• Title/Summary/Keyword: gastrointestinal toxicity

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Epidemiology and Clinical Analysis of Poisoning of Glufosinate Herbicide - Multicenter Study - (Glufosinate 제초제 중독의 실태 조사와 임상적 특성 고찰 - 다기관 연구 -)

  • Lee, Sung-Woo;Hong, Yun-Sik;Kwon, Woon-Yong;Park, Joon-Seok;Eo, Eun-Kyung;Oh, Bum-Jin;Lee, Mi-Jin;Suh, Joo-Hyun;Roh, Hyung-Keun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.5 no.1
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    • pp.36-42
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    • 2007
  • Purpose: To assess the epidemiology and the clinical features of Glufosinate herbicide in Korea. Methods: Data was prospectively collected during 1 year since August 2005 from 38 hospital in Korea. We analyzed the epidemiologic characters and clinical manifestations of Glufosinate poisoning. In addition, the characteristics of patients with severe central nervous system toxicity were separately analyzed to find poor prognosis relating factors. Results: During study periods, there were 715 persons of poisoning of herbicides and insecticides. 6.3% (45 persons) of the agricultural chemicals poisoning had Glufosinate poisoning. There were 36 cases of suicide attempts and 7 cases of accidental exposure, The major of poisoning route was oral ingestion (44 cases). 28.9 % of the study patients had not toxic symptoms. The most common symptoms were gastrointestinal symptoms relating surfactant irritation. 67.7% of central nervous symptoms occurred lately. 10 persons showed severe central nervous system toxicity. 4 persons of them showed poor outcomes (1 death, 3 hopeless discharged). Complications of respiratory failure and renal failure related with poor outcome. Conclusion: Majority of patients ingested Glufosinate for suicide attempt. 22.2% of patients with Glufosinate poisoning showed delayed serious central nervous system toxicity. Early supportive care of altered mentality may prevent late respiratory complications and improve the outcomes.

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16 Cases of Anti-obesity Drug Intoxication Experienced in 4 Emergency Departments (4개 응급센터에 내원한 비만치료제 중독 환자들의 다양한 임상양상 경험: 16례)

  • Han, Sung Hoon;So, Byung Hak;Jung, Won Joong;Kim, Hyung Min
    • Journal of The Korean Society of Clinical Toxicology
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    • v.10 no.2
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    • pp.111-117
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    • 2012
  • Purpose: In Korea, few studies have examined the acute toxicity of anti-obesity drugs. The purpose of this study is to analyze the general characteristics and clinical aspect of acute anti-obesity drug intoxication. Methods: We retrospectively investigated patients admitted to the emergency department after anti-obesity drug intoxication between March, 2004 and February, 2012. The medical records of these patients were reviewed for demographic data, toxicologic history, time elapsed to presentation, clinical symptoms and signs, treatment, and outcome. Results: There were a total of 18 anti-obesity intoxication cases during the study period; of 16 which were included in our study. The purchasing route of the anti-obesity drug was mainly through a doctor's prescription (68.8%), however, some were obtained through the internet and the pharmacies. The mean time to The most commonly ingested antiobesity drug was sibutramine (31.3%) and many of the cases (62.5%) were multi-drug ingestions. The most common clinical manifestations were gastrointestinal symptoms (94%), but, CNS symptoms (75%) and cardiovascular symptoms (75%) were almost equally present. 13 patients (81%) were discharged after clearance of toxic symptoms and signs with a mean observational period of 7.0 hours. 3 patients were admitted for observation and treatment; of which 1 patient died due to fatal complications. Conclusion: Most anti-obesity intoxications show mild toxicity and a nonfatal clinical course. However, the recent trend toward prescribing psychostimulant anti-obesity medication, which can be fatal after an acute overdose, calls physicians' attention to treating of anti-obesity intoxications.

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Long Term Outcomes of Patients with Endometrial Carcinoma Treated with Radiation - Siriraj Hospital Experience

  • Setakornnukul, Jiraporn;Petsuksiri, Janjira;Wanglikitkoon, Sirentra;Warnnissorn, Malee;Thephamongkhol, Kullathorn;Chansilp, Yaowalak;Veerasarn, Vutisiri
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2279-2285
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    • 2014
  • Background: To evaluate treatment outcomes of patients with stage I-III endometrial cancer treated with postoperative radiation. Materials and Methods: A retrospective review of 166 endometrial cancer patients, undergoing surgery and postoperative radiotherapy at Siriraj Hospital from 2005-2008 was performed. Pathology was reviewed. Results of treatment were reported with 5-year loco-regional recurrence free survival (LRRFS), 5-year overall survival (OS), patterns of failure and toxicity, and according to stage and risk groups. Results: Median follow up time was 62.8 months. Pathological changes were found in 36.3% of the patients after central reviews, leading to 19% changes in risk groups. Most of the patients (83.7%) received pelvic radiation (PRT) and vaginal brachytherapy (VBT). Five-year LRRFS and OS of all patients were 94.9% and 85.5%, respectively. There was no recurrence or death in low and low-intermediate risk groups. For the high-intermediate risk group, 5-year LRRFS and OS were 96.2% and 90.8%, respectively, and for the high risk group 90.5% and 71%. Late grade 3 and 5 gastrointestinal toxicity was found in 3% and 1.2% of patients, respectively. All of them received PRT 5,000 cGy in 25 fractions. Conclusions: Low and intermediate risk patients had good results with surgery and adjuvant radiation therapy. For high risk patients, postoperative radiation therapy alone appeared to be inadequate as the most common pattern of failure was distant metastasis.

Effects on hematology and blood biochemistry profile of intramuscular meloxicam injection in Brahminy kite and Barn owl

  • Ratiwan Sitdhibutr;Raveewan Ploypan;Sirawit Subaneg;Chaiyan Kasorndorkbua
    • Journal of Veterinary Science
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    • v.24 no.3
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    • pp.43.1-43.8
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    • 2023
  • Background: Meloxicam is used widely for exotic animal analgesia, but its toxicity in common raptor species in Thailand is unclear. Objectives: This study evaluated the single-dose effect of intramuscular meloxicam in common raptor species in Thailand for short-term and long-term periods. Methods: Twenty-two raptors were administered a single 1 mg/kg dose of meloxicam individually via intramuscular injection. The following were evaluated: clinical appearance, body weight, body condition score, body temperature, fecal appearance, complete blood cell count, and biochemistry panel before (day 0) and after the injection (1, 7, and 30 days). The collected samples were categorized into three groups: Brahminy kite (Haliastur indus) (n = 10), adult Barn owl (Tyto javanica) (n = 4), and juvenile Barn owl (n = 8). Results: None of the raptors in the study groups showed any abnormalities. The hematological profiles were significantly different in the short-term period (day 1 and day 7). The creatinine, aspartate aminotransferase, and creatinine kinase increased in several groups. On the other hand, the packed cell volume decreased in the Brahminy kite and juvenile Barn owl groups. According to the findings, an intramuscular injection of 1 mg/kg meloxicam affected the blood biochemistry panel of the muscle, but the affected raptors recovered within one week. Conclusions: An intramuscular injection of meloxicam at a single 1 mg/kg dose in Brahminy kites and Barn owls was not associated with the morbidity, hepatotoxicity, gastrointestinal toxicity, and nephrotoxicity in the short- and long-term periods.

Anticancer effect of metformin alone and in combination with 2-deoxy-D-glucose on mouse T cell lymphoma EL4 cells (마우스 T 세포 림프종 EL4 세포에 대한 metformin 단독 및 2-deoxy-D-glucose와 병용의 항암효과 )

  • Si-Yeon Kim;Hong-Gu Joo
    • Korean Journal of Veterinary Research
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    • v.63 no.3
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    • pp.30.1-30.8
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    • 2023
  • Metformin is a treatment used widely for non-insulin-dependent diabetes mellitus with few side effects and acts by inhibiting hepatic gluconeogenesis and glucose absorption from the gastrointestinal tract. Lymphoma is one of the most common hematological malignancies in dogs. Chemotherapy is used mainly on lymphoma, but further research on developing anticancer drugs for lymphoma is needed because of its severe side effects. This study examined the anticancer effects of metformin alone and in combination with 2-deoxy-D-glucose (2-DG), a glucose analog, on EL4 cells (mouse T cell lymphoma). Metformin reduced the metabolic activity of EL4 cells and showed an additive effect when combined with 2-DG. In addition, cell death was confirmed using a trypan blue exclusion test, Hochest 33342/propidium iodide (PI) staining, and Annexin V/PI staining. An analysis of the cell cycle and mitochondria membrane potential (MMP) to investigate the mechanism of action showed that metformin stopped the G2/M phase of EL4 cells, and metformin + 2-DG decreased MMP. Metformin exhibited anticancer effects as a G2/M phase arrest mechanism in EL4 cells and showed additive effects when combined with 2-DG via MMP reduction. Unlike cytotoxic chemotherapeutic anticancer drugs, metformin and 2-DG are related to cellular glucose metabolism and have little toxicity. Therefore, metformin and 2-DG can be an alternative to reduce the toxicity caused by chemotherapeutic anticancer drugs. Nevertheless, research is needed to verify the in vivo efficacy of metformin and 2-DG before they can be used in lymphoma treatments.

Preliminary Results of Concurrent Radiation Therapy and Chemotherapy in Locally Advanced Cervical Carcinoma (국소적으로 진행된 자궁 경부암에서 방사선과 항암화학요법 병행치료의 예비적 결과)

  • Yang KM;Ahn SD;Choi EK;Chang HS;Kim YT;Nam JH;Mok JE
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.355-361
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    • 1993
  • Since May 1991, authors have conducted a pilot study to determine the feasibility and evaluate the effect of concurrent radiation therapy and chemotherapy with 5-FU and Cis-platinum for locally advanced cervical cancer (stage IIB-IVA). Radiation therapy consisted of external irradiation to whole pelvis (4140 cGy/23 fx) in 4.5 weeks followed by high dose rate intracavitary radiation therapy (HDR ICRT) to deliver a dose of 30 to 35 Gy to A point in 6 to 7 fractions. After the intracavitary radiation therapy, parametrial boost was delivered for B point dose of 60 Gy in Stage IIB and 65 Gy in stage IIIB. 5-FU (1000 $mg/m^2/24hr$ for 96 hour iv infusion) and Cis-platinum (20 $mg/m^2/day$ IV bolus for 3 days) were given during the second week of external RT and the second course chemotherapy administered at the first HDR ICRT with the same method as the first chemotherapy. Sixteen patients (10 stage IIB,4 stage IIIB,2 stage IVA) were registered to this protocol. Among these 16 patients, two refused treatment after 2 fractions of external irradiation, and one could not continue intracavitary irradiation because of treatment related genitourinary toxicity. So 14 patients were evaluated for toxicity and 13 patients were evaluated for response analysis. Five of 14 patients developed grade 3 gastrointestinal toxicity but 4 of them recovered at the completion of treatment. One stage IIIB patient with inguinal lymph node metastasis who received higher dose of radiation in spite of initial poor performance status did not recover from gastrointestinal toxicity at the completion of treatment. And she died of distant metastasis at one month after the completion of treatment. Two of 14 evaluable patients showed weight loss, more than $10\%$ of initial weight. One patient developed grade 3 leukopenia. In this study, the average total treatment period of completely treated patients was 75 days and three of them took more than 80 days (84, 84, 89 days). Toxicities were generally acceptable and there were no treatment related death. At the last follow-up, complete response was achieved in $62\%(8/13)$ and especially of nine patients with stage IIB, eight patients showed complete response. This study suggests that concurrent radiation therapy and chemotherapy (5-FU and Cis-platinum) is tolerable and effective. Further follow-up is needed to determine whether this protocol will have a favorable impact on survival and to evaluate the late effect on normal tissues. In future, prospective randomized trials are needed to compare the standard radiation therapy alone with concurrent chemotherapy and radiation therapy for locally advanced cervical carcinoma.

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A Comparative Toxicological Study of Dried Mylabris phalerata Extract and it's Modifier : Single Dose Toxicity on Male Mice (반묘(斑猫)와 가공반묘(加工斑猫)의 단회투여(單回投與) 독성에 대한 비교연구)

  • Roh, Heui-Mok;Kim, Seong-Mo;Choi, Hong-Sik
    • The Korea Journal of Herbology
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    • v.24 no.3
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    • pp.1-12
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    • 2009
  • Objectives : The objective of this study was to compare, the potency of toxicity of Cantharidin containing dried Mylabis phalerata (MP) extract and it's modifier. Methods : They were monitored at dosage level 2,000, 1,000, 500, 250 and 125 mg/kg, respectively. Changes of body weight, clinical signs, mortality, LD50, macroscopic changes of gastrointestinal tract and liver were observed after single oral dose of test articles with changes of serum Gastrin and Somatostatin levels. Results : Dosage-dependent decrease of body weight and/or gains were demonstrated in dried MP extract-dosing groups, were also detected in modified and dried MP extract-dosing groups at 2,000 and 1,000 mg/kg-dosing group. However, below 500 mg/kg-dosing group, the body weights were significantly increased compared to that of equal dosage group of dried MP extract-dosing group. Dosage-dependently detected clinical signs in dried MP extract-dosing groups, were also detected in modified and dried MP extract-dosing groups at 2,000 and 1,000 mg/kg-dosing group. However, below 500 mg/kg-dosing group, these clinical signs dramatically were decreased compared to that of equal dosage group of dried MP extract-dosing group. Dosage-dependent increase of mortality rates were observed in dried MP extract-dosing groups, were also detected in modified and dried MP extract-dosing groups at 2,000 and 1,000 mg/kg-dosing group. However, below 500 mg/kg-dosing group, the mortalities were significantly decreased compared to that of equal dosage group of dried MP extract-dosing group. The LD50 of dried MP extract in male mice was dramaticlly increased in their modify, 265.86 vs 426.99 mg/kg. Dosage-dependently increase of number of hemorrhagic and/or erythematous spots detected in the gastrointestinal tracts of dried MP extract-dosing groups, were also detected in modified and dried MP extract-dosing groups at 2,000 and 1,000 mg/kg-dosing group. However, below 500 mg/kg-dosing group, these abnormal spots were dramatically decreased compared to that of equal dosage group of dried MP extract-dosing group. Dosage-dependently increase of degrees of enlargement and congestion detected in the liver of dried MP extract-dosing groups, were also detected in modified and dried MP extract-dosing groups at 2,000 and 1,000 mg/kg-dosing group. However, below 500 mg/kg-dosing group, these abnormal signs were dramatically decreased compared to that of equal dosage group of dried MP extract-dosing group. Dosage-dependently increase of serum gastrin levels of dried MP extract-dosing groups, were also detected in modified and dried MP extract-dosing groups at 2,000 and 1,000 mg/kg-dosing group. However, below 500 mg/kg-dosing group, these abnormal increase were dramatically decreased compared to that of equal dosage group of dried MP extract-dosing group. Dosage-dependently increase of serum somatostatin levels of dried MP extract-dosing groups, were also detected in modified and dried MP extract-dosing groups at 2,000 and 1,000 mg/kg-dosing group. However, below 500 mg/kg-dosing group, these abnormal increase were dramatically decreased compared to that of equal dosage group of dried MP extract-dosing group. Conclusions : The toxicity of dried MP extract was reduced by their modify.

Effects of the Dried Root of Codonopsis pilosula on Gastrointestinal Motor Function in Mice (당삼이 마우스 위장관 운동 기능에 미치는 영향)

  • Kim, Min Woo;Kim, Hyun Jin;Kim, Moon-Moo;Lee, Eun-Woo;Kwon, Hyun Ju;Kim, Byung Woo;Lee, Hyun-Tai
    • Journal of Life Science
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    • v.26 no.11
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    • pp.1253-1258
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    • 2016
  • Although major advances have been achieved in our understanding and treatment of diseases in many areas of medicine, relatively few improvements have been made in the area of gastrointestinal (GI) motor function. The dried root of Codonopsis pilosula (Franch.) Nannf. (CP) has been used as a traditional folk medicine for improving poor GI function in East Asia, including China and Korea. In the present study, neither aqueous (CP-W) nor ethanolic (CP-E) extracts of CP showed significant toxicity, even at an oral dose of 5 g/kg to mice. The effects of CP-W and CP-E on GI motor function were investigated by measuring in vivo the gastric emptying rate (GER) and intestinal transit rate (ITR) in mice. In normal mice, the ITR was significantly increased by CP-W in a dose-dependent manner, whereas the GER was not significantly affected by any CP extracts. The ITR was significantly retarded in the mice with experimental GI motility dysfunction (i.e., peritoneal irritation by acetic acid) compared with that in normal mice. However, the retardation was significantly recovered by the pre-treatment of CP-W in a dose-dependent manner. The above results suggest that CP-W might be a potential prokinetic agent preventing or alleviating GI motility dysfunctions in human patients.

Efficacy of Neoadjuvant Chemotherapy and Radiotherapy for the Histology-confirmed Intracranial Germinoma - Preliminary Report (조직학적으로 확진된 두개내 배아종의 전보조화학요법 후 방사선치료의 성적 - 예비적 결과)

  • Noh, Young-Ju;Kim, Hak-Jae;Heo, Dae-Seog;Shin, Hee-Yung;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.93-99
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    • 2002
  • Purpose : We intended to decrease late CNS reaction after radical radiotherapy for an intracranial germinoma by using combined neoadjuvant chemotherapy and involved-field radiotherapy. The efficacy in terms of its acute toxicity and short-term relapse patterns was analyzed. Materials and Methods : Eighteen patients were treated with combined neoadjuvant chemotherapy and radiotherapy between 1995 and 2001. The chemotherapy regimen used was the Children's Cancer Group (CCG) 9921A (cisplatin, cyclophosphamide, VP-16, vincristine) for 5 patients younger than 16 years, BEP (bleomycin, VP-16, cisplatin) for 12 patients, and EP (VP-16, cisplatin) for 1 patient. The radiotherapy covered the whole craniospinal axis for 5 patients, the whole brain for 1, and the partial brain (involved field) for 12. the primary lesion received tumour doses between 3,960 and 5,400 cGy. Results : The male to female ratio was 16:2 and the median age was 16 years old. The tumors were located in the pineal gland in 12 patients, in the suprasellar region in 1, in the basal ganglia In 1, in the thalamus in 1. Three patients had multiple lesions and ventricular seedings were shown at MRI. In 3 patients, tumor cells were detected in the cerebrospinal fluid and MRI detected a spinal seeding in 2 patients. The response to neoadjuvant chemotherapy was complete remission in 5 patients, partial remission in 12, and no response in 1. However, after radiotherapy, all except 1 patient experienced complete remission. The toxicity during or after chemotherapy greater than or equal to grade III was remarkable; hematologic toxicity was observed in 11 patients, liver toxicity in none, kidney toxicity in none, and gastrointestinal toxicity in one. One patient suffered from bleomycin-induced pneumonitis. Radiotherapy was therefore stopped and the patient eventually died of respiratory failure. The other 17 are alive without any evidence of disease or relapse during an average of 20 months follow-up. Conclusion : A high response rate and disease control was experienced, which was the same as observed other studies and the morbidity from chemotherapy-induced toxicity was similar. With these results, the results from adjuvant chemotherapy and involved-field radiotherapy cannot be concluded to be equal to those from extended-field radiotherapy. The long term follow-up study on later complications are required in order to draw definite conclusions on the optimal management with minimum side effects.

Santalum album Linn wood and its oil: An aromatic Unani traditional medicine with versatile pharmacological activities

  • Sultana, Arshiya;Rahman, Khaleequr
    • CELLMED
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    • v.8 no.3
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    • pp.14.1-14.6
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    • 2018
  • Santalum album Linn. [Family: Santalaceae] is commonly known as white sandalwood, sandal safaid and safed chandan. It is one of the most valuable trees and second costliest wood in the world. Sandalwood and its oil is extensively used in the Unani and other traditional systems of medicine as it has blood purifier, anti-inflammatory, analgesic, exhilarant, cardiotonic, antiseptic, nervine tonic and expectorant properties. It is used in skin, cardiac, liver, gastrointestinal, respiratory, integument and urogenital disorders. These uses are supported and proven by many in vitro or in vivo studies. The proven pharmacological activities of S. album are antimicrobial, anti-oxidant, anti-inflammatory, antimutagenic and anti-fatigue. The research has proven that sandal oil or its constituents have anti-microbial activity. Sandalwood oil showed skin cancer preventive effect in mice and its constituent alpha santalol showed the anticancer property. The methanolic extract of wood was confirmed for antioxidant, free radical scavenging, analgesic and anti-inflammatory activities. ${\alpha}$ and ${\beta}$ santalols present in sandal oil showed sedative effects. Sandalwood tea had a significant effect on heart muscles of frog and showed increased myocardial contractility. Its oil showed significant changes in hepatic xenobiotic metabolizing enzymes. Sandalwood oil and its major constituents showed less acute oral and dermal toxicity in laboratory animals. Hence, the aforementioned studies justify the uses of sandalwood and its oil mentioned in the classical Unani literature. However, further clinical trials are suggested to confirm its efficacy and safety in humans.