1.Pharmacologic Treatment of Childhood Asthma.
Journal of the Korean Medical Association 2007;50(12):1130-1135
The goal of asthma treatment is to achieve and maintain clinical asthma control state and normal or near-normal lung function. Medications to treat asthma can be classified as controllers and relievers. Controller medications are taken daily on a long-term basis to keep asthma under clinical control, and reliever medications are used on an as-needed basis, which act quickly to reverse bronchoconstriction and relieve the asthma symptoms. Inhaled therapy is the cornerstone of asthma treatment for children of all ages, but the choice of medication should be individualized for each patient. The choice of medication should include consideration of the efficacy of drug delivery, cost, safety, ease of use, convenience, and documentation of its use in the patient's age group.
Asthma*
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Bronchoconstriction
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Child
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Humans
;
Lung
2.Immunoglobulins for Prophylaxis or Treatment of Infectious Diseases.
Journal of the Korean Medical Association 2008;51(12):1151-1157
Administration of antibodies as a passive immunization is indicated for the replacement of deficiencies, prophylaxis or amelioration of infectious diseases for susceptible individuals and those at high risk for complications of infections. Antibodies can be administered either as human or animal plasma or serum, as pooled human immunoglobulin (IG) for intravenous or intramuscular use, as high-titer human IG from immunized or convalescing donors, or as monoclonal antibodies. Immunoglobulins are widely used for prevention of hepatitis A and measles and specific immunoglobulins are used for prevention of hepatitis B, tetanus, rabies, and varicella in susceptible people. A humanized murine monoclonal antibodies against respiratory syncytial virus have been licensed. This paper reviews the current use and recommendation of antibody products for the prevention and treatment of infectious diseases.
Animals
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Antibodies
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Antibodies, Monoclonal
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Chickenpox
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Communicable Diseases
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Hepatitis A
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Hepatitis B
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Humans
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Immunization, Passive
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Immunoglobulins
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Measles
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Plasma
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Rabies
;
Respiratory Syncytial Viruses
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Tetanus
;
Tissue Donors
3.Diagnosis and Treatment of Neuropathic Pain.
Journal of the Korean Medical Association 2008;51(12):1139-1148
Since the earliest descriptions of pain related to injury of the nervous system, it has been recognized that the characteristics of this type of pain differ markedly from those of pain due to nonneural tissue damage. Later as new analgesics were developed, it became clear that neurogenic pain was very often refractory to these drugs. Recently neuropathic pain is defined as "pain initiated or caused by a primary lesion or dysfunction in the nervous system." Inflammatory reaction and neuropathic pain are often considered to be distinct entities. The development of neuropathic pain involves not only neuron but also inflammatory cells, chemokines, and glial cells. Treatment of neuropathic pain is difficult and frequently unrewarding. The basic principles are (1)the identification and elimination of the underlying pathologic mechanism that maintains central sensitization; (2)the use of nonsteroidal anti-inflammatory drugs to reduce peripheral sensitization and modulate the activity of nociceptors; (3)the use of tricyclic antidepressants to induce sleep and decrease lancinating and burning neuropathic pain; (4)a trial of gabapentin, pregabalin, lamotrigine and topamax; (5)the use of lidocaine patch for intractable trigeminal neuralgia; (6)sympathetic blockade for complex regional pain syndrome while patients are stick sympathetically maintained; (7)dorsal column stimulation; (8)intrathecal therapies including morphine, clonidine, and GABAB agonists when other less invasive therapies have failed. In this article we reviewed the role of peripheral inflammation for development of neuropathic pain, diagnosis, and new opportunities for treatment of neuropathic pain, especially focused on medical treatments with antiepileptics and antidepressants.
Amines
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Analgesics
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Anticonvulsants
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Antidepressive Agents, Tricyclic
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Burns
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Chemokines
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Clonidine
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Cyclohexanecarboxylic Acids
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gamma-Aminobutyric Acid
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Humans
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Inflammation
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Lidocaine
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Morphine
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Nervous System
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Neuralgia
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Neuroglia
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Neurons
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Pregabalin
;
Triazines
4.Cancer -Targeted MR Molecular Imaging.
Journal of the Korean Medical Association 2009;52(2):121-124
Magnetic resonance (MR) imaging has been widely used in the clinic because of the benefit of high spatial and temporal resolution, and the excellent anatomical tissue contrast. Cancer-targeted MR molecular imaging comprises 3 major components: a relevant molecular target which is specifically highly expressed on the membrane of the cancer cell; a target specific imaging probe which is composed of superparamagnetic iron oxide nanoparticle coreconjugated target specific ligand such as antibody, peptide, and molecules; MR imaging hardware and software which are sensitive to the imaging probe. Among the various molecular targets, HER2/neu receptor antibody, folic acid, and arginine-glycine-aspartic acid (RGD) are well known targeting ligands. The sensitivity of the cancer-targeted MR imaging is affected by the magnetic susceptibility of the T2 contrast agent, resolution of the image, targeting efficiency of the imaging probe, and image acquisition pulse sequence. Recently, successful cancer-targeted MR imaging with T1 contrast agent and cancer-specific molecular MR imaging using innate contrast of the cancer cell by chemical exchange phenomenon without using the imaging probe has been introduced. Cancer-targeted MR molecuar imaging is a robust diagnostic method to detect cancer at the cellular stage of the cancer development and it would help improve early detection rate of the cancer.
Ferric Compounds
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Folic Acid
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Iron
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Ligands
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Magnetic Resonance Imaging
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Magnetic Resonance Spectroscopy
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Magnetics
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Magnets
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Membranes
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Molecular Imaging
;
Nanoparticles
5.Imaging of Cancer Metabolism using Positron Emission Tomography.
Journal of the Korean Medical Association 2009;52(2):113-120
In the 1920's, Warburg reported an observation that cancer cells depend on glycolysis even in the presence of available oxygen likely due to impaired function of mitochondria. Since then, this Warburg s effect has been the most important hypothesis in cancer metabolism and is considered as a seventh hallmark of many human cancers. Aerobic glycolysis was originally attributable to increased bioenergetic needs in rapidly proliferating cancer cells. Recently, biosynthetic aspects of aerobic glycolysis, which reprograms cancer metabolism to synthesize macromolecules such as nucleotides, fatty acids, amino acids, etc., are under active investigation. Introduction of positron emission tomography (PET) and metabolic radiotracers including F-18 flurorodeoxyglucose (FDG) and C-11 acetate made it possible to image cancer metabolism in vivo and to renew the interests on this issue. Studies have found that cancer cells with highly glycolysis features are associated with resistance to many chemotherapeutic regimens and radiation treatment. Therefore, development of glycolytic inhibitors can have an incremental effect to conventional treatments. In addition, functional imaging with metabolic radiotracers will continuously play important roles in detecting cancers and monitoring therapeutic responses to novel anti-metabolic approaches to cancer cells.
Amino Acids
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Electrons
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Energy Metabolism
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Fatty Acids
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Glycolysis
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Humans
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Mitochondria
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Nucleotides
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Oxygen
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Positron-Emission Tomography
6.Redefining Physicians Role in Free -Trade Era-Risks and Opportunities.
Journal of the Korean Medical Association 2009;52(2):110-111
As we move forward at a greater speed into global economic world, the current international health care market and our position in the market provide a wide variety of economic and political issues for our health care professionals and our government entities to consider. To optimize medical care to denizens of Korea and to prepare to compete in global medical marketplace, Korean medical practitioners and institutions will face evolving, more refined, and more specific reviews of practice quality and practioner competence. These efforts will focus on reducing medical errors, improving communication with patients and medical providers, and enhancing clinical outcomes
Delivery of Health Care
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Health Care Sector
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Humans
;
Korea
;
Medical Errors
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Mental Competency
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Physician's Role
7.Bipolar Disorder.
Journal of the Korean Medical Association 2007;50(4):348-356
Bipolar disorder is one of the most distinct syndromes in psychiatry. Bipolar I disorder affects approximately 1 percent of the population worldwide. About 50 percent of patients with bipolar illness have a family history of the disorder. Studies of twins suggest that the concordance rate of bipolar illness is between 40 percent and 80 percent in monozygotic twins. Although researchers have proposed myriad subtypes of depression, there are two major subtypes of disorder according to DSM-IV-TR: bipolar I and bipolar II. Bipolar I disorder is diagnosed on the basis of a single lifetime manic or mixed episode. Indeed, in one follow-up survey of tertiary care patients, depressive symptoms were more than three times as frequent as manic symptoms. Antidepressant monotherapy in an undiagnosed bipolar disorder patient can have devastating effects. So, clinical evaluation of a patient presenting with depression should always include the assessment for bipolar disorder. In addition to major episodes, it is important to pay attention to the course of subsyndromal and prodromal symptoms. Treatment options for bipolar disorder have rapidly expanded over the last decade. The literature supports the efficacy of a list of agents for the management of bipolar disorder, including lithium, valproate, lamotrigine, and carbamazepine, as well as the atypical antipsychotics olnazapine, risperidone, quetiapine, ziprasidone, and aripiprazole.
Antipsychotic Agents
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Aripiprazole
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Bipolar Disorder*
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Carbamazepine
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Depression
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Follow-Up Studies
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Humans
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Lithium
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Quetiapine Fumarate
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Prodromal Symptoms
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Risperidone
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Tertiary Healthcare
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Twins, Monozygotic
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Valproic Acid
8.Eye Movements Recording with Video-oculography (VOG).
Journal of the Korean Medical Association 2007;50(4):343-347
The measurement of eye movements in three dimensions is an important tool to investigate the human oculomotor system. When compared with the conventional electro-nystagmography (ENG) and scleral search coil system (SSCS), the video-oculography (VOG) has a higher accuracy and is a more comfortable and reliable method for the 3D-measurement of human eye movements.
Eye Movements*
;
Humans
9.HIV/AIDS Vaccine.
Journal of the Korean Medical Association 2007;50(4):337-342
Recent researches have suggested approaches to HIV immunization that might result in at least a partially effective vaccine against infection with HIV-1. In particular, advances in our understanding of animal models, the vaccine-elicited celluar immunity and neutralizing antibody provide rational strategies for the development of this vaccine. Some advanced-phase clinical trials of HIV vaccine are ongoing. Although the creation of an effective HIV-1 vaccine remains an enormous challenge, the continuing progress in these areas provides a reason to be optimistic about our ultimate ability to control the spread of AIDS.
Acquired Immunodeficiency Syndrome
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Antibodies, Neutralizing
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HIV
;
HIV-1
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Immunization
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Models, Animal
10.Prevention of HIV/AIDS.
Journal of the Korean Medical Association 2007;50(4):330-336
The prevention of HIV infection is based on strategies that interrupt sexual, blood-borne, and perinatal transmission of the virus. Post-exposure prophylaxis using anti-retroviral therapy is recommended in case of mucosa or injured skin when exposed to blood, semen, vaginal/anal secretion, breast milk, or body fluid containing visible blood within no more than 72 hours. The combination of antiretroviral prophylaxis, elective caesarean delivery, and avoidance of breast feeding has reduced perinatal transmission to less than 2%. Because prophylactic chemotherapy does not guarantee perfect prevention and the adverse effects or toxicity of the drugs are considerably high, a subject who is willing to continue on with the highly risky behavior would not be a proper candidate for post-exposure prophylaxis. There is no evidence that a three-drug regimen is more likely to be effective than a two-drug regimen; however, the recommendation of a three-drug regimen is based on the assumption that the maximal suppression of viral replication will provide the best chance of preventing infection. The most frequently administered regimen is zidovudine (600 mg per day in two or three divided doses) and lamivudine (150 mg orally twice a day) for 4 weeks, with or without the addition of a protease inhibitor in selected cases.
Body Fluids
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Breast Feeding
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Drug Therapy
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HIV Infections
;
Lamivudine
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Milk, Human
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Mucous Membrane
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Post-Exposure Prophylaxis
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Protease Inhibitors
;
Semen
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Skin
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Zidovudine