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Slowing the Progression of Chronic Kidney Disease in Children and Adolescents (소아 청소년 만성 콩팥병의 진행 억제)

  • Ha, Il-Soo;Choi, Yong
    • Childhood Kidney Diseases
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    • v.14 no.1
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    • pp.1-9
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    • 2010
  • Slowing the progression of chronic kidney disease is much more important in children and adolescents with a relatively longer remaining life span. A practical way to assess the rate of progression of chronic kidney disease is to measure the change of GFR estimated by formulae. To slow the progression, hypertension and proteinuria have to be controlled strictly, and hypoplastic anemia must be treated with erythropoietin. If not contraindicated, ACE inhibitor or angiotensin receptor blocker is recommended with monitoring of the side effects. Trials to slow the progression should be commenced as soon as the chronic kidney disease is confirmed and needs to be continued until renal transplantation as long as residual renal function remains. An online system, the Korean Pediatric Chronic Kidney Disease Registry (http://pedcrf.or.kr/), provides tools that are useful in evaluation and management of the children and adolescents with chronic kidney diseases.

Myositis Ossificans Progressiva localized on hands and feet with slow progression - One case report - (수족부에 국한되어 완만한 임상경과를 보이는 진행성 골화성 근염 - 1예 보고 -)

  • Kim, Jae-Hwa;Cho, Duck-Yun;Yoon, Hyung-Ku;Han, Soo-Hong;Kim, Dong-Jun
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.2
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    • pp.247-250
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    • 2002
  • Myositis ossificans progressiva, otherwise called fibrodysplasia ossificans progressiva is a rare hereditary disease of unknown etiology, which is characterized by progressive ectopic ossification in connective tissues of the muscles, tendons, fascia and aponeurosis. We report a case of myositis ossificans progressiva confined to hands and feet, which has an unusual clinical feature with slow progression.

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Solution to Slow Down Myopia Progression

  • Jung, Ji-Won
    • Journal of Korean Clinical Health Science
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    • v.8 no.1
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    • pp.1386-1397
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    • 2020
  • Purpose: To examine the effectiveness of various treatments; bifocal spectacles, orthokeratology, atropine, and time spent in outdoors; in slowing down the myopia progression for Asian adolescents (6-18age). Methods: The research focused on examining the most effective treatment in controlling myopia based on the literature sources that have been published. Through meta-analysis of various research papers that already has been done in this field, a lot of data was collected. For each treatment, the difference in axial length and spherical equivalent over time was measured and recorded. To quantitatively record the difference, both axial length and spherical equivalent was determined by value of control group value of treatment group. The paper compared the effectiveness of each treatment based on the data that was measured. Results: Adolescents who chose to spend time outdoors in order to slow down myopia progression had axial length difference of 0.03 mm and spherical equivalent difference of 0.17 D. Adolescents that used atropine had axial length difference of 0.36 mm and spherical equivalent difference of 0.92 D. Bifocal spectacle resulted in axial length difference of 0.21 mm and spherical equivalent difference of 0.59 D, and for orthokeratology 0.23 mm and 0.04 D, respectively. Axial length wise, myopia was most controlled by the atropine since there was a greatest difference between the group that got the treatment and the group that did not have the treatment. According to the spherical equivalent difference data, myopia was most controlled by atropine. Conclusion: Atropine showed the most effective result in controlling myopia among the four treatment. Again, compared to other three treatment, using atropine appeared to have greatest ability in slowing down myopia progression since adolescents who were treated with atropine had greatest difference from adolescents in the control group that had the same condition but didn't get the treatment. However, every treatment was only used for 2 or 3 years which is quite short time period to measure the long term effect of the four treatments. Also, since atropine is a pharmaceutical method to control myopia, it may harm adolescents' eyes compared to optical or environmental treatment.

How to delay the progression of chronic kidney disease: focusing on medications

  • Jeesu Min
    • Childhood Kidney Diseases
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    • v.28 no.2
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    • pp.51-58
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    • 2024
  • Patients with chronic kidney disease (CKD) bear a significant financial burden and face numerous complications and higher mortality rates. The progression of CKD is associated with glomerular injury caused by glomerular hyperfiltration and oxidative stress. Factors such as uncontrolled hypertension, elevated urine protein levels, anemia, and underlying glomerular disease, contribute to CKD progression. In addition to conservative treatment, several medications are available to combat the progression of CKD to end-stage kidney disease. Renin-angiotensin-aldosterone system blockers could slow the progression of CKD by reducing glomerular hyperfiltration, lowering blood pressure, and decreasing inflammation. Mineralocorticoid receptor antagonists inhibit the mineralocorticoid receptor signaling pathway, thereby attenuating inflammation and fibrosis. Sodium-glucose cotransporter 2 inhibitors exhibit protective effects on the kidneys and against cardiovascular events. Tolvaptan, a selective vasopressin V2-receptor antagonist, decelerates the rate of increase in total kidney volume and deterioration of kidney function in patients with rapidly progressive autosomal dominant polycystic kidney disease. The protective effects of AST-120 remain controversial. Due to a lack of evidence regarding the efficacy and safety of these medications in children, it is imperative to weigh the benefits and adverse effects carefully. Further research is essential to establish the efficacy and safety profiles in pediatric populations.

Role of Cerebrospinal Fluid Biomarkers in Clinical Trials for Alzheimer's Disease Modifying Therapies

  • Kang, Ju-Hee;Ryoo, Na-Young;Shin, Dong Wun;Trojanowski, John Q.;Shaw, Leslie M.
    • The Korean Journal of Physiology and Pharmacology
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    • v.18 no.6
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    • pp.447-456
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    • 2014
  • Until now, a disease-modifying therapy (DMT) that has an ability to slow or arrest Alzheimer's disease (AD) progression has not been developed, and all clinical trials involving AD patients enrolled by clinical assessment alone also have not been successful. Given the growing consensus that the DMT is likely to require treatment initiation well before full-blown dementia emerges, the early detection of AD will provide opportunities to successfully identify new drugs that slow the course of AD pathology. Recent advances in early detection of AD and prediction of progression of the disease using various biomarkers, including cerebrospinal fluid (CSF) $A{\beta}_{1-42}$, total tau and p-tau181 levels, and imagining biomarkers, are now being actively integrated into the designs of AD clinical trials. In terms of therapeutic mechanisms, monitoring these markers may be helpful for go/no-go decision making as well as surrogate markers for disease severity or progression. Furthermore, CSF biomarkers can be used as a tool to enrich patients for clinical trials with prospect of increasing statistical power and reducing costs in drug development. However, the standardization of technical aspects of analysis of these biomarkers is an essential prerequisite to the clinical uses. To accomplish this, global efforts are underway to standardize CSF biomarker measurements and a quality control program supported by the Alzheimer's Association. The current review summarizes therapeutic targets of developing drugs in AD pathophysiology, and provides the most recent advances in the clinical utility of CSF biomarkers and the integration of CSF biomarkers in current clinical trials.

Potential Roles of Protease Inhibitors in Cancer Progression

  • Yang, Peng;Li, Zhuo-Yu;Li, Han-Qing
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8047-8052
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    • 2016
  • Proteases are important molecules that are involved in many key physiological processes. Protease signaling pathways are strictly controlled, and disorders in protease activity can result in pathological changes such as cardiovascular and inflammatory diseases, cancer and neurological disorders. Many proteases have been associated with increasing tumor metastasis in various human cancers, suggesting important functional roles in the metastatic process because of their ability to degrade the extracellular matrix barrier. Proteases are also capable of cleaving non-extracellular matrix molecules. Inhibitors of proteases to some extent can reduce invasion and metastasis of cancer cells, and slow down cancer progression. In this review, we focus on the role of a few proteases and their inhibitors in tumors as a basis for cancer prognostication and therapy.

Biological Characterization of HIV-1 Isolates from Long-term non-progressors (LTNP) and Rapid Progressors (RP) in Korea

  • Nam, Jeong-Gu;Kang, Chun;Lee, Sung-Rae;Lee, Joo-Shil
    • The Journal of Korean Society of Virology
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    • v.28 no.4
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    • pp.347-358
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    • 1998
  • To analyze the correlation between biological phenotypes of HIV-1 isolates and disease progression, we selected 9 long-term non-progressors (LTNP) and 12 rapid progressors (RP) from HIV-1 infected Korean. We isolated HIV-1 isolates by culture of PBMC of LTNP and RP with normal PBMC and measured HIV-1 p24 antigen production. The HIV-1 isolation rate from LTNP was 55.6% (5/9). And 4 HIV-1 LTNP isolates were non-syncytium inducing (NSI) phenotype and showed slow/low replication. The HIV-1 isolation rate from RP was 91.7% (11/12) which was higher than that from LTNP. Besides 3 RP HIV-1 isolates which showed syncytium inducing (SI) phenotype, 8 RP HIV-1 isolates showed NSI phenotype in normal PBMC and MT-2 cell line. All RP HIV-1 isolates replicated more rapidly than LTNP HIV-1 isolates. Comparing the replication kinetics and syncytium forming capacity of HIV-1 isolates from LTNP and RP, we suggest that the difference of biological phenotype of HIV-1 isolates could be related with disease progression of HIV-1 infected persons.

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Effects of Early Cell Damage from Repetitive Intermittent Fever Exposure in Alopecia Progression and Evaluation of New Candidate Drugs: Ibuprofen, Menthol, and Cetirizine (간헐적 발열 반응에 의한 세포 손상과 이와 관련된 탈모 치료를 위한 신 후보물질 연구)

  • Lim, Sung Cil;Moon, Hong Seop
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.3
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    • pp.187-194
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    • 2016
  • Background: Alopecia areata (AA) is a very disturbing and expensive disorder in which the exact etiology is not known and it is yet to be treated completely well. Most alopecia patients exhibit some inflammation in the hair follicles regardless of the causes. The clinical symptoms of alopecia present very diversely while the prime symptom is local intermittent fever which are related to inflamed cells. Methods: This study aimed to evaluate how repetitive intermittent fever can damage the normal human dermal fibroblast (NHDF) cells and investigated the cytotoxic and proliferative effects after application of new candidate drugs (ibuprofen, menthol, cetirizine) for alopecia in comparison to minoxidil. Results: This study demonstrated that ibuprofen, menthol, or/and cetirizine can prevent or slow down the damage of NHDF cells from intermittent fever in early alopecia. Aggressive preventative intervention with those drugs before complete destruction of hair follicle by excessive repetitive fever, is a very important step for alopecia therapy and these drugs are recommended as candidate drugs for alopecia in the future. Conclusion: Aggressive preventative intervention with drugs before complete destruction of hair follicles (NHDF cells) by excessive repetitive fever is a very important step for alopecia therapy or progression.

Development of Free-form PALs for Correcting Wavefront Refraction (파면굴절력 교정을 위한 자유형상 누진가입도렌즈 개발)

  • Baarg, Saang-Bai;Jeong, Mee-Suk
    • Journal of the Korean Society for Precision Engineering
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    • v.27 no.2
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    • pp.50-59
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    • 2010
  • In this paper, two kind of free-form progressive addition lenses (PALs) were designed with Zernike polynomial surface and anatomically accurate finite presbyopic schematic eyes which have aspheric cornea, aspheric GRIN crystalline lens, aspheric retina, and Gaussian apodization factor. Geometrical and diffraction MTFs were used for the optimization process in sequence. 5th orders of Zernike polynomials were used for the evaluation of progression zones of the two examples. The target MTF was set as 0.22 at 100 lp/mm which satisfies the standard visual resolution. These examples were fabricated with a CNC diamond turning machine controlled by slow tool servo (STS). After polishing process, the wavefront aberrations were measured with a laser interferometer on the ten test points across the progression zones and then compared with three current commercially available PALs on the optical performance. Astigmatic aberrations of the examples are very lower than the three selected PALs and have more increased stabilized progressive intermediate zones and near zones. It is expected to give better clear and comfortable distance, intermediate and near visions than other conventional PALs and to improve the adaptability of presbyopic patients to PALs.

Identification and Application of Biomarkers in Molecular and Genomic Epidemiologic Research

  • Lee, Kyoung-Mu;Han, So-Hee;Park, Woong-Yang;Kang, Dae-Hee
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.6
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    • pp.349-355
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    • 2009
  • Biomarkers are characteristic biological properties that can be detected and measured in a variety of biological matrices in the human body, including the blood and tissue, to give an indication of whether there is a threat of disease, if a disease already exists, or how such a disease may develop in an individual case. Along the continuum from exposure to clinical disease and progression, exposure, internal dose, biologically effective dose, early biological effect, altered structure and/or function, clinical disease, and disease progression can potentially be observed and quantified using biomarkers. While the traditional discovery of biomarkers has been a slow process, the advent of molecular and genomic medicine has resulted in explosive growth in the discovery of new biomarkers. In this review, issues in evaluating biomarkers will be discussed and the biomarkers of environmental exposure, early biologic effect, and susceptibility identified and validated in epidemiological studies will be summarized. The spectrum of genomic approaches currently used to identify and apply biomarkers and strategies to validate genomic biomarkers will also be discussed.