• Title/Summary/Keyword: clinical response

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Dyssynergic Defecation in Chronically Constipated Children in Korea

  • Sun Hwan Bae
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.26 no.2
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    • pp.127-133
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    • 2023
  • Purpose: Dyssynergic defecation (DSD) is one of the important causes of chronic constipation in children. We aimed to analyze the clinical features, diagnostic test results, and treatments for DSD in children. Methods: Children diagnosed with DSD using fluoroscopic defecography were enrolled in this study. Clinical data, including the results of colon transit time (CTT) test and biofeedback (BF) therapy, were collected from medical records retrospectively. Results: Nineteen children were enrolled. The median age was 9 years (6-18 years), the median frequency of bowel movement was 1/7 days (1-10 days), the median duration of constipation was 7.0 years (2-18 years), the median age of onset of constipation was 2.5 years (1-11 years). In the CTT test, outlet obstruction type was noted in 10/18 (55.6%), slow transit type in 5/18 (27.8%), and normal transit in 1/18 (5.6%). The median CTT was 52 hours (40-142 hours). Initial medical therapy was performed with the polyethylene glycol 4000, and the response was good in 9/19 (47.4%), fair in 9/19 (47.4%), and poor in 1/19 (5.0%). BF was performed in 8/19, with good results in 6/8 (75.0%) children and failure in 2/8 (25.0%) children. After long-term medical therapy (11/19), 3/5 showed good response with medication alone, 6/8 showed good response with BF and medication combined. Conclusion: DSD should be considered as a cause of chronic constipation in children, especially in those with abnormal CTT test results. BF combined with medical therapy is effective even with age-limited cooperation.

The perception of Hospice Health Professionals on the Hospice Clinical Nurse Specialist System (호스피스 전문간호사 제도에 관한 인식)

  • Oh, Pok-Ja;Lee, Hee-Jung;Kim, Bog-Ja
    • Asian Oncology Nursing
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    • v.3 no.1
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    • pp.15-23
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    • 2003
  • Purpose: This study was to find out hospice nurses and other health professionals' perception on the system of hospice and palliative nurse specialist. Methods: Using questionnaire, 63 nurses and 22 other health professionals answered about the benefit required qualification, workforce standard, and the extent of autonomy needed for hospice and palliative nurse specialist. Data was collected from August, 2002 to November, 2002. and analyzed by using SPSS 10 program. Results: 1) 96.4% of the subjects perceived that hospice nurse specialist will improve the quality of care and patient satisfaction. 2) The most frequent response for the type of education required for hospice nurse specialist was one year post RN program. 3) The most frequent response for the required clinical experience of hospice nurse specialists was minimum of four to five years. 4) The most important qualification for the hospice nurse specialists was an "good relationship with others", and "clinical experience". 5) One to two hospice nurse specialist per hospice facility was viewed as a sufficient number. 6. Autonomy was viewed as the most important characteristic which should be granted to hospice nurse specialist. Conclusion: The results of this study can be used as a basic information in establishing hospice nurse specialist program.

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The Effect of Differences in Age and Sex on Vestibular Evoked Myogenic Potentials (연령과 성별의 차이가 전정 유발근전위에 미치는 영향)

  • Moon, Sung-Sik;Kim, Kyoung-Mi;Kim, Young-Ji;Kim, Young-Hwal
    • Korean Journal of Clinical Laboratory Science
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    • v.39 no.2
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    • pp.136-140
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    • 2007
  • The aim of this study was to examine the effect of differences in age and sex on vestibular evoked myogenic potentials (VEMP), particularly in normal participants. Briefly, the VEMP is a response elicited by loud clicks or tone bursts recorded from the tonically contracted sternocleidomastoid muscle. A total of 72 participants were divided into 6 groups according to their age and sex (20~30/F, 20~30/M, 40~50/F, 40~50/M, ${\geq}60/F$, ${\geq}60/M$). We got the data of latency, amplitude, and asymmetry index of the amplitude(ASI) from them. As a result of this study, there are variations in VEMP amplitudes and ASI depending on the muscle tension and the intensity of stimuli. In contrast, the latency of the response is usually less varied and does not differ significantly.

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Current Status of Clinical Practice for Gastric Cancer Patients in Korea -A Nationwide Survey- (전국 위암 환자 진료 현황에 관한 설문조사 결과)

  • ;Yang Han-Kwang
    • Journal of Gastric Cancer
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    • v.4 no.2
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    • pp.95-108
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    • 2004
  • This nationwide survey was conducted to evaluate the current status of clinical practice for gastric cancer patients in Korea. The Information Committee of the Korean Gastric Cancer Association (KGCA) sent questionnaires containing 45 items about the preoperative diagnosis, medical and surgical treatment, and postoperative follow-up for gastric cancer patients to all 298 KGCA members in 108 institutes. Response rates were $32.6\%$ (97/298) for individuals and $59.3\%$ (64/108) for institutes. Most university hospitals responded (response rate of university hospitals: $71.6\%$, 48/67). The preoperative staging work up was performed primarily by abdominal CT, followed by bone scans, abdominal ultrasound, endoscopic ultrasound, and so on. Gastric cancer patients with stages II, III, and IV usually received adjuvant chemotherapy after a curative operation. About half of the surgeons regarded 2 cm as a safe resection margin in early gastric cancer and 5 cm in advanced gastric cancer. More than half of surgeons usually performed a D2 lymph node dissection in early gastric cancer and D2+$\alpha$ lymph node dissection in advanced gastric cancer. About $20\%$ of surgeons performed less invasive surgery and/or function-preserving surgery, such as a pylorus-preserving gastrectomy, a laparoscopic wedge resection, or a laparoscopy-assisted distal gastrectomy.

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Controversies in Usefulness of EEG for Clinical Decision in Epilepsy: Cons. (간질 치료에서 뇌파의 임상적 유용성에 관한 논란: 부정적 관점에서)

  • Lee, Seo-Young;Lee, Sang-Kun;Kim, Nam Hee
    • Annals of Clinical Neurophysiology
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    • v.9 no.2
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    • pp.69-74
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    • 2007
  • Electroencephalogram (EEG) is a representative diagnostic tool in epilepsy. However, there are several points of debate on the role of EEG in diagnosis and management of epilepsy. We suggest that EEG has some limitations for differential diagnosis from nonepileptic episodic diseases, classification of epilepsy, prediction of recurrence, and evaluation of treatment response. Interictal EEG cannot diagnose or exclude epilepsy because interictal epileptic discharge (IED) is frequently absent in epilepsy and can appear in nonepileptic conditions. Although EEG is helpful in classification of epilepsy, focal spikes in generalized epilepsy and secondary bilateral synchrony in localization related epilepsy cause interrater disagreement. It is controversial whether EEG predicts recurrence after the first seizure in adults. The predictive value of EEG in antiepileptic drug (AED) withdrawal is not absolute. The prognosis after AED withdrawal depends on epilepsy syndrome. Many studies could not confirm the value of EEG in assessing the treatment response. After all, epilepsy is clinically diagnosed and assessed. Interictal EEG alone does not provide decisive information and routine follow-up of EEG is not recommended.

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A Clinical Report of Three Patients with Acute Stress Disorder, Post-Traumatic Stress Disorder Treated by Oriental Medical Treatments (급성 스트레스장애 및 외상후 스트레스장애의 한의학적 치료 3례)

  • Hwang, Jeong-Hyun;Ko, Jae-Sang;Bae, Jae-Ik;Koo, Byung-Soo;Kim, Geun-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.22 no.3
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    • pp.75-85
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    • 2011
  • Objectives : In this case report, we will present three patients diagnosed with acute stress disorder or post-traumatic stress disorder improved by application of oriental medical treatments. Methods : We treated three patients with acute stress disorder or post-traumatic stress disorder by oriental medical treatments. The effect of oriental medical treatments were evaluated by STAI and clinical symptoms such as anxiety, insomnia, palpitation, startle response. Results : As a result of oriental treatments, clinical symptoms such as anxiety, insomnia, palpitation, startle response were improved, and STAI scores also decreased. Conclusions : These results suggest that oriental treatments may have an effect on acute stress disorder and post-traumatic stress disorder.

Recent Progress in Immunotherapy for Advanced Gastric Cancer (진행성 위암에 대한 면역 요법의 최신 지견)

  • Byeong Seok Sohn
    • Journal of Digestive Cancer Research
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    • v.10 no.1
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    • pp.22-30
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    • 2022
  • Immune checkpoint inhibition has been established as a new treatment option for various types of carcinoma, and many clinical trials are being actively conducted as a treatment for advanced or metastatic gastric cancer, either as a monotherapy with an immune checkpoint inhibitor or as a combination therapy with standard chemotherapy. In the CheckMate-649 clinical trial to confirm the efficacy of the combination of nivolumab and chemotherapy (FP) in advanced gastric cancer and gastroesophageal junction cancer, nivolumab group showed improvement in overall survival in programmed death ligand 1-positive cancer patients compared with placebo group. Also, the combination therapy of pembrolizumab, trastuzumab and chemotherapy (FP) in first-line treatment was tested through the KEYNOTE-811 trial. The pembrolizumab group showed 22.7% of improvement in objective response rate compared with placebo group. Accordingly, the combination of nivolumab/pembrolizumab with standard chemotherapy was approved for the first-line treatment. In KEYNOTE-059 trials for patients with progressive disease after at least two lines of chemotherapy, pembrolizumab monotherapy showed improvement in objective response rate and overall survival, and the use of pembrolizumab was approved for the third-line or more treatment. In this article, we review the result of clinical trials related to immune checkpoint inhibitors that have been recently introduced in the treatment of gastric cancer.

Mechanisms Underlying the Role of Myeloid-Derived Suppressor Cells in Clinical Diseases: Good or Bad

  • Yongtong Ge;Dalei Cheng;Qingzhi Jia;Huabao Xiong;Junfeng Zhang
    • IMMUNE NETWORK
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    • v.21 no.3
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    • pp.21.1-21.22
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    • 2021
  • Myeloid-derived suppressor cells (MDSCs) have strong immunosuppressive activity and are morphologically similar to conventional monocytes and granulocytes. The development and classification of these cells have, however, been controversial. The activation network of MDSCs is relatively complex, and their mechanism of action is poorly understood, creating an avenue for further research. In recent years, MDSCs have been found to play an important role in immune regulation and in effectively inhibiting the activity of effector lymphocytes. Under certain conditions, particularly in the case of tissue damage or inflammation, MDSCs play a leading role in the immune response of the central nervous system. In cancer, however, this can lead to tumor immune evasion and the development of related diseases. Under cancerous conditions, tumors often alter bone marrow formation, thus affecting progenitor cell differentiation, and ultimately, MDSC accumulation. MDSCs are important contributors to tumor progression and play a key role in promoting tumor growth and metastasis, and even reduce the efficacy of immunotherapy. Currently, a number of studies have demonstrated that MDSCs play a key regulatory role in many clinical diseases. In light of these studies, this review discusses the origin of MDSCs, the mechanisms underlying their activation, their role in a variety of clinical diseases, and their function in immune response regulation.

Physiological Predictors of Treatment Response to Biofeedback in Patients With Panic Disorder

  • Seongje Cho;In-Young Yoon;Ji Soo Kim;Minji Lee;Hye Youn Park
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.1
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    • pp.19-24
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    • 2023
  • Objectives : Biofeedback is a useful non-pharmacological treatment for panic disorder (PD), but no studies have identified physiological markers related to the treatment response. This study investigated predictors of the treatment response for biofeedback in patients with PD. Methods : A retrospective study based on the electronic medical records of 372 adult patients with PD was performed. Patients received biofeedback treatment at least once, and physiological markers including heart rate, heart rate variability, respiratory rate, skin conductance, skin temperature, and electromyography were collected before the treatment began. The patients were classified as responders or non-responders based on the change in Clinical Global Impression-Severity (CGI-S) score. Results : The response rate to biofeedback treatment was 30.4%. Multivariable logistic regression analysis revealed that a higher CGI-S score at baseline and fewer benzodiazepine prescriptions were associated with a better response to biofeedback treatment. According to subgroup analyses, the baseline CGI-S score, dose of benzodiazepines, and skin conductance are candidate predictors of the response to biofeedback treatment in men, while only baseline disease severity was associated with the treatment response in women. Conclusions : The present results suggest that skin conductance may be target marker and predictor for biofeedback in male patients with PD.

Comparison between Response AC/A and CA/C Ratio according to Additional Spherical Powers and Prism Powers (가입렌즈 도수와 프리즘 굴절력 변화에 따른 반응 AC/A비와 CA/C비 비교)

  • Roh, Byeong-Ho;Yu, Dong-Sik;Son, Jeong-Sik;Kwak, Ho-Weon
    • Journal of Korean Ophthalmic Optics Society
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    • v.20 no.3
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    • pp.341-347
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    • 2015
  • Purpose : This study was to examine a correlation of response AC/A ratio by additional spherical powers with PD(Pupilary distance) and relative accommodation, and was to investigate correlation of CA/C ratio by prism powers. The mean differences between a reciprocal response AC/A ratio and a CA/C ratio were compared, and were suggested to be used as data in the refractive power and prism prescriptions in the clinical. Methods: The open field autorefractometer (Nvision-K 5001, Shin nippon) and Howell target at 40 cm fixation distance to 62 persons with average $22.62{\pm}2.84$ ages were used to measure the response AC/A ratio according to additional Spherical powers. The CA/C ratios were measured using the DOG card at 40cm according to prism powers. Results: When the response accommodation according to Additional Spherical power changes and the response accommodation according to prism power changes were compared, it was larger than the response accommodation according prism power change. These were significant differences statistically. The correlation of response AC/A ratio and PD is showed as r = -0.158, the CA / C ratio is shown as r = 0.093. The correlation of response AC/A ratio and relative accommodation showed as r = -0.253, the CA/C ratio showed as r = 0.566 that is predictable correlation. The correlation of response AC/A ratio and CA/C ratio showed as r = -0.355 that is low minus correlation (p = 0.000). The difference between a reciprocal response AC/A ratio and a CA/C ratio showed $0.12{\pm}0.06D/{\Delta}$ with a significant difference statistically (p=0.000). Conclusions: The correlation of relative accommodation and CA/C ratio showed that depend on the individual, The more a relative accommodation is, the higher a response accommodation of convergence by convergence stimulus is. The reciprocal response AC/A and CA/C ratio showed significant differences statistically. This can have higher CA/C ratio in patients with low AC/A ratio in clinical as an independent variable. Thus when the abnormal binocular vision was prescribed in the clinical, it is necessary to consider the accommodative response even if the AC/A ratio is a normal range.