• Title/Summary/Keyword: pharmacy service

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DN200434, an orally available inverse agonist of estrogen-related receptor γ, induces ferroptosis in sorafenib-resistant hepatocellular carcinoma

  • Dong-Ho, Kim;Mi-Jin, Kim;Na-Young, Kim;Seunghyeong, Lee;Jun-Kyu, Byun;Jae Won, Yun;Jaebon, Lee;Jonghwa, Jin;Jina, Kim;Jungwook, Chin;Sung Jin, Cho;In-Kyu, Lee;Yeon-Kyung, Choi;Keun-Gyu, Park
    • BMB Reports
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    • v.55 no.11
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    • pp.547-552
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    • 2022
  • Sorafenib, originally identified as an inhibitor of multiple oncogenic kinases, induces ferroptosis in hepatocellular carcinoma (HCC) cells. Several pathways that mitigate sorafenib-induced ferroptosis confer drug resistance; thus strategies that enhance ferroptosis increase sorafenib efficacy. Orphan nuclear receptor estrogen-related receptor γ (ERRγ) is upregulated in human HCC tissues and plays a role in cancer cell proliferation. The aim of this study was to determine whether inhibition of ERRγ with DN200434, an orally available inverse agonist, can overcome resistance to sorafenib through induction of ferroptosis. Sorafenib-resistant HCC cells were less sensitive to sorafenibinduced ferroptosis and showed significantly higher ERRγ levels than sorafenib-sensitive HCC cells. DN200434 induced lipid peroxidation and ferroptosis in sorafenib-resistant HCC cells. Mechanistically, DN200434 increased mitochondrial ROS generation by reducing glutathione/glutathione disulfide levels, which subsequently reduced mTOR activity and GPX4 levels. DN200434 induced amplification of the antitumor effects of sorafenib was confirmed in a tumor xenograft model. The present results indicate that DN200434 may be a novel therapeutic strategy to re-sensitize HCC cells to sorafenib.

Cost-Effectiveness Analysis of Home-Based Hospice-Palliative Care for Terminal Cancer Patients

  • Kim, Ye-seul;Han, Euna;Lee, Jae-woo;Kang, Hee-Taik
    • Journal of Hospice and Palliative Care
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    • v.25 no.2
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    • pp.76-84
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    • 2022
  • Purpose: We compared cost-effectiveness parameters between inpatient and home-based hospice-palliative care services for terminal cancer patients in Korea. Methods: A decision-analytic Markov model was used to compare the cost-effectiveness of hospice-palliative care in an inpatient unit (inpatient-start group) and at home (home-start group). The model adopted a healthcare system perspective, with a 9-week horizon and a 1-week cycle length. The transition probabilities were calculated based on the reports from the Korean National Cancer Center in 2017 and Health Insurance Review & Assessment Service in 2020. Quality of life (QOL) was converted to the quality-adjusted life week (QALW). Modeling and cost-effectiveness analysis were performed with TreeAge software. The weekly medical cost was estimated to be 2,481,479 Korean won (KRW) for inpatient hospice-palliative care and 225,688 KRW for home-based hospice-palliative care. One-way sensitivity analysis was used to assess the impact of different scenarios and assumptions on the model results. Results: Compared with the inpatient-start group, the incremental cost of the home-start group was 697,657 KRW, and the incremental effectiveness based on QOL was 0.88 QALW. The incremental cost-effectiveness ratio (ICER) of the home-start group was 796,476 KRW/QALW. Based on one-way sensitivity analyses, the ICER was predicted to increase to 1,626,988 KRW/QALW if the weekly cost of home-based hospice doubled, but it was estimated to decrease to -2,898,361 KRW/QALW if death rates at home doubled. Conclusion: Home-based hospice-palliative care may be more cost-effective than inpatient hospice-palliative care. Home-based hospice appears to be affordable even if the associated medical expenditures double.

Current status of opioid prescription in South Korea using narcotics information management system

  • Soo-Hyuk Yoon;Jeongsoo Kim;Susie Yoon;Ho-Jin Lee
    • The Korean Journal of Pain
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    • v.37 no.1
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    • pp.41-50
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    • 2024
  • Background: Recognizing the seriousness of the misuse and abuse of medical narcotics, the South Korean government introduced the world's first narcotic management system, the Narcotics Information Management System (NIMS). This study aimed to explore the recent one-year opioid prescribing patterns in South Korea using the NIMS database. Methods: This study analyzed opioid prescription records in South Korea for the year 2022, utilizing the dispensing/administration dataset provided by NIMS. Public data from the Korean Statistical Information Service were also utilized to explore prescription trends over the past four years. The examination covered 16 different opioid analgesics, assessed by the total number of units prescribed based on routes of administration, type of institutions, and patients' sex and age group. Additionally, the disposal rate for each ingredient was computed. Results: In total, 206,941 records of 87,792,968 opioid analgesic units were analyzed. Recently, the overall quantity of prescribed opioid analgesic units has remained relatively stable. The most prescribed ingredient was oral oxycodone, followed by tapentadol and sublingual fentanyl. Tertiary hospitals had the highest number of dispensed units (49.4%), followed by community pharmacies (40.2%). The highest number of prescribed units was attributed to male patients in their 60s. The disposal rates of the oral and transdermal formulations were less than 0.1%. Conclusions: Opioid prescription in South Korea features a high proportion of oral formulations, tertiary hospital administration, pharmacy dispensing, and elderly patients. Sustained education and surveillance of patients and healthcare providers is required.

Health Status and Health Care Utilization in a Rural Area, Nepal (네팔 도서지역 주민들의 상병상태 및 의료이용양상)

  • Lee, Myung-Ken;Kim, Myung-Ho;Lee, Myung-Sun;Park, Kyoung-Ok
    • Journal of agricultural medicine and community health
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    • v.21 no.2
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    • pp.231-241
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    • 1996
  • The estimation of medical care status and the planning of health service program should be done according to each community resident's socio-medical background and public health service. In this point, it is most necessary to be set the exact and new socio-economic statistics data in Nepal, one of the worst countries in national health status. We surveyed 668 house, 3,425 residents in Dolka area, Nepal from January 25th to February 1st, 1995. 1. In personal characteristics, the ratio of men and women was similar, the person who were below 19 years old were 28.1% and the single were 52.4%. The illeterate person were 50.3% and the lower group in economic status which had been estimated by interviewers were 46.9%. 2. In sanitational characteristics, the person who used stream water or rainwater to drink were 42.2% and the person who always boiled water to drink were only 8.3%. The person who had not toilet in their house were 67.3% and the lower group in sanitational status which had been estimated by interviewers were 61.8%. 3. The prevalence rate of illness during the last one month were 8.6% and the chronic were 26.1% and the acute were 72.5%. The distribution of sickness symptom were headache, fever and joint pain in order and the person who took no medical treatment among the sick were 37.0%. The patterns of medical utilization were public health center, hospital and pharmacy in order. 4. Illness prevalence was significantly related to sex, age, merital status and educational experience. The residents who were women, 40 years old or more, married and had not educational experience were apt to take illness. 5. Medical utilization was significantly related to educational experience, job, distance from home to medical facilities and economic status. The person who had educational experience, were officer workers or merchants, lived near by medical facilities and had higher economic status took medical treatment very well.

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Trends in Domestic and International Clinical Research of Craniosacral Therapy: Scoping Review (두개천골요법의 국내외 임상 연구 동향: 스코핑 리뷰)

  • Kwak, Min-Jae;Han, Yun-Hee;Geum, Ji-Hye;Park, Shin-Hyeok;Woo, Hyeon-Jun;Ha, Won-Bae;Lee, Jung-Han
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.3
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    • pp.13-27
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    • 2022
  • Objectives This study investigated the trends in domestic and international clinical research in craniosacral therapy, classified as a type of Chuna manual therapy, and suggested further directions in Korean medicine. Methods This scoping review was performed using the Arksey and O'Malley methodological framework and preferred reporting items as per the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews checklist. Eight electronic databases (PubMed, EMBASE, Cochrane Library, Koreanstudies Information Service System [KISS], KMBASE, Oriental Medicine Advanced Searching Integrated System [OASIS], Research Information Sharing Service [RISS], ScienceON) were searched to identify articles with the search terms "craniosacral therapy" and "cranial osteopathy" until December 2021. Results Forty-five studies were eligible as per our inclusion criteria. Most research studies (n=44) were conducted in the field of medicine and pharmacy, especially in rehabilitation medicine (n=16). As a result of the study design, randomized controlled trials (n=20) were the most common, and chronic pain (n=9) was the most frequently targeted disease, followed by headache (n=7). Thirty-two studies suggested interventions and 20 studies used Upledger's 10-step protocol. The average duration of craniosacral therapy was 41 min per session, administered 1.4 times per week. Outcome measurements were analyzed and categorized with the examination procedure for the patient. Conclusions This is the first scoping review of craniosacral therapy in Korea, and we believe that our findings could support its utility as Chuna. In the future, more studies should be conducted to establish the evidence of clinical efficacy of craniosacral therapy and develop standard techniques in Korean medicine.

Performance of Occupational Health Services by Type of Service : Cost Benefit Analysis (사업장 보건관리 사업의 형태별 수행성과 분석 -비용편익 분석을 중심으로-)

  • Cho, Tong Ran;Kim, Hwa Joong
    • Korean Journal of Occupational Health Nursing
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    • v.4
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    • pp.5-29
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    • 1995
  • Occupational health services in Korea have been operated as dual types : one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job performance shape and efficiency, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area ; 154 places (39.4%) managed by designated health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares that have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation and B/C ratio using SPSS PC program. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. Most of the expense for environmental control of all health care services expenditures shows that there is almost no fundamental improvement because more expenses are needed for procuring personal protective equipment and measuring work environment instead of environmental improvement. 3. It is investigated how much the cost of occupational health care services needs per worker, and calculated how much the cost needs per service hour per worker. The results from this show that the cost of occupational health services at workplaces with their own managers used less than the cost of health care agencies, eventually the former gives better services with less cost than the latter. 4. Benefit/Cost ratio is also produced by total benefit/total cost. The result from the above way reads 4.57 as a whole, while their own manager having workplaces reads 4.82 and the agencies do l.56. Even if their own manager performing workplaces spent more cost, this system produces more benefit than the agencies management. 5. The B/C ratio for medical organization such as local clinic, health care center and pharmacy shows more than or equal to at the workplaces controlled by the agencies. It is inferred that benefit would be much less than the cost used, with so being inefficient. 6. It is assumed that the efficiency ratio of health education is equal to reduction rate of workers medical organization visit. Estimated reduction rate 5%, 10%, 15%, show that the efficiency ratio of health education have an effect on producing benefits. It is estimated that more benefit can be produced if more qualitative education will be provided for enhancing health care efficiency. 7. Results of this study cannot be generalized because there are large scale of deviation in case of workplaces with less than 300 full time workers, but B/C ratio reads 2.69 as a whole and 3.25 at workplaces with their own health care manager are higher than 1.63 at the workplaces manged by the agencies. Finally, all the benefit concerning health care services could not be quantified, measured and shown on the value of money. This is a reason that a considerable part of benefits are so underestimated. This is also thought that measurement tools should be developed for measuring benefits of health care services with a comprehensive quantification. in the future. It is also expected that efficiency of occupational health care services should be investigated using cost-effectiveness analysis.

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Simultaneous Characterization of Sofalcone and Its Metabolite in Human Plasma by Liquid Chromatography -Tandem Mass Spectrometry

  • Han, Sang-Beom;Jang, Moon-Sun;Lee, Hee-Joo;Lee, Ye-Rie;Yu, Chong-Woo;Lee, Kyung-Ryul;Kim, Ho-Hyun
    • Bulletin of the Korean Chemical Society
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    • v.26 no.5
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    • pp.729-734
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    • 2005
  • A sensitive and selective method for quantitation of sofalcone and its active metabolite in human plasma has been established using liquid chromatography-electrospray ionization tandem mass spectrometry (LC-ESI/MS/MS). Plasma samples were transferred into 96-well plate using an automated sample handling system and spiked with 10 $\mu$L of 2 $\mu$g/mL $d_3$-sofalcone and $d_3$-sofalcone metabolite solutions (internal standard), respectively. After adding 0.5 mL of acetonitrile to the 96-well plate, the plasma samples were then vortexed for 30 sec. After centrifugation, the supernatant was transferred into another 96-well plate and completely evaporated at 40 ${^{\circ}C}$ under a stream of nitrogen. Dry residues were reconstituted with mobile phase and were injected into a $C_{18}$ reversed-phase column. The limit of quantitation of sofalcone and its metabolite was 2 ng/mL, using a sample volume of 0.2 mL for analysis. The reproducibility of the method was evaluated by analyzing 10 replicates over the concentration range of 2 ng/mL to 1000 ng/mL. The validation experiments of the method have shown that the assay has good precision and accuracy. Sofalcone and its metabolite produced a protonated precursor ion ([M+H]$^+$) of m/z 451 and 453, and a corresponding product ion of m/z 315 and 317, respectively. Internal standard ($d_3$-sofalcone and $d_3$-sofalcone metabolite) produced a protonated precursor ion ([M+H]$^+$) of m/z 454 and 456 and a corresponding product ion of m/z 315 and 317, respectively. The method has been successfully applied to a pharmacokinetic study of sofalcone and its active metabolite in human plasma.

A Basie Community Health Survey in Rural Korea (Soyang-Myun) (소양면 지역사회 환경기초조사)

  • Choi, Sung-Yul
    • Journal of Preventive Medicine and Public Health
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    • v.6 no.1
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    • pp.133-160
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    • 1973
  • 1. Introduction Community medicine with the concept of comprehensive medical care and an ideal medical care delivery system not only for an individual or family but for the whole community has emerged. In April 1970, the Presbyterian Medical Center started a hospital based community health service project in order to improve the health of the people in rural areas. Prior to commencing a comprehensive medical care system, a family survey was needed. The major objective of this survey was to obtain information concerning the people and their environment so as to be able to plan and implement a comprehensive medical care program in Soyang-Myun. 2. Survey Method An interview using a family record form was carried out for each household. This family record form was designed to get information about demography, family planning, environmental sanitation and vital statistics. Prior to beginning, the members of the survey team were trained in interviewing techniques for three days. The team consisted of a public health nurse, four nurse-aides, a sanitarian and four health extension workers who are working in our project, The survey was carried out during the period November 1971 to March 1972. 3. Project area 1) Population of Soyang-Myun was 11,668; male, 5,962 and female, 5,706. Sex ratio: 104.5. 2) Households : 1,858 3) Family size: The average household consisted of 6.3 persons. 4) Educational level of householder a. Illiterate 13% b. No schooling but able to read 10% c. Preschool children 19% d. Primary school 47% e. Middle school 7% f. High school 3% g. College or University 1% 5) Occupational distribution of householders a. Farmer 67% b. Laborer 13% c. Office worker 4% d. Merchant 4% e. Industrial worker 2% f. Unemployed 8% g. Miscellaneous 2% 6) Religious affiliation a. No religion 74% b. Buddhist 12% c. Protestant 10% d. Catholic 4% 4. Survey results Living Environment : a. Home ownership 95% b. Kinds of roofing Straw-thatched house 84% Tile-roofed house 10% Slate-roofed house 5% Other 1% c. Floor space Less than 6 pyong 10% 6-10 pyong 53% 11-15 pyong 24% 16-20 pyong 9% More than 20 pyong 4% d. Radio ownership 80% Environmental Sanitation : a. the source of drinking water public well 49% private well 30% drainage water 9% steam water 8% well pump 3% water distribution system 1% b. Distance between well and toilet more than 16meters 38% 6-10 meter 31% 11-15 meters 14% Less than 6 meters 17% c. The status of well management Bad 72% Fair 26% Good 2% d. General sanitary state of house Bad 37% Fair 51% Good 12% e. House drainage system had no house drainage. 77% Family Planning : a. 24% of the people have used contraceptives, but 12% ceased to use them. 76% have never used contraceptives. b. used methods 1oop 68% oral pill 16% vasectomy 4% condom 1% tubal ligation 1% two or more methods 10% Maternal Health : a. The number of conceptions of housewives under 50 years of age. 11 times 26% 6 times 11% 5 times 11% 4 times 9% b. The place of delivery own house 88% hospital 1% others 11% Treatment of general sickness : a. The place of treatment Soyang Health Center 31% Hospital (private or otherwise) 26% Pharmacy 14% Herb medicine 5% Private care 5% No treatment 12% Miscellaneous 7% b. Usual causes of diseases Unknown 46% Tuberculosis 29% Neuralgia 8% CVA 3% Bronchitis 3% Others 11%

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Anti-proliferative Effects of Acid Extract of Gracilaria Verrucosa on Primary Human Prostate Cancer Cells (꼬시래기 산추출물의 primary 인체 전립선 암세포 증식억제 효과)

  • Hong, Seong-Min;Cho, Hyun-Dong;Kim, Jeong-Ho;Lee, Ju-Hye;Song, Woo-Si;Lee, Sung-Tae;Lee, Mi-Kyung;Seo, Kwon-Il
    • Journal of Life Science
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    • v.26 no.10
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    • pp.1130-1136
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    • 2016
  • The purpose of this study was to investigate the anti-proliferative and apoptotic effects of acid extract of Gracilaria verrucosa (AEG) on RC-58T/h/SA#4 primary human prostate cancer cells. AEG significantly decreased the cell viability of prostate cancer cells in a dose-dependent manner. AEG also showed relatively low cytotoxicity on normal cell (RWPE-1). The morphology of prostate cancer cells treated with AEG was distorted to shrunken cell masses. In addition, it was revealed that AEG induced cell death as evidenced by increased formation of apoptotic body and nuclear condensation. Furthermore, AEG clearly modulated the down regulation of Bcl-2 (anti-apoptotic)/Bax (pro-apoptotic) family and activated caspase-3 as an effector caspase in a dose-dependent manner. AEG inhibited cell proliferation induced by environmental hormones as a bisphenol A in a dose-dependent manner. These results indicate that AEG act as anti-proliferative effects as a potential therapeutic agent on primary human prostate cancer cells.

Physiological Function and Development of Beverage from Grifola frondosa (잎새버섯 추출물의 생리 기능 및 음료 제조)

  • Lee, Jae-Sung;Lee, Jong-Suk
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.36 no.10
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    • pp.1241-1247
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    • 2007
  • Contents of polyphenol compounds and the physiological activity of extracts from Grifola frondosa by water and methanol extraction were investigated to determine their functional effects. A functional beverage was developed using the extracts. The yield and phenolic compounds content of the water extracts were highest (49.2% and 327 mg/100 g, respectively), while for the methanol extraction method they were 28.7% and 130 mg/100 g, respectively. DPPH (1,1-diphenyl-2-picrylhydrazyl) radical scavenging activity was 76.3% for the water extract and 65.4% for methanol extract, whereas the superoxide dismutase (SOD)-like activity was low ($26.3{\sim}36.8%\;at\;1,000{\mu}g/mL$ concentration) Angiotensin converting enzyme (ACE) inhibitory effect of water extract (75.1%) was higher compared to the methanol extracts (41.2%). Tyrosinase inhibition activity was 42.5% for the water extracts and 31.8% for the methanol extracts at $1,000{\mu}g/mL$ concentration. The most acceptable formulation for G. frondosa beverage developed was 0.5% G. frondosa water extract, 8.0% oligosaccharide, 2.0% green tea extract, 2.0% jujube extract, 1.0% Solomon's seal extract, 0.01% vitamin C, and 2.0% apple extract. The final product had 9.8 Brix and color values of L, 35.2+1.1; a, 3.2+0.2; b, 13.6+0.3.