• Title/Summary/Keyword: therapeutic ratio

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Novel biological strategies to enhance the radiation therapeutic ratio

  • Kim, Jae Ho;Jenrow, Kenneth A.;Brown, Stephen L.
    • Radiation Oncology Journal
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    • 제36권3호
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    • pp.172-181
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    • 2018
  • Successful anticancer strategies require a differential response between tumor and normal tissue (i.e., a therapeutic ratio). In fact, improving the effectiveness of a cancer therapeutic is of no clinical value in the absence of a significant increase in the differential response between tumor and normal tissue. Although radiation dose escalation with the use of intensity modulated radiation therapy has permitted the maximum tolerable dose for most locally advanced cancers, improvements in tumor control without damaging normal adjacent tissues are needed. As a means of increasing the therapeutic ratio, several new approaches are under development. Drugs targeting signal transduction pathways in cancer progression and more recently, immunotherapeutics targeting specific immune cell subsets have entered the clinic with promising early results. Radiobiological research is underway to address pressing questions as to the dose per fraction, irradiated tumor volume and time sequence of the drug administration. To exploit these exciting novel strategies, a better understanding is needed of the cellular and molecular pathways responsible for both cancer and normal tissue and organ response, including the role of radiation-induced accelerated senescence. This review will highlight the current understanding of promising biologically targeted therapies to enhance the radiation therapeutic ratio.

불안장애 환자에서의 치료약제 중복사용에 대한 후향적 의약품사용평가 연구 (Retrospective Drug Utilization Review Study on the Therapeutic Duplication in Patients with Anxiety Disorders)

  • 박찬현;손현순;신현택;최경업
    • 한국임상약학회지
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    • 제20권1호
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    • pp.39-49
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    • 2010
  • The present study was aimed to examine the occurrence and influencing factors therapeutic duplication (TD) of medications for anxiety disorders by analyzing the relevant prescription data. In this study, the prescription data issued on March 19, 2008 in domestic medical institutes were utilized. TD was defined as more than two medications under the same therapeutic classification per prescription based on the Anatomical Therapeutic Classification (ATC) code. The assessment of TD was performed based on the number of cases and on the ratio determined. To identify the influencing factor of TD, the variables related to the differences in the TD ratio were analyzed based on the results of the Chi-Square test conducted with the variables; patients, medical institutes, diseases, and treatments. The number and ratio of TD were determined to be 1,333 out of the total of 19,219 anxiety disorder cases, and 6.94%, most cases involving benzodiazepine derivatives, respectively. The TD ratio was found to be higher in relation to males than to females. Patients with national health insurance benefits have a higher TD ratio compared to the medical-aid beneficiaries. The TD ratios were highest in clinics, psychiatry divisions, and Gyeongsang district. The TD ratio of the cases with more than two anxiety disorders was found to be higher than that of the cases with only one anxiety disorder. As the number of medications per prescription increased, the TD ratio was shown to have become gradually higher. In conclusion, in order to prevent TD, the concurrent DUR system should be implemented. The prescribers and pharmacists must be educated regarding duplicated medications to promote the safe and effective use of medicines, without unnecessary TD.

백혈병의 한의학적 질병 관점과 약물 기전 조사 (Review of Leukemia in Eastern Medicine Theory)

  • 강다혜;윤용선;조성훈;김준기
    • 동국한의학연구소논문집
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    • 제11권
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    • pp.1-40
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    • 2008
  • The leukemia is caused by with abnormal changes of the hemotopoietic cell and in the various neoplasm group which occurs from lymph organization and the bone marrow occurs disrupts immigrates toward the blood of circumference and a hemotopoiesis and the arm discouragement royal tomb and is a disease which infiltrates with the organization. Western medical diagnosis and classification and presents eastern medicinal demonstration which is confronted in him about the leukemia, eastern medicinal diagnosis and treatment the clinical dissertation against precisely, saw and dissertation precisely tried about leukemia therapeutic effect of the herbal extract, last from conclusion like this dissertation precisely in the base which tries groped the direction of eastern medicinal treatment method research about the leukemia. Eastern medicine approach led about diagnosis and treatment of the leukemia and with leukemia treatment the medical herb which the eastern medicine possesses in development and room sacrifice an eastern medicine theory and the false eye presented the drug which is therapeutic possibility and they presented. The eastern medicine demonstration and therapeutic method is showing the therapeutic ratio which is effective about the leukemia. But according to the patient does a about prescription and therapeutic method differently and the room my composition is complicated and clinical day is consistent decides upon a reproducibility and a therapeutic ratio with difficult point of accumulation, with standardization of therapeutic method has the difficult point of supply. In treatment of the leukemia demonstrates a nature of a disease consequently with theory of eastern medicine and appropriately prescribes endeavors raises a therapeutic ratio and the medical herb and room proposal remedial value, under verifying reveals the clinical trial which is standardized leads and the medical herb and a room sacrifice and the verification and supply of effect and safety are necessary.

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암환자의 치료범위를 벗어난 INR 원인 분석 (Causes for Non-therapeutic INRs in Cancer Patients: Single Center Analysis)

  • 박은;이혜숙;김향숙;아영미;이병구;이주연
    • 한국임상약학회지
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    • 제23권3호
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    • pp.232-238
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    • 2013
  • Background: Although thromboembolism is common and one of the major causes of mortality in cancer patients, maintaining therapeutic anticoagulation effect with warfarin is challenging. This study aimed to determine the prevalence and the causes of non-therapeutic INR (International Normalized Ratio) in cancer patients. Methods: Medical and pharmacy records for cancer patients managed by the pharmacist-run anticoagulation service (ACS) between May, 2010 and April, 2011 at Seoul National University Hospital were retrospectively reviewed. The causes of non-therapeutic INR were identified and compared with the results from a former study with mechanical heart valve patients. Results: A total of 335 cancer patients and 6,737 patient-visits were analyzed producing 68% (n=4,590) of non-therapeutic INR readings. Eighty-five percent of the non-therapeutic INR readings were categorized as sub-therapeutic. Frequent causes linked to non-therapeutic INR included inadequate dosage adjustment (21.8%), changes in health status (11.8%), dietary changes (8.1%), and drug interactions (4.2%). More than half of the non-therapeutic INR values had no known etiology. As causes for non-therapeutic INR, changes in health status (p<0.0001), adverse reactions (p<0.0001), and dietary changes (p=0.017) were statistically more frequent in cancer patients than in patients with mechanical heart valves. Furthermore, exposure to sub-therapeutic INR were more prevalent in cancer patients than in patients with mechanical heart valve (p<0.0001). Conclusions: This study shows that there is a tendency to keep the level of INR low and that health status change, dietary change, and drug interactions are found to be frequent causes for non-therapeutic INR in cancer patients.

Effects of Therapeutic Climbing Training on the Balance and Gait Ability in Chronic Stroke Patients

  • Lee, Soin;Ko, Mingyun;Park, Seju
    • 국제물리치료학회지
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    • 제11권3호
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    • pp.2126-2134
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    • 2020
  • Background: Therapeutic climbing training, which originated in Germany, is a wall-hanging rock climbing-based therapy to increase the body's coordination through movement of the upper and lower limbs against gravity. However, there are no studies examining the effectiveness of therapeutic climbing training to treat balance and gait ability in patients with chronic stroke. Objectives: To investigate therapeutic climbing training program on balance and gait in patients with chronic stroke. Design: Pretest-posttest control group design. Methods: Fourteen patients with chronic hemiplegic stroke participated. Participants were randomized into the therapeutic climbing training group (TCTG, n=7) and the standard rehabilitation program group (SRPG, n=7) group. All subjects participated in the same standard rehabilitation program consisting of 60 minutes 5 times a week for 6 weeks. TCTG participated additionally in the therapeutic climbing program consisting of 30 minutes sessions 3 times a week for the same 6 weeks. Berg balance scale (BBS), Gaitview Measure, Timed up and go test (TUG) were measured. Results: In the TCTG, revealed a statistical difference in BBS between the groups; in the difference of plantar pressure ratio in the static standing position revealed a statistical difference between the groups after training; the balance ability in the one-leg standing tests increased significantly; the time in TUG decreased significantly after training in both groups; The changes in the difference of dynamic plantar pressure ratio were reduced significantly in the TCTG. Conclusion: Therapeutic climbing training contribute to improve balance and walking function in patients with chronic stroke.

치료적운동이 전방두부자세 환자의 자세, 통증 및 비대칭적 근육활성에 미치는 영향: 증례보고 (Effects of Therapeutic Exercise on Posture, Pain and Asymmetric Muscle Activity in a Patient with Forward Head Posture: case report)

  • 유경태;이호성
    • 대한물리의학회지
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    • 제11권1호
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    • pp.71-82
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    • 2016
  • PURPOSE: The purpose of this case report was to determine the effect of therapeutic exercise on posture, pain, and muscle activity in two patients with forward head posture (FHP). METHODS: A-31-year-old male (patient A) and a 19-year-old women (patient B) presented with FHP, neck pain, and headache. The therapeutic exercise program consisted of cervical mobilization, deep cervical flexors strengthening, and cervical extensors stretching, for 40 min/d, 2 d/week, for 8 weeks. Neck pain (VAS), neck disability (NDI), cervical range of motion (CROM), lateral view of cervical spine X-ray (indicating the FHP), and asymmetrical neck and shoulder muscular activity ratio were measured before, after 4 weeks, and after 8 weeks of corrective exercise. RESULTS: VAS and NDI decreased in patients A and B after exercise compared to before the program. CROM increased in patients A and B at flexion, extension, side bending, and rotation after exercise compared to before the program. FHP decreased in patients A and B at distance after exercise compared to before the program. In addition, asymmetrical neck and shoulder muscles activity ratio improved in patients A and B after exercise compared to before the program. CONCLUSION: We demonstrated in a case report that therapeutic exercise increases ROM, decreases pain and disability of neck, FHP, and asymmetry muscle activity ratio in patients with FHP. These finding have clinical implications for therapeutic exercise in patients with FHP.

고에너지 방사선치료용 조직등가보상체에 관한 고찰 (A Study of Tissue-equivalent Compensator for 10MV X-ray and Co-60 Gamma-ray)

  • 최태진;홍영락;임찬수;정호용
    • 대한방사선치료학회지
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    • 제1권1호
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    • pp.47-51
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    • 1985
  • Authors describe some useful data when constructing tissue-equivalent compensators which would compensate tissue deficit in the treatment field of high energy electromagnetic radiation Tissue equivalent compensator is made of lucite. The ratio of compensator thickness to the thickness of tissue deficit depends on radiation energy, field size and the distance from the compensator to patient skin. When the compensator is separated from skin surface, the thickness ratio is always smaller than 1.0. This means that the larger the separation, the contribution to the total dose by means of scattered radiation from a tissue equivalent compensator is smaller. Authors propose that the thickness of lucite as tissue equivalent compensator is 0.57 times tissue deficit and the separation between compensator and skin is at least 15m for Co-60 gamma ray and 25cm for 10MV X-ray.

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항정신병약물의 임상치료지침 (A Clinical Therapeutic Guideline of Antipsychotic Drugs)

  • 윤도준
    • 생물정신의학
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    • 제1권1호
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    • pp.7-16
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    • 1994
  • I will try to serve as the basis for the development of a clinical therapeutic guideline of antipsychotic drugs. Knowing that many patients fail standard treatment recommendations, either because of insufficient efficacy or intolerance to adverse effects, led us to emphasize the importance of the guideline. The clinicians continually assimilate new information about recent advances, including : novel agents targeted to impact specific components of various neurotransmitter systems ; combination strategies ; alternative uses of existing agents ; and specialized requirements of a growing number of identified diagnostic subtypes. The cost to benefit ratio must always be considered when developing a therapeutic guideline.

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라니티딘을 함유한 새로운 의약조성물(DWP302)의 위장질환 치료효과 (Therapeutic Effects on Gastrointestinal Diseases of a New Combined Ranitidine Preparations, DWP302)

  • 유병권;조태순;김영만;염제호;유영효
    • Biomolecules & Therapeutics
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    • 제2권2호
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    • pp.185-189
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    • 1994
  • The eight combined products composed of ranitidine.HCI, tripotassium dicitrato bismuthate and sucralfate were prepared with various ratios and studied in therapeutic effects of them on various gastrointestinal diseases. These were induced in rats with the porous ligation, ethanol-HCI, acetic acid and cysteamine method, etc. In all experimental setting, the effect of the combined treating was more pronounced than the effect of each drug alone. Specially, the combined treatment consisted of ranitidine : tripotassium dicitrato bismuthate sucralfate ratio of 1.5 : 2 : 6 showed the most powerful therapeutic effect on acute gastric ulcer model and revealed a significant acceleration of the healing on chronic gastroduodenal ulcer model. And that, therapeutic doses of ranitidine, tripotassium dicitrato bismuthate arid sucralfate given in combination had an additive or, in some case, synergistic effect. From the above results, this combined treatment may useful to heal the gastrointestinal diseases that aren't cured well by treatment of each them alone.

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장애영역별 특수학교 요육실기교사의 스트레스 비교 연구 (A Comparative Study of Stress Level of Therapeutic Education Teachers According to Their Responsibilities in Special School Setting)

  • 정태훈
    • The Journal of Korean Physical Therapy
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    • 제4권1호
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    • pp.69-78
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    • 1992
  • The purpose of this survey is to grasp the special school therapeutic education teachers, stress degrees in the real educational fields, and to campare the different stress degrees by the teaching responsibilities, by set by age, by the careers of special teaching profession, by his or her assiduity by the academic careers and teacher qualification, and by the reasons of stress. To perform this survey, the writer analyzed the answer sheets of the questionnairs returned by 85 special school therapeutic education teachers all over the country. The results of the analysis are as follows: First, the mean value of stress by the whole teachers was shown as endurable, and there was no difference among stress towels by the teaching responsibilities. As for the ratio of teachers confronted with the dangerous level of stress. the teachers taking charge of feebleminded school teachers the highest ratio, and those charging of deaf & dumb school teachers, the lowest. Second, the comparison by age didn't result in any difference, but in the relation of age to the handicap division there appeared meaningful differences. That is in the case of the therapeutic education theachers charging of crippled school, it revealed that the older they were, the more stress they suffered. In the case of the teachers charging of visually deaf & dumb school the tendency was opposite. The comparison by the special teaching profession careers, there showed no difference in the stress degree. The high or low academic careers didn't make any influence on the therapeutic education teachers stress degree. Third, The revealed on the highest stress degress, because reasons of relation the student's parents with students behavior.

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