• Journal of Periodontal and Implant Science
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• 제24권3호
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• pp.607-617
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• 1994

To determine the effect of tenascin on forming periodontal pocket and pseudopocket, the ginival tissues were surgically obtained from the patients with adult periodontitis(10) and non-inflammatory phenytoin-associated gingival hyperplasia(5). The excised tissue specimens were fixed in neutral formalin for $6{\sim}24$ hours, embedded with paraffin, sectioned at 4-6m in thickness, mounted on glass slides coated with 3-aminopropyltriethoxysilane(Sigma Chemical Co., St. Louis, MO, U.SA.) and immunohistochemically processed by Avidin-Biotin peroxidase complex method for the localization of tenascin, using monoclonal mouse anti-human tenascin antiboday(Chemicon-International Inc., Temecula, CA, U.S.A., 1: 5,000) as the primary antibody. Regardless of periodontal pocket and pseudopocket, tenascin was localized along the connective tissue subjacent to basement membrane of gingival epithelium, and strong positive reactivity was obviously noted in the papillary projections of gingival connective tissue. The results suggest that tenascin may affect the development of papillary projections and the proliferation of epithelial cells.

• 한국독성학회:학술대회논문집
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• 한국독성학회 2002년도 Current Trends in Toxicological Sciences
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• pp.44-64
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• 2002

Embryonic prostaglandin H synthases (PHSs) and lipoxygenases bioactivate xenobiotics (phenytoin, thalidomide, benzo[a]pyrene) to free radical intermediates that initiate reactive oxygen species (ROS) formation, which oxidatively damage cellular macromolecules and/or alter signal transduction.(omitted)

• 대한약학회:학술대회논문집
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• 대한약학회 2003년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2-2
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• pp.225.2-226
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• 2003

The prolonged mechanical grinding process may enhance the bioavailability of the drugs due to the change of solid state such as micronization and decrease of crystallinity. A series of attempts to enhance the bioavailability of insoluble drugs have been made by the fine grinding technique using a planetary mill. The objective of the present study is to investigate the possibility of improving the dissolution properties of poorly water- soluble drugs such as diphenyl hydrantoin (phenytoin) and diphenyl dimethyl dicarboxylate (DDB) based on the molecular interaction between drug and additives during pharmaceutical processing to be related with the bioavailability behavior. (omitted)

• Tuberculosis and Respiratory Diseases
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• 제57권1호
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• pp.55-60
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• 2004

간질이나 신경성 통증 등으로 많이 쓰이고 있는 phenytoin, carbamazepine, 그리고 phenobarbital등의 항경련제는 피부, 임파절, 간 그리고 폐 등을 포함하는 전신적인 반응을 동반하는 anticonvulsant hyper-sensitivity syndrome을 유발할 수 있다. 그 임상양상은 환자에 따라 매우 다양하며 드물게 치명적인 경과를 가질 수 있어 의심되는 경우에는 약제의 사용중단이 가장 중요한 것으로 알려져 있다. 저자들은 carbamazepine을 투여 후 피부병변, 고열, 호산구증다증, 임파절종대와 호산구성폐렴을 보였던 환자를 anticonvulsant hypersensitivity syndorme으로 진단하고 원인약제 투여중단 후, 증상, 혈액학적 이상소견 그리고 방사선학적 이상소견의 호전이 관찰되었던 1예을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한한방내과학회지
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• 제23권2호
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• pp.268-273
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• 2002

Anticonvulsant hypersensitivity syndrome includes fever, skin eruptions, lymphadenopathy, hematologic abnormality and hepatitis, but its mechanism remains unknown. Anticonvulsants including phenytoin, carbamazepine can cause hypersensitivity reaction. We treated a patient who had severe itching sensation and insomnia: he had undergone an operation for cerebral hemorrhage and was administered anti-convulsant agents to prevent convulsions. We administered the anti-convulsant, Dangkwieumja(Dangguiyinzi). After the treatment, clinical symptoms caused by hypersensitivity were improved.

• Journal of Korean Neurosurgical Society
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• 제56권5호
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• pp.448-450
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• 2014

Nefopam, a centrally acting analgesic, has been used to control postoperative pain. Reported adverse effects are anticholinergic, cardiovascular or neuropsychiatric. Neurologic adverse reactions to nefopam are confusion, hallucinations, delirium and convulsions. There are several reports about fatal convulsive seizures, presumably related to nefopam. A 71-year-old man was admitted for surgery for a lumbar spinal stenosis. He was administered intravenous analgesics : ketorolac, tramadol, orphenadrine citrate and nefopam HCl. His back pain was so severe that he hardly slept for several days; he even needed morphine and pethidine. At 4 days of administration of intravenous analgesics, the patient suddenly started generalized tonic-clonic seizures for 15 seconds, and subsequently, status epilepticus; these were not responsive to phenytoin and midazolam. After 3 days of barbiturate coma therapy the seizures were controlled. Convulsive seizures related to nefopam appear as focal, generalized, myoclonic types, or status epilepticus, and are not dose-related manifestations. In our case, the possibility of convulsions caused by other drugs or the misuse of drugs was considered. However, we first identified the introduced drugs and excluded the possibility of an accidental misuse of other drugs. Physicians should be aware of the possible occurrence of unpredictable and serious convulsions when using nefopam.

• Clinical and Experimental Pediatrics
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• 제55권3호
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• pp.111-113
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• 2012

Hashimoto's encephalopathy (HE) is a rare, poorly understood, autoimmune disease characterized by symptoms of acute or subacute encephalopathy associated with increased anti-thyroid antibody levels. Here, we report a case of a 14-year-old girl with HE and briefly review the literature. The patient presented with acute mental changes and seizures, but no evidence of infectious encephalitis. In the acute stage, the seizures did not respond to conventional antiepileptic drugs, including valproic acid, phenytoin, and topiramate. The clinical course was complicated by the development of acute psychosis, including bipolar mood, insomnia, agitation, and hallucinations. The diagnosis of HE was supported by positive results for antithyroperoxidase and antithyroglobulin antibodies. Treatment with methylprednisolone was effective; her psychosis improved and the number of seizures decreased. HE is a serious but curable, condition, which might be underdiagnosed if not suspected. Anti-thyroid antibodies must be measured for the diagnosis. HE should be considered in patients with diverse neuropsychiatric manifestations.

• Journal of Oral Medicine and Pain
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• 제42권1호
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• pp.20-24
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• 2017

Drug-induced gingival overgrowth (DIGO) is an adverse drug reaction mainly described with three types of commonly prescribed drugs, namely, calcium channel blockers (CCBs) (nifedipine, diltiazem, and verapamil), anti-convulsants (phenytoin), and immunosuppressive agents (cyclosporine). Numerous reports have associated gingival overgrowth with the newer generation of immunosuppressive agents (tacrolimus, sirolimus, and everolimus), and CCBs (amlodipine, felodipine, nicardipine, and manidipine). Especially, patients concomitantly medicated with an immunosuppressive agent and CCB have a higher DIGO chance. Dentists need to be aware of drugs that induce gingival overgrowth, the possibility of DIGO, and risk factors, and also prevent the progression of DIGO by early detection of DIGO, consultation about the drug change, and the maintenance of strict dental hygiene regimes.

• 약학회지
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• 제26권4호
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• pp.223-229
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• 1982

Uremia is associated with defective protein binding of weakly acidic drugs, whereas the protein binding of basic drugs tends to be normal. The exact chemical nature of compound(s) and mechanism for these changes as yet is unknown, and has not been defined. Organic solvent extraction of pooled normal human urine following hydrolysis by hydrochloric acid produced an extract, which when added to normal human serum, was capable of inducing binding defects similar to those in uremia. Binding defects were observed with the weakly acidic drugs such as nafcillin, salicylate, sulfamethoxazole and phenytoin while the binding of the basic drugs such as trimethoprim and quinidine were unaffected. The binding defects induced by the hydrolyzed urine extract could readily be corrected by same organic solvent extraction of acidified serum and the defects could be transferred to the normal human serum using the organic solvent layer at the physiologic pH (7.4). Followed by reacidification ind extraction of the binding defects induced serum with the same solvent, separated several fractions were obtained on thin-layer chromatography. One of these fractions could reinduce the binding defects and this factor(s) is apparently weakly acidic compounds and tightly bound to serum at physiologic pH, but extractable at acidic pH, and its molecular weight range is approximately 500 or less similar to those seen in uremia. These findings strongly support the hypothesis that the drug binding defect in uremia is due to the accumulation of endogenous metabolic products which arc normally excreted by the kidneys but accumulate in renal failure.

• Journal of Periodontal and Implant Science
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• 제39권1호
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• pp.103-108
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• 2009

Purpose: It is well recognized that gingival enlargement is induced by unwanted effect associated with three major drugs/drug groups - phenytoin, cyclosporine, and the calcium channel blockers. The present case report describes the effect and limitation of non-surgical treatment in gingival enlargement cases. Materials and methods: Three cases included 2 drug-influenced gingival enlargement patients and a idiopathic gingival fibromatosis patient. For the drug-influenced gingival enlargement patients, the medication was replaced with other medication. And then, all the patients were treated non-surgically. Results: Drug-influenced gingival enlargements had been reduced after non-surgical treatment and the results were well-maintained. In the idiopathic gingival fibromatosis case, non-surgical treatment resulted in only limited reduction of gingival enlargement, and surgical periodontal treatment was unavoidable. Conclusion: These case reports indicated that non-surgical periodontal treatment with change in medication was effective in the treatment of drug-influenced gingival enlargements. Non-surgical approach can be considered as the primary management to reduce the gingival enlargement. If non-surgical treatment encounters a limitation, surgical treatment should be considered.