The neuroprotective effects of herbal ethanol extracts from Gynostemma pentaphyllum (GP-EX) in 6-hydroxydopamine (6-OHDA)-lesioned rat model of Parkinson's disease treated with L-DOPA were investigated. Rats were prepared for the Parkinson's disease model by 6-OHDA-lesioning for 14 days. The rats were then treated with L-DOPA (10 and 20 mg/kg) with or without the oral administration of GP-EX (30 mg/kg, daily) for 28 days. L-DOPA (20 mg/kg) treatment for 28 days enhanced dopaminergic neuronal cell death in 6-OHDA-lesioned rat groups, but L-DOPA (10 mg/kg) did not. However, the oral administration of GP-EX (30 mg/kg) for 28 days ameliorated the enhanced neurotoxic effects induced by chronic L-DOPA treatment in 6-OHDA-lesioned rat groups by increasing tyrosine hydroxylase (TH)-immunohistochemical staining and the number of TH-immunopositive cells surviving in the substantia nigra. In addition, GP-EX administration (30 mg/kg) for 28 days recovered the levels of dopamine and norepinephrine of the striatum in 6-OHDA-lesioned rat groups, which were markedly reduced by L-DOPA treatment (20 mg/kg). GP-EX (30 mg/kg) did not produce any signs of toxicity, such as weight loss, diarrhea, or vomiting in rats during the 28-day treatment period. These results suggest that GP-EX has protective functions against chronic L-DOPA-induced neurotoxic reactions in dopaminergic neurons in the 6-OHDA-lesioned rat model of Parkinson's disease. Therefore, GP-EX may be beneficial in the prevention of adverse symptoms in parkisonian patients.
The purpose of this study was to evaluate the clinical efficacy of a standardized special ethanol extract from Gynostemma pentaphyllum as a management for anxiety and stress of normal population. This is a two-arm, parallelgroup, randomized, double blind clinical trial comparing Gynostemma pentaphyllum extract 200 mg bid (GP-EX, n=48) or placebo bid (n=54). The main outcome measures were the decrease in anxiety sensitivity index (ASI), the State version (S-STAI) of the Stait-Trait Anxiety Inventory (STAI) and the Trait version (T-STAT) of the STAI from baseline over a 6 weeks treatment period. In more anxious group (S-STAI50 or ASI19), the anxiety in group with GP-EX was decreased significantly than one in normal population with placebo [S-STAI50: T-STAI = from $57.7{\pm}6.5$ ($mean{\pm}S.D.$) to $46.8{\pm}11.2$ in normal population with GP-EX, p=0.002 vs. from $54.1{\pm}9.9$ to $49.0{\pm}9.6$ in normal population with placebo, p>0.05; ASI19: T-STAI = from $47.2{\pm}12.0$ to $42.4{\pm}11.1$ in normal population with GP-EX, p=0.022 vs. from $48.7{\pm}11.5$ to $46.0{\pm}10.4$ in normal population with placebo, p>0.05]. The most frequently reported adverse reactions considered possibly related to treatment were mild gastrointestinal events. GP-EX is more effective than placebo and is well tolerated as a therapy for anxiety and stress of normal population.
Jung, Hyun Ho;Chang, Won Seok;Kim, Se Joo;Kim, Chan-Hyung;Chang, Jin Woo
Journal of Korean Neurosurgical Society
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v.61
no.4
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pp.427-433
/
2018
Obsessive compulsive disorder is a debilitating condition characterized by recurrent obsessive thoughts and compulsive reactions. A great portion of the obsessive compulsive disorder (OCD) patients are managed successfully with psychiatric treatment such as selective serotonin-reuptake inhibitor and cognitive behavioral psychotherapy, but more than 10% of patients are remained as non-responder who needs neurosurgical treatments. These patients are potential candidates for the neurosurgical management. There had been various kind of operation, lesioning such as leucotomy or cingulotomy or capsulotomy or limbic leucotomy, and with advent of stereotaxic approach and technical advances, deep brain stimulation was more chosen by neurosurgeon due to its characteristic of reversibility and adjustability. Gamma knife radiosurgery are also applied to make lesion targeting based on magnetic resonance (MR) imaging, but the complication of adverse radiation effect is not predictable. In the neurosurgical field, MR guided focused ultrasound has advantage of less invasiveness, real-time monitored procedure which is now growing to attempt to apply for various brain disorder. In this review, the neurosurgical treatment modalities for the treatment of OCD will be briefly reviewed and the current state of MR guided focused ultrasound for OCD will be suggested.
Yoo, Hyung-Sik;Suh, Jung-Ho;Lee, Jong-Tae;Kim, Dong-Ik;Park, Chang-Yun;Kim, Byung-Soo;Park, Chan-H.;Thakur, M.
The Korean Journal of Nuclear Medicine
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v.20
no.2
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pp.61-71
/
1986
An iodized oil such as Ethiodol or Lipiodol was selectively retained in the tumor vessels of the large hepatomas as well as in the small daughter hepatomas for long periods following the intra-arterial hepatic injection of such contrast material. The specific aim of the study is to deliver a high internal radiation dose to hepatocellular carcinoma (HCC) in an attempt to control the disease. We were able to replace a small fraction of the stable iodine (I-127) of the 37% iodine in Lipiodol by the $I^{-131}$ with 100% exchange efficiency. $I^{-131}$ labeled Lipiodol was injected through the super-selected tumor feeding artery under superselection or into the proper hepatic arterial level of patients who have malignant hepatomas confirmed by aspiration cytology serum AFP and various imaging modalities. Clinical traial was performed on 43 cases during recent 6 months and follow-up observation was carried out. No severe complications or other adverse reactions were encountered until nowdays. $I^{-131}-Lipiodol$ was stable in vivo and no significant activity was noted in the thyroid, stomach, blood and urine after the injection. Only small fraction of radioisotope activity was noticed in the both side of lungs. Tumor to normal liver radio was very high. Therefore, $I^{-131}-Lipiodol$ (or P-32-Lipiodol) will be effective delivering high internal radiation dose to the tumor while delivering small radiation doses to normal tissues. Labeling, tumor dose calculation and preliminary findings will be presented.
Objectives The purpose of this study is to evaluate efficacy and safety of Mahaenggamsuktang for treating mycoplasma pneumonia in children based on the randomized controlled trials (RCTs). Methods Literatures were searched from OASIS, KISS, NDSL, CNKI, Cochrane, Embase and Pubmed, and the search was conducted on January 29, 2020. Only RCTs published since 2000 were included. Trials comparing Mahaenggamsuktang combined with antibiotics or antibiotics treatment alone for the treatment of mycoplasma pneumonia in children were included. Results 17 trials, including 2,241 participants with mycoplasma pneumonia were included in this review. As a result of the meta-analysis, total effective rate of combination of Mahaggamsuktang and antibiotics was 1.24 times higher than that of the antibiotics alone, which was statistically significant. Symptoms with fever, lung sounds, cough, chest X-ray lesion findings, wheezing were also significantly reduced in the treatment group with Mahaenggamseoktang and antibiotics. Also, Serum CRP level was significantly lower with combination treatment. The incidence of adverse reactions was lower in the treatment group with Mahaenggamseoktang and antibiotics, but it was not statistically significant. Conclusions As a result of meta-analysis, combination treatment of Mahaenggamseoktang and antibiotics seems significantly effective for the treatment of mycoplasma pneumonia in children. In order to have a higher level of evidence for efficacy and safety of Mahaenggamsuktang in treating mycoplasma pneumonia, additional RCTs with good qualities are required.
Marchesini, Maurizio;Flaviano, Edoardo;Bellini, Valentina;Baciarello, Marco;Bignami, Elena Giovanna
The Korean Journal of Pain
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v.31
no.4
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pp.296-304
/
2018
Epiduroscopy is defined as a percutaneous, minimally invasive endoscopic investigation of the epidural space. Periduroscopy is currently used mainly as a diagnostic tool to directly visualize epidural adhesions in patients with failed back surgery syndrome (FBSS), and as a therapeutic action in patients with low back pain by accurately administering drugs, releasing inflammation, washing the epidural space, and mechanically releasing the scars displayed. Considering epiduroscopy a minimally invasive technique should not lead to underestimating its potential complications. The purpose of this review is to summarize and explain the mechanisms of the side effects strictly related to the technique itself, leaving aside complications considered typical for any kind of extradural procedure (e.g. adverse reactions due to the administration of drugs or bleeding) and not fitting the usual concept of epiduroscopy for which the data on its real usefulness are still lacking. The most frequent complications and side effects of epiduroscopy can be summarized as non-persistent post-procedural low back and/or leg discomfort/pain, transient neurological symptoms (headache, hearing impairment, paresthesia), dural puncture with or without post dural puncture headache (PDPH), post-procedural visual impairment with retinal hemorrhage, encephalopathy resulting in rhabdomyolysis due to a dural tear, intradural cyst, as well as neurogenic bladder and seizures. We also report for first time, to our knowledge, a case of symptomatic pneumocephalus after epiduroscopy, and try to explain the reason for this event and the precautions to avoid this complication.
Objective: To observe the curative effects of rh-endostatin combined with DP regimen in treating patients with advanced esophageal cancer and analyze the correlation of CT perfusion (CTP) parameters and the expression of vascular endothelial growth factor (VEGF). Methods: Twenty patients with esophageal cancer confirmed pathologically were randomly divided into combined treatment (rh-endostatin+DP regimen) group and single chemotherapy group, 10 patients in each group, respectively. All patients were given conventional CT examination and CTP imaging for primary tumor. The level of VEGF, the size of tumor and CTP parameters (BF, BV, PS and MTT) before treatment and after 2 cycles of treatment were determined for the comparison and the correlation between CTP parameters and VEGF expression was analyzed. Results: the therapeutic effect of rh-endostatin+DP regimen group was superior to single chemotherapy group. VEGF level after treatment in rh-endostatin+DP regimen group was obviously lower than single chemotherapy group (P<0.01). The expression of VEGF had positive correlation with BF and BV but negative correlation with MTT. Compared with treatment before for rh-endostatin+DP regimen group, BF, BV and PS decreased while MTT increased after treatment (P<0.05). However, there were no significant differences between treatment before and after treatment in single chemotherapy (P>0.05). Conclusions: Rh-endostatin can down-regulate the expression of VEGF in esophageal cancer, change the state of hypertransfusion and high permeability of tumor vessels and had the better curative effect and slighter adverse reactions when combined with chemotherapy.
Background: Although efficacy of aprepitant for suppressing emesis associated with single-dose cisplatin has been demonstrated, there are limited data on the antiemetic effect of this oral neurokinin-1 receptor antagonist during daily administration of cisplatin. Accordingly, we investigated the efficacy and safety of aprepitant in patients with head and neck cancer (HNC) receiving combination therapy with cisplatin and 5-FU (FP therapy). Materials and Methods: Twenty patients with HNC were prospectively studied who received a triple antiemetic regimen comprising granisetron ($40{\mu}g/kg$ on Days 1-4), dexamethasone (8 mg on Days 1-4), and aprepitant (125 mg on day 1 and 80mg on days 2-5) with FP therapy (cisplatin $20mg/m^2$ on days 1-4; 5-FU $400mg/m^2$ on days 1-5) (aprepitant group). We also retrospectively studied another 20 HNC patients who received the same regimen except for aprepitant (control group). Results: For efficacy endpoints based on nausea, the aprepitant group showed significantly better results, including a higher rate of complete response (no vomiting and no salvage therapy) for the acute phase (p=0.0342), although there was no marked difference between the two groups with regard to percentage of patients in whom vomiting was suppressed. There were no clinically relevant adverse reactions to aprepitant. Conclusions: This study suggested that a triple antiemetic regimen containing aprepitant is safe and effective for HNC patients receiving daily cisplatin therapy.
Doxorubicin (DOX) is one of the most effective anticancer agents used for the treatment of multiple cancers; however, its use is limited by its short half-life and adverse drug reactions, especially cardiotoxicity. In this study, we found that the conjugate of DOX with APTA12 (Gemcitabine incorporated G-quadruplex aptamer) was significantly more cancer selective and cytotoxic than DOX. The conjugate had an affinity for nucleolin, with higher uptake and retention into the cancer cells than those of DOX. Further, it was localized to the nucleus, which is the target site of DOX. Owing to its mechanism of action, DOX has the ability to intercalate into the nucleotides thus making it a suitable drug to form a conjugate with cancer selective aptamers such as APTA12. The conjugation can lead to selectively accumulate in the cancer cells thus decreasing its potential nonspecific as well as cardiotoxic side effects. The aim of this study was to prepare a conjugate of DOX with APTA12 and assess the chemotherapeutic properties of the conjugate specific to cancer cells. The DOX-APTA12 conjugate was prepared by incubation and its cytotoxicity in MCF-10A (non-cancerous mammary cells) and MDA-MB-231 (breast cancer cells) was assessed. The results indicate that DOX-APTA12 conjugate is a potential option for chemotherapy especially for nucleolin expressing breast cancer with reduced doxorubicin associated side effects.
Journal of the korean academy of Pediatric Dentistry
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v.25
no.4
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pp.843-848
/
1998
Pulpotomy is a frequently used treatment modality in primary teeth. It is method by which infected coronal pulp is removed while retaining vital radicular pulp. Since its introduction in 1930 by Sweet formocresol remains the most popular medicament for this treatment. However, despite its outstanding bactericidal properties, formocresol is known to cause adverse tissue reactions. Theoretically, formocresol disinfects and fixes radicular pulp and thus prevents infection and internal resorption. In reality, however, it leads to chronic inflammation and is sometimes responsible for failures through abscess formation and internal root resorption. Also, Myers et al., in 1978, reported on the systemic distribution of FC and other studies have followed with reports of its immunological, mutagenic and carcinogenic effects. Much effort has, therefore, focused on the development of alternative medicaments and techniques. Since its introduction in 19C, ferric sulfate proven itself as an effective hemostatic agent and is used as an astringent in dentistry. In 1988, Landau and Johnsen suggested ferric sulfate be used as a medicament in pulpotomy and many studies have focused on it to overcome the toxic effects of FC. Ferric sulfate acts through its ferric ion and iron ion, which react with blood protein leading to aggregation. The aggregated protein acts to plug the blood vessels, causing mechanical hemostasis. As blood clot formation is minimal, there is reduced inflammation of radicular pulp and enhanced healing. There are no reports regarding its systemic distribution. This is a report of cases treated by the author using pulpotomy with ferric sulfate.
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