• The Journal of Korean Medical History
• /
• v.30 no.1
• /
• pp.51-59
• /
• 2017

Shihosamul-tang (柴胡四物湯, Bupleurum Four Substances Decoction) is a very effective and widely utilized prescription in Korean medicine. However, there has not been a clinical example written in the classical literature of Korean medicine that deals with Shihosamul-tang and the delicate and changeable clinical use of Shihosamul-tang remains unknown. This study tries, for the first time, to show the clinical practice of Shihosamul-tang through review of KyungBoSinPyun (輕寶新篇). KyungBoSinPyun is a medical book containing 143 case records in the tradition of the East Asian practice of describing clinical encounters and the therapies employed. This study examines eight examples of case records within KyungBoSinPyun highlighting use of Shihosamul-tang. The purpose is to understand how Shihosamul-tang is applied in clinical practice compared to the description of Shihosamul-tang in Donguibogam (東醫寶鑑). Different descriptions about the symptoms and transformation methods of the prescription have been found in the eight examples of Shihosamul-tang case records contained in KyungBoSinPyun. This paper concludes that the difference between clinical practice and a typical description in medical books should be overcome by medical virtuosity and the potential for change for each clinical case, which is gained when seeing beyond the text of medical books.

• Clinical Endoscopy
• /
• v.57 no.4
• /
• pp.454-465
• /
• 2024

Background/Aims: Gastrointestinal bleeding is a significant and potentially lethal event. We aimed to review the efficiency and safety of self-assembling peptides for the treatment and prevention of gastrointestinal tract bleeding. Methods: We conducted a systematic search for studies describing the endoscopic use of self-assembling peptides for treatment or prevention of bleeding in the gastrointestinal tract in a parallel, independent fashion. The primary outcomes were rates of successful initial hemostasis, delayed bleeding, and rebleeding. The secondary outcomes were adverse events and ease and volume of gel used. Results: Seventeen studies were analyzed. Overall success rate of self-assembling peptides in gastrointestinal bleeding was 87.7% (38%-100%), regardless of etiology or associated treatments. Rebleeding rate ranged from 0% to 16.2%, with a mean of 4.7%, and overall delayed bleeding rate was 5% (range, 0%-15.9%). Only three adverse events were reported in a pooled number of 815 patients. The volume of gel used varied (0.43 to 3.7 mL) according to indication and type of bleeding. Conclusions: The limited available data on the use of self-assembling peptides in gastrointestinal endoscopy suggest a high efficiency and good safety profile.

• Korean Journal of Psychosomatic Medicine
• /
• v.25 no.2
• /
• pp.120-128
• /
• 2017

Objectives : Although antipsychotics are commonly used to control symptoms of delirium, there is a lack of research on the prescription pattern and its clinical effects. The purpose of this study was to investigate the effect of antipsychotics prescription pattern on clinical course of delirious patients consulted to psychiatry. Methods : During the period from July 2016 to February 2017, 212 patients who were referred for delirium were reviewed for their medical records. The duration of delirium was monitored using CAM-ICU, and duration of admission, mortality, and delirium at discharge were reviewed. Clinical course was compared among three groups according to the antipsychotic drug administration pattern: Continuous use group, optimal use group and PRN use group. Results : The pattern of taking antipsychotic medication longer than duration of delirium did not associated with better clinical course compared with the pattern of adapting to the period of delirium and rather increased the risk of taking antipsychotic medication at discharge. When used for a shorter period than the delirium period, it was associated with poor clinical course. Conclusions : The results of this study suggest that a strategy to administer antipsychotics for a minimum period, according to periods of delirium, is appropriate. Also, efforts are needed to minimize the use of antipsychotic drugs after recovery from delirium.

• The Journal of Internal Korean Medicine
• /
• v.41 no.6
• /
• pp.984-992
• /
• 2020

Objectives: This survey research was conducted to evaluate real-time non-face-to-face education in clinical Korean medicine conducted during the COVID-19 outbreak. Methods: This study was conducted with all 3rd and 4th grade students of the Department of Korean Medicine, Gachon University. The Korean Internal Medicine (Pulmonary) lecture course was held from April 1st to July 1st, 2020 for one semester. The lectures were conducted through real-time non-face-to-face education using the Cisco Webex program, and the lectures were mainly conducted by sharing a PowerPoint summarizing textbook. The questionnaire consisted of 3 parts and a total of 18 questions. The survey was conducted anonymously to ensure the confidentiality of all responses. Results: The overall score for real-time non-face-to-face education was 74.69±18.15 points. The efficiency of real-time non-face-to-face education was 2.12±0.78 points, and opinions on the expansion of future use were 2.08±0.91 points and were generally positive. The ratio of non-face-to-face education and face-to-face education in future clinical Korean medicine theory lectures was about 63:27, with a higher proportion of non-face-to-face education. Conclusions: Promoting clinical Korean medicine as a non-face-to-face education has generally been positively evaluated in terms of efficiency and overall, and its use should be expanded in the future. In particular, it will be necessary to use non-face-to-face education in the theory classes of clinical Korean medicine. However, technical problems involving internet, video, equipment, and communication tools will need to be improved in the future.

• Korean Journal of Clinical Pharmacy
• /
• v.32 no.2
• /
• pp.84-92
• /
• 2022

Background: Topical corticosteroids (TCs) are available both as over-the-counter drugs and prescription medicines at pharmacies. Although they are generally safe drugs, inappropriate and excessive use could result in potential side effects. Thus, it is important to have appropriate knowledge regarding the use of TCs. We performed a cross-sectional survey to assess public knowledge and the potential misuse or overuse of TCs. Methods: A cross-sectional and nationwide online survey was conducted among participants who were aware of TCs. The survey items included sources of information, indications, potential side effects, and methods of application of TCs. A comparative analysis was conducted between those with (TC users) and without (TC non-users) an experience of using TCs. Results: Among 3,000 participants, 74.4% were TC users. The mass media was the most common information source of TCs, and only one-third of the surveyed people relied on pharmacists or doctors for information. Regarding indications and application methods, incorrect answer rate was high in some items, but respondents showed adequate knowledge. However, awareness of the safety of TCs was low. Overall, the TC users showed a higher knowledge of TCs than TC non-users. Conclusions: Public knowledge of the use of TCs appears to be appropriate. However, we found potential misuse or overuse of some items and a lack of awareness of the side effects concerning TCs. Thus, healthcare professionals' significant role is required.

• Journal of Radiopharmaceuticals and Molecular Probes
• /
• v.9 no.1
• /
• pp.23-33
• /
• 2023

Prostate cancer ranks as the world's second most frequently diagnosed cancer among men, and is responsible for the fifth highest number of cancer-related deaths in this population. The development of effective diagnostic and therapeutic approaches for prostate cancer remains a major challenge in the field of oncology. Over the past few years, the prostate-specific membrane antigen (PSMA) has raised as a hopeful tracer for the diagnosis and treatment of prostate cancer.Various radioisotopes, such as ¹³¹I, ^99mTc, ⁶⁸Ga, and ¹⁷⁷Lu, have been used to label PSMA analogues, with varying degrees of success. Among these, ⁶⁸Ga-PSMA-11 and ¹⁷⁷Lu-PSMA-617 have emerged as the most promising radioligands for clinical use. Recently, researchers have been exploring the use of other radioisotopes, such as ²¹¹At, ⁸⁹Zr, ^64/67Cu, and ^203/212Pb, for the labeling of PSMA-targeted radioligands. These radioisotopes have unique properties that may offer advantages over existing radioligands, such as longer half-lives, higher specific activities, and different emission profiles. Efforts are currently underway to develop these radiopharmaceuticals and make them more widely available for clinical use. These exciting developments highlight the potential of PSMA-targeted radioligands for the diagnosis and treatment of prostate cancer, and provided significant implications for the management of this disease in the future. The current study aims to provide a comprehensive summary of the latest research and clinical applications of radiolabeled PSMA inhibitors for diagnoses and therapy of prostate cancer, emphasizing the exciting developments in the field and their potential impact on clinical practice.

• The Korean journal of internal medicine
• /
• v.39 no.1
• /
• pp.77-85
• /
• 2024

Background/Aims: There may be many predictors of anticoagulation-related gastrointestinal bleeding (GIB), but until now, systematic reviews and assessments of the certainty of the evidence have not been published. We conducted a systematic review to identify all risk factors for anticoagulant-associated GIB to inform risk prediction in the management of anticoagulation-related GIB. Methods: A systematic review and meta-analysis were conducted to search PubMed, EMBASE, Web of Science, and Cochrane Library databases (from inception through January 21, 2022) using the following search terms: anticoagulants, heparin, warfarin, dabigatran, rivaroxaban, apixaban, DOACs, gastrointestinal hemorrhage, risk factors. According to inclusion and exclusion criteria, studies of risk factors for anticoagulation-related GIB were identified. Risk factors for anticoagulant-associated GIB were used as the outcome index of this review. Results: We included 34 studies in our analysis. For anticoagulant-associated GIB, moderate-certainty evidence showed a probable association with older age, kidney disease, concomitant use of aspirin, concomitant use of the antiplatelet agent, heart failure, myocardial infarction, hematochezia, renal failure, coronary artery disease, helicobacter pylori infection, social risk factors, alcohol use, smoking, anemia, history of sleep apnea, chronic obstructive pulmonary disease, international normalized ratio (INR), obesity et al. Some of these factors are not included in current GIB risk prediction models. such as anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction, etc. Conclusions: The study found that anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction et al. were associated with anticoagulation-related GIB, and these factors were not in the existing prediction models. This study informs risk prediction for anticoagulant-associated GIB, it also informs guidelines for GIB prevention and future research.

• Clinical and Experimental Pediatrics
• /
• v.56 no.5
• /
• pp.196-201
• /
• 2013

Fluoroquinolones are an important class of antibiotics that are widely used in adult patients because of their broad spectrum of activity, good tissue penetration, and oral bioavailability. However, fluoroquinolone use in children is limited because juvenile animals developed arthropathy in previous experiments on fluoroquinolone use. Indications for fluoroquinolone use in patients younger than 18 years, as stated by the U.S. Food and Drug Administration, include treatment of complicated urinary tract infections and postexposure treatment for inhalation anthrax. In Korea, the systemic use of fluoroquinolones has not been approved in children younger than 18 years. Although concerns remain regarding the adverse musculoskeletal effects of fluoroquinolones in children, their use in the pediatric population has increased in many circumstances. While pediatricians should be aware of the indications and adverse effects of fluoroquinolones, recent studies have shown that the risk for musculoskeletal complications in children did not significantly increase following fluoroquinolone treatment. In addition, fluoroquinolones may be particularly helpful in treating multidrug-resistant infections that have not responded to standard antibiotic therapy in immunocompromised patients. In the present article, we provide an updated review on the safety and current recommendations for using fluoroquinolones in children.

• Journal of Korean Academy of Nursing
• /
• v.53 no.6
• /
• pp.610-621
• /
• 2023

Purpose: The purpose of this study was to understand the experiences of final-year undergraduate nursing students in observing the use of physical restraints on patients in the course of clinical practice. Methods: Three focus group interviews were conducted with 12 Korean nursing students who could provide sufficient information about their observation of physical restraints. The collected data was analyzed through conventional content analysis. Results: The data were classified into four theme clusters, and nine themes. The four theme clusters included 'recognized as an unavoidable means,' 'experienced problems with the use of physical restraints,' 'realized the importance of the nurse's role and efforts,' and 'aspire to learn about correct use of physical restraints.' While nursing students recognized the necessities and problems of using physical restraints in clinical practice, and the importance of nurses' role and effort, the results found that education related to the use of physical restraints should be more systematic within the nursing curriculum. Conclusion: This study highlights the necessity of educating nursing students to ensure they acquire accurate knowledge and awareness regarding the use of physical restraints, and suggests the inclusion of systematic guidelines through simulation or extracurricular activities.

• Korean Journal of Clinical Pharmacy
• /
• v.21 no.3
• /
• pp.243-248
• /
• 2011

낙상은 노인의 건강을 위협하는 가장 심각한 문제 중의 하나이며, 조기사망, 신체손상, 운동장애, 심리학적 기능장애를 유발하는 원인이기도 하다. 본 연구의 목적은 국내 노인전문 요양병원 입원 환자들의 의약품 사용이 낙상에 미치는 영향을 평가하는데 있다. 후향적으로 원내 의무기록 정보를 이용하여 환자-대조군 연구를 수행하였고, 2008년 1월부터 2010년 12월까지 3년 기간에 입원한 65세 이상을 대상으로 하였다. 입원기간 중 낙상을 경험한 34명의 노인환자들을 환자군으로 선택하였으며 낙상을 경험하지 않은 68명의 노인환자들을 무작위 추출하여 1:2의 환자군:대조군비율로 연구 대상 환자들을 선정하였다. 환자군이 복용한 의약품을 대조군이 복용한 의약품과 비교하였으며 각 계열별 의약품과 낙상위험도 관계를 평가하였다. 두 그룹간의 인구통계학적 특성은 유사하였고 연령, 성별, 복용 의약품수, 고혈압 유무, 혈중 크레아티닌 수치, 혈중 나트륨 수치, 혈압 또는 심박수에 유의한 차이는 없었다. 항히스타민제와 본 연구에서 유일하게 기타 수면보조제로 분류된 졸피뎀이 유의하게 낙상위험도를 증가시켰다.