• Title/Summary/Keyword: Drug Development

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Analyses on the Mean Length of Stay of and the Income Effects due to Early Discharge of Car Accident Patients at General Hospital (3차 병원에 입원한 교통사고환자의 평균 재원기간과 조기퇴원시의 수입증대효과 분석연구)

  • Ryu, Ho-Sihn
    • Research in Community and Public Health Nursing
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    • v.10 no.1
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    • pp.70-79
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    • 1999
  • This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.

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Constrictive Bronchiolitis Accompanied By Non-Hodgkin's Lymphoma (비 Hodgkin 림프종과 동반된 교착성 세기관지염)

  • Lee, Kye Young;Jee, Young Koo;Choi, Young Hi;Myong, Na Hye;Kim, Keun Youl
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.613-622
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    • 1996
  • Constrictive bronchiolitis, one of small airway diseases, is very rare and occupies one of the two arms of bronchiolitis obliterans together with proliferative bronchiolitis. Proliferative bronchiolitis, presenting the prototype with bronchiolitis obliterans with organizing pneumonia(BOOP), can be easily taken into diagnostic consideration in terms of relatively rapid clinical course and radiologic presentation as if atypical pneumonia with interstitial and alveolar infiltrations. Meanwhile constrictive bronchiolitis is not only very Tare but also easily overlooked as chronic obstructive pulmonary diseases such as emphysema, because it usually shows normal chest radiographic finding and obstructive pattern in pulmonary function test. In the aspects of the response to treatment, proliferative bronchiolitis showed dramatic response to the corticosteroid while constrictive bronchiolitis is intractable, which is easily explained on the basis of the pathologic characteristics of cicartrical replacement of bronchiolar walls. The bronchiolitis, both proliferative and constrictive, can be associated with diverse conditions such as inhalational injury, postinfectious process, drug of chemical induced reactions, connective tissue diseases, and organ trasplantation. And there is idiopathic type which has no associated condition. There is one explanation that both types of bronchiolitis lie on the same disease spectrum because the different disease pattern can be evoked from the same etiology. In contrast, another explanation is suggested that both types of bronchiolitis are one of nonspecific tissue reaction rather than a disease specific histologic finding because the various types of causes can provoke the same histologic findings. These dilemma remains for further investigation. With literature investigation, the authors report a case of constrictive bronchiolitis proven by open lung biopsy in 47 year old female who was diagnosed as non-Hodgkin's lymphoma and simultaneously had relatively rapid progression of airflow obstruction and showed negative radiographic finding without the rise factors for the development of chronic obstructive lung disease. We consider it as idiopathic because we could not find any relationship between constrictive bronchiolitis and non-Hodgkin's lymphoma on the literature search and it requires further investigation.

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Expression of Serotonin(5-HT) Receptor Isotypes in Reproductive Organs of Male Rat (수컷 흰쥐 생식기관에서의 세로토닌 수용체 아형 유전자 발현)

  • 이성호
    • Development and Reproduction
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    • v.6 no.2
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    • pp.111-115
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    • 2002
  • 5-Hydroxytryptamine(5-HT; serotonin) system has been implicated in the modulation of male sexual behaviors and the secretion of reproductive hormones. In human males, selective serotonin re-uptake inhibitors(SSRIs) are known to improve the major male sexual dysfunction, premature ejaculation, through the central nervous system-mediated pathways. As numerous hormone and local factors, 5-HT may have peripheral role in the regulation of male sexual function. The expression of 5-HT receptor subtypes in the target tissue, however, has not been explored yet. The present study was undertaken to test whether the 5-HT receptor subtypes are expressed in the reproductive tissues of male rat, especially in ejaculatory machinery such as seminal vesicle and vas deferens. To do this, reverse transcription-polymerase chain reaction(RT-PCR) and Southern blot analysis were employed. The transcripts for the 1A, 1B and 2C subtypes of 5-HT receptor were amplified in all the tested tissues. The present study demonstrated the expression of 5-HT receptor in the rat ejaculatory machinery, suggesting that 5-HT may play a pivotal role in the male sexual function via not only central pathway but also peripheral route. Further study on the receptor subtype-specific effect and their harmonized mode of action will be needed to establish the understanding of ejaculation mechanism and drug design.

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Effects of Ibandronate on the Expression of Matrix Metalloproteinases in Human U2OS Osteosarcoma Cells (사람 U2OS 골육종 세포에서 Matrix Metalloproteinase의 발현에 Ibandronate가 미치는 영향)

  • Jung, Sung-Taek;Seo, Hyoung-Yeon;Xin, Zeng-Feng;Kim, Yang-Kyung;Kim, Hyung-Won
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.2
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    • pp.111-121
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    • 2009
  • Background: Osteosarcoma is one of the most common primary malignant tumors of bone occurring mainly in children and adolescents. Although surgery combined with chemotherapy has markedly improved patient survival during the last years, the use of anticancer drugs is still associated with serious problem, such as the frequent acquisition of drug-resistant phenotypes and occurrence of "secondary malignancies". Several solid tumors display enhanced expression of matrix metalloproteinases (MMPs), and recently clinical trials have been initiated on MMP-inhibitors. On the other hand, bisphosphonates (BPs) are inhibitors of bone resorption, and widely used to treat osteoclast-mediated bone diseases. Also they appear to possess direct antitumor activity. Methods: One osteosarcoma cell line (U2OS) was treated with ibandronate (0, 0.1, 1, $10{\mu}M$) for 48 hours. Cell viabilities were determined using MTT assay, the mRNA levels of MMP-2 and MT1-MMP were detected by reverse-transcription polymerase chain reaction, the amount of MMP-2 and MT1-MMP protein were measured by Westernblot, the activities of MMP-2 were observed by Gelatin zymography, and Matrigel invasion assays were used to investigate the invasive potential of osteosarcoma cell lines before and after ibandronate treatment. Results: The invasiveness of U2OS cell line was reduced dose-dependently following 48 hour treatment of up to $10{\mu}M$ of the ibandronate at which concentration no cytotoxicity occurred. Furthermore, the gelatinolytic activities and protein and mRNA levels of MMP-2 and MT1-MMP were also suppressed by increasing ibandronate concentrations. Conclusion: Given that MMP-2 is instrumental in tumor cell invasion, it is very likely that the reduction in osteosarcoma cell invasion by ibandronate is a consequence, at least in part, of suppressed expression of both MMP-2 and MT1-MMP. Isolation of a molecule (s) responsible for the bisphosphonate inhibition of tumor cell invasion would pave the way for the development of a new generation of metastasis inhibitors.

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Clinical Features of Benign Infantile Convulsions with Gastroenteritis (위장관염과 동반된 양성 영아 경련의 임상적 고찰)

  • Lee, Jung Sun;Kwon, Hae Oak;Jee, Young Mee;Chae, Kyu Young
    • Clinical and Experimental Pediatrics
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    • v.48 no.7
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    • pp.753-759
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    • 2005
  • Purpose : This study was performed to characterize clinical features of benign convulsions with gastroenteritis(CwG) in infants. Methods : We reviewed clinical features of 67 episodes in 64 patients with afebrile seizure accompanied gastroenteritis admitted to Dept. of Pediatrics Bundang CHA hospital from January 2001 to June 2004. Patients with meningitis, encephalitis/encephalopathy or apparent history of epilepsy were excluded. Results : There were 32 boys and 35 girls. The age of onset ranged from 1 to 42 months($18.5{\pm}6.1$ months). The number of children admitted to the hospital with acute gastroenteritis was 2,887 in the same period. The percentage of patients with CwG was 2.3. Seizure type was exclusively generalized tonic or tonic-clonic seizure. The average number of seizures during a single episode was 3.1 (range, 1-13). Two or more seizures occurred in 53(79.1%) of the 67 episodes. Antiepileptic drugs were administered for 42 episodes. Seizure did not cease after the administration of one kind of antiepileptic drug in 23 episodes(54.7%). The seizures were rather refractory to initial antiepileptic treatment. There were no abnormalities in serum biochemistry test including glucose and electrolytes. Cerebrospinal fluid was normal in all 54 episodes. Stool cultures were negative in 49 episodes. Rotavirus was positive in stools in 51(82.3%) of 62 episodes. Norovirus was positive in stools in 2 episodes and astrovirus in 1 of 18 episodes. CT and/or MRI were performed in 15 cases and demonstrated no neuroradiologic abnormalities. Of 73 Interictal EEG, initial 24 cases showed occasional spike or sharp wave discharges from the mid-line area during stage I-II sleep, which were apparently differentiated from vertex sharp transient or K-complexes. The mean follow-up period was 5.7 months(1-36 months). Three patients experienced a recurrence of CwG, but all patients exhibited normal psychomotor development at the last follow-up. Conclusion : Afebrile infantile convulsions with gastroenteritis are brief generalized seizure in cluster with normal laboratory findings and good prognosis. Therefore CwG is likely to be categorized as situation-related seizure of special syndrome. Recognition of this entity should lead to assurance of the parents and long-term anticonvulsant therapy is not usually warranted.

The Relationship between the Refractive Power and Nutrient Intake of the Growth Period in Accordance with the Income (소득에 따른 성장기 영양소 섭취와 굴절력과의 관계)

  • Ye, Ki-Hun;Lee, Wan-Seok
    • Journal of Korean Ophthalmic Optics Society
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    • v.18 no.2
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    • pp.213-229
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    • 2013
  • Purpose: The Nutrient intake during the growth period is a critical factor for the development of the vision. In this study, we have analyzed the nutrient that has a correlation with the decrease of induced visual impairment. In addition, we investigated visual acuity and correlation of the nutrient in the higher-income youth and low-income youth. Methods: We used the Korean National Health and Nutrition Examination Survey 2010 document. The Korean National Health and Nutrition Examination Survey didn't show the clear standard of carbohydrates and fats, so we used the data from the Ministry of Food and Drug Safety standards with each 330 g, 51 g. In order to compare the correlation of nutrients and refraction, Nutrients has been classified macronutrients(energy, dietary fiber, protein, carbohydrate, fat), fat-soluble vitamins (vitamin A), water-soluble vitamins (vitamin C, riboflavin, niacin), trace minerals (iron), minerals (calcium, phosphorus, sodium, potassium) and water. Results: We investigated the correlation between refraction and nutrients on average about 328 subjects belonging to the high-income group. The fat intake was $54.21{\pm}32.60$ g, and it was about 2~10 times less than the recommended daily intake (112-540 g). Refractive power and fat intake showed a statistically significant correlation (O.D:p=0.033, O.S:p=0.029). We investigated the correlation between refraction and nutrients on average about 309 subjects belonging to the lowincome group. The phosphorus showed higher ingested by the $1118.75{\pm}501.98$ mg, and the sodium showed intake more than three times recommended intake by the $3705.24{\pm}2089.42$ mg. In addition, unlike other macro mineral it showed that was a correlation on the refraction by the 0.031. Conclusions: A broad variety of taking nutrition and good eating habits at the time of growth seems to have an effects to the good growth and vision and the senescence inhibition of vision.ave an effect to the good growth, the good vision and the senescence inhibition of vision.

Studies on the Fracture Healing in the Alloxan treated Rabbits (Alloxan 투여 가토(家兎)에 대한 골절치유 실험)

  • Kim, Sung-Joon
    • The Korean Journal of Pharmacology
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    • v.7 no.1
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    • pp.53-65
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    • 1971
  • It is well known that diabetes mellitus is associated with metabolic derangements, such as hyper-glycemia, ketosis, glycosuria, and also widespread alterations in the blood vessels, kidneys, eyes, peripheral nerves and heart. It is also recognized that healing of skin wound is delayed in diabetics. In bone, according to Aegerter, osteopenia develops in diabetes mellitus and it is chiefly ascribed to overutilization of protein. Shim claims that total blood flow to the entire skeletal system is approximately 4 to 8 percent of resting cardiac output and blood supply to the skeletal system would be decreased on account of secondary arteriosclerotic changes in the diabetics. An adequate blood supply is an essential factor in the healing process of fracture, and disturbed blood flow, either local or systemic, will invariably delay union of the fragments or the fragments from being fused. As the author has encountered several cases of diabetics in whom healing of fracture was delayed or incomplete, this experimental study was undertaken to elucidate the effects of hyperglycemia and diabetes mellitus on the healing process of fracture. In this experiment adult albino rabbits, weighing about 2 kg. were used and divided into 6 groups. The femur of each animal was fractured surgically, and then the healing process of fracture was periodically checked by radiography at an interval of one week for a period of 6 weeks. Thereafter, all the rabbits were killed to obtain tissue preparation of the femur. The experimental groups were as follows; 1) Control group: Six rabbits sustained a surgical fracture to the femur, without being given any other treatment or drug. 2) Alloxan-treated group: For inducing diabetes, alloxan was given intravenously to 17 rabbits in various dose as follows; to 7 of them 40 mg/kg, to 6 rabbits 80 mg/kg and to 4 rabbits 120 mg/kg of body weight, respectively. 3) Insulin-treated group: Protamine-zinc insulin was injected subcutaneously to each of 6 rabbits in a daily dose of 1 unit per kilogram of body weight. 4) Group treated with insulin after alloxan: Four rabbits were given 80 mg of alloxan once and than 1 unit of insulin per kilogram of body weight daily. Another 5 rabbits were injected 1 unit of insulin per kg of body weight daily following administration of alloxan in a dose of 120 mg/kg. 5) Homotransplantation group: Following intravenous injection of alloxan in a dose of 120 mg/kg, 10 rabbits underwent homotransplantation of a short bone segment to the femur. Five of them were subsequently given 1 unit/kg of insulin daily. 6) Sugar-treated group: six rabbits were fed $15{\sim}20$ gm of sugar daily throughout the period of experiment. The results obtained are summarized as follows; 1. Blood sugar level and damage to the pancreatic islet increased proportionately when alloxan was given to the rabbits in various doses. No appreciable change could be observed in the islets when the blood sugar level was altered by either oral administration of sugar or subcutaneous injection of insulin. 2. Comparing with the control group, healing of fracture was delayed in the alloxan-treated group, while callus formation and periosteal reaction were shown to be more prominent in this group and subsequently, the ultimate osseous tissue formed at the fracture site was significantly smaller in amount and less compact. These findings were more marked as the amount of alloxan increased. 3. Administration of insulin prevented the delay in healing process of fracture in the rabbits with alloxan-induced hyperglycemia. In this case, the course and progression of fracture healing were almost similar to those of control group. 4. Union between the host bone and the fragment transplanted from other rabbit of the same species was more delayed in the group treated with alloxan alone than in the group to which insulin was administered after development of alloxan-induced diabetes. In both groups periosteal new bone developed from the ends of the host bone, above and below the transplanted fragment, and directly fused with failure of periosteal callus to bridge the adjacent ends of the host bone and the transplanted fragment. 5. The healing process of fracture was not inhibited by alteration in blood sugar level when the blood sugar was abnormally increased by excessive sugar intake or lowered by administration of insulin alone. The healing of fracture in these groups progressed similarly as in the control group. In brief summary, it appears that the healing process of fracture would be definitely disturbed in diabetic state brought about by damage to the pancreatic islet. As such an inhibition could be overcome with insulin, it seems that insulin plays an important role in healing of fracture, but alteration in blood sugar level alone does not modify healing process of fracture to significant degree.

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Clinical Characteristics and Prognosis of Neonatal Seizures (신생아 경련의 임상적 양상 및 예후에 관한 고찰)

  • Kim, Chang Wu;Jang, Chang Hwan;Kim, Heng Mi;Choe, Byung Ho;Kwon, Soon Hak
    • Clinical and Experimental Pediatrics
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    • v.46 no.12
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    • pp.1253-1259
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    • 2003
  • Backgroud : Seizures in the neonate are relatively common and their clinical features are different from those in children and adults. The study aimed to provide the clinical profiles of neonatal seizure in our hospital. Methods : A total of 41 newborns with seizures were enrolled in this study over a period of three years. They were evaluated with special reference to risk factors, neurologic examinations, laboratory data, neuroimaging studies, EEG findings, seizure types, response to treatment, and prognosis, etc. Results : The average age at onset of seizures was $6.1{\pm}4.6days$ and the majority of patients(42%) had multifocal clonic seizure and 24% had subtle seizure. Factors that are known to increase risk of neonatal seizures include abnormal delivery history, birth asphyxia, and electrolyte imbalance, etc. However, they remain obscure in about 20% of cases. More than 50 percent showed abnormal lesions on neuroimaging studies such as brain hemorrhage, periventricular leukomalacia, brain infarction, cortical dysplasia, hydrocephalus, etc. and 17 out of 32 patients showed abnormal electroencephalographic patterns. Phenobarbital was tried as a first line antiepileptic drug and phenytoin was added if it failed to control seizures. The treatments were terminated in the majority of patients during the hospital stay. The overall prognosis was relatively good except for those with abnormal EEG background or congenital central nervous system malformations. Conclusion : Neonatal seizures may permanently disrupt brain development. Better understanding of their clinical profiles and appropriate management may lead to a reduction in neurological disability in later childhood.

Basic Studies on the Development of Diet for the Treatment of Obesity II. Comparison of the Inhibitory Effect of Algae and Crude Drug Components on Obesity (비만치료식 개발을 위한 기초연구 2. 조류와 생약성분의 비만억제작용 비교)

  • CHOI Jin-Ho;CHOI Jae-Sue;BYUN Dae-Seok;YANG Dal-Sun
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.19 no.5
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    • pp.485-492
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    • 1986
  • This study was designed to compare the inhibitory effects of algae components such as alginic acid and chlorella extract with the red ginseng saponin and garlic components such as alliin and scordinin on obesity. These components supplemented to basic diet were fed ad libitum to Sprague Dawley rats for 4 weeks, and the inhibitory effects on obesity were evaluated by measuring body weight gain and feed efficiency, the contents of glucose and cholesterol in serum, lipase activity in serum, lipid contents in liver and adipose tissue around epididymis and ovarium, and Lee index, etc. Among the inhibitory effects of these components on obesity, Na-alginate($71\%$) was the most effective (p<0.01), and the others were effective (p<0.001) in the order of scordinin ($76\%$) = chlorella ($76\%$)> alliin ($86\%$) for body weight gain, but Na-alginate ($68\%$) was the most effective, followed by alliin ($79\%$) for feed efficiency (p<0.001). In the inhibitory effects on lipid accumultion in liver and adipose tissue, Na-alginate ($84\%$) among these components was the most effective (p<0.001) in liver, but Na-alginate ($54\%$) was the most effective (p<0.001), followed by alliin ($64\%$), and followed by scordinin ($66\%$) in adipose tissues around epididymis and ovarium (p<0.001). The inhibitory effect on obesity evaluated by Lee index was observed in Na-alginate ($91\%$) only (0.001). The decreasing effects of lipid content in liver by these components were effective in the order of alliin ($40\%$)> saponin ($58\%$)> Na-alginate($62\%$)> chlorella ($64\%$)> scordinin ($74\%$) (p<0.001). G lucose contents in serum were significantly decreased in cases of Na-alginate ($67\%$), saponin ($73\%$), scordinin ($74\%$) and alliin ($83\%$), and cholesterol contents in serum were significantly decreased in cases of Na-alginate ($82\%$), chlorella ($86\%$) and saponin ($89\%$) (p<0.001). The increasing effect of lipase activity in serum was effective in cases of Na-alginate ($109\%$) and saponin ($104\%$), while garlic components such as alliin and scordinin, and chlorella were decreased. It is proved that the inhibitory effect of alginic acid which is the major component of brown algae on obesity was more effective than those of ginseng and garlic components such as saponin, alliin and scordinin.

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Optimization of Processing Process for Functional Anchovy Fish Sauce in Addition with Raw Sea Tangle (다시마를 첨가한 기능성 멸치액젓 제조조건 확립)

  • Jeong, Min-Hong;Jeong, Woo-Young;Gyu, Hyeon-Jin;Jeong, Sang-Won;Park, Hun-Kyu;Cho, Young-Je;Shim, Kil-Bo
    • Journal of Fisheries and Marine Sciences Education
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    • v.25 no.6
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    • pp.1408-1418
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    • 2013
  • To investigate the quality properties of functional anchovy fish sauce added with raw sea tangle, 2%, 5%, and 10% (w/w) of sea tangle was added to 25% (w/w) salted anchovy and then fermented at $20^{\circ}C$. During fermentation period, the amino nitrogen contents were increased at all groups and the highest contents were at 450 days of fermentation with $11.99{\pm}0.08$, $12.51{\pm}0.08$, and $11.95{\pm}0.08mg/mL$ at 2%, 5%, and 10% addition of raw sea tangle, respectively. After later, the contents were keeping at a similar level. VBN contents were continuously increased until 270 days of fermentation with $208.10{\pm}3.50$, $210.00{\pm}4.10$, $215.15{\pm}1.50mg/100ml$ at 2%, 5%, 10% addition of raw sea tangle, respectively. Alginic acid recovery was gradually increased in fermentation duration, showed the highest concentration at 540 days of fermentation with 67.00, 67.25, 67.90% at 2%, 5% and 10% addition of raw sea tangle, respectively. Dietary fiber recovery was rapidly increased at the beginning of fermentation and then decreased slowly as the fermentation is progressed. The highest recovery was at 30 days with 18.7, 18.6, and 17.9%, and the lowest was at 360 days with 8.7 and 11.1% at 2 and 10% addition of raw sea tangle, respectively, and 450 days with 11.4% at 5% sea tangle. The lowest fucoidan contents were exhibited at 30 days of fermentation with 0.07% at both of 2% and 5% addition, and 90 days with 0.10% at 10% addtion of sea tangle. The highest fucoidan contents were 270 days showing 0.24, 0.25, and 0.23% at 2, 5, and 10% addition, respectively. All groups adding different sea tangle concentration were not significantly different at all properties. However, the newly developed products were sufficient to the standard guideline of Korea Food Drug Adminstration. The best processing process of functional anchovy fish sauce in addition with raw sea tangle is 2% addition of raw sea tangle and fermented more than 450 days. The results obtained in this study indicated that the fish sauce added with sea tangle is superior in taste, functions to traditional fish sauce and could be competitive fishery fermented food.