• 생물정신의학
• /
• 제23권3호
• /
• pp.80-88
• /
• 2016

Vascular dementia is a very frequent form of dementia. Debates over classification and diagnostic criteria, and controversy over identifiable treatment targets will continue until distinct pathophysiological mechanism of vascular dementia is found. Clinical diagnostic criteria are sufficiently strong to be useful for clinical trials, but need further refinement. Cognitive changes in vascular dementia are more variable than other disorders, and are dependent on the vascular pathology. Accurate diagnosis of vascular dementia is known to need the presence of reliable cerebrovascular disease on brain imaging. Although it seems obvious that cerebrovascular disease causes pathological damage and impaired cognition, it is very difficult to find the accurate contribution of cerebrovascular pathology to cognitive decline. Most studies have shown a small but significant benefit of cholinesterase inhibitors on cognition, the significance of this effect has been slight and benefits on global functioning, activities of daily living, and behaviour have not been consistently reported. Management of vascular dementia should focus on identifying and managing vascular risk factors.

• Clinical and Experimental Pediatrics
• /
• 제48권1호
• /
• pp.1-5
• /
• 2005

Pediatricians often encounter some electrocardiographic abnormalities in infants and children. However, treatment or referral to pediatric cardiologist is not indicated for all arrhythmias. Many of them are benign in nature. Benign arrhythmias can be defined as the arrhythmias that no serious problem currently exists and no treatment is needed. The prognosis of benign arrhythmias is so good that the condition will never be associated with future health problem. However, some of them are benign now, but have potential for variable degrees of change to a nonbenign condition and some form of follow-up is required. For the appropriate management of electrocardiographic abnormalities, not infrequently seen in infants and children, correct diagnosis of abnormal electrocardiogram and understanding of characteristics of arrhythmias are required.

• The Korean Journal of Medicine
• /
• 제93권6호
• /
• pp.501-508
• /
• 2018

Obesity is a chronic disorder that is a significant risk factor for diabetes, cardiovascular diseases, malignancy, and other chronic diseases. Lifestyle modifications form the basis of most treatments for obesity, but it has become clear that such modifications alone are not enough for many obese patients. When a behavioral approach is insufficient, pharmacological treatment may be recommended. In recent years, the US Food and Drug Administration (FDA) has withdrawn several therapeutic options for obesity due to their side effects, but has approved four novel anti-obesity agents. Until recently, orlistat was the only drug approved for the management of long-term obesity, but the US FDA approved the novel anti-obesity drugs lorcaserin and phentermine/topiramate in 2012, and naltrexone/bupropion and liraglutide in 2014. The present review discusses the different pharmacotherapeutic options for the treatment of obesity.

• Tuberculosis and Respiratory Diseases
• /
• 제87권1호
• /
• pp.12-21
• /
• 2024

The management of severe asthma presents a significant challenge in asthma treatment. Over the past few decades, remarkable progress has been made in developing new treatments for severe asthma, primarily in the form of biological agents. These advances have been made possible through a deeper understanding of the underlying pathogenesis of asthma. Most biological agents focus on targeting specific inflammatory pathways known as type 2 inflammation. However, recent developments have introduced a new agent targeting upstream alarmin signaling pathways. This opens up new possibilities, and it is anticipated that additional therapeutic agents targeting various pathways will be developed in the future. Despite this recent progress, the mainstay of asthma treatment has long been inhalers. As a result, the guidelines for the appropriate use of biological agents are not yet firmly established. In this review, we aim to emphasize the current state of biological therapy for severe asthma and provide insights into its future prospects.

• 보건행정학회지
• /
• 제14권2호
• /
• pp.34-57
• /
• 2004

Universal health insurance normally requires a basic benefit package, whose design intersects with almost all other aspects of the health insurance debate. Despite its central importance, basic benefit package has not received the analysis it deserves in Korea. The issue of how to decide which health services should be delivered and to whom has been a matter for consistent policy debate. Many industrialized countries observed in this study have been dealing explicitly or implicitly with the basic benefit package. The methods vary from having a specific positive list of services (Bismarkian countries) to the use of guidelines (Beveridgian countries). The purpose of this paper is to form the underlying principles and process for determining what is included or left out by getting accurate and representative responses from health-related personnel. Mail survey is used. Economic burden for treatment, seriousness of disease and urgency of treatment are ranked at the first three priorities. Services that had been suspended because of financial crisis in health insurance scheme in 2001 were selected as items which should firstly be expanded into coverage. Diagnostic test against heart disease and vaccination were also selected as items which should additionally belong to the list of covered services.

• 대한기관식도과학회지
• /
• 제9권1호
• /
• pp.30-38
• /
• 2003

Cancers of the cervical esophagus occur uncommonly, but treatment is remaining a challenging problem and surgery demands special knowledge of abdominal, thoracic, and neck surgery. The primary risk factor is chronic heartburn, leading to a sequence of esophagitis, Barrett's esophagus, reflux esophagitis and etc. Among the various treatment modalities, Surgery is still a mainstay of treatment. The main aim of surgery is not only oncologically adequate resection but also preservation or restoration of physiologic functions, such as deglutition and phonation. Surgical treatment of cervical esophageal cancer is influenced by special problems arising from tumor factors, patient factors and surgeon factors. Complete clearance of loco-regional disease and prevention of postoperative complications are of particular importance for the improvement of long-term survival in patients with these cancers. So the cervical and thoracic extension of these tumors usually required an extensive lymphadenectomy with primary resection. Radical resection of the primary site almostly include sacrifice of the larynx, but the voice could be rehabilitated with various methods, such as tracheoesophageal prosthesis or tracheoesophageal shunts, etc. Restoration of the esophageal conduit can be performed using gastric or colon interposition, radial forearm free flap or jejunum free flap, etc. Recently, the advances of radiation therapy and chemotherapy will enable less extended resections with greater rates of laryngeal preservation. At initial presentation, up to 50％ to 70％ of patients will have advanced locoregional or distant disease with virtually no chance for cure. Patients with advanced but potentially resectable esophageal cancer are generally treated by surgery with some form of neoadjuvant chemotherapy, radiotherapy, or both, with 5-year survivals in the 20％ to 30％ range. So the significant adverse factors affecting survival should be taken into account to select the candidates for surgery.

• The Korean Journal of Pain
• /
• 제26권4호
• /
• pp.368-373
• /
• 2013

Background: Bertolotti's syndrome (BS), a form of lumbago in lumbosacral transitional vertebrae, is an important cause of low back pain in young patients. The purpose of this study was to assess the etiology of low back pain and the efficacy of treatment offered to patients with BS. Methods: All patients of BS Castellvi type1a during a period of 6 months were enrolled in the study. The patients underwent interventional pain procedures for diagnosis and pain relief. Response to the therapy was assessed based on VAS and ODI scores. A 50% decrease in VAS score or a VAS score less than 3 would be considered adequate pain relief. Results: All 20 patients diagnosed with BS during the 6-month observation period had scoliosis. Common causes of back pain were the ipsilateral L5-S1 facet joint, neoarticulation, the SI joint, and disc degeneration. Responses to various interventions for pain relief were different and inconsistent from patient to patient. In particular, responses to interventions for neoarticular pain were generally poor. Conclusions: Pain in patients with BS does not usually respond to interventional pain treatment. A very dynamic treatment approach must be pursued while managing BS patients, and the treatment plan must be individualized at various stages in order to obtain satisfactory pain relief.

• 대한예방한의학회지
• /
• 제16권3호
• /
• pp.37-51
• /
• 2012

Objectives : The objective of this study is to determine the present state of patients with breast cancer use of Korean medicine(KM) and predictive factors for the use. Through this, the present study is intended to present reasonable treatment approaches for patients with breast cancer as well as communicating correct information on KM to healthcare providers and presenting objective alternatives for patients with breast cancer management based on the subjects' experience in health benefits obtained from their use of KM. Methods : To collect data for the present study, questionnaire surveys were conducted on outpatients who visited four hospitals located in Seoul, Korea during around three weeks from May 31, 2012. Although the total number of the questionnaire sheet distributed in the form of directly asking questionnaire questions was 300, 12 incomplete questionnaire sheets were excluded. Therefore, the number of questionnaire sheets actually used in analyses was 288 and thus the collect rate was 96%. Results : Major results of this study are as follows. First, the number of subjects who responded to the questionnaire was 288 in total. Forty-six percent of the patients reported KM usage and the most commonly used ginseng and qigong/exercise. KM use was found to be associated with age, experiencing side effects of cancer treamnent. Factors that affect the use of KM were analyzed by Linear Logistic Regression and the results showed that age, experiencing side effects of cancer treatment, effectiveness of cancer treatment, and satisfaction of the treatment were factors that were related with relatively more frequent use of KM. Conclusions : Comparing the previous studies, it could be seen that patients with breast cancer were highly interested in and used KM in which conventional medicine and KM are used simultaneously. Knowledge on the integrative use of KM and conventional therapies is necessary for cancer physicians and traditional Korean medical doctors to help patients make informed choices. KM use may play a role in the positive benefits associated with process of breast center treatment. Healthcare providers should communicate correct information on the KM use that has been scientifically verified and talk with each other openly. The fact that the significant correlation between predictive factors for the use of KM was identified trough the present study is quite meaningful.

• 한국세라믹학회지
• /
• 제49권3호
• /
• pp.236-240
• /
• 2012

The reticulated carbon foam have been used for their excellent properties in terms of thermal management which is getting important in industrial field currently. In this study, we measure the mechanical properties of the reticulated carbon foam which is heat-treated at various temperature from the prepared low-density phenol foam. Simultaneously, we observe microstructures with high resolution transmission microscope and measure the residual oxygen content of carbon foams to figure out the relationship between the apparent change of properties such as weight loss and linear shrinkage during heat treatment. In conclusion, the carbon foam heat-treated at $1400^{\circ}C$ shows the highest strength, and the mechanical behavior is believed to be strongly related to the creation of nano-size graphite crystals from the amorphous carbon during heat treatment. On the other hand, it is turned out that the weight loss occurred at the temperature under $1400^{\circ}C$ comes from the elimination of oxygen in the form of $CO_2$ or CO, but no evidence is found on weight loss mechanism at the temperature above $1400^{\circ}C$.

• 한국산림과학회지
• /
• 제97권2호
• /
• pp.156-164
• /
• 2008

Recognizing the importance of the multi-purpose management of natural deciduous forest, this study was carried out to implement the partial cutting for stand regulation to examine agroforestry practice as well as other concurrent forest resource production, and to investigate the changes in stand characteristics and understory vegetation in a silvopasture practiced natural deciduous stand in the Research Forest of Kangwon National University, Korea. Three different partial cutting intensities (68.1%, 48.6%, and control) were performed in the unmanaged natural deciduous stand in order to improve the growing condition, especially light condition, for introducing some commercial herbaceous plants on the forest floor to establish agroforestry and/or silvopastoral system. Dominated by Quercus varibilis Blume (50.5%) and Quercus dentata Thum. ex Murray (42.6%), eight tree species were composed of the study forest, including poles of Pinus desiflora Siebold & Zucc and sapling of Pinus Koraiensis Siebold & Zucc. The total of 87 (13 tree species, 12 shrub species, 58 herbaceous species, and 4 woody climbers) vascular plant species were observed in study site after partial cutting treatments, while that of before partial cutting was 53 species (14 tree species, 8 shrubs species, 30 herbaceous species, and 1 woody climbers). The proportion of life form spectra in plot B was Mi (28.4%)-Na (23.0%)-Ge (17.5%)-Ch (10.8%)-He (9.5%)-MM (6.7%)-Th (4.1%). No statistically significant differences were observed in changes of life form spectra from before to after partial cutting treatment and among partial cutting gradients in this study. Partial cutting and scratching for forage sowing made plants invade easily on the forest floor, and light partial cutting (LPC) plot (500 stems/ha) had much higher number of undersory species than those of heavy partial cutting (HPC) plot (310 stems/ha) and control plot (1,270 stems/ha).