Apoptotic Cell-Mimetic Polymers for Anti-Inflammatory Therapy

Mitsuhiro Ebara 전남대학교 의과학연구소 2019 전남의대학술지 Vol.55 No.1

The field of biomaterials has seen a strong rejuvenation due to the new potential to modulate immune system in our body. This special class of materials is called “immunomodulatory biomaterials”. Generally, three fundamental strategies are followed in the design of immunomodulatory biomaterials: (1) immuno-inert biomaterials, (2) immuno-activating biomaterials, and (3) immuno-tolerant biomaterials. While many applications of immuno-inert biomaterials such as biocompatible medical implants have been already proposed in the past decades, the ability to engineer biological activity into synthetic materials greatly increases the number of their potential uses and improves their performance in more traditional applications. The major focus of researchers is now set on developing immuno-tolerant biomaterials for anti-inflammatory therapies. In this review, we therefore introduce recent developments of immuno-tolerant biomaterials. Especially we introduce an apoptotic cell membrane- inspired polymer and its post-inflammatory effects on immune cells in this article.

Comparison of Endoscopic Variceal Ligation and Endoscopic Variceal Obliteration in Patients with GOV1 Bleeding

홍형주,전충환,이두현,조은애,박선영,조성범,박창환,주영은,김현수,최성규,유종선 전남대학교 의과학연구소 2013 전남의대학술지 Vol.49 No.1

The aim of this study was to compare the efficacy, rebleeding rates, survival, and complications of endoscopic variceal ligation (EVL) with those of endoscopic variceal obliteration (EVO) in patients with acute type 1 gastroesophageal variceal (GOV1)bleeding. Data were collected retrospectively at a single center. A total of 84 patients were selected (20 patients underwent EVL; 64 patients underwent EVO) from February 2004 to September 2011. Their clinical characteristics, laboratory results, vital signs,Child-Pugh score, Model for End-stage Liver Disease (MELD) score, and overall mortality were evaluated. There were no significant differences in baseline characteristics between the two groups. The success rate in initial control of active bleeding was not significantly different between the EVL and EVO groups (18/20 EVL, or 90.0%, compared with 62/64 EVO, or 96.9%; p=0.239). The early rebleeding rate was also not significantly different between the groups (3/18 EVL, or 16.7% compared with 17/62 EVO,or 27.4%; p=0.422). The late rebleeding rate of the EVL group was lower than that of the EVO group (3/18 EVL, or 16.7%, compared with 26/59 EVO, or 44.1%; p=0.042). The time-to-rebleeding was 594 days for the EVL group and 326 days for the EVO group (p=0.054). In the multivariate analysis, portal vein thrombosis (PVT) was a significant risk factor for early rebleeding. Hepatocellular carcinoma (HCC) and previous history of bleeding were significant risk factors for very late rebleeding. In conclusion, EVL is better than EVO in reducing late rebleeding in acute GOV1 bleeding. HCC, PVT,and previous bleeding history were significant risk factors for rebleeding.

Effect of Atorvastatin-Eluting Stents in a Rabbit Iliac Artery Restenosis Model

임경섭,정명호,배인호,박준규,박대성,김종민,김정하,조동련,심두선,박근호,홍영준,안영근 전남대학교 의과학연구소 2013 전남의대학술지 Vol.49 No.3

Statins have pleiotropic effects, which include the inhibition of neointima hyperplasia,the inhibition of vascular inflammation, and platelet inhibition. The aim of this study was to examine the effect of an atorvastatin-eluting stent (AES) in a rabbit iliac artery overstretch restenosis model. Ten rabbits were used in this study (10 rabbits, 10 iliac arteries for each stent). An AES and paclitaxel-eluting stent (PES) were implanted in the left and right iliac arteries in a rabbit (2 stents in each rabbit). The stents were deployed with oversizing (stent/artery ratio 1.3:1), and histopathologic analysis was assessed at 28 days after stenting. There were no significant differences in the injury score, lumen area, or inflammation score. There were significant differences in the neointimal area (0.7±0.18 mm2 in the AES group vs. 0.4±0.25 mm2 in the PES group,p<0.01), in the percentage stenosis area (14.8±5.06% in the AES group vs. 10.5±6.80%in the PES group, p<0.05), and in the fibrin score (0.4±0.51 in the AES group vs. 2.7±0.48 in the PES group, p<0.001). Although the AES did not suppress neointimal hyperplasia compared with the PES, it showed a superior arterial healing effect in a rabbit iliac artery overstretch restenosis model.

A Case of Membranous Glomerulonephritis with Superimposed Anti-Neutrophil Cytoplasmic Antibody-Associated Rapidly Progressive Crescentic Glomerulonephritis

김유형,최대은,김해리,함영록,전재웅,정사라,이강욱,나기량 전남대학교 의과학연구소 2015 전남의대학술지 Vol.51 No.2

Idiopathic membranous glomerulonephritis (IMGN) is commonly diagnosed in adultswith proteinuria. Rapid deterioration of renal function is a rare complication of IMGN,except when accompanied by renal vein thrombosis, malignant hypertension, or otherunderlying disease, including lupus nephritis. Here, we present a case of rapid deteriorationof renal function in a patient with MGN superimposed with anti-neutrophil cytoplasmicantibody (ANCA)-associated rapidly progressive crescentic glomerulonephritis(RPGN). Overall, about 20 cases of MGN with ANCA-associated RPGN have beenreported. This case of biopsy-proven MGN with ANCA-associated RPGN is the firstto be reported in Korea.

Percutaneous Forceps Retrieval of an Embolized Amplatzer Duct Occluder

Yi-Sik Kim,이상록 전남대학교 의과학연구소 2015 전남의대학술지 Vol.51 No.2

Transcatheter closure of patent ductus arteriosus with the Amplatzer duct occludershows excellent results. However, there is a risk of device embolization after deployment. We report the case of a 33-year-old man in whom an embolized Amplatzer devicewas retrieved from the right pulmonary artery by a percutaneous method. We also reviewthis uncommon severe complication and offer technical tips for percutaneousremoval.

Comparison of Minimally Invasive Total Hip Arthroplasty versus Conventional Hemiarthroplasty for Displaced Femoral Neck Fractures in Active Elderly Patients

박경순,오창선,윤택림 전남대학교 의과학연구소 2013 전남의대학술지 Vol.49 No.2

Fractures of the femoral neck in elderly patients can be treated by internal fixation,hemiarthroplasty, or total hip arthroplasty (THA), and the treatment modality used should be determined on the basis of considerations of the degree of fracture displacement,age, functional demands, and the risk factors for surgery and anesthesia. We studied 85 active elderly patients who underwent minimally invasive two-incision THA or conventional bipolar hemiarthroplasty (BHA) within 2 weeks of injury for the treatment of acute displaced femoral neck fractures. Patients were followed up for a minimum of 24 months. The average operation times were 70 minutes in the THA group and 46 minutes in the BHA group (p=0.002), and average blood losses during the perioperative period were 921 cc and 892 cc, respectively (p=0.562). In the THA group, the average postoperative Harris hip score was 88.3 and the average Western Ontario and McMaster University score was 28.8, whereas in the BHA group the corresponding scores were 80.4 (p=0.006) and 32.5 (p=0.012), respectively. There were 2 cases of hip dislocation in the THA group, and 2 cases in the BHA group underwent conversion to THA. Our short-term follow-up results were better for minimally invasive two-incision THA than for conventional BHA for the treatment of acute displaced femoral neck fractures in active elderly patients.

Laparoscopic Management of Complicated Urachal Remnants

정희종,권휘안,한동엽 전남대학교 의과학연구소 2013 전남의대학술지 Vol.49 No.1

Managing persistent and symptomatic urachal anomalies requires wide surgical excision of all anomalous tissue with a cuff of bladder tissue via the open approach. We report 7 cases with complete laparoscopic removal of symptomatic urachal remnants with or without a cuff of bladder tissue. We expected that this technique would be less invasive and have lower morbidity. We report on the feasibility of this approach, including efficacy and outcomes. Eight patients with a mean age of 36.5 years who had symptomatic urachal diseases underwent laparoscopic excision between July 2004 and July 2012. With the use of four ports, the urachal remnant was dissected transperitoneally and then removed via the umbilicus port. The clinical results of laparoscopic urachal remnant excision as a minimally invasive surgery, the perioperative records, and pathologic results were evaluated. There were no intraoperative or postoperative complications. Mean surgery time was 2.7 hours. Mean hospital stay was 14.6 days. The patients with bladder cuff resection had a long admission and Foley catheterization period (mean, 14.4 and 11 days). Pathological evaluations were 6 cases of infected urachal cysts, 1 case of infected urachal sinus, and 1 case of urachal adenocarcinoma. We found no postoperative complications including any symptom recurrence or voiding difficulty during a mean follow-up of 46.3 months. The perioperative surgical outcomes achieved infection control and symptomatic relief and additionally good cosmesis. Complete laparoscopic removal of symptomatic urachal remnants with or without a cuff of bladder tissue seems to be a safe, effective, and better cosmetic alternative with the advantages of a minimally invasive approach.

Predictive Efficacy of Interim Positron Emission Tomography/Computed Tomography (PET/CT) for the Treatment of Aggressive Lymphoma

양덕환,정성훈,안재숙,김여경,민정준,범희승,이제중,김형준 전남대학교 의과학연구소 2015 전남의대학술지 Vol.51 No.3

The prognostic value of whole-body positron emission tomography/computed tomography(PET/CT) with 18F-fluoro-2-deoxy-D-glucose (FDG) shortly after the onset of inductionchemotherapy or mid treatment could help to predict long-term clinical outcomesin patients with Hodgkin’s or Non-Hodgkin’s lymphoma. However, FDG is nota tumor-specific substance, and it may accumulate to the point of being detected in avariety of benign conditions or at physiologic anatomical sites, which may give rise tofalse-positive interpretation. In an attempt to standardize the reporting criteria for interimPET/CT, the First International Workshop on Interim PET in Lymphoma suggestedvisual response criteria with the Deauville five-point scale, and the standardizeduptake value (SUV) has been investigated in comparison with this visual system. Aquantitative approach using the measurement of maximal SUV (SUVmax) or the reductionrate of SUVmax (ΔSUVmax) might be more appropriate in early-responsePET/CT for reducing false-positive rates or for decreasing interobserver variability ininterpretation. In this review, the predictive efficacy of PET/CT is discussed for thetreatment of aggressive lymphoma, especially in terms of an interim PET/CT-basedprognostic model.

Activation of the Renal PI3K/Akt/mTOR Signaling Pathway in a DOCA-Salt Model of Hypertension

마성권,최준석,주수연,김하연,김창성,배은희,이종은,김수완 전남대학교 의과학연구소 2012 전남의대학술지 Vol.48 No.3

The present study investigated the changes that occurred in the mammalian target of rapamycin (mTOR) signaling pathway in the kidney as a result of deoxycorticosterone acetate (DOCA)-salt hypertension. Rats were implanted with DOCA strips (200mg/kg) 1 week after unilateral nephrectomy and were then supplied with 0.9% saline to drink. Four weeks after DOCA implantation, systolic blood pressure (SBP) was measured by use of the tail-cuff method. The expression levels of phosphorylated phosphatidylinositol-3-kinase (PI3K), Akt, and mTOR, as well as the protein expression levels of ED-1 and cyclooxygenase-2 (COX-2), transforming growth factor-β1 (TGF-β1), α-smooth muscle actin (SMA), caspase-3, Bax, and Bcl-2, were then examined in the kidney by semiquantitative immunoblotting. DOCA-salt hypertensive rats were found to have significantly increased SBP as well as an increased kidney weight-to-body weight ratio. Moreover, the phosphorylation of PI3K, Akt, and mTOR was increased in the kidney of DOCA-salt hypertensive rats compared with the control, as was the protein expression of ED-1, COX-2, TGF-β1, and α-SMA. The expression levels of caspase-3 and Bax were increased significantly, whereas Bcl-2 expression was decreased. In conclusion,the phosphorylation of PI3K/Akt/mTOR was increased in the kidney of DOCA-salt hypertensive rats.

Two Different Successful Angioplasty Methods in Patients with Stenotic Coronary Artery Ectasia

Suk-Kyu Oh,Seung-Woon Rha,Hyungdon Kook,Dong Hyeok Kim,Seo Young Ho,Sun Hwa Kim,Cheol Ung Choi,오동주 전남대학교 의과학연구소 2012 전남의대학술지 Vol.48 No.3

There is no current guideline for percutaneous coronary angioplasty in stenotic ectatic coronary arteries because of the heterogeneity of the coronary artery morphology. We report two successful angioplasty cases in coronary artery ectasia with different clinical scenarios. One case showed atherosclerotic stenosis in the ectatic portion of the right coronary artery that was aggravated after a coronary artery bypass graft. In this case,balloon angioplasty alone without stenting showed acceptable results at the 6-month follow-up coronary angiography. In the other case, we used a peripheral artery balloon and stent for stenosis in the ectatic portion of a large coronary artery. Six-month follow-up coronary angiography showed excellent patency of the previously implanted peripheral stent.