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Efficacy and Safety of Mycophenolate Mofetil in Children with Steroid Dependent Nephrotic Syndrome

  • Lim, Taek Jin;Kim, Seong Heon;Kim, Su Young
    • Childhood Kidney Diseases
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    • v.19 no.2
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    • pp.105-111
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    • 2015
  • Purpose: Steroid dependent nephrotic syndrome (SDNS) is a chronic illness in childhood hard to treat. Steroid sparing drugs are often used, because long-term steroid therapy can cause severe side effects. We studied to compare efficacy between MMF and other drugs including cyclosporine and levamisole. Methods: This study was performed retrospectively on patients with SDNS, who were treated at Pusan National University Children's hospital. MMF group included 11 patients who were treated with MMF for at least six months between June 2012 and July 2014. As control groups, cyclosporine group (n=15) and levamisole group (n=18) included patients treated between January 2008 and July 2014. Number of relapse was analyzed in patients treated more than six months, and relapse free for one year was analyzed in patients treated more than one year. Results: In MMF group, ten were boys and mean age at onset was 5.8 years. Mean age at starting of MMF was 8.6 years. Number of relapse in MMF group was reduced significantly after treatment from 3.4 /year to 0.2 /year (P=0.003). There was no significant difference in number of relapse among groups (MMF: 0.2 /year, cyclosporine: 0.5 /year, levamisole: 0.5 /year). Comparing the early relapse within six months after treatment levamisole group was significantly higher than the other two groups (P=0.04). Conclusions: MMF which is used in SDNS significantly reduced the relapse and side effects were rare. In addition, MMF did not show any significant difference in comparison with the other two groups in number of relapse and relapse free for one year.

Trend and Characteristics of High Cost Patients in Health Insurance (건강보험 고액진료비 환자의 추이 및 특성 분석)

  • Jeong, Seo Hyun;Jang, Ho Yeon;Kang, Gil Won
    • Health Policy and Management
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    • v.28 no.4
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    • pp.352-359
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    • 2018
  • Background: The purpose of this study is to propose an analysis of trends and characteristics of high-cost patients who take over 40% of total national health insurance medical expenses. Methods: It has been analyzed the tendency of high-cost patients by open data based on the medical history information of 1 million people among national health insurance subscriber from 2002 to 2015. To conduct detailed study of characteristics of high-cost patients, multiple regression has been performed by sex, age, residence, main provider, and admission status based on the top 5% group. Results: The amount of medical expenses and the number of high-cost patients have gradually increased in decades. The number of high-cost patients for Korean won (KRW) 5,000,000 category has increased by 7.6 times, KRW 10,000,000 category has increased by 14.1 times in comparing of year 2002 and 2015. Top 5% medical expenses have increased by 4.6 times. In consideration of the characteristics of patients, the incidence of high medical expenses has been higher in female patients than male ones, the older patients than in the younger. Patients residence in Gyeonsang or Jeonla province have had a high incidence of medical expenses than other area. The disease including dementia, cerebral infarction, and cerebrovascular disease for high-cost patients has been also increased. Conclusion: The major increase factor for high medical expenses is the aging of population. The elderly population receiving inpatient care residing in the province that increases high medical costs have to management. There is an urgent need to develop a mechanism for predicting and managing the cost of high-cost medical expenses for patients who have a heavy financial burden.

Influence of Hazy Weather on Patient Presentation with Respiratory Diseases in Beijing, China

  • Ping, Jie
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.607-611
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    • 2015
  • Background: Chronic respiratory disease is an important factor for development of lung cancer. To explore the influence of hazy weather on respiratory diseases and its variation the present study was conducted. Materials and Methods: Data from air pollution surveillance from January to October 2014 and case records of visiting patients in the $263^{th}$ Hospital of Chinese PLA in the corresponding period were collected to analyze the relevance between different degrees of air pollution (hazy weather) and the number of visiting patients in Department of Respiratory Disease. Results: Air quality index (AQI) of hazy weather had significantly positive association with particulate matter 2.5 ($PM_{2.5}$) and the number of patients with 5 kinds of respiratory diseases i and different pollutants had distinct influences on various respiratory diseases. Conclusions: The degree of air pollution in Beijing City is in close association with the number of patients with respiratory diseases, in which $PM_{2.5}$ and $SO_2$ are in more significant influences on all respiratory diseases. This could have essential implications for lung cancer development in China.

A CLINICAL STUDY ON BOOT CANAL TREATED PATIENTS (근관치료 환자에 대한 임상적 고찰)

  • Lee, Jong-Man
    • Restorative Dentistry and Endodontics
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    • v.7 no.1
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    • pp.117-124
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    • 1981
  • In order to observe the frequency of visits and the distribution of endodontically treated patients according to age, sex, diagnosis, type of teeth, the author had surveyed the 17,250 outpatients of the Infirmary of the College Dentistry, Yonsei University from January 1976 to December 1978. 773 cases, 660 patients among 728 endodontically treated patients were studied. The obtained results were as follow; 1. The average frequency of visits were 5.95 in uppers and 5.88 in lowers. 2. The average frequency of visits were 5.79 in males and 6.02 in females. 3. At the age of under 14, the average frequency of visits were 7.42 in uppers and 6.76 in lowers. 4. According to diagnoses, the average frequency of visits in periapical granuloma or cyst were 2.80 in uppers and 3.16 in lowers. 5. The number of endodontically treated teeth had revealed as follow; upper incisors 27.94%, lower molars 25.87%, and upper molars 15.13% 6. The number of endodontically treated teeth by diagnoses were as follow; periapical abscess 45.27%, pulpit is 37.51%, tooth fracture 8.40%. 7. The number of endodontically treated teeth were 51.99% in the age of from 20 to 34.

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A Study on the Characteristics of Low Back Pain and Shoulder-Arm Pain Patients by Sasang Constitution (요통과 견비통 환자에서 사상체질별 특성 연구)

  • Shin, Woo Young;Ko, Ho Yeon;Jeong, Su-Hyeon;Shin, Mi Ran
    • Journal of Sasang Constitutional Medicine
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    • v.29 no.4
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    • pp.336-346
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    • 2017
  • Objectives The purpose of this study is to investigate the characteristics of low back pain and shoulder arm pain patients according to the Sasang Constitution. Method We classified Seventy-nine participants by their Sasang Constitution. We investigated various aspects of the participant's pain such as the location of pain, diseases and Syndrome Differentiation etc. then intended to confirm relationship the Sasang Constitution and these research items through the statistics analysis. Results The numbers of lower back pain patients was statistically higher in Soyangin group than any other groups and the number of shoulder arm pain patients was statistically higher in Taeeumin group or Eumin group (Taeeumin group and Soeumin group) than Soyangin group. The number of diabetes patients and obesity patients was statistically higher in Taeeumin lower back pain patients, and that of obesity patients was statistically higher in Taeeumin shoulder arm pain patients than any other groups. The numbers of shoulder arm pain patients due to blood stasis and lower back pain patients due to kidney deficiency were statistically higher in Soyangin group than any other groups. The numbers of shoulder arm pain patients due to phlegm fluid retention and lower back pain patients due to phlegm fluid retention were statistically higher in Taeeumin group than any other groups. Conculsions The characteristics of lower back pain and shoulder arm pain could be different according to Sasang constitution.

The Effects of Abdominal Meridian Massage on Constipation in Institutionalized Psychiatric Patients Taking Antipsychotic Drugs (항정신 약물을 복용하는 시설거주 정신과 환자의 변비 완화를 위한 경락마사지 효과)

  • Kim, Inja;Cho, Yu Na
    • Korean Journal of Adult Nursing
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    • v.19 no.5
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    • pp.127-137
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    • 2007
  • Purpose: It was investigated if abdominal meridian massage has effects on constipation in institutionalized psychiatric patients taking antipsychotic drugs. Methods: According to the constipation screening tests, 22 patients were selected as subjects. One group pre and post repeated measurement design was used. Constipation was operationalized as perceived constipation, frequency of defecation, frequency of bowel sound, and number of medicine taken to relieve constipation. Abdominal meridian massage was given for two weeks, 10-15 minutes each time and 10 times in total. Results: Perceived constipation, frequency of bowel sound, and number of medicine taken were significantly improved after massage. Except for number of medicine taken, the effects on perceived constipation and frequency of bowel sound were found to be persistent 2 weeks after massage. Conclusion: Based upon these results, abdominal meridian massage was recommended as independent nursing intervention for the relief of constipation in psychiatric patients who taking anti-psychotic drugs. Further studies to investigate the maximal duration time of effects and whether the effects of intermittent application of this method is more beneficial than the continuous application of this method are necessary.

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The Prescribing Patterns of Antipsychotic Drugs and Antiparkinsonian Drugs in Elderly Patients with Dementia (노인 치매 환자의 항정신병약물 및 항파킨슨약물 처방 현황)

  • Yoon, Soo Mi;Lee, Sungwon;Chang, Ji-Eun;Lee, Young Sook;Rhew, Kiyon
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.2
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    • pp.81-86
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    • 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.

A Study on the Pain in Patients with Temporomandibular Disorders using Korean Pain Rating Scale (측두하악장애환자에서 한국어 통증척도를 이용한 통증에 관한 연구)

  • Yoing-Gyu Bae;Kyung-Soo Han
    • Journal of Oral Medicine and Pain
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    • v.19 no.2
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    • pp.169-180
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    • 1994
  • The aim of this study was to compare pain descriptions in common dental patients with those in patients with Temporomandibular disorders(TMDs). The study sample consisted of 104 common dental patients and 74 patients with TMDs, and their chief complaint was pain, Subjects were classified common dental pain group and TMDs pain group, respectively. All the subjects completed Korean Pain Rating Scale(KPRS) on first visit. KPRS contains 90 pain terms, which divided into 20 subclasses in 3 dimensions. Each subclass contains 3-6 pain terms. each patient had chosen only one term from each subclass. If there was no proper term, subject could pass the subclass without completion. Words chosen were categorized into sensory, affective, miscellaneous and total dimension. Thereafter they were processed and analyzed by SPSS/PC+ statistical package program with respect to rank values, scale values, number of words chosen and frequency of each subclass. The obtained results of this study were as follows : 1. Total mean number of words chosen was 7.6. 2. Chronic patients groups with Temporomandibular disorders had chosen more freuently from the subclasses in affective dimension than the patients in acute common dental pain group. 3. Frequency of affective dimension was higher in chronic patients groups with Temporomandibular disorders than that of acute patients group with Temporomandibular disorders. 4. Chronic patients group with Temporomandibular disorders had higher frequency in constrictive pressure pain, traction pressure pain, dull pain and fatigue-related pain terms than acute common dental patients group. 5. Acute patients group with Temporomandibular disorders had higher frequency in traction pressure pain and dull pain terms but had lower frequency in chemical pain, peripheral nerve pain and cold pain terms than acute common dental patients groups. 6. There were high positive correlation between the scale- and rank-value in the pain rating index.

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Comparison of Oral Health Behavior and Oral Health Indexes between Patients Undergoing Scaling Regularly and Those Undergoing Scaling Irregularly (스케일링 환자들의 정기적인 스케일링과 비정기적인 스케일링의 구강건강행동지수와 구강건강지수 비교)

  • Kim, Yu-Rin
    • The Korean Journal of Health Service Management
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    • v.11 no.1
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    • pp.171-180
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    • 2017
  • Objectives : The objective of this study was to compare oral health behaviors and oral health indices between regular scaling group and irregular scaling group. Methods : This study was performed at M Dental Clinic in Busan on 352 dental patients treated between January 2014 and June 2015 using V6.0 software and medical interviews. The 352 patients were divided into 3 groups and oral health behavior (OHB) and oral health indices were compared. Results : The OHB scores significantly differed among Groups C and A. Group C had the lowest number of "Bad" scores for the Simplified Debris Index (S-DI), Simplified Calculus Index (S-CI), and Simplified Oral Hygiene Index (S-OHI). Groups B and A had the lowest number of "Excellent" scores. Group C had the lowest bleeding on probing (BOP), calculus rate (CR) and decayed teeth (DT). Furthermore, Group C had the highest number of missing teeth (MT) and filled teeth (FT). Conclusions : Patients who underwent regular scaling had the highest OHB and oral health index scores. This emphasizes the importance of regular scaling for prevention and early detection of oral disease.

A Single-Center Retrospective Study on the Effects of Korean Medicine in 342 Traffic Accident Cases

  • Jeong, Jin-Ho;Ku, Jaseung;Hwang, Ji Hye
    • Journal of Pharmacopuncture
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    • v.24 no.3
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    • pp.122-137
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    • 2021
  • Objectives: In South Korea, traffic accident victims can be treated under automobile insurance coverage. Korean medicine (KM) clinics have reported the largest number of automobile insurance fee claims among medical institutions. This study investigated the status of the KM automobile insurance system in a single KM clinic. Methods: We retrospectively surveyed the medical charts of 342 traffic accident patients treated at the Jisung KM clinic between January 2009 and June 2017. Results: Most of the patients were men and in their 30s. The most common method of locating the clinic was an internet search. The most common traffic accident type was collision between vehicles (83.63%), with 70.76% of patients visiting during the most acute phase. The major disease codes included S434, M4836, F072, S0600, and S3350. The most frequent treatment period was within 1 month of the accident, and most patients received 10 or fewer treatments. The mean treatment duration and number of treatments were 37.68 ± 45.11 days and 11.68 ± 10.63 treatments, respectively. The initial pain numerical rating scale (NRS), 7.32 ± 0.96, decreased to 3.57 ± 1.40 at the end of treatment, with a symptom improvement score of 1.87 ± 0.60. Regarding sex, age, disease duration, location at the time of the accident, presence of additional and psychological symptoms, and chuna, there were statistically significant differences in treatment duration and number of treatments. A higher number of treatments and the longer treatment duration was associated with a higher initial NRS, lower post-treatment NRS, and better improvement score. Since the introduction of traffic accident (TA) pharmacopuncture, the rate of use of a single type of pharmacopuncture increased; however, no significant differences in treatment duration and number, NRS before and after treatment, and improvement score were observed between treatment groups before and after TA pharmacopuncture. No adverse reactions were observed for any treatment. Conclusion: This study confirmed the previous findings of a high treatment effect of KM under automobile insurance. We also observed significant correlations based on a detailed medical status, which may explain the increasing use of KM in the automobile insurance system. Additional multi-center studies in different regions are needed.