• 제목/요약/키워드: Clinical stress

검색결과 1,856건 처리시간 0.04초

원위경비골인대 손상의 치료 동향: 대한족부족관절학회 회원 설문조사 분석 (Current Trends in the Treatment of Syndesmotic Injury: Analysis of the Korean Foot and Ankle Society (KFAS) Member Survey)

  • 조재호;조병기;정비오;정진화;배서영;2021 대한족부족관절학회
    • 대한족부족관절학회지
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    • 제26권2호
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    • pp.95-102
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    • 2022
  • Purpose: This study was based on the Korean Foot and Ankle Society (KFAS) member survey and aimed to report the current trends in the management of syndesmotic injuries over the last few decades. Materials and Methods: A web-based questionnaire containing 36 questions was sent to all KFAS members in September 2021. The questions were mainly related to the preferred techniques and clinical experiences in the treatment of patients with syndesmotic injuries. Answers with a prevalence ≥50% of respondents were considered a tendency. Results: Seventy-six (13.8%) of the 550 members responded to the survey. The results showed that the most preferred method to diagnose a syndesmotic injury was magnetic resonance imaging (MRI). Intraoperatively, the external rotation stress test and the Cotton test were most frequently used to confirm syndesmotic diastasis. The reduction was usually done by a reduction clamp. One 3.5-mm screw was used most frequently over three cortices at 2~4 cm above the ankle joint. The preferred ankle position during fixation was 0° dorsiflexion. Removal of the syndesmotic screw was routinely done by most surgeons, mainly because of the limitation of movement and risk of screw breakage. Factors that affect suture button selection included non-rigid fixation which enables adequate fixation, early weight-bearing, and an infrequent need to remove the hardware. Inadequate reduction was considered the main factor that affects poor prognosis. Conclusion: This study proposes updated information about the current trends in the management of syndesmotic injuries in Korea. Consensuses in both the diagnostic and therapeutic approach to patients with syndesmotic injury were identified in this survey study. This study may raise the awareness of the various possible approaches toward the injury and should be used to further establish a standard protocol for the management of syndesmotic injuries.

눈에 대한 미세먼지의 독성 평가를 위한 쥐 각막 상피 세포의 적용 (Application of Primary Rat Corneal Epithelial Cells to Evaluate Toxicity of Particulate Matter 2.5 to the Eyes)

  • 김다혜;황보현;이혜숙;정재훈;최영현
    • 생명과학회지
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    • 제32권9호
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    • pp.712-720
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    • 2022
  • 비록 PM2.5 노출과 다양한 안구 표면 질환과 관련성이 많은 선행 연구에서 알려졌지만, PM2.5 가 각막에 미치는 세포 독성에 대한 연구는 거의 수행되지 않았다. 본 연구의 목적은 PM에 의한 각막 상피세포의 유해성을 평가하기 위한 in vitro 모델로서 쥐의 각막유래 상피세포(primary rat corneal epithelial cells, RCE cells)의 효능을 조사하는 것이다. 이를 위하여 쥐의 눈에서 분리한 1차 배양 세포가 각막 상피세포임을 pan-cytokeratin 염색을 통하여 확인하였으며, PM2.처리에 의한 각막 상피세포의 형태학적 변화를 동반한 생존율의 억제는 세포사멸 유도와 관련이 있었다. 또한 PM2.가 처리된 각막 상피세포에서는 ROS의 생성이 증가되었으며, 이는 미토콘드리아 기능 장애와 연관성이 있었다. 이와 함께 PM2.는 각막 상피세포에서 NO, TNF-α, IL-1β 및 IL-6를 포함한 염증 매개인자 및 사이토카인의 생성을 증가시켰다. 아울러 heatmap 분석을 통해 BLNK, IL-1RA, Itga2b, ABCb1a 및 Ptgs2가 미세먼지 유도 안구 질환의 임상 치료를 위한 잠재적인 표적 유전자로서 제시하였다. 결론적으로 본 연구의 결과는 1차 쥐의 각막 상피세포가 PM2.에 의한 각막 상피세포 병리기전 연구에 유용한 모델일 수 있으며, 산화적 및 염증성 반응이 PM2.유발 안구 표면 장애 유도에 핵심적인 역할을 함을 알 수 있었다.

Melatonin Attenuates Mitochondrial Damage in Aristolochic Acid-Induced Acute Kidney Injury

  • Jian Sun;Jinjin Pan;Qinlong Liu;Jizhong Cheng;Qing Tang;Yuke Ji;Ke Cheng;Rui wang;Liang Liu;Dingyou Wang;Na Wu;Xu Zheng;Junxia Li;Xueyan Zhang;Zhilong Zhu;Yanchun Ding;Feng Zheng;Jia Li;Ying Zhang;Yuhui Yuan
    • Biomolecules & Therapeutics
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    • 제31권1호
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    • pp.97-107
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    • 2023
  • Aristolochic acid (AA), extracted from Aristolochiaceae plants, plays an essential role in traditional herbal medicines and is used for different diseases. However, AA has been found to be nephrotoxic and is known to cause aristolochic acid nephropathy (AAN). AA-induced acute kidney injury (AKI) is a syndrome in AAN with a high morbidity that manifests mitochondrial damage as a key part of its pathological progression. Melatonin primarily serves as a mitochondria-targeted antioxidant. However, its mitochondrial protective role in AA-induced AKI is barely reported. In this study, mice were administrated 2.5 mg/kg AA to induce AKI. Melatonin reduced the increase in Upro and Scr and attenuated the necrosis and atrophy of renal proximal tubules in mice exposed to AA. Melatonin suppressed ROS generation, MDA levels and iNOS expression and increased SOD activities in vivo and in vitro. Intriguingly, the in vivo study revealed that melatonin decreased mitochondrial fragmentation in renal proximal tubular cells and increased ATP levels in kidney tissues in response to AA. In vitro, melatonin restored the mitochondrial membrane potential (MMP) in NRK-52E and HK-2 cells and led to an elevation in ATP levels. Confocal immunofluorescence data showed that puncta containing Mito-tracker and GFP-LC3A/B were reduced, thereby impeding the mitophagy of tubular epithelial cells. Furthermore, melatonin decreased LC3A/B-II expression and increased p62 expression. The apoptosis of tubular epithelial cells induced by AA was decreased. Therefore, our findings revealed that melatonin could prevent AA-induced AKI by attenuating mitochondrial damage, which may provide a potential therapeutic method for renal AA toxicity.

Notoginseng leaf triterpenes ameliorates mitochondrial oxidative injury via the NAMPT-SIRT1/2/3 signaling pathways in cerebral ischemic model rats

  • Weijie, Xie;Ting, Zhu;Ping, Zhou;Huibo, Xu;Xiangbao, Meng;Tao, Ding;Fengwei, Nan;Guibo, Sun;Xiaobo, Sun
    • Journal of Ginseng Research
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    • 제47권2호
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    • pp.199-209
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    • 2023
  • Background: Due to the interrupted blood supply in cerebral ischemic stroke (CIS), ischemic and hypoxia results in neuronal depolarization, insufficient NAD+, excessive levels of ROS, mitochondrial damages, and energy metabolism disorders, which triggers the ischemic cascades. Currently, improvement of mitochondrial functions and energy metabolism is as a vital therapeutic target and clinical strategy. Hence, it is greatly crucial to look for neuroprotective natural agents with mitochondria protection actions and explore the mediated targets for treating CIS. In the previous study, notoginseng leaf triterpenes (PNGL) from Panax notoginseng stems and leaves was demonstrated to have neuroprotective effects against cerebral ischemia/reperfusion injury. However, the potential mechanisms have been not completely elaborate. Methods: The model of middle cerebral artery occlusion and reperfusion (MCAO/R) was adopted to verify the neuroprotective effects and potential pharmacology mechanisms of PNGL in vivo. Antioxidant markers were evaluated by kit detection. Mitochondrial function was evaluated by ATP content measurement, ATPase, NAD and NADH kits. And the transmission electron microscopy (TEM) and pathological staining (H&E and Nissl) were used to detect cerebral morphological changes and mitochondrial structural damages. Western blotting, ELISA and immunofluorescence assay were utilized to explore the mitochondrial protection effects and its related mechanisms in vivo. Results: In vivo, treatment with PNGL markedly reduced excessive oxidative stress, inhibited mitochondrial injury, alleviated energy metabolism dysfunction, decreased neuronal loss and apoptosis, and thus notedly raised neuronal survival under ischemia and hypoxia. Meanwhile, PNGL significantly increased the expression of nicotinamide phosphoribosyltransferase (NAMPT) in the ischemic regions, and regulated its related downstream SIRT1/2/3-MnSOD/PGC-1α pathways. Conclusion: The study finds that the mitochondrial protective effects of PNGL are associated with the NAMPT-SIRT1/2/3-MnSOD/PGC-1α signal pathways. PNGL, as a novel candidate drug, has great application prospects for preventing and treating ischemic stroke.

RAW264.7 세포에서 Cymbopogon Citratus 에탄올 추출물의 HO-1 유도를 통한 항산화 효과 (Anti-Oxidative Effects of Cymbopoton Citratus Ethanol Extract through the Induction of HO-1 Expression in RAW 264.7 Cells)

  • 박충무;윤현서
    • 대한통합의학회지
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    • 제11권4호
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    • pp.73-82
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    • 2023
  • Purpose : Cymbopogon citratus, also known as lemongrass, has widely spread around the world and its essential oil is usually applied in food, perfume, and other industrial purposes. In addition, C. citratus has also been used for the treatment of inflammation, digestive disorders, and diabetes in traditional medicine. In this study, the antioxidative activity of C. citratus ethanol extract (CCEE) was analyzed in RAW 264.7 cells through the induction of one of phase II enzymes, heme oxygenase (HO)-1 by nuclear factor-erythroid 2 p45-related factor (Nrf)2, mitogen-activated protein kinase (MAPK), and phosphoinositide 3-kinase (PI3K)/Akt. Methods : The antioxidative activity of CCEE against oxidative stress and its underlying molecular mechanisms were analyzed by the cell viability assay, intracellular reactive oxygen species (ROS) formation assay, and Western blot analysis in RAW 264.7 cells. Results : The results exhibited that CCEE potently attenuated tert-butyl hydroperoxide (t-BHP) induced intracellular ROS levels in a dose-dependent manner without any cytotoxicity. CCEE treatment significantly induced the expression of HO-1 which is known for its antioxidative capacity. In addition, CCEE treatment significantly upregulated the expression of Nrf2, a corresponding transcription factor for the regulation of antioxidative enzymes, which was in accordance with the HO-1 overexpression. MAPK and PI3K/Akt were also evaluated for their important roles in the regulation of cellular redox homeostasis against oxidative damage. As a result, the potent HO-1 expression was mediated by not extracellular regulated kinase (ERK), c-Jun NH2 terminal kinase (JNK), p38, but phosphoinositide 3-kinase (PI3K) phosphorylation. To confirm the antioxidative activity of CCEE-induced HO-1 expression, oxidative damage was initiated by t-BHP and attenuated by CCEE treatment, which was identified by HO-1 selective inhibitor and inducer. Conclusion : Consequently, CCEE potently induced the HO-1-mediated antioxidative potential through the modulation of Nrf2 and PI3K/Akt signaling pathways in RAW 264.7 cells. These results suggest that CCEE could be a promising strategy for the mitigation against cellular oxidative damage.

RAW 264.7 세포에서 Lycopene의 MAPK/Nrf2/HO-1 신호 전달 체계를 통한 항산화 효과 (Anti-oxidative Activity of Lycopene Via the Induction of HO-1 Expression by MAPK/Nrf2 Signaling Pathway in RAW 264.7 Cells)

  • 박충무;안현;윤현서
    • 대한통합의학회지
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    • 제12권1호
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    • pp.1-10
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    • 2024
  • Purpose: Lycopene is abundantly contained in Tomatoes and is known for diverse biological activities such as antioxidant, anti-inflammatory, and anticancer effects. In this study, the antioxidative potential of lycopene was investigated through the induction of hemeoxygenase (HO)-1 by nuclear factor-erythroid 2 p45-related factor2 (Nrf2) and upstream signaling molecules, mitogen-activated protein kinase (MAPK) and phosphoinositide 3-kinase (PI3K)/Aktin RAW 264.7 cells. Methods: The antioxidative potential of lycopene against oxidative stress and its molecular mechanisms were determined by the cell viability assay, intracellular reactive oxygen species (ROS) formation assay, and Western blot analysis in RAW 264.7 cells. Results: Lycopene treatment significantly attenuated tert-butyl hydroperoxide (t-BHP) induced intracellular ROS formation in a dose-dependent manner without any cytotoxicity. In addition, 50 µM of lycopene for 6 h treatment induced potent HO-1 expression and its transcription factor, Nrf2. MAPK and PI3K/Aktwere also analyzed due to their critical roles in the regulation of cellular redox homeostasis against oxidative damage. As a result, phosphorylation of extracellular regulated kinase (ERK) was significantly induced by lycopene treatment while the activated status of c-Jun NH2-terminal kinase (JNK), p38, and Akt, were not given any effect. To confirm the antioxidative mechanism of HO-1 mediated by ERK activation, each selective inhibitor was employed in a protection assay, in which oxidative damage occurred by t-BHP. Lycopene, SnPP, and CoPP treatments reflected accelerated HO-1 expression could be a protective role against oxidative damage-initiated cell death. A selective inhibitor for ERK significantly inhibited the lycopene-induced cytoprotective effect but selective inhibitors for other signaling molecules did not attenuate the rate of t-BHP-induced cell death. Conclusion: In conclusion, lycopene potently scavenged intracellular ROS formation and enhanced the HO-1 mediated antioxidative potential through the modulation of Nrf2, MAPK signaling pathway in RAW 264.7 cells.

Diurnal Variation in Hydration of the Cervical Intervertebral Disc Assessed Using T2 Mapping of Magnetic Resonance Imaging

  • Chanyuan Liu;Jingyi Wang;Bowen Hou;Yitong Li;John N. Morelli;Peisen Zhang;Jun Ran;Xiaoming Li
    • Korean Journal of Radiology
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    • 제23권6호
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    • pp.638-648
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    • 2022
  • Objective: The study aimed to investigate the diurnal variation in cervical disc hydration and its relationship with cervical degeneration. Materials and Methods: C3-C7 discs of 86 prospectively enrolled participants (37 males, 49 females; mean age ± standard deviation, 23.5 ± 2.5 years) were assessed using T2 mapping in the morning and evening. All discs were stratified by Miyazaki grade or C2-C7 Cobb angle and T2 values (T2). The degree of diurnal T2 variation (T2-DDV), defined as (morning T2 - evening T2)/morning T2 x 100%, was measured for the entire disc, annulus fibrosus (AF), nucleus pulposus (NP), and endplate zones. Results: T2 of the entire disc decreased significantly after the daytime load (p < 0.001), with a T2-DDV of 13.3% for all discs and 16.0%, 12.2%, and 13.0% for healthy (grade I), mild degenerative (grade II), and advanced degenerative (grade III/IV) discs, respectively. T2 of regional NPs and AFs decreased significantly from morning to evening (p ≤ 0.049) except in the healthy anterior inner AF (p = 0.092). Compared with healthy discs, mild degenerative discs displayed lower T2 and T2-DDV in regional NPs (p < 0.001). Advanced degenerative discs showed higher T2-DDV in the anterior inner AF compared with healthy discs (p = 0.050). Significant diurnal T2 changes in the endplate zones were observed only in healthy discs (p = 0.013). Cervical discs in the low Cobb angle group showed higher T2-DDV in the anterior AFs and anterior NP and lower T2-DDV in the posterior AF than those in the high Cobb angle group (p ≤ 0.041). Conclusion: This study characterized the diurnal variation in hydration of the cervical discs as assessed using T2 mapping and revealed early chemo-mechanical coupling dysfunction in degenerating discs. Cervical sagittal alignment on MRI can affect the diurnal stress patterns of the cervical discs. T2 mapping is sensitive to disc biomechanical dysfunction and offers translational potential from biomechanical research to clinical application.

Correct Closure of the Left Atrial Appendage Reduces Stagnant Blood Flow and the Risk of Thrombus Formation: A Proof-of-Concept Experimental Study Using 4D Flow Magnetic Resonance Imaging

  • Min Jae Cha;Don-Gwan An;Minsoo Kang;Hyue Mee Kim;Sang-Wook Kim;Iksung Cho;Joonhwa Hong;Hyewon Choi;Jee-Hyun Cho;Seung Yong Shin;Simon Song
    • Korean Journal of Radiology
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    • 제24권7호
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    • pp.647-659
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    • 2023
  • Objective: The study was conducted to investigate the effect of correct occlusion of the left atrial appendage (LAA) on intracardiac blood flow and thrombus formation in patients with atrial fibrillation (AF) using four-dimensional (4D) flow magnetic resonance imaging (MRI) and three-dimensional (3D)-printed phantoms. Materials and Methods: Three life-sized 3D-printed left atrium (LA) phantoms, including a pre-occlusion (i.e., before the occlusion procedure) model and correctly and incorrectly occluded post-procedural models, were constructed based on cardiac computed tomography images from an 86-year-old male with long-standing persistent AF. A custom-made closed-loop flow circuit was set up, and pulsatile simulated pulmonary venous flow was delivered by a pump. 4D flow MRI was performed using a 3T scanner, and the images were analyzed using MATLAB-based software (R2020b; Mathworks). Flow metrics associated with blood stasis and thrombogenicity, such as the volume of stasis defined by the velocity threshold ($\left|\vec{V}\right|$ < 3 cm/s), surface-and-time-averaged wall shear stress (WSS), and endothelial cell activation potential (ECAP), were analyzed and compared among the three LA phantom models. Results: Different spatial distributions, orientations, and magnitudes of LA flow were directly visualized within the three LA phantoms using 4D flow MRI. The time-averaged volume and its ratio to the corresponding entire volume of LA flow stasis were consistently reduced in the correctly occluded model (70.82 mL and 39.0%, respectively), followed by the incorrectly occluded (73.17 mL and 39.0%, respectively) and pre-occlusion (79.11 mL and 39.7%, respectively) models. The surfaceand-time-averaged WSS and ECAP were also lowest in the correctly occluded model (0.048 Pa and 4.004 Pa-1, respectively), followed by the incorrectly occluded (0.059 Pa and 4.792 Pa-1, respectively) and pre-occlusion (0.072 Pa and 5.861 Pa-1, respectively) models. Conclusion: These findings suggest that a correctly occluded LAA leads to the greatest reduction in LA flow stasis and thrombogenicity, presenting a tentative procedural goal to maximize clinical benefits in patients with AF.

Beneficial effects of oral antioxidant supplementation on semen quality parameters, reproductive hormones, and sperm DNA integrity in men with idiopathic oligoasthenoteratozoospermia

  • Chaymae Rochdi;Meriem Ouadrhiri;Larbi Allai;Ibtissam Bellajdel;Samira Mamri;Hafsa Taheri;Hanane Saadi;Ahmed Mimouni;Mohammed Choukri
    • Clinical and Experimental Reproductive Medicine
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    • 제51권2호
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    • pp.135-141
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    • 2024
  • Objective: Recently, oral antioxidants in combined forms have been used to treat men with idiopathic infertility. This study aimed to evaluate the effects of treatment with vitamin C, vitamin E, selenium, zinc, arginine, L-carnitine, and coenzyme Q10 on sperm quality parameters, DNA integrity, reproductive hormones, and pregnancy rates in men with infertility and idiopathic oligoasthenoteratozoospermia (OAT). Methods: A prospective study was conducted on 420 men with infertility and idiopathic OAT who took an oral supplement of antioxidant SP-Power tablets twice daily for 6 months. Semen quality, reproductive hormones, and the DNA fragmentation index (DFI) were evaluated at baseline and at 3 and 6 months after supplementation, using the World Health Organization 2021 guidelines. Results: No significant difference was observed in volume or the percentage of typical morphology during treatment. A significant improvement in sperm concentration was observed after supplementation (8.67±1.41, 12.17±1.91, and 19.01±0.86 at baseline, 3, and 6 months respectively, p<0.01). The total motility, progressive motility, and total motile sperm count also increased significantly (p<0.01), whereas the DFI decreased after 6 months. There was an increase in normal FSH levels and testosterone levels after 6 months of supplementation of antioxidant SP-Power but these differences were not statistically significant (p=not significant and p=0.06, respectively). Conclusion: Supplementation with SP-Power tablets improved sperm quality parameters, sperm DFI, some reproductive hormones, and pregnancy rates in men with infertility and idiopathic OAT, which could be attributed to the supplement's synergistic antioxidant action. Further studies are needed to determine the effects of supplementation on oxidative stress markers.

얼렌증후군에서 컬러필터가 읽기능력에 미치는 영향 (The Effect of Color Filter on the Reading Ability in Teenager with Irlen-Syndrome)

  • 이동준;임현성
    • 한국안광학회지
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    • 제18권2호
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    • pp.125-136
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    • 2013
  • 목적: 본 연구는 설문을 통해 광과민성 난독증인 얼렌증후군(Meares-Ilren syndrome visual stress: MISViS)으로 진단을 받은 청소년을 대상으로 검사와 관련된 설문조사 및 각자 읽기에 도움이 되는 필터를 이용한 필터 사용 전, 후 읽기속도를 측정하여 읽기 속도 개선 효과를 비교분석하였다. 방법: 얼렌증후군 진단은 MISViS 선별설문결과에서 임상기준 점수(MISViS score) 2.13 이상으로 나오면 얼렌증후군이 있는 것으로 진단하였다. 읽기검사는 문맥이 맞지 않고, 내용이 없는 문장으로 구성된 검사지를 1분 동안 읽도록 하여 읽기 속도를 측정하였다. 15개의 컬러필터 그룹으로 구성되어 있는 필터 kit에서 각 그룹의 농도가 최하위인 필터를 선택하여 착용시킨 후 반응을 관찰하였다. 결과: 얼렌증후군 그룹의 MISViS score는 2.57이었고, 정상그룹의 MISViS score는 0.66이었다. 얼렌증후군 그룹의 필터착용 전과 후 읽기속도결과는 읽기속도(reading speed) $102.27{\pm}27.86(wpm)$에서 $118.87{\pm}26.99(wpm)$ (p=0.001), 정상그룹의 읽기속도는 $132.93{\pm}6.88(wpm$)에서 $133.43{\pm}6.64(wpm)$ (p=0.131)의 결과를 보였다. 두 그룹간의 필터 착용 전과 후의 오류변화 결과는 얼렌증후군 그룹이 줄생략(skipping)은 $0.25{\pm}0.62$회에서 0회(p=0.191), 단어잘못읽기(error)는 $1.83{\pm}1.69$회에서 $0.17{\pm}0.38$회 (p=0.004), 반복읽기(repetition)는 0회 이었다. 정상그룹의 줄생략(skipping)은 0회, 단어잘못읽기(error)는 $0.21{\pm}0.43$회에서 $0.07{\pm}0.27$회(p=0.336), 반복읽기(repetition)는 $0.14{\pm}0.36$회에서 0회 (p=0.165)의 결과를 보였다. 얼렌증후군 15명에서 선택된 컬러 필터의 색은 청색계열 컬러 필터의 선택비율이 40%로 가장 높게 나타났고, 정상대조군 14명에서 선택된 컬러 필터는 회색계열 컬러 선택비율이 29%로 가장 높게 나타났다. 결론: 본 연구 결과는 MISViS score가 얼렌증후군을 선별하는 기준으로 적용될 수 있음을 보여주고 있다. 얼렌증후군으로 진단받은 청소년들은 각자에 적합한 컬러필터를 착용 했을 때 읽기 개선 효과에 도움이 되는 것으로 나타났다. 얼렌증후군에서 컬러필터 선택은 개인에 적합한 고유의 컬러필터 파장이 서로 다르므로 선택을 신중하게 해야 할 것으로 사료된다.