• Annals of Clinical Neurophysiology
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• v.22 no.2
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• pp.61-66
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• 2020

Critical illness neuromyopathy (CINM) is a common but frequently underdiagnosed condition in critically ill patients that contributes to ventilator weaning failure and limb weakness in intensive care unit (ICU). CINM is subdivided into critical illness polyneuropathy and critical illness myopathy, and the occurrence of these conditions in the ICU is associated with multiple organ failure due to sepsis or certain medications. CINM survivors might have persistent functional disabilities and a poor quality of life. This situation demonstrates the need for efforts to minimize or prevent CINM in critically ill patients. This article provides a current overview of CINM and the associated clinical strategies.

• Journal of Oral Medicine and Pain
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• v.44 no.1
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• pp.31-34
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• 2019

The aim of this case report is to present a case of 68-year-old male with a history of multiple myeloma and the intravenous use of Zometa (zoledronic acid) who had developed medication-related osteonecrosis of the jaw (MRONJ) following a hot pizza burn to the palate. Clinical and radiographic findings revealed grade 1 MRONJ of the right side of the hard palate. Soft tissue trauma and delayed epithelialization may be associated with some cases of MRONJ. Patients on anti-resorptive medications or anti-angiogenic drugs should be informed of the risk of bone exposure and subsequent MRONJ secondary to physical/chemical insults to the bone and soft tissue in the oral cavity.

• Journal of Korean Dental Science
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• v.17 no.2
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• pp.75-83
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• 2024

Stevens-Johnson syndrome (SJS) is a severe adverse cutaneous drug reaction seen rarely in clinical practice. Although relatively rare, the condition can be fatal. Mainly, it is caused by side effects of certain medications. Previous reports have associated Stevens-Johnson syndrome with abnormal root development, but the other long-term dental complications have rarely been reported. In this case, the patient developed SJS at the age of 5, and abnormal root development of the maxillary and mandibular first molars and mandibular incisors was observed, as well as impaction of the mandibular canine and enamel hypomineralization of multiple teeth. Accordingly, appropriate restorative treatment and orthodontic treatment were performed, and the clinical characteristics of this symptoms and its treatment were discussed in more detail. We aim to highlight the need for dentists to be aware of the potential dental complications of SJS and to enable early diagnosis and management of the condition to avoid undesirable sequelae.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.14 no.1
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• pp.3-11
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• 2003

Attention-deficit/Hyperactivity disorder(ADHD) is the most common psychiatric disorder of childhood and among the most prevalent chronic health conditions affecting school-aged children. Children with ADHD experience significant functional problems, such as school difficulties, academic underachievement, troublesome interpersonal relationships with family members and peers, and low self-esteem. The most widely used pharmacological treatments for ADHD are psychostimulants, such as methylphenidate and amphetamine salts. These medications provide clinical efficacy by increasing the availability of catecholamines, primarily dopamine, in the frontal lobe of the brain. immediate-release(IR) formulations of sychostimulants were among the most effective psychotrophic medications in the psychopharmacological treatment. However, there are some limitations of IR formulations：the short half-life and duration of efficacy, which result in the need for multiple daily dosing and the poor compliance. These limitations have led to the development of once-daily, extended-release(ER) formulations of methylphenidate and amphetamine salts. However, these ER formulations may not be as immediately helpful to ADHD children due to delayed onset of action and the acute tolerance which is the failure to sustain the efficacy with the same concentration of drug as the initial stage of medication. OROS-methylphenidate(Concerta$^{\circledR}$) given once a day produces an ascending-pattern plasma drug level generated by the osmotically released, timed drug-delivery system. These new formulations of the psychostimulants have been shown to be a useful alternative to old stimulant medications through the evidence by the clinical trials.

• Journal of Korean society of Dental Hygiene
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• v.12 no.5
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• pp.973-985
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• 2012

Objectives : The aim of this study is to investigate the possible impact factors on adults' self-reports of dry mouth and to develop strategies to improve oral health education policy. Methods : This study was conducted on a total of 622 self-administered questionnaires adult above 20 and under 65 years of age living in Seoul and Gyeonggi provinces. The final participants consisted of 443 adults without chronic illness, taking medications and wearing dentures. The Hierarchical Multiple Regression model with three stages was used to assess the association for exposure of interest, such as socio-demographics, health-related behavior, mental health and self-reported of dry mouth. Results : The participants reported mean score of dry mouth($6.32{\pm}4.47$), of which 191 were male($6.81{\pm}4.56$) and 252 were female($5.94{\pm}4.37$). Hierarchical Multiple Regression revealed that the score of dry mouth was shown to be significantly higher for the following people: Males, who were employed, unemployed, negative self-perceived general health, perceived stress, and participants who had no experience awareness of distress in two weeks. The explanatory power was 21.9%. The most powerful impact factor regarding to employment was shown to be negatively associated to dry mouth, and self-perceived general health, experiencing awareness of distressful in two weeks was also important factors. Conclusions : Based on these results in order to develop oral health education policy strategies for the prevention and management of dry mouth, there need to be considered for the employee.

• Journal of Korean Clinical Nursing Research
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• v.24 no.1
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• pp.56-66
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• 2018

Purpose: This quasi-experimental study was done to develop image-use medication education for older inpatients and to evaluate the effects on their knowledge, self-efficacy, and misuse of medication. Methods: Fifty nine elders (experimental group - 30, and control group - 29) received medication education once a week for 3 weeks. Data were collected before (pretest), right after (post 1), and 4 weeks after the program finished (post 2). Drug Use Knowledge Scale, Self-efficacy for Appropriate Medication Use Scale, and Drug Misuse Scale were used. Analysis included descriptive statistics, $x^2$ test, repeated measured ANOVA. Results: Findings showed significant differences in knowledge of medication and drug misuse between groups according to time(pretest, post 1, and post 2). At post 1 and post 2, knowledge and self-efficacy levels were significantly higher and misuse scores were lower in the experimental group compared to the control group. Conclusion: Findings indicate that elder-tailored medication education consisting of group education and individual guidance with images is effective and practical for medicine safety in elderly inpatients. Moreover, it could lead to a healthier life for elders, even elders with multiple chronic diseases and taking several medications.

• Journal of Korean Public Health Nursing
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• v.15 no.2
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• pp.342-350
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• 2001

This study was designed to investigate the knowledge of urinary incontinence and its affecting factors among women aged over 30 years in Korea, and to provide the basic data for the primary urinary incontinence management program through the community-based cross sectional study from May 7 to July 18, 2000. The subjects, who were able to understand the questionnaires and consented their participation in the study, consisted of 2183 women, aged over 30 up to 89 years, residing in Seoul, Kyongki$\cdot$Kangwon, Chungchong, YongNam, HoNam, Cheju provinces. It took about 20 to 30 minutes to fill up the questionnaires. The data were analyzed by multiple regression with using SAS program. The results were as follows ; 1. The overall reported knowledge of urinary incontinence was $5.21\pm3.05$(range 0-14). Over the half of the subjects gave the correct answer to 5 items which referred to effects, treatment and management of urinary incontinence. Among items associated with the cause, two items, such as 'many common over-the-counter medications can cause involuntary urine loss', and 'involuntary urine loss is caused by only one or two conditions', were less likely to be correctly answered. 2. Those who were younger, had more education, or had urinary incontinence, were more likely to provide correct answers. The above findings indicated that the education program and campaign of the urinary incontinence should be developed and operated for those who are elderly and have had less education.

• Childhood Kidney Diseases
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• v.19 no.2
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• pp.71-78
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• 2015

The incidence of acute kidney injury (AKI) in critically ill pediatric patients has been reported as increasing to 25 %, depending on population characteristics. The etiology of AKI has changed over the last 10-20 years from primary renal disease to the renal conditions associated with systemic illness. The AKI in pediatric population is associated with increased mortality and morbidity, and prevention is needed to reduce the consequence of AKI. It is known that the most important risk factors for AKI in critically ill pediatric patients are clinical conditions to be associated with decreased renal blood flow, direct renal injury, and illness severity. Renal hypoperfusion leads to neurohormonal activation including renin-angiotensin-aldosterone system, sympathetic nervous system, antidiuretic hormone, and prostaglandins. Prolonged renal hypoperfusion can result in acute tubular necrosis. The direct renal injury can be predisposed under the condition of renal hypoperfusion, and appropriate treatment of volume depletion is important to prevent AKI. The preventable causes of AKI include contrast-induced nephropathy, hemodynamic instability, inappropriate mediation use, and multiple nephrotoxic insults. Given the evidence of preventable factors for AKI, several actions such as the use of protocol for prevention of contrast-induced nephropathy, appropriate treatment of volume depletion, vigorous treatment of sepsis, avoidance of combinations of nephrotoxic medications, and monitoring of levels of drugs should be recommended.

• Korean Journal of Clinical Pharmacy
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• v.21 no.2
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• pp.156-160
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• 2011

서론: 본 연구는 불필요한 소화기관용 약제의 처방이 한국에서의 처방전 당 약물 개수를 증가시키는 것과의 연관성을 검토하고자 수행되었다. 연구방법: 연구를 위한 자료로 건강보험심사평가원의 처방전 데이터와 환자의 기타 모든 의료보험 청구데이터를 이용하였고, 두 데이터셋을 연결하여 처방전들을 소화기관용 약제의 필요성에 따라 소화기관질환 그룹, 관절염질환 그룹,소화기관용 약제 처방이 불필요할 것으로 그 외 질환 그룹으로 구분, 분리하였다. 결과: 처방전 당 약물의 평균 개수의 분포는 세 그룹에서 비슷한 양상을 보였는데, 관절염질환 그룹과 그 외 질환 그룹의 거의 절반 이상은 한 개의 소화기관용 약제를 포함하였다. 세 그룹 모두 처방전 당 약물 개수와 처방전 당소화기관용 약제의 개수가 1차 선형관계를 보였다. 그 외 질환 그룹에서는 처방전 당 전체 약물이 평균 6개를 넘는 경우, 적어도 한 개의 소화기관용 약제가 포함되었다. 본 연구는 불필요한 소화기관용 약제를 처방하는 것은 다제처방의 매우 유의한 예측인자임을 보였다. 결론: 향후, 약제 처방전의 질을 향상시키기 위해서는 각각의 약물을, 특히 소화기관용 약제를, 처방 시 약제의 불가피한 필요성에 대해 판단할 수 있어야 할 것이다.

• Tuberculosis and Respiratory Diseases
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• v.68 no.5
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• pp.286-289
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• 2010

A 55-year old woman with advanced stage non-small cell lung cancer was admitted to hospital for the management of severe chest pain, which measured 7 out of 10 on a numerical rating scale (NRS). Despite palliative radiation and the application of multiple epidural blocks, she continued to experience severe cancer pain. We gradually increased the dose of transdermal fentanyl patches from $500{\mu}g/hr$ to $3,650{\mu}g/hr$, for 3 months without any significant side effects. Concomitantly, adjuvant therapy with antidepressants and anticonvulsants were added, decreasing the patient's pain to NRS 3~4 down from 7. After being transferred to a hospice clinic, her chest pain was well-controlled below NRS 4 by means of strong opioid medications, including the highest dose of transdermal fentanyl $4,050{\mu}g/hr$ for more than 16 months.