• 한국임상약학회지
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• 제13권2호
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• pp.59-66
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• 2003

Filgrastim is used as an indispensable adjuvant drug to reduce the degree and duration of chemotherapy-induced neutropenia. The purpose of this research is to study the use of filgrastim by reviewing retrospective medical records of breast cancer patients who have been treated by filgtastim in the National Cancer Center. 84 patients have received 323 cycles of chemotherapy, of which 134 cycles were treated by filgrastim $(41.5\%)$. Among those 134 cycles, 34 were for prophylaxis $(21.6\%)$, and 100 for treatment of neutropenia $(74.6\%)$. The frequence of filgrastim usage was more than $50\%$ in frequency with regimens containing docetaxel. For prophylaxis, the median of filgrastim initiation was measured on the day of chemotherapy (-3rd-13th). For the treatment, on the other hand, the median appeared on the 9th day (4th-2lst) after chemotherapy, which showed very wide distribution. Time to filgrastim initiation ranged between the 7th and the 9th day after chemotherapy in docetaxel+doxorubicin combination regimen and docetaxel single regimen, whereas it showed after the 10th day in doxorubicin+cyclophosphamide combination regimens. For the treatment, 48 out of 61 patients $(73.8\%)$ in 63 cycles have experienced fever, had to visit the emergency room, required hospitalization, caused infection, transfusion, dosage reduction and schedule changes in spite of using filgrastim with chemotherapy. For prophylaxis, 11 out of 19 patients $(17.9\%)$ in 11 cycles have experienced the same results. In conclusion, the guideline of time to the initiation and the last is required for cost-effective administration of filgrastim because of the difference occurring ANC nadir, the severity and duration of neutropenia by chemotherapy regimens.

• 대한골관절종양학회지
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• 제2권1호
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• pp.38-46
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• 1996

The traditional methodology in Ewing's sarcoma was chemotherapy and radiotherapy. Recently surgery is reemerging as an important therapeutic tool and some paper report increased survival with it. The purpose of this nonrandomized study is to evaluate our result of Ewing's sarcoma with surgery, retrospectively. We experienced 30 cases for seven years and among them 6 were extraskeletal. In location, axial was 10 cases and peripheral was 20. By Enneking's classification, state IIB was 26 cases and IIIB was 4. Eighteen patients took operation, chemotherapy and/or radiotherapy, and remaining twelve took chemotherapy and/or radiotherapy only. Type of operation was limb salvage in 16 cases and amputation 2. Average dosage of radiation was 45.1Gy. Six kinds of chemotherapeutic regimen were used, but among them main protocols were Ifosfamide-Adriamycin(17 cases) and IESS(Cytoxan, Adriamycin, Methotrexate, Vincristine:8 cases). Complications were as follows. In operation group, there were 3 local recurrence and one case of nonunion. In nonoperated group, one local recurrence and one pancytopenia resulting in death. Average follow up was 29.7 months. Kaplan-Meier's ten year actuarial survival rate for the whole 30 cases was 26.8%. Significant difference in survival exists between central and peripheral lesions(p=0.05, by log rank test). Types of chemotherapy and surgery itself showed no significance. But surgery is important in function and local control. More intensive chemotherapeutic regimen to prevent distant metastasis and combined surgery and radiotherapy may be needed in Ewing's sarcoma.

• Journal of Chest Surgery
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• 제31권9호
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• pp.867-872
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• 1998

배경: 심폐바이패스에 의한 개심술시 적절한 항응고요법은 수술 관련 혈액응고장애를 최소화한다 는 점에서 중요하다. 심폐바이패스시 헤파린 및 프로타민 투여량을 결정하는데에는 활성화응고시간을 이 용한 고정용량법이 용량반응 곡선을 이용한 방법과 함께 보편적으로 사용되고 있다. 대상 및 방법: 저자들은 고정용량법에 대한 전향적 연구를 통해 고정용량 투여후 헤파린 및 프로 타민의 추가 투여 빈도, 헤파린 저항및 헤파린 유발성 혈소판감소증 빈도, 심폐바이패스시 활성화응고시 간 변화 양상, 그리고 아프로티닌 사용시 활성화응고시간 변화등을 분석하였다. 심폐바이패스 시작전 헤 파린 300 unit/kg를 투여하고 5분후 그리고 심폐바이패스 시작후 10분, 30분, 60분(이후 30분 간격)의 활성화응고시간을 측정하여 400초 이하인 경우 100 unit/kg 헤파린을 추가 투여하였다. 프로타민 중화는 사용 헤파린 100 unit당 1 mg을 투여한후 30분에 측정한 활성화응고시간이 130초 이상 또는 130초 미만이 라도 명백한 응고장애가 있을 경우 0.5mg/kg 추가 투여하였다. 결과: 서울대병원에서 개심술을 받은 환자중 80명(성인 50명, 소아 30명)을 대상으로 하였다. 수 술전 활성화응고시간은 성인에서 114.3$\pm$19.3초, 소아에서 119.5$\pm$18.2초로 나이, 체중, 체표면적 및 성 별에 따른 유의한 차이는 발견되지 않았다. 과거 개심술 병력도 수술전 활성화응고시간에 영향이 없었다. 고정용량법 투여후 헤린 추가 투여가 필요하였던 경우는 성인 환자 10례(20%), 소아 환자 3례(10%)였다. 프로타민 추가투여가 필요하였던 경우는 성인에서 9례(18%), 소아에서 10례(33%)였다. 심폐바이패스 시간 과 프로타민 추가 투여 사이에는 상관관계를 찾을수 없었다. 헤파린저항을 보였던 경우는 성인에서만 2명 (4%)이었고 소아는 없었다. 헤파린 유발성 혈소판감소증은 성인에서 2례(4%), 소아에서 1례(3.3%) 관찰되 었다. 심폐바이패스 운용중 활성화응고시간은 시간경과에 따라 길어지는 양상을 보였다. 성인환자에서 저 용량 아프로티닌이 12례(24%)에서 사용되었는데, 이들에서는 심폐바이패스중 활성화응고시간(celite를 활 성물질로 사용)이 비사용군에 비해 높았고, 활성 물질로 kaolin을 사용했을 때의 활성화응고시간은 celite ACT에 비하여 낮게 나타났다. 결론: 결론적으로 헤파린 및 프로타민 고정 용량 투여법은 큰 문제 없이 운용될 수있으나 추가 용량 투여 빈도의 측면에서는 만족할만한 수준은 되지 못하였다.

• 대한수의학회지
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• 제37권2호
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• pp.291-299
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• 1997

In order to establish optimal dosage schedules and withdrawal times for sulfamethazine(SMZ) in pigs, pharmacokinetic and tissue distribution experiments were conducted in pigs. For comparative purposes, tissue depletion kinetics are also studied in rats. From three pigs administered with SMZ i.v., the pharmacokinetic profile of SMZ in two pigs was adequately described by a one-compartment open model whereas that in one pig was patterned after a two-compartment open model. Volume of distribution(Vd) was 0.48~0.57 L/kg and biological half-life($t_{1/2}$) was 11.8-16.8 h. From three pigs dosed with SMZ p.o., pharmacokinetic profile was explainable with a one-compartment open model. Time to reach maximum SMZ concentration in serum (Tmax) was 2.8 h, 3.2 h and 7.5 h. Elimination half-life was 2.8-7.5 h. The descending order in concentration of SMZ was plsama > kidney > liver > lung > heart > pancreas > spleen > duodenum > ileum > brain > adipsoe tissue from three pigs sacrificed at 5h, 29h and 54h after the administration of SMZ, p.o.. The protein binding of SMZ in pigs was 55.2%($2.5{\mu}g/ml$), 71.5% ($5{\mu}g/kg$) and 71.5%($10{\mu}g/ml$). The mean systemic bioavailability (F) of SMZ p.o. was 49.1 %. Meanwhile the pharmacokinetic profile of SMZ in rats was adequately described by a one-compartment open model. Absorption of SMZ p.o. in the rat was very rapid. In conclusion, the oral optimal dosage regimen of SMZ for pigs was the initial dose of 45.7 mg/kg followed by the maintenance dose of 30.2 mg/kg for high specific pathogens to SMZ. The time to reach below the stipulated residual allowable concentration (0.1 ppm) was calculated 93 h after oral administration of 200 mg/kg recommended by manufactureres.

• 약학회지
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• 제43권2호
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• pp.160-168
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• 1999

The purpose of this study was to determine pharmacokinetic parameters of vancomycin using peak and trough plasma level (PTL) and Bayesian analysis in 20 Korean normal volunteers, 16 gastric cancer and 12 lymphoma patients and also using the compartment model dependent (nonlinear least squares regression: NLSR) and compartment model independent (Lagrange) analysis in 10 ovarian cancer patients. Nonparametric expected maximum (NPEM) algorithm for calculation of the population pharmacokinetic parameters was used, and these parameters were applied for clinical pharmacokinetic parameters by Bayesian analysis. Vancomycin was administered as dose of 1.0 g every 12 hrs for 3 days by IV infusion over 60 minutes in normal volunteers, gastric cancer and lymphoma patients. Population pharmacokinetic parameters, K and Vd in gastric cancer and lymphoma patients using NPEM algorithm were $0.158{\pm}0.014{\;}hr^{-1},{\;}0.630{\pm}0.043{\;}L/kg{\;}and{\;}0.131{\pm}0.0261{\;}hr^{-1},{\;}0.631{\pm}0.089{\;}L/kg$ respectively. The K and Vd in gastric cancer and lymphoma patients using Bayesian analysis were $0.151{\pm}0.027,{\;}0.126{\pm}0.056{\;}hr^{-1}{\;}and{\;}0.62{\pm}0.105,{\;}0.63{\pm}0.095{\;}L/kg$. The K and Vd in ovarian cancer patient using the NLSR and Lagrange analysis were $0.109{\pm}0.008,{\;}0.126{\pm}0.012{\;}hr^{-1}{\;}and{\;} 0.76{\pm}0.08,{\;}0.69{\pm}0.19{\;}L/kg$, respectively. It is necessary for effective dosage regimen of vancomycin in cancer patients to use these population parameters.

• 한국임상약학회지
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• 제3권2호
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• pp.131-137
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• 1993

The effects of gastric acidity on the bioavailability of scopolamine hydrobromide and ${\ell}$-hyoscya-mine were studied in rabbits. Each drug was administered orally at dose of 0.2mg/kg to gastric acidity controlled rabbits. The plasma concentration of scopolamine and ${\ell}$-hyoscyamine were determined by selected ion monitoring in GC/MSCScopolamine; m/Z= 138, ${\ell}$-Hyoscyamine; m/z= 124). Rabbits with hypoacidity showed significantly higher Cp and AVC than rabbits with hyperacidity after oral administration of each drug. From the results of this experiment, it is desirable that dosage regimen of dose of scopolamine and hyoscyamine should be adjusted when the drugs should be administered with antacids in clinical practice.

• 한국임상약학회지
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• 제15권1호
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• pp.50-54
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• 2005

The purpose of this study is to investigate the effect of aspirin on the pharmacokinetics of pranoprofen by oral coadministration of pranoprofen (5 mg/kg) with aspirin (5, 10 and 20 mg/kg) in Sprague-Dawley rats. After oral coadministration of pranoprofen with aspirin, the area under the plasma concentration-time curves (AUC) of pranoprofen was increased significantly by 10 mg/kg (p<0.05) and 20 mg/kg (p<0.01) of aspirin coadministration, and peak concentrations ($C_{max}$) of pranoprofen was increased significantly by coadministration of 20 mg/kg aspirin (p<0.05) compared to pranoprofen alone. Relative bioavailabilities (RB${\%}$) of pranoprofen in coadmistration were higher (from 1.42 to 1.67 fold) than control. The half-lives ($t_{1/2}$) of pranoprofen in coadministration were increased significantly (p<0.05) by 20-mg/kg aspirin. Based on these results, we might be considered that the pharmacokinetics of pranoprofen would be affected by coadministration of aspirin, by inhibit its metabolism in the liver and the tubular secretion of the kidney with the same acidic property. It should take into consideration in dosage regimen of pranoprofen when coadministration of pranoprofen with aspirin in treatment of rheumatoid arthritis.

• 약학회지
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• 제54권5호
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• pp.370-376
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• 2010

The aim of this study is to investigate the effect of apigenin on the pharmacokinetics of tamoxifen in rats. Tamoxifen was administered orally (10 mg/kg) or intravenously (2 mg/kg) without or with oral administration of apigenin (0.4, 2.0 or 8.0 mg/kg) to rats. The effect of apigenin on the P-glycoprotein (P-gp) and CYP3A4 activity was also evaluated. Apigenin inhibited CYP3A4 enzyme activity with 50% inhibition concentration ($IC_{50}$) of 1.8 ${\mu}M$. In addition, apigenin significantly enhanced the cellular accumulation of rhodamine 123 in MCF-7/ADR cells overexpressing P-gp. The plasma concentrations of tamoxifen were increased significantly by apigenin compared to control. The areas under the plasma concentration-time curve (AUC) and the peak concentrations ($IC_{max}$) of tamoxifen with apigenin were significantly higher than those of the control group. Consequently, the relative bioavailability (RB%) of tamoxifen with apigenin was 2-3-fold higher than the control, and absolute bioavailability (AB%) of tamoxifen were significantly higher (p<0.05 with co-administration, p<0.01 with pretreatment) than those of the control. The increased bioavailability of tamoxifen in rats with apigenin might be associated with the inhibition of an efflux pump P-glycoprotein and CYP3A4 by apigenin. From these results, dosage regimen of tamoxifen may be need to adjust when concomitantly administered with apigenin.

• 한국임상약학회지
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• 제8권1호
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• pp.23-28
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• 1998

The pharmacokinetics of atenolol (25 mg/kg, i.v.) in the folate-induced renal failure rabbits was studied. Renal failure was induced by the i.v. injection of folate (50, 100, and 200 mg/kg). At folate dose of 100 and 200 mg/kg, the serum creatinine concentration (Scr) and blood urea nitrogen (BUN) increased significantly compared with control rabbits. Plasma concentrations and AUC of atenolol increased significantly at folate dose of 100 and 200 mg/kg. The elimination rate constant $(K_{el})$ and total body clearance $(CL_t)$ of atenolol decreased significantly, and half-life ($t_{1/2}$) and mean residence time (MRT) of atenolol increased significantly at folate dose of 100 and 200 mg/kg. The serum creatinine concentration $(S_{cr})$ correlated well (p<0.05) with half-life $(t_{1/2})$ and elimination rate constant $(K_{el})$ of atenolol, as well as BUN with AUC and total body clearance $(CL_t)$ of atenolol.

• 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.