• Title/Summary/Keyword: Treatment Efficacy

Search Result 4,434, Processing Time 0.028 seconds

Does Lymphovenous Anastomosis Effect Mammalian Target of Rapamycin Inhibitor-associated Lymphedema Patients?

  • Inah Yoon;Hyung Bae Kim;Jeongmok Cho;Changsik John Pak;Hyunsuk Peter Suh;Jae Yong Jeon;Joon Pio Hong
    • Archives of Plastic Surgery
    • /
    • v.51 no.3
    • /
    • pp.321-326
    • /
    • 2024
  • The mammalian target of rapamycin (mTOR) inhibitors are used to prevent organ transplant rejection and are preferred over other immunosuppressants due to its low nephrotoxicity. However, mTOR inhibitors have been associated with various adverse effects including lymphedema. Although rare in incidence, previously known treatments for mTOR inhibitor-induced lymphedema were limited to discontinuation of related drugs and complex disruptive therapy with variable results. In this article, three patients who developed lymphedema in their lower limbs after using mTOR inhibitors, including two bilateral and one unilateral case, were treated with physiologic surgery methods such as lymphovenous anastomosis (LVA) and lymph node transfer. The efficacy of the treatment was evaluated. In the three cases described, cessation of the drug did not lead to any reduction in edema. The use of LVA and lymph node transfer resulted in early reductions in volume but failed to sustain over time. All patients underwent secondary nonphysiologic surgery such as liposuction resulting in sustained improvement. This series presents the first physiologic approach to mTOR inhibitor-induced lymphedema. Although further study is warranted, the physiologic surgical options may have limited success and nonphysiologic options may offer better sustainable results.

Surgical Results with Low-Grade Arteriovenous Malformations : A Single Center 14-Year Experience

  • Woo-Jun Hong;Kang-Hee Ahn;Yong-Jun Lee;Woong-Beom Kim;You-Sub Kim;Tae-Sun Kim;Sung-Pil Joo
    • Journal of Korean Neurosurgical Society
    • /
    • v.67 no.5
    • /
    • pp.541-549
    • /
    • 2024
  • Objective : Advancements in AVM surgical techniques for cerebral arteriovenous malformation (AVM) underscore its efficacy. Our research aims to showcase the positive outcomes of treating low-grade AVMs surgically, focusing on safety and effectiveness. Methods : We retrospectively reviewed 55 patients (36 males and 19 females; average age 37.4 years) with Spetzler-Martin (S-M) grade 1 and 2 AVMs who underwent surgical resection between January 2009 and December 2022. Results : In our study, 55 patients with S-M grade 1 and 2 AVMs underwent surgical resection, evenly divided between grades 1 (50.9%) and 2 (49.1%). Intracranial hemorrhage was the primary symptom in 74.5% of cases. Pre-operative Glasgow coma scale (GCS) scores revealed 69.1% of patients scored above 13, with 18% below 8. Successful resection was achieved in 87.3%. Postoperatively, 95.5% of ruptured and 90.9% of unruptured AVM patients showed lower or same modified Rankin scale scores. Poorer outcomes were significantly linked to lower GCS scores and intranidal/flow-related aneurysms through multivariate logistic regression. Postoperative seizures noted in nine patients, were exclusive to the ruptured AVM group. Conclusion : Our findings indicate surgical resection as a beneficial treatment for low-grade AVMs, yielding high cure rates and positive functional outcomes in both ruptured and unruptured cases. Preoperative GCS scores and the presence of associated aneurysms are predictive of postoperative functional status. Additionally, managing postoperative seizures effectively is key to enhancing prognosis.

Antagonistic Efficacy of Symbiotic Bacterium Xenorhabdus sp. SCG against Meloidogyne spp.

  • Jong-Hoon Kim;Byeong-Min Lee;Hyung Chul Lee;In-Soo Choi;Kyung-Bon Koo;Kwang-Hee Son
    • Journal of Microbiology and Biotechnology
    • /
    • v.34 no.8
    • /
    • pp.1627-1635
    • /
    • 2024
  • The inhabitation and parasitism of root-knot nematodes (RKNs) can be difficult to control, as its symptoms can be easily confused with other plant diseases; hence, identifying and controlling the occurrence of RKNs in plants remains an ongoing challenge. Moreover, there are only a few biological agents for controlling these harmful nematodes. In this study, Xenorhabdus sp. SCG isolated from entomopathogenic nematodes of genus Steinernema was evaluated for nematicidal effects under in vitro and greenhouse conditions. The cell-free filtrates of strain SCG showed nematicidal activity against Meloidogyne species J2s, with mortalities of > 88% at a final concentration of 10%, as well as significant nematicidal activity against the three other genera of plant-parasitic nematodes in a dose-dependent manner. Thymine was isolated as active compounds by assay-guided fractionation and showed high nematicidal activity against M. incognita. Greenhouse experiments suggested that cell-free filtrates of strain SCG efficiently controlled the nematode population in M. incognita-infested tomatoes (Solanum lycopersicum L., cv. Rutgers). In addition, a significant increase in host plant growth was observed after 45 days of treatment. To our knowledge, this is the first to demonstrate the nematicidal activity spectrum of isolated Xenorhabdus species and their application to S. lycopersicum L., cv. Rutgers under greenhouse conditions. Xenorhabdus sp. SCG could be a promising biological nematicidal agent with plant growth-enhancing properties.

Decellularized Matrices for the Treatment of Tissue Defects: from Matrix Origin to Immunological Mechanisms

  • Xinyue Wang;Jiqiang Guo;Qing Yu;Luyao Zhao;Xiang Gao;Li Wang;Meiling Wen;Junrong Yan;Meiwen An;Yang Liu
    • Biomolecules & Therapeutics
    • /
    • v.32 no.5
    • /
    • pp.509-522
    • /
    • 2024
  • Decellularized matrix transplantation has emerged as a promising therapeutic approach for repairing tissue defects, with numerous studies assessing its safety and efficacy in both animal models and clinical settings. The host immune response elicited by decellularized matrix grafts of natural biological origin plays a crucial role in determining the success of tissue repair, influenced by matrix heterogeneity and the inflammatory microenvironment of the wound. However, the specific immunologic mechanisms underlying the interaction between decellularized matrix grafts and the host immune system remain elusive. This article reviews the sources of decellularized matrices, available decellularization techniques, and residual immunogenic components. It focuses on the host immune response following decellularized matrix transplantation, with emphasis on the key mechanisms of Toll-like receptor, T-cell receptor, and TGF-β/SMAD signaling in the stages of post-transplantation immunorecognition, immunomodulation, and tissue repair, respectively. Furthermore, it highlights the innovative roles of TLR10 and miR-29a-3p in improving transplantation outcomes. An in-depth understanding of the molecular mechanisms underlying the host immune response after decellularized matrix transplantation provides new directions for the repair of tissue defects.

Prophylactic endoscopic transpapillary gallbladder stenting to prevent acute cholecystitis induced after metallic stent placement for malignant biliary strictures: a retrospective study in Japan

  • Fumisato Kozakai;Yoshihide Kanno;Shinsuke Koshita;Takahisa Ogawa;Hiroaki Kusunose;Toshitaka Sakai;Keisuke Yonamine;Kazuaki Miyamoto;Haruka Okano;Yuto Matsuoka;Kento Hosokawa;Hidehito Sumiya;Kei Ito
    • Clinical Endoscopy
    • /
    • v.57 no.5
    • /
    • pp.647-655
    • /
    • 2024
  • Background/Aims: Endoscopic biliary drainage using self-expandable metallic stents (SEMSs) for malignant biliary strictures occasionally induces acute cholecystitis (AC). This study evaluated the efficacy of prophylactic gallbladder stents (GBS) during SEMS placement. Methods: Among 158 patients who underwent SEMS placement for malignant biliary strictures between January 2018 and March 2023, 30 patients who attempted to undergo prophylactic GBS placement before SEMS placement were included. Results: Technical success was achieved in 21 cases (70.0%). The mean diameter of the cystic duct was more significant in the successful cases (6.5 mm vs. 3.7 mm, p<0.05). Adverse events occurred for 7 patients (23.3%: acute pancreatitis in 7; non-obstructive cholangitis in 1; perforation of the cystic duct in 1 with an overlap), all of which improved with conservative treatment. No patients developed AC when the GBS placement was successful, whereas 25 of the 128 patients (19.5%) without a prophylactic GBS developed AC during the median follow-up period of 357 days (p=0.043). In the multivariable analysis, GBS placement was a significant factor in preventing AC (hazard ratio, 0.61; 95% confidence interval, 0.37-0.99; p=0.045). Conclusions: GBS may contribute to the prevention of AC after SEMS placement for malignant biliary strictures.

Current status and clinical outcome of endoscopic hemostatic powder in gastrointestinal bleeding: a retrospective multicenter study

  • Zie Hae Lim;Seung In Seo;Dae-Seong Myung;Seung Han Kim;Han Hee Lee;Selen Kim;Bo-In Lee
    • Clinical Endoscopy
    • /
    • v.57 no.5
    • /
    • pp.620-627
    • /
    • 2024
  • Background/Aims: Few multicenter studies have investigated the efficacy of hemostatic powders in gastrointestinal (GI) bleeding. We aimed to investigate the clinical outcomes of hemostatic powder therapy and the independent factors affecting rebleeding rates. Methods: We retrospectively recruited patients who underwent a new hemostatic adhesive powder (UI-EWD; Next-Biomedical) treatment for upper and lower GI bleeding between January 1, 2020 and March 1, 2023. We collected patients' medical records and bleeding lesions. The primary outcomes were clinical and technical success rates, and the secondary outcomes were early and delayed bleeding rates refractory bleeding rate, mortality rate, and factors affecting early rebleeding rates. Results: This study enrolled 135 patients (age: 67.7±13.6 years, male: 74.1%) from five hospitals. Indications for UI-EWD were peptic ulcers (51.1%), post-procedure-related bleeding (23.0%), and tumor bleeding (19.3%). The clinical and technical success rates were both 97%. The early, delayed, and refractory rebleeding rates were 19.3%, 11.1%, and 12.8%, respectively. Initially elevated blood urea nitrogen (BUN) levels (p=0.014) and Forrest classification IA or IB compared with IIA or IIB (p=0.036) were factors affecting early rebleeding. Conclusions: UI-EWD showed high clinical and technical success rates; however, rebleeding after UI-EWD therapy in patients with initially high BUN levels and active bleeding, according to the Forrest classification, should be considered.

Evaluation of cryoablation using a prototype cryoablation needle in swine liver

  • Hyunjoon Son;Jonghyun Lee;Sung Yong Han;Tae In Kim;Dong Uk Kim;Daejin Kim;Gun-Ho Kim
    • Clinical Endoscopy
    • /
    • v.57 no.5
    • /
    • pp.675-682
    • /
    • 2024
  • Background/Aims: Pancreatic cancer poses significant challenges due to its tendency for late-stage diagnosis and high mortality rates. Cryoablation, a technique used to treat various types of cancer, has shown potential in enhancing the prognosis of pancreatic cancer when combined with other therapies. However, its implementation is often limited by the need for lengthy procedures and specialized equipment. This study aims to develop a cryoablation needle optimized for endoscopic ultrasonography to simplify its application in treating pancreatic cancer. Methods: The study involved conducting cryoablation experiments on swine liver tissue. It utilized cryo-needles to evaluate the extent of cell death across various temperatures and durations of cryoablation. Results: The cryoablation system, which employed liquid carbon dioxide, achieved rapid cooling, reaching temperatures below -60 ℃ within 30 seconds and maintained the cryoablation process for 200 seconds. These conditions resulted in necrosis of the liver tissue. Notable cellular changes were observed up to 15 mm away from the cryoablation needle. Conclusions: This experimental study successfully demonstrated the efficacy of using a cryo-needle for cryoablation in swine liver tissue. Further trials involving pancreatic tissue are expected to verify its effectiveness, underscoring the importance of continued research to establish its role as a complementary therapy in pancreatic cancer treatment.

Study on the Efficacies of Anti-acne Cosmetic Containing Lactonic Hydroxy Acid for Improving Acne Skin Care (락톤형 하이드록시애씨드를 적용한 여드름 피부 개선 화장품 효능 연구)

  • Moonki Baek;Bum-Ho Bin
    • Journal of the Society of Cosmetic Scientists of Korea
    • /
    • v.50 no.3
    • /
    • pp.279-288
    • /
    • 2024
  • This study investigates the efficacy of anti-acne cosmetics containing lactonic hydroxy acid, specifically gluconodeltalactone (GDL), in improving acne skin treatment. In sebaceous cells induced by linoleic acid, GDL at concentrations of 1.0 mg/mL or higher demonstrated a concentration-dependent inhibition of lipid synthesis. Antibacterial activity of GDL against Cutibacterium acnes (C. acnes) was confirmed through minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) assays. Based on these in vitro results, a clinical test was conducted involving 65 participants to evaluate the effects of a anti-acne cosmetic formulation containing 3% GDL over an eight-week period. The results indicated a statistically significant improvement (p < 0.05) in both inflammatory acne lesions (papules, pustules, and nodules) and non-inflammatory lesions (comedones) from as early as two weeks of application, without any reported skin irritation. The results confirm that cosmetics with GDL can be used effectively and safely without long-term skin irritation, even for consumers with sensitive acne-prone skin.

The Effect of Herbal Medicine for Chronic Kidney Disease: A Systematic Review and Meta-Analysis (만성신부전에 대한 한약 치료의 효과 : 체계적 문헌 고찰 및 메타분석)

  • Soo-hwa Hong;U-ryeong Chung;Gil-cho Shin
    • The Journal of Internal Korean Medicine
    • /
    • v.45 no.4
    • /
    • pp.568-590
    • /
    • 2024
  • Objectives: This study aimed to evaluate the effect of herbal medicine on patients with non-dialysis chronic kidney disease (CKD). Methods: Articles published from 2011 to February 17, 2024 were searched via PubMed, EMBASE, Cochrane Library, CNKI, CiNii, KISS, RISS, and OASIS. The quality of included articles was evaluated using a risk-of-bias tool. Meta-analyses considered the effects of herbal medicines on the total effective rate, renal function estimates (GFR, SCr, BUN, 24h-Upro), and other indicators (e.g., uric acid, hemoglobin, and bone density-related indicators). Results: A total of 13 RCTs were included in this study. The treatment group showed a significantly higher total effective rate (RR: 1.47, 95% CI: 1.33-1.62, P<0.00001) and GFR (MD: 9.28, 95% CI: 6.52-12.04, P<0.00001), together with improvements in other renal function indicators, except for 24h-Upro (p=0.05). There were no significant differences in uric acid, hemoglobin, and bone density-related indicators. Adverse events were minimal in both groups. Conclusion: For non-dialysis CKD, this study supports the effectiveness of nine herbal medicines, either alone or in combination with Western medicines. However, even the meta-analyses provide insufficient evidence to conclusively guarantee the safety and efficacy of all types of herbal medicines in treating CKD. Therefore, additional well-designed studies are necessary to enhance the clinical application of herbal medicines in CKD.

Chronic oral administration of Passiflora incarnata extract has no abnormal effects on metabolic and behavioral parameters in mice, except to induce sleep

  • Gwang-Ho Kim;Sun Shin Yi
    • Laboraroty Animal Research
    • /
    • v.35
    • /
    • pp.31-38
    • /
    • 2019
  • Although the number of prescriptions and dependence on sleeping pills are increasing, the associations with unexpected abnormal behaviors and metabolic diseases caused by the overuse of sleeping pills are not well understood. In particular, such as abnormal eating-behavior and the occurrence of metabolic disorders caused by psychological unstable states are reported. For this reason, herbal medicine, which has not had such side effects in recent years, is attracting attention as an alternative medicine/food for sleeping inducer. We have used ethanol extracts from Passiflora incarnata (PI) to steadily obtain positive effects on sleep and brain microenvironment. However, as mentioned earlier, sleep-inducing efficacy can only be used safely if the behavioral and metabolic abnormalities do not appear. Thus, in this study, we used Phenomaster equipment to continuously monitor the movement, feeding, water consumption, gas changes, etc. in C57BL/6 mice at a dose of 500 mg/kg/day for 5 consecutive days with PI extract group compared with the control group. Before sacrifice, differences in body composition of mice were also compared. Monitoring of 24 h/5 days through the equipment showed no change in PI-treated group in anything except for significant decrease in blood melatonin levels and activity after PI administration. Taken together, the statistically insignificance of any behavioral and metabolic phenomenon produced by repeated treatment of PI are not only expected to have an accurate sleep effect, but are also free of side effects of the prescribed sleeping pills. This study has given us greater confidence in the safety of the PI extracts we use for sleep-inducer.