• Title/Summary/Keyword: bridging therapy

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Bioequivalence Test of Gabapentin 800 mg Tablets (가바펜틴 800밀리그람 정제의 생물학적동등성시험)

  • Kim, Se-Mi;Shin, Sae-Byeok;Kang, Hyun-Ah;Cho, Hea-Young;Lee, Yong-Bok
    • YAKHAK HOEJI
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    • v.52 no.4
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    • pp.299-305
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    • 2008
  • Gabapentin, 1-(aminomethyl) cyclohexaneacetic acid, is a amino acid derivative, and is clinically effective in the treatment of neuropathic pain and partial seizures of epilepsy as a complementary therapy. The purpose of the present study was to evaluate the bioequivalence of two gabapentin tablets, $Neurontin^{R}$ tablet 800 mg (Pfizer Pharmaceuticals Co., Ltd.) and Gabapenin tablet 800 mg (Hanmi Pharm. Co., Ltd.), according to the guidelines of the Korea Food and Drug Administration (KFDA). The release of gabapentin from the two gabapentin formulations in vitro was tested using KP VIII Apparatus II method with 0.06 M HCI dissolution media. Twenty six healthy male subjects, $23.85{\pm}2.24$ years in age and $69.40{\pm}11.11$ kg in body weight, were divided into two groups and a randomized $2{\times}2$ crossover study was employed. After a single tablet containing 800 mg as gabapentin was orally administered, blood samples were taken at predetermined time intervals and the concentrations of gabapentin in serum were determined using HPLC with fluorescence detector. The dissolution profiles of two formulations were similar in the tested dissolution media. The pharmacokinetic parameters such as $AUC_{t}$, $C_{max}$ and $T_{max}$ were calculated, and ANOVA test was utilized for the statistical analysis of the parameters using logarithmically transformed $AUC_{t}$, $C_{max}$ and untransformed $T_{max}$. The results showed that the differences between two formulations based on the reference drug, $Neurontin^{R}$, were 1.28%, 0.63% and 0.62% for $AUC_{t}$, $C_{max}$ and $T_{max}$, respectively. There were no sequence effects between two formulations in these parameters. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of log 0.8 to log 1.25 (e.g., $log0.9097{\sim}log1.1598$ and $log0.8919{\sim}log1.1262$ for $AUC_{t}$ and $C_{max}$, respectively). Thus, the criteria of the KFDA bioequivalence guideline were satisfied, indicating Gabapenin tablet 800 mg was bioequivalent to $Neurontin^{R}$ tablet 800 mg.

The Effects of Bridge Exercise with Contraction of Hip Adductor Muscles on Thickness of Abdominal Muscles (고관절 내전근 수축을 이용한 교각운동이 복부근육의 두께에 미치는 영향)

  • Lee, Geon-Cheol;Bae, Won-Sik;Kim, Chi-Hyok
    • Journal of the Korean Society of Physical Medicine
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    • v.9 no.2
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    • pp.233-242
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    • 2014
  • PURPOSE: The purpose of this study was to determine the correlation between the hip adductor muscles and abdominal muscles during bridge exercise. METHOD: Participants who met the criteria for this study(n=36) were divided into the three groups. The first experimental group performed normal bridge exercises and the second group performed bridge exercises with the contraction of the hip adductor muscles and the control group didn't perform any exercise. Transversus abdominis muscle thickness was measured by ultrasound imaging with a special transducer head device, at pre exercise, after 2 weeks, 4 weeks, and 6 weeks. RESULT: Data were analyzed using repeated ANOVA with the level of significance set at ${\alpha}=.05$. Transversus abdominis muscle thickness was influenced by contraction of the hip adductor muscles during bridge exercise in people without lower back pain. Compared with normal bridge exercise, transversus abdominis muscle thickness significantly increased in thickness during bridge exercise with contraction of the hip adductor muscles(p<.05). CONCLUSION: The results from this study showed that contraction of the hip adductor muscles during bridge exercise increased change in the transversus abdominis muscle thickness. These results can be a good source to prevent low back pain due to hip adductor weakness. Therefore, inducing activation of hip adductor with abdominal stabilizing exercise is more effective in patients with low back pain.

Clinical Importance of the Smear layer

  • Cho, Yong-Bum
    • Proceedings of the KACD Conference
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    • 2002.11a
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    • pp.720-720
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    • 2002
  • A number of investigations have shown that the presence of bacteria is prerequisite for developing pulpal and/or periradicular pathosis. Depending on the stage of pulpal pathosis, various species of bacteria can be cultured from infected root canals. Kakehashi et al. showed that exposure of pulpal tissue in germ-free rats was characterized by minimal inflammation and dentinal bridging while exposure of pulpal tissue in conventional rats with normal oral flora was characterized by pulpal necrosis, chronic inflammation, and periapical lesions. Currently used methods of cleaning and shaping, especially rotary instrumentation techniques, produce a smear layer that covers root canal walls and the openings to the dentinal tubules. The smear layer contains inorganic and organic substances that include fragments of odontoblastic processes, microorganisms, their by products and necrotic materials. Because of its potential contamination and adverse effect on the outcome of root canal therapy, it seems reasonable to suggest removal of the smear layer for disinfection of the entire root canal system. Presence of this smear layer prevents penetration of intracanal medications into the irregularities of the root canal system and the dentinal tubules and also prevents complete adaptation of obturation materials to the prepared root canal surfaces. Removal of the smear layer by an intracanal irrigant and placement of an antibacterial agent in direct contact with the content of dentinal tubules should allow disinfection of this complex system and better outcome for the root canal therapy. A new solution, which was a mixture of a tetracycline, an acid, and a detergent(MTAD), was developed in the Department of Endodontics, Dental School. Lorna Linda University, USA. It has been demonstrated that MTAD was an effective solution for the removal of the smear layer and does not significantly change the structure of the dentinal tubules when used as a final irrigant in conjunction with 1 % NaOCl as a root canal irrigant. Studies are in progress to compare the anti- microbial properties of this newly developed solution with those of sodium hypochlorite and EDTA that are currently used to irrigate the root canals and remove the smear layer from the surfaces of instrumented root canals.canals.

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Effects of the Symmetry of Muscle Activity by Application of Visual Feedback using Tension Sensor and Inclinometer during Bridge Exercise with Sling (슬링을 이용한 교각운동 시 장력센서와 경사계를 이용한 시각적 피드백이 근활성도에 미치는 영향)

  • Kwon, Yu-Jeong;Song, Min-Young
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.1
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    • pp.133-140
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    • 2021
  • Purpose: This study aimed to compare the relative muscle activity on the erector spinae, gluteus maximus, and hamstring, using a non-visual feedback bridge exercise and a visual feedback bridge exercise with a tension sensor and clinometer. Methods: Twenty-two healthy subjects participated in this study. The study subjects performed bridge exercises without visual feedback, bridge exercises using a tension sensor, and bridge exercises using an inclinometer in the supine position, and the muscle activity of the left and right erector spinae, gluteus maximus, and hamstring muscles was measured while maintaining isometric contraction during the bridge movement. Muscle activity was measured by using surface an electromyography equipment. To standardize the measured action potential of each muscle, the maximum voluntary isometric contraction was measured. The bridge exercise was repeated 3 times for 5s each. Using repeated analysis of variance, we compared the significant difference in EMG activity for each muscle between the three experiments, and all statistical processing was performed using SPSS version 26. The statistical significance level was set at α = 0.05. Results: During bridging exercises, the asymmetry of the muscle activity of the erector spinae and gluteus maximus during visual feedback guiding was lower than that during no visual feedback. However, there was no significant difference. Moreover, the asymmetry of the muscle activity of the hamstring muscles was significantly lower during tension sensor visual feedback than that during no visual feedback (p<0.05). Conclusion: These findings suggest that bridge exercise with visual feedback using a tension sensor and an inclinometer is effective in inducing symmetrical movement. When it is necessary to symmetrically adjust the weight load of both feet during the bridge exercise, it is effective to apply visual feedback using a tension sensor.

Effectiveness of High-Volume Therapeutic Plasma Exchange for Acute and Acute-on-Chronic Liver Failure in Korean Pediatric Patients

  • Lim, Hyeji;Kang, Yunkoo;Park, Sowon;Koh, Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.6
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    • pp.481-488
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    • 2022
  • Purpose: Liver transplantation (LT) is the only curative treatment for acute liver failure (ALF) and acute-on-chronic liver failure (ACLF). In high-volume therapeutic plasma exchange (HV-TPE), extracorporeal liver support filters accumulate toxins and improve the coagulation factor by replacing them. In this study, we aimed to evaluate the effectiveness of HV-TPE in pediatric patients with ALF and ACLF. Methods: We reviewed the records of children waiting for LT at Severance Hospital who underwent HV-TPE between 2017 and 2021. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), total and direct bilirubin (TB and DB), gamma-glutamyl transferase (GGT), ammonia, and coagulation parameter-international normalized ratio (INR) were all measured before and after HV-TPE to analyze the liver function. The statistical analysis was performed using IBM SPSS Statistics for Windows, version 26.0 (IBM Co., Armonk, NY, USA). Results: Nine patients underwent HV-TPE with standard medical therapy while waiting for LT. One had neonatal hemochromatosis, four had biliary atresia, and the other four had ALF of unknown etiology. Significant decreases in AST, ALT, TB, DB, GGT, and INR were noted after performing HV-TPE (930.38-331.75 IU/L, 282.62-63.00 IU/L, 11.75-5.59 mg/dL, 8.10-3.66 mg/dL, 205.62-51.75 IU/L, and 3.57-1.50, respectively, p<0.05). All patients underwent LT, and two expired due to acute complications. Conclusion: HV-TPE could remove accumulated toxins and improve coagulation. Therefore, we conclude that HV-TPE can be regarded as a representative bridging therapy before LT.

The Effect of Bridging Exercise on Dysmenorrhea Back Pain of Women University Students (교각운동이 월경곤란증으로 인한 허리통증을 가진 여대생에게 미치는 영향)

  • Jeong, Yeonwoo;Hong, Sanghyeon;Lee, Seunghyub
    • Journal of The Korean Society of Integrative Medicine
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    • v.4 no.4
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    • pp.1-6
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    • 2016
  • Purpose : This study determines the effect and sustainability of the trunk stability exercise program, specifically using the bridge exercise, by measuring Visual Analogue Scale(VAS), Menstrual Distress Questionaire(MDQ) and muscle strength in women university students complaining of low back pain. Methods : The trunk stability exercise program was progressed by 22 women university students, for 4 weeks, (3 times a week, 1 hour per session). At this time, low back pain happened at the period of menstruation and was measured using VAS, Dysmenorrhea using the MDQ tool and abdominal and back muscle strength using HUR. This study was evaluated 4 times (before and after the exercise program, after 4 weeks and 8 weeks) to investigate the effect of time variation after the exercise program. Results : The trends showed a decrease in VAS and MDQ and an increase in abdominal and back muscle strength. Therefore, these results were evaluated positively from a statistical perspective(p<.05). Conclusions : The trunk stability exercise results in a decreased VAS and MDQ, and increases the muscle strength in women university students who complained of low back pain form dysmenorrhea. Therefore, the low back pain from dysmenorrhea could have been avoided and quality of everyday life improved.

The Effect of Closed-Chain Exercise on Weight Supporting Rate and Balance Ability in Stroke Patients (닫힌-사슬 운동이 뇌졸중 환자의 체중지지율과 균형능력에 미치는 영향)

  • Kim, Hee-Gwon
    • PNF and Movement
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    • v.9 no.1
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    • pp.1-9
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    • 2011
  • Purpose : The purpose of this study is to analyze the effect of closed-chain exercise on weight supporting rate change within hemiplegic side and static dynamic balance ability in stroke patients. Methods : The subjects of the study were 13 hemiplegic patients who carried out closed-kinematic chain exercise program over 6 weeks. The exercises of the program are stand to sit with stall bar, stair-up & down by a hemiplegic leg and bridging exercise crossing the non-hemiplegic leg onto the hemiplegic leg. Each exercise was carried out over 3 sets of 10reps. Results : The results of this study were summarized as follows: 1. After intervention, there was a statistically significant change in the weight supporting rate within hemiplegic and non-hemiplegic side(P<0.05). 2. After intervention, there was a statistically significant change in the static balance(FICSIT-4) ability(P<0.05). 3. After intervention, there was a statistically significant change in the dynamic balance(FSST, TUG, FRT) ability(P<0.05). Conclusion : The results of the study suggests that closed-chain exercise program in stroke patients improves their weight supporting rate and enhance the static dynamic balance.

The Effect of Therapeutic Exercise Program on Static·Dynamic Balance Performance in Hemiplegic Patients (치료적 운동프로그램이 편마비 환자의 정적·동적 균형 수행력에 미치는 영향)

  • Kim, Hee-Gwon
    • PNF and Movement
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    • v.9 no.4
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    • pp.13-21
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    • 2011
  • Purpose : The purpose of this study was to analyze the effect of closed kinematic chain exercise and proprioceptive neuromuscular facilitation exercise on the static dynamic balance performance of hemiplegic patients in order to suggest them therapeutic intervention methods. Methods : The subjects of this study were 18 hemiplegic patients grouped into 2 subgroups according to the exercise program. one group of closed kinematic chain exercise carried out sit to stand, Hooklying with pelvic lift(bridging) and stair-up & down by a hemiplegic leg. The other group of proprioceptive neuromuscular facilitation exercise carried out leg flexion-extension pattern in supine position, leg flexion pattern in standing and stabilizing reversal exercise in stating position. Each exercise was carried out over 3 sets of 10reps. Results : The results of this study were summarized as follows: 1. For both groups, there were statistically significant changes in the static balance (FICSIT-4) performance after exercise program (p<.05). 2. For both groups, there were statistically significant changes in the dynamic balance (FSST, TUG, FRT) performance after exercise program (p<.05). 3. In the comparison between both groups, there was no statistically significant difference in the static dynamic balance performance (FICSIT-4, FSST, TUGT, ER) after exercise program. Conclusion : As the results of the study shows closed kinematic chain exercise and proprioceptive neuromuscular facilitation exercise affect the improvement of hemiplegic patients'' static dynamic balance performance, it is supposed that these exercises could be therapeutic exercise program in clinical situations.

Complex open elbow fracture-dislocation with severe proximal ulna bone loss: a case report of massive osteochondral allograft surgical treatment

  • Concina, Chiara;Crucil, Marina;Theodorakis, Emmanouil;Saggin, Giorgio;Perin, Silvia;Gherlinzoni, Franco
    • Clinics in Shoulder and Elbow
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    • v.24 no.3
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    • pp.183-188
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    • 2021
  • We report a case of a 69-year-old right-dominant man who had an open Monteggia-like lesion of the right elbow (Gustilo-Andersen IIIA) with severe proximal ulna bone loss associated with an ipsilateral ulnar shaft fracture due to a motorcycle accident. The patient underwent two-stage surgery. Wound debridement and bridging external fixation were performed at first. Three months later, a frozen massive osteochondral ulnar allograft was implanted and fixed with a locking compression plate. A superficial wound infection appeared 5 weeks after the second surgery. Superficial wound debridement, negative pressure therapy, and antibiotics were administered for 3 months, achieving infection healing. At 3 years post-surgery, the elbow range of motion was satisfactory with a Disabilities of the Arm, Shoulder and Hand (DASH) score of 16.7. Radiographs and computed tomography scans showed good allograft-bone integration without allograft reabsorption or hardware loosening. Although not complication-free, massive ulna osteochondral allograft implantation can be considered a valid option in cases of open Monteggia-like lesions associated with ulnar shaft fracture and severe bone loss in active patients, whenever osteosynthesis or joint replacement is not a proper solution. This type of bone stock restoration allows for future surgery, if needed.

Endoscopic ultrasound-guided intervention for inaccessible papilla in advanced malignant hilar biliary obstruction

  • Partha Pal;Sundeep Lakhtakia
    • Clinical Endoscopy
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    • v.56 no.2
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    • pp.143-154
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    • 2023
  • Advanced malignant hilar biliary obstruction (MHBO) with inaccessible papilla poses a significant challenge to endoscopists, as drainage of multiple liver segments may be warranted. Transpapillary drainage may not be feasible in patients with surgically altered anatomy, duodenal stenosis, prior duodenal self-expanding metal stent, and after initial transpapillary drainage, but require re-intervention for draining separated liver segments. Endoscopic ultrasound-guided biliary drainage (EUS-BD) and percutaneous trans-hepatic biliary drainage are the feasible options in this scenario. The major advantages of EUS-BD over percutaneous trans-hepatic biliary drainage include a reduction in patient discomfort and internal drainage away from the tumor, thus reducing the possibility of tissue or tumor ingrowth. With innovations, EUS-BD is helpful not only for bilateral communicating MHBO but also for non-communicating systems with bridging hilar stents or isolated right intra-hepatic duct drainage by hepatico-duodenostomy. EUS-guided multi-stent drainage with specially designed cannulas and guidewires has become a reality. A combined approach with endoscopic retrograde cholangiopancreatography for re-intervention, interventional radiology, and intraductal tumor ablative therapies has been reported. Stent migration and bile leakage can be minimized with proper stent selection and technique, and stent blocks can be managed with EUS-guided interventions in a majority of cases. Future comparative studies are required to establish the role of EUS-guided interventions in MHBO as rescue or primary therapy.