• 제목/요약/키워드: therapeutic relationship

검색결과 427건 처리시간 0.03초

Agonistic Anti-CD137 Monoclonal Antibody Treatment Induces CD11b+Gr-1+ Myeloid-derived Suppressor Cells

  • Lee, Jung-Mi;Seo, Jeong-Hwan;Kim, Yeon-Jeong;Kim, Yun-Sun;Ko, Hyun-Jeong;Kang, Chang-Yuil
    • IMMUNE NETWORK
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    • 제10권3호
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    • pp.104-108
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    • 2010
  • CD137 (4-1BB/tnfrsf9) has been shown to co-stimulate T cells. However, agonistic anti-CD137 monoclonal antibody (mAb) treatment can suppress $CD4^+$ T cells, ameliorating autoimmune diseases, whereas it induces activation of $CD8^+$ T cells, resulting in diverse therapeutic activity in cancer, viral infection. To investigate the CD137-mediated T cell suppression mechanism, we examined whether anti-CD137 mAb treatment could affect $CD11b^+Gr-1^+$ myeloid-derived suppressor cells (MDSCs). Intriguingly, anti-CD137 mAb injection significantly increased $CD11b^+Gr-1^+$ cells, peaking at days 5 to 10 and continuing for at least 25 days. Furthermore, this cell population could suppress both $CD8^+$ T cells and $CD4^+$ T cells. Thus, this study demonstrated that, for the first time, anti-CD137 mAb treatment could induce $CD11b^+Gr-1^+$ MDSCs under normal conditions, suggesting a possible relationship between myeloid cell induction and CD137-mediated immune suppression.

환자가 지각하는 의료인의 볼친절경험에 관한 연구 (Patient의s Perceptions of Health Professionals의 Unkind Behavior)

  • 김문실;신윤희
    • 대한간호학회지
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    • 제22권4호
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    • pp.421-443
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    • 1992
  • The purpose of this study was to identify patients' perceptions of health professionals' unkind behavior and the effects of this unkind behavior using a Phenomenological research methodology. Understanding of this phenomena should enlighten nurses to interaction and relationship problems between patient and health professionals and thus lead to further research toward enhancing these interaction and relationships. The subjects were 40 adult patients hospitalized in a university hospital in Seoul. They were from 20 to 65 yews old and hospitalized at IM, GS, OS, NS, OB /GY ward. Their hospital days were from 4 to 72. Data were collected from July 29 to August 9, 1991 and from January 6 to 17, 1992. The research questions were “What behavior on the part of health professionals you perceive as unkind and what effect does such behavior have in you\ulcorner”. Responses to the non-structured open-ended questions were audio-recorded during the interviews done by two nurses researchers. Data were analyzed using the phenomenological method of Colazzi. The validity was enhanced by confirmation of the analysis by two nursing clinical researchers, and professor of psychology, and philosophy, all knowledgable of phenomenological research. From the protocols, 146 significant statements about unkind behavior were organized into 38 formulating meanings which were then grouped into six clusters of themes. Patients' Perceived health professional' unkind behavior as being cold, insincere, unconcerned, disregardful, lacking in technical skill, and failing to provide a therapeutic environment. From the protocols, 65 significant statements about the influence of such behavior on patient care were organized into 18 formulating meanings which were then grouped into four clusters of themes. Patients perceived these unkind behavior influencing then emotionally, physically and having negative effects on their compliance with medical and nursing care. The study points to the need for health professionals to understand how their behavior may be perceived by their patients as unkind behavior. Patients perceptions of health professionals' unkind behavior may suggest the opposite desire, that professionals have exellent medical knowledge and skill and that they be sincere, concerned, respectful and warm emotionally toward their patients.

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초분광 이미징 시스템을 이용한 암 혈관 분석에 대한 연구 (A study on the tumor induced microvasculature using hyperspectral imaging system)

  • 최세운
    • 한국정보통신학회:학술대회논문집
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    • 한국정보통신학회 2015년도 춘계학술대회
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    • pp.622-624
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    • 2015
  • 암 세포 주변의 저산소증은 방사선, 항암치료제, 절제술 등을 이용한 항암치료법에 중요한 역할을 하는데, 특히 암세포 주변의 모세혈관 내에서의 산소의 이동 분석은 암의 발달 및 전이, 주변 혈관의 생성과 변이에 직간접적 영향을 미친다. 따라서 현재 암 병변 주변의 모세혈관 내 헤모글로빈 산소포화도를 측정하고 혈관의 생성 및 변이상태를 측정하는 연구가 활발하게 진행되고 있지만, 대부분의 계측장비는 침습적인 방법으로 진행되며, 해상도 또한 기대이하의 공간 및 시간영역을 제공하는 한계가 있다. 따라서 본 연구에서는 비침습적 헤모글로빈 산소포화도 이미지와 다양한 이미지프로세싱 기법을 이용하여 실시간 혈관변화의 분석을 통해 암 혈관 생성 및 변이의 특성을 제공할 수 있는 초분광 이미징 시스템 활용 방법을 제시하고자 한다.

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자발화에 나타난 3-4세 아동의 어중종성 습득 (Coda Sounds Acquisition at Word Medial Position in Three and Four Year Old Children's Spontaneous Speech)

  • 우혜경;김수진
    • 말소리와 음성과학
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    • 제5권3호
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    • pp.73-81
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    • 2013
  • Coda in the word-medial position plays an important role in acquisition of our speech. Accuracy of the coda in the word-medial position is important as a diagnostic indicator since it has a close relationship with degrees of disorder. Coda in the word-medial position only appears in condition of connecting two vowels and the sequence causes diverse phonological processes to happen. The coda in the word-medial position differs in production difficulty by the initial sound in the sequence. Accordingly, this study aims to examine the tendency of producing a coda in the word-medial position with consideration of an optional phonological process in spontaneous speech of three and four year old children. Data was collected from 24 children (four groups by age) without speech and language delay. The results of the study are as follows: 1) Sonorant coda in the word-medial position showed a high production frequency in manner of articulation, and alveolar in place of articulation. When the coda in the word-medial position is connected to an initial sound in the same place of articulation, it revealed a high frequency of production. 2) The coda in word-medial position followed by an initial alveolar stop revealed a high error rate. Error patterns showed regressive assimilation predominantly. 3) The order of difficulty that Children had producing codas in the word-medial position was $/k^{\neg}/$, $/p^{\neg}/$, /m/, /n/, /ŋ/ and /l/. Those results suggest that in targeting coda in the word-medial position for evaluation, we should consider optional phonological process as well as the following initial sound. Further studies would be necessary which codas in the word-medial position will be used for therapeutic purpose.

요추 추간판 탈출증 환자의 보존적 치료 후 변화된 자기공명영상에 따른 임상적 고찰 (Clinical Study for Patients with Lumbar Disc Herniation on Change of Magnetic Resonanse Imaging after Conservative Treatment)

  • 권혁준;정해찬;김호준;박영회;금동호;이명종
    • 한방재활의학과학회지
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    • 제19권3호
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    • pp.81-90
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    • 2009
  • Objectives : To analyze the therapeutic outcomes of back pain modalities in patients with disc herniation according to the change of Magnetic Resonanse Imaging(MRI) whom were treated with herbal medicine, chuna, acupuncture, bee-venom acupuncture. Methods : Clinical outcomes of 35 patients diagnosed with lumbar disc herniation by MRI examination, treated conservatively, were analyzed according to MRI follow-up change. Patients underwent MRI examaintion at baseline and after 24th week of treatment. Patients are divided into three groups ; improved, unchanged, worsened. 35 patients with lumbar disc herniation were treated with chuna therapy, acupuncture, bee-venom acupuncture once a week and took herbal medicine after a meal two times daily. The patients' clinical outcomes were assessed at baseline, 12th week, 24th week by Visual analogue scale(VAS), Oswestry disability index(ODI). Results : 1. MRI follow-up exams on regression of disc herniation resulted on 42.86% of cases by conservative treatment. 2. VAS(low back pain and sciatica) and ODI of disability of daily activities showed significant decrease in "improved" and "unchanged" groups compared to "worsened" group(P<0.05). 3. VAS(low back pain and sciatica) and ODI change after treatment did not show any relationship with MRI follow-up change(P<0.05). Conclusions : This study suggests that "improved" and "unchanged" groups compared to "worsened" group on MRI follow-up in patients with lumbar disc herniation were more effective when treated with herbal medicine, chuna therapy, acupuncture, bee-venom acupuncture. MRI follow-up change does not affect clinical changes in patients with lumbar disc herniation.

한국인 주요우울증 환자에서의 세로토닌 5A 수용체의 유전자 다형성 및 Citalopram 치료반응과의 관련성 (Association of the 5-HT5A Receptor Gene Polymorphisms and Citalopram Response in Korean Patients with Major Depressive Disorder)

  • 심진현;백종우;오정웅;강이헌;이화영;이민수
    • 생물정신의학
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    • 제15권4호
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    • pp.303-309
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    • 2008
  • Objectives : Some reports have suggested that 5-HT5A polymorphism allelic association was associated with depression, however, there has been no report about relationship between the 5-HT5A gene and antidepressant response. We conducted the association study of the 5-HT5A receptor gene polymorphisms (-19G/C,12A/T) and response to citalopram in Korean patients with major depressive disorder(MDD). Methods : A total of 106 patients with major depressive disorder were included in this study. The patient's symptoms were measured by 21-item Hamilton Depression Rating Scale(HAMD) at baseline, week 1, week 2, week 4 and week 8 during citalopram treatment. A Responder to citalopram was defined by 50% reduction of total HAMD scores. To analyze genetic polymorphisms, a polymerase chain reaction based method was used. Results : At week 8, responders were 62, non-responders were 44. No significant differences of genotypes or allelic association in 19G/C and 12A/T polymorphisms were observed between responsive and non-responsive patients. Conclusion : These results do not support the hypothesis that this polymorphism of the HT5A receptor gene is involved in the therapeutic response to citalopram.

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Nutlin-3 downregulates p53 phosphorylation on serine392 and induces apoptosis in hepatocellular carcinoma cells

  • Shi, Xinli;Liu, Jingli;Ren, Laifeng;Mao, Nan;Tan, Fang;Ding, Nana;Yang, Jing;Li, Mingyuan
    • BMB Reports
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    • 제47권4호
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    • pp.221-226
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    • 2014
  • Drug-resistance and imbalance of apoptotic regulation limit chemotherapy clinical application for the human hepatocellular carcinoma (HCC) treatment. The reactivation of p53 is an attractive therapeutic strategy in cancer with disrupted-p53 function. Nutlin-3, a MDM2 antagonist, has antitumor activity in various cancers. The post-translational modifications of p53 are a hot topic, but there are some controversy ideas about the function of phospho-$Ser^{392}$-p53 protein in cancer cell lines in response to Nutlin-3. Therefore, we investigated the relationship between Nutlin-3 and phospho-$Ser^{392}$-p53 protein expression levels in SMMC-7721 (wild-type TP53) and HuH-7 cells (mutant TP53). We demonstrated that Nutlin-3 induced apoptosis through down-regulation phospho-$Ser^{392}$-p53 in two HCC cells. The result suggests that inhibition of p53 phosphorylation on $Ser^{392}$ presents an alternative for HCC chemotherapy.

The origin-of-cell harboring cancer-driving mutations in human glioblastoma

  • Lee, Joo Ho;Lee, Jeong Ho
    • BMB Reports
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    • 제51권10호
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    • pp.481-483
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    • 2018
  • Glioblastoma (GBM) is the most common and aggressive form of human adult brain malignancy. The identification of the cell of origin harboring cancer-driver mutations is the fundamental issue for understanding the nature of GBM and developing the effective therapeutic target. It has been a long-term hypothesis that neural stem cells in the subventricular zone (SVZ) might be the origin-of-cells in human glioblastoma since they are known to have life-long proliferative activity and acquire somatic mutations. However, the cell of origin for GBM remains controversial due to lack of direct evidence thereof in human GBM. Our recent study using various sequencing techniques in triple matched samples such as tumor-free SVZ, tumor, and normal tissues from human patients identified the clonal relationship of driver mutations between GBM and tumor-free SVZ harboring neural stem cells (NSCs). Tumor-free SVZ tissue away from the tumor contained low-level GBM driver mutations (as low as 1% allelic frequency) that were found in the dominant clones in its matching tumors. Moreover, via single-cell sequencing and microdissection, it was discovered that astrocyte-like NSCs accumulating driver mutations evolved into GBM with clonal expansion. Furthermore, mutagenesis of cancer-driving genes of NSCs in mice leads to migration of mutant cells from SVZ to distant brain and development of high-grade glioma through the aberrant growth of oligodendrocyte precursor lineage. Altogether, the present study provides the first direct evidence that NSCs in human SVZ is the cell of origin that develops the driver mutations of GBM.

CYP2D6 P34S Polymorphism and Mirtazapine Responses in Koreans with Major Depression

  • Jeon, Si-On;Chang, Hun-Soo;Lee, Hwa-Young;Ham, Byung-Joo;Kang, Rhee-Hun;Jeong, Yoo-Jung;Lee, Min-Soo
    • Molecular & Cellular Toxicology
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    • 제5권4호
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    • pp.346-353
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    • 2009
  • Drug metabolism is a critical determinant of the therapeutic and adverse effects of many psychotropic drugs. The metabolism depends on the pharmacokinetics of a drug, which includes its absorption, distribution, and elimination. Psychotropic drugs are metabolized mainly by cytochrome P450 (CYP) enzymes; about 20 of these enzymes exist and they are often responsible for the rate-limiting step of drug metabolism. CYP2D6 is the best-characterized P450 enzyme that exhibits polymorphism in humans. This study determined the relationship between the CYP2D6*10 (P34S) polymorphism and the response to mirtazapine in 153 Koreans with major depressive disorder (MDD). The genotype frequencies were compared using logistic regression analysis, and between-genotype differences in the decrease in the 21-item Hamilton Depression (HAMD21) score over the 12-week treatment period were analyzed using a linear regression analysis. The proportion of remitters was lower in patients with MDD possessing the S allele than in P allele carriers after 2 weeks of mirtazapine treatment. Similarly, the reductions in the HAMD21 and Clinical Global Impression (CGI) scores in S allele carriers were smaller than those in patients with the P allele after 2 weeks of mirtazapine treatment. In the analysis of depression symptoms, the sleep and delusion scores had smaller reductions in S allele carriers. Based on the Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS), the psychic adverse effects of mirtazapine were associated with CYP2D6 P34S, while weight gain was not. These results suggest that CYP2D6 P34S affects the outcome of mirtazapine treatment in patients with MDD, and that this polymorphism may be a good genetic marker for predicting the clinical outcome of mirtazapine treatment.

Mutational Analysis of Korean Patients with Phenylketonuria

  • Koo, Soo Kyung;Lee, Kwang-Soo;Jung, Sung-Chul;Lee, Jong-Eun;Lee, Dong Hwan
    • 대한유전성대사질환학회지
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    • 제4권1호
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    • pp.5-12
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    • 2004
  • Purpose Phenylketonuria is an inborn error of metabolism, which is inherited as an autosomal recessive trait. PKU is resulting from deficiency of phenylalanine hydroxylase. PAH gene spans about 90 kb on chromosome 12q and comprises 13 exons. In order to define the genetic basis of PKU and the frequencies and distribution of PAH mutations in the Korean population, we analyzed PAH gene in independent 80 patients with PKU. Methods All 13 exons including exon-intron boundaries and 2 kb of 5' upstream region of the PAH gene were analyzed by PCR-direct sequencing methods. Results PAH gene analysis revealed 39 different mutations including 10 novel mutations. The novel mutations consisted of 9 missense mutations (P69S, G103S, N207D, T278S, P281A, L293M, G332V, S391I and A447P) and a novel splice site variant (IVS10-3C>G). R243Q, IVS4-1G>A, and E6-96A>G were the most relevant mutations and they accounted in the whole for 38% of the mutant alleles identified in this study. We also observed that. $BH_4$ responsibility was. associated with genotype of R241C, R53H and R408Q. Conc1ustion Our present study with 80 participants extends the previous results to more comprehensive understanding of PAH allele distribution and frequency in Koreans. Although Korean mutation profile of PAH is similar to those of the nearest oriental populations (Japanese, Chinese, and Taiwanese), several different characteristic features are revealed. The characterization of the genotype-phenotype relationship was also performed. Our data would be very useful information for diagnosis, genetic counseling and planning of dietary and therapeutic strategies in Korean PAH patients.

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