• 제목/요약/키워드: prescription rate

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Observational Properties of Wolf-Rayet stars and Type Ib/Ic supernova progenitors

  • 정무건;윤성철
    • 천문학회보
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    • 제45권1호
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    • pp.42.3-42.3
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    • 2020
  • We investigate the observational properties of Wolf-Rayet stars, suggest the constraint of their mass-loss rate and apply our results to the observed progenitor candidates of Type Ib/Ic supernovae (iPTF13bvn and SN 2017ein). For this purpose, we adopt the WR star models with various mass-loss rates and wind terminal velocities. We obtain the high resolution spectra of those models at the pre-supernova phase using the radiative transfer code CMFGEN. We verify the optically faint property of SN Ic progenitors and show that the optical faintness is mainly originated by the high effective temperature at the photosphere. We also show that a simple analytic model for WR winds using a constant opacity can roughly predict the photospheric parameters. We show that the change of the mass-loss rate and the terminal wind velocity critically affects the optical luminosity. We find the optical luminosities of SN Ic progenitor models with our fiducial mass-loss rate prescription are fainter than the detection limits. We also suggest the mass-loss rate of WR stars may not exceed 2 times of our fiducial value by comparing our predictions with the detection limit of SN Ib/Ic progenitors. The directly observed progenitor candidate of iPTF13bvn can be explained by our SN Ib progenitor models. We find that the SN 2017ein progenitor candidate is too bright and too blue to be a SN Ic progenitor.

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의료질평가지원금 제도의 의약품안전사용서비스 평가지표 도입에 따른 의료기관의 행태 변화 (Changes in the Behavior of Healthcare Organizations Following the Introduction of Drug Utilization Review Evaluation Indicators in the Healthcare Quality Evaluation Grant Initiative)

  • 김현정;유기봉;원영주;장한솔;이광수
    • 보건행정학회지
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    • 제34권2호
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    • pp.178-184
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    • 2024
  • 연구배경: 본 연구는 의료질평가지원금 drug utilization review (DUR) 평가지표 도입 전·후의 DUR 점검률 및 의약품 중복처방 예방률 변화 차이를 비교하여 DUR 평가지표의 도입과 안전한 의약품 사용 간의 효과성을 파악하고자 한다. 방법: 본 연구는 2018년 건강보험심사평가원(Health Insurance Review and Assessment Service) DUR 자료(DUR 평가지표 도입 전)와 2023년 의료질평가지원금 평가 결과 산출 자료(DUR 평가지표 도입 후)를 활용하였다. 종속변수는 DUR 평가지표로, DUR 점검률과 의약품 중복처방 예방률 지표를 활용하였다. 독립변수는 DUR 평가지표 도입 여부이며, 통제변수는 의료기관 단위변수로, 종별 구분, 설립 구분, 소재지, DUR 청구 software 업체, 병상 수를 선정하였다. 결과: DUR 평가지표 도입 전·후의 의약품 중복처방 예방률 변화 차이를 분석한 결과, DUR 평가지표 도입 전·후의 의약품 중복처방 예방률은 통계적으로 유의미한 차이가 있었으며, DUR 평가지표 도입 후 의약품 중복처방 예방률이 유의미하게 증가하였다. 결론: 본 연구의 정책적 시사점은 다음과 같다. 첫째, DUR 시스템의 지속적인 평가 진행이 필요하다. 본 연구를 통해 DUR 평가지표 도입 후 의약품 중복처방 예방률이 유의하게 증가한 것을 확인하였다. 따라서 DUR 시스템의 효과를 계속해서 검토하고 의약품 사용의 안전성을 확대하기 위해 DUR 시스템의 지속적인 평가 진행이 필요할 것으로 판단된다. 둘째, DUR 시스템 정보를 활용하는 의료기관과 이를 관리하는 기관과의 협력 파트너십 구축이 필요하다. 의료기관의 적극적인 DUR 점검 참여와 관리기관의 다각적인 지원을 바탕으로 공동의 노력과 협력이 이루어진다면, DUR 시스템의 활성화를 통해 안전한 의약품 사용을 보장하고 국민건강을 보호하며, 의료의 질적 수준 향상을 불러올 것으로 판단된다.

한의학의 항종양 면역치료에 관한 연구 -1990년 이후 발표된 실험논문을 중심으로- (Compilation of 104 Experimental Theses on the Antitumor and Immuno-activating therapies of Oriental Medicine)

  • 강연이;김태임;박종오;김성훈;박종대;김동희
    • 동의생리병리학회지
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    • 제17권1호
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    • pp.1-24
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    • 2003
  • This study was done to compile 104 experimental theses which are related to the antitumor and immuno-activating therapies between February 1990 through February 2002. Master's and doctoral theses were dassified by schools, degrees, materials, effects, experimental methods of antitumor and immunoactivity, and results. The following results were obtained from this study : 1. Classifying the theses by the school, 34.6% were presented by Daejeon University, 29.8% by Kyung-hee University and 11.5% by Won-kwang University. Of all theses, 51.0% were aimed for the doctoral degree and 43.3% were for the master's degree. All of three universities have their own cancer centers. 2. Classifying the theses by herb materials, complex prescription accounted for 60.3%, single herb accounted for 24.8% and herbal acupuncture accounted for 14.2%. Considering the key principles of the traditional medicine, complex prescription was much more thoroughly studied than single herb prescription. The results showed that the complex prescription had both antitumor activity and immuno-activating activity, which might reflects on multi-activation mechanisms by complex components. 3. Classifying the theses by the efficacy of herbs examined, in single herb, invigorating spleen and supplementing was 35.5%, expelling toxin and cooling was 29.0%, activating blood flow and removing blood stasis was 12.9%. In herbal acupuncture, invigorating spleen and supplementing was 52.9%, expelling toxin and cooling was 29.4%. In complex prescription, pathogen-free status was 41.9%, strengthening healthy qi to eliminate pathogen was 35.5%, strengthening healthy qi was 22.6%. It is presumed that the antitumor and immunoactivating therapy based on syndrome differentiation is the best way to develop oriental oncology. 4. Classifying the theses by antitumor experiments, cytotoxic effect was 48.1 %, survival time was 48.1 % and change of tumor size was 42.3%. Survival rate was not necessarily correlated with cytotoxicity. These data reflect the characteristic, wholistic nature of the oriental medicine which is based on BRM (biological response modifier). 5. Classifying the theses by immunoactivating experiments, hemolysin titer was 51.0%, hemagglutinin titer was 46.2% and NK cell's activity was 44.2%. In the future studies, an effort to elucidate specific molecular and cellular mechanisms of cytokine production in the body would be crucial. 6. Classifying the theses according to the data in terms of antitumor activity, 50% was evaluated good, 24.0% was excellent, and 15.5% have no effect. In an evaluation of immuno-activating activity, 35.9% was excellent and 18.0% showed a little effect. The index point, as described here, may helps to use experimental data for clinical trials. Changes in index points by varying dosage implicate the importance of oriental medical theory for prescription. 7. In 167 materials, IIP (immunoactivating index point, mean : 3.12±0.07) was significantly higher than AIP(antitumor index point, mean : 2.83±0.07). These data demonstrate that the effect of herb medicine on tumor activity depends more on immunoactivating activity than antitumor activity. This further implies that the development of herbal antitumor drugs must be preceded by the mechanistic understanding of immunoactivating effect. 8. After medline-searching tumor and herb-related articles from NCBI web site, we conclude that most of the studies are primarily focused on biomolecular mechanisms and/or pathways. Henceforth, we need to define the biomolecular mechanisms and/or pathways affected by herbs or complicated prescriptions. 9. Therefore, the most important point of oriental medical oncology is to conned between experimental results and clinical trials. For the public application of herbal therapy to cancer, it is critical to present the data to mass media. 10. To develop the relationship of experimental results and clinical trials, university's cancer clinic must have a long-range plan related to the university laboratories and, at the same time, a regular consortium for this relationship is imperative. 11. After all these efforts, a new type herbal medicine for cancer therapy which is to take care of the long-term administering and safety problem must be developed. Then, it would be expected that anti-tumor herbal acupuncture can improve clinical symptoms and quality of life (QOL) for cancer patients. 12. Finally, oriental medical cancer center must be constructed in NCC (National Cancer Center) or government agency for the development of oriental medical oncology which has international competitive power.

임신시 향정신성 약물의 임상약리학 (Clinical Pharmacology of Psychotropic Agents in Pregnancy)

  • 노형근
    • 생물정신의학
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    • 제3권2호
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    • pp.149-155
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    • 1996
  • Doctors who treat pregnant women ore usually cautious in writing their prescription for the drugs. The problem of which psychotropic medications ore sale during pregnancy seems to remain unsolved for many years. Although the rate of absorption is reduced due to a reduced rate of gastric emptying, the extent of absorption of drug is generally unchanged during pregnancy. Plasma volume and total body water increase during pregnancy. There is suggestion that drug metabolizing activity may be increased in pregnancy. Since the pregnancy increase the glomerular filtration rate significantly, drugs mainly eliminated by renal excretion will be cleared more quickly. Factors contributing to the potential teratogenecity of a drug include the type of compound, dose and duration of use, developmental stage of fetus at the time of exposure, and the effect of the drug on fetal pharmacokinetics. All major classes of psychotropic agents should be assumed to diffuse readily across the placenta to the fetus and to be present in some quantity in the breast milk. To decide when and how to start the drug treatment depends on an assessment of the risks related both with and without drug treatment of psychiatric disorders.

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중환자실 경장영양 환자의 영양지원, 위 잔여량 및 영양상태 (Nutritional Support, Gastric Residual Volume and Nutritional Status during Enteral Nutrition in Intensive Care Unit Patients)

  • 이민주;강지연
    • 성인간호학회지
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    • 제26권6호
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    • pp.621-629
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    • 2014
  • Purpose: The purpose of this study was to investigate the nutritional support, gastric residual volume, and nutritional status of the intensive care unit (ICU) patients on enteral feeding. Methods: A descriptive longitudinal design was used to collect 5 day data on enteral nutrition of 52 ICU patients in an university hospital. Nutritional support was calculated with actual caloric intake compared to individual caloric requirement. Residual volumes were measured prior to routine feedings, and the serum albumin levels and the total lymphocyte counts were checked to evaluate nutritional status. The data were analyzed using one group repeated measures ANOVA, paired t-test, and Spearman's bivariate correlation analysis. Results: The subjects received their first enteral feeding on the $5.75^{th}$ day of ICU admission. The mean nutritional support rate was 49.1% of the requirement, however prescription rate and support rate were increased as time goes by. Gastric residual volumes were less than 10 cc in 95% cases. A significant negative correlation was found between nutritional support and nutritional status. Conclusion: The nutritional support for ICU patient was low compared to the requirement, and their nutritional status was worse than at the time of ICU admission. Further studies are necessary to develop nursing interventions for improving nutritional support for ICU patients.

The Effect of Electroacupuncture on the Heart Rate Variability of Stroke Patients under Mental Arithmetic Stress

  • Oh, Jae-Gun;Kwon, So-Yeon;Yun, Henja;Sung, Kang-Keyng
    • 대한한의학회지
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    • 제33권4호
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    • pp.50-59
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    • 2012
  • Objectives: This study aimed to compare the effects of high frequency electroacupuncture, low frequency electroacupuncture and manual acupuncture on the autonomic nervous system in stroke patients by using a heart rate variability measuring device. Methods: Thirty-nine participants were recruited and each participated in the high frequency electroacupuncture group, low frequency electroacupuncture group, manual acupuncture group and non-acupuncture group. Some participants received needle insertion with 100 Hz stimulation, with 2Hz stimulation and manual stimulation under mental arithmetic stress during 2 sections. Other participants maintained in the supine position without acupuncture under mental arithmetic stress during the 2 sections. Acupuncture needles were directly inserted perpendicularly to the right Liv 3 acupoint followed by delivery of electric pulses to these points for 8 minutes. Heart rate variability was measured 8 minutes before and 16 minutes after acupuncture stimulation by a heart rate variability measuring system. Results: We found a significant elevated HF total power between 1 section and 2 section and between 1 section and 4 section in the non-acupuncture group, between 3 section and 4 section in the 100Hz electroacupuncture group, and between 1 section and 2 section in the manual acupuncture group and with no change in the 2Hz electroacupuncture group. We also found a significant VLF total power between 2 section and 3 section in the 2Hz electroacupuncture group and between 1 section and 4 section and between 2 section and 4 section in the 100Hz electroacupuncture group. All four groups showed no significant differences in other parameters including heart rate mean, low-frequency power, and the ratio of low-frequency power to high-frequency power. Conclusions: This study may be a basis for research about effects of acupuncture and electroacupuncture because the parameters measured, heart rate variability, showed differences according to acupuncture.

체감의이인탕(體感薏苡仁湯) 복용(服用)과 전침시술(電鍼施術)이 체지방(體脂肪) 감소(減少)에 미치는 효과(效果) (한방치료((韓方治療)의 부분비만(部分肥滿) 개선(改善) 효과(效果)) (Effect of Chegamuiyiin-tang and Electro-lipolysis Acupuncture on the Reduction of Body Fat (Effect of Oriental Medicine on Localized Obesity))

  • 김선민;김길수
    • 한방비만학회지
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    • 제2권1호
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    • pp.13-23
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    • 2002
  • Background & Methods: In order to study the effect of electro-lipolysis-acupuncture, 57 outpatients who have had herbal medication in Kirin Oriental Hospital were devided to two groups; acupuncture-treated group(46) vs non-acupuncture-treated group(11) Acupuncture-treated group was given electro-lipolysis-acupuncture at least two times a week and administered with herbal diet medication, whereas non-acupuncture-treated group was administered only with herbal diet medication. Results: Mean age, body weight and BMI of these two group at the start point of the treatment were $27.22({\pm}7.64)\;vs \;29.09({\pm}8.73),\;67.76({\pm}9.34)\;vs\;67.00({\pm}10.69),\;and\;26.20({\pm}3.02)\;vs\;26.14({\pm}4.10)$ in the order of acupuncture-treated and non-acupuncture groups. After one month of treatment, change rate of body weight, BMI, total fat, percentage of fat was significantly higher in acupuncture-treated group. Also the change rate of arm circumference, hip circumference and thigh circumference was significantly higher in acupuncture-treated group. The change rate of abdominal circumference and WHR of acupuncture-treated group was higher than that of non-acupuncture-treated group with no statistical significance. The circumference reduction rate according to herbal dieting program was higher in this order, abdomen, arms, chest, thighs and hips. On the other hand, chest circumference change rate over weight loss rate, which is the portion no acupuncture treatment was given to, and AMC change rate was higher in non-acupuncture-treated group. Conclusion: These results imply that herbal dieting program combined with electro-lipolysis-acupuncture is more effective on reducing body fat, size reduction of localized obesity and preservation of muscle than herbal prescription only dieting program.

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급성상기도감염 환자의 항생제 처방에 영향을 주는 요인 (Analysis of Factors Related to the Prescription of Antibiotics for the Acute Upper Respiratory Infection)

  • 최원정;임은실;김태현;서혜선;최기춘;정우진
    • 보건행정학회지
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    • 제25권4호
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    • pp.256-263
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    • 2015
  • Background: Initial treatment of acute upper respiratory infection (AURI) should not include antibiotics because most AURIs are caused by virus. However, the prescription rate of antibiotics in Korea is higher than in any other countries. Inappropriate use of antibiotics in Korea accelerated the emergence of antibiotics resistance and increased the social and economic burden. The objective of this study was to investigate the factors related to antibiotics use for the AURI among children-adolescents and adults. Methods: This study analyzed the Health Insurance Review and Assessment Service-National Patient Sample data which was nationally representative sampling stratified by sex and age. Results: The influencing factors of antibiotics use for AURI are gender, age, types of medical security, primary disease, existence of concomitant disease, treatment seasons, first visit or revisit, indicated specialty, types of medical institution, and location of medical institution. Conclusion: The results showed health policy makers are required to place more efforts to resolve inappropriate antibiotics use. Especially they need to establish a health policy to reduce the gap between areas and specialties and recommend standardized clinical guidelines according to the subgroup code of AURI and the age group of patients.

요양급여심사기준 완화에 따른 비스테로이드성 항염제 및 위장관 보호제 처방 변화 및 안정성 분석 (Prescribing Pattern and Safety Analysis of Nonsteroidal Anti-inflammatory Drug and Gastro- Protective Agent following Reimbursement Guidelines Relaxation)

  • 한미혜;노은선;남진현;이상원;이의경
    • 한국임상약학회지
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    • 제27권4호
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    • pp.250-257
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    • 2017
  • Objective: The prevalence rate of osteoarthritis in Koreans aged 50 years or older is 14.3%, and the total amount of medical costs is more than KRW 1 trillion. Recently, the reimbursement guidelines for osteoarthritis treatment have changed. Methods: In this study, we sought to describe prescription patterns of nonsteroidal anti-inflammatory drugs (NSAIDs) and gastro-protective agent (GPA) and analyze the clinical and economic impacts of the new policy using the national health insurance claims data. The incidence of upper gastrointestinal adverse event by policy change was identified through the odds ratio, and changes in medicine and medical costs related to osteoarthritis through mean and median. Results: There were 204,552 patients before the reimbursement guidelines relaxation and 239,710 after it, a 17.2% rise. The prescription ratio was 3.3% for the patients prescribed with COX-2 selective NSAIDs alone and 1.3% for those with both COX-2 selective NSAIDs and GPA combination before the reimbursement guidelines relaxation. The reimbursement guidelines relaxation significantly increased their ratios to 6.9% and 2.8%, respectively. Gastrointestinal adverse events significantly reduced by 1.21%p after reimbursement guidelines relaxation. The average medicine cost per person increased significantly to KRW 140,291 from KRW 137,323 after the reimbursement guidelines relaxation, while the average medical cost per person slightly decreased from KRW 311,605 to KRW 310,755 after the relaxation, showing no meaningful difference. Conclusion: The reimbursement guidelines relaxation may influence on decreasing the upper gastrointestinal adverse event, increasing the medicine costs and maintaining the medical costs for osteoarthritis.

두드러기 증례 연구에서 사용된 한약 처방 분석 (Analysis of Korean Herbal Medicine Used in Case Studies of Treating Urticaria)

  • 박중군;강세현;강동원;김규석;김윤범
    • 한방안이비인후피부과학회지
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    • 제31권3호
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    • pp.12-25
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    • 2018
  • Objectives : The purpose of this study is to analyze the use of herbal medicine for the treatment of urticaria in case studies and to find the general tendency of herbal medicine treatment and to establish the primary treatment direction of urticaria. Methods : In the domestic databases, Oriental medicine Advanced Searching Integrated System (OASIS), Korean Traditional Knowledge Portal (KTKP), National Discovery for Science Leader (NDSL), Research Information Sharing Service (RISS), we selected among the case study papers published in the last 20 years using search terms related to "urticaria". Reports related to Sasang Constitutional medicine were excluded and total of 15 papers were finally selected. Results : 23 prescriptions were retrieved from 15 papers. The most commonly used prescription was Seungmagalgeun-tang (升麻葛根湯), and Bangpoongtongsung-san (防風通聖散) and Pyeongwi-san (平胃散) were presented twice. Commonly used herbs are Glycyrrhizae Radix et Rhizoma (甘草), Zingiberis Rhizoma Recens (生薑), and Scutellariae Radix (黃芩). 18 out of 78 herbs are belonging to heat-clearing medicinal (淸熱藥) and 16 out of 78 herbs are belonging to exterior-releasing medicinal (解表藥). Concurrent therapies such as acupuncture, pharmacoacupuncture, moxibustion, cupping therapy, ice pack applying therapy were performed and several evaluation methods were used, patient's subjective remission rate was the most used. Conclusions : Through this study, we were able to discover the tendency of herbal medicine prescription for the treatment of urticaria.