• Title/Summary/Keyword: 약제투여

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Gefitinib-Related Interstitial Pneumonia (Gefitinib 투여 후 발생한 간질성 폐렴)

  • Lee, Ho Jin;Nam, Seung Bum;Jung, Jae Wook;Na, Im Il;Kim, Cheol Hyeon;Ryoo, Baek-Yeol;Choe, Du Whan;Kang, Jin Hyung;Lee, Jae Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.2
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    • pp.134-139
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    • 2007
  • Gefitinib is a novel drug used to treat advanced non-small cell lung cancer. However, drug-related interstitial pneumonia is a major life-threatening side effect, which has a worldwide prevalence of 0.3-0.4%. In Japan, the prevalence is high as 3-4% but the actual frequency in Korea has not been officially assessed. We report two cases of gefitinib-induced interstitial lung disease during the treatment of non-small cell lung cancer. High-resolution computerized tomography (HRCT) of one case showed nonspecific ground glass opacity and the chest x-ray of another case showed diffuse bilateral ground glass opacity. The former patient showed a rapid good response to corticosteroid treatment whereas the latter died despite receiving aggressive treatment with high dose corticosteroid and empirical antibiotics.

Radioprotective Effects of Cysteamine, Isothiouronium Derivatives and Their Combinations with a Phosphorothioate (Cysteamire, Isothiouronium 유도체(誘導體) 및 이들과 Phosphorothioate와의 혼합물(混合物)들의 방사선(放射線) 방호효과(防護效果))

  • Kim, You-Sun;Kim, Ok-Hee
    • Journal of Radiation Protection and Research
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    • v.7 no.1
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    • pp.11-16
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    • 1982
  • Cysteamine(Mercaptoethyiamine, MEA), S,2-Aminoethylisothiouronium Bromide. HBr (AET), and S-(2-Aminoethyl) Dihydrogen Phosphorothioate (WR-638) were prepared and radioprotective effects of these chemicals and their combinations against $^{60}Co$ ${\gamma}-ray$ radiation were studied ,in irradiated ICR mice. Intraperitonially administered chemicals or their combinations resulted drug deaths in cases of MEA, AET, and their combinations, whereas there were a slight or no drug death in cases of WR-638 and the combination of AET with WR-638. All tested chemicals and their combinations yielded radioprotective effects against $^{60}Co$ $\gamma-ray$ radiation. An additive radioprotection effect was observed in case of the combination of AET with WR-638.

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A Case of Gemcitabine Plus Nanoparticle Albumin Bound (nab)-paclitaxel Induced Cardiotoxicity in Patient of Metastatic Pancreatic Cancer (전이성 췌장암 환자에서 Gemcitabine과 Nanoparticle Albumin Bound (nab)-Paclitaxel로 인한 허혈성 심독성 발생 1례)

  • Mi Kang Kim;Se Woo Park
    • Journal of Digestive Cancer Research
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    • v.5 no.1
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    • pp.62-65
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    • 2017
  • Pancreatic cancer is an aggressive disease and despite the efforts of the past few decades, the 5-year overall survival (OS) rate remains disappointing and does not exceed 10% in Korea. Especially, only 15-20% of patients are candidates for surgical resection because most patients are diagnosed with locally advanced or metastatic disease, and their only treatment approach is palliative chemotherapy. Since the first chemo-regimen of Gemcitabine and Nanoparticle albumin bound (nab) - paclitaxel was brought to clinical practice in 2013, the improvement in overall survival, progression-free survival, and response rate was achieved in patients with metastatic pancreatic adenocarcinoma. We report the case of a young patient with cardiogenic shock accompanied by multi-organ failure after 4th cycle Gemcitabine and nab-paclitaxel chemotherapy with partial response.

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Clinical Observations of the Drug Induced Hepatitis during Antituberculosis Medication (항결핵제 투여 중 나타난 간기능 장애의 임상적 고찰)

  • Park, Moon-Hwan;Yun, Sang-Won;Kim, Kung-Ho;Lee, Mung-Sun;Cho, Dong-Ill;Rhu, Nam-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.4
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    • pp.405-412
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    • 1994
  • Background: In Korea, the prevalence of tuberculosis and hepatitis is high, and combined therapy with rifampicin and pyrazinamide is used in tuberculosis, so drug induced hepatitis is not only problem of tuberculosis therapy but also cause of treatment failure. However most of recent reports on drug induced hepatitis during antituberculosis medication have dealt with its pathogenesis and have stressed the biochemical, and histopathological aspects of the disorder, whereas this study was designed primarily to provide information on the clinical features. Method: The subjects of study were 1414 patients treated with antituberculosis drugs on the department of chest medicine at National Medical Center during the 5-year 6-month period from January 1, 1988, to June 30, 1993. Retrospective analysis of clinical features for the 29 patients who developed drug induced hepatitis was done. Results: 1) The incidence of antituberculosis drug induced hepatitis was 2.1%. 2) Male to fema1e ratio of antituberculosis drug induced hepatitis was 2:1, but case rates among males and females were not significantly different. 3) Rates of drug induced hepatitis according to age distribution shows the most common incidence between 35 to 49 year old age group, but rates among groups of age were not significant1y different. 4) Drug induced hepatitis was most common in the case of moderate advanced pulmonary tuberculosis(rate is 2.78%), but rates among types of tuberculosis were not significant1y different. 5) 18 cases(62%) of antituberculosis drug induced hepatitis patients had no signs or symptoms. In remaining cases, they were nausea, vomiting, jaundice, hepatomegaly, icteric sclera, right upper quadrant tenderness in order. 6) 22 cases(76%) of antituberculosis drug induced hepatitis cases had occured within the first month. 7) The duration of abnormal liver function was $28{\pm}5$(Mean${\pm}$SD), ranged from 5 days to 180 days. 8) One case of antituberculosis drug induced hepatitis died. 9) The levels of abnormal GOT ranged from 64 to 1055U/L and GPT from 68 to 931U/L. Conclusion: There are no dicided predisposing factors of antituberculosis drug induced hepatitis, so it should be done biochemical monitoring as well as close monitoring for overt signs or symptoms of hepatitis to avoid the development of irreversible hepatic reaction, especially at the treatment of the first month.

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Clinical Characteristics of Paradoxical Response to Chemotherapy in Pulmonary Tuberculosis (항결핵제 사용 중 폐병변의 일시적 악화를 보인 환자의 임상상)

  • Kim, Soo-Hee;Chung, Hyo-Young;Lee, Ghie-Dong;Shin, Min-Ghie;Jung, Tae-Sik;Jin, Byung-Cheol;Kim, Hyun-Jung;You, Jin-Jong;Lee, Jong-Deog;Hwang, Young-Sil
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.1
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    • pp.27-35
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    • 2002
  • Background : The paradoxical response refers to an enlargement of old lesions or unexpected new ones during apparently adequate antituberculous therapy. This response has been reported in cases of intracranial tuberculoma, tuberculous lymphadenopathy, tuberculous pleurisy and pulmonary tuberculosis. However, there are few reports on its frequency and clinical characteristics. Materials and Methods : This study enrolled 205 patients who were treated with first line antituberculous agents for more than 6 months. We retrospectively studied 155 patients with pulmonary tuberculosis and 57 patients with pleural tuberculosis (7 patients had both) from July 1998 to March 2000. The patients were divided into the paradoxical response group and the non-paradoxical group. The clinical characteristics of the paradoxical response group and the non-paradoxical group. The clinical characteristics of the paradoxical group were investigated. Statistical analysis was done with an independent sample T-test and Chi-squared test. Results : 29 of the 205 patients(14.1%) had paradoxical response. Among the 29 patients, there were 19 pulmonary tuberculosis, 8 tuberculous pleurisy(2 patients had both). Paradoxical response appeared 32 days (mean 35 days in pulmonary tuberculosis, mean 25 days in tuberculous pleurisy) after the beginning of chemotherapy. The duration to regress less than half of initial chest lesion was 114 days in pulmonary tuberculosis and 124 days in tuberculous pleurisy, respectively. Most common clinical manifestation of paradoxical response patients was coughing in both pulmonary tuberculosis and tuberculous pleurisy. Male sex, high blood WBC count and high level of pleural fluid LDH were related with paradoxical response. Conclusion : These findings suggest that presponse usually appears 1 month and disappears within 4 months after the beginning of anti-tuberculous chemotherapy. Paradoxical response was relatively correlated with male sex, high blood WBC count and high level of pleural fluid LDH.

Radiation-induced Apoptosis is Differentially Modulated by PTK Inhibitors in K562 Cells (K562 백혈병 세포주에서 방사선에 의해 유도되는 Apoptosis에 미치는 PTK Inhibitors의 영향)

  • Lee Hyung Sik;Moon Chang Woo;Hur Won Joo;Jeong Su Jin;Jeong Min Ho;Lee Jeong Hyeon;Lim Young kin;Park Heon Joo
    • Radiation Oncology Journal
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    • v.18 no.1
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    • pp.51-58
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    • 2000
  • Purpose :The effect of PTK inhibitors (herbimycin A and genistein) on the induction of radiation-induced apoptosis in Ph-positive KS62 leukemia cell line was investigated. Materials and Methods :K562 cells in exponential growth phase were irradiated with a linear accelerator at room temperature. For 6 MV X-ray irradiation and drug treatment, cultures were initiated at 2×106 cells/mL. The cells were irradiated with 10 Gy. Stock solutions of herbimycin A and genistein were prepared in dimethyl sulphoxide (DMSO). After incubation at 37$^{\circ}C$ for 0$\~$48 h, the extent of apoptosis was determined using agarose gel electrophoresis and TUNEL assay. The progression of cells through the cell cycle after irradiation and drug treatment was also determined with flow cytometry. Western blot analysis was used to monitor bel-2, bel-X$_{L}$ and bax protein levels. Results :Treatment with 10 Gy X-irradiation did not result in the induction of apoptosis. The HMA alone (500 nM) also failed to induce apoptosis. By contrast, incubation of K562 cells with HMA after irradiation resulted in a substantial induction of nuclear condensation and fragmentation by agarose gel electro-phoresis and TUNEL assay. Genistein failed to enhance the ability of X-irradiation to induce DNA fragmentation. Enhancement of apoptosis by HMA was not attributable to downregulation of the bel-2 or bel-X$_{L}$ anti-apoptotic proteins. When the cells were irradiated and maintained with HMA, the percentage of cells in G2/M phase decreased to 30$\~$40$\%$ at 48 h. On the other hand, cells exposed to 10 Gy X-irradiation alone or maintained with genistein did not show marked cell cycle redistribution. Conclusion : We have shown that nanomolar concentrations of the PTK inhibitor HMA synergize with X-irradiation in inducing the apoptosis in Ph (+) K562 leukemia cell line. While, genistein, a PTK inhibitor which is not selective for p210$^{bcr/abl}$ failed to enhance the radiation induced apoptosis in KS62 cells. It is unlikely that the ability of HMA to enhance apoptosis in K562 cells is attributable to bel-2 family. It is plausible that the relationship between cell cycle delays and cell death is essential for drug development based on molecular targeting designed to modify radiation-induced apoptosis.

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The Role of Resectional Surgery for the Treatment of Localized Multi-drug Resistant Pulmonary Tuberculosis (국소 병변의 다제 내성 폐결핵 환자에서 폐절제술의 역할)

  • An, Chang-Hyeok;Ahn, Jong-Woon;Kang, Kyeong-Woo;Kang, Soo-Jung;Lim, Young-Hee;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.6
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    • pp.676-683
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    • 2000
  • Background : Surgery may have a role when medical treatment alone is not successful in patients with multidrug resistant (MDR) pulmonary tuberculosis (PTB). To document the role of resection in MDR PTB, we analyzed 4 years of our experience. Methods : A retrospective review was performed on thirteen patients that underwent pulmonary resection for MDR PTB between May 1996 and February 2000. All patients had organisms resistant to many of the first-line drugs including isoniazid (INH) and rifampicin (RFP). Results : The thirteen patients were $37.5{\pm}12.4$ years old (mean${\pm}$S.D.)(M : F=5:8), and their sputum was culture positive even with adequate medication for prolonged periods ($109.7{\pm}132.0$ months), resistant to 2-8 drugs including isoniazid and rifampin. All patients had localized lesion(s) and most (92.3%) had cavities. At least 3 sensitive anti-TB medications were started before surgery in all patients according to the drug sensitivity test. The preoperative $FEV_1$ was $2.37{\pm}0.83$ L. Lobectomy was performed in 11 patients and pleuropneumonectomy in two. Postoperative mortality did not occur, but pneumonia occurred as a complication in one (7.7%). After $41.5{\pm}58.9$ days (range 1~150 days) follow up, negative conversion of sputum culture was achieved in all patients within 5 months. Only one patient (7.7%) recurred 32 months after lung resection. Conclusion : When medical treatment alone is not successful, surgical resection can be a good treatment option in patients with localized MDR PTB.

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Application of unmanned helicopter on pest management in rice cultivation (무인 항공기 이용 벼 병해충 방제기술 연구)

  • Park, K.H.;Kim, J.K.
    • Journal of Practical Agriculture & Fisheries Research
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    • v.10 no.1
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    • pp.43-58
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    • 2008
  • This research was conducted to determine the alternative tool of chemical spray for rice cultivation using the unmanned helicopter(Yamaha, R-Max Type 2G-remote controlled system) at farmer's field in Korea. The unmanned helicopter tested was introduced form Japan. In Korea the application of chemicals by machine sprayer for pest management in rice cultivation has been ordinarily used at the farmer's level. However, it involved a relatively high cost and laborious for the small scale of cultivation per farm household. Farm population has been highly decreased to 7.5% in 2002 and the population is expected to rapidly reduce by 3.5% in 2012. In Japan, pest control depending on unmanned helicopter has been increased by leaps and bounds. This was due in part to the materialization of the low-cost production technology under agricultural policy and demand environmentally friendly farm products. The practicability of the unmanned helicopter in terms of super efficiency and effectiveness has been proven, and the farmers have understood that the unmanned helicopter is indispensable in the future farming system that they visualized. Also, the unmanned helicopter has been applied to rice, wheat, soybean, vegetables, fruit trees, pine trees for spraying chemicals and/or fertilizers in Japan Effect of disease control by unmanned helicopter was partially approved against rice blast and sheath blight. However, the result was not satisfactory due to the weather conditions and cultural practices. The spray density was also determined in this experiment at 0, 15, 30, and 60cm height from the paddy soil surface and there was 968 spots at 0cm, 1,560 spots at 15cm, 1,923 spots at 30cm, and 2,999 spots at 60cm height. However, no significant difference was found among the treatments. At the same time, there was no phytotoxicity observed under the chemical stray using this unmanned helicopter, nor the rice plant itself was damaged by the wind during the operation.

Clarithromycin Therapy for Scrub Typus (쯔쯔가무시(Tsutusgamushi)병에서 Clarithromycin의 치료 효과)

  • Kim, Soon;Jung, Eun Mi;Moon, Kyung Hyun;Yoe, Sung Yeob;Eum, Soo Jung;Lee, Joo Hyung;Jo, Sung Rae;Ma, Sang Hyuk
    • Pediatric Infection and Vaccine
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    • v.9 no.2
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    • pp.175-181
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    • 2002
  • Purpose : Scrub typhus(tsutsugamushi disease) is a febrile disease characterized by fever, rash, eschar, lymphadenopathy. Therapy with tetracycline(doxycycline) or chloramphenicol is currently recommended for the treatment for scrub typhus. But there are limitations in usage a tetracycline(doxycycline) for scrub typhus in the children. Recently, there was a report that azithromycin, a macrolide antibiotic was used for scrub typhus in pregnant woman successfully. So we evaluated the effectiveness of the Clarithromycin, other a macrolide antibiotic, for scrub typhus. Methods : Seven patients with scrub typhus at department of internal medicine and three patients with scrub typhus at department of pediatrics Masan Fatima Hospital were involved for this study. A serologic diagnosis for scrub typhus were performed by use of passive hemagglutination test. Clarithromycin(Abbott Laboratories, North Chicago, IL, USA) was administrated orally in a daily dose of 500 mg for adult patients and 15 mg/kg/bid/day for pediatric patients. Results : There were 7 cases of adult patients, varying from 28 to 76 years of age and 3 cases of pediatirc patients, varying from 4 to 7 years of age with scrub typhus. All of cases had fever, myalgia, headache, rash, eschar. Seven cases had positive passive hemagglutination test and eight cases had abnormal liver function. Mean duration for the removal of fever after medication was 1.3 day(1~2 days) and all cases were recovered without complications. Conclusion : Our results suggest that Clarithromycin therapy may be effective for scrub typhus.

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Clinical Features Affecting the Efficacy of Systemic Clonazepam for Management of Burning Mouth Syndrome (구강작열감증후군의 치료를 위한 전신적 클로나제팜의 투여 시 환자의 임상적 특징에 따른 효능의 차이에 관한 연구)

  • Min, Bo-Kyong;Jung, Jae-Kwang;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.37 no.3
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    • pp.161-167
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    • 2012
  • Burning mouth syndrome(BMS) is defined as chronic, painful burning sensation in the oral mucosa. Treatments for BMS include medication and psychiatric interventions. Capsaicin, alpha-lipoic acid, and topical and systemic clonazepam showed more effective in reducing the symptoms of BMS in the previous studies. The purpose of this study is to evaluate of the therapeutic efficacy of systemic clonazepam in BMS and to elucidate the relationships between such a efficacy and various clinical features, including age, pain intensity, pain duration, previous dental history and condition of oral mucosa. A retrospective clinical records audit was performed of patients diagnosed with BMS between January 2011 and August 2012. Patients were prescribed 0.5 mg clonazepam two times daily. Pain was assessed by patients on an 11-point numeric rating scale (NRS; 0 to 10) before and 1-2 weeks after systemic administration of clonazepam. The efficacy of clonazepam was evaluated in terms of patient's age, initial pain intensity, pain duration, presence or absence of precipitating event, condition of the tongue, presence or absence of denture. A total of 50 patients (46 women, 4 men) were included in this study. The patients were divided into two or three groups according to above clinical features. The amount of mean NRS reduction in patients with severe initial pain was $3.33{\pm}2.74$, whereas that in patients with mild initial pain was $1.64{\pm}1.54$. The amount of mean NRS reduction in oldest patients was $3.53{\pm}1.94$ (${\geq}$70yrs), and those in another younger patients were $2.88{\pm}1.80$(< 60yrs) and $1.54{\pm}2.86$(60yrs ${\leq}$ age < 70yrs), respectively. It was concluded that the older patients and the patients with higher intensity of initial pain tend to show better efficacy of clonazepam. However, There were no statistically significant differences according to pain duration, presence or absence of precipitating events, tongue fissuring, and wearing dentures.