• Title/Summary/Keyword: prescription pattern

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Evaluation of Using Pattern of the Topical Agents in Korean Community (한국 외래형 국소용 피부 외용제의 사용 현황에 대한 기초 평가)

  • Cheon, Young Ju;Kim, Sug Hyun;Kim, Ok Ju;Hong, Se Hwa;Yang, Jin Wook;Kim, Jung Tae;Lim, Sung Cil
    • YAKHAK HOEJI
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    • v.58 no.6
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    • pp.378-386
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    • 2014
  • Topical agents including of steroids are easily exposed to Korean patients in community setting. Those topical agents must be use cautiously because can cause adverse drug reaction unlike other oral medication. We evaluate the using pattern topical agents of Korean in community setting. We performed a questionnaire survey in three different pharmacies (general community pharmacy, dermatology clinic oriented pharmacy, general hospital oriented pharmacy) and in three university town. The survey asked necessity of topical agents, the number of applications per day, application period, site, and exist of steroids ingredient, etc. Total 330 people was participated in the survey from May 1st to July 31st, 2014. We analysed the survey by the frequency of each question and cross-analysis of the compliance between general public and pharmacy groups. In results, Korean people used topical agents for sudden skin diseases (66.9%), was gotten by dermatologist's prescription (89.1%), and did not know their diagnosis (39.2%). The people applied topical agents on face (22.3%), less one half FTU (finger tip unit) per application (61.9%), less than one week (62.9%). Though they was received drug education from pharmacist (52.2%), did not heard about adverse effects (78.4%). And compliance of applied times in pharmacy group was higher than in-non-pharmacy group (56% vs 38%, p=0.002). The highest compliance between 3 pharmacy subgroup was general community pharmacy (76.3% vs 61.6%, 61.2%, p=0.039). Compliance of applied duration was no difference between groups. Majority of respondents did not know diversity of ingredients, potency, application area of topical steroids, and replied to feel some vague reluctance and to think so dangerous about topical steroids. In conclusion, Korean people in community use topical agents well but still some exposed to risk from topical agents.

Current Status of Clinical Practice for Gout in Korean Medicine - On-line (Web-Based) Survey (통풍의 한의임상진료현황 - 온라인(웹기반) 설문조사)

  • Hwang, Ji Hye;Lee, Kwang Ho;Nam, Dong Woo;Yook, Tae-han;Song, Ho Sueb
    • Korean Journal of Acupuncture
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    • v.38 no.1
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    • pp.16-31
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    • 2021
  • Objectives : The purpose of this study was to investigate the current status of clinical practice for gout in Korean Medicine (KM). Methods : On-line survey was adopted for this study, targeted at KM Doctors who were registered in the Association of Korean Medicine. The questionnaire included the general status of treatment, pattern identification and treatment method according to three stages given: acute, chronic and asymptomatic hyperuricemia stage. Results : Data from a total of 384 respondents was analyzed. Participants who responded most were in their 40s, working in KM clinics located in Seoul. Acupuncture and herbal medicines were the top priority treatments in preparing recommendations in clinical practice guidelines for gout, and where clinical trials were considered essential. As of the past year, the average number of first visits per month was 86.7%, and the average treatment duration was less than 1 month, accounting for 72.9%. As for the diagnostic method used for gout patients, the "diagnosed by clinical pattern" response was the highest, and the "blood and urine test" response was the highest as the diagnostic equipment used. As for the evaluation scale being used, the "VAS/NRS" response was the highest. Regardless of the gout stage, acupuncture was the most commonly used treatment method for gout patients, and bee venom pharmacopuncture was the highest for the pharmacopuncture used. In the case of herbal medicine, it was found that a wider variety of herbal medication uninsured in health insurance and herbal prescription were used for the staged treatment of gout than herbal medication in national health insurance coverage. In clinical practice, "acupuncture treatment three times a week" was the most common, and the "acupoints in the limb" were the most frequently used; LR3 and SP3 were the most frequently used acupoints. Conclusions : It is suggested that this survey should be helpful to develop clinical practice guideline for gout that reflects actual clinical practice.

Changing Trends in the Occurrence and Management of Delirium for 5 Years in a University Hospital (일 대학병원에서 5개년간 섬망의 발생 및 치료 경향의 변화)

  • Bae, Jae Ho;Kang, Won Sub;Paik, Jong Woo;Kim, Jong Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.2
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    • pp.112-119
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    • 2012
  • Objectives : Delirium is a disorder defined as a sudden disturbance in thinking, speaking, acting and sleep pattern due to altered level of consciousness and cognitive function. The objective of this study is to analyze characteristics and therapeutic methods of the delirious patients during the recent 5 years, and provide basic data for further studies and investigation regarding delirium in the occurrence and treatment. Methods : We retrospectively reviewed medical records of 475 patients who were consulted for delirium in Kyunghee University Medical Center from January 2007 to December 2011. Results : During the 5 years, among the 475 patients who were diagnosed as delirium, men were more common(61.7%). The most commonly consulted reason and cause were sleep disturbance(80.8%) and post-operational delirium(30.9%), respectively. The medication prescription percentage was 76.6% and was significantly increased year after year. Ratio of using antipsychotics were 76.4% among prescribed medication and the most frequently prescribed antipsychotic drug was quetiapine(46.8%). Other specialists commonly misdiagnosed delirium when the patient was previously diagnosed as dementia(6.8%). Conclusions : In our study, post-operational delirium was the most commonly referred reason and the percentage of medication prescription tended to increase. Patients with history of dementia were more easily misdiagnosed as diseases other than delirium. Our study suggests that we should evaluate symptoms, causes, reasons of consultation, management tendency of delirium. We should also closely observe changes in sleep patterns and establish the prevention strategies for post-operational delirium and therapeutic bases for pharmacotherapy.

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A Study on Dementia Alzheimer's type published to chinese magazine (중의잡지(中醫雜誌)에 보고(報告)된 Alzheimer형(型) 치매에 대(對)한 고찰(考察))

  • Chae, Jong-gul;Lee, Sang-ryong
    • Journal of Haehwa Medicine
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    • v.10 no.1
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    • pp.453-469
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    • 2001
  • This study attempted to analyze the contents of the research papers concerning the diagnosis and treatment of Alzheimer-type dementia presented in the magazine of Chinese Medicine published in China over the period between 1998 and 2000. As a result, the following conclusion was drawn: 1. The Chinese medical category of Alzheimer-type dementia includes amnesia, dementia, stupidity, depression symptom complex, insanity and the like and uses the as the criterion for diagnosis and treatment effect evaluation. 2. The clinical symptoms of Alzheimer-type dementia include lowered intelligence, deterioration of memory, understanding and judgemental power, retardation of the reaction, emotional changes, character changes, behavioral changes and the like and are divided into mild, medium and serious according to the degree of symptom. 3. From the perspective of Bon-Heo-Pyo-Shil(state of deficient vital essence and excessive pestilential vapor), the pattern of Byun-Sung(identification) is divided into deficiency symptom complex, excessive symptom complex and indiscernible fullness and emptiness. The deficiency symptom complex includes deficiency of the liver and kidney, deficiency of essence of the kidney, deficiency of the reservoir of marrow and the like. The excessive symptom complex includes internally blocked stagnant blood, blocking of the passageway due to turbid phlegm, blood stasis due to stagnation of chi, and the like. The indiscernible fullness and emptiness symptom complex includes the deficiency of essence of kidney, blocking of the passageway due to stagnant phlegm, blood stasis due to the deficiency of kidney, blood stasis due to the deficiency of heart and the like. 4. The therapeutics and' prescription of Alzheimer-type dementia include the following: Bo-Shin-Ik-Su-Tang for tonifying the kidney, replenishing the marrow and plugging the essence; Ki-Guk-Ji-Hwang-Hwan-Ga-mi for reinforcing the vital essence of the liver and kidney; Kwi-Bi-Tang-Hap-Yang-Shim-Tang for invigorating the functioning of the spleen and nourishing the heart; Hyel-Bu-Chuk-Eo-Tang-Ga-Mi for activating the blood and resolving the stagnancy of the blood; Bo-Yang-Hwan-Oh-Tang for replenishing chi, activating the blood and resolving the stagnancy of the blood; Beoh-Kwang-Mong-Sung-Tang for invigorating the functioning of the spleen, replenishing the kidney, resolving the phlegm and enlivening the brain; n-Dam-Tang-Ga-Mi for invigorating the functioning of the spleen, replenishing chi, and removing the phlegm and unclogging the passageway); Se-Shim-Tang-Ga-Mi for removing the stagnancy of the liver and resolving the phlegm; and the like. 5. The research papers on, the medication cases of Alzheimer-type dementia understand the pathology of Alzheimer-type dementia from a consistent perspective. They view the pathology of Alzheimer-type dementia as the disease of Bon-Heo-Pyo-Shil(state of deficient vital essence and excessive pestilential vapor) with the combination of the deficiency of essence of the kidney, the deficiency of the brain marrow, blood stasis and blocked phlegm and the like and recommend the prescription of using Bo and Sa simultaneously for treating Alzheimer-type dementia. 6. The research papers on the medication cases of Alzheimer-type dementia reported that the use of creative prescriptions such as Si-Sam-Hang-Ji-Tang, Ji-Yung-Tang, Ka-Mi-Yunh-Ji-Hwan, Ja-Sin-Hwal-Hyel-Tang, Kal-Chang-Ik-Ji-Tang, Ho-Su-Bok-Ji-Tang, Kun-Noe-Ok-Ji-Hap-Je and the like led to the average high efficacy of 85.5%.

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Awareness and Impact of COPD in Korea: An Epidemiologic Insight Survey

  • Hwang, Yong-Il;Kwon, O-Jung;Kim, Young-Whan;Kim, Young-Sam;Park, Yong-Bum;Lee, Myung-Goo;Kim, Dong-Gyu;Jang, Seung-Hun;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.6
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    • pp.400-407
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    • 2011
  • Background: There were a few studies which were conducted to know about the behavior of the chronic obstructive pulmonary diseases (COPD) patients. The aims of this study was to explore the behaviour of COPD patients, such as awareness and impact of disease, the pathway of visiting doctors, and the treatment pattern and preference. Methods: A face-to-face interview of 300 subjects with COPD was conducted. Results: The most concerned symptom which made the respondents to visit the hospital was 'breathlessness' (78%). Only 58% of them knew the exact diagnosis. Seventy-three percent of them visited the hospital 'once a month' or 'once every 2 month'. They have made 12.8 prescheduled visits to the hospital in the past 1 year. Unscheduled visits and hospital stay figured to two in the past year. Only 11% of respondents felt they were currently in good health. 'Severe' and 'very severe' COPD patients perceived their health to be in a worse condition than 'mild' and 'moderate' COPD patients. When conditions worsened, 42% of patients were hospitalized. The most common prescription treatment was a fixed combination of inhaled corticosteroids and long-acting ${\beta}2$ agonists (48%), followed by a long acting anticholinergics (38%). Conclusion: Over forty percent of the patients didn't know exactly about their condition. Most of them had a negative attitude toward their current health status. Doctors need to know more about COPD patients in terms of their attitude toward the disease, impact of the disease, interaction with healthcare professionals and treatment related problems.

A Survey on Korean Medicine Doctors' Recognition and Clinical Fields of Treating Primary Dysmenorrhea for Developing Korean Medicine Clinical Practice Guideline for Dysmenorrhea (월경통 한의표준임상진료지침 개발을 위한 한의사의 인식과 원발성 월경통 치료에 관한 실태조사)

  • Woo, Hye-Lin;Ji, Hae-Ri;Park, Kyoung-Sun;Hwang, Deok-Sang;Lee, Chang-Hoon;Jang, Jun-Bock;Lee, Jin-Moo
    • The Journal of Korean Obstetrics and Gynecology
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    • v.30 no.2
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    • pp.93-106
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    • 2017
  • Objectives: This study is aimed to figure out Korean medicine doctors' recognition of Korean Medicine clinical practice guidelines (CPG) and clinical fields of treating primary dysmenorrhea before developing CPG for dysmenorrhea. Methods: We conducted a questionnaire survey targeting 515 Korean medicine doctors belonging to the Association of Korean Medicine by e-mail and analyzed the answers. Results: 81.2% of the respondents knew the concepts and contents of CPG, and 98.7% agreed about the necessity of CPG. 94.2% were willing to use CPG for dysmenorrhea in learning and treating. Average number of patients visiting the respondents' clinics for dysmenorrhea was 3.9, the main age group was 20s (63.1%), and the treatments the patients given before were mostly Western treatments such as pain killers and hormonal drugs. The respondents answered that they diagnosed patients with dysmenorrhea mainly with pattern diagnosis (41.6%), and treated them with herbal medicine (39.2%), acupuncture (31.6%) and moxibustion (22.6%) for 2-3 months. They answered that the acupoint they use most was San yin jiao, and the prescription was Gui-zhi-fu-ling-wan, They answered that the field considered to need further study was decoction of herbal medicine most (27.4%), and the field considered to need insurance coverage was also decoction of herbal medicine most (40.2%). Conclusions: We figured out Korean Medicine doctors' recognition of CPG, clinical diagnosis, treatment, cost for treating dysmenorrhea, and fields of clinical research and policy they required.

Prognostic value of pretreatment 18F-FDG PET-CT in radiotherapy for patients with hepatocellular carcinoma

  • Jo, In Young;Son, Seok-Hyun;Kim, Myungsoo;Sung, Soo Yoon;Won, Yong Kyun;Kang, Hye Jin;Lee, So Jung;Chung, Yong-An;Oh, Jin Kyoung;Kay, Chul-Seung
    • Radiation Oncology Journal
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    • v.33 no.3
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    • pp.179-187
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    • 2015
  • Purpose: The purpose of this study was to investigate the predictable value of pretreatment $^{18}F$-fluorodeoxyglucose positron emission tomography-computed tomography ($^{18}F$-FDG PET-CT) in radiotherapy (RT) for patients with hepatocellular carcinoma (HCC) or portal vein tumor thrombosis (PVTT). Materials and Methods: We conducted a retrospective analysis of 36 stage I-IV HCC patients treated with RT. $^{18}F$-FDG PET-CT was performed before RT. Treatment target was determined HCC or PVTT lesions by treatment aim. They were irradiated at a median prescription dose of 50 Gy. The response was evaluated within 3 months after completion of RT using the Response Evaluation Criteria in Solid Tumors (RECIST). Response rate, overall survival (OS), and the pattern of failure (POF) were analyzed. Results: The response rate was 61.1%. The statistically significant prognostic factor affecting response in RT field was maximal standardized uptake value (maxSUV) only. The high SUV group (maxSUV ${\geq}5.1$) showed the better radiologic response than the low SUV group (maxSUV < 5.1). The median OS were 996.0 days in definitive group and 144.0 days in palliative group. Factors affecting OS were the %reduction of alpha-fetoprotein (AFP) level in the definitive group and Child-Pugh class in the palliative group. To predict the POF, maxSUV based on the cutoff value of 5.1 was the only significant factor in distant metastasis group. Conclusion: The results of this study suggest that the maxSUV of $^{18}F$-FDG PET-CT may be a prognostic factor for treatment outcome and the POF after RT. A %reduction of AFP level and Child-Pugh class could be used to predict OS in HCC.

Quality Assurance of Multileaf Collimator Using Electronic Portal Imaging (전자포탈영상을 이용한 다엽시준기의 정도관리)

  • ;Jason W Sohn
    • Progress in Medical Physics
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    • v.14 no.3
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    • pp.151-160
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    • 2003
  • The application of more complex radiotherapy techniques using multileaf collimation (MLC), such as 3D conformal radiation therapy and intensity-modulated radiation therapy (IMRT), has increased the significance of verifying leaf position and motion. Due to thier reliability and empirical robustness, quality assurance (QA) of MLC. However easy use and the ability to provide digital data of electronic portal imaging devices (EPIDs) have attracted attention to portal films as an alternatives to films for routine qualify assurance, despite concerns about their clinical feasibility, efficacy, and the cost to benefit ratio. In this study, we developed method for daily QA of MLC using electronic portal images (EPIs). EPID availability for routine QA was verified by comparing of the portal films, which were simultaneously obtained when radiation was delivered and known prescription input to MLC controller. Specially designed two-test patterns of dynamic MLC were applied for image acquisition. Quantitative off-line analysis using an edge detection algorithm enhanced the verification procedure as well as on-line qualitative visual assessment. In conclusion, the availability of EPI was enough for daily QA of MLC leaf position with the accuracy of portal films.

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The Origin, Change, and Composition of Soeumin's Bojungikgi-tang (소음인(少陰人) 보중익기탕(補中益氣湯)의 기원, 변천과정 및 구성 원리)

  • Song, Eun-Young;Lee, Eui-Ju;Lee, Jun-Hee;Koh, Byung-Hee
    • Journal of Sasang Constitutional Medicine
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    • v.24 no.1
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    • pp.1-12
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    • 2012
  • 1. Objective : The purpose of this study is to understand the origin, changes and composition of Soeumin's Bojungikgi-tang. 2. Methods : 1) Analyzed the context of the progressive transformation of soeumin's Bojungikgi-tang in related passages from "Donguibogam (東醫寶鑑)", "Donguisusebowon Chobongwon (東醫壽世保元 草本卷)", "Donguisusebowon Gabobon (東醫壽世保元 甲午 本)", "Donguisusebowon Sinchukbon (東醫壽世保元 辛丑本)", "Dongmuyugo (東武遺稿)" 2) Examined the differences between the utilization of Soeumin's Bojungikgi-tang in pre-existing manuscripts according to pathological pattern and more specifically at a pathological stage. 3) Analyzed the total primary effect of the herbs as a prescriptive category, as well as the herbal properties of each component. 3. Results and Conclusions : 1) Originally Dongwon's Bojungikgi-tang was prescribed as a stomach & spleen organ tonifying medicine so it was easily applied and established as a prescription appropriate for Soeumin constitutional types with a weaker spleen organ. 2) From Gabobon(甲午本), Soeumin's Bojungikgi-tang was modified, excluding Bupleurum falcatum(柴胡), Cimicifuga heracleifolia (升麻) and substituting Teucrium chamaedrys(藿香), Ophiopogon japonicus(蘇葉) which are herbs appropriate for the Soeumin constitutional type. 3) In the Gabobon(甲午本), the Gegi-tang which has yang raising properties is included in the Soeumin's Bojungikgi-tang. In Sinchukbon(辛丑本), the Gegi-tang of the Soeumin's Bojungikgi-tang in the Gabobon was excluded and the Gegi-tang mutated into Hwangigyeji-tang. 4) In the Gabobon(甲午本), as the Soeumin's Bojungikgi-tang was prescribed for Soeumin disease regardless of favorable-unfavorable patterns and mild-severe patterns, the stage of the disease when to prescribe Soeumin's Bojungikgi-tang was not clarified. 5) As of the Sinchukbon(辛丑本) edition, as Soeumin's prescriptions have been obvious, the soeumin's Bojungikgi-tang was applied to Mang-yang disease with Hwangigyeji-tang and Seungyangikki-tang 6) As of the Sinchukbon(辛丑本) edition, the Soeumin's Bojungikgi-tang has been applied to parients having both exterior-heat Mang-yang disease and Greater-yin disease, at the same time. 7) As of the Sinchukbon(辛丑本) edition, finally, the Soeumin's Bojungikgi-tang formula has been established as gathering Qi and middle tonification with Panax ginseng(人蔘), Astragalus membranaceus(黃芪), keeping the spleen healthy with Artractylodes japonica(白朮), keeping the spleen strong with Angelica acutiloba(當歸), rooting the spleen with Citrus reticulata(陳皮), raising Yang and middle jiao with Teucrium chamaedrys(藿香), Ophiopogon japonicus(蘇葉), middle tonification with Glycyrrhiza glabra(甘草灸), Zingiber officinale(生薑), Zizyphus jujuba(大棗).

Study on Utilization of Oriental Medicine by Residents in Rural Areas (농촌지역(農村地域)의 한방의료이용실태(韓方醫療利用實態) 일부(一部) 농촌지역(農村地域)의 군보건소이용자(群保建所利用者)를 중심(中心)으로-)

  • Kim, Jin-Soon
    • Journal of agricultural medicine and community health
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    • v.15 no.2
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    • pp.118-129
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    • 1990
  • Socioeconomic status in this county progressed rapidly, this has brought about many changes in health care fields, namely, pattern of disease prevalence and morbidity, increase of the aged people, and also availability of health care in rural areas. According to the utilization study of medical care, it showed that the oriental medicine is used for the treatment of lasted chronic disease not the minor and common diseases which is quick in its effect. Particularly, in rural areas. prevalence of chronic disease is higher than that in urban areas. Although the health cafe need of the oriental medicine is high in rural areas, the distribution of manpower and facilities is lower than that in urban areas. Therefore the government has planned to implement the demonstration project for the oriental medicine at the designated 3 health centers in rural areas. The purpose of this study was to collect the utilization level of oriental medical care of the people in rural areas. To meet the purpose of this study, patient interview were applied. 790 patients visited to health center in project areas were selected and analyzed by experienced interviewers from 2 April to 21 April 1990. The major findings of this study were as follows ; 1) Of the 790 patients, 32.6 percent of the respondents had experience of using the oriental medicine. As for the utilization by age and sex. 54.8% of those was female and 70.7% was 40 years of age and more. 2) Reaction to the question of educational achievement showed that on schooling and primary school graduates accounted for 63.1%. 3) The most user of oriental medicine resides in country level, where the health center is located, and 80 percent of those users resides within 10Km. 4) More than 50% of the total was the chronic diseases which lingered for more than 3months. 5) 32.6 percent of the total cases used the oriental medicine. 61.2% among those was treated by oriental medical care hospital and 38.8% by oriental drug dispensaries etc. 6) The contont of oriental medical care varied ; 50.1% for prescription of herb drugs for treatment, 25.1% for health maintenance and 23.9% for acupuncture, moxibustion etc. 7) As for the motivation for using the oriental medicine. 56.6% of the respondents was for treatment of diseases and 27.9% wes for strengthening the physical weakness. 8) As for the effectiveness of the oriental medicine. 70.3% of the total cases satisfied with that treatment and 84.2% of the total cases will use the oriental medicine when is provided by health center.

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