• Title/Summary/Keyword: Evidence Combination

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Chemotherapy for Lung Cancer in the Era of Personalized Medicine

  • Lee, Seung Hyeun
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.3
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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.

Cardiac Arrest in Conjunction with Hypoglycemia in a Non-Diabetic Patient with Cerebral Infarction (당뇨병이 없는 뇌경색 환자에서 발생한 저혈당과 동반된 심정지)

  • Ko, Jeongmin;Lee, Ji-Yong
    • Journal of Neurocritical Care
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    • v.11 no.2
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    • pp.143-147
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    • 2018
  • Background: Hypoglycemia is uncommon in people without diabetes. There have been only a few reports of cardiac arrest in conjunction with hypoglycemia in non-diabetic patients. Case Report: A 66-year-old man visited the emergency room with dizziness. He was a chronic alcoholic. Laboratory test showed no evidence of diabetes mellitus. Brain magnetic resonance imaging revealed a left cerebellar infarction. Abdomen computed tomography demonstrated liver cirrhosis with minimal ascites. During his hospital stay, he consumed only a small amount of food because of nausea and headache. On hospital day 4, he had a cardiac arrest after two seizure episodes. His blood glucose was 10 mg/dL. The combination of liver cirrhosis, renal failure and poor oral intake was presumed to be the causes of the severe hypoglycemia. Conclusion: We report a rare case of cardiac arrest occurring in conjunction with severe hypoglycemia in a non-diabetic patient with cerebral infarction.

Some Influences of Anisotropy in Clay Soil and Rocks

  • R.H.G.Parry
    • Proceedings of the Korean Geotechical Society Conference
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    • 1997.06c
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    • pp.1.2-22
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    • 1997
  • Anisotropic behaviour in soils and soft rocks may be either fabric of stress related ultra in practice is invariably a combination of both. Theoretical studies in the paper include tile iMluence oil untrained strength of assuming both the critical state and Mo21r-Coulomb concepts to hold, and the influence of elastic anisotropy oil predicted undrained effective stress paths. The predictions stemming from these theoretical concepts are examined in the light of evidence from triaxial compression and extension tests oil laboratory prepared, compacted and natural clays and from triaxial compression tests on clay shales. The experimental studies also show the Buence of sample orientation on untrained snear strength, as wen as the iIBluence of anisotropy old the effective stress angle cishearing resistance and of stress patn on measured stiffness.

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Physical Connection between Ionized Outflows and Radio jets in Young Radio Quasars.

  • Hwang, Seong Hyeon;Kim, Minjin
    • The Bulletin of The Korean Astronomical Society
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    • v.45 no.1
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    • pp.65.2-65.2
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    • 2020
  • We present NIR spectroscopic data of young radio quasars obtained from Flamingos-2 (F2) at Gemini-South. The targets are originally selected from Wide-Field Infrared Survey Explorer survey in combination with radio survey data, such as FIRST and NVSS. Our goal is to find observational evidence of jet-driven outflows, which is expected to be present in young luminous quasars from the theoretical studies. While 16 targets were observed with F2, narrow emission lines ([O III] or Hα) were detected in 7 targets. FWHM of the emission lines (up to 2500 km/s) were remarkably broad compared to ordinary quasars, revealing the presence of strong outflows. The black hole mass estimated from Eddington limit ranges from ~108 to 109 solar mass, indicating that the target quasars are likely to be progenitors of massive galaxies. Finally, we present the comparisons between the outflow velocity and the physical properties of radio jets derived from the VLA radio imaging data, in order to investigate the physical connection between the ionized outflows and radio jets.

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Diagnostic and management challenge of concurrent tongue squamous cell carcinoma with an unknown parapharyngeal mass

  • Raymond Shupak;Roderick Kim;Jun Hyuk Huh
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.1
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    • pp.56-59
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    • 2024
  • There are very few case reports of the diagnosis and management of concurrent oral cavity and parapharyngeal space tumors. We present a case involving a 49-year-old female who presented with oral cavity squamous cell carcinoma confirmed by biopsy. Initial diagnostic workup revealed a concurrent parapharyngeal mass. Diagnostic studies and surgical therapy were tailored to account for both pathological entities. The patient was treated with a combination of surgery and adjuvant therapy. The surgical strategy was designed to address both lesions simultaneously. One year post-surgery, the patient had good response to therapy with no evidence of persistent or recurrent disease. This report discusses the outcome and treatment of a rare case of concurrent squamous cell carcinoma with a complicating parapharyngeal space tumor. It explores the diagnostic process, comprehensive workup, and the surgical management.

Chyle leak after head and neck surgeries: a comprehensive review of diagnosis and management strategies

  • Aparna Ganesan;Nehal C. Singh;Naren P. Khatri;Charanjeet Singh Madaan;Savreek Kaur;Amanjot Kaur
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.1
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    • pp.3-12
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    • 2024
  • Chyle leaks are uncommon complications after head and neck surgeries. Although uncommon, such a complication is noteworthy mention due to its perplexing diagnosis and management strategies. This scoping review aims to highlight and emphasize the diagnosis and management options proposed in the literature. A comprehensive search was performed in PubMed, Google Scholar, Cochrane Library, and Scopus databases and identified 617 articles that were reduced to 40 studies and reports after applying the eligibility criteria. Although numerous treatment options ranging from simple, conservative measures to invasive surgical procedures have been mentioned for low-output, high-output, and massive leaks, there is no concrete evidence on the best method. Thus, a combination of management options must be customized by case for optimum results.

Clinical Study of Chuna Combination Therapy for Patients with Persistent Pain and Dysfunction after Total Knee Arthroplasty (슬관절 전치환술 후 지속 통증 및 기능 장애가 있는 환자에 대한 추나병행치료 임상연구)

  • Lee, Woong-Jin;Lee, Jin-Hyun;Park, Tae-Yong;Park, Jung-Sik;Song, Yun-Kyung
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.2
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    • pp.123-138
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    • 2022
  • Objectives This study was conducted to evaluate the clinical efficacy and safety of the chuna combination treatment for patients who complain of functional impairment and pain even 3 months after total knee arthroplasty. Methods 24 patients who had 3 months of surgery and who had knee joint pain with a score of 4 or higher on the numerical rating scale (NRS) for more than a week were selected as subjects. The test group received usual care and Chuna treatment and the control group received the administration of drugs as usual care. And then the clinical efficacy and safety were compared and evaluated. Follow-up was performed 1 month after the end of treatment. Results As a result of the analysis, it was confirmed that the primary parameter Korean Western Ontario and McMaster Universities (K-WOMAC) showed statistical significance in the amount of change in visit 2-visit 10 (V2-V10) in the pain domain and in the amount of change in visit 2-follow 1 (V2-FU1) in the functional domain and total score domain. The secondary parameter (NRS, risk of fall, and range of motion) showed a tendency to decrease in the degree of discomfort, but statistical significance could not be confirmed. Conclusions Because this study did not have enough study subjects, it is difficult to use the results as confirmatory evidence. However, it was confirmed that the 4-week Chuna treatment had a significant effect and safety in patients who underwent total knee arthroplasty. Therefore, this study is meaningful as a prior research data to prepare confirmatory evidence in the future.

Role of soy lecithin combined with soy isoflavone on cerebral blood flow in rats of cognitive impairment and the primary screening of its optimum combination

  • Hongrui Li;Xianyun Wang;Xiaoying Li;Xueyang Zhou;Xuan Wang;Tiantian Li;Rong Xiao;Yuandi Xi
    • Nutrition Research and Practice
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    • v.17 no.2
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    • pp.371-385
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    • 2023
  • BACKGROUND/OBJECTIVES: Soy isoflavone (SIF) and soy lecithin (SL) have beneficial effects on many chronic diseases, including neurodegenerative diseases. Regretfully, there is little evidence to show the combined effects of these soy extractives on the impairment of cognition and abnormal cerebral blood flow (CBF). This study examined the optimal combination dose of SIF + SL to provide evidence for improving CBF and protecting cerebrovascular endothelial cells. MATERIALS/METHODS: In vivo study, SIF50 + SL40, SIF50 + SL80 and SIF50 + SL160 groups were obtained. Morris water maze, laser speckle contrast imaging (LSCI), and hematoxylin-eosin staining were used to detect learning and memory impairment, CBF, and damage to the cerebrovascular tissue in rat. The 8-hydroxy-2'-deoxyguanosine (8-OHdG) and the oxidized glutathione (GSSG) were detected. The anti-oxidative damage index of superoxide dismutase (SOD) and glutathione (GSH) in the serum of an animal model was also tested. In vitro study, an immortalized mouse brain endothelial cell line (bEND.3 cells) was used to confirm the cerebrovascular endothelial cell protection of SIF + SL. In this study, 50 µM of Gen were used, while the 25, 50, or 100 µM of SL for different incubation times were selected first. The intracellular levels of 8-OHdG, SOD, GSH, and GSSG were also detected in the cells. RESULTS: In vivo study, SIF + SL could increase the target crossing times significantly and shorten the total swimming distance of rats. The CBF in the rats of the SIF50 + SL40 group and SIF50 + SL160 group was enhanced. Pathological changes, such as attenuation of the endothelium in cerebral vessels were much less in the SIF50 + SL40 group and SIF50 + SL160 group. The 8-OHdG was reduced in the SIF50 + SL40 group. The GSSG showed a significant decrease in all SIF + SL pretreatment groups, but the GSH showed an opposite result. SOD was upregulated by SIF + SL pretreatment. Different combinations of Genistein (Gen)+SL, the secondary proof of health benefits found in vivo study, showed they have effective anti-oxidation and less side reaction on protecting cerebrovascular endothelial cell. SIF50 + SL40 in rats experiment and Gen50 + SL25 in cell test were the optimum joint doses on alleviating cognitive impairment and regulating CBF through protecting cerebrovascular tissue by its antioxidant activity. CONCLUSIONS: SIF+SL could significantly prevent cognitive defect induced by β-Amyloid through regulating CBF. This kind of effect might be attributed to its antioxidant activity on protecting cerebral vessels.

Interventions for anesthetic success in symptomatic irreversible pulpitis: A network meta-analysis of randomized controlled trials

  • Sivaramakrishnan, Gowri;Alsobaiei, Muneera;Sridharan, Kannan
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.6
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    • pp.323-341
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    • 2019
  • Background: Local anesthetics alone or in combination with adjuncts, such as oral medications, have routinely been used for pain control during endodontic treatment. The best clinical choice amongst the vast numbers of agents and techniques available for pain control for irreversible pulpitis is unclear. This network meta-analysis combined the available evidence on agents and techniques for pulpal anesthesia in the maxilla and mandible, in order to identify the best amongst these approaches statistically, as a basis for future clinical trials. Methods: Randomized trials in MEDLINE, DARE, and COCHRANE databases were screened based on inclusion criteria and data were extracted. Heterogeneity was assessed and odds ratios were used to estimate effects. Inconsistencies between direct and indirect pooled estimates were evaluated by H-statistics. The Grading of Recommendation, Assessment, Development, and Evaluation working group approach was used to assess evidence quality. Results: Sixty-two studies (nine studies in the maxilla and 53 studies in the mandible) were included in the meta-analysis. Increased mandibular pulpal anesthesia success was observed on premedication with aceclofenac + paracetamol or supplemental 4% articaine buccal infiltration or ibuprofen+paracetamol premedication, all the above mentioned with 2% lignocaine inferior alveolar nerve block (IANB). No significant difference was noted for any of the agents investigated in terms of the success rate of maxillary pulpal anesthesia. Conclusion: Direct and indirect comparisons indicated that some combinations of IANB with premedication and/or supplemental infiltration had a greater chance of producing successful mandibular pulpal anesthesia. No ideal technique for maxillary anesthesia emerged. Randomized clinical trials with increased sample size may be needed to provide more conclusive data. Our findings suggest that further high-quality studies are required in order to provide definitive direction to clinicians regarding the best agents and techniques to use for mandibular and maxillary anesthesia for irreversible pulpitis.

Combining Multiple Sources of Evidence to Enhance Web Search Performance

  • Yang, Kiduk
    • Journal of Korean Library and Information Science Society
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    • v.45 no.3
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    • pp.5-36
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    • 2014
  • The Web is rich with various sources of information that go beyond the contents of documents, such as hyperlinks and manually classified directories of Web documents such as Yahoo. This research extends past fusion IR studies, which have repeatedly shown that combining multiple sources of evidence (i.e. fusion) can improve retrieval performance, by investigating the effects of combining three distinct retrieval approaches for Web IR: the text-based approach that leverages document texts, the link-based approach that leverages hyperlinks, and the classification-based approach that leverages Yahoo categories. Retrieval results of text-, link-, and classification-based methods were combined using variations of the linear combination formula to produce fusion results, which were compared to individual retrieval results using traditional retrieval evaluation metrics. Fusion results were also examined to ascertain the significance of overlap (i.e. the number of systems that retrieve a document) in fusion. The analysis of results suggests that the solution spaces of text-, link-, and classification-based retrieval methods are diverse enough for fusion to be beneficial while revealing important characteristics of the fusion environment, such as effects of system parameters and relationship between overlap, document ranking and relevance.