• Title/Summary/Keyword: Non-drug therapy

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Anti-tumor Activity and Apoptosis-regulation Mechanisms of Bufalin in Various Cancers: New Hope for Cancer Patients

  • Yin, Pei-Hao;Liu, Xuan;Qiu, Yan-Yan;Cai, Jian-Feng;Qin, Jian-Min;Zhu, Hui-Rong;Li, Qi
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5339-5343
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    • 2012
  • The induction of apoptosis in target cells is a key mechanism for most anti-tumor therapies. Bufalin is a cardiotonic steroid that has the potential to induce differentiation and apoptosis of tumor cells. Research on bufalin has so far mainly involved leukemia, prostate cancer, gastric cancer and liver cancer, and has been confined to in vitro studies. The bufadienolides bufalin and cinobufagin have been shown to induce apoptosis in a wide spectrum of cancer cell. The present article reviews the anticancer effects of bufalin. It induces apoptosis of lung cancer cells via the PI3K/Akt pathway and also suppressed the proliferation of human non-small cell lung cancer A549 cell line in a time and dose dependent manner. Bufalin, bufotalin and gamabufotalin, key bufadienolides, significantly sensitize human breast cancer cells with differing ER-alpha status to apoptosis induction by the TNF-related apoptosis-inducing ligand (TRAIL). In addition, bufadienolides induce prostate cancer cell apoptosis more significantly than that in breast epithelial cell lines. Similar effects have been observed with hepatocellular carcinoma (HCC) but the detailed molecular mechanisms of inducing apoptosis in this case are still unclear. Bufalin exerts profound effects on leukemia therapy in vitro. Results of multiple studies indicate that bufalin has marked anti-tumor activities through its ability to induce apoptosis. Large-scale randomized, double-blind, placebo or positive drug parallel controlled studies are now required to confirm the efficacy and apoptosis-inducing potential of bufalin in various cancers in the cliniucal setting.

Effect of Anti-oxidant, Anti-inflammatory and Anti-invasive of PMA-induced Matrix Metalloproteinase (MMP-2) and MMP-9 Activities of Water Extract and Solvent Fractions of Saururus Chinensis (삼백초 물 추출물과 유기용매 분획물의 항산화, 항염증 및 PMA에 의해 유도된 MMP-2 및 MMP-9활성 침윤 억제 효과)

  • Kim, Jun-Ho;Kim, Eun-Jung
    • Journal of Life Science
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    • v.26 no.5
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    • pp.584-591
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    • 2016
  • Saururus chinensis is a perennial plants, its flavonoid compound is known to exhibit anti-oxidative activity. This study was aimed to investigate the effect of Water Extract and Solvent Fractions of Saururus chinensis on antioxidant, anti-inflammatory and anti-invasive of Phorbol 12-myristate 13-acetate (PMA)-induced matrix metalloproteinase (MMP-2) and MMP-9 activities. Plant samples were fractionated into hexane, CHCl3, ethyl acetate, butanol, and water fractions, and each of these was assayed individually. The water fraction showed the highest extraction yield at 9.25%(w/w). Anti-oxidative activity was analyzed by DPPH assay. Cell viability was detected by the MTS assay. Anti-inflammatory activity was assayed by the nitric oxide (NO) production in mouse macrophage Raw 264.7 cells. The activity and mRNA expression of MMP-2 and MMP-9 in human oral squamous carcinoma YD-10B cells were examined by zymography and RT-PCR. As results, MMP-2/-9 activation was increased in PMA induced YD-10B cells. In PMA-treated YD-10B cells, the increased mRNA expression and protein activation of MMP-2/-9 were significantly inhibited in the ethyl acetate fraction. The ethyl acetate fraction showed the highest anti-oxidative activity at 73.38%. The ethyl acetate fraction at non-cytotoxic concentrations significantly exhibited the anti-inflammatory activity of Raw 264.7 cells in dose-dependent manner. In conclusion, these findings demonstrate that the ethyl acetate fraction obtained from a chinensis water extract potentiates a promising therapeutic anti-invasive agent and, therefore, as an anti-cancer drug for cancer prevention and therapy in oral cancer.

Preoperative short course radiotherapy with concurrent and consolidation chemotherapies followed by delayed surgery in locally advanced rectal cancer: preliminary results

  • Aghili, Mahdi;Sotoudeh, Sarvazad;Ghalehtaki, Reza;Babaei, Mohammad;Farazmand, Borna;Fazeli, Mohammad-Sadegh;Keshvari, Amir;Haddad, Peiman;Farhan, Farshid
    • Radiation Oncology Journal
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    • v.36 no.1
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    • pp.17-24
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    • 2018
  • Purpose: This study aimed to assess complications and outcomes of a new approach, that is, combining short course radiotherapy (SRT), concurrent and consolidative chemotherapies, and delayed surgery. Materials and Methods: In this single arm phase II prospective clinical trial, patients with T3-4 or N+ M0 rectal adenocarcinoma were enrolled. Patients who received induction chemotherapy or previous pelvic radiotherapy were excluded. Study protocol consisted of three-dimensional conformal SRT (25 Gy in 5 fractions in 1 week) with concurrent and consolidation chemotherapies including capecitabine and oxaliplatin. Total mesorectal excision was done at least 8 weeks after the last fraction of radiotherapy. Primary outcome was complete pathologic response and secondary outcomes were treatment related complications. Results: Thirty-three patients completed the planned preoperative chemoradiation and 26 of them underwent surgery (24 low anterior resection and 2 abdominoperineal resection). Acute proctitis grades 2 and 3 were seen in 11 (33.3%) and 7 (21.2%) patients, respectively. There were no grades 3 and 4 subacute hematologic and non-hematologic (genitourinary and peripheral neuropathy) toxicities and perioperative morbidities such as anastomose leakage. Grade 2 or higher late toxicities were observed among 29.6% of the patients. Complete pathologic response was achieved in 8 (30.8%) patients who underwent surgery. The 3-year overall survival and local control rates were 65% and 94%, respectively. Conclusion: This study showed that SRT combined with concurrent and consolidation chemotherapies followed by delayed surgery is not only feasible and tolerable without significant toxicity but also, associated with promising complete pathologic response rates.

Reducing the waiting time of parkinson's patients in outpatient pharmacy by improving EMR and workflow (외래약국에서 파킨슨병 환자 투약대기시간 단축을 위한 전산 및 업무 흐름 개선)

  • Choi, Dan-Hee;Yim, Ji-Yoon;Lee, Yong-Hwa
    • Quality Improvement in Health Care
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    • v.20 no.1
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    • pp.28-40
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    • 2014
  • Objectives: Prescriptions for Parkinson's can be dispensed at the outpatient pharmacy. In general, the treatment of Parkinson's disease requires a multitude of drugs, sometimes taken 4 to 6 times a day at specific times as prescribed by the medical practitioner. Said "time-specific therapy" is one of the major reasons of dispensing delay observed at the outpatient pharmacy. Because our establishment lacked a computerized system to support time-specific prescriptions, they were not recognized electronically. They had to be issued and dispensed manually, which required a greater amount of time than the automated process. To solve the problem, a new sig code was developed to handle time-specific prescriptions with a comprehensive automated dispensing system to support it. This study aims to create electronic programs and streamline the process to increase dispensing performance. And thus, ensure greater patient safety and dispensing accuracy within a shorter dispensing time and also increase employee satisfaction through a decreased workload. Methods: After identifying the problems caused by non-electronic prescriptions an automated system that allowed the issuance of time-specific prescriptions was developed. A new sig code was created that could be recognized by the Pharmacy electronic medical program, the label printer to group medications by administration times and the Automatic Tablet Counter(ATC) to count the grouped drugs accordingly. Result: With the new sig code, the practitioner became able to electronically select the times of drug administration while issuing the prescription. This 'time-specific prescription' can now be recognized by the pharmacy electronic medical program, the label printer and the ATC like any other prescription. Conclusion: The developed program started operating on September 2013. Although not all Parkinson's patients have been issued with the new electronic 'time-specific prescription', the overall dispensing process has become more streamlined and accurate. As the medical team continues to integrate the new system in their practice an additional decrease of the dispensing time is predicted. Future program upgrades and other new time-saving approaches are scheduled, which are expected to further increase the service quality of our outpatient pharmacy.

Effects of host modulation by nonsteroidal anti-inflammatory drugs on periodontal disease: a systematic review and meta-analysis (비스테로이드성 항염증제를 이용한 숙주조절이 치주질환에 미치는 영향: 체계적 고찰 및 메타 분석)

  • Kang, Dae-Young;Cho, In-Woo;Shin, Hyun-Seung;Ahn, Hyeong-Sik;Kim, Hyun-Jung;Park, Jung-Chul
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.1
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    • pp.7-18
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    • 2017
  • Purpose: Nonsteroidal anti-inflammatory drugs that prohibit biosynthesis of arachidonic acid metabolites have been considered potent host modulation agents. The aim of this review was to determine the effect of nonsteroidal anti-inflammatory drugs adjunctive with nonsurgical periodontal treatment in patients with periodontal disease. Materials and Methods: Three electronic databases were searched to identify relevant studies. The methodological quality and mean differences of the change in clinical attachment level and probing depth were analyzed according to Cochrane review methods. Results: Twelve studies were included in the methodological assessment and nine studies were suitable for inclusion in the meta-analysis. The mean difference in the clinical attachment level gain did not differ significantly between the nonsteroidal anti-inflammatory drugs and control groups at any observation time. The highest mean difference in clinical attachment level gain was 0.30 mm at 4 weeks (95% confidence interval = -0.37 to 0.97). There was a significant mean difference in the probing depth reduction, of 0.34 mm (95% confidence interval = 0.29 to 0.40) at 6 weeks. Conclusion: Therefore, nonsteroidal anti-inflammatory drugs have additional therapeutic effect when administrated with nonsurgical periodontal treatment.

Chemical Properties and Nitrite Scavenging and Acetylcholinesterase Inhibitory Activities from Salicornia herbaciea Seed (함초 씨앗의 화학적 특성과 아질산염 소거능 및 아세틸콜린에스터레이스 저해 효과)

  • Lim, Geum-Sook;Kim, Ran;Jeon, Kyung-Mi;Choi, Hyun-Suk;Cho, Hoon;Koh, Ha-Young;Choi, Chang-Nam
    • KSBB Journal
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    • v.28 no.6
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    • pp.372-379
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    • 2013
  • This study was to investigate the chemical properties and nitrite scavenging and acetylcholinesterase inhibitory activities from Salicornia herbaciea seed. The lactic acid content of seed was about 2.0 fold higher than that of stem. Among various free sugars, the maximum fructose of seed, glucose of stem, and mannose contents of root were obtained, 176.3, 125.6, and 112.8 mg/100g, respectively. The maximum leucine content of seed among the essential amino acid was obtained, 853.7 mg/100g, which was about 3.0 or 6.0 folds higher than that of root or stem. In the case of glutamic acid of seed, it was 2,388.7 mg/100g, which was 5.6 or 9.8 folds higher han that of root or stem. The ratio of essential amino acid and total amino acid of seed was 30.14%. The ${\gamma}$-aminobutyric acid contents of seed, stem, and root were 43.87, 23.88, and 27.8 mg/100g, respectively. The catechin content of seed was an order of epigallocatechin (723.2 mg/100g) > epigallocatechingallate (654.3 mg/100g) > epicatechin (443.5 mg/100g) > gallocatechin (314.1 mg/100g). Especially, the non-gallated catechins content was about 2.0 folds higher than that of gallated catechins content. The nitrite scavenging activity of seed increased from 38.7 to 65.9% when the hot-water extract content of seed at pH 1.2 increased from 1.0 to 5.0 mg/mL. However, it was decreased to 25.7% at pH 6. The acetylcholinesterase inhibitory activity of seed was increased from 13.2 to 44.6% when the extract content increased from 20 to 100 mg/mL. These results show that S. herbaciea seed has a good potential to be used as a source of material or additive in cosmetics, food, and drug compositions.

Disulfiram Suppresses Invasive Ability of Osteosarcoma Cells Via the Inhibition of MMP-2 and MMP-9 Expression

  • Cho, Hyun-Ji;Lee, Tae-Sung;Park, Jae-Bok;Park, Kwan-Kyu;Choe, Jung-Yoon;Sin, Doo-Il;Park, Yoon-Yub;Moon, Yong-Suk;Lee, Kwang-Gill;Yeo, Joo-Hong;Han, Sang-Mi;Cho, Young-Su;Choi, Myeong-Rak;Park, Nam-Gyu;Lee, Yun-Sik;Chang, Young-Chae
    • BMB Reports
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    • v.40 no.6
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    • pp.1069-1076
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    • 2007
  • Cancer cells, characterized by local invasion and distant metastasis, are very much dependant on the extracellular matrix. The expression of matrix metalloproteinases (MMPs) has been implicated in the invasion and metastasis of cancer cells. In this study, we reported the effects of disulfiram, a clinically used anti-alcoholism drug, on tumor invasion suppression, as well as its effects on the activity of MMP-2 and MMP-9 in human osteosarcoma cells (U2OS). Disulfiram has been used for alcohol aversion therapy. However, recent reports have shown that disulfiram may have potential in the treatment of human cancers. Herewith, we showed that the anti-tumor effects of disulfiram, in an invasion assay using U2OS cells and that disulfiram has a type IV collagenase inhibitory activity that inhibits expression of genes and proteins responsible for both cell and non-cell mediated invasion on pathways. In conclusion, disulfiram inhibited expression of MMP-2 and MMP-9 and it regulated the invasion of human osteosarcoma cells. These observations raise the possibility of disulfiram being used clinical for the inhibition of cancer invasion.

Relationship between Knowledge on Diabetes, Self-care Activities, and Self Effectiveness of Diabetics Patients (당뇨병 환자의 당뇨지식, 자가간호활동과 자기효능감의 관계 - 일 종합병원 환자를 대상으로 -)

  • Lee, Mee-Hwa;Kim, Yeun-Young
    • Journal of Home Health Care Nursing
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    • v.10 no.1
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    • pp.15-24
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    • 2003
  • This study provides some basic information on the improvement of diabetics' self-care activities through examining the patients' knowledge on diabetes, self-care activities, and how much they feel those activities are effective and through studying the correlation among the three factors. One hundred and fifty four patients were subjected to this study, who were treated or hospitalized in a hospital in Pusan. Researches were conducted from October 21 to November 9, 2002, and information were gathered by questionnaire and direct conversation with the patients. The data was processed through SPSS WIN 10.0 program. The Date were analyzed by descriptive statistics, ANOVA, t-test, Pearson correlation coefficient and Spearman rank correlation coefficient. The results of this study was the followings; 1) The subjects' knowledge on diabetes ranged from 6 to 23 points with a mean of 17.01 points. 2) The subjects' self-care activities ranged from 21 to 103 points with a mean of 67.72 points. That of the patients with regular treatments appeared to have the highest points (3.51) and the lowest points appeared in the measurement of sugar level in blood (2.60) 3) The subjects' feelings of effectiveness ranged from 21 to 103 points with a mean of 70.01 points. Drug therapy had the highest point (3.94) and diet showed the lowest (3.37) 4) In the general characteristics of the subjects, the more education a subject had, the more knowledge on diabetes he or she appeared to have (F=3.36, p=0.012). The self-care activities were significantly high among non-alcoholic subjects (F=4.301. p=.016). The subjects' feelings of effectiveness were higher in female patients than in male patients(t=2.132 , p=.035), and those in the ages between 51 and 60 felt more effectiveness (F=4.198. p=.003). In addition, married subjects felt more effectiveness than the unmarried (t=2.856, p=0.005), and the more education a patient had. the more effectivess he or she felt (F=2.879, p=.025). 5) In the subjects' pathological characteristic, the subjects who experienced diabetes education showed more knowledge on diabetes, more self-care activity, and more effectiveness than those without the education (t=3.193, p=.002; t=2.299, p=.023; t=2.128, p=.035). 6) As the results of the analyses of correlations among knowledge on diabetes, self-care activity, and effectiveness, the more knowledge on diabetes a patient had, the more self-care activity and the more effectiveness he or she showed (p=0.283. p=0.002; p=0.182, p=0.036). Self-care activity became higher as the feeling of effectiveness appeared higher (r=.550, p=.000). Based on the results above, several suggestions were made; 1) This study was conducted in one hospital, so it is difficult to generalize the results. It is necessary to gather more information from more patients through repeated researches. 2) The study on the other factors which can affect a patient's self-care activity is required. 3) The development of a program which improves a patient's self-care activity, knowledge on diabetes. and effectiveness is needed.

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Effectiveness of alendronate as an adjunct to scaling and root planing in the treatment of periodontitis: a meta-analysis of randomized controlled clinical trials

  • Chen, Jin;Chen, Qian;Hu, Bo;Wang, Yunji;Song, Jinlin
    • Journal of Periodontal and Implant Science
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    • v.46 no.6
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    • pp.382-395
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    • 2016
  • Purpose: Alendronate has been proposed as a local and systemic drug treatment used as an adjunct to scaling and root planing (SRP) for the treatment of periodontitis. However, its effectiveness has yet to be conclusively established. The purpose of the present meta-analysis was to assess the effectiveness of SRP with alendronate on periodontitis compared to SRP alone. Methods: Five electronic databases were used by 2 independent reviewers to identify relevant articles from the earliest records up to September 2016. Randomized controlled trials (RCTs) comparing SRP with alendronate to SRP with placebo in the treatment of periodontitis were included. The outcome measures were changes in bone defect fill, probing depth (PD), and clinical attachment level (CAL) from baseline to 6 months. A fixed-effect or random-effect model was used to pool the extracted data, as appropriate. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated. Heterogeneity was assessed using the Cochrane ${\chi}^2$ and $I^2$ tests. Results: After the selection process, 8 articles were included in the meta-analysis. Compared with SRP alone, the adjunctive mean benefits of locally delivered alendronate were 38.25% for bone defect fill increase (95% CI=33.05%-43.45%; P<0.001; $I^2=94.0%$), 2.29 mm for PD reduction (95% CI=2.07-2.52 mm; P<0.001; $I^2=0.0%$) and 1.92 mm for CAL gain (95% CI=1.55-2.30 mm; P<0.001; $I^2=66.0%$). In addition, systemically administered alendronate with SRP significantly reduced PD by 0.36 mm (95% CI=0.18-0.55 mm; P<0.001; $I^2=0.0%$) and increased CAL by 0.39 mm (95% CI=0.11-0.68 mm; P=0.006; $I^2=6.0%$). Conclusions: The collective evidence regarding the adjunctive use of alendronate locally and systemically with SRP indicates that the combined treatment can improve the efficacy of non-surgical periodontal therapy on increasing CAL and bone defect fill and reducing PD. However, precautions must be exercised in interpreting these results, and multicenter studies evaluating this specific application should be carried out.

Korean Medication Algorithm Project for Bipolar Disorder 2018 (KMAP-BP 2018): Fourth Revision

  • Woo, Young Sup;Bahk, Won-Myong;Lee, Jung Goo;Jeong, Jong-Hyun;Kim, Moon-Doo;Sohn, InKi;Shim, Se-Hoon;Jon, Duk-In;Seo, Jeong Seok;Min, Kyung Joon;Kim, Won;Song, Hoo-Rim;Yoon, Bo-Hyun
    • Clinical Psychopharmacology and Neuroscience
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    • v.16 no.4
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    • pp.434-448
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    • 2018
  • Objective: The Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was first published in 2002 through an expert consensus of opinion, and updated in 2006, 2010, and 2014. This study constitutes the fourth revision of the KMAP-BP. Methods: A 50-item questionnaire was used to obtain the consensus of experts regarding pharmacological treatment strategies for various phases of adult bipolar disorder and six items for pediatric bipolar disorder. The review committee included 84 Korean psychiatrists and 43 child and adolescent psychiatry experts. Results: The preferred first-step strategies for acute mania were the combination of a mood stabilizer (MS) and an atypical antipsychotic (AAP), MS monotherapy, and AAP monotherapy. A combination of a MS and an AAP, and AAP monotherapy were preferred for psychotic mania. The first-step strategies for mild to moderate bipolar depression were monotherapy with MS, AAP, or lamotrigine (LMT), and the combination of a MS and an AAP or LMT, or a combination of an AAP and LMT. The combination of two among a MS, AAP, and LMT were preferred for non-psychotic severe depression. A combination of a MS and an AAP or the combination of an AAP with an antidepressant or LMT were the first-line options for psychotic severe depression. Conclusion: The recommendations of the KMAP-BP 2018 have changed from the previous version by reflecting recent developments in pharmacotherapy for bipolar disorder. KMAP-BP 2018 provides clinicians with a wealth of information regarding appropriate strategies for treating patients with bipolar disorder.