• The Korean Journal of Pain
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• v.36 no.4
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• pp.458-464
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• 2023

Background: Fibromyalgia (FM) is a complex disorder characterized by widespread chronic pain and tenderness in the muscles, ligaments, and soft tissues. It is a chronic pain condition often accompanied by other symptoms and comorbidities. To effectively manage FM, it is crucial to obtain fundamental epidemiological data pertaining to the target population. Therefore, this study was conducted to elucidate the epidemiological characteristics of FM in the Korean population. Methods: Population-based medical data of 51,276,314 subscribers to the National Health Insurance Service of Korea from 2014 to 2018 were used in this study. Results: The overall incidence of FM ranged from 441 (2014) to 541 (2018) cases per 100,000 person-years, with a higher prevalence observed among female patients compared to male patients. The incidence gradually increased until middle age, followed by a decrease. The highest incidence rates were observed in the fifth decade of life for females and the sixth decade of life for males. When categorizing the affected parts of the body, the shoulder region was observed to be the most frequently affected. A comparison of the drug prescriptions based on medical specialty showed that antidepressants were the most commonly prescribed medications. The management of FM leads to consistent increases in medical expenses, regional disparities, and variations in prescription patterns across different medical specialties. Conclusions: The findings of this study will not only contribute to the understanding of FM characteristics but also provide a vital foundation for efficient management of FM in Korea.

• The Journal of Internal Korean Medicine
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• v.45 no.1
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• pp.55-74
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• 2024

Objectives: This study reviewed the status of adverse event (AE) reporting in VigiAccess using anti-obesity agents as examples and explored the possibility of its use and future challenges. Methods: AE reports related to some representative drugs among herbal medicines (HMs), complex HM prescriptions, ingredients of supplements, and over-the-counter and prescription medicines were investigated using VigiAccess on February 1, 2024. Results: AE reports on prescription drugs were overwhelmingly higher than those on HMs or supplements. Although most reports were submitted from North America, reports on Ephedra sinica and green tea extract (GTE) were more from Asia and Europe, respectively. The female population reported more, and the difference in the sex ratio was the smallest for Ephedra spp. The age group was concentrated on young adults, but many older patients reported GLP-1 receptor agonist-related AEs. Symptoms related to the gastrointestinal and nervous systems were most commonly reported, but mental and cardiac disorders were common in Ephedra-type HMs. Hepatobiliary disorders are also commonly found in GTE-related reports. Conclusions: VigiAccess was useful for easily checking the global status of AE reporting for prescription drugs. However, several limitations were observed in using VigiAccess for HMs because of the few reports. Thus, it is necessary to increase the number of reports by education and to promote AE reporting among HM prescribers and users. The full range of HMs should be included in the pharmacovigilance system, and the coding and classification of HMs should be revised.

• The Korean Journal of Pain
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• v.37 no.1
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• pp.41-50
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• 2024

Background: Recognizing the seriousness of the misuse and abuse of medical narcotics, the South Korean government introduced the world's first narcotic management system, the Narcotics Information Management System (NIMS). This study aimed to explore the recent one-year opioid prescribing patterns in South Korea using the NIMS database. Methods: This study analyzed opioid prescription records in South Korea for the year 2022, utilizing the dispensing/administration dataset provided by NIMS. Public data from the Korean Statistical Information Service were also utilized to explore prescription trends over the past four years. The examination covered 16 different opioid analgesics, assessed by the total number of units prescribed based on routes of administration, type of institutions, and patients' sex and age group. Additionally, the disposal rate for each ingredient was computed. Results: In total, 206,941 records of 87,792,968 opioid analgesic units were analyzed. Recently, the overall quantity of prescribed opioid analgesic units has remained relatively stable. The most prescribed ingredient was oral oxycodone, followed by tapentadol and sublingual fentanyl. Tertiary hospitals had the highest number of dispensed units (49.4%), followed by community pharmacies (40.2%). The highest number of prescribed units was attributed to male patients in their 60s. The disposal rates of the oral and transdermal formulations were less than 0.1%. Conclusions: Opioid prescription in South Korea features a high proportion of oral formulations, tertiary hospital administration, pharmacy dispensing, and elderly patients. Sustained education and surveillance of patients and healthcare providers is required.

• Clinical and Experimental Pediatrics
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• v.49 no.10
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• pp.1042-1049
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• 2006

Purpose : This study was conducted to survey the preliminary data on risk behaviors and to identify the factors that prevent risk-behaviors in late adolescence. Methods : Freshmen(n=1,297) beginning the first semester in Korea University, Seoul, Korea completed self-administered risk behavior questionnaires, comprising 5 domains : demographics, smoking, drinking, drug abuse and sexual behavior. Results : The rate of smoking experience was higher in people having friends who smoke and the predictors of transition to current smoking were male gender, urban residence, friends' smoking, and nicotine dependence. The rate of high risk drinking was higher among students who are male and who had experience of heavy episodic drinking. The study group showed a low prevalence of narcotic users, but two-thirds of students could get medicine easily without prescriptions. The prevalence of sexual experience was 6.5 percent, and the sexual education was not a predictor of contraceptive behavior. The prevalence of homosexuality was 1.6 percent, and the rate of mostly heterosexuality was higher in female students. Conclusion : The main targets of youth health education should be campaigns aimed at atcessation of reinforcing risk behaviors and the development of a surveillance system for the prevention of chronic disease. These results can be used to find risk factors of health-risk behaviors among late adolescents.

• The Journal of Korean Obstetrics and Gynecology
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• v.27 no.1
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• pp.152-166
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• 2014

Purpose: The purpose of this study is to compare with the result of experimental study about antithrombotic effect by reviewing recent oriental medicine journals that have been published since 2001' in Korea. Methods: Articles on antithrombotic effect that have been published from 2001' to 2013' in oriental medicine journals registered National Research Foundation of Korea were searched. After that, 12 articles using same 'thrombosis condition model' were selected and reviewed. Results: The results were as follows. 1. If there is no limit drug concentrations, platelet aggregation induced by adenosine diphosphate (ADP) in hyulbuchukeo-tanggamibang (HBCT) was the largest aggregation inhibitory effect and platelet aggregation induced by epinephrine in Saegeum-san (SGS), Jogan-tanggagambang (JGTG), hyulbuchukeo-tanggamibang (HBCT) had a large inhibitory effect on aggregation. 2. At the lowest concentration, Mokdan-san (MDS) of the inhibition of platelet aggregation induced by ADP and Hyunhosaik-san (HHS) of the inhibition of platelet aggregation induced by epinephrine were effective. 3. Pulmonary embolism induced by collagen and epinephrine in Neungasojeok-tang (NSJT) has the highest antithrombotic effect. 4. Pathological conditions of extravasated blood by dextran, Jogan-tanggagambang (JGTG) has the highest inhibitory effect on decrease in platelet numbers. Compared to the rest of the experimental drug, Saegeum-san (SGS), Heanggyonghonghwa-tang (HGTHHT), Wusl-san (WSS), Mokdan-san (MDS) showed significant inhibitory effect on the prothrombin time (PT) increases. Honghwadanggui-san (HDS), Saegeum-san (SGS) showed significant inhibitory effect on increase in activated partial thromboplastin time (APTT) and Jogan-tanggagambang (JGTG), Heanggyonghonghwa-tang (HGTHHT) showed significant inhibitory effect on decrease in fibrinogen. Conclusions: This result will provide useful information for the prescriptions of antithrombotic medicine in the field of Oriental medicine. We will have to carry out further studies that will compare each herb used in the diseases caused by extravasated blood.

• The Korea Journal of Herbology
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• v.32 no.2
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• pp.87-95
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• 2017

Objectives : Infectious diseases by Methicillin-Resistant Staphylococcus aureus (MRSA) are a growing problem worldwide. Characteristic of MRSA is endlessly mutation to resist antibiotics. Daehwanggo (DHG) is one of the oriental medicine prescriptions contained in Principles and Practice of Eastern Medicine. Daehwanggo was mainly used for external preparation from old times. The purpose of this study is to confirm possibility as supplementary drug of DHG about antibiotics through observation of synergy effect between DHG and commercial antibiotics and to observe restriction on growth of MRSA on any pathway through observation of mechanism. Methods : The minimum inhibitory concentration (MIC) of DHG against MRSA is $500{\sim}2000{\mu}g/m{\ell}$ by broth dilution method. In the checkerboard method, the combinations of DHG with antibiotics has partial synergistic effect or synergy effect and DHG markedly reduced the MICs of the antibiotics oxacillin (OX), gentamicin (GT) against MRSA. In the inhibition of resistance mechanism of DHG against MRSA, the expression of resistance gene and protein about ${\beta}-lactam$ antibiotic was reduced. Also, we observed the effect of DHG about cell membrane permeability against MRSA, and confirmed that DHG suppressed growth of strains by increasing cell membrane permeability. Results : Basis on the result, we speculate that DHG increase antibacterial activity of antibiotics against MRSA by changing the structure of cell wall of MRSA. Conclusions : These data suggest that Daehwanggo possesses possibility as supplementary drug about antibiotics against MRSA.

• Korean Journal of Oriental Medicine
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• v.2 no.1
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• pp.71-83
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• 1996

Hyang-Yack-Ku-Keup-Bang(鄕藥救急方) is our own, medical work written about the middle of the time of Korea Dynasty. I restored and researched this book because it needed to be illuminated about its medico-historic value and then I came to some conclusions as follows. 1. Hyang-Yack-Ku-Keup-Bang was published in Dae-jang-do-kam(大藏都監) of Kanghaw island(江華島) about the middle of Korea Dynasty. Choi Ja-ha(崔自河) republished it on original publication ground in Euiheung(義興) of Kyungsang-Province(慶尙道) in July, Taejong's(太宗) 17th year of Chosen Dynasty (A.D.1417) and this book was published again in Chungcheng Province(忠淸道) in Sejong's(世宗) 9th year(A.D.1427). The book published in Taejong's days was in the possession of books department of Kung-nae-cheng(宮內廳) in Japan and was the oldest medical book of existing ones. 2. Bang-Jung-Hyang-Yack-Mock-Cho-Bu(方中鄕藥目草部) of this book was originally intended to be adjusted in each division with the title of Bang-Jung-Hyang-Yack-Mock(方中鄕藥目). But Herb part(草部) only followed editing progress of Jeung-Lew-Bon-Cho(證類本草), the rest is not divided into each part and is together arranged at the below of Herb part with the title of Bang-Jung-Hyang-Yack-Mock-Cho-Bu. The Korean inscriptions on some drugstuffs in this book are different between Native Name(鄕名) of three volumes of provisions and general-spoken(俗云) of Bang-Jung-Hyang-Yack-Mock-Cho-Bu. In this, it is estimated that the publishing time and editor of tile volume of provisions and Bang-Jung-Hyang-Yack-Mock-Cho-Bu are different. I think Choi Ja-ha compiled this behind three volumes of provisions when he published. 3. This book picked some prescriptions which consisted of obtainable drugs with ease in Korea in the books of Chell-Keum-Yo-Bang(千金要方), Oi-Dae-Bi-Yo(外臺秘要), Tae-Peong-Sung-Hye-Bang(太平聖惠方), Ju-Hu-Bang(?後方), Kyung-Hum-Yang- Bang(經驗良方) Bo-Je-Bon-Sa-Bang(普濟本事方) Bi-Ye-Baik-Yo-Bang(備預百要方) and so on and got together our own prescriptions. On the whole Bi-Ye-Baik-Yo-Bang was a chief referrence book, On this, other books referred to and corrected. 4. In provisions quoted from Hyang-Yack-Jip-Sung-Bang(鄕藥集成方), there are seven provisions; leg-paralysis part, coughing part, headache part, obstetrics part, etc. don't show in this book. This is why Choi Ja-ha published only certain texts on Dae-jang-do-kam edition his own posession. So we can think the existing edition has a little misses compared with original edition. 5. This book recorded only names of drugstuffs in animal drug department like fowls, crab, goldbug, earthworm, etc. and didn't tell us ways of taking those. This is effect of Buddhist culture on medicine. This is efforts to practice 'Don't murder';one of Five Prohibition of Buddhism. 6. Beacause this book was published at the time, when our originative medicine would be set forth. This followed the Chinese ways in Theory, Treatment, Prescription and used 'Hyang Yack' in Medication out of theory of Korean medicine, which was a transitional form. So this is all important material which tell us aspects of development of 'Hyang Yack' the middle of Korea Dynasty.and this is also the beginning of originative, medical works like Dong-Eui-Bo-Kam(東醫寶鑑), Dong-Eui-Su-Bo-Won(東醫壽世保元). 7. There are few contents based on 'Byen-Jeung-Lon-Chi(辨證論治)'in this book. So we can see this book is not for doctors who study medical thoughts but for general public who suffer from diseases resulted from war. Because this book was written for a first-aid treatmeant, this is an index of medical service for the people those days. And this is also an useful datum for first-aid medicine or military medicine in these modern days. 8. Nowadays, parts of learned world of Korean medicine disregard essential theories and want to explain Korean medicine only by the theories or the methods of Western medicine. Moreover they don't adopt Chinese and Japanese theorys & thoughts about Oriental medicine in our own style and just view in there level. What was worse, there is a growing tendency for them to indulge in a trimming policy of scholarship and to take others' ideas. I think these trends to ignore our own medical thoughts involving growth of 'Hyang Yack' in the middle of Korea Dynasty, Dong-Eui-Bo-Kam and Dong-Eui-Su-Se-Bo-Won. So we, as researchers of Korean medicine, must get out of this tendency, and take over brilliant tradition and try to develop originative Korean medicine.

• Health Policy and Management
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• v.5 no.2
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• pp.35-69
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• 1995

The managerial environment of hospitals in Korea characterized by low levels of medical insurance fees is worsening by increasing government regulations as to the utilization of medical services, rising costs of labor, material, and medical equipments, growing patient expectations concerning the quality of services, and escalating competitions among large hospitals in the market. Hospitals should seek for their survival strategies in this harsh environment and they should have information about costs of their products in doing so. However, it has not been available due to the complexity of the production process of hospital services. The objectives of this study were to develop a service-based cost accounting model and to apply the developed model to a study hospital to obtain cost information of hospital services. A model commonly used for the job-order product cost accounting in the manufacturing industry was modified for the use in hospitals in Korea. Actual costs, instead of standard costs, incurred to produce a unit of services during a given period of time were estimated in the model. Data required to implement the model included financial information, statistics for the allocation of supportive cost center costs to final cost centers, statistics for the allocation of final cost center costs to services, and the volume of each services charged to patients during a study period. The model was executed using data of a university teaching hospital located in Seoul for the fiscal year 1992. Data for financial information, allocation statistics fo supportive service costs, and the volume of services, most of them in electronic form, were available to the study. Data for allocation statistics of final cost center costs were collected in the study. There were 15 types of evaluation and management service, 2, 923 types of technical service, and 2, 608 types of drug and material service charged to patients in the study hospital during the fiscal year 1992. Labor costs of each of seven types of pesonnel, material costs of 611 types of drugs and materials, and depreciation costs of 212 types of medical equipments, miscellaneous costs, and indirect costs incurred in producing a unit of each services were estimated. Medical insurance fees for basic services such as evaluation and management of inpatients and outpatients, injection, and filling prescriptions, and for operating procedures were found to be set lower than costs. Infrequent services which use expensive medical equipments showed negative revenuse as well. On the other hand, fees for services not covered by the insurance such as CT, MRI and Sonogram, and for laboratory tests were higher than costs. This study has a significance in making it possible for a hospital to obtain cost information for all types of services which produced income based on all types of expenses incurred during a given period of time. This information can assist the management of a hospital in finding an effective cost reduction strategy, an efficient service-mix strategy under a given fee structure, and an optimum strategy for within-hospital resource allocations.

• Journal of agricultural medicine and community health
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• v.18 no.2
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• pp.105-119
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• 1993

The purpose of this study was to evaluate the program for the control of acute respiratory infections(ARI) in children in a Korean rural area(Yonchon county). Evaluating the program, we focused on the pattern of prescription and appropriateness of antibiotics prescribed by the health personnel who had participated in the ARI Control Program. It was implemented at the primary health care setting in rural area, such as district hospital, health subcenters, and health posts. During six-months programme monitoring period, medical records were reviewed and collected data were analysed by the pediatrician, research coordinator of this study. The baseline data were collected from medical records of the same period(six months) of one year before the implementation of the ARI programme. The study results were as follow : 1. Common cold was the most prevalent disease(78.7%. 594 cases) among the all ARI cases (755 cases). The less frequent cases were bronchitis(11.9%), acute pharyngitis(5.2%), and pneumonia(1.8%). 2. Significant reduction in the use of antibiotics was observed after the programme implementation. Ninety three(15.7%) of 594 common cold cases were received antibiotics compared with 282(35.2%) of 802 in the baseline period. In the cases of bronchitis and acute pharyngitis, the reduction rates were 15.1% and 23.2% respectively compared to the baseline period. 3. Mean duration of antibiotics prescription was 1.81-1.75 days, similar to the baseline data. 4. The appropriateness rate of antibiotics prescriptions were 84.3%(common cold), 35.6% (bronchitis) and 28.2%(acute pharyngitis). In the case of pneumonia, the antibiotics prescription was compatible to the criteria developed. 5. Pediatrician prescribed antibiotics more appropriately for all cases than general practitioners in health sub-center, and nurse practitioners in health posts. 6. Antibiotics therapy was shown to be of no effect in the treatment of the all ARI cases. At the 5 and 10 days check-up of common cold cases after visits, proportion of improved patients were 58.3% in the antibiotics-used group and 51.4% in the control group. In the other cases of ARI, the patterns of response were similar to common cold. None of the differences in outcome between the antibiotics-used and control group was statistically significant. This ARI programme may have substantial a substantial impact on antibiotics use at the public health institutions(district hospital, health subcenters, health posts) which are of major domain for primary health care in Korean rural areas.

• Journal of Oriental Neuropsychiatry
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• v.19 no.2
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• pp.111-122
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• 2008

Objective : Herb medicines are potential sources of useful edible and medicinal plants. They are used as a drug because of their various biological activities such as immunomodulatory, antiviral, and antitumor functions. Nelumbo nucifera have been applied in Chinese herbal prescriptions to improve tissue inflammation. However, it has not been elucidated on the effect of the flower of Nelumbo nucifera in cells. Method : In the present study, to examine the effect of that on glioma cells, U87, the essential oil was extracted from the flower of Nelumbo nucifera (NN essential oil). U87 cells were exposed to different concentrations of 2-40 ug/ml of NN essential oil in ethanol. Cell viability was measured by MTT assay at 24 h. To find out the intracellular target signal molecule(s) for this antiproliferative activity of NN essential oil, phosphorylation of Akt, ERM, MAPK or p38 proteins were examined by Western blot analysis. To study long term effect of NN essential oil in U87 cells, the image of cells treated with NN essential oil for 4 days were obtained. Results and Conclusion : NN essential oil was shown to exhibit antitumor activity in glioma cells, at a broad range of concentrations of 10-40 ug/ml. The phosphorylation of Akt and Endoplasmic Reticulum Matrix (ERM) proteins which known to be involved in the cell death, were gradually decreased to 2 hours after addition 20 ug/ml of NN essential oil. However, the phosphorylation of mitogen-activated protein (MAPK) and p38 was found to increase in NN essential oil treated cells. NN essential oil treated cells showed decreased glioma cell number. These results provide a possible NN essential oil-induced inhibitory signal for tumor cell proliferation that is initiated by the decrease in Akt activity. Moreover, it is likely that the activation of p38 is required for the NN essential oil-induced inhibition of tumor proliferation.