• Title/Summary/Keyword: clinical response

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Clinical Pharmacogenomics of Drug Metabolizing Enzymes and its Clinical Application (약물대사효소의 유전적 다형성 및 임상적 응용)

  • Kim, Kyung-Im;Kim, Seung-Hee;Park, Ji-Eun;Chae, Han-Jung;Choi, Ji-Sun;Shin, Wan-Gyun;Son, In-Ja;Oh, Jung-Mi
    • Korean Journal of Clinical Pharmacy
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    • v.16 no.2
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    • pp.155-164
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    • 2006
  • Great inter-variability in drug response and adverse drug reactions is related to inter-variability of drug bioavailability, drug interaction and patient's disease and physyological state that cause change in absorption, distribution, metabolism and excretion of drugs. However, these alone do not sufficiently predict and explain inter-variability in drug response. In recent studies, it is reported that inter-variability in drug response and adverse drug reactions may largely resulted from genetically determined differences in drug absoption, distribution, metabolism and drug target proteins. Especially, the major human drug-metabolizing enzymes such as CYP450, N-acetyl tranferase, thiopurine S-methyl transferase, glutathione S-transferase are identified as the major gene variants that cause inter-individual variability in drug's response and adverse drug reactions. These variations may have most significant implications for those drugs that have narrow therapeutic index and serious adverse drug reactions. Therefore, the genetic variation such as polymorphisms in drug metabolizing enzymes can affect the response of individuals to drugs that are used in the treatment of depression, psychosis, cancer, cardiovascular disorders, ulcer and gastrointestinal disorders, pain and epilepsy, among others. This review describes the pharmacogenomics of the drug metabolizing enzymes associated with the drug response and its clinical applications.

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DNA Repair Gene Polymorphisms Do Not Predict Response to Radiotherapy-Based Multimodality Treatment of Patients with Rectal Cancer: a Meta-analysis

  • Guo, Cheng-Xian;Yang, Guo-Ping;Pei, Qi;Yin, Ji-Ye;Tan, Hong-Yi;Yuan, Hong
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.713-718
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    • 2015
  • Background: A number of association studies have been carried out to investigate the relationship between genetic polymorphisms in DNA repair genes and response to radiotherapy-based multimodality treatment of patients with rectal cancer. However, their conclusions were inconsistent. The objective of the present study was to assess the role of DNA repair gene genetic polymorphisms in predicting genetic biomarkers of the response in rectal cancer patients treated with neoadjuvant chemoradiation. Materials and Methods: Studies were retrieved by searching the PubMed database, Cochrane Library, Embase, and ISI Web of Knowledge. We conducted a meta-analysis to evaluate the association between genetic polymorphisms and the response in rectal cancer treated with neoadjuvant chemoradiation by checking odds ratios (ORs) and 95% confidence intervals (CIs). Results: Data were extracted from 5 clinical studies for this meta-analysis. The results showed that XRCC1 RS25487, XRCC1 RS179978, XRCC3 RS861539, ERCC1 RS11615 and ERCC2 RS13181 were not associated with the response in the radiotherapy-based multimodality treatment of patients with rectal cancer (p>0.05). Conclusions: This study shows that DNA repair gene common genetic polymorphisms are not significantly correlated with the radiotherapy-based multimodality treatment in rectal cancer patients.

Insight into the prognostic factors of chronic inflammatory demyelinating polyneuropathy

  • Baek, Seol-Hee
    • Annals of Clinical Neurophysiology
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    • v.22 no.1
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    • pp.8-12
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    • 2020
  • Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune-mediated neuropathy with heterogeneous features. Appropriate treatment will produce a favorable outcome, but a poor treatment response and severe disability have also been reported. The roles of the clinical phenotypes and electrophysiological features of CIDP as well as of autoantibodies against nodal and paranodal proteins have been highlighted previously due to their association with the treatment response and long-term prognosis. This review addresses the diverse factors associated with the prognosis of CIDP.

Prognostic Sub-Grouping of Diffuse Large B-Cell Lymphomas into Germinal Centre And Post Germinal Centre Groups by Immunohistochemistry after 6 Cycles of Chemotherapy

  • Hassan, Usman;Mushtaq, Sajid;Mamoon, Nadira;Asghar, Asghar Hussain;Ishtiaq, Sheeba
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1341-1347
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    • 2012
  • Introduction: Diffuse large B-cell lymphomas (DLBCL) can be divided into germinal centre (GC-DLBCL) and post germinal centre (post GC-DLBCL) groups by applying immunohistochemical antibodies. As these subgroups respond differently to chemotherapy, it is possible at diagnosis to select a poor prognostic subgroup for aggressive treatment. Objective: To determine the frequencies of GC-DLBCL and post GC-DLBCL in patients by immunohistochemistry (IHC) and the clinical response after six cycles of chemotherapy. Subjects and Methods: In this descriptive study conducted in AFIP and CMH, Rawalpindi and NORI, Islamabad, from September 2010 to September 2011, a total of 75 pretreatment cases of DLBCL diagnosed during the study period were included. Cases were segregated in to GC-DLBCL and post GC-DLBCL groups according to results of immunohistochemistry markers CD10, BCL6 and MUM1. Immediate clinical response was assessed after 6 cycles of chemotherapy. Response was divided into complete response, partial response, stable disease or relapse or progression. Results: The mean age was $54.2{\pm}15$. Males were 53 (70.7%). Forty (53.3%) cases comprised the GC-DLBCL group; 25(62.5%) of them showed a complete response. Most patients of the post GC-DLBCL 19(54%) showed relapse/progression. Results of immediate clinical response in both prognostic subgroups were significant (p<0.05). Results regarding positivity with immunohistochemical antibodies CD10 (p 0.011), BCL6 (p 0.013) and MUM1 (p 0.000) regarding immediate clinical response were also significant. Conclusion: GC-DLBCL group shows better response to CHOP chemotherapy regimen. Immunohistochemistry should be used to further classify DLBCL as this can enable us to select aggressive group for aggressive treatment. This manuscript is important because the study is the first to becarried out exclusively in Pakistan or our part of the world.

A Design of Clinical Information Exchange Framework for Performance Improvement based on Lazy Response Model (지연 응답 모델에 기반한 성능 개선 진료정보 교류 프레임워크의 설계)

  • Lee, Se-Hoon;Shim, Woo-Ho
    • Journal of the Korea Society of Computer and Information
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    • v.17 no.9
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    • pp.157-164
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    • 2012
  • Recently medical service environment, the clinical information exchange which contribute to medical safety, promotion of service quality and patient's convenience, efficiency of medical procedures and medical management is essential medical service model. But, practical exchange of clinical information which variation of information level, absence of standardization system, build of heterogeneous information systems is difficult in each medical institute. In this paper, We analyzed the related technical standardizations and the models of clinical information exchange. So, we designed the clinical information exchange system based on the ideal lazy response model which is aimed at vitalizations the exchange of clinical information under domestic law environment. In case of exchange the clinical information, we separate CDA document flow from metadata flow. As a experimental result we acquired 24% improved performance compared with existed system based on the lazy response model.

A Study on the Relationship between Experience of Verbal Abuse and Clinical Practice Stress during Clinical Practicum of Nursing Students (간호대학생의 임상실습중 언어폭력경험과 임상실습 스트레스와의 관계연구)

  • Yang, Seung Ae
    • Journal of Internet of Things and Convergence
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    • v.7 no.2
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    • pp.31-40
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    • 2021
  • Objectives: This study was conducted to investigate the degree of verbal abuse, emotional response, nursing professionalism, clinical practice stress during clinical practicim of nursing students. Methods: A sample of convenience was 106 nursing students, and a questionnaire was used to measure their verbal abuse, emotional response, nursing professionalism, clinical practice stress. Data were analyzed by descriptive statistics, t-test, one-way ANOVA, and multiple linear regression. Results: A significant positive correlation was found among verbal abuse, emotional response, clinical practice stress(r=.683, r=.573). Grade of which the participant was in, verbal abuse(𝛽=.487), emotional response(𝛽=.240) were significant predictive variables of which accounted for 49% of the variance in clinical practice stress. Conclusions: The results from this study can provide basic data on the development of strategies for nursing college students to cope with verbal abuse and to manage stress under clinical practice

Modeling of the Parathyroid Hormone Response after Calcium Intake in Healthy Subjects

  • Ahn, Jae Eun;Jeon, Sangil;Lee, Jongtae;Han, Seunghoon;Yim, Dong-Seok
    • The Korean Journal of Physiology and Pharmacology
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    • v.18 no.3
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    • pp.217-223
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    • 2014
  • Plasma ionized calcium ($Ca^{2+}$) concentrations are tightly regulated in the body and maintained within a narrow range; thus it is challenging to quantify calcium absorption under normal physiologic conditions. This study aimed to develop a mechanistic model for the parathyroid hormone (PTH) response after calcium intake and indirectly compare the difference in oral calcium absorption from PTH responses. PTH and $Ca^{2+}$ concentrations were collected from 24 subjects from a clinical trial performed to evaluate the safety and calcium absorption of Geumjin Thermal Water in comparison with calcium carbonate tablets in healthy subjects. Indirect response models (NONMEM Ver. 7.2.0) were fitted to observed $Ca^{2+}$ and PTH data, respectively, in a manner that absorbed but unobserved $Ca^{2+}$ inhibits the secretion of PTH. Without notable changes in $Ca^{2+}$ levels, PTH responses were modeled and used as a marker for the extent of calcium absorption.

Quantitative Assessment of the Association between ABC Polymorphisms and Osteosarcoma Response: a Meta-analysis

  • Chen, Xu;Jiang, Min;Zhao, Rui-Ke;Gu, Guo-Hao
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.11
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    • pp.4659-4664
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    • 2015
  • Background: ABC proteins are one key type of transport superfamilies which undertake majority of drug transport, which affect the osteosarcoma response to chemotherapeutics. Previous studies have suggested the association between ABC polymorphisms and osteosarcoma response. However, the results of previous studies remain controversial. Therefore, we perform a meta-analysis to get a more precise estimation of this association. The association between ABC polymorphisms and osteosarcoma response was assessed by odds ratios (ORs) together with their 95% confidence intervals (CIs). Three polymorphisms of ABC including ABCB1 rs1128503, ABCC3 rs4148416 and ABCC2 rs717620 polymorphism were investigated. Overall, significant association was observed between ABCC3 rs4148416 polymorphism and osteosarcoma response under allele contrast (T vs. C: OR=1.73, 95%CI=1.09-2.74, P=0.019), homozygote comparison (TT vs. CC: OR=2.00, 95%CI=1.25-3.23, P=0.004), recessive genetic model (TT vs. TC/CC: OR=1.80, 95%CI=1.14-2.84, P=0.011) and dominant genetic model (TT/TC vs. CC: OR=1.70, 95%CI=1.20-2.42, P=0.003). Moreover, significant association was also observed in Caucasian population rather than Asian population for ABCB1 rs1128503 polymorphism. We conclude that ABCC3 rs4148416 polymorphism was significantly associated with poor osteosarcoma response and ABCB1 rs1128503 polymorphism was significantly associated with good osteosarcoma response in Caucasian population rather than Asian population.

Clinical outcomes and prognostic factors in patients with mycosis fungoides who underwent radiation therapy in a single institution

  • Jang, Bum-Sup;Kim, Eunji;Kim, Il Han;Kang, Hyun-Cheol;Ye, Sung-Joon
    • Radiation Oncology Journal
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    • v.36 no.2
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    • pp.153-162
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    • 2018
  • Purpose: We aimed to evaluate clinical outcomes including progression-free survival (PFS), overall survival (OS), partial response, and complete response in patients who underwent radiation therapy (RT) for mycosis fungoides (MF). Also, we sought to find prognostic factors for clinical outcomes. Materials and Methods: Total 19 patients confirmed with MF between 1999-2015 were retrospectively reviewed. Clinical and treatment characteristics, clinical outcomes, and and toxicities were analyzed. Results: Eleven patients were treated with total skin electron beam radiotherapy (TSEBT) and 8 patients with involved field radiation therapy (IFRT) with median dose of 30 Gy, respectively. The median time interval from diagnosis to RT was 2.6 months (range, 0.4 to 87.3 months). The overall response rate was 100%; 11 patients (57.9%) had a complete response and 8 patients (42.1%) a partial response. The presence of positive lymph node at the time of consultation of RT was associated with lower OS (p = 0.043). In multivariate analysis, PFS was significantly lower for patients with increased previous therapies experienced following RT (p = 0.019) and for patients showing PR during RT (p = 0.044). There were no reported grade 3 or more skin toxicities related with RT. Conclusion: Both IFRT and TSEBT are effective treatment for MF patients. Patients with short disease course before RT or complete response during RT are expected to have longer PFS. Positive lymph node status at the initiation of RT was associated woth poor OS, suggesting other treatment modalities such as low-dose RT for patients with low life-expectancy.