• Title/Summary/Keyword: clinical response

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Evaluation of Cancer Treatment Using FDG-PET (FDG-PET을 이용한 암 치료 효과의 평가)

  • Ryu, Jin-Sook
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.1
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    • pp.64-73
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    • 2002
  • FDG-PET has potential as an effective, non-invasive tool to measure tumor response to anticancer therapy. The changes in tumor FDG uptake may provide an early, sensitive guide to the clinical and subclinical response of tumors to cancer treatment, as well as functional assessment of residual viable tumor. This may allow the evaluation of subclinical response to anticancer drugs in early clinical trials and improvements in patients management. However, monitoring tumor responses with FDG-PET is still in its infancy. The methods of measurement of FDG uptake are currently diverse and timing with respect to anti cancer therapy variable. Therefore, there is a need for larger-scale trials along with standardized methodology and a collection of reproducibility data. The recent guideline from the European group seems to be the most comprehensive. In future, the combination of morphological and metabolic images may improve the quantitative nature of these measurements by relating tumor viability to total tumor mass. More data on sensitivity and specificity of FDG-PET technique are needed along with continued advancement of PET methodology.

The Relationship between the Serum Cytokine and Clinical Improvement in Major Depressive Disorder (주요 우울증에서 혈중 Cytokine과 임상적 호전과의 관계)

  • Kim, Hyon Chul;Lee, Sang Kyu;Kim, Do Hoon;Son, Bong Ki
    • Korean Journal of Biological Psychiatry
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    • v.10 no.1
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    • pp.70-79
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    • 2003
  • Object : Currently, the alteration of cytokine system has been known to play an important role in regard to depressive symptom. We focused on the relationship between immunological parameters and clinical improvement in major depressive disorder. Method : Data were collected on 26 patients with major depressive disorder using a 8-week prospective follow-up design. After 8-week treatment period with fluoxetine, patients were classified into a response group and a non-response group according to their psychopathological outcome as evaluated by Hamilton Depression Rating Scale. The differences of the immunological parameters between pre-treatment phase and post-treatment phase were compared among patients. The difference of those was also compared within each phase among them. The relationship between socio-demographic variables, depression, cytokine, mononuclear cells was examined by correlation analysis. Multiple regression analyses were performed to explore the predictors of clinical improvement of major depressive disorder. Result : Pre-treatment levels of IL-$1{\beta}$ in the response group were significantly higher than those in the non-response group. Pre-treatment levels of IL-$1{\beta}$ of all patients and in the response group were positively correlated with pre-treatment monocyte counts. Patients with subsequent remission showed significantly lower IL-6 values at baseline than those with non-response. Post-treatment values of IL-6 did not differ significantly among the patients. The correlation test showed more frequent relations among cytokines and mononuclear cells in the response group than in the non-responder group. Especially, serum level of IL-6 in pre-treatment phase was only significantly correlated with HAMD score after 8-week treatement phase, while other cytokines and mononuclear cells were not. Pretreatment level of IL-6 was of paramount importance in predicting clinical improvement of depressive symptom. Conclusion : The immune system of major depressive disorder patients might dichotomize the patients into subsequent responders and non-responders. Immune system might be of great influence on the clinical improvement of major depressive disorder. The mode of interaction between depression and cellular immune function and the mediators responsible for the cytokine production need to be studied further.

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Pharmacodynamic principles and target concentration intervention

  • Holford, Nick
    • Translational and Clinical Pharmacology
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    • v.26 no.4
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    • pp.150-154
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    • 2018
  • This tutorial reviews the principles of dose individualisation with an emphasis on target concentration intervention (TCI). Once a target effect is chosen then pharmacodynamics can predict the target concentration and pharmacokinetics can predict the target dose to achieve the required response. Dose individualisation can be considered at three levels: population, group and individual. Population dosing, also known as fixed dosing or "one size fits all" is often used but is poor clinical pharmacology; group dosing uses patient features such as weight, organ function and comedication to adjust the dose for a typical patient; individual dosing uses observations of patient response to inform about pharmacokinetic and pharmacodynamics in the individual and use these individual differences to individualise dose.

A Study on Attitude of Clinical Nurses Toward Professional Nursing (일부지역 간호사의 간호전문직에 대한 태도 조사 연구)

  • Park, Youn-Suk
    • The Korean Nurse
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    • v.31 no.5
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    • pp.39-52
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    • 1992
  • As society has changed, the demand for improved health care has increased. To keep up with this type of social need, professional nursing care is seeking to efficiently satisfy the care needs of human beings. The goal of clinical nurse is to meet nursing care needs of patients. This study was designed to survey attitudes of nursing profession of clinical nurses. The following specific 5 objectives were investigated and the attitudes of clinical nurses were determined. 1. The social position of nursing as a profession. 2. Factors influencing the development of nursing. 3. The future of nursing. 4. Their work. 5. Job satisfaction. The subjects consisted of 120 nurses who are working at 5 general hospital over 150 beds Ill CHONG NAM. The nurses were surveyed by means of a questionnaire from May 24 to Jun 15, 1992. The tool used for this study was based on earlier work by Lee, Nam Hi(1978) and Kim, Myong Hee(1984). Computer was used for Data Analysis. Frequency and Percentage were used to examine the genera] characteristics of the subjects. ANOV A and t.test were used to test the relation in characteristics of the subjects and attitudes Loward nursing prfession. The finding of this study were as follows; 1. Social position of nursing as a profession; The response with the highest agreement was "The professional nursing organization is less power. ful than the other professional organization" 3.333 points, and the response with the lowest agreement was "Nursing get a big salary" 2.225 points. 2. Factors influencing the development of nursing; the response with the highest agreement was "Hospital environment should be improved" 4.267 points, and the response with the lowest agreement was "Nurses satisfaction with salary"2.175 points. 3. The future of nursing; the response with the highest agreement was "Along the deveiopmem of science technique will be elevated educational state and graduate to needed in nursing" 3.958 points, and showed generally positive response toward the future of nursing. 4. Their work; the response with the highest agreement was "Work loading due to nursing staff insufficient" 4. 308 points, the response with the lowest agreement was "Nurses are unkind to patient" 2.508 points. 5. The subject's view regarding job satisfaction;it showed that "Interpersonal nursing staffs" 3.508 points, showed generally unsatisfactory response toward job satisfaction. 6. The relationship between the subject's attitudes toward professional nursing and general characteristics showed a significant difference statistically in regard to the field of work(P<.05). 7. The relationship between general characteristics and the subject's attitudes toward factors influencing the development of nursing showed a significant difference statistically in regard to the age and the status of position(P<.05). The subject's attitude toward the future of nursing showed a significant difference statistically in regard to the age and the period of nursing career and the field of work(P<.05, P<.005). The subject's attitude toward the job satisfaction showed a significant difference statistically in regard to the age and the period of nursing career and the status of position and the field of work(P<.005).

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Relationship between Violence Response, Coping, and Burnout among Emergency Department Nurses (응급실 간호사의 폭력반응, 대응 및 소진간의 관계)

  • Yang, Jin-Hyang;Jung, Hye-Youn
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.16 no.1
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    • pp.103-111
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    • 2009
  • Purpose: The purpose of this study was to identify relationships between violence response, coping, and burnout among emergency department nurses. Method: This descriptive study using self report questionnaires was conducted from October 1 to October 20, 2008. Participants were 147 general nurses working in emergency departments in hospitals having over 500 beds and located in Busan. ANOVA and Pearson's correlation coefficients with SPSS PC+ WIN 14.0. were used to analyze the data. Results: Scores for violence response, coping, and burnout were 3.08 (1-5 scale), 2.57 (1-4 scale), and 3.22 (1-5 scale) respectively. There were significant differences in violence response and burnout by education, clinical careers, clinical careers in ED, and plans to work in the future, and no significant differences in coping by general characteristics. There was a significant and highly positive relationship between violence response and burnout. Conclusion: The degree of violence response and burnout was comparatively high, while that of coping was average. Therefore, it is necessary to develop effective programs related to prevention and coping with violence for nurses in emergency departments. Institutional measures by hospital authorities are also needed to improve the nursing quality by providing a safe workplace.

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Clinical Course of Infliximab Treatment in Korean Pediatric Ulcerative Colitis Patients: A Single Center Experience

  • Kim, Jong Min;Lee, Yoo Min;Kang, Ben;Choe, Yon Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.17 no.1
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    • pp.31-36
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    • 2014
  • Purpose: Infliximab (IFX) is considered safe and effective for the treatment of ulcerative colitis (UC) in both adults and children. The aim of this study was to evaluate the short- and long-term clinical course of IFX in Korean children with UC. Methods: Pediatric patients with UC who had received IFX infusions between November 2007 and May 2013 at Samsung Medical Center were retrospectively investigated. The clinical efficacy of IFX treatment was evaluated at 8 weeks (short term) and 54 weeks (long term) after the initiation of IFX treatment using the Pediatric Ulcerative Colitis Activity Index (PUCAI). The degree of response to IFX treatment was defined as complete response (PUCAI score=0), partial response (decrement of PUCAI score${\geq}20$ points), and non-response (decrement of PUCAI score <20 points). Adverse events associated with IFX treatment were also investigated. Results: Eleven pediatric patients with moderate to severe UC had received IFX. The remission rate after IFX treatment was 46% (5/11) and 82% (9/11) at 8 weeks and 54 weeks after IFX treatment, respectively. All patients who were steroid-dependent before treatment with IFX achieved remission at 54 weeks and were able to stop treatment with corticosteroids, while all steroid-refractory patients failed to achieve remission at 54 weeks after treatment with IFX. Conclusion: Response to IFX treatment after 8 weeks may predict a favorable long-term response to IFX treatment in Korean pediatric UC patients.

Clinical Application of Transcatheter Arterial Chemoembolization Combined with Synchronous C-arm Cone-Beam CT Guided Radiofrequency Ablation in treatment of Large Hepatocellular Carcinoma

  • Wang, Zhi-Jun;Wang, Mao-Qiang;Duan, Feng;Song, Peng;Liu, Feng-Yong;Wang, Yan;Yan, Jie-Yu;Li, Kai;Yuan, Kai
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1649-1654
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    • 2013
  • Objective: This work aimed to evaluate the safety and clinical efficacy of transcatheter arterial chemoembolization (TACE) combined with c-arm cone-beam CT guided synchronous radiofrequency ablation (RFA) in treatment of large hepatocellular carcinoma (HCC). Methods: 21 patients with large HCC were studied from January 2010 to March 2012. TACE combined with synchronous C-arm cone-beam CT guided RFA were performed on a total of 25 lesions. Conventional imaging examination (CEUS, enhanced CT or MRI) and AFP detection were regularly conducted to evaluate the technical success rate of combined treatment, complications, treatment response, time without disease recurrence and survival rate. Results: The technical success rate of combined treatment was 100%, without any significant complication. After 1 month, there were 19 cases with complete response and 2 cases with partial response, with an complete response rate of 90.4% (19/21) and a clinical effective rate of 100% (21/21). The complete response rates of single nodular lesions (100%, 17/17) was significantly higher than that of multiple nodular lesions (50%, 2/4) (P<0. 05). During 2 to 28 months of follow-up, in 19 cases with complete response, the average time without disease recurrence was $10.8{\pm}6$ months. The total survival rates of 6, 12 and 18 months in 21 patients were 100%, respectively. Conclusion: TACE combined with synchronous C-arm CT guided RFA is safe and effective for treatment of large HCC. The treatment efficacy for single nodular lesion is better than that for multiple nodular lesions.

Single Nucleotide Polymorphism of Interferon Lambda-4 Gene is not Associated with Treatment Response to Pegylated Interferon in Thai Patients with Chronic Hepatitis B

  • Limothai, Umaporn;Wasitthankasem, Rujipat;Poovorawan, Yong;Tangkijvanich, Pisit
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.13
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    • pp.5515-5519
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    • 2015
  • The single nucleotide polymorphism (SNP) ss469415590 in the interferon lambda-4 (IFNL4) gene has recently been reported to have an association with treatment response in chronic hepatitis C. However, any importance of the SNP in association with response to pegylated interferon (PEG-IFN) therapy in patients with chronic hepatitis B (CHB) is unclear. We retrospectively analyzed data for Thai patients with CHB treated with PEG-IFN for 48 weeks. Virological response (VR) for HBeAg-positive CHB was defined as HBeAg seroconversion plus HBV DNA level <2,000 IU/mL at 24 weeks post-treatment. VR for HBeAg-negative CHB was defined as an HBV DNA level <2,000 IU/mL at 48 weeks. The SNP was identified by real time PCR using the TaqMan genotyping assay with MGB probes. A total 254 patients (107 HBeAg-positive and 147 HBeAg-negative) were enrolled in the study. The distribution of TT/TT, ${\Delta}G/TT$ and ${\Delta}G/{\Delta}G$ genotypes was 221 (87.0%), 32 (12.6%) and 1 (0.4%), respectively. Patients with non-TT/TT genotypes had significantly higher baseline HBV DNA levels than patients with the TT/TT genotype. In HBeAg-positive CHB, 41.2% of patients with TT/TT genotype versus 50.0% with non-TT/TT genotype achieved VR (P=0.593). In HBeAg-negative CHB, the corresponding figures were 40.3% and 43.5%, respectively (P=0.777). There was no significant correlation between the SNP genotypes and HBsAg clearance in both groups of patients. In summary, ss469415590 genotypes were not associated with response to PEG-IFN in Thai patients with HBeAg-positive and HBeAg-negative CHB.