• 대한한방소아과학회지
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• 제34권4호
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• pp.77-100
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• 2020

Objectives The purpose of this study is to investigate recent clinical studies on the effect of herbal medicine for pediatric tonsillitis in China, and to seek better methods to treat and study for pediatric tonsillitis in Republic of Korea. Methods We searched clinical studies from the China National Knowledge Infrastructure (CNKI) by search formula (SU='扁桃体炎'+'扁桃炎'+'扁桃腺炎'+'乳蛾'+'喉蛾'+'蚕蛾'+'石蛾'+'珠蛾'+'肉蛾'+'乳蛾風'+爛乳風'+'tonsillitis') and (SU='中樂'+'中医樂'+'本草'+'湯'+'丸'+'散'+'方'+'顆粒'+'膠囊'+'自擬'+'herb'+'herbal'+'decoction'+'remedy'+'Chinese medicine'+'Korean medicine'+'kampo'+'formula'+'herbal drug'+'Chinese drug'+'plant'+'Chinese prescription'+'traditional medicine'+'Medicine, East Asian Traditional'+'Herbal Medicine') in professional search from January 2016 to August 2020. We analyzed the literature focusing on the treatment methods and results. Results Among 1464 searched studies, 35 randomized controlled trials were selected and analyzed. In most studies, the effectiveness of oral administration of herbal medicine on pediatric tonsillitis was significant. Most commonly used herbs were Fructus Forsythiae (連翹), Radix Glycyrrhizae (甘草), Radix Scutellariae (黃芩), Herba Menthae (薄荷), Fructus Arctii (牛蒡子), Radix Scrophulariae (玄蔘), Radix Platycodi (桔梗), Flos Lonicerae (金銀花), Radix Isatidis (板藍根), Radix Bupleuri (柴胡), Fructus Gardeniae (梔子), Rhizoma Belamcandae (射干), Radix et Rhizoma Rhei (大黃), Gypsum Fibrosum (石膏). Conclusions By analyzing the improvement of indicators such as total effective rate, cured rate, symptom disappearance time and symptom score, we found that herbal medicine treatment can help improve pediatric tonsillitis. However, additional studies are needed to solidify these findings.

• 한국임상약학회지
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• 제29권2호
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• pp.79-88
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• 2019

Backgrounds: Inflammatory bowel disease (IBD) including ulcerative colitis (UC) and Crohn's disease (CD) increased prevalence and economic burden. Objectives: This study aimed to investigate drug use pattern in IBD patients in a real world. Methods: National Health Insurance claim data from 2010 to 2014 were used in this population-based study. All IBD patients diagnosed during study period were enrolled. IBD medications included 5-aminosalicylic acid (ASA), glucocorticoid, immunomodulator and anti-tumor necrosis factor-${\alpha}$ agent(anti TNF-${\alpha}$). Growth rate of IBD prevalence, prescribed drug classes, duration of drug therapy and medication cost were analyzed. Number and percentage of patients for categorical variables, and mean and median for continuous variables were presented. Results: Total numbers of patients were 131,158 and 57,286 during 5 years, and their annual growth rate were 3.2 and 5.7% for UC and CD. UC and CD were prevalent in the 40-50 (41.2%) and 20-30 age groups (36.0%). About 60% of IBD patients was prescribed any of medications. 5-ASA was the most frequently prescribed, followed by corticosteroid and immunomodulator. Anti TNF-${\alpha}$ use was the lowest, but 5 times higher than UC in CD. Combination therapies with different class of drugs were in 29% for UC and 62% for CD. Mean prescription days per patient per year were 306 and 378, and the median medication cost per patient per year was KRW 420,000 (USD 383) and KRW 830,000 (USD755), for UC and CD, respectively. Conclusions: Increasing prevalence of IBD requires further studies to contribute to achieve better clinical outcomes of drug therapy.

• 한국임상약학회지
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• 제29권3호
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• pp.193-201
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• 2019

Background and Objective: Since the introduction of hospital pharmacy residency programs in 1983, hospital pharmacists in South Korea have been expected to expand their roles. However, their services and the outcomes have not been fully understood. In this study, we conducted a systematic review of Korean hospital pharmacist-provided interventions with regard to intervention type, intervention consequences, and target patient groups. Methods: A literature search of the following databases was performed: Embase, PubMed, Medline, KoreaMed, RISS, KMbase, KISS, NDSL, and KISTI. The search words were "hospital pharmacist", "clinical pharmacist", and "Korea". Articles reporting clinical or economic outcome measures that resulted from hospital pharmacist interventions were considered. Numeric measures for the acceptance rate of pharmacist recommendations were subjected to meta-analysis. Results: Of the 1,683 articles searched, 44 met the inclusion selection criteria. Most articles were published after 2000 (81.8%) and focused on clinical outcomes. Economic outcomes had been published since 2011. The interventions were classified as patient education, multidisciplinary team work, medication assessment, and guideline development. The outcome measures were physicians' prescription changes, clinical outcomes, patient adherence, economic outcomes, and quality of life. The acceptance rate was 80.5% (p < 0.005). Conclusion: Studies on pharmacist interventions have increased and showed increased patient health benefits and reduced medical costs at Korean hospital sites. Because pharmacists' professional competency would be recognized if the economic outcomes of their work were confirmed and justified, studies on their clinical performance should also include their economic impact.

• Tuberculosis and Respiratory Diseases
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• 제43권1호
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• pp.14-21
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• 1996

연구배경: 다제 내성 폐결핵 환자의 임상적 특성과 약제별 내성률, 치료에 영향을 미치는 인자, 이차 약제로 인한부작용, 치료내용 및 차료성적 등을 살펴 보고자 하였다. 대상: 약제 감수성 검사상 두가지 이상의 일차 약제에 동시 내성을 보이는 환자를 대상으로 후향성 연구를 시행하였다. 치료 결과의 판정은 정기적으로 6개월 이상 추적 관찰이 가능했던 환자만을 대상으로 치료후 호전을 1개월 이상의 간격으로 시행한 가래 검사상 3회 이상 음성이고 방사선 소견이 호전되거나 6개월 이상 변화가 없는 경우로, 치료 실패를 6개월간의 치료에도 균 음전화가 되지 않거나 방사선 소견상 악화를 보이는 경우로 정의하였다. 대상 환자들은 감수성 검사 결과에 따라 감수성 약제를 4제 이상 투여하여 치료받았다. 결과: 1) 총 71예와 환자를 대상으로 조사한 결과 35예(49%)에서 방사선상 공동을 관찰할 수 있었고 평균 4.1개의 약물에 내성을 지니고 있었는데 90%가 INH, RFP 동시 내성을 보였다. 2) 치료 결과의 판정이 가능하였던 55예중 35예(67%)의 환자가 치료후 호전을 보였으며 치료 실패는 18예(33%)이었다. 일차 내성 환자가 5예이었는데 치료 결과 판정이 가능하였던 4예는 모두 치료에 성공하였다. 3) 약제 부작용은 14예(20%)에서 나타났는데 간기능 악화가 6예로 가장 많았고 어지러움증 5예, 고요산 혈증을 동반한 관절통이 3예, 이명 3예 등의 순이었다. 이들 부작용의 절반 이상이 투약후 3개월 이내에 발생 하였다. 4) 약제 감수성 검사를 반복했을 때 INH, RFP의 경우 100% 가까운 일치율을 보였고 EMB, PZA 80% 정도 나머지 약물은 50% 미만이었다. 5) 5예의 환자가 수출을 받았고 이 중 1예는 항결핵 화학 요법의 보조적 치료로 수술을 했는데 균 음전화에 성공하였다. 결론: 다제 내성 폐결핵 환자에서도 규칙적인 약물 복용과 적절한 처방으로 약 2/3 정도에서 호전이 관찰되어 적극적인 항결핵 화학 요법을 시행해야 할 것으로 생각되지만 치료와 예후 판정에 도움이 되는 인자를 찾지는 못하였다.

• 한국작물학회지
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• 제50권4호
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• pp.247-255
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• 2005

ice yield and plant growth response to nitrogen (N) fertilizer may vary within a field, probably due to spatially variable soil conditions. An experiment designed for studying the response of rice yield to different rates of N in combination with variable soil conditions was carried out at a field where spatial variation in soil properties, plant growth, and yield across the field was documented from our previous studies for two years. The field with area of 6,600 m2 was divided into six strips running east-west so that variable soil conditions could be included in each strip. Each strip was subjected to different N application level (six levels from 0 to 165kg/ha), and schematically divided into 12 grids $(10m \times10m\;for\;each\;grid)$ for sampling and measurement of plant growth and rice grain yield. Most of plant growth parameters and rice yield showed high variations even at the same N fertilizer level due to the spatially variable soil condition. However, the maximum plant growth and yield response to N fertilizer rate that was analyzed using boundary line analysis followed the Mitcherlich equation (negative exponential function), approaching a maximum value with increasing N fertilizer rate. Assuming the obtainable maximum rice yield is constrained by a limiting soil property, the following model to predict rice grain yield was obtained: $Y=10765{1-0.4704^*EXP(-0.0117^*FN)}^*MIN(I-{clay},\;I_{om},\;I_{cec},\;I_{TN},\; I_{Si})$ where FN is N fertilizer rate (kg/ha), I is index for subscripted soil properties, and MIN is an operator for selecting the minimum value. The observed and predicted yield was well fitted to 1:1 line (Y=X) with determination coefficient of 0.564. As this result was obtained in a very limited condition and did not explain the yield variability so high, this result may not be applied to practical N management. However, this approach has potential for quantifying the grain yield response to N fertilizer rate under variable soil conditions and formulating the site-specific N prescription for the management of spatial yield variability in a field if sufficient data set is acquired for boundary line analysis.

• 한국콘텐츠학회논문지
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• 제13권3호
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• pp.218-228
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• 2013

본 연구는 우리나라 청소년의 체중조절행동 실태를 파악하고 이에 영향을 미치는 요인을 파악함으로써 향후 청소년의 체중조절을 위한 교육과 상담의 기초자료를 생성하기기 위해 시도되었다. 연구 자료는 2011년 청소년건강행태온라인조사 원시자료를 이용하였고, 연구대상자는 지난 30일 동안 체중조절을 시도한 적이 있는 중고등학생 37,472명이었다. 연구결과 여학생이 남학생에 비해 건강한 체중조절행동(운동, 적절한 식이), 부적절한 체중조절행동(단식, 원푸드 다이어트)과 극단적인 체중조절행동(설사약, 처방받지 않은 약, 식사 후 구토)을 더 많이 하였다. 남녀학생 모두에서 비만할수록 건강한 체중조절행동과 부적절한 체중조절 행동을 더 많이 하였다. 극단적 체중조절행동 중 의사가 처방하지 않은 약 복용은 남학생의 경우 저체중군에서 여학생의 경우 비만군에서 높았다. 건강한 체중조절행동에 영향을 미치는 변수는 성, 학년, 가족풍요도, 어머니 교육수준, 주관적 체형, 비만도였다. 부적절한 체중조절행동에 영향을 미치는 변수는 성, 학년, 지역, 아버지 교육 수준, 주관적 체형이었고, 극단적 체중조절행동에 영향을 미치는 변수는 성, 학년, 주관적 체형, 비만도였다. 이러한 결과는 청소년에게 부적절한 체중조절해동의 폐해에 대한 교육과 지속적으로 적절한 식이와 운동을 격려하는 예방프로그램이 필요함을 시사한다.

• 농촌의학ㆍ지역보건
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• 제33권1호
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• pp.37-45
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• 2008

본 연구는 시설 신축 여부에 따른 환경요인이 고혈압 조절에 미치는 영향을 미치는 지 여부를 파악하기 위해 1994년부터 약 10여년 동안 시행되어 온 농촌의료서비스 개선사업에 의한 보건기관 신축 여부와 인구학적 개인 요인, 전문의 여부 등 의사 요인의 영향을 함께 고려하여 분석한 연구이다. 고혈압 조절에 영향을 미치는 요인에 관한 연구천성아, 나백주, 김철웅, 이무식 7는 주로 개인 특성에 대한 연구가 이미 수행되었지만 의사의 특성 요인 및 의료 조직 및 시설의 위치 등 환경 요인에 대한 분석은 미흡하였다.조사는 충청도 일부 지역 6개 시,군으로 농어촌의료서비스 개선사업 대상지역이다. 해당 지역의 6개 보건소 및 산하 59개 보건지소에 2005년 7월 1일부터 2006년 6월 30일까지 한번이라도 고혈압 진료를 위해 환자가 내원하거나 보건소 직원이 직접 방문하여 투약 혹은 상담을 한 내용이 기록된 자료 가운데 분석에 적합한 약 2만5천건의 고혈압 환자 진료 자료를 분석하였다.연구결과 전체적인 보건기관에 혈압수치 조절율은 53.9%이었으며 여성이 남성보다 혈압이 잘 조절되었으면 60대와 70대의 혈압 조절율이 유의하게 높았다(p<0.01). 또한 개선지역이 미개선 지역에 비해 혈압조절율이 유의하게 높았다(p<0.01). 전문의 기준으로 일반의에서 혈압조절율이 다변량 분석에서 유의하게 낮았다(p<0.01). 이 연구는 진료에 적합한 시설이 환자진료 과정에서 의료진의 만족도와 환자의 안정감을 향상시키고 이는 결국 환자관리의 순응도 등을 높이는데 기여하여 진료결과의 질적 향상에도 영향을 미칠 수 있음을 실증적으로 확인하였다. 이는 향후 농어촌의료서비스개선사업이 지역사회 건강결과 향상에 미치는 효과를 계량화 하는 기초 자료가 될 수 있을 것으로 판단한다.연구 기금본 연구는 한국개발연구원이 발주하고 한국보건사회연구원이 수행한 “농어촌의료서비스개선사업의 심층평가” 연구의 지원으로 수행하였습니다.감사의 말씀본 연구에 적극 협조해 주신 프로그램 개발업체 GST 이재익 사장과 민상익 연구원에게 깊은 감사를 드립니다.

• Journal of Korean Neurosurgical Society
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• 제54권2호
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• pp.107-111
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• 2013

Objective : We investigated the effectiveness of stereotactic gamma knife Radiosurgery (GKR) for radioresistant brain metastases with the impact upon histology. Methods : Between April 2004 and May 2011, a total of 23 patients underwent GKR for 67 metastatic brain tumors from 12 renal cell cancers, 5 sarcomas and 6 melanomas. The mean age was 56 years (range, 18 to 79 years). Most of the patients were classified as the Radiation Therapy Oncology Group recursive partitioning analysis class II (91.3%). The synchronous metastasis was found in 6 patients (26.1%) and metachronous metastasis in 17 patients (73.9%). We analyzed the local control rate, intracranial progression-free survival (PFS) and overall survival (OS). Results : The mean tumor volume for GKR was 2.24 cc and the mean prescription dose was 19.4 Gy (range, 10 to 24) to the tumor margin. Out of metachronous metastases, the median duration to intracranial metastasis was 3.3 years in renal cell cancer (RCC), 2.4 years in melanoma and 1.1 years in sarcoma (p=0.012). The total local control rate was 89.6% during the mean 12.4 months follow-up. The six-month and one-year local control rate was 90.2% and 83% respectively. Depending on the pathology, the control rate of RCC was 95.7%, sarcoma 91.3% and melanoma 80.5% during the follow-up. The common cause of local failure was the tumor bleeding in melanoma. The median PFS and OS were 5.2 and 8.4 months in RCC patients, 6.5 and 9.8 months in sarcoma, and 3.8 and 5.1 months in melanoma. Conclusion : The GKR can be one of the effective management options for the intracranial metastatic tumors from the radioresistant tumors. The melanoma showed a poor local control rate compared to other pathologies because of the hemorrhage.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권1호
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• pp.19-27
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• 2020

Objectives: Pentoxifylline (PTX) is a methylxanthine derivative that has been implicated in the pathogenesis of peripheral vessel disease and intermittent lameness. The purpose of this study was to investigate the effect of PTX and tocopherol in patients diagnosed with osteoradionecrosis (ORN), bisphosphonate-related osteonecrosis of the jaw (BRONJ), and chronic osteomyelitis using digital panoramic radiographs. Materials and Methods: This study was performed in 25 patients who were prescribed PTX and tocopherol for treatment of ORN, BRONJ, and chronic osteomyelitis between January 2014 and May 2018 in Seoul National University Dental Hospital. Radiographic densities of the dental panorama were compared prior to starting PTX and tocopherol, at 3 months, and at 6 months after prescription. Radiographic densities were measured using Adobe Photoshop CS6 (Adobe System Inc., USA). Blood sample tests showing the degree of inflammation at the initial visit were considered the baseline and compared with results after 3 to 6 months. Statistical analysis was performed using the Mann-Whitney test and repeated measurement ANOVA using IBM SPSS 23.0 (IBM Corp., USA). Results: Eight patients were diagnosed with ORN, nine patients with BRONJ, and the other 8 patients with chronic osteomyelitis. Ten of the 25 patients were men, average age was 66.32±14.39 years, and average duration of medication was 151.8±80.65 days (range, 56-315 days). Statistically significant increases were observed in the changes between 3 and 6 months after prescription (P<0.05). There was no significant difference between ORN, BRONJ, and chronic osteomyelitis. Only erythrocyte sedimentation rate (ESR) was statistically significantly lower than before treatment (P<0.05) among the white blood cell (WBC), ESR, and absolute neutrophil count (ANC). Conclusion: Long-term use of PTX and tocopherol can be an auxiliary method in the treatment of ORN, BRONJ, or chronic osteomyelitis in jaw.

• 대한임상독성학회지
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• 제10권1호
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• pp.8-14
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• 2012

Purpose: The Tox-Info system is a poisonous substance information database developed by the Korean National Institute of Food and Drug Safety Evaluation. The aim of this study was to estimate the coverage effectiveness of the Tox-Info system by comparing the toxic substances included in the database with the distribution of the toxic substances implicated in the cases of intoxicated patients presenting to emergency departments. The secondary aim of the study was to propose any additional substances that should be added to the database. Methods: We retrospectively reviewed the medical records of patients suffering with toxic exposure who had visited any of 12 selected emergency departments in Korea from January 2010 to December 2011. The identified toxic substances were classified into groups including prescription drugs, agricultural chemicals, household products, animals or plants, herbal drugs, and others. We calculated the coverage rate of the Tox-Info database relative to the number of intoxication cases and the type of toxic substances involved. Results: A total of 5,840 intoxicated patient records were collected. Their mean age was $46.6{\pm}20.5$ years and 56.2% were female. Of the total intoxication cases, 87.8% of the identified toxic substances were included in the Tox-Info database, while only 41.6% of all of the types of identified toxic substances were included. Broken down by category, 122 prescription drugs, 15 agricultural chemicals, 12 household products, 14 animals or plants and 2 herbal drugs involved in poisoning cases were not included in the Tox-info database. Conclusion: This study demonstrated the clinical usefulness of the Tox-Info system. While 87.8% of the substances involved in the cases were included in the Tox-Info database, the database should be continuously updated in order to include even the most uncommon toxic substances.