Earticle

Studies of oxaliplatin, 5-fluorouracil and leucovorin in pretreated metastatic colorectal cancer showed that oxaliplatin dose intensity is important prognostic factor for objective response rates and progression-free-survival (PFS). To evaluate response rates, PFS and toxicity according to oxaliplatin dose intensity, we retrospectively analyzed data from patients with metastatic colorectal cancer received oxaliplatin,5-fluorouracil, leucovorin regimens. Sixty-three patients were reviewed in this study, 42 patients received low dose intensity oxaliplatin (LDI: ) and 21 patients high dose intensity oxaliplatin (HDI: $>85\;mg/m^2/2wks$). Objective responses occurred in 10 HDI patients and 9 LDI patients (p = 0.014). Median PFS was 24.7 weeks in HDI group, with of HDI patients progression free at 6 months, and 20.5 weeks in LDI group, with of LDI patients progression free at 6 months (p = 0.344). Increased oxaliplatin dose intensity was not associated with neutropenia, thrombocytopenia, neuropathy, nausea and vomiting. This study showed that oxaliplatin dose intensification significantly improves objective response rate in pretreated metastatic colorectal cancer without increasing severe toxicity.

Although most children with idiopathic nephrotic syndrome respond to corticosteroid therapy, many responders show steroid dependency and frequent relapse. In these children, one of the major problems is the serious side effects resulting from continuous steroid therapy. Thus, this study was conducted to assess the therapeutic efficacy and safety of six-month cyclosporine treatment with the low-dose deflazacort therapy in children with nephrotic syndrome. Thirty children with steroid dependence (SD), frequent relapse (FR) and steroid resistance (SR) were enrolled in this study. They were treated with 6-month oral cyclosporine plus the low-dose deflazacort therapy at Samsung Medical Center from September 2002. The dosage of cyclosporine was started at 5 mg/kg/day and was monthly adjusted to maintain clinical remission and/or a trough blood level, while deflazacort dosage was reduced gradually. Clinical evaluation and monitoring of cyclosporine toxicity were performed every weeks. Outcomes were compared to the latest sir-month period of steroid only therapy before cyclosporine treatment. Student's t-test and ANOVA were used for statistical analysis. Out of 28 children with SD and FR, 23 sustained remission, and 5 experienced 1 or 2 relapses during therapy. Out of 2 children with SR, 1 child sustained remission, and 1 child showed no response. The mean duration of remission and occurrence of relapse were significantly improved (p <.0001). In addition, the mean dosage of steroid was significantly reduced (p=.003). Although a number of adverse effects occurred in this study, they were not so serious as to necessitate discontinuation of the therapy. No nephrotoxicity was observed. Twenty out of the 28 children who had been in remission relapsed after withdrawal of cyclosporine. Fifteen of these children showed relapse within a month. These results demonstrated that the combination of cyclosporine with the low-dose deflazacort was efficient and safe in children with SD and FR during the six-month treatment. However, further studies are necessary in order to resolve the problem of high relapse rate after discontinuation of cyclosporine.

There was clinical study to support the efficacy that the anti-inflammatory and analgesic properties of deoxyribonuclease, bromelain helped to reduce symptoms of inflammation. The current study investigated the effects of deoxyribonuclease, bromelain on local traumatic edema. The author used a drug containing proteolytic and mucolytic enzymes, deoxyribonuclease and bromelain, into 61 patients from 16 to 89 years old. The therapeutic response and tolerance had been excellent, which was permitted to a swift resolution on local traumatic edema and a prompt functional reestablishment. These results demonstrated that the drug was effective in local edema symptoms, pains and improving general condition suffering from trauma. Consequently, the use of the proteolytic and mucolytic enzyme require improvement in the rehabilitation of the injured.

The purpose of this study was to investigate the pharmacokinetic changes of verapamil in rabbits with hepatic disorder induced by carbon tetrachloride. The plasma concentrations of verapamil were increased significantly (p<0.05, in slight group; P<0.01, in moderate and severe group) in all groups of hepatic disorder compared to the control group. Morover, the increase), moderate ( increase), and severe ( increase) hepatic disorder groups were significantly (p<0.05, in slight; p<0.01, in moderate and severe) higher than that in control rabbits. These resulted in significantly (p<0.05, in slight; p<0.01, in moderate and severe) greater area under the plasma concentration-time curve (AUC) in moderate ( increase), moderate ( increase), and severe ( increase) hepatic disorder groups than that in control rabbits. Hence, the relative bioavailability values were 149, 195, and for slight, moderate, and severe hepatic disorder groups, respectively. This could be due to decrease in metabolism of verapamil in the liver because of suppressed hepatic function in the hepatic disorder groups because verapamil is mainly metabolized in the liver.