• 제목/요약/키워드: Evidence-based laboratory medicine

검색결과 68건 처리시간 0.025초

Heat shock protein X purified from Mycobacterium tuberculosis enhances the efficacy of dendritic cells-based immunotherapy for the treatment of allergic asthma

  • Kim, Hye-Young;Kang, Hyun Kyu;Cho, Joon;Jung, In Duk;Yoon, Gun Young;Lee, Min-Goo;Shin, Sung Jae;Park, Won Sun;Park, Jong-Hwan;Ryu, Seung-Wook;Park, Yeong-Min;You, Ji Chang
    • BMB Reports
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    • 제48권3호
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    • pp.178-183
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    • 2015
  • Dendritic cells play an important role in determining whether na${\ddot{i}}$ve T cells mature into either Th1 or Th2 cells. We determined whether heat-shock protein X (HspX) purified from Mycobacterium tuberculosis regulates the Th1/Th2 immune response in an ovalbumin (OVA)-induced murine model of asthma. HspX increased interferon-gamma, IL-17A, -12 and transforming growth factor (TGF)-${\beta}$ production and T-bet gene expression but reduced IL-13 production and GATA-3 gene expression. HspX also inhibited asthmatic reactions as demonstrated by an increase in the number of eosinophils in bronchoalveolar lavage fluid, inflammatory cell infiltration in lung tissues, airway luminal narrowing, and airway hyper-responsiveness. Furthermore, HspX enhanced OVA-induced decrease of regulatory T cells in the mediastinal lymph nodes. This study provides evidence that HspX plays critical roles in the amelioration of asthmatic inflammation in mice. These findings provide new insights into the immunotherapeutic role of HspX with respect to its effects on a murine model of asthma.

Sopungsungi-won (SP) Prevents the Onset of Hyperglycemia and Hyperlipidemia in Zucker Diabetic Fatty Rats

  • Kim, Youn-Young;Kang, Hyo-Joo;Ko, Sung-Kwon;Chung, Sung-Hyun
    • Archives of Pharmacal Research
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    • 제25권6호
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    • pp.923-931
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    • 2002
  • Sopungsungi-won (SP) is a known for\mula for senile constipation and diabetes mellitus, based on traditional Korean medicine. The preventive effect of SP on the development of overt diabetes in Zucker diabetic fatty (ZDF) rats was evaluated. When administered orally through a diet for 8 weeks, diabetic conditions such as hyperglycemia, polydipsia and hypertriglyceridemia were all ameliorated in SP-treated rats. In parallel with the onset and progression of hyperglycemia in the ZDF control rats; there was a marked decline in plasma insulin concentrations from 26.1 $\mu$U/ml, at age 7 weeks, to 14.8 $\mu$U/ml at age 15 weeks. In the SP-treated rats, however, the plasma insulin concentrations did not decline, and SP at a dose of 5 g/kg significantly increased the insulin levels to 31.9 $\mu$U/ml. Early normalization of plasma insulin and a retained ability to subsequently increase plasma insulin were indicative of a pancreatic $\beta$ cell protective action by the SP for\mula. In addition, expressions of an insulin-responsive gene and corresponding protein, glucose transporter 4 (GLUT4), in skeletal \muscle, were also determined in SP- and rosiglitazone-treated ZDF rats. mRNA and protein levels of GLUT4 in SP-treated rats were upregulated in a dose dependent manner. Furthermore, when ZDF rats were treated with 2 g/kg of the SP for\mula, the activity of glucose-6-phosphatase was decreased by 49%, whereas the activity of glucokinase was increased by 196%, compared to the ZDF control rats. Taken together, these data provide evidence that the SP for\mula markedly lowered the plasma glucose levels, probably through an effect not only on improvement of insulin action, but through a combined sti\mulation of glycolysis and an inhibition of gluconeogenesis in the liver, and also suggest the validity of SP's clinical use in the treatment of type 2 diabetes mellitus following further toxicological investigation.

High Frequency of Enteric Protozoan, Viral, and Bacterial Potential Pathogens in Community-Acquired Acute Diarrheal Episodes: Evidence Based on Results of Luminex Gastrointestinal Pathogen Panel Assay

  • Hawash, Yousry A.;Ismail, Khadiga A.;Almehmadi, Mazen
    • Parasites, Hosts and Diseases
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    • 제55권5호
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    • pp.513-521
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    • 2017
  • Infectious diarrhea is endemic in most developing countries. We aimed to investigate the protozoan, viral, and bacterial causes of acute diarrhea in Taif, Saudi Arabia. A cross-sectional prospective 1-year study was conducted on 163 diarrheal patients of various ages. Stool samples were collected, 1 per patient, and tested for 3 protozoa, 3 viruses, and 9 bacteria with the Luminex Gastrointestinal Pathogen Panel. Overall, 53.4% (87/163) of samples were positives (20.8% protozoa, 19.6% viruses, 2.8% bacteria, and 9.8% mixed). Rotavirus (19.6%), Giardia duodenalis (16.5%), and Cryptosporidium spp. (8.5%) were the mostly detected pathogens. Adenovirus 40/41 (4.2%), Salmonella (3%), Shiga toxin-producing Escherichia coli (3%), and Entamoeba histolytica (2.4%) were also detected. Norovirus GI/II, Vibrio cholerae, Yersinia enterocolitica, and Clostridium difficile toxin A/B were not detected in any patients. All pathogens were involved in coinfections except E. histolytica. Giardia (5.5%) and rotavirus (3%) were the most commonly detected in co-infections. Enterotoxigenic E. coli (2.4%), Campylobacter spp. (2.4%), E. coli 0157 (1.8%), and Shigella spp. (1.2%) were detected in patients only as co-infections. Infections were more in children 0-4 years, less in adults <40 years, and least >40 years, with statistically significant differences in risk across age groups observed with rotavirus (P<0.001), Giardia (P=0.006), and Cryptosporidium (P=0.036) infections. Lastly, infections were not significantly more in the spring. This report demonstrates the high burden of various enteropathogens in the setting. Further studies are needed to define the impact of these findings on the clinical course of the disease.

Chinese Patients with Gastric Cancer Need Targeted Adjuvant Chemotherapy Schemes

  • Shi, Wen-Tao;Wei, Lei;Xiang, Jin;Su, Ke;Ding, Qiong;Tang, Meng-Jie;Li, Ji-Qiang;Guo, Yi;Wang, Pu;Zhang, Jing-Wei
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권10호
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    • pp.5263-5272
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    • 2012
  • Background: Gastric cancer (GC) is one of the most common cancers in China. Adjuvant chemotherapy (AC) is a routine auxiliary treatment for GC recommended by the guidelines issued in 2011 by the Ministry of Health of the People's Republic of China, but the relevant credible consequences in China have been insufficient because of China's late start and ethical concerns. Methods: A series of databases, including Cochrane Library, MEDLINE, EMBASE, the Chinese database of the National Knowledge Infrastructure and the VIP database, were searched by 2 reviewers independently for studies investigating AC for GC through March 2012. The retrieved literature was screened according to the eligibility criteria. Results: A total of 35 randomized control trials (RCTs) were subjected to the final analysis, including 4,043 patients in treatment group and 3,884 in the control group, as well as 4 clinical-control trials (CCTs), which accessed the final analysis with 238 and 252 patients, respectively. AC reduced the risk of death as a protective treatment with statistical significance (HR=0.91, 95%CI: [0.85, 0.97], P=0.002), and it seemed more effective for Asian than non-Asian patients. The effects of AC were not influenced by the starting time (P>0.05). D2 lymphadenectomy-based chemotherapy was effective (HR=0.89, 95%CI: [0.80, 0.99], P=0.04). Oral S-1 40 mg/m2 after D2 lymphadenectomy might be a better choice for Asians with advanced GC and might result in a greater reduction of adverse events than in non-Asian patients. GRADE quality assessment determined that the strength of the evidence from foreign studies from Europe, the United States and Asian countries other than China was high, while it was moderate for Chinese studies. Conclusion: AC was effective or even curative in Chinese patients in general, although it is still necessary to optimize a targeted AC scheme for Chinese patients with GC.

Air Pollution Exposure and Cardiovascular Disease

  • Lee, Byeong-Jae;Kim, Bumseok;Lee, Kyuhong
    • Toxicological Research
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    • 제30권2호
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    • pp.71-75
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    • 2014
  • Ambient air pollution (AAP) and particulate matters (PM) have been closely associated with adverse health effects such as respiratory disease and cardiovascular diseases. Previous studies have examined the adverse health effects associated with short- and long-term exposure to AAP and outdoor PM on respiratory disease. However, the effect of PM size ($PM_{2.5}$ and $PM_{10}$) on cardiovascular disease has not been well studied. Thus, it remains unclear how the size of the inhalable particles (coarse, fine, or ultrafine) affects mortality and morbidity. Airborne PM concentrations are commonly used for ambient air quality management worldwide, owing to the known effects on cardiorespiratory health. In this article, we assess the relationship between cardiovascular diseases and PM, with a particular focus on PM size. We discuss the association of $PM_{2.5}$ and $PM_{10}$, nitrogen dioxide ($NO_2$), and elemental carbon with mortality and morbidity due to cardiovascular diseases, stroke, and altered blood pressure, based on epidemiological studies. In addition, we provide evidence that the adverse health effects of AAP and PM are more pronounced among the elderly, children, and people with preexisting cardiovascular and respiratory conditions. Finally, we critically summarize the literature pertaining to cardiovascular diseases, including atherosclerosis and stroke, and introduce potential studies to better understand the health significance of AAP and PM on cardiovascular disease.

Benefits and risks of therapeutic alternatives for macrolide resistant Mycoplasma pneumoniae pneumonia in children

  • Yang, Hyeon-Jong
    • Clinical and Experimental Pediatrics
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    • 제62권6호
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    • pp.199-205
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    • 2019
  • Although Mycoplasma pneumoniae pneumonia (MPP) has been generally susceptible to macrolides, the emergence of macrolide-resistant MPP (MRMP) has made its treatment challenging. MRMP rapidly spread after the 2000s, especially in East Asia. MRMP is more common in children and adolescents than in adults, which is likely related to the frequent use of macrolides for treating M. pneumoniae infections in children. MRMP is unlikely to be related to clinical, laboratory, or radiological severity, although it likely prolongs the persistence of symptoms and the length of hospital stay. Thereby, it causes an increased burden of the disease and poor quality of life for the patient as well as a societal socioeconomic burden. To date, the only alternative treatments for MRMP are secondary antimicrobials such as tetracyclines (TCs) or fluoroquinolones (FQs) or systemic corticosteroids; however, the former are contraindicated in children because of concerns about potential adverse events (i.e., tooth discoloration or tendinopathy). A few guidelines recommended TCs or FQs as the second-line drug of choice for treating MRMP. However, there have been no evidence-based guidelines. Furthermore, safety issues have not yet been resolved. Therefore, this article aimed to review the benefits and risks of therapeutic alternatives for treating MRMP in children and review the recommendations of international or regional guidelines and specific considerations for their practical application.

EBM 기반구축을 위한 사물탕 연구 문헌 분석 (Analysis of Studies on Samul-tang for Fundamental Establishment of Evidence Based Medicine)

  • 김정훈;이준경;하혜경;서창섭;이호영;정다영;이남헌;이진아;황대선;신현규
    • 동의생리병리학회지
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    • 제23권4호
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    • pp.779-788
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    • 2009
  • To establish the fundament for EBM of Traditional Korean Medicine, the papers on Samul-tang which was frequently used in medical institutions of Traditional Korean Medicine were analyzed through researching domestic and international literatures. The papers were classified by the registration of domestic or international journals, by the year of publishment, by experimental methods, by laboratory animals used in biological experiment and by the kinds of studies on biological efficacy. Of total 67 papers on Samul-tang, 58 volumes were registered in domestic journals and 9 volumes were in international journals of which 8 volumes were in SCI journals. Since 1978, publishments of papers have continuously increased. The papers on instrumental analyses were 6, biological studies were 58 volumes, clinical studies were 3. Instrumental analyses were preceeded with standard compounds(gallic acid, albiflorin, paeoniflorin, benzoic acid, ferulic acid, 5-HMF). And biological studies showed improvement of cardiovascular function and circulation, antianemia, brain protection, immunoregulation, antistress, radioprotection, antifatigue, antiinflammation and antiallergy, antioxidative effect. Through clinical studies, antifatigue, improvement of insomnia and osteoporosis were reported. Samul-tang could be used to tonify and activate blood. And further study on clinical field need to be conducted in accordance with biological study.

EBM 기반구축을 위한 귀비탕(歸脾湯) 연구 문헌 분석 (Analysis of Studies on Guibi-tang(Guipitang) for Fundamental Establishment of Evidence Based Medicine(EBM))

  • 김정훈;이준경;하혜경;서창섭;이미영;이호영;정다영;이남헌;이진아;황대선;신현규
    • 동의신경정신과학회지
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    • 제20권3호
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    • pp.205-216
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    • 2009
  • Objectives : To establish the fundaments for EBM of Traditional Korean Medicine, the papers on Guibi-tang(Guipitang) which were frequently used in medical institutions of Traditional Korean Medicine were analyzed through researching domestic and international literatures. Methods : The papers were classified by the year of publishment, by experimental methods, by laboratory animals used in biological experiment and by the kinds of studies on biological efficacy. Results : Of total 39 papers were registered in domestic journals. Since 1980, publishments of papers have continuously increased. The papers on biological studies were 34 volumes, clinical studies were 5 volumes. Biological studies mainly showed the effects of anti-stress, anti-oxidant, hemostasis, anti-osteoporosis, gastroprotection, reproductive ability, brain cell activity, radioprotection. And clinical studies showed improvements of fearful throbbing, memory and orientation, insomnia, vericose vein, schizophrenia. Conclusions : Guibi-tang(Guipitang) could be used to fortify the spleen, nourish the heart and then control the blood. However biological studies need to be conducted in accordance with clinical study and further clinical studies on randomized controlled trials should be proceeded.

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말초 혈액 CD56+Natural Killer Cell 증가에 기인한 습관성 유산 환자에서 정맥 내 면역글로블린 치료의 효과에 관한 연구 (Effectiveness of Intravenous Immunoglobulin Therapy in Women with Recurrent Spontaneous Abortions and Elevated Pre-conceptional Peripheral Blood CD56+ Natural Killer Cell Percentage)

  • 차선화;박찬우;김해숙;조동희;김진영;강인수;궁미경;양광문
    • Clinical and Experimental Reproductive Medicine
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    • 제32권2호
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    • pp.165-170
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    • 2005
  • Objective: The aim of present study was to evaluate the effectiveness of low-dose intravenous immunoglobulin (IVIg) therapy in women with recurrent spontaneous abortions (RSA) and elevated pre-conceptional peripheral blood CD56+Natural Killer (NK) cell percentage. Study Design: Retrospective case control study. Materials and Methods: Thirty three women with RSA and elevated pre-conceptional peripheral blood CD56+NK cell percentage who had received low-dose IVIg therapy (400 mg/kg per day, every 4 week, until 20 gestational weeks) were included in this study. Controls were nine women with RSA and elevated pre-conceptional peripheral blood CD56+ Natural Killer (NK) cell percentage who had not received IVIg therapy were included in this study. Medical records of study and control groups were retrospectively analyzed and we compared the successful pregnancy outcomes between two groups. Successful pregnancy outcome was defined as pregnancy ongoing beyond 25 gestational weeks. Results: Age, number of previous abortions, pre-conceptional CD56+NK cell percentage and type of RSA were not statistically different between two groups. Otherwise, twenty-five women who received IVIg therapy (25/33, 75.8%) but, only three women who had not received (3/9, 33.3%) had a successful pregnancy outcome and the rate difference between two groups was statistically significant. Conclusion: Based on our study, low-dose IVIg therapy have a effective role in treatment of RSA patients with elevated pre-conceptional peripheral blood CD56+ Natural Killer (NK) cell percentage, but more larger scaled prospective study is needed for available of conclusive evidence.

Risk Factors for COVID-19 Infection Among Healthcare Workers. A First Report From a Living Systematic Review and meta-Analysis

  • Dzinamarira, Tafadzwa;Nkambule, Sphamandla Josias;Hlongwa, Mbuzeleni;Mhango, Malizgani;Iradukunda, Patrick Gad;Chitungo, Itai;Dzobo, Mathias;Mapingure, Munyaradzi Paul;Chingombe, Innocent;Mashora, Moreblessing;Madziva, Roda;Herrera, Helena;Makanda, Pelagia;Atwine, James;Mbunge, Elliot;Musuka, Godfrey;Murewanhema, Grant;Ngara, Bernard
    • Safety and Health at Work
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    • 제13권3호
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    • pp.263-268
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    • 2022
  • Health care workers (HCWs) are more than ten times more likely to be infected with coronavirus infectious disease 2019 (COVID-19) than the general population, thus demonstrating the burden of COVID-19 among HCWs. Factors that expose HCWs to a differentially high-risk of COVID-19 acquisition are important to elucidate, enable appropriate public health interventions to mitigate against high risk and reduce adverse outcomes from the infection. We conducted a systematic review and meta-analysis to summarize and critically analyze the existing evidence on SARS-CoV-2 risk factors among HCWs. With no geographical limitation, we included studies, in any country, that reported (i) the PCR laboratory diagnosis of COVID-19 as an independent variable (ii) one or more COVID-19 risk factors among HCWs with risk estimates (relative risk, odds ratio, or hazard ratio) (iii) original, quantitative study design, and published in English or Mandarian. Our initial search resulted in 470 articles overall, however, only 10 studies met the inclusion criteria for this review. Out of the 10 studies included in the review, inadequate/lack of protective personal equipment, performing tracheal intubation, and gender were the most common risk factors of COVID-19. Based on the random effects adjusted pooled relative risk, HCWs who reported the use of protective personal equipment were 29% (95% CI: 16% to 41%) less likely to test positive for COVID-19. The study also revealed that HCWs who performed tracheal intubations were 34% (95% CI: 14% to 57%) more likely to test positive for COVID-19. Interestingly, this study showed that female HCWs are at 11% higher risk (RR 1.11 95% CI 1.01-1.21) of COVID-19 than their male counterparts. This article presents initial findings from a living systematic review and meta-analysis, therefore, did not yield many studies; however, it revealed a significant insight into better understanding COVID-19 risk factors among HCWs; insights important for devising preventive strategies that protect them from this infection.