• The Journal of Korean Medicine
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• v.42 no.3
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• pp.44-55
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• 2021

Objectives: As the use of herbal medicinal products (HMPs) increases worldwide, systematic verification of the safety of HMPs is required. The induction of cardiotoxicity is one of the major factors in post-approval withdrawal of medicinal products, and drug-induced cardiotoxicity assessment is emerging as an important step in drug development. In the present study, we evaluated human ether-à-go-go-related gene (hERG) potassium channel-related cardiotoxicity to predict the risk of cardiac arrhythmia in thirteen herbal medicines known to have cardiac toxicity. Methods: We measured the inhibition rate of hERG potassium channel activity of 13 medicinal herbal extracts in hERG-expressing HEK 293 cells using an automated patch-clamping system. Quinidine was used as a positive control for inhibition of hERG activity. Results: Extracts of Evodiae Fructus, Strychni Semen, and Corydalis Tuber potently inhibited the activity of hERG, and IC₅₀ values were 3.158, 19.87, and 41.26 ㎍/mL, respectively. Cnidi Fructus, Ephedra Herba, Lithospermi Radix, Polygoni Multiflori Radix, Visci Ramulus et Folium, Asiasari Radix et Rhizoma, and Scolopendra weakly inhibited hERG activity, and the IC₅₀ value for each herbal medicine was more than 400 ㎍/mL. Aconiti Kusnezoffii Tuber and two types of Aconiti Lateralis Radix Preparata (Po and Yeom) had weak inhibitory activity against hERG, and the IC₅₀ values were more than 700 ㎍/mL. The IC₅₀ value of quinidine against hERG was 1.021 𝜇M. Conclusion: Evodiae Fructus, Strychni Semen, and Corydalis Tuber acted as potent inhibitors against hERG. These herbal medicines may cause cardiac arrhythmia through QT prolongation, so care should be taken when taking them.

• Journal of Hospice and Palliative Care
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• v.26 no.2
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• pp.69-79
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• 2023

Purpose: This study aimed to investigate the involvement of patients who died from hematologic neoplasms in the decision-making process surrounding the withdrawal of life-sustaining treatment (LST). Methods: A total of 255 patients diagnosed with hematologic neoplasms who ultimately died following decisions related to LST during their end-of-life period at a university hospital were included in the study. Data were retrospectively obtained from electronic medical records and analyzed utilizing the chi-square test, independent t-test, and logistic regression. Results: In total, 42.0% of patients participated in the decision-making process regarding LST for their hematologic neoplasms, while 58.0% of decisions were made with family involvement. Among these patients, 65.1% died in general wards and 34.9% in intensive care units (ICUs) as a result of decisions such as the suspension of LST. The period from the LST decision to death was longer when the decision was made by the patient (average, 27.15 days) than when it was made by the family (average, 7.48 days). Most decisions were made by doctors and family members in the ICU, where only 20.6% of patients exercised their right to make decisions regarding LST, a rate considerably lower than 79.4% observed in general wards. Decisions to withhold or withdraw LST were more commonly made by patients themselves than by their families. Conclusion: The key to discussing the decision to suspend hospice care and LST is respecting the patient's self-determination. If a patient is lucid prior to admission to the ICU, considerations about suspending LST should involve the patient input.

• Journal of Life Science
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• v.22 no.4
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• pp.532-537
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• 2012

We investigated the effect of smoking on cardiovascular responses during acute dynamic exercise. Eleven college students who had been smoking (duration of smoking: $7.45{\pm}0.90$ years; number of cigarettes per day: $17.72{\pm}1.22$) participated in this study. All subjects completed a graded exercise testing to determine the relative exercise intensity. The cardiovascular responses were measured at rest, and during mild and moderate exercise immediately, 24, and 48 hours after smoking. The same procedures were repeated during 24-h smoking withdrawal. All subjects were continuously instrumented to measure systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), stroke volume (SV), cardiac output (CO), and total vascular conductance (TVC) at rest and during exercise. The results showed that compared to the nicotine abstention, SBP, DBP, MAP, and HR were significantly higher at 24 and 48 hours after smoking ($p$<0.05), and CO was significantly higher at rest and during moderate exercise ($p$<0.05). There were no differences in SV and TVC before and after smoking. Thus, the results suggest that smoking is associated with an exaggerated sympathetic nerve activity during dynamic exercise. Consequently, smoking cessation may help reduce cardiac events, such as stroke and heart attack, during exercise.

• Journal of Pharmaceutical Investigation
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• v.9 no.2
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• pp.11-21
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• 1979

It has been reported from our department that a few agents, such as $K_2S_2O_5,\;NaHSO_3,$ nicotinamide have a marked stabilizing effect in vitro on metoclopramide which is relatively unstable compound. In order to study the effect of these stabilizers on the action of metoclopramide in vitro, the fate of this compound combined with $K_2S_2O_5,\;NaHSO_3$ and nicotinamide, respectively, was studied and furthermore, the change of the biological activity of metoclopramide due to these stabilizers was studied by using the isolated stomach strip of rat. The blood concentration of metoclopramide was measured by using Bakke's method at the various time after intravenous injection of the mixed metoclopramide solution with the stabilizers. In order to study the excretion of the drug, rabbits were anesthesized and catheterized into bladder for withdrawal of urine. After intravenous injection of the mixed metoclopramide solution, urine was collected for 5 hours and the conjugated forms of metoclopramide as well as the free form were determined by using Arita's method. In the biological study of the metoclopramide combined with stabilizers, the contractability of the isolated rat stomach strip was observed by using polygraph recorder. The results were following: 1. When metoclopramide was administered with nicotinamide as stabilizer, the blood concentration of the unchanged from and the rate of the clearance of this compound were very similar to that of metoclopramide alone. On the other hand, other stabilizers, $K_2S_2O_5\;and\;NaHSO_3$, brought about 40% decrease in blood concentration of the unchanged form at 15 min after intravenous injection however, the rate of clearance of metoclopramide with $K_2S_2O_5\;or\;NaHSO_3$ was very slow. 2. In the case of urinary excretion, the excretory pattern of the metabolites of metoclopramide with $NaHSO_3$ or nicotinamide was very similar to that of metoclopramide alone. But metodopramide plus $K_2S_2O_5$ group showed the maked depression of excretion for first 1 hour. 3. In composition of metabolites, when metoclopramide was administered with $K_2S_2O_5$ or $NaHSO_3$, the sulfonate conjugation was predominant. But the glucuronic acid conjugation was predominant in metoclopramide plus nicotinamide gronp. 4. In the experiments on the biological activity of the metoclopramide, this compound exhibited the marked contracting effect in isolatd rat stomach strip. Specially, the meetoclopramide combined with $K_2S_2O_5$ showed the strong contraction of the isolated strip, suggesting the potenciating effect of $K_2S_2O_5$ on the action of metoclopramide in the isolated strip.

• The Journal of Engineering Geology
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• v.28 no.4
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• pp.541-552
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• 2018

The implementation of drought measures in the upstream areas of river basins is seldom considered with respect to water supply. However, the demand for such measures is increasing rapidly owing to the occurrence of severe droughts, and interventions on streams and the water supply are needed. Physical interventions are an option to prevent streams from becoming dry and to maintain stream water flow, but dam construction is challenging because of environmental and ecological considerations. Here, a feasibility study was conducted to assess the potential effects of sand dams, which are widely used in arid regions in Africa. The SWAT-K model, which is a hydrologic model used for Korean watersheds, is used to estimate the flow rate of water in an ungauged watershed. The changes in water storage of the sand-dammed reservoir and in downstream flow rates are estimated for two types of sand dam (natural and dredged). The results show that sand dams are capable of increasing the downstream flow rate during normal conditions and of mitigating water supply problems caused by the withdrawal of water during drought periods.

• Animal Bioscience
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• v.36 no.1
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• pp.75-83
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• 2023

Objective: The objective of this study was to describe a methodological procedure to quantify the heat production (HP) partitioning in basal metabolism or fasting heat production (FHP), heat production due to physical activity (HPA), and the thermic effect of feeding (TEF) in roosters. Methods: Eighteen 54-wk-old Hy Line Brown roosters (2.916±0.15 kg) were allocated in an open-circuit chamber of respirometry for O₂ consumption (VO₂), CO₂ production (VCO₂), and physical activity (PA) measurements, under environmental comfort conditions, following the protocol: adaptation (3 d), ad libitum feeding (1 d), and fasting conditions (1 d). The Brouwer equation was used to calculate the HP from VO₂ and VCO₂. The plateau-FHP (parameter L) was estimated through the broken line model: HP = U×(R-t)×I+L; I = 1 if t<R or I = 0 if t>R; Where the broken-point (R) was assigned as the time (t) that defined the difference between a short and long fasting period, I is conditional, and U is the decreasing rate after the feed was withdrawn. The HP components description was characterized by three events: ad libitum feeding and short and long fasting periods. Linear regression was adjusted between physical activity (PA) and HP to determine the HPA and to estimate the standardized FHP (st-FHP) as the intercept of PA = 0. Results: The time when plateau-FHP was reached at 11.7 h after withdrawal feed, with a mean value of 386 kJ/kg^0.75/d, differing in 32 kJ from st-FHP (354 kJ/kg^0.75/d). The slope of HP per unit of PA was 4.52 kJ/mV. The total HP in roosters partitioned into the st-FHP, termal effect of feeding (TEF), and HPA was 56.6%, 25.7%, and 17.7%, respectively. Conclusion: The FHP represents the largest fraction of energy expenditure in roosters, followed by the TEF. Furthermore, the PA increased the variation of HP measurements.

• Journal of Preventive Medicine and Public Health
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• v.16 no.1
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• pp.163-192
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• 1983

In order to facilitate the Korean government's efforts in integrating family planning and maternal & child health at the primary health care level (or township level), the Soon Chun Hyang College of Medicine, with the financial and technical assistance of WHO, has under-taken a service research project. The project has employed a quasi-experimental study design introducing interventions tat provide crucial factors lacking in the ongoing government programs such as midwives and qualified referral physicians. The study is being conducted in three locations, one control area and two study areas. Before introducing trained Nurse/Midewives into the study areas, a baseline prevalence survey was undertaken from 15 July 1981 to 10 August 1981 in selelcted townships of Seosan County. In this sample survey of bath the study and control areas, 2,484 eligible women (97% reponse rate) were interviewed to obtain benchmark data on basic evaluation indicators related to family planning and maternal and child health. The salients results were summarized as follows.: 1. CONTACT RATES WITH HEALTH WORKERS; During the year preceding the survey, 12% of women were visited by government health workers. The primary reason for such visits by health workers was family planning (45% of the visits). About 34% of the women visited the health centers during the year. The primary reason for visiting health centers was immunizations for their children (45% of the visits). 3. FAMILY PLANNING USE RATE; The baseline data showed little difference between women in the study area and the control area on contraceptive use. Approximately 59% were currently using some methods. However, among those current users, almost half were practicing less effective methods of birth control such as rhythm or withdrawal. Among other methods, the tubectomy was the most popular (16%), while use of the IUD, oral pill and condom together reached only 14%. 3. PRENATAL CARE RATE; About 75% of the women reported no prenatal care for their last births (the youngest child of each women), Additionally, among women received prenatal care, over half had only one visit. 4. ATTENDANCE AT DELIVERY; Most of the women surveyed (over 80%) were attended by a non-medical person during their last delivery. These figures are somewhat comparable to the national figure of 84% for remote areas. 5. POSTNATAL CARE; The proportion of women reporting postnatal care was only 4.5%, and postnatal care was not received by the majority of women surveyed. 6. CHILD HEALTH CARE: In contrast to the low rate of maternity care for women themselves, most women reported obtaining immunization care for their children. About 75% of the women obtained Polio and/or DPT, 58% BCG, and 44% Measles vaccine for their children. However, in terms of illness care, while 35% of the women stated that their youngest child had been sick during the month preceding the survey, only 28% of these women took their child to the clinic for treatment. 7. COMPLICATIONS OF PREGNANCY AND DELIVERY AND ABNORMALITIES IN THE NEWBORN; Among all last deliveries, 18% of the women had pregnancy complications and 9% of the women had complications during delivery About 5% of the women reported abnormality in their most recent newborn. 8. REPRODUCTION EFFICIENCY; PERINATAL MORTALITY AND INFANT MORTALITY Based on data from the pregnancy history in this survey, reproduction efficiency was estimated. Out of the 11,154 pregnancies reported by all women surveyed, foetal loss was 21% (almost 16% were induced abortions) and infant deaths before reaching one year old were 3.1%. The reproduction efficiency was, therefore, reduced to 76%. In terms of perinatal and infant mortality rates, the former was 40.2 per 1,000 total births and the latter was 39.3 per 1,000 live births. Both rates described J shaped relationships with age of mothers and parity, and they were also correlated with birth interval and mother's education. In summary, this baseline survey data indicated a need for (1) improving contraceptive practices with more effective methods to prevent unwanted pregnancies and (2) providing better services for maternal and child care to protect wanted pregancies. In the Korean rural setting. the author believes that the latter is more important as the value of each child has increased as a result of the family planning campaign for the past two decades. This calls for more effective integration of Family Planning and MCH programmes to meet the needs of the family in each stage of the child bearing and rearing period with deploying more qualified personnel than the current government program personnel.

• Journal of Nutrition and Health
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• v.36 no.7
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• pp.736-742
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• 2003

Soybeans have been a major protein source for many centuries in Korea. Soybeans contain phytochemicals which are isoflavones, biochemically active component. Isoflavone is a kind of phytoestrogen, structurally and functionally similar to estrogen. It has been reported that the breast milk and blood of breast feeding mothers who consume soy products contain isoflavones. This study was conducted to investigate the effects of soy milk supplement on the isoflavones (daidzein, genistein) concentration of breast milk, plasma and urine from breast feeding woman. Seventeen healthy women who delivered at Kyung Hee Medical Center were recruited. For the first 2 weeks after delivery, seventeen women ingested 400 ml (isoflavone 43.2 mg) of soy milk on the given time starting from the day of giving birth. For the next 2 weeks, soy milk ingestion was withdrawn. Dietary intake and anthropometric data were checked and breast milk, blood, and 24 hr urine samples were collected on the day of giving birth, the 14th (the last day of the supplement phase) and 28th (the last day of the withdrawal phase) day, respectively. HPLC analysis was used to measure the concentration of isoflavones. Dietary intakes of the subjects were inadequate for the Korean RDA regardless of soy milk supplementation. Especially, intakes of vit A, calcium, and iron were very low. The Anthropometric data such as LBM, TBW, PIBW, BMI checked on the day of 14th decreased and maintained their levels by the 28th day. Daidzein concentration in breast milk was not affected by soy milk supplementation. However, genistein concentration decreased by the 28th day (14th day: 0.89 $\pm$ 0.10 $\mu$g/ml, 28th day : 0.48 $\pm$ 0.07 $\mu$g/ml) (p < 0.05). Plasma daidzein and genistein concentrations were not changed by the 14th day and decreased by the 28th day (14th day: 49.64 $\pm$ 3.30 ng/ml, 26.72 $\pm$ 2.90 ng/ml, 28th day: 38.30 $\pm$ 4.40 ng/ml, 6.51 $\pm$ 0.50 ng/ml, respectively) (p < 0.05). Twenty four hour urine concentrations of daidzein and genistein significantly increased by the 14th day and decreased by the 28th day (14th day: 5.80 :t 0.3 mg/d, 4.17 $\pm$ 0.2 mg/d, 28th day: 6.72 $\pm$ 0.4 mg/d, 5.09 $\pm$ 0.5 mg/d, respectively) (p < 0.001). The rate of urinary recovery of daidzein was greater than that of genistein. The results of this study indicate that the supplement of dietary soy milk to the lactating women elevates the contents of isoflavone in the breast milk.

• Korean Journal of Clinical Pharmacy
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• v.14 no.1
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• pp.11-23
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• 2004

Although most children with idiopathic nephrotic syndrome respond to corticosteroid therapy, many responders show steroid dependency and frequent relapse. In these children, one of the major problems is the serious side effects resulting from continuous steroid therapy. Thus, this study was conducted to assess the therapeutic efficacy and safety of six-month cyclosporine treatment with the low-dose deflazacort therapy in children with nephrotic syndrome. Thirty children with steroid dependence (SD), frequent relapse (FR) and steroid resistance (SR) were enrolled in this study. They were treated with 6-month oral cyclosporine $(Cypol-N^{(R)})$ plus the low-dose deflazacort $(Calcort^{(R)})$ therapy at Samsung Medical Center from September 2002. The dosage of cyclosporine was started at 5 mg/kg/day and was monthly adjusted to maintain clinical remission and/or a trough blood level, while deflazacort dosage was reduced gradually. Clinical evaluation and monitoring of cyclosporine toxicity were performed every $2\sim4$ weeks. Outcomes were compared to the latest sir-month period of steroid only therapy before cyclosporine treatment. Student's t-test and ANOVA were used for statistical analysis. Out of 28 children with SD and FR, 23 $(82.1\%)$ sustained remission, and 5 $(17.9\%)$ experienced 1 or 2 relapses during therapy. Out of 2 children with SR, 1 child sustained remission, and 1 child showed no response. The mean duration of remission and occurrence of relapse were significantly improved (p <.0001). In addition, the mean dosage of steroid was significantly reduced (p=.003). Although a number of adverse effects occurred in this study, they were not so serious as to necessitate discontinuation of the therapy. No nephrotoxicity was observed. Twenty out of the 28 children who had been in remission relapsed after withdrawal of cyclosporine. Fifteen of these children showed relapse within a month. These results demonstrated that the combination of cyclosporine with the low-dose deflazacort was efficient and safe in children with SD and FR during the six-month treatment. However, further studies are necessary in order to resolve the problem of high relapse rate after discontinuation of cyclosporine.

• Environmental Sciences Bulletin of The Korean Environmental Sciences Society
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• v.1 no.2
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• pp.125-136
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• 1997

Digestion of a municipal wastewater sludge by the anaerobic sequencing batch reactor(ASBR) was investigated to evaluate the performance of the ASBR process at a critical condition of high-solids-content feed. The reactors were operated at an HRT of 10 days with an equivalent loading rate of 0.8-1.5 gVS/L/d at $35^{\circ}C.$ The main conclusions drawn from this study were as follows: 1. Digestion of a municipal wastewater sludge was possible using the ASBR in spite of high concentration of settleable solids in the sludge. The ASBRS with 3- and 4-day cycle period showed almost identical high digestion performances. 2. No adverse effect on digestion stability was observed in the ASBRS in spite of withdrawal and replenishment of $30\%\;or\;40\%$ of liquid contents. A conventional anaerobic digester could be easily converted to the ASBR without any stability problem. 3. Flotation thickening occurred in thicken step of the ASBRS throughout steady state, and floating bed volume at the end of thicken period occupied about $70\%$ of the working volume of the reactor. Efficiency of flotation thickening in the ASBRS could be comparable to that of additional gravity thickening of a completely mixed digester. 4. Solids were accumulated rapidly in the ASBR during start-up period. Solids concentrations in the ASBRS were 2.6 times higher than that in the completely mixed control reactor at steady state. Dehydrogenase activity had a strong correlation with the solids concentration. Dehydrogenase activity of the digested sludge in the ASBR was 2.9 times higher than that of the sludge in the control reactor, and about 25 times higher than that of the subnatant in the ASBR. 5. Remarkable increase in equivalent gas production of $52\%$ was observed at the ASBRS compared with the control reactor in spite of similar Quality of clarified effluent from the ASBRS and control reactor. The increase in gas production from the ASBRS was believed to be combined results of accumulation of microorganisms, higher driving force applied, and additional long-term degradation of organics continuously accumulated.