• 제목/요약/키워드: induction therapy

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Change in the treatment strategy for pediatric Crohn's disease

  • Kim, Mi-Jin;Choe, Yon-Ho
    • Clinical and Experimental Pediatrics
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    • 제53권9호
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    • pp.830-833
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    • 2010
  • Crohn's disease is characterized by chronic inflammation involving any portion of the gastrointestinal tract. Treating Crohn's disease is a major challenge for clinicians, as no curative therapy currently exists. Pediatric Crohn's disease is characterized by frequent relapses, a wide extent of disease, a high prevalence of extraintestinal manifestations, and a severe clinical course. The classic therapeutic approach is known as the 'step-up' strategy, and follows a progressive course of treatment intensification as disease severity increases. Although this approach is usually effective for symptom control, many patients become either resistant to or dependent on corticosteroids. The efficacy of infliximab suggests that, rather than a progressive course of treatment, early intense induction may reduce complications associated with conventional treatment and improve quality of life. Intensive early therapy with infliximab is known as the 'top-down' strategy. Such therapy offers the potential for altering the natural history of Crohn's disease, and is changing treatment paradigms. However, the relatively new concept of an early aggressive or 'top-down' treatment approach is not yet widely accepted, especially in pediatric patients. The results of our current study demonstrate that early and intensive treatment of pediatric Crohn's disease patients with infliximab, at initial diagnosis, was more effective for maintaining remission and reducing flares.

Review of two immunosuppressants: tacrolimus and cyclosporine

  • HyunJong Lee;Hoon Myoung;Soung Min Kim
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제49권6호
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    • pp.311-323
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    • 2023
  • Immunosuppressants are vital in organ transplantation including facial transplantation (FT) but are associated with persistent side effects. This review article was prepared to compare the two most used immunosuppressants, cyclosporine and tacrolimus, in terms of mechanism of action, efficacy, and safety and to assess recent trials to mitigate their side effects. PubMed and Google Scholar queries were conducted using combinations of the following search terms: "transplantation immunosuppressant," "cyclosporine," "tacrolimus," "calcineurin inhibitor (CNI)," "efficacy," "safety," "induction therapy," "maintenance therapy," and "conversion therapy." Both immunosuppressants inhibit calcineurin and effectively down-regulate cytokines. Tacrolimus may be more advantageous since it lowers the likelihood of acute rejection, has the ability to reverse allograft rejection following cyclosporine treatment, and has the potential to reinnervate nerves. Meanwhile, graft survival rates seem to be comparable for the CNIs. To avoid nephrotoxicity, various immunosuppressants other than CNIs have been studied. Despite averting nephrotoxicity, these medications show increases in acute rejection or other types of adverse effects compared to CNIs. FT has been a topic of interest for oral and maxillofacial surgeons, and the postoperative usage of immunosuppressants is crucial for the long-term prognosis of FT. As contemporary transplantation regimens incorporate novel medications along with CNIs, further research is required.

The Effect of Proprioceptive Position Sense by Lumbar Flexors and Extensors

  • Park, Ji-Won;Ko, Yu-Min;Park, Seol
    • The Journal of Korean Physical Therapy
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    • 제24권6호
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    • pp.414-418
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    • 2012
  • Purpose: Muscle fatigue affects proprioception, and it causes problems in spinal stability. The purpose of this study was to examine the effect on the accuracy of reproducing the lumbar angles before lumbar exercise and after fatiguing isokinetic lumbar exercise. Methods: Thirty healthy adults participated in this study. Before induction of fatigue by exercise, the proprioception was measured by Biodex. Lumbar positions were passively maintained on stimulation position ($25^{\circ}$ flexion and $25^{\circ}$ extension), and back to the starting position. Subjects actively repositioned the remembered stimulation position, and error degrees between the stimulation position and reposition were measured. Using an isokinetic device at $120^{\circ}$/sec of velocity of angle lumbar flexion/extension exercise resulted in muscle fatigue. The post-fatigue proprioceptive position sense was used in the same way as in pre-fatigue measurement. Results: Means of position sense of pre-fatigue were $2.19{\pm}1.97$ on flexion angle, and $5.04{\pm}2.84$ on extension angle. After exercise induced fatigue, means of position sense were $2.37{\pm}1.83$ on flexion angle, and $4.93{\pm}2.57$ on extension angle. Results of this study showed significant differences of lumbar proprioceptive position sense between pre- and post-fatigue. Conclusion: Lumbar proprioception sense in active repositioning in flexion and extension was affected in the presence of muscle fatigue. Therefore, it should be noted that therapeutic exercise for patients with abnormal proprioceptive sense or elderly people must be performed with care because muscle fatigue can cause secondary damage.

근타박상시 치료용 초음파가 혈관내피성장인자와 Substance-P 발현에 미치는 효과에 대한 면역조직화학적 연구 (An Immunohistochemical Study of Effects of Therapeutic Ultrasound on the Expression of VEGF and Substance-P in Muscle Contusion Injury)

  • 김용수;오태영;김석범
    • The Journal of Korean Physical Therapy
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    • 제15권4호
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    • pp.46-64
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    • 2003
  • Therapeutic angiogenesis is the controlled induction or stimulation of new blood vessel formation to reduce unfavourable tissue effects caused by local hypoxia and to enhance tissue repair. Therapeutic ultrasound can be considered as a physical agent to deliver therapeutic angiogenesis. The purpose of this study was to evaluate the effect of therapeutic ultrasound after muscle contusion injury by observed immunoreactivity of vascular endothelial growth factor(VEGF) that plays an important role in angiogenesis and substance-P in pain transmission. Ultrasound irradiation(1MHz, $1W/cm^2$, continuous mode, treatment time 5 min) was applied through water submersion technique to 1 limb daily by kept off 5cm from muscle belly of gastrocnemius. The result of this study were as follows. 1. In morphological observation, there were no significant changes excepts of 7 days. At 7 days, granular tissue viewed abundantly in control group. In other groups, general feature were increased interspace of muscle fiber; centronucleated muscle fiber; collapsed of muscle and nerve tissue; appeared inflammatory cell. 2. The VEGF was expressed in interspace of muscle fiber. Especially, at 7 days in experimental group, VEGF was showed in connective tissue surrounding gastrocnemius muscle. 3. The VEGF was higher expressed in experimental group at 2 and 3 days, but in control group at 7 days. These data suggest therapeutic ultrasound enhanced production of VEGF in the early day relatively, therefore stimulated angiogenesis in the skeletal muscle induced contusion injury. Also therapeutic ultrasound may stimulate pain relief by diminish of substance-P in dorsal horn of spinal cord.

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선호 음악요법이 전신마취 산부인과 수술 환자의 불안과 활력 징후에 미치는 효과 (Effect of favorite music therapy on anxiety and vital sign in patients undergoing gynecologic surgery using the general anesthesia)

  • 양정임;노민영;양경희
    • 한국산학기술학회논문지
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    • 제16권2호
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    • pp.1189-1199
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    • 2015
  • 본 연구의 목적은 산부인과 전신마취 수술환자의 불안과 활력징후에 선호음악이 미치는 효과를 검증하는 것이다. 연구 설계는 비동등성 대조군 전후 시차설계이다. 연구기간은 2013년 5월 1일부터 7월 30일까지이며, 대상자는 W대학병원의 산부인과 수술환자로 실험군 21명, 대조군 23명, 총 44명이다. SPSS Win 18.0을 활용하여 Repeated measures ANOVA로 자료를 분석하였다. 연구 결과 선호음악을 제공받은 실험군과 제공받지 않은 대조군 간의 불안은 수술실 입실 시와 마취직전 사이 및 마취 직전과 의식 회복 후(p=.003; p=.011)의 시점에서 유의한 차이를 보였다. 수축기 혈압은 의식 회복 후와 회복실 퇴실 시 사이에 유의한 차이를 보였으며(p=.023), 맥박은 마취 직전과 의식 회복 후 사이에서 유의한 차이가 있었다(p=.016). 향후 선호음악 요법은 산부인과 전신마취 수술환자의 불안 감소 및 안정된 활력징후를 유지를 위한 효과적인 간호중재로 적용될 수 있다.

Development and assessment of nano drug delivery systems for combined delivery of rosuvastatin and ezetimibe

  • Mohamed Ali Metwally;El-Yamani Ibrahim El-Zawahry;Maher Amer Ali;Diaa Farrag Ibrahim;Shereen Ahmed Sabry;Omnia Mohamed Sarhan
    • The Korean Journal of Physiology and Pharmacology
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    • 제28권3호
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    • pp.275-284
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    • 2024
  • Worldwide, cardiovascular disease is the main cause of death, which accordingly increased by hyperlipidemia. Hyperlipidemia therapy can include lifestyle changes and medications to control cholesterol levels. Statins are the medications of the first choice for dealing with lipid abnormalities. Rosuvastatin founds to control high lipid levels by hindering liver production of cholesterol and to achieve the targeted levels of low-density lipoprotein cholesterol, another lipid lowering agents named ezetimibe may be used as an added therapy. Both rosuvastatin and ezetimibe have low bioavailability which will stand as barrier to decrease cholesterol levels, because of such depictions, formulations of this combined therapy in nanotechnology will be of a great assistance. Our study demonstrated preparations of nanoparticles of this combined therapy, showing their physical characterizations, and examined their behavior in laboratory conditions and vivo habitation. The mean particle size was uniform, polydispersity index and zeta potential of formulations were found to be in the ranges of (0.181-0.72) and (-13.4 to -6.24), respectively. Acceptable limits of entrapment efficiency were affirmed with appearance of spherical and uniform nanoparticles. In vitro testing showed a sustained release of drug exceeded 90% over 24 h. In vivo study revealed an enhanced dissolution and bioavailability from loaded nanoparticles, which was evidenced by calculated pharmacokinetic parameters using triton for hyperlipidemia induction. Stability studies were performed and assured that the formulations are kept the same up to one month. Therefore, nano formulations is a suitable transporter for combined therapy of rosuvastatin and ezetimibe with improvement in their dissolution and bioavailability.

The Effects of NEES on PARP Expression and Cell Death in Rat Cerebral Cortex After Ischemic Injury

  • Kim, Sung-Won;Lee, Jung-Sook;Um, Ki-Mai;Kim, Ji-Sung;Lee, Suk-Hee;Choi, Yoo-Rim;Kim, Nyeon-Jun;Kim, Bo-Kyoung;Cho, Mi-Suk;Park, Joo-Hyun;Kim, Soon-Hee
    • 국제물리치료학회지
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    • 제1권2호
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    • pp.107-112
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    • 2010
  • The majority of strokes are caused by ischemia and result in brain tissue damage, leading to problems of the central nervous system including hemiparesis, dysfunction of language and consciousness, and dysfunction of perception. The purpose of this study was to investigate the effects of Poly(ADP-ribose) polymerase(PARP) on necrosis in neuronal cells that have undergone needle electrode electrical stimulation(NEES) prior to induction of ischemia. Ischemia was induced in male SD rats(body weight 300g) by occlusion of the common carotid artery for 5 min, after which the blood was reperfused. After induction of brain ischemia, NEES was applied to Zusanli(ST 36), at 12, 24 and 48 hours. Protein expression was investigated using immuno-reactive cells, which react to PARP antibodies in cerebral nerve cells, and Western blotting. The results were as follows: In the cerebral cortex, the number of PARP reactive cells after 24 hours significantly decreased(p<.05) in the NEES group compared to the GI group. PARP expression after 24 hours significantly decreased(p<.05) in the NEES group compared to the GI group. As a result, NEES showed the greatest effect on necrosis-related PARP immuno-reactive cells 24 hours after ischemia, indicating necrosis inhibition, blocking of neural cell death, and protection of neural cells. Based on the results of this study, NEES can be an effective method of treating dysfunction and improving function of neuronal cells in brain damage caused by ischemia.

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효능기대증진프로그램을 적용한 운동요법이 자기효능과 대사에 미치는 영향-인슐린 비의존성 당뇨병 환자를 중심으로- (The Effects of Exercise Therapy Applied in an Efficacy Expectation Promoting Program on Self-Efficacy and Metabolism.- in NIDDM(Non-Insulin Dependent Diabetes Mellitus) Patients -)

  • 김춘자
    • 대한간호학회지
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    • 제28권1호
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    • pp.132-142
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    • 1998
  • This study was conducted to investigate whether exercise therapy applied in an efficacy expectation promoting program based on the self-efficacy theory of Bandura(1977) would increase self-efficacy and metabolism in NIDDM patients. The study design was a nonequivalent control group pre-test post-test quasi-experimental desist The exercise therapy applied in the efficacy expectation promoting program was composed of a staged exercise program, a small booklet relating personal experience with diabetes mellitus and a telephone coaching program on performance accomplishment. vicarious experience and verbal persuasion, which are all induction modes of efficacy expectation. The subjects of the study were twenty eight NIDDM patients who received follow-up care regularly through the out-patient department of endocrine medicine in one general hospital which had a diabetic clinic. Fourteen were assigned to the experimental group and fourteen to the control group. The experimental group participated in the exercise therapy applied in the efficacy expectation promoting program from three to five times per week for four weeks and the control group did not have the program. The collected data were analyzed using the X²-test, t-test, paired t-test, and Cronbach's Alpha using SPSS /PC/sup +/. The results are summarized as follows 1. Experimental group had higher efficacy score than control group(t=5.98, p=.00). And. There was a significant different in the efficacy score before exercise therapy applied in the efficacy expectation promoting program and after in experimental group(t=-6.42, p=.00). 2. Experimental group did not have lower level of glucose metabolism than control group(FBS : t=.32, p=.75, HbAlC : t=.60, p=.55, pc 2hrs. glucose : t=-.29, p=.78). But, There was a significant different in the aunt of glucose metabolism before exercise therapy applied in the efficacy expectation promoting program and after in experimental group(FBS : t=3.63, p=.003, HbAlC t=4.20, p=.00, pc 2hrs. glucose : t=1.93, p=.001). 3. Levels of lipid metabolism were partly a significant different between Experimental group and control group(triglyceride t=-1.87, p=.07, HDL cholesterol : t=-.29, p=.77. body weight : t=1.78, p=.09, Total cholesterol : t=-2.17, p=.04). And, There was partly a significant different in the amount of lipid metabolism before exercise therapy applied in the efficacy expectation promoting program and after in experimental group(triglyceride : t=2.50, p=.03, HDL cholesterol : t=-.43, p=.67, body weight : t=5.34. p=.00, Total cholesterol : t=2.26, p=.04). In conclusion, it was found that exercise therapy applied in an efficacy expectation promoting program was an effective nursing intervention for increasing self-efficacy and metabolism.

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Efficacy of 10-Injection Induced Modified Rush Immunotherapy in Dogs with Atopic Dermatitis

  • Kim, Hyun-Tae;Lee, Wang-Hui;Park, Seong-Jun
    • 한국임상수의학회지
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    • 제37권3호
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    • pp.141-144
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    • 2020
  • Modified rush immunotherapy (IT), by combination of rush IT and conventional IT, provides a faster method to reach maintenance dose, leading to higher patient adherence when compared with conventional IT, decreasing systemic adverse reactions when compared with a standard rush IT. Ten atopic dogs of this study include fulfillment of Favrot's criteria. Offending allergens were identified by the use of IDST. During the induction period, the dogs were received a total of 10 injections. Five injections were administrated every 30 minutes in a day with gradually increasing amounts and concentrations of allergens, and the last 5 injections were administered every 3 days. The efficacy of 10-injection induced mRIT was assessed using the canine atopic dermatitis extent and severity index (CADESI). During maintenance period, reduction rate from baseline scores varied between 3.2% and 60.9% and the after 6 months of therapy for CADESI-03 score in 6 of the 10 dogs. Adverse reactions were not observed in these dogs during induction period by mRIT with 10 injections. Based on these results, our modified rush IT protocol is considered to be a useful protocol to treat canine atopic dermatitis.

Cytotoxicity, Apoptosis Induction and Anti-Metastatic Potential of Oroxylum indicum in Human Breast Cancer Cells

  • Kumar, D.R. Naveen;George, V. Cijo;Suresh, P.K.;Kumar, R. Ashok
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권6호
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    • pp.2729-2734
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    • 2012
  • Despite clinical advances in anticancer therapy, there is still a need for novel anticancer metabolites, with higher efficacy and lesser side effects. Oroxylum indicum (L.) Vent. is a small tree of the Bignoniaceae family which is well known for its food and medicinal properties. In present study, the chemopreventive properties of O. indicum hot and cold non-polar extracts (petroleum ether and chloroform) were investigated with MDA-MB-231 (cancer cells) and WRL-68 (non-tumor cells) by XTT assay. All the extracts, and particularly the petroleum ether hot extract (PHO), exhibited significantly (P<0.05) higher cytotoxicity in MDA-MB-231 when compared to WRL-68 cells. PHO was then tested for apoptosis induction in estrogen receptor (ER)-negative (MDA-MB-231) and ER-positive (MCF-7) breast cancer cells by cellular DNA fragmentation ELISA, where it proved more efficient in the MDA-MB-231 cells. Further, when PHO was tested for anti-metastatic potential in a cell migration inhibition assay, it exhibited beneficial effects. Thus non-polar extracts of O. indicum (especially PHO) can effectively target ER-negative breast cancer cells to induce apoptosis, without harming normal cells by cancer-specific cytotoxicity. Hence, it could be considered as an extract with candidate precursors to possibly harness or alleviate ER-negative breast cancer progression even in advanced stages of malignancy.