• Title/Summary/Keyword: pharmacotherapy

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Effect of Pharmacological Treatment for Attention-Deficit Hyperactivity Disorder on Motor Coordination: Open Label Study (주의력결핍 과잉행동장애 아동의 약물치료가 운동협응력에 미치는 효과: 개방연구)

  • Park, Kee Jeong;Kweon, Kukju;Lee, Saejeong;Lim, Yun Shin;Joung, Yoo Sook;Kim, Hyo-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.28 no.4
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    • pp.244-251
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    • 2017
  • Objectives: The objective of this study was to investigate the effect of pharmacological treatments for attention-deficit hyperactivity disorder (ADHD) on motor coordination, using the Developmental Coordination Disorder Questionnaire (DCDQ). Methods: The participants were recruited from April 2015 to November 2016 from the Department of Psychiatry of Asan Medical Center and were treated for 3 months with methylphenidate or atomoxetine. The illness severity at baseline and 3 months were scored using the ADHD Rating Scale (ARS), Clinical Global Impression-Severity Scale (CGI-S) and/or Clinical Global Impression-Improvement Scale (CGI-I). A total of 39 children with ADHD (age $8.0{\pm}1.4years$, 36 boys) completed the Advanced Test of Attention (ATA) and their parents completed the DCDQ at baseline and 3 months. The paired t-test, mixed between-within analysis of variance and correlation analysis were used. Results: The CGI-S (p<0.001), ARS (p<0.001), and fine motor/hand writing (p=0.005) on the DCDQ were significantly changed between pre-treatment and post-treatment. When the participants were divided into those who were suspected of having developmental coordination disorder (DCD) (n=23) and those who probably did not (n=16), the control during movement, fine motor/hand writing and general coordination scores on the DCDQ showed the main effects for group (p<0.001, p<0.001 and p<0.001, respectively). The fine motor/hand writing on the DCDQ has a significant main effect for time [F(1,37)=7.31, p=0.010, ${\eta}^2=0.405$] and the interaction effect between group and time was also significant [F(1,37)=4.63, p=0.038, ${\eta}^2=0.111$]. The baseline visual commission error on the ATA is significantly correlated with the changes in the DCDQ total scores (r=0.330, p=0.040). Conclusion: Our results provide preliminary evidence that pharmacological treatment for ADHD improves not only the core symptoms of ADHD, but also the motor coordination. Further studies are needed to confirm the effect of the pharmacological treatment for ADHD on the motor coordination.

Results of Public Awareness Survey of Panic Disorder at the 2014 Mental Health Exposition in Seoul (2014년 정신건강박람회 공황장애 인식도 조사)

  • Rho, Seung Sun;Huh, Hyu Jung;Chae, Jeong Ho;Kim, Daeho;Lee, Dong-Woo;Seo, Ho Jun
    • Anxiety and mood
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    • v.10 no.2
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    • pp.176-181
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    • 2014
  • Objective : Despite high prevalence and effective treatments of panic disorder, lots of patients are not properly treated due to lack of awareness of the disorder. This study summarizes and presents the results from Public Awareness Survey of Panic Disorder during the Mental Health Exposition held in Seoul in April, 2014. Methods : A total of 401 participants who visited the booth of the Korean Academy of Anxiety Disorder agreed and completed the survey. The questionnaires comprised of three sections; first, after given a case of patient with panic disorder, participants were asked to choose a diagnosis and treatment options. Second, participants were asked to differentiate the symptoms of panic disorder from those of other mental disorders and answer where they acquired the knowledge of the disorder. Third, visual analogue scales were used to get more detailed information for several issues about panic disorder. The incidence and ratio for each question were provided and compared. Results : Among the participants, 78% reported a patient within the case need treatment, and 30% accurately recognized it was panic disorder. As for treatment needed, 40% selected psychotherapy by psychiatrists, 28% chose counseling by psychologist, 23% said that they can overcome it by self-care. Only 2% of participants selected the pharmacotherapy as treatment needed. Approximately 40% of participants have encountered information about the disorder from gossips of celebrities, 32% from mass-media, and merely 6% from medical professionals. About 80% of participants could discriminate the symptom of panic disorder from those of depression, schizophrenia, or generalized anxiety disorder. Conclusion : Our results suggest that substantial proportions of participants have the awareness of panic disorder, while as for treatment they were strongly biased against pharmacologic treatments. Most of their source of the awareness was not relied upon professional information. Efforts for giving correct information and increasing public awareness of panic disorder are needed to bridge a gap between professionals and general public.

Clinical Considerations of Trigeminal Neuralgia (삼차신경통 진단 및 치료의 중요 고려사항)

  • Jeon, Young-Mi;Tae, Il-Ho;Choi, Jong-Hoon;Ahn, Hyung-Joon;Shim, Woo-Hyun;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • v.32 no.4
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    • pp.449-453
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    • 2007
  • Trigeminal neuralgia is defined as "a sudden, usually unilateral, brief stabbing recurrent pain in the distribution of one or more branches of the fifth cranial nerve" by the International Association for the Study of Pain(IASP). Trigeminal neuralgia is classified as an idiopathic trigeminal neuralgia with no apparent cause and a symptomatic trigeminal neuralgia which is caused by a structural lesion such as brain tumor. Over 80% of the tumors are meningioma, acoustic neuroma, and epidermoid tumors. Symptomatic trigeminal neuralgia can not be excluded even if old-aged patient does not have abnormal neurologic sign and symptom, and good response to pharmacotherapy. Therefore, initial examinations such as MRI or CT are essential to exclude symptomatic trigeminal neuralgia. When compared with CT, MRI, especially gadolinium enhanced MRI, has an increased sensitivity in the detection of intracranial lesions. The most effective medical treatment of trigeminal neuralgia is carbamazepine. The most common side effects of carbamazepine include drowsiness, dizziness, unsteadiness, nausea, anorexia. Hepatotoxicity, bone marrow depression are the most feared side effect of carbamazepine therapy but occurs rarely. It require periodic complete blood cell counts as well as hepatic and renal function tests. It has been recommended that complete blood cell counts is done every 2 weeks for the first 2months and then quaterly thereafter. Oxcarbazepine can be used if neutropenia occurs.

Comparative Drug Evaluation of Atorvastatin versus Rosuvastatin in Pharmacotherapy of Korean Patients with Dyslipidemia

  • Park, Seon-Young;Lee, Myung-Koo;Lim, Sung-Cil
    • Biomolecules & Therapeutics
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    • v.16 no.1
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    • pp.54-60
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    • 2008
  • Dyslipidemia is the multiple lipid metabolic disorders which is one of the high risk factors for the atherosclerotic diseases. It increases the morbidity and mortality and therefore, must be treated with antilipidemic agents. HMG-Co A reductase inhibitors (statins), one of many antidyslipidemic agents, have shown to be significant improvement from the various cholesterol levels. Especially, data from many comparative trials suggest that rosuvastatin is more effective than atorvastatin among many other statins. The aims of this study were to evaluate the efficacy and safety between rosuvastatin and atorvastatin in the treatment of Korean patients with dyslipidemia. Currently the Korean Society of Lipidology and Atherosclerosis based on the Korean health screening data suggests that Korean patients with dyslipidemia should be treated by the target cholesterol levels according to the Adult Treatment Panel III guidelines of the US National Cholesterol Education Program (NCEP-ATP III). We reviewed retrospectively all medical histories of the total 392 dyslipidemic patients with atorvastatin or rosuvastatin from June 1st, 2004 to August 31st, 2006 in Chungbuk National University Medical Center. Patients were classified as total 4 groups by the NCEP-ATP III Guidelines. The numbers of enrolled patients were each 5 mg atorvastatin (n=34), 10 mg atorvastatin (n=148), 5 mg rosuvastatin (n=94) and 10 mg rosuvastatin (n=82). In comparison between groups, rosuvastatin groups in the lowering LDL-C had better efficacies, and the results were each 22% (5 mg atorvastatin), 33.3% (10 mg atorvastatin), 35% (5 mg rosuvastatin) and 41.3% (10 mg rosuvastatin) with the dose relationship (P=0.000). Rosuvastatin groups also have shown to be more significantly reducing Total Cholesterol levels compared to atorvastatin groups with the no dose relationship (P=0.000). In the lowering of non-HDL cholesteroles, rosuvastatin groups showed significantly better efficacies than atorvastatin with the dose-relationship (P=0.000). Each medication groups did not demonstrate the differences in the changing of HDL cholesterol and triglyceride levels (P=0.096, 0.309, respectively). In conclusion, rosuvastatin was better efficacious than atrovastatin in reducing LDL-C Total Chol, and Tg. Therefore, rosuvastatin is a good antilipidemic agents for Korean patients with dyslipidemia and it can use to minimize the morbidity and mortality related to the cardiovascular diseases in Korean.

Pain and Stress (통증과 스트레스)

  • Sihn, Woo-Yong;Yu, Bum-Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.15 no.1
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    • pp.29-34
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    • 2007
  • Pain is subjective and greatly influenced by prior experiences, but it is real. Pain associated with an organic(objective) pathology is more easily explained and treated. However, atypical or unexplainable pain is usually a source of greater confusion and frustration. Pain may be divided into four general diagnostic categories. 1) pain with anatomic features and objective findings 2) pain with anatomic features and without objective findings 3) pain with non-anatomic features associated with stress and somatization 4) pain with non-anatomic features associated with perceived physical injury. There is a well-established relationship between emotional, physical and/or sexual abuse history and development of chronic pain. It has been suggested that the link between somatization and abuse involves a paradoxical pattern of hiding feelings and reality, while seeking acknowledgment of suffering. History of abuse may physiologically and developmentally increase a person's susceptability to pain and organic changes can be associated with psychogenic disease. Patients with chronic pain should be treated with multidisciplinary approaches including exercise, meditation, cognitive therapy, medications, and biofeedback. Cognitive therapy alters patient's cognition and management of pain and alleviates pain, especially associated with stress. Antidepressants are the most commonly used medications and pain control effects have no relation with mood changes. Biofeedback with relaxation training, exercise and meditation may also be effective in pain control.

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Comparative evaluation of the safety and efficacy of recombinant FVIII in severe hemophilia A patients

  • Abolghasemi, Hassan;Panahi, Yunes;Ahmadinejad, Minoo.;Toogeh, Gholamreza;Karimi, Mehran;Eghbali, Aziz;Mirbehbahani, Nargess Bigom;Dehdezi, Bighan Keikhaei;Badiee, Zahra;Hoorfar, Hamid;Eshghi, Peyman;Maghsoudi, Nader;Sahebkar, Amirhossein;Gholami-Fesharaki, Mohammad
    • Journal of Pharmacopuncture
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    • v.21 no.2
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    • pp.76-81
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    • 2018
  • Objective: This study compared the safety and efficacy of $Safacto^{(R)}$ versus $xyntha^{(R)}$ in patients with severe hemophilia A. Methods: Thirty-three male patients with severe hemophilia A were randomly divided into two groups. Seventeen patients received $Safacto^{(R)}$ and 16 patients received $Xyntha^{(R)}$ for four consecutive times. The dosage of FVIII was 40-50 IU/kg for each injection. Plasma level of FVIII activity was evaluated before every injection, 15 minutes after the injection and one month after the start of the trial. The rate of factor VIII activity, pain and joint motion were also assessed before and after the treatment. Results: Plasma level of FVIII clotting activity in $Safacto^{(R)}$ and $Xyntha^{(R)}$ were $1.96{\pm}0.5IU/dl$ and $1.63{\pm}0.5IU/dl$ and increased to $88.84{\pm}25.2IU/dl$ and $100.09{\pm}17.8IU/dl$, respectively (P<0.001). Pain score and range of motion improvement were $9.3{\pm}0.9$ and $8.7{\pm}0.1$ in $Safacto^{(R)}$ (P=0.17); and $9.4{\pm}0.8$ and $8.8{\pm}0.3$ in $Xyntha^{(R)}$ (P=0.35), respectively. No allergic or other unfavorable reactions was observed with either of the preparations. Conclusion: This study showed that $Safacto^{(R)}$ has a favorable efficacy and safety profile.

Stellate Ganglion Block and Electrical Acupuncture for Treatment of Allergic Rhinitis (성상신경절 차단과 전기침 자극에 의한 알레르기성 비염의 치료)

  • Kim, Jin-Seung;Jin, Sun-Mi;Cho, Sung-Kyung;Kim, Bong-Il;Lee, Sang-Hwa
    • The Korean Journal of Pain
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    • v.6 no.2
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    • pp.208-212
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    • 1993
  • Allergy is one of the most common intractable disease, and also allergic rhinitis is the common symptom of the allergic diseases encountered in the otolaryngologic department. There are number of treatment such as: allergen avoidance by environmental control, pharmacotherapy, allergen immunotherapy and more. But choosing the exact reguired treatment is very difficult and troublesome. During the past 3 years, we have provided treatments to 49 allergic rhinitis patients with the combined therapy of stellate ganglion block(SGB) and eletrical acupuncture(E-AP) with very good results. From our experiences we highly recommend the combined therapy with SGB and E-AP for allergic rhinitis.

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Frontal Face Region Extraction & Features Extraction for Ocular Inspection (망진을 위한 정면 얼굴 영역 및 특징 요소 추출)

  • Cho Dong-Uk;Kim Sun-Young
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.30 no.6C
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    • pp.585-592
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    • 2005
  • One of the most important things in the researches on diseases is to attach more importance to prevention of a disease and preservation of health than to treatment of a disease, also to foods rather than to medicines. In this context, the most significant concern in examining a patient is to find the presence of disease, and, if any, to diaguose the type of disease, after which a pharmacotherapy is followed. In this paper, various diagnosis methods of Oriental medicines are discussed. And ocular inspection, the most important method among the 4 disease diagnoses of Oriental medicines, is studied. Observing a person's shape and color has been the major method for ocular inspection, which usually has been dependent upon doctor's intuition as of these days. We are developing an automatic system which provides objective basic data for ocular inspection. As the first stage, we applied the signal processing techniques to automatic feature extraction of faces for ocular inspection. Firstly, facial regions are extracted from the point of frontal view, which was followed by extraction of their features. The experiment applied to 20 persons showed that frontal face regions are perfectly extracted, as well as their features, such as eyes, eyebrows, noses and mouths. Future work will seek to address the issues of morphological operation for a few unfinished extraction results, such as combined hair and eyebrows.

Evaluation of Therapeutic Differences of Angiotensin II Receptor Blockers and Calcium Channel Blockers Among Hypertensive Patients Classified by Oriental Traditional Way (한국적 의학 기준에 근거한 고혈압환자의 Angiotensin II Receptor Blockers와 Calcium Channel Blockers의 약물 평가)

  • Lee, Ok Sang;Cheon, Young Ju;Ye, Kyong Nam;Yoon, Hee Young;Kim, Jung Tae;Lee, Yun Jeong;Lim, Sung Cil
    • YAKHAK HOEJI
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    • v.58 no.2
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    • pp.141-149
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    • 2014
  • Background: Oriental lifestyle for treating diseases has been developed and well-accepted for a long time among Koreans. Sasang Constitution theory, originated from Korean traditional medicine, suggests that medication treatment should be differentiated by each patient's body classification (So-yang [SY], So-eum [SE], Tae-yang [TY], and Tae-eum [TE]), in contrary to western medicine's theory that medication should be applied equally by disease indication without such classification. However, the pharmacotherapeutic outcomes of these theories have not been compared to date. In this study, we aimed to compare the two theories by evaluating blood pressure (BP), which is lowered as a therapeutic outcome, among hypertensive patients taking angiotensin II receptor blockers (ARBs) or calcium channel blockers (CCBs), two most commonly used antihypertensive classes in Korea. Methods: From April 2006 to June 2012, we retrospectively collected data on hypertensive patients with Sasang Constitution classification at Kyunghee University Hospital at Gangdong, one of the East-West collaborative medical centers in Korea. We collected information on age, gender, underlying diseases, antihypertensive drugs (ARB, CCB, ARB+CCB), and BP by reviewing the electronic medical records. We excluded patients with missing blood pressure at baseline or follow-up, or those who had a change in their antihypertensive drug class during follow-up. Results: We selected a total of 573 patients (SY: 165, SE: 158, TY: 0, TE: 250). Baseline BPs were on average 139.0/82.0 mmHg for SY, 137.8/78.5 mmHg for SE, and 138.7/79.2 mmHg for TE. In all three groups, CCBs were the most prescribed, followed by combination therapy with ARB+CCB, then ARBs. BP reduction after 1 month of initial medication was significantly different among the drug classes, but not in Sasang constitutional classification (ARB [SY: -12.4/-4.7, SE: -12.3/-2.5, TE: -8.6/-1.8], CCB [SY: -12.3/-5.4, SE: -13.0/-2.3, TE: -10.8/-6.0], ARB+CCB [SY: -15.6/-6.7, SE: -18.4/-8.1, TE: -20.2/-6.7], drug [$P{\leq}0.05$/P>0.05], constitutional type [P>0.05/P>0.05]). Conclusion: We observed significant differences in reduction of blood pressure by classes of drugs (ARB+CCB>CCB>ARB) but not by Sasang constitutional classification. Therefore, current approach of antihypertensive pharmacotherapy assisted by Western medicine is appropriate for treatment of hypertension. However, further larger scale or prospective studies are required in order to confirm these results.

The Difference of Efficacy for Oral Hypoglysemic Pharmacotherapy Based on Sasang Constitutional Medicine Among Type II Diabetes Mellitus Patients in Korea (제 2형 당뇨병 환자에서 사상체질에 따른 경구 혈당강하요법의 치료 반응성 및 사용 패턴 평가)

  • Kim, Ji Yeon;Lee, Myung Koo;Kim, Jung Tae;Lim, Sung Cil
    • YAKHAK HOEJI
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    • v.58 no.1
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    • pp.71-79
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    • 2014
  • Although Korean patients with type 2 diabetes mellitus (T2DM) are generally treated by western medicine, many of them strongly believe in the traditional oriental Sasang constitutional classification and depend on it for food, health supplements, and oriental medicines decision making. Sasang constitutional classification is a part of traditional Korean medicine that divides people into four constitutional types (Tae-Yang: TY, Tae-Eum: TE, So-Yang: SY, and So-Eum: SE), which differ in inherited characteristics such as appearance, personality traits, susceptibility to diseases, and drug responses. It is recommended for T2DM patients to control their blood glucose very well from early stages with drugs and diet. However, many T2DM patients respond differently to their drugs, even though they receive the same medicine. Therefore, the present study investigated whether Sasang constitutional type can explain the therapeutic differences between oral hypoglycemic agents (OHAs) therapy (mono, dual and triple drug therapy). Patients of 618 with T2DM diagnosis and Sasang constitutional type known who received both western and oriental medicine treatment in a hospital between April 2006 and April 2013 retrospectively studied. HbA1c (%) and blood glucose (mg/dl) levels before OHAs therapy and 3 month after were collected for metformin (MET) or sulfonylurea (SU) monotherapy, MET+SU dual therapy, MET+except SU (where was either alpha-glucosidase inhibitor, dipeptidyl peptidase-4 inhibitor, meglitinide or thiazolidinedione) dual therapy, and triple therapy, according to Sasang constitutional type. For statistical analysis, ANOVA was used and paired t-test by SPSS 19.0 where P values less than 0.05 were considered statistically significant. Pattern was similar levels of HbA1c and blood glucose and which was decreased in order of mono, MET+SU dual, MET+except SU dual and triple therapy. In all patients comparison, for the So-yang (SY) constitutional type, either monotherapy was less effective; for Te-eum (TE) type, MET+SU dual therapy was less effective while MET+except SU dual therapy was more effective and the triple therapy was less effective; and for So-eum (SE) type, the triple therapy was more effective. For the management of TE type it is recommended to use drugs except SU when dual therapy is needed, restrict triple therapy and consider dual and insulin therapy; for SY type it is recommended to follow current guidelines; and for SE type it is advisable to skip dual therapy and start the triple therapy early. Finally, the therapeutic response to OHAs is different among Korean T2DM patients with different Sasang constitutional types. Taken together, the choice of effective OHAs therapy for each type is necessary in order to minimize the poor control of blood glucose level, the risk of complications, and the costs from a failure of therapy.