• 제목/요약/키워드: Methotrexate(MTX)

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반하사심탕 혈맥약침이 흰쥐의 CINV(Chemotherapy-Induced Nausea and Vomiting)에 미치는 영향 (The Anti-emetic Effect of Banhasasim-tang Intravenous Herbal Acupuncture in MTX-induced Rat-Pica Model)

  • 조영권;이찬;이현진;임윤경
    • 대한한의학회지
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    • 제38권1호
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    • pp.34-45
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    • 2017
  • Objectives: This study aimed to investigate the effect of banhasasim-tang intravenous herbal acupuncture (BST-IVHA) on emesis induced by chemotherapy in rats. Methods: This study used methotrexate(MTX)-induced Rat-Pica model. The rats were randomly allocated into seven groups; normal group, two saline groups, four Banhasasim-tang(BST) groups (groups treated with BST-IVHA). All the experimental animals except those in the normal group were injected with MTX. Those in the pre-treatment groups were treated with saline injection (saline group) or BST-IVHA (BST group) before MTX injection. Those in the post-treatment groups were treated with saline injection or BST-IVHA after MTX injection. Two different dosages of BST-IVHA solution (low dose; BST-1 group, high dose; BST-2 group) were used. The changes in body weight, food intake, and kaolin consumption at 24h, 48h, and 60h were monitored and analyzed. Results: 1. No significant change was found in body weight. 2. The food intake at 48h was increased significantly in the BST-1 pre-treatment group($19.89{\pm}0.01g$) compared to the pre-saline group($18.68{\pm}0.26g$). 3. The kaolin consumption was significantly decreased in the BST-1 pre-treatment group at 24h($0.24{\pm}0.02g$) and 60h($0.36{\pm}0.14g$), in the BST-2 pre-treatment group at 48h($0.02{\pm}0.01g$) and 60h($0.80{\pm}0.31g$) compared to the pre-saline group($24h:0.81{\pm}0.37g$, $48h:0.76{\pm}0.43g$, $60h:1.56{\pm}0.03g$). The kaolin consumption was also significantly decreased in the in the BST-1 post-treatment group at 24h($0.05{\pm}0.02g$), 48h($0.64{\pm}0.06g$) and 60h($0.14{\pm}0.05g$), in the BST-2 post-treatment group at 48h($0.01{\pm}0.01g$) and 60h($0.01{\pm}0.01g$) compared to the post-saline group($24h:0.51{\pm}0.4g$, $48h:3.58{\pm}0.33g$, $60h:2.5{\pm}0.2g$). Conclusions: BST-IVHA showed an anti-emetic effect in MTX-induced rat-pica model. This result suggests that BST-IVHA could be an effective treatment for chemotherapy-induced emesis.

DNA 상해요인에 의한 Schizosaccharomyces pombe RecA 유사 단백질의 유도생성 (The RecA-like protein of Schizosoccharomvces pombe: its cellular level is induced by DNA-damaging agents)

  • 이정섭;박상대
    • 한국동물학회지
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    • 제37권2호
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    • pp.232-239
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    • 1994
  • RecA protein plans a central role in homologous recombination and DNA repair in Escherichia cofi (E. colD. The function 8nd structure of this protein are universal in prokarvotes and also conserved in eukaryotes such as yeast. The RecA-like protein with 74 lInDa in size has already been identified and purified from a fission yeast Schizosaccharomyces pombe (5. pommel (Lee, 19911. From this study it was revealed that the RecA-like protein of 5. pombe was highly inducible to various DNA damaging agents and inhibitors of nucleotide pool svnthesizins enzymes. The cellular level of the 5. pombe RecA-like protein wi,u markedly increased, upto 5- to 10-fold, by treatment with various DNA-damains agents including ultraviolet (UV) light, methyl methanesulfonate WS),4-nitroquinoline-1-oxide (4-NQO), and mitomycin-C (MMC), similar to E. cofi RecA protein. Interestingly, the protein level was also increased by inhibitors of nucleotide pool forming enzlwnes such as methotrexate (MTX) and hvdroxvurea (HU). The most effective doses for the inducibility of 4-NQO, MMS, W, MMC, MTX, and HU were 0.2 Ug/ml, 30 mM, 200 J/ma, 0.4 $\mus/ml,$ 1 Ug/ml, and 100 mM, respectively. The range of effective duration time for the inducibilitv of RecA-like protein was from 270 to 450 mins. These results suggest that the 5. pombe RecA-like protein also platys an imortant role in cellular responses to DNA damage as in E. coli system.

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Factors associated with the prescription of probiotics in patients with inflammatory bowel disease: a cross-sectional study

  • Joo Kyung Kim;Jae Hee Cheon
    • Journal of Yeungnam Medical Science
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    • 제40권1호
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    • pp.37-48
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    • 2023
  • Background: Commensal bacteria play an important role in the pathogenesis of inflammatory bowel disease (IBD) and probiotics have been used as treatment options. We aimed to explore the current use of probiotics and factors associated with their prescription in patients with IBD. Methods: This cross-sectional study was conducted on a single hospital-based cohort. Patients were eligible if they were ≥18 years old, visited the IBD clinic as an outpatient more than twice during the study period, and had a confirmed diagnosis of IBD. Patients were divided into two groups based on the prescription of probiotics. Clinical assessments were compared between the two groups. Results: In total, 217 patients were enrolled in this study. In patients with Crohn disease (CD), moderate or severe abdominal pain; prior use of methotrexate (MTX), iron, thiopurines, or biologics; history of IBD-related surgery; and stool frequency were independently associated with the prescription of probiotics. In patients with ulcerative colitis (UC), moderate or severe abdominal pain, hematochezia, stool frequency, and moderate or severe physician global assessment score were independently associated with the prescription of probiotics. Conclusion: Increased disease activity may be associated with fewer prescriptions of probiotics in patients with IBD. However, physicians prescribed probiotics to control symptoms, such as abdominal pain and increased stool frequency in patients with UC and CD, and hematochezia in patients with UC. Additionally, the use of MTX and iron, and a history of IBD-related surgeries were associated with more frequent probiotic prescriptions in patients with CD.

원발성 중추신경계 림프종의 치료전략 (Treatment Strategies for Primary Central Nervous System Lymphoma)

  • 김일만;이창영;손은익;김동원;임만빈;김상표
    • Journal of Korean Neurosurgical Society
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    • 제30권3호
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    • pp.334-341
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    • 2001
  • Objective : We have currently changed treatment strategies to methotrexate(MTX)-based preirradiation chemotherapy with subsequent planned radiation for the initial therapy of primary central nervous system lymphoma (PCNSL). The aim of this study was to evaluate the results of treating PCNSL with chemotherapy plus radiotherapy (CRT) or radiotherapy(RT) alone. Method and Material : This study involved 10 females and 3 males patients with a mean age of 54.2 years. All patients underwent surgery, open(8 cases) or stereotactic biopsy(5 cases) for histological diagnosis. Eleven tumors were diffuse large B-cell lymphomas. Tumor volume change in the follow-up images and survival time were evaluated in patients treated with CRT and RT alone. In the beginning, two patients received ProMACE-Cytabom chemotherapeutic regimen, but did not complete the course and died of progressive tumor 8 and 9 months after diagnosis, respectively. One patient died at 6 months before chemotherapy. These three were excluded from the survival analysis. Five patients(RT group) completed full courses of cranial irradiation with or without boost. For the current combined modality treatment, high-dose MTXbased chemotherapy(systemic and intrathecal MTX, IV vincristine, and oral procarbazine) followed by whole brain irrdiation to 45Gy to tumor was introduced in 5 patients of CRT group. Result : A complete response was achieved in three of five who received RT only and in all of five who received CRT. All patients in CRT groups are in disease free status at a mean 23 months following therapy. The RT group patients refused any additional salvage therapy at tumor relapse and survived at mean 20 months from diagnosis. The Karnofsky performance status improved in eight of ten patients with treatment. The treatment toxicity included leukoencephalopathy in RT group and severe leukopenia, transient hepatitis, avascular necrosis of femoral head, hearing loss, and amenorrhea in CRT group, respectively. Conclusion : The combined modality therapy of MTX-based chemotherapy plus radiotherapy for PCNSL may enhance tumor response and improve patient survival. The patients who received CRT should be carefully followed up because of the higher risk of treatment-induced late neurotoxicity.

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한방혼합액 APA-01의 면역 증강 효과 (Enhancement of Immune Response by New Herb Mixture, APA-01, in Mice)

  • 이영선;한옥경;박찬우;전태원;이은실;신상우;김광중;김효정
    • 동의생리병리학회지
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    • 제16권3호
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    • pp.483-489
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    • 2002
  • APA-01, which is an aqueous extract of five Chinese herbs, is a modified formula of Huoxiang-Zhengqi-San. The effect of new herb extract on immune response was investigated. The parameter examined to assess apparent immune response of APA-01 in mice included changes of body weight, relative weight of immune organs, cell proliferation and cytokine gene expression. The body weight and relative weight of immune organs were not significantly changed among the tested groups. In the spleen cell prolijeration assay, APA-01 increased the cell proliferation in a dose-dependent manner. Methotrexate (MTX), an agent of immune suppression, inhibited the spleen cell proliferation (IC/sub 50/: 800㎍/㎖). However, APA-01 significantly inhibited the suppression of mouse spleen cell proliferation. Therefore, it seems that APA-01 has a reducing effect of immune suppression. Immunomodulatory effect of APA-01 was further investigated using reverse transcription polymerase chain reaction (RT-PCR) in mouse spleen cells. In RT-PCR test, APA-01 enhanced the expression of cyclooxygenase-2 (COX-2) mRNA in a dose-dependent manner. In spite of immune suppression by MTX, COX-2 mRNA was induced by co-treatment with APA-01. These results suggest that APA-01 stimulates the proliferation of spleen cells, regulates the expression of COX-2 mRNA, and accelerates the recovery of inhibition of spleen cell proliferation induced by MTX, thus providing the immunological basis for clinical benefit of APA-01.

소아 혈액종양 환자에서 중추신경계 예방적 치료 후 발생한 백질뇌병증 (Leukoencephalopathy after CNS Prophylactic Therapy in Pediatric Hematologic Malignancy)

  • 이준화;이선민;최은진;이건수
    • Clinical and Experimental Pediatrics
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    • 제46권6호
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    • pp.566-571
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    • 2003
  • 목 적 : 백질뇌병증은 중추신경계 예방 요법을 시행하는 혈액종양 환자들에게는 심각한 합병증의 하나로, 이러한 백질뇌병증을 최소화하기 위해서는 조기 진단과 그에 따른 치료 방법의 변경이 중요하다 하겠다. 이 연구는 소아 혈액종양 환자에서 예방적 중추신경계 치료에 따른 백질뇌병증의 임상 양상 및 치료 방법 변경 후의 예후에 관해 조사하고, 백질뇌병증의 발생을 최소화하기 위한 정기적 두부 자기공명영상 촬영의 의의를 살펴보고자 시행되었다. 방 법 : 1995년 10월부터 2002년 5월까지 경북대학교병원 소아과에서 급성 림프구성 백혈병 및 B세포 림프종으로 진단받고 중추신경계 예방 치료 후 백질뇌병증이 발견된 16명의 환자를 대상으로 병력지와 MRI를 후향적으로 조사하였다. 결 과 : 급성 림프구성 백혈병 환자 15명과 B세포 림프종 환자 1명의 백질뇌병증 진단 시 연령은 중앙값 5년 3개월이었고, 남녀비는 3 : 1이었다. 항암치료 시작 후 백질뇌병증 진단까지 걸린 시간은 2개월에서 17개월이었다. 백질뇌병증 발생 전 투여한 척수강 내 MTX 투여 횟수는 2회에서 15회로 16명에서 모두 시행하였고, 두부 방사선 치료는 10명에서만 시행하였고 용량은 1,800 rads였다. 백질뇌병증 진단 전 경련, 성격 변화, 두통, 정신 이상, 구음 장애, 의식 변화 등의 정신신경학적 증상이 있었던 경우가 10명 있었으며 증상이 없었던 경우가 6명이었다. 백질뇌병증이 진단되었던 16명의 환자 중 4명은 사망하였으며 나머지 12명의 환아 중에서 현재 계속 항암치료 중인 경우가 8명, 항암치료를 종료한 환자가 3명, 그리고 보호자가 원하여 항암치료를 중지한 경우가 1명이었다. 백질뇌병증 진단 후 자기공명영상의 추적관찰을 시행한 경우가 12명, 시기상 아직 시행하지 못한 경우가 4명이었으며 추적관찰을 시행한 경우 중 자기공명영상에서 병변이 호전된 경우가 4명, 지속되는 경우가 6명, 악화된 경우가 2명이었다. 병변이 호전된 4명 중 2명은 병변이 거의 사라져 정상에 가까운 소견을 보였다. 결 론 : 중추신경계 예방 요법으로 사용하는 척수강 내 MTX 주입 요법과 두부 방사선 조사를 비롯하여 정맥으로 투여되는 MTX 또한 백질뇌병증을 유발하며, 이러한 백질뇌병증은 증상없이 발현되는 경우도 많아 병변의 조기발견을 위한 정기적인 자기공명영상의 촬영이 필요하며, 백질뇌병증의 발견 즉시 즉각적인 조치를 취하여 신경학적 기능의 회복을 가능하게 해야 할 것이라고 생각된다.

Risk of Breast Cancer and Total Malignancies in Rheumatoid Arthritis Patients Undergoing TNF-α Antagonist Therapy: a Meta-analysis of Randomized Control Trials

  • Liu, Yang;Fan, Wei;Chen, Hao;Yu, Ming-Xia
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권8호
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    • pp.3403-3410
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    • 2014
  • Context: Interest exits in whether TNF-alpha antagonists increase the risk of breast cancer and total malignancies in patients with rheumatoid arthritis (RA). Objectives: To analyze the risk of malignancies, especially breast cancer, in patients with RA enrolled in randomized control trials (RCTs). Methods: A systematic literature search for RCTs from 1 January 1998 to 1 July 2013 from online databases, such as PubMed, WILEY, EMBASE, ISI web of knowledge and Cochrane Library was conducted. Studies included RCTs that compared the safety of at least one dose of the five TNF-${\alpha}$ antagonists with placebo or methotrexate (MTX) (or TNF-${\alpha}$ antagonists plus MTX vs placebo plus MTX) in RA patients for more than 24 weeks and imported all the references into document management software EndNote${\times}6$. Two independent reviewers selected studies and extracted the data about study design, patients' characteristics and the type, number of all malignancies. Results: 28 RCTs from 34 records with 11,741 patients were analyzed. Of the total, 97 developed at least one malignancy during the double-blind trials, and breast cancer was observed in 17 patients (17.5% of total malignancies). However, there was no statistically significant increased risk observed in either the per protocol (PP) model (OR 0.65, 95%CI [0.22, 1.93]) or the modified intention to treat (mITT) model (OR 0.75, 95%CI [0.25, 2.21]). There were also no significant trend for increased risk of total malignancies on anti-TNF-${\alpha}$ therapy administered at approved doses in either model (OR, 1.06, 95%CI [0.64, 1.75], and OR, 1.30, 95%CI [0.80, 2.14], respectively). As to the two models, modified intention to treat model analysis led to higher estimation than per protocol model analysis. Conclusions: This study did not find a significantly increased risk of breast cancer and total malignancies in adults RA patients treated with TNF-${\alpha}$ antagonists at approved doses. However, it cannot be ignored that more patients developed malignancies with TNF-${\alpha}$ antagonists therapy compared with patients with placebo or MTX, in spite of the lack of statistical significance, so that more strict clinical trials and long-term follow-up are needed, and both mITT and PP analyses should be used in such safety analyses.

Reduced-dose whole-brain radiotherapy with tumor bed boost after upfront high-dose methotrexate for primary central nervous system lymphoma

  • Lee, Tae Hoon;Lee, Joo Ho;Chang, Ji Hyun;Ye, Sung-Joon;Kim, Tae Min;Park, Chul-Kee;Kim, Il Han;Kim, Byoung Hyuck;Wee, Chan Woo
    • Radiation Oncology Journal
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    • 제38권1호
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    • pp.35-43
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    • 2020
  • Purpose: This retrospective study compares higher-dose whole-brain radiotherapy (hdWBRT) with reduced-dose WBRT (rdWBRT) in terms of clinical efficacy and toxicity profile in patients treated for primary central nervous system lymphoma (PCNSL). Materials and Methods: Radiotherapy followed by high-dose methotrexate (HD-MTX)-based chemotherapy was administered to immunocompetent patients with histologically confirmed PCNSL between 2000 and 2016. Response to chemotherapy was taken into account when prescribing the radiation dose to the whole brain and primary tumor bed. The whole brain dose was ≤23.4 Gy for rdWBRT (n = 20) and >23.4 Gy for hdWBRT (n = 68). Patients manifesting cognitive disturbance, memory impairment and dysarthria were considered to have neurotoxicity. A median follow-up was 3.62 years. Results: The 3-year overall survival (OS) and progression-free survival (PFS) were 70.0% and 48.9% with rdWBRT, and 63.2% and 43.2% with hdWBRT. The 3-year OS and PFS among patients with partial response (n = 45) after chemotherapy were 77.8% and 53.3% with rdWBRT, and 58.3% and 45.8% with hdWBRT (p > 0.05). Among patients with complete response achieved during follow-up, the 3-year freedom from neurotoxicity (FFNT) rate was 94.1% with rdWBRT and 62.4% with hdWBRT. Among patients aged ≥60 years, the 3-year FFNT rate was 87.5% with rdWBRT and 39.1% with hdWBRT (p = 0.49). Neurotoxicity was not observed after rdWBRT in patients aged below 60 years. Conclusion: rdWBRT with tumor bed boost combined with upfront HD-MTX is less neurotoxic and results in effective survival as higher-dose radiotherapy even in partial response after chemotherapy.

Schizosaccbarornyces pombe에서 Escherichia coli RecA 항체에 의한 Ribonucleotide Reductase 효소활성 저해 (Ribonucleotide Reductase Activity of Schizosaccbarornyces pombe Is Inhibited by Escherichia coli RecA Antibody)

  • 이정섭;천민석;김옥봉;박종군;김시욱;박열;양영기;홍승환;박상대
    • 한국동물학회지
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    • 제38권4호
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    • pp.565-569
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    • 1995
  • 분열형 호모인 Schizosaccbarornyces pombe에서 RecA 유사 단백질은 hydroxyurea (HU)나 methotrexate (MTX)와 같은 nucleotide pool 형성에 관여하는 효소의 저해제에 의해 유도발현된다. 본 연구에서는 대장균의 RecA 단백질과 S. pombe의 ribonucleotide reductase가 구조적으로 유사한지를 RecA 항체를 이용한 면역침전법과 [5-$^3$H]CDP를 기질로하는 thin layerchromatography방법을 통하여 알아보고자 하였다. S. pombe의 rinonucleotide reductase활성은 100mM HU에 의해 대조군에 비해 26.3% 저해되었으며, RecA 항체를 이용한 면역침전에 의해서도 43.3% 저해되었다. 이와 같은 결과는 S. pombe의 rinonucleotide reductase가 대장균의 RecA 단백질과 구조적으로 유사함을 시사하는 것이다.

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Recent Advancements of Treatment for Leptomeningeal Carcinomatosis

  • Gwak, Ho-Shin;Lee, Sang Hyun;Park, Weon Seo;Shin, Sang Hoon;Yoo, Heon;Lee, Seung Hoon
    • Journal of Korean Neurosurgical Society
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    • 제58권1호
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    • pp.1-8
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    • 2015
  • Treatment of Leptomeningeal carcinomatosis (LMC) from solid cancers has not advanced noticeably since the introduction of intra-cerebrospinal fluid (CSF) chemotherapy in the 1970's. The marginal survival benefit and difficulty of intrathecal chemotherapy injection has hindered its wide spread use. Even after the introduction of intraventricular chemotherapy with Ommaya reservoir, frequent development of CSF flow disturbance, manifested as increased intracranial pressure (ICP), made injected drug to be distributed unevenly and thus, the therapy became ineffective. Systemic chemotherapy for LMC has been limited as effective CSF concentration can hardly be achieved except high dose methotrexate (MTX) intravenous administration. However, the introduction of small molecular weight target inhibitors for primary cancer treatment has changed the old concept of 'blood-brain barrier' as the ultimate barrier to systemically administered drugs. Conventional oral administration achieves an effective concentration at the nanomolar level. Furthermore, many studies report that a combined treatment of target inhibitor and intra-CSF chemotherapy significantly prolongs patient survival. Ventriculolumbar perfusion (VLP) chemotherapy has sought to increase drug delivery to the subarachnoid CSF space even in patients with disturbed CSF flow. Recently authors performed phase 1 and 2 clinical trial of VLP chemotherapy with MTX, and 3/4th of patients with increased ICP got controlled ICP and the survival was prolonged. Further trials are required with newly available drugs for CSF chemotherapy. Additionally, new LMC biologic/pharmacodynamic markers for early diagnosis and monitoring of the treatment response are to be identified with the help of advanced molecular biology techniques.