• The Korean Journal of Pain
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• v.20 no.1
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• pp.26-30
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• 2007

Background: Epidural steroid injections (ESI) are a common treatment for spinal disorders. Previous research has shown that aspiration of the syringe is not a sensitive test for placement of an intravascular needle. Serious complications have been reported from injection of steroids and local anesthetics into the vascular space. In addition to safety concerns, the efficacy may decline with partial injection outside the desired epidural location. We hypothesized that incidence of vascular problems is increased in patients who undergo spine surgery compared with the patients who don't undergo spine surgery. We investigated the incidence of vascular problems during lumbosacral transforaminal ESI and we compared the difference of vascular problems between the patients who undergo spinal surgery and those patients who don't undergo spinal surgery. Methods: Two hundreds and three patients were consecutively recruited and they received 299 fluoroscopically guided lumbosacral transforaminal ESIs. Injection of contrast was performed under live dynamic fluoroscopy with using digital substraction analysis. The observed uptake pattern was classified into one of three categories: flashback, aspirated, and positive contrast with negative flashback and aspiration. Results: The vascular incidence rate was 20.4%. Transforaminal ESIs performed at S1 had avascular incidence rate of 27.8% compared with 17.7% for all the other lumbar injection sites. The sensitivity of spontaneous observation of blood in the needle hub or blood aspirate for predicting an intravascular injection in lumbar transforaminal ESIs was 70.4%. Conclusions: There is a high incidence of intravascular problems when performing transforaminal ESIs, and this is significantly increased in patients with previous spine surgery. Using a flash or blood aspiration to predict an intravascular injection is not sensitive therefore; a negative flash or aspiration is not reliable. Fluoroscopically guided procedures without contrast confirmation are prone to instill medications intravascularly. This finding confirms the need for not only fluoroscopic guidance, but also for contrast injection instillation when performing lumbosacral transforaminal ESIs, and especially for patients with previous spine surgery.

• Journal of Pharmaceutical Investigation
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• v.34 no.4
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• pp.299-303
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• 2004

Prescription filling in powder form is performed in community pharmacy practice to adjust dose for children and patients who cannot swallow whole tablet. However, there are few reports regarding the stability of the active ingredient and possible microbial growth after the medication is dispensed to powder form. This study examined the stability of atenolol, an antihypertensive agent, and microbial growth in the unit dose pouches dispensed at twenty-one community pharmacies located in Taegu area. Randomly chosen first unit dose pouch contained 77.4% of the prescribed dose of the drug and there were only four community pharmacies that dispensed the drug within 10% deviation from the dose prescribed by physician. Surprisingly, there were three community pharmacies that dispensed the drug with greater than 40% deviation, which may pose a major concern regarding the efficacy and safety of the drug prescribed for the treatment of hypertension. Atenolol content during a month did not indicate significant change, showing 5.4%, 4.3%, and 3.3% of decrease in 50%, 80%, and 90% relative humidity conditions, respectively. Microbiological examination during a month showed less than 0.5 microorganism in high power field (hpf) in all the relative humidity conditions tested. Based on this study, pharmacy practice in community pharmacy needs to be rigorously regulated to ensure that the dose of the prescribed drug is properly incorporated into the unit dose pouch dispensed as powder form.

• Journal of Pharmaceutical Investigation
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• v.34 no.6
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• pp.477-482
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• 2004

The aim of the present study was to investigate the efficacy of a mixed gel formulation composed of sodium carboxymethyl cellulose and gellan gum (Na-CMC gel) for the prevention of adhesions after laminectomy. The anti-adhesive effect of the Na-CMC gel was tested in a controlled randomized study using an animal model of lumbar laminectomy. The animals (60 female Sprague-Dawley rats) were randomly allocated into two treatment groups to receive the Na-CMC gel on the injured area or no gel (control). The incidence of adhesions and their grade were blindly evaluated at 4, 8 and 12 weeks after surgery. The amount of scar tissue and tenacity were grossly reduced by the Na-CMC gel at postoperative 4, 8, and 12 weeks. The mean adhesion scores were 0.75, 1.25, and 1.38 at 4, 8, and 12 weeks in the gel-treated group, respectively. No significant inflammatory reaction was observed and the healing of wound was not affected by the Na-CMC gel. The Na-CMC gel reduced the amount of scar formation and tenacity in rat laminectomy model without affecting the healing of operation wound and other complications. Therefore, the Na-CMC gel may be the potential to prevent postsurgical adhesions in clinical state.

• Journal of Embryo Transfer
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• v.29 no.4
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• pp.321-325
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• 2014

The present study was performed on farm animals to test the effectiveness of progesterone-releasing intravaginal device (Cue-Mate$^{(R)}$ 1.56 g) and injection of prostaglandin $F_{2{\alpha}}$ ($PGF_{2{\alpha}}$) for synchronization estrus in Hanwoo cattle. The cattle were at random stage of the estrus cycle. The cows were artificially inseminated at day 7 after Cue-Mate withdrawal, using commercial semen from Korean native bulls. There was a season effect on the estrus synchronization rate. It was higher in spring (94.3%) followed by winter (93.3%), autumn (90.4%) and summer (67.2%). In summary, The results of this study revealed that season has influences on estrus behavior of cattle with no significant effect on pregnancy rate. In summary, we suggest summer reproductive management to alleviate the effects of heat stress. It should be based on intensive cooling combined with hormonal treatment. Given that different subgroups of cows benefit differently from the treatments, selective hormonal administration should be considered.

• Journal of Microbiology and Biotechnology
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• v.22 no.7
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• pp.883-888
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• 2012

The efficacy of cowdung, Bangladesh Institute of Nuclear Agriculture (BINA)-biofertilizer, and Bangladesh Agricultural University (BAU)-biofungicide, alone or in combination, was evaluated for controlling foot rot disease of lentil. The results exhibited that BINA-biofertilizer and BAU-biofungicide (peat soil-based Rhizobium leguminosarum and black gram bran-based Trichoderma harzianum) are compatible and have combined effects in controlling the pathogenic fungi Fusarium oxysporum and Sclerotium rolfsii, which cause the root rot of lentil. Cowdung mixing with soil (at 5 t/ha) during final land preparation and seed coating with BINA-biofertilizer and BAU-biofungicide (at 2.5% of seed weight) before sowing recorded 81.50% field emergence of lentil, which showed up to 19.85% higher field emergence over the control. Post-emergence deaths of plants due to foot rot disease were significantly reduced after combined seed treatment with BINA-biofertilizer and BAU-biofungicide. Among the treatments used, only BAU-biofungicide as the seed treating agent resulted in higher plant stand (84.82%). Use of BINA-biofertilizer and BAU-biofungicide as seed treating biocontrol agents and application of cowdung in the soil as an organic source of nutrient resulted in higher shoot and root lengths, and dry shoot and root weights of lentil. BINA-biofertilizer significantly increased the number of nodules per plant and nodules weight of lentil. Seeds treating with BAU-biofungicide and BINA-biofertilizer and soil amendment with cowdung increased the biomass production of lentil up to 75.56% over the control.

• Microbiology and Biotechnology Letters
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• v.48 no.2
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• pp.230-235
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• 2020

The global evolution of antibiotic resistance has threatened the efficacy of available treatment options with ravaging impacts observed in developing countries. As a result, investigations into the prevalence of antibiotic resistance and the role of plasmids are crucial. In this study, we investigated the presence and distribution of bla_TEM and gyrA genes, plasmid profiles, and the antimicrobial susceptibility pattern of Salmonella strains isolated from raw meat and stool sources across Niger State, Nigeria. Ninety-eight samples, comprising 72 raw meat and 26 stool samples, were screened for Salmonella spp. The antimicrobial susceptibility of Salmonella isolates to 10 commonly used antimicrobial agents was determined using the KirbyBauer disc diffusion method. Isolates were further analyzed for plasmids, in addition to PCR amplification of beta-lactamase (bla_TEM) and gyrA genes. A total of 31 Salmonella spp. were isolated, with 22 from raw meat (70.97%) and 9 from stool (29.03%). Salmonella spp. with multiple resistance patterns to ceftazidime, cefuroxime, ceftriaxone, erythromycin, ampicillin, cloxacillin, and gentamicin were detected. Ofloxacin and ciprofloxacin were found to be the most effective among the antibiotics tested, with 67.7% and 93.5% susceptible isolates, respectively. Nine (29.03%) isolates harbored plasmids with molecular sizes ranging between 6557 bp and 23137 bp. PCR amplification of gyrA was detected in 1 (3.23%) of the 31 isolates while 28 isolates (90.32%) were positive for bla_TEM. This study shows the incidence of antibiotic resistance in Salmonella isolates and the possible role of plasmids; it also highlights the prevalence of ampicillin resistance in this local population.

• The Korean Journal of Pharmacology
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• v.31 no.2
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• pp.261-269
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• 1995

Background; To explore the efficacy of aspartate as NAD regenerating agent for ethanol and acetaldehyde oxidation, we performed crossover challenge in two groups of volunteers by coadministration of various doses of aspartate, asparagine and ethanol. Methods; 18 healthy male volunteers were randomly divided into two groups. 6 volunteers of the first group were administered 5 gm monosodium aspartate(MSA), 5 gm asparagine or placebo with 100 ml of $40^{\circ}$ whiskey by the 3 way-crossover design, while 12 volunteers of the other group were administered placebo, 1, 2 or 5 bottles of $Aspar^(circledR)$ containing 1 gm of MSA per bottle with 100 ml of $40^{\circ}$ whiskey by the 4 way-crossover design. Ethanol(and acetaldehyde) concentrations in venous blood drawn at 0, 0.25, 0.5, 1, 2, 4, 8th hour after ethanol ingestion were analysed by gas chromatogaphy. Subjective symptoms, liver function tests and psychomotor function tests were also performed during the study periods. Result; Plasma concentration and AUC of acetaldehyde in asparagine and MSA trials on ethanol ingestion were significantly lower than those of placebo trial in the 1st group. Plasma ethanol concentration of 5 bottle $Aspar^(circledR)$ trial was significantly lower than that of placebo trial in the 2nd group. Improvement of subjective symptoms or psychomotor performance by the treatment was not statistically significant. Conclusion; Aspartate and asparagine may be prospective candidates for acceleration of ethanol metabolism and prevention of ethanol toxicity.

• Quality Improvement in Health Care
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• v.5 no.1
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• pp.152-165
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• 1998

Background : In this paper patient outcomes research is going to be reviewed and described, to be compared with relevant studies, and to consider the application in Korea. Methods : We compiled and reviewed the articles and materials related to patient outcomes research especially by PORT(Patient Outcomes Research Team) and rearranged them for seeking the main point and comparing with relevant studies. Results : Patient outcomes research emphasizes patient outcomes as well as conventional clinical outcomes. It is prospective study observing effectiveness in real situation instead of efficacy in ideal condition. Patient outcomes research comprises of 6 fields ; literature review and meta-analysis, use of claims data, decision modeling, outcomes assessment, cost of care, dissemination of research findings. SAA(small-area variations analysis), appropriateness study and clinical practice guideline are connected with patient outcomes research. Conclusion : In view of the fact that current medical policy in Korea is shifting its focus from accessibility to the improvement in quality and cost containment, and is stressing patient-based research, patient outcomes research is one direction for which the medicine is accountable and assessable. Considering that the number of patient receiving medical treatment in Korea is higher than the West, patient outcomes research has competitive power as against the West.

• Quality Improvement in Health Care
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• v.14 no.2
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• pp.125-132
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• 2008

Background : The number of outpatient injected anticancer drug is increasing. and the pathway of prescribing, compounding, and injecting anticancer drug is processed very rapidly in out-patient department. Moreover, Dose of anticancer drug is often changed depending on side effect of patients. So we need more effective inspection of anticancer drug prescriptions. The purpose of this study was to analyze the prescription errors for anticancer drugs in Out-Patient Department and to suggest system to prevent them. Method : The study took place at Asan Medical Center from July to September 2007. The pharmacists performed inspection of anticancer drug prescriptions before compounding and injecting. We used protocol-based anticancer drug order program and Electronic Medical Record (EMR). Result : During the study period, we analyzed 4683 prescriptions for out-patient. And we detected 55 medication errors (1.2%). Most common errors included dosage above or below the correct ones (56.3%), followed by incorrect treatment duration. Because most of dosing errors were in the range of usual dosage, it was hard to detect them. So when inspecting the prescription, we considered the medical records of individual patients. As a result, we could raise the efficiency of intervention. Therefore inspection using EMR could possibly reduce the number of anticancer drug errors. Conclusion : we are preventing the medication errors on stability and dosage above or below the maximum therapeutic dose according to the previous inspection system. However most of dosing errors were in the range of usual dosage according to the result of this study. Because of there was interpatient variability of dosage depending adverse effect. For improvement of quality assurance, we suggest inspection system based on patient's medical history.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.30 no.1
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• pp.74-86
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• 2017

Objectives : This study aimed to assess the scientific evidence for the use of Hwanglyeonhaedok-tang, a traditional herbal formula, in the treatment of rhinitis, and prepare the basis for the investigational new drug application by analyzing the experimental studies. Methods : Ten electronic databases were searched up to December, 2016 without language limitation. Experimental studies on the anti-inflammatory and anti-allergic effects of Hwanglyeonhaedok-tang against rhinitis were included. We extracted data about study design, characteristics of intervention, outcomes, and pharmacological effects from the included studies and summarized them. Results : Eight hundred and thirty-three potentially relevant studies were identified, of which 18 experimental studies met our inclusion criteria. Of 18 included studies, 5 had conducted cell viability test, and all studies had reported that Hwanglyeonhaedok-tang was non-cytotoxic. Hwanglyeonhaedok-tang exhibits anti-inflammatory effect by regulating the inflammation-related cytokines including nitric oxide(NO), prostaglandin $E_2(PGE_2)$, interleukin-6(IL-6), and tumor necrosis $factor-{\alpha}(TNF-{\alpha})$ in vitro and in vivo. Hwanglyeonhaedok-tang exhibits anti-allergic effect by suppressing eosinophil, and histamine levels. Hwanglyeonhaedok-tang helps in the recovery of nasal mucous membrane by supressing goblet cells, heat shock protein 70, and substance P. Conclusions : This study suggests that Hwanglyeonhaedok-tang has the potential to be developed as therapeutic agent for rhinitis. Further experimental and clinical studies needed to be performed to prove the safety and efficacy.