• Title/Summary/Keyword: Clinical Use

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Interleukin-18 Synergism with Interleukin-2 in Cytotoxicity and NKG2D Expression of Human Natural Killer Cells

  • Qi, Yuan-Ying;Lu, Chao;Ju, Ying;Wang, Zi-E;Li, Yuan-Tang;Shen, Ya-Juan;Lu, Zhi-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7857-7861
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    • 2014
  • Natural killer (NK) cells play an important role in anti-tumor immunity. Interleukin (IL)-18 is an immunoregulatory cytokine that induces potent NK cell-dependent anti-tumor responses when administrated with other cytokines. In this study, we explored the effects of combining IL-18 and IL-2 on NK cytotoxicity as well as expression levels of the NK cell receptor NKG2D in vitro. Freshly isolated PBMCs were incubated for 48 h with IL-18 and IL-2, then CD107a expression on $CD3^-CD56^+$ NK cells was determined by three-colour flow cytometry to evaluate the cytotoxicity of NK cells against human erythroleukemia K562 cells and human colon carcinoma HT29 cells. Flow cytometric analysis was also employed to determine NKG2D expression on NK cells. The combined use of IL-18 and IL-2 significantly increased CD107a expression on NK cells compared with using IL-18 or IL-2 alone, suggesting that the combination of these two cytokines exerted synergistic enhancement of NK cytotoxicity. IL-18 also enhanced NKG2D expression on NK cells when administered with IL-2. In addition, blockade of NKG2D signaling with NKG2D-blocking antibody attenuated the up-regulatory effect of combining IL-18 and IL-2 on NK cytolysis. Our data revealed that IL-18 synergized with IL-2 to dramatically enhance the cytolytic activity of human NK cells in a NKG2D-dependent manner. The results appear encouraging for the use of combined IL-18 and IL-2 in tumor immunotherapy.

A Comparison of Vancomycin and Metronidazole for the Treatment of Clostridium difficile-associated Diarrhea (CDAD) in Medical Intensive Care Unit (MICU) (내과계 중환자실 재원 성인 환자의 Clostridium difficile associated Diarrhea에 대한 Metronidazole과 Vancomycin의 치료효과 비교)

  • Cho, Eun Ae;Lee, Kyung A;Kim, Jae Song;Kim, Soo Hyun;Son, Eun Sun
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.2
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    • pp.77-82
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    • 2017
  • Background: Clostridium difficile associated diarrhea (CDAD) is a leading cause of hospital-associated gastrointestinal illness. Risk factors for CDAD include advanced age, long-term admission, antibiotics, proton-pump inhibitor or $H_2$ blocker use and immunosuppression. The practice guideline of American Journal of Gastroenterology (2013) suggests metronidazole for the first-line therapy of mild-moderate CDAD as well as vancomycin for severe CDAD. MICU inpatients receiving stress ulcer prophylaxis and antibiotics are susceptible to nosocomial CDAD. Therefore, this study aimed to evaluate occurrence and treatment of CDAD in MICU. Methods: Patients who were admitted to the MICU and had CDAD from August 2012 to August 2015 were analyzed retrospectively. Results: Of the 90 patients with CDAD, 20 patients (2.22%) had mild-moderate CDAD (16 received metronidazole and 4 received vancomycin therapy) and 70 patients (77.8%) had severe CDAD(54 received metronidazole and 16 received vancomycin therapy). Among the patients with mild- moderate CDAD, treatment with metronidazole or vancomycin resulted in same clinical cure in 50% of the patients (p=1.00). Among the patients with severe CDAD, treatment with metronidazole or vancomycin resulted in clinical cure in 40.7% and 50.0% of the patients, respectively (p=0.511). Clinical symptoms recurred in 7.4% of the severe CDAD patients treated with metronidazole and 6.3% of those treated with vancomycin(p=0.875). Conclusion: Our findings suggest that metronidazole and vancomycin are equally effective for the treatment of mild-moderate CDAD; however, vancomycin demonstrated higher clinical cure rate and lower recurrence rate for severe CDAD, although the difference was not statistically significant. For better clinical outcomes, appropriate medication use by disease severity is needed.

The Influence of Self-compassion, Conflict Resolution Strategy on the Adaptation of Clinical Practice in Nursing College Students (간호대학생의 자기자비, 갈등해결전략이 임상실습 적응에 미치는 영향)

  • Jang, Hyun-Jung;Lee, Yun Jeong
    • The Journal of the Convergence on Culture Technology
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    • v.7 no.2
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    • pp.77-83
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    • 2021
  • This study was conducted to explore the effects of self-sufficiency and conflict resolution strategies on clinical practice adaptation for 4th graders in nursing college and provide basic data when preparing education and training measures for positive clinical practice adaptation. The data of 243 4th graders in nursing students were analyzed using the SPSS/WIN 22.0 program. As a result of exploring factors that affect clinical practice adaptation, the higher clinical practice satisfaction, the more self-isolated, the less over-identical, and the use of compromise as a conflict resolution strategy and the use of avoidance and domination. These variables were 43.3% influential in explaining the adaptability of nursing students to clinical practice.

A Review of Clinical Studies of Chinese Medicine Treatment of Polycystic Kidney Disease Using the CNKI Database (다낭신의 중의치료에 대한 임상연구 동향 - CNKI검색을 중심으로)

  • Ju, Ah-ra;Park, Mi-so;Choi, Yo-sup;Choo, Won-jung;Baek, Hye-kyung;Park, Mu-jin
    • The Journal of Internal Korean Medicine
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    • v.42 no.3
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    • pp.225-238
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    • 2021
  • Objective: This research reviews and investigates the trends in recent clinical studies of polycystic kidney disease (PKD) in China. Method: We searched for clinical studies discussing Oriental medicine-based treatments for PKD in the China National Knowledge Infrastructure (CNKI) database. Thirteen clinical articles published from 2001 to 2019 were analyzed. The search focused on the authors, publication year, type of study, purposes of study, method and duration of treatment, evaluation criteria, and results of the selected articles. Results: Of the articles from the database, 9 case series and 4 randomized controlled trials (RCTs) were analyzed. Ten articles used herbal medicine; 4 used herbal medicine for external use. Gamigyejibokryeong-hwan was the most common herbal prescription. The most frequently used herb was Polia Sclerotium (茯苓), and Cnidii Rhizoma (川芎) was employed in all the external uses. All 13 studies confirmed the efficacy of Oriental medicine treatments. Conclusion: 1. Scientifically designed and more varied clinical studies are required to develop treatments for PKD. 2. The current study could be used as basic data in future clinical studies on treatment and further studies of PKD.

Current Perspectives on Emerging CAR-Treg Cell Therapy: Based on Treg Cell Therapy in Clinical Trials and the Recent Approval of CAR-T Cell Therapy (장기이식 거부반응과 자가면역질환 치료제로서의 CAR Treg 세포치료제의 가능성: Treg 세포치료제 임상시험 현황과 CAR T 세포치료제 허가 정보를 바탕으로)

  • Kang, Koeun;Chung, Junho;Yang, Jaeseok;Kim, Hyori
    • Korean Journal of Transplantation
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    • v.31 no.4
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    • pp.157-169
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    • 2017
  • Regulatory T cells (Treg) naturally rein in immune attacks, and they can inhibit rejection of transplanted organs and even reverse the progression of autoimmune diseases in mice. The initial safety trials of Treg against graft-versus-host disease (GVHD) provided evidence that the adoptive transfer of Treg is safe and capable of limiting disease progression. Supported by such evidence, numerous clinical trials have been actively investigating the efficacy of Treg targeting autoimmune diseases, type I diabetes, and organ transplant rejection, including kidney and liver. The limited quantity of Treg cells harvested from peripheral blood and subsequent in vitro culture have posed a great challenge to large-scale clinical application of Treg; nevertheless, the concept of CAR (chimeric antigen receptor)-Treg has emerged as a potential resolution to the problem. Recently, two CAR-T therapies, tisagenlecleucel and axicabtagene ciloleucel, were approved by the US FDA for the treatment of refractory or recurrent acute lymhoblastic leukemia. This approval could serve as a guideline for the production protocols for other genetically engineered T cells for clinical use as well. The phase I and II clinical trials of these agents has demonstrated that genetically engineered and antigen-targeting T cells are safe and efficacious in humans. In conclusion, both the promising results of Treg cell therapy from the clinical studies and the recent FDA approval of CAR-T therapies are paving the way for CAR-Treg therapy in clinical use.

Case of Restless Leg Syndrome Patient with Chronic Kidney Failure Treated with Jakyakgamcho-tang (만성 신장병 환자의 하지불안증후군에 대한 작약감초탕 치험 1례)

  • So-Min Jung;Seong-Wook Lee;Han-Gyul Lee;Ki-Ho Cho;Sang-Kwan Moon;Woo-Sang Jung;Seungwon Kwon
    • The Journal of Internal Korean Medicine
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    • v.44 no.2
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    • pp.146-157
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    • 2023
  • Restless leg syndrome is a nervous system disorder that causes an overpowering urge to move one's legs. Symptoms of restless leg syndrome usually worsen when one tries to fall asleep and can prevent sufficient sleep. Restless leg syndrome is common in patients with chronic kidney failure and can be caused or worsened by chronic kidney failure and hemodialysis. Various medications can treat restless leg syndrome, though the long-term use of medications can cause augmentation and adverse effects. In addition, the use of dopamine agonists is limited in patients with chronic kidney failure. This is because the dose of administration should be controlled for patients with chronic kidney failure, and the treatment effect has not been clearly proven. This study reports the case of a 56-year-old male diagnosed with chronic kidney failure complaining of uncomfortable leg sensations. The patient underwent Korean medicine treatment using Jakyakgamcho-tang. The IRLS, NRS, and AIS scores were evaluation tools during treatment. This study suggested significantly improved symptoms through the individual interventions of Jakyakgamcho-tang in a restless leg syndrome patient with chronic kidney failure.

A Case of Cold Medicine-Induced Hepatitis Treated with Herbal Medicine

  • Son, Chang-Gue
    • The Journal of Korean Medicine
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    • v.32 no.6
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    • pp.112-116
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    • 2011
  • Objectives: To inform the clinical features of drug-induced liver injury (DILI), and study traditional Korean medicine (TKM)-based strategies or therapeutics. Methods: A female patient with hepatitis after long term use of medication for cold symptoms was treated with Oriental therapies, after which the clinical outcome was evaluated by serum biochemical parameters and ultrasonography. Results: Clinical and biochemical levels were fluctuating during administration of cold medicine, but the patient completely recovered her health with herbal medicines. Conclusion: This case report would provide information about a typical DILI by western medicine followed by treatment with traditional Korean medicine.

Clinical application of gonadotropin-releasing hormone analogs in children and adolescents

  • Kim, Ho-Seong
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.294-299
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    • 2010
  • Although the increasing incidence of central precocious puberty (CPP) in Korea has recently raised public concerns about health and growth problems, there are many areas of uncertainty regarding the pathogenesis, diagnosis, and management of CPP. In this paper, we review the definition of precocity, the assessment of CPP, and the hormonal abnormalities that support the diagnosis. In addition, we review the practical guidelines regarding the clinical use of gonadotropin-releasing hormone analogs in children with CPP. Indications for treatment, determination of dosage, monitoring during treatment, and discontinuation of therapy are discussed.

Clinical Applications of Light Therapy for Sleep Disorders (수면장애에서 광치료의 이용)

  • Sohn, Chang-Ho
    • Sleep Medicine and Psychophysiology
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    • v.15 no.1
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    • pp.12-16
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    • 2008
  • Light therapy (also called light treatment or phototherapy) involves scheduled exposure to bright artificial light. Evidence-based treatments for sleep disorders especially for circadian rhythm sleep disorders include light therapy and pharmacotherapy. In clinical practice, many of patients with sleep problems tend to impair circadian rhythmicity. Considering that light is the most potent entraining agent of circadian rhythm, careful use of light therapy can be recommended for patients with several kinds of sleep disorders. I briefly review the possible therapeutic mechanisms and clinical applications of light therapy, focusing on circadian sleep disorders.

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Molecular Targeting Agents in Cancer Therapy: Science and Society

  • Shaikh, Asim Jamal
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1705-1708
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    • 2012
  • The inception of targeted agents has revolutionized the cancer therapy paradigm, both for physicians and patients. A large number of molecular targeted agents for cancer therapy are currently available for clinical use today. Many more are in making, but there are issues that remain to be resolved for the scientific as well as social community before the recommendation of their widespread use in may clinical scenarios can be done, one such issue being cost and cost effectiveness, others being resistance and lack of sustained efficacy. With the current knowledge about available targeted agents, the growing knowledge of intricate molecular pathways and unfolding of wider spectrum of molecular targets that can really matter in the disease control, calls for only the just use of the agents available now, drug companies need to make a serious attempt to reduce the cost of the agents. Research should focus on agents that show sustained responses in preclinical data. More needs to be done in laboratories and by the pharmaceutical industries, before we can truly claim to have entered a new era of targeted therapy in cancer care.