beta-Lapachone has drawn increasing attention as an anti-inflammatory and anti-cancer drug. However, its oral bioavailability has not been yet assessed, which might be useful to develop efficient dosage forms possibly required for non-clinical and clinical studies and future market. The aim of the present study was thus to investigate pharmacokinetic properties of beta-lapachone as well as its first-pass metabolism in the liver, and small and large intestines after oral administration to measure the absolute bioavailability in rats. A sensitive HPLC method was developed to evaluate levels of beta-lapachone in plasma and organ homogenates. The drug degradation profiles were examined in plasma to assess the stability of the drug and in liver and intestinal homogenates to evaluate first-pass metabolism. Pharmacokinetic profiles were obtained after oral and intravenous administration of beta-lapachone at doses of 40 mg/kg and 1.5 mg/kg, respectively. The measured oral bioavailability of beta-lapachone was 15.5%. The considerable degradation of beta-lapachone was seen in the organ homogenates but the drug was quite stable in plasma. In conclusion, we suggest that the fairly low oral bioavailability of beta-lapachone may be resulted from the first-pass metabolic degradation of beta-lapachone in the liver, small and large intestinal tracts and its low aqueous solubility.
Administration, Intravenous ; Administration, Oral ; Animals ; Biological Availability* ; Chromatography, High Pressure Liquid ; Dosage Forms ; Intestines ; Liver ; Metabolism* ; Pharmacokinetics ; Plasma ; Rats* ; Solubility

BACKGROUND: Hydrofluoric acid_(HF) is widely used in many industrial and domestic settings such as etching glass, and polishing metals. HF is one of the most corrosive inorganic acids and can produce progressive and serious tissue necrosis with severe pain. Since HF chemical burns can be asymptomatic for the first few hours, it is crucial to understand its toxicity and the early use of antidote. CASE: A 37-year-old man presented with erythematous lesion and pain on his face, anterior neck, both forearms, both thighs, and left ankle after injury resulting from a chemical burn caused by HF. He showed normal vital signs and dyspnea, but complained of a sore throat. Liquid form of HF had splashed on his face and anterior neck first and run down his forearms and thighs while working at HF supply tanks. Some of the HF was splashed into his mouth. He immediately removed his clothes and showered with abundant water. A 4.5% calcium gluconate jel was applied to the involved area. He was given subcutaneous injection of 10% calcium gluconate solution. During 17 days of admission he didn't show any signs of systemic intoxication or deep tissue defects. CONCLUSIONS: Immediate cleansing of the affected area with running cold water is the first critical treatment for a chemical burn due to HF. Applying calcium gluconate gel within one hour was very effective for preventing further damage to the injured area as well as systemic injury. In order to reduce the risk of accident and perform first-aid treatment quickly, it is imperative to provide workers with safety education and establish safety facilities.
Adult ; Animals ; Ankle ; Burns, Chemical ; Calcium Gluconate ; Cold Temperature ; Dyspnea ; Forearm ; Glass ; Gluconates ; Humans ; Hydrofluoric Acid ; Injections, Subcutaneous ; Metals ; Mouth ; Neck ; Necrosis ; Pharyngitis ; Running ; Thigh ; Vital Signs ; Water

Purpose: Intensive cytotoxic chemotherapy increases the risk of infection in patients with cancer by inducing bone marrow suppression and mucosal injury. Febrile neutropenia (FN) is the most important clinical adverse event in patients with cancer receiving cytotoxic chemotherapy. To prevent FN, standard precautions including hand and respiratory hygiene are generally recommended, but the exact effect of non-pharmacologic intervention has not been clearly proven in the clinical setting. We aimed to compare the incidence of FN between the pre-coronavirus disease 19 (COVID-19) era vs. the postCOVID-19 era. Methods: We retrospectively enrolled patients with breast cancer who received an adriamycin and cyclophosphamide (AC) regimen containing adjuvant chemotherapy at Jeju National University Hospital. We compared the incidence of FN between the pre- and post-COVID-19 period and analyzed characteristics of the event and other clinical risk factors. Results: In total, 149 patients were enrolled, including 94 who received AC chemotherapy in the pre-COVID-19 era and 55 who received it in the post-COVID-19 era. Sixteen patients (10.7%) experienced FN. Fourteen (14.9%) and 2 events (3.6%) occurred in pre-COVID-19 and post-COVID-19 eras, respectively. The post-COVID-19 era was the only risk factor for FN (P = 0.032). Conclusion We found an association between FN occurrence and the COVID-19 outbreak, providing indirect evidence of the importance of non-pharmacological measures to reduce FN risk in patients with breast cancer. Further research is required to confirm the standard precautions for FN prevention in patients with cancer.

Purpose: Intensive cytotoxic chemotherapy increases the risk of infection in patients with cancer by inducing bone marrow suppression and mucosal injury. Febrile neutropenia (FN) is the most important clinical adverse event in patients with cancer receiving cytotoxic chemotherapy. To prevent FN, standard precautions including hand and respiratory hygiene are generally recommended, but the exact effect of non-pharmacologic intervention has not been clearly proven in the clinical setting. We aimed to compare the incidence of FN between the pre-coronavirus disease 19 (COVID-19) era vs. the postCOVID-19 era. Methods: We retrospectively enrolled patients with breast cancer who received an adriamycin and cyclophosphamide (AC) regimen containing adjuvant chemotherapy at Jeju National University Hospital. We compared the incidence of FN between the pre- and post-COVID-19 period and analyzed characteristics of the event and other clinical risk factors. Results: In total, 149 patients were enrolled, including 94 who received AC chemotherapy in the pre-COVID-19 era and 55 who received it in the post-COVID-19 era. Sixteen patients (10.7%) experienced FN. Fourteen (14.9%) and 2 events (3.6%) occurred in pre-COVID-19 and post-COVID-19 eras, respectively. The post-COVID-19 era was the only risk factor for FN (P = 0.032). Conclusion We found an association between FN occurrence and the COVID-19 outbreak, providing indirect evidence of the importance of non-pharmacological measures to reduce FN risk in patients with breast cancer. Further research is required to confirm the standard precautions for FN prevention in patients with cancer.

Purpose: Intensive cytotoxic chemotherapy increases the risk of infection in patients with cancer by inducing bone marrow suppression and mucosal injury. Febrile neutropenia (FN) is the most important clinical adverse event in patients with cancer receiving cytotoxic chemotherapy. To prevent FN, standard precautions including hand and respiratory hygiene are generally recommended, but the exact effect of non-pharmacologic intervention has not been clearly proven in the clinical setting. We aimed to compare the incidence of FN between the pre-coronavirus disease 19 (COVID-19) era vs. the postCOVID-19 era. Methods: We retrospectively enrolled patients with breast cancer who received an adriamycin and cyclophosphamide (AC) regimen containing adjuvant chemotherapy at Jeju National University Hospital. We compared the incidence of FN between the pre- and post-COVID-19 period and analyzed characteristics of the event and other clinical risk factors. Results: In total, 149 patients were enrolled, including 94 who received AC chemotherapy in the pre-COVID-19 era and 55 who received it in the post-COVID-19 era. Sixteen patients (10.7%) experienced FN. Fourteen (14.9%) and 2 events (3.6%) occurred in pre-COVID-19 and post-COVID-19 eras, respectively. The post-COVID-19 era was the only risk factor for FN (P = 0.032). Conclusion We found an association between FN occurrence and the COVID-19 outbreak, providing indirect evidence of the importance of non-pharmacological measures to reduce FN risk in patients with breast cancer. Further research is required to confirm the standard precautions for FN prevention in patients with cancer.

Purpose: Intensive cytotoxic chemotherapy increases the risk of infection in patients with cancer by inducing bone marrow suppression and mucosal injury. Febrile neutropenia (FN) is the most important clinical adverse event in patients with cancer receiving cytotoxic chemotherapy. To prevent FN, standard precautions including hand and respiratory hygiene are generally recommended, but the exact effect of non-pharmacologic intervention has not been clearly proven in the clinical setting. We aimed to compare the incidence of FN between the pre-coronavirus disease 19 (COVID-19) era vs. the postCOVID-19 era. Methods: We retrospectively enrolled patients with breast cancer who received an adriamycin and cyclophosphamide (AC) regimen containing adjuvant chemotherapy at Jeju National University Hospital. We compared the incidence of FN between the pre- and post-COVID-19 period and analyzed characteristics of the event and other clinical risk factors. Results: In total, 149 patients were enrolled, including 94 who received AC chemotherapy in the pre-COVID-19 era and 55 who received it in the post-COVID-19 era. Sixteen patients (10.7%) experienced FN. Fourteen (14.9%) and 2 events (3.6%) occurred in pre-COVID-19 and post-COVID-19 eras, respectively. The post-COVID-19 era was the only risk factor for FN (P = 0.032). Conclusion We found an association between FN occurrence and the COVID-19 outbreak, providing indirect evidence of the importance of non-pharmacological measures to reduce FN risk in patients with breast cancer. Further research is required to confirm the standard precautions for FN prevention in patients with cancer.

PURPOSE: Onyx has been successfully applied in the treatment of various neurovascular lesions. However, some experience is required to get accustomed to its unpredictable fluoroscopic visibility during injection. This in vitro study aimed to evaluate the characteristics of radiopacity change in a simulated embolization procedure. MATERIALS AND METHODS: Using a bench-top Onyx injection experiment simulating a typical brain arteriovenous malformation embolization, nine cycles of casting modes (continuous injection) and plugging modes (injection with intermittent pauses) were performed. Radiodensity of Onyx droplets collected from the microcatheter tip and the distal head portion of the microcatheter were measured as time lapsed. Distribution of droplet radiodensity (radiodensity) and distribution of radiographic grade (grade) were analyzed and compared by repeated measurements. RESULTS: Within-group analysis revealed no significant radiodensity change with time (P>0.05). The radiodensity was significantly higher in the casting mode than in the plugging mode (P<0.01). The lateral radiograph of the microcatheter showed higher radiopacity (P<0.01) and better evenness (P<0.01) in the casting mode than in the plugging mode. A significant difference in microcatheter attenuation (both radiographic grade mean and SD; P<0.01) was noted between the two modes. Radiodensity had a significant influence on the radiopacity and radiopacity evenness of the microcatheter. CONCLUSION: The radiopacity of the Onyx can vary significantly over time because of early precipitation of tantalum powder. Radiopacity decreased significantly during plugging modes, characterized by pauses between injections.
Arteriovenous Malformations ; Brain ; Head ; In Vitro Techniques* ; Tantalum

Objective: Although fluid resuscitation is the cornerstone of treatment for sepsis, the role of body water status in sepsis is poorly understood. This study aimed to understand how body water and its distribution are modified in patients with sepsis and those with non-septic infection compared to healthy individuals. Methods: Two groups of adults presumed to have non-septic infection (n=87) and sepsis (n=54) were enrolled in this prospective study in a single emergency department, and they were compared to sex-, age-, and height-matched (1:3 ratio) healthy controls (n=11,190) from retrospective data in a health promotion center. Total body water (TBW), intracellular water (ICW), and extracellular water (ECW), determined using direct segmental multi-frequent bioelectrical impedance analysis (InBody S10) were expressed as indices for normalization by body weight (BW). The ratio of ECW to TBW (ECW/TBW) was evaluated to determine body water distribution. Results: TBW/BW, ICW/BW, and ECW/BW were significantly higher in the non-septic infection group than in the healthy group (P<0.001), but ECW/TBW was not significantly different (P=0.690). There were no differences in TBW/BW and ICW/BW between the sepsis and healthy groups (P=0.083 and P=0.963). However, ECW/BW and ECW/TBW were significantly higher in the sepsis group than in the healthy group (P<0.001). Conclusion Compared to the healthy group, the ratio of body water to BW was significantly increased in the non-septic infection group, while ECW/BW and ECW/TBW were significantly increased in the sepsis group. These indices could be utilized as diagnostic variables of body water deficit in septic patients.

Purpose: The obesity prevention and management program led by public health centers are important in the community.This study aims to identify the current status of obesity prevention and management programs at public health centers and perceptions regarding facilitators and barriers when implementing programs. Methods: This study used a concurrent mixed methods design. A survey was conducted to investigate the current status and infrastructure of the obesity prevention and management program at eighty-three public health centers nationwide. Nine program managers and six local residents with experience in the program were interviewed by using a semi-structured questionnaires. Results Most of the infrastructure facilities for the program were inadequate, and insufficient budgets and lack of professional staff were identified as barriers. Facilitators included diversification of program delivery methods, operator competence, and visible outcomes and rewards. For the effectiveness of the program, it is vital to have adequate assistants, a sufficient budget, various promotional methods, and connections with various institutions in the community. On this basis, it is acknowledged that the public health center serves as a platform for preventing and managing obesity in the community. Conclusion: It is expected that infrastructure improvements in public health centers and the link with community resources are needed. In addition, there is an urgent need to set standards for obesity prevention and management programs implemented in public health centers to ‘resolve regional disparities’.

OBJECTIVE: A widely applicable, non-invasive screening method for non-alcoholic fatty liver disease (NAFLD) is needed. We aimed to develop and validate an index combining computed tomography (CT) and routine clinical data for screening for NAFLD in a large cohort of adults with pathologically proven NAFLD.MATERIALS AND METHODS: This retrospective study included 2218 living liver donors who had undergone liver biopsy and CT within a span of 3 days. Donors were randomized 2:1 into development and test cohorts. CT(L-S) was measured by subtracting splenic attenuation from hepatic attenuation on non-enhanced CT. Multivariable logistic regression analysis of the development cohort was utilized to develop a clinical-CT index predicting pathologically proven NAFLD. The diagnostic performance was evaluated by analyzing the areas under the receiver operating characteristic curve (AUC). The cutoffs for the clinical-CT index were determined for 90% sensitivity and 90% specificity in the development cohort, and their diagnostic performance was evaluated in the test cohort.RESULTS: The clinical-CT index included CT(L-S), body mass index, and aspartate transaminase and triglyceride concentrations. In the test cohort, the clinical-CT index (AUC, 0.81) outperformed CT(L-S) (0.74; p < 0.001) and clinical indices (0.73–0.75; p < 0.001) in diagnosing NAFLD. A cutoff of ≥ 46 had a sensitivity of 89% and a specificity of 41%, whereas a cutoff of ≥ 56.5 had a sensitivity of 57% and a specificity of 89%.CONCLUSION: The clinical-CT index is more accurate than CT(L-S) and clinical indices alone for the diagnosis of NAFLD and may be clinically useful in screening for NAFLD.