• Korean Journal of Clinical Pharmacy
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• v.29 no.2
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• pp.89-100
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• 2019

Background: Invasive aspergillosis (IA) is associated with high morbidity and mortality, particularly among immunocompromised patients, such as lung transplant recipients. Voriconazole, the first-line therapy for IA, shows a non-linear pharmacokinetic profile and has a narrow therapeutic range. Careful and appropriate administration is necessary, primarily because it is used for critically ill patients; however, the clinical usefulness of therapeutic drug monitoring (TDM) has not been sufficiently verified. Therefore, in this study, we validated the safety and efficacy of voriconazole TDM in lung transplant recipients receiving only voriconazole for IA treatment. Methods: The electronic medical records of lung transplant recipients (${\geq}19$ years of age) administered only voriconazole for > 7 days for treatment of IA from June 1, 2013 to May 31, 2018 were analyzed retrospectively. Results: Among the 54 patients, 27 each were allocated to TDM and non-TDM groups, respectively. There were no significant differences in patient characteristics between the two groups except for ICU-hospitalization status. Of the TDM group patients, 81.5% needed adjustment of voriconazole dosage because the levels were out of target range. Comparison of two groups showed that treatment response was higher throughout treatment and switching rates of second-line agents were significantly lower in the TDM group, but it was insufficient to confirm safety improvements through voriconazole TDM. Conclusions: Considering that the treatment response tended to be higher and the rates of switching to second-line antifungal agents were lower in the TDM group, voriconazole TDM may increase the therapeutic effect on IA in lung transplant patients.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.3
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• pp.47-53
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• 2023

PURPOSE: A visual feedback method was proposed to induce brain stimulation in a stroke patient, and among them, there was a treatment using a mirror. On the other hand, mirror therapy focuses only on the functional changes in body movements, and analysis of neurophysiological mechanisms of brain activity is lacking. In addition, studies on evaluating the activity and response generated in specific brain regions during visual feedback training using mirrors are insufficient. METHODS: Fifteen healthy adults (male: 10, female: 5, Years: 23.33 ± 1.23), who were right-handed were recruited. By attaching the C3, Cz, and C4 channels in the sensorimotor cortex using an electroencephalogram, training was performed under the conditions without mirror-based visual feedback (No-condition) and with visual feedback (Tasks-condition). At this time, the immediate activity of the mu-rhythm in response to training was separated and evaluated. RESULTS: The tasks-condition of C3, Cz, and C4 channels activated the relative mu-rhythm rather than the no-condition, and all showed significant differences (p < .05). In addition, in all channels at the start time, the tasks-condition was more active than the no-condition (p < .05). The activity of the cortical response was higher in the tasks-condition than in the no-condition (p < .05). CONCLUSION: The mu-rhythm activity can be evaluated objectively when visual feedback using a mirror is applied to healthy subjects, and a basic analysis protocol is proposed.

• Korean Journal of Bronchoesophagology
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• v.14 no.2
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• pp.31-37
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• 2008

Background and Objectives: In most cases of benign neck cysts, surgical excision has been considered as treatment of choice. However, sometimes complete excision is very difficult, and recurrences has been occured due to insufficient surgery frequently. In this point of view, non-surgical treatment has been attempted with sclerosing agents such as picibanil(OK-432). In this study, we evaluated the efficacy of picibanil sclerotherapy for benign neck cysts. Materials and methods: We retrospectively reviewed 53 patients(27 males, 26 females) who had undergone sclerotherapy with picibanil for benign neck cysts such as ranula, lymphangioma, thyroglossal duct cyst and branchial cyst. Information was gathered with respected to age, sex, number of injections, side effect and outcome of treatment. All patients were treated with intralesional aspiration of cystic contents and injection of picibanil, and followed on neck ultrasonography or neck CT. Results: 53 patients received sonoguided sclerotherapy using picibanil(OK-432). 31 patients(41.3%) showed total shrinkage, near total shrinkage(more than 90% of volume) in 7 patients(9.3%), marked shrinkage(more than 70%) in 5 patients(6.6%) and partial shrinkage(less than 70%) in 17 patients. 15 patients(20%) reaveled no response and 8 patients showed recurrences with repeated sclerotherapy. The side effects of therapy were observed by symptoms such as fever, localized pain and odynophagia. However, these complications disappeared after several days in all cases. Conclusions: We recognized that picibanil(OK-432) sclerotherapy for benign neck cyst is a safe and effective procedures as a primary treatment before considering surgery.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.5 no.1
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• pp.157-168
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• 2010

Objectives: The aim of this study was to investigate the curriculum of Chuna manual medicine (CMM)-related subjects in oriental medicine college and to let CMM have opportunities to develope current curriculum and basic circumstance for CMM. Methods: Questionnaire was obtained from 11 oriental medicine college and 1 school of Korean medicine, Pusan National University, bye-mail. If there was any insufficient information from response, we asked more information by direct call. Results and Conclusions: The findings from our study can be summarized as follows: 1. There are three CMM-related subjects, CMM, Oriental Rehabilitation Medicine (ORM) and Neuromusculoskeletology(NMS). All curriculums of 8 colleges belonged to classification I have CMM and DRM courses. Curriculums of 4 colleges belonged to classification II, have ORM or NMS course without CMM course. 2. 10 colleges of 11 ones which have ORM course, have major compulsory courses, 1 college has a major optional course. 5 colleges of 8 ones which have CMM course, have major compulsory courses, 3 colleges have major optional courses. 2 colleges have only part-time lecturers for CMM course, other 2 college have cooperation of specialized professors and part-time lecturers, another 8 colleges have only specialized professors. 3. Most CMM-related subjects is teached at 3 or 4 grade of medical course. The units taken for CMM-related subjects is minimum 4 units to maximum 8 units in total about 160 units. 4. Total class hour for CMM-related subjects is minimum 120 hours to maximum 225 hours, and practice hours is about minimum 30 hours to maximum 75 hours. 5. The systematic regulation and financial support is needed for patients to get the best CMM treatment, because the present curriculum of CMM is insufficient for carrying out the best manual therapy for patients.

• Clinical Endoscopy
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• v.56 no.2
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• pp.194-202
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• 2023

Background/Aims: Endoscopic therapy for neoplastic Barrett's esophagus (BE) has become the standard of care over the past two decades. In clinical practice, we regularly encounter patients who fail to achieve complete squamous epithelialization of the esophagus. Although the therapeutic strategies in the individual stages of BE, dysplasia, and esophageal adenocarcinoma are well studied and largely standardized, the problem of inadequate healing after endoscopic therapy is only marginally considered. This study aimed to shed light on the variables influencing inadequate wound healing after endoscopic therapy and the effect of bile acid sequestrants (BAS) on healing. Methods: Retrospective analysis of endoscopically treated neoplastic BE in a single referral center. Results: In 12.1% out of 627 patients, insufficient healing was present 8 to 12 weeks after previous endoscopic therapy. The average follow-up duration was 38.8±18.4 months. Complete healing was achieved in 13 patients already after intensifying proton pump inhibitor therapy. Out of 48 patients under BAS, 29 patients (60.4%) showed complete healing. An additional eight patients (16.7%) improved, but only partial healing was achieved. Eleven (22.9%) patients showed no response to BAS augmented therapy. Conclusions: In cases of insufficient healing even under exhaustion of proton pump inhibitors, treatment with BAS can be an option as an ultimate healing attempt.

• Journal of Korean Neurosurgical Society
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• v.67 no.4
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• pp.458-466
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• 2024

Objective : Several clinical studies have explored the feasibility and efficacy of radiosurgical treatment for mesial temporal lobe epilepsy, but the long-term safety of this treatment has not been fully characterized. This study aims to report and describe radiation-induced cavernous malformation as a delayed complication of radiosurgery in epilepsy patients. Methods : The series includes 20 patients with mesial temporal lobe epilepsy who underwent Gamma Knife radiosurgery (GKRS). The majority received a prescribed isodose of 24 Gy as an adjuvant treatment after anterior temporal lobectomy. Results : In this series, we identified radiation-induced cavernous malformation in three patients, resulting in a cumulative incidence of 18.4% (95% confidence interval, 6.3% to 47.0%) at an 8-year follow-up. These late sequelae of vascular malformation occurred between 6.9 and 7.6 years after GKRS, manifesting later than other delayed radiation-induced changes, such as radiation necrosis. Neurological symptoms attributed to intracranial hypertension were present in those three cases involving cavernous malformation. Of these, two cases, which initially exhibited an insufficient response to radiosurgery, ultimately demonstrated seizure remission following the successful microsurgical resection of the cavernous malformation. Conclusion : All things considered, the development of radiation-induced cavernous malformation is not uncommon in this population and should be acknowledged as a potential long-term complication. Microsurgical resection of cavernous malformation can be preferentially considered in cases where the initial seizure outcome after GKRS is unsatisfactory.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.6173-6180
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• 2013

Background: Our objective was to determine the knowledge and attitudes of Thai generalists (general physicians) toward palliative terminal cancer care (PC) in a primary care setting. Materials and Methods: We performed a cross-sectional descriptive survey using a self-administered questionnaire. The total number of completed and returned questionnaires was 63, giving a 56% response rate. Data analysis was based on these (Cronbach's alpha=0.82) and percentages and mean values were assessed using the Fisher's exact test to determine the correlation of variables. Results: Overall, attitude and knowledge levels were slightly satisfactory. Results indicated that general physicians had moderate scores in both attitudes (84.1%) and knowledge (55.7%) regarding palliative terminal cancer care. However, they had insufficient knowledge regarding truth telling, pain control and management with morphine, emergency management in terminal cancer care and treatment of fluid intake in terminal stages. Attitude and knowledge scores were statistically correlated (p=0.036). Knowledge scores were further positively associated with being taught palliative care in their medical curriculum (p=0.042). Conclusions: Formal education in palliative care and development of palliative care services are very much needed in Thailand to provide holistic care to terminally ill patients.

• Clinical and Experimental Pediatrics
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• v.59 no.sup1
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• pp.121-124
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• 2016

Turner syndrome (TS) is a genetic disorder in phenotypic females that has characteristic physical features and presents as partial or complete absence of the second sex chromosome. Growth hormone deficiency (GHD) is a condition caused by insufficient release of growth hormone from the pituitary gland. The concomitant occurrence of TS and GHD is rare and has not yet been reported in Korea. Here we report 2 cases of TS and GHD. In case 1, GHD was initially diagnosed. Karyotyping was performed because of the presence of the typical phenotype and poor response to growth hormone therapy, which revealed 45,X/45,X+mar. The patient showed increased growth velocity after the growth hormone dose was increased. In case 2, a growth hormone provocation test and chromosomal analysis were performed simultaneously because of decreased growth velocity and the typical TS phenotype, which showed GHD and a mosaic karyotype of 45,X/46,XX. The patient showed spontaneous pubertal development. In female patients with short stature, it is important to perform a throughout physical examination and test for hormonal and chromosomal abnormalities because diagnostic accuracy is important for treatment and prognosis.

• Journal of Applied Biological Chemistry
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• v.63 no.2
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• pp.131-136
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• 2020

When blood vessels are damaged, a fast hemostatic response should occur to minimize blood loss and maintain normal circulation. Platelet activation and aggregation are essential in this process. However, excessive platelet aggregation or abnormal platelet aggregation may be the cause of cardiovascular diseases such as thrombosis, stroke, and atherosclerosis. Therefore, finding a substance capable of regulating platelet activation and suppressing agglutination reaction is important for the prevention and treatment of cardiovascular diseases. 6,7-Dimethoxy-2H-chromen-2-one (Scoparone), found primarily in the roots of Artemisia or Scopolia plants, has been reported to have a pharmacological effect on immunosuppression and vasodilation, but studies of platelet aggregation and its mechanisms are still insufficient. This study confirmed the effect of scoparone on collagen-induced human platelet aggregation, TXA₂ production, and major regulation of intracellular granule secretion (ATP and serotonin release). In addition, the effect of scoparone on the phosphorylation of the phosphoproteins PI3K/Akt and mitogen-activated protein kinases (MAPK) involved in signal transduction in platelet aggregation was studied. As a result, scoparone significantly inhibited the phosphorylation of PI3K/Akt and MAPK, which significantly inhibited platelet aggregation through TXA₂ production and intracellular granule secretion (ATP and serotonin release). Therefore, we suggest that scoparone is an antiplatelet substance that regulates the phosphorylation of phosphoproteins such as PI3K/Akt and MAPK and is of value as a preventive and therapeutic agent for platelet-derived cardiovascular disease.

• Journal of Environmental Health Sciences
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• v.26 no.2
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• pp.70-79
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• 2000

This study was done for the purpose of investigating the status of the use and perceptions of pesticides among the farmers who spray them in person. And it was also done to provide the basic statistics for the Agricultural Health Policy and study. Over the part of agricultural area in Kyungju and Ulsan City, Korea, from July to September 1999, 1032 questionnaires were distributed and 561 of them were collected and 447 were analysed. Major results of this study are as follows. The proportion of those who have special location for pesticides storage was only 5.3%, and that of those who lock hte storage location was only 13.6%. As to the treatment of bottles after use, most common response was 'burn in home'(47.7%). Most farmers purchase pesticides through 'pesticide store' or 'Agricultural Cooperatives'. The knowledge and Usage of pesticides depends in large part on experiences. The farmers who cultivate orchard spray pesticides more frequently than those cultivate paddy rice mainly. Most common pesticides in use are oganophosphates and carbamates. And also the pesticides that contains so-called 'Environmental Hormone' are used. The perception about the hazards of pesticides is rather superficial and insufficient. 'Herbicide(Gramoxon·Paraco)'(38%) is accepted as the most hazardous by farmers.