• YAKHAK HOEJI
• /
• v.54 no.6
• /
• pp.455-460
• /
• 2010

We evaluated the inappropriateness of metformin use in patients with type 2 diabetes and chronic medical conditions to identify the frequency of the prescription metformin in violation of the food and drug administration (FDA) black box warning. We reviewed medical records of 307 outpatients who received metformin at endocrinology department in a hospital setting between January 1, 2005 and August 30, 2009. Of the 307 outpatients, 25 discontinued treatment of metformin due to elevated serum creatinine level (Scr${\geq}$1.5 mg/dl in male, Scr${\geq}$1.4 mg/dl in female), cancers, and/or liver disease. 5 were lost to follow-up. 89 (29.0%) of the patients had cardiovascular disease, 54.1% for hypertension, 9.8% for liver disease, and 60 (20.8%) for chronic kidney disease. 12 patients (3.9%) with chronic kidney disease and/or elevated serum creatinine level, and 1 patient (0.3%) with lactic acidosis were contraindicated to metformin use. Metformin should be avoided in 7 outpatients (2.3%) with active hepatitis and 1 patient (2.6%) with liver cirrhosis. Of the 307 outpatients, 13 (4.2%) patients who received metformin at the first visit and 16 (8.7%) patients who received metformin at the last visit violated to black box warning. 8 (2.6%) of the patients were in precautionary conditions to metformin use. Adjusted mean difference of serum creatinine was -0.16 mg/dl [95% CI: -0.22 to -0.11 (p<0.05)] and adjusted mean difference of alanine aminotransferase was 4.46 IU/l [95% CI: 2.47 to 6.44 (p<0.05)] between the first visit and the last visit. Critical number of elderly patients who are at the high risks of drug-disease and drug-laboratory interaction is exposed to the inappropriate metformin use in violation of black box warning. The periodic evaluation of metformin use and monitoring prescription through drug utility review (DUR) system is needed to improve patients' safety and to reduce adverse drug events.

• Korean Journal of Clinical Pharmacy
• /
• v.28 no.3
• /
• pp.250-253
• /
• 2018

When stenting is applied to treat myocardial infarction, antiplatelet agents are administered to prevent thrombosis, which increases the risk of bleeding. Patients with myocardial infarction are also more likely to have osteoarthritis simultaneously, because both diseases occur frequently in elderly patients. Patients with osteoarthritis often use analgesics, especially nonsteroidal anti-inflammatory drugs (NSAIDs); hence, patients with both diseases use analgesics and antiplatelet agents simultaneously. The risk of bleeding increases with the use of antiplatelet agents and this is further increased when NSAIDs are added. We would like to report a case that reflects this situation. A 60-year-old man underwent stenting after ST-elevation myocardial infarction, and was treated with aspirin and clopidogrel. This patient also received a pelubiprofen prescription from another physician to treat osteoarthritis. After the patient took pelubiprofen twice, he found a bruise on his wrist and reported it to the pharmacist. It is unlikely that this is rare in community pharmacies, so pharmacists should pay careful attention to the concomitant administration of analgesics to patients receiving antiplatelet agents and should provide appropriate education to patients.

• Archives of Plastic Surgery
• /
• v.36 no.1
• /
• pp.80-83
• /
• 2009

Purpose: Isolated hypoglossal nerve palsy is a rare manifestation of various underlying disease. This article presents a rare complication of general anesthesia associated with an surgical procedure on a case of zygomatic fracture. Methods: An 18-year-old female patient was referred to our department by painful swelling on her left zygomatic area after the traffic accident. Left zygomatic complex fracture was identified on the simple x-ray and facial bone CT scan, and the fracture was treated with open reduction and internal fixation under general anesthesia. On the first postoperative day, she complained of difficulty in swallowing solid food, dysarthria and deviated tongue to her right side. There was no abnormal findings on the neurological examination, brain MRI and routine chemistry. She was diagnosed with transient hypoglossal nerve palsy and dexamethasone with multi-vitamins was administrated intravenously for 5 days. Results: The symptoms were completely resolved by the ninth postoperative day and the patient was discharged without any other complications. Conclusion: The hypoglossal(cranial nerve XII)nerve supplies motor innervation to all of the ipsilateral extrinsic and intrinsic tongue muscles. The hypoglossal nerve damage may caused by the compression between the airway and the hyoid bone during the endotracheal intubation, and direct trauma due to excessive pressure or neck extension. We described a rare case of unintended injury to hypoglossal nerve and care must be taken not to cause the hypoglossal nerve damage especially in facial plastic surgery with excessive neck extension under general anesthesia.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.15 no.2
• /
• pp.148-151
• /
• 2017

Methemoglobinemia is a condition in which the iron portion of hemoglobin, which binds to oxygen, is oxidized to produce methemoglobin, which increases blood concentration. There are many causes of methemoglobinemia, the most common being food, drugs, and chemicals. A 75-year-old male patient who had taken an herbicide did not notice any nonspecific symptoms. However, after 4 hours, his methemoglobin levels increased to 17.1%, while after 7 hours it increased to 26.5%, at which time intravenous administration of methylene blue 1 mg/kg (an antidote) was started. After a total of five doses of methylene blue at 1 mg/kg due to reactive methemoglobinemia for about 36 hours, the methemoglobin levels increased to 23.7%. Because no more methylene blue could be administered, 10 g of ascorbic acid (vitamin C) was administered intravenously. After 82 hours, ascorbic acid 10 g was administered six times for repeated reactive methemoglobinemia. No additional reactive methemoglobinemia was observed. The ventilator and endotracheal tube were successfully removed on day 5 after admission.

• Journal of Korean society of Dental Hygiene
• /
• v.18 no.2
• /
• pp.227-237
• /
• 2018

Objectives: This study aims to recognize the importance of dental hygiene process diagnosis of dental hygiene process which can comprehensively grasp the patient's problem and to use it as a basis for establishing the patient's preventive treatment plan. Methods: This study did survey to 443 patients who received treatment based on the oral health care program from a dental clinic in Busan from January 2015 to January 2017. Data analysis was performed using IBM SPSS Statistics (Version 21.0), and statistical significance level was set at ${\alpha}=0.05$. Binary logistic regression analysis was performed to the dental hygiene problems affecting the dental hygiene plan. Results: There were significant differences in dental hygiene problems between male and female respondents on various dental problems such as dental plaque deposition, attrition, stain, dental fear, possibility of jaw joint disorder, food pressing, possibility of malocclusion. There were also significant differences in dental hygiene plans between male and female respondents in air-Jet, non-smoking education, and sealant. The most common dental hygiene plan was scaling, The problem of stain showed that the scaling plan was 0.20 times less. The explanatory power of the model was 43.5%, and the Hosmer and Lemeshow tests were 0.345. Conclusions: Therefore, if we continue to study the factors affecting the dental hygiene problems and the plan, we can reduce the burden of the dental hygienists applying the dental hygiene process in the dental clinic. And, it is expected that the oral health care program using the dental hygiene process will spread to the dental clinic as an excellent oral preventive program.

• Journal of Korean Medicine for Obesity Research
• /
• v.2 no.1
• /
• pp.89-94
• /
• 2002

We experienced a male patient who was diagnosed as very severe abdominal obesity. From the 3rd of January to the 14th of April we applied herbal medication(Tiganyiyiren-tang), very low calorie diet, aerobic exercise, behavioral therapy, electrolipolysis, infra-red therapy, auricular acupuncture, and aqua-massage to him. And we examined the changes of his height, weight, body composition, body size, liver functional test, abdominal CT finding. The food production of this year has decreased by 5 percent. His weight decreased by 28.2%, PIBW by 28.5%, BMI by 28.2%, PBF by 22.7%, and WHR by 15.9%. The circumference of upper extremity decreased by 25.7%, the circumference of the muscle of upper extremity by 18.2%, the circumference of chest by 20.5%, the circumference of abdomen by 29.5%, the circumference of hip by 17.4%, and the circumference of thigh by 15.9%. In the liver functional test GOT decreased from 42IU/l to 361U/I, GPT from 1211U/l to 48IU/I. Total cholesterol from 211mg/dl to 152mg/dl, and Trigliceride from 192mg/dl to 81 mg/dl. In the abdominal CT finding the amount of fat in the abdominal cavity decreased from $9732mm^2$ to $3639mm^2$.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.34 no.4
• /
• pp.317-323
• /
• 2018

When oral cancer develops in the maxilla, oro-nasal communication occurs after surgical treatment including removal of the primary site. Restoration through an obturator is necessary to prevent food from storing due to non-oral opening, and to ensure proper pronunciation and aesthetic restoration. In this case, the patient was treated with right hemi-maxillectomy due to oral cancer and has residual abutment and poor periodontal support due to the effect of head and neck radiotherapy. The obturator was treated with a hybrid telescopic double crown denture. Reporting a successful prognosis in 18 months of follow-up.

• International Journal of Advanced Culture Technology
• /
• v.7 no.1
• /
• pp.216-224
• /
• 2019

The number of patients from Middle Eastern Arabic countries is steadily increasing in respect to the South Korean government's medical tourism strategies. Word of mouth is one of the main determinants concerning the Middle Eastern Arab patients' medical tourism destination. Further, patients' satisfaction affects repurchase and revisit intention. This study aimed to measure the level of Middle Eastern Arab patients' satisfaction, and to measure the effect of different medical factors on satisfaction in such patients who are seeking medical attention in South Korea. A 110 Middle Eastern Arab patients who visited South Korea for medical purposes participated in our survey between November, 2016 and April, 2017. All factors had a high mean (${\geq}4.24$; ${\geq}84.8/100$) except for one factor (hospital halal meals (3.82; 76.4)). To identify factors influencing participants' overall satisfaction we used multiple regression analysis. Physicians, interpreters, and halal meals were the main factors influencing overall Middle Eastern Arab patients' satisfaction. Physicians and interpreters in Korea are recommended to be oriented to basic Islamic beliefs and Middle Eastern Arab patients' behavior. Daily communication, such as speaking directly to the patient, limiting important issues to two or three at a time, and translating sentence by sentence, could help to improve Middle Eastern Arab patients' satisfaction. Enlisting Middle Eastern nutrition specialists in medical institutions in South Korea may substantially improve non-medical services satisfaction such as halal food and dietary restrictions.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.34 no.2
• /
• pp.91-98
• /
• 2021

Objective : The purpose of this study is to report a case of lacquer allergy improved by Korean medicine treatment. Methods : The patient visited our hospital complaining of rash, and pruritus which lasted for 10days after eating lacquer chicken. Considering that patient's symptoms occurred due to food allergen, we prescribed Injinho-tang(Yinchenhao-tang) and acupuncture at Daejang-Junggyeok for 7days. Results : On the 4th day of treatment, pruritus decreased to less than half of the initial treatment, and skin symptoms also improved to a mild level. About a week later, most of the skin symptoms disappeared (Total Objective Symptom score decreased 10 to 3), and subjective symptoms such as pruritus improved to about 30% of the time of the first visit (Total Subjective Symptom score decreased 12 to 3). Conclusions : After 7days of Korean medicine treatment, lacquer tree allergy with skin lesions and pruritus has improved considerably.

• Journal of Korean Dental Hygiene Science
• /
• v.4 no.1
• /
• pp.39-51
• /
• 2021

Background: Limited information is available regarding the associations of various nutrients and periodontitis in Korea. Furthermore, these associations have been controversial in previous studies. Therefore, the present study aimed to evaluate the associations between several nutrients and periodontitis. Methods: Pooled data from the 2007~2010 and 2012 Korea National Health and Nutrition Examination Surveys (KNHANES) were used for the present study. Periodontitis was defined using the World Health Organization (WHO) Community Periodontal Index. All participants completed the Food Frequency Questionnaire (FFQ), which was analyzed using CAN-Pro 4.0. Vitamins A, B₁, B₂, and C, iron, phosphorus, calcium, and protein were selected for analysis. Multiple logistic regression analyses were used to estimate the odds ratios (ORs) for periodontitis. Results: Lower intake of phosphorus (adjusted odds ratio [AOR] = 1.86), calcium (AOR = 1.25), and protein (AOR = 1.52) were associated with periodontitis in males, and lower intake of vitamins A (AOR = 1.32), B1 (AOR = 1.21), B2 (AOR = 1.24), and C (AOR = 1.21), iron (AOR = 1.25), phosphorus (AOR = 1.33), and protein (AOR = 1.27) showed significant relationships with periodontitis in females. In the sociodemographic, somatic, and health behavior-adjusted models, lower phosphorus (AOR = 2.68) and protein (AOR = 1.68) intake in younger males, and lower vitamin A intake (AOR = 1.37) in middle-aged females were significantly associated with periodontitis. Conclusions: The results of the present study demonstrated a significant association between periodontitis and nutrient intake. To avoid an insufficient nutrient supply for a patient with periodontal disease, the patient's diet should be closely monitored.