• YAKHAK HOEJI
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• v.57 no.2
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• pp.101-109
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• 2013

Depressive disorders are the most common psychiatric problem in the elderly. Most depression treatment guidelines emphasize treatment with antidepressant medication and recommend that benzodiazepine use be minimized for limited period, particularly to elderly patients. In order to evaluate appropriate use of antidepressants and benzodiazepine, retrospective review of prescriptions was performed. The study population are older than 65 years who had been newly diagnosed with major depressive disorder in specialty mental health at a community general hospital from January $1^{st}$, 2007 to October $31^{th}$, 2012 (N=373). Initial antidepressant accounted for 89.5% with SSRI, and escitalopram accounted for 60.9% of SSRI group. 79% or more of the patients were prescribed the recommended dosage. The maintenance rate for 4 weeks of initial antidepressant was 48% and 6 weeks was 39%. Treatment-discontinuation rate was 68% at 3 month. Alprazolam (short acting benzodiazepine) was prescribed the most, followed by clonazepam (long acting benzodiazepine) and then diazepam. 55% of patients received a duplicated prescription for short acting plus long acting benzodiazepine. 61% of patients used long acting benzodiazepines. Prescribed dosages of benzodiazepines were commonly within a recommended range, while no one was prescribed a appropriate period (up to 2 weeks) except for the early discontinued patients. Appropriate use of zolpidem was only 16.2%. The depressed elderly treated in specialty mental health mostly received long-term treatment with benzodiazepines in combination with antidepressants, guideline recommendations was not followed. Multidisciplinary interventions like audit and feedback of benzodiazepine use are needed and education for the elderly is needed to properly maintain antidepressant treatment.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.29 no.4
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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.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.8 no.1
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• pp.133-145
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• 1998

The purposes of this study were to assess current status of respirator usage among workers in the small-scale industries and to identify those factors causing respirator wearers not to continuously wear respirators during work. Total 168 workers participated voluntarily in the survey. In order to cover all possible reasons, though not exclusive, 33 diverse questions were developed based upon the results in the published literatures and from researchers' own experience. The most common type of respirator worn was the disposable single-use respirator(42%). However, masks made of gauze, which should not be considered as a respirator, were widely used (38%). Only 28% of respondents indicated they wear respirators continuously during work. The major reasons for removing respirators include, in descending order of frequency, difficulty in breathing (46%), sweating (39%), bothered by frequent removal (21%), inadequate mask size (19%) and hot air temperature inside the respirator (19%), etc. In addition, minor reasons including mask design, administrative, and personal reasons were also identified. These reasons should be considered in a well designed respirator program in order to improve workers' acceptance and usage of respirators.

• Journal of Korean Neurosurgical Society
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• v.58 no.2
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• pp.163-166
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• 2015

The prophylactic use of phenytoin during and after brain surgery and cranial irradiation is a common measure in brain tumor therapy. Phenytoin has been associated with variety of adverse skin reactions including urticaria, erythroderma, erythema multiforme (EM), Stevens-Johnson syndrome, and toxic epidermal necrolysis. EM associated with phenytoin and cranial radiation therapy (EMPACT) is a rare specific entity among patients with brain tumors receiving radiation therapy while on prophylactic anti-convulsive therapy. Herein we report a 41-year-old female patient with left temporal glial tumor who underwent surgery and then received whole brain radiation therapy and chemotherapy. After 24 days of continous prophylactic phenytoin therapy the patient developed minor skin reactions and 2 days later the patient returned with generalized erythamatous and itchy maculopapuler rash involving neck, chest, face, trunk, extremities. There was significant periorbital and perioral edema. Painful mucosal lesions consisting of oral and platal erosions also occurred and prevented oral intake significantly. Phenytoin was discontinued gradually. Systemic admistration of corticosteroids combined with topical usage of steroids for oral lesions resulted in complete resolution of eruptions in 3 weeks. All cutaneous lesions in patients with phenytoin usage with the radiotherapy must be evoluated with suspicion for EM.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.4
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• pp.228-234
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• 2020

Objectives: The number of patients undergoing oral anticoagulant therapy for cardiovascular and cerebrovascular disease is increasing. However, the risk of bleeding after tooth extraction in patients receiving warfarin is unclear. Here, we assess the risk of bleeding after tooth extraction in patients on warfarin. Materials and Methods: The study included 260 patients taking warfarin who underwent tooth extraction (694 teeth). The patients were divided into those whose teeth were extracted while they were taking warfarin, those who discontinued warfarin before extraction, and those who underwent extraction while receiving heparin bridging therapy. Bleeding complications in the two groups were compared. Results: Of the 260 patients, 156 underwent extraction while taking warfarin, 70 stopped taking warfarin before extractions, and 34 received heparin bridging therapy and stopped taking either medication before extractions. Bleeding complications occurred in 9 patients (3.5%) and 9 tooth sites (1.3%). Among the 9 patients with bleeding complications, 6 underwent extraction while taking warfarin, 2 stopped warfarin before extraction, and 1 underwent extraction after receiving heparin bridging therapy. No significant difference was seen between patient groups regarding bleeding after extractions (P=0.917). Conclusion: Warfarin use does not increase the risk of post-extraction bleeding and can therefore be continued during tooth extraction.

• YAKHAK HOEJI
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• v.37 no.2
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• pp.172-181
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• 1993

The purpose of this study was to evaluate the clinical efficacy and safety of NRM which was newly developed as a combination product containing antacids, digestive enzyme and herbal drugs, and OTA powder, called OHTA'S ISAN on the morret, for the treatment of various symptoms in upper gastrointestinal diseases. 63 patients were recruited, 36 as a treated group with NRM and 27 as a controlled one with OTA. Patients were randomly allocated to receive either NRM or OTA t.i.d. for treatment of upper G-1 symptoms and undergone endoscopic, symptomatic and clinical laboratory assessments before and after 2 weeks. The results were as follows; 1. The general improvement rates of subjective symptoms in upper G-1 diseases were observed in 100%(32/32) for NRM and in 92%(23/25) for OTA. 2. The overall effective rates in terms of the symptoms and endoscopic findings were 88.9%(32/36) for NRM and 85.2%(23/27) ,or OTA respectively. 3. In NRM group, no significant side effects by NRM were observed except a mild and transient vomiting in one patient, but in OTA group treatment was discontinued due to nousea in one patient, However, there were no clinically significant changes detected in the laboratory parameters. According to the result of this trial, it is cocluded that NRM was safe and effective and (but not statistically significant) was superior to OTA in the treatment of gastrointestinal diseases caused by gastritis, gastric and duodenal ulcer, functional gastrointestinal disorder, non-ulcer dyspepsia etc.

• 대한예방의학회:학술대회논문집
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• 1994.02b
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• pp.270-284
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• 1994

Interim analyses of randomized trials enable investigators to make more efficient use of limited research resources and to satisfy ethical requirements that a regimen be discontinued as soon as it has been established to have an inferior efficacy/toxicity profile. Unfortunately. the integrity and credibility of these trials can be compromised if inappropriate procedures are used in monitoring interim data. 'In this paper we discuss how group sequential designs provide useful guidelines that enable one to satisfy the valid objectives of interim monitoring while avoiding undesirable consequences, and we consider how flexible one can be in the way such designs are implemented. We also provide motivation for the role of data-monitoring committees in preserving study integrity and credibility in either government- or industry-sponsored trials. In our view. these committees should have multidisciplinary representation and membership limited to individuals free of apparent significant conflict of interest, and ideally should be the only individuals to whom the data analysis center provides interim results on relative efficacy of treatment regimens. Finally. we discuss some important practical issues such as estimation following group sequential testing, anal ysis of secondary outcomes after using a group sequential design applied to a primary outcome, early stopping of negative trials. and the role of administrative analyses.

• Proceedings of the National Institute of Ecology of the Republic of Korea
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• v.2 no.2
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• pp.76-81
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• 2021

With continuous decline of Philippine forest cover, sustainable forest management and restoration are essential to restore destroyed forest ecosystems. Unfortunately, of ten most planted trees in reforestation projects in the Philippines, eight are exotic species, with large leaf mahogany (Swietenia macrophylla) being the most dominant. In this study, effect of Swietenia macrophylla in reforestation projects on native tree species was evaluated. Effects of S. macrophylla leaf litter, frequency, and canopy closure on the growth of the Philippine native species Pterocarpus indicus were investigated. Results showed that S. macrophylla leaf litter significantly inhibited the growth of P. indicus seedlings based on root collar-to-shoot height. The standardized growth rate of seedlings in plots without S. macrophylla leaf litter was significantly higher than the growth rate of seedlings in plots with leaf litter. Furthermore, there was no significant difference in the standardized growth rate of seedlings between plots without leaf litter and a control plot. On the contrary, S. macrophylla tree frequency and canopy closure showed no significant effect. These results attest to the negative effect of widely planted S. macrophylla to a valuable Philippine native tree P. indicus. With accumulating scientific evidence about negative effects of S. macrophylla on native trees, discontinued use in tree planting and reforestation efforts with active management of restoration sites previously planted with large leaf mahogany are needed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.50 no.4
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• pp.189-196
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• 2024

Objectives: This study aimed to evaluate the association between use of direct oral anticoagulants (DOACs) and post-extraction bleeding and to quantify bleeding risk in patients receiving DOACs. Materials and Methods: The study included 293 patients who were taking DOACs and underwent tooth extraction (414 teeth). The patients were divided into those who had the extraction while taking DOACs and those who discontinued DOACs before the extraction. Bleeding complications were recorded and compared between the patient groups and types of DOACs. Results: Of the 293 patients, 12 patients (6.9%) had post-extraction bleeding. Post-extraction bleeding occurred in 12 of the 414 tooth extraction sites. Among the 246 patients who underwent dental extraction while continuing DOAC therapy, 12 patients (8.5%) had post-extraction bleeding. Among the 47 patients who underwent dental extraction after discontinuing the administration of DOACs, none reported post-extraction bleeding. There was no significant difference in the number of patients with post-extraction bleeding between the two groups (P=0.122). Conclusion: Continuing DOAC therapy during dental extraction does not increase post-extraction bleeding tendency. These results are consistent with those of previous studies.

• Korean Journal of Psychosomatic Medicine
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• v.30 no.2
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• pp.66-72
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• 2022

Clozapine is accepted as the "gold standard" antipsychotics for treatment-resistant schizophrenia. Clozapine rarely causes extrapyramidal syndrome and tardive dyskinesia, which are common with other antipsychotics, and only a transient elevation of hyperprolactinemia has been reported. Despite such clinical usefulness, there are limitations to the use of clozapine due to adverse drug reactions (ADR). Fever is a common in adverse drug reactions associated with clozapine. At initiation of clozapine most fatal ADR such as agranulocytosis and neuroleptic malignant syndrome associated with fever, in which case clozapine should be discontinued immediately. However, as benign causes of fever are much more frequent than life-threatening ADR, clozapine should not be discontinued unconditionally in the event of fever during clozapine initiation. In addition, fever may occur at any time during the maintenance of clozapine treatment. In particular, since the risk of pneumonia does not decrease over time, and clozapine has a higher risk of pneumonia than other antipsychotic drugs, it is recommended to adjust clozapine dosage through therapeutic drug monitoring.