Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive endoscopic technique that has many diagnostic and therapeutic implications. It is a procedure with small but significant life-threatening complications. To ensure the best possible care, minimize complications, and improve the quality of health care, a constant review of the performance of the operator using ideal benchmark standards is needed. Hence, quality indicators are necessary. The American and European Societies of Gastrointestinal Endoscopy have provided guidelines on quality measures for ERCP, which describe the skills to be developed and training to be implemented in performing quality ERCP. These guidelines have divided the indicators into pre-procedure, intraprocedural, and post-procedure measures. The focus of this article was to review the quality indicators of ERCP.
DNA cancer vaccines as an approach in tumor immunotherapy are still being investigated in preclinical and clinical settings. Nevertheless, only a small number of clinical studies have been published so far and are still active. The investigated vaccines show a relatively stable expression in in-vitro transfected cells and may be favorable for developing an immunologic memory in patients. Therefore, DNA vaccines could be suitable as a prophylactic or therapeutic approach against cancer. Due to the low efficiency of these vaccines, the administration technique plays an important role in the vaccine design and its efficacy. These DNA cancer vaccine delivery systems include physical, biological, and non-biological techniques. Although the pre-clinical studies show promising results in the application of the different delivery systems, further studies in clinical trials have not yet been successfully proven.
Objective: Musculoskeletal neck pain have many symptoms which include decreased range of motion (ROM) and muscle strength, and increased pain. However, the management methods are controversial. The purpose of this study was to examine the effects of three interventions on ROM, strength, and pressure pain threshold (PPT) with musculoskeletal neck pain. Design: Pretest-posttest design. Methods: Thirty subjects participated in this experiment. They were randomly assigned to thefollowing groups: passive stretching (PS) group (n=10), massage (MASS) group (n=10), and muscle energy technique (MET) group (n=10). The treatment were applied bilaterally on the upper trapezius. The PS was applied 3 times for 30 seconds each time. The MASS was applied using two different techniques for 2 minutes per technique. For MET, the subjects performed 2 sets of 3 repetitions of isometric resistance exercise that was maintained for 10 seconds, followed by 10 seconds of rest. ROM, strength, and PPT parameters were measured after intervention. Results: In the MASS group, there was a significant improvement in all outcomes except for muscle strength (p<0.05). In the MET group, ROM and strength significantly improved compared to the pre-treatment results (p<0.05). As result of measuring the amount of change in each group, there was a significant difference in ROM (flexion) in the PS group compared with the MASS and MET group, a significant difference in strength in the MET group compared with the PS and MASS groups, and a significant difference in PPT in the MASS groups compared with the PS and MET groups (p<0.05). Conclusions: This study showed that PS, MASS, and MET are effective methods for improving ROM, strength, and PPT for musculoskeletal neck pain. Therefore, various therapeutic interventions for improving ROM, strength, and pain are suggested.
Purpose: The purpose of this study was to examine the effects of proprioceptive neuromuscular facilitation (PNF) wrist taping, after the application of a rhythmic stabilization (RS) technique, on the decrease of pain and the increase of grip strength in physical therapists who complained of wrist pain and to provide basic data on interventions for wrist pain patients. Methods: The subjects were 15 peoples in their 20s who complained of pain with a visual analogue scale (VAS) at five points or higher due to overuse of their wrists. They were randomly assigned to a control group, to which PNF wrist taping was applied after stretching (n=7), or to an experimental group (n=8), to which PNF wrist taping was applied after application of the RS technique of PNF. The experiment was conducted for four weeks, five times per week. VAS was measured in order to measure pain decrease, and grip strength (GS) was measured using a dynamometer. In order to compare within-group differences before and after the intervention, a paired t-test was performed, and in order to compare differences between the two groups, the analysis of covariance (ANCOVA) was used. All statistically significant levels were set at ${\alpha}=0.05$. Results: There were significant differences in changes of VAS and GS within each group before and after the intervention (p<0.01), but there was no significant difference between the two groups. Conclusion: This study applied PNF wrist taping after the application of stretching or PNF RS to patients who complained of pain beyond a sense of discomfort; these interventions resulted in a decrease in pain and an increase in the grip strength of the subjects. Taping and therapeutic techniques using PNF are considered to be usefully applied as one of the programs to improve wrist pain patients' pain and grip strength.
El-Mahdi, Magda M.;Mansour, Wafaa A.;Hammam, Olfat;Mehana, Noha A.;Hussein, Taghreed M.
Parasites, Hosts and Diseases
/
v.52
no.2
/
pp.151-162
/
2014
The technique of stem cells or hepatocytes transplantation has recently improved in order to bridge the time before whole-organ liver transplantation. In the present study, unfractionated bone marrow stem cells (BMSCs) were harvested from the tibial and femoral marrow compartments of male mice, which were cultured in Dulbecco's modified Eagle's medium (DMEM) with and without hepatocyte growth factor (HGF), and then transplanted into Schistosoma mansoni- infected female mice on their 8th week post-infection. Mice were sacrificed monthly until the third month of bone marrow transplantation, serum was collected, and albumin concentration, ALT, AST, and alkaline phosphatase (ALP) activities were assayed. On the other hand, immunohistopathological and immunohistochemical changes of granuloma size and number, collagen content, and cells expressing OV-6 were detected for identification of liver fibrosis. BMSCs were shown to differentiate into hepatocyte-like cells. Serum ALT, AST, and ALP were markedly reduced in the group of mice treated with BMSCs than in the untreated control group. Also, granuloma showed a marked decrease in size and number as compared to the BMSCs untreated group. Collagen content showed marked decrease after the third month of treatment with BMSCs. On the other hand, the expression of OV-6 increased detecting the presence of newly formed hepatocytes after BMSCs treatment. BMSCs with or without HGF infusion significantly enhanced hepatic regeneration in S. mansoni-induced fibrotic liver model and have pathologic and immunohistopathologic therapeutic effects. Also, this new therapeutic trend could generate new hepatocytes to improve the overall liver functions.
Ryu, Sang Baek;Bae, Eun Kyung;Kim, Jinhyung;Hwang, Yong Sup;Im, Changkyun;Chang, Jin Woo;Shin, Hyung-Cheul;Kim, Kyung Hwan
The Korean Journal of Physiology and Pharmacology
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v.17
no.4
/
pp.299-306
/
2013
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has been widely used as a treatment for the movement disturbances caused by Parkinson's disease (PD). Despite successful application of DBS, its mechanism of therapeutic effect is not clearly understood. Because PD results from the degeneration of dopamine neurons that affect the basal ganglia (BG) network, investigation of neuronal responses of BG neurons during STN DBS can provide informative insights for the understanding of the mechanism of therapeutic effect. However, it is difficult to observe neuronal activity during DBS because of large stimulation artifacts. Here, we report the observation of neuronal activities of the globus pallidus (GP) in normal and PD model rats during electrical stimulation of the STN. A custom artifact removal technique was devised to enable monitoring of neural activity during stimulation. We investigated how GP neurons responded to STN stimulation at various stimulation frequencies (10, 50, 90 and 130 Hz). It was observed that activities of GP neurons were modulated by stimulation frequency of the STN and significantly inhibited by high frequency stimulation above 50 Hz. These findings suggest that GP neuronal activity is effectively modulated by STN stimulation and strongly dependent on the frequency of stimulation.
Journal of Dental Rehabilitation and Applied Science
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v.19
no.2
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pp.115-124
/
2003
One of the important things in the full mouth reconstruction is the determination of therapeutic position. Centric jaw relation is used as a therapeutic position for the full mouth reconstruction. There are several techniques associated with recording this position. Five clinically acceptable techniques are as follows: 1) Swallowing or free closure, 2) Chin point guidance, 3) Bimanual method 4) Myo-monitor technique, 5) Anterior deprogrammer. Centric relation obtained utilizing the anterior acrylic resin platform in this case. Another important thing in full mouth reconstruction is provisional restoration. Provisional restorations are an excellent diagnostic instrument, especially in full remain esthetics, phonetics, function, parafunction, and dysfunction after evaluation and acceptance through clinical trial with the provisional restorations should be accurately transferred to the final restorations to ensure the same clinical success. Especially, anterior guidance should be accurately transferred to the final restorations. An accurate anterior guidance is critical for optimal esthetics, phonetics, comfort, function, stress minimization, and longevity of teeth and restorations. To record optimum anterior guidance, customized anterior guide table is used in this case. Considering previously mentioned points, we did successive treatment. And it resulted in a better situation esthetically and functionally. Followings are what we cared in treating a patient in this case. 1) Accurate centric relation recording 2) Accurate transference of anterior guidance to the final restorations.
Kobet, Robert A.;Pan, Xiaoping;Zhang, Baohong;Pak, Stephen C.;Asch, Adam S.;Lee, Myon-Hee
Biomolecules & Therapeutics
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v.22
no.5
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pp.371-383
/
2014
The nematode Caenorhabditis elegans (C. elegans) offers a unique opportunity for biological and basic medical researches due to its genetic tractability and well-defined developmental lineage. It also provides an exceptional model for genetic, molecular, and cellular analysis of human disease-related genes. Recently, C. elegans has been used as an ideal model for the identification and functional analysis of drugs (or small-molecules) in vivo. In this review, we describe conserved oncogenic signaling pathways (Wnt, Notch, and Ras) and their potential roles in the development of cancer stem cells. During C. elegans germline development, these signaling pathways regulate multiple cellular processes such as germline stem cell niche specification, germline stem cell maintenance, and germ cell fate specification. Therefore, the aberrant regulations of these signaling pathways can cause either loss of germline stem cells or overproliferation of a specific cell type, resulting in sterility. This sterility phenotype allows us to identify drugs that can modulate the oncogenic signaling pathways directly or indirectly through a high-throughput screening. Current in vivo or in vitro screening methods are largely focused on the specific core signaling components. However, this phenotype-based screening will identify drugs that possibly target upstream or downstream of core signaling pathways as well as exclude toxic effects. Although phenotype-based drug screening is ideal, the identification of drug targets is a major challenge. We here introduce a new technique, called Drug Affinity Responsive Target Stability (DARTS). This innovative method is able to identify the target of the identified drug. Importantly, signaling pathways and their regulators in C. elegans are highly conserved in most vertebrates, including humans. Therefore, C. elegans will provide a great opportunity to identify therapeutic drugs and their targets, as well as to understand mechanisms underlying the formation of cancer.
Jin, Seung Young;Yun, Hye Ri;Choi, Yun Jung;Park, Jun Dong;Kim, Jin Tae;Kang, Chang Hyun;Park, Young Sik;Choi, Young Hun;Kim, Woo Sun;Suh, Dong In
Clinical and Experimental Pediatrics
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v.60
no.7
/
pp.232-236
/
2017
Pulmonary alveolar proteinosis (PAP) is a rare disease in children characterized by intra-alveolar accumulation of surfactant proteins, which severely reduces gaseous exchange. Whole lung lavage (WLL) is the preferred technique for the treatment of severe PAP. Herein, we present a pediatric case of PAP treated with WLL. An 11-year-old boy was admitted with the chief complaint of a dry cough lasting 6 months. He developed symptoms of dyspnea on exertion and had difficulty in climbing stairs. He was ultimately diagnosed with PAP through video-assisted thoracoscopic lung biopsy. As first-line of treatment for PAP, he underwent therapeutic WLL for each of his lungs on separate days. After a brief recovery, his symptoms gradually worsened; therefore, he underwent a second WLL. This is the first pediatric case of PAP relapse despite successful WLL in Korea.
Therapeutic garments are an undeveloped area and yet they have the potential to generate considerable profit for the fashion industry. In traditional Chinese medicine, there are spots and pathways on the body through which energy flows and practitioners consider that disease results when this energy flow is hindered. Clothes which stimulate the spots can therefore potentially help to cure disease. In addition, clothes are worn every day and can therefore offer prolonged treatment certainly in comparison with other treatments. Obesity is a big problem nowadays and one which is caused by poor energy circulation (according to TCM). A garment which stimulates the spots can assist energy flow and therefore cause the wearer to lose weight. In the process, it can also alleviate side effects of obesity such as diabetes and high blood pressure. The was to stimulate spots include acupuncture, acupressure, moxibustion etc. There are lots of products to press spots which improve energy flow both in the Western and Chinese markets. The basic principle of circulation is in fact the same in both Western and Chinese medicine. However, most of these are products are footwear ones because they can easily provide the necessary stimulation to reduce tiredness and improve circulation. For garments, to press the spots effectively it is best to use tight clothes such as corsets and leggings. The important point is to tighten the body and to make energy flow and yet feel comfortable at the same time. Choice of fabric is therefore an important issue. Although the idea has been introduced, it will be necessary to develop a technique which will allow the necessary amount of pressure to be applied. It could be concluded that this area has a lot of possibility for the future but further research will need to be done before the idea becomes workable.
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