• Title/Summary/Keyword: individualized medicine

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A Survey of Student Satisfaction with a Portfolio Process and Assessment (포트폴리오 과정 및 평가에 대한 학생의 만족도조사)

  • Yoo, Dong-Mi;Han, Jae-Jin;Eo, Eun-Kyung
    • Korean Medical Education Review
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    • v.16 no.1
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    • pp.42-49
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    • 2014
  • The purposes of this study were to identify and analyze students' attitudes and satisfaction to the portfolio process and assessment for the Introduction to Clinical Medicine course at Ewha Womans University School of Medicine in Seoul, Korea. The subjects consisted of 64 medical school students. Questionnaires consisting of 20 5-point Likert-type items were developed, including three question domains: 1) orientation, 2) portfolios in general, 3) individualized feedback. The mean and median were found and frequency analysis was performed to identify the common characteristics of the participants. A major finding was that 54.7% of the respondents felt that the self-reflection involved in building the portfolio was a valuable learning experience. Plus, the majority of respondents perceived that the individualized feedback had a positive tone and its contents were specific, practical, and constructive. The students perceived that building and writing portfolios heightened their understanding of exit learning outcomes and enhanced their reflective thinking and self-directed learning skills. Meanwhile, some students perceived that there was too much paperwork in the portfolio process and that the process was time consuming. Furthermore, 32.8% of the respondents said that they had difficulty establishing their learning strategies by themselves and self-directing their learning during the portfolio process. In conclusion, it is expected that building a portfolio can help students not only to enhance their ability to accumulate and use their personal learning resources but also to develop the professional qualities required by doctors, such as self-directed learning, self-reflection, lifelong learning, team work, organizational skills, time management and prioritization, and professional thinking and behavior.

The Benefit of Individualized Custom Bolus in the Postmastectomy Radiation Therapy : Numerical Analysis with 3-D Treatment Planning (유방전절제술 후 방사선치료를 위한 조직보상체 개발 및 3차원 치료계획을 통한 유용성 분석)

  • Cho Jae Ho;Cho Kwang Hwan;Keum Kichang;Han Yongyih;Kim Yong Bae;Chu Sung Sil;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.82-93
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    • 2003
  • Purpose : To reduce the Irradiation dose to the lungs and heart in the case of chest wail irradiation using an oppositional electron beam, we used an Individualized custom bolus, which was precisely designed to compensate for the differences In chest wall thickness. The benefits were evaluated by comparing the normal tissue complication probablilties (NTCPS) and dose statistics both with and without boluses. Materials and Methods : Boluses were made, and their effects evaluated in ten patients treated using the reverse hockey-stick technique. The electron beam energy was determined so as to administer 80% of the irradiation prescription dose to the deepest lung-chest wall border, which was usually located at the internal mammary lymph node chain. An individualized custom bolus was prepared to compensate for a chest wall thinner than the prescription depth by meticulously measuring the chest wall thickness at 1 emf intervals on the planning CT Images. A second planning CT was obtained overlying the individuailzed custom bolus for each patient's chest wall. 3-D treatment planning was peformed using ADAC-Pinnacle$^{3}$ for all patients with and without bolus. NTCPS based on 'the Lyman-Kutcher' model were analyzed and the mean, maximum, minimum doses, V$_{50}$ and V$_{95}$ for 4he heari and lungs were computed. Results .The average NTCPS in the ipsliateral lung showed a statistically significant reduction (p<0.01), from 80.2${\pm}$3.43% to 47.7${\pm}$4.61%, with the use of the individualized custom boluses. The mean lung irradiation dose to the ipsilateral iung was also significantly reduced by about 430 cGy, Trom 2757 cGy to 2,327 cGy (p<0.01). The V$_{50}$ and V$_{95}$ in the ipsilateral lung markedly decreased from the averages of 54.5 and 17.4% to 45.3 and 11.0%, respectively. The V$_{50}$ and V$_{95}$ In the heart also decreased from the averages of 16.8 and 6.1% to 9.8% and 2.2%, respectively. The NTCP In the contralateral lung and the heart were 0%, even for the cases with no bolus because of the small effective mean radiation volume values of 4.4 and 7.1%, respectively Conclusion : The use of an Individualized custom bolus in the radiotherapy of postrnastectorny chest wall reduced the NTCP of the ipsilateral lung by about 24.5 to 40.5%, which can improve the complication free cure probability of breast cancer patients.

Individualized Therapy to Manage Quadriplegic Spastic Cerebral Palsy with Unani Treatment Modalities

  • Fahmida Kousar;Arshiya Sultana;Shahzadi Sultana;Taseen Banu;Arfa Begum
    • CELLMED
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    • v.13 no.14
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    • pp.16.1-16.14
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    • 2023
  • Objective: Cerebral palsy (CP) is a neurodevelopment disorder attributed to an insult or injury to the developing brain with abnormalities in muscular tone, movement and motor skill. Improvement in quality of life and ameliorating symptoms can be achieved. Therefore, this case report details a distinctive approach to treating a 5-year-old male child with quadriplegic spastic cerebral palsy utilizing Unani treatment modalities. Methods: The treatment regimen commenced with 'Habb Ayarij for constipation followed by Sharbat Ustukhuddus administered orally. Notably, Sharbat Ustukhuddus was combined with Melia Azedarach L. leaves vapour bath. Subsequently, Roghan Babunna douche was performed followed by Dalk Layyin andcontinued until symptomatic improvement was observed. Majun Falasfa, Khamira Marwareed and Khameera Gauzaban were administered for 30 days. The therapeutic outcome included anthropometrical measurements, developmental milestones, spasm/reflex scale, and muscle power grading. Results and conclusion: Over the course of a 2-year follow-up, several clinical findings emerged. These included notable improvements in anthropometric measurements, developmental milestones such as improved head control and sitting ability, and a reduction in spasticity of the upper limbs, along with decreased muscle spasms. The therapeutic outcome of this individualized and holistic approach is potentially due to the multifaceted properties of medicinal plants (Musakkin wa Muharrik wa Muqawwi-i- A'sab wa Dimāgh, Munawwim, Dafi-i-Tashannuj, Muqawwi-i-Qalb-i-Ruh). Furthermore, the use of Dalk and Naṭūl was instrumental in providing nourishment to musculoskeletal cells and initiating intracellular signaling cascades. While these findings are encouraging, further research in the form of case series andrandomized controlled trials is warranted to validate the efficacy of this unique holistic approach.

Fertility preservation for patients with gynecologic malignancies: The Korean Society for Fertility Preservation clinical guidelines

  • Lee, Sanghoon;Kim, Seul Ki;Hwang, Kyung Joo;Kim, Tak;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.44 no.4
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    • pp.175-180
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    • 2017
  • Fertility preservation plays a central role in cancer care since an increasingly large number of cancer patients are surviving as a result of improvements in diagnostic and therapeutic strategies. Physicians who take part in the initial diagnosis and management of gynecologic cancer should understand the importance of fertility preservation. Since indications for fertility preservation are limited to early-stage gynecologic cancer, a surgeon must carefully consider each indication. Before performing fertility-sparing surgery, health professionals should compare its oncologic and pregnancy outcomes with those of other standard treatments. Individualized treatment strategies should be delivered depending on the patient's situation, and physicians should provide timely information and appropriate counseling.

How Should Medical Education Be Planned for Medical Students' Future? (의과대학생이 만날 미래, 어떻게 준비할 것인가?)

  • Jeong, Jihoon
    • Korean Medical Education Review
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    • v.16 no.3
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    • pp.141-146
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    • 2014
  • This study focused on investigating the future medicine and health care industry paradigm shift and suggesting the right direction for the medical education system in order for students to be better prepared in the near future. Here, I will discuss four issues related to the future of medicine: Health 2.0, digital health, personalized medicine, and innovations of the public healthcare system. Every issue has lessons for medical education and teaching for students who major in health professions. However, it is obvious that the present is an important period of time as, currently, we are at an early stage in the future health care environment. Recently, there have been rapid transformations in various fields of medicine. Therefore, if we fail to lead medical education in the right direction, medical students will suffer from major problems in coping with these changes.

Herbal Medicine Treatment for Induction and Maintenance of Remission in Ulcerative Colitis: A Case Report (한약치료를 통해 관해가 유도된 궤양성대장염 환자: 증례보고)

  • Lee, Byung-Hee;Won, Jiyoon;Lee, Hyangsook
    • Korean Journal of Acupuncture
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    • v.36 no.3
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    • pp.181-187
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    • 2019
  • This case report details induction and maintenance of remission in a 34-year-old female patient with ulcerative colitis (UC) after Korean herbal medicine treatment. The patient diagnosed as UC after a series of examinations including endoscopy in a western medical hospital mainly presented bloody diarrhea and dyspepsia and symptoms were persistent even with medications. She was given individualized Korean herbal medicine prescriptions for 7 months and the symptoms were monitored during treatment and no adverse events were reported. After clinical remission, endoscopic remission was also confirmed by colonoscopy. Clinical remission was maintained for 30 months after treatment without Western medication for UC. This case report shows that Korean herbal medicine treatment may have the potential for complete remission of UC and further research is warranted.

Phenytoin Toxicity in a Korean Patient Homozygous for $CYP2C9^{\ast}3$

  • Lee, Soo-Youn;Kim, Jong-Won;Kim, Jong-Soo
    • Molecular & Cellular Toxicology
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    • v.2 no.4
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    • pp.262-265
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    • 2006
  • We report a case of phenytoin toxicity due to impaired drug metabolism in a patient homozygous for $CYP2C9^{\ast}3$. A 46-year-old woman was taking phenytoin to prevent postoperative seizures. She attained high serum phenytoin levels at the standard doses (300 mg/day) and developed symptoms of phenytoin toxicity including blurred vision, nausea and headache. The patient was treated with reduced doses of phenytoin and then phenytoin therapy was finally discontinued. Genotyping for CYP2C9 revealed that this patient had a homozygous genotype, $CYP2C9^{\ast}3/^{\ast}3$. This is the first Korean case of phenytoin toxicity with homozygous $CYP2C9^{\ast}3$. This case suggests the clinical usefulness of pharmacogenetic testing for individualized dosage adjustments of phenytoin.

Introduction of Vaccinomics to Develop Personalized Vaccines in Light of Changes in the Usage of Hantaan Virus Vaccine (Hantavax®) in Korea

  • Bae, Jong-Myon
    • Journal of Preventive Medicine and Public Health
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    • v.52 no.5
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    • pp.277-280
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    • 2019
  • The Ministry of Food and Drug Safety of Korea made an official announcement in March 2018 that the total number of inoculations of Hantaan virus vaccine ($Hantavax^{(R)}$) would change from 3 to 4. Some aspects of this decision remain controversial. Based on the characteristics of Hantaan virus (HTNV) and its role in the pathogenesis of hemorrhagic fever with renal syndrome, it might be difficult to develop an effective and safe HTNV vaccine through the isolate-inactivate-inject paradigm. With the development of high-through-put 'omics' technologies in the 21st century, vaccinomics has been introduced. While the goal of vaccinomics is to develop equations to describe and predict the immune response, it could also serve as a tool for developing new vaccine candidates and individualized approaches to vaccinology. Thus, the possibility of applying the innovative field of vaccinomics to develop a more effective and safer HTNV vaccine should be considered.

The involvement of Parkin-dependent mitophagy in the anti-cancer activity of Ginsenoside

  • Sun, Xin;Hong, Yeting;Shu, Yuhan;Wu, Caixia;Ye, Guiqin;Chen, Hanxiao;Zhou, Hongying;Gao, Ruilan;Zhang, Jianbin
    • Journal of Ginseng Research
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    • v.46 no.2
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    • pp.266-274
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    • 2022
  • Colon cancer, the third most frequent occurred cancer, has high mortality and extremely poor prognosis. Ginsenoside, the active components of traditional Chinese herbal medicine Panax ginseng, exerts antitumor effect in various cancers, including colon cancer. However, the detailed molecular mechanism of Ginsenoside in the tumor suppression have not been fully elucidated. Here, we chose the representative ginsenoside Rg3 and reported for the first time that Rg3 induces mitophagy in human colon cancer cells, which is responsible for its anticancer effect. Rg3 treatment leads to mitochondria damage and the formation of mitophagosome; when autophagy is inhibited, the clearance of damaged mitochondria can be reversed. Next, our results showed that Rg3 treatment activates the PINK1-Parkin signaling pathway and recruits Parkin and ubiquitin proteins to mitochondria to induce mitophagy. GO analysis of Parkin targets showed that Parkin interacts with a large number of mitochondrial proteins and regulates the molecular function of mitochondria. The cellular energy metabolism enzyme GAPDH is validated as a novel substrate of Parkin, which is ubiquitinated by Parkin. Moreover, GAPDH participates in the Rg3-induced mitophagy and regulates the translocation of Parkin to mitochondria. Functionally, Rg3 exerts the inhibitory effect through regulating the nonglycolytic activity of GAPDH, which could be associated with the cellular oxidative stress. Thus, our results revealed GAPDH ubiquitination by Parkin as a crucial mechanism for mitophagy induction that contributes to the tumor-suppressive function of ginsenoside, which could be a novel treatment strategy for colon cancer.

Application of 3D Simulation Surgery to Orbital Wall Fracture : A preliminary Case Study

  • Choi, Jong-Woo
    • Journal of International Society for Simulation Surgery
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    • v.1 no.1
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    • pp.16-18
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    • 2014
  • The orbit has a very special anatomical structure. The complex anatomical structure should be restored when we encounter the patient with orbital wall fracture. Unless these specific anatomy were reconstructed well, the patient should suffer from various complications such enophthalmos, diplopia or orbital deformity. In addition, because the patient has a his own specific orbital shape, individualized approach will be necessary. The aim of this trial is to try to restore the original orbit anatomy as possible based on the mirrored three dimensional CT images based on the computer simulation. Preoperative computed tomography (CT) data were processed for the patient and a rapid prototyping (RP) model was produced. At the same time, the uninjured side was mirrored and superimposed onto the traumatized side, to create a mirror-image of the RP model. In order to restore the missing skipped images between the cuts of CT data because of the thinness of the orbital walls, we manipulated the DICOM data for imaging the original orbital contour using the preoperatively manufactured mirror-image of the RP model. And we fabricated Titanium-Medpor to reconstruct three-dimensional orbital structure intraoperatively. This prefabricated Titanium-Medpor was then inserted onto the defected orbital wall and fixed. Three dimensional approach based on the computer simulation turned out to be very successful in this patient. Individualized approach for each patient could be an ideal way to manage the traumatic patients in near future.