• Korean Circulation Journal
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• 제53권3호
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• pp.113-133
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• 2023

Owing to a large-jeopardized myocardium, left main coronary artery disease (LMCAD) represents the substantial high-risk anatomical subset of obstructive coronary artery disease. For several decades, coronary artery bypass grafting (CABG) has been the "gold standard" treatment for LMCAD. Along with advances in CABG, percutaneous coronary intervention (PCI) has also dramatically evolved over time in conjunction with advances in the stent or device technology, adjunct pharmacotherapy, accumulated experiences, and practice changes, establishing its position as a safe, reasonable treatment option for such a complex disease. Until recently, several randomized clinical trials, meta-analyses, and observational registries comparing PCI and CABG for LMCAD have shown comparable long-term survival with tradeoffs between early and late risk-benefit of each treatment. Despite this, there are still several unmet issues for revascularization strategy and management for LMCAD. This review article summarized updated knowledge on evolution and clinical evidence on the treatment of LMCAD, with a focus on the comparison of state-of-the-art PCI with CABG.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제25권2호
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• pp.73-81
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• 2014

Objectives : The purpose of this study was to investigate the use of various treatment modalities including pharmacotherapy, educational-behavioral therapy, and complementary alternative treatment for children with mental retardation (MR) or autism spectrum disorder (ASD) in Korea. Methods : The sample consisted of 50 parents who have children with MR (N=28) or ASD (N=22) : 38 boys, 12 girls ; mean age 14.06 (4.14) years old. A questionnaire was composed of the experienced modality, duration, cost, satisfaction, etc. Results : According to the results, 56.0%, 100.0%, and 36.0% of children with MR or ASD have experienced pharmacological treatment, educational-behavioral therapy and complementary alternative medicine (CAM), respectively. Children who experienced educational-behavioral therapy and CAM experienced 3.52 kinds of education-behavioral therapy and 2.78 kinds of CAM, respectively. Monthly cost of pharmacological treatment was lowest among three modality categories. Regarding treatment satisfaction by parental report, the lowest score was recorded for CAM. Conclusion : Parents who have a child with MR or ASD are trying many treatment modalities and feeling the burden of their treatment.

• Parasites, Hosts and Diseases
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• 제55권6호
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• pp.587-599
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• 2017

The immune response against Trichinella spiralis at the intestinal level depends on the $CD4^+$ T cells, which can both suppress or promote the inflammatory response through the synthesis of diverse cytokines. During the intestinal phase, the immune response is mixed (Th1/Th2) with the initial predominance of the Th1 response and the subsequent domination of Th2 response, which favor the development of intestinal pathology. In this context, the glucocorticoids (GC) are the pharmacotherapy for the intestinal inflammatory response in trichinellosis. However, its therapeutic use is limited, since studies have shown that treatment with GC suppresses the host immune system, favoring T. spiralis infection. In the search for novel pharmacological strategies that inhibit the Th1 immune response (proinflammatory) and assist the host against T. spiralis infection, recent studies showed that resiniferatoxin (RTX) had anti-inflammatory activity, which decreased the serum levels of IL-12, $INF-{\gamma}$, $IL-1{\beta}$, $TNF-{\alpha}$, NO, and $PGE_2$, as well the number of eosinophils in the blood, associated with decreased intestinal pathology and muscle parasite burden. These researches demonstrate that RTX is capable to inhibit the production of Th1 cytokines, contributing to the defense against T. spiralis infection, which places it as a new potential drug modulator of the immune response.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제6권1호
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• pp.34-42
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• 1995

청소년기의 경계선 인격장애는 충동조절의 결여, 타인에 대한 평가절하와 자신보다는 대상에 대하여 만족감을 얻으려는 욕구, 분리 방어기제를 특징으로 하는 인격장애로서 성인의 경계선 인격장애와 비슷한 양상으로 나타난다. 청소년기의 경계선 인격장애의 주요한 증상은 우울, 불안, 정체성 위기와 이러한 정체성 위기로 인한 반사회적인 행동을 흔히 볼 수 있다. 따라서 이들 증상들과 정상 청소년들이 보일 수 있는 질풍노도의 양상과 구별이 힘든 경우가 있다. 경계선 인격장애에서는 대상관계의 불안정, 정동의 불안정, 분리 등 미숙한 방어기제로 인해서 심한 스트레스하에서 정신병적 삽화가 나타날 수 있으며, 이로인해 정신분열증, 정동장애, 분열형 인격장애, 편집형 인격장애등과 감별진단이 필요하다. 청소년기 경계선 인격장애의 원인으로는 정신역동적 요소, 유전적 요인을 포함한 생물학적 요소, 가족역동적인 요소등을 복합적으로 고려해야 한다. 치료는 개인정신치료, 그룹치료, 가족치료, 약물치료 등이 있다. 소아 청소년기 경계선 인격장애가 성인기 경계선 인격장애로 될 것인가에 대해서는 논란이 되고 있다.

• 동의신경정신과학회지
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• 제14권1호
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• pp.161-174
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• 2003

Attention deficit hyperactivity disorder(ADHD) is one of the most common childhood-onset psychiatric disorders. It is distinguished by symptoms of hyperactivity, inattention, and impulsivity. The etiology of ADHD is unknown, and the disorder may several different causes. The pharmacotherapy most widely used for ADHD occasionally gives rise to ill effects. The studys of ADHD were approached from the viewpoint of medicine and pedagogics, but it is rare from the viewpoint of the Korean Medicine. So, we searched for the studies on ADHD of Chinese Traditional Medicine(TCM) in last eight years(1995-2002). In TCM, ADHD was placed under the category of 'wind(風)-one of the five pathogenic factors', 'insomnia(失眠)', 'forgetfulness(健忘)' and 'restlessness(躁動)', etc. Jang and Bu(the internal organs; 臟腑) related with the differentiations of syndrome about ADHD were liver(肝), heart(心), spleen(脾), kidney(腎) and gallbladder(膽). Among them, liver(肝), kidney(腎) and spleen(脾) were important. The herbal medicines used in ADHD had the effects of spirit-calming(安神), orifices-opening(開竅), Eumyang-balance(陰陽平衡). And acupuncture therapy, ear-acupuncture therapy and dietary treatment, etc. were used in the treatment of ADHD. We expect that this review about ADHD in TCM help the clinical study of ADHD in Korean Medicine.

• 정신신체의학
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• 제7권2호
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• pp.256-262
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• 1999

만성 통증은 신체적, 심리적, 사회환경적 요인들이 복합적으로 작용한 결과로서 나타나기 때문에 생물정신사회적 관점에서 접근해야 하며 치료는 다각적이고 포괄적인 체제하에서 상호 긴밀한 협력을 필요로 한다. 치료의 목표는 즉각적인 통증의 해소보다는 재활에 초점을 맞추어 환자의 활동과 기능이 증진됨에 따라 부수적으로 통증이 완화될 수 있도록 해야 할 것이다. 정신과적 영역에서 만성 통증의 치료는 정신의학적 평가로부터 시작하는데 여기에는 스트레스와 연관된 통증의 정신생리적 기전과 이상 질병행동과 관련된 조작적 조건화 기전, 그리고 증상으로서 통증을 동반하거나 만성 통증에 의해서 유발되는 정신과적 질환들에 대한 평가가 포함된다. 정신과적 치료를 약물치료와 심리적 치료로 나눌 때 약물치료에는 마약성 진통제, 비스테로이드성 소염제, 향정신성약물, 항경련제 들이 포함되는데 그 중에서도 항우울제가 가장 중요한 역할을 한다. 심리적 치료로는 역동적 정신치료와 행동치료적 방법들이 있고 행동치료적 접근법에는 자가조절기법과 조작적 조건화기법 등이 포함되는데, 환자가 갖는 대인관계의 어려움, 신체적 손상, 이상 질병행동 등을 고려하여 적절한 방법을 적용하게 된다.

• 정신신체의학
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• 제7권2호
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• pp.274-280
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• 1999

중추신경계와 말초신경계의 손상으로 인한 다양한 기전에 의해서 신경병성 통증이 생길 수 있다. 특정한 질병과 관련된 기전에 의해서 생기는 경우는 거의 없고, 진단과는 상관없이 한 환자에서 여러 가지 기전이 동시에 관여하여 생긴다. 신경병성 통증은 신경학적 검사와 환자의 문진으로부터 쉽게 진단할 수 있으나 치료는 아직 만족할 만하지 못하다. 신경병성 통증의 치료가 어렵다 하더라도 의사가 치료시 문제점을 완전히 이해하고 있다면 적절한 치료에 도달될 수 있을 것이다. 적절한 약물의 선택은 환자마다 효과가 있는 약제, 용량, 혈중농도 등이 각기 다르기 때문에 치료의 시도와 실패의 반복을 통해서 얻어질 수 있다. 효과가 있다고 알려진 각 약물들의 적절한 치료연구는 신경병성 통증의 약물치료에 있어 핵심일 것이다. 삼환계 항우울제는 일차약물로 알려져 있고 이에 대한 효과가 만족스럽지 못할 경우에는 항경련제, 국소마취성 항부정맥제제, clonidine, 마약성 진통제, 국소도포제 순으로 사용해 볼 수 있다. Venlafaxine, nefazodone 같은 항우울제가 최근에 삼환계 항우울제 보다 부작용이 적고 비슷한 효과가 있으며, 항경련제인 gabapentine도 효과있는 약물로 널리 사용되고 있다.

• Advances in Traditional Medicine
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• 제10권4호
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• pp.239-253
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• 2010

Coenzyme $Q_{10}$ ($CoQ_{10}$, or ubiquinone) is an electron carrier of the mitochondrial respiratory chain (electron transport chain) with antioxidant properties. In view of the involvement of $CoQ_{10}$ in oxidative phosphorylation and cellular antioxidant protection a deficiency in this quinone would be expected to contribute to disease pathophysiology by causing a failure in energy metabolism and antioxidant status. Indeed, a deficit in $CoQ_{10}$ status has been determined in a number of neuromuscular and neurodegenerative disorders. Primary disorders of $CoQ_{10}$ biosynthesis are potentially treatable conditions and therefore a high degree of clinical awareness about this condition is essential. A secondary loss of $CoQ_{10}$ status following HMG-CoA reductase inhibitor (statins) treatment has been implicated in the pathophysiology of the myotoxicity associated with this pharmacotherapy. $CoQ_{10}$ and its analogue, idebenone, have been widely used in the treatment of neurodegenerative and neuromuscular disorders. These compounds could potentially play a role in the treatment of mitochondrial disorders, Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis, Friedreich's ataxia, and other conditions which have been linked to mitochondrial dysfunction. This article reviews the physiological roles of $CoQ_{10}$, as well as the rationale and the role in clinical practice of $CoQ_{10}$ supplementation in different neurological diseases, from primary $CoQ_{10}$ deficiency to neurodegenerative disorders. These will help in future for treatment of patients suffering from neurodegenerative disease.

• 한국임상약학회지
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• 제19권2호
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• pp.110-119
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• 2009

Medication compliance is essential to improve person's health status through pharmacotherapy. Since separation of dispensing and prescription has been implemented, the importance of pharmacist's role on medication counseling have been emphasized, especially among outpatients. The objective of this study is to investigate the effect of patient's satisfaction with pharmacist's medication counseling on medication compliance among outpatients. We used the 2005 Korea National Health and Nutrition Survey data to examine medication compliance of persons who visited pharmacy. Ordered logistic regression analysis was conducted to assess whether patient's satisfaction with pharmacist's medication counseling was associated with medication compliance. Overall, 86.17% of study subjects(5,494) reported to take the prescribed medicines correctly and 80.54% of respondents were satisfied with pharmacist's medication counseling. Logistic regression analysis presents patient's satisfaction with pharmacist's counseling is significantly associated with medication compliance after controlling patient's characteristics(proxy-measured by age, family income, educational attainments, comorbid conditions). Interestingly, even patients who are dissatisfied with pharmacist's counseling have slightly higher odds of better compliance to medication therapy than those without pharmacist's counseling. In addition, higher educational attainments and older age groups are associated with better medication compliance. In conclusion, pharmacist's medication counseling appears to be effective in improving medication compliance. Further research that assess medication counseling in detail needs to develop strategies to improve medication adherence.

• 한국보건간호학회지
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• 제34권2호
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• pp.263-276
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• 2020

Purpose: This paper systematically reviewed the effects of smoking cessation (SC) intervention among female smokers. Methods: A systematic search was performed targeting articles published on eight electronic databases, from January 1, 2010, to February 25, 2020. Nine studies were included in the systematic review. The risk of bias (RoB) tool was used to evaluate the quality of scientific evidence. Results: A randomized controlled trial (RCT) was performed in all nine studies. Interventions were classified as exercise (n=4), cognitive behavioral counseling (n=2), motivational counseling (n=1), group counseling with self-help group (n=1), and pharmacotherapy (n=1). The SC rates were measured using a 7-days point prevalence abstinence in 55.6% of the studies. Exercise studies showed higher SC rates in the experimental groups than control groups after the intervention, but the differences were not significant. Other interventions were employed in two or fewer studies or did not conduct long-term follow-up, thus we were unable to examine effects of these interventions. Conclusion: It is necessary to develop SC programs for female smokers by carefully considering the characteristics of female smokers. Further research will be needed to confirm the effects of SC programs in certain subgroups among females. Also more experimental studies on SC intervention should be carried out with scientific rigor.