• Title/Summary/Keyword: Disease Progression

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An Analysis of the Prevalence and Pattern Identification of Korean Medicine for Acute Stress Disorder and Post Traumatic Stress Disorder in Patients with Traffic Injuries (교통사고 상해증후군 환자의 급성 스트레스 장애와 외상 후 스트레스 장애의 유병률과 한의변증유형 분석)

  • Lee, Yu Jin;Lee, Sung Joon;Cheong, Moon Joo;Lim, Jung Hwa;Jo, Hee Geun;Kim, Bo Min;Chung, Sun-Yong;Kwak, Hui-Yong;Park, Bo Ra;Park, Tae-Yong;Shin, Byung-Cheul;Kang, Hyung Won
    • Journal of Oriental Neuropsychiatry
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    • v.32 no.1
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    • pp.1-11
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    • 2021
  • Objectives: To investigate the prevalence of acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) in patients with traffic injuries. In addition, PTSD patients was classified using 'pattern identification for jing ji and zheng chong'. Methods: Questionnaires such as the primary care PTSD screen for DSM-5(PC-PTSD-5), Korean version of PTSD checklist-5 (PCL-5-K), and the instrument of pattern identification for jing ji and zheng chong were conducted on 195 patients within 3 days to 1 year after traffic accidents. Patients were recruited from six medical institutions. Collected data were used to determine the prevalence of acute stress disorder and post-traumatic stress disorder. Results: On PC-PTSD-5, the prevalence was 39.1% for ASD and 50% for PTSD. On PCL-5-K, the prevalence was 20.4% for ASD and 29.3% for PTSD. Satisfying both PC-PTSD-5 and PCL-5-K, the prevalence was 18.2% for ASD and 25.8% for PTSD. As a result of pattern identification for jing ji and zheng chong, 'weakness of heart and gall bladder type' accounted for the highest proportions in both ASD and PTSD groups. Conclusions: In this study, the prevalence was 39.1% for ASD and 50% for PTSD by PC-PTSD-5. Satisfying both PC-PTSD-5 and PCL-5-K, the prevalence was 18.2% for ASD and 25.8% for PTSD. Further large-scale prospective studies are needed to analyze the prevalence of ASD and PTSD, the rate of progression from ASD to PTSD, and the type of pattern identification.

Correlation of advanced glycation end products and heme oxygenase-1 in Korean diabetic patients (제2형 당뇨병 환자에서 최종당화산물과 heme oxygenase-1의 상관성)

  • Choi, Ha-Neul;Koo, Da-Hye;Yim, Jung-Eun
    • Journal of Nutrition and Health
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    • v.55 no.3
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    • pp.348-358
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    • 2022
  • Purpose: Hyperglycemia accelerates the formation of advanced glycation end products (AGEs), a group of compounds formed via non-enzymatic glycation/glycoxidation. Type 2 diabetes mellitus (T2DM) is related to oxidative stress, resulting in some overgeneration of AGEs. The accumulation of AGEs in T2DM patients leads to increased inflammation, DNA damage, tissue damage, progression of diabetic microvascular disease, and nephropathy. Heme oxygenase-1 (HO-1) is an intracellular enzyme that catalyzes the oxidation of heme. Expression of HO-1 in the endothelium and in muscle monocytes/macrophages was upregulated upon exposure to reactive oxygen species or oxidized low-density lipoprotein. Cells activated by oxidative stress are reported to release HO-1 in the serum. In the current study, we discuss the oxidative status according to the level of AGEs and the association of HO-1 with AGEs or urinary DNA damage marker in type 2 diabetic Korean patients. Methods: This study enrolled 36 diabetic patients. Subjects were classified into two groups by serum AGEs level (Low AGEs group: < 0.85 ng/mL serum AGEs; High AGEs group: ≥ 0.85 ng/mL serum AGEs). Body composition was measured using bioelectrical impedance analysis. Blood and urinary parameters were measured using commercial kits. Results: No significant differences were observed in the general characteristics and body composition between the two groups. Serum HO-1 concentration was significantly higher in the High AGEs group than in the Low AGEs group. After adjustment of age and gender, a correlation was performed to assess the association between serum HO-1 and serum AGEs or urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG). Our results indicate that serum HO-1 is positively correlated with serum AGEs and urinary 8-OHdG. Conclusion: Taken together, our results indicate that in diabetes patients, a high level of HO-1 is associated with a high concentration of AGEs and 8-OHdG, probably reflecting a protective response against oxidative stress.

Opioids and Antidepressants for Pain Control in Musculoskeletal Disease (근골격계 질환에서 통증 조절을 위한 마약성 진통제 및 항우울제)

  • Park, Se-Jin;Kim, Woo Sub;Jang, Taedong
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.1-8
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    • 2020
  • The progression of aging and the increase in musculoskeletal diseases have led to an increase in invasive treatment methods, including various surgical methods, but conservative treatment should be attempted before surgical treatment in musculoskeletal diseases. Medication for pain control, such as acetaminophen, non-steroidal anti-inflammatory drugs, steroid, opioids, antidepressants, etc., is one of the most popular methods for pain control. If the pain receptors on peripheral organ are stimulated, pain is transmitted to the brain by the ascending pathway, and the brain then secretes endogenous opioids, such as endorphin, by the descending pathway for pain control. Opioids are substances that act on the opioid receptors, and there are three receptors for opioids. The affinity for each receptor varies according to the tissue and the patient's systemic status. Antidepressants work on the synapses in the central nervous system and its main mechanism is regulation of the ascending pathway. This is mainly effective in chronic pain and neuropathic pain, which is similar in effectiveness to opioids. This review focuses on the effectiveness, method of use, and side effects of opioids and antidepressants.

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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    • v.31 no.1
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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.

Measurement of Minimum Inhibitory Concentration of Toxic Chemicals against Pseudomonas aeruginosa and Staphylococcus aureus (유해 화학물질 처리에 의한 녹농균과 포도상구균의 성장저해최소농도 측정)

  • Jiseon An;Jingyeong Kim;Jae Seong Kim;Chang-Soo Lee
    • Clean Technology
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    • v.29 no.2
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    • pp.135-144
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    • 2023
  • Pseudomonas aeruginosa and Staphylococcus aureus are the two most frequently encountered pathogens responsible for chronic wound infections, often coexisting in such cases. These infections exhibit heightened virulence compared to single infections, leading to unfavorable patient outcomes. The interaction among microorganisms within polymicrobial infections has been shown to exacerbate disease progression. Polymicrobial infections, prevalent in various contexts such as the respiratory tract, wounds, and diabetic foot, typically involve diverse microorganisms, with Pseudomonas aeruginosa and Staphylococcus aureus being the most commonly identified pathogens. This study aimed to compare the growth patterns of bacteria under a concentration gradient of toxic chemicals, focusing on a Gram-negative strain of Pseudomonas aeruginosa and a Gram-positive strain of Staphylococcus aureus. The minimum inhibitory concentration (MIC), which signifies the concentration at which bacterial growth is inhibited, was determined by performing broth microdilution and assessing the bacteria's growth curves. The growth curves of both Pseudomonas aeruginosa and Staphylococcus aureus were confirmed, and the exponential growth phases were applied to calculate the doubling times of bacteria. The MIC value for each toxic chemical was determined through broth microdilution. These results allowed for the identification of disparities in growth rates between Gram-positive and Gram-negative bacteria, as well as differences in resistance to individual toxic substances. We expect that this approach has a strong potential for further development towards the innovative treatment of bacteria-associated infections.

Research for the Development of an Integrated Medical System for Idiopathic Pulmonary Fibrosis: Based on an Analysis of Questionnaire Survey in Doctor and Patient Groups (특발성 폐섬유증의 통합의료 협진 모델 개발을 위한 의료진 및 환자 대상 설문조사 연구)

  • Jiwon Park;Beom-Joon Lee;Jeong-Won Shin;Su-Hyun Chin;Jung-Min Yang;Sooduk Kim;Kwan-Il Kim;Hye Sook Choi;Hee-Jae Jung
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.366-386
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    • 2023
  • Objective: In this study, a questionnaire survey was conducted for doctors and patients to obtain basic data necessary for the development of an integrated medical system for idiopathic pulmonary fibrosis (IPF). Methods: Questionnaires were developed separately for doctors and patients through an expert group meeting. The survey subjects were recruited online and offline, and finally, responses from 231 doctors and 59 patients were used for statistical analysis. Results: The most important parts in the treatment of IPF for both doctors and patients were the "improvement of respiratory symptoms," "improvement of quality of life," and "prevention of disease progression." Antifibrotic agents were prescribed at a high rate, and 100% of the specialists in Western medicine (WM) and 45.8% of patients reported experiencing side effects. As for the additional payment costs that patients considered as affordable for an integrated medical system, "under 50,000 won (about 38$)" was reported the most in both doctor and patient groups. With regard to the reasons for their reluctance to recommend an integrated medical system for IPF, specialists in WM responded highly to "uncertain evidence for treatment effectiveness." Regarding complementary and alternative medicine therapies that can be beneficial in patients with IPF, "lifestyle management," "diet management," "herb," "relaxation therapy," and "psychotherapy" were ranked high in both doctor and patient groups. Conclusions: In this study, a questionnaire survey on IPF was conducted to review actual treatment status, analyze shortcomings, and identify considerations for the development of an integrated medical system for IPF in the future.

Co-occurrence Analyses of Antibiotic Resistance Genes and Microbial Community in Human and Livestock Animal Feces (사람 및 가축 유래 분변 미생물 군집과 항생제 내성 유전자 간 상관 관계에 대한 연구)

  • Jiwon Jeong;Aprajita Bhandari;Tatsuya Unno
    • Korean Journal of Environmental Agriculture
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    • v.41 no.4
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    • pp.335-343
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    • 2022
  • BACKGROUND: Antibiotics used in animal husbandry for disease prevention and treatment have resulted in the rapid progression of antibiotic resistant bacteria which can be introduced into the environment through livestock feces/manure, disseminating antibiotic resistant genes (ARGs). In this study, fecal samples were collected from the livestock farms located in Jeju Island to investigate the relationship between microbial communities and ARGs. METHODS AND RESULTS: Illumina MiSeq sequencing was applied to characterize microbial communities within each fecal sample. Using quantitative PCR (qPCR), ten ARGs encoding tetracycline resistance (tetB, tetM), sulfonamide resistance (sul1, sul2), fluoroquinolone resistance (qnrD, qnrS), fluoroquinolone and aminoglycoside resistance (aac(6')-Ib), beta-lactam resistance (blaTEM, blaCTX-M), macrolide resistance (ermC), a class 1 integronsintegrase gene (intI1), and a class 2 integrons-integrase gene (intI2) were quantified. The results showed that Firmicutes and Bacteroidetes were dominant in human, cow, horse, and pig groups, while Firmicutes and Actinobacteria were dominant in chicken group. Among ARGs, tetM was detected with the highest number of copies, followed by sul1 and sul2. Most of the genera belonging to Firmicutes showed positive correlations with ARGs and integron genes. There were 97, 34, 31, 25, and 22 genera in chicken, cow, pig, human, and horse respectively which showed positive correlations with ARGs and integron genes. In network analysis, we identified diversity of microbial communities which correlated with ARGs and integron genes. CONCLUSION(S): In this study, antibiotic resistance patterns in human and livestock fecal samples were identified. The abundance of ARGs and integron genes detected in the samples were associated with the amount of antibiotics commonly used for human and livestocks. We found diverse microbial communities associated with antibiotics resistance genes in different hosts, suggesting that antibiotics resistance can disseminate across environments through various routes. Identifying the routes of ARG dissemination in the environment would be the first step to overcome the challenge of antibiotic resistance in the future.

Analysis of miRNA expression in the trachea of Ri chicken infected with the highly pathogenic avian influenza H5N1 virus

  • Suyeon Kang;Thi Hao Vu;Jubi Heo;Chaeeun Kim;Hyun S. Lillehoj;Yeong Ho Hong
    • Journal of Veterinary Science
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    • v.24 no.5
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    • pp.73.1-73.16
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    • 2023
  • Background: Highly pathogenic avian influenza virus (HPAIV) is considered a global threat to both human health and the poultry industry. MicroRNAs (miRNA) can modulate the immune system by affecting gene expression patterns in HPAIV-infected chickens. Objectives: To gain further insights into the role of miRNAs in immune responses against H5N1 infection, as well as the development of strategies for breeding disease-resistant chickens, we characterized miRNA expression patterns in tracheal tissues from H5N1-infected Ri chickens. Methods: miRNAs expression was analyzed from two H5N1-infected Ri chicken lines using small RNA sequencing. The target genes of differentially expressed (DE) miRNAs were predicted using miRDB. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis were then conducted. Furthermore, using quantitative real-time polymerase chain reaction, we validated the expression levels of DE miRNAs (miR-22-3p, miR-146b-3p, miR27b-3p, miR-128-3p, miR-2188-5p, miR-451, miR-205a, miR-203a, miR-21-3p, and miR-200a3p) from all comparisons and their immune-related target genes. Results: A total of 53 miRNAs were significantly expressed in the infection samples of the resistant compared to the susceptible line. Network analyses between the DE miRNAs and target genes revealed that DE miRNAs may regulate the expression of target genes involved in the transforming growth factor-beta, mitogen-activated protein kinase, and Toll-like receptor signaling pathways, all of which are related to influenza A virus progression. Conclusions: Collectively, our results provided novel insights into the miRNA expression patterns of tracheal tissues from H5N1-infected Ri chickens. More importantly, our findings offer insights into the relationship between miRNA and immune-related target genes and the role of miRNA in HPAIV infections in chickens.

Deciphering the DNA methylation landscape of colorectal cancer in a Korean cohort

  • Seok-Byung Lim;Soobok Joe;Hyo-Ju Kim;Jong Lyul Lee;In Ja Park;Yong Sik Yoon;Chan Wook Kim;Jong-Hwan Kim;Sangok Kim;Jin-Young Lee;Hyeran Shim;Hoang Bao Khanh Chu;Sheehyun Cho;Jisun Kang;Si-Cho Kim;Hong Seok Lee;Young-Joon Kim;Seon-Young Kim;Chang Sik Yu
    • BMB Reports
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    • v.56 no.10
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    • pp.569-574
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    • 2023
  • Aberrant DNA methylation plays a pivotal role in the onset and progression of colorectal cancer (CRC), a disease with high incidence and mortality rates in Korea. Several CRC-associated diagnostic and prognostic methylation markers have been identified; however, due to a lack of comprehensive clinical and methylome data, these markers have not been validated in the Korean population. Therefore, in this study, we aimed to obtain the CRC methylation profile using 172 tumors and 128 adjacent normal colon tissues of Korean patients with CRC. Based on the comparative methylome analysis, we found that hypermethylated positions in the tumor were predominantly concentrated in CpG islands and promoter regions, whereas hypomethylated positions were largely found in the open-sea region, notably distant from the CpG islands. In addition, we stratified patients by applying the CpG island methylator phenotype (CIMP) to the tumor methylome data. This stratification validated previous clinicopathological implications, as tumors with high CIMP signatures were significantly correlated with the proximal colon, higher prevalence of microsatellite instability status, and MLH1 promoter methylation. In conclusion, our extensive methylome analysis and the accompanying dataset offers valuable insights into the utilization of CRC-associated methylation markers in Korean patients, potentially improving CRC diagnosis and prognosis. Furthermore, this study serves as a solid foundation for further investigations into personalized and ethnicity-specific CRC treatments.

Efficacy and Safety of Trastuzumab Deruxtecan and Nivolumab as Third- or Later-Line Treatment for HER2-Positive Advanced Gastric Cancer: A Single-Institution Retrospective Study

  • Keitaro Shimozaki;Izuma Nakayama ;Daisuke Takahari;Kengo Nagashima;Koichiro Yoshino ;Koshiro Fukuda;Shota Fukuoka ;Hiroki Osumi ;Mariko Ogura ;Takeru Wakatsuki;Akira Ooki ;Eiji Shinozaki;Keisho Chin ;Kensei Yamaguchi
    • Journal of Gastric Cancer
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    • v.23 no.4
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    • pp.609-621
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    • 2023
  • Purpose: Determination of optimal treatment strategies for HER2-positive advanced gastric cancer (AGC) in randomized trials is necessary despite difficulties in direct comparison between trastuzumab deruxtecan (T-DXd) and nivolumab as third or later-line treatments. Materials and Methods: This single-institution, retrospective study aimed to describe the real-world efficacy and safety of T-DXd and nivolumab as ≥ third line treatments for HER2-positive AGC between March 2016 and May 2022. Overall, 58 patients (median age, 64 years; 69% male) were eligible for the study (T-DXd group, n=20; nivolumab group, n=38). Results: Most patients exhibited a HER2 3+ status (72%) and presented metastatic disease at diagnosis (66%). The response rates of 41 patients with measurable lesions in the T-DXd and nivolumab groups were 50% and 15%, respectively. The T-DXd and nivolumab groups had a median progression-free survival of 4.8 months (95% confidence interval [CI], 3.3, 7.0) and 2.3 months (95% CI, 1.5, 3.5), median overall survival (OS) of 10.8 months (95% CI, 6.9, 23.8) and 11.7 months (95% CI, 7.6, 17.1), and grade 3 or greater adverse event rates of 50% and 2%, respectively. Overall, 64% patients received subsequent treatment. Among 23 patients who received both regimens, the T-DXd-nivolumab and nivolumab-T-DXd groups had a median OS of 14.0 months (95% CI, 5.0, not reached) and 19.3 months (95% CI, 9.5, 25.1), respectively. Conclusions: T-DXd and nivolumab showed distinct efficacy and toxicity profiles as ≥ third line treatments for HER2-positive AGC. Considering the distinct features of each regimen, they may help clinicians personalize optimal treatment approaches for these patients.