• 제목/요약/키워드: treatment outcome

검색결과 2,840건 처리시간 0.039초

Influence of Serum VEGF Levels on Therapeutic Outcome and Diagnosis/Prognostic Value in Patients with Cervical Cancer

  • Du, Ke;Gong, Hong-Ying;Gong, Zhi-Min
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권20호
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    • pp.8793-8796
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    • 2014
  • Objective: To explore the influence of serum vascular endothelial growth factor (VEGF) level on therapeutic outcome and diagnosis/prognostic value in patients with cervical cancer. Materials and Methods: A total of 37 patients diagnosed with cervical cancer by biopsy were selected and treated with concurrent chemoradiotherapy. Double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) was adopted before treatment to assess VEGF levels, and its relationships with clinicopathological features and short-term therapeutic effects were analyzed. Results: The median VEGF level in 37 patients before treatment was 647.15 (393.35~1125.16) pg/mL. Serum VEGF levels in patients aged <50 years, in International Federation of Gynecology and Obstetrics (FIGO) stage IIIa~IVa, with lymph node metastasis and tumor size >4 cm were significantly increased (P<0.05). The complete remission (CR) rate was 48.7% (18/37), partial remission (PR) rate was 35.1% (13/37), stable disease (SD) rate was 13.5% (5/37) and progressive disease (PD) rate was 2.70% (1/37), so the objective remission rate (ORR) after treatment was 83.8% (31/37). Logistic regression analysis showed that tumor size and serum VEGF level before treatment were independent risk factors affecting the therapeutic outcome, and the higher the level of serum VEGF, the worse the prognosis when tumor size>4 cm. Some 56.8% of patients manifested with myelosuppression, 37.8% with leucopenia, 24.3% with thrombocytopenia, 5.41% with diarrhea, 46.0% with nausea and vomiting, 21.6% with hair loss and 8.11% with hepatic and renal injury during the treatment. Conclusions: Serum VEGF level may reflect the degree of malignancy of cervical cancer and predict therapeutic effect, which is of great importance to cancer diagnosis and prognosis.

Clinical Outcomes of Spontaneous Spinal Epidural Hematoma : A Comparative Study between Conservative and Surgical Treatment

  • Kim, Tackeun;Lee, Chang-Hyun;Hyun, Seung-Jae;Yoon, Sang Hoon;Kim, Ki-Jeong;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • 제52권6호
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    • pp.523-527
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    • 2012
  • Objective : The incidence of spontaneous spinal epidural hematoma (SSEH) is rare. Patients with SSEH, however, present disabling neurologic deficits. Clinical outcomes are variable among patients. To evaluate the adequate treatment method according to initial patients' neurological status and clinical outcome with comparison of variables affecting the clinical outcome. Methods : We included 15 patients suffered from SSEH. Patients were divided into two groups by treatment method. Initial neurological status and clinical outcomes were assessed by the American Spinal Injury Association (ASIA) impairment scale. Also sagittal hematoma location and length of involved segment was analyzed with magnetic resonance images. Other factors such as age, sex, premorbid medication and duration of hospital stay were reviewed with medical records. Nonparametric statistical analysis and subgroup analysis were performed to overcome small sample size. Results : Among fifteen patients, ten patients underwent decompressive surgery, and remaining five were treated with conservative therapy. Patients showed no different initial neurologic status between treatment groups. Initial neurologic status was strongly associated with neurological recovery (p=0.030). Factors that did not seem to affect clinical outcomes included : age, sex, length of the involved spinal segment, sagittal location of hematoma, premorbid medication of antiplatelets or anticoagulants, and treatment methods. Conclusion : For the management of SSEH, early decompressive surgery is usually recommended. However, conservative management can also be feasible in selective patients who present neurologic status as ASIA scale E or in whom early recovery of function has initiated with ASIA scale C or D.

습관성 유산 환자에서 저용량 면역글로불린 치료와 말초혈액 내 Natural Killer (NK) 세포의 임계치에 관한 연구 (The Preconceptional Level of Peripheral Natural Killer Cells which was Expected to Bring Successful Treatment Outcome using Low-dose Intravenous Gamma Immunoglobulin (IVIg) Infusion in Patients with Recurrent Spontaneous Abortion)

  • 차선화;김해숙;김혜옥;송인옥;유근재;궁미경;강인수;양광문
    • Clinical and Experimental Reproductive Medicine
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    • 제32권3호
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    • pp.217-222
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    • 2005
  • Objectives: We aimed to investigate the clinical effect of low-dose intravenous immunoglobulin treatment in unexplained recurrent spontaneous aborters (RSA) with elevated peripheral CD56+ natural killer (NK) cell levels and to determine the pre-conceptional NK cell percentage predictive of subsequent successful pregnancy outcome. Materials and Methods: Sixty four cases of unexplained recurrent miscarriage with elevated peripheral NK cells (>15%) were received low dose IVIg infusion at the dosage of 400 mg/Kg/month after confirmation of gestational sac and continued until 20 weeks. The patients were divided into two groups according to the pregnancy outcome: Group I was success of treatment defined as live birth at or after 25 gestational weeks and Group II was failure of treatment. The preconceptional levels of the peripheral blood NK cells were compared between two groups. Results: Fifty-three pregnancies resulted in live births after 25 weeks and 11 resulted in abortion (Overall success rate of IVIG treatment was 82.8%). Preconceptional CD56+ NK cell percentage in group II ($27.4{\pm}1.9%$) was higher than those in group I ($22.3{\pm}0.8%$). By using ROC curve, optimal discrimination between success and failure of treatment was achieved with ${\leq}27%$ of preconceptional NK cell percentage. Conclusion: In RSA patients with elevated NK cells, we suggest that preconceptional peripheral blood CD56+ NK cell level could be a useful marker for predicting successful treatment outcome of low-dose IVIg infusion.

혈액투석을 받고있는 환자에서 자발성 뇌출혈 (Cerebral Hemorrhage in Patients on Maintenance Hemodialysis)

  • 박재석;문재곤;김창현;이호국;황도윤
    • Journal of Korean Neurosurgical Society
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    • 제30권sup1호
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    • pp.115-119
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    • 2001
  • Objective : The cause and clinical outcome of cerebral hemorrhage in patients on maintenance hemodialysis have been poorly studied in korea. The purpose of this paper is to clarify the clincal features and the outcome of cerebral hemorrhage in patients on maintenance hemodialysis. Method : We analyzed clincal features and the outcome of cerebral hemorrhage in 14 patients on maintenance hemodialysis. Hematomas were reviewed and evaluated for location, size, and intraventricular extension by the one of the authors without any prior informations. The axial slice of CT film that the hematoma was appeared in maximal dimension was chosen for evaluations. Result : Hypertension was found in 71.4%(10 cases) and motality rate was 78.5%(11 cases). Basal ganglia hemorrhage was found in 50%(7 cases), subcortex in 28.5%(4 cases), pons in 14.2%(2 cases). Size of hematoma in patients on maintenance hemodialysis was significantly larger than that of hypertensive cerebral hemorrhage patients(p=0.0061). The 4 cases of basal ganglia hemorrhage without intraventricular hemorrhage and subarachnoid hemorrhage were good mental state at the onset of stroke because of small mass effect relative to the size of hematoma. The duration of hemodialysis treatment prior to strokes ranged from 1 to 107 months. Strokes developed within 6 hours of the previous hemodialysis are 5 cases. Average serum albumin concentration was 3.4g/dl. The use of heparin is less responsible for the development of cerebral hemorrhage in patients on maintenance hemodialysis Conclusion : Cerebral hemorrhage in patients on maintenance hemodialysis is more severe in terms of hematoma size and clinical outcome. Therefore, the prevention and treatment of cerebral hemorrhage in patients on maintenance hemodialysis should be more aggressive.

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Identification of indirect effects in the two-condition within-subject mediation model and its implementation using SEM

  • Eujin Park;Changsoon Park
    • Communications for Statistical Applications and Methods
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    • 제30권6호
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    • pp.631-652
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    • 2023
  • In the two-condition within-subject mediation design, pairs of variables such as mediator and outcome are observed under two treatment conditions. The main objective of the design is to investigate the indirect effects of the condition difference (sum) on the outcome difference (sum) through the mediator difference (sum) for comparison of two treatment conditions. The natural condition variables mean the original variables, while the rotated condition variables mean the difference and the sum of two natural variables. The outcome difference (sum) is expressed as a linear model regressed on two natural (rotated) mediators as a parallel two-mediator design in two condition approaches: the natural condition approach uses regressors as the natural condition variables, while the rotated condition approach uses regressors as the rotated condition variables. In each condition approach, the total indirect effect on the outcome difference (sum) can be expressed as the sum of two individual indirect effects: within- and cross-condition indirect effects. The total indirect effects on the outcome difference (sum) for both condition approaches are the same. The invariance of the total indirect effect makes it possible to analyze the nature of two pairs of individual indirect effects induced from the natural conditions and the rotated conditions. The two-condition within-subject design is extended to the addition of a between-subject moderator. Probing of the conditional indirect effects given the moderator values is implemented by plotting the bootstrap confidence intervals of indirect effects against the moderator values. The expected indirect effect with respect to the moderator is derived to provide the overall effect of moderator on the indirect effect. The model coefficients are estimated by the structural equation modeling approach and their statistical significance is tested using the bias-corrected bootstrap confidence intervals. All procedures are evaluated using function lavaan() of package {lavaan} in R.

여드름의 한약 치료 임상연구에 대한 비뚤림 위험 평가 (The Assessment of Risk of Bias on Clinical Studies of Herbal Treatment for Acne)

  • 박혜련;노석선
    • 혜화의학회지
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    • 제24권1호
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    • pp.15-24
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    • 2015
  • Objectives : This study was carried out to assess the risk of bias of clinical trials on acne treatment with herbal medicine that have been published in Korea. Methods : 7 electronic databases in Korea were searched for clinical trials on acne treatment. Two independent reviewers selected clinical trials on herbal medicine treatment for acne. Selected studies are categorized according to DAMI(Study Design Algorithm for Medical literature of Intervention). RCTs are assessed according to Cochrane RoB(Risk of Bias), non-randomized studies(Before-after studies) are assessed according to RoBANS(Risk of Bias Assessment tool for Non-randomized Study). Results : After selection process, 25 articles are left. Among 25 articles, 3 RCTs and 4 before-after studies are finally included. In RCTs, the proportion of 'unclear' is high in criteria of 'random sequence generation', 'allocation concealment', and 'blinding'. In before-after studies, 'high' is high in criteria of 'blinding for outcome assessment' and 'incomplete outcome data'. Conclusions : Considering the above results of the assessment, it is necessary to conduct more well designed clinical trials on acne treatment with herbal medicine.

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특발성 말초성 안면신경마비(Bell's Palsy)에 대한 한방치료와 양방병용치료의 비교 고찰 (Comparative Clinical Study between Oriental Medicine and Oriental-Western Medicine Treatment on Bell's palsy)

  • 김남옥;채상진;손성세
    • Journal of Acupuncture Research
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    • 제18권5호
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    • pp.99-108
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    • 2001
  • Objective : Lately variable oriental-western medicine treatment have been used for Bell's palsy. The purpose of this study is comparison of clinical treatment outcome between oriental medicine group and oriental-western medicine group. Materials and Methods : From 08-01-2000 to 07-30-2001, 30 Bell's palsy out-patients who visited within 5days after onset and treated more than 3weeks at the Department of Acupuncture & Moxibustion, Bundang CHA Oriental Medicine Hospital were selected for two groups. One group(A group) was treated by oriental medicine therapy(Acupunture, Herb, Physical therapy), the other group(B group) was treated by oriental-western medicine therapy(Acupunture, Herb, Physical therapy, Administration of prednison). Two group was composed of 15 patients respectively and measured by HBGS(House-Brackmann Grading System) and DEFS(Detailed Evaluation of Facial Symmetry of Pillsbury and Fisch) at first visit and 3weeks after. Result and Conclusion : A group was marked more higher than B group in treatment outcome. But we discovered that it is not significant differences between two groups.

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소음인 태음증으로 진단한 소뇌성 운동실조 환자 1례 (A Case Study of Soeumin Greater Yin Symptomatology Patient Diagnosed as Cerebellar Ataxia)

  • 박유경;이미숙;배나영
    • 사상체질의학회지
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    • 제26권2호
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    • pp.194-204
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    • 2014
  • Objectives The aim of this study was to examine significant improvement of gait ataxia, vertigo and tremor after treatment with Sipyimigwanjung-tang, Hyangsayangwi-tang in a Soeumin Greater Yin Symptomatology patient Diagnosed as Cerebellar ataxia. Methods The patient was diagnosed with Soeumin Greater Yin Symptomatology and treated with Soeumin's constitutional medications and acupuncture. The primary outcome measures for this study were the Unified Multiple System Atrophy Rating Scale(UMSARS) and Cerebellar function test to assess the overall function of patient. Secondary outcome assessment included Global Assessment Scale(GAS), change of patient's sleep, stool and digestion. Results The symptoms of gait ataxia, vertigo and tremor decreased from GAS 100 to GAS 0~40 after treatment, and the UMSARS score decreased in Part I, II. Conclusions This case showed that Sasang Constitutional medicine treatment can be effective treatment method for cerebellar ataxia. We consider that consistent treatment can contribute to improve the patient's quality of life.