• Title/Summary/Keyword: Drug-associated

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The Role of Endoscopic Interventions in Palliative Care for the Gastrointestinal Tumors (소화기 종양에 대한 내시경적 완화치료)

  • Hye Kang Kim;Dae Young Cheung
    • Journal of Digestive Cancer Research
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    • v.2 no.1
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    • pp.1-4
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    • 2014
  • Palliative care for cancer aims to relieve the discomfort and pain from the cancer itself and associated conditions. Gastrointestinal cancers originate from the tube like structure of gastrointestinal tract and cause complications such as obstruction, bleeding, adhesion, invasion, and perforation to adjacent organ. Recent advances in interventional endoscopy enables endoscopy physicians to do safe and effective care for gastrointestinal cancer patients. Endoscopic palliation includes stent, hemostasis, nutritional support and targeted drug delivery. Self expandable metallic stent is one of the most important modalities in gastrointestinal palliation. Through the endoscopy or over the wire pre-placed by endoscopy, stents restore the gastrointestinal luminal patency and relieve the obstructive condition. Endoscopic hemostasis is another important palliation in gastrointestinal cancer patients. Epinephrine injection, argon plasma coagulation and thermal cauterization are usual modalities for hemostasis. Histoacryl glue and fibrin glue are also available. Hemostatic nanopowder spray is newly reported effective in benign disease and is supposed to be effective also in cancer bleeding. Enteral feeding tubes including gastro- or jejunostomy and nosoduodenal tubes are placed by using endoscopic guidance. Enteral feeding tubes role as the route of easily absorbable or semi-digested nutrients and effectively maintain both patients calorie requirements and gut microenvironment. Photodynamic therapy is the one of the outstanding medical employments of photo-physics. Especially for superficial cancers in esophagus, photodynamic therapy is very useful in cancer removal and maintaining organ structure. In biliary neoplasm, photodynamic therapy is well known to be effective in cancer ablation and biliary ductal patency restoration. Targeted drug delivery is the lastest issue in palliative endoscopy. Debates and questions are still on the table. In this article, the role of endoscopic interventions in palliative care for the gastrointestinal tumors will be thoroughly reviewed.

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Renal Impairment Associated with Weekly Cisplatin and Gemcitabine Combination Therapy for Treatment of Biliary Tract Cancer

  • Galam Leem;Hee Seung Lee;Moon Jae Chung;Jeong Youp Park;Si Young Song;Seungmin Bang
    • Journal of Digestive Cancer Research
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    • v.4 no.1
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    • pp.36-38
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    • 2016
  • Biliary tract cancer, a relatively rare disease, is usually found in an unresectable stage. Weekly cisplatin plus gemcitabine has been applied as a standard first-line therapy for advanced biliary tract cancer, but almost up to 3-5% patients experience drug induced renal impairment. Many anticancer medication guidelines recommend drug adjustment when kidneys are damaged, but weekly cisplatin is somewhat low dose so that there is a controversy on reducing the dose. And it is known that the cumulative dose of cisplatin is the most important factor contributing to renal impairment. Therefore, clinicians face troubles whether or not to maintain the chemotherapy. Here, we reported a patient whose renal function (eGFR) had been decreased as the number of chemotherapy increased, so her chemotherapy should be stopped. Since we held the chemotherapy on her, the disease progressed aggressively. Weekly cisplatin regimen is just 25 mg/m2, so it may be meaningless to reduce this dose, and it is well known that cumulative dose of cisplatin is the most important factor contributing to renal impairment, it is better not to use cisplatin anymore. Therefore, we recommend that if the patient responds well to weekly cisplatin plus gemcitabine regimen, it would be beneficial to use gemcitabine alone.

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Restoring Ampicillin Sensitivity in Multidrug-Resistant Escherichia coli Following Treatment in Combination with Coffee Pulp Extracts

  • Anchalee Rawangkan;Atchariya Yosboonruang;Anong Kiddee;Achiraya Siriphap;Grissana Pook-In;Ratsada Praphasawat;Surasak Saokaew;Acharaporn Duangjai
    • Journal of Microbiology and Biotechnology
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    • v.33 no.9
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    • pp.1179-1188
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    • 2023
  • Escherichia coli, particularly multidrug-resistant (MDR) strains, is a serious cause of healthcare-associated infections. Development of novel antimicrobial agents or restoration of drug efficiency is required to treat MDR bacteria, and the use of natural products to solve this problem is promising. We investigated the antimicrobial activity of dried green coffee (DGC) beans, coffee pulp (CP), and arabica leaf (AL) crude extracts against 28 isolated MDR E. coli strains and restoration of ampicillin (AMP) efficiency with a combination test. DGC, CP, and AL extracts were effective against all 28 strains, with a minimum inhibitory concentration (MIC) of 12.5-50 mg/ml and minimum bactericidal concentration of 25-100 mg/ml. The CP-AMP combination was more effective than CP or AMP alone, with a fractional inhibitory concentration index value of 0.01. In the combination, the MIC of CP was 0.2 mg/ml (compared to 25 mg/ml of CP alone) and that of AMP was 0.1 mg/ml (compared to 50 mg/ml of AMP alone), or a 125-fold and 500-fold reduction, respectively, against 13-drug resistant MDR E. coli strains. Time-kill kinetics showed that the bactericidal effect of the CP-AMP combination occurred within 3 h through disruption of membrane permeability and biofilm eradication, as verified by scanning electron microscopy. This is the first report indicating that CP-AMP combination therapy could be employed to treat MDR E. coli by repurposing AMP.

Computational Evaluation on the Interactions of an Opaque-Phase ABC Transporter Associated with Fluconazole Resistance in Candida albicans, by the Psidium guajava Bio-Active Compounds

  • Mithil Vora;Smiline Girija Aseervatham Selvi;Shoba Gunasekaran;Vijayashree Priyadharsini Jayaseelan
    • Journal of Pharmacopuncture
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    • v.27 no.2
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    • pp.91-100
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    • 2024
  • Objectives: Candida albicans is an opportunistic pathogen that occurs as harmless commensals in the intestine, urogenital tract, and skin. It has been influenced by a variety of host conditions and has now evolved as a resistant strain. The aim of this study was thus detect the fluconazole resistant C. albicans from the root caries specimens and to computationally evaluate the interactions of an opaque-phase ABC transporter protein with the Psidium guajava bio-active compounds. Methods: 20 carious scrapings were collected from patients with root caries and processed for the isolation of C. albicans and was screened for fluconazole resistance. Genomic DNA was extracted and molecular characterization of Cdrp1 and Cdrp2 was done by PCR amplification. P. guajava methanolic extract was checked for the antifungal efficacy against the resistant strain of C. albicans. Further in-silico docking involves retrieval of ABC transporter protein and ligand optimization, molinspiration assessment on drug likeness, docking simulations and visualizations. Results: 65% of the samples showed the presence of C.albicans and 2 strains were fluconazole resistant. Crude methanolic extract of P. guajava was found to be promising against the fluconazole resistant strains of C. albicans. In-silico docking analysis showed that Myricetin was a promising candidate with a high docking score and other drug ligand interaction scores. Conclusion: The current study emphasizes that bioactive compounds from Psidium guajava to be a promising candidate for treating candidiasis in fluconazole resistant strains of C. albicans However, further in-vivo studies have to be implemented for the experimental validation of the same in improving the oral health and hygiene.

Association Between Persistent Treatment of Alzheimer's Dementia and Osteoporosis Using a Common Data Model

  • Seonhwa Hwang;Yong Gwon Soung;Seong Uk Kang;Donghan Yu;Haeran Baek;Jae-Won Jang
    • Dementia and Neurocognitive Disorders
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    • v.22 no.4
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    • pp.121-129
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    • 2023
  • Background and Purpose: As it becomes an aging society, interest in senile diseases is increasing. Alzheimer's dementia (AD) and osteoporosis are representative senile diseases. Various studies have reported that AD and osteoporosis share many risk factors that affect each other's incidence. This aimed to determine if active medication treatment of AD could affect the development of osteoporosis. Methods: The Health Insurance Review and Assessment Service provided data consisting of diagnosis, demographics, prescription drug, procedures, medical materials, and healthcare resources. In this study, data of all AD patients in South Korea who were registered under the national health insurance system were obtained. The cohort underwent conversion to an Observational Medical Outcomes Partnership-Common Data Model version 5 format. Results: This study included 11,355 individuals in the good persistent group and an equal number of 11,355 individuals in the poor persistent group from the National Health Claims database for AD drug treatment. In primary analysis, the risk of osteoporosis was significantly higher in the poor persistence group than in the good persistence group (hazard ratio, 1.20 [95% confidence interval, 1.09-1.32]; p<0.001). Conclusions: We found that the good persistence group treated with anti-dementia drugs for AD was associated with a significant lower risk of osteoporosis in this nationwide study. Further studies are needed to clarify the pathophysiological link in patients with two chronic diseases.

Anti-proliferative Efficacy of Xanthorrhizol on Cancer Cells via Activation of hTAS2R38 among 25 Human Bitter Taste Receptors

  • Yiseul Kim;Hyun-Jin Na;Min Jung Kim
    • Journal of the Korean Society of Food Culture
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    • v.39 no.3
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    • pp.166-172
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    • 2024
  • Human bitter taste-sensing type 2 receptors (hTAS2Rs) are expressed in various human tissues and may be associated with various cell signaling pathways, cell progression, and cell physiology in each tissue. hTAS2Rs can be a potential drug target because it is also expressed in some cancer cells. Xanthorrhizol (XNT) has various biological activities, such as anticancer, antimicrobial, anti-inflammatory, and antioxidant. XNT produces a bitter taste, but the specific hTAS2R activated is unknown, and the hTAS2R-mediated effect of XNT on cancer cells has not been studied. This study discovered the target receptor of XNT among 25 hTAS2Rs and confirmed the possibility of the hTAS2R-mediated inhibition of cancer cell proliferation. XNT activated only one receptor, hTAS2R38 (EC50=1.606±0.021 ㎍/mL), and its activity was inhibited by probenecid, a hTAS2R38 antagonist. When HepG2 and MCF-7 cells were treated with XNT or phenylthiocarbamide (PTC), a known hTAS2R38 agonist, both chemicals inhibited cancer cell proliferation. XNT targets the human bitter taste receptor TAS2R38 and inhibits the proliferation of HepG2 and MCF-7 cells mediated by TAS2R38. This suggests that TAS2R38 may be a new target for disease treatment and a potential new factor for drug development.

Pro-apoptotic effect of the novel benzylidene derivative MHY695 in human colon cancer cells

  • Gwangbeom Heo;Dongwan Kang;Chaeun Park;Su Jin Kim;Jieun Choo;Yunna Lee;Jin‑Wook Yoo;Yunjin Jung;Jaewon Lee;Nam Deuk Kim;Hae Young Chung;Hyung Ryong Moon;Eunok Im
    • Oncology Letters
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    • v.18 no.3
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    • pp.3256-3264
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    • 2019
  • The induction of apoptosis is a useful strategy in anti-cancer research. Various Moon Hyung Yang (MHY) compounds have been developed as novel anti-cancer drug candidates; in the present study, the pro-apoptotic effects of (Z)-5-(3-ethoxy-4-hydroxybenzylidene)-2-thioxothiazolidin-4-one (MHY695) on HCT116 human colon cancer cells were assessed. MTT assays were performed to investigate the dose-dependent cytotoxic effects of MHY695 on HCT116 cells. Immunofluorescence staining and flow cytometry analyses were performed to identify apoptotic cell death, and western blot analysis was used to investigate the apoptotic-signaling pathways. A mouse xenograft model was also used to determine the effects of MHY695 in vivo. MHY695 decreased the viability of HCT116 cells and induced apoptotic cytotoxicity. The apoptotic mechanisms induced by MHY695 involved the dephosphorylation of Bcl-2-associated agonist of cell death protein following protein kinase B inactivation, induced myeloid leukaemia cell differentiation protein and BH3-interacting domain death agonist truncation, caspase-3 and -9 activation and poly (ADP-ribose) polymerase cleavage. In addition, MHY695 significantly suppressed tumor growth in the mouse xenograft model, compared with the vehicle control. Notably, MHY695 exhibited potent anti-cancer effects in four different types of human colon cancer cell line, including Caco-2, DLD-1, HT-29 and HCT116. Additionally, MHY695 showed reduced cytotoxicity in NCM460, normal colonic epithelial cells. Furthermore, MHY-induced cytotoxicity in colon cancer cells was independent of the tumor suppressor protein p53. Collectively, these observations suggested that MHY695 may be a novel drug for the treatment of colon cancer.

Loganin Ameliorates Acute Kidney Injury and Restores Tofacitinib Metabolism in Rats: Implications for Renal Protection and Drug Interaction

  • Hyeon Gyeom Choi;So Yeon Park;Sung Hun Bae;Sun-Young Chang;So Hee Kim
    • Biomolecules & Therapeutics
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    • v.32 no.5
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    • pp.601-610
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    • 2024
  • Tofacitinib, a Janus kinase (JAK) inhibitor used to treat rheumatoid arthritis, is metabolized through hepatic cytochrome P450 (CYP), specifically CYP3A1/2 and CYP2C11. Prolonged administration of rheumatoid arthritis medications is generally associated with an increased risk of renal toxicity. Loganin (LGN), an iridoid glycoside, has hepatorenal regenerative properties. This study investigates the potential of LGN to mitigate acute kidney injury (AKI) and its effects on the pharmacokinetics of tofacitinib in rats with cisplatin-induced AKI. Both intravenous and oral administration of tofacitinib to AKI rats significantly increased the area under the plasma concentration-time curve from time 0 to infinity (AUC) compared with control (CON) rats, an increase attributed to the decelerated non-renal clearance (CLNR) and renal clearance (CLR) of tofacitinib. Administration of LGN to AKI rats, however, protected kidneys from severe impairment, restoring the pharmacokinetic parameters (AUC, CLNR, and CLR) of tofacitinib to those observed in untreated CON rats, with partial recovery of kidney function, as evidenced by an increase in creatinine clearance. Possible interactions between drugs and natural components should be considered, especially when co-administering both a drug and a natural extract containing LGN or iridoid glycosides to patients with kidney injury.

Ceftizoxime-induced immune hemolytic anemia associated with multi-organ failure (Ceftizoxime 투약 후 면역용혈빈혈 및 다발장기부전)

  • Huh, Jin-Young;Ahn, Ari;Kim, Hyungsuk;Kwon, Seog-Woon;An, Sujong;Lee, Jae Yong;Kwon, Byoung Soo;Oh, Eun Hye;Park, Do Hyun;Huh, Jin Won
    • Journal of Yeungnam Medical Science
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    • v.34 no.1
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    • pp.123-127
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    • 2017
  • Drug-induced immune hemolytic anemia (DIIHA) is a rare side effect of drugs. DIIHA may cause a systemic inflammatory response that results in acute multi-organ failure and death. Ceftizoxime belongs to the class of third generation cephalosporins, which are the most common drugs associated with DIIHA. Herein, we present a case of a 66-year-old man who developed fatal DIIHA after receiving a second dose of ceftizoxime. He was admitted to receive photodynamic therapy. He had a history of a single parenteral dose of ceftizoxime 3 months prior to admission. On the day of the procedure - shortly after the infusion of ceftizoxime - the patient's mental status was altered. The blood test results revealed hemolysis. Oliguric acute kidney injury developed, and continuous renal replacement therapy had to be applied. On the suspicion of DIIHA, the patient underwent plasmapheresis. Diagnosis was confirmed by a detection of drug-dependent antibody with immune complex formation. Although his hemolysis improved, his liver failure did not improve. He was eventually discharged to palliative care, and subsequently died.

A Study on The Clinical Characteristics and Treatment in Burning Mouth Syndrome (구강 작엽감 증후군 (BMS)의 임상적 특징 및 치료에 관한 연구)

  • Mi-Jung Yeom;Chong-Youl Kim
    • Journal of Oral Medicine and Pain
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    • v.20 no.1
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    • pp.39-52
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    • 1995
  • Burning mouth syndrome is characterized by a burning sensation in oral cavity without clinical signs. There has b een no established theories about the diagnosis and treatment. The purpose of this article is to examine the clinical feature of BMS patients of Korean and to present a treatment protocol that can be helpful in clinical applications. The subjects chosen for the study were 52 patients who had visited Department of Oral Diagnosis at Yonsei University Dental Hospital and were diagnosed as BMS. We did questionnaires and precise oral exam, laboratory exam, grouping of our patients, individual treatment for the groups and classification of responses to the treatment. The following results were obtained: 1. Chief complaints were throbbing (71.2%), pricking, stinging, tingling (30.8%), burning(25a%). The tongue is the most frequently affected site (82.7%), followed by full mouth, gingiva, palate, buccal mucosa, lips, throat, labial mucosa and floor of mouth. 2. The average age of onset was 48.1 year and the male to female ratio was 1 to 3. The average duration of symptom was 11.69 months for male and 23.07 months for female. 3. 32.7% of patients had appealed continuous pain, which was the most cases. Aggravating factors were peppery food, salty food, hot food, fatigue, tension conversation, sour food, cold food and toothpaste. Reducing factors were cold food, diet, going to sleep and smoking. 4. Associated symptoms were dry mouth, other life problem, altered taste perception, bad taste, throat pain, tingle and difficulty in swallowing. 5. Most of patients had appealed that there was not associated event on onset of symptom, and the order of prevalence is as fallow; dental treatment, stress, denture wearing, an attack of a systemic disease. 92.3% of patient appealed that there was no psychological withering and 7.7% of patients appealed positively. 6. There were eight males and four females that had jobs. 7. There was no family history in 100% of patients in questions about presence of family history. 8. 96.2% of patients appealed that there was no oral habits. 13.5% of patients had dryness of oral mucosa in oral exam. A significant relation to dental prosthesis was not observable, but incidence of diseases due to stress appeared high in BMS which had the clinical characteristics as above. A group having low serum iron was 63.5% and in this group period of potential iron deficiency appeared high in incidence just before move to anemia. A group represented positive response was 38.5% in fungus study for Candida albicans. Since we can expect high treatment response by prescription of iron-contained drug and antifungal drug in these patients, diagnosing patients' condition of BMS can be achieved in more various aspects through study for serum iron and Candida albicans. Furthermore, it is expected that treatment protocol can be made.

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