• The Korean Journal of Pain
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• v.19 no.2
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• pp.187-191
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• 2006

Background: Patient-controlled epidural analgesia (PCEA), using a local anesthetic-opioid mixture, has been effectively applied after total knee replacement (TKR) surgery, which is associated with intense postoperative pain that requires postoperative analgesia for both rehabilitation and the pain itself. However, adverse opioid-related effects, such as nausea, vomiting and pruritus, are commonly encountered. It was our hypothesis that the adverse opioid-related effects could be reduced by the addition of naloxone, an opioid antagonist, to a mixture of fentanyl-ropivacaine PCEA. Methods: In 120 patients undergoing elective TKR surgery, epidural or combined spinal-epidural (CSE) anesthesia was performed and PCEA applied. In the control group (n = 65), 0.16% ropivacaine and $3{\mu}g/ml$ fentanyl ($2.4{\mu}g/ml$ for those older than 65 yrs) were administered. In the naloxone group (n = 55), naloxone ($2{\mu}g/ml$) was coadministered with the above regimen. The incidence and severity of postoperative nausea and vomiting, and the frequency of pruritus, the visual analog score (VAS) and the PCEA volume used were assessed 6 and 24 hrs after surgery. Results: The incidence of nausea and vomiting during the early postoperative period, and those of pruritus during the late postoperative period were significantly lower in the naloxone group. The VAS pain scores, the PCEA volume used and amount of rescue IV meperidine were similar in the two groups. Conclusions: A small dose of naloxone mixed with an opioid significantly reduces the incidence and severity of adverse opioid-related effects in PCEA, without reducing the analgesic effect.

• Proceedings of the Korea Society of Environmental Biology Conference
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• 2002.11a
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• pp.141-144
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• 2002

Environmental estrogens are natural or synthetic substances present in the aquatic environment, especially in effluent from sewage treatment. However, the adverse effects of these estrogenic substances on fish reproduction are unknown. Di-2-ethylhexyl phthalate (DEHP) is the most common phthalate, which Ps used as a plasticizer in polyvinylchloride (PVC), and it is widespread in the environment and has been found in aquatic organisms and sediments. Therefore, juvenile common carps (Cyprinus carpio) were exposed to nominal concentrations of 17$\beta$-estradiol (E2) (0.5, 5, 50 $\mu\textrm{g}$/L) and DEHP (10, 100, 500 $\mu\textrm{g}$/L) for 21 days, to determine the adverse reproductive effects of these compounds on plasma vitellogenin (VTG) induction, sex steroid level, and gonad weight. Electrophoresis (SDS-PAGE) revealed that much of VTG was induced in fish exposed to 5 and 50 E$_2$ $\mu\textrm{g}$/L, but none of DEHP exposure showed induction. Enzyme-linked immunosorbent assay (ELISA) revealed that VTG was significantly induced in fish exposed to 5 and 50 E$_2$ $\mu\textrm{g}$/L, and combination of 50 E$_2$ $\mu\textrm{g}$/L with 10 and 500 DEHP $\mu\textrm{g}$/L, but none of DEHP exposure showed induction. Analysis of sex steroid levels in some fish revealed that testosterone (T) was detected in both male and female fish of the control and DEHP exposures, but none of fish exposed to 22 concentrations had detectable testosterone level. On the other hand, E$_2$ exposure induced 17$\beta$-estradiol in plasma of male fish, but there was no induction of 17$\beta$-estradiol in plasma of male fish exposed to DEHP. Comparison of gonadosomatic index (GSI) revealed that maximal E$_2$ exposure inhibited ovarian growth, but maximal DEHP exposure stimulated testicular growth. The results indicated that those comparisons can be a useful bio-indicator for determining adverse reproductive effect of endocrine disrupting chemicals (EDCs).

• Korean Journal of Clinical Pharmacy
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• v.23 no.2
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• pp.129-136
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• 2013

Objectives: Among many new drugs that are under investigation with intent to treat cancer, oral kinase inhibitors are proven to be effective in numerous clinical trials and easy to administer. Due to these advantages the use of oral kinase inhibitors is increasing. Oral kinase inhibitors are metabolized by CYP450 which can result either increase of adverse effect or decrease of drug effect by drug interaction when used concurrently with other agents. In this research, the medication records of patients on oral kinase inhibitors from Oct. 2010 to Nov. 2011 were reviewed to investigate potential drug interactions. Methods: From Oct. 2010 to Nov. 2011, cancer patients in Inha University Hospital who took oral kinase inhibitors more than once were included. The patients' medication records were reviewed to list out concurrent medications that have interaction potential with oral kinase inhibitors, the frequency of concurrent use, and the severity of interaction result using Micromedex$^{(R)}$ and Lexicomp-online$^{(R)}$ as references. Results: As a result, 90 cases of drug with interaction potential were prescribed by Micromedex$^{(R)}$ and 179 cases by Lexicomp-online$^{(R)}$ data. In case of severity, 33.3% by Micromedex$^{(R)}$ and 26.3% by Lexicomp-online$^{(R)}$ were categorized as Major and 65.6% by Micromedex$^{(R)}$ and 72.6% by Lexicomp-online$^{(R)}$ as Moderate. The number of adverse events was 92 cases which 58.7% were on skin and 19.6% on Gastro-intestinal tract. Conclusions: Considerable number of drug with interaction potential was used though each oral kinase inhibitors showed differences in extent. Hence there exists the risk of drug interaction in patients taking oral kinase inhibitors with other drugs.

• Environmental Analysis Health and Toxicology
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• v.31
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• pp.11.1-11.6
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• 2016

Objectives A hazard assessment of di(2-ethylhexyl) phthalate (DEHP), a commonly used workplace chemical, was conducted in order to protect the occupational health of workers. A literature review, consisting of both domestic and international references, examined the chemical management system, working environment, level of exposure, and possible associated risks. This information may be utilized in the future to determine appropriate exposure levels in working environments. Methods Hazard assessment was performed using chemical hazard information obtained from international agencies, such as Organization for Economic Cooperation and Development-generated Screening Information Data Set and International Program on Chemical Safety. Information was obtained from surveys conducted by the Minister of Employment and Labor ("Survey on the work environment") and by the Ministry of Environment ("Survey on the circulation amount of chemicals"). Risk was determined according to exposure in workplaces and chemical hazard. Results In 229 workplaces over the country, 831 tons of DEHP have been used as plasticizers, insecticides, and ink solvent. Calculated 50% lethal dose values ranged from 14.2 to 50 g/kg, as determined via acute toxicity testing in rodents. Chronic carcinogenicity tests revealed cases of lung and liver degeneration, shrinkage of the testes, and liver cancer. The no-observed-adverse-effect level and the lowest-observed-adverse-effect level were determined to be 28.9 g/kg and 146.6 g/kg, respectively. The working environment assessment revealed the maximum exposure level to be $0.990mg/m^3$, as compared to the threshold exposure level of $5mg/m^3$. The relative risk of chronic toxicity and reproductive toxicity were 0.264 and 0.330, respectively, while the risk of carcinogenicity was 1.3, which is higher than the accepted safety value of one. Conclusions DEHP was identified as a carcinogen, and may be dangerous even at concentrations lower than the occupational exposure limit. Therefore, we suggest management of working environments, with exposure levels below $5mg/m^3$ and all workers utilizing local exhaust ventilation and respiratory protection when handling DEHP.

• Development and Reproduction
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• v.20 no.3
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• pp.187-196
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• 2016

The objective of the current study was to determine acute plasma stress responses in two size groups of juvenile Epinephelus akaara (average body weight: $8.4{\pm}2.1$ and $3.3{\pm}0.6g$; 150 and 120 days after hatch, respectively) exposed to abrupt salinity drops (from 34 practical salinity unit, PSU seawater to 18, 10 PSU (experiment 1) or 26, 18, 10 PSU (experiment 2), respectively). Plasma glucose, glutamic oxalate transaminase, glutamic pyruvate transaminase, red blood cell counts, and gill histology were determined during 72 h exposure. Significantly increased plasma glucose, glutamic oxalate transaminase levels, and red blood cell counts were observed in fish exposed to 18 or 10 PSU. Histological changes, such as hyperplasia and lifting of epithelium in the gill secondary lamellae, were also observed in fish exposed to 18 or 10 PSU at 72 h post-drop. E. akaara exposed to sudden salinity drops to 18 or 10 PSU still seems to undergo the primary adjustment phase before fish reaches a new homeostasis, whereas fish exposed to 26 PSU seems to mount osmotic changes. Therefore, the no observed adverse effect levels for 72 h acute salinity challenge was 26 PSU in our study, and salinity drop to 18 PSU and below can possibly cause acute adverse effect, in which fish could be vulnerable to additional stresses such as a temperature changes or handling stress.

• Journal of Periodontal and Implant Science
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• v.29 no.3
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• pp.553-560
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• 1999

The aim of the present study was to evaluate the effect of the expanded polytetrafluoroethylene (e-PTFE) membrane exposure on the initial healing of the periodontal tissue in guided tissue regeneration (GTR) procedure. 90 sites selected from 90 patients were treated with gingival flap surgery supported by an e-PTFE membrane. The material included angular bony defects with probing attachment loss of > 5mm or degree II furcation involvement. Treated sites were classified with membrane exposure group and non-exposure group at membrane removal and evaluated healing type. The results were obtained as follows. 1. e-PTFE membrane was exposed at 61 sites (67.8%) among 90 sites. 2. Thirteen sites (14.4%) depicted rapid healing type, 65 sites (72.2%) depicted typical healing type, 9 sites (10%) showed delayed healing type and 3 sites (3.3%) were categorized as adversed healing type. 3. In e-PTFE membrane exposure group, 1 site (1.6%), 51 sites (83.6%), 6 sites (9.8%) and 3 sites (4.9%) showed rapid healing type, typical healing type, delayed healing type and adverse healing type respectively. 4. In e-PTFE membrane non-exposure group, 12 sites (41.3%), 14 sites (48.3%) and 3 sites (10.3%) showed rapid healing type, typical healing type and delayed healing type respectively. Adverse healing type was not observed. 5. The rate of favourable healing between e-PTFE membrane exposure group and non-exposure group was not statistically significant(p=0.56). These results suggest that the prevention of membrane exposure may be important to obtain rapid healing type. However favourable healing could be obtained with stringent infection control program even if membrane was exposed.

• Neonatal Medicine
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• v.25 no.3
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• pp.118-125
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• 2018

Purpose: The pre-pregnancy body mass index (BMI) is associated with adverse neonatal outcomes. However, studies on very low birth weight (VLBW) infants are rare. This study aimed to investigate the effect of maternal pre-pregnancy BMI on VLBW infants. Methods: This retrospective study evaluated singleton VLBW infants born at the CHA Gangnam Medical Center from 2006 to 2016. The neonates were classified into three groups according to the maternal pre-pregnancy BMI: underweight (<$18.5kg/m^2$), normal weight (${\geq}18.5$ to <$23kg/m^2$), and overweight or obese (${\geq}23kg/m^2$). Clinical characteristics and morbidities of mothers and infants were analyzed. Results: A total of 181 infants belonging to underweight (16.6%), normal weight (58.6%), and overweight or obese (24.8%) groups were enrolled. The pre-pregnancy BMI had a significant negative correlation with gestational age (r=-0.198, P=0.001) and a significant positive correlation with the z-score of the birth weight (r=0.078, P=0.001) and body length (r=0.067, P=0.008). The number of extremely preterm infants was significantly higher in the overweight or obese group. The proportion of risk of small for gestational age infants was higher in the underweight group (adjusted odds ratio [OR], 2.958; 95% confidence interval [CI], 1.113 to 7.864), whereas that of infants with severe retinopathy of prematurity was higher in the overweight or obese group (adjusted OR, 9.546; 95% CI, 1.230 to 74.109). Conclusion: In our population of VLBW infants, the pre-pregnancy BMI was associated with gestational age, intrauterine growth, and adverse neonatal outcomes. Therefore, proper weight control before pregnancy is important.

• Toxicological Research
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• v.34 no.4
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• pp.343-354
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• 2018

Aluminum oxide nanoparticles ($Al_2O_3$ NPs) are among the most widely used nanomaterials; however, relatively little information about their risk identification and assessment is available. In the present study, we aimed to investigate the potential toxicity of $Al_2O_3$ NPs following repeated inhalation exposure in male Sprague-Dawley rats. Rats were exposed to $Al_2O_3$ NPs for 28 days (5 days/week) at doses of 0, 0.2, 1, and $5mg/m^3$ using a nose-only inhalation system. During the experimental period, we evaluated the clinical signs, body weight change, hematological and serum biochemical parameters, necropsy findings, organ weight, and histopathology findings. Additionally, we analyzed the bronchoalveolar lavage fluid (BALF), including differential leukocyte counts, and aluminum contents in the major organs and blood. Aluminum contents were the highest in lung tissues and showed a dose-dependent relationship in the exposure group. Histopathology showed alveolar macrophage accumulation in the lungs of rats in the $5mg/m^3$ group during exposure and recovery. These changes tended to increase at the end of the recovery period. In the BALF analysis, total cell and neutrophil counts and lactate dehydrogenase, tumor necrosis factor-${\alpha}$, and interleukin-6 levels significantly increased in the 1 and $5mg/m^3$ groups during exposure. Under the present experimental conditions, we suggested that the no-observed-adverse-effect level of $Al_2O_3$ NPs in male rats was $1mg/m^3$, and the target organ was the lung.

• Asian-Australasian Journal of Animal Sciences
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• v.23 no.11
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• pp.1436-1444
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• 2010

The objectives of this study were to determine the highest inclusion of licury (Syagrus coronate) cake in the diet of growing Boer goats without adverse effects on intake and digestibility and to determine its effects on ingestive behavior and physiological responses. Twenty entire, one year old 3/4 Boer goats, 18.1 kg (DS = 2.2) average body weight (BW), were allocated to dietary treatments in a completely randomized design. Each animal was confined in a $1.0\;m^2$ pen with a suspended floor and given ad libitum access to clean, fresh water. Diets were formulated to meet NRC (2007) requirements and the ingredients were: 50% of Tifton-85 (Cynodon sp.) hay, corn meal, soybean meal, mineral and vitamin premix, and licury cake. The treatments were: i) no addition of licury cake to the diet, ii) 15% (DM basis) addition of licury cake, iii) 30% licury cake and, iv) 45% licury cake. The experiment lasted for 17 days; the first 10 days were used to adapt the animals to the diets and facilities. The inclusion of licury cake increased the fiber concentration of the diets; however, there was no effect on either dry matter (DM) or organic matter (OM) intake. There was a linear increase (p<0.05) in the EE content of the diet as the addition of licury cake increased; however, EE intake did not differ (p>0.05) between treatments. The digestibility of non-fibrous carbohydrates (NFC) decreased with increasing inclusion of licury cake, as did NFC intake. The efficiency of ingestion of DM and NDF presented a negative quadratic effect with the inclusion of licury cake. Results from this study indicate that licury cake can be fed to goats at up to 45% of the diet without adverse effects on either intake or digestibility.

• Structural Engineering and Mechanics
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• v.63 no.4
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• pp.509-519
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• 2017

Wind field in mountainous regions demonstrates unique distribution characteristic as compared with the wind field of the flat area, wind load and wind effect are the key considerations in structural design of television towers situated in mountainous regions. The television tower to be constructed is located at the top of Xiushan Mountain in Nanjing, China. In order to investigate the impact of terrain factors of hilltops on wind loads, firstly a wind tunnel test was performed for the mountainous area within 800m from the television tower. Then the tower basal forces such as bending moments and shear strength were obtained based on high frequency force balance (HFFB) test. Based on the experiments, the improved method for determining the load combinations was applied to extract the response distribution patterns of foundation internal force and peak acceleration of the tower top, then the equivalent static wind loads were computed under different wind angles, load conditions and equivalent goals. The impact of terrain factors, damping ratio and equivalent goals on the wind load distribution of a television tower was discussed. Finally the equivalent static wind loads of the television tower under the 5 most adverse wind angles and 5 most adverse load conditions were computed. The experimental method, computations and research findings provide important references for the anti-wind design of high-rise structure built on hilltops.