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16 Cases of Anti-obesity Drug Intoxication Experienced in 4 Emergency Departments (4개 응급센터에 내원한 비만치료제 중독 환자들의 다양한 임상양상 경험: 16례)

  • Han, Sung Hoon;So, Byung Hak;Jung, Won Joong;Kim, Hyung Min
    • Journal of The Korean Society of Clinical Toxicology
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    • v.10 no.2
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    • pp.111-117
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    • 2012
  • Purpose: In Korea, few studies have examined the acute toxicity of anti-obesity drugs. The purpose of this study is to analyze the general characteristics and clinical aspect of acute anti-obesity drug intoxication. Methods: We retrospectively investigated patients admitted to the emergency department after anti-obesity drug intoxication between March, 2004 and February, 2012. The medical records of these patients were reviewed for demographic data, toxicologic history, time elapsed to presentation, clinical symptoms and signs, treatment, and outcome. Results: There were a total of 18 anti-obesity intoxication cases during the study period; of 16 which were included in our study. The purchasing route of the anti-obesity drug was mainly through a doctor's prescription (68.8%), however, some were obtained through the internet and the pharmacies. The mean time to The most commonly ingested antiobesity drug was sibutramine (31.3%) and many of the cases (62.5%) were multi-drug ingestions. The most common clinical manifestations were gastrointestinal symptoms (94%), but, CNS symptoms (75%) and cardiovascular symptoms (75%) were almost equally present. 13 patients (81%) were discharged after clearance of toxic symptoms and signs with a mean observational period of 7.0 hours. 3 patients were admitted for observation and treatment; of which 1 patient died due to fatal complications. Conclusion: Most anti-obesity intoxications show mild toxicity and a nonfatal clinical course. However, the recent trend toward prescribing psychostimulant anti-obesity medication, which can be fatal after an acute overdose, calls physicians' attention to treating of anti-obesity intoxications.

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A Review of Recent Clinical Researches in Chinese Medical Journal for Efficacy and Safety of Pediatric Herbal Medicine Inhalation Therapy (소아 무화흡입요법의 효과 및 안전성에 대한 최신 중의학 임상 연구 고찰 - 2010년 이후 발표된 임상 연구 논문을 중심으로 -)

  • Park, Sul Gi;Park, So Hyun;Shin, Dong Gil;Lee, Sun Haeng;Lee, Jin Yong
    • The Journal of Pediatrics of Korean Medicine
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    • v.33 no.3
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    • pp.82-102
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    • 2019
  • Objectives The purpose of this study is to investigate clinical studies on the efficacy and safety of herbal medicine inhalation therapy in children by analyzing recent randomized controlled trials conducted in China. Methods We searched the clinical studies from the China Academic Journal (CAJ) in China National Knowledge Infrastructure (CNKI) using a by key word '霧化吸入' and specific criteria from 1st January 2010 to 2nd July 2019. Data regarding years of publication, demographic information, target diseases or symptoms, treatment methods, outcome measure, results and adverse events are collected for this study. Results Total of 44 randomized controlled trials were selected and analyzed. Respiratory diseases and symptoms (84.1%) were the most frequent target diseases that herbal medicine inhalation therapy was used. Acute stomatitis was another disease state that the therapy was used. In most of the studies, the herbal medicine inhalation in children showed significant efficacies. The most commonly used herbal medicines were Ephedrae Herba (麻黃), Lonicera Flos (金銀花), Armeniacae Semen (杏仁), Glycyrrhizae Radix et Rhizoma (甘草), Scutellaria Radix (黃芩), Forsythia Fructus (連翹) etc. Hardly any adverse effects were reported from the trials selected. Conclusions Based on the results of the clinical studies from China, herbal medicine inhalation therapy in children can be an effective and safe option for treatment and symptom improvement.

Direct and Indirect Costs of Chronic Obstructive Pulmonary Disease in Korea

  • Kim, Changhwan;Kim, Younhee;Yang, Dong-Wook;Rhee, Chin Kook;Kim, Sung Kyoung;Hwang, Yong-Il;Park, Yong Bum;Lee, Young Mok;Jin, Seonglim;Park, Jinkyeong;Hahm, Cho-Rom;Park, Chang-Han;Park, So Yeon;Jung, Cheol Kweon;Kim, Yu-Il;Lee, Sang Haak;Yoon, Hyoung Kyu;Lee, Jin Hwa;Lim, Seong Yong;Yoo, Kwang Ha
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.1
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    • pp.27-34
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    • 2019
  • Background: Understanding the burden of disease is important to establish cost-effective treatment strategies and to allocate healthcare resources appropriately. However, little reliable information is available regarding the overall economic burden imposed by chronic obstructive pulmonary disease (COPD) in Korea. Methods: This study is a multicenter observational research on the COPD burden in Korea. Total COPD costs were comprised of three categories: direct medical, direct non-medical, and indirect costs. For direct medical costs, institutional investigation was performed at 13 medical facilities mainly based on the claims data. For direct non-medical and indirect costs, site-based surveys were administered to the COPD patients during routine visits. Total costs were estimated using the COPD population defined in the recent report. Results: The estimated total costs were approximately 1,245 million US dollar (1,408 billion Korean won). Direct medical costs comprised approximately 20% of the total estimated costs. Of these, formal medical costs held more than 80%. As direct non-medical costs, nursing costs made up the largest percentage (39%) of the total estimated costs. Costs for COPD-related loss of productivity formed four fifths of indirect costs, and accounted for up to 33% of the total costs. Conclusion: This study shows for the first time the direct and indirect costs of COPD in Korea. The total costs were enormous, and the costs of nursing and lost productivity comprised approximately 70% of total costs. The results provide insight for an effective allocation of healthcare resources and to inform establishment of strategies to reduce national burden of COPD.

Aurora kinase A induces migration and invasion by inducing epithelial-to-mesenchymal transition in colon cancer cells

  • Hong, On-Yu;Kang, Sang Yull;Noh, Eun-Mi;Yu, Hong-Nu;Jang, Hye-Yeon;Kim, Seong-Hun;Hong, Jingyu;Chung, Eun Yong;Kim, Jong-Suk
    • BMB Reports
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    • v.55 no.2
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    • pp.87-91
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    • 2022
  • Aurora kinase is a family of serine/threonine kinases intimately associated with mitotic progression and the development of human cancers. Studies have shown that aurora kinases are important for the protein kinase C (PKC)-induced invasion of colon cancer cells. Recent studies have shown that aurora kinase A promotes distant metastasis by inducing epithelial-to-mesenchymal transition (EMT) in colon cancer cells. However, the role of aurora kinase A in colon cancer metastasis remains unclear. In this study, we investigated the effects of aurora kinase A on PKC-induced cell invasion, migration, and EMT in human SW480 colon cancer cells. Treatment with 12-O-tetradecanoylphorbol-13-acetate (TPA) changed the expression levels of EMT markers, increasing α-SMA, vimentin, and MMP-9 expression and decreasing E-cadherin expression, with changes in cell morphology. TPA treatment induced EMT in a PKC-dependent manner. Moreover, the inhibition of aurora kinase A by siRNAs and inhibitors (reversine and VX-680) suppressed TPA-induced cell invasion, migration, and EMT in SW480 human colon cells. Inhibition of aurora kinase A blocked TPA-induced vimentin and MMP-9 expression, and decreased E-cadherin expression. Furthermore, the knockdown of aurora kinase A decreased the transcriptional activity of NF-κB and AP-1 in PKC-stimulated SW480 cells. These findings indicate that aurora kinase A induces migration and invasion by inducing EMT in SW480 colon cancer cells. To the best of our knowledge, this is the first study that showed aurora kinase A is a key molecule in PKC-induced metastasis in colon cancer cells.

An Investigation into Acupuncture Treatment of Verbal Disturbance after stroke (중풍후(中風後) 언어장애(言語障碍)에 대한 침구치료(鍼灸治療)의 문헌적(文獻的) 고찰(考察))

  • Kim Jae-Soo;Lee Jae-Dong;Choi Do-Young;Park Yeong-Bae;Koh Hyung-Kyun;Ahn Byoung-Choul;Park Dong-Seok;Kim Chang-Hwan;Kang Sung-keel;Lee Yun-Ho;Choi Yong-Tae
    • Journal of Acupuncture Research
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    • v.15 no.2
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    • pp.537-550
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    • 1998
  • Purpose ; This Investigation was aimed to find out the Acupuncture therapy of verbal disturbance after stroke in Oriental Medicine. Methods ; We surveyed the oriental medical books which are from to recent published books that have articles about verbal disturbance. Results ; It is used on Acupuncture points: Yomchon(CV23), Amun(GV15), Chondol(CV22), Tongni(HT5), Pungnyung(ST40), Pungbu(GV16), Crugu(TE6), Yongchon(KI1), Hapkok(LI4), Paekoe(GV20), Kokchi(LI11), Puryu(KI7), Shinsu(BL23), Kumjin-okaek, Chohae(KI6). Conclusions ; The concept of phonation organ in Neiching is same as that of modern physiology. Verbal disturbance includes aphasia, dysarthrosis, aphonia, etc. The acupuncture treatment of verbal disturbance after stroke could be effective. Verbal disturbance of central nervous disease is relative with Sul-um(舌?) and that of periperal nervous disease is relative with Hu-um(侯?) in oriental medicine. From the above research, we could conclude that the acupuncture therapy on verbal disturbance should start from finding out the proper acu-points and theories in ancient oriental books and recent books and we will apply those acu-points and theories in clinic. We also concluded that the more research on clinical part should be performed.

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Clinical Features, Diagnosis, Management, and Outcomes of Idiopathic Pulmonary Fibrosis in Korea: Analysis of the Korea IPF Cohort (KICO) Registry

  • Jegal, Yangjin;Park, Jong Sun;Kim, Song Yee;Yoo, Hongseok;Jeong, Sung Hwan;Song, Jin Woo;Lee, Jae Ha;Lee, Hong Lyeol;Choi, Sun Mi;Kim, Young Whan;Kim, Yong Hyun;Choi, Hye Sook;Lee, Jongmin;Uh, Soo-Taek;Kim, Tae-Hyung;Kim, Sang-Heon;Lee, Won-Yeon;Kim, Yee Hyung;Lee, Hyun-kyung;Lee, Eun Joo;Heo, Eun Young;Yang, Sei Hoon;Kang, Hyung Koo;Chung, Man Pyo;Korea ILD Study Group,
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.2
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    • pp.185-194
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    • 2022
  • Background: The Korea Interstitial Lung Disease Study Group has made a new nationwide idiopathic pulmonary fibrosis (IPF) registry because the routine clinical practice has changed due to new guidelines and newly developed antifibrotic agents in the recent decade. The aim of this study was to describe recent clinical characteristics of Korean IPF patients. Methods: Both newly diagnosed and following IPF patients diagnosed after the previous registry in 2008 were enrolled. Survival analysis was only conducted for patients diagnosed with IPF after 2016 because antifibrotic agents started to be covered by medical insurance of Korea in October 2015. Results: A total of 2,139 patients were analyzed. Their mean age at diagnosis was 67.4±9.3 years. Of these patients, 76.1% were males, 71.0% were ever-smokers, 14.4% were asymptomatic at the time of diagnosis, and 56.9% were at gender-age-physiology stage I. Occupational toxic material exposure was reported in 534 patients. The mean forced vital capacity was 74.6% and the diffusing capacity for carbon monoxide was 63.6%. Treatment with pirfenidone was increased over time: 62.4% of IPF patients were treated with pirfenidone initially. And 79.2% of patients were treated with antifiboritics for more than three months during the course of the disease since 2016. Old age, acute exacerbation, treatment without antifibrotics, and exposure to wood and stone dust were associated with higher mortality. Conclusion: In the recent Korean IPF registry, the percentage of IPF patients treated with antifibrotics was increased compared to that in the previous IPF registry. Old age, acute exacerbation, treatment without antifibrotics, and exposure to wood and stone dust were associated with higher mortality.

From the Onset of Panic Symptoms to Getting to a Psychiatric Treatment : The Change by Improved Public Awareness of Panic Disorder in Korea (증상의 발현부터 치료의 시작까지 : 한국인의 공황장애 인식도 변화가 치료적 접근에 미친 영향)

  • Choi, Yong-Won;Seo, Ho-Jun;Han, Sang-Woo;Hong, Jin-Pyo;Lee, Kyoung-Uk;Kim, Se-Joo;Lim, Se-Won;Lee, Sang-Hyuk;Yang, Jong-Chul;Lee, Seung-Jae;Park, Seon-Cheol;Gim, Min-Sook;Chae, Jeong-Ho
    • Anxiety and mood
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    • v.15 no.2
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    • pp.61-67
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    • 2019
  • Objective : This study aimed to investigate the general process from the symptom onset to the psychiatric treatment in Korean panic patients and the effect of improved public awareness on it. Methods : This study has a retrospective design. The subjects were the new patients with panic disorder who visited the psychiatric outpatient clinic in twelve university-affiliated hospitals all across Korea. The medical chart was reviewed retrospectively and the data were collected including chief complaints of symptoms, recent stressors, the time to visit the psychiatric outpatient clinic, and visit of other departments and diagnostic approaches for their symptoms. Results : A total of 814 participants were included in the study. The most common department other than psychiatry the panic patients visited were cardiology (28.3%), general internal medicine (16.0%) and neurology (11.4%). The most frequently used diagnostic tests were a echocardiography (17.9%), 24-hour Holter monitoring (11.2%), and brain MRI (8.2%). Only 37.3% of participants visited psychiatric clinic directly. About 80% of participants visited psychiatric department within 1 year after their first panic symptoms and it took $13.8{\pm}13.7weeks$ on average. Comparing before and after 2012, the number of participants increased who visit directly the psychiatric clinic without visiting other departments (p=0.002) and without visiting emergency room (p<0.001). Conclusions : Our results suggest that a substantial number of patients visit departments other than psychiatry when they experience first panic symptoms. However, most patients begin psychiatric treatment within 1 year after their first symptoms and the number of patient are increasing who visit psychiatric department directly without visiting other departments.

Challenge of Personalized Medicine in the Genomic Era (유전의료시대의 "맞춤의학")

  • Kim, Hyon-J.
    • Journal of Genetic Medicine
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    • v.5 no.2
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    • pp.89-93
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    • 2008
  • "Personalized medicine," the goal of which is to provide better clinical care by applying patient's own genomic information to their health care is a global challenge for the $21^{st}$ century "genomic era." This is especially true in Korea, where provisions for clinical genetic services are inadequate for the existing demand, let alone future demands. Genomics-based knowledge and tools make it possible to approach each patient as a unique biological individual, which has led to a paradigm-shift in medical practice, giving it more of a predictive focus as compared with current treatment oriented approach. With recent advancements in genomics, many genetic tests, such as susceptibility genetic tests, have been developed for both rare single gene diseases and more common multifactorial diseases. Indeed, genetic tests for presymtomatic individuals and genetic tests for drug response have become widely available, and personalized medicine will face the challenge of assisting patients who use such tests to make appropriate and wise use of genetic risk assessment. A major challenge of genomic medicine lies in understanding and communicating disease risk in order to facilitate and support patients and their families in making informed decisions. Establishment of a health care system with provisions for genetic counseling as an integral part of health care service, in addition to genomic literacy of health care providers, is vital to meet this growing challenge. Realization of the promise of personalized medicine in the era of genomics for improvement of health care is dependent on further development of next generation sequencing technology and affordable sequencing test costs. Also necessary will be policy development concerning the ethical, legal and social issues of genomic medicine and an educated and ready medical community with clinical practice guidelines for genetic counseling and genetic testing.

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The Literature Study on Classification of Cause and the Effect of Acupuncture and Moxibustion Treatment for Dentalgia (치통(齒痛)의 병인병기(病因病機) 및 침구치료(鍼灸治療)에 대(對)한 문헌적(文獻的) 고찰(考察))

  • Lee, Seong-no;Lee, Hyun;Lee, Byung-ryul
    • Journal of Haehwa Medicine
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    • v.10 no.1
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    • pp.269-286
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    • 2001
  • Objectives : This Investigation was aimed to find out the Classification of Cause and the Effect of Acupuncture and Moxibustion Treatment for Dentalgia Methods : We surveyed the oriental medical books from $\ll$HungTiNeiChing$\gg$ to recent published books concerning the Acupuncture therapy for Dentalgia Results : 1. Since the time of $\ll$HungTiNeiChing$\gg$ there was called "yateng", "yatong", "chiyaqutong", "kouchitong", "nichi", "chichong", "fengchi", "chongshitong", "chongshiyachi", "chifengzhongtong", "chiyinzhong", "yachuangzhongtong" 2. The Oriental Medical cause of Dentalgia are fire, wind, cold, blood stasis, stomach-heat, phlegm, difficiency of kidney, late snack, insect and wound, and then the Western Medical cause are cacodontia, periodontal disease, trigeminal nerve pain, stress 3. The meridians used for the treatment are large intestine, stomach, triple warmer, gallbladder and small intestine 4. The most frequently used acupuncture point for the treatment are Hapkok(LI3), Naejong(S44), Hyopko(S6), Igan(LI2), Sohae(H3), Yanggok(SI5), Hagan(S7), Taeyong(S5), Samgan(LI3), Kokehi(LI11) 5. The most frequently used moxibustion for the treatment are Sungjang(CV24), Yolgyol(L7), Kyonu(LI15), Taeyon(L9), Hapkok(LI3) 6. In the superior dental pain there commonly used the acupuncture point of stomach meridian, triple warmer meridian, gallbladder meridian in the inferior dental pain there commonly used the acupuncture point of large intestine meridian. 7. The most frequently used acupuncture point for the superior dental pain are Naejong(ST44), Yanggok(SI5), Chongnyong(G17), Kakson(TE20), In the inferior detal pain there are Taeyong(S5), Hapkok(LI3), Igan(LI2), Sangyang(LI1), Samgan(LI3) 8. In the treatment of dental pain The Acupuncture therapy utilized the division of region are the Erzhen therapy(耳針療法), the Touzhen therapy(頭鍼療法), the Shouzhen therapy(手鍼療法), the Zuzhen therapy(足鍼療法), the Bizhen therapy(鼻針療法), the Wanhuaizhen therapy 9. In dental pain the other therapy are the Taozhen therapy(陶鍼療法), the Pifuzhen therapy(皮膚針療法), the Dianzhen therapy(電鍼療法), the Yaozhen therapy(藥針療法).

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Structural Analysis of the Graduate Medical School Student's Perception about 'Good Doctor' (의학전문대학원생의 '좋은 의사'에 대한 인식 구조 분석)

  • Yoo, Hyo-Hyun;Lee, Jun-Ki;Shin, Sein
    • The Journal of the Korea Contents Association
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    • v.15 no.9
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    • pp.631-638
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    • 2015
  • The purpose of this study is to provide developmental direction of medical education by analysing graduate medical school student's perception structure about 'good doctor' and the difference between graduate medical school student's perception structure about 'good doctor' before and after clerkship. Subject of study is medical students in 1st~4th year. NetMiner 4.0 program, which is social network analysis, was used to analyse. Many of the words that students used to describe good doctor were similar. But especially lots of times they used 'patient', 'treatment', 'competence', 'heart' and a word 'patient' showed highest degree centrality. Higher density of network and mean degree centrality were shown in students who experienced clerkship. 'Diagnosis and treatment', 'medical communication', 'attitudes to patients', 'medical knowledge', 'basic competence' these 5 groups were shown in network of students before and after clerkship in common. In the case of students after clerkship, 'lifelong learning ' groups have been added, so were the 6 groups. Considering the fact that social responsibility, professionalism, medical humanities are emphasized in recent medical education, students have lack of perception structure about good doctor, therefore education of this area needs to be strengthened.