• Title/Summary/Keyword: regimen

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Effect of Conditioning Regimen Intensity on Cytomegalovirus Infection and Related Risk Factors Analysis in Allogeneic Hematopoietic Stem Cell Transplantation (동종조혈모세포이식에서 거대세포바이러스 감염에 미치는 전처치요법 강도의 영향과 관련위험인자 분석)

  • Lee, Hye-Min;Heo, Yoon-Jeong;Im, Hyun-Jeong;Chung, Seon-Young;In, Yong-Won;Jung, Chul-Won;Lee, Young-Mee;Sohn, Kie-Ho
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.2
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    • pp.123-130
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    • 2012
  • 거대세포바이러스(Cytomegalovirus; CMV) 감염은 동종조혈모세포이식 환자의 주요 사망원인 중 하나이다. 용량감소전처치(Reduced-intensity conditioning; RIC)를 이용한 조혈모세포이식은 골수억제전처치(Myeloablative conditioning; MAC)에 비해 골수억제 및 면역억제가 적으므로 CMV 감염 발생율을 감소시킬 것이라 예상되었으나 예방적 면역억제요법, T세포 제거 약제의 사용 등으로 서로 상이한 결과가 보고되고 있다. 2007년 1월부터 2009년 12월까지 총 141명의 환자(MAC 113명, RIC 28명)가 동종조혈모세포이식을 받았으며, CMV 감염은 MAC 62.8%, RIC 57.1% (p = 0.310), CMV 질환은 각각 12.4%, 14.3% (p = 0.785)에서 발생하였다. CMV 감염/질환 발생빈도와 CMV 항원 혈증검사 지속기간, 초기/최고치, 생존율은 두 군간 유의한 차이가 없었다. CMV 감염 위험인자에 대한 다변량분석 결과, 환자가 고령일수록(HR 1.024, 95% CI 1.002-1.045; p = 0.031) 또는 grade 2 이상의 급성 이식편대숙주병이 발생한 경우에(HR 1.849, 95% CI 1.031-3.315; p=0.039) CMV 감염 발생 위험율이 유의하게 높았다. 결론적으로, 전처치요법 강도에 따른 CMV 감염의 발생빈도와 발현양상의 차이는 없었으나, 고령이거나 grade 2 이상의 급성 이식편대숙주병이 발생한 환자의 경우 CMV 감염 발생과 유의한 연관성을 보였다. 이상과 같은 결과에 비춰 봐서 CMV 질환이 대부분 이식 100일 이후에 발생한 점을 고려할 때, 이식 후 CMV 감염 발생 시 ganciclovir 선제요법과 함께 이들 환자들에게 지속적인 모니터링을 실시하는 것이 필요할 것으로 사료된다.

Clinical Effect of the Subantimicrobial Dose of Doxycycline ( SDD ) on the Chronic Periodontitis (만성치주염 환자에 대한 저용량 독시싸이클린의 임상적 효과)

  • Kim, Yoon-Sik;Paik, Jeong-Won;Kim, Chang-Sung;Choi, Seong-Ho;Kim, Chong-Kwan
    • Journal of Periodontal and Implant Science
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    • v.32 no.2
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    • pp.415-428
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    • 2002
  • Periodontal disease is a complex infectious disease caused by bacteria in the oral mucosa, which results in gingival inflammation, breakdown of periodontal tissues, bone resorption, and finally tooth loss. Mechanical plaque control methods-scaling and root planing are effective methods to stop the progression of such periodontal disease. It was reported that subantimicrobial dose of doxycycline(SDD) regimen could improve clinical conditions of periodontal tissues without causing the overgrowth of opportunistic organisms that was a typical antibiotic side effect. Therefore pharmacological therapy, used in conjunction with mechanical therapy could be considered a useful treatment modality in the treatment of chronic periodontal disease. In this study, 30 patients diagnosed as moderate to advanced chronic periodontitis were divided into 2 groups. In this double-blind, placebo-controlled study, the patients were administered 20mg doxycycline capsule or placebo capsule b.i.d. for 4months, after scaling and root planing. Clinical parameters-bleeding on probing, pocket depth and clinical attachment level were compared and evaluated between these groups at periods of first visit, 1 month, 2 months, 3 months, 4 months. The results were as follows ; 1. In case of moderate periodontitis, pocket depth showed significant reduction after treatment in both the control & experiment groups, when compared with the baseline values(p<0.01), but in case of advanced periodontitis, only the experiment group showed significant reduction after treatment when compared with the baseline values(p<0.05). Statistically significant reduction in pocket depth was observed in the experiment group compared to the control group(p<0.05). 2. In case of moderate periodontitis, clinical attachment level showed significant reduction after treatment in both the control & experiment groups, when compared with the baseline values(p<0.01), but in case of advanced periodontitis, only the experiment group showed significant reduction after treatment when compared with the baseline values(p<0.05). Statistically significant reduction in clinical attachment level was observed in the experiment group compared to the control group(p<0.05). 3. Bleeding on probing improved after treatment in both the groups. In case of moderate periodontitis, the experiment group showed statistically significant reduction of bleeding on probing when compared with the control group at 1 and 4 months after treatment(p<0.05). In case of advanced periodontitis, treatment resulted in statistically significant reduction of bleeding on probing in both the groups(p<0.05). These results indicate that the use of subantimicrobial dose of doxycycline is a useful supplement to mechanical treatment for periodontal patients in ameliorating the clinical parameters such as periodontal pocket, attachment level, and bleeding on probing.

ANTICARIOGENIC EFFECT OF FLUORIDE RELEASED FROM SEALANT COMPARED TO TOPICAL FLUORIDE APPLICATION METHODS (국소적인 불소도포제재와 불소유리 치면열구전색재의 내산성 효과)

  • Park, Ki-Tae;Shon, Heung-Kyu;Chai, Byung-Jai;Park, Kwang-Kyun;Shon, Dong-Su;Lee, Jong-Gap
    • Journal of the korean academy of Pediatric Dentistry
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    • v.24 no.1
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    • pp.148-172
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    • 1997
  • Sixty human premolar teeth were used for this in vitro study. After each tooth was sectioned mesiodistally, one half was used for the experimental group and the other half for the control. Three groups were made for each fluoride applying method and twenthy teeth were assigned to each group. Ten teeth were used for evaluating total fluoride amount and the other ten were used for firmly-bound fluoride. Fluorshield was used for fluoride-releasing sealant and 1.23% APF, 0.05% NaF were used for topical application fluorides. Each tooth was cleaned with a tooth brush using nonfluoride containing pumice before the experiment. In the sealant group, fluoroshield was applied to the enamel surface without etching procedure and stored in $37^{\circ}C$ saline for 30 days. After 30 days, sealant was removed with explorer without scratching the enamel surface and washed with distilled water and dried. In the APF group, each tooth was immersed in 1.23% APF for 30 min then washed and dried in the same manner. In the NaF group, each tooth was immersed in 0.05% NaF for 24 hours then washed and dried as described above. After each fluoride regimen was applied, ten teeth were randomly selected from each group and immersed in 1M KOH solution for 24 hours to remove loosely-bound fluoride possibly deposited by the three different fluorides applied. In each group, total fluoride amount deposited and the amount of enamel removed by acid biopsy were calculated. After loosely-bound fluoride was removed, firmly-bound fluoride deposited and the amount of enamel removed by acid biopsy were also calculated. Total fluoride amount deposition was significantly increased in the APF and NaF groups, but not in the sealant group. Amount of enamel removed by acid-biopsy was also significantly diminished in the APF and NaF groups, but not in the sealant groups. After loosely-bound fluoride was removed from each groups, no statistical difference was found in the amount of firmly-bound fluoride in any groups. Also no effect of firmly-bound fluoride on enamel dissolution was shown in any groups after loosely-bound fluoride was removed from each group. In conclusion, topical application method of APF or NaF is more effective than fluoride-releasing sealant application to make $CaF_2$ coating on enamel surface and $CaF_2$ coating is the main source for anticariogenic effect of fluoride. However, longterm anticariogenic effect of fluoride-releasing sealant should be further evaluated.

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The Evaluation of Teicoplanin Usage in a University Hospital (대학병원에서의 Teicoplanin의 사용 현황 조사 및 실태 평가)

  • Kim, Eun A;Oh, Jung Mi
    • Korean Journal of Clinical Pharmacy
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    • v.11 no.1
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    • pp.19-29
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    • 2001
  • Teicoplanin, a glycopeptide antibiotic, has potential for use as an alternative to vancomycin in the treatment of gram-positive bacterial infections. However, unlike vancomycin, there is a lack of study on teicoplanin's efficacy and safety and the guideline for its use is not available, yet. The objective of this study was to investigate and evaluate the pattern of teicoplanin usage in a university hospital. A retrospective study was performed on 72 adult patients, who took teicoplanin for 3 continuous days at D. University hospital from 1 January 1999 to 30 June 2000. The microorganisms treated with teicoplanin were methicillin-resistant Staphylocorcus aureus $(69\%)$, coagulase-negative Staphylococci $(12\%)$, Enterococcus $(4\%)$, vancomycin-resistant Enterococci $(2\%)$, Streptococci $(2\%)$, and Bacillus $(1\%)$. The types of infection treated with teicoplanin were surgical wound infection $(58\%)$, lower respiratory infection $(11\%)$, bactremia $(7\%)$, urinary tract infection $(5\%)$, pleural fluid infection $(4\%)$, and peritoneal fluid infection $(2\%)$. The mean duration of teicoplanin usage was 16.5 days and teicoplanin was used with 1.4 other antibiotics, which were aminoglycosides (isepamicin, amikacin, netilmicin, astromicin) or quinolones (ciprofloxacin, tosufloxacin) or the third generation cephalosporin (ceftazidime). Only 24 cases $(28.6\%)$ met with the criteria for the justification of use, and the rest of 60 cases $(71.4\%)$ did not meet the criteria. In 84 cases $(100\%)$, blood culture tests were performed prior to the initial dose of teicoplanin. In 83 cases $(99\%)$, serum creatinine were conducted before the initial doses. In 45 cases $(53.6\%)$, serum creatinine was monitored at least twice weekly. In 55 cases $(65.5\%)$, WBC was tested at least twice weekly. In 84 cases $(100\%)$, body temperature was monitored at least once per nursing shift. In 15 cases out of 56 cases, maximum temperature decreased at least 1 degree within 3 days of teicoplanin use. In 15 case out of 35 cases, WBC values were within the normal range after treatment. In 23 cases $(27.4\%)$, dosage regimen was appropriate. Drug-related adverse effects were reported in 13 cases. Nephrotoxicity (progressively increasing SCr. or sustained SCr increase of $\geq$0.5 mg/dl from baseline) was noted in five cases. Neutropenia (absolute neutrophil count <1,500 $cells/mm^3$) was noted in one case and eosinophilia (total eosinophil count >350 $cells/mm^3$) was noted in seven cases. A more strict control on use of teicoplanin is required, considering that teicoplanin is categorized as one of restricted antibiotics.

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The Palliative Care and Hospice for the People Living with HIV (HIV 감염인을 위한 완화의료와 호스피스)

  • Choi, Jae-Phil
    • Journal of Hospice and Palliative Care
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    • v.20 no.3
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    • pp.159-166
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    • 2017
  • According to the advance of antiretroviral regimen and the early treatment strategy, people living with human immunodeficiency virus (PLWH) are achieving the goal of virologic suppression and immune restoration. Most of them no more die of acquired immunodeficiency syndrome (AIDS) defining illnesses, and become older with chronic comorbidities such as cardiovascular, metabolic, hepatic, renal and neurological diseases. However some PLWH still visit hospitals as late presenters with very low CD4+ T cell counts, so that they suffer AIDS defining illnesses to die or experience severe neurological complications resulting in disabilities. Early palliative interventions are needed on the various symptoms of PLWH. Thus far chronic pains such as distal symmetric sensory polyneuropathies have been underevaluated. Active pain-relieving interventions are important to them. Recently we define end of life condition of human immunodeficiency virus (HIV) or eligibility to hospice care after adjusting current status of HIV treatment. Hospice teams should pay attention to the specific medical conditions, psychological needs, and social circumstances of PLWH. With just standard precautions as common infection control measures, general hospice cares can be provided to them like to other hospices subjects. For giving PLWH opportunities to have the end of life with value and dignity, hospice multidisciplinary team should intervene them early and aggressively. Now we need more clinical experiences and institutional improvements.

Effect of Various Energy Regimens on Egg Production and Feed Cost of Broiler Breeders Peaked in Winter Season (동절기 산란피크 육용종계 산란기의 에너지 공급체계가 산란능력과 경제성에 미치는 영향)

  • 함영훈;김상인;이규호
    • Korean Journal of Poultry Science
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    • v.30 no.3
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    • pp.169-175
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    • 2003
  • This experiment was conducted to study the optimum energy feeding regimens fur broiler breeders peaked in winter season with 400 caged hens of Ross strain. Four energy supply regimens which were different in daily energy allotment during laying period were employed for 40 weeks from 24 to 64 weeks of age. All experimental diets were formulated to contain 2,750 kcal ME/kg with adjustments made in total feed allotment to provide the desired energy levels. Total consumption of the feed would provide 20 g of protein, 4 g of calcium and 0.35 g of available phosphorus. There were no difference in hen-day egg production and average egg weight among the regimens of energy supply. Feed, ME and feed cost required per egg or per kg egg were significantly increased as the level of energy allotment increased(p<0.05). It was concluded that the energy supply regimen, which supplied 280 kcal ME per day at the age of 24 weeks and then increased the energy supply up to 400 kcal ME per day at the peak period of 30∼34 weeks of age, was superior in feed, ME and feed cost required per egg or per kg egg without any adverse effect on eg production and egg weight.

Immunogenicity and Safety of a Two Doses of Hepatitis A Vaccine(VAQTATM) in Healthy Children and Adolescents (건강한 소아와 청소년에 대한 A형 간염(VAQTATM) 2회 접종시 면역원성 및 안전성에 대한 연구)

  • Lee, Jin Soo;Park, Ji Ho;Sohn, Young Mo
    • Pediatric Infection and Vaccine
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    • v.8 no.2
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    • pp.160-167
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    • 2001
  • Purpose : To assess the immunogenicity, safety, and tolerability of hepatitis A vaccine ($VAQTA^{TM}$) in healthy children and adolescents. Methods : Eligible subjects aged 2 to 17 years received 25 U/0.5 mL of $VAQTA^{TM}$ intramuscularly at 0 and 24 week schedule. Bleeds were obtained prior to vaccination and 4 weeks after the second dose to ascertain serostatus. To detect antibody to HAV after vaccination with an inactivated HA vaccine, a modification of the $Abbott^{(R)}$ HAVAB kit was used. Sample with titers ${\geq}10$ mIU/mL were considered seroconverted. Adverse experiences were monitored. Results : 102 subjects(54 male, 48 female) were enrolled. The mean age was $6.8{\pm}3.5$ years. Two subjects were seropositive, two were lost of follow up. 88 subjects were available for a per protocol analysis and 90 for all subjects with serology after the second dose, and ten withdral. All subjects(95% CI, 94.8~100) seroconverted. Geometric mean titers was 7,991.1(95% CI, 6,481.1~9,852.7) with very little difference in per protocol analysis and all subjects analysis. Adverse experiences to $VAQTA^{TM}$ were generally mild and transient. Conclusion : The pediatric two-dose regimen of $VAQTA^{TM}$ was found to be highly immunogenic, generally well tolerated and resulted in 100% seroconversion. Regarding Korea is in transition from a high to low risk region resulting in a paradox increase of clinical disease and disease burden, routine vaccination should be considered in order to control hepatitis A effectively.

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Complication of Intraoperative Radiation Therapy (IORT) in Gastric Cancer (위암의 수술중 방사선 치료의 합병증)

  • Kim Myung Se;Kim Sung Kyu;Song Sung Kyo;Kim Hong Jin;Kwan Koing Bo;Kim Heung Dae
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.187-192
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    • 1992
  • Local control is the important prognostic factor in cancer treatment because local control decrease the relative risk of metastatic spread and inclose distant metastasis free suwival. IORT is the modality which could increase local control without incressing complication, combined with curative operation. Eventhough we could achieve significant deacreased local failure by IORT and curative resection, it should not be committed as a main treatment modality without proving acceptable complications. Therapeutic Radiology Department of Yeungnam University Medical Center have tried 58 IORT from June 15, 1988, and performed 53 IORT En patients with gastric cancer. No local failure has been reported by regular follow up so far. Nine cases ($17\%$) of treatment related complicaiton were reported including intestinal obstrution, hemorrhage, sepsis, and bone marrow depression. These complications could be comparable to Jo's $25.2\%$ (chemotherapy + operation), Kim's $18\%$ (chemotherapy only in inoperable patients), because our treatment regimen is consisted of IORT (1500 cGy), external irradiation (--4500 cGy) and extensive chemotherapy(FAM, 5FU + MMC, BACOP).

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The Influences of Meles meles Oil on Health Status, Diabetic Index and Serum Lipid Profile in Non - Insulin Dependent Diabetes Mellitus Patients (오소리 지질이 인슐린 비의존형 당뇨환자의 건강상태 당뇨지표 및 혈청지질농도에 미치는 영향)

  • 박성혜;백승화;한종현
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.7
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    • pp.1139-1146
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    • 2004
  • The purpose of this study was to investigate the possibility of Meles meles oil as an functional resource. To assess the effects of Meles meles oil in 25 non-insulin dependent diabetes mellitus (DM) persons, we examined changes of fat intake level, hematological and chemical variables, serum DM indices and lipid contents during the Meles meles oil supplementation. Polyunsaturated fatty acid and $\omega$3 fatty acid intake were significantly increased by Meles meles oil intakes. The levels of LDL-cholesterol and triglyceride were significantly decreased while HDL-cholesterol was significantly increased. Iron status improved during Meles meles oil intakes. These results show that modest dose of Meles meles oil supplementation can decrease serum triglyceride, cholesterol level without any changes in blood glucose level in NIDDM patients. These results indicated that Meles meles oil diet is effective therapeutic regimen for the control of metabolic derangements in diabetes mellitus. Also, these results imply that Meles meles oil can be used as possible food resources and functional food materials. However, large amounts of Meles meles oil should be used cautiously in NIDDM patients.

Determination of Optimal Added-Levels of Inuloprebiotics for Promotion of Growing Performance in Broiler Chickens (육계의 성장능력 향상을 위한 이눌로프리바이오틱스의 적정 첨가수준 결정)

  • Park, Byung-Sung
    • Journal of Life Science
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    • v.21 no.5
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    • pp.684-692
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    • 2011
  • The present study furthered this research by determining the optimal level of inuloprebiotics derived from Korean Jerusalem artichoke to promote growth in broiler chickens. On hatch day, 320 male Ross 308 broilers were randomly allotted to four groups for a 35-day feeding regimen. The groups were a control (no supplementation), diet supplementation with antibiotics (8 ppm avilamycin), supplementation with 200 ppm inuloprebiotics, and supplementation with 250 ppm inuloprebiotics. Body weight and feed intake were comparably high in the two inuloprebiotics groups, and exceeded the values for the control and antibiotics groups. Body weight and feed intake was higher in chickens fed the antibiotics supplemented diet, compared to controls. There were significant differences among treatment groups. Feed conversion ratio during total experimental periods was significantly high in the control group compared to the inuloprebiotics-fed groups, but no significant difference was evident using antibiotics or inuloprebiotics dietary supplementation. Carcass weight, dressing percentage, and weight of breast and thigh muscle were significantly higher for inuloprebiotics-fed chickens, compared with control and antibiotic-fed chickens. Inuloprebiotics concentration was not significant, while antibiotics-fed chickens displayed significantly higher values than control chickens. Abdominal fat was significantly reduced (19.08%-23.30%) and blood immunoglobulin and the weight of the thymus and Bursa of Fabricius were significantly increased in chickens receiving inuloprebiotics-supplemented feed, compared to control and antibiotics fed groups. In the lower intestine, the viable counts of beneficial bacteria (Bifidobacteria and Lactobacillus) were significantly increased and counts of harmful bacteria (Escherichia coli and Salmonella sp.) were significantly decreased in the presence of the inuloprebiotics, compared to control and antibiotic. The present results support 200 ppm as an optimal level of Korean Jerusalem artichoke-derived inuloprebiotics as a dietary supplement to improve growth in broiler chickens.