A simple, rapid and selective liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) is developed and validated for quantification of venlafaxine in human plasma with simple liquid-liquid extraction step consisted of extraction with ether and dichloromethane for 10 min and mixing with 1 M sodium acetate in human plasma using fluoxetine as an internal standard (IS). The analyte are separated using an isocratic mobile phase consisted of acetonitrile and 5 mM ammonium formate (4/3, v/v) on a isocratic YMC hydrosphere C18 (2.0x50.0 mm, 3.0 microm) column and analyzed by MS/MS in the multiple reaction monitoring (MRM) mode using the transitions of respective [M+H](+) ions, m/z 278.2-->260.3 and m/z 310.1-->148.1 for quantification of venlafaxine and IS, respectively. The standard calibration curves showed good linearity within the range of 1.0-200.0 ng/mL (r2=0.9986, 1/chi2 weighting). The lower limit of quantification (LLOQ) was 1.0 ng/mL. The retention times of venlafaxine and IS were 0.6 min and 0.7 min that means the potential for the high-throughput potential of the proposed method. In addition, no significant metabolic compounds were found to interfere with the analysis. Acceptable precision and accuracy were obtained for the concentrations over the standard curve range. The validated method was successfully applied to bioequivalence study after 75-mg of venlafaxine sustained-release (SR) capsule in 24 healthy Korean subjects.
Ammonium Compounds ; Calibration ; Chromatography, Liquid ; Ether ; Fluoxetine ; Humans ; Ions ; Liquid-Liquid Extraction ; Methylene Chloride ; Pharmacokinetics ; Plasma* ; Sodium Acetate ; Tandem Mass Spectrometry ; Therapeutic Equivalency* ; Venlafaxine Hydrochloride

OBJECTIVES: This study aimed to investigate differences in unmet dental care needs according to employment status and if factors have relevance to unmet dental care needs due to "economic burden" and "no time to spare for visiting". METHODS: Multivariate logistic regression analysis was performed to examine the factors that affected the prevalence of unmet dental care needs due to "economic burden" and "no time to spare for visiting" in an economically active population comprised of subjects aged 20-64 years. RESULTS: Compared to regular workers, part-time workers experienced 1.28-times more unmet dental care needs, while students experienced 0.64-times fewer unmet dental care needs. With regard to reasons related to "economic burden", the rate of experiencing unmet dental care needs was 1.37-times higher for part-time workers than for regular workers. Regarding reasons related to "no time to spare for visiting", the rate of experiencing unmet dental care needs was 0.51-times lower in part-time workers compared with regular workers. In economically inactive people, these values were 0.51-times lower in the unemployed, 0.37-times lower in students, 0.23-times lower in house workers, 0.20-times lower in subjects with disease and injury, and 0.20-times lower in early retirees compared to regular workers. CONCLUSIONS: Part-time workers experienced more unmet dental care needs compared with regular workers. With regard to "economic burden", a significant difference in unmet dental care needs was observed between regular workers and part-time workers. Additionally, regarding "no time to spare for visiting", people who were economically inactive because of unemployment, student or house-worker status, diseases and injury, and retirement experienced fewer unmet dental care needs compared with regular workers.
Dental Care* ; Employment* ; Humans ; Logistic Models ; Prevalence ; Retirement ; Unemployment

No abstract available.
Polyarteritis Nodosa*

No abstract available.

No abstract available.
Education ; Humans

No abstract available.
Humans ; Hypophosphatemia*

BACKGROUND: A rehabilitation hospital has the characteristics of longer hospital stay, a variety of medical and paramedical personnels involved in treatment, and more probability of the primary care giver being a nonmedical person. The purpose of this study is to describe the characteristics of nosocomial infection in a rehabilitation hospitals METHODS: Surveillance was done in a rehabilitation hospital affiliated university hospital from June to August 1996, May to June 1997, and July to September 1999. Nosocomial infection was investigated by an infection control practitioner (JCP) according to the Center for Disease Control and Prevention (CDC)'s definitions visiting the rehabilitation wards regularly. RESULTS: The overall NI rates were 3.83 in 1996, 4.42 in 1997 and 1.91 in 1999 per 1,000 patient days, and the urinary tract infection (UTI) rates were 2.82 in 1996, 2.87 in 1997 and 1.07 in 1999 per 1,000 patient days. Both of overall NI rate and UTI rate in 1999 decreased significantly compared with that in 1996 and 1997 (P<0.001). Comparing the ward specific NI rate, the average NI rate of the spinal cord injury ward was the highest (5.67 per 1,000 patient days) and that of the pediatric rehabilitation ward was the lowest (0.83 per 1,000 patient days). UTI constituted of the largest proportion of NIs. The distribution of UTI showed a decreasing tendency from 73.47% in 1996 to 56.00% in 1999, but the distribution of gastrointestinal infection showed an increasing tendency from 4.08% and 5.40% in 1997 and 1996 to 24.00% in 1999. The commonly isolated organisms were E. coli (33.63%), Enterococcus spp. (12.73%) and C. difficile (7.27%). It reflected that the main infection was UTI. CONCLUSION: The main NI in rehabilitation hospital was the UTI. It means that the infection control program of rehabilitation hospital should be focused on the control of UTI. Surveillance in the rehabilitation hospital enabled us to describe the characteristics of nosocomial infection in the rehabilitation hospital. NI rate was decreased through continuous communications and educations with factual datum and involvement of various medical and paramedical personnels. These results show that NI surveillance is crucial for an efficient infection control program.
Allied Health Personnel ; Centers for Disease Control and Prevention (U.S.) ; Cross Infection* ; Enterococcus ; Humans ; Infection Control ; Infection Control Practitioners ; Length of Stay ; Primary Health Care ; Rehabilitation* ; Spinal Cord Injuries ; Urinary Tract Infections

Milk-alkali syndrome (MAS), a triad of hypercalcemia, metabolic alkalosis, and renal failure, is associated with ingestion of large amounts of calcium and absorbable alkali. MAS is the third most common cause of hypercalcemia in hospital, after primary hyperparathyroidism and malignant neoplasm. MAS is not often reported in the Korean literature. We describe MAS secondary to intake of calcium citrate for the treatment of osteoporosis with thoracic spine compression fracture. A 70-year-old man presented to our hospital with a 1-week history of general weakness and lethargy. He was found with acute kidney injury (serum creatinine, 4.6 mg/dL), hypercalcemia (total calcium, 14.8 mg/dL), and alkalosis. Laboratory evaluation excluded both hyperparathyroidism and malignancy. Mental status and serum calcium level was normalized within a week after proper hydration and intravenous administration of furosemide. However, he developed aspiration pneumonia, pseudomembranous colitis, and sepsis with multi-organ failure. Despite intensive treatment including inotropics, mechanical ventilation, and renal replacement therapy, he expired with no signs of renal recovery on the 28th hospital day.
Acute Kidney Injury ; Administration, Intravenous ; Aged ; Alkalies ; Alkalosis ; Calcium Citrate ; Calcium* ; Creatinine ; Eating ; Enterocolitis, Pseudomembranous ; Fractures, Compression ; Furosemide ; Humans ; Hypercalcemia* ; Hyperparathyroidism ; Hyperparathyroidism, Primary ; Lethargy ; Osteoporosis ; Pneumonia, Aspiration ; Renal Insufficiency ; Renal Replacement Therapy ; Respiration, Artificial ; Sepsis ; Spine

PURPOSE: Many patients with benign prostatic hyperplasia (BPH) have storage symptoms. The aim of this study was to evaluate the effects of treatment with a 5-alpha reductase inhibitor (5ARI) on storage symptoms in patients with BPH. METHODS: This study was conducted in 738 patients with lower urinary tract symptoms secondary to BPH. Patients with a prostate volume of higher than 30 mL on the transrectal ultrasound were classified into two groups: group A, in which an alpha blocker was solely administered for at least 12 months, and group B, in which a combination treatment regimen of an alpha blocker plus 5ARI was used. This was followed by an analysis of the changes in parameters such as the total International Prostate Symptom Score (IPSS), voiding symptom subscore, and storage symptom subscore between the two groups. In addition, we examined whether there was a significant difference between the two groups in the degree of change in storage symptoms between before and after the pharmacological treatment. RESULTS: Of the 738 men, 331 had a prostate volume > or =30 mL, including 150 patients in group A and 181 patients in group B. Total IPSS, the voiding symptom subscore, and the storage symptom subscore were significantly lower after treatment than before treatment in both groups (P<0.05). A comparison of the degree of change between before and after treatment, however, showed no significant differences in the storage symptom subscore between the two groups (P>0.05). CONCLUSIONS: Alpha blocker and 5ARI combination treatment is effective for patients with BPH including storage symptoms. However, 5ARI does not exert a significant effect on storage symptoms in BPH patients.
5-alpha Reductase Inhibitors ; Humans ; Lower Urinary Tract Symptoms ; Male ; Oxidoreductases ; Prostate ; Prostatic Hyperplasia ; Urinary Bladder, Overactive

BACKGROUND/OBJECTIVES: Atherosclerosis particularly due to high circulating level of low-density lipoprotein is a major cause of cardiovascular diseases. Ellagic acid is a natural polyphenolic compound rich in pomegranates and berries. Our previous study showed that ellagic acid improved functionality of reverse cholesterol transport in murine model of atherosclerosis. The aim of this study is to investigate whether ellagic acid inhibited inflammation-associated atherosclerotic plaque formation in cholesterol-fed apolipoprotein E (apoE)-knockout (KO) mice.MATERIALS/METHODS: Wild type mice and apoE-KO mice were fed a cholesterol-rich Paigen diet for 10 weeks to induce severe atherosclerosis. Concurrently, 10 mg/kg ellagic acid was orally administered to the apoE-KO mice. Plaque lesion formation and lipid deposition were examined by staining with hematoxylin and eosin, Sudan IV and oil red O. RESULTS: The plasma leukocyte profile of cholesterol-fed mice was not altered by apoE deficiency. Oral administration of ellagic acid attenuated plaque lesion formation and lipid deposition in the aorta tree of apoE-KO mice. Ellagic acid substantially reduced plasma levels of soluble vascular cell adhesion molecule and interferon-γ in Paigen diet-fed apoE-KO mice.When 10 mg/kg ellagic acid was administered to cholesterol-fed apoE-KO mice, the levels of CD68 and MCP-1 were strongly reduced in aorta vessels. The protein expression level of nitric oxide synthase-2 (NOS2) in the aorta was highly enhanced by supplementation of ellagic acid to apoE-KO mice, but the expression level of heme oxygenase-1 (HO-1) in the aorta was reduced. Furthermore, ellagic acid diminished the increased aorta expression of the inflammatory adhesion molecules in cholesterol-fed apoE-KO mice. The treatment of ellagic acid inhibited the scavenger receptor-B1 expression in the aorta of apoE-KO mice, while the cholesterol efflux-related transporters were not significantly changed. CONCLUSION These results suggest that ellagic acid may be an atheroprotective compound by attenuating apoE deficiency-induced vascular inflammation and reducing atherosclerotic plaque lesion formation.