• Title/Summary/Keyword: Immunosuppressants

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Behavior patterns of patients with oral mucosal disease (구강점막질환 환자의 행동패턴 연구)

  • Ok, Soo-Min;Kim, Kyung-Hee;Jeon, Hye-Mi;Heo, Jun-Young;Ahn, Yong-Woo;Jeong, Sung-Hee
    • The Journal of the Korean dental association
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    • v.52 no.12
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    • pp.744-752
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    • 2014
  • There are many causes of oral mucosal diseases, so accordingly, there are various treatments available. The most commonly used agents include adrenocortical hormones, antifungals, antivirals, antibacterials, and immunosuppressants. However, it must also be noted that improving oral hygiene and nutrition, and reducing stress are effective in symptom relief. Furthermore, patients with existing diseases of the oral mucosa should avoid behavior that may cause an increase in pain. Unfortunately, many patients are unaware of the activities that may lead to increased pain and therefore do not avoid these activities. The aim of this study was to investigate and analyze the behavior of patients with oral mucosal disease with regard to activities that led to increase pain. This cross-sectional study was performed on a sample of patients with oral mucosal disease selected from the Oral Medicine Clinic of the Pusan National Hospital during March to August 2013. These patients were randomly selected. From a total of 479 patients, 116 patients with mucosal disease were selected and 73 fully completed questionnaires were included in the analysis. Data were collected by using self-completed questionnaires. The results were as follows: Mean score of Question 13 (Not smoking) is $2.47{\pm}1.11$. Mean score of Question 11 (Not drinking alcohol or not using mouthwash containing alcohol) is $2.22{\pm}1.15$. The other questions resulted in scores lower than 1.5. The answers to the questions were scored according to the following assigned numerical values: not keeping = score of 0; little keeping = score of 1; often keeping = score of 2; always keeping = score of 3. In conclusion, patients with oral mucosal diseases unknowingly engage in activities that result in an increase in pain. Therefore, they need to be educated about how to behave to protect oral mucosal lesion.

A Case of Pulmonary Tuberculosis with Delayed Diagnosis Due to the Temporary Clinical Improvement After Use of Levofloxacin and Amikacin Under the Impression of Community Acquired Pneumonia (폐렴을 의심하여 Levofloxacin과 Amikacin을 사용 후 일시적 호전을 보여 진단이 늦어진 폐결핵 1예)

  • Lee, Hee Seok;Kang, Young Ae;Oh, Jin Young;Lee, Jae Ho;Yoo, Chul Gyu;Lee, Choon-Taek;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo;Yim, Jae-Joon
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.4
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    • pp.395-401
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    • 2003
  • Fluoroquinolone is one of the first-line antibiotics recommended for treating community-acquired pneumonia. However, using fluroquinolones for presumptive community-acquired pneumonia can delay the diagnosis and the treatment of pulmonary tuberculosis because of its strong activity against mycobacteria. Here, we report a case of a 54-year-old female taking immunosuppressants after a renal transplant whose diagnosis of pulmonary tuberculosis was delayed as a result of the use of levofloxacin and amikacin under the original impression of community-acquired pneumonia. This case suggests that clinicians should consider the possibility of pulmonary tuberculosis in the case of a partial response of the pneumonia to flouroquinolones and/or aminoglycosides.

Bioconversion of Rare Sugars by Isomerases and Epimerases from Microorganisms (미생물 유래 당질관련 이성화효소 및 에피머효소를 이용한 희소당 생물전환)

  • Kim, Yeong-Su;Kim, Sang Jin;Kang, Dong Wook;Park, Chang-Su
    • Journal of Life Science
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    • v.28 no.12
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    • pp.1545-1553
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    • 2018
  • The International Society of Rare Sugars (ISRS) defines rare sugars as monosaccharides and their derivatives that rarely occur in nature. Rare sugars have recently received much attention because of their many uses including low-calorie sweeteners, bulking agents, and antioxidants, and their various applications including as immunosuppressants in allogeneic rat liver transplantation, as potential inhibitors of various glycosidases and microbial growth, in ischemia-reperfusion injury repair in the rat liver, and in segmented neutrophil production without detrimental clinical effects. Because they rarely exist in nature, the production of rare sugars has been regarded as one of the most important research areas and, generally, they are produced by chemical synthesis. However, the production of rare sugars by bioconversion using enzymes from microorganisms has been receiving increased attention as an environmentally friendly alternative production method. In particular, D-allulose, D-allose, and D-tagatose are of interest as low-calorie sweeteners in various industries. To date, D-tagatose 3-epimerase, D-psicose 3-epimerase, and D-allulose 3-epimerase have been reported as D-allulose bioconversion enzymes, and L-rhamnose isomerase, Galactose 6-phosphate isomerase, and Ribose 5-phosphate isomerase have been identified as D-allose production enzymes. Elsewhere, D-tagatose has been produced by L-arabinose isomerase from various microorganisms. In this study, we report the production of D-allulose, D-allose, and D-tagatose by microorganism enzymes.

Immunostimulatory Activity of Agarwood through Activation of MAPK Signaling Pathway in RAW 264.7 Murine Macrophages (RAW 264.7 대식세포에서 MAPKs 신호 전달 경로의 활성화를 통한 침향의 면역 자극 활성)

  • Ji, Seon Yeong;Hwangbo, Hyun;Lee, Hyesook;Koo, Young Tae;Kim, Jin Soo;Lee, Ki Won;Noh, Dong Jin;Choi, Yung Hyun
    • Journal of Life Science
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    • v.31 no.8
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    • pp.745-754
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    • 2021
  • Deterioration of the immune function weakens the body's resistance to various infections, leading to a series of diseases. Immunomodulatory biomaterials have been used to reduce the side effects of immunosuppressants or to enhance immunity. Agarwood is the aromatic resinous portion of Aquilaria trees that has been traditionally used as a medicinal herb for the treatment of various diseases. Although previous studies have shown that agarwood can improve the body's immunity, evidence for this claim is still lacking. In this study, the immune-enhancing effects of the agarwood methanol extracts of Aquilaria malaccensis Lamk were evaluated in a RAW 264.7 macrophage model. Based on the results, the agarwood extracts markedly enhanced phagocytosis in the absence of cytotoxicity. The agarwood extract-treated RAW 264.7 cells exhibited the typical morphology of activated macrophages, which are spindle-shaped with elongated filopodia. Agarwood extract also significantly increased the production of nitric oxide (NO), which is associated with the increased expression of inducible NO synthase. Moreover, the secretion and expression levels of cytokines, such as tumor necrosis factor-α and interleukin (IL)-1β and IL-6, were increased by agarwood treatment. Notably, these are also associated with a mitogen-activated protein kinase signaling pathway. Taken together, our findings provide scientific evidence that agarwood has potential immune-enhancing effects in vitro.

Anti-atopic dermatitis effects of Parasenecio auriculatus via simultaneous inhibition of multiple inflammatory pathways

  • Kwon, Yujin;Cho, Su-Yeon;Kwon, Jaeyoung;Hwang, Min;Hwang, Hoseong;Kang, Yoon Jin;Lee, Hyeon-Seong;Kim, Jiyoon;Kim, Won Kyu
    • BMB Reports
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    • v.55 no.6
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    • pp.275-280
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    • 2022
  • The treatment of atopic dermatitis (AD) is challenging due to its complex etiology. From epidermal disruption to chronic inflammation, various cells and inflammatory pathways contribute to the progression of AD. As with immunosuppressants, general inhibition of inflammatory pathways can be effective, but this approach is not suitable for long-term treatment due to its side effects. This study aimed to identify a plant extract (PE) with anti-inflammatory effects on multiple cell types involved in AD development and provide relevant mechanistic evidence. Degranulation was measured in RBL-2H3 cells to screen 30 PEs native to South Korea. To investigate the anti-inflammatory effects of Parasenecio auriculatus var. matsumurana Nakai extract (PAE) in AD, production of cytokines and nitric oxide, activation status of FcεRI and TLR4 signaling, cell-cell junction, and cell viability were evaluated using qRT-PCR, western blotting, confocal microscopy, Griess system, and an MTT assay in RBL-2H3, HEK293, RAW264.7, and HaCaT cells. For in vivo experiments, a DNCBinduced AD mouse model was constructed, and hematoxylin and eosin, periodic acid-Schiff, toluidine blue, and F4/80-staining were performed. The chemical constituents of PAE were analyzed by HPLC-MS. By measuring the anti-degranulation effects of 30 PEs in RBL-2H3 cells, we found that Paeonia lactiflora Pall., PA, and Rehmannia glutinosa (Gaertn.) Libosch. ex Steud. show an inhibitory activity of more than 50%. Of these, PAE most dramatically and consistently suppressed cytokine expression, including IL-4, IL-9, IL-13, and TNF-α. PAE potently inhibited FcεRI signaling, which mechanistically supports its basophil-stabilizing effects, and PAE downregulated cytokines and NO production in macrophages via perturbation of toll-like receptor signaling. Moreover, PAE suppressed cytokine production in keratinocytes and upregulated the expression of tight junction molecules ZO-1 and occludin. In a DNCB-induced AD mouse model, the topical application of PAE significantly improved atopic index scores, immune cell infiltration, cytokine expression, abnormal activation of signaling molecules in FcεRI and TLR signaling, and damaged skin structure compared with dexamethasone. The anti-inflammatory effect of PAE was mainly due to integerrimine. Our findings suggest that PAE could potently inhibit multi-inflammatory cells involved in AD development, synergistically block the propagation of inflammatory responses, and thus alleviate AD symptoms.

Facial Paralysis and Myositis Following the H3N2 Influenza Vaccine in a Dog

  • Ju-Hyun An;Ye-In Oh;So-Hee Kim;Su-Min Park;Jeong-Hwa Lee;Ga-Hyun Lim;Kyung-Won Seo;Hwa-Young Youn
    • Journal of Veterinary Clinics
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    • v.40 no.5
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    • pp.336-340
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    • 2023
  • A dog (2-year old, female, Shih-Tzu) presented with hyperthermia and right-sided facial paralysis characterized by the inability to close the right eye and drooling from the right side of the mouth after H3N2 influenza vaccination [A/Canine/Korea/01/07(H3N2) strain; Caniflu-Max, Bionote, Hwaseong, Gyeonggi-do, ROK]. To determine the cause of the fever and neurological symptoms, physical examination, ophthalmic examination, thoracic and abdominal radiography, abdominal ultrasonography, complete blood counts, serum chemistry values, and electrolyte levels were determined. In addition, Cerebrospinal fluid analysis, antinuclear antibody test, fever of unknown origin polymerase chain reaction (PCR) panel, tick-borne pathogen PCR panel were performed. As a result, hyperthermia, leukocytosis, and elevated C-reactive protein were confirmed. In addition, neurological examination revealed decreased right eyelid reflexes, corneal reflexes, threat response, and facial sensation, it was possible to suspect problems with the trigeminal and facial nerves of the cranial nerve. Magnetic resonance imaging revealed a lesion suggestive of myositis in the right muscular lesion at atlanto-occipital junction level on site of vaccine injection. Therefore, right-sided facial paralysis was tentatively determined to be a secondary cause of nerve damage caused by myositis. The patient was treated with immunosuppressants such as prednisolone and mycophenolate mofetil. After 3 months of immunosuppressant therapy, the patient's symptoms improved.

Antibody response to COVID-19 vaccination in patients on chronic hemodialysis

  • Heejung Choi;Sungdam Han;Ji Su Kim;Bumhee Park;Min-Jeong Lee;Gyu-Tae Shin;Heungsoo Kim;Kyongmin Kim;A-Young Park;Ho-Joon Shin;Inwhee Park
    • Clinical and Experimental Vaccine Research
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    • v.12 no.3
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    • pp.249-259
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    • 2023
  • Purpose: Since patients on hemodialysis (HD) are known to be vulnerable to coronavirus disease 2019 (COVID-19), many studies were conducted regarding the effectiveness of the COVID-19 vaccine in HD patients in Western countries. Here, we assessed antibody response of HD patients for 6 months post-vaccination to identify the duration and effectiveness of the COVID-19 vaccine in the Asian population. Materials and Methods: We compared antibody response of the COVID-19 vaccine in HD patients with healthy volunteers. Patient and control groups had two doses of ChAdOx1 nCoV-19 and mRNA-1273, respectively. Immunoglobulin G (IgG) was measured before vaccination, 2 weeks after the first dose, 2 and 4 weeks, 3 and 6 months after the second dose. Neutralizing antibody was measured before vaccination and at 2 weeks, 3 and 6 months after second dose. Since the third dose was started in the middle of the study, we analyzed the effect of the third dose as well. Results: Although antibody production was weaker than the control group (n=22), the patient group (n=39) showed an increase in IgG and neutralizing antibody after two doses. And, 21/39 patients and 14/22 participants had a third dose (BNT162b2 or mRNA-1273 in the patient group, mRNA-1273 in the control group), and it did not affect antibody response in both group. Trend analysis showed IgG and neutralizing antibody did not decrease over time. Age, sex, and HD vintage did not affect antibody production in HD patients. Patients with higher body mass index displayed better seroresponse, while those on immunosuppressants showed poor seroresponse. Conclusion: Two doses of vaccination led to significant antibody response in HD patients, and the antibody did not wane until 6 months.

Azathioprine Therapy in $Henoch-Sch\"{o}nlein$ Purpura Nephritis Accompanied by Nephrotic syndrome (신증후군을 동반한 HSP 신염에서 Azathioprine의 치료 효과)

  • Son Jin-Tae;Kim Ji-Hong;Kim Pyung-Kil;Chung Hyeun-Joo
    • Childhood Kidney Diseases
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    • v.2 no.1
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    • pp.41-49
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    • 1998
  • Treatment of $Henoch-Sch\"{o}nlein$ purpura nephritis(HSPN) accomanied by nephrotic syndrome is still controversal, even though both corticosteroids and immunosuppressants have been used for therapy. Azathioprine(AZA) is a chemical analog of the physiologic purines-adenine, guanine, and hyoxanthine and an antagonist to purine metabolism which may inhibit RNA and DNA synthesis and is mainly used for immunosuppressive agent. We studied the effects of AZA in HSPN accompanied by nephrotic syndrome and evaluating the clinical status and histopathologic changes by sequential biopsies following the treatment. Fifteen patients with nehprotic syndrome either initially or during the course of HSPN confirmed by renal biopsies were treated with AZA(2 mg/kg/day) and prednisolone (0.5-1 mg/kg/day qod) for 8months. Folow up renal biopsy was done after treatment in 11 patients. The clinical status of the patients on admission were C(12 cases) and B(3 cases). Improvement of clinical status were showed in 12 cases, but 3 cases were not improved and 1 case was aggrevated after AZA treatment. Complete remission of proteinuria were in 8 cases(53.3%), partial remission were in 4 cases(26.7%) and persistence of proteinuria and hematuria were in 3 cases(20.0%). The loss of hematuria were in 10 cases(66.7%). Histopathologically and immunopathologically, 4 cases were improved. This study suggests that, although control studies are needed, AZA could be used in the treatment of HSPN accompanied by nephrotic syndrome.

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A study on the degree of need of the knowledge of pathophysiology, clinical microbiology and mechanisms and effects of drugs in clinical nurses (기초간호자연과학의 병태생리학, 병원미생물, 약물의 기전과 효과 내용별 필요도에 대한 연구)

  • Choe, Myoung-Ae;Byun, Young-Soon;Seo, Young-Sook;Hwang, Ae-Ran;Kim, Hee-Seung;Hong, Hae-Sook;Park, Mi-Jung;Choi, S-Mi;Lee, Kyung-Sook;Seo, Wha-Sook;Shin, Gi-Soo
    • Journal of Korean Biological Nursing Science
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    • v.2 no.1
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    • pp.1-19
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    • 2000
  • The purpose of this study was to define the content of the requisite knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs needed for clinical knowledge for nursing practice. Contents of knowlege on pathological physiology, clinical microbiology, and mechanisms and effects of drugs were constructed from syllabus of basic nursing subjects in 4 colleges of nursing, and textbooks. The degree of need of 72 items was measured with a 4 point scale. The subjects of this study were college-graduated 136 nurses from seven university hospital in Seoul and three in Chonnam Province, Kyungbook Province, and Inchon. They have been working at internal medicine ward, surgical ward, intensive care unit, obstetrics and gynecology ward, pediatrics ward, opthalmology ward, ear, nose, and throat ward, emergency room, rehabilitation ward, cancer ward, and hospice ward. The results were as follows : 1. The highest scored items of the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs necessary for nursing practice were side effects of drugs, anticoagulants, mechanisms of drugs, antihypertensive drugs, tolerance and addiction of drugs, interactions among drugs, hospital infection in the order of importance. The lowest scored item was structure of microorganisms. 2. The highest order of need according to unit was repair in tissue injury unit, definition etiology classification of inflammation in inflammation unit, transplantation and immunologic response in alterations in immunity unit, thrombus and thrombosis in disorders of cardiovascular function unit, gene disorders in genetic disorders unit, hospital infection in infection unit, virus in microorganisms unit, side reactions of drugs in introduction unit, anticonvulsants in drugs for central nervous system unit, local anesthesia in anesthesia unit, anticoagulants in drugs for cardiovascular system unit, anti-inflammatory drugs in antibiotics unit, anti-ulcer drugs in drugs for digestive system unit, and bronchodilators in drugs for respiratory system unit. 3. The common content of the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs needed for all clinical areas in nursing were side effects of drugs, anticoagulants, interactions among drugs, and hospital infection. However, the degree of need of each pathological physiology, clinical microbiology, clinical microbiology, and mechanisms and effects of drugs was different depending on clinical areas. 4. Significant differences in the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs necessary for nursing practice such as tissue changes due to injurious stimuli, degenerative changes of tissue, alterations in metabolism of carbohydrates, ischemia, hyperemia and congestion, hospital infection, structure of microorganism, classification of microorganism, bacteria, virus, antidepressants, antipsychotic drugs, antiemetic drugs, antiparkinsonism drugs, antianxiety drugs, antibiotics, tuberculostatics, antiviral drugs, antifungal drugs, parasiticides, antiulcer drugs, antidiarrheais, and anti constipation drugs were shown according to the work area. 5. Significant differences in the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs necessary for nursing practice such as transplantation and immunologic response, alterations in the metabolism of uric acid, structure of microorganism, classification of microorganism, immunosuppressants, drugs for congestive heart failure were demonstrated according to the duration of work. Based on these findings, all the 72 items constructed by Korean Academic Society of Basic Nursing science should be included as contents of the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs.

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The Basic Data Analysis of Lupus Nephritis in Children (소아 루프스 신염에 대한 기초 조사)

  • Min Jae Hong;Paek Kyung Hoon;Park Kyung Mi;Kim Jung Sue;Ha Il Soo;Cheong Hae Il;Kim Joong Gon;Choi Yong
    • Childhood Kidney Diseases
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    • v.3 no.1
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    • pp.80-87
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    • 1999
  • Purposes : Renal involvement is a potentially serious complication of systemic lupus erythematosus (SLE). There have been only few studies of lupus nephritis in pediatric age. In this study, the clinical manifestations, pathologic findings, response to treatment, and clinical course of lupus nephritis in children were analyzed. And the results will provide basic data for future nation-wide prospective multi-center study. Methods . The medical records of 46 children clinically and pathologically diagnosed to have lupus nephritis at Seoul National University Children's Hospital during 1986 to 1997 were analyzed retrospectively. Results : 1) The median age of diagnosis of lupus nephritis was 12.8 years ($2\;years\~\;15year$ 8months), and the sex ratio was 1:2.5. 2) FANA($85.7\%$), anti-ds-DNA antibody ($78.0\%$), and malar rash ($60.8\%$) were the most common findings among the classification criteria by ARA Decreased C3 was detected in $88.9\%$ of patients. 3) Hematuria ($87.0\%$) was the most common renal symptom, and WHO class IV lupus nephritis was identified in 41 cases by renal biopsy. 4) In most of patients, the disease activity was controlled relatively well with a single or combined therapy of prednisolone, azathioprine, or cyclophosphamide. The response revealed no difference according to the mode of treatment. 5) Infection, especially of Varicella-Zoster virus and candida, was the most common complication during the disease course. Conclusion : The renal involvement was noted in $87.0\%$ of childhood SLE, and $89.1\%$ of renal lesions was WHO class IV lupus nephritis known to associated with poor long-term prognosis. So, aggressive treatment using immunosuppressants in the early disease course may be helpful to increase long-term prognosis of lupus nephritis. A prospective multi-center study is necessary to analyze the therapeutic efficacy of various treatment modalities.

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