• Annals of Clinical Neurophysiology
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• v.14 no.1
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• pp.1-6
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• 2012

Low back pain is a common clinical condition with heterogeneous causes and challenges to manage. High prevalence and numerous assessments result in an enormous socioeconomic burden. Clinician must conduct efficient and stepwise evaluation process to rule out serious spinal pathology, neurologic involvement, and identify risk factors for chronicity. The process can be achieved through the focused history taking and physical examination. Certain factors related to serious spinal pathology include age (>50 years), trauma, unexplained fever, recent urinary or skin infection, unrelenting night or rest pain, unexplained weight loss, osteoporosis, immunosuppression, steroid use, and widespread neurological symptoms. In non-specific low back pain, diagnostic imaging and laboratory studies are often unnecessary and can disturb an appropriate management. For the management of acute low back pain, patient education and medication such as acetaminophen, non-steroidal anti-inflammatory drugs, and muscle relaxants are recommended. For chronic low back pain, behavior therapy, back exercise, and spinal manipulation are beneficial. The evidence based approach could improve success rate of management, result in prevention of acute low back pain from being chronic intractable pain.

• Journal of Chest Surgery
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• v.55 no.4
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• pp.338-356
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• 2022

Lung transplantation (LT) is now considered as an effective treatment option for end-stage lung diseases that improves the short and long-term survival rates and quality of life. As increasingly many LT procedures are being performed, the medical complications of LT are also increasing in frequency and emerging as a very important issue for transplant clinicians. Although chronic lung allograft dysfunction and infection are major causes of death after LT, many medical complications, several of which result from immunosuppressive treatment, contribute to increased mortality and morbidity. This article reviews the most frequent and important medical complications of LT, accompanied by a review of the literature and studies from South Korea, including lung allograft rejection, infection, and non-allograft organ systemic complications.

• 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.

• Clinical and Experimental Vaccine Research
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• v.12 no.1
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• pp.13-24
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• 2023

This systematic and meta-analysis aims to evaluate humoral and cellular responses to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine among kidney transplant recipients (KTRs). We conducted a systematic literature search across databases to evaluate seroconversion and cellular response rates in KTRs receiving SARS-CoV-2 vaccines. We extracted studies that assessed seroconversion rates described as the presence of antibody de novo positivity in KTRs following SARS-CoV-2 vaccination published up to January 23rd, 2022. We also performed meta-regression based on immunosuppression therapy used. A total of 44 studies involving 5,892 KTRs were included in this meta-analysis. The overall seroconversion rate following complete dose of vaccines was 39.2% (95% confidence interval [CI], 33.3%-45.3%) and cellular response rate was 41.6% (95% CI, 30.0%-53.6%). Meta-regression revealed that low antibody response rate was significantly associated with the high prevalence of mycophenolate mofetil/mycophenolic acid (p=0.04), belatacept (p=0.02), and antiCD25 induction therapy uses (p=0.04). Conversely, tacrolimus use was associated with higher antibody response (p=0.01). This meta-analysis suggests that postvaccination seroconversion and cellular response rates in KTRs are still low. And seroconversion rate was correlated with the type of immunosuppressive agent and induction therapy used. Additional doses of the SARS-CoV-2 vaccine for this population using a different type of vaccine are considered.

• Korean Journal of Veterinary Research
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• v.50 no.4
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• pp.323-326
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• 2010

Candidiasis is a mycosis caused by the mycelial yeast of the Candida genus which is opportunistic pathogen of humans, animals, and birds. Under some conditions such as prolonged antibiotic therapy, overcrowding, and immunosuppression, the opportunistic Candida can cause disease. Chicken candidiasis is sporadically occurred and characterized by unsatisfactory growth, listlessness, roughness of feathers, and death. A case of 23 weeks old layer with history of increased mortality and anemia was submitted to our Lab. At necropsy, the characteristic lesions were observed in the crop and proventriculus. The whitish pseudomembrane, that are peeled easily, was found in the crop. Proventriculus was swollen and the mucosa was covered with hemorrhagic exudate. The histological changes of the affected crop are epithelial hyperplasia, hydropic degeneration, and mycelia formation. Smears made from the necrotic mucosal surfaces of the crop revealed the presence of large number of yeast cells and mycelia. Pure cultures of yeast colonies were obtained from the potato dextrose agar. The yeast cells were identified as Candida albicans by gene sequencing. To our knowledge, this is the first report of candidiasis in chickens with anemia in Korea.

• Toxicological Research
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• v.25 no.4
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• pp.225-230
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• 2009

The genotoxic effects of DHU001, a polyherbal formula were evaluated using the mouse micronucleus test. DHU001 was administered once a day for 2 continuous days by oral gavage to male ICR mice at doses of 2000, 1000 and 500 mg/kg. Cyclophosphamide was used as a known genotoxic agent in a positive control. The appearance of a micronucleus is used as an index for genotoxic potential. In addition, the changes on the total white blood cells and differential counts on the lymphocytes, neutrophils, eosinophils, basophils and monocytes in the prepared blood smears were also conducted to observe the possible immunosuppression. The results indicats that DHU001 showed no genotoxicity effects up to 2000 mg/kg dosing levels and did not influenced on the total white blood cells and differential counts. In addition, it is also considered that there were no problems from cytotoxicity of DHU001 tested in this study because the polychromatic erythrocyte ratio was detected as > 0.41 in all tested groups.

• Clinical and Experimental Pediatrics
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• v.63 no.8
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• pp.291-300
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• 2020

Advances in autoimmune encephalitis studies in the past 10 years have led to the identification of new syndromes and biomarkers that have transformed the diagnostic approach to the disorder. The disorder or syndrome has been linked to a wide variety of pathologic processes associated with the neuron-specific autoantibodies targeting intracellular and plasma membrane antigens. However, current criteria for autoimmune encephalitis are quite dependent on antibody testing and responses to immunotherapy, which might delay the diagnosis. This form of encephalitis can involve the multifaceted presentation of seizures and unexpected behavioral changes. The spectrum of neuropsychiatric symptoms in children is less definitive than that in adults, and the incorporation of clinical, immunological, electrophysiological, and neuroradiological results is critical to the diagnostic approach. In this review, we document the clinical and immunologic characteristics of autoimmune encephalitis known to date, with the goal of helping clinicians in differential diagnosis and to provide prompt and effective treatment.

• Journal of Chest Surgery
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• v.37 no.1
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• pp.88-91
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• 2004

Aortic regurgitation is not a rare complication of Takayasu's disease. Aortic regurgitation may aggravate cerebral ischemic syndrome like syncope in patients with stenotic or occlusive lesions in cerebral branches of aorta secondary to acute or progressive inflammation. In a 34-yrs-old male patient who complained of syncope and exertional dyspnea with occlusion of both carotid arteries and severe stenoses of both subclavian arteries, occlusion of right coronary artery, and aortic regurgitation, his symptom was improved with perioperative aggressive steroid therapy, stent insertion in both subclavian arteries, and aortic valve replacement.

• BMB Reports
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• v.57 no.9
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• pp.388-399
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• 2024

Immunotherapy represents a promising treatment strategy for targeting various tumor types. However, the overall response rate is low due to the tumor microenvironment (TME). In the TME, numerous distinct factors actively induce immunosuppression, restricting the efficacy of anticancer immune reactions. Recently, metabolic reprogramming of tumors has been recognized for its role in modulating the tumor microenvironment to enhance immune cell responses in the TME. Furthermore, recent elucidations underscore the critical role of metabolic limitations imposed by the tumor microenvironment on the effectiveness of antitumor immune cells, guiding the development of novel immunotherapeutic approaches. Hence, achieving a comprehensive understanding of the metabolic requirements of both cancer and immune cells within the TME is pivotal. This insight not only aids in acknowledging the current limitations of clinical practices but also significantly shapes the trajectory of future research endeavors in the domain of cancer immunotherapy. In addition, therapeutic interventions targeting metabolic limitations have exhibited promising potential as combinatory treatments across diverse cancer types. In this review, we first discuss the metabolic barriers in the TME. Second, we explore how the immune response is regulated by metabolites. Finally, we will review the current strategy for targeting metabolism to not simply inhibit tumor growth but also enhance antitumor immune responses. Thus, we could suggest potent combination therapy for improving immunotherapy with metabolic inhibitors.

• Korean Journal of Clinical Pharmacy
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• v.22 no.2
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• pp.181-186
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• 2012

Objective: To report a fatal case of Multidrug-resistant Acinetobacter baumannii (MDR-AB) in a patient with interstitial lung disease (ILD) on high-dose glucocorticoids. Case Summary: A 66-year-old man with a history of coniosis was transferred to the hospital with progressive cough and sputum production. This patient has been diagnosed with pneumonia and ILD on admission, requires antimicrobial therapy and systemic immunosuppressants. He received high dose of methylprednisolone and cyclophosphamide for ILD as well as ceftriaxone and azithromycin for pneumonia. On day 7 in the intensive care units (ICUs), patient had fever and leukocytosis, thus antimicrobials were switched to piperacillin. After 13 days in the ICU, Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus (MRSA) were isolated on transtracheal aspirate (TTA) and meropenem was initiated. However, it was revealed a multidrug-resistant Acinetobacter baumannii (MDR-AB) species, resistant to carbapenem. Patient was administered colistin but expired due to septic shock on day 84. Discussion: Systemic immunosuppressive therapy can result in infections that may compromise patient's survival. MDR-AB has emerged as a serious cause of nosocomial infections in immunocompromised patients. MDR-AB is resistant to most standard antimicrobials and therapeutic options are limited. Conclusion: We report our recent experience with a fatal MDR-AB pneumonia in a patient with ILD, who had to be treated with high dose glucocorticoids and immunosuppressnts.