• 약학회지
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• 제54권6호
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• pp.455-460
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• 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.

• 한국임상약학회지
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• 제28권3호
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• pp.250-253
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• 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
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• 제36권1호
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• pp.80-83
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• 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.

• 대한임상독성학회지
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• 제15권2호
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• pp.148-151
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• 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.

• 한국치위생학회지
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• 제18권2호
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• pp.227-237
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• 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.

• 한방비만학회지
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• 제2권1호
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• pp.89-94
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• 2002

2001년 1월 3일부터 2001년 4월 14일까지 고도의 복부비만으로 판정받은 1례의 환자에서 체감의이인탕의 한약복용, 초저열량식이요법(600kcal), 유산소운동(6km/h속도의 속보60분),행동수정요법(평소보다 50% 증가된 활동량), 전기지방분해침(Lipodren)40분, Infared therapy,이침, Aqua-pt(수압마사지)등을 입원 및 통원치료로 시행하여 비만지표, 신체사이즈, 간기능 검사, 복부 전산화단층촬영 상에서 유의한 변화를 관찰하였기에 보고하는 바이다.

• 구강회복응용과학지
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• 제34권4호
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• pp.317-323
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• 2018

구강암이 상악에 발생하게 되면 원발 부위의 제거를 포함한 외과적 처치 후 비구강 개통(oro-nasal communication)이 발생하게 된다. 비구강 개통으로 인한 음식물의 저류를 막고 및 원할한 발음 및 심미적 회복을 위해서는 구강 폐색장치(Obturator)를 통한 수복이 필요하다.본 증례에서는 구강암으로 인해 우측 상악 편측절제술(hemi-maxillectomy) 시행하고 두경부 방사선 치료의 영향으로 인해 잔존 지대치의 우식과 불량한 치주지지를 보이는 환자에서 구강폐색장치(obturator)를 하이브리드형 이중관의치(hybrid telescopic double crown denture)로 수복하였다. 18개월 간 경과관찰에서 성공적인 예후를 보여 이를 보고하고자 한다.

• International Journal of Advanced Culture Technology
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• 제7권1호
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• pp.216-224
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• 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.

• 한방안이비인후피부과학회지
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• 제34권2호
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• pp.91-98
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• 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.

• 대한치위생과학회지
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• 제4권1호
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• pp.39-51
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• 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.