• Toxicological Research
• /
• v.29 no.4
• /
• pp.285-292
• /
• 2013

Ginseng is a well-known traditional medicine used in Asian countries for several thousand years, and it is currently applied to medicine, cosmetics, and nutritional supplements due to its many healing and energygiving properties. It is well demonstrated that ginsenosides, the main ingredient of ginseng, produce a variety of pharmacological and therapeutic effects on central nerve system (CNS) disorders, cardiovascular disease, endocrine secretions, aging, and immune function. Korean red ginseng extract is a dietary supplement containing ginsenoside Rb1 and ginsenoside Rg1 extracted from Panax ginseng. While the pharmacokinetics and bioavailability of the extract have been well established, its toxicological properties remain obscure. Thus, four-week oral toxicity studies in rats were conducted to investigate whether Korean red ginseng extract could have a potential toxicity to humans. The test article was administered once daily by oral gavage to four groups of male and female Sprague-Dawley (SD) rats at dose levels of 0, 500, 1,000, and 2,000 mg/kg/day for four weeks. Neither deaths nor clinical symptoms were observed in any group during the experiment. Furthermore, no abnormalities in body weight, food consumption, ophthalmology, urinalysis, hematology, serum biochemistry, gross findings, organ weights, or histopathology were revealed related to the administration of the test article in either sex of any dosed group. Therefore, a target organ was not determined in this study, and the no observed adverse effect level (NOAEL) of Korean red ginseng extract was established to be 2,000 mg/kg/day.

• Journal of Ginseng Research
• /
• v.44 no.5
• /
• pp.717-724
• /
• 2020

Background: Malignant arrhythmias require drug therapy. However, most of the currently available antiarrhythmic drugs have significant side effects. Ginsenoside Rg2 exhibits excellent cardioprotective effects and appears to be a promising candidate for cardiovascular drug development. So far, the oral toxicity and antiarrhythmic effects of Rg2 have not been evaluated. Methods: Acute oral toxicity of Rg2 was assessed by the Limit Test method in mice. Subchronic oral toxicity was determined by repeated dose 28-day toxicity study in rats. Antiarrhythmic activities of Rg2 were evaluated in calcium chloride-induced arrhythmic rats. Antiarrhythmic mechanism of Rg2 was investigated in arrhythmic rats and H9c2 cardiomyocytes. Results: The results of toxicity studies indicated that Rg2 exhibited no single-dose (10 g/kg) acute oral toxicity. And 28-day repeated dose treatment with Rg2 (1.75, 3.5 and 5 g/kg/d) demonstrated minimal, if any, subchronic toxicity. Serum biochemical examination showed that total cholesterol in the high-dose cohort was dramatically decreased, whereas prothrombin time was increased at Day 28, suggesting that Rg2 might regulate lipid metabolism and have a potential anticoagulant effect. Moreover, pretreatment with Rg2 showed antiarrhythmic effects on the rat model of calcium chloride induced arrhythmia, in terms of the reduced duration time, mortality, and incidence of malignant arrhythmias. The antiarrhythmic mechanism of Rg2 might be the inhibition of calcium influx through L-type calcium channels by suppressing the phosphorylation of Ca²⁺/calmodulin-dependent protein kinase II. Conclusion: Our findings support the development of Rg2 as a promising antiarrhythmic drug with fewer side effects for clinical use.

• Journal of Preventive Medicine and Public Health
• /
• v.46 no.4
• /
• pp.201-209
• /
• 2013

Objectives: The goal of this study was to perform an economic analysis of a primary stenting with drug-eluting stents (DES) compared with bare-metal stents (BMS) in patients with acute myocardial infarction (AMI) admitted through an emergency room (ER) visit in Korea using population-based data. Methods: We employed a cost-minimization method using a decision analytic model with a two-year time period. Model probabilities and costs were obtained from a published systematic review and population-based data from which a retrospective database analysis of the national reimbursement database of Health Insurance Review and Assessment covering 2006 through 2010 was performed. Uncertainty was evaluated using one-way sensitivity analyses and probabilistic sensitivity analyses. Results: Among 513 979 cases with AMI during 2007 and 2008, 24 742 cases underwent stenting procedures and 20 320 patients admitted through an ER visit with primary stenting were identified in the base model. The transition probabilities of DES-to-DES, DES-to-BMS, DES-to-coronary artery bypass graft, and DES-to-balloon were 59.7%, 0.6%, 4.3%, and 35.3%, respectively, among these patients. The average two-year costs of DES and BMS in 2011 Korean won were 11 065 528 won/person and 9 647 647 won/person, respectively. DES resulted in higher costs than BMS by 1 417 882 won/person. The model was highly sensitive to the probability and costs of having no revascularization. Conclusions: Primary stenting with BMS for AMI with an ER visit was shown to be a cost-saving procedure compared with DES in Korea. Caution is needed when applying this finding to patients with a higher level of severity in health status.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.19 no.4
• /
• pp.181-189
• /
• 2019

Local anesthetic systemic toxicity (LAST) refers to the complication affecting the central nervous system (CNS) and cardiovascular system (CVS) due to the overdose of local anesthesia. Its reported prevalence is 0.27/1000, and the representative symptoms range from dizziness to unconsciousness in the CNS and from arrhythmias to cardiac arrest in the CVS. Predisposing factors of LAST include extremes of age, pregnancy, renal disease, cardiac disease, hepatic dysfunction, and drug-associated factors. To prevent the LAST, it is necessary to recognize the risk factors for each patient, choose a safe drug and dose of local anesthesia, use vasoconstrictor, confirm aspiration and use incremental injection techniques. According to the treatment guidelines for LAST, immediate application of lipid emulsion plays an important role. Although lipid emulsion is commonly used for parenteral nutrition, it has recently been widely used as a non-specific antidote for various types of drug toxicity, such as LAST treatment. According to the recently published guidelines, 20% lipid emulsion is to be intravenously injected at 1.5 mL/kg. After bolus injection, 15 mL/kg/h of lipid emulsion is to be continuously injected for LAST. However, caution must be observed for >1000 mL of injection, which is the maximum dose. We reviewed the incidence, mechanism, prevention, and treatment guidelines, and a serious complication of LAST occurring due to dental anesthesia. Furthermore, we introduced lipid emulsion that has recently been in the spotlight as the therapeutic strategy for LAST.

• Journal of Biomedical Engineering Research
• /
• v.42 no.6
• /
• pp.287-294
• /
• 2021

Cardiotoxicity assessment of all drugs has been performed according to the ICH guidelines since 2005. Non-clinical evaluation S7B has focused on the hERG assay, which has a low specificity problem. The comprehensive in vitro proarrhythmia assay (CiPA) project was initiated to correct this problem, which presented a model for classifying the Torsade de pointes (TdP)-induced risk of drugs as biomarkers calculated through an in silico ventricular model. In this study, we propose a TdP-induced risk group classifier of artificial neural network (ANN)-based. The model was trained with 12 drugs and tested with 16 drugs. The ANN model was performed according to nine features, seven features, five features as an individual ANN model input, and the model with the highest performance was selected and compared with the classification performance of the qNet input logistic regression model. When the five features model was used, the results were AUC 0.93 in the high-risk group, AUC 0.73 in the intermediate-risk group, and 0.92 in the low-risk group. The model's performance using qNet was lower than the ANN model in the high-risk group by 17.6% and in the low-risk group by 29.5%. This study was able to express performance in the three risk groups, and it is a model that solved the problem of low specificity, which is the problem of hERG assay.

• The Korean Journal of Physiology and Pharmacology
• /
• v.13 no.6
• /
• pp.437-442
• /
• 2009

A non-steroidal anti-inflammatory drug (NSAID) has many adverse effects including cardiovascular (CV) risk. Diclofenac among the nonselective NSAIDs has the highest CV risk such as congestive heart failure, which resulted commonly from the impaired cardiac pumping due to a disrupted excitationcontraction (E-C) coupling. We investigated the effects of diclofenac on the L-type calcium channels which are essential to the E-C coupling at the level of single ventricular myocytes isolated from neonatal rat heart, using the whole-cell voltage-clamp technique. Only diclofenac of three NSAIDs, including naproxen and ibuprofen, significantly reduced inward whole cell currents. At concentrations higher than $3\;{\mu}M$, diclofenac inhibited reversibly the $Na^+$ current and did irreversibly the L-type $Ca^{2+}$ channels-mediated inward current $(IC_{50}=12.89\pm0.43\;{\mu}M)$ in a dose-dependent manner. However, nifedipine, a well-known L-type channel blocker, effectively inhibited the L-type $Ca^{2+}$ currents but not the $Na^+$ current. Our finding may explain that diclofenac causes the CV risk by the inhibition of L-type $Ca^{2+}$ channel, leading to the impairment of E-C coupling in cardiac myocytes.

• Journal of Life Science
• /
• v.18 no.9
• /
• pp.1263-1270
• /
• 2008

The purpose of this study is to investigate the effect of exercise mode and anti-hypertensive drug responding status on the cardiovascular response and perceived exertion in acute coronary syndrome (ACS) patients. Seventy-five patients who participated in six-week exercise rehabilitation therapy performed a treadmill running and a cycle ergometer exercise at intensities of 60%HRR and 85%HRR respectively. Systolic and diastolic blood pressure, mean arterial blood pressure (MAP), rate pressure production (RPP), and ratings of perceived exertion (RPE) were measured. The results of cardiovascular response by the different exercise modes with moderate and intensive intensity of anti-hypertensive drug responder and nonresponder ACS patients were following: First cycle ergometer exercise induced significantly higher SBP, DBP, MAP, RPP and MAP than treadmill running exercise at the intensities of 60%HRR and 85%HRR in both anti-hypertensive responder and nonresponder ACS patients (p<0.05). Secondly anti-hypertensive nonresponder ACS patients had significantly higher DBP and MAP that anti-hypertensive responder ACS patients at all the exercise modes (p<0.05). Finally there was no difference of RPP between anti-hypertensive responder and nomresponder ACS patients, although anti-hypertensive nonresponder ACS patients showed higher blood pressure and RPP than anti-hypertensive responder ACS patients. In conclusion, cycle ergometer induced increased cardiovascular response at same intensities of treadmill running exercise and anti-hypertensive nonresponder ACS patients had even more increased cardiovascular response than anti-hypertensive responder ACS patients with no difference in perceived exertion during exercise. These results suggested that cycle ergometer exercise should be greatly careful with the risk of higher blood pressure, especially for those who are patients with hypertensive blood pressure.

• Preventive Nutrition and Food Science
• /
• v.7 no.3
• /
• pp.327-331
• /
• 2002

Tea is a pleasant, popular and safe beverage in the world. During the past decade, epidemiological studies have shown that tea catechins intake is associated with lower risk of cardiovascular disease. Tea provides a dietary source of health-promoting components to help humans reduce a wide variety of cancer risks and chronic diseases. The antioxidative activity of tea-derived catchins has been extensively studied. The antioxidant effect is a synergistic action between catechins e.g. EGCG, EGC, ECG, EC, pheophytins a and b, and other components in tea leaves, which aye more bioavailable for human body. Green tea has a Higher content of catechins than other kinds of tea. Green tea extract with hot water has high potential and more efficiency to reduce cancer risk than any other tea products or pure EGCG. Protein, iyon, and other food components may interfere with the bioavailability of ten catechins. Interaction of catechins with drug affects the cancer-preventive activity of some cancer-fighting medication. Further studies are required to determine the bioavailability of tea catechins and cancer-preventive functionality.

• CELLMED
• /
• v.10 no.2
• /
• pp.13.1-13.7
• /
• 2020

Arusa (Adhatoda vasica) is an important medicinal plant widely used in Unani system of medicine of (Family-Acanthaceae). The leaves of Adhatoda vasica contain several biologically active phytochemicals such as alkaloids, tannins, saponins, phenolics and flavonoids. It mainly consists of pyrroquinazoline, alkaloids, viz. vasicine, vasicol, vasicinone, peganine along with other minor constituents. The plant possesses diverse pharmacological activities, In Unani system of medicine, the drug is described as having dafa-e-tashannuj (anti-spasmodic), qatil-e-jarasim (antibiotic), mukhrij-e-balgham (expectorant), dafa-e-humma (antipyretic) properties due to which it is prescribed in a wide range of ailments like influenza, tuberculosis, bronchitis, gastric ulcers etc. Leaf juice is beneficial in the treatment of dysentery and diarrhoea. Various other activities like radio modulation, hypoglycaemic effect, cardiovascular protection, antitubercular, antiviral, hepatoprotective and antioxidant activity have also been reported.

• BMB Reports
• /
• v.42 no.7
• /
• pp.393-400
• /
• 2009

High-density lipoprotein (HDL) is a proven biomarker for the monitoring of changes in antioxidant and anti-inflammation capability of body fluids. The beneficial virtues of HDL are highly dependent on its lipids and protein compositions, and their ratios. In normal state, the HDL particle is enriched with lipids and several HDL-associated enzymes, which are responsible for its antioxidant activity. Lower HDL-cholesterol levels (<40 mg/dL) have been recognized as an independent risk factor for coronary artery disease, as well as being a known component of metabolic syndrome. Functional and structural changes of HDL have been recognized as factors pivotal to the evaluation of HDL-quality. In this review, I have elected to focus on the functional and structural correlations of HDL and the roles of HDL-associated apolipoproteins and enzymes. Recent clinical applications of HDL have also been reviewed, particularly the therapeutic targeting of HDL metabolism and reconstituted HDL; these techniques represent promising emerging strategies for the treatment of cardiovascular disease, for drug or gene therapy.