Chonnam medical journal最新文献

This study aimed to investigate changes in candidemia incidence, species distribution, antifungal susceptibility, initial antifungal use, and mortality trends in Korea before and during the COVID-19 pandemic. A retrospective analysis was conducted on candidemia cases from two tertiary care hospitals in Korea between 2017 and 2022. Data were compared between the pre-pandemic (2017-2019) and pandemic (2020-2022) periods. Statistical methods included incidence rate ratios (IRRs) and multivariate Cox regression to assess 30-day mortality risk factors. A total of 470 candidemia cases were identified, with 48.7% occurring pre-pandemic and 51.3% during the pandemic. While the overall incidence of candidemia remained similar across the two periods (IRR 1.15; p=0.13), the incidence in intensive care units (ICUs) significantly increased during the pandemic (IRR 1.50; p<0.01). The distribution of Candida species did not differ significantly between the two periods. Fluconazole non-susceptibility in C. albicans markedly decreased (10.0% vs. 0.9%, p<0.01), whereas C. glabrata exhibited a significant rise in caspofungin non-susceptibility during the pandemic (0% vs. 22.4%, p<0.01). Echinocandin use increased (21.8% vs. 34.4%; p<0.01), while fluconazole use declined (48.0% vs. 32.8%; p<0.01). Although the 30-day mortality rate was higher during the pandemic (60.2% vs. 57.2%), the difference was not statistically significant (p=0.57). The findings highlight the need for region-specific surveillance and tailored management strategies to improve candidemia outcomes, especially during healthcare disruptions like the COVID-19 pandemic.

Mild cognitive impairment (MCI) is a condition characterized by noticeable deficits in memory retrieval or other cognitive domains than the individuals with the same age but do not significantly interfere with daily functioning. It represents an intermediate stage between normal aging and dementia, and a crucial opportunity for intervention prior to extensive cognitive decline. Transcranial direct current stimulation (tDCS), a non-invasive neuromodulation technique, has shown promise in enhancing global cognition in MCI. Current evidence suggests that tDCS provides short-term cognitive benefits, particularly in memory and attention, with moderate effects observed in processing speed. However, its impact on executive function and language remains inconsistent, highlighting variability in individual responses and study methodologies. While long-term efficacy remains uncertain due to limited longitudinal research and short follow-up periods, safety concerns, especially with self-administered tDCS such as in home-based tDCS, underscore the need for proper training and device innovation. Despite this, tDCS is a promising, portable tool for cognitive enhancement in MCI, with potential to delay progression to dementia. Addressing challenges such as optimizing stimulation protocols, accounting for individual neuroanatomical variability, and establishing long-term effectiveness will be essential for its broader clinical adoption. Future research should focus on standardizing methodologies, incorporating biomarkers to predict treatment response, and conducting large-scale, longitudinal studies to refine its therapeutic application.

Redox imbalances, which result from excessive production of reactive oxygen species (ROS) or malfunctioning of the antioxidant system, are the source of oxidative stress. ROS affects all structural and functional components of cells, either directly or indirectly. In addition to causing genetic abnormalities, excessive ROS also oxidatively modifies proteins by protein oxidation and peroxidation and alters lipid structure via advanced lipoxidation, decreasing function and promoting damage or cell death. On the other hand, low levels of ROS constitute important redox-signaling molecules in various pathways that maintain cellular homeostasis and regulate key transcription factors. As a result, ROS can affect various cellular processes, such as apoptosis, migration, differentiation, and proliferation. ROS can act as signaling molecules, controlling various normal physiological activities at the cellular level. Furthermore, there is an increasing body of evidence indicating the role of ROS in various clinical conditions. In this review, we will summarize the role of ROS in physiological and pathological processes and antioxidant action during oxidative stress.

High-Performance Liquid Chromatography (HPLC) is an essential analytical technique in the biopharmaceutical industry, crucial for the separation, identification, and quantification of complex biological molecules such as monoclonal antibodies and recombinant proteins. It plays a vital role in assessing the purity, potency, and stability of biopharmaceutical products, which are critical for regulatory approval. HPLC offers high resolution and sensitivity, allowing for the detection of small quantities of compounds in complex samples. Its versatility is evident in various modes, including reversed-phase, ion-exchange, size-exclusion, and affinity chromatography. However, challenges remain, such as selecting the appropriate stationary phase, addressing peak overlapping and matrix interference, and optimizing operational parameters like flow rate and mobile phase composition. Standardization and method validation are essential for ensuring reproducibility, accuracy, and regulatory compliance in HPLC analyses. The need for reliable reference materials and calibration methods is also a significant challenge. Recent advancements in HPLC technology, including ultra-high-performance liquid chromatography (UHPLC) and hybrid systems that integrate HPLC with mass spectrometry, are helping to overcome these challenges by enhancing sensitivity, resolution, and analysis speed. In summary, as biopharmaceutical products grow more complex, HPLC's role will continue to evolve, highlighting the need for ongoing research and development to refine this critical analytical tool.

This study hypothesized that oxidative stress in women with diminished ovarian reserve (DOR) can influence in vitro fertilization (IVF) outcomes. Therefore, we investigated the effect of intraovarian platelet-rich plasma (PRP) administration on the oxidative stress state in follicular fluid in DOR patients. Following the follow-up of a retrospective cohort study, follicular fluid was isolated from twenty-five DOR patients. The total antioxidant capacity (TAC), catalase (CAT), and superoxide dismutase (SOD) activities, total oxidant status (TOS), and malondialdehyde (MDA) levels were measured before and after intraovarian PRP administration using colorimetric methods. The levels of estradiol (E2), anti-mullerian hormone (AMH), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were measured at baseline and after two menstrual cycles. The quantity and quality of oocytes and embryos were assessed at both stages. Following intraovarian PRP injection, an increase in TAC levels, elevated CAT and SOD activities, and a decline in TOS and MDA content in the follicular fluid of DOR women were observed. AMH and E2 hormone levels also increased post-treatment. Additionally, a relative increase in the number and quality of oocytes and embryos was observed after a single PRP injection. Intraovarian PRP injection improves the oxidative state of follicular fluid and potentially enhances IVF outcomes in DOR women.

Type 2 diabetes mellitus (T2DM) is a widespread metabolic condition characterized by elevated glucose levels followed by deficiency in insulin secretion. Metformin notably decreased the incidence of T2DM by 31% and it exerts its effects through various signaling pathways. Databases searched included PubMed, Google Scholar, and Scopus from 2000 to 2024. One of the primary mechanisms involves AMPK activation which causes reduced lipogenesis and improved fatty acid oxidation in the liver and muscles. Key molecules affected by metformin include acetyl-CoA carboxylase (ACC) and sterol regulatory element-binding protein 1c (SREBP-1c), both involved in lipid synthesis regulation. Aerobic exercise has also emerged as a crucial component in managing T2DM due to its improved effects on hyperglycemia and insulin sensitivity. Key signaling pathways affected in T2DM include the PI3K/Akt, AMP-activated protein kinase (AMPK), and MAPK/ERK pathways which play essential roles in regulating glucose homeostasis, glycogenesis, and insulin secretion. When comparing the mechanisms and efficacy of aerobic exercise and metformin, it becomes evident that aerobic exercise primarily enhances physical fitness and metabolic function, while metformin exerts its effects through biochemical pathways involving AMPK activation. Aerobic exercise and metformin are effective for managing T2DM, though they operate through different mechanisms. Regular aerobic exercise improves insulin sensitivity, enhances cardiovascular health, and promotes weight loss, while metformin primarily decreases hepatic gluconeogenesis and enhances insulin secretion. Understanding the intricate signaling pathways affected by metformin and aerobic exercise provides valuable insights into its mechanisms of action and clinical implications for treating diabetic patients effectively.

Colonoscopy is a key procedure for the early detection of colorectal cancer. Despite its importance, the discomfort associated with colonoscopy often requires sedation, and the ideal sedation regimen remains to be determined. In this prospective randomized controlled trial, patients scheduled for colonoscopy were randomly assigned to two different sedation protocols. Group A received a combination of midazolam and propofol, while group B was given midazolam and pethidine. The study analyzed data from 51 patients, with 23 in group A and 28 in group B. The incidence of adverse events was similar across both groups. Additionally, no significant differences were observed in cecal intubation times or total procedure durations. Notably, group A had a lower frequency of required postural changes (1.0±.7 vs. 1.5±0.7, p=0.02) and a reduced rate of manual compression (52.2% vs. 82.1%, p=0.02). There were no significant differences between the groups regarding subjective pain or overall satisfaction. Both sedation regimens were found to be safe and effective. The midazolam and propofol combination was associated with a smoother procedure, evidenced by fewer postural adjustments and less manual compression needed during colonoscopy.

COVID-19 can lead to pulmonary complications, including organizing pneumonia. Steroids are essential in treating post-COVID-19 organizing pneumonia. However, research on the clinical benefits of initiating steroid treatment early for this condition is limited. To investigate the steroid initiation time in its association with treatment duration and corticosteroid dose for treating post-COVID-19 organizing pneumonia, we analyzed the data of 91 patients with post-COVID-19 organizing pneumonia at Chonnam National University Hospital between October 2020 and December 2022. Patients were categorized into early and late groups based on time from COVID-19 diagnosis to steroid initiation time for organizing pneumonia. The mean time interval between COVID-19 infection and steroid initiation time for treating organizing pneumonia, was 18.4±8.6 days. Within the early treatment group (treatment initiated <18.4 days after COVID-19), which included 55 patients, the mean duration of steroid treatment was 43.1±18.3days. In contrast, the late treatment group (initiated ≥18.4 days after COVID-19), which consisted of 36 patients, had a longer mean duration of steroid treatment 59.1±22.6 days) (p<0.01). Regarding corticosteroid dosing, the early treatment group had an average dosage of 0.5±0.3 mg/kg/day, in contrast to the late group, which averaged 0.8±0.3 mg/kg/day (p<0.01). Regression analysis showed steroid initiation time significantly influenced treatment duration (β=0.80 , p<0.01) and dosage (β=0.03, p<0.01). The clinical benefits of early steroid treatment for post-COVID-19 organizing pneumonia may lie in its association with reduced steroid treatment duration and dosage.