• 제목/요약/키워드: Treatment Efficacy

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Discontinuation Rate of Doxepin in Insomnia Patients (불면증 환자의 Doxepin 치료 중단율)

  • Lee, Ji Hyeon;Kim, Sung-Min;Hong, Seung-Chul;Seo, Ho-Jun;Kim, Tae-Won;Um, Yoo-Hyun;Jeong, Jong-Hyun
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.1
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    • pp.51-58
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    • 2018
  • Objectives : We aimed to investigate the discontinuation rate and reasons of doxepin base prescription pattern in insomnia outpatients of psychiatry department of a university hospital. Methods : 534 patients prescribed doxepin were screened. 201 patients were included and reviewed for their medical records retrospectively. The discontinuation rate and reasons of doxepin after 2 months of prescription were investigated. Patients were divided into three groups according to the prescription patterns. The initial group, prescribed doxepin as the first hypnotic, the add-on group, prescribed doxepin while maintaining existing hypnotics, and the switching group, prescribed doxepin after discontinuation of existing hypnotics. Results : The discontinuation rate after 2 months of prescription of doxepin was 56.2%. There were significant differences in the discontinuation rate among three groups. The initial group had the highest while the add-on group had the lowest (p=0.018). In reasons for discontinuation of doxepin among three groups, lack of efficacy (p<0.001) and adverse events (p<0.001) were significantly higher in the add-on group. In the initial group, patient's refusal (p=0.022) and unknown or loss to follow up (p<0.001) were significantly higher. Conclusions : The results of this study suggested that add-on is superior than switching method and gradual reduction of existing hypnotics is necessary to maintain doxepin treatment and prevent adverse events. Additional large scale prospective studies are needed to evaluate various factors and risks of discontinuation of doxepin.

Mechanism of Inhibitory Effect of Imipramine on Isolated Rat Detrusor Muscle in Relation to Calcium Modulation (흰쥐 적출 방광 배뇨근의 수축성에 대한 Imipramine의 작용과 Calcium동원 기전과의 관계)

  • Lee, Jong-Bum;Yoo, Kae-Joon;Ha, Jeoung-Hee;Kwon, Oh-Cheol;Lee, Kwang-Youn;Kim, Won-Joon
    • The Korean Journal of Pharmacology
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    • v.28 no.1
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    • pp.81-89
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    • 1992
  • Enuresis is a common voiding disorder among children. There are several therapeutic regimens for the disorder available today; behavioral therapies, psychotherapy, bladder training, sleep interruption, hypnosis and drug therapy. Recently, the efficacy of drug therapy has been acknowledged, particularly of antidepressants. Among the tricyclic antidepressants, imipramine is most frequently employed for the treatment of enuresis. Present study was undertaken to investigate the mechanism of imipramine on the contractility of urinary bladder in relation to the calcium modulation using isolated strips of rat detrusor urinae. 1. The electric fileld stimulation-induced contraction was abolished by imipramine, but partially inhibited by atropine. 2. Imipramine reduced the basal tone and diminished the phasic activity of detrusor muscle concentration-dependently, which was similar to that of diltiazem, a calcium channel blocker. 3. Imipramine suppressed the maximal responses and shifted the concentration-response curves of bethanechol and ATP to right. 4. Imipramine inhibited the calcium-induced recovery of tension in calcium-free physiologic salt solution (PSS) with a mode of action similar to that of diltizaem. 5. A23187, a calcium ionophore recovered the basal tone which had been reduced by imipramine in normal PSS. 6. In calcium-free PSS, A23187 could recover the abolished basal tone with the pretreatment of imipramine, but it exerted a partial recovery with the pretreatment of TMB-8, an inhibitor of intracellular calcium release. Based on these results, it is suggested that the inhibitory action of imipramine on the detrusor muscle exerted in part by blockade of the muscarinic and purinergic receptors, and interference with the influx of extracellular calcium, but not with the release of intracellular stored calcium, is involved in its mechanism of action.

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Antifungal activity of pesticides to control dry rot and blue mold during garlic storage (마늘 저장 중 마름썩음병과 푸른곰팡이병 억제를 위한 농약의 살균활성)

  • You, Oh-Jong;Lee, Yong-Hoon;Jin, Yong-Duk;Kim, Jin-Bae;Hwang, Se-Gu;Han, Sang-Hyun;Kim, Jang-Eok
    • The Korean Journal of Pesticide Science
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    • v.11 no.4
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    • pp.331-338
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    • 2007
  • The major fungal diseases which effecting garlic storage are blue mold and dry rot, caused by Penicillium hirsutum and Fusarium oxysporum, respectively. In order to reduce the damage by the pathogenic fungi, here we report the effects of 11 fungicides tested to reduce spoilage during storage of garlics. In the in vitro antimicrobial activity test, the fungicides, diphenylamine, prochloraz and tebuconazole showed 0.3, 2.2, and 1.3 nun inhibition zone to F. oxysporium, and cyprodinil, diphenylamine, fenbuconazole, hexaconazole, penconazole, prochloraz, propiconazole, pyrimethanil and tebuconazole exhibited 0.2, 2.4, 0.8, 0.4, 1.2, 1.5, 1.2, 0.4 and 1.5 mm to P. hirsutum, respectively. To test the in vivo control effect, when the diphenylamine, prochloraz, and tebuconazole were treated by standard concentration, the fungal mycelium of F. oxysporium started to grow 5 days after inoculation, and 80, 63.3 and 83.3% of the inoculated cloves are infected 11 days after inoculation. When the tebuconazole were treated by standard concentration, the P. hirsutum was completely inhibited the growth of the fungi. In case of diphenylamine, penconazole and propiconazole treatment, the P. hirsutum was observed 7 days after inoculation and $20{\sim}23.3%$ of the cloves were infected 11 days after inoculation. When cyprodinil, prochloraz and pyrimethanil were treated, pathogens occurred 5 days after inoculation and $60{\sim}100%$ of the cloves infected 11 days after inoculation. Three fungicides such as diphenylamine, prochloraz and tebuconazole also suppressed remarkably the infection and growth of F. oxysporium and P. hirsutum on garlic when both of the pathogens are inoculated after the garlic cloves were dipped for 10 min in the suspension of each agrochemical. Overall, diphenylamine, prochloraz and tebuconazole showed effective control efficacy on dry rot and blue mold There was significant correlation between in vitro and in vivo assay in diphenylamine and prochloraz to F. oxysporum and cyprodinil, prochloraz and pyrimethanil to P. hirsutum.

The Effectiveness of Ultrasound-guide Steroid Injection According to Morton's Neuroma Size (모톤씨 신경종 크기에 따른 초음파 유도하 스테로이드 주사 효과의 비교분석)

  • Kim, Hak Jun;Hur, Chang Ryong;Kim, Jae Kyun;Jang, Kyu Seon
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.5 no.2
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    • pp.61-65
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    • 2012
  • Purpose: The aim of this study was to evaluate the effectiveness of ultrasound-guide steroid injection according to Morton's neuroma size. Materials and Methods: From October 2008 to September 2011, 17 patients (23 cases) diagnosed with Morton's neuroma were investigated. All cases were female and mean age was 52.6 years old. Neuroma were measured by the horizontal and longitudinal length of the mass and underwent ultrasound-guided steroid (5 mg dexamethasone) injection. The efficacy of the injection was determined by Visual Analogue Scale pain score and patient satisfaction(subdivided 4 group-much improved, improved, not improved, aggrevation) Results: 7 of 23(30.4%) cases showed much improved and improved satisfaction and mean longitudinal and horizontal length were $0.71{\pm}0.39cm$ and $0.47{\pm}0.24cm$, respectively. 16 of 23(69.6%) cases showed not improved and aggrevation satisfaction and mean longitudinal and horizontal length were $0.83{\pm}0.42cm$ and $0.54{\pm}0.14cm$, repectively. There was a significant difference in VAS and patient satisfaction in case longitudinal and horizontal length were smaller than 0.5 cm and 0.4 cm. (p<0.05) Conclusion: The ultrasonography is a important modality in diagnosis and treatment of morton's neuroma. Ultrasound-guide steroid injection is effective in case longitudinal and horizontal length were smaller than 0.5 cm and 0.4 cm, respectively.

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The Efficacy of Nebulized 3 Percent Hypertonic Saline Solution and Fenoterol in Infants with Bronchiolitis (영아 세기관지염에서 3% 고장성 식염액과 Fenoterol 병용흡입 치료의 효과)

  • Park, Joon Young;Jeong, Young Mi;Jeong, Soo Jin;Seo, Son Sang
    • Clinical and Experimental Pediatrics
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    • v.48 no.5
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    • pp.518-522
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    • 2005
  • Purpose : To evaluate the effect of inhaled hypertonic saline solution in hospitalized infants with bronchiolitis. Methods : A randomized double blind trial was performed from October 2003 to May 2004. A total of eighty patients <1 year of age with a clinical diagnosis of acute viral bronchiolitis were enrolled and assigned to receive either of the following : inhalation of 2 mL(0.5 mg) fenoterol added to 2 mL of 0.9 percent saline solution(group 1; n=40) or 2 mL(0.5 mg) fenoterol added to 2 mL of 3 percent saline solution(group 2; n=40). This therapy was repeated at six hours interval after admission. They were evaluated daily just before and 20 minutes after nebulization. The outcome measures included changes in clinical severity score(based on respiratory rate, presence of wheezing, retraction, and general condition) after nebulization and duration of hospitalization. Results : In the clinical severity score, a significant improvement was observed during the 72 hours of hospitalization in both groups(P<0.05). The basic clinical severity scores before inhalation were decreased significantly faster in group 2 as compared to group 1 on each day of treatment(P<0.05). The mean duration of hospital stay was significantly reduced in group 2 than group 1($5.9{\pm}1.9days$ versus $7.4{\pm}2.0days$, P<0.05). No adverse effects were associated with inhaled therapy. Conclusion : These results suggest that a nebulized 3 percent saline solution plus 0.5 mg fenoterol may be more effective than a 0.9 percent saline solution plus 0.5 mg fenoterol in accelerating the clinical recovery of infants with viral bronchiolitis.

The Efficacy of Ultrasonography-guided S1 Selective Nerve Root Block (초음파를 이용한 제 1천추 선택적 신경근 차단술의 유용성)

  • Jeon, Young Dae;Kim, Tae Gyun;Shim, Dae Moo;Kim, Chang Su
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.2
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    • pp.113-119
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    • 2014
  • Purpose: This study was to evaluate effect and efficiency of S1 selective nerve root block using ultrasonography-guided compared with fluoroscopy-guided for lumbar disc herniation or spinal stenosis patients. Materials and Methods: Between February 2012 and December 2013, 38 patients who were with lower leg radiating pain for more than 1months and underwent S1 selective spinal nerve root block in our institution, were reviewed. They divided into two groups: Group A included 18 patients with ultrasonography-guided and Group B included 20 patients with fluoroscopy-guided. Treatment effectiveness was assessed using a visual analogue scale (VAS) and the Korea Modified Oswestry Disability Index (K-MODI). They were evaluated its preoperatively, postoperatively and 1 month later. We were recorded whole procedure time. Results: VAS was improved from 7.4 to 4.7 at 1 month in group A and from 7.39 to 4.36 at 1month in group B. K-MODI was improved from 72.8 to 43.3 at 1month in group A and from 73.8 to 44.1 at 1month in group B. Whole procedure time were $477.53{\pm}115.02s$, $492.47{\pm}144.38s$ in group A, group B, respectively. But there was no significant difference in VAS and K-MODI between two groups. Conclusion: Ultrasonography-guided sacral nerve root block is effective and accurate method in sacral radiating pain.

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Comparison of IVF-ET Outcomes between GnRH Antagonist Multiple Dose Protocol and GnRH Agonist Long Protocol in Patients with High Basal FSH Level or Advanced Age (높은 기저 난포 자극 호르몬 수치를 가지는 환자와 고령 환자의 체외수정시술을 위한 과배란 유도에서 GnRH antagonist 다회 투여법과 GnRH agonist 장기요법의 효용성에 대한 연구)

  • Kim, JY;Kim, NK;Yoon, TK;Cha, SH;Kim, YS;Won, HJ;Cho, JH;Cha, SK;Chung, MK;Choi, DH
    • Clinical and Experimental Reproductive Medicine
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    • v.32 no.4
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    • pp.315-324
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    • 2005
  • Objectives: To compare the efficacy of GnRH antagonist multiple dose protocol (MDP) with that of GnRH agonist long protocol (LP) in controlled ovarian hyperstimulation for in vitro fertilization in patients with high basal FSH (follicle stimulating hormone) level or old age, a retrospective analysis was done. Methods: Two hundred ninety four infertile women (328 cycles) who were older than 41 years of age or had elevated basal FSH level (> 8.5 mIU/mL) were enrolled in this study. The patients had undergone IVF-ET after controlled ovarian hyperstimulation using GnRH antagonist multiple dose protocol (n=108, 118 cycles) or GnRH agonist long protocol (n=186, 210 cycles). The main outcome measurements were cycle cancellation rate, consumption of gonadotropins, the number of follicles recruited and total oocytes retrieved. The number of fertilized oocytes and transferred embryos, the clinical pregnancy rates, and the implantation rates were also reviewed. And enrolled patients were divided into three groups according to their age and basal FSH levels; Group A - those who were older than 41 years of age, Group B - those with elevated basal FSH level (> 8.5 mIU/mL) and Group C - those who were older than 41 years of age and with elevated basal FSH level (> 8.5 mIU/mL). Poor responders were classified as patients who had less than 4 retrieved oocytes, or those with $E_2$ level <500 pg/mL on the day of hCG injection or those who required more than 45 ampules of exogenous gonadotropin for stimulation. Results: The cancellation rate was lower in the GnRH antagonist group than in GnRH agonist group, but not statistically significant (6.8% vs. 9.5%, p=NS). The amount of used gonadotropins was significantly lower in GnRH antagonist group than in agonist group ($34.8{\pm}11.3$ ampules vs. $44.1{\pm}13.4$ ampules, p<0.001). The number of follicles > 14 mm in diameter was significantly higher in agonist group than in antagonist group ($6.7{\pm}4.6$ vs. $5.0{\pm}3.4$, p<0.01). But, there were no significant differences in clinical pregnancy rate (24.5% in antagonist group vs. 27.4% in agonist group, p=NS) and implantation rate (11.4% in antagonist group vs. 12.0% in agonist group, p=NS) between two groups. Mean number of retrieved oocytes was significantly higher in GnRH agonist LP group than in GnRH antagonist MDP group ($5.4{\pm}3.5$ vs. $6.6{\pm}5.0$, p<0.0001). But, the number of mature and fertilized oocytes, and the number of good quality (grade I and II) and transferred embryos were not different between two groups. In each group A, B, and C, the rate of poor response did not differ according to stimulation protocols. Conclusions: In conclusion, for infertile women expected poor ovarian response such as who are old age or has elevated basal FSH level, a protocol including a controlled ovarian hyperstimulation using GnRH antagonist appears at least as effective as that using a GnRH agonist, and may offer the advantage of reducing gonadotropin consumption and treatment period. However, much work remains to be done in optimizing the GnRH antagonist protocols and individualizing these to different cycle characteristics.

Clinical Study of Long Term Effect of Transvaginal Ultrasound Guided Radiofrequency Myolysis for Treatment of Uterine Leiomyoma (자궁근종 치료를 위한 질경유 초음파 유도하 고주파 자궁근종용해술의 장기간 효과에 대한 임상적 연구)

  • Lee, Woo-Seok;Lee, Il-Han;Kim, Dong-Ho;Lee, Sang-Hun
    • Clinical and Experimental Reproductive Medicine
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    • v.35 no.1
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    • pp.77-82
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    • 2008
  • Objective: This study was performed to investigate the efficacy and safety of radiofrequency (RF) myolysis under transvaginal ultrasound guidance. Methods: Transvaginal RF myolysis had been performed in one hundred nine women with uterine leiomyoma at Chung-Ang University hospital between Dec. 2004 and Mar. 2007. All patients, mean aged $42.8{\pm}5.8$ years, desired their uterine conservation. Patients underwent physical examination, transvaginal pelvic ultrasound for measurement of the lesions preoperatively. Follow up was done at 1 week, 1 month, 3 months, 6 months after RF myolysis by same physician and measurement of size and volume of myoma and improvement of myoma specific symptoms such as menorrhagia and dysmenorrhea were checked at each visit. Results: The mean maximal diameter of myomas treated by RF myolysis was $6.1{\pm}0.5\;cm$ and average time of the procedure was $16.3{\pm}8.5$ minutes. A significant decrease of myoma size and volume was observed at 1 month after myolysis. Mean reduction in maximal diameter was $29.9{\pm}4.8%$ at 1 week (p<0.001), $41.5{\pm}1.5%$ at 1 month (p=0.05), $46.2{\pm}3.9%$ at 3 months (p=0.003), $54.6{\pm}6.1%$ at 6 months (p<0.001) after RF myolysis respectively. Mean reduction in volume was $44.4{\pm}8.3%$ (p=0.001), $68.1{\pm}4.2%$ (p=0.035), 73.9$73.9{\pm}4.8%$ (p=0.042), $84.5{\pm}5.1%$ (p<0.001) at the same follow up period respectively. Significant improvement of symptom was observed at 3 months after RF myolysis. Transient low abdominal pain and prolonged vaginal bleeding were detected in 3 patients each but spontaneously resolved and no serious complication has been noticed or found. Conclusion: This study shows transvaginal RF myolysis could be a safe and effective method to treat uterine leiomyoma, allowing uterine conservation with significant volume reduction and rapid return to normal activity.

The Preparation of Magnetic Chitosan Nanoparticles with GABA and Drug Adsorption-Release (GABA를 담지한 자성 키토산 나노입자 제조와 약물의흡수 및 방출 연구)

  • Yoon, Hee-Soo;Kang, Ik-Joong
    • Korean Chemical Engineering Research
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    • v.58 no.4
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    • pp.541-549
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    • 2020
  • The Drug Delivery System (DDS) is defined as a technology for designing existing or new drug formulations and optimizing drug treatment. DDS is designed to efficiently deliver drugs for the care of diseases, minimize the side effects of drug, and maximize drug efficacy. In this study, the optimization of tripolyphosphate (TPP) concentration on the size of Chitosan nanoparticles (CNPs) produced by crosslinking with chitosan was measured. In addition, the characteristics of Fe3O4-CNPs according to the amount of iron oxide (Fe3O4) were measured, and it was confirmed that the higher the amount of Fe3O4, the better the characteristics as a magnetic drug carrier were displayed. Through the ninhydrin reaction, a calibration curve was obtained according to the concentration of γ-aminobutyric acid (GABA) of Y = 0.00373exp(179.729X)-0.0114 (R2 = 0.989) in the low concentration (0.004 to 0.02 wt%) and Y = 21.680X-0.290 (R2 = 0.999) in the high concentration (0.02 to 0.1 wt%). Absorption was constant at about 62.5% above 0.04 g of initial GABA. In addition, the amount of GABA released from GABA-Fe3O4-CNPs over time was measured to confirm that drug release was terminated after about 24 hr. Finally, GABA-Fe3O4-CNPs performed under the optimal conditions were spherical particles of about 150 nm, and it was confirmed that the properties of the particles appear well, indicating that GABA-Fe3O4-CNPs were suitable as drug carriers.

Efficacy of Weekly 0.1% Amitraz Dip with 4% Chlorhexidine Shampoo on Juvenile Onset Generalized Pyodemodicosis Unresponsive to Ivermectin Therapy in Japanese Chin Dog (Japanese Chin 종에서 발생한 Ivermectin에 반응을 보이지 않은 전신성 농성 모낭충 감염증에 대한 0.1% Amitraz와 4% Chlorhexidine의 국소치료 일례)

  • Jeong, Hyo-Hoon;Jeong, A-Young;Hoh, Woo-Pil;Eom, Ki-Dong;Lee, Keun-Woo;Oh, Tae-Ho
    • Journal of Veterinary Clinics
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    • v.20 no.2
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    • pp.237-241
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    • 2003
  • A case of juvenile onset generalized demodicosis of one year old, intact female Japanese Chin dog weighing 3.1kg was presented to the Small Animal Clinic of the College of Veterinary Medicine of Kyungpook National University. The diagnosis was made based on the physical examination, deep skin scrapings, hematology, serum chemistry, endocrinologic evaluation and bacterial culture. Numerous D. canis mites of various stages were observed in multiple skin scraping samples. CBC, serum chemistry, $T_3$, $T_4$ and free $T_4$ values were within normal range and Staphylococcus intermedius was isolated in bacterial culture of pustules. The dog was healthy other than skin lesions at the presentation. The three different treatment protocols were tried for the case. No clinical improvement was observed during 13 weeks of orally given daily basis ivermectin therapy at 600ug/kg and 2 weeks of spot-on weekly basis selamectin therapy at 30 mg/kg with cephalexin given orally twice a day at 25 mg/kg. However, a remarkable remission was seen by 0.1% amitraz dip on weekly basis with 4% chlorhexidine bath given twice a week. The secondary staphylococcal infection and accompanied pruritus was almost disappeared in two weeks and she was recovered clinically normal in 9 weeks of therapy. The therapy was continued for 4 more weeks to prevent relapse. The dog is clinically normal and being monitored for development of any abnormal dermatological signs for the time being.