ABSTRACT
Unity, understanding our pharmacist pharmacy education and training and their ecosystems rather then overwrite the system will get you ready to integrate and balance searching for contacts. Since 2015 we started the 6-year pharmacy education in the North were already carried out (the current 5.5 years). This chemist (or pharmacist) educate university education and vocational school and health officials made in the training school in jimyeo. Duration of each is to the University of 5.5 years, college three years, health officer training school two years and various types of training methods (weekly, communication, special) is applied is positive. License test system is also in favor of the state graduation test graduation test committee of professors in the university college diploma than the national notification system, and pharmacists 'qualifications'-are licensed is granted. The North Korean education system pharmacists and pharmacist review and analysis test system for the future reunification of Korea oriented education system pharmacists and pharmacists in health care personnel office systems through correct understanding and awareness-will be a useful resource integration plan designed to pharmacists.
Subject(s)
Humans , Delivery of Health Care , Democratic People's Republic of Korea , Ecosystem , Education , Education, Pharmacy , Financing, Organized , Korea , Licensure , PharmacistsABSTRACT
Porphyrias are inherited metabolic disorders resulting from a specific enzyme defect in the heme biosynthetic pathway. Porphyrias are induced by various precipitants. Clinical features include abdominal pain, neurologic manifestations, autonomic neuropathy, and mental disturbance. Diagnosis may be delayed because of variable symptoms that mimic other diseases and because of the rarity of of porphyrias. Although most patients with known porphyria can complete anesthesia and surgery safely, undiagnosed porphyric patients are in danger of porphyric crisis due to inadvertent exposure to precipitating drugs and environment. We report a case of a patient who experienced delayed emergence with neurological disturbance after general anesthesia, ultimately diagnosed as acute intermittent porphyria.
Subject(s)
Humans , Abdominal Pain , Anesthesia , Anesthesia, General , Biosynthetic Pathways , Delayed Emergence from Anesthesia , Diagnosis , Guillain-Barre Syndrome , Heme , Neurologic Manifestations , Porphyria, Acute Intermittent , Porphyrias , Spine , Wernicke EncephalopathyABSTRACT
OBJECTIVES: This study was conducted in order to investigate the influence of sexual trauma on the psychopathology and quality of life of children and adolescents in Korea. METHODS: Twenty-seven children and adolescents and their caretakers who visited the Kangwon Sunflower Center participated in a cross-sectional study. Participants completed the Korean version of Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version, Child Behavior Checklist (CBCL), and Child Health Questionnaire-Parent Form-50 (CHQ-PF-50). Their scores were compared with those of a age and sex-matched control group of 27 healthy children and adolescents. RESULTS: Victims of sexual violence showed higher t score in Withdrawn, Social problems, Delinquent behavior, Externalizing problems, and Total problems in CBCL, compared with control group. In CHQ-PF-50, there were lower scores on Bodily pain/discomfort, Behavior, Mental health, Time impact in parents, and Family activities subscales in victims of sexual violence. While Behavior and Family activities subscale showed negative correlations with Delinquent behavior, Externalizing problems, and Total problems in CBCL. Mental health subscale showed negative correlations with Social problems, Delinquent behavior, Externalizing problems, and Total problems. In addition, Time impact on parent subscale showed a negative association with Delinquent behavior in CBCL. CONCLUSION: The current study provided evidence suggesting that victims of sexual violence had a higher level of psychopathology and lower level of quality of life.
Subject(s)
Adolescent , Child , Humans , Checklist , Child Behavior , Child Health , Cross-Sectional Studies , Helianthus , Korea , Mental Health , Mood Disorders , Parents , Psychopathology , Quality of Life , Sex Offenses , Social Problems , Surveys and QuestionnairesABSTRACT
BACKGROUND: Laparoscopic surgery with reverse Trendelenburg position and carbon dioxide pneumoperitoneum has been known to increase the endotracheal tube (ETT) cuff pressure and the incidence of postoperative sore throat. The purpose of this study was to evaluate the effect of the Trendelenburg position and pneumoperitoneum on the ETT cuff pressure and the effect of adjustment of ETT cuff pressure on the incidence of sore throat during laparoscopic gynecologic surgery. METHODS: One hundred fifty-four female patients undergoing laparoscopic gynecologic surgery were randomly assigned to either control group or adjusted group. In control group, initial cuff pressure was set at 30 cmH2O in the supine position without any adjustment during surgery. Cuff pressure of adjusted group was adjusted to maintain 30 cmH2O throughout the operation. Cuff pressures at intubation (P(imme)), at carbon dioxide insufflation and the Trendelenburg position (P0), and at 10 minute intervals throughout surgery (P10-P60 and P(end)) were checked. Postoperative airway complications including sore throat, hoarseness, dysphagia and cough were compared between the two groups at 2 hours and 24 hours after surgery. RESULTS: In control group, P0 and P10 were significantly higher than P(imme). The cuff pressure decreased with time, thereby; P50 (28.2 +/- 4.3), P60 (27.5 +/- 4.0) and P(end) (25.9 +/- 4.2) were significantly lower than P(imme) (P < 0.05). The incidences and severity of airway complications were not different between two groups. CONCLUSIONS: ETT cuff pressure decreased in laparoscopic gynecologic surgery. Therefore, controlled cuff pressure does not decrease the incidence of postoperative airway complications.
Subject(s)
Female , Humans , Carbon Dioxide , Cough , Deglutition Disorders , Gynecologic Surgical Procedures , Head-Down Tilt , Hoarseness , Incidence , Insufflation , Intubation , Laparoscopy , Pharyngitis , Pneumoperitoneum , Supine PositionABSTRACT
There are many problems in the anesthetic management of patients with scar contracture. In this case, a 41-year-old male with severe scar contracture on his face, neck, anterior chest, and both shoulders underwent surgery for resurfacing with flaps. We tried to awake fiberoptic orotracheal intubation with GlideScope(R) Video laryngoscope guide after surgical release of contracture under local anesthesia. We report a successful management of a patient with severe burn contracture achieved by combined effort of surgeons and anesthesiologists.
Subject(s)
Humans , Male , Anesthesia, Local , Burns , Cicatrix , Contracture , Intubation , Laryngoscopes , Neck , Shoulder , ThoraxABSTRACT
BACKGROUND: Upper respiratory infections (URIs) are the most common infections in developed countries and are the major reasons for the consumption of medicines including antibiotics. In Korea, antibiotics and glucocorticoids were dispensed by pharmacies without prescriptions before July 2000, when the dispensation of antibiotics without doctor's prescriptions was prohibited. The objective of this study is to investigate the rate of antibiotic dispensation by pharmacies for the treatment of common cold and to identify the dispensing pattern for URI management in 2005, i.e., 5 years after the establishment of the prohibition policy. MATERIALS AND METHODS: In August 2005, medical students visited 90 drugstores in three cities (Seoul, Chonan, and Chunchun) and received medications for the treatment of illnesses that simulate the common cold, i.e., rhinorrhea and nasal stuffiness that had lasted for one day and were not accompanied by fever. The components of the dispensed medicines were identified by pharmacists at a university hospital. RESULTS: All the components of the dispensed medicines were identifiable in 85 cases (94.4%), and the mean number of medicines was 1.36 (S.D.+/-0.724); no difference was observed among the three cities. The antibiotics ampicillin and chloramphenicol were identified in two pharmacies in Seoul and Chunchun, respectively. Glucocorticoids were not dispensed in any case, and a nonsteroidal antiinflammatory drug was dispensed in only one case. Compound medicines are increasingly used as cold remedies; the components of the most frequently dispensed medicine were acetaminophen, chlorpheniramine, and pseudoephedrine. Herbal medicines were also frequently included in cold remedies (38.9%); licorice (30%) and ginger (26%) were the two most frequently used medicinal herbs. CONCLUSION: There was a marked decrease in the dispensation of antimicrobials, glucocorticoids, and nonsteroidal antiinflammatory drugs without doctor's prescriptions. Chloramphenicol continued to be dispensed as a URI medication. Increased use of compound and herbal medicines as cold remedies suggests a need for the evaluation of the additional benefits of herbal medicines, their adverse effects, and the drug interactions between herbal and conventional medicines.
Subject(s)
Humans , Acetaminophen , Ampicillin , Anti-Bacterial Agents , Chloramphenicol , Chlorpheniramine , Common Cold , Developed Countries , Drug Interactions , Fever , Zingiber officinale , Glucocorticoids , Glycyrrhiza , Herbal Medicine , Korea , Pharmacies , Pharmacists , Plants, Medicinal , Prescriptions , Pseudoephedrine , Respiratory Tract Infections , Seoul , Students, MedicalABSTRACT
BACKGROUND: Upper respiratory infections (URIs) are the most common infections in developed countries and are the major reasons for the consumption of medicines including antibiotics. In Korea, antibiotics and glucocorticoids were dispensed by pharmacies without prescriptions before July 2000, when the dispensation of antibiotics without doctor's prescriptions was prohibited. The objective of this study is to investigate the rate of antibiotic dispensation by pharmacies for the treatment of common cold and to identify the dispensing pattern for URI management in 2005, i.e., 5 years after the establishment of the prohibition policy. MATERIALS AND METHODS: In August 2005, medical students visited 90 drugstores in three cities (Seoul, Chonan, and Chunchun) and received medications for the treatment of illnesses that simulate the common cold, i.e., rhinorrhea and nasal stuffiness that had lasted for one day and were not accompanied by fever. The components of the dispensed medicines were identified by pharmacists at a university hospital. RESULTS: All the components of the dispensed medicines were identifiable in 85 cases (94.4%), and the mean number of medicines was 1.36 (S.D.+/-0.724); no difference was observed among the three cities. The antibiotics ampicillin and chloramphenicol were identified in two pharmacies in Seoul and Chunchun, respectively. Glucocorticoids were not dispensed in any case, and a nonsteroidal antiinflammatory drug was dispensed in only one case. Compound medicines are increasingly used as cold remedies; the components of the most frequently dispensed medicine were acetaminophen, chlorpheniramine, and pseudoephedrine. Herbal medicines were also frequently included in cold remedies (38.9%); licorice (30%) and ginger (26%) were the two most frequently used medicinal herbs. CONCLUSION: There was a marked decrease in the dispensation of antimicrobials, glucocorticoids, and nonsteroidal antiinflammatory drugs without doctor's prescriptions. Chloramphenicol continued to be dispensed as a URI medication. Increased use of compound and herbal medicines as cold remedies suggests a need for the evaluation of the additional benefits of herbal medicines, their adverse effects, and the drug interactions between herbal and conventional medicines.
Subject(s)
Humans , Acetaminophen , Ampicillin , Anti-Bacterial Agents , Chloramphenicol , Chlorpheniramine , Common Cold , Developed Countries , Drug Interactions , Fever , Zingiber officinale , Glucocorticoids , Glycyrrhiza , Herbal Medicine , Korea , Pharmacies , Pharmacists , Plants, Medicinal , Prescriptions , Pseudoephedrine , Respiratory Tract Infections , Seoul , Students, MedicalABSTRACT
Neutropenic enterocolitis is observed in approximately 10~46% of patients with acute leukemia, as well as in patients with other diseases, like acquired immunodeficiency syndrom (AIDS), that lead to profound neutropenia. Patients who become neutropenic after combined chemotherapy are at special risk of developing neutropenic enterocolitis. With the recently increasing numbers of patients with solid tumors treated with high-dose chemotherapy, the frequency of this disease is expected to increase. However, this disease has been rarely reported in patients with colon cancer treated with leucovorin and 5-fluorouracil for adjuvant chemotherapy. We report a case of neutropenic enterocolitis after a treatment of 5-fluorouracil and leucovorin for sigmoid colon cancer.
Subject(s)
Humans , Chemotherapy, Adjuvant , Colon , Colonic Neoplasms , Drug Therapy , Enterocolitis, Neutropenic , Fluorouracil , Leucovorin , Leukemia , Neutropenia , Sigmoid NeoplasmsABSTRACT
BACKGROUND: The Bispectral Index (BIS) and the Auditory Evoked Potential (AEP) have been suggested to reflect the level of sedation or hypnosis for intravenous and inhalational anesthetics. The Auditory Evoked Potential Index (AEPindex) has been shown to be reliable in indicating potential awareness during propofol anesthesia. This study was designed to determine the effects of three different anesthetic techniques on the AEPindex and BIS. The three techniques used were midazolam/Remifentanil, ketamine/Remifentanil, and propofol/Remifentanil. All agents were delivered using target controlled infusion (TCI). METHODS: We studied 39 patients scheduled for elective cardiac surgery. Patients were allocated randomly to receive either midazolam/remifentanil (n = 15), ketamine/remifentanil (n = 9) or propofol/remifentanil (n = 15) administered by TCI. AEPindex and BIS were monitored continuously and blood concentrations of propofol, midazolam and ketamine were measured every 5 minutes during anesthesia until the start of surgery. RESULTS: AEPindex and BIS had high values in the awake state, which declined following anesthetic induction. Values of AEPindex were comparable between all the three anesthetic techniques, whereas BIS was significantly higher during anesthesia with midazolam or ketamine than during propofol anesthesia. CONCLUSIONS: AEPindex was a reliable monitor of the depth of general anesthesia irrespective of the anesthetic used. BIS showed marked variability during anesthesia produced by midazolam/remifentanil and ketamine/remifentanil, and would not be suitable for measuring depth of anesthesia with these techniques.
Subject(s)
Humans , Anesthesia , Anesthesia, General , Anesthetics , Evoked Potentials, Auditory , Hypnosis , Ketamine , Midazolam , Propofol , Thoracic SurgeryABSTRACT
BACKGROUND: Patients treated with regional anesthesia often require concomitant medication for comfort and sedation. Propofol is widely used for this purpose, but studies upon awareness or post-operative retrograde amnesia are limited. So we designed this study to investigate the frequency of retrograde amnesia on various effect-site concentrations of propofol by using target controlled infusion (TCI). METHODS: Ninety patients (ASA I, II) undergoing orthopedic or urogenital surgery with spinal, epidural or axillary block were randomly assigned to one of six groups. Target concentrations of propofol in the six groups were respectively 1.0, 1.2, 1.4, 1.6, 1.8, or 2.0 microgram/ml. When the effect site concentration reached the target concentration in each group, we waited for 5 minutes and then lowered the target concentration to 0.5 microgram/ml. When the effect site concentration returned to 0.5 microgram/ml, we again waited for 5 minutes and then showed the patient number and picture cards and asked the patient to memorize them. Subsequently the target concentration was returned to the original level. In the post anesthesia care unit, retrograde amnesia was checked 2 hours after eye opening and then rechecked 24 hours later. RESULTS: The percentages of retrograde amnesia checked 2 hours after eye opening were 27%, 27%, 40%, 40%, 40%, and 53% (number card) and 27%, 27%, 40%, 47%, 53%, and 63% (picture card) for propofol dose of 1.0, 1.2, 1.4, 1.6, 1.8, and 2.0 microgram/ml. A significant correlation was found between the propofol concentration and the percentage of retrograde amnesia for picture but not for the numbered cards. The percentages of retrograde amnesia observed at 24 hours after eye opening were similar to the 2 hour results. CONCLUSIONS: When propofol is used for sedation at 1.0 2.0 microgram/ml, retrograde amnesia increases in proportion to the effect site concentration. Many patients can recall intra-operative awareness, and thus we cannot be assured of effective retrograde amnesia. Therefore although a patient is under deep sedation, careful consideration of awareness and recall is needed.
Subject(s)
Humans , Amnesia, Retrograde , Anesthesia , Anesthesia, Conduction , Deep Sedation , Orthopedics , PropofolABSTRACT
Actinomycosis is a rare chronic suppurative disease caused by actinomyces species, which are normal flora in the oral cavity and gastrointestinal tract, and characterized by formation of sulfur granule. Actinomyces can affect cervicofacial, pulmonary, abdominal and pelvic area. However, abdominal and pelvic inflammations are less frequently observed. Most of abdominal actinomycosis develop after abdominal operation, trauma, inflammatory bowel disease or use of intrauterine devices. The definitive diagnosis was made after histopathological study of the tissues. Treatment is long-term antibiotic therapy. Herein, we report a case of a 69-year-old woman with an unusual form of abdominal actinomycosis after total gastrectomy.
Subject(s)
Aged , Female , Humans , Actinomyces , Actinomycosis , Diagnosis , Gastrectomy , Gastrointestinal Tract , Inflammation , Inflammatory Bowel Diseases , Intrauterine Devices , Mouth , Sulfur , Upper Gastrointestinal TractABSTRACT
The delivery of optimal orthodontic treatment is greatly influenced by clinician's ability to predict and control tooth movement by applying well-known force system to dentition. It is very important to determine the location of the centers of resistance of a tooth or teeth in order to have better understanding the nature of displacement characteristics under various force levels. In this study, three dimensional finite element analysis was used to measure the initial displacement of the consolidated teeth under loading. The purpose of this study was to define the location of the centers of resistance at the upper six anterior segment. To observe the changes of six anterior segment, 200gm, 250gm, 300gm, and 350gm forces at right and left hand side each were imposed toward lingual direction. For this study, two cases, six anterior teeth and six anterior teeth after corticotomy, were reviewed. In addition, it was reviewed the effects of changes on the location of the center of resistance in both cases based on different degree of forces aforementioned. The results were that : 1. The instantaneous center of resistance for the six anterior teeth was vertically located between level 4 and level 5, which is, at 6.76mm, 44.32 % apical to the cementoenamel junction level. 2. The instantaneous center of resistance for the six anterior teeth after corticotomy was located vertically between level 4 and level 5, that is, at 7.09mm, 46.38 % apical to the cementoenamel junction level. 3. Changes of force showed little effect on the location of the center of resistance in each case. 4. It was observed that the location of the instantaneous center of resistance for the six anterior teeth after corticotomy was changed more than the six anterior teeth without corticotomy to the apical part, and the displacement of the consolidated anterior teeth moved further in case of the consolidated teeth after corticotomy.
Subject(s)
Dentition , Finite Element Analysis , Hand , Tooth Cervix , Tooth Movement Techniques , ToothABSTRACT
We report a case of reversible pituitary enlargement due to hypothyroidism in a 3-year-old male. OnT1-weighted images, the mass was located in the anterior lobe of the pituitary gland, and the signal intensity ofthe mass was equal to that of brain cortex. Gd-DTPA enhanced T1-weighted images showed homogeneous enhancement ofthe mass. After supplemental therapy with thyroid hormone for 8 months, MRI showed that the pituitary gland wasmarkedly smaller.
Subject(s)
Child, Preschool , Humans , Male , Brain , Gadolinium DTPA , Hyperplasia , Hypothyroidism , Magnetic Resonance Imaging , Pituitary Gland , Thyroid GlandABSTRACT
We report a case of reversible pituitary enlargement due to hypothyroidism in a 3-year-old male. OnT1-weighted images, the mass was located in the anterior lobe of the pituitary gland, and the signal intensity ofthe mass was equal to that of brain cortex. Gd-DTPA enhanced T1-weighted images showed homogeneous enhancement ofthe mass. After supplemental therapy with thyroid hormone for 8 months, MRI showed that the pituitary gland wasmarkedly smaller.
Subject(s)
Child, Preschool , Humans , Male , Brain , Gadolinium DTPA , Hyperplasia , Hypothyroidism , Magnetic Resonance Imaging , Pituitary Gland , Thyroid GlandABSTRACT
PURPOSE: To investigate whether the result of RigiScan after intracorporeal injection could predict the result of duplex ultrasonography, and determine the necessity of duplex ultrasonography. MATERIALS AND METHODS: We performed both RigiScan and duplex ultrasonography after intracorporeal injection in 18 men with erectile dysfunction. All of the patients were evaluated by history taking, physical examination, laboratory test, hormonal tests, and neurologic examination before RigiScan and duplex ultrasonography. We measured maximal arterial diameter, peak systolic velocity, end-diastolic velocity using a 7 MHz. color Doppler unit and these results of duplex ultrasonography were compared with penile rigidity and tumescence measured by RigiScan. RESULTS: The positive and negative predictive value of RigiScan were 81.8% and 85.7%, respectively. The result of RigiScan was comparable with that of duplex ultrasonography and the accuracy of RigiScan was resonable. CONCLUSIONS: According to this results, duplex ultrasonography was needed if the response of RigiScan is abnormal after intracorporeal injection. However, duplex ultrasonography can be ommitted if the response of RigiScan is normal after intracorporeal injection.
Subject(s)
Humans , Male , Erectile Dysfunction , Mass Screening , Neurologic Examination , Physical Examination , UltrasonographyABSTRACT
Extrarenal Wilms' tumor is extremely rare and occurs predominantly in children. There are less than 50 well-documented cases of extrarenal Wilms' tumor in the literature. Herein, a case of extrarenal Wilms' tumor, whose mass was found in the inguinal region during an operation for the cryptorchidism, is reported in a 2 year old child with a brief review of literature. This case report illustrates the importance of pathologic examination of similar soft masses, found incidentally during operations.