• Title/Summary/Keyword: bridging therapy

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Strategies and Advancement in Antibody-Drug Conjugate Optimization for Targeted Cancer Therapeutics

  • Kim, Eunhee G.;Kim, Kristine M.
    • Biomolecules & Therapeutics
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    • v.23 no.6
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    • pp.493-509
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    • 2015
  • Antibody-drug conjugates utilize the antibody as a delivery vehicle for highly potent cytotoxic molecules with specificity for tumor-associated antigens for cancer therapy. Critical parameters that govern successful antibody-drug conjugate development for clinical use include the selection of the tumor target antigen, the antibody against the target, the cytotoxic molecule, the linker bridging the cytotoxic molecule and the antibody, and the conjugation chemistry used for the attachment of the cytotoxic molecule to the antibody. Advancements in these core antibody-drug conjugate technology are reflected by recent approval of Adectris$^{(R)}$(anti-CD30-drug conjugate) and Kadcyla$^{(R)}$(anti-HER2 drug conjugate). The potential approval of an anti-CD22 conjugate and promising new clinical data for anti-CD19 and anti-CD33 conjugates are additional advancements. Enrichment of antibody-drug conjugates with newly developed potent cytotoxic molecules and linkers are also in the pipeline for various tumor targets. However, the complexity of antibody-drug conjugate components, conjugation methods, and off-target toxicities still pose challenges for the strategic design of antibody-drug conjugates to achieve their fullest therapeutic potential. This review will discuss the emergence of clinical antibody-drug conjugates, current trends in optimization strategies, and recent study results for antibody-drug conjugates that have incorporated the latest optimization strategies. Future challenges and perspectives toward making antibody-drug conjugates more amendable for broader disease indications are also discussed.

Can Cancer Therapy be Achieved by Bridging Apoptosis and Autophagy: a Method Based on microRNA-Dependent Gene Therapy and Phytochemical Targets

  • Vijayarathna, Soundararajan;Gothai, Sivapragasam;Jothy, Subramanion L;Chen, Yeng;Kanwar, Jagat R;Sasidharan, Sreenivasan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7435-7439
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    • 2015
  • A failure of a cell to self destruct has long been associated with cancer progression and development. The fact that tumour cells may not instigate cell arrest or activate cell death mechanisms upon cancer drug delivery is a major concern. Autophagy is a mechanism whereby cell material can be engulfed and digested while apoptosis is a self-killing mechanism, both capable of hindering multiplication after cell injury. In particular situations, autophagy and apoptosis seem to co-exist simultaneously or interdependently with the aid of mutual proteins. This review covers roles of microRNAs and chemopreventive agents and makes an attempt at outlining possible partnerships in maximizing cancer cell death with minimal normal cell damage.

Effects of Bridging Exercise using Vibration Stimulation and ADIMs on the Lengthening and Thickness of Transversus Abdominis in Healthy Adults

  • Kong, Kwan-Woo
    • The Journal of Korean Physical Therapy
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    • v.28 no.6
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    • pp.393-397
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    • 2016
  • Purpose: This study was conducted in an effort to determine the effects of various abdominal drawing-in maneuver (ADIM) on the thickness and length of the transversus abdominis (TrA) when using lumbar stabilization exercises on healthy adults. Methods: 72 healthy adults were divided into four groups of 18 subjects each, to which different ADIM methods were applied. 1) a simple ADIM exercise, 2) an ADIM with pressure bio-feedback units, 3) an ADIM exercise with sling, and 4) an ADIM exercise with sling and vibration. Changes in the thickness and sliding length of TrA were measured when ADIM was conducted in the supine position prior to exercise and again when beginning the exercises. Following exercise, changes in the thickness and sliding length of TrA were measured using the same methods. Differences in group measurements prior to and following exercise were compared using a one-way analysis of variance. A paired t-test was applied to compare the before and after differences within each group. Results: Differences in TrA thickness change revealed that the ADIM exercise with sling and vibration group showed a significant difference in measurements taken prior to and following exercise. Differences in TrA length change revealed that the ADIM exercise with sling and vibration group showed a significant difference in measurements taken prior to and following exercise. Conclusion: ADIM exercise with vibration stimulation conducted in the bridge posture while in a prone position using a sling can be recommended as an effective exercise to improve the function of lumbar TrA.

Effects of Balance Control and Functional Activities During Gym Ball Exercises in Elderly People (노인의 공 운동치료가 균형과 기능적인 활동에 미치는 효과)

  • Hwang, Su-Jin;Lee, Su-Young
    • Physical Therapy Korea
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    • v.11 no.3
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    • pp.25-32
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    • 2004
  • The use of a gym ball is becoming more popular for dynamic balance exercises. However, little is known about the effects of the dynamic ball exercises in the elderly. The purpose of this study was to compare balance and functional mobility after dynamic balance exercises using a gym ball to reduce the risk factorfor falls. All of the 15 subjects were women between the ages of 68 and 91 (mean age=79.9 yrs, SD=5.87) at anursing home in Wonju. Seven of fifteen subjects were placed in the experimental group and the others in the control group. Three clinical tests were used to determine the degree of balance and functional mobility before beginning the exercise program, after 4 weeks of gym ball exercise, and after 8 weeks of gym ball exercise. These three tests included Timed Up & Go (TUG), Berg Balance Scale (BBS) and the Functional Independence Measure (FIM). Dynamic ball exercises training for 8 weeks (5 days per week) included side stretching, prone walking, bridging, marching and opposite arm and leg lifting. There were significant differences found before the gym ball exercise program began and after 4 weeks and then 8 weeks in the experimental group (p<.05). Significant differences between the groups were shown for TUG and BBS (p<.05). No significant difference was noted between the groups for FIM. Therefore, gym ball exercises can improve dynamic balance and may be recommended to include in a therapeutic program to help the elderly reduce their risk of a fall.

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Comparison of the Effects of Abdominal Draw-In and Expansion Maneuvers on Trunk Stabilization in Patients With Low Back Pain and Lumbar Spine Instability (요추부 불안정성을 가진 요통환자의 복부 드로우-인 기법과 복부 확장 기법을 이용한 체간안정화운동의 효과 비교)

  • Lee, Ho-Jun;Kim, Suhn-Yeop
    • Physical Therapy Korea
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    • v.22 no.1
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    • pp.37-48
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    • 2015
  • This study aimed to investigate the effect of the abdominal drawing-in maneuver (ADIM) and abdominal expansion maneuver (AEM) on trunk stabilization, as well as trunk muscle activities and differences in quadruple visual analogue scale, Korean Oswestry Disability Index, and Fear Avoidance Beliefs Questionnaire scores, in patients with chronic low back pain and lumbar spine instability. To increase intra-abdominal pressure during the trunk stabilization exercise, the technique of pushing the abdomen out using diaphragmatic abdominal breathing suggested by Pavel Koral was used, which we termed the AEM. Fifty patients who tested positive on more than three of the five lumbar spine instability tests were separated from 138 patients with chronic low back pain of these patients, 16 were placed in the control group (trunk stabilization exercise), 17 were placed in the ADIM group (trunk stabilization exercise with ADIM), and 17 were placed in the AEM group (trunk stabilization exercise with AEM). Each group participated in the study for 30 minutes three times weekly for 4 weeks. Surface electromyography was used to measure the trunk muscle activities during the kneeling forward and supine bridging positions, and one-way repeated analysis of variance was used to determine the statistical significance of the trunk muscle activities in the rectus abdominis, internal oblique (IO), erector spinae, and multifidus (MF) muscles. The ADIM and AEM groups showed relatively larger improvements in psychosocial and functional disability level than control group. There were significant changes among the three groups, those from the measured values of the AEM group was significantly higher than the other two groups in changes in IO and MF trunk muscle activities (p<.05). This finding demonstrates that trunk stabilization exercises with AEM is more effective than ADIM for increasing trunk deep muscle activity of chronic low back pain patients with lumbar spine instability.

The effects of the angles of the knee and heel-off on the muscle activity during a bridge exercise

  • Kim, Byeong-jo;Lee, Su-kyoung;Lee, Jung-hoon;Kwon, Hae-yeon
    • Journal of the Korean Society of Physical Medicine
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    • v.10 no.3
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    • pp.95-100
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    • 2015
  • PURPOSE: The purpose of this study is to investigate the effects of the angles of the knee and heel-off on the muscle activity during a bridge exercise. METHODS: 15 healthy adult men and women with the balance ability and joint working range required for performing a bridge exercise participated in this study, in which $120^{\circ}$, $90^{\circ}$ and $60^{\circ}$ angles of the knee-flexion and heel-off were applied during the bridge exercise. RESULTS: Our data showed that there were significant differences in muscle activities of elector spinae and rectus abdominis when $120^{\circ}$ and $60^{\circ}$ angles of the knee were applied, of internal oblique when $120^{\circ}$ and $60^{\circ}$ were applied, and external oblique when $90^{\circ}$ and $60^{\circ}$ were applied. When heel-off was applied, there were significant differences in muscle activities of elector spinae and rectus abdominis when $120^{\circ}$ and $60^{\circ}$ were applied, of internal oblique when $120^{\circ}$ and $60^{\circ}$ were applied, and external oblique when $90^{\circ}$ and $60^{\circ}$ were applied. CONCLUSION: In this study on an application of heel-off to the bridge exercise, we showed that the effect of the angles of the knee on the muscle activities of elector spinae, rectus abdominis, internal oblique and external oblique were all similar to the regular bridge exercise, but overall muscle activities were increased with heel-off when compared with the regular bridge exercise.

The Effect of Novel Stretching on the Range of Motion and Acromio-Humeral Distance in Patients with Glenohumeral Internal Rotation Deficits with Posterior Shoulder Tightness (노벨 스트레칭과 관절가동술이 어깨 후방 뻣뻣함으로 인한 어깨관절 안쪽돌림 결핍 환자의 관절가동범위와 봉우리-위팔뼈 거리에 미치는 영향)

  • Yong-Tae, Kim;Sang-Bin, Lee
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.28 no.3
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    • pp.33-40
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    • 2022
  • Background: The cross-body and the sleeper stretches have been used to improve posterior shoulder tightness (PST). However, such stretching techniques may not always help achieve scapular stability and may even aggravate patient's symptoms. Therefore, a new stretching technique (passive glenohumeral internal rotation with bridging) was developed as a more effective method that may allow for greater scapular stability without aggravating the symptoms. Thus, this study aimed to examine and compare this novel stretching technique to determine its effect on the range of motion (ROM) and acromio-humeral distance (AHD) in patients with glenohumeral internal rotation deficits (GIRD) with posterior shoulder tightness. Methods: A total of 30 symptomatic patients with asymmetrical GIRD were randomly assigned to two groups: the novel stretching group (n=15) and the joint mobilization group (n=15). The intervention was conducted twice a week for a total of four weeks. The ROM of shoulder internal rotation was measured by a goniometer and the AHD was evaluated by an X-ray before and after the intervention. Results: Both the treatments improved ROM and AHD in patients with GIRD (p<.05). However, the improvements in internal rotation ROM and AHD in the novel stretching group were significantly greater than that of the subjects in the mobilization group. There was a significant difference between the two groups (p<.05). Conclusion: These results show that both novel stretching and joint mobilization improved ROM and AHD in patients with GIRD with PST. However, novel stretching was more effective than joint mobilization.

Resuscitative Endovascular Balloon Occlusion of the Aorta for an Iliac Artery Aneurysm: Case Report

  • Chang, Sung Wook;Chun, Sangwook;Lee, Gyeongho;Seo, Pil Won
    • Journal of Chest Surgery
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    • v.54 no.5
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    • pp.429-432
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    • 2021
  • Isolated iliac artery aneurysm (IAA) is rare, but can be fatal. Emergency surgery is performed in cases of hemorrhagic shock due to a suddenly ruptured IAA, which may have a high mortality rate because of massive non-compressible torso hemorrhage (NCTH). Recently, resuscitative endovascular balloon occlusion of the aorta (REBOA) has been accepted as an alternative to aortic cross-clamping via open thoracotomy to achieve hemostasis in trauma patients with profound shock due to NCTH and is considered an emerging bridging therapy for damage control. However, there is limited information on the use of REBOA in non-trauma patients with shock. Herein, we describe a patient with impending cardiac arrest due to isolated ruptured IAA, in whom perioperative bleeding was successfully controlled by REBOA.

A Case of Treating Chest Pain Associated with Myocardial Bridge (흉통(胸痛)이 있는 심근교(myocardial bridge) 환자의 치험 1례)

  • Kim, Bo-ram;Choi, Dong-jun;Lim, Sung-woo
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.10 no.1
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    • pp.74-80
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    • 2009
  • Myocardial bridging, a congenital coronary anomaly, is present when a segment of a major epicardial coronary artery, runs intramurally through the myocardium. So with each systole, the coronary artery is compressed. It has been associated with angina, arrhythmia, myocardial infarction and sudden cardiac death. This is a case of a 39-year-old woman who was diagnosed myocardial bridge. She complained of recurrent chest pain, palpitation. We diagnosed her as Gyesimtong(JiXiTong, 悸心痛), and prescribed Jeongkicheonhyang-tang(正氣天香湯). After treatment, all of the symptoms had improved and have not recurred for 18 months. This case suggests that oriental medicine therapy can be applicable to improve in symptoms of myocardial bridge.

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Bioequivalence Test of Gabapentin 800 mg Tablets (가바펜틴 800밀리그람 정제의 생물학적동등성시험)

  • Kim, Se-Mi;Shin, Sae-Byeok;Kang, Hyun-Ah;Cho, Hea-Young;Lee, Yong-Bok
    • YAKHAK HOEJI
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    • v.52 no.4
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    • pp.299-305
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    • 2008
  • Gabapentin, 1-(aminomethyl) cyclohexaneacetic acid, is a amino acid derivative, and is clinically effective in the treatment of neuropathic pain and partial seizures of epilepsy as a complementary therapy. The purpose of the present study was to evaluate the bioequivalence of two gabapentin tablets, $Neurontin^{R}$ tablet 800 mg (Pfizer Pharmaceuticals Co., Ltd.) and Gabapenin tablet 800 mg (Hanmi Pharm. Co., Ltd.), according to the guidelines of the Korea Food and Drug Administration (KFDA). The release of gabapentin from the two gabapentin formulations in vitro was tested using KP VIII Apparatus II method with 0.06 M HCI dissolution media. Twenty six healthy male subjects, $23.85{\pm}2.24$ years in age and $69.40{\pm}11.11$ kg in body weight, were divided into two groups and a randomized $2{\times}2$ crossover study was employed. After a single tablet containing 800 mg as gabapentin was orally administered, blood samples were taken at predetermined time intervals and the concentrations of gabapentin in serum were determined using HPLC with fluorescence detector. The dissolution profiles of two formulations were similar in the tested dissolution media. The pharmacokinetic parameters such as $AUC_{t}$, $C_{max}$ and $T_{max}$ were calculated, and ANOVA test was utilized for the statistical analysis of the parameters using logarithmically transformed $AUC_{t}$, $C_{max}$ and untransformed $T_{max}$. The results showed that the differences between two formulations based on the reference drug, $Neurontin^{R}$, were 1.28%, 0.63% and 0.62% for $AUC_{t}$, $C_{max}$ and $T_{max}$, respectively. There were no sequence effects between two formulations in these parameters. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of log 0.8 to log 1.25 (e.g., $log0.9097{\sim}log1.1598$ and $log0.8919{\sim}log1.1262$ for $AUC_{t}$ and $C_{max}$, respectively). Thus, the criteria of the KFDA bioequivalence guideline were satisfied, indicating Gabapenin tablet 800 mg was bioequivalent to $Neurontin^{R}$ tablet 800 mg.