Development of a LC-MS/MS for Quantification of Venlafaxine in Human Plasma and Application to Bioequivalence Study in healthy Korean Subjects

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.

Clinical Significance of Non-Alcoholic Fatty Liver Disease as a Risk Factor for Prehypertension

Previous epidemiologic studies have shown the clinical association between non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease (CVD). However, there is only limited information about the effect of NAFLD on the development of hypertension. Accordingly, we investigated the clinical association between NAFLD and prehypertension. A prospective cohort study was conducted on the 11,350 Korean men without prehypertension for 5 yr. The incidences of prehypertension were evaluated, and Cox proportional hazard model was used to measure the hazard ratios (HRs) for the development of prehypertension according to the degree of NAFLD (normal, mild, moderate to severe). The incidence of prehypertension increased according to NAFLD states (normal: 55.5%, mild: 63.7%, moderate to severe: 70.3%, P<0.001). Even after adjusting for multiple covariates, the HRs (95% confidence interval) for prehypertension were higher in the mild group (1.18; 1.07-1.31) and moderate to severe group (1.62; 1.21-2.17), compared to normal group, respectively (P for trend <0.001). The development of prehypertension is more potentially associated with the more progressive NAFLD than normal and milder state. These findings suggest the clinical significance of NAFLD as one of risk factors for prehypertension.

Cognitive Behavioral Therapy for Sexually Abused Children

OBJECTIVES: Child sexual abuse is a highly prevalent societal problem that cuts across all ethnic, racial, educational, and socioeconomic groups. There has been mounting empirical evidence for the efficacy of manual-based, cognitive behavioral treatment(CBT) for sexually abused children. Therefore, the aim of this review was to address the rationale and efficacy of CBT for sexually abused children, and to introduce a broad outline of a typical CBT program for young people suffering the emotional and behavioral consequences of sexual abuse. METHODS: A selective literature review was undertaken. RESULTS: To date, trauma-focused CBT is the most effective treatment for the sexually abused child. The rationale and efficacy of CBT was reviewed and a typical CBT program was outlined session by session. CONCLUSION: Based on trauma-focused CBT for sexually abused children, the results demonstrate the need for future development of a standard CBT program for the Korean population.

Sertoli Cell Adenomas in Complete Testicular Feminization Syndrome / 대한산부인과학회잡지

Testicular feminization is an uncommon genetic disorder with considerably familial predisposition and results in total feminization due to end-organ unresponsiveness to androgens. It is characterized by the presence of testes in phenotypically female with adequate breast development, normal extemal genitalia, absence of mullerian structures, and meager or absence of body hair. These patients characteristically have male karyotype(XY) and negative sex chromatin and are at increased risk of undergoing malignant transformation of the undescended gonad. In recent times, the malignant potential of the dysgenetic gonads in the intersex patients with a Y chromosome has been stressed by many authors, but few reports of an association between testicular feminization syndrome and benign tumors such as Sertoli cell adenomas. In the present study, postoperative pathology revealed that the gonads were Sertoli cell adenomas. The main features of clinical presentation and histological studies are briefly discussed with a review of the literature.

The Application of Doppler Ultrasound in the Assessment of Fetal Weight / 대한산부인과학회잡지

OBJECTIVE: The objective of this study was to determine the relationship between the fetal doppler flow velocimetry and birth weight in low risk pregnancy population. METHODS: From December 1995 to May 1996, We prospectively performed doppler study in 254 uncomplicated, term pregnant women, who visited Pohang Hospital, Dongguk University. Using pulsed color doppler, we measured umbilical artery RI, middle cerebral artery RI and middle cerebral-umbilical artery RI ratio within one week before delivery. RESULTS: The result was that low birth weight group (below 2500gm) had very significant lationship with umbilical artery RI(P<0.01), middle cerebral artery RI(P<0.05) and middle cerebral-umbilical artery RI ratio(P<0.05), but there was no significant relationship in these blood flow indices between normal birth weight group (2501gm- 3999gm) and macrosomia group (above 4000gm). CONCLUSIONS: We concluded that application of doppler ultrasonopaphy in the assessment of fetal weight is somewhat helpful for identification of low birth weight, not for macrosomia.

Two Cases of Mayer-Rokitansky-Kster-Hauser Syndrome Managed by McIndoe Operation / 대한산부인과학회잡지

Mayer-Rokitansky-Kster-Hauser Syndrome is characterized by the absence of the vagina and uterus, the presence of apparently normal tubes and ovaries, feminine appeara-nce, normal female secondary sexual characteristics, a normal 46,XX karyotype, and a fem-inine psychosexual orientation. Various methods of surgical treatment have been introduced, but the ideal method is still not found. The two cases reviewed in this paper were all treated with McIndoe operation using full thickness skin graft. Both women were satisfied with vaginal depth and excellent result was achieved. We report two vaginoplasties in patients of Mayer-Rokitansky-Kster-Hauser Syndr- ome including a brief review of literature.