Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 41
Filtrar
1.
J Colloid Interface Sci ; 581(Pt A): 21-30, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-32768732

RESUMO

Lanthanide ion (Ln3+)-doped nanoscale hydroxyapatites (nHAp) with tunable luminescence have attracted increasing attention due to their potential applications as useful biomedical tools (e.g., imaging and clinical therapy). In this study, we reported that doping Terbium (III) ions (Tb3+) in self-activated luminescent nHAp via a facile hydrothermal reaction, using trisodium citrate (Cit3-), generates unique emission-tunable probes known as Cit/Tb-nHAp. The morphology, crystal phase, and luminescence properties of these Cit/Tb-nHAp probes are studied in detail. Moreover, the results demonstrate that the luminescence of self-activated nHAp originates from the carbon dots trapped within the nHAp crystals, in which partial energy transfer occurs from carbon dots (CDs) to Tb3+. The color tunability is successfully achieved by regulating the addition of Cit3-. Biocompatibility study indicates that when co-cultured with C6 glioma cells in vitro for 3 days, ≤800 ppm Cit/Tb-nHAp is not cytotoxic for C6 glioma cells. We also present in vitro data showing efficient cytoplasmic localization of transferrin conjugated Cit/Tb-nHAp into C6 glioma cells by fluorescence cell imaging. We have successfully engineered Cit/Tb-nHAp, a promising biocompatible agent for future in vitro and in vivo fluorescence bioimaging.

2.
Respir Res ; 21(1): 273, 2020 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-33076916

RESUMO

BACKGROUND: Immunoglobulin G4-related lung disease (IgG4-RLD) is the pulmonary manifestation of a systemic fibroinflammatory disease characterized by lymphoplasmacytic infiltration with an abundance of IgG4-positive plasma cells. Long-term clinical course and outcomes of IgG4-RLD remain unclear. We aimed to identify clinical characteristics, treatment outcomes, and longitudinal pulmonary function changes in patients with IgG4-RLD according to the radiologic classification. METHODS: Chest computed tomography findings of 37 subjects were classified into five subtypes: solid nodular, bronchovascular, alveolar interstitial, round ground glass opacity, and alveolar consolidative. Radiologic treatment outcomes and longitudinal pulmonary function changes were compared among the different radiologic subtypes. RESULTS: The mean age of the subjects was 55.6 years, and 78.4% were male. Among the five radiologic subtypes, alveolar consolidative and solid nodular type were most common, accounting for approximately 29.7% each of the total cases. Prednisone with or without azathioprine was administered to 31 patients (median treatment duration 14 months). In the treated patients, serial images showed complete response or partial response in 77.4%. However, relapse was documented in 25.0% of those who showed complete or partial response. In patients whose longitudinal lung function data were available (n = 20), the lung function was found to be stable during follow-up. Alveolar consolidative type showed the highest complete response rate, whereas alveolar interstitial type showed the lowest response rate, either complete or partial. CONCLUSIONS: Most patients showed a favorable outcome with regards to radiologic improvement and maintenance of pulmonary function; however, the response differed according to the radiologic subtype.

3.
Small ; : e2004861, 2020 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-33103373

RESUMO

Stable battery operation involving high-capacity electrode materials such as tin (Sn) has been plagued by dimensional instability-driven battery degradation despite the potentially accessible high energy density of batteries. Rational design of Sn-based electrodes inevitably requires buffering or passivation layers mostly in a multi-stacked manner with sufficient void inside the shells. However, undesirable void engineering incurs energy loss and shell fracture during the strong calendaring process. Here, this study reports an inverse design of freestanding 3D graphene electrodes sequentially passivated by capacity-contributing Sn and protective/buffering TiO2 . Monodisperse polymer bead templates coated with inner TiO2 and outer SnO2 layers generate regular macropores and 3D interconnected graphene framework while the inner TiO2 shell turns inside out to fully passivate the surface of Sn nanoparticles during the thermal annealing process. The prepared 3D freestanding electrodes are simultaneously buffered by electronically conductive and flexible graphene support and ion-permeable/mechanically stable TiO2 nanoshells, thus greatly extending the cycle life of batteries more than 5000 cycles at 5 C with a reversible capacity of ≈520 mAh g-1 with a high volumetric energy density.

4.
Redox Biol ; 37: 101760, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-33096425

RESUMO

Superoxide dismutase 1 (SOD1) binds copper and zinc ions and is one of three superoxide dismutases responsible for destroying free superoxide radicals in the body. Reactive oxygen species (ROS), including free superoxide radicals, play important roles in colitis. However, the role of SOD1 in oxidative stress under colitis remains unclear. Here, we examined the role of SOD1 in the DSS-induced mouse model of colitis. SOD1 deficiency resulted in severe oxidative stress with body weight loss, epithelial barrier disruption and decreased antioxidant enzyme activities. The levels of neutrophils, monocytes, pro-inflammatory CD11c+ macrophages and CD11b+CD103- dendritic cells (DCs) were increased, while anti-inflammatory CD206+ macrophages and CD11b-CD103+ DCs were decreased, in DSS-treated SOD1-knockout (KO) mice compared to DSS-treated wild-type mice. Furthermore, rescue of SOD activity in SOD1-KO mice by oral gavage of B. amyloliquefaciens SOD (BA SOD) significantly ameliorated enhanced DSS-induced colitis in these mice by suppressing p38-MAPK/NF-κB signaling, which can induce inflammation and apoptosis. Taken together, our results suggest that SOD1-mediated inhibitory responses play a crucial role in limiting the development of DSS-induced colitis, and that BA SOD is a promising candidate for treating colitis.

5.
Sci Rep ; 10(1): 15620, 2020 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-32973215

RESUMO

In patients with idiopathic pulmonary fibrosis (IPF), the effects of antifibrotic agents on the prognosis remain unclear. This study aimed to investigate the impact of antifibrotic treatment on the risks of mortality, hospitalisation, and acute exacerbation in real-world patients with IPF. A total of 1213 IPF patients (biopsy-proven cases: 405) were included in this retrospective study. Propensity score matching was used to adjust for differences in baseline characteristics between patients who received antifibrotic treatment and who did not. A Cox proportional hazard model was used to compare the risks of all-cause mortality, hospitalisation, acute exacerbation, and mortality following acute exacerbation between the two groups. From the 1213 patients, 474 matched pairs were generated. The mean age of the patients in the matched cohort was 65.8 years and 82.8% were men. The median follow-up duration was 27 months. Antifibrotic treatment significantly reduced the risks of mortality [hazard ratio (HR), 0.59; 95% confidence interval (CI), 0.48-0.72; p < 0.001], all-cause hospitalisation (HR 0.71), respiratory-related hospitalisation (HR 0.67), acute exacerbation (HR 0.69), and mortality after acute exacerbation (HR 0.60). Our results suggest that antifibrotic treatment may reduce the risks of all-cause mortality, hospitalisation, acute exacerbation, and mortality after acute exacerbation in patients with IPF.

6.
Yonsei Med J ; 61(2): 154-160, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31997624

RESUMO

PURPOSE: Recently, obstetric massive transfusion protocols have shifted toward early intervention. This study aimed to develop a prediction model for transfusion of ≥5 units of packed red blood cells (PRBCs) during cesarean section in women with placenta previa. MATERIALS AND METHODS: We conducted a cohort study including 287 women with placenta previa who delivered between September 2011 and April 2018. Univariate and multivariate logistic regression analyses were used to test the association between clinical factors, ultrasound factors, and massive transfusion. For the external validation set, we obtained data (n=50) from another hospital. RESULTS: We formulated a scoring model for predicting transfusion of ≥5 units of PRBCs, including maternal age, degree of previa, grade of lacunae, presence of a hypoechoic layer, and anterior placentation. For example, total score of 223/260 had a probability of 0.7 for massive transfusion. Hosmer-Lemeshow goodness-of-fit test indicated that the model was suitable (p>0.05). The area under the receiver operating characteristics curve (AUC) was 0.922 [95% confidence interval (CI) 0.89-0.95]. In external validation, the discrimination was good, with an AUC value of 0.833 (95% CI 0.70-0.92) for this model. Nomogram calibration plots indicated good agreement between the predicted and observed outcomes, exhibiting close approximation between the predicted and observed probability. CONCLUSION: We constructed a scoring model for predicting massive transfusion during cesarean section in women with placenta previa. This model may help in determining the need to prepare an appropriate amount of blood products and the optimal timing of blood transfusion.


Assuntos
Transfusão de Sangue , Cesárea , Modelos Biológicos , Placenta Prévia/terapia , Adulto , Calibragem , Feminino , Humanos , Modelos Logísticos , Idade Materna , Análise Multivariada , Nomogramas , Gravidez , Probabilidade , Curva ROC , Estudos Retrospectivos , Adulto Jovem
7.
Int J Mol Sci ; 20(24)2019 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-31817673

RESUMO

MicroRNAs (miRNAs) can be used to target a variety of human malignancy by targeting their oncogenes or tumor suppressor genes. The developmental endothelial locus-1 (Del-1) might be under miRNA regulation. This study investigated microRNA-137 (miR-137) function and Del-1 expression in triple-negative breast cancer (TNBC) cells and tissues. Del-1 mRNA and miRNA-137 levels were determined via qRT-PCR in breast cancer cells (MDA-MB-231, MCF7, SK-BR3, and T-47D) and tissues from 30 patients with TNBC. The effects of miR-137 on cell proliferation, migration, and invasion were determined using MTT assays, wound healing, and Matrigel transwell assays. The luciferase reporter assay revealed direct binding of miR-137 to the 3'-UTR of Del-1. miR-137 inhibited cell proliferation, migration, and invasion of MDA-MB-231 cells. Among the 30 TNBC specimens, miR-137 was downregulated and Del-1 level in plasma was significantly elevated relative to normal controls. It is concluded that miR-137 regulates Del-1 expression in TNBC by directly binding to the Del-1 gene and cancer progression. The results implicate miR-137 as a new therapeutic biomarker for patients with TNBC.


Assuntos
Proteínas de Ligação ao Cálcio/metabolismo , Moléculas de Adesão Celular/metabolismo , Proliferação de Células/fisiologia , MicroRNAs/metabolismo , Neoplasias de Mama Triplo Negativas/metabolismo , Proteínas de Ligação ao Cálcio/genética , Moléculas de Adesão Celular/genética , Linhagem Celular Tumoral , Proliferação de Células/genética , Ensaio de Imunoadsorção Enzimática , Regulação Neoplásica da Expressão Gênica/genética , Regulação Neoplásica da Expressão Gênica/fisiologia , Humanos , MicroRNAs/genética , Plasmídeos/genética , Neoplasias de Mama Triplo Negativas/genética
8.
ACS Nano ; 13(12): 14357-14367, 2019 Dec 24.
Artigo em Inglês | MEDLINE | ID: mdl-31755706

RESUMO

Design of freestanding electrodes incorporated with redox-active organic materials has been limited by the poor intrinsic electrical conductivity and lack of methodology driving the feasible integration of conductive substrate and the organic molecules. Single-walled carbon nanotube (SWCNT) aerogels, which possess continuous network structure and high surface area, offer a three-dimensional electrically conducting scaffold. Here, we fabricate monolithic organic electrodes by coating a nanometer-scale imide-based network (IBN) that possesses abundant redox-active sites on the 3D SWCNT scaffold. The substantially integrated 3D monolithic organic electrodes sustain high electrical conductance through a 3D electronic pathway in their compressed form (∼21 µm). A thin and controllable layer (<8 nm) of IBN organic materials has a strong adhesion onto the ultra-lightweight and conductive substrate and facilitates multielectron redox reactions to deliver a specific capacity of up to 1550 mA h g-1 (corresponding to the areal capacity of ∼2.8 mA h cm-2). The redox-active IBN in synergy with the 3D SWCNT scaffold can enable superior electrochemical performances compared to the previously reported organic-based electrode architectures and inorganic-based electrodes.

9.
Ann Hematol ; 98(10): 2311-2318, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31432214

RESUMO

The role of adjunctive corticosteroid in septic shock remains debatable, and its role has not been assessed in neutropenic patients. We evaluated whether hydrocortisone reduces 28-day mortality in neutropenic patients with septic shock. We conducted a retrospective cohort study between January 2012 and May 2017 at a tertiary care center in South Korea. Patients who developed septic shock treated with at least one vasopressor and whose absolute neutrophil count was < 1000 cells/µL were included. Patients were classified into a steroid and a no-steroid group. The primary outcome of the study was 28-day mortality. Propensity score matching was used to adjust baseline characteristics and disease severity between the groups. Of the 287 patients analyzed, 189 were classified in the no-steroid group and 98 in the steroid group. Fifty propensity score-matched pairs were compared for the study outcomes. We found no significant difference in 28-day mortality between patients treated with and without steroid after propensity score matching (38.0% and 42.0%, respectively; p = 0.838). Incidences of pneumonia and gastrointestinal bleeding were more frequent in the steroid group, but it was not statistically significant after matching. In conclusion, adjunctive hydrocortisone was not associated with reduced 28-day mortality in neutropenic patients with septic shock.


Assuntos
Hidrocortisona/administração & dosagem , Neutropenia , Choque Séptico , Adulto , Idoso , Feminino , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/mortalidade , Humanos , Hidrocortisona/efeitos adversos , Incidência , Masculino , Pessoa de Meia-Idade , Mortalidade , Neutropenia/complicações , Neutropenia/tratamento farmacológico , Neutropenia/mortalidade , Pneumonia/etiologia , Pneumonia/mortalidade , Estudos Retrospectivos , Choque Séptico/complicações , Choque Séptico/tratamento farmacológico , Choque Séptico/mortalidade , Fatores de Tempo
10.
Artigo em Inglês | MEDLINE | ID: mdl-31354255

RESUMO

Background: Frequent development of adverse events and consequent low adherence are major barriers in the wide use of roflumilast. Asian patients may be more susceptible to adverse events due to low BMI. In this study, we aimed to determine if a dose-escalation strategy is useful to improve the drug adherence rate. Methods: This was a randomized, prospective, open-label, single-blind study to compare the adherence rate to roflumilast according to a dose-escalation or conventional dose strategy in patients with COPD in South Korea. Patients were randomized into two groups (1:1), either roflumilast 500 µg once daily for 12 weeks or roflumilast 250 µg once daily for 4 weeks, and then 500 µg for 12 weeks. The primary outcome was the percentage of patients prematurely discontinuing roflumilast due to adverse events. Results: A total of 55 patients were randomly assigned to either a conventional-dose group (n=28) or a dose-escalation group (n=27). Discontinuation rates of roflumilast due to adverse events were 46.4% for the conventional-dose group and 59.3% for the dose-escalation group. The median time to discontinuation was not different between groups (58 days for the conventional-dose group, 56 days for the dose-escalation group, p=0.629). In a multivariate analysis, older age was a significant risk factor for drug discontinuation. Conclusion: High discontinuation rates of roflumilast were observed in both groups regardless of the dose-escalation strategy. The frequent discontinuation suggests that the dose-escalation strategy may not be useful in Asian patients. Clinical trial: This study is registered at www.ClinicalTrials.gov with identifier number NCT02018432.


Assuntos
Aminopiridinas/administração & dosagem , Benzamidas/administração & dosagem , Adesão à Medicação , Inibidores da Fosfodiesterase 4/administração & dosagem , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Fatores Etários , Idoso , Aminopiridinas/efeitos adversos , Benzamidas/efeitos adversos , Ciclopropanos/administração & dosagem , Ciclopropanos/efeitos adversos , Feminino , Humanos , Masculino , Inibidores da Fosfodiesterase 4/efeitos adversos , Estudos Prospectivos , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Fatores de Risco , Seul , Método Simples-Cego , Fatores de Tempo , Resultado do Tratamento
11.
Vaccine ; 37(29): 3820-3824, 2019 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-31151800

RESUMO

BACKGROUND: The demand on effective and safe anthrax vaccine is increasing as a part of the preparedness for possible bioterrorism in the future. We performed a randomized, single-blind, placebo controlled phase II clinical study to evaluate the immunogenicity and safety of a novel recombinant protective antigen (rPA) anthrax vaccine, GC1109, in healthy adult volunteers. METHODS: Participants were randomized to experiment groups (0.3 mL, 0.5 mL, and 1.0 mL of GC1109) or placebo group (normal saline 0.5 mL) in 2:2:2:1 ratio. They received respective vaccines intramuscularly at 0, 4 and 8 weeks. Immunogenicity was evaluated by seroconversion rate and geometric mean titer (GMT) of lethal toxin neutralizing assay (TNA) and anti-PA IgG by ELISA. Safety was assessed by laboratory tests, and solicited and unsolicited adverse events on diary cards. RESULTS: 30, 29, 30 participants were randomized to 0.3, 0.5, and 1.0 mL of GC1109 groups, respectively, while 15 to placebo group. 92 participants received all three doses. In per-protocol analysis, TNA GMTs at week 12 were 296.5, 285.2, and 433.2 in the three groups, respectively. Seroconversion rates measured by ELISA were 100% at week 12 in the three groups. Local and systemic vaccine-related adverse events were frequent; however, most of them were mild, and no serious events were observed. CONCLUSIONS: A new rPA anthrax vaccine GC1109 was immunogenic after three doses of intramuscular administration, and was well-tolerated.

12.
Exp Neurobiol ; 28(2): 172-182, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31138988

RESUMO

Rheb (Ras homolog enriched in the brain) is a small GTPase protein that plays an important role in cell signaling for development of the neocortex through modulation of mTORC1 (mammalian-target-of-rapamycin-complex-1) activity. mTORC1 is known to control various biological processes including axonal growth in forming complexes at the lysosomal membrane compartment. As such, anchoring of Rheb on the lysosomal membrane via the farnesylation of Rheb at its cysteine residue (C180) is required for its promotion of mTOR activity. To test the significance of Rheb farnesylation, we overexpressed a farnesylation mutant form of Rheb, Rheb C180S, in primary rat hippocampal neurons and also in mouse embryonic neurons using in utero electroporation. Interestingly, we found that Rheb C180S maintained promotional effect of axonal elongation similar to the wild-type Rheb in both test systems. On the other hand, Rheb C180S failed to exhibit the multiple axon-promoting effect which is found in wild-type Rheb. The levels of phospho-4EBP1, a downstream target of mTORC1, were surprisingly increased in Rheb C180S transfected neurons, despite the levels of phosphorylated mTOR being significantly decreased compared to control vector transfectants. A specific mTORC1 inhibitor, rapamycin, also could not completely abolish axon elongation characteristics of Rheb C180S in transfected cells. Our data suggests that Rheb in a non-membrane compartment can promote the axonal elongation via phosphorylation of 4EBP1 and through an mTORC1-independent pathway.

13.
J Korean Med Sci ; 34(15): e120, 2019 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-31001937

RESUMO

Bronchial thermoplasty is a nonpharmacological treatment for severe asthma that delivers thermal energy to the bronchial walls and reduces hypertrophied smooth muscle mass. Previous studies have shown its efficacy and safety, resulting in approval from the Food and Drug Administration in 2010. In Korea, the first bronchial thermoplasty was carried out in 2014; 4 patients have undergone the procedure so far. This case series presents the medical history and treatment outcomes of these 4 patients. All patients presented with uncontrolled asthma despite optimal medical treatment. Bronchial thermoplasty was performed at the right lower lobe, left lower lobe, and both upper lobes in order at 3-week intervals. All procedures were performed under general anesthesia. Two patients had significant decreases in exacerbations and required a lower dose of inhaled corticosteroids after the procedure. One patient had slightly fewer exacerbations but failed to reduce the use of systemic corticosteroids. One patient had no change in symptoms. One limitation of bronchial thermoplasty is the difficulty of predicting clinical responders. However, since more therapeutic options are needed in the management of severe asthma, especially T2-low asthma, discussion with experts about the feasibility and necessity of bronchial thermoplasty will ensure the best possible care.


Assuntos
Asma/terapia , Termoplastia Brônquica , Corticosteroides/uso terapêutico , Agonistas de Receptores Adrenérgicos beta 2/uso terapêutico , Adulto , Asma/diagnóstico , Asma/tratamento farmacológico , Broncoscopia , Feminino , Fluoroquinolonas/uso terapêutico , Fluticasona/uso terapêutico , Volume Expiratório Forçado , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia , Xinafoato de Salmeterol/uso terapêutico , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X
14.
Pharmacoepidemiol Drug Saf ; 28(4): 507-514, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30848013

RESUMO

PURPOSE: We aimed to evaluate the efficacy and safety of rivaroxaban in thromboprophylaxis compared with those of aspirin in real-world patients who underwent hip arthroplasty using nationwide claims data. METHODS: Patients aged more than or equal to 18 years with at least one hip arthroplasty including total and partial hip replacements and hip replacement revisions during July 2009 to June 2013 were identified from the Health Insurance Review and Assessment (HIRA) database. The study outcome was incidence rate of thromboembolic events and anticoagulation-related major bleeding within 90 days of hip arthroplasty. RESULTS: The incidence of overall venous thromboembolism (VTE) within 90-day postsurgery was significantly higher in the aspirin cohort than it was in the rivaroxaban cohorts. Bleeding events associated with pharmacological thromboprophylaxis in patients who received rivaroxaban were not significantly different from that in aspirin-treated patients. In aspirin cohorts, 65.7% of patients received less than 3-week treatment while about half received a less than 14-day treatment, and 31.7% received more than 3-week treatment in the rivaroxaban cohort. CONCLUSIONS: This study demonstrates that rivaroxaban was more effective in preventing VTE following hip arthroplasty without raising bleeding risks in clinical settings. Age more than or equal to 80 years, women, and a history of thromboembolism were the risk factors of VTE incidence.


Assuntos
Anticoagulantes/administração & dosagem , Artroplastia de Quadril/efeitos adversos , Aspirina/administração & dosagem , Hemorragia Pós-Operatória/epidemiologia , Rivaroxabana/administração & dosagem , Tromboembolia Venosa/epidemiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/efeitos adversos , Aspirina/efeitos adversos , Feminino , Seguimentos , Humanos , Incidência , Masculino , Anamnese/estatística & dados numéricos , Pessoa de Meia-Idade , Hemorragia Pós-Operatória/induzido quimicamente , República da Coreia/epidemiologia , Fatores de Risco , Rivaroxabana/efeitos adversos , Fatores Sexuais , Resultado do Tratamento , Tromboembolia Venosa/etiologia , Tromboembolia Venosa/prevenção & controle
15.
J Thorac Dis ; 10(10): 5784-5795, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30505486

RESUMO

Background: Macrolide antibiotics are the most important pharmacological agents for the treatment of nontuberculous mycobacterial disease. We investigated the incidence of acute cardiovascular events in patients taking macrolides for nontuberculous mycobacterial disease and determined the difference in risk between clarithromycin and azithromycin. Methods: A population-based retrospective cohort study was conducted in South Korea using the Health Insurance Review and Assessment Service database. Patients ≥40 years treated with macrolide for nontuberculous mycobacteria (NTM) between 2011 and 2015 were examined. The primary outcome was hospitalization or emergency department visit for cardiovascular disease along with acute myocardial infarction, cerebrovascular disease, and cardiac arrhythmia. The standardized incidence ratio (SIR) for cardiovascular disease was calculated by comparing the patients with the general population in the year 2013. Cox proportional hazard model was used to compare the risk between clarithromycin and azithromycin. Results: In total, 16,525 patients with nontuberculous mycobacterial disease treated with macrolide were included; 13,870 received clarithromycin and 2,655 received azithromycin. The cardiovascular incidence was significantly higher in patients with nontuberculous mycobacterial disease than in the age- and sex-stratified general population [SIR, 1.44; 95% confidence interval (CI), 1.27-1.61]. The risk was not significantly different between patients treated with clarithromycin and azithromycin (adjusted hazard ratio, 0.90; 95% CI, 0.65-1.24). Conclusions: The incidence of cardiovascular disease was significantly higher in patients treated with macrolide for nontuberculous mycobacterial disease than in the general population. This risk was not different between patients treated with clarithromycin and azithromycin.

16.
J Korean Med Sci ; 33(47): e292, 2018 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-30450023

RESUMO

Background: We investigated the incidence of active tuberculosis among patients with inflammatory bowel disease (IBD) treated with tumor necrosis factor (TNF) inhibitors, with or without latent tuberculosis infection (LTBI). Methods: The study was performed at a Korean tertiary referral center between January 2011 and June 2017. In total, 740 patients with IBD who underwent LTBI screening tests and were followed-up for ≥ 1 year after TNF inhibitor treatment initiation were enrolled. LTBI was detected on the basis of tuberculin skin test results, interferon-gamma release assay results, chest X-ray findings, and previous tuberculosis treatment history. The patients were classified into LTBI (n = 84) or non-LTBI (n = 656) group. The risk of developing tuberculosis in each group was assessed on the basis of standardized incidence ratio (SIR) and 95% confidence interval (CI) for active tuberculosis. Results: Mean patient age was 33.1 years, and patients with Crohn's disease were predominant (80.7%). Within 1 year after the initiation of TNF inhibitor treatment, 1 patient in the LTBI group (1/84; 1.2%) and 7 patients in the non-LTBI group (7/656; 1.1%) developed active tuberculosis. The overall 1-year incidence of tuberculosis among the patients was significantly higher than that among the general population (SIR, 14.0; 95% CI, 7.0-28.0), and SIR was not affected by LTBI status (LTBI group: 14.5, 95% CI, 2.0-102.6; non-LTBI group: 14.0, 95% CI, 6.7-29.4). Conclusion: Patients with IBD undergoing TNF inhibitor treatment showed a higher 1-year incidence of tuberculosis than the general population irrespective of LTBI status.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Doenças Inflamatórias Intestinais/tratamento farmacológico , Tuberculose/diagnóstico , Fator de Necrose Tumoral alfa/imunologia , Adalimumab/uso terapêutico , Adulto , Doença de Crohn/tratamento farmacológico , Doença de Crohn/patologia , Feminino , Seguimentos , Humanos , Incidência , Doenças Inflamatórias Intestinais/patologia , Infliximab/uso terapêutico , Tuberculose Latente/diagnóstico , Tuberculose Latente/epidemiologia , Masculino , Pessoa de Meia-Idade , República da Coreia , Estudos Retrospectivos , Centros de Atenção Terciária , Tuberculose/epidemiologia , Adulto Jovem
17.
Respir Med ; 143: 109-115, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30261981

RESUMO

OBJECTIVES: We aimed to investigate the usefulness of routine chest radiograph (CXR) examinations for patients with inflammatory arthritis treated with a tumor necrosis factor (TNF) inhibitor in terms of (i) the role of CXR in baseline latent tuberculosis infection (LTBI) screening and (ii) detecting asymptomatic active tuberculosis after TNF inhibitor initiation. METHODS: From January 2011 to June 2017, 469 patients with inflammatory arthritis were enrolled in the study at a tertiary referral center in South Korea. At our institution, CXR was performed for all patients undergoing a tuberculin skin test (TST) and/or an interferon-gamma release assay (IGRA) at the LTBI screening visit. LTBI treatment was determined by (i) positive TST or IGRA or (ii) CXR findings suggestive of spontaneously healed tuberculosis. After TNF inhibitor initiation, patients were recommended to undergo CXR at a specified interval. RESULTS: Of 469 patients, 187 were treated for LTBI. Among them, 181 patients were treated for LTBI because of a positive TST or IGRA result. TST was considered positive if induration size was ≥10 mm. The remaining six patients were considered positive on the basis of CXR findings compatible with spontaneously healed tuberculosis, such as noncalcified nodules with distinct margins and fibrotic linear opacity, despite demonstrating negative results for TST and IGRA. Thus, CXR had a diagnostic value as a baseline LTBI test in 6 (1.3%) patients. After TNF inhibitor initiation, 2 patients who had respiratory symptoms were diagnosed with active tuberculosis. For asymptomatic patients, routine CXR follow-up could not detect any case of active pulmonary tuberculosis within 1 year (n = 219) or after 1 year (n = 217). CONCLUSIONS: CXR should be performed as one of the LTBI screening tests for patients with inflammatory arthritis in a tuberculosis-prevalent country. However, after TNF inhibitor treatment, routine CXR follow-up was not advantageous.


Assuntos
Antirreumáticos/administração & dosagem , Antirreumáticos/efeitos adversos , Artrite/tratamento farmacológico , Tuberculose Latente/diagnóstico por imagem , Tuberculose Latente/etiologia , Radiografia Torácica , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Adalimumab/administração & dosagem , Adalimumab/efeitos adversos , Adalimumab/farmacologia , Adulto , Anticorpos Monoclonais/administração & dosagem , Anticorpos Monoclonais/efeitos adversos , Anticorpos Monoclonais/farmacologia , Antirreumáticos/farmacologia , Estudos de Coortes , Etanercepte/administração & dosagem , Etanercepte/efeitos adversos , Etanercepte/farmacologia , Feminino , Humanos , Inflamação , Infliximab/administração & dosagem , Infliximab/efeitos adversos , Infliximab/farmacologia , Masculino , Pessoa de Meia-Idade , República da Coreia , Estudos Retrospectivos
18.
Food Sci Biotechnol ; 27(3): 715-724, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30263797

RESUMO

Long-term aging of Yakju, a traditional Korean liquor made of rice and Nuruk (a fermentation agent), causes browning and odor and flavor development. This study investigated the effects of heat-treated Nuruk (50-80 °C, 30 min) on Yakju quality. The saccharogenic powers and glucoamylase, α-amylase, and carboxypeptidase activities were similar in non-heat-treated Nuruk and that treated at 50 °C. However, acidic protease and alcohol dehydrogenase decreased above 50 °C. The content of nitrogen-containing compounds was inversely proportional to the heat-treatment temperature. Compounds that cause off-flavors decreased at 50-60 °C, but increased at 70-80 °C, whereas compounds that provide fragrance increased at 50-60 °C. Sensory evaluation indicated that bad taste attributes were higher in Yakju produced using non-heat-treated Nuruk. Therefore, heat treatment of Nuruk at 50 °C can be adopted as a method for improving Yakju quality, as enzymatic activities that affect color, aroma, and taste are regulated.

19.
Obstet Gynecol Sci ; 61(4): 489-496, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30018903

RESUMO

Objective: To describe the clinical outcomes of frozen-thawed embryo transfer (FET) with artificial preparation of the endometrium, using a combination of estrogen (E2) and progesterone (P4) with or without a gonadotropin-releasing hormone agonist (GnRHa), and the modified natural cycle (MNC) with human chorionic gonadotropin (hCG) trigger. Methods: In this retrospective study, we evaluated 187 patients during 3 years (February 2012-April 2015). The patients were allocated to the following treatment groups: group A, comprising 113 patients (181 cycles) who received GnRHa+E2+P4; group B, comprising 49 patients (88 cycles) who received E2+P4; and group C, comprising 25 patients (42 cycles) who received hCG+P4. The inclusion criteria were regular menstrual cycles (length 24-35 days) and age 21-45 years. Results: The primary outcome of the study - implantation rate (IR) per embryo transferred - was not statistically different among the 3 groups. Similar results were found for the IRs with fetal heartbeat per embryo transferred (68/181 [37.6%] in group A vs. 22/88 [25.0%] in group B vs. 14/42 [33.3%] in group C) and for the live birth rates (LBRs) per embryo transferred (56/181 [30.9%] in group A vs. 18/88 [20.5%] in group B vs. 11/42 [26.2%] in group C). Conclusion: Although the pregnancy outcomes were better in the hormone therapy with GnRHa group, hormone therapy FET with GnRHa for pituitary suppression did not result in significantly improved IRs and LBRs when compared with hormone therapy FET without GnRHa or MNC FET.

20.
PLoS One ; 13(7): e0198756, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29975703

RESUMO

This study aims to compare the latent tuberculosis infection (LTBI) screening strategy of interferon-gamma release assay (IGRA)-alone and in combination with tuberculin skin tests (TSTs) before the initiation of tumor necrosis factor (TNF) inhibitor treatment in patients with inflammatory arthritis. Between January 2011 and June 2017, we enrolled 476 patients who were followed up for ≥1 year after the TNF inhibitor initiation in a tertiary referral center in South Korea. Inflammatory arthritis comprised rheumatoid arthritis in 266 (55.9%) and ankylosing spondylitis in 210 (44.1%) patients. The following strategies were used for LTBI screening during the study period: (i) from January 2011 to October 2014, the combination of TST and QuantiFERON-TB Gold In-Tube (QFT-GIT); (ii) between November 2014 and February 2015, QFT-GIT-alone and (iii) since March 2015, either the combination of TST and QFT-GIT or QFT-GIT-alone depending on the attending physician's choice. We compared the screening strategies of QFT-GIT alone and in combination with TST. Overall, 338 (71.0%) patients received LTBI screening tests using the combination of TST and QFT-GIT, and 138 (29.0%) received QFT-GIT-alone. In addition, the LTBI tests were positive in 159 (47.0%) of 338 patients using the combination tests, and 43.8% (148/338) required LTBI treatment. Meanwhile, the LTBI tests were positive in 32.6% (45/138) of QFT-GIT-alone patients, and 30.4% (42/138) required LTBI treatment. Among 338 patients who received combination tests, 2 patients developed active tuberculosis within 1 year after the TNF inhibitor initiation. Of patients who received QFT-GIT-alone, no patient developed tuberculosis. In conclusion, among patients who received QFT-GIT-alone, the number of patients who required LTBI treatment declined compared to the TST and QFT-GIT combination, and none developed active tuberculosis within 1 year, suggesting that QFT-GIT-alone could be a potential screening strategy for diagnosing LTBI in patients with inflammatory arthritis in South Korea.


Assuntos
Artrite Reumatoide/diagnóstico , Testes de Liberação de Interferon-gama , Tuberculose Latente/diagnóstico , Teste Tuberculínico , Adulto , Idoso , Idoso de 80 Anos ou mais , Artrite Reumatoide/complicações , Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/patologia , Feminino , Humanos , Inflamação/complicações , Inflamação/tratamento farmacológico , Inflamação/patologia , Tuberculose Latente/tratamento farmacológico , Tuberculose Latente/patologia , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Espondilite Anquilosante/diagnóstico , Espondilite Anquilosante/tratamento farmacológico , Espondilite Anquilosante/patologia , Centros de Atenção Terciária , Fator de Necrose Tumoral alfa/antagonistas & inibidores
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA