CT perfusion (CTP) has been applied increasingly in research of ischemic stroke. However, in clinical practice, it is still a relatively new technology. For neurologists and radiologists, the challenge is to interpret CTP results properly in the context of the clinical presentation. In this article, we will illustrate common CTP patterns in acute ischemic stroke using a case-based approach. The aim is to get clinicians more familiar with the information provided by CTP with a view towards inspiring them to incorporate CTP in their routine imaging workup of acute stroke patients.
Cytidine Triphosphate ; Humans ; Perfusion ; Stroke

OBJECTIVE: This study was done to evaluate the correlation between carpal tunnel pressure (CTP), electrodiagnostic and ultrasonographic findings in patients with carpal tunnel syndrome (CTS). METHODS: CTP was measured during endoscopic carpal tunnel release (ECTR) for CTS using Spiegelberg ICP monitoring device with parenchymal type catheter. Neurophysiologic severity and nerve cross sectional area were evaluated using nerve conductive study and ultrasonography (USG) before ECTR in all patients. RESULTS: Tests were performed in a total of 48 wrists in 39 patients (9 cases bilateral). Maximum CTP was 56.7 +/- 19.3 mmHg (Mean +/- SD) and 7.4 +/- 3.3 mmHg before and after ECTR, respectively. No correlation was found between maximum CTP and either neurophysiologic severity or nerve cross sectional area, whereas we found a significant correlation between the latter two parameters. CONCLUSION: CTP was not correlated with neurophysiologic severity and nerve cross sectional area. Dynamic, rather than static, pressure in carpal tunnel might account for the basic pathophysiology of CTS better.
Carpal Tunnel Syndrome ; Catheters ; Cytidine Triphosphate ; Electrodiagnosis ; Humans ; Wrist

BACKGROUND: In recent years, clinical trials have considerably increased and relevant education programs to clinical trials have been developed and implemented since 2008 in Korea. To enhance the quality as well as global competitiveness of clinical trial professionals (CTPs), a certification program of the human resource is needed. Accordingly, in Korea the first and the second certification examinations were implemented in February and October 2012, respectively. In this paper, introduction of the certification program of the human resource is described, and results of the certification examinations and questionnaire survey are presented. METHODS: Data including the examination results and questionnaire survey was collected by cooperative officials in Korea National Enterprise for Clinical Trials. Applicants who were selected eligible for examination by the steering committee were asked to complete questionnaires provided with the test papers on the day of the certification examination. RESULTS: In the first certification examination, a total of 221 eligible participants completed the examination. 99.5 % of the participants responded the questionnaire survey. In the second examination, a total of 223 applicants participated. The examination consisted of 50 multiple-choice questions with cut-off score of 70 per cent score.176 & 194 CTPs passed the first & second examinations respectively. CONCLUSION: This paper that described the results of the two certification tests and questionnaire surveys might be helpful in establishment and activation of the certification program in the future. Quality improvement of CTPs and international competitiveness of clinical trial in Korea can be anticipated by the certification program.
Certification ; Cytidine Triphosphate ; Humans ; Korea ; Quality Improvement ; Surveys and Questionnaires ; Silanes

BACKGROUND: In recent years, clinical trials have considerably increased and relevant education programs to clinical trials have been developed and implemented since 2008 in Korea. To enhance the quality as well as global competitiveness of clinical trial professionals (CTPs), a certification program of the human resource is needed. Accordingly, in Korea the first and the second certification examinations were implemented in February and October 2012, respectively. In this paper, introduction of the certification program of the human resource is described, and results of the certification examinations and questionnaire survey are presented. METHODS: Data including the examination results and questionnaire survey was collected by cooperative officials in Korea National Enterprise for Clinical Trials. Applicants who were selected eligible for examination by the steering committee were asked to complete questionnaires provided with the test papers on the day of the certification examination. RESULTS: In the first certification examination, a total of 221 eligible participants completed the examination. 99.5 % of the participants responded the questionnaire survey. In the second examination, a total of 223 applicants participated. The examination consisted of 50 multiple-choice questions with cut-off score of 70 per cent score.176 & 194 CTPs passed the first & second examinations respectively. CONCLUSION: This paper that described the results of the two certification tests and questionnaire surveys might be helpful in establishment and activation of the certification program in the future. Quality improvement of CTPs and international competitiveness of clinical trial in Korea can be anticipated by the certification program.
Certification ; Cytidine Triphosphate ; Humans ; Korea ; Quality Improvement ; Surveys and Questionnaires ; Silanes

BACKGROUND/AIMS: The aim of this study was to study the efficacy and safety of zolpidem for sleep disturbances in patients with cirrhosis. METHODS: Fifty-two Child-Turcotte-Pugh (CTP) class A or B cirrhotics with Pittsburgh Sleep Quality Index >5 were randomized to either zolpidem 5 mg daily (n=26) or placebo (n=26) for 4 weeks. RESULTS: The therapy of 4 weeks was completed by 23 patients receiving zolpidem (3 stopped treatment due to excessive daytime drowsiness) and 24 receiving placebo (2 refused to continue the study). In the zolpidem group, after 4 weeks of therapy, there was significant increase in total sleep time (TST) and sleep efficiency compared to baseline and improvement in polysomnographic parameters of sleep initiation and maintenance (i.e., decrease in sleep latency time, decrease in wake time, and decreases in number of arousals and periodic limbs movements per hour of sleep), without any significant change in sleep architecture. CONCLUSIONS: Four weeks of 5 mg daily zolpidem in CTP class A or B cirrhosis patients with insomnia led to significant increases in TST and sleep efficiency and improvement in polysomnographic parameters of sleep initiation and maintenance without any significant change in sleep architecture.
Arousal ; Cytidine Triphosphate ; Extremities ; Fibrosis ; Humans ; Sleep Initiation and Maintenance Disorders

Carpal tunnel syndrome(CTS), the most common compressive neuropathy, is usually diagnosed by clinical features and nerve conduction test(NCS). However, NCS might show no abnormal finding. Ultrasonography(USG), known as helpful adjunctive in diagnosis of CTS, also might show false negative finding. A 33-year-old woman presented with complaints of pain and numbness in median nerve area on her right hand for 4 years. Despite typical clinical features of CTS, neither NCS nor USG showed abnormal finding. Because of persistent symptom, without significant improvement on conservative management, endoscopic carpal tunnel release(ECTR) was performed with carpal tunnel pressure(CTP) measurement. The measured CTP was 27.9mmHg before ECRT, which was reduced to 5.9mmHg after operation. The pain and numbness subsided after operation. Our case showed the usefulness of CTP measurement in diagnosis of CTS. The measurement of CTP might be an important diagnosis modality for some patients having CTS, especially in cases without definitive findings in NCS and USG.
Adult ; Carpal Tunnel Syndrome ; Cytidine Triphosphate ; Electromyography ; Female ; Hand ; Humans ; Hypesthesia ; Median Nerve ; Neural Conduction

Backgrouad & Aims: Cyclophosphamide, adriamycin and cisplatin(CAP) combination chemo- therapy improved the response rate in the treatment of advanced epithelial ovarian cancer, and it has been the gold standard. However, adriamycin is a rather toxic drug, and there is still confusion concerning the choice of adriamycin to be included in optimal regimen. The present study was designed to compare the activity and toxicity of combination regimens in advanced epithelial ovarian cancer between CAP and CTP which substitutes adriamycin with pirarubicin(THP- adriamycin). PATIENTS AND METHODS: From March 1995 to December 1997, 47 patients with FIGO stage III-IV epithelial ovarian cancer who were diagnosed after initial cytoreductive surgery were divided into two groups at random: (1) The case group were treated with CTP(500/40/50 mg/m2) as a first line chemotherapy. (2) The control group were treated with CAP(500/50/50 mg/m2) as that of case group. Clinical characteristics, response rates and toxicities according to Gynecologic Oncology Group criteria were compared between those treated with CAP and CTP respectively. RESULTS: Forty one patients out of 47 were evaluable and the number of patients in case and control group was 22 and 19 respectively. There was no significant differences in patient characteristics such as age, stage, histologic type between two groups. Clinical complete response rate was 50.0%(11/22) in patients treated with CTP regimen and 47.4%(9/19) with CAP regimen and there was no significant difference between two groups. Second look operation was undergone in 10 patients of CTP group and 7 patients of CAP group who showed clinical complete response and the pathologic complete response rate was 27.3%(6/22) with CTP and 21.1%(4/19) with CAP. The incidence of leukocytopenia of grade 3 or 4 was more frequently occurred in CAP group(52.6%, 10/19) than CTP group(22.7%, 5/22). There was no significant difference in the incidence of other toxicitied such as hepatic, renal and G-I toxicities. Suspicious cardiac toxicity according to the finding of EKG was seen in 15.8%(3/19) only with CAP regimen and all of them showed decreased cardiac function in gated blood pool scan. There were no significant differences in risponse rates between two groups, but the incidence of cardiac toxicity and leukocytopenia o f grade 3 or 4 was more frequently occurred in CAP group than CTP group. CONCLUSION : CTP regimen has comparable response rates to CAP regimen, with lower incidence of hematolohic and cardiac toxicity.
Cyclophosphamide* ; Cytidine Triphosphate ; Doxorubicin* ; Drug Therapy ; Drug Therapy, Combination* ; Electrocardiography ; Humans ; Incidence ; Leukopenia ; Ovarian Neoplasms*

BACKGROUND: There is a lack of research on the status of clinical trial pharmacy and clinical trial pharmacist (CTP) in Korea. This study was aimed to investigate the current status of clinical trial pharmacy and clinical trial pharmacists. METHODS: The survey was performed using the 41-item questionnaire designed to investigate information on the following; (1) current status of clinical trial pharmacy designated by Korea Food and Drug Administration, (2) current status of working condition, management, and satisfaction index of CTP. Data collected was analyzed by t-test and chi2. RESULTS: Among the CTPs who responded, 92.7% belonged to department of pharmacy, and 7.3% to clinical trial center. 90.2% of the respondents were women. Forty-two point seven percents of the respondents had more than 3 years of experience in the clinical trial field. 36.6% answered that the current number of CTPs in the institution was '2'. Sixty-three point four percents answered that they subsumed an additional post. Regarding the question on "whether the equipment and working environment of your clinical trials pharmacy is adequate", 65.1% of the respondents answered as 'Inadequate'. Ninety-eight point eight percents answered that work-related education is needed. Ninety-three point nine percents answered that the quality of clinical trials is related to the improvement of the working environment of CTP. CONCLUSION: Clinical trial pharmacy's facility and number of actually working CTP were insufficient. Proper and continuous education and training for CTPs are needed to improve the quality of clinical trials conducted in Korea, with strong institution support and timely regulation change.
Cytidine Triphosphate ; Surveys and Questionnaires ; Female ; Humans ; Korea ; Pharmacists ; Pharmacy ; Silanes ; United States Food and Drug Administration

BACKGROUND AND PURPOSE: Collateral status is an important factor determining outcome in acute ischemic stroke (AIS). Hence, different collateral scoring systems have been introduced. We applied different scoring systems on single- and multi-phase computed tomography (CT) angiography (spCTA and mpCTA) and compared them to CT perfusion (CTP) parameters to identify the best method for collateral evaluation in patients with AIS. METHODS: A total of 102 patients with AIS due to large vessel occlusion in the anterior circulation who underwent multimodal CT imaging and who were treated endovascularly were included. Collateral status was assessed on spCTA and mpCTA using four different scoring systems and compared to CTP parameters. Logistic regression was performed for predicting favorable outcome. RESULTS: All collateral scores correlated well with each other and with CTP parameters. Comparison of collateral scores stratified by extent of perfusion deficit showed relevant differences between groups (P < 0.01 for each). An spCTA collateral score discriminated best between favorable and unfavorable outcome as determined using the modified Rankin Scale 3 months after stroke. CONCLUSIONS: Collateral status evaluated on spCTA may suffice for outcome prediction and decision making in AIS patients, potentially obviating further imaging modalities like mpCTA or CTP.
Angiography* ; Collateral Circulation ; Cytidine Triphosphate ; Decision Making ; Humans ; Logistic Models ; Methods ; Perfusion* ; Stroke* ; Treatment Outcome

OBJECTIVE: To explore the feasibility of preparing compound tablets for the treatment of hypertension by fused deposition modeling (FDM) 3D printing technology and to evaluate the quality of the printed compound tablets in vitro. METHODS: Polyvinyl alcohol (PVA) filaments were used as the exci-pient to prepare the shell of tablet. The ellipse-shaped tablets (the length of major axes of ellipse was 20 mm, the length of the minor axes of ellipse was 10 mm, the height of tablet was 5 mm) with two separate compartments were designed and printed using FDM 3D printer. The height of layer was 0.2 mm, and the thickness of roof or floor was 0.6 mm. The thickness of shell was 1.2 mm, and the thickness of the partition wall between the two compartments was 0.6 mm. Two cardiovascular drugs, captopril (CTP) and hydrochlorothiazide (HCT), were selected as model drugs for the printed compound tablet and filled in the two compartments of the tablet, respectively. The microscopic morphology of the tablets was observed by scanning electron microscopy (SEM). The weight variation of the tablets was investigated by electronic scale. The hardness of the tablets was measured by a single-column mechanical test system. The contents of the drugs in the tablets were determined by high performance liquid chromatography (HPLC), and the dissolution apparatus was used to measure the in vitro drug release of the tablets. RESULTS: The prepared FDM 3D printed compound tablets were all in good shape without printing defects. The average weight of the tablets was (644.3±6.55) mg. The content of CTP and HCT was separately (52.3±0.26) mg and (49.6±0.74) mg. A delayed in vitro release profile was observed for CTP and HCT, and the delayed release time for CTP and HCT in vitro was 20 min and 40 min, respectively. The time for 70% of CTP and HCT released was separately 30 min and 60 min. CONCLUSION CTP and HCT compound tablets were successfully prepared by FDM 3D printing technology, and the printed tablets were of good qualities.
Captopril ; Cytidine Triphosphate ; Drug Liberation ; Hydrochlorothiazide ; Printing, Three-Dimensional ; Tablets/chemistry* ; Technology, Pharmaceutical/methods*