• Sleep Medicine and Psychophysiology
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• v.9 no.2
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• pp.106-114
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• 2002

Objectives: Daytime sleepiness is a common symptom and is associated with sleep behavior, sleep deprivation, and night shift, etc. It is also one of the most important symptoms of sleep disorders like obstructive sleep apnea (OSA). According to our survey on Korean literature, a few studies have dealt with daytime sleepiness, and we have not been able to locate any study comparing normal subjects with polysomnography-proven sleep disorder patients regarding daytime sleepiness. We aimed at comparing daytime sleepiness among normal healthy daytime workers, medical students being expected to have daytime sleepiness due to chronic sleep deprivation, and patients having sleep disorders diagnosed with polysomnography. We also studied the association between subjective daytime sleepiness and objective polysomnographic findings in patients with sleep disorders. Methods: One hundred three hospital workers, 137 medical students, and patients with sleep disorders were studied. Sleep disorders included OSA, periodic limb movements in sleep (PLMS), insomnia, and narcolepsy. The degree of subjective sleepiness in each group was measured by the Korean version of Epworth sleepiness scale and compared. The relationship between polysomnographic findings reflecting severity of sleep disorder in each patient group and subjective sleepiness was analyzed. As for patients with narcolepsy, the relationship between the mean sleep latency and subjective sleepiness was studied. Results: There was a significant difference of ESS score (F=68.190, dF=5.752, p<0.001) among daytime workers, medical students, and sleep disorder patients. In OSA patient group, the degree of the sleepiness had no significant correlation either with mean O2 satuaration (p=0.062) or with RDI (p=0.807). In PLMS patient group, there was no correlation between periodic limb movement index (PLMI) and subjective sleepiness (p=0.761). In narcolepsy patient group, the subjective sleepiness had no correlation with mean sleep latency measured with MSLT (p=0.055). Conclusion: We found a significant difference of subjective sleepiness among daytime workers, medical students, and patients with sleep disorders. However, no consistent correlation was found between severity of subjective sleepiness and objective polysomnographic findings reflecting severity of each sleep disorder. This research confirms that the evaluation of subjective sleepiness is important clinically, but it cannot substitute the objective measures such as nocturnal polysomnography and MSLT.

• Tuberculosis and Respiratory Diseases
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• v.45 no.5
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• pp.1039-1046
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• 1998

Background: Sleep-related breathing disorders(SRBD) and periodic leg movements disorder(PLMD) are both common, and are considered as separate sleep disorders. However, both disorders show high comorbidity. SRBD and PLMD can result in excessive daytime sleepiness and insomnia due to frequent sleep fragmentation. So, it is very important to consider the presence of PLMD, when we are dealing with the diagnosis and management of SRBD. The objectives of this study were to determine the incidence of PLMD in patients with SRBD, and to describe any differences between patients with and without PLMD. Method: The authors reviewed the sleep recordings of 106 patients with a final diagnosis of SRBD(obstructive sleep apnea or upper airway resistance syndrome), who underwent full nocturnal polysomnography, including the monitoring of the anterior tibialis electromyogram. All sleep records were recorded and scored using the standard criteria. The data was analyzed by the student t-test. Result: 106 patients(M=76, F=30) were included in the analysis. Data revealed a mean age of $49.5{\pm}13.6$ years, a respiratory disturbance index(RDI) of $22.3{\pm}25.4$/hour sleep, a lowest oxygen saturation of $84.9{\pm}11.3%$, a maximal esophageal pressure of $-41.0{\pm}19.1cmH_2O$, and PLM index(PLMI) of $13.1{\pm}22.4$movements/hour sleep. Forty four percent(47 of 106 patients) had a PLMI of greater than 5 on this study. The mean age of the patients with PLMD was significantly higher than that of the patients without PLMD(p<0.005). Female patients with SRBD accompanied more PLMD(p<0.05). The apnea index of the patients with PLMD was significantly lower than that of the patients without PLMD(p<0.01). The percentage of stage 1 sleep in the patients with PLMD was significantly lower than that of the patients without PLMD(p<0.05). Conclusion: The prevalence of PLMD in the patients with SRBD was high at 44.3%. The patients with PLMD were older and had more high RDI in comparison to the patients without PLMD, which was consistent with previous findings. The authors recommend that more careful consideration of PLMD is required when diagnosing and treating SRBD.

• Journal of Oriental Neuropsychiatry
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• v.28 no.3
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• pp.183-194
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• 2017

Objectives: Chijasitang (CJST) has been prescribed for patients with anxiety disorder, and is believed to treat insomnia. The present study was carried out to investigate whether Fructus Gardeniae, Fermented Semen Sojae Preparatum and CJST have beneficial effects on treating anti-stress. Methods: The mice were divided into the following groups: normal, control, positive control, and experimental. Then, the experimental groups were further divided into the Fructus Gardeniae group (FG), the Fermented Semen Sojae Preparatum group (FS), the Chijasitang water extract group (CJSTW), and the Chijasitang 30% ethanol extract group (CJSTE). In the positive control group, a single dose of imipramine ($500{\mu}g/g$) was applied to the mice. In the experimental groups, each single dose of FG, FS, CJSTW and CJSTE ($50{\mu}g/g$) was applied to the mice. After one hour, the mice in all groups except the normal group were exposed to immobilization stress. Their body weights, phagocytosis, nitric oxide in macrophage, corticosterone, and adrenocorticotropic hormone (ACTH) were observed. Results: Fructus Gardeniae, Fermented Semen Sojae Preparatum and Chijasitang prevented weight loss and suppressed the decrease of phagocytosis in the mice after their exposure to immobilization-stress. Although they did not influence the amount of NO, they suppressed the increment of ACTH and corticosterone in the immobilization-stressed mice. Conclusions: According to the results of this study, they suggest that Fructus Gardeniae, Fermented Semen Sojae Preparatum and Chi-Ja-Si-Tang all have some anti-stress effects.

• The Journal of Internal Korean Medicine
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• v.21 no.3
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• pp.369-376
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• 2000

Purpose : Cerebrovascular disease is the most frequent cause of death in Korea and it remains severe disabilities disturbing normal life, According to the previous studies, mortality of the stroke in the first one week is up to the 20% and 95% of stroke patients in the acute stage are accompanied by more than one complications. These complications affect not only the acute stage mortality but also the late stage rehabilitations. In Korea the oriental medicine is preformed in the treatment of stroke. Therefore it is important to recognize thoroughly the complications in the acute stage of stroke and to prevent them. But studies about complications of acute stage stroke is rarely presented in the fields of oriental medicine. So this study is prepared for investigating the characteristics and frequency of complications in the acute stage of stroke. And we are to assess the importance of theses acute complications by systemic reviewing the previous studies. Methods : Fifty one patients are included who had been admitted to ICU(intensive care unit) of Chenju Hospital of Wonkwang Oriental Medicine. Twenty nine patients are diagnosed as ischemic stroke and twenty one patients are diagnosed hemorrhagic stroke. Medical and neurological complications were investigated retrospectively based on medical notes excluding primary symptoms of stroke Le. motor weakness, sensory disturbance and speech disorder. And risk factors of stroke such as D.M. or hypertension are excluded. Results : Medical complications are more frequent than neurological ones. Most frequent medical complication is dysuria(61%) and constipation(45%), fever(30%) and aspiration pneumonia(22%) are followed in order of frequency. In Neurological complication dysphagia(56%), the exacerbation of infarction due to increased intracranial pressure(24%), irritability or insomnia(21%) is most frequently complicated in order of frequency. Conclusions : These complications are mostly caused by bed rest state in acute stage stroke. It is supposed that more aggressive management can prevent theses ones. And it is possible to improve the medical and neurological conditions by sticking theses study results.

• Annals of Clinical Neurophysiology
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• v.17 no.1
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• pp.17-23
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• 2015

Background: Sleep-related disturbances and sleep disorders are common in Parkinson's disease (PD) and have a great impact on daily life of PD patients. This study was done to find the sleep characteristics and sleep disturbing factors in PD patients according to disease severity through clinical interview and polysomnographic (PSG) study. Methods: Fifty patients with PD (22 males, age $60.6{\pm}6.4$, Hoehn and Yahr (HY) stage $2.7{\pm}1.0$) were recruited and thoroughly interviewed about their sleep. PSG was performed on the patients taking routine antiparkinsonian medications. Patients were grouped into mild and moderate/severe group according to HY stage, and the results were compared between each group. Results: Ninety-four percent of total patients had one or more sleep-related disturbances based on the interview or PSG. On interview, the moderate/severe group complained more insomnia and REM sleep behavior disorder (RBD) than mild group. In PSG findings, the moderate/severe group showed lower sleep efficiency, longer sleep latency, REM sleep latency, waking time after sleep onset, and higher prevalence of RBD. Conclusions: In this study, most patients with PD had sleep disturbances. Clinical interview and PSG findings revealed deterioration of sleep quality along the disease severity. Our results suggest that sleep disturbances in PD patients are prevalent and warrant clinical attention, especially to the patients with advanced disease.

• Korean Journal of Occupational Health Nursing
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• v.26 no.3
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• pp.184-196
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• 2017

Purpose: We investigated the effects of emotional labor and workplace violence on various physical and mental health outcomes among female workers. Methods: We obtained data from 24,760 female workers who participated in the 4th Korean Working Conditions Survey (2014). Hierarchical logistic regression analysis was used to analyze the relationships. Results: Female emotional workers were more exposed to workplace violence than were female non-emotional workers. Verbal abuse was the most common type of workplace violence. Logistic regression analyses revealed that (1) emotional labor was significantly associated with higher odds of having musculoskeletal or abdominal pain (physical health outcomes), along with overall fatigue (a mental health outcome), and (2) workplace violence experiences were significantly associated with higher odds of musculoskeletal pain, headache/eye strain, abdominal pain, depression/anxiety disorder, overall fatigue, and insomnia/sleep disturbance, after controlling for covariates. Conclusion: This study demonstrated that both emotional labor and workplace violence have negative effects on physical and mental health. However, workplace violence experience has a stronger negative impact on health outcomes than does emotional labor alone. A management system to eradicate workplace violence and programs aimed at managing emotional labor are urgently needed at the organizational level.

• The Journal of Korean Medical History
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• v.33 no.1
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• pp.1-9
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• 2020

Pubescent Angelica is generally used in musculoskeletal diseases of lower extremity, itching, external contraction (外感) and furuncle, with the effect of dispelling wind, draining dampness, dispersing the external (解表) and stopping pain. The disease parts of Treasured Mirror of Eastern Medicine (東醫寶鑑) contain 121 examples of the usage of Pubescent Angelica. Cases of musculoskeletal diseases and itching are mainly in the External Bodily Elements section (外形篇), and those of external contraction and furuncle are mainly in the Miscellaneous Disorder section (雜病篇). Internal Bodily Elements section (內景篇) has 10 prescriptions that involve Pubescent Angelica, in Dreams (2), Voice (1), Uterus (4), Parasites (1), and Feces (2) chapters. Their specific symptoms are insomnia and sleep paralysis (Dreams), loss of voice due to external contraction (Voice), uterine hemorrhage (Uterus), phthisis (Parasites), and constipation and diarrhea (Feces). It is not easy for students beginning their clinical training to link the effects of Pubescent Angelica and its actual usage, especially in the area of internal medicine. By Analyzing the whole cases of Pubescent Angelica in the Treasured Mirror, we found various usages out of reach of basic knowledge of the herb. Such method can be utilized not only in developing herbal knowledge-based products, but also in improving Korean medicine education, by enhancing the occupational competency bridging basic and clinical knowledge.

• Journal of Oriental Neuropsychiatry
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• v.21 no.2
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• pp.201-214
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• 2010

Y$\grave{u}$zh$\grave{e}$ng(鬱證) comes from obstruction of qi by stress. The patient has depressed mood, irritable sign, chest discomfort, costal pain, angry state or some strange feeling on the throat. Oh-Ji-Sang-Seung(五志相勝) therapy is base on the theory of interrelation in five elements in oriental medicine. The contents of Oh-Ji-Sang-Seung(五志相勝) therapy include five subjugations of five emotions. Anxiety subjugates fear(思勝恐), fear subjugates joy(恐勝喜), joy subjugates pity(喜勝悲), pity subjugates anger(悲勝怒), and anger subjugates anxiety(怒勝思). Forgiveness program is a kind of psychological therapies to decrease the degree of anger and it is included in Oh-Ji-Sang-Seung(五志相勝) therapy. In this case, a female patient, 50 years old, who suffered from Y$\grave{u}$zh$\grave{e}$ng(鬱證) with chest discomfort, irritable sign, easily angry state, depressed mood, hot flush, insomnia. We used Oh-Ji-Sang-Seung(五志相勝) therapy besides herbal medication, acupuncture to her condition got improved. Therefore we reported it for the treatment.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.11 no.1
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• pp.88-98
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• 2011

Lesch-Nyhan syndrome is a X-linked recessive disorder caused by a deficiency of the enzyme hypoxanthine-guanidine phosphoribosyltransferase (HPRT), enzyme to recycle purines. Case history: born induced vaginal delivery at 40 weeks complicated by premature membrane ruputure, body weight 2.820 gm. He showed failure to thrive showing severe protein aversion like milk products and pink daper. Developmental delay revealing rolling over at 10.5 month, followed by regression. Seizure at 2 months, His poor oral feeding was lifelong problem. Weak crying, spastic, choreoathetoid movement. Self mutilating behavior noted and diagnosed at age 3 years. No family history of consanguinity and neurological disorders. Method: Laboratory test, physical exam, imaging study and molecular. Clinical follow up Treat ment with allopurinol. Result: uric acid 10.5 mg/dL (N 3.5-7.9), APRT 151.1uM/ min/ml pro(25.7-101), HPRT 7.6 (N 233.5-701) and c.151C>T hemizygote (p,Arg51X). Abdominal sonogram showed staghorn calculi in both kidneys, brain MRI brain atrophy. Clinical follow up showed, seizure at 2 mo, developmental delay (head control and, rolling over at at 11mo, pointing body part at 2 yr 7 mo, eye hand coordination at 2 y 11mo,creeping at 3 y 7 mo, speaking words at 6 y 6 mo ),and developmental regression at 3 yr of age. Sleeping problem including insomnia and severe constipation. Self mutilating behavior (lip bite) started at 2.5 yr, neurologic sx including intermittent upward gaze accompanied by swallowing difficulty at 3 y 7 mo grand mal seizure at 4.5 yr and spastic extremity and trunchal hypotonia and choleoathetoid movement and ataxia at 6.5 yr. Scoliosis with severe spasticity at 9 yr 9 mo. Acute life threatening episode with irregular breathing at 9 yr and 9 mo, Emaciation and nephrolithiasis and recurrent pneumonia. Died suddenly at 10 yr 3 mo. Conclusion: life long feeding problem, chronic gut motility dysfunction, sleeping difficulty and progressing neurologic deterioration and nephrolithiasis despite normal serum uric acid maintence by allopurinol treatment.

• Journal of Trauma and Injury
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• v.26 no.4
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• pp.304-307
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• 2013

Food bolus impaction is the most common cause of esophageal foreign body obstruction in adults. Other causes include intentional ingestion in psychiatric patients or prison inmates. We experienced successful treatment of a patient with intentional ingestion of multiple sharp foreign bodies(25 cutter and razor fragments). A 47-year-old male patient who was suffering from chronic alcoholism was admitted, via the emergency room, with dysphagia and neck pain. He was suffering from alcoholic liver cirrhosis and psychiatric problems, such as chronic alcoholism, anxiety disorder and insomnia. The patient had intended to leave the hospital after having swallowed the sharp objects. Plain radiographs and computed tomography (CT) scan showed multiple, scattered metal fragments in the esophagus, stomach, and small bowel. We performed emergent endoscopy and successfully removed one impacted blade in the upper esophagus using by a snare with an overtube. The rest of the fragments had already passed through the pylorus, so we could not find them with endoscopy. We checked the patient with simple abdominal radiographs and careful physical examinations every day. All remaining fragments were uneventfully excreted through stool during the patient's 6 day hospital stay. Finally, we were able to confirm the presence of the objects in the stool, and radiographs were negative. The patient was discharged without complications after 14 days hospital stay and then was followed by the Department of Psychiatry.