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Pharmacoeconomic Analysis of Tafluprost compared with Latanoprost on the Treatment of Primary open Angle Glaucoma or Ocular Hypertension in Korea (녹내장치료에 있어서 Tafluprost와 Latanoprost의 경제성평가)

  • Kang, Suk-Hyun;Song, Hyun-Jin;Heo, Ji-Heong;Lee, Eui-Kyung
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.3
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    • pp.278-287
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    • 2010
  • The main objective of this study is to evaluate the cost-effectiveness of tafluprost compared with latanoprost in primry open Angle Glaucoma (POAG) or ocular hypertension OH patients in Korea. A decision analytic model was developed from a societal perspective to estimate clinical outcome, drug cost and glaucoma related cost. The model assumes branch like following: successful treatment, switching to other drug, adding other drug, laser or surgery. Treatment success rate is defined as the percentage of patients with elevated IOP achieving <20% reduction, and discontinuation rate is the percentage of patients who were withdrawn due to severe adverse events. A model that is comprised of 1 month cycle length has 1 year. Treatment success rate and discontinuation rate were obtained from published literatures searched in database. Resource utilizations and costs were calculated with national health insurance data and clinical expert opinions. Sensitivity analyses were performed on crucial parameters. Tafluprost is less costly than latanoprost, $609.0 vs $651.2 expected cost. Thus tafluprost was shown to be dominant compared with latanoprost. The results of sensitivity analysis revealed stable across most of the included parameters. According to this study, tafluprost shows more clinical outcome for 1 year than latanoprost. In addition, first-line treatment of tafluprost is a more cost-minimizing strategy associated with POAG or OH compared with latanoprost.

Evaluation of alveolar crest bone loss via premolar bitewing radiographs: presentation of a new method

  • Safi, Yaser;Kadkhodazadeh, Mahdi;Safai, Pooria;Esmaeelinejad, Mohammad;Shamloo, Nafiseh
    • Journal of Periodontal and Implant Science
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    • v.44 no.5
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    • pp.222-226
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    • 2014
  • Purpose: This study aimed to assess the interdental bone level in premolar bitewing radiographs while retracting the cheeks. Methods: Seventy-two horizontal bone defects were created on dried mandibles and maxillae. The distance from the bone level to the cement-enamel junction of premolars was detected by a modified digital caliper (considered the gold standard). The reliability of all radiographs was assessed by intraclass correlation coefficient (ICC), and the validity was compared to the gold standard using the analysis of variance test. P-values less than 0.05 were considered statistically significant. Results: This study showed that the reliability of radiographs without a cheek simulator and with 0.16 second exposure time was significantly higher than that of the two other groups (ICC=0.96 compared to 0.93 and 0.88, respectively). The results from the radiographs without a cheek simulator and with 0.16 second exposure time were more similar to the gold standard measures than those of the two other groups, although the difference was not statistically significant. Conclusions: Retracting the buccal soft tissue plays an important role in increasing the accuracy of radiographs in detecting the interdental alveolar bone level and produces more accurate results than increasing the exposure time, although it does not have a significant role in reliability of results.

Identification of Amino Acid Residues Involved in Feedback Inhibition of the Anthranilate Synthase in Escherichia coli

  • Kwak, Joon-Hyeok;Hong, Kwang-Won;Lee, Sung-Haeng;Hong, Jin-Han;Lee, Se-Yong
    • BMB Reports
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    • v.32 no.1
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    • pp.20-24
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    • 1999
  • The first step of the branch pathway in tryptophan biosynthesis is catalyzed by anthranilate synthase, which is subjected to feedback inhibition by the end product of the pathway. The $trpE^{FBR}$ gene from a mutant Escherichia coli strain coding for anthranilate synthase that was insensitive to feedback inhibition by tryptophan has been cloned. To identify the amino acid changes involved in the feedback regulation of anthranilate synthase, the nucleotide sequence of the mutant $trpE^{FBR}$ gene was determined. Sequence analysis of the $trpE^{FBR}$ gene revealed that four bases were changed in the structural gene while alteration was not found in the 5' control region. Among these base changes, only two base substitutions caused the alterations in amino acid sequences. From the results of restriction fragment exchange mapping, the 61st nucleotide, C to A substitution, that changed $Pro^{21}{\rightarrow}Ser$ was identified as the cause of the desensitization to feedback inhibition by tryptophan. Additional feedback-resistant enzymes of the E. coli anthranilate synthases were constructed by site-directed mutagenesis to examine the effect of the $Ser^{40}\;{\rightarrow}\;Arg^{40}$ change found in the $trpE^{FBR}$ gene of Brevibacterium lactofermentum. From the feedback inhibition analysis, the $Pro^{21}{\rightarrow}Ser$ and $Ser^{40}{\rightarrow}Arg$ mutants maintained about 50% and 90% of their maximal activities, respectively, even at the extreme concentration of 10 mM tryptophan. From these results, we suggest that the $Pro^{21}$ and $Ser^{40}$ residues are involved in the tryptophan binding in the E. coli enzyme.

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Surgical Treatment of Carpal Tunnel Syndrome through a Minimal Incision on the Distal Wrist Crease: An Anatomical and Clinical Study

  • Yoo, Hye Mi;Lee, Kyoung Suk;Kim, Jun Sik;Kim, Nam Gyun
    • Archives of Plastic Surgery
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    • v.42 no.3
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    • pp.327-333
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    • 2015
  • Background An anatomical analysis of the transverse carpal ligament (TCL) and the surrounding structures might help in identifying effective measures to minimize complications. Here, we present a surgical technique based on an anatomical study that was successfully applied in clinical settings. Methods Using 13 hands from 8 formalin-fixed cadavers, we measured the TCL length and thickness, correlation between the distal wrist crease and the proximal end of the TCL, and distance between the distal end of the TCL and the palmar arch; the TCL cross sections and the thickest parts were also examined. Clinically, fasciotomy was performed on the relevant parts of 15 hands from 13 patients by making a minimally invasive incision on the distal wrist crease. Postoperatively, a two-point discrimination check was conducted in which the sensations of the first, second, and third fingertips and the palmar cutaneous branch injuries were monitored (average duration, 7 months). Results In the 13 cadaveric hands, the distal wrist crease and the proximal end of the TCL were placed in the same location. The average length of the TCL and the distance from the distal TCL to the superficial palmar arch were $35.30{\pm}2.59mm$ and $9.50{\pm}2.13mm$, respectively. The thickest part of the TCL was a region 25 mm distal to the distal wrist crease (average thickness, $4.00{\pm}0.57mm$). The 13 surgeries performed in the clinical settings yielded satisfactory results. Conclusions This peri-TCL anatomical study confirmed the safety of fasciotomy with a minimally invasive incision of the distal wrist crease. The clinical application of the technique indicated that the minimally invasive incision of the distal wrist crease was efficacious in the treatment of the carpal tunnel syndrome.

Microsurgical Replantation of Very Distally Amputated Finger (수지 첨부 절단의 재접합술)

  • Kang, Hong-Dae;Kim, Johng-Jin;Lee, Nae-Ho;Yang, Kyung-Moo;Moon, Ji-Hyun
    • Archives of Reconstructive Microsurgery
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    • v.16 no.2
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    • pp.75-81
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    • 2007
  • Introduction: Microsurgical replantation of amputated digit have become common procedure in recent years. However replantation of fingertip amputation, Zone I by Yamano classification, is still difficult because digital arteries branch into small arteries and also digital veins are hard to separate from the immobile soft tissue. So, fingertip amputation was covered by volar V-Y flap, composite graft, cross finger flap and groin flap. But patients who have been treated by these methods experience shortening of digit, nail deformity, excessive tenderness and persistent pain. Replantation could solve most of these problems. Material & Methods: In our department, from March 2004 to August 2007, 36 digits in 32 patients with complete amputation at distal to nail base were replanted using a microsurgical technique. Results: The overall survival rate of the replanted finger was 75%. Venous anastomosis was possible in 8 cases and impossible in 28 cases. In latter cases external bleeding technique was applied with medical leech. Conclusion: After replantation, a few patient complained decreased sensibility, nail deformity and cold intolerance. But most of patients were satisfied with the functional and cosmetic appearance of the viable replanted digits. We believe the replantation should be the first choice in fingertip amputation.

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A Case of Plexiform Neurofibroma Arising from Laryngeal Surface of Epiglottis (후두개 후두면에 발생한 망상형 신경섬유종 1예)

  • Kim, So Yeon;Kim, Tae Hwan;Lee, Sang Hyuk;Jin, Sung Min
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.26 no.2
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    • pp.137-140
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    • 2015
  • Neurofibroma is characterized as a benign, slow growing neoplasm, originating from Schwann cells or fibroblast in peripheral nerve sheaths. It may appear as a solitary tumor or have multiple localizations in von Recklinghausen disease. They are commonly found in the gastrointestinal tract and laryngeal neurofibromas are extremely rare, accounting for only 0.03 to 0.1% of benign tumors of the larynx. The aryepiglottic fold and arytenoid are the common site of occurrence for laryngeal neurofibroma, because the branch of the superior laryngeal nerve is involved. We present a case of solitary plexiform neurofibroma arising from the laryngeal surface of epiglottis in a 55-year old female who found the lesion incidentally. We removed the tumor completely by transoral laser surgery and no recurrence was found after 7 months. The case of solitary neurofibroma arising from laryngeal surface of epiglottis has not been reported in Korea. We report this case regarding the diagnosis and treatment with review of literatures.

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BEHAVIORAL CHANGES IN KOREAN ELEMENTARY, MIDDLE, AND HIGH SCHOOL STUDENTS FOLLOWING BASIC EDUCATION IN MEDICAL RADIATION

  • Han, Eun Ok;Kim, Jae Rok;Kye, Suh Youn;Choi, Yoon Seok
    • Journal of Radiation Protection and Research
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    • v.40 no.1
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    • pp.36-45
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    • 2015
  • by providing objective information regarding medical radiation for elementary, middle, and high school students in Korea, who are expected to have a high ripple effect in education, and by analyzing behavioral changes in the selection of medical radiation, this study aimed to deduce the basis for educational intervention. The tools used in the study were a questionnaire, including questions about perception, knowledge, attitude, and behavior toward medical radiation; video and Power-point materials for the lesson; simulated radiation diagnosis selection form; and radiation treatment selection form to find out about behavior. A post-test demonstrated that the objective knowledge about medical radiation of all the students turned out to be significantly higher (p<0.000) after the lesson compared to before the lesson. However, there were no statistically significant behavioral changes. Rather, for high school students, the behavior of selecting medical radiography and treatment was significantly lower (p<0.000) after the lesson. For the more impressionable children in the lower grades, the lesson must not only provide an opportunity to understand and pay attention to diverse viewpoints, but also encourage them to make ethical decisions based on value. Since it can be predicted that attitude or behavioral changes through education or publicity can be expected from adults older than high school students, issues regarding dangers like radiation exposure must be treated as an issue of value judgment predicated on multifaceted considerations.

A Study on the Change of Space Configuration of Dentistry in Korea - Focused on the Analysis of School of Dentistry and Dental Hospital located in Seoul (한국 치의 공간구성의 변화에 관한 연구 - 서울시 소재 치과대학/치의학대학원과 치과병원 분석을 중심으로)

  • Jeong, Taejong;Choi, Jaepil
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.23 no.1
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    • pp.25-36
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    • 2017
  • Purpose: The analysis of space configuration of dentistry through examining Korean dental history and comparison are necessary for the development of planning of the dental healthcare system. This study has been started in order to provide basic information for the planning of hospital architecture in dentistry. Methods: Literature review of space configuration and historical background in dentistry have been conducted. The changes of site plan and space configuration of Seoul National University, Yonsei University and Kyunghee University, School of Dentistry and Dental Hospital have been analyzed in dental history of Korea and corresponding spaces. Results: The result of this study can be summarized in three points. The first one is that space configuration of dentistry in Korea is different from that of West. The clinical treatment space had been started first and the education and research space was followed after a short interval. The second one is that the space configuration in School of Dentistry and Dental Hospital shows that dental space had differentiated and specialized to dental education and clinical space in a building. It had spatially divided and separated to the education and research complex and the dental hospital and it had a branch building. The third one is that the dental public health in Korea has not been actively applied until recently and it should be developed in a near future. Implications: It is necessary to analyze space configuration of other dental schools and their hospitals to develop the relationship between space and program in healthcare system.

Congenital Aortic Valvular Insufficiency Caused by Abnormal Valvular Structures in a Labrador Retriever Dog (래브라도 리트리버종 개의 비정상 판막 구조에 의한 선천성 대동맥 판막 부전)

  • Moon, Hyeong-Sun;Lee, Seung-Gon;Lee, Sang-Eun;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.233-237
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    • 2007
  • A 10-month-old intact male Labrador Retriever dog was referred with the primary complaint of exercise intolerance, especially after vigorous exercise. Physical examination revealed split S1 and grade III/VI diastolic regurgitant murmur at the left apex and base, respectively. ECG finding was normal sinus rhythm at rest, but supraventricular tachycardia with bundle branch blocks after exercise. Thoracic radiography revealed dilated ascending aorta with normal range of cardiac silhouette (VHS 10.2). Echocardiography revealed abnormal valvular structures just above the aortic valvular cusps causing aortic regurgitation with a reduction of left ventricular ejection fraction (LVEF). Based on those findings, the case was diagnosed as congenital aortic regurgitation caused by abnormal valvular structures. The dog was managed with diltiazem and exercise restriction. This is a rare case of aortic deformity in dogs.

Inhibitory Effects of Iranian Thymus vulgaris Extracts on in Vitro Growth of Entamoeba histolytica

  • Behnia, Maryam;Haghighi, Ali;Komeylizadeh, Hossein;Tabaei, Seyyed-Javad Seyyed;Abadi, Alireza
    • Parasites, Hosts and Diseases
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    • v.46 no.3
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    • pp.153-156
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    • 2008
  • One of the most common drugs used against a wide variety of anaerobic protozoan parasites is metronidazole. However, this drug is mutagenic for bacteria and is a potent carcinogen for rodents. Thymus vulgaris is used for cough suppression and relief of dyspepsia. Also it has antibacterial and antifungal properties. The aim of this study was to investigate antiamebic effect of Thymus vulgaris against Entamoeba histolytica in comparison with metronidazole. One hundred gram air-dried T. vulgaris plant was obtained and macerated at $25^{\circ}C$ for 14 days using n-hexane and a mixture of ethanol and water. For essential oil isolation T. vulgaris was subjected to hydrodistillation using a clevenger-type apparatus for 3 hr. E. histolytica, HM-1: IMSS strain was used in all experiments. It was found that the minimal inhibitory concentration (MIC) for T. vulgaris hydroalcoholic, hexanic extracts, and the essential oil after 24 hr was 4 mg/mL, 4 mg/mL, and 0.7 mg/mL, respectively. After 48 hr the MIC for T. vulgaris hydroalcoholic and hexanic extracts was 3 and 3 mg/mL, respectively. Therefore, it can be concluded that the Iranian T. vulgaris is effective against the trophozoites of E. histolytica.