• Title/Summary/Keyword: comparison of efficacy

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Clinical Experience of $VNUS^{(R)}Closure$ fast in Treatment of Varicose Vein: Comparison with Traditional Radiofrequency Ablation (하지정맥류 치료를 위한 2세대 고주파 열폐쇄술($VNUS^{(R)}Colosure$ fast)과 기존의 고주파 열폐쇄술($VNUS^{(R)}Closure$ plus)의 임상치험 비교 분석)

  • Kim, Woo-Shik;Lee, Jeong-Sang;Jeong, Seong-Cheol;Shin, Vong-Chul
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.635-641
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    • 2010
  • Background: Radiofrequency endovenous ablation of incompetent saphenous vein has gaining popularity over the conventional ligation and stripping as a minimally invasive technique. The latest version of radiofrequency endovenous catheter, $VNUS^{\circledR}Colosure$ fast VNUS medical Technologies, San Jose, CA, adopted a segmental ablation system, instead of continous pullback, is designed to reduce treatment time in comparison with the previous model $VNUS^{\circledR}Colosure$ plus VNUS medical Technologies, San Jose, CA. The purpose of this study is to compare the difference between two endovenous radiofrequency ablation systems in terms of treatment efficacy and complication rates. We analyze the initial efficacy and complication rates of $VNUS^{\circledR}Colosure$ fast with $VNUS^{\circledR}Colosure$ plus. Material and Method: Between June 2006 and August 2009, $VNUS^{\circledR}Colosure$ plus was performed to treat varicose vein on 59 limbs in 41. patients and $VNUS^{\circledR}Colosure$ fast was performed on 76 limbs in 67 patients. We retrospectively compared in both group with sex, mean treatment time, mean treatment diameter, conjugated treatment, and complications after the procedure. Result: All patient were symptomatic and diagnosed as varicose vein and underwent level 2 clinical classification with color duplex scan. The mean treatment time for the great saphenous vein was significantly less with $VNUS^{\circledR}Colosure$ fast ($17.0{\pm}6.5min$) than $VNUS^{\circledR}Colosure$ plus ($62.7{\pm}9.8min$). There was no significant difference in 1 yr closure rate between groups (p=0.32). Minor complications such as skin burn, thrombophlebitis, ecchymosis, hematoma, cellulitis, tenderness, and there were not different between the groups. Conclusion: Both $VNUS^{\circledR}Colosure$ fast and $VNUS^{\circledR}Colosure$ plus are effective methods of endovenous saphenous ablation. $VNUS^{\circledR}Colosure$ fast is superior to the previous model with less treatment time preserving compatible efficacy and complications. The efficacy of $VNUS^{\circledR}Colosure$ fast for long term closure rate remains to be established.

Literature Review of Empowerment Intervention Studies for Patients with Chronic Physical Health Conditions in Korea (만성적인 신체질환을 가진 환자에게 적용된 임파워먼트 중재 연구 고찰 - 국내를 중심으로)

  • Kim, Jiyoung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.8
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    • pp.455-467
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    • 2020
  • This study was a systematic review examining the effect of empowerment intervention studies among patients with chronic physical health conditions in Korea. The PICOT-SD (Participants, Intervention, Comparison, Outcomes, Timing of outcome measurement, Setting, Study design) strategy was applied. A total of 19 studies published between January 2000 and April 2020 were selected. Study participants were rheumatoid arthritis patients, hemodialysis patients, stroke patients, diabetes mellitus patients, chronic pulmonary disease patients, hypertensive patients, cancer patients, chronic kidney disease patients, and kidney transplantation patients, etc. A total of 17 studies were found to have presented a conceptual framework. Empowerment skills were participation, dialogue, experience, interaction, support, and problem solving, etc. The most frequently used dependent variables were self-care (n=13), empowerment (n=10), self-efficacy (n=7), and depression (n=5). Self-care, empowerment, and self-efficacy showed significant improvement among patients in at least 60% of the included studies. Based upon this review, there is evidence that empowerment intervention studies are an effective method to improve the health of patients with chronic physical health conditions. This study further suggests the development of an empowerment intervention program to verify the effects of the various variables identified in this study.

Comparison of Antinociceptive Effect of Korean and American Bee Venoms on Pain in Rodent Models (설치동물에서 통증에 대한 한국산 및 미국산 봉독의 진통효과의 비교)

  • Kim, Jong-Min;Han, Tae-Sung;Kang, Seong-Soo;Kim, Gon-Hyung;Choi, Seok-Hwa
    • Journal of Veterinary Clinics
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    • v.27 no.6
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    • pp.663-667
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    • 2010
  • Experiments were undertaken to assess the antinociceptive effect of bee venom (BV) in rodent animal models. Comparison of antinociceptive efficacy between Korean BV and commercially available American BV was the primary interest of the study. Korean BV was collected using BV collector devices in which an electrical impulse is used to stimulate the worker bee (Apis mellfera L.) to sting and release venom. After collection, whole BV was evaporated until dry using the BV collector. Commercially available dried American BV was purchased from Sigma Company in USA. Korean and American sourced BVs were diluted and amounts of 6 mg/kg body weight (BW), 0.6 mg/kg BW and 0.06 mg/kg BW were tested. BV was subcutaneously injected to produce an antinociceptive effect and the antinociceptive efficacy was evaluated using a writhing test in mice and a formalin test in rats. The antinociceptive effects of the two BVs tested were similar in mice for visceral pain and showed a dose-dependent response. The antinociceptive effect of Korean BV was not significantly different compare to American BV. These results suggest that Korean BV may be used to achieve an antinociceptive effect for use in medical therapies.

A DOUBLE BLIND CROSS-OVER COMPARISON OF ANTIDEPRESSANT AND ANTIANXIETY EFFECTS OF PAROXETINE AND PLACEBO IN CHILD-ADOLESCENT AND ADULT DEPRESSIVE NEUROSIS (소아 ${\cdot}$ 청소년 및 성인 우울신경증 환자에 대한 Paroxetine의 항우울 및 항불안 효과 검증 : 위약과의 이중맹 교차 비교실험)

  • Kim, S. Peter;Hong, Kyung-Sue
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.5 no.1
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    • pp.83-92
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    • 1994
  • Paroxetine is a potent and selective serotoin re-uptake inhibitor. It is well known as an effective and safe antidepressant and increasingly used for neurotic or non-psychotic depression with anxiety symptoms. The present study assessed antidepressant and antianxiety efficacy and tolerability of paroxetine against placebo in child-adolescent and adult depressive neurosis patients. 232 subjects aged 8-55 years and meeting DSM-III-R criteria for depressive neurosis or dysthymia were divided into 8 subgroups according to their sex and age(8-11 yeard old, 12-17 years old, 18-35 years old and 36-55 years old subgroup in each male and female group). In each subgroup, the randomly assigned half of the patients were treated with paroxetine(10-30mg/day) and the others with placebo for the first 2 weeks in double blind fashion. After 1 week of drug-washout period, paroxetine and placebo groups were crossed over. The depression and anxiety symptoms were assessed with Hamilton Depression Scale(HDS) and Hamilton Anxiety Scale(HAS) at baseline and every 1 week during the trial periods. The levels of reduction in HDS and HAS scores from baseline after 2-week trial were compared between paroxetine- and placebo- treated periods by paired t-test. In all the 8 subgroups, statistically significant differences between paroxetine and placebo were found on the antidepressant efficacy after 2-week treatment. The antidepressant efficacy of paroxetine compared to placebo was most prominent in child and adolescent female groups. On anxiety symptoms, paroxetine was also significantly more effective than placebo. The antianxiety efficacy of paroxetine compared to placebo was most prominent in male and female child groups and young adult female group aged 18-35 years. As for the adverse effects of paroxetine, 3 out of 232 subjects reported mild indigestion and abdominal pain. however, in all the 3 cases, the symptoms improved without reduction of dosage or discontinuation of the drug. In conclusion, paroxetine showed significantly higher antidepressant and antianxiety efficacy compared to placebo in child-adolescent and adult depressive neurosis patients after 2-week treatment. Further trials of paroxetine in depressive neurosis are warranted to elucidate the long-term antidepressant and antianxiety efficacy of paroxetine.

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Comparison of Intracardiac Echocardiography Versus Transesophageal Echocardiography for Guidance During Transcatheter Aortic Valve Replacement

  • Sang-Hyup Lee;Seunguk Oh;Young-Guk Ko;Yong-Joon Lee;Seung-Jun Lee;Sung-Jin Hong;Chul-Min Ahn;Jung-Sun Kim;Byeong-Keuk Kim;Kyu-Yong Ko;Iksung Cho;Chi Young Shim;Geu-Ru Hong;Donghoon Choi;Myeong-Ki Hong
    • Korean Circulation Journal
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    • v.54 no.2
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    • pp.63-75
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    • 2024
  • Background and Objectives: Evidence regarding the efficacy and safety of intracardiac echocardiography (ICE) for guidance during transcatheter aortic valve replacement (TAVR) is limited. This study aimed to compare the clinical efficacy and safety of ICE versus transesophageal echocardiography (TEE) for guiding TAVR. Methods: This prospective cohort study included patients who underwent TAVR from August 18, 2015, to June 31, 2021. Eligible patients were stratified by echocardiographic modality (ICE or TEE) and anesthesia mode (monitored anesthesia care [MAC] or general anesthesia [GA]). Primary outcome was the 1-year composite of all-cause mortality, rehospitalization for cardiovascular cause, or stroke, according to the Valve Academic Research Consortium-3 (VARC-3) definition. Propensity score matching was performed, and study outcomes were analyzed for the matched cohorts. Results: Of the 359 eligible patients, 120 patients were matched for the ICE-MAC and TEEGA groups, respectively. The incidence of primary outcome was similar between matched groups (18.3% vs. 20.0%; adjusted hazard ratio, 0.94; 95% confidence interval [CI], 0.53-1.68; p=0.843). ICE-MAC and TEE-GA also had similar incidences of moderate-to-severe paravalvular regurgitation (PVR) (4.2% vs. 5.0%; adjusted odds ratio, 0.83; 95% CI, 0.23-2.82; p=0.758), new permanent pacemaker implantation, and VARC-3 types 2-4 bleeding. Conclusions: ICE was comparable to TEE for guidance during TAVR for the composite clinical efficacy outcome, with similar incidences of moderate-to-severe PVR, new permanent pacemaker implantation, and major bleeding. These results suggest that ICE could be a safe and effective alternative echocardiographic modality to TEE for guiding TAVR.

Efficacy of ketamine in the treatment of migraines and other unspecified primary headache disorders compared to placebo and other interventions: a systematic review

  • Chah, Neysan;Jones, Mike;Milord, Steve;Al-Eryani, Kamal;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.5
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    • pp.413-429
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    • 2021
  • Background: Migraine headaches are the second leading cause of disability worldwide and are responsible for significant morbidity, reduction in the quality of life, and loss of productivity on a global scale. The purpose of this systematic review and meta-analysis was to evaluate the efficacy of ketamine on migraines and other primary headache disorders compared to placebo and other active interventions, such as midazolam, metoclopramide/diphenhydramine, and prochlorperazine/diphenhydramine. Methods: An electronic search of databases published up to February 2021, including Medline via PubMed, EMBASE, Web of Science, and Cochrane Library, a hand search of the bibliographies of the included studies, as well as literature and systematic reviews found through the search was conducted to identify randomized controlled trials (RCTs) investigating ketamine in the treatment of migraine/headache disorders compared to the placebo. The authors assessed the risk of bias according to the Cochrane Handbook guidelines. Results: The initial search strategy yielded 398 unduplicated references, which were independently assessed by three review authors. After evaluation, this number was reduced to five RCTs (two unclear risk of bias and three high risk of bias). The total number of patients in all the studies was 193. Due to the high risk of bias, small sample size, heterogeneity of the outcomes reported, and heterogeneity of the comparison groups, the quality of the evidence was very low. One RCT reported that intranasal ketamine was superior to intranasal midazolam in improving the aura attack severity, but not duration, while another reported that intranasal ketamine was not superior to metoclopramide and diphenhydramine in reducing the headache severity. In one trial, subcutaneous ketamine was superior to saline in migraine severity reduction; however, intravenous (I.V.) ketamine was inferior to I.V. prochlorperazine and diphenhydramine in another study. Conclusion: Further double-blind controlled studies are needed to assess the efficacy of ketamine in treating acute and chronic refractory migraines and other primary headaches using intranasal and subcutaneous routes. These studies should include a long-term follow-up and different ketamine dosages in diagnosed patients following international standards for diagnosing headache/migraine.

Efficacy and Safety of Trastuzumab Deruxtecan and Nivolumab as Third- or Later-Line Treatment for HER2-Positive Advanced Gastric Cancer: A Single-Institution Retrospective Study

  • Keitaro Shimozaki;Izuma Nakayama ;Daisuke Takahari;Kengo Nagashima;Koichiro Yoshino ;Koshiro Fukuda;Shota Fukuoka ;Hiroki Osumi ;Mariko Ogura ;Takeru Wakatsuki;Akira Ooki ;Eiji Shinozaki;Keisho Chin ;Kensei Yamaguchi
    • Journal of Gastric Cancer
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    • v.23 no.4
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    • pp.609-621
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    • 2023
  • Purpose: Determination of optimal treatment strategies for HER2-positive advanced gastric cancer (AGC) in randomized trials is necessary despite difficulties in direct comparison between trastuzumab deruxtecan (T-DXd) and nivolumab as third or later-line treatments. Materials and Methods: This single-institution, retrospective study aimed to describe the real-world efficacy and safety of T-DXd and nivolumab as ≥ third line treatments for HER2-positive AGC between March 2016 and May 2022. Overall, 58 patients (median age, 64 years; 69% male) were eligible for the study (T-DXd group, n=20; nivolumab group, n=38). Results: Most patients exhibited a HER2 3+ status (72%) and presented metastatic disease at diagnosis (66%). The response rates of 41 patients with measurable lesions in the T-DXd and nivolumab groups were 50% and 15%, respectively. The T-DXd and nivolumab groups had a median progression-free survival of 4.8 months (95% confidence interval [CI], 3.3, 7.0) and 2.3 months (95% CI, 1.5, 3.5), median overall survival (OS) of 10.8 months (95% CI, 6.9, 23.8) and 11.7 months (95% CI, 7.6, 17.1), and grade 3 or greater adverse event rates of 50% and 2%, respectively. Overall, 64% patients received subsequent treatment. Among 23 patients who received both regimens, the T-DXd-nivolumab and nivolumab-T-DXd groups had a median OS of 14.0 months (95% CI, 5.0, not reached) and 19.3 months (95% CI, 9.5, 25.1), respectively. Conclusions: T-DXd and nivolumab showed distinct efficacy and toxicity profiles as ≥ third line treatments for HER2-positive AGC. Considering the distinct features of each regimen, they may help clinicians personalize optimal treatment approaches for these patients.

Comparative Study on Anti-inflammatory Effects and Compound Contents of Multi-herbal Extracts HT008 produced by Different Manufacturing Methods (한약복합추출물 HT008의 제조방법에 따른 항염증 효능 및 성분함량 비교연구)

  • Lee, Donghun;Song, Jungbin;Song, Mikyung;Gaire, Bhakta Prasad;Park, Juyeon;Jin, Aihong;Choi, Ho-Young;Kim, Hocheol
    • The Korea Journal of Herbology
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    • v.28 no.4
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    • pp.71-76
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    • 2013
  • Objectives : The biological activities and compound contents of herbal medicine vary depending on manufacturing processes. In this study, we compared anti-inflammatory effects and compound contents of three kinds of multi-herbal extract HT008 produced by different manufacturing processes in order to determine chemical and biological equivalence. Methods : HT008 was produced by three different manufacturing methods: 1. Freeze dried extract of Eleutherococcus senticosus, Scutellaria baicalensis and Angelica sinensis (HT008 FD), 2. Spray dried extract of E. senticosus and S. baicalensis combined with reflux extract of A. sinensis (HT008 SD), 3. Spray dried extract of E. senticosus and S. baicalensis combined with supercritial fluid extract of A. sinensis (HT008 SF). Anti-inflammatory effects were evaluated using acetic acid induced pain model and ${\lambda}$-carageenan induced paw edema model. Compound contents were evaluated by HPLC quantitative analysis of standard compounds of HT008, eleutheroside E, baicalin, z-ligustilide. Results : HT008 FD, HT008 SD and HT008 SF significantly decreased acetic acid induced pain index and ${\lambda}$-carrageenan induced paw edema volume compared with that of control group. There was no significant difference in efficacy among the HT008 FD, HT008 SD and HT008 SF. Standard compound contents of HT008 FD, HT008 SD and HT008 SF were quantified within the range of Korean pharmacopoeia or other research. Conclusions : Three different manufacturing methods of multi-herbal extracts have been developed without noticeable difference in the efficacy or compound contents. The results might be used to establish manufacturing process and industrialization of herbal extracts.

A Systematic Review of Korean Medicine for Non-Alcoholic Fatty Liver Disease (비알콜성 지방간질환의 한방치료에 대한 체계적 문헌고찰)

  • Lee, Yu-ri;Cho, Na-kyung;Choi, Hong-sik;Kim, Seung-mo;Kim, Kyung-soon
    • The Journal of Internal Korean Medicine
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    • v.40 no.1
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    • pp.13-37
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    • 2019
  • Objectives: The purpose of this study was to assess the effects of Korean medicine for non-alcoholic fatty liver disease (NAFLD). We analyzed the result of randomized controlled trials (RCTs) that applied Korean medicine to NAFLD patients through meta analysis and systematic review. Methods: The key question was to the effects of Korean medicine for NAFLD patients according to the PICO-SD (participants, intervention, comparison, outcome, study design) and we included only RCTs. We searched 10 databases including NDSL, KMBASE, KISS, KISTI, KoreaMed, Koreantk, OASIS, Cochrane, Pubmed, EMBASE without a language restriction. We assessed risk of bias by Cochrane group's Risk of Bias tool. Results: The finally selected 12 RCTs were analyzed. Total number of participants was 1189 (male 719, female 470) as 684 and 505 in the oriental medicine group (i.e. herbal drugs, acupuncture, acupoint embedding therapy) and control group (conventional drugs, placebo), respectively. The meta analysis results of examining 7 RCTs comparing the therapeutic efficacy of herbal medicine with that of Western medicine showed statistically significant (p<0.05) differences in the efficacy evaluation, liver function test results, blood lipids, and TNF-${\alpha}$. Furthermore, the meta analysis results of investigating 3 RCTs comparing the therapeutic efficacy of herbal medicine with that of a placebo showed statistically significant (p<0.05) differences in the liver function test results, blood lipids, and waist circumference. Conclusions: The research showed that Korean medicine for NAFLD can be effective treatment. But more studies are required to enhance the level of evidence and we should report on safety.

Comparison of Efficacy and Toxicity of First Line Chemotherapy with or without Epirubicin for Patients with Advanced Stage Soft Tissue Sarcoma

  • Cao, Jie;Huang, Xin-En;Liu, Jin;Wu, Xue-Yan;Lu, Yan-Yan
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7171-7177
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    • 2013
  • Purpose: To compare the safety and efficacy of first-line chemotherapy regimen with or without doxorubicin in treating patients with advanced soft tissue sarcoma (STS). Patients and Methods: We retrospectively analyzed a cohort of 56 patients histologically confirmed with STS who were treated at Jiangsu Cancer Hospital and Research Institute from July 2011 to June 2012.The basic element of first line chemotherapy contained epirubicin in group B and lacked epirubicin in group A. Response was assessed using RECIST criteria. The Kaplan-Meier method was used to estimate progress free survival (PFS). Results: According to RECIST criteria, patients in group treated by chemotherapy without epirubicin, the objective response (OR) ratio was 6.5 % (CR0%+PR6.5%). Disease control rate (DCR=CR+PR+SD) was 25.8% with a median follow-up of 14.6 months, including 2 patients achieving a partial response (PR 6.5%) and a stable response (SD 19.4%) in 6. In group B with epirubicin based regimens, no patient had complete response, PR (28 %) was observed in 7 and SD (24 %) in 6. DCR was observed in 13 patients (52%). By Fisher's exact test, the DCR difference between the two groups was statistically significant (p=0.046). In group A, median PFS was 3.0 months (95%CI:2.1-3.8), compared with 4.0 months (95% CI:3.03-4.97) in group B (p=0.0397 by log-rank test). Epirubicin based chemotherapy and ECOG performance status 0-1 were identified as favorable factors for progression in our cohort of patients. Differences of nonhematologic and hematologic toxicities were not statistically significant between the two groups, and the addition of epirobicin was not associated with cardiac toxicity (p=0.446). Conclusion: Our study demonstrates that epirubicin-based chemotherapy is effective and well tolerated, and is superior to chemotherapy without epirubicin regarding efficacy. Therefore it is recommended that epirubicin-based chemotherapy should be considered as first line for patients with advanced STS.