• 보건세계
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• v.59 no.3
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• pp.8-12
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• 2012

- DOT하 결핵환자 치료 성공율을 90% 이상 달성 ${\rightarrow}$ 치료 완료후 2년이내 균양성 재발율을 3% 미만으로 달성 - 질병관리본부와 결핵연구원, 보건소 및 민간 병의원에서 치료받고 있는 결핵환자에 대한 WHO의 결핵조기퇴치 기본 전략인 직접복약확인체계(DOTS, Directly observed treatment short course)시범사업 본격 실시

• Journal of Chest Surgery
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• v.38 no.11 s.256
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• pp.746-760
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• 2005

Background: Following the implantation of heart valve prostheses, it is important to maintain therapeutic INR to reduce the risk of thromboembolism. The objectives of this study were to determine the causes of nontherapeutic INRs, and to identify the factors associated with nonadherences to warfarin therapy in Korean outpatients with prosthetic heart valves managed by a pharmacist-run anticoagulation service (ACS). Material and Method: A retrospective chart review was completed for all patients enrolled in the ACS at Seoul National University Hospital from March, 1997b to September, 2000. The data on 868 patients (5,304 visits) who were at least 6 months post-valve replacement were included. All possible causes of nontherapeutic INRs were documented for each patient visit. The association of covariates to noncompliance was investigated by univariate analysis. Result: The reasons for nontherapeutic INRs were identified as follows: inadequate dosage adjustment $(21\%)$, nonadherences to dosing regimen $(13\%)$, drug/herbal interactions $(12\%)$, changes in diet $(7\%)$, and indeterminate cause $(42\%)$. Younger age, shorter duration of ACS and longer duration of warfarin therapy were associated with nonadherence. Conclusion: In this study, nonadherence and interactions between diet and medications were found to be important factors influencing nontherapeutic INRs. Longer duration of enrollment in the ACS affected the adherence to warfarin therapy Positively whereas younger age and longer duration of warfarin therapy affected negatively.

• Tuberculosis and Respiratory Diseases
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• v.56 no.5
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• pp.485-494
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• 2004

Background : To assess the effects of mDOT implementation on sputum smear conversion for AFB (Acid fast bacilli) positive pulmonary tuberculosis patients, modified Directly Observed Treatment (mDOT) was started on October $8^{th}$ 2001 at a health center in Seoul. mDOT was defined through weekly interviewing and supervising of a patient by a supervisor (doctor, nurse, or lay health worker). The sputum smear conversion of a mDOT group was compared with that of a self-medication (self) group. Methods : This study included 52 AFB positive pulmonary tuberculosis patients registered at a health center in Seoul between October $8^{th}$ 2001 and April $23^{rd}$ 2002. 24 and 28 patients were enrolled in the mDOT and self medication groups, respectively. Paired (1:1) individual matching, by gender, extent of disease, relapse and age-matching variables, was performed between the two groups, resulting in 20 paired matches. This prospective study was planned as an unblinded, non-randomized quasiexperimental pilot project. Outcomes were identified from results of sputum smear examinations for AFB in both groups at 2 weeks, and 1 and 2 months. The paired matching data were analyzed using the SAS program version 8.1 by McNemar test. Results : At the end of 2 weeks of treatment, the sputum smear conversion of the mDOT group was somewhat higher than that of the self medication group (78.57 vs. 50%, p-value=0.289), and after 1 month of treatment no statistically significant difference was shown between the two groups (83.33 vs. 50, p-value=0.125). At the end of 2 months of treatment (initial intensive phase), the sputum smear conversions of the mDOT and self groups were 95 and 75%, respectively (p-value=0.219). Conclusions : The implementation of mDOT did not result in clinically significant increases in the sputum smear conversion at 2 weeks, and 1 and 2 months compared with that of the self medication group. However, the increases experienced might contribute to diminishing the infectious period of AFB positive patients, and this approach may act as a guide for a specific group of patients. In this study, mDOT was performed for one hundred percent of the intensive treatment phase. It can also be an effective treatment for pulmonary tuberculosis patients, and may be useful for some high risk tuberculosis patients.

• Journal of Industrial Convergence
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• v.20 no.7
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• pp.97-105
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• 2022

Objectives: This study was performed to analyze the effect of nurse-led education on results for patients with gout. Methods: The face-to-face education was conducted by a specialist nurse. Patient satisfaction and drug adherence, serum uric acid was assessed. Results: Patient satisfaction was significantly higher in the nurse-led education group than in the usual care group. The serum uric acid level on the second visit was lower after patient education. In addition, the mean drug adherence in the nurse-led group was significantly higher than in the usual care group on the second and third visits. Conclusion: The nurse-led education about gout improves patient satisfaction, drug adherence, and serum uric acid level in patients with gout.

• 대한예방의학회:학술대회논문집
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• 2002.10a
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• pp.533-533
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• 2002

• The Journal of Internal Korean Medicine
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• v.42 no.5
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• pp.1001-1008
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• 2021

Objective: The aim of this case study was to describe a case of iris diagnosis of primary hyperhidrosis and the use of Korean medicine. Methods: A patient with symptoms of hyperhidrosis was diagnosed as having Taeeumin after assessment using the four basic Korean diagnostic methods. Iris diagnosis was used for further examination. The images obtained showed a remarkably defined collarette and increased nerve rings, which suggested an overactive sympathetic nerve system. Under the diagnosis of Taeeum, a Korean herbal medicine was prescribed with additional herbs to help alleviate the hyperactivity of the sympathetic nervous system. Results: The patient had been receiving treatment for hyperhidrosis for >30 years, with various medical attempts to relieve her symptoms, which were ineffective. She showed signs of improvement from day 4 into the treatment, and 80% of her symptoms were improved after completing a 6-week treatment course. Conclusion: The herbal medicine prescribed to the patient proved effective for reducing her chronic symptoms that had been unresponsive to previous medical treatments.

• The Korean Society of Law and Medicine
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• v.16 no.2
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• pp.55-84
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• 2015

The tuberculosis is the infectious disease. Generally, the active tuberculosis patient can infect the 10 persons for one year within the daily activities like casual conversation and singing together. The infectivity of tuberculosis can continue for a life time, and infected persons can remain at risk for developing active tuberculosis. To control this contagious disease, along with the active tuberculosis patients, non-infectious but non-compliant patients who can be infectious if their immune systems become impaired have to be managed. To control the non-complaint patients, medical treatment order should be combined with the public order. Because tuberculosis is the risk of community health, the human rights like liberty and freedom of movement can be restricted for public welfare under the article 37(2) of constitution. Even when such restriction is imposed, no essential aspect of the freedom or right shall be violated. The degree of restriction on the rights of citizens is different what methods are chosen to non-complaint patients. For example, under the directly observed therapy program, the patients and medical staffs make an appointment and meet to confirm the drug intakes according to the schedule, which is the medical treatment combined with the mildest public order. If the patients break the appointments or have the history of disobedient, the involuntary detention can obtain the legitimate cause. The Tuberculosis Prevention Act has the two step programs on this involuntary detention, The admission order (Article 15) is issued when the patients are infectious. The quarantine order (Artle 15-2) is issued when the patients are infectious and non-complaint. The legal criteria for involuntary detention are discussed and published through the international conventions and covenants. For example, World Health Organization had made guidance on human rights and involuntary detention for tuberculosis control. The restrictions should be carried out in accordance with the our law and in the legitimate objective of public interest. And the restriction should be based on scientific evidence and not imposed in an unreasonable or discriminatory manner. We define and adopt these international criteria under our constitution and legal system. Least restrictive alternative principle, proportionality principle and the individual evaluation methods are explained through the reviews of United States court decisions. Habeas Corpus Act is reviewed and adopted as the procedural due process to protect the patient rights as a citizen. Along with that, what conditions and facilities which are needed to performed quarantine order are discussed.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.11
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• pp.121-129
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• 2019

This study aimed to develop a planned discharge nursing intervention guideline for patients with pneumothorax, and to examine its influence on drug compliance, knowledge about disease, compliance level with therapeutic regimen, and nursing satisfaction. Methods: The planned discharge nursing intervention guideline was developed based on comprehensive literature reviews and clinical experiences. Patients having video-assisted thoracoscopic surgery at a single general hospital were allocated to either intervention (n=30) or control group (n=29). Participants in the intervention group were administered planned discharge nursing intervention thrice, 30 minutes each, by a cardiovascular nurse. Standard care was provided to patients in the control group. Data were collected from March, 2010 to December, 2010. Results: Participants in the intervention group presented statistically significant improvement in drug compliance (t=-2.05, p=0.044), pill count (t=-2.61, p=0.011), knowledge about disease (t=-4.39, p=0.001), and nursing satisfaction (t=-4.13, p=0.001). No significant difference in compliance levels was observed with standard therapeutic regimen. Conclusion: Planned discharge nursing intervention can be successfully implemented for patients undergoing thoracoscopic surgery. Further research is required to evaluate long-term effects like complication or relapse.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.3
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• pp.323-332
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• 2021

This study was undertaken to develop a new combination tablet containing silodosin and solifenacin succinate for treating urination disorders, for which a simultaneous analytical method of silodosin and solifenacin succinate was established. The aqueous solubility of silodosin and solifenacin succinate was determined to be higher than 1 mg/ml in various buffers, and dissolution of the silodosin and solifenacin succinate commercial products was accomplished within 30 minutes. The drug-excipients compatibility test was subsequently evaluated using differential scanning calorimetry. Excipients without compatibility were selected, and various combination formulations were prepared applying the wet granulation method. Of these, the formulation comprising silodosin, solifenacin succinate, lactose hydrate, MCC PH101, sodium lauryl sulfate (SLS), Povidone K30, crospovidone and magnesium stearate, having a weight ratio of 8/10/56/112/2/6/6/2, respectively, showed equivalence comparative to the dissolution achieved with the commercial products of silodosin (Thrupas tab) and solifenacin succinate (Vesicare tab). Thus, we propose that compared to the currently available commercial products, this novel combination tablet containing silodosin and solifenacin succinate is an effective alternative for the treatment of urination disorders.

• Journal of Chest Surgery
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• v.38 no.11 s.256
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• pp.761-772
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• 2005

Background: Following the implantation of heart valve prostheses, it is important to maintain therapeutic INR to reduce the risk of thromboembolism. The objective of this study was to suggest a practical dosing guideline for Korean outpatients with prosthetic heart valves managed by a pharmacist-run anticoagulation service (ACS). Material and Method: A retrospective chart review was completed for all patients enrolled in the ACS at Seoul National University Hospital from March, 1997 to September, 2000. Patients who were at least 6 months post-valve replacement and had nontherapeutic INR value (less than 2.0 or greater than 3.0) were included. The data on 688 patients (1,782 visits) requiring dosing adjustment without any known drug or food interaction with warfarin were analyzed. The amount of adjusted dose and INR changes based on the INR at the time of the event were calculated. Aortic valve replacements (AVR) patients and mitral or double valve replacement (MVR/DVR) patients were evaluated separately. Result: Two methods for the warfarin dosage adjustment were suggested: Guideline I (mg-based total weekly dose (TWD) adjustment), Guideline II (percentage-based TWD adjustment). The effectiveness of Guideline 1 was superior to Guideline II overall in patients with both AVR and MVR/DVR. Conclusion: The guideline suggested in this study could be useful when the dosage adjustment of wafarin is necessary in outpatients with mechanical heart valves.