• 대한감각통합치료학회지
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• 제15권1호
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• pp.21-32
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• 2017

목적 : 지각운동프로그램이 주의력결핍과잉행동장애(Attention-Deficit/Hyperactivity Disorder; ADHD) 아동의 시각운동통합기술과 운동기술에 미치는 영향을 알아보고자 한다. 연구방법 : ADHD로 진단 받았으나 약물중재를 받고 있지 않는 8세 남아를 대상으로 실시하였다. 실험설계는 개별실험연구(single-subject research design) 중 A-B-A(follow up) 설계를 사용하였고, 기초선 A는 3회기, 중재기 B는 8회기, 추적기간 A는 3회기였다. 기초선기간과 추적기간에는 자유 놀이를 40분간 실시한 후 시각운동통합기술을 보기 위해 한국판시지각발달검사의 하위 항목인 따라 그리기와 운동기술을 보기 위해 줄넘기를 실시하였다. 중재기 B에는 지각운동프로그램을 40분간 제공한 후 한국판시지각발달검사의 하위 항목인 따라 그리기와 줄넘기를 실시하였다. 결과 : 시각운동통합기술을 측정하기 위한 따라 그리기 항목의 표준점수는 기초선 기간에는 평균 4.7점의 열등수준을 보였지만 중재기간에서는 평균 9.6점의 평균 수준을 유지하였으며, 추적기간에서는 7.7점의 평균이하의 수준을 보였다. 아동의 운동기술의 변화를 측정한 줄넘기에서는 기초선 기간에는 4.3회, 중재기간에서는 5.9회로 증가된 운동능력을 보였으나, 추적기간에서는 5회로 약간 감소하였다. 결론 : 지각운동프로그램이 ADHD 아동의 시각운동통합기술과 운동기술의 수행의 변화에 긍정적 효과가 있었다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제22권4호
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• pp.253-261
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• 2011

Objectives : This study aimed to investigate the efficacy and safety of Metadate CD (MCD) when given to Korean children and adolescents with attention-deficit hyperactivity disorder (ADHD). We also explored the effects of the drug on diverse neuro-cognitive functions. Methods : Ninety-one subjects with ADHD (mean age 8.6${\pm}$2.2 years) were recruited at 6 outpatient clinics in Seoul, Korea. We used the ADHD Rating Scale (ARS), Clinical Global Impression (CGI), and comprehensive attention test (CAT) to measure the drug's effects. Results : After 0.92${\pm}$0.32mg/kg/day of MCD were administered for 57.4${\pm}$7.6 days, there was a 48.5% reduction in the mean total ARS scores (p<.001). Fifty-seven subjects (64.8%) showed either much improved or very much improved outcomes on the CGI-Improvement scale. The CGI-Severity scale also decreased from an average of 4.7 to an average of 2.9 (p<.001). Errors and response time standard deviations of the CAT, sustained attention test-to-response tasks, the flanker test, and divided attention test scores decreased after treatment (p<.05). The forward memory span of the spatial working memory test scores increased (p<.05). Thirty-five patients (39.8%) experienced side effects, of which the most common were headache (14.8%), nausea (12.5%), and anorexia (9.1%). Conclusion : This open-label study suggests that MCD is effective and safe in improving the symptoms and neurocognitive functions of Korean children and adolescents with ADHD.

• 약학회지
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• 제55권5호
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• pp.411-418
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• 2011

The dissolution test method and an analytical procedure by HPLC were developed and validated for nafronyl oxalate capsules and tramadol hydrochloride capsules. These drugs were not yet characterized by the dissolution specifications in the Korean Pharmaceutical Codex. So, with each reference and test drugs, we did the preliminary and standard experiments based on the Korean Pharmacopeia Guideline of dissolution testing for solid oral dosage forms. The dissolution test for nafronyl oxalate capsules was carried out under sink conditions as follows: dissolution medium phosphate buffer pH 6.8, paddle rotation speed 100 rpm and vessel volume 900 ml. More than 80% of its label amount was released within 30 min in this method. Also the dissolution test for tramadol hydrochloride capsules was carried out under sink conditions as follows: dissolution medium water, paddle rotation speed 50 rpm and vessel volume 900 ml. More than 90% of its label amount was released within 15 min in this method. The dissolution samples were analyzed with a validated HPLC analytical procedure. The analytical methodology showed acceptable values in terms of specificity, linearity, precision and accuracy. The dissolution test methods described above were adequate for the purpose and may be proposed as a pharmacopeial standard to assess the performance of nafronyl oxalate capsules and tramadol hydrochloride capsules. Furthermore, the outcomes of this study were expected to help create an environment where safe and high quality drugs would be distributed on the domestic market making contributions to advancing public health.

• Tuberculosis and Respiratory Diseases
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• 제70권1호
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• pp.28-35
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• 2011

Background: The aim of the study was to describe the characteristics, treatments, and outcomes of critically ill patients with pandemic Influenza A/H1N1 2009 at a major medical center in Korea. Methods: This retrospective observational study examined critically ill adult patients with pandemic Influenza A/H1N1 2009, who were admitted to the AMC between August and December 2009. Results: 27 patients with confirmed pandemic Influenza A/H1N1 2009 were admitted to the intensive care unit (ICU) at the Asan Medical Center (AMC). The median age (IQR) was 59 years (41~67), and 66.7% of the patients were older than 51 years. A total of 81.5% of the patients had 2 or more co-morbidities. The median time (IQR) from symptom onset to presentation was 2 days (1~4), and the median time from presentation to ICU admission was 0 days (0~1.5). All patients received oseltamivir (300 mg/day) and 13 patients received triple combination therapy (oseltamivir, amantadine, ribavirin). Twelve patients required mechanical ventilation on the first day of ICU admission. A total of 6 patients (22.2%) died within 28 days of admission. The patients who died had significantly higher acute physiology and chronic health evaluation (APACHE) II and sequential organ failure assessment (SOFA) scores at presentation. There were no significant differences in age, co-morbidities, or antiviral regimens between survivors and non-survivors. Conclusion: Critical illness related to pandemic Influenza A/H1N1 2009 was common in elderly patients with chronic co-morbidities. All patients were given high-dose oseltamivir or triple combination antiviral therapy. Nonetheless, patients with critical illnesses associated with pandemic Influenza A/H1N1 2009 had a death rate of 22.2%.

• 대한물리치료과학회지
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• 제9권4호
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• pp.15-23
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• 2002

In order to find the effects of physical therapy on the recovery of motor functions and mental state, a survey was conducted to 63 patients who, diagnosed as stroke by brain CT, had been hospitalized in a university medical center located in Jeonbuk provincial area from December 2000 to August 2001. The outcomes of the survey are as follows: 1. The subjects of the study were composed of 35 males(55.6%) and 28 females(44.4%), with 34(54.0%) below 60 in age and 29(46.0%) older than 60 years. 2. As to type of lesion, the surveyed patients were divided into 28(44.4%) with cerebral infarction, 24(38.1%) with cerebral hemorrhage, and 11(17.5%) with subarachnoid hemorrhage. In terms of size of lesion, they were divided into 29(46.0% with less than tan 1cm, 15 (23.8%) with $1{\sim}2cm$ and 19(30.2%) with longer than 2cm. Thirty-five patients(55.7%) reported paralysis in their right side, while 28(44.8%) complained paralysis in their left side. No recidivation was reported by 51(81.1%) while recidivation was asserted by 12(19%). Among them, 27(42.9%) had no past history but 36(57.1%) had such. 3. Regarding the time hour onset to admission to physical therapy, 46patients(73.0%) experienced it for less than one month, while 17(27.0%) for longer than one month. In terms of period of physical therapy, 30(47.6%) underwent the therapy for less than one month, 18(28.6%) for 1-2 months and 15(23.8%) for longer than 2 months. As is shown in the above study, the longer the period of physical therapy is, the more changes might occur in points of MMSE-K and MMAS. It may, therefore, be concluded that sufficiently longer period of physical therapy ensures the increased recovery of physical functions from stroke.

• 대한물리치료과학회지
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• 제9권4호
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• pp.83-94
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• 2002

Within physical therapy education, there has been increased attention to curricula and course that emphasize problem solving, clinical reasoning, and synthesis of information across traditional discipline-specific boundaries. This article describes the development implementation, and outcomes of a problem-based learning course in Physical therapy. The course was designed to help students to integrate the various elements of a physical therapy curriculum and to enhance their abilities to respond to an ever-changing health care environment. An evaluation of the course by the first 50 students who completed it revealed both strengths and weaknesses. Students responded that the course enhanced their professional behavior, including interpersonal communication skills, team work, and follow-through with professional responsibilities. The learning package was developed by the authors and implemented to a college students during three weeks of the first semester of 2001. Most studies which conducted PBL module development were short period or temporary PBL package application and evaluation rather than a whole semester's. While, this study carried on partial integrated PBL curriculum development and application with recomposing content of the two subjects to one subject Physical therapy which includes four PBL packages. This package was developed from a simple concept to complex and partial integrated PBL curriculum application systematically variable learning methods such as discussion, practice, lecture, video. There are 2 classes, each class has 25 students, in the college. Each class has 5 small groups consisting 5 students. Two tutors proceeded discussion charging each class also, they used multiple methods and materials like tutorials, self-directed learning, lecture, and video. The package is 5 grades and 5 hours per week and the rate of discussion, lecture is 4, 1 respectively. One of the most change is the increase of interaction between students and tutors. Whenever students need information and suggestion, they can visit tutors who provide reading materials and guide for the direction of self learning. Therefore, this study describes the PBL package development process and application during one semester recomposing contents of two subjects to Physical therapy concepts. Besides, it will contribute to active application of existing each subject to tutors who intend to convert as PBL methods. The study has significant meaning to show potentiality of partially integrated PBL application, using systematic PBL package development from two subjects contents. However, when students' need of yearning is over the extent of Introduction of Physical therapy and Rehabilitation medicine, tutors should set learning extent. So, there is limitation to attain completely integrated PBL education within one subject, therefore, it is high lighted to proceed development of integrated curriculum to maximize learning effects of PBL. It is exected that partial integrated PBL package development and application will distribute to prosper excellent physiotherapist in practice.

• Journal of Preventive Medicine and Public Health
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• 제30권3호
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• pp.643-664
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• 1997

This study is to provide evidence-based recommendations for the most-effective treatments of benign prostatic hyperplasia based on patient preference or clinical need, and to meta-analyze the Korean literatures for the development of BPH treatment guidelines. For these analyses, extensive literature searches (208 articles), with priority given to the Korean Journal of Urology, were conducted from 1960 to August, 1996. Meta-analysis, like all statistical analysis, has two main functions: data summarization (qualitative meta-analysis) and smoothing o. pattern recognition (quantitative meta-analysis). As well, critical reviews and syntheses with the mean and 90-percent confidence intervals for the likelihood were used to evaluate empirical evidence and significant outcomes of the BPH treatment literatures (106 articles). For this task, the Methodologic Panel for BPH Guidelines was composed of multidisciplinary experts in the field. The results of the study were summarized as follows: For all that watchful waiting is an appropriate treatment strategy for the majority of patients with prostatism, we couldn't find the Korean literatures which carried this article. The literatures on alpha-1-adrenergic receptor blockers provide no evidence to suggest that any one alpha blocker is more effective than another. The finasteride reduces the size of the prostate, on average, and leads to a small yet perceptible reduction in sysptoms. Of all treatment options, prostate surgery with transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), and so on, offers the best chance for symptom improvement. However, surgery also has the highest rates of significant complications. Therefore, surgery need not always be a treatment of last resort. Balloon dilation of the prostatic urethra is clearly less effective than surgery in relieving symptoms, but it is associated with fewer complications. Emerging technologies for treating BPH include lasers, coils, stents, thermal therapy and hyperthermia. Established technologies will also be reanalyzed as results of new trials are reported. Although this study has some limitations due to lacking for good quality literatures, ' it provides a cornerstone for our medical research. It represents the most current scientific knowledge regarding the clinical epidemiology including treatment of BPH. It will be revised and updated as needed.

• 대한임상독성학회지
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• 제17권2호
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• pp.102-107
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• 2019

Purpose: Acute carbon monoxide (CO) poisoning is one of the most common types of poisoning and a major health problem worldwide. Treatment options are limited to normobaric oxygen therapy, administered using a non-rebreather face mask or hyperbaric oxygen. Compared to conventional oxygen therapy, high-flow nasal cannula oxygen (HFNC) creates a positive pressure effect through high-flow rates. The purpose of this human pilot study is to determine the effects of HFNC on the rate of CO clearance from the blood, in patients with mild to moderate CO poisoning. Methods: CO-poisoned patients were administered 100% oxygen from HFNC (flow of 60 L/min). The fraction of COHb (fCOHb) was measured at 30-min intervals until it decreased to under 10%, and the half-life time of fCOHb (fCOHb t_1/2) was subsequently determined. Results: At the time of ED arrival, a total of 10 patients had fCOHb levels ≥10%, with 4 patients ranging between 10% and 50%. The mean rate of fCOHb elimination patterns exhibits logarithmic growth curves that initially increase quickly with time (HFNC equation, Y=0.3388*X+11.67). The mean fCOHbt_1/2 in the HFNC group was determined to be 48.5±12.4 minutes. Conclusion: In patients with mild to moderate CO poisoning, oxygen delivered via high flow nasal cannula is a safe and comfortable method to treat acute CO toxicity, and is effective in reducing the COHb half-life. Our results indicate HFNC to be a promising alternative method of delivering oxygen for CO toxicity. Validating the effectiveness of this method will require larger studies with clinical outcomes.

• 생명과학회지
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• 제31권9호
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• pp.849-855
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• 2021

최근에는 나노기술이 다양한 분야에 도입되고 활용되면서 신약개발이 가속화되고 있다. 나노입자는 약물의 단일 투여로 장기간 동안 혈중 약물 농도를 유지하고, 병리학적 부위에만 선택적으로 방출되는 장점이 있어 비병리 주위에 대한 부작용을 줄일 수 있다. Poly (D,L-lactic-co-glycolic acid) (PLGA)는 가장 광범위하게 개발된 생분해성 고분자 중 하나이다. PLGA는 다양한 응용분야의 약물전달에 널리 사용된다. 또한 FAD에 의해 약물전달 시스템으로 승인되었으며, 유전자 치료제와 같은 제어방출제형에 널리 적용된다. PLGA 나노입자는 수동 및 능동 표적화 방법을 사용하여 특정 세포 유형에 고효율의 전달 시스템으로 개발되었다. 이러한 PLGA 나노입자를 이용한 약물전달체 개발 후 표적 부위에 선택적으로 약물을 전달하고 질병에 따라 장기간 유효 혈중 농도를 최적화한다. 이 리뷰논문에서 우리는 유전자 치료를 위한 PLGA 나노 물질을 기반으로 하는 성상 세포 선택적 나노입자의 개발을 조사하여 세포 특이적으로 치료결과를 향상시키는 방법에 중점을 두고자 한다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권5호
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• pp.413-429
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• 2021

Background: Migraine headaches are the second leading cause of disability worldwide and are responsible for significant morbidity, reduction in the quality of life, and loss of productivity on a global scale. The purpose of this systematic review and meta-analysis was to evaluate the efficacy of ketamine on migraines and other primary headache disorders compared to placebo and other active interventions, such as midazolam, metoclopramide/diphenhydramine, and prochlorperazine/diphenhydramine. Methods: An electronic search of databases published up to February 2021, including Medline via PubMed, EMBASE, Web of Science, and Cochrane Library, a hand search of the bibliographies of the included studies, as well as literature and systematic reviews found through the search was conducted to identify randomized controlled trials (RCTs) investigating ketamine in the treatment of migraine/headache disorders compared to the placebo. The authors assessed the risk of bias according to the Cochrane Handbook guidelines. Results: The initial search strategy yielded 398 unduplicated references, which were independently assessed by three review authors. After evaluation, this number was reduced to five RCTs (two unclear risk of bias and three high risk of bias). The total number of patients in all the studies was 193. Due to the high risk of bias, small sample size, heterogeneity of the outcomes reported, and heterogeneity of the comparison groups, the quality of the evidence was very low. One RCT reported that intranasal ketamine was superior to intranasal midazolam in improving the aura attack severity, but not duration, while another reported that intranasal ketamine was not superior to metoclopramide and diphenhydramine in reducing the headache severity. In one trial, subcutaneous ketamine was superior to saline in migraine severity reduction; however, intravenous (I.V.) ketamine was inferior to I.V. prochlorperazine and diphenhydramine in another study. Conclusion: Further double-blind controlled studies are needed to assess the efficacy of ketamine in treating acute and chronic refractory migraines and other primary headaches using intranasal and subcutaneous routes. These studies should include a long-term follow-up and different ketamine dosages in diagnosed patients following international standards for diagnosing headache/migraine.