• Title/Summary/Keyword: clinical response

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Effects of the Combination Chemotherapy of Docetaxel and Cisplatin in Non-Small Cell Lung Cancer Patients (비소세포성 폐암환자에서의 Docetaxel과 Cisplatin의 복합요법에 대한 효과)

  • Bang, Eun Sook;Oh, Jung Mi
    • Korean Journal of Clinical Pharmacy
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    • v.12 no.1
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    • pp.1-6
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    • 2002
  • Central Cancer Registry of Korean National Cancer Center in 1999 reported that mortality from lung cancer is higher than mortality from stomach cancer or hepatocellular carcinoma in Korean male. Lung cancer is classified into small cell cancer and non-small cell lung cancer (NSCLC), and NSCLC patients account for $70\%$ of the whole lung cancer patients. The purpose of this study was to evaluate the efficacy and toxicity of docetaxel and cisplatin combination in Korean patients with NSCLC. All patients who had received the combination therapy of docetaxel and cisplatin for histologically confirmed NSCLC in Ajou University Hospital between 2000. $2\~2001$. 4 were retrospectively evaluated for the responses and toxicities of that combination therapy. Nineteen patients were treated with docetaxel 75 $mg/m^2$ on Day 1 and cisplatin 25 $mg/m^2$ on Day 1-3 every 4 weeks. The response for combination regimen was evaluated by CT scans after 2 or 3 cycles of treatments. Seventeen patients were evaluated for the responses and the 19 patients far the toxicities. Among the 19 patients (14 men and 5 women), there were one patient $(5.3\%)$ with stage I disease, 4 patients $(21.1\%)$ with stage III disease, and 14 patients $(73.1\%)$ with stage IV disease. Of the 17 patients who were evaluable for response, complete response (CR) was not observed in any patient while partial response (PR) was observed in 5 patients $(29.4\%)$. The overall response rate (CR+PR) was $29.4\%$. Stable disease (SD) was observed in 11 patients $(64.7\%)$ and progressive disease (PD) in 1 patient $(5.9\%)$. The toxicities were graded by NCI (National Cancer Institute) Common Toxicity Criteria for the evaluable 70 cycles. Grade 3 or 4 neutropenia occurred in 53 cycles $(76\%)$. Four patients were hospitalized due to febrile neutropenia. The combination chemotherapy of docetaxel and cisplatin was effective as NSCLC treatments, however, the regimen must be administered carefully due to its hematological side effects.

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Assessing the Validity of the Preclinical Objective Structured Clinical Examination Using Messick's Validity Framework (Messick의 타당도 틀을 활용한 임상실습 전 실기시험의 타당도 평가)

  • Lee, Hye-Yoon;Yune, So-Jung;Lee, Sang-Yeoup;Im, Sunju
    • Korean Medical Education Review
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    • v.23 no.3
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    • pp.185-193
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    • 2021
  • Students must be familiar with clinical skills before starting clinical practice to ensure patients' safety and enable efficient learning. However, performance is mainly tested in the third or fourth years of medical school, and studies using the validity framework have not been reported in Korea. We analyzed the validity of a performance test conducted among second-year students classified into content, response process, internal structure, relationships with other variables, and consequences according to Messick's framework. As results of the analysis, content validity was secured by developing cases according to a pre-determined blueprint. The quality of the response process was controlled by training and calibrating raters. The internal structure showed that (1) reliability by generalizability theory was acceptable (coefficients of 0.724 and 0.786, respectively, for day 1 and day 2), and (2) the relevant domains had proper correlations, while the clinical performance examination (CPX) and objective structured clinical examination (OSCE) showed weaker relationships. OSCE/CPX scores were correlated with other variables, especially grade point average and oral structured exam scores. The consequences of this assessment were (1) making students learn clinical skills and study themselves, while causing too much stress for students due to lack of motivation; (2) reminding educators of the need to apply practical teaching methods and to give feedback on the test results; and (3) providing an opportunity for faculty to consider developing support programs. It is necessary to develop the blueprint more precisely according to students' level and to verify the validity of the response process with statistical methods.

The Sedative Effects of Submucosal Midazolam in Children (소아 진정 시 구강 협점막하로 투여한 Midazolam의 효과에 관한 연구)

  • Lee, Young-Eun;Park, Mi-Eung;Kim, Yun-Hee;Jung, Sang-Hyuk;Baek, Kwang-Woo
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.5 no.2 s.9
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    • pp.101-106
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    • 2005
  • Purpose: This retrospective study assessed the effectiveness of submucosal (SM) midazolam (M), oral chloral hydrate (CH), hydroxyzine (H), and nitrous oxide (N) 99 uncooperative pediatric dental patients over 182 sedation sessions. Methods: Selection criteria included good medical health (ASA I), from 2 to 6 years of age, uncooperative behavior, and the need for restorations and dental surgery. The children who was administerated with CH H, N was Group 1 (48 case). The children who was administerated with CH, H, N, M was Group 2 (51 case). All the patients received oral CH (50-70 mg/Kg), H (1 mg/Kg) and N (less than 50%). Additionally the Group 2 received SM midazolam (0.1-0.2 mg/kg). Behavior response was rated as quiet (Q), crying (C), movement (M), or struggling (S) every 5 minutes through operative procedures. Behavior response rating was assigned to Houpt scale of Overall behavior. Data was analyzed using Chi-Square Test. Results: The Group 2 had more effective (88.2%) than the Group 1 (68.8%)(P = 0.05). Also, vomiting response decreased in the Group 2 (94.4%) than those with oral administration of chloral hydrate alone without SM midazolam (77.1%)(P = 0.05). Conclusions: SM midazolam improved the quality of sedation and vomiting response.

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Clinical and Neuropsychological Factors Associated with Treatment Response and Adverse Events of Atomoxetine in Children with Attention-Deficit/Hyperactivity Disorder

  • Park, Kee Jeong;Kim, Hyo-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.30 no.2
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    • pp.74-82
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    • 2019
  • Objectives: The objective of this study was to investigate clinical and neuropsychological factors associated with treatment response and adverse events of atomoxetine in children with attention-deficit/hyperactivity disorder (ADHD) in Korea. Methods: Children with ADHD were recruited at the Department of Psychiatry of Asan Medical Center from April 2015 to April 2018. Diagnoses of ADHD and comorbid psychiatric disorders were confirmed with the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. The subjects were subsequently treated with atomoxetine for 12 weeks and illness severity was scored using the ADHD Rating Scale, Clinical Global Impression-Severity scale (CGI-S) and/or Improvement scale (CGI-I), at pre- and post-treatment. They also completed the Advanced Test of Attention (ATA), while their caregivers completed the Korean Personality Rating Scale for Children (KPRC) at pre- and post-treatment. Independent t-test, Fisher's exact test, ${\chi}^2$ test, mixed between-within analysis of variance and correlation analysis were used for statistical analysis. Results: Sixty-five children with ADHD (mean age: $7.9{\pm}1.4years$, 57 boys) were enrolled, of which, 33 (50.8%) were treatment responders. Scores on the social dysfunction subscale of the KPRC (p=0.021) and commission errors on the visual ATA (p=0.036) at baseline were higher in treatment non-responders than in responders; however, the statistical significances disappeared after adjusting for multiple comparisons. Mood changes were also observed in 13 subjects (20.0%), and three of them discontinued atomoxetine due to this. Additionally, atomoxetine-emergent mood change was observed more frequently in girls (p=0.006), while the intelligence quotient (p=0.040) was higher in those subjects with mood changes than in those without. Conclusion: The results of our study suggest that clinical and neuropsychological factors could be associated with treatment response or adverse events of atomoxetine in children with ADHD. Further long-term studies with larger samples are needed.

Fotemustine, Teniposide and Dexamethasone in Treating Patients with CNS Lymphoma

  • Wu, Jing-Jing;Wang, Xin-Hua;Li, Ling;Li, Xin;Zhang, Lei;Sun, Zhen-Chang;Fu, Xiao-Rui;Ma, Wang;Chang, Yu;Zhang, Xu-Dong;Han, Li-Juan;Zhang, Ming-Zhi
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.11
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    • pp.4733-4738
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    • 2014
  • Purpose: We developed and evaluated a regimen including fotemustine, teniposide and dexamethasone (FTD) for treating patients with central nervous system (CNS) lymphoma based on pharmacokinetic properties of individual agents and in combination. Patients and Methods: In a comparison study, 8 patients with primary CNS lymphoma (PCNSL) and 8 with secondary CNS lymphoma (SCNSL) were treated with FTD (comprising fotemustine 100 mg/m2, 1h infusion, day 1; teniposide 60 mg/m2, >0.5 h infusion, on day 2, 3, 4; dexamethasone 40 mg, 1h infusion, on day 1, 2, 3, 4 and 5; and methotrexate 12 mg, cytosine arabinoside 50 mg plus dexamethasone 5 mg intrathecally, on day 2 and 7). Cycles were repeated every 3 weeks. After response assessment, patients received whole brain radiotherapy. Results: Of the 8 PCNSL patients, 4 (50%) achieved CR and 3 (38%) PR, an overall response rate of 88%. Four patients (50%) were in continuing remission at the end of this study after a median follow-up of 30 months (range 10 to 56 months). Of the 8 SCNSL patients the overall response rate was 63% (CR+PR: 38%+25%). All responses were achievable with predictable toxicity mainly reflecting reversible myelosuppression. Conclusion: This study suggests that FTD could be an effective treatment for CNS lymphoma, and is worthy of further evaluation.

Trans-arterial Chemo-Embolization in Treating Elderly Patients with Hepatocellular Carcinoma

  • Zhang, Jian-Feng;Liu, Jun-Mao;Zhang, Nin;Du, Chao;Zheng, Qin
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.7201-7204
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    • 2015
  • Background: This analysis was conducted to evaluate the efficacy and safety of Trans-arterial Chemo-Embolization (TACE) in treating Elderly patients with Hepatocellular Carcinoma (EHPC). Methods: Clinical studies evaluating the efficacy and safety of TACE on response and safety for patients with EHPC were identified by using a predefined search strategy. Pooled response rate of treatment were calculated. Results: In TACE based regimen, clinical studies which including patients with EHPC were considered eligible for the evaluation of response. And, in these TACE based treatments, pooled analysis suggested that, in all 288 patients whose response could be assessed, the pooled reponse rate was 29.5%(85/288) in TACE based treatment. The most commonly encountered TACE-related morbidity was liver function impairment. No grade III or IV renal or liver toxicity were observed. No treatment related death occurred in EHPC patients with TACE based treatments. Conclusion: This evidence based analysis suggests that TACE based treatments are associated with mild response rate and accepted toxicities for treating patients with EHPC.

Clinical Study on Immediate Response after Acupuncture on Local Acupoints and Distal Acupoints for Neck Pain Patients (경항통 환자에 대한 원위취혈 및 근위취혈의 침치료 직후 효과에 대한 비교 연구)

  • Lee, Hwi-Yong;Song, Beom-Yong;Yook, Tae-Han;Kang, Ji-Sook;Hong, Kwon-Eui
    • Journal of Acupuncture Research
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    • v.25 no.6
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    • pp.183-192
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    • 2008
  • Objectives : The purpose of this study was to compare immediate response after acupuncture on Local Acupoints group and Distal Acupoints group for neck pain patients. Methods : From January 2nd 2008 to August 31th 2008, 10 neck pain patients were divided into 2 groups. One group(test I group) was taken Local Acupoints, and the other group(test II group) was taken Distal Acupoints. To check immediate response and satisfaction of needling, visual analog scale(VAS), range of motion(ROM), clinical evaluation grade and five-point likert scale were used before and after treatment. Results : Both acupuncture therapy showed immediate response and good effect on neck pain. And test I group showed more immediate response than test II group on all categories. Conclusions : Local Acupoints group can be recommended as an immediate and useful therapy to treat neck pain.

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Pemetrexed is Mildly Active with Good Tolerability in Treating Patients with Gastric Cancer

  • Lan, Hai;Lin, Cong-Yao;Li, Yan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7137-7139
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    • 2014
  • Background: This systemic analysis was conducted to evaluate the efficacy and safety of pemetrexed based chemotherapy in treating patients with metastatic gastric cancer (MGC) as a salvage chemotherapy. Methods: Clinical studies evaluating the efficacy and safety of pemetrexed based regimens on response and safety for patients with gastric cancer were identified by using a predefined search strategy. Pooled response rates (RRs) of treatment were calculated. Results: In pemetrexed based regimens, 4 clinical studies including 171 patients with advanced gastric cancer were considered eligible for inclusion. Systemic analysis suggested that, in all patients, pooled RR was 25.1% (43/171) in pemetrexed based regimens. Major adverse effects were neutropenia, anorexia, fatigue, and anemia. No treatment related death occurred in pemetrexed based treatment. Conclusion: This systemic analysis suggests that pemetrexed based regimens are associated with mild activity with good tolerability in treating patients with MGC.

Clinical Implementation of Precision Medicine in Gastric Cancer

  • Jeon, Jaewook;Cheong, Jae-Ho
    • Journal of Gastric Cancer
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    • v.19 no.3
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    • pp.235-253
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    • 2019
  • Gastric cancer (GC) is one of the deadliest malignancies in the world. Currently, clinical treatment decisions are mostly made based on the extent of the tumor and its anatomy, such as tumor-node-metastasis staging. Recent advances in genome-wide molecular technology have enabled delineation of the molecular characteristics of GC. Based on this, efforts have been made to classify GC into molecular subtypes with distinct prognosis and therapeutic response. Simplified algorithms based on protein and RNA expressions have been proposed to reproduce the GC classification in the clinical field. Furthermore, a recent study established a single patient classifier (SPC) predicting the prognosis and chemotherapy response of resectable GC patients based on a 4-gene real-time polymerase chain reaction assay. GC patient stratification according to SPC will enable personalized therapeutic strategies in adjuvant settings. At the same time, patient-derived xenografts and patient-derived organoids are now emerging as novel preclinical models for the treatment of GC. These models recapitulate the complex features of the primary tumor, which is expected to facilitate both drug development and clinical therapeutic decision making. An integrated approach applying molecular patient stratification and patient-derived models in the clinical realm is considered a turning point in precision medicine in GC.