• Journal of the korean academy of Pediatric Dentistry
• /
• v.25 no.4
• /
• pp.710-716
• /
• 1998

It is one of difficulties to control children who show definitely negative behavior in dental clinic. In such a case, the pharmacologic management has been used to provide quality care, minimize the extremes of disruptive behavior, promote a positive psychologic response to treatment and patient welfare and safety. Deep sedation can be defined as a controlled, pharmacologically-induced state of depressed consciousness from which the patient is not easily aroused which may be accompanied by a partial loss of protective reflexes. In this retrospective report, the sedation records of 200 pediatric dental patients of ASA Class I & II who were not successfully treated under conscious sedation were used for analysis. Most frequently used regimen of deep sedation was the co-medication of midazolam(0.3mg/kg), enflurane(1.0-2.0 vol%) and 50-70% $N_2O_2$. The average age and weight of the patients was 4.6 yr (S.D: 2.72) and 18.7kg(S.D: 6.35) respectively. The average operative time was 52 minutes and midazolam (0.1-0.2cc) was additionally administered intranasally to prolong the operative time as needed. The episodes of untoward side effects were reported during and/or after the procedure in 58 patients. Serious adverse reactions such as cyanosis or laryngospasm were even reported in 7 patients but without mortality. Deep sedation is a very effective way of completing the dental treatments for those who failed to respond well to the conscious sedation. This technique has many practical advantages over general anesthesia case but the demands for the rigid monitoring criteria limit its use in general practice setting. The continuous efforts to improve the safety of the medication and the technique are required for the benefits of the patients and parent.

• Korean Journal of Clinical Pharmacy
• /
• v.26 no.3
• /
• pp.207-212
• /
• 2016

Objective: Prescription rate of dabigatran and rivaroxaban, which are the direct oral anticoagulants (DOAC), has increased. We have analyzed the prescription trend and medication use of dabigatran and rivaroxaban in patients with non-valvular atrial fibrillation (NVAF). Methods: It was retrospectively studied from September 2012 to April 2014 using the electronic medical records and the progress notes. Patients with NVAF (n=424) were evaluated on the medication use, prescribing preferences, adverse drug reactions (ADRs) and the availability of prescription reimbursement of dabigatran (n=210) and rivaroxaban (n=214). Results: Dabigatran was prescribed higher than rivaroxaban (23.3% versus 7.5%, p<0.001) in the neurology department, but rivaroxaban was prescribed higher compared to dabigatran in the cardiology department (87.4% versus 74.3%, p<0.001). Dabigatran was prescribed more than rivaroxaban in high risk patients with CHADS2 score ${\geq}3$ (44.3% versus 31.3%, p=0.006). Dabigatran patients seemed to have more ADRs than patients with rivaroxaban (25.2% versus 11.2%, p<0.001), but no serious thrombotic events and bleeding were found. Only 35.6% (n=151) were eligible for prescription reimbursement by the National Health Insurance (NHI). Bridging therapy (86, 31.5%) and direct-current cardioversion (57, 20.2%) were main reasons of ineligibility for reimbursement. Conclusion: Prescription preferences were present in choosing either dabigatran or rivaroxaban for patients with NVAF. Inpatient protocols and procedures considering patient-factors in NVAF need to be developed.

• Korean Journal of Clinical Pharmacy
• /
• v.30 no.2
• /
• pp.81-86
• /
• 2020

Background: The number of patients with dementia continues to increase as the age of aging continues to grow. Psychiatric symptoms caused by senile dementia are controlled using antipsychotics. However, these antipsychotics can lead to Parkinson's disease, and abuse of dopamine derivatives such as levodopa among Parkinsonian drugs can lead to psychosis. Therefore, we evaluated the patterns of prescribed antipsychotics and antiparkinsonian drugs in patients with senile dementia. Methods: We used data from the sample of elderly patients from the Health Insurance Review and Assessment Service (HIRA-APS-2016). We analyzed the patterns of prescribing antipsychotics and antiparkinsonian drugs including prescribed daily dosage, period of prescription, and number of patients with both antipsychotics and antiparkinsonian drugs for senile dementia. Results: Among the 159,391 patients with dementia included in this analysis, 4,963 patients (3.1%) and 16,499 patients (10.4%) were prescribed typical and atypical antipsychotic drugs, respectively. The most frequently prescribed typical antipsychotic was haloperidol (4,351 patients with dementia), whereas the atypical agent was quetiapine (12,719 patients). The most frequently prescribed antiparkinsonian drugs were in the order of levodopa/carbidopa, benztropine, and ropinirole. In addition, 1,103 and 3,508 patients prescribed typical and atypical antipsychotics, respectively, were co-prescribed antiparkinsonian drugs. Conclusions: Atypical antipsychotics were the preferred prescription in patients with senile dementia. The prescription dose was relatively low; however, the average treatment duration was mostly long-term. Selection of antipsychotics and/or antiparkinsonian drugs should be made carefully in senile dementia and the causal relationship of adverse drug reactions needs further study.

• Journal of East-West Nursing Research
• /
• v.17 no.2
• /
• pp.96-102
• /
• 2011

Purpose: Patient-controlled epidural analgesia (PCEA) is an effective method for controlling post surgical pain. However, it is associated with adverse drug reactions such as nausea and vomiting. In this, study we tested the effects of Nei-Guan (P6) acupressure on PCEA-associated nausea, vomiting, and pain in geriatric patients after total knee replacement arthroplasty (TKRA). Methods: Ninety-nine patients who had TKRA for the first time were randomly assigned to either, experiment group (n=50) or control groups (n=49). All patients received PCEA immediately after surgery, but acupressure on Nei-Guan (P6) point was applied to experiment group only. Ten minutes of finger acupressure on Nei-Guan (P6) acupressure point was applied twice with 15 minute-interval in the experiment group. The incidence of nausea, vomiting, and retching as well as pain intensity were assessed at 12 and 24 hours after surgery. Nausea, and vomiting were assessed by Index of Nausea, Vomiting and Retching (INVR) questionnaire. Pain intensity was measured with frequency of analgesics. Results: Vomiting both was significantly different between two groups at 12 hours (t=-2.18, p=0.03) and 24 hours (t=-2.64, p=0.01) after surgery. Total scores of nausea, vomiting and retching in experimental group was significantly lower than control group 24hours after surgery (t=-2.18, p=0.03). However, pain was not different between two groups. Conclusion: Nei-Guan (P6) acupressure may be considered as an effective nursing intervention to decrease PCEA-associated nausea and vomiting in older patients after TKRA.

• Tuberculosis and Respiratory Diseases
• /
• v.41 no.5
• /
• pp.546-551
• /
• 1994

Gold therapy of rheumatoid arthritis is effective, but adverse reactions are also common. There are some cutaneous, hematologic, renal, and pulmonary side effects which have been associated with immunologic abnormalities. Also, hypersensitivity pneumonitis induced by gold therapy was rarely reported in literature. But, the mechanism for the induction of the pulmonary disease is not known. We report a case of seropositive rheumatoid arthritis presented as gold induced hypersensitivity pneumonitis which was confirmed by the peripheral blood lymphocyte stimulation test with gold.

• The Journal of Internal Korean Medicine
• /
• v.37 no.3
• /
• pp.560-567
• /
• 2016

Objectives: The medical records, including laboratory test results, of a patient with autoimmune hepatitis (AIH)-primary biliary cirrhosis (PBC) overlap syndrome were reviewed to observe changes in steroid-induced adverse reactions before and after herbal medicine treatment.Methods: We investigated the records of a 44-year-old female patient with AIH-PBC overlap syndrome treated at the Kyung Hee University Korean Medicine Hospital. Injinchunggan-tang and its modified decoctions were administered, and any changes inclinical manifestations as well as laboratory test results were monitored.Results and Conclusions: Significant decreases in ALP, GGT, ALT, and AST levels were observed after oral administration of the herbal medicines. Improvements in steroid-induced symptoms (hyperglycemia, fatigue, and moon face) were also observed. Injinchunggan-tang and its modified prescriptions are promising candidates for proper management of AIH-PBC overlap syndrome.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.11 no.sup1
• /
• pp.83-92
• /
• 2008

Helicobacter pylori is the causative agent of chronic gastritis and has a role in the pathogenesis of peptic ulcer diseases, and gastric cancer. There have been reports suggesting a close link between these gastroduodenal disorders and a state of vitamin C deficiency. In this paper, the past, present and future perspectives on H. pylori infection and vitamin C will be discussed under the following view points. Since the ecological niche of H. pylori is the mucus layer and intercellular junctions of the gastric epithelium, the various kinds of host inflammatory cells motivated by the local and systemic immune responses cannot eliminate the microorganisms. When the invading foreign body is not removed, despite full activation of defense mechanisms, adverse consequences of the immune responses develop on the host gastric mucosa. The reasons for the body vitamin C depletion could be explained as follows; 1) the increased vitamin C consumption by increased oxygen free radical production through the prolonged hypersensitivity reactions in the gastric mucosa, 2) the increased vitamin C oxidation by the nitrite which is formed from nitrate reduction by the intragastric bacteria proliferated in the hypochlorhydric gastric cavity, 3) the strong ${\gamma}$-glutamyltranspeptidase activity of H. pylori which depletes the glutathiones in gastric mucosa. Depletion of glutathiones in the stomach favors irreversible oxidative destruction of ascorbic acid. Both persistent inflammatory burdens in the stomach by H. pylori and resultant vitamin C depletions synergistically and uninhibitedly might aggravate the hypothetical sequence of gastric carcinogenesis: atrophic gastritis${\rightarrow}$intestinal metaplasia${\rightarrow}$dysplasia${\rightarrow}$gastric adenocarcinoma. High intake of vitamin C could reverse the hypothetical sequence of the gastric carcinogenesis via direct and indirect effects on H. pylori and host-parasite relationships.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.15
• /
• pp.6765-6768
• /
• 2015

Aims: To study the effectiveness of human recombinant endostatin injection (Endostar(R)) combined with cisplatin doublets in treating advanced non-small cell lung cancer (NSCLC), and to evaluate outcome by CT perfusion imaging. Methods: From April 2011 to September 2014, 76 patients with advanced NSCLC who were treated with platinum-based doublets were divided into group A (36 patients) and group B (40 patients). Endostar(R) 15mg/day was administered 4 days before chemotherapy and combined with chemotherapy from day 5 in group A, and combined with chemotherapy from the first day in Group B. Endostar(R) in the two groups was injected intravenously for 14 days. Results: Treatment effectiveness in the two groups differed with statistical significance (p<0.05). Effectiveness evaluated by CT perfusion imaging, BF, BV, MTT and PS also demonstrated significant differences (all p<0.05). Adverse reactions in the two groups did not significantly vary (p> 0.05). Conclusions: The response rate with Endostar(R) administered 4 days before chemotherapy and combined with chemotherapy from day 5 in group A was better than Endostar(R) combined with chemotherapy from the first day, and CT perfusion imaging could be a reasonable method for evaluation of patient outcomes.

• Journal of the Korean Society for Heat Treatment
• /
• v.18 no.2
• /
• pp.91-98
• /
• 2005

Both commercially pure titanium and Ti-6Al-4V alloy have been widely used as biomaterials because of their excellent biocompatibility, corrosion resistance and mechanical properties. However, in recent years, vanadium has been found to cause cytotoxic effects and adverse tissue reactions, while aluminium has been associated with potential neurological disorders. A newly designed ${\alpha}+{\beta}$ type Ti alloy, Ti-10Ta-10Nb alloy showed superior properties to CP Ti and Ti-6Al-4V alloy in the point of biomaterial, and elucidated the future uses as a biomaterial. Microstructural changes of Ti-10Ta-10Nb alloy after hot-rolling, warm-rolling, solution and aging treatment were investigated. According to TEM results, the microstructures after solution treatment were composed of mostly ${\alpha}$ phase with a trace of ${\beta}$ phase due to adding ${\beta}$-phase stabilizer tantalum and niobium. The microstructures after warm-rolling is coarse and elongated ${\alpha}$ phase and hot rolling resulted in very fine ${\alpha}$ widmanst$\ddot{a}$tten. The highest value of hardness was obtained by aging treatment at $400^{\circ}C$ for 20hr in which microstructure consisted of very fine ${\alpha}$ phase in ${\beta}$ matrix.

• The Journal of Internal Korean Medicine
• /
• v.40 no.6
• /
• pp.1202-1209
• /
• 2019

Objectives: The purpose of this study was to confirm the effects of an auricular acupressure (AA) program for smoking cessation in high school students from 2015 to 2017. Methods: The study investigated 12 high school students who had been smokers. Subjects were treated for three years. Each program was composed of five AA treatments. Average daily smoking and adverse reactions were checked for one week before each procedure. The AA was administered weekly at the endocrine point, lung point, throat point, nasal fossae point, bronchial tube point, and mouth point. Results: The mean number of cigarettes smoked per day after each year of treatment significantly decreased from 5.33±3.58 to 3.54±2.08 in 2015 (p=0.046). However, it increased from 5.75±2.30 to 6.00±3.61 in 2017 (p=0.80). The number of cigarettes smoked before treatment was found to be higher than the number of cigarettes after treatment in the previous year. No significant results were obtained from analysis of the change in the amount of smoking within each year. Conclusion: Social influence, such as the subject's academic stress and peer relationships, may have been a major factor in the change in the amount of smoking. Although the AA did not show a strong effect in smoking cessation, it appears to have value as a supplementary means of stopping smoking.