284 resultados para Eun Yung


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Programa de doctorado: Sistemas Inteligentes y Aplicaciones Numéricas en la Ingeniería.

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In this thesis, atomistic simulations are performed to investigate hydrophobic solvation and hydrophobic interactions in cosolvent/water binary mixtures. Many cosolvent/water binary mixtures exhibit non-ideal behavior caused by aggregation at the molecular scale level although they are stable and homogenous at the macroscopic scale. Force-field based atomistic simulations provide routes to relate atomistic-scale structure and interactions to thermodynamic solution properties. The predicted solution properties are however sensitive to the parameters used to describe the molecular interactions. In this thesis, a force field for tertiary butanol (TBA) and water mixtures is parameterized by making use of the Kirkwood-Buff theory of solution. The new force field is capable of describing the alcohol-alcohol, water-water and alcohol-water clustering in the solution as well as the solution components’ chemical potential derivatives in agreement with experimental data. With the new force field, the preferential solvation and the solvation thermodynamics of a hydrophobic solute in TBA/water mixtures have been studied. First, methane solvation at various TBA/water concentrations is discussed in terms of solvation free energy-, enthalpy- and entropy- changes, which have been compared to experimental data. We observed that the methane solvation free energy varies smoothly with the alcohol/water composition while the solvation enthalpies and entropies vary nonmonotonically. The latter occurs due to structural solvent reorganization contributions which are not present in the free energy change due to exact enthalpy-entropy compensation. It is therefore concluded that the enthalpy and entropy of solvation provide more detailed information on the reorganization of solvent molecules around the inserted solute. Hydrophobic interactions in binary urea/water mixtures are next discussed. This system is particularly relevant in biology (protein folding/unfolding), however, changes in the hydrophobic interaction induced by urea molecules are not well understood. In this thesis, this interaction has been studied by calculating the free energy (potential of mean force), enthalpy and entropy changes as a function of the solute-solute distance in water and in aqueous urea (6.9 M) solution. In chapter 5, the potential of mean force in both solution systems is analyzed in terms of its enthalpic and entropic contributions. In particular, contributions of solvent reorganization in the enthalpy and entropy changes are studied separately to better understand what are the changes in interactions in the system that contribute to the free energy of association of the nonpolar solutes. We observe that in aqueous urea the association between nonpolar solutes remains thermodynamically favorable (i.e., as it is the case in pure water). This observation contrasts a long-standing belief that clusters of nonpolar molecules dissolve completely in the presence of urea molecules. The consequences of our observations for the stability of proteins in concentrated urea solutions are discussed in the chapter 6 of the thesis.

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Opposing effects of ondansetron and tramadol on the serotonin pathway have been suggested which possibly increase tramadol consumption and emesis when co-administered. In a randomized, double-blinded study, 179 patients received intravenous ondansetron, metoclopramide, or placebo for emesis prophylaxis. Analgesic regimen consisted of tramadol intraoperative loading and subsequent patient-controlled analgesia. Tramadol consumption and response to antiemetic treatment were compared. Additionally, plasma concentrations of ondansetron and (+)O-demethyltramadol and CYP2D6 genetic variants were analyzed as possible confounders influencing analgesic and antiemetic efficacy. Tramadol consumption did not differ between the groups. Response rate to antiemetic prophylaxis was superior in patients receiving ondansetron (85.0%) compared with placebo (66.7%, P = .046), with no difference to metoclopramide (69.5%). Less vomiting was reported in the immediate postoperative hours in the verum groups (ondansetron 5.0%, metoclopramide 5.1%) compared with placebo (18.6%; P = .01). Whereas plasma concentrations of (+)O-demethyltramadol were significantly correlated to CYP2D6 genotype, no influence was detected for ondansetron. Co-administration of ondansetron neither increased tramadol consumption nor frequency of PONV in this postoperative setting. PERSPECTIVE: Controversial findings were reported for efficacy of tramadol and ondansetron when co-administered due to their opposing serotonergic effects. Co-medication of these drugs neither increased postoperative analgesic consumption nor frequency of emesis in this study enrolling patients recovering from major surgery.

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An influence of polymorphic cytochromes P450 (CYP) 2D6 genetic variants on antiemetic efficacy of ondansetron has been suggested. However, the role of CYP3A in ondansetron metabolism and efficacy has been unclear. In this study, we evaluated the hypothesis that genotype-dependent CYP2D6 and CYP3A activity selectively influences plasma concentrations of ondansetron enantiomers. Additionally, the effects of doubling the ondansetron dose on genotype-dependent plasma concentrations were investigated.

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To compare the intravascular ultrasound virtual histology (IVUS-VH) appearance of the polymeric struts of the first (Revision 1.0) and the second (Revision 1.1) generation bioresorbable vascular scaffold (BVS).

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Context During the past 2 decades, a major transition in the clinical characterization of psychotic disorders has occurred. The construct of a clinical high-risk (HR) state for psychosis has evolved to capture the prepsychotic phase, describing people presenting with potentially prodromal symptoms. The importance of this HR state has been increasingly recognized to such an extent that a new syndrome is being considered as a diagnostic category in the DSM-5. Objective To reframe the HR state in a comprehensive state-of-the-art review on the progress that has been made while also recognizing the challenges that remain. Data Sources Available HR research of the past 20 years from PubMed, books, meetings, abstracts, and international conferences. Study Selection and Data Extraction Critical review of HR studies addressing historical development, inclusion criteria, epidemiologic research, transition criteria, outcomes, clinical and functional characteristics, neurocognition, neuroimaging, predictors of psychosis development, treatment trials, socioeconomic aspects, nosography, and future challenges in the field. Data Synthesis Relevant articles retrieved in the literature search were discussed by a large group of leading worldwide experts in the field. The core results are presented after consensus and are summarized in illustrative tables and figures. Conclusions The relatively new field of HR research in psychosis is exciting. It has the potential to shed light on the development of major psychotic disorders and to alter their course. It also provides a rationale for service provision to those in need of help who could not previously access it and the possibility of changing trajectories for those with vulnerability to psychotic illnesses.

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Bipolar affective disorder (BD) is a severe, recurrent and disabling disorder with devastating consequences for individuals, families and society. Although these hazards and costs provide a compelling rationale for development of early detection and early intervention strategies in BD, the development of at-risk criteria for first episode mania is still in an early stage of development. In this paper we review the literature with respect to the clinical, neuroantomical and neuropsychological data, which support this goal. We also describe our recently developed bipolar at-risk criteria (BAR). This criteria comprises the peak age range of the first onset of bipolar disorder, genetic risk, presenting with sub-threshold mania, cyclothymic features or depressive symptoms. An initial pilot evaluation of the BAR criteria in 22 subjects indicated conversion rates to proxies of first-episode mania of 23% within 265 days on average, and high specificity and sensitivity of the criteria. If prospective studies confirm the validity of the BAR criteria, then the criteria would have the potential to open up new avenues of research for indicated prevention in BD and might therefore offer opportunities to ameliorate the severity of, or even prevent BD.

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Chemotherapeutic use of 5-fluorouracil (5FU) is compromised by 10-20% of patients developing severe toxicity. Recently described genetic variation in dihydropyrimidine dehydrogenase (DPYD) has been shown to be a major predictor of 5FU toxicity. Here, we describe a new genotyping assay for routine clinical use that covers all the major DPYD risk variants.

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OBJECTIVE: To use a study on dysgeusia to assess the usefulness of an otology database. STUDY DESIGN: Data were extracted from the international Common Otology Database. INTERVENTION: Primary stapes operations. MAIN OUTCOME MEASURE AND RESULTS: From a cohort of 14 otologists, only 8 (57%) were able to satisfy external validation and maintain data input for a period of at least 6 months. The rates of dysgeusia varied from 0 to 39% at 3 months and 0 to 27% at 6 months. The percentages of patients with taste disturbance at 6 months in the "nerve-cut" and "nerve-preserved" groups were 22.7 and 10.9%, respectively, although this was not statistically significant (chi2; p = 0.325). CONCLUSION: Many surgeons found it difficult to maintain a prospective otology database. The rates of certain subjective symptoms such as dysgeusia are influenced by how vigorously the reviewers prompt the response from the patients. Dysgeusia after stapes surgery is common even if the chorda tympani nerve is preserved. Many patients whose chorda tympani nerve is divided may not complain of dysgeusia.