Clinical Factors Associated with Quality of Life in Patients with Thyroid Cancer

The incidence of thyroid cancer is rapidly increasing worldwide. Recently, attention to quality of life (QOL) issues has been increasingly addressed in the management of cancer. The goal of this review is provide a systematic overview for clinical factors associated with QOL in patients with thyroid cancer. Age is often cited as a QOL predictor with older patients more vulnerable than younger patients. High levels of fatigue and psychological distress such as anxiety and depression might be associated with decreased QOL. Although surgery for thyroid cancer leads to worse QOL shortly, there is a trend towards recovery with time. Levothyroxine treatment in thyroid cancer can result in similar or slightly impaired QOL. Thyroid hormone withdrawal causes significant reductions of QOL of thyroid cancer patients. The use of recombinant human thyrotropin (rhTSH) instead of thyroid hormone withdrawal can prevent QOL deterioration by thyroid hormone withdrawal. Generally, thyroid cancer survivors have a similar or slightly worse QOL compared with the normative population. In conclusion, thyroid cancer has a considerable impact on QOL of patients, and therefore multidisciplinary approach with special concern for QOL is recommended. The incidence of thyroid cancer is rapidly increasing worldwide. Recently, attention to quality of life (QOL) issues has been increasingly addressed in the management of cancer. The goal of this review is provide a systematic overview for clinical factors associated with QOL in patients with thyroid cancer. Age is often cited as a QOL predictor with older patients more vulnerable than younger patients. High levels of fatigue and psychological distress such as anxiety and depression might be associated with decreased QOL. Although surgery for thyroid cancer leads to worse QOL shortly, there is a trend towards recovery with time. Levothyroxine treatment in thyroid cancer can result in similar or slightly impaired QOL. Thyroid hormone withdrawal causes significant reductions of QOL of thyroid cancer patients. The use of recombinant human thyrotropin (rhTSH) instead of thyroid hormone withdrawal can prevent QOL deterioration by thyroid hormone withdrawal. Generally, thyroid cancer survivors have a similar or slightly worse QOL compared with the normative population. In conclusion, thyroid cancer has a considerable impact on QOL of patients, and therefore multidisciplinary approach with special concern for QOL is recommended.ope

Characteristics of Intrinsic Functional Connectivity of Amygdalar Subregions in Social Anxiety Disorder

Objective : The amygdala has been considered to be a critical region in the pathophysiology of social anxiety disorder, but subregional connectivity pattern has not been examined yet despite lots of previous functional neuroimaging studies. Methods : Resting-state functional magnetic resonance imaging data was obtained in 19 patients with social anxiety disorder and 20 normal controls, and default mode functional connectivity with each of basolateral, centromedial and superficial areas of the amygdala was measured and compared between the two groups. Results : Differential amygdala-based networks between the two groups were distributed to all over the brain. In particular, however, a bias on the amygdala-cingulate pathway was observed in the superficial amygdala only. Connectivity strengths between the superficial amygdala and perigenual anterior cingulate cortex were correlated with scores of social interaction and avoidance. Conclusion : Our findings provide new insights into understanding of the intrinsic cognitive bias model of social anxiety disorder. An abnormality in superficial amygdala-anterior cingulate connectivity may influence on cognitive processing of socially-relevant information in social anxiety disorder.ope

Behavioral Characteristics of Face Recognition for Self and Others in Patients with Social Phobia

Objective : The amygdala has been considered to be a critical region in the pathophysiology of social anxiety disorder, but subregional connectivity pattern has not been examined yet despite lots of previous functional neuroimaging studies. Methods : Resting-state functional magnetic resonance imaging data was obtained in 19 patients with social anxiety disorder and 20 normal controls, and default mode functional connectivity with each of basolateral, centromedial and superficial areas of the amygdala was measured and compared between the two groups. Results : Differential amygdala-based networks between the two groups were distributed to all over the brain. In particular, however, a bias on the amygdala-cingulate pathway was observed in the superficial amygdala only. Connectivity strengths between the superficial amygdala and perigenual anterior cingulate cortex were correlated with scores of social interaction and avoidance. Conclusion : Our findings provide new insights into understanding of the intrinsic cognitive bias model of social anxiety disorder. An abnormality in superficial amygdala-anterior cingulate connectivity may influence on cognitive processing of socially-relevant information in social anxiety disorder.ope

Relationship between stress levels and treatment in patients with temporomandibular disorders

OBJECTIVES: Stress may have an impact on treatment types that patients receive for temporomandibular disorders (TMDs). This study sought to investigate the relationship between the stress index and type of treatments in patients with TMD. MATERIALS AND METHODS: The psychosocial well-being index-short form (PWI-SF) was used to evaluate stress levels in ninety-two patients with TMD. Treatment types were classified into two groups: one group received counseling, physical therapy or medication, while the second group received splint therapy or surgical intervention. RESULTS: The high-risk group (PWI-SF> or =27, the higher the points, the more severe the stress level) was more frequently treated by splint therapy than the low-risk group (PWI-SF<27). Female TMD patients reported higher PWI-SF scores than male TMD patients. CONCLUSION: This study suggests a relationship between stress levels and treatment types for patients with TMD. Thus, the appropriate evaluation and management of stress could be an important factor in treating TMD.ope

Efficacy and safety of haloperidol versus atypical antipsychotic medications in the treatment of delirium

BACKGROUND: Most previous studies on the efficacy of antipsychotic medication for the treatment of delirium have reported that there is no significant difference between typical and atypical antipsychotic medications. It is known, however, that older age might be a predictor of poor response to antipsychotics in the treatment of delirium. The objective of this study was to compare the efficacy and safety of haloperidol versus three atypical antipsychotic medications (risperidone, olanzapine, and quetiapine) for the treatment of delirium with consideration of patient age. METHODS: This study was a 6-day, prospective, comparative clinical observational study of haloperidol versus atypical antipsychotic medications (risperidone, olanzapine, and quetiapine) in patients with delirium at a tertiary level hospital. The subjects were referred to the consultation-liaison psychiatric service for management of delirium and were screened before enrollment in this study. A total of 80 subjects were assigned to receive either haloperidol (N = 23), risperidone (N = 21), olanzapine (N = 18), or quetiapine (N = 18). The efficacy was evaluated using the Korean version of the Delirium Rating Scale-Revised-98 (DRS-K) and the Korean version of the Mini Mental Status Examination (K-MMSE). The safety was evaluated by the Udvalg Kliniske Undersogelser side effect rating scale. RESULTS: There were no significant differences in mean DRS-K severity or K-MMSE scores among the four groups at baseline. In all groups, the DRS-K severity score decreased and the K-MMSE score increased significantly over the study period. However, there were no significant differences in the improvement of DRS-K or K-MMSE scores among the four groups. Similarly, cognitive and non-cognitive subscale DRS-K scores decreased regardless of the treatment group. The treatment response rate was lower in patients over 75 years old than in patients under 75 years old. Particularly, the response rate to olanzapine was poorer in the older age group. Fifteen subjects experienced a few adverse events, but there were no significant differences in adverse event profiles among the four groups. CONCLUSIONS: Haloperidol, risperidone, olanzapine, and quetiapine were equally efficacious and safe in the treatment of delirium. However, age is a factor that needs to be considered when making a choice of antipsychotic medication for the treatment of delirium.ope

Highly Efficient Diagnostic Platforms Using DNA Aptamers and their Practical Applications

DoctorFor several decades, a precise diagnosis has been widely studied in the world for the development of rapid, cost-effective and personalized treatment to severe diseases. To build up such a disease detection method, the biomarkers arose as novel criteria of diagnosis. The term “biomarker” refers to an indicator of the biological process that can be measured in the body to predict the incidence of disease. However, in many cases, biomarkers are often present at very low concentrations in various other proteins, resulting it more difficult to identify them. Therefore, highly efficient detection technologies are necessary to make an accurate examination for biomarkers in the early stage of the disease. Currently, clinical diagnosis with biomarkers is conducted by traditional methods such as antibody-based enzyme-linked immunosorbent assay (ELISA). However, antibodies have shortcomings to utilize such as long discovery times, huge size, poor stability, etc. Aptamers are widely used as the biomolecular probe to remedy the antibody’s shortcomings. Aptamers are oligo-nucleic acids or peptides molecules, which usually have strong binding affinity to the specific biomarker. Each aptamer has particular 3-D structures originated from its own sequence, enabling the specific binding affinity to target biomarker over other proteins. Aptamers can be productively used to detect thousands of proteins simultaneously in platforms for multiplex discovery, where antibodies usually have problems with cross-reactivity. Through various modifications, large range of additional chemical moieties can be added at any desired position in the oligonucleotide sequences, therefore the functional groups brought the features of proteins, small molecule drugs, and antibodies together into aptamers, providing the aptamers as a most versatile reagent in medical applications. In the next chapters, newly developed diagnostic platforms using DNA aptamers are fully introduced to prove that diagnostic applications of DNA aptamers are effective. In chapter 2, a highly sensitive detection platform for immune biomarker was developed. The rod-shaped gold electrodes with circular gold surface were used. The aptasensor specifically detected membrane-bound IL-5RA on human eosinophils according to the number of the eosinophils. We further examined the usability of soluble IL-5RA (sIL-5RA) in the serum as a novel biomarker for the diagnosis of eosinophil-related diseases. When eosinophilic inflammation occurs, the concentration of sIL-5RA in the blood is highly elevated. To diagnose eosinophilic inflammation, the aptasensor was calibrated in phosphate-buffered saline (PBS) to detect sIL-5RA. The detection limit of the aptasensor in PBS was 1.69 pg/mL, which is lower than that of commercially available ELISA kits. The dynamic range of the aptasensor was 10–10,000 pg/mL, with high specificity over other serum proteins and interleukin family members. The aptasensor was capable of distinguishing between patients with eosinophilic asthma (EA) and normal controls (NCs) based on serum sIL-5RA levels. Consequently, the fabricated aptasensor will contribute to the development of novel diagnostic systems for IL-5RA-related diseases. In chapter 3, an ultra-sensitive detection system for cardiac biomarker was developed. In this study, a plasmonic enzyme-linked aptamer assay (ELAA) was developed to enable the quantification of cTnI with a wide detection range. This detection system involved cTnI specific aptamers that were identified in a previous study and signal amplification was performed using the plasmonic effect of gold nanoparticles (AuNPs), which depends on the size and shape of the particles. Based on simple UV-Vis spectroscopy, the designed plasmonic ELAA showed ultra-sensitive performance in the analysis of cTnI with a wide detection range 1 fM–1 nM (detection limit: 0.52 fM), which has not been demonstrated previously

Effective therapy for prostate cancers

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와이드닝 과정 중의 온도 조절을 통한 세포 배양용 AAO 나노 단계 구배 패턴 제작

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Ultra-effective photothermal therapy for prostate cancer cells using dual aptamer-modified gold nanostars

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