• 한국임상약학회지
• /
• 제24권4호
• /
• pp.255-264
• /
• 2014

Objective: The aims of this study are to investigate the total volume of prescribed medicines against Alzheimer's disease (AD) and the trends of usage by analyzing the claims-data from the Korea National Health Insurance Service. Method: The demographic and claims-data were included the major AD treating medicines such as donepezil, galantamine, rivastigmine and memantine, and analyzed during the period of 2010~2012. The assessing criteria were gender, age, habitation, types of medical institution, code of ingredients, outcomes of treatment, volume and amount of claims, and the numbers of patients with dementias. After trimming the data, it were analyzed by the market size, demographic traits, characteristics of medical service, characteristics of each anti-AD medicine, etc. Results: Among the chosen 4 medicines, donepezil had the top prescription volumes. Most prevalent prescribing preparations of donepezil were conventional types. However, among the non-conventional types, oro-dispersible formulation is the fast increasing one in both volume and growth rate. This specialized preparations to improve both toleration and adherence, tend to being prescribed generally at the tertiary medical institutions. While the younger patients with mild-to-moderate AD mostly treated by expensive medicines in resident at the tertiary hospitals, the rest older patients with severe AD have been treated non-expensive one at long-term care facilities. Conclusion: AD is a chronic illness therefore, long-term use of therapeutic medications are highly important. If an anti-AD treatment was applied steadily in the earlier stages, it would be achieved not only improving the quality of life of patient but also reducing the expenses in the medical and nursing cares. As the socioeconomical impacts of AD is expanding, healthcare professionals need to aware the importance of pharmacotherapy and to improve sociopolitical fundamentals.

• 한방안이비인후피부과학회지
• /
• 제30권4호
• /
• pp.62-74
• /
• 2017

Objectives : The purpose of this study is to investigate the effect of laser therapy for diabetic ulcer by using methods of systematic review. Methods : In this review, PubMed, Cochrane library, Web of Science, CNKI, CiNii, J-STAGE, NDSL and OASIS were used as the search engines. The search period is from the start date of the search engine to October 3, 2016. Randomized controlled trials(RCTs) using laser therapy for diabetic ulcer were searched and extracted by two independent researchers. Risk of bias(RoB) of Cochrane was used to assess methodological quality of studies. Results : Finally, five RCTs were selected. The follow-up period ranged from 15 days to 20 weeks. InGaAlP laser, GaAlAs laser and light emitting diode(LED) were used to treat diabetic ulcer. The clinical trials used sham laser irradiation or standard treatment as control in comparison to laser therapy. The endpoints included ulcer size, rate of healing and time to healing with follow-up period. The RCTs demonstrated therapeutic outcomes with no adverse effect. Most items of RoB were unclear and methodological quality was low. Conclusions : Our analysis suggests that laser therapy has therapeutic effects for diabetic ulcer. However, more systematic and stringent clinical trials will be required.

• 동의생리병리학회지
• /
• 제21권3호
• /
• pp.626-633
• /
• 2007

To access the safety and efficacy of Chungyeoldodam-tang(CDT), a traditional herbal medicine prescription, on hypertension we examined various parameters involved in the pathogenesis of hypertension. CDT seems to be safe because CDT at the concentrations lower that 250 ug/ml showed no toxic effects in cultured human fibroblast and no toxic effects on liver function. The production of reactive oxygen species (ROS) were greatly decreased in CDT treated group compared with control, and angiotensin converting enzyme activities were reduced by CDT in a dose dependent manner. There was no differences in weight of hearts between control and CDT treated group. The blood pressure and pulse rate were significantly decreased. CDT greatly reduced the levels of plasma hormones including aldosterone, dopamine, and norepinephrine, but not epinephrine, and serum electrocytes including Na$^+$ and Cl$^-$, but not K$^+$. were also decreased. The levels of uric acid, BUN and creatinine were significantly decreased compared with control. These results suggested that CDT has suppressive effects on various pathologic factors in hypertension, and CDT has potential as a safe and effective therapeutics for hypertension.

• 한국정보통신학회:학술대회논문집
• /
• 한국해양정보통신학회 2009년도 춘계학술대회
• /
• pp.899-902
• /
• 2009

최근 컴퓨터 네트워크와 무선 통신 기술의 발전은 원격 의료 상담, 원격 환자 모니터링과 같이 의료 분야에서 폭넓은 범위의 원격 어플리케이션에 대한 적용을 가능하게 해주었다. 본 논문은 환자의 생리학적인 데이터를 수집 및 관리하기 위한 RF 통신 기반의 헬스케어 어플리케이션을 설계하고, 전체적인 실험 과정을 기술한다. 그리고 MySQL 데이터베이스는 환자의 생체 데이터인 체온, 혈압, 심장 박동수 등의 데이터를 기록하고 환자에 대한 의사의 처방 등 의료 행위에 대한 정보를 저장하기 위해 설계한다. 따라서 헬스케어 어플리케이션에서 인증 받은 사용자는 환자의 수집 데이터를 조회하고 수집된 데이터는 임상 실험을 위한 데이터 재구성에 활용할 수 있다. 이런 환경은 수시로 체크해야 하는 병실의 온도 습도를 유비쿼터스 센서 네트워크를 통해 자동으로 처리하며 모바일 폰 또는 웹 상에서 입력받아 데이터베이스에 저장하므로 컴퓨터를 통해 체계적으로 관리가 가능하다. 그리고 환자 가족들에게 병원에서 처리되고 있는 데이터를 쉽게 접근하도록 지원함으로써 의료 서비스의 향상을 기대할 수 있다.

• 생물정신의학
• /
• 제27권2호
• /
• pp.42-57
• /
• 2020

Electroconvulsive therapy (ECT) is indicated for various mental disorders (e.g., major depressive disorder, schizophrenia, and bipolar disorder) and the behavioral and psychological symptoms of dementia in elderly patients. Furthermore, ECT is a useful first-line treatment in emergency and crisis situations such as suicide risk, violent behavior, catatonia, and food refusal, which are more frequent in elderly patients. ECT is also effective in the treatment of the motor symptoms of neurological disorders, such as Parkinson's disease and Huntington's disease. Due to the high risk of various physical diseases, the comorbid physical conditions of elderly patients should be individually controlled to optimize ECT treatment. Compared to young adults, in elderly patients the seizure threshold is higher, the seizure duration is shorter, and the anesthetic dose is lower. On the contrary, the response rate in the elderly is both faster and higher. Considering potential cognitive decline and the prevention of further deterioration of cognitive function in elderly patients, in the absence of significant comorbidities, twice weekly sessions and right unilateral electrode placement with a lower seizure threshold and less cognitive effect are preferred to bilateral electrode placement, which has a high risk of adverse cognitive effects. After an acute course of ECT, continuation and maintenance of ECT, combined with prescription of therapeutic drugs, may prevent possible relapse or recurrence of mental disorders. In conclusion, ECT can be used to treat mental disorders in elderly adults, with safety and effectiveness comparable to that in young adults.

• 동의신경정신과학회지
• /
• 제30권2호
• /
• pp.59-69
• /
• 2019

Objectives: Case report is a description of medical experience that contains a patient's information and treatments. It has been used to determine the effectiveness and side effect of the treatments. Case report can be used for medical, scientific, or educational purposes. The objective of this study was to evaluate the quality of case reports published in Journal of Oriental Neuropsychiatry from 2013 to 2017 using CARE and CARES guideline. Methods: Case reports were selected from Journal of Oriental Neuropsychiatry and their quality assessed using CARE guideline and CARES guideline. The items of CARE and CARES guideline were assessed as 'Sufficient', 'Not sufficient', 'Not reported', 'Not applicable'. The outcome was analyzed using case reports and items. Results: 26 case reports were selected. For CARE guideline, 'Sufficient' percentage was min at 22.2%, max at 46.4% with a median of 39.3%. Sum of 'Sufficient', 'Not sufficient' percentage was min at 59.3%, max at 85.7% with a median of 75.0%. Items 'Timeline', 'Diagnostic assessment', 'Follow up and outcomes', 'Informed consent' were not reported in more than 50% of all case reports. Items 'Keywords', 'Abstract', 'Introduction', 'patient information', 'Diagnostic assessment', 'Therapeutic interventions', 'Follow up and outcomes' were not sufficiently reported in more than 50% of all case reports. For CARES guideline, 'Sufficient' percentage was min at 0%, max at 50% with a median of 0%. Sum of 'Sufficient', 'Not sufficient' percentage was min at 33.3%, max at 100% with a median of 92.9%. Items of herbal prescription 'herb', 'decoction', 'use', items of acupuncture treatment 'materials', 'techniques', items of moxibustion treatment 'materials', 'techniques' were not sufficiently reported in more than 50% of all case reports. Conclusions: The reporting rate of items was good. But the quality of reporting was low. Also, particular items were not reported frequently. Therefore, there is a need to improve the quality of case reports in Journal of Oriental Neuropsychiatry.

• 대한한방내과학회지
• /
• 제41권6호
• /
• pp.1089-1099
• /
• 2020

Objective: The purpose of this study was to investigate the effect of cinnamon on the treatment of Parkinson's disease (PD) and to introduce its use in Korea. Method: We searched the experimental studies in electronic databases (PubMed, CNKI, Wanfang, CiNii, J-STAGE, Science ON, and OASIS) using the key search terms "cinnamic acid", "cinnamon", "cinnamomum", "Parkinson's disease", "Parkinson disease", "Parkinsonism", and "dopamine". This study only involved experimental studies (in vivo and in vitro) that adopted cinnamon as a single administration and measured indicators relating to Parkinson's disease, including parkin, tyrosine hydroxylase (TH), and dopamine. Results: A Total of 11 literature studies were selected, and they all showed that treatment with cinnamon has a neuroprotective effect. Cinnamon activated neuroprotective factors and restored neurotransmitters and it reduced the rate of oxidative stress and inflammation in neurons. As a result, cell viability was upregulated, while cell apoptosis and neurodegeneration were downregulated. Five in vivo studies, through behavioral tests, also confirmed that cinnamon recovers locomotor function in PD models. Conclusion: We identified that cinnamon is an effective neural protector and improves motor performance in behavioral testing in the experimental PD studies.

• 대한두개안면성형외과학회지
• /
• 제22권6호
• /
• pp.319-323
• /
• 2021

Background: Prophylactic antibiotics are used to prevent surgical wound infection; however, proper indications must be followed with careful consideration of the risks and benefits, especially in clean or clean-contaminated wounds. Nasal bone fractures are the most common type of facial bone fracture. The most common method for treating nasal bone fracture is closed reduction, which is performed inside the nasal cavity without an incision. The purpose of this study was to determine the need for antibiotic use in the closed reduction of nasal bone fractures. Methods: A retrospective study was conducted using data from the National Insurance Service Ilsan Hospital of the Republic of Korea between 2016 and 2018. The records of patients who underwent closed reduction of nasal bone fracture were reviewed and classified according to sex, age, comorbidities, perioperative antibiotic usage, postoperative complications, nasal packing, anesthesia type, surgeon's specialty, and operation time. Results: Among the 373 patients studied, the antibiotic prescription rate was 67.3%. Just 0.8% of patients were prescribed preoperative antibiotics only, 44.0% were prescribed postoperative antibiotics only, and 22.5% were prescribed both preoperative and postoperative antibiotics. There were no cases that satisfied the definition of "surgical site infection." Furthermore, 2.1% of infection-related complications (e.g., mucosal swelling, synechia, and anosmia) occurred only in the antibiotic usage group. The use of nasal packing, anesthesia type, and surgeon's specialty did not show any difference in infection-related complication rates. Conclusion: According to the study findings, the routine use of perioperative antibiotics is not recommended in uncomplicated nasal bone fracture surgery.

• 한국임상약학회지
• /
• 제32권3호
• /
• pp.155-165
• /
• 2022

Background: Chronic obstructive pulmonary disease (COPD) is not completely reversible and requires long-term management with appropriate treatment. This study aimed to analyze trends in treatment regimens and medication costs for COPD patients using a national claims database. Methods: We conducted this analysis using National Patient Sample data from the Health Insurance Review and Assessment Service covering the period from 2015 to 2018. We have constructed a dataset comprising COPD disease classification codes J43.x and J44.x (based on KCD-7 code, J43.0 was excluded) and compiled a list of drugs fitting current guidelines. To identify trends, we calculated frequency, ratio, and compound annual growth rate (CAGR) using the numbers of prescriptions and patients. Results: The number of COPD patients was 7,260 in 2018, slightly decreased from 2015. Most of these COPD patients were aged 60 or older and included a high proportion of males (72.2%; 2018). The number of patients prescribed inhaled medications increased gradually from 2015 to 2018 (9,227 (47.1%); 2015, 9,285 (51.5%); 2018), while the number of patients prescribed systemic beta-agonists and Xanthines has decreased since 2015 (CAGR -14.7; systemic beta-agonist, -5.8; Xanthines). The per capita cost of medication has increased by 0.4% (KRW 206,667; 2018, KRW 204,278; 2015) annually during the study period. Conclusion: This study showed that treatment with inhaled medications had continuously increased in accord with changing guidelines, but oral medications were still widely used. It is necessary to emphasize the importance of inhaled medications in treating COPD to reduce additional economic burden through appropriate medication use.

• 한국컴퓨터정보학회논문지
• /
• 제27권2호
• /
• pp.187-194
• /
• 2022

척수장애인들에게 있어 신체활동 및 운동을 장려함으로써 건강 결과에 긍정적인 영향을 미칠 수 있도록 하는 것이 중요하다. 현재 증거에 따르면 IT기반으로 하는 근력 및 근지구력, 심폐 운동, 전기 자극 운동과 로봇 운동 등 모두 체력 구성 요소를 개선하고 2차 건강 합병증의 위험을 줄이며 만성 신체 장애가 있는 사람들의 전반적인 건강에 긍정적인 영향을 미칠 수 있다. 근력 및 근지구력을 증진하기 위해서는 운동 빈도는 주 2회, 3세트 실시하도록 하며 근력의 증진을 위해서는 < 5 Reps으로, 일반적인 강도는 6~15회 반복하도록 하며, 근지구력을 향상시키기 위해서는 15~30회 반복하도록 한다. 심폐 능력의 향상을 위해서는 주 3-5회, 20~60분, 최고심박수의 50~80%로 실시하도록 하였다. 따라서 IT 기반의 다양한 운동 이점을 실현하고 전문 장비, 시설 및 트레이너에 대한 접근을 위한 더 높은 자원 투자가 필요하다.