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Retrospective Drugs Utilization Review Study for Chronic Kidney Disease Using National Health Insurance Database (건강보험 자료를 이용한 만성신부전 환자의 신독성 약물사용 현황)

  • Kim, Dong-Sook;Lee, Hyun-Jeong;Son, In-Ja;Kim, Gui-Sook;Shin, Joo-Young;Lee, Kun-Sei
    • YAKHAK HOEJI
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    • v.53 no.3
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    • pp.138-144
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    • 2009
  • The purpose was to implement drug utilization review (DUR) for whom were diagnosed with chronic kidney disease (CKD) population using health insurance claim data. This study constructed drug utilization database using Health Insurance Review and Assessment Service (HIRA) database and selected contraindicated drugs with kidney based on previously developed drug utilization guide and reviewing other countries' examples. Main outcome measures were the proportion of prescription for 1 or more drugs of concern. The cohort included 115,948 subjects, who were diagnosed with chronic kidney disease. Inappropriate drugs with CKD patients was some used, and the most commonly prescribed classes were aluminum drugs. However it is difficult to find problems with inappropriate drug because claims data doesn't have laboratory data. Based on the result of retrospective drug utilization review study, more studies should be analysed drug utilization patterns and monitoring system should be developed.

Effect of Hemodialysis on Dogs with Acute Renal Failure Induced by Ethylene Glycol (Ethylene Glycol로 유발된 급성신부전증 이환견에 대한 혈액투석효과)

  • Cho Hyo-Gueon;Lee Jung-Yeon;Liu Jian-Zhu;Song Kun-Ho;Park Seong-Jun;Kim Duck-Hwan
    • Journal of Veterinary Clinics
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    • v.23 no.1
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    • pp.36-40
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    • 2006
  • The aim of this study is to clarify the therapeutic effect of hemodialysis (HD) on acute renal failure in dogs experimentally induced by ethylene glycol (EG) ingestion in experiment 1(HD on 12 and 36 hours after EG injestion) and experiment 2(HD on 24 and 48 hours after EG injestion). Clinical signs such as vomiting, depression, ataxia and knuckling were improved on experiment 1 and 2. White blood cell (WBC) and platelets (PLT) were decreased, and packed cell volume (PCV) was increased after hemodialysis, however, no significant differences were observed in experiment 1 and 2. BUN, creatinine and phosphorus was significantly decreased in experiment 1 and 2, respectively. These results suggested that hemodialysis was effective for acute renal failure in dogs induced by EG ingestion.

Application of Pediatric Hemodialysis System to Experimental Renal Failure in Dogs (실험적으로 유발한 신부전 개에서 소아용 혈액투석기의 적용에 관한 연구)

  • 신현호;김완희;이충호;남치주;권오경
    • Journal of Veterinary Clinics
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    • v.17 no.2
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    • pp.340-345
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    • 2000
  • The purpose of the present study was to evaluate the possibility of application of pediatric hemodialysis system to dogs weighing less than 6 kg. Six healthy dogs (B .W, 3-6 kg) were used_ Experimental end-stage renal failure was induced by bilateral nephrectomy or bilateral ligation of ure-ters. Hemodialysis was performed when blood urea nitrogen (BUN) value increased over 90 mg/dl and every other day thereafter. Daily investigated parameters included clinical clinical signs such as vomiting, fecal appearance and activity and laboratory data such as PCV, WBC, RBC, BUN, creatinine, Ca, P, $Na^+ Cl^-and K^+$During hemodialysis treatment, BUN and creatinine values were measured hourly. Severe vomiting and inappetence were shown 2 days after infliction of kidney disorder and melena and mucous faces were observed 3 days. The signs were not corrected by hemodialysis treatment. Avel- age hemodialysis treatment time was $5.5 {\times} 0.7$,/TEX> hours until BUN value decreased to normal range. Abnor- mal hematological and electrolytes values were reduced within normal levels after hemodialysis treatments. The complications oft hemodialysis included vomiting, nausea, obstruction of intravascular catheter, tremor, seizure, temporary visual loss and continued decrease in PCV It is suggested that pediatric hemedialysis system can be applied to acute renal failure and acute toxicity. Further works on improvements in maintaining patency of catheter and in managing the complications of hemo- dialysis should be conducted.

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A Case Report of Chronic Renal Failure(stage4) on Stroke Patient through Integrative Medicine Therapy. (만성 신부전 환자의 중풍치료에 대한 한·양방 협진효과 증례보고)

  • Hwang, Yunkyeong;Lee, Boram;Kim, Wonill
    • Herbal Formula Science
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    • v.24 no.3
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    • pp.233-242
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    • 2016
  • Objective : Chronic renal failure(CRF) is defined as a permanent reduction in glomerular filtration rate(GFR), resulting in Structural and functional abnormalities. The purpose of this thesis is to report the improvement of a CRF stage4 on stroke patient through integrative medicine therapy.Methods : We treated the patient with herbal medication(Sibjeondaebo-tang gagambang), acupuncture and moxibustion as well as Western medication. We measured the Creatinine, BUN, eGFR in the serum and observed clinical symptoms During 4monthsResult : After treatment, the level of BUN and Creatinine was decreased and eGFR was increased. And the symptoms of CRF(edema, anorexia, general weakness) were improved.Conclusion : This study suggests that Integrative Medicine Therapy is effective in the treatment of CRF symptoms. In the future, for the effective management of CRF, It is considered necessary to build a systematic integrative medicine therapy.

사회문제해결형 R&D 현황 및 특성 분석 : NTIS Data를 중심으로

  • Im, Hong-Tak
    • Proceedings of the Korea Technology Innovation Society Conference
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    • 2017.11a
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    • pp.755-755
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    • 2017
  • 공공분야에서의 지식생산이라는 국가 R&D사업의 본연의 임무에 사회문제해결이라는 보다 구체적인 요구가 커지고 있다. 취약계층, 노인, 장애인과 같은 사회적 약자들의 삶의 질 개선에 더불어 조류 인플루엔자, 미세먼지오염 등 국민생활에 영향을 주는 사회문제의 해결에 과학기술지식이 기여하라는 사회적 요청이 커지고 있다. 그동안 산업 지원과 학문 발전을 중심으로 발전해오던 국가R&D시스템이 이제는 공공분야에서의 지식생산시스템 격상이라는 과제를 안게 되었다. 정부는 2012년 '신과학기술 프로그램 추진전략(안)'을 통해서 이러한 요구를 수용하기 시작했으며 2014년에 다(多)부처 기획을 통해 11개 사업 분야를 선정하고 사회문제해결을 위한 R&D를 다(多)부처 사업으로서 2015년부터 시작하였다. 또한 과학기술정보통신부(구 미래부)는 단일 부처사업으로서 '사회문제해결형 사업' 을 2104년부터 추진하였다. 논문이나 특허보다는 현장문제의 해결책, 솔루션 생산을 목표로 제시하였으며 현장의 사용자나 시민이 연구개발의 전 과정에 참여하는 리빙랩이라는 새로운 방법론의 적용을 사회문제해결형 R&D사업의 성격으로 제안하였다. 본 연구는 사회문제해결형 R&D라는 이 새로운 시도가 국가R&D 시스템 안에서 어떻게 시행되었는지 NTIS data를 통해서 분석해보고자 한다. 먼저 다부처 기획으로 선정되어 추진된 과제들의 특성, 즉 연구적용분야, 연구 단계 등을 분석하고 단일부처 사업으로 수행된 '사회문제해결형 사업' 및 유사 단일부처 사업 과제들의 특성을 알아본다. 연구수행주체, 연구방법론 등 사회문제해결형 R&D 기획에서 제시한 새로운 방법들의 수행 여부를 알아보고 이를 통해 공공분야 국가R&D 시스템의 발전 및 사회문제해결형 R&D 사업의 향후 발전 방안을 제안한다.

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A Hybrid EMR System to bridge Source-Oriented and Problem-Oriented Medical Record (SOMR과 POMR의 혼용을 위한 하이브리드 EMR 시스템)

  • Kim, Jong-Ho;Kim, Hyun-Ju
    • 한국IT서비스학회:학술대회논문집
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    • 2007.11a
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    • pp.364-369
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    • 2007
  • 다양한 의료서비스를 정형화되고 효율적인 방법으로 제공하기 위하여 최근 의료기관의 EMR(Electronic Medical Record; 전자의무기록) 시스템의 도입이 급속도로 확산되고 있다. 그러나 국내에서 구축되고 있는 EMR은 초기에 기대했던 EMR의 도입목적을 중분하게 달성하지 못하고 있다. 이는 근본적으로 EMR의 방향성과 구조에 한계를 지니고 있기 때문이다. 국내에서 구축되고 있는 대부분의 전자의무기록시스템은 자료수집원 지향 의무기록 (Source Oriented Medical Record; SOMR) 방식으로 개별 사실을 수집하고 제시하기 위한 관찰자 중심, 서식중심의 시스템이며 차트 이송과 종이를 없애는 것이 주목적이다. SOMR 방식은 EMR의 다양한 도입목적, 특히 임상자료의 효과적 활용을 충족시킬 수 없는 태생적인 한계를 지니고 있기 때문에 문제지향 의무기록 (Problem Oriented Medical Record; POMR) 방식의 EMR과 적절한 혼용전략 (Hybrid Strategy)이 절실히 요구된다. 본 연구의 목적은 SOMR 시스템과 POMR 시스템이 보완적으로 결합된 하이브리드 EMR 아키텍처를 제시하고 아키텍처를 구성하는 데 필요한 기술적 요소들과 그들간의 상호관계 틀 파악한 후 이를 기반으로 개발방법론을 도출하는 것이다. 또한 만성신부전증 환자 사례를 이용하여 앞서 제시된 개발방법론에 따라 프로토타입을 개발하였다. 본 연구는 EMR 시스템이 SOMR 구조에만 편향됨으로써 발생될 수 있는 다양한 문제들을 해결함으로써 진료의 품질 항상, 임상연구의 활성화, 조직적이고 과학적인 진료계획의 수립과 같은 소외되어 왔던 EMR의 목표를 실현할 수 있을 것으로 기대 된다.

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A Study on the Characteristics Comparison of Single Chip and Two Chip Transceiver for the Fiber Optic Modules (광모듈용 단일 칩 및 2 칩 트랜시버의 특성비교 연구)

  • Chai Sang-Hoon;Jung Hyun-Chae
    • Journal of the Institute of Electronics Engineers of Korea SD
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    • v.43 no.5 s.347
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    • pp.48-53
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    • 2006
  • This paper describes the electrical characteristics of monolithic optical transceiver circuitry being used in the fiber optic modules. It has been designed and fabricated, and compared with two chips version transceiver when operates at 155.52 Mbps data rates. To avoid noise and interference between transmitter and receiver on one chip, layout techniques such as special placement, power supply separation, guard ring, and protection wall were used in the design. To compare the two kind of fiber optic modules using each chip, single chip version has similar properties to two chip version in the electrical characteristics as noise and others.

A case of Diagnosing Paraquat Intoxication on Transferred Patient with Acute Renal Failure (원인 불명의 급성 신부전으로 발현된 급성 파라콰트중독 1례)

  • Gil Hyo Wook;Yang Jong Oh;Lee Eun Young;Hong Sae Yong
    • Journal of The Korean Society of Clinical Toxicology
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    • v.2 no.1
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    • pp.45-48
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    • 2004
  • Paraquat, a widely used herbicide, is extremely toxic, causing multiple organ failure in human. Many treatment modality has been used, but now paraquat is very fatal drug. Elimination rate of plasma paraquat seems to be a factor for the survival rate. So early diagnosis and early treatment are very important. Plasma paraquat concentration could be measured by radioimmunoassay. But it is impossible that the test was done at Emergency room and the result was checked immediately. There was relation between plasma paraquat concentrations and urine paraquat concentration. Because of its simplicity and low cost, urine paraquat concentration test is complementary to the plasma concentration measurement. If the patient has psychotic problem or unconscious mental state, and is observed unexplained dyspnea and oral ulcer, urine paraquat test is very important to rule out acute paraquat intoxication. We experienced a patient who was presented as unexplained acute renal failure initially and was diagnosed as paraquat intoxication later.

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Two Cases of Acute Renal Failure due to Rhabdomyolysis Complicating Doxylamine Succinate Intoxication (독시라민 과다복용에 의한 횡문근 용해 및 급성 신부전 2례)

  • Jung Jae Kwon;Kim Sung Ho;Kim In Seek;Kim Seon Woong;Ju Dong Wook;Lee Duk Hyun;Kim Jong Kun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.2 no.1
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    • pp.15-19
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    • 2004
  • Doxylamine succinate is an antihistamine used primarily as a sleep-induction. It can be gotten without a doctor's prescription in Korea, so it' s overdoses were frequently encountered. There were several reports that the overdoses of doxylamine might cause rhabdomyolysis, but few cases have been reported that it is related to acute renal failure (ARF). In cases that ARF occur, most of them are not severe enough to require hemodialysis. We experienced two cases of severe rhabdomyolysis complicating ARF after doxylamine overdose and treated with hemodialysis. Clinicians should be aware of the potentially lethal complications of rhabdomyolysis in patients who ingest doxylamine succinate and the needs for prompt intervention and careful assessment of renal function.

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One Case Report of Chronic Renal Failure Patient Prescribed Gyulpyjeonwon (귤피전원(橘皮煎元)을 처방한 만성신부전 환자 1례에 대한 보고)

  • Jung, Gi-Hun;Chang, Sun-Kyu;Cho, Chung-Sik;Kim, Chul-Jung
    • Journal of Haehwa Medicine
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    • v.16 no.2
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    • pp.229-234
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    • 2007
  • Objectives : Chronic renal failure(CRF) is a pathophysiologic process with multiple etiologies, resulting in the inexorable attrition of nephron number and function and frequently leading to end-stage renal disease. It causes various symptoms(edema, general body weakness, nausea, anorexia, uremia, osteodystrophy and so on) which impair quality of life and long term complications. The purpose of this case is to report the improvement of a patient with chronic renal failure. Methods : We treated the patient with herbal medication(Gyulpyjeonwon) and measured the creatinine, BUN, albumin, hemoglobin in the serum. Results : Gyulpyjeonwon decreased serum creatinine and BUN level and increased serum albumin and hemoglobin level. And the symptoms of CRF(edema, general body weakness, anorexia) was improved significantly. Conclusions : This case suggests the efficacy of herbal medication(Gyulpyjeonwon) to patient who was involved CRF.

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