• 제목/요약/키워드: combined therapy

검색결과 1,544건 처리시간 0.027초

Effects of PEP-1-FK506BP on cyst formation in polycystic kidney disease

  • Jo, Hyo Sang;Eum, Won Sik;Park, Eun Young;Ko, Je Young;Kim, Do Yeon;Kim, Dae Won;Shin, Min Jea;Son, Ora;Cho, Su Bin;Park, Jung Hwan;Lee, Chi Hern;Yeo, Eun Ji;Yeo, Hyeon Ji;Choi, Yeon Joo;Youn, Jong Kyu;Cho, Sung-Woo;Park, Jinseu;Park, Jong Hoon;Choi, Soo Young
    • BMB Reports
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    • 제50권9호
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    • pp.460-465
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    • 2017
  • Polycystic kidney disease (PKD) is one of the most common inherited disorders, involving progressive cyst formation in the kidney that leads to renal failure. FK506 binding protein 12 (FK506BP) is an immunophilin protein that performs multiple functions, including regulation of cell signaling pathways and survival. In this study, we determined the roles of PEP-1-FK506BP on cell proliferation and cyst formation in PKD cells. Purified PEP-1-FK506BP transduced into PKD cells markedly inhibited cell proliferation. Also, PEP-1-FK506BP drastically inhibited the expression levels of p-Akt, p-p70S6K, p-mTOR, and p-ERK in PKD cells. In a 3D-culture system, PEP-1-FK506BP significantly reduced cyst formation. Furthermore, the combined effects of rapamycin and PEP-1-FK506BP on cyst formation were markedly higher than the effects of individual treatments. These results suggest that PEP-1-FK506BP delayed cyst formation and could be a new therapeutic strategy for renal cyst formation in PKD.

Aromatase Inhibition and Capecitabine Combination as 1st or 2nd Line Treatment for Metastatic Breast Cancer - a Retrospective Analysis

  • Shankar, Abhishek;Roy, Shubham;Rath, Goura Kishor;Julka, Pramod Kumar;Kamal, Vineet Kumar;Malik, Abhidha;Patil, Jaineet;Jeyaraj, Pamela Alice;Mahajan, Manmohan K
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권15호
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    • pp.6359-6364
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    • 2015
  • Background: Preclinical studies have shown that the combination of an aromatase inhibitor (AI) and capecitabine in estrogen receptor (ER)- positive cell lines enhance antitumor efficacy. This retrospective analysis of a group of patients with metastatic breast cancer (MBC) evaluated the efficacy and safety of combined AI with capecitabine. Materials and Methods: Patients with hormone receptor-positive metastatic breast cancer treated between 1st January 2005 and 31st December 2010 with a combination of capecitabine and AI were evaluated and outcomes were compared with those of women treated with capecitabine in conventional dose or AI as a monotherapy. Results: Of 72 patients evaluated, 31 received the combination treatment, 22 AI and 19 capecitabine. The combination was used in 20 patients as first-line and 11 as second-line treatment. Mean age was 46.2 years with a range of 28-72 years. At the time of progression, 97% had a performance status of <2 and 55% had visceral disease. No significant difference was observed between the three groups according to clinical and pathological features. Mean follow up was 38 months with a range of 16-66 months. The median PFS of first-line treatment was significantly better for the combination (PFS 21 months vs 8.0 months for capecitabine and 15.0 months for AI). For second-line treatment, the PFS was longer in the combination compared with capecitabine and Al groups (18 months vs. 5.0 months vs. 11.0 months, respectively). Median 2 year and 5 year survival did not show any significant differences among combination and monotherapy groups. The most common adverse events for the combination group were grade 1 and 2 hand-for syndrome (69%), grade 1 fatigue (64%) and grade 1 diarrhoea (29%). Three grade 3 hand-foot syndrome events were reported. Conclusions: Combination treatment with capecitabine and AI used as a first line or second line treatment was safe with much lowered toxicity. Prospective randomized clinical trials should evaluate the use of combination therapy in advanced breast cancer to confirm these findings.

"Sandwich" Chemotherapy (CT) with Radiotherapy (RT) Improves Outcomes in Patients with Stage IE/IIE Extranodal Natural Killer (NK)/T-cell Lymphomas

  • Zhang, Jing;Zhu, Meng-Yuan;Wang, Liang;Wang, Hua;Wang, Wei-Da;Geng, Qi-Rong;Lu, Yue
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권7호
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    • pp.4061-4066
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    • 2013
  • The extranodal natural killer/T-cell lymphoma (ENKTL) shows high local or systemic failure rates when radiotherapy (RT) is taken as the primary treatment, suggesting a role for chemotherapy (CT) added to RT for this disease. However, the appropriate mode of combined modality therapy (CMT) has not been fully defined. A total of one hundred and twenty-one patients with ENKTL receiving sandwich CT with RT were reviewed between January 2003 and August 2012. The primary endpoints were the response rate, progression-free survival (PFS), overall survival (OS), and the relapse rate. After the initial CT, there were 84 (69.4%) patients in CR, 22 (18.2%) patients in PR, 9 (7.4%) patients in SD, and 6 (5%) patients in PD, respectively. At the end of RT, the CR, PR, SD, and PD rates for all patients were 90.9% (n=110), 1.7% (n=2), 4.1% (n=5), and 3.3% (n=4), respectively. After a median follow-up of 42.3 months (3.5~112.3 months), the 5-year PFS was 74.7% (95% CI 70.4%~79.0%), and 5-year OS was 77.3% (95% CI 67.9%~86.7%). Disease progression was documented in 25 (20.7%) patients. The rates of systemic failure, local failure, and regional failure were 18.2%, 5.8%, 1.7%, respectively. Twenty death events (16.5%) were observed for the entire group of patients (18 deaths related to PD). Furthermore, CR to the initial CT and low Korean Prognostic Index (KPI) can independently predict long PFS and OS. The sandwich CMT achieved an excellent outcome for localized ENKTL with acceptable toxicity. We recommend it can be applied as the optimal choice for localized ENKTL.

경부 림프절 종대로 발현한 원발 부위 불명의 전이암 (Metastatic Carcinoma of an Unknown Primary Site Presented to the Neck)

  • 김태용;조요한;김진수;홍용상;이근욱;윤탁;송은기;나임일;신현춘;김동완;이재서;성명훈;허대석
    • 대한두경부종양학회지
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    • 제20권2호
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    • pp.181-188
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    • 2004
  • Background: About 3% of all cancer patients suffer from cancer of unknown primary origin. Generally, carcinoma of unknown primary (CUP) carries a grave prognosis, but primary tumor presented to the neck is exception to this. The aims of study are to determine the role of chemotherapy and to find the prognostic factors in unknown primary tumor presented to the neck. Method and Material: Eighty-four patients were diagnosed with unknown primary tumor presented to the neck between January 1996 and June 2002. Among 84 patients, 43 patients (52%) received chemotherapy, radiation or surgery were performed in 20 patients (23%), 21 patients (25%) had no treatment. Results: The response rates to chemotherapy were 87.5% in CUP only localized to the neck and 44.0% in CUP systemically involved (p=0.012). A median follow-up duration was 6.4 years and overall median survival time was 9 months. The median overall survival time of patients treated with chemotherapy were 17 months and that of patients who received surgery or radiation were 20 months (p=0.3548). The important prognostic factors were performance status and the number of involved organ. Conclusion: The prognosis of patients with CUP presented to the neck is more favorable than that of patients with CUP of other localization. The effectiveness of chemotherapy for CUP only localized to the neck was similar to that of surgery or radiation. The important prognostic factors were performance status and the number of involved organ.

양호교사(養護敎師)의 초등학생(初等學生)에 대한 비만관리(肥滿管理) (School Nurses Obesity Management in Elementary School Children)

  • 박현옥;박재용
    • 한국학교보건학회지
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    • 제12권2호
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    • pp.217-230
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    • 1999
  • The purpose of this study is to find out problems in obesity management through survey and analysis of the actual conditions from the view of a elementary schools school-nurses and to establish fundamental data for efficient obesity management. The subjects for this study were 313 numbers of elementary school-nurses in Kyung-Sang-Pook-Do. The data were collected through mail questionaries from November 1 to November 30, 1997. The major findings in this survey were as follows: 49.8% of the school-nurses who responded in the survey were in their 30s. The average career was 7.3years. The average service duration in their present school was 2.3 years, 55.6% of them were serving at schools which have less than ten classes total 77.2% of them were serving rural areas, 79.6% of them were serving at schools with fewer than 100 obese students. The total obesity prevalence rate was 11.4%, 13.3% were girls, 9.3% were boys. The measurement of height and weight is performed once a year for all surveyed students (91.7%), but obese students were measured as much five times (51.1%). The rate of obesity management planning was 74.1%, however the rates of evaluation and role assignment were 41. 2%, and 24.3%. 79.6% of the surveyed schools have health education classes for obesity, the rate compared (8.0 periods per year) to the whole of health education (79.1 periods per year) is 10.1%. 99.9% of the schools had counseling rooms for obesity (combined with nursing rooms) but they were used. The roote of individual counseling was 84.3%. The frequency counseling was six times a year for about 15 minutes. Obesity counseling records were kept 93.6% of the time and individual information cards were kept 98.7% of the time. The frequency of parents counseling was 42.8% and the survey shows that the main problem here was insufficient counseling facilities. The frequency of dietary guidance and exercise therapy was 84.3% and the dietary instructor was usually the school nurse at 51.7%. The frequency of obesity student exercise was 1-2 times a week and more-than-10-minutes at a time. They skip rope during the morning self-study class. The number on problem of exercise guidance at 56.2% was students' non-cooperativeness. School-nurses, 87.9%, answered that obesity management at school is necessary and 86.9% mentioned the shortage of obesity related information in present physical exercise books. From the plural responses of executing the obesity management, there are many similar problems: lack of knowledge and non-cooperation in parents at 41.9%, is predominant followed by of knowledge and non-cooperation in the children. The third problem is the lack of funds and facilities.

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국내 자폐스펙트럼장애 아동의 병원 기반 조기 집중 중재 실태 조사 (A Survey on the Status of Hospital-Based Early Intensive Intervention for Autism Spectrum Disorder in South Korea)

  • 이주영;문덕수;신석호;유희정;변희정;서동수
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제28권4호
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    • pp.213-219
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    • 2017
  • Objectives: Early intensive interventions are very important for children with autism spectrum disorder. We examined the actual conditions of hospital-based early intensive interventions for autism spectrum disorder in Seoul, in order to help develop and implement an evidence-based early intensive intervention model for use in Korea. Methods: Nine hospital-based institutes running an early intensive intervention program for children with autism spectrum disorder responded to a questionnaire in September 2014. They provided a brief introduction to their program, explained its theoretical bases, and reported the number of children, their age, intervention time, duration and so on. Results: In the majority of the institutions, the intervention was provided for over 20 hours every week, and the theoretical bases included various applied behavioral analysis (ABA) methods and other therapies (language and occupational therapy). The therapist-child ratio ranged from 1:1 to 5:3. Various types of therapists were involved, including behavioral analysts, special education teachers and (or) language pathologists. There was only one clinic where the behavioral analyst was the main therapist. Usually, the intervention was terminated just before the child entered elementary school. The main merit of the hospital-based intervention in our survey was the effectiveness of the multi-disciplinary intervention plan and its other merits were the accuracy of the diagnosis, its ability to be combined with medicine, and so on. Conclusion: The current hospital-based early intensive intervention programs provide interventions for over 20 hours per week and employ multidisciplinary approaches. However, there are very few institutes for children with autism and very few intervention specialists and specialist education courses in the country. We need more educational programs for intervention therapists and have to try to develop policies which encourage the implementation of an evidence-based early intensive intervention program nationwide.

Effectiveness of alendronate as an adjunct to scaling and root planing in the treatment of periodontitis: a meta-analysis of randomized controlled clinical trials

  • Chen, Jin;Chen, Qian;Hu, Bo;Wang, Yunji;Song, Jinlin
    • Journal of Periodontal and Implant Science
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    • 제46권6호
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    • pp.382-395
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    • 2016
  • Purpose: Alendronate has been proposed as a local and systemic drug treatment used as an adjunct to scaling and root planing (SRP) for the treatment of periodontitis. However, its effectiveness has yet to be conclusively established. The purpose of the present meta-analysis was to assess the effectiveness of SRP with alendronate on periodontitis compared to SRP alone. Methods: Five electronic databases were used by 2 independent reviewers to identify relevant articles from the earliest records up to September 2016. Randomized controlled trials (RCTs) comparing SRP with alendronate to SRP with placebo in the treatment of periodontitis were included. The outcome measures were changes in bone defect fill, probing depth (PD), and clinical attachment level (CAL) from baseline to 6 months. A fixed-effect or random-effect model was used to pool the extracted data, as appropriate. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated. Heterogeneity was assessed using the Cochrane ${\chi}^2$ and $I^2$ tests. Results: After the selection process, 8 articles were included in the meta-analysis. Compared with SRP alone, the adjunctive mean benefits of locally delivered alendronate were 38.25% for bone defect fill increase (95% CI=33.05%-43.45%; P<0.001; $I^2=94.0%$), 2.29 mm for PD reduction (95% CI=2.07-2.52 mm; P<0.001; $I^2=0.0%$) and 1.92 mm for CAL gain (95% CI=1.55-2.30 mm; P<0.001; $I^2=66.0%$). In addition, systemically administered alendronate with SRP significantly reduced PD by 0.36 mm (95% CI=0.18-0.55 mm; P<0.001; $I^2=0.0%$) and increased CAL by 0.39 mm (95% CI=0.11-0.68 mm; P=0.006; $I^2=6.0%$). Conclusions: The collective evidence regarding the adjunctive use of alendronate locally and systemically with SRP indicates that the combined treatment can improve the efficacy of non-surgical periodontal therapy on increasing CAL and bone defect fill and reducing PD. However, precautions must be exercised in interpreting these results, and multicenter studies evaluating this specific application should be carried out.

Survival Benefit of Perioperative Chemotherapy in Patients with Locally Advanced Gastric Cancer: a Propensity Score Matched Analysis

  • Eom, Bang Wool;Kim, Sohee;Kim, Ja Yeon;Yoon, Hong Man;Kim, Mi-Jung;Nam, Byung-Ho;Kim, Young-Woo;Park, Young-Iee;Park, Sook Ryun;Ryu, Keun Won
    • Journal of Gastric Cancer
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    • 제18권1호
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    • pp.69-81
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    • 2018
  • Purpose: It has been reported that the survival of patients with locally advanced gastric cancer (LAGC) is better in East Asia countries than in developed western countries; however, the prognosis of LAGC remains poor. This study aimed to evaluate the effects of perioperative chemotherapy on the long-term survival of East Asia patients with LAGC. Materials and Methods: From October 2006 through August 2008, 43 patients with LAGC received perioperative S-1 combined with weekly docetaxel in a phase II study (neoadjuvant group). These patients were matched using propensity scores to patients who underwent surgery without neoadjuvant chemotherapy during the same period (surgery group). The surgical outcomes and long-term survivals were compared between the 2 groups. Results: After matching, 43 and 86 patients were included in the neoadjuvant and surgery groups, respectively, and there was no significant difference in their baseline characteristics. Although the operating time was longer in the neoadjuvant group, there was no significant difference in postoperative complications between the 2 groups. The neoadjuvant group had a significantly higher 5-year overall survival (OS) rate (73.3% vs. 51.1%, P=0.005) and a trend towards higher 5-year progression-free survival (PFS) (62.8% vs. 49.9%, P=0.145). In the multivariate analysis, perioperative chemotherapy was an independent factor for OS, with a hazard ratio of 0.4 (P=0.005) and a marginal effect on the PFS (P=0.054). Conclusions: Perioperative chemotherapy was associated with better long-term survival without increasing postoperative complications in the setting of D2 surgery for patients with LAGC, suggesting that perioperative chemotherapy can be a therapeutic option in East Asia countries.

Schedule-Dependent Effects of Kappa-Selenocarrageenan in Combination with Epirubicin on Hepatocellular Carcinoma

  • Ji, Yu-Bin;Ling, Na;Zhou, Xiao-Jun;Mao, Yun-Xiang;Li, Wen-Lan;Chen, Ning
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권8호
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    • pp.3651-3657
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    • 2014
  • Hepatocellular carcinoma (HCC) has a relatively higher incidence in many countries of Asia. Globally, HCC has a high fatality rate and short survival. Epirubicin, a doxorubicin analogue, may be administered alone or in combination with other agents to treat primary liver cancer and metastatic diseases. However, the toxic effects of epirubicin to normal tissues and cells have been one of the major obstacles to successful cancer chemotherapy. Here, we investigated the effects of epirubicin in combination with kappa-selenocarrageenan on mice with H22 implanted tumors and HepG-2 cell proliferation, immune organ index, morphology, cell cycle and related protein expressions in vivo and in vitro with sequential drug exposure. The inhibitory rate of tumor growth in vivo was calculated. Drug sensitivity was measured by MTT assay, and the King's principle was used to evaluate the interaction of drug combination. Morphological changes were observed by fluorescent microscopy. Cell cycle changes were analyzed by flow cytometry. Expression of cyclin A, Cdc25A and Cdk2 were detected by Western blotting. In vivo results demonstrated that the inhibitory rate of EPI combined with KSC was higher than that of KSC or EPI alone, and the Q value indicated an additive effect. In addition, KSC could significantly raise the thymus and spleen indices of mice with H22 implanted tumors. In the drug sensitivity assay in vitro, exposure to KSC and EPI simultaneously was more effective than exposure sequentially in HepG-2 cells, while exposure to KSC prior to EPI was more effective than exposure to EPI prior to KSC. Q values showed an additive effect in the simultaneous group and antagonistic effects in the sequential groups. Morphological analysis showed similar results to the drug sensitivity assay. Cell cycle analysis revealed that exposure to KSC or EPI alone arrested the cells in S phase in HepG-2 cells, exposure to KSC and EPI simultaneously caused accumulation in the S phase, an effect caused by either KSC or EPI. Expression of cyclin A, Cdc25A and Cdk2 protein was down-regulated following exposure to KSC and EPI alone or in combination, exposure to KSC and EPI simultaneously resulting in the lowest values. Taken together, our findings suggest that KSC in combination with EPI might have potential as a new therapeutic regimen against HCC.

전치부 개방교합의 진단과 치료 (The Diagnosis and Treatment of Anterior Openbite Malocclusion)

  • 장영일;문성철
    • 대한치과교정학회지
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    • 제28권6호
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    • pp.893-904
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    • 1998
  • 교정적으로 치료할 수는 있지만 많은 노력을 필요로 하는 부정교합들이 존재한다. 특히, 전방 개교는 치료하기 어렵고, 많은 경우 외과적 수술을 동반하여야 한다. 이러한 문제를 해결하기 위해, 여러 치료기전에 대한 연구가 소개되었다. 제안된 치료기전들은 직접, 간접적으로 근신경계와 형태학적인 특징과 원인적 혹은 환경적 요소에 기초를 둔다. 성장 변이에 따라 안모의 수직 관계는 증가하나, 적절한 치아치조 보상기전으로 정상교합 관계가 유지된다. 그러나, 부적절하거나, 부정적인 치아치조 보상기전이 일어나는 경우 개교가 발생할 수 있다. 골격 부조화가 너무 심해 교정치료만으로 해결되기 어렵다면, 악구강계의 기능과 심미를 증진시키기 위하여 수술이 행해져야만 한다. 그러나, 많은 경우 적절한 진단과 치료계획으로 주어진 골격패턴에 알맞게 교정 치료를 변형시키면, 만족스런 결과를 얻을 수 있다. Multiloop Edgewise Arcgwire(MEAW) 기법은 주로 치아치조 영역에서 치료 변화가 일어나며, 자연적인 치아치조 보상기전과 상당한 유사성을 보인다. 다시 말해서 MEAW기법은 교정의가 자연적인 치아치조 보상을 교정적으로 유도한다고 할 수 있다. 골격 패턴에 알맞은 교정적인 치아치조 보상으로 개교를 치료했다고 해도, 자연적인 치아치조 보상을 억재해왔던 원인요소가 남아 있다면, 재발이 일어난다. 원인요소는 초진시 진단되고 치료와 보정시기에도 고려되어야한다.

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