• Title/Summary/Keyword: therapeutic option

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Traumatic Aortic Injury: Single-center Comparison of Open versus Endovascular Repair

  • Cho, Jun Woo;Kwon, Oh Choon;Lee, Sub;Jang, Jae Seok
    • Journal of Chest Surgery
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    • v.45 no.6
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    • pp.390-395
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    • 2012
  • Background: Conventional open repair is a suboptimal therapy for blunt traumatic aortic injury (BTAI) due to the high postoperative mortality and morbidity rates. Recent advances in the thoracic endovascular repair technique may improve outcomes so that it becomes an attractive therapeutic option. Materials and Methods: From August 2003 to March 2012, 21 patients (mean age, 45.81 years) with BTAI were admitted to our institution. Of these, 18 cases (open repair in 11 patients and endovascular repair in 7 patients) were retrospectively reviewed and the early perioperative results of the two groups were compared. Results: Although not statistically significant, there was a trend toward the reduction of mortality in the endovascular repair group (18.2% vs. 0%). There were no cases of paraplegia or endoleak. Statistically significant reductions in heparin dosage, blood loss, and transfusion amounts during the operations and in procedure duration were observed. Conclusion: Compared with open repair, endovascular repair can be performed with favorable mortality and morbidity rates. However, relatively younger patients who have acute aortic arch angulation and a small aortic diameter may be a therapeutic challenge. Improvements in graft design, delivery sheaths, and graft durability are the cornerstone of successful endovascular repair.

Revisiting Use of Growth Factors in Myelodysplastic Syndromes

  • Newman, Kam;Maness-Harris, Lori;El-Hemaidi, Ihab;Akhtari, Mojtaba
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1081-1091
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    • 2012
  • Myelodysplastic syndromes (MDS) represent a heterogeneous group of clonal hematologic neoplasms characterized by morphologic dysplasia, aberrant hematopoiesis and peripheral blood refractory cytopenias. MDS is recognized to be associated with an increased risk of symptomatic anemia, infectious complications and bleeding diathesis, as well as a risk of progression to acute myeloid leukemia, particularly in patients with a high IPSS score. The advent of use of hematopoietic growth factors such as granulocyte colony-stimulating factor (G-CSF) and recombinant erythropoietin (EPO) has improved symptoms in MDS patients in addition to some data that suggest there might be an improvement in survival. G-CSF is an effective therapeutic option in MDS patients, and it should be considered for the management of refractory symptomatic cytopenias. G-CSF and EPO in combination can improve outcomes in appropriate MDS patients such as those with lower-risk MDS and refractory anemia with ring sideroblasts (RARS). This article reviews use of growth factors for lower-risk MDS patients, and examines the data for G-CSF, EPO and thrombopietic growth factors (TPO) that are available or being developed as therapeutic modalities for this challenging disease.

A Case Study of a Serious Antibiotics-associated diarrhea Patient Treated with Modified Hyangsayukgunja-tang (중증 항생제 유발 설사 환자에 대한 향사육군자탕(香砂六君子湯) 가감방(加減方) 투여 1예)

  • Park, Soim;Kang, Da-Hyun;Seo, Ho-Seok;Kim, Jin-Won
    • Herbal Formula Science
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    • v.22 no.2
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    • pp.121-131
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    • 2014
  • Objectives : The purpose of this study is to report a therapeutic effects of a Korean herbal prescription for antibiotics-associated diarrhea. Methods : Modified Hyangsayukgunja-tang was prescribed once or twice a day to a antibiotics-associated diarrhea patient. To observe the therapeutic effects, the frequency of defecation was counted and Bristol Stool Form Index was used. Laboratory tests were conducted periodically. Results : The frequency of defecation was decreased from 9 times a day to once a day. According to Bristol Stool Form Index, stool form was improved from Type 7 to Type 5. The level of red blood cell, hemoglobin and albumin increased slightly from the day of admission to discharge. Conclusions : Hyangsayukgunja-tang can be a choosable treatment option for a serious antibiotics-associated diarrhea.

Use of a botulinum toxin A in dentistry and oral and maxillofacial surgery

  • Park, Kyung-Soo;Lee, Chi-Heun;Lee, Jung-Woo
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.3
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    • pp.151-157
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    • 2016
  • Botulinum toxin (BT) was the first toxin to be used in the history of human medicine. Among the eight known serotypes of this toxin, those currently used in medicine are types A and B. This review article mainly discusses BT type A (BTA) because it is usually used in dentistry including dental anesthesiology and oral and maxillofacial surgery. BTA has been used mainly in the treatment of temporomandibular joint disorder (TMD) and hypertrophy and hyperactivity of the masticatory muscles, along with being a therapeutic option to relieve pain and help in functional recovery from dental and oral and maxillofacial surgery. However, it is currently used broadly for cosmetic purposes such as reducing facial wrinkles and asymmetry. Although the therapeutic effect of BTA is temporary and relatively safe, it is essential to have knowledge about related anatomy, as well as the systemic and local adverse effects of medications that are applied to the face.

Magnetic Resonance-Guided Focused Ultrasound : Current Status and Future Perspectives in Thermal Ablation and Blood-Brain Barrier Opening

  • Lee, Eun Jung;Fomenko, Anton;Lozano, Andres M.
    • Journal of Korean Neurosurgical Society
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    • v.62 no.1
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    • pp.10-26
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    • 2019
  • Magnetic resonance-guided focused ultrasound (MRgFUS) is an emerging new technology with considerable potential to treat various neurological diseases. With refinement of ultrasound transducer technology and integration with magnetic resonance imaging guidance, transcranial sonication of precise cerebral targets has become a therapeutic option. Intensity is a key determinant of ultrasound effects. High-intensity focused ultrasound can produce targeted lesions via thermal ablation of tissue. MRgFUS-mediated stereotactic ablation is non-invasive, incision-free, and confers immediate therapeutic effects. Since the US Food and Drug Administration approval of MRgFUS in 2016 for unilateral thalamotomy in medication-refractory essential tremor, studies on novel indications such as Parkinson's disease, psychiatric disease, and brain tumors are underway. MRgFUS is also used in the context of blood-brain barrier (BBB) opening at low intensities, in combination with intravenously-administered microbubbles. Preclinical studies show that MRgFUS-mediated BBB opening safely enhances the delivery of targeted chemotherapeutic agents to the brain and improves tumor control as well as survival. In addition, BBB opening has been shown to activate the innate immune system in animal models of Alzheimer's disease. Amyloid plaque clearance and promotion of neurogenesis in these studies suggest that MRgFUS-mediated BBB opening may be a new paradigm for neurodegenerative disease treatment in the future. Here, we review the current status of preclinical and clinical trials of MRgFUS-mediated thermal ablation and BBB opening, described their mechanisms of action, and discuss future prospects.

Fibroblast-derived interleukin-6 exacerbates adverse cardiac remodeling after myocardial infarction

  • Hongkun Li;Yunfei Bian
    • The Korean Journal of Physiology and Pharmacology
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    • v.28 no.3
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    • pp.285-294
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    • 2024
  • Myocardial infarction is one of the leading causes of mortality globally. Currently, the pleiotropic inflammatory cytokine interleukin-6 (IL-6) is considered to be intimately related to the severity of myocardial injury during myocardial infarction. Interventions targeting IL-6 are a promising therapeutic option for myocardial infarction, but the underlying molecular mechanisms are not well understood. Here, we report the novel role of IL-6 in regulating adverse cardiac remodeling mediated by fibroblasts in a mouse model of myocardial infarction. It was found that the elevated expression of IL-6 in myocardium and cardiac fibroblasts was observed after myocardial infarction. Further, fibroblast-specific knockdown of Il6 significantly attenuated cardiac fibrosis and adverse cardiac remodeling and preserved cardiac function induced by myocardial infarction. Mechanistically, the role of Il6 contributing to cardiac fibrosis depends on signal transduction and activation of transcription (STAT)3 signaling activation. Additionally, Stat3 binds to the Il11 promoter region and contributes to the increased expression of Il11, which exacerbates cardiac fibrosis. In conclusion, these results suggest a novel role for IL-6 derived from fibroblasts in mediating Stat3 activation and substantially augmented Il11 expression in promoting cardiac fibrosis, highlighting its potential as a therapeutic target for cardiac fibrosis.

The Role of Autophagy in Eosinophilic Airway Inflammation

  • Jinju Lee;Hun Sik Kim
    • IMMUNE NETWORK
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    • v.19 no.1
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    • pp.5.1-5.12
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    • 2019
  • Autophagy is a homeostatic mechanism that discards not only invading pathogens but also damaged organelles and denatured proteins via lysosomal degradation. Increasing evidence suggests a role for autophagy in inflammatory diseases, including infectious diseases, Crohn's disease, cystic fibrosis, and pulmonary hypertension. These studies suggest that modulating autophagy could be a novel therapeutic option for inflammatory diseases. Eosinophils are a major type of inflammatory cell that aggravates airway inflammatory diseases, particularly corticosteroid-resistant inflammation. The eosinophil count is a useful tool for assessing which patients may benefit from inhaled corticosteroid therapy. Recent studies demonstrate that autophagy plays a role in eosinophilic airway inflammatory diseases by promoting airway remodeling and loss of function. Genetic variant in the autophagy gene ATG5 is associated with asthma pathogenesis, and autophagy regulates apoptotic pathways in epithelial cells in individuals with chronic obstructive pulmonary disease. Moreover, autophagy dysfunction leads to severe inflammation, especially eosinophilic inflammation, in chronic rhinosinusitis. However, the mechanism underlying autophagy-mediated regulation of eosinophilic airway inflammation remains unclear. The aim of this review is to provide a general overview of the role of autophagy in eosinophilic airway inflammation. We also suggest that autophagy may be a new therapeutic target for airway inflammation, including that mediated by eosinophils.

The role of FGF-2 in smoke-induced emphysema and the therapeutic potential of recombinant FGF-2 in patients with COPD

  • Kim, You-Sun;Hong, Goohyeon;Kim, Doh Hyung;Kim, Young Min;Kim, Yoon-Keun;Oh, Yeon-Mok;Jee, Young-Koo
    • Experimental and Molecular Medicine
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    • v.50 no.11
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    • pp.9.1-9.10
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    • 2018
  • Although the positive effects of recombinant fibroblast growth factor-2 (rFGF-2) in chronic obstructive pulmonary disease (COPD) have been implicated in previous studies, knowledge of its role in COPD remains limited. The mechanism of FGF2 in a COPD mouse model and the therapeutic potential of rFGF-2 were investigated in COPD. The mechanism and protective effects of rFGF-2 were evaluated in cigarette smoke-exposed or elastase-induced COPD animal models. Inflammation was assessed in alveolar cells and lung tissues from mice. FGF-2 was decreased in the lungs of cigarette smoke-exposed mice. Intranasal use of rFGF-2 significantly reduced macrophage-dominant inflammation and alveolar destruction in the lungs. In the elastase-induced emphysema model, rFGF-2 improved regeneration of the lungs. In humans, plasma FGF-2 was decreased significantly in COPD compared with normal subjects (10 subjects, P = 0.037). The safety and efficacy of inhaled rFGF-2 use was examined in COPD patients, along with changes in respiratory symptoms and pulmonary function. A 2-week treatment with inhaled rFGF-2 in COPD (n = 6) resulted in significantly improved respiratory symptoms compared with baseline levels (P < 0.05); however, the results were not significant compared with the placebo. The pulmonary function test results of COPD improved numerically compared with those in the placebo, but the difference was not statistically significant. No serious adverse events occurred during treatment with inhaled rFGF-2. The loss of FGF-2 production is an important mechanism in the development of COPD. Inhaling rFGF-2 may be a new therapeutic option for patients with COPD because rFGF-2 decreases inflammation in lungs exposed to cigarette smoke.

Vagus Nerve Stimulation Through Electro-acupuncture for Inflammatory Bowel Disease (염증성 장 질환에서 전침을 중심으로 한 미주신경자극에 대한 고찰)

  • Minjeong Kim;Dongwon Kim;Chaehyun Park;Jae-Woo Park;Seok-Jae Ko
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.455-465
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    • 2023
  • Inflammatory bowel disease (IBD) is defined as a chronic inflammatory-mediated disease that causes ulceration and inflammation in the gastrointestinal tract. Among most patients, the course of chronic inflammation repeatedly shows intermittent exacerbations and alternating remissions. However, despite the various therapeutic options to relieve symptoms, such as corticosteroids, TNF-α inhibitors, and antibiotic drugs, there is no known cure for IBD. Nonetheless, previous research has revealed that the autonomic nervous system is involved in the pathophysiology of IBD. In this study, we reviewed clinical trials confirming the therapeutic effect of vagus nerve stimulation (VNS) on IBD in vivo. We searched in vivo and human studies on Pubmed using keywords combined with "vagus nerve stimulation", "VNS", and "inflammatory bowel disease". All studies included in this review reported that direct VNS is effective in relieving symptoms of IBD and has no severe adverse effects. The most frequently stimulated site was the unilateral cervical vagus nerve area, and parameters for stimulation were set as 5-20 Hz. Based on the results, we aim to summarize the evidence for the efficacy of VNS on IBD and suggest the possibility of auricular electroacupuncture treatment as a therapeutic option for IBD.

Transarterial Embolization for Sporadic Renal Angiomyolipoma: Patient Selection and Technical Considerations for Optimal Therapeutic Outcomes (산발성 신장 혈관근지방종에 대한 경동맥 색전술: 최적의 치료 결과를 위한 환자 선택 및 기술적 고려 사항)

  • Yena Jung;Min Jeong Choi;Bong Man Kim;You Me Kim;Yumi Seo
    • Journal of the Korean Society of Radiology
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    • v.83 no.3
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    • pp.559-581
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    • 2022
  • Although renal angiomyolipoma (AML) is a benign tumor, treatment may be necessary occasionally because it can cause potentially life-threatening retroperitoneal hemorrhage. Transarterial embolization (TAE) is a safe and effective treatment option to prevent the hemorrhagic rupture of AMLs and relieve the symptoms caused by enlarged lesions or active bleeding. However, there is no clear consensus regarding the indications for prophylactic TAE in patients with sporadic renal AMLs. In urgent TAE for bleeding AMLs, there is a likelihood of incomplete embolization when the focus is on stabilizing the clinical symptoms. This pictorial essay discusses the patient selection and technical considerations to achieve optimal therapeutic effects as well as the follow-up findings after TAE.