• 제목/요약/키워드: hospital Phase

검색결과 1,071건 처리시간 0.029초

Pemetrexed Induces G1 Phase Arrest and Apoptosis through Inhibiting Akt Activation in Human Non Small Lung Cancer Cell Line A549

  • Wu, Dong-Ming;Zhang, Peng;Xu, Guang-Chao;Tong, Ai-Ping;Zhou, Cong;Lang, Jin-Yi;Wang, Chun-Ting
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권4호
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    • pp.1507-1513
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    • 2015
  • Pemetrexed is an antifolate agent which has been used for treating malignant pleural mesothelioma and non small lung cancer in the clinic as a chemotherapeutic agent. In this study, pemetrexed inhibited cell growth and induced G1 phase arrest in the A549 cell line. To explore the molecular mechanisms of pemetrexed involved in cell growth, we used a two-dimensional polyacrylamide gel electrophoresis (2-DE) proteomics approach to analyze proteins changed in A549 cells treated with pemetrexed. As a result, twenty differentially expressed proteins were identified by ESI-Q-TOF MS/MS analysis in A549 cells incubated with pemetrexed compared with non-treated A549 cells. Three key proteins (GAPDH, HSPB1 and EIF4E) changed in pemetrexed treated A549 cells were validated by Western blotting. Accumulation of GAPDH and decrease of HSPB1 and EIF4E which induce apoptosis through inhibiting phosphorylation of Akt were noted. Expression of p-Akt in A549 cells treated with pemetrexed was reduced. Thus, pemetrexed induced apoptosis in A549 cells through inhibiting the Akt pathway.

Changes in bioimpedance analysis components before and after hemodialysis

  • Kim, Hyunsuk;Choi, Gwang Ho;Shim, Kwang Eon;Lee, Jung Hoon;Heo, Nam Ju;Joo, Kwon-Wook;Yoon, Jong-Woo;Oh, Yun Kyu
    • Kidney Research and Clinical Practice
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    • 제37권4호
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    • pp.393-403
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    • 2018
  • Background: This study compared nutritional parameters in hemodialysis (HD) subjects and controls using bioimpedance analysis (BIA) and investigated how BIA components changed before and after HD. Methods: This cross-sectional study included 147 subjects on maintenance HD from two hospitals and 298 propensity score-matched controls from one healthcare center. BIA was performed pre- and post-HD at mid-week dialysis sessions. Results: Extracellular water/total body water (ECW/TBW) and waist-hip ratio were higher in the HD patients; the other variables were higher in the control group. The cardiothoracic ratio correlated best with overhydration (r = 0.425, P < 0.01) in HD subjects. Blood pressure, hemoglobin, creatinine, and uric acid positively correlated with the lean tissue index in controls; however, most of these nutritional markers did not show significant correlations in HD subjects. Normal hydrated weight was predicted to be higher in the pre-HD than post-HD measurements. Predicted ultrafiltration (UF) volume difference based on pre- and post-HD ECW/TBW and measured UF volume difference showed a close correlation ($r^2=0.924$, P < 0.01). Remarkably, the leg phase angle increased in the post-HD period. Conclusion: The estimated normal hydrated weight using ECW/TBW can be a good marker for determining dry weight. HD subjects had higher ECW/TBW but most nutritional indices were inferior to those of controls. It was possible to predict UF volume differences using BIA, but the post-HD increase in leg phase angle, a nutritional marker, must be interpreted with caution.

Long-term Survival Outcomes of Laparoscopic Gastrectomy for Advanced Gastric Cancer: Five-year Results of a Phase II Prospective Clinical Trial

  • Ahn, Sang-Hoon;Kang, So Hyun;Lee, Yoontaek;Min, Sa-Hong;Park, Young Suk;Park, Do Joong;Kim, Hyung-Ho
    • Journal of Gastric Cancer
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    • 제19권1호
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    • pp.102-110
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    • 2019
  • Purpose: Despite an increased acceptance of laparoscopic gastrectomy (LG) in early gastric cancer (EGC), there is insufficient evidence for its oncological safety in advanced gastric cancer (AGC). This is a prospective phase II clinical trial to evaluate the feasibility of LG with D2 lymph node dissection (LND) in AGC. Materials and Methods: The primary endpoint was set as 3-year disease-free survival (DFS). The eligibility criteria were as follows: 20-80 years of age, cT2N0-cT4aN3, American Society of Anesthesiologists score of 3 or less, and no other malignancy. Patients were enrolled in this single-arm study between November 2008 and May 2012. Exclusion criteria included cT4b or M1, or having final pathologic results as EGC. All patients underwent D2 lymphadenectomy. Three-year DFS rates were estimated by the Kaplan-Meier method. Results: A total of 157 patients were enrolled. The overall local complication rate was 10.2%. Conversion to open surgery occurred in 11 patients (7.0%). The mean follow-up period was $55.0{\pm}20.4months$ (1-81 months). The cumulative 3-year DFS rates were 76.3% for all stages, and 100%, 89.3%, 100%, 88.0%, 71.4%, and 35.3% for stage IB, IIA, IIB, IIIA, IIIB, and IIIC, respectively. Recurrence was observed in 37 patients (23.6%), including hematogenous (n=6), peritoneal (n=13), locoregional (n=1), distant node (n=8), and mixed recurrence (n=9). Conclusions: In addition to being technically feasible for treatment of AGC in terms of morbidity, LG with D2 LND for locally advanced gastric cancer showed acceptable 3-year DFS outcomes.

Hepatocellular Carcinoma: Texture Analysis of Preoperative Computed Tomography Images Can Provide Markers of Tumor Grade and Disease-Free Survival

  • Jiseon Oh;Jeong Min Lee;Junghoan Park;Ijin Joo;Jeong Hee Yoon;Dong Ho Lee;Balaji Ganeshan;Joon Koo Han
    • Korean Journal of Radiology
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    • 제20권4호
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    • pp.569-579
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    • 2019
  • Objective: To investigate the usefulness of computed tomography (CT) texture analysis (CTTA) in estimating histologic tumor grade and in predicting disease-free survival (DFS) after surgical resection in patients with hepatocellular carcinoma (HCC). Materials and Methods: Eighty-one patients with a single HCC who had undergone quadriphasic liver CT followed by surgical resection were enrolled. Texture analysis of tumors on preoperative CT images was performed using commercially available software. The mean, mean of positive pixels (MPP), entropy, kurtosis, skewness, and standard deviation (SD) of the pixel distribution histogram were derived with and without filtration. The texture features were then compared between groups classified according to histologic grade. Kaplan-Meier and Cox proportional hazards analyses were performed to determine the relationship between texture features and DFS. Results: SD and MPP quantified from fine to coarse textures on arterial-phase CT images showed significant positive associations with the histologic grade of HCC (p < 0.05). Kaplan-Meier analysis identified most CT texture features across the different filters from fine to coarse texture scales as significant univariate markers of DFS. Cox proportional hazards analysis identified skewness on arterial-phase images (fine texture scale, spatial scaling factor [SSF] 2.0, p < 0.001; medium texture scale, SSF 3.0, p < 0.001), tumor size (p = 0.001), microscopic vascular invasion (p = 0.034), rim arterial enhancement (p = 0.024), and peritumoral parenchymal enhancement (p = 0.010) as independent predictors of DFS. Conclusion: CTTA was demonstrated to provide texture features significantly correlated with higher tumor grade as well as predictive markers of DFS after surgical resection of HCCs in addition to other valuable imaging and clinico-pathologic parameters.

양산 부산대학교병원의 건설사업관리 적용현황과 발전 방향 (A Study on the Current Status of Application of Construction Management in Pusan National University Yangsan Hospital and Guidelines for CM Improvement)

  • 박종순;신창준;유병기;전재열
    • 한국건설관리학회:학술대회논문집
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    • 한국건설관리학회 2008년도 정기학술발표대회 논문집
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    • pp.5-12
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    • 2008
  • 양산 부산대학교병원 건립공사는 종합병원 의료타운 신축 프로젝트이다. 계획단계부터 건설사업관리자(CMr)가 참가하여 설계 시공일괄사업자를 선정한 후, 실시설계 진행과정을 거쳐 시공단계, 시공이후단계에 이르기까지 프로젝트의 모든 단계에 건설사업관리(CM) 업무를 일관적으로 적용한 사례이다. 또한 설계와 시공의 추진에 Fast Track을 도입하여 공기단축에 성공한 것에 그 의미를 찾을 수 있다. 본 사례는 설계 이전단계에 설계시공일관업체를 선정하였으며, Fast Track수법의 적용을 염두에 둔 설계 및 공사일정계획, 설계단계의 설계관리, Fast Track에 입각한 단계별 공사발주 및 계약관리, 기본설계 실시설계단계의 VE 수행, 시공단계에서의 설계변경 관리, 시공 후 유지관리 단계의 운용관리 등 건설사업관리 업무가 모든 단계에서 다각적으로 제공되었다. 본 보고에서는 상기와 같은 건설사업관리 적용상의 과제와 개선방향, 특히 설계 시공일괄사업에서 효율적으로 CM 업무를 수행할 수 있는 방안을 제시하여, 초대형 턴키(Turnkey) 프로젝트의 CM적용에 기여하고자 한다.

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주요우울증환자에서 Acute Phase Proteins 농도 변화에 관한 연구 (Study on Alterations of Acute Phase Proteins in Patients with Major Depression)

  • 김용구;김사준;이민수
    • 생물정신의학
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    • 제2권1호
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    • pp.70-76
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    • 1995
  • A few researchers have reported that major depression may be associated with higher levels of positive acute phase proteins(APPs), such as haptoglobin(Hp), ${\alpha}1$-antitrypsin(${\alpha}1AT$), ceruloplasmin(Cp) and lower levels of negative APPs(visceral proteins), such as albumin(Alb) and transferrin(Tf). Elevated levels of positive APPs and a drop in negative APPs constitute important indicators of immune activation. This study was designed to investigate whether altered serum concentrations of positive APPs and of negative APPs reflect the state of depression. Twenty patients who fulfilled DSM-III-R criteria for major depressive disorder and for dysthymic disorder and twelve normal healthy controls were included. The authors measured positive APPs(Hp, ${\alpha}1AT$, Cp) and negative APPs(Alb, Tf) using rate nephelometry and bromcresol green method. 1) There were significant increases of ${\alpha}1AT$, Cp in major depressed patients as compared with normal controls. Trends towards higher Hp and lower Alb, Tf in major depressed patients were observed. 2) No significant difference of APPs concentrations between dysthymic patients and normal controls was found. 3) Severity of depression(HDRS, BDI score) was related to Hp, Cp, ${\alpha}1AT$ value positively. Our findings are partially compatible with the hypothesis that major depression may be accompanied by acute phase response with higher levels of positive APPs and lower levels of negative APPs.

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전.후방보행 방법과 트레드밀 각도변화에 따른 넙다리곧은근과 앞정강이근의 활성도 비교 (Comparison between Rectus Femoris and Tibialis Anterior in Terms of the Levels of Activity Varying Depending on Walking Patterns (forward and backward) and Varied Treadmill Slopes)

  • 김은영;이승병;전범수;권혁수;유달영
    • 대한정형도수물리치료학회지
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    • 제16권2호
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    • pp.76-81
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    • 2010
  • Purpose: This study examined how the degrees of muscle activity of Rectus Femoris and Tibialis Anterior during the four phases of walking vary according to three different treadmill slopes of $0^0$, $7^0$, and $15^0$. Methods: Subjects were 14 randomly selected healthy students attending G University in Seoul, Korea who had never had articular problems with lower limb and had no difficulties walking at the time of study. Results: 1) With respect to Rectus Femoris, in every phase of both forward and backward walking, there were significant differences among all of the slope degrees (p <.05), while the activity increased with increased slope degrees in every phase of backward walking. 2) For Tibialis Anterior, only in P2 and P3 of both forward and backward walking there were significant differences in every slope (p <.05). Conclusion: Both Rectus Femoris and Tibialis Anterior were found to be more active during backward walking compared to backward walking. In addition, the activity degree of Rectus Femoris was high between the early part of two foot support phase and the early part of one foot support phase, whereas that of Tibialis Anterior was high between the early part of one foot support phase and the latter part of both foot support phase.

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An R package UnifiedDoseFinding for continuous and ordinal outcomes in Phase I dose-finding trials

  • Pan, Haitao;Mu, Rongji;Hsu, Chia-Wei;Zhou, Shouhao
    • Communications for Statistical Applications and Methods
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    • 제29권4호
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    • pp.421-439
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    • 2022
  • Phase I dose-finding trials are essential in drug development. By finding the maximum tolerated dose (MTD) of a new drug or treatment, a Phase I trial establishes the recommended doses for later-phase testing. The primary toxicity endpoint of interest is often a binary variable, which describes an event of a patient who experiences dose-limiting toxicity. However, there is a growing interest in dose-finding studies regarding non-binary outcomes, defined by either the weighted sum of rates of various toxicity grades or a continuous outcome. Although several novel methods have been proposed in the literature, accessible software is still lacking to implement these methods. This study introduces a newly developed R package, UnifiedDoseFinding, which implements three phase I dose-finding methods with non-binary outcomes (Quasi- and Robust Quasi-CRM designs by Yuan et al. (2007) and Pan et al. (2014), gBOIN design by Mu et al. (2019), and by a method by Ivanova and Kim (2009)). For each of the methods, UnifiedDoseFinding provides corresponding functions that begin with next that determines the dose for the next cohort of patients, select, which selects the MTD defined by the non-binary toxicity endpoint when the trial is completed, and get oc, which obtains the operating characteristics. Three real examples are provided to help practitioners use these methods. The R package UnifiedDoseFinding, which is accessible in R CRAN, provides a user-friendly tool to facilitate the implementation of innovative dose-finding studies with nonbinary outcomes.

Effect of luteal phase support with vaginal progesterone on pregnancy outcomes in natural frozen embryo transfer cycles: A meta-analysis

  • Seol, Aeran;Shim, Yoo Jin;Kim, Sung Woo;Kim, Seul Ki;Lee, Jung Ryeol;Jee, Byung Chul;Suh, Chang Suk;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • 제47권2호
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    • pp.147-152
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    • 2020
  • Objective: The purpose of this study was to determine the effect of vaginal progesterone for luteal phase support (LPS) on the clinical pregnancy rate (CPR) in natural frozen embryo transfer (FET) cycles via a meta-analysis. Methods: We performed a meta-analysis of randomized controlled trials (RCTs) and retrospective studies that met our selection criteria. Four online databases (PubMed, Embase, Medline, and the Cochrane Library) were searched between January 2017 and May 2017. Studies were selected according to predefined inclusion criteria and meta-analyzed using R software version 2.14.2. The main outcome measure was CPR. Results: A total of 18 studies were reviewed and assessed for eligibility. One RCT (n = 435) and three retrospective studies (n = 3,033) met the selection criteria. In a meta-analysis of the selected studies, we found no significant difference in the CPR (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.60-1.55) between the vaginal progesterone and control groups. An analysis of the two retrospective cohort studies that reported the live birth rate (LBR) following FET showed a significantly higher LBR in the vaginal progesterone group (OR, 1.72; 95% CI, 1.21-2.46). A subgroup meta-analysis of FET conducted 5 days after injection of human chorionic gonadotropin showed no significant differences between the two groups with regard to the CPR (OR, 1.18; 95% CI, 0.90-1.55) or miscarriage rate (OR, 0.73; 95% CI, 0.36-1.47). Conclusion: The results of this meta-analysis of the currently available literature suggest that LPS with vaginal progesterone in natural FET cycles does not improve the CPR.

마리화나 남용환자의 역동적인 발달요인과 문제해결 (Dynamic Developmental Factors and their Problem Solving of Patients that Abuse Marihuana)

  • 원정숙
    • 대한간호학회지
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    • 제4권3호
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    • pp.105-116
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    • 1974
  • This study was made on patients who were Hospitalized due to sickness caused by the abuse of marihuana at the Psychiatric Section of a hospital during the period from Feb. to Oct., 1974. The following conclusion was obtained by reviewing the literature with respect to the nursing, and problem solving of those patients. 1. It appears that marihuana is a comparatively mild intoxicant in ordinary preparation without causing physical dependence or tolerance. 2. According to the status of men who are marihuana smokers, approximately 20% of them were college students, those preparing to retake college entrance examinations, non-employed and pharmacists. The men belong mostly to the middle foreigner′s mistress of higher, income bracket, and in the case of women, most of the smokers were US. servicemen entertainers. 3. Dynamic developmental factors: Case 1. : The patient had a characteristic, hysterical and emotionally unitable character, and was of low intelligence, In addition, to this already existing problem, the added uses of marihuana caused a mental illness to develope. Case 2 : The character, was reserved and introspective, her creative power and sentiment was fading and his ability of self-control was weakened. She used the smoking of marihuana to get rid of her own feeling of inferiority complex and tensions coming from interpersonal relationships. Case 3 : The patient was unconditionally resistive to the authoritativeness of superiors and irresponsible in his relationship with women, in his attitude concerning sex in general. He smoked marihuana because he felt become peace-loving and get enchanted experience through smoking it. 4. The points of issue appearing from the above case; (1) Movement of anti-social feelings against the "established system" by the youngsters. (2) Family problem. (3) Shamelessness, loss of motivation, disorderly attitude toward the sex, (4) Worries concerning the future. (5) Lack of knowledge concerning smoking of cigarette and marihuana. Chronic use of marihuana made, those youngman who had originally been ambitions to achieve something in life, lazy, inefficient, unable to make long-term plans, are such weak mined persons that they did not try to overcome problems when encountered. This will pose a great and important question in the mental health of the society, 5. Treatment and Problem sieving According to the literature, we will have to place importance upon hospitalized treatment The phases of treatment were divided into five parts. (1) Prehospital phase (2) Withdrawal Phase (3) Rehabilitation phase (4) Transitional phase (5) After-care phase The experiments have proved that there was much progress in the recovery of patients through environment therapy, supportive therapy and group psychotherapy. This was the above mentioned 5 phases of treating process in accordance with the weekly schedule of the hospital. It was thought that the patients would require prolonged after care management even after they were released from the hospital and that they will also require periodic visit, to the hospital and doctor′s interview with their family. In conclusion, the question of the young generation and marihuana smoking is becoming a great social problem in which their resistances to the "established system" and society is growing in the from of antiestablishment movements. In our country, the smoking of marihuana is gradually developing, therefore, I think, that it would be a very fortunate thing for us, if this report could be helpful for the motivation of further study on the questions of the young generation and its problems.

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