• Journal of The Korean Society of Clinical Toxicology
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• v.21 no.2
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• pp.151-155
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• 2023

Licorice is a perennial herb belonging to the legume family that mainly grows in northeastern China, Mongolia, Siberia, and other regions. It is used in traditional medicine in the form of dried roots in the East and the West. The main active component of licorice, glycyrrhizin, is known to produce mineralocorticoid effects when consumed chronically, which can lead to apparent mineralocorticoid excess syndrome. Herein, we present the case of a 72-year-old woman who was admitted to the emergency room with severe generalized weakness and difficulty keeping her neck upright, which had developed after daily consumption of licorice-infused water for the past 2 months. Blood tests revealed metabolic alkalosis and severe hypokalemia, and an electrocardiogram showed ventricular bigeminy. The patient was treated with daily potassium and spironolactone supplements, leading to a significant improvement in muscle strength after a week. One week later, the patient was discharged, showing rare ventricular premature contractions on electrocardiography, but with no specific complaints. Chronic licorice ingestion leading to hypokalemia and muscle weakness can be life-threatening, necessitating the discontinuation of the causative agent, close monitoring, and cautious supplementation of potassium and spironolactone as treatment.

• The Korean Journal of Pain
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• v.13 no.2
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• pp.187-190
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• 2000

Background: From our clinical experience, there were some problems in paratracheal stellate ganglion block at 6th cervical level (C 6 SGB), for example, lesser change in blood flow of the upper extremity and more occurrence of hoarseness. This study was undertaken to compare the various effectiveness of C 6 SGB and paratracheal stellate ganglion block at 7th cervical level (C 7 SGB). Methods: Forty patients were equally divided into 2 groups. In the Group I, patients were undertaken C 6 SGB with 0.25% bupivacaine 6 mL and in the Group II, patients were undertaken C 7 SGB with 0.25% bupivacaine 6mL. The skin temperature of index finger was measured before and after SGB and the warm sensation on face and upper extremity, hoarseness and upper extremity paralysis were studied. Results: The skin temperature of index finger was increased significantly from $33.95{\pm}0.89^{\circ}C$ to $34.51{\pm}0.90^{\circ}C$ in the Group I and from $33.94{\pm}0.82^{\circ}C$ to $35.38{\pm}0.66^{\circ}C$ in the Group II (P<0.05) The increase of skin temperature of index finger after procedure was $0.56{\pm}0.09^{\circ}C$ in the Group I and $1.44{\pm}0.02^{\circ}C$ in the Group II. The increase of skin temperature of index finger in the Group II was more statistically significant than Group I (P<0.05). The occurance of hoarseness in the Group II was significantly less than in the Group I. There was no significant difference in warm sensation on face and upper extremity and paralysis of upper extremity in both Groups. Conclusions: C 7 SGB showed better sympathetic block effect on upper extremity than C 6 SGB and hoarseness did not occur in C 7 SGB.

• Journal of Veterinary Clinics
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• v.24 no.2
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• pp.208-213
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• 2007

A 15 kg 6-year-old intact male Jindo dog with a history of a respiratory distress, hindlimb paralysis with necrosed skin of dorsal digit for three weeks was referred to Animal Medical Center, Chonbuk National University. Heartworm infection was identified by kit examination. In plain thoracic radiographs, dilated pulmonary arteries reverse D sign and focal interstitial pattern was compatible with heartworm infection and possible pulmonary thromboembolism. Abdominal radiographs showed poor serosal detail indicating fluid accumulation within peritoneal cavity. No evidence of musculoskeletal abnormalities was found. Ultrasonography presented focal wedge-shaped hyperechogenecity on the both poles of left kidney, weak or absent pulse on the distal to the external iliac artery as well as ascites and irregular liver margin. Multi-organ failure was strongly supposed by blood profile including leukocytosis, anemia, hemoglobinuria bililubinemia, hypoalbuminemia, imbalance of electrolytes, and increased hepatic and renal function values. Interestingly, the glucose level is remarkably lower in pelvic limb compared to thoracic limb. Suspected pulmonary thromboembolism, renal infarction and femoral arterial embolization causing hindlimb paralysis and dermatic necrosis were confirmed by 3D reconstructed CT imaging. Prior to taking a consideration of euthanasia, interventional radiology was experimentally attempted but failed due to not recovered from general anesthesia. Early and accurate diagnosis of thromboembolism is valuable and 3D reconstructed CT images might be very useful to show the correct way to treat effectively.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.5 no.2
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• pp.280-292
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• 1998

Pressure sores are a serious concerns in that respect to increasing risk of medical complications and medical costs. Prevention and care of pressure sores is an essential area of nursing practice. The nurse at ICU should be more careful of maintaining the skin integrity of patients especially than at any other place. This study was conducted to determine if the risk facotrs of pressure sores and nutritional status of the patients at risk for pressure sores is related the occurance of pressure sore. The risk group refers the patients having the below 14 scores of the braden scale. The 100 subjects were recruited from the ICU ward at an university hospital in Choongnam. The parameters for nutritional status are the blood chemistry including plasma protein, albumin, hemoglobin and the anthropometric measurements consisting of weight, BMI, LBM, the proportion of body fat, body fluid and triceps skin fold using bioimpedence analizer and caliper. The results are as follows : 1. The subjects were 55 years and stayed 8 days on average. Of the 100 subjects, males were 61%, neurologic/neurosurgical diseases were 68% and the incidence of pressure sores was 17% mainly occuring within 3days after the admission. 2. The present paralysis(or paraplegia) and edema(arm, leg, trunk) were showed more significantly the subjects with pressure sores than those without pressure sores. 3. Regarding with the nutritional status, the subjects with pressure sores had significantly lower the weight, BMI, LBM, body fluid, albumin than the ones without pressure sores. This results were supported the reports of previous studies that the decreased weight and albumin could be the important predictors of pressure sores. Thereafter we should encourage these factors to be utilized in predicting pressure sores for a comprehensive assessment. Nurse should identify patients at risk of the development of pressure sores, assess their nutritional status and dietary intake at regular intervals.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2001.05a
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• pp.503-506
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• 2001

There are four factors for patient monitoring : electrocardiography, blood pressure, temperature and respiration. While there are a lot of studies of E.C.C (electro-cardiography) monitoring system in the world, the studies of Respiratory system are not enough and leave much to be desired in the country. In this paper, we developed a respiratory system with the electrical impedance change of the lungs depending on the breath. Using the same electrode, we can monitor E.C.C and Respiration simultaneously, so we can monitor a patient's no-breathing state due to the central nerve paralysis in the emergency room easily. In this monitoring system, the analog part was made separated from the digital part for reducing power source noise and protecting patient from electric shock. The analog part consists of the several parts a high-frequency sine-wave generator, all amplifier for amplifying any impedance change signal, an analog processing part for rectifying and filtering. And the digital parts consists of three parts an AD convertor for converting analog signal to digital signal, digital filter, and a digital part for digital signal processing. This system's merits are using the same electrode with E.C.C and developing the multiple patient monitoring system easily.

• Biomedical Science Letters
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• v.18 no.4
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• pp.399-405
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• 2012

The brain is the body's most organized and controlled organ, and it governs various psychological and mental functions. A brain abnormality could greatly affect one's physical and mental abilities, and consequently one's social life. Brain disorders can be broadly categorized into three main afflictions: stroke, brain tumor, and dementia. Among these, stroke is a common disease that occurs owing to a disorder in blood flow, and it is accompanied by a sudden loss of consciousness and motor paralysis. The main types of strokes are infarction and hemorrhage. The exact diagnosis and early treatment of an infarction are very important for the patient's prognosis and for the determination of the treatment direction. In this study, texture features were analyzed in order to develop a prototype auto-diagnostic system for infarction using computer auto-diagnostic software. The analysis results indicate that of the six parameters measured, the average brightness, average contrast, flatness, and uniformity show a high cognition rate whereas the degree of skewness and entropy show a low cognition rate. On the basis of these results, it was suggested that a digital CT image obtained using the computer auto-diagnostic software can be used to provide valuable information for general CT image auto-detection and diagnosis for pre-reading. This system is highly advantageous because it can achieve early diagnosis of the disease and it can be used as supplementary data in image reading. Further, it is expected to enable accurate medical image detection and reduced diagnostic time in final-reading.

• Archives of Plastic Surgery
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• v.47 no.2
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• pp.187-193
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• 2020

Upper limb nerve damage is a common condition, and evidence suggests that functional recovery may be limited following peripheral nerve repair in cases of delayed reconstruction or reconstruction of long nerve defects. A 26-year-old man presented with traumatic injury from a wide, blunt wound of the right forearm caused by broken glass, with soft tissue loss, complete transection of the radial and ulnar arteries, and a large median nerve gap. The patient underwent debridement and subsequent surgery with a microsurgical free radial fasciocutaneous flap to provide a direct blood supply to the hand; the cephalic vein within the flap was employed as a venous vascularized chamber to wrap the sural nerve graft and to repair the wide gap (14 cm) in the median nerve. During the postoperative period, the patient followed an intensive rehabilitation program and was monitored for functional performance over 5 years of follow-up. Our assessment demonstrated skin tropism and sufficient muscle power to act against strong resistance (M5) in the muscles previously affected by paralysis, as well as a good localization of stimuli in the median nerve region and an imperfect recovery of two-point discrimination (S3+). We propose a novel and efficient procedure to repair >10-cm peripheral nerve gap injuries related to upper limb trauma.

• Korean Journal of Veterinary Pathology
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• v.2 no.1
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• pp.53-60
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• 1998

A fourteen-month-old Holstein bull from a private cattle fattening farm at Ansung county in Kyunggi Province Korea was submitted on August 2nd 1997, for examination at the Pathology Division of the National Veterinary Research Institute. The bull died within 24 hours after developing clinical signs of abrupt inertia, complete anorexia high fever(40.3℃) diffuse severe emphysematous swelling of upper part of the right hind leg lateral recumbancy and paralysis. At necropsy diffuse severe subcutaneous redness and influx of serosanguinous exudate containing gas bubbles had accumulated under the thorax right hip and upper region of right hind leg. Muscles in upper right hind leg were blackish to dark red and yellowish brown in color. Muscle bundles were dry and separated by gas bubbles and serosanguinous fluids and muscles sections from affected regions floated in water. Histopathologically muscle fibers were partially or entirely degenerated fragmented and separated by exudate and gaseous substance mixed with polymorphonuclear cells. Blood vascular walls in affected regions showed severe acute fibrinoid necrosis. Typical large rod-shaped bacteria with or without oval central to subterminal spores were frequently observed in tissue sections stained with H-E and Gram stain. The large Gram-positive anaerobic endospore-producing rods were isolated from the suspension of muscle lesions. Isolated bacteria were identified as Clostridium(CL) chauvoei and CL. sordellii by biochemical tests. This case was diagnosed as blackleg based on the typical clinical signs gross finding histopathological observation and bacteriological results. This is the first case report on blackleg associated with Cl. chauvoei and Cl. sordellii in Holstein cattle in Korea.

• The Korean Journal of Physiology
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• v.10 no.1
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• pp.41-48
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• 1976

Tetrodotoxin (TTX) is the purified active principle responsible for tetrodon (Puffer-fish) poisoning which has long been known in the Orient. The pharmacological actions of TTX have been rather extensively investigated. Two of the most prominent effects of intravenousely administered TTX are severe hypotension and respiratory paralysis resulting from its depressant actions on tissues. This depressant actions of TTX in turn result from the selective inhibition of sodium-carrying mechanism which is essential to generation of the action potential. TTX differs from local anesthetics in that it does not affect potassium conductance. Although the mechanism of the hypotensive action of TTX remains a subject of controversy, most investigator agree that TTX-induced hypotension is caused by alteration in the blood vessels rather than the heart. Not only the study on the effects of TTX on cardiac function is meager but the results of reported works are often contradictory. The present study was undertaken to investigate the effect of TTX on the electrocardiogram of the rabbit and to compare them with well known electrocardiographical characteristics found in digitalis and quinidine intoxicated animals. The results obtained from the present study are summarized as follows. 1. No changes were found in P-R interval and QRS duration after i.v. administration of $1.0\;{\mu}g/kg\;to\;1.5\;{\mu}g/kg$ TTX to the animals. It is obvious that there were no conduction disturbance between atria and ventricles as well as in the ventricular tissue. 2. In $1.0\;{\mu}g/kg$ TTX group, S-T interval and T-P segment were not changed whereas marked changes were observed in $1.5\;{\mu}g/kg$ TTX group. 3. The first and second degree A-V blocks appeared in the $2.0\;{\mu}g/kg$ TTX group. 4. TTX differs from digitalis and quinidine in that it does not cause S-T interval depression and T-wave inversion. In contrast with digitalis, TTX caused Q-T interval prolongation.

• Journal of The Korean Society of Clinical Toxicology
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• v.2 no.1
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• pp.7-11
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• 2004

Purpose: We would evaluate the cardiovascular manifestations of the patients with acute organophosphate and carbamate poisoning in the emergency department. Methods: This was retrospectively studied with the review of patient's charts, included total 38 patients were admitted during the past two years in the emergency department of Yeungnam university hospital with the diagnosis of organophosphate or carbamate poisoning. Results: Cardiovascular complications were variously developed in many patients. Electrocardiographic findings were as follows; 4 ($10.5\%$) cardiac arrhythmias included 1 cardiac arrest caused by ventricular fibrillation, 14 ($36.8\%$) sinus tachycardias, 3 ($7.9\%$) sinus bradycardias, and 17 ($44.7\%$) normal sinus rhythms. Conduction disturbances were 23 ($60.5\%$) like as prolonged QTc, 4 ($10.5\%$) ST-T changes, 2 (5.3%) first degree AV block, and 3 ($7.9\%$) right bundle branch block were shown. Other cardiovascular complications were 22 ($57.9\%$) hypertensives, 4 ($10.5\%$) hypotensives, 15 ($39.5\%$) tachycardias, 2 ($5.3\%$) bradycardias, 18 ($47.4\%$) hypoxemics, 12 ($31.6\%$) metabolic acidosis, and 9 ($23.7\%$) pulmonary edemas. Sixteen patients ($42.1\%$) needed ventilatory support because of respiratory paralysis. No patients died in hospital and 36 ($94.7\%$) patients were alive-discharged. Conclusion: Cardiovascular complications are variously in patients with acute organophosphate and carbamate poisoning. Especially, some findings included ventricular arrhythmias, QTc prolongation, hypoxemia, acidosis, and blood pressure changes are known as major precipitating factors to increase the mortality. So, intensive support and aggressive treatment are needed in patients shown various cardiovascular manifestations in the emergency department.