• Clinical and Experimental Pediatrics
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• v.48 no.4
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• pp.406-410
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• 2005

Purpose : Anticonvulsants have a number of side effects and some of them may be attributed to a disturbance of serum trace metal homeostasis. Although they are minor building components in tissues, they play important functional roles in the peripheral and central nervous system. We measured serum copper and zinc levels in epileptic children who were treated with anticonvulsants to know the effects of anticonvulsants on serum copper and zinc levels. Methods : Serum copper and zinc levels were determined in 64 epileptic patients receiving anticonvulsant therapy in Chungnam National University Hospital, and in 20 normal controls. Sixty-four epileptic patients were divided into three groups : 16 patients who were treated with valproic acid monotherapy; 26 patients who were treated with valproic acid in addition to other anticonvulsants; and 22 patients who were treated with anticonvulsants except for valporic acid. Results : All patients receiving anticonvulsants had significantly lower serum copper levels($80.21{\pm}19.42{\mu}g/dL$) in comparison to the normal controls($102.12{\pm}32.8{\mu}g/dL$). Serum zinc levels in patients receiving anticonvulsants($79.78{\pm}21.88{\mu}g/dL$) were not statistically different from those of controls ($85.26{\pm}29.81{\mu}g/dL$). There were no significant difference of serum copper and zinc levels among the three groups. Conclusion : In this study, we clearly showed that anticonvulsants decreased serum copper levels. Although we did not observe any clinical findings related to copper deficiency, we should pay attention to potent copper deficiency in patients with anticonvulsant treatment.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.16 no.2
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• pp.93-101
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• 2016

Purpose: McArdle disease, glycogen storage disease type V (GSD V), is one of the most common adolescent-onset glycogen storage diseases. It is caused by recessive mutations in PYGM encoding myophosphorylase, which is critical to glycogen metabolism. Since only a few korean patients have been reported, we will observe the clinical and genetic features of three korean patients with McArdle disease. Methods: We retrospectively reviewed the medical records of three patients with genetically confirmed McArdle disease, including the results of forearm ischemic exercise test, electromyogram, nerve conduction velocity, muscle biopsy, and PYGM analysis in peripheral leukocytes. Results: All three cases were males and their age of symptom onset was 12, 5, 14 years old, respectively. A high basal level of serum creatine kinase was noted in all three patients. They experienced the recurrent episodes of rhabdomyolysis, but second wind phenomenon was not definite. In muscle biopsy, subsarcolemmal space vacuoles including periodic acid schiff stained materials were found in two patients, while no evidence of glycogen storage disease was found in the other. A total of five different mutations, $p.Arg50^*$, p.Trp798Arg, $p.Arg50^*$, p.Glu779del, $p.Asp511Thrfs^*28$ and p.Phe710del, were found in three patients. Avoidance of isometric exercise, aerobic exercise and glucose intake before each exercise were recommended for all patients. Conclusion: The three Korean patients with McArdle disease showed the typical manifestations of the condition. The most mutations were private. Therefore, identification of more cases with long-term follow-up will be required to understand the clinical and genetic features of this disease among Korean population.

• Tuberculosis and Respiratory Diseases
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• v.42 no.1
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• pp.84-92
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• 1995

Background: Nasal applied continuous positive airway pressure(CPAP) is a highly effective method of treatment for obstructive sleep apnea syndrome. More than a decade of accumulated experience with this treatment modality confirmed that it is unquestionably the medical treatment of choice for patients with obstructive sleep apnea syndrome. However it takes long time to reach optimal CPAP pressure. To save the time to reach optimal pressure, it is necessary to clarify the time to reach optimal pressure for treatment of obstructive sleep apnea syndrome. Method: CPAP pressure is titrated during an overnight study according to a standardized protocol. Just before the presleep bio-calibration procedures, the technician applies the nasal mask and switches on the clinical CPAP unit. Initial positive for pressure is typically 3.0 centimeters of water pressure. After sleep onset, the technician gradually increases the pressure until sleep-disordered breathing events disappear or become minimal. The pressure must maintain maximal airway patency during both NREM and REM sleep to be considered effective. Before recommending a final pressure setting, sleep recording and oximetry data are reviewed by an American Board of Sleep Medicine certified Sleep Specialist and a Registrered Polysomnographic Technologist. Results: We examined the time required to reach optimal pressure during routine CPAP titration in 127 consecutively evaluated individuals diagnosed with sleep-disordered breathing. Results indicate that 33% of patients required more than four hours to attain satisfactory titration. This indicates that a four-hour session is marginally enough time, at best, to determine a proper CPAP pressure setting. Moreover, 60 of 127 patients required further adjustment after optimal pressure was reached. These additional pressure trials were needed to confirm that higher pressures were not superior for eliminating sleep-disordered breathing events. Conclusions: The data presented underscore the logistical difficulty of titrating CPAP during split-night studies without modifying the titration procedure. Futhermore, the time needed to reach optimal pressure makes it improbable that proper CPAP titration can be performed during a 2-3 hour nap study.

• Tuberculosis and Respiratory Diseases
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• v.40 no.3
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• pp.283-291
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• 1993

Background: Long-term low flow oxygen therapy not only increases survival, but also improves the quality of life in patients with chronic obstructive pulmonary disease (COPD) with chronic hypoxemia. For the assessment and improvement of the status of home oxygen therapy, we analyzed clinical experience of 26 patients who have been administered low flow oxygen at home. Method: Twenty-six patients (18 men and 8 women) who have been received long-term oxygen therapy (LTOT) at home were examined. We reviewed physical characteristics, clinical history, pulmonary function test, ECG, arterial blood gas analysis, hemoglobin and hematocrit, types of oxygen devices, inhalation time per day, concentration of administered $O_2$, duration of $O_2$ therapy, and problems in the home oxygen therapy. Results: The underlying diseases of patients were COPD 14 cases, far advanced old pulmonary tuberculosis 9 cases, bronchiectasis 2 cases, and idiopathic pulmonary fibrosis 1 case. The reasons for LTOT at home were noted for cor pulmonale 21 cases, for dyspnea on exertion and severe ventilatory impairment 4 cases, and for oxygen desaturation during sleep 1 case. The mean values of aterial blood gas analysis before home oxygen therapy were $PaO_2$ 57.7 mmHg, $PaCO_2$ 48.2 mmHg, and $SaO_2$ 87.7%. And the mean values of each parameters in the pulmonary function test were VC 2.05 L, $FEV_1$ 0.92 L, and $FEV_1$/FVC% 51.9%. Nineteen patients have used oxygen tanks as oxygen devices, 1 patient oxygen concentrator, 2 patients oxygen tank and liquid oxygen, and other 4 patients oxygen tank together with portable oxygen. The duration of oxygen therapy was below 1 year in 3 cases, 1~2 years in 15 cases, 3~5 years in 6 cases, 9 years in 1 case, and 10 years in 1 case. All patients have inhalated oxygen with flow rate less than 2.5 L/min. And only 10 patients have inhalated oxygen more than 15 hours per day, but most of them short time per day. Conclusion: For the effective oxygen administration, it is necessary that education for long-term low flow oxygen therapy to patients, their family and neighbor should be done, and also the institutional backup for getting convenient oxygen devices is required.

• Science of Emotion and Sensibility
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• v.13 no.1
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• pp.187-196
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• 2010

Recently, people have been suffering from stress-related fatigue and psychological disorders. Most people depend on medicine for pain relief; many treat pain also through alternative medicine or replacement therapy. However, drug therapy has many side effects, including increased stress after the therapy. In comparison, alternative therapies such as massage and foot reflexology are less damaging to the body, and such therapies can be provided without physical or psychological discomfort. In this regard, the author had previously co-developed color foot reflexology, which combines the merits of color therapy and foot reflexology; color foot reflexology has been shown to have beneficial effects without undue pain. This study investigates the effects of color foot reflexology on the physiological response of the body by comparing the body’s response to the signal with that to the placebo. Healthy adult subjects were selected for the experiment, which was conducted under optimal experimental conditions and design. The results indicated that when stimulated, parasympathetic nerves increased in HRV and that blood pressure, pulse, body heat, peripheral blood flow were dramatically activated. However, the results for the placebo indicated minimal changes or irregular outcomes. The results provide strong evidence for the beneficial effects of the color foot reflexology instrument on the autonomic nervous system and on the physiological response of the body. Future research is warranted to verify the results of the current study by examining patients suffering from diseases and disorders arising from irregular physiological functions in the context of the foot.

• Journal of Oral Medicine and Pain
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• v.38 no.2
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• pp.161-174
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• 2013

This study was designed to evaluate the pain control effect by morphine injection to masticatory muscle pain patients. Patients with masticatory muscle pain visited the Department of Oral Medicine, Kyung Hee University Dental Hospital were recruited to this study and diagnosed by RDC/TMD. Experimental group were divided into four group; saline injection group (n=10), lidocaine injection group (n=10), morphine 1.5 mg injection group (n=10) and morphine 3 mg injection group (n=10). Evaluation list was the subjective pain evaluation(visual analogue scale, Mc Gill pain questionnaire, pain drawing) and the objective pain evaluation(pressure pain threshold, pressure pain tolerance) and evaluation time was injection before, after 1 hour, 24 hour, 48 hour and then it was analyzed statistically. The results were as follows : 1. The subjective pain evaluation were significantly different statistically in morphine 3 mg group after 48 hour. (VAS: p<0.01, MGQ: p<0.001, PD: p<0.05) 2. The objective pain evaluation were significantly different statistically in morphine 1.5 mg group after 1 hour. (PPT: p<0.01, PPTol: p<0.05) 3. The morphine 3 mg group were more significantly different than lidocaine group and morphine 1.5 mg group statistically in the McGill pain questionnaire evaluation. (1h: p<0.01, 24h: p<0.01, 48h: p<0.001) Therefore, it was revealed that the morphine 3 mg injection was effective to pain control for masticatory muscle pain patients within 48 hours and more effect than lidocaine injection.

• Pediatric Infection and Vaccine
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• v.4 no.2
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• pp.210-217
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• 1997

Purpose: To prevent residual physical disability and chronic infection, prompt diagnosis and adequate treatment are important in the skeletal infections in children. Although radioisotope scanning is knwon as the method of choice for early diagnosis of bone infection, we conducted a study on twenty nine children who had skeletal infections to reevaluate the most appropriate way in diagnosis and management. Methods: A retrospective study was conducted on twenty nine children, who were admitted to the departments of Pediatrics and Orthopedic Surgery and who had acute osteomyelitis or septic arthritis, through review of medical records, radiologic & radioisotope study results. Their diagnoses were confirmed by bacteriologic cultures on the aspirated specimens from suspected bony lesions. Results: 1) Among twenty nine patients, there were 6 infants including 5 newborn infants, and 23 children were aged between 1 and 15 years. Male to female ratio was 1.4 to 1. 2) Point tenderness was noted in all cases, and the common physical signs were swelling, limitation of motion, fever and local heat in the order of frequency. 3) Fifty two percents of the patients were diagnosed within a week after onset of symptoms and all cases were within 15 days. 4) Leukocytosis was noted in only 58.6% of cases but erythrocyte sedimentation rate was increased in all cases except only one case. Staphylococcus aureus was revealed as the most common etiologic agent. 5) Radioisotope scans showed hot uptake in five of six cases(83.3%) who had no abnormal finding on plain skeletal radiolograms. Conclusions: Although radioisotope scan and MRI are helpful in early diagnosis before radiologic finding was detected on plain X-ray film, the antimicrobial therapy can be started after bacteriologic study of the aspirated specimens from the suspected skeletal lesions if skeletal infection is highly suspected clinically.