• Title/Summary/Keyword: adverse reaction

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The safety and efficacy of EGF-based cream for the prevention of radiotherapy-induced skin injury: results from a multicenter observational study

  • Kang, Hyun-Cheol;Ahn, Seung-Do;Choi, Doo-Ho;Kang, Min Kyu;Chung, Woong-Ki;Wu, Hong-Gyun
    • Radiation Oncology Journal
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    • v.32 no.3
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    • pp.156-162
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    • 2014
  • Purpose: This study was designed to evaluate the efficacy and safety of topically applied recombinant human epidermal growth factor (rhEGF) for the prevention of radiation-induced dermatitis in cancer patients. Materials and Methods: From December 2010 to April 2012, a total of 1,172 cancer patients who received radiotherapy (RT) of more than 50 Gy were prospectively enrolled and treated with EGF-based cream. An acute skin reaction classified according to the Radiation Therapy Oncology Group 6-point rating scale was the primary end point and we also assessed the occurrence of edema, dry skin, or pruritus. Results: The percentage of radiation dermatitis with maximum grade 0 and grade 1 was 19% and 58% at the time of 50 Gy, and it became 29% and 47% after completion of planned RT. This increment was observed only in breast cancer patients (from 18%/62% to 32%/49%). Adverse events related to the EGF-based cream developed in 49 patients (4%) with mild erythema the most common. Skin toxicity grade >2 was observed in 5% of the patients. Edema, dry skin, and pruritus grade ${\geq}3$ developed in 9%, 9%, and 1% of the patients, respectively. Conclusion: Prophylactic use of an EGF-based cream is effective in preventing radiation dermatitis with tolerable toxicity. Further studies comparing EGF cream with other topical agents may be necessary.

CLINICAL STUDY ON THE CONSCIOUS SEDATION WITH MIDAZOLAM INTRANASAL SPRAY (미다졸람의 비강내 분무를 이용한 의식진정에 대한 증례보고)

  • Kim, Hyun-Sik;Choi, Jung-Lim;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.25 no.4
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    • pp.782-787
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    • 1998
  • The treatment for pediatric dental patient has become more complex than the previous, because patients of pediatric dentistry, younger than the previous, and they were often combined with systemic disease. And, the importnace of conscious sedation has been increased by this time for this reason. In a variety of CNS depressants, newly developed imidazobenzodiazepine (midazolam) is well known as a safe and effective medicament. It has a rapid onset, minimized cardiovascular depression and various possible administering, route, so it is commonly used for the conscious sedation of pediatric dental patients. Recently, "intranasal drop-in method" draws attention for its safety, but discomfort during administration and posterior dripping through pharynx diminish its popularity. Now more advanced method for intranasal administration is introduced for conscious sedation for pediatric dental patients, it is "intranasal spray" with aerosol form of medicament. With this method, we can achieve some benefits as belows : 1. Diminished discomfort during intranasal spray than nitranasal drop-in. 2. Rapid osnet and reduction than intranasal drop-in. 3. Eliminatin of adverse reaction, such as rhinorrhea. 4. More improved behavior rating scale.

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An Improvement Plan with Assessment of Therapeutic Drug Monitoring Service for Vancomycin (Vancomycin Therapeutic Drug Monitoring 운영 실태 조사와 업무 개선 방안)

  • Kim, Hae-Sook;Lee, Suk-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.19 no.2
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    • pp.120-130
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    • 2009
  • The objective of this study was to analyze and to improve therapeutic drug monitoring(TDM) service of vancomycin in a local hospital. Patients with TDM service between September 2005 and December 2008 were included and the data were collected for vancomycin use and components of TDM. During that period, 421 cases of TDM service of vancomycin in 236 patients were retrospectively reviewed. The first dosages of vancomycin were appropriate in 135(57.2%) patients and administration of vancomycin was discontinued in 126(53.4%) patients due to therapeutic failure or adverse drug reaction. MRSA was identified in 191(80.9%) patients and 135(70.7%) samples for the identification were sputum. According to the TDM reports, 232(55.1%) serum samples were obtained at the steady-state conditions and 55.5% of the samples that were drawn before the steady-state was due to the physician's inappropriate knowledge about the steady-state. Based on the time of vancomycin administration, 35.8% of the samples were not obtained at the recommended sampling time. For the patients in general wards, the most common reason for the incorrect samples was routine serum sampling by the laboratory medicine phlebotomists between 6 and 8 a.m. except sunday. In contrast, samples drawn by nurses or physicians at inappropriate time were the most common reason for the incorrect samples with patients in the intensive care units. Physicians accepted 68.5% of the recommendations for vancomycin dosage and administration. In conclusion, TDM service of vancomycin needs to be improved in inappropriate sampling time and vancomycin dosage. For solving these problems, current team made of TDM pharmacists and physicians of laboratory medicine can be expanded to include a physician of infectious diseases, nurses and laboratory medicine phlebotomists as new members. Through the TDM service of vancomycin by the new team, we can settle the problems and make the guideline for the scientific controversies associated with therapeutic monitoring of vancomycin.

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Pattern of Pharmacist Consultation among the Health Counseling Services via Internet Portal Sites: A Pilot Study (국내 포털사이트에서의 지식검색서비스를 이용한 약사와의 상담 패턴에 대한 시험적 연구)

  • Kim, Heejin;Park, Jun Ha;Ji, Eunhee
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.4
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    • pp.324-329
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    • 2016
  • Background: With the development of information and communication technology, there is a growing number of people looking for health information on the internet. This pilot study was performed to analyze the pattern of pharmacist consultation on the internet portal site. Methods: Questions and answers posted on the portal site "Naver Jisik-iN" from March 1st to 31th in 2016 were collected. Medications asked were categorized into prescription drugs, nonprescription drugs, sanitary aids, emergency drugs, functional health foods, and others. Medications were subcategorized into 14 according to the anatomical therapeutic chemical classification system. Questions were divided into 10 categories based on Hepler's drug-related problems. Results: Of the 955 cases, females accounted for 59.5% and inquirers from 11 to 40 years old, 89.4%. The number of prescription drugs, nonprescription drugs, sanitary aids, emergency drugs, functional health foods, and others were 428 (44.8%), 328 (34.3%), 31 (3.3%), 2 (0.2%), 122 (12.8%), and 44 (4.6%), respectively. Questions for drugs acting on alimentary tract and metabolism took up 27.4% followed by those on nervous system, 13.6% and anti-infectives for systemic use, 12.2%. Pharmacist consultation regarding drug information, drug interaction, and adverse reaction occupied 47.9%, 15.2%, and 12.3%, respectively. Conclusion: Health counseling through online is predicted to increase steadily, so pharmacists should broaden their boundaries beyond off-line pharmacies to meet social needs.

Selective Catalytic Oxidation of Ammonia in the Presence of Manganese Catalysts (망간촉매하에서 암모니아의 선택적 산화반응)

  • Jang, Hyun Tae;Park, YoonKook;Ko, Yong Sig;Cha, Wang Seog
    • Korean Chemical Engineering Research
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    • v.46 no.3
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    • pp.498-505
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    • 2008
  • The selective catalytic oxidation of ammonia was carried out in the presence of natural manganese ore (NMO) and manganese as catalysts using a homemade 1/4" reactor at $10,000hr^{-1}$ of space velocity. The inlet ammonia concentration was maintained at 2,000 ppm, with an air balance. The manganese catalyst resulted in a substantial ammonia conversion, with adsorption activation energies of oxygen and ammonia of 10.5 and 22.7 kcal/mol, respectively. Both $T_{50}$ and $T_{90}$, defined as the temperatures where 50% and 90% of ammonia, respectively, are converted, decreased significantly when alumina-supported manganese catalyst was applied. Increasing the manganese weight percent by 15 wt% increased the lower temperature activity, but 20 wt% of manganese had an adverse effect on the reaction results. An important finding of the study was that the manganese catalyst benefits from a strong sulfur tolerance in the conversion of ammonia to nitrogen.

Angelica Sinensis Polysaccharide Induces Erythroid Differentiation of Human Chronic Myelogenous Leukemia K562 Cells

  • Wang, Lu;Jiang, Rong;Song, Shu-Dan;Hua, Zi-Sen;Wang, Jian-Wei;Wang, Ya-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3715-3721
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    • 2015
  • Leukemia is a clonal disorder with blocked normal differentiation and cell death of hematopoietic progenitor cells. Traditional modalities with most used radiation and chemotherapy are nonspecific and toxic which cause adverse effects on normal cells. Differentiation inducing therapy forcing malignant cells to undergo terminal differentiation has been proven to be a promising strategy. However, there is still scarce of potent differentiation inducing agents. We show here that Angelica sinensis polysaccharide (ASP), a major active component in Dong quai (Chinese Angelica sinensis), has potential differentiation inducing activity in human chronic erythro-megakaryoblastic leukemia K562 cells. MTT assays and flow cytometric analysis demonstrated that ASP inhibited K562 cell proliferation and arrested the cell cycle at the G0/G1 phase. ASP also triggered K562 cells to undergo erythroid differentiaton as revealed by morphological changes, intensive benzidine staining and hemoglobin colorimetric reaction, as well as increased expression of glycophorin A (GPA) protein. ASP induced redistribution of STAT5 protein from the cytoplasm to the nucleus. Western blotting analysis further identified that ASP markedly sensitized K562 cells to exogenous erythropoietin (EPO) by activating EPO-induced JAK2/STAT5 tyrosine phosphorylation, thus augmenting the EPO-mediated JAK2/STAT5 signaling pathway. On the basis of these findings, we propose that ASP might be developed as a potential candidate for chronic myelogenous leukemia inducing differentiation treatment.

Down-regulated MYH11 Expression Correlates with Poor Prognosis in Stage II and III Colorectal Cancer

  • Wang, Ren-Jie;Wu, Peng;Cai, Guo-Xiang;Wang, Zhi-Min;Xu, Ye;Peng, Jun-Jie;Sheng, Wei-Qi;Lu, Hong-Fen;Cai, San-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7223-7228
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    • 2014
  • The MYH11 gene may be related to cell migration and adhesion, intracellular transport, and signal transduction. However, its relationship with prognosis is still uncertain. The aim of this study was to investigate correlations between MYH11 gene expression and prognosis in 58 patients with stage II and III colorectal cancer. Quantitative real-time polymerase chain reaction was performed in fresh CRC tissues to examine mRNA expression, and immunohistochemistry was performed with paraffin-embedded specimens for protein expression. On univariate analysis, MYH11 expression at both mRNA and protein levels, perineural invasion and lymphovascular invasion were related to disease-free survival (p<0.05; log-rank test). Cancers with lower MYH11 expression were more likely to have a poor prognosis. Otherwise, MYH11 expression was unrelated to patient clinicopathological features. On multivariate analysis, low MYH11 expression proved to be an independent adverse prognosticator (p<0.05). These findings show that MYH11 can contribute to predicting prognosis in stage II and III colorectal cancers.

Significant Genotype Difference in the CYP2E1 PstI Polymorphism of Indigenous Groups in Sabah, Malaysia with Asian and Non-Asian Populations

  • Goh, Lucky Poh Wah;Chong, Eric Tzyy Jiann;Chua, Kek Heng;Chuah, Jitt Aun;Lee, Ping-Chin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7377-7381
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    • 2014
  • CYP2E1 PstI polymorphism G-1259C (rs3813867) genotype distributions vary significantly among different populations and are associated with both diseases, like cancer, and adverse drug effects. To date, there have been limited genotype distributions and allele frequencies of this polymorphism reported in the three major indigenous ethnic groups (KadazanDusun, Bajau, and Rungus) in Sabah, also known as North Borneo. The aim of this study was to investigate the genotype distributions and allele frequencies of the CYP2E1 PstI polymorphism G-1259C in these three major indigenous peoples in Sabah. A total of 640 healthy individuals from the three dominant indigenous groups were recruited for this study. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) at G-1259C polymorphic site of CYP2E1 gene was performed using the Pst I restriction enzyme. Fragments were analyzed using agarose gel electrophoresis and confirmed by direct sequencing. Overall, the allele frequencies were 90.3% for c1 allele and 9.7% for c2 allele. The genotype frequencies for c1/c1, c1/c2 and c2/c2 were observed as 80.9%, 18.8%, and 0.3%, respectively. A highly statistical significant difference (p<0.001) was observed in the genotype distributions between indigenous groups in Sabah with all Asian and non-Asian populations. However, among these three indigenous groups, there was no statistical significant difference (p>0.001) in their genotype distributions. The three major indigenous ethnic groups in Sabah show unique genotype distributions when compared with other populations. This finding indicates the importance of establishing the genotype distributions of CYP2E1 PstI polymorphism in the indigenous populations.

Safety of Korean Herbal Medicine Used with Western Medicine on Liver Function : Prospective Observational Study (한방병원 입원환자의 한.양방 약물 병용에 따른 간 기능 안전성 평가 : 전향적 관찰연구)

  • Bae, Su-Hyun;Park, Sang-Eun;Kang, Chang-Wan;Hong, Sang-Hoon
    • The Journal of Internal Korean Medicine
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    • v.34 no.2
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    • pp.192-203
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    • 2013
  • Objectives : To investigate the incidence of drug-induced liver injury (DILI) by combined-prescription of Korean herbal medicine (KHM; prescribed herbal medicine by doctors of traditional Korean medicine) and Western medicine on liver function. Methods : Sixty-nine in-patients who took KHM and Western medicine for various conditions were enrolled for prospective observational study. All subjects were given liver and renal function tests at the start of hospitalization to establish a baseline. After taking KHM and Western medicine, tests were done at approximately 4-week intervals afterwards. Results : Fifty-three subjects showed normal liver function test (LFT) at baseline, 50 subjects (72.5%) remained within the normal range at the second test, while 3 subjects (4.3%) tests revealed slight increase of LFT. However not a single patient had a high enough raised LFT to indicate liver injury. Sixteen of 69 subjects had abnormal baseline, 11 subjects recovered to normal levels and 5 subjects remained at abnormal level. Among all subjects, there was no statistically significant increase in LFT level between the first and second tests. Conclusions : This study shows that the combined-prescription of KHM and Western medicine did not cause any DILI. In some cases, combined treatment increased LFT levels but those increases were not high enough to have statistical significance. Additional large scale and systematical studies are required for more conclusive proof and results.

A Case of Amiodarone-Induced Pulmonary Toxicity (Amiodarone에 의해 유발된 폐 독성 1예)

  • Shim, Jae-Jeong;Lee, Sang-Hwa;Yoo, Jae-Myung;Suh, Hong-Suk;Oh, Dong-Joo;Joh, Jae-Youn;In, Kwang-Ho;Yoo, Se-Hwa;Kang, Kyung-Ho;Kang, Eun-Young;Chae, Yang-Suk
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.1
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    • pp.51-57
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    • 1994
  • Amiodarone is a potent antiarrythmic agent used in the treatment of refractory tachyarrythmias and premature ventricular contractions. Amiodarone may be responsible for the frequent and various side effects including corneal deposits, abnormal liver function test, hyperthyriodism or hypothyroidism, bluish discoloration of the skin, neuropathies, and the others. However, pulmonary toxicity is most serious adverse reaction limiting the clinical efficacy. Rescently, we experienced a case of pulmonary toxicity induced by low dose 10-month amiodarone treatment for atrial fibrilation with rapid ventricular response. Lung biopsy reveals interstitial inflammation, fibrosis, hyperplasia of pneumocytes, and foamy macrophages. Respiratory symptoms and abnormal chest X-ray findings were nearly complete cleared after using steroid and withdrawal of amiodarone. We report a case of amiodarone-induced pulmonary toxicity with literature review.

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