• 제목/요약/키워드: 비약물적 치료

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Therapeutic comparison between low-dose sustained-release theophylline dry syrup and capsule in children with mild persistent asthma (유소아 경증 지속성 천식에서 저용량 서방형 테오필린 건조시럽과 캡슐 제형의 치료 효과 비교)

  • Lee, Hyun Seung;Lee, Hae Kyung;Kwon, Hi Jeong;Kim, Jeong Hee;Rha, Yeong Ho;Kim, Jin Tack;Kim, Young Ho;Lee, Hae Rhan;Pyun, Bok Yang
    • Clinical and Experimental Pediatrics
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    • v.50 no.3
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    • pp.284-291
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    • 2007
  • Purpose : Theophylline has recently been reported to have concurrent anti-inflammatory effects at low therapeutic plasma concentrations which are below the doses at which significants, clinically useful bronchodilatation is evident. Sustained-release formulation in capsule and dry syrup forms were developed to reduce its adverse effects and improve its clinical effects. We compared the therapeutic effects of theophylline dry syrup and capsules in children with mild asthma. Methods : Ninety children with mild asthma were randomized to receive either theophylline dry syrup (n=44) or theophylline capsules (n=46); 4 mg per kilogram of body weight, twice a day, for 12 weeks. Baseline and serial measurements of daytime and nighttime asthma symptom score were performed. Compliance scores, drug swallowing scores, and drug usability scores were measured every 4 weeks. Each scoring was rated on a scale of 0-4. Serum theophylline concentration were measured at 4 and at 12 weeks. To examine the anti-inflammatory effect of theophylline on asthma, Serum eosinophilic cationic protein as a marker of airway inflammation caused by eosinophil was measured 12 weeks pre- and post-administration. Results : The daytime and nighttime asthma symptom scores of the two groups after 4 weeks significantly improved over the baseline score. Daytime and nighttime asthma symptom scores in the dry syrup group were statistically lower at all time points except for the nighttime symptom scores at 4 weeks. Compliance scores, drug swallowing scores, and drug usability scores in the dry syrup group were significantly higher at the end time point. Only in the dry syrup group was the serum ECP at the end time point statistically lower than baseline. Conclusion : Low-dose sustained-release theophylline may be safe and effective in bronchial asthma and this effect may be mediated by its anti-inflammatory action mechanisms. Especially, when used in children with asthma, dry syrup formulation is recommended because of its higher compliance than capsule formulation.

Piperis Nigri Fructus Extract Ameliorates Psychological Stress in Mice (생쥐의 심리적 스트레스에 대한 호초(胡椒)의 효과)

  • Lee, So Young;Choi, Jae Hong;Jeong, Hyang Sook;Kim, Young Gyun;Cho, Su In
    • Journal of Haehwa Medicine
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    • v.21 no.2
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    • pp.95-104
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    • 2013
  • 스트레스로 인한 인체의 반응은 중추신경계, 시상하부, 변연계 및 기타 표적기관으로부터 시작되는데, 자율신경계 반응, 내분비계 반응, 면역계 반응 등을 통하여 복합적인 신체 증상으로 발현되며, 스트레스 상황에서는 시상하부-뇌하수체-부신 축 (HPA axis)과 교감신경계의 작용으로 여러 신경전달물질 방출에 변화가 생기며 이러한 변화는 면역기전에 중요한 역할을 하고 일부는 면역세포의 활성에 직접적으로 영향을 미쳐 신체 각종 질병의 원인이 될 것으로 추정된다. 한의학에서는 천인상응(天人相應)의 관점에서 육기(六氣)를 생체자극의 외적 요인으로 간주하고, 생체내적 현상인 정신이 외적 자극을 통하여 나타나는 생체반응을 칠정(七情)으로 보았으며, 이러한 관점에서 스트레스는 신체에 오장(五臟)의 허실(虛實), 혈허(血虛), 정손(精損), 기역(氣逆), 기(氣)의 순환장애, 담연(痰涎), 화(火) 등의 병적인 요인을 만들어 준다. 본 연구에서 재료로 사용된 호초 (Piper nigrum Linne)는 후추나무의 과실을 말린 것으로서 세계적으로 널리 사용되는 향신료이며, 한의학에서는 온중제한하기(溫中除寒下氣), 쾌격소담(快膈消痰), 해독(解毒)등의 효능으로 한담식적(寒痰食積) 완복냉통(脘腹冷通) 곽란(癨亂) 토사(吐瀉)등의 치료에 활용되어 왔다. 특히 쾌격소담(快膈消痰)하는 작용은 정신적 스트레스에 유효할 것으로 생각되므로 본 연구에 이용하게 되었다. 실험동물은 ICR계 생쥐를 이용하였으며, 심리적 스트레스는 옆쪽 cage에서 다른 마우스의 신체에 가해지는 전기 충격을 하루 1시간 동안 지켜보게 하는 것으로 유발하였으며, 이 상태에서 약물을 투여한 그룹을 실험군, 그렇지 않은 그룹을 대조군으로 하였다. 정상군은 아무런 자극 없이 하루 1시간 동안 일정 공간에 가두어 두는 것으로 하였다. 실험 결과, 호초(胡椒) 추출물을 100mg/kg/day 용량으로 5일간 투여한 실험군은 아무런 처치를 하지 않은 대조군에 비해 혈장 중 corticosterone 함량이 유의하게 감소되었고, 뇌에서의 noradrenalin 분비량이 유의하게 증가되었으며, plus maze test에서의 머무름 시간이 연장되는 것으로 나타나 호초(胡椒)가 심리적 스트레스를 효과적으로 억제하고 진정작용이 있는 것으로 사료되나 구체적인 작용기전 및 인체에서의 효과에 대해서는 향후의 보다 자세한 연구가 필요할 것으로 생각된다.

Dopamine Transporter Density of the Basal Ganglia in Children with Attention Deficit Hyperactivity Disorder Assessed with I-123 IPT PECT (I-123 IPT SPECT를 이용한 주의력결핍 과잉행동장애 아동에서의 methylphenidate 투여 전후의 기저 신경절 도파민 운반체 밀도 변화 측정)

  • Ryu, Won-Gee;Kim, Tae-Hoon;Ryu, Young-Hoon;Yun, Mi-Jin;Cheon, Keun-Ah;Chi, Dae-Yoon;Kim, Jong-Ho;Choi, Tae-Hyun;Lee, Jong-Doo
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.4
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    • pp.235-244
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    • 2003
  • Purpose: Attention deficit hyperactivity disorder (ADHD) has been known as psychiatric disorder in childhood associated with dopamine dysregulation. In present study, we investigated changes in dopamine transporter (DAT) density of the basal ganglias using I-123 N-(3-iodopropen-2-yl) -2-carbomethoxy-3beta-(4-chlorophenyl) tropane [I-123 IPT] SPECT in children with ADHD before and after methylphenidate treatment. Materials and Method: Nine drug-naive children with ADHD and seven normal children were included in the study. We peformed brain SPECT two hours after the intravenous administration of I-123 IPT and made both quantitative and qualitative analyses using the obtained SPECT data, which were reconstructed for the assessment of soecific/nonspecific DAT binding ratios in the basal ganglia. All children with ADHD reperformed [123I]IPT SPECT after treatment with methylphenidate(0.7mg/kg/d) during about 8 weeks. SPECT data reconstructed for the assessment of specific/nonspecific DAT binding ratio of the basal ganglia were compared between before and after treatment methylphenidate. We investigated correlation between the change of ADHD symptom severity assessed with ADHD rating scale-IV and specific/nonspecific DAT binding ratio of basal ganglia. Results: Children with ADHD had a significantly greater specificinonspecific DAT binding ratio of the basal ganglia comparing to normal children(Right : z = 2.057, p = 0.041 : Left : z : 2.096, p = 0.032). Under treatment with methylphenidate in all children with ADHD, specificinonspecific DAT binding ratio of both basal ganglia decreased significantly greater than before treatment with methylphenidate (Right : t = 3.239, p = 0.018 ; Left : t = 3.133, p = 0.020). However, no significant correlation between the change of ADHD symptom severity scores and specific/nonspecific DAT binding ratio of the basal ganglia were found. Conclusions: These findings support the complex dysregulation of the dopaminergic neurotransmitter system in children with ADHD.

Antimicrobial Photodynamic Therapy on Pseudomonas aeruginosa Using a Diode Laser and PhotoMed, Methyl Pheophorbide A, or Radachlorin® (다이오드 레이저와 PhotoMed, Methyl Pheophorbide A, Radachlorin®을 이용한 녹농균에 대한 항균 광역학 요법)

  • Young-Kyu SONG;Keun-Dol YOOK;Ji-Won KIM
    • Korean Journal of Clinical Laboratory Science
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    • v.56 no.1
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    • pp.52-58
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    • 2024
  • Photodynamic therapy (PDT) activates intracellular oxygen using a photosensitizer activated by light of a specific wavelength and is a potential means of treating wound infections caused by antibiotic-resistant bacteria. Pseudomonas aeruginosa (P. aeruginosa) is typically non-pathogenic in healthy individuals but can induce severe illnesses like sepsis in the immunocompromised. Antibiotics have been conventionally used to treat P. aeruginosa infections, but increasing antibiotic resistance caused by drug misuse poses a growing challenge to the management of these infections. This study aimed to investigate the ability of PDT using photosensitizers (PhotoMed, Methyl pheophorbide A, or Radachlorin®) and a diode laser to inhibit P. aeruginosa. Suspensions of P. aeruginosa and a photosensitizer were inoculated into Petri dishes and incubated for 30 minutes. Samples were then irradiated with the laser at 3 J/cm2, and after incubation, colony areas were measured. P. aeruginosa killing rates were 79.65% for PhotoMed, 47.36% for Methyl pheophorbide A, and 40.91% for Radachlorin®. This study shows that PDT using a diode laser and a photosensitizer constitutes an effective practical therapeutic approach for inhibiting P. aeruginosa.

Psychosocial Impact of Chronic Orofacial Pain (만성 구강안면통증의 사회심리적 영향)

  • Yang, Dong-Hyo;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.34 no.4
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    • pp.397-407
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    • 2009
  • The aim of the study was to evaluate psychosocial impact of non-dental chronic orofacial pain (OFP) on daily living using the graded chronic pain (GCP) scale. It is also investigated the clinical profile such as demographics, event related to initiation of OFP and prior treatments for patients. During previous 6 months since September 2008, 572 patients (M:F=1:1.5, mean age=34.7 years) with non-dental OFP attended university-based specialist orofacial pain clinic (Dankook University Dental Hospital, Cheonan) to seek care although 63% of them already experienced related treatment for their OFP problem. They visited the most frequently general dental practitioner and orthopedic doctors due to their pain problem and medication was the most commonly employed modality. Most of the patients (89.2%) had TMD and the most common related event to initiation of their pain was trauma, followed by dental treatment. Almost half of the patients (46%) suffered from chronic pain(${\geq}6\;M$) and 40% of them exhibited relatively high disability due to chronic OFP. GCP pain intensity and disability days were significantly different for age and diagnosis (p<0.05) but not for gender and duration. GCP grades were affected by all the factors including gender, age, pain duration and diagnosis.(p=0.000) Female gender, elders, and long lasting pain were closely related to high disability. The patients with neuropathic Pain and mixed OFP rather than TMD were graded as being highly disabled. Conclusively, a considerable percentage of chronic OFP patients reports high pain-related disability in their daily, social and work activity, which suggest a need for psychosocial support and importance of earlier referral for appropriate diagnosis and tailored management.

Long-term Outcome of Treatment of Mycobacterium Abscessus Pulmonary Disease (Mycobacterium abscessus 폐질환 치료의 장기 성적)

  • Jo, Kyung Uk;Park, Soo Jung;Hong, Seok Chan;Oh, Yeon-Mok;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.2
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    • pp.98-104
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    • 2007
  • Background: Although there is an increasing incidence of Mycobacterium abscessus pulmonary disease in Korea, the optimal therapeutic regimen has not yet been established and there are no reports of the long-term treatment outcomes. This study examined the long-term treatment outcomes of M. abscessus pulmonary disease. Methods: Twenty-nine patients diagnosed with M. abscessus pulmonary according to the American Thoracic Society criteria and treated from January 1996 to December 2003 were enrolled in ghis study. The clinical characteristics, radiological findings, treatment outcome, and follow up data were analyzed retrospectively. Results: The mean age of the 29 patients was 56.1 (${\pm}13.6$) years and there was a female (22/29) dominance. The chest radiography revealed the nodular bronchiectatic type to be dominant (69%, 20/29). Twenty-seven (93.1%) were prescribed clarithromycin-containing regimens, and injectable drugs, mainly aminoglycosides, were included in the regimen of nineteen patients. The most predominant regimen (48.3%) consisted of clarithromycin and amikacin. The treatment success, failure, and default were achieved in 19(65.5%), 9(31.0%), and 1(3.4%), respectively. The median duration to culture conversion was 42 days (range 15-362) and the median duration of treatment in the success group was 543 days (range 176-1,160). An adjunctive surgical resection was performed in five patients, which resulted in treatment success in two patients. After the completion of treatment, nineteen patients were followed up for a median duration of 931 days (range 230-2,294). Only one (5.3%) patient relapsed 45 days after completing treatment. Conclusion: Treatment with clarithromycin-containing regimens resulted in a successful treatment in approximately two thirds of patients with M. abscessus pulmonary disease. The long-term relapse rate was also quite low.

Cross-resistance Between Rifampicin and Rifabutin and Its Relationship with rpoB Gene Mutations in Clinically Isolated MDR-TB Strains (다제내성 결핵 균주에서 리팜핀과 리파부틴간의 교차내성률 및 rpoB 유전자 돌연변이와의 연관성)

  • Kim, Byoung Ju;Oh, Seung Hwan;Cho, Eun Jin;Park, Seung Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.2
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    • pp.171-179
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    • 2006
  • Background : Despite the emerging danger of MDR-TB to human beings, there have only been a limited number of drugs developed to treat MDR-TB since 1970. This study investigated the cross-resistance rate between rifampicin (RFP) and rifabutin (RBU) in order to determine the efficacy of rifabutin in treating MDR-TB. In addition, the results of rifabutin were correlated with the rpoB mutations, which are believed to be markers for MDR-TB and RFP resistance. Methods : The MICs of RBU were tested against 126 clinical isolates of MDR-TB submitted to the clinical laboratory of National Masan TB Hospital in 2004. Five different concentrations ($10-160{\mu}g/ml$) were used for the MICs. The detection of the rpoB mutations was performed using a RFP resistance detection kit with a line probe assay(LiPA), which contains the oligonucleotide probes for 5 wide type and 3 specific mutations (513CCA, 516GTC, and 531TTG) The rpoB mutation was determined by direct sequencing. Results : The rate of cross-resistance between RFP and RBU was 70.5%(74/105) at $20{\mu}g/ml$ RBU(ed note: How much RFP?) Most mutations (86.3%) occurred in the 524~534 codons. The His526Gln, His526Leu, Leu533Pro, Gln513Glu, and Leu511Pro mutations(Ed note: Is this correct?) were associated with the susceptibilty to RBU. Conclusion : Based on the cross-resistance rate between RFP and RBU, RBU may be used effectively in some MDR-TB patients. Therefore, a conventional drug susceptibility test for RBU and a determination of the critical concentration are needed. However, rpoB gene mutation test may be have limited clinical applications in detecting RBU resistance.

Effects of Oyster Shell Extract on Papain-induced Osteoarthritis in C57BL/6J Mice (굴 패각 추출물이 Papain으로 유도된 골관절염 C57BL/6J Mice에 미치는 영향)

  • Lee, Se-Young;Kim, Hak-Ju;Han, Ji-Sook
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.8
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    • pp.1183-1189
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    • 2013
  • We investigated the effects of oyster shell extract (OSE) on papain-induced osteoarthritis in C57BL/6J mice. Osteoarthritis was induced in mice by a papain injection into the knee joint. The mice were divided into a total of five groups (n=8). The normal group was untreated, whereas the papain group (negative control) was induced with osteoarthritis and treated with water daily. The papain+DS group (positive control) was treated with diclofenac sodium. Papain+OSE groups were treated with OSE concentrations of 100 and 200 mg/kg/bw for 20 days. Proteoglycan content in articular cartilage was analyzed through safranine-O fast green staining and H&E staining. The histopathological changes in cartilage were measured by the Rudolphi score approach. The contents of tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), interleukin (IL)-$1{\beta}$, and IL-6 in plasma were analyzed by the ELISA method. After experiments, body weights of the treated groups were not significantly different compared with the normal group. Cartilage loss and joint instability significantly improved in a dose-dependent manner in the OSE-treated group compared with the papain group (P<0.05). Proteoglycan content was significantly higher in the OSE-treated group than the papain group (P<0.05). Osteoarthritis scores of the OSE-treated group were significantly decreased compared with the papain group (P<0.05). TNF-${\alpha}$, IL-$1{\beta}$, and IL-6 content in the plasma of the papain+OSE treated groups significantly decreased in a dose-dependent manner compared with the papain group (P<0.05). These results suggest that OSE treatment might have anti-arthritic effects on papain-induced osteoarthritis in C57BL/6J mice.

The Effect of Sympathectomy on Bone: -Evaluation with Quantitative Bone Scintigraphy- (흰쥐에서 교감신경절제술이 골에 미치는 영향 : -정량적 골스캔을 이용한 평가-)

  • Kim, Hak-Hee;Yang, Woo-Jin;Lee, Seong-Yong;Chung, Soo-Kyo;Park, Jang-Sang;Yim, Jung-Ik;Bahk, Yong-Whee;Shinn, Kyung-Sub
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.1
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    • pp.85-88
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    • 1994
  • 근래 골조직에 있어서 자율신경의 기능에 대하여 많은 연구가 이루어지고 있으며, 골내의 자율신경의 해부학적 분포는 많이 알려져 있다. 그러나 임상적으로 반사적 교감신경 이상이나 레이노드 현상등과 같은 교감신경의 기능이상증에서나, 버거씨병 등의 치료 목적으로 시행되고 있는 교감신경 절제술 후, 자율신경기능의 변화가 사지골의 혈류나 골대사에 미치는 영향에 대하여는 아직도 논란의 여지가 있다. 저자들은 교감신경절제술 후 시간 경과에 따른 골에 미치는 영향을 알아보기 위하여 흰쥐에서 골대사와 혈류상태를 비교적 충실히 반영하는 정량적 골스캔을 시행하였다. 체중 $300{\sim}400g$의 수컷 흰쥐 10마리에서 복강을 통한 편측 요추부 교감신경절제술을 시행하였고, 수술 전과 후 1일, 3일, 1주, 2주, 3주, 4주에 양측 하지에서 각각 골스캔을 시행하고 교감신경 절제측 하지와 정상 하지에 대칭적으로 관심구역을 정하여 양측의 골스캔상 섭취계수를 비교하였다. 측정부위는 각 하지의 대퇴골간, 경골간 및 중족골로 하였다. 교감신경 절제술을 시행한 하지에서는 골스캔 소견상 수술 후 1일 또는 3일부터 동위원소 집적이 유의하게 증가되었으며 원위부로 갈수록 더욱 증가되었다. 그러나 3주 이후에는 정상측 수준으로 환원되었다. 교감신경절제술 후 골스캔상 동위원소집적이 증가되는 것은 골자체의 혈류가 증가되기 때문이며 이차적으로 골의 흡수를 유발하여 골밀도가 감소하는 것으로 생각되는데 이러한 변화는 시술 후 1일 째부터 관찰되어 사지골이 교감신경 절제에 매우 민감하게 반응하는 것을 알 수 있었다.9m}Tc$-MAA를 이용한 간 동맥 혈류 검사는 간암에서 색전술의 효과를 정확히 평가할 수 있는 유용한 검사법으로 이용될 수 있으리라 생각한다. 활성화 과정을 알아볼 수 있었으며 위상영상히스토그램을 통하여 이를 정량화하여 심실내 전기적 활성의 비동시성 여부를 추적관찰 할 수 있는 비관혈적검사임을 확인하였다.며, 3. $^{99m}Tc$으로 표지된 avidin과 streptavidin은 먼저 간으로 흡수된 후 대사된 다음 신장으로 배설된다는 사실을 알았다.damole에 의한 부작용은 흉통, 두통, 복통 등의 순이었고 전예에서 호전되었으며 생명에 위험을 초래할 수 있는 정도의 심장마비나 심부정맥은 한 예에서도 없었다. 결론적으로 dipyridamole은 약물부하 심근 SPECT 검사에 안전하게 사용할 수 있는 약물로 사료된다. 미소핵 빈도수가 증가하는 경향을 보였으나, 각 군간에 통계학적으로 유의한 차이는 없었다(p>0.05). 결론 : 임상적으로 치료를 중단하게 되는 1000mCi/60 Kg(16.67 mCi/Kg)를 투여한 군에서도 생쥐 골수내 미소핵이 발현되지 않는 것으로 보아, 방사성옥소는 비교적 안심하고 치료에 사용할 수 있는 제제로 사료되었다.반드시 비례하지만은 않아서 시간경과에 따른 추후 검사가 필요하리라 생각된다. 또한 방광요관역류가 있는 환아에서 DMSA 섭취율로 신기능을 평가할 때, 특히 영유아에서 연령에 따른 고려가 있어야 할 것으로 보인다.었다. 4) $^{99m}Tc-DISIDA$ hepatobiliary scintigram 음성율을

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Heart Rate Variability in Patients with Anxiety Disorder and Effects of Selective Serotonin Reuptake Inhibitor (불안장애 환자에서의 심박변이도와 세로토닌재흡수억제제투여 후의 치료효과)

  • Lee, Kang-Joon;Kim, Hyun;Lee, Seung-Hwan;Park, Young-Min;Chung, Young-Cho
    • Korean Journal of Psychosomatic Medicine
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    • v.14 no.2
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    • pp.94-101
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    • 2006
  • Objectives : A variety of symptoms are typically reported during anxiety period, several of which are clearly linked to the autonomic nervous system(ANS), such as palpitations, chest pain and shortness of breath. Using spectral analysis of heart rate, several studies have shown that patients with anxiety disorder are characterized by a reduced heart rate variability(HRV), indicative of abnormalities in ANS fuction. To further evaluate the effect of anxiety and medication on autonomic function, 30 patients and 30 matched control subjects were assessed. Methods : Using spectral analysis of heart rate, which consisted of standardised measurements of HRV, we compared ANS between 30 patients with DSM-IV diagnosed anxiety disorder and 30 healthy controls, and investigated the autonomic effects of SSRI treatment. Five-minute HRV recordings were obtained before and after SSRI treatment and were analysed. Results : Five-minute HRV recordings in anxiety disorder patients revealed that a significant reduction in HRV was shown compared to controls. There was no significant changes in HRV between before and after SSRI treatment. Conclusion: Anxiety disorder patients showed a significant reduction in HRV compared to controls. SSRIs do not affect HRV influenced by ANS function. Further study is needed to confirm these things. Patients with anxiety disorder may suffer from functional disturbances in the interaction between the sympathetic and parasympathetic autonomic tree.

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