• 한국임상약학회지
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• 제23권2호
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• pp.129-136
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• 2013

Objectives: Among many new drugs that are under investigation with intent to treat cancer, oral kinase inhibitors are proven to be effective in numerous clinical trials and easy to administer. Due to these advantages the use of oral kinase inhibitors is increasing. Oral kinase inhibitors are metabolized by CYP450 which can result either increase of adverse effect or decrease of drug effect by drug interaction when used concurrently with other agents. In this research, the medication records of patients on oral kinase inhibitors from Oct. 2010 to Nov. 2011 were reviewed to investigate potential drug interactions. Methods: From Oct. 2010 to Nov. 2011, cancer patients in Inha University Hospital who took oral kinase inhibitors more than once were included. The patients' medication records were reviewed to list out concurrent medications that have interaction potential with oral kinase inhibitors, the frequency of concurrent use, and the severity of interaction result using Micromedex$^{(R)}$ and Lexicomp-online$^{(R)}$ as references. Results: As a result, 90 cases of drug with interaction potential were prescribed by Micromedex$^{(R)}$ and 179 cases by Lexicomp-online$^{(R)}$ data. In case of severity, 33.3% by Micromedex$^{(R)}$ and 26.3% by Lexicomp-online$^{(R)}$ were categorized as Major and 65.6% by Micromedex$^{(R)}$ and 72.6% by Lexicomp-online$^{(R)}$ as Moderate. The number of adverse events was 92 cases which 58.7% were on skin and 19.6% on Gastro-intestinal tract. Conclusions: Considerable number of drug with interaction potential was used though each oral kinase inhibitors showed differences in extent. Hence there exists the risk of drug interaction in patients taking oral kinase inhibitors with other drugs.

• 대한치과의사협회지
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• 제54권1호
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• pp.57-66
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• 2016

This study was to evaluate the effects of oral health education conducted on air force personnel according to the use of disclosing solution. They were divided into 3 groups: Group A: oral health education was not conducted, Group B: oral health education was conducted without using disclosing solution, and Group C: oral health education was conducted using disclosing solution. The subjects who had not participated in the education at least once were excluded, and the remaining 83 subjects received oral health education four times and one time each week. The probing depth, plaque index, gingival index, and bleeding on probing were measured one week before the implementation of the first oral health education and one week after the implementation of the fourth oral health education. The results of verifying the homogeneity of the clinical indices before the oral health education showed statistically significant differences in bleeding on probing among the three groups. The results of comparing the clinical indices among the three groups after the oral health education exhibited statistically significant differences in the plaque and gingival indices among the three groups. Groups B and C showed lower values than Group A. The comparison of the clinical indices before and after the oral health education showed statistically significant improvements in all clinical indices after the education in Group C. The results suggested that the oral health education using disclosing solution could maximize that visual effects and encourage self-motivation, consequently improve the oral hygiene of the patients.

• Journal of Acupuncture Research
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• 제35권2호
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• pp.75-80
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• 2018

Background: The aim of this study was to assess the feasibility of conducting a clinical study of using acupuncture for chronic pain in patients with osteoporotic thoracolumbar vertebral compression fractures (VCFs) in the outpatient setting. Methods: A prospective case-series attempting to recruit 20 participants was performed from February 11, 2016, to December 31, 2016. We provided Manual and electrical acupuncture was provided one 1 to three 3 times a week, for 6 weeks, up to 18 sessions. The primary clinical outcome was the average pain intensity as measured by the visual analog scale (VAS) at 6 weeks. Secondary outcomes included back-specific dysfunction (Oswestry disability index), quality of life (quality of life questionnaire-26), patient-reported improvement, use of other healthcare resources, and adverse events at 6 weeks. Use of healthcare resources and adverse events were additionally followed-up at 12 weeks by telephone. Results: Of 33 patients screened, a total of 7 were enrolled in the study. Manual and electrical acupuncture was provided 1 to 3 times a week, for 6 weeks, up to 18 sessions. We observed reduced pain intensity at 6 weeks in all participants. The change in the quality of life and back-specific dysfunction was inconsistent among participants. Mild, temporary adverse events were observed in three patients. Conclusion: In our clinical setting, it was not feasible to recruit sufficient participants and to assess the efficacy of acupuncture for chronic pain after osteoporotic thoracolumbar VCFs under a year. Strategies to improve recruitment and to identify barriers to participation are required for future clinical trials.

• 한국임상약학회지
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• 제26권1호
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• pp.33-39
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• 2016

Background: Elements of informed consent including capacity, disclosure, understanding, voluntariness, and permission of the participant, are all crucial for clinical trials to be legally and ethically valid. During the informed consent process, the patient information leaflet is an important information source which prospective research subjects can utilize in their decision-making. In the adequate provision of information, KGCP guideline necessitate 20 specific items, as well as the use language that individuals can understand. This study measures the vocabulary level of patient information leaflets in an effort to provide an objective evaluation on the readability of such material. Methods: The word difficulty of 13 leaflets was quantitatively evaluated using Kim kwang Hae's vocabulary grading framework, which was compared to the difficulty level of words found in the $6^{th}$ grade Korean textbook. The quantitative outcomes were statistically analyzed using chi-squared tests and linear by linear association for ordinal data. Results: There was a statistically significant difference between the vocabulary level and frequency of words in leaflets and the 6th Korean textbook. The leaflets were on average 260 sentences and about roughly 15 pages long, including lay language (easier or equal to language used in primary school) of around 12% less; technical language of around 4.5% more. As the vocabulary grades increase, there was a distinct difference in vocabulary level between Korean textbook and each information leaflet (p < 0.001). Conclusion: Patient information leaflets may fail to provide appropriate information for self-determination by clinical trial subject through the difficulty level of its wording. Improvements in the degree of patients' understanding and appropriate use of information leaflets are collaboratively equipped to strengthen patient's autonomy and therefore guaranteeing participant's rights.

• Asian Pacific Journal of Cancer Prevention
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• 제13권3호
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• pp.979-983
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• 2012

Background : Previous studies have suggested a lack of complete cross-resistance between steroidal (exemestane) and non-steroidal aromatase inhibitors (nSAI). Methods : Eighty-eight metastatic breast cancer (MBC) patients who received 25 mg of exemestane orally once a day at the National Cancer Center, Korea, between 2003 and 2009, were reviewed retrospectively. All patients had received nSAI for metastatic disease prior to exemestane therapy. Results : The median age was 52 years (range, 33-79), and 13 (14.8%) patients were premenopausal who concomitantly received GnRH agonist. Exemestane was given as a second- (80.7%) or third-line (19.3%) hormone therapy. The clinical benefit (CB) rate (complete response + partial response + stable disease ${\geq}$ 24 weeks) was 30.7%, with a median CB duration of 10.0 months (range, 6.3-78.7). The median progression-free survival (PFS) was 3.0 months (95% confidence interval [CI], 1.99-4.01) and the overall survival (OS) 21.5 months (95% CI, 17.96-25.04), with a median followup of 50.3 months. Patients who achieved CB had longer OS than those patients who did not (29.6 vs 17.9 months; P=0.002). On univariate analysis of predictive factors, patients who had achieved CB from previous nSAI tended to show lower CB rate (24.6% vs 44.4%, respectively; P=0.063) and shorter PFS (2.8 vs 4.8 months, respectively; p=0.233) than patients who had not. Achieving CB from previous nSAI became independent predictive factor for CBR to exemestane on multivariable analysis (Odds ratio = 2.852, P = 0.040). Conclusions : Exemestane after nSAI failure was effective in prolonging CB duration. The drug's efficacy seemed to be inferior in patients who had benefit from previous nSAI use.

• Genomics & Informatics
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• 제21권3호
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• pp.31.1-31.8
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• 2023

Multiple myeloma (MM) is a hematological malignancy. It is widely believed that genetic factors play a significant role in the development of MM, as investigated in numerous studies. However, the application of genomic information for clinical purposes, including diagnostic and prognostic biomarkers, remains largely confined to research. In this study, we utilized genetic information from the Genomic-Driven Clinical Implementation for Multiple Myeloma database, which is dedicated to clinical trial studies on MM. This genetic information was sourced from the genome-wide association studies catalog database. We prioritized genes with the potential to cause MM based on established annotations, as well as biological risk genes for MM, as potential drug target candidates. The DrugBank database was employed to identify drug candidates targeting these genes. Our research led to the discovery of 14 MM biological risk genes and the identification of 10 drugs that target three of these genes. Notably, only one of these 10 drugs, panobinostat, has been approved for use in MM. The two most promising genes, calcium signal-modulating cyclophilin ligand (CAMLG) and histone deacetylase 2 (HDAC2), were targeted by four drugs (cyclosporine, belinostat, vorinostat, and romidepsin), all of which have clinical evidence supporting their use in the treatment of MM. Interestingly, five of the 10 drugs have been approved for other indications than MM, but they may also be effective in treating MM. Therefore, this study aimed to clarify the genomic variants involved in the pathogenesis of MM and highlight the potential benefits of these genomic variants in drug discovery.

• 한국임상약학회지
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• 제11권1호
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• pp.30-41
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• 2001

Recently, the use of electronic drug information databases has been increased alternative to printed references. However, databases vary widely in quality and quantity of drug information provided and many questions have arisen about their accuracy, completeness, and reliability. This study was designed to compare and evaluate the drug information contained in four Korean drug information databases which are available on CD-ROM and internet. Four Korean drug information databases selected to be evaluated were eKIMS, Datapower, KPA Standard Drug Information and Korean Drug Formulary. Databases were searched and evaluated from August 10 to September 30, 2000 by the same trained searcher to minimize the bias. The database evaluation form was developed for objective evaluation of each databases in terms of credibility of database, convenience of use and other characteristics. The second form was developed for quantitative and qualitative assessment of the drug information provided by the databases. The results of the study showed that there were no significant differences in 4 databases in terms of convenience of use and other characteristics. However, for credibility of databases, Korean Drug Formulary was significantly superior to all other databases (P<0.05). It showed that information provided by Korean Drug Formulary was the best in terms of pharmacokinetics, chemistry, comparisons and eKIMS was the best in terms of drug identification (P<0.05). For accuracy and completeness of information provided, the study could not find a significant difference between 4 databases (P>0.05).

• 한국임상약학회지
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• 제30권2호
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• pp.120-126
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• 2020

Objective: The rising number of carbapenemase-resistant Enterobacteriaceae (CRE) cases has become a concern worldwidely. This study investigated patient characteristics with CRE and analyzed the risk factors associated with its acquisition. Methods: A retrospective review of the electronic medical records of the Kangbuk Samsung Medical Center from May 2016 to April 2019 was performed. The inclusion criterion was hospitalized patients aged ≥18 years with confirmed CRE acquisition. Patients were divided by CRE acquired and non-required patients. CRE acquired patients were those with CRE confirmed by their active surveillance cultures, while non-acquired patients were those with carbapenemase-sensitive Enterobacteriaceae (CSE). If CRE was isolated more than once during hospitalization, only the first isolation was used for data analysis. Patient characteristics, antibiotic used, and the duration of use were compared between two groups using univariate analysis, and the risk factors associated with CRE were analyzed using multiple logistic regression analysis. Results: Among the 73 CRE acquired patients, 44 (60.3%) were positive for carbapenemase-producing Enterobacteriaceae (CPE). Infection from Klebsiella pneumonia (42 cases, 57.5%), Escherichia coli (17 cases, 23.3%), and Enterobacter cloacae (5 cases, 6.8%). The risk of CRE acquisition was significantly increased by 4.99 times [confidence interval (CI), 1.40-17.78; p=0.013] with mechanical ventilation, 3.86 times (CI, 1.59-9.36; p=0.003) with penicillin administration, and 21.19 times (CI, 6.53-68.70; p<0.001) with carbapenem administration. Conclusions: Proper antibiotic use including the selection, frequency, and duration, and patients on mechanical ventilators need close monitoring.

• Asian Pacific Journal of Cancer Prevention
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• 제15권4호
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• pp.1707-1710
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• 2014

Background: The objective of this study was to evaluate baseline use and positive rates of staging images (bone scan, CT) in newly diagnosed patients with prostate cancer (PCa) and to improve staging image overuse. Materials and Methods: This retrospective study covered a consecutive series of patients with PCa who underwent stage imaging at our institution between 2006 and 2011. Various clinical and pathological variables (age, PSA, biopsy Gleason score, clinical T stage, positive biopsy core rate) were evaluated by multivariate logistic regression analysis for their ability to predict a positive staging image. All patients were stratified according to the NCCN risk stratification and positive rates were compared in each risk group. Results: 410 patients (100%) underwent a bone scan and 315 patients (76.8%) underwent a CT scan. Some 51 patients (12.4%) had a positive bone scan, clinical T3 and T4 being significant independent predictors. Positive bone scan rates for low-, intermediate-, high-, and very high-risk groups were 0%, 0%, 8.25%, and 56.6%. Some 59 (18.7%) patients had a positive CT scan, with elevated PSA and clinical T3, T4 as significant independent predictors. Low-, intermediate-, high- and very high-risk group rates were 0%, 0%, 13.8% and 80.0%. Conclusions: The incidences of positive staging image in low- and intermediate- risk group were reasonably low. Following feedback on these results, staging in low- and intermediate- risk groups could be omitted.

• 대한한방내과학회지
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• 제40권6호
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• pp.1015-1025
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• 2019

Objectives: There have been many studies reporting the clinical value of Euphorbia kansui Radix or Melonis Calyx, but few systematic studies of the changes that may occur after taking such herbal medication. This study aimed to investigate the characteristics of the patient group, possible changes in blood test and InBody test results, and to discover the current state and future direction of clinical use of Euphorbia kansui Radix or Melonis Calyx. Methods: This study investigated patients who were hospitalized at Kyung-Hee University Korean Medicine Hospital for at least two days from 1 March 2016 to 1 March 2019, specifically evaluating patients aged 19 and over who underwent blood tests, including an electrolyte test and an InBody test before and after taking Euphorbia kansui Radix or Melonis Calyx. Results: Among a total of 134 patients, 72 patients (53.7%) were treated with Euphorbia kansui Radix and 62 patients (46.3%) were treated with Melonis Calyx, in the context of previously diagnosed abnormal weight gain. Laboratory findings were that Na and K levels were significantly reduced in both groups. In an InBody test, body mass index (BMI), intracellular water, extracellular water, protein, mineral, and skeletal muscle were significantly reduced in both groups. Conclusions: From these results, we suggest that, although Euphorbia kansui Radix and Melonis Calyx may not induce serious adverse effects, attention should be paid to the electrolyte level with the use of these treatments. In terms of syndrome differentiation, more clinical uses will be available in the future.