The Korean Government has launched a pilot program of the Drug Utilization Review (DUR) system in an effort to facilitate safe and adequate use of pharmaceuticals by providing reference to physicians and pharmacists at the prescription or dispense stage, with regards to the drugs that should not be combined or should not be given to certain age groups. Implementation of the DUR system is absolutely necessary in Korea, as the number of drug taken per patient is on a continuous rise with increase of senior population and development of new pharmaceuticals. The DUR system is expected to contribute to promotion of people's health and reduction of pharmaceutical expense. However, for a successful establishment of the DUR system, the following conditions should be considered: First, inclusion of non-prescription drugs in the system, Second, review on the current classification of non-prescription and prescription drugs, Third, review on therapeutic duplication contraindication, age contraindication, and gravida contraindication by physicians as clinical experts. Moreover, reimbursement within the framework on medical fee schedule for the DUR system should be followed as well as the efforts to adjust problems through open discussion between insurers and providers.
Appointments and Schedules ; Drug Utilization ; Drug Utilization Review ; Fees, Medical ; Humans ; Insurance Carriers ; Korea ; Nonprescription Drugs ; Pharmacists ; Prescription Drugs ; Prescriptions

The separation of pharmaceutical prescription and dispensing has been mandatory in Korea since July 1, 2000. This policy aimed to reduce drug abuse, prevent the distribution of drugs without a prescription, decrease medical costs and insurance premiums, and provide high-quality health-care services. However, the policy was launched without careful consideration of actual benefits to patients or the resulting national financial burden, and its initial aims remain unfulfilled. Koreans have complained that the policy is inconvenient; a 2008 survey revealed that 87% of people would prefer to have their medications dispensed at medical institutes, rather than at pharmacies. People wish to select a convenient dispensing site; the current policy particularly inconveniences disabled and elderly individuals. From 2000 to 2009, dispensing fees totaled 18,432.4 billion Korean won (16.4 billion US dollar), comprising 27% of all pharmaceutical costs. These fees have contributed to the accelerated rise in national health-care expenses (the most rapid in the world) and to the 2.2-fold increase in insurance-premium payments in 2009, in contrast to those in 2000. Pharmaceuticals continue to be dispensed without a physician's prescription and antibiotic abuse has not been controlled. The increasingly prevalent occurrence of multi-drug resistant bacteria constitutes a serious social problem. The Korean government should recognize the difficulties posed by the financial burden of this policy and its failure to achieve a separation between pharmaceutical prescription and dispensing. To improve this policy, we urge the government to undertake a fair and scientific re-evaluation, despite objections by interest groups to such actions.
Academies and Institutes ; Aged ; Bacteria ; Delivery of Health Care ; Fees and Charges ; Humans ; Insurance ; Insurance, Health ; Korea ; Pharmacies ; Prescription Fees ; Prescriptions ; Public Opinion ; Social Problems ; Substance-Related Disorders

To determine whether intraocular pressure is overestimated in diabetes with increased corneal thickness. Fifty-four patients with proliferative retinopathy and thirty-six control subjects were included in this study. Corneal thickness was measured by ultrasound pachymetry and intraocular with Goldmann tonometer in all subjects. There were no significant differences in age distribution between control and diabetes mellitus group (59.5 +/-10.4 years versus 60.6 +/-9.5 years). The corneal thickness was greater in patients with diabetes mellitus than in controls (566.8 +/-30.4 micrometerversus 549.9 +/-28.7 micrometer, p<0.05). The intraocular pressure was increased in diabetes mellitus than in controls, too (14.8 +/-2 .6 mmHgversus 13.1 +/-2.7 mmHg,p<0.05). The corneal thickness was correlated with the intraocular pressure (p<0.05). The increased intraocular pressure in diabetes mellitus is associated with increased corneal thickness.
Age Distribution ; Diabetes Mellitus ; Glaucoma ; Humans ; Intraocular Pressure* ; Ultrasonography

OBJECTIVE: To establish the objective method of diagnosing the myofascial pain syndrome through diagnostic ultrasound and pathology. METHOD: Hamstring muscles of 7 female house rabbits, weighing 2.5~3.0 Kg, were studied. The existence of nodule was confirmed by palpation and through diagnostic ultrasound. A horizontal length, vertical length, thickness, and an area of hyperechoic region were measured. Hyperechoic regions were biopsied and stained with hematoxylin-eosin. RESULTS: All examined rabbits had muscular nodules in the medial hamstring. Characteristic increase of echogenecity was observed in the medial hamstring muscles. Some uneven hyperechoic areas were seen in the lateral hamstring muscles. Fatty degeneration and giant round cells were observed in the medial hamstring where the echogenecity was increased. The giant round cells were observed only in the lateral hamstring. CONCLUSION: Increased echogenecity of the medial hamstring muscle is probably contributed by muscles cells with fatty degeneration and giant round cells, and some portions of hyperechogenecity of lateral hamstring requires further study.
Female ; Humans ; Muscles ; Myofascial Pain Syndromes* ; Palpation ; Pathology ; Rabbits ; Ultrasonography*

Intrathecal baclofen (ITB) therapy has been proven to reduce severe spasticity in cerebral palsy (CP). However, few results reported the objective gait pattern change after ITB bolus injection in adult ambulatory CP. We therefore evaluated observational and kinematic gait patterns at different ITB bolus injection doses. We performed a test trial of 3-day ITB bolus injections at doses of 12.5 microg, 25 microg, and 50 microg in ambulatory CP. We evaluated modified Ashworth scale, visual analogue scale, observational gait scale, and kinematic gait analysis after ITB bolus injection. Intrathecal administration of low-dose baclofen 25 microg was successfully used not only for the treatment of spasticity but also for the treatment of gait disturbance, whereas the higher dose baclofen 50 microg induced foot drop and deteriorated gait pattern. We experienced dose-dependent changes in gait pattern confirmed by the observational and kinematic gait assessments after ITB bolus injection in adult ambulatory CP.
Adult* ; Baclofen* ; Cerebral Palsy* ; Foot ; Gait* ; Humans ; Muscle Spasticity

OBJECTIVE: Several lines of pharmacological evidences including the data of animal studies indicate that serotonin 2C receptor (5HT2C) is involved in the pharmacodynamic process of serotonin dopamine antagonists (SDA)-induced weight gain. Controversial data have been reported on the association between the polymorphisms of 5HT2C receptor gene and antipsychotics-induced weight gain. This study aims at investigating the association between the polymorphisms of 5HT2C receptor gene and SDA-induced weight gain in korean schizophrenic patients. METHODS: Seventy-seven schizophrenia patients in their first episode or patients who did not take any antipsychotics for the previous two months were recruited. All the patients were administered with one of the SDAs (risperidone, olanzapine, quetiapine, clozapine) for 8weeks. Body mass index (BMI) were measured weekly during the 8weeks. The subjects were genotyped for the -759 C/T and -697 G/C polymorphism of the 5HT2C receptor gene. RESULTS: The degree of linkage disequilibrium between the two polymorphic loci genotyped are almost 100%. Significant association was not observed between polymorphisms of the 5HT2C receptor gene (-759 C/T and -697 G/C) and SDA-induced weight gain after 8 weeks of treatment. CONCLUSION: Our data do not support the involvement of the polymorphisms of 5HT2C receptor gene (-759 C/T and -697 G/C) in SDA- induced weight gain. Further studies with sufficient sample size are warranted to follow up on the trend of high weight gain in the male patients having -759 T (-697 C) allele.
Alleles ; Animals ; Antipsychotic Agents ; Body Mass Index ; Dopamine Antagonists ; Dopamine* ; Follow-Up Studies ; Humans ; Linkage Disequilibrium ; Male ; Receptor, Serotonin, 5-HT2C ; Sample Size ; Schizophrenia* ; Serotonin* ; Weight Gain* ; Quetiapine Fumarate

Colonic varix, which is a rare cause of lower gastrointestinal bleeding, can be developed by various diseases. Colonic variceal bleeding is more fatal than esophageal variceal bleeding. Klippel-Trenaunay-Weber syndrome is a rare congenital vascular malformation characterized by the clinical triad of bony or soft tissue hypertrophy, hemangioma and varicosities or vascular malformations. We report a 42-year-old female patient with fatal sigmoid variceal bleeding. She had dilated vessels over her body and face, and both superior and inferior vena cava were obstructed. She underwent an emergent operation due to uncontrolled massive bleeding from sigmoid varices. We report a case of Klippel-Trenaunay-Weber syndrome with literature review.
Adult ; Colon ; Colon, Sigmoid* ; Esophageal and Gastric Varices ; Female ; Hemangioma ; Hemorrhage ; Humans ; Hypertrophy ; Klippel-Trenaunay-Weber Syndrome* ; Varicose Veins* ; Vascular Malformations ; Vena Cava, Inferior

Objective: The Huntington’s Disease Quality of Life Battery for Carers (HDQoL-C) is used to evaluate caregiver quality of life. This study aimed to develop and validate the Korean version of the HDQoL-C (K-HDQoL-C) to assess the burden on Korean caregivers of Huntington’s disease (HD) patients. Methods: A total of 19 HD caregivers (7 females, mean age 55.4±14.6 years) participated in this study. The K-HDQoL-C, a translation of the English version, consisted of demographic information, caring aspects, life satisfaction, and feelings about life. It was administered twice, 2 weeks apart. Internal consistency was evaluated using Cronbach’s α, and test-retest reliability was assessed with intraclass correlation coefficients. The relationship with the Zarit Burden Interview-12 (ZBI-12) was analyzed. Results: The internal consistencies of the K-HDQoL-C were 0.771 (part 2), 0.938 (part 3), and 0.891 (part 4). The test-retest reliability ranged from 0.908 to 0.936. Part 3 was negatively correlated with the ZBI-12, and part 4 was positively correlated with the ZBI-12 (r=-0.780, 0.923; p<0.001). Conclusion The K-HDQoL-C effectively evaluates the challenges faced by HD caregivers, particularly in terms of care aspects and life satisfaction.

Objective: The Huntington’s Disease Quality of Life Battery for Carers (HDQoL-C) is used to evaluate caregiver quality of life. This study aimed to develop and validate the Korean version of the HDQoL-C (K-HDQoL-C) to assess the burden on Korean caregivers of Huntington’s disease (HD) patients. Methods: A total of 19 HD caregivers (7 females, mean age 55.4±14.6 years) participated in this study. The K-HDQoL-C, a translation of the English version, consisted of demographic information, caring aspects, life satisfaction, and feelings about life. It was administered twice, 2 weeks apart. Internal consistency was evaluated using Cronbach’s α, and test-retest reliability was assessed with intraclass correlation coefficients. The relationship with the Zarit Burden Interview-12 (ZBI-12) was analyzed. Results: The internal consistencies of the K-HDQoL-C were 0.771 (part 2), 0.938 (part 3), and 0.891 (part 4). The test-retest reliability ranged from 0.908 to 0.936. Part 3 was negatively correlated with the ZBI-12, and part 4 was positively correlated with the ZBI-12 (r=-0.780, 0.923; p<0.001). Conclusion The K-HDQoL-C effectively evaluates the challenges faced by HD caregivers, particularly in terms of care aspects and life satisfaction.

Objective: The Huntington’s Disease Quality of Life Battery for Carers (HDQoL-C) is used to evaluate caregiver quality of life. This study aimed to develop and validate the Korean version of the HDQoL-C (K-HDQoL-C) to assess the burden on Korean caregivers of Huntington’s disease (HD) patients. Methods: A total of 19 HD caregivers (7 females, mean age 55.4±14.6 years) participated in this study. The K-HDQoL-C, a translation of the English version, consisted of demographic information, caring aspects, life satisfaction, and feelings about life. It was administered twice, 2 weeks apart. Internal consistency was evaluated using Cronbach’s α, and test-retest reliability was assessed with intraclass correlation coefficients. The relationship with the Zarit Burden Interview-12 (ZBI-12) was analyzed. Results: The internal consistencies of the K-HDQoL-C were 0.771 (part 2), 0.938 (part 3), and 0.891 (part 4). The test-retest reliability ranged from 0.908 to 0.936. Part 3 was negatively correlated with the ZBI-12, and part 4 was positively correlated with the ZBI-12 (r=-0.780, 0.923; p<0.001). Conclusion The K-HDQoL-C effectively evaluates the challenges faced by HD caregivers, particularly in terms of care aspects and life satisfaction.