Kim, Dong-hyun;Noh, Ji-won;Jeong, Su-min;Ahn, Se-young;Ahn, Young-min;Lee, Byung-cheol;Yoo, Jung-hwa
The Journal of Internal Korean Medicine
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v.40
no.6
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pp.1015-1025
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2019
Objectives: There have been many studies reporting the clinical value of Euphorbia kansui Radix or Melonis Calyx, but few systematic studies of the changes that may occur after taking such herbal medication. This study aimed to investigate the characteristics of the patient group, possible changes in blood test and InBody test results, and to discover the current state and future direction of clinical use of Euphorbia kansui Radix or Melonis Calyx. Methods: This study investigated patients who were hospitalized at Kyung-Hee University Korean Medicine Hospital for at least two days from 1 March 2016 to 1 March 2019, specifically evaluating patients aged 19 and over who underwent blood tests, including an electrolyte test and an InBody test before and after taking Euphorbia kansui Radix or Melonis Calyx. Results: Among a total of 134 patients, 72 patients (53.7%) were treated with Euphorbia kansui Radix and 62 patients (46.3%) were treated with Melonis Calyx, in the context of previously diagnosed abnormal weight gain. Laboratory findings were that Na and K levels were significantly reduced in both groups. In an InBody test, body mass index (BMI), intracellular water, extracellular water, protein, mineral, and skeletal muscle were significantly reduced in both groups. Conclusions: From these results, we suggest that, although Euphorbia kansui Radix and Melonis Calyx may not induce serious adverse effects, attention should be paid to the electrolyte level with the use of these treatments. In terms of syndrome differentiation, more clinical uses will be available in the future.
Background: Herbal medication is widely used in the Korean Medicine Hospital, and drug-induced liver injury (DILI) in Korea has increased proportionally. Herb-induced liver injury now accounts for approximately 40% of cases of hepatotoxicity in Korea, according to research data. Currently, however, the component responsible for the toxicity is usually unknown or can only be suspected. Objective: To study the hepatotoxicity of Cheongsimyeonja-tang in DILI. Methods: A retrospective review was conducted of 82 inpatients between April 2010 and March 2017 with suspected drug-induced liver injury (n=5). The standard criteria (RUCAM scale) for drug-induced liver injury (DILI) were applied. The electronic medical records (EMRs) were retrospectively reviewed to identify the relevant database. Aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and total bilirubin (T. Bili) were analyzed in blood samples before and after the administration of Cheongsimyeonja-tang. Results: Five cases out of 82 patients had a criterion-referenced probable (RUCAM) score ranging from 6 to 8 points DILI. However, statistical analysis of the liver function parameters results of the 82 patients did not show a statistically meaningful elevation after taking Cheongsimyeonja-tang. Conclusions: These data suggest a relationship between Cheongsimyeonja-tang and DILI. More studies are needed to validate these observations and to explore their implications.
Rifampin is common drug to treat tuberculosis. Rifampin induced acute renal failure, hemolytic anemia and thrombocytopenia is rare and severe complication. We have experienced a case of rifampin induced acute renal failure, hemolytic anemia and thrombocytopenia. Forty-six years old male was suffered from reactivation of pulmonary tuberculosis, and had to medicate antituberculosis drugs including rifampin(600mg/day). Seven years ago, antituberdulosis medication were successfully administered to treat pulmonary tuberculosis without any side effects of drugs. But eight days after readministration of rifampin, fever, abdominal pain, vomiting, oliguria, elevated BUN and creatinine were developed. And thrombocytopenia was also identified after administration of rifampin. The patient was recovered slowly after discontinuation of rifampin & intensive medical care. The renal function was normalized at 55 days after cessation of rifampin. The renal pathologic findings were interstitial nephritis and acute tubular necrosis. And, the rifampin dependent antibodies were identified by indirect antiglobulin test in the presence of rifampin. So we report this case with a brief review of literature.
Kim, Min-Jeong;Park, Sang-Dong;Lee, A-Ram;Kim, Kyung-Ho;Jang, Jun-Hyouk;Kim, Kap-Sung
Journal of Acupuncture Research
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v.19
no.2
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pp.238-249
/
2002
Facial palsy is commonly encountered disease in the clinic but bilateral facial palsy is known as rare disease. Type of facial nerve paralysis include unilateral, recurrent ipsilateral, recurrent alternating and bilateral simultaneous palsies. Among the types, the reported incidence of bilateral simultaneous palsy is 0.3~2% of facial paralysis patients. We experienced I case of patient with bilateral simultaneous facial palsy that was concluded as bilateral bell's palsy. Objective : The purpose of this paper is to report the patient with bilateral facial palsy, who improved by oriental medical treatment. Another purpose is to review the current literature and to differential diagnosis of bilateral facial paralysis. Methods and Results : The patient was treated by acupuncture, herb medication and self-massage on facial muscle for 14 weeks. House-brackmann grading score was improved into I/I (Rt/Lt) from IV/IV. Conclusion : Through reviewing some literatures and reports, It is concluded that bilateral facial palsy was related to many other disorders and more ominous than unilateral facial palsy. therefore, its work-up should include a complete neurologic assesment and thorough evaluation. also, we consider that bilateral Bell's palsy can improve by oriental medical treatments.
Background : A report published by the National Institute of Toxicological Research (NITR) in January 2004 about toxic hepatitis in Korea contained the result of analysis on 55 cases of severe toxic hepatitis from 7 university hospitals for 8 months. NITR claimed that the extrapolated annual frequency of severe toxic hepatitis in Korea was 1904 cases per year. They also claimed that the most frequent etiology of severe toxic hepatitis were herbal medications and similar plant preparations (61.7%), contrasted with traditional therapeutic preparations and healthy foods (29.1%). I have investigated that report to be certain of the result because it is a very important subject for public health and society in Korea. Results : The NITR report has too many problems to have faith in its results. They include the following: 1. The report uses only 55 cases to estimate annual prevalence rate of severe toxic hepatitis in Korea. 2. There was a large regional preponderancy in the NITR report (2 cases in Seoul from a population of 10.17 million, 19 cases in Gwangju from a population of 1.4 million) 3. There was another preponderancy that selected much fewer cases caused by western medication (9.1%) than other reasons. 4. The NITR report used a modified scale than that officially recognized to diagnose toxic hepatitis. 5. There was a mistake using the scale to adapt the right indications. 6. They collected cases before beginning the study, although it was a prospective study. There was also not any questionnaire or other materials concerned with alcohol, drugs, or history of past liver disease. Conclusions : NITR is one of the important official arms of the government of Korea. Nevertheless, there is a severe problem in validity because of selection bias, uncertain accuracy, and insufficiency of raw materials in the report. Therefore it seems incorrect to generalize the results of the report and there is a lack of confidence in it as a national study publishing by the NITR.
Song, Misoon;Choi, Suyoung;Kim, Se-An;Seo, Kyoungsan;Lee, Soo Jin;Kim, Eun Ho
Journal of muscle and joint health
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v.21
no.3
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pp.184-194
/
2014
Purpose: The purpose of this study was to develop and validate a diabetes management self-efficacy scale for older adults (DMSES-O). Methods: A preliminary DMSES-O of 22 items was derived from a literature review and seven domains of self-management behaviors. Content validity was confirmed by experts in diabetes self-management education. To test the reliability and validity of the DMSES-O, data were collected from 150 older adults with type 2 diabetes. The data were analyzed using exploratory factor analysis, and Cronbach's ${\alpha}$ and Pearson's correlation coefficients were calculated. Results: From the exploratory factor analysis, 17 significant items in six subscales were derived. Factors derived were named "problem solving for hypoglycemia and self-monitoring blood glucose," "problem solving for hyperglycemia," "coping with psychological distress and taking medication," "reducing risks of diabetes complications," "appropriate exercise," and "healthy eating." The criterion-related validity of the DMSES-O was established by its correlation with the Summary of Diabetes Self-care Activities Questionnaire. Cronbach's ${\alpha}$, a measure of internal consistency, was .84 for the overall scale and ranged from .54 to .80 for the subscales. Conclusion: The DMSES-O is a reliable and valid instrument to measure selfefficacy for diabetes self-management among older adults.
Objectives : To explore the factors influencing antibiotics prescription by primary health physicians for acute upper respiratory infections(URI). Methods : We performed a survey of 370 primary health physicians randomly sampled in April, 2003. The questionnaire consisted of a prescription on the scenario of acute bronchitis case, along with opinions and reasons for prescribing antibiotics on URI. Results : We found that 54.7% of the physicians prescribed antibiotics on the example case of acute bronchitis which is known as not needing antibiotics. Female physicians and ENT physicians had a greater tendency to prescribe antibiotics. The factors influencing antibiotics prescription on URI were the belief about the effectiveness of antibiotics, preference for their own experiences rather than clinical guidelines, perception of patients' expectations, and perception of competitive environment. The prescription of antibiotics in the example case was affected by how much they usually prescribe antibiotics (OR=2.400, 95% CI=1.470-3.917) and the physicians who thought that antibiotics were helpful for their income prescribed antibiotics more than others (OR=6.773, 95% CI=1.816-25.254). Conclusion : These findings demonstrated that the false belief on the effectiveness of antibiotics, patient's expectation of medication and fast relief of symptoms, and perception of competitive environment all affected the physicians prescription of antibiotics on URI. It may help to find barriers to accommodate scientific evidence and clinical guidelines among physicians and to specify subgroups for education about appropriate prescription behaviors.
Park, Jin Su;Lee, Young Woo;Lee, Sang Hyuk;Jin, Sung Min
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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v.26
no.1
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pp.58-62
/
2015
Xanthoma disseminatum (XD) is a benign, non-Langerhans cell histiocytosis characterized by disseminated xanthomatous lesions with face, flexures, and mucosa. Most of XD develops in mucocutaneous lesions including skin, oral cavity and pharynx, however laryngeal involvement is uncommon. While the natural course of XD is usually benign and often self-limiting, but XD develop in critical anatomical locations may result in morbidity and mortality. Localized mucous lesions in oropharynx and larynx lead to dysphagia, dyspnea and air way obstruction. The diagnosis of XD was based on clinical, histological and immunohistochemical findings. The treatment is complex and non-consensual. Local treatment with cryotherapy, radiotherapy, surgery, and carbon dioxide lasers have been attempted with various results. Systemic medication with peroxisome proliferator-activated gamma receptors, statins, fenofibrate, chlorodeoxyadenosine, cyclophosphamide, doxycycline, and cyclosporine have also been reported, but none have proven particularly successful. A 59-year-old man presented with respiratory symptoms because of laryngeal involvement of XD. We had to remove the obstructive lesion for relieving the symptoms. We experienced XD in Larynx that was rare in otorhinolaryngology. So we report this case with review of literatures.
The Journal of Korean Academic Society of Nursing Education
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v.8
no.1
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pp.38-50
/
2002
The purpose of this study is to identify the relationship among injury prevention practices, health locus of control, and response patterns to HLOC of the elderly. Subjects were 121 healthy elderly. The data had been collected from November 5 to 18 in 2001 and analyzed with descriptive statistics, t-test, ANOVA, Pearson's correlation and stepwise multiple regression. Health locus of control and injury prevention practices were measured by using MHLC scale and an instrument created by the researcher on the basis of the results of literature review respectively. The results of this study were as follows: The mean score of injury prevention practices was 2.80 and the mean scores for the health locus of control were internal health locus of control : 17.25, external health locus of control : 16.09, and chance health locus of control : 14.26. The response patterns of the HLOC identified were six types; pure internal, pure powerful others, pure chance, double external, believers in control, and complex control. The 'pure internal' was the largest group(35.5%), and the 'believers in control' was the next(31.4%). The relationship between internal health locus of control and the injury prevention practices of the elderly revealed a significant correlation(r=.215, p=.018). The relationship between external health locus of control and the injury prevention practices of the elderly revealed a significant correlation (r= .208, p=.022). There was significant difference between response patterns of the health locus of control and injury prevention practices(F=2.393, p=.042). There were significant differences between injury prevention practices and general characteristic factors, which were education, family type, administration of medication, injury experience, ADL, and self-directed search for health information. Self-directed search for health information, injury experience, and education explained 16.7% of the variance for injury prevention practices. The above results may be used as the basic data for seeking more efficient way of improving safety of the elderly.
Since 2006, the Computerized Restricted Antibiotic Control Program (CRACP) has been incorporated to facilitate a more efficient approval process of vancomycin use at the Chonbuk National University Hospital. The purposes of the study were to evaluate proper use of vancomycin and to examine if there is any improvement when administering the CRACP. The use of vancomycin was retrospectively reviewed by a medical record review based on the American Society of Hospital Pharmacists (ASHP) criteria (i.e., indication, use of critical process indicators and use of outcome measurements) and compared before (Group I) and after the CRACP (Group II). Two hundred fifty six patient records were evaluated (138 in Group I and 118 in Group II). There was a statistically significant improvement in the report of justification for vancomycin use after CRACP (42.0% vs. 62.7%, p=0.001). Out of eight critical process indicators, two indicators (appropriate cultures prior to medication [68.8% vs. 85.6%, p=0.002] and serum vancomycin level measurement [0% vs. 7.6%, p=0.001]) were significantly improved after CRACP. The total incidence of adverse effects was decreased from 14.5% to 6.8%. In addition, there was a statistically significant difference in WBC count reduction within normal range (52.8% vs. 73.1%, p=0.024). The CRACP appears to be a promising approach to improve use of vacomycin in a hospital setting. However, further evaluation for the long-term period should be performed to confirm the performance of the program.
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