• Title/Summary/Keyword: Frequency of prescription

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Treat-to-Target Strategy for Asian Patients with Early Rheumatoid Arthritis: Result of a Multicenter Trial in Korea

  • Song, Jason Jungsik;Song, Yeong Wook;Bae, Sang Cheol;Cha, Hoon-Suk;Choe, Jung-Yoon;Choi, Sung Jae;Kim, Hyun Ah;Kim, Jinseok;Kim, Sung-Soo;Lee, Choong-Ki;Lee, Jisoo;Lee, Sang-Heon;Lee, Shin-Seok;Lee, Soo-Kon;Lee, Sung Won;Park, Sung-Hwan;Park, Won;Shim, Seung Cheol;Suh, Chang-Hee;Yoo, Bin;Yoo, Dae-Hyun;Yoo, Wan-Hee
    • Journal of Korean Medical Science
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    • v.33 no.52
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    • pp.346.1-346.11
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    • 2018
  • Background: To evaluate the therapeutic benefits of the treat-to-target (T2T) strategy for Asian patients with early rheumatoid arthritis (RA) in Korea. Methods: In a 1-year, multicenter, open-label strategy trial, 346 patients with early RA were recruited from 20 institutions across Korea and stratified into 2 groups, depending on whether they were recruited by rheumatologists who have adopted the T2T strategy (T2T group) or by rheumatologists who provided usual care (non-T2T group). Data regarding demographics, rheumatoid factor titer, anti-cyclic citrullinated peptide antibody titer, disease activity score of 28 joints (DAS28), and Korean Health Assessment Questionnaire (KHAQ) score were obtained at baseline and after 1 year of treatment. In the T2T group, the prescription for disease-modifying antirheumatic drugs was tailored to the predefined treatment target in each patient, namely remission (DAS28 < 2.6) or low disease activity (LDA) ($2.6{\leq}DAS28$ < 3.2). Results: Data were available for 163 T2T patients and 162 non-T2T patients. At the end of the study period, clinical outcomes were better in the T2T group than in the non-T2T group (LDA or remission, 59.5% vs. 35.8%; P < 0.001; remission, 43.6% vs. 19.8%; P < 0.001). Compared with non-T2T, T2T was also associated with higher rate of good European League Against Rheumatism response (63.0% vs. 39.8%; P < 0.001), improved KHAQ scores (-0.38 vs. -0.13; P = 0.008), and higher frequency of follow-up visits (5.0 vs. 2.0 visits/year; P < 0.001). Conclusion: In Asian patients with early RA, T2T improves disease activity and physical function. Setting a pre-defined treatment target in terms of DAS28 is recommended.

A Study on a paradigm of Radix Aconiti(附子) in the treatment of heart-systemic disease(心系疾患) due to heat syndrome(熱證) (심계영역질환(心系領域疾患) 화열증(火熱證)에 사용된 부자(附子)의 활용(活用)에 대한 문헌적(文獻的) 연구(硏究))

  • Lee, Kyung-Ae;Kweon, Jung-Nam;Lee, Won-Chul
    • The Journal of Dong Guk Oriental Medicine
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    • v.6 no.2
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    • pp.145-165
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    • 1998
  • We inquired into the prescription including Radix Aconiti(附子) on the records of the past. According to the role of Radix Aconiti(附子), we can divide into four group. (1) In the case of excess in the upper and deficiency in the lower(上盛下虛), heat in the upper and cold in the lower(上熱下寒), Radix Aconiti(附子) supplies the fire from the gate of life(命門火) and the fire of deficiency type(虛火) is recurred into the origine(根源) by it. (2) In the case that Yang(陽) is kept externally by Yin(陰)-excess in the interior(陰盛格陽), and there is heat syndrome in the exterior with cold syndrome in the interior(裏寒外熱), Radix Aconiti(附子) can remove cold(祛寒) and revitalizes(回陽). (3) In the case of the heat of excess type syndrome(實熱證), Radix Aconiti(附子) treats heat-syndrome(熱證) with heat-clearing(淸熱) drug. (4) In the case of wind-syndrome(風證) and phlegm-syndrome(痰證), Radix Aconiti(附子) supplies the kidney-Yang(元陽) and promotes movement of the other drugs. According to frequency in use of drugs, we can divide into four group. (1) In e case of the fire of deficiency type(虛火), Radix Aconiti(附子) is used with drugs of invigorating-Yin(補陰), invigorating-Yang(補陽) and diuresis(利水), such as Rhizoma rehmanniae(熟地黃), Cortex cinnamomi(肉桂), Fructus comi(山茱萸), Poria, etc. (2) In the case that Yang is kept externally by Yin(陰)-excess in the interior(陰盛格陽), Radix Aconiti(附子) is used with drugs of dispelling cold(祛寒) and revitalization(回陽), such as Rhizoma zingiberis siccatum(乾薑), Radix glycyrrhizae(甘草), Radix ginseng(人蔘), etc. (3) In the case of the heat of excess type syndrome(實熱證), Radix Aconiti(附子) is used with drugs of heat-clearing(淸熱), such as Rhizoma coptidis(黃蓮). (4) In the case of wind-syndrome(風證) and phlegm-syndrome(痰證), Radix Aconiti(附子) is used with drugs of dispersing(發散), invigorating(補氣), enriching the blood(補血), removing the phlegm(去痰), heat-clearing(淸熱). such as Radix oxterici koreani(羌活), Radix ledebouriellae(防風), Radix ginseng(人蔘), Radix angelicae gigantis(當歸), etc. Especially in many of cases, Radix Aconiti(附子) is used with drugs of nourishing-Yin(滋陰), but it is hardly used with drugs of treating middle-jiao energy(中氣).

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Current Status of Symptom and Pain Control in Cancer Patients Treated with Chemotherapy (화학요법을 받는 암환자의 증상 및 통증조절 현황)

  • Chung, Young;Na, Duck-Mi;Kim, Jin-Sun;Yang, Kyung-Mi
    • Journal of Hospice and Palliative Care
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    • v.6 no.2
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    • pp.144-151
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    • 2003
  • Purpose : The purpose of this study was to identify the current status of symptom and pain control in cancer patients treated with chemotherapy. Methods : The study population consisted of 66 cancer patients treated with chemotherapy and the data was collected by chart audit and using questionnaire from 19 clinicians in an university hospital during the period of August 7 to 24, 2001. The degree of symptom, analgesics type, dose, administration route, and pain control method of cancer patients treated with chemotherapy was investigated. The collected data were analyzed by frequency, percent, mean, and SD using SPSS $PC^+$ program. Results : The number of cancer patients treated with chemotherapy was 66, male 35 (53.0%), female was 31 (47.0%). The largest of age group was $61{\sim}69$(34.8%) years old. Most frequent cancer site was stomach 19 case (28.8%), cole-rectal 17 case (25.8%), urinary 11 case (16.7%) in the respective order. The most common stage of cancer was stage 3, 14 case (29.2%). The most frequent duration of diagnosis was under 3 month, 25 (37.9%). The frequent symptom of cancer patients treated with chemotherapy was marasmus ($2.4193{\pm}1.2220$), pain ($1.9333{\pm}1.2194$), sleep disorders ($1.7142{\pm}1.0384$), personality change ($1.5806{\pm}0.8971$) in the respective order. 3) The analgesics used for pai control were narcotic analgesics 66.2% and nonnarcotic analgesics 33.8%. Pain control method were regular basis+as needed 47.4%, as needed 31.6%, regular basis 21.0% in order. Administration route were oral 50.7%, injection 41.8%, patch 7.5% in order. Conclusion : The most frequent symptom of cancer patients treated with chemotherapy were marasmus and pain. The frequent analgesics was narcotic analgesics but 21% of the clinician regularly prescribed analgesics for pain control. Thus this prescription was insufficient for pain control. Administration route that were used more oral or injection than patch. Based on this evidence, it seemed that more active practice and education about evaluation and pain control of cancer patients treated with chemotherapy are needed.

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Vegetation of Jangdo Island (장도의 식생)

  • Choi, Byoung-Ki;Kim, Jong-Won;Kim, Seong-Yeol;Lim, Jeong-Cheol
    • Korean Journal of Environment and Ecology
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    • v.26 no.4
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    • pp.512-527
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    • 2012
  • Jangdo Island (area $1.54km^2$) located in the western end of Dadohae Haesang National Park has been recognized as an prominent ecoregion possessing high moor and national biodiversity hotspot. In terms of the Z$\ddot{u}$rich-Montpellier School's phytosociology, we investigate the diversity of plant communities on the island and reevaluate the Jangdo wetland designated as Ramsar site. Ten physiognomic types of the Jangdo's vegetation were classified into 22 syntaxa (3 associations, 15 communities and 4 subcommunities). Jangdo wetland was actually denominated as 'eutrophic wetland' by Pharagmitetea and Orizetea rather than 'high moor'. Nevertheless, existence value of the Jangdo wetland is evaluated very high as a stepping stone for migratory birds and even plant dispersions. A new site of the northernmost distribution of Arachniodo-Castanopsietum sieboldii, which is a kind of cold-resistant phytocoenosis among the Camellietea japonicae of the warm-temperate broad-leaved forests, was described. Hosta yingeri-Carpinus turczaninovii var. coreana community and Carex wahuensis var. robusta-Juniperus chinensis var. procumbens community were described specifically as an endemic and an edaphic vegetation type, respectively. The unique Jangdo's vegetation reflects regional environmental conditions such as much higher frequency of frost-free days and the highest number of annual average foggy days in Korea and a well-developed aquifer in the depressed basin formed by differential erosion. We identified that human interventions (pasture, logging, forest fire, cultivation, etc.) has been involved intensively on every vegetation types, even though a rugged and inaccessible topography of the island. Particularly the Jangdo wetland has been recently threatened by fundamental distortion on hydrological system. We request an immediate establishment of the conservation prescription manual.

Usefulness of Rotation for Toric Soft Lenses Using Objective Refraction (타각적 굴절검사를 이용한 토릭 소프트 렌즈 회전 평가의 유용성)

  • Yu, Dong-Sik;Moon, Byeong-Yeon;Son, Jeong-Sik
    • Journal of Korean Ophthalmic Optics Society
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    • v.16 no.3
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    • pp.265-272
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    • 2011
  • Purpose: The clinical usefulness of rotation evaluation using objective refraction in toric soft lenses fitting was investigated. Methods: Toric soft lenses were fitted for 32 subjects (64 eyes; mean age of 24.69 ${\pm}$ 1.65 years) with astigmatism and both eyes of each subject were fitted with toric soft lenses. Objective refraction-based lenses rotation was evaluated from refraction and over-refraction data by indirect calculating technique. These calculated data were compared with the measured data from slit lamp with direct measuring technique. Results: Orientation of toric soft lenses around zero position (within ${\pm}$ 5$^{\circ}$ vertical line) was investigated. The orientations to the direction of nose of measured and calculated values were 69.78% and 63.64%, respectively, which showed similar values between two techniques. Agreement frequency between measured and calculated values in the magnitude of lenses rotation 54.69% and 82.82% for 10$^{\circ}$ and 20$^{\circ}$ of vertical line, respectively. The 95% limits of agreement between calculation and measurement were from -10.08$^{\circ}$ to 12.65$^{\circ}$, and mean difference was 1.29$^{\circ}$ within ${\pm}$ 10$^{\circ}$. The result showed there was no significant difference (p = 0.1984) and high correlation (r = 0.56, p = 0.0004) between two techniques. But the 95% limits of agreement was widen in ${\pm}$ 20$^{\circ}$ of vertical line. The magnitude of lens rotation between two methods was 9.66 ${\pm}$ 6.16$^{\circ}$, 16.17 ${\pm}$ 12.38$^{\circ}$ and 10.58 ${\pm}$ 12.02$^{\circ}$ for normal, loose and tight fitted conditions. Conclusions: From the results with smaller difference between two techniques, it was found that higher availability of subjective over-refraction data can be used as a supplementary tool for subjective refraction. An application using objective refraction with direct measuring could be provide high success in prescription on toric soft lenses.

A Study of Current Perception Threshold of Trigeminal Nerve after Tooth Implantation (치아임플란트 시술 후 삼차신경에서의 전류인지역치에 대한 연구)

  • Lim, Hyun-Dae;Lee, Jung-Hyun;Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.32 no.2
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    • pp.187-200
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    • 2007
  • This study attempted to contribute to the clinical application of implant operation by making a quantitative nerve examination using a neurometer for the evaluation of sensory disturbances that could be incurred after the implantation in the dental clinics, and it intended to establish an objective guideline in the evaluation of sensory nerve after the operation of implant. An inspection was performed with the frequencies of 2000Hz, 250 Hz and 5 Hz before and after the operations of tooth implant using $Neurometer^{(R)}$ CPT/C (Neurotron, Inc. Baltimore, Maryland, USA) for 44 patients who had performed an implant operation among the patients coming to Daejeon Sun Dental Hospital in 2006 and 30 people for control group. The measuring sites were maxillary nerve ending and mandibular nerve ending of trigeminal nerve according to the implant operating regions. The current perception threshold (CPT) by each nerve fiber was specifically responded under the electric stimulation of 2000 Hz in case of $A{\beta}$ fiber and of 250 Hz in case of $A{\delta}$ fiber and of 5Hz in case of C fiber. The CPT test could be performed to assess the damages of peripheral nerve in the trigeminal nerve area and it stimulated selective nerve fibers by generating the electricity of specific frequency in the peripheral nerve area. The nerve fibers with varied thickness were responsive selectively to the electric stimulation with different frequencies; accordingly, they applied the electric stimulation with different frequencies and the reaction threshold of $A{\beta},\;A{\delta}$ and C fibers selectively responsive to each electric current could be individually evaluated. In the assessment through the CPT, the increase and decrease of the CPT could be measured so that sensory disturbances such as hyperaesthesia or hypoaesthesia could be diagnosed. This study could obtain the following results after the assessment of the CPT before and after the implant operation. 1. In the assessment before and after the implant operation, the CPT in the frequencies of 2000 Hz, 250 Hz, 5 Hz for maxillary branch increased on the whole after the operation and the CPT for mandibular branch in the $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz )after the operation increased statistically significantly. 2. For the groups of patients with medically compromised or its subsequent medicinal prescription, there were no significant differences before and after the implant operation and for the control groups, significantly high CPT was shown after the implant operation in the left $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz). 3. In the comparison of the measured value of the CPT before the operation between the control group and the implant operation group, the latter group had a significantly high measured value of the CPT in the right $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz) and there were significant differences in $A{\beta}$-fiber(2000 Hz) in the CPT assessment after the implant operation for the control group. 4. Male participants had higher CPT than female counterparts; however, there were no statistic significances. In the CPT evaluation before and after implant operation, there were no statistical differences in the male group while the right C-fiber(5 Hz) and left $A{\beta}$-fiber(2000Hz) were significantly high in the female group. 5. In the comparison between the group who complain sensory disturbance and the other group, the CPT increased on the whole in the former group, but there were no statistical significances. In the groups, whom there was an increase in VAS, the CPT after the implant operation in the right C-fiber(5 Hz) increased significantly; meanwhile, in case that the VAS mark was '0' before and after the operation, the CPT after the operation in the left $A{\beta}$-fiber(2000 Hz) increased significantly. This study suggested that the CPT measurements using $Neurometer^{(R)}$ CPT/C, provide useful information of objective and quantitative sensory disturbances for tooth implantation.