• Title/Summary/Keyword: drug use evaluation

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Relationship of Level of Stress, Life Style, Subjective Symptoms and Clinical Diagnosis in Clients taken Multiphasic Screening Program (종합검진 수검자의 스트레스 수준과 생활습관, 자각증상 및 임상적 진단의 관련성)

  • Park, Jun-Han;Chun, Jin-Ho;Kang, Jang-Mi;Son, Byung-Chul;Kim, Dae-Hwan;Lee, Chang-Hee;Jeong, Kui-Won;Urm, Sang-Hwa
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.4 s.63
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    • pp.728-739
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    • 1998
  • To improve wellness and quality of life by recognizing the health efforts of stress, the author estimated the relationships between stress, subjective symptoms and clinical diagnosis through a questionnaire and a battery of specified laboratory tests; electrocardiography, blood pressure, cholesterol, aspartate aminotransferase(AST), alanine aminotransferase(ALT), gamma glutamyl transferase$(\gamma-GTP)$, fasting blood sugar, gastro-endoscopy or UGI, abdominal sonography, etc. The data was gathered from 337 clients who were undergoing multiphasic screening program at a University Hospital from January to March 1998. The mean age of subjects was $46.5{\pm}11.2$ years and the mean of body mass index was $24.0{\pm}3.7kg/m^2$. The mean vol of stress was $18.5{\pm}6.0$ expressed as the score out of 40. By general characteristics and lift style among male, mean level of stress was significantly higher in case of lower socioeconomic status, habitual drug use, longer daily working time(>10 hours), no regular exercise, drinkers, irregular meal, skip-ping breakfast(p<0.05). In case of female, that was significantly higher in case of lower education, lowe. socioeconomic status, longer daily working time(>10 hours), no regular exercise, drinkers, smokers, irregular meal, skipping breakfast(p<0.05). Significant correlations were observed between stress and subjective symptoms in all kinds of organ system (p<0.01). Correlation coefficients of stress among male were relatively high with neuro-psychiatric symptom$(\gamma=0.476)$ and cardio-vascular symptom$(\gamma=0.361)$ in order, and correlation coefficients of stress among female was highest with neuro-psychiatric symptom$(\gamma=0.371)$. The prevalence of the diagnosis through the battery of laboratory tests was high in upper gastrointestinal disorders and hypercholesterolemia in order in both sex group. Among male the mean score of stress was significantly high in ulcerative peptic disorder of upper gastrointestine and hepatopathy in order (p<0.05) . Among female that was significantly high in diabetes mellitus. In summary, it is likely that there are associations between stress, subjective symptoms and clinical diagnosis. To promote wellness and quality of life it would be of value that periodic stress evaluation program and stress management including apropriate control of smoking and drinking, regular exercise and meal.

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Review of Allowable Condition of the Discretionary not Covered Service (임의비급여 허용요건에 관한 검토)

  • Park, Tae-Shin
    • The Korean Society of Law and Medicine
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    • v.13 no.2
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    • pp.11-38
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    • 2012
  • The Supreme Court stand in the position in specific lawsuit that it doesn't allow the discretionary not covered service, but recently in revocation suit of fine disposal that is imposed on medical fee of leukemia patient, it altered the existing adjudgement and admitted the discretionary not covered service exceptionally. It put forward the allowable condition roughly in that case. According as this alteration, it has become more important to embody the allowance conditions of exceptions. The Supreme Court presented three things, which are procedural condition, medical condition and subscriber's agreement. Concerning procedural condition, several present conciliation procedures are as follows: medical care benefit arret request, relative value conciliation etc, prior request on anti-cancer drug among chemicals which exceed acceptance criteria, request of non benefit object on common drugs. To be granted the existence of those system, there should be no obstacle to use that. Even if it were so, we should take circumstances into consideration; individual situation is unescapable concerning substance and urgency of the discretionary not covered service, process of the procedure, time required etc. Regarding medical condition, safety and effectiveness will be verified through evaluation procedures of new medical skill. About the necessity, the Supreme Court made clear through a sentence that it allow the discretionary not covered service, in case that needs to treat a patient out of the standard of medical benefit. Strict interpretation is right and it answer the purpose of the sentence that the supreme court permit the discretionary not covered service, exceptionally. We need to differentiate medical necessity and medical validity. Subscriber's agreement should holds true if it entails full explanation, and if it is preliminary, explicit and individual. On this account, it should be difficult to admit that someone agree effectively when he call for the affirmation that he is recipient of medical care. Reasonable expense needs to be a part of review whether the agreement is valid. Meanwhile If we adjust system of medical expense and eventually reorganize a fee for consultation payment system (Fee-for-service controlled by item to DRG (Diagnosis Related Groups)), controversial area of the discretionary not covered service will be decreased and that will guarantee the discretion of the doctor.

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Proteome in Toxicological Assessment of Endocrine Disrupting Chemicals (프로테오믹스를 이용한 내분비계 교란물질 환경독성 연구)

  • 김호승;계명찬
    • Korean Journal of Environmental Biology
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    • v.21 no.2
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    • pp.87-100
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    • 2003
  • It is important to understand the potential human health implications of exposure to environmental chemicals that may act as hormonally active agents. It is necessary to have an understanding of how pharmaceutical and personal care products and other chemicals affect the ecosystem of our planet as well as human health. Endocrine disruption is defined as the ability of a chemical contaminating the workplace or the environment to interfere with homeostasis, development, reproduction, and/or behavior in a living organism or it's offspring. Certain classes of environmentally persistent chemicals such as polychlorinated biphenyls (PCBs), dioxins, furans, and some pesticides can adversely effect the endocrine systems of aquatic life and terrestrial wildlife. Research continues to support the theory of endocrine disruption. However, endocrine disruption researches have been applied to proteomics poorly. Proteomics can be defined as the systematic analysis of proteins for their identity, quantity and function. It could increase the predictability of early drug development and identify non-invasive biomarkers of tonicity or efficacy. Proteome analysis is most commonly accomplished by the combination of two-dimensional gel electrophoresis (2D/E) and MALDI-TOF mass spectrometry (MS) sr protein chip array and SELDI-TOF MS. Proteomics have an opportunity to play an important role in resolving the question of what role endocrine disruptors play in initiating human disease. Proteomics can also play an imfortant role in the evaluation of the risk assessment and use of risk management and risk communication tools required to address public health concerns related to notions of endocrine disruptors. Understanding the need for the proteomics and possessing knowledge of the developing biomakers used to abbess endocrine activity potential will he essential components relevant to the topic of endocrine disruptors.

Evaluation of Filtration Performance Efficiency of Commercial Cloth Masks (시판되고 있는 유사마스크 제품의 여과효율성능 비교평가)

  • Jang, Ji Young;Kim, Seung Won
    • Journal of Environmental Health Sciences
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    • v.41 no.3
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    • pp.203-215
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    • 2015
  • Objectives: This study was designed to evaluate the filtration efficiencies and pressure drops of five commercial cloth masks (4 plate type, 1 cup type) in comparison to the performance of a class 1 disposable respirator (reference respirator). A further objective was to evaluate the effects of the number of layers and wash treatment independently on filtration efficiencies and pressure drops. Methods: Polydisperse NaCl aerosols were generated in an aerosol chamber and their concentrations were measured by an optical particle counter (OPC) in the size range of $0.3{\sim}10{\mu}m$ (five channels). Results: The filtration efficiencies of the five cloth masks and the reference respirator were D: 9.5%, C: 18.5%, E: 23.6%, A: 28.5%, B: 29.7% and R: 91.1%, respectively, and the pressure drops through them were C, D: 0.8 Pa, E: 1.7 Pa, B: 6.4 Pa, A: 42.7 Pa and R: 19.3 Pa, respectively. The filtration efficiencies of the cloth masks and reference respirator were below the class 1 respirator criterion (${\geq}94.0%$) of the Ministry of Employment and Labor (MOEL) and Ministry of Food and Drug Safety (MFDS). The pressure drops satisfied the class 1 respirator criterion (${\leq}70Pa$) of MOEL and MFDS. When the cloth masks were folded into two and four layers, the filtration efficiencies of cloth masks A, B, C, D (plate type) increased 1.7-4.6 times, and 2.3-6.8 times, respectively, compared to the efficiencies of the same products in a single layer. Pressure drops increased as the number of layers was increased. The filtration efficiency of cloth mask E with a liner was 1.3 times higher than that of the same mask without a liner, and the pressure drop was lower in the no-liner configuration. After a single washing, the filtration efficiencies of all the cloth mask products decreased 1.04-4.0 times compared to those of the same products intact. For the cloth masks C and E, their filtration efficiencies were significantly decreased after washing (p<0.05). The pressure drops of all cloth masks were 1.2-2.0 times lower after washing. Conclusions: The filtration efficiencies of the five cloth masks were below 30% and did not improve greatly by increasing the number of layers. After a single washing, their performances decreased. Considering the above and other issues identified with cloth masks, such as poor fit and stretched fibers through use, people should not expect protection against particulate matters from the cloth masks on the market.

Food Components and Sensual Characterization of Commercial Plain-dried Silver-stripe Round Herring (시판 소건 샛줄멸의 식품성분 및 관능 특성)

  • Kim, Hyung-Jun;Yoon, Min-Seok;Park, Yong-Seok;Ha, Jin-Hwan;Jung, In-Kwon;Heu, Min-Soo;Kim, Jin-Soo
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.11
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    • pp.1457-1464
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    • 2008
  • For the effective use of under-utilized resources, silver-stripe round herring (SSRH), the plain-dried SSRH was investigated and compared with boiled-dried SSRH and boiled-dried anchovy on the food component and sensual characterization. Moisture content and salinity of the plain-dried SSRH were 31.9% and 7.6%, respectively. Moisture content of the plain-dried SSRH was higher, while the salinity was lower than those of boiled-dried SSRH and anchovy. According to the results of peroxide value, fatty acid composition, Hunter b value, and browning index, the rancidity was higher in plain-dried SSRH than in boiled-dried SSRH and anchovy. When compared to the boiled-dried SSRH and anchovy, the plain-dried SSRH was higher in calcium and phosphorus contents, while lower in total content of amino acid. According to the results of hot-water soluble-N, trichloroacetic acid-N, free amino acid, and taste value, the taste of plain-dried SSRH was superior to those of the boiled-dried SSRH and anchovy. The results of chemical components and sensory evaluation indicated that the plained-dried SSRH could be substituted for boiled-dried anchovy classified into special grade, if fish odor of SSRH can be improved.

Relationship between Delirium and Clinical Prognosis among Older Patients underwent Femur Fracture Surgery (대퇴부골절 후 수술환자의 섬망과 임상예후와의 관계)

  • Shim, Jae-Lan;Hwang, Seon-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.2
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    • pp.649-656
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    • 2016
  • This study was a retrospective examination to identify the association of postoperative delirium of the prognosis on following femur fracture surgery in elderly patients. Data was collected from the medical records of elderly patients (aged 65 years or older), who underwent femur fracture surgery from July 2010 to January 2014, following on 3-years in one university hospital. A total of 68 patients were involved. There were 31 cases (45.6%) with delirium and 37 cases (54.4%) without delirium. The participant's average age was 80.8 (patients with delirium), and 81.8 (delirium without patients) years of age, respectively, and most of them were female. There was no significant difference between the two groups. Taking five or more medications, serum creatinine level, and the total medical costs were significantly different in the delirium group and non-delirium group. In addition, the proportional hazard model of Cox to determine the predictors for the major clinical outcome occurring after surgery revealed delirium, five or more multi-drug use, and an experience of transfusion to be significant predictors. In conclusion, postoperative delirium in the elderly undergoing femur fracture surgery can have a negative clinical outcome in patients and caregivers. Therefore, a preoperative evaluation and management of the risk factors will be necessary.

Comparative Drug Evaluation of Atorvastatin versus Rosuvastatin in Pharmacotherapy of Korean Patients with Dyslipidemia

  • Park, Seon-Young;Lee, Myung-Koo;Lim, Sung-Cil
    • Biomolecules & Therapeutics
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    • v.16 no.1
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    • pp.54-60
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    • 2008
  • Dyslipidemia is the multiple lipid metabolic disorders which is one of the high risk factors for the atherosclerotic diseases. It increases the morbidity and mortality and therefore, must be treated with antilipidemic agents. HMG-Co A reductase inhibitors (statins), one of many antidyslipidemic agents, have shown to be significant improvement from the various cholesterol levels. Especially, data from many comparative trials suggest that rosuvastatin is more effective than atorvastatin among many other statins. The aims of this study were to evaluate the efficacy and safety between rosuvastatin and atorvastatin in the treatment of Korean patients with dyslipidemia. Currently the Korean Society of Lipidology and Atherosclerosis based on the Korean health screening data suggests that Korean patients with dyslipidemia should be treated by the target cholesterol levels according to the Adult Treatment Panel III guidelines of the US National Cholesterol Education Program (NCEP-ATP III). We reviewed retrospectively all medical histories of the total 392 dyslipidemic patients with atorvastatin or rosuvastatin from June 1st, 2004 to August 31st, 2006 in Chungbuk National University Medical Center. Patients were classified as total 4 groups by the NCEP-ATP III Guidelines. The numbers of enrolled patients were each 5 mg atorvastatin (n=34), 10 mg atorvastatin (n=148), 5 mg rosuvastatin (n=94) and 10 mg rosuvastatin (n=82). In comparison between groups, rosuvastatin groups in the lowering LDL-C had better efficacies, and the results were each 22% (5 mg atorvastatin), 33.3% (10 mg atorvastatin), 35% (5 mg rosuvastatin) and 41.3% (10 mg rosuvastatin) with the dose relationship (P=0.000). Rosuvastatin groups also have shown to be more significantly reducing Total Cholesterol levels compared to atorvastatin groups with the no dose relationship (P=0.000). In the lowering of non-HDL cholesteroles, rosuvastatin groups showed significantly better efficacies than atorvastatin with the dose-relationship (P=0.000). Each medication groups did not demonstrate the differences in the changing of HDL cholesterol and triglyceride levels (P=0.096, 0.309, respectively). In conclusion, rosuvastatin was better efficacious than atrovastatin in reducing LDL-C Total Chol, and Tg. Therefore, rosuvastatin is a good antilipidemic agents for Korean patients with dyslipidemia and it can use to minimize the morbidity and mortality related to the cardiovascular diseases in Korean.

Performance Characteristic of a CsI(Tl) Flat Panel Detector Radiography System (CsI(TI) Indirect Flat Panel Detector의 선질에 따른 물리적 영상 평가)

  • Jeong, Hoi-Woun;Min, Jung-Hwan;Kim, Jung-Min;Park, Min-Seok;Lee, Gaung-Young
    • Journal of radiological science and technology
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    • v.35 no.2
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    • pp.109-117
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    • 2012
  • The purpose of this work was to evaluate an amorphous silicon cesium iodide based indirect flat-panel detector (FPD) in terms of their modulation transfer function (MTF), Wiener spectrum (WS, or noise power spectrum, NPS), and detective quantum efficiency (DQE). Measurements were made on flat-panel detector using the International Electrotechnical Commission (IEC) defined RQA3, RQA5, RQA7, and RQA9 radiographic technique. The MTFs of the systems were measured using an edge method. The WS(NPS) of the systems were determined for a range of exposure levels by two-dimensional (2D). Fourier analysis of uniformly exposed radiographs. The DQEs were assessed from the measured MTF, WS(NPS), exposure, and estimated ideal signal-to-noise ratios. Characteristic curve in the RQA3 showed difference in the characteristic curve from RQA5, RQA7, RQA9. MTFs were not differences according to x-ray beam quality. WS(NPS) was reduced with increasing dose, and RQA 3, RQA5, RQA7, RQA9 as the order is reduced. DQE represented the best in the 1mR, RQA 3, RQA5, RQA7, RQA9 decrease in the order. The physical imaging characteristics of FPD may also differ from input beam quality. This study gives an initial motivation that the physical imaging characteristics of FPD is an important issue for the right use of digital radiography system.

A Double-Blind Comparison of Paroxetine and Amitriptyline in the Treatment of Depression Accompanied by Alcoholism : Behavioral Side Effects during the First 2 Weeks of Treatment (주정중독에 동반된 우울증의 치료에서 Paroxetine과 Amitriptyline의 이중맹 비교 : 치료초기 2주 동안의 행동학적 부작용)

  • Yoon, Jin-Sang;Yoon, Bo-Hyun;Choi, Tae-Seok;Kim, Yong-Bum;Lee, Hyung-Yung
    • Korean Journal of Biological Psychiatry
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    • v.3 no.2
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    • pp.277-287
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    • 1996
  • Objective : It has been proposed that cognition and related aspects of mental functioning are decreased in depression as well as in alcoholism. The objective of the study was to compare behavioral side effects of paroxetine and amitriptyline in depressed patients accompanied by alcoholism. The focused comparisons were drug effects concerning psychomotor performance, cognitive function, sleep and daytime sleepiness during the first 2 weeks of treatment. Methods : After an alcohol detoxification period(3 weeks) and a washout period(1 week), a total of 20 male inpatients with alcohol use disorder (DSM-IV), who also had a major depressive episode(DSM-IV), were treated double-blind with paroxetine 20mg/day(n=10) or amitriptyline 25mg/day(n=10) for 2 weeks. All patients were required to have a scare of at least 18 respectively on bath the Hamilton Rating Scale far Depression(HAM-D) and Beck Depression Inventory(BDI) at pre-drug baseline. Patients randomized to paroxetine received active medication in the morning and placebo in the evening whereas those randomized to amitriptyline received active medication in the evening and placebo in the morning. All patients performed the various tasks in a test battery at baseline and at days 3, 7 and 14. The test battery included : critical flicker fusion threshold for sensory information processing capacity : choice reaction time for gross psychomotor performance : tracking accuracy and latency of response to peripheral stimulus as a measure of line sensorimotor co-ordination and divided attention : digit symbol substitution as a measure of sustained attention and concentration. To rate perceived sleep and daytime sleepiness, 10cm line Visual analogue scales were employed at baseline and at days 3, 7 and 14. The subjective rating scales were adapted far this study from Leeds sleep Evaluation Questionnaire and Epworth Sleepiness Scale. In addition a comprehensive side effect assessment, using the UKU side effect rating scale, was carried out at baseline and at days 7 and 14. The efficacy of treatment was evaluated using HAM-D, BDI and clinical global impression far severity and improvement at days 7 and 14. Results : The pattern of results indicated thai paroxetine improved performance an mast of the lest variables and also improved sleep with no effect on daytime sleepiness aver the study period. In contrast, amitriptyline produced disruption of performance on same tests and improved sleep with increased daytime sleepiness in particular at day 3. On the UKU side effect rating scale, mare side effects were registered an amitriptyline. The therapeutic efficacy was observed in favor of paroxetine early in day 7. Conclusion : These results demonstrated thai paroxetine in much better than amitriptyline for the treatment of depressed patients accompained by alcoholism at least in terms of behavioral safety and tolerability, furthermore the results may assist in explaining the therapeutic outcome of paroxetine. For example, and earlier onset of antidepressant action of paroxetine may be caused by early improved cognitive function or by contributing to good compliance with treatment.

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Evaluation of Antidepressant Drug Effect in a Depressive Animal Model by Proton MR Spectroscopy (양성자 자기공명분광법을 이용한 우울증 동물모델에서의 항우울제 약물 효능 평가)

  • Kim, Sang-Young;Choi, Chi-Bong;Lee, Sung-Ho;Woo, Dong-Cheol;Yoon, Seong-Ik;Hong, Kwan-Soo;Lee, Hyun-Sung;Cheong, Chae-Joon;Jee, Bo-Keun;Hong, Sung-Tak;Kim, Hwi-Yool;Choe, Bo-Young
    • Progress in Medical Physics
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    • v.19 no.2
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    • pp.95-101
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    • 2008
  • In this study, we observed the alteration of choline signal intensity in hippocampus region of the depressive rat model induced by forced swimming test (FST). The purpose of this study was to evaluate the antidepressant efficacy in the depressive animal model using MR spectroscopy. Fourteen experimentally naive male Sprague-Dawley rats weighting $160{\sim}180\;g$ were used as subjects. Drug injection group was exposed to the FST except for control group. The drugs were administered subcutaneously (SC) in a volume equivalent to 2ml/kg. And three injections were administered 23, 5, and 1h before beginning the given test. 1H MR spectra were obtained with use of a point resolved spectroscopy (PRESS) localization sequence performed according to the following parameters: repetition time, 2500 ms; echo time, 144 ms; 512 average; 2048 complex data points; voxel dimensions, $1.5{\times}2.5{\times}2.5\;mm^3$ ; acquisition time, 25min. There were no differences in NAA/Cr and Cho/Cr ratio between the right and the left hippocampus both normal control rats and antidepressant-injected rats. Also, no differences were observed in NAA/Cr and Cho/Cr ratio between the normal control rats and the antidepressant-injected rats both the right and the left hippocampus. In this study, we found the recovery of choline signals in the depressive animal model similar to normal control groups as injecting desipramine-HCl which was antidepressant causing anti-immobility effects. Thus, we demonstrated that MR spectroscopy was able to aid in evaluating the antidepressant effect of desipramine-HCl.

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