• Korean Journal of Clinical Pharmacy
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• v.20 no.3
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• pp.242-247
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• 2010

Controlling inappropriate antibiotics prescribing for acute upper respiratory infections(URI) is a very important for prudent use of antibiotics and resistance control. Health Insurance Review and Assessment Service (HIRA) introduced Prescribing Evaluation Program and publicly reported antibiotics prescribing rate for URI of each health institution. We performed segmented regression analysis of interrupted time series to estimate the effect of public report on antibiotics prescribing rate using national health insurance claims data. The results indicate that just before the public report period, clinics' monthly antibiotics prescribing rate for URI was 66.7%. Right after the public report, the estimated antibiotics prescribing rate dropped abruptly by 12.3%p. There was no significant changes in month-to-month trend in the prescribing rate before and after the intervention.

• The Journal of Korean Medicine
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• v.33 no.3
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• pp.82-94
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• 2012

Objectives: The aim of study was to develop a standard clinical oriental medicine evaluation instrument for chronic obstructive pulmonary disease (COPD). Methods: We appointed 10 respiratory professors of oriental medicine as the advisory committee. The committee was organized and met several times to discuss the patterns of syndrome differentiation (辨證) and its items based on clinical symptoms of COPD patients and review of published literature. Then the committee investigated the importance of items by e-mail and decided the weight and final weight, respectively. Results: According to the answers and conferences, we determined the Korean oriental medical assessment tool for COPD comprised of the 7 type of patterns of syndrome differentiation which have 9 items with the mean weight and final weight of each item, respectively. Conclusions: This Korean oriental medical assessment tool for COPD was newly developed through expert consensus. We expect to apply this tool to subsequent research as its validity and reliability is further confirmed.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.22 no.3
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• pp.191-199
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• 2012

Objectives: The study aim was to evaluate the application of a chemical exposure assessment tool for the Korean workplace. The Ministry of Employment and Labor in Korea (KMOEL) introduced the need for workplace risk assessments in 2011, requiring the Korean chemical industry to consider both domestic and international chemical regulation policies (e.g., estimations of exposure scenarios). Exposure scenarios are required in the European Union as part of material safety data sheets (MSDS) under the Registration, Evaluation, Authorization, and Restriction of Chemicals (REACH) system. Methods: Although many programs for the estimation of exposure have been developed worldwide, to date there is no standard for the Korean workplace. To develop programs suitable for the Korean workplace, we examined the applicability of the European Center for Ecotoxicology and Toxicology of Chemicals target risk assessment (ECETOC TRA), which is recommended by the European Chemical Agency (ECHA). Results: To investigate the applicability of the ECETOC TRA to Korean industry, this study simulated 15 industrial processes. The predicted respiratory exposures for four processes using origin input parameters were underestimated compared to the measured respiratory exposure. Using calibrated input parameters, results for two processes were underestimated compared to the measured respiratory exposure. This result suggests that the use of calibrated input parameters reduces the differences between predicted and measured respiratory exposure. Conclusions: we developed applicable exposure estimating method by modifying the ECETOC TRA program; one suggested the development of exposure estimating program that explains Korea domestic workplace exposure scenario.This study will support the introduction of exposure scenario in MSDS system and protect health of worker from hazardous chemical.

• Health Policy and Management
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• v.28 no.4
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• pp.402-410
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• 2018

Background: Monitoring appropriate medication categories can provide early warning of certain disease outbreaks. This study aimed to present a methodology for selecting and monitoring medications relevant to the surveillance of acute respiratory tract infections, such as influenza. Methods: To estimate correlations between acute febrile respiratory tract infection and some medication categories, the cross-correlation coefficient (CCC) was used and established. Two databases were used: real-time prescription trend of antivirals, anti-inflammatory drugs, antibiotics using Drug Utilization Review Program between 2012 and 2015 and physicians' number of encounters with acute febrile respiratory tract infections such as influenza outbreaks using the national level health insurance claims data. The seasonality was also evaluated using the CCC. Results: After selecting six candidate diseases that require extensive monitoring, influenza with highly specific medical treatment according to the health insurance claims data and its medications were chosen as final candidates based on a data-driven approach. Antiviral medications and influenza were significantly correlated. Conclusion: An annual correlation was observed between influenza and antiviral medications, anti-inflammatory drugs. Suitable models should be established for syndromic surveillance of influenza.

• Korean Journal of Clinical Pharmacy
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• v.27 no.3
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• pp.186-194
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• 2017

Objectives: A significant concern has been raised about the emerging resistance that is largely caused by the excessive or inappropriate use of antibacterial agents for viral respiratory infections. This study investigated the trend of respiratory tract infections (RTIs) and the use of antibiotics. Methods: Utilizing the national level health insurance claims data from 2005 to 2008, we examined encounter days, antibiotic use, and the prescription rate for respiratory tract infections including upper respiratory tract infections (URTIs), lower respiratory tract infections (LRTIs), and otitis media in outpatient settings. The antibiotic use was measured as defined daily dose per 1,000 patients per day (DDD/1,000 patients/day). Results: The visit for URTI increased from 141,693,465 in 2005 to 120,717,966 in 2008 and the visit for LRTI decreased from 61,778,718 to 66,930,122. For RTIs, prescription rates of antibiotics decreased from 65.2% to 58.5% for URTIs and 76.9% to 68.3% for LRTIs from 2005 to 2008. The antibiotic use decreased to 20.85 DDD/1,000 patients/day after a significant increase of 22.01 DDD/1,000 patients/day in 2006. Among antibiotics, J01CR had the highest use- 7.93 DDD/1,000 patients/day followed by J01DC of 3.71 DDD/1,000 patients/day and J01FA of 3.2 DDD/1,000 patients/day. One notable trend is that J01FA presented a continuous increase in antibiotic use from 2.3 in 2005 to 3.26 DDD/1,000 patients/day in 2008. Conclusion: The use of antibiotics had poor compliance to guidelines for RTIs. Despite decrease in the use of antibiotics, prescription rates for URTIs were still about 50% indicating that the delayed prescribing antibiotics (or wait-and-see) were not observed.

• The Journal of Internal Korean Medicine
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• v.37 no.1
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• pp.109-134
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• 2016

Objectives: The aim of this study was to help develop a guideline for the common cold. We searched recent clinical studies of the common cold in Western medicine and reviewed their objectives, inclusion and exclusion criteria, primary outcome, secondary outcome, and assessment tools to establish evidenced-based guideline.Methods: We searched electronic databases (Cochrane Library, MEDLINE, EMBASE) to identify eligible randomized controlled trials (RCTs) about the common cold for the last 10 years. We included 29 RCTs and showed their research summary via their objectives, participants, interventions, control, treatment duration, and results. We also analyzed the definition of the common cold presented in the article, inclusion and exclusion criteria, primary and secondary outcomes, and assessment tools.Results: We reported the aforementioned areas in detail. At first, the definition of the common cold was confused across the articles. Second, herbal medication clinical trials for the common cold have been extensively studied recently. Third, the eligibility criteria frequently included the Jackson Symptom score. Fourth, validated assessment tools (i.e., the Wisconsin Upper Respiratory Symptom Survey-21) have only been used in a few recent studies.Conclusions: Our research will be helpful to establish Korean herbal medicine clinical trial guidelines for the common cold.

• Tuberculosis and Respiratory Diseases
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• v.69 no.6
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• pp.450-455
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• 2010

Background: High cortisol levels are frequently observed in patients with severe infections are of prognostic value in sepsis. The aim of this study was to evaluate the clinical usefulness of serum cortisol in assessment for the severity of community-acquired pneumonia (CAP). Methods: This study analyzed the results of 52 CAP subjects admitted in Changwon Fatima Hospital between July 2008 to May 2010. Total serum cortisol, infection markers such as C-reactive protein (CRP), procalcitonin (PCT) and CURB (Confusion, Uremia, Respiratory rate, Blood pressure)-65 were examined retrospectively. Results: In clinically unstable subjects on admission day 4, baseline serum cortisol, CURB-65, and CRP were elevated significantly compared to those of stable subjects. Area under curve (AUC) of cortisol, CRP, and CURB-65 from ROC curves were 0.847, 0.783, and 0.724 respectively. In the subjects with serum cortisol ${\geq}22.82{\mu}g/dL$, CRP, PCT, CURB-65 score, and mortality were significantly elevated. Conclusion: These findings suggest that measurement of serum cortisol in early stage may provide helpful information in the assessment of CAP severity.

• Clinical and Experimental Pediatrics
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• v.50 no.5
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• pp.422-429
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• 2007

Measurement of lung function is an integral component of respiratory physiology and of clinical assessment of lung diseases in school age children and adults. Pulmonary function test of infants and children under the age of 2 years have now been standardised and are being used both in research and as an adjunct to clinical management. By contrast, until recegntly, children of preschool age, i.e. between 2-6 years represented a major challenge for pulmonary function test assessment, this particular period commonly being referred to as the 'dark ages' of Pediatric Pulmonology. Measurement of lung function in preschool-aged children is now feasible. However, much work remains to be done in standardizing how these tests are performed, and in understanding the most appropriate role for the various tests in the study of growth and development of the respiratory system and in the clinical management of children in this age group. As the field develops and the knowledge of respiratory physiology in this age group expands, investigation of different and more appropriate algorithm use in preschool children, together with development of more appropriate reference data, may result in improved disease discrimination.

• The Journal of Korean Medicine
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• v.32 no.6
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• pp.10-17
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• 2011

Background: Vibration response imaging (VRI) is a new technology that records energy generated by airflow during the respiration cycle. Analysis of lung sound using VRI may overcome the limitations of auscultation. Objectives: To set a VRI standard for healthy Koreans, we conducted a clinical assessment to evaluate breath sound images and quantification in healthy subjects and compared the findings with reported breath sound characteristics. Methods: Recordings were performed using the VRIxp. Eighty subjects took a deep breath four times during a 12-second interval while sitting upright. The quantitative aspect was analyzed using the VRI quantitative lung data (QLD) for total left lung, total right lung and for six lung regions: left upper lung (LUL), left middle lung (LML), left lower lung (LLL), right upper lung (RUL), right middle lung (RML), right lower lung (RLL). The qualitative aspect was provided through image assessments by three reviewers. Results: In all regions the left lung had significantly higher QLD than the right lung (P<0.005, paired t-test). The inter-rater agreement was 0.78. 84% of the images were found normal by the final assessment. Among the 16% (n=13) of images with abnormal final assessment, the most common flawed features were dynamic image (77%, n=10) and maximum energy frame (MEF) shape (77%, n=10). No significant differences were found between males and females for QLD but there were significant differences in qualitative aspects including dynamic images, MEF shape, and missing LLL. Conclusion: The characteristics of healthy Koreans are similar to those of Western subjects reported previously. VRI is easy to use and objective, and so is helpful to diagnose patients with respiratory diseases and to monitor the progress of diseases after medical treatments.

• Proceedings of the Korean Environmental Health Society Conference
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• 2005.06a
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• pp.326-329
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• 2005

A worker who grinded the inner parts of camshafts for automobile engines using water-soluble metalworking fluid (MWF) for 14 years was diagnosed with sinusitis. We postulated that the outbreak of sinusitis could be associated with exposure to microbes contaminated in water-soluble MWF during the grinding operation. To suggest responsible agents for this outbreak, quantitative exposure assessment for chemical and biological agents and prevalence of work-related respiratory symptoms by questionnaire were studied. The exposure ranges of MWF mist (0.59 $mg/m^3$to 2.12 $mg/m^3$) measured during grinding exceeded 0.5 $mg/m^3$ of the recommended exposure limit (REL). Grinder's exposures to bacteria, fungi and endotoxins were also generally higher than not only the proposed standards, but also those reported by several studies to identify the cause of respiratory effects. Statistical test indicated that the prevalence rate of reported symptoms related to nasal cavities showed no significant differences among the operations. Evaluation on grinding operation characteristics and quantitative exposure assessment indicated that repeated exposure to MWF mist including microbes contaminated from the use of water-soluble MWF may cause respiratory diseases like sinusitis or at least increase susceptibility to the development of sinusitis