• Clinical and Experimental Pediatrics
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• 제50권5호
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• pp.493-496
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• 2007

Dapsone은 나병과 여러 수포성 피부 질환의 치료에 널리 사용되고 있다. 일반적인 투여 용량의 dapsone은 부작용이 드물지만, 피부, 신경계, 위장관, 간, 신장과 혈액학적 합병증을 일으킬 수 있다. 이들 부작용 중 하나인 dapsone 증후군은 약물 투여 수주 후에 발생하여, 예측 불가능하게 진행하며 치명적인 경과를 취할 수 있는 중증 약물 과민 반응이다. 저자들은 dapsone 투여 4주 후에 열, 박탈성 피부염, 황달, 용혈성 빈혈, 늑막 삼출 등의 특징적인 임상 소견을 보인 dapsone 증후군 1례를 경험하였기에 보고하는 바이다.

• 성인간호학회지
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• 제18권3호
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• pp.488-499
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• 2006

Purpose: Behavioral symptoms in dementia (BSD) are one of the most disturbing behaviors to caregivers and a major reason for nursing home placement. Behavioral symptoms are often treated with psychotropic drugs (PD), however, the effect of such drugs for the frail elderly dementia patient is not certain because of their critical adverse effects. Theoretical model applicable to nursing practice for BSD in nursing homes, which is essential in guiding and evaluating such interventions, is absent. This article presents the process of developing a theoretical model of BSD in nursing homes. Method: Using Walker and Avants' theory synthesis method, three behavior models and two system models were incorporated into the proposed model to provide the theoretical and analytical explanation of the relationships between PD usage, its determinants, and BSD. Results: Resident variables and nursing home variables related to the two focal concepts (i.e., PD usage and BSD) were identified. Resident variables include demographical characteristics such as age and gender, and dementia-compromised functions such as cognitive and functional impairment. Nursing home variables include facility characteristics such as ownership type and size, and physical and psychosocial environment. Conclusion: The proposed model suggests that fulfillment of resident unmet needs through improvement of physical and psychosocial environment may produce better health outcomes of nursing home residents with BSD. Assessment and intervening environmental triggers of such behaviors are also suggested to be prior to the PD usage.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.973-978
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• 2016

Background: Between October 2012 and February 2015, 25 patients with metastatic colorectal cancer (mCRC) (mean age, $57.0{\pm}12.1years$) were granted access to aflibercept via the Aflibercept Named Patient Program at four centers. Materials and Methods: Here we reported the initial experience of aflibercept / FOLFIRI in combination. We evaluated treatment-related adverse events (AEs), progression-free survival (PFS) and overall survival (OS). Results: The majority of the patients experienced gastrointestinal toxicity (grade 1-2), with diarrhea (52%), mucositis (52%), and nausea/vomiting (20%) being largely observed. Neutropenia (16%) and febrile neutropenia (8%) were common grade 3-4 hematological events. Aflibercept-related toxicity was managed as per practice guidelines. No grade 5 event was reported. Median PFS was 6.12 months (95% CI, 4.80-7.20) and OS was 12 months (95% CI, 9.80-14.18). The partial response (PR), stable disease (SD), and progressive disease (PD) rates were 25% (95% CI: 23.4-27.0), 37.5% (95% CI: 31.6-43.3), and 37.5% (95% CI: 22.5-52.5), respectively. Conclusions: Aflibercept/FOLFIRI can be administered safely in a second line setting to Malaysian patients with mCRC, as the AEs experienced were generally reversible and manageable. The safety and efficacy outcomes were consistent with those observed in Western populations.

• 대한두경부종양학회지
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• 제36권1호
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• pp.1-8
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• 2020

It is well established that cancer patients are more susceptible to infection because of the immunosuppressive status caused by both disease itself and anticancer treatment, including surgery and chemoradiation. Head and neck cancer (HNC) patients are generally at high-risk for coronavirus disease 2019 (COVID-19) infection and serious adverse outcomes. Although there is an urgent need for guidance in the delivery of safe, quality oncologic care, no international consented recommendation addressed the management of HNC patients in COVID-19 due to limited data. In this review, we summarized the consideration for head and neck oncologic care in the context of the COVID-19 pandemic, based on the data and the very recent recommendations from the Korean Cancer Association and National Cancer Center. COVID-19 should be taken into consideration in the comprehensive management of HNC patients, and multidisciplinary evaluation of multilevel surgical-risks, discussion of optimized strategy, and shared-decision-making with the patient are needed to maximize both the safety from infectious pandemic and outcome of surgical and oncologic care.

• Journal of Korean Biological Nursing Science
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• 제19권1호
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• pp.30-37
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• 2017

Purpose: The aims of this study were to identify prevalence and identify factors related to sarcopenic obesity among community-dwelling elderly women. Methods: This is a secondary analysis of the prospective cohort study. Our analysis included 338 elderly women (${\geq}65$ years old) in South Korea as a part of the Community-dwelling Older Adult Health Cohort (COHC) Study (2014-2015). Sarcopenic obesity was defined as the Asian Working Group of Sarcopenia recommendations and upper two quintiles for percentage body fat. Logistic regression analysis was used to determine the factors related to sarcopenic obesity including chronic diseases, medications, stress, fatigue, depression, exercise, level of proteins on body compositions, smoking, and alcohol use. Results: The prevalence of sarcopenic obesity was 6.2%. A lower protein on body compositions (OR 0.017, 95% CI 0.003-0.081, p< .001), a larger number of medications (OR 2.104, 95% CI 1.404-3.152, p< .001), and a higher level of fatigue (OR 1.255, 95% CI 1.023-1.541, p= .030) were related factors of sarcopenic obesity. Conclusion: The findings suggest that nutritional interventions focusing on protein intakes should be needed to prevent sarcopenic obesity among the elderly women. Polypharmacy issue for preventing adverse outcomes and level of fatigue as indicator for early identification are also considered to develop community prevention programs.

• 한국임상약학회지
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• 제27권2호
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• pp.113-118
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• 2017

Objective: International institutes such as Global institute for Asthma(GINA), KAAACI(Republic of Korea), NHLBI(USA), BTS(UK) and JSA(Japan) have published guidelines for asthma treatment. The aim of this study was to compare the representatives' international guidelines of pharmacotherapy for pediatric asthma. Methods: The recommendations related to pharmacotherapy for pediatric asthma were extracted from the latest representatives' international guidelines, and comprehensive comparisons were conducted. Results: Major comparison outcomes between international guidelines were evaluated as follows: classification system on severity and pediatric age group, recommendation for inhaled corticosteroid dose, recommendation for pediatric age group of theophylline in mild asthma, and recommendation for pediatric age group of tiotropium in severe asthma. Clinical trials emphasized the adverse effects of theophylline, whereas tiotropium demonstrated beneficial actions for pediatric asthma. Therefore, theophylline was recommended for older patients with persistent asthma, and tiotropium was considered to be suitable for younger patients with severe asthma according to GINA guidelines. Conclusion: These findings address the requirement to harmonize international guidelines of pharmacotherapy in pediatric asthma. In addition, the findings suggest that KAAACI needs to update its pharmacotherapy guidelines of theophylline, tiotropium and other medicines recently approved.

• 한국임상약학회지
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• 제30권3호
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• pp.143-148
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• 2020

Objective: This study aimed to investigate pharmaceutical care for critically ill neonates and suggest targeted strategies compatible with the Korean health-system pharmacy. Methods: Articles that reported pharmacy practices for critically ill neonates were reviewed. Pharmaceutical care practices and roles of neonatal pharmacists were identified, and criteria were developed for neonates in need of specialized care by clinical pharmacists. Results: Neonatal pharmacists play many roles in the overall medication management pathway. For clinical decision support, multidisciplinary ward rounds, clinical pharmacokinetic services, and consultation for pharmacotherapy and nutrition support were conducted. Prevention and resolution of drug-related problems through review of medication charts contributed to medication safety. Pharmaceutical optimization of intravenous medication played an important role in safe and effective therapy. Information on the use of off-label medicine, recommended dosage and dosing schedules, and stability of intravenous medicine was provided to other health professionals. Most clinical practices for neonates in Korea included therapeutic drug monitoring and nutrition support services. Reduction in medication errors and adverse drug reactions, shortening the duration of weaning medicines, decreasing the use and cost of antimicrobials, and improvement in nutrition status were reported as the outcomes of pharmacist-led interventions. The essential criteria of pharmaceutical care, including for patients with potential high-risk factors for drug-related problems, was developed. Conclusion: Pharmaceutical care for critically ill neonates varies widely. Development and provision of standardized pharmaceutical care for Korean neonates and a stepwise strategy for the expansion of clinical pharmacy services are required.

• Journal of Korean Neurosurgical Society
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• 제59권4호
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• pp.405-409
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• 2016

Meningiomas are typically diagnosed by their characteristic appearance on conventional magnetic resonance imaging (MRI). However, detailed image findings regarding peri- and intra-tumoral anatomical structures, tumor consistency and vascularity are very important in pre-surgical planning and surgical outcomes. At the 7.0 T MRI achieving ultra-high resolution, it could be possible to obtain more useful information in surgical strategy. Four patients who were radiologically diagnosed with intracranial meningioma in 1.5 T MRI underwent a 7.0 T MRI. Three of them underwent surgery afterwards, and one received gamma knife radiosurgery. In our study, the advantages of 7.0 T MRI over 1.5 T MRI were a more detailed depiction of the peri- and intra-tumoral vasculature and a clear delineation of tumor-brain interface. In the safety issues, all patients received 7.0 T MRI without any adverse event. One disadvantage of 7.0 T MRI was the reduced image quality of skull base lesions. 7.0 T MRI in patients with meningiomas could provide useful information in surgical strategy, such as the peri-tumoral vasculature and the tumor-brain interface.

• 한국발생생물학회지:발생과생식
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• 제19권4호
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• pp.167-180
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• 2015

Arsenic is a toxic metalloid that exists ubiquitously in the environment, and affects global health problems due to its carcinogenicity. In most populations, the main source of arsenic exposure is the drinking water. In drinking water, chronic exposure to arsenic is associated with increased risks of various cancers including those of skin, lung, bladder, and liver, as well as numerous other non-cancer diseases including gastrointestinal and cardiovascular diseases, diabetes, and neurologic and cognitive problems. Recent emerging evidences suggest that arsenic exposure affects the reproductive and developmental toxicity. Prenatal exposure to inorganic arsenic causes adverse pregnancy outcomes and children's health problems. Some epidemiological studies have reported that arsenic exposure induces premature delivery, spontaneous abortion, and stillbirth. In animal studies, inorganic arsenic also causes fetal malformation, growth retardation, and fetal death. These toxic effects depend on dose, route and gestation periods of arsenic exposure. In males, inorganic arsenic causes reproductive dysfunctions including reductions of the testis weights, accessory sex organs weights, and epididymal sperm counts. In addition, inorganic arsenic exposure also induces alterations of spermatogenesis, reductions of testosterone and gonadotrophins, and disruptions of steroidogenesis. However, the reproductive and developmental problems following arsenic exposure are poorly understood, and the molecular mechanism of arsenic-induced reproductive toxicity remains unclear. Thus, we further investigated several possible mechanisms underlying arsenic-induced reproductive toxicity.

• 대한치과의사협회지
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• 제53권12호
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• pp.926-934
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• 2015

Obstructive sleep apnea (OSA), most common respiratory disorder of sleep, is characterized by intermittent partial or complete occlusions of the upper airway due to loss of upper airway dilating muscle activity during sleep superimposed on a narrow upper airway. Termination of these events usually requires arousal from sleep and results in sleep fragmentation and hypoxemia, which leads to poor quality of sleep, excessive daytime sleepiness, reduced quality of life and numerous other serious health consequences. Untreated OSA may cause, or be associated with, several adverse outcomes, including daytime sleepiness, increased risk for motor vehicle accidents, cardiovascular disease, and depression. Various treatments are available, including non-surgical treatment such as medication or modification of life style, continuous positive airway pressure (CPAP) and oral appliance (OA). Skeletal surgery for obstructive sleep apnea (OSA) aims to provide more space for the soft tissue in the oropharynx to prevent airway collapse during sleep. Conventional surgical techniques include uvopalatopharyngoplasty(UPPP), genioglossus advancement (GA), and maxillomandibular advancement (MMA). Surgical techniques, efficacy and complications of skeletal surgery are introduced in this review.