• 대한약침학회지
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• 제20권4호
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• pp.280-286
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• 2017

Objective: This case series aims to report the efficacy and the safety of using snake venom pharmacopuncture (SVP) for chemotherapy-induced peripheral neuropathy (CIPN). Methods: Three heterogeneous cancer (1 endometrium, 1 cervix, and 1 prostate cancer) patients were referred to the East-West Cancer Center (EWCC), Dunsan Korean Medicine Hospital of Daejeon University, from August 02, 2017, to September 15, 2017, for treatment with SVP, and they were treated with SVP 4 times, 6 times, and 8 times, respectively. During the treatment period, the efficacy of SVP therapy was assessed by using the Numerical Rating Scale (NRS) and the Common Terminology Criteria for Adverse Events (CTCAE), and the stability was evaluated by using blood tests. Following each session, all patients were examined closely for any allergenic responses or adverse effects. Results: All patients showed noticeable improvements of their NRS and CTCAE scores. Except for bleeding and bruising at the SVP injection site, no major side effects were noted. One of the patients reported mild chilling and a sore throat after receiving the second treatment; those symptoms went away after a few hours. No hematologic toxicity, hepatotoxicity, or nephrotoxicity was found on the blood test. Conclusion: The results of this research suggest positive potential benefits of using SVP for treating patients with CIPN. Also, the excellent safety results of SVP seen in this research should lead to larger clinical trials aimed at developing SVP into a potential intervention for managing patients with the symptoms of CIPN.

• Archives of Plastic Surgery
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• 제38권1호
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• pp.121-126
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• 2011

Purpose: Vaccum-assisted closure (VAC) has rapidly evolved into a widely accepted treatment of contaminated wounds, envenomations, infiltrations, and wound complications. This results in a sealed, moist environment where tissue is given the opportunity to survive as edema is removed and perfusion is increased. Many plastic surgeons now place a VAC device directly over the fasciotomy site at the time of the initial procedure. Large amounts of the fluid are withdrawn, and fasciotomies can be closed primarily sooner. This study was designed to observe the effect of VAC in preventing complications in snake bitten hands. Methods: In our study of three cases of snake bite, three of them underwent the VAC treatment & fasciotomy of the wound in the hand. This cases, the posterior compartment of the hand was bitten for a few days, releasing incisions were made of the posterior hand and 125 mmHg of continuous vacuum was applied to fasciomy incision site and the biting wound. The dressings were changed three times per week. Results: Our study examining the effects of applied vacuum in preventing snake bite wounds showed that the incidence of tissue necrosis and compartment syndrome was significantly lower for vacuum-treated wounds than for conservative wounds. Serum myoglobin, CK-MB, and CPK levels measured after fasciotomy incision were significantly decreased. We obtained satisfactory results from early dorsal fasciotomy, drainage of the edema with the VAC system, and then primary closure. The postoperative course was uneventful. Conclusion: Envenomation is a term implying that sufficient venom has been introduced into the body to cause either local signs at the site of the bite and/or systemic signs. Use of the vacuum-assisted closure device in snake bite can result in a decreased rate of tissue necrosis, lymphatic fluid collection, hemolytic fluid collection, and edema. Early fasciotomy of the dorsal hand and VAC apply is the alternative treatment of the snake bite.

• 대한임상독성학회지
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• 제15권1호
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• pp.1-10
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• 2017

Purpose: This study was conducted to identify predictors of serious poisoning in patients with snake bite based on initial findings. Methods: We conducted a retrospective study of patients with snake bite who were treated at the emergency department between January 2010 and December 2016. The patients were divided into two groups according to the severity of symptoms based on the traditional snakebite severity grading scale. The mild poisoning group (MP) was classified as those who had a grade I snakebite severity during the hospital stay, and the severe poisoning group (SP) was classified as patients who had grade I at the time of admission, but progressed to grade II-IV during hospitalization. Initial clinical manifestations and laboratory findings of the two groups were compared. Results: Bite to hospital time intervals of SP were longer than those of MP (p=0.034), and the local effect score (LES) was higher in SP (p<0.001). Laboratory analyses revealed that creatine phosphokinase (p=0.044), creatine phosphokinase MB isoenzyme (CK-MB, p=0.011) and serum amylase (p=0.008) were significantly higher in SP. LES, CK-MB and serum amylase were significant prognostic predictors as indicated by univariate logistic regression analysis. Multivariate analysis revealed the following two significant predictors: LES (odds ratio=3.983, p<0.001) and serum amylase (odds ratio=1.020, p=0.017). Conclusion: In managing cases of snake bites, clinical manifestations and laboratory findings must be carefully evaluated. LES and serum amylase are predictive factors for severe poisoning, which is especially important to rapid determination of the intensive care of the patient.

• 대한약침학회지
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• 제25권2호
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• pp.114-120
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• 2022

Objectives: Antivenom serums have been used extensively for over a century and are the only effective treatment option for snake bites and other dangerous animal envenomations. In therapeutic serum centers, a wide range of antivenoms is made from animal serum, mainly equine and sheep, that are immunized with single or multiple venoms. This work aimed to use caprylic acid (CA) to purify therapeutic snake antivenom. Methods: Plasma was obtained from equine immunized with a mixture of venoms. Immunized plasma was obtained by precipitation of different concentrations (2-5%) of CA. This methodology was compared to that based on ammonium sulfate (AS) precipitation. Sediment plasma proteins were purified by ion-exchange chromatography. Protein assay, SDSPAGE, and agar gel diffusion were performed. Results: The total protein precipitation with AS was higher than precipitation with CA, but the best results were obtained when CA was added to the plasma until a final CA concentration of 5% was reached. Chromatography and electrophoresis indicated a stronger band for the 5% CA, and the gel diffusion assay showed antigen-antibody interaction in the purified serum. Conclusion: The use of CA compared to the routine method for purifying hyperimmune serums is a practical and cost-effective method for preparing and producing therapeutic serums. It constitutes a potentially valuable technology for alleviating the critical shortage of antivenom in Iran.

• BMB Reports
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• 제32권3호
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• pp.306-310
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• 1999

The partial cDNA of the MT-c clone encoding snake venom metalloprotease was subcloned and expressed in E. coli. The expressed metalloprotease was purified by affinity chromatography in the presence of urea, and then successfully refolded into its functional form, retaining metalloprotease activity that hydrolyzes fibrinogen. The simple and convenient refolding strategy established in this work was highly efficient in recovering the recombinant enzyme activity. Experimental evidence suggests that the C-terminal amino acid stretch of 16 residues is a critical sequence for proper folding of the metalloprotease domain.

• Archives of Plastic Surgery
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• 제36권5호
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• pp.605-610
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• 2009

Purpose: Substantial tissue necrosis after snake bites requiring coverage with flap surgery is extremely rare. In this article, we report 7 cases of soft tissue defects in the upper and the lower extremities caused by snake bites, which needed to be covered with flaps. Among the vast mass of publications on snake bites there has been no report that focuses on flap coverage of soft tissue defects due to snake bite sequelae. Methods: Seven cases of soft tissue defects with tendon, ligament, or bone exposure after snake bites were included. All patients were males without comorbidities, the average age was 35 years. All of them required coverage with a flap. In 6 cases, the defect was localized on the upper extremity, in one case the lesion was on the lower extremity. Local flaps were used in 6 cases, one case was covered with a free flap. The surgical procedures included one kite flap, one cross finger flap and digital nerve reconstruction with a sural nerve graft, one reverse proximal phalanx island flap, one groin flap, one adipofascial flap, one neurovascular island flap, and one anterolateral thigh free flap. The average interval from injury to flap surgery was 23.7 days. Results: All flaps survived without complication. All patients regained a good range of motion in the affected extremity. Donor site morbidities were not observed. The case with digital nerve reconstruction recovered a static two point discrimination of 7 mm. The patient with foot reconstruction can wear normal shoes without a debulking procedure. Conclusion: The majority of soft tissue affection after snake bites can be treated conservatively. Some severe cases, however, may require the coverage with flap surgery after radical debridement, especially, if there is exposure of tendon, bone or neurovascular structures. There is no doubt that definite coverage should be performed as soon as possible. But we also want to point out that this principle must not lead to a premature coverage. If the surgeon is not certain that the wound is free of necrotic tissue or remnants of venom, it is better to take enough time to get a proper wound before flap surgery in order to obtain a good functional and cosmetic result.

• Journal of Acupuncture Research
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• 제25권3호
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• pp.53-69
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• 2008

목적 : 이 연구는 Vipera lebetina turanica의 사독약침액(蛇毒藥鍼液)(Snake venom toxin, SVT)이 인간 신경아세포종의 암세포주인 SK-N-SH 세포에서 암세포성장의 억제 및 그 기전에 대하여 살펴보고자 하였다. 방법 : SVT를 처리한 후 SK-N-SH의 성장억제를 관찰하기 위해 CCK-8 assay와 LDH assay를 시행하였고, apoptosis 평가에는 세포형태의 관찰과 DAPI, TUNEL, Annexin V-PI double staining assay 및 cell detachment assay를 시행하였다. 세포자멸사 관련 세포기전을 보기 위하여 세포주기, 세포내 칼슘량, 세포내 활성산소량 및 미토콘드리아의 세포막전위 변화를 측정하였고, DNA fragmentation assay를 시행하였으며, 세포자멸사 조절 단백인 Bax, Bcl-2, caspase-3, -9의 발현 변화 관찰에는 western blot analysis를 시행하였다. 결과 : SK-N-SH 세포에 SVT를 처리한 후, 신경아세포종 세포의 성장, Apoptosis의 유발 및 기전의 영향을 관찰하여 다음과 같은 결과를 얻었다. 1. SVT를 처리한 SK-N-SH 세포 관찰에서 세포독성은 농도의존적으로 증가하는 경향이 있는 반면 암세포성장의 유의한 억제는 $20{\mu}g/m{\ell}$ SVT에 의해서만 나타났다. 2. 세포자멸사 평가에서 SVT를 처리한 SK-N-SH 세포는 세포자멸사의 특징적 형태를 나타내었다. TUNEL assay에서는 세포자멸사 활성세포가 미약하게 나타난 반면 cell detachment assay와 Annexin V-PI double staining에서는 각각 세포박리와 세포자멸사 활성세포의 유의한 증가를 나타내었다. 3. 세포자멸사 관련 세포기전연구에서 SVT를 처리한 SK-N-SH 세포의 세포주기, 세포 내 칼슘양 및 DNA fragmentation에는 유의한 변화가 관찰되지 않은 반면 세포내 활성산소 양은 유의한 증가를 나타내었고, 그에 따른 미토콘드리아 세포막 전위의 유의한 변동이 관찰되었다. 4. SVT를 처리한 SK-N-SH는 세포자멸사 관련 단백 발현에서 Bax에 대해 유의한 증가를 나타내지 않았으나 caspase-3 및 caspase-9의 유의한 증가와 Bcl-2의 유의한 감소를 나타내었다. 결론 : 이상의 결과는 SVT가 세포 내 활성산소를 증가시킴으로써 미토콘드리아의 세포막전위에 변화를 일으켜 인간 신경아세포종 세포주인 SK-N-SH의 세포박리와 유관한 세포자멸사를 유발함으로써 증식억제 효과가 있음을 입증한 것이다.

• Journal of Acupuncture Research
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• 제25권2호
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• pp.41-57
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• 2008

목적 : 이 연구는 Vipera lebetina turanica의 사독약침액(蛇毒藥鍼液)(Snake venom toxin, SVT)이 인간 신경아세포종의 암세포주인 SK-N-MC 세포에서 암세포성장의 억제 및 그 기전에 대하여 살펴보고자 하였다. 방법 : SVT를 처리한 후 SK-N-MC의 성장억제를 관찰하기 위해 CCK-8 assay와 LDH assay를 시행하였고, apoptosis 평가에는 세포형태의 관찰과 DAPI, TUNEL, Annexin V-PI double staining assay 및 cell detachment assay를 시행하였다. 세포자멸사 관련 세포기전을 보기 위하여 세포주기, 세포내 칼슘량, 세포내 활성산소량 및 미토콘드리아의 세포막전위 변화를 측정하였고, DNA fragmentation assay를 시행하였으며, 세포자멸사 조절 단백인 Bax, Bcl-2, caspase-3, -9의 발현 변화 관찰에는 western blot analysis를 시행하였다. 결과 : SK-N-MC 세포에 SVT를 처리한 후, 신경아세포종 세포의 성장, Apoptosis의 유발 및 기전에 영향을 관찰하여 다음과 같은 결과를 얻었다. 1. SVT를 처리한 SK-N-MC 세포 관찰에서 $20{\mu}g/m{\ell}$ SVT 처리가 암세포성장의 유의한 억제를 나타내었다. 세포독성 관찰에서 SVT처리는 처리하지 않은 것에 비하여 증가를 나타내었다. 2. 세포자멸사 평가에서 SVT를 처리한 SK-N-MC 세포는 세포자멸사의 특징적 형태를 나타내었다. TUNEL assay에서는 세포자멸사 활성세포가 미약하게 나타난 반면 cell detachment assay와 Annexin V-PI double staining에서는 각각 세포박리와 세포자멸사 활성세포의 유의한 증가를 나타내었다. 3. 세포자멸사 관련 세포기전연구에서 SVT를 처리한 SK-N-MC 세포의 세포주기, 세포내 칼슘량 및 DNA fragmentation에는 유의한 변화가 관찰되지 않은 반면 세포내 활성산소 양은 유의한 증가를 나타내었고, 그에 따른 미토콘드리아 세포막 전위의 유의한 변동이 관찰되었다. 4. SVT를 처리한 SK-N-MC는 세포자멸사 관련 단백 발현에서 caspase-9에 대해 유의한 증가를 나타내지 않았으나 Bax 및 caspase-3의 유의한 증가와 Bcl-2의 유의한 감소를 나타내었다. 결론 : 이상의 결과는 SVT가 세포내 활성산소를 증가시키므로 미토콘드리아의 세포막전위에 변화를 일으켜 인간 신경아세포종 세포주인 SK-N-MC의 세포박리와 유관한 세포자멸사를 유발하므로 증식억제 효과가 있음을 입증한 것이다.

• Journal of Acupuncture Research
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• 제26권3호
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• pp.27-38
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• 2009

목적 : 이 연구는 Vipera lebetinat turanica의 사독약침액(蛇毒藥鍼液)(Snake venom toxin, SVT)이 인간 유방암 세포주인 MCF-7과 MDA-MB-231 세포에서 암세포성장의 억제 및 그 기전에 대하여 살펴보고자 하였다. 방법 : SVT를 처리한 후 MCF-7과 MDA-MB-231의 성장억제를 관찰하기 위해 CCK-8 assay를 시행하였고, apoptosis 평가에는 TUNEL assay를 시행하였다. 세포자멸사 관련 세포기전을 보기 위하여 세포내 활성산소량 및 미토콘드리아의 세포막전위 변화를 측정하였고, 세포자멸사 조절 단백인 Bax, Bcl-2 발현 변화 관찰에는 westem blot analysis를 시행하였다. 결과 : MCF-7과 MDA-MB-231 세포에 SVT를 처리한 후, 유방암 세포의 성장, Apoptosis의 유발 및 기전에 미치는 영향을 관찰하여 다음과 같은 결과를 얻었다. 1. MCF-7 세포와 MDA-MB-231 세포에서 SVT를 처리한 후 유방암 세포 성장이 억제되었다. 2. TUNEL assay를 통한 세포자멸사 평가에서 SVT를 처리한 MCF-7세포와 MDA-MB-231 세포 모두 세포자멸사 활성세포의 유의한 증가를 나타내었다. 3. 세포자멸사 관련 세포기전연구에서 SVT를 처리한 MCF-7 세포와 MDA-MB-231 세포에서 세포내 활성산소의 유의한 증가와 미토콘드리아 세포막 전위의 유의한 변동이 관찰되었다. 4. SVT를 처리한 MCF-7세포와 MDA-MB-231세포는 세포자멸사 관련 단백 발현에서 Bax의 유의한 증가와 Bcl-2의 유의한 감소를 나타내었다. 결론 : 이상의 결과는 SVT가 세포내 활성산소를 증가시킴으로써 미토콘드리아의 세포막전위에 변화를 일으켜 유방암 세포주인 MCF-7과 MDA-MB-231 세포에 세포자멸사를 유발하여 증식억제 효과가 있음을 입증한 것이다.

• 한국미생물·생명공학회지
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• 제15권2호
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• pp.135-139
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• 1987

Aspergillus 속 균주 MK-24로부터 venom proteinase inhibitor의 생산조건을 검토한 결과 질소원으로서는 유기능질소가 균생육에 있어서는 매우 좋았으나 물질생성에 있어서는 무기능질소보다 못하였다. 무기질소원으로서는 sodium nitrate가 가장 좋은 효과를 보였다. 단소원으로서는 glucose가 대부분 당류와 비슷한 결과를 나타내었고 특히 arabitol, xylitol, salicin 등은 본 균주가 단소원으로 사용치 못하는 것으로 추정되었으며, vitamin 류는 물질생성에 무관하였으며 금속염류로서는 효과적인 것은 없으나, Ag$^+$, Co$^{++}$, $Zn^{++}$ 등은 억제하였다. 배양온도와 pH는 각각 3$0^{\circ}C$와 pH 5가 균의 생육과 저해물질생성에 제일 적당하였고, 단소원과 질소원으로서 glucose 2%, NaNo$_3$ 0.3%을 가한 액체배지에서 7일간 정치배양 하였을 때 저해물질생육이 가장 좋았다.