• Title/Summary/Keyword: The experience prescription

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A Historical Study on the Treatments of 鼻鼽(bí qiú) ('비구(鼻鼽)'에 대한 의사학적 연구)

  • Oh, Byung-Gun;Maeng, Woong-Jae;Kim, Hoon
    • The Journal of Korean Medical History
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    • v.24 no.1
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    • pp.97-110
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    • 2011
  • Rhinitis, inflammation of the nasal cavity caused by the disease in our country that a recent trend is the rapidly increasing number of patients. It causes multiple complications and interfere with daily life and social life in case of being viewed as a mild cold. The rhinitis treatment for symptomatic therapy in modern medicine is staying because the situation is exposing the limitations. so traditional medicine is trying to find a solution but that is not easy. In modern medicine, rhinitis is defined as a set of histological lesions and clinical symptoms, but traditional medicine has developed in dealing with each symptoms in disease. The treatment that doesn't distinguish any treatment in growing numbers of patients does not seem to validate, because doctors treat without considering the difference of recognition. Looking at the symptoms for each, I found that each symptoms and causes are varied according to doctors and era. In spite of considering all of that in treatment, it was ignored or underestimated in modern medicine. Furthermore, in traditional medicine, they just conjugated certain period theory and only had limited treatment by a lack of integrated awareness about definition and mechanism. In addition, in case of mentioning about the causes of prescription in each medical books, there were not enough explain about pathological states. Therefore, these causes should be made to further the research about the validity, pathogenesis and treatment. We can see that theory could be established and modified by the accumulation of clinical experience, observations through classification by each of the causes, prescription and treatment. In traditional medicine simply does not pay attention only to nasal inflammation, such as the impact of Meridian and organs considered to have focused on the fundamental treatment. This increased immune resistance to the modern rhinitis patients may offer new therapeutic approaches. I hope this paper would be helpful to find the treatment with uncovered theory in modern medicine.

Prescription Pattern of 1 Year Clozapine Maintenance and Augmentation Agents in Schizophrenia Spectrum Disorders (조현병 스펙트럼 장애의 1년 유지 치료에서 클로자핀과 병용 치료제의 처방 양상 분석)

  • Kim, Jaewon;Kim, Se Hyun;Jang, Jin-Hyeok;Moon, Sun-Young;Kang, Tae Uk;Kim, Minah;Kwon, Jun Soo
    • Korean Journal of Biological Psychiatry
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    • v.28 no.2
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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.

Contact lens Prescription and Satisfaction with Astigmatism Eye (난시안의 콘택트렌즈 처방과 만족도에 관한 연구)

  • Kim, Mi-Yeon;Kim, Yeong-Mi;Kim, Tae-Hun;Sung, A-Young
    • Journal of Korean Ophthalmic Optics Society
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    • v.11 no.4
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    • pp.317-322
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    • 2006
  • For this study we made up a question investigation to analyze a grade of satisfaction and a side effect about the prescription actual condition of contact lens of person with astigmatism among the person who has a error of refraction. The whole patient of refractive error was 46 person, there were 11 person who only wear spectacles by correction of visual acuity among person to a question investigation and 35 person who only wear contact lens. Under investigation 35 person who only wear contact lens, there were 25 person who experience the problem which occurs because of contact lens wearing for a long time. The most patient who made up a question investigation very choose remainder item except for item of very satisfaction. The their reason that could not satisfaction was non corrected astigmatism, wrong prescription, wrong Base curve, out of life span etc.

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Study on Effect of Learning Treatment Chart (의안(醫案) 학습효과에 대한 연구)

  • Kim, Yong-Chan;Shin, Hyeun-Kyoo;Kim, Byung-Soo;Kang, Jung-Soo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.3
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    • pp.580-585
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    • 2005
  • Treatment chart(醫案) is a document that doctors have described about their own practice. Western doctor's chart has a prescribed form, but otherwise chart of oriental medicine is a free form. As It has no prescribed form, doctors of oriental medicine have recorded important facts that they think especially. For example, details are patient's name, age, sex and address, the name of disease, state of pulse and tongue, state of secretions(stools, urine, perspiration, etc.), color of face, state of sleep and thirst, diagnosis, prescription, improvement of herb, teaching, and so forth. If we study on chart of oriental medicine, we draw a lesson about practices of a famous doctors. Through that we can increase ability of diagnosis and adaptation to circumstance, make ourselves familiar with use of past prescriptions and way of changing prescription, and learn narrative story of past doctors' personal experience, their though and teaching. As chart of oriental medicine had many methods to take a measure to meet the false situation, we can learn that. Through chart of oriental medicine, we can improve our practice of oriental medicine.

A Study on two cases of Insanity in "WooJam JabJeo(愚岑雜著)" ("우잠잡저(愚岑雜著)" 소재(所在) 광증(狂證) 이안(二案)에 관(關)한 연구(硏究))

  • Park, Sang-Young;Kwon, Oh-Min;Lee, Jung-Hwa;Oh, Jun-Ho
    • Journal of Korean Medical classics
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    • v.24 no.6
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    • pp.101-110
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    • 2011
  • There are not a few cases in Oriental medicine where a different prescription should be given to some of the patients whose symptoms are similar to each other. In other words, there might happen a misdiagnosis due to an extremely delicate difference in symptoms of the same diseases, causing a patient's condition to get worse or to be even on the brink of death. In such a context, the records in "WooJam JabJeo(愚岑雜著)" are worthwhile to do in-depth research on. Jang-Taegyung described his first-hand experience in major medical treatment very vivaciously during his ages between 25 and 42. Particularly, most of the prescriptions recorded in this book include not only his empirical prescriptions on the patients who life was almost on the brink of death but it also so plentifully contained the process of overcoming the side effect caused by other clinics' misdiagnosis; thus, that this book is drawing attention in that it could be indispensable materials not only in the research on medical history but also for clinical treatment. Particularly, as regards two cases of insanity, this book mentions the reason for using totally different prescription on one case from the other case even though the two cases had a similar symptom, through which we can acquire somewhat concrete experience in curing scenes though indirectly during the period of the Joseon Dynasty. We were able to get the result from the analysis of the two cases of insanity as follows: 1. WooJam, in treating the two cases of insanity due to the severe exacerbation of yang energy, managed to treat the one case by inducing a bowel movement and the other case by inducing urination. Such a different treatment seems to be greatly attributable to the constitutional factor of the two patients. Such an Oriental-medicine-based method of diagnosis and prescription as WooJam's is rarely found in Western medicine-i.e., that's why more thorough research on Oriental medicine is deeply required. 2. In case of the second patient, the patient arrived at insanity due to another clinic's treatment on perspiration on the patient with severe mouth thirst. This medical story once again highlights the importance of a diagnosis in today's Oriental medicine and at the same time it's a good example showing how big the side effect caused by the abuse of medicinal herbs is. The second patient's body fluids ran dry and finally his yang energy got exacerbated all the more due to the treatment by perspiration.

The Administration Patterns of Analgesics and Sedatives for Patients in SICU (외과중환자를 위한 진통제와 진정제의 투여 양상)

  • 김화순
    • Journal of Korean Academy of Nursing
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    • v.31 no.2
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    • pp.304-314
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    • 2001
  • Major purposes of this study were to investigate the administration patterns of analgesics and sedatives in SICU and to identify the factors influencing the use of prn analgesics and sedatives by ICU nurses. The sample of this descriptive study was 50 adult patients in SICU and 53 ICU nurses. Patient's medical records were reviewed to investigate names, doses, the routes of administration, the interval of administration, and the type of prescription of sedatives and analgesics administered. Study medications were narcotics, hypnotics, and antipsychotics. To identify the factors influencing the use of prn analgesics and sedatives, 53 ICU nurses checked 9 items, and rank them from first to fifth. The selection of items was based on the previous studies and the experience of the investigator. The results of the study are as follows: 1. The mean age of the subjects was 53 years, 24 patients out of 50 subjects had received mechanical ventilation therapy. Most of the patients received neurosurgeries and abdominal surgeries. 2. For 4 days, 13 total study medications and combination of these were administered to the patients. Commonly prescribed drugs were Ketoprofen and Midazolam. Twenty six to fourty two percent of the patients did not receive any drugs for at least one day during the four days. 3. On the average, the study drugs were administerd 1.4 to 2.6 times per day during 4 days. 4. More than 50 percent of the prescription was as-needed (prn) except those of the POD 3. Fourteen percent of the patients did not have any prescription for sedation and pain control after surgery. 5. Examination of the frequency of sedatives and analgesics bolus administration revealed that a greater number of doses were given during daytime (from 7 am. to 7 pm.) than nighttime (from 7 pm. to 7 am.). The difference was significant at Alpha, .05. 6. First factor that most influenced nurses to administer sedatives and analgesics for intubated patients was the evaluation of patient's vital signs (51%). For non- intubated patients, the factors that nurses considered important were the patients' complaints of pain (64%) and evaluations of patients' vital signs (23%). In conclusion, the results of this study indicate that patients in SICU might not receive enough analgesics and sedatives to feel completely free from pain during the post operational period. Future study should be focused on the evaluation of the adequacy of current practice for pain and anxiety control in terms of the SICU patient's response.

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Two-Day Fraction Gamma Knife Radiosurgery for Large Brain Metastasis

  • Joo-Hwan Lee;In-Young Kim;Shin Jung;Tae-Young Jung;Kyung-Sub Moon;Yeong-Jin Kim;Sue-Jee Park;Sa-Hoe Lim
    • Journal of Korean Neurosurgical Society
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    • v.67 no.5
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    • pp.560-567
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    • 2024
  • Objective : We investigated how treating large brain metastasis (LBM) using 2-day fraction Gamma Knife radiosurgery (GKRS) affects tumor control and patient survival. A prescription dose of 10.3 Gy was applied for 2 consecutive days, with a biologically effective dose equivalent to a tumor single-fraction dose of 16.05 Gy and a brain single-fraction dose of 15.12 Gy. Methods : Between November 2017 and December 2021, 42 patients (mean age, 68.3 years; range, 50-84 years; male, 29 [69.1%]; female, 13 [30.9%]) with 44 tumors underwent 2-day fraction GKRS to treat large volume brain metastasis. The main cancer types were non-small cell lung cancer (n=16), small cell lung cancer (n=7), colorectal cancer (n=7), breast cancer (n=3), gastric cancer (n=2), and other cancers (n=7). Twenty-one patients (50.0%) had a single LBM, 19 (46.3%) had a single LBM and other metastases, and two had two (4.7%) large brain metastases. At the time of the 2-day fraction GKRS, the tumors had a mean volume of 23.1 mL (range, 12.5-67.4). On each day, radiation was administered at a dose of 10.3 Gy, mainly using a 50% isodose-line. Results : We obtained clinical and magnetic resonance imaging follow-up data for 34 patients (81%) with 35 tumors, who had undergone 2-day fraction GKRS. These patients did not experience acute or late radiation-induced complications during follow-up. The median and mean progression-free survival (PFS) periods were 188 and 194 days, respectively. The local control rates at 6, 9, and 12 months were 77%, 40%, and 34%, respectively. The prognostic factors related to PFS were prior radiotherapy (p=0.019) and lung cancer origin (p=0.041). Other factors such as tumor volumes, each isodose volumes, and peri-GKRS systemic treatment were not significantly related to PFS. The overall survival period of the 44 patients following repeat stereotactic radiosurgery (SRS) ranged from 15-878 days (median, 263±38 days; mean, 174±43 days) after the 2-day fraction GKRS. Eight patients (18.2%) were still alive. Conclusion : Considering the unsatisfactory tumor control, a higher prescription dose should be needed in this procedure as a salvage management. Moreover, in the treatment for LBM with fractionated SRS, using different isodoses and prescription doses at the treatment planning for LBMs should be important. However, this report might be a basic reference with the same fraction number and prescription dose in the treatment for LBMs with frame-based SRS.

Cyberknife Dosimetric Planning Using a Dose-Limiting Shell Method for Brain Metastases

  • Yoon, Kyoung Jun;Cho, Byungchul;Kwak, Jung Won;Lee, Doheui;Kwon, Do Hoon;Ahn, Seung Do;Lee, Sang-Wook;Kim, Chang Jin;Roh, Sung Woo;Cho, Young Hyun
    • Journal of Korean Neurosurgical Society
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    • v.61 no.6
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    • pp.753-760
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    • 2018
  • Objective : We investigated the effect of optimization in dose-limiting shell method on the dosimetric quality of CyberKnife (CK) plans in treating brain metastases (BMs). Methods : We selected 19 BMs previously treated using CK between 2014 and 2015. The original CK plans ($CK_{original}$) had been produced using 1 to 3 dose-limiting shells : one at the prescription isodose level (PIDL) for dose conformity and the others at low-isodose levels (10-30% of prescription dose) for dose spillage. In each case, a modified CK plan ($CK_{modified}$) was generated using 5 dose-limiting shells : one at the PIDL, another at intermediate isodose level (50% of prescription dose) for steeper dose fall-off, and the others at low-isodose levels, with an optimized shell-dilation size based on our experience. A Gamma Knife (GK) plan was also produced using the original contour set. Thus, three data sets of dosimetric parameters were generated and compared. Results : There were no differences in the conformity indices among the $CK_{original}$, $CK_{modified}$, and GK plans (mean 1.22, 1.18, and 1.24, respectively; p=0.079) and tumor coverage (mean 99.5%, 99.5%, and 99.4%, respectively; p=0.177), whereas the $CK_{modified}$ plans produced significantly smaller normal tissue volumes receiving 50% of prescription dose than those produced by the $CK_{original}$ plans (p<0.001), with no statistical differences in those volumes compared with GK plans (p=0.345). Conclusion : These results indicate that significantly steeper dose fall-off is able to be achieved in the CK system by optimizing the shell function while maintaining high conformity of dose to tumor.

Necessity and Introduction Plan for Agrochemical Pharmacist System to Strengthen Expertise in Pest Diagnosis and Prescription (병해충 진단 및 처방의 전문성 강화를 위한 식물의약사(식물위생전문가) 제도의 필요성과 도입방안)

  • Jae Su Kim;Deok Ho Kwon;Se Jin Lee;Sueyeon Lee
    • Korean journal of applied entomology
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    • v.62 no.2
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    • pp.69-78
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    • 2023
  • The currently implemented Positive List System, sales manager training, and pesticide sales record systems focus on the safety of determined pesticide use, but the proposed agrochemical pharmacist (AP) system aims accurate diagnosis and reasonable prescription. In this study, 81% of famers claimed expert assistance for purchasing and applying pesticides, and 42~86% of sales managers insisted on the strengthening expertise in diagnosis and prescription. In the institutionalization of AP, a special implementation guideline is essential to embrace the present sales managers with long experience. Sales managers of commercial and agricultural cooperatives recognize the qualifications of agrochemical pharmacists as a strategy to differentiate themselves from competitors, and increase sales through market positioning of "pesticides prescribed by trustworthy agrochemical pharmacists", not sales managers anymore.

Experience of Self-management and Coping with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환자 자가관리와 증상악화에 대한 대처 경험)

  • Choi, Ja-Yun;Yun, So-Young
    • The Journal of the Korea Contents Association
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    • v.20 no.11
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    • pp.342-353
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    • 2020
  • This study aimed to identify the experience of daily self-management (SM) and coping with acute exacerbation (AE) in COPD patients. A interview was conducted with 32 COPD patients, and data were analyzed according to the content analysis method. As a result of this study, the experience of daily SM was 'Implementing activities preventing from disease', 'Performing endurable exercise', 'Compliance with the medication regimens', 'Enforcing the dietary management', and 'Taking a rest.' Five major themes were drawn. And, for the experience of coping with AE, four major themes were derived: 'Using medical services', 'Getting enough rest', 'Taking prescription drugs', and 'Taking breathing technique.' COPD patients need continous education to detect earily specific symptoms and to cope with worsening symptoms.