• Title/Summary/Keyword: 치료부작용

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Efficacy and Safety during the Combination Therapy of Imipramine and Desmopressin in Primary Monosymptomatic Nocturnal Enuresis (어린이의 일차성 단일 증상성 야뇨증에서 Imipramine과 Desmopressin 복합 약물치료의 효과 및 안전성)

  • Yeo Ji-Hyun;Choi Jung-Youn;Chung Hyo-Seok;Lee Kyung-Soo;Ko Cheol-Woo;Kim Kyo-Sun;Kim Kee-Hyuk;Kim Jung-Soe;NamGoong Mee-Kyung;Park Young-Seo;Pai Ki-Soo;Yoo Kee-Hwan;Park Yong-Hoon
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.129-137
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    • 2004
  • Purpose : Nocternal enuresis is a common disorder. Tricyclic antidepressant and desmopressin have been accepted pharmacological treatment for this disorder We conducted a cooperative study to investigate the efficacy and adverse reactions of imipramine, desmopressin and combination treatment in children with primary monosymptomatic nocturnal enuresis(PMNE). Methods: Data from a large multicenter study were analysed. In the period of 8 months in 2002, the study comprised of 168 children(78 boys and 90 girls, 5 to 15 years old) with PMNE for imipramine, desmopressin or combination treatment. Before treatment a history, physical examination and laboratory tests were performed and the children were observed for 2 weeks. Response rate, adverse reactions and enuresis episodes after stopping drug administration were evaluated after 12-weeks of imipramine, desmopressin or combination of both. Results: After 4 weeks, the frequency of bed wetting in all treated patients decreased during treatment significantly Even though a 30-50%, reduction in the number of wet nights were 68.6%, 74.4% and 86.1% during 12 weeks treatment by imipramine, desmopressin and both of them respectively, there was no significant difference between them. The most common adverse reaction was decreased appetite from imipramine administration. But no serious drug-related adverse events were reported. Conclusion: Efficacy of the combination therapy of imipramine and desmopressin in PMNE appears not to be better than either drug alone. It is necessary to pay attention on account of adverse reactions during imipramine treatment even though imipramine and desmopressin were generally well tolerated.

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Cyclophosphamide in the Treatment of Idiopathic UIP and NSIP (통상성 간질성 폐렴과 비특이성 간질성 폐렴의 치료에 있어 Cyclophosphamide의 역할)

  • Jeon, Kyeongman;Chung, Man Pyo;Shin, Sung-Chul;Yu, Chang Min;Koh, Won-Jung;Suh, Gee Young;Kim, Hojoong;Kwon, O Jung;Kim, Tae Sung;Lee, Kyung Soo;Han, Joungho
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.2
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    • pp.175-187
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    • 2003
  • Background : Although corticosteroid and cytotoxic agent such as cyclophosphamide have been used for the treatment idiopathic interstitial pneumonia (IIP), efficacy of these toxic drugs are unclear because previous reports included the patients who did not undergo surgical lung biopsy and none evaluated the response according to histopathologic entities of IIP. To answer this, we retrospectively analyzed the treatment response and side effects of corticosteroids and cyclophosphamide therapy in patients with idiopathic UIP and NSIP. Methods : Among 61 patients with UIP and 26 patients with NSIP diagnosed by surgical lung biopsy at Samsung Medical Center from July 1996 to June 2002, those who received corticosteroid or cyclophosphamide therapy for at least 6 months and were followed for at least one year after the initiation of treatment were enrolled (32 UIP, 23 NSIP). Treatment response of 55 patients was assessed by ATS response criteria (clinical symptoms, pulmonary function test and radiological findings). Adverse reactions to either agent (42 cases of cyclophosphamide${\pm}$low-dose prednisolone, 49 cases of prednisolone alone) were also analyzed. Results : Irrespective of treatment regimen, NSIP showed more favorable response than UIP (6 months: 78.3% vs. 9.4%, 12 months: 69.6% vs. 9.4%, p<0.001). Cyclophosphamide showed comparable response to corticosteroid in NSIP while its efficacy was as poor as those of corticosteroid therapy in UIP. Significant adverse reaction to drug more frequently occurred in corticosteroid group (35.7%) than cyclophosphamide group (14.3%) (p=0.017). Conclusion : Cyclophosphamide is effective and more tolerable than corticosteroids in the treatment of idiopathic nonspecific interstitial pneumonia.

The Study of Normal Tissue Complication Probability(NTCP) for Radiation Pneumonitis by Effective Volume Method (유효체적 방법과 임상분석을 통한 방사선에 의한 정상 폐조직의 부작용 확률에 관한 연구)

  • Ahn Seung Do;Choi Eun Kyung;Yi Byong Yong;Chang Hyesook
    • Radiation Oncology Journal
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    • v.15 no.3
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    • pp.243-249
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    • 1997
  • Purpose : In radiation therapy, NTCF is very importart indicator of selecting the optimal treatment plan. In our study, we tried to find out usefullness of NTCP in lung cancer by comparng the incidence of radiation pneumonitis with NTCP. Materials and Methods : From August 1993 to December 1994, thirty six patients with locally advanced non=small cell lung cancer were treated by concurrent chemoradiation therapy. Total dose of radiation therapy was 6480cGy (120cGy, bid) and chemotherapeutlc agents were mitomycin C. vinblastion, cisplatin (2 cycles, 4 weeks interval). We evaluated the development of raniation pneumonitis by CT scan, chest x-rar and clinical symptoms. We used grading system of South Western Oncology Group (SWOG) for radiation pneumanitis. Dose Volume Histograms (DVH) were analyzed for ipsilateral and whole lung, Non uniform DVH was translated to uniform DVH by effective volume method. With these data, we calculated NTCP for ipsilateral and whole lung. Finally we compared the clinical results to NTCP. Results : Eight of thrity six patients developed radiation pneumonitis. Of these 8 patients , 6 had grade I severity and 2 had grade II. The average NTCP value cf the patients who showed radiation pneumonitis was significantly higher than that uf the patients without pneumonitis $(66\%\;vs.\;26.4\%)$. But the results of pulmonary function test was not correlated with NTCP. Conclusion : NTCP of lung is very good indicator for selecting rival treatment planning in lung cancer. According to the results of NTCP, it may be possible to adjust target volume and optimize target dose. In the near future, we are going to anaiyze the effect of hyperfractionation and concurrent chemotherapy in addition to NTCP.

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Neoadjuvant Chemotherapy and Radiation Therapy in Advanced Stage Nasopharyngeal Carcinoma (진행된 병기의 비인강암에서의 선행보조 항암화학요법과 방사선치료)

  • Hong Semie;Wu Hong-Gyun;Park Charn II
    • Radiation Oncology Journal
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    • v.17 no.4
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    • pp.275-280
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    • 1999
  • Purpose : To assess the feasibility and the toxicity of the neoadjuvant chemotherapy on the treatment of patients with locoregionally advanced nasopharyngeal carcinoma. Methods and Materials : We analyzed 77 previously untreated and histologically confirmed advanced stage nasopharyngeal carcinoma patients treated with neoadjuvant chemotherapy followed by radiation therapy at the Seoul National University Hospital between 1984 and 1996. The stage distribution was as follows : AJCC stage III-2, stage IV-75. Sixty-six patients received infusion of 5-FU (1000 mg/m$^2$, on Day 1$\~$5) and cisplatin (100 mg/m$^2$, on Day 1), eleven patients received infusion of 5-FU (1000 mg/m$^2$, on Day 1 $\~$5) and carboplatin (300 mg/m$^2$, on Day 1) as neoadjuvant chemotherapy Prior to radiation therapy. The median follow-up for surviving patients was 44 months. Results : The overall chemotherapy response rates were 87$\%$. The toxicities of chemotherapy were mild. Only 3 patients experienced Grade 3 toxicities (1 for cytopenia, 2 for nause/vomiting). The degree of radiation induced mucositis was not severe, and ten patients developed Grade 2 mucositis. The 5-year overall survival rates were 68$\%$ and the 5-year disease free survival rates were 65$\%$. The 5-year freedom from distant metastasis rates were 82$\%$ and 5-year locoregional control rates were 75$\%$. Conclusion : This single institution experience suggests that neoadjuvant chemotherapy improves overall survival and disease free survival for patients with advanced stage nasopharyngeal carcinoma without increase of toxicity.

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당뇨일기 - 인슐린 치료에도 합병증이?

  • Gwak, Jeong-Eun
    • The Monthly Diabetes
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    • s.240
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    • pp.60-61
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    • 2009
  • 당뇨병은 인슐린 분비 기능이 고장 났거나 잘 작동되지 않을 때 발생하는 질병이다. 이 때문에 근본적으로 인슐린 투여가 필요한데, 인슐린 치료 중에 부작용을 호소하는 당뇨병환자들이 많이 있어 이에 대한 적절한 이해와 대처가 필요하다.

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Pharmacologic Treatment of Essential Hypertension (고혈압의 약물 치료)

  • Shim, B.S.
    • Journal of Yeungnam Medical Science
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    • v.6 no.2
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    • pp.1-11
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    • 1989
  • 고혈압의 치료 목적은 부작용없이 지속적으로 혈압을 정상으로 유지하여 target organ의 손상을 막고 수명을 연장시키는데 있다. 이러한 목적을 달성하기 위하여 특히 약제 선택이 아주 중요하며 Stepped care approach와 Individualized approach을 동시에 이용하면 좋은 효과를 얻을 것으로 기대된다.

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Reirradiation in Rcurrent Cervical Cancer Following Definite Radiation Therapy (근치적 방사선치료 후 재발한 자궁경부암의 재 방사선치료)

  • Kim, Jin-Hee;Choi, Tae-Jin;Kim, Ok-Bae
    • Radiation Oncology Journal
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    • v.19 no.3
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    • pp.230-236
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    • 2001
  • Purpose : To evaluate treatment results in terms of local control, complications and survival after reirraidiation in recurrent cervical cancer following definite radiation therapy. Material and methods : From November 1987 through March 1998, eighteen patients with recurrent cervical cancer following definite radiation therapy were subsequently treated with reirradiation at Keimyung University Dongsan Medical Center. In regard to the initial FIGO stage, one patient was stage la, five were stage IIa, three were IIb, two were IIb and two were IVa. The age range was 37 to 79 years old with median age of 57. The time interval from initial definite radiation therapy to recurrence ranged from 6 to 122 months with a median of 58 months. The recurrent sites were the uterine cervix in seven patients, vagina in ten and pelvic lymph node in one. Reirradiation was peformed with external radiation and intracavitary radiation in twelve patients, external radiation and implantation in four and external radiation alone in two. The range of external radiation dose was $2,100\~5,400\;cGy$ and the range of the total radiation dose was $3,780\~8,550\;cGy$. The follow-up periods ranged from 8 to 20 months with median of 25 following reirradiation. Results : Fourteen of eighteen patients $(78\%)$ had local control just after reirradiation. The two year disease free survival (2YDFS) rate was $53.6\%$. There were statistically significant differences in the 2YDFS according to both recurrent site (2YDFS $28.5\%$ in uterine cervix, $71.4\%$ in vagina, (p=0.03)) and the total dose (2YDFS $71.8\%$ in >6,000 cGy , $25\%$ in $\leq6,000$ cGy, p=0.007). Seven of ten patients who were followed for more than 20 months remain alive and disease free (7/18, $39\%$). Patients treated with external radiation and intracavitary radiation had a higher rate of 2YDFS. Seven patients including 4 patients with no local control experienced local failure in the uterus or vagina and two patients died with distant metastasis. Complications included rectal bleeding in 3 patients, bowel obstruction treated with surgery in two, hematuria in one, radiation cystitis in two, soft tissue swelling in two and vaginal necrosis spontaneously healed in one. There was no statistical difference in complications according to the total dose or the time to recurrence from initial radiation. Conclusion : In patients with recurrence following definite radiation therapy in the uterine cervical cancer, reirradiation may be effective but requires an effort to reduce radiation induced severe complications.

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