• 제목/요약/키워드: Targeted therapy

검색결과 403건 처리시간 0.024초

소아 급성 림프모구 백혈병: 과거, 현재, 미래 (Acute lymphoblastic leukemia in children: past, present and future)

  • 강형진;신희영;안효섭
    • Clinical and Experimental Pediatrics
    • /
    • 제50권7호
    • /
    • pp.601-605
    • /
    • 2007
  • The cure rate of acute lymphoblastic leukemia (ALL) in children dramatically improved over past 5 decades from zero to about 80%. The main cause of improvement is owing to the development of chemotherapy by multicenter clinical trial of large study groups with the understanding of leukemia biology. Recently, pediatric ALL protocols were applied to the treatment of adolescent and even adult ALL patients. For nearly 30 years, clinical factors have been used to risk-stratify therapy for children with ALL, so that the most intensive therapies are reserved for those patients at the highest risk of relapse. The risk groups of ALL are divided as standard- (low- plus intermediate-), high- and very high-risk group according to the prognostic factors, and treatment results improved by this risk based treatment. The factors used to risk-stratify therapy include age, gender, presenting leukocyte count, immunophenotype, cytogenetic aberrations including ploidy and translocations, and initial response after 1 to 2 weeks of therapy. But treatment efficacy is the most important determinant and can abolish the clinical significance of most, if at all, prognostic factors. Today, in the era of intensive, multiagent regimens, there is increasing evidence that we have reached the limits of prognostic significance of currently applied clinical risk factors in childhood ALL. As the cure rate of ALL is about 80%, introducing new prognostic factors such as new molecular prognostic markers, new methods of assessment about minimal residual disease, and pharmacogenetic study, with the development of stem cell transplantation and molecular targeted therapy are needed to cure residual 20% of childhood ALL patients without short and long term complications.

Local ablative radiotherapy for oligometastatic non-small cell lung cancer

  • Suh, Yang-Gun;Cho, Jaeho
    • Radiation Oncology Journal
    • /
    • 제37권3호
    • /
    • pp.149-155
    • /
    • 2019
  • In metastatic non-small cell lung cancer (NSCLC), the role of radiotherapy (RT) has been limited to palliation to alleviate the symptoms. However, with the development of advanced RT techniques, recent advances in immuno-oncology therapy targeting programmed death 1 (PD-1) and programmed death ligand 1 (PD-L1) and targeted agents for epidermal growth factor receptor (EGFR) mutation or anaplastic lymphoma kinase (ALK) translocation allowed new roles of RT in these patients. Within this metastatic population, there is a subset of patients with a limited number of sites of metastatic disease, termed as oligometastasis that can achieve long-term survival from aggressive local management. There is no consensus on the definition of oligometastasis; however, most clinical trials define oligometastasis as having 3 to 5 metastatic lesions. Recent phase II randomized clinical trials have shown that ablative RT, including stereotactic ablative body radiotherapy (SABR) and hypofractionated RT, to primary and metastatic sites improved progression-free survival (PFS) and overall survival (OS) in patients with oligometastatic NSCLC. The PEMBRO-RT study, a randomized phase II study comparing SABR prior to pembrolizumab therapy and pembrolizumab therapy alone, revealed that the addition of SABR improved the overall response, PFS, and OS in patients with advanced NSCLC. The efficacy of RT in oligometastatic lung cancer has only been studied in phase II studies; therefore, large-scale phase III studies are needed to confirm the benefit of local ablative RT in patients with oligometastatic NSCLC. Local intensified RT to primary and metastatic lesions is expected to become an important treatment paradigm in the near future in patients with metastatic lung cancer.

Nationwide Analysis of Treatment Patterns for Korean Breast Cancer Survivors Using National Health Insurance Service Data

  • Chung, Il Yong;Lee, Jihyoun;Park, Suyeon;Lee, Jong Won;Youn, Hyun Jo;Hong, Jung Hwa;Hur, Ho
    • Journal of Korean Medical Science
    • /
    • 제33권44호
    • /
    • pp.276.1-276.10
    • /
    • 2018
  • Background: The National Health Insurance Service (NHIS) established a healthcare claim database for all Korean citizens. This study aimed to analyze the NHIS data and investigate the patterns of breast cancer treatments. Methods: We constructed a retrospective female breast cancer cohort by analyzing annual incident cases. The annual number of newly diagnosed female breast cancer was compared between the NHIS data and Korea National Cancer Incidence Database (KNCIDB). The annual treatment patterns including surgery, chemotherapy, radiation therapy, endocrine therapy and targeted therapy were analyzed. Results: A total of 148,322 women with newly diagnosed invasive breast cancer during 2006-2014 was identified. The numbers of newly diagnosed invasive breast cancer cases were similar between the NHIS data and KNCIDB, which demonstrated a strong correlation (r = 0.995; P < 0.001). The age distribution of the breast cancer cases in the NHIS data and KNCIDB also showed a strong correlation (r = 1.000; P < 0.001). About 85% of newly diagnosed breast cancer patients underwent operations. Although the proportions of chemotherapy use have not changed during 2006-2014, the total number of chemotherapy prescriptions sharply increased during this period. The proportions of radiotherapy and anti-hormonal therapy increased. Among the anti-hormonal agents, tamoxifen was the most frequently prescribed medication, and letrozole was the most preferred endocrine treatment in patients aged ${\geq}50$ years. Conclusion: Along with the increased breast cancer incidence in Korea, the frequencies of breast cancer treatments have increased. The NHIS data can be a feasible data source for future research.

The Effect of Abdominal Drawing-in Maneuver with Pressure Biofeedback Unit in Various Postures on Abdominal Muscle Contraction

  • Lee, Seunghoon;Lee, Sangyeol
    • Physical Therapy Rehabilitation Science
    • /
    • 제11권2호
    • /
    • pp.136-144
    • /
    • 2022
  • Objective: This study was to identify the effect of pressure biofeedback applied in various postures that allow the application of abdominal drawing-in. Design: A cross sectional study. Methods: The study intended to compare changes in the thickness of abdominal muscles between different postures when abdominal drawing-in was performed using a pressure biofeedback unit in five postures and to compare differences in terms of measures such as the transverse abdominis's preferential activation ratio(PAR). Data measured from 30 healthy individuals were used for data analysis. A paired t-test and repeated measures analysis of variance was performed to compare the thickness of each abdominal muscle. Results: The transverse abdominis's and internal oblique's thickness showed statistically significant differences in all postures when abdominal drawing-in (p<0.05). In the comparison between the postures, statistically significant differences were observed between the positions of hook-lying and wall support standing and between supine and wall support standing and between hook-lying and sitting (p<0.05). In terms of the transverse abdominis's PAR in each posture, statistically significant differences were observed between hook-lying and quadruped, hook-lying and sitting, hook-lying and wall support standing, quadruped and supine, sitting and supine, as well as wall support standing and supine (p<0.05). Conclusions: When abdominal drawing-in using pressure biofeedback unit is performed for stabilization exercises, selecting and applying specific postures according to targeted muscles and the subject's functional ability will help provide a more efficient and accurate intervention.

외상 후 스트레스 장애 환자를 위한 국내 프로그램 체계적 고찰 (A Systematic Review of Programs for Post-traumatic Stress Disorder Patients in South Korea)

  • Ik-Sung KIM;Eun-Sol JU
    • 융합경영연구
    • /
    • 제12권1호
    • /
    • pp.97-104
    • /
    • 2024
  • Purpose: This study attempted to systematically review the programs of patients with post-traumatic stress disorder in South Korea over the past decade, identify specific methods and effects, and present program guidance guidelines through them. Research design, data and methodology: This study is a systematic literature review, and studies registered in the RISS, NDSL, DBpia, and KmBASE search databases from January 1, 2013 to August 31, 2023 were targeted. Keywords were 'post-traumatic stress disorder', 'program' or 'treatment'. A total of 2,324 documents were searched, and 237 duplicate papers were excluded. After that, the title and abstract were viewed, and 2,058 papers that did not meet the inclusion criteria and exclusion criteria were excluded. In addition, the full text was checked and the final 11 documents were analyzed excluding 18 documents. Results: Among the 11 literatures, 45.45% of randomized control studies and 54.54% of non-randomized control studies were found. As for gender, 41.18% of women, 28.64% of 30-39 years old, and 34.27% of trauma causes were industrial accidents. Programs for patients with post-traumatic stress disorder were classified into art therapy, cognitive behavior therapy, and mindfulness programs, and art therapy was the most used at 45.45%. The sessions of the program were widely applied at 45.45% for 10 sessions and 36.36% for 60 minutes per session. Conclusions: This study has a limitation in that it only analyzed domestic intervention programs within 10 years. However, this study is meaningful in that it is intended to present program guidance guidelines through reviewing domestic programs for post-traumatic stress patients. In the future, it is necessary to conduct research such as expanding the scope of literature review at home and abroad.

Ginsenoside Rg4 Enhances the Inductive Effects of Human Dermal Papilla Spheres on Hair Growth Via the AKT/GSK-3β/β-Catenin Signaling Pathway

  • Lee, Yun Hee;Choi, Hui-Ji;Kim, Ji Yea;Kim, Ji-Eun;Lee, Jee-Hyun;Cho, So-Hyun;Yun, Mi-Young;An, Sungkwan;Song, Gyu Yong;Bae, Seunghee
    • Journal of Microbiology and Biotechnology
    • /
    • 제31권7호
    • /
    • pp.933-941
    • /
    • 2021
  • Ginsenoside Rg4 is a rare ginsenoside that is naturally found in ginseng, and exhibits a wide range of biological activities including antioxidant and anti-inflammatory properties in several cell types. The purpose of this study was to use an in vivo model of hair follicle (HF)-mimic based on a human dermal papilla (DP) spheroid system prepared by three-dimensional (3D) culture and to investigate the effect of Rg4 on the hair-inductive properties of DP cells. Treatment of the DP spheroids with Rg4 (20 to 50 ㎍/ml) significantly increased the viability and size of the DP spheres in a dose-dependent manner. Rg4 also increased the mRNA and protein expression of DP signature genes that are related to hair growth including ALP, BMP2, and VCAN in the DP spheres. Analysis of the signaling molecules and luciferase reporter assays further revealed that Rg4 induces the activation of phosphoinositide 3-kinase (PI3K)/AKT and the inhibitory phosphorylation of GSK3β, which activates the WNT/β-catenin signaling pathway. These results correlated with not only the increased nuclear translocation of β-catenin following the treatment of the DP spheres with Rg4 but also the significant elevation of mRNA expression of the downstream target genes of the WNT/β-catenin pathway including WNT5A, β-catenin, and LEF1. In conclusion, these results demonstrated that ginsenoside Rg4 promotes the hair-inductive properties of DP cells by activating the AKT/GSK3β/β-catenin signaling pathway in DP spheres, suggesting that Rg4 could be a potential natural therapy for hair growth.

두개천골요법의 국내외 임상 연구 동향: 스코핑 리뷰 (Trends in Domestic and International Clinical Research of Craniosacral Therapy: Scoping Review)

  • 곽민제;한윤희;금지혜;박신혁;우현준;하원배;이정한
    • 한방재활의학과학회지
    • /
    • 제32권3호
    • /
    • pp.13-27
    • /
    • 2022
  • Objectives This study investigated the trends in domestic and international clinical research in craniosacral therapy, classified as a type of Chuna manual therapy, and suggested further directions in Korean medicine. Methods This scoping review was performed using the Arksey and O'Malley methodological framework and preferred reporting items as per the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews checklist. Eight electronic databases (PubMed, EMBASE, Cochrane Library, Koreanstudies Information Service System [KISS], KMBASE, Oriental Medicine Advanced Searching Integrated System [OASIS], Research Information Sharing Service [RISS], ScienceON) were searched to identify articles with the search terms "craniosacral therapy" and "cranial osteopathy" until December 2021. Results Forty-five studies were eligible as per our inclusion criteria. Most research studies (n=44) were conducted in the field of medicine and pharmacy, especially in rehabilitation medicine (n=16). As a result of the study design, randomized controlled trials (n=20) were the most common, and chronic pain (n=9) was the most frequently targeted disease, followed by headache (n=7). Thirty-two studies suggested interventions and 20 studies used Upledger's 10-step protocol. The average duration of craniosacral therapy was 41 min per session, administered 1.4 times per week. Outcome measurements were analyzed and categorized with the examination procedure for the patient. Conclusions This is the first scoping review of craniosacral therapy in Korea, and we believe that our findings could support its utility as Chuna. In the future, more studies should be conducted to establish the evidence of clinical efficacy of craniosacral therapy and develop standard techniques in Korean medicine.

스트레칭 후 시간 경과에 따른 머리척추각과 근긴장도 변화 연구 (Effects of Stretching Time on Head Spine Angle and Muscle Tone)

  • 손지윤;유영천;김지윤;박희원;유지현;이유권;임병언;최지명;김재현
    • 산업과 과학
    • /
    • 제2권3호
    • /
    • pp.15-21
    • /
    • 2023
  • 본 연구에서는 스트레칭 전후 머리척추각 변화와 스트레칭 후 휴식 시간 경과에 따른 근긴장도 변화를 알고자 하였다. 건강한 20-30대 남녀 학생 57명을 대상으로 하였고, 머리척추각은 스트레칭 전과 후를 비교하였다. 스트레칭은 정적 수동 스트레칭을 적용하였고, 30초 실시 후 휴식 시간 10초로 총 3회 반복하였으며, 근긴장도 측정 장비를 사용하여 스트레칭 전, 직후, 2분 후, 5분 후를 측정하였다. 스트레칭 전후의 머리척추각은 결과적으로 유의한 차이가 없었으며, 스트레칭 후 휴식 시간에 따른 근긴장도 변화는 스트레칭 전보다 5분 후가 더 유의한 차이를 보였다. 스트레칭을 실시한 직후에 바로 신체활동을 하는 것보다는 적어도 5분 이상의 휴식을 취하여 근긴장도를 낮춘 후 활동하는 것이 보다 효과적이다.

운전재활과 관련된 연구에 관한 고찰 (A Study of Research on Related Driving Rehabilitation)

  • 김보라;이현진
    • 대한통합의학회지
    • /
    • 제2권3호
    • /
    • pp.23-30
    • /
    • 2014
  • Purpose : The purpose of this study was to grasp the general status and trend of the driving rehabilitation research focusing on interested topics, study subjects, therapeutic approaches, study designs, etc. Methods : It targeted 18 papers published in the RISS (Research Information Service System) from 2000 to 2014, and performed a descriptive statistical analysis by classifying these papers to topics, study subjects, study forms, study designs, study fields, and researchers. Results : As a result of the analysis, for the study form in the driving rehabilitation field, the rate of experimental papers was 61.1%, the highest. Major study subjects turned out to be occupational therapists, the disabled, and the aged, in order. For the study quality and design, the rate of survey and non randomized-single experimental study, which correspond to stage IV, was the highest, and the general study quality was found to be low. For the study field, the rates of the roles and recognition of occupational therapists, evaluation on driving ability of the disabled, and institutional improvement and future measures were the highest, each of which being 16.7%. Conclusion : Through this study, major study subjects and study quality in the driving rehabilitation field could be grasped, and it could be found that for development of the driving rehabilitation field, higher quality researches on more various study subjects would be needed in the future.

Medulloblastoma in the Molecular Era

  • Kuzan-Fischer, Claudia Miranda;Juraschka, Kyle;Taylor, Michael D.
    • Journal of Korean Neurosurgical Society
    • /
    • 제61권3호
    • /
    • pp.292-301
    • /
    • 2018
  • Medulloblastoma is the most common malignant brain tumor of childhood and remains a major cause of cancer related mortality in children. Significant scientific advancements have transformed the understanding of medulloblastoma, leading to the recognition of four distinct clinical and molecular subgroups, namely wingless (WNT), sonic hedgehog, group 3, and group 4. Subgroup classification combined with the recognition of subgroup specific molecular alterations has also led to major changes in risk stratification of medulloblastoma patients and these changes have begun to alter clinical trial design, in which the newly recognized subgroups are being incorporated as individualized treatment arms. Despite these recent advancements, identification of effective targeted therapies remains a challenge for several reasons. First, significant molecular heterogeneity exists within the four subgroups, meaning this classification system alone may not be sufficient to predict response to a particular therapy. Second, the majority of novel agents are currently tested at the time of recurrence, after which significant selective pressures have been exerted by radiation and chemotherapy. Recent studies demonstrate selection of tumor sub-clones that exhibit genetic divergence from the primary tumor, exist within metastatic and recurrent tumor populations. Therefore, tumor resampling at the time of recurrence may become necessary to accurately select patients for personalized therapy.