• 제목/요약/키워드: treatment criteria

검색결과 2,100건 처리시간 0.031초

Meta-analysis of Associations between ATM Asp1853Asn and TP53 Arg72Pro Polymorphisms and Adverse Effects of Cancer Radiotherapy

  • Su, Meng;Yin, Zhi-Hua;Wu, Wei;Li, Xue-Lian;Zhou, Bao-Sen
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권24호
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    • pp.10675-10681
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    • 2015
  • Background: The ataxia telangiectasia mutated (ATM) protein and p53 play key roles in sensing and repairing radiation-induced DNA double strand breaks (DSBs). Accumulating epidemiological evidence indicates that functional genetic variants in ATM and TP53 genes may have an impact on the risk of radiotherapy-induced side effects. Here we performed a meta-analysis to investigate the potential interaction between ATM Asp1853Asn and TP53 polymorphisms and risk of radiotherapy-induced adverse effects quantitatively. Materials and Methods: Relevant articles were retrieved from PubMed, ISI Web of Science and the China National Knowledge Infrastructure (CNKI) databases. Eligible studies were selected according to specific inclusion and exclusion criteria. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled to estimate the association between ATM Asp1853Asn and TP53 Arg72Pro polymorphisms and risk of radiotherapy adverse effects. All analyses were performed using the Stata software. Results: A total of twenty articles were included in the present analysis. In the overall analysis, no significant associations between ATM Asp1853Asn and TP53 Arg72Pro polymorphisms and the risk of radiotherapy adverse effects were found. We conducted subgroup analysis stratified by type of cancer, region and time of appearance of side effects subsequently. No significant association between ATM Asp1853Asn and risk of radiotherapy adverse effects was found in any subgroup analysis. For TP53 Arg72Pro, variant C allele was associated with decreased radiotherapy adverse effects risk among Asian cancer patients in the stratified analysis by region (OR=0.71, 95%CI: 0.54-0.93, p=0.012). No significant results were found in the subgroup analysis of tumor type and time of appearance of side effects. Conclusions: The TP53 Arg72Pro C allele might be a protective factor of radiotherapy-induced adverse effects among cancer patients from Asia. Further studies that take into consideration treatment-related factors and patient lifestyle including environmental exposures are warranted.

혈액투석 환자의 삶의 질에 미치는 예측변인 분석 (The Effect of Anticipated Variables on Hemodialysis Patient′s Quality of Life)

  • 조계화;성기월
    • 대한간호학회지
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    • 제30권2호
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    • pp.413-424
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    • 2000
  • The purpose of this study was to analyze the effect of anticipated variables on hemodialysis that was impact patients' quality of life. The subjects of the study were 104 patients who were over 18 years old. They were enrolled at Kidney dialysis unit in General Hospital located in T and M city, Republic Korea. And the duration of treatment was more than 6 months. They all met the research criteria and agreed to participate in the research. The research instrument have 25 questionnaire which were originally Ferrans' (1985) instrument to measure the quality of life for hemodialysis patients and later changed by Lee, Suk-Ja into the 35 items after eliminating repeated contents, the Cronbach's $\alpha$in this study was .87. The stress instrument was measured by 36 items which were modified and supplemented the instrument developed by Kim, Yong-Kyong(15) for hemodialysis patients, and the Cronbach's $\alpha$was .9333. Depression instrument was 20 questions modified BDI(Beck Depression Inventory) to meet hemodialysis patients' conditions, and Cronbach's $\alpha$ was .92. June 25, 1999 and the data was analyzed by SPSS/PC, and the statistical techniques were ANOVA(variables analysis), Scheffe test, Multiple Regression. The findings of this study were as follows: 1. The effect of general characteristics on hemodialysis patients' quality of life, the characteristics showing a statistically, significant difference were the existence of an occupation(t=6.7353, P= .0109), marital status (F=4.3550, P= .0290), economic status (F=4.6475, P= .0118) and presence of care support (F=2..4738, P= .0494). 2. The effect of general characteristics on the patient's stress, the characteristics showing a significant difference were gender (t= 4.1143, p= .0451), education level (F= 4.3550, p= .008), the existence of an occupation (t=8.7498, p= .0038), and presence of care support(F=3.1715, p= .0169). 3. The effects of general characteristics on depression, the characteristics were education level (F=3.7517, P= .0069), the existence of religion(t=9.4843, p= .0027), an occupation (t=15.3745, p= .0002), marital status (F=3.3400, P= .0223) and presence of care support (F=3.7605, p= .0069). 4. The Multiple Regression is used to identify the effect of anticipated variables on the patient's quality of life. The variables were depression (T=-9.656, P=.000), marital status (T=-2.287, P=.0243) and the regression expression was Y=117.62053 - 1.13618Χ$_1$ + 2.66213Χ$_2$$_1$: Depression, Χ$_2$ : Marriage), The explanation of the total regression expression appeared to be 52.578%.

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Microbiology and Epidemiology of Infectious Spinal Disease

  • Jeong, Se-Jin;Choi, Seung-Won;Youm, Jin-Young;Kim, Hyun-Woo;Ha, Ho-Gyun;Yi, Jin-Seok
    • Journal of Korean Neurosurgical Society
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    • 제56권1호
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    • pp.21-27
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    • 2014
  • Objective : Infectious spinal disease is regarded as an infection by a specific organism that affects the vertebral body, intervertebral disc and adjacent perivertebral soft tissue. Its incidence seems to be increasing as a result of larger proportion of the older patients with chronic debilitating disease, the rise of intravenous drug abuser, and the increase in spinal procedure and surgery. In Korea, studies assessing infectious spinal disease are rare and have not been addressed in recent times. The objectives of this study are to describe the epidemiology of all kind of spinal infectious disease and their clinical and microbiological characteristics as well as to assess the diagnostic methodology and the parameters related to the outcomes. Methods : A retrospective study was performed in all infectious spinal disease cases presenting from January 2005 to April 2010 to three tertiary teaching hospitals within a city of 1.5 million in Korea. Patient demographics, risk factors, clinical features, and outcomes were assessed. Risk factors entailed the presence of diabetes, chronic renal failure, liver cirrhosis, immunosuppressants, remote infection, underlying malignancy and previous spinal surgery or procedure. We comparatively analyzed the results between the groups of pyogenic and tuberculous spinal infection. SPSS version 14 statistical software was used to perform the analyses of the data. The threshold for statistical significance was established at p<0.05. Results : Ninety-two cases fulfilled the inclusion criteria and were reviewed. Overall, patients of tuberculous spinal infection (TSI) and pyogenic spinal infection (PSI) entailed 20 (21.7%) and 72 (78.3%) cases, respectively. A previous spinal surgery or procedure was the most commonly noted risk factor (39.1%), followed by diabetes (15.2%). The occurrence of both pyogenic and tuberculous spondylitis was predominant in the lumbar spine. Discs are more easily invaded in PSI. At initial presentation, white cell blood count and C-reactive protein levels were higher in PSI compared to TSI (p<0.05). Etiological agents were identified in 53.3%, and the most effective method for identification of etiological agents was tissue culture (50.0%). Staphyococcus aureus was the most commonly isolated infective agent associated with pyogenic spondylitis, followed by E. coli. Surgical treatment was performed in 31.5% of pyogenic spondylitis and in 35.0% of tuberculous spondylitis cases. Conclusion : Many previous studies in Korea usually reported that tuberculous spondylitis is the predominant infection. However, in our study, the number of pyogenic infection was 3 times greater than that of tuberculous spinal disease. Etiological agents were identified in a half of all infectious spinal disease. For better outcomes, we should try to identify the causative microorganism before antibiotic therapy and make every effort to improve the result of culture and biopsy.

서울시 상수계통에서 병원성균 Aeromonas (감마-프로테오박테리아) 분포연구 (Detection and Distribution of the Pathogenic Bioagent Aeromonas (Gamma-Proteobacteria) in Water Supplies of Seoul)

  • 이은숙;이목영;한선희;가종억
    • 미생물학회지
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    • 제43권2호
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    • pp.106-110
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    • 2007
  • USEPA 1605 방법을 이용하여 서울시 상수도계통에서 Aeromonas를 조사하였다. 2002년 7월부터 2003년 12월까지 매월 한강수계 하천수와 서울시 정수장에서 공급되는 정수, 수돗물에서 시료를 채취하였다. Aeromonas는 선택배지(ADA-V)를 사용하여 membrane 필터 표면에 성장한 노란색 집락을 계수하여 측정하였다. 하천수에서는 Aeromonas가 $1.0{\times}10^{0}-9.8{\times}10^{3}\;CFU/ml$의 농도로 검출되었으며, 정수에서는 검출되지 않았다. 수돗물에서는 141개 중 1개의 시료에서 1 CFU/500 ml의 농도로 검출되었다. 확인된 Aeromonas는 대부분 비병원성인 A. salmonicida(51%)였고, 이 외에도 A. caviae(4.7%), A. schubertti(3.4%), A. sobria(3.8%), A. hydrophila(2.1%), A ichithiosmia(0.4%)등이 동정되었다. A. salmonicida에 대한 염소 저항성을 평가한 결과, 0.2 mg/L 염소농도에서 30초 접촉 후, 99.99% (일부)가 제거되었다. USEPA 1605 방법에서 제시한 정도관리를 수행한 결과, 정도관리 허용기준을 만족하였다. 본 연구를 통해 서울시 상수도계통에서 Aeromonas에 대한 안전성이 확보되었다.

정상 한국 성인에서 발목관절 외측 안정성의 방사선학적 계측 (Radiographic Measurement of Ankle Lateral Stability in Normal Korean Adults)

  • 손현철;김용민;김동수;최의성;박경진;조병기;박지강;홍경호
    • 대한족부족관절학회지
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    • 제14권1호
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    • pp.41-46
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    • 2010
  • Purpose: Anterior drawer and varus stress test are commonly used for radiologic evaluation of chronic lateral ankle instability. However, there are controversies regarding the method of measurement and the normal value. This study was performed to investigate radiologic normal values in normal Korean adults and to analyze differences by age and gender. Materials and Methods: Sixty Korean adults were recruited and divided in three groups (20 in their twenties, 20 in their thirties, 20 in their forties). There were 10 males and 10 females in each group. The selection criteria were no history of ankle injury and no evidence of instability on physical examination. Radiologic measurement of varus talar tilt and anterior talar translation were performed through anterior and varus stress radiographs using Telos device (150N force). The measurement was repeated twice by three researchers, and intraobserver reproducibility and interobserver reliability were analyzed. The average talar tilt and anterior talar translation were obtained. Results: Talar tilt and anterior talar translation on ankle stress radiographs had good intraobserver reproducibility and interobserver reliability. Talar tilt was average $3.7^{\circ}$ and $5.1^{\circ}$ in male and female of twenties of age, $3.9^{\circ}$ and $4.8^{\circ}$ in their thirties, $3.4^{\circ}$ and $4.5^{\circ}$ in their forties. Anterior talar translation was average 3.5 mm and 4.2 mm in their twenties, 4.1 mm and 3.8 mm in their thirties, 3.6 mm and 4.1 mm in their forties. There was no significant difference in talar tilt and anterior talar translation by age. However, there was significant difference in talar tilt by gender. Conclusion: Normal range of talar tilt angle in Korean adults was below $8.3^{\circ}$, and normal range of anterior talar translation was below 7.6 mm. It seems to be able to serve as a good reference for radiologic evaluation and for treatment of chronic lateral ankle instability.

상완골 근위부 분쇄성 골절 및 탈구에서 시행한 견관절 반치환술 (Hemiarthroplasty in Comminuted Fracture and Dislocation of the Proximal Humerus)

  • 황성관;김용석
    • Clinics in Shoulder and Elbow
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    • 제1권2호
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    • pp.205-211
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    • 1998
  • 저자들은 상완골 근위부의 골절탈구로 일차성 견관절 반치환술로 치료받은 환자 25례중 14례를 대상으로 치료결과를 분석하여 다음과 같은 결론을 얻었다. 1. 전례에서 동통은 소실되거나 완화되었으나 Neer의 평가에 따라 총 14례중 5례에서만 만족할만 한 결과를 믿었으며 나머지 9례에서는 불만족한 결과를 보였다. 2. 수상시 상완곤두의 분쇄상이 심하거나, 수술이 지연되어 골편치 연화가 심한 경우 상완골 길이와 humeral offset의 유지가 힘들었으며, 견관절 반치환술 시팽한 측이 정상측보다 1cm 이상 단축을 보인 경우가 5례였으며 이 경우 능동적 견관절 운동범위가 정상측보다 감소되었다. 3. 견관절 반치환술은 분쇄상 상완골 근위부 골절에서 사용되어지며 동통의 감소와 기능의 호전은 있으나 완전한 회복은 어려우며 수술시 연부조직 손상이 적고 적당한 후염각, 결절의 재건 과 회전근개의 수복은 필수적이다. humeral offset과 길이의 유지는 술 후 능동적 견관절 운동 범위의 향상에 영향을 미치며 아울러 환자의 협조하에 체계적인 재활운동이 필요할 것으로 사료된다.

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LPS로 유발된 대식세포의 염증반응에 대한 청상보하탕(淸上補下湯)의 효과 (Effect of Chungsangboha-tang on LPS induced Anti-inflammatory in THP-1 cells)

  • 이경희;김홍렬;정희재;이형구
    • 대한한방내과학회지
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    • 제29권1호
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    • pp.12-24
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    • 2008
  • Background and Objective : Chungsangboha-tang (CSBHT) has analgesic, sedative, anti-convulsive and anti-histamine effects, so it alleviates the symptoms of asthma. For the comparison of anti-inflammatory effect(s) on CSBHT, PD098059 was used as a negative control. Materials and Methods : This study emphasized THP-1 cells, which had been well characterized as a human monocytic leukemic cell line. The cells resemble monocytes with respect to several criteria and can be differentiated into macrophage-like cells by treatment with PMA. By using the MTS assay, it was possible to prove the safety of CSBHT. Results : Results shows that the CSBHT did not affected cell survival within $10^{1}$ ng/ml to $10^{5}$ ng/ml. Especially, $10^{5}$ ng/ml CSBHT treated cells show 70% deduction of $TNF-{\alpha}$ gene expression against that of LPS treated group. Furthermore, $IL-1{\beta}$, IL-6, IL-8, IL-10 and $TNF-{\alpha}$ levels are down-regulated when treated with CSBHT with concentrations up to 100 ug/ml on monocyte-derived macrophages. Interestingly, CSBHT-treated samples showed that overall transcriptional activities were down-regulated to 20% of that of PD098059 ($TNF-{\alpha}$ inhibitor). At protein level, the expression of $TNF-{\alpha}$ showed similar results as that of transcriptional activity. Results show that the protein level decreased more in the CSBHT-treated group (487 ${\pm}$ 87 pg/ml) than in the LPS-treated group (703 ${\pm}$ 103 pg/ml). In addition, the protein level of IL-8 in the CSBHT treated-group (9.84 ${\pm}$ 3.28 ng/ml) decreased similar as the expression of the control and PD098059-treated groups. Conclusion : CSBHT affects immune response, especially allergic responses and suppression of inflammatory reaction. The results provide us an alternative way to care for clinical inflammatory diseases, not only asthma but also the other possible general inflammatory and allergic diseases.

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Helicobacter pylori의 in vivo 연구를 위한 ethanol-pretreating animal model의 개발 (Establishment of ethanol-pretreating animal model to study Helicobacter pylori infection)

  • 이진욱;김승희;박탄우;김옥진
    • 대한수의학회지
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    • 제46권4호
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    • pp.327-335
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    • 2006
  • A stable and reliable Helicobacter pylori (H. pylori) infection animal model would be necessary for evaluating vaccine efficacy and helpful for understanding the pathological mechanism of the organism. The aim of the present study is to investigate the effect of ethanol treatment prior to H. pylori inoculation on associated gastric mucosal injury and to establish ethanol-pretreating animal model to study H. pylori infection. Male Mongolian gerbils were used for the study. H. pylori was orally inoculated after 12 h fasting. 3 h prior to H. pylori inoculation, a group of gerbils was orally treated with absolute ethanol, 60% and 40% ethanol respectively. Another group of animals was treated either with H. pylori culture media alone or with different concentrations of ethanol plus culture media. Gerbils were killed 4 or 8 weeks after H. pylori inoculation. The colonization of H. pylori was confirmed by both histological examination and rapid urease test. Mucosal damage was evaluated grossly and histologically according to the criteria. The colonization of H. pylori and pathological changes in gastric mucosa of the animals were also observed. Although no significant change to the gastric mucose was observed in the animals treated either with H. pylori culture media alone or with different concentrations of ethanol plus culture media, persistent H. pylori infection was seen in the mucosa and mucosal leucocyte infiltration and severe epithelial damage was observed in the Helicobacter and ethanol + Helicobacter groups after 4 weeks. The gross and histological scores were higher in the ethanol + Helicobacter than in the Helicobacter alone group. As the results, ethanol-pretreatment with 60% concentration induced severe pathogenic changes by H. pylori infection in 5 weeks-old Mongolian gerbils. These results suggested that ethanol-pretreatment before H. pylori inoculation could increase the severity of gastric mucosal inflammation and enhance the colonization of H. pylori. The established ethanol-pretreating animal model would contribute to screen new drugs against H. pylori and be used as an useful tool for various animal experiments with H. pylori strains.

식은 땀을 호소하는 진행성 암 환자에서 비스테로이드성 항염증 제제를 이용한 치료 (Non-Steroid Anti-Inflammatory Agents for Management of Cold Sweating in Advanced Cancer Patients)

  • 최혜정;송하나;강정훈
    • Journal of Hospice and Palliative Care
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    • 제19권4호
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    • pp.331-334
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    • 2016
  • 목적: 진행성 암 환자에서 발열이 동반되지 않은, 암성 발한에서 NSAID (non-steroid anti-inflammatory drug) 치료 효과를 알아보고자 함이 목적이다. 방법: 다음과 같은 조건을 만족하는 환자를 대상으로 후향적으로 의무 기록을 조사하였다. 1) 수술적 절제나 항암방사선 치료로 완치가 불가능한 진행성 암 환자 2) 숫자평가등급 4점 이상의 식은 땀을 호소하며 발열이 동반되지 않은 환자 3) 식은 땀의 원인이 될 만한 감염이 없고, 마약성 진통 및 호르몬 차단제를 현재 최근 1개월 이내 새롭게 사용하지 않는 환자 4) 식은 땀 치료를 위해 NSAID를 사용하고, NRS 평가가 치료 전 후 시행한 환자. 결과: 총 13명의 환자가 등록되었다. 남자가 9명(69%)이었고, 평균 59세(범위: 50~71)였다. 암종별 빈도는 담도암, 췌장암, 위암, 전립선암 순이었다. 치료 전 환자들의 식은 땀은 평균 NRS 6.5 (최소값: 4, 최대값: 10) 이었고, 치료 후에는 NRS 1.9 (최소값: 0, 최대값: 5)이었다. 평균 추적 관찰 기간은 9.1일이었다. 결론: 진행성 암 환자에서 열이 동반되지 않은 중등도 이상의 식은 땀 환자에서 NSAID는 효과적인 치료방법이다.

CT를 이용한 혈복강의 등급: 비장 손상의 정도 및 회복의 객관화 (CT Based Hemoperitoneum Scoring for Clinicians: Objectifying the Severity of Splenic Injury and Recovery)

  • 신홍경;송라영;한호성;윤유석;조재영;황대욱;정규환;김영기;이우형
    • Journal of Trauma and Injury
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    • 제26권4호
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    • pp.273-279
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    • 2013
  • Purpose: In patients with splenic trauma, Computed Tomography (CT) scan is helpful in selecting treatment options and evaluating resolution after NOM (Non-Operative Management). The purpose of this study was to suggest a CT based hemoperitoneum (HP) scoring system that can easily be used by clinicians to evaluate the severity of injury and recovery. Methods: A retrospective review of patients with splenic trauma admitted to our hospital between May 2003 and January 2013 was conducted. Patients diagnosed with isolated spleen injury who had a CT scan on admission were included. 1 or 2 points were given according to location and amount of hematoma in the CT image. Using the existing ultrasonography (US) based HP scoring system, the same method was applied to obtain our CT based HP scoring (CBHS) system, which ranges from 0 to 8 points. The CBHS system can be easily used by clinicians for a quick assessment of splenic injury. Results: Of the 39 patients meeting the inclusion criteria, 6 patients were managed operatively and 33 nonoperatively. There was a significant difference in CBHS between the OM (operative management) group and the NOM group.(p=0.03) CBHS showed correlation with Hb (hemoglobin), Hct (hematocrit), spleen injury grade(AAST), and Hounsfield unit of ROI (Region of interest). (p=0.17, p=0.18, p<0.000, p=0.02, respectively) After successful NOM with stabilized Hb level, the amount of hemoperitoneum was scored in the follow-up CT. CBHS demonstrated correlation with decreased spleen injury grade, decreased Hounsfield unit of ROI (Region of interest) (p=0.039, p=0.049, respectively), and also objectively reflected patient recovery. Conclusion: CBHS can be used as an objective and intuitive tool for clinicians in grading the severity of splenic injury by scoring the amount of hemoperitoneum, and in assessing recovery.