• Title/Summary/Keyword: pain response

Search Result 793, Processing Time 0.025 seconds

Study on Development of Assessment Guideline and Endpoints for Clinical Trial with Antitumor Natural Products (천연물 항암제제 임상시험 평가지표 개발연구)

  • Namgung, Mi-Ae;Chang, Yoo-Sung;Jeong, Seung-Gi;Kim, Jin-Seung;Yoon, Sung-Woo;Jang, Ki-Young;Yoo, Hwa-Seung;Jung, Myeon-Woo;Lee, Sung-Ho;Kim, Sung-Hoon
    • Journal of Physiology & Pathology in Korean Medicine
    • /
    • v.20 no.6
    • /
    • pp.1678-1727
    • /
    • 2006
  • This study was perfromed to develop the assessment guideline and endpoints for clinical trial with anticancer herbal medicine. The botanical products used to humans for long time may be applied to phase 3 clinical trial after submitting the evidences for safety and efficacy of them or completion of basic requirement of phase 1 and phase 2 for safety confirmation and dose determination. Syndrome improvement was chiefly evaluated by Zubrod and karnofsky(%) methods. We suggest the general clinical trial assessment with botanical products, by following assessment points, that is, tumor size for 50 points, survival fate for 10 points, major syndromes for 40 points. It is recommendable that the each symptom of Qi deficiency syndrome, blood deficiency syndrome and Qi stagnation syndrome was allocated by assessment points, Similarly, the each symptom was given the assessment points according to the severity of symptom, for example, slight for 3 points, moderate for 2 points and severe for 1 point in hepatocelluar carcinoma and lung cancer. Then, the efficacy of botanical products was evaluated by the difference between pre-treatment and post-treatment. Asking the neoplastic patients of questionnaire on physical, emotional, cognitive, social and role subjects availability, three more syndromes (Fatigue, Pain and Nausea/Vomit), quality of life(QOL) will be evaluated by GLM statistics. In addition, in case of lung cancer, 13 questions will be asked by the EORTC QLQ-C13 forms. As the assessment of endpoints for efficacy to reduce side effects induced by chemotherapy and radiotherapy, the data of image scanning and hemato-urinalysis can be usefully applied on immune response, weight loss, indigestion, hemopoietic damage and injury of liver and kidney, while the changes of syndromes of side effect can be evaluated by differentiation methods of Qi and blood and five viscera. However, it is still necessary to determine the ratio between scientific analytical method and Oriental differentiation method as well as confirm the Oriental assessment endpoints by clinical trial. In addition, we suggest the continuous development of assessment endpoints on other carcinomas except of hepatocelluar carcinoma and lung cancer in future.

The study on ShanghanLun PingMaiFa (1) (『상한론(傷寒論)·평맥법(平脈法)』에 관한 연구(1))

  • Choi, Jin-Young;Park, Kwang-Cheon;Jeong, Han-Sol;Ha, Ki-Tae;Shin, Sang-Woo
    • The Journal of Korean Medical History
    • /
    • v.25 no.2
    • /
    • pp.63-96
    • /
    • 2012
  • The PingMaiFa chapter, which is the second chapter of SongBon ShangHanLun, is the scholarly description(專論) of the pulse and pathological mechanism but has not been studied and published yet. This study is about article 1-13 which is the first part of The PingMaiFa chapter. We compared the original texts within the editions, comparing and analyzing the annotations of successive dynastic medical group. The articles of The SongBon ShangHanLun PingMaiFa chapter 1-13 is consisted as is shown: article 1 states about the general features of normal pulse (平脈) and its physiological mechanism and the morbid pulses (病脈) caused by wind, cold, retained fluid, pain and heat vexation, article 1,10 state about the normal pulses of Five viscera (lung, heart, spleen, liver and kidney) and their manipulations in pulse taking, article 2 states about the differentiations of deficiency and excess syndrome according to pulse conditions, article 3, 4 state about the estimation of good prognoses and a factitious disorder by the combination of pulses and symptoms, article 6 states about Latent qi (伏氣) and its diagnostic features, article 5 states about inspection and listening examination as co-diagnostic methods of the pulse diagnosis, article 7, 8, 9 state that the emotions, such as fear and shame, and the dietary are important factors to consider for making diagnosis, article 11 states about the overwhelming pulse (相乘脈) which indicates the abnormal correlations between five phases and appears in four patterns as the dissolute(縱), the unrighteous(橫), the unfavorable(逆) and the favorable(順), article 12 states about 6 harmful pulses(殘賊脈), which are string-like pulse(弦脈), tight pulse(緊脈), floating pulse(浮脈), slippery pulse(滑脈), sunken pulse(沈脈), rough pulse(澁脈), article 13 states about "JaeGoe"(災怪) which is an unexpected response after treatment and it comes because of the formulas that had before. Throughout all these articles, The PingMaiFa chapter not only offers great value for Pulse-taking diagnosis, but also leads to a better understanding of clinical applications.

The Single-Session Group Education for Advanced & Terminal Cancer Patients and their Family Members (진행암 및 말기암 환자와 가족을 위한 집단 교육 프로그램)

  • Lee, Young-Sook;Heo, Dae-Seuk;Kim, Mi-Ra;Kim, Won-Gyung;Choi, Jeong-Yun
    • Journal of Hospice and Palliative Care
    • /
    • v.7 no.1
    • /
    • pp.64-72
    • /
    • 2004
  • Purpose: This research aims to assess the effect of a single session of group education of hospice program at Seoul National University Hospital for the advanced and terminal cancer patients and their family members. Methods: Response to questionnaires from 89 participants were evaluated using SAS and CHISQ analysis. The questionnaires included the following items: 1) the characteristics of participants; 2) the characteristics of patients; 3) the difficulties of patient care; 4) the satisfaction with the program Results: The participants consist of 33 patients (37.5%) and 56 family members (56.2%). Diagnosis included mainly stomach, lung, breast, and colon cancer. Participants of family members consisted of spouse, parent, children, daughter-in-law, and siblings (in decreasing order). The participants were interested in the medical information, nutrition, pain and symptom management, and psychosocial adaptation. They had difficulties in emotional problem, nutrition and symptom management. Even though it was a single session of group education, the level of satisfaction was high (95%). Conclusion: This research shows that even the single session of the group education for the advanced and terminal cancer patients and their family members is very helpful by giving them the necessary information. In order to develop comprehensive care-giving services, more specific informations, more opportunities to participate in such sessions and longer question-answer time is required.

  • PDF

Tuberous Sclerosis Complex with Crohn's Disease (크론병과 병발한 결절성경화증 1예)

  • Kim, Min Hee;Lee, Yoon Jin;Kim, Jae Young;Yi, Yoon Young;Kang, Joon Won
    • Journal of the Korean Child Neurology Society
    • /
    • v.26 no.4
    • /
    • pp.284-287
    • /
    • 2018
  • Tuberous sclerosis complex (TSC) is an autosomal dominant disorder caused by mutation of one of two genes, TSC1 (encoding hamartin, 9q34) and TSC2 (encoding tuberin, 16p13). It invades the central nervous system and various parts of the body, causing various symptoms. Crohn's disease (CD) is a chronic immune-mediated disease that has not been clearly elucidated. It is thought to be caused by an excessive immune response of the body to bacteria that normally exist in the digestive tract with genetic factors. No cases have been reported in which both of the above-mentioned diseases occurred simultaneously. We report a case of CD in a patient with TSC. A 12-year-old boy was brought to our hospital because of abdominal pain. Skin lesions were observed in the TSC. Fundus examination revealed a hamartoma in the right retina. Brain magnetic resonance imaging revealed a subendothelial giant cell astrocytoma (SEGA). On the basis of these findings, he was diagnosed as having TSC. Blood test results showed increased levels of inflammatory markers. On abdominal ultrasonography, his colon walls were observed to be thickened with increased vascularity of the proximal ascending colon, ileocecal valve, and terminal ileum. Colonoscopy revealed discontinuous ulcerations and inflammations of the ileum, IC valve, and cecum, similar to those found in CD. Everolimus was administered orally for the SEGA but was discontinued frequently owing to the exacerbation of CD. The possibility of CD should be kept in mind in patients with TSC considering to undergo treatment for SEGA.

Dexamethasone Facilitates NF-κB Signal Pathway in TNF-α Stimulated Rotator Cuff Tenocytes

  • Ji, Jong-Hun;Kim, Young-Yul;Patel, Kaushal;Cho, Namjoon;Park, Sang-Eun;Ko, Myung-Sup;Park, Suk-Jae;Kim, Jong Ok
    • Journal of Microbiology and Biotechnology
    • /
    • v.29 no.2
    • /
    • pp.297-303
    • /
    • 2019
  • Corticosteroids are commonly used for pain control in rotator cuff tear. Deregulated $NF-{\kappa}B$ activation is a hallmark of chronic inflammatory diseases and has been responsible for the pathogenesis of rotator cuff tear. The Dexamethasone(DEXA) is a synthetic corticosteroid. The purpose of this study was to examine the exact effect of dexamethasone on $NF-{\kappa}B$ signaling in rotator cuff tear. We measured $NF-{\kappa}B$ expression in four groups: control, $TNF-{\alpha}$-treated, DEXA-treated, and combined treatment with $TNF-{\alpha}$ and DEXA. Tenocytes were isolated from patients with rotator cuff tears and pre-incubated with $TNF-{\alpha}$ (10 ng/ml), DEXA ($1{\mu}M$), or both of them for 10 min, 1 h, and 2 h. Expression of p65, p50, and p52 in the nuclei and cytosol was analyzed by western blotting and immunofluorescence imaging using confocal microscopy. We also evaluated nucleus/cytosol (N/C) ratios of p65, p50, and p52. In our study, the combined treatment with DEXA and $TNF-{\alpha}$ showed increased N/C ratios of p65, p50, and p52 compared with those in the $TNF-{\alpha}$ group at all time points. Additionally, in the DEXA group, N/C ratios of p65, p50, and p52 gradually increased from 10 min to 2 h. In conclusion, DEXA promoted the nuclear localization of p65, p50, and p52, but was not effective in inhibiting the inflammatory response of $TNF-{\alpha}$-stimulated rotator cuff tear.

History and Concept of Manual Therapy (도수치료의 역사 및 개념)

  • Moon, Sang Ho;Lee, Song;Bae, Dae Kyung
    • Journal of the Korean Orthopaedic Association
    • /
    • v.55 no.1
    • /
    • pp.29-37
    • /
    • 2020
  • Manual therapy has undergone parallel development throughout many parts of the world dating back to ancient times for at least 2,500 years. The earliest historical reference to the practice of manual therapy in Greece, dates back to 400 B.C. Over the centuries, manual medicines have fallen in and out of favor with the medical profession. To truly understand the principle, it is important to know that manual therapy was initially the mainstay of the three leading alternative health care systems, osteopathy, chiropractic, and most notably physical therapy. These were all founded in the latter part of the 19th century in response to the shortcomings in allopathic medicine. Although it has been around for a long time and has been used all over the world, there are a few reports on manual therapy treatment, and most papers provided a low level of evidence. Despite the controversies over manual therapy, its use appears to be increasing gradually. This article reviews the history of manual therapy from ancient times to the present including Korean history, discusses the current state of knowledge on manual therapy, and informs physicians who manage musculoskeletal pain.

Cannabidiol Inhibits Lipogenesis by Regulating Akt/AMPK-SREBP-1 Pathway in Sebocytes (피지세포에서 Akt/AMPK-SREBP-1 경로를 통한 CBD의 피지 합성 억제 효능)

  • Yoon Gyung Kwon;Ji Young Yoon;Hanon Lee;Dong Hyo Kim;Jun Hyo Lee;Diane M Thiboutot;Dae Hun Suh;Byoung Jun Park
    • Journal of Life Science
    • /
    • v.33 no.4
    • /
    • pp.343-348
    • /
    • 2023
  • Acne is one of the most common skin diseases, mainly occurring in adolescence. The pathophysiology of acne involves not only hormonal, genetic and environmental factors, but also other factors including hyperseborrhea, inflammation, over-keratinization of follicular keratinocytes and overgrowth of Cutibacterium acnes (C. acnes). Cannabidiol (CBD) is known to relieve pain, stress and inflammation. Moreover, cannabis extracts containing CBD have been reported to be effective in treating acne. However, the therapeutic effect of CBD on acne remains unclear. Therefore, this study aimed to investigate the effect and mechanism of CBD on lipogenesis in SEB-1 sebocytes. We treated sebocytes with CBD and found that it not only inhibited lipid synthesis, but also inhibited cell proliferation by inducing apoptosis. We then demonstrated that sterol response element-binding protein-1 (SREBP-1) mediates the inhibitory effect of CBD on lipogenesis. Furthermore, Akt and adenosine monophosphate-activated protein kinase (AMPK), upstream regulators of SREBP-1, were regulated by CBD treatment. Taken together, our studies demonstrate that CBD inhibits adipogenesis by regulating the Akt/AMPK-SREBP-1 signaling pathway, providing potential for use as a therapeutic agent for acne. Further research is needed to confirm the effect of CBD on inflammation caused by hyperkeratosis, which will increase the possibility of using CBD for acne treatment.

It Was Possible to Reduce the Pain of the Victims of Humidifier Disinfectant (가습기살균제 피해자의 아픔을 줄일 수 있었다)

  • Kim, Pangyi;Choi, Yoon-Hyeong;Park, YeongChul;Park, Tae-Hyun;Leem, JongHan
    • Journal of Environmental Health Sciences
    • /
    • v.48 no.1
    • /
    • pp.1-8
    • /
    • 2022
  • Objectives: The purpose of this study is to reveal the circumstances under which the cases of harm to health caused by humidifier disinfectant were neglected and show the points where the number of victims and the degree of damage could have been reduced. In addition, it attempts to describe how damage management proceeded immediately after the incident and actually exacerbated the damage. Finally, it explores the unfortunate aspects of the recent trial. By doing so, it attempts to take this as an opportunity to consider whether a tragic event such as the humidifier disinfectant incident could occur in the future. Methods: This study collected and analyzed data on chemical material characteristics related to humidifier disinfectants, data on health effect characteristics, data on related laws and regulations from the Ministry of Environment, data related to the damage investigation by the Korea Environmental Industry and Technology Institute, and current contents. Results: The lack of related systems and laws is the area where the greatest responsibility for the cause of the humidifier disinfectant disaster falls, so it is difficult for the government to escape this responsibility. Establishing a dedicated department to identify the prevalence of certain diseases within the functions of the Health Insurance Review and Assessment Service to monitor health can greatly contribute to the prevention and management of diseases through early detection and management of group outbreaks caused by harmful factors. Humidifier disinfectant damage relief should have been expanded earlier beyond HDLI (humidifier disinfectant lung injury) to include non-specific diseases such as asthma, pneumonia, and interstitial pneumonia. The scope of relief benefits should have also been expanded earlier to include the payment of disability benefits. Fortunately, with the 2020 revision of the Special Act, the conditions for estimating causal relations were eased and individual screening systems such as health impact assessment were reorganized along with the introduction of a rapid screening system. Conclusions: The management system for chemical substances in a country is clearly of paramount importance, and the ministry in charge must have a response system in case of damage to health effects. Administration that looks at the victims' situation from their point of view is needed, and technical countermeasures are required to quickly recognize the prevalence of certain diseases.

Strategies for Managing Dementia Patients through Improving Oral Health and Occlusal Rehabilitation: A Review and Meta-analysis

  • Yeon-Hee Lee;Sung-Woo Lee;Hak Young Rhee;Min Kyu Sim;Su-Jin Jeong;Chang Won Won
    • Journal of Korean Dental Science
    • /
    • v.16 no.2
    • /
    • pp.128-148
    • /
    • 2023
  • Dementia is an umbrella term that describes the loss of thinking, memory, attention, logical reasoning, and other mental abilities to the extent that it interferes with the activities of daily living. More than 50 million individuals worldwide live with dementia, which is expected to increase to 131 million by 2050. Recent research has shown that poor oral health increases the risk of dementia, while oral health declines with cognitive decline. In this narrative review, the literature was based on the "hypothesis" that dementia and oral health have a close relationship, and appropriate oral health and occlusal rehabilitation treatment can improve the quality of life of patients with dementia and prevent progression. We conducted a literature search in PubMed and Google Scholar databases, using the search terms "dementia," "major neurocognitive disorder," "dentition," "occlusion," "tooth loss," "dental prosthesis," "dental implant," and "occlusal rehabilitation" in the title field over the past 30 years. A total of 131 studies that scientifically addressed dementia, oral health, and/or oral rehabilitation were included. In a meta-analysis, the random effect model demonstrated significant tooth loss increasing the dementia risk 3.64-fold (pooled odds ratio=3.64, 95% confidence interval [2.50~5.32], P-value=0.0348). Tooth loss can be an important indicator of cognitive function decline. As the number of missing teeth increases, the risk of dementia increases. Loss of teeth can lead to a decrease in the ascending information to the brain and reduced masticatory ability, cerebral blood flow, and psychological atrophy. Oral microbiome dysbiosis and migration of key bacterial species to the brain can also cause dementia. Additionally, inflammation in the oral cavity affects the inflammatory response of the brain and the complete body. Conversely, proper oral hygiene management, the placement of dental implants or prostheses to replace lost teeth, and the restoration of masticatory function can inhibit symptom progression in patients with dementia. Therefore, improving oral health can prevent dementia progression and improve the quality of life of patients.

Intrapleural Fibrinolysis with Urokinase versus Alteplase in Complicated Pleural Effusions and Empyema: A Prospective Randomized Controlled Trial

  • Sudipt Adhikari;Vikas Marwah;Robin Choudhary;Indermani Pandey;Tentu Ajai Kumar;Virender Malik;Arpita Pemmaraju;Shrinath Vasudevan;Suraj Kapoor
    • Tuberculosis and Respiratory Diseases
    • /
    • v.87 no.3
    • /
    • pp.378-385
    • /
    • 2024
  • Background: Intrapleural fibrinolytic therapy (IPFT) has been used as an effective agent since 1949 for managing complicated pleural effusion and empyema. Several agents, such as streptokinase, urokinase (UK), and recombinant tissue plasminogen activator (rt-PA), have been found to be effective with variable effectiveness. However, a head-tohead controlled trial comparing the efficacy of the most frequently used agents, i.e., UK and rt-PA (alteplase) for managing complicated pleural effusion has rarely been reported. Methods: A total of 50 patients were randomized in two intervention groups, i.e., UK and rt-PA. The dose of rt-PA was 10 mg, and that of UK was 1.0 lac units. UK was given thrice daily for 2 days, followed by clamping to allow the retainment of drugs in the pleural space for 2 hours. rt-PA was instilled into the pleural space twice daily for 2 days, and intercostal drainage was clamped for 1 hour. Results: A total of 50 patients were enrolled into the study, of which 84% (n=42) were males and 16% (n=8) were females. Among them, 30 (60%) patients received UK, and 20 (40%) patients received alteplase as IPFT agents. The percentage of mean±standard deviation changes in pleural opacity was -33.0%±9.9% in the UK group and -41.0%±14.9% in the alteplase group, respectively (p=0.014). Pain was the most common adverse side effect, occurring in 60% (n=18) of the patients in the UK group and in 40% (n=8) of the patients in the alteplase group (p=0.24), while fever was the second most common side effect. Patients who reported early (within 6 weeks of onset of symptoms) showed a greater response than those who reported late for the intervention. Conclusion: IPFT is a safe and effective option for managing complicated pleural effusion or empyema, and newer agents, such as alteplase, have greater efficacy and a similar adverse effect profile when compared with conventional agents, such as UK.