• Title/Summary/Keyword: Clinical Use

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Overview of Herbal Medicine Practice in the USA

  • Staba, E. John;Staba, Joyce E.
    • Natural Product Sciences
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    • v.4 no.1
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    • pp.1-8
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    • 1998
  • An overview of the history of the evolution of health practice in the United States. The development of selected laws regulating the marketing of botanical commodities and recent efforts to standardize them. Some consideration is given to the clinical testing and clinical use of botanical commodities.

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Resident Perceptions of Competency-Based Korean Medicine Education: A Qualitative, Content Analysis Study Conducted using Focus Group Interviews

  • Jiseong Hong
    • The Journal of Korean Medicine
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    • v.44 no.4
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    • pp.59-71
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    • 2023
  • Objectives: The new educational system emphasizes acquisition of clinical competency by the time of graduation from Korean medicine colleges that allow Korean medicine doctors to immediately perform clinical tasks. This study investigated awareness of competency-based education in Korean medicine hospital residents who must simultaneously undergo training and assist medical students in clinical practice. Methods: This was a qualitative research that was conducted using focus group interviews (FGIs) to investigate the awareness of demands for improvement in competency-based Korean medicine education in Korean medicine hospital. To apply the principles and procedures of FGIs, a semi-structured questionnaire was developed. Data analysis was conducted using the five steps of framework analysis. Results: According to contents analysis, first competency-based education that reflects actual clinical practice tasks is needed. Second, sufficient basic skill mastery education must be reinforced. Third, an intermediate curriculum that mediates clinical practice and basic education is needed. Fourth, the Objective Structured Clinical Examination and Clinical Performance Examination must be expanded to prepare for the Korean medicine doctor practical test. Conclusions: Korean medicine residents reported the gap between clinical practice and use of knowledge and skills acquired in the curriculum while acting as direct observers and educations of clinical clerkship in hospitals. Based on this exploratory study it is necessary to conduct research on the educational competency of Korean medicine residents who play an important role as educational leaders in Korean medicine clinical practice training.

Rapid Typing of Clinical Strains of Mycobacterium tuberculosis by IS6110-based Outward PCR

  • Kim, Yeun;Lee, Uen-Ho;Park, Young-Kil;Bai, Gill-Han;Cho, Sang-Nae;Lee, Hye-Young
    • Biomedical Science Letters
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    • v.10 no.2
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    • pp.163-169
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    • 2004
  • Worldwide, tuberculosis remains one of the leading infectious diseases, accounting for nearly 3 million deaths and more than 8 million new cases annually. DNA typing of Mycobacterium tuberculosis is important for the control of tuberculosis, since it can be used to track transmission route of tuberculosis, source of internal laboratory contaminations, and to answer questions on the nature of tuberculosis infections such as reactivation or exogenous reinfection of disease. At present, IS6110-based RFLP is the choice of method for typing large numbers of clinical isolates of M. tuberculosis, since it has the highest resolution power. However, RFLP requires long time, high cost and qualified experts, so only reference level laboratories can use the RFLP technique. In order to have an optional molecular typing method suitable for the clinical settings, this study evaluated the use of one of PCR-based typing methods, IS6110-based outward PCR for typing clinical isolates of M. tuberculosis. In brief, the results from this study showed that IS6110-based RFLP is useful to discriminate diverse clinical isolates of M. tuberculosis as well as to identify clinical isolates that belong to the same family or cluster groups that have been previously classified by RFLP analysis. In addition, the banding profiles resulted from IS6110-based outward PCR seemed to represent genomic characteristics of M. tuberculosis, since strains belong to the K-family generated unique band that is not present in any other strains but present only in the genome of K-family strains. The IS6110-based outward PCR was also shown to be useful with DNAs isolated directly from liquid cultures indicating this method can be suitable for typing M. tuberculosis in clinical settings.

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Interleukin-18 Synergism with Interleukin-2 in Cytotoxicity and NKG2D Expression of Human Natural Killer Cells

  • Qi, Yuan-Ying;Lu, Chao;Ju, Ying;Wang, Zi-E;Li, Yuan-Tang;Shen, Ya-Juan;Lu, Zhi-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7857-7861
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    • 2014
  • Natural killer (NK) cells play an important role in anti-tumor immunity. Interleukin (IL)-18 is an immunoregulatory cytokine that induces potent NK cell-dependent anti-tumor responses when administrated with other cytokines. In this study, we explored the effects of combining IL-18 and IL-2 on NK cytotoxicity as well as expression levels of the NK cell receptor NKG2D in vitro. Freshly isolated PBMCs were incubated for 48 h with IL-18 and IL-2, then CD107a expression on $CD3^-CD56^+$ NK cells was determined by three-colour flow cytometry to evaluate the cytotoxicity of NK cells against human erythroleukemia K562 cells and human colon carcinoma HT29 cells. Flow cytometric analysis was also employed to determine NKG2D expression on NK cells. The combined use of IL-18 and IL-2 significantly increased CD107a expression on NK cells compared with using IL-18 or IL-2 alone, suggesting that the combination of these two cytokines exerted synergistic enhancement of NK cytotoxicity. IL-18 also enhanced NKG2D expression on NK cells when administered with IL-2. In addition, blockade of NKG2D signaling with NKG2D-blocking antibody attenuated the up-regulatory effect of combining IL-18 and IL-2 on NK cytolysis. Our data revealed that IL-18 synergized with IL-2 to dramatically enhance the cytolytic activity of human NK cells in a NKG2D-dependent manner. The results appear encouraging for the use of combined IL-18 and IL-2 in tumor immunotherapy.

A Comparison of Vancomycin and Metronidazole for the Treatment of Clostridium difficile-associated Diarrhea (CDAD) in Medical Intensive Care Unit (MICU) (내과계 중환자실 재원 성인 환자의 Clostridium difficile associated Diarrhea에 대한 Metronidazole과 Vancomycin의 치료효과 비교)

  • Cho, Eun Ae;Lee, Kyung A;Kim, Jae Song;Kim, Soo Hyun;Son, Eun Sun
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.2
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    • pp.77-82
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    • 2017
  • Background: Clostridium difficile associated diarrhea (CDAD) is a leading cause of hospital-associated gastrointestinal illness. Risk factors for CDAD include advanced age, long-term admission, antibiotics, proton-pump inhibitor or $H_2$ blocker use and immunosuppression. The practice guideline of American Journal of Gastroenterology (2013) suggests metronidazole for the first-line therapy of mild-moderate CDAD as well as vancomycin for severe CDAD. MICU inpatients receiving stress ulcer prophylaxis and antibiotics are susceptible to nosocomial CDAD. Therefore, this study aimed to evaluate occurrence and treatment of CDAD in MICU. Methods: Patients who were admitted to the MICU and had CDAD from August 2012 to August 2015 were analyzed retrospectively. Results: Of the 90 patients with CDAD, 20 patients (2.22%) had mild-moderate CDAD (16 received metronidazole and 4 received vancomycin therapy) and 70 patients (77.8%) had severe CDAD(54 received metronidazole and 16 received vancomycin therapy). Among the patients with mild- moderate CDAD, treatment with metronidazole or vancomycin resulted in same clinical cure in 50% of the patients (p=1.00). Among the patients with severe CDAD, treatment with metronidazole or vancomycin resulted in clinical cure in 40.7% and 50.0% of the patients, respectively (p=0.511). Clinical symptoms recurred in 7.4% of the severe CDAD patients treated with metronidazole and 6.3% of those treated with vancomycin(p=0.875). Conclusion: Our findings suggest that metronidazole and vancomycin are equally effective for the treatment of mild-moderate CDAD; however, vancomycin demonstrated higher clinical cure rate and lower recurrence rate for severe CDAD, although the difference was not statistically significant. For better clinical outcomes, appropriate medication use by disease severity is needed.

The Influence of Self-compassion, Conflict Resolution Strategy on the Adaptation of Clinical Practice in Nursing College Students (간호대학생의 자기자비, 갈등해결전략이 임상실습 적응에 미치는 영향)

  • Jang, Hyun-Jung;Lee, Yun Jeong
    • The Journal of the Convergence on Culture Technology
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    • v.7 no.2
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    • pp.77-83
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    • 2021
  • This study was conducted to explore the effects of self-sufficiency and conflict resolution strategies on clinical practice adaptation for 4th graders in nursing college and provide basic data when preparing education and training measures for positive clinical practice adaptation. The data of 243 4th graders in nursing students were analyzed using the SPSS/WIN 22.0 program. As a result of exploring factors that affect clinical practice adaptation, the higher clinical practice satisfaction, the more self-isolated, the less over-identical, and the use of compromise as a conflict resolution strategy and the use of avoidance and domination. These variables were 43.3% influential in explaining the adaptability of nursing students to clinical practice.

A Review of Clinical Studies of Chinese Medicine Treatment of Polycystic Kidney Disease Using the CNKI Database (다낭신의 중의치료에 대한 임상연구 동향 - CNKI검색을 중심으로)

  • Ju, Ah-ra;Park, Mi-so;Choi, Yo-sup;Choo, Won-jung;Baek, Hye-kyung;Park, Mu-jin
    • The Journal of Internal Korean Medicine
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    • v.42 no.3
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    • pp.225-238
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    • 2021
  • Objective: This research reviews and investigates the trends in recent clinical studies of polycystic kidney disease (PKD) in China. Method: We searched for clinical studies discussing Oriental medicine-based treatments for PKD in the China National Knowledge Infrastructure (CNKI) database. Thirteen clinical articles published from 2001 to 2019 were analyzed. The search focused on the authors, publication year, type of study, purposes of study, method and duration of treatment, evaluation criteria, and results of the selected articles. Results: Of the articles from the database, 9 case series and 4 randomized controlled trials (RCTs) were analyzed. Ten articles used herbal medicine; 4 used herbal medicine for external use. Gamigyejibokryeong-hwan was the most common herbal prescription. The most frequently used herb was Polia Sclerotium (茯苓), and Cnidii Rhizoma (川芎) was employed in all the external uses. All 13 studies confirmed the efficacy of Oriental medicine treatments. Conclusion: 1. Scientifically designed and more varied clinical studies are required to develop treatments for PKD. 2. The current study could be used as basic data in future clinical studies on treatment and further studies of PKD.

Current Perspectives on Emerging CAR-Treg Cell Therapy: Based on Treg Cell Therapy in Clinical Trials and the Recent Approval of CAR-T Cell Therapy (장기이식 거부반응과 자가면역질환 치료제로서의 CAR Treg 세포치료제의 가능성: Treg 세포치료제 임상시험 현황과 CAR T 세포치료제 허가 정보를 바탕으로)

  • Kang, Koeun;Chung, Junho;Yang, Jaeseok;Kim, Hyori
    • Korean Journal of Transplantation
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    • v.31 no.4
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    • pp.157-169
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    • 2017
  • Regulatory T cells (Treg) naturally rein in immune attacks, and they can inhibit rejection of transplanted organs and even reverse the progression of autoimmune diseases in mice. The initial safety trials of Treg against graft-versus-host disease (GVHD) provided evidence that the adoptive transfer of Treg is safe and capable of limiting disease progression. Supported by such evidence, numerous clinical trials have been actively investigating the efficacy of Treg targeting autoimmune diseases, type I diabetes, and organ transplant rejection, including kidney and liver. The limited quantity of Treg cells harvested from peripheral blood and subsequent in vitro culture have posed a great challenge to large-scale clinical application of Treg; nevertheless, the concept of CAR (chimeric antigen receptor)-Treg has emerged as a potential resolution to the problem. Recently, two CAR-T therapies, tisagenlecleucel and axicabtagene ciloleucel, were approved by the US FDA for the treatment of refractory or recurrent acute lymhoblastic leukemia. This approval could serve as a guideline for the production protocols for other genetically engineered T cells for clinical use as well. The phase I and II clinical trials of these agents has demonstrated that genetically engineered and antigen-targeting T cells are safe and efficacious in humans. In conclusion, both the promising results of Treg cell therapy from the clinical studies and the recent FDA approval of CAR-T therapies are paving the way for CAR-Treg therapy in clinical use.