• 제목/요약/키워드: pre-clinical system

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Association between metabolic syndrome components and cardiac autonomic modulation in southern Indian adults with pre-metabolic syndrome: hyperglycemia is the major contributing factor

  • Endukuru Chiranjeevi Kumar;Girwar Singh Gaur;Dhanalakshmi Yerrabelli;Jayaprakash Sahoo;Balasubramaniyan Vairappan;Alladi Charanraj Goud
    • The Korean Journal of Physiology and Pharmacology
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    • v.27 no.1
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    • pp.49-59
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    • 2023
  • Metabolic syndrome (MetS) involves multi-factorial conditions linked to an elevated risk of type 2 diabetes mellitus and cardiovascular disease. Pre-metabolic syndrome (pre-MetS) possesses two MetS components but does not meet the MetS diagnostic criteria. Although cardiac autonomic derangements are evident in MetS, there is little information on their status in pre-MetS subjects. In this study, we sought to examine cardiac autonomic functions in pre-MetS and to determine which MetS component is more responsible for impaired cardiac autonomic functions. A total of 182 subjects were recruited and divided into healthy controls (n=89) and pre-MetS subjects (n=93) based on inclusion and exclusion criteria. We performed biochemical profiles on fasting blood samples to detect pre-MetS. Using standardized protocols, we evaluated anthropometric data, body composition, baroreflex sensitivity (BRS), heart rate variability (HRV), and autonomic function tests (AFTs). We further examined these parameters in pre-MetS subjects for each MetS component. Compared to healthy controls, we observed a significant cardiac autonomic dysfunction (CAD) through reduced BRS, lower overall HRV, and altered AFT parameters in pre-MetS subjects, accompanied by markedly varied anthropometric, clinical and biochemical parameters. Furthermore, all examined BRS, HRV, and AFT parameters exhibited an abnormal trend and significant correlation toward hyperglycemia. This study demonstrates CAD in pre-MetS subjects with reduced BRS, lower overall HRV, and altered AFT parameters. Hyperglycemia was considered an independent determinant of alterations in all the examined BRS, HRV, and AFT parameters. Thus, hyperglycemia may contribute to CAD in pre-MetS subjects before progressing to MetS.

Evidence-based herbal medicine in efficacy and safety assessments

  • Park, Jin-Han
    • Advances in Traditional Medicine
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    • v.8 no.2
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    • pp.103-110
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    • 2008
  • Herbal medicine is the use of medicinal plants for prevention and treatment of diseases: it ranges from traditional and popular medicines of every country to the use of standardized and tritated herbal extracts. Generally cultural rootedness enduring and widespread use in a traditional medical system may indicate safety, but also efficacy of treatments, especially in herbal medicine where tradition is almost completely based on remedies containing active principles at very low and ultra low concentrations or relying on magical-energetic principles. The efficacy and safety assessments of medicines, whether modern or herbal, invariably encounter challenges or problems during the course of pre-clinical and clinical research. Some of the challenges in evidence-based herbal medicinal research are unique, and the researcher must be cognizant of them in order to safeguard the quality of the data obtained. Key challenges are: the quality of raw materials; appropriateness of biological/pharmacological activity assessment methodology, and data interpretation; standardization methodology; pharmacokinetics and bioavailability of active constituents and metabolites; clinical dosage formulation/production; and clinical study designs and outcome measures.

Current status and clinical application of patient-derived tumor organoid model in kidney and prostate cancers

  • Eunjeong Seo;Minyong Kang
    • BMB Reports
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    • v.56 no.1
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    • pp.24-31
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    • 2023
  • Urological cancers such as kidney, bladder, prostate, and testicular cancers are the most common types of cancers worldwide with high mortality and morbidity. To date, traditional cell lines and animal models have been broadly used to study pre-clinical applications and underlying molecular mechanisms of urological cancers. However, they cannot reflect biological phenotypes of real tissues and clinical diversities of urological cancers in vitro system. In vitro models cannot be utilized to reflect the tumor microenvironment or heterogeneity. Cancer organoids in three-dimensional culture have emerged as a promising platform for simulating tumor microenvironment and revealing heterogeneity. In this review, we summarize recent advances in prostate and kidney cancer organoids regarding culture conditions, advantages, and applications of these cancer organoids.

Comparison of Pre-processed Brain Tumor MR Images Using Deep Learning Detection Algorithms

  • Kwon, Hee Jae;Lee, Gi Pyo;Kim, Young Jae;Kim, Kwang Gi
    • Journal of Multimedia Information System
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    • v.8 no.2
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    • pp.79-84
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    • 2021
  • Detecting brain tumors of different sizes is a challenging task. This study aimed to identify brain tumors using detection algorithms. Most studies in this area use segmentation; however, we utilized detection owing to its advantages. Data were obtained from 64 patients and 11,200 MR images. The deep learning model used was RetinaNet, which is based on ResNet152. The model learned three different types of pre-processing images: normal, general histogram equalization, and contrast-limited adaptive histogram equalization (CLAHE). The three types of images were compared to determine the pre-processing technique that exhibits the best performance in the deep learning algorithms. During pre-processing, we converted the MR images from DICOM to JPG format. Additionally, we regulated the window level and width. The model compared the pre-processed images to determine which images showed adequate performance; CLAHE showed the best performance, with a sensitivity of 81.79%. The RetinaNet model for detecting brain tumors through deep learning algorithms demonstrated satisfactory performance in finding lesions. In future, we plan to develop a new model for improving the detection performance using well-processed data. This study lays the groundwork for future detection technologies that can help doctors find lesions more easily in clinical tasks.

Clinical Experience of Anterior Cervical Interbody Fusion with the PCB System (전방 경추 유합술에서의 PCB System의 임상적 경험)

  • Kim, Sung Han;Kim, Ho Jin;Kang, Jae Kyu;Doh, Jong Oung;Lee, Chun Dae
    • Journal of Korean Neurosurgical Society
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    • v.30 no.10
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    • pp.1170-1176
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    • 2001
  • Objective : The purpose of the study was to evaluate the clinical and radiological results after discectomy and Lubboc bone graft in the surgical management of the cervical diseases with a new titanium interbody implant and integrated screw fixation(PCB) by anterior approach. Methods : The authors retrospectively analyzed 28 cases of anterior cervical fusion with PCB system and Lubboc bone(xeno graft) from september 1998 to december 2000. Twenty-eight patients with cervical diseases underwent decompression cervical lesion and followed from 5 to 27 months with a mean follow-up of 14 months. There patients were evaluated with clinically and radiologically at immediate postoperative period and at 3, 6, 9, and 12 months. Result : The authors investigated the pre- and postoperative intervertebral disc space, clinical outcomes, radiography fusion rate, and Cobb angle in the fixed segments by anterior approach. The lordotic angles and height of disc space were increased after the operation. The clinical outcome of patients follow-up was good or excellent result based on Odom's criteria with improvement of clinical symptom in about 92.9% of the cervical diseases. Two patients showed loosening of the lower and upper cervical screw of PCB instruments, and two patients showed swallowing difficulty and wound infection Conclusion : The PCB system is a new implant for anterior cervical interbody fusion in the degenerative cervical disease and disc herniations. It provides immediate stability and segment distraction. The results of this study indicate that the PCB system is safe, easy handling of hardware, less complications, high fusion rate, and has provide the keeping the intervertebral disc space height and lordotic angles.

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The Change of Sagittal Alignment of the Lumbar Spine after Dynesys Stabilization and Proposal of a Refinement

  • Park, Won Man;Kim, Chi Heon;Kim, Yoon Hyuk;Chung, Chun Kee;Jahng, Tae-Ahn
    • Journal of Korean Neurosurgical Society
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    • v.58 no.1
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    • pp.43-49
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    • 2015
  • Objective : $Dynesys^{(R)}$ is one of the pedicle-based dynamic lumbar stabilization systems and good clinical outcome has been reported. However, the cylindrical spacer between the heads of the screws undergoes deformation during assembly of the system. The pre-strain probably change the angle of instrumented spine with time and oblique-shaped spacer may reduce the pre-strain. We analyzed patients with single-level stabilization with $Dynesys^{(R)}$ and simulated oblique-shaped spacer with finite element (FE) model analysis. Methods : Consecutive 14 patients, who underwent surgery for single-level lumbar spinal stenosis and were followed-up more than 24 months (M : F=6 : 8; age, $58.7{\pm}8.0$ years), were analyzed. Lumbar lordosis and segmental angle at the index level were compared between preoperation and postoperative month 24. The von Mises stresses on the obliquely-cut spacer ($5^{\circ}$, $10^{\circ}$, $15^{\circ}$, $20^{\circ}$, $25^{\circ}$, and $30^{\circ}$) were calculated under the compressive force of 400 N and 10 Nm of moment with validated FE model of the L4-5 spinal motion segment with segmental angle of $16^{\circ}$. Results : Lumbar lordosis was not changed, while segmental angle was changed significantly from $-8.1{\pm}7.2^{\circ}$ to $-5.9{\pm}6.7^{\circ}$ (p<0.01) at postoperative month 24. The maximum von Mises stresses were markedly decreased with increased angle of the spacer up to $20^{\circ}$. The stress on the spacer was uneven with cylindrical spacer but it became even with the $15^{\circ}$ oblique spacer. Conclusion : The decreased segmental lordosis may be partially related to the pre-strain of Dynesys. Further clinical and biomechanical studies are required for relevant use of the system.

Development of a Wide Dose-Rate Range Electron Beam Irradiation System for Pre-Clinical Studies and Multi-Purpose Applications Using a Research Linear Accelerator

  • Jang, Kyoung Won;Lee, Manwoo;Lim, Heuijin;Kang, Sang Koo;Lee, Sang Jin;Kim, Jung Kee;Moon, Young Min;Kim, Jin Young;Jeong, Dong Hyeok
    • Progress in Medical Physics
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    • v.31 no.2
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    • pp.9-19
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    • 2020
  • Purpose: This study aims to develop a multi-purpose electron beam irradiation device for preclinical research and material testing using the research electron linear accelerator installed at the Dongnam Institute of Radiological and Medical Sciences. Methods: The fabricated irradiation device comprises a dual scattering foil and collimator. The correct scattering foil thickness, in terms of the energy loss and beam profile uniformity, was determined using Monte Carlo calculations. The ion-chamber and radiochromic films were used to determine the reference dose-rate (Gy/s) and beam profiles as functions of the source to surface distance (SSD) and pulse frequency. Results: The dose-rates for the electron beams were evaluated for the range from 59.16 Gy/s to 5.22 cGy/s at SSDs of 40-120 cm, by controlling the pulse frequency. Furthermore, uniform dose distributions in the electron fields were achieved up to approximately 10 cm in diameter. An empirical formula for the systematic dose-rate calculation for the irradiation system was established using the measured data. Conclusions: A wide dose-rate range electron beam irradiation device was successfully developed in this study. The pre-clinical studies relating to FLASH radiotherapy to the conventional level were made available. Additionally, material studies were made available using a quantified irradiation system. Future studies are required to improve the energy, dose-rate, and field uniformity of the irradiation system.

The Effect of Backrest Elevation Education on ICU Nurse's Knowledge, Perception and Performance (침상각도 상승 교육에 대한 중환자실 간호사의 지식, 인식 및 수행 정도)

  • Lee, Hyun Sim;Park, Young Woo;Kim, Jung Yeon;Lee, Eun Sook;Park, Ai Soon;Han, A Reum;Kim, Eun A;Lee, Ho Sun;Koh, Shin Ok
    • Journal of Korean Clinical Nursing Research
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    • v.14 no.3
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    • pp.117-128
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    • 2008
  • Purpose: This study was conducted to examine the differences of knowledge, perception, and performance between the points of time before and after ICU nurses had the backrest elevation education. Method: The study subjects were 58 nurses at a medical and surgical ICU of one general Y hospital located in Seoul. They received the education, including backrest elevation guideline and related education materials. Data were collected from May 11 throughout August 12, 2007 with a structured questionnaire. Results: 1) There were significant differences in the mean scores of knowledge(2.21 at pre-education, 5.24 at post-education), perception(36.96 at pre-education, 53.36 at post-education), and performance(32.08 at pre-education, 43.51 at post-education), 2) There was a significant correlation between nurse's perception and performance (p=.000). 3) The nurse's perception regarding the importance of the back rest elevation education was significantly effective on their performance (p=.000). Conclusion: The backrest elevation education would contribute to improve ICU nurse's knowledge, perception and performance. The more the nurses would consider the importance of this education, the better they would perform the nursing intervention of backrest elevation.

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Prognostic Value of Inferior Shift of P wave Axis after Catheter Ablation for Longstanding Persistent Atrial Fibrillation based on Dallas Lesion Set Including Anterior Line

  • Shin, Dong Geum;Kim, Tae-Hoon;Jeong, Hyunmin;Kim, Alexander;Uhm, Jae-Sun;Joung, Boyoung;Lee, Moon-Hyoung;Hwang, Chun;Pak, Hui-Nam
    • International Journal of Arrhythmia
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    • 제18권2호
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    • pp.66-76
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    • 2017
  • Background and Objectives: Although an anterior linear ablation is an effective lesion set in radiofrequency catheter ablation (RFCA) for longstanding persistent atrial fibrillation (L-PeAF), its durability for bidirectional block (BDB) is only about 60% at repeat procedure. We hypothesized that changes in electrocardiogram (ECG) may predict an anterior line block state and the clinical outcome of L-PeAF ablation. Subjects and Methods: We studied 304 L-PeAF patients (77% male, $60{\pm}10yrs$), who consistently underwent RFCA Dallas lesion set (circumferential pulmonary vein isolation, posterior box lesion, and anterior line) protocol with subsequent comparison of pre-procedural and post-procedural P wave axes, and one year follow-up (n=205) sinus rhythm (SR) ECGs. Results: 1. P wave axis shifted inferiorly at immediate post-procedure (p<0.001), and was independently correlated with BDB of anterior line (${\ss}=10.4$, 95% confidence interval [CI] 2.79-17.94, p=0.008). 2. The degree of post-procedural inferior shift of P wave axis did not reflect clinical recurrence within one-year (n=205, p=0.923), potentially due to conduction recovery of an anterior line. However, among 160 patients without clinical recurrence within one-year, P wave axis at one-year ECG was independently associated with very late recurrence of AF after one-year (n=160, hazard ratio [HR] 0.98; 95% CI 0.97-0.99, p=0.001), during $45.6{\pm}16.7$ months of follow-up. 3. Among 22 patients who underwent repeat procedures, P wave axis shift was more significant in patients with maintained BDB of an anterior line than in those without (p=0.015). Conclusion: An inferior shift of P wave axis reflects the achievement and the maintenance of an anterior line BDB, and is associated with better long-term clinical outcome after catheter ablation for L-PeAF based on Dallas lesion set.

Complementary and Alternative Medicine for treating Low Back Pain with Teaching Exercise: A narrative review

  • Kim, Yeonhak;Yang, Gi-Young
    • The Journal of Korean Medicine
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    • v.41 no.4
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    • pp.78-87
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    • 2020
  • Objectives: In modern society, many people have low back pain (LBP) and spinal diseases. About 80% of them experience severe LBP more than once in their lifetime. We can find studies on many Korean medicine-based treatments, such as acupuncture treatment for LBP and exercise therapy, which are effective in reducing the symptoms. This study focuses on the combined effect of both Korean medicine and exercise therapy for treating LBP. Method: For this review, we searched for articles focusing on pain and disability recovery in pre-clinical and clinical studies of extension and flexion exercise therapy related to LBP. The search databases were as follows: PubMed, Google Scholar, and seven Korean electronic databases (Korea Citation Index (KCI), Korean studies Information Service System (KISS), Research Information Service System (RISS), Oriental Medicine Advanced Searching Integrated System (OASIS), DBPIA, National Digital Science Library (NDSL), and KOREAMED). The keywords were as follows: Korean Medicine, back pain, flexion exercise, extension exercise, McKenzie method, McKenzie exercise, Williams' flexion exercise, and Mechanical Diagnosis and Therapy. Results & Conclusions: This review shows the usefulness of flexion and extension exercises for LBP treatment and effective patient education, but further studies are necessary.