• Clinical Endoscopy
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• v.57 no.3
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• pp.309-316
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• 2024

The treatment of obesity and its comorbidities ranges from clinical management involving lifestyle changes and medications to bariatric and metabolic surgery. Various endoscopic bariatric and metabolic therapies recently emerged to address an important therapeutic gap by offering a less invasive alternative to surgery that is more effective than conservative therapies. This article comprehensively reviews the technical aspects, mechanism of action, outcomes, and future perspectives of one of the most promising endoscopic bariatric and metabolic therapies, named duodenojejunal bypass liner. The duodenojejunal bypass liner mimics the mechanism of Roux-en-Y gastric bypass by preventing food contact with the duodenum and proximal jejunum, thereby initiating a series of hormonal changes that lead to delayed gastric emptying and malabsorptive effects. These physiological changes result in significant weight loss and improved metabolic control, leading to better glycemic levels, preventing dyslipidemia and non-alcoholic fatty liver disease, and mitigating cardiovascular risk. However, concern exists regarding the safety profile of this device due to the reported high rates of severe adverse events, particularly liver abscesses. Ongoing technical changes aiming to reduce adverse events are being evaluated in clinical trials and may provide more reliable data to support its routine use in clinical practice.

• Journal of Korea Association of Health Promotion
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• v.2 no.1
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• pp.71-76
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• 2004

The Metabolic syndrome is a constellation of lipid and non-lipid factors of metabolic origin. The presence of any 3 of the following factors is considered sufficient for diagnosis : hypertension(BP <130/85mmHg), low HDL-cholesterol (<40mg% in men, <50mg% in woman), high triglyceride(>150mg%) and abdominal obesity(abdominal girth >102cm in men, 88cm in woman). The major adverse consequence of the metabolic syndrome is cardiovascular disease. Several studies have shown an association between metabolic syndrome and increased cardiovascular events. In Korea, the prevalence of the factor of metabolic syndrome has been increasing since 20 years previously when the Korean economy began to grow rapidly, with a resultant change in lifestyle, toward that of western countries. Thus, the management of the metabolic syndrome is an important social and medical issue in terms of the national health problem. This review will consider each factor in turn, providing insight for health care providers in an effort to prevention of cardiovascular events and maintenance of quality of life in persons with metabolic syndrome was discussed.

• Journal of Korean Academy of Dental Administration
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• v.8 no.1
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• pp.8-14
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• 2020

To provide high-quality oral health services, the concept of measurable oral health quality must first be defined. Owing to reports of significant preventable adverse events in the healthcare service provision process, the recognition and consensus of patient safety and patient-centered health service provision was formed. Six areas that are important medical care have been identified, including the quality along with existing concepts such as timeliness, effectiveness, equity, and efficiency of medical services. While there is ongoing research on the quality of oral health, there is not yet any internationally accepted definition. The purpose of this study is to introduce the ideas of oral healthcare quality and quality indicators that have been developed and announced in the field of dentistry.

• Quality Improvement in Health Care
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• v.23 no.2
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• pp.23-34
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• 2017

Purpose: Nurse's second victim experiences could influence organizational negative work-related outcome. The purpose of this study was to investigate the casual relationship between nurses' second victim experience and third victim experience and multiple mediation effects of second victim supports. Methods: A cross-sectional, self-report survey (the Second Victim Experience and Support Tool) was conducted with 305 nurses working in a general hospital. Data were collected from October 20 to November 25, 2016 and analyzed using SPSS Win version 23.0. Results: The nurses' perceived second victim experience was $3.24{\pm}0.61$ and the third victim experience was $3.12{\pm}0.92$. Nurses' second victim experience was found to have a direct effect on increasing third victim experience and indirect effect of colleague support as mediator (p<.05). However, institutional support and supervisor support had not a partial and indirect effect on third victim experience. Conclusion:This study is one of the first to connect second victim experience to third victim experience in South Korea. This study broadens the understanding of the negative effects of a second victim experience influence third victim experience. When involvement in patient safety events, the important role of colleague support in limiting nurse's third victim experience have been acknowledged. This study reinforces the efforts health care leaders are making to develop interventional programs to colleague support their staff as they recover from adverse event involvement.

• Journal of Mycology and Infection
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• v.24 no.1
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• pp.1-8
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• 2019

Background: Scalp seborrheic dermatitis is a common disease characterized by flaking and itching of the scalp. Conventional treatment options, such as the use of topical corticosteroids and antifungal agents, may cause adverse effects and reduce user satisfaction rates; thus, it is important to explore other treatment options for scalp seborrheic dermatitis. Objective: We aimed to evaluate the efficacy and safety of a new-formula shampoo containing natural ingredients, including the extract of Rosa centifolia petals, epigallocatechin gallate, zinc pyrithione, and climbazole. Methods: A total of 50 patients with scalp seborrheic dermatitis were enrolled and divided into two groups: the new-formula shampoo-treated group and the 1.5% ciclopirox olamine shampoo-treated group. Clinical severity scores, sebum secretion, and inflammatory cytokines were assessed. In addition, patient satisfaction and adverse events were assessed using a questionnaire. Results: The new-formula shampoo was comparable with ciclopirox in reducing the clinical severity scores and sebum secretion. Patients' improvement scores and user satisfaction rates were higher in the new-formula shampoo group than in the 1.5% ciclopirox olamine shampoo-treated group. The inflammatory cytokine levels considerably changed in both groups during the course of the study. Conclusion: Thus, the new-formula shampoo can be considered a treatment option for patients with scalp seborrheic dermatitis.

• Korean Journal of Clinical Pharmacy
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• v.25 no.3
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• pp.171-177
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• 2015

Background: Androgenetic alopecia (AGA), one of alopecias, requires continuous treatment in order to prevent or stop it, and patient's compliance is very important. Currently, only two drugs (finasteride, minoxidil) have been approved for AGA by Food and Drug Administration of United States (US FDA). However, another ${\alpha}-2$ reductase inhibitor, dutasteride, is approved by Korea Ministry of Food and Drug Safety (MFDS) through a phase III trial. For treatment, pharmacotherapy of AGA usually combines topical minoxidil 7% with one of oral <${\alpha}-2$ reductase inhibitor. Objectives: We evaluated the comparative efficacy and adverse effect between topical minoxidil 7%/finasteride 1 mg and topical minoxidil 7%/dutasteride 0.5 mg pharmacotherapy for outpatients with AGA. Also we evaluated the relationship between therapeutic effect and regular hospital visit. Method: This study was performed retrospectively based on electronic medical record (EMR) data of total 98 patients (topical minoxidil 7% with dutasteride 0.5 mg ($Avodart^{(R)}$) or finasteride 1 mg ($Alopecia^{(R)}$, $Propecia^{(R)}$) with diagnosis of AGA from department of dermatology at a secondary hospital from January $1^{st}$, to May $31^{st}$, 2014. Results: The efficacy and adverse event of topical minoxidil 7%/dutasteride 0.5 mg (DUTA group) were 100% and 45.7%, and of topical minoxidil 7%/finasteride 1 mg (FINA group) were 92.1% and 33.3%, respectively. The mean onset time of responses and adverse events in the FINA group were 3.86 months and 4.43 months. Those in the DUTA group were 3.97 months and 5.06 months. Conclusion: Both FINA and DUTA group were highly effective, but the DUTA group showed higher efficacy and adverse effects than those in the FINA group. Dutasteride may be another alternative in AGA treatment.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.16 no.2
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• pp.65-70
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• 2013

Azathioprine is the most common drug used to maintain clinical remission in inflammatory bowel disease. This drug is also important as a steroid-sparing agent in steroid-dependent and chronically active inflammatory bowel disease. Nevertheless, many questions remain concerning the optimal treatment regimens of azathioprine. The dose of azathioprine has to be reduced or the therapy has to be discontinued frequently because of drug-induced toxicity. In this review, we discuss monitoring of thiopurines, adverse events, malignant complications and how to use azathioprine safely and usefully.

• Journal of agricultural medicine and community health
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• v.7 no.1
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• pp.74-79
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• 1982

Recently in Korea, integration of F.P. & MCH programs for effective and efficient implementation of the health programs has been discussed actively. In fact, categorical health workers in fields have been trained and changed as an integrated health workers by government. But one of the most important problems that had to be solved for successful integration of F.P. and MCH programs, is that there must be a common indicator for the evaluation of the two health services (integrated indicator). We regarded reproductive efficiency (=R.E.) that had been proposed by Charlotter M$\ddot{u}$ller et al, as the good integrated indicator. The object of this brief article is to introduce the meaning of reproductive efficiency and to illustrate the usefulnesses of R.E. as the integrated health indicator by applying this indicator to the data from preliminary survey of Seosan demonstration project for integration of F.P. & MCH service supported by WHO. The results and conclusions are as follows 1) Definition of R.E. is the percentage of pregnancies that succeed in production normal, surving children after taking into account the frequency of all measurable types of adverse outcomes (End point for evaluation of survival is one year of age). 2) On the basis of the past pregnant history, reproductive efficiency of the 2,484 eligible women (15-44 years) was roughly 75% (But, in the concept of good births, it is not regarded whether the survived infant is normal health or not). 3) Compared with the results of the other two surveys of the rural area in Korea, reproductive efficiency has been slightly decreased than before, in spite of family planning and MCH services for past 20 years. Because the quantity of increased abortion rate overwhelmed that of the decreased infant mortality rate. 4) Reproductive efficiency has the object for measure many events during the period from the conception (Wanted pregnancy) to an normal surviving children as an 1 year of age. So these heterogenous adversities, ie, induced abortion, still births, spontaneous abortion, neonate & infant death, are aggregated as R.E. However, if the information of these important events and reproductive efficiency were given, R.E. is used as the comprehensive evaluation indicator for F.P. and M.C.H. after meticulous analysis the various components of R.E. 5) Economic loss for adverse outcomes of preg were pregnancy were calculated applying the medical cost at the relatively small sized hospital of small city. Economic loss for 100 cases of adverse outcome is 10,420,000 won, and economic loss for infant death is 46.1% of the total loss. So, it is rational to invest much more effort and than before to MCH programs.

• Korean Circulation Journal
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• v.52 no.4
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• pp.324-337
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• 2022

Background and Objectives: Identifying patients with high bleeding risk (HBR) is important when making decisions for antiplatelet therapy strategy. This study evaluated the impact of ticagrelor monotherapy after 3-month dual antiplatelet therapy (DAPT) according to HBR in acute coronary syndrome (ACS) patients treated with drug eluting stents (DESs). Methods: In this post-hoc analysis of the TICO trial, HBR was defined by 2 approaches: meeting Academic Research Consortium for HBR (ARC-HBR) criteria or Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent DAPT (PRECISE-DAPT) score ≥25. The primary outcome was a 3-12 months net adverse clinical event (composite of major bleeding and adverse cardiac and cerebrovascular events). Results: Of the 2,980 patients without adverse events during the first 3 months after DES implantation, 453 (15.2%) were HBR by ARC-HBR criteria and 504 (16.9%) were HBR by PRECISE-DAPT score. The primary outcome rate was higher in HBR versus non-HBR patients (by ARC-HBR criteria: hazard ratio [HR], 2.87; 95% confidence interval [CI], 1.76-4.69; p<0.001; by PRECISE-DAPT score: HR, 3.09; 95% CI, 1.92-4.98; p<0.001). Ticagrelor monotherapy after 3-month DAPT was associated with lower primary outcome rate than ticagrelor-based 12-month DAPT regardless of HBR by ARC-HBR criteria, with similar magnitudes of therapy effect for HBR and non-HBR patients (p-interaction=0.400). Results were consistent by PRECISE-DAPT score (p-interaction=0.178). Conclusions: In ACS patients treated with DESs, ticagrelor monotherapy after 3-month DAPT was associated with lower rate of adverse clinical outcomes regardless of HBR, with similar magnitudes of therapy effect between HBR and non-HBR.

• The Korean Journal of Pain
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• v.32 no.2
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• pp.69-78
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• 2019

Pain therapy often entails gastrointestinal adverse events. While opioids are effective drugs for pain relief, the incidence of opioid-induced constipation (OIC) varies greatly from 15% to as high as 81%. This can lead to a significant impairment in quality of life, often resulting in discontinuation of opioid therapy. In this regard, a good doctor-patient relationship is especially pivotal when initiating opioid therapy. In addition to a detailed history of bowel habits, patient education regarding the possible gastrointestinal side effects of the drugs is crucial. In addition, the bowel function must be regularly evaluated for the entire duration of treatment with opioids. Furthermore, if the patient has preexisting constipation that is well under control, continuation of that treatment is important. In the absence of such history, general recommendations should include sufficient fluid intake, physical activity, and regular intake of dietary fiber. In patients of OIC with ongoing opioid therapy, the necessity of opioid use should be critically reevaluated in terms of an with acceptable quality of life, particularly in cases of non-cancer pain. If opioids must be continued, lowering the dose may help, as well as changing the type of opioid. If these measures do not suffice, the next step for persistent OIC is the administration of laxatives. If these are ineffective as well, treatment with peripherally active ${\mu}$-opioid receptor antagonists should be considered. Enemas and irrigation are emergency measures, often used as a last resort.