• YAKHAK HOEJI
• /
• v.58 no.4
• /
• pp.268-276
• /
• 2014

Background: World Health Organization considers opioid analgesic use as an important measure in the treatment of pain relief. However, there are limited data about the pattern of opioid analgesic use in tertiary care hospitals in Korea. The aim of this study was to describe the trends in the prescribed amount of the opioid for 13 years from 2000 to 2012 in a single tertiary care hospital. Methods: The data from the prescribed amount of opioid use in patients aged over 18 years were retrieved from medical charts and longitudinal pharmacy records of Seoul National University Hospital. Yearly prescribed amount of opioids were calculated using defined daily dose adjusted by hospital stay (DDD/1000${\bullet}$HS). Results: Over the 13 years of the study period, overall use of opioid has increased by 64.1%. Although, the opioid use by hospitalized patients comprised 98%~99% of total amount of opioid use, the proportions of opioid use by outpatient and by cancer patient increased from 1.1% to 2.2% and from 60.5% to 69.3%, respectively. The use of non-injectable opioids has increased by 47% and that of injectables has increased by 70%. While the amount of codeine and morphine use has decreased, the use of both transdermal and injection formulation of fentanyl has increased dramatically. Also, the use of oxycodone has increased, especially in outpatient setting. Conclusion: This longitudinal study showed that opioid analgesic use in tertiary hospital, especially in outpatient is continuously increasing. Improvement in pain management in tertiary care hospital can be cautiously inferred based on this results.

• Korean Journal of Clinical Pharmacy
• /
• v.21 no.1
• /
• pp.30-35
• /
• 2011

The objective of this study was to find out drug use pattern of narcotic analgesics in university hospitals in Korea. A university hospital located in Kyungbuk province was chosen for this study. The drug use pattern was analyzed in terms of ingredient, administration route, patient type, and attending department. Amount of drug usage was counted by unit dose defined by the number of ampule or vial for injectable, tablet or capsule for oral, and each for patch preparations. Result showed that 11 narcotic analgesic ingredients were used during 2007-2009, and the drug usage was increased by about 20% annually during the period. Proportion of oral preparations used for pain management was about two third of all narcotic analgesics usage and kept increasing during the period. Proportion of the drug usage for outpatients was also steadily increased. Notably, the usage of oral preparations of oxycodone, morphine, and hydromorphone was rapidly increased for the management of cancer pain while the usage of codeine and codeine-containing composite preparations for cancer pain were minimal (<10%). About 90% of all narcotic analgesics were used by physicians in Internal Department, especially in Oncology Division of the Department. These findings suggest that pain management is becoming more aggressive and in agreement with WHO's guidelines regarding selection of administration route. However, in terms of 3-step ladder for cancer pain management, the drug use pattern was not congruent to WHO's guidelines. Therefore, in conclusion, it appears that physicians need to try to be congruent to the guidelines when using narcotic analgesics for cancer pain.

• Korean Journal of Adult Nursing
• /
• v.15 no.2
• /
• pp.205-214
• /
• 2003

Purpose: This study was conducted to examine the nurses' knowledge about and attitude toward cancer pain management. Method: Study subjects of this retrospective cross-sectional survey study were 343 nurses sampled conveniently in a tertiary teaching hospital in Seoul. Seven measurement tools were used to collect data on demographic data, knowledge about and attitude toward cancer pain management, barrier to cancer pain management, knowledge about and concerns for the opioid use, and professional education of cancer pain management. Result: Nurses showed knowledge deficit when their knowledge on the cancer pain management and the opiod use was evaluated using two case scenarios and the 15-item questionnaire respectively. Ninety-five percent of the nurses believed that cancer pain management is a major problem. However, inadequate staff knowledge of pain management was rated as the single most important barrier to adequate pain management by 20.4% of nurses. Only 10.9% and 23.2% of the nurses replied that nursing school's education and professional education in cancer pain management respectively, were adequate. Conclusion: This study confirms the existence of knowledge deficits and attitudinal barriers among Korean nurses that can impede cancer pain management. This study suggests a need for professional education for nurses on cancer pain management.

• Korean Journal of Clinical Pharmacy
• /
• v.25 no.4
• /
• pp.280-285
• /
• 2015

Objectives: To suggest direction for improving policies by understanding current management of narcotics or psychotropic drugs and analyzing their distributions and usage. Method: We conducted a comparison analysis between health insurance claims and the amount supplied to health care institutions for narcotics or psychotropic drugs through health insurance claims data and drug distribution supply data from 2010 to 2012 collected from Korea Pharmaceutical Information Service Center (KPIS). Furthermore, we carried out literature investigation and online search to comprehend the current management of narcotics drugs in Korea. Results: The amount supplied to medical institutions for all drugs in 2012 was 19.4 trillion won, which increased from 19.5 trillion in 2011 by 0.54%. For narcotic drugs, the amount supplied was 318.4 billion won in 2011 and increased to 335.1 billion won by 5.3% in 2012, which exceeded the rate of increase for the amount supplied for all drugs. The proportion of amount claimed in the total amount supplied to medical institutions for all drugs was 60.5% in 2012, whereas the proportion of amount claimed for narcotic drugs was 55.6%, which showed that narcotic drugs were used relatively less within health insurance. Furthermore, management of the current domestic distribution supply data focuses on manufacturing and medical institution supply stages. Conclusion: Hereafter, the management of narcotics or psychotropic drugs needs to be improved by reinforcing active monitoring in optimal prescription and usage in patients by collecting and analyzing information on drug usage of patients.

• 한국사회복지학회:학술대회논문집
• /
• 2004.04a
• /
• pp.705-731
• /
• 2004

This study is to be used for research material for pastoral counseling, by analyzing grounded-theoretically how substance abusers' awareness of self and experience of relations affects problems in abusing drugs. The subject of this study was chosen as 9 prisoners who were able to participate in group counseling, among those who were in prison for substance abuse and had more than 6 months of penal servitude left. In addition, in order to indicate counseling research methods through this study, 12 group counselings were carried out during October 24th. 2002 and February 14th. 2003 and verbatim were written out to be used as original material. After the research material was analyzed, they could be categorized into 60 concepts on the whole from 'conflict' and 'constraining thinking' to 'rationalization' and 'avoidance'. When these concepts were organized into groups of similarity, there were all together 20 categories. From this study, it can be found that substance abusers had "problems about self" and "problems about relations". The factor which affected their use of drugs was the area of relations, where as henceforth their use of drugs, the situation in which they could not escape from the use of substances was affected by problems within the area of self. When facing such problems as substance abuse, the pastoral counselor must create a holding environment through counseling, and perform good enough mothering by being insightful and providing active support on the problem. They must also help one's growth into "an empathizing self", "an accepting self", "a trusting self", "a hopeful self", who can empathize, accept, trust and hope, through experience in separation from the problem, conversion, meta-communication, self-rumination, relations and inspiration of hope. Likewise, the church must be able to act as a "place of growth and skill" which aids in the forming of relations and helps to be aware of self through experience in, and understanding of, relations.

• Biomolecules & Therapeutics
• /
• v.5 no.2
• /
• pp.133-149
• /
• 1997

4-week repeated dose toxicity of DA-5018, a new capsaicin analogue analgesic agent, was examined in 5D rats at dosage levels of 0,0.4,2, 10 and 50 mg/kg/day. DA-5018 was administered orally to 17 males and 17 females per group at doses of 0, 10 and 50 mg/kg and to 12 males and 12 females per group at doses of 0.4 and 2 mg/kg. After the administration period, 5 males and 5 females at the 0, 10 and 50 mg/kg were placed on withdrawal for 2 weeks. Treatment-related clinical signs were observed at 10 and 50 mg/kg. Clinical signs observed immediately after the administration of DA-5018 were grooming, sedation or depression, lacrimation, atacia, reddening of extremities and ears, ventral or lateral recumvincy, respiratory distress, cyanosis and convulsion. Delayed-type clinical signs including focal scabbing and depilation around nose were also observed 1 or 2 weeks after the start of administration of DA-5018. Only at the 50 mg/kg group, corneal opacities, reduced body weight gain (male) and death (male 6/17, female 3/17) were noted. In blood biochemical analysis, serum levels of glucose and triglyceride decreased at 10 and 50 mg/kg. In hematological examination, there were increases in the number of red blood cell, hemoglobin content and percent of hematocrit at 10 and 50 mg/kg. Pulmonary enlargement and hemorrhagic spot, focal scabbing and depilation around nose and corneal opacities were seen at the necropsy of the animals died during the dosing of DA-5018 50 mg/kg. Focal scabbing and depilation around nose were observed in the animals terminally necropsied at doses of 10 and 50 mg/kg. Histopathological examination revealed pulmonary hemorrhage, focal necrosis in the scabbed area, corneal necrosis, fibrosis and neovasculization in the stroma. At 0.4 and 2 mg/kg, there were no significant toxic changes attributable to the administration of DA-5018. In conclusion, target organs following to 4-week repeated dose of DA-5018 in the rat were determined to be lung, skin and eyes. Definite toxic dose and no-observed-adverse-effect-level (NOAEL) were estimated to be 50 and 2 mg/kg/day, respectively.

• The Korean Journal of Applied Statistics
• /
• v.33 no.2
• /
• pp.203-213
• /
• 2020

The self-controlled case series (SCCS) study measures the relative risk of exposure to exposure period by setting the non-exposure period of the patient as the control period without a separate control group. This method minimizes the bias that occurs when selecting a control group and is often used to measure the risk of adverse events after taking a drug. This study used SCCS to examine the increased risk of side effects when two or more drugs are used in combination. A conditional Poisson model is assumed and analyzed for drug interaction between the narcotic analgesic, tramadol and multi-frequency combination drugs. Bayesian inference is used to solve the overfitting problem of MLE and the normal or Laplace prior distributions are used to measure the sensitivity of the prior distribution.

• Journal of Ginseng Research
• /
• v.14 no.2
• /
• pp.178-186
• /
• 1990

The analgesic effect of morphine was antagonized and the development of tolerance was suppressed by the modification of the neurologic function in the animals treated with ginseng saponins The activation of the spinal descending inhibitory systems as well as the supraspinal structures by the administration of morphine was inhibited in the animals treated with ginseng saponine intracerebrally or intrathecally. The development of morphine tolerance and dependence, and the abrupt expression of naloxone inducted abstinence syndrom were also inhibited by ginsenoside Rb1, Rb2, Rg1 and Re. These results suggest that ginsenoside Rbl, Hbs, Rgl and Re are the bioactive components of panax ginseng on the inhibition of the development of morphine tolerance and dependence, and the inhibition of abrupt abstinence sindrome. In addition, further research on the minor components of Pnnnxkinsenl should be investigated. A single or daily treatment with ginseng saponins did not induce any appreciable changes in the brain in level of monoamines at the variolls time intervals and at the various day intervals, respectively. The inhibitory or facilitated effects of ginseng saponins on electrically evoked contractions in guinea pig ileum ($\mu$-receptor) and mouse vats deferens ($\delta$-receptor) were not mediated through opioid receptors. The antagonism of a $\chi$ receptor agonist, U-50, 488H was also not mediated through opioid receptors in the animals treated with ginseng saponins, but mediated through serotonergic mechanisms. Ginseng saponins inhibited morphine 6-dehydrogenase which catalyzed the production of morphinone from morphine, and increased hepatic glutathione contents for the detoxication of morphinone. This result suggests that the dual action of the above plays an important role in the inhibition of the development of morphine tolerance and dependence.

• The Optical Journal
• /
• s.158
• /
• pp.48-51
• /
• 2015

2013년 12월 2일에 아마존의 제프 베조스가 드론을 통하여 30분 배송을 실현하겠다고 배송 테스트를 했다. 고객이 주문한 물건을 플라스틱 보호 박스에 잘 담아 드론에 싣고 고객의 마당에 떨구고 돌아오는 모습을 담았다. 미국의 모든 언론은 드론에 대하여 대서특필하였고, 30분 배송의 실현 가능성에 대한 논쟁을 벌였다. 그 해 연말, 아마존은 쇼핑특수를 누렸다. 돈 안들이고 광고를 독특하게 한 셈이다. 나는 개인적으로 아마존의 드론 배달을 '쇼'라고 생각했다. 고객들의 주거 형태, 드론 비행의 법적인 문제, 드론으로 발생되는 사고, 사람들의 인식 등등 문제가 산적해 있기 때문이다. 그런데 2015년 초부터 알리바바는 1시간 내 차(Tea) 배달 서비스를 상하이와 광저우에서 테스트 중이라고 한다. 또한, DHL이 바다를 건너 섬으로 의약품을 수송하는 시연을 했다. CES 2015에서는 드론 전용관을 만들어 많은 사람들과 언론의 주목을 받았다. 마치 꿈과 같던 것이 실현되는 느낌이었다. 드론을 띄울 수 있는 권리 외에도 드론을 떨어뜨릴 권리도 논의되고 있다. 일본 총리관저에 드론이 떨어지기도 했다. 미국에서는 소형 드론에 폭발물을 탑재하여 타격하는 영상을 보이기도 했다. 개인적인 프라이버시가 존중되어야 할 가정집 위로 카메라가 달린 드론이 날아다니기도 하며, 재소자들의 수감시설에 마약과 담배를 실어 나르다 적발되기도 하였다. 부작용도 만만치 않다는 이야기이다. 나는 학생들에게 100만 원이 넘는 드론을 구매하여 주었더니, 동력인 배터리가 20분밖에 안 된다고 투덜거린다. 영상에 그리고 비행에 소리가 너무 난다고 또 투덜거린다. 바람에 밀려 조정이 어렵다고 또한 투덜투덜하더니만, 결국은 비행 중 조절이 안 되고 떨어져서 결국 박살이 났다. 내구성이 약하다는 이야기는 곧 전반적으로 아직 한계가 있으며 개선할 점이 많다는 의미이다. 위와 같은 부정적인 요인에도 불구하고 드론은 새로운 서비스의 융합으로 신시장이 기대되는 만큼 많은 국가와 기업들이 주목하고 있다. 미국가전협회(CEA)는 2015년 세계 드론 시장이 2014년보다 무려 55% 성장한 1억 3,000만 달러의 규모로 성장하고 5년 뒤에는 10억 달러까지 증가할 것으로 전망하면서 드론 산업의 가능성을 높게 평가하기도 했다.

• Analytical Science and Technology
• /
• v.23 no.1
• /
• pp.83-88
• /
• 2010

For the evaluation of our laboratory's 11-nor-${\Delta}^9$-tetrahydrocannabinol-9-carboxylic acid (THCCOOH) urinalysis test, THCCOOH urinalysis test was carried out with Certified Reference Material (CRM). The used CRM was THCCOOH in freeze-dried urine produced by NIST as Standard Reference Material 1507b. Comparing the estimated value of our laboratory with CRM, the results was coincided in the confidence level of approximately 95%.