• 한국보건간호학회지
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• 제29권2호
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• pp.285-297
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• 2015

Purpose: The purpose of this study was to analyze published studies on medication adherence in Korea. Methods: The studies were identified and data were collected from Oct. to Nov. 2014 through the RISS, KISS, NDSL, and Nanet websites. Key words including medication adherence and medication compliance were used. A total of 37 published studies were reviewed using criteria developed by researchers. Results: Studies published and associated with adherence have increased since 2010. Several instruments have be enused to date however, there is no critical standard regarding medication adherence. In addition, various interventions are available and have positive effects but the main concept is also deferent with adherence and compliance. Conclusion: There sults show that research related to adherence has actively increased. How ever there are various concepts, method sand standard. Therefore more studies are required in the future for development of a unified concept, methods and standards for adherence for future.

• 한국임상약학회지
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• 제21권2호
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• pp.106-114
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• 2011

1) 제주도 사업의 경우에 고양시보다 의료기관의 참여도가 높았는데 이것은 처방내에서 혹은 동일 의사의 처방내에서 병용금기나 중복의 발생을 줄이는 노력을 기울인 사실을 의미하였다. 빈도수에 있어서 병용금기는 고양시에서 처방전 1만 건당 0.45건 발생에서 제주도는 0건으로, 중복의 경우는 고양시에서 1만 건당 197건에서 제주도는 23건으로 감소하였다. 2) 하지만 제주도의 의료기관 참여도가 높음에도 불구하고 다른 의사 처방과의 점검에서는 병용금기 및 중복이 뚜렷이 감소하지 않았다. 병용금기의 발생은 고양시에서 1만 건당 4.95건에서 제주도의 경우 4.16건으로, 중복의 경우에 고양시의 경우 1만 건당 426건에서 제주도는 381건으로 감소하였지만 그 차이는 동일 의사 점검에서와 같은 뚜렷한 감소가 아닌 미세한 것이었다. 3) 두 지역을 통합하여 계산하였을 때 병용금기 발생의 동일 의사 점검: 다른 의사 점검의 비(比)(ratio)는 1:23으로 계산되었다. 4) 고양시 지역에서 중복의 발생은 동일 의사 점검: 다른 의사 점검의 비(比)(ratio)는 1: 2.12이었으며 제주도의 경우 그 비(比)(ratio)는 1:16.5이다. 5) 병용금기나 중복의 발생 문제 대부분이 다른 의사가 발행한 복수 처방에 의한 의약품의 병용에서 비롯하는 문제이며 이것은 의도하거나 인지하지 못한다는 점에서 단순 다제병용보다 심각한 문제를 포함할 수 있다. 6) 연구의 발견점은 의료 및 약사용 측면에서 통합성을 높이는 정책대안의 시급성을 시사하고 있으며 DUR제도의 확대강화와 단골약국 이용을 통하여 이러한 목표를 향한 정책을 지지해주는 결과라고 볼 수 있다.

• Journal of Korean Neurosurgical Society
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• 제54권2호
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• pp.118-124
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• 2013

Objective : Subthalamic nucleus (STN) deep brain stimulation (DBS) is an effective treatment of choice for patients with advanced idiopathic Parkinson's disease (PD) who have motor complication with medication. The objectives of this study are to analyze long-term follow-up data of STN DBS cases and to identify the factors related to outcomes. Methods : Fifty-two PD patients who underwent STN DBS were followed-up for more than 3 years. The Unified Parkinson's Disease Rating Scale (UPDRS) and other clinical profiles were assessed preoperatively and during follow-up. A linear regression model was used to analyze whether factors predict the results of STN DBS. We divided the study individuals into subgroups according to several factors and compared subgroups. Results : Preoperative activity of daily living (ADL) and the magnitude of preoperative levodopa response were shown to predict the improvement in UPDRS part II without medication, and preoperative ADL and levodopa equivalent dose (LED) were shown to predict the improvement in UPDRS part II with medication. In UPDRS part III with medication, the magnitude of preoperative levodopa response was a predicting factor. Conclusion : The intensity of preoperative levodopa response was a strong factor for motor outcome. And preoperative ADL and LED were strong factors for ADL improvement. More vigorous studies should be conducted to elucidate how levodopa-induced motor complications are ameliorated after STN DBS.

• Physical Therapy Rehabilitation Science
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• 제2권2호
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• pp.99-103
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• 2013

Objective: Clinical measures that quantify upper extremity function are needed for the accurate evaluation of patients and to plan an intervention strategy. The purpose of this study was to examine the relationship between the Unified Parkinson's Disease Rating Scale (UPDRS)-Motor Exam and upper extremity performance as a quantifying clinical tool of upper extremity function in persons with Parkinson's disease. Design: Cross-sectional study. Methods: Thirty-two idiopathic Parkinson's Disease persons participated in this study. To investigate the relationship between the UPDRS-motor exam, Box and Block test (BBT), and Action Research Arm Test (ARAT) by two physical therapists. The examination took up to 1 hour, and the participants were invited to rest between each clinical measure in order to minimize the effects of fatigue. Clinical measures were assessed while the subjects were in the "on" phase of their medication cycle, generally 1-3 hour after taking their anti-Parkinson's medications. Results: In more affected side, the UPDRS-motor exam was significantly negative correlated with the BBT (p<0.05) but it was not significantly correlated with the ARAT. In less affected side, only positively correlation was significantly shown between BBT and ARAT (p<0.05). On the other hand, between BBT and ARAT were not significantly correlated with the UPDRS-motor exam. Conclusions: The UPDRS-motor exam is effective tool which was significantly correlated with manual dexterity in more affected upper extremity. But The UPDRS-motor exam is not effective tool in less affected upper extremity.

• Journal of Acupuncture Research
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• 제36권2호
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• pp.113-117
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• 2019

Parkinson's disease (PD) is a neurodegenerative disease, where treatment with medication may lead to gastrointestinal (GI) symptoms. The objective of this case study was to investigate the effectiveness of Korean medicine (KM) in treating PD with drug-induced GI dysfunction. A 70-year-old female participant was diagnosed with PD in 2010 and drug-induced gastritis in 2016. Her major symptoms were related to GI, PD, and overall feeling of weakness. She was treated with KM including pharmacopuncture, acupuncture, moxibustion, and herbal medicines, in combination with Western medicines during 46 days of in-patient care. This study showed an improvement in symptoms and scores on the GI symptom scale, Unified Parkinson's disease rating scale, Hoehn and Yahr staging, Berg balance scale, PD quality of life, and stress index at discharge. This case demonstrated that the symptoms of drug-induced GI dysfunctions in PD was improved by treatment with KM.

• Parasites, Hosts and Diseases
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• 제59권5호
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• pp.507-512
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• 2021

Since 1993, vivax malaria has been recognized as a public health burden in Korea. Despite of pan-governmental malaria-control efforts and the dramatic reduction in the burden of this disease over the last 10 years, vivax malaria has not been well controlled and has remained continuously endemic. We focused interviewed and examined the charts of 28 confirmed vivax malaria patients given malarial therapy for whom daily records were kept from Gimpo-si, Gyeonggi-do of Korea. Various epidemiological characteristics of vivax malaria, including the incubation period, medication used, and recurrence, and an evaluation of the parasitic characteristics from the focused interviews of patients from this region are described here. Most of the participants indicated the 3 most common symptoms of malaria (headache, chills and fever). Of the 28 cases, 2 experienced a second attack and there were 17 and 11 cases with short- and long-term incubation periods, respectively, yielding a short-term to long-term ratio of 1.5. Based on the parasitemia stages, most of the participants were tested at 5 to 7 days (11 cases) and 7 to 15 days (11 cases) after initial wave of asexual parasites. In conclusion, public health authorities should consider developing management measures to decrease the time lag for diagnosis and drafting unified and robust guidelines for drug use for malaria and drawing up unified and robust guidelines on the use of medication for malaria. It also suggests that routine monitoring, surveillance, and precise medical surveys in high-risk vivax malaria endemic areas are pivotal to controlling this persistent public disease and finally eliminating it from Korea.

• 한국정밀공학회지
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• 제30권5호
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• pp.559-563
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• 2013

This study aims to quantify the effects of medication (Med) and deep brain stimulation (DBS) on resting rigidity in patients with Parkinson's disease. We tested 10 limbs of five patients under each of four treatment conditions: 1) baseline, 2) DBS, 3) Med, 4) DBS + Med. Rigidity at the wrist joint was assessed using the Unified Parkinson's Disease Rating Scale (UPDRS). The examiner randomly imposed flexion and extension movement on patient's wrist joint. Resistance to passive movement was quantified by viscoelastic properties. Not only rigidity score but also damping constant showed improvements in rigidity by DBS and Med treatments (p<0.05). This indicates that the viscosity can represent the change in rigidity due to DBS as well as Med, which was manifested by UPDRS score.

• 대한한방내과학회지
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• 제30권4호
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• pp.901-908
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• 2009

Parkinson's disease is a slowly progressive degenerative disorder of the central nervous system. It is characterized by tremor when muscles are at rest, increased muscle tone, slowness of voluntary movements, and difficulty maintaining balance. In oriental medicine, these symptoms are diagnosed as yin(陰)-deficiency of liver and kidney, deficiency of qi(氣) and blood, retention of phlegm(痰), qi-stagnation and blood stasis. In this case, we diagnosed patients as deficiency of qi(氣) and blood type according to symptoms and treated by herbs that strengthen yang and benefiting yin for two weeks, while maintaining existing parkinson's western medication. After treatment, clinical symptoms were improved, while UPDRS (Unified Parkinson's Disease Rating Scale) score was decreased. These cases suggest that oriental medicine therapy maybe effective in the treatment of Parkinson's disease.

• 근관절건강학회지
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• 제19권3호
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• pp.350-361
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• 2012

Purpose: The purpose of this study is to explore the level of bone mineral densities of the femur neck and to identify factors affecting bone mineral density of the femur in Parkinson's disease (PD) patients. Methods: Participants were 121 PD patients visiting the outpatient clinic of D University Hospital in B City. Bone mineral density was measured at the femur neck by using a dual-energy x-ray absorptiometry. The serum vitamin D level, the amounts of milk intake, caffeine intake, cigaret smoking, and alcohol consumption, and the number of steps taken daily were measured. Past and present disease history, the medication history, and duration of the disease were also collected. The level of disability was obtained by neurologists using the Hoehn and Yahr stage and the Unified Parkinson's Disease Rating Scale. Results: Among PD patients, 57% had osteopenia and 15.7% had osteoporosis. The bone mineral density of the femur was associated with weight, serum vitamin D level, age, and working status. Conclusion: The identification of weight and serum vitamin D level as important predictive factors emphasizes the importance of balanced nutrition for PD patients.

• Journal of Korean Neurosurgical Society
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• 제30권8호
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• pp.976-980
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• 2001

Objectives : For Parkinsonian patients who had not reacted favorably on drug therapy are good candidate for ventroposterolateral pallidotomy, although not curative. We studied these patients after unilateral pallidotomy, to confirm the effectiveness and safety of this procedure. Methods : We evaluated the 17 patients with idiopathic Parkinson's diesease who had undergone unilateral posteroventral pallidotomy. All patients responded to levodopa initially. Mean age was 55 years(38-75years), and mean duration of disease was 9.8 years(3-20years). Pre-and postoperative evaluation at 3 month intervals included Unified Parkinson's Disease Rating scale(UPDRS) scoring, Hoehn and Yahr(H & Y) staging, and neuropsychological examinations. Results : Pallidotomy significantly improved parkinsonian symptom(tremor, rigidity, bradykinesia, dyskinesia, sensory symptom). Nine of 10 patients who showed dyskinesia preoperatively significant improvement. The mean dose of levodopa in 9 patients was lowered. The mean H & Y score and UPDRS score were improved in on and/or off time in 15 patients. Among patients who were not improved, one patient worsened, and the others showed no change. The mean overall UPDRS off score changed from 76 preoperatively to 44(33%) at 6 months and from 70 to 52(25%) at 1 year. Transient surgical morbidity was showen in four patients and included dysarthria, hypotonia and confusion. Conclusion : We conclude that pallidotomy is safe and effective in patients who have levodopa-reponsive parkinsonism with severe symptom fluctuation. Unilateral pallidotomy also considered helpful to ipsilateral symptom. Unilateral pallidotomy can improve all of parkinsonian's symptom and allow to reduce the levodopa medication. Most of patients show satisfactory results.