• Title/Summary/Keyword: Drug response

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일부 농촌지역의 결핵 치료 환자에 대한 실태 조사에 관한 연구

  • 이재희
    • Journal of Korean Academy of Nursing
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    • v.1 no.1
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    • pp.85-94
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    • 1970
  • This is a study of 21 tuberculosis patients receiving medical treatment at the Public Health Center in Kyongi Do, Pu Chun Gun and at the General Hospital. The results cover the findings of the period from May, 1969 to November 1970. The information obtained is based on personal interviews with the patients, and symptomatic diagnosis made from observations. The following statistics when not equalling 100% contain only the responses of the two extremes in each case. The findings of the research are as follows: 1. 52.3% of the patients in the study are males and 47.7% are females. 28.6% of the subjects are between 20 and 29 years of age and an equal percent are between 30 and 39 years. 2. 47.5% of the subjects had graduated from primary school, while only 4.8% had graduated from high school. 3. 57.1% of the patients said they had no religions beliefs, while 4.8% professed to being Buddhists or believing in superstition. 4. 47.3% of the people said they were unemployed, while 4.8% classified themselves as labourers. 5. In response to how tuberculosis was first detected in their respective cases, 52.6% became aware of their disease through X-ray results, while 4.8% were discovered to have tuberculosis when being treated for other diseases at the hospital. 6. When asked how many of the patients knew anything about their disease when treated, 57.1% knew nothing about tuberculosis when they received treatment, while 42.9% had some knowledge of the disease. 7. Of those who knew something about tuberculosis, 61.9% learned about from doctors and nurses, while 4.8% learned from other people. 8. 57.1% of the patients knew that tuberculosis is a communicable disease, while 42.9% did not know. 9. 52.4% of the patients did not know the cause of tuberculosis while 4.9% believed the disease was caused by a curse. 10. When asked about the extent of treatment, 52.4% responded that they had undergone continuous treatment, while 4.8% had not received treatment. 11.The reasons given for not continuing treatment were the following: economic factors 55.6%; side reactions to the treatment, lack of knowledge of how to get treatment, of the need for treatment, or of the positive effects of treatment 11.1%. 12. 61.9% of the subjects usually took the medical treatment at home, 9.5% took it in the mountains or at the beach. 13. 42.9% of the patients received drugs for treatment at the local public health center, while 4.8% received them at the hospital 14. 33.3% of the patients received P.A.S+I.N.H.+S.M. for treatment of tuberculosis, while 4.8% received P.A.S.+S.M.. and some secondary drug. 15. Of the patients who took some extra medicine for tuberculosis, 38.1% took a Chinese drug, while 9.5% took herb medicine. 16. 38.1% of the patients had continued treatment for three years, 4.8% had interrupted the treatment. 17. When asked about the development of the disease after treatment, the patients gave the following information: after one month, 90.5% thought the treatment helped, while 9.5% weren't sure; after one year, 55.6% thought it was good, while 5.5% thought it was not; after three years, 63.6% had a very bad condition. while 4.8% didn't know. 18. 61.9% of the patients were unconcerned about covering their mouths when they coughed, while 38.1% covered their mouths. 19. 57.2% were unconcerned they spit, while 23.8% spit into a waste basket. 20. 66.7% were unconcerned about sterilizing tableware, while 9.5% handled it separately. 21. 66.7% were unconcerned about ventilating their room, while 9.5% ventilated the room twice a week.

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Quantitative Microbial Risk Assessment Model for Staphylococcus aureus in Kimbab (김밥에서의 Staphylococcus aureus에 대한 정량적 미생물위해평가 모델 개발)

  • Bahk, Gyung-Jin;Oh, Deog-Hwan;Ha, Sang-Do;Park, Ki-Hwan;Joung, Myung-Sub;Chun, Suk-Jo;Park, Jong-Seok;Woo, Gun-Jo;Hong, Chong-Hae
    • Korean Journal of Food Science and Technology
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    • v.37 no.3
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    • pp.484-491
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    • 2005
  • Quantitative microbial risk assessment (QMRA) analyzes potential hazard of microorganisms on public health and offers structured approach to assess risks associated with microorganisms in foods. This paper addresses specific risk management questions associated with Staphylococcus aureus in kimbab and improvement and dissemination of QMRA methodology, QMRA model was developed by constructing four nodes from retail to table pathway. Predictive microbial growth model and survey data were combined with probabilistic modeling to simulate levels of S. aureus in kimbab at time of consumption, Due to lack of dose-response models, final level of S. aureus in kimbeb was used as proxy for potential hazard level, based on which possibility of contamination over this level and consumption level of S. aureus through kimbab were estimated as 30.7% and 3.67 log cfu/g, respectively. Regression sensitivity results showed time-temperature during storage at selling was the most significant factor. These results suggested temperature control under $10^{\circ}C$ was critical control point for kimbab production to prevent growth of S. aureus and showed QMRA was useful for evaluation of factors influencing potential risk and could be applied directly to risk management.

A Double-Blind Comparison of Paroxetine and Amitriptyline in the Treatment of Depression Accompanied by Alcoholism : Behavioral Side Effects during the First 2 Weeks of Treatment (주정중독에 동반된 우울증의 치료에서 Paroxetine과 Amitriptyline의 이중맹 비교 : 치료초기 2주 동안의 행동학적 부작용)

  • Yoon, Jin-Sang;Yoon, Bo-Hyun;Choi, Tae-Seok;Kim, Yong-Bum;Lee, Hyung-Yung
    • Korean Journal of Biological Psychiatry
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    • v.3 no.2
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    • pp.277-287
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    • 1996
  • Objective : It has been proposed that cognition and related aspects of mental functioning are decreased in depression as well as in alcoholism. The objective of the study was to compare behavioral side effects of paroxetine and amitriptyline in depressed patients accompanied by alcoholism. The focused comparisons were drug effects concerning psychomotor performance, cognitive function, sleep and daytime sleepiness during the first 2 weeks of treatment. Methods : After an alcohol detoxification period(3 weeks) and a washout period(1 week), a total of 20 male inpatients with alcohol use disorder (DSM-IV), who also had a major depressive episode(DSM-IV), were treated double-blind with paroxetine 20mg/day(n=10) or amitriptyline 25mg/day(n=10) for 2 weeks. All patients were required to have a scare of at least 18 respectively on bath the Hamilton Rating Scale far Depression(HAM-D) and Beck Depression Inventory(BDI) at pre-drug baseline. Patients randomized to paroxetine received active medication in the morning and placebo in the evening whereas those randomized to amitriptyline received active medication in the evening and placebo in the morning. All patients performed the various tasks in a test battery at baseline and at days 3, 7 and 14. The test battery included : critical flicker fusion threshold for sensory information processing capacity : choice reaction time for gross psychomotor performance : tracking accuracy and latency of response to peripheral stimulus as a measure of line sensorimotor co-ordination and divided attention : digit symbol substitution as a measure of sustained attention and concentration. To rate perceived sleep and daytime sleepiness, 10cm line Visual analogue scales were employed at baseline and at days 3, 7 and 14. The subjective rating scales were adapted far this study from Leeds sleep Evaluation Questionnaire and Epworth Sleepiness Scale. In addition a comprehensive side effect assessment, using the UKU side effect rating scale, was carried out at baseline and at days 7 and 14. The efficacy of treatment was evaluated using HAM-D, BDI and clinical global impression far severity and improvement at days 7 and 14. Results : The pattern of results indicated thai paroxetine improved performance an mast of the lest variables and also improved sleep with no effect on daytime sleepiness aver the study period. In contrast, amitriptyline produced disruption of performance on same tests and improved sleep with increased daytime sleepiness in particular at day 3. On the UKU side effect rating scale, mare side effects were registered an amitriptyline. The therapeutic efficacy was observed in favor of paroxetine early in day 7. Conclusion : These results demonstrated thai paroxetine in much better than amitriptyline for the treatment of depressed patients accompained by alcoholism at least in terms of behavioral safety and tolerability, furthermore the results may assist in explaining the therapeutic outcome of paroxetine. For example, and earlier onset of antidepressant action of paroxetine may be caused by early improved cognitive function or by contributing to good compliance with treatment.

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Mechanism of Inhibitory Effect of Imipramine on Isolated Rat Detrusor Muscle in Relation to Calcium Modulation (흰쥐 적출 방광 배뇨근의 수축성에 대한 Imipramine의 작용과 Calcium동원 기전과의 관계)

  • Lee, Jong-Bum;Yoo, Kae-Joon;Ha, Jeoung-Hee;Kwon, Oh-Cheol;Lee, Kwang-Youn;Kim, Won-Joon
    • The Korean Journal of Pharmacology
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    • v.28 no.1
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    • pp.81-89
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    • 1992
  • Enuresis is a common voiding disorder among children. There are several therapeutic regimens for the disorder available today; behavioral therapies, psychotherapy, bladder training, sleep interruption, hypnosis and drug therapy. Recently, the efficacy of drug therapy has been acknowledged, particularly of antidepressants. Among the tricyclic antidepressants, imipramine is most frequently employed for the treatment of enuresis. Present study was undertaken to investigate the mechanism of imipramine on the contractility of urinary bladder in relation to the calcium modulation using isolated strips of rat detrusor urinae. 1. The electric fileld stimulation-induced contraction was abolished by imipramine, but partially inhibited by atropine. 2. Imipramine reduced the basal tone and diminished the phasic activity of detrusor muscle concentration-dependently, which was similar to that of diltiazem, a calcium channel blocker. 3. Imipramine suppressed the maximal responses and shifted the concentration-response curves of bethanechol and ATP to right. 4. Imipramine inhibited the calcium-induced recovery of tension in calcium-free physiologic salt solution (PSS) with a mode of action similar to that of diltizaem. 5. A23187, a calcium ionophore recovered the basal tone which had been reduced by imipramine in normal PSS. 6. In calcium-free PSS, A23187 could recover the abolished basal tone with the pretreatment of imipramine, but it exerted a partial recovery with the pretreatment of TMB-8, an inhibitor of intracellular calcium release. Based on these results, it is suggested that the inhibitory action of imipramine on the detrusor muscle exerted in part by blockade of the muscarinic and purinergic receptors, and interference with the influx of extracellular calcium, but not with the release of intracellular stored calcium, is involved in its mechanism of action.

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Efficiency and Side Effects of Sorafenib Therapy for Advanced Hepatocellular Carcinoma: A Retrospective Study by the Anatolian Society of Medical Oncology

  • Berk, Veli;Kaplan, Mehmet Ali;Tonyali, Onder;Buyukberber, Suleyman;Balakan, Ozan;Ozkan, Metin;Demirci, Umut;Ozturk, Turkan;Bilici, Ahmet;Tastekin, Didem;Ozdemir, Nuriye;Unal, Olcun Umit;Oflazoglu, Utku;Turkmen, Esma;Erdogan, Bulent;Uyeturk, Ummugul;Oksuzoglu, Berna;Cinkir, Havva Yesil;Yasar, Nurgul;Gumus, Mahmut
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7367-7369
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    • 2013
  • Background: Inoperable and metastatic hepatocellular carcinoma (HCC) is associated with a poor prognosis and low chemotherapeutic efficiency. Sorafenib is an oral multi-kinase inhibitor exerting its effects via the RAF/MEK/ERK pathway, vascular endothelial growth factor receptor (VEGFR) and platelet derived growth factor receptor beta (PDGFR-${\beta}$) tyrosine kinases. Randomized studies have shown a significant contribution of sorafenib to life expectancy and quality of life of cancer patients. The aim of the present study is to evaluate the efficacy and side effects of sorafenib therapy in Turkey. Materials and Methods: Data for 103 patients (82 males, 21 females) receiving sorafenib therapy in 13 centers from February 2008 to December 2012 were evaluated. Median age was 61 years and median ECOG performance status was 1 (range: 0-2). 60 patients (58%) had hepatitis B, 15 patients (15%) had hepatitis C infection and 12 patients (12%) had a history of alcohol consumption. All of the patients had Child scores meeting the utilization permit of the drug in our country (Child A). Results: A total of 571 cycles of sorafenib therapy were administered with a median of four per patient. Among the evaluable cases, there was partial response in 15 (15%), stable disease in 52 (50%), and progressive disease in 36 (35%). Median progression-free survival was 18 weeks and median overall survival was 48 weeks. The dose was reduced only in 6 patients and discontinued in 2 patients due to grade 3-4 toxicity, 18 patients (17%) suffering hand-foot syndrome, 7 (7%) diarrhea, and 2 (2%) vomiting. Conclusions: This retrospective study demonstrated better efficacy of sorafenib therapy in patients with advanced HCC compared to the literature while progression-free survival and overall survival findings were comparable. The side effect rates indicate that the drug was tolerated well. In conclusion, among the available treatment options, sorafenib is an efficient and tolerable agent in patients with inoperable or metastatic HCC.

Suspected Upper Gastrointestinal Bleeding by Interaction of Clozapine and Buspirone (상부위장관 출혈이 의심되는 클로자핀과 부스피론의 상호작용)

  • Sung, Yu-Mi;Kim, Soo-In;Yun, Kyu-Wol;Lim, Weon-Jeong
    • Korean Journal of Psychosomatic Medicine
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    • v.14 no.1
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    • pp.62-66
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    • 2006
  • Introduction: Unexpected serious and lethal drug interactions can be occurred by polypharmacy for treatment-resistant psychiatric disorders. We report a case who has suspected upper gastrointestinal bleeding after the combination of clozapine and buspirone. Case : A 69-year-old woman with DSM-IV schizophrenia who was admitted to our hospital had no previous medical problems. Findings on physical exam, laboratory values, EEG, and a magnetic reso-nance imaging scans were no abnormality, except for slightly low level of hemoglobin at admission. Because of aggravating anxiety symptom, a trial of buspirone was begun from 15mg, in addition to olanzapine 30mg. And then olanzapine was switched to clozapine due to her treatment-refractory his-tory and poor response on this admission. Moreover, At the admission 11 weeks later, after 4 weeks of starting buspirone and clozapine, she was placed on a regimen of clozapine 300mg and buspirone 60mg. At this point, she started to complaint nonspecific abdominal pain for 4 days and then hematemesis, melena and hypotension were developed suddenly with negative findings in gastroduodenoscopy. After stopping all medication, the suspected upper gastrointestinal bleeding was subsided. After the regimen was switched back to clozapine only, psychotic symptoms were improved without the recurrence of the adverse events. Conclusion : We concluded that the upper gastrointestinal bleeding in this case was attributed to the drug interaction with clozapine and buspirone, although the definite mechanism is not clear. The clini-cians should be very cautious to prescribe the combination of clozapine and buspirone due to a possible lethal adverse effect.

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The Adjuvant Effect of Subcutaneous Interferon-gamma in the Treatment of Refractory Multidrug-resistant Pulmonary Tuberculosis (난치성 다제내성 폐결핵에서 피하주사 Interferon-gamma 치료의 효과: 예비연구)

  • Kim, Eun Kyung;Shim, Tae Sun;Lee, Jung Yeon;Oh, Yeon-Mok;Lim, Chae-Man;Lee, Sang Do;Koh, Younsuck;Kim, Dong Soon;Kim, Won Dong;Kim, Woo Sung
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.3
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    • pp.226-233
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    • 2004
  • Background : Interferon-gamma (IFN-${\gamma}$) is a critical cytokine in the defense against a Mycobacterium tuberculosis infection. Even though IFN-${\gamma}$ has occasionally been used in the treatment of refractory multidrug-resistant tuberculosis (MDR-TB) with some promising results, there is still some controversy regarding the therapeutic efficacy of IFN-${\gamma}$. This study was performed to examine the effect of subcutaneous IFN-${\gamma}$ in the treatment of MDR-TB patients. Methods : Six patients with refractory MDR-TB were enrolled in this study. Two million IU of IFN-${\gamma}$ was administered subcutaneously three times a week with the concomitant administration of antituberculous drugs for at least for 28 weeks. During the IFN-${\gamma}$ therapy, the sputum smear and culture, radiological and clinical evaluations were performed every 4 weeks throughout the study period. Results : The mean age of the 6 patients was 37 years (ranges, 15-61 years). The drug susceptibility test to standard antituberculous drugs revealed resistance to an average of 6.8 (${\pm}1.2$) agents including isoniazid and rifampicin. An average of 10.8 (${\pm}1.3$) antituberculous drugs were prescribed before IFN-${\gamma}$ therapy. The culture became negative in 2 patients (33%) after initiating IFN-${\gamma}$ therapy; one at 8 weeks, and the other at 24 weeks. Finally, after stopping the IFN-${\gamma}$ therapy after 28 weeks, the culture became positive again in the two patients who were culture-negative. The other 4 patients who failed in the culture conversion are still on antituberculous treatment except for one who died of tuberculosis. Conclusion : Even though 28 weeks of subcutaneous IFN-${\gamma}$ therapy in combination with antituberculous drugs was successful in inducing the culture-negative conversion in some patients with refractory MDR-TB, the culture became positive again after stopping the IFN-${\gamma}$ therapy. This suggests that subcutaneous IFN-${\gamma}$ therapy may have suppressive effect on tuberculosis only during the IFN-${\gamma}$ therapy period in some patients. Further studies will be needed to determine the optimum dose, the administration route, the duration of therapy, and the predicting factors of the response to adjuvant IFN-${\gamma}$ therapy.

Determination of Practical Dosing of Warfarin in Korean Outpatients with Mechanical Heart Valves (인공심장판막 치환환자의 Warfarin 용량결정)

  • Lee Ju Yeun;Jeong Young Mi;Lee Myung Koo;Kim Ki-bong;Ahn Hyuk;Lee Byung Koo
    • Journal of Chest Surgery
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    • v.38 no.11 s.256
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    • pp.761-772
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    • 2005
  • Background: Following the implantation of heart valve prostheses, it is important to maintain therapeutic INR to reduce the risk of thromboembolism. The objective of this study was to suggest a practical dosing guideline for Korean outpatients with prosthetic heart valves managed by a pharmacist-run anticoagulation service (ACS). Material and Method: A retrospective chart review was completed for all patients enrolled in the ACS at Seoul National University Hospital from March, 1997 to September, 2000. Patients who were at least 6 months post-valve replacement and had nontherapeutic INR value (less than 2.0 or greater than 3.0) were included. The data on 688 patients (1,782 visits) requiring dosing adjustment without any known drug or food interaction with warfarin were analyzed. The amount of adjusted dose and INR changes based on the INR at the time of the event were calculated. Aortic valve replacements (AVR) patients and mitral or double valve replacement (MVR/DVR) patients were evaluated separately. Result: Two methods for the warfarin dosage adjustment were suggested: Guideline I (mg-based total weekly dose (TWD) adjustment), Guideline II (percentage-based TWD adjustment). The effectiveness of Guideline 1 was superior to Guideline II overall in patients with both AVR and MVR/DVR. Conclusion: The guideline suggested in this study could be useful when the dosage adjustment of wafarin is necessary in outpatients with mechanical heart valves.

The Analysis for Minimum Infective Dose of Foodborne Disease Pathogens by Meta-analysis (메타분석에 의한 식중독 원인 미생물들의 최소감염량 분석)

  • Park, Myoung Su;Cho, June Ill;Lee, Soon Ho;Bahk, Gyung Jin
    • Journal of Food Hygiene and Safety
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    • v.29 no.4
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    • pp.305-311
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    • 2014
  • Minimum infective dose (MID) data has been recognized as an important and absolutely needed in quantitative microbiological assessment (QMRA). In this study, we performed a comprehensive literature review and meta-analysis to better quantify this association. The meta-analysis applied a final selection of 82 published papers for total 12 species foodborne disease pathogens (bacteria 9, virus 2, and parasite 1 species) which were identified and classified based on the dose-response models related to QMRA studies from PubMed, ScienceDirect database and internet websites during 1980-2012. The main search keywords used the combination "food", "foodborne disease pathogen", "minimum infective dose", and "quantitative microbiological risk assessment". The appropriate minimum infective dose for B. cereus, C. jejuni, Cl. perfringens, Pathogenic E. coli (EHEC, ETEC, EPEC, EIEC), L. monocytogenes, Salmonella spp., Shigella spp., S. aureus, V. parahaemolyticus, Hepatitis A virus, Noro virus, and C. pavum were $10^5cells/g$ (fi = 0.32), 500 cells/g (fi = 0.57), $10^7cells/g$ (fi = 0.56), 10 cells/g (fi = 0.47) / $10^8cells/g$ (fi = 0.71) / $10^6cells/g$ (fi = 0.70) / $10^6cells/g$ (fi = 0.60), $10^2{\sim}10^3cells/g$ (fi = 0.23), 10 cells/g (fi = 0.30), 100 cells/g (fi = 0.32), $10^5cells/g$ (fi = 0.45), $10^6cells/g$ (fi = 0.64), $10{\sim}10^2particles/g$ (fi = 0.33), 10 particles/g (fi = 0.71), and $10{\sim}10^2oocyst/g$ (fi = 0.33), respectively. Therefore, these results provide the preliminary data necessary for the development of foodborne pathogens QMRA.

Free Radical Scavenging Effect and Oxidative Stress Protective Activity of Domestic Processed Polygoni Multiflori Radix (국내산 법제 하수오의 라디칼 소거능 및 산화적 스트레스 개선 효과)

  • Kim, Hyun Young;Kim, Jun Young;Cho, Eun Ju;Choi, Ji Myung;Hwang, Chung Eun;Lee, Hee Yul;Ahn, Min Ju;Lee, Jin Hwan;Kim, Yun-Geun;Ko, Keon Hee;Goo, Young-Min;Oh, Kyeong Yeol;Cho, Kye Man
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.44 no.6
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    • pp.809-815
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    • 2015
  • In this study, we confirmed biological compounds from methanol (MeOH) extract of processed Polygoni Multiflori Radix (PPMR), and the radical scavenging effect and oxidative stress protective activity of MeOH extract of PPMR were investigated under in vitro conditions using LLC-$PK_1$ renal epithelial cells. In HPLC analysis, MeOH extract of PPMR contained four species of biological compounds named 2,3,5,4'-tetrahydroxystilbene 2-O-${\beta}$-D-glucoside, emodin, chrysophanol, and rhein. 2,3,5,4'-Tetrahydroxystilbene 2-O-${\beta}$-D-glucoside was detected as the main compound in PPMR as 115.02 mg/kg. MeOH extract of PPMR showed 2,2-diphenyl-1-picrylhydrazyl (DPPH), 2,2'-azino-bis (3-ethylbenzthiazoline-6-sulphonic acid) diammonium salt (ABTS), and hydroxyl radical scavenging activities in a concentration- dependent manner. In particular, upon $50{\mu}g/mL$ of PPMR extract treatment, DPPH, ABTS, and hydroxyl radical scavenging activities were approximately 48.4%, 57.9%, and 81.2%, respectively. LLC-$PK_1$ cell viability declined in response to oxidative stress induced by pyrogallol, sodium nitroprusside (SNP), and morpholinosydnonimine (SIN-1) generators of NO, $O_2{^-}$, and $ONOO^-$, respectively. However, MeOH extract of PPMR significantly and dose-dependently inhibited oxidative-stressed LLC-$PK_1$ cell cytotoxicity. In fact, upon $50{\mu}g/mL$ of PPMR extract treatment, LLC-$PK_1$ cell viabilities were approximately 82.1%, 89.1%, and 77.6% compared to stress levels induced by pyrogallol, SNP, and SIN-1, respectively.