• Title/Summary/Keyword: Gastrointestinal side effect

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Photodynamic Diagnosis and Therapy for Peritoneal Carcinomatosis from Gastrointestinal Cancers: Status, Opportunities, and Challenges

  • Kim, Hyoung-Il;Wilson, Brian C.
    • Journal of Gastric Cancer
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    • v.20 no.4
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    • pp.355-375
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    • 2020
  • Selective accumulation of a photosensitizer and the subsequent response in only the light-irradiated target are advantages of photodynamic diagnosis and therapy. The limited depth of the therapeutic effect is a positive characteristic when treating surface malignancies, such as peritoneal carcinomatosis. For photodynamic diagnosis (PDD), adjunctive use of aminolevulinic acid- protoporphyrin IX-guided fluorescence imaging detects cancer nodules, which would have been missed during assessment using white light visualization only. Furthermore, since few side effects have been reported, this has the potential to become a vital component of diagnostic laparoscopy. A variety of photosensitizers have been examined for photodynamic therapy (PDT), and treatment protocols are heterogeneous in terms of photosensitizer type and dose, photosensitizer-light time interval, and light source wavelength, dose, and dose rate. Although several studies have suggested that PDT has favorable effects in peritoneal carcinomatosis, clinical trials in more homogenous patient groups are required to identify the true benefits. In addition, major complications, such as bowel perforation and capillary leak syndrome, need to be reduced. In the long term, PDD and PDT are likely to be successful therapeutic options for patients with peritoneal carcinomatosis, with several options to optimize the photosensitizer and light delivery parameters to improve safety and efficacy.

Drug research and development tend to hyperlipidemia (이상지질혈증과 치료제 연구개발 경향)

  • Seol, In-Chan
    • Journal of Haehwa Medicine
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    • v.18 no.2
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    • pp.1-12
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    • 2009
  • Most of the cholesterol is synthesized by liver in the body while about one of third is taken via dietary. The main functions of cholesterol is to protect membranes in cell surface, avoid the arterial bleeding by hypertension, and prolong the life of erythrocytes, and so on. However, overload of cholesterol leads to arteriosclerosis associated with leading death cause. Lack of physical activity, emotional and environmental stress, and low intake of protein or vitamin E induce the unbalance between HDL- and LDL-cholesterol so become a basis of ischemic disorders in heart, brain and elsewhere in the body. So far, four major classes of medications for hyperlipidemia are HMG-CoA reductase inhibitors (statins), bile acid sequestrants, nicotinic acid, and fibric acids. The statins can lower LDL and levels triglyceride, but may induce myopathy and an elevation of liver enzyme levels. The bile acid sequestrants lower LDL levels and raise HDL levels with no effect on triglyceride levels but side effects of gastrointestinal (GI) distress, constipation, and a decrease in the absorption of other drugs. Nicotinic acid and fibric acids lower LDL and triglyceride levels with showing flushing, hyperglycemia, hyperuricemia, GI distress, and hepatotoxicity dyspepsia, gallstones, myopathy, and unexplained noncardiac death as adverse effects. Above western drugs lower cholesterol by 15 to 30% while all have notable adverse effects. In traditional medicine, hyperlipidemia is regarded as retention of phlegm and fluid disease. Etiology and pathogenesis of hyperlipidemia is basically based on Spleen-Deficiency and Phlegm-Stagnation, accumulation and stasis of -heat, and Qi & blood stagnation induced by Phlegm-damp, water-dampness, and blood stasis. Thereby, strengthening Spleen and dissolving Phlegm, clearing away heat and diuresis, and supplementing Qi and activating blood circulation are commonly used therapeutic methods for hyperlipidemia. The traditional herbal medicine, have been used for patients with CVA, hypertension or hyperlipidemia in Oriental hospital or Oriental clinic. The lock and key theory is used to develop most of western medicine, however many diseases are caused by mixed factors in body-complex system. We expect that Oriental pharmacological theory could be newborn as a novel drug showing high advantage of blood levels of lipidsand QOL of performance without side effects.

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Protective and Healing Effects of both Jiguyangwi-tang and Gamijiguyangwi-tang on Gastric Mucosa Injuries induced by Cyclophosphamide in Mice (지구양위탕과 가미지구양위탕의 항암제에 의해 손상된 위장관의 회복효과에 관한 연구)

  • 권오희;류기원;류봉하;윤상협;백태현
    • The Journal of Korean Medicine
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    • v.22 no.2
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    • pp.84-93
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    • 2001
  • This research was to find out the protective and healing effects of both the Jiguyangwi-tang and the Gamijiguyangwi-tang on the gastric mucosa injuries by cyclophosphamide. At first, Jiguyangwi-tang and Gamijiguyangwi-tang extract were administered to the mice before one week, and then integral administration of those two drugs(each herbal extract and cyclophosphamide) were followed for another one week, respectively. After finishing those treatments, I have examined the state of the both ulcer and inflammation on the damaged gastric mucosa cell and watched the level of proliferating cell nuclear antigen(PCNA), Bcl-2, and apoptosis. These results were as follows, 1. Gastric mucosa inflammation have more significantly reduced in groups of integral administration of Jiguyangwi-tang plus cyclophosphamide, Gamijiguyangwi-tang plus cyclophosphamide and cyclophosphamide then in group of single cyclophosphamide. 2. Gastric ulcer have been reduced in groups of integral administration of Jiguyangwi-tang plus cyclophosphamide, Gamijiguyangwi-tang plus cyclophosphamide and cyclophosphamide then in group of single cyclophosphamide. But the significance have not shown. 3. PCNA level have more significantly elevated in integral administration of Jiguyangwi-tang plus cyclophosphamide and Gamijiguyangwi-tang plus cyclophosphamide and cyclophosphamide then in group of single cyclophosphamide. 4. The significance of both apoptosis induction and bcl-2level have not noticed among all groups. 5. Between Jiguyangwi-tang and Gamijiguyangwi-tang, the differance of effect was not admitted in statistically From these results, it is suggested that Jiguyangwi-tang and Gamijiguyangwi-tang are useful medicines in protecting gastric inflammation and ulcer, that is gastrointestinal side-effect of cyclophosphamide. The preventing effect of Jiguyangwi-tang and Gamijiguyangwi-tang may be through the 'affecting the period of cell division', but not the inhibition of apoptosis.

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Ginger and Its Pungent Constituents Non-Competitively Inhibit Serotonin Currents on Visceral Afferent Neurons

  • Jin, Zhenhua;Lee, Goeun;Kim, Sojin;Park, Cheung-Seog;Park, Yong Seek;Jin, Young-Ho
    • The Korean Journal of Physiology and Pharmacology
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    • v.18 no.2
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    • pp.149-153
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    • 2014
  • Nausea and emesis are a major side effect and obstacle for chemotherapy in cancer patients. Employ of antiemetic drugs help to suppress chemotherapy-induced emesis in some patients but not all patients. Ginger, an herbal medicine, has been traditionally used to treat various kinds of diseases including gastrointestinal symptoms. Ginger is effective in alleviating nausea and emesis, particularly, for cytotoxic chemotherapy drug-induced emesis. Ginger-mediated antiemetic effect has been attributed to its pungent constituents-mediated inhibition of serotonin (5-HT) receptor activity but its cellular mechanism of action is still unclear. Emetogenic chemotherapy drugs increase 5-HT concentration and activate visceral vagal afferent nerve activity. Thus, 5-HT mediated vagal afferent activation is essential to provoke emesis during chemotherapy. In this experiment, water extract of ginger and its three major pungent constituent's effect on 5-HT-evoked responses were tested on acutely dispersed visceral afferent neurons with patch-clamp methods. The ginger extract has similar effects to antiemetic drug ondansetron by blocking 5-HT-evoked responses. Pungent constituents of the ginger, [6]-shogaol, [6]-gingerol, and zingerone inhibited 5-HT responses in a dose dependent manner. The order of inhibitory potency for these compounds were [6]-shogaol>[6]-gingerol>zingerone. Unlike well-known competitive 5-HT3 receptor antagonist ondansetron, all tested ginger constituents acted as non-competitive antagonist. Our results imply that ginger and its pungent constituents exert antiemetic effects by blocking 5-HT-induced emetic signal transmission in vagal afferent neurons.

The Comparison Study on the Effect of Bowel Movement between Bo-Ryu Enema(보류관장, Bao-Liu Enema) and General Enema in Patients at the Acute Stage of Cerebrovascular Accident (급성기 중풍 환자에 있어서 보류관장과 일반관장의 사하효과에 대한 비교 연구)

  • 손동혁;조기호;김영석;배형섭;이경섭;이영구
    • The Journal of Korean Medicine
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    • v.22 no.3
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    • pp.51-62
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    • 2001
  • Objectives : In Oriental Medicine, the improvement of constipation is very important for patients at the acute stage of cerebrovascular accident. For constipation, oral medicine has usually been used but is not available to stroke patients with dysphagia and mental disorder, and may bring about side effects on the gastrointestinal tract. In such cases, general enema has been used for assistant therapy, We needed to develop a more effective enema technique on constipation of stroke patients. Methods : Sixty-three patients were researched. We treated 29 patients with Bo-Ryu enema and 34 patients with general enema. To compare the effect of the Bo-Ryu enema group with that of the general enema group, we analyzed general characteristics, bowel movement, abdominal examination and related symptoms. Results : Sixty-three patients comprised the Bo-Ryu (n=29) and general (n=34) enema groups. Between the Bo-Ryu and general enema groups, the Bo-Ryu enema was more effective than the general enema in the number of bowel movements, total and corrected amount of stool, tonus of rectus abdominis muscle and abdominal discomfort. However, there were not significant differences in the power of abdominal muscle, digestion and physical power. Among the subgroups, Bo-Ryu enema group was most effective in the number of bowel movements, total amount of stool and tonus of rectus abdominis muscle, and Bo-Ryu enema group was best in the corrected amount of stool and abdominal discomfort. Conclusions : Bo-Ryu enema should be considered as an effective and safe treatment for patients with constipation during the acute stage of cerebrovascular accident.

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Effects of 5-HT4 selective receptor agonist, mosapride citrate on electrocardiogram in dogs

  • Chae, Ji Sang;Ahn, Jin Ok;Coh, Ye Rin;Park, Chong Woo;Youn, Hwa Young
    • Korean Journal of Veterinary Research
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    • v.52 no.3
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    • pp.163-167
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    • 2012
  • Mosapride stimulated dietary motility was introduced because of the arrhythmogenic effect of cisapride. Cisapride, 5-HT receptor agonist, induces prolongation of QT interval. Additionally, this condition can raise the possibility of acute, "malignant" arrhythmias such as torsade de pointes. It is hard to find any reports about effects of mosapride on cardiac parameters in dogs. By confirming electrocardiogram (ECG) parameters, the surface extremity leads ECG that was obtained from the four-limb electrodes and which was recorded by an ECG recorder after administration of mosapride 3 mg/kg PO b.i.d, and mosapride 3 mg/kg with itraconazole 5 mg/kg PO b.i.d, respectively. QT interval was shortened on the days of 3, 5, and post-day 1 in both mosapride 3 mg/kg administrated group and mosapride with itraconazole group. Heart rate increased significantly. QTc was slightly prolonged in mosapride administration group and mosapride with itraconazole group. However, all dogs of QTc were in normal variation (150~250 msec). Besides, the dogs showed no side effects reported in human medicine during the administration with these drugs. Although mosapride can increase the heart rate, this study suggest that mosapride may be useful for the dogs with disorders of gastrointestinal motility because of no fatal arrhythmogenic effect inspite of administration with itraconazole in dogs.

Status of reports of adverse events related to botanical herbal medicines with toxic precautions officially managed by Korean government: A descriptive analysis from WHO VigiAccess (WHO VigiAccess에 수록된 식물성 독성주의한약재 관련 이상사례 보고 현황)

  • Mikyung Kim
    • The Journal of Korean Medicine
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    • v.45 no.1
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    • pp.165-181
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    • 2024
  • Objectives: This study was aimed to review the global status of adverse event (AE) reports and the characteristics of the reported AEs of plants managed as herbal medicines (HMs) with toxic precautions in Korea. Methods: This is a cross-sectional quantitative study that analyzed information available through VigiAccess, a website that provides summarized statistical information from the WHO's global AE database to the public. VigiAccess was searched in 8 Jan, 2024. Information on the total number of reports, number of reports by year and continent, and the age and gender of patients were obtained, and the types of frequently reported AEs were also reviewed. Results: Data on the status of report submissions were obtained for a total of 9 HMs including Aconitum ciliare, Aconitum carmichaeli, Arisaema japonicum, Pinellia ternata, Euphorbiae Lathyridis, Croton tiglium, Strychni Ignatii, Strychnons nux-vomica, and Linum usitatissimum. The number of reports per HM was from 1 to 137. The most commonly reported type of AEs were gastrointestinal disorders in most of the HMs, followed by neurological disorders. Serious adverse events were reported only in Strychni Ignatii, Strychnons nux-vomica, and Linum usitatissimum, including one case of death. Conclusions: This study shows the status of reported AEs of botanicals considered as HMs with toxic precautions in Korea based on real world data. However, when interpreting the findings of this study, readers should consider the significant limitations of this study mainly because of the characteristics of the data source.

Second-Line Irinotecan after Cisplatin, Fluoropyrimidin and Docetaxel for Chemotherapy of Metastatic Gastric Cancer

  • Kucukzeybek, Yuksel;Dirican, Ahmet;Erten, Cigdem;Somali, Isil;Can, Alper;Demir, Lutfiye;Bayoglu, Ibrahim Vedat;Akyol, Murat;Medeni, Murat;Tarhan, Mustafa Oktay
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2771-2774
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    • 2012
  • Aim: Tumors of upper gastrointestinal tract are among the cancers that have a quite lethal course. Cytotoxic chemotherapy is the most efficient therapeutic modality for metastatic gastric cancer. In patients who do not respond to first-line treatment, the response rate to second-line therapies is generally low and the toxicity rates high. This study concerned the efficacy and the side effect profile of second-line therapy with irinotecan in the patients who were being followed-up with the diagnosis of metastatic gastric cancer in $\dot{I}$zmir, Turkey. Materials and Methods: We retrospectively evaluated the efficacy and toxicity in 31 patients with metastatic gastric adenocarcinoma who presented to the polyclinic of Medical Oncology of Izmir Ataturk Education and Research Hospital between May 2008 and July 2011. All received chemotherapy regimens containing cisplatin, fluoropyrimidine (5-FU) and docetaxel as the first-line therapy for late stage disease. Irinotecan as a single agent was given at a dose of 210 mg/$m^2$ on each 21 days. Irinotecan (180 mg/$m^2$ on day 1), 5-FU (500 mg/$m^2$ on days 1-2) and leucovorin (LV; 60 mg/$m^2$ on days 1-2) as a combined regimen were given over a 14 day period. Results: Median age was 54 (range, 31-70). Irinotecan was given as a combined regimen for median 6 cycles (range, 3-12) and as a single agent for median 3 cycles (range, 1-10). Metastases were detected in one site in six patients (19%), in two different sites in 17 patients (55%) and in three or more sites in eight patients (26%). Four patients (12.9%) showed partial response and six patients (19.3%) showed stable disease. Progression-free survival (PFS) was found to be 3.26 months (95% CI, 2.3-4.2). Median overall survival (OS) was found to be 8.76 months (95% CI, 4.5-12.9). The most commonly seen grade 3/4 side effect was neutropenia but the the therapy was generally well-tolerated. Conclusions: In this study, it was demonstrated that second-line therapy with irinotecan given following the first-line therapy with cisplatin, fluoropyrimidine (5-FU) and docetaxel was efficient and safe. Further studies are needed for confirmation.

Evaluation of cyclooxygenase (COX) inhibition in rosemary extract (로즈마리 추출물의 cyclooxygenase (COX) 효소 및 유전자 발현에 미치는 영향)

  • Sehee Lee;Soo-yeon Park;Kyeong Jin Kim;Sonwoo Kim;Yanghoon P. Jung;Ji Yeon Kim
    • Journal of Applied Biological Chemistry
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    • v.66
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    • pp.114-121
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    • 2023
  • Selective cyclooxygenase (COX)-2 inhibition is a novel strategy to reduce the risk of gastrointestinal side effects caused by conventional nonsteroidal anti-inflammatory drugs. However, some selective COX-2 inhibitors have become apparent to increase the risk of severe cardiovascular disease. The aim of this study was to examine the anti-inflammatory effect of rosemary extract (RE) and confirm the safety of cardiovascular side effects. Inhibition of COX enzyme activity was assessed, and the levels of COX-2 and prostaglandin E2 (PGE2) and COX-1 and thromboxane B2 (TXB2) were evaluated in lipopolysaccharide (LPS)-induced RAW 264.7 cells. The 40% RE group showed increased COX-2 inhibition activity in a dose-dependent manner, whereas the 50% RE group only exhibited at 100 ㎍/mL. In a cell-based study, COX-2 mRNA expression was similar in both RE groups and PGE2 levels tended to decrease in the 40% RE group compared to the LPS group in the LPS pretreatment condition. In the LPS posttreatment condition, the COX-2 mRNA expression decreased in the 40% RE group, and PGE2 levels were increased in the 40 and 50% RE groups. In both conditions, there was no significant difference in COX-1 and TXB2 levels. In conclusion, 40 and 50% RE showed significant COX-2 inhibition, similar to the positive control group. It was confirmed that the inhibition of the COX-2 expression, but the effect did not affect the balance between prostacyclin and TXB2. These results indicate that rosemary showed COX-2 inhibition activity with a low risk of cardiovascular diseases.

A Change in the Diagnosis of a Korean Pediatric Outpatients following the COVID-19 Pandemic (코로나19 유행에 따른 한방소아청소년과 외래 환자의 진단명 변화)

  • Seo, Hae Sun;Park, So Hyun;Park, Sul Gi;Lee, Sun Haeng;Lee, Jin Yong
    • The Journal of Pediatrics of Korean Medicine
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    • v.35 no.4
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    • pp.16-33
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    • 2021
  • Objectives This study aims to provide directions for future Korean pediatric medicine treatment and researches by analyzing the characteristics of diseases of Korean pediatric outpatients before and after the COVID-19 epidemic. Methods We analyzed the medical records of 10,868 new patients aged 0-18 who visited the Korean pediatrics at Kyung Hee university hospital from January 1, 2019 to June 30, 2021. All patients were divided into 2 groups; patients who visited from January 1, 2019 to December 31, 2019, before the coronavirus epidemic, and patients who visited from January 1, 2020 to June 30, 2021, after the coronavirus epidemic. Within the two groups, the diagnosis distribution was performed for the entire population, by gender and by age group. Diagnoses were classified as allergy, growth, gastrointestinal, respiratory, general body supplementation, neuropsychiatric, skin, urogenital, musculoskeletal, and other systems. Results According to the comparative analysis results of before and after the COVID epidemic, there was a decreasing trend of diagnoses in relates to allergy, respiratory, urogenital, musculoskeletal system. On the other side, there was an increasing trend in gastrointestinal, general body supplementation, growth, neuropsychiatric, skin and other system. Changes in diagnosis based on gender and age group will be described below. Conclusions This study analyzed the characteristics of diseases of Korean pediatric outpatients before and after the COVID-19 epidemic, and suggested the direction of future Korean medicine treatment and researches for pediatrics. Also, this study aimed to propose proper treatments for children by showing the role of Korean pediatric medicine related to growth and development of children during the epidemic. However, this study has limitations such as failure to track the long-term impact of COVID-19. Thus, long term follow-up studies are needed to show the effect of COVID-19 on Korean pediatric medicine.