• 한국임상약학회지
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• 제20권3호
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• pp.268-277
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• 2010

This study was conducted to analyze the cost-utility of ramosetron monotherapy, trimebutine monotherapy and trimebutine+loperamide combination therapy in male diarrhea-predominant patients with irritable bowel syndrome (IBS) in Korean healthcare setting. We constructed a decision-analytical model to estimate both total costs for each state of health and outcomes such as IBS-symptoms improvement for 3 and 6 months time horizon. Base analysis found that for ramosetron treatment with the price of KW910 for 5 ${\mu}g$ tablet, incremental cost effectiveness ratios (ICERs, cost per quality-adjusted life day) were KW85,000 and KW62,000 for 3 months and 6 months, respectively, compared with trimebutine. But ramosetron was a dominant strategy when compared with trimebutine+loperamide for both 3 months and 6 months. Sensitivity analyses showed robust results for drug acquisition costs till ramosetron price of KW950/tablet. In conclusion, ramosetron was a cost-effective regimen compared with trimebutine or trimebutine+loperamide from the societal perspective.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제7권1호
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• pp.102-107
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• 2004

저자들은 객담을 뱉지 못하는 뇌성마비 환아에서 객담 검사와 방사선학적 검사, 대장 조영술과 복부전산화단층촬영 검사를 통해, 폐결핵에 동반되어 상행 결장을 침범한 장결핵을 진단하고 항결핵제를 투여하여 임상적 호전을 가져온 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.1617-1623
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• 2016

Cisplatin-based concurrent chemoradiation plays an undisputed key role as definitive treatment in unresectable patients with locally advanced squamous cell carcinoma head and neck or as an organ preservation strategy. Treatment with 100 mg/m2 3-weekly cisplatin is considered the standard of care but is often associated with several adverse events. The optimum drug schedule of administration remains to be defined and presently, there is insufficient data limiting conclusions about the relative tolerability of one regimen over the other. This review addresses regarding the optimal dose schedule of cisplatin focusing mainly on three-weekly and weekly dose of cisplatin based concurrent chemoradiotherapy in locally advanced head and neck cancer with an emphasis on mucositis, dermatitis, systemic toxicity, compliance, and treatment interruptions. To derive a definitive conclusion, large prospective randomized trials are needed directly comparing standard 3-weekly cisplatin ($100mg/m^2$) with weekly schedule ($30-40mg/m^2$) of concurrent cisplatin based chemoradiotherapy in locally advanced squamous cell carcinoma head and neck.

• Parasites, Hosts and Diseases
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• 제37권4호
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• pp.289-292
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• 1999

BALB/c mice infected with a high virulent strain of Trypanosoma brucei gambiense IL3707 were treated intraperitoneally (ip) with either Melarsoprol （Mel-B) or PSG(+) buffer as controls. The mice were subsequently monitored regularly for parasites by direct microscopic examination of their tail blood or buffy coat and by polymerase chain reaction (PCR). Mel-B was found to be an effective drug for treatment against T.b. gambiense because at the end of the first treatment schedule, all treated mice were negative for parasites even by PCR, while all the control animals were positive. Three of the five Mel-B treated mice, while parasitologically negative, were PCR positive between 53 and 80 days post infection (DPI), indicating that they still harbored an infection. All treated mice were subsequently negative for parasites even by PCR at 88 DPI. A combination of conventional microscopic examination and PCR offers a good prediction of cure following treatment of trypanosomosis.

• 대한약침학회지
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• 제21권1호
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• pp.26-34
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• 2018

Objective: The purpose of this study was to investigate the efficacy and safety of spinal-Z, derived from Peganum harmala seeds and Dracocephalum Kotschyi Boiss leaves, in patients with esophageal and stomach adenocarcinoma, and squamous cell carcinoma of the esophagus. Methods: Sixty-one patients with malignancies of the upper gastrointestinal tract were randomly assigned to one of two groups (treatment or control) in a double-blind fashion. Six capsules of Spinal-Z were prescribed to the patients with the regimen of 600 mg/m2/day, and placebo to the control group, for six months. Results: There were no significant differences between the two groups with regard to age, sex, duration of cancer, type of cancer and family history of cancer. There were significant differences in abdominal pain, heartburn, constipation and vomiting between the two groups, following spinal-Z therapy. Evaluation of drug side effects showed no difference in cough or other respiratory symptoms, itching, headache or dizziness between the two groups, both before and after treatment. Conclusion: This study indicates that Spinal-Z is safe and efficacious in the management of patients with upper gastrointestinal tract cancers.

• 한국임상약학회지
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• 제19권1호
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• pp.32-36
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• 2009

The aim of this study was to investigate the effect of simvastatin on the pharmacokinetics of nicardipine in rats. Pharmacokinetic parameters of nicardipine were determined after an oral administration of nicardipine (12 mg/kg) to rats coadministered with simvastatin (0.3 and 1.0 mg/kg). Compared with the control (given nicardipine alone), coadministration of simvastatin (1.0 mg/kg) significantly (p<0.05) increased the area under the plasma concentration (AUC) and peak plasma concentration ($C_{max}$) of nicardipine. The relative bioavailability (RB%) of nicardipine increased from 1.19- to 1.48-fold. However there were no significant changes in $t_{max}$, and $t_{1/2}$ of nicardipine. The enhanced oral bioavailability of nicardipine might be due to an inbition of cytochrom P450 3A mediated-metabolism of nicardipine in the intestine and in the liver by simvastatin. Based on these results, the concurrent use of simvastatin significantly enhanced the oral exposure of nicardipine in rats. The dosage regimen of nicardipine should be taken into consideration for potential drug interaction when combined with simvastatin in clinics.

• 대한의사협회지
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• 제61권11호
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• pp.662-669
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• 2018

The cutaneous melanoma has been regarded as rare disease entity in Korea for long time but it shows a silent growth recently. Furthermore the management of cutaneous melanoma including staging system, surgical principle, sentinel lymph node biopsy and subsequent complete node dissection and, most importantly, immunotherapy and target therapy against cutaneous melanoma recently. The incidence of cutaneous melanoma is steadily increasing in Korea but its increase is rapid recent 2 decades to 4.3 times and should be greater soon according to the steeper increase of life expectancy. New staging system proposed by American Joint Committee on Cancer (2017) includes changes in individual TNM category and stage groups, particularly from a prognostic viewpoint. Dermoscopy has been successfully introduced in the differential diagnosis of pigmented skin lesion focusing on cutaneous melanoma by non-invasive simple diagnostic tool. Sentinel lymph node biopsy was a issue of long debate whether survival benefit is real or not. Temporary conclusion about this question is reached after two large scale studies and immediate complete node dissection should be performed in a certain situations. Most important change is drug therapy focusing on immunotherapy and target therapy. Braf- and MEK-inhibitor, immune checkpoint inhibitor and PD-1 blocker has been proved to be effective as a sole or combination regimen against advanced and/or high-risk adjuvant setting of cutaneous melanoma. In conclusion, these remarkable changes will be reviewed shortly here.

• Journal of Yeungnam Medical Science
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• 제38권3호
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• pp.251-257
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• 2021

Vedolizumab (VDZ) has been approved for the treatment of inflammatory bowel diseases (IBDs) in patients aged ≥18 years. We report a case of a pediatric patient with Crohn disease (CD) who was successfully treated with VDZ. A 16-year-old female developed severe active pulmonary tuberculosis (TB) during treatment with infliximab (IFX). IFX was stopped, and TB treatment was started. After a 6-month regimen of standard TB medication, her pulmonary TB was cured; however, gastrointestinal symptoms developed. Due to the concern of the patient and parents regarding TB reactivation on restarting treatment with IFX, VDZ was started off-label. After the second dose of VDZ, the patient was in clinical remission and her remission was continuously sustained. Ileocolonoscopy at 1-year after VDZ initiation revealed endoscopic healing. Therapeutic drug monitoring conducted during VDZ treatment showed negative antibodies to VDZ. No serious adverse events occurred during the VDZ treatment. This is the first case report in Korea demonstrating the safe and effective use of VDZ treatment in a pediatric CD patient. In cases that require recommencement of treatment with biologics after recovery of active pulmonary TB caused by anti-tumor necrosis factor agents, VDZ may be a good option even in pediatric IBD.

• Journal of Digestive Cancer Research
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• 제11권1호
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• pp.1-8
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• 2023

Pancreatic cancer treatment has advanced. In particular, effective chemotherapy regimen development has fundamentally altered the therapeutic concept and strategy for pancreatic cancer treatment. Consequently, the prognosis of patients with pancreatic cancer has gradually improved. Conversion surgery for locally advanced pancreatic cancer may offer long-term survival or even a full recovery in some individuals. In contrast, metastatic pancreatic cancer has long been considered a surgical contraindication because aggressive surgical resection of the metastatic lesions does not prolong patient survival. Unexpectedly positive benefits of anticancer therapy in recent clinical experience were observed even with metastatic pancreatic cancer. To date, little evidence presented the success of surgical resection for metastatic pancreatic cancer treatment in such rare cases. However, hope and concern are growing that surgical intervention, even in patients with metastatic cancer, may result in favorable outcomes. Several studies suggested different surgical intervention effects depending on metastasis sites and patterns. Thus, this review summarizes the current status of surgery in the multidisciplinary treatment of oligometastatic pancreatic cancer and discusses future perspectives.

• Tuberculosis and Respiratory Diseases
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• 제46권6호
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• pp.767-774
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• 1999

연구배경 : 결핵성 림프절염은 폐외결핵중 가장 흔한 것으로 보고되어 있으나 폐결핵을 동반하지 않은 종격동 결핵성 림프절염은 상당히 드문 것으로 알려져 있으며 특히 감별진단에 어려움이 있으며 정확한 치료 기간에 대해서도 아직 확립되어 있지 않다. 이에 저자 등은 다른 부위의 결핵 감염을 동반하지 않으며 조직학적으로 확진된 일차성 종격동 결핵성 림프절염에 대한 방사선학적 소견과 임상 양상, 치료 기간 및 치료에 대한 림프절의 반응에 대하여 연세대학교 의과대학 부속 세브란스병원에 내원하여 조직학적으로 확진된 23예에 대하여 후향적으로 조사하여 보고하는 바이다. 방 법 : 1991년부터 1997년까지 연세대학교 의과대학 부속 세브란스 병원에 내원한 환자중 다른 부위에 결핵 감염을 동반하지 않으면서 조직학적으로 증명된 종격동 결핵성 림프절염 환자 23명을 대상으로 하여 성별, 호발 연령, 단순 흉부 X-선에서 이상 위치, 흉부 전산화 단층촬영에서 림프절의 위치, 치료 기간 및 치료 종결후의 흉부 전산화 단층촬영상의 변화 등에 대하여 후향적으로 조사 하였다. 결 과 : 총 23명의 환자를 대상으로 조사하였으며 남자가 7명 여자가 16명이었고 남 녀비는 1 : 2.4 이고 호발 연령은 20대에서 40대 까지가 전체의 82%를 차지하였다. 단순 흉부 X-선에서 음영 종대는 부기관부위 림프절만을 침범한 경우가 55%, 폐문 주위 30%, 양측모두를 침범한 경우가 15% 이었고 우측과 좌측의 비는 4.6 : 1 이였다. 흉부 전산하 단층촬영시 1cm 이상의 림프절 종대가 있는 위치는 부기관부 림프절 33%, 기관 분기부 림프절 20%, 폐문 림프절 13%, 기관기관지부위 림프절 8%, 전종격동 림프절 5%, 쇄골상 림프절 8%, 대동맥궁하 림프절 8% 이었다. 23명의 환자중 치료 종결후 추적관찰이 이루어진 16명을 대상으로 하였으며 HERZ를 사용한 경우 12개월 치료가 43%, 14개월 치료가 13%, 18개월 치료가 25%였고 HERZ를 사용할 수 없어 2차 약제를 사용한 3명의 경우 18개월간의 치료 기간이 소요되었다. 추적관찰 결과 12개월의 HERZ를 사용한 1예에서 재발하였으나 동일한 약제로 다시 12개월 치료후 재발의 증거는 없었다. 치료 종결후 시행한 흉부 전산화 단층촬영 결과 2예에서 림프절 종대의 완전 소실을 포함하여 77%에서 50% 이상의 림프절 크기의 감소가 있었으며 3예에서는 크기의 변화가 없었으나 계속 적인 추적관찰상 재발의 증거는 없었다. 결 론 : 저자 등은 이번 연구 결과 다른 부위의 결핵 감염이 없는 종격동 결핵성 림프절염에서 치료 기간중의 특별한 합병증이 없는 경우 HERZ 약제를 이용하여 최소 12개월 이상의 치료가 필요하다고 생각되며 이차 약제를 사용한 경우에는 최소 18개월 이상의 치료가 필요하다고 생각된다. 향후 더 많은 환자를 대상으로한 전향적 연구를 통하여 적절한 치료 기간의 설정이 필요하다고 생각된다.