• 대한한방소아과학회지
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• 제36권3호
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• pp.19-34
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• 2022

Objectives To investigate the effect of Jakyakgamcho-tang (JGT) on Dextran sulfate sodium (DSS) induced ulcerative colitis. Methods Experimental animals were divided into six groups; group 1, normal group; group 2, DSS-induced colitis group; group 3, 5-aminosalicylic acid (5-ASA)-treated group; group 4, Glycyrrhiza Uralensis (Gamcho, GC)-treated group; group 5, Paeoniae Radix (Jakyak, JY)-treated group; group 6, JGT-treated group. Inflammatory cytokines and their metabolites were detected. Result In the JGT group, the levels of tumor necrosis factor alpha (TNF-α), prostaglandin E2 (PGE2) were significantly decreased, whereas that of Interleukin-10 (IL-10) were significantly increased. In addition, the metabolite profile changed in the JGT group with most metabolites increasing. Conclusion This study demonstrates that the therapeutic potential of JGT in ulcerative colitis. Further studies should be conducted to confirm our findings.

• 대한한의학방제학회지
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• 제29권3호
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• pp.147-153
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• 2021

Ulcerative colitis (UC) is one of inflammatory bowel diseases (IBD) with unknown etiopathogenesis. This case report details remission of UC induced by Korean herbal medicine treatment. A 31-year-old male patient diagnosed as UC after a series of examinations including endoscopy and fecal calprotectin (FC) test. He had severe bloody diarrhea over 10-20 times a day despite taking 5-aminosalicylic acid and steroid. He was given individualized Korean herbal medicine Dowha-tang according to pattern identification. After taking Dowha-tang for 7 months, clinical remission was achieved. The symptoms disappeared and FC level went down to normal level. No adverse events were reported. This case report shows that Korean herbal medicine treatment may have the potential for clinical remission of UC. Further investigation is warranted.

• 한국임상약학회지
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• 제30권2호
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• pp.102-112
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• 2020

Objective: To analyze the prescription patterns for the treatment of ulcerative colitis (UC) and to investigate factors co-occurring with systemic corticosteroid use. Methods: We used patient-level data from Korean National Health Insurance claims database to identify patients diagnosed with UC (ICD-10 code : K51) and their medications prescribed for UC between January 1 and Decemeber 31, 2017. We found that medications for UC treatment were 5-aminosalicylic acid (5-ASA), immunomodulators, biologics, and corticosteroids. We presented the prescription pattern according to the sex, age group, type of health insurance, site of UC, type of medical institution, and concomitant medication. To evaluate factors associated with prescription of systemic corticosteroids for UC, we used a multivariate logistic regression model to estimate adjusted odds ratios (aORs) and their 95% confidence intervals (CIs). Results: Of 1,469 UC patients, 74.5% used 5-ASA and 15.2% used systemic corticosteroids. 5-ASA constituted 77.5% of all prescriptions and systemic corticosteroids accounted for 13.1%. The most widely used therapy was 5-ASA monotherapy (54.8%), followed by a double therapy with 5-ASA and immunomodulators (8.2%) or 5-ASA and systemic corticosteroids (7.2%). Systemic corticosteroids were more likely to be prescribed with immunomodulators (aOR=1.88, 95% CI=1.54-2.28) and biologics (aOR=2.82, 95% CI=2.28-3.50) than without them. Conclusions: We found that 15.2% of UC patients were prescribed with a systemic corticosteroid, which is less than reported previously. Systemic corticosteroids were more likely to be prescribed with immunomodulators and biologics.

• Tuberculosis and Respiratory Diseases
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• 제51권5호
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• pp.474-481
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• 2001

염증성 장질환 환자에서 폐주변부에 발생하는 진행성 폐침윤과 기침, 발열, 호흡곤란 등의 호흡기계 증상, 말초혈액내 호산구중다중의 발현, 다른 호산구중다중을 유발할 만한 약제나 기생충 감염 등의 원인이 없는 경우에 메살라진이나 설파살라진에 의한 호산구성 폐렴의 가능성율 생각하고, 약제 투여 중단과 스테로이드 사용을 고려해야 하며, 기관지경을 통한 기관지 폐포액에서 호산구 증가와 lymphocyte stimulation test, 폐생검올 통해 진단할 수 있다. 저자들은 궤양성 대장염 환자에서 부작용이 적다고 알려진 메살라진에 의한 호산구성 폐렴 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 한국임상약학회지
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• 제29권2호
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• pp.79-88
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• 2019

Backgrounds: Inflammatory bowel disease (IBD) including ulcerative colitis (UC) and Crohn's disease (CD) increased prevalence and economic burden. Objectives: This study aimed to investigate drug use pattern in IBD patients in a real world. Methods: National Health Insurance claim data from 2010 to 2014 were used in this population-based study. All IBD patients diagnosed during study period were enrolled. IBD medications included 5-aminosalicylic acid (ASA), glucocorticoid, immunomodulator and anti-tumor necrosis factor-${\alpha}$ agent(anti TNF-${\alpha}$). Growth rate of IBD prevalence, prescribed drug classes, duration of drug therapy and medication cost were analyzed. Number and percentage of patients for categorical variables, and mean and median for continuous variables were presented. Results: Total numbers of patients were 131,158 and 57,286 during 5 years, and their annual growth rate were 3.2 and 5.7% for UC and CD. UC and CD were prevalent in the 40-50 (41.2%) and 20-30 age groups (36.0%). About 60% of IBD patients was prescribed any of medications. 5-ASA was the most frequently prescribed, followed by corticosteroid and immunomodulator. Anti TNF-${\alpha}$ use was the lowest, but 5 times higher than UC in CD. Combination therapies with different class of drugs were in 29% for UC and 62% for CD. Mean prescription days per patient per year were 306 and 378, and the median medication cost per patient per year was KRW 420,000 (USD 383) and KRW 830,000 (USD755), for UC and CD, respectively. Conclusions: Increasing prevalence of IBD requires further studies to contribute to achieve better clinical outcomes of drug therapy.

• Tuberculosis and Respiratory Diseases
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• 제52권2호
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• pp.128-136
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• 2002

연구배경 : 다제내성 결핵 환자에서 fluoroquinolone계 약물이 빈번하게 처방되고 있음에도 불구하고, 이의 약동학적 특성에 대한 연구가 부족한 실정이다. 그러므로, 본 연구에서는 fluoroquinolone계 약물의 하나인 ofloxacin을 복용하고 있는 다제내성 결핵 환자에서의 ofloxacin의 약동학적 특성을 분석하였고, 아울러 ofloxacin의 약동학적 특성을 전신쇠약 상태와 연관지어 분석하였다. 방 법 : 300 mg b.i.d. 의 ofloxacin 용법을 포함하여 prothionamide, cycloserine, para-aminosalicylic acid, kanamycin 및 streptomycm 등의 2차 항결핵제제를 복용 중인 20명의 다제내성 결핵 환자를 대상으로 하였다. 전신쇠약 상태가 ofloxacin의 약동학에 미치는 영향을 평가하기 위하여 body mass indes (BMI)에 따라 환자를 두 군 (A 군 ; 18.5 $\leq$ BMI < 23, B군 : < 18.5)으로 나누어 두 군간의 ofloxacin의 항정상태 약동학적 특성을 비교분석하였다. 한 달 이상의 고정용법으로 항정상태에 이른 피험자에서 약동학 연구를 위하여 혈액을 경시적으로 13회 취하였고, 뇨 시료도 24 사간까지 취하였다. 혈장 및 뇨의 ofloxacin 농도를 HPLC를 이용하여 측정한 후 각각의 약동학적 분석을 시행하였다. 결 과 : Ofloxacin 의 AUC는 B군에서 $31.4{\pm}8.9{\mu}g/ml{\cdot}h$로 A군의 24.1+6.2 ${\mu}g/ml{\cdot}h$보다 유의하게 큰 것으로 나타났다(p<0.05). 항정상태에서 A군의 ofloxacin의 청소율 (Cl/F)은 $0.16{\pm}0.03$ L/h/kg로 산출되었고, B군에서는 $0.14{\pm}0.03$ L/h/kg로 나타났다. Ofloxacin의 반감기($t_{1/2}$)는 두 군간에 차이를 보이지 않았다(A군 : $5.3{\pm}0.8$시간, B군 $5.7{\pm}0.9$시간)으며 다른 약동학적 경수들도 두 군간의 유의한 차이를 보이지 않았다. 결 론 : 이상의 연구결과는 정상 피험자에 비하여 다제내성 결핵 환자에서 ofloxacin의 약동학적 특성이 유의하게 다르지 않음을 나타내고 있다. 한편, 만성 다제내성 결핵 환자의 전신쇠약 정도는 혈장 ofloxcaicn의 농도에 변화를 유발하는 것으로 기대된다.

• 대한간호학회지
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• 제42권2호
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• pp.207-216
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• 2012

Purpose: This study was conducted to determine the risk factors among patients with depression with Crohn's disease. Methods: Data were collected by questionnaire from 276 patients who were diagnosed with Crohn's disease at a tertiary hospital located in Seoul. Measurements included patients' demographic characteristics, clinical characteristics, depression level, and health-related quality of life. Data were analyzed using t-test, $X^2$-test, Wilcoxon rank sum test, and logistic regression analyses. Results: The incidence rate of depression (BDI-II${\geq}$14scores) was 31.9% (n=88). Univariate analysis revealed that being a woman, school graduation status, economic status (low), BMI(<$18.5Kg/m^2$), disease duration (${\geq}3$ years), CDAI (${\geq}150$ scores), frequency of hospital admission (${\geq}2$), extra-intestinal manifestation (arthralgia, stomatitis), administration of 5-aminosalicylic acid, and disease related quality of life (SIBDQ<50 scores) were associated with depression. Multivariate analysis revealed that economic status (low), school graduation status, and quality of life (SIBDQ<50 scores) were more likely to report high level of depression. Conclusion: Future research should consider managing depression as an essential component of comprehensive care for patients with Crohn's disease. In addition, further research is needed to develop strategies to better improve quality of life among patients with Crohn's disease who are depressed.

• Tuberculosis and Respiratory Diseases
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• 제78권2호
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• pp.78-84
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• 2015

Background: Reports of therapeutic drug monitoring (TDM) for second-line medications to treat multidrug-resistant tuberculosis (MDR-TB) remain limited. Methods: A retrospective cohort from the Virginia state tuberculosis (TB) registry, 2009-2014, was analyzed for TDM usage in MDR-TB. Drug concentrations, measured at time of estimated peak ($C_{max}$), were compared to expected ranges. Results: Of 10 patients with MDR-TB, 8 (80%) had TDM for at least one drug (maximum 6 drugs). Second-line drugs tested were cycloserine in seven patients (mean $C_{2hr}$, $16.6{\pm}10.2{\mu}g/mL$; 4 [57%] below expected range); moxifloxacin in five (mean $C_{2hr}$, $3.2{\pm}1.5{\mu}g/mL$; 1 [20%] below); capreomycin in five (mean $C_{2hr}$, $21.5{\pm}14.0{\mu}g/mL$; 3 [60%] below); para-aminosalicylic acid in five (mean $C_{6hr}$, $65.0{\pm}29.1{\mu}g/mL$; all within or above); linezolid in three (mean $C_{2hr}$, $11.4{\pm}4.1{\mu}g/mL$, 1 [33%] below); amikacin in two (mean $C_{2hr}$, $35.3{\pm}3.7{\mu}g/mL$; 1 [50%] below); ethionamide in one ($C_{2hr}$, $1.49{\mu}g/mL$, within expected). Two patients died: a 38-year-old woman with human immunodeficiency virus/acquired immune deficiency syndrome and TB meningitis without TDM, and a 76-year-old man with fluoroquinolone-resistant (pre-extensively drug-resistant) pulmonary TB and low linezolid and capreomycin concentrations. Conclusion: Individual pharmacokinetic variability was common. A more standardized approach to TDM for MDR-TB may limit over-testing and maximize therapeutic gain.

• Parasites, Hosts and Diseases
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• 제60권5호
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• pp.309-315
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• 2022

Inflammatory bowel disease (IBD) is a chronic and recurrent illness of the gastrointestinal tract. Treatment of IBD traditionally involves the use of aminosalicylic acid and steroids, while these drugs has been associated with untoward effects and refractoriness. The absence of effective treatment regimen against IBD has led to the exploration of new targets. Parasites are promising as an alternative therapy for IBD. Recent studies have highlighted the use of parasite-derived substances, such as excretory secretory products, extracellular vesicles (EVs), and exosomes, for the treatment of IBD. In this report, we examined whether EVs secreted by Giardia lamblia could prevent colitis in a mouse model. G. lamblia EVs (GlEVs) were prepared from in vitro cultures of Giardia trophozoites. Clinical signs, microscopic colon tissue inflammation, and cytokine expression levels were detected to assess the effect of GlEV treatment on dextran sulfate sodium (DSS)-induced experimental murine colitis. The administration of GlEVs prior to DSS challenge reduced the expression levels of pro-inflammatory cytokines, including tumor necrosis factor alpha, interleukin 1 beta, and interferon gamma. Our results indicate that GlEV can exert preventive effects and possess therapeutic properties against DSS-induced colitis.

• Asian Spine Journal
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• 제12권6호
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• pp.1069-1077
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• 2018

Study Design: A case study. Purpose: To assess the chronological changes of the disease-related kyphosis after chemotherapy alone, secondly to clarify the role of growth cartilage in the healed lesion on kyphosis change, and to define the accurate prediction time in assessing residual kyphosis. Overview of Literature: None of the previous papers up to now dealt with the residual kyphosis, stability and remodeling processes of the affected segments. Methods: One hundred and one spinal tuberculosis children with various stages of disease processes, age 2 to 15 years, were the subject materials, between 1971 to 2010. They were treated with two different chemotherapy formula: before 1975, 18 months of triple chemotherapy (isoniazid [INH], para-aminosalicylic acid, streptomycin); and since 1976, 12 months triple chemotherapy (INH, rifampicin, ethambutol, or pyrazinamide). The first assessment at post-chemotherapy one year and at the final discharge time from the follow-up (36 months at minimum and 20 years at maximum) were analyzed by utilizing the images effect of the remaining growth plate cartilage on chronological changes of kyphosis after initiation of chemotherapy. Results: Complete disc destruction at the initial examination were observed in two (5.0%) out of 40 cervical spine, eight (26.7%) out of 30 dorsal spine, and six (19.4%) out of 31 lumbosacral spine. In all those cases residual kyphosis developed inevitably. In the remainders the discs were partially preserved or remained intact. Among 101 children kyphosis was maintained without change in 20 (19.8%), while kyphosis decreased in 14 children (13.7%), and increased in 67 children (66.3%) with non-recoverably damaged growth plate, respectively. Conclusions: It could tentatively be possible to predict the deformity progress or non-progress and spontaneous correction at the time of initial treatment, but it predictive accuracy was low. Therefore, assessment of the trend of kyphotic change is recommended at the end of chemotherapy. In children with progressive curve change, the deformity assessment should be continued till the maturity.