• Title/Summary/Keyword: 비약물적 치료

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Problematized obesity and standardization of treatment: Multiple translation in lapband surgery network (문제화된 비만과 치료의 표준화 과정: 랩밴드 수술 연결망에서의 다중번역)

  • Han, Gwang Hee;Kim, Byoung Soo
    • Journal of Science and Technology Studies
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    • v.13 no.2
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    • pp.137-172
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    • 2013
  • Globally, awareness about obesity is increasing rapidly. In Korea, obesity is recognized as a disease and steps are being taken to treat it. From the health governance point of view, such standardized measures amplify the risk of obesity and thus play an important part in the prevention of the disease. In this context, various obesity treatments act as a medium for the problem-solving process. In recent years, obesity surgery has been viewed as a rational solution to the problem of obesity. In the context of standardization of treatment, Callon's "Process of Translation" in STS theories highlights the importance of the central actor (Obligatory Passage Point; OPP). However, in the case of obesity, it is difficult to identify a single OPP to project different perspectives of an actor's needs. "Lapband surgery" often acts as a "boundary object" in this context. This article assesses this absence of central actors in the process of problem solving through a case study of adoption of Lapband surgery in Korea. Further, we attempt to suggest an analytical framework with a boundary object and multiple translation concepts to aid solving the problem of obesity.

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Nonpharmacological treatment of arrhythmia (소아 부정맥의 비약물적 치료)

  • Bae, Eun-Jung
    • Clinical and Experimental Pediatrics
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    • v.49 no.9
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    • pp.930-936
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    • 2006
  • Although antiarrhythmic medication has been the main treatment modality for arrhythmia in children, in recent decades technological development and computerization have made great advances in nonpharmacological therapy. This article reviews the transcatheter radiofrequency ablation for tachycardia in children, recent advances of device therapy for bradycardia, antitachycardia pacing, implantable cardioverter defibrillator. As a new field of device therapy, cardiac resynchronization therapy for congestive heart failure is also mentioned.

Dopamine Transporter Density Assessed with $[^{123}I]IPT$ SPECT Before and After Risperidone Treatment in Children with Tourette's Disorder (뚜렛 장애 아동에서 Risperidone 치료 전후 $[^{123}I]IPT$ SPECT로 측정한 기저 신경절 도파민 운반체 밀도)

  • Kim, Tae-Hoon;Ryu, Won-Gee;Park, Se-Young;Chi, Dae-Yoon;Choi, Tae-Hyun;Lee, Kyung-Yul;Cheon, Keun-Ah;Yun, Mi-Jin;Kim, Jai-Keun;Lee, Jong-Doo;Ryu, Young-Hoon
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.1
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    • pp.41-51
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    • 2004
  • PURPOSE: Tourette's disorder (TD), which is characterized by multiple waxing and waning motor tics and one or more vocal tics, is known to be associated with abnormalities in the dopaminergic system. To testify our hypothesis that risperidone would improve tic symptoms of TD patients through the change of the dopaminergic system, we measured the dopamine transporter (DAT) densities between drug-naive children with TD and normal children, and investigated the DAT density before and after treatment with risperidone in drug-naive children with TD, using iodine-123 labelled $N-(3-iodopropen-2-yl)-2{\beta}-carbomethoxy-3beta-(4-chlorophenyl)tropane$ ($[^{123}I]IPT$) single photon omission computed tomography (SPECT). MATERIALS and METHODS: $[^{123}I]IPT$ SPECT Imaging and Yale Global Tic Severity Scale-Korean version (YGTSS-K) for assessing the tic symptom severity were carried out before and after treatment with risperidone for 8 weeks in nine drug-naive children with TD. Eleven normal children also underwent SPECT imaging 2 hours after an intravenous administration of $[^{123}I]IPT$. RESULTS: Drug-naive children with TD had a significantly greater increase in the specific/nonspecific DAT binding ratio of both basal ganglia compared with the normal children. However, no significant difference in the specific/nonspecific DAT binding ratio of the basal ganglia before and after treatment with risperidone in children with TD was found, although tic symptoms were significantly improved with risperidone. CONCLUSION: These findings suggest that DAT densities are directly associated with the pathophysiology of TD, however, that the effect of risperidone on tic symptoms in children with TD is not attributed to the change of dopaminergic system.

The Effect of Antipsychotic Drug Treatment on Serum VEGF, sVEGFR-1, and sVEGFR-2 Level in Schizophrenia - A Preliminary Study - (정신분열병 환자에서 항정신병약물 치료가 혈청 VEGF, sVEGFR-1 및 sVEGFR-2의 농도에 미치는 영향 - 예 비 연 구 -)

  • Kim, Tae Hyun;Kim, Do Hoon;Lee, Sang Kyu;Son, Bong Ki;Jung, Jun Sub
    • Korean Journal of Biological Psychiatry
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    • v.14 no.4
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    • pp.232-240
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    • 2007
  • Objectives : Vascular endothelial growth factor(VEGF), one of potent cytokines, and its receptors were related with various biological functions and pathological conditions. The purpose of this study was to investigate the changes of serum level of free VEGF, soluble VEGFR-1, and soluble VEGFR-2 after treatment with atypical antipsychotic drug in schizophrenia. Method : The schizophrenic patients were diagnosed with DSM-IV and were prospectively followed up for 4 and 8 weeks. Thirteen schizophrenic patients were evaluated their clinical assessment with serum levels of free VEGF, sVEGFR-1, sVEGFR-2, and positive and negative symptom scale(PANSS) at baseline, 4 weeks, and 8 weeks after treatment with atypical antipsychotic drug. Thirteen normal control subjects were recruited and matched with the patient group by age and sex. Result : The serum level of free VEGF($295.2{\pm}43.7$pg/ml)and sVEGFR-2($8259{\pm}336.7$) at baseline(before treatment) in schizophrenic patients were not significantly different, compared with the control group($199.0{\pm}28.8$ and $8481{\pm}371.9$) respectively. However, the serum level of sVEGFR-1($86.2{\pm}10.3$, p<0.05) was significantly increased in the schizophrenic patients compared with the control group($59.0{\pm}6.4$). After treatment with antipsychotic drug, the serum levels of free VEGF at 4 weeks($338.9{\pm}56.5$) and 8 weeks($309.5{\pm}58.7$) were not significantly, different compared with baseline. But the serum levels of sVEGFR-1 was significantly decreased at 8 weeks ($57.3{\pm}6.3$, p<0.05) after antipsychotic drug treatment. The serum levels of sVEGFR-2 were decreased at 4 weeks ($7761{\pm}403.0$, p<0.05) and 8 weeks($7435{\pm}333.5$, p<0.05) compared with baseline. Conclusion : The decreased serum level of sVEGFR-1 and sVEGFR-2 might be affected by dopaminergic system which was influenced by antipsychotic drug.

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Design of swelling gastroretentive drug delivery system for sustained release of metformin (메트포르민의 서방출을 위한 팽윤성 위체류 약물전달시스템 설계)

  • Weon, Kwon Yeon;Kim, Se Gie
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.3
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    • pp.215-222
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    • 2020
  • Metformin is a recommended first-line therapy drug for type 2 diabetes patients. However, compared to other oral antidiabetic drugs (OAD), metformin has a large unit dosage, with bioavailability of 40-60%. This limiting bioavailability is because metformin is absorbed only in the upper gastrointestinal tract as a BCS class 3 drug. Hence, we propose that applying the Gastroretentive Drug Delivery System (GRDDS) and extending drug release time in the stomach will result in improved bioavailability. We selected the swelling type delivery system, as it is considered the most stable gastroretention technology compared to other GRDDSs. We modified the swelling excipient by using a natural swelling excipient to form a swelling tablet made of carrageenan and hydroxypropyl methylcellulose (HPMC). Our results indicate that the swelling complex tablet made of carrageenan and HPMC has a good swelling ability and shows required sustained release in a dissolution pattern. In addition, the carrageenan complex has a better swelling ability than the marketed metformin tablet, as determined by the ratio, (swelling ability)/(excipient weight). Taken together, our results indicate that the carrageenan complex can be developed as a good swelling excipient. Further optimizations are required for the commercialization of the carrageenan complex.

Survey of Knowledge on Insomnia for Sleep Clinic Clients (수면클리닉을 방문한 환자들의 불면증에 대한 인식조사)

  • Soh, Minah
    • Sleep Medicine and Psychophysiology
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    • v.26 no.1
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    • pp.23-32
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    • 2019
  • Objectives: Insomnia is not only the most common sleep-related disorder, but also is one of the most important. Knowledge of the comorbidities of insomnia is essential for proper treatment including pharmacological and non-pharmacological methods to prevent disease chronification. This study aimed to determine sleep clinic patients' knowledge of insomnia. Methods: This study recruited 44 patients (24 males and 20 females; mean age $54.11{\pm}16.30years$) from the sleep clinic at National Center for Mental Health. All subjects were asked to complete a self-report questionnaire about their reasons for visiting a sleep clinic and about their knowledge of treatment and comorbidities of insomnia. Results: The reasons for visiting the sleep clinic were insomnia symptoms of daytime sleepiness, irregular sleeping time, nightmares, snoring, and sleep apnea, in that order. Of the responders, 72.7% had a comorbidity of insomnia, and 22.7% showed high-risk alcohol use. In addition, 70.5% of responders chose pharmacological treatment of insomnia as the first option and reported collection of information about treatment of insomnia mainly from the internet and medical staff. More than half (52.3%) of the respondents reported that they had never heard about non-pharmacological treatments of insomnia such as cognitive behavioral treatment (CBT-I) or light therapy. The response rate about comorbidities of varied, with 75% of responders reporting knowledge of the relation between insomnia and depression, but only 38.6% stating awareness of the relation between insomnia and alcohol use disorder. Of the total responders, 68.2% were worried about hypnotics for insomnia treatment, and 70% were concerned about drug dependence. Conclusion: This study showed that patients at a sleep clinic had limited knowledge about insomnia. It is necessary to develop standardized insomnia treatment guidelines and educational handbooks for those suffering from insomnia. In addition, evaluation of alcohol use disorders is essential in the initial assessment of sleep disorders.

OROS Methylphenidate Treatment of Secondary Adult ADHD after Traumatic Brain Injury (외상성 뇌손상 후 이차적으로 발생한 성인 주의력결핍 과잉행동장애에서 OROS Methylphenidate의 치료효과:증례 및 고찰)

  • Lim, Myung Ho;Lee, Woo Chul
    • Korean Journal of Biological Psychiatry
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    • v.12 no.2
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    • pp.221-226
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    • 2005
  • The incidence of the Attention Deficit Hyperactivity Disorder secondary to the traumatic brain injury, such as traffic accidents, is increasing;the variety of the treatment modality is also increasing. This case was studied to see if OROS Methylphenidate(Concerta), which is one of the most commonly used medication in Attention Deficit Hyperactivity Disorder patients, not only improves the patient's attention, but also their impulsivity, hyperactivity and aggression. According to the case result, the medication showed an improvement of the impulsivity, aggression, and attention in the secondary Attention Deficit Hyperactivity Disorder patients after the traumatic brain injury.

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Type 2 Diabetes Pathogenesis: Impairment of Insulin/IGF-1 Signaling (제2형 당뇨병 병인: 인슐린/IGF-1 신호전달 장애)

  • Park, Sun-Min
    • Food Industry And Nutrition
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    • v.10 no.3
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    • pp.10-18
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    • 2005
  • 제2형 당뇨병은 인슐린 저항성과 인슐린 분비능의 장애에 의해서 복합적으로 나타나는 대사성 증후군 중 하나이다. 인슐린 저항성은 용어에서도 알 수 있듯이 인슐린 신호전달의 저하로 인한 인슐린 작용 감소가 나타나고 이는 인슐린 분비가 증가하더라도 포도당 이용은 감소된 상태이다. 인슐린 분비능은 직접적으로 인슐린 작용과는 무관한 것처럼 보이지만 자세히 살펴보면 인슐린 분비능의 중요한 역할을 하는 췌장 베타세포의 성장과 생존은 인슐린/IGF-1 신호 전달과 밀접한 관계가 있으므로 인슐린 분비능도 인슐린/IGF-1 신호전달과 관련이 있다. 그러므로 인슐린/IGF기 신호전달의 장애는 제2형 당뇨병의 병인에 매우 중요한 요인이다. 그러므로 제2형 당뇨병을 효과적으로 예방 또는 치료하기 위해서는 근육, 지방세포와 간등에서 인슐린 신호전달을 향상시켜 포도당 이용을 증가시키고, 시상하부에서 인슐린 신호전달을 향상시켜 식욕을 적절하게 조절할 수 있도록 하여 과체중이나 비만의 발생을 방지하고 췌장의 베타세포에서 인슐린/IGF-1 신호전달을 향상시켜 베타세포의 성장과 생존을 향상시켜 포도당에 대한 인슐린 분비 능을 촉진시키는 것이다. 최근에 FDA에서 승인받은 Exenatide는 glucagons like peptide-1 receptor agonist로 시상하부에 작용하여 식욕조절도 하고 췌장의 베타세포에서 IRS2의 발현을 증가시켜 인슐린/IGF-1 신호전달을 향상시켜 insulinotropic 작용을 가지는 것으로 알려졌다. 이 Exenatide는 도마뱀의 독침에서 분리한 peptide로 천연물로부터 유래된 약물이므로 천연물로부터 제2형 당뇨병을 치료할 수 있는 약물을 발견할 가능성은 매우 높으므로 이에 대한 연구는 체계적으로 이루어져야 하겠다.

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A Case of Gorham-Stout Disease with Life-threatening Chylothorax Successfully Treated with the Combined Therapy of mTOR Inhibitor and Beta-blocker (mTOR inhibitor와 beta-blocker 병합요법으로 성공적으로 치료된 Gorham-Stout 질환)

  • Ryu, Kyungguk;Seo, Go Hun;Kim, Yoon-Myung;Choi, Jin-Ho;Yoo, Han-Wook;Lee, Beom Hee
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.17 no.1
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    • pp.24-30
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    • 2017
  • Gorham-Stout disease is a rare disorder characterized by lymphovascular proliferation and destruction of osseous matrix. The etiology of this condition remains poorly understood. Chylothorax as a consequence of lymphatic leakage in thoracic cage may cause a severe life-threatening complication, accompanying respiratory difficulty. Currently, there is no standard management for this extremely rare condition. Here we describe a patient affected by Gorham-Stout disease successfully managed by the combined treatment of mTOR inhibitor and beta-blocker. A previously healthy 11-year-old female developed dyspnea and chest pain with a massive pleural effusion. The ligation of right thoracic duct and bilateral pleurodesis temporarily decreased her pleural effusion, which was aggravated repetitively and required frequent admission and tube thoracotomies. Along with bilateral pleural adhesiolysis with thoracotomy, the combined treatment of oral beta-blocker and mTOR inhibitor was commenced. After 1 month of oral medication, her pleural effusion was not increased and she was free of respiratory difficulty on room air without chest tubes. Over eleven months of treatment, no serious adverse reaction was noted and her condition has been stable with no further admission required.

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Anxiety Disorders after Traumatic Brain Injury (외상성 뇌손상 후의 불안장애)

  • Kim, Young-Chul
    • Korean Journal of Biological Psychiatry
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    • v.7 no.1
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    • pp.46-54
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    • 2000
  • Traumatic brain injury(TBI) is generally considered to be a risk factor for psychiatric disorders, especially depression and anxiety disorder. Despite the anxiety disorders are frequent sequelae after traumatic brain injury, the patients have not been payed medical attention and treated by doctors properly. The factors of precipitating and sustaining the anxiety disorders after TBI are brain injury itself, and the patient's or caregiver's response to the disability after TBI. To diagnose and treat them effectively, the knowledge about the mechanisms of and symptoms after TBI have to be needed. Psychiatrist should be a supportive and good listener to the patients who are complaining anxiety symptoms and differentiate whether the psychiatric symptoms are due to TBI or not. Because the TBI patients are very sensitive to drug side effects, doctors have to be familiar with the side effects as well as the mechanisms of action of the common psychotropics.

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