• Title/Summary/Keyword: National disease control

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An Effect of Aquatic Exercise Program with Self-help Group Activites and Strategies for Promoting Self-efficacy on Pain, Physiological Parameters and Quality of Life in Patients having Rheumatoid Arthritis. (자조집단 활동과 자기효능성 증진법을 이용한 수중운동 프로그램이 류마티스 관절염 환자의 통증, 생리적 지수 및 삶의 질에 미치는 영향)

  • Kim, Jong-Im
    • Journal of muscle and joint health
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    • v.1 no.1
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    • pp.1-30
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    • 1994
  • Rheumatoid arthritis is a chronic systematic disease with unpredictable course of exacerbation and remission, characterized by pain, joint deformity and reduced activity by joint limitation. The growing public awareness of the need for health management of chronic illnesses, provides impetus for nursing to demonstrate social effectiveness by active nursing intervention in this vast area in general, and with rheumatoid condition in particular. However, nursing interventions to date have not demonstrated its active participation in the management of chronic conditions. Nursing intervention for the patients having rheumatoid arthritis is one such area that needs to be studied intensively and to demonstrate their effectiveness empirically. The purposes of this study were two fold : first, to develop a comprehensive program that was intensified with therapeutic joint exercises in water, self-help group activities and utilization of self-efficacy promoting strategies : and secondly, to determine the effect of aquatic exercise program on pain, physiological changes and quality of life in the rheumatoid arthritis patients. Thirty five female subjects participating in this study were selected from outpatients in the Rheumatism Center, Hanyang University hospital. The period of data collection was from December, 1992 to March, 1993 in seoul and Taejeon. Subjects in Taejeon were assigned to the experimental group. The comprehensive aquatic exercise program for the experimental group was carried out three times a week for 6 weeks in regular swimming pool. Subjects in Seoul did not participated in the program, and treated as the control group. Data were analyzed with repeated measure MANCOVA, t-test, ANCOVA, percentage of change, Kruskal-Wallis 1-Way ANOVA using SPSS $PC^+$ program. Results were obtained as follows : 1) Scores on Korean pain scale, Numeric pain score, and RAI score of the experimental group were significantly lower than those of the control group (t=2.11, p=0.022 ; F=4.40, p=0.044 : t=3.10, p=0.002). 2) There was significant improvement in the physiological parameters (higher joint movement parameters, F=15.64, p=0.024 ; higher lean body mass, percentage of change=+12.2, lower body weight, t=1.01, p=0.026 : lower ESR, t=1.69, p=0.001) in the experimental group compaired with subjects In the control group. 3) There was significant improvement in the specific self-efficacy score through the comprehensive aquatic exercise program(t=2.73, p=0.011), but not in the general self- efficacy score(t=0.62, p=0.113). 4) The quality of life failed to show significant improvement in the experimental group as compaired with the control group (F=3.69, p=0.064). 5) In the experimental group, findings from additional analysis showed no significant difference in the specific self-efficacy between those who continued to aquatic exercise after completing 6 week program and those who stopped (X2=0.086, p=0.690). Therefore, adherence to aquatic exercise program for 6 weeks seem to be affected mainly by self-help group activities. An indepth study to delve into articulation of mechanisms affecting the effect of aquatic exercise program be recommended. A further study is necessary to determine the difference in the effect of group and individual aquatic exercise program, to assess factors affecting adherence to exercise for an extended length of time.

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A Study of the Relationship to the Student's Health Behavior, Belief, Value and Health Service Utilization -With Emphasis on Family Structure and Other Variables- (학생(學生)의 건강행위(健康行爲), 신념(信念), 가치(價値) 및 보건의료(保建醫療) 이용(利用)에 미치는 영향(影響)에 관(關)한 연구 -가족(家族)의 형태(形態) 및 제특성(諸特性)을 중심(中心)으로-)

  • Chung, Yeon Kang
    • Journal of the Korean Society of School Health
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    • v.6 no.1
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    • pp.9-44
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    • 1993
  • An explorative and descriptive study in order to determine the effect of family structure and other socio-demographic variables on health behavior, belief, locus, and value and utilization of public health service was carried out. Data were collected from 1,653 subjects randomly sampled in three areas, Seoul, Kyunggi province, and Cheju province. From Seoul 849 subjects were selected, 397 subjects Kyunggi, and 407 subjects from Cheju, respectively. Self-reporting questionaires were administered during the period from March to June, 1992. The major findings were as follows: 1) The subjects visited herb-doctor's at irregular intervals mainly to have tonic medicine prepared. They preferred herb-doctor's rather than with doctors at clinics and hospitals. Statistically significant difference was found among the regions studied (p<0.05). 2) The reason for visiting hospitals was primarily for treatment of diseases. They preferred hospital because they felt that the hospitals offer much highly reliable treatment services as well as medical accessibility. For the purpose of hospital utilization, statistically significant differences existed among sex, educational level, family type and region. However, no significance was found among sex, educational level, and region (p<0.05). 3) The subjects utilized general hospitals mainly for diagnosis and treatment of diseases. They preferred general hospitals because of their much better facilities and reliability. Statistical significance was found among sex, educational level, and region (p<0.05). 4) The subjects visited dentist at irregular intervals basis. They visited once half a year or three to four months. their purpose of visit was mainly for diagnosis and treatment of diseases. Statistical significance differences were found among educational level, region and economic standard (p<0.05). 5) Whenever their illnesses were mild and the pharmacies was located in nearby they visited to pharmacies. They visited once a month and patient medicines. Statistically significant differences were found among sex, educational level and region (p<0.05). 6) The subjects believed that herb medicine was quite efficacious for treatment of some diseases, particularly by information handed down through time-honored tradition and experience. However, they recognized that the efficacy of folk medicine can vary with type and severity of diseases. Statistical significance was among sex, educational level, region and economic standard (p<0.05). 7) The reason why subjects believed that pray and superstition are effective for treatment of certain type of diseases, particularly in neuropathy, was the belief in God's almighty. Statistically significant differences were found among sex, educational level, regions and economic standard (p<0.05). 8) Most of subjects under same condition preferred western medicine because they believed that it is more scientific and prompts in showing therapeutic effect. Statistical significance was not found in the choice of type of public health service among, regions. But significant differences were found among sex, educational level and region (p<0.05). 9) The subjects looked for pharmacy if they thought the symptom was mild. However, they visited hospitals for chronic disease and general hospitals for emergency treatment. Statistical significances were found among educational level, region and economic standard (p<0.05). 10) Although most of students wanted to have a healthy life as for the component of health standard and value, they think that they are not healthy (p<0.05). As for the health behavior, significant difference was found in the proportion of smoking and drinking between educational level and region (p<0.05). The health locus was affected by educational level, and health behavior was influenced by region, sex and educational level. The utilization of type of public health service was influenced by family type and region, and health belief by region and educational level, and the health values by region and economic standard respectively, most of correlation showed statistical significance. Among them, the highest correlation was seen between locus of control and external/internal locus of control, which is quite obvious. The correlation between health belief and behavior was the next highest, but still low (0.343). All the other variables are low but significant except only a few of those. These findings indicate that health education should be incorporated into the curriculum so as to develop desirable health habit, and ability of self-control in accordance with their growth stages. A systematic and scientific understanding on the herb/folk medicine is needed, and greater reliability of the utilization of public health services are is still required. Health policy for equal distribution of health service throughout the country along the hierarchical health service system and complementary mutual assistance and cooperation among various health organizations are also required.

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Echocardiographic Parameters of Pulmonary Atresia with Intact Ventricular Septum(PA/IVS) (심실 중격 결손을 동반하지 않은 폐동맥 폐쇄 환아에서의 심초음파 계측치)

  • Lee, Young Seok;Kim, Yeo Hyang;Hyum, Myung Chul;Lee, Sang Bum
    • Clinical and Experimental Pediatrics
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    • v.46 no.5
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    • pp.484-489
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    • 2003
  • Purpose : To understand morphologic and hemodynamic variations in patients with pulmonary atresia with intact ventricular septum(PA/IVS), and to decide the best treatment modalities, we measured right ventricular volume, inflow, and outflow valvular annulus size in these patients and compared them with those of normal newborns. Methods : Eight patients with PA/IVS diagnosed by echocardiography from January to December 2001 were enrolled in this study. Among the total eight patients, five were male and three were female. The mean age of patients was 6.9 days(1-34 days), and the mean body weight was 3,343 gm (2,970-4,000 gm). Ten fullterm newborn infants with sepsis or hyperbilirubinemia without heart disease were enrolled as a control group. Echocardiographic and Doppler studies using Acuson Aspen (7Mh probe) were recorded on super-VHS videotape and later on, with review mode. We measured volumes of right and left ventricles, aortic, pulmonic, mitral and tricuspid valvular annulus sizes using an installed program, and then these parameters were compared with those of the control group. Results : Mean Z-value of tricuspid valvular annulus in PA/IVS was $-3.69{\pm}2.80$(-8.4--0.45), and tricuspid/mitral valvular annulus size ratio $0.68{\pm}0.15$(0.43--0.84). The more the tricuspid/mitral valvular annulus size ratio, the more Z-value of tricuspid valvular annulus(P=0.003, r=0.885). Those patients who underwent pulmonary valvuloplasty(balloon or surgical) had a tendency toward larger volume of the right ventricle, more Z-value of pulmonic and tricuspid valvular annulus, and more tricuspid/mitral valvular annulus size ratio than those patients who underwent a shunt operation. Conclusion : Compared to a measurement of the volume of the right ventricle, measurements of tricuspid/mitral valvular annulus size ratio and Z-value of tricuspid valvular annulus may be easier and better parameters to decide the treatment method and to predict prognosis in PA/IVS patients.

Safety Assesment of Pesticides Treated on Garlic to Control Black Rot during the Storage (마늘 저장 중 부패병 방제를 위하여 처리한 농약의 경시적 농약 잔류량 평가)

  • You, Oh-Jong;Jin, Yong-Duk;Hwang, Se-Gu;Lee, Yong-Hoon;Ihm, Yang-Bin;Kim, Jin-Bae;Kwon, Oh-Kyung;Kyung, Kee-Sung;Kim, Jang-Eok
    • The Korean Journal of Pesticide Science
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    • v.13 no.3
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    • pp.148-158
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    • 2009
  • We tested and selected some agrochemicals reducing the occurrence of major pests and diseases during garlic storage. Tebuconazole, diphenylamine and prochloraz as fungicides and dimethate as a insecticide were sprayed or drenched before harvest. And the harvested garlic was dipped in each of the agrochemicals. The residues of pesticides in garlic bulbs treated were analyzed every month from harvesting time for 6 months. In case of Danyang garlic, which was treated with pesticides before and after harvesting, the residues of diphenylamine, tebuconazole, prochloraz, and dimethoate ranged from 0.008 to 0.28, from 0.03 to 0.32, from 0.02 to 0.12, and from 0.02 to 0.25 mg/kg, respectively. In case of Uiseong garlic, the residues of diphenylamine, tebuconazole, prochloraz and dimethoate ranged from 0.008 to 0.09, from 0.08 to 0.45, from 0.02 to 0.57, and from 0.04 to 0.38 mg/kg, respectively. And, in case of Namdo garlic, the residues of diphenylamine, tebuconazole, prochloraz, and dimethoate ranged from 0.008 to 0.52, from 0.07 to 1.67, from 0.02 to 0.17, and from 0.03 to 0.73 mg/kg, respectively. Some of the garlic samples treated with tebuconazole exceeded its maximum residue limits (MRLs) of 0.1 mg/kg set by Korea Food Drug Administration (KFDA), but dimethoate was detected below its MRL of 1.0 mg/kg. In case of diphenylamine and prochloraz, their MRLs for garlic were not set. Adapting their MRLs, 5.0 mg/kg of diphenylamine for apple and pear and 0.5 mg/kg of prochloraz for strawberry and grape, residue levels of diphenylamine and procloraz were below than their MRLs, with the exception of samples two times treated with procloraz in Namdo garlic. These results indicate that dimethoate can be used as an agrochemical to control the postharvest disease in garlic in only MRL aspect.

Anti-Inflammatory Effects of Poly-${\gamma}$-Glutamic Acid on DNCB-Induced Allergic Contact Dermatitis in Dogs (개에서 DNCB에 의해 유발된 알레르기성 접촉피부염에 대한 폴리감마글루탐산의 항염증 효과)

  • Kim, Hyun-Gon;Kim, Kil-Soo;Oh, Tae-Ho
    • Journal of Veterinary Clinics
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    • v.29 no.4
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    • pp.283-296
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    • 2012
  • Allergic contact dermatitis (ACD) is an inflammatory skin disease and regarded as a prototype of T-cell mediated delayed-type hypersensitivity reactions. Poly-${\gamma}$-glutamic acid (PGA) is a biodegradable polymer that is produced by Bacillus subtilis. This study was performed to assess the effects of PGA in a canine model of ACD. ACD was induced on the back of dogs induced by sensitization and repeated application by 2,4-dinitro-1-chlorobenzene (DNCB). Topical treatment of PGA was applied once a day for 12 days and skin biophysical parameters including transepidermal water loss (TEWL), skin hydration, skin pH, skin thickness and erythema index, were measured every two days during experimental periods. Histopathology and immunohistochemistry were performed to evaluate the antiinflammatory effect. In skin biophysical parameters, TEWL, skin hydration, skin thickness and erythema index were significantly increased, with a maximum increase appeared on day 2 (p < 0.05). On the other hand, skin pH was significantly decreased, with a maximum decrease appeared on day 2 (p < 0.01). After the completion of PGA treatment, skin biophysical parameters were significantly reached those of baseline in a time-dependent manner (p < 0.05). In histopathology, marked increases of epidermal thicknesses were induced after DNCB challenge with numerous inflammatory cell infiltrations and edematous changes, decreases of connective tissue occupied regions in dermis. In addition, marked increases of cytokine - tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) and interferon-${\gamma}$ (IFN-${\gamma}$)-immunoreactivities in the dermis and of apoptotic markers - caspase-3 and PARP-immunoreactivities in the epidermis were observed in DNCB-PBS control as compared with intact control, respectively (p < 0.01). It means, the ACD and related apoptotic changes were induced by DNCB in the present study. However, these ACD induced by DNCB and related apoptosis in epidermis were significantly inhibited by treatment of PGA treated skin, the decreases of infiltrated inflammatory cells and related decreases of pro-inflammatory cytokine immunoreactivities were also observed (p < 0.01). Based on these findings, PGA may have anti-inflammatory and alleviatory effects in the allergic contact dermatitis.

Treatment Results in Anal Cancer : Non-operative Treatment Versus Operative Treatment (항문암의 치료성적 : 비수술적방법과 수술적방법의 결과 비교)

  • Chie Eui Kyu;Ha Sung Whan;Park Jae-Gahb;Bang Yung-Jue;Heo Dae Seog;Kim Noe Kyeong
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.62-67
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    • 2002
  • Purpose : This study was undertaken to analyze the efficacy and sphincter preservation rate of platinum based neoadjuvant chemotherapy Plus radiotherapy versus abdominoperineal resection and Postoperative radiotherapy for anal cancer. Materials and Methods : Data of forty-two patients with anal cancer were retrospectively analyzed. Among thirty-eight patients with epidermoid histology, four patients received radiotherapy, and nineteen patients received abdominoperineal resection and adjuvant radiotherapy with or without chemotherapy $(APR+RT{\pm}CT)$, and fifteen patients received neoadjuvant chemotherapy and radiotherapy (CRT). The CRT regimen was composed of three cycles of 5-fluorouracil $(1,000\;mg/m^2\;bolus\;on\;D1\~5)$ and cisplatin $(60\;mg/m^2\;bolus\;on\;D1)$ followed by 50.4 Gy to the tumor bed and regional lymphatics over 5.5 weeks. Both inguinal lymphatics were treated with an identical dose schedule. Residual disease was treated with an additional three cycles of identical adjuvant chemotherapy. An identical dose schedule was used for post-operative radiotherapy. Median follow-up period was eighty-five months. Results : Overall five-year survival rates were $80.3\%$, 88.9 and $79.4\%$ for entire patients, $APR+RT{\pm}CT$ group, and the CRT group, respectively. No significant difference was found between the two groups (p=0.49). Anus preservation rate for the CRT group was $86.7\%$. Age (0=0.0164) and performance status (p=0.0007) were found to be significant prognostic factors by univariate analysis. Age (p=0.0426), performance status (p=0.0008), and inguinal lymph node metastasis (e=0.0093) were statistically significant prognostic factors by multivariate analysis. No case of RTOG grade 3 complication or higher was reported. Conclusion : This and other recent studies have shown that combined chemotherapy plus radiotherapy for anal cancer results in a high rate of anal sphincter preservation as well as local control and survival. Furthermore, neoadjuvant use of chemotherapy with a cisplatin based regimen rather than a concurrent regimen may lead to a decrease in complications.

Effect of Hog Millet Supplementation on Hepatic Steatosis and Insulin Resistance in Mice Fed a High-fat Diet (고지방식이로 유도한 지방간 마우스에서 기장 첨가식이가 지방간 및 인슐린 저항성에 미치는 영향)

  • Park, Mi-Young;Jang, Hwan-Hee;Lee, Jin-Young;Lee, Young-Min;Kim, Jae-Hyun;Park, Jae-Hak;Park, Dong-Sik
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.4
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    • pp.501-509
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    • 2012
  • The dietary intake of whole grains is known to reduce the incidence of chronic diseases such as obesity, diabetes, cardiovascular disease, and cancer. In our previous study, hog millet (HM, $Panicum$ $miliaceum$ L.) water extract showed the highest anti-lipogenic activity among nine cereal types in 3T3-L1 cells. In this study, the effect of hog millet water extract on hepatic steatosis and lipid metabolism in mice fed a high fat diet was investigated. Mice were fed a normal-fat diet (ND), high-fat diet (HFD) or HFD containing 1% or 2% (w/w) HM for 7 weeks. Body weight and food intake were monitored during the study period. Insulin resistance by homeostasis model assessment (HOMA-IR), fasting lipid profile, hepatic fatty acid metabolism-related gene expression determined, and intraperitoneal glucose tolerance test (IGTT) were performed at the study's end. The results indicated that 1% and 2% HM diets effectively decreased liver weights, blood TG and T-cholesterol levels (p<0.05), while the HDL-cholesterol level was increased (p<0.05) compared to HFD-induced steatotsis mice. Hepatic lipogenic-related gene ($PPAR{\alpha}$, L-FABP, and SCD1) expressions decreased, whereas lipolysis- related gene (CPT1) expression increased in animals fed the 2% PME diet (p<0.05). In addition, mice fed 1% or 2% HM diet had markedly decreased IGTT and HOMA-IR, compared to the those of the HFD-induced hepatic steatosis control group (p<0.05). These results indicated that HM inhibited hepatic lipid accumulation by regulating fatty acid metabolism, and suggested that HM is useful in the chemoprevention or treatment of high fat-induced hepatic steatosis and hepatic steatosis-related disorders including hyperlipidemia, glucose sensitivity, and insulin resistance.

Innovative approaches to the health problems of rural Korea (한국농촌보건(韓國農村保健)의 문제점(問題點)과 개선방안(改善方案))

  • Loh, In-Kyu
    • Journal of agricultural medicine and community health
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    • v.1 no.1
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    • pp.5-9
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    • 1976
  • The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

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A Phase I/II Trial of $DCVac/IR^{(R)}$ Dendritic Cell Immunotherapy Combined with Irradiation in Cases of Refractory Colorectal Cancer with Multiple Liver Metastases (기존의 치료에 반응하지 않는 다발성 간전이 대장암 환자에서 방사선조사와 병합한 수지상세포 면역치료의 1, 2상 임상시험)

  • Choi, Young-Min;Lee, Hyung-Sik;Kwon, Hyuk-Chan;Han, Sang-Young;Choi, Jong-Cheol;Chung, Ju-Seop;Kim, Chang-Won;Kim, Dong-Won;Kang, Chi-Duk
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.104-112
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    • 2008
  • Purpose: To assess the toxicity and tumor response induced by $DCVac/IR^{(R)}$ dendritic cell(DC) immunotherapy combined with irradiation for refractory colorectal cancer patients with multiple liver metastases. Materials and Methods: Between May 2004 and November 2006, applicants from a pool of refractory colorectal cancer patients with multiple liver metastases were enrolled. The patients were registered after having signed the informed consent form, which had been approved by the Institutional Review Board from the Dong-A University and Busan National University Hospital. DCs were obtained from peripheral blood of each patient, and then cultured in vitro. A total of $6{\times}10^6$ DCs were packed into a vial($DCVac/IR^{(R)}$, 0.5 ml) at the convenience of each patient's schedule. On the day before and on the day of each vaccination, each patient received a 4 Gy radiation dose to the target tumor. On the day of vaccination, the indicated dose of autologous DCs was injected into the irradiated tumor using ultrasound-guided needle injection procedures. A total of four vaccinations were scheduled at three 2-week intervals and one 4 week interval at the Dong-A University and Busan National University Hospital. If the tumor status was deemed to be stable or responding to therapy, an additional vaccination dose or two was approved at 4 week intervals beyond the fourth immunization. A tolerance test for DCs was conducted by injecting a range of doses($3{\times}10^6\;to\;12{\times}10^6$ DCs) after the 3rd injection. Moreover, the maximal tolerable dose was applied to additional patients. Treatment safety was evaluated in all patients who had at least one injection. Treatment feasibility was evaluated by the 10th week by assessing the response of patients having at least 4 injections. For systemic toxicities, the evaluation was performed using the National Cancer Institute Common Toxicity Criteria, whereas adverse effects were recorded using common WHO toxicity criteria. Results: Of the 24 registered patients, 22 received the DCs injections. Moreover, of the 14 patients that applied for the tolerance test, only 11 patients completed it because 3 patients withdrew their testing agreement. A grade 3 or more side effect, which was possibly related to the DC injection, did not occur in additional patients. The $12{\times}10^6$ DC injection was identified as the maximum tolerable dose, and was then injected in an additional 8 patients. Patients tolerated the injection fairly well, with no fatal side effects. In order to assess the feasibility of DC immunotherapy, the response was evaluated in other hepatic lesions outside of the targeted hepatic lesion. The response evaluation was performed in 15 of the 17 patients who received at least 4 injections. Stable and progressive disease was found in 4 and 11 patients, respectively. Conclusion: The DC-based immunotherapy and radiotherapy is theoretically synergistic for the local control and systemic control. The $DCVac/IR^{(R)}$ immunotherapy combined with irradiation was tolerable and safe in the evaluated cases of refractory colorectal cancer with multiple liver metastases. Future work should include well designed a phase II clinical trials.

Searching for Rotationable Vegetables for Paratylenchus projectus in Lettuce Greenhouse (해바라기침선충(Paratylenchus projectus) 피해 경감을 위한 윤작작물 탐색)

  • Kwon, Giyoon;Seo, Jongmin;Park, Sohee;Kang, Heonil;Park, Namsook;Choi, Insoo
    • Research in Plant Disease
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    • v.26 no.4
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    • pp.272-278
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    • 2020
  • The severe lettuce damage caused by Paratylenchus projectus was first reported in 2019 in Korea. To find high-value rotation crops for the control of P. projectus, nine vegetables, Brassica juncea (leaf mustard), B. rapa subsp. nipposinica (kyona), B. oleracea var. italica (broccoli), B. rapa subsp. chinensis (bok choy), B. oleracea var. viridis (kale), B. oleracea var. gongylodes (kohlrabi), Cichorium endivia (endive), C. intybus (chicory), Ipomoea aquatica (morning glory) were planted in d-10-cm clay pots in greenhouse. The growth of vegetables was compared between inoculated with 3,000 P. projectus per 100 ㎤ of soil and non-inoculated. Treatments were replicated 10 times. After 100 days, the reduction of fresh top weight was 30.4% in C. intybus, 35.1% in I. aquatica, 36.9% in B. oleracea var. acephala, 40.5% in C. endivia, 42.1% in B. rapa, 47.5% in B. rapa subsp. nipposinica, 50.4% in B. oleracea var. gonglodes, 56.3% in B. oleracea var. italica, and 66.0% in B. juncea. Nematode multiplication rates (Pf/Pi) were lower in I. aquatica (0.64) and C. endivia (1.1), but higher in B. oleracea var. gongylodes (2.54). Considering these results, I. aquatica is suitable for the rotation crop with lettuce until better rotation crops developed.