• Title/Summary/Keyword: Sequence of therapies

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Cardiac Resynchronization Therapy (심장재동시화치료)

  • Kim, Hyong-Jun;Shin, Dong-Gu
    • Journal of Yeungnam Medical Science
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    • v.22 no.2
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    • pp.131-140
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    • 2005
  • Heart failure is a clinical syndrome comprised of a number of symptoms and signs associated with congestion and/or hypoperfusion. Specific pharmacologic therapies have been developed to slow disease progression from early to more advanced stages. Once symptoms have developed, aggressive multimodality interventions are instituted to alleviate symptoms and improve clinical status and quality of life; especially in those patients that present symptoms. Recently, an evolving adjunctive therapeutic modality, that involves using implanted electrical devices: cardiac resynchronization with or without implantable cardioverter defibrillators (ICD). has been used for management. Cardiac resynchronization therapy (CRT) is a proven treatment for selected patients with heart failure-induced conduction disturbances and ventricular dyssynchrony. When used in combination with stable, optimal medical therapy, CRT is designed to reduce symptoms and improve cardiac function by restoring the mechanical sequence of ventricular activation and contraction. This review summarizes the rationale, procedure, clinical trials, and clinical indications for CRT.

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MicroRNAs in Colorectal Cancer: from Diagnosis to Targeted Therapy

  • Orang, Ayla Valinezhad;Barzegari, Abolfazl
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.6989-6999
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    • 2014
  • Colorectal cancer (CRC) is one of the major healthcare problems worldwide and its processes of genesis include a sequence of molecular pathways from adenoma to carcinoma. The discovery of microRNAs, a subset of regulatory non-coding RNAs, has added new insights into CRC diagnosis and management. Together with several causes of colorectal neoplasia, aberrant expression of oncomiRs (oncogenic and tumor suppressor miRNAs) in cancer cells was found to be indirectly result in up- or down-regulation of targeted mRNAs specific to tumor promoter or inhibitor genes. The study of miRNAs as CRC biomarkers utilizes expression profiling methods from traditional tissue samples along with newly introduced non-invasive samples of faeces and body fluids. In addition, miRNAs could be employed to predict chemo- and radio-therapy responses and be manipulated in order to alleviate CRC characteristics. The scope of this article is to provide a comprehensive review of scientific literature describing aberrantly expressed miRNAs, and consequently dysregulation of targeted mRNAs along with the potential role of miRNAs in CRC diagnosis and prognosis, as well as to summarize the recent findings on miRNA-based manipulation methods with the aim of advancing in anti-CRC therapies.

Cell Surface Antigen Display for Neuronal Differentiation-Specific Tracking

  • Kim, Sang Chul;Lee, Eun-Hye;Yu, Ji Hea;Kim, Sang-Mi;Nam, Bae-Geun;Chung, Hee Yong;Kim, Yeon-Soo;Cho, Sung-Rae;Park, Chang-Hwan
    • Biomolecules & Therapeutics
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    • v.27 no.1
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    • pp.78-84
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    • 2019
  • Cell therapeutic agents for treating degenerative brain diseases using neural stem cells are actively being developed. However, few systems have been developed to monitor in real time whether the transplanted neural stem cells are actually differentiated into neurons. Therefore, it is necessary to develop a technology capable of specifically monitoring neuronal differentiation in vivo. In this study, we established a system that expresses cell membrane-targeting red fluorescent protein under control of the Synapsin promoter in order to specifically monitor differentiation from neural stem cells into neurons. In order to overcome the weak expression level of the tissue-specific promoter system, the partial 5' UTR sequence of Creb was added for efficient expression of the cell surface-specific antigen. This system was able to track functional neuronal differentiation of neural stem cells transplanted in vivo, which will help improve stem cell therapies.

Orthodontic tooth movement after periodontal regeneration of intrabony defects

  • Conchita Martin;Mariano Sanz
    • The korean journal of orthodontics
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    • v.54 no.1
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    • pp.3-15
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    • 2024
  • The prevalence of intrabony defects in patients with advanced periodontitis stages III and IV is high. These patients usually need both periodontal treatment and orthodontic therapy, including tooth movement through bone defects, to improve masticatory function, aesthetics, and overall quality of life. Clinical practice guidelines recommend periodontal regenerative surgical interventions to resolve these defects and propose initiating orthodontic tooth movement (OTM) once periodontal therapy goals have been met. Surgical interventions using various regenerative technologies like barrier membranes and enamel matrix proteins, combined or not with bone replacement grafts, have proven effective in regenerating lost periodontal tissues. However, the combination of periodontal and orthodontic treatments requires consideration of how periodontal regenerative therapies influence OTM. Studies suggest that regenerated bone may differ in density, composition, vascularity, and cellular activity, potentially affecting the speed and efficiency of OTM, and potential root resorption of moved teeth. Understanding the sequence and timing of implementing OTM after regenerative periodontal interventions is crucial due to their interlinked processes of bone resorption and formation. This narrative review aims to uncover scientific evidence regarding these combined treatments, examining the impacts of different regenerative technologies on OTM and delineating their advantages, limitations, and best practices.

Novel biological strategies to enhance the radiation therapeutic ratio

  • Kim, Jae Ho;Jenrow, Kenneth A.;Brown, Stephen L.
    • Radiation Oncology Journal
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    • v.36 no.3
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    • pp.172-181
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    • 2018
  • Successful anticancer strategies require a differential response between tumor and normal tissue (i.e., a therapeutic ratio). In fact, improving the effectiveness of a cancer therapeutic is of no clinical value in the absence of a significant increase in the differential response between tumor and normal tissue. Although radiation dose escalation with the use of intensity modulated radiation therapy has permitted the maximum tolerable dose for most locally advanced cancers, improvements in tumor control without damaging normal adjacent tissues are needed. As a means of increasing the therapeutic ratio, several new approaches are under development. Drugs targeting signal transduction pathways in cancer progression and more recently, immunotherapeutics targeting specific immune cell subsets have entered the clinic with promising early results. Radiobiological research is underway to address pressing questions as to the dose per fraction, irradiated tumor volume and time sequence of the drug administration. To exploit these exciting novel strategies, a better understanding is needed of the cellular and molecular pathways responsible for both cancer and normal tissue and organ response, including the role of radiation-induced accelerated senescence. This review will highlight the current understanding of promising biologically targeted therapies to enhance the radiation therapeutic ratio.

Studies on the method and the theory of moxibustion in "BianQueXinShu(扁鵲心書) (vol. I)" ("편작심서(扁鵲心書).권상(卷上)"에 나타난 뜸법에 대한 연구(硏究))

  • Kim, Hyun-Dong;Lee, Yong-Bum
    • Journal of Korean Medical classics
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    • v.20 no.2
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    • pp.175-193
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    • 2007
  • A theory of the school which attach great importance to moxibustion therapy was more developed from 'Ge Hong(葛洪)', 'Wang Tao(王燾)' up to "BianQueXinShu(扁鵲心書)" of 'Dou Cai(竇材)' in Song Dynasty. The first volume of "BianQueXinShu" was described about the principles of health preserving method, diagnosis, treatment related with meridian system, support Yang theory, moxibustion therapy over the 10 chapters and in the continued 3 chapters, explained the symptoms and related moxibustion therapies. The summary is as follows. The Yang energy is the essence of the human body and it is minutely explained in "Hwangdineijing(黃帝內經)". However, the younger scholars after 'Zhang Zhongjing(張仲景)' held different views with "Hwangdineijing" so they didn't control serious diseases. Supporting the Yang energy, it will be possible to human body in good health and long life and perennial youth and longevity. To do like this, the first important thing is a moxibustion, the second is a Taoist hermit medication(丹藥) and the third is well usage of Radix Aconiti Lateralis Preparata. According to the sequence of Yang energy deficiency, the stages of diseases are classified as Ordinary Gi(平氣), Latter deficient state(微虛), The more deficient state(甚虛), Exhausting state(將脫), Exhausted state(已脫) and in the consideration of each stage, it is used gradually with warm-natured berbs, warm-acrid herbs, warm-heated herbs and moxibustion therapy. If it comes to the stage of Exhausted state, the Yang energy is too weak to treat a disease. Therefore it is easy to harm human body with usage the treatment of the Purgationist school theory or the Cold and cool medical school theory, so it is needed a great attention to use these therapies. To summarized the keynote of 'Du Jae''s moxibustion therapy, the one is a minority of selection of points(1$^{\sim}$2 acupuncture points), the second is a majority of moxibustion units(50$^{\sim}$500 units), and the other is a focused selection of points on spleen and kidney(especially Gwanwon, CC4). And in this book, it was explained concretely about the size of moxibustion, according to the experiment with mentioned size, the burning time of moxibustion was almost 4 min 40 sec, so the big size moxibustion was one of the characteristic of moxibustion therapy revealed in this book. Also it was used 'Suseongsan(睡聖散)' - a kind of analgesic herb complexes - to reduce a pain during the usage of moxibustion therapy in this book. To develop the moxibustion theory, it is more investigated in the future that there wasn't significant relation between Gwanwon(CC4) and spleen and kidney meridian in theory, compared to many used Gwanwon(CC4) in the prescription, where as mentioned the importance of spleen and kidney in treatment, that considering the burning time(1 unit - 4 min 40 sec, 12 units an hour, maximum 288 units a day) there were no guidances about meals, sleeping, stool and urine, and that there was no concrete study about the toxicity of 'Suseongsan' as analgesic moxibustion therapy.

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Molecular Markers for Patients with Thymic Malignancies: not Feasible at Present?

  • Avci, Nilufer;Cecener, Gulsah;Deligonul, Adem;Erturk, Elif;Tunca, Berrin;Egeli, Unal;Tezcan, Gulcin;Akyildiz, Elif Ulker;Bayram, Ahmet Sami;Gebitekin, Cengiz;Kurt, Ender;Evrensel, Turkkan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3457-3460
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    • 2014
  • Background: Thymomas and thymic carcinomas are rare malignancies and devising clinically effective molecular targeted therapies is a major clinical challenge. The aim of the study was to analyze BLC2 and vascular endothelial growth factor receptor (VEGFR) expression and KRAS and EGFR mutational status and to correlate them with the clinical characteristics of patients with thymomas and thymic carcinomas. Materials and Methods: A total of 62 patients (mean age: $50.4{\pm}13.2$ years) with thymomas and thymic carcinomas were enrolled. The expression of BLC2 and VEGFR in tumor cells and normal tissues was evaluated by RT-PCR. The mutational status of the KRAS and EGFR genes was investigated by PCR with sequence specific primers. Results: The BLC2 and VEGFR expression levels did not differ significantly between tumor and normal tissues. Moreover, there were no clearly pathogenic mutations in KRAS or EGFR genes in any tumor. None of the molecular markers were significantly related to clinical outcomes. Conclusions: Changes in levels of expression of BLC2 and VEGFR do not appear to be involved in thymic tumorigenesis. Moreover, our data suggest that KRAS and EGFR mutations do not play a major role in the pathogenesis of thymomas and thymic carcinomas.

Gene Mutations of 23S rRNA Associated with Clarithromycin Resistance in Helicobacter pylori Strains Isolated from Korean Patients

  • Kim, Jung-Mogg;Kim, Joo-Sung;Kim, Na-Young;Kim, Yeoung-Jeon;Kim, In-Young;Chee, Young-Joon;Lee, Chul-Hoon;Jung, Hyun-Chae
    • Journal of Microbiology and Biotechnology
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    • v.18 no.9
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    • pp.1584-1589
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    • 2008
  • Although resistance of Helicobacter pylori to clarithromycin is a major cause of failure of eradication therapies, little information is available regarding gene mutations of clarithromycin-resistant primary and secondary H. pylori isolates in Korea. In the present study, we examined gene mutations of H. pylori 238 rRNA responsible for resistance to clarithromycin. DNA sequences of the 238 rRNA gene in 21 primary clarithromycin-resistant and 64 secondary clarithromycin-resistant strains were determined by PCR amplification and nucleotide sequence analyses. Two mutations of the 238 rRNA gene, A2143G and T2182C, were observed in primary clarithromycin-resistant isolates. In secondary isolates, dual mutation of A2143G+T2182C was frequently observed. In addition, A2143G+T2182C+ T2190C, A2143G+T2182C+C2195T, and A2143G+T2182C+A2223G were observed in secondary isolates. Furthermore, macrolide binding was tested on purified ribosomes isolated from T2182C or A2143C mutant strains with $[^{14}C]$erythromycin. Erythromycin binding increased in a dose-dependent manner for the susceptible strain but not for the mutant strains. These results indicate that secondary isolates show a greater variety of 238 rRNA gene mutation types than primary isolates, and triple mutations of secondary isolates are associated with A2143G+T2182C in H. pylori isolated from Korean patients.

Comparison of concurrent chemoradiotherapy versus sequential radiochemotherapy in patients with completely resected non-small cell lung cancer

  • Kim, Hwan-Ik;Noh, O Kyu;Oh, Young-Taek;Chun, Mison;Kim, Sang-Won;Cho, Oyeon;Heo, Jaesung
    • Radiation Oncology Journal
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    • v.34 no.3
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    • pp.202-208
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    • 2016
  • Purpose: Our institution has implemented two different adjuvant protocols in treating patients with non-small cell lung cancer (NSCLC): chemotherapy followed by concurrent chemoradiotherapy (CT-CCRT) and sequential postoperative radiotherapy (PORT) followed by postoperative chemotherapy (POCT). We aimed to compare the clinical outcomes between the two adjuvant protocols. Materials and Methods: From March 1997 to October 2012, 68 patients were treated with CT-CCRT (n = 25) and sequential PORT followed by POCT (RT-CT; n = 43). The CT-CCRT protocol consisted of 2 cycles of cisplatin-based POCT followed by PORT concurrently with 2 cycles of POCT. The RT-CT protocol consisted of PORT followed by 4 cycles of cisplatin-based POCT. PORT was administered using conventional fractionation with a dose of 50.4-60 Gy. We compared the outcomes between the two adjuvant protocols and analyzed the clinical factors affecting survivals. Results: Median follow-up time was 43.9 months (range, 3.2 to 74.0 months), and the 5-year overall survival (OS), locoregional recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were 53.9%, 68.2%, and 51.0%, respectively. There were no significant differences in OS (p = 0.074), LRFS (p = 0.094), and DMFS (p = 0.490) between the two protocols. In multivariable analyses, adjuvant protocol remained as a significant prognostic factor for LRFS, favouring CT-CCRT (hazard ratio [HR] = 3.506, p = 0.046) over RT-CT, not for OS (HR = 0.647, p = 0.229). Conclusion: CT-CCRT protocol increased LRFS more than RT-CT protocol in patients with completely resected NSCLC, but not in OS. Further studies are warranted to evaluate the benefit of CCRT strategy compared with sequential strategy.

The Study on the Root Surfaces with SEM and EPMA Following Periodontal Treatment with Curet and Ultrasonic Scaler (Curet과 Ultrasonic Scaler를 이용한 치주치료후 SEM과 EPMA를 이용한 잔존치근면에 대한 연구)

  • Kim, Jae-Hyuk;Kim, Chong-Yeo;Lim, Sung-Bin;Chung, Chin-Hyung
    • Journal of Periodontal and Implant Science
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    • v.29 no.2
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    • pp.387-400
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    • 1999
  • One of the fundamental causes of periodontal disease is accumulation of bacterial plaque and calculus and most effective method of removing these plaque and calculus are scaling and root planning using hand curet and ultrasonic scaler. Many studies concerning residual degenerated mineral content after periodontal therapies have been carried out, but some problems about these studies were also known. This research studies mineral concents and distribution of residual root surfaces after perfoming hand curet and ultrasonic scaler on root surfaces of single rooted teeth which were extracted for periodontal reasons. EPMA were used to avoid errors from chemical quantative analysis and in addition SEM observation was also performed. The results were as follows. 1. No differences were found between curet group andultrasonic scaler group in Ca, P, Mg and Na level. 2. Concentration level was decreased in the sequence of Ca, P, Mg and Na. 3. Ca and P level were decreased as going to apical portion at curet group and ultrasonic scaler group. 4. More cementum was removed at cervical portion compared to other portion at curet group and ultrasonic scaler group. 5. Ca, P, Mg level was higher in dentin compared to cememtum. There was no difference in mineral level for Ca, P, Mg and Na between root surfaces treated with hand curet and ultrasonic scaler.

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