• Journal of Korean Clinical Nursing Research
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• v.19 no.3
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• pp.443-454
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• 2013

Purpose: The purpose of this study was to evaluate the effects of periodic reminding interventions on medication adherence, self-efficacy, and pain intensity for home-based lung cancer patients. Methods: A quasi-experimental nonequivalent control group, pretest and posttest design was used. The intervention comprised of individual education by tailored image-combined medication instructions, daily reminding text message, and weekly telephone calls for four weeks. The subjects in this study consisted of 62 lung cancer patients (31 in the experimental group, and 31 in the control group). Mann-Whitney U-test was applied to analyze the data. Results: Experimental group who received periodic reminding intervention program better adhered to prescribed medication compared to the control group (z=-6.14, p<.001). Experimental group demonstrated higher level of self-efficacy compared to the control group (z=-6.74, p<.001). Experimental group experienced less intense average pain compared to the control group (z=-6.29, p<.001). Conclusion: The findings suggest that periodic reminding interventions can be applied as an effective nursing intervention to promote medication adherence and self-efficacy to improve and pain management for home-based lung cancer patients.

• Journal of Life Science
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• v.22 no.8
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• pp.991-998
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• 2012

Ginseng is one of the most commonly used herbal medicines and health foods. Korean red ginseng (KRG; Panax ginseng C.A. Meyer) extract is known to have potential therapeutic activities, such as anti-viral effects, the amelioration of food allergies, anti-oxidant effects, and obesity reduction. Nevertheless, no reports have been issued the modulatory effects of KRG extract on the activity of cytochrome P450 (CYP). In the present study, we investigated the modulatory effect of KRG extract in vitro and in vivo by using pooled human liver microsomes and male ICR mice. When human liver microsomes were incubated with KRG extract at 0.01-10 mg/ml, CYP1A2, 2B6, 2C19, 2D6, and 3A were not significantly inhibited by KRG extract, although CYP2B6 was slightly inhibited. Mice were orally administered KRG extract at 50, 250, or 500 mg/kg daily for 3, 7, or 14 days. However, the activities of CYPs in mouse livers were not significantly different from those of vehicle-treated controls. In conclusion, no significant ginseng-drug interaction was observed. KRG extract did not significantly modulate the activities of CYPs in vitro or in vivo.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.2 no.2
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• pp.194-203
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• 1999

Purpose: Childhood pancreatitis has more various and somewhat different etiology than adult. Until now the analysis of severity in childhood pancreatitis were not well-known, although several studies have been made. Therefore, we studied the etiology and complications in childhood pancreatitis and analyzed whether Ranson and CT criteria could be applicated to evaluate the severity of childhood pancreatitis patients. Methods: The records of 30 patients with pancreatitis under 15 years of ages who were diagnosed in Asan medical center were reviewed. Age, sex, history, etiology, clinical features and treatment was reviewed in all patients but complications, Ranson and CT criteria were available in only 12 patients. Correlation between the number of complications and both Ranson and CT criteria were calculated with Spearman correlation coefficient. Results: 1. Median age at diagnosis was 7.3 years of age. 28 cases were acute pancreatitis and 2 cases were chronic pancreatitis. 2. Etiology: choledochal cyst(8 cases), drug (7 cases), trauma (4 cases), infection (3 cases), biliary stone or bile sludge (3 cases), idiopathic (2 cases) Hemolytic uremic syndrome, pancreatic duct obstruction, iatrogenic (1 case). 3. Local complications were ascites (5 cases), pseudocyts (4 cases) and systemic complications were hyperglycemia (4 cases), hypocalcemia (3 cases), pleural effusion (3 cases), etc. 4. Positive correlation was found between the number of complication and Ranson creteria (r=0.78, P=0.0016) and between the number of complication and CT criteria (r=0.65, P=0.015) in 13 cases. Conclusion: A trial to search the biliary duct anomaly may help to find the causes of childhood idiopathic pancreatitis, and both Ranson and CT criteria can be applicated to pediatric patients to evaluate the severity of childhood pancreatitis.

• Sleep Medicine and Psychophysiology
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• v.26 no.1
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• pp.23-32
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• 2019

Objectives: Insomnia is not only the most common sleep-related disorder, but also is one of the most important. Knowledge of the comorbidities of insomnia is essential for proper treatment including pharmacological and non-pharmacological methods to prevent disease chronification. This study aimed to determine sleep clinic patients' knowledge of insomnia. Methods: This study recruited 44 patients (24 males and 20 females; mean age $54.11{\pm}16.30years$) from the sleep clinic at National Center for Mental Health. All subjects were asked to complete a self-report questionnaire about their reasons for visiting a sleep clinic and about their knowledge of treatment and comorbidities of insomnia. Results: The reasons for visiting the sleep clinic were insomnia symptoms of daytime sleepiness, irregular sleeping time, nightmares, snoring, and sleep apnea, in that order. Of the responders, 72.7% had a comorbidity of insomnia, and 22.7% showed high-risk alcohol use. In addition, 70.5% of responders chose pharmacological treatment of insomnia as the first option and reported collection of information about treatment of insomnia mainly from the internet and medical staff. More than half (52.3%) of the respondents reported that they had never heard about non-pharmacological treatments of insomnia such as cognitive behavioral treatment (CBT-I) or light therapy. The response rate about comorbidities of varied, with 75% of responders reporting knowledge of the relation between insomnia and depression, but only 38.6% stating awareness of the relation between insomnia and alcohol use disorder. Of the total responders, 68.2% were worried about hypnotics for insomnia treatment, and 70% were concerned about drug dependence. Conclusion: This study showed that patients at a sleep clinic had limited knowledge about insomnia. It is necessary to develop standardized insomnia treatment guidelines and educational handbooks for those suffering from insomnia. In addition, evaluation of alcohol use disorders is essential in the initial assessment of sleep disorders.

• The Korean Journal of Gastroenterology
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• v.72 no.5
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• pp.271-273
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• 2018

내시경 시술 전 일시적으로 항응고제를 중단하는 것은 위장관 출혈의 위험과 혈전색전증의 위험 사이에 적절한 균형을 잡기 어렵기 때문에 논란의 여지가 많다. 와파린은 새로운 경구용 항응고제(direct oral anticoagulant agent, DOAC)보다 임상의에게 더 친숙하고, 효과를 쉽고 빠르게 전환시킬 수 있다는 장점이 있지만 복잡한 약역동학 특징과 좁은 치료적 범위 때문에 관리가 어렵다. 반면, DOAC는 약물의 모니터링 및 용량 조절 없이 정해진 용량으로 처방이 가능하며, 빠르게 작용하고, 반감기가 짧아 관리가 쉽지만 해독제가 없다는 단점이 있다. 이전 연구들에서 DOAC를 복용한 환자들은 와파린을 복용한 환자들보다 시술과 관련되지 않은 위장관 출혈의 위험이 높았다고 보고한 바 있다. 하지만 시술과 관련된 위장관 출혈 위험에 대하여는 알려진 바가 없는 실정이다. 미국이나 유럽 내시경 가이드라인들에서는 저위험 내시경 시술을 받는 환자들에서는 와파린과 DOAC를 유지하도록 권고하고 있으며, 고위험 시술의 경우에는 와파린를 사용하는 환자들에서 헤파린 교량 요법(heparin bridging)을 시행하도록 권고하고 있다. 임상적으로 DOAC를 사용하는 환자들 또한 혈전색전증을 예방하기 위하여 헤파린 교량 요법을 시행해볼 수 있는데, 와파린 및 DOAC의 헤파린 교량 요법과 관련된 출혈 및 혈전색전증 위험의 차이 또한 명확하지 않다. 따라서 저자들은 1) 와파린과 DOAC 치료를 받는 환자들에서의 출혈, 혈전색전증 및 사망의 위험을 비교하고자 하였으며, 2) 13종류의 고위험 내시경 시술 중에서 시술별 위험을 비교하고, 3) 헤파린 교량 요법이 합병증의 발생을 증가시키지 않는지 확인하고자 본 연구를 진행하였다. 일본 대규모 국가 입원 환자 데이터베이스를 이용하여 2014년 4월부터 2015년 5월까지 시술 전 와파린 또는 DOAC(rivaroxaban, apixaban, dabigatran, edoxaban)를 복용하고, 13종류의 고위험 내시경 시술을 시행받은 20세 이상의 성인 환자 총 16,977명을 확인하였다. 고위험 시술은 용종 절제술, 내시경 점막절제술, 내시경 점막하박리술, 협착 부위의 풍선확장술, 내시경 지혈술, 내시경 정맥결찰술, 내시경 주사 경화요법, 내시경 괄약근절개술, 내시경 초음파 유도하 미세침 흡인 검사, 경피적 위루술을 포함하였다. 일대일 성향 점수 매칭 분석(propensity score matching, 나이, 성별, 체질량 지수, 기저 질환, 병원의 규모, 시술의 종류, 약물의 종류를 매칭)을 시행하여 와파린군과 DOAC군에서 시술 위장관 출혈 및 혈전색전증, 사망의 발생을 비교하였다. 또한 경구항혈전제와 헤파린 교량 치료 시행 유무에 따라, DOAC 단독군, 와파린 단독군, DOAC와 헤파린 교량 요법군, 와파린과 헤파린 교량요법군으로 나누어, 하위군(subgroup) 분석을 시행하였다. 5,046쌍이 성향 점수 매칭 분석에 포함되었으며, 와파린군에서 DOAC군보다 통계적으로 의미 있게 위장관 출혈의 비율이 높았다(12.0% vs. 9.9% p=0.02). 혈전색전증 발생률(5.4% vs. 4.7%)과 입원중 사망률(5.4% vs. 4.7%)은 양 군에서 의미 있는 차이는 없었다. DOAC 종류별로 나누어 하위군 분석을 시행하였을 때, 와파린군은 rivaroxaban군에 비하여 위장관 출혈의 비율이 높았으며, rivaroxaban군, dabigatran군에 비하여 혈전색전증의 비율이 높았고, 입원 중 사망률에서는 의미 있는 차이는 없었다. 내시경 시술의 종류로 보정하였을 때 위장관 출혈 및 혈전색전증, 사망률은 DOAC 단독으로 치료한 환자에서보다 와파린과 헤파린 교량 요법(bridging) 또는 DOAC과 헤파린 교량 요법을 시행한 환자에서 높았다. 시술 종류 중에서는 위루관 삽입술에 비하여 내시경 점막하박리술, 내시경 점막절제술 및 내시경 정맥류결찰술, 내시경 주사경화요법을 시행한 환자에서 위장관 출혈의 위험이 가장 높았으며, 하부 내시경 점막절제술, 하부 용종 절제술, 내시경적 유두괄약근절제술 또는 내시경 초음파 유도하 미세침 흡인 검사는 중등도 위험을 보였다.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.130-137
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• 2019

Objectives : When a patient who attempts suicide visits the emergency room, it is important that the departments of emergency medicine, internal medicine, and psychiatry communicate with each other and prioritize treatment. This study was conducted to verify the effectiveness of the multidisciplinary emergency consultation system (ECS) for drug intoxicated patients. Methods : We retrospectively analyzed the data from medical records prior to the ECS, from July 2017 to May 2018, and after the ECS, from July 2018 to May 2019, to verify the effectiveness of the system. Results : After the ECS, admission to open wards was significantly higher than to the intensive care units (χ²=8.567, p=0.014). In addition, the proportion of consultations to the department of psychiatry among patients admitted to other departments tended to increase (χ²=4.202, p=0.053), and the time required for consultation response decreased (Z=-2.031, p=0.042). As a result of the consultation, the proportion of the patients who had been transferred to the department of psychiatry was increased (χ²=4.692, p=0.043), and the time spent to transfer tended to decrease (Z=-1.941, p=0.052). Conclusions : After implementing the ECS for drug intoxicated patients, unnecessary intensive care unit admissions, consultation response time, and the time spent to transfer were reduced, and the rate of consultation referrals and transfer rates increased. This means that the multidisciplinary consultation system rapidly provided essential medical services to patients at lower medical costs.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.6
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• pp.592-602
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• 2020

This study examined the contribution of the risk factors that cause cardiovascular disease in Koreans. The subjects were 20,012 adults aged 30~74 years who were enrolled from the 2005~2013 Korean National Health and Nutrition Examination Survey, had filled the risk factors data, and had no cardiovascular disease history. Data analysis was conducted using SAS 9.3, and a weighted composite sample design analysis was performed. The contribution was obtained by applying a squared semi-partial correlation. As a result, they were higher in the order of age (63.9%), smoking (17.3%), systolic blood pressure (7.9%), diabetes (6.9%), antihypertensive medication use (3.0%), and BMI (0.9%) in men. In women, the contributions were in the order of age (54.1%), systolic blood pressure (23.5%), diabetes (13.6%), antihypertensive medication use (5.1%), smoking (3.1%), and BMI (0.6%%). According to age bracket analysis, smoking (51.8~33.7%) was the biggest risk factor, followed in order by age (26.6%) in their 30s and systolic blood pressure (17.3~21.0%) in those older than 40 years in men. In women, the systolic blood pressure (56.2~40.5%) was the main contributor to the risk factors, followed by age (24.0%) in their 30s and diabetes (13.6~32.6%) in those older than 40 years. The contribution of the income level was similar. Therefore, to prevent cardiovascular disease, various programs that reflect the contributions of the risk factors should be developed. Moreover, it is recommended to use the results shown in this study as basic data.

• The Journal of the Korea Contents Association
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• v.17 no.6
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• pp.479-489
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• 2017

The purpose of this study was to identify factors associated with falls among older adults. This cross-sectional study used the data of 10,272 older adults who participating in the Korean Elderly survey, including demographic and health related characteristics. The data were analyzed with complex samples in SPSS ver. 23.0. The results of multiple logistic regression analysis showed that age (OR=1.262, 95%CI 1.111-1.433), education (OR=0.846, 95%CI 0.764-0.937), subjective health status (OR=1.172, 95% CI 1.041-1.320; OR=1.422, 95%CI 1.289-1.570), number of chronic illness (OR=1.438, 95%CI 1.050-1.968), number of medications (OR=0.798, 95%CI 0.659-0.967), muscle strength of low extremities (OR=1.260, 95%CI 1.101-1.441), and fear of falling (OR=3.576, 95%CI 3.166-4.039; OR=14.236, 95%CI 12.637-16.038)were significantly associated with fall accidents in the elderly. Thus, it is necessary to develop fall prevention program to reduce fear of falling and improve health status in the elderly.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.14 no.1
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• pp.22-25
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• 2018

Lennox-Gastaut syndrome (LGS) is one of the most severe epileptic encephalopathies of childhood onset. It is characterized by multiple types of generalized seizures, slowness of intellectual growth, and specific electroencephalogram pattern. It is one of the most difficult epilepsy syndromes to treat and is frequently resistant to treatment. In this case report, we report a case of dental treatment under general anesthesia in a child with LGS. A 4-year-6-month old boy with LGS visited Seoul National University Dental Hospital for dental treatment. Dental treatment was planned under general anesthesia because of his medical condition. Treatment was successfully done without any postoperative complications. If a LGS patient requires dental treatment, a treatment plan should be established to take into account the degree of seizure, the medication being used, and the cooperation of the patient. If the degree of seizure is severe and the patient's cooperation is poor, dental treatment under general anesthesia would be advantageous.

• Science of Emotion and Sensibility
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• v.10 no.4
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• pp.603-611
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• 2007

Initially, this study was to develop reliable and effective alcohol-associated visual cues. Alcoholic picture cues were chosen from the Normative Appetitive Picture System (NAPS). Additional images consisted of Korean beer and mild liquor was pre-tested to select the pictures that would induce craving most intensely. The images that recorded the highest scores on a scale were chosen through the pre-test. And then, the reliability and validity were examined for the selected alcohol cues from NAPS and pre-test via another psychometric test. Secondly, the study was to investigate differences in craving between subjects with alcohol use disorders (AUDs) and non-alcoholic control subjects when exposed to the alcohol visual cues. Alcohol abusers with AUD (n=9) and demographically similar non-abusers (n=9) participated in this study. After given 5cc of alcohol, subjects were exposed to different types of stimuli (i.e., alcohol, nonalcoholic beverage, and visual control pictures and one rest (cross-hair)). Craving levels were rated through self-report on a Likert scale immediately after the presentation of visual cues. Results showed statistically significant differences between the AUD group and the control group in the Obsessive Compulsive Drinking Scale (OCDS) scores, pre-sip and post-sip alcohol craving. Also, the AUD group showed significantly a higher level of craving during alcohol cues compared to the control group. In conclusion, alcohol craving induced by alcohol cues among subjects with AUD was found to be different from that of non-abusers.