• The Journal of Internal Korean Medicine
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• v.20 no.1
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• pp.232-243
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• 1999

In the Oriental Medicine, the breathing problem is defined as one of the symptoms such as Cheon-Jeung, Hyo-Jeung and chronic respiratory organs disease. Its source is heard to be the functional reduction of descending of Lung and Kidney. The organs for breathing are known as Lung, Spleen and Kidney. In this research, some remarkable results are referred which were detected by measuring the variations of the breathing volume of 20 patients after taking Keumsuyukunjeon. Picrometer is used for the measurement of the volume. The investigation had been performed since from January 1 st to August 31th of 1998. The patients for the experiment were mainly composed of patients who had trouble in breathing due to the pneumonectasis, sthmas, pneumonias. The percent of men is 67% in sex distribution and the ratio of persons over 50's was 85%. After Keumsuyukunjeon was taken to the patients, the enhancement ratio of breathing volume was appeared as 7.7%. The analysis based on an age was that the patients of 40's show the highest volumetric advancement. The ratio of breathing volume was the aged patients whose lung or kidney is weak and it can be used as the prescription for supplement of body and lung. From the relations between the breathing volume before treatment and the enhancement ratio, the increase of the enhancement ratio and the better response to the medicine were shown to the more serious patients. The period of treatment was 27.5 days average. The enhancement ratio of smoker was 23. and that of non-smoker was 50. At the test of relation between the trouble rate in breathing and the enhancement ratio. Grade Ⅲ shows the highest enhancement value 50%. From the experimental results, It is found that Keumsuyukunjeon gives a noticeable benefit for the patients whose main symptom was breathing problem. Long-term treatments for the serious and aged patients will make much more efficient to the reduction of the symptoms.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.11 no.1
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• pp.269-283
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• 1998

Paranasal sinusitis, especially chronic is one of the most common diseases in the field of otolaryngology. It is similar to Bee Yeun(鼻淵) in oriental medicine. Most cases of sinusitis are due to anatomical abnormalities within ostiomeatal unit or disturbed mucocilliary flow. The ostiomeatal unit is the first place of contact with bacteria and allergens during aspiration, and it can be obstructed easily by minute mucosal swelling due to anatomical narrowness. Therefore the treatment of paranasal sinusitis is not easy and often leads to recurrences in spite of long term treatment or surgical therapy. We studied 83 patients who had visited our hospital with complaints of nasal symptoms; they had been diagnosed as having paranasal sinusitis through an endoscopy or CT scan in another hospital and were diagnosed as the paranasal sinusitis through a PNS series. The results were as follows: 1. Age and sex distribution: The most common occurence was found between 6-10 and 1-5 years old. The Males Were 52($62.7\%$) and Females were 31($37.3\%$). 2. By residence 58 cases lived in apts: 25 lived in houses. 3. The longest duration of disease varied from a lower of 13 to a higher of 36 months in 22 cases and from 7 to 12 months in 21 cases. 4. The most common complication & past history with otolaryngologic or allergic disease were adenoid or tonsil hypertrophy & tonsillectomy and adenoidectomy (21 cases). In decreasing order the others were atopic dematitis, otitis media with effusion and allergic rhinitis. 5. Distribution of paranasal sinus disease was most common in both maxillary sinuses in 52 cases. 12 cases showed a normal PNS X-ray series but these had been diagnosed as paranasal sinusitis with an endoscopy or CT scan in another hospital. 6. Common sinusitis - related symptoms were from highest incidence to lowest nasal obstruction, postnasal drip rhinorrhea, frontal headache, cough with sputum. 7. The most administered of prescription was Gamibangpoongtongsungsan and Sunbangpaedoksan extract. 8. In 26 cases the subjects showed significant improvement symptoms in PNS X-ray series : In 21 case showed partial improvement symptoms.

• Korean Journal of Clinical Pharmacy
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• v.32 no.3
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• pp.155-165
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• 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.

• The Korean Journal of Pain
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• v.37 no.2
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• pp.119-131
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• 2024

There are growing concerns regarding the safety of long-term treatment with opioids of patients with chronic non-cancer pain. In 2017, the Korean Pain Society (KPS) developed guidelines for opioid prescriptions for chronic non-cancer pain to guide physicians to prescribe opioids effectively and safely. Since then, investigations have provided updated data regarding opioid therapy for chronic non-cancer pain and have focused on initial dosing schedules, reassessment follow-ups, recommended dosage thresholds considering the risk-benefit ratio, dose-reducing schedules for tapering and discontinuation, adverse effects, and inadvertent problems resulting from inappropriate application of the previous guidelines. Herein, we have updated the previous KPS guidelines based on a comprehensive literature review and consensus development following discussions among experts affiliated with the Committee on Hospice and Palliative Care in the KPS. These guidelines may assist physicians in prescribing opioids for chronic non-cancer pain in adult outpatient settings, but should not to be regarded as an inflexible standard. Clinical judgements by the attending physician and patient-centered decisions should always be prioritized.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.289-293
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• 2001

Objectives : The optimal treatment of craniopharyngioma is controversial. Despite recent advances in microsurgical management, complete surgical removal of craniopharyngioma remains very difficult. Radiation added to surgery is effective, but radiation therapy resulted in untoward side effect in young patient. Gamma knife radiosurgery offers the theoretical advantage of a reduced radiation dose to surrounding structures during the treatment of residual or recurrent craniopharyngioma compared with fractionated radiotheraphy. We described retrospective analysis of tumor size and clinical symptoms of patients after gamma knife radiosurgery in residual or recurrent craniopharyngioma were performed. Material and Methods : From September 1990 to January 2000, 18 patients of craniopharyngioma were treated by gamma knife radiosurgery. All patient had undergone surgery, but residual or recurrent tumor was found and all of them treated postoperative gamma knife radiosurgery. The mean age was 19(from 6 to 66) and male to female ratio was 10 to 8 and 8 patients were below 15 years old. In young age group(below age 15), the average volume of the tumor was $2904.8mm^3$ and mean maximal gamma knife dose was 34.9Gy. In old age group(older than 15), the average volume of the tumor was $2590.4mm^3$ and mean maximal gamma knife dose was 45.2Gy. The size of the tumor was average $2730.1mm^3$($88-12000mm^3$), mean average radiation dose was 40.7Gy and the mean prescription dose was 17.6 Gy(4-35Gy) delivered to a median prescription 50.7% isodose. Results : The follow up was from 1 year to 9 years(mean 59.1 months) after gamma knife radiosurgery. The tumor was controlled in 13(72.2%) patients. The tumor decreased in 9 patients and not changed in 4 patients. The tumor size increased in 4(22.2%) patients during follow up period. In two cases the tumor size increased because of its cystic portion was increased, but their solid portion of the tumor was not changed. In another two patients, the solid portion of the tumor was increased. So, one patient underwent reoperation and the other patient underwent operation and repeated gamma knife radiosurgery. The tumor recurred in one case(5.6%) that is a outside of irradiated site. The presenting symptoms were improved in 4 patients(improved visual acuity in 1, controlled increased intracranial presure sign in 3 patients). In one case, visual acuity decreased after gamma knife radiosurgery. The endocrine symptoms were not influenced by gamma knife radiosurgery. Conclusion : Craniopharyngioma can be treated successfully by gamma knife radiosurgery. Causes of the tumor regrowth are inadequate dose planning because of postoperatively poor margination of the tumor, close approximation of optic nerve and residual tumors outside the target lesion. Recurrence can develop 4 years after gamma knife radiosurgery. Volume is important, but the accurate targeting is more important to prevent tumor recurrence. If the tumor definition is not clear during planning gamma knife surgery, long-term image follow up is required.

• Journal of agricultural medicine and community health
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• v.44 no.1
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• pp.28-38
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• 2019

Objectives: We searched and reviewed the literature including the laws or acts, statistics, guidelines, papers and conference proceedings related to home visit nursing care in South Korea. Method: We searched and reviewed the literature including the laws or acts, statistics, guidelines, papers and conference proceedings related to home visit nursing care in Korea. Results: There are three types of home care nursing in Korea. Public health center provides home visit nursing to vulnerable population by registered nurses for free, based on community health act in public health center. As of 2017, 1,261,208 people were enrolled in the visiting health program of public health center. Health behavior and disease management has been improved and showed having cost-benefit effect among the enrolled people in visiting health program. Visiting nursing care in long-term care services is provided by registered nurses or nurse aid, based on long-term care act. The cost is paid as the unit price according to service time. 1,095,764 older people used long-term care services in 2017, only 0.2% of total cost used for home visiting nursing. Even though the number of user of home visiting nursing, it was reported that users spent less medical cost and hospitalized shorter. Hospital-based home care nursing is provided to patients and their families under the prescription of a doctor by family nurse specialists who are employed by medical institute based on medical law. Four hundred sixty family nurse specialists worked for hospital-based home care nursing and hospital-based home care services accounted for 0.038% of total medical expenses in 2017. Conclusion: Even though home visit nursing care services are different in aspect of legal basis, personnel, running institutes, and cost basis, home visit nursing care showed cost-benefit effect and good health outcomes. In order to advance home visit nursing care, the integrated home visiting care, improvement of working condition, and revision of legal basis should be considered.

• Journal of Oriental Neuropsychiatry
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• v.12 no.2
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• pp.103-122
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• 2001

The clinical study was carried out the 58 patients with Headache who were treated in Department of Neuropsychiatry, College of Oriental Medicine, Dae Jeon University from 14 October 1999 to 15 October 2001. The results were summarized as follows. 1. The ratio of male and female was 15:43, 40s(36.2%) was frequent, the ratio of Tension headache and Migraine was 43:12, hypernoia and overwork oneself were the most inducing factor. 2. In distribution of the period of the clinical history, Tension headache was comparatively short term within 1 month(62.8%) and Migraine was comparatively long term over 1 year(91.7%), Tension headache was frequent at whole portion(41.3%) and occipital portion(26.1%), Migraine was frequent at temporal portion(76.9%). 3. In pain type, Tension headache has many vandlike discomport type, Migraine has many pulsatile type, neck-stiffness-pain and dizziness were mainly coexited. 4. Toung aspect has many SULDAMHONGTAEBAEKHOO(舌淡紅苔白厚), GINMAEK(緊脈) and HEUNMAEK(弦脈) were frequent in Pulse type, the GAEDAMSUNKIJEETONG(祛淡順氣止痛) prescription drugs were frequent such as GEYNTONGA(肩痛A), GEYNTONGDODAMTANG(?通導淡湯), Tension headache patients were well treated(90.7%). 5. In Tension headache and Migraine, the Curve has many SL except Tension headache‘s 2th SANGHAN(상한), in Regulation RR was frequent at 1th, 2th, 3th, 4th, 7th SANGHAN and RL was frequent at 5th, 6th SANGHAN, the result of Graph, Activity and Reactivity have many low response at the whole. 6. The Curve was within normal limit at whole portion and frequent SL at temporal portion, the whole and temporal portion s Regulation also have many RR at 1th, 2th, 3th, 4th, 7th SANGHAN and RL at 5th, 6th SANGHAN, Activity and Reactivity have many low response at the whole. 7. The occipital and frontal portion‘s Curve have many SL at 1th SANGHAN, the occipital portion’s Regulation has many RR at 1th, 2th, 4th, 7th SANGHAN and RL at 5th, 6th SANGHAN, Activity has many low response at the whole, Reactivity has many low response at 1th, 4th, 5th, 6th SANGHAN and high response 2th, 3th SANGHAN, the frontal portion s Regulation has many RL at 1th, 3th, 5th, 6th, 7th SANGHAN and RR at 4th SANGHAN, Activity and Reactivity also have many low response at the whole except 6th, 7th SANGHAN respectively.

• Proceedings of the Korean Society of Developmental Biology Conference
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• 2003.10a
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• pp.101-101
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• 2003

Main strategy for a treatment of Parkinson's disease (PD), due to a progressive degeneration of dopaminergic neurons, is a pharmaceutical supplement of dopamine derivatives or ceil replacement therapy. Both of these protocols have pros and cons; former exhibiting a dramatic relief but causing a severe side effects on long-term prescription and latter also having a proven effectiveness but having availability and ethical problems Embryonic stem (ES) cells have several characteristics suitable for this purpose. To investigate a possibility of using ES cells as a carrier of therapeutic gene(s), human ES (hES, MB03) cells were transfected with cDNAs coding for tyrosine hydroxylase (TH) in pcDNA3.1 (+) and the transfectants were selected using neomycin (250 $\mu /ml$). Expression of TH being confirmed, two of the positive clone (MBTH2 & 8) were second transfected with GTP cyclohydrolase 1 (GTPCH 1) in pcDNA3.1 (+)-hyg followed by selection with hygromycin-B (150 $\mu /ml$) and RT-PCR confirmation. By immune-cytochemistry, these genetically modified but undifferentiated dual drug-resistant cells were found to express few of the neuronal markers, such as NF200, $\beta$-tubulin, and MAP2 as well as astroglial marker GFAP. This results suggest that over-production of BH4 by ectopically expressed GTPCH I may be involved in the induction of those markers. Transplantation of the cells into striatum of 6-OHDA- denervated PD animal model relieved symptomatic rotational behaviors of the animals. Immunohistochemical analyses showed the presence of human cells within the striatum of the recipients. These results suggest a possibility of using hES cells as a carrier of therapeutic gene(s).

• Health Policy and Management
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• v.10 no.2
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• pp.41-77
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• 2000

This study aimed at the analysis, from the perspective of rationality, of policy making process in the separation of prescribing and dispensing. This study is to identify the characteristics and problems of the policy process to introduce the new durg-prescription system, and make policy recommendations. In terms of separation of prescribing and dispensing, the development of policy making process can be divided into two periods; periods before and after the inauguration of the govemment of people. In the period before the govermment of poeple, one of the major characteristics of policy decision on the new system was the poweful influence of interset groups. At that time, the ministry lacked the problem-solving ability and commitment on the policy. Consequently, during the former period, the policy making process had been driven by interest groups. Therefore, the original purpose of the policy to secure the pulic health was lost. During the latter period, there was also the strong influence of interst groups, complexity of interest, the ministry's inability of problem solving. However, in this period, it is notable that this has drawn nation-wide attention, severl civic grouos have participated in the policy making process, and that the number and voice of these groups have remarkably increased. With regards to rationality, incrementalish model is highly sutable to explain the policy making process in the former period. But in the latter period when the new drugperscripition system became a national issue and civic groups began to participte in this matter more actively, rational model is more explanatory that incrementalism to understand the process. During the latter period, the original goal of this policy was not distored by a few interest groups thanks to the rapid development of civil movement and therebly a big influence of civic groups on the policy making. For that reson, a jigh level of rationality is found in the policy-making process of the latter period. Some suggestions to achieve the rationality in the policy making process based on the results of this study are as follows; Frist, the public's participation should be enered in the policy making process. Second, the govermment should make contiuns efforts to enhance its ability of long-term planning and policy implementation, and increase rationality of policy making process. Third, balance among interset groups should take place in the process of policy making. Forth, sound, constructive, and logical activity of interest groups is necessary to express and promote their interests.

• Journal of Veterinary Clinics
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• v.34 no.6
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• pp.449-453
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• 2017

A 3-year-old castrated male Maltese dog, weighing 4.8 kg was referred with hindlimb ataxia and right forelimb proprioceptive deficits were shown for 20 months. Chiari-like malformation and syringomyelia diagnosed through MRI at a local animal hospital and Knuckling of right forelimb and reluctance to walk were managed with steroid. The medical management was getting ineffective to manage for the symptoms one month before referred. Physical and neurological examinations, radiography, computed tomography, and magnetic resonance imaging were performed and diagnoses of caudal occipital malformation syndrome (COMS) and subsequent syringomyelia (SM) were made. Given that pharmacological treatment was previously ineffective, surgical intervention was recommended. Foramen magnum decompression with duraplasty using $Lyoplant^{(R)}$ was performed. Three days post-surgery, the dog showed improved gait and activity. After 2 months, the dog received no additional prescription medications. At the 12-month follow-up after surgery, the dog showed no clinical problems or recurrences, despite complete cessation of pharmacological treatment. In present report, we applied $Lyoplant^{(R)}$ as a dural graft has been carried out in a dog with COMS. Surgical decompression with $Lyoplant^{(R)}$ was an effective long-term (12-month) treatment for COMS without the need for any pharmacological treatment.