• 제목/요약/키워드: Combine therapy

검색결과 49건 처리시간 0.029초

외상 후 스트레스 장애(PTSD)의 정신치료에 대한 양·한방 비교 고찰 (A Comparative Study between the Korean-medical and the Western-medical Psychotherapy on PTSD)

  • 박아름;박세진;손아현;허한솔
    • 동의신경정신과학회지
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    • 제29권1호
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    • pp.1-8
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    • 2018
  • Objectives: The purpose of this study is to compare the Korean-medical and the Western-medical psychotherapy on PTSD for improving the Korean-medical psychotherapy on this issue. Methods: We surveyed recent articles relating to psychotherapy on the incidence of PTSD. Results: Under the circumstances of this study, we note that applying the qigong therapeutics would be helpful when conducting relaxation training on the identified PTSD patients. We understand that taking a systematic desensitization style in the use of the kyungja-pyungji treatment is recommended. It would also be more effective to combine other treatments such as the use of the I-Jeong-Byeon-Gi Therapy and the five minds mutual restriction therapy. We have shown that by using the five minds mutual restriction therapy for the imagery rescripting has a better a synergy effect for optimum patient outcomes for patients who have been diagnosed with PTSD. Conclusions: Our study has shown that by improving the shortcomings of the Korean psychotherapy and utilizing Western psychotherapy's merits, we expect to increase the efficacy of the Korean psychotherapy with these recommendations for changes in this case.

Reirradiation of head and neck cancer in the era of intensity-modulated radiotherapy: patient selection, practical aspects, and current evidence

  • Kim, Yeon Sil
    • Radiation Oncology Journal
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    • 제35권1호
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    • pp.1-15
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    • 2017
  • Locoregional failure is the most frequent pattern of failure in locally advanced head and neck cancer patients and it leads to death in most of the patients. Second primary tumors occurring in the other head and neck region reach up to almost 40% of long-term survivors. Recommended and preferred retreatment option in operable patients is salvage surgical resection, reporting a 5-year overall survival of up to 40%. However, because of tumor location, extent, and underlying comorbidities, salvage surgery is often limited and compromised by incomplete resection. Reirradiation with or without combined chemotherapy is an appropriate option for unresectable recurrence. Reirradiation is carefully considered with a case-by-case basis. Reirradiation protocol enrollment is highly encouraged prior to committing patient to an aggressive therapy. Radiation doses greater than 60 Gy are usually recommended for successful salvage. Despite recent technical improvement in intensity-modulated radiotherapy (IMRT), the use of concurrent chemotherapy, and the emergence of molecularly targeted agents, careful patient selection remain as the most paramount factor in reirradiation. Tumors that recur or persist despite aggressive prior chemoradiation therapy imply the presence of chemoradio-resistant clonogens. Treatment protocols that combine novel targeted radiosensitizing agents with conformal high precision radiation are required to overcome the resistance while minimizing toxicity. Recent large number of data showed that IMRT may provide better locoregional control with acceptable acute or chronic morbidities. However, additional prospective studies are required before a definitive conclusion can be drawn on safety and effectiveness of IMRT.

Photodynamic Therapy-Mediated Temporal Expression of Thymidine Kinase Genes Ligated to the Human Heat Shock Promotor: Preliminary in vitro Model Study of Enhanced Phototoxicity by PDT-Induced Gene Therapy

  • Kim, Mo-Sun;Kim, Tae-An;Kim, Jong-Ki
    • Journal of Photoscience
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    • 제9권3호
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    • pp.41-43
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    • 2002
  • PDT-mediated cyototoxicity basically depends on the penetrated light-dose into the tumor tissue. This limits the efficiency of PDT to the superficial tumor region typically less than 1 cm. The localized photochemical generation of reactive oxygen species, including singlet oxygen is known to increase expression of assortment of early response genes including heat shock protein. In order to increase PDT cytotoxicity in the treatment of solid tumor, it is desirable to combine PDT with other therapeutic effects. In this preliminary study we evaluated enhanced cytotoxicity from the PDT-mediated expression of thymidine kinase in a transfected tumor cell line. Two types of photo sensitizers, a hematoporphyrin derivative(Photogem, Russia) and aluminium sulphonated phthalocyanine(Photosense, Russia) were used to evaluate the overexpression of hsp-70 in PDT-treated cell. Transient increase of hsp-70 was observed at 6-8 hrs later following irradiation in the photosense-treated cell whereas it was not observed in Photogem-treated cell. In the presence of ganciclovia, transfected cell showed a 17% increase in the cytotoxicity compared to the PDT only cell.

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유방암 Tumor bed 치료 시 혼합 전자선 치료 방법에 대한 고찰 (A Study on the Treatment of Combine Electron Beam in the Treatment of Breast Cancer Tumor Bed)

  • 이건호;강효석;최병준;박상준;정다이;이두상;안민우;전명수
    • 대한방사선치료학회지
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    • 제31권1호
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    • pp.51-56
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    • 2019
  • 목 적: 수술 후 유방암 환자의 1차 방사선치료 후 2차 방사선치료 시 단일전자선을 사용하는 것과 서로 다른 에너지의 전자선을 혼합하여 사용하는 방법에 대해 유용성을 평가하고자 한다. 대상 및 방법: 본 연구에서는 2018년 1월부터 10월까지 본원 유방암 방사선 치료 환자를 대상으로 하였으며, 혼합 전자선을 사용하여 2차 치료를 진행한 환자 59명 중 에너지 6 MeV, 9 MeV를 혼합 사용한 환자 40명(A그룹)과 9 MeV, 12 MeV를 혼합 사용한 환자 19명(B그룹)을 대상으로 진행하였다. 각 그룹의 환자마다 6 MeV, 9 MeV, Combine(6 MeV / 9 MeV)와 9 MeV, 12 MeV, Combine(9 MeV / 12 MeV) 각기 다른 방법으로 세 가지 치료계획을 세우고, 원발병소에 전달되는 최대선량, D95, D5과 폐의 전달되는 최대선량, 평균선량, $V_3$, $V_5$, $V_{10}$을 비교 분석하였다. 결 과: A그룹 치료계획의 D95 평균값은 6 MeV에서 $785.33{\pm}225.37cGy$, 9 MeV에서 $1121.79{\pm}87.02cGy$, SUM(6 MeV / 9 MeV)에서 $1010.98{\pm}111.17cGy$였으며, 6 MeV / 9 MeV에서의 평균값이 처방 선량에 가장 적합했다. 치료하는 유방 방향의 폐의 저선량 영역 $V_3$,$V_5$의 평균값은 6 MeV / 9 MeV에서 $3.24{\pm}3.49%$, $0.72{\pm}1.55%$였고, 9 MeV에서 $7.25{\pm}4.59%$, $3.07{\pm}2.64%$로 가장 높은 값을 보였고, 6 MeV에서 $0.21{\pm}0.45%$, $0.03{\pm}0.07%$로 가장 낮은 값을 보였다. 폐의 최대선량과 평균선량은 6 MeV / 9 MeV에서 $727.78{\pm}137.27cGy$, $49.16{\pm}24.44cGy$였으며, 9 MeV에서 $998.97{\pm}114.35cGy$, $85.33{\pm}41.18cGy$로 가장 높았고, 6 MeV에서 $387.78{\pm}208.88cGy$, $9.27{\pm}6.60cGy$로 가장 낮았다. $V_{10}$의 값은 모두 0에 가까웠다. B그룹도 A그룹의 패턴으로 나타났다. 결 론: 폐의 $V_3$, $V_5$의 저선량 영역에서 상대적인 차이가 나타났으며, 혼합 에너지 적용 시 원발병소의 선량 전달에 있어서 가장 효과적임을 알 수 있었다. 유방암 추가 방사선 치료 시 전자선 에너지를 combine하여 사용하는 방법이 에너지 재원으로부터 제한되는 에너지의 효과를 좀 더 효과적으로 사용할 수 있는 방법이라고 사료되며 비록 작은 선량차이이기 때문에 간과하고 넘어갈 수 있는 부분들도 다시 한번 생각해본다면 조금 더 환자에게 도움이 되는 방사선 치료가 될 수 있을 것으로 사료된다.

물리치료가 슬관절 내측측부인대 손상을 동반한 전방십자인대 재건술 후 운동기능 회복에 미치는 영향 (The effects of functional movement recovery of physical therapy after ACL reconstruction with MCL injury)

  • 김인섭;임원식;배성수
    • The Journal of Korean Physical Therapy
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    • 제14권1호
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    • pp.27-37
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    • 2002
  • This is the study of the knee joint injured patients at the orthopaedic surgery clinic where is located in Daejon, who has MCL combine injured ACL reconstruction caused by sport activity and accident during the period from Jan. 2001 to Oct. 2001. By comparing with groups between 7th case of I-group for MCL combined stitch and II-group for ACL reconstruction since 6weeks cast. We have been concluded with that following results. 1. Range of motion for the knee was not limited at 5th case(37%) of I-group, 6th case(42%) of II-group and the cases of Flexion deficit less then 10 -degree were 2nd case(13%) of I-group and II-group 1st case(8%) with no extension deficit more then 5 -degree. 2. The level of activity that tells you whether you are capable of exercise for six month after operation. It han been divided by 3 levels. The case of capable of doing low risk exercise(swimming, cycling, etc.) was 5th case of I-group, the case of capable of doing medium risk exercise(jogging, etc.) was 3rd case of I-group and 4th case of II-group and the case of capable of doing high risk exercise(football, etc.) were 3rd case of I-group and 3rd case of II-group. 3. The timing of the return to their job were average 6.4 weeks for I-group and average 22.9 weeks for II-group(P<.05, statistical difference). 4. There was no statistical difference between I-group and II-group for the timing of the return to their job(P>.05). 5. By using VAS to compare them there was no statistical difference between I-group and II-group of clinical results according to Lysholm scale.

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FES와 부분적인 체중지지를 결합한 지상보행훈련이 만성 뇌졸중 환자의 보행과 균형에 미치는 영향 (Effect of the Combined Use of FES and Over ground Walking with Partial Body-Weight Support on Walking and Balance Competency in Patients with Chronic Strokes)

  • 왕계석;윤세원;조운수;김용남
    • 대한임상전기생리학회지
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    • 제10권1호
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    • pp.15-22
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    • 2012
  • Purpose : We investigated the effects of the combined use of FES and over ground walking with partial body-weight support (PBWS) on walking function and balance control in people with chronic strokes. Methods : Twenty-seven people who were ambulatory after chronic strokes were evaluated. The exercise's intervention consisted of the combined use of FES and over ground walking with PBWS and general exercise groups. The FES + PBWS group and general exercise group consisted on a-20-minute session per day, 3 times a week during a 4 week period. The evaluation was carried out before, after, and two weeks after the exercise intervention. Outcome measures were a 6 Minute Walk Test, 6-Meter walk Test, Timed Up and Go Test, and a Balance Test, measured before and after the exercise interventions at a-2 week follow up. Results : The endurance was significantly increased in both the FES+PBWS group and general exercise group (p<0.05). Significant increase on the gait velocity was observed in both the FES+PBWS group and general exercise group (p<0.05). The TUG was significantly different in both the FES + PBWS group and general exercise group (p<0.05). However there were no differences in both the between-group & interaction. The stability index was significantly different in both the FES + PBWS group and general exercise group (p<0.05). Conclusion : In conclusion, the combined use of FES and over ground walking with PBWS led to an improvement in walking function and balance control. Thus, it is possible to combine the use of FES and over ground walking with PBWS for physical therapy intervention to improve walking function and balance control. It is suggested to apply this intervention in the clinical field.

Effects of Dynamic Exercise Program Using Thera-Band on Craniovertebral Angle in Adults with Forward Head Posture

  • Shin, Hyungsoo;Kim, Kihyun;Jung, Namjin
    • 국제물리치료학회지
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    • 제11권1호
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    • pp.1960-1968
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    • 2020
  • Background: The alignment of the neck and shoulder is important in people with forward head posture. However, previous studies have mainly conducted fragmentary studies on the neck and shoulders, and studies on the combined movement of the neck and shoulders are incomplete. Objective: To investigate the effects of 6 week dynamic exercise program using Thera-band on craniovertebral angle (CVA) in adults with forward head posture. Design: Quasi-experimental study. Methods: The study was conducted on 24 adults with forward head posture and experimented with neck and shoulder exercises and divided them into groups of neck exercises, shoulder exercises, and neck and shoulder exercises to measure CVA values before and after the experiment. The neck exercise program included flexion and extension muscles of the neck and shoulder exercises included dynamic exercise of the upper extremities such as the trapezius muscles and serratus anterior muscle. The CVA results were measured using PA200. Results: Following the interventions, neck exercise group showed significant improvement in CVA (P<.05), but shoulder exercise group and combined exercise group did not show any significant results (P>.05). However, both groups showed some positive results. Significant differences were seen in the comparisons between the three groups (P<.05), and the results of the post-hoc test showed significant differences in neck exercise group and shoulder exercise, neck exercise and combine exercise group. Conclusion: This study suggested that the Thera-band neck exercise is beneficial for foward head posture patients and is expected to be used in clinical trials.

Antimicrobial Effects of Photodynamic Therapy Using Blue Light Emitting Diode with Photofrin and Radachlorine against Propionibacterium acnes

  • Kwon, Pil-Seung
    • 대한임상검사과학회지
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    • 제47권1호
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    • pp.6-10
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    • 2015
  • Photodynamic therapy (PDT) apply photosensitizers and light. The purpose of this study was to evaluate the in vitro efficacy of PDT using blue LED (light emitting diode) with photofrin and radachlorin for Propionibacterium acnes. The colony forming units method was used to assess the antibacterial activity. Suspension (1 mL) containing P. acnes at $1{\times}10^5CFU/mL$ were prepared and then 2 fold serial diluted to $12.5{\mu}g/mL$ from $50{\mu}g/mL$ concentration of photofrin and radachlorin. After 60 minutes incubation, light was irradiated for 10 to 30 minutes using the following light source of wavelength 460 nm, each energy density 36, 72 and $108J/cm^2$. Bacterial growth was evaluated after 72 hours incubation in a Phenylethanol Blood Agar (PEBA) culture. In addition, flow cytometric analysis were performed to measure the live cell after PDT. Also transmission electron microscopy (TEM) was employed to evaluate the effect of pathogens by PDT. The PDT Group was perfectly killed to all kind of photosensitizers dose of $12.5{\mu}g/mL$ with irradiation of 10 minutes. Also other Groups were killed to all kind of photosensitizers dose of $6.25{\mu}g/mL$ with irradiation time of 20 and 30 minutes. The flow cytometry showed a lower number of viable bacteria in the PDT group compared to the control group. The images of the TEM results were showed in cytoplasmic membrane damage and partially deformed to cell morphologies. These results suggest that radachlorin and photofrin combine blue LED PDT can be effectively treated when was proved treatment for acnes therapy.

The maintenance mechanism of hematopoietic stem cell dormancy: role for a subset of macrophages

  • Cheong-Whan Chae;Gun Choi;You Ji Kim;Mingug Cho;Yoo-Wook Kwon;Hyo-Soo Kim
    • BMB Reports
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    • 제56권9호
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    • pp.482-487
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    • 2023
  • Hematopoiesis is regulated by crosstalk between long-term repopulating hematopoietic stem cells (LT-HSCs) and supporting niche cells in the bone marrow (BM). Here, we describe the role of KAI1, which is mainly expressed on LT-HSCs and rarely on other hematopoietic stem-progenitor cells (HSPCs), in niche-mediated LT-HSC maintenance. KAI1 activates TGF-β1/Smad3 signal in LT-HSCs, leading to the induction of CDK inhibitors and inhibition of the cell cycle. The KAI1-binding partner DARC is expressed on macrophages and stabilizes KAI1 on LT-HSCs, promoting their quiescence. Conversely, when DARC+ BM macrophages were absent, the level of surface KAI1 on LT-HSCs decreases, leading to cell-cycle entry, proliferation, and differentiation. Thus, KAI1 acts as a functional surface marker of LT-HSCs that regulates dormancy through interaction with DARC-expressing macrophages in the BM stem cell niche. Recently, we showed very special and rare macrophages expressing α-SMA+ COX2+ & DARC+ induce not only dormancy of LT-HSC through interaction of KAI1-DARC but also protect HSCs by down-regulating ROS through COX2 signaling. In the near future, the strategy to combine KAI1-positive LT-HSCs and α-SMA/Cox2/DARC triple-positive macrophages will improve the efficacy of stem cell transplantation after the ablative chemo-therapy for hematological disorders including leukemia.

Concomitant EGFR Inhibitors Combined with Radiation for Treatment of Non-small Cell Lung Carcinoma

  • Zheng, De-Jie;Yu, Guo-Hua;Gao, Jian-Feng;Gu, Jun-Dong
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권8호
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    • pp.4485-4494
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    • 2013
  • Epidermal growth factor receptor (EGFR) is considered to be one of the key driver genes in non-small cell lung cancer (NSCLC). Several clinical trials have shown great promise of EGFR tyrosine kinase inhibitors (TKIs) in the first-line treatment of NSCLC. Many advances have been made in the understanding of EGFR signal transduction network and the interaction between EGFR and tumor microenvironment in mediating cancer survival and development. The concomitant targeted therapy and radiation is a new strategy in the treatment of NSCLC. A number of preclinical studies have demonstrated synergistic anti-tumor activity in the combination of EGFR inhibitors and radiotherapy in vitro and in vivo. In the present review, we discuss the rationale of the combination of EGFR inhibitors and radiotherapy in the treatment of NSCLC.