• 제목/요약/키워드: Clinical investigation

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A Review of Dose Finding Methods and Theory

  • Cheung, Ying Kuen
    • Communications for Statistical Applications and Methods
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    • 제22권5호
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    • pp.401-413
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    • 2015
  • In this article, we review the statistical methods and theory for dose finding in early phase clinical trials, where the primary objective is to identify an acceptable dose for further clinical investigation. The dose finding literature is initially motivated by applications in phase I clinical trials, in which dose finding is often formulated as a percentile estimation problem. We will present some important phase I methods and give an update on new theoretical developments since a recent review by Cheung (2010), with an aim to cover a broader class of dose finding problems and to illustrate how the general dose finding theory may be applied to evaluate and improve a method. Specifically, we will illustrate theoretical techniques with some numerical results in the context of a phase I/II study that uses trinary toxicity/efficacy outcomes as basis of dose finding.

뇌혈관질환에서 SPECT와 PET의 임상적 응용 (Clinical Application of SPECT and PET in CerebroVascular Disease)

  • 나영신
    • 대한핵의학회지
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    • 제37권1호
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    • pp.1-12
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    • 2003
  • Single photon emission computed tomography(SPECT) and positron emission tomography(PET) are modern imaging techniques that allow for both qualitative and quantitative assessment of hemodynamic changes in cerebrovascular diseases. SPECT has been becoming an indispensable method to investigate regional cerebral blood flow because equipment and isotope are easily available in most general hospitals. Acetazolamide stress SPECT has also been proved to be useful to evaluate the cerebrovascular reserve of occlusive cerebrovascular diseases and to select surgical candidate. PET has gained wide spread clinical use in the evaluation of the hemodynamic and metabolic consequences of extracranial or intracranial arterial obstructive disease despite its complexity and limited availability. PET has been established as an invaluable tool in the pathophysilogy investigation of acute ischemic stroke. The potentials, limitations, and clinical applications of SPECT and PET in various cerebrovascular diseases will be discussed in this article with reviews of literatures.

Sjögren's Syndrome: an Update on Diagnostic, Clinical, and Basic Aspects for Oral Medicine Specialists

  • Lee, Kyung-Eun
    • Journal of Oral Medicine and Pain
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    • 제43권4호
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    • pp.99-111
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    • 2018
  • $Sj{\ddot{o}}gren^{\prime}s$ syndrome (SjS) is a common autoimmune disorder characterized by lymphocytic infiltration in the salivary and lacrimal glands, resulting in severe dry mouth or eyes. As a result, most of SjS patients suffer from oral dryness and can visit the department of oral medicine with or without diagnosis of SjS. Therefore, oral medicine specialists should know clues, which may indicate the diagnosis of SjS from the clinical and laboratory investigations. By the recent SjS criteria, SjS can be diagnosed by focus score, ocular staining, Schirmer's test, unstimulated whole saliva flow rate, and anti-SSA/Ro antibodies. The aim of this article is to review the diagnostic criteria, clinical investigation, and basic aspect related to SjS and to make oral medicine specialists play an important role in the detection of emerging SjS.

Chemotherapy for Lung Cancer in the Era of Personalized Medicine

  • Lee, Seung Hyeun
    • Tuberculosis and Respiratory Diseases
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    • 제82권3호
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    • pp.179-189
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    • 2019
  • Although recent advances in molecular targeted therapy and immuno-oncology have revolutionized the landscape of lung cancer therapeutics, cytotoxic chemotherapy remains an essential component of lung cancer treatment. Extensive evidence has demonstrated the clinical benefit of chemotherapy, either alone or in combination with other treatment modalities, on survival and quality of life of patients with early and advanced lung cancer. Combinational approaches with other classes of anti-neoplastic agents and new drug-delivery systems have revealed promising data and are areas of active investigation. Chemotherapy is recommended as a standard of care in patients that have progressed after tyrosine kinase inhibitors or immune checkpoint inhibitors. Chemotherapy remains the fundamental means of lung cancer management and keeps expanding its clinical implication. This review will discuss the current position and future role of chemotherapy, and specific consideration for its clinical application in the era of precision medicine.

Mouse models of breast cancer in preclinical research

  • Park, Mi Kyung;Lee, Chang Hoon;Lee, Ho
    • Laboraroty Animal Research
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    • 제34권4호
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    • pp.160-165
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    • 2018
  • Breast cancer remains the second leading cause of cancer death among woman, worldwide, despite advances in identifying novel targeted therapies and the development of treating strategies. Classification of clinical subtypes (ER+, PR+, HER2+, and TNBC (Triple-negative)) increases the complexity of breast cancers, which thus necessitates further investigation. Mouse models used in breast cancer research provide an essential approach to examine the mechanisms and genetic pathway in cancer progression and metastasis and to develop and evaluate clinical therapeutics. In this review, we summarize tumor transplantation models and genetically engineered mouse models (GEMMs) of breast cancer and their applications in the field of human breast cancer research and anti-cancer drug development. These models may help to improve the knowledge of underlying mechanisms and genetic pathways, as well as creating approaches for modeling clinical tumor subtypes, and developing innovative cancer therapy.

R을 이용한 결과 변수에 따른 최적의 Cut-off Point 결정 (Determining the Optimal Cut-off Point According to the Outcome Variables Using R)

  • 양주연;이혜선
    • Journal of Digestive Cancer Research
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    • 제10권2호
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    • pp.99-106
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    • 2022
  • Clinical research ultimately aimed to promptly diagnose and prevent diseases through precise biomarker development. Finding the optimal cut-off point of a regularly measured biomarker can help its interpretation and ultimately help in disease investigation and diagnosis, more specifically in determining the presence of diseases. Therefore, this study aimed to use the characteristics of outcome variables in clinical research to explain how to determine the optimal cutoff point. The outcome variables can be divided into dichotomous, ordinal, and survival types. The optimal cut-off point can be determined by finding points that maximize the Youden index, extended Youden index, and log-rank statistics. This study will enable clinical researchers to accurately determine the optimal cut-off points for regularly measured biomarkers, thereby enabling prompt disease diagnosis for effective treatment.

결합조직 이식술후 이식편의 수축률에 관한 임상적 연구 (The Clinical Study on Shrinkage Rate of Graft Following Connective Tissue Autografts)

  • 김영준;임성빈;정진형
    • Journal of Periodontal and Implant Science
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    • 제30권3호
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    • pp.639-650
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    • 2000
  • The purpose of this study was to evaluate clinical changes in graft size after treatment with connective tissue autograft in human. 40 premolar teeth in 23 patients having the following mucogingival problemswere selected. The width of extension, attached gingiva including free marginal gingiva, width of transplant and clinical sulcus depth were measured at the initial examination, 2, 12 and 24 weeks following the connective tissue autograft and free gingival autograft. The change of width of extension, attached gingiva including free marginal gingiva, width of transplant and clinical sulcus depth according to healing process in both graft procedures was statistically analyzed by ANOVA test and independent ttest using SPSS program. The results were as follows : 1. The change of keratinized gingiva in both grafting procedures was increased significantly at 24 weeks post-op. 2. The clinical sulcus depth exhibited no marked changes throughoutthe entire investigation in both grafting procedures. 3 . After 12 weeks, no dimensional variation was seen in graft size in both grafting procedures. 4. Shrinkage differs significantly in both grafting procedures. From the day of graft to 24 weeks after surgery the percentages of shrinkage were connective tissue autograft 55% and free gingival autograft 29%.

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UAE로 취업한 한인 의료직 종사자의 임상 경험 (Korean Migrant Health Professionals with Clinical Experience in UAE Hospitals)

  • 염진영;김정수
    • 대한방사선기술학회지:방사선기술과학
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    • 제41권4호
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    • pp.361-367
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    • 2018
  • This study was intented as an investigation of the meaning of clinical experience for gapproach was used to investigate clinical experience for Korean health professionals, A total of 10 health professional immigrants working in UAE hospitals were selected who has experience in Korea over 2 years and UAE for 1 year. Data were collected through in-depth interviews, participant observation and questionnaire. The findings were created with four essential themes; struggling to adapt at workplace at the beginning, feeling frustrated to communicate with different languages, professional reputations as a specialist, a variety of opportunities for self-development supported from hospitals and caring system of staff's health. The results indicate that the Korean health professionals were able to develop capabilities and competency with clinical experience in UAE hospitals. The results of this study suggest that lived experimental evidence for Korean migrants of health professionals. A further direction of this study, will be expected to provide more experimental information for health professional immigrants to middle east.

Ursolic Acid Promotes Apoptosis of SGC-7901 Gastric Cancer Cells through ROCK/PTEN Mediated Mitochondrial Translocation of Cofilin-1

  • Li, Rui;Wang, Xia;Zhang, Xiao-Hong;Chen, Hong-Hai;Liu, Yan-Dong
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권22호
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    • pp.9593-9597
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    • 2014
  • Ursolic acid, extracted from the traditional Chinese medicine bearberry, can induce apoptosis of gastric cancer cells. However, its pro-apoptotic mechanism still needs further investigation. More and more evidence demonstrates that mitochondrial translocation of cofilin-1 appears necessary for the regulation of apoptosis. Here, we report that ursolic acid (UA) potently induces the apoptosis of gastric cancer SGC-7901 cells. Further mechanistic studies revealed that the ROCK1/PTEN signaling pathway plays a critical role in UA-mediated mitochondrial translocation of cofilin-1 and apoptosis. These findings imply that induction of apoptosis by ursolic acid stems primarily from the activation of ROCK1 and PTEN, resulting in the translocation of cofilin-1 from cytoplasm to mitochondria, release of cytochrome c, activation of caspase-3 and caspase-9, and finally inducing apoptosis of gastric cancer SGC-7901 cells.

Factors in Dry Period Associated with Intramammary Infection and Subsequent Clinical Mastitis in Early Postpartum Cows

  • Leelahapongsathon, Kansuda;Piroon, Tipapun;Chaisri, Wasana;Suriyasathaporn, Witaya
    • Asian-Australasian Journal of Animal Sciences
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    • 제29권4호
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    • pp.580-585
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    • 2016
  • The objective of this study was to determine cow characteristics and farm management factors during the dry period associated with early postparturient intramammary infection (IMI) and subsequent clinical mastitis (CM). Data were collected three times: before drying off (P1), during the dry period (P2), and 5 to 14 days after calving (P3), using questionnaires and farm investigation. Milk samples were aseptically collected for bacterial identification at P1 and P3. Factors associated with IMI and CM were analyzed using multiple logistic regression models. The final model showed that IMI in early postpartum was significantly associated with full insertion of dry cow antibiotic, dry cows in barns with a combination of tie and free stalls, body condition score (BCS) in dry period and after calving, and milk yield before drying off. For IMI cows, factors significantly associated with clinical expression of mastitis were having daily barn cleaning, teat disinfected with alcohol before administration of dry cow therapy, BCS before drying off, milk yield before drying off, and days in milk at drying off. In conclusion, both cow and farm management factors are associated with the IMI rate and subsequent expression of clinical signs of mastitis in early postpartum cows.