• Title/Summary/Keyword: Behavioral symptoms

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Evaluation on the Quality of Research Field with Traditional Herbal Prescriptions for Dementia Therapy (치매 치료용 한약 처방의 연구성과에 대한 정성평가)

  • Heo, Eun-Jung;Kang, Jong-Seok;Kang, Hyung-Won;Jeon, Won-Kyung
    • Journal of Oriental Neuropsychiatry
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    • v.23 no.1
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    • pp.93-114
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    • 2012
  • Objective : This study aimed to review the performance of traditional herbal prescriptions for treating dementia and present a strategy for research on dementia therapy utilizing herbal medicine. Methods : A definition was made to clarify the technology regarding the development of herbal prescriptions for treating dementia. The queries were compounded based on the initial keywords provided by experts in the field, then applied to the Web of Science database search engines from January 1986 to September 2011 to search related scientific articles. Before performing the analysis, papers were extracted from the initial search reviewed by experts and 80 articles were selected. Then, the selected papers were analyzed in terms of publish year, country, and type of herbal prescriptions. Furthermore, the research performance evaluation for treating dementia by herbal prescriptions was also created in terms of country and organization based on forward citation analysis. In addition to, for the evaluation regarding research quality, we classified and reviewed papers into two types: clinical studies and experimental studies. Results : According to the quantitative information analysis of 80 articles, the number of papers has increased by 21.9% per the yearly mean from 1995, and Japan had the largest portion within this research field. There were 34 kinds of traditional herbal prescriptions, among them Ukgansan had the highest number of studies followed by Jodeungsan, Dangkisoosan and so on. In addition, quality index as calculated by cites per paper is higher than average in Switzerland, Turkey and Japan. In the view of the evaluation on quality there were 12 clinical studies, 8 RCT reported that herbal prescriptions had efficacy at cognition, behavioral & psychological symptoms (BPSD) and activity of daily life (ADL) in various type of dementia. In experimental studies most of the studies were performed using animal models. The studies using Ukgansan were aimed at improving BPSD. The papers studied with Jodeungsan and Dangkisoosan targeted vascular dementia. Conclusions : In this study, research to develop traditional herbal prescriptions for treating dementia has the potential to improve symptoms since herbal medicines work as both multi-function and multi-target in dementia with multiple pathological or neurotoxic pathways. Therefore, the results of the research should be used in order to establish strategies to develop technology for treating dementia with traditional herbal prescriptions in the future.

An Analysis of Resourcefulness Research (자원동원성 연구논문 분석)

  • Suh, Soon Rim;Lee, Eun Ok;Kim, Jung Hee
    • Korean Journal of Adult Nursing
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    • v.13 no.1
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    • pp.15-28
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    • 2001
  • The purpose of this study was to identify the trends of resourcefulness researche studies for suggesting the future direction of study. Study design, types of subjects, measurement tools, study concept, and outcome were examined by reviewing 61 research studies published from 1980 to 1999. The results were as follows: 1. There were 24 works in the 1980s and 37 works in 1990, according to the published year of resourcefulness study. Nonexperimental studies like descriptive study, correlational study and comparative study were more frequent than experimental studies. 2. Research studies that consisted of 30- 100 subjects were the most numerous with 27 studies in all. The majority of study subjects was shown as healthy students and depressive patients. 3. Most studies used Rosenbaum's Self Control Schedule(SCS) for assessing resourcefulness. Reliabilities of resourcefulness researches were cronbach ${\alpha}=.70$ or more. According to statisitical tests done for internal validity, SCS was negatively correlated to maladaptation. Factor analysis revealed that the most parsimonious structure was 3 to 6 factors. The total communality variance in the SCS was about 40 %. Other tools used with the SCS were about coping, depression, satisfaction of life and symptoms, self management and health promotion. 4. In correlational studies, concepts like depression, anxiety, and psychological symptoms were related to resourcefulness negatively. Adaptive functioning, life satisfaction and self achievement had positive correlations to resourcefulness. 5. Studies on comparison between a healthy person and depressive patient or smoker and non-smoker were done. There were coping, depression, symptom, self efficacy, health problem and self-control as comparative concepts. 6. Study subjects consisted of depressive patients in 9 of 18 experimental studies. The majority of studies were done with cognitive-behavioral therapy as an experimental intervention. The most effective treatment was revealed in high resourcefulness group. Since the above findings, resourcefulness research increased since 1980 and mostly non-experimental design for quantitative study were done. In the field of nursing, research about resourcefulness was in an initial stage. It is expected that further research needed to be done. Recommendations on the basis of the present research suggest that it is necessary to replicate studies, develop nursing intervention enhancing resourcefulness and apply it to patients with chronic diseases including cancer.

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Aerodynamic Features and Voice Therapy Interventions of Functional Voice Disorder after Thyroidectomy (갑상선 절제 술 후 기능적 음성장애의 공기역학적 특징과 음성치료 중재)

  • Lee, Chang-Yoon;An, Soo-Youn;Chang, Hyun;Jeong, Hee Seok;Son, Hee Young
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.26 no.1
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    • pp.25-33
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    • 2015
  • Background and Objectives:The objective of this study was to investigate the features of post-thyroidectomy subjective voice disorder by Voice Handicap Index (VHI) and Voice Symptom Scale (VOISS) through aerodynamic analysis and to investigate the appropriate voice therapy intervention. Materials and Methods:Twenty post-thyroidectomy patients who had no recurrent laryngeal nerve paralysis through laryngeal stroboscopy were enrolled for this study. Acoustic and aerodynamic evaluations were performed before operation, 2 weeks and 3 months after operation. Subjective voice evaluation was performed by VHI and VOISS. Aerodynamic evaluation was compared and analysed by maximum phonation time(MPT), phonation threshold pressure(PTP), mean air flow rate(MFR), etc. Subjective voice evaluation was surveyed through VHI and VOISS. To evaluate patients' symptoms related to functional voice disorder, scores on physical domain in VHI and VOISS were selected to be compared for each session. Results: The 10 out of 20 participants who complained of voice symptoms had no significant difference with pre-operation in acoustic evaluation, but all showed higher scores on 2 weeks and 3 months after operation compared to pre-operation, in VHI-physical domain and selected questionnaires in VOISS. They reduced MPT and increased PTP value simultaneously. Laryngeal massage and breathing training were simultaneously treated to them, 5 participants resulting in improvement in MPT and PTP compared to pre-treatment. Conclusion:Patients who complained voice change with no organic damage after thyroidectomy were all shown to have reduced MPT and increased PTP in some by aerodynamic evaluations. Reduced MPT may imply some problem in air flow beneath glottis. Increased PTP suggests much more effort in vocalization mechanism than pre-operation. Comparing aerodynamic evaluations in post-thyroidectomy may provide information on behavioral interventions. Additionally, study on laryngeal massage and breathing training simultaneously treated to patients with such voice disorder is needed to be conducted with larger number of participants.

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An Open-Label Study of the Improvements in Clinical Symptoms and Neurocognitive Functions in Korean Children and Adolescents with Attention-Deficit Hyperactivity Disorder after Treatment with Metadate CD (국내 주의력결핍 과잉행동장애 아동 및 청소년에서 메타데이트CD의 임상증상 및 신경인지기능 개선 효과에 대한 개방 연구)

  • Yoo, Han-Ik K.;Kim, Bong-Seog;Joung, Yoo-Sook;Bahn, Geon-Ho;Song, Dong-Ho;Ahn, Dong-Hyun;Lee, Young-Sik
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.22 no.4
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    • pp.253-261
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    • 2011
  • Objectives : This study aimed to investigate the efficacy and safety of Metadate CD (MCD) when given to Korean children and adolescents with attention-deficit hyperactivity disorder (ADHD). We also explored the effects of the drug on diverse neuro-cognitive functions. Methods : Ninety-one subjects with ADHD (mean age 8.6${\pm}$2.2 years) were recruited at 6 outpatient clinics in Seoul, Korea. We used the ADHD Rating Scale (ARS), Clinical Global Impression (CGI), and comprehensive attention test (CAT) to measure the drug's effects. Results : After 0.92${\pm}$0.32mg/kg/day of MCD were administered for 57.4${\pm}$7.6 days, there was a 48.5% reduction in the mean total ARS scores (p<.001). Fifty-seven subjects (64.8%) showed either much improved or very much improved outcomes on the CGI-Improvement scale. The CGI-Severity scale also decreased from an average of 4.7 to an average of 2.9 (p<.001). Errors and response time standard deviations of the CAT, sustained attention test-to-response tasks, the flanker test, and divided attention test scores decreased after treatment (p<.05). The forward memory span of the spatial working memory test scores increased (p<.05). Thirty-five patients (39.8%) experienced side effects, of which the most common were headache (14.8%), nausea (12.5%), and anorexia (9.1%). Conclusion : This open-label study suggests that MCD is effective and safe in improving the symptoms and neurocognitive functions of Korean children and adolescents with ADHD.

Regulator of G-Protein Signaling 4 (RGS4) Controls Morphine Reward by Glutamate Receptor Activation in the Nucleus Accumbens of Mouse Brain

  • Kim, Juhwan;Lee, Sueun;Kang, Sohi;Jeon, Tae-Il;Kang, Man-Jong;Lee, Tae-Hoon;Kim, Yong Sik;Kim, Key-Sun;Im, Heh-In;Moon, Changjong
    • Molecules and Cells
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    • v.41 no.5
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    • pp.454-464
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    • 2018
  • Crosstalk between G-protein signaling and glutamatergic transmission within the brain reward circuits is critical for long-term emotional effects (depression and anxiety), cravings, and negative withdrawal symptoms associated with opioid addiction. A previous study showed that Regulator of G-protein signaling 4 (RGS4) may be implicated in opiate action in the nucleus accumbens (NAc). However, the mechanism of the NAc-specific RGS4 actions that induce the behavioral responses to opiates remains largely unknown. The present study used a short hairpin RNA (shRNA)-mediated knock-down of RGS4 in the NAc of the mouse brain to investigate the relationship between the activation of ionotropic glutamate receptors and RGS4 in the NAc during morphine reward. Additionally, the shRNA-mediated RGS4 knock-down was implemented in NAc/striatal primary-cultured neurons to investigate the role that striatal neurons have in the morphine-induced activation of ionotropic glutamate receptors. The results of this study show that the NAc-specific knock-down of RGS4 significantly increased the behaviors associated with morphine and did so by phosphorylation of the GluR1 (Ser831) and NR2A (Tyr1325) glutamate receptors in the NAc. Furthermore, the knock-down of RGS4 enhanced the phosphorylation of the GluR1 and NR2A glutamate receptors in the primary NAc/striatal neurons during spontaneous morphine withdrawal. These findings show a novel molecular mechanism of RGS4 in glutamatergic transmission that underlies the negative symptoms associated with morphine administration.

A Case of Multiple System Atrophy-Parkinsonism Type (MSA-P) with Gait Disturbance and Posture Instability Treated with Korean Medicine (보행 장애와 자세 이상 등을 호소하는 다계통 위축증(MSA-P) 한의 치험 1례)

  • Lee, Sang-hwa;Shin, Hee-yeon;Jeong, Hye-seon;Kim, Seo-young;Yang, Seung-bo;Cho, Seung-yeon;Park, Jung-mi;Ko, Chang-nam;Park, Seong-uk
    • The Journal of Internal Korean Medicine
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    • v.40 no.5
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    • pp.743-751
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    • 2019
  • This case report suggests the potential effects of Korean medicine for the gait disturbance and posture instability of Multiple System Atrophy-Parkinsonism (MSA-P). A patient with MSA-P who had gait disturbance and posture instability was given a series of Korean medicine, including acupuncture, pharmacopuncture, electro-acupuncture, moxibustion, and herbal medicine, for 15 days of hospitalization. During the hospitalization period, the severity and progression of the disease was measured with the Unified Multiple System Atrophy Rating Scale (UMSARS) and a video recording of a 20-meter round timed walking test. The UMSARS Part I and II scores decreased from 14 to 5 and 9 to 5, respectively. An improvement was also noted in standing and walking posture, and the walking time was shortened from 30 to 25 seconds in the 20-meter round-trip walking test. Dysarthria, dysphagia, and non-motoring symptoms like sleep behavioral disorders and constipation were also improved. The findings of this case study suggest that this series of Korean medicine has potential therapeutic effects for patients with MSA-P with motor and non-motor symptoms.

Rg3-enriched Korean Red Ginseng extract inhibits blood-brain barrier disruption in an animal model of multiple sclerosis by modulating expression of NADPH oxidase 2 and 4

  • Lee, Min Jung;Choi, Jong Hee;Oh, Jinhee;Lee, Young Hyun;In, Jun-Gyo;Chang, Byung-Joon;Nah, Seung-Yeol;Cho, Ik-Hyun
    • Journal of Ginseng Research
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    • v.45 no.3
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    • pp.433-441
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    • 2021
  • Background: Multiple sclerosis (MS) and its animal model, the experimental autoimmune encephalomyelitis (EAE), are primarily characterized as dysfunction of the blood-brain barrier (BBB). Ginsenoside-Rg3-enriched Korean Red Ginseng extract (Rg3-KRGE) is known to exert neuroprotective, anti-inflammatory, and anti-oxidative effects on neurological disorders. However, effects of Rg3-KRGE in EAE remain unclear. Methods: Here, we investigated whether Rg3-KRGE may improve the symptoms and pathological features of myelin oligodendroglial glycoprotein (MOG)35-55 peptide - induced chronic EAE mice through improving the integrity of the BBB. Results: Rg3-KRGE decreased EAE score and spinal demyelination. Rg3-KRGE inhibited Evan's blue dye leakage in spinal cord, suppressed increases of adhesion molecule platelet endothelial cell adhesion molecule-1, extracellular matrix proteins fibronection, and matrix metallopeptidase-9, and prevented decreases of tight junction proteins zonula occludens-1, claudin-3, and claudin-5 in spinal cord following EAE induction. Rg3-KRGE repressed increases of proinflammatory transcripts cyclooxygenase-2, inducible nitric oxide synthase, interleukin (IL)-1 beta, IL-6, and tumor necrosis factor-alpha, but enhanced expression levels of anti-inflammatory transcripts arginase-1 and IL-10 in the spinal cord following EAE induction. Rg3-KRGE inhibited the expression of oxidative stress markers (MitoSOX and 4-hydroxynonenal), the enhancement of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase 2 (NOX2) and NOX4, and NADPH activity in the spinal cord of chronic EAE mice. Furthermore, apocynin, a NOX inhibitor, mimicked beneficial effects of Rg3-KRGE in chronic EAE mice. Conclusion: Our findings suggest that Rg3-KRGE might alleviate behavioral symptoms and pathological features of MS by improving BBB integrity through modulation of NOX2/4 expression.

Second Asian Consensus on Irritable Bowel Syndrome

  • Gwee, Kok Ann;Gonlachanvit, Sutep;Ghoshal, Uday C;Chua, Andrew SB;Miwa, Hiroto;Wu, Justin;Bak, Young-Tae;Lee, Oh Young;Lu, Ching-Liang;Park, Hyojin;Chen, Minhu;Syam, Ari F;Abraham, Philip;Sollano, Jose;Chang, Chi-Sen;Suzuki, Hidekazu;Fang, Xiucai;Fukudo, Shin;Choi, Myung-Gyu;Hou, Xiaohua;Hongo, Michio
    • Journal of Neurogastroenterology and Motility
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    • v.25 no.3
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    • pp.343-362
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    • 2019
  • Background/Aims There has been major progress in our understanding of the irritable bowel syndrome (IBS), and novel treatment classes have emerged. The Rome IV guidelines were published in 2016 and together with the growing body of Asian data on IBS, we felt it is timely to update the Asian IBS Consensus. Methods Key opinion leaders from Asian countries were organized into 4 teams to review 4 themes: symptoms and epidemiology, pathophysiology, diagnosis and investigations, and lifestyle modifications and treatments. The consensus development process was carried out by using a modified Delphi method. Results Thirty-seven statements were developed. Asian data substantiate the current global viewpoint that IBS is a disorder of gut-brain interaction. Socio-cultural and environmental factors in Asia appear to influence the greater overlap between IBS and upper gastrointestinal symptoms. New classes of treatments comprising low fermentable oligo-, di-, monosacharides, and polyols diet, probiotics, non-absorbable antibiotics, and secretagogues have good evidence base for their efficacy. Conclusions Our consensus is that all patients with functional gastrointestinal disorders should be evaluated comprehensively with a view to holistic management. Physicians should be encouraged to take a positive attitude to the treatment outcomes for IBS patients.

Effect of Hominis Placenta Pharmacopuncture for a Patient with Mild Cognitive Impairment: A Randomized, Double-Blind, Placebo-Controlled, Multi-Center Trial

  • Kim, Yunna;Eom, Yoon Ji;Kwon, Dohyung;Lee, Jae Hyok;Jung, In Chul;Cho, Eun;Lee, Ji Eun;Cho, Seung-Hun
    • Journal of Oriental Neuropsychiatry
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    • v.32 no.2
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    • pp.81-93
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    • 2021
  • Objectives: Mild cognitive impairment (MCI) is condition of cognitive decline shown in transition from normal aging to dementia. Hominis placenta pharmacopuncture (HPP) is a treatment that combines effects of medication and acupuncture by injecting Hominis placenta into acupoints. The objective of this study was to evaluate the efficacy and safety of HPP for MCI. Methods: This was a randomized, double-blind, placebo-controlled, two-center clinical trial. Eligible patients were randomly allocated to either the HPP group or the placebo group. HPP or saline as placebo was administered to participants for eight weeks. Changes in symptoms were observed. The primary outcome was difference in mean change of Korean Version of the Montreal Cognitive Assessment (MoCA-K) score between the HPP group and the placebo group. Cognitive function, overall status of mood and sleep, and quality of life (QoL) were also assessed. Safety assessment and economic analysis were then conducted. Results: Thirty participants were enrolled. One participant in the placebo group dropped out. The score of MoCA-K increased after treatment. Its mean change was smaller in the HPP group than in the control group. HPP ameliorated Global Deterioration Scale and Korean Dementia Rating Scale subtests for attention, organization, and memory compared to the placebo. However, none of them was significantly different between the two groups. Mood, sleep, and QoL all improved more in the HPP group than in the placebo group, although differences between the two groups were not statistically significant. There was no adverse event probably related to the drug. HPP treatment needed KRW 345,000 more than the placebo group in improving Geriatric Quality of Life scale-Dementia score by one point for one year. Conclusions: Although HPP treatment did not significantly improve cognition, it changed behavioral and psychological symptoms in MCI.

Efficacy of alpha-lipoic acid in patients with burning mouth syndrome compared to that of placebo or other interventions: a systematic review with meta-analyses

  • Christy, Jessica;Noorani, Salman;Sy, Frank;Al-Eryani, Kamal;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.5
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    • pp.323-338
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    • 2022
  • Burning mouth syndrome (BMS) is a chronic oral disorder of unknown etiology which presents therapeutic challenges. Alpha-lipoic acid (ALA) has been studied as a potential treatment for BMS. The objective of this systematic review and meta-analysis was to evaluate the effectiveness of ALA compared to that of placebo or other interventions in individuals with BMS. Randomized controlled trials (RCT) using ALA to treat BMS were identified from MEDLINE, Cochrane Library, EMBASE, and Web of Science up to February 3, 2021. The assessment of the risk of bias in the included studies was based on the Cochrane guidelines. The primary outcome evaluated was the visual analog scale (VAS) pain intensity. ALA was compared with placebo, clonazepam, gabapentin, pregabalin, ALA plus gabapentin, capsaicin, Biotène®, and laser therapy. Altogether, 137 records were scanned for inclusion/exclusion, and nine RCTs (two unclear and seven at high risk of bias) were included in the qualitative and quantitative analyses, with a total of 594 patients with BMS included in this review. All studies reported an improvement in VAS pain scores ranging from -0.72 to -2.77. Meta-analysis results showed a non-significant reduction in pain intensity for ALA (P = 0.616) compared to that of placebo on a VAS of 0-10. Patients taking ALA were 1.923 times more likely to show an improvement in self-reported BMS symptoms (P = 0.031) than those in the placebo group. Clonazepam and pregabalin showed a significant VAS pain reduction of 4.08 and 4.68 (P < 0.001), respectively, compared to that with ALA. Although ALA intervention provided a non-significant improvement in the pain score and was more likely to produce a reduction in BMS symptoms, the evidence was of low quality. Further research is needed to establish clear guidelines for the use of ALA for BMS treatment.