• 한국임상약학회지
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• 제24권3호
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• pp.193-198
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• 2014

Objective: This study was conducted to compare the adherence, clinical and economical utility of fixed-dose combination tablets of sitagliptin/metformin with concomitant administration of sitagliptin and metformin in patients with type 2 diabetes mellitus. Methods: Adherence was measured as the medication possession ratio (MPR) of ${\geq}80%$, and MPR was calculated as the number of total prescription days divided by the total treatment period. Hemoglobin $A_{1C}$ ($HbA_{1c}$) differences between baseline and predetermined periods were analyzed. Proportions of patients who achieved $HbA_{1c}$ less than 6.5% for three or more consecutive times were compared. To evaluate cost-effectiveness, prices of sitagliptin, metformin and sitagliptin/metformin tablets were investigated. Results: More than 90% of patients showed adherence in both groups (92.0% in fixed-dose combination group vs 95.9% in concomitant administration group), and there was no statistically significant difference (P = 0.113). Proportion of patients with HbA1c less than 6.5% for three or more consecutive times tended to be somewhat higher in fixed dose combination group than in concomitant administration group without a statistically significant difference (32.6% vs. 28.0%, P = 0.344). Total price of metformin and sitagliptin was cheaper up to 222 KRW in the case of fixed-dose combination tablets compared to the case of concomitant administration. Conclusion: The sitagliptin/metformin fixed-dose combination tablet had a similar patient adherence and was not significantly different in efficacy to the concomitant administration of each component. In terms of drug prices, fixed-dose combination tablets were cheaper than concomitant administration of each tablet.

• Journal of Periodontal and Implant Science
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• 제26권1호
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• pp.117-132
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• 1996

The purpose of this study was to evaluate the bacterial adherence on e-PTFE membrane immersed in whole saliva from subjects with different periodontal status. Experiment involved 3 subject groups: 5 persons with healthy periodontium(probing depth below 3mm and no signs of gingival inflammation including bleeding on probing), 10 patients with gingivitis(probing depth below 3mm and apparent signs of gingival inflammation), and 10 patients with advanced periodontitis(probing depth over 7mm and apparent signs of gingival inflammation). Each disease group was included before and after scaling and root planing treatment. After obtaining whole saliva from each subject, e-PTFE membrane(Gore-Tex periodontal membrane : $GTPM^{(R)}$, W.L. Gore & Associates, Flagstaff, USA) specimens were immersed at room temperature in the saliva aliqouts for 1, 3, 7 days. The weight between pre - and post - immersion in saliva was measured with the analytical balance and the difference was recorded. The specimens were processed for SEM observation. The bacterial adherence on the membrane specimens was evaluated using the scanning electron microscope images. The obtained results were as follows : 1. There was no difference in the weight of bacteria adherent to e-PTFE membrane specimens according to the periodontal status and the immersion periods. 2. As the exposure time to saliva increased, the bacterial adherence to the membrane specimen significantly increased in all groups(P<0.005). 3. As the severity of periodontal disease increased, the bacterial adherence to the membrane specimens significantly increased(p<0.001). 4. After scaling and root planing, the bacterial adherence to the membrane specimens significantly decreased in gingivitis and periodontitis patient group(P<0.001). These results suggest that bacterial contamination on exposed barrier membrane surface be reduced through improvement of periodontal status and oral health environment before and after GTR procedure for the successful outcome.

• Clinical and Experimental Pediatrics
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• 제53권3호
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• pp.364-372
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• 2010

목 적: 성공적인 천식 치료를 위해서는 증상이 조절된 이후에도 일정 기간의 유지 치료가 지속되어야 하며, 이를 위해서는 소아 환자의 경우 보호자의 순응도가 매우 중요하다. 본 연구는 천식 조절상태 환아의 보호자가 장기간의 유지 치료에 순응하는 데 관련된 요인을 알아보고자 하였다. 방 법: 고려대학교 안암병원 소아청소년과에서 천식으로 진단하여 유지 치료를 받고 있는 환아 중에서 NAEPP 가이드라인에 따른 천식 조절상태가 최소 3개월 이상 유지되면서 치료 순응도가 높은 보호자 18명을 대상으로 하였다. 질적 분석 방법 중 하나인 심층 면담을 통해 보호자들의 천식 치료와 관한 경험, 천식 및 천식 치료에 대한 인식, 치료자와의 상호 관계에 대한 자료를 얻고, 이들의 높은 치료 순응도와 관련된 요인들을 분석하였다. 결 과: 총 18명의 보호자(어머니 15명, 아버지 1명, 할머니 2명)가 심층 면담에 참여하였고 이들의 평균 연령은 40.0세였다. 심층면담 결과 보호자 및 환자 영역에 해당하는 8개의 순응 요인과 치료 영역에 해당하는 4개의 순응 요인이 밝혀졌다. 보호자 및 환자 영역에서는 천식 치료 후 증상 호전에 따른 일상활동의 수행(77.8%), 천식의 장기간 치료 필요성에 대한 인식(50.0%), 부작용보다 우선하는 치료제의 필요성에 대한 가치 인식(38.9%) 등이 주로 언급되었다. 치료 영역에서 가장 흔히 언급된 요인은 치료자에 대한 신뢰(77.8%), 진료 방식 및 태도에 대한 전반적인 만족(77.8%), 객관적인 검사를 통한 지속적인 치료 필요성의 제시(38.9%)였다. 결 론: 소아 천식 치료의 순응도 향상을 위해서는 보호자/환자 측면의 요인과 치료 측면의 복합적인 작용에 대한 고려가 필요하다. 치료자로서는 보호자와의 상호 협력 관계 형성을 위한 노력이 가장 기본적으로 선행되어야 할 것으로 생각된다.

• Journal of Preventive Medicine and Public Health
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• 제57권3호
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• pp.212-222
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• 2024

Objectives: Epilepsy is a chronic disease that requires long-term treatment and intervention from health workers. Medication adherence is a factor that influences the success of therapy for patients with epilepsy. Therefore, this study aimed to analyze the role of pharmacists in improving the clinical outcomes of epilepsy patients, focusing on medication adherence. Methods: A scoping literature search was conducted through the ScienceDirect, PubMed, and Google Scholar databases. The literature search included all original articles published in English until August 2023 for which the full text was available. This scoping review was carried out by a team consisting of pharmacists and neurologists following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews and the Joanna Briggs Institute guidelines, including 5 steps: identifying research questions, finding relevant articles, selecting articles, presenting data, and compiling the results. Results: The literature search yielded 10 studies that discussed pharmacist interventions for patients with epilepsy. Five articles described educational interventions involving drug-related counseling with pharmacists. Two articles focused on similar pharmacist interventions through patient education, both verbal and written. Three articles discussed an epilepsy review service, a multidisciplinary intervention program involving pharmacists and other health workers, and a mixed intervention combining education and training with therapy-based behavioral interventions. Conclusions: Pharmacist interventions have been shown to be effective in improving medication adherence in patients with epilepsy. Furthermore, these interventions play a crucial role in improving other therapeutic outcomes, including patients' knowledge of self-management, perceptions of illness, the efficacy of antiepileptic drugs in controlling seizures, and overall quality of life.

• Nutrition Research and Practice
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• 제9권4호
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• pp.343-349
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• 2015

BACKGROUND/OBJECTIVES: Fermentation of dietary fiber results in production of various short chain fatty acids in the colon. In particular, butyrate is reported to regulate the physical and functional integrity of the normal colonic mucosa by altering mucin gene expression or the number of goblet cells. The objective of this study was to investigate whether butyrate modulates mucin secretion in LS174T human colorectal cells, thereby influencing the adhesion of probiotics such as Lactobacillus and Bifidobacterium strains and subsequently inhibiting pathogenic bacteria such as E. coli. In addition, possible signaling pathways involved in mucin gene regulation induced by butyrate treatment were also investigated. MATERIALS/METHODS: Mucin protein content assay and periodic acid-Schiff (PAS) staining were performed in LS174T cells treated with butyrate at various concentrations. Effects of butyrate on the ability of probiotics to adhere to LS174T cells and their competition with E. coli strains were examined. Real time polymerase chain reaction for mucin gene expression and Taqman array 96-well fast plate-based pathway analysis were performed on butyrate-treated LS174T cells. RESULTS: Treatment with butyrate resulted in a dose-dependent increase in mucin protein contents in LS174T cells with peak effects at 6 or 9 mM, which was further confirmed by PAS staining. Increase in mucin protein contents resulted in elevated adherence of probiotics, which subsequently reduced the adherent ability of E. coli. Treatment with butyrate also increased transcriptional levels of MUC3, MUC4, and MUC12, which was accompanied by higher gene expressions of signaling kinases and transcription factors involved in mitogen-activated protein kinase (MAPK) signaling pathways. CONCLUSIONS: Based on our results, butyrate is an effective regulator of modulation of mucin protein production at the transcriptional and translational levels, resulting in changes in the adherence of gut microflora. Butyrate potentially stimulates the MAPK signaling pathway in intestinal cells, which is positively correlated with gut defense.

• 정신간호학회지
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• 제27권4호
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• pp.342-354
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• 2018

Purpose: The purposes of this study were to develop an acceptance commitment-based cognitive behavioral program for patients with schizophrenia and to use it as an intervention tool for psychiatric mental health nursing and thereby confirm the program's effects on patients' psychological flexibility, psychological well-being, and treatment adherence including insight and attitude toward treatment. Methods: This study consisted of a pretest, posttest 1, and posttest 2 for a nonequivalent control group design. The participants were 42 patients with schizophrenia (experimental group: 21, control group: 21). The acceptance commitment-based cognitive behavioral program was conducted in 10 sessions for 5 weeks. Data collected from February to April 2018 were analyzed using the SPSS/WIN 25.0 for $x^2$ test, Fisher's exact test, independent t-test, and repeated measurement ANOVA. Results: The differences between experimental and control groups were statistically significant regarding psychological flexibility, psychological well-being, and insight. Conclusion: This study findings suggest that the acceptance commitment-based cognitive behavioral program can be used as an effective mental health nursing intervention for psychological flexibility, psychological well-being, and insight of patients with schizophrenia.

• Journal of Microbiology and Biotechnology
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• 제12권5호
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• pp.746-752
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• 2002

The purpose of the present study was to examine the antagonistic activities of Enterococcus faecalis strain PL9003 (PL9003) on Helicobacter pylori. This strain was isolated from infant feces and found to inhibit both the growth of H. pylori and its in vitro adherence to the human gastric cell line MKN-45. The binding of PL9003 to MKN-45 was observed under a light microscope after Cram staining and under a scanning electron microscope. When detected with an FITC-conjugate antibody, both viable and nonviable PL9003 were found to decrease the number of H. pylori bound to MKN-45. When detected by an enzyme-linked immunoabsorbent assay, about 70% of the H. pylori bound on MKN-45 disappeared with the four-1314 addition of viable or nonviable PL9003. The spent culture supernatant (SCS) of PL9003 also decreased the viability of H pylori even after neutralization and pepsin treatment. The above results suggest that PL9003 has a potential as a new probiotic for the stomach.

• 정신신체의학
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• 제25권1호
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• pp.46-55
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• 2017

연구목적 외래치료명령제는 정신질환을 앓고 있는 사람이 특정한 외래치료 프로그램에 참여하도록 법에 의해 명령을 내리는 사회적 강제 제도이다. 본 연구에서는 외래치료명령제 및 정신질환자들의 치료 순응도에 영향을 미치는 요인들에 관해 알아보고자 하였다 방법 정신건강의학과 전문의 60명을 대상으로 2016년 10월에서 11월까지 외래치료명령제 및 치료 순응도에 관한 설문조사를 실시하였다. 설문지 각 문항은 문헌조사를 통하여 초안을 작성하고 3명의 정신건강의학과 전문의 및 1명의 법학전문대학원 교수의 의견 조회 과정을 거쳐서 최종적으로 확정하였다. 설문에 응답한 대상자들의 답변을 기술 통계를 이용하여 분석하였으며, 외래치료명령제의 실효성 점수에 대해서는 중앙값과 최고치, 최저치를 알아보았다. 결과 60명의 정신건강의학과 전문의 중에서 45명(75.0%)이 외래치료명령제를 알고 있었지만, 지난 12개월 중에 이를 이용한 전문의는 2명(4.0%)이었고, 주관적 실효성 점수는 40점/100점으로 그 실효성은 매우 낮게 나타났다. 또한 재입원 환자 중 외래 치료를 지속적으로 받았던 환자의 비율은 37.7%, 외래치료를 임의 중단한 환자 비율은 53.1%로 임의 중단 환자가 차지하는 비율이 더 높았다. 퇴원 환자 중에서는 약 2/3가량이 지속적인 치료를 받고 있었다. 임의로 치료를 중단한 환자의 관리방법으로 '아무런 조치를 취하지 않는다'(n=27)와 '파악하지 않음'(n=15)가 대부분이었지만 '정신건강증진센터 연락한다'는 의견은 2명으로 매우 저조하였다. 또한 임의 중단 환자에 대한 효율적인 조치로서는 '정신건강증진센터에 연계해야한다'는 의견이 가장 많았다(n=30). 결론 현재 시행되는 외래치료명령제는 실효성이 낮고, 외래치료 환자의 치료순응도 또한 매우 저조하였다. 따라서 이에 대한 효과적인 개입을 위해 제도적, 행정적 개선이 필요하며, 향후 정신건강증진센터의 역할이 중요할 것으로 판단된다.

• Journal of Korean Biological Nursing Science
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• 제19권3호
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• pp.131-140
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• 2017

Purpose: Dyslipidemia was a known risk factor for cardiovascular disease and was a leading cause of mortality in worldwide. This study aimed to determine the factors associated with prevalence and medication treatment of dyslipidemia in Korean adult population. Methods: In this study, based on the criteria set by the Korean Society of Lipidology and Atherosclerosis, the factors associated with prevalence and medication treatment of dyslipidemia was evaluated in a population of 12,506 people ($age{\geq}20$), who participated in the Korean National Health and Nutrition Examination Survey (2013-2015). The findings were tested by using multivariate logistic regression. Results: Dyslipidemia prevalence rate was 36.5%. Among populations with dyslipidemia, 17.5% were treated with lipid-lowering drugs. In the multivariate logistic regression model, male, increase in age, lower education level, non-drinker, current smoking, less physical activity, increase of body mass index, hypertension, and diabetes were associated with an increased odd of dyslipidemia. Female, increase in age, higher income, excess fat intake, hypertension, diabetes, myocardial infarction, and angina were associated with an increased odd of medication treat. Conclusion: The results of this study could be used to screen patients at the high risk for dyslipidemia or to predict medication adherence.

• The Korean Journal of Physiology and Pharmacology
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• 제8권6호
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• pp.319-327
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• 2004

This study was aimed at evaluating the effect of defibrotide on the development of the surgically induced reflux esophagitis, on gastric secretion, lipid peroxidation, polymorphonuclear leukocytes (PMNs) accumulation, polymorphonuclear leukocytes adherence, superoxide anion and hydrogen peroxide production in PMNs, scavenge of hydroxyl radical and hydrogen peroxide, cytokine (interleukin-1 ${\beta}$, tumor necrosis $factor-{\alpha}$) production in blood, and intracelluar calcium mobilization in PMNs. Defibrotide did not inhibit the gastric secretion and not change the gastric pH. Treatment of esophagitis rats with defibrotide inhibited lipid peroxidation, and myeloperoxidase (MPO) in the esophagus in comparison with untreated rats. Defibrotide significantly decreased the PMN adherence to superior mesenteric artery endothelium in a dose-dependent manner, Superoxide anion and hydrogen peroxide production in $1{\mu}M$ formylmethionylleucylphenylalanine (fMLP)- or $0.1{\mu}g/ml$ N-phorbol 12-myristate 13-acetate (PMA)-activated PMNs was inhibited by defibrotide in a dose-dependent fashion. Defibrotide effectively scavenged the hydrogen peroxide but did not scavenge the hydroxyl radical. Treatment of esophagitis rats with defibrotide inhibited interleukin-1 ${\beta}$ production in the blood in comparison with untreated rats, but tumor necrosis $factor-{\alpha}$ production was not affected by defibrotide. The fMLP-induced elevation of intracellular calcium in PMNs was inhibited by defibrotide. The results of this study suggest that defibrotide may have partly beneficial protective effects against reflux esophagitis by the inhibition lipid peroxidation, PMNs accumulation, PMNs adherence to endothelium, reactive oxygen species production in PMNs, inflammatory cytokine production(i.e. interleukin-1 ${\beta}$), and intracellular calcium mobilization in PMNs in rats.