thyroid stimulating antibody (TSAb) and Thyroid stimulating hormone receptor antibody (TSH-R-Ab) was observed. After treatment, in TFT, T3 decreased by 31.66%, fT4 decreased by 32.82% in Case 1, and T3 decreased by 43.42%, and fT4 decreased by 37.32% in Case 2. In the thyroid autoantibody test, TSAb decreased by 7.59%, and TSH-R-Ab decreased by 53.19% in Case 1, and TSAb decreased by 33.45%, TSH-R-Ab decreased by at least 7.75% in Case 2. Besides this, there was a decreasing trend of Wayne's index, and a loss of typical symptoms of hyperthyroidism also declared the efficacy. Conclusion: From these results, AJBHT is very effective in the regulation of TFT and improving the symptoms of hyperthyroidism, and is also expected to be an effective alternative to antithyroid drugs for patients who have side effects or drug intolerance.

Ameliorating Effects of the Cognitive-Enhancing Korean Herbs on Neurotoxic-Induced Amnesia in Rats (새로운 제형의 치매치료제제의 효능연구)

  • Kim Ji Hyun;Jung Jin Yong;Chae Yoon Byung;Hahm Dae Hyun;Park Yang Jin;Lee Hye Jung;Shim Insop
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.2
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    • pp.303-310
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    • 2002
  • Ancient Korean physicians have used several oriental herbs to cure dementia and these effects were described in the Korean herbal books. Some cognitive-enhancing oriental herbs have been widely used as a herbal medicine against dementia. However, few of studies have proved their efficacy in treatment for dementia. In the present study, we investigated the effects of herbal compounds, which are mainly consisted of Uncaria sinensis, Corydalis yanhusuo and Acorus gramineus on learning and memory in Mortis water maze task and the central cholinergic system of the rats with neurotoxic medial septum lesion. In water maze test, the animals were trained to find a platform in a fixed position during 6 days and then received a 60-s probe trial in which the platform was removed from the pool on the 7th day. Ibotanic and 192 saporin lesion of the medial septum (MS) impaired the performance of maze test and degenerated choline acetyltransferase (ChAT) in the brain, which is a marker of the central cholinergic system. Daily administrations of herbal medicine (100mg/kg, p.o.) for 21 consecutive days produced significant reversals of the neurotoxic-induced deficit in learning and memory. These treatments also reduced the loss of cholinergic immunoreactive neurons in the brain induced by neurotoxin. These results demonstrated that herbal compounds ameliorated learning and memory deficits through effects on the central nervous system, partly through effect on the acetylcholine system. Our studies suggest an evidence of these herbs as treatment of Alzheimer's disease.

Screening of the Biologoical Activity from Water Extracts of the Medicinal Plants and the Protective Effect of R. palmatum on MTPT-induced Neurotoxicity (한약재 물 추출물의 생리활성 검색 및 MPTP-유도 신경독성에 대한 대황의 보호효과)

  • Kim Tae Eun;Yoon Yeo Min;Park Yong In;Kim Youn Seok;Jeon Byung Hun;Kim Myung Dong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.6
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    • pp.1666-1685
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    • 2004
  • This present study was designed to screen medicinal plants for the treatment of brain diseases such as Parkinson's disease or aging. We tested the effects of the water extracts from 38 species medicinal plants on antioxidant capacity, monoamine oxidase B (MAO-B) inhibitory activity, acetylcholinesterase (AChE) inhibition and antiperoxidation activity in vitro. The water extracts from 38 species were tested on their antioxidant activity using radical scavenging effects against ABTS+. The water extract of C. sappan was showed the highest antioxidant capacity, the antioxidant activity at 1 Jig of herbal extract being 0.38mM TE. Lipid peroxidation in brain homogenates induced by NADPH and ADP-Fe/sup 2+/ was strong inhibited by C. sappan and R. palmatum extracts. Among the 38 medicinal plants investigated, R. palmatum showed significant biological activity (antioxidant capacity, MAO-B inhibiory activity, and AChE inhibitory activity). The protective efficacy of R. palmatum water extract on 1-methyl-4­phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced parkinsonism and its possible mechanism were studied in C57BL/6 mice. Treatment of R. palmatum water extract protected biomacromolecules such as lipids from oxidative damage induced by MPTP. The content of MDA in brain tissue was decreased significantly by R. palmatum extract. These results suggest that R. palmatum water extract plays on effective role in attenuating MPTP-induced neurotoxicity in mice. This protective effect of R. palmatum might be estimated the result from the inhibitory activity on monoamine oxidase B and the enhancement of antioxidant activity.