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Korean Medication Algorithm for Bipolar Disorder 2018 : The Elderly (한국형 양극성 장애 약물치료 알고리듬 2018 : 노인)

  • Jung, Young-Eun;Kim, Moon-Doo;Bahk, Won-Myong;Yoon, Bo-Hyun;Jon, Duk-In;Seo, Jeong Seok;Kim, Won;Lee, Jung Goo;Woo, Young Sup;Jeong, Jong-Hyun;Sohn, InKi;Shim, Se-Hoon;Song, Hoo-Rim;Min, Kyung Joon
    • Mood & Emotion
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    • v.16 no.3
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    • pp.123-128
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    • 2018
  • Objectives : The fourth revision of Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was performed to provide more proper guidelines for clinicians. In this study, we evaluated treatment strategies of elderly patients with bipolar disorders of KMAP-BP 2018. Methods : Sixty-one psychiatrists of the review committee with vast clinical experiences in treating bipolar disorders, completed the survey. An expert consensus was obtained, on pharmacological treatment strategies for elderly patients with bipolar disorder. The executive committee analyzed results, and discussed the results to produce the final algorithm. Results : In elderly patients with bipolar disorder, first-line treatment option for acute manic episode is monotherapy, with atypical antipsychotics or mood stabilizer, and a combination of mood stabilizer and atypical antipsychotics. First-line treatment option for acute depressive episode, was a combination of mood stabilizer and atypical antipsychotics, monotherapy with atypical antipsychotic or mood stabilizer, and atypical antipsychotics with lamotrigine. Conclusion : In KMAP-BP 2018, the recommendation for treatment option in elderly patients with bipolar disorder, was newly introduced. We expect this algorithm may provide valuable information, and facilitate treatment of elderly patients with bipolar disorder.

Korean Medication Algorithm for Bipolar Disorder 2018 : Safety and Tolerability (한국형 양극성 장애 약물치료 알고리듬 2018 : 안정성과 내약성)

  • Sohn, InKi;Bahk, Won-Myong;Yoon, Bo-Hyun;Jon, Duk-In;Seo, Jeong Seok;Kim, Won;Lee, Jung Goo;Woo, Young Sup;Jeong, Jong-Hyun;Kim, Moon-Doo;Jung, Young-Eun;Shim, Se-Hoon;Song, Hoo-Rim;Min, Kyung Joon
    • Mood & Emotion
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    • v.16 no.3
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    • pp.134-139
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    • 2018
  • Objectives : Treatment for bipolar disorder is often complicated by various clinical situations. We undertook a survey of expert opinions to facilitate clinical decisions in special situations such as weight gain, metabolic syndrome, hyperprolactinemia, genetic counseling, and treatment adherence. Methods : A written survey that asked treatment strategies related to safety and tolerability, was prepared focused on weight gain, antipsychotic related hyperprolactinemia, lamotrigine related skin rash, treatment non-adherence and genetic counseling. Sixty-one experts of the review committee completed the survey. Results : In the case of weight gain related to medications, experts preferred exercise and education for diet-control. First chosen medications were lamotrigine, aripiprazole and ziprasidone. Recommendations based on expert survey results for treatment of bipolar patients in other special situations are outlined. Conclusion : With limitation of expert opinions, authors hope that results of this study provide valuable information to make clinical decisions about treatment of bipolar disorder in complicated situations.

Change in the Prevalences and Risk Factors of Atrophic Gastritis and Intestinal Metaplasia in Korea: Multicenter Clinical Trials (위축성 위염과 장상피화생의 유병률 변화 및 위험인자의 변화: 다기관 연구 비교)

  • Hwang, Young-Jae;Kim, Nayoung;Kim, Sung Eun;Baik, Gwang Ho;Lee, Ju Yup;Park, Kyung Sik;Joo, Young-Eun;Myung, Dae-Seong;Kim, Hyeon Ju;Song, Hyun Joo;Kim, Heung Up;Nam, Kwangwoo;Shin, Jeong Eun;Kim, Hyun Jin;Kim, Gwang Ha;Lee, Jongchan;Lim, Seon Hee;Seo, Geom Seog;Choi, Suck Chei
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.4
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    • pp.247-257
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    • 2018
  • Background/Aims: The aim of this study was to analyze the trend of the prevalences of atrophic gastritis (AG) and intestinal metaplasia (IM) from 2011 to 2016~2017 in Korea. And, the risk factors of AG and IM were compared between 2011 and 2016~2017. Materials and Methods: A total of 4,023 subjects in 2011 and 2,506 subjects in 2016~2017 were enrolled. AG and IM were diagnosed on the basis of endoscopic findings. Multivariate analysis was performed for risk factors of AG and IM. Seventeen factors were analyzed. Results: The seroprevalence of Helicobacter pylori decreased from 2011 (59.8%; 2,407/4,023) to 2016~2017 (51.6%; 1,293/2,506; P<0.001). The prevalence of AG decreased from 2011 to 2016~2017 (P=0.018), but that of IM increased (P<0.001). The risk factors of AG in 2011 were male sex, old age, H. pylori immuoglobulin G (IgG) positivity, family history of gastric cancer (GC), and high-salt diet. For IM in 2011, the risk factors were male sex, old age, H. pylori IgG positivity, and family history of GC. Risk factors of AG in 2016~2017 were old age, H. pylori IgG positivity, and country of residence. For IM in 2016~2017, the risk factors were male sex, old age, family history of GC, high fasting glucose level (${\geq}126mg/dL$), H. pylori IgG positivity, and low income level. Conclusions: The difference in prevalence trends of AG and IM between 2016~2017 and 2011 could be the result of the different risk factors of AG and IM, such as decreased prevalence of H. pylori infection.

Comparison of Regional Variation in Food Component of Top Shell, Omphalius pfeifferi capenteri (어획지별 바다방석고둥의 식품성분 특성)

  • HA Jin-Hwan;KIM Poong-Ho;SIM Hyo-Do;KIM Jin-Soo;KIM In-Soo
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.34 no.4
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    • pp.384-388
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    • 2001
  • In order to investigate regional variation of food component in the top shells, Omphalius pfeifferi capenteri, caught from Jeju, Sogwipo, Hallim and Songsan, Jeju island, Republic of Korea, food sanitary (heavy metal and volatile basic nitrogen), nutritional (mineral, total amino acid contents, fatty acid composition), taste (extractive nitrogen) components and sensory evaluation (color, texture and taste) were measured. From the result of the contents of heavy metal and volatile basic nitrogen, the top shell might not invoke health risk in using food source, The extractive nitrogen contents of top shell were $343.0\~385.4\;mg/100\;g$. The amounts of total amino acids were $12.5\~13.2\;g/100\;g$, and the major compound among them were glutamic acid, proline and aspartic acid. The major compound among mineral were sodium, calcium, potassium and magnesium. In fatty acid composition, polyenes with essential component or healthy functionality such as 20:4n-6, 20: 5n-3 and 22: 5n-3 were the major components. But, lipid content was extremely small. Judging from the results of chemical and sensory evaluation described a above, food components were not different among top shells caught from various area.

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Korean Medication Algorithm for Bipolar Disorder 2018 : Children and Adolescents (한국형 양극성 장애 약물치료 알고리듬 2018 : 소아/청소년)

  • Shim, Se-Hoon;Bahk, Won-Myong;Yoon, Bo-Hyun;Jon, Duk-In;Seo, Jeong Seok;Kim, Won;Lee, Jung Goo;Woo, Young Sup;Jeong, Jong-Hyun;Kim, Moon-Doo;Sohn, Inki;Song, Hoo-Rim;Min, Kyung Joon
    • Mood & Emotion
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    • v.16 no.3
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    • pp.109-122
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    • 2018
  • Objectives : The objective of this study was to revise the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) 2014: Children and Adolescents. Methods : We performed the survey, using a questionnaire comprising 22 questions according to each situation, in children and adolescents with bipolar disorder. Results : First-line pharmacotherapeutic strategies for manic episode in children with bipolar disorder were a combination of mood stabilizer (MS) and an atypical antipsychotics (AAP), monotherapy with an AAP, risperidone, and aripiprazole. Aripiprazole was selected as first-line medication for depressive episode in children with bipolar disorder, and aripiprazole, and risperidone were selected as first-line at high-risk children. First-line pharmacotherapeutic strategies for manic episode in adolescents were a combination of MS and an AAP, monotherapy with an AAP valproate, lithium, risperidone (Treatment of Choice, TOC), aripiprazole, and quetiapine. First-line pharmacotherapeutic strategies for depressive episode in adolescents, were a combination of an atypical antipsychotics and lamotrigine, valproate, aripiprazole (TOC), risperidone, and quetiapine. For depressive episodes in adolescents at high risk for bipolar disorder, valproate, aripiprazole (TOC), and risperidone were selected as first-line medication. Conclusion : We expect that the present KMAP-BP 2018-children and adolescents, is useful for clinicians to treat children and adolescents with bipolar disorder.

Korean Medication Algorithm for Bipolar Disorder 2018 : Medical Comorbidity (한국형 양극성 장애 약물치료 알고리듬 2018 : 신체 질환이 동반되었을 경우)

  • Song, Hoo Rim;Bahk, Won-Myong;Yoon, Bo-Hyun;Jon, Duk-In;Seo, Jeong Seok;Kim, Won;Lee, Jung Goo;Woo, Young Sup;Jeong, Jong-Hyun;Kim, Moon-Doo;Sohn, InKi;Shim, Se-Hoon;Min, Kyung Joon
    • Mood & Emotion
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    • v.16 no.3
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    • pp.129-133
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    • 2018
  • Objectives : The fourth revision of Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was performed in 2018, to provide newer guidelines for clinicians. In this section, we examined expert opinions to facilitate clinical decisions relative to treating bipolar disorder with medical comorbidity. Methods : The survey was completed by the review committee, consisting of 61 experienced psychiatrists. This part of the survey constitutes treatment strategies, under major medical comorbidities. The executive committee analyzed results, and discussed the final production of algorithm. Results : Aripiprazole was the first-line medication for bipolar patients with metabolic syndrome, cardiovascular, hepatic, renal, and cerebrovascular comorbidities. Ziprasidone also was recommended as the first-line medication in case of metabolic syndrome. Lithium also was regarded as the first-line medication, in case of hepatic problems. Valproate also was considered as the first-line medication, in case of cerebrovascular problems. Conclusion : This study provided the most recent consensus among experts, for treatment of bipolar disorder with physical problems.

Pasture Production as Affected by Two Varieties of Tall Fescue(Festuca arundinacea Sch.) Fawn and Roa on Grazing Pasture (방목 혼파초지에서 Endophyte 감염과 비감염 Tall fescue품종 차이에 따른 목초생산성 및 토양 이.화학성에 미치는 영향)

  • Kim, M.C.;Hyun, Y.J.;Chang, D.J.
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.23 no.4
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    • pp.247-254
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    • 2003
  • A study was carried to compare two varieties of tall fescue(Festuca arundinacea Schr.): Fawn (endophyte infection) and Roa(endophyte-free). The study examined plant height, botanical composition, and dry matter yield of mixed pasture. The cattle grazed on a mixed pasture of tall fescue species and orchardgrass(Dactylis glomerata L.), perennial ryegrass(Lolium perenne L.) and white clover(Trifolium repens L.) during March 22, 1997, to September 21, 1997. The number of grazing animals was 4.3/ paddock(50m x50m) and was adjusted according to the condition of pasture. Dry matter yields determined on ungrazed pasture(7-time harvests) were 1,690 $\pm$407kg and 1,128 $\pm$ 238kg/ha on pastures consisting of Fawn and Roa, respectively. This difference was significant(P<0.01). There were 17.71 $\pm$ 1.27cm and 12.83$\pm$0.90cm in average plant lengths of Fawn and Roa(P<0.01), respectively The botanical composition of tall fescue and orchardgrass in the mixture treatment included in the Fawn variety were shown in 34.2 and 3.8%, comparing Roa with 17.1 and 9.6%, on the 21th of September, 1997, respectively. Tall fescue Roa represented a higher botanical composition than orchardgrass(a main species on Cheju). Crude protein content of Fawn was slightly less than that of Roa. From these results, we may conclude that Roa variety is nutritionally better, but is less adaptible to high temperature climate than Fawn. However, Roa variety is still better than orchardgrass in high temperature conditions.

Etiology and Risk Factors of Community-Acquired Pneumonia in Hospitalized Children During the COVID-19 Pandemic in South Korea (국내 코로나19 판데믹 기간 발생한 입원을 요하는 소아청소년 지역사회폐렴의 원인과 위험 인자)

  • Hae Min Kang;Seung Ha Song;Bin Ahn;Ji Young Park;Hyunmi Kang;Byung Ok Kwak;Dong Hyun Kim;Joon Kee Lee;Soo-Han Choi ;Jae Hong Choi;Eun Hwa Choi;Ki Wook Yun
    • Pediatric Infection and Vaccine
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    • v.30 no.1
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    • pp.20-32
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    • 2023
  • Purpose: This study aimed to identify the etiology and risk factors of community-acquired pneumonia (CAP) requiring hospitalization in Korean children during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Clinical information of children admitted with CAP to Seoul National University Children's Hospital (SNUCH) between January 1, 2021, and February 28, 2022, was retrospectively collected and analyzed. In addition, the etiologic diagnosis and demographic data of children with CAP who were discharged at the other seven hospitals between January and February 2022 were collected. Pneumonia was diagnosed using strict criteria comprising clinical symptoms, physical examination findings, and chest radiographic findings. Results: Among 91 children hospitalized with CAP at SNUCH during the 14-month period, 68.4% were aged <5 years and 79.1% had underlying diseases. Among the 95 CAP cases, respiratory assistance was required in 70.5%, and the use of a ventilator was required in 20.0%. A total of five patients expired, all of whom were either immunocompromised or had underlying neurological diseases. Neurological diseases and immunosuppression were significantly correlated with respiratory assistance (P=0.003) and death (P=0.014). A total of 55% of the detected respiratory pathogens were viruses, the most common of which was rhinovirus at 35.9%. Among the 169 children hospitalized for CAP at the eight institutions, ≥1 respiratory virus was detected in 92.3%, among which respiratory syncytial virus (79.8%) was the most prevalent. Conclusions: Even during the COVID-19 pandemic, Korean children were hospitalized with CAP caused by seasonal respiratory viral pathogens. Although atypical and pyogenic bacteria were not detected, continuous clinical monitoring and further prospective studies should be conducted.