• Phonetics and Speech Sciences
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• v.5 no.1
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• pp.27-38
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• 2013

Healthcare providers in Korea are using conservative pharmacological treatment for Alzheimer's disease (AD) to delay the progress of the disease or to mitigate its behavioral and neurological symptoms. However, there is a growing need for interventions using practical non-pharmacologic treatment, as the effects of pharmacological treatments has faced limitations. This research provided a cognitive rehabilitation program to 3 AD patients and used a multiple baseline design across subjects to examine the effects. Performing reality orientation therapy (ROT) for 1 cycle (4 weeks) resulted in a slight increase in accuracy and responsiveness on an orientation task, mainly with patients with mild cases of AD. Also, in the sub-domain of the Korean-Mini Mental Status Examination performed to examine changes in cognitive ability, there were minimal changes in place orientation. In functional communication, however, there were no significant differences before and after the intervention. In conclusion, we found that ROT was an effective intervention for improving accuracy and responsiveness in the orientation of patients with mild cases of AD. In future studies, the effect of non-pharmacological interventions can be evaluated more reliably by examining the interaction effects of sample size, length of the intervention, outcome measurements, and pharmacological intervention.

• Journal of Oriental Neuropsychiatry
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• v.26 no.3
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• pp.251-266
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• 2015

Objectives: The purpose of this study is to investigate the research about using tuina therapy for depression and to determine its efficacy. Methods: All relevant articles were searched in the China National Knowledge Infrastructure using the terms 'tuina' and 'depression'. Results: Forty-one studies were selected, 34 randomized controlled trials (RCTs) and 7 prospective studies. The Chinese Classification of Mental Disorders and Hamilton Depression Rating Scale were used most frequently as diagnostic criteria and an assessment tool, respectively. Conduction exercise therapy was used in all studies; in contrast, Zheng Xing exercise therapy was used in only 1 study of depression patients with neck vertebrae disease. In 9 RCTs that showed scores of more than 2 points on a modified Jadad scale, tuina therapy had significant antidepressant efficacy compared with conventional treatment. However, more high-quality studies are required. Conclusions: Tuina therapy has a valid therapeutic effect on depression according to studies published in China; if evidence accumulates from high-quality studies, it can be considered a non-pharmacologic treatment for depression in Korean medicine, as well.

• Annals of dermatology
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• v.30 no.6
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• pp.688-693
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• 2018

Background: There are few pharmacologic options to reduce erythema and flushing in patients with recalcitrant erythematotelangiectatic rosacea (ETR). We previously reported two cases of refractory flushing and erythema of rosacea that were successfully treated with intradermal botulinum toxin injection, and additional research is needed to prove the efficacy and safety of this treatment. Objective: To report the efficacy and safety of botulinum toxin injection as an aid in persistent erythema of rosacea patients. Methods: A total of 20 Korean patients with recalcitrant ETR were enrolled to receive treatment by injection of botulinum toxin. Patients received one treatment of intradermal botulinum toxin injection and were assessed 1, 2, 4, and 8 weeks after treatment. The severity of erythema and telangiectasia was investigated by a non-treating physician, and the Erythema Index (EI) was assessed by mexameter at each visit. Patient satisfaction and any adverse events were also assessed at each visit. Results: 17 patients completed all follow-up visits and were included in the analysis. Intradermal injection of botulinum toxin significantly reduced erythema severity and EI in ETR patients. Patients reported a satisfaction score of $2.94{\pm}0.56$ at 8 weeks after treatment. Except for three patients who discontinued the study early due to inconvenience of facial muscle paralysis, 17 patients participating in the final analysis did not report side effects except injection pain at the time of the procedure. Conclusion: Intradermal injection of botulinum toxin can be used as an effective and relatively safe adjuvant agent for recalcitrant and persistent erythema of ETR patients.

• Tuberculosis and Respiratory Diseases
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• v.81 no.2
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• pp.99-105
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• 2018

Acute exacerbation(s) of chronic obstructive pulmonary disease (AECOPD) tend to be critical and debilitating events leading to poorer outcomes in relation to chronic obstructive pulmonary disease (COPD) treatment modalities, and contribute to a higher and earlier mortality rate in COPD patients. Besides pro-active preventative measures intended to obviate acquisition of AECOPD, early recovery from severe AECOPD is an important issue in determining the long-term prognosis of patients diagnosed with COPD. Updated GOLD guidelines and recently published American Thoracic Society/European Respiratory Society clinical recommendations emphasize the importance of use of pharmacologic treatment including bronchodilators, systemic steroids and/or antibiotics. As a non-pharmacologic strategy to combat the effects of AECOPD, noninvasive ventilation (NIV) is recommended as the treatment of choice as this therapy is thought to be most effective in reducing intubation risk in patients diagnosed with AECOPD with acute respiratory failure. Recently, a few adjunctive modalities, including NIV with helmet and helium-oxygen mixture, have been tried in cases of AECOPD with respiratory failure. As yet, insufficient documentation exists to permit recommendation of this therapy without qualification. Although there are too few findings, as yet, to allow for regular andr routine application of those modalities in AECOPD, there is anecdotal evidence to indicate both mechanical and physiological benefits connected with this therapy. High-flow nasal cannula oxygen therapy is another supportive strategy which serves to improve the symptoms of hypoxic respiratory failure. The therapy also produced improvement in ventilatory variables, and it may be successfully applied in cases of hypercapnic respiratory failure. Extracorporeal carbon dioxide removal has been successfully attempted in cases of adult respiratory distress syndrome, with protective hypercapnic ventilatory strategy. Nowadays, it is reported that it was also effective in reducing intubation in AECOPD with hypercapnic respiratory failure. Despite the apparent need for more supporting evidence, efforts to improve efficacy of NIV have continued unabated. It is anticipated that these efforts will, over time, serve toprogressively decrease the risk of intubation and invasive mechanical ventilation in cases of AECOPD with acute respiratory failure.

• The Korean Journal of Pain
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• v.33 no.2
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• pp.108-120
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• 2020

From the perspective of the definition of pain, pain can be divided into emotional and sensory components, which originate from potential and actual tissue damage, respectively. The pharmacologic treatment of the emotional pain component includes antianxiety drugs, antidepressants, and antipsychotics. The anti-anxiety drugs have anti-anxious, sedative, and somnolent effects. The antipsychotics are effective in patients with positive symptoms of psychosis. On the other hand, the sensory pain component can be divided into nociceptive and neuropathic pain. Non-steroidal anti-inflammatory drugs (NSAIDs) and opioids are usually applied for somatic and visceral nociceptive pain, respectively; anticonvulsants and antidepressants are administered for the treatment of neuropathic pain with positive and negative symptoms, respectively. The NSAIDs, which inhibit the cyclo-oxygenase pathway, exhibit anti-inflammatory, antipyretic, and analgesic effects; however, they have a therapeutic ceiling. The adverse reactions (ADRs) of the NSAIDs include gastrointestinal problems, generalized edema, and increased bleeding tendency. The opioids, which bind to the opioid receptors, present an analgesic effect only, without anti-inflammatory, antipyretic, or ceiling effects. The ADRs of the opioids start from itching and nausea/vomiting to cardiovascular and respiratory depression, as well as constipation. The anticonvulsants include carbamazepine, related to sodium channel blockade, and gabapentin and pregabalin, related to calcium blockade. The antidepressants show their analgesic actions mainly through inhibiting the reuptake of serotonin or norepinephrine. Most drugs, except NSAIDs, need an updose titration period. The principle of polypharmacy for analgesia in case of mixed components of pain is increasing therapeutic effects while reducing ADRs, based on the origin of the pain.

• The Journal of Korea Institute of Information, Electronics, and Communication Technology
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• v.14 no.5
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• pp.403-412
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• 2021

Alzheimer's disease (AD) is the most common cause of dementia, showing progressive neurodegeneration. Although oral medications for symptomatic improvement still take a huge part of treatment, there are several limitations caused by pharmacology-based real world clinic. In this respect, non-pharmacologic treatment for AD is rising to prominence. Transcranial direct current stimulation (tDCS) is a one of the non-invasive neuromodulation technique, using low-voltage direct current. In terms of safety, tDCS already has been proven through numerous previous reports. This review focused on behavioral, neurophysiologic and histopathologic improvement by applying tDCS in AD rodent models, thereby suggesting reliable background evidence for human-based tDCS study.

• Korean Journal of Biological Psychiatry
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• v.21 no.2
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• pp.37-48
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• 2014

Besides from medical data, the patients who were previously called as attention disorder, mental instability, moral imbeciles, or moral defectives, can also be identified by exploring literatures and historical figures. In the past, as we can notice from the titles, they were recognized as a 'moral defect group'. And rather than treating them, separation from the society was the main solution. After the endemic encephalitis from 1917 to late 1920s, however, many survivors suffered from behavioral problems similar to those of the previous 'moral defect group' and studies on the relationship between brain damage and behavior problems were started henceforth. After being known as the 'minimal brain dysfunction', it was developed into the current attention-deficit/hyperactivity disorder. While the disease concept changed and developed over time, after numerous trials and errors, treatment medication starting from central nervous system stimulants such as amphetamine and methylphenidate is used for treatment in children and adult patients with ADHD, and most recently non-stimulants such as atomoxetine has become the one of the first line treatment options. Although we went through a thorough verification process of the safety and efficacy of the medication by contemplating the historical development process, we believe that adjustment is needed for remaining concerns on medication abuse and slight differences in disease paradigm and therapeutic philosophy depending on cultures.

• The Journal of Pediatrics of Korean Medicine
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• v.31 no.1
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• pp.52-62
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• 2017

Objectives The purpose of this study is to review pre-existing clinical practice guidelines for autism spectrum disorders, and refer those in developing a new practice guideline. Methods A total of 9 existing clinical practice guidelines for autism spectrum disorder developed from 2010 to 2016 were searched by Google scholar and Pubmed, and were reviewed those literatures in three parts: general, diagnosis & evaluation, and intervention. Results There were no consistency in the recommendation methods of 9 clinical care guidelines (such as the method of rating and recommendation intensity for diagnosis, evaluation, and treatment). However, in the diagnosis and evaluation section, frequently used evaluation and diagnostic tools are mentioned in most clinical practice guidelines, and the types of pharmacologic and non-pharmacological treatments that are mainly recommended in treatment are equally mentioned in most clinical practice guidelines could confirm. Conclusions 1. Some guideline recommendations are graded according to each criterion. Recommendations presented in various databases were based on systematic reviews or other literatures. The most utilized database were PsycINFO, CINAHL, Cochrane. 2. DSM-5 and ICD-10 were the most common used diagnostic criteria, and DSM-IV was used as a diagnostic standard in the guideline published before 2013. The tools used for diagnosis and evaluation were also varied. However, most recommended ones were ADI-R, ADOS-G, and DISCO. 3. Treatment was largely divided into pharmacological intervention and non-pharmacological intervention. In some guideline, the interventions were divided into pediatric and adult. Most of the pharmacological interventions were not recommended due to lack of evidence, but in cases in which specific symptoms were aimed, they recommended to seek professional help. 4. In addition to interventions, each guideline referred to supportive interventions that may be helpful in the daily life of patients with ASD, which may need to be addressed in future clinical guidelines.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.4
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• pp.696-700
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• 2004

Gingival fibromatosis is a non-inflammatory oral disease, characterized by slowly progress enlargement of the free and attached gingiva. Gingival fibromatosis may have familial tendency. Gingival enlargement usually begins with the eruption of the permanent dentition but can also develop with the eruption of the primary dentition. In this case, a 6-year-old female had gingival enlargement at birth. There was no familial, medical and pharmacologic history of gingival overgrowth. Treatment is gingivectomy with a rigorous program of oral hygiene. Recurrence of gingival fibromatosis may well be inevitable. Therefore there is no general aggrement as to the timing of surgical intervention. Generally the best time is when all the permanent teeth have erupted. However early intervention can improve oral function and esthetic and psychologic effect.

• Journal of Korean Clinical Nursing Research
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• v.17 no.2
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• pp.275-285
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• 2011

Purpose: Head-up position during sleep is one of the non-pharmacologic interventions for the treatment of orthostatic hypotension. Because the head-up position causes discomfort in many patients, this approach may not be acceptable to all patients. We compared the systolic blood pressure in erect position, orthostatic hypotension, orthostatic disability score, and the improvement rates of orthostatic hypotension between the 20 cm head-up group and the 10 cm head-up group. Methods: A control pre/post-test design was used. Between August 1, 2009 and November 15, 2010, we consecutively enrolled patients who showed orthostatic hypotension in patients with Parkinsonian disorders. Sixty-seven patients were prospectively enrolled and forty-four patients were completed the study. Results: There were no statistically significant differences found in the systolic blood pressure in erect position, orthostatic hypotension, and orthostatic disability scores between the two groups. However, five patients showed improvement in 20 cm head-up group and one patient was showed improvement in 10 cm head-up Group. Conclusion: Orthostatic hypotension is decreased with 20 cm head-up position in some patients with Parkinsonian disorders (p=.034). Further research investigating the relationships between orthostatic hypotension and head-up position are warranted.