• Title/Summary/Keyword: efficacy and safety

Search Result 1,788, Processing Time 0.029 seconds

Investigation of Leksell GammaPlan's ability for target localizations in Gamma Knife Subthalamotomy (감마나이프 시상하핵파괴술에서 목표물 위치측정을 위한 렉셀 감마플랜 능력의 조사)

  • Hur, Beong Ik
    • Journal of the Korean Society of Radiology
    • /
    • v.13 no.7
    • /
    • pp.901-907
    • /
    • 2019
  • The aim of this study is to evaluate the ability of target localizations of Leksell GammaPlan(LGP) in Gamma Knife Subthalamotomy(or Pallidotomy, Thalamotomy) of functional diseases. To evaluate the accuracy of LGP's location settings, the difference Δr of the target coordinates calculated by LGP (or LSP) and author's algorithm was reviewed for 10 patients who underwent Deep Brain Stimulation(DBS) surgery. Δr ranged from 0.0244663 mm to 0.107961 mm. The average of Δr was 0.054398 mm. Transformation matrix between stereotactic space and brain atlas space was calculated using PseudoInverse or Singular Value Decomposition of Mathematica to determine the positional relationship between two coordinate systems. Despite the precise frame positioning, the misalignment of yaw from -3.44739 degree to 1.82243 degree, pitch from -4.57212 degree to 0.692063 degree, and rolls from -6.38239 degree to 7.21426 degree appeared. In conclusion, a simple in-house algorithm was used to test the accuracy for location settings of LGP(or LSP) in Gamma Knife platform and the possibility for Gamma Knife Subthalamotomy. The functional diseases can be treated with Gamma Knife Radiosurgery with safety and efficacy. In the future, the proposed algorithm for target localizations' QA will be a great contributor to movement disorders' treatment of several Gamma Knife Centers.

Delayed Burr Hole Surgery in Patients with Acute Subdural Hematoma : Clinical Analysis

  • Choi, Yoon Heuck;Han, Seong Rok;Lee, Chang Hyun;Choi, Chan Young;Sohn, Moon Jun;Lee, Chae Heuck
    • Journal of Korean Neurosurgical Society
    • /
    • v.60 no.6
    • /
    • pp.717-722
    • /
    • 2017
  • Objective : To evaluate the effectiveness and efficacy of delayed burr hole surgery in relation to the reduction of postoperative subdural hematoma (SDH) volume in patients with acute SDH. Methods : We retrospectively analyzed patients with acute SDH who received delayed burr hole surgery at our institute. Age, sex, Glasgow coma scale, maximal SDH thickness, volume of SDH, midline shifts, hounsfield unit (HU), and medical history of anticoagulant agent usage were recorded. Outcome measures were delayed operation day, reduction of SDH volume after operation, and the Glasgow outcome scale (GOS) score at discharge. The patients were divided two groups according to the postoperative reduction of volume of SDH (${\geq}50%$, group A; <50%, group B). We also analyzed variables and differences between two groups. Results : Eighteen patients were available for this analysis. The mean delayed of surgery was $13.9{\pm}7.5$ days. Maximal thickness of SDH was changed from $10.0{\pm}3.5mm$ to $12.2{\pm}3.7mm$. Volume of SDH was changed from $38.7{\pm}28.0mL$ to $42.6{\pm}29.6mL$. Midline shifts were changed from $5.8{\pm}3.3mm$ to $6.6{\pm}3.3mm$. HU were changed from $66.4{\pm}11.2$ to $53.2{\pm}20.6$. Post-operative reduction of SDH volume was $52.1{\pm}21.1%$. Eleven patients (61%) had a discharge GOS score of 1 (good recovery). Ten patients (56%) were enrolled in group A. Midline shifting was greater in group A than in group B ($7.4{\pm}3.3$ vs. $3.0{\pm}2.4mm$; p<0.02). The delay of surgery was shorter for group A than group B ($9.2{\pm}2.3$ vs. $19.8{\pm}7.7$ days; p<0.0008). Conclusion : Among well selected patients, delayed burr hole surgery in patients with acute SDH may be effective for reduction of SDH volume. Further studies will be necessary to establish the effectiveness and safety of delayed burr hole surgery in patients with acute SDH.

Clinical Research of Warm Needle Acupuncture for Chronic Low Back Pain: A Protocol for Randomized, Controlled Pilot Study (온침이 만성요통에 미치는 효과에 대한 무작위배정 대조군 예비 임상연구 프로토콜)

  • Seo, Yeonho;Kim, Taeoh;Cho, Whisung;Ko, Junhyuk;Ahn, Jonghyun;Kim, Soo Jeon;Lee, Hansol;Chang, Hokyung;Kim, Hyungsuk;Kim, Koh-Woon;Cho, Jae-Heung;Chung, Wonseok;Song, Mi-Yeon
    • Journal of Korean Medicine Rehabilitation
    • /
    • v.30 no.4
    • /
    • pp.155-164
    • /
    • 2020
  • Objectives This study is aimed to evaluate the feasibility of further clinical research of warm needle acupuncture as an effective and safe treatment for chronic low back pain. Methods Thirty participants will be randomly assigned to the Warm needle acupuncture group (n=15) and Dry needle acupuncture group (n=15). All patients will receive acupuncture therapy twice a week for 6 weeks, but only the experimental group will receive thermal stimulation. The primary outcome will be measured using the visual analogue scale for bothersomeness of low back pain, and the secondary outcome will be measured using the VAS for pain intensity, Oswestry disability index, 36-Item Short Form Health Survey, Beck's depression inventory, and amount of analgesics used. Conclusions The results of this study will be used to determine the feasibility of a future large-scale randomized controlled trial that provides clinical evidence for the efficacy and safety of warm needle acupuncture in the treatment of patients with chronic low back pain.

Effects of Tiamulin on Starry Flounder, Platichthys stellatus Infected with Streptococcus parauberis HFTC0083 (Tiamulin이 Streptococcus parauberis HFTC0083에 감염된 강도다리(Platichthys stellatus)에 미치는 영향)

  • Joo, Min-Soo;Kim, Boseong;Kim, Do-Hyung;Seo, Jung-Soo;Kwon, Mun-Gyeong;Jee, Bo-Young;Park, Chan-Il
    • Journal of Marine Life Science
    • /
    • v.4 no.1
    • /
    • pp.29-37
    • /
    • 2019
  • In order to control disease caused by multi-drug resistant bacteria in the aquaculture, the use of veterinary antibiotics, which are prohibited to fish, is increasing, instead of the existing fisheries antibiotics. Among them, tiamulin is illegally used in some cultured fish because it exhibits effective antibacterial activity against Gram-positive bacteria. To prevent unauthorized use, treatment of fish should be accompanied by a prescription from veterinarians or fisheries disease managers through research on fish of tiamulin. Tiamulin was injected intramuscularly at 5, 10 and 15 mg kg-1 for the streptococcus-infected starry flounder, but did not show any therapeutic effect. Oral administration at a concentration of 15 and 30 mg kg-1 was similarly ineffective. The concentrations of 30 and 60 mg kg-1 resulted in death due to toxicity of antibiotics. Therefore, it is inappropriate to treat antibiotics with streptococcus-infected starry flounder.

Comparing Effectiveness Rituximab (Mabthera®) to Other Second-line Biologics for Rheumatoid Arthritis Treatment in Patients Refractory to or Intolerant of First-line Anti-tumor Necrosis Factor Agent: An Observational Study

  • Park, Yong-Wook;Kim, Ki-Jo;Yang, Hyung-In;Yoon, Bo Young;Kim, Sang Hyon;Kim, Seong-Ho;Kim, Jinseok;Oh, Ji Seon;Kim, Wan-Uk;Lee, Yeon-Ah;Choe, Jung-Yoon;Park, Min-Chan;Lee, Sang-Heon
    • Journal of Rheumatic Diseases
    • /
    • v.24 no.4
    • /
    • pp.227-235
    • /
    • 2017
  • Objective. Failure of first-line anti-tumor necrosis factor (TNF) agents in in rheumatoid arthritis patients leads to decisions among second-line biologic agents. To better inform these decisions, the therapeutic effectiveness of rituximab is compared with other second-line biologic agents in this observational study. Methods. Between November 2011 and December 2014, study subjects were observed for 12 month periods. Patients with an inadequate response to initial anti-TNF agent received either rituximab or alternative anti-TNF agents (adalimumab/etanercept/infliximab) based on the preference of patients and physicians. The efficacy end point of this study was the change in 28-joint count Disease Activity Score (DAS28) at six and 12 months from baseline. Safety data were also collected. Results. Ninety patients were enrolled in the study. DAS28 at six months did not change significantly whether the patients were treated with rituximab or alternative anti-TNF agents in intention-to-treat analysis (n=34, $-1.63{\pm}0.30$ vs. n=31, $-2.05{\pm}0.34$) and standard population set analysis (n=31, $-1.51{\pm}0.29$ vs. n=24, $-2.21{\pm}0.34$). Similarly, the change in DAS28 at 12 months did not reach statistical significance ($-1.82{\pm}0.35$ in the rituximab vs. $-2.34{\pm}0.44$ in the alternative anti-TNF agents, p=0.2390). Furthermore, the incidences of adverse events were similar between two groups (23.5% for rituximab group vs. 25.8% for alternative anti-TNF agents group, p=0.7851). Conclusion. Despite the limitations of our study, switching to rituximab or alternative anti-TNF agents after failure of the initial TNF antagonist showed no significant therapeutic difference in DAS28 reduction.

A Study on the Particle Size of Sand to Prevent Penetration of Subterranean Termite (Reticulitermes speratus kyushuensis) in Wooden Buildings (국내 지중흰개미의 목조건축물 유입 차단을 위한 모래의 적정 입도 연구)

  • Kim, Si Hyun;Kim, Tae Heon;Chung, Yong Jae
    • Journal of Conservation Science
    • /
    • v.38 no.2
    • /
    • pp.80-86
    • /
    • 2022
  • Termites cause massive damage to wooden architectural heritage structures. Chemical treatments have been commonly used to control them. In foreign countries, physical barriers made of sheet and particles impenetrable to termite are being used as an alternative to the chemical method. To study the efficacy of physical barriers, we investigated the appropriate sand particle size that can prevent the penetration of R. speratus kyushuensis. Upon evaluating the barrier properties of sand with particle sizes ranging from 0.85 to 4.00 mm, the penetration of termites was found to be effectively blocked at a particle size range of 1.00 to 2.80 mm. At smaller particle sizes, termites managed to move the sand particles and build an almost linear mud tube to penetrate the sand layer. At larger particle sizes, the termites could penetrate the sand layer by passing through the sand gaps.

Efficacy of antibacterial treatments of fresh ginseng (Panax ginseng C.A. Meyer) (항균제 처리에 따른 수삼의 미생물 저감화 효과)

  • Choi, Jun-Bong;Cho, Won-Il
    • Korean Journal of Food Science and Technology
    • /
    • v.54 no.1
    • /
    • pp.75-79
    • /
    • 2022
  • Fresh, washed ginseng can be contaminated with microorganism loads as high as 6.5 log CFU/g for total bacteria and 4.3 log CFU/g for mold. The goal of this study was to test eight antibacterial agents on ginseng. Immersing fresh ginseng washed in 1% (w/w) sodium citrate, sodium diacetate, sodium acetate, citric acid, and sodium lactate solution for 1 h resulted in a bactericidal effect of 31.0-97.5% for total bacteria. Among the organic acids, sodium citrate had the best antibacterial effect, with total bacteria reduced from 6.5 log to 4.9 log CFU/g. A 1% (w/w) vitamin B1 lauryl sulfate solution with surfactant function by hydrophilic and hydrophobic sites can reduce 2.7 log CFU/g (99.8% inactivation) on total bacteria. In the 1% (w/w) calcium oxide solution, total bacteria were reduced by 3 log, showing an excellent inactivation effect of 99.9%. Calcium oxide is a highly useful material for inactivation of microorganisms in fresh ginseng.

The Clinical Effect of Sparfloxacin for the Treatment of Acute Respiratory Infection (호흡기 감염 질환에서 Sparfloxacin의 임상효과)

  • Lee, Hak-Jun;Park, Hye-Jung;Shin, Chang-Jin;Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Kwan-Ho;Lee, Hyun-Woo
    • Journal of Yeungnam Medical Science
    • /
    • v.15 no.2
    • /
    • pp.246-253
    • /
    • 1998
  • Sparfloxacin is a new synthetic quinolone antimicrobial developed at the Research Laboratories of Dainippon Pharmaceutical Co, Ltd. To evaluate the efficacy and safety of sparfloxacin in acute pulmonary infection, we administered sparfloxacina(100mg) twice in a day to 30 patients who had signs and symptoms of acute pulmonary infectious diseases regardless of their underlying lung disease for 7 days. The results were as follows: 1) A total 30 patients were enrolled in the trial. Among them, 24 cases(80%) had underlying lung problems such as chronic obstructive pulmonary disease(36.4%), bronchiectasis(36.4%), bronchial asthma(3.3%), or lung cancer(3.3%). 2) In 26 cases(86.6%), we observed effective improvement, and 4 cases(13.4%) show mildly effective improvement of symptoms and signs of respiratory infection. 3) In 23 cases(73.4%), we observed bacteriological eradication in culture or decreased the number of bacteria by Gram stain which found dominantly in previous Gram stain. 4) The significant side effect was not noted. The above results suggested that sparfloxacin was effective as a first line therapy in patients with acute respiratory infection.

  • PDF

Outcomes of partially covered self-expandable metal stents with different uncovered lengths in endoscopic ultrasound-guided hepaticogastrostomy: a Japanese retrospective study

  • Takeshi Okamoto;Takashi Sasaki;Tsuyoshi Takeda;Tatsuki Hirai;Takahiro Ishitsuka;Manabu Yamada;Hiroki Nakagawa;Takafumi Mie;Takaaki Furukawa;Akiyoshi Kasuga;Masato Ozaka;Naoki Sasahira
    • Clinical Endoscopy
    • /
    • v.57 no.4
    • /
    • pp.515-526
    • /
    • 2024
  • Background/Aims: The optimal length of the uncovered portion of partially covered self-expandable metal stents (PCSEMSs) used in endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) remains unclear. This study investigated the safety and efficacy of PCSEMSs with different uncovered lengths, with a focus on stent migration and time to recurrent biliary obstruction (RBO). Methods: Outcomes of patients undergoing EUS-HGS using PCSEMSs with 5-mm and 20-mm uncovered portions at our institution from January 2016 to December 2021 were compared. Results: Sixty-two patients underwent EUS-HGS using PCSEMS (5/20-mm uncovered portions: 32/30). Stent migration occurred only in the 5-mm group. There were no differences in RBO rates (28.1% vs. 40.0%) or median time to RBO (6.8 vs. 7.1 months) between the two groups. Median overall survival (OS) was longer in the 20-mm group (3.1 vs. 4.9 months, p=0.037) due to the higher number of patients that resumed chemotherapy after EUS-HGS (56.7% vs. 28.1%, p=0.029). Good performance status, absence of hepatic metastases, and chemotherapy after EUS-HGS were independent predictors of longer OS. Conclusions: No migration was observed in patients treated with PCSEMS with 20-mm uncovered portions. Patients treated with PCSEMS with 20-mm uncovered portions performed at least as well as those treated with 5-mm uncovered portions in all material respects.

Prasugrel-based De-Escalation of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention in Patients With STEMI

  • You-Jeong Ki;Bong Ki Lee;Kyung Woo Park;Jang-Whan Bae;Doyeon Hwang;Jeehoon Kang;Jung-Kyu Han;Han-Mo Yang;Hyun-Jae Kang;Bon-Kwon Koo;Dong-Bin Kim;In-Ho Chae;Keon-Woong Moon;Hyun Woong Park;Ki-Bum Won;Dong Woon Jeon;Kyoo-Rok Han;Si Wan Choi;Jae Kean Ryu;Myung Ho Jeong;Kwang Soo Cha;Hyo-Soo Kim;HOST-RP-ACS investigators
    • Korean Circulation Journal
    • /
    • v.52 no.4
    • /
    • pp.304-319
    • /
    • 2022
  • Background and Objectives: De-escalation of dual-antiplatelet therapy through dose reduction of prasugrel improved net adverse clinical events (NACEs) after acute coronary syndrome (ACS), mainly through the reduction of bleeding without an increase in ischemic outcomes. Whether the benefits of de-escalation are sustained in highly thrombotic conditions such as ST-elevation myocardial infarction (STEMI) is unknown. We aimed to assess the efficacy and safety of de-escalation therapy in patients with STEMI or non-ST-segment elevation ACS (NSTE-ACS). Methods: This is a pre-specified subgroup analysis of the HOST-REDUCE-POLYTECH-ACS trial. ACS patients were randomized to prasugrel de-escalation (5 mg daily) or conventional dose (10 mg daily) at 1-month post-percutaneous coronary intervention. The primary endpoint was a NACE, defined as a composite of all-cause death, non-fatal myocardial infarction, stent thrombosis, clinically driven revascularization, stroke, and bleeding events of grade ≥2 Bleeding Academic Research Consortium (BARC) criteria at 1 year. Results: Among 2,338 patients included in the randomization, 326 patients were diagnosed with STEMI. In patients with NSTE-ACS, the risk of the primary endpoint was significantly reduced with de-escalation (hazard ratio [HR], 0.65; 95% confidence interval [CI], 0.48-0.89; p=0.006 for de-escalation vs. conventional), mainly driven by a reduced bleeding. However, in those with STEMI, there was no difference in the occurrence of the primary outcome (HR, 1.04; 95% CI, 0.48-2.26; p=0.915; p for interaction=0.271). Conclusions: Prasugrel dose de-escalation reduced the rate of NACE and bleeding, without increasing the rate of ischemic events in NSTE-ACS patients but not in STEMI patients.