• Title/Summary/Keyword: therapeutic ranges

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Effect of electrical stimulation and vitamin AD3E on fracture healing in a rat model (전기자극과 vitamin AD3E가 랫드 골절치유에 미치는 영향)

  • Bae, Chun-slk;Cho, Yong-seong;Chang, Kyung-jin
    • Korean Journal of Veterinary Research
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    • v.37 no.4
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    • pp.863-873
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    • 1997
  • Electrical stimulation and vitamin $AD_3E$ administration have been shown to enhance the repair of biological tissues such as bone, ligament and tendon, The objective of this study were (a) to investgate the therapeutic effects of different levels of electrical stimulation and vitamin $AD_3E$ administration on fracture healing in a rat model and (b) to identify the most effective voltage level. Ninety Sprague-dawley rats were divided into electrical stimulation group and vitamin $AD_3E$ administration group. Electricla stimulation group was divided into four groups on the basis of the level of current delivered. The experimental groups received current (which varied by group), while the controls, with identical electrodes, received no current. In vitamin $AD_3E$ administration group, experimental group was injected 2,500 IU of vitamin A, 1,250 IU of vitamine $D_3$, 1mg of vitamine E intramuscularly. And in control group 0.1ml of saline was injected intramuscularly. After time periods (7-day, 14-day, 21-day for stimulation all rats were tested with combination of biochemical, roentgenologic and histomorphological methods. The results obtained were as follows ; In electrical stimulation groups, serum calcium and inorganic phosphorus level of experimental and control groups showed non specific change within normal physiological ranges. In vitamin $AD_3E$ administration group, serum calcium level of experimental and control groups showed non specific changes within normal physiological ranges, while experimental group showed slightly higher serum inorganic phosphorus level. According to roentgenologic and histomorphological examination, 2V 25Hz electrical stimulation group and vitamine $AD_3E$ administration group showed statistically significant improvements in bone density and ossification reaction until day 14. The terapeutic effect of stimulation on fracture healing was similiar to that of vitamin $AD_3E$ administration. In this study stimulation of 2V 25Hz was the most effective level of electrical stimulation for the healing of fracture of rats.

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Intracranial Pressure and Cerebral Blood Flow Monitoring after Bilateral Decompressive Craniectomy in Patients with Acute Massive Brain Swelling (급성 중증 뇌종창 환자의 양측성 감압개두술 후 뇌압 및 뇌혈류 측정)

  • Yoo, Do-Sung;Kim, Dal-Soo;Huh, Pil-Woo;Cho, Kyoung-Suck;Park, Chun-Kun;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.3
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    • pp.295-306
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    • 2001
  • Objectives : The management of massive brain swelling remains an unsolved problem in neurosurgical field. Despite newly developed medical and pharmacological therapy, the mortality and morbidity due to massive brain swelling remains high. According to many recent reports, surgical decompression with dura expansion is superior to medical management in patients with massive brain swelling. We performed surgical treatment on the first line of treatment, and followed medical management in case with refractory increased intracranial pressure(ICP). To show the quantitative effect of decompressive surgery on the intracranial pressure, we performed ventricular puncture and checked the ventricular ICP continuously during the decompressive surgery and postoperative period. Materials and Methods : Fifty-one patients with massive brain swelling, undergoing bilateral decompressive craniectomy with dura expansion, were studied in this study. In all patients, ventricular puncture was performed at Kocher's point on the opposite side of massive brain swelling. The ventricular pressure was monitored continuously, during the bilateral decompression procedures and postoperative period. Results : The initial ventricular ICP were varied from 13mmHg to 112mmHg. Immediately after the bilateral craniectomy, mean ventricular ICP decreased to $53.1{\pm}15.8%$ of the initial ICP(ranges from 5mmHg to 87mmHg). Dura opening decreased mean ICP by additional 36.7% and made the ventricular pressure $16.4{\pm}10.5%$ of the initial pressure (ranges from 0mmHg to 28mmHg). Postoperatively, ventricular pressure was lowered to $20.2{\pm}22.6%$(ranged from 0mmHg to 62.3mmHg) of the initial ICP. The ventricular ICP value during the first 24 hours after decompressive surgery was found to be an important prognostic factor. If ICP was over 35mmHg, the mortality was 100% instead of additional medical(barbiturate coma therapy and hypothermia) treatments. Conclusion : Bilateral decompression with dura expansion is considered an effective therapeutic modality in ICP control. To obtain favorable clinical outcome in patients with massive brain swelling, early decision making on surgical management and proper patient selection are mandatory.

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Inspection on the acoustic output of the focused extracorporeal focused shock wave therapeutic devices approved by MFDS (식약처에서 허가된 집속형 ESWT 치료기의 음향 출력 분석)

  • Choi, Min Joo;Jeon, Sung Joung;Kwon, Oh Bin;Lee, Min Young;Cho, Jin Sik;Kim, Han Soo;Maeng, Eun Ho
    • The Journal of the Acoustical Society of Korea
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    • v.39 no.4
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    • pp.303-317
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    • 2020
  • Extracorporeal Shock Wave Therapy (ESWT) is an innovative treatment in chronic musculoskeletal pain management and cardiovascular diseases. In this study, we surveyed the acoustic shock wave outputs from the domestically used focal type ESWT devices. The survey data were collected through 30 technical documents registered to the Ministry of Food and Drug Safety (MFDS), Rep. Korea. The results show that the focusing geometry varies largely, 5 mm to 65 mm in the focal length, 3 mm to 30 mm in focal width, and 4 mm to 108 mm in focal depth. The maximum positive pressure (P+) ranges from 7 MPa to 280 MPa, the focal Energy Flux Density (EFD) from 0.0035 mJ/㎟ to 35 mJ/㎟, and the energy per pulse (E) from 0.737 mJ to 80.86 mJ. All domestic PE-type (five) and one EM-type domestic devices included in the analysis of the correlation between P+ and EFD are shown to be far beyond the usual ranges and do not comply with expected correlation so that the reliability of their data was suspected. For the suspected, post-performance tests are required by a recognized testing agency. MFDS guidelines need to be revised so that the pass criteria for the shock wave acoustic outputs can be based on the clinical tests for indications.

Therapeutic Results of Concurrent Chemoradiation in Locally Advanced Uterine Cervical Cancer (국소적으로 진행된 자궁경부암에서 방사선과 Cisplatin의 동시병합요법의 치료결과)

  • Kang, Seung-Hee;Suh, Hyun-Suk;Yang, Kwang-Mo;Lee, Eung-Soo;Park, Sung-Kwon
    • Radiation Oncology Journal
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    • v.13 no.1
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    • pp.55-61
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    • 1995
  • Purpose : Despite a development of therapeutic machines and advance in modern radiation therapy techniques, locally advanced cervical carcinoma has shown high rate of local failure and poor survival rate, Combination of chemotherapy and radiotherapy demonstrated benefit in improving local control and possibly the overall survival. Our study was performed to evaluate effect of concurrent chemoradiation on locally advanced uterine cervical cancer. Methods and Materials : Twenty six patients with locally advanced stage(FIGO stage IIB with ${\geq}5cm$ in diameter, III, IVA) were treated with combination of radiation therapy and concurrent cisplatinum between May of 1988 and September of 1993 at our hospital. Radiation therapy consisted of external irradiaton and 1-2 sessions of intracavitary irradiation. Cisplatinum was administered in bolus injection of 25mg/$m^2$ at weekly intervals during the course of external radiation therapy. Results : Of the 26 Patients, twenty-five patients were evaluable for estimation of response. Median follow-up period was 25 months with ranges from 3 to 73 months. Stage IIB, III, and IVA were 16, 5, 4 patients, respectively, Twenty patients were squamous cell carcinoma. Response was noted in all 25 patients: complete response(CR) in 17/25($68\%$), Partial response(PR) in 8/25($32\%$). Of the 24 patients except one who died of sepsis at 3 months follow-up, seventeen patients($70.8\%$) maintained local control in the pelvis: 16/17($94.1\%$) in CR, 1/17($14.3\%$) in PR. Fourteen of the 17 patients with CR are alive disease free on the completion of follow-up. Median survival is 28 months for CR and 15 months for PR. Analysis of 5-year survival by stage shows 11/16($59.8\%$) in IIB, 3/5($60.0\%$) in III, and 1/4($25.0\%$) in IVA. Overall 5-year survival rate was $55.2\%$. Ten patients recurred: 4 at locoregional, 3 in distant metastasis and 3 with locoregional and distant site. Toxicity by addition of cisplatinum was not excessive. Conclusion : Although the result of this study was obtained from small number of patients, it is rather encouraging in view of markedly improved response rate compared with the results of historical group.

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Clinical Investigation and Treatment of Thyroid Diseases with Radioactive Iodine($^{131}I$) -Report 4- (방사성동위원소옥소(放射性同位元素沃素)($^{131}I$)에 의(依)한 갑상선질환(甲狀腺疾患)의 임상적연구(臨床的硏究) -제 4 보-(第 4 報))

  • Kim, M.H.;Lee, B.H.;Chung, K.T.;Chang, K.J.;Kim, M.J.;Lee, J.K.;Lee, M.
    • The Korean Journal of Nuclear Medicine
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    • v.1 no.1
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    • pp.67-78
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    • 1967
  • Over the past 6 years, from May 1960 to June 1966, 1,716 patients with various diseases of thyroid were examined and thyroid function tests with $^{131}I$ were done. Among them, 545 patients with hyperthyroidism were treated with $^{131}I$. A summary of the clinical data of the $^{131}I$-thyroid function tests and the therapeutic results of $^{131}I$ were presented and discussed. 1. The patients examined consisted of; 596 cases(34.7%) with toxic diffuse goiter, 412 cases(24.0%) with non-toxic nodular goiter, 278 cases(16.2%) with euthyroidism, 236 cases(13.8%) with non-toxic diffuse goiter, 89 cases(5.2%) with hypothyroidism, 53 cases(3.1%) with toxic nodular goiter, 32 cases(1.9%) with thyroiditis and 20 cases(1.2%) with dyshormonogenesis. 2. There were 218(12.7%) male patients and 1,498(87.3%) female patients, showing a ratio of 1:6.9. female predominantly. 3. The majority of patients(79.6%) were in the 3rd through 5th decades of their lives showing the peak in the 4th decades(35.9%). 4. The diagnostic values and normal ranges of $^{131}I$ uptake test, 48 hour serum activity, $T_3$ red blood cell uptake and $PB^{131}I$ conversion ratio were discussed. 5. An attention was given to dyshormonogenesis, a qualitative hypothyroidism, due to its characteristic findings of clinical and $^{131}I$ thyroid function tests, and its pathogenesis was briefly reviewed. 6. Among 545 patients with hyperthyroidism treated with $^{131}I$, 68.3% was cured after single. therapeutic dose and another 24.0% was cured after second dose. 7. The complications of $^{131}I$ therapy were discussed in some details and myxedema had developed. in 3.9% of our cases. No thyroid cancer was found after $^{131}I$ therapy.

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Clinical Investigation and Treatment of Thyroid Diseases with Radioactive Iodine($^{131}I$) (방사성(放射性) 동위원소옥소(同位元素沃素)($^{131}I$)에 의(依)한 갑상선질환(甲狀腺疾患)의 임상적(臨床的) 연구(硏究) - 제 5 보 (第 五 報) -)

  • Lee, Mun-Ho;Koh, Chang-Soon;Ro, Heung-Kyu;Lee, Chung-Sang;Koo, In-Seu;Suh, Hwan-Jo;Lee, Kyung-Ja;Lee, Hong-Kyu
    • The Korean Journal of Nuclear Medicine
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    • v.4 no.2
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    • pp.29-39
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    • 1970
  • A summary of the clinical data of the $^{131}I$-thyroid function tests and the therapeutic results of $^{131}I$ among the 2,658 patients of various thyroid diseases treated over the past 10 years from May 1960 to Oct. 1969 at the Radioisotope Clinic and Laboratory, SNUH were presented and dscussed. 1. The patients examined consisted of: 929 cases (34.9%) of diffuse toxic goiter, 762 cases (28.7%) of diffuse nontoxic goiter, 699 cases (26.3%) of nodular nontoxic goiter, 58 cases (2.2%) of nodular toxic goiter and 210. cases (7.9%) of hypothyroidism. 2. There were 300 (11.4%) male and 2358 (88.6%) female, showing a ratio of 1:8. 3. The majority of patients (79.1%) were in the 3rd-5th decades of their lives. 4. The normal ranges, diagonstic values of $^{131}I$ uptake test, 48 hrs, serum activity, BMR and main subjective symptoms of various thyroid diseases were discussed. 5. In the 579 patients among 867 cases with hyperthyroidism treated with $^{131}I$, 47.8% were confirmed to be cured completely after single therapeutic doses. 6. The complications of $^{131}I$ therapy were discussed and myxedema had developed in 6.75% of our patients. 7. The results of $^{131}I$ thyroid function tests were analysed among the 160 cases of thyroid diseases which were confirmed the diagnosis with histopathological measures.

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Analysis of Chromosomal Aberration Induced by Low Dose of Radiation (저선량방사선에 의한 염색체이상 빈도)

  • Yi, Chun-Ja;Ha, Sung-Whan
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.233-240
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    • 1993
  • Chromosomal aberration analysis, as a basis for biological radiation dosimetry, was performed for radiation dose ranges below 150 cGy. The yield, ratio of lymphocytes with dicentric and/or ring chromosomes, was 0, 0, 0.4, 0.5, 0.6, 0.8, 1.8, 5.5, 8.0, and $18.5\%$ for 0,5, 10, 15, 20, 25, 50, 75, 100 and 150 cGy, respectively. The Qdr, ratio of dicentric and ring chromosomes in total lymphocytes, was 0, 0, 0.004, 0.005, 0.006, 0.009, 0.018, 0.055, 0.084 and 0.207, respectively. The Qdr, ratio of dicentric and ring chromosomes in lymphocytes with aberration, was 1.0 for the radiation doses up to 75 cGy and 1.05 and 1.11 for 100 and 150 cGy, respectively. From the results, it seems possible to estimate radiation dose from Ydr when the exposure is 25 cGy or more. All the 5 radiation workers studied, with exposure much less than 1 mSv per month, had chromosomal aberrations. And acentric fragment pairs, in addition to dicentric and ring chromosomes, showed good dose response relationship and so may be useful for biological dosimetry for low dose radiation.

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Clinical Evaluation of Dose Distribution in High Dose Rate Intracavitary Irradiation in the Treatment of Cervical Cancer (고선량 강내 조사법을 이용한 자궁 경부암의 방사선 치료 계획에 대한 임상적 고찰)

  • Shin, Sei-One;Kim, Myung-Se
    • Journal of Yeungnam Medical Science
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    • v.6 no.1
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    • pp.87-98
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    • 1989
  • Clinical estimation of bladder and rectal doses from high dose rate intracavitary irradiation in carcinoma of the cervix uteri has been initiated on a routine basis in an effort to obtain the optimum radiotherapeutic dose. Simulation films with contrast media are used to image the bladder and rectum, and dose rates are estimated at various interesting points with the aid of treatment planning computer, NEC Therac-2300. Fifty-three patients have been reviewed in order to ascertain the correlation between radiation dose at interesting points in the bladder and rectum and the dose at Point A and B. The dose ratio between doses at Point A 'and interesting points is an important clinical factor in evaluating the treatment planning. This also serves as documentation of the dose to normal structures within the treatment volume. Authors conclude that obtained data are within acceptable ranges and routine simulation films of the bladder and rectum after administration of contrast media with dose calculations at interesting points provide important information for optimizing radiotherapy planning in the treatment of cervical carcinoma without increased time and effort or patient's discomfort.

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Signal Transduction Events Elicited by Natural Products: Role of MAPK and Caspase Pathways in Homeostatic Response and Induction of Apoptosis

  • Kong, Ah-Ng Tony;Yu, Rong;Chen, Chi;Mandlekar, Sandhya;Primiano, Thomas
    • Archives of Pharmacal Research
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    • v.23 no.1
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    • pp.1-16
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    • 2000
  • Many natural products elicit diverse pharmacological effects. Using two classes of potential chemopreventive compounds, the phenolic compounds and the isothiocyanates, we review the potential utility of two signaling events, the mitogen-activated protein kinases (MAPKs) and the ICE/Ced-3 proteases (caspases) stimulated by these agents in mammalian cell lines. Studies with phenolic antioxidants (BHA, tBHQ), and natural products (flavonoids; EGCG, ECG, and isothiocyanates; PEITC, sulforaphane), provided important insights into the signaling pathways induced by these compounds. At low concentrations, these chemicals may activate the MAPK (ERK2, JNK1, p38) leading to gene expression of survival genes (c-Fos, c-Jun) and defensive genes (Phase II detoxifying enzymes; GST, QR) resulting in survival and protective mechanisms (homeostasis response). Increasing the concentrations of these compounds will additionally activate the caspase pathway, leading to apoptosis (potential cytotoxicity). Further increment to suprapharmacological concentrations will lead to nonspecific necrotic cell death. The wider and narrow concentration ranges between the activation of MAPK/gene induction and caspases/cell death exhibited by phenolic compounds and isothiocyanates, respectively, in mammalian cells, may reflect their respective therapeutic windows in vivo. Consequently, the studies of signaling pathways elicited by natural products will advance our understanding of their efficacy and safety, of which many man become important therapeuitc drugs of the future.

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Outcomes of nonsurgical periodontal therapy in severe generalized aggressive periodontitis

  • Bouziane, Amal;Benrachadi, Latifa;Abouqal, Redouane;Ennibi, Oumkeltoum
    • Journal of Periodontal and Implant Science
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    • v.44 no.4
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    • pp.201-206
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    • 2014
  • Purpose: Aggressive periodontitis, especially in its severe form, was traditionally considered to have an unfavourable prognosis. It required a complex treatment and its stabilization was often achieved by surgical therapy. The aim of this study was to investigate the results of nonsurgical periodontal treatment in severe generalized forms of aggressive periodontitis. Methods: Patients with advanced generalized aggressive periodontitis were included in the study. Probing depth (PD) of pockets ${\geq}7mm$ and clinical attachment level (CAL) of sites with attachment loss ${\geq}5mm$ were measured at baseline before nonsurgical periodontal treatment, at re-evaluation, and after treatment. The following other parameters were recorded: resolution of inflammation and bone fill. We compared the baseline values with re-evaluation and posttreatment values using the Friedman test. The Wilcoxon test with the Bonferroni correction was used for both re-evaluation and posttreatment values. Results: Seven patients with 266 periodontal sites were examined. A significant difference was found between values, reported as medians with interquartile ranges, for PD at baseline (7.94 [7.33-8.19] mm) and both re-evaluation (4.33 [3.63-5.08] mm) and posttreatment (3.54 [3.33-4.11] mm) values (P=0.002). A significant difference was also found between values for CAL at baseline (9.02 [7.5-9.2] mm) and both re-evaluation (6.55 [6.30-6.87] mm) and posttreatment (6.45 [5.70-6.61] mm) (P=0.002). Inflammation was resolved and angular bone defects were repaired in all cases. Conclusions: These therapeutic results suggest that this form of periodontitis could have positive outcomes after nonsurgical periodontal treatment. The reparative potential of tissue affected by severe aggressive periodontitis should encourage clinicians to save apparently hopeless teeth in cases of this form of periodontitis.