• 제목/요약/키워드: treatment delay effect

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Propensity score methods for estimating treatment delay effects (생존자료분석에서 성향 점수를 이용한 treatment delay effect 추정법에 대한 연구)

  • Jooyi Jung;Hyunjin Song;Seungbong Han
    • The Korean Journal of Applied Statistics
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    • v.36 no.5
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    • pp.415-445
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    • 2023
  • Oftentimes, the time dependent treatment covariate and the time dependent confounders exist in observation studies. It is an important problem to correctly adjust for the time dependent confounders in the propensity score analysis. Recently, In the survival data, Hade et al. (2020) used a propensity score matching method to correctly estimate the treatment delay effect when the time dependent confounder affects time to the treatment time, where the treatment delay effects is defined to the delay in treatment reception. In this paper, we proposed the Cox model based marginal structural model (Cox-MSM) framework to estimate the treatment delay effect and conducted extensive simulation studies to compare our proposed Cox-MSM with the propensity score matching method proposed by Hade et al. (2020). Our simulation results showed that the Cox-MSM leads to more exact estimate for the treatment delay effect compared with two sequential matching schemes based on propensity scores. Example from study in treatment discontinuation in conjunction with simulated data illustrates the practical advantages of the proposed Cox-MSM.

Effect of Delayed Clozapine Initiation on Acute Treatment Response in Treatment-Resistant Schizophrenia (클로자핀의 지연된 사용이 치료저항성 조현병 환자의 급성기 약물 반응에 미치는 영향)

  • Yang, So Yung;Choi, Jung-Kyu;Park, Sunyoung;Park, Jaesub
    • Korean Journal of Schizophrenia Research
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    • v.24 no.2
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    • pp.52-59
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    • 2021
  • Objectives: Recent studies have reported that delayed initiation of clozapine can affect clinical response in patients with treatment-resistant schizophrenia (TRS). This study aimed to explore the relationship between delayed initiation of clozapine and acute treatment response. Methods: Sixty-five inpatients with TRS who started clozapine for the first time were included through a retrospective chart review. Acute treatment response was defined as a 30% reduction in the Positive and Negative Syndrome Scale score or a Clinical Global Impression of Improvement score of 1 (very much improved) or 2 (much improved) at 4 weeks after initiating clozapine. Results: After meeting the TRS criteria, the mean delay for initiating clozapine was approximately 13.8 months. The delay was shorter in patients who showed a better response to clozapine in logistic regression analysis (p=0.037). Conclusion: Our findings suggest that reducing the delay in initiating clozapine increases the effectiveness of clozapine in patients with TRS.

STUDY ON THERMOSENSITIVITY OF CHITOSAN SCAFFOLD AND ON ITS EFFECTS ON FIBROBLAST PROLIFERATION IN CELL THERAPY FOR SOFT TISSUE AUGMENTATION (연조직 증강을 위한 세포치료 시 비계로서 키토산의 온도 감응성 및 섬유모세포의 증식에 미치는 영향에 관한 연구)

  • Kim, Jung-Ho;Choi, Jin-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.3
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    • pp.146-152
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    • 2009
  • Traditional surgical method or injection using filler is performed for soft tissue augmentation. Surgical methods have disadvantage of surgical morbidity. Commercially available injectable materials have the disadvantages such as resorption, short-term effect. repeated application and hypersensitivity. Significant shortcoming of cell therapy using autologous fibroblasts is delay of treatment effect. Chitosan/${\beta}$-glycerol phosphate (GP) solution has thermosensitive property and allows sol-gel transition at physiologic pH and temperature. These properties may resolve the delay of treatment effect. The purposes of this study are to evaluate the viscosity and pH changes of chitosan/${\beta}$-GP solutions and to evaluate the effect of chitosan/${\beta}$-GP solution on fibroblast proliferation and production of collagen. We measured the viscosity and pH as function of temperature, of the solution containing 1:0.7, 1:0.75, 1:0.8 chitosan (1, 10, 100, 700 kDa) /${\beta}$-GP. Fibroblasts from ears of 5 rats were cultured in chitosan/${\beta}$-GP solutions for 3 weeks. Cell proliferation and collagen contents were measured every week with WST (water-soluble tetrazolium salt) assay and Collagen assay respectively. The Results are 1) Chitosan(100 kDa<)/${\beta}$-GP solution (1:0.75) showed sol-gel transition at physiologic pH and body temperature and injectable properties. It will enable to resolve the delay in treatment effect 2) Cell proliferation and total collagen contents of the control group were increased with time. However, these decreased after the 1st week in experimental group 3) Collagen contents in the experimental group are higher than that of control group. Chitosan/${\beta}$-GP solution may provide favorable conditions for cell function

Growth Inhibition of Uterine Leiomyoma Cells Using Rhubarb (대황이 자궁상종세포의 세포자멸사에 미치는 영향)

  • Yang Young Phil;Kim Hyun Tae;Kim Sang Chan;Baek Seung Hee;Kim Mi Rye;Kwon Young Kyu
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.1
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    • pp.200-205
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    • 2004
  • Uterine leiomyoma is the most common tumor in the female genital tract. Although the tumor is benign, it is of paramount importance since it often causes profuse menstrual bleeding, pressure symptoms, and infertility. Nevertheless, the etiology and patholphysiology of this abnormality remain poorly understood. The traditional definitive treatment for uterine leiomyomas is hysterectomy and, even today, symptomatic leiomyomas are the leading cause of hysterectomy in Korea. Clearly, the development of a safe, effective, and nonsurgical method of treatment for leiomyoma would be of great benefit to many women. The present study was designed to investigate the effect of Rhubarb on apoptosis in uterine leiomyoma cells. Results demonstrate that Rhubarb inhibited cell growth in dose-dependent manner. Cell growth significantly decreased to 60% of control in the treatment of Rhubarb (300㎍/㎖). Associated with the decreased response, there was a concomitant and significant delay of subG1 8.32% above baseline in the treatment of Rhubarb (300㎍/㎖). The delay of subG1 showed a dose-dependent manner, as evidenced by the flow cytometry. The reduced cellular viability on exposure to Rhubarb may represent the induction of apoptosis, at least in part, as concomitantly evidenced by enhanced DNA fragmentation, PARP cleavage and caspase 9 and decreased pro-caspase 3. In addition, Rhubarb decreased clAP1 expression levels in dose-dependent manner. Talcen together, there results suggest that Rhubarb can produce a potent inhibition effect of apoptosis and implicate the delay of G1 phase in the cell cycle and pathways of caspase 3 and 9 in the mechanism underlying inhibitory apoptosis effect of Rhubarb.

Effect of Increased Intracellular pH by HMA on the Cytotoxicity of Combined Treatment of Hyperthermia and Chemotherapy (HMA의 세포내 산도증가가 온열과 항암화학 치료의 세포독성에 미치는 효과)

  • Hur, Won-Joo;Song, Chang-Won
    • Radiation Oncology Journal
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    • v.13 no.2
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    • pp.121-128
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    • 1995
  • Purpose: The enhanced cytotoxic effect of combined treatment of hyper-thermia and chemotherapy by increasing intracellular acidity with HMA was investigated. Materials and Methods: FSall tumor cells were injected on the hindlegs of female $C_3H$ mice. When the tumor volume reached about 200mm3, experiments were performed on the groups classified as follows: Group I :Control, Group II : Melphalan alone (2.5mg/kg, 5mg/kg, 10mg/kg, 15mg/kg), Group III : Heat alone $(42.5^{\cdot}C$ for 1 hour) Group IV : Melphalan + Heat $(42.5^{\cdot}C$ for 1 hour), Group V : HMA(10mg/kg) + Melphalan(5.0mg/kg) + Heat$(42.5^{\cdot}C$ for 1hour). Each group included 8-12 mice on each experiment HMA (3-amino-6-chloro-5-(1-homopiperidyl )-N-(diaminomethylene) -c-pyrazinecarboxamide), an analog of amiloride which increases intracellular pH(pHi) was dissolved in dimethyl sulfoxide (DMS) and injected into the tumor-bearing mice through the tail vein. 10mg/kg of HMA and each dose of melphalan were injected into peritoneum of the tumor-bearing mice 30 minutes before heating. Tumor growth delay was calculated when the tumor volme reached at $1500mm^3$ Excision assay was performed on each group and repeated 2-4 times. Results : Tumor growth delay of each experimental groups at $1500mm^3$ were 9, 10, 13 and 19 days respectively. In vivo-in vitro excision assay using FSall tumor cells, the cytotoxicity of each experimental groups was $1.2{\times}10^7,\;1{\times}10^7,\;6{\times}10^6,\;1.7{\times}10^6\;and\;1{\times}10^5$ clonogenic cells/gm respectively When HMA was added to the combined treatment of heat and .chemotherapy, the tumor growth was delayed more than combined treatment without HMA i.e., 6 days tumor growth delay at $1500mm^3$ of tumor volume. Conclusion: The combined effect of cytotoxicity by heat and chemotherapy can be much more enhanced by HMA.

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ANALYSIS OF A NONAUTONOMOUS PREDATOR-PREY MODEL INCORPORATING A PREY REFUGE AND TIME DELAY

  • Samanta, G.P.;Garain, D.N.
    • Journal of applied mathematics & informatics
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    • v.29 no.3_4
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    • pp.955-967
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    • 2011
  • In this paper we have considered a nonautonomous predator-prey model with discrete time delay due to gestation, in which there are two prey habitats linked by isotropic migration. One prey habitat contains a predator and the other (a refuge) does not. Here, we have established some sufficient conditions on the permanence of the system by using in-equality analytical technique. By Lyapunov functional method, we have also obtained some sufficient conditions for global asymptotic stability of this model. We have observed that the per capita migration rate among two prey habitats and the time delay has no effect on the permanence of the system but it has an effect on the global asymptotic stability of this model. The aim of the analysis of this model is to identify the parameters of interest for further study, with a view to informing and assisting policy-maker in targeting prevention and treatment resources for maximum effectiveness.

A Case Report of Efficacy of Growth Height and Peak-Luteinizing Hormone Level Suppression on Idiopathic Gonadotropin-Dependent Precocious Puberty Patient Using Herbal Remedy, Aesopjiyoun-tang

  • Nam, Se-hion;Lee, Chong-hai;Tang, Yu-wei;Liu, Yuan-sheng;Kim, Ki-chul;Chun, Sang-yeol;Yeom, Yu-rim;Kim, Hyung chang;Lee, Myoung-deok
    • The Journal of Korean Medicine
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    • v.36 no.4
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    • pp.150-155
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    • 2015
  • The purpose of this report is to evaluate effect of Korean medical treatment on idiopathic gonadotropin-dependent precocious puberty (G-DPP) patient received herbal medicine. We administered Aesopjiyoun-tang remedy to idiopathic G-DPP and analyzed the delay effect by hormonal value and radiographs; the height growth effect by measurement of height. After Korean medical treatment, suppression effect to peak-Luteinizing Hormone level (LHL) is 14.39IU/L to 10.9IU/L for 13month, growth effect to height value is 11cm/13month; and change of mean growth velocity (MGV) is 6.08cm/year to 10.06cm/year. The gain in height by treatment is 3.98cm/year. The result suggests Aesopjiyoun-tang can be an effective treatment for G-DPP. Herbal medicine can be used as an alternative treatment in place of the GnRH treatment.

Understanding Barriers to Malaysian Women with Breast Cancer Seeking Help

  • Norsa'adah, Bachok;Rahmah, Mohd Amin;Rampal, Krishna Gopal;Knight, Aishah
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3723-3730
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    • 2012
  • Delay in help-seeking behaviour which is potentially preventable has a major effect on the prognosis and survival of patients with breast cancer. The objective of this study was to explore reasons for delay in seeking help among patients with breast cancer from the East Coast of peninsular Malaysia. A qualitative study using face-to-face in-depth interview was carried out involving 12 breast cancer patients who had been histo-pathologically confirmed and were symptomatic on presentation. Respondents were selected purposely based on their history of delayed consultation, diagnosis or treatment. All were of Malay ethnicity and the age range was 26-67 years. Three were in stage ll, seven in stage lll and two in stage lV. At the time of interview, all except one respondent had accepted treatment. The range of consultation time was 0.2-72.2 months with a median of 1.7 months, diagnosis time was 1.4-95.8 months( median 5.4 months )and treatment time was 0-33.3 months (median 1.2 months). The themes derived from the study were poor knowledge or awareness of breast cancer, fear of cancer consequences, beliefs in complementary alternative medicine, sanction by others, other priorities, denial of disease, attitude of wait and see and health care system weakness. Help-seeking behaviour was influenced by a complex interaction of cognitive, environmental, beliefs, culture and psycho-social factors. Breast cancer awareness and psychological counselling are recommended for all patients with breast symptoms to prevent delay in seeking clinical help.

Effect of bleaching on human teeth and reduced treatment on negative influence -Review (치아 미백제가 치아에 미치는 영향과 부작용 최소화를 위한 처치에 관한 고찰)

  • Choi, Jae-Yoon;Shim, Youn-Soo
    • Journal of Korean society of Dental Hygiene
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    • v.6 no.4
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    • pp.481-493
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    • 2006
  • The purpose of the review article was to summarize and discuss the available information concerning the effect of bleaching on human teeth and reduced treatment on negative influence. Tooth bleaching effect was differ from extent of concentration and application period of a tooth bleaching agent, certainly full knowledge prior treatment about adverse effect possible appearance and follow clinical treatment for the least reduce. It remains unclear in how far those observation may result in significant adverse effect under clinical conditions. Nevertheless, further investigation are necessary to elucidate these aspect more precisely. The findings of the study were as follows : 1. It is recommended to delay placement of restorations after termination of bleaching therapy for at least 1-3 weeks. 2. Reduced negative influence that is clinical feasibility of catalase in protecting bleached surface against Oxygen radical. 3. The residual peroxide in tooth after bleaching seems to be removed by gradual diffusion and it may be possible to eliminate the adverse effect on tooth by using water displacement solution, ethylalcohol and aceton including it for effective removal of free radical oxygen.

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A Study on the Ignition Delay Effect by Flame-Resistance Paint Treatment (방염 처리에 따른 화재지연 효과 연구)

  • Oh, Kyu-Hyung;Kim, Hwang-Jin;Lee, Sung-Eun
    • Fire Science and Engineering
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    • v.23 no.2
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    • pp.111-116
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    • 2009
  • 17 kinds of fire resistant paint which are currently used were painted on the MDF(middle density fiber board), which suitable to the regulation of Fire Service Act. And we investigate a ignition delay effect under a exposure condition of radiative heat of fire. Radiative heat flux was controlled from $10kW/m^2$ to $30kW/m^2$ using the cone heater. Ignition time, ignition type and surface temperature of the sample were measured. Based on the experimental result, critical heat flux of the fire resistant paint treated sample was $10kW/m^2$ and there were no ignition delay effect above the $30kW/m^2$. And it was found that it will be difficult to expect the fire resistant effect above $400^{\circ}C$ of sample surface temperature.