Neuropathic pain presents a therapeutic challenge because patients cannot be relieved from it, even when all known medical options have been tried. Several treatment guidelines have been provided, and several pharmacotherapies have been proposed with non-pharmacological treatments. This study aimed to present the current pharmacological and non-pharmacological treatments used to treat patients with neuropathic pain. Furthermore, several treatment guidelines for neuropathic pain are compared.Current Concepts: Tricyclic antidepressants, gabapentinoids, and serotonin-norepinephrine reuptake inhibitors are the first-line agents recommended by clinical guidelines in several countries. Tramadol and topical agents are recommended as second-line agents. Opioids and cannabinoids are recommended as third-line agents; cannabinoids are recommended by Canadian treatment guidelines. Combination therapy may be more effective because it results in synergistic pain-relieving effects, and the individual drug dose may be lower. Non-pharmacologic treatment is recommended as third-line or supplementary management because of the lack of evidence.Discussion and Conclusion: Several guidelines have recommended similar drugs; however, it is impossible to completely cure neuropathic pain. Therefore, therapeutic goals must be realistically discussed to improve patient compliance. In addition, additional studies based on pathophysiological mechanisms should be conducted to improve the management of neuropathic pain.

Neuropathic pain presents a therapeutic challenge because patients cannot be relieved from it, even when all known medical options have been tried. Several treatment guidelines have been provided, and several pharmacotherapies have been proposed with non-pharmacological treatments. This study aimed to present the current pharmacological and non-pharmacological treatments used to treat patients with neuropathic pain. Furthermore, several treatment guidelines for neuropathic pain are compared.Current Concepts: Tricyclic antidepressants, gabapentinoids, and serotonin-norepinephrine reuptake inhibitors are the first-line agents recommended by clinical guidelines in several countries. Tramadol and topical agents are recommended as second-line agents. Opioids and cannabinoids are recommended as third-line agents; cannabinoids are recommended by Canadian treatment guidelines. Combination therapy may be more effective because it results in synergistic pain-relieving effects, and the individual drug dose may be lower. Non-pharmacologic treatment is recommended as third-line or supplementary management because of the lack of evidence.Discussion and Conclusion: Several guidelines have recommended similar drugs; however, it is impossible to completely cure neuropathic pain. Therefore, therapeutic goals must be realistically discussed to improve patient compliance. In addition, additional studies based on pathophysiological mechanisms should be conducted to improve the management of neuropathic pain.

The occurrence of chronic inflammatory demyelinating polyneuropathy (CIDP) related to coronavirus disease 2019 (COVID-19) has rarely been reported. We describe two patients who were diagnosed with CIDP after COVID-19 vaccination. A 72-year-old man presented with a progressive tingling sensation and weakness below both knees for two weeks. He had been vaccinated against COVID-19 (mRNA-1273 vaccine) a month before the appearance of symptoms. Demyelinating polyneuropathy was observed in the nerve conduction studies (NCS). Intravenous immunoglobulin (IVIg) was administered under the diagnosis of GuillainBarré syndrome (GBS), and his symptoms were improved. However, his symptoms relapsed at 10 weeks from the onset. Oral prednisolone, azathioprine, and IVIg were administered as treatment. The second case was a 50-year-old man who complained of a bilateral leg tingling sensation and gait disturbance lasting four weeks. He had received the Ad26.COV2.S vaccine against COVID-19 five weeks prior. Demyelinating polyneuropathy was observed in the NCS. He was treated with oral prednisolone, azathioprine, and IVIg for CIDP because his symptoms had lasted for more than 12 weeks from the onset. A causal relationship has not been established between COVID-19 vaccination and CIDP; however, CIDP may follow COVID-19 vaccination. As CIDP treatment is different from that for GBS, clinicians should closely monitor patients diagnosed with GBS associated with COVID-19 whether they deteriorate after initial treatment.

OBJECTIVE: This study examined the effects on mortality and cell death after biomass charcoal combustion, in which carbon monoxide (CO) emissions were reduced using a biomass combustion improver in mice. METHODS: The biomass (glycerin) charcoal (Biomass CharCoal by Pusan National University, BCCP) was generated in the Power Generation System laboratory, Pusan National University. The effects and molecular mechanisms of biomass charcoal in carbon monoxide poisoning were examined by analyzing the mouse mortality, circulating leukocytes, carboxyhemoglobin (COHb), and expression of the inflammation-related genes, and cleaved capase-3 using enzyme-linked-immunosorbent-assays, real-time polymerase chain reaction, or Western blotting. RESULTS: The mortality rates were lower in the BCCP-exposed mice than in the raw charcoal-exposed mice. The circulating leukocytes were lower in the BCCP-exposed mice than in the raw charcoal-exposed mice. On the other hand, there was no significantly difference in the levels of COHb between both mice. Interestingly, the expression of the apoptosis-related gene, cleaved-capase 3, and the inflammation and tissue necrosis-related gene and receptor for the advanced glycation end products were reduced markedly in the BCCP-exposed mice compared to the raw charcoal-exposed mice. Decreased inflammation and tissue necrotic factors could be molecular mechanisms for the decreased mortality rates after BCCP burning. CONCLUSION: Biomass charcoal (BCCP) reduced the mortality rates and inflammation and tissue necrotic factors by 30%–40%. These results suggest that the biomass charcoal (BCCP) could reduce the incidence of suicide and CO-associated delayed symptoms after charcoal burning. Furthermore, it could extend the time for rescue in suicide attempts using charcoal burning.
Animals ; Biomass* ; Blotting, Western ; Burns* ; Busan ; Carbon Monoxide Poisoning ; Carbon Monoxide* ; Carbon* ; Carboxyhemoglobin ; Cell Death ; Charcoal* ; Glycosylation End Products, Advanced ; Hand ; Incidence ; Inflammation ; Leukocytes ; Mice* ; Mortality* ; Real-Time Polymerase Chain Reaction ; Suicide

PURPOSE: Replication-competent adenoviruses (Ads) are promising new modalities for the treatment of cancer. Selective replication of a viral agent in tumor may lead to improved efficacy over non-replicating Ads due to viral multiplication, lysis of the infected cancer cell and spread to surrounding cells. In our previous studies it was shown that the E1B 55 kD-deleted Ad (YKL-1) exhibits tumor specific replication and cell lysis, but with reduced cytolytic effects compared to the wild type adenovirus (Int J Cancer 2000;88: 454-463). Thus, improving the potency of oncolytic Ads remains an important goal for cancer gene therapy. To increase the oncolytic ability of YKL-1, an adenovirus death protein (ADP) gene was reintroduced under the control of a CMV or MLP promoter at the E3 region of the YKL-1, generating an YKL-cADP and YKL-mADP, respectively. MATERIALS AND METHODS: The in vitro cytolytic effect of ADP expressing Ads was evaluated by MTT assay, and the induction of apoptosis by ADP expressing Ads was examined by TUNEL analysis. Finally, the antitumor effect of ADP expressing Ads was demonstrated in C33A xenograft tumor model. RESULTS: The YKL-cADP exerted a markedly enhanced cytolytic effect against H460 and SK-Hep1 cancer cell lines. The TUNEL assay indicated that the ADP-mediated cytotoxicity was largely driven by apoptosis. Finally, the YKL-cADP showed a superior antitumor effect than the YKL-1 or YKL-mADP in C33A xenografts. CONCLUSION: These lines of evidence demonstrate that the YKL-cADP induces efficient cell lysis, which is critical for the addition of therapeutic value to replicating Ads in cancer gene therapy.
Adenosine Diphosphate ; Adenoviridae* ; Apoptosis ; Cell Line ; Genes, Neoplasm ; Heterografts ; In Situ Nick-End Labeling

No abstract available.
Receptors, Somatostatin* ; Somatostatin*

BACKGROUND: The recent change in pharmaceutical education system following the paradigm shift to patient-oriented pharmacy service requires an in-depth discussion to reorganize a future direction and establish a basis for maximizing social values of community pharmacy service. OBJECTIVE: This study was conducted to review the current status of community pharmacy service provision in Korea based on published literatures. METHODS: The electronic databases of National Digital Science Library and Electronic National Assembly Library were used to search the journal articles and dissertation papers. A search term "community pharmacy" was used and the published period was limited to papers published after year 2001, when the legal separation of prescribing and dispensing was implemented. Relevant study reports were also searched manually. Information about pharmacy service provision and study outcomes were retrieved from the selected papers, and classified by predefined individual service scope. RESULTS: A total 33 papers reporting services provided by community pharmacies were selected (journal article 11, dissertation paper 17, and study report 5). Pharmacy services identified in these papers could be classified into prescription dispensing service, pharmaceutical care service, self medication service, other products service, and health promotion service. Twenty papers reported prescription dispensing services, three papers reported pharmaceutical care service, and only two papers reported health promotion service. Current community pharmacy services are highly dependent on prescription drugs while expanded services such as pharmaceutical care and health promotion are peripheral. Most prevalent research topic was medication counseling service (18 papers), reflecting that community pharmacists generally consider it to be the most important and fundamental service. Overall, current pharmacy services are very limited and focus on prescription dispensing service. CONCLUSION: At this point of time requiring expansion and quality improvement of community pharmacy services, we suggest further lively discussion to strengthen pharmacist's functional identity and set conditions for providing socially expected services.
Community Pharmacy Services ; Counseling ; Education, Pharmacy ; Health Promotion ; Humans ; Korea* ; Pharmaceutical Services* ; Pharmacies* ; Pharmacists ; Prescription Drugs ; Prescriptions ; Quality Improvement ; Self Medication ; Social Values

Objective: The purpose of this study is to identify personality types that can influence breast cancer screening (BCS) compliance among Korean women with breast cancer using a mixed-method approach. Methods: The participants consisted of 93 women who underwent surgery for breast cancer between July 2010 and March 2012. The demographic and medical characteristics of the participants were evaluated through structured interviews. To identify personality types, in-depth interviews were performed and the transcribed interviews were evaluated using interpretive phenomenological analysis. The participants were categorized into two groups (compliance and non-compliance) based on compliance with the Korean Breast Cancer Society recommendations for BCS. Results: Five personality types were identified through phenomenological analysis. There were significant differences in the chi-square test results for the BCS compliance and non-compliance groups according to age (p=0.048), cancer stage (p<0.001), and personality types (p=0.018). Logistic regression showed that the odds ratio for compliance with BCS was 9.35 (p=0.01) for individuals with a cautious-organized personality type, 9.38 (p=0.02) for those with a cautious-dependent personality, and 10.58 (p=0.04) for those with a sensitive-downcast personality compared to those with a cautious personality type. Conclusion Participants with cautious-organized, cautious-dependent, and sensitive-downcast personality types were less likely to follow the BCS recommendations than those with a cautious personality type. This study provides a basis for the future development of an effective questionnaire to investigate the personality types of individuals with breast cancer in order to predict compliance with BCS.