• Title/Summary/Keyword: systemic review

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다양한 인체 장기에서 보일 수 있는 면역글로불린 G4 관련 질환: 임상화보 (Systemic Manifestations of Immunoglobulin G4-Related Disease: A Pictorial Essay)

  • 박경리;최요원;강보경;이지영;박정선;신수진;구혜령
    • 대한영상의학회지
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    • 제82권3호
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    • pp.575-588
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    • 2021
  • 면역글로불린 G4 (immunoglobulin G4; 이하 IgG4) 관련 질환은 특징적인 병리 소견을 동반한 섬유화를 일으키는 전신 염증성 질환이다. 영상검사는 IgG4 관련 질환의 진단 및 치료 반응 평가에 필수적이다. 본 임상화보는 IgG4 관련 질환의 다양한 임상 증례를 통해 영상 소견 및 감별진단을 제시함으로써 IgG4 관련 질환에 대한 이해의 폭을 넓히고자 한다.

급성인두염의 한약 치료에 대한 체계적 문헌 고찰 및 메타분석 : 중국 논문을 중심으로 (A Systemic Review and Meta-Analysis of Herbal Medicine Treatment for Acute Pharyngitis : Based on Chinese Articles)

  • 이영은;임지원;최지영;지선영;황보민
    • 한방안이비인후피부과학회지
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    • 제37권3호
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    • pp.1-16
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    • 2024
  • Objectives : The purpose of this study is to investigate the effectiveness and safety of herbal medicine treatment for acute pharyngitis. Methods : 2 databases(Wangfang Med Online, CNKI) were used to search Randomized Controlled Trials(RCTs) that used herbal medicine treatment for acute pharyngitis, which were published from January 2007 until April 2024. Results : 9 RCTs were selected in this study, and all studies compared herbal medicine alone treatment with western medicine alone treatment. The most frequently used medicine was Toxin-removing medicinal(淸熱解毒藥). Platycodonis Radix(桔梗) was the most frequently used herb. Meta-analysis of nine studies showed that the Total Effective Rate(TER) of treatment group was statistically higher than that of control group(RR:1.12, 95% CI:1.06 to 1.19, p<0.00001, I2=22%). Meta-analysis of 3 studies showed that the total symptom score of treatment group statistically improved than that of control group(MD: -1.00, 95% CI: -1.30 to -0.71, p<0.00001, I2=0%). Mild adverse events such as anorexia were identified in 4 RCTs, but no serious adverse events were reported. Conclusion : Using herbal medicine alone can be more effective and safe in improving acute pharyngitis than using western medicine. But further well-designed studies are needed because heterogeneity between studies existed and the quality of the reports needs to be improved.

패혈증 마우스 모델에서 가와사키병의 관상동맥 병변 관찰: 예비연구와 문헌고찰 (Coronary Arterial Lesions of Kawasaki Disease Observed in a Mouse Model of Sepsis: A Pilot Study and a Review of the Literature)

  • 김주현;김효진;신정하;최의윤;이수영;한지환
    • Pediatric Infection and Vaccine
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    • 제24권2호
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    • pp.102-107
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    • 2017
  • 목적: 가와사키병의 환아뿐만 아니라, 다른 전신 염증 질병의 환아들에 관상동맥 병변(coronary arterial lesion [CAL])의 발생이 보고되었다. 본 연구에서는 전형적인 전신염증반응증후군(systemic inflammatory response syndrome [SIRS])의 소견을 보이는 패혈증 마우스 모델에서 가와사키병 환아에게 관찰되는 CAL이 발생하는지 확인하고자 하였다. 방법: 생후 6주 C57BL/6 마우스에 내독소를 복강내주사하여 SIRS를 보이는 패혈증 모델을 유도하였다. 대조군과 패혈증군의 주요 장기의 조직학적 소견을 비교하였고 패혈증 마우스에서 CAL을 찾기 위한 시도를 하였다. 결과: 대조군과 비교하여, 염증세포의 침윤이 패혈증 마우스의 심장, 간, 신장에 상대적으로 증가하였다. 패혈증 마우스의 심장에서 심근(심근염)과 심장 주위 연조직에 림프구 침윤을 확인하였다. 또한, 패혈증 마우스의 관상동맥을 관찰하였지만, CAL을 확인할 수는 없었다. 결론: 본 연구에서 패혈증 마우스 모델에서 CAL의 존재를 확인하는 것은 실패하였다. 하지만, SIRS를 유발하는 많은 종류의 원인 질병에서 CAL이 발생한다는 것은 잘 알려져 있다. 가와사키병을 포함한 다양한 전신 염증 질병에 나타나는 CAL의 임상적 의미에 대한 연구가 필요할 것이다.

Effects of resistance training on the inflammatory response

  • Celle, Mariana C.;Fernandez, Maria Luz
    • Nutrition Research and Practice
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    • 제4권4호
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    • pp.259-269
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    • 2010
  • Resistance training (RT) is associated with reduced risk of low grade inflammation related diseases, such as cardiovascular disease and type 2 diabetes. The majority of the data studying cytokines and exercise comes from endurance exercise. In contrast, evidence establishing a relationship between RT and inflammation is more limited. This review focuses on the cytokine responses both following an acute bout, and after chronic RT. In addition, the effect of RT on low grade systemic inflammation such as individuals at risk for type 2 diabetes is reviewed. Cytokines are secreted proteins that influence the survival, proliferation, and differentiation of immune cells and other organ systems. Cytokines function as intracellular signals and almost all cells in the body either secrete them or have cytokine receptors. Thus, understanding cytokine role in a specific physiological situation such as a bout of RT can be exceedingly complex. The overall effect of long term RT appears to ameliorate inflammation, but the specific effects on the inflammatory cytokine, tumor necrosis factor alpha are not clear, requiring further research. Furthermore, it is critical to differentiate between chronically and acute Interleukin-6 levels and its sources. The intensity of the RT and the characteristics of the training protocol may exert singular cytokine responses and as a result different adaptations to exercise. More research is needed in the area of RT in healthy populations, specifically sorting out gender and age RT acute responses. More importantly, studies are needed in obese individuals who are at high risk of developing low grade systemic inflammatory related diseases. Assuring adherence to the RT program is essential to get the benefits after overcoming the first acute RT responses. Hence RT could be an effective way to prevent, and delay low grade systemic inflammatory related diseases.

경구용 옥수수불검화정량추출물 치료제(인사돌)의 임상적 유효성 데이터의 통계적 타당성에 대한 연구 (Analysis of the statistical validity of clinical effectiveness data of a systemic titrated extract of Zea Mays L. unsaponifiable fraction chemotherapeutic agent (Insadol))

  • 최용근;;이정열;신상완
    • 대한치과의사협회지
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    • 제53권7호
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    • pp.476-484
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    • 2015
  • Purpose: This study intended to analyze the validity of clinical effectiveness data of clinical trials testing systemic titrated extract of Zea Mays L. unsaponifiable fraction chemotherapeutic agent. Material and Methods: Among 5 clinical trials claimed as proof of clinical effectiveness on the Web site of the manufacturer of this chemotherapeutic agent, a review of 4 clinical trials, written in either Korean or English, was conducted. Data were extracted from studies for the following variables: year of publication, age, sample size, follow-up period, combination with contemporary periodontal treatments, randomization, randomization check, blinded measurement, and statistical test type. Results: The study subjects' age intervals were too diverse to decide a common target population to generalize the findings. No study stated clearly the rationale for the sample size determination. Follow-up period to observe the start of clinical effectiveness was inconsistent and decided without any rationale of pathophysiological latent period. Randomization to make the comparisons on the same start line was performed but failed in a study. Randomization effect was not checked in 4 studies. Performance of blinded measurement of clinical outcomes to prevent bias was unclear in 2 studies. Type of statistical test was inappropriate in 3 studies. Conclusions: Based on the analysis of the validity of data on clinical and demographic variables, the four available clinical trials have not demonstrated compelling evidence of therapeutic effectiveness of systemic titrated extract of Zea Mays L. unsaponifiable fraction chemotherapeutic agent to improve prognosis of periodontal disease either with the contemporary periodontal treatment or without it.

Novel Biomarkers for Prediction of Response to Preoperative Systemic Therapies in Gastric Cancer

  • Cavaliere, Alessandro;Merz, Valeria;Casalino, Simona;Zecchetto, Camilla;Simionato, Francesca;Salt, Hayley Louise;Contarelli, Serena;Santoro, Raffaela;Melisi, Davide
    • Journal of Gastric Cancer
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    • 제19권4호
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    • pp.375-392
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    • 2019
  • Preoperative chemo- and radiotherapeutic strategies followed by surgery are currently a standard approach for treating locally advanced gastric and esophagogastric junction cancer in Western countries. However, in a large number of cases, the tumor is extremely resistant to these treatments and the patients are exposed to unnecessary toxicity and delayed surgical therapy. The current clinical trials evaluating the combination of preoperative systemic therapies with modern targeted and immunotherapeutic agents represent a unique opportunity for identifying predictive biomarkers of response to select patients that would benefit the most from these treatments. However, it is of utmost importance that these potential biomarkers are corroborated by extensive preclinical and translational research. The aim of this review article is to present the most promising biomarkers of response to classic chemotherapeutic, anti-HER2, antiangiogenic, and immunotherapeutic agents that can be potentially useful for personalized preoperative systemic therapies in gastric cancer patients.

아토피피부염의 치료 (Treatment of Atopic Dermatitis)

  • 한태영;나찬호;이지현;김혜원;박창욱;서영준;손상욱;신민경;안지영;이양원;장용현;박영립;유박린
    • 대한피부과학회지
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    • 제56권10호
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    • pp.581-593
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    • 2018
  • Atopic dermatitis (AD) is a common, chronic, relapsing, inflammatory skin disease that affects both children and adults. AD is the cause of considerable morbidity including severe pruritus and impaired quality of life. Treatments for active disease include avoidance of triggering factors, barrier repair, topical medications including topical corticosteroids (TCs) and topical calcineurin inhibitors (TCIs), phototherapy, antibacterial agents, and systemic immunosuppressants including cyclosporine. Until recently, the only Food and Drug Administration (FDA)-approved systemic treatment options for patients with moderate-to-severe AD were steroids and cyclosporine. Systemic steroids are not recommended by current guidelines and are commonly associated with disease rebound. Instead, clinicians choose from several off-label immunosuppressants. In 2018, the Korean FDA approved dupilumab for adults with moderate-to-severe AD whose disease is not adequately controlled with topical therapies. The implementation of treatment guidelines for AD is challenging. Herein, we review the several treatment modalities for AD and recommend a treatment algorithm.

Research progress on hydrogel-based drug therapy in melanoma immunotherapy

  • Wei He;Yanqin Zhang;Yi Qu;Mengmeng Liu;Guodong Li;Luxiang Pan;Xinyao Xu;Gege Shi;Qiang Hao;Fen Liu;Yuan Gao
    • BMB Reports
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    • 제57권2호
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    • pp.71-78
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    • 2024
  • Melanoma is one of the most aggressive skin tumors, and conventional treatment modalities are not effective in treating advanced melanoma. Although immunotherapy is an effective treatment for melanoma, it has disadvantages, such as a poor response rate and serious systemic immune-related toxic side effects. The main solution to this problem is the use of biological materials such as hydrogels to reduce these side effects and amplify the immune killing effect against tumor cells. Hydrogels have great advantages as local slow-release drug carriers, including the ability to deliver antitumor drugs directly to the tumor site, enhance the local drug concentration in tumor tissue, reduce systemic drug distribution and exhibit good degradability. Despite these advantages, there has been limited research on the application of hydrogels in melanoma treatment. Therefore, this article provides a comprehensive review of the potential application of hydrogels in melanoma immunotherapy. Hydrogels can serve as carriers for sustained drug delivery, enabling the targeted and localized delivery of drugs with minimal systemic side effects. This approach has the potential to improve the efficacy of immunotherapy for melanoma. Thus, the use of hydrogels as drug delivery vehicles for melanoma immunotherapy has great potential and warrants further exploration.

선천성 심질환에서 우심부전 (Right-sided heart failure in congenital heart diseases)

  • 정조원
    • Clinical and Experimental Pediatrics
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    • 제50권11호
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    • pp.1055-1060
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    • 2007
  • Right-sided heart failure is a major problem among patients with congenital heart diseases, due to the prevalence of congenital heart defects and the association of pulmonary hypertension. More attention is focused on the structure of the right heart particularly in association with congenital heart defects and chronic lung disease. The right ventricle (RV) may support the pulmonary circulation, and sometimes the systemic circulation (systemic RV) in congenital heart defects. Despite major progress being made, assessing the RV remains challenging, often requiring a multi-imaging approach and expertise (echocardiography, magnetic resonance imaging, nuclear and cineangiography). Evidence is accumulating that RV dysfunction develops in many of these patients and leads to considerable morbidity and mortality. While there is extensive literature on the pathophysiology and treatment of left heart failure, the data for right-sided heart failure is scarce. Therefore RV function in certain groups of congenital heart disease patients needs close surveillance and timely and appropriate intervention to optimise outcomes. An understanding of RV physiology and hemodynamics will lead to a better understanding of current and future treatment strategies for right heart failure. This will review right-sided heart failure with the implications of volume and pressure loading of the RV in congenital heart diseases.

임상가를 위한 특집 2 - 치주 질환과 동맥경화성 심혈관 질환의 관계성에 대한 고찰과 치주처치 (The review and treatment regarding on association between periodontitis and atherosclerotic cardiovascular diseases)

  • 이효정
    • 대한치과의사협회지
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    • 제51권9호
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    • pp.501-510
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    • 2013
  • This paper reviews a current view regarding the association between periodontitis and atherosclerotic cardiovascular diseases (ACVD). Many evidences have suggested that there exist biological mechanisms by which periodontitis can lead to ACVD. Periodontal infection can lead to direct bacterial invasion into endothelial tissues through the blood stream, then the bacteria can activate the host inflammatory response followed by atheroma formation, maturation and exacerbation. Also, chronic periodontal infections may indirectly induce endothelial activation or dysfunction through a state of systemic inflammation as evidenced by elevated plasma acute proteins, IL-6 and fibrinogen as well. There is moderate evidence that periodontal treatment can reduce systemic inflammation and improvement of both clinical surrogate markers. But there is no periodontal intervention study available on primary ACVD prevention. There is consistent and strong epidemiologic evidence, including in vitro, animal and clinical studies, that periodontitis imparts increased risk for future ACVD. However, evidences from intervention trials to date are not sufficient to confirm the multi directional causality of periodontitis in ACVD etiology. Well-designed intervention trials on the impact of periodontal treatment on the prevention of ACVD outcomes are needed.