• Journal of Preventive Medicine and Public Health
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• v.37 no.4
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• pp.381-389
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• 2004

Objective : To compare the efficacy between SKI306X and Diclofenac by using generalized estimating equations (GEE) methodology in the analysis of correlated bivariate binary outcome data in Osteoarthritis (OA) diseases. Methods : A randomized, double-blind, active comparator-controlled, non-inferiority clinical trial was conducted at 5 institutions in Korea with the random assignment of 248 patients aged 35 to 75 years old with OA of the knee and clinical evidence of OA. Patients were enrolled in this study if they had at least moderate pain in the affected knee joint and a score larger than 35mm as assessed by VAS (Visual Analog Scale). The main exposure variable was treatment (SKI 306X vs. Diclofenac) and other covariates were age, sex, BMI, baseline VAS, center, operation history (Yes/No), NSAIDS (Y/N), acupuncture (Y/N), herbal medicine (Y/N), past history of musculoskeletal disease (Y/N), and previous therapy related with OA (Y/N). The main study outcome was the change of VAS pain scores from baseline to the 2nd and 4th weeks after treatment. Pain scores were obtained as baseline, 2nd and 4th weeks after treatment. We applied GEE approach with empirical covariance matrix and independent(or exchangeable) working correlation matrix to evaluate the relation of several risk factors to the change of VAS pain scores with correlated binary bivariate outcomes. Results : While baseline VAS, age, and acupuncture variables had protective effects for reducing the OA pain, its treatment (Joins/Diclofenac) was not statistically significant through GEE methodology (ITT:aOR=1.37, 95% CI=(0.8200, 2.26), PP:aOR=1.47, 95% CI=(0.73, 2.95)). The goodness-of-fit statistic for GEE (6.55, p=0.68) was computed to assess the adequacy of the fitted final model. Conclusions : Both ANCOVA and GEE methods yielded non statistical significance in the evaluation of non-inferiority of the efficacy between SKI306X and Diclofenac. While VAS outcome for each visit was applied in GEE, only VAS outcome for the fourth visit was applied in ANCOVA. So the GEE methodology is more accurate for the analysis of correlated outcomes.

• Journal of The Korean Dental Society of Anesthesiology
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• v.4 no.2 s.7
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• pp.84-89
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• 2004

Background: Many studies on efficacy of preemptive analgesia have been processed in different ways. But the value of preemptive analgesia is still controversial. The goal of this study was to compare analgesic effect of an NSAID according to three different administration times for oral surgical pain. Patients and Methods: Using a randomized, parallel-group, single-center, and active-controlled test design, this study was conducted to healthy 80 patients undergoing a surgical removal of an impacted mandibular third molar requiring bone removal. The oral NSAID was first administered 1 hour preoperatively, or 1 hour postoperatively, or no scheduled administration in pre or postsurgery. Whenever patients felt at least moderate pain (score ${\ge}$ 5 on a 10-point scale) after surgery, they were instructed to take the same drug. Pain intensities and times to the first and second onset of postoperative pain from end of surgery were assessed for 24 hours. Results: Of the enrolled eighty subjects in this study, 25 patients were assigned to preemptive, 26 to post-treatment and 29 to no treatment group. The demographic distribution and duration of surgery in the three groups were statistically similar. The mean time to first onset of postoperative pain was significantly prolonged in post-treatment group (277.2 minutes, p < 0.05) compared to preemptive (158.4 minutes) and no treatment group (196.5 minutes). The mean time to second onset of postoperative pain was not significantly different among the three groups. No significant statistical difference was found among the mean pain intensities at the first and second onset of postoperative pain in the three groups. Conclusions: In this small selected group of subjects and limited study design, the analgesic effects of NSAID administered preoperatively were no longer effective for postoperative pain. The results in this population imply that scheduled postoperative analgesics before pain development are adequate for postoperative analgesia without preoperative administration.

• Journal of Life Science
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• v.17 no.1 s.81
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• pp.110-115
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• 2007

It has been previously described that transcription factor early growth response gene product 1 (EGR-1) functions as a tumor suppressor gene. This study was conducted to demonstrate that EGR-1 induction by phytochemical apigenin and its derivative isovitexin can mediate the growth suppression of the intestinal epithelial tumor cells. Apigenin and isovitexin induced EGR-1 gene expression both in the dose and time-dependent manners. Moreover the induction was relatively late around 9-12 hr after treatment of HCT-116 cells, while several anti-inflammatory agent such as NSAIDS and catechins elicit the ECR-1 gene expression at much earlier time about 1-3 hr after treatment. In terms of signal transduction, ERK1/2 was critical for apigenin-induced EGR-1 gene expression and its promoter activation. When EGR-1 gene expression was blocked with EGR-1 small interference RNA, the cytotoxicity of apigenin in the human epithelial cells was attenuated, suggesting the involvement of EGR-1 in the anti-tumoric activity of apigenin. To link the EGR-1 induction to EGR-1-regulated gene products in colon cancer, NSAID-Activated Gene 1 (NAG-1) was demonstrated to be elevated by apigenin and isovitexin at 24-48 hr after treatment. Taken together, apigenin-activated ERK1/2 mediated EGR-1 gene induction, which was associated with suppression of the cellular viability by apigenin compound.

• Journal of Life Science
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• v.17 no.7 s.87
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• pp.996-1001
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• 2007

To investigate whether sulindac, sulindac sulfone, and sulindac sulfide could affect cancer cell viabilities, human colorectal HCTl16 cells were treated with 10 ${\mu}M$ of each NSAID. Among treated NSAms, sulindac sulfide dramatically decreased the cell viabilities detected by MTS and the cytotoxic effect showed dose-dependent manner. To understand the molecular mechanism of cell death in response to sulindac sulfide treatment, we performed oligo DNA microarray analysis. We found that 23 genes were up-regulated more than 2 folds, whereas 33 genes were down-regulated more than 2 folds by treatment of 10 ${\mu}M$ sulindac sulfide. Among the up-regulated genes, we selected 3 genes (NAG-1, DDIT3, PCK2) and performed RT-PCR and quantitative real-time PCR to cofirm microarray data. The results of RT-PCR and real-time PCR were highly accorded with those of microarray experiment. As NAG-1 is well-known gene as tumor suppressor, we detected changes of NAG-1 expression by 10 ${\mu}M$ of sulindac, sulindac sulfone, and sulindac sulfide. The results of RT-PCR and quantitacve real-time PCR indicated that sulindac sulfide was the strongest inducer of NAG-1 among treated NSAIDS. This result implies that induction of NAG-1 by sulindac sulfide plays important role in cell death of colorectal cancer. Overall, we speculate that these results may be helpful in understanding the molecular mechanism of the cancer chemoprevention by sulindac sulfide in human colorectal cancer.

• The Journal of Korean Medicine
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• v.28 no.1 s.69
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• pp.87-93
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• 2007

Objectives : This study was to assess the effectiveness of Oriental medical treatment on carpal tunnel syndrome, comparing its outcome with that of Western medical treatment. Methods : After being diagnosed with carpal tunnel syndrome by electromyography, subjects were enrolled in Kyung Hee Medical Center from March 2006 to January 2007. We prescribed Kejibokryung-hwan to the Oriental medical therapy group (OM group) and NSAIDS to the Western medical therapy group (WM group). Effectiveness was assessed by degree of pain using visual analog scale (VAS) before and after 3 weeks' treatment. Adverse effects were also monitored. Results : There were 21 patients in the OM group and 19 in the WM group. No statistical significant difference was detected at the baseline assessment. After 3 weeks of medication, pain was reduced about 26% in the OM group and 46% in the WM group. These findings might be explained by that more than half of the WM group received local steroid injection, which has been known to have more rapid analgesic effect that oral medication. Although pain reduction rate was higher in the WM group than in the OM group, we suggest that Oriental medical treatment is still effective, faking into consideration the fact that completely recovered cases were found only in the OM group. No adverse effect was found in either of the groups. Conclusion : This work could help us to understand the effectiveness of Oriental medical treatment on carpal tunnel syndrome.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.4
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• pp.661-667
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• 2001

Though a consensus seems to exist about the regulation of the use of sugar-containing food, however. an unrecognized and significant supply of cariogenic carbohydrate remains in the form of sugar-containing liquid oral medicine to prevent dental caries. children who are taking long-term sugar-containing liquid medicine have an increased risk of developing dental caries. The aim of this study is to get the information about the sugars in liquid medicines prescribed for the children. To get the information, the number and date of all prescriptions of liquid medicines for one month at pediatric hospital of Seoul National University Hospital were investigated. From that data, the most frequently used pediatric oral liquid medicine is presented. Then, for the information of the type and contents of sweeteners in that preferred medicines, the manufacturers of each medicines were asked for the data of sugar types and contents, and the informations about the medicine contents were collected via facsimile. The most frequently used pediatric oral liquid medicine were followed as expectorant, purge, antibiotic, drug for iron deficiency anemia, sedative, antihistamine, anticonvulsant, NSAIDs in order. The mean value of sweetener content in liquid medicines was $52.3{\pm}22.4g/100ml$ and most frequently used sweetener is sucrose.

• The Journal of the Korean bone and joint tumor society
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• v.12 no.2
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• pp.103-111
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• 2006

Purpose: Sternocostoclavicular hyperostosis (SCCH) is a disease of unknown etiology, which is characterized by periosteal reaction and endosteal hyperossification of the sternum, clavicles and upper ribs as well as ossification of the surrounding soft tissue. SCCH is a well recognized but uncommon condition which is important differential diagnosis to consider to avoid misdiagnosis and to differentiate the condition from malignant process. But few studies have reported long-term clinical result of SCCH. We report long-term clinical result of SCCH. Materials and Methods: From 1986 to 2000, 17 cases of SCCH were followed up over two to 14 years. We evaluated the radiologic, pathologic and clinical results. Results: Four men and thirteen women were studied. The age when first symptom appeared were raged from17 to 60(average-48.7) There are no specific bacteriological, serological or histological finding. Usually a permanent increase in the erythrocyte sedimentation rate is found. The radiological examination showed the signs of proliferate destructive arthritis in most case. The majority of patients respond to NSAIDs and antibiotics. Conclusion: Sternocostoclavicular hyperostosis is uncommon benign condition, but important condition in the differential diagnosis of inflammatory or malignant process of this joint.

• Journal of The Korean Dental Society of Anesthesiology
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• v.3 no.1 s.4
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• pp.10-18
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• 2003

Background: Studies on the pain have been dealing with many different ways for last several centuries. Especially, preemptive analgesia is being used as a method to control the postoperative pain. Many studies on its efficacy have been processed in different ways about various drugs, administration methods and times for various operations. And the value of preemptive analgesia are still controversial regarding the results of other clinical studies. The authors performed a clinical study on efficacy of preemptive analgesia using an non-steroidal anti-inflammatory drug (NSAID) for the surgical extraction of impacted third molar teeth and present the more effective pain treatment after oral surgery with literature review. Methods: Using a randomized double blind test design, this study compared the analgesic efficacies of an NSAID, Talniflumate 370 mg. This drug administrated first either 1 hour preoperatively (experimental group) or when the pain developed moderately to severely over 5 scale of verbal rating scales (0-10) to respective 30 patients undergoing the removal of impacted third molars. Pain intensity and the time from the end of surgery were assessed postoperatively whenever the patients demanded additional drug over 5 scale for forty eight hours using same verbal rating scales. Results: The sex distribution, the age of the patients. and the time required for surgery in two groups were similar. The average first time for demanding additional drug after surgery was 163.9 minutes in experimental group and 191.5 minutes in control group. At this time, the average pain intensity was 5.8 in experimental group and 6.1 in control group. And the average second time for demanding additional drug was 365.5 minutes in experimental group and 351.8 minutes in control group. At this time. the average pain intensities were 6.6 in experimental group and 6.2 in control group. No statistically significant difference was found between the average first times and second times, and the average pain intensities at first and second times in two groups. Conclusions: From these results the efficacy of preemptive analgesia used in this study was not appeared. This clinical study indicates that many NSAIDs administrated preoperatively in present practices have weak efficacy of preemptive analgesia for postoperative pain, thus the authors recommend that only postoperative analgesics are adequate without preoperative use of analgesics.

• Journal of Veterinary Clinics
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• v.31 no.6
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• pp.527-530
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• 2014

A 7-year-old neutered male Korean domestic short-haired cat was referred to our clinic to treat constipation which had persisted for 6 months. The rectal examination revealed narrowing of the right lateral portion of the pelvic canal. A reduced pelvic canal diameter by pelvic fracture malunion was revealed on radiography. The pelvic canal diameter ratio measured from preoperative was 0.68. Based on rectal and radiographic examinations, constipation caused by pelvic canal narrowing was confirmed. Pelvic symphyseal distraction-osteotomy and iliac wedge osteotomy were performed. An iliac osteotomy of the ilium was performed to ease the pelvic symphyseal distraction. After the symphysis was split longitudinally, pelvic symphyseal distraction was maintained by using a spacer made of poly-methyl-methacrylate. The osteotomy of the ilium was fixed using a bone plate and screws. Increased pelvic canal diameter was confirmed on post-operative radiography and the postoperative pelvic canal diameter ratio was 0.91. The patient received antibiotics, NSAIDs, crystalloids and Lactulose for post-operative care. The cat recovered normal defecation abilities and did not have constipation at one week postoperatively. No episodes of constipation persisting longer than 6 months have been reported by owners in previous studies. Pelvic symphyseal distraction osteotomy and iliac wedge osteotomy may prove to be a useful surgical procedure to treat pelvic canal stenosis that is caused by pelvic fracture malunion.

• Journal of Yeungnam Medical Science
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• v.23 no.1
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• pp.36-44
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• 2006

Background: There is controversy regarding whether COX-2 specific inhibitors are associated with elevation of blood pressure. We compared the effects of aspirin, indomethacin, and celecoxib for vascular reactivity induced by phenylephrine. We also tested the effects of indomethacin and NO donor on COX-1 and COX-2 protein expression, as well as nitrite production in culture medium of vascular smooth muscle cells. Materials and Methods: In this experiment, we used the isometric tension study for vascular reactivity. After 45 minutes of pretreatment with aspirin, indomethacin, celecoxib, and phenylephrine induced contractions were tested. COX-1 and COX-2 protein expressions were analyzed by Western blot and nitrite production by the Griess reaction. Results: Although celecoxib pretreatment caused enhanced arterial contraction, aspirin pretreatment induced more potent arterial contraction than celecoxib in the isometric tension study of rabbit femoral artery. COX-1 protein expression was unchanged by indomethacin, SNP and NOR-3; COX-2 protein expression was increased by the addition of indomethacin, SNP, and NOR-3. Especially, NOR-3, a NO donor, significantly increased COX-2 protein expression with unstimulated conditions as well as LPS stimulation. Induction of nitrite production was higher with NOR-3 treatment than SNP treatment with LPS stimulation. Conclusion: These results suggest that aspirin caused more potent vascular contraction than celecoxib and indomethacin. COX-2 expression in VSMC depended on the types of NO donor and LPS stimulation.