• 한국미생물생명공학회:학술대회논문집
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• 한국미생물생명공학회 2000년도 Proceedings of 2000 KSAM International Symposium and Spring Meeting
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• pp.3-6
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• 2000

Antimicrobial resistance has been a well-recognized problem ever since the introduction of penicillin into clinical use. History of antimicrobial development can be categorized based on the major antibiotics that had been developed against emerging resistant $pathogens^1$. In the first period from 1940 to 1960, penicillin was a dominating antibiotic called as a "magic bullet", although S.aureus armed with penicillinase led antimicrobial era to the second period in 1960s and 1970s. The second stage was characterized by broad-spectrum penicillins and early generation cephalosporins. During this period, nosocomial infections due to gram-negative bacilli became more prevalent, while those caused by S.aureus declined. A variety of new antimicrobial agents with distinct mechanism of action including new generation cephalosporins, monobactams, carbapenems, ${\beta}$-lactamase inhibitors, and quinolones characterized the third period from 1980s to 1990s. However, extensive use of wide variety of antibiotics in the community and hospitals has fueled the crisis in emerging antimicrobial resistance. Newly appeared drug-resistant Streptococcus pneumoniae (DRSP), vancomycin-resistant enterococci (VRE), extended-spectrum ${\beta}$-lactamase-producing Klebsiella, and VRSA have posed a serious threat in many parts of the world. Given the recent epidemiology of antimicrobial resistance and its clinical impact, there is no greater challenge related to emerging infections than the emergence of antibiotic resistance. Problems of antimicrobial resistance can be amplified by the fact that resistant clones or genes can spread within or between the species as well as to geographically distant areas which leads to a global concern$^2$. Antimicrobial resistance is primarily generated and promoted by increased use of antimicrobial agents. Unfortunately, as many as 50 % of prescriptions for antibiotics are reported to be inappropriate$^3$. Injudicious use of antibiotics even for viral upper respiratory infections is a universal phenomenon in every part of the world. The use of large quantities of antibiotics in the animal health industry and farming is another major factor contributing to selection of antibiotic resistance. In addition to these background factors, the tremendous increase in the immunocompromised hosts, popular use of invasive medical interventions, and increase in travel and mixing of human populations are contributing to the resurgence and spread of antimicrobial resistance$^4$. Antimicrobial resistance has critical impact on modem medicine both in clinical and economic aspect. Patients with previously treatable infections may have fatal outcome due to therapeutic failure that is unusual event no more. The potential economic impact of antimicrobial resistance is actually uncountable. With the increase in the problems of resistant organisms in the 21st century, however, additional health care costs for this problem must be enormously increasing.

• 대한소아치과학회지
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• 제28권4호
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• pp.661-667
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• 2001

치아우식증을 예방하기 위해 당분을 포함한 음식의 사용을 조절해야 한다는 것에는 동의하지만 어쩔 수 없이 인지되지 못한 체 액체약에 포함된 형태로 공급되는 상당량의 당분이 존재한다. 당분을 포함한 액체약을 장기간 복용할 때는 우식 발생의 위험성이 증가될 수 있다. 본 연구는 경구용 액체약을 처방받는 경우를 고려하여 약제를 통한 당분의 섭취량에 대한 정보를 얻어 치아우식증의 예방에 도움을 주고자 조사를 하였다. 본 연구는 서울대병원 어린이병원에서 처방된 경구용 액체약을 조사하여 소아 환자에서 흔히 사용되는 액체약의 목록을 구하였고, 현재 국내에서 시판되고 있는 액체약을 기준으로 각 제조사에 자료를 요청하여 생산중인 액체약에서 그 속에 함유된 감미제의 종류와 함량에 대해 조사하였다. 아동에서 흔히 사용되는 액체약은 진해거담제, 암모니아혈증 치료제, 항생제, 빈혈약, 진정제, 항히스타민제, 항전간제, 비마약성진통제의 순이였다. 액체약에 함유된 감미제의 평균함량은 $52.3{\pm}22.4g/100ml$이었다. 그리고, 액체약에 함유된 감미제 중 가장 많이 사용되는 것은 백당이었다.

• Journal of Preventive Medicine and Public Health
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• 제35권4호
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• pp.340-350
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• 2002

Objectives : To evaluate the annual visit days, the annual prescription days and the medical costs of hypertensive patients. Methods : The medical insurance records of 40,267 incident patients with the diagnostic code of hypertension from September 1998 through August 1999 in Daegu city were reviewed. Results : The proportion of the most proper medical care pattern group (Group VIII) who visited for 6-15 days with 240 prescription days or more a year was only 6.2%. The proper care group (Group IX) who visited for more than 16 days with 240 prescription days or more a year was 9.3%. The overall proper care group (Group VIII+IX) was therefore 15.5%. The proportion of the insufficient care group (Group I, IV) in both the number of visiting days and prescription days was 57.4%. The mean prescription day of the most proper group (Group VIII) was 29 days; the mean annual medical expenses,453,587won; the mean annual amount paid by patients, 218,013won; and mean medical expenses per prescription day, 1,483won. The proportion of the overall proper care group (Group VIII+IX) was significantly higher in adults aged 50-59, those who were enrolled in industrial workers health insurance as well as government employees and private school teachers health insurance, and those who made a higher contribution per month (p<0.01). According to the type of medical facilities, the proportion of the most proper medical care pattern group was highest in the general hospitals (9.3%) but the overall proper care group was higher in the public health centers (22.1%) and private clinics (17.1%). Conclusions : The management system of hypertension should be reinforced urgently. Therefore, it is necessary to develop guidelines including the number of visiting days per year and prescription days per visit day, and make the system provide medical facilities to more properly care for hypertensive patients.

• 한방비만학회지
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• 제20권2호
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• pp.138-148
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• 2020

Objectives: The aim of this study is to evaluate the effects of Bangpungtongseong-san (Fangfengtongsheng-san, BTS) and Daesiho-tang (Dachaihu-tang, DST) on weight loss and improvement in lipid metabolism and glucose metabolism. Furthermore, we intend to develop a prediction model for drug effects through the analysis of the single nucleotide polymorphism (SNP), gut-microbiota, and the expression of immune-related biomarkers. Methods: This study is a single-center, randomized, double-blind, parallel-design clinical trial. One hundred twenty-eight participants will be assigned to the BTS group (n=64) and DST group (n=64). Both groups will be administered 4 g medication three times a day for up to 2 weeks. The primary outcomes is weight loss. The secondary outcomes include bioelectrical impedance analysis, waist circumstance, body mass index, total cholesterol, high-density lipoprotein, triglyceride, insulin resistance. The exploratory outcomes include 3-day dietary recall, food frequency questionnaire, quality of life questionnaire, gut microbiota analysis, immune biomarkers analysis, and SNP analysis. Assessment will be made at baseline and at week 4, 8, and 12. Conclusions: This protocol will be implemented by approval of the Institutional Review Board of Dongguk University. The results of this trial will provide a systematic evidence for the treatment of obesity and enable more precise herbal medicine prescriptions.

• Journal of Yeungnam Medical Science
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• 제2권1호
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• pp.95-102
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• 1985

대구 및 그 인접지역의 질병 발생 경향을 추정하고, 영남대학교 의과대학 부속병원의 약제수급 계획을 위한 참고자료를 얻기 위하여, 1985년 3월부터 동년 8월까지 당 병원 외래에 내원한 환자들을 위하여 내려진 약물 처방을 전산 집계하여 다음과 같은 결과를 얻었다. 가장 빈번히 처방된 약물로 부터 100종의 약물을 처방빈도 순으로 나열하였던 바, diazepam, aluminum compound, acetaminophen, isoniazid, metoclopramide, $polaranine^{(R)}$, carboxymethylcystein, ephedrine, codeine, caroverine (이하생략) 등의 순으로 나타났으며, 이와 같이 선정된 100종의 약물을 임상용도별로 분류하여 총 처방회수 521,855회에 대한 백분율을 조사한 결과는 다음과 같다. 중추신경계약물 (20.57%)이 가장 많았고, 다음은 위장관 및 평활근에 작용하는 약물 (18.64%), 호흡기계약물 (16.11%), 항균제 (15.12%), 심혈관 계약물 (5.64%)의 순으로 많았으며, 그 다음은 소염제 (4.33%), 단독비타민제 (3.76%), 호르몬 및 항호르몬제 (3.29%), 감기치료제 (3.12%), 이뇨제 (2.81%), 간기능이상치료제 (2.02%), 자율신경계약물 (1.89%), 항히스타민제 (1.02%) 및 소독약 (0.74%) 등의 순으로 나타났다.

• 대한본초학회지
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• 제27권2호
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• pp.1-16
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• 2012

Objective : To investigate the current status of prescription drugs in Oriental medical institutes and to draw up a future plan for the revitalization of Oriental medical health insurance, this survey has been performed. Method : The survey has been made with 321 doctors working at Oriental medical institutes in Daegu and Kyungbuk areas for a period of 3 month from June 1, 2010 until September 1, 2010. Result : 1. When it comes to the current status of the use of herbal drugs in Oriental Health insurance, most of doctors surveyed prescribe insurance drugs, and they prescribe insurance drugs to patients, who are less than 20% of total patients visiting their clinics. 2. The awareness of Herbal Health Care Drugs is investigated. When it comes to the understanding of the difference between insurance drugs(powder type drugs) and granular type drugs, doctors admit that they differ only in one aspect, whether or not their being covered by health insurance. Based on the survey results on the understanding of insurance coverage of granular type drugs, doctors, even though they long for granular type drugs to be accepted as insurance drugs, are worrying whether the number of outpatients might dwindle due to increased insurance co-payments. They also point out that the biggest obstacles in the expansion of the granular type drugs as insurance drugs are the lack of understanding of the government and the objection of the Health Insurance Review and Assesment service (HIRA) for fear of increased insurance claims. 3. Upon investigation on Oriental medicine doctors' understandings of herbal pharmaceutical industry, it is found that doctors' responses on pharmaceutical industry are not all positive ones('new product development and neglect of R&D infrastructure' and 'smallness of industry'). When it is investigated what area needs the greatest improvement in herbal pharmaceutical industry, 'securing sufficient capital, good manufacturing, and strengthening quality control', is the highest. 4. When it is asked what are the most needed in order to improve herbal health insurance medicine, responses such as 'the increase in the accessibility to and the utilization of Oriental medical clinics through the diversification of the means of prescriptions', 'the improvement of insurance benefits(cap adjustments)', 'increase the proportion of high quality medicinal plants', 'the ceiling of co-payments(deductible) at 20,000 won or more', 'expansion of the choices of formulations', 'formulational expansions of tablets and pills', and finally 'admittance and expansion of granular type drug as insurance drug' are the highest. 5. Upon investigating the general characteristics of the current status of the usage of Oriental health care herbal drugs, the followings are observed. First, the frequency of use of health insurance drugs by the doctors who use health insurance with general characteristics shows similar differences in case of total monthly sales amount (p<0.001), average number of daily patients (p<0.05). Secondly, as to the willingness of the expanded usage of insurance drugs, similar differences are observed in case of total monthly sales amount (p<0.05). 6. Upon investigating the general characteristics of the perception of Herbal health care drugs, the followings are observed. First, inspecting general characteristics and insurance claims due to increased co-payments(deductible amount) reveals similar differences in case of working period (p<0.01) and in case of total monthly sales amount (p <0.01). Secondly, inspecting general characteristics and the obstacles that hinder granular type drugs from being accepted as health care insurance drugs shows similar differences in case of working period (p<0.05). 7. Upon investigating the general characteristics of the understanding of Oriental Herbal pharmaceutical companies, the followings are observed. First, opinions on the general characteristics of pharmaceutical companies, when examined with variance analysis, shows similar differences in case of total monthly sales amount (p<0.05). Secondly, when opinions are examined on general characteristics and the problems of herbal pharmaceutical companies, similar differences are found in case of working period (p<0.01) and in case of total monthly sales amount (p<0.001). Lastly, opinions on the general characteristics and reforms of pharmaceutical companies, similar differences are observed in case of working period (p<0.001). 8. Upon investigating the general characteristics of the improvement of insurance Herbal drugs, the followings are observed. First, regarding general characteristics and insurance benefits, similar differences are observed in case of working period (p<0.05), in case of total monthly sales amount (p<0.05), and in case of average number of daily patients (p<0.01). Secondly, opinions on the general characteristics and the needs for the improvement of Herbal insurance drugs are examined in 5 different aspects, which are the approval of granular type drugs as insurance drugs, the expanded practices of the number of prescription insurance drugs, the needs of a variety of formulations, the needs of TFT of which numbers of Oriental medical doctors are members for the revision of the existing system, and the needs of adjusting the current ceiling of the fixed amount and the fixed rate. When processed by the analysis of variance, the results show similar differences in case of average number of daily patients (p<0.01). Conclusion : From the results of this study the first measures to take are, to reform overall insurance benefit system, including insurance co-payment system(fixed rate cap adjustment), to expand the number of the herbal drugs to be prescribed matching with insurance benefit accordingly, and to revitalize herbal medicine insurance system through the change of various formulations. In addition, it is recommended to improve the effectiveness of herbal medicine by making plans to enhance the efficacy of herbal medicine and by enabling small pharmaceutical companies to outgrow themselves.

• 대한한의학방제학회지
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• 제15권1호
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• pp.185-197
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• 2007

Objective : This study was conducted to investigate the effects of Hwangryunhaedok-Tang and Geongangbuja-Tang on the change of interleukin-6 (IL-6) and tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$) level induced by LPS I.C.V. injection in mice. Method : We devided group into 6 mice and 6 mice were assingned to each group. In the normal group only saline was administered intragastrically, and in the control group LPS was injected intracerebroventricularly 1 hr after intragastric administration of saline. In the experiment groups Hwangryunhaedok-Tang(0.5g/kg, 1.0g/kg, 3.0g/kg) was administered intragastrically to mice 1 hr prior to LPS(100mg/mouse) I.C.V. injection.. Also Geongangbuja-Tang (0.5g/kg, 1.0g/kg, 3.0g/kg) was administered intragastrically to mice 1 hr prior to LPS(100mg/mouse) I.C.V. injection. To measure the plasma IL-6 and $TNF-{\alpha}$ level of mice, their blood samples were collected from retro-orbital plexus, immediately centrifuged at $4^{\circ}C$, and plasma was removed and stored frozen at $-83^{\circ}C$ for later determination of IL-6 and $TNF-{\alpha}$. The level of IL-6 and $TNF-{\alpha}$ production was measured by enzyme-linked immunosorbent assay in the plasma. Result : Regarding IL-6 level, The 0.5g/kg and the 1g/kg groups of Geongangbuja-Tang decreased IL-6 level. Especially the 3g/kg control group decreased IL-6 level significantly than the normal group(p<0.01). Regarding $TNF-{\alpha}$ level, the 3g/kg group of Geongangbuja-Tang decreased it significantly(p<0.05). Conclusion : These data revealed that Hwangryunhaedok-Tang might not have the anti imflammatory effect and Geongangbuja-Tang(3g/kg)might have the anti imflammatory effect by reducing the plasma IL-6 and $TNF-{\alpha}$ level in mice LPS Injection.EIM (Eighteen Incompatible Medicaments) is an important component in Oriental pharmacology and is directly related to clinical prescriptions. Medical practitioners argued that the definite cause and meaning of EIM was ambiguous and therefore debated the issue of clinical application of the EIM. This study conducted an in-depth literary research on the origin, meaning and contents of EIM with the purpose to contribute in its efforts to be used clinically. Even after thousands of years have past since establishment of Oriental medicine, EIM is still tabooed and was an obstacle that hindered ideologies. Modern herbal medicine texts claim that the use of EIM can reduce treatment effects and promote poisoning and side effects. However, since long ago, there has been medical practitioners who reject this as false. Recently, poisoning caused by EIM has been claimed to be from the toxicity of the drug itself, rather than the result of interaction between the drugs, and therefore they suggest that EIM is not a forbidden domain. In addition, EIM showed a difference in number depending on the era. However, this can be understood not as a definite number, but instead as a warning to be careful during combination of drugs for use as clinical medicine. Historically, there were very few cases in which EIM was used for clinical tests and thus, the clinical value is not, while others applied EIM directly to their bodies, which showed signs for the usefulness and potential of EIM for us. A more concrete and in-depth study must be made on EIM.

• 대한간호학회지
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• 제25권4호
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• pp.709-728
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• 1995

The job related activities of sixty nine nurses, working in the emergency rooms of three university hospitals, were analyzed for six days according to preestablished checklist of nursing activities ; the frequency of these activities and the amount of time spent in each specific nursing activity. The established checklist was monitored every five minutes for the duration of the duty autu, thus producing 414 items of data. The data were not gathered on consecutive days but over the period of one month from May 6, 1994 to June 5, 1994. The following conclusions are derived from analysis of the data : 1. Twelve categories of nursing activities were obtained : The primary activity was communication related to the patient and all information pertaining to the patient. Other activities included maintaining the patient's record, observation and assessment of the patient, cooperation with other medical personnel, management of equipment and drugs, procedure and treatment, specimen collection, consultation and education for the patient, including drug management and personal hygiene and any other relevant education to the patient's condition. 2. The average frequency of categorized nursing activity can be classified as follows : communication related to patient was the highest at 17.6 times. The next was maintaining the patient's record at 17.3 times. The observation and assessment occurred 16.9 times. Consultation and education for patients and family, 8 times, medication, 5.7 times, and procedures and treatments, 6 times. 3. The average time required for each activity was as follows : 230.1 minutes (or maintaining the patient's record, 204.9 minutes for communication related to the patient, 199.2 minutes for observation and assessment, 71.2 minutes for medication, 66 minutes for consultation and education of the patient and family, and 51.8 minutes for procedures and treatment. 4. The most demanding nursing activity in the emergency room for the nurse was answering questions from the patient's family, maintaining communication between the medical staff, maintaining and reviewing the patient's charts, writing prescriptions and monitoring 1. V. infusion rates. 5. The most time consuming nursing activities for the emergency room nurse include maintaining and following the patient's charts, communication between the medical staff, answering questions from the patient's family, observation of the patient and relaying all of the appropriate patient information to the incoming nurses during a shift change. 6. The F-test was administered to measure the required time for the categorized nursing activities according to day, evening, and night-shift nurses. There were significant differences (p<.05) in specimen collection, observation and assessment, cooperation between medical staffs, personal hygiene, communication related to patient, education and re-search. Posterior multiple comparison test showed that specimen collection, cooperation between medical staffs and personal hygiene were mostly done by the evening-shift nurses. Also most observations and assessments were done by the night-shift nurses. Education and communication to patients were done by day-shift nurses. Thus there were significant difference between shifts for the main nursing activities. So there should considev a reallocation of the duty of nurses on each shift. 7. The F-test also indicated that there wes a similarity in time duration for procedures and treatments and for cooperation between medical staff and nurses in all three hospitals. However, the remaining categories of nursing activities also showed a significant difference between the three hospitals. This indicated that there were differences in each emergency room that influence time for each categorized nursing activities and this should be given more consideration. Recommendations : 1. A seasonal difference should be considered in the activities of nurses in the emergency room and a comparative analysis should be carried out to deter-mine seasonal differentiation. 2. A study on more objectively measurable nursing activities should be administered as well as one determining the subjective responds towards nursing activities in the emergency room.