• 생물정신의학
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• 제14권1호
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• pp.21-27
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• 2007

Objectives : As a part of plan to develop evidence-based treatment guidelines for depression that is more suitable for Korean situation, we investigate the present status and client's requirements for non-pharmacological treatment of depression in Korean clinical situation. Methods : Subjects were patients with depression in 12 university hospitals which are located in metropolises in Korea. We analyzed the records from questionnaires about current clinical status and requirements for the non-pharmacological treatment of depression in Korea. Results : 50.8% of the subjects have experienced non-pharmacological treatments for their depression. The preference of non-pharmacological treatment method of depression is exercise/interesting activity, counseling by psychiatrists and psychotherapy, and the best effective treatment method is psychotherapy (Es=4.36). Actually, the mean consultation time by psychiatrist is $11.31{\pm}7.16$ min, and the appropriate consultation time for client's situation is $18.39{\pm}8.95$ min. During consultation, patients' satisfaction measurement for psychiatrist's explanation about pharmacological treatment is $64.17{\pm}27.11$, and satisfaction measurement for psychiatrist's counseling for their depression about personal problems, resent stress, interpersonal relationship is $61.66{\pm}26.63$. Conclusion : In Korea, many psychiatrists offered biologically oriented treatment to their patients with depression, and patients' satisfaction measurement about consultation by psychiatrists is low. Many patients wanted to combined pharmacological and non-pharmacological treatment for their depression, and aspired to information about complementary and self-help treatment methods. It is necessary to develop non-pharmacological treatment guideline for depression which reflect the clinical situation in Korea and meet Korean patients' need.

• 수면정신생리
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• 제23권2호
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• pp.77-83
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• 2016

목 적 : 본 연구는 1차 및 2차, 3차 의료기관에 종사하는 의사 102명을 대상으로 설문조사를 통해 불면증 환자의 치료 실태를 조사하고자 하였다. 방 법 : 총 102명의 정신건강의학과 및 타과 전공 의사들이 설문에 참여하였고, 분석에 포함된 설문조사 대상자는 100명이었다. 결 과 : 실제 치료 장면에서 가장 자주 사용되고 있는 치료는 약물학적 치료였으며, 수면위생 교육과 인지행동 치료 등의 비약물학적 치료도 시행이 되고 있는 것으로 나타났다. 그러나 비약물학적 치료를 시행하더라도 그 효과에 대한 만족도는 높지 않았다. 의사가 보기에 불면증 환자들의 비약물학적 치료에 대한 관심은 일정 수준 있는 것으로 나타났으나 이에 대한 식견이나 의식 수준은 아직 미흡한 것으로 보고되었고, 치료의 실행도 충분히 적절하게 이루어지고 있지는 않은 것으로 보고되었다. 본 연구에서는 추가적으로 의료진이 생각하는 불면증 환자의 적정 진료를 위해 요구되는 점에 대해서도 탐색하였다. 결 론 : 본 연구는, 치료적 개입에 대한 보다 구체적인 정보를 획득하지는 못했다는 점, 환자를 대상으로도 설문을 실시하지는 못했다는 점 등의 제한점을 지니고 있으나, 그럼에도 불구하고 불면증 치료의 개선과 변화를 위해 필요한 현황 조사를 면밀히 실시했다는 점에서 그 의의가 있다. 결론적으로 다수의 의사들이 불면증의 비약물학적 치료가 중요하다고 생각하고 있었으나 진료 현실에서 적용하기 힘든 부분이 있다고 보고하였다. 본 연구 결과는 불면증에 대한 적정 치료를 위해 비약물학적 치료를 위한 진료 여건 개선 및 의사대상 교육이 필요함을 제시하였다.

• 생물정신의학
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• 제19권4호
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• pp.179-186
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• 2012

Depression and executive dysfunction are common neuropsychiatric sequelae of stroke. Patients with stroke are more predisposed to depression and executive dysfunction compared to patients with similar degree of physical disability. Both depression and executive dysfunction are also associated with poor prognosis such as high mortality and delayed recovery after stroke. Complex neurobiological and anatomical mechanisms are associated with the development of depression and executive dysfunction after stroke. Activation of pro-inflammatory cytokines is thought to be associated with onset of depression, whereas injuries in frontal-subcortical circuit are thought to be a link between depression and executive dysfunction. Early detection of depressive symptoms and both pharmacological and non-pharmacological treatment would be helpful. In this review paper, the authors investigated 1) biological and neuroanatomical substrate for poststroke depression and executive dysfunction, 2) the relationship and common etiopathology for poststroke depression and executive dysfunction, and 3) pharmacological and non-pharmacological treatment for poststroke depression. The contents of the paper are as follows : the prevalence, clinical manifestation, and biological etiology for poststroke depression, neuroanatomical abnormalities as a common etiological factor for depression and executive dysfunction, pharmacotherapy and non-pharmacological approach.

• 생물정신의학
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• 제13권4호
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• pp.226-233
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• 2006

Depression is one of the most common mental disorders. Some characteristics of depression in Korea were elucidated. The tendency to express depressive feeling through somatic complaints is more prominent in Korea than in Western countries. Careful studies on depressive symptoms suggest that guilt and suicidal idea are apparent among Korean depressive patients as well as among Western subjects. But most depressive patients in Korea are reluctant to express suicidal idea, which is hidden under the somatic complaints. We should remember the possibility of research artifacts or cultural bias with regard to the evaluation of depressive symptoms of a country in comparison with other countries. Non-pharmacological treatment of depression includes dynamic psychotherapy, cognitive behavioral therapy, interpersonal psychotherapy, self-care treatment, etc. Some kinds of Korean culture relevant psychotherapies are introduced: Tea therapy, Imago therapy, Tao psychotherapy, and combined approach. Interest in the aged people is growing recently, and the research about the factors which affect the depressive disorders in older patients and treatment strategy for them is ongoing.

• 보건교육건강증진학회지
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• 제35권5호
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• pp.35-45
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• 2018

Objectives: Despite the importance of Non-pharmacological interventions for Eating Disorders, no meta-analysis providing definite conclusions in this field has been reported. The purpose of the this study was to conduct meta-analysis of Non-pharmacological interventions for the improvement of eating disorders. Methods: We searched the Koreamed, KISTI, KMBASE, RISS and KISS and so on up to October 2017 using search terms such as ((Eating disorders OR anorexia OR binge) AND (Mediation OR program OR treatment OR therapy OR technique)) in Korean. Results: Initial searches yielded 602 citations. Of these results, seven met selection criteria. Interventions reduced the risk of binge eating disorder (standardised mean difference [SMD] -2.133, 95% CI -3.107~-1.159). Interventions reduced drive for leanness (-1.857, -3.143~-0.571), body dissatisfaction (-1.357, -2.238~-0.477), depression (-0.745, -1.298~-0.192), but not physical function (0.191, -0.089~0.471). Conclusions: The results from this study indicate that Non-pharmacological Interventions may help Eating disorders' binge eating, drive for thinness, body dissatisfaction, depression. However, larger-scale studies are needed to confirm this conclusion.

• 정신신체의학
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• 제31권1호
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• pp.1-9
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• 2023

신경인지장애 환자들은 인지저하 뿐만 아니라 초조, 공격성, 우울, 배회 등의 정신행동증상들을 나타내며 이로 인해 환자와 가족이 상당한 고통을 받게 된다. 정신행동증상의 치료를 위해서는 환자 중심의, 비약물학적인 치료가 우선되어야한다. 본 논문은 신경인지장애 환자에서 나타나는 정신행동증상을 관리하고 치료하기 위한 비약물학적인 개입에 대하여 기술하였다. 초조, 우울, 무감동, 불면, 배회 등의 정신행동증상을 조절하기 위해서는 환경변화, 약물 등의 유발 인자를 파악하고 평가한 뒤, 그러한 문제를 해결해주는 것이 중요하다. 비약물학적인 개입 방법으로는 안심시키기, 활동 격려하기, 주의를 분산시키기, 환경을 변화시키기 등을 들 수 있다. 환자의 관점에서 행동을 이해하고, 그들의 요구와 능력에 맞게 접근해야한다. 비약물학적인 개입 방법으로 회상요법, 음악치료, 향기요법, 다중감각자극요법, 운동요법, 광선치료, 마사지 요법, 인지중재치료, 애완동물요법 등의 다양한 요법이 시행되고 있으며, 이러한 접근 방법이 환자의 우울, 무감동, 초조, 공격성, 불안, 배회, 불면 등의 증상을 호전시켜준다고 알려져 있다. 그러나, 효과에 대한 증거 수준이 높지 않아 향후에 좀 더 광범위하고 정확한 효과 검증 연구가 필요하다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1571-1576
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• 2016

Alteration of the acetylation status of chromatin and other non-histone proteins by HDAC inhibitors has evolved as an excellent epigenetic strategy in treatment of cancers. The present study was sought to identify compounds with positive pharmacological profiles targeting HDAC1. Analogues of Vorinostat synthesized by Cai et al, 2015 formed the test compounds for the present pharmacological evaluation. Hydroxamte analogue 6H showed superior pharmacological profile in comparison to all the compounds in the analogue dataset owing to its better electrostatic interactions and hydrogen bonding patterns. In order to identify compounds with even better high affinity and pharmacological profile than 6H and Vorinostat, virtual screening was performed. A total of 83 compounds similar to Vorinostat and 154 compounds akin to analogue 6H were retrieved. SCHEMBL15675695 (PubCid: 15739209) and AKOS019005527 (PubCid: 80442147) similar to Vorinostat and 6H, were the best docked compounds among the virtually screened compounds. However, in spite of having good affinity, none of the virtually screened compounds had better affinity than that of 6H. In addition SCHEMBL15675695 was predicted to be a carcinogen while AKOS019005527 is Ames toxic. From, our extensive analysis involving binding affinity analysis, ADMET properties predictions and pharmacophoric mappings, we report Vorinostat hydroxamate analogue 6H to be a potential candidate for HDAC inhibition in treatment of cancers through an epigenetic strategy.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권4호
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• pp.369-376
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• 2021

In adult patients with dental phobia, dental treatment may be difficult, or may not be possible. Depending on the level of fear or anxiety, non-pharmacological or pharmacological behavior management techniques are used in the dental treatment of such patients. Among the pharmacological behavior management techniques, minimal sedation, that is, the lowest depth of sedation, can be easily obtained in adult patients using oral sedatives, does not require special equipment or tools, and does not affect ventilatory and cardiovascular function. Diazepam is an anxiolytic drug belonging to the benzodiazepine family that, in addition to relieving anxiety, produces muscle relaxation, and is a representative drug used in adult patients with fear of dental treatment. Herein, we report the case of a 50-year-old woman with severe dental fear who successfully underwent long-term dental treatment in approximately 20 visits with minimal sedation using oral diazepam. In addition, we reviewed the considerations for the use of benzodiazepines for minimal sedation.

• Tuberculosis and Respiratory Diseases
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• 제86권3호
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• pp.183-195
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• 2023

Bronchiectasis, which is characterized by irreversibly damaged and dilated bronchi, causes significant symptoms, poor quality of life, and increased economic burden and mortality rates. Despite its increasing prevalence and clinical significance, bronchiectasis was previously regarded as an orphan disease, and ideal treatment of this disease has been poorly understood. The European Respiratory Society and British Thoracic Society have recently published guidelines to assist physicians in the clinical field. Guidelines and reports suggest comprehensive management that includes both non-pharmacological and pharmacological treatment. Physiotherapy and pulmonary rehabilitation are two of the most important non-pharmacologic therapies in bronchiectasis patients; long-term inhaled antibiotics and macrolide therapy have gained significant evidence in reducing exacerbation risk in frequent exacerbators. In this review, we summarize recent updates on bronchiectasis treatment to prevent exacerbation and manage clinical deterioration.

• 말소리와 음성과학
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• 제5권1호
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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.