• 대한방사선기술학회지:방사선기술과학
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• 제30권1호
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• pp.39-46
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• 2007

CT 조영제의 부작용을 예방하여 환자만족도와 방사선사 및 간호사의 업무만족도를 향상을 위해 표준진료지침서를 개발하고 적용하였다. 표준진료지침서 개발은 팀으로 구성하여 단계적으로 실시하였다. 대상은 환자 및 방사선사와 간호사를 대상으로 만족도를 평가하였다. 표준진료지침서를 적용하는 군이 만족도가 높게 조사되었고, 방사선사와 간호사는 표준진료지침서를 적용하는 경우 환자의 조영제 부작용 정보를 사전에 파악하는 효과와 조영제 부작용을 예방 효과가 있어 만족도가 증가하였다. 조영제 부작용은 표준진료지침서를 적용하기 전 90명에서 적용 후 66명으로 감소하는 효과가 있었다. 표준진료지침서를 적용하여 환자 정보제공(24%), 조영제 예방효과(19%), 조영제 부작용의 사전 인지효과(39%), 지식정도(19%)로 업무 만족도 향상 효과가 있었다. 혈관외유출은 표준진료지침서 적용전은 13건이었고, 적용 후는 6건으로 감소하였다. 혈관외유출 위치와 조영제 용량을 종합의료정보시스템(HMIS)에 입력하여 혈관외유출 예방과 검사 만족도를 높이는 효과가 있다. 환자 정보를 파악하여 조영제 부작용 예방효과와 처치로 의료 질 향상 및 만족도 증가하였다. 표준진료지침서를 지속적으로 적용하여 환자, 검사자의 만족도 및 의료질을 증진하도록 한다.

• Tuberculosis and Respiratory Diseases
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• 제61권2호
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• pp.150-156
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• 2006

배 경: 최근 폐암 환자에서 사용하는 표적치료 항암약물인 gefitinib (Iressa)은 종양세포의 표피성장인자 수용체의 티로신 키나아제 활동을 선택적으로 억제하여 종양 세포의 성장에 관여하는 신호를 차단함으로써 치료효과를 나타낸다. Gefitinib 복용에 의한 피부 부작용으로 여드름양 발진, 피부 건조증, 모발 변화 등이 알려져 있다. 대상 및 방법: 2004년 10월부터 2005년 9월까지 화순전남대병원에서 비소세포 폐암으로 진단받고 gefitinib을 복용 중인 환자들 중 피부 부작용이 발생하여 피부과에 의뢰된 환자 23명을 대상으로 임상 양상을 분석하였다. 결 과: 나이는 23-72세였고, 비소세포 폐암의 종류는 선암 17명, 편평상피세포 폐암 5명이었고, 여자 6명, 남자 17명이었다. 가장 흔한 부작용은 여드름양 발진으로 15명(65.2%)에서 발생하였으며, 주로 두피, 얼굴, 가슴, 등 부위에 무증상의 홍반성 구진으로 나타나며 대부분 gefitinib 복용 1달 이내에 발생하였다. 여드름양 발진의 빈도는 gefitinib 치료에 대한 반응과 유의한 상관관계를 보이지 않았고, 조직 형에 따른 차이도 관찰되지 않았다. 피부 소양증은 9명(39.1%)에서 발생하였으며 경도의 전신 소양증이 가장 많았고, 특히 눈 주변의 소양증을 호소하였다. 인설을 동반한 피부 건조증이 6명(26.1%)에서 발생하였고, 손발바닥의 홍반과 표피 박탈이 5명(21.7%), 손톱이나 발톱주변에 조갑주위염이 5명(21.7%)에서 발생하였다. 드물게 모발이 부러지거나 겨드랑이, 오금에 간찰진이 발생하였다. 결 론: 본 연구에서 gefitinib에 의한 다양한 피부 부작용들을 관찰할 수 있었다. Gefitinib을 처방하는 의사들은 피부 부작용에 대한 관심이 필요하며 환자들에게 피부 관리에 대한 교육과 필요한 경우 피부과 의사와 함께 피부 부작용을 치료함으로써 부작용을 경감시킬 수 있었다.

• Biomolecules & Therapeutics
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• 제32권1호
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• pp.1-12
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• 2024

Adverse drug reactions (ADRs) are an inherent aspect of drug use. While approximately 80% of ADRs are predictable, immune system-mediated ADRs, often unpredictable, are a noteworthy subset. Skin-related ADRs, in particular, are frequently unpredictable. However, the wide spectrum of skin manifestations poses a formidable diagnostic challenge. Comprehending the pathomechanisms underlying ADRs is essential for accurate diagnosis and effective management. The skin, being an active immune organ, plays a pivotal role in ADRs, although the precise cutaneous immunological mechanisms remain elusive. Fortunately, clinical manifestations of skin-related ADRs, irrespective of their severity, are frequently rooted in immunological processes. A comprehensive grasp of ADR morphology can aid in diagnosis. With the continuous development of new pharmaceuticals, it is noteworthy that certain drugs including immune checkpoint inhibitors have gained notoriety for their association with ADRs. This paper offers an overview of immunological mechanisms involved in cutaneous ADRs with a focus on clinical features and frequently implicated drugs.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제16권3호
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• pp.171-177
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• 2013

Purpose: This study was aimed to evaluate the frequency and course of adverse events associated with azathioprine treatment in Korean pediatric patients with inflammatory bowel disease. Methods: Total of 174 pediatric patients (age range, 1 to 19 years) with inflammatory bowel disease who received azathioprine in order to maintain remission at Samsung Medical Center (Seoul, Korea) from January 2002 through December 2012 were included in this study. Medical records of these subjects were retrospectively reviewed regarding the development of adverse events associated with azathioprine treatment. Results: Ninety-eight patients (56.3%) of 174 patients experienced 136 episodes of adverse events, requiring dose reduction in 31 patients (17.8%), and discontinuation in 18 patients (10.3%). The mean dose of azathioprine that had been initially administered was $1.32{\pm}0.42$ mg/kg/day. Among the adverse reactions, bone marrow suppression developed in 47 patients (27.0%), requiring dose reduction in 22 patients (12.6%) and discontinuation in 8 patients (4.6%). Other adverse events that occurred were gastrointestinal disturbance (15.5%), hair loss (12.1%), pancreatitis (7.5%), arthralgia (6.9%), hepatotoxicity (2.9%), skin rash/allergic reactions (2.9%), headache/dizziness (2.3%), sepsis (0.6%), and oral mucositis (0.6%). Conclusion: Bone marrow suppression, especially leukopenia was most commonly associated with azathioprine treatment in Korean pediatric inflammatory bowel disease patients. Close observation for possible adverse events is required in this population with inflammatory bowel diseases who are under treatment with azathioprine.

• 대한안전경영과학회지
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• 제16권4호
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• pp.427-431
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• 2014

The purpose of this study is to monitor the current adverse reactions in administering CT contrast agents at general hospitals and also to suggest the practical guidelines to minimize the risk and to show the successful patient management. At four Dajeon city general hospitals, the contrast agents were administered in 646,828 cases and the overall prevalence of adverse reactions was 4,110 cases from January 2010 to December 2013. However, we excluded the two hospitals' 3,658 cases because the patients' data was inadequate. Consequently, the case surveys on the rest of 452 cases have been studied and submitted. After comparing the patients with a control group, we evaluated that the key factors of the adverse reactions were the gender and age difference of the patients, the examination period, the examination method, the quantity and administrating speed of the contrast agents. Even though the four general hospitals have their own management systems on adverse reactions, but their systems were not satisfying. To improve the quality of the management systems and to investigate further cases, some hospital administration procedures on the subject should be systemized and general hospitals should follow the recommended procedures. Moreover, the existing three-year-term evaluation should not only judge the adverse reaction management but also conclude some details on the sub criteria of the evaluation. The details on the sub criteria include the contrast agent characters, the quantity and administrating speed of the drug, the incidents' occurred time, an anamnesis; a case history, the medical history of the patients and the reaction occurring body parts, and the examination title. The details of the medical examiners are also added to the sub criteria.

• 약학회지
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• 제53권6호
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• pp.328-333
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• 2009

Contrast media are substances that are used to enhance the contrast of structures or fluids within the body in medical imaging. Those are commonly used to enhance the visibility of blood vessels and the gastrointestinal tract. The aim of this study is to evaluate patients who got injected iopamidol, developed as one of contrast medium regarding changes in cardiovascular system and especially, adverse drug reactions. This study were performed on randomly selected a total of 51 patients (range of 15~85 years old) who got injected contrast medium, Iopamidol at a P hospital in Gyeonggi province from September 22nd, 2008 to January 24th, 2009. Data were collected by questionnaire though person to person. We analyzed the data by SPSS (Version 12. for windows). Methods of analysis were frequency and cross analysis. In results, 19.6% (n=10) were founded for adverse drug reactions of contrast medium. 25.0% (n=4) of 10 patients who had adverse drug reactions of contrast medium had took abdomen contrast test. 2 patients of those took contrast test for chest. Also, 3.9% (n=2) patients felt vomiting and nausea after injection of contrast medium. In conclusion, 19.6% patients experienced adverse drug reaction of contrast medium. Therefore, when taking radiation test, we should make efforts to minimize adverse drug reactions to achieve suitable and effective treatment.

• 한국임상약학회지
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• 제27권4호
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• pp.221-227
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• 2017

Background: As personalized healthcare industry has attracted much attention, big data analysis of healthcare data is essential. Lots of healthcare data such as product labeling, biomedical literature and social media data are unstructured, extracting meaningful information from the unstructured text data are becoming important. In particular, text mining for adverse drug reactions (ADRs) reports is able to provide signal information to predict and detect adverse drug reactions. There has been no study on text analysis of expert opinion on Korea Adverse Event Reporting System (KAERS) databases in Korea. Methods: Expert opinion text of KAERS database provided by Korea Institute of Drug Safety & Risk Management (KIDS-KD) are analyzed. To understand the whole text, word frequency analysis are performed, and to look for important keywords from the text TF-IDF weight analysis are performed. Also, related keywords with the important keywords are presented by calculating correlation coefficient. Results: Among total 90,522 reports, 120 insulin ADR report and 858 tramadol ADR report were analyzed. The ADRs such as dizziness, headache, vomiting, dyspepsia, and shock were ranked in order in the insulin data, while the ADR symptoms such as vomiting, 어지러움, dizziness, dyspepsia and constipation were ranked in order in the tramadol data as the most frequently used keywords. Conclusion: Using text mining of the expert opinion in KIDS-KD, frequently mentioned ADRs and medications are easily recovered. Text mining in ADRs research is able to play an important role in detecting signal information and prediction of ADRs.

• 대한방사선기술학회지:방사선기술과학
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• 제30권2호
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• pp.89-93
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• 2007

조영제를 사용한 방사선과 검사의 조영제 부작용에 대한 위험성은 잘 알려져 있으며, 조영제의 부작용을 줄이기 위한 연구도 지속적으로 진행되어 왔다. 또한 조영제 부작용에 대한 사전검사를 하더라도 조영제에 의한 치명적 부작용을 예측하기 어렵다. 이러한 조영제 부작용에 대한 법적책임에 대하여 최근에는 의료기관개설자의 책임이 중요시되고 있다. 의료기관은 환자의 건강을 목적으로 하는 조직체이다. 그리고 조직체는 그 구성원에 의한 과실에 책임이 있다. 그러므로 의료기관개설자는 의료서비스에 대해서 기대가능한 모든 노력을 하여야 하며, 불충분 또는 불완전한 조직편성 및 진료조치가 이루어지지 않게 하여야 할 조직의무를 부담한다. 이러한 점에서 의료기관은 방사선조영검사시에 조영제를 주입하는 단계로부터 검사의 완료에 이르기까지 전과정에 충분하고도 완전한 조직편성과 적정한 진료 확보를 위한 제반조치를 취할 책임이 있다. 따라서 환자의 안전과 진료의 적정을 위하여 의료기관이 조직적으로 필요한 조치를 시행하지 않거나 불충분한 경우에는 불법행위법상 의료기관 독자적인 조직책임을 지게 되며, 의료기관의 조직의무위반은 의료기관 자신의 책임이므로 내부관계에서 의료기관종사자 개인에게 구상권을 행사할 수 없다.

• Tuberculosis and Respiratory Diseases
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• 제78권3호
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• pp.161-167
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• 2015

Tuberculosis (TB) remains a major global health problem, and the incidence of TB cases has not significantly decreased over the past decade in Korea. The standard short course regimen is highly effective against TB, but requires multiple TB-specific drugs and a long treatment duration. Recent studies using late-generation fluoroquinolones and/or high-dose rifapentine-containing regimens to shorten the duration of TB treatment showed negative results. Extending the treatment duration may be considered in patients with cavitation on the initial chest radiograph and positivity in sputum culture at 2 months of treatment for preventing TB relapse. Current evidence does not support the use of fixed-dose combinations compared to separate drugs for the purpose of improving treatment outcomes. All patients receiving TB treatment should be monitored regularly for response to therapy, facilitation of treatment completion, and management of adverse drug reactions. Mild adverse effects can be managed with symptomatic therapy and changing the timing of the drug administration, but severe adverse effects require a discontinuation of the offending drugs.

• 한국응급구조학회지
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• 제25권3호
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• pp.93-109
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• 2021

Purpose: This study aims to investigate the knowledge and attitudes regarding adverse drug reactions (ADR) of emergency medical services (EMS) students, so that suggestions for further education on ADR can be made. Methods: A survey on knowledge and attitude was created and modified according to Lee's and Kim's test tool. In total, 149 students' data were collected and compared with previous studies. Results: Knowledge of ADR was relatively low (54%) but attitude was relatively high (75%). Clinical experience was important in knowledge and attitude. Knowledge and attitude showed a positive correlation. Conclusion: Increased knowledge of ADR leads to a more active attitude towards it. Hence, modification of the education system to provide a more personalized education is required.