• Title/Summary/Keyword: internal medicine

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A comparative study of quality of life of patients with maxillofacial fracture and healthy controls at two tertiary healthcare institutions

  • Somoye, Mayowa Solomon;Adetayo, Adekunle Moses;Adeyemo, Wasiu Lanre;Ladeinde, Akinola Ladipo;Gbotolorun, Micah Olalekan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.5
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    • pp.351-359
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    • 2021
  • Objectives: Despite treatment, the pre-traumatic facial appearance of patients with maxillofacial fractures might not be able to be restored, and this difference can affect the person's quality of life (QoL). This study was designed to evaluate changes in QoL of people with maxillofacial fractures. Materials and Methods: The study population was comprised of participants with maxillofacial fracture and age- and sex-matched healthy controls without history of such fracture. QoL was measured using the World Health Organization Quality of Life BREF (WHOQOL-BREF) questionnaire, which was administered to the patients before treatment (Time 1), at 6 weeks post-treatment (Time 2), and at 12 weeks postoperatively (Time 3). The values were compared with those of healthy controls. The QoL was compared between closed reduction group and open reduction and internal fixation group. Results: The QoL scores of people with maxillofacial fracture before treatment were significantly lower (P=0.001) than those of healthy controls in all domains of the WHOQOL-BREF. The QoL scores in the psychological and social domains of patients with maxillofacial fracture at Time 3 were still lower than those of healthy controls (P=0.001). Conclusion: The QoL of patients with maxillofacial fracture was significantly reduced before treatment in all domains and remained reduced in both psychological and social domains weeks after treatment. Therefore, clinicians must be aware of and manage the residual psychosocial issues that can accompany the post-treatment period of maxillofacial injury.

ABT-737 ameliorates docetaxel resistance in triple negative breast cancer cell line

  • Hwang, Eunjoo;Hwang, Seong-Hye;Kim, Jongjin;Park, Jin Hyun;Oh, Sohee;Kim, Young A;Hwang, Ki-Tae
    • Annals of Surgical Treatment and Research
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    • v.95 no.5
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    • pp.240-248
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    • 2018
  • Purpose: This study aimed to validate the synergistic effect of ABT-737 on docetaxel using MDA-MB-231, a triple negative breast cancer (TNBC) cell line overexpressing B-cell lymphoma-2 (Bcl-2). Methods: Western blot analysis was performed to assess expression levels of Bcl-2 family proteins and caspase-related molecules. Cell viability was assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Cell cycle distribution was determined by flow cytometry analysis. Benzyloxycarbonyl-Val-Ala-Asp(OMe)-fluoromethylketone (z-VAD-fmk) was used for pretreatment to assess the role of caspases. Results: Cell viability of MDA-MB-231 after combination treatment with ABT-737 and docetaxel was significantly lower than that after docetaxel or ABT-737 monotherapy based on MTT assay (both P < 0.001), with a combination index of 0.41. The proportion of sub-G1 population after combination treatment was significantly higher than that after docetaxel or ABT-737 monotherapy (P = 0.001, P = 0.003, respectively). Pretreatment with z-VAD-fmk completely restored cell viability of MDA-MB-231 from apoptotic cell death induced by combination therapy (P = 0.001). Although pro-caspase-8 or Bid did not show significant change in expression level, pro-casepase-9 showed significantly decreased expression after combination treatment. Cleaved caspase-3 showed increased expression while poly (ADP-ribose) polymerase cleavage was induced after combination treatment. However, hypoxia-inducible factor 1-alpha and aldehyde dehydrogenase 1 totally lost their expression after combination treatment. Conclusion: Combination of ABT-737 with docetaxel elicits synergistic therapeutic effect on MDA-MB-231, a TNBC cell line overexpressing Bcl-2, mainly by activating the intrinsic pathway of apoptosis. Therefore, adjunct of ABT-737 to docetaxel might be a new therapeutic option to overcome docetaxel resistance of TNBCs overexpressing Bcl-2.

The Changing Epidemiology of Gastroesophageal Reflux Disease: Are Patients Getting Younger?

  • Yamasaki, Takahisa;Hemond, Colin;Eisa, Mohamed;Ganocy, Stephen;Fass, Ronnie
    • Journal of Neurogastroenterology and Motility
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    • v.24 no.4
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    • pp.559-569
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    • 2018
  • Background/Aims Gastroesophageal reflux disease (GERD) is a common disease globally with increasing prevalence and consequently greater burden on the Healthcare system. Traditionally, GERD has been considered a disease of middle-aged and older people. Since risk factors for GERD affect a growing number of the adult population, concerns have been raised that increasingly younger people may develop GERD. We aim to determine if the proportion of younger patients has increased among the GERD population. Methods The incidence of GERD as well as several variables were evaluated during an 11-year period. Explorys was used to evaluate datasets at a "Universal" and Healthcare system in northern Ohio to determine if trends at a local level reflected those at a universal level. GERD patients were classified into 7 age groups (15-19, 20-29, 30-39, 40-49, 50-59, 60-69, and ${\geq}70$ years). Results The proportion of patients with GERD increased in all age groups, except for those who were ${\geq}70$ years in the universal dataset (P < 0.001) and those who were ${\geq}60$ years in the Healthcare system (P < 0.001). The greatest rise was seen in 30-39 years in both datasets (P < 0.001). Similarly, the proportion of GERD patients who were using proton pump inhibitors increased in all age groups except for those who were ${\geq}70$ years in both datasets (P < 0.001), with the greatest increase being the group 30-39 years (P < 0.001). Conclusion Over the last decade, there has been a significant increase in the proportion of younger patients with GERD, especially those within the age range of 30-39 years.

Calculation of Effective Half-life of Gamma Emission Radionuclide using Bio-kinetic Model (생체역동학 모델을 이용한 감마선 방출 핵종의 유효반감기 계산)

  • Lee, Sang-Kyung;Jeong, Kyu-Hwan;Lee, Ji-Yon;Kim, Bong-Gi;Kim, Jung-Min
    • Journal of Radiation Industry
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    • v.12 no.4
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    • pp.277-285
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    • 2018
  • Patients administered radioisotope for medical purposes are regulated by each country to quarantine them until their body's radioactivity contents decrease below release criteria. To predict the quarantine period and provide it to medical staffs and patients, it is necessary to approach the assessment of the exposure dose of persons due to patients in a realistic manner. For this purpose, a whole-body effective half-life should be applied to the dose assessment equation instead of the physical half-life. In this study, we constructed a bio-kinetic model for each nuclear species based on the ICRP publication to obtain a whole-body effective half-life of 10 unsealed gamma-ray emitting nuclei from the notification of Nuclear Safety and Security Commission, and calculated the effective half-life mathematically by simulating the distribution of the radioisotope administered in the whole body as well as each organ scale. The whole-body effective half-life of $^{198}Au$, $^{67}Ga$, $^{123}I$, $^{111}In$, $^{186}Re$, $^{99m}Tc$, and $^{201}TI$ were 1,93, 2.57, 0.295, 2.805, 1.561, 0.245, and 2.397 days respectively. However, it was found to be undesirable to offer a single value of the effective half-life of $^{125}I$, $^{131}I$, and $^{169}Yb$ because the changes in the effective half-life show no linearity. A bio-kinetic model created for the internal exposure assessment has been shown to be possible to calculate the effective half-life of radioisotopes administered in the patient's body, but subsequent studies of radiolabeled compounds are required as well.

Conceptual Understanding of Thought-Action Fusion and Cognitive Fusion : Focus on Obsessive-Compulsive Symptoms (사고-행동 융합과 인지적 융합의 개념적 이해 : 강박증을 중심으로)

  • Lee, Sang Won;Lee, Kyung-Uk;Choi, Mina;Lee, Seung Jae
    • Anxiety and mood
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    • v.15 no.1
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    • pp.1-12
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    • 2019
  • Thought-action fusion (TAF) is a tendency to blindly assume causal relations between their thoughts and external reality. On the other hand, cognitive fusion (CF) is a tendency to take internal experiences, such as thoughts and feeling, literally rather than view them as random events. However, these two terms are often confusedly used and, in fact, have conceptual overlaps. Therefore, this study aimed to identify their distinctive features through a comprehensive review of the definition, origin, measurements and clinical implications especially on the understanding of obsessive-compulsive symptoms. The cognitive-behavioral concept of TAF is confined to erroneous and maladaptive beliefs about the connection between thoughts and behaviors. The CF is a broader construct that entails taking thoughts and feelings as facts and engaging or struggling with them such that the quality of life is lowered. They also have different theoretical backgrounds, developing processes and therapeutic approaches. From the perspective of the obsessive-compulsive disorder, both concepts have been studied as mid-structures for this illness. Recently, the effectiveness of psychological therapies related to these concepts such as defusion therapy has been tested. However, it is yet still in its infancy. In the future, complementary advances between the two concepts with studies on biological substrates is needed.

Long-term stability after multidisciplinary treatment involving maxillary distraction osteogenesis, and sagittal split ramus osteotomy for unilateral cleft lip and palate with severe occlusal collapse and gingival recession: A case report

  • Kokai, Satoshi;Fukuyama, Eiji;Omura, Susumu;Kimizuka, Sachiko;Yonemitsu, Ikuo;Fujita, Koichi;Ono, Takashi
    • The korean journal of orthodontics
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    • v.49 no.1
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    • pp.59-69
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    • 2019
  • In this report, we describe a case involving a 34-year-old woman who showed good treatment outcomes with long-term stability after multidisciplinary treatment for unilateral cleft lip and palate (CLP), maxillary hypoplasia, severe maxillary arch constriction, severe occlusal collapse, and gingival recession. A comprehensive treatment approach was developed with maximum consideration of strong scar constriction and gingival recession; it included minimum maxillary arch expansion, maxillary advancement by distraction osteogenesis using an internal distraction device, and mandibular setback using sagittal split ramus osteotomy. Her post-treatment records demonstrated a balanced facial profile and occlusion with improved facial symmetry. The patient's profile was dramatically improved, with reduced upper lip retrusion and lower lip protrusion as a result of the maxillary advancement and mandibular setback, respectively. Although gingival recession showed a slight increase, tooth mobility was within the normal physiological range. No tooth hyperesthesia was observed after treatment. There was negligible osseous relapse, and the occlusion remained stable after 5 years of post-treatment retention. Our findings suggest that such multidisciplinary approaches for the treatment of CLP with gingival recession and occlusal collapse help in improving occlusion and facial esthetics without the need for prostheses such as dental implants or bridges; in addition, the results show long-term post-treatment stability.

A Study on the Acoustic Analysis Method of the External Ear Canal Using DICOM Images (DICOM 영상을 이용한 외이도 음향해석 방법에 관한 연구)

  • Kim, Hyeong-Gyun
    • Journal of the Korea Convergence Society
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    • v.10 no.3
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    • pp.73-79
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    • 2019
  • This study simulated external ear canal modeling with different external ear canal lengths, vertical flexion angles, and inner/outer diameter ratios using digital imaging and communications in medicine(DICOM) of the head temporal region and measured the acoustic sensitivity. The experiment was performed by increasing the audible frequency for humans by 200 Hz and expressing the frequency constantly transmitted at 1 Pa as the eardrum acoustic volume and presented the measurements by linear and quadratic curve regression analysis. The results showed that the longer the external ear canal length and the higher the ratio of the outer/inner diameter, the faster the acoustic response at lower frequencies. The acoustic sensitivity correlation of the meta-model using regression analysis showed a 77% influence by the external ear canal length and 5% by the external/internal diameter ratio, while the vertical flexion angle did not show a significant relationship. This showed that auditory acoustic sensitivity of humans is a factor that reacts faster at a low frequency when the external ear canal length is longer and when the difference between the outer and inner diameter is higher.

Development and validation of LC-MS/MS for bioanalysis of hydroxychloroquine in human whole blood

  • Park, Jung Youl;Song, Hyun Ho;Kwon, Young Ee;Kim, Seo Jin;Jang, Sukil;Joo, Seong Soo
    • Journal of Biomedical and Translational Research
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    • v.19 no.4
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    • pp.130-139
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    • 2018
  • This study aimed to analyze a high-performance liquid chromatography (HPLC) separation using a pentafluorophenyl column of parent drug hydroxychloroquine (HCQ) and its active metabolite, desethylhydroxchloroquine (DHCQ) applying to determine bioequivalence of two different formulations administered to patients. A rapid, simple, sensitive and specific liquid chromatography-tandem mass spectrometry (LC-MS/MS) method has been developed and validated for bioanalysis of HCQ and its metabolite DHCQ in human whole blood using deuterium derivative $hydroxychloroquine-D_4$ as an internal standard (IS). A triple-quadrupole mass spectrometer was operated using electrospray ionization in multiple reaction monitoring (MRM) mode. Sample preparation involves a two-step precipitation of protein techniques. The removed protein blood samples were chromatographed on a pentafluorophenyl (PFP) column ($50mm{\times}4.6mm$, $2.6{\mu}m$) with a mobile phase (ammonium formate solution containing dilute formic acid) in an isocratic mode at a flow rate of 0.45 mL/min. The standard curves were found to be linear in the range of 2 - 500 ng/mL for HCQ; 2 - 2,000 ng/mL for DHCQ in spite of lacking a highly sensitive MS spectrometry system. Results of intra- and inter-day precision and accuracy were within acceptable limits. A run time of 2.2 min for HCQ and 2.03 min for DHCQ in blood sample facilitated the analysis of more than 300 human whole blood samples per day. Taken together, we concluded that the assay developed herein represents a highly qualified technology for the quantification of HCQ in human whole blood for a parallel design bioequivalence study in a healthy male.

Effects of Anti-ecotoxicological Curcumin Nanospheres on Feed Efficiency and Fecal Odor in Mice (환경 독성 억제효과를 가진 커큐민 나노스피어가 마우스의 사료 효율 및 악취저감에 미치는 영향)

  • Park, Jeong-Bae;Lee, Young-Min;Park, Moon-Ki;Min, Taesun;Lee, Sei-Jung
    • Journal of Environmental Science International
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    • v.28 no.2
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    • pp.183-189
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    • 2019
  • Curcumin ($C_{21}H_{20}O_6$) is a hydrophobic polyphenol found in turmeric. Although curcumin has been used as a natural medicine, its major limitation is related to poor absorption from the gut. Therefore, we developed a method for preparation of Curcumin Nanospheres (CN) to improve the aqueous-phase solubility of curcumin and investigate the functional role of CN in promoting feed efficiency and odor reduction in mice. CN showed inhibitory effects on actate dehydrogenase (LDH) cytotoxicity induced by ecotoxic substance toluene in gut epithelial HCT116 cells. In addition, the weights of internal organs (liver, heart, kidneys, and spleen) and the levels of serum Glutamate Oxaloacetate Transaminase (GOT), Glutamate Pyruvate Transaminase (GPT), and LDH did not show significant differences between mice administered oral CN for two weeks and compared to the control group. Interestingly, CN not only reduced hydrogen sulfide ($H_2S$) and ammonia ($NH_3$) levels and fecal odor, but also improved feed efficiency in mice. These results demonstrate that oral nano-delivery of anti-ecotoxicological CN is a functional system to deliver curcumin to the gut to improve feed efficiency and reduce fecal odor in mice.

Do We Have to Treat Helicobacter pylori for Elderly Patients to Prevent Gastric Cancer? (고령 환자에서 위암 발병 감소를 위해 헬리코박터 제균 치료를 해야 하는가?)

  • Park, Seon-Young
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.3
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    • pp.215-216
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    • 2018
  • 위암의 발병률이 감소하고 있기는 하지만 전 세계적으로 여전히 연 100만 명 이상이 새롭게 위암으로 진단되고 있으며, 앞으로 향후 몇십 년 동안은 인구의 고령화로 인하여 위암에 대한 사회적 경제적 부담이 줄어들지 않을 것으로 추측된다. 최근 메타분석에서 Helicobacter pylori 제균 치료가 위암발병을 33~47% 감소시킨다고 보고하였으나, 중국에서 시행된 무작위 대조 연구에서는 제균 치료가 위암의 전구 병변 감소에 도움이 되지 않았다고 보고하고 있어 위축성 위염이나 장상피화생을 동반한 경우 제균 치료가 위암 예방에 큰 도움이 되지 않을 수 있음을 제시하고 있다. 그렇다면 위축성 위염이 있는 경우가 많은 고령 환자에서는 과연 헬리코박터 제균 치료가 도움이 될 것인가? 저자들은 빅데이터 분석을 통해 헬리코박터 제균 치료가 위암 발병에 미치는 영향을 성별과 연령에 따라 분석하였다. 2003년부터 2012년까지 'Hospital Authority'에 등록된 clarithromycin 포함 3제 요법을 받은 환자들에서의 위암 발생률과 2003년부터 2013년까지 'Hong Kong Cancer Registry'에 등록된 성별과 연령이 일치된 대조군에서의 위암기대 발생률(expected incidence)을 비교하였다. 3제 요법을 받은 73,237명의 환자들을 확인하였을 때, 평균 7.6년의 추적기간 중 200명(0.27%)에서 위암이 발생하였다. 연령에 따라 40세 미만, 40~59세, 60세 이상의 그룹으로 나누어 각각 위암발생률을 대조군과 비교한 결과 60세 이상 환자군에서만 standardized incidence ratio (SIR)가 0.82로 감소하였다. 치료 성공여부에 따라 위암 발생률을 분석하였을 때, 제균 치료에 성공한 60세 이상 군에서 SIR이 0.78로 감소하였으나 재 치료를 받은 40~59세 군에서는 SIR이 2.43으로 증가하였다. 제균 치료시점이 위암 발생률에 미치는 영향으로는 제균 치료 후 10년 미만에서의 위암 발생률에는 큰 영향이 없었으나 10년 이상 경과한 경우 60세 이상 군과 40~59세 군에서의 위암 발병률이 대조군의 위암 예측 발병률보다 낮았다.