• Journal of Medicine and Life Science
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• 제18권1호
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• pp.1-10
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• 2021

Omega-3 fatty acids (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) may be beneficial for the primary and secondary prevention of cardiovascular events (CVEs), especially in patients with myocardial infarction or heart failure with reduced ejection fraction. For this purpose, one to two seafood meals per week is preferentially recommended. Omega-3 fatty acids with a high-dose EPA formula (4 g/day) may be more effective than EPA+DHA mixed supplements for the secondary prevention of CVE. Krill oil also contains omega-3 fatty acids, but at a much lower dose compared to fish oil. Supplemental vitamins and minerals have not shown the preventive effects on CVE in prospective, and randomized clinical trials, except for one Chinese study showing the stroke prevention effects of folic acid. The clinical benefit of chelation therapy in reducing CVEs is uncertain.

• Asian-Australasian Journal of Animal Sciences
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• 제18권8호
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• pp.1130-1134
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• 2005

An experiment was performed using 20 calves of about one-month old to investigate the effect of chelation therapy with calcium disodium ethylenediaminetetraacetate ($CaNa_2$EDTA) alone or along with antioxidant $\alpha$-tocopherol in lead loaded calves on blood trace minerals, erythrocytic sulfahydryl groups and some haematobiochemical parameters. Fifteen calves were given lead orally at a daily dose of 7.5 mg of 99% pure lead acetate/kg body weight for 28 days. Then the lead was withdrawn on day 28 and the calves were randomly divided into three groups. Each group of five animals was either treated with $CaNa_2$EDTA alone at the dose rate of 110 mg/kg body weight in two divided doses for 4 days or along with $\alpha$-tocopherol at the dose rate of 100 mg/kg body weight orally daily for 7 days, keeping the remaining five calves as lead-exposed untreated controls. Blood samples were collected at the end of the lead exposure (day 0) and thereafter on day 2, 4, 7 and 10 from the start of the chelation treatment. The treatment with EDTA alone led to slow but non-significant improvement in blood copper level, but incorporation of antioxidant $\alpha$-tocopherol in chelation therapy resulted in its significant decline, as recorded on day 7-post treatment. Withdrawal of lead or treatment with $CaNa_2$EDTA alone or along with $\alpha$-tocopherol enhanced the erythrocytic thiol contents and the levels of T-SH and P-SH became statistically (p<0.05) comparable to those of lead-exposed controls by day 7 and 4, respectively. There was no significant (p>0.05) change in serum urea, creatinine, total protein and albumin levels between the treatment groups. It is concluded from the present investigation that treatment with $CaNa_2$EDTA at the present dose rate is safe to be used for chelation in lead loaded calves.

• Natural Product Sciences
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• 제27권2호
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• pp.78-85
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• 2021

Through bio-guided isolation, two natural iron chelators were isolated from Mangifera indica L. leaves, identified as mangiferin (1) and iriflophenone-3-C-𝛽-D-glucoside (2). Their iron-chelating activity was compared to that of Desferal^® using bipyridyl assay and EDTA as a standard. Mangiferin showed the highest activity with IC₅₀ value of 0.385 mM (162.85 ㎍/mL). Furthermore, two combinations of mangiferin with Desferal^® (M-D) and iriflophenone-3-C-𝛽-D-glucoside (M-I) were evaluated. The results showed that mangiferin potentiated the iron chelation activity of Desferal^® about 46%, also that M-I combination is a promising candidate formula for iron chelation therapy. In addition, mangiferin and Desferal-iron complexes were prepared and characterized by IR, UV, and Mass spectra to compare their mode of chelation to iron. Their structural stability was studied by DFT calculations. Furthermore, they displayed increased ABTS antioxidant activity when bound to iron as compared to their free form, which enhances their pharmacological importance.

• Toxicological Research
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• 제33권4호
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• pp.299-304
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• 2017

Thallium and its compounds are a class of highly toxic chemicals that cause wide-ranging symptoms such as gastrointestinal disturbances; polyneuritis; encephalopathy; tachycardia; skin eruptions; hepatic, renal, cardiac, and neurological toxicities; and have mutagenic and genotoxic effects. The present research aimed to evaluate the efficacy of the chelating agents deferasirox (DFX) and deferiprone (L1) in reducing serum and tissue thallium levels after the administration of thallium (III), according to two different dosing regimens, to several groups of Wistar rats for 60 days. It was hypothesized that the two chelators might be more efficient as a combined therapy than as monotherapies in removing thallium (III) from the rats' organs. The chelators were administered orally as either single or combined therapies for a period of 14 days. Serum and tissue thallium (III) and iron concentrations were determined by flame atomic absorption spectroscopy. Serum and tissue thallium (III) levels were significantly reduced by combined therapy with DFX and L1. Additionally, iron concentrations returned to normal levels and symptoms of toxicity decreased.

• 월간산업보건
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• 통권84호
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• pp.31-33
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• 1995

입에서 금속성 입맛을 동반하여 심한 위장관계 증상(예, 혈변, 복통, 오심, 구토)과 상부위장관출혈이 있으면 중금속 중독이 있음을 시사한다. 중금속은 유기형태와 무기형태 모두 유독함을 기역해야 한다. 혈액, 소변, 그리고 특히 모발내의 레벨이 급인성 중독을 정확하게 반영하지 않은 경우가 종종 있다. 중금속 중독이 된 많은 환자들이 킬레이션 치료(chelation therapy)에 효과가 있다.

• 대한한방내과학회지
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• 제44권2호
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• pp.252-259
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• 2023

Objectives: This study identified the effect of Korean medicine treatment on a patient with iron overload who discontinued iron chelation therapy. Methods: A 64-year-old woman with iron overload was treated with Saenggangunbi-tang from November 14, 2022, to March 15, 2023, to reduce fatigue and improve laboratory findings. We observed changes in the symptoms and improvement of laboratory findings during the four-month treatment. Results: The approximately four-month treatment with Saenggangunbi-tang showed considerable improvement in laboratory findings and fatigue. In addition, no adverse effects, such as liver injury, were observed during Korean medicine treatment. Conclusion: This study suggests the availability of Saenggangunbi-tang as a therapeutic option for managing patients with iron overload.

• 대한임상검사과학회지
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• 제49권4호
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• pp.495-497
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• 2017

Thalassemia major is a genetic disorder with a defective synthesis of either the alpha or the beta chain of hemoglobin A. Blood transfusion is crucial for the survival in these patients. Unfortunately, endocrine dysfunction is a very common complication in these patients and is principally due to excessive iron overload as a result of frequent blood transfusions. Although regular blood transfusion may increase life expectancy, disturbances in growth and pubertal development, abnormal gonadal functions, impaired thyroid, parathyroid and adrenal functions, diabetes, and disorderly bone growth are common side effects. We hereby present a case of a 23-year-old, unmarried woman with beta thalassemia major presenting with primary amenorrhea, poor development of secondary sexual character, and short stature. Thorough history, clinical examination, and laboratory investigation, including dynamic function test (insulin tolerance test) were conducted. These tests confirmed that she had multiple endocrinopathies, including hypogonadotropic hypogonadism, growth hormone deficiency, and subclinical adrenal insufficiency, which were caused by iron overload. She required hormone replacement therapy. Early recognition of possible deficiencies in hypothalamo-pituitary-end organ hormones caused by iron overload in thalassemia patients that undergo frequent blood transfusion procedures is essential. Appropriate treatments, including transfusion regimen and chelation therapy, as well as specific treatment of each complication are the crucial for the successful management and improvement of quality of life these patients.

• Clinical and Experimental Pediatrics
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• 제50권12호
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• pp.1225-1230
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• 2007

목 적 : 만성 빈혈로 대량 수혈을 받아야 하는 환아들에서는 조직과 장기에 철이 축적될 수 있다. 이러한 환아들에서 효과적인 철킬레이트 치료의 목적은 충분한 양의 철을 제거하여 체내에서 철로 인한 장기 손상이 나타나지 않도록 하는데 있다. 본 연구는 후향적으로 대량 수혈을 받은 환아들에서 정맥 투여한 deferoxamine의 효과를 알아보고자 하였다. 방 법 : 2005년 3월부터 2007년 1월까지 15명의 대량 수혈을 받았던 환아들을 대상으로 하였으며 이들 중 수혈 의존성 환아들은 한 달에 1단위 이상의 농축 적혈구 수혈을 최근 6개월 이상 계속 받고 있는 환아들로 정의하였다. 7일 동안 deferoxamine을 10-30 mg/kg/day로 24시간 지속 정맥주입하였으며 투여 전, 후 그리고 3개월 후의 혈청 철, 총철결합능, ferritin을 수혈 의존성 환아들과 수혈 비의존성 환아들로 나누어 비교하였다. 결 과 : 6명의 남아와 9명의 여아가 있었으며 이들의 나이는 5.6-21.3(중앙값 8.3)세였고 수혈 의존성 환아들은 7명, 수혈 비의존성 환아들은 8명이었다. 수혈 의존성 환아들의 ferritin은 deferoxamine 투여 전과 후, 3개월 후에 의미 있는 차이를 보이지 않았으나 수혈 비의존성 환아들에서는 투여 전과 비교 시 투여 3개월 후에는 의미 있는 감소를 보였다(P=0.046). Deferoxamine 정맥주입과 연관된 이상 반응은 경미하였으며 1-2일 내에 소실되었다. 결 론 : 7일 동안 정맥주입하는 deferoxamine은 수혈 비의존성 환아들에서 단기간의 효과적인 치료로 사용될 수 있을 것으로 생각되지만 수혈 의존성 환아들의 경우에는 철의 축적을 막기 위해 유지 요법이 필요할 것으로 생각된다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권2호
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• pp.224-227
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• 2000

Gunshot wounds to the face are often dramatic at the time of presentation. Although care must be individualized, protocol approach helps the clinician rapidly evaluate patient and plan treatment. Early X-ray films help to determine the precise trajectory. Rapid neurologic assessment and early CT scanning based on physical examination ot trajectory will allow for identification of even occult injuries early. Lead poisoning arising from bullet lead in the synovial cavity of the hip, synovial cavity of the chest and pleural space have been reported. A combination of surgical debridement and chelation therapy with oral succimer produce a satisfactory outcome. We have managed a patient with Lt facial gunshot wound and Lt mandible angle fracture by open reduction of angle fracture and surgical removal of remnant bullet and medially advanced cheek skin flap. We have obtained good result and report this case with review of literatures.

• BLOOD RESEARCH
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• 제53권4호
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• pp.314-319
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• 2018

Background Iron overload is a risk factor affecting all patients with thalassemia intermedia (TI). We aimed to determine whether there is a relationship of serum ferritin (SF) and alanine aminotransferase (ALT) with liver iron concentration (LIC) determined by R2 magnetic resonance imaging (R2-MRI), to estimate the most relevant degree of iron overload and best time to chelate in patients with TI. Methods In this cross-sectional study, 119 patients with TI (mean age years) were randomly selected and compared with 120 patients who had a diagnosis of thalassemia major (TM). Correlations of LIC, as determined by R2-MRI, with SF and ALT levels, were assessed in all participants. A P-value <0.05 was considered statistically significant. Results SF and LIC levels were lower in patients with TI than in those with TM; only ferritin values were significant. We found a statistically significant relationship between SF and LIC, with cut-off estimates of SF in patients with TI who had splenectomy and those who entered puberty spontaneously (916 and 940 ng/mL, respectively) with LIC >5 mg Fe/g dry weight (P<0.0001). A significant relationship was also found for patients with TI who had elevated ALT level (63.5 U/L), of 3.15 times the upper normal laboratory limit, using a cut-off for LIC ${\geq}5mg\;Fe/g\;dry\;weight$. Conclusion We determined the cut-off values for ALT and SF indicating the best time to start iron chelation therapy in patients with TI, and found significant correlations among iron overload, SF, and ALT.