• 제목/요약/키워드: Exposure therapy

검색결과 439건 처리시간 0.026초

Effects of Hypobaric Conditions on Apoptosis Signalling Pathways in HeLa Cells

  • Arican, Gul Ozcan;Khalilia, Walid;Serbes, Ugur;Akman, Gizem;Cetin, Idil;Arican, Ercan
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권12호
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    • pp.5043-5047
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    • 2014
  • Nowadays increasing effectiveness in cancer therapy and investigation of formation of new strategies that enhance antiproliferative activity against target organs has become a subject of interest. Although the molecular mechanisms of apoptosis can not be fully explained, it is known that cell suicide program existing in their memory genetically is activated by pathophysiological conditions and events such as oxidative stress. Low pressure (hypobaric) conditions that create hypoxia promote apoptosis by inhibiting cell cycling. In this study, determination of the effects of fractional hypobaric applications at different times on HeLa cells at cellular and molecular levels were targeted. Experiments were carried out under hypobaric conditions (35.2 kPa) in a specially designed hypobaric cabin including 2% $O_2$ and 98% N. Application of fractional hypobaric conditions was repeated two times for 3 hours with an interval of 24 hours. At the end of the implementation period cells were allowed to incubate for 24 hours for activation of repair mechanisms. Cell kinetic parameters such as growth rate (MTT) and apoptotic index were used in determination of the effect of hypobaric conditions on HeLa cells. Also in our study expression levels of the Bcl-2 gene family that have regulatory roles in apoptosis were determined by the RT-PCR technique to evaluate molecular mechanisms. The results showed that antiproliferative effect of hypobaric conditions on HeLa cells started three hours from the time of application and increased depending on the period of exposure. While there was a significant decrease in growth rate values, there was a significant increase in apoptotic index values (p<0.01). Also molecular studies showed that hypobaric conditions caused a significant increase in expression level of proapoptotic gene Bax and significant decrease in antiapoptotic Bfl-1. Consequently fractional application of hypobaric conditions on HeLa cell cultures increased both antiproliferative and apoptotic effects and these effects were triggered by the Bax gene.

Functional outcome predictors following mandibular reconstruction with osteocutaneous fibula free flaps: correlating early postoperative videofluoroscopic swallow studies with long-term clinical results

  • Gonzalez, Santiago R.;Hobbs, Bradley;Vural, Emre;Moreno, Mauricio A.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제41권
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    • pp.30.1-30.8
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    • 2019
  • Background: Advancements in the field of microvascular surgery and the widespread adoption of microvascular surgical techniques have made the use of osteocutaneous fibula free flaps the standard of care in the surgical management of segmental mandibular defects. Although the literature possesses abundant evidence to support the effectiveness of fibula free flaps as a reconstructive method, there are relatively few studies reporting on outcomes as objectively measured by videofluoroscopic swallowing studies (VFSS). The purpose of this study is to explore the potential correlation between early postoperative VFSS and the long-term swallowing outcomes in patients who underwent mandibular reconstruction with fibula free flaps. Methods: We performed a retrospective chart review of 36 patients who underwent mandibular reconstruction with osteocutaneous fibular free flaps between 2009 and 2012. Demographics, clinical variables, VFSS data, and diet information were retrieved. Penetration and aspiration findings on VFSS, long-term oral feeding ability, and the need for gastrostomy tube were statistical endpoints correlated with postoperative clinical outcomes. Results: Thirty-six patients were reviewed (15 females and 21 males) with a mean age of 54 years (7-81). Seventeen cases were treated for malignancy. The size of the bony defect ranged from 3 to 15 cm (mean = 9 cm). The cutaneous paddle, a surrogate for soft tissue defect, ranged from 10 to 125 ㎠ (mean = 52 ㎠). A gastrostomy tube was present in patients preoperatively (n = 8), and postoperatively (n = 14). Seventeen patients had neoadjuvant exposure to radiation. Postoperative VFSS showed penetration in 13 cases (36%) and aspiration in seven (19%). Overall, 29 patients (80.6%) achieved unrestricted diet, and this was statistically correlated with age (p = 0.037), radiation therapy (p = 0.002), and preoperative gastrostomy tube (p = 0.03). The presence of penetration or aspiration on VFSS was a strong predictor for long-term unrestricted oral diet (p < 0.001). Conclusion: Early postoperative VFSS is an excellent predictor for long-term swallowing outcomes in patients undergoing mandibular reconstruction with osteocutaneous fibula free flaps.

개구장애를 동반한 피부근염 환자 증례 (A Case Report: Limitation of Mouth Opening in Dermatomyositis)

  • 김혜경;김기석;김미은
    • Journal of Oral Medicine and Pain
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    • 제35권2호
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    • pp.155-163
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    • 2010
  • 피부근염은 특발성의 염증성 결합조직 질환으로서 점진적인 근육의 쇠약과 특징적인 피부 발진의 증상을 보이는 전신적 자가 면역 질환의 일종이며 근력 약화와 함께 나타나거나 흔히 선행하는 특징적 발진에 의해 진단된다. 가장 특징적인 피부증상은 상안검의 부종과 함께 나타나는 푸르면서 보라색 발진인 heliotrophic rash, 안면부와 상부 흉부의 넓적하고 붉은 발진 (flat red rash), 피부의 인설(scaling)현상을 나타내는 손가락 관절(knuckle)부위의 두드러진 Gottron's papules (violaceous scaly eruption)등 이다. 근육 증상으로 주로 근위부 사지 근육의 약화를 동반한 근육의 염증성 및 퇴행성 변화를 보인다. 피부 근염은 종종 소화기계 (gastrointestinal tract)와 호흡기계 (respiratory system)를 침범하며 15%~25%에서 악성변화를 보인다. 치료는 피부증상뿐 아니라 근육 증상도 악화시킬 수 있는 자외선에 대한 노출을 피하고 일차적으로 전신적 corticosteroid를 사용하며 증상이 심하거나 steroid에 반응이 없을 때 다른 면역억제제를 사용할 수 있다. 피부근염에서 안면근은 침범되지 않으며 저작근의 이환 역시 거의 없다. 본 증례를 통해 피부근염을 앓고 있는 환자에서 개구장애가 발생할 수 있으며, 이는 근경축과 유사한 양상을 보임을 알 수 있었다. 따라서 피부근염 환자에서 발생할 수 있는 개구장애는 회복이 어려울 수 있으므로, 점진적으로 개구량이 줄어드는 것을 막고 정상적인 개구량을 확보 할 수 있도록 지속적인 개구운동 등의 치료가 필요하다고 사료된다.

Gentiopicroside Ameliorates the Progression from Hepatic Steatosis to Fibrosis Induced by Chronic Alcohol Intake

  • Yang, Hong-Xu;Shang, Yue;Jin, Quan;Wu, Yan-Ling;Liu, Jian;Qiao, Chun-Ying;Zhan, Zi-Ying;Ye, Huan;Nan, Ji-Xing;Lian, Li-Hua
    • Biomolecules & Therapeutics
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    • 제28권4호
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    • pp.320-327
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    • 2020
  • In current study, we aimed to investigate whether the gentiopicroside (GPS) derived from Gentiana manshurica Kitagawa could block the progression of alcoholic hepatic steatosis to fibrosis induced by chronic ethanol intake. C57BL/6 mice were fed an ethanol-containing Lieber-DeCarli diet for 4 weeks. LX-2 human hepatic stellate cells were treated with GPS 1 h prior to transforming growth factor-β (TGF-β) stimulation, and murine hepatocyte AML12 cells were pretreated by GPS 1 h prior to ethanol treatment. GPS inhibited the expression of type I collagen (collagen I), α-smooth muscle actin (α-SMA) and tissue inhibitor of metal protease 1 in ethanol-fed mouse livers with mild fibrosis. In addition, the imbalanced lipid metabolism induced by chronic ethanol-feeding was ameliorated by GPS pretreatment, characterized by the modulation of lipid accumulation. Consistently, GPS inhibited the expression of collagen I and α-SMA in LX-2 cells stimulated by TGF-β. Inhibition of lipid synthesis and promotion of oxidation by GPS were also confirmed in ethanol-treated AML12 cells. GPS could prevent hepatic steatosis advancing to the inception of a mild fibrosis caused by chronic alcohol exposure, suggesting GPS might be a promising therapy for targeting the early stage of alcoholic liver disease.

급성일산화탄소중독(急性一酸化炭素中毒)의 신경학적(神經學的) 후유증(後遺症)에 관(關)한 역학적(疫學的) 연구(硏究) (An Epidemiological Study on the Neurological Sequelae of Acute Carbon Monoxide Poisoning)

  • 박병주;조수헌;안윤옥;신영수;윤덕로
    • Journal of Preventive Medicine and Public Health
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    • 제17권1호
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    • pp.5-24
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    • 1984
  • There has been an immense need for elaborate studies on the complications and the neuological sequelae generated by acute carbon monoxide (CO) poisoning which is highly prevalent in Korea due to widespread adoption of the anthracite coal briquette as domestic fuel for heating and for cooking. For this epidemiological study, a total of 444 subjects who received hospital emergency care for acute CO poisoning during the period of March 1982 to February 1983 were randomly selected from the emergency patients's lists of 13 general hospitals in Seoul area. Informations on the neurological sequelae were elucidated by means of home visiting with prearranged questionnaire consisting questions and concise neurological examination. The findings obtained were summarized as follows; 1. The complications were found in 18% of the surveyed and acute decubitus was comprised 67.5% of the complications. 2. The total cumulative incidence of the neurological sequelae was 41.2 per 100 patients and the absolute incidence rate regardless of the duration after poisoning was 40.8%. 3. The incidence of the neurological sequelae was higher in the older age than in the younger and also higher in female than in male. Twice higher incidence was observed in the admitted patients than in the non-admitted patients and the incidence became higher in proportion to the duration of CO exposure, coma and admission. The poorer the consciousness level of patients found, at emergency room and at discharge, the higher the incidence. The incidence of the neurological sequelae by emergency care was higher in hyperbaric oxygen therapy group(51.9%) than in 100% $O_2$ group(38.0%) 4. A total of five variables significantly associated with the occurrence of the neurological sequelae were selected by the stepwise discriminant analysis. The variables were following course of emergency care, age, consciousness level at discharge, admission duration, and consciousness level at emergency room in their sequence of discriminant power. Eight variables were selected as those associated with the degree of the neurological sequelae through the stepwise multiple regression analysis. Of these variables, the acute decubitus alone explained 21.1% of the total variation ana all the eight variables could explain 36.5% of the same. The remaining seven variables listed in the order of their relative importance were: age, consciousness level at discharge, admission duration, coma duration and consciousness level at emergency room. 5. It was postulated that unexpectedly high incidence of the neurological sequelae of the CO poisoning in this epidemiological study was mainly due to the inadequate emergency care and the lack of efficient and sophisticated treatment measure. In the effort to minimize the incidence of grave neurological sequelae of acute CO poisoning, new guidelines for the emergency care and treatment should be pursued with efficient ways.

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퇴행성 관절염 환자를 대상으로 새로운 진통제 평가를 위한 임상시험자료의 GEE 분석 (Analysis of Repeated Measured VAS in a Clinical Trial for Evaluating a New NSAID with GEE Method)

  • 임회정;김윤이;정영복;성상철;안진환;노권재;김정만;박병주
    • Journal of Preventive Medicine and Public Health
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    • 제37권4호
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    • pp.381-389
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    • 2004
  • Objective : To compare the efficacy between SKI306X and Diclofenac by using generalized estimating equations (GEE) methodology in the analysis of correlated bivariate binary outcome data in Osteoarthritis (OA) diseases. Methods : A randomized, double-blind, active comparator-controlled, non-inferiority clinical trial was conducted at 5 institutions in Korea with the random assignment of 248 patients aged 35 to 75 years old with OA of the knee and clinical evidence of OA. Patients were enrolled in this study if they had at least moderate pain in the affected knee joint and a score larger than 35mm as assessed by VAS (Visual Analog Scale). The main exposure variable was treatment (SKI 306X vs. Diclofenac) and other covariates were age, sex, BMI, baseline VAS, center, operation history (Yes/No), NSAIDS (Y/N), acupuncture (Y/N), herbal medicine (Y/N), past history of musculoskeletal disease (Y/N), and previous therapy related with OA (Y/N). The main study outcome was the change of VAS pain scores from baseline to the 2nd and 4th weeks after treatment. Pain scores were obtained as baseline, 2nd and 4th weeks after treatment. We applied GEE approach with empirical covariance matrix and independent(or exchangeable) working correlation matrix to evaluate the relation of several risk factors to the change of VAS pain scores with correlated binary bivariate outcomes. Results : While baseline VAS, age, and acupuncture variables had protective effects for reducing the OA pain, its treatment (Joins/Diclofenac) was not statistically significant through GEE methodology (ITT:aOR=1.37, 95% CI=(0.8200, 2.26), PP:aOR=1.47, 95% CI=(0.73, 2.95)). The goodness-of-fit statistic for GEE (6.55, p=0.68) was computed to assess the adequacy of the fitted final model. Conclusions : Both ANCOVA and GEE methods yielded non statistical significance in the evaluation of non-inferiority of the efficacy between SKI306X and Diclofenac. While VAS outcome for each visit was applied in GEE, only VAS outcome for the fourth visit was applied in ANCOVA. So the GEE methodology is more accurate for the analysis of correlated outcomes.

Proposed Treatment Protocol for Frostbite: A Retrospective Analysis of 17 Cases Based on a 3-Year Single-Institution Experience

  • Woo, Eun-Kyung;Lee, Jong Wook;Hur, Gi-Yeun;Koh, Jang-Hyu;Seo, Dong-Kook;Choi, Jai-Ku;Jang, Young-Chul
    • Archives of Plastic Surgery
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    • 제40권5호
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    • pp.510-516
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    • 2013
  • Background This paper discusses the treatment protocol for patients with frostbite. Methods We performed a retrospective analysis of a series of 17 patients with second- and higher-degree frostbite who had been treated at our medical institution between 2010 and 2012. Results Our clinical series of patients (n=17) included 13 men and four women, whose mean age was $42.4{\pm}11.6$ years (range, 22-67 years). The sites of injury include the foot in six patients (35.3%), the hand in six patients (35.3%) and the facial region in five patients (29.4%). Seven patients with second-degree frostbite were completely cured with only conservative treatment during a mean period of $12.7{\pm}3.3$ days (range, 8-16 days). Of the five patients with third-degree frostbite, two underwent skin grafting following debridement, and the remaining three achieved a complete cure with conservative treatment during a mean period of $35{\pm}4.3$ days (range, 29-39 days). Five patients with fourth-degree frostbite were treated with surgical procedures including amputation. Conclusions With the appropriate conservative management in the early stage of onset, surgeons should decide on surgery after waiting for a sufficient period of time until the demarcation of the wound. Continuous management of patients is also needed to achieve functional recovery after a complete cure has been achieved. This should also be accompanied by patient education for the avoidance of re-exposure to cold environments.

백하수오 에탄올추출물이 방사선조사에 따른 흰쥐의 혈구 및 장기에 미치는 영향 (The Effects of Cynanchi wilfordii Radix Ethanol Extracts upon Irradiated Rat's Blood and Organ)

  • 김장오;최준혁;신지혜;정도영;민병인
    • 대한방사선기술학회지:방사선기술과학
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    • 제39권3호
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    • pp.451-459
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    • 2016
  • 방사선 사고 및 방사선 치료 등 방사선에 의한 과피폭의 피해를 줄이기 위해 방사선방호제 개발연구는 활발히 진행되고 있다. 이에 화학적 합성물이 아닌 항산화, 항암, 면역 증강에 효과적인 것으로 알려진 백하수오를 이용하여 방사선방호효과를 확인하였다. 백하수오 에탄올추출물을 Sprague Dawley Rat (SD Rat)에 14일간 1일 1회 경구 투여하고, 7 Gy X-ray를 조사한 후 1일, 4일, 7일, 21일의 시간 변화에 따른 혈구성분, 비장 지수의 변화 및 간과 자궁의 조직변화를 관찰하였다. 실험결과 백하수오 에탄올추출물을 섭취한 실험군의 백혈구 수치(p < 0.05)와 비장 지수(p < 0.05)가 대조군보다 회복이 빠른 것을 확인하였다. 간 조직에서는 핵의 응축, 세포질의 팽창, 염증세포의 침윤이 감소하였으며, 자궁샘 조직은 세포고사가 감소한 것을 확인하였다. 위의 결과를 토대로 백하수오 에탄올추출물은 방사선 조사에 따른 혈구 및 장기의 피해를 줄일 수 있는 새로운 방사선방호제로써 유용할 것으로 기대되며, 방사선 사고와 같은 비상관리 분야에 적절한 시사점을 제공할 수 있다.

Bactericidal Efficacy of Vital-Oxide®, Disinfectant Solution Against Salmonella Typhimurium and Brucella Ovis

  • Cha, Chun-Nam;Lee, Yeo-Eun;Kang, In-Jin;Yoo, Chang-Yeul;An, Sun-Jeong;Kim, Suk;Lee, Hu-Jang
    • 한국식품위생안전성학회지
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    • 제27권1호
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    • pp.50-54
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    • 2012
  • 살모넬라와 부루셀라는 가축에 심각한 질병을 유발하며, 축산업과 식품산업에 많은 경제적 손실을 초래하고 있다. 본 연구에서는, 이산화염소와 베타인 염산염을 주성분으로 한 소독제 바이탈옥사이드의 $Salmonella$ $typhimurium$$Brucella$ $ovis$에 대한 효력시험을 수행하였다. 배지희석법을 이용한 살균효력시험은 $4^{\circ}C$에서 30분 동안 시험 세균을 희석 소독제에 노출시켜 소독제의 가장 효과적인 낮은 희석배수를 결정하는 시험이다. 바이탈옥사이드와 시험 세균들을 처리조건에 따라 증류수, 경수, 그리고 유기물 등으로 희석하여 반응을 시켰다. 유기물 조건에서, $Salmonella$ $typhimurium$$Brucella$ $ovis$에 대한 바이탈옥사이드의 살균력은 경수조건에서의 살균력과 비교하여 낮게 나타났는데, 이는 유기물들에 의한 소독제의 살균 유효성분에 대한 저해작용에 따른 것으로 생각된다. 바이탈옥사이드는 $Salmonella$ $typhimurium$$Brucella$ $ovis$와 같은 가축병원성 질병들에 대해 살균효과를 갖고 있기 때문에, 이 소독제는 세균성 질병의 확산을 제어하는데 이용될 수 있을 것으로 사료된다.

수종의 방법으로 임프란트 표면 처치후 표면의 형태 및 성분 변화 분석에 관한 연구 (The XPS and SEM Evaluation of Various Technique for Cleansing and Decontamination of The Rough Surface Titanium Implants)

  • 김선봉;임성빈;정진형
    • Journal of Periodontal and Implant Science
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    • 제31권4호
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    • pp.749-763
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    • 2001
  • Osseointegrated titanium implants have become an integral therapy for the replacement of teeth lost. For dental implant materials, titanium, hydroxyapatite and alumina oxide have been used, which of them, titanium implants are in wide use today. Titanium is known for its high corrosion resistance and biocompatability, because of the high stability of oxide layer mainly consists of $TiO_2$. With the development of peri-implantitis, the implant surface is changed in surface topography and element composition. None of the treatments for cleaning and detoxification of implant surface is efficient to remove surface contamination from contaminated titanium implants to such extent that the original surface elemental composition. In this sights, the purpose of this study was to evaluate rough surface titanium implants by means of scanning electron microscopy(SEM) and X-ray photoelectron spectroscopy(XPS) with respect to surface appearance and surface elemental composition. Moreover, it was also the aim to get the base for treatments of peri-implantitis. For the SEM and XPS study, rough surface titanium models were fabricated for control group. Six experimental groups were evaluated: 1) long-time room exposure, 2 ) air-powder abrasive cleaning for 1min, 3) burnishing in citric acid(pH1) for 1min, 4) burnishing in citric acid for 3min, 5) burnishing in tetracycline for 1min, 6) burnishing in tetracycline for 3min. All experimental treatments were followed by 1min of rinsing with distilled water. The results were as follows: 1. SEM observations of all experimental groups showed that any changes in surface topography were not detected when compared with control group. (750 X magnification) 2. XPS analysis showed that in all experimental groups, titanium and oxygen were increased and carbon was decreased, when compared with control group. 3. XPS analysis showed that the level of titanium, oxygen and carbon in the experimental group 3(citric acid treatment for 1min, followed by 1min of distilled water irrigation) reached to the level of control group. 4. XPS analysis showed that significant differences were not detected between the experimental group 1 and the other experimental groups except of experimental group 3. The Ti. level of experimental group 2, airpowder abrasive treatment for lmin followed by 1min of saline irrigation, was lower than the Ti. level of tetracycline treated groups, experimental group 5 and 6. From the result of this study, it may be concluded that the 1min of citric acid treatment followed by same time of rinsing with distilled water gave the best results from elemental points of view, and can be used safely to treat peri-implantitis.

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