• 대한한방소아과학회지
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• 제35권3호
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• pp.67-88
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• 2021

Objectives The purpose of this study is to analyze randomized clinical trials (RCTs) on traditional Chinese medicine to summarize its efficacy and safety for the treatment of functional gastrointestinal disorders (FGIDs) in children. Methods We searched literatures published up to March 19, 2021 using two Chinese electronic databases. Data regarding patients, interventions, results, and adverse events were extracted from RCTs of herbal medicine for children with FGIDs. Results A total of 34 RCTs were included: 16 trials on functional dyspepsia, 7 trials on functional constipation, 6 trials on functional abdominal pain, 4 trials on irritable bowel syndrome, and 1 trial on functional diarrhea. 26 of 29 trials that reported total effective rate, the treatment group showed a significant improvement compared to the control group. Most of other evaluation indicators, such as symptom score, symptom disappearance time, and recurrence rate also demonstrated statistically significant improvement. Of the 16 studies which reported safety, 5 studies reported no adverse reactions in either group, and 4 studies reported no statistically significant differences in the incidence of adverse events between two groups. Also, reported adverse events were mostly mild. Conclusions Herbal medicine may help improve symptoms of FGIDs in children. However, due to limited types of studies on sub-diseases of FGIDs and small sample sizes in each study, additional large scale clinical studies on various other FGIDs are necessary.

• 한국임상약학회지
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• 제19권2호
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• pp.105-109
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• 2009

In July 2008, The National Police Hospital has developed the CPOE system(Computerized Physician Order Entry system) which links the medicine master and introduced the new program for the injectable antimicrobial agents. After introducing new system, we wanted to check the management of oral antimicrobial agents. Because new system has limitation that new system control only the use of the injectable antimicrobial agents. So we tried to evaluate the use of oral levofloxacin, which was chosen by a medical specialist of the infection. We retrospectively analyzed the appropriateness of oral levofloxacin through EMR(Electric Medical Record) of 72 inpatients who received oral levofloxacin in National Police Hospital in December 2008. We applied the modified ASHP(American Society of Health- System Pharmacists) DUE(Drug Use Evaluation) criteria, which is composed of justification of drug use, critical indicators, complications and outcome measures. Acceptable cases of use of levofloxacin were 67(93.01%) and 57cases(79.2%) showed good outcome. However critical indicators were not performed very well. We want to suggest the new system for the management of the medical therapeutics by the pharmacist in charge.

• Journal of Chest Surgery
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• 제57권1호
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• pp.44-52
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• 2024

Background: Visceral pleural invasion (VPI) is a poor prognostic factor that contributes to the upstaging of early lung cancers. However, the preoperative assessment of VPI presents challenges. This study was conducted to examine intraoperative pleural carcinoembryonic antigen (pCEA) level and maximum standardized uptake value (SUVmax) as predictive markers of VPI in patients with clinical T1N0M0 lung adenocarcinoma. Methods: A retrospective review was conducted of the medical records of 613 patients who underwent intraoperative pCEA sampling and lung resection for non-small cell lung cancer. Of these, 390 individuals with clinical stage I adenocarcinoma and tumors ≤30 mm were included. Based on computed tomography findings, these patients were divided into pleural contact (n=186) and non-pleural contact (n=204) groups. A receiver operating characteristic (ROC) curve was constructed to analyze the association between pCEA and SUVmax in relation to VPI. Additionally, logistic regression analysis was performed to evaluate risk factors for VPI in each group. Results: ROC curve analysis revealed that pCEA level greater than 2.565 ng/mL (area under the curve [AUC]=0.751) and SUVmax above 4.25 (AUC=0.801) were highly predictive of VPI in patients exhibiting pleural contact. Based on multivariable analysis, pCEA (odds ratio [OR], 3.00; 95% confidence interval [CI], 1.14-7.87; p=0.026) and SUVmax (OR, 5.25; 95% CI, 1.90-14.50; p=0.001) were significant risk factors for VPI in the pleural contact group. Conclusion: In patients with clinical stage I lung adenocarcinoma exhibiting pleural contact, pCEA and SUVmax are potential predictive indicators of VPI. These markers may be helpful in planning for lung cancer surgery.

• 동의생리병리학회지
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• 제27권5호
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• pp.587-593
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• 2013

Exhaustion syndrome(虛勞) became broadly experienced symptoms in Korean population. In this work, we carried out a systematic literature review on exhaustion syndrome(ES) and chronic fatigue. We searched through the databases Koreanstudies Information Service System, Oriental Medicine Advanced Searching Integrated System, DataBase Periodical Information Academic for the articles published between 1994 and 2013, with the keywords 'exhaustion syndrome(虛勞)', 'consumption(虛損)', 'overexertion syndrome(勞倦)', 'fatigue', 'chronic fatigue' and 'degree of fatigue'. Among the first-run rough-searched 602 articles, we narrowed down the scope within the field of Oriental medicine (126 articles), and finally selected 28 articles appropriate to the intended research field; the selected articles were categorized by literature study(7 papers), clinical treatment (7), clinical diagnosis (5), treatment effects of herbal medicine (2), diagnosis in Sasang medicine and treatment effect of dry cupping therapy (2), and questionnaire-based diagnosis (5). We found that the overall research level on ES remained in the preliminary stages, and more efforts are needed in the field of terminology definition and standardization of diagnosis, and treatment efficacy validation beyond muscle fatigue. Finally, to develop reliable diagnostic devices on ES, we proposed a study design that included the development of objective ES diagnostic indicators and a clinical validation procedure.

• Clinical and Experimental Pediatrics
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• 제60권11호
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• pp.353-358
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• 2017

Purpose: To develop and evaluate a simple screening tool to assess hearing loss in newborns. A derived score was compared with the standard clinical practice tool. Methods: This cohort study was designed to screen the hearing of newborns using transiently evoked otoacoustic emission and auditory brain stem response, and to determine the risk factors associated with hearing loss of newborns in 3 tertiary hospitals in Northern Thailand. Data were prospectively collected from November 1, 2010 to May 31, 2012. To develop the risk score, clinical-risk indicators were measured by Poisson risk regression. The regression coefficients were transformed into item scores dividing each regression-coefficient with the smallest coefficient in the model, rounding the number to its nearest integer, and adding up to a total score. Results: Five clinical risk factors (Craniofacial anomaly, Ototoxicity, Birth weight, family history [Relative] of congenital sensorineural hearing loss, and Apgar score) were included in our COBRA score. The screening tool detected, by area under the receiver operating characteristic curve, more than 80% of existing hearing loss. The positive-likelihood ratio of hearing loss in patients with scores of 4, 6, and 8 were 25.21 (95% confidence interval [CI], 14.69-43.26), 58.52 (95% CI, 36.26-94.44), and 51.56 (95% CI, 33.74-78.82), respectively. This result was similar to the standard tool (The Joint Committee on Infant Hearing) of 26.72 (95% CI, 20.59-34.66). Conclusion: A simple screening tool of five predictors provides good prediction indices for newborn hearing loss, which may motivate parents to bring children for further appropriate testing and investigations.

• 대한임상검사과학회지
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• 제48권4호
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• pp.312-320
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• 2016

본 연구는 금식 여부에 따른 혈당치 분포 차이를 분석하였고 공복 혈당치와 혈당조절지표인 당화혈색소, 프록토사민, 1,5-AG의 상관성을 분석하여 전당뇨병 선별에 필요한 추가 정보를 제공하고자 하였다. 단국대학교병원에 내원한 707명의 외래 환자를 금식 군과 비금식 군으로 나누어 혈당 검사를 시행한 후 각 군의 혈당치 평균을 산출하고 성별, 연령별 및 임상과 별 결과치 분포를 분석을 하였다. 또한 건강검진을 목적으로 내원한 금식 상태의 153명에 대해 혈당치와 당화혈색소, 프록토사민, 1,5-AG을 측정하여 혈당치와 혈당조절지표의 상관성을 평가하였다. 비금식 군의 혈당 평균치는 111.9 mg/dL, 금식 군은 103.6 mg/dL로서 유의한 차이가 있었고 (p<0.05) 평균치 차이는 여자가 4.8 mg/dL로서 남자의 12.2 mg/dL보다 적었다. 연령대에 따른 중앙값의 차이는 비금식 군에서만 유의한 차이가 있었고(Kruskal-Wallis test, p<0.01) 금식 군에서는 유의하지 않았다. 공복 시 포도당 장애 선별 구간에서 혈당 농도와 상관성이 높은 검사 종목은 1,5-AG로 평가되었다. 저자들은 금식 여부에 따른 혈당치 분포의 차이를 외래 환자를 대상으로 분석하였으며, 건강검진 대상자의 결과치 분석을 통해 1,5-AG가 프록토사민, 당화혈색소보다 공복 혈당치와 유의한 상관성이 있는 것으로 평가하였다. 당뇨병 선별 시 혈당 측정과 함께 단기 혈당 조절능력을 반영하는 지표가 활용될 수 있을 것으로 사료된다.

• 대한임상독성학회지
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• 제6권1호
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• pp.25-31
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• 2008

Purpose: Acute organophosphate (OP) poisoning may be monitored by measuring the acetylcholinesterase (AChE). It is important to assess severity and establish prognostic tests in the early stage of OP poisoning. The aim of this study was to look at the relationship between various clinical aspects of the OP poisoning, prognostic indicators of OP poisoning including Simplified Acute Physiology Score (SAPS) 3, and the associated changes in AChE levels. Methods: Clinical data and initial AChE levels from thirty-seven patients with OP poisoning were prospectively reviewed from 12 teaching hospitals in South Korea from August 2005 to July 2006. Clinical manifestations at the time of arrival such as miosis, respiratory abnormality, salivation, urinary incontinence, GCS score, AVPU scale, need for intubation, and mechanical ventilation requirements were recorded. SAPS 3 was calculated using clinical data and laboratory results. Results: The median level of AChE was 9.8 (1.3-53.6) U/gHb. There was no significant difference in AChE levels between the groups with and without cholinergic symptoms. The median level of AChE of the patients who required intubation and those who did not were 3.5 U/gHb and it 19.7 U/gHb respectively (Mann-Whitney test; p<0.001). The AChE levels were also significantly different (p=0.007) in patients who needed mechanical ventilation compared to those who did not with AChE levels found to be 3.1 U/gHb and it was 14.8 U/gHb, respectively. Level of consciousness assessed using the AVPU scale was correlated with AChE levels (Kruskal-Wallis test; p=0.013). GCS score were correlated with AChE levels (p=0.007, Spearman's rho = 0.454). In addition, the lower the level of initial AChE, the longer the ICU stay (p=0.029, Spearman's rho=-0.380). SAPS 3 was inversely correlated with the initial AChE (p<0.001, Spearman's rho=-0.633). Conclusion: In the acute OP poisoning, low AChE levels appear to help indicate the severity of poisoning. The initial AChE level may be a useful prognostic parameter for acute OP poisoning.

• Journal of Preventive Medicine and Public Health
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• 제45권3호
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• pp.127-136
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• 2012

The challenge facing the Korean National Health Insurance includes what to spend money on in order to elevate the 'value for money.' This article reviewed the changing issues associated with quality of care in the Korean health insurance system and envisioned a picture of an effective pay-for-performance (P4P) system in Korea taking into consideration quality of care and P4P systems in other countries. A review was made of existing systematic reviews and a recent Organization for Economic Cooperation and Development survey. An effective P4P in Korea was envisioned as containing three features: measures, basis for reward, and reward. The first priority is to develop proper measures for both efficiency and quality. For further improvement of quality indicators, an electronic system for patient history records should be built in the near future. A change in the level or the relative ranking seems more desirable than using absolute level alone for incentives. To stimulate medium- and small-scale hospitals to join the program in the next phase, it is suggested that the scope of application be expanded and the level of incentives adjusted. High-quality indicators of clinical care quality should be mapped out by combining information from medical claims and information from patient registries.

• Journal of Trauma and Injury
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• 제20권2호
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• pp.83-89
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• 2007

Purpose: This research was performed to determine which clinical signs and symptoms of brain injury are sensitive indicators of skull fracture (SF) and intracranial injury (ICI) in head injured children. Methods: We conducted a prospective study of minor head trauma in children younger than 2 years of age for a 1-year period. Skull radiographs, brain computed tomography (CT), and data forms, including mechanism of injury, symptoms, physical findings, and hospital course, were completed for each child. Results: Of 137 study subjects, 17 (12.4%) had SF/ICI. Falls were the most common mechanism of injury, and heights of fall above 1 meter were associated with incidence of SF/ICI (p<0.05). Scalp abnormalities were not associated with incidence of SF/ICI. As for clinical symptoms, lethargy and a grouping of features (irritability & vomiting) were associated with incidence of SF/ICI (p<0.05). The incidence of seizure, loss of consciousness, vomiting, irritability, and scalp abnormality did not differ significantly between those with normal radiologic findings and those with SF/ICI. Among asymptomatic patients, 11 (14.5%) patients had SF/ICI, and among patients with normal scalp findings, 9 (12.7%) patients had SF/ICI. Conclusion: Clinical signs and symptoms, except for lethargy and a grouping of features (irritability & vomiting), were not sensitive predictors of SF/ICI. Nevertheless, SF/ICI occurred among normal children. In such a case, a liberal policy of CT scanning is warranted.

• 한방안이비인후피부과학회지
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• 제37권2호
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• pp.58-73
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• 2024

Objectives : This study was designed to review and analyze domestic research trends of Korean medicine treatment on otitis media, and present data for further research and treatment of otitis media. Methods : Two researchers used six search engines to search for papers on Korean medicine treatment for otitis media published from January 1, 2000 to December 31, 2023. A total of 16 papers were searched, and bibliographic information, main and accompanying symptoms, treatment period, treatment method, evaluation scale, and treatment results of each study were analyzed. Scottish Intercollegiate Guidelines Network was used to evaluate the evidence level. Results : The most common otitis media symptom was hearing loss (12 times). The most frequently mentioned herbs were Ledebouriella seseloides (22 times) and Angelica gigas (20 times), which are the ingredients of the most commonly used prescriptions, Hyunggyeyungyo-tang (5 times), Takrisodok-yeum (4 times), and Bojungikgi-tang (3 times). All the clinical trial papers were conducted on Kamihyunggyeyungyo-tang, which showed improvement in otitis media-related indicators. The most frequently mentioned meridians were the Triple Energizer (44 times), Clinical trials were conducted on the Triple Energizer, the Gall Bladder, and the Small Intestines meridians. The most frequently used acupoints were SI19 (10 times), TE21 (9 times), TE17 (9 times). In clinical trials, acupuncture treatment with TE05, GB15, TE06, SI05, GB38, and KI02 showed a significant improvement in otitis media symptoms. Conclusions : It is believed that more efficient otitis media treatment and follow-up research can be performed by using the above-mentioned research results.