• Korean Journal of Clinical Pharmacy
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• v.26 no.2
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• pp.128-136
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• 2016

Objective: This study was to explore the association between having a usual source of care and adherence to medicines in patient with chronic diseases. Methods: The 2012 Korea Health Panel was used as a data source. We analyzed 4,418 respondents that were diagnosed with chronic diseases and utilized health care services. Non-adherence to medication, a dependent variable, was defined as "not taking the medicines that were prescribed for treating chronic disease" or "not following the direction for medication". Whether having a usual source of care or not was used as a key independent variable, which was defined as having a regular site or a regular doctor for medical test, treatment, and consultation. Sex, age, education level, marital status, income, the type of health insurance, the number of chronic disease and CCI (Charlson Comorbidity Index) were included as covariates in the analysis. We conducted a multivariate logistic regression. Results: Totally, 30 percent of respondents reported to experience non-adherence to medication. Having a usual source of care was significantly associated with lower non-adherence to medication regardless its type, which is a regular doctor (OR=0.61, 95% CI=0.53-0.70) or a regular site (OR=0.67, 95% CI=0.58-0.78). Furthermore, having a usual source of care was associated with both of medication persistence (OR=0.66, 95% CI=0.54-0.81) and compliance (OR=0.65, 95% CI=0.56-0.76). Conclusion: Our results showed the possibility that usual source of care is able to conduct a positive role in improving adherence to medication with better management of chronic disease.

• Korean Journal of Clinical Pharmacy
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• v.28 no.1
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• pp.17-23
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• 2018

Objective: Opioid analgesics, for postoperative pain management, are an indispensable group of medication; however, they also have a variety of adverse drug reactions (ADR). Multimodal methods, combining non-opioid analgesics with opioid analgesics, have been investigated to increase the effects of analgesics and reduce ADR with opioid-sparing effects. The purpose of this study was to compare the effects of patient-controlled analgesia (PCA) with fentanyl alone, and PCA with fentanyl and intravenous (i.v.) propacetamol to determine the effects of pain control, cumulative opioid usage, and opioid ADR. Methods: The subjects were patients who underwent total knee arthroplasty at the Seoul Veterans hospital from January 1, 2015 to December 31, 2016. The study period was from postoperative day 0 (POD0) to day 3 (POD3), and the retrospective study was conducted using electronic medical records. Results: Pain severity was significantly low at POD1 (p = 0.017), POD2 (p = 0.003), and POD3 (p = 0.002) in the multimodal group. The fentanyl only group frequently reported both moderate and severe pain at a statistically significant level. This was consistent with the analysis of the pro re nata (PRN) intramuscular analgesia usage at the time of numerical rating scale (NRS) 4 and above. The opioid-sparing effect confirmed that the average opioid dose equivalent to i.v. morphine dose was 9.4 mg more than that used for the multimodal group in the fentanyl only group. The ADRs and length of stay between the two groups were not statistically different. Conclusion: The results of this study suggest that the combination therapy of fentanyl and i.v. propacetamol is superior to fentanyl monotherapy.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.13
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• pp.5305-5309
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• 2014

Background: This study aimed to assess the most common physical side effects experienced by local chemotherapy patients. Their perceptions of these side effects and informational needs from clinical pharmacists were also evaluated. Materials and Methods: This was a single-center, cross-sectional study. A face-to-face interview guided by a structured questionnaire with cancer patients admitted to receive repeated cycles of chemotherapy was conducted. Information collected included chemotherapy-related side effects after last chemotherapy experience, the most worrisome side effects, the side effects overlooked by healthcare professionals and the preferred method, amount and source of receiving related information. Results: Of 99 patients recruited, 90 participated in this survey (response rate: 90.9%). The majority were in the age range of 45-64 years (73.3%) and female (93.3%). Seventy-five (83.3%) and seventy-one (78.9%) experienced nausea and vomiting, respectively. Both symptoms were selected as two of the most worrisome side effects (16.7% vs. 33.3%). Other common and worrisome side effects were hair loss and loss of appetite. Symptoms caused by peripheral neuropathies were perceived as the major symptoms being overlooked (6.7%). Most patients demanded information about side effects (60.0%) and they would like to receive as much information as possible (86.7%). Oral conversation (83.3%) remained as the preferred method and the clinical pharmacist was preferred by 46.7% of patients as the educator in this aspect. Conclusions: The high prevalence of chemotherapy-related side effects among local patients is of concern. Findings of their perceptions and informational needs may serve as a valuable guide for clinical pharmacists to help in side effect management in Malaysia.

• The Journal of Internal Korean Medicine
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• v.31 no.2
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• pp.264-272
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• 2010

Objectives : This study was carried out to measure perceptions about Traditional Korean Medicine hospitals and provide data for improvement of TKM hospital management. Methods : We surveyed the general population from 1st to 17th December, 2008, and patients visiting a TKM hospital from 1st June to 9th December, 2008. Results : Result as follows. 1. The response ratio for the generally preferred medical institution was in the order of western medical clinic, pharmacy, general hospital, TKM clinic, TKM hospital. 2. The response ratio for the preferred medical institution for herbal medicine treatment was in the order of TKM clinic, herbal medicine store, TKM hospital, pharmacy. The preferred medical institution for acupuncture treatment was in the order of TKM clinic, TKM hospital, acupuncture clinic, public health center. 3. The most common response to reason for receiving traditional Korean medical care was "traditional Korean medical care is more effective than western medical care." 4. The proportion of first treatment and second treatment of patients visiting at TKM hospital was about 1:1. 5. 72.3% of patients had been to another medical institution. 6. The response ratio for the first visited medical institution for the same disease was in the order of general hospital, western medical hospital, western medical clinic, TKM clinic. 7. The response ratio for the concern about TKM treatment was in the order of expensive charge for TKM treatment, uncertainty of TKM treatment effect. Conclusions : Through this research, we can understand the perception about TKM hospital treatment of the general population and patients visiting TKM hospitals.

• YAKHAK HOEJI
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• v.60 no.2
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• pp.92-99
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• 2016

Parkinson's disease (PD) is one of the representative neurodegenerative movement disorders with the selective loss of dopaminergic neurons in the substantia nigra. 6-Hydroxydopamine (6-OHDA) is widely used as an experimental model system to mimic PD and has been reported to cause neuronal cell death via oxidative and/or nitrosative stress. Therefore, daily intake of dietary or medicinal plants which fortifies cellular antioxidant capacity can exert neuroprotective effects in PD. In the present study, we have investigated the protective effect of Korean red ginseng (KRG) against 6-OHDA-induced nitrosative death in C6 glioma cells. Treatment of C6 cells with 6-OHDA decreased cell viability and increased expression of inducible nitric oxide synthase, production of nitric oxide as well as peroxynitrite, and formation of nitrotyrosine. 6-OHDA led to apoptotic cell death as determined by decreased Bcl-2/Bax, phosphorylation of JNK, activation of caspase-3, and cleavage of PARP. Conversely, pretreatment of C6 cells with KRG attenuated 6-ODHA-induced cytotoxicity, apoptosis, and nitrosative damages. To further elucidate the molecular mechanism of KRG protection against 6-OHDA-induced nitrosative cell death, we have focused on the cellular self-defense molecules against exogenous noxious stimuli. KRG treatment up-regulated heme oxygenase-1 (HO-1), a key antioxidant enzyme essential for cellular defense against oxidative and/or nitrosative stress via activation of Nrf2. Taken together, these findings suggest KRG may have preventive and/or therapeutic potentials for the management of PD.

• Journal of muscle and joint health
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• v.21 no.2
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• pp.125-134
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• 2014

Purpose: The purpose of this study was to identify factors associated with quality of life of nursing students during clinical practice. Methods: A convenience sample of 332 nursing students completed the questionnaire from July to September, 2013. A self-reported questionnaire was used to obtain data on quality of life, stress related to clinical practice, and health promotion behavior. Data was analyzed with independent t-test, one way ANOVA and Scheff${\acute{e}}$'s post hoc test, Pearson correlation coefficients, and hierarchical multiple regression by using SPSS version 20.0. Results: There were significant differences in quality of life scores by age, economic status, interpersonal relationships, daytime somnolence, number of visits in pharmacy and/or healthcare center, health status, and stress management. Quality of life had positive correlation with health promotion behavior but had negative correlation with the level of stress related to clinical practice. Models including these variables explained 34.3% (F=9.77, p<.001) of the variance for quality of life. Age, economic status, sleep amount, numbers of pharmacy/hospital visits, health status, stress during clinical practice, and health promotion behavior were significantly associated with quality of life in nursing students. Conclusion: There is a need to develop and implement new strategies that will result in improvement in nursing students' quality of life.

• The Korean Journal of Physiology and Pharmacology
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• v.17 no.3
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• pp.245-251
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• 2013

The purpose of this study was to investigate the effects of fluvastatin on the pharmacokinetics of repaglinide in rats. The effect of fluvastatin on P-glycoprotein and CYP3A4 activity was evaluated. The pharmacokinetic parameters and blood glucose concentrations were also determined after oral and intravenous administration of repaglinide to rats in the presence and absence of fluvastatin. Fluvastatin inhibited CYP3A4 activity in a concentration-dependent manner with a 50% inhibition concentration($IC_{50}$) of 4.1 ${\mu}M$ and P-gp activity. Compared to the oral control group, fluvastatin significantly increased the AUC and the peak plasma level of repaglinide by 45.9% and 22.7%, respectively. Fluvastatin significantly decreased the total body clearance (TBC) of repaglinide compared to the control. Fluvastatin also significantly increased the absolute bioavailability (BA) of repaglinide by 46.1% compared to the control group. Moreover, the relative BA of repaglinide was 1.14- to 1.46-fold greater than that of the control. Compared to the i.v. control, fluvastatin significantly increased the $AUC_{0-{\infty}}$ of i.v. administered repaglinide. The blood glucose concentrations showed significant differences compared to the oral controls. Fluvastatin enhanced the oral BA of repaglinide, which may be mainly attributable to the inhibition of the CYP3A4-mediated metabolism of repaglinide in the small intestine and/or liver, to the inhibition of the P-gp efflux transporter in the small intestine and/or to the reduction of TBC of repaglinide by fluvastatin. The study has raised the awareness of potential interactions during concomitant use of repaglinide with fluvastatin. Therefore, the concurrent use of repaglinide and fluvastatin may require close monitoring for potential drug interactions.

• Korean Journal of Clinical Pharmacy
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• v.28 no.2
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• pp.117-123
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• 2018

Background: Prostatitis, one of the most common diseases of the prostate, is a complex disease with various clinical features. This study aims to analyze the utilization and prescribing patterns of antibiotics in Korean patients with prostatitis between 2008 and 2015. Methods: We used the National Health Insurance Database complied from the Health Insurance Review and Assessment Service (HIRA). The outcomes included the number of claims, number of patients, medical cost, and length of stay for each year. In addition, the prescribing patterns of antibiotics, including fluoroquinolone, and low-dose use of ciprofloxacin and levofloxacin were investigated. Results: The total number of patients and medical cost increased by 9.5% and 51.7% from 2008 to 2015, respectively. Most prostatitis patients were classified as chronic prostatitis patients. The prescribing proportion of antibiotics for chronic prostatitis outpatients decreased from 71.0% to 66.9% from 2008 to 2015, and fluoroquinolone accounted for more than half of the total antibiotics. Over 80% of prescription of levofloxacin and ciprofloxacin was identified to be for low-dose use. Conclusion: Most of the patients with prostatitis experienced pain relief and condition improvement after antibiotic treatment; however, chronic prostatitis and chronic pelvic pain syndrome recur easily. Therefore, active disease management and further studies are needed to enhance our understanding of effective treatment for prostatitis.

• Korean Journal of Health Education and Promotion
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• v.31 no.2
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• pp.41-53
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• 2014

Objectives: The purpose of this study was to evaluate the education contents on safe use of medications in healthcare textbooks for elementary, middle and high schools. Methods: We examined 6 textbooks for the $5^{th}$ grade, 4 textbooks for middle school, 3 textbooks for high school, and 5 education materials published by the Korea Food and Drug Administration, National Health Insurance Service, and Seoul City Government. To evaluate the contents in health textbooks, we developed the 30 evaluation items. Results: Middle school textbooks had the most educational contents followed by high school and elementary school textbooks. Public education materials for the teenagers included more educational contents than those for children. The education material published by National Health Insurance Service had the highest score and the rest of the books earned under 15. And there were no core contents in medication education. Conclusions: Medication education through health textbooks should be strengthened to raise the level of medication awareness, to use medications safely, to prevent the drug abuse and misuse, and to establish the responsible judgment of medication information in the mass media. The current contents were found to be insufficient to meet these goals of medication education.

• Korean Journal of Medicinal Crop Science
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• v.24 no.2
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• pp.93-100
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• 2016

Background: A set of logical criteria that can accurately identify and verify the cultivation region of raw materials is a critical tool for the scientific management of traditional herbal medicine. Methods and Results: Volatile compounds were obtained from 19 and 32 samples of Angelica gigas Nakai cultivated in Korea and China, respectively, by using steam distillation extraction. The metabolites were identified using GC/MS by querying against the NIST reference library. Data binning was performed to normalize the number of variables used in statistical analysis. Multivariate statistical analyses, such as Principal Component Analysis (PCA), Partial Least Squares-Discriminant Analysis (PLS-DA), and Orthogonal Partial Least Squares-Discriminant Analysis (OPLS-DA) were performed using the SIMCA-P software. Significant variables with a Variable Importance in the Projection (VIP) score higher than 1.0 as obtained through OPLS-DA and those that resulted in p-values less than 0.05 through one-way ANOVA were selected to verify the marker compounds. Among the 19 variables extracted, styrene, ${\alpha}$-pinene, and ${\beta}$-terpinene were selected as markers to indicate the origin of A. gigas. Conclusions: The statistical model developed was suitable for determination of the geographical origin of A. gigas. The cultivation regions of six Korean and eight Chinese A. gigas. samples were predicted using the established OPLS-DA model and it was confirmed that 13 of the 14 samples were accurately classified.