• Title/Summary/Keyword: 비약물적 치료

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The Effectiveness of Traditional Korean Medicine for Treating Postoperative Ileus in Gastric Cancer Patients: A Systematic Review and Meta-Analysis (위암 수술 후 장마비에 대한 한의학적 치료의 효과 : 체계적 문헌 고찰 및 메타분석)

  • Bae, Hye-ri;Kim, Eun-ji;Seo, Hyun-sik;Lee, Nam-hun
    • The Journal of Internal Korean Medicine
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    • v.43 no.4
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    • pp.625-642
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    • 2022
  • Objectives: Postoperative ileus (POI) is a common impairment of gastrointestinal motility and causes a delay in postoperative recovery, as well as an increased length of hospital stay, but no single strategy has a significant recuperative effect on POI. Studies of traditional Korean medicine (TKM) have reported improvements in bowel function after surgery. The aim of this systematic review was to assess the effectiveness of TKM on postoperative ileus in gastric cancer patients. Methods: We used six databases to search for studies published from January 1, 2007, until May 11, 2022. The included studies were those reporting gastric cancer patients who received TKM treatment after gastrectomy through indicators related to POI. Results: The search identified 27 RCTs that used herbal medicine (Daegeonjung-tang and Gami-leejoongtang), herbal medicine combined with acupuncture (Sama-tang, Gumiseunggi-tang, Daeseunggi-tang, and Insam-tang), acupuncture, acupuncture and moxibustion, electroacupuncture, warm needling, transcutaneous electroacupuncture (TEA), low-frequency electrical acupoint stimulation (LEAS), moxibustion, auricular acupressure, and ST-36 acupoint injection with neostigmine as treatments for POI. The time to first flatus was shortened by herbal medicine combined with warm needling (Sama-tang, Gumiseunggi-tang, Daeseunggi-tang, and Insam-tang), acupuncture, electroacupuncture, warm needling, TEA, moxibustion, auricular acupressure, and ST-36 acupoint injection with neostigmine (p<0.00001). The time to the first defecation decreased significantly in response to the herbal medicine combined with warm needling (Sama-tang, Gumiseunggi-tang, Daeseunggi-tang, and Insam-tang), acupuncture, electroacupuncture, warm needling, TEA, moxibustion, auricular acupressure, and ST-36 acupoint injection with neostigmine (p<0.00001). No serious adverse events occurred. Conclusions: TKM could be a promising option for preventing and resolving POI in gastric cancer patients after gastrectomy.

General Treatment Strategy for Intervention in Lower Extremity Arterial Disease (하지동맥 질환의 인터벤션: 전반적 치료 계획 수립)

  • Je Hwan Won
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.500-511
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    • 2021
  • The prevalence of lower extremity disease is increasing with age. With recent technological advancements, endovascular treatment is being performed more frequently. The treatment goal of intermittent claudication is to improve walking and reduce claudication. To achieve these goals, anatomical durability and patency are important. In patients with critical limb ischemia, the lesions are diffuse and particularly severe in below-the-knee arteries. The treatment goal of critical limb ischemia is to promote wound healing and to prevent major amputation, which is evaluated by the limb salvage rate. Primary stenting using covered or bare metal stents is a widely accepted endovascular treatment. While drug-eluting technologies with or without atherectomy are widely used in the treatment of femoropopliteal disease, balloon angioplasty is the mainstay treatment for below-the-knee intervention. CT angiography provides a road map for planning endovascular treatment in patients without absolute contraindications.

Nonparmetric Method for Identifying Effective and Safe Doses using Placement (유효하고 안전한 용량 결정에 위치를 이용한 비모수적 방법)

  • Kim, Sunhye;Kim, Dongjae
    • The Korean Journal of Applied Statistics
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    • v.27 no.7
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    • pp.1197-1205
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    • 2014
  • Typical clinical dose development studies consist of the comparison of several doses of a drug with a placebo. The primary interest is to find therapeutic window that satisfying both efficacy and safety. In this paper, we propose nonparametric method for identifying effective and safe doses in linear placement using score function. The Monte Carlo simulation is adapted to estimate the power and the family-wise error rate(FWE) of proposed procedure are compared with previous methods.

Study on Effect of Varience of Physiological Responses in Color Foot Reflexology Using Color Light (컬러광을 활용한 발반사요법이 인체 생리적 반응 변화에 미치는 영향에 관한 연구)

  • Jin, Hye-Ryeon;Yu, Mi;Park, Kyung-Jun;Kim, Nam-Gyun;Chung, Sung-Whan;Kim, Dong-Wook
    • Science of Emotion and Sensibility
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    • v.13 no.1
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    • pp.187-196
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    • 2010
  • Recently, people have been suffering from stress-related fatigue and psychological disorders. Most people depend on medicine for pain relief; many treat pain also through alternative medicine or replacement therapy. However, drug therapy has many side effects, including increased stress after the therapy. In comparison, alternative therapies such as massage and foot reflexology are less damaging to the body, and such therapies can be provided without physical or psychological discomfort. In this regard, the author had previously co-developed color foot reflexology, which combines the merits of color therapy and foot reflexology; color foot reflexology has been shown to have beneficial effects without undue pain. This study investigates the effects of color foot reflexology on the physiological response of the body by comparing the body’s response to the signal with that to the placebo. Healthy adult subjects were selected for the experiment, which was conducted under optimal experimental conditions and design. The results indicated that when stimulated, parasympathetic nerves increased in HRV and that blood pressure, pulse, body heat, peripheral blood flow were dramatically activated. However, the results for the placebo indicated minimal changes or irregular outcomes. The results provide strong evidence for the beneficial effects of the color foot reflexology instrument on the autonomic nervous system and on the physiological response of the body. Future research is warranted to verify the results of the current study by examining patients suffering from diseases and disorders arising from irregular physiological functions in the context of the foot.

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Association Between Psychiatric Medications and Urinary Incontinence (정신과 약물과 요실금의 연관성)

  • Jaejong Lee;SeungYun Lee;Hyeran Ko;Su Im Jin;Young Kyung Moon;Kayoung Song
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.63-71
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    • 2023
  • Urinary incontinence (UI), affecting 3%-11% of males and 25%-45% of females globally, is expected to rise with an aging population. It significantly impacts mental health, causing depression, stress, and reduced quality of life. UI can exacerbate psychiatric conditions, affecting treatment compliance and effectiveness. It is categorized into transient and chronic types. Transient UI, often reversible, is caused by factors summarized in the acronym DIAPPERS: Delirium, Infection, Atrophic urethritis/vaginitis, Psychological disorders, Pharmaceuticals, Excess urine output, Restricted mobility, Stool impaction. Chronic UI includes stress, urge, mixed, overflow, functional, and persistent incontinence. Drug-induced UI, a transient form, is frequently seen in psychiatric treatment. Antipsychotics, antidepressants, and other psychiatric medications can cause UI through various mechanisms like affecting bladder muscle tone, altering nerve reflexes, and inducing other conditions like diabetes or epilepsy. Specific drugs like lithium and valproic acid have also been linked to UI, though mechanisms are not always clear. Managing UI in psychiatric patients requires careful monitoring of urinary symptoms and judicious medication management. If a drug is identified as the cause, options include discontinuing, reducing, or adjusting the dosage. In cases where medication continuation is necessary, additional treatments like desmopressin, oxybutynin, trihexyphenidyl, or amitriptyline may be considered.

Enhancement of Tumor Radioresponse by Combined Chemotherapy in Murine Mepatocarcinorna (마우스 간암에서 항암제-방사선 복합요법을 이용한 치료 효과 향상)

  • Seong, Jin-Sil;Kim, Sung-Hee;Suh, Chang-Ok
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.329-336
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    • 2000
  • Backgrounds : The purpose of this study was to identify drugs that can enhance radioresponse of murine fepatocarcinorna. Methods : CSH/HeJ mice bearing 8 mm tumors of murine fepatocarcinorna, HCa-1, were treated with 25 Gy radiation and one of the following drugs: 5-Fu, 150 mghg; adriamycin, 8 mg/kg; cisplatin, 6 mg/kg; paclitaxel, 40 mg/kg; and gemcitabine, 50 mg/kg. Tumor response to the treatment was determined by tumor growth delay assay and by enhancement factor. Apoptotic level was assessed in tissue sections. Expression of regulating molecules was analyzed by western blotting for p53, Bcl-2, Bax, Bcl-XL, Bcl-XS, and p21$^{WAF1/CIP1}$. Results :Among the drugs tested, only gemcitabine enhanced the antitumor effect of radiation, with enhancement factor of 1.6. Induction of apoptosis by a combination of gemcitabine and radiation was shown as only additive level. In analysis of radiation-induced expression of regulating molecules, the most significant change by combining gemcitabine was activation of p21$^{WAF1/CIP1}$ Conclusion :Gemcitabine is the first drug showing an enhancement of radioresponse in murine hepatocarcinoma, when combined with radiation. The key element of enhancement is thought to be p21$^{WAF1/CIP1}$.

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Rare Disease Research and Orphan Drug Development (희귀질환 연구와 치료제 개발 동향)

  • Lee, Shinhaeng;Lee, Jangik I.
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.1
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    • pp.1-13
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    • 2013
  • 희귀질환이란 일반적으로 그 유병율이 인구 일만 명당 5명 이하인 질환을 말한다. 세계에는 약 7,000여종의 희귀질환이 알려져 있고 학술지에 매 주 대략 5종의 새로운 희귀질환이 보고되고 있다. 희귀 의약품(orphan drug)이란 희귀질환치료제 또는 수익성이 없어 개발을 기피하는 일반질환 치료제로서 정부가 지정한 의약품을 말한다. Orphan 의약품의 개발에는 많은 장점이 있다. Orphan 의약품으로 정부의 지정을 받으면 세금감면을 통한 연구비 지원, 임상시험 비용 지원, 신약허가 심사비 면제, 시장독점권 부여 등의 특혜가 주어진다. 희귀질환의 대부분은 단순한 유전적 결함에 의하는 경우가 많아 치료제의 표적발견이 비교적 쉬우므로 개발 성공률이 높고, 임상시험기간이 짧으며, 시판허가를 받을 확률이 높아 연구개발비용이 적게 든다. 그 결과 전세계 orphan 의약품 시장은 최근 매년 6%씩 성장하여 2014년에는 약 1,120억달러의 시장을 형성할 것으로 추정된다. Orphan 의약품 시장은 현재 매년 8.9%씩 성장하고 글로벌 시장의 51%를 점유하는 미국을 중심으로 확장되어 가고 있으며, 총매출액의 64.3%가 유전자재조합의약품에 의한 것으로 알려져 있다. 이러한 의약품시장의 변화와 사회적 요구에 부응하여 한국 또한 희귀질환 치료제 개발의 활성화를 위해 재정적 지원체계를 구축하고, 허가관리를 개선하며, 법률적 제도를 완비하는 과정에 있다. 현재 희귀질환의 치료적 타겟을 찾아 신물질이나 기존의 약물을 발굴하는 과정이 주로 대학이나 연구 중심 병원에서 이루어지고 있다. 제도가 잘 정립되어 있는 미국 시장을 겨낭하여 orphan 의약품 개발을 전략적으로 수행한다면 큰 성공을 거둘 수 있을 것으로 기대된다.

Behavioral Variant Frontotemporal Dementia Phenocopy Syndrome (행동증상 아형 전측두엽 치매 표현형모사 증후군)

  • Cheon, Jin Sook
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.1
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    • pp.3-11
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    • 2017
  • Objectives : The aim of this study was to draw attention toward so called 'behavioral variant frontotemporal dementia(bvFTD) phenocopy syndrome', which is difficult to discriminate with the primary psychiatric disorders, showing poor response to conventional therapeutic drugs, leading to higher risk to misdiagnoses and legal problems. Furthermore, the author insisted that our interest and study on them must be continued. Methods : English articles published during 2000 thru 2016 had been searched by internet with the combination of words such as 'frontotemporal', 'phenocopy' and 'behavioral', and reviewed. Besides, two clinical vignettes were described. Results : Precise diagnosis is important because patients' behavioral symptoms can influence on their families and community. However, disease-modifying treatment for bvFTD are not developed until now, and recent therapeutic drugs are only good for specific symptoms, while deterioration progresses in spite of proper psychiatric management. The possible bvFTD patients are not progressed into probable bvFTD clinically, showing no decline of cogntive and social function, no decrease of activity function, longer survival time, and normal neuroimaging for several years. Conclusions : Rather than expected, there are much more patients having clinical symptoms, course and diagnostic findings including neuroimaging, which are atypical to classical frontotemporal dementia and primary psychiatric disorders. If our knowledge and discriminating ability is improved, discovery rate of that cases will be increased. However, the identity of these atypical features are not clarified until now, it must be further actively investigated.

Pulmonary Features of Hyperimmunoglobulin E (Job's) Syndrome (Hyperimmunoglobulin E (Job's) syndrome에서 발현되는 호흡기증상)

  • Min, Byoung-Ju;Shin, Jae-Seung;Lee, In-Sung;Shin, Young-Kyoo
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.6
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    • pp.651-656
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    • 2002
  • Hyperimmunoglobulin E syndrome, otherwise known as Job's syndrome, is an immune disorder characterized by an abnormal elevation of the circulating immunoglobulin E level, and recurrent infections of the skin and sinopulmonary tract. The syndrome has various pulmonary features, e.g., pneumonia, pneumatocele, pneumothorax, lung abscesses and empyema. We report a case of hyperimmunoglobulin E syndrome, with various respiratory clinical manifestation. Medical therapy, including prophylactic antibiotics, has been the cornerstone for the treatment of hyperimmunoglobulin E syndrome. Even if surgical intervention is required, minimal pulmonary parenchymal resection is recommended.

Linear Accelerator Radiosurgery for Trigeminal Neuralgia: Case Report (선형가속기를 이용한 삼차신경통의 정위적 방사선수술: 증례보고)

  • Yun Hyong-Geun
    • Radiation Oncology Journal
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    • v.24 no.2
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    • pp.144-148
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    • 2006
  • Trigeminal neuralgia is defined as an episodic electrical shock-like sensation in a dermatomal distribution of the trigeminal nerve. When medications fail to control pain, various procedures are used to attempt to control refractory pain. Of available procedures, stereotactic radiosurgery is the least invasive procedure and has been demonstrated to produce significant pain relief with minimal side effects. Recently, linear accelerators were introduced as a tool for radiosurgery of trigeminal neuralgia beneath the already accepted gamma unit. Author have experienced one case with trigeminal neuralgia treated with linear accelerator. The patient was treated with 85 Gy by means of 5 mm collimator directed to trigeminal nerve root entry zone. The patient obtained pain free without medication at 20 days after the procedure and remain pain free at 6 months after the procedure. He didn't experience facial numbness or other side effects.