• Title/Summary/Keyword: Acute Respiratory Distress Syndrome

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Cryo-EM as a powerful tool for drug discovery: recent structural based studies of SARS-CoV-2

  • Han‑ul Kim;Hyun Suk Jung
    • Applied Microscopy
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    • v.51
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    • pp.13.1-13.7
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    • 2021
  • The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has arisen as a global pandemic affecting the respiratory system showing acute respiratory distress syndrome (ARDS). However, there is no targeted therapeutic agent yet and due to the growing cases of infections and the rising death tolls, discovery of the possible drug is the need of the hour. In general, the study for discovering therapeutic agent for SARS-CoV-2 is largely focused on large-scale screening with fragment-based drug discovery (FBDD). With the recent advancement in cryo-electron microscopy (Cryo-EM), it has become one of the widely used tools in structural biology. It is effective in investigating the structure of numerous proteins in high-resolution and also had an intense influence on drug discovery, determining the binding reaction and regulation of known drugs as well as leading the design and development of new drug candidates. Here, we review the application of cryo-EM in a structure-based drug design (SBDD) and in silico screening of the recently acquired FBDD in SARS-CoV-2. Such insights will help deliver better understanding in the procurement of the effective remedial solution for this pandemic.

A Case of Vivax Malaria Complicated by Adult Respiratory Distress Syndrome and Successful Management with Extracorporeal Membrane Oxygenation

  • Lee, Hyun-Jung;Baek, Ji-Hyeon;Chae, Myoung-Hun;Joo, Hoyeon;Lee, Jin-Soo;Chung, Moon-Hyun;Park, Yun-Kyu;Kim, Joung-Teak
    • Parasites, Hosts and Diseases
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    • v.51 no.5
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    • pp.551-555
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    • 2013
  • Complicated malaria is mainly caused by Plasmodium falciparum, but, increasingly, Plasmodium vivax is also being reported as a cause. Since the reemergence of indigenous vivax malaria in 1993, cases of severe malaria have been steadily reported in Korea. Herein, we report a case of vivax malaria complicated by adult respiratory distress syndrome (ARDS) that was successfully managed with extracorporeal membrane oxygenation (ECMO). A 59-year-old man presented at our hospital with fever and abdominal pain, which had persisted for 10 days. On admission, the patient had impaired consciousness, shock, hypoxia and haziness in both lungs, jaundice, thrombocytopenia and disseminated intravascular coagulation, metabolic acidosis, and acute kidney injury. A peripheral blood smear and a rapid diagnostic test verified P. vivax mono-infection. Ten hours after admission, hypoxia became more severe, despite providing maximal ventilatory support. The administration of antimalarial agents, ECMO, and continuous venovenous hemofiltration resulted in an improvement of his vital signs and laboratory findings. He was discharged from the hospital 7 weeks later, without any sequelae.

Korean Red Ginseng, a regulator of NLRP3 inflammasome, in the COVID-19 pandemic

  • Jung, Eui-Man;Lee, Geun-Shik
    • Journal of Ginseng Research
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    • v.46 no.3
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    • pp.331-336
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    • 2022
  • Coronavirus disease 2019 (COVID-19) exhibits various symptoms, ranging from asymptomatic to severe pneumonia or death. The major features of patients in severe COVID-19 are the dysregulation of cytokine secretion, pneumonia, and acute lung injury. Consequently, it leads to acute respiratory distress syndrome, disseminated intravascular coagulation, multiple organ failure, and death. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative virus of COVID-19, influences nucleotide-binding oligomerization domain, leucine-rich repeat, and pyrin domain containing 3 (NLRP3), the sensor of inflammasomes, directly or indirectly, culminating in the assembly of NLRP3 inflammasome and activation of inflammatory caspases, which induce the inflammatory disruption in severe COVID-19. Accordingly, the target therapeutics for inflammasome has attracted attention as a treatment for COVID-19. Korean Red Ginseng (KRG) inhibits several inflammatory responses, including the NLRP3 inflammasome signaling. This review discusses the role of KRG in the treatment and prevention of COVID-19 based on its anti-NLRP3 inflammasome efficacy.

POST-EXTUBATION ACUTE RESPIRATORY DISTRESS SYNDROME OCCURRED IN THE ORTHOGNATHIC SURGERY PATIENT : A CASE REPORT (악교정 수술 환자에서 발관 후 발생된 급성 호흡곤란 증후군 : 증례보고)

  • Park, Ji-Young;Lee, Jung-A;Yun, Sung-Hun;Park, Min-Kyou;Kim, Chang-Hyun;Park, Je-Uk
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.1
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    • pp.79-84
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    • 2007
  • Acute respiratory distress syndrome(ARDS) is severe acute hypoxic respiratory failure state with dynamic impairment in oxygen and carbon dioxide transfer with the need for high levels of supplementary oxygen and a high minute ventilation. This syndrome is caused by pulmonary edema due to increased permeability of the alveolar capillary barrier by various factors. ARDS is an uncommon, but a potentially life-threatening complication. Therefore, immediate diagnosis and appropriate therapy must be performed. The present case is post-extubation ARDS immediately occurred in an orthognathic surgery patient who are healthy 19-year-old man. He rapidly recovered from ARDS without complication by early diagnosis and proper treatment. This case report was aimed to describe the process of the development, possible causes and the management of ARDS occurred in an orthognathic surgery patient

Therapeutic Role of Inhaled Nitric Oxide for Acute Respiratory Failure in the Early Phase of Trauma (외상환자의 초기 호흡 부전에 대한 흡입산화질소의 적용)

  • Kim, Byoung Sung;Kyoung, Kyu-Hyouck;Park, Hojong
    • Journal of Trauma and Injury
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    • v.28 no.3
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    • pp.104-107
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    • 2015
  • Purpose: Nitric oxide (NO) is a vasodilator and inhaled NO (iNO) is used in acute respiratory distress syndrome (ARDS) to improve alveolocapillary gas exchange. The mechanism to improve oxygenation is likely to redistribute blood flow from unventilated areas to ventilated areas. Though improvement of oxygenation, iNO therapy has not been shown to improve mortality and considered as only rescue therapy in severe hypoxemia. We conducted the study to investigate an efficacy of iNO in trauma patients with severe hypoxemia. Methods: We reviewed the trauma patients who underwent iNO therapy retrospectively from 2010 to 2014. Degree of hypoxemia was represented as $PaO_2/FiO_2$ ratio (PFR) and the severity of patient was represented with sequential organ failure assessment (SOFA) score. Patients were divided into the survivor group and non-survivor group according to the 28-day mortality. Results: A total of 20 patients were enrolled. The mortality of 28-day was 40%. There were no significant differences between survivor and non-survivor group in age, sex, severity of injury, PFR and SOFA score. There was significant difference in initiation time of iNO after injury (p=0.047). Maximum combinations of sensitivity and specificity for timing of iNO therapy were observed using cut-off of 3-day after injury with a sensitivity of 88% and specificity of 75%. Conclusion: Though iNO therapy does not influence the mortality, iNO therapy may decrease the mortality caused by respiratory failure in the early phase of trauma.

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COVID-19 progression towards ARDS: a genome wide study reveals host factors underlying critical COVID-19

  • Shama Mujawar;Gayatri Patil;Srushti Suthar;Tanuja Shendkar;Vaishnavi Gangadhar
    • Genomics & Informatics
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    • v.21 no.2
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    • pp.16.1-16.14
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    • 2023
  • Coronavirus disease 2019 (COVID-19) is a viral infection produced by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus epidemic, which was declared a global pandemic in March 2020. The World Health Organization has recorded around 43.3 billion cases and 59.4 million casualties to date, posing a severe threat to global health. Severe COVID-19 indicates viral pneumonia caused by the SARS-CoV-2 infections, which can induce fatal consequences, including acute respiratory distress syndrome (ARDS). The purpose of this research is to better understand the COVID-19 and ARDS pathways, as well as to find targeted single nucleotide polymorphism. To accomplish this, we retrieved over 100 patients' samples from the Sequence Read Archive, National Center for Biotechnology Information. These sequences were processed through the Galaxy server next generation sequencing pipeline for variant analysis and then visualized in the Integrative Genomics Viewer, and performed statistical analysis using t-tests and Bonferroni correction, where six major genes were identified as DNAH7, CLUAP1, PPA2, PAPSS1, TLR4, and IFITM3. Furthermore, a complete understanding of the genomes of COVID-19-related ARDS will aid in the early identification and treatment of target proteins. Finally, the discovery of novel therapeutics based on discovered proteins can assist to slow the progression of ARDS and lower fatality rates.

Molecular Mechanisms of Neutrophil Activation in Acute Lung Injury (급성 폐손상에서 호중구 활성화의 분자학적 기전)

  • Yum, Ho-Kee
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.6
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    • pp.595-611
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    • 2002
  • Akt/PKB protein kinase B, ALI acute lung injury, ARDS acute respiratory distress syndrome, CREB C-AMP response element binding protein, ERK extracelluar signal-related kinase, fMLP fMet-Leu-Phe, G-CSF granulocyte colony-stimulating factor, IL interleukin, ILK integrin-linked kinase, JNK Jun N-terminal kinase, LPS lipopolysaccharide, MAP mitogen-activated protein, MEK MAP/ERK kinase, MIP-2 macrophage inflammatory protein-2, MMP matrix metalloproteinase, MPO myeloperoxidase, NADPH nicotinamide adenine dinucleotide phosphate, NE neutrophil elastase, NF-kB nuclear factor-kappa B, NOS nitric oxide synthase, p38 MAPK p38 mitogen activated protein kinase, PAF platelet activating factor, PAKs P21-activated kinases, PMN polymorphonuclear leukocytes, PI3-K phosphatidylinositol 3-kinase, PyK proline-rich tyrosine kinase, ROS reactive oxygen species, TNF-${\alpha}$ tumor necrosis factor-a.

Update on the Extracorporeal Life Support

  • Huh, Jin-Won
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.3
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    • pp.149-155
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    • 2015
  • Extracorporeal life support (ECLS) is a type of cardiopulmonary bypass. It is an artificial means of supplying oxygen and removing $CO_2$ on behalf of damaged lungs while patients are recovering from underlying diseases. Recently, the use of ECLS is rapidly increasing as this machine becomes smaller, less invasive and easier to use. In addition, the improvement of clinicians' technique and outcome is increasing their application to patients with acute respiratory distress. In this regard, the purpose of this review is to introduce the physiological principles, risk factors, and advantages of ECLS, clinical rationale for using ECLS, ventilatory strategy during ECLS, which are still causing different opinions, the weaning from ECLS, and the use of anticoagulant.

Association among Lifestyle and Risk Factors with SARS-CoV-2 Infection

  • Yi Ko;Zi-Ni Ngai;Rhun-Yian Koh;Soi-Moi Chye
    • Tuberculosis and Respiratory Diseases
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    • v.86 no.2
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    • pp.102-110
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    • 2023
  • Coronavirus disease 2019 (COVID-19) has become a major health burden worldwide, with over 600 million confirmed cases and 6 million deaths by 15 December 2022. Although the acute phase of COVID-19 management has been established, the long-term clinical course and complications due to the relatively short outbreak is yet to be assessed. The current COVID-19 pandemic is causing significant morbidity and mortality around the world. Interestingly, epidemiological studies have shown that fatality rates vary considerably across different countries, and men and elderly patients are at higher risk of developing severe diseases. There is increasing evidence that COVID-19 infection causes neurological deficits in a substantial proportion to patients suffering from acute respiratory distress syndrome. Furthermore, lack of physical activity and smoking are associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) susceptibility. We should therefore explore why lack of physical activity, smoking, etc causing a population more susceptible to SARS-CoV-2 infection, and mechanism involved. Thus, in this review article, we summarize epidemiological evidence related to risk factors and lifestyle that affect COVID-19 severity and the mechanism involved. These risk factors or lifestyle interventions include smoking, cardiovascular health, obesity, exercise, environmental pollution, psychosocial social stress, and diet.

Enhancement of Mass Transfer Using Piezoelectric Material in Fluid Flow System

  • Kim, Gi-Beum;Chong, Woo-Suk;Kwon, Tae-Kyu;Hong, Chul-Un;Kim, Nam-Gyun;Jheong, Gyeong-Rak
    • 제어로봇시스템학회:학술대회논문집
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    • 2004.08a
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    • pp.165-170
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    • 2004
  • The purpose of this work was to assess and quantify the beneficial effects of long-term gas exchange, at varying frequencies, for the development of a vibrating intravascular lung assistance device (VIVLAD), for patients suffering from acute respiratory distress syndrome (ARDS). The experimental design and procedure have been applied to the construction of a new device for assessing the effectiveness of membrane vibrations. An analytical solution has been developed for the hydrodynamics of flow through a bundle of sinusoidally vibrated hollow fibers, with the intention of gaining insight into how wall vibrations might enhance the performance of the VIVLAD. As a result, the maximum oxygen transfer rate was reached at the maximum amplitude and through the transfer of vibrations to the hollow fiber membranes. The device was excited by a frequency band of 7Hz at various water flow rates, as this frequency was the 2nd mode resonance frequency of the flexible beam. 675 hollow fiber membranes were also bundled, within the blood flow, into the device.

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