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Prediction of the human in vivo antiplatelet effect of S- and R-indobufen using population pharmacodynamic modeling and simulation based on in vitro platelet aggregation test

  • Noh, Yook-Hwan;Han, Sungpil;Choe, Sangmin;Jung, Jin-Ah;Jung, Jin-Ah;Hwang, Ae-Kyung;Lim, Hyeong-Seok
    • Translational and Clinical Pharmacology
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    • v.26 no.4
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    • pp.160-165
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    • 2018
  • Indobufen ($Ibustrin^{(R)}$), a reversible inhibitor of platelet aggregation, exists in two enantiomeric forms in 1:1 ratio. Here, we characterized the anti-platelet effect of S- and R-indobufen using response surface modeling using $NONMEM^{(R)}$ and predicted the therapeutic doses exerting the maximal efficacy of each enantioselective S- and R-indobufen formulation. S- and R-indobufen were added individually or together to 24 plasma samples from drug-naïve healthy subjects, generating 892 samples containing randomly selected concentrations of the drugs of 0-128 mg/L. Collagen-induced platelet aggregation in platelet-rich plasma was determined using a Chrono-log Lumi-Aggregometer. Inhibitory sigmoid $I_{max}$ model adequately described the anti-platelet effect. The S-form was more potent, whereas the R-form showed less inter-individual variation. No significant interaction was observed between the two enantiomers. The anti-platelet effect of multiple treatments with 200 mg indobufen twice daily doses was predicted in the simulation study, and the effect of S- or R-indobufen alone at various doses was predicted to define optimal dosing regimen for each enantiomer. Simulation study predicted that 200 mg twice daily administration of S-indobufen alone will produce more treatment effect than S-and R-mixture formulation. S-indobufen produced treatment effect at lower concentration than R-indobufen. However, inter-individual variation of the pharmacodynamic response was smaller in R-indobufen. The present study suggests the optimal doses of R-and S-enantioselective indobufen formulations in terms of treatment efficacy for patients with thromboembolic problems. The proposed methodology in this study can be applied to the develop novel enantio-selective drugs more efficiently.

Comparison of Dosimetrical and Radiobiological Parameters on Three VMAT Techniques for Left-Sided Breast Cancer

  • Kang, Seong-Hee;Chung, Jin-Beom;Kim, Kyung-Hyeon;Kang, Sang-Won;Eom, Keun-Yong;Song, Changhoon;Kim, In-Ah;Kim, Jae-Sung
    • Progress in Medical Physics
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    • v.30 no.1
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    • pp.7-13
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    • 2019
  • Purpose: To compare the dosimetrical and radiobiological parameters among various volumetric modulated arc therapy (VMAT) techniques using restricted and continuous arc beams for left-sided breast cancer. Materials and Methods: Ten patients with left-sided breast cancer without regional nodes were retrospectively selected and prescribed the dose of 42.6 Gy in 16 fractions on the planning target volume (PTV). For each patient, three plans were generated using the $Eclipse^{TM}$ system (Varian Medical System, Palo Alto, CA) with one partial arc 1pVMAT, two partial arcs 2pVMAT, and two tangential arcs 2tVMAT. All plans were calculated through anisotropic analytic algorithm and photon optimizer with 6 MV photon beam of $VitalBEAM^{TM}$. The same dose objectives for each plan were used to achieve a fair comparison during optimization. Results: For PTV, dosimetrical parameters such as Homogeneity index, conformity index, and conformal number were superior in 2pVMAT than those in both techniques. $V_{95%}$, which indicates PTV coverage, was 91.86%, 96.60%, and 96.65% for 1pVMAT, 2pVMAT, and 2tVMAT, respectively. In most organs at risk (OARs), 2pVMAT significantly reduced the delivered doses compared with the other techniques, excluding the doses to contralateral lung. For the analysis of radiobiological parameters, a significant difference in normal tissue complication probability was observed in ipsilateral lung while no difference was observed in the other OARs. Conclusions: Our study showed that 2pVMAT had better plan quality and normal tissue sparing than 1pVMAT and 2tVMAT but not for all parameters. Therefore, 2pVMAT could be considered the priority choice for the treatment planning for left breast cancer.

Effect of Developmental Disorders of Maxillary First Molars on Orofacial Morphology (악안면 형태에 대한 상악 제1대구치 발육장애의 영향)

  • Park, Soyoung;Jeong, Taesung;Kim, Jiyeon;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.46 no.2
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    • pp.209-218
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    • 2019
  • This study was aimed to evaluate orofacial morphologies on the cases of developmental disorders of maxillary first molars. Panoramic radiographs, lateral cephalographs, and clinical photos of 2983 children who attended the Pediatric Dental Clinic of Pusan National University Dental Hospital from 2006 to August 2017 were assessed retrospectively. 34 patients were selected whose maxillary first molars were missed or developmentally delayed unilaterally or bilaterally. Demirjian's method was used for estimating dental age, then which was compared to chronologic age of children. Parameters expressing skeletal and dentoalveolar disharmony were checked and compared with control. Additionally, occlusion relationship was evaluated. Maxillary dental age was significantly delayed compared to chronologic age. Several parameters which show skeletal open-bite tendency and skeletal class III malocclusion with maxillary retrusion were statistically significant. Anterior crossbite and edge-bite were expected in most of these cases, but compensation by occlusion and soft tissue was also verified which might mask skeletal class III tendency. Congenital missed or developmentally delayed maxillary first molars might be related with declined growth of maxilla. If developmental disorders of maxillary first molars were verified during clinical examination, careful monitoring of orofacial growth was necessary during puberty and timed orthopedic and orthodontic intervention were considered.

A study on the selection of candidates for public bases according to the spatial distribution characteristics Automated External Defibrillator in Daegu City (대구시 자동심장충격기 공간분포 특성에 따른 공공 거점후보지 선정 연구)

  • Beak, Seong Ryul;Kim, Jun Hyun
    • Journal of the Korean Society of Surveying, Geodesy, Photogrammetry and Cartography
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    • v.38 no.6
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    • pp.599-610
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    • 2020
  • The AED (Automated External Defibrillator) is not evaluated for spatial accuracy and temporal availability even if it is located within a building or a specific area that needed necessary to partition by spatial analysis and location allocation analysis. As a result of the analysis, the spatial analysis was performed using the existing public data of AED with applied the GIS location analysis method. A public institution (119 safety center, police box) was selected as a candidate for a public AED base that can operate 24 hours a day, 365 days a year according to the characteristics of each residential area. In addition, Thiessen Polygons were created for each candidate site and divided by regions. In the analysis of the service was analyzed regional in terms of accessibility to emergency medical services in consideration of the characteristics of AED, that emergency vehicles could arrive within 4 minutes of the time required for emergency medical treatment in most areas of the study area, but it did not areas outside of the city center. As a result, It was found that the operation of the AED base service center centered on vehicles of public institutions is effective for responding to AED patients at night and weekend hours. 19 Safety Center under and police box the jurisdiction of Daegu City to establish an AED service center for public institutions, location-based distance, attribute analysis, and minimization of overlapping areas that the method of using a vehicle appeared more efficient than using the existing walking type AED.

An Analysis of the Trends of Aromatherapy Researches in Chinese Literatures

  • Sun, Jiao-Jing;Kim, Kyeong-Ran
    • Journal of the Korea Society of Computer and Information
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    • v.26 no.1
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    • pp.239-251
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    • 2021
  • Traditional Chinese medicine has treated diseases and improved health in nature-based experience. Advanced nations began to be interested in naturopathic therapy in the late 19th century and it led China to research aromatherapy. This study searched previous researches related with aromatherapy and generally analyzed aroma oil, applied body parts, methods of use, and period of use. For research contents, scientific and society journals from 2000 to 2019 related with aromatherapy were searched in CNKI(www.cnki.com) and WANFANG DATE(www.wanfang.com). Finally, 30 papers were selected through 5-step qualitative evaluation and expert review and analyzed. Frequency and percentage(%) were calculated by means of the Excel 2013 Program and represented by a chart. The results of analyzing aromatherapy trends are as follows. All 30 papers were researched in the medical society. The most common symptom was irritation and anxiety that appeared in 13 papers. Lavender oil and bergamot oil were commonly used aroma oil. Commonly applied part and method were nose and nasal inhalation. For aroma oil associated with symptoms, lavender oil was the best in irritative, anxious, and negative emotion, depression, labor pain, sleep disorder, migraine, tension, and vomiting, pain, and fatigue after operation. Lemon, ginger, and peppermint oil was good for nausea. Based on the findings, this study derived applied body parts, methods of use, and period of use in aromatherapy. However, most aromatherapy was used for patients in the nursing and medical fields in the simple form of inhalation and local massage. This study will suggest a standard ground that aromatherapy is good for pain, colic pain, and tension in a short period but needs a long period for the efficacy of psychological and neurological symptoms.

Complications of implants confronting the extruded posterior teeth (정출된 구치와 대합되는 임플란트의 합병증)

  • Jung, Yeon-Wook;Lee, Su-Yeon;Kim, Hee-Jung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.36 no.4
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    • pp.232-241
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    • 2020
  • Purpose: This study investigated the complications and patterns of implants that confronted with the extruded natural teeth. Materials and Methods: Among patients who received implant treatment between 2006 and 2018 at Chosun University Dental Hospital, only implants that had a maintenance period of at least 5 years and that both implants and confronting natural teeth could be measured and compared on a radiograph were selected. They were divided into two groups. Group 1, experimental group consisted of Implants confronting the extruded natural posterior teeth (n = 167: maxilla (Group 1max) = 92, mandible (Group 1man) = 75) and Group 2, control group consisted of Implants confronting the normal natural posterior teeth (n = 656: maxilla (Group 2max) = 272, mandible (Group 2man) = 384). Results: The incidence of complications between Group 1 and Group 2 was statistically significant. In particular, there was a statistically significant difference between the frequency of marginal bone loss and the amount of marginal bone loss. Conclusion: The extruded natural tooth may cause more frequent complications including bone resorption in the opposing implant.

Nursing Students' Attitudes toward Abortion and Perceptions of Euthanasia and Good death (간호대학생의 낙태에 대한 태도와 안락사 및 좋은 죽음에 대한 인식)

  • Kim, Kyung sook
    • Journal of Convergence for Information Technology
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    • v.11 no.3
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    • pp.68-76
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    • 2021
  • This study was attempted to understand the relationship between the attitudes toward abortion, euthanasia, and the level of perception of good death among nursing college students and related factors. The data were collected by using structured questionnaires and the subjects were selected in C and G city. The research method was a descriptive research study, and the mean, standard deviation, frequency analysis, and Pearson's correlation coefficients were analyzed for the variables. The results of this study are as follows. The degree of support for the abortion opposition was 2.51±.56 (score range 1-4), and the opposition to abortion was superior to the approval..The perception of euthanasia was 3.06±.47 points (4 point scale), which was positively recognized at a higher level than the middle, and the good death perception was 2.97±.47 points (4 point scale), which was moderate. 97.1% of the respondents said that they had abortion decisions, and 5.7% of the university students experienced abortion. The attitude toward abortion showed negative correlation with the attitude toward euthanasia (r=-.374, p<.001), showing that the more supportive the anti-abortion, the more positive the attitude toward euthanasia. Therefore, it is necessary to educate the subjects to protect and respect the human rights of patients based on the dignity of life and humanistic thinking while providing nursing services.

Changes in Total Work, Blood Viscosity and Hematocrit during Maximum Strength Type and Endurance Type Resistance Exercise (최대근력 저항운동과 근지구력 저항운동시 총운동량, 혈액점도 및 적혈구용적률의 변화)

  • Jeong, Hwan-Jong;Jang, Tae-Su;Kim, Ki-Hong
    • Journal of the Korean Applied Science and Technology
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    • v.38 no.1
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    • pp.271-279
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    • 2021
  • The purpose of this study was to investigate the effects of maximum and endurance resistance exercises on total work, blood viscosity, and erythrocyte volume ratio. The study subjects were selected as 15 men in their twenties with 12 months or more of resistance exercise experience, and the bench press 1RM was measured before the experiment, and the experiment for each condition was cross-allocated at intervals of one week, and the maximum repetition was performed in 6 sets. As a result, the total amount of exercise showed that the muscular endurance strength was higher than that of the maximum muscular strength (p<.001), and the blood viscosity and erythrocyte volume ratio were higher after exercise than before (p<.01) regardless of the total exercise amount. In summary, it was found that blood viscosity was not affected by exercise intensity and amount of exercise, and increased with one-time resistance exercise. This is clinically significant in constructing a resistance exercise program, and it is considered to be a reference material in creating an exercise program for clinical patients related to vascular disease.

Analyzing Health Information Technology and Electronic Medical Record System-Related Patient Safety Incidents Using Data from the Korea Patient Safety Reporting and Learning System (환자안전보고학습시스템 자료를 활용한 의료정보기술 및 전자의무기록시스템 관련 환자안전사건 분석)

  • Cho, Dan Bi;Lee, Yu-Ra;Lee, Won;Lee, Eu Sun;Lee, Jae-Ho
    • Quality Improvement in Health Care
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    • v.27 no.2
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    • pp.57-72
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    • 2021
  • Purpose: At present, there are a variety of serious patient safety incidents related to problems in health information technology (HIT), specifically involving electronic medical records (EMRs). This emphasizes the need for an enhanced electronic medical record system (EMRS). As such, this study analyzed both the nature of and potential to prevent incidents associated with HIT/EMRS based on data from the Korea Patient Safety Reporting and Learning System (KOPS). Methods: This study analyzed patient safety incidents submitted to KOPS between August 2016 and December 2019. HIT keywords were used to extract HIT/EMRS incidents. Each case was reviewed to confirm whether the contributing factors were related to HIT/EMRS (HIT/EMRS-related incidents) and if the incident could have been prevented (HIT/EMRS-preventable incidents). The selected reports were summarized for general clarity (e.g., incident type, and degree of harm). Results: Of the 25,515 obtained reports, 2,664 incidents (10.4%) were HIT-related, while 2,525 (9.9%) were EMRS-related. HIT/EMRS-related incidents were the third largest type of incident followed by 'fall' and 'medication incidents.' More than 80% of HIT/EMRS-related incidents were medication-related, accounting for approximately one-third of the total number of medication incidents. Approximately 10% of HIT/EMRS-related incidents resulted in patient harm, with more than 94% of these deemed as preventable; further, sentinel events were wholly preventable. Conclusion: This study provides basic data for improving EMR use/safety standards based on real-world patient safety incidents. Such improvements entail the establishment of long-term plans, research, and incident analysis, thus ensuring a safe healthcare environment for patients and healthcare providers.

Association of Suicidal Ideation With Dental Pain among Korean Adolescents (한국 청소년에서 치통과 자살 생각의 연관성)

  • Baek, Ju Won;Lee, Kuy Haeng;Yang, Chan-Mo
    • Korean Journal of Psychosomatic Medicine
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    • v.30 no.1
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    • pp.46-53
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    • 2022
  • Objectives : This study aimed to assess the possible association of dental pain with suicidal ideation among adolescents by analysing data from the 2018 Korean Youth Risk Behavior Survey, a nationwide online survey. Methods : Of 62,823 adolescent middle and high school students in Korea, 60,040 participants were selected for analysis, after excluding cases with missing values. Participants were given a questionnaire about their self-evaluation of health including dental pain and suicidal ideation. Logistic regression analysis demonstrated the relationships between dental pain and suicidal ideation after controlling for potential confounding factors. Results : The proportion of Korean adolescents reporting suicidal ideation was 13.3%. The proportion of adolescents who experienced dental pain was 23.4%. Compared to adolescents who did not report dental pain, adolescents who reported experiencing dental pain were significantly more likely to experience suicidal ideation (OR=1.94, p<0.001). In two multivariate models, the relationships between dental pain and suicidal ideation (AOR=1.24, p<0.001) were statistically significant. Conclusions : Dental pain was associated with increased risk of suicidal ideation among Korean adolescents, even when controlling for sociodemographic factors and other health conditions. It is necessary to consider screening adolescent patients who present with dental pain for suicidal ideation.