Optimization of micelle-encapsulated extremely small sized iron oxide nanoparticles as a T1 contrast imaging agent: biodistribution and safety profile.


Journal

Journal of nanobiotechnology
ISSN: 1477-3155
Titre abrégé: J Nanobiotechnology
Pays: England
ID NLM: 101152208

Informations de publication

Date de publication:
16 Jul 2024
Historique:
received: 28 03 2024
accepted: 03 07 2024
medline: 17 7 2024
pubmed: 17 7 2024
entrez: 16 7 2024
Statut: epublish

Résumé

Iron oxide nanoparticles (IONPs) have been cleared by the Food and Drug Administration (FDA) for various clinical applications, such as tumor-targeted imaging, hyperthermia therapy, drug delivery, and live-cell tracking. However, the application of IONPs as T1 contrast agents has been restricted due to their high r2 values and r2/r1 ratios, which limit their effectiveness in T1 contrast enhancement. Notably, IONPs with diameters smaller than 5 nm, referred to as extremely small-sized IONPs (ESIONs), have demonstrated potential in overcoming these limitations. To advance the clinical application of ESIONs as T1 contrast agents, we have refined a scale-up process for micelle encapsulation aimed at improving the hydrophilization of ESIONs, and have carried out comprehensive in vivo biodistribution and preclinical toxicity assessments. The optimization of the scale-up micelle-encapsulation process, specifically employing Tween60 at a concentration of 10% v/v, resulted in ESIONs that were uniformly hydrophilized, with an average size of 9.35 nm and a high purification yield. Stability tests showed that these ESIONs maintained consistent size over extended storage periods and dispersed effectively in blood and serum-mimicking environments. Relaxivity measurements indicated an r1 value of 3.43 mM This study effectively optimized a scale-up process for the micelle encapsulation of ESIONs, leading to the production of hydrophilic ESIONs at gram-scale levels. These optimized ESIONs showcased properties conducive to T1 contrast imaging, such as elevated r1 relaxivity and a reduced r2/r1 ratio. Biodistribution study underscored their prolonged bloodstream presence and efficient clearance through the liver and bile, without significant renal involvement. The preclinical toxicity tests affirmed the safety of the ESIONs, supporting their potential use as T1 contrast agent with versatile clinical application.

Sections du résumé

BACKGROUND BACKGROUND
Iron oxide nanoparticles (IONPs) have been cleared by the Food and Drug Administration (FDA) for various clinical applications, such as tumor-targeted imaging, hyperthermia therapy, drug delivery, and live-cell tracking. However, the application of IONPs as T1 contrast agents has been restricted due to their high r2 values and r2/r1 ratios, which limit their effectiveness in T1 contrast enhancement. Notably, IONPs with diameters smaller than 5 nm, referred to as extremely small-sized IONPs (ESIONs), have demonstrated potential in overcoming these limitations. To advance the clinical application of ESIONs as T1 contrast agents, we have refined a scale-up process for micelle encapsulation aimed at improving the hydrophilization of ESIONs, and have carried out comprehensive in vivo biodistribution and preclinical toxicity assessments.
RESULTS RESULTS
The optimization of the scale-up micelle-encapsulation process, specifically employing Tween60 at a concentration of 10% v/v, resulted in ESIONs that were uniformly hydrophilized, with an average size of 9.35 nm and a high purification yield. Stability tests showed that these ESIONs maintained consistent size over extended storage periods and dispersed effectively in blood and serum-mimicking environments. Relaxivity measurements indicated an r1 value of 3.43 mM
CONCLUSIONS CONCLUSIONS
This study effectively optimized a scale-up process for the micelle encapsulation of ESIONs, leading to the production of hydrophilic ESIONs at gram-scale levels. These optimized ESIONs showcased properties conducive to T1 contrast imaging, such as elevated r1 relaxivity and a reduced r2/r1 ratio. Biodistribution study underscored their prolonged bloodstream presence and efficient clearance through the liver and bile, without significant renal involvement. The preclinical toxicity tests affirmed the safety of the ESIONs, supporting their potential use as T1 contrast agent with versatile clinical application.

Identifiants

pubmed: 39014410
doi: 10.1186/s12951-024-02699-8
pii: 10.1186/s12951-024-02699-8
doi:

Substances chimiques

Contrast Media 0
Micelles 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

419

Subventions

Organisme : National Research Foundation of Korea
ID : 2021R1F1A1064340
Organisme : National Research Foundation of Korea
ID : 2020R1A2C2101069

Informations de copyright

© 2024. The Author(s).

Références

Kandasamy G, Maity D. Recent advances in superparamagnetic iron oxide nanoparticles (SPIONs) for in vitro and in vivo cancer nanotheranostics. Int J Pharm. 2015;496(2):191–218.
pubmed: 26520409 doi: 10.1016/j.ijpharm.2015.10.058
Hilger I. In vivo applications of magnetic nanoparticle hyperthermia. Int J Hyperth. 2013;29(8):828–34.
doi: 10.3109/02656736.2013.832815
Jordan A, Wust P, Fahling H, John W, Hinz A, Felix R. Inductive heating of ferrimagnetic particles and magnetic fluids: physical evaluation of their potential for hyperthermia. Int J Hyperth. 1993;9(1):51–68.
doi: 10.3109/02656739309061478
Chertok B, Moffat BA, David AE, Yu F, Bergemann C, Ross BD, et al. Iron oxide nanoparticles as a drug delivery vehicle for MRI monitored magnetic targeting of brain tumors. Biomaterials. 2008;29(4):487–96.
pubmed: 17964647 doi: 10.1016/j.biomaterials.2007.08.050
Mahmoudi M, Sant S, Wang B, Laurent S, Sen T. Superparamagnetic iron oxide nanoparticles (SPIONs): development, surface modification and applications in chemotherapy. Adv Drug Deliv Rev. 2011;63(1–2):24–46.
pubmed: 20685224 doi: 10.1016/j.addr.2010.05.006
Lee N, Kim H, Choi SH, Park M, Kim D, Kim HC, et al. Magnetosome-like ferrimagnetic iron oxide nanocubes for highly sensitive MRI of single cells and transplanted pancreatic islets. Proc Natl Acad Sci U S A. 2011;108(7):2662–7.
pubmed: 21282616 pmcid: 3041081 doi: 10.1073/pnas.1016409108
Li L, Jiang W, Luo K, Song H, Lan F, Wu Y, et al. Superparamagnetic iron oxide nanoparticles as MRI contrast agents for non-invasive stem cell labeling and tracking. Theranostics. 2013;3(8):595–615.
pubmed: 23946825 pmcid: 3741608 doi: 10.7150/thno.5366
Thorek DL, Chen AK, Czupryna J, Tsourkas A. Superparamagnetic iron oxide nanoparticle probes for molecular imaging. Ann Biomed Eng. 2006;34(1):23–38.
pubmed: 16496086 doi: 10.1007/s10439-005-9002-7
Wang YX. Superparamagnetic iron oxide based MRI contrast agents: current status of clinical application. Quant Imaging Med Surg. 2011;1(1):35–40.
pubmed: 23256052 pmcid: 3496483
Weissleder R, Elizondo G, Wittenberg J, Rabito CA, Bengele HH, Josephson L. Ultrasmall superparamagnetic iron oxide: characterization of a new class of contrast agents for MR imaging. Radiology. 1990;175(2):489–93.
pubmed: 2326474 doi: 10.1148/radiology.175.2.2326474
Corot C, Robert P, Idee JM, Port M. Recent advances in iron oxide nanocrystal technology for medical imaging. Adv Drug Deliv Rev. 2006;58(14):1471–504.
pubmed: 17116343 doi: 10.1016/j.addr.2006.09.013
Pouliquen D, Perdrisot R, Ermias A, Akoka S, Jallet P, Le Jeune JJ. Superparamagnetic iron oxide nanoparticles as a liver MRI contrast agent: contribution of microencapsulation to improved biodistribution. Magn Reson Imaging. 1989;7(6):619–27.
pubmed: 2630844 doi: 10.1016/0730-725X(89)90530-4
Ros PR, Freeny PC, Harms SE, Seltzer SE, Davis PL, Chan TW, et al. Hepatic MR imaging with ferumoxides: a multicenter clinical trial of the safety and efficacy in the detection of focal hepatic lesions. Radiology. 1995;196(2):481–8.
pubmed: 7617864 doi: 10.1148/radiology.196.2.7617864
Pultrum BB, van der Jagt EJ, van Westreenen HL, van Dullemen HM, Kappert P, Groen H, et al. Detection of lymph node metastases with ultrasmall superparamagnetic iron oxide (USPIO)-enhanced magnetic resonance imaging in oesophageal cancer: a feasibility study. Cancer Imaging. 2009;9:19–28.
pubmed: 19414293 pmcid: 2681289 doi: 10.1102/1470-7330.2009.0004
Weissleder R, Elizondo G, Wittenberg J, Lee AS, Josephson L, Brady TJ. Ultrasmall superparamagnetic iron oxide: an intravenous contrast agent for assessing lymph nodes with MR imaging. Radiology. 1990;175(2):494–8.
pubmed: 2326475 doi: 10.1148/radiology.175.2.2326475
Yang BY, Moon SH, Seelam SR, Jeon MJ, Lee YS, Lee DS, et al. Development of a multimodal imaging probe by encapsulating iron oxide nanoparticles with functionalized amphiphiles for lymph node imaging. Nanomed (Lond). 2015;10(12):1899–910.
doi: 10.2217/nnm.15.41
Yoo RE, Choi SH, Cho HR, Jeon BS, Kwon E, Kim EG, et al. Magnetic resonance imaging diagnosis of metastatic lymph nodes in a rabbit model: efficacy of PJY10, a new ultrasmall superparamagnetic iron oxide agent, with monodisperse iron oxide core and multiple-interaction ligands. PLoS ONE. 2014;9(9):e107583.
pubmed: 25216040 pmcid: 4162649 doi: 10.1371/journal.pone.0107583
Trivedi RA, Mallawarachi C, JM UK-I, Graves MJ, Horsley J, Goddard MJ, et al. Identifying inflamed carotid plaques using in vivo USPIO-enhanced MR imaging to label plaque macrophages. Arterioscler Thromb Vasc Biol. 2006;26(7):1601–6.
pubmed: 16627809 doi: 10.1161/01.ATV.0000222920.59760.df
Dousset V, Delalande C, Ballarino L, Quesson B, Seilhan D, Coussemacq M, et al. In vivo macrophage activity imaging in the central nervous system detected by magnetic resonance. Magn Reson Med. 1999;41(2):329–33.
pubmed: 10080281 doi: 10.1002/(SICI)1522-2594(199902)41:2<329::AID-MRM17>3.0.CO;2-Z
Kim BH, Lee N, Kim H, An K, Park YI, Choi Y, et al. Large-scale synthesis of uniform and extremely small-sized iron oxide nanoparticles for high-resolution T1 magnetic resonance imaging contrast agents. J Am Chem Soc. 2011;133(32):12624–31.
pubmed: 21744804 doi: 10.1021/ja203340u
Lu Y, Xu YJ, Zhang GB, Ling D, Wang MQ, Zhou Y, et al. Iron oxide nanoclusters for T 1 magnetic resonance imaging of non-human primates. Nat Biomed Eng. 2017;1(8):637–43.
pubmed: 31015599 doi: 10.1038/s41551-017-0116-7
Anselmo AC, Mitragotri S. A review of clinical translation of Inorganic nanoparticles. AAPS J. 2015;17(5):1041–54.
pubmed: 25956384 pmcid: 4540735 doi: 10.1208/s12248-015-9780-2
Bao Y, Sherwood J, Sun Z. Magnetic iron oxide nanoparticles as T 1 contrast agents for magnetic resonance imaging. J Mater Chem C. 2018;6(6):1280–90.
doi: 10.1039/C7TC05854C
Hu F, Jia Q, Li Y, Gao M. Facile synthesis of ultrasmall PEGylated iron oxide nanoparticles for dual-contrast T1- and T2-weighted magnetic resonance imaging. Nanotechnology. 2011;22(24):245604.
pubmed: 21508500 doi: 10.1088/0957-4484/22/24/245604
Tromsdorf UI, Bruns OT, Salmen SC, Beisiegel U, Weller H. A highly effective, nontoxic T1 MR contrast agent based on ultrasmall PEGylated iron oxide nanoparticles. Nano Lett. 2009;9(12):4434–40.
pubmed: 19799448 doi: 10.1021/nl902715v
Wei H, Bruns OT, Kaul MG, Hansen EC, Barch M, Wisniowska A, et al. Exceedingly small iron oxide nanoparticles as positive MRI contrast agents. Proc Natl Acad Sci U S A. 2017;114(9):2325–30.
pubmed: 28193901 pmcid: 5338531 doi: 10.1073/pnas.1620145114
Lee YK, Jeong JM, Hoigebazar L, Yang BY, Lee YS, Lee BC, et al. Nanoparticles modified by encapsulation of ligands with a long alkyl chain to affect multispecific and multimodal imaging. J Nucl Med. 2012;53(9):1462–70.
pubmed: 22859859 doi: 10.2967/jnumed.111.092759
Kim BH, Shin K, Kwon SG, Jang Y, Lee HS, Lee H, et al. Sizing by weighing: characterizing sizes of ultrasmall-sized iron oxide nanocrystals using MALDI-TOF mass spectrometry. J Am Chem Soc. 2013;135(7):2407–10.
pubmed: 23356417 doi: 10.1021/ja310030c
Carion O, Mahler B, Pons T, Dubertret B. Synthesis, encapsulation, purification and coupling of single quantum dots in phospholipid micelles for their use in cellular and in vivo imaging. Nat Protoc. 2007;2(10):2383–90.
pubmed: 17947980 doi: 10.1038/nprot.2007.351
Ko GB, Yoon HS, Kim KY, Lee MS, Yang BY, Jeong JM, et al. Simultaneous multiparametric PET/MRI with Silicon Photomultiplier PET and Ultra-high-field MRI for small-animal imaging. J Nucl Med. 2016;57(8):1309–15.
pubmed: 27081173 doi: 10.2967/jnumed.115.170019
Son JW, Kim KY, Park JY, Kim K, Lee YS, Ko GB, et al. SimPET: a preclinical PET insert for simultaneous PET/MR Imaging. Mol Imaging Biol. 2020;22(5):1208–17.
pubmed: 32285357 doi: 10.1007/s11307-020-01491-y
Heinz H, Pramanik C, Heinz O, Ding YF, Mishra RK, Marchon D, et al. Nanoparticle decoration with surfactants: molecular intercations, assmbly, and applications. Surf Sci Rep. 2017;72(1):1–58.
doi: 10.1016/j.surfrep.2017.02.001
Ling DS, Hackett MJ, Hyeon T. Surface ligands in synthesis, modification, assembly and biomedical applications of nanoparticles. Nano Today. 2014;9(4):457–77.
doi: 10.1016/j.nantod.2014.06.005
Ling D, Lee N, Hyeon T. Chemical synthesis and assembly of uniformly Sized Iron Oxide nanoparticles for Medical Applications. Acc Chem Res. 2015;48(5):1276–85.
pubmed: 25922976 doi: 10.1021/acs.accounts.5b00038
Bobo D, Robinson KJ, Islam J, Thurecht KJ, Corrie SR. Nanoparticle-based Medicines: a review of FDA-Approved materials and clinical trials to date. Pharm Res. 2016;33(10):2373–87.
pubmed: 27299311 doi: 10.1007/s11095-016-1958-5
Moon SH, Yang BY, Kim YJ, Hong MK, Lee YS, Lee DS, et al. Development of a complementary PET/MR dual-modal imaging probe for targeting prostate-specific membrane antigen (PSMA). Nanomedicine. 2016;12(4):871–9.
pubmed: 26739097 doi: 10.1016/j.nano.2015.12.368
Hagberg GE, Scheffler K. Effect of r(1) and r(2) relaxivity of gadolinium-based contrast agents on the T(1)-weighted MR signal at increasing magnetic field strengths. Contrast Media Mol Imaging. 2013;8(6):456–65.
pubmed: 24375901 doi: 10.1002/cmmi.1565
So YH, Lee W, Park EA, Kim PK. Investigation of the characteristics of New, Uniform, extremely small Iron-based nanoparticles as T1 contrast agents for MRI. Korean J Radiol. 2021;22(10):1708–18.
pubmed: 34402245 pmcid: 8484154 doi: 10.3348/kjr.2020.1455
Arami H, Khandhar AP, Tomitaka A, Yu E, Goodwill PW, Conolly SM, et al. In vivo multimodal magnetic particle imaging (MPI) with tailored magneto/optical contrast agents. Biomaterials. 2015;52:251–61.
pubmed: 25818431 pmcid: 4379444 doi: 10.1016/j.biomaterials.2015.02.040
Haegele J, Duschka RL, Graeser M, Schaecke C, Panagiotopoulos N, Ludtke-Buzug K, et al. Magnetic particle imaging: kinetics of the intravascular signal in vivo. Int J Nanomed. 2014;9:4203–9.
doi: 10.2147/IJN.S49976
Lind K, Kresse M, Debus NP, Muller RH. A novel formulation for superparamagnetic iron oxide (SPIO) particles enhancing MR Lymphography: comparison of physicochemical properties and the in vivo behaviour. J Drug Target. 2002;10(3):221–30.
pubmed: 12075823 doi: 10.1080/10611860290022651
Roohi F, Lohrke J, Ide A, Schutz G, Dassler K. Studying the effect of particle size and coating type on the blood kinetics of superparamagnetic iron oxide nanoparticles. Int J Nanomed. 2012;7:4447–58.
Arami H, Khandhar A, Liggitt D, Krishnan KM. In vivo delivery, pharmacokinetics, biodistribution and toxicity of iron oxide nanoparticles. Chem Soc Rev. 2015;44(23):8576–607.
pubmed: 26390044 pmcid: 4648695 doi: 10.1039/C5CS00541H
Weissleder R, Stark DD, Engelstad BL, Bacon BR, Compton CC, White DL, et al. Superparamagnetic iron oxide: pharmacokinetics and toxicity. AJR Am J Roentgenol. 1989;152(1):167–73.
pubmed: 2783272 doi: 10.2214/ajr.152.1.167
Mohs AM, Lu ZR. Gadolinium(III)-based blood-pool contrast agents for magnetic resonance imaging: status and clinical potential. Expert Opin Drug Deliv. 2007;4(2):149–64.
pubmed: 17335412 doi: 10.1517/17425247.4.2.149
Bremerich J, Bilecen D, Reimer P. MR angiography with blood pool contrast agents. Eur Radiol. 2007;17(12):3017–24.
pubmed: 17639407 doi: 10.1007/s00330-007-0712-0
Subhan MA, Yalamarty SSK, Filipczak N, Parveen F, Torchilin VP. Recent advances in Tumor Targeting via EPR Effect for Cancer Treatment. J Pers Med. 2021;11(6).
Golombek SK, May JN, Theek B, Appold L, Drude N, Kiessling F, et al. Tumor targeting via EPR: strategies to enhance patient responses. Adv Drug Deliv Rev. 2018;130:17–38.
pubmed: 30009886 pmcid: 6130746 doi: 10.1016/j.addr.2018.07.007
Seo HJ, Nam SH, Im HJ, Park JY, Lee JY, Yoo B, et al. Rapid Hepatobiliary Excretion of Micelle-Encapsulated/Radiolabeled Upconverting Nanoparticles as an Integrated Form. Sci Rep. 2015;5:15685.
pubmed: 26494465 pmcid: 4616227 doi: 10.1038/srep15685
Heine M, Bartelt A, Bruns OT, Bargheer D, Giemsa A, Freund B, et al. The cell-type specific uptake of polymer-coated or micelle-embedded QDs and SPIOs does not provoke an acute pro-inflammatory response in the liver. Beilstein J Nanotechnol. 2014;5:1432–40.
pubmed: 25247125 pmcid: 4168844 doi: 10.3762/bjnano.5.155
Bleicher AG, Kanal E. A serial dilution study of gadolinium-based MR imaging contrast agents. AJNR Am J Neuroradiol. 2008;29(4):668–73.
pubmed: 18184840 pmcid: 7978187 doi: 10.3174/ajnr.A0905
Park SH, Nam Y, Choi HS, Woo STJIMRI. Quantification of gadolinium concentration using GRE and UTE sequences. 2017;21(3):171–6.
Elster AD, Sobol WT, Hinson WH. Pseudolayering of Gd-DTPA in the urinary bladder. Radiology. 1990;174(2):379–81.
pubmed: 2296649 doi: 10.1148/radiology.174.2.2296649
Crowe L, Wang Y, Gatehouse P, Tessier J, Waterton J, Robert P, et al. editors. Ex vivo MR imaging of atherosclerotic rabbit aorta labelled with USPIO—enhancement of iron loaded regions in UTE imaging. Proc Intl Soc Mag Reson Med; 2005.
Bernd H, De Kerviler E, Gaillard S, Bonnemain B. Safety and tolerability of ultrasmall superparamagnetic iron oxide contrast agent: comprehensive analysis of a clinical development program. Invest Radiol. 2009;44(6):336–42.
pubmed: 19661843 doi: 10.1097/RLI.0b013e3181a0068b
McCormack PL. Ferumoxytol: in iron deficiency anaemia in adults with chronic kidney disease. Drugs. 2012;72(15):2013–22.
pubmed: 22994536 doi: 10.2165/11209880-000000000-00000
Auerbach M, Pappadakis JA, Bahrain H, Auerbach SA, Ballard H, Dahl NV. Safety and efficacy of rapidly administered (one hour) one gram of low molecular weight iron dextran (INFeD) for the treatment of iron deficient anemia. Am J Hematol. 2011;86(10):860–2.
pubmed: 21922526 doi: 10.1002/ajh.22153
Schiller B, Bhat P, Sharma A. Safety and effectiveness of ferumoxytol in hemodialysis patients at 3 dialysis chains in the United States over a 12-month period. Clin Ther. 2014;36(1):70–83.
pubmed: 24315802 doi: 10.1016/j.clinthera.2013.09.028

Auteurs

Minseok Suh (M)

Department of Nuclear Medicine, College of Medicine, Seoul National University, Seoul, Korea.
Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea.
Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea.

Ji Yong Park (JY)

Department of Nuclear Medicine, College of Medicine, Seoul National University, Seoul, Korea.
Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea.
Medical Research Center, College of Medicine, Seoul National University, Seoul, Korea.
Cancer Research Institute, Seoul National University, Seoul, 03080, Republic of Korea.

Guen Bae Ko (GB)

Medical Research Center, College of Medicine, Seoul National University, Seoul, Korea.
Brightonix Imaging Inc, Seoul, Korea.

Ji Yoon Kim (JY)

Department of Nuclear Medicine, College of Medicine, Seoul National University, Seoul, Korea.
The Interdisciplinary Program of Cancer Biology, Seoul National University, Seoul, Korea.

Do Won Hwang (DW)

Research and Development Center, THERABEST Co., Ltd., Seoul, South Korea.

Louis Rees (L)

In Vitro Toxicology Group, Institute of Life Science, Swansea University Medical School, Swansea, Wales, UK.

Gillian E Conway (GE)

In Vitro Toxicology Group, Institute of Life Science, Swansea University Medical School, Swansea, Wales, UK.

Shareen H Doak (SH)

In Vitro Toxicology Group, Institute of Life Science, Swansea University Medical School, Swansea, Wales, UK.

Hyelim Kang (H)

School of Advanced Materials Engineering, Kookmin University, Seoul, Korea.

Nohyun Lee (N)

School of Advanced Materials Engineering, Kookmin University, Seoul, Korea.

Taeghwan Hyeon (T)

Center for Nanoparticle Research, Institute for Basic Science (IBS), Seoul, Korea.
School of Chemical and Biological Engineering, Institute of Chemical Processes, Seoul National University, Seoul, Korea.

Yun-Sang Lee (YS)

Department of Nuclear Medicine, College of Medicine, Seoul National University, Seoul, Korea. wonza43@snu.ac.kr.
Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea. wonza43@snu.ac.kr.

Dong Soo Lee (DS)

Department of Nuclear Medicine, College of Medicine, Seoul National University, Seoul, Korea. dsl@snu.ac.kr.
Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea. dsl@snu.ac.kr.
Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea. dsl@snu.ac.kr.
Medical Research Center, College of Medicine, Seoul National University, Seoul, Korea. dsl@snu.ac.kr.
Cancer Research Institute, Seoul National University, Seoul, 03080, Republic of Korea. dsl@snu.ac.kr.
Medical Science and Engineering, School of Convergence Science and Technology, Pohang University of Science and Technology (POSTECH), Pohang, Korea. dsl@snu.ac.kr.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH