• 한국임상약학회지
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• 제20권3호
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• pp.221-228
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• 2010

In 2009, American Journal of Health-System Pharmacy (AJHP) recommended that targeting vancomycin trough concentrations of 10 mg/L or more because of therapeutic failure and potential risk of developing vancomycin resistance. Therefore, new dosage guidelines that could achieve to these higher target were needed. The aims of this study were to develop dosage guidelines targeting new vancomycin trough concentration and to evaluate the performance of these new guidelines. All data analysis were performed using NONMEM(R). Population pharmacokinetic model was first developed from vancomycin dosage and concentration data collected retrospectively during routine therapeutic drug monitoring in 441 patients, then new vancomycin dosage guidelines were developed by using the model to predict vancomycin trough and peak concentrations in a simulated dataset. The estimates, such as, vancomycin concentration trough level, time to achieve target level, mean error were performed to evaluate and compare difference between conventional dosage and new dosage guidelines. The proposed dosage guidelines were predicted to achieve 43.5% of vancomycin trough level within 10~20 mg/L, which is significantly higher than current guidelines (26.3%). Time to achieve target trough level was 19.4 hours in new guidelines comparing to 93.1 hours in the conventional dosage. Thus, new vancomycin dosage guidelines have been developed to achieve new target trough concentrations earlier and more consistently than conventional guidelines.

• 가정∙방문간호학회지
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• 제22권1호
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• pp.69-77
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• 2015

Purposes: The purpose of the study was to evaluate knowledge of hepatitis C and compliance with therapeutic guidelines and their correlation. Methods: Participants included a total of 197 subjects with chronic hepatitis C from 4 general hospitals. Subjects were asked 25 items of knowledge on hepatitis C and 17 items of compliance with therapeutic guidelines. The collected data was analyzed for frequency, percentage, average, standard deviation, t-test, ANOVA and Pearson's correlation coefficient. with the help of SPSS 21.0 program. Results: The subject's knowledge on chronic hepatitis C expressed as percentage was 67.1%. Compliance of the research participants gained $3.96({\pm}0.76)$ points in general on a 5-point scale. Learned compliance was higher when the patients were 45 years old and over. female and with spouse. There was a statistically significantly positive correlation between knowledge and compliances. Conclusions: Development of educational programs requires consideration of patient characteristics, particularly education on the male patients under 45 years of age.

• 한국전문물리치료학회지
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• 제11권4호
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• pp.43-49
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• 2004

It is not common in rehabilitation situation to encounter patients exhibiting paralysis or other disabilities which have no apparent organic basis. Even without organic causes for their signs and symptoms these patients often require comprehensive treatment and management. Patients with conversion disorder often pose particular difficulties because of diagnostic confusion and the lack of therapeutic strategies for rehabilitation management. We feel that systematic functional rehabilitation is helpful in resolving symptom and recovering normal function in the patient suffering from conversion disorder since it provides motivation and reduces reinforcements which contribute to sustained disabled state. This report describes the patient with hysterical motor paralysis who is successfully treated with structured physical therapy. The objectives of this report are to provide therapeutic guidelines for physical therapy and to emphasize the role of physical therapist in the assessment and treatment of hysterical paralysis.

• 한국임상약학회지
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• 제20권3호
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• pp.213-220
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• 2010

Therapeutic duplication (TD) is a serious problem that frequently occurring primarily in the ambulatory setting in Korea. Implementation of concurrent drug utilization review (DUR) is a promising way to reduce inappropriate prescription and dispensing, and improve patient safety. This study was aimed to develop the process of DUR module of TD. Sixty-five drug ingredients classified into the drug category of the antipyretic, analgesic, and anti-inflammatory drug approved in Korea (The KFDA-dess nated classification codes of 114 or 264) were reviewed for this purpose. The drug ingredients (and products) were reclassified based on WHO's Anatomical, Therapeutic and Chemical (ATC) classification system. The clinical practice guidelines, textbooks and product labels on therapeutic uses of these drugs in Korea and several fores n countries were reviewed. If the drugs were categorized into the same therapeutically duplicable class, they were defined not to be used concurrently because the concurrent use was "therapeutically duplicated (unnecessary or even harmful)". Among the studied drug products, the following 5 drug classes were considto beas "therapeutic duplication": (1), on-t tooid DURnti-inflammatory drugs (NSAIDs, including s Dicylates), (2),Anilidts, (3),Opioids, (4) Ergot Dk Doids and (5) 5-$HT_1$ receptor agonot s. Therefore, concurrent prescribing or dispensing of more than 2 drug ingredients any in the above same classes should be considered as TD and needed to be warrant for careful review by pharmacists before dispensing.

• Molecules and Cells
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• 제45권5호
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• pp.284-290
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• 2022

Exosome, a type of nanoparticles also known as small extracellular vesicles are gaining attention as novel therapeutics for various diseases because of their ability to deliver genetic or bioactive molecules to recipient cells. Although many pharmaceutical companies are gradually developing exosome therapeutics, numerous hurdles remain regarding manufacture of clinical-grade exosomes for therapeutic use. In this mini-review, we will discuss the manufacturing challenges of therapeutic exosomes, including cell line development, upstream cell culture, and downstream purification process. In addition, developing proper formulations for exosome storage and, establishing good manufacturing practice facility for producing therapeutic exosomes remains as challenges for developing clinical-grade exosomes. However, owing to the lack of consensus regarding the guidelines for manufacturing therapeutic exosomes, close communication between regulators and companies is required for the successful development of exosome therapeutics. This review shares the challenges and perspectives regarding the manufacture and quality control of clinical grade exosomes.

• Clinical and Experimental Pediatrics
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• 제62권6호
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• pp.199-205
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• 2019

Although Mycoplasma pneumoniae pneumonia (MPP) has been generally susceptible to macrolides, the emergence of macrolide-resistant MPP (MRMP) has made its treatment challenging. MRMP rapidly spread after the 2000s, especially in East Asia. MRMP is more common in children and adolescents than in adults, which is likely related to the frequent use of macrolides for treating M. pneumoniae infections in children. MRMP is unlikely to be related to clinical, laboratory, or radiological severity, although it likely prolongs the persistence of symptoms and the length of hospital stay. Thereby, it causes an increased burden of the disease and poor quality of life for the patient as well as a societal socioeconomic burden. To date, the only alternative treatments for MRMP are secondary antimicrobials such as tetracyclines (TCs) or fluoroquinolones (FQs) or systemic corticosteroids; however, the former are contraindicated in children because of concerns about potential adverse events (i.e., tooth discoloration or tendinopathy). A few guidelines recommended TCs or FQs as the second-line drug of choice for treating MRMP. However, there have been no evidence-based guidelines. Furthermore, safety issues have not yet been resolved. Therefore, this article aimed to review the benefits and risks of therapeutic alternatives for treating MRMP in children and review the recommendations of international or regional guidelines and specific considerations for their practical application.

• 대한의용생체공학회:의공학회지
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• 제36권5호
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• pp.162-168
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• 2015

In this study, we suggested the performance and safety testing guideline for low intensity pulsed ultrasound (LIPUS) represented by the ultrasound fracture treatment device and cartilage treatment device and low intensity focused ultrasound (LIFU) represented by ultrasonic face lifting device. For these study, the international standards and management regulations of Korea, Japan and United State were analyzed. And the usefulness and applicability were evaluated by testing with commercial equipment and reflecting the views of the industry and experts. As a result of this study, the safety and performance test guidelines for low intensity therapeutic ultrasound device were proposed by presenting the 10 items for LIPUS and 12 items for LIFU. The suggested guidelines are considered a high utilization in the domestic testing and approval authorities. And they are also thought to be useful to new technology development.

• The Journal of Korean Physical Therapy
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• 제12권3호
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• pp.497-507
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• 2000

This study was performed to understanding on guidelines for using therapeutic modalities according to injury phases of soft tissue. Clinical decisions on how and when therapeutic modalities may be used should be based on recognition of signs and symptoms. as well as some awareness of the time frames associated with the various phases of the Healing process. The physical therapist must have a sound understanding of that process in terms of the sequence of the various process of healing stage. The results of this study are as follows: 1. Once an acute injury has occured, the healing process consists of the imflammatory response phase, the fibroblastic-repair phase, and the maturation-remodeling phase and can impede by various pathologic factors. 2. Modality use in the initial acute injury phase and the inflammatory response phase should be directed toward limiting the amount of swelling and reducing pain. 3. Modality use in the Fibroblastic repair phase may be change from cold to heat. The purpose of heat is to increase circulation to the injured area to promote healing. 4. During the Maturation-Remodeling phase, some type of heating modalities, ultrasound, or short wave and microwave diathermy should be used to increase circulation to the deeper tissue. In this phases, physical therapists must control training and conditioning habits to allow the injury to heal sufficiently.

• 국제물리치료학회지
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• 제10권1호
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• pp.1725-1733
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• 2019

Background: In some clinical guidelines followed in clinical practice, nonsurgical treatments are recommended as the primary intervention for patients with lumbar disc herniation (LDH). However, the effect of a therapeutic exercise program based on stabilization of the lumbar spine for treatment of multilevel LDH has not been evaluated thoroughly. Objective: To investigate the effects of therapeutic exercise on pain, physical function, and magnetic resonance imaging (MRI) findings in a patient with multilevel LDH. Design: Case Report Methods: A 43-year-old female presented with low back pain, radicular pain and multilevel LDH (L3-L4, L4-L5, L5-S1). The therapeutic exercise program was conducted. in 40-min sessions, three times a week, for 12 weeks. Low back and radicular pain, lumbar disability, and physical function were measured before and after 6 and 12 weeks of the exercise program. MRI was performed before and after 12 weeks of the program. Results: After 6 and 12 weeks of the therapeutic exercise, low back and radicular pain and lumbar disability had decreased, and lumbar range of motion (ROM) was improved bilaterally, compared with the initial values. Also improved at 6 and 12 weeks were isometric lumbar strength and endurance, and the functional movement screen score. The size of disc herniations was decreased on MRI obtained after 12 weeks of therapeutic exercise than on the pre-exercise images. Conclusions: We observed that therapeutic exercise program improved spinal ROM, muscle strength, functional capacity, and size of disc herniation in LDH patient.

• Journal of Digestive Cancer Research
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• 제4권1호
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• pp.10-16
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• 2016

There were no Korean evidence-based multidisciplinary guidelines for gastric cancer. Experts from related societies developed guidelines de novo to meet Korean circumstances and requirements, including 23 recommendation statements for diagnosis (n=9) and treatment (n=14) based on relevant key questions. The quality of the evidence was rated according to the GRADE evidence evaluation framework and the recommendation grades were classified as either strong or weak. The topics of the guidelines cover diagnostic modalities (endoscopy, endoscopic ultrasound, and radiologic diagnosis), treatment modalities (surgery, therapeutic endoscopy, chemotherapy, and radiotherapy), and pathologic evaluation. Major limitation of the present guideline is that there is no enough evidences in Korea. Therefore, clinical studies about gastric cancer for evidence generation should be conducted.