• 제목/요약/키워드: Combined modality treatment

검색결과 136건 처리시간 0.025초

Is There Additive Therapeutic Effect When GCSF Combined with Adipose-Derived Stem Cell in a Rat Model of Acute Spinal Cord Injury?

  • Min, Joongkee;Kim, Jeong Hoon;Choi, Kyoung Hyo;Yoon, Hyung Ho;Jeon, Sang Ryong
    • Journal of Korean Neurosurgical Society
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    • 제60권4호
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    • pp.404-416
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    • 2017
  • Objective : Functional and neural tissue recovery has been reported in many animal studies conducted with stem cells. However, the combined effect of cytokines and stem cells has not yet been adequately researched. Here, we analyzed the additive effects of granulocyte colony-stimulating factor (GCSF) on adipose-derived stem cells (ADSCs) infusion in the treatment of acute spinal cord injury (SCI) in rats. Methods : Four days after intrathecal infusion tubes implantation in Sprague-Dawley rats, SCI was induced with an infinite horizon impactor. In the Sham group (n=5), phosphate-buffered saline was injected 3, 7, and 14 days after SCI. GCSF, ADSCs, and ADSCs with GCSF were injected at the same time in the GCSF (n=8), ADSC (n=8), and ADSC+GCSF groups (n=7), respectively. Results : The ADSC and ADSC+GCSF groups, but not the GCSF group, showed significantly higher Basso-Beattie-Bresnahan scores than the Sham group during 8 weeks (p<0.01), but no significant difference between the ADSC and ADSC+GCSF groups. In the ladder rung test, all four groups were significantly different from each other, with the ADSC+GCSF group showing the best improvement (p<0.01). On immunofluorescent staining (GAP43, MAP2), western blotting (GAP43), and reverse transcription polymerase chain reaction (GAP43, nerve growth factor), the ADSC and ADSC+GCSF groups showed higher levels than the Sham and GCSF groups. Conclusion : Our analyses suggest that the combination of GCSF and ADSCs infusions in acute SCI in the rat does not have a significant additive effect. Hence, when combination agents for SCI stem cell therapy are considered, molecules other than GCSF, or modifications to the methodology, should be investigated.

위암의 수술중 방사선 치료의 합병증 (Complication of Intraoperative Radiation Therapy (IORT) in Gastric Cancer)

  • 김명세;김성규;송선교;김홍진;권굉보;김흥대
    • Radiation Oncology Journal
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    • 제10권2호
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    • pp.187-192
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    • 1992
  • 영남대학교 의료원 치료방사선과에서 1988년 6월 15일에 위암 환자의 수술중 방사선치료를 시작한 이래 1992년 8월 30일까지 총 58예에서 시도하여 그중 53예에서 IORT를 실시하였으며, 정기적인 추적 검사에서 한명의 국소재발 환자도 보고되지 않고 있다. 출혈(3예), 장관폐쇄(3예), 폐혈증(2예), 골수기능저하(1예)를 포함한 총 9예($17\%$)의 합병증이 보고되었고, 이중 6예 ($13\%$)가 사망하였다. IORT(1500 cGy), 외부 방사선치료(-4500 cGy)와 강한 항암제를 병합치료 하였음에도 불구하고 주등(수술과 항암제 치료)의 $25.2\%$, 김등(수술 불가능한 환자에서 항암제 투여)의 $18\%$, 리등(수술)의 $18.5\%$, Kramling등(IORT 2800-3500 cGy)의 $35.3\%$에 비해 낮은 합병증을 보여 IORT가 위암의 치료에 공헌할 수 있음을 시사하였다. 그러나 비교적 높은 치사율($11.3\%$)은 더욱 세심한 수술수기 및 수술 후 환자의 치료가 필요하며 외부 방사선치료와 항암제치료의 적절한 시기 조절 및 치료선량의 가감이 필요할 것으로 생각된다.

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Laser-assisted Delivery of a Combined Antioxidant Formulation Enhances the Clinical Efficacy of Fractional Microneedle Radiofrequency Treatment: A Pilot Study

  • Kim, Jihee;Kim, Soo Min;Jung, Bok Ki;Oh, Sang Ho;Kim, Young-Koo;Lee, Ju Hee
    • Medical Lasers
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    • 제10권3호
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    • pp.161-169
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    • 2021
  • Background and Objectives Fractional microneedle radiofrequency systems are popular options to increase elasticity in aging skin. Laser-assisted drug delivery is a promising method for the epidermal injection of topically applied drugs and cosmetic ingredients. This study assesses the safety and efficacy of topical delivery of L-ascorbic acid, vitamin E, and ferulic acid after fractional microneedle radiofrequency treatment for reducing photodamage. Materials and Methods In this prospective, single-center, split-face, controlled pilot study, six women (mean age, 48.0 years; range, 35-57 years; Fitzpatrick skin types III and IV) exhibiting mild to moderate photodamage, underwent a single session of fractional microneedle radiofrequency treatment. The patients were instructed to apply the antioxidant formulation to only one side of the face. Patients were evaluated 3 days, 7 days, and 4 weeks thereafter, using three-dimensional imaging and ultrasound. Ex vivo, the full-thickness human skin was used for molecular and histological evaluation. Statistical analysis was achieved by applying t-tests, Mann-Whitney U tests, and one-way analyses of variance. Results Compared to the untreated side, the antioxidant-treated side exhibited a significant increase in dermal thickness (10.32% vs. 17.54%, p < 0.05), but not in skin elasticity (4.76% vs. 4.69%, p > 0.05). The difference in erythema between the sides was statistically not significant (p > 0.05). In the ex vivo model, expression of FGF2 in the skin was significantly increased after application of the antioxidant formulation, as compared to results obtained subsequent to fractional microneedle radiofrequency treatment only (p < 0.01). Conclusion This study demonstrates that for the treatment of photodamaged skin, laser-assisted delivery of the antioxidant formulation is a safe and effective adjuvant modality following fractional microneedle radiofrequency.

감비환과 가르시니아 캄보지아 병용 투여의 체중감량 효과와 안전성: 후향적 관찰연구 (Effect and Safety of Combined Treatment of Gambihwan and Garcinia Cambogia on Weight Loss: A Retrospective Observational Study)

  • 윤상훈;이은지;조현정;한예지;김현호;윤영희;최예용;박종승;임정태
    • 한방비만학회지
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    • 제20권1호
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    • pp.31-39
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    • 2020
  • Objectives: Obesity is becoming more popular disease worldwide. Because of the side effects of conventional obesity treatment modality, herbal medicine treatment is becoming more preferred. Gambihwan which including Ephedra sinica Staph is widely used in traditional Korean Medicine practice for obesity treatment. Garcinia cambogia is a kind of health functional food that has body fat reducing effect. Nowadays, ephedra and Garcinia cambogia are often used simultaneously in clinical practice of Korean Medicine. However, the effectiveness and safety of combination therapy in obesity treatment is not well established. Methods: We conducted retrospective observational study to explore effectiveness and safety of combination therapy. We evaluated effect of combined treatment of Gambihwan and Garcinia cambogia on body weight, body mass index, body fat mass, and waist hip ratio reduction. We also assessed safety via liver function test and adverse event. Results: Finally, 23 patients were included. In paired t-test, body weight significantly decreased from 64.50±14.50 kg to 62.94±13.85 kg (P<0.001) and body mass index were also significantly decreased from 24.43±3.79 kg/㎡ to 23.83±3.59 kg/㎡ (P<0.001). Body fat mass was also reduced. Aspartate transaminase and alanine aminotransferase were not significantly increased. There were no drug-induced liver injury and no severe adverse event. Conclusions: In our retrospective review, we found combination therapy of Gambihwan and Garcinia cambogia reduce body weight, body mass index and body fat mass. There were no severe adverse event and drug induced liver injury which indicated safety of combination therapy in obesity treatment.

Minimal Subdermal Shaving by Means of Sclerotherapy Using Absolute Ethanol: A New Method for the Treatment of Axillary Osmidrosis

  • Shim, Hyung-Sup;Min, Sung-Kee;Lim, Jin-Soo;Han, Ki-Taik;Kim, Min-Cheol
    • Archives of Plastic Surgery
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    • 제40권4호
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    • pp.440-444
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    • 2013
  • Background Axillary osmidrosis is characterized by unpleasant odors originating from the axillary apocrine glands, resulting in psychosocial stress. The main treatment modality is apocrine gland removal. Until now, of the various surgical techniques have sometimes caused serious complications. We describe herein the favorable outcomes of a new method for ablating apocrine glands by minimal subdermal shaving using sclerotherapy with absolute ethanol. Methods A total of 12 patients underwent the procedure. The severity of osmidrosis was evaluated before surgery. Conventional subdermal shaving was performed on one side (control group) and ablation by means of minimal subdermal shaving and absolute ethanol on the other side (study group). Postoperative outcomes were compared between the study and control groups. Results The length of time to removal of the drain was 1 day shorter in the study group than in the control group. There were no serious complications, such as hematoma or seroma, in either group, but flap margin necrosis and flap desquamation occurred in the control group, and were successfully managed with conservative treatment. Six months after surgery, we and our patients were satisfied with the outcomes. Conclusions Sclerotherapy using absolute ethanol combined with minimal subdermal shaving may be useful for the treatment of axillary osmidrosis. It can reduce the incidence of seroma and hematoma and allow the skin flap to adhere to its recipient site. It can degrade and ablate the remaining apocrine glands and eliminate causative organisms. Furthermore, since this technique is relatively simple, it takes less time than the conventional method.

중도 치주염에 이환된 치아의 보존을 위한 의도적 재식술을 통한 치료: 증례보고 (Treatment of a tooth with severe periodontal involvement using intentional replantation: case report)

  • 최윤경;정경화;이주연;주지영;김현주;권은영
    • 구강회복응용과학지
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    • 제35권2호
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    • pp.98-104
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    • 2019
  • 의도적 재식술은 흔히 근관 치료가 실패한 경우 사용되는 치료법이나, 중도의 치주 질환에 이환된 치아에서는 대개 추천되지 않는다. 그러나, 일부 연구들은 의도적 재식술을 이용하여 치주 질환에 이환된 치아를 성공적으로 치료한 것을 보고한 바가 있다. 본 연구에서는 중도 치주염에 이환된 치아를 의도적 재식술을 이용하여 치료한 증례를 보고하고자 한다. 해당 치아는 근관-치주 복합 병소로 진단 후 근관치료를 선행하였으나 광범위한 골소실을 나타냈으며, 이에 의도적으로 발치 후 치근 표면의 국소 인자를 완전히 제거한 후 재식하였다. 의도적 재식술을 이용하여 본 증례에서 중도 치주염에 이환된 치아를 발치하지 않고 3년간의 경과 관찰 기간 동안 보존할 수 있었다.

비인강암의 방사선치료성적 (Radiation Therapy of Nasopharyngeal Cancers)

  • 신세원;김성규;김명세
    • Journal of Yeungnam Medical Science
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    • 제9권2호
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    • pp.312-320
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    • 1992
  • 1986년 4월부터 1992년 3월까지 6년간 영남대학교 의과대학 부속병원 치료방사선과에 내원하여 근치적인 방사선치료를 시행한 후 6개월 이상 추적조사가 가능하였던 31명의 치료성적은 다음과 같다. 대상환자 31명중 남자가 22명으로 여자보다 2.4배 많았으며 30세미만 3명을 제외하면 30대에서 60대까지 고른분포를 보였다. 병리조직학적 분류상 편평세포암이 13명, 미분화세포암이 18명이었다. 임상적병기는 I기 1명, II기 2명, III기 6명, IV기 22명이었다. 31명중 방사선치료만 시행된 경우가 11명, 항암제등과 병합치료를 시행한 경우가 20명이었다. 편평세포암 환자 11명중 6명에서 방사선치료만을 시행하였고 5명에서 병합치료를 시행하였으나, 미분화세포암에서는 18명중 5명은 방사선치료만을 시행하였고 13명은 병합치료를 실시하였다. 치료에 대항 반응은 치료방법에 따른 차이가 없었으나, 방사선치료만 시행한 경우에 편평세포암 6명중 3명이 완전관해를 보인 반면에, 미분화세포암 5명 모두 완전관해를 보여 큰 차이를 보였으나 병합치료에서는 세포형태에 따른 차이가 소실되었다. 치료 후 1년 생존율은 치료방법에 따른 차이가 없었다. 완전관해를 보인 환자 22명중에서 방사선치료만 시행한 8명중 6명에서 재발을 보였으며 그중 3명은 원격전이를 동반하였으나, 병합치료를 시행한 14명중에서 3명만이 재발을 보였으며 그중2명은 원격전이를 보였다. 이상의 결과에서 치료방법에 따른 관해율은 비슷하였으나 치료 후 추적과정에서 발생하는 재발은 방사선치료만 시행한 경우보다 병합치료를 실시한 경우에 현저히 줄어듬을 보여주어 비인강암에 대한병합치료가 국소재발의 감소 및 원격전이의 감소를 통하여 생존율의 향상에도 기여하리라 사료된다.

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국소 진행된 두경부암의 병합요법 : 치료 방법에 따른 비교 (Combined Modality Treatment in Head and Neck Cancer)

  • 박인규;이호준;윤상모;김재철
    • 대한두경부종양학회지
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    • 제17권1호
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    • pp.32-37
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    • 2001
  • Objectives: We performed this study to compare the short term results of induction chemotherapy and radiotherapy versus concurrent chemoradiotherapy in patients with locally advanced head and neck cancer. Materials and Methods: From Oct. 1985 to May 1998, 121 patients with locally advanced head and neck cancer were treated with induction chemotherapy and radiotherapy (induction group) or concurrent chemoradiotherapy (concurrent group), and a retrospective analysis was done. Induction chemotherapy was done for 97 patients, and concurrent chemotherapy for 24 patients. Age, sex, performance status, and pathologic types were evenly distributed between two groups. Primary site showed nasopharynx(72.2%), oropharynx(27.8%) in induction group, and nasopharynx(50%), oropharynx(50%) in concurrent group. Chemotherapy regimen was CF(cisplatin and 5-fluorouracil) for 67 patients and CVB (cisplatin, vincristine, bleomycin) for 30 patients in induction group, and CF for all of 24 patients in concurrent group. Proportion of patients treated with more than 2 cycles of planned chemotherapy was 94.8% in induction group and 87.5% in concurrent group. Conventionally fractionated radiotherapy with daily fraction size of 1.8-2.0Gy and 5 fractions/week was done. Total dose was 61-95Gy (median 73.4Gy) for induction group, and 69.4-75.4Gy (median 69.4Gy) for concurrent group. Follow-up time was 4-161 months (median 38 months) for induction group, 7-35 months (median 21.5 months) for concurrent group, respectively. Results: According to treatment modality, overall 2-year survival rates were 68.0% for induction group, 74.3% for concurrent group (p>0.05). two-year disease-free survival rates were 51 % and 74% (p=0.05). Complete response rates were 67.4% for induction group and 83.3% for concurrent group (p=0.09). The incidence of grade 3-4 hematologic toxicity (2.1% vs. 25%, p=0.001) and grade 3-4 mucositis (9.3% vs. 37.5%, p=0.002) during radiotherapy was higher in concurrent group. Conclusion: Concurrent chemoradiotherapy showed a trend of improvement in short-term survival and treatment response when compared with induction chemotherapy and radiotherapy in locally advanced head and neck cancer. A more controlled randomized trial is needed.

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방사선 조사와 Adriamycin 병용 투여가 마우스 소장에 미치는 영향에 관한 연구 (The Combined Effect of Adriamycin and Irradiation on the Small Intestinal Villi of Mice)

  • 홍성언;안치열
    • Radiation Oncology Journal
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    • 제4권1호
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    • pp.1-13
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    • 1986
  • 방사선 조사와 adriamycin 병용투여가 마우스 소장 소낭선세포의 방사선 감수성에 미치는 영향을 관찰하고 adriamycin의 방사선 증강효과를 측정하기 위하여 $C_3H$계 마우스 120마리를 cobalt-60원 격치료기로 전복부에 조사하였다. 방사선 단독조사군은 1,000rad에서 1,600rad까지, adriamycin병용투여군은 900rad에서 1,400rad까지 각각 100rad씩 증강시켜 조사하였고 adriamycin 10mg/kg을 조사 2시간전과 4시간후에 각각 복강내에 주사하였다. 실험군은 84시간 후에 공장을 절제하고 소낭선 측정법을 이용하여 세포생존곡선을 작성하므로써 adriamycin 병용투여시의 조사효과를 측정하였으며, 주사전자현미경(SEM)으로 소장융모의 형태변화를 관찰하여 다음과 같은 효과를 얻었다. 1) 조사군의 환상면당 소낭선수는 평균 $130{\pm}16$개이었다. 2) 방사선 단독조사 군에서 소낭선세포의 평균 치사선량은 160rad이었으며, 방사선조사 2시간과 4시간후 adriamycin 병용투여군은 모두 170rad이었다. 3) 방사선조사 2시간전과 4시간 후에 adriamycin 투여군의 dose effect factor(DEF)는 1.19와 1.26이었다. 4) 주사전자현미경소견에서 조사선량 증가에 따라 소장융모의 손상이 각각 다른 형태로 뚜렷이 변하였으며, conical collapse형태로 면한 것은 단독조사군의 1,200rad와 adriamycin병용투여군의 1,000rad에서 각각 관찰되었다. 이상의 실험결과로 보아 마우스 소장에서 방사선과 adriamycin 병용투여시 $19{\sim}26%$의 유의한 조사효과 상승이 관찰되었으므로 향후 복부나 골반부에 방사선조사와 항암제를 병용하는 경우에는 방사선 감수성이 높은 장기인 소장에 대한 손상을 고려하여 임상에서 암의 방사선치료에 깊은 배려가 필요하다고 사료된다.

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레이저를 이용하여 후두미세수술을 시행한 환자에서 음성치료를 시작한 시기에 따른 음성 호전 결과에 관한 연구 (A Study of Voice Improvement According to the Onset Time of Voice Therapy after Laryngomicrosurgery)

  • 김한균;정필상;오양희;김영훈
    • 대한후두음성언어의학회지
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    • 제12권1호
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    • pp.22-27
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    • 2001
  • Backgrounds and Objectives : There have been reported many studies which evaluate the effectiveness of combined laryngomicrosurgery(LMS) and voice therapy for the patients with benign vocal cord lesions. But the difference of voice improvement by onset time of voice therapy has not been reported. The purpose of this study is to analyze the differences of voice improvement by voice analysis test between the two groups with different onset time of voice therapy. Materials and Methods : Two groups, each of which comprises 15 patients, were analyzed. For the one group, the voice therapy was initiated 1 day after LMS. For the other, the therapy was initiated 1 week after LMS. Voice analytic parameters of the two groups were statistically analized to identify difference in voice improvement. Results : All measured parameters improved after voice therapy in two groups and showed no significant difference between two groups. Conclusions : The onset time of voice therapy after LMS has no significant impact on post-operative voice quality in the patients with benign vocal cord lesions. Early onset of post-operative voice therapy may serve as treatment modality for patients with benign vocal cord lesions.

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