• Journal of Acupuncture Research
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• v.40 no.2
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• pp.150-155
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• 2023

Drug-induced dyskinesia is an involuntary muscle movement caused by various dopamine receptor-blocking drug exposure, such as antipsychotics, antidepressants, and antiemetics. Causative drug removal is the main treatment for drug-induced dyskinesia whenever possible because its pathophysiology lacks a universally accepted mechanism; however, the symptoms can persist for years or decades in many patients even after causative drug removal. Herein, we present a case of drug-induced dyskinesia in a 61-year-old female patient who consumed medication for approximately 10 years for her depression, anxiety, and insomnia. Cervical and facial dyskinesia was suggested to be related to perphenazine and levosulpiride administration. The patient received acupuncture, pharmacopuncture, herbal medicine, and chuna treatment for 81 days during hospitalization. The symptoms were evaluated using the Abnormal Involuntary Movement Scale, Toronto Western Spasmodic Torticollis Rating Scale, Tsui's score, and Numeric Rating Scale, which revealed remarkable improvement, suggesting the effectiveness of combined Korean medicine for drug-induced dyskinesia.

• Clinical Pain
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• v.18 no.1
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• pp.48-51
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• 2019

Symmetrical proximal weakness and characteristic dermatologic manifestations are important in the diagnosis of dermatomyositis. We report a case of atypical presentation of dermatomyositis due to previous steroid use and also report steroid-induced myopathy which may occur from steroid administration during the course of treatment. A 77-year-old man, previous steroid user, showed rapidly progressing weakness after abruptly stopped medication. He has presented erythematous papule on face and anterior chest but no heliotrope rash and Gottron's papules were observed. Muscle enzyme (creatine kinase) concentration is increased, and needle electromyography shows increased spontaneous activity on proximal limb muscle. The muscle biopsy confirmed dermatomyositis. During the course of treatment, he revealed persistent weakness despite the continuous steroid use and stable creatine kinase level. Electrodiagnostic study suggests steroid-induced myopathy and after tapering steroid, proximal muscle strength improved. This case reports the effect of steroid use on dermatomyositis patients and a process of diagnosing coexisting steroid induced myopathy during treatment.

• Journal of Oral Medicine and Pain
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• v.48 no.3
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• pp.118-122
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• 2023

In this study, we investigate the emergence of bullous pemphigoid (BP) after the administration of the Severe Acute Respiratory Syndrome-Coronavirus Disease 2019 (SARSCOVID-19) vaccine. The study presents two cases of women, aged 47 and 53, diagnosed with BP following SARS-COVID-19 vaccination. BP is a common autoimmune blistering disorder prevalent among older populations, with an incidence rate ranging from 2 to 40 cases per million individuals. This condition arises when autoantibodies target adhesive proteins in the skin, resulting in blister formation and mucosal erosion. Drug-induced bullous pemphigoid (DIBP) shares similarities with the classic form of BP but may be influenced by medication usage. Notably, DIBP exhibits distinct characteristics, such as affecting a younger demographic and involving mucosal regions more prominently than classic BP. The growing incidence of BP is linked to factors such as an aging population and the rise of drug-induced cases. This case report provides valuable insights into comprehending DIBP, elucidating post-vaccination discomforts, particularly those related to oral lesions and the exacerbation of existing lesions. By elucidating these aspects, we aim to advance the understanding of DIBP within the medical community.

• The Journal of Internal Korean Medicine
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• v.45 no.2
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• pp.278-286
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• 2024

A cutaneous adverse drug reaction (CADR) refers to an unexpected skin and mucosal reaction caused by drug administration. In the present case, a 65-year-old male presented with generalized itching and a maculopapular rash after taking Western medication, including anticonvulsants and a nonsteroidal anti-inflammatory drug (NSAID). He was treated with Gamiseungmagalgeun-tang, a traditional Korean herbal medicine. After treatment, the patient's symptoms improved, without recurrence. Based on this experience, traditional Korean herbal medicine, including Gamiseungmagalgeun-tang, may be beneficial for improving symptoms of CADRs.

• Journal of Hospice and Palliative Care
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• v.19 no.2
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• pp.119-126
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• 2016

Purpose: This study analyzed the difference in survival time of patients with delirium according to sedative medication. Methods: From January 2012 through December 2013, a retrospective cohort study was performed using the electronic medical records (EMR) of Pusan National University Hospital. Among 900 patients who died from cancer, we selected 240 who suffered delirium based on the EMR. The Nu-DESC delirium screening test was used to diagnose delirium. Results: The median length of delirium period was five days. Delirium characteristics were dominated by inappropriate behaviors (35.0%). Sedatives were administered in 72.1% of the cases. The most frequently used sedative was haloperidol which was used in 59.6% of cases. The delirium period significantly differed by patients' age (F=3.96, P=0.021), cancer type (F=3.31, P=0.010), chemotherapy (t=-3.44 P=0.001). The average survival time was 16.85 days for the sedative medication group and 9.37 days for the non-medication group, which, however, was not significant (t=1.766, P=0.079). Conclusion: In this study, the use of sedatives did not affect patients' survival time. Thus, appropriate sedative medication can be positively recommended to comfort terminal cancer patients and their families.

• The Korean Journal of Physiology
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• v.8 no.2
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• pp.75-78
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• 1974

It was planned to investigate, by observing incorporation of $[^3H]$ thymidine into liver cells, the influence of Panax Ginseng upon hepatic DNA synthesis in mice that received ACTH. Thirty male mice $(body\;weight:\;18{\sim}20\;g)$ were divided equally into the ginseng-ACTH and the saline-ACTH groups. Each animal of the ginseng-ACTH and the saline-ACTH groups received every day (subcutaneously) 0.05 m1/10 g body weight of ginseng extract (4 mg of ginseng alcohol extract in 1 ml of saline) and the same amount of saline, respectively, for 5 days. On the 5th experimental day, all animals received 0.01 unit of ACTH intraperitoneally one hour. after the last medication, and $1{\mu}Ci/g$ body weight of $[^3H]$ thymidine after one more hour. Five animals, at a time, of each group were sacrificed 1, 10, and 24 hours after thymidine administration, and their hepatic radioactivity was measured autoradiographically in terms of the % number of radioactive cells in 1,000 cell counts (Radioactive Index, R.1.). Following results were obtained: 1. The hepatic radioactive indices obtained from the saline-ACTH group 1, 10, and 24 hr after $[^3H]$ thymidine administration were $1.50{\pm}0.32,\;2.16{\pm}0.33\;and\;2.79{\pm}0.31\;(mean{\pm}S.D.)$, respectively. 2. The corresponding values obtained from the ginseng-ACTH group $(2.71{\pm}0.22,\;3.85{\pm}0.29,\;and\;5.06{\pm}0.31)$ were significantly higher than the values of the saline-ACTH group. It is inferred from the above results that the ginseng tends to prevent reduction in hepatic DNA synthesis caused by ACTH administration.

• Korean Journal of Veterinary Research
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• v.16 no.1
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• pp.77-96
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• 1976

In order to investigate the effects and acting mechanism on ovaries, thyroid glands and hypophyses of rabbits in short term administration of sulfadimethoxine (SDM) as medical dose, a total of 90 virgin albino rabbits (mean body weight, 1,362g) were selected at random and alloted to two groups. Rabbits in one group served as controls and the others were administered SDM of 50 mg/kg/day for 5 weeks, and then reared without medication for 4 weeks. Pathological changes of the three organs were observed each week for 9 weeks and the results obtained were summarized as follows: 1. Mean body weights of both groups manifested slow increasing tendency but mean hypophysis weights fluctuated throughout the experimental term. Mean ovary weights of experiments were decreased significantly from the 3rd to 6th week but mean thyroid weights of experiments were increased significantly from the 1st to 6th week compared with those of controls. 2. Many ovarian follicles of each developing stage showed follicular atresia accompanying atrophy or necrosis of oocytes and of disintegrated follicular cells. Theca interna cells and sudanophilic interstitial cells showed atrophy and diminished sudanophilic granules and also liquor folliculi were diminished. These changes icreased from the 1st week, remaining so for 5 weeks and returned to normal status in the 8th or 9th week. 3. The thyroid gland showed a typical hyperplastic goiter. Hypertrophic and hyperplastic epithelia follicular manifested cuboidal or columnar form showing tiny or small vacuoles in cytoplasm. The follicles showed atrophy and decreasing colloidal materials. Necrotic and regenerative changes were also present. The interfollicular vessels showed congestion and hemorrhage. These changes increased from the 1st week, remaining so for 5 weeks and returned to normal status in the 9th week. 4. The rates of differential cell counts of hypophyses revealed increase of basophils (gonadotrophs and thyrotrophs) and decrease of chromophobes. Basophils which had diminished granules stainable with HE, PAS and AF revealed hypertrophy, hyperplasia, and increasing of tiny or small vacuoles in cytoplasm. These changes increased from the 1st week, remaining so for 5 weeks and returned to normal status in the 8th or 9th week. As summarized above histologically, administration of SDM led thyrotrophs and gonadotrophs of pituitary glands to hyperactivity but revealed retrogressive and compensatory changes with functional disturbance in ovaries and thyroid glands. These changes were transitional and attributed to direct actions of the drugs on the ovaries and thyroid glands.

• Toxicological Research
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• v.33 no.3
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• pp.255-263
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• 2017

Chemotherapy is associated with male infertility. Cisplatin (cis-diamminedichloro-platinum (II) (CDDP) as a chemotherapy medication used to treat a number of cancers has been reported to most likely induce testicular toxicity. Administration of antioxidants, such as pentoxifylline (PTX) may reduce some Adverse Drug Reactions (ADRs) of CDDP. Therefore, this study investigated the potentially protective effects of PTX on CDDP-induced testicular toxicity in adult male rats. For this purpose, 42 male rats were randomly divided into 7 groups. The rats were orally pretreated with PTX at the 3 doses of 75, 150, and 300 mg/kg once a day for 14 successive days. On the $14^{th}$ day of the study, they were intraperitoneally (IP) administered with a single dose of CDDP (7 mg/kg). Finally, the sperm/testis parameters, serum levels of reproductive hormones, including testosterone, Luteinizing Hormone (LH), and Follicle Stimulating Hormone (FSH) as the pivotal endocrine factors controlling testicular functions, and histopathological changes of testis tissue were examined. Pretreatment with the two doses of 75 and 150 mg/kg PTX indicated significant increases in the sperm count and motility induced by CDDP administration. The right and significantly left testis weights were decreased following the treatment with 300 mg/kg of PTX plus CDDP. However, 75 mg/kg of PTX plus CDDP showed the best near-to-normal histopathological features. The results demonstrated that PTX alone enhanced some parameters, such as the sperm count, while reducing other parameters, including sperm fast motility and germ layer thickness. Furthermore, despite testosterone or LH levels, the mean serum FSH level was significantly augmented by the doses of 75 and 150 mg/kg. It was concluded that PTX administration cannot reduce CDDP-induced testicular toxicity even at high doses (e.g., 300 mg/kg), while it seemed to partially intensify CDDP toxicity effects at a dose of 75 mg/kg. Thus, further research is required in this regard.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.2
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• pp.120-128
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• 2017

Objectives : Although antipsychotics are commonly used to control symptoms of delirium, there is a lack of research on the prescription pattern and its clinical effects. The purpose of this study was to investigate the effect of antipsychotics prescription pattern on clinical course of delirious patients consulted to psychiatry. Methods : During the period from July 2016 to February 2017, 212 patients who were referred for delirium were reviewed for their medical records. The duration of delirium was monitored using CAM-ICU, and duration of admission, mortality, and delirium at discharge were reviewed. Clinical course was compared among three groups according to the antipsychotic drug administration pattern: Continuous use group, optimal use group and PRN use group. Results : The pattern of taking antipsychotic medication longer than duration of delirium did not associated with better clinical course compared with the pattern of adapting to the period of delirium and rather increased the risk of taking antipsychotic medication at discharge. When used for a shorter period than the delirium period, it was associated with poor clinical course. Conclusions : The results of this study suggest that a strategy to administer antipsychotics for a minimum period, according to periods of delirium, is appropriate. Also, efforts are needed to minimize the use of antipsychotic drugs after recovery from delirium.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.3
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• pp.191-196
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• 2020

Objectives: Beyond the original application approved by the U.S. Food and Drug Administration, recombinant human bone morphogenetic protein-2 (rhBMP-2) is used for medication-related osteonecrosis of the jaw (MRONJ) treatment because of its bone remodeling enhancement properties. The purpose of the study was to investigate the bone formation effect of rhBMP-2/absorbable collagen sponge (ACS) in patients with MRONJ. Materials and Methods: In this retrospective cohort study, 26 female patients diagnosed with MRONJ and who underwent mandibular sequestrectomy at Ajou University Dental Hospital from 2010 to 2018 were included. The experimental group was composed of 18 patients who received rhBMP-2/ACS after sequestrectomy, while the control group was composed of 8 patients who did not receive rhBMP-2/ACS after sequestrectomy. A total dose of 0.5 mg of rhBMP-2 was used in the experimental group at a concentration of 0.5 mg/mL. Follow-up panoramic X-rays were taken immediately after the surgery and more than 6 months after the surgery. Using those X-rays, a radiographic index of bone defect area was calculated using the modified Ihan Hren method, which measures radiographic density of the normal bone and the defect site. Results: This study suggests that rhBMP-2 contributes to new bone formation. The mean radiographic index immediately after surgery and more than 6 months after the surgery for the experimental group was 68.4% and 79.8%, respectively. The mean radiographic index immediately after surgery and more than 6 months after the surgery for the control group was 73.4% and 76.7%, respectively (Wilcoxon signed rank test, P>0.05). The mean radiographic index increased 11.4% in the experimental group and 3.27% in the control group (Mann-Whitney U-test, P<0.05). Conclusion: Based on the results, use of rhBMP-2/ACS on bone defect sites after sequestrectomy could be a successful strategy for treatment of MRONJ patients.