• The Korean Journal of Pain
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• 제27권2호
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• pp.103-111
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• 2014

Nefopam (NFP) is a non-opioid, non-steroidal, centrally acting analgesic drug that is derivative of the nonsedative benzoxazocine, developed and known in 1960s as fenazocine. Although the mechanisms of analgesic action of NFP are not well understood, they are similar to those of triple neurotransmitter (serotonin, norepinephrine, and dopamine) reuptake inhibitors and anticonvulsants. It has been used mainly as an analgesic drug for nociceptive pain, as well as a treatment for the prevention of postoperative shivering and hiccups. Based on NFP's mechanisms of analgesic action, it is more suitable for the treatment of neuropathic pain. Intravenous administration of NFP should be given in single doses of 20 mg slowly over 15-20 min or with continuous infusion of 60-120 mg/d to minimize adverse effects, such as nausea, cold sweating, dizziness, tachycardia, or drowsiness. The usual dose of oral administration is three to six times per day totaling 90-180 mg. The ceiling effect of its analgesia is uncertain depending on the mechanism of pain relief. In conclusion, the recently discovered dual analgesic mechanisms of action, namely, a) descending pain modulation by triple neurotransmitter reuptake inhibition similar to antidepressants, and b) inhibition of long-term potentiation mediated by NMDA from the inhibition of calcium influx like gabapentinoid anticonvulsants or blockade of voltage-sensitive sodium channels like carbamazepine, enable NFP to be used as a therapeutic agent to treat neuropathic pain.

• Archives of Plastic Surgery
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• 제49권3호
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• pp.457-461
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• 2022

Kaposi's sarcoma (KS) is a cancer that causes patches of abnormal tissue to grow under the skin. It also occurs in the immunosuppressive population. KS is currently believed to be caused by infection with human herpes virus-8 (HHV-8) in non-human immunodeficiency virus patient. A 79-year-old female visited the outpatient clinic presenting with increasing number and size of palpable masses on both upper and lower extremities. She was first diagnosed as drug-erupted dermatitis and stopped her medications, but the symptoms got worse. We did partial biopsy, and KS with HHV-8 was diagnosed histopathologically. She planned to undergo further evaluations and proper treatments. This rare case suggests the need to consider a classic type of KS in the differential diagnosis of specific dermatologic symptoms such as macular, nodular, and darkish patches of upper or lower extremities in elderly patients. It is believed that this case helps to strengthen awareness of this rare disease.

• 한국정보처리학회:학술대회논문집
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• 한국정보처리학회 2022년도 춘계학술발표대회
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• pp.549-552
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• 2022

최근 소셜미디어 리뷰 데이터를 활용한 약물 이상 반응 탐지 연구가 활발히 진행되고 있지만, 약물을 복용하기 전 증상과 약물 이상 반응을 구분하지 못한다는 한계가 있다. 본 논문에서는 약물 이상 반응 탐지에서 약물 복용 전의 증상을 구분할 수 있는 Filtering Clinical BERT(FC-BERT) 모델을 제안하였다. FC-BERT 는 약물 복용 전 증상과 다른 약물에 대한 부작용 표현을 제거하기 위해 약물명이 나오기 전 모든 문장을 제거하는 필터링과 약물-부작용 쌍을 추출하는 모델을 사용했다. 성능 평가 실험을 위해 문장에 대한 ADE(Adverse Drug Event) 여부가 들어있는 ADE Corpus V2 데이터를 활용하였고 SPARK NLP 라이브러리에서 제공하는 ADE Pipeline 모델과 비교하여 성능 평가를 실시하였다. 실험 결과 필터링을 활용한 FC-BERT 모델이 기존 모델보다 정확도, 평균 정밀도, 평균 재현율, 평균 F1-score 가 모두 높은 결과를 보여주었다. 본 논문에서 제시한 모델은 기존 연구의 한계점을 보완하여 보다 정확한 약물 부작용 시그널을 탐지하는데 기여할 수 있을 것이다.

• 한국임상약학회지
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• 제22권1호
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• pp.30-40
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• 2012

In Korea, elderly population aged 65 and older are about 5.0% and 10.7% in 1990 and 2009, respectively. Since elderly people may experience physiologic changes with aging and their pharmacodynamic and pharmcokinetic parameters also have been undergone changes, several adverse drug reactions can occur more frequently than young people. Especially, neuropsychiatric adverse drug reactions such as delirium and drowsiness endanger elderly patients more. The purpose of this study is to evaluate the outpatient prescriptions using drug causing delirium and drowsiness in elderly patients aged 65 and older. We retrospectively reviewed prescriptions for elderly patients collected from four community pharmacies from January 2nd to February 1st, 2010. One pharmacy was located closed to a general hospital, and others were located closed to a internal medicine or an ENT clinic. The each number of the collected prescriptions was followings; Group A (n=496) from internal medicine department of a general hospital; Group B (n=44) from ENT department of general hospital; Group C (n=144) from internal medicine clinic; Group D (n=110) from ENT clinic. In result, in Group A, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.38 In Group B, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.09 In Group C, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.51. In Group D, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.72. Especially, in Group D, the percentage of prescription that drugs causing delirium or drowsiness per Rx prescribed more than 3 is 52.73% In all the 4 groups, over the 60% of drugs causing delirium and/or drowsiness per prescription of elderly patients were prescribed. It means elderly patients take 2 drugs causing delirium and/or drowsiness among 3 drugs, which is very serious. Frequently prescribed drugs causing delirium and/or drowsiness were followings; GI agents, antitussives & expectorants, histamine H1 antagonist, analgesics, antibiotics. Among these drugs, GI agents was high raking in all the 4 groups, and pharmacists should caution elderly patients when counseling. In the internal medicine groups (Group A,C), drugs concerning chronic diseases were prescribed frequently. In conclusion, pharmacist's role is important. Pharmacists are well informed of the drugs causing delirium or drowsiness and it is important to explain about ADRs slowly and easily to the elderly patients that receive drugs causing delirium or drowsiness. And institutional device is needed. For example, when doctors prescribe drugs for the elderly patients, message is needed that supply some informations about drugs causing delirium or drowsiness.

• Asian Pacific Journal of Cancer Prevention
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• 제15권24호
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• pp.10967-10970
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• 2015

Objective: To analyze the efficacy and survival associated factors of gefitinib combined with cisplatin and gemcitabine for advanced non-small cell lung cancer. Materials and Methods: A total of 57 patients with advanced non-small cell lung cancer (NSCLC), who received platinum-based chemotherapy regimens for more than 1 cycle, were treated with gefitinib combined with cisplatin and gemcitabine until disease progression. Efficacy, survival time and adverse reactions were observed. The Kaplan-Meier method was adopted for analysis of survival and Cox regression for associated influencing factors. Results: The patients were followed up until October 31, 2013, and the median follow-up time was 19 months. Of 57 patients, there were 4 (7.0%) with complete remission (CR), 8 (14.0%) with partial remission, 31 (54.4%) with stable disease, and 14 (24.6%) with disease progression. The remission rate was 21.1% and the disease control rate was 75.4%. The median progression-free survival (PFS) time and the median overall survival time were 10 months and 15.2 months. The one-year, two-year and three-year survival rates were 47.4%, 23.3% and 10.0%. Gender and pathological types were the independent risk factors influencing PFS time (P=0.028, P=0.009). Tumor pathological type and early efficacy were independent factors for the prognosis (P=0.018, P=0.000). Adverse reactions were mostly rashes of I~II degree and diarrhea and slightly increasing level of aminopherase. The skin adverse event incidence of III degree or above was 1.8% (1/57) and brain metastasis was foudn in 31.6% (18/57). Conclusions: Gefitinib combined with cisplatin andgemcitabine, is effective for patients with IIIb~IV NSCLC who received multiple cycles of chemotherapy.

• Journal of Korean Neurosurgical Society
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• 제58권2호
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• pp.163-166
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• 2015

The prophylactic use of phenytoin during and after brain surgery and cranial irradiation is a common measure in brain tumor therapy. Phenytoin has been associated with variety of adverse skin reactions including urticaria, erythroderma, erythema multiforme (EM), Stevens-Johnson syndrome, and toxic epidermal necrolysis. EM associated with phenytoin and cranial radiation therapy (EMPACT) is a rare specific entity among patients with brain tumors receiving radiation therapy while on prophylactic anti-convulsive therapy. Herein we report a 41-year-old female patient with left temporal glial tumor who underwent surgery and then received whole brain radiation therapy and chemotherapy. After 24 days of continous prophylactic phenytoin therapy the patient developed minor skin reactions and 2 days later the patient returned with generalized erythamatous and itchy maculopapuler rash involving neck, chest, face, trunk, extremities. There was significant periorbital and perioral edema. Painful mucosal lesions consisting of oral and platal erosions also occurred and prevented oral intake significantly. Phenytoin was discontinued gradually. Systemic admistration of corticosteroids combined with topical usage of steroids for oral lesions resulted in complete resolution of eruptions in 3 weeks. All cutaneous lesions in patients with phenytoin usage with the radiotherapy must be evoluated with suspicion for EM.

• Journal of Dairy Science and Biotechnology
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• 제31권1호
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• pp.67-73
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• 2013

Food allergy is defined as adverse reactions toward food mediated by aberrant immune mechanisms. Cow's milk allergy is one of the most common food allergies in childhood. This allergy is normally outgrown in the first year of life, however 15% of allergic children remain allergic. Cow's milk allergy seem to be associated with casein (${\alpha}_{s1}$-CN), ${\beta}$-lactoglobulin and whey protein. In addition to this, many other milk proteins are antigenic and capable of inducing immune responses. Various food processing affects the stability, structure and intermolecular interactions of cow milk proteins, as a result reduction the allergenic capacity. Heating, hydrolysis, chemical, proteolytic and other processes such as gamma-ray irradiation, high pressure, using probiotics treatments of milk to obtain hypoallergenic milk have been developed to reduce allergic reactions.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.691-694
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• 2013

Purpose: By carrying out a meta-analysis of randomized controlled trials that compared sorafenib or combined chemotherapy with placebo or combined chemotherapy, the effectiveness of sorafenib in hepatocellular carcinoma was evaluated in the present study, which also provided clinical practice guidelines of evidence-based-medicine. Methods: We reviewed PubMed citations concerning sorafenib treating hepatocellular carcinoma in randomized controlled trials from Jan 2000 to July 2012. All the literature was extracted by Cochrane systematic reviews and underwent meta-analysis with RewMan 5.0 software. Results: Finally, four papers documenting randomized controlled studies were included. Compared with controls, sorafenib was shown to significantly increase overall survival (OS), time to progression (TTP), and disease control rates (DCR), but not the time to symptom progression (TTSP) in hepatocellular carcinoma patients. The incidence of grade-III/IV adverse reactions, including hand-foot-skin reactions, diarrhea, hypertension and skin rash or desquamation, in sorafenib treatment group was higher than that in controls. However, there was no significant difference in the incidence of hypodynamia between the two groups. Conclusions: Sorafenib exerts significant curative effects in hepatocellular carcinoma.

• 셀메드
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• 제5권2호
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• pp.13.1-13.5
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• 2015

Many patients with psoriasis look for treatment options other than conventional treatment to control their disease with less side effects. We evaluated the prevalence and characteristics of herbal therapy usage among patients with psoriasis in Turkey. A self-prepared questionnaire about herbal therapies was applied to the psoriatic patients attended our dermatology clinic between October 2013 and December 2013. A total of 100 patients (55 male, 45 female; 7 - 80 years of age) were included in this study. Fortynine percent of patients used at least one form of herbal therapies. Juniperus oxycedrus and Aloe vera were found to be the most frequently used plants. 36.7% of the patients get benefit from herbal therapy. Only 12.2% of patients had informed their clinicians during or after herbal therapy usage. 22.4% of the patient had continued conventional treatment during herbal therapies. Side effects related with herbal therapy were developed in 26.5% of the patients. The risk of side effects was found to be 5.23 times more in patients using phytotherapies systemically compared with ones using topically. Our results show that herbal therapy usage is common among patients with psoriasis in Turkey. Since herbal therapies have the potential of interacting with the medical treatment modalities and causing life threatening allergic reactions, clinicians should be aware of plants used in psoriasis and possible adverse reactions related with them and also should not forget asking about herbal therapy history.

• Tuberculosis and Respiratory Diseases
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• 제58권1호
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• pp.83-88
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• 2005

Leflunomide는 최근에 개발된 항류마티스 약물로서 기존의 약물과 작용기전이 다르면서 효과가 우수하여 활동성 류마티스관절염에 널리 사용되고 있다. 알려진 부작용에는 간독성과 피부독성, 조혈기능부전, 위장관계 증상등이 있는데, 시판후 조사에서는 호흡기계 부작용도 드물지만 경한 정도에서 치명적인 경우까지 모두 보고 되었다. 세계 각 처에서의 시판후 조사에 의하면 호흡기계 부작용으로 사망한 경우가 있어서 심각한 폐독성의 가능성을 시사한다. 우리나라에서는 leflunomide로 인한 호흡기계 부작용에 대한 보고가 없었다. 저자들은 leflunomide에 의한 간질성 폐렴 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.