• Title/Summary/Keyword: high-dose therapy

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Apoptotic Effects of Sipimikwanjung-tang of Sasang Constitutional Medicine in Human Hepatoblastoma Cells

  • Song Seung-Yun;Bae Young-Chun;Lee Sang-Min;Kim Kyung-Yo;Joo Jong-Cheon;Ko Ki-Duk;Park Soo-Jeong;Lee Kyung-Sung;Choi Yong-Seok;Kim Jong-Yeol
    • The Journal of Korean Medicine
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    • v.26 no.1 s.61
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    • pp.46-58
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    • 2005
  • Objective : This study on Sipimikwanjung-tang was undertaken to evaluate its antioxidant capacities and antiperoxidation activities in rat liver tissues. Sipimikwanjung-tang which has been one of the prescriptions in sasang constitutional medicine is usually applied for the therapy of various liver diseases. It is elucidated that Sipimikwanjung-tang has antioxidants on liver tissue of rat and the cytotoxic effects on human hepatoblastoma Hep G2 cells. Methods: Sipimikwanjung-tang extract in antioxidant effects of Hep G2 cells is evaluated by MTT assay, DAPI staining, DNA fragmentation assays and FACS can analysis. Results: Sipimikwanjung-tang induced apoptosis in Hep G2 cells, and induced G1 and G2M arrest of the cell cycle as well as a significant increase in PARP and caspase-3 activity. It induced an increase in $H_2O_2$ generation and the subsequent $NF-{\kappa}B$ activation and also induced cell apoptosis through the caspase-3-dependent pathways in the low concentration of Sipimikwanjung-tang extracts. However, the high dose of Sipimikwanjung-tang extract in Hep G2 cells inhibited $TGF-{\beta}l-induced$ apoptosis via increase in cellular $H_2O_2$, formation and $NF-{\kappa}B$ activation in human hepatoblastoma Hep G2 cells. Conclusion: From this study, the possibility that Sipimikwanjung-tang extracts apply to antioxidant and apoptotic treatment of disease is revealed.

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A case of steroid-induced psychosis in a child having nephrotic syndrome with toxic epidermal necrolysis (신증후군 환아에서 발생한 독성표피괴사용해 치료를 위해 사용된 고용량 스테로이드로 인한 정신질환 1례)

  • Kim, Sae Yoon;Lee, Jae Min;Park, Yong Hoon
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.437-441
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    • 2010
  • Toxic epidermal necrolysis (TEN) and Stevens Johnson syndrome (SJS) are rare, life-threatening mucocutaneous -diseases, usually attributable to drugs and infections. Corticosteroids have been used in the management of TEN for the last 30 years. This remains controversial and is still much debated. TEN can occur despite administration of high doses of systemic corticosteroids. The psychiatric side effects of corticosteroids can include headache, insomnia, depression, and mood disorders with or without psychotic episodes. Steroid-induced psychosis is dealt with by tapering or discontinuing the steroid; antipsychotics are also sometimes used. We report a case of an 11-year-old boy who was admitted with TEN. He had also been diagnosed as having nephrotic syndrome in the past. Remission was achieved through induction therapy and by maintaining the use of steroids. After a full-dose intravenous dexamethasone for TEN, he showed psychotic symptoms. We diagnosed him as having steroid-induced psychosis. We tapered the steroid use and initiated an atypical antipsychotic medication, olazapine and intravenous immunoglobulin (IV-IG). His symptoms dramatically improved and he was discharged.

Analysis and Management of Complications of Open Reduction and Medpor Insertion through Transconjunctival Incision in Blowout Fractures (안와골절에서 결막절개를 통한 Medpor 내고정술의 합병증 분석과 치료)

  • Lee, Ji Won;Choi, Jae Il;Ha, Won;Yang, Wan Suk
    • Archives of Craniofacial Surgery
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    • v.13 no.1
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    • pp.22-28
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    • 2012
  • Purpose: In accordance to an increased interest in facial appearance and the popularization of computed tomography scanning, the number of diagnosis and treatment of blowout fractures has been increased. The purpose of this article is to review pure blowout fracture surgery through transconjunctival incision focusing on complications and their management. Methods: In this retrospective study, 583 patients, who had been treated for pure blowout fracture through transconjunctival incision from 2000 to 2009, were evaluated. Their hospital records were reviewed according to their sex, age, fracture site, preoperative presentations, time interval between trauma and surgery, and postoperative complications. Results: According to postoperative follow-up results, there were early complications that included wound dehiscence and infection (0.2%), hematoma (insomuch as extraocular movement is limited) (0.7%), lacriminal duct injury (0.5%), and periorbital nerve injury (0.7%). In addition, there were late complications that lasted more than 6 months, that included persistent diplopia (1.7%), extraocular movement limitation (0.9%), enophthalmos (1.0%), periorbital sensation abnormalities (1.0%), and entropion (0.5%). Conclusion: We propose the following guidelines for prevention of postoperative complications: layer by layer closure; bleeding control with the epinephrine gauzes, Tachocomb, and Tisseel; conjunctival incision 2 to 3 mm away from punctum; avoidance of excessive traction; performing surgical decompression and high dose corticosteroid therapy upon confirmation of nerve injury; atraumatic dissection and insertion of Medpor Barrier implant after securing a clear view of posterior ledge; using Medpor block stacking technique and BioSorb FX screw fixation; performing a complete resection of the anterior ethmoidal nerve during medial wall dissection; and making an incision 2 to 3 mm below the tarsal plate.

DELAYED VISUAL LOSS BY INDIRECT TRAUMATIC OPTIC NEUROPATHY RELATED TO PANFACIAL FRACTURE: A CASE REPORT (범안면 골절과 연관된 간접적 외상성 시신경 병증에 의한 시력상실 증례)

  • Lee, Jong-Bok;Lee, Dae-Jeong;Choi, Moon-Ki;Min, Seung-Ki
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.1
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    • pp.81-85
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    • 2009
  • As panfacial fractures are involved multiple fracture, there are possibility of many pre-operative & postoperative complications. It is necessary to do exact pre-operative evaluation, appropriate operation and care, for preventing and treating these complications, especially related to optic nerve injury. The complication occurs rarely after periorbital facial bone fracture, and indirect injuries may occur as a result of impact shearing force transmitted into the optic nerve axons or to the nutrient vessels of the optic nerve. Also indirect injuries may occur after the force of impact because of vasospasm and swelling of the optic nerve within the confines of the nonexpansile optic canal. It is necessary to active evaluation and treatments involving decompression of the orbit surgically and high dose steroid therapy in relation to panfacial fracture. But sometimes this treatments are limited due to severe swelling of the face and related multiple bone fractures in the body. This case showed the delayed neuropathy, at last visual loss, in spite of megadose methylprednisolone administration. The purpose of this article is to present indirect traumatic optic neuropathy that is one of many complications in panfacial bone fracture.

The Inhibitory Effects of Ahnjeonbaekho-tang on FRTL-5 Cell Proliferation and Thyroxine Synthesis

  • Kang, Shin-Ik;Lee, Byung-Cheol;Ahn, Young-Min;Doo, Ho-Kyung;Ahn, Se-Young
    • The Journal of Internal Korean Medicine
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    • v.27 no.3
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    • pp.653-663
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    • 2006
  • Objective : Graves' disease, the most common cause of hyperthyroidism, is an autoimmune disorder associated with autoantibodies to the TSH receptor. The clinical features of Graves' disease are goiter and hypermetabolic symptoms induced by excessive hormones. Antithyroid drug therapy is the first-line treatment for Graves' disease in Korea, Japan and European countries. Yet in spite of a long period and high-dose of treatment, it is hard to achieve remission because of adverse effects, frequent recurrence and resistance to antithyroid drugs. Recently, it has been reported that the abnormal thyroid hormone and clinical symptoms of Graves' disease were reduced by Ahnjeonbaekho-tang (AJBHT). Methods : To investigate the effectiveness and action mechanism of AJBHT, we studied the influence of AJBHT on FRTL-5 thyroid cell proliferation, DNA synthesis and expression of T4, TSH, cAMP, Tg and TPO mRNA. Results : AJBHT significantly inhibited the FRTL-5 cell proliferation, DNA synthesis, T4 synthesis, cAMP production and the expression of Tg mRNA in comparison with control and MMI. Conclusions : These results suggest that AJBHT may inhibit the cell proliferation and DNA synthesis by regulating the cAMP, and suppress the T4 synthesis by modulating Tg mRNA expression and cAMP synthesis, and that it may be useful agent for treating the goiter and hormone abnormality of Graves' disease.

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The protective effect of Halal food extract in pancreatic beta cell lines.

  • Kim, Seong-sun;Jin, Yu-Mi;Song, Young-Jae;AYE, AYE;Soh, Ju-Ryoun;Jeon, Yong-Deok;Jin, Jong-Sik
    • Proceedings of the Plant Resources Society of Korea Conference
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    • 2019.04a
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    • pp.121-121
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    • 2019
  • In Islamic dietary guidelines, Halal foods are allowed as edible blessed food. Most foods were categorized within halal for Muslims. The main point of Halal food is that foods are clean in every process and based on Halal standard which might be different in each country. Most pancreatic ${\beta}$ cells synthetize, store, and release insulin. Specific molecular, functional as well as ultrastructural traits of pancreatic ${\beta}$ cells could control their insulin secretion properties and survival phentoype. Insulin-secreting pancreatic ${\beta}$-cells are essential regulators of mammalian metabolism. In addition, the pancreatic ${\beta}$ cell plays an important role in the pathogenesis of type 1 and type 2 diabetes as improving glucose homeostasis by preserving, expanding and improving the function of this key cell type. However, the pharmacological effect of halal food has not been unclear yet, especially food habit-dependent diabetes. The aim of the this study was to determine the preventive effect of Iran plants extract (Almond, Garlic, Cumin, Ginkgo biloba, Holy basil, Psyllium, Satureja khuzistanica, Fenugreek, Green tea, Ipomoea betatas, Blueberry) on RINm5F cells and MIN6 cells as pancreatic ${\beta}$ cell line. The cytotoxicity of the extracts of Iran plants on RINm5F cells and MIN6 cells were measured by using MTT assays. The preventive effects of Iran plant extracts were measured by WST-8 cell proliferation assay on streptozotocin (STZ)-induced cell death in MIN6 cells. In presented result showed that all extract of Iran plants (0.01-10mg/ml) did not show cytotoxicity in RINm5F cells and MIN6 cells. Among non-cytotoxic extract, the protective effects could be detect in high dose concentration. These results suggest that the extract of Iran plants may serve as a potential therapy for diabetes.

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Implementation of Enhanced Recovery after Surgery (ERAS) Program in Perioperative Management of Gastric Cancer Surgery: a Nationwide Survey in Korea

  • Jeong, Oh;Kim, Ho Goon
    • Journal of Gastric Cancer
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    • v.19 no.1
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    • pp.72-82
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    • 2019
  • Purpose: Despite its clinical benefits, enhanced recovery after surgery (ERAS) is less widely implemented for gastric cancer surgery. This nationwide survey investigated the current status of the implementation of ERAS in perioperative care for gastric cancer surgery in South Korea. Materials and Methods: This survey enrolled 89 gastric surgeons from 52 institutions in South Korea. The questionnaire consisted of 24 questions about the implementation of the ERAS protocols in the management of gastric cancer surgery. The survey was carried out using an electronic form sent via email. Results: Of the 89 gastric surgeons, 58 (65.2%) answered that they have knowledge of the concept and details of ERAS, 45 (50.6%) of whom were currently applying ERAS for their patients. Of the ERAS protocols, preoperative education (91.0%), avoidance of preoperative fasting (68.5%), maintenance of intraoperative normothermia (79.8%), thromboprophylaxis (96.5%), early active ambulation (64.4%), and early removal of urinary catheter (68.5%) were relatively well adopted in perioperative care. However, other practices, such as avoidance of preoperative bowel preparation (41.6%), provision of preoperative carbohydrate-rich drink (10.1%), avoidance of routine abdominal drainage (31.4%), epidural anesthesia (15.9%), single-dose prophylactic antibiotics (19.3%), postoperative high oxygen therapy (36.8%), early postoperative diet (14.6%), restricted intravenous fluid administration (53.9%), and application of discharge criteria (57.3%) were not very well adopted for patients. Conclusions: Perioperative management of gastric cancer surgery is largely heterogeneous among gastric surgeons in South Korea. Standard perioperative care based on scientific evidence needs to be established to improve the quality of surgical care and patient outcomes.

Clinical Features and Hearing Outcomes of Sudden Sensorineural Hearing Loss in Diabetic Patients

  • Ju, Yeo Rim;Park, Hyoung-sik;Lee, Min Young;Jung, Jae Yun;Choi, Ji Eun
    • Journal of Audiology & Otology
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    • v.25 no.1
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    • pp.27-35
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    • 2021
  • Background and Objectives: This study aimed to evaluate the clinical features and the clinical factors associated with prognosis of sudden sensorineural hearing loss (SSNHL) in diabetic patients. Subjects and Methods: Forty-nine diabetic with unilateral SSNHL were retrospectively included. All patients received systemic high dose steroid therapy within one month after onset and had more than one month of follow-up audiogram. The basic characteristics of the patients, initial and follow-up audiograms, laboratory data, and methods of steroid treatment were collected. Results: Compared to reference values in healthy subjects, 79%, 55%, and 45% of the patients had higher values of mean neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR), respectively. Older patients had significantly less degree of hearing loss, but they also had significantly worse hearing thresholds in the unaffected ear. After steroid treatment, less than half patients (47%) showed hearing recovery. Simultaneous intratympanic dexamethasone (ITD) injections with systemic steroid did not confer an additional hearing gain or an earlier recovery rate in diabetic patients with SSNHL. In the multivariate analysis, initial hearing thresholds of affected ear and timing of steroid treatment were significantly associated with hearing prognosis in diabetic patients with SSNHL. Conclusions: Diabetic patients with SSNHL tended to have increased NLR, LMR, and PLR, which are reported to be associated with microvascular angiopathy. Simultaneous ITD injections to improve hearing recovery in diabetic patients with SSNHL seems unnecessary.

Clinical Features and Hearing Outcomes of Sudden Sensorineural Hearing Loss in Diabetic Patients

  • Ju, Yeo Rim;Park, Hyoung-sik;Lee, Min Young;Jung, Jae Yun;Choi, Ji Eun
    • Korean Journal of Audiology
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    • v.25 no.1
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    • pp.27-35
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    • 2021
  • Background and Objectives: This study aimed to evaluate the clinical features and the clinical factors associated with prognosis of sudden sensorineural hearing loss (SSNHL) in diabetic patients. Subjects and Methods: Forty-nine diabetic with unilateral SSNHL were retrospectively included. All patients received systemic high dose steroid therapy within one month after onset and had more than one month of follow-up audiogram. The basic characteristics of the patients, initial and follow-up audiograms, laboratory data, and methods of steroid treatment were collected. Results: Compared to reference values in healthy subjects, 79%, 55%, and 45% of the patients had higher values of mean neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR), respectively. Older patients had significantly less degree of hearing loss, but they also had significantly worse hearing thresholds in the unaffected ear. After steroid treatment, less than half patients (47%) showed hearing recovery. Simultaneous intratympanic dexamethasone (ITD) injections with systemic steroid did not confer an additional hearing gain or an earlier recovery rate in diabetic patients with SSNHL. In the multivariate analysis, initial hearing thresholds of affected ear and timing of steroid treatment were significantly associated with hearing prognosis in diabetic patients with SSNHL. Conclusions: Diabetic patients with SSNHL tended to have increased NLR, LMR, and PLR, which are reported to be associated with microvascular angiopathy. Simultaneous ITD injections to improve hearing recovery in diabetic patients with SSNHL seems unnecessary.

Sodium Picosulphate with Magnesium Citrate versus Polyethylene Glycol for Bowel Preparation in Children: A Systematic Review

  • Dziechciarz, Piotr;Ruszczynski, Marek;Horvath, Andrea
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.3
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    • pp.228-239
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    • 2022
  • Purpose: To compare the effectiveness, tolerability, acceptability, and safety of sodium picosulphate with magnesium citrate (PS/Mg) and polyethylene glycol (PEG) in children (≤18 years) preparing for colonoscopy. Methods: Three electronic databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials) were searched till July 2020. Only randomized controlled trials (RCTs) were included. At least two authors independently selected studies and performed risk of bias assessment and data extraction. Results: Four RCTs (n=390), with overall good quality were included. A meta-analysis of two trials (n=224) found no statistically significant difference between the groups with respect to the proportion of patients who had excellent and good scores (≥6 points) according to the Boston Bowel Preparation Scale (relative risk: 0.99; 95% confidence interval [CI]: 0.90 to 1.08). Excellent and good scores were observed in both groups in approximately 90% of children. A meta-analysis of two other trials (n=150) showed no significant difference between the groups with respect to the mean total score for the Ottawa Bowel Preparation Scale (mean difference: 0.20; 95% CI: -0.74 to 1.14). Both regimens provided a comparable safety profile; however, PS/Mg was significantly superior to high volume PEG in terms of tolerability (abdominal pain, nausea, vomiting, bloating/flatulence/fullness) and acceptability (ease of formulation consumption, taste acceptance, need for nasogastric tube, compliance with full dose). Conclusion: PS/Mg provides a quality and safety profile similar to PEG for bowel cleansing; however, it has better acceptance and tolerance in children preparing for colonoscopy.