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Comparisons of 12-Hour and 24-Hour Sustained-Release Theophyllines in the Management of Asthma (천식치료에서 서방형 Theophylline의 1일 1회 제형과 1일 2회 제형의 비교)

  • Lee, Yang-Deok;Park, Seoung-Ju;Lee, Heung-Bum;Lee, Yong-Chul;Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.3
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    • pp.293-299
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    • 2001
  • Background : Sustained-release theophylline, which is generally prescribed as a twice-daily equal-dose regimen, is one of the more common asthma treatments. The development of a sustained-release drug delivery technology that enables improved control of the theophylline blood levels represents a significant advancement in both the efficacy and safety of dosing. Method : A crossover study was conducted with 25 adult chronic asthmatic patients requiring daily bronchodilator therapy. The study group included thirteen males and twelve females with ages ranging from 19 to 71 years. The overall approach was to place the patients first on the twice-daily preparation($Etheophyl^{(R)}$) for 28 days at 8 AM and 8 PM, and measure the pulmonary function and theophylline level on the 28th day. The patients were subsequently switched to the once-daily preparation($Uniphyl^{(R)}$) in the same daily dose at 8 PM on the 29th day and the same parameters were measured on the 56th day. Results : The mean serum levels of theophylline were $8.18{\pm}1.66\;{\mu}g/ml$ in the $Etheophyl^{(R)}$-treated period and $8.00{\pm}1.75\;{\mu}g/ml$ in the $Uniphyl^{(R)}$-treated period. ln addition, the $FEV_1$ showed $71.40{\pm}7.48$ percent in the $Etheophyl^{(R)}$-treated and $69.18{\pm}9.00$ percent in the $Uniphyl^{(R)}$-treated period. Thus there were no significant differences between the once-daily and twice-daily preparation. Conclusion : The results indicated little clinical differences between the two medications. The two drugs are equally effective in controlling asthma over the four weeks of treatment.

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Antimicrobial Resistance of Bacteria Isolated from Bronchoalveolar lavage (BAL) in Patients with Lung Infiltrations in Burn and Non-Burn Intensive Care Unit (화상 중환자실과 비화상 중환자실 폐 침윤 환자에서 기관지폐포 세척술(BAL)을 통해 획득한 호흡기 검체에서 분리된 균주에 대한 항균제 내성 실태)

  • Kim, Jong-Yeop;Kim, Cheol-Hong;Park, Soo-Hee;Ko, Yoo-Sang;Kim, Mi-Jung;Kang, Hye-Ryun;Hwang, Yong Il;Park, Yong-Bum;Jang, Seung-Hoon;Woo, Heungjeong;Kim, Dong-Kyu;Lee, Myung-Koo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.6
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    • pp.506-515
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    • 2007
  • Background: Nosocomial pneumonia in an intensive care unit (ICU) is associated with a high mortality rate. Diagnosing a respiratory tract infection in critically ill patients is still difficult but detailed information for the pathogens is needed to establish an adequate antimicrobial treatment. This study examined the causative organisms and their antimicrobial resistance using bronchoalveolar lavage (BAL) from patients suspected of having pneumonia in the ICU. Methods: From January 2004 to June 2006, ICU patients with diffuse lung infiltration were prospectively enrolled. The BAL was used to diagnose the respiratory infection, with 104 > or = organisms considered a positive result. The most common organisms and their antimicrobial resistances were analyzed from the quantitative BAL cultures in the burn ICU and non-burn ICU. Results: A total 72 patients were included, 35 (M 29, F 6) in the burn ICU and 37 (M 26, F 11) in the non-burn ICU. 27 patients (77.1%) in the burn ICU and 22 patients (59.5%) in the non-burn ICU met the criteria for a positive BAL culture. The major pathogens were Staphylococcus aureus, Acinetobacter species and Pseudomonas aeruginosa. All strains (100%) of Staphylococcus aureus isolated from BAL (9 cases) were methicillin-resistant (MRSA) in the burn ICU, but 5 strains (71.4%, 7 cases) were MRSA in the non-burn ICU. Regarding Pseudomonas aeruginosa, the rate of resistance to amikacin, ciprofloxacin, cefepime, imipenem, ceftazidime, piperacillin/tazobactam in the burn and non-burn ICU ranged from 45.5% to 90% and 25% to 50%, respectively. In addition, the rate of resistance of Acinetobacter species to the above drugs in the burn and non-burn ICU ranged from 81.8% to 100% and 62.5% to 100%, respectively. Conclusions: These results are expected to provide useful guidelines for choosing the effective empirical antimicrobial therapy in patients with lung infiltrations in the burn and non-burn ICU.

Comparison of the Medication Effects between Milnacipran and Pregabalin in Fibromyalgia Syndrome Using a Functional MRI: a Follow-up Study (섬유근통 환자에 대한 Milnacipran과 Pregabalin 약물치료에 대한 기능적 자기공명영상에서의 후속 영향 비교)

  • Kang, Min Jae;Mun, Chi-Woong;Lee, Young Ho;Kim, Seong-Ho
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.4
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    • pp.341-351
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    • 2014
  • Purpose : In this study, the medication effects of Milnacipran and Pregabalin, as well known as fibromyalgia treatment medicine, in fibromyalgia syndrome patients were compared through the change of BOLD signal in pain related functional MRI. Materials and Methods: Twenty fibromyalgia syndrome patients were enrolled in this study and they were separated into two groups according to the treatment medicine: 10 Milnacipran (MLN) treatment group and 7 Pregabalin (PGB) treatment group. For accurate diagnosis, all patients underwent several clinical tests. Pre-treated and post-treated fMRI image with block-designed pressure-pain stimulation for each group were obtained to conduct the statistical analysis of paired t-test and two sample t-test. All statistical significant level was less than 0.05. Results: In clinical tests, the clinical scores of the two groups were not significantly different at pre-treatment stage. But, PGB treatment group had lower Widespread Pain Index (WPI) and Brief Fatigue Inventory (BFI) score than those of MLN treatment group at post-treatment stage. In functional image analysis, BOLD signal of PGB treatment group was higher BOLD signal at several regions including anterior cingulate and insula than MLN treatment group at post-treatment stage. Also, paired t-test values of the BOLD signal in MLN group decreased in several regions including insula and thalamus as known as 'pain network'. In contrast, size and number of regions in which the BOLD signal decreased in PGB treatment group were smaller than those of MLN treatment group. Conclusion: This study showed that MLN group and PGB group have different medication effects. It is not surprising that MLN and PGB have not the same therapeutic effects since these two drugs have different medicinal mechanisms such as antidepressants and anti-seizure medication, respectively, and different detailed target of fibromyalgia syndrome treatment. Therefore, it is difficult to say which medicine will work better in this study.

Clinical Characteristics of Neonatal Status Epilepticus (신생아 간질 중첩증의 임상 특성)

  • Jung, Kyeong Hun;Kim, Yun Hee;Kwon, Young Se;Jun, Yong Hoon;Kim, Soon Ki;Son, Byong Kwan
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1342-1347
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    • 2005
  • Purpose : Among perinatal risk factors, neonatal seizures are one of the strongest independent discriminators of adverse outcome, representing high risks of mortality and neurologic morbidity. This study was undertaken to evaluate the neurologic outcome of neonatal status epilepticus according to underlying etiology, seizure pattern, onset time, and duration. Methods : We reviewed retrospectively 36 neonates(19 males, 17 females) with status epilepticus who were admitted to the neonatal intensive care unit, Inha Hospital between July, 1988 and June, 2003. They were evaluated with neurologic examination, laboratory data, EEG findings, and neuroimaging studies etc. Results : The mean gestational period of the patients was $37.0{\pm}3.6$ weeks and birth weight was $2.70{\pm}0.82$ kilogram. Fifty two point eight percent of the neonates were male and 66.7 percent were born at term. The most common cause of neonatal status epilepticus was hypoxic-ischemic encephalopathy. In preterm babies, intracranial hemorrhages showed an especially high frequency(P=0.034). Gestational age and birth weight did not show a correlation with neurologic complications. The incidence of neurological sequelae were significantly related to prolonged seizures lasting more than 1 hour(P=0.002). Neonates with seizures within the first 72 hours tended to be more frequent among those who developed adverse outcomes(P=0.016). Generalized tonic seizures had the worst prognosis, whereas those children who had subtle seizures had better outcomes than any other type(P<0.05). Generalized tonic seizures were primarily represented on EEG by abnormal background, whereas subtle seizure showed a significantly more normal EEG than any other seizures(P<0.05). Conclusion : Our results indicate that neonatal status epilepticus with early onsets, prolonged durations. And generalized tonic types can predict an increased risk for neurologic sequelae. So, those seizures must be perceived as medical emergencies and treated aggressively with antiepileptic drugs.

An Ethnographic Study about Taegyo Practice in Korea (태교 실천에 대한 일상생활 기술적 연구)

  • 김현옥
    • Journal of Korean Academy of Nursing
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    • v.27 no.2
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    • pp.411-422
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    • 1997
  • The purpose of this study is twofold : (i) to investigate how much effort the married couples are making for the good health of both the pregnant woman and her unborn child from the time of their marriage to and during the period of conception : and (ii) to comprehensive investigate socio-cultural back-grounds which affect prenatal effort. Result of this study provide a basis for the prenatal care program which will be appropriate to our culture. This study has been done by the ethnographic research method. The subjects of this study are 53 people in all consisting of 33 pregnant women and 20 husbands. In order to investigate socio-cultural factors which influence Taegyo, producers of Taegyo music were interviewed. In addition the researcher surveyed the markets of Taegyo music, participated in special courses of prenatal education, analyzed the content of the books and periodicals dealing with Taegyo, and collected the concept of Taegyo distributed by the mass media. The full-fledged study continued for eight months from February to August.1996. The data were analyzed as soon as they were collected. Spradly's(1979, 1980) developmental, sequential method of domain analysis. taxonomic analysis, componential analysis, and theme analysis in this order was adopted as the procedure of analyzing the data. To obtain the exactness of study, Sandelowski's (1986) four criteria, that is, Credibility, Fittingness, Auditability, and Confirmability were applied to all stages of data collection, data analysis, the interpretation of the result, and the description of the result. The following are the result : 1. The couples' Taegyo at the stage of preconception was related to their physical, psychological, spiritual conditions under which a healthy baby will be born. Specific methods they prefer are : "the choice of one's spouse." "physical check-up," "physical good health, " "praying, " and so on. 2. When the marriod couple have sex in order to conceive, their Taegyo was related to the imposition of their physical, psychological, and environmental conditions. Specific methods they prefer are : "having sex at specific time, " "having sex in nice place." "to purify their minds while having sex," and so on. 3. The married couples' Taegyo while they are in pregnancy was related to the imposition of their physical. psychological, emotionmental. environmental, social and spiritual conditions. Specific methods they prefer are : "listening to music. " "reading," "looking at beautiful things only," "to avoid looking at or listening to bad things." "to eat food in good shape, " "to avoid drugs," "eating Korean herbal medicine." "sexual abstinence," "to avoid dangerous places," "to keep emotional tranquility," "moderate exercises and rest." "leading a pure life." "praying." "being aware of their words and behavior." "for the couple to keep a good relationship." "interaction with their unborn child," "to support Taegyo for pregnant women," and so on. 4. The married couple put Taegyo into practice on the basis of the following principles : the principle of respecting an unborn child, the principle of forming a good disposition. the principle of top-down parental love, the principle of synergy between a pregnant woman and her unborn child, the principle of expecting a good child, the principle of forming a good habit, and the principle of acquiring a parental role. 5. The practice of Taegyo is influenced by such factors as the married couple, the supporting system, and the mass media. As the husband -and-wife factor, their information of Taegyo, the degree of importance is assigned to their characters, their time to spare, their healthiness, the age of pregnant woman, their conception plan, their religion, their belief of the Taegyo effects, and the birth of a baby in this order. The factor of the supporting system consists of her husband's support, her family support, and her neighbor's support. The mass media factors include the broadcasting media, books specialized in Taegyo, periodicals for pregnant women, booklets for advertizing powdered milk, Taegyo music of record manufacturing companies, and the teaching materials for gifted children. Among these the mass media is especially taking advantage of Taegyo as its main source of economic profits are leading the public behavior pattern to a prodigal one. Taegyo is a self-control behavior which requires practice for the following : the physical and psychological good health of the pregnant woman and her unborn child, the development of the unborn child's good character, the development of the unborn child's intelligence and talents, the expectation of the unborn child's good features. shape a good habit, the expectation of the unborn child's bright future, and the learning of a parental role, the expectation of male birth. Above all it is a type of our good cultural tradition which pursues a value higher than the one that the prenatal care does. The principles of pregnancy care inherent in the habit of Taegyo will provide us a guideline for the development of the prenatal care.

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The life and medical idea of Yoo Chang (유창(喩昌)의 생애(生涯)와 의학사상(醫學思想))

  • Kim, Soo-Yeol;Yoon, Chang-Yeol
    • Journal of Korean Medical classics
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    • v.4
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    • pp.101-126
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    • 1990
  • At early Cheong (淸) dynasty, in medical aspect by dependent on practical studying attitude that must found a theory only by an evidence, there had been a tendancy that hoped direct research of sages' mind-eye by escaping the theory of individual classes since Geum-Won (金-元) dynasty. Yoo Chang (喩昌), born in Man-Ryeok (萬曆) 12th year of Myung (明) dynasty (A.D.1583) and dead in Gang-Hee (康熙) 3rd year of Cheong (淸) dynasty (A.D.1664). The results were as follows after studying his practical idea of medicine. 1. Yoo Chang, by recognizing the ${\ll}$Sang-Han-Ro${\gg}$ has lost its true meaning after commented by Wang Hee (王熙), Lim Eog (林億), Seong Moo-I (成無巳), etc. according to Bang Yoo-Jip's (方有執) Chak-Gan-Jung-Jeong (錯簡重訂) theory, he diversified the protocal of ${\ll}$Sang-Han-Ro${\gg}$ 397 method and arranged under Six Meridian part. (六經) 2. The theory of Sam-Gang-Jeong-Rip (三綱鼎立) can be summerized Gye-Ji (桂枝) syndrome which is the case of Wind (風) has injured Wi (衛) stage, Ma-hwang (麻黃) syndrome which is the case of Cold (寒) has injured Yeong (榮) stage, Dae-Cheong-Ryong (大靑龍) syndrome which is the case both of Wind-Cold (風寒) has injured Yeong-Wi (榮衛) stage, and there has been Sam-Gang-Jeong-Rip theory by anterior medical practitioners already but the person who formally used its Sam-Gang-Jeong-Rip term is Yoo Chang. 3. Yoo Chang seized the On Byeng (溫病) by dividing three category and in Byon-Jeung-Si-Chi (辨證施治) he influenced to many aspect of establishment of later Byon-Jeung system On-Byong (溫病의 辨證體系) pertaining to Triple-Warmer by O-Dang (吳瑭) introducing Triple-Wanner Theory. (三焦理論) 4. At Chu-Jo-Ron (秋燥論) of ${\ll}$EUi-Moon-Beop-Ryo${\gg}$, while ${\ll}$Nae-Gyeong${\gg}$ describing if humidity injury Lung, then occur a disorder in it, Yoo Chang recognized that of au tuam when dryness injure Lung there occure a disorder is it so he insisted that at this case, must use Cheong-Joe-Goo-Pye method (淸操救肺法) withherbs, pertaing to Gam-Yoo-Ja-Yoon(甘柔滋潤性) property and he invented Cheong-Joe-Goo-Pye-Tang. (淸操救肺湯) 5. Yoo Chang', so called, Dae-Gi (大氣) indicates Yang-Gi (陽氣) of chest, he insisted that man's creation and every physiological activity depends on maintainence of Dae-Gi, and it integrate Yeong-Gi (榮氣), Wea-Gi (衛氣), Jong-Gi (宗氣), Jang-Boo-Ji-Gi (臟腑之氣), Gyeong-Rak-Ji-Gi. (經絡之氣) 6. Yoo Chang's expression about partical function and character of stomach, not only bolster its theory of historical physician's expression, that is stomach is. foundatness of postnatal period, but also it has corresponding aspect with modern medicine and clinic. 7. Yoo Chang emphasized "if one cure a disease, be must understood the character of disease first and use drugs later" (先議病 後用藥) phrase about of drug usage, and his theory of Geup-Rew-Man-Joo method (急流挽舟) and three therapy of Simple Ascite (單腹腸) are all unique opinion based upon this phrase mentioned above. 8. Yoo Chang's practical idea of medicine greatly influenced to Jang Ro (張璐), Hwang Won-A (黃元御), Oh Eui-Rak (吳儀洛), Joo Yang-Joon (周揚俊), etc. and theory of Sam-Gang-Jeng-Rip (三綱鼎立), Triple Warmer Theory of On Byong (溫疫의 三焦論治), Chu-Jo-Ron (秋燥論), Dae-Gi-Ron (大氣論) etc. became important object to student of Sang-Han (傷寒) and On-Byeng. (溫病) 9. Yoo Chang's Writings has more practical meaning than other physician's, especially, later the idea of Sang-Han (傷寒) and On-Byong (溫病) greatly contributed to development of Sang-Han theory and formation of On-Byong theory.

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A research on Hyang-Yack-Ku-Keup-Bang(鄕藥救急方) (Restoration and Medico-Historic Investigation) (향약구급방(鄕藥救急方)에 대(對)한 고증(考證))

  • Sheen, Yeong-Il
    • Korean Journal of Oriental Medicine
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    • v.2 no.1
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    • pp.71-83
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    • 1996
  • Hyang-Yack-Ku-Keup-Bang(鄕藥救急方) is our own, medical work written about the middle of the time of Korea Dynasty. I restored and researched this book because it needed to be illuminated about its medico-historic value and then I came to some conclusions as follows. 1. Hyang-Yack-Ku-Keup-Bang was published in Dae-jang-do-kam(大藏都監) of Kanghaw island(江華島) about the middle of Korea Dynasty. Choi Ja-ha(崔自河) republished it on original publication ground in Euiheung(義興) of Kyungsang-Province(慶尙道) in July, Taejong's(太宗) 17th year of Chosen Dynasty (A.D.1417) and this book was published again in Chungcheng Province(忠淸道) in Sejong's(世宗) 9th year(A.D.1427). The book published in Taejong's days was in the possession of books department of Kung-nae-cheng(宮內廳) in Japan and was the oldest medical book of existing ones. 2. Bang-Jung-Hyang-Yack-Mock-Cho-Bu(方中鄕藥目草部) of this book was originally intended to be adjusted in each division with the title of Bang-Jung-Hyang-Yack-Mock(方中鄕藥目). But Herb part(草部) only followed editing progress of Jeung-Lew-Bon-Cho(證類本草), the rest is not divided into each part and is together arranged at the below of Herb part with the title of Bang-Jung-Hyang-Yack-Mock-Cho-Bu. The Korean inscriptions on some drugstuffs in this book are different between Native Name(鄕名) of three volumes of provisions and general-spoken(俗云) of Bang-Jung-Hyang-Yack-Mock-Cho-Bu. In this, it is estimated that the publishing time and editor of tile volume of provisions and Bang-Jung-Hyang-Yack-Mock-Cho-Bu are different. I think Choi Ja-ha compiled this behind three volumes of provisions when he published. 3. This book picked some prescriptions which consisted of obtainable drugs with ease in Korea in the books of Chell-Keum-Yo-Bang(千金要方), Oi-Dae-Bi-Yo(外臺秘要), Tae-Peong-Sung-Hye-Bang(太平聖惠方), Ju-Hu-Bang(?後方), Kyung-Hum-Yang- Bang(經驗良方) Bo-Je-Bon-Sa-Bang(普濟本事方) Bi-Ye-Baik-Yo-Bang(備預百要方) and so on and got together our own prescriptions. On the whole Bi-Ye-Baik-Yo-Bang was a chief referrence book, On this, other books referred to and corrected. 4. In provisions quoted from Hyang-Yack-Jip-Sung-Bang(鄕藥集成方), there are seven provisions; leg-paralysis part, coughing part, headache part, obstetrics part, etc. don't show in this book. This is why Choi Ja-ha published only certain texts on Dae-jang-do-kam edition his own posession. So we can think the existing edition has a little misses compared with original edition. 5. This book recorded only names of drugstuffs in animal drug department like fowls, crab, goldbug, earthworm, etc. and didn't tell us ways of taking those. This is effect of Buddhist culture on medicine. This is efforts to practice 'Don't murder';one of Five Prohibition of Buddhism. 6. Beacause this book was published at the time, when our originative medicine would be set forth. This followed the Chinese ways in Theory, Treatment, Prescription and used 'Hyang Yack' in Medication out of theory of Korean medicine, which was a transitional form. So this is all important material which tell us aspects of development of 'Hyang Yack' the middle of Korea Dynasty.and this is also the beginning of originative, medical works like Dong-Eui-Bo-Kam(東醫寶鑑), Dong-Eui-Su-Bo-Won(東醫壽世保元). 7. There are few contents based on 'Byen-Jeung-Lon-Chi(辨證論治)'in this book. So we can see this book is not for doctors who study medical thoughts but for general public who suffer from diseases resulted from war. Because this book was written for a first-aid treatmeant, this is an index of medical service for the people those days. And this is also an useful datum for first-aid medicine or military medicine in these modern days. 8. Nowadays, parts of learned world of Korean medicine disregard essential theories and want to explain Korean medicine only by the theories or the methods of Western medicine. Moreover they don't adopt Chinese and Japanese theorys & thoughts about Oriental medicine in our own style and just view in there level. What was worse, there is a growing tendency for them to indulge in a trimming policy of scholarship and to take others' ideas. I think these trends to ignore our own medical thoughts involving growth of 'Hyang Yack' in the middle of Korea Dynasty, Dong-Eui-Bo-Kam and Dong-Eui-Su-Se-Bo-Won. So we, as researchers of Korean medicine, must get out of this tendency, and take over brilliant tradition and try to develop originative Korean medicine.

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Change of interictal epileptiform discharges after antiepiletic drug treatment in childhood epilepsy (소아 간질 환자에서 항경련제 치료 후 간질파의 변화)

  • Kim, Mun-Ju;Nam, Sang-Ook
    • Clinical and Experimental Pediatrics
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    • v.53 no.4
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    • pp.560-564
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    • 2010
  • Purpose : Electroencephalography (EEG) findings can play a critical role in a variety of decisions, including initiation and withdrawal of antiepileptic drugs (AEDs) therapy. Interictal epileptiform discharges (IEDs) are predictor of recurrent seizures. We investigated IEDs in EEG after AED therapy and related factors in epileptic children. Methods : The subjects were 257 children [151 males and 106 females; age, 6.79 (3.40) years; duration of therapy, 2.48 (1.85) years] diagnosed with epilepsy at the Department of Pediatrics, Pusan National University Hospital between January 2001 and December 2007, who received AEDs for more than 6 months. EEG was performed at the intervals of 6-12 months. We divided patients into 4 groups according to IED detection before and after AEDs treatment. Related clinical factors, including gender, age at the start of treatment, seizure type, cause of seizure, AED frequency, seizure control, duration of AED therapy, and background activity were investigated in the 4 groups. Results : Generalized epilepsy was relatively frequen in patients who did not show IEDs in last follow-up EEG. There were no clinically significant differences according to gender, age at the start of treatment, cause of seizure, AED frequency, seizure control, duration of AED medication, and background activity in the 4 groups ($P$>0.05). Conclusion : IEDs changed after AED treatment in one-third of the patients. Generalized epilepsy is positive factor for negative IEDs in last follow-up EEG.

Epidemiology and clinical characteristics of headache comorbidity with epilepsy in children and adolescents (소아청소년 간질 환자에서 동반된 두통의 역학과 임상적 특징)

  • Rho, Young Il
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.672-677
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    • 2007
  • Purpose : To assess the prevalence and characteristics of headache comorbidity with epilepsy in children and adolescents in a specialty epilepsy clinic. Methods : Two hundred twenty nine consecutive patients attending the Chosun University Hospital Pediatric Epilepsy Clinic (mean age $10.0{\pm}4.1\;years$, range 4-17, M:F ratio 1.1:1.0) were interviewed with a standardized headache questionnaire. Headache was classified according to the International Classification of Headache Disorders, 2nd Edition and epilepsy was classified according to the International League Against Epilepsy. Disability was assessed using pediatric migraine disability assessment (PedMIDAS). Results : Of the 229 epilepsy patients, 86 (37.6%) had co-morbid headache. Of the headache patients, 64 (74.4%) had migraine (65.6%- migraine without aura, 20.3% - migraine with aura, 14.1% - probable migraine). The mean headache frequency was $7.2{\pm}8.4$ per month, mean duration was $2.2{\pm}4.0$ hours, mean severity was $5.2{\pm}2.2$ out of 10, and mean PedMIDAS score was $13.0{\pm}35.4$. The proportion of females was not higher in epilepsy with headache patients (48.8%) compared to epilepsy patients alone (48.0%). In the patients with migraine, 48.4% had complex partial seizures, 17.2% had simple partial seizures, and 34.4% had generalized seizures (P=0.368). A postictal association of migraine was reported in 18.8% with 17.2% reporting a preictal headache, and 7.8% reporting an ictal headache. Conclusion : The prevalence of headache in pediatric epilepsy is higher than that in general pediatric population, suggesting a co-morbidity of headache in epilepsy patients with migraine being the most frequent headache disorder. Altered cerebral excitability resulting in an increased occurrence of spreading depression may explain the headache comorbidity with epilepsy. Further studies are needed to assess the etiology of this co-morbidity as well as assess the frequency, duration, severity and disability response to antiepileptic drugs.

The Effect of the Improvement of the Sales Regulation of General Medicine and Political Proposals (일반의약품 판매규제 완화효과와 정책제언)

  • Yeom, Min-Sun
    • Journal of Distribution Research
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    • v.15 no.5
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    • pp.237-255
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    • 2010
  • The Korean Pharmacist Law has limited the sales of medicine to pharmacies. This has caused difficulty in purchasing medicine late at night or on holidays, which has limited the range of customers' selections and accelerated customers' discomfort, accordingly. Also, the rapid progress of aging has quickly boosted medical expenses for seniors, and has served as a factor that aggravates the budget of national medical insurance. Meanwhile, advanced countries, including the USA and Japan, have allowed the sales of general medicine, of which the safety and efficacy have been tested, in general retail stores such as convenience stores or super markets from the perspective of supporting self-medication. In particular, Japan, which has a strong tendency of pursuing safety in the world, diversified sales channels for general medicine in order to control quickly rising medical expenses. As a result, Japan has achieved the effect of easing various regulations as follows in the economic and social fields. First, the increasing distribution channels of general medicine from pharmacies to general retail stores provoked a potential demand, which also expanded related markets. Second, the competition between sales channels resulted in the reduction of the price of medicine. Third, the growing sales channels of medicine have extended the options of consumers and, subsequently, the convenience in the use of consumers has increased. Fourth, the creation of a competitive environment owing to the diversification of sales channels has accelerated an effort to enhance corporate competitiveness. Fifth, the foundation of enhancing the financial soundness of medical expenses has been prepared through the formation of a self-medication environment. In 2000, the Korean population aged 65 or over exceeded 7%, and it is anticipated to be over 14% by 2018; thus, the increase of national medical expenses will be sped up. As a way of being prepared for the era of aging, we, just as other advanced countries, need to create a self-treatment environment by diversifying the sellers of general medicine, and, thus, reduce spending on personal medical expenses, enhance the financial soundness of national medical insurance, and, further, promote the welfare of consumers.

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