• Tuberculosis and Respiratory Diseases
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• 제39권1호
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• pp.24-27
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• 1992

연구배경 : Angiotensin converting enzyme(ACE) 길항제인 Captopril용 최근 널리 쓰이는 혈압강하제로 바교적 부작용이 적은 것으로 알려져왔다. 그러나 1985년 Sesoko 등이 처음으로 Captopril에 의한 기침을 보고한 이래 관심이 높아져 최근 여러 예가 보고되고 있다. 방법 : 저자들은 최근 경험한 Captopril에 의한 기침환자 15명에 대한 임상상을 후향적으호 분석 하여 다음과 같은 결과를 얻었다. 결과 : 1) 대상 환자의 평균 연령은 58.5세 였으며, 남자 5예, 여자 10예 였다. 2) 대상 환자의 질환은 고혈압이 13예, 울혈성 심부전이 2예 였으며 과거력상 흡연력이 있었던 경우가 3예였다. 3) 대상 환자의 Captopril 하루 평균 사용량은 43.3mg 이었고, 사용기간은 5일에서 180일 까지 다양하였다. 4) Captopril에 의한 기침으로 판명되기 까지의 기침의 기간은 평균 47.5일 이었고, Captopril 사용 중지 후 기침이 소실될때 까지의 기간은 1~7일 이었다. 결론 : Captopril을 사용하고 있는 환자에서 원인없이 기침이 발생하였을 때는 Captopril에 의한 기침을 강력히 의심해야 한다.

• 기본간호학회지
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• 제12권1호
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• pp.91-100
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• 2005

Purpose: This research used quantitative research to identify differences in death consciousness between pre and post education. The study was also designed to further understanding of the effects of nursing education by using a qualitative analysis to examine hospice education experience. Method: This study a one group pre-post test design. Results: 1 The mean score for the students' death consciousness before the hospice education averaged $2.15{\pm}\;.33$, a medium level for death Consciousness. The Score after education was $2.25{\pm}\;.36$, that is, there was higher score for death consciousness after education. 2. The result of classification, giving their names and categorizing the experience of being in a coffin shown to be self-reflection, regret, recognition to death, death as discontinuation of life, the last closing from everything, death as a sad and cruel event, death as another world, specialist intuition of nursing. Conclusion: This research provided an opportunity for nursing students to consider death earnestly and realistically through hospice nursing education. We also discovered affirmative changes in the students' viewpoint of death, students who in future clinical practice may work with elders. We also found increases in motives to develop ability to present effective aid to dying patients.

• Journal of Yeungnam Medical Science
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• 제1권1호
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• pp.171-178
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• 1984

저자들은 최근 영남대학교 의과대학 부속병원에서 대장암으로 인한 설사를 세균성 적리로 인한 설사로 잘못 알고 계속적인 항생제 투여로 말미암아 생긴 위막성 장염 1례를 경험 치료하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Yeungnam Medical Science
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• 제29권2호
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• pp.121-124
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• 2012

Valaciclovir is metabolized to acyclovir after ingestion and thereafter exerts its antiviral activity. Because of its superior pharmacokinetic profile, it has quickly replaced acyclovir in the treatment of herpesvirus infection. Neurotoxicity caused by valaciclovir has been reported, however, among patients with pre-existing impaired renal function. This paper reports a case of neurotoxicity of valaciclovir in a patient with end-stage renal disease who was undergoing continuous ambulatory peritoneal dialysis (CAPD). A 67-year-old female on CAPD took 500 mg of valaciclovir twice for herpes zoster. After she took her second dose orally, she developed confusion and disorientation, along with involuntary movements. Her mental confusion progressed to a coma. Discontinuation of valaciclovir showed no rapid improvement. There- fore, hemodialysis was started. After two sessions of hemodialysis, the patient became alert; and after four sessions of hemodialysis, her neurological abnormalities were completely reversed. In conclusion, valaciclovir can induce life-threatening neurotoxicity, especially in CAPD patients, even with appropriate dose reduction, which can be effectively managed by hemodialysis.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제19권3호
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• pp.162-167
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• 2008

Objectives: The aim of this study was to identify characteristics of children and adolescents who were victims of sexual assault in Korea. Methods: The subjects were 60 children and adolescents who visited the one-stop center as victims of sexual assault. The medical records of victims of sexual trauma were retrospectively reviewed. We studied the demographic data of the victims, their relationship to their perpetrator, the characteristics of the assault (frequency, duration, place, type), and the process from sexual assault to treatment. We also paid special attention to how the characteristics of the victims or perpetrators affected the characteristics of the assault or follow-up treatment. Results: There were several differences between sexual assaults committed by strangers and those committed by acquaintances. Sexual assaults committed by acquaintances lasted for a longer period of time than those committed by strangers. In addition, it took more time for victims of sexual assaults committed by acquaintances to seek treatment than those who were victims of sexual assaults committed by strangers. The majority (55.0%) of victims were between 10 and 15 years of age. Forty percent of the perpetrators were teenagers, and two of them were under the age of 10. Voluntary discontinuation of treatment was more frequent in adolescents than in children. Conclusion: All teenage victims of sexual assault need some sort of urgent intervention. In addition, approachable methods are needed in order to prevent sexual abuse by strangers or acquaintances.

• 사상체질의학회지
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• 제21권3호
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• pp.209-215
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• 2009

1. Objects: This case study reports a liver injury in treatment of constipation with Yeoldahanso-tang plus Rheum rhabarbarum. 2. Methods: The patient's subjective symptoms and the laboratory data including aspartate transaminase(AST), alanine transaminase(ALT), alkaline phosphatase(ALP), and gamma($\gamma$)-glutamyl transpeptidase(GGT) were observed before and after liver injury. We used the Roussel Uclaf Causality Assessment Method(RUCAM) scale in order to find out whether if Yeoldahanso-tang plus Rheum rhabarbarum was related with the liver injury. 3. Results: The patient's AST and ALT were elevated more than twice after a 3week administration period of herbal medicine. After discontinuation of the herbal medicine and administration of hepatic protective medication, AST and ALT decreased. The patient's general condition improved during hospitalization. The RUCAM score was estimated at 8. 4. Conclusions: This case is presented to bring more attention to the toxicity of herbal medicine.

• 약학회지
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• 제51권5호
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• pp.327-335
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• 2007

This study was to evaluate economic impact of a comprehensive pharmaceutical care intervention provided by community pharmacists on drug-related morbidity and mortality in the elderly population, in a societal perspective. Clinical outcomes of pharmaceutical care included compliance increase, inappropriate medication discontinuation, and subsequent drug-related morbidity and mortality reduction. Economic outcomes included cost savings from direct medical costs reduction such as medication and healthcare resource utilization. Input costs for pharmaceutical care included pharmacist time and computerized prescription review supporting program costs. Model parameters of outcomes were derived from published literatures, and costs were from literatures and health insurance statistical data in Korea. Annual costs and benefits were estimated in the year 2005. Current usual care and standardized pharmaceutical care required 0.3 and 2.0 hours per year respectively, for elderly outpatient using average 4.4 prescription drugs per visit and average annual frequency of 17.8 pharmacy visits. Comprehensive pharmaceutical care provided to overall elderly outpatients at community pharmacies would have cost of \74,994 mil. and benefit of \357,002 mil. per year. Benefit:cost ratio was 4.8:1 and net benefit was \282,008 mil/year. It was corresponded to net benefit of \73,816/year for individual elderly patient. In addition, pharmaceutical care was estimated to reduce 1,531 drug-related deaths/year. Conclusively this study, a first attempt in Korea to evaluate an economic value of pharmaceutical care at community pharmacies, proved that it was a cost-effective intervention having significant economic benefit.

• 한방안이비인후피부과학회지
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• 제29권4호
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• pp.142-155
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• 2016

Objectives: The purpose of this study is to examine whether there is a significant efficacy difference on infant and young child atopic dermatitis patients treated with Korean Medicine Treatment through 6 months between topical steroid used group and non-steroid group. Methods: The degree of atopic dermatitis was measured by the Objective SCORAD Index (OSI) with photographs of patients. Detailed analysis of the OSI score was compared based on the use of topical steroid. Results: 1. There was not a significant difference between the topical steroid group and the non-steroid group in regards of gender, age and initial OSI score. 2. The non-steroid group's OSI score decreased significantly from 50.17 to 29.20. 3. The topical steroid group's OSI score decreased significantly from 54.21 to 34.95. 76.19% of the patients in the topical steroid group discontinued steroid use within the 6-month period. The average time of discontinuation since the beginning of treatment was 3.36 months. 4. The OSI Improvement rate comparison of topical steroid group with non-steroid group did not show a significant difference over a 3-month and 6-month period. 5. Distribution of severe cases decreased in Both topical steroid and non-steroid group after 6 month treatment. Conclusions: The OSI score of infant and young child atopic dermatitis patients in both topical steroid and non-steroid group was decreased significantly with Korean medicine treatment through 6 months. There was no significant difference between topical steroid group and non-steroid group in OSI improvements over a 3-month period and 6-month period.

• Childhood Kidney Diseases
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• 제11권1호
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• pp.92-99
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• 2007

후두엽 가역성 뇌병증 증후군은 고혈압, 자간증, 신부전으로 인한 고혈압 및 면역억제약물 등 의 병력과 함께 두통, 구토, 경련, 시야장애 등 임상적 증상을 보이고 뇌 자기공명영상에서 특징적인 소견을 보이는 질환군이다. 저자들은 스테로이드 저항성 신증후군 환아에서 사이클로스포린 투여 중 발생한 후두엽 가역성 뇌병증 증후군을 경험하였기에 보고하는 바이다.

• 한국임상약학회지
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• 제26권1호
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• pp.59-69
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• 2016

Background: The subcutaneous formulation of biologic disease-modifying antirheumatic drugs (DMARDs) was preferred due to favored self-administration and would be an economical treatment option for patients with rheumatoid arthritis. This study was to compare the economic impact of biologic DMARDs administered by subcutaneous injection in patients with rheumatoid arthritis who had inadequate response to conventional DMARDs. Methods: The cost-minimization analysis was conducted to estimate the lifetime health care costs of treatment sequences with subcutaneous biologic DMARDs as first-line therapy from a health care system perspective. The Markov model was developed to represent the transitions through treatment sequences based on American College of Rheumatology response rate and discontinuation rate. The health care costs comprised the cost of medications, administration, dispensing, outpatient visits, test/diagnostic examination, palliative therapy and treatment of serious infection. All costs were expressed in 2016 Korean Won (KRW) and discounted at 5%. Results: The mean lifetime health care cost per patient was lowest in the etanercept sequence, which was estimated at KRW 63,441,679. The incremental costs of the treatment sequence started with adalimumab, golimumab, abatacept, and tocilizumab were KRW 7,985,730, KRW 4,064,669, KRW 2,869,947, and KRW 4,282,833, respectively, relative to etanercept sequence. These differences in costs mainly were attributable to medication costs. One-way and probabilistic sensitivity analyses confirmed that etanercept represented the option with the lowest cost compared with comparators. Conclusion: This study found that etanercept is likely a cost-saving treatment option among subcutaneous biologic DMARDs in patients with rheumatoid arthritis.