• 한국의료질향상학회지
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• 제3권1호
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• pp.144-152
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• 1996

Background : Because of introduction of nationwide health care system in 1989 and the improvement of socioeconomic status of population the number of outpatient visiting university hospital has good facilities and manpower has increased. So the waiting time for medical service at university hospital are lengthened. Particularly outpatients complain that waiting for prescribed drugs at pharmacy depart are long. Reducing waiting time at pharmacy depart door-to-door delivery system that the patients applying for door-to-door delivery receive prescribed drug at home without waiting at pharmacy depart were studied. The objective of this study is to analysis the opinion of outpatients for door-to-door delivery system, to study the appropriateness of adopting the system and to produce ideal model for the system. Method : Outpatients waiting drug at pharmacy depart were questioned about door-to-door delivery system. to find the factors affect utilizing the system the logistic regression was used. Result : 83.3% of the patients want to utilize the system without charging, and 72.9% of the patients want to utilized system with charging. 68.3% of patients with charging want to use this system because of long waiting time at pharmacy depart. 50% of patients who do not want to use door-to-door do not use this system because of incorrect delivery. The affecting factors to utilize the system were sex, waiting time, fee. Conclusion : The model for door to door delivery system. 1. door-to-door personnel reside in hospital and the patient want to utilize the system apply for the delivery with charging. 2. The applied drugs dispense at spare time. 3. Delivery company gathers drug at appointed time and delivers. 4. The delivery fee is 2,000-3,000 won. 5. To prevent from loss and changing the drug the name of patient on packet are printed and drug packet are sealed. 6. The company submit the confirm sheet which are written that the patient received drug correctly to hospital. 7. The delivery time of drug is reserved for the convenience of receiving.

• 한국동물위생학회지
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• 제46권2호
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• pp.167-173
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• 2023

An 8-year-old female neutered Maltese dog exhibited signs of serious thunderstorm phobia including panting, wandering, shivering, hiding, crying or whining, or trying to escape from the house. In this study, we administered clomipramine and alprazolam and observed behavioral improvement for 3 years. Clinical symptoms measured according to the storm phobia assessment (SPA) were significantly high with an initial total score of 19 points. However, it improved to a total score of 8 on day 176 after drugs administration and returned to the normal level with the total score of 5 points on the 983 days. When the symptoms for the first 4 treatments and the last 4 treatments were compared in 2 groups, the total score of all clinical symptoms decreased to -62.83% in the last 4 treatments. This study found that treatment with alprazolam and clomipramine was associated with a decrease in clinical signs of storm anxiety, suggesting that two drugs would be effective in reducing symptoms caused by anxiety, thunderstorm phobia, and noise phobia. In this follow up study, we hope that more studies would be conducted on behavior modification for treatment of storm phobia in veterinary medicine.

• 기본간호학회지
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• 제5권2호
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• pp.207-224
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• 1998

The purposes of this study were to identify nurse's recognition and performance and to represent the factors of hindrance in the IV therapy management. The subjects were 420 nurses who worked at five general hospitals in Pusan. Tha data were collected using a questionnaire and the period of data collection was from January 1 to January 31, 1998. The instrument for this study was made by author oneself on the basis of guidelines Simmons et al', CDC' Stanley' and Kurdi' guideline, Cllinical Nurse's Association' that consist of 68 items for 5 fields ; pre-injection, just before-injection, needle-injection, during injection, post-injection field. Cron-bach Alpha coefficient of recognition and performance in the IV therapy management was .93 and .87. The datas were analized by a SPSS program using frequency, percent, paired t-test, t-test and oneway ANOVA. The results obtained were as follows : 1. The mean score of recognition in IV therapy management was significantly higher than that of performance(t=5.86, P<.001). 2. The items of lower than mean score of each fields in performance were the identification of drugs, hands washing, patient teaching about medication, disinfectional methods of the injection site and the rubber stopper in bottle, the use of disposable gloves, mask and eye goggles at the chemotherapy preparation, use of tape and armboard, changing the IV tubing, labeling the dressing over the injection site, observation and recordings of patient's condition after medication and confirmation of the needle length at the needle removal. 3. The factors of hindrance in IV therapy were 'having no time', 'insufficiency of goods', 'unknowing of methods', 'no disadvantage', and 'factors of doctor's doing'. The most important factor was 'have no time', especially item of hands washing. The other factors of hindrance showed high frequency in the following items ; 'insufficiency of goods' in the use of disposable gloves, mask and eye goggles at the chemotherapy preparation, 'unknowing of methods' in the certification of drugs compatibility, 'no disadvantage' in the labeling the dressing over the injection site, and 'factors of doctor's doing' in the changing the subclavian catheter dressing and checking the glucose level during the TPN infusion. In conclusion, there is necessity of educational program which can improve the nurse's knowledge of drugs, disinfection methods, comfort of patient and recordings in IV therapy management and alternative plan which are political and financial aids such as setting up the sink, giving of paper towels and necessary goods in the IV therapy for reducing the factors of hindrance for IV therapy management.

• Tuberculosis and Respiratory Diseases
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• 제43권6호
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• pp.862-870
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• 1996

Background : Multidrug-resistant tuberculosis(MDR-Tb) has been increased not only in Asia but also in Western society, which may cause public health problems and reduce the efficacy of treatment of tuberculosis. In Western society HIV infection is believed to do a central role in increasing incidence of MDR tuberculosis, but MDR-Tb in Korea may be somewhat different about clinical features, underlying disorders, and prognosis. Goble et al reponed that overall treatment failure rate in MDR-Tb including resistance to isoniazid(INH) and rifampin (RFP) was 44 %. The aim of this study is to find the treatment result in Korea and the factors determining the prognosis. Methods: A retrospective study of pulmonary tuberculosis cultured M. tuberculosis from sputum or bronchial washing fluid between 1986 through 1992 was conducted in the Seoul Paik Hospital, Inje University. We reviewed clinical courses of 141 patients, who had a tuberculosis with resistance to 2 or more drugs including isoniazid(INH) and rifampin(RFP). One hundred and 4 patients of 141 patients had completed treatment and followed up for more than one year. Results: Of 104 (mean age $43.6{\pm}16.7$, M: F=63 : 41) patients with sufficient follow-up data, 73(84.6%) patients responded which is defined as negative Sputum cultures for at least 3 consecutive months. Seven patients(6.7%) had a failure in negative conversion and 9(8.7%) of the patients who initially responded relapsed. Overall treatment failure rate was 15.4%, Patients who were treated for less than 12 months had a higher relapse rate(12.3%) than 18 months(4.9%). And there was a statistically significant correlation between the relapse rate and the number of drugs to which isolates wera resistant(p<0.05). Conclusion : The treatment failure rate of MDR-Tb in Korea was lower than previous studies in western Country and the major determining factor of prognosis was the number of resistant drugs to M. tuberculosis at drug sensitivity test. For reducing the relapse rate, we recommend more than 12 months of treatment for MDR tuberculosis.

• 경영정보학연구
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• 제24권1호
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• pp.21-37
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• 2022

신약을 개발하는 한 가지 방법의 하나인 신약 재창출(Drug Repositioning)은 이미 사람들에게 사용할 수 있도록 승인된 약물들이 다른 용도로 사용되도록 하여 새로운 적응증을 발견하는 유용한 방법이다. 최근에는 머신러닝 기술의 발달로 방대한 생물학적 정보를 분석하여 신약 개발에 활용하는 경우가 증가하고 있다. 신약 재창출에 머신러닝 기술을 활용하면 효과적인 치료법을 신속하게 찾아내는 데 도움을 줄 것이다. 현재 심각한 급성 호흡기 증후군인 코로나바이러스(COVID-19)에 의한 신종 질병으로 전 세계가 힘든 시간을 보내고 있다. 이미 임상적으로 승인된 약물의 용도를 변경하는 신약 재창출은 COVID-19 환자를 치료하기 위한 치료제의 대안이 될 수 있다. 본 연구는 머신러닝 기법을 활용하여 신약 재창출 분야에 대한 연구 동향을 살펴보고자 한다. Pub Med에서 웹 스크래핑 기법을 사용하여 'Drug Repositioning'이라는 키워드로 총 4,821건의 논문을 수집하였다. 데이터 전처리 후, 4,419건의 논문을 대상으로 빈도분석, LDA 기반 토픽모델링, Random Forest 분류 분석 및 예측 성능평가를 수행하였다. Word2vec 모델을 기반으로 연관어를 분석하였고, PCA 차원 축소 후 K-Means 군집화하여 레이블을 생성한 후, t-SNE 알고리즘을 이용하여 논문이 형성하고 있는 그룹을 시각화하고, LDA 결과에 계층적 군집화를 적용하여 히트맵으로 시각화하였다. 본 연구는 신약 재창출과 관련된 연구 주제가 무엇인지를 파악하고, 머신러닝 알고리즘을 사용하여 대량의 문헌에서 의미 있는 주제를 도출하고 시각화하는 방법을 제시하였다. 향후 신약 재창출 분야의 연구나 개발 전략을 수립하기 위한 기초자료로 활용되는 데 도움을 줄 것이라고 기대한다.

• 한국임상약학회지
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• 제30권2호
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• pp.113-119
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• 2020

Background: Reducing the total anticholinergic burden (AB) in older adults is recommended owing to the several peripheral and central adverse effects. This study aimed to identify the AB status of patients admitted to geriatric centers for assessing the influence of the pharmacist-involved multidisciplinary geriatric team care on reducing the AB. Methods: We retrospectively reviewed the medical records of 328 older patients hospitalized in geriatric centers from July 1, 2018 to June 30, 2019, who received comprehensive geriatric assessment and pharmaceutical interventions from a multidisciplinary geriatric team. We measured the total AB scores for the medications at the time of admission and upon hospital discharge using the Korean Anticholinergic Burden Scale (KABS). The pre-admission factors associated with high AB (KABS score ≥3) at the time of admission were identified. Results: The proportion of patients with high AB significantly decreased from 41.8% (136/328) at the time of admission to 25.0% (82/328) on discharge (p<0.001). The pre-admission AB of patients transferred from skilled nursing facilities (odds ratio[OR]: 2.85, 95% CI: 1.26-3.75), taking more than 10 medications (OR: 3.70, 95% CI: 1.55-8.82), suffering from delirium (OR: 2.80, 95% CI: 1.04-7.50), or depression (OR: 2.78, 95% CI: 1.04-7.41) were significantly high. Antipsychotics were the most frequent classes of drugs that contributed to the total KABS score at the time of admission, followed by antihistamines. Conclusions: This study demonstrated that the multidisciplinary teams for geriatric care are effective at reducing AB in older adults. The factors associated with high AB should be considered when targeting pharmaceutical care in geriatric individuals.

• 보건행정학회지
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• 제9권3호
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• pp.70-94
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• 1999

This paper was performed for a cost-effectiveness analysis of pharmacologic treatment of hypercholesterolemia. Agents modeled were cholestyramine, gemfibrozil. bezafibrate, lovastatin, pravastatin, simvastatin. Pharmacologic effectiveness was estimated by regression from reported clinical trials. Pharmacologic effects were expressed as the percent change of blood cholesterol level. Cost estimates included patients' travel expenses and time loss as well as resource consumption in the health care sector. Bezafibrate was the most efficient agent for reducing total cholesterol levels, having an cost over 1 year of ￦31.400 per percent reduction in total cholesterol. Simvastatin (10mg/d) was also efficient(￦33,100 per percent reduction). Chole styramine(8g/d) was least efficient at ￦90,200. For low-density lipoprotein cholesterol. simvastatin(10mg/d) was most efficient, at ￦23,200 per percent reduction, followed by lovastatin(20mg/d) at ￦28,000. Gemfibrozil was least efficient at ￦77,800 per percent reduction. For high-density lipoprotein cholesterol. bezafibrate(400mg/d) was most efficient at ￦39,300 per percent increase of high-density lipoprotein cholesterol. Cholestyramine was least efficient at ￦514,700. Analyses combining low-density lipoprotein cholesterol and high-density cholesterol effects suggest that bezafibrate(600mg/d) and simvastatin (10mg/d) were most efficient for reducing cardiovascular risk. The cost-effectiveness analysis results show that both simvastatin and bezafibrate could be efficient treatment. Simvastatin provide more effective treatment at higher cost, whereas bezafibrate is more cost-effective, as it may be less effective, at lower cost. Therefore, clinicians should choose reasonable treatment according to the patient's needs This pharmacoeconimc analysis will provide a guideline for efficient pharmacologic treatment and also be reference data for pricing new drugs.

• 한국약용작물학회지
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• 제24권1호
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• pp.31-37
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• 2016

Background : We studied the anti-oxidant activity and anti-inflammatory effects of Spiraea fritschiana Schneid extract (SFSE). Methods and Results : The SFSE was prepared using methanol and was evaluated for its total phenol and flavonoid content, DPPH (1,1-diphenyl-2-picrylhydrazyl) free-radical scavenging activity, reducing power, and effect on nitric oxide (NO) production, and cell viability by using real-time polymerase chain reaction (PCR). The total phenol content was $212.78{\mu}g{\cdot}galli$c acid equivalent (GAE)/mg and the total flavonoid content was $66.84{\mu}g{\cdot}quercetin$ equivalent (QE)/mg. The extract showed antioxidant activity (DPPH free-radical scavenging activity) with $RC_{50}$ value of $76.61{\mu}g/m{\ell}$. The reducing power of the extract was Abs 0.58 at $250{\mu}g/m{\ell}$. Cell viability was determined using the MTT 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. To evaluate anti-inflammatory activity, we examined the inhibitory effects on lipopolysaccharide-(LPS)-induced NO production in RAW 264.7 cells. The NO inhibition rate was 90% at $200{\mu}g/m{\ell}$ SFSE. At the same concentration, the expression of pro-inflammatory genes such as inducible nitric oxide synthase (iNOS) and cyclooxygenase (COX)-2 also decreased. Conclusions : Our results suggest that SFSE is a novel resource for the development of foods and drugs that possess anti-oxidant and anti-inflammatory activity.

• The Korean Journal of Pain
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• 제35권4호
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• pp.361-382
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• 2022

The third opium war may have already started, not only due to illicit opioid trafficking from the Golden Crescent and Golden Triangle on the international front but also through indiscriminate opioid prescription and opioid diversion at home. Opioid use disorder (OUD), among unintentional injuries, has become one of the top 4 causes of death in the United States (U.S.). An OUD is defined as a problematic pattern of opioid use resulting in clinically significant impairment or distress, consisting of 2 or more of 11 problems within 1 year, as described by the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition. Observation of aberrant behaviors of OUD is also helpful for overworked clinicians. For the prevention of OUD, the Opioid Risk Tool and the Current Opioid Misuse Measure are appropriate screening tests before and during opioid administration, respectively. Treatment of OUD consists of 3 opioid-based U.S. Food and Drug Administration-approved medications, including methadone, buprenorphine, and naltrexone, and non-opioid-based symptomatic medications for reducing opioid withdrawal syndromes, such as α₂ agonists, β-blockers, antidiarrheals, antiemetics, non-steroidal anti-inflammatory drugs, and benzodiazepines. There are at least 6 recommendable guidelines and essential terms related to OUD. Opioid stewardship programs are now critical to promoting appropriate use of opioid medications, improving patient outcomes, and reducing misuse of opioids, influenced by the successful implementation of antimicrobial stewardship programs. Despite the lack of previous motivation, now is the critical time for trying to reduce the risk of OUD.

• Asian Pacific Journal of Cancer Prevention
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• 제14권4호
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• pp.2201-2205
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• 2013

Colorectal cancer (CRC) is one of the most common cancers in many parts of the world. Its development is a multi-step process involving three distinct stages, initiation that alters the molecular message of a normal cell, followed by promotion and progression that ultimately generates a phenotypically altered transformed malignant cell. Reports have suggested an association of the phosphoinositide-3-kinase (PI3K)/Akt pathway with colon tumorigenesis. Activation of Akt signaling and impaired expression of phosphatase and tensin homolog (PTEN) (a negative regulator of Akt) has been reported in 60-70% of human colon cancers and inhibitors of PI3K/Akt signaling have been suggested as potential therapeutic agents. Around 80% of human colon tumors possess mutations in the APC gene and half of the remainder feature ${\beta}$-catenin gene mutations which affect downstream signaling of the PI3K/Akt pathway. In recent years, there has been a great focus in targeting these signaling pathways, with natural and synthetic drugs reducing the tumor burden in different experiment models. In this review we survey the role of PI3K/Akt/mTOR and Wnt signaling in CRC.