• Journal of Korean Neurosurgical Society
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• 제57권3호
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• pp.192-196
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• 2015

Objective : Tremor is a common movement disorder that interferes with daily living. Since the medication for tremor has some limitations, surgical intervention is needed in many patients. In certain patients who cannot undergo aggressive surgical intervention, Gamma Knife thalamotomy (GKT) is a safe and effective alternative. Methods : From June 2012 to August 2013, 7 patients with an intractable tremor underwent GKT. Four of these 7 patients had medical comorbidities, and 3 patients refused to undergo traditional surgery. Each patient was evaluated with the modified Fahn-Tolosa-Marin tremor rating scale (TRS) along with analysis of handwriting samples. All of the patients underwent GKT with a maximal dose of 130 Gy to the left ventralis intermedius (VIM) nucleus of the thalamus. Follow-up brain MRI was performed after 3 to 8 months of GKT, and evaluation with the TRS was also performed. Results : Six patients showed objective improvement in the TRS score. Excluding one patient who demonstrated tremor progression, there was 28.9% improvement in the TRS score. However, five patients showed subjective improvement in their symptoms. On comparing the TRS scores between follow-up periods of more and less than 4 months, the follow-up TRS score at more than 4 months of GKT was significantly improved compared to that at less than 4 months of GKT. Follow-up MRI showed radiosurgical changes in 5 patients. Conclusion : GKT with a maximal dose of 130 Gy to the VIM is a safe procedure that can replace other surgical procedures.

• 한국임상약학회지
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• 제32권1호
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• pp.27-36
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• 2022

Background: Medication-related problems (MRPs) frequently occur during the discharge period. Elderly patients, particularly, are at high risk for these problems due to polypharmacy and the use of potentially inappropriate medications. The purpose of this study was to build and implement collaboration between general hospital and community pharmacies to address MRPs among high-risk elderly patients before/after discharge. Methods: This retrospective study was conducted between June and December of 2020. The inclusion criteria were patients with aged ≥65 years; residents of Jeonju; discharged from Jeonbuk National University hospital; either on medication of exceeding 10 medications (or high-risk medications) after hospitalization through the emergency room, or having severe illness. Patients received medication reconciliation and counselling by hospital pharmacists before discharge and home-visit pharmaceutical care as follow-up by community pharmacists after discharge. Results: Twenty-two patients agreed to home-visit pharmaceutical services. Fifteen and 11 patients completed the first and second home-visit pharmaceutical care service, respectively. Forty-two MRPs were identified in 15 patients. The types of high-frequency MRPs were incorrect administration of drug, adverse drug reactions, medication non-compliance, drug-drug interactions, lifestyle modifications, and expired medication disposal. After consultation with the pharmacist, 34 out of 42 MRPs were resolved. Conclusions: Transitional care for high-risk elderly patients before and after discharge was successfully built and implemented through a collaboration between general hospital and community pharmacies. This study suggests that home-visit pharmaceutical services may have positive effects on the safe use of drugs during the transition period; however, additional research is needed to expand on these findings.

• 대한간호학회지
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• 제29권1호
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• pp.183-195
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• 1999

The purpose of this study is to describe the health care status of Korean Immigrants in New Zealand. The sample consisted of 155 Koreans who were randomly selected from the Korean Immigrants telephone book in Auckland, N.Z. They had health problems that required health management both physically (50.3%) and psychologically(70.3%). During the previous year, the average rate of medical contact with a general practitioner was 1$\pm$1.29 times. Korean immigrants who had health problems first attempted to resolve the problem through self medication rather than utilize health care services. They would only visit a general practitioner if they had severe subjective symptoms or no relief from self medication. Even if they think they need to visit the health care service, 41.9% of the subjects did not go back for follow-up care. Generally, the person who demonstrated positive health care behaviors was male, a college level graduate or higher, lived in N.Z. longer than 2 years, had a high score on health status by self assessment, and he placed few demands on health care services. Barriers to a healthy lifestyle are communication difficulties in expressing subjective symptoms, understanding the physician's treatment and medication plans, difficulty in accessing the appointment system and the high cost of service.

• Asian Pacific Journal of Cancer Prevention
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• 제16권4호
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• pp.1591-1597
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• 2015

Background: Korea has experienced rapid economic development in a very short period of time. A mixture of traditional and modern risk factors coexists and the rapid change in non-genetic factors interacts with genetic constituents. With consideration of these unique aspects of Korean society, a large-scale genomic cohort study-the Health Examinees (HEXA) Study-has been conducted to investigate epidemiologic characteristics, genomic features, and gene-environment interactions of major chronic diseases including cancer in the Korean population. Materials and Methods: Following a standardized study protocol, the subjects were prospectively recruited from 38 health examination centers and training hospitals throughout the country. An interview-based questionnaire survey was conducted to collect information on socio-demographic characteristics, medical history, medication usage, family history, lifestyle factors, diet, physical activity, and reproductive factors for women. Various biological specimens (i.e., plasma, serum, buffy coat, blood cells, genomic DNA, and urine) were collected for biorepository according to the standardized protocol. Skilled medical staff also performed physical examinations. Results: Between 2004 and 2013, a total of 167,169 subjects aged 40-69 years were recruited for the HEXA study. Participants are being followed up utilizing active and passive methods. The first wave of active follow-up began in 2012 and it will be continued until 2015. The principal purpose of passive follow-up is based on data linkages with the National Death Certificate, the National Cancer Registry, and the National Health Insurance Claim data. Conclusions: The HEXA study will render an opportunity to investigate biomarkers of early health index and the chronological changes associated with chronic diseases.

• Journal of Chest Surgery
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• 제47권4호
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• pp.358-366
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• 2014

Background: To improve sinus rhythm conversion, the Cox maze III procedure with narrow mazes (width: ${\leq}3.0cm$) was performed in combination with left atrial volume reduction. Methods: From October 2007 to April 2013, 87 patients with atrial fibrillation (paroxysmal in 3, persistent in 14, and permanent in 70) underwent the Cox maze procedure concomitant with another cardiac procedure. They were followed-up with serial electrocardiographic and echocardiographic studies. We used 24-hour Holter monitoring tests to evaluate postoperatively symptomatic patients. Results: At the mean follow-up time of 36.4 months, 81 patients (94.2%) had sinus rhythm and two were on anti-arrhythmic medication (one on a beta-blocker and the other on amiodarone). Five patients (5.8%) with postoperative recurrent and persistent atrial fibrillation never experienced sinus rhythm conversion; however, they did not require any medication for rate control. On postoperative echocardiography, the left atrial A waves were more frequently observed after concomitant mitral valve repair than after concomitant mitral valve replacement (82.4% vs. 40.4%, respectively; p<0.001). Conclusion: For the Cox maze procedure, narrow mazes and atrial volume reduction resulted in excellent sinus rhythm conversion without the preventive use of anti-arrhythmic drugs, and they did not affect the presence of the left atrial A waves on echocardiography.

• 생물정신의학
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• 제8권1호
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• pp.140-146
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• 2001

In clinical setting, treatment-refractoriness, medication induced tardive dyskinesia and amenorrhea in chronic schizophrenia are frequently problematic. However, there are few guideline solving these problem available to clinicians. The goal of this study was collecting clinical data on clinical effectiveness and predictors of response of switching to olanzapine. We attempted to switch to olanzapine from risperidone and clozapine in chronic 31(risperidone 17, clozapine 14) schizophrenia and schizoaffective disorder patients suffering from sustained symptoms, weekly blood monitoring, medication induced tardive dyskinesia and amenorrhea. Previous antipsychotics dosage was gradually decreased for 2 or 3weeks, at the same time olanzapine dosage was gradually increased. At baseline, after 1 week, after 2 weeks and after 4 weeks we checked Brief Psychiatric Rating Scale, Clinical Global Impression Scale, Sympson-Angus Rating Scale, Barnes Akathisia Rating Scale and followed up after 12 months. Successful switch after 4 weeks was achieved in 25 patients(clozapine 9(64.2%), risperidone 16(94.1%)). Overall, mean BPRS and CGI scores increased significantly. Successful maintenance after 12 months was achieved in 17 patients(clozapine 5(35.7%), risperidone 12(70.5%)). Overall, mean BPRS and CGI scores increased significantly too. Switching to olanzapine from other atypical antipsychotics is recommendable in chronic schizophrenia with treatment refractoriness and drug induced side effect.

• Journal of Korean Neurosurgical Society
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• 제61권2호
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• pp.201-211
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• 2018

Objective : The purpose of this study was to analyze the variability of clopidogrel responses according to duration of a clopidogrel drug regimen after stent-assisted coil embolization (SAC), and to determine the correlation between the variability of clopidogrel responses and thromboembolic or hemorrhagic complications. Methods : A total of 47 patients who underwent SAC procedures to treat unruptured intracranial aneurysms were enrolled in the study. Preoperatively, patients received more than seven days of aspirin (100 mg) and clopidogrel (75 mg), daily. P2Y12 reaction unit (PRU) was checked with the VerifyNow test one day before the procedure (pre-PRU) and one month after the procedure (post-PRU). PRU variability was calculated as the difference between the initial response and the follow-up response. Patients were sorted into two groups based on their response to treatment : responsive and hypo-responsive. Results : PRU variability was significantly greater in the hypo-responsive group when compared to the responsive group (p=0.019). Pre-PRU and serum platelets counts were significantly correlated with PRU variation (p=0.005 and p=0.004, respectively). Although thromboembolic complication had no significant correlated factors, hemorrhagic complication was correlated with pre-PRU (p=0.033). Conclusion : In conclusion, variability of clopidogrel responses during clopidogrel medication was correlated to serum platelet counts and the initial clopidogrel response. Thromboembolic and hemorrhagic complications did not show correlation with the variability of clopidogrel response, or the clopidogrel response after one month of medication; however, hemorrhagic complication was associated with initial clopidogrel response. Therefore, it is recommended to test patients for an initial clopidogrel response only, as further tests would be insignificant.

• Journal of Menopausal Medicine
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• 제24권3호
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• pp.204-209
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• 2018

Objectives: Aim of present study was designed to investigate the soporific effect of fennel among menopausal women. Methods: The present double-blinded and placebo-controlled trial examined the fennel effect on Pittsburgh Sleep Quality Index (PSQI). Total score and relevant 7 components, including sleep duration, sleep latency, use of sleeping medication, subjective sleep quality, sleep disturbances, daytime dysfunction and habitual sleep efficiency among 50 menopausal women compared to control group within a 12-week follow-up. Results: The patients in both groups reported no certain side effects and all subjects completed the study. The mean actual sleep duration was 5 hours and 66 minutes. Intergroup comparison revealed no statistically significant differences in the mean total PSQI score (P = 0.439), subjective sleep quality (P = 0.826), habitual sleep efficiency (P = 0.127), sleep disturbances (P = 0.130), use of sleeping medication (P = 0.52) and daytime dysfunction (P = 0.439). A tendency toward significant between 2 groups was seen concerning the sleep duration (P = 0.059). Intergroup comparison showed significantly borderline levels (P = 0.059). Conclusions: The treatment of 12 weeks with fennel caused a slight effect that did not reach to significant. These findings should be considered cautiously because of small sample size, short-term follow-up and subjective measure of sleep quality.

• Nutrition Research and Practice
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• 제13권2호
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• pp.141-149
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• 2019

BACKGROUND/OBJECTIVES: This study examined the association between refined grain consumption by subtype and the incidence of hypertension from the Korean Genome and Epidemiology Study data. SUBJECTS/METHODS: In total, 5,018 participants (2,439 men and 2,579 women) from 40 to 69 years without hypertension were recruited at the beginning (2001-2002). Blood pressure and antihypertensive medication use were assessed biennially for the incidence of hypertension during the 8-year follow-up period (2009-2010). Hypertension was diagnosed as systolic blood pressure ${\geq}140mmHg$ or diastolic blood pressure ${\geq}90mmHg$ or antihypertensive medication use. Dietary intake including refined grains was assessed by a food frequency questionnaire at baseline and the follow-up (2005-2006). A multivariate Cox proportional hazard model was used to examine hazard ratios (HRs) and 95% confidence intervals (CIs) for incident hypertension according to refined-grain consumption. RESULTS: A total of 1,377 cases of hypertension (710 men and 667 women) were newly ascertained. Frequent noodle consumers (${\geq}5servings/week$) among the women had a 2.3-fold higher risk of hypertension than infrequent noodle consumers after adjustment for potential confounders (HR = 2.31, 95% CI = 1.33-4.01, P for trend = 0.0001). However, no significant association was found among the men. The intake of other refined grain products such as white rice and breads was not associated with the incidence of hypertension. CONCLUSION: Frequent noodle consumption was positively associated with a risk of incident hypertension in South Korean women.

• Clinical and Experimental Pediatrics
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• 제50권5호
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• pp.484-488
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• 2007

목 적 : VPA치료를 받는 소아 청소년기 간질환자들에서 체중증가의 비율과 체중증가에 관련되는 예측 인자를 알아보고자 하였다. 방 법 : 2001년 1월 1일부터 2004년 12월 31일까지 VPA 치료를 받기 시작한 8세에서 17세까지의 환아를 대상으로 하였다. 제외기준은 치료 시작후 6개월 이내 치료가 중단된 경우, 체중에 영향을 주는 약물을 병합한 경우 등이었다. VPA 치료 시작시와 치료 시작 후 한번이상 재방문시에 체중과 신장이 측정되어 두 시점에서 BMI를 측정한 후 대상 환아들을 백분위수에 따라 4가지의 BMI군으로 분류하여 BMI군의 상승여부를 조사했으며 체중증가율을 의미하는 BMI difference를 계산하였다. 또한 체중증가에 영향을 미치는 여러 인자들을 회귀분석 하였다. 결 과 : 전체 36명중 총 8명의 환아가 VPA 치료전보다 최소 한 단계 이상의 BMI군의 상승변화를 보였으며 대상환아의 72.2%에서 체중증가(BMI difference의 증가)를 나타내었다. 신경정신 발달(P=0.017), 간질 형태(P=0.001), 투약기간(P=0.035)은 통계적으로 유의한 체중증가에 영향을 미치는 예측인자였다. 결 론 : VPA는 간질 환아에서 체중증가를 유발하며 정상 신경정신 발달, 전신 발작형 간질, 12개월 이상의 투약기간이 체중증가의 예측인자로 생각된다. 따라서 VPA 치료를 받는 소아 간질환자에서는 치료 시작 전에 VPA로 인한 체중증가의 가능성을 고려하여 치료 받는 중 BMI의 지속적인 감시측정이 필요할 것으로 생각된다.