• 제목/요약/키워드: Adjunctive therapy

검색결과 104건 처리시간 0.028초

What Can We Apply to Manage Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Acute Respiratory Failure?

  • Kim, Deog Kyeom;Lee, Jungsil;Park, Ju-Hee;Yoo, Kwang Ha
    • Tuberculosis and Respiratory Diseases
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    • 제81권2호
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    • pp.99-105
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    • 2018
  • Acute exacerbation(s) of chronic obstructive pulmonary disease (AECOPD) tend to be critical and debilitating events leading to poorer outcomes in relation to chronic obstructive pulmonary disease (COPD) treatment modalities, and contribute to a higher and earlier mortality rate in COPD patients. Besides pro-active preventative measures intended to obviate acquisition of AECOPD, early recovery from severe AECOPD is an important issue in determining the long-term prognosis of patients diagnosed with COPD. Updated GOLD guidelines and recently published American Thoracic Society/European Respiratory Society clinical recommendations emphasize the importance of use of pharmacologic treatment including bronchodilators, systemic steroids and/or antibiotics. As a non-pharmacologic strategy to combat the effects of AECOPD, noninvasive ventilation (NIV) is recommended as the treatment of choice as this therapy is thought to be most effective in reducing intubation risk in patients diagnosed with AECOPD with acute respiratory failure. Recently, a few adjunctive modalities, including NIV with helmet and helium-oxygen mixture, have been tried in cases of AECOPD with respiratory failure. As yet, insufficient documentation exists to permit recommendation of this therapy without qualification. Although there are too few findings, as yet, to allow for regular andr routine application of those modalities in AECOPD, there is anecdotal evidence to indicate both mechanical and physiological benefits connected with this therapy. High-flow nasal cannula oxygen therapy is another supportive strategy which serves to improve the symptoms of hypoxic respiratory failure. The therapy also produced improvement in ventilatory variables, and it may be successfully applied in cases of hypercapnic respiratory failure. Extracorporeal carbon dioxide removal has been successfully attempted in cases of adult respiratory distress syndrome, with protective hypercapnic ventilatory strategy. Nowadays, it is reported that it was also effective in reducing intubation in AECOPD with hypercapnic respiratory failure. Despite the apparent need for more supporting evidence, efforts to improve efficacy of NIV have continued unabated. It is anticipated that these efforts will, over time, serve toprogressively decrease the risk of intubation and invasive mechanical ventilation in cases of AECOPD with acute respiratory failure.

의이인(薏苡仁)의 염증성 사이토카인 발현 및 조절에 관한 연구 (Inhibitory Effect of Coicis Semen Extract(CSE) on Pro-inflammatory Mediatory)

  • 윤혜진;이유진;강미선;백정한
    • 대한한방소아과학회지
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    • 제23권1호
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    • pp.159-171
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    • 2009
  • Objectives This study was evaluated the effects of CSE the regulatory mechanism of NO and cytokines in the LPS-stimulated Raw 264.7 cells. Methods The Coicis Semen MeOH extract dissolved in EMEM for 1 hour prior to the addition of LPS(1${mu}g/ml$). The cell viability was measured by MTT assay, and Nitric Oxide production was monitored by measuring the nitrite content in culture medium. The levels of cytokine and PGE2 were analyzed by sandwich immunoassays. Results CSE inhibited the production of NO (0.03 and 0.1 mg/ml), $TNF-{\alpha}$ (0.03 and 0.1 mg/ml), $IL-1{\beta}$ (0.03 and 0.1 mg/ml), IL-6 (0.03, 0.1 mg/ml) and PGE2(0.03 and 0.1 mg/ml) in Raw 264.7 cells activated with LPS(lipopolysaccharide). Conclusion According to the results above, Coicis Semen can produce anti-inflammatory effect, which may play a role in adjunctive therapy in Gram-negative bacterial infections.

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상악동에 발생한 국균증의 치험2례 (TWO CASES REPORT OF MAXILLARY SINUS ASPERGILLOSIS)

  • 김수민;여환호;김영균;김수관;조재오
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제18권4호
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    • pp.726-733
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    • 1996
  • Aspergillosis of the maxillary sinus was rare disease, but it was increasing tendency with overuse antibiotics, streoid hormones, and anticanncerous agents. The clinical features and X-ray findings are similar to chronic suppurative paranasal sinusitis. Aspergillosis of the maxillary siuses may occur as a chronic diseae in an otherwise healthy person. This infection is usually confined to a single paranasal sinus, the maxillary antrum, though it can involve the orbit and may initiate with findings of proptosis and decreased vision. The disease is characterized by a wide range of initial symptoms, and should be considered as a possible diagnosis in sinusitis refractory to antibiotics and antral lavage. The choice of treatment of this disease is radical surgery and adjunctive systemic antifungal therapy. We experienced a case of right maxillary sinus aspergillosis in a 34 years old male who has dull pain on Rt. zygoma area, and a case of left maxillary sinus aspergillosis in a 30 years old male who had been suffered from nasal stiffness and frontal headache for 3-4 years. We reported two cases with review of literature.

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포공영(蒲公英)의 염증성 사이토카인 발현 및 조절에 관한 연구 (Inhibitory Effect of Taraxaci Herba Extract (THE) on Pro-inflammatory Mediatory)

  • 노경호;백정한
    • 대한한방소아과학회지
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    • 제23권3호
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    • pp.165-176
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    • 2009
  • Objectives The purpose of this study is to find out the effect of Taraxaci Herba Extract (THE), LPS, on pro-inflammatory mediatory. Methods After the treatment of Taraxaci Herba MeOH extract dissolved in EMEM for 1 hour prior to the addition of LPS ($1\;{\mu}g/ml$), cell viability was measured by MTT assay, Nitric Oxide production was monitored by measuring the nitrite content in culture medium. And levels of cytokine and PGE2 were analyzed by sandwich immunoassays. Results THE inhibited the production of nitrite and nitrate (0.03 and 0.1 mg/ml), TNF-$\alpha$, (0.03 and 0.1 mg/ml), IL-$1{\beta}$(0.03 and 0.1 mg/ml), IL-6 (0.01, 0.03 and 0.1 mg/ml) and PGE2(0.03 and 0.1 mg/ml) activated with LPS. In Raw 264.7 cells activated with lipopolysaccharide. Conclusions According to the results above, Taraxaci Herba can produce anti-inflammatory effect, which may play a role in adjunctive therapy in Gram-negative bacterial infections.

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Age-Related Male Osteoporosis, and Soy, Its Alternative Therapy - Review-

  • Soung, Do-Yu;Chung, Hae-Young;Rhee, Sook-Hee;Park, Kun-Young
    • Preventive Nutrition and Food Science
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    • 제10권3호
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    • pp.298-309
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    • 2005
  • As the population of the elderly grows, the prevalence of osteoporosis and its related fractures will increase in both men and women. The etiology, preventive and curative strategies of male osteoporosis are relatively unknown and understudied in comparison with those of female osteoporosis. Even currently approved therapies, e.g. bisphophonates, parathyroid hormone, and testosterone for male osteoporosis are in need of further investigation to test their safety and efficacy. Isoflavones which are found in soy have been shown to positively affect bone by stimulating bone formation while concurrently slowing down bone resorption. These observations mainly come from studies that have employed women or female animal models of osteoporosis. Therefore, there is a need to explore the role of soy and its isoflavones in preventing bone loss or rebuilding bone utilizing men or animal models of .male osteoporosis. From the review of existing literature it is too early to state the extent to which men with osteoporosis can benefit from consumption of soy or its isoflavones. In this review, the efficacy of soy and its isoflavones as alternative and/or adjunctive treatment for male osteoporosis will be discussed.

소타액선에 발생한 기저세포선암의 치험례 (BASAL CELL ADENOCARCINOMA OF THE MINOR SALIVARY GLAND - A CASE REPORT)

  • 구명숙;권대근;김종배
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제28권5호
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    • pp.390-394
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    • 2002
  • Basal cell adenocarcinoma is an epithelial neoplasm which is cytologically and histomorphologically similar to basal cell adenoma but is different because of the infilitrative growth. This tumor, a rare salivary gland tumor newly classified as basal cell adenocarcinoma by the WHO in 1991, is infiltrative, locally destructive and tends to recur but metastasis is less common. The differential diagnosis includes basal cell adenoma, adenoid cystic carcinoma, and basaloid squamous carcinoma. Nearly 90 percent of these tumors occurr in the parotid gland and can be classified into low grade carcinomas with a relative good prognosis. Basal cell adenocarcinoma of minor salivary gland is very rare and has a less favorable clinical course compared with that of the major salivary glands. This is a case of basal cell adenocarcinoma occurring at the minor salivary gland of the soft palate. We treated this patient with block excision and adjunctive radiation therapy.

Protective Effect of Right Ventricular Mitochondrial Damage by Cyclosporine A in Monocrotaline-induced Pulmonary Hypertension

  • Lee, Dong Seok;Jung, Yong Wook
    • Korean Circulation Journal
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    • 제48권12호
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    • pp.1135-1144
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    • 2018
  • Background and Objectives: Mitochondria play a key role in the pathophysiology of heart failure and mitochondrial permeability transition pore (MPTP) play a critical role in cell death and a critical target for cardioprotection. The aim of this study was to evaluate the protective effects of cyclosporine A (CsA), one of MPTP blockers, and morphological changes of mitochondria and MPTP related proteins in monocrotaline (MCT) induced pulmonary arterial hypertension (PAH). Methods: Eight weeks old Sprague-Dawley rats were randomized to control, MCT (60 mg/kg) and MCT plus CsA (10 mg/kg/day) treatment groups. Four weeks later, right ventricular hypertrophy (RVH) and morphological changes of right ventricle (RV) were done. Western blot and reverse transcription polymerase chain reaction (RT-PCR) for MPTP related protein were performed. Results: In electron microscopy, CsA treatment prevented MCT-induced mitochondrial disruption of RV. RVH was significantly increased in MCT group compared to that of the controls but RVH was more increased with CsA treatment. Thickened medial wall thickness of pulmonary arteriole in PAH was not changed after CsA treatment. In western blot, caspase-3 was significantly increased in MCT group, and was attenuated in CsA treatment. There were no significant differences in voltage-dependent anion channel, adenine nucleotide translocator 1 and cyclophilin D expression in western blot and RT-PCR between the 3 groups. Conclusions: CsA reduces MCT induced RV mitochondrial damage. Although, MPTP blocking does not reverse pulmonary pathology, it may reduce RV dysfunction in PAH. The results suggest that it could serve as an adjunctive therapy to PAH treatment.

Efficacy of Herbal Medicine as an Adjunctive Therapy of Chemotherapy for Cervical Cancer: A Systematic Review and Meta-analysis

  • Oh, Seung Yun;Kim, Mi Suk;Joo, Jong Cheon;Song, Yung Sun
    • 동의생리병리학회지
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    • 제34권5호
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    • pp.255-262
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    • 2020
  • This study aimed to evaluate the efficacy of herbal medicine (HM) combined with chemotherapy (CT) for cervical cancer. Ten electronic databases including Pubmed, Cochrane library, Embase, Korean databases, and Chinese medical databases were systematically searched up to October 2019. All randomized controlled trials with HM combined with CT to treat cervical cancer were included. A total of 21 trials were included for analysis. Compared to the control group, HM combined with CT group significantly increased tumor response (complete and partial response) (risk ratio [RR] = 1.24, 95% CI: 1.15-1.33, p < 0.00001) and Karnofsky performance score (standardized mean difference [SMD] = 1.71, 95% CI: 1.41-2.01, p < 0.00001). Also, HM combined with CT group remarkably reduced CT toxicity. In Conclusion, our study suggests that HM might be a potential option for cervical cancer to enhance curative efficacy and reduce CT toxicity.

Eosinophilic Granuloma Treated with Prednisolone and Azathioprine in a Dog

  • Jang, Moonseok;Lee, Wanghui;Park, Seongjun
    • 한국임상수의학회지
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    • 제39권4호
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    • pp.192-196
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    • 2022
  • A two-year-old, intact male, 45 kg Doberman Pinscher was referred with dermal nodular lesions affecting the left hindlimb. The cytological examination revealed eosinophilic inflammation. Skin biopsy specimens showed canine eosinophilic granuloma (CEG). The dog was administered oral prednisolone (1.5 mg/kg/day) and azathioprine (2 mg/kg/day). After one week, the skin lesions diminished dramatically, but the dog presented with severe watery diarrhea. The prednisolone dose was reduced by 0.9 mg/kg/day. The lesions and diarrhea improved markedly after one week. Prednisolone was tapered by 25% of the previous dose every week to 0.2 mg/kg/day. Azathioprine was also reduced to therapy every other day. After seven weeks of combination treatment, the medications were withdrawn, but the dog had a recurrence one week later. Azathioprine (2 mg/kg/EOD) was reintroduced for two weeks. There was no relapse after all the medications had been withdrawn. This case indicates that CEG can be managed with prednisolone and azathioprine. Azathioprine may be an effective adjunctive immunosuppressive agent, and may be considered as a well-tolerated prednisolone sparing agent to treat CEG.

Cognitive outcomes in late childhood and adolescence of neonatal hypoxic-ischemic encephalopathy

  • Lee, Bo Lyun;Glass, Hannah C.
    • Clinical and Experimental Pediatrics
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    • 제64권12호
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    • pp.608-618
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    • 2021
  • Hypoxic-ischemic encephalopathy (HIE) is the most common cause of neonatal encephalopathy with a global incidence of approximately 1 to 8 per 1,000 live births. Neonatal encephalopathy can cause neurodevelopmental and cognitive impairments in survivors of hypoxic-ischemic insults with and without functional motor deficits. Normal neurodevelopmental outcomes in early childhood do not preclude cognitive and behavioral difficulties in late childhood and adolescence because cognitive functions are not yet fully developed at this early age. Therapeutic hypothermia has been shown to significantly reduced death and severe disabilities in term newborns with HIE. However, children treated with hypothermia therapy remain at risk for cognitive impairments and follow-up is necessary throughout late childhood and adolescence. Novel adjunctive neuroprotective therapies combined with therapeutic hypothermia may enhance the survival and neurodevelopmental outcomes of infants with HIE. The extent and severity of brain injury on magnetic resonance imaging might predict neurodevelopmental outcomes and lead to targeted interven tions in children with a history of neonatal encephalopathy. We provide a summary of the long-term cognitive outcomes in late childhood and adolescence in children with a history of HIE and the association between pattern of brain injury and neurodevelopmental outcomes.