• Asian Pacific Journal of Cancer Prevention
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• 제16권7호
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• pp.2915-2921
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• 2015

Background: Some recent clinical trials have been conducted to evaluate a combination of EGFR- TKI with chemotherapy for advanced NSCLC patients as second-line therapy, but the results on the efficacy of such trials are inconsistent. The aim of this meta-analysis was to evaluate the efficacy and safety of combination of EGFR-TKI and chemotherapy for patients with advanced NSCLC who failed first-line treatment. Materials and Methods: We searched relative trials from PubMed, EMBASE, ASCO Abstracts, ESMO Abstracts, Cochrane Library and Clinical Trials.gov. Outcomes analyzed were overall response rate (ORR), progression- free survival (PFS), overall survival (OS) and major toxicity. Results: Seven trails eventually were included in this meta-analysis, covering 1,168 patients. The results showed that the combined regimen arm had a significant higher ORR (RR 1.76 [1.16, 2.66], p=0.007) and longer PFS (HR 0.75 [0.66-0.85], p<0.00001), but failed to show effects on OS (HR 0.88 [0.68-1.15], p=0.36). In terms of subgroup results, continuation of EGFR-TKI in addition to chemotherapy after first-line EGFR-TKI resistance confered no improvement in ORR (RR 0.95 [0.68, 1.33], p=0.75) and PFS (HR 0.89[0.69, 1.15], p=0.38), and OS was even shorter (HR1.52 [1.05-2.21], p=0.03). However, combination therapy with EGFR-TKI and chemotherapy after failure of first-line chemotherapy significantly improved the ORR (RR 2.06 [1.42, 2.99], p=0.0002), PFS (HR 0.71 [0.61, 0.82], p<0.00001) and OS (HR 0.74 [0.62-0.88], p=0.0008), clinical benefit being restricted to combining EGFR-TKI with pemetrexed, but not docetaxel. Grade 3-4 toxicity was found at significantly higher incidence in the combined regimen arm. Conclusions: Continuation of EGFR-TKI in addition to chemotherapy after first-line EGFR-TKI resistance should be avoided. Combination therapy of EGFR-TKI and pemetrexed for advanced NSCLC should be further investigated for prognostic and predictive factors to find the group with the highest benefit of the combination strategy.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.515-521
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• 2013

Purpose: To evaluate the efficacy and toxicity of induction chemotherapy followed by concurrent chemoradiotherapy (the treatment group) versus concurrent chemoradiotherapy with or without adjuvant chemotherapy (the control group) for locoregionally advanced nasopharyngeal carcinoma. Methods: The search strategy included Pubmed, Embase, the Cochrane Library, China National Knowledge Internet Web, Chinese Biomedical Database and Wanfang Database. We also searched reference lists of articles and the volumes of abstracts of scientific meetings. All randomized controlled trials were included for a meta-analysis performed with RevMan 5.1.0. The Grading of Recommendations Assessment, Development, and Evaluation system (GRADE) was used to rate the level of evidence. Results: Eleven studies were included. Risk ratios of 0.99 (95%CI 0.72-1.36), 0.37 (95%CI 0.20-0.69), 1.08 (95%CI 0.84-1.38), 0.98 (95%CI 0.75-1.27) were observed for 3 years overall survival, 3 years progression-free survival, 2 years loco-regional failure-free survival and 2 years distant metastasis failure-free survival. There were no treatment-related deaths in either group in the 11 studies. Risk ratios of 1.90 (95%CI 1.24-2.92), 2.67 (95%CI 0.64-11.1), 1.04 (95%CI 0.79-1.37), 0.98 (95%CI 0.27-3.52) were found for grade 3-4 leukopenia, grade 3-4 thrombocytopenia, grade 3-4 mucous membrane, and grade 3-4 hepatic hematologic and gastrointestinal toxicity, the most significant toxicities for patients. Conclusion: Compared with the control group, induction chemotherapy followed by concurrent chemoradiotherapy was well tolerated but could not significantly improve prognosis in terms of overall survival, loco-regional failure-free survival or distant metastasis failure-free survival.

• 한국과학교육학회지
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• 제19권3호
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• pp.400-408
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• 1999

본 연구에서는 화학 개념 학습에 적용한 협동학습에서 소집단 구성 방법의 효과를 조사하였다. 연구에 사용된 두 가지 소집단 구성 방법은 사전 성취 수준 측면에서 상 중 하위 수준의 학습자가 모두 포함된 HML(High-Medium-Low) 방법과 상 하위 수준의 학습자로 구성된 소집단과 중위 수준의 학습자로만 구성된 소집단이 공존하는 HL/MM(High Low/Medium-Medium) 방법이다. 서울 지역의 고등학교에서 3개 학급(136명)을 선정하여 통제 집단과 처치 집단으로 무선 배치하였다. 수업 처치 전에 과학 수업에 대한 태도 검사 참여도 마찰도 경쟁도의 하위 영역으로 구성된 학습 환경에 대한 인식검사, 그리고 자아 존중감 검사를 실시하였고, 중간고사 성적을 구하였다. 각 점수는 공변인으로 사용하였다. 수업 처치 후, 사전 검사로 실시한 세 검사와 개념 이해도 검사를 실시하였다. 이원 공변량 분석 결과, 개념 이해도에서 수업 처치와 사전 성취 수준 사이에 상호작용 효과가 있었다. 하위 수준에서 HL/MM 협동학습 집단의 개념 이해도가 다른 두 집단에 비하여 유의미하게 높았다. 학습 환경에 대한 인식 중 참여도 영역에서는 소집단 구성 방법에 관계없이 협동학습 집단 학생들이 통제 집단 학생들보다 긍정적으로 인식하였다.

• 한국환경성돌연변이발암원학회지
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• 제19권1호
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• pp.46-55
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• 1999

To develop a chemopreventive strategy based on the different stages of premalignant lesions, we hypothesized that the inhibitory effect of chemopreventive agents is influenced by different promotion stages during carcinogenesis. DMBA-TPA-induced skin carcinogenesis was used with ICR mice and chlorophyllin (CHL) was applied as a chemopreventive agent. In vitro assay was performed with Salmonella typhi. TA100 to observe any anti-mutagenic activity of CHL against DMBA. Pre-initiation and pre-promotion effects of CHL were observed by CHL treatment before initiation and before promotion. To evaluate the inhibitory effect at different promotion stages, each group was divided into three subgroups after TPA promotion for 6, 18 and 24 weeks, respectively ; the first subgroup was immediately sacrificed after termination of TPA, the second subgroup was treated with CHL, and the third subgroup was sacrificed 8 weeks after termination of TPA without CHL treatment. The degrees of epithelial dysplasia, papilloma formation, and invasive carcinoma were observed histologically, and GST-Pi expression was observed immunohistochemically. ODC mRNA level was analyzed by reverse transcriptase-polymerase chain reaction. Results showed : CHL dose-dependently inhibited the mutation of Salmonella typhi. TA100; the incidence of epithelial dysplasia and papilloma formation was lower in pre-initiation and pre-promotion CHL-treated mice than DMBA-TPA-treated mice; no invasive carcinoma developed in pre-initiation CHL-treated groups, while 67% of DMBA-TPA treated mice had carcinomas; GST-Pi expression decreased when CHL was treated before initiation and before promotion; and when CHL was treated after termination of TPA application at 18 and 24- week-TPA promotion stages, respectively, the incidence of epithelial dysplasia and papilloma was markedly reduced compared to non-treated groups. When comparing the incidence of epithelial dysplasia and papilloma between the immediately-sacrificed subgroup and the non-treated group with a waiting period, we speculated that the 18-week-TPA promotion stage might belong to the promoter-independent progression stage. At the 18-week-TPA promotion stage, the level of ODC mRNA in the CHL-treated group was clearly reduced to the level of normal tissue. Taking these results together, CHL showed both anti-initiation and anti-promotion effects, while the inhibitory effect of CHL was prominent in the 18-week-TPA promotion stage. However, CHL seems to be incapable of completely blocking the progression in the 24-week-TPA promotion stage.

• BMB Reports
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• 제42권1호
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• pp.59-64
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• 2009

Hepatitis B virus (HBV) infection is highly prevalent worldwide. The major challenge for current antiviral treatment is the elevated drug resistance that occurs via rapid viral mutagenesis. In this study, we developed AAV vectors to simultaneously deliver two or three shRNAs targeting different HBV-related genes. These vectors showed markedly better antiviral effects than ones that delivered a single shRNA in vitro. A dual shRNA expression vector (AAV-157i/1694i), which simultaneously expressed two shRNAs targeted the S and X genes of HBV, reduced HBsAg, HBeAg and HBV DNA levels by $87{\pm}4$, $80.3{\pm}2.6$ and $86.2{\pm}7%$ respectively, eight days post-transduction. In a mouse model of prophylactic treatment, HBsAg and HBeAg were reduced to undetectable levels and the serum HBV DNA level was reduced by at least 100 fold. These results indicate that AAV-157i/1694i generates potent anti-HBV effects and that the strategy of constructing multi-shRNA expression vectors may lead to enhanced anti-HBV efficacy and overcome the evading mechanism of the virus and thus the development of drug resistance.

• 생명과학회지
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• 제19권3호
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• pp.343-348
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• 2009

벼도열병균은 벼의 주요 병해인 벼도열병의 원인균이다. 식물병원균의 침입 시 식물체로부터 발생하는 ROS는 식물의 방어기작으로 중요하며, 특히 아미노산의 하나인 methionine은 ROS에 의해 산화되어 methionine sulfoxide로 변화될 수 있다. 식물병원균은 식물체로 부터의 ROS에 의한 산화반응을 회피하기 위해 methionine sulfoxide reductase B (MSRB)와 같은 항산화 효소를 가지는데 본 연구에서는 벼도열병균에서의 MSRB 유전자를 동정하고 분자적 특성을 살펴보았다. MSRB 유전자는 벼도열병균의 게놈 상에 단일 유전자로 존재하며 과산화수소 처리에 의해 유전자발현이 다소 증가하는 경향을 보였다. 이러한 결과로 MSRB 유전자는 벼도열병균의 항산화 기작에 관여할 가능성이 높다고 판단된다.

• Journal of Hospice and Palliative Care
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• 제19권3호
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• pp.201-210
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• 2016

섬망은 완화치료를 받는 말기암환자에서 흔히 나타나는 증상으로 임종기에 접어들수록 빈도는 증가한다. 섬망은 환자와 가족의 삶의 질에 부정적인 영향을 줄 뿐 아니라, 높은 사망률과 관련되어 있으나 실제 임상에서 의료진들이 적절히 인지하지 못하고 있다는 연구들이 보고되고 있다. 이는 우울이나 치매와 같은 정신질환과의 중복되는 특성, 섬망에 대한 평가 및 진단에 대한 지식의 부족 등이 원인으로 생각되고 있다. 이를 개선하기 위해 현재까지 알려진 섬망 선별검사를 통해 섬망환자를 정확히 인지하고, 진단하는 것이 완화의료 영역에서 섬망 증상 관리에 우선되어야 할 분야로 생각된다. 섬망이 진단되었을 때는 유발요인을 확인하고 약물이나 탈수, 감염 등의 가역적인 원인에 대해서는 이를 교정하는 것이 섬망을 조절에 가장 중요한 부분이다. 이와 함께 소음을 줄이거나, 적절한 조명을 유지하는 등의 환자의 주변 환경을 안정적으로 유지하는 등의 비약물적 치료가 병행되어야 한다. 비약물적 치료로 효과가 없거나, 증상이 심한 경우에 항정신병 약물과 벤조디아제핀과 같은 진정효과가 있는 약물을 사용할 수 있으며, 현재까지는 저용량의 할로페리돌 투여가 가장 효과적인 치료 약제로 인정되고 있다. 비정형적 항정신병 약물로는 Olanzapine, Quetiapine, Risperidone 등이 있으며 현재까지 보고된 바로는 할로페리돌과 비교하여 섬망 개선 효과는 비슷하나 추체외로 증상이 드물고 진정 효과가 있어 경구 섭취가 가능한 경우 고려해 볼 수 있는 약제로 생각된다. 현재까지 완화의료 영역에서의 섬망에 사용할 수 있는 약물에 대한 연구 결과는 근거가 충분하지 않은 상태이며, 이로 인해 임상에서 활용할 수 있는 임상진료 지침 또한 부족한 상태이다. 현재까지는 중환자실, 노인 환자에서의 연구 결과를 바탕으로 한 결과를 토대로 완화의료 영역에서의 섬망 치료에 이용하였지만 추후 말기암환자에서의 섬망에 대한 연구를 바탕으로 한 임상진료지침의 개발도 필요할 것으로 생각된다.

• Asian-Australasian Journal of Animal Sciences
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• 제23권10호
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• pp.1354-1363
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• 2010

This study compared the effect of four different feeding methods for gestating gilts on reproductive performance and growth of their progeny. A total of 40 F1 primiparous sows (Yorkshire${\times}$Landrace) were allotted to four treatments in a completely randomized design (CRD). For treatments, gestating period of sows was divided into three trimesters (0-35 d, 36-90 d and 91-110 d) and different amounts of feed were provided to each treatment group by Flat, Down-Up-Down (DUD), Up-Down-Up (UDU) and Down-Up-Up (DUU) feeding methods. The experimental diet was formulated to meet or exceed the standards of NRC (1998). Body weight gain of gestating gilts from d 0 to 110 was affected by feeding method (p<0.05). When gilts were fed constant feed ration (Flat feeding), less body weight loss was observed during lactation (-0.9 kg, p<0.05) and desirable backfat thickness (average 19.5 mm) was acquired at 110 days of gestation. Feed intake of lactating sows tended to be greater (4.22, 3.60, 3.97 and 4.13 kg/d, p>0.05) as sows in Flat feeding treatment had lower backfat thickness during gestation compared with other treatments (p<0.05). When gestating gilts were fed higher amount of feed during mid-trimester, the number of stillborn (1.4 piglet per litter, p<0.05) and mummies (0.8 piglet per litter, p = 0.25) were increased compared to other treatments. Feeding methods for gestating gilts had no effect on litter weight and gain of litter weight during the nursing period. Flat feeding method resulted in decreased plasma glucose concentration at 7 d postpartum (p<0.05), and increased LH concentration at 21 d postpartum (p<0.01) compared to other treatments. These results suggested that higher feed intake of gestating gilts resulted in detrimental effects on body condition and reproductive performance of sows. When gestating gilts consumed constant feed during gestation (2 kg/d), better reproductive performance and less body weight loss in lactation were observed because sows consumed more feed during the whole lactation period. Consequently, Flat feeding will be a desirable feeding strategy for gestating gilts to maximize reproductive performance, and better body condition of sows without any negative influence on the growth of their progeny.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.6033-6038
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• 2015

Background: Experience of lung cancer includes negative impacts on both physical and psychological health. Pain is one of the negative experiences of lung cancer. Cognitive behavioral therapy techniques are often recommended as treatments for lung cancer pain. The objective of this review was to synthesize the evidence on the effectiveness of cognitive behavioral therapy techniques in treating lung cancer pain. This review considered studies that included lung cancer patients who were required to 1) be at least 18 years old; 2) speak and read English or Thai; 3) have a life expectancy of at least two months; 4) experience daily cancer pain requiring an opioid medication; 5) have a positive response to opioid medication; 6) have "average or usual" pain between 4 and 7 on a scale of 0-10 for the day before the clinic visit or for a typical day; and 7) able to participate in a pain evaluation and treatment program. This review considered studies to examine interventions for use in treatment of pain in lung cancer patients, including: biofeedback, cognitive/attentional distraction, imagery, hypnosis, and meditation. Any randomized controlled trials (RCTs) that examined cognitive behavioral therapy techniques for pain specifically in lung cancer patients were included. In the absence of RCTs, quasi-experimental designs were reviewed for possible conclusion in a narrative summary. Outcome measures were pain intensity before and after cognitive behavioural therapy techniques. The search strategy aimed to find both published and unpublished literature. A three-step search was utilised by using identified keywords and text term. An initial limited search of MEDLINE and CINAHL was undertaken followed by analysis of the text words contained in the title and abstract, and of the index terms used to describe the article. A second search using all the identified keywords and index terms was then undertaken across all included databases. Thirdly, the reference list of all identified reports and articles were searched for additional studies. Searches were conducted during January 1991- March 2014 limited to English and Thai languages with no date restriction. Materials and Methods: All studies that met the inclusion criteria were assessed for methodological quality by three reviewers using a standardized critical appraisal tool from the Joanna Briggs Institute (JBI). Three reviewers extracted data independently, using a standardized data extraction tool from the Joanna Briggs Institute (JBI). Ideally for quantitative data meta-analysis was to be conducted where all results were subject to double data entry. Odds ratios (for categorical data) and weighted mean differences (for continuous data) and their 95% confidence intervals were to be calculated for analysis and heterogeneity was to be assessed using the standard Chi-square. Where statistical pooling was not possible the finding were be presented in narrative form. Results: There were no studies located that met the inclusion requirements of this review. There were also no text and opinion pieces that were specific to cognitive behavioral therapy techniques pain and lung cancer patients.Conclusions: There is currently no evidence available to determine the effectiveness of cognitive behavioural therapy techniques for pain in lung cancer patients.

• 성인간호학회지
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• 제13권1호
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• pp.123-135
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• 2001

The purpose of this study is to analyze the structural pattern of nurses' pain management with patients who experience pain. As a research method, the Q methodology, which is useful for an objective view of a highly abstract concept, was applied. The data collecting activity of this study was from August, 21st, 2000 to November, 24th 2000. The Q-population, the previous thesis and a literature review were done. Questions about pain management by the nurse on the patients, caregivers, nursing students, doctors, nurses, and others were asked in documentary work and in-depth interviews. In all, 223 units of the Q-population were formed, and the last 35 units of the Q-population were extracted. The data on the P-sample was collected from 41 nurses who worked in the medical and surgical units of a hospital that belonges to C university in Seoul. The research results were constituted in 3 types. Type I was the 'pattern of judging by objectivity'. The statement on which most of the people highly agreed for those patterns was shown by 'If patients said that they are suffering from pain, we sufficiently performed an assessment about the etiology, location, duration and degree'. For type I, the same pain was found in different locations according to the patients, so the etiology of the pain should be identified first place. Since ways of coping are different according to pain etiology, it was thought that it is important to assess sufficiently the pain etiology, location, duration, and degree. Therefore, when patients complain of pain, the pain etiology should be identified and assessed; according to the result, pain management should be performed systematically. Type II was the 'pattern of accepting by subjectivity'. The statement on which most of the people highly agreed for those patterns was shown as 'If patients said that they are suffering from pain, the medical treatment should be performed rapidly and speedily.' For type II, when the patient complains of pain, treatment should be performed quickly in order to prevent the condition getting worse, and it is thought that activity is a reasonable duty. Further, by trying to show empathy after pain is admitted and by understanding and coping rapidly with the pain of patients, an attitude which matched the altruistic morals of nurses is being shown. Type III was the 'pattern of worrying about', and the statement on which most of the people highly agreed for those patterns was shown is 'When there is a pain, to help patients to tolerate the pain to the highest degree.' In type III, the pain is a subjective expression, so there is a difference according to every individual. Therefore, actually if there is no measurement of pain, it could be exaggerated so nurses should help patients to tolerate it to the utmost. Even if there is a way to remove pain without an analgesic drug, nurses were reluctant to perform pain management as they possibly could. Through these research results, pain management of nurses was classified in 3 types, and structural characteristics in each type were discovered. Based upon the characteristics according to the type, an individualized pain management intervention strategy should be established and the follow up work performed.