• BMB Reports
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• 제56권4호
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• pp.225-233
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• 2023

Hepatocellular carcinoma (HCC) is a very common form of cancer worldwide and is often fatal. Although the histopathology of HCC is characterized by metabolic pathophysiology, fibrosis, and cirrhosis, the focus of treatment has been on eliminating HCC. Recently, three-dimensional (3D) multicellular hepatic spheroid (MCHS) models have provided a) new therapeutic strategies for progressive fibrotic liver diseases, such as antifibrotic and anti-inflammatory drugs, b) molecular targets, and c) treatments for metabolic dysregulation. MCHS models provide a potent anti-cancer tool because they can mimic a) tumor complexity and heterogeneity, b) the 3D context of tumor cells, and c) the gradients of physiological parameters that are characteristic of tumors in vivo. However, the information provided by an multicelluar tumor spheroid (MCTS) model must always be considered in the context of tumors in vivo. This mini-review summarizes what is known about tumor HCC heterogeneity and complexity and the advances provided by MCHS models for innovations in drug development to combat liver diseases.

• Journal of Hospice and Palliative Care
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• 제26권3호
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• pp.145-148
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• 2023

Preserving dignity is a significant concern for individuals approaching the end of their lives, as they face an increasing number of conditions that can potentially compromise their dignity. This article discusses dignity therapy as one intervention method aimed at enhancing the psychological and spiritual well-being of patients with terminal illnesses. Dignity therapy is an empirically supported therapeutic intervention that interviews patients with nine questions about what is important to them and what they want to remember, culminating in the production of a document based on these conversations. This intervention serves as a valuable tool and framework, enabling clinical professionals to reflect on dignity. It also provides clinicians with a medium to connect with patients on a deeply human level.

• Journal of Genetic Medicine
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• 제20권2호
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• pp.46-51
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• 2023

Exonic copy number variation (CNV), involving deletions and duplications at the gene's exon level, presents challenges in detection due to their variable impact on gene function. The study delves into the complexities of identifying large CNVs and investigates less familiar but recurrent exonic CNVs, notably enriched in East Asian populations. Examining specific cases like DRC1, STX16, LAMA2, and CFTR highlights the clinical implications and prevalence of exonic CNVs in diverse populations. The review addresses diagnostic challenges, particularly for single exon alterations, advocating for a strategic, multi-method approach. Diagnostic methods, including multiplex ligation-dependent probe amplification, droplet digital PCR, and CNV screening using next-generation sequencing data, are discussed, with whole genome sequencing emerging as a powerful tool. The study underscores the crucial role of ethnic considerations in understanding specific CNV prevalence and ongoing efforts to unravel subtle variations. The ultimate goal is to advance rare disease diagnosis and treatment through ethnically-specific therapeutic interventions.

• IMMUNE NETWORK
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• 제16권1호
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• pp.33-43
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• 2016

Cell-penetrating peptides (CPPs) are short amino acids that have been widely used to deliver macromolecules such as proteins, peptides, DNA, or RNA, to control cellular behavior for therapeutic purposes. CPPs have been used to treat immunological diseases through the delivery of immune modulatory molecules in vivo. Their intracellular delivery efficiency is highly synergistic with the cellular characteristics of the dendritic cells (DCs), which actively uptake foreign antigens. DC-based vaccines are primarily generated by pulsing DCs ex vivo with various immunomodulatory antigens. CPP conjugation to antigens would increase DC uptake as well as antigen processing and presentation on both MHC class II and MHC class I molecules, leading to antigen specific CD4⁺ and CD8⁺ T cell responses. CPP-antigen based DC vaccination is considered a promising tool for cancer immunotherapy due to the enhanced CTL response. In this review, we discuss the various applications of CPPs in immune modulation and DC vaccination, and highlight the advantages and limitations of the current CPP-based DC vaccination.

• 재활치료과학
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• 제11권4호
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• pp.41-53
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• 2022

목적 : 본 연구는 정신장애인의 직업재활 평가도구를 확인하고 분석함으로써 작업치료 영역에서 임상적으로 유용하게 활용할 수 있는 정신장애인 직업재활 평가도구의 개발을 위한 기초자료로 활용하는 것이다. 연구방법 : 문헌 검색은 Pubmed 데이터베이스를 사용하였으며, 분석 내용은 개발연도, 평가방식, 문항 수, 척도, 평가 문항을 분석하였다. 분석 방법은 각 평가 항목을 기능, 내적요인, 환경, 정신증상의 4가지 범주로 구분하여 각 평가도구의 평가 요소에 대해 파악하였다. 결과 : 검색어를 통한 Pubmed 검색 시 161개의 문헌이 검색되었고, 선정 방법에 따라 Griffiths Work Behavior Scale (GWBS), Occupational Functioning Scale (OFS), Social and Occupational Functioning Assessment Scale (SOFAS), Work Ability Index (WAI), Work Behaviour Inventory (WBI), Work Environment Impact Scale (WEIS), Work and Social Adjustment Scale (WSAS)의 7개 평가도구가 선별되었다. 모든 평가도구의 평가항목은 직무와 관련된 기능평가를 포함하였으며, 각 평가도구의 목적에 따라 내적요인, 환경, 정신증상에 대한 측정이 이루어지는 것으로 나타났다. 결론 : 직업 기술은 신체, 인지, 사회기술, 대처능력 등 다양한 기능이 복합적으로 작용하는 기술이다. 따라서 본 연구에서 분석한 기능, 내적요인, 환경, 정신증상의 4가지 요소가 포함될 필요가 있으며, 평가과정에서 발생하는 물리적 제약을 보완하기 위해 ICT 융합 평가도구의 개발함으로써 보다 효율적인 정신장애인 직업재활 평가가 이루어져야 할 것이다.

• Journal of Trauma and Injury
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• 제24권2호
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• pp.136-142
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• 2011

Purpose: Blunt pancreatic injury has a high mortality rate, especially if adequate management is delayed. Although many guidelines exist for diagnosis and treatment, there is no consensus to date. Therefore, we analyzed the role of endoscopic retrograde cholangiopancreatography (ERCP) as a diagnostic and therapeutic tool for the treatment of traumatic pancreatic injury. Methods: We retrospectively reviewed the electronic medical records (EMR) database at Asan Medical Center (Seoul, South Korea) to identify all patients diagnosed with trauma to the pancreas between June 2003 and December 2010. Clinical and operative findings, CT (computed tomography) images, and ERCP findings were assessed. Results: A total of 40 patients were evaluated in this study. Of these, 14 patients underwent diagnostic ERCP, and 26 did not. Of the 14 patients who underwent diagnostic ERCP, 5 were found to have normal pancreatic ducts, thereby preventing a needless laparotomy in these patients. Of the patients diagnosed with ductal injury, four were treated with endoscopic intervention, and four underwent an exploratory laparotomy. The remaining patient was treated with radiologic intervention (percutaneous drainage) to manage pancreatic pseudocyst formation. Conclusion: Our findings suggest that ERCP is a beneficial diagnostic and therapeutic modality for the treatment of traumatic pancreatic injury.

• Journal of Chest Surgery
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• 제20권1호
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• pp.39-47
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• 1987

The records of 268 patients, who were diagnosed as spontaneous pneumothorax during the period 1975 to 1984, treated at the department of thoracic and cardiovascular surgery, Hanyang University Hospital, were reviewed retrospectively to evaluate the effect of surgical intervention on each indications. Of these,.61 patients [22.8%] were taken operation to treat the pneumothorax after closed thoracostomy. We have classified the 61 patients to evaluate the therapeutic effect on each indications. And the therapeutic effect is based on the chest tube indwelling days. The results were as follows: 1. The chest tube indwelling days of the group who were taken closed thoracostomy only was average 14.13*9.17 days [range 5-66 days], and that of the group who were finally taken the thoracotomy after closed thoracostomy was 21.85*12.30 days [range 5-55 days]. 2. The indications of thoractomy were thoracoscopic findings, recurrence and continuous air leakage. 3. The chest tube indwelling day of the group who was taken thoracotomy by thoracoscopic findings was average 11.67*6.51 day, that was relatively short compared to those of the other groups. 4. The continuous air leakage group after closed thoracostomy was subdivided into three subgroups, continuous air leakage in 1st attack, thoracoscopic findings in 1st attack, and recurrence. 5. Of these, the chest tube indwelling day of the subgroup, who was taken operation by thoracoscopic findings, was 21.33e8.26, that was relatively short compared with those of the other subgroups. We use the thoracoscope as excellent diagnostic tool to detect the operation indication in the spontaneous pneumothorax patients. And we gain the benefits to shorten the chest tube indwelling days and admission days, and also to protect the recurrence.

• Clinical and Experimental Pediatrics
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• 제58권12호
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• pp.484-490
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• 2015

Purpose: To determine the efficacy and safety of oral propranolol as a first-line treatment for superficially located infantile hemangioma (IH) and propose an assessment tool to measure treatment response. Methods: Patients with superficial IH under 1 year of age were prospectively recruited between May 2012 and December 2013 at the Department of Pediatrics of Chungbuk National University Hospital. Propranolol was administered to 12 infants (median age, 3.8 months) while monitoring cardiovascular and adverse metabolic effects. If a patient showed no adverse events, the dosage was gradually increased up to 3 mg/kg/day and maintained for 1 year. We used our own scoring system to assess treatment response using parameters like change in color, and longest diameter, and thickness of the IH. Results: Eleven out of 12 patients completed the protocol with consistent improvement of hemangiomas during therapy. Patients on propranolol showed a more than 50% involution in the first 3 months, with additional steady involution until 1 year. Patients with the highest scores at 1 month maintained their score and showed better responses until treatment termination. The patient with the lowest score at 1 month did not show any further regression and stopped propranolol treatment 4 months after initiation. In two children with recurrences after successful therapeutic regression, propranolol was effective after being reintroduced. Propranolol treatment was not interrupted in any patient due to adverse events. Conclusion: Oral propranolol at 3 mg/kg/day showed a consistent, rapid, and therapeutic effect on superficial IHs without significant adverse events.

• The Korean Journal of Pain
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• 제29권1호
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• pp.3-11
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• 2016

A nerve block is an effective tool for diagnostic and therapeutic methods. If a diagnostic nerve block is successful for pain relief and the subsequent therapeutic nerve block is effective for only a limited duration, the next step that should be considered is a nerve ablation or modulation. The nerve ablation causes iatrogenic neural degeneration aiming only for sensory or sympathetic denervation without motor deficits. Nerve ablation produces the interruption of axonal continuity, degeneration of nerve fibers distal to the lesion (Wallerian degeneration), and the eventual death of axotomized neurons. The nerve ablation methods currently available for resection/removal of innervation are performed by either chemical or thermal ablation. Meanwhile, the nerve modulation method for interruption of innervation is performed using an electromagnetic field of pulsed radiofrequency. According to Sunderland's classification, it is first and foremost suggested that current neural ablations produce third degree peripheral nerve injury (PNI) to the myelin, axon, and endoneurium without any disruption of the fascicular arrangement, perineurium, and epineurium. The merit of Sunderland's third degree PNI is to produce a reversible injury. However, its shortcoming is the recurrence of pain and the necessity of repeated ablative procedures. The molecular mechanisms related to axonal regeneration after injury include cross-talk between axons and glial cells, neurotrophic factors, extracellular matrix molecules, and their receptors. It is essential to establish a safe, long-standing denervation method without any complications in future practices based on the mechanisms of nerve degeneration as well as following regeneration.

• Journal of Microbiology and Biotechnology
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• 제19권9호
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• pp.1070-1076
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• 2009

Telomerase reverse transcriptase (TERT), which prolongs the replicative life span of cells, is highly upregulated in 85-90% of human cancers, whereas most normal somatic tissues in humans express limited levels of the telomerase activity. Therefore, TERT has been a potential target for anticancer therapy. Recently, we described a new approach to human cancer gene therapy, which is based on the group I intron of Tetrahymena thermophila. This ribozyme can specifically mediate RNA replacement of human TERT (hTERT) transcript with a new transcript harboring anticancer activity through a trans-splicing reaction, resulting in selective regression of hTERT-positive cancer cells. However, to validate the therapeutic potential of the ribozyme in animal models, ribozymes targeting inherent transcripts of the animal should be developed. In this study, we developed a Tetrahymena-based trans-splicing ribozyme that can specifically target and replace the mouse TERT (mTERT) RNA. This ribozyme can trigger transgene activity not only also in mTERT-expressing cells but hTERT-positive cancer cells. Importantly, the ribozyme could selectively induce activity of the suicide gene, a herpes simplex virus thymidine kinase gene, in cancer cells expressing the TERT RNA and thereby specifically hamper the survival of these cells when treated with ganciclovir. The mTERT-targeting ribozyme will be useful for evaluation of the RNA replacement approach as a cancer gene therapeutic tool in the mouse model with syngeneic tumors.