• IMMUNE NETWORK
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• v.16 no.2
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• pp.99-108
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• 2016

Colorectal cancer is the third leading cancer worldwide. Although incidence and mortality of colorectal cancer are gradually decreasing in the US, patients with metastatic colorectal cancer have poor prognosis with an estimated 5-year survival rate of less than 10%. Over the past decade, advances in combination chemotherapy regimens for colorectal cancer have led to significant improvement in progression-free and overall survival. However, patients with metastatic disease gain little clinical benefit from conventional therapy, which is associated with grade 3~4 toxicity with negative effects on quality of life. In previous clinical studies, cell-based immunotherapy using dendritic cell vaccines and sentinel lymph node T cell therapy showed promising therapeutic results for metastatic colorectal cancer. In our preclinical and previous clinical studies, cytokine-induced killer (CIK) cells treatment for colorectal cancer showed favorable responses without toxicities. Here, we review current treatment options for colorectal cancer and summarize available clinical studies utilizing cell-based immunotherapy. Based on these studies, we recommend the use CIK cell therapy as a promising therapeutic strategy for patients with metastatic colorectal cancer.

• Korean Journal of Clinical Pharmacy
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• v.21 no.4
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• pp.319-331
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• 2011

Purpose: The purpose of this study is to evaluate current criteria for insurance coverage by Health Insurance Review & Assessment Service (HIRA) on the systemic therapy used in the treatment of advanced or metastatic renal cell carcinoma (RCC), by reviewing all available clinical evidences including a variety of clinical practice guidelines. Methods: We searched clinical databases and collected data from published phase 1 through 3 randomized clinical trials on all systemic therapies used in RCC, including novel targeted therapies. Additionally, current clinical practice guidelines on the management of kidney cancer or RCC were reviewed. Based on the collected data we evaluated the appropriateness of the HIRA criteria for insurance coverage on the systemic therapy of RCC whether they are evidence-based and up to date. Results: On the basis of the collected data we concluded that there was a need for a revision in HIRA criteria for systemic therapy of RCC. Despite recent emerging therapeutic advances and changes in therapeutic strategies of management of RCC, some of anticancer regimens were inappropriately listed even though they were not proven to provide efficacy or safety superior to those of other therapies. We thus proposed an updated recommendation based on current clinical evidences. Conclusion: Systemic therapy of RCC is being rapidly changed with the advancement of understanding of the molecular biology of cancer. Consequently newly developed targeted therapies are becoming the standard therapy in the management of medically or surgically unresectable advanced or metastatic RCC. To provide effective and safe therapy to patients with RCC, the criteria for insurance coverage should be made carefully taking into consideration of most up-to-date and high-quality clinical evidences, and should be continuously reviewed so as to reflect evidence-based clinical practice.

• Korean Journal of Clinical Pharmacy
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• v.27 no.2
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• pp.105-112
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• 2017

Background: Generic medications are approved on the basis of bioequivalence with brand medications in healthy volunteers rather than the target population, there remains a substantial uncertainty regarding their clinical effectiveness and safety. The object of this paper is to compare the clinical equivalence of generic statin drugs in patients. Methods: Literature published before September 2016, which is indexed in PubMed, EMBASE, RISS, comparing generic to brand products in statins. Outcomes included blood lipid level, proportion of days covered (adherence), hospitalization and mortality. Results: 511 citations were screened, of which 11 studies met eligibility criteria (6 randomized clinical trials, 5 observational studies). Generic atorvastatin was clinical equivalent with brand drugs in blood lipid level (3 RCTs) and generic simvastatin was also clinical equivalent with brand drugs (2 RCTs). 2 of 3 studies reported no significant difference in proportion of days covered except 1 study which reported generic statin significantly enhance proportion of days covered (p<0.001). Hospitalization was no significant difference in all studies (p>0.05). 1 study reported that all cause of mortality was significantly low in generic drugs (p<0.0001). Conclusion: Published data on comparing clinical efficacy of generic and brand statins were insufficient in both quantity and quality. This systematic review suggests that additional studies on clinical equivalence and safety of generic medications in patients would be needed.

• Korean Journal of Clinical Pharmacy
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• v.3 no.1
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• pp.1-13
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• 1993

The intraction between cimetidine and rifampicin was studied pharmacokinetically in normal human subjects. The serum level and the area under the serum concentration curve(AUC) of rifampicin administrated orally were elevated significantly by cimetidine. Volume of distribution, total clearance and elimination rate constant of rifampicin were reduced significanyly by cimetidine. Biological half-life of rifampicin was prolonged significantly by cimetidine. The mechanism of this results is probably related to the inhibition of rifampicin metabolism(deacetyl form) or reduction of blood flow in the liver. It is desirable that dosage regimen of rifampicin shoud be adjusted when combined with cimetidine in clinical pharmacy practice.

• Korean Journal of Clinical Pharmacy
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• v.19 no.1
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• pp.37-42
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• 2009

The purpose of this study was to evaluate barriers to pharmacists' routine work in community setting. A survey was given to 281 pharmacists who enrolled in 16-week clinical pharmacy educating program in continuous education center for advanced pharmacy at Seoul National University. Three main questions that pharmacists were asked to answer were: (1) difficulties on dispensing prescription, (2) difficulties on communicating with doctors, (3) most difficult disease on patients counseling. The response rates for the survey were more than 60 % for each three questions (62.63 %, 63.7 %, and 64.41 %, respectively). The top three barriers to dispensing prescription were lack of professional knowledge about medications, prescription error and its solving ability and patient counseling. The top three barriers to communicating with doctors were lacking of opportunity to discuss about patients' medication due to unavailability of doctors, doctors' attitude using authoritative manner, and a pharmacist's lack of knowledge. The top 4 most difficult diseases on patients counseling were cardiovascular disorders, dermatologic disorders, endocrinologic disorders, and psychiatric disorders.

• Proceedings of the PSK Conference
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• 2001.10a
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• pp.164.1-164.1
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• 2001

• Korean Journal of Clinical Pharmacy
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• v.25 no.2
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• pp.102-110
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• 2015

Objective: This study was to investigate the perception gap between preceptors and pharmacy students on community pharmacy experiential education. Methods: The online survey was performed for 55 preceptors and 215 pharmacy students separately from April 1 to April 30, 2014. The preceptors were who completed community pharmacy practice experience at least a session and the students were who involved in community pharmacy practice for more than 21 days. The questionnaires were prepared based on the lesson contents guideline of Introductory Pharmacy Practice Education of Community Pharmacy by Korea Association of Pharmacy Education. The survey questions were consisted with demographic characteristics, evaluation of student and preceptors, benefits and disadvantages of pharmacy practice for both groups. Results: A total of 27 (49.1%) preceptors and 103 (47.9%) pharmacy students responded to the survey questionnaires. Preceptors indicated that students lacked face-to-face communication ability with patients, caregivers, and physicians. One of the Benefits of participating in pharmacy practice education as a preceptor included the improvement of self-esteem (70.37%). Disadvantages were identified as workload burden due to teaching and preceptor responsibilities at the same time. All students responded that benefits of experiencing pharmacy practice education were helping them determine their career, and they would consider working in community pharmacies (68.93%). However, handling over-the-counter drugs and communicating with doctors or nurses were identified as barriers. In addition, preceptors and pharmacy students expressed necessity of the standard text books and curriculums. Conclusion: This study identified the perception gap on community pharmacy experiential education between preceptors and pharmacy students. For the successful implementation of pharmacy practice experience, the effective and appropriate methods should be developed.

• Korean Journal of Clinical Pharmacy
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• v.27 no.3
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• pp.119-126
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• 2017

Background: As the demands of pharmacist's role and quality performance have increased, the verification of pharmacist's ability has been required. In this study, we aimed to select appropriate items for assessment of pharmacist's knowledge, attitude and performance. Methods: Based on the pharmacist job analysis, we selected duties and tasks in consideration of applying pharmacy practical examination through brainstorming of internal researchers and group discussion with experts. Survey was conducted to evaluate the tasks according to the criteria detailed below: Realistic, Understandable, Measurable, Behavioral and Achievable (RUMBA). The subjects included professors at colleges of pharmacy and instructors of institutional or community pharmacy settings. Results: Nine duties including 41 tasks were drawn for the survey through primary internal researchers. Of the 90 respondents, 95.6% were professors or preceptors who was engaged in practical training, and 62.2% had more than five years of practical experience. As a result of survey and discussion with expert panel, selected seven duties were selected as followings: 'Patient (customer) reception', 'Drug preparation and distribution', 'Patient care', 'Administration', 'Patient counseling', 'Non-prescription medication counseling', and 'Provision of drug information'. The final 20 tasks from seven duties were chosen to assess skills that a pharmacist should be able to perform. Conclusion: This is the first study to select the items that can be included in pharmacist practical examination in the future, based on the RUMBA criteria. As a next step, it is necessary to study how to implement these items.

• BMB Reports
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• v.44 no.10
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• pp.659-664
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• 2011

As part of the search for biologically active anti-osteoporotic agents that enhance differentiation and mineralization of osteoblastic MC3T3-E1 cells, we identified the ginsenoside Rh2(S), which is an active component in ginseng. Rh2(S) stimulates osteoblastic differentiation and mineralization, as manifested by the up-regulation of differentiation markers (alkaline phosphatase and osteogenic genes) and Alizarin Red staining, respectively. Rh2(S) activates p38 mitogen-activated protein kinase (MAPK) in time- and concentration-dependent manners, and Rh2(S)-induced differentiation and mineralization of osteoblastic cells were totally inhibited in the presence of the p38 MAPK inhibitor, SB203580. In addition, pretreatment with Go6976, a protein kinase D (PKD) inhibitor, significantly reversed the Rh2(S)-induced p38 MAPK activation, indicating that PKD might be an upstream kinase for p38 MAPK in MC3T3-E1 cells. Taken together, these results suggest that Rh2(S) induces the differentiation and mineralization of MC3T3-E1 cells through activation of PKD/p38 MAPK signaling pathways, and these findings provide a molecular basis for the osteogenic effect of Rh2(S).

• Herbal Formula Science
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• v.14 no.2
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• pp.1-8
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• 2006

ElM (Eighteen Incompatible Medicaments) is an important component in Oriental pharmacology and is directly related to clinical prescriptions. Medical practitioners argued that the definite cause and meaning of ElM was ambiguous and therefore debated the issue of clinical application of the ElM. This study conducted an in-depth literary research on the origin, meaning and contents of ElM with the purpose to contribute in its efforts to be used clinically. Even after thousands of years have past since establishment of Oriental medicine. ElM is still tabooed and was an obstacle that hindered ideologies. Modern herbal medicine texts claim that the use of ElM can reduce treatment effects and promote poisoning and side effects. However, since long ago, there has been medical practitioners who reject this as false. Recently, poisoning caused by ElM has been claimed to be from the toxicity of the drug itself, rather than the result of interaction between the drugs. and therefore they suggest that ElM is not a forbidden domain. In addition. ElM showed a difference in number depending on the era. However, this can be understood not as a definite number. but instead as a warning to be careful during combination of drugs for use as clinical medicine. Historically. there were very few cases in which ElM was used for clinical tests and thus, the clinical value is not yet clear. However. some medical practitioners clinically applied it and found clear results for it. while others applied ElM directly to their bodies. which showed signs for the usefulness and potential of ElM for us. A more concrete and in-depth study must be made on ELM.