OBJECTIVES: In Korea, pharmacists can dispense medicines without doctor's prescription. This causes the high proportion of pharmaceutical expenditures. The study shows the prescribing behaviors of practicing pharmacists with the simulated patient of arthritis. We select the arthritis as a subject of simulation, because the arthritis is one of the major health problems and the abuse of cortico-steroids is usual in treatment of arthritis patients. METHODS: Twenty drug stores among the 320 drug stores in a district, Seoul, Korea were randomly selected. One of the researchers visited the drug stores and received the medicines from the pharmacists after explaining standardized scenario of arthritis. The simulated patient recorded the practice behaviors of pharmacists. RESULTS: The mean number of prescribed drugs are four and half. Among the twenty pharmacists, the nineteen prescribed non-steroidal anti-inflammatory drugs and the seven(35%) prescribed the cortico-steroids. The antacids were prescribed by the fourteen(70%) pharmacists. The five(25%) pharmacists only recommended the simulated patients to visit the medical doctors, and the three(15%) performed physical examination to the simulated patients. The three pharmacists(15%) asked the past history of the drug adverse effects and no pharmacist explained the adverse effects of prescribed medicines. CONCLUSIONS: The research shows that the cortico-steroids are frequently prescribed and the pharmacists commonly do not give the explanations of the prescribed medicines to the arthritis patients.
Antacids ; Arthritis* ; Health Expenditures ; Humans ; Korea ; Patient Simulation ; Pharmacists* ; Physical Examination ; Prescriptions* ; Seoul

The treatment modalities of bilateral renal cell carcinoma are variable, but many urologists have had serious difficulties in choosing the best one. We experienced a very rare case of bilateral synchronous multifocal renal cell carcinoma in a 38-year-old female. First, We have planned for partial nephrectomy of the right kidney and radical nephrectomy of the left kidney. However, tumor extended into parenchyme of the low 1/3 portion of the right kidney on the frozen section. Therefore, we performed selective ligation of the anterior branch of the right renal artery, which was mainly supplied the tumor mass and left radical nephrectomy was also performed. During one year after operation, renal function was well maintained.
Adult ; Carcinoma, Renal Cell* ; Female ; Frozen Sections ; Humans ; Kidney ; Ligation ; Nephrectomy ; Renal Artery