• Title/Summary/Keyword: Treatment Efficacy

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The Effect of the Improvement of the Sales Regulation of General Medicine and Political Proposals (일반의약품 판매규제 완화효과와 정책제언)

  • Yeom, Min-Sun
    • Journal of Distribution Research
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    • v.15 no.5
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    • pp.237-255
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    • 2010
  • The Korean Pharmacist Law has limited the sales of medicine to pharmacies. This has caused difficulty in purchasing medicine late at night or on holidays, which has limited the range of customers' selections and accelerated customers' discomfort, accordingly. Also, the rapid progress of aging has quickly boosted medical expenses for seniors, and has served as a factor that aggravates the budget of national medical insurance. Meanwhile, advanced countries, including the USA and Japan, have allowed the sales of general medicine, of which the safety and efficacy have been tested, in general retail stores such as convenience stores or super markets from the perspective of supporting self-medication. In particular, Japan, which has a strong tendency of pursuing safety in the world, diversified sales channels for general medicine in order to control quickly rising medical expenses. As a result, Japan has achieved the effect of easing various regulations as follows in the economic and social fields. First, the increasing distribution channels of general medicine from pharmacies to general retail stores provoked a potential demand, which also expanded related markets. Second, the competition between sales channels resulted in the reduction of the price of medicine. Third, the growing sales channels of medicine have extended the options of consumers and, subsequently, the convenience in the use of consumers has increased. Fourth, the creation of a competitive environment owing to the diversification of sales channels has accelerated an effort to enhance corporate competitiveness. Fifth, the foundation of enhancing the financial soundness of medical expenses has been prepared through the formation of a self-medication environment. In 2000, the Korean population aged 65 or over exceeded 7%, and it is anticipated to be over 14% by 2018; thus, the increase of national medical expenses will be sped up. As a way of being prepared for the era of aging, we, just as other advanced countries, need to create a self-treatment environment by diversifying the sellers of general medicine, and, thus, reduce spending on personal medical expenses, enhance the financial soundness of national medical insurance, and, further, promote the welfare of consumers.

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Introduction and feasibility study of the HD-270 MLC (HD-270 MLC의 소개 및 유용성평가)

  • Kim Dae Young;Kim Won Taek;Lee Hwa Jung;Lee Kang Hyeok
    • The Journal of Korean Society for Radiation Therapy
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    • v.15 no.1
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    • pp.1-9
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    • 2003
  • I. Purpose The multileaf collimator(MLC) has many advantages, but use of the MLC increased effective penumbra and isodose undulation in dose distribution compared with that of an alloy block. In this work, we introduced the HD-270 MLC, which can improve the above disadvantages of MLC, and reported its feasibility study. II. Method and Materials The HD-270 MLC is a technique which combines the use of the existing Siemens multileaf collimator(3D MLC) with patient translation perpendicular to the leaf plane. The technique produces a smoothed isodose distribution with the reduced isodose undulation and effective penumbra. To assess the efficacy of the HD-270 technique and determine the appropriate resolution, a polygonal shaped MLC field was made to produce field edge angles from 0 degree to 75 degree with a step of 15 degree. Each HD-270 group was generated according to the allowed resolution, i. e., 5, 3, and 2mm. The experiment was carried out on Primus, a Siemens linear accelerator configured with HD-270 MLC. The total 60 MU of 6 MV photon beam was delivered to X-Omat film(Kodak, USA) at a SAD of 100 cm and 1.5 cm depth in solid water phantom. Exposed films were scanned by Lumiscan75(LUMISYS) and analyzed using RIT113 software(Radiological Imaging Technology Inc., USA). To test the mechanical accuracy of table movement, the transverse, longitudinal, and vertical positions were controlled by a consol with ${\pm}5\;mm,\;{\pm}4\;mm,\;{\pm}3\;mm,\;and\;{\pm}2\;mm$ steps, and then measured using a dial gauge with an accuracy of 0.001 inch. During the experiments, the table loaded with about 50Kg human phantom to simulate the real treatment situation. III. Results The effective penumbra and isodose undulation became larger with increase the resolution and field edge angle. The accuracy of the table movement on each direction is good within the ${\pm}1\;mm$. IV. Conclusion Clinical use of the MLC can be increased by using of the HD-270 MLC which complements to the disadvantages of the MLC.

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Effect of Various Organic Materials on Weed Control in Environment-friendly Rice Paddy Fields (벼 친환경재배에서 다양한 유기자원별 잡초방제효과)

  • Kwon, Oh-Do;Park, Heung-Gyu;An, Kyu-Nam;Lee, Yeen;Shin, Seo-Ho;Shin, Gil-Ho;Shin, Hae-Ryoung;Kuk, Yong-In
    • Korean Journal of Weed Science
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    • v.30 no.3
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    • pp.272-281
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    • 2010
  • The objective of this research was to find out the weed management techniques in environment-friendly rice paddy fields through the study on herbicidal effects and problems of various organic materials. This experiment was conducted under different conditions of weed species and weed densities in environment-friendly rice paddy fields. There was no difference in weedy efficacy on golden apple snail (GAS), paper mulching (PM), and machine weeding (MW) between low and high weed densities. However, the effect of weed control in rice bran (RB) and effective microorganism (EM) + molasses was higher in high weed density than in low weed density. In general, the effect of weed control as affected by various organic materials was in the order of GAS (97-100%) > PM (93-98%) > RB (15-80%) > EM (7-31%). GAS provided excellent control of all weed species tested except for Persicaria hydropiper. PM gave acceptable control of the weed species except for Echinochloa crus-galli, Ludwigia prostrata, and Eleocharis kuroguwai. However, MW gave fair control (70% biomass reduction) of all weed species tested. BR followed by MW or EM followed by MW treatments had similar effect on weed control compared to each treatment alone. However, BR followed by GAS or EM followed by GAS provided 100% control of weed species tested. The level of rice foliar injury caused by various organic materials was in the order of GAS and MW (10-20%) > RB (10-15%) > PM and EM (5-7%). Typical symptoms of organic materials are wilting, inhibition of growth, missing hill, and reduction of tiller. Cost for weed control of GAS, RB, EM, and PM were 2.1, 3.1, 2.3, and 13.2 times higher than that of the herbicide. These data indicate that GAS was the best method for weed management in environmentfriendly rice paddy fields. Further study is required to elucidate the mechanisms underlying the rice injury as affected by GAS.

Assessment of the Effectiveness of Biofeedback Therapy in Children with Pelvic Floor Dyssynergia (소아 골반저 근실조에서 바이오피드백 치료의 유용성)

  • Park, Kie-Young;Chang, Soo-Hee;Kim, Kyung-Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.1
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    • pp.51-59
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    • 2007
  • Purpose: Recently well-developed anorectal function tests have revealed that there is an obvious pelvic floor dyssynergia (PFD) pattern in pediatric patients with constipation, as well as in adult's. The use of biofeedback therapy (BT) has been widely implemented in adult PFD patients; however, this approach has only rarely been considered for pediatric PFD patients. Therefore, we assessed the effectiveness of BT in children with PFD. Methods: We studied 70 children with PFD, who were referred to the department of pediatrics at the Asan Medical Center for the management of soiling or chronic constipation from September 2002 to February 2005. Diagnosis of PFD and assessment of the efficacy of BT for PFD treatment were carried out along with several ano-rectal function tests (cine-defecography, ano-rectal manometry, balloon expulsion test and intra-anal EMG); in addition, a questionnaire was administered. The BT based intra-anal EMG was performed. A follow-up telephone interview was performed more than 6 months later. Results: Most of the symptoms and results of the ano-rectal function tests were statistically improved after BT. In comparisons between the BT and control groups (BT refusal group due to poor compliance), the symptoms were statistically improved at follow-up. Therefore, for the shortterm improvement of symptoms, BT was better than conservative therapy alone. The negative feelings associated with ano-rectal function testing and BT were directly associated with failure or success of therapy. Conclusion: Pediatric patients with constipation or soiling that presented with an obvious PFD pattern showed that BT was a useful therapeutic tool for rapid improvement of symptoms.

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Combined Transcatheter Arterial Chemoembolization and Local Radiotherapy for Unresectable Hepatocellular Carcinoma (절제불가능 원발성 간암에서 경간동맥 항암 색전술과 국소 방사선의 병용요법)

  • Seong Jinsil;Keum Ki Chang;Han Kwang Hyub;Lee Do Yun;Lee Jong Tae;Chon Chae Yoon;Moon Young Myoung;Kim Gwi Eon;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.16 no.2
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    • pp.159-165
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    • 1998
  • Purpose : The best prognosis for hepatocellular carcinoma can be achieved with surgical resection. However, the number of resected cases is limited due to the advanced lesion or associated liver disease. A trial of combined transcatheter arterial chemoembolization(TACE) and local radiotherapy(RT) for unresectable hepatocellular carcinoma(HCC) was prospectively conducted and its efficacy and toxicity were investigated. Materials and Methods : From 1992 to 1994, 30 Patients with unresectable HCC due either to advanced lesion or to associated cirrhosis were entered in the study Exclusion criteria included the presence of extrahepatic metastasis, liver cirrhosis of Child's class C, tumors occupying more than two-thirds of the whole liver, and an ECOG scale of more than 3. Patient cHaracteristics were : mean tumor size $8.95\pm3.4cm$, serum AFP+ in all patients, portal vein thrombosis in all patients, liver cirrhosis in 22 patients, and UICC stage III and IVA in 10 and 20 patients, respectively. TACE was performed with the mixture of Lipiodol(5ml) and Adriamycin(50mg) and Gelfoam embolizatin. RT(mean dose $44.0\pm9.3Gy$) 10 days with conventional fractionation. Results : An objective response was observed in 19 patients($63.3\%$). Survival rates at 1 2, and 3 years were $67\%,\;33.3\%$ and $22.2\%$, respectively. Median survival was 17 months. There were 6 patients surviving more than 3 years. Distant metastasis occurred in 10 patients, with 8 in the lung only and 2 in both lung and bone, Toxicity included transient elevation of liver function test in all patients, fever in 20, thrombocytopenia in 4, and nausea and vomiting in 1. There was no treatment-related death. Conclusion : Combined TACE and RT appear to produce a favorable response and survival results with minimal toxicity.

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Clinical Application of Compressed Spectral Array During Deep Hypothermia (초저체온하 대동맥수술 환자에서 완전 순환차단의 안전한 체온 및 기간에 대한 연구 - 뇌파 Compressed Spectral Array의 임상적 응용 -)

  • 장병철;유선국
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.752-759
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    • 1997
  • Profound hypothermia protects . cerebral function during total circulatory arrest(TCA) in the surgical treatment of a variety of cardiac and aortic diseases. Despite its importance, there is no ideal technique to monitor the brain injury from ischemia. Since 1994, we have developed compressed spectral array(CSA) of electroencephalography(EEG) and monitored cerebral activity to reduce ischemic injury. The purposes of this study are to analyse the efficacy of CSA and to establish objective criteria to consistently identify the safe level of temperature and arrest time. We studied 6 patients with aortic dissection(AD, n=3) or aortic arch aneurysm(n=3, ruptured in 2). Body temperatures from rectum and esophagus and the EEG were monitored continuously during cooling and rewarming period. TCA with cerebral ischemia was performed in 3 patients and TCA with selective cerebral perfusion was performed in 3 patients. Total ischemic time was 30, 36 and 56 minutes respectively for TCA group and selective perfusion time was 41, 56 and 92 minutes respectively for selective perfusion group. The rectal temperatures for flat EEG were between 16.1 and 22. $1^{\circ}C$ (mean: 18.4 $\pm$ 2.0): the esophageal temperatures between 12.7 and $16.4^{\circ}C$ (mean $14.7\pm1.6).$ The temperatures at which EEG reappeared $5~15.4^{\circ}C$ for esophagus. There was no neurological defic t and no surgical mortality in this series. In summary, the electrical cerebral activity Teappeared within 23 minutes at the temperature less than $16^{\circ}C$ for rectum. It seemed that $15^{\circ}C$ of esophageal temperature was not safe for 20 minutes of TCA and continuous monitoring the EEG with CSA to identify the electrocerebral silence was useful.

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Development of a Culture Medium for Growth and Sporulation of Bacillus polyfermenticus SCD (프로바이오틱 비스루트균의 아포생산을 위한 최적배지 개발)

  • Lee, Kwang-Ho;Park, Kyu-Yong;Kim, Seong-Mi;Kim, Won-Seok;Paik, Hyun-Dong
    • Korean Journal of Food Science and Technology
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    • v.34 no.2
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    • pp.263-268
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    • 2002
  • Bacillus polyfermenticus SCD, which is commonly called a 'Bisroot' strain, has been appropriately used for the treatment of long-term intestinal disorders, since the live strains, in the form of active endospores, can successfully reach the target intestine. Goal of this study was to develop an industrial medium for growth and sporulation of B. polyfermenticus SCD. From the results of effect of mixed carbon sources on growth and sporulation of B. polyfermenticus SCD, glucose 2% and starch 2% was particularly found to be the most effective for the maximum number of spore production, resulting in spore cells of $4.3{\times}10^9\;spores/mL$ with a sporulation yield of 91%. For the effect of nitrogen sources, the maximum spore cells of $5.7{\times}10^9\;spores/mL$ of B. polyfermenticus SCD with a sporulation yield of 97% was obtained when B. polyfermenticus SCD was cultivated in an optimum nitrogen source medium containing 5% soybean flour. A medium involving proper phosphate salt yielded the maximum number of a spore cells of $6.0{\times}10^9\;spores/mL$ with a sporulation yield of 95%. Finally, the efficacy of an industrial medium (KH5 medium) on growth and sporulation of B. polyfermenticus SCD was investigated in jar fermenter. The higher number of viable cells $(3.3{\times}10^{10}\;cells/mL)$ and spore cells $(3.0{\times}10^{10}\;spores/mL)$ were obtained in 5 L fermenter when compared with a 500 mL baffle flask cultivation. Thus, KH5 medium developed in this study shows promise as an industrial medium because of higher cells and sporulation yield.

Effect of Fermented Cirsium japonicum Extract on Testosterone Deficiency Syndrome (엉겅퀴 발효 추출물을 통한 남성 갱년기 증상 개선 효과)

  • Jeong, Byung Seo;Kim, Seong Hoon;Kim, Hyun Pyo
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.46 no.7
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    • pp.790-800
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    • 2017
  • As men get older, total testosterone levels decline gradually, and concentrations of free and bioavailable testosterone decline sharply with each decade beyond their 30s. Andropause or testosterone deficiency syndrome (TDS) is defined as a decrease in sexual satisfaction or decline in general well-being accompanied by low levels of testosterone in older men. This male climacteric is characterized by nervousness, reduced potency, decreased libido, irritability, fatigue, depression, memory problems, sleep disturbances, and hot flushes. Cirsium japonicum (CJ) is used as a traditional medicine for hemorrhage, blood congestion, and inflammation in Korea. However, there is no report on the efficacy of CJ treatment for TDS. In this study, we observed the mitigating effect of CJ extract (CE) and fermented CJ extract (FCE) on symptoms of TDS. In elderly male rats, total and testosterone levels, hind limbs muscles, forced swimming time, and total and motile sperm counts significantly increased after daily intake of CE and FCE for 6 weeks. In contrast, sex hormone binding globulin, retroperitoneal fat, total serum cholesterol, and triglyceride levels were significantly reduced in CE and FCE groups. However, there was no difference in prostate specific antigen, aspartate aminotransferase, and alanine aminotransferase levels among all groups, which means CE and FCE did not have putative adverse effects. In a cell experiment, we also observed that CE and FCE enhanced expression of genes related to testosterone biosynthesis but reduced genes involved in testosterone conversion. On the whole, these positive effects on TDS were greater in FCE compared to CE. Thus, these results suggest the potential of FCE as a promising natural product for recovering testosterone levels and alleviating TDS.

Phase II Trial of Irinotecan plus Cisplatin Combination as First Line Therapy for Patients with Small cell Lung Cancer (소세포폐암 환자에서 1차 항암 치료제로서 Irinotecan 과 Cisplatin 병합요법에 관한 2상 연구)

  • Jeong, Hye Cheol;Lee, Sang Yeub;Kim, Jung Ha;Ha, Eun Sil;Jung, Jin Yong;Lee, Kyung Ju;Lee, Seung Hyeun;Kim, Se Joong;Lee, Eun Joo;Hur, Gyu Young;Lee, Sung Yong;Kim, Je Hyeong;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.1
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    • pp.57-64
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    • 2006
  • Background : Recently, there have been several studies showing that irinotecan hydrochloride, a topoisomerase I inhibitor, is effective against extensive disease(ED) small cell lung cancer (SCLC). We conducted a phase II trial to evaluate the efficacy and toxicity of irinotecan plus cisplatin as a 1st line therapy for both limited and extensive disease SCLC. Methods : The study was conducted between January 2002 and June 2004. Patients were treated with $60mg/m^2$ irinotecan on day 1, 8, 15 and $60mg/m^2$ cisplatin on day 1, every 4 weeks. During concurrent thoracic irradiation for limited disease (LD)-SCLC patients, dose of irinotecan was reduced to $40mg/m^2$. Prophylactic cranial irradiation was given to patients with complete remission (CR) after chemotherapy. Results : Median ages of LD- and ED- SCLC were 64 years and performance status (PS) was 0-2. In patients with LD-SCLC, the response rate after concurrent chemoradiotherapy was 85% (CR, 6; Partial response [PR], 11). The median survival was 20 months (95% CIs, 15.6 to 24.4) with 1-and 2-year survival rates of 85% and 35%, respectively. Median progression free survival (PFS) was 12 months (95% CIs, 6.2 to 18.1) with 1- year PFS of 36%. In ED-SCLC, the response rate was 83.4% (CR, 1; PR, 14). The median survival was 14.5 months (95% CIs, 8.8 to 20.1) with 1-year survival rates of 75%. Median PFS was 6.3 months (95% CIs, 5.6 to 7.1) with 1- year PFS of 20%. The major toxicities (grade 3 or 4) of this regimen included leukopenia, anemia, thrombocytopenia, nausea/vomiting, and diarrhea without life threatening complication. Conclusion : Our data shows that the combination of irinotecan plus cisplatin as a first line therapy is effective and tolerable in the treatment of both LD- and ED- SCLC.

Beneficial Effect of Korea Red Ginseng on Halitosis; Attenuation of H2S Induced Inflammatory Mediators and cystathionine γ-lyase Expression (고려홍삼의 구강악취 억제기능; H2S 생성에 따른 염증매개 유전자 및 cystathionine γ-lyase의 약화기능)

  • Choi, Ki-Seok;Lee, So-Jung;Lee, Jeong-Sang;Hong, Kyung-Sook;Kim, Jeong-Gon;Kim, Yoon-Jae;Hahm, Ki-Baik
    • Journal of Ginseng Research
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    • v.33 no.4
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    • pp.367-377
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    • 2009
  • Halitosis is a generally accepted marker of diseases in the oral cavity and of systemic and gastrointestinal disorders. Based on these authors' previous findings (that (1) there is a close association between H. pylori infection and halitosis; (2) Korea red ginseng may suppress the colonization of H. pylori, fight H. pylori-induced cytotoxicity, and impose significant anti-inflammatory actions in patients with chronic gastritis; and (3) H. pylori infection is linked with the generation of significant levels of volatile sulfur compounds (VSCs), and the levels of VSCs correlate significantly with H. pylori-associated mucosal damages), in the current study, the authors documented the molecular mechanisms of Korea red ginseng's efficacy in ameliorating halitosis. When the RAW 264.7 cells were treated with the $H_2S$ releasing compound NaHS, the mRNA expression of cystathionine ${\gamma}$-lyase (CSE), IL-6, COX-2, and iNOS were more significantly induced compared with the vehicle-treated group. The cytoskeletal components of ezrin's and moesin's mRNA expressions were elevated by NaHS treatment accompanied by the activation of MAPK, p38, and ERK. Korea red ginseng pretreatment reduced both the NaHS-induced CSE expression and the proinflammatory genes (e.g., IL-6, COX-2, and iNOS) in a concentration-dependent manner. The ERM expression and the phosphorylation of p38 were also significantly reduced by Korea-red-ginseng pretreatment. Overall, Korea red ginseng pretreatment imposed significant anti-inflammatory effects through the downregulation of the NaHS-triggered proinflammatory gene expression, CSE, and ERM mRNA expression. Korea red ginseng could thus be said to be a key remedy of halitosis and to be effective in relieving gastric inflammation.