• 한국임상약학회지
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• 제34권1호
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• pp.30-38
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• 2024

Background: This study examined the public's perceptions of repeat dispensing as one of the measures to reduce the harmful effects of long-term prescriptions in Korea. Methods: From January 11 to 25, 2021, an online survey was conducted for adults using convenience sampling. A self-developed questionnaire was used. Results: There were 310 respondents, of which 228 (73.5%) preferred repeat dispensing. When considering the additional fee payment, 188 (60.6%) preferred repeat dispensing, and 54 (67.5%) out of a total of 80 chronic disease patients preferred it. It was confirmed that there was a difference in the willingness to repeat dispensing considering the additional cost depending on whether the patient had a chronic disease and the distance from home to the nearest pharmacy. As a result of subgroup analysis for patients with chronic diseases, frequency of outpatient visit, number of prescription days, method of packaging pharmaceuticals, and distance from home to the nearest pharmacy were identified as variables that could well predict the willingness to repeat dispensing considering paying additional fees. The preference for repeat dispensing may vary depending on conditions such as additional cost range, frequency and period of prescription use, disease and patient characteristics, so a careful approach is necessary. Conclusion: It is necessary for the government to consider the introduction of repeat dispensing with interest in the public demand.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제6권1호
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• pp.3-17
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• 1995

아동에서의 경계선 장애는 현실감각의 불안정, 대인관계의 장애, 충동조절의 장애, 심한 기능의 변동, 발달상의 불균형, 불안등을 보이며 현재의 진단 체계로는 진단하기 어려운 환아를 의미한다. 본 논문에서는 Bemporad등과 Vera등이 제안한 '경계선 아동'에 부합하는 7세에서 11세 사이의 8명의 소아정신과를 내원한 아동들을 대상으로 37개의 병인들을 비교하여 다음과 같은 결과를 얻었다. 1) 임상적인 특징으로는 모든 환아들이 다 남아였으며, 현재의 진단체계에서는 진단을 내리기가 어려웠고, 공존정신과적인 진단이 많았다. 주소는 산만하고 또래와 어울리지 못한다는 것이 많았다. 현실과 환상사이의 경계가 불명확한 것과 사고의 장애가 특징적인 증상이었다. 2) 심리학적 및 신경생리학 검사상 지능은 보통수준이었으며, 동작성 지능이 언어성 지능보다 우수한 경향이 있었다. 투사법 검사에서는 사고 장애의 지표는 보였으며, 정서적으로 불안정하고 공격성이 심하였다. 반수에서 주의력 검사상 주의력결핍을 시사하였다. 기질적인 요인은 뚜렷하지 않았다. 3) 발달력 및 가족력상 원하지 않았던 아이가 많았고, 주 양육자는 어머니였으나, 양육방식에 중등도의 문제가 있었다. 부모간에 불화가 많았고, 사회 경제적으로는 중하가 많았다. 언어발달은 대부분에서 지연이 되었거나, 성장하면서 점차로 정상이 되었다. 공격적이어서 또래들로 부터 따돌림을 많이 받았다. 4) 치료 및 경과상 6세경에 처음 병원에 방문하였으며, 평균 치료 기간은 2년이었고, 주로 외래에서 치료를 받았다. 약물치료에 대한 반응은 뚜렷하지 않았으며, 장기 놀이치료의 필요성이 암시되었다. 본 연구 방법에 여러 가지 제한점이 있으나 앞으로 이 장애의 명확한 진단 기준을 확립하고 역학 및 치료에 대한 연구들이 이루어져야 할 것이다.

• 정신신체의학
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• 제6권2호
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• pp.104-119
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• 1998

This study was conducted to determine the important factors in the illness behavior of panic disorder patients. And then, find the best ways to lead the patients who have recurrent panic attacks to the adequate therapeutic situations. We studied 53 patients diagnosed as panic disorder according to DSM-IV among the outpatients who had been followed up at Bong Seng Memorial Hospital for 6 Ms, from May 1997 to October 1997. To evaluate the illness behaviors, we designed a checklist including socio-demographic data, degree of subjective distress from medical and psychiatric treatment, panic symptoms, life events, places of help-seeking, Anxiety Sensitivity Index. Using the checklist, we had semistructured interviews with the panic disorder patients to elucidate their help-seeking behaviors from first panic attack to diagnosing as panic disorder. The results were as follows ; 1) After first panic attack, the patients initially sought help at 1) Emergency room 40%, 2) Rest &/or Personal emergency care 35%, 3) Pharmacy 10%, 4) Outpatient care at hospital 10%, 5) Oriental medicine 5%. 2) Considering the panic symptoms, derealization, paresthesia and the severity of panic symptoms were the most important factors affecting the patient's help-seeking behaviors who had experienced the first panic attack. 3) Most of all the patients (80%) were apt to visit the hospitals within 15 days after experiencing about 3 panic attacks. 4) Before diagnosed as panic disorder, the patients had visited 3-5 health care centers during about 1 year. 5) Primary care physicaians(for example, emergency care physicians, family doctors and internists) had the most important roles in treating or guiding the patients to the adequate therapeutic situations. From the above results, the authors propose that non-psychiatric physicians have to know the panic disorder or attacks exactly. When patients complaint sudden onset physical symptoms e.g. palpitation, dyspnea, dizziness or the cognitive symptoms like the fear of death or insanity, physicians should consider the possibility of panic attack and encourage the patients to be evaluated for psychiatric illness.

• Journal of Chest Surgery
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• 제42권4호
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• pp.492-496
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• 2009

배경: 급성 폐색전증은 그 치료가 어려우며 대량의 색전증이 발생하여 심인성 쇼크를 동반할 경우 치명적인 결과를 초래할 수 있다. 과거 폐색전증 환자의 수술적 치료는 마지막 수단으로 여겨져 왔다. 하지만 저자들은 폐색전증 제거술을 시행한 7예의 경험을 토대로 치료 대안으로서 수술의 필요성을 검토하고자 하였다. 대상 및 방법: 8년간 본원에서 폐색전 제거술을 시행한 환자들의 의무 기록을 바탕으로 후향적 연구를 시행하였다. 입원 기간 및 마지막 외래 진료까지 경과 관찰하였다. 결과: 7명의 환자(남자 4명, 여자 3명)가운데 4명의 환자가 대량 폐색전증이었으며 나머지 3명은 아급성 폐색전증이었다. 3명의 환자는 수술 전 체외막산소공급장치를 삽입하고 수술을 받았다. 사망한 환자 없이 모두 퇴원하였으며 수술 후 시행한 심초음파 결과상 6명의 환자에서 폐동맥 고혈압 소견 없었다. 결론: 폐색전증 제거술은 대량의 폐색전증 환자에서 낮은 사망률로 시행할 수 있으며 저자들은 수술 전심인성 쇼크 상태인 환자에서 체외막산소공급장치가 생존율을 향상시킬 것으로 생각된다.

• 한방재활의학과학회지
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• 제27권4호
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• pp.97-109
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• 2017

Objectives The aim of this study is to analyze the patients who have low back pain through registry. Methods We registered patients with low back pain who visited department of korean rehabilitation medicine in university hospitals on study. We collected data from 116 subjects consisted of 51 inpatients and 65 outpatients and ruled out 8 who didn't have pattern identification data at the point of inpatient or outpatient visit so we analyzed 108 in total. We used Pearson's product moment correlation to find correlationship among variables, and analyzed statistical data using Phyton scipy library stats package. Results We set general features, region of the pain, physical examination, ROM, questionnaire results, pattern identification as variables and draw a conclusion by analyzing these variables. Conclusions Registry aimed at low back pain patients was established in department of korean rehabilitation medicine of university hospitals and exploratory analysis based on data were made. Through the registry, we expect that more advanced studies will be performed; for example, executing research which verifies effectiveness and stability of korean medical treatment or developing tools to fill the gap between pattern identification and disease identification.

• Asian Pacific Journal of Cancer Prevention
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• 제16권2호
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• pp.783-786
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• 2015

Background: Utilizing geriatric screening tools for the identification of vulnerable older patients with cancer is important. The aim of this study is to evaluate the hospitalization risk of elderly hematologic cancer patients based on geriatric assessment and laboratory parameters. Materials and Methods: In this cross sectional study 61 patients with hematologic malignancies, age 65 years and older, were assessed at a hematology outpatient clinic. Standard geriatric screening tests; activities of daily living (ADL), instrumental activities of daily living (IADL), Mini Nutritional Assessment (MNA), Mini Mental State Examination (MMSE), timed up and go test (TUG), geriatrics depression scale (GDS) were administered. Demographic and medical data were obtained from patient medical records. The number of hospitalizations in the following six months was then recorded to allow analysis of associations with geriatric assessment tools and laboratory parameters. Results: The median age of the patients, 37 being males, was 66 years. Positive TUG test and declined ADL was found as significant risk factors for hospitalization (p=0.028 and p=0.015 respectively). Correlations of hospitalization with thrombocytopenia, vitamin B12 and folic acid deficiency were statistically significant (p=0.004, p=0.011 and p=0.05 respectively). Conclusions: In this study, geriatric conditions which are usually unrecognized in a regular oncology office visit were identified. Our study indicates TUG and ADL might be use as predictive tests for hospitalization in elderly oncology populations. Also thrombocytopenia, and vitamin B12 and folic acid deficiencies are among the risk factors for hospitalization. The importance of vitamin B12 and folic acid vitamin replacement should not be underestimated in this population.

• Childhood Kidney Diseases
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• 제15권2호
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• pp.184-190
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• 2011

Henoch-Sch$\ddot{o}$nlein 자반증은 2-38%의 남자 환아에서음낭을침범할수있다. 음낭침범은 Henoch-Sch$\ddot{o}$nlein 자반증의 임상 경과 중 어느 시기에든 나타날 수 있으며, 자반이 나타나기 전 혹은 자반이 사라지고 난 후에도 나타날 수 있어 진단이 늦어지거나 오진될 수 있다. 특히 급성 음낭 통증이 동반된 경우 응급 수술이 필요한 고환염전과 감별하는 것이 중요하다. 첫번째 환자는 Henoch-Schonlein 자반증을 진단 받기 전 급성 음낭 통증이 발생하였으며, 두번째 환자는 Henoch-Schonlein 자반증을 치료받고 약 한 달이 경과한 후 급성 음낭 통증이 발생하여 방문하였다. 두 경우 모두 음낭 도플러 초음파 검사를 시행하였고 부고환으로는 증가된 혈류, 고환으로는 정상 혈류를 보여 부고환염을 진단하고 고환염전을 배제할 수 있었으며, 단기간의 스테로이드 치료를 통해 부고환염은 호전되었다. Henoch-Sch$\ddot{o}$nlein 자반증에서 동반된 급성 부고환염은 보존적 치료만을 통해 빠른 속도로 호전될 수 있는 질환이지만, 고환염전으로 오진되거나 이를 배제하지 못하는 경우 불필요한 수술이 시행될 수 있으므로 증상 발생 초기에 도플러 초음파 검사를 시행하는 것이 중요할 것으로 사료된다.

• 대한한방부인과학회지
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• 제31권3호
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• pp.61-78
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• 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.

• Tuberculosis and Respiratory Diseases
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• 제80권4호
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• pp.377-384
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• 2017

Background: Proper education regarding inhaler usage and optimal management of chronic obstructive pulmonary disease (COPD) is essential for effectively treating patients with COPD. This study was conducted to evaluate the effects of a comprehensive education program including inhaler training and COPD management. Methods: We enlisted 127 patients with COPD on an outpatient basis at 43 private clinics in Korea. The patients were educated on inhaler usage and disease management for three visits across 2 weeks. Physicians and patients were administered a COPD assessment test (CAT) and questionnaires about the correct usage of inhalers and management of COPD before commencement of this program and after their third visit. Results: The outcomes of 127 COPD patients were analyzed. CAT scores ($19.6{\pm}12.5$ vs. $15.1{\pm}12.3$) improved significantly after this program (p<0.05). Patients with improved CAT scores of 4 points or more had a better understanding of COPD management and the correct technique for using inhalers than those who did not have improved CAT scores (p<0.05). Conclusion: A comprehensive education program including inhaler training and COPD management at a primary care setting improved CAT scores and led to patients' better understanding of COPD management.

• 약학회지
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• 제59권6호
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• pp.270-277
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• 2015

There is a lack of evidence on the impact of pharmacist interventions in diabetes care in South Korea. The aim of this study was to investigate the effects of pharmacist counseling on clinical and humanistic outcomes in patients with type 2 diabetes. An uncontrolled before-and-after study was conducted at the outpatient diabetes clinic in a teaching hospital in Gyeongnam, South Korea between January 2 and November 30, 2014. A total of 37 patients were enrolled. During the study periods, the participants and pharmacists met every 2 weeks via follow-up telephone calls in addition to face-to-face meetings upon returning for care visit. At each meeting, a structured patient counseling was performed and the average duration of each meeting was 15~30 minutes. The participants were requested to record daily self-care activities. At the end of this study, patients' satisfaction on pharmacist care was evaluated using the questionnaire developed by us. Compared to baseline, significant reductions (mean${\pm}$standard deviation, p<0.05) in HbA1c were observed at each follow-up period: $-0.32{\pm}0.72%$ from baseline to 3 months; $-0.52{\pm}0.76%$ from baseline to 6 months; $-0.72{\pm}0.76%$ from baseline to 9 months. Over the same follow-up period, the proportions of patients achieving target HbA1c (defined as HbA1c<6.5%) were 3.1%, 10.3%, and 20%, respectively. The proportions of patients who never missed a dose during the same follow-up period were 43.8%, 31.0%, and 20.0%, respectively. The results from the patient satisfaction survey indicated that pharmacist counseling improved patients' knowledge about diabetes and possible drug interactions. Especially, the information on a healthy diet and lifestyle was the most satisfying. To conclude, follow-up telephone calls combined with face-to-face meetings improved clinical and humanistic outcomes in patients with type 2 diabetes mellitus.