• 제목/요약/키워드: First-line treatment

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한국산 2미기록종 Oxytricha balladyna와 O. longa (유모문: 다막강: 하모목) (Two Newly Recorded Ciliates, Oxytricha balladyna and O. longa (Ciliophora: Spirotrichea: Sporadotrichida) from Korea)

  • 권춘봉;신만균
    • Animal Systematics, Evolution and Diversity
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    • 제20권2호
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    • pp.171-178
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    • 2004
  • 해안의 소나무 아래 토양과 하수처리장 폭기조에서 채집된 섬모충이 각각 Oxytricha balladyna와 O. longa으로 동정되었다. 이 종들은 한국에서 처음 보고 되는 것으로 생체표본과 protargol로 염색한 표본에 근거하여 재기재하였다. 유사 종들과 비교한 결과 Oxytricha balladyna는 한 개의 소핵이 두 개의 대핵사이에 위치하고. 5개의 후방극모, 3개의 미극모, 5열의 등쪽섬모열이 있으며 세포질에 granule이 없다. O. longa는 소핵이 각각 대핵 부근에 한 개씩 위치하며, 3개의 postoral ventral cirri가 직선상으로 배열하며 후방극모 (transverse cirri)와 멀다. 4개의 후방극모, 2개의 미극모와 4열의 등쪽섬모열이 있으며 특히 세포질에 Yellow-green granules이 관찰되어 특이하였다.

Clinical Guideline for Childhood Urinary Tract Infection (Second Revision)

  • Lee, Seung Joo
    • Childhood Kidney Diseases
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    • 제19권2호
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    • pp.56-64
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    • 2015
  • To revise the clinical guideline for childhood urinary tract infections (UTIs) of the Korean Society of Pediatric Nephrology (2007), the recently updated guidelines and new data were reviewed. The major revisions are as follows. In diagnosis, the criterion for a positive culture of the catheterized or suprapubic aspirated urine is reduced to 50,000 colony forming uits (CFUs)/mL from 100,000 CFU/mL. Diagnosis is more confirmatory if the urinalysis is abnormal. In treating febrile UTI and pyelonephritis, oral antibiotics is considered to be as effective as parenteral antibiotics. In urologic imaging studies, the traditional aggressive approach to find primary vesicoureteral reflux (VUR) and renal scar is shifted to the targeted restrictive approach. A voiding cystourethrography is not routinely recommended and is indicated only in atypical or complex clinical conditions, abnormal ultrasonography and recurrent UTIs. $^{99m}Tc$-DMSA renal scan is valuable in diagnosing pyelonephritis in children with negative culture or normal RBUS. Although it is not routinely recommended, normal scan can safely avoid VCUG. In prevention, a more natural approach is preferred. Antimicrobial prophylaxis is not supported any more even in children with VUR. Topical steroid (2-4 weeks) to non-retractile physiologic phimosis or labial adhesion is a reasonable first-line treatment. Urogenital hygiene is important and must be adequately performed. Breast milk, probiotics and cranberries are dietary factors to prevent UTIs. Voiding dysfunction and constipation should be properly treated and prevented by initiating toilet training at an appropriate age (18-24 months). The follow-up urine test on subsequent unexplained febrile illness is strongly recommended. Changes of this revision is not exclusive and appropriate variation still may be accepted.

Gamma Knife Radiosurgery for Cancer Metastasized to the Ocular Choroid

  • Cho, Kyung Rae;Lee, Kyung Min;Han, Gyule;Kang, Se Woong;Lee, Jung-Il
    • Journal of Korean Neurosurgical Society
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    • 제61권1호
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    • pp.60-65
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    • 2018
  • Objective : Choroidal metastases (CMs) are the most common intraocular tumor. Management is mainly radiation therapy with goals of pain control and visual improvement. However, many radiation-related complications are reported. Since gamma knife radiosurgery (GKS) for CM was first reported in 1995, few cases have been reported. We report 7 cases of CMs treated with GKS. Methods : From April 2011 to November 2014, 7 patients with CM underwent GKS. Their median age at treatment was 64 years (range, 51-71 years). Four males and three females were treated. Lung cancer was the most common primary pathology, followed by renal cell carcinoma and stomach cancer. Four patients had multiple cerebral lesions and were treated simultaneously for choroidal lesions. The median marginal dose of 20 Gy (range, 15-25 Gy) was administered at the 50% isodose line. Results : Median follow-up period after GKS was 8 months (range, 2-38.3 months). Four patients expired due to underlying malignancy progression. Except for two patients who were not followed with magnetic resonance image after GKS, all patients showed size reduction in the treated lesions, but a new choroidal lesion appeared in one patient and one recurred. Six of seven patients reported subjectively improved visual symptoms. Visual acuity improved in 2 patients, and 2 were stable upon objective examination. One patient showed no improvement in visual acuity, but ocular pain was relieved; another patient showed improved vision and tumor remission, but visual deterioration recurred. Conclusion : GKS was shown to be safe and effective and should be considered for CM treatment.

Surgical Treatment of Dermatomal Capillary Malformations in the Adult Face

  • Kim, Yoo-Jeong;Oh, Suk-Joon;Lee, Jun-Sang;Yang, Ji-Hoon;Koh, Sung-Hoon;Jung, Sung-Won
    • Archives of Plastic Surgery
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    • 제39권2호
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    • pp.126-129
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    • 2012
  • Background : Facial capillary malformations (CMs) rarely recede; they often become darker and raised in proportion to their growth. These malformations may hypertrophy in adulthood, resulting in increased disfigurement and dysfunction. Laser treatment is considered a first-line therapy for focal CMs, but thick wide lesions, which are accompanied by hypertrophy and have a well-circumscribed nodularity, may be treated with surgical excision and reconstruction. Methods : We retrospectively reviewed the records of 25 consecutive patients who had undergone complete or partial excisions of facial capillary malformations in our unit. After the excisions, the defects that encompassed their facial aesthetic units were subsequently covered by various methods, including primary closures, local flaps, expanded flaps, split-thickness skin grafts, and full thickness skin grafts. Results : The data demonstrated satisfactory results and reliability. Our patients were treated without significant complications, and all of the patients were moderately or fully satisfied with the outcome of their surgeries. Conclusions : Among the many reconstructive options for adult patients with facial capillary malformations, thick split-thickness skin grafts can be a good choice for the coverage of widely excised wounds.

Vincristine 투여로 호전된 미만성 신생아 혈관종증 (Successful Management with Vincristine after Failure of Prednisolone Therapy for Diffuse Neonatal Hemangiomatosis)

  • 이학성;허순영;김원덕
    • Clinical and Experimental Pediatrics
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    • 제48권9호
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    • pp.1004-1008
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    • 2005
  • 혈관종은 영아에서 가장 흔한 양성 종양으로 이 중 15-30%는 다발성 혈관종을 보인다. 미만성 신생아 혈관종증은 피부와 다수의 내부 장기를 침범하는 질환으로 치료하지 않는 경우 치명적일 수 있기 때문에 신속하고 적극적인 치료가 요구된다. 치료는 부신피질 호르몬이 1차 선택 약제로 사용되며 이에 반응하지 않으면 인터페론, 절재술, 전색술, 방사선 치료 등을 이용할 수 있다. Interferon alfa-2a는 매우 효과적이나 강직성 양마비(spastic diplegia)와 같은 심각한 합병증이 보고되고 있다. 저자들은 출생 직후 호흡곤란과 전신의 피부 혈관종을 주소로 입원하여 Kasabach-Merritt 증후군을 동반한 미만성 신생아 혈관종증을 진단 받았던 1례에서 스테로이드 치료에 대해 혈소판 감소증 및 소모성 응고장애의 호전은 있었으나 혈관종의 수 및 크기의 호전이 없어 vincristine을 투여하여 치료에 성공하였기에 문헌 고찰과 함께 보고하는 바이다.

Challenges and opportunities in integrating complementary and alternative medicine into mainstream of the Malaysian healthcare system

  • Tahir, Nurul Ain Mohd;Thomas, Paraidathathu;Li, Shu Chuen
    • 셀메드
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    • 제5권4호
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    • pp.23.1-23.6
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    • 2015
  • Complementary and alternative medicine (CAM) practice is still popular among the Malaysian population nowadays although western or allopathic medicine is the first line of treatment. Dissatisfaction with health services and therapeutic effects of western medicine or preference for holistic, integrative approach in treatment are common reasons favouring the increasing popularity of CAM practices. The efforts toward integration of CAM and western medicine in Malaysia were rather slow and in a piece-meal fashion. Strategic efforts in strengthening government and self-regulation among practitioners, formalizing education, promoting research, and cultivating national and international networks are necessary to achieve an integrative system. Regulations to restrict the practice and sale of CAM products to licensed practitioners, strict and mandatory registration of the practitioners, inclusion of CAM in essential medicines list, and pricing regulations must be comprehensively discussed. Development of curriculum, offers of scholarship and incentives, promotion of courses and seminars for professionals is necessary to increase the numbers of CAM experts. Malaysia should follow the efforts of other countries on the production and documentation of local CAM data, allocation of funding, and establishment of research centres to assess the efficacy of potentially useful local products. Local and international collaboration in research and continuous education is important for exchange of knowledge and skills. In conclusion more coordinated efforts in regulation of CAM practice and products, formalizing CAM training and education would significantly move the process forward and allow the public to enjoy more health benefits from CAM practice in Malaysia.

Pharmacologic Management of Chronic Pain

  • Park, Hue-Jung;Moon, Dong-Eon
    • The Korean Journal of Pain
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    • 제23권2호
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    • pp.99-108
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    • 2010
  • Chronic pain is a multifactorial condition with both physical and psychological symptoms, and it affects around 20% of the population in the developed world. In spite of outstanding advances in pain management over the past decades, chronic pain remains a significant problem. This article provides a mechanism- and evidence-based approach to improve the outcome for pharmacologic management of chronic pain. The usual approach to treat mild to moderate pain is to start with a nonopioid analgesic. If this is inadequate, and if there is an element of sleep deprivation, then it is reasonable to add an antidepressant with analgesic qualities. If there is a component of neuropathic pain or fibromyalgia, then a trial with one of the gabapentinoids is appropriate. If these steps are inadequate, then an opioid analgesic may be added. For moderate to severe pain, one would initiate an earlier trial of a long term opioid. Skeletal muscle relaxants and topicals may also be appropriate as single agents or in combination. Meanwhile, the steps of pharmacologic treatments for neuropathic pain include (1) certain antidepressants (tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors), calcium channel ${\alpha}2-{\delta}$ ligands (gabapentin and pregabalin) and topical lidocaine, (2) opioid analgesics and tramadol (for first-line use in selected clinical circumstances) and (3) certain other antidepressant and antiepileptic medications (topical capsaicin, mexiletine, and N-methyl-d-aspartate receptor antagonists). It is essential to have a thorough understanding about the different pain mechanisms of chronic pain and evidence-based multi-mechanistic treatment. It is also essential to increase the individualization of treatment.

Vitamin C Up-regulates Expression of CD80, CD86 and MHC Class II on Dendritic Cell Line, DC-1 Via the Activation of p38 MAPK

  • Kim, Hyung Woo;Cho, Su In;Bae, Seyeon;Kim, Hyemin;Kim, Yejin;Hwang, Young-Il;Kang, Jae Seung;Lee, Wang Jae
    • IMMUNE NETWORK
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    • 제12권6호
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    • pp.277-283
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    • 2012
  • Vitamin C is an essential water-soluble nutrient which primarily exerts its effect on host defense mechanisms and immune homeostasis, but the mechanism related to immune-potentiation is poorly understood. Since dendritic cells (DCs) are known as a potent antigen presenting cell (APC) that could enhance the antigen specific immune responses, we investigate the effects of vitamin C on activation of DCs and its related mechanism by using dendritic cell lines, DC-1. First, we found that there was no damage on DC-1 by 2.5 mM of vitamin C. In the presence of vitamin C, the expression of CD80, CD86, and MHC molecules was increased, but it was decreased by the pre-treatment of SB203580, p38 MAPK-specific inhibitor. We confirmed the phosphorylation of p38 MAPK was increased by the treatment of vitamin C. Taken together, these results suggest that vitamin C could enhance the activity of dendritic cells via the up-regulation of the expression of CD80, CD86, and MHC molecules and the activation of p38 MAPK is related to this process.

Comparative Proteomic Profiling of Pancreatic Ductal Adenocarcinoma Cell Lines

  • Kim, Yikwon;Han, Dohyun;Min, Hophil;Jin, Jonghwa;Yi, Eugene C.;Kim, Youngsoo
    • Molecules and Cells
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    • 제37권12호
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    • pp.888-898
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    • 2014
  • Pancreatic cancer is one of the most fatal cancers and is associated with limited diagnostic and therapeutic modalities. Currently, gemcitabine is the only effective drug and represents the preferred first-line treatment for chemotherapy. However, a high level of intrinsic or acquired resistance of pancreatic cancer to gemcitabine can contribute to the failure of gemcitabine treatment. To investigate the underlying molecular mechanisms for gemcitabine resistance in pancreatic cancer, we performed label-free quantification of protein expression in intrinsic gemcitabine-resistant and -sensitive human pancreatic adenocarcinoma cell lines using our improved proteomic strategy, combined with filter-aided sample preparation, single-shot liquid chromatography-mass spectrometry, enhanced spectral counting, and a statistical method based on a power law global error model. We identified 1931 proteins and quantified 787 differentially expressed proteins in the BxPC3, PANC-1, and HPDE cell lines. Bioinformatics analysis identified 15 epithelial to mesenchymal transition (EMT) markers and 13 EMT-related proteins that were closely associated with drug resistance were differentially expressed. Interestingly, 8 of these proteins were involved in glutathione and cysteine/methionine metabolism. These results suggest that proteins related to the EMT and glutathione metabolism play important roles in the development of intrinsic gemcitabine resistance by pancreatic cancer cell lines.

Biological Functions and Identification of Novel Biomarker Expressed on the Surface of Breast Cancer-Derived Cancer Stem Cells via Proteomic Analysis

  • Koh, Eun-Young;You, Ji-Eun;Jung, Se-Hwa;Kim, Pyung-Hwan
    • Molecules and Cells
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    • 제43권4호
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    • pp.384-396
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    • 2020
  • Breast cancer is one of the most common life-threatening malignancies and the top cause of cancer deaths in women. Although many conventional therapies exist for its treatment, breast cancer still has many handicaps to overcome. Cancer stem cells (CSCs) are a well-known cause of tumor recurrences due to the ability of CSCs for self-renewal and differentiation into cell subpopulations, similar to stem cells. To fully treat breast cancer, a strategy for the treatment of both cancer cells and CSCs is required. However, current strategies for the eradication of CSCs are non-specific and have low efficacy. Therefore, surface biomarkers to selectively treat CSCs need to be developed. Here, 34 out of 641 surface biomarkers on CSCs were identified by proteomic analysis between the human breast adenocarcinoma cell line MCF-7 and MCF-7-derived CSCs. Among them, carcinoembryonic antigen-related cell adhesion molecules 6 (CEACAM6 or CD66c), a member of the CEA family, was selected as a novel biomarker on the CSC surface. This biomarker was then experimentally validated and evaluated for use as a CSC-specific marker. Its biological effects were assessed by treating breast cancer stem cells (BCSCs) with short hairpin (sh)-RNA under oxidative cellular conditions. This study is the first to evaluate the biological function of CD66c as a novel biomarker on the surface of CSCs. This marker is available as a moiety for use in the development of targeted therapeutic agents against CSCs.