• Title/Summary/Keyword: 비약물적 치료

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Outcome of Conservative Treatment for Patients with Disc Displacement of Temporomandibular Joint (측두하악관절 원판변위 환자의 보존적 치료결과)

  • Kim, Kyung-Hee;Kim, Ik-Hwan;Ko, Myung-Yun;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.32 no.3
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    • pp.305-318
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    • 2007
  • To evaluate the treatment outcome after conservative treatment in patients with TMJ disc displacement which is the most common temporomandibular joint arthropathy, the subjects were chosen among the patients who presented to the Department of Oral Medicine of Pusan National University Hospital, diagnosed as TMDs and treated with conservative methods from 1994 to 2006 for 13 years. 88 patients with diagnosis of DD/cR and 60 patients with diagnosis of DD/sR were selected as the experimental group and 74 patients with diagnosis of masticatory muscle disorder (MMD) were selected as the control group. Subjective symptoms and clinical findings were investigated to evaluate and compare the subjects' status at the first visit and the last visit. The results were as follows; 1. Pain, noise, LOM and MCO measurements of DD/cR, DD/sR and MMD groups were markedly improved after conservative treatments including behavior therapy, physical therapy, medication and splint therapy. 2. At the first visit, high score of pain in MMD group, high score of noise and large MCO measurement in DD/cR group and high LOM score in DD/sR group were observed. At the last visit, high score of noise and increased MCO measurement in DD/cR group and high score of pain and LOM in DD/sR group were observed. 3. Among the patients who complained joint sound at their first visit, about 60% showed complete loss of joint sound after conservative treatment 4. DD/cR and DD/sR groups showed satisfactory outcomes after conservative treatments such as behavior therapy, physical therapy, medication and splint therapy while MMD group showed similar treatment outcome irrespective of the treatment modality used. 5. There was no difference in treatment outcomes after conservative treatments when the subjects were classified and compared according to gender, age group and chronicity. 6. MMD showed satisfactory prognosis in 10 treatments in less than 6 months while DD showed favorable prognosis in 10-20 treatments for 6 months to 2 years.

Surgical Treatment for Cervical Esophageal Cancer (경부식도암에 대한 수술적 치료)

  • Kim, Dae-Hyun;Baek, Hee-Jong;Lee, Hae-Won;Park, Jong-Ho
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.253-259
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    • 2008
  • Background: The incidence of cervical esophageal cancer is low compared with that of thoracic esophageal cancer, and the role of surgery for cervical esophageal cancer is limited compared with that of radiotherapy or chemotherapy. This study was carried out to determine the outcome of surgery for cervical esophageal cancer. Material and Method: We analyzed retrospectively medical records of 43 patients who had undergone curative surgical resection for cervical esophageal cancer from January 1989 to December 2002. Follow-up loss was absent and the last follow-up was carried out in February 28, 2004. Result: The mean age was 60 years old and the male to female ratio was 40:3. Histologic types were squamous cell carcinoma 42 patients and malignant melanoma 1 patient. The methods used for esophageal reconstruction were gastric pull-up 32 patients, free jejunal graft 7 patients and colon interposition 4 patients. Postoperative complications occurred in 31 patients (72%), and operative mortality occurred in 7 patients (16%). Pathologic stages were I 3, IIa 14, IIb 1, III 19, and IVa 6 patients. Tumor recurrence occurred in 16 patients (44%), and the 3 and 5-year survival rates were 29.3% and 20.9%. Conclusion: The reported surgical results for cervical esophageal cancer showed somewhat high operative mortality, postoperative complication rates and recurrence rates and a low long-term survival rate. It is suggested that multimodality treatment including surgery is needed for the treatment of cervical esophageal cancer because radiotherapy or chemotherapy without surgery could not relieve dysphagia or resolve the tumor completely.

Short-lasting headaches in children and adolescents (소아청소년에서 short-lasting headaches)

  • Rho, Young-il
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.869-874
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    • 2009
  • Purpose : Short attacks of headache are present in the pediatric age group. Short-lasting headaches (SLH) have been infrequently reported in children and adolescents. This study aims to assess the prevalence, clinical characteristics, treatment, and prognosis of short-lasting headaches in children and adolescents. Methods : One hundred twenty-three consecutive patients attended the Chosun University Hospital Headache Center between March 2006 and July 2007. Among 123 headache patients, 44 patients with one key criterion, namely, recurrent headaches episodes of a few seconds to less than 30 minutes, were selected. Results : Of the 123 headache patients, 44 (35.8%, males 18, females 26) had SLH. The mean age was 9.24 years (range 2.3-14.2). The mean headache frequency was $11.50{\pm}10.30$ per month, mean severity was $4.86{\pm}1.36$ out of 10, and the mean PedMIDAS score was $7.97{\pm}17.51$. SLH was significantly more common in children <6 years old (10/22, 45.5%) than in ${\geq}6$ years old (34/101, 33.7%) (P=0.015). The nature of pain was pressure in 30.2%, stabbing in 27.9%, throbbing in 18.6%, and dull in 11.7%. In 52.4% patients, the pain occurred in the front, one side of the temple in 28.5%, both sides of the temple in 7.1%, and back in 4.8% patients. The duration of attacks was <6 minutes in 38% and ${\geq}6$ minutes in 61.4%. The intensity of the pain was 4-6 out of 10 in 75.0%, in 13.6% 1-3, and in 11.4% 7-10. Treatment was significantly effective in reducing the frequency, duration, and severity of headaches and the PedMIDAS score after 3 months (P<0.05). Conclusion : Short attacks of headache are common (35.8%) in children and adolescents. These are difficult to classify according to International Headache Society criteria. The outcome, after a period of 3 months to 2 years, was favorable in most patients. Further studies are needed to gather more data and to obtain a better description of these forms of headache in the pediatric group.

A Drug-Induced Liver Injury by Western Medication (양약으로 유발된 약인성 간손상 환자 임상보고)

  • Son, Chang-gue
    • The Journal of Internal Korean Medicine
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    • v.36 no.1
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    • pp.69-75
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    • 2015
  • Objectives : To investigate the clinical features of drug-induced liver injury (DILI) and traditional Korean medicine (TKM) -based management. Methods : A female patient diagnosed with DILI caused by Western drugs had been treated with Oriental therapies, then the subjective clinical outcome and biochemical parameters were monitored. Results : A 73-year-old female had taken Western drugs (nonsteroidal anti-inflammatory and skeletal muscle relaxants) for about 3 months, and complained of severe abdominal discomfort and tiredness. Her RUCAM score was 9, which met the criteria for DILI (AST 90 IU/L, ALT 100 IU/L, ALP 191 IU/L, and GGT 614 IU/L). She was treated with herbal drugs, moxibustion, and acupuncture, and her symptoms completely resolved, with normalized hepatic enzymes within two weeks. Conclusions : This case report provides a clinical characteristic for a typical DILI caused by Western medicine, and shows an example of a TKM-based application.

Analysis of Factors Affecting Medication Adherence to Improve Life Care in Patients with Hypertension (고혈압 환자의 라이프케어 증진을 위한 약물 순응도 영향요인 분석)

  • Gil, Eun-Ha
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.2
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    • pp.213-224
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    • 2020
  • Purpose: This study is a descriptive and secondary analytical study that uses panel data to identify the factors of medication adherence to improve life care of hypertensive patients. Methods: The subjects of this study were 2,484 patients who were taking medication after hypertension using Korea Medical Panel 2015 data (β-version 1.0). Data analysis was performed using Chi-Square, Scheffe's test, and logistic regression using SPSS/win 22.0. Results: The level of medication adherence in patients with hypertension was 94.2%. The factors of medication adherence were gender and age in Model I of demographic factors, and the presence of disability, smoking, and drinking in Model II. Model III, which added drug use factors, was identified as drinking, drug duration, side effects, drug satisfaction, and payment of drug costs. Conclusion: In order to improve life care for hypertension patients, education and interventions on the importance of take medication and side effects of medications and how to take them will be needed in the early stages of diagnosis.

Preparation and Characterization of Solid Dispersions of Eprosartan Using Spray Drying Method (분무 건조 방식으로 제조한 에프로살탄 고체분산체 제조 및 특성 분석)

  • Hwang, Jun Seok;Kim, So Hee;Cho, Sun Hang;Huh, Kang Moo
    • Polymer(Korea)
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    • v.37 no.4
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    • pp.442-448
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    • 2013
  • In this study, we developed and optimized hydrophilic polymer-based solid dispersion formulations (SDs) using a spray drying method for improving the aqueous solubility of eprosartan, one of poorly soluble drugs that has been broadly used for the treatment of high blood pressure. Hydroxylpropylcellulose (HPC) and poly(vinyl pyrrolidone) (PVP) were used as hydrophilic polymer matrices and poloxamer 407 (P407) added as a polymeric surfactant. Various kinds of solid dispersions with different drug/polymer compositions were prepared and their physico-chemical properties were compared. As the polymer content increased, the drug crystallinity in the SDs significantly decreased and the dissolution properties were enhanced. The PVP based SDs were observed to have relatively reduced crystallinity and an enhanced dissolution rate than HPC-based SDs, due to better miscibility between drug and polymer matrix. For PVP based SDs, the drug crystallinity almost disappeared and the dissolution properties significantly increased by more than 3~7 times.

The Improvement Effect of MMSC (DL-Methionine Methylsulfonium Chloride) in Functional Dyspepsia Animal Models (동물모델을 이용한 MMSC(DL-Methionine Methylsulfonium Chloride)의 기능성소화불량증 개선효과)

  • Kim, Jae Min;Cha, Myoung Hee;Lee, Don Haeng;Lee, Woon Kyu
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.12
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    • pp.2076-2081
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    • 2013
  • The objective of this study is to investigate the gastric emptying and gastrointestinal transit improvement effect of DL-methionine methylsulfonium chloride (MMSC) in functional dyspepsia animal models. Cisplatin causes nausea, vomiting, and inhibition of gastric emptying. Rats were divided into four groups: G1 (normal group), G2 (gastric emptying induced by cisplatin), G3 (gastric emptying induced by cisplatin with itopride 30 mg/kg pretreatment), and G4 (gastric emptying induced by cisplatin with MMSC 4 mg/kg pretreatment). Immediately after an oral administration of a liquid meal (phenol red), delayed gastric emptying was induced by cisplatin (10 mg/kg (i.p.)). After 20 min in the cisplatin administration, the animals were sacrificed. In rats treated with cisplatin, the gastric emptying rate was significantly reduced. On the other hand, MMSC reversed the reduction of gastric emptying induced by cisplatin. And also, MMSC caused to travel FITC-dextran more significantly longer distance than the control, which is based on the values of the mean geometric center in the atropine driven delayed gastrointestinal transit animal models. Furthermore, MMSC drastically increased the gastrointestinal transit in rats, considerably increased the values of the mean geometric center (MGC), compared to the control, which was comparable to that of mosapride. These results suggest that MMSC could be an effective component for the treatment of functional dyspepsia.

The Comparison of Behavioral Response of Additional Submucosal Midazolam with Oral Chloral Hydrate, Hydroxyzine and Nitrous Oxide for Pediatric Conscious Sedation (소아 진정 치료 시 Chloral Hydrate와 Hydroxyzine 복용 후 구강 점막으로 투여한 Midazolam의 행동 반응 비교)

  • Park, Hui-Jun;Jung, Sang-Hyuk;Baek, Kwang-Woo
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.7 no.1
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    • pp.6-12
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    • 2007
  • 배경: 소아 진정 치료 시 서로 다른 용량의 chloral hydrate와 hydroxyzine을 복용 후 midazolam을 구강 점막 하 주사했을 때 행동 반응을 비교하였다. 방법: 총 32회 진정법을 통해 치과치료를 받은 30명의 나이 24-72개월, 체중 20 kg 미만의 미국 마취과학회 신체등급 I의 건강하지만 겁이 많고 협조가 안 되는 소아 환자를 대상으로 2개 치아이상의 보존 치료 및 발치를 필요로 하는 환자를 대상으로 하였다. 호흡기 질환이 있는 아이들은 이 연구에서 제외되었다. 연구 계획은 이대 목동 병원의 임상 실험 심사 위원회에 제출되었다. 1군은 chloral hydrate 50 mg/kg와 hydroxyzine 1 mg/kg 복용 후 점막 하 midazolam 0.2 mg/kg을 추가 투여했고 2군은 chloral hydrate 60 mg/kg와 hydroxyzine 1 mg/kg 복용 후 점막 하 midazolam 0.1 mg/kg을 주사 받았다. 50% nitrous oxide는 치료 중 두 군 모두 유지되었다. 전날 수면 시간과 약물 복용 태도를 기록하였으며 모든 치료 과정은 비디오로 촬영되었다. 맥박 산소 계측기를 이용하여 경피적 산소 포화도와 맥박수를 기록하였고 행동 반응은 Houpt scale을 이용하여 매 2분마다 40분 동안 기록되었다. 전반적인 행동 반응은 Houpt scale를 이용하여 평가되었다. 모든 자료는 SPSS 통계 프로그램을 이용하여 two sample independent t-test를 사용하였다. P 값은 0.05 미만인 경우를 통계학적으로 유의하다고 보았다. 결과: 두 군 간의 경피적 산소 포화도와 맥박수는 모두 정상 범위이며 유의한 차이가 없었다. 행동 반응 비교에서는 치료 처음 10분 동안 2군이 1군에 비해 점수가 높게 나왔으며(P < 0.05), 그 외에는 유의한 차이가 없었다. 전날 총 수면 시간과 약물을 복용하는 태도는 수면 치료 중의 행동 반응에 영향을 주지 않았다. 결론: Chloral hydrate 50 mg/kg 복용과 점막 하 midazolam 0.2 mg/kg은 chloral hydrate 60 mg/kg 복용과 점막 하 midazolam 0.1 mg/kg과 비교할 때 두 약물의 조합은 모두 소아 환자 수면 치료시 안전하고 효과적인 용량이다. Overall behavior와 Q (quiet)의 분포를 비교해 볼 때 두 군 모두 성공적인 진정효과를 기대할 수 있다.

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Effect of Pilocarpine Mouthwash on Xerostomia (구강건조증에 대한 필로카핀 구강양치액의 효과)

  • Kim, Ji-Hyun;Park, Ju-Hyun;Kwon, Jeong-Seung;Ahn, Hyung-Joon
    • Journal of Oral Medicine and Pain
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    • v.36 no.1
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    • pp.21-24
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    • 2011
  • Xerostomia is subjective feeling of dry mouth, a symptom that may or may not be accompanied by hyposalivation, an objective decrease in salivary flow. There are many causes induced xerostomia like drugs, salivary gland diseases, radiation therapy to the head and neck region, Sjogren syndrome, emotional stress etc. Insufficient salivary flow creates complications with oral candidiasis, dental caries, periodontitis, halitosis, dysgeusia. So finally, these complications lead to an overall decline in quality of life. Managements of xerostomia are eliminating or alterating the etiologic factors, relieving symptoms, preventing or correcting the consequences of salivary dysfunction, treating underlying disease and stimulating salivation. One of the salivation stimulation agents studied to treat xerostomia was the pilocarpine muscarinic agonist. Pilocarpine is one of salivation stimulants, a parasympathomimetic drug and non-selective muscarinic receptor agonist. Systemic pilocarpine has been used to stimulate salivary secretion. But systemic administration of pilocarpine has limitations such as increased risk of side effects and contraindications. Side effects of systemic pilocarpine administration are sweating, urinary and gastrointestinal disturbance, risk of cardiovascular and pulmonary disorders. This drug must be used carefully by patients with controlled asthma, chronic bronchitis, pulmonary or cardiac disease. Patient with acute asthma, narrow angle glaucoma, iritis should not use pilocarpine. Like this, systemic pilocarpine has many limitations. So, many investigators also have looked at the effectiveness of topical pilocarpine. Here we present patients with xerostomia which was relieved by pilocarpine mouthwash.

Clinical Diagnosis and Its Medical Managements from Patients with Gastrointestinal Diseases (위장관 질환자의 임상진단과 치료방법)

  • 김재웅
    • The Korean Journal of Food And Nutrition
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    • v.10 no.2
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    • pp.186-192
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    • 1997
  • Endoscopic diagnosis and medical management from K43 and C45 patients, whose sex, occupation, character and life patterns are quite different each other, were discussed. The K43 was patient with erosive gastritis, which may caused by maldietary habits and life stresses. Although the effective drugs such as H2-receptor antagonists with atacids, H+/K+-pump inhibitors, prokinetics, colloidal bismuth, and sucralfates, were administrated for long time, symptomatic relief of abdominal pain was not improved. The tests of clinical phathology and abdominal sonogram were normal, visceral hypersensitivity was appeared from barostat test of stomach. However C45 had taken headache during every day life, and endoscopically confirmed as a gastric·duodenal ulcer patiant, which may caused by chronic use of NSAIDs. The her ulceric symptoms were suppressed from active stage to healing stage by using combination therapy for H. pylori with traditional antipeptic ulcer drugs, where as amitriptyline was administrated to the K43 but not effective. Nonulcer dyspepsia and irritable bowel syndrome is pooly defined, and affect about 15% of the population annually in U. S. A. but don't seek medical care. Author would like to point out that statistics for visceral pains are absent in Korea.

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