• 약학회지
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• 제58권4호
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• pp.268-276
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• 2014

Background: World Health Organization considers opioid analgesic use as an important measure in the treatment of pain relief. However, there are limited data about the pattern of opioid analgesic use in tertiary care hospitals in Korea. The aim of this study was to describe the trends in the prescribed amount of the opioid for 13 years from 2000 to 2012 in a single tertiary care hospital. Methods: The data from the prescribed amount of opioid use in patients aged over 18 years were retrieved from medical charts and longitudinal pharmacy records of Seoul National University Hospital. Yearly prescribed amount of opioids were calculated using defined daily dose adjusted by hospital stay (DDD/1000${\bullet}$HS). Results: Over the 13 years of the study period, overall use of opioid has increased by 64.1%. Although, the opioid use by hospitalized patients comprised 98%~99% of total amount of opioid use, the proportions of opioid use by outpatient and by cancer patient increased from 1.1% to 2.2% and from 60.5% to 69.3%, respectively. The use of non-injectable opioids has increased by 47% and that of injectables has increased by 70%. While the amount of codeine and morphine use has decreased, the use of both transdermal and injection formulation of fentanyl has increased dramatically. Also, the use of oxycodone has increased, especially in outpatient setting. Conclusion: This longitudinal study showed that opioid analgesic use in tertiary hospital, especially in outpatient is continuously increasing. Improvement in pain management in tertiary care hospital can be cautiously inferred based on this results.

• 한국동물위생학회지
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• 제47권1호
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• pp.19-26
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• 2024

Canine atopic dermatitis (CAD) is an inflammatory and pruritic skin disease with a genetic predisposition, characterized by allergic sensitivity. It is known for its distinctive clinical features, including a high recurrence rate and chronic progression. To manage CAD, medications such as steroids and immunosuppressants are commonly used, but consideration should be given to the potential resistance and side effects associated with long-term use. In order to reduce these risks, various adjunctive factors are currently under consideration. One of these adjunctive agents, probiotics have shown effectiveness in regulating atopic dermatitis by modulating immune responses, as demonstrated in several recent studies. In this study, a substance combining three probiotics-L. plantarum, L. reuteri, and Ped. Acidilactici-was used in patients diagnosed with CAD, and its clinical effects and safety were evaluated. The trial involved four groups: a group receiving conventional treatment for atopic dermatitis (A), a group prescribed low-dose probiotics (B), a group prescribed high-dose probiotics (C), and a group prescribed topical probiotics (D). For assessment, the Canine Atopic Dermatitis Extent and Severity Index (CADESI), Trans-Epidermal Water Loss (TEWL) test, gut microbiome, and serum IgE test were conducted. As a result, the CAD severity index (CADESI-4) significantly decreased in the probiotics groups (B & C). In the serum total IgE test, the groups consuming probiotics showed a significant difference, while the group using topical probiotics (D) did not exhibit a significant change. Also, the TEWL test showed improved scores in the probiotics groups (B & C). Therefore, L. plantarum, L. reuteri, and Ped. Acidilactici probiotic combination could be considered as an effective adjunctive treatment, especially for atopic patients with moderate to severe skin lesions.

• 한국임상수의학회지
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• 제41권1호
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• pp.49-53
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• 2024

A two-year-old, spayed female, 22.5 kg Pungsan was referred with chronic crusts and erosion on the nose. A referring veterinarian prescribed an anti-inflammatory dose (0.5-1 mg/kg/day) of oral glucocorticoids for 5 months, but skin lesions showed no meaningful improvement. A dermatological evaluation revealed a crust, depigmentation, erosion, and erythematous lesion over the nasal planum with a loss of the normal cobblestone texture. Also, firm and multifocal plaques over the thigh, groin, axilla, and dorsum were detected. A cytology examination on the nose, thigh, groin, axilla, and dorsum revealed moderate neutrophilic inflammation and bacterial infection. Abdominal radiography and ultrasonography revealed subcutaneous calcified materials along the thigh, groin, axilla, and dorsum. Calcinosis cutis was suspected because of the adverse effect of previous prolonged corticosteroid therapy. A histopathology examination of the nose lesion revealed moderate to severe degenerative or apoptotic changes of the basal layer and lymphoplasmacytic interface dermatitis. Facial discoid lupus erythematosus (FDLE) was diagnosed based on the history and the clinical, cytological, and histopathological results. Minocycline (7 mg/kg PO q 12 h) and niacinamide (500 mg/dog PO q 12 h) were prescribed as initial treatment. Glucocorticoids were not administered due to the presence of calcinosis cutis induced by previous corticosteroid treatment. After 6 weeks of treatment, the clinical signs on the nose were mildly improved. At this time, topical 1% pimecrolimus cream (twice daily) was initiated, while minocycline and niacinamide were continued at the same dose. The nasal planum markedly improved after 6 weeks of additional treatment, hence minocycline and niacinamide were prescribed for an additional 2 weeks and stopped, and the patient was continued solely on topical pimecrolimus. The dog's skin lesion has been maintained in clinical remission with topical 1% pimecrolimus twice daily for more than 5 months.

• 생물정신의학
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• 제28권2호
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• pp.50-57
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• 2021

Objectives Clozapine is the most effective atypical antipsychotic agent for the treatment-resistant schizophrenia (TRS), however, only 40%-70% of TRS patients respond to clozapine. Moreover, TRS encompasses various symptom dimensions. Therefore, augmentation with other medications for clozapine is frequently applied. However, the prescription pattern of clozapine and combined medications in Korea is yet to be examined. This study aims to investigate the maintenance treatment pattern of clozapine and augmentation agents in one Korean tertiary hospital. Methods The patients with schizophrenia spectrum disorders under clozapine maintenance, defined as one-year clozapine continuation, were subjected for analysis. Medication data at one-year time-point after clozapine initiation was extracted and analyzed. Results Among total 2897 patients having clozapine prescription experience from January 2000 to December 2018, 1011 patients were on clozapine maintenance. The mean age of clozapine initiation was 30.2 ± 11.3 years, and the maintenance dose of clozapine was 217.8 ± 124.3 mg/day. Combination rate of antipsychotics, mood stabilizers, and antidepressants were 43.5%, 25.3%, 38.6%, respectively. Most frequently prescribed drugs in each category were aripiprazole, valproate, and sertraline. Olanzapine equivalent dose of combined antipsychotics was 10.4 ± 7.7 mg/day. Male patients were prescribed higher dose of combined antipsychotics and higher rate of antidepressants. Female patients had later onset of clozapine prescription. Patients with two or more combined antipsychotics were prescribed higher dose of clozapine and higher rate of antidepressants compared to patients with one combined antipsychotic. Conclusions Taken together, among the patients taking clozapine, a substantial rate of patients were under polypharmacy. The present findings based on the real-world prescription pattern could provide the valuable clinical information on the treatment of TRS-related conditions.

• 대한방사선치료학회지
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• 제23권2호
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• pp.91-96
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• 2011

목 적: 전신조사방사선치료를 시행한 환자에서 체질량지수와 열형광선량계를 이용한 선량측정 정보를 비교 분석하여 환자에게 보다 균등한 선량을 조사하고자 한다. 대상 및 방법: 2006년부터 2011년 8월까지 전신조사방사선치료를 시행한 환자 28명을 대상으로 하였다. 각 환자는 열형광선량계를 이용하여 두부, 경부, 흉부, 복부, 골반부, 대퇴부, 슬관절부, 족관절부에서 선량을 측정하였다. 각각의 환자에 대하여 처방 중심점인 복부점과 각 측정점에서의 선량측정치를 비교하였고, 선량기준이 되는 복부점의 측정값과 환자의 체질량지수를 비교 분석하였다. 결 과: 28명 환자에서 처방에 기준이 되는 중심점인 복부선량은 평균 $100.6{\pm}5.5%$이었고, 복부점과 다른 7개의 측정점 평균값과의 최대 차이는 두부, 경부, 흉부, 골반부, 대퇴부, 슬관절부, 족관절부에서 각각 $92.8{\pm}4.2%$, $97.6{\pm}6.2%$, $96.4{\pm}5.5%$, $102.6{\pm}5.3%$, $103.4{\pm}7.9%$, $95.8{\pm}5.9%$, $96.1{\pm}5.5%$였다. 각각의 환자에 대하여 복부점의 선량과 환자의 체질량지수와 관계를 산점도(scatter plot)로 나타내고 선형관계를 회귀분석 한 결과, 회귀직선은 선량(y)=-1.009 BMI (x)＋123.3이고 $R^2$값은 0.697로 나타났다. 결 론: 전신방사선치료시 열형광선량계로 측정된 자료를 바탕으로 선량을 평가하였고 분석 결과 처방 선량에 대하여 기준이 되는 복부선량은 평균 $100.6%{\pm}5.5%$로 만족하였다. 본 실험결과 체질량지수와 선량과의 관계 분석을 통하여 얻은 정보에 따라 체질량지수가 높은 환자에 대하여 보정 값을 적용한다면 보다 균등한 선량을 달성할 수 있을 것으로 사료된다.

• 대한방사선기술학회지:방사선기술과학
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• 제41권6호
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• pp.603-610
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• 2018

This study examined the following: accuracy of the exposure conditions in the inverter device and three-phase device; output waveform over the exposure conditions; and average and standard deviation of the output waveform. After assessing whether the dose corresponding to the theoretical dose was presented, the following conclusions were obtained: 1. The accuracy of the tube voltage(kVp) and tube current(mA) exposure time(sec) was within the tolerable level prescribed in Korea's Safety Management Standards. In the error, Inverter device was large the tube voltage and exposure time, the three-phase device was large the tube current. 2. In terms of the output waveform of the exposure conditions and the average and standard deviation of the output waveform, the higher tube voltage and larger tube current resulted in greater standard deviation in pulsation. Moreover, the standard deviation of pulsation was shown to be greater in the inverter device than the three-phase device; there was also greater standard deviation in the inverter device considering the exposure time. 3. Regarding the exposure conditions over the output dose, all linearity showed the coefficient of variation which had an allowable limit of error within 0.05. Although the output dose ratio for the inverter device was 1.00~1.10 times no difference that of the three-phase device, there was almost no difference in dose ratio between the tube currents.

• Nuclear Engineering and Technology
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• 제55권1호
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• pp.248-253
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• 2023

Directly, it is not possible to measure the absorbed dose of radiopharmaceuticals in the organs of the human body. Therefore, simulation methods are utilized to estimate the dose in distinct organs. In this study, individual organs were separately considered as the source organ or target organ to calculate the mean absorption dose, which SAF and S factors were then calculated according to the target uptake via MIRD method. Here, ^99mTc activity distribution within the target was analyzed using the definition and simulation of ideal organs by summing the fraction of cumulative activities of the heart as source organ. Thus, GATE code was utilized to simulate the Zubal humanoid phantom. To validate the outcomes in comparison to the similar results reported, the accumulation of activity in the main organs of the body was calculated at the moment of injection and cardiac rest condition after 60 min of injection. The results showed the highest dose absorbed into pancreas was about 21%, then gallbladder 18%, kidney 16%, spleen 15%, heart 8%, liver 8%, thyroid 7%, lungs 5% and brain 2%, respectively, after 1 h of injection. This distinct simulation model may also be used for different periods after injection and modifying the prescribed dose.

• 대한임상독성학회지
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• 제3권2호
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• pp.130-134
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• 2005

Lithium is mainly prescribed for manic and depressive disorder, also frequently prescribed for the other diseases such as migraine, cluster headache, alcoholism, and obsessive-compulsive disorder. An acute lithium intoxication occurs in cases of patients ingesting large amount lithium at a time, a chronic lithium intoxication occurs in patients on chronic lithium therapy. Acute or chronic lithium poisoning occurs frequently in case of patients on chronic lithium therapy ingesting larger dose than prescribed. Manifestations of lithium poisoning are various. It is possible nervous, cardiovascular, renal, gastrointestinal and endocrine systems to be involved. Due to intracellular high concentration, mortality rate is high in acute lithium intoxication patients on chronic lithium therapy. We report a case of acutely intoxicated 40-year-old male on chronic lithium therapy. His chief complaints were deterioration and high fever. On his arrival to an emergency department, he was in cardiac arrest. He restored return of spontaneous circultion (ROSC) 5 minutes later after cardiopulmonary cerebral resuscitation (CPCR) and referred to department of internal medicine for hemodialysis. Vigorous treatment was given to the patient, but he was expired at 4th hospital day.

• 약학회지
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• 제31권4호
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• pp.204-212
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• 1987

Rifampicin is an indispensable drug along with isoniazid for the control of tuberculosis and is usually prescribed as the combination of rifampicin and isoniazid. This paper is attemtped to investigate the interaction of rifampicin and isoniazid. Isoniazid was administered orally at a dose of 30mg/kg of rabbits pretreated with rifampicin 7.5mg/kg, 15mg/kg, and 30mg/kg, respectively twice daily for 9 days. The results are as follows: The blood level and relative bioavailability of isoniazid were decreased significantly (p<0.05) by rifampicin at a dose of 15mg/kg and 30mg/kg. The renal clearance of total isoniazid and ratio of its metabolites to isoniazid were increased significantly (p<0.05) by rifampicin at a dose of 15mg/kg and 30mg/kg. It seemed to be due to enzyme induction by rifampicin. Elimination rate constant ($\beta$) of isoniazid was increased and half life ($t_{1/2$\beta}$) was decreased by rifampicin pretreatment. Dosage regimen of isoniazid after long term administration of rifampicin should be adjusted carefully.

• 비만대사연구학술지
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• 제1권1호
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• pp.43-45
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• 2022

Intensive lifestyle modifications and anti-obesity medications are essential for obesity treatment. Antiobesity medications should be selected according to the patient's comorbidities, symptoms, and preferences. This case report describes the treatment of a morbidly obese patient with a history of depression, who complained of tingling and numbness after total thyroidectomy for papillary thyroid cancer. Very low-dose controlled-release phentermine/topiramate was prescribed and intensive lifestyle modifications were encouraged. As a result, the patient effectively lost weight and reached a near-normal weight without adverse drug effects. This implies that even an off-label anti-obesity medication low dose may be better for some patients, and the most important factor in obesity treatment is patient-tailored treatment.