• Title/Summary/Keyword: drug-use

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The Effect of Pleurodesis with Doxycycline in the Rabbit (토끼에서 Doxycycline을 이용한 흉막유착 효과)

  • Won, Kyoung-Sook;Park, Keon-Uk;Jeon, Won-Ho;Baik, Jae-Jung;Jeong, Yeon-Tae;Suh, Jung-Il;Son, Jin-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.531-536
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    • 1994
  • Background: The intrapleural instillation of tetracycline for pleural sclerosis had been most commonly used in patients with symptomatic malignant pleural effusion or recurrent pneumothorax for a long time. Unfortunately, at a time of expanding use of this agent, the production of injectable tetracycline hydrochloride used for pleurodesis was discontinued by its sole manufacturer in mid-1991 because the manufacturer was unable to meet US Food and Drug Administration purity standards. So we performed a preliminary study of doxycycline, as a alternative pleural sclerosant on rabbit pleura and compared its efficacy with that of tetracycline. Method: Eighteen New Zealand white rabbits weighing 2 to 3kg(mean 2.6kg) were devided into three groups. In each groups, one tetracycline(20 mg/ml/kg) and two doxycycline solutions(7 mg/ml/kg and 20 mg/ml/kg) instillated into the right pleural space through an 18-gauge angiocath with care to prevent pneumothorax. All rabbits were sacrificed after 28 days. Results: 1) In the group of tetracycline 20 mg/ml/kg(six rabbits), five rabbits showed partial pleural symphysis with several fibrous bands, and one rabbit died on 22th day. 2) In the group of doxycycline 7 mg/ml/kg(six rabbits), three rabbits showed partial pleural symphysis and the other three rabbits showed complete pleural symphysis without necrosis of underlying parenchymal lung tissue. 3) In the group of doxycycline 20 mg/ml/kg(six rabbits), two rabbits showed complete pleural symphysis without lung necrosis, another two rabbits showed complete pleural symphysis with lung necrosis, and the other two rabbits died on 4th and 13th day, respectively. Conclusion: We concluded that doxycycline is a highly effective sclerosing agent having stronger pleurodesis effect with that of tetracycline by dose base and its optimal dosage was considered as 7 mg/ml/kg with minimal complications.

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Attempted Suicides in South Korea : A Multi-Center Analysis of Causes, Methods, and Psychiatric Diagnoses of Suicidal Attempters in 2013 (응급실 방문 자살기도자들의 기도 원인, 방법, 정신과적 진단에 대한 다기관 분석)

  • Kim, Hyeyoung;Kim, Bora;Kang, Seung-Gul;Kim, Moon-Doo;Kim, Min-Hyuk;Kim, Soo In;Kim, Jae Min;Moon, Eunsoo;Ahn, Joon-Ho;Lee, Kyung-Uk;Lee, Sang-Hyuk;Lee, Seung Jae;Jeong, Seong Hoon;Chung, Young-Chul;Jung, Hee Yeon;Ju, Gawon;Cha, Boseok;Ha, Tae Hyon;Ahn, Yong-Min
    • Korean Journal of Biological Psychiatry
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    • v.22 no.4
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    • pp.187-194
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    • 2015
  • Objectives To examine direct causes of attempted suicides, methods adopted to commit suicide, and psychiatric diagnoses among suicide attempters in South Korea. Methods A total of 1359 suicide attempters who had visited emergency department of 17 medical centers due to suicide attempt from May 2013 to Nov 2013 were interviewed using semi-structured questionnaires. Results Psychiatric symptoms were the most common cause of suicide attempts (62.2%), followed by interpersonal relationships (24.4%). Women attempted suicide more often for interpersonal reasons, whereas men were more likely to do so for financial and job-related reasons. Half of participants (55.8%) attempted suicide by drug intoxication, which was more prevalent among females and those who had previous history of psychiatric disease or previous suicide attempt. Men were more likely to use more lethal methods such as pesticide poisoning and gas inhalation than women. Pesticide poisoning was also prevalent among the elderly group and the rural population. Near ninety-five percent (94.5%) of participants received a psychiatric diagnosis : the most frequent diagnosis was depressive disorder. Conclusions This is the first nationwide study of cases of attempted suicide. When stratified by age groups, gender, urbanicity, living alone or not, presence of physical illness, previous psychiatric history, and previous suicide attempt, there were significant differences with respect to causes, methods of attempted suicides and psychiatric diagnoses of suicide attempters.

Cardiac Intracoronary Stenting vs CABG: Prevention of Medical Accident (심장 스텐트 시술과 의료사고 예방)

  • Kim, Kyoung Reay;Park, Kook Yang
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.163-194
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    • 2017
  • Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

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Effects of ischemic preconditioning, KATP channel on the SOD activation and apoptosis in ischemic reperfused skeletal muscle of rat (허혈양상화와 KATP 통로가 허혈후 재관류된 흰쥐의 골격근육에서 SOD 활성 및 apoptosis에 미치는 영향)

  • Abn, Dong-choon;Paik, Doo-jin;Yang, Hong-hyun
    • Korean Journal of Veterinary Research
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    • v.39 no.5
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    • pp.878-895
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    • 1999
  • Ischemic preconditioing (IPC), i.e., a preliminary brief episode of ischemia and reperfusion, has been shown to reduce the cell damage induced by long ischemia and reperfusion. Superoxide radical which is produced during reperfusion after ischemia was recognized as a factor of the ischemic injury and it is dismutated into $H_2O_2$ and $O_2$ by two types of intracellular superoxide dismutase (SOD), Cu,Zn-SOD in cytoplasm and Mn-SOD in mitochondria. Recently oxygen free radicals are suggested to induce the apoptosis, however mechanism of the reduced apoptosis by ischemic preconditioing was unknown, while many studies performed in mammalian heart indicated that ATP-sensitive $K^+$ ($K_{APT}$) channel activation related with the protective effects. The aim of present study is to investigate 1) whether IP upregulate the Cu,Zn-SOD and Mn-SOD activities, and 2) whether ischemic preconditioning decreases apoptosis via $K_{APT}$ channel activation in timely reperfused skeletal muscle after long ishemia. The experimental animals, Sprague-Dawley rats weighing 250~300g, were divided into 8 groups; 1) control group, 2) ischemic preconditioning only groups, 3) pinacidil, a $K_{APT}$ channel opener, treatment only groups, 4) glibenclamide, a $K_{APT}$ channel blocker, treatment only groups, 5) ischemia groups, 6) ischemia after IPC groups, 7) ischemia and pinacidil treatment groups, and 8) IP and ischemia after glibenclamide pretreatment groups. Animals of the control group were administered with the vehicle (DMSO) alone. Pinacidil (1mg/kg) was administered intravenously 5 minutes after initiation of ischemia, and glibenclamide (0.5mg/kg) was injected intravenously 20 minutes before IPC. In rats that were ischemic preconditioned, the left common iliac artery was occluded for 5 minutes followed by 5 minutes of reperfusion by three times using vascular clamp. Ischemia was done by occlusion of the same artery for 4 hours. The specimens of left rectus femoris muscle were obtained immediately (0 hour), 12 hours, 24 hours after drug administrations, IP or ischemia and reperfusion. The immunoreactivities of SOD and its alterations were observed by use of sheep antihuman Cu,Zn-SOD and Mn-SOD antibodies on the $10{\mu}m$ cryosections. The incidencies of apoptosis were observed by TUNEL methods with in situ apoptosis detection kit on $6{\mu}m$ paraffine section. The results obtained were as follows : 1. After IPC, immunoreactivities of Cu,Zn-SOD mainly in the small-sized fibers were increased by 24 hours, that of Mn-SOD at 0 hour and 24 hours. 2. No significant changes in immunoreactivities of SOD was observed in the pinacidil and in the glibenclamide treatment only groups, and in the ischemia only groups. 3. The immunoreactivities of the Cu,Zn-SOD were increased in the ischemia after IPC groups and the ischemia and pinacidil treatment groups. 4. The immunoreactivities of the Cu,Zn-SOD in the IPC and ischemia after glibenclamide pretreatment groups were not increased except for the 12 hours reperfusion group. But, Mn-SOD immunoreactivities were increased in the 0 hours, 12 hours and 24 hours after reperfusion. 5. In the control group, the IPC only groups, and the pinacidil treatment only groups, negative or trace apoptotic reactions were observed, but the positive apoptotic reaction occured in the glibenclamide treatment groups. 6. Moderate or many number of apoptosis were revealed in the ischemia groups, and also the IPC and ischemia after glibenclamide pretreatment group except for 12 hours and 24 hours after reperfusion. However, the incidence of apoptosis was decreased in the ischemia after IPC groups and in the ischemia and pinacidil treatment groups. 7. There is a coincidence between the increase of Cu,Zn-SOD immunoreactivities and the decrease of apoptosis in the presence of ischemia and reperfusion. These results suggest that the protective effects of ishemic preconditioing may related to the SOD activation, and the ischemic preconditioning decreases the apoptosis partially via $K_{APT}$ channel activation in timely reperfused rat skeletal muscle. It is also suggested that inhibition of apoptosis by IPC may related with the SOD activation.

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The actual conditions on drug abuse among High school students in Busan city (고등학생(高等學生)의 약물(藥物) 남용(濫用) 실태(實態))

  • Cho, Yeon-Sook
    • Journal of the Korean Society of School Health
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    • v.3 no.1
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    • pp.101-118
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    • 1990
  • This study was intended to investigate actual conditions and problems relating to a variety of substance which have been used by students. A Questionnaire survey was carried out with the subject of 2411 students in an academic boys' high school, academic girls' high school, technical boys' high school and technical girls' high school in Pusan, from the 15th day to 29th day of March, 1989. The summarized results were as follows. There was not a remarkable difference in distribution of these subjects in boys' & girls' high school. The common and good health condition of subjects accounted for 90 percent or higher. 24.4 percent of them also had smoking experience, 11.6 percent of which continues to smoking. The understanding rate of these substances name other than sedative, psychostimulants and antihypnotic accounted for 90 percent or higher. The experience rate taking these substances for one year showed that anodyne, digestive and nutritive tonic accounted for 70 percent, antihypnotic for 15.6 percent, sedative for 1.4 percent, respectively, and psychostimulants for 0.5 percent. Moreover. it was shown that drugs accounted for 1.5 percent, bond for 1.4 percent, and thinner for 0.5 percent. The rate of the daily experiencers who took anodyne, digestive, nutritive tonic, sedatives, and psychostimulants and so on was 7.7 percent, 6.2 percent, 5.2 percent, 5.9 percent, and 5.0 percent respectively. This fact implied that there was a serious problem in high school students' non - narcotic abuse. The usage rate of these substances for treatment purpose showed that anodyme accounted for 90 percent or higher, and digestive for 70-80 percent, respectively, where girl students showed higher rate than one of boy students. Additionally, there was higher the usage rate for other purposes. The usage rate of drugs was highest when these students felt melancholy and curiousity. Their obtaining place appeared that these students mainly obtained these drugs, bonds and thinners from a small shop or peddler and their friend while they usually obtained other substance from the pharmacy and medical institute. The first usage time of these substances appeared during the middle school (the age of 14-15) which was the highest rate. The smoker of all subjects used remarkly large substances as compared with one of no-smoker. Particularly, it appeared that the usage of drugs was very closely related to smoking. The large number of students did not use these substances for oesrable purposes even though they understood the name of these substances. For this reason, from primasy schools it is required to teach the students dependence and harmful effects caused by these substances abuse. Moreover, it was shown that these students firstly used these substances during the middle school (the age of 14-15)due to curiosity. As a result, it is very urgent to give the students health education suitabale for prevention of these substance abuse, when considering harmful effects of these substances. And so health education for no-smoking. Finally, considering that it is very easy to obtain these substances from a small shop and pharmacy, the regulation of these substances control should be considered and completed in the future.

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Aprotinin Therapy for Cardiac Operation in Adult -Full dose regimen- (개심술에서 아프로티닌의 효과 (고용량 요법))

  • 장운하;오태윤;김미혜
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.358-363
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    • 1999
  • Background: Recently, many cardiac centers have been using aprotinin to reduce operative bleeding in cardiac operations using cardiopulmonary bypass. A variety of reports have confirmed the effectiveness of the drug in cardiac operations. In addition to the operations which could be considered to cause severe operative bleeding such as redo operation, long cardiopulmonary bypass operation and etc, the use of aprotinin is increasing in the field of primary cardiac operations. Varying doses of regimen have been introduced since the first report by Royston et al, and also various opinions on the effectiveness and safeness of the each regimen have been reported. We reviewed our own experience of the full dose aprotinin regimen(Hammersmith regimen) retrospectively. Material and Method: From October 1994 to February 1998, 40 cases of cardiac operative patients were randomized into two groups: aprotinin group(20 patients) which received a full dose aprotinin regimen and control group(20 patients) which did not receive aprotinin. To evaluate the degree of bleeding decrease, we analysed and compared the amount of postoperative 6 hours and 24 hours bleeding in the each group. To confirm the renal dysfunction, we measured the postoperative creatinine level. Result: In the amount of postoperative 6 hours bleeding, a statistically significant bleeding decrease was demonstrated in the aprotinin group compared to the control group(aprotinin group: 186${\pm}$40cc, control group:409${\pm}$69cc, P=0.010). Similar result was observed in the postoperative 24 hours(aprotinin group:317${\pm}$53cc, control group: 671${\pm}$133cc, P=0.024). Conclusion: We concluded that full dose regimen of aprotinin can remarkably reduce postoperative bleeding in cardiac operations without significant renal dysfunctions.

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Laboratory Diagnosis of Coronavirus Disease 19 (COVID-19) in Korea: Current Status, Limitation, and Challenges (국내 중증 급성 호흡기 증후군 코로나 바이러스의 검사실 내 진단: 현재, 한계점 그리고 직면한 과제)

  • Song, Gi Seon;Lee, You-Rim;Kim, Sungmin;Kim, Wontae;Choi, Jungwon;Yoo, Dahyeon;Yoo, Jungyoung;Jang, Kyung-Tae;Lee, Jaewang;Jun, Jin Hyun
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.3
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    • pp.284-295
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    • 2020
  • In December 2019, the first coronavirus disease- 2019 (COVID-19) patient was reported in Wuhan, Hubei Province, China. Since then, the number of patients who suffered severe acute respiratory syndrome caused by the novel Coronavirus (SARS-CoV-2 or 2019-nCoV) has increased dramatically in Korea. This new variant virus induces pulmonary diseases, including cough, sore throat, rhinorrhea, dyspnea, and pneumonia. Because SARS-CoV-2 is an RNA virus, real-time reverse-transcriptase PCR has been used widely to diagnose COVID-19. As the Korea Centers for Disease Prevention and Control (KCDC) and Ministry of Food & Drug Safety (MFDS) approved emergency use authorization, clinical specimens collected from COVID-19 patients and even healthy people have been clinically diagnosed by laboratory medicine. Based on a literature search, this paper reviews the epidemiology, symptoms, molecular diagnostics approved by KCDC, a current diagnosis of COVID-19 in the laboratories, the difference between molecular and serological diagnosis, and guidelines for clinical specimens. In addition, the Korean guidelines of biosafety for clinical laboratory scientists are evaluated to prevent healthcare-associated infection. The author's experience and lessons as clinical laboratory scientists will provide valuable insights to protect the domestic and international health community in this COVID-19 pandemic around the world.

The Comparison and Distribution of Temperatures Established in Display Stands and Food Surfaces for Cold and Frozen Foods in large Discount Stores in Korea (대형할인매장에서의 냉장.냉동식품 판매대의 설정온도와 판매식품 표면온도 비교 및 온도분포 분석)

  • Choi, Moon-Sil;Choi, Jeong-Ae;Kim, Mee-Hye;Bahk, Gyung-Jin
    • Journal of Food Hygiene and Safety
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    • v.26 no.4
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    • pp.308-314
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    • 2011
  • This study surveyed and compared the temperatures established in display stands and food surfaces for cold and frozen foods in large discount stores in Korea. The temperatures established in display stands for cold food ranged with $3.5{\pm}1.8^{\circ}C$ as mean, minimum and maximum were $0^{\circ}C$ and $7^{\circ}C$. However, the surface temperatures of cold food on sale ranged with $10.7{\pm}2.9^{\circ}C$ as a mean, minimum $4.6^{\circ}C$ and maximum $18.4^{\circ}C$. Totally, the surface temperature of cold food on sale was $7.2^{\circ}C$, as a mean, higher than established in display stands for cold food in large discount stores in Korea. 53% of the surveyed cold foods were more than $10^{\circ}C$ in surface temperature and only 47% was less than $10^{\circ}C$. The differences between temperatures were lowest in fruits, salads and vegetables, but highest in milk products. On the other hand, the temperatures established in display stands for frozen food showed a range with $-20.7{\pm}1^{\circ}C$ as a mean. However, the surface temperatures of frozen food on sale showed a range with $-15.4{\pm}5^{\circ}C$ as a mean, minimum $-28^{\circ}C$ and maximum $-4.6^{\circ}C$ (included defrosting). The surface temperatures of frozen food, frozen meats, frozen processed foods and ice creams were $-13.8^{\circ}C$, $-15.9^{\circ}C$, and $-16.8^{\circ}C$, respectively. Only 32.3% of surveyed frozen foods showed less than $-18^{\circ}C$ in surface temperature. In conclusion, the temperatures established on cold and frozen food display stands were less than those of cold and frozen food surfaces on sale. There was also much variation in food surface temperatures during cold and frozen food storage and sales. Therefore, a temperature management system technology use at the distribution level for cold and frozen foods will be developed.

Pre-Harvest Residual Characteristics of Boscalid and Pyraclostrobin in Paprika at Different Seasons and Plant Parts (파프리카 재배 중 살균제 boscalid와 pyraclostrobin의 사용시기에 따른 작물 부위별 생산단계 잔류특성)

  • Cho, Kyu-Song;Lee, So-Jung;Lee, Dong-Yeol;Kim, Yeong-Jin;Choe, Won-Jo;Lee, Je-Bong;Kang, Kyu-Young
    • The Korean Journal of Pesticide Science
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    • v.15 no.3
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    • pp.269-277
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    • 2011
  • Recent outbreak of new diseases and pests which were introduced from abroad, seriously hampered both quality and safety of paprika fruits. This study has been carried out to aid an establishment of guideline for safe use of pesticides and reduction of their residues on paprika. Systemic fungicides boscalid and pyraclostrobin of either mixed (a.i.; 13.6+6.8%) or single (a.i.; 47 and 18.8%, respectively) water dispersible granule formulation(WG) products were sprayed with recommended or double dosage on paprika grown in green house at March and June. To draw pre-harvest residue limit, residues of each fungicide were analyzed from fruits collected eight times from 18 to 1 day pre-harvest. The biological half-lives of both boscalid and pyraclostrobin in mixed formulation in March and June were slightly shorter than those of single formulation which ranged from 14.4 to 20.1 days. Residue levels of both fungicides of single formulation in fruits in June were about one lower compared to those in March. However, application of double dosage frequently exceeded MRLs from fruits grown both seasons. These results showed that residue levels on fruits persisted longer period of time, more than two weeks, and so the case applied in winter season. The dissipation of fungicides on leaves and fruits was compared. The distribution of both fungicides in leaves was 20-200 times higher than that of fruits and persisted up to 18 days of pre-harvest period at the concentration of 10-40 ${\mu}g\;g^{-1}$. This study indicated that the mixed formulation product exhibited low residues in fruits, but high and long enough to pathogen growth in leaves.

The Outcome of Postoperative Radiation Therapy for Patients with Stage II Pancreatic Cancer (T3 or N1 Disease) (2기(T3 또는 N1) 췌장암 환자들의 수술 후 방사선치료의 성적 및 고찰)

  • Kim, Sang-Won;Kim, Myung-Wook;Kim, Wook-Hwan;Kang, Seok-Yun;Kang, Seung-Hee;Oh, Young-Taek;Lee, Sun-Young;Yang, Ju-No;Chun, Mi-Sun
    • Radiation Oncology Journal
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    • v.25 no.4
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    • pp.213-218
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    • 2007
  • Purpose: To analyze retrospectively the outcome of postoperative radiation therapy with or without concurrent chemotherapy for curatively resected stage II pancreatic cancer with T3 or N1 disease. Materials and Methods: Between January 1996 and December 2005, twenty-eight patients completed adjuvant radiation therapy at Ajou University Hospital. The patients had either pathologic T3 stage or N1 stage. The radiation target volume encompassed the initial tumor bed identified preoperatively, resection margin area and celiac nodal area. In the case of N1 patients, the radiation field extended to the lower margin of the L3 vertebra for covering both para-aortic lymph nodes bearing area. The median total radiation dose was 50 Gy. Ten patients received concurrent chemotherapy. Results: Thirteen patients (46%) showed loco-regional recurrences. The celiac axis nodal area was the most frequent site (4 patients). Five patients showed both loco-regional recurrence and a distant metastasis. Patients with positive lymph nodes had a relatively high probability of a distant metastasis (57.1%). Patients that had a positive resection margin showed a relatively high local failure rate (57.1%). The median disease-free survival period of all patients was 6 months and the 1-and 2-year disease free survival rates were 27.4% and 8.2%, respectively. The median overall survival period was 9 months. The 2-and 3-year overall survival rates were 31.6% and 15.8%, respectively. Conclusion: The pancreatic cancer patients with stage II had a high risk of local failure and a high risk of a distant metastasis. We suggest the concurrent use of an effective radiation-sensitizing chemotherapeutic drug and adjuvant chemotherapy after postoperative radiation therapy for the treatment of patients with stage II pancreatic cancer.