• Korean Journal of Clinical Pharmacy
• /
• v.23 no.4
• /
• pp.344-364
• /
• 2013

Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are immune-complex-mediated hypersensitivity reactions that predominantly involve skin and mucous membranes. Despite the low incidence, both are considered medical emergencies as the mortality rate has been estimated at 30-50%. Although as many as half of cases are idiopathic, several drugs have been implicated as main cause of SJS/TEN. This review therefore aimed to identify drugs that were potentially associated with SJS/TEN and compare the relative risk of the medications. Method: A comprehensive search was performed using MEDLINE, EMBASE and 5 Korean databases. We defined study drugs as non-steroidal anti-inflammatory drugs (NSAIDs), antibiotics, antiepileptics, and allopurinol. Only epidemiologic studies investigating associations between the above drugs and drug-induced SJS/TEN were included. Two reviewers independently selected and evaluated candidate papers and extracted odds ratios or incidence rates. Meta-analysis was performed only for drugs that were reported from 4 or more studies. Results: We found 8 case-control studies, 3 cohort studies and 1 RCT. The ranges of adjusted ORs were 0.6-34.0 for NSAIDs, 1.6-302.0 for antiepileptics, 0.3-10.0 for antibiotics and 1.0-187.0 for allopurinol. The drug with the highest incidence of SJS/TEN was carbamazepine (40 persons/1,000 DDD). Conclusion: Finally, the risk was highest in first 8 weeks after onset of treatment in all drugs.

• Journal of Periodontal and Implant Science
• /
• v.28 no.4
• /
• pp.611-632
• /
• 1998

Chitosan has been known as a wound healing agent. The purpose of this study was to evaluate the biocompatibility and guided bone regenerative effect of chitosan and chitosan-cellulose membranes. The effects of chitosan and chitosan-cellulose membranes on the growth and survival of human periodontal ligament cells were examined by rapid colorimetric MTT(tetrazolium) assay, and the tissue response and resorption pattern were observed by implanting the membranes into the subcutaneous tissue of the back of rats for 6 weeks. To evaluate the guided bone regenerative potential of membranes, the amount of newly formed bone in the rat calvarial defects(8mm in diameter) was measured by histomorphometry and radiomorphometry 1,2 and 4 weeks after implantation of membranes. Chitosan and chitosan-cellulose membranes showed no adverse effect on the growth and survival of human periodontal ligament cells. When membranes were subcutaneously implanted, inflammatory reaction was observed at 1 week and which gradually subsided 2weeks after implantation. Membranes remained intact throughout the experimental period of 6 weeks. Radiomorphometric analysis of the craniotomy sites revealed that chitosan and chitosan-cellulose membrane implanted sites showed increased radiopacity over control. Statistically significant differences with control were found in chitosan-cellulose membrane implanted group at 2 and 4 weeks, and chitosan membrane implanted group at 4 weeks(P<0.05). Histomorphometric data indicated a pattern of osseous healing similar to radiomorphometric analysis. There was a statistically significant difference between control and chitosan-cellulose membrane implanted group at 4 weeks(P<0.05). These results implicate that chitosan and chitosan-cellulose membrane might be useful for guided bone regeneration.

• Proceedings of the Korean Environmental Health Society Conference
• /
• 2005.12a
• /
• pp.103-114
• /
• 2005

Chlorine disinfection has been used in drinking water supply to disinfect the water-borne microbial disease which may cause to serious human disease. As Chlorination is still the least costly, relatively easy to use, chlorination is the primary means to disinfect portable water supplies and control bacterial growth in the distribution system. However, chlorine also reacts with natural organic matter (NOM), which presents in nearly all water sources, and then produces disinfection by-product (DBps), which may have adverse health effects. Although the existent DBPs have been reported in drinking water supplies, it is not feasible to predict the levels of the various DBPs due to the complex chemistry reaction involved. The objectives of this study were to investigate seasonal variation of DBPs formation and difference of DBPs concentration in the plant to tap water. The average concentration of THMs was 20.04 ${\mu}g/{\ell}$, HAAs 8-15 ${\mu}g/{\ell}$, HANs 2-4.5 ${\mu}g/{\ell}$ respectively. Distant variation of DBPs formation is that THMs concentration increase by 17% at 2 km point from the plant and by 28% at 7 km and HAAs, HANs also increase each by 16%, 32%, at 2 km from the plant and 35%, 56%, at 7 km. DBPs increase in water supply pipe continually. The seasonal occurrence of DBPs is that in May and August DBPs concentration is very high then in March, in May DBPs concentration is highest. The temperature is main factor of DBPs formation, precursor also. Precursor which was accumulated for winter flowed into the raw water by flooding in spring and summer and produced DBPs. Therefore for the supply of secure drinking water, it is required to protect precursor of flowing into raw water and to add to BCAA and DBAA to drinking water standards.

• Journal of Korean Society of Water and Wastewater
• /
• v.28 no.2
• /
• pp.235-248
• /
• 2014

The widespread occurrence of dissolved endocrine disrupting compounds(EDCs) and pharmaceutical active compounds(PhACs) in water sources is of concern due to their adverse effects. To remove these chemicals, adsorption of EDCs/PhACs on granular activated carbon(GAC) was investigated, and bisphenol A, carbamazepine, diclofenac, ibuprofen, and sulfamethoxazole were selected as commonly occurring EDCs/PhACs in the aquatic environment. Various adsorption isotherms were applied to evaluate compatability with each adsorption in the condition of single-solute. Removal difference between individual and competitive adsorption were investigated from the physicochemical properties of each adsorbate. Hydrophobicity interaction was the main adsorption mechanism in the single-solute adsorption with order of maximum adsorption capacity as bisphenol A > carbamazepine > sulfamethoxazole > diclofenac > ibuprofen, while both hydrophobicity and molecular size play significant roles in competitive adsorption. Adsorption kinetic was also controled by hydrophobicity of each adsorbate resulting in higher hydrophobicity allowed faster adsorption on available adsorption site on GAC. EDCs/PhACs adsorption on GAC was determined as an endothermic reaction resulting in better adsorption at higher temperature ($40^{\circ}C$) than lower temperature ($10^{\circ}C$).

• Biomolecules & Therapeutics
• /
• v.21 no.5
• /
• pp.371-380
• /
• 2013

Doxorubicin is still main drug in chemotherapy with limitation of use due to adverse drug reaction. Increased oxidative stress and alteration of nitric oxide control have been involved in cardiotoxicity of doxorubicin (DOX). A Disintegrin And Metalloproteinase (ADAMs) are transmembrane ectoproteases to regulate cell-cell and cell-matrix interactions, but role in cardiac disease is unclear. The aim of this study was to determine whether DOX activates peroxynitrite and ADAM 10 and thus ADAM and matrix metalloproteinase (MMP) induce cardiac remodeling in DOX-induced cardiomyopathy. Adult male Sprague-Dawley rats were subjected to cardiomyopathy by DOX (6 times of 2.5 mg/kg DOX over 2-weeks), and were randomized as four groups. Then followed by 3, 5, 7, and 14 days after cessation of DOX injection. DOX-injected animals significantly decreased left ventricular fractional shortening compared with control by M-mode echocardiography. The expressions of cardiac nitrotyrosine by immunohistochemistry were significant increased, and persisted for 2 weeks following the last injection. The expression of eNOS was increased by 1.9 times (p<0.05), and iNOS was marked increased in DOX-heart compared with control (p<0.001). Compared to control rats, cardiac ADAM10- and MMP 9- protein expressions increased by 20 times, and active/total MMP 9 proteolytic activity showed increase tendency at day 14 after cessation of DOX injection (n=10, each group). DOX-treated $H_9C_2$ cell showed increased ADAM10 protein expression with dose-dependency (p<0.01) and morphometric changes showed the increase of ventricular interstitial, nonvascular collagen deposition. These data suggest that activation of cardiac peroxynitrite with increased iNOS expression and ADAM 10-dependent MMP 9 expression may be a molecular mechanism that contributes to left ventricular remodeling in DOXinduced cardiomyopathy.

• The Journal of Internal Korean Medicine
• /
• v.39 no.3
• /
• pp.323-337
• /
• 2018

Objective: The purpose of this research is to investigate Chinese clinical studies of the treatment of hiccup after stroke with herbal medicine. Methods: We used the China National Knowledge Infrastructure (CNKI) database to search for clinical studies about using herbal medicine to treat hiccup after stroke. Results: Nineteen clinical articles Until August 31, 2017 were analyzed. The most commonly used herbal prescription was Xuanfudaizhe-tang (旋覆代?湯). According to analysis, the most commonly used medical herbs were Haematitum (代?石), Inulae Flos (旋覆花), and Pinelliae Tuber (半夏). Clinical symptoms, total incidence rate of adverse reaction, recurrence rate, symptom improvement time, patient satisfaction comparison, and dietary status improvement were used to evaluate the treatments. The effective rate of the treatment group was 86.0-97.8%, significantly higher than control group in all papers. Side effects occurred much less frequently in the treatment group than in the western medicine control group. Conclusion: The treatment of hiccup after stroke with herbal medicine was shown to be highly effective in 19 studies. Additional well-designed clinical trials are needed; this study can be used as a basis for further research regarding the treatment of hiccup after stroke.

• Journal of Applied Biological Chemistry
• /
• v.56 no.4
• /
• pp.205-211
• /
• 2013

Nitrate is a naturally occurring compound in plant and can be converted to nitrite in the nitrogen cycle and vice versa. Therefore, it is easy to find nitrate in plants including vegetables. Especially, it is known that high levels of nitrate found in leafy vegetables. Nitrate itself is relatively non-toxic but its metabolites and reaction products such as nitrite, nitric oxide and N-nitroso compounds, may produce adverse health effects such as methaemoglobinaemia and carcinogenesis. To execute the risk assessment of dietary nitrate and nitrite for the intake of vegetables, it is investigated that the levels of nitrate and nitrite in 23 vegetables (798 samples). The range of concentration were 0-6,719mg/kg for nitrate and 0-1,635mg/kg for nitrite, respectively. The Estimated daily intakes (EDI) were 0.85-1.38 mg/kg body weight/day for nitrate and 0.02-0.03 mg/kg body weight/day for nitrite by ages. We conclude that there are no health concerns for eating various vegetables since the EDI were below the Tolerable Daily Intake (3.7 mg/kg body weight/day for nitrate, 0.06 mg/kg body weight/day for nitrite) level established by WHO.

• Quality Improvement in Health Care
• /
• v.2 no.1
• /
• pp.86-109
• /
• 1995

Clinical trials of drugs on humans is the final and most important stage in evaluating the safety and efficacy of the drugs. Good Clinical Practice(GCP) standards were announced in 1987 to protect testees' rights as well as to ensure validity of the clinical trial results, but its implementation has been delayed until now. The purpose of this study is to evaluate the preparedness of the designated institutions to abide by GCP standards during clinical trials, and thereby to determine GCP implementability at the institutions. Survey on the status of clinical trials was conducted for the designated 83 clinical trial hospitals. Response rate was 95.2%. Donabedian's quality assessment model was applied as the basic framework for the study. And the relative - weights for the evaluation items were determined by expert's evaluation. Among the designated 83 hospitals, 39 conducted clinical trials to obtain drug manufacturing approval from 1990 to 1994. Only 19 institutions are found to be able to meet the requirements of KGCP. Structure variables - manpower, organization, and facility -, which are the basic elements for GCP, are evaluated as unsatisfied in many hospitals. Institutions which established IRB accounted for 41 or 51.9%, but those who have a protocol evaluation guideline, or Adverse Drug Reaction(ADR) reporting system were only 12 and 21 institutions, respectively. Also, the institutions providing educational programs on conducting clinical trials are few - 20. The study results indicates that the level of conducting KGCP is unsatisfactory. However, more institutions are expected to be able to meet the standards soon because GCP standards does not require so much regulation on facilities, but stress importance on research methodology and human right. At present as the institutions for clinical trials are primarily training hospitals with residency programs, such efforts as education will accelerate the implementability of GCP in Korea. Institutions must build the appropriate infrastructure and government must prepare to strongly enforce KGCP before it can successfully take place.

• Journal of Pharmacopuncture
• /
• v.18 no.4
• /
• pp.59-62
• /
• 2015

Objectives: A previous study showed that bee venom (BV) could cause anaphylaxis or other hypersensitivity reactions. Although hypersensitivity reactions due to sweet bee venom (SBV) have been reported, SBV has been reported to be associated with significantly reduced sensitization compared to BV. Although no systemic immediate hypersensitive response accompanied by abnormal vital signs has been reported with respect to SBV, we report a systemic immediate hypersensitive response that we experienced while trying to use SBV clinically. Methods: The patient had undergone BV treatment several times at other Oriental medicine clinics and had experienced no adverse reactions. She came to acupuncture & moxibustion department at Semyung university hospital of Oriental medicine (Je-cheon, Korea) complaining of facial hypoesthesia and was treated using SBV injections, her first SBV treatment. SBV, 0.05 cc, was injected at each of 8 acupoints, for a total of 0.40 cc: Jichang (ST4), Daeyeong (ST5), Hyeopgeo (ST6), Hagwan (ST7), Yepung (TE17), Imun (TE21), Cheonghoe (GB2), and Gwallyeo (SI18). Results: The patient showed systemic immediate hypersensitive reactions. The main symptoms were abdominal pain, nausea and perspiration, but common symptoms associated with hypersensitivity, such as edema, were mild. Abdominal pain was the most long-lasting symptom and was accompanied by nausea. Her body temperature decreased due to sweating. Her diastolic blood pressure could not be measured on three occasions. She remained alert, though the symptoms persisted. The following treatments were conducted in sequence; intramuscular epinephrine, 1 mg/mL, injection, intramuscular dexamethasone, 5 mg/mL, injection, intramuscular buscopan, 20 mg/mL, injection, oxygen ($O_2$) inhalation therapy, 1 L/minutes, via a nasal prong, and intravascular injection of normal saline, 1 L. After 12 hours of treatment, the symptoms had completely disappeared. Conclusion: This case shows that the use of SBV does not completely eliminate the possibility of hypersensitivity and that patients who received BV treatment before may also be sensitized to SBV. Thus, a skin test should be given prior to using SBV.

• Journal of Veterinary Clinics
• /
• v.34 no.6
• /
• pp.441-444
• /
• 2017

A 15-year-old spayed female Miniature Schnauzer was presented for unilateral foreleg lameness and pain. On physical examination, left elbow joint swelling and stiffness were identified. On a computed tomography (CT) scan, a periosteal reaction of the left humerus from the distal metaphysis to the epiphysis and cortical destruction of the medial condyle was observed. Based on blood tests, histopathology, and immunohistochemistry, it was concluded as a skeletal histiocytic sarcoma. Since the patient's pain was not controlled despite application of a fentanyl patch, a left forelimb amputation was decided upon as part of the palliative therapy. Metronomic chemotherapy with toceranib phosphate and pamidronate was initiated. Toceranib was administered for 3 months without the development of any adverse effects except mild neutropenia. However, 3 months after initiating treatment, the toceranib was discontinued due to moderate gastrointestinal disturbances. Over the next 2 months, a left mandibular bone mass and cortical bone destruction in the bilateral tibia and tarsal joint were identified on CT. The patient became unwilling to eat and was noted to have severe skeletal pain. The anorexia and lethargy were progressively worsening and the owner decided to euthanize the patient. A necropsy was performed and the patient was definitively diagnosed with disseminated histiocytic sarcoma based on histopathologic and immunohistochemical analyses. This report describes a Miniature Schnauzer dog with DHS managed with surgical removal and metronomic chemotherapy with toceranib that survived with an improved quality of life for 7 months.