• 약학회지
• /
• 제54권6호
• /
• pp.455-460
• /
• 2010

We evaluated the inappropriateness of metformin use in patients with type 2 diabetes and chronic medical conditions to identify the frequency of the prescription metformin in violation of the food and drug administration (FDA) black box warning. We reviewed medical records of 307 outpatients who received metformin at endocrinology department in a hospital setting between January 1, 2005 and August 30, 2009. Of the 307 outpatients, 25 discontinued treatment of metformin due to elevated serum creatinine level (Scr${\geq}$1.5 mg/dl in male, Scr${\geq}$1.4 mg/dl in female), cancers, and/or liver disease. 5 were lost to follow-up. 89 (29.0%) of the patients had cardiovascular disease, 54.1% for hypertension, 9.8% for liver disease, and 60 (20.8%) for chronic kidney disease. 12 patients (3.9%) with chronic kidney disease and/or elevated serum creatinine level, and 1 patient (0.3%) with lactic acidosis were contraindicated to metformin use. Metformin should be avoided in 7 outpatients (2.3%) with active hepatitis and 1 patient (2.6%) with liver cirrhosis. Of the 307 outpatients, 13 (4.2%) patients who received metformin at the first visit and 16 (8.7%) patients who received metformin at the last visit violated to black box warning. 8 (2.6%) of the patients were in precautionary conditions to metformin use. Adjusted mean difference of serum creatinine was -0.16 mg/dl [95% CI: -0.22 to -0.11 (p<0.05)] and adjusted mean difference of alanine aminotransferase was 4.46 IU/l [95% CI: 2.47 to 6.44 (p<0.05)] between the first visit and the last visit. Critical number of elderly patients who are at the high risks of drug-disease and drug-laboratory interaction is exposed to the inappropriate metformin use in violation of black box warning. The periodic evaluation of metformin use and monitoring prescription through drug utility review (DUR) system is needed to improve patients' safety and to reduce adverse drug events.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제26권3호
• /
• pp.165-175
• /
• 2015

Objectives : The purpose of this study was to investigate changes in child and adolescent outpatients at a university hospital in Daegu from 2004 to 2013. Methods : The subjects were first-visit patients under 18 years old, who visited Dongsan Medical Center, Keimyung University, from January 1, 2004 to December 31, 2013. Computerized medical records of 2,738 patients (male 1,906, female 832) were reviewed. Results : The ratio of male to female was 2.3 : 1 in the period of study. The most prevalent age category was 7-9 years. The mean age was $10.12{\pm}4.68$ years ($9.84{\pm}4.59$ years in males, $10.76{\pm}4.81$ years in females). The ratio of child and adolescent patients to total outpatients was 27.0%. The most common diagnostic category was the attention-deficit hyperactivity disorder (ADHD) group, followed by the mental retardation (MR) group. In males, the ADHD, MR, communication disorder groups were more prevalent, but in females, the MR, ADHD, depressive disorder groups were more prevalent. Conclusion : The female to male ratio and total mean age were on the rise. The ADHD group was the most prevalent and the depressive disorder group was also on the rise in this period.

• 디지털융복합연구
• /
• 제15권7호
• /
• pp.231-238
• /
• 2017

본 연구는 초진환자와 재진환자의 병원선택요인을 비교 분석하기 위한 목적으로 수행하였다. 4개 지역 G, H, S, U 종합병원을 이용한 외래환자를 대상으로 2016년 8월 1일부터 8월 31일까지 4주간 직접 설문조사를 통해 499부의 자료를 수집하였다. 주요 연구결과는 다음과 같다. 초진환자의 경우 인적요인, 효율성요인 접근성요인이 유의한 양(+)의 영향력을 미쳤다. 그리고 재진환자의 경우 인적요인, 물리적요인, 접근성요인, 대외이미지요인, 소득이 유의한 양(+)의 영향력을 미치는 것으로 나타났다. 본 연구 결과를 통해, 초진과 재진환자의 병원선택요인을 비교 분석하고 고객만족도를 높여 궁극적으로 수익성의 제고를 통하여 병원경영 전략을 수립하는데 중요한 참고자료가 될 수 있기를 기대한다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제31권4호
• /
• pp.185-192
• /
• 2020

Objectives: Our study aimed to analyze the demographic and clinical characteristics of children and adolescents during their first visit to psychiatric outpatient departments for the management of suicidal ideation and behavior, and to compare the changes before and in 2012 or later. Methods: This multicenter study was conducted at five university hospitals in a metropolitan area in South Korea. Medical records of patients aged 6-18 years were retrospectively reviewed from January 2009 to December 2016. Patients were analyzed by classifying them into suicidal and non-suicidal groups based on their visit to the hospital for management of suicidal ideation or suicide attempt and other mental problems, respectively. Results: There were differences in the year of visit, diagnosis, education level, and referral sources between patients in the suicidal and non-suicidal groups. Multiple regression analysis was conducted based on the sex, education level, referral by school, and diagnosis of depression in patients in the suicidal group, which revealed significant association. Conclusion: Suicide-related problems were significantly associated with the sex, education level, referral by school, and a diagnosis of depression in the patients. A well-connected referral system would be necessary for professional mental health management of high-risk children and adolescents.

• 한방안이비인후피부과학회지
• /
• 제1권1호
• /
• pp.73-81
• /
• 1988

The study was clinically performed in the 65 outpatients with pruritus who visited the Dept. of Dermatology, Oriental Medicial Hospital, Kyung Hee University and oriental medical clinic of Hang Ki Park from Jan. 1985 through Dec. 1986. The results were summarized as follows: 1. Among 65 outpatients, male was 20 ($30.8\%$) and female was 45 ($69.2\%$). In the distribution of age, 10S was $21.5\%,\;and\;20S\;20\%$ at the first visit. 2. In the distribution of season, the peak incidence occured in Spring ($35.4\%$) and next incidence in Winter ($20\%$). 3. In the distribution of duration, $41.5\%$ was between 1 year and 5 years, $20\%$ between 1 month and 6 months, $12.3\%$ between 6 months and 1 year, $9.2\%$ between 5 years and 10 years, $7.7\%$ over 10 years. 4. In regard to the itching lesion, $66.2\%$ showed pruritus throughout the whole body, including partially $15.4\%$ in their heads and faces, $12.3\%$ in their hands and legs, and $6.3\%$ in their shoulders, sides and hips. 5. The most frequently used prescription, was Gosanhomasan (苦蔘胡麻散) which occupied $60.7\%$ of all, in next order of frequency, Gamisamooltang (加味四物湯 $21.4\%$) Gupoongchongkisan (祛風淸肌散 $12.5\%$) and Bangpoongtongsungsan (防風通聖散 $5.4\%$). 6. In regard to the therapeutic duration, $46.2\%$ was showed under 10 days, $18.5\%$ between 10 days and 20 days, and $16.9\%$ between 30 days and 60 days. 7. In the 35 patients, who were confirmed to show apparent result by continual treatment, curative rate was more than $57.6\%$. According to above results, we can confirm that efficacy of therapeutic measures by the oriental medicine on pruritic dermatoses was increased in proportion to therapeutic duration and we feel sure that the therapeutic efficacy can be gradually increased as we expect to make a deep study of the disease and to give correct medical treatment to the nature of the disease.

• 대한영양사협회학술지
• /
• 제11권1호
• /
• pp.125-132
• /
• 2005

Hypercholesterolemia has been regarded as a major risk factor of coronary heart disease(CHD). CHD is increasing in recent years among Koreans due to westernization of lifestyle and dietary behaviors. In the United States, implementation of the National Cholesterol Education Program(NCEP) had resulted 40% decline in mortality from CHD. This study was designed to evaluate the effect of medical nutrition therapy on serum lipid levels and discuss the effective nutrition education contents. Thirty outpatients(Male 40%, female 60%) with hypercholesterolemia were educated by medical nutrition therapy(MNT) protocol. At first visit and after three months of MNT, we assessed serum lipid profile, body weight and surveyed general characteristics, lifestyle and food habits through questionnaire. After 12 weeks of MNT, there were significant reductions in serum cholesterol and low-density lipoprotein cholesterol(LDL-C). Foods habits and lifestyle were changed to the desirable patterns. These results indicate that lipid profile is improved by changes of dietary behaviors and lifestyle. Especially in case of obesity, cholesterol lowering effect of MNT was more powerful. Consequently, MNT is effective on reduction of serum lipids by behavior change in hypercholesterolemic patients.

• 한방안이비인후피부과학회지
• /
• 제14권2호
• /
• pp.253-261
• /
• 2001

Objectives This study was performed to evaluate the clinical effect of acupuncture on children's myopia. Methods Among the outpatients with myopia who visited to Department of Acupuncture & Moxibustion, National Medical Center from June 2000 to May 2001, we selected 50 cases that did not involve ,any other pathological condition of eyes and patient age was below 17, whose eyes including with glasses or naked examined by monoocular and biocular visual acuity test per each visit and followed up for 6 weeks. Results We investigated 29 female and 21 male patients. The most distribution of age was 12.26. First mean biocular visual acutity was $0.2{\pm}0.074$. Last mean biocular visual acuity after 6 weeks was $0.8{\pm}0.046(p<0.001). Improved cases on biocular test were 38 cases($76.00\%$). Conclusions These results suggest that the acupuncture therapy is effective treatment modality on children's myopia.

• 한방안이비인후피부과학회지
• /
• 제36권1호
• /
• pp.96-109
• /
• 2023

Objectives : The objective of this study is to predict how future infectious diseases will affect healthcare utilization patterns within korean medicine hospitals and, specifically, departments of ophthalmology, otolaryngology and dermatology of Korean medicine. Methods : We retrospectively analyzed medical records of patients who visited Kyung Hee University Korean Medicine Hospital during Pre COVID-19(from March 1st, 2018 to Feb 29th, 2019) and Post COVID-19(from March 1st, 2019 to Feb 28th, 2022). The data was analyzed by visit type and diagnosed disease code. Results : 1. After the COVID-19 break-out, the number of first visit patients increased but those of revisit patients, total patients, and revisit/first visit ratio decreased in all departments. 2. In Kyung Hee University Korean Medicine Hospital, the decrease rate of the number of total patients diagnosed with diseases of respiratory system(J00-J99) was the highest, while that for diseases of circulatory system(I00-I99) was the lowest. 3. In the department of Ophthalmology and Otolaryngology of Korean Medicine, the decrease rate of the number of total patients with nose disease was the highest, followed by eye disease and ear disease. 4. In the department of Dermatology of Korean Medicine, the number of total patients with dermatitis remained consistent, while the number of total patients with skin appendage disease showed relatively high decrease rate. Conclusions : Severe or chronic diseases showed relatively low decrease rate of the number of total patients. While mild diseases or diseases with high probability of exposure to COVID-19 infection during treatment showed high decrease rate of the number of total patients.

• 정신신체의학
• /
• 제28권1호
• /
• pp.53-62
• /
• 2020

연구목적 최근 공황장애와 초기 외상 사건에 대한 연구결과가 축적되는데, 아직까지 공황장애의 경과나 치료와 아동기 외상 연구는 드문 실정이다. 이 연구는 공황장애 외래 환자에서 아동기 외상 병력과 약물치료 유지 기간 사이의 상관 관계를 조사하였다. 방 법 이 횡단적 연구는 한 대학병원 정신건강의학과 외래를 방문한 공황장애 환자를 대상으로 일생의 외상력, 우울, 불안 및 외상후 스트레스 증상과 약물치료 기간을 조사하였다. 2012년 3월~2016년 2월까지 총 135명의 공황장애 외래 초진 환자를 대상으로 설문지 연구를 실행하였으며 이중 53명(39%)이 거절하거나 불완전한 설문을 작성하여 나머지 82명의 자료를 분석하였다. 설문지에는 외상력 선별 검사(Trauma History Screen), 벡우울척도, 벡불안척도, 간편 외상후 스트레스 장애 체크리스트 설문지가 포함되었다. 결 과 일생 동안 경험한 외상 종류의 수와 치료기간은 음의 상관관계를 나타내었다(rho=-0.269, p=0.015). 외상의 아형을 볼 때는 아동기 신체 학대와 치료 기간 사이에 유의한 부정 상관 결과를 보였다(rho=-0.298, p=0.007). 결 론 이 연구의 결과는 심리적 외상, 특히 아동기의 대인관계적 외상이 공황장애의 치료 유지에 영향을 줄 수 있는 것을 시사한다. 향후 연구에서는 아동기 외상과 불량한 치료 유지를 중재하는 요인, 예를 들어 치료 관계나 치료에 대한 기대 부족 등에 대한 연구가 필요하다.

• 대한한방부인과학회지
• /
• 제31권3호
• /
• pp.61-78
• /
• 2018

Objectives: The purpose of this study was to analyze the current characteristics of outpatients with postpartum disease and provide a treatment instruction in the clinical field. Methods: To analyze characteristics of outpatients with postpartum disease, We searched medical records from January 1, 2015 to December 31, 2017 using Z34 (Supervision of normal pregnancy), O94 (Sequelae of complication of pregnancy), U327 (産後風) and 388 postpartum patients were analyzed. Results: 1. The general characteristics of the subjects are as follows. The average age was $33.73{\pm}3.62$ years old, 356 (91.75%) patients are full term pregnancy, 201 (51.81%) patients are first delivery, 79 (20.36%) patients had past history of abortion and 63 (16.24%) patients had past history of gynecologic disease. 2. The most subjects visited in April (10.31%). The mean duration from delivery date to visiting date was $131.5{\pm}214.6$ days. The mean number of visits after the initial visit was $1.91{\pm}1.7$. 3. The characteristics related with pregnancy and delivery are as follows. The number of subjects taken assisted reproductive technology was 19 (4.9%) and suffering from gestational disease was 28 (7.22%). The mean body weight difference between full term pregnancy and visiting date was $-8.24{\pm}3.57kg$. The number of subjects discharging lochia on visiting date was 167 (43.04%) and breastfeeding was 262 (67.53%). 4. The most chief complaint was arthralgia in 217 (55.93%) followed by general weakness, cold sensation, edema, sweating disorder, dizziness, lower abdominal pain, digestion disorder, heat sensation, defecation disorder and urination disorder. 5. The most accompanied symptom was arthralgia in 322 (82.99%), followed by sleep disorder, cold sensation, general weakness, sweating disorder, defecation disorder, edema, dizziness, digestion disorder, urination disorder, lower abdominal pain and heat sensation. 6. A total of 356 subjects were taken herbal medicine. The most prescribed herbal medicine to subjects was Gungguijohyeol-eum-gamibang (29.59%). Conclusions: These results could be helpful to diagnose and treat postpartum patients in Korean gynecologic clinical fields.