• Title/Summary/Keyword: Medication safety

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Association of Liver Dysfunction with Self-Medication History in Korean Healthy Male Adults (건강한 한국 성인남성의 자가약물복용력에 따른 간기능 장애 발생여부 조사)

  • Bae, Jong-Myon;Park, Byung-Joo;Lee, Moo-Song;Kim, Dong-Hyun;Shin, Myung-Hee;Ahn, Yoon-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.4 s.55
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    • pp.801-814
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    • 1996
  • Background: Korean people could abuse healthy foods as well as medications, which might cause serious side effects. The aim of this study was elucidating liver dysfunction due to the self-medications of hepatotonics, healthy foods and herb medications by nested case-control study. Methods: Study subjects were drawn from male members of Seoul Cohort Study who were recruited by self-administered structured questionnaire survey through mailing to the healthy men between the age of 40 and 59 years through the program of biennial health check-up offered by Korea Medical Insurance Corporation(KMIC). The liver dysfunction was defined as the level of serum AST and ALT above 40 IU/L and increased in more than one hunderd per-cent during the 2 year follow-up period. To estimate the odds ratio between self-medication and liver dysfunction after controlling for potential confounders, logistic regression was performed. Results: During the follow-up period, 30 members were identified to fit into case criteria and 2,625 members were selected as control. In logistic regression analyses, history of healthy foods intake, age under 45 years, obesity, and habit of regular exercise were significantly associated with liver dysfunction. The following factors exhibited no statistical significance: intake of hepatotonics, of herb medicine; history of disease in family, of operation, and of radiologic examination; smoking habits and drinking amounts. Conclusion: The significant association between the intake of healthy foods and the liver dysfunction illustrates that chronically optional overuse of healthy foods might bring to hazards to health. As the increasing trend of the size of purchasing healthy foods in Korea, pharmacoepidemiologic studies evaluating the safety and efficacy of the widely used healthy foods should be performed in the near future.

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Multicenter, Open-Labeled, Observational Clinical Trial to Investigate the Efficacy and Safety of Oral Administration of Megace Suspension in Patients with Head and Neck Cancer During Radiotherapy (방사선 치료 중인 두경부 종양 환자를 대상으로 메게이스 내복 현탁액 경구투여 후 유효성 및 안전성에 관한 다기관, 공개, 관측연구)

  • Kim, Se-Heon;Kim, Min-Sik;Kim, Young-Mo;Kim, Hyun-Su;Nam, Soon-Yuhl;Rho, Young-Soo;Park, Young-Hak;Baek, Chung-Hwan;Bong, Jung-Pyo;Lee, Kang-Dae;Lee, Yong-Seop;Jung, Kwang-Yoon;Chung, Sung-Min;Chung, Pil-Sang;Joo, Young-Hoon;Chu, Hyung-Ro;Choi, Eun-Chang;Tae, Kyung;Hong, Ki-Hwan
    • Korean Journal of Head & Neck Oncology
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    • v.24 no.1
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    • pp.57-63
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    • 2008
  • Background and Purpose:Nausea, vomiting and weight loss are common problems that are encountered in the course of cancer patient treatment who are receiving radiotherapy. In this study, we are aiming to analyze the effect of megestrol acetate on quality of life of head and neck cancer patients receiving radiotherapy, resulting from improvement of weight loss, appetite and nutritional status via multicenter, open-labeled, observational clinical trial. Material and Methods:A total of 270 patients from 10 medical institutes who are receiving radiotherapy or who have completed radiotherapy within 3 months, between February 2007 and February 2008, were selected as candidates for the study. Megestrol acetate suspension(megace) was given to the subjectives once a week for 4 weeks with the amount of 20ml(megestrol 800mg). Measurement of weight and questionnaire surveys were carried out three times: at the start of the study, 4 weeks after the start of the medication, and 4 weeks after the end of the medication, respectively. Results:The group who has received megace had a total number of 199, and control group was 70. The group who have received megace showed mean weight loss of 1kg in 8 weeks, compared with the weight loss of 5.5kg in control group, which showed that the medication was effective in reducing the amount of weight loss(P=0.027). The group who received megace had a tendency to report a reduced rate of decrease in the score of appetite, nausea and vomiting, and QOL score, but it did not have statistical significance(P>0.05). Conclusion:Megestrol acetate have reduced the degree of weight loss significantly, and it has a tendency to reduce the rate of decrease in appetite, aggravation of nausea and vomiting, and quality of life.

Development of Korean Medical Psychotherapy and Preliminary Clinical Trial for Post Traumatic Stress Disorder (외상 후 스트레스 장애에 대한 한방정신요법 기반 심리치료 개발 및 예비적 임상시험)

  • Kim, Jin-Hyung;Sue, Joo-Hee;Lee, Go-Eun;Kim, Nam-Kwen;Choi, Sung-Youl;Lyu, Yeoung-Su;Kang, Hyung-Won
    • Journal of Oriental Neuropsychiatry
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    • v.26 no.1
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    • pp.49-61
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    • 2015
  • Post traumatic stress disorder (PTSD) is an anxiety disorder that usually occurs after suffering from a psychological trauma that can not threatening events, which is one of the individual's subjective pain and their families and the larger society due to the chronic disease burden results. Treatment with a medication, as well as cognitive behavioral therapy (CBT), exposure therapy, prolonged exposure therapy (PE), eye-movement desensitizing, and reprocessing (EMDR) are preferentially performed, including psychotherapy. Korean medical psychotherapy consists of a wide range of manual therapy, but it does not have systematically screening limits. This study was developed by Korean medical psychotherapy program for PTSD, and it was carried out as a preliminary clinical trial for validity. The Korean medical psychotherapy program for PTSD consists of four stages as follows: building chapter of safety, flow and send, accept, and integration. Based on this preliminary clinical study of PTSD, seven patients were treated for 2 hours per week for 5 weeks. We report the meaningful results gained by observing the changes in IES-RK points, questionnaire on five-faceted mindfulness, quality of life, anxiety, depression, insomnia, hwabyung scale, HRV, and EEG, before and after the Korean medical psychotherapy program.

THE COMPARATIVE STUDY ON THE CONSCIOUS SEDATIVE EFFECT OF CHLORAL HYDRATE/HYDROXYZINE AND MIDAZOLAM FOR MANAGEMENT OF THE DIFFICULT PEDIATRIC PATIENT (CHLORAL HYDRATE/HYDROXYZINE의 경구투여와 MIDAZOLAM의 경구 및 비강내 투여의 의식진정효과에 관한 비교연구)

  • Kim, Seon-Mi;Yang, Kyu-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.24 no.1
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    • pp.280-292
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    • 1997
  • The purpose of this study was to assess the sedative effect of three kinds of medication for management of the uncooperative 60 children aged from 16 months to 87 months required extensive treatment. The patients were given randomly a dose of 75mg/kg of chloral hydrate and hydroxyzine 25mg orally or 0.5mg/kg of midazolam orally or 0.3mg/kg of midazolam intranasally. All the children were restrained in a Pediwrap and were monitored with Pulse oximeter for assessing the safety of patients. According to rating scale, sleep, crying, movement, and overall behavior were checked for evaluation of the clinical sedative effect. The results were as follows: 1. In the evaluation of sleep, rating scale of chloral hydrate/hydroxyzine was superior to the other group(p<0.05). 2. In the evaluation of crying and movement at beginning of treatment, rating scale of chloral hydrate/hydroxyzine was superior to the other group(p<0.05), but during the treatment, rating scale of each group was not significantly different (p>0.05). 3. In the evaluation of overall behavior, 80% children of chloral hydrate/hydroxyzine were rated good or very good. With the oral and intranasal midazolam, 60% children were rated good or very good respectively. 4. There were no clinical signs of significant cyanosis and respiratory depression. Clinically, chloral hydrate/hydroxyzine was proved to be more effective sedation than any other sedative method. Oral and intranasal midazolam were also safe and effective sedation in young children undergoing pediatric dental procedures.

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The Application of Brain Stimulation in Psychiatric Disorders : An Overview (정신질환에서 뇌자극술의 적용)

  • Roh, Daeyoung;Kang, Lee Young;Kim, Do Hoon
    • Korean Journal of Biological Psychiatry
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    • v.24 no.4
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    • pp.167-174
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    • 2017
  • Based on advances in biotechnology and neuroscience, neuromodulation is poised to gain clinical importance as a treatment modality for psychiatric disorders. In addition to old-established electroconvulsive therapy (ECT), clinicians are expected to understand newer forms of neurostimulation, such as deep brain stimulation (DBS), vagus nerve stimulation (VNS), repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS). Given the growing interest in non-invasive neuromodulation technologies, clinicians may seek sufficient information about neuromodulation to inform their clinical practice. A growing literature suggests that applications of non-invasive neuromodulation have evidence particularly for indications where treatments are currently insufficient, such as drug-resistant depression. However, positive neuromodulation studies require replication, and the precise interactions among stimulation, antidepressant medication, and psychotherapy are unknown. Further studies of long-term safety and the impact on the developing brain are needed. Non-invasive neuromodulatory devices could enable more individualized treatment. However, do-it-yourself (DIY) stimulation kits require a better understanding of the effects of more frequent patterns of stimulation and raise concerns about clinical supervision, regulation, and reimbursement. Wide spread enthusiasm for therapeutic potential of neuromodulation in clinical practice settings should be mitigated by the fact that there are still research gaps and challenges associated with non-invasive neuromodulatory devices.

Clinical Observation on Effectiveness of Taegeuk Acupuncture for Patients in Sub-health Status: a Case Series (아건강(亞健康) 치료[치미병(治未病)]에 미치는 태극침법의 효능에 대한 임상적 관찰)

  • Kim, Jae-Kyu;Chae, Han;Kim, Kun-Hyung;Noh, Seung-Hee
    • Journal of Acupuncture Research
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    • v.28 no.4
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    • pp.111-117
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    • 2011
  • Objectives : This study aimed to report observed effectiveness and safety of Taegeuk acupuncture for patients in sub-health status. Methods : We analyzed clinical medical records of 36 outpatients who have visited the Pusan national university Korean medicine hospital between March and June, 2010. Patients received 6 sessions of Taegeuk acupuncture according to their constitutional types. Hepatic dullness sound and symptom reduction were used for the evaluation of clinical effectiveness of Taegeuk acupuncture. One traditional Korean medicine doctor performed all treatment procedures and assessments. Patients were allowed to continue their previous medication during acupuncture treatment. However, no additional traditional Korean medicinal interventions except the acupuncture were conducted during the whole treatment period. Results : After 6 sessions of Taegeuk acupuncture, mean hepatic dullness sound scores (0~100) were reduced from $97.3{\pm}9.0$ to $24.3{\pm}23.7$ with statistical significance (n=36, p<0.001). Mean symptom reduction scores (0~100) were changed from 0 to $53.3{\pm}29.6$ with statistical significance (n=24, p<0.001). 24 patients reported 44 cases of additional improvements of perceived health condition during or after the treatment course. No serious adverse events related to the Taegeuk acupuncture treatment were observed. Conclusions : Taegeuk acupunture may be a feasible, effective and safe treatment intervention for patients with chronic symptoms. Further well-designed studies are needed to confirm those observed improvements and evaluate benefits of Taegeuk acupuncture.

Clinical Demands for Evidence-based Medical Interventions and Diagnostic Technology in Oriental Medicine (근거중심의학에 기반한 한의치료기술 및 한방진단기기 개발을 위한 임상수요조사)

  • Kim, Gyeong-Cheol;Park, Sang-Woog;Song, Kyung-Hoon;Park, Joo-Yeon;Hong, Sang-Min;Lee, Hai-Woong
    • Journal of Society of Preventive Korean Medicine
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    • v.14 no.2
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    • pp.121-133
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    • 2010
  • Objects : To establish directions to evidence-based medical interventions and diagnosis technology in oriental medicine, we did survey research among oriental medical doctors. Methods : Systematically-organized questionnaires were provided for survey. 105 Oriental medical doctors nationwide participated in the survey. We investigated diseases of their patients, differential diagnosis methods, frequently used medical interventions, needs for diagnosis devices, evidence-based clinical manuals, etc. Results : In oriental medical clinics, the most frequent patient class was patients with musculo-skeletal diseases. Oriental medical doctors assumed that the preparation of care solution for chronic life-style diseases was the most urgent. Dong-Eui-Bo-gam(東醫寶鑑) was the most frequently used reference for their herbal medication prescription. Fixed document for diagnosis and treatment were thought to be the most important in the developing evidence-based clinical manuals. Conclusions : Validity and reliability should be considered as very important in developing oriental diagnosis devices. Evidence-based clinical manuals are needed to build standardized document for diagnosis and treatment and to verify efficacy and safety of oriental medical diagnosis and treatment.

Titanium Mesh Cage for Anterior Stabilization in Tuberculous Spondylitis : Is It Safe?

  • Bak, Koang-Hum;Cheong, Jin-Hwan;Kim, Jae-Min;Kim, Choong-Hyun;Kim, Seung-Bum
    • Journal of Korean Neurosurgical Society
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    • v.40 no.6
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    • pp.412-418
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    • 2006
  • Objective : The safety of titanium metal cages in tuberculous spondylitis has not been investigated. We evaluated the outcome and complications of titanium mesh cages for reconstruction after thoracolumbar vertebrectomy in the tuberculous spondylitis. Methods : There were 17 patients with 18 operations on the tuberculous spondylitis in this study. Sixteen patients were operated with anterior corpectomy and reconstruction with titanium mesh cage followed by posterior transpedicular screw fixations on same day, two pateints were operated by either anterior or posterior approach only. After the affected vertebral body resection and pus drainage from the psoas muscle, titanium mesh cage, filled with morselized autogenous bone, was inserted. All the patients had antituberculosis medication for 18 months. The degree of kyphosis correction and the subsidence of cage were measured in the 15 patients available at a minimum of 2 years. Outcome was assessed with various cross-sectional outcome measures. Recurrent infection was identified by serial ESR[Erythrocyte Sedimentation Rate] and CRP[Cross Reactive Protein]. Results : There was no complication from the use of a titanium mesh cage. Recurrent infection was not detected in any case. Average preoperative of $9.2^{\circ}$ was reduced to $-2^{\circ}$ at immediate postoperative period, and on final follow up period kyphotic angle was measured to be $4.5^{\circ}$. Postoperatively, subsidence was detected in most patients especially at ambulation period, however further subsidence was prevented by the titanium mesh cage. Osseous union was identified in all cases at the final follow-up. Conclusion : The cylindrical mesh cage is a successful instrument in restoring and maintaining sagittal plane alignment without infection recurrence after vertebrectomy for tuberculous spondylitis.

The Effects of Acupuncture on the Insomnia, Anxiety and Depression of Liver Cancer Patients: Pilot study

  • Lee, Chang-Hyeong;Kim, Byung-Seok;Kim, Ji-Suk;Kwon, Hyo-Jung;Choi, Ae-Ryun;Kwak, Min-A;Kim, Seung-Mo
    • The Journal of Korean Medicine
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    • v.33 no.2
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    • pp.34-46
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    • 2012
  • Objectives: Most patients who have cancer suffer from anxiety and depression. Because most liver cancer patients have cirrhosis, medication can aggravate their liver function. We need the most effective treatment such that the anxiety and depression can be improved without causing deterioration of liver function. The purpose of this study is to examine the effects of acupuncture on the anxiety and depression of liver cancer patients. Methods: 8 liver cancer patients who complained of distress were treated by acupuncture three times a week for four weeks (12 times in total). Evaluation of the anxiety, depression and insomnia was measured by NCC (National Cancer Center) score. On visits 1, 4, 7, 10, and 13 we had patients check NCC score after acupuncture treatment. To check deterioration of liver cancer, we checked their abdominal CT, Child-Pugh score and blood test. Results: After 12 treatments, NCC of the anxiety, depression and insomnia were significantly decreased in all of the patients without causing deterioration of liver function. In particular, symptoms were almost completely improved in 6 patients. Conclusions: This study suggests that acupuncture treatment will be beneficial for liver cancer patients to reduce anxiety, depression and insomnia. For liver cancer patients with cirrhosis or chronic hepatitis, a large-scale study to confirm efficacy and safety of acupuncture is needed.

Effects of Insamsansa-eum (Renshenshanzha-yin) on Hypercholesterolemia and Analysis of Its Effects according to the Pattern Identification

  • Park Seong-Uk;Jung Woo-Sang;Moon Sang-Kwan;Cho Ki-Ho;Kim Young-Suk;Bae Hyung-Sup;Ko Chang-Nam
    • The Journal of Korean Medicine
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    • v.27 no.2 s.66
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    • pp.253-261
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    • 2006
  • Backgrounds : Hyperlipidemia is a major cause of cardiovascular disease (CVD). Lowering serum cholesterol levels could reduce the risk of CVD. Insamsansa-eum (Renshenshanzha-yin, ISE), composed of Ginseng Radix and Crataegii Fructus, is a new medicine developed to treat hyperlipidemia and CVD. Objectives : In this study, we intended to explore the clinical effects of ISE on patients with hypercholesterolemia, and moreover we also compared its effects according to the pattern identification. Methods : Subjects were administered ISE with the dose of 600 mg three times a day for 4 weeks. Patterns of subjects were identified with diagnostic scoring system for Yin-Yang and the condition of Excess-Deficiency before treatment. Serum lipids were measured at baseline and after 4 weeks of medication. Results : ISE lowered total cholesterol(TC), triglyceride(TG), total lipid(TL), phospholipid(PL) and low density lipoprotein cholesterol(LDL) significantly. Compared with the data of our previous study, it was less effective than Atorvastatin but showed equal lipids-lowering effect to Chunghyul-dan (Qingxue-dan, CHD). In Yang pattern group, ISE was less effective in lowering TG and LDL than it was in not-Yang-not-Yinpattern group. On safety assessment, there was no adverse effect, hepatic or renal toxicity. Conclusions : We suggest that ISE is a safe and useful herbal medicine for hypercholesterolemia, and moreover it could be more useful when it is used for patients with not Yang pattern.

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