• Title/Summary/Keyword: prophylactic

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Next-generation Vaccines for Infectious Viral Diseases (차세대 감염병 백신)

  • Sun-Woo Yoon
    • Journal of Life Science
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    • v.33 no.9
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    • pp.746-753
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    • 2023
  • Viral infectious diseases have been regarded as one of the greatest threats to global public health. The recent coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a stark reminder of the threat posed by emerging viral infections. Developing and producing appropriate and efficient vaccines and therapeutics are the only options to combat this pandemic. The COVID-19 pandemic has highlighted the need for novel vaccine platforms to control and prevent emerging viral diseases. Conventional vaccine platforms, including live-attenuated vaccine and inactivated vaccines, pose limitations in the speed of vaccine development, manufacturing capacity, and broad protection for emergency use. Interestingly, vaccination with the SARS-CoV-2 vaccine candidate based on the mRNA-lipid nanoparticle (LNP) platform protected against COVID-19, confirming that the nucleoside-modified candidate is a safe and effective alternative to conventional vaccines. Moreover, the prophylactic strategies against the COVID-19 pandemic have been mRNA nucleic acid-based vaccines and nanoparticle-based platforms, which are effective against SARS-CoV-2 and its variants. Overall, the novel vaccine platform has presented advantages compared with the traditional vaccine platform in the COVID-19 pandemic. This review explores the recent advancements in vaccine technologies and platforms, focusing on mRNA vaccines, digital vaccines, and nanoparticles while considering their advantages and possible drawbacks.

Guidelines for Transrectal Ultrasonography-Guided Prostate Biopsy: Korean Society of Urogenital Radiology Consensus Statement for Patient Preparation, Standard Technique, and Biopsy-Related Pain Management

  • Myoung Seok Lee;Min Hoan Moon;Chan Kyo Kim;Sung Yoon Park;Moon Hyung Choi;Sung Il Jung
    • Korean Journal of Radiology
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    • v.21 no.4
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    • pp.422-430
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    • 2020
  • The Korean Society of Urogenital Radiology (KSUR) aimed to present a consensus statement for patient preparation, standard technique, and pain management in relation to transrectal ultrasound-guided prostate biopsy (TRUS-Bx) to reduce the variability in TRUS-Bx methodologies and suggest a nationwide guideline. The KSUR guideline development subcommittee constructed questionnaires assessing prebiopsy anticoagulation, the cleansing enema, antimicrobial prophylaxis, local anesthesia methods such as periprostatic neurovascular bundle block (PNB) or intrarectal lidocaine gel application (IRLA), opioid usage, and the number of biopsy cores and length and diameter of the biopsy needle. The survey was conducted using an Internet-based platform, and responses were solicited from the 90 members registered on the KSUR mailing list as of 2018. A comprehensive search of relevant literature from Medline database was conducted. The strength of each recommendation was graded on the basis of the level of evidence. Among the 90 registered members, 29 doctors (32.2%) responded to this online survey. Most KSUR members stopped anticoagulants (100%) and antiplatelets (76%) one week before the procedure. All respondents performed a cleansing enema before TRUS-Bx. Approximately 86% of respondents administered prophylactic antibiotics before TRUS-Bx. The most frequently used antibiotics were third-generation cephalosporins. PNB was the most widely used pain control method, followed by a combination of PNB plus IRLA. Opioids were rarely used (6.8%), and they were used only as an adjunctive pain management approach during TRUS-Bx. The KSUR members mainly chose the 12-core biopsy method (89.7%) and 18G 16-mm or 22-mm (96.5%) needles. The KSUR recommends the 12-core biopsy scheme with PNB with or without IRLA as the standard protocol for TRUS-Bx. Anticoagulants and antiplatelet agents should be discontinued at least 5 days prior to the procedure, and antibiotic prophylaxis is highly recommended to prevent infectious complications. Glycerin cleansing enemas and administration of opioid analogues before the procedure could be helpful in some situations. The choice of biopsy needle is dependent on the practitioners' situation and preferences.

Anti-thrombotic effect of artemisinin through regulation of cAMP production and Ca2+ mobilization in U46619-induced human platelets (U46619 유도의 사람 혈소판에서 cAMP 생성 및 Ca2+동원의 조절을 통한 Artemisinin의 항혈전 효과)

  • Chang-Eun Park;Dong-Ha Lee
    • Journal of Applied Biological Chemistry
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    • v.66
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    • pp.402-407
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    • 2023
  • The regulation of platelet aggregation is crucial for maintaining normal hemostasis, but abnormal or excessive platelet aggregation can contribute to cardiovascular disorders such as stroke, atherosclerosis, and thrombosis. Therefore, identifying substances that can control or suppress platelet aggregation is a promising approach for the prevention and treatment of these conditions. Artemisinin, a compound derived from Artemisia or Scopolia plants, has shown potential in various areas such as anticancer and Alzheimer's disease research. However, the specific role and mechanisms by which artemisinin influences platelet activation and thrombus formation are not yet fully understood. This study investigated the effects of artemisinin on platelet activation and thrombus formation. As a result, cAMP production were increased significantly by artemisinin, as well as phosphorylated VASP and IP3R which are substrates to cAMP-dependent kinase by artemisinin in a significant manner. The Ca2+ normally mobilized from the dense tubular system was inhibited due to IP3R phosphorylation from artemisinin, and phosphorylated VASP by artemisinin aided in inhibiting platelet activity via αIIb/β3 platelet membrane inactivation and inhibiting fibrinogen binding. Finally, artemisinin inhibited thrombin-induced thrombus formation. Therefore, we suggest that artemisinin has importance with cardiovascular diseases stemming from the abnormal platelets activation and thrombus formation by acting as an effective prophylactic and therapeutic agent.

Fermented Protaetia brevitarsis Larvae Ameliorates Chronic Ethanol-Induced Hepatotoxicity in Mice via AMPK and TLR-4/TGF-β1 Pathways

  • Hyo Lim Lee;Jong Min Kim;Min Ji Go;Seung Gyum Joo;Tae Yoon Kim;Han Su Lee;Ju Hui Kim;Jin-Sung Son;Ho Jin Heo
    • Journal of Microbiology and Biotechnology
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    • v.34 no.3
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    • pp.606-621
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    • 2024
  • This study evaluated the hepatoprotective effect of fermented Protaetia brevitarsis larvae (FPB) in ethanol-induced liver injury mice. As a result of amino acids in FPB, 18 types of amino acids including essential amino acids were identified. In the results of in vitro tests, FPB increased alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) activities. In addition, FPB treatment increased cell viability on ethanol- and H2O2-induced HepG2 cells. FPB ameliorated serum biomarkers related to hepatoxicity including glutamic oxaloacetic transaminase, glutamine pyruvic transaminase, total bilirubin, and lactate dehydrogenase and lipid metabolism including triglyceride, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol. Also, FPB controlled ethanol metabolism enzymes by regulating the protein expression levels of ADH, ALDH, and cytochrome P450 2E1 in liver tissue. FPB protected hepatic oxidative stress by improving malondialdehyde content, reduced glutathione, and superoxide dismutase levels. In addition, FPB reversed mitochondrial dysfunction by regulating reactive oxygen species production, mitochondrial membrane potential, and ATP levels. FPB protected ethanol-induced apoptosis, fatty liver, and hepatic inflammation through p-AMP-activated protein kinase and TLR-4/NF-κB signaling pathways. Furthermore, FPB prevented hepatic fibrosis by decreasing TGF-β1/Smad pathway. In summary, these results suggest that FPB might be a potential prophylactic agent for the treatment of alcoholic liver disease via preventing liver injury such as fatty liver, hepatic inflammation due to chronic ethanol-induced oxidative stress.

Is antibiotic prophylaxis necessary after endoscopic ultrasound-guided fine-needle aspiration of pancreatic cysts?

  • Seifeldin Hakim;Mihajlo Gjeorgjievski;Zubair Khan;Michael E. Cannon;Kevin Yu;Prithvi Patil;Roy Tomas DaVee;Sushovan Guha;Ricardo Badillo;Laith Jamil;Nirav Thosani;Srinivas Ramireddy
    • Clinical Endoscopy
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    • v.55 no.6
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    • pp.801-809
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    • 2022
  • Background/Aims: Current society guidelines recommend antibiotic prophylaxis for 3 to 5 days after endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic cystic lesions (PCLs). The overall quality of the evidence supporting this recommendation is low. In this study, we aimed to assess cyst infection and adverse event rates after EUS-FNA of PCLs among patients treated with or without postprocedural prophylactic antibiotics. Methods: We retrospectively reviewed all patients who underwent EUS-FNA of PCLs between 2015 and 2019 at two large-volume academic medical centers with different practice patterns of postprocedural antibiotic prophylaxis. Data on patient demographics, cyst characteristics, fine-needle aspiration technique, periprocedural and postprocedural antibiotic prophylaxis, and adverse events were retrospectively extracted. Results: A total of 470 EUS-FNA procedures were performed by experienced endosonographers for the evaluation of PCLs in 448 patients, 58.7% of whom were women. The mean age was 66.3±12.8 years. The mean cyst size was 25.7±16.9 mm. Postprocedural antibiotics were administered in 274 cases (POSTAB+ group, 58.3%) but not in 196 cases (POSTAB- group, 41.7%). None of the patients in either group developed systemic or localized infection within the 30-day follow-up period. Procedure-related adverse events included mild abdominal pain (8 patients), intra-abdominal hematoma (1 patient), mild pancreatitis (1 patient), and perforation (1 patient). One additional case of pancreatitis was recorded; however, the patient also underwent endoscopic retrograde cholangiopancreatography. Conclusions: The incidence of infection after EUS-FNA of PCLs is negligible. Routine use of postprocedural antibiotics does not add a significant benefit.

Splenic artery steal syndrome after liver transplantation - prophylaxis or treatment?: A case report and literature review

  • Sofia Usai;Marco Colasanti;Roberto Luca Meniconi;Stefano Ferretti;Nicola Guglielmo;Germano Mariano;Giammauro Berardi;Matteo Cinquepalmi;Marco Angrisani;Giuseppe Maria Ettorre
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.4
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    • pp.386-394
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    • 2022
  • Splenic artery steal syndrome (SASS) is a cause of graft hypoperfusion leading to the development of biliary tract complications, graft failure, and in some cases to retransplantation. Its management is still controversial since there is no universal consensus about its prophylaxis and consequently treatment. We present a case of SASS that occurred 48 hours after orthotopic liver transplantation (OLTx) in a 56-year-old male patient with alcoholic cirrhosis and severe portal hypertension, and who was successfully treated by splenic artery embolization. A literature search was performed using the PubMed database, and a total of 22 studies including 4,789 patients who underwent OLTx were relevant to this review. A prophylactic treatment was performed in 260 cases (6.2%) through splenic artery ligation in 98 patients (37.7%) and splenic artery banding in 102 (39.2%). In the patients who did not receive prophylaxis, SASS occurred after OLTx in 266 (5.5%) and was mainly treated by splenic artery embolization (78.9%). Splenic artery ligation and splenectomies were performed, respectively, in 6 and 20 patients (2.3% and 7.5%). The higher rate of complications registered was represented by biliary tract complications (9.7% in patients who received prophylaxis and 11.6% in patients who developed SASS), portal vein thrombosis (respectively, 7.3% and 6.9%), splenectomy (4.8% and 20.9%), and death from sepsis (4.8% and 30.2%). Whenever possible, prevention is the best way to approach SASS, considering all the potential damage arising from an arterial graft hypoperfusion. Where clinical conditions do not permit prophylaxis, an accurate risk assessment and postoperative monitoring are mandatory.

Community development and parasite control (지역사회개발(地域社會開發)과 기생충(寄生虫))

  • Rim, Han-Jong
    • Journal of agricultural medicine and community health
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    • v.1 no.1
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    • pp.10-21
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    • 1976
  • The traditional application of night soil to vegetable gardens and rice paddies results in a most wide spread condition of parasitism, with a variety of helminths found in Korea. In addition to the above fact, the peculiar habit of the consumption of raw vegetables, fish, crustaceans and mammals provides a means of infestations of helminths. During the last sixty years numerous reports were found on the prevalence of helminths amongst the Korean population in different parts of the country, and it was generally recognized that ascariasis, hookworm disease, filariasis, clonorchiasis and paragonimiasis constitute the important helminthic disease in Korea. In practical measures of parasite control activities the main measures are summarized as mass-treatment, night-soil disposal and transmission control. Among the three, the mass-treatment has been commonly applied, however, no reduction of transmission has been obtained by treatment of a population. Therefore, the ultimate eradication of parasites will depend upon the application of comprehensive environmental sanitation measures. The basic environmental measures will be concerned with (a) the safe disposal of human excreta, (b) the provision of adequate and safe water supplies in such a way as to promote a higher standard of personal hygiene in the population, and (c) the prevention of food contamination by faecal material. Additional environmental measures will deal with the improvement of housing and housing hygiene and with general community development. Community development means social and cultural as well as economic development. The control measures on the parasitic endemic diseases, such as clonorchiasis and paragonimiasis are the good examples for community health development in Korea. The control of Clonorchis and Paragonimus infections are theoretically very simple, as the infection can only invade the human body by way of encysted metacercaria which are taken into the body when eating passive intermediate hosts(fishes, crabs and crayfishes). Although prophylactic measures in the case of the infections deal with above merely consist the fishes in cooking or submerging in hot water before eating them, it is exceedingly difficult to carry out such simple measures in face of century old traditions, to which the relatively primitive population clings with great tenacity. There is no one universally applicable method of control. The choice of methods must be dictated by the nature of the environment. the habit and custom of the people. the pattern of transmission and the resources of the country. There must exist a well organized public health infrastructure. Since a control programme is of necessity on a longterm basis and continuity in its implementation is essential. An investigation should be made on the prevalence of the diseases and its relationships to irrigation engineering, freshwater ecology, agricultural methods, hydro-electric schemes, and the development of communities in affected areas. In conclusion, however. the control of clonorchiasis and paragonimiasis in Korea is not an impossible task. A combination of efforts with major emphasis on health education and mass chemotherapy coupled with governmental aid in enforcing legislative public health measures could reduce the diseases. Health education in particular attempts following four things: (a) It supplies a person with enough general knowledge about a disease to make the preventive measures. (b) It makes a person feel sufficiently about the importance of his own health to make him alter his behavior and adopt these preventive measure. (c) It makes him concerned for the health others. (d) It tries to make him feel so strongly about the first three that be supports and even initiates preventive action by the community. Educational efforts should be directed primarily toward school children because it is during the early years that most persons become infected, and also because children are less entrenched in their food habits so that, the educational process should be involved at various levels in successive changes of knowledge, attitude, beha viour, habit and custom of their lives. The most parasitic endemic diseases are related to community diseases. In caring for a sick community. the first stage is to gather epidemiological data, the next is to make inferences from it-to make the community diagnosis. The third is to prescribe community treatment or community health action part of a community health action programme. The community health action is the sum of the steps decided upon to remedy the critical features revealed by the community diagnosis. Action takes various forms; health education is the most important.

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Twice Daily Radiation Therapy Plus Concurrent Chemotherapy for Limited-Stage Small Cell Lung Cancer (국한성병기 소세포폐암에서 하루 두 번 분할조사와 동시 화학방사선치료)

  • Yeo Seung-Gu;Cho Moon-June;Kim Sun-Young;Kim Ki-Whan;Kim Jun-Sang
    • Radiation Oncology Journal
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    • v.24 no.2
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    • pp.96-102
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    • 2006
  • Purpose: A retrospective study was performed to evaluate the efficiency and feasibility of twice daily radiation therapy plus concurrent chemotherapy for limited-stage small cell lung cancer in terms of treatment response, survival, patterns of failure, and acute toxicities. Materials and Methods: Between February 1993 and October 2002, 76 patients of histologically proven limited-stage small cell lung cancer (LS-SCLC) were treated with twice daily radiation therapy and concurrent chemotherapy. Male was in 84% (64/76), and median age was 57 years (range, 32-75 years). Thoracic radiation therapy consisted of 120 or 150 cGy per fraction, twice a day at least 6 hours apart, 5 days a week. Median total dose was 50.4 Gy (range, 45-51 Gy). Concurrent chemotherapy consisted of CAV ($cytoxan\;1000mg/m^2,\;adriamycin\;40mg/m^2,\;vincristine\;1mg/m^2$) alternating with PE ($cisplatin\;60mg/m^2,\;etoposide\;100mg/m^2$) or PE alone, every 3 weeks. The median cycle of chemotherapy was six (range, 1-9 cycle). Prophylactic cranial irradiation (PCI) was recommended to the patients who achieved a complete response (CR). PCI scheme was 25 Gy/10 fractions. Median follow up was 18 months (range, 1-136 months). Results: Overall response rate was 86%; complete response in 39 (52%) and partial response in 26 (34%) patients. The median overall survival was 23 months. One, two, and three year overall survival rate was 72%, 50% and 30%, respectively. In univariate analysis, the treatment response was revealed as a significant favorable prognostic factor for survival (p<0.001). Grade 3 or worse acute toxicities were leukopenia in 46 (61%), anemia in 5 (6%), thrombocytopenia in 10 (13%), esophagitis in 5 (6%), and pulmonary toxicity in 2 (2%) patients. Of 73 evaluable patients, 40 (55%) patients subsequently had disease progression. The most frequent first site of distant metastasis was brain. Conclusion: Twice daily radiation therapy plus concurrent chemotherapy produced favorable response and survival for LS-SCLC patients with tolerable toxicities. To improve the treatment response, which proved as a significant prognostic factor for survival, there should be further investigations about fractionation scheme, chemotherapy regimens and compatible chemoradiotherapy schedule.

The Effects of Steroid on Acute Lung Injury in the Mouse Induced by Whole Lung Irradiation (전폐조사로 유발된 마우스의 급성폐손상에 대한 스테로이드의 효과)

  • Sung, Nak-Kwan;Shin, Sei-One;Kwon, Kun-Young
    • Radiation Oncology Journal
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    • v.15 no.1
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    • pp.37-47
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    • 1997
  • Purpose : To investigate ultrastructural changes of the mouse lung induced by whole lung gamma irradiation and to evaluate the effect of prophylactic administration of steroid against acute lung injury. Materials and Methods :. One hundred and twenty ICR mice were used and whole lung was irradiated with telecobalt machine. Whole lung doses were 8 and 12Gy, and 10mg of methyl prednisolone was administrated intraperitoneally for two and four weeks. At the end of the observation period, mice were sacrificed by cervical dislocation. The lungs were removed and fixed inflated. Histopathological examination of acute radiation injuries were Performed by light microscopic and transmission electron microscopic examination. Results : Control group with BGy is characterized by damage to the type I Pneumocyte and the endothelial cell of the capillary. edema of alveolar wall and interstitium. and fibroblast proliferation. Control group with 120y is characterized by more severe degree of type 1 pneumocyte damage and more prominant inflammatory cell infiltration. Destructed cell debris within the alveolar space were also noted After steroid administration, 8Gy experimental group showed decreased degree of inflammatory reactions but fibroblast proliferation and basal lamina damages were unchanged. Experimental group with 12Gy showed lesser degree of inflammatory reactions similar to changes of 8Gy experimental group. Conclusion : These studies suggest that the degree of interstitial edema and inflammatory changes were related to radiation dose but Proliferation of the fibroblast and structural changes of basal lamina were not related to radialion dose. Experimental administration of steroid for 2 to 4 weeks after whole lung irradiation suggest that steroid can suppress alveolar and endothelial damages induced by whole lung irradiation but Proliferation of the fibroblast and structural changes of basal lamina were not related to administration of steroid.

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Radiation Therapy of Testicular Seminoms (고환 정상피종의 방사선 치료 성적)

  • Wu, Hong-Gyun;Oh, Do-Hoon;Ha, Sung-Whan
    • Radiation Oncology Journal
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    • v.12 no.3
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    • pp.361-368
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    • 1994
  • Purpose : Testicular seminomas are radiosensitive and adjuvant radiation therapy after orchiectomy results in long term survival in early stage diseases, Ten year results of radiation therapy after orchiectomy and results of definitive treatment of recurrent seminoma are Presented. Materials and Methods : Between August 1980 and February 1990. 32 Patients with testicular seminomas were treated at the Department of Therapeutic Radiology, Seoul Natoinal University Hospital. Twenty-seven Patients received radiation therapy after orchiectomy and 5 patients for treatment of recurrent tumors. Two of postoperatively treated patients and 2 of recurrent patients were excluded from the study because of incomplete treatment. Of the patients treated postoperatively, 18 were stage I, 5 were stage IIA, one was stage IIB, and one was stage IIC. There were 4 ipsilateral and 2 contralateral cryptorchids. Preoperatively, ${\beta}$-HCG levels were elevated in 5 patients. Median dose to pelvic and paraaortic lymph node area was 2900 cGy (1550-4550 cGy). One patient with stage I, 4 with stage IIA, and 1 with stage IIB received prophylactic mediastinal irradiation. Two patients were treated with chemotherapy before radiation therapy. Median follow-up period was 104(3-144) months. Result: Local control rates were 100% at 5 years after orchiectomy. Five year survival rates were 94.4% in Stage I and 100% in Stage II patients, One patient with stage I disease died 3 months after surgery due to mediastinal metastasis. AII the 3 patients treated for recurrent disease are alive without disease. Conclusion : Postorchiectomy radiation to the pelvis and para-aortic area remains the treatment of choice for Patient with early stage testicular seminoma. Radiation therapy is also an excellent treatment modality for recurrent seminoma.

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