• Title/Summary/Keyword: treatment strategy

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The Palliative Care and Hospice for the People Living with HIV (HIV 감염인을 위한 완화의료와 호스피스)

  • Choi, Jae-Phil
    • Journal of Hospice and Palliative Care
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    • v.20 no.3
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    • pp.159-166
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    • 2017
  • According to the advance of antiretroviral regimen and the early treatment strategy, people living with human immunodeficiency virus (PLWH) are achieving the goal of virologic suppression and immune restoration. Most of them no more die of acquired immunodeficiency syndrome (AIDS) defining illnesses, and become older with chronic comorbidities such as cardiovascular, metabolic, hepatic, renal and neurological diseases. However some PLWH still visit hospitals as late presenters with very low CD4+ T cell counts, so that they suffer AIDS defining illnesses to die or experience severe neurological complications resulting in disabilities. Early palliative interventions are needed on the various symptoms of PLWH. Thus far chronic pains such as distal symmetric sensory polyneuropathies have been underevaluated. Active pain-relieving interventions are important to them. Recently we define end of life condition of human immunodeficiency virus (HIV) or eligibility to hospice care after adjusting current status of HIV treatment. Hospice teams should pay attention to the specific medical conditions, psychological needs, and social circumstances of PLWH. With just standard precautions as common infection control measures, general hospice cares can be provided to them like to other hospices subjects. For giving PLWH opportunities to have the end of life with value and dignity, hospice multidisciplinary team should intervene them early and aggressively. Now we need more clinical experiences and institutional improvements.

Angiocentric Immunoproliferative Lesions(AILs) in Nose (코의 Angiocentric Immunoproliferative Lesions(AILs))

  • Han Ji-Youn;Kim Jae-You;Lee Youn-Soo;Chung Su-Mee;Kim Min-Shik;Yoon Sei-Chul;Kim Hoon-Kyo;Cho Seung-Ho;Kim Byung-Kee;Lee Kyung-Shik;Kim Dong-Jip
    • Korean Journal of Head & Neck Oncology
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    • v.12 no.1
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    • pp.16-21
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    • 1996
  • Lymphomatoid granulomatosis, polymorphic reticulosis, midline malignant reticulosis, or lethal midline granuloma have similar histologic features of an angiocentric and angiodestructive lymphoreticular proliferation representing the same nosologic entity. The term 'angiocentric immunoproliferative lesion' (AIL) was proposed by Jaffe, Costa, and Martin. The malignant potential of AILs is originally uncertain, but the facts that AILs have a relatively short survival, and most of them usually progress to an overt malignant lymphoma and survival is inversely proportional to the large, atypical lymphoreticular cells suggest that AILs are malignane. We experienced 17 AILs in nose during 16-year period and retrogradely analized them to recognize the problems in the diagnosis and to establish the further therapeutic strategies. The results were as follows; Twelve of total 17 patients who had diagnosed as histologic grade 1 and 2 had received radiation therapy as an initial treatment and the complete response rate was 91.7%(11/12), but 6 out of 11 had local recurrence and 5 had progress to overt maligant lymphoma within 2years. Three patients with the histologic grade 3 and 2 with unclear histologic grade had received CHOP chemotherapy and there was 1 case with complete response. Two patients with unclear histologic grade had been proved to be malignant histiocytosis by bone marrow biopsy during the clinical course. The overall duration of survival was 2 - 119 months and the 5-year survival rate was 71.9%. And the achievement of initial complete response was the most important prognostic factor of overall survival(P=0.006). Our results suggest that the treatment strategy according to the histologic grading scheme is efficient and more aggressive combination chemotherapy may be necessary to achieve complete response in patients with histologic grade III and II, because most of them progress to overt malignant lymphoma during its process.

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Analysis of the positive word-of-mouth, Quality of medical service and customer satisfaction of patients in dental clinics (치과의원 내원환자들의 긍정적 구전과 치과 의료서비스 품질 및 고객만족도 분석)

  • Yang, Hae-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.12
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    • pp.4928-4934
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    • 2010
  • Dental health care in modern society has gradually been developing with patients'expectation, desire, and medical knowledge according to the changes in the medical industry. Dental marketing strategy is necessary to construct a better dental health environment in order to cope with customers' changes and desire. The purpose of this study was to evaluate the positive comments by word-of-mouth experience, quality of dental clinic service and customer satisfaction among dental patients. The study surveyed 5oo subjects being treated at 6 dental clinics in Seoul and Gyeonggi province. It was conducted from March 22 to April 9, 2010. The subject groups with a positive experience through word - of - mouth who had a perception about the quality of dental clinic service (p<.001) and customer satisfaction (p<.001) were higher than other groups who had no comments on their dental treatment and clinics. The results showed that there was a correlation(r=. 852, p<.001) between the positive comments by word-of- mouthabout the quality of dental clinics service and customer satisfaction. The perception of dental clinic service and patients' satisfaction with positive comments by word of mouth was highly recognized by older and more experienced patients of dental treatment. Therefore, the results suggest that empirical information on important factors about strategic marketing lead to positive comments by word of mouth experience for patients in dental clinics.

Endoscopic Management of Pineal Region Tumors with Associated Hydrocephalus (수두증을 동반한 송과체 부위 종양에 대한 내시경적 치료)

  • Kim, Jeong Hoon;Ra, Young Shin;Kim, Joon Soo;Ahn, Jae Sung;Kim, Chang Jin;Kwun, Byung Duk
    • Journal of Korean Neurosurgical Society
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    • v.30 no.5
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    • pp.575-580
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    • 2001
  • Purpose : In general, pineal region tumors are managed by using microsurgical approach or stereoctactic biopsy. However, in selected cases endoscopic approach to pineal lesions might prove to be as effective as microsurgery and less invasive. We report an alternative surgical strategy for managing certain patients with pineal neoplasms that allows treatment of the symptomatic hydrocephalus as well as tumor biopsy under direct vision in the same sitting. Materials and Methods : Twenty-two patients with pineal region tumors with associated hydrocephalus were treated in one session by endoscopic third ventriculostomy and endoscopic tumor biopsy at our institution from October 1996 to January 2000. All patients were retrospectively evaluated. Results : There was no operative mortality. There was one cause of significant bleeding during biopsy, but was controlled endoscopically, and the patient recovered completely without neurologic deficit resulting from intra-operative bleeding. The symptoms related to increased intracranial pressure(ICP) have resolved in all patients, and the need for a shunt is completely eliminated. Histological diagnosis was achieved in 21 of the 22 patients by this procedure. A biopsy was not obtained in one patient. Although this pineal region tumor was seen endoscopically, this could not be biopsied because of technical difficulties in working around an enlarged massa intermedia. The lesions included fourteen germinomas, three mixed germ cell tumors, and one each of the followings: pineocytoma, pineoblastoma, pineocytoma/pineoblastoma(intermediate type), meningioma, and low grade glioma. Five of the 22 patients subsequently underwent formal microsurgical tumor removal. Additional chemotherapy or radiotherapy could then be initiated according to the histological diagnosis. Conclusion : We consider that endoscopy affords a minimally invasive way of reaching three objectives by one-step surgery in the management of pineal region tumors with associated hydrocephalus : 1) cerebrospinal fluid(CSF) sample for analysis of tumour markers and cytology, 2) treatment of hydrocephalus by third ventriculostomy, and 3) several biopsy specimens can be obtained identifying tumors which will require further open surgery or adjuvant radiation and/or chemotherapy. However, complications and morbidities should be emphasized so as to be avoided with further technical experience.

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Bioconverted Jeju Hallabong tangor (Citrus kiyomi × ponkan) peel extracts by cytolase enhance antioxidant and anti-inflammatory capacity in RAW 264.7 cells

  • Chang, Yun-Hee;Seo, Jieun;Song, Eunju;Choi, Hyuk-Joon;Shim, Eugene;Lee, Okhee;Hwang, Jinah
    • Nutrition Research and Practice
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    • v.10 no.2
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    • pp.131-138
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    • 2016
  • BACKGROUND/OBJECTIVES: Citrus and its peels have been used in Asian folk medicine due to abundant flavonoids and usage of citrus peels, which are byproducts from juice and/or jam processing, may be a good strategy. Therefore, the aim of this study was to examine antioxidant and anti-inflammatory effects of bioconversion of Jeju Hallabong tangor (Citrus kiyomi ${\times}$ ponkan; CKP) peels with cytolase (CKP-C) in RAW 264.7 cells. MATERIALS/METHODS: Glycosides of CKP were converted into aglycosides with cytolase treatment. RAW 264.7 cells were pre-treated with 0, 100, or $200{\mu}g/ml$ of citrus peel extracts for 4 h, followed by stimulation with $1{\mu}g/ml$ lipopolysaccharide (LPS) for 8 h. Cell viability, DPPH radical scavenging activity, nitric oxide (NO), and prostagladin $E_2$ ($PGE_2$) production were examined. Real time-PCR and western immunoblotting assay were performed for detection of mRNA and/or protein expression of pro-inflammatory mediators and cytokines, respectively. RESULTS: HPLC analysis showed that treatment of CKP with cytolase resulted in decreased flavanone rutinoside forms (narirutin and hesperidin) and increased flavanone aglycoside forms (naringenin and hesperetin). DPPH scavenging activities were observed in a dose-dependent manner for all of the citrus peel extracts and CKP-C was more potent than intact CKP. All of the citrus peel extracts decreased NO production by inducible nitric oxide synthase (iNOS) activity and $PGE_2$ production by COX-2. Higher dose of CKP and all CKP-C groups significantly decreased mRNA and protein expression of LPS-stimulated iNOS. Only $200{\mu}g/ml$ of CKP-C markedly decreased mRNA and protein expression of cyclooxygenase-2 in LPS-stimulated RAW 264.7 cells. Both 100 and $200{\mu}g/ml$ of CKP-C notably inhibited mRNA levels of $interleukin-1{\beta}$ ($IL-1{\beta}$) and IL-6, whereas $200{\mu}g/ml$ CKP-C significantly inhibited mRNA levels of $TNF-{\alpha}$. CONCLUSIONS: This result suggests that bioconversion of citrus peels with cytolase may enrich aglycoside flavanones of citrus peels and provide more potent functional food materials for prevention of chronic diseases attributable to oxidation and inflammation by increasing radical scavenging activity and suppressing pro-inflammatory mediators and cytokines.

The study was to investigate the Spontaneous therapy, TENS and Ice therapy of Biceps brachii after induction of DOMS (자연치유와 경피신경전기자극치료, 그리고 냉치료가 지연성근육통이 유발된 위팔두갈래근의 통증과 근력 및 근활성도에 미치는 영향)

  • Kim, Keun-Jo;Lee, Cu-Rie;Jung, Byeong-Ok;Bang, Hyun-Soo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.12
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    • pp.3902-3909
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    • 2009
  • The purpose of this study was to investigate the spontaneous therapy, TENS(transcutaneous electrical nerve stimulation) and ice therapy after induction of DOMS(delayed onset muscle soreness) through application of eccentrically exercise in ralation to biceps brachii muscle of opposite-dominance. And to explain this, we analyzed VAS(visual analogue scales), peak torque, RMS(roots mean square) when exercising elbow joint. The subjects were 30 adults without any physical defect. Subjects were divided into three groups that spontaneous therapy, TENS therapy and ice therapy after DOMS induction, choosen movement could get the maximal peak torque in angular velocity of $60^{\circ}$/sec, and mearsured peak torque, RMS and VAS. 1. The VAS was significantly decreased after 3 days application of TENS than other groups(p<.05). 2. The peak torque was significantly increased after 3 days application of TENS than other groups(p<.05). 3. The RMS was significantly increased after 3 days application of TENS than other groups(p<.05). This study showed that TENS therapy application were effective treatment strategy on DOMS than spontaneous therapy and ice therapy. Therefore, it could be considered as a treatment method in the patients with DOMS.

Four Cases of Extracorporeal Membrane Oxygenation for Congenital Diaphragmatic Hernia (체외막형산소섭취로 치료한 선천성 횡경막 탈장 4례)

  • Kim, Bo-Eun;Ha, Eun-Ju;Kim, Young-A;Kim, Seong-Uk;Park, Jeong-Jun;Yun, Tae-Jin;Kim, Dae-Yeon;Kim, Seong-Chul;Lee, Byong-Sop;Kim, Ellena;Kim, Ki-Soo;Pi, Soo-Young;Park, Seong-Jong
    • Neonatal Medicine
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    • v.16 no.1
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    • pp.64-70
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    • 2009
  • Congenital diaphragmatic hernia (CDR) with severe pulmonary hypoplasia is associated with significant mortality. Recently, several new therapeutic methods have been suggested, such as high-frequency oscillatory ventilation and inhaled nitric oxide. For hypoxemic respiratory failure unresponsive to these advanced medical treatment options, extracorporeal membrane oxygenation (ECMO) serves as the last potentially effective treatment. An understanding of the pathophysiology of pulmonary hypertension associated with CDH led to a strategy involving preoperative stabilization and delayed surgical intervention with ECMO. We describe four cases of ECMO, including the first report of ECMO for neonatal CDH in Korea.

Inhibition of chromosomal region maintenance 1 suppresses the migration and invasion of glioma cells via inactivation of the STAT3/MMP2 signaling pathway

  • Shan, Qianqian;Li, Shengsheng;Cao, Qiyu;Yue, Chenglong;Niu, Mingshan;Chen, Xiangyu;Shi, Lin;Li, Huan;Gao, Shangfeng;Liang, Jun;Yu, Rutong;Liu, Xuejiao
    • The Korean Journal of Physiology and Pharmacology
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    • v.24 no.3
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    • pp.193-201
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    • 2020
  • Chromosomal region maintenance 1 (CRM1) is associated with an adverse prognosis in glioma. We previously reported that CRM1 inhibition suppressed glioma cell proliferation both in vitro and in vivo. In this study, we investigated the role of CRM1 in the migration and invasion of glioma cells. S109, a novel reversible selective inhibitor of CRM1, was used to treat Human glioma U87 and U251 cells. Cell migration and invasion were evaluated by wound-healing and transwell invasion assays. The results showed that S109 significantly inhibited the migration and invasion of U87 and U251 cells. However, mutation of Cys528 in CRM1 abolished the inhibitory activity of S109 in glioma cells. Furthermore, we found that S109 treatment decreased the expression level and activity of MMP2 and reduced the level of phosphorylated STAT3 but not total STAT3. Therefore, the inhibition of migration and invasion induced by S109 may be associated with the downregulation of MMP2 activity and expression, and inactivation of the STAT3 signaling pathway. These results support our previous conclusion that inhibition of CRM1 is an attractive strategy for the treatment of glioma.

A Comparative Study on the Traditional Medicine Policies between Korea and China: Focused on the Second Korean Medicine Development Plan and the 12.5 Traditional Chinese Medicine Development Plan (한국과 중국의 전통의학 정책 비교: 제2차 한의약육성발전계획 및 중의약사업발전 12.5규획 중심)

  • Ko, Chang-Ryong;Ku, Nam-Pyong;Seol, Sung-Soo
    • Journal of Korea Technology Innovation Society
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    • v.17 no.2
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    • pp.421-447
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    • 2014
  • Traditional medicine has been integrated into the national health system in many countries such as Korea, China, Taiwan, etc. Korea and China are most representative among them. The purpose of this study is to compare the policies on traditional medicine in Korea and China focusing on where it came from and where it is headed. In this regard, the study suggested the first analysis tool in the world for analyzing the policy of traditional medicine. The results of the study are as follows: First of all, the development process of Korean Medicine (KM) and Traditional Chinese Medicine (TCM) shows the same pattern, that is, both are influenced by its own national policies. Secondly, the difference between the two countries is due to the gap in the development status or the different aspects in national heath system. TCM is more vitalized in health system and has larger category, and stays ahead in globalization compared to KM. TCM covers Chinese medicine, integrative medicine and ethno-medicine. Korea emphasizes the role of KM in the declining birthrate and aging society, and promotes the overseas patient invitation strategy. China, on the other hand, establishes the medical system for emergency medical treatment and preventive treatment of major diseases and promotes overseas expansion of TCM service. In addition, Korea stressed the safety and distribution of herbal medicine, and China emphasizes production technologies. Korea has a strong medical device industry along with the government's fostering policy; however, in China, medical devices are in the R&D stage yet. Even though both countries promotes the drug development from natural products, Korea focuses on developing herbal cosmetics in application industry, but China shows weakness in policies on application industry. China shores up the foundation for culture and theory of traditional medicine, while Korea doesn't have related policy. Korea places emphasis on promoting collaboration with international organizations and medical volunteer programs, whereas China is more interested in mutual cooperation and real trade with other countries.

Intercontinental comparison of caustic ingestion in children

  • Rafeey, Mandana;Ghojazadeh, Morteza;Mehdizadeh, Amir;Hazrati, Hakimeh;Vahedi, Leila
    • Clinical and Experimental Pediatrics
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    • v.58 no.12
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    • pp.491-500
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    • 2015
  • Purpose: To investigate the caustic ingestion in children among different continents according to demographic characteristics (core purpose), main symptoms, common caustic agents, signs and symptoms, management, treatment and complications. Methods: This systematic review was performed by searching the databases Science Direct, ProQuest, Google Scholar, and PubMed, electronically and manually. We included studies that were published from 1980 to 2013, at University of Medical Sciences of Tabriz, Iran. A strategic search was performed with keywords including caustic, corrosive, ingestion and children, and was limited to articles in English and Persian. Statistical analysis was performed by SPSS ver. 18. Results: Of 63 selected articles of caustic ingestion with 9,888 samples, the proportion of Africa was 3 articles (4.8%) and 95 samples (1%), America 9 articles (14.3%) and 305 sample (3%), Asia 29 articles (46%) and 2,780 samples (28.1%), Europe 17 articles (27%) and 3,002 samples (30.4%), and Oceania 5 articles (7.9%) and 3,706 samples (37.5%). The average age was in the Africa $3.07{\pm}2.02years$, America $3.17{\pm}1.83years$, Asia $3.34{\pm}1.58years$, Europe $3.58{\pm}2.09years$ and Oceania $3.52{\pm}2.02years$. Sex distribution was in Africa 76 males (0.91%) and 19 females (0.23%), America 49 males (0.58%) and 41 females (0.49%), Asia 1,575 males (18.76%) and 1,087 females (12.95%), Europe 1,018 males (12.13%) and 823 females (9.8%), and Oceania 1,918 males (22.85%) and 1,788 females (21.3%). Statistical analysis of the data indicated higher consumption in Europe and Oceania in the boys with higher average age of years. Conclusion: The comparison of caustic ingestion indicated that the cause substances of caustic ingestion in children are different among continents, therefore prevention strategy and different treatment guidelines among continents will be needed.