BACKGROUND: If two or more doctors prescribe for one patient, each doctor must be careful to minimize the number of drugs and the frequency of admistration, and also be careful to avoid duplicating drugs. The purpose of this study is to evaluate the appropriateness of prescription for the patient who visits two or more doctors. METHODS: In a tertiary hospital, outpatients who received prescriptions simultaneously from two or more doctors were selected, and the number of drugs, the frequency of admistration and duplication of drugs were evaluated. RESULTS: The number of eligible patients was 887. The number of drugs was 5.2 for patients who visited 2 doctors, and 8.1 for patients who visited 3 doctors. 13% of patients who visited 2 doctors received more than 8 drugs, and 32.6% of patients who visited 3 doctors received more than 10 drugs. The frequency of administration per day was 3.7 for patients who visited 2 doctors, and 5.0 for patients who visited 3 doctors. 12% of patients who visited 2 doctors had to take drug more than 6 times a day and 9.3% of patients who visited 3 doctors had to take drug more than 8 times a day. 9.2% of total patients received duplicated drugs. The duplication of drugs was more frequent among patients who visited 2 doctors than who visited 3 doctors. CONCLUSIONS: For the patients who visited two or more doctors, the number of drugs and frequency of admistration was inappropriate and duplication of drugs was found, therefore the doctors should make more efforts to avoid inappropriate prescription.
Drug Prescriptions* ; Humans ; Inappropriate Prescribing ; Outpatients ; Prescriptions ; Tertiary Care Centers

BACKGROUND: To comparatively analysis the epidemiological changes in the acute drug intoxication between 1980s and 1990s. METHODS: We reviewed retrospectively the medical records of the patients with acute drug intoxication in the emergency department of the Inha hospital from June 1986 to April 1987 and from June 1996 to May 1997. And we performed comparative analysis between two result. RESULTS: The ratio of the acute drug intoxication in the emergency medical center was reduced significantly in 1990s against 1980s. Sexual ratio and prevalent age group has no significant interval changes between 1980s and 1990s. The prevalent seasons were Spring in 1980s and Summer in 1990s but has no significance. The most commonly used drugs was rodentides in 1980s and hypnosedatives in 1990s and shown significant interval changes. The most common motive was suicidal attempts in both 1980s and 1990s, but significantly reduced. After emergency treatment the rate of curative-discharge has improved and the rate of admission has decreased significantly in 1990s against 1980s. The most critical agent was agricultural chemicals in both 1980s and 1990s. The mortality rate has no significant interval changes. CONCLUSION: There were some significant interval changes of the acute drug intoxication in prevalence rate, commonly used drugs, ratio of suicidal attempt and curative-discharge rate between 1980s and 1990s. New education programs far preventing acute drug intoxication and strict legal control of drugs are important and necessary.
Agrochemicals ; Education ; Emergencies ; Emergency Service, Hospital ; Emergency Treatment ; Humans ; Medical Records ; Mortality ; Prevalence ; Retrospective Studies ; Seasons

No abstract available.

BACKGROUND: Dizziness is a common complaint in patients presenting to the emergency room and that has various pathologic causes. This study investigate the clinical differences in dizziness between the central origin and the peripheral origin and to provides the clues far diagnosis and proper treatment. METHODS: We analysed 290 patients with dizziness during 12 months period prospectively, who visited in ED, Inha University Hospital from Jan. 1997 to Dec. 1997. We analysized sex ratio, characteristics of the dizziness, associated past illness, associated symptoms, severity, results of the special radiologic study, nystagmus type, and causes of central origin and peripheral origin dizziness. RESULTS: Male to female ratio was 1:1.4 in central origin(n=165) and 1:2.0 in peripheral origin(n=125). Most common age group was 11th decade in both groups. According to the characteristics of the dizziness, rotation sense was the main complaint of the peripheral origin dizziness. Most common past illness was hypertension in both groups. MRI has diagnostic priority than CT scan in central origin dizziness. Types of nystagmus has some significant differences between two groups. CONCLUSION: Dizziness may represented as a sign of significant pathological neurologic status especially in central origin. So we must precisely evaluate the patient history, neurologic examination of the inner ear and CNS, and special radiologic study incliding MRI.
Diagnosis ; Dizziness* ; Ear, Inner ; Emergency Service, Hospital ; Female ; Humans ; Hypertension ; Magnetic Resonance Imaging ; Male ; Neurologic Examination ; Prospective Studies ; Sex Ratio ; Tomography, X-Ray Computed

There are many options for the management of osteoarthritis of the knee joint. Recently, arthroscopic surgery has been added to the armamentorium of the treatment modalities in osteoarthritis of the knee which does not respond to conservative treatment. Among 74 arthroscopic pocedures(including partial menisectomy, removal of loose bodies, synovectomy, cartilage drilling and simple lavage) done for osteoarthritis of the knee, 68 patients studied at average 3.1 years after procedure and the results were as follows 1. Seventy-one percent of patients had at least 2.5 years or more relief of pain and symptoms. 2. Fifty-six percent were still good at follow-up of 3.1 years. 3. The best result were obtained after removal of loose bodies and resection of unstable flap tear of a meniscus in association with mild osteoarthritis. 4. The poor result were obtained in patients with severe degenerative changes of both femoral condyle, 5. The results were much better in the normally aligned knee compared with valgus knee.
Arthroscopy ; Cartilage ; Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Osteoarthritis ; Tears

OBJECTIVE: For many years, the Papanicolaou smear has been used to detect pre-malignant and malignant disease of the cervix. Although the use of cytology in screening has reduced morbidity and mortality from invasive cervical cancer, there has been concerned about the low sensitivity of cervical cytology in detection of preclinical disease of the cervix. So cervicography is introduced. In order to find out the efficacy of cytology and cervicography in early diagnosis of cervical cancer, this study included 1028 patients who visited the Department of Obstetrics and Gynecology, Cho-sun University Hospital From December 1, 1995 to March 31, 1998. And we choosed 321 samples who underwent biopsies. METHODS: Women simultaneously underwent an exo and endo-cervical smear, and then two cervicography was obtained with applying 5% acetic acid. Because all of the subjects choosed in statistical analysis were examined by colposcopy or postoperative biopsies, the presence or abscence of disease was determined by the histologic findings. RESULTS: 1. The sensitivity and specificity of cytology was 55.4% and 86.6%. 2. The sensitivity and specificity of cervicography was 71.3% and 59.7%. 3. When cervicography and Papanicolaou smear were used conjointly, the sensitivity and specificity was 90.1% and 58.8%. 4. However the specificity of the combined test was lower than cytology alone, the sensitivity of the combined test was significantly higher. CONCLUSION: The double combined tests of Papanicolaou smear and Cervicography were very useful in the early diagnosis of cervical neoplasia.
Acetic Acid ; Biopsy ; Cervix Uteri ; Colposcopy ; Early Diagnosis ; Female ; Gynecology ; Humans ; Mass Screening* ; Mortality ; Obstetrics ; Papanicolaou Test ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

PURPOSE: The goal of this in vivo study is to determine the feasibility and efficacy of suicide gene therapy using adenovirus-mediated herpes simplex virus thymidine kinase (HSV-TK) and the prodrug acyclovir (ACV) system in animal model of human prostate cancer. MATERIALS AND METHODS: We used a replication-defective adenoviral vector containing the beta-galactosidase gene (Ad-CMV-beta-gal) as a control and Adenovirus-Cytomegalovirus-Thymidine Kinase (Ad-CMV-TK) as the therapeutic vector under the trascriptional control of the CMV promoter. Transduction efficiency was assessed in vitro by infection of LNCaP and PC-3 human prostate cancer cells with Ad-CMV-beta-gal utilizing X-gal staining. TK activity in LNCaP and PC-3 cells infected with Ad-CMV-TK was determined by measuring the TK-mediated [3H]-Ganciclovir (GCV) phosphorylation. Sensitivity of LNCaP and PC-3 cells to Ad-CMV-TK in vitro was determined after infection of therapeutic vector with or without ACV. Subcutaneous tumors were established in athymic nude(nu/nu) mice with PC-3 cells, and Ad-CMV-TK/ACV sucide gene therapeutic system-induced inhibition of tumor growth in vivo was determined in separate and controlled experiments. RESULTS: The mean TK activity was significantly higher in Ad-CMV-TK-infected LNCaP and PC-3 cells than in cells infected with Ad-CMV-beta-gal that was used as a control(P<0.05). The growth of human prostate cancer cells with Ad-CMV-TK was significantly inhibited by the addition of GCV in vitro(p<0.05). In vivo experiments using PC-3 human prostate cancer animal model demonstrated that tumor volume and growth at the conclusion of experiment was significantly attenuated in the suicide toxic gene therapy (Ad-CMV-TK / ACV) group compared with Ad-CMV-TK, ACV and no treatment control groups(p<0.05). CONCLUSIONS: Adenovirus-mediated suicide gene therapy using HSV-TK / ACV system provides an effective therapy in an experimental human prostate cancer animal model by significantly inhibiting tumor growth.
Acyclovir ; Adenoviridae ; Animals ; beta-Galactosidase ; Genetic Therapy* ; Herpes Simplex* ; Humans ; Mice ; Models, Animal ; Phosphorylation ; Phosphotransferases* ; Prostate* ; Prostatic Neoplasms* ; Simplexvirus* ; Suicide* ; Thymidine Kinase ; Tumor Burden

No abstract available.
Malaria*

A patient with extraskeletal cervical epidural Ewing's sarcoma who presented with cervical radiculopathy is reported. A 58-year-old woman presented with right posterolateral neck pain and upper extremity radiculopathy. The computed tomography myelography showed epidural and paravertebral masses on right side, with widening of the ipsilateral neural foramina at the C2-C3 level. On magnetic resonance images, the mass was isointense to soft tissue on T1-weighted images, hyperintense on T2-weighted images, and showed diffuse enhancement on GdTA enhanced T1-weighted images. The staged, combined posterior and anterior approach were done and the tumor mass was subtotally removed. During postoperative adjuvant chemotherapy with Cytoxane, Adriamycin, Vincristine, Prednisolone regimen, the patient died of severe compression of upper cervical cord by recurrent, extended tumor mass in the spinal canal.
Chemotherapy, Adjuvant ; Cyclophosphamide ; Doxorubicin ; Drug Therapy ; Female ; Humans ; Middle Aged ; Myelography ; Neck Pain ; Prednisolone ; Radiculopathy ; Sarcoma, Ewing* ; Spinal Canal ; Upper Extremity ; Vincristine

OBJECTIVE: The purpose of this study is to determine the effects of glutathione on cisplatin-induced cytotoxicity of human cervical carcinoma cell lines (SiHa: squamous cell carcinoma cell, CaSki: epidermoid metastatic carcinoma cell). METHODS: Human cervical carcinoma cells (SiHa, CaSki) were incubated with culture media (RPMI1640) in the presence of cisplatin and/or buthionine sulfoximine (BSO), as a inhibitor of gamma-glutamyl- cysteine synthetase, and/or glutathione (GSH) and/or 2-oxo 4-thiazolidine carboxylic acid (OTC). The viable cells were examined by using 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) and was determined by spectrophotometer at 570 nm. RESULTS: The incubation of cervical cells with cisplatin resulted in an decreasing cells viability by dose response. The MTT reduction rate were not different by BSO (5 mM) treatment in cervical cell lines. The viable cells were increased significantly by glutathione (5 mM) or OTC (5 mM) in cisplatin-treated cell lines. CONCLUSION: gamma-glutamylcysteine synthetase inhibitor had no effect on cisplatin toxicity. GSH and OTC had effect on cisplatin cytotoxicity. So, These result suggested that cervical cancer line cells were more susceptive to protective effects of glutathione and OTC than BSO on cisplatin induced-toxicity.
Buthionine Sulfoximine ; Carcinoma, Squamous Cell ; Cell Line* ; Cisplatin ; Culture Media ; Cysteine ; Glutathione* ; Humans* ; Ligases ; Uterine Cervical Neoplasms*