• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.21 no.3
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• pp.174-181
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• 2010

Objectives: To identify the factors affecting long-term adherence to methylphenidate treatment in children with attention-deficit hyperactivity disorder (ADHD). Methods: A retrospective medical record review of 239 ADHD patients (mean age $9.3{\pm}2.6$ years, range 6.0-17.4 years) who had visited the child and adolescent psychiatry clinic at a university hospital, in Seoul, Korea from March 2005 to February 2008. Subjects were diagnosed as ADHD based on the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders 4th edition, text revision version (DSM-IV-TR) and underwent neuropsychological tests including the continuous performance test (CPT). Treatment discontinuation was defined as the last prescription date when the medication possession rate (MPR) became less than 0.80. Subjects were divided into three groups and labeled as Group I, non-adherence without pharmacotherapy, Group II, non-adherence with short-term pharmacotherapy, and Group III, adherence with long-term pharmacotherapy. Results: Ninety (37.7%) patients were grouped as non-adherent (Groups I+II) and 149 (62.3%) as adherent (Group III). The adherence group exhibited lower intelligence, higher symptom severity, and a higher number of comorbid psychiatric disorders than controls. The use of stimulants was significantly associated with long-term adherence to treatment. Additionally, the duration of interval between the date of the first visit and the date of the first prescription was positively associated with long-term adherence. Conclusion: About two-thirds of patients diagnosed as ADHD adhered to the treatment six months after the first visit. With respect to patient evaluation and the development of treatment strategies, factors affecting early drop-out and longer follow-up must be considered.

• Korean Journal of Occupational Health Nursing
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• v.11 no.2
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• pp.91-107
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• 2002

In order to evaluate the factors related to therapeutic compliance of hypertensive patients in small and medium scale industry, the questionnaire survey and the blood pressure measurement were performed on 138 hypertensive patients who were reported to have C or $D_2$ result of hypertension at the workers' periodic health examination from March to November 2001. The contents of questionnaire included the informations of factors related to therapeutic compliance of hypertensive patients such as, age, sex, marital status, income, education levels, scale, occupation, work duration, smoking and drinking habits, exercise, family history, stress and A type personality, employer's concern, organizational culture, health status, awareness, knowledge and attitude toward the needs of hypertension treatment, and experience of health education. The results of the study were as follows: 1. The proportion of those who were compliant to the treatment of hypertension was 41.3% of subjects. Among small scale industry less than 50 employees, the rate of therapeutic compliance group was 27.5% and therapeutic noncompliance group was 72.5%. Among medium scale industry more than 50 employees, the rate of therapeutic compliance group was 60.3% and therapeutic noncompliance group was 39.7%. 2. Among therapeutic noncompliance group, 95.1% of patients were aware of the fact that workers have hypertension, and 77.8% of patients got 6-10 marks of hypertension related knowledge. For health education, 27.2% were experienced and 34.6% said no intention to participate. And for hypertension treatment, 9.9% said no need to get the treatment and 44.4% said have no idea whether get treatment or not. 3. The significant factors related to therapeutic compliance of hypertensive patients in small scale industry were work duration, A type personality(anger), health status, attitude toward the needs of hypertension treatment, and experience of health education. 4. The significant factors related to therapeutic compliance of hypertensive patients in medium scale industry were age, occupation, subjective symptom, attitude toward the needs of hypertension treatment, and experience of health education. In consideration of above findings, it was suggested that in order to improve the therapeutic compliance in small and medium scale industry hypertensives, it be necessary to change attitude, perception, knowledge and treatment of hypertension by various methods such as effective health education and individually consulting programs by occupational health professional.

• The Journal of Korean society of community based occupational therapy
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• v.9 no.2
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• pp.33-42
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• 2019

Objective : The aim of this study was to evaluate the current knowledge regarding constraint-induced movement therapy (CIMT) and its application in clinical practice by physiatrists and therapists in pediatric rehabilitation area in Korea. Methods : Online survey via E-mails was sent to a total of 510 members (204 physiatrists and 306 therapists) of the Korean Society of Pediatric Rehabilitation and Developmental Medicine (KSPRDM). Results : The response rate was 35.1% (179 of 510). A total of 179 questionnaires was completed by 39 physiatrists, 89 physiotherapists, 48 occupational therapists, and 3 speech therapists. 45.8% of responders had worked over 6 years in the pediatric rehabilitation setting and a total of 58.1% (n=104) of the sample had used CIMT. The main limitations of clinically applying CIMT included limited staff and inappropriate clinical setting (35.1%, n=61), lack of understanding (19.5%, n=34), and developmental issues of function on the unaffected side (13.8%, n=24). The cooperation of patients (77.6%, n=76), cognitive/behavioral factors (42.9%, n=42), and cooperation of caregivers (25.5%, n=25) were the 3 major concerns that could be limitations with CIMT. Conclusions : Although considerable evidence supports the use of CIMT, many of physiatrist and therapists do not apply this method in practice. The improvement of limitations is necessary for wide use of CIMT in clinical practice in Korea.

• Korean Journal of Psychosomatic Medicine
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• v.2 no.1
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• pp.3-9
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• 1994

The psychobiological model of cancer has a long history, with Galen's view on melancholic woman being often quoted. From a historical perspective, the 1950s witnessed a surge of interest in psychosomatic medicine and in researches linking psychological, social, and environmental factors to disease onset and progression. The 1960s witnessed the growth of animal experiements, in the hope of better understanding the effects of psychological and behavioral factors on carcinogenesis while controlling confounding variables. The 1970s saw rapid advances in immunology and neurochemistry. Further researches in the 1980s in psychoneuroimmunology explored relationships between immunological responses and psychosocial variables, and their implications for cancer vulnerability and progression. In this review, the interacting aspects of oncology and psychiatry are presented with selected major findings in the fold of psychooncology researches.

• The Korean Society of Law and Medicine
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• v.16 no.2
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• pp.55-84
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• 2015

The tuberculosis is the infectious disease. Generally, the active tuberculosis patient can infect the 10 persons for one year within the daily activities like casual conversation and singing together. The infectivity of tuberculosis can continue for a life time, and infected persons can remain at risk for developing active tuberculosis. To control this contagious disease, along with the active tuberculosis patients, non-infectious but non-compliant patients who can be infectious if their immune systems become impaired have to be managed. To control the non-complaint patients, medical treatment order should be combined with the public order. Because tuberculosis is the risk of community health, the human rights like liberty and freedom of movement can be restricted for public welfare under the article 37(2) of constitution. Even when such restriction is imposed, no essential aspect of the freedom or right shall be violated. The degree of restriction on the rights of citizens is different what methods are chosen to non-complaint patients. For example, under the directly observed therapy program, the patients and medical staffs make an appointment and meet to confirm the drug intakes according to the schedule, which is the medical treatment combined with the mildest public order. If the patients break the appointments or have the history of disobedient, the involuntary detention can obtain the legitimate cause. The Tuberculosis Prevention Act has the two step programs on this involuntary detention, The admission order (Article 15) is issued when the patients are infectious. The quarantine order (Artle 15-2) is issued when the patients are infectious and non-complaint. The legal criteria for involuntary detention are discussed and published through the international conventions and covenants. For example, World Health Organization had made guidance on human rights and involuntary detention for tuberculosis control. The restrictions should be carried out in accordance with the our law and in the legitimate objective of public interest. And the restriction should be based on scientific evidence and not imposed in an unreasonable or discriminatory manner. We define and adopt these international criteria under our constitution and legal system. Least restrictive alternative principle, proportionality principle and the individual evaluation methods are explained through the reviews of United States court decisions. Habeas Corpus Act is reviewed and adopted as the procedural due process to protect the patient rights as a citizen. Along with that, what conditions and facilities which are needed to performed quarantine order are discussed.

• Journal of Digital Convergence
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• v.11 no.9
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• pp.255-265
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• 2013

The purpose of this study was to identify the variation factors of hypertension medication rate between regions and to use them as a basic data for establishment of hypertension management business plan which is customized by region. The data were collected from community health survey, National Statistics Office and National Health Insurance Corporation, and were analyzed using the geographically weighted regression. As the result of analysis, the factors that influenced the hypertension medication rate between regions were subjective recognition rate of health level, the rate of medical aid client and the number of health facility per one hundred thousand of population. According to the geographically weighted regression, the total of 230 regional regression models composed of major variables which affected the hypertension medication rate were calculated. However, this study has several limitations that the explanatory power of model is not high and others. Therefore, a follow-up study which is based on the actual data of compliance with hypertension medication will be necessary.

• The Korean journal of helicobacter and upper gastrointestinal research
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• v.18 no.4
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• pp.277-279
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• 2018

전 세계적으로 Helicobacter pylori의 항생제 내성률은 지속적으로 증가하고 있으며, 기존의 제균 치료에 실패한 H. pylori 감염 환자들에 대한 효과적인 구제요법(rescue therapy)의 필요성 역시 증가하고 있다. 이 연구는 두 개 기관, 공개, 평행 그룹, 무작위 배정 연구로서 불응성 H. pylori 감염 환자들의 구제요법으로 유전자형 내성을 기반한 치료(genotype resistance-guided therapy)와 경험적 치료(empirical therapy) 중 어느 것이 보다 효과적인지를 비교하고자 하였다. 2012년 10월부터 2017년 9월까지 20세 이상의 불응성 H. pylori 감염 환자들을 대상으로 하였으며, 불응성 H. pylori 감염은 과거 두 종류 이상의 H. pylori 제균 치료를 받았음에도 불구하고 H. pylori 제균에 실패한 환자들로 정의하였다. 이들에게서 한 군은 14일간의 유전자형 내성을 기반한 순차 치료(n=21 in trial 1, n=205 in trial 2)를, 다른 한 군은 환자들의 과거 제균 치료 종류를 감안한 14일간의 경험적 순차 치료(n=20 in trial 1, n=205 in trial 2)를 시행하였다. 순차 치료법은 첫 7일은 esomeprazole 40 mg과 amoxicillin 1 g을 하루 두 번 복용한 다음, 나머지 7일은 esomeprazole 40 mg과 metronidazole 500 mg, 그리고 1) levofloxacin 250 mg 또는 2) clarithromycin 500 mg 또는 3) tetracycline 500 mg을 하루 두 번 복용하는 것으로 구성하였다. 23S ribosomal RNA (rRNA)나 gyrase A에 대한 내성 관련 돌연변이 여부는 direct sequencing을 통한 중합효소연쇄반응(polymerase chain reaction, PCR) 검사를 이용하였고, 제균 성공 여부는 요소호기검사를 통해 확인하였다. 일차 결과 지표는 치료 방법에 따른 제균율로 정하였다. Trial 1에서는 tetracycline 대신 doxycycline 100 mg을 사용하였는데, 제균 성공률이 유전자형 내성을 기반한 치료군에서는 17명(81%), 경험적 치료군에서는 12명(60%)으로 나타났다(P=0.181). 하지만, 다른 순차 치료군들과 비교하였을 때, doxycycline을 포함한 순차 치료군의 제균율이 현저히 낮은 것으로 나타나서(15/26, 57.7%) doxycycline을 포함한 순차 치료법은 종결하기로 하고, trial 2부터는 doxycycline 대신 tetracycline으로 교체하여 연구를 지속하였다. Trial 2의 intention-to-treat (ITT) 분석 결과, 유전자형 내성을 기반한 치료군에서는 160/205명(78%), 경험적 치료군에서는 148/205명(72.2%)으로 두 그룹 간의 통계적인 제균율의 차이는 보여주지 못하였다(P=0.170). 부작용 및 환자 순응도에서도 양 군 간의 의미 있는 차이는 없었다. 따라서, 두 종류 이상 H. pylori 제균 치료에 실패한 환자들이라고 할지라도 기존의 제균 치료력을 바탕으로 적절한 경험적 치료를 시행하는 것은 유전자형 내성을 기반한 치료 정도의 효과는 있으며 접근성, 비용, 환자들의 선호도 등의 여러 가지 부가적인 사항들을 고려할 때, 제균 치료력을 고려한 경험적 치료는 간단한 수준의 유전자형 내성을 기반한 치료의 대안으로 받아들여질 수 있을 것으로 제안하였다.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.10 no.2
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• pp.425-431
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• 2009

To provide fundamental educational materials for the effective management of patients with high blood pressure and diabetes in korea, and to expand the scope of such educational businesses the survey was administered between September 2007 and February 2008 to 1,213 consenting patients suffering from high blood pressure and diabetes in private medical centers within Daejeon in Korea. The patients were provided with standardized education materials and were monitored whether they were conducting a controlled management of their blood pressure and diabetes level as well as monitoring changes in their daily routine. Out of the 1,213 patients, 51.3% of the patients suffered only from high blood pressure, 26.3% suffered only from diabetes and 22.4% suffered from both high blood pressure and diabetes (Condor difference was not considered in this research). Physical education was the most commonly used education upon visitation to these medical centers, which was then followed by eating habits and weight management, respectively. The education demanded and preferred from the patients was similar to the education provided during the visitations. 56.7% of the medical doctors responded that the majority of the patients were passive in controlling and managing their illnesses. 63.7% of the participants believed that the education provided through this research was effective.

• Korean Journal of Psychosomatic Medicine
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• v.4 no.1
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• pp.138-145
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• 1996

The behaviors associated with illness are different depend upon individuals even if Patients complaints same symptoms and have same disease. Understanding the patterns of those behaviors become one of the important elements in determining the diagnostic and treatment approaches and treatment compliance. The sick role plays a essencial part in abnormal illness behavior. The characteristics of abnormal illness behavior ran be applied to many parts in medicine. In case of the various kinds of functional disorders whose organic foundations are obscure and in applying the cognitive therapy, rehabilitation program and occupational therapy, the assessment and evaluation of the abnormal illness behvior is known to be beneficial. For improving the comprehensive psychiatric treatments which could be applied to the Koreans more effectively in patients with somatoform disorders and other various kinds of neurotic disorders further researches especially on the medico-historical and socio-cultural aspects of the illness behavior should be followed. And understanding the abnormal illness behavior would be helpful in enhancing the medical cost effectiveness.

• 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.