Integrative Medicine Focusing on Ultrasound-Guided High-Dose Shinbaro 2 Pharmacopuncture for Acute Herniated Intervertebral Discs: A Case Report.

This study aimed to investigate the effects of ultrasound-guided high-dose Shinbaro 2 pharmacopuncture on the pain, dysfunction, and quality of life in patients with low back pain and radiating pain due to an acute herniated intervertebral disc (HIVD). A 39-year-old male patient with low back pain and radiating pain caused by an acute HIVD was treated with Korean and Western integrative medicine, with a focus on ultrasound-guided high-dose Shinbaro 2 pharmacopuncture at Kambin's triangle. The treatment lasted 16 weeks, including a 12-day hospitalization. The low back pain and radiating pain were evaluated using the numeric rating scale (NRS). The lumbar function and quality of life were assessed using the Oswestry disability index (ODI) and the EuroQol five-dimension index (EQ5D). Satisfaction was gauged using the patient global impression of change (PGIC). After treatment, the NRS score decreased from 10 to 1, whereas the ODI and EQ5D scores improved from 84.44 to 28.89 and from 0.303 to 0.871, respectively. The PGIC was rated as 1, indicating considerable improvement. Notably, the changes observed during hospitalization were significant. This report suggests that ultrasound-guided high-dose Shinbaro 2 pharmacopuncture at Kambin's triangle significantly improves the pain, dysfunction, and quality of life in patients with an acute HIVD, demonstrating its potential usefulness among Korean medicine practitioners.

Determinants of wearer satisfaction factors for harnesses in upper-limb assistive wearable robots.

Wearable robots are increasingly being deployed for use in industrial fields. However, only a few studies have focused on the usability of wearable robots. The present study evaluated the factors affecting the usability of a harness in securing a wearable robot to the body because the harness directly affects the work efficiency, and thus its design and use require careful consideration. A comparative evaluation of the arrangement of the Vest Exoskeleton before and after improvements was conducted, in which participants performed a benchmark assembly task while wearing the robot. Results showed that wearability decreased after the improvements due to the additional straps and buckles used, but the overall wearing satisfaction improved as a result of increased stability. Stability and convenience were the main factors affecting the overall wearing satisfaction, while sub-indicators included wearing comfort and tactile sensation. Therefore, improvements in stability, such as those related to fixation strength and tactile sensation, had a direct positive impact on the overall wearing satisfaction.

Solution-Mediated Phase Transformation of Aripiprazole: Negating the Effect of Crystalline Forms on Dissolution and Oral Pharmacokinetics.

We aimed to evaluate the effect of crystalline forms of aripiprazole, an antipsychotic drug for schizophrenia, on the dissolution rates and oral pharmacokinetics. Solubility, intrinsic dissolution rates, and tablet dissolution rates of the monohydrate (MA) and the anhydrous form (AA) were measured in various aqueous media while monitoring the phase transformation by ATR-FTIR. And their oral pharmacokinetics in dogs were compared. The intrinsic dissolution rate of MA was lower compared to AA, confirming its thermodynamic stability relative to AA in water. Phase transformations during the solubility measurement were media-dependent: In simulated gastric fluid, both AA and MA changed to HCl salt form, whereas AA and HCl salt form transformed to MA in simulated intestinal fluid. In vitro dissolution rates and dog oral pharmacokinetics of AA and MA tablets were similar. The results suggest that the solution-mediated transformation to HCl salt or MA negates the effect of different crystalline forms on dissolution rates in vivo and, consequently, on oral pharmacokinetics. We emphasize the importance of the dissolution tests employing various bio-relevant media for better prediction of in vivo performance and the selection of a solid form for development.

The effects of acupuncture on occipital neuralgia: a systematic review and meta-analysis.

BACKGROUND: Occipital neuralgia is one of the main causes of occipital pain. This systematic review aims to assess the level of evidence in randomized controlled trials (RCTs) on the effects of acupuncture on occipital neuralgia. METHODS: We searched 11 databases and a journal archive from their inception up to December 2019 for relevant RCTs. We did not place any specific restrictions on patients diagnosed with occipital neuralgia, such as age or gender. We included studies that used an acupuncture intervention group, with or without the control group treatment, and that set a control group receiving active, interventional treatment such as medication. For outcomes, we used visual analogue scale (VAS) and effective rate. RESULTS: We included a total of 11 RCTs. All VAS scores (mean difference [MD] -2.35, 95% confidence interval [CI] -2.84, - 1.86) and effective rate values (odds ratio [OR] 4.96, 95% CI 2.24, 10.96) showed significant differences in effect between acupuncture treatment alone and the control group treatment. Similarly, combined acupuncture treatment with control group treatment also showed significant effects in effective rate (OR 6.68, 95% CI 1.11, 40.37). We performed a subgroup analysis on studies that used acupuncture only as the intervention and reported the effective rate, and found that all acupuncture subgroups showed significant effects compared to the control group treatments. None of the studies reported severe adverse effects. CONCLUSIONS: Although acupuncture only and combined acupuncture treatments showed significant effects compared to medication, the results of this study are inconclusive. Studies with rigorous study design and larger sample sizes are needed to confirm the role of acupuncture in this field. TRIAL REGISTRATION: International prospective register for systematic review (PROSPERO) number CRD42019128050.

Emodin-nicotinamide (1:2) cocrystal identified by thermal screening to improve emodin solubility.

Emodin (EM), an anthraquinone obtained from natural products, is known for many pharmacological activities. However, further evaluation and interpretation of toxicity or pharmacological activity of emodin are limited due to its poor aqueous solubility. We aimed to identify an emodin cocrystal with improved pharmaceutical properties. Among various compounds screened by thermal analysis, nicotinamide (NCT) was identified as a potential cocrystal coformer, based on the presence of an exothermal peak in DSC profiles of the physical mixture of EM and NCT. Crystallization of EM-NCT cocrystal (EM-NCT) using slow or rapid solvent evaporation method yielded a novel cocrystal at 1:2 ratio. Single crystal structure analysis revealed EM dimers and NCT tetramers connected alternatively via H-bonds to make one-dimensional chains which are joined by inter-chain H-bonds between NCT to form two-dimensional layers. The EM molecules are planar with intramolecular H-bonds between O atoms. Compared with EM, the EM-NCT cocrystal showed improved aqueous solubility, dissolution rate, and stability. Hence, EM-NCT cocrystal is proposed as a more suitable solid form for further development as pharmaceutical products.

Usage Trends of Open Access and Local Journals: A Korean Case Study.

Articles from open access and local journals are important resources for research in Korea and the usage trends of these articles are important indicators for the assessment of the current research practice. We analyzed an institutional collection of published papers from 1998 to 2014 authored by researchers from Seoul National University, and their references from papers published between 1998 and 2011. The published papers were collected from Web of Science or Scopus and were analyzed according to the proportion of articles from open access journals. Their cited references from published papers in Web of Science were analyzed according to the proportion of local (South Korean) or open access journals. The proportion of open access papers was relatively stable until 2006 (2.5 ~ 5.2% in Web of Science and 2.7 ~ 4.2% in Scopus), but then increased to 15.9% (Web of Science) or 18.5% (Scopus) in 2014. We analyzed 2,750,485 cited references from 52,295 published papers. We found that the overall proportion of cited articles from local journals was 1.8% and that for open access journals was 3.0%. Citations of open access articles have increased since 2006 to 4.1% in 2011, although the increase in open access article citations was less than for open access publications. The proportion of citations from local journals was even lower. We think that the publishing / citing mismatch is a term to describe this difference, which is an issue at Seoul National University, where the number of published papers at open access or local journals is increasing but the number of citations is not. The cause of this discrepancy is multi-factorial but the governmental / institutional policies, social / cultural issues and authors' citing behaviors will explain the mismatch. However, additional measures are also necessary, such as the development of an institutional citation database and improved search capabilities with respect to local and open access documents.

Study on user interface of pathology picture archiving and communication system.

OBJECTIVES: It is necessary to improve the pathology workflow. A workflow task analysis was performed using a pathology picture archiving and communication system (pathology PACS) in order to propose a user interface for the Pathology PACS considering user experience. METHODS: An interface analysis of the Pathology PACS in Seoul National University Hospital and a task analysis of the pathology workflow were performed by observing recorded video. Based on obtained results, a user interface for the Pathology PACS was proposed. RESULTS: Hierarchical task analysis of Pathology PACS was classified into 17 tasks including 1) pre-operation, 2) text, 3) images, 4) medical record viewer, 5) screen transition, 6) pathology identification number input, 7) admission date input, 8) diagnosis doctor, 9) diagnosis code, 10) diagnosis, 11) pathology identification number check box, 12) presence or absence of images, 13) search, 14) clear, 15) Excel save, 16) search results, and 17) re-search. And frequently used menu items were identified and schematized. CONCLUSIONS: A user interface for the Pathology PACS considering user experience could be proposed as a preliminary step, and this study may contribute to the development of medical information systems based on user experience and usability.

What do faculties need most in a faculty development program?

PURPOSE: This study examined two overarching topics: to what extent do faculties acknowledge class readiness, execution of lessons, and evaluation of the session; and what core content should be strengthened in a medical school faculty development program? METHODS: In November 2012, 37 faculties completed a detailed survey on the needs of medical school faculty development programs. The 14-item survey assessed the importance, operational frequency, difficulty in accomplishment, class readiness, execution of teaching, and evaluation of the session. RESULTS: Faculties were aware of the importance of class readiness, execution of teaching, and evaluation of the session but had a low level of accomplishment with regard to execution of the instruction and evaluation of the session. Four subitems of session evaluation were considered very important but showed low operational frequency, high difficulty in accomplishment, and low accomplishment ability. The successful discussion class item had the lowest operational frequency and accomplishment ability. The core contents that should be strengthened in medical school faculty development programs are diagnose students' class readiness (prior knowledge) (35.5%) and providing class session with suitable level/content (32.3%). CONCLUSION: Before designing faculty development programs, a needs assessment is useful in providing more tailored content for the faculty.

What kind of feedback do medical students want?

PURPOSE: Feedback in medical education is as important as developing the curriculum and choosing the right method of instruction. This study measured three overarching areas: student satisfaction rates with academic feedback, the type and helpfulness of the feedback, and the types of feedback that students want. METHODS: In December 2013, 166 students answered a student survey that consisted of 26 items. The survey asked questions on their experiences with the overall feedback that was given the previous semester, the satisfaction rate, the type of feedback that was received, the helpfulness of the feedback, and the types of feedback that were desired after examinations and learning tasks. RESULTS: Overall, 35% of the students were satisfied with the feedback that they received in the previous semester. Students wanted more systematic (61.4%) and timely feedback (30.1%). The types of feedback that were most desired were "written comment feedback from the teacher" (51.8%) for learning tasks and "item difficulty, percentile ranks feedback" for examinations (62.0%). CONCLUSION: Students found the current feedback to be helpful, but the lack of feedback that students desired indicates that we must provide more systematic feedback in a more timely manner.

Using a medical volunteer program to motivate medical freshmen.

PURPOSE: A task force identified 4 core properties of motivation-related improvement and developed a medical volunteer program for 63 medical freshmen in 2012. Three overarching topics were examined: What were the contents of the program? Did students' motivation improve? Were the students satisfied with the course? Pretest and posttest motivation levels and program evaluation forms were analyzed. METHODS: We organized a series of committee meetings and identified 4 core factors of motivation. The program was conducted for 63 medical freshmen in March 2012. The program evaluation form was analyzed using SPSS 17.0. RESULTS: The core factors of motivation were interest in medical studies, volunteer-mindedness, medical humanities, and self-management. The program was composed of lectures, medical volunteer hours, and program evaluation and feedback sessions. Students' motivation differed significantly with regard to interest in medical studies (t=-2.40, p=0.020) and volunteer-mindedness (t=-3.45, p=0.001). Ninety percent of students were satisfied with the program, 67.8% of students were satisfied with the medical volunteer activity, and the feedback session of the program was meaningful (66.1%). CONCLUSION: The medical volunteer program, held in the first month of the medical education year, was meaningful, but the reasons for dissatisfaction with the program should be examined. We should also develop a system that has lasting beneficial effects on academic achievement and career selection.

Binary mixing of micelles using Pluronics for a nano-sized drug delivery system.

Pluronics with different structural compositions and properties are used for several applications, including drug delivery systems. We developed a binary mixing system with two Pluronics, L121/P123, as a nano-sized drug delivery carrier. The lamellar-forming Pluronic L121 (0.1 wt%) was incorporated with Pluronic P123 to produce nano-sized dispersions (in case of 0.1 and 0.5 wt% P123) with high stability due to Pluronic P123 and high solubilization capacity due to Pluronic L121. The binary systems were spherical and less than 200-nm diameter, with high thermodynamic stability (at least 2 weeks) in aqueous solution. The CMC of the binary system was located in the middle of the CMC of each polymer. In particular, the solubilization capacity of the binary system (0.1/0.1 wt%) was higher than mono-systems of P123. The main advantage of binary systems is overcoming limitations of mono systems to allow tailored mixing of block copolymers with different physicochemical characteristics. These nano-sized systems may have potential as anticancer drug delivery systems with simple preparation method, high stability, and high loading capacity.

Crystallization and preliminary X-ray crystallographic analysis of enoyl-acyl carrier protein reductase from Helicobacter pylori.

Enoyl-acyl carrier protein reductase (ENR) catalyzes the NADH-dependent stereospecific reduction of alpha,beta-unsaturated fatty acids bound to the acyl-carrier protein. ENR from Helicobacter pylori has been overexpressed in Escherichia coli and has been crystallized in the presence of its cofactor NADH and the inhibitor triclosan (or its analogue diclosan) at 296 K using polyethylene glycol (PEG) 400 as a precipitant. For the triclosan (or diclosan) complex, diffraction data to 2.5 (or 2.3) A resolution have been collected using synchrotron X-rays. The crystals belong to the monoclinic space group P2(1), with unit-cell parameters a = 73.35, b = 94.91, c = 75.38 A, beta = 106.21 degrees for the triclosan complex (or a = 73.25, b = 95.07, c = 75.02 A, beta = 106.53 degrees for the diclosan complex). The asymmetric unit contains one homotetramer, with a corresponding V(M) of 2.10 A(3) Da(-1) and a solvent content of 41% by volume.