• Title/Summary/Keyword: 비약물적 치료

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THE EFFICACY AND SAFETY OF RISPERIDONE IN CHILD & ADOLESCENT PSYCHIATRIC INPATIENT (소아 청소년 정신과 입원 환자에서 Risperidone의 효과 및 안정성에 관한 연구)

  • Park Jeong-Hyun;Kim Boong-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.2
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    • pp.239-250
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    • 2005
  • Objective : The purpose of this study was obtaining data on the efficacy and safety of risperidone in child and adolescent psychiatric patients. Method : Thirty one children and adolescents (males n=18, females n=13, age ranged from 5.4 to 17.3 years) treated with risperidone were selected among child and adolescent psychiatric inpatients of Seoul National University Hospital from January, 2001 to June, 2002, and charts for them were reviewed retrospectively. Results : The primary psychiatric disorders treated with risperidone were schizophrenia and other psychosis, bipolar I disorder with psychotic features, Tourette's disorder, autism spectrum disorders, mixed receptive and expressive language disorder, attention deficit-hyperactivity disorder, conduct disorder and obsessive-compulsive disorder. twelve of these had comorbid mental retardation. Primary target symptoms of risperidone were psychotic symptoms (n=13 or $41.9\%$), behavioral symptoms (n=10 or $32.3\%$) including aggression, impulsivity, hyperactivity, stereotypy nonresponsive to other psychiatric treatments, and chronic and severe tics (n=8, $25.8\%$). The efficacy of risperidone was measured by clinical global improvement (CGI) for target symptoms, $67.7\%$ of subjects showed moderate or marked improvements and its therapeutic effect appeared to be maintained during at least 7.5 months. Mean daily dosage of risperidone was $0.05{\pm}0.01mg/kg$, the group with psychotic symptoms had significantly higher mean daily dosage (0.07mg/kg) compared with other two groups (0.04mg/kg) with behavioral symptoms or tics. A variety of adverse events were reported in this study : weight gain (n=23) most commonly reported, extrapyramidal symptoms (n=15), autonomic symptoms (n=6), sedation (n=5) and symptoms related to hyperprolactinemia (n=2) etc. Although there was no drug change related to the adverse events of risperidone, and $90\%$ of subjects at their last visits were maintained on it, thus its tolerability appeared good. Conclusions Results suggest that risperidone may be relatively safe and effective drug in managing a wide variety of child and adolescent psychopathologies such as psychotic symptoms, behavioral symptoms including aggression, impulsivity, hyperactivity and stereotypy nonresponsive to other psychiatric treatments, and chronic and severe tics. Controlled and long-term studies of efficacy and safety of risperidone treatment for children and adolescents are recommended in the future.

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Clinical Analysis of Surgical Results and Preoperative Management of Acute Aortic Dissection (급성 대동맥박리증의 수술성적 및 수술전 처치에 대한 임상적 고찰)

  • 현성열;박국양;이재웅;이창하;전양빈;박철현;염석란;신종환;민순식
    • Journal of Chest Surgery
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    • v.35 no.12
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    • pp.876-881
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    • 2002
  • Acute aortic dissection associated with high mortality rate has an extremely poor prognosis if early diagnosis and treatment are not received. Recently, with advanced computed tomography and echocardiography, diagnostic rate is higher and early operation is possible. Therefore preoperative medical therapy at ER(emergency room) lowered the mortality rate. This study was done to analyze the results with preoperative management at ER and operations, retrospectively. Material and Method: A series of 42 patients treated surgically for acute aortic dissections from 1991 to 2001 were included in this study. There were 18 males and 24 females. Mean age was 51.1 years. The admission course through emergency and outpatient department(OPD) was 34 and 8 respectively. Result: 26 patients underwent ascending aorta replacement-7 combined aortic valve replacements, 7 patients underwent descending aorta replacements and 9 patients received Bentall's operation. At emergency department, 20 patients received antihypertensive drugs and $\beta$-receptor blockers and 6 patients died. 22 patients did not receive antihypertensive and $\beta$-receptor block drugs and 10 patients died. There were 16(38%) overall deaths. Conclusion: Early diagnosis at ER or OPD is essential for acute aortic dissection, and it is important to select the most appropriate noninvasive interventions as possible. Therefore, preoperative drug therapy at ER is suggested according the patient conditions.

Bioactive Functions of Detoxified Puffer Liver Oil (제독처리한 복어 간유의 생리활성)

  • 최종원;김나영;김동수
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.32 no.7
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    • pp.1126-1131
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    • 2003
  • In this study, we investigated the effects of detoxified puffer liver (PL) oil on fatigue, hepatotoxicity and hyperlipidemia. There are no toxicities in both raw and purified PL oil. The test of swimming time was extended in detoxified PL oil pretreated group compared to the non-treated group. When rats treated with PL oil, the hepatic injuries induced by carbon tetrachloride or DL-galactosamine were reduced. The increased serum triglyceride and total cholesterol by poloxamer-407 were lowered by treating with PL oil remarkably. Also the bleeding time of hyperlipidemic animals was extended and plasma clotting time was delayed by PL oil.

위평충제치료소아소화성궤양98례임상관찰여수방보고(胃平沖劑治療小兒消化性潰瘍98例臨床觀察與隨訪報告) -위평충제(胃平沖劑)로 소아 소화성궤양 환자 98예(例)에 대한 임상치료 및 추적관찰 결과에 대한 연구-

  • Jin So-Jeong;Yun Hye-Min;Lee So-Jeong;Yeon Yun-Guk
    • The Journal of Pediatrics of Korean Medicine
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    • v.15 no.1
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    • pp.261-265
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    • 2001
  • 소아의 소화성궤양은 소아 소화계질환 중에서 발병율이 점차 늘어나고 있는 추세에 있다. 최근 소아과에서 내시경의 활용이 활발해지면서 장기적으로 반복하여 위완통(胃脘痛), 변혈 (便血)및 구혈(嘔血)이 나타나는 경우 궤양성질환의 가능성이 높은 것으로 밝혀지고 있다. 본원에서는 유명한 중의사 왕붕비(王鵬飛) 교수의 비완통(脾脘痛) 치험방을 토대로 많은 임상을 거쳐 위평충제(胃平沖劑)를 개발하여 1992년6월부터 1997년12월까지 위내시경 검사를 통하여 위궤양으로 진단된 98명의 소아환자에게 투여하여 관찰한 바 만족스러운 효과가 나타나 이를 보고한다. 위평충제(胃平衝劑)의 처방구성은 자초(紫草), 청대(靑黛), 곽향(藿香), 유향(乳香), 회향(茴香), 정향(丁香), 황련(黃連), 적석지(赤石脂), 황정(黃精) 등이다. 한의학적 이론에 따르면 불규칙하고 자극성이 강한 음식섭취 습관은 비위(脾胃)를 손상시켜 중주(中州)를 옹체(壅滯)시키므로 기(氣)의 원활한 소통이 이루어지지 않으면 부통즉통(不通卽痛)의 기전으로 발전한다. 또한 근래 소아들이 각종 정신적인 압박으로 스트레스가 쌓이면서 간기울결(肝氣鬱結)을 초래하여 울화(鬱火)로 인하여 혈락(血絡)이 손상되면서 출혈증상이 나타난다. 왕교수의 견해에 따르면 체내에 어혈이 제거되지 않으면 기혈(氣血)의 순환이 더욱 악화되어 어적(瘀積)이나 궤양 또는 경새(梗塞) 등을 일으키게 된다고 하였다. 따라서 위평충제(胃平沖劑)는 활혈화어(活血化瘀), 청열해독(淸熱解毒)과 더불어 익기양위(益氣養胃), 거어지통(祛瘀止痛)의 효능이 있는 약물들로 구성되었다. 동물실험에서 위평충제(胃平衝劑)는 궤양표면을 보호하고 치유하며 재발을 방지하는 효과가 있는 것으로 확인되었고, 위액의 분비, 위단백질효소의 활성에 대한 억제 및 진통효과도 있는 것으로 입증되었다.행하여 사용하는 것이 바람직하며, 단순한 중약 투여는 일부 양약에 의한 소아성장에 미치는 영향을 피할 수 있어 더 많은 임상연구가 이어져야 한다.(當歸) 목단피(牧丹皮) 울김(鬱金) 정력자(?歷子) 세신(細辛) 오미자(五味子) 구기자(枸杞子) 산수황육(山茱黃肉) 황기(黃?) 감초(甘草) 등을 기본적으로 사용한다. 비신양허형(脾腎陽虛型)은 온보비신(溫補脾腎) 화어척담(化瘀滌痰)을 원칙으로 하며, 처방에는 구마황( 灸麻黃) 세신(細辛) 오미자(五味子) 당귀(當歸) 단삼(丹蔘) 울김(鬱金) 정력자(?歷子) 반하(半夏) 보골지(補骨脂) 선령비(仙靈脾) 태자삼(太子蔘) 황기(黃?) 감초(甘草) 등을 기본적으로 사용한다. 치험(治驗): (1) 천식의 실증(實證)은 치료를 한 뒤 완화단계에 접어들면서 허증(虛證)으로 전화되는데, 허천(虛喘)도 역시 천식이니 만큼 단순히 보법(補法)만 사용하여서는 안된다. 시종일관 천식치료에는 척담화어(滌痰化瘀)의 원칙을 지켜야 한다. 폐내(肺內)의 담어(痰瘀)가 철저하게 제거되어야 폐(肺)의 순환기능을 개선시켜 기도(氣道)의 염증을 신속히 흡수하고 치유할 수 있다. 이와 같은 치료과정은 약 3-6개월이 필요하다. 완화단계의 기간이 길어질수록 완치될 확률도 높아진다. (2) 급성기 천식은 폐(肺)를 다스려야 한다. 폐(肺)를 다스리는 방법에는 선폐(宣肺), 청폐(淸肺), 온폐(溫肺), 윤폐(潤肺) 및 척담거어(滌痰祛瘀) 등이 있다. (3) 증상이 완화되면 신(腎)을 다스린다. 천식은 신허(腎虛)가 근본적인 원인이므로 완화단계에서 심지어 발작기에도 보신제(補腎劑)를 추가하여 사용하면 배의 효과를 얻을 수 있다. (4) 비(脾)의 기능을 강화하여 근본을 채우는 부비배본(扶脾培本)도 중요하다. 후천의 수곡정미(水穀精微)로 선천을 충족시키고 자양하는 것은 질병에 대한 저항력을

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Effects of Water-Soluble Polysaccharides from Tott on Lipid Absorption and Animal Body Weight (톳 유래 수용성 다당류의 Lipase 저해활성과 지질 및 체중변화에 미치는 영향)

  • Baek, Gu;Goo, Bon Geun;Ahn, Byung Jae;Park, Jae Kweon
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.4
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    • pp.556-562
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    • 2013
  • We examined the anti-obesity effects of water-soluble polysaccharides (WSP-A) extracted from the seaweed Hijikia fusiforme (Tott in Korean). The extracted alginate-like polysaccharide (verified by FT-IR and HPAEC-PAD analysis) was examined in a lipase inhibition assay and animal experiments. WSP-A inhibited lipase up to 30%, with over 80% of the initial activity retained until the 1 hour reaction in vitro. There was a 30% loss in the rate of weight gain in rats fed a high-fat diet. WSP-A therefore seems to serve as a healthy weight loss agent by inhibiting lipases, thus preventing the absorption of fat in the body.

Clinical Characteristics of Type 2 Diabetes in Children and Adolescents (소아 및 청소년 2형 당뇨병의 임상적 특징)

  • Lee, Seong Yong;Shin, Choong Ho;Yang, Sei Won
    • Clinical and Experimental Pediatrics
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    • v.45 no.6
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    • pp.754-763
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    • 2002
  • Purpose : The incidence of type 2 diabetes in children and adolescents has been reported to increase recently. The aim of this study is to investigate the clinical features of type 2 diabetes developing during childhood and adolescent period. Methods : The medical records of 33 patients with type 2 diabetes were reviewed. We analysed clinical manifestations, demographic data, and modes and responses of treatment. Results : Age at diagnosis was $13.4{\pm}1.8$ years. Seventy percent of patients revealed pubertal signs at diagnosis. Half of the patients had BMI more than $25kg/m^2$. Seventy-three percent of patients had family history of type 2 diabetes. Acanthosis nigricans were found in 18% of patients. Nineteen(57.6%) patients were diagnosed incidentally by random urine or blood glucose test without any typical diabetic symptom or sign. The modes of therapy to control hyperglycemia were insulin alone(75.8%), oral hypoglycemic agents alone(9.1%), insulin and oral hypoglycemia agents(9.1%), and only diet with exercise(6%). At the time of investigation, 45.5% of patients were not using insulin. The typical diabetic symptoms at diagnosis were more prevalent in patients who required insulin for more than two years than patients who did not(P<0.05). Conclusion : The development of type 2 diabetes in children and adolescents is possibly related to puberty, obesity, family history, and defects in insulin secretion rather than insulin resistance. Many children and adolescents with type 2 diabetes required insulin initially and some of them could discontinue. More than half of the patients were diagnosed as diabetes without any typical symptom or sign, which might be one of the predictive factors of the prolonged insulin requirement.

Acute Occlusal Change Following Acute Anterior Disc Displacement without Reduction: A Case Report (급성 비정복성 관절원판 변위에 따른 급성 교합변화의 증례)

  • Jung, Jae-Kwang;Hur, Yun-Kyung;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.37 no.4
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    • pp.205-211
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    • 2012
  • A 35 year-old female presented with the complaint of sudden occurrence of bite change and concurrent opening limitation, as well as pain in the right temporomandibular joint (TMJ) during mouth opening. From her history it was revealed that she had simple clicking of right TMJ for several years before onset of these symptoms, and that the clicking sound subsided recently after development of opening limitation. On clinical examination, anterior open bite, midline shift of the mandible to right, and premature contacts on left posterior teeth were observed. Maximum mouth opening and lateral movement to left were also restricted. On magnetic resonance images, the right TMJ showed anterior disc displacement without reduction and the posterior joint space is greatly collapsed by retrusion of the condyle. It was thought that the sudden occurrence of occlusal change would be resulted from abrupt displacement of the mandible associated with development of the anterior disc displacement without reduction. The stabilization appliance traction therapy was performed initially for first 3 months along with physical and pharmacologic therapy. However, the anterior open bite and opening limitation didn't resolve and the position of mandible still remained altered. So the stabilization appliance was changed to intermaxillary traction device. Then the mandible returned progressively to normal position and the occlusion became more stable and comfortable. After 5 months of intermaxillary traction therapy, the anterior open bite was dissolved completely and the occlusion became stabilized satisfactorily along with recovery of normal mouth opening range. On post-treatment magnetic resonance image, remodeling of condylar head was observed.

A Study on the Penetration of Dexamethasone into Oral Mucosa with the Use of Iontophoresis (이온영동법에 의한 Dexamethasone의 구강점막에의 침투에 관한 연구)

  • Sung-Woo Lee;Young-Ku Kim;Hong-Seop Kho
    • Journal of Oral Medicine and Pain
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    • v.16 no.1
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    • pp.9-23
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    • 1991
  • 이온 영동법은 전기력의 도움으로 이온화된 물질의 신체조직내 침투를 증가시키는 술식으로서 전신적 부작용은 줄어드는 반면, 국소부위의 약물농도를 증가시킬 수 있다는 장점 때문에 효과적인 국소요법으로 인정받고 있다. 치의학 분야에서는 과민상아질의 치료를 위해 불소 이온영동법이 빈번히 이용되어져 왔으며, 국소마취제나 항바이러스 제재의 도포시에도이용되었다.또,이온 영동법에 의한 스테로이드 투여로 피부나 구강점막의 염증성 질환의 효과적 치료를 보고한 많은 문헌이 있으나, 이온영동법에 의한 스테로이드의 구강점막에의 침투량이나 분포에 관해서는 거의 소개된 바가 없는 실정이다. 본 연구는 방사선 동위원소가 부착된 dexamethasone을 이온영동법을 이용하여 가토의 협점막에 침투시킨후 자기방사선 술식에 의해 그 침투량과 분포를 대조군과 비교 평가하였으며 다음과 같은 결과를 얻었다. 1. 이온영동법은 단순 국소도포에 비해 dexamethasone과 0.1M 인산소다 완충용액의 혼합액(dexamethasone in 0.1M sodium phosphate buffer solution)의 가토 협점막 침투량을 증가시켰으며, 양극을 사용하였을 때 더 효과적이었다. 2. Dexamethasone과 0.1M 인산소다 완충용액의 혼합액 투여 4시가, 24시간후 까지도 양극 잉온영동법이 효과적이었으며 은입자의 감소는 투여 4시간부터 24시간 후 사이에 주로 일어났다. 3. 인산소다 완충용액의 첨가는 양극 및 음극에 의한 이온영동법 모두에 효과적이었으며, 양극에 가장 효과적이었고 단순도포군에는 영향을 미치지 않았다. 4. 이온영동법에 의한 스테로이드 투여는 피부뿐만 아니라구강점막 염증성 병소의 효과적 치료술식으로 여거질 수 있다. 시와 maximal clenching시 사이의 치아 접촉시간에서도 유의한 상관관계를 보였다.

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중의치료소아효천임상관찰(中醫治療小兒哮喘臨床觀察) -소아천식에 대한 중약치료의 임상관찰-

  • Yun Hye-Min;Yang Yeon;Jang Ryeo-Yeong
    • The Journal of Pediatrics of Korean Medicine
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    • v.15 no.1
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    • pp.267-270
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    • 2001
  • 소아천식은 기도의 만성 염증 및 과민반응을 특징으로 나타내고 있어 염증을 일으키거나 알레르기 반응을 일으키는 물질로부터 차단하는 방법이 효과적임을 현대의학에서 이미 밝히고 있다. 한의학에서는 천증(喘證)에 본디 뿌리 깊은 근원(천유숙근(喘有夙根))이 있다고 간주하여 허약한 체질은 내적인 요인이고, 풍한침습(風寒侵襲)은 유발요인이며, 담음복폐(痰飮伏肺)와 신기휴허(腎氣虧虛)는 재발의 근본이라고 하였다. 본 연구에서는 소아 천식에 구마황(灸麻黃), 은행(銀杏), 건강(乾薑), 오미자(五味子), 백전(白前), 구백부(灸百部), 소자(蘇子) 등을 사용하였고, 경우에 따라 황기(黃?) 혹은 선령비(仙靈脾)를 추가하여 正氣(正氣)를 강화시키는 목적으로 사용하였다. 약리학적 연구에 따르면 마황과 건강, 오미자 등은 모두 기도의 염증세포 침윤(浸潤)를 억제하고 항알레르기 효과가 있으며, 건강과 오미자는 또한 히스타민에 대한 길항효과(拮抗效果)도 있는 것으로 알려져 있다. 은행 추출물은 혈소판 활성화 수용체에 대한 길항작용을 갖고 있으므로 이러한 물질들로 인한 기관지의 경련을 방지하여 천식증상을 왕화시킨다. 구백부(灸百部)는 지해(止咳)효과가 뛰어나다. 소아천식에 대한 치료는 표본동치(標本同治)의 원칙을 지키며, 증상이 완화된 단계에서도 중약 투여를 1-2개월 지속시키는 것이 중요하다. 소아에게 있어서 천식증상이 완화된 후 어혈(瘀血) 상태가 성인에 비해 심하지는 않지만, "구병필어(久病必瘀)"의 결과에 유의할 필요가 있다. 천식이 장기간 지속되면 필히 혈액순환 장애가 수반되므로 천궁(川芎)이나 단삼(丹蔘) 등의 활혈제(活血劑)를 가미하여 사용하면 효과를 높일 수 있다. 결론적으로 소아의 천식은 항염증, 평천(平喘), 화담(火痰), 지해(止咳)와 더불어 보신익기화어(補腎益氣化瘀)의 약물을 병행하여 사용하는 것이 바람직하며, 단순한 중약 투여는 일부 양약에 의한 소아성장에 미치는 영향을 피할 수 있어 더 많은 임상연구가 이어져야 한다.

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Survey on Period Prevalence Rate and Therapeutic Practice For Low Back Pain in Adult Population of Rural Area (농촌지역 성인의 요통 유병률과 치료방법 조사)

  • Lee Seung-Ju;Park Jung-Han
    • The Journal of Korean Physical Therapy
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    • v.3 no.1
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    • pp.109-121
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    • 1991
  • To investigate the period prevalence rate and therapeutic practic for low back pain (LBP) in the adult population of rural area, a personal interview was conducted for 2.024 persons or 20-59 years old in Seohu Myon, Andong County, Kyungpook Province between 1st and 20th of April, 1991. The period prevalence rate (l February 1990-31 January 1991) of LBP for 1,106 adults who were interviewed was $47.9\%$. The age adjusted period prevalence rate for males was $43.7\%$ and that for females was $52.3\%$ and the difference was statistically significant (p<0.005). Clinical course of th LBP was acute in $14.1\%$ of males and $9.0\%$ of females, recurrent in $57.0\%$ and $55.2\%$, and chronic in $28.9\%$ and $35.8\%$, respectively. Common causes of the LBP were insidious on set with aging without known cause$(48.1\%)$, heavy work $(15.1\%)$, and trauma $(11.3\%)$. Due to LBP $12.5\%$ of the patients were not able to stand or walk for more than an hour and $2.5\%$ were bed-ridden or unable to carry out daily routine. To have the LBP diagnosed $10.2\%$ of the patients utilized a oriental medical clinic or hospital, $31.3\%$ visited a clinic or hospital, and $56.6\%$ hat not utilized any medical facility. Main reason for not having the LBP diagnosed was that the LBP was tolerable. The most popular therapeutic method that the LBP patients chose at the first was drug and physical therapy. Herb medicine was most commonly used when the first therapeutic method was not effective and the acupuncture was the most popular choice of therapy when the second therapeutic method failed. Folk medicine was utilized in $15.5\%$ of the LBP patients and it included 36 regimens such as tincture of motherwort (Leonurus sibiricus), boiled chicken with liquor, etc. It was revealed by this survey that the LBP is a serious health problem in the rural area and many of the LBP patients do not utilize a clinic or hospital but take non-scientific folk remedy. To prevent the economic waste and side effects of the folk remedy, public health education is needed for tile rational therapy of LBP.

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