• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.3
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• pp.427-436
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• 2008

Purpose. The objective of this study was to evaluate the behavioral response and assess the effectiveness of additional intranasal (IN) and submucosal (SM) administration of midazolam during pediatric sedation for dental procedure. Material and methods. Thirty-three cases of healthy (ASAⅠ), uncooperative children aged from 24 to 72 month old at pediatric dental clinic of Ewha Womans University Hospital were selected for this study. Children received oral chloral hydrate 50 mg/kg with hydroxyzine 1.0 mg/kg. After waiting for 45 minutes, midazolam 0.2 mg/kg was administrated via IN route and via SM route randomly maintaining 50% of $N_2O$. A pulse oximeter and a capnograph were used for measuring vital signs ($SpO_2$, PR, RR, $EtCO_2$) throughout the sedation. Behavioral response was evaluated as Quiet (Q), Crying (C), Movement (M) or Struggling (S) in every 2 minutes for 40 minutes. Results. There were also no statistically significant differences in vital signs of the two groups. The behavioral response for the first ten minutes during sedation was a statistically significant difference (P < 0.05) between the two groups. After the first ten minutes, it was revealed that there was no significant difference. Conclusion. This study demonstrated that the addition of IN midazolam to the combination of oral chloral hydrate with hydroxyzine and nitrous oxide/oxygen inhalation is as safe and effective as that of SM midazolam in pediatric sedation for dental procedure.

• Journal of Oral Medicine and Pain
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• v.38 no.4
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• pp.357-366
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• 2013

This study is designed to evaluate the treatment outcome of occlusal stabilizing splint and to assess follow-up study of condylar bony changes using cone beam computed tomography(CBCT) in adolescents patients (12-19 years) with TMJ osteoarthritis(OA). 167 eroded condyles in 149 subjects were chosen among the patients who presented to the Department of Oral Medicine of Pasan National University Hospital, diagnosed as TMJ osteoarthritis by clinical exam, x-ray and CBCT from 2009 to 2012. They were treated conservatively with physical therapy, medication, behavioral therapy and occlusal stabilizing splint therapy. After average 9 months, CBCT was retaken and subjective symptoms and clinical findings were investigated. Condyle bony changes were classified by unchanged, less severe and more severe. The obtained results were as follow: 1. Pain, Noise, LOM(Limitation of motion) and MCO(Maximum comfortable opening) measurement of TMJ OA patients were markedly improved after conservative treatment. 2. In the occlusal stabilizing splint therapy group, Pain and LOM were statistically significant improved than non-occlusal stabilizing splint therapy group. 3. In the acute occlusal stabilizing splint therapy group, Pain and LOM were remarkably improved. 4. In comparison of CBCT1 and CBCT2 images, the transition of bone changes to lesser severe was most commonly in joint with erosive change. 5. In the non-occlusal stabilizing splint therapy group, the transition of condylar bone changes from erosion to more severe was many than occlusal stabilizing splint therapy group.

• Journal of Hospice and Palliative Care
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• v.16 no.4
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• pp.205-215
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• 2013

Most terminally ill cancer patients experience various physical and psychological symptoms during their illness. In addition to pain, they commonly suffer from fatigue, anorexia-cachexia syndrome, nausea, vomiting and dyspnea. In this paper, I reviewed some of the common non-pain symptoms in terminally ill cancer patients, based on the National Comprehensive Cancer Network (NCCN) guidelines to better understand and treat cancer patients. Cancer-related fatigue (CRF) is a common symptom in terminally ill cancer patients. There are reversible causes of fatigue, which include anemia, sleep disturbance, malnutrition, pain, depression and anxiety, medical comorbidities, hyperthyroidism and hypogonadism. Energy conservation and education are recommended as central management for CRF. Corticosteroid and psychostimulants can be used as well. The anorexia and cachexia syndrome has reversible causes and should be managed. It includes stomatitis, constipation and uncontrolled severe symptoms such as pain or dyspnea, delirium, nausea/vomiting, depression and gastroparesis. To manage the syndrome, it is important to provide emotional support and inform the patient and family of the natural history of the disease. Megesteol acetate, dronabinol and corticosteroid can be helpful. Nausea and vomiting will occur by potentially reversible causes including drug consumption, uremia, infection, anxiety, constipation, gastric irritation and proximal gastrointestinal obstruction. Metoclopramide, haloperidol, olanzapine and ondansetron can be used to manage nausea and vomiting. Dyspnea is common even in terminally ill cancer patients without lung disease. Opioids are effective for symptomatic management of dyspnea. To improve the quality of life for terminally ill cancer patients, we should try to ameliorate these symptoms by paying more attention to patients and understanding of management principles.

• Journal of Veterinary Clinics
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• v.28 no.1
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• pp.33-39
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• 2011

The present study was aimed to investigate the effect of intraperitoneal bupivacaine instillation on postoperative pain after laparoscopic ovariohysterectomy (LOHE) in dogs. Twelve female German shepherd dogs (17-30 kg) were divided into two groups. The treatment group received 4.4 mg/kg of instilled intraperitoneal bupivacaine diluted to 0.25% with an equivalent volume of saline after pneumoperitoneum, but the control group received 1.76 ml/kg of 0.9% saline. Two blind observers measured the extent of dog's pain and sedation by using dynamic interactive visual analogue scale (DIVAS) preoperatively and 0.5, 1, 2, 4, 6, and 12 h postoperatively. At each designated time, blood cortisol, glucose, and creatine kinase (CK) concentrations were also measured. Based on the repeated-measures ANOVA, there were significant differences in time-dependent postoperative changes in patterns of DIVAS-pain score between two groups. In addition, the treatment group had significantly lower DIVAS-pain scores at 1, 2, 4, and 6 h postoperatively compared to the control group. DIVAS-sedation score and biochemical measures including cortisol, glucose, and CK did not show any significant differences between two groups. No complications associated with bupivacaine administration were observed. Thus, instilled bupivacaine intraperitoneally may be an effective method on relieving behavioral expressions associated with postoperative pain after laparoscopic ovariohysterectomy in dogs.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.1
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• pp.118-126
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• 2008

Dental fear is one of the main barriers to the use of dental services, leading patients to avoid periodical dental check-ups or treatments, thus making oral health worse, and sometimes becoming the reason that dental professionals fail control the behavior of patients. Therefore, a dental fear must be controlled carefully in order to promote oral health and effective dental treatment. This study was taken from 313 people 13 to 18 year olds to measure their levels of dental fear. After analyzing the characteristics of dental fear and its related factors, as well as other factors which influence dental fear, we acquired the following results. 1. The level of dental fear was high, compared with advanced countries with relatively good oral health. 2. The strongest physiological response experienced during a dental treatment was the tension of muscles. These dental fears were mainly related to anesthetic needles and drills. 3. Levels of dental fear became higher, the number of times for the dental services utilization had reduced, avoid regular dental examination and perceived oral disease symptoms increased. 4. One of the biggest influences on dental fears turns out to be direct painful experiences and beliefs about dentists.

• Korean Journal of Acupuncture
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• v.30 no.4
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• pp.298-304
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• 2013

Objectives : We examined mutual inhibitory effects of combined acupoints in arthritic pain induce by carrageenan(CA). Electroacupuncture(EA) is considered a potentially useful treatment for arthritis. Although the analgesic effect of acupuncture is well documented, little is understood about its biological basis. There are many previous studies of positive effect of combined acupoint, this study was conducted to see the mutual inhibitory effects produced by combined acupoint(ST36 and PC7) on arthritic rats. Methods : For the induction of inflammatory pain rat model, CA was injected into the knee joint cavity. There are four groups; EA was applied to bilateral PC7 acupoints(PC7 group), ST36 acupoints(ST36 group), and both PC7 and ST36 acupoints(ST36+PC7 group) except for the control group. The pain level were assessed to determine the change in weight bearing force. We also examined the COX-2 expression in dorsal horn using immunohistochemistry and western blot analysis. Results : The ST36+PC7 group data showed the significant reduction of weight bearing force and the induction of COX-2 protein expression compared with the ST36 group. Conclusions : Simultaneous EA applied to the ST36 and PC7 acupoints reduced the analgesic effect of the ST36 group on knee inflammatory pain.

• Korean Journal of Psychosomatic Medicine
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• v.4 no.2
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• pp.269-276
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• 1996

A theroretical study was made on the psychodynamism of somatoform disorder. Somatoform disorder is caused by a defense mechanism of somatization. Somatization is the tendency to react to stimuli(drives, defenses, and conflict between them) physically rather than psychically(Moore, 1990). Ford(1983) said it is a way of life, and Dunbar(1954) said it is the shift of psychic energy toward expression in somatic symptoms. As used by Max Shur(1955), somatization links symptom formation to the regression that may occur in response to acute and chronic conflict. In the neurotic individual psychic conflict often provokes regressive phenomena that may include somatic manifestations characteristic of an earlier developmental phase. Schur calls this resomatization. Pain is the most common example of a somatization reaction to conflict. The pain has an unconscious significance derived from childhood experiences. It is used to win love, to punish misdeeds, as well as a means to amend. Among all pains, chest pain has a special meaning. Generally speaking, 'I have pain in my chest' is about the same as 'I have pain in my mind'. The chest represent the mind, and the mind reminds us about the heart. So we have a high tendency to recognize mental pain as cardiac pain. Kellner(1990) said rage and hostility, especially repressed hostility, are important factors in somatization. In 'Psychoanalytic Observation on Cardiac Pain', psychoanalyst Bacon(1953) presented clinical cases of patients who complained of cardiac pain in a psychoanalytic session that spread from the left side of their chests down their left arms. The pain was from rage and fear which came after their desire to be loved was frustrated by the analyet. She said desires related to cardiac pain were dependency needs and aggressions. Empatic relationship and therapeutic alliances are indispensable to psychotherapy in somatoform disorder. The beginning of therapy is to discover a precipitating event from the time their symptoms have started and to help the patient understand a relation between the symptom and precipitating event. Its remedial process is to find and interpret a intrapsychic conflict shown through the symptoms of the patient. Three cases of somatoform disorder patients treated based on this therapeutic method were introduced. The firt patient, Mr. H, had been suffering from hysterical aphasia with repressed rage as ie psychodynamic cause. An interpretation related to the precipitating event was given by written communication, and he recovered from his aphasia after 3 days of the session. The second patient was a dentist in a cardiac neurosis with agitation and hypochondriasis, whose psychodynamism was caused by a fear that he might lose his father's love. His symptom was also interpreted in relation to the precipitating event. It showed the patient a child-within afraid of losing his father's love. His condition improved after getting a didactic interpretation which told him, to be master of himself, The third patient was a lady transferred from the deparment of internal medicine. She had a frequent and violent fit of chest pains, whose psychodynamic cause was separation anxiety and a rage due to the frustration of dependency needs. Her symptom vanished dramatically when she wore a holler EKG monitor and did not occur during monitoring. By this experience she found her symptom was a psychogenic one, and a therapeutic alliance was formed. later in reguar psychotherapy sessions, she was told the relaton between symptoms and precipitating events. Through this she understood that her separation anxiety was connected to the symptom and she became less terrifide when it occurred. Now she can travel abroad and take well part in social activities.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.95-101
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• 2021

Patients complaining with somatic symptoms are very common in clinical practice, and are often consulted to medical department. But it is difficult to treat well. The treatment of somatic symptom disorder is multi-modal as none of the methods on their own provide a satisfactory outcome. The treatment of somatic symptoms disorders is complicated by lack of boundary, conceptual clarity, and overemphasis on psychosocial causation and effectiveness of psychological treatments. In clinical practice all classes of psychotropics are used to treat somatic symptoms disorder. Drugs such as tricyclic antidepressants, serotonin reuptake inibitors(SSRI), serotonin and noradrenalin reuptake inhibitors (SNRI), atypical antipsychotics are studied. The evidence indicates that these drugs are effective in somatic symptom disorders. All classes of antidepressants seem to be effective against somatic symptom disorders. SSRIs are more effective against hypochondriasis and body dysmorphic disorder, and SNRIs appear to be more effective than other antidepressants when pain is predominant. The author suggest that psychiatrists should know how to treat patients complaining with somatic symptoms by using not only psychotherapeutic approach but also pharmacological treatment. It will be helpful to reduce suffering and increase quality of life of these patients.

• Industry Promotion Research
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• v.6 no.3
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• pp.25-35
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• 2021

Middle-aged women experience diverse psychological and physical stresses and tensions through the menopause, aging, and taking up too many social roles, which often leads to sleep disorder. But there are not many scientific researches on the issue. Therefore, the research of efficacy of singing bowl that helps relax middle-aged women who have sleep disorder is needed to improve their health. This study was conducted with Giorgi's phenomenological method with 4 middle-aged women with sleep disorder, whose Pittsburgh sleeping quality scale marked over 5 points, who took part in singing bowl experience for 40 minutes and did the interview. The study resulted in following conclusions that through participants' singing bowl experience, 518 constructive meanings, 15 meaning units, 7 sub components, and 2 group subjects were drawn up. Firstly, when participants took part in the singing bowl experience, they underwent physical, mental, imagery experiences which are physical pain and muscle relaxation, mental relaxation, and positive mindset and imaginary images and colors. Secondly, physical changes that the participants felt after singing bowl experience was increased physical relaxation, improved physical symptoms and more physical activities, and psychologically participants also felt reduced anxiety, increased happiness and positive mentality. And behavioral changes are relaxed movements, increased activities, and improved sleep is huge benefit through changes of sleep pattern. In this study, singing bowl is confirmed to be effective both physically and psychologically on relaxing the middle-aged women's tensions that are caused by sleep disorders and singing bowl experience is meaningful in that the middle-aged women as well as modern people with the sleep disorders can be helped to have better lives.

• Journal of Oral Medicine and Pain
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• v.23 no.4
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• pp.403-418
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• 1998

The aim of this study was to measure effects of the following items to pain and pain behavior reaction in patients with chronic orofacial pain. Items that contribute to the first factor(Environmental Influences) measure environmental sources of information that may affect illness behavior; Second factro(Loss of Control) measure appraisals and attributions perceived to influence personal views aobut pain; Third factor(Health Care Avoidance) measures a variety of avoidant behaviors; Fouth factor(Past and Current Experiences) measures experiences with treatment); Fifth factor(Physiological Responsivity) measures physiological parameters that are experienced in association with pain; Sixth factor(Thoughts of Disease Progression) measures thoughts regarding the etiology and progression of disease in relation to pain. 150 patients that were consist of 40 male and 110 female were participated in this study. The obtained results of this study were as follows : 1. Environmental influences and loss of control scales were recorded high score in patients with chronic orofacial pain 2. "Physician's descriptions of what your pain will be like" and "Physician's facial expression when they ask about your pain" items from the environmental influences were recorded high score. These results indicated that responsibility of doctro is very important to the pain reaction behavior of patients. Also, items from thoughts regarding the etiology and progression of disease in relation to pain influenced to the pain reaction. 3. There were significant defferences on the "nurses' descriptions of what you pain will be like", "physician's and nurses' facial expression when they ask about your pain", "TV and radio", and "Literature" items from the environmental influences between male and female patients. 4. There were no significant differences on the each scale between arthrogenous and combitnation group and significant correlated with all 6 scales.