• 한국융합학회논문지
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• 제11권12호
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• pp.419-427
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• 2020

본 연구는 중년기 과민성방광증후군 환자의 증상심각도와 스트레스가 우울에 미치는 영향에 대해 알아보기 위한 서술적 조사연구이다. 연구대상자는 G광역시에 소재한 비뇨기과 의원 및 병원 외래에서 과민성방광증후군으로 진단받은 40~60세의 중년기 환자 167명을 대상으로 하였다. 자료분석은 SPSS 23.0 프로그램을 이용하였으며, 빈도분석, pearson' correlation, t-test, multiple regression로 분석하였다. 연구 결과 중년기 과민성방광증후군 환자의 우울에 영향을 미치는 요인은 증상심각도, 연령, 배우자 유무 순으로 나타났다. 따라서 대상자의 우울을 감소시키기 위해 적극적 치료 유도와 생활 습관 교정 및 행동치료를 교육하고, 연령대별, 배우자 유무에 따른 맞춤형 간호 중재를 수행할 수 있는 프로그램을 개발이 필요하다.

• BMB Reports
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• 제55권3호
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• pp.148-153
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• 2022

Etoposide is a chemotherapeutic medication used to treat various types of cancer, including breast cancer. It is established that pulsed electromagnetic field (PEMF) therapy can enhance the effects of anti-cancer chemotherapeutic agents. In this study, we investigated whether PEMFs influence the anti-cancer effects of etoposide in MCF-7 cells and determined the signal pathways affected by PEMFs. We observed that co-treatment with etoposide and PEMFs led to a decrease in viable cells compared with cells solely treated with etoposide. PEMFs elevated the etoposide-induced PARP cleavage and caspase-7/9 activation and enhanced the etoposide-induced down-regulation of survivin and up-regulation of Bax. PEMF also increased the etoposide-induced activation of DNA damage-related molecules. In addition, the reactive oxygen species (ROS) level was slightly elevated during etoposide treatment and significantly increased during co-treatment with etoposide and PEMF. Moreover, treatment with ROS scavenger restored the PEMF-induced decrease in cell viability in etoposide-treated MCF-7 cells. These results combined indicate that PEMFs enhance etoposide-induced cell death by increasing ROS induction-DNA damage-caspase-dependent apoptosis.

• 대한두경부종양학회지
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• 제38권2호
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• pp.7-13
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• 2022

Human papillomavirus (HPV) is a causative agent for a subset of oropharyngeal cancer (OPC). The current standard of care (SOC) for locally advanced OPC is 70 Gy definitive radiotherapy (RT) concurrent with cisplatin, which entails significant proportions of acute and late grade 3 or higher toxicities. Accordingly, discovery of favorable prognosis of HPV-related OPC has led to enthusiasm to attenuate subspecialties therapy in multidisciplinary treatment. Diverse deintensification strategies were investigated in multiple phase 2 trials with an assumption that attenuated treatments result in comparable oncologic outcome and less toxicities compared with SOC. Several trials on chemotherapy deintensification revealed that concomitant administration of cisplatin is not to be omitted or substituted for cetuximab without compromising progression-free survival or local control. A transoral robotic surgery (TORS) is investigated as alternative local treatment, but TORS plus SOC or mild deintensified adjuvant RT showed similar toxicities and inferior oncologic outcomes compared with SOC definitive RT or moderately deintensified RT. However, it has been reported that TORS plus deintensified 30-36 Gy adjuvant RT results in excellent outcome and less late toxicity compared with SOC adjuvant RT. Several phase 2 trials reported apparently equivalent progression-free survival and local control and similar adverse effects with moderately deintensified 60 Gy RT compared with SOC 70 Gy RT. Further dose reduction below 60 Gy has been investigated using biology-directed approaches, which use response to induction chemotherapy or metabolic images to triage HPV-positive OPC for deintensified RT. In summary, these trials provide valuable insights for future directions. Available evidence consistently showed that moderately deintensified RT is effective and safe for HPV-positive OPC in both definitive and adjuvant settings. Concurrent cisplatin remains an essential component without which progression-free survival is significantly compromised for advanced HPV-positive OPC. A simple incorporation of TORS to SOC may be detrimental for oncologic outcome without anticipated toxicity reduction. Given the lack of level 1 evidence, it is prudent to curb an unjustified deviation from the current SOC and limit any deintensified strategies to clinical trials and adhere to the current SOC.

• Natural Product Sciences
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• 제29권1호
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• pp.42-49
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• 2023

This study investigated the effect of ethanol extracts of horsetail, alfalfa, ortie, chêne and aleppo oak on blood coagulation in vitro. Extraction was performed by the maceration method. Extracts were mixed with platelet and plasma, then prothrombin time (PT), activated partial thromboplastin time (APTT) and platelet aggregation tests were conducted. Alfalfa extract had a dose-dependent effect on the PT. Ortie, and horsetail, reduced the PT significantly compared to control group. Alfalfa, horsetail, and ortie reduced the APTT, but their effect was insignificant compared to the control group. The pooled extract showed the highest effect compared to the single extracts in a dose-dependent manner. Horsetail and alfalfa induced platelet aggregation in response to arachidonic acid but not in response to collagen. In the case of ortie, no aggregation occurred regarding the arachidonic acid, and incomplete was observed in response to collagen. Interestingly, blood clotting occurred immediately after adding the chêne, aleppo oak and the pooled extract, and therefore platelet poor plasma (PPP) and platelet rich plasma (PRP) became jelly. Generally, chêne and aleppo oak, as well as pooled extract, were more effective in inducing both primary and secondary coagulation pathways via shortening the PT and APTT, and induction of platelet aggregation.

• 대한약침학회지
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• 제26권4호
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• pp.298-306
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• 2023

Objectives: Cucumis sativus L. (C. sativus) is vegetable commonly used for managing blood pressure and often consumed in combination with standard antihypertensive therapy, despite lack of scientific evidence supporting their use. Combination of herbs and standard medication could have positive or negative effects. Therefore, this study aimed to evaluate the antihypertensive activity of C. sativus and the combined effect with losartan in the hypertensive rat model induced by angiotensin II. Angiotensin II is a component of the renin-angiotensin-aldosterone system that, upon binding to its receptor, constricts blood vessels leading to elevation of blood pressure. Methods: In an antihypertensive study, rats received C. sativus orally at doses of 9, 18, 27, and 36 mg/kg (full dose); while in a combination study, animals received losartan 2.25 mg/kg combined by either with C. sativus 9 or 18 mg/kg. The standards group received losartan 2.25 mg/kg or 4.5 mg/kg (full dose). Results: Blood pressure was measured using the tail-cuff method. C. sativus significantly attenuated angiotensin II-induced hypertension as observed in groups receiving C. sativus at 9, 18, 27, and 36 mg/kg at 30 minutes after induction showed the average change (Δ) of systolic blood pressure (SBP) and diastolic blood pressure (DBP) with respect to time zero were 28.8/18.3, 24.8/15.8, 22.8/15.5, and 11.5/9.0 mmHg, respectively. Whereas the average change (Δ) of SBP and DBP in the rats receiving the combination of half doses of C. sativus and losartan were 8.8/9.0 mmHg, respectively. These diminished effects were better than a full dose of C. sativus and comparable with a full dose of losartan (6.5/7.8 mmHg). Conclusion: The present findings indicate that C. sativus dose-dependently blocks blood pressure elevation induced by angiotensin II. The combination of half dose of C. sativus and losartan has an additive effect in lowering blood pressure.

• Human Ecology Research
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• 제62권2호
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• pp.369-383
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• 2024

The aim of this study was to develop and implement a program based on Cognitive Behavior Therapy (CBT) for female college students experiencing body dissatisfaction. To systematize the program development process, we adopted the service design method. First, we conducted In-Depth Interviews (IDIs) to identify the difficulties faced by six female college students who experience body dissatisfaction, and to determine what kind of help they needed. Second, content analysis of the findings revealed that female college students were experiencing emotional-behavior problems which derived from the discrepancy between their ideal body image and the reality. Third, a prototype of a cognitive reconstruction program was developed to help transform their perceived 'body distortion' to a rational cognitive concept and thus reduce maladaptive consequences of 'body dissatisfaction'. The overall program consisted of three therapeutic components and seven steps. Fourth, to assess the effectiveness of the program, survey and IDIs were conducted. The results revealed that it is appropriate to use a cognitive model to solve problems caused by body dissatisfaction, and that understanding and reconstructing one's own cognitive processes can be effective in reducing body dissatisfaction. However, based on feedback from participants, a number of revisions were proposed, such as including sufficient induction regarding the behavioral change.

• Journal of Chest Surgery
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• 제41권3호
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• pp.354-359
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• 2008

배경: 와파린은 항응고제로 쓰이는 약물로서 주로 간 대사에 의해 배설되는 약물이다. 리팜핀은 결핵 혹은 심내막염 등에 쓰이는 항생제로 2C9과 3A4를 포함한 CYP계열 효소 유도를 일으키는 대표적인 약물이다. 따라서 두 약물을 병용할 경우 리팜핀의 효소 유도에 의한 와파린 대사율 증가로 와파린의 항응고 효과는 감소한다. 이에 따라 와파린의 적절한 용량 조절이 요구되나 정확한 증량과 감량 정도는 제시되지 못하고 있는 실정이다. 이에 본 연구에서는 와파린 복용 환자 중 리팜핀을 병용하게 된 환자를 대상으로 두 약물의 병용 전후, 상호작용의 정도를 시간 경과에 따라 평가하고, 상호작용에 영향을 미치는 요인을 분석하고 또한 이를 토대로 두 약물의 병용 전후, 임상에서 활용할 수 있는 와파린 용량 결정 방법을 설정하고자 하였다. 대상 및 방법: OO병원 항응고 치료 상담 팀의 상담기록지를 1998년 1월부터 2006년 9월까지 후향적으로 검토하여 리팜핀을 병용하게 된 환자를 대상으로 하였다(n=15). 결과: 리팜핀 병용 전 전체 환자의 평균 INR은 $2.25{\pm}0.52$이며 병용 초기 100일간의 평균 INR은 $1.98{\pm}0.28$이었다. 이 경우 병용 전과 병용 초기의 평균 INR은 유의한 차이가 없었다(paired t-test, p>0.05). 리팜핀 병용 중단 직전 2회 측정한 INR의 평균은 $2.19{\pm}0.34$이고 병용 중단 이후 INR의 평균은 $2.49{\pm}0.43$으로 병용 중단 전과 후의 INR 평균은 유의한 차이를 보였으나(paired t-test, p<0.05)모두 치료유효역 범위 내에 있었다. 결론: 항응고 치료 상담 팀의 용량 조절이 적절하다고 판단하여 항응고 치료 상담 팀의 조절을 근거로 병용 시작 시와 병용 중단시의 와파린 용량조절 수식을 도출해냈다

• Tuberculosis and Respiratory Diseases
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• 제44권1호
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• pp.162-174
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• 1997

연구배경 : HSVtk 유전자를 암세포에 이입하여 GCV에 대해 선택적으로 감수성을 증가시키는 HSVtk/GCV 유전자치료에서 bystander effect는 모든 암세포에 유전자를 이입하지 않고도 치료효과를 얻을 수 있도록 한다. 그러나 현존하는 viral vector는 유전자이입 효율이 낮아 임상적으로 치료효과를 기대하는데는 한계가 있다. 따라서 유전자의 이입효율이 높은 새로운 vector의 개발과 함께 bystander effect의 극대화를 통해 치료효과를 증가시킬 수 있는 방법 등이 요구된다. 최근 gap junction을 통한 세포간의 metablic cooperation이 bystander effect의 주요기전임이 밝혀졌고 retinoids는 gap junction을 통한 세포간의 communication을 증가시킨다고 보고되었다. 저자들은 HSVtk/GCV 유전자치료에서 bystander effect에 미치는 retinoids의 효과를 조사하였다. 방 법 : Adenovus와 retrovirus vector를 이용하여 connexin 43를 발현하는 악성중피종세포와 connexin 43를 발현하지 않는 SKHep-J 세포주에 HSVtk 유전자를 이입한 후 HSVtk 유전자가 이입된 세포와 HSVtk 유전자가 이입되지 않은 세포들을 여러가지 비율로 혼합한 mixing study를 시행하였으며 $10^{-10}M-10^{-6}M$ RA 처리 유무에 따른 bystander effect에 의한 살상효과를 비교하였다. 그리고 gap junction을 통한 세포간의 communication에 대한 retinoids의 영향을 조사하기 위해 retinoids 처리에 따른 세포간 communication을 FACS를 이용하여 double-dye transfer study로 측정하였다. 결 과 : Connexin 43를 발현하지 않는 SKHep-J 세포주에서는 RA 처리유무에 따른 bystander effect에 의한 살상효과의 차이가 없었다. 그러나 connexin 43를 발현하는 악성중피종 세포주에서는 $10^{-8}M-10^{-6}M$ RA처리시 세포간의 communication과 bystander effect가 RA를 처리하지 않은 대조군에 비해 유의하게 증가되었다. 결 론 : RA는 gap junction을 통한 세포간의 communication을 증가시켜 HSVtk/GCV 유전자치료에서 bystander effect에 의한 살상효과를 증가시켰다. 이러한 결과는 HSVtk/GCV 유전자치료의 효과를 증가시킬 수 있는 새로운 방법이 될 수 있을 것으로 생각된다.

• 대한두경부종양학회지
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• 제14권2호
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• pp.156-163
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• 1998

Background & Objectives: Frameless fractionated stereotactic radiotherapy(FFSRT) is a modification of stereotactic radiosurgery(SRS) with radiobiologic advantage of fractionation without losing mechanical accuracy of SRS. Local recurrence of head and neck cancer at or near skull base benefit from reirradiation. Main barrier to successful palliation is dose limitation secondary to normal tissue tolerance. We try to evaluate the efficacy and safety of FFSRT as a new modality of reirradaton in these challenging patients. Materials & Methods: Seven patients with recurrent head & neck cancer involving at or near skull base received FFSRT from September 1995 to November 1997. Six patients with nasopharyngeal cancer had received induction chemotherapy and curative radiation therapy. One patient with maxillary sinus cancer had received total maxillectomy and postoperative radiation therapy as a initial treatment. Follow-up ranged from 11 to 32 months with median of 24 months. Three of 7 patients received hyperfractionated radiation therapy(1.1-1.2Gy/fraction, bid, total 19.8-24Gy) just before FFSRT. All patients received FFSRT(3-5Gy/fraction, total 15-30Gy/5-10fractions). Chemotherapy(cis-platin $100mg/m^2$) were given concurrently with FFSRT in four patients. Second course of FFSRT were given in 4 patients with progression or recurrence after initial FFSRT. Because IF(irregularity factor; ratio of surface area of target to the surface area of sphere with same volume as a target) is too big to use conventional stereotactic RT using multiple arc method for protection of radiation damage to critical normal tissue, all patients received FFSRT with conformal method using irregular static ports. Results: Five of 7 patients showed complete remission in follow-up CT &/or MRI. Three of these five patients who developed marginal, in-field, and out-field recurrences, respectively. Another one of complete responders has been dead of G-I bleeding without evidence of local recurrence. One partial responder who showed progressive disease 15 months after initial FFSRT has received additional FFSRT, and then he is well-being with symptomatic improvement. One minmal responder who showed progression of locoregional disease 9 months after $1^{st}$ FFSRT has received 2nd FFSRT, and then he is alive with stable disease. Five of 7 case had showed direct invasion to skull base and had complaint headache and various symptoms of cranial nerve involvement. Four of these five case showed improvement of neurologic symptoms after FFSRT. No significant neurologic complicaltion related to FFSRT was observed during follow-up periods. Tumor volumes were ranged from 3.9 to 50.7 cc and surface area ranged from 16.1 to $114.9cm^2$. IF ranged from 1.21 to 1.74. The average ratio of volume of prescription isodose shell to target volume was 1.02 that indicated the improvement of target coverage and dose distribution with FFSRT with conformal method compared to target coverage with FFSRT with multiple arc method. Conclusion: Our initial experience suggests that FFSRT with conformal method was relatively effective and safe modality in the treatment of recurrent head and neck cancer involving at or near skull base. Treatment benefit included good palliation of symptoms and reasonable radiographic response. However, more experience and additional follow-up are needed to better assess its ultimate role in treating these challenging patients.

• Radiation Oncology Journal
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• 제20권3호
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• pp.206-214
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• 2002

목적 : 하인두암 환자에서 방사선단독치료와 항암화학요법 병용치료시의 반응과 생존율, 그리고 합병증에 영향을 미치는 요소를 알아보고자 하였다. 대상 및 방법 : 1984년 1월부터 1999년 12월까지 고신대학교 복음병원 치료방사선과에서 치료를 받았던 환자 중 근치적 목적으로 방사선치료 단독 또는 항암화학요법과 병용치료를 받았던 56명을 대상으로 후향적 조사를 하였다. 방사선 단독치료(Group I)가 24명$(42.9\%)$, 항암화학방사선치료(Group II)가 32명$(57.1\%)$이었다. 방사선치료는 정규분할 조사법으로 9명$(16.4\%)$, 과분할조사로 분할선량이 $1.15\~1.2\;Gy$인 경우가 26명$(47.2\%)$, 1.35 Gy인 경우가 18명$(32.7\%)$, 가속과분할조사로 2명$(3.6\%)$이 치료받았으며 총 방사선량은 $40.5\~83.5\;Gy$ (평균선량 68.3 Gy)이었다. 항암화학요법은 cisplatin $100\;mg/m^2$을 day 1에, 5-FU $1,000\;mg/m^2$를 day $2\~6$에 방사선치료에 선행해서 사용하였으며 3주 간격으로 시행하였고 환자에 따라 1회에서 3회까지 시행하였다(평균 2.3회). 추적관찰기간은 1개월에서 195개월 이었고 중앙값은 28개월이었다. 결과 : 전체 대상 환자들의 3년 및 5년 생존율은 $40.6\%,\;27.6\%$였고, Group I은 $50.0\%,\;30.0\%$, II는 $36.4\%,\;26.3\%$였다. 국소제어율은 Group I에서 완전관해율이 $70.0\%$, Group II에서는 완전관해율이 $67.7\%$였다. 생존율에 영향을 미치는 예후인자로는 방사선치료에 대한 반응과 림프절 병기로 나타났다. 항암화학요법을 병용한 군에서 합병증 발생율이 높았으나 다분할 조사군에서는 정규분할조사군보다 적게 나타났다. 결론 : 하인두암의 방사선치료 결과는 방사선치료에 대한 반응과 경부 림프절 병기에 따라 좌우되었다. Cisplatin, 5-FU를 방사선치료 전 선행하여 $1\~3$회 사용하는 것은 하인두암의 국소제어율과 생존율에 가치가 없는 것으로 증명되었으며 오히려 합병증을 높이는 것으로 판명되었다. 다분할 방사선치료는 후기 합병증을 저하시키는 것으로 판명되었다.