• 동국한의학연구소논문집
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• 제6권2호
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• pp.109-133
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• 1998

근래 들어 악성종양의 발병률은 점점 상승하고 있으며 소화기암은 전체 악성종양중 높은 발생빈도를 보이는 질병으로 한의학계에서도 치료를 위해 많은 연구를 하고 있다. 소화기암의 증후와 치료에 관하여 열격, 반위(反胃), 적취(積聚), 장독(臟毒)을 위주로 명(明) 청대(淸代)까지의 역대(歷代) 문헌(文獻)을 통해 고찰(考察)한 결과 이는 복강내 악성종양과 증후에 있어서 유사성을 나타내며 치료는 초기에는 거사법(祛邪法)을, 중기에는 공보겸시(攻補兼施)를, 후기에는 부정법(扶正法)을 위주로 하는 것으로 나타났다. 역대 문헌에서는 이에 대한 처방구성을 다양하게 언급하여 향후 소화기암 치료에 응용할 수 있을 것으로 사료(思料)된다.

• 한국임상약학회지
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• 제19권2호
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• pp.131-145
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• 2009

Background: Medication counseling is important to improve qualify of pharmaceutical care, but there are lack of studies to investigate satisfied counseling practice in community pharmacies. Purpose: This study was to investigate current medication counseling provided by community pharmacists. Method: Questionnaires to assess medication counseling practices were mailed to nationwide 1,269 community pharmacists who were Sookmyung Women's University alumni. Result: One hundred sixty five pharmacists were responded to the questionnaires (response rate 13.63%). 16.8% of them all respondents had counseling room in their pharmacies. 75% and 29.9% of respondents provided patient counseling always for new and refilled prescriptions, respectively. Counseling was provided primarily by verbal, but especially for drug name, usage and storage, it was provided in written concurrently. 31.1% of respondents was satisfied with counseling practices by themselves, and a major barrier of unsatisfied counseling was lack of time in 64.6% of respondents. Majorities of respondents (66.3% and 76.3%) spent 1-3 minutes and <1 minute, for new prescription and refilled prescription, respectively. Approximate 99% of respondents presented necessity of standardized patient counseling information for drugs and 97.6% responded that quality of patient counseling would be improved by using software containing counseling information. Old respondent group had higher accumulative patient counseling practice scores and pharmacy owner group took much time for counseling, resulting in higher scores too. Conclusion: This study showed that qualified patient counseling practice has not been reached in community pharmacies. Much more discussion to seek ways to improve the quality would be necessary.

• 대한간호학회지
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• 제36권8호
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• pp.1352-1358
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• 2006

Purpose. The purpose of this study were to investigate the effects of a 12-week brisk walking program on triglycerides (TG) and apolipoprotein B (Apo B) and to compare these effects to those of a brisk walking plus diet program in middle-aged overweight/obese ($BMI{\geq}23$) Korean women with hypertriglyceridemia. Method. This analysis was done with nineteen middle-aged overweight/obese Korean women who completed either the brisk walking program (9 women) or the brisk walking plus diet program (10 women) for 12 weeks. The brisk walking consisted of walking for 20 to 50 minutes/day at an intensity of 40 to 70% of heart rate reserve (HRR) for 3 to 6 days/week. The diet consisted of 60 minutes of group education and 20 to 30 minutes of individual counseling every week. TG and Apo B were assessed pre- and post-intervention. Results. TG and Apo B decreased significantly after the brisk walking program (Z = -2.31, p = 0.021; Z = -2.59, p = 0.009). TG and Apo B lowering effects of the brisk walking program were not significantly different from those of the brisk walking plus diet program (U = 37.0, P = 0.549; U = 42.0, P = 0.842). Conclusion. Brisk walking can be an effective intervention for overweight/obese middle-aged women with hypertriglyceridemia in reducing cardiovascular risk by lowering TG and Apo B levels. Adding diet to brisk walking may have no additional significant effects on changes in TG and Apo B.

• 대한한의정보학회지
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• 제18권1호
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• pp.64-77
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• 2012

Donguibogam, Korea's cultural heritage and traditional Oriental medicine book listed in the World Heritage three years ago, is indeed great in its importance and value. Korea's posterity has sought treatment methods through the medical book and their researches on that book have continued. However, it is rare to make the concrete analysis on the medicines for prescriptions recorded in the book. In this study, we reviewed "Ears" in the Section "Bodily Appearance" among the five chapters of Donguibogam, and analyzed the 55 types of prescriptions for ear diseases, the medical characteristics, tastes, prime classification of medical herbs, and acupunctural effects, and the dosage forms depending on prescriptions. For insect-entering ear diseases and 20 kinds of a single-medicine prescription also, the treatments are presented in the book, but we presented the texts only and excluded them in the analysis. We also excluded overlapping prescriptions and adding and reducing prescriptions of the 55 prescriptions, and thus classified the left 42 proscriptions by dosage form. As a result: 1. With respect to medical characteristics, the medicine with warm characteristics reached 9 types(40.9%), the highest rate, followed by the medicine with cold characteristics 8 types (36.4%). 2. Concerning medical tastes, the medicine with bitter taste included 12 types (54.5%), the medicine with sour taste 10 types (45.5%), and the medicine with sweet taste 7 types (31.8%). It was unusual that of the 22 medicines used for multipurpose, no medicine with the taste was found. 3. For the acupunctural effects, the medicine with acupuncture effects for spleen medirian reached 12 types in total (54.5%). On the contrary, the medicine with the effects for pericardium meridian reached only one (4.5%) among the total of 22 medicines. 4. In the dosage form of 42 prescriptions, powder medicine was 15 types (35.7%), and decoction medicine was 14 (33.3%). Powder, dedoction, and pill medicines accounted for 90.4% of the total medicine type. It was found that in particular, for ear diseases powder medicine was used more frequently than decoction medicine.

• 한국임상약학회지
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• 제22권4호
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• pp.291-303
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• 2012

As respiratory tract infections (RTI) account for about 60% of all antibiotic prescriptions in outpatient care setting, there are significant concerns about emerging resistance that are largely due to the excessive or inappropriate use of antibacterial agents for viral respiratory infections. This study was aimed to develop retrospective drug utilization review (DUR) program of antibiotics for RTIs using Delphi methods. Retrospective DUR criteria of antibiotics for RTIs were identified based on clinical practice guidelines and opinion of experts. Expert panel members were clinical doctors and pharmacists and Delphi method was applied by survey on 16 members of panels. The claim data from Korean Health Insurance Review & Assessment (HIRA) were used to examine trends in outpatient antibiotic prescription between Janunary to December of 2008. As results, Quality index for RTI was assessed for the claim type, antibiotics use of quantity, duration, number and cost. Antibiotic prescription rate for RTIs, Defined Daily Dose (DDD), and duration of antibiotics use were more recognized as significant quality index by experts' opinion. Use of first line agents suggested by guidelines was low and duration of antibiotics use was shorter compared to the recommendations. Antibiotics were over prescribed for RITs. However, dose and duration of antibiotics were under-used.

• Journal of Preventive Medicine and Public Health
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• 제40권3호
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• pp.249-258
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• 2007

Objectives : The aims of this study were to estimate the antihypertensive medication adherence in people with a disability and a history of taking antihypertensive medication, and to identify the factors affecting medication adherence. Methods : The National Health Insurance claims data were linked with the National Disability Registry. People with a disability, who received a prescription of antihypertensives, were identified from a total of 85,098 cases. Cumulative medication adherence (CMA) was used as an indicator of medication adherence. A CMA > 80% was defined as appropriate medication adherence. Multiple logistic regression analysis was used to identify the factors affecting medication adherence. Results : The average CMA in a total of 85,098 patients was 79.5%. The appropriate adherence $(CMA{\geq}80%)$ rate was 54.5% and 20.5% of patients had a CMA < 50%. Multiple logistic regression analysis revealed that the probability of appropriate adherence decreased with decreasing number of prescription days per visit, increasing number of providers, the patients' residential area moving from urban to rural areas, and when patients have an internal organ disability, auditory impairment, mobility impairment. Conclusions : The adherence to antihypertensive medication in people with a disability is influenced by various socio-economic, clinical and regional factors. In particular, the disabled who have locomotive and communication disabilities and internal organ impairments have a higher probability of under-adherence to antihypertensive medication adherence in Korea.

• 동의생리병리학회지
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• 제18권1호
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• pp.265-273
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• 2004

KBPTS is the fortified prescription of Bang-pung-tong-sung-san (BPTS) by adding Spatholobi Clulis and Salviae Miltiorrzae Radix. BPTS prescription has been used in Qriental medicine for the treatments of vascular diseases including hypertension, stroke, and arteriosclerosis, and nervous system diseases. Yet, the overall mechanism underlying its activity at the cellular levels remains unknown. To investigate the protective role of KBPTS on brain functions, noxious stimulations were applied to neurons in vitro and in vivo. KBPTS pretreatment in cultured cortical neurons of albino ICR mice rescued death caused by AMPA, NMDA, and kainate as well as by buthionine sulfoximine (BSO) and ferrous chloride (Fe/sup 2+/) treatments. Furthermore, KBPTS promoted animal's recovery from coma induced by a sublethal dose of KCN and improved survival by a lethal dose of KCN. To examine its physiological effects on the nervous system, we induced ischemia in the Sprague-Dawley rat's brain by middle cerebral artery (MCA) occlusion. Neurological examination showed that KBPTS reduced the time which is required for the animal after MCA occlusion to respond in terms of forelimb and hindlimb movement$. Histological examination revealed that KBPTS reduced ischemic area and edema rate and also protected neurons in the cerebral cortex and hippocampus from ischemic damage. Thus, the present data suggest that KBPTS may play an important role in protecting neuronal cells from external noxious stimulations.

• 한국의료질향상학회지
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• 제5권1호
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• pp.58-75
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• 1998

Background : In Korea, the rational use of antibiotics are rarely controlled, and their patterns of utilization are not understood. In order to reduce the excessive use and to improve the appropriate use of antibiotics, it is necessary to accurately determine present uses of antibiotics in hospitals. Methods : Analysis of the use of prescription drugs was performed on NFMI(National Federation of Medical Insurance) 1994 medical expense claim data. A stratified sampling by types of hospitals, departments, and diseases was obtained from 1994 August data. Patients with secondary diseases were excluded. In this study, 2,697 adults with URI, 6,397 children with URI, 704 adults with bronchitis, and 1,838 children with bronchitis were included. Results : Most patients were prescribed medication (95.2-99.6%). Of the patients prescribed medication, more than 85% of URI patients and more than 91% of bronchitis patients were prescribed antibiotics. Antibiotics expenses accounted for 14% of total medical expenses in adults and 9% of total medical expenses in children. In adults with URI, antibiotics expenses accounted for 52% of drug expenses. Of the patients prescribed antibiotics, average number of antibiotics used was 1.6-1.7. For patients who are prescribed antibiotics, drug expenses were 62-97% greater than patients not prescribed antibiotics. When children were prescribed antibiotics, the highest price of drugs prescribed were 3.4-fold greater. In addition, the number of drugs prescribed also increased by more than one. Elderly patients, more than 60 years, were prescribed antibiotics less frequently. Children less than 10 years and elderly patients greater than 60 years old were prescribed fewer antibiotics than other patients. And they were prescribed medications for longer days than other patients. Conclusion : This study demonstrated that the average rate of prescribing antibiotics was higher in Korea than other countries. Measures to reduce overuse of antibiotics and to improve the appropriate prescription of antibiotics must be considered for cost effective treatment and overall health of people.

• 한국방사선학회논문지
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• 제7권6호
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• pp.409-414
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• 2013

본 연구에서는 전립샘암 환자에게 방사선 치료법인 3차원 입체조형법과 세기조절치료법을 각각 적용 할 경우 선량분포의 차이를 관찰하여 치료기법의 우수성을 평가하고자 하였다. 실험대상자 10명의 컴퓨터 단층 모의치료영상을 얻어 종양학과 전문의가 종양용적 및 정상장기를 구분하고 종양용적에 흡수선량을 80 Gy로 설정한 후 각각 다른 치료계획을 수립하였다. 그 결과 선량분포윤곽은 세기조절치료법이 우수 하였고 종양조직의 흡수선량은 세기조절치료법이 처방선량에 근접(100.2%)하였으며 정상조직 흡수율(방광, 직장, 소장, 좌 우 대퇴골두) 또한 우수하였다. 즉, 전립샘암의 방사선 치료시 세기조절방사선치료가 입체조형치료법보다 선량적인 면에서 양호한 것으로 분석되었다.

• 한국간담췌외과학회지
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• 제27권4호
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• pp.394-402
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• 2023

Backgrounds/Aims: Acute pancreatitis is an emergency presentation, which can range from mild to life threatening. Intravenous fluids are the cornerstone of management. Although the WATERFALL trial described the optimal fluid rate in mild/moderate pancreatitis, this trial excluded patients with moderate-severe/severe pancreatitis. The aim of this study was to establish clinical practice regarding intravenous fluid administration in acute pancreatitis and assess its effect on mortality. Methods: Prospective multi-centre audit of patients with acute pancreatitis was conducted. Data were collected regarding intravenous fluid administration within 72 hours of admission. The primary outcome was 30-day mortality. Multivariable logistic regression was used to identify predictors of 30-day mortality. Results: Those with severe pancreatitis received more fluid; median 5.7 L versus 4 L in 72 hours (p = 0.003). Participants with severe pancreatitis who died within 30 days received a median of 2,750 mL in the first 24 hours, compared to 4,000 mL in those who survived. The following factors were significant predictors of 30-day mortality: age, Glasgow score, C-reactive protein, ischaemic heart disease, and pancreatitis aetiology. Overall, volume of intravenous fluid was not associated with mortality. However, the effect of intravenous fluid volume on mortality differed significantly depending on pancreatitis severity. In severe pancreatitis, increased volume of intravenous fluid was associated with significant reductions in mortality (odds ratio = 0.655; 0.459-0.936; p = 0.020). Conclusions: In severe pancreatitis, more aggressive fluid prescription was associated with decreased mortality; however, this was not the case in milder disease. Further prospective trials guiding fluid resuscitation in severe pancreatitis are needed, as the impact of fluid on this population appears to differ from that in those with milder disease.