• The Korean Journal of Pain
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• v.9 no.2
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• pp.385-389
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• 1996

Background: Nowadays, epidural morphine is commonly used in postoperative pain control. But epidural morphine may produce some side-effects, e.g. pruritus, nausea, vomiting, urinary retention and respiratory depression. Especially, pruritus is the most common complaint in pain-controlled patients by epidural morphine. So we evaluated whether addition of epidural butorphanol affects the degree of pruritus and pain score in pain controlled patients who by epidural morphine after hysterectomy. Methods: Group 1(N=15) received postoperative epidural 0.1% bupivacaine 100ml plus morphine 10 mg, group 2(N=15) received the mixture of butorphanol 2 mg with same regime as in group 1, group 3(N=15) received the mixture of butorphanol 4 mg with same regime as in group 1. All of the three groups received these solutions by infusion pump, 1 ml/hour, for postoperative 4 days. all groups received additional morphine 1.2 mg in 0.2% bupivacaine 6ml epidurally when the peritoneum was closed under general anesthesia. The severity of pain, pruritus, nausea and vomiting was estimated by 10 cm VAS(visual analogue scale) and somnolence by positive or negative during postoperative 4 days. Results: Severity of pruritus, but not nausea and vomiting was decreased in group 2 and 3 compared with group 1(p<0.05). Pain score was increased in group 3 at postoperative day(POD) 0 and 2 compared with group 1(p<0.05). Incidence of somnolence in group 1, 2 and 3 were $2.7{\pm}0.7,\;5.3{\pm}0.7$ and $10.0{\pm}1.0$ respectively. Conclusion: These results suggest that butorphanol reduce the degree of pruritus, the most common side effect of morphine, but increase the incidence of somnolence.

• Clinical and Experimental Pediatrics
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• v.58 no.1
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• pp.37-40
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• 2015

The presence of a single coronary artery is a rare congenital anomaly; such patients often present with severe myocardial ischemia. We experienced the case of a 13-year-old girl with the right coronary artery originating from the left circumflex artery. She visited our Emergency Department owing to severe chest pain; her cardiac enzyme levels were elevated, but her initial electrocardiogram (ECG) was normal. Echocardiography showed normal anatomy and normal regional wall motion. When she presented with recurrent chest pain on admission, the ECG showed significant ST-segment elevation in the left precordial leads and inferior leads with ST-segment depression in aVR lead, suggesting myocardial ischemia, and her cardiac enzyme levels were also elevated. We performed coronary angiography that showed a single right coronary artery originating from the left circumflex artery without stenosis. We confirmed the presence of a single coronary artery using coronary computed tomography. In addition, the treadmill test that was performed showed normal results. She was discharged from the hospital without any medications but with a recommendation of a regular followup.

• Journal of The Korean Society of Clinical Toxicology
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• v.7 no.2
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• pp.69-76
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• 2009

Purpose: Various electrocardiogram (ECG) changes can occur in patients with acute organophosphate poisoning (OPP) and may be associated with the clinical severity of poisoning. The present study aimed to evaluate the extent and frequency of ECG changes and cardiac manifestations, and their association with acute OPP clinical severity. Methods: Seventy-two adult patients admitted to our emergency department with a diagnosis of acute OPP were studied retrospectively. ECG changes and cardiac manifestations at admission were evaluated. ECG changes between respiratory failure (RF) group and no respiratory failure (no RF) groups were compared. Results: Prolongation of QTc interval (n=40, 55.6%) was the most common ECG change, followed by sinus tachycardia (n=36, 50.0%). ST-T wave changes such as ST segment elevation or depression and T wave change (inversion or non-specific change) were evident in 16 patients (22.2%). Prolongation of QTc interval was significantly higher in the RF group compared with the no RF group (p=0.03), but was not an independent predictor for RF in acute OPP (OR; 4.00, 95% CI; 0.70-23.12, p=0.12). Conclusion: While patients with acute OPP can display ECG changes that include prolongation of QTc interval, sinus tachycardia, and ST-T wave changes at admission, these changes are not predictors of respiratory failure.

• Archives of Pharmacal Research
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• v.27 no.10
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• pp.1065-1072
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• 2004

Depression is associated with a dysfunctional serotonin (5-hydroxytryptamine; 5-HT) system. More recently, several lines of evidence suggest that an important factor in the development of depression may be a deficit in the function and expression of $5-HT_{1A}$ receptors. The present study assessed if Nelumbinis Semen (N. s.) had an anti-depression effect through reversing a decrease in $5-HT_{1A}$receptor binding in rats with depression-like symptoms induced by chronic mild stress. Using a $5-HT_{1A}$ receptor binding assay, with a specific $5-HT_{1A}$receptor agonist, 8- OH-DPAT (8-hydroxy-2-(di-n-propylamino) tetralin), the mechanism of the anti-depression effect of N. s. on rats was investigated, and the effects compared with two well-known antidepressants, Hyperium Perforatum (St. Johns Wort) and fluoxetine (Prozac). Animals were divided into five groups: the normal (N) group without chronic mild stress (CMS), the control (C) group under CMS for 8 weeks, the Nelumbinis Semen (N. s.) treatment group under CMS for 8 weeks, the Hyperium Perforatum (H. p.) treatment group under CMS for 8 weeks and finally, the fluoxetine (F) treatment group under CMS for 8 weeks. Each treatment was administered to rats during the last 4 weeks of the 8-week CMS. A sucrose intake test was performed to test the anti-depression effect of N. s. The N. s. treatment significantly reversed the decreased sucrose intake under CMS (P<0.05 compared to control group under CMS). In the CA2 and CA3 regions of the hippocampus, both N. s. and H. p. reversed the CMS-induced decrease in $5-HT_{1A}$receptor binding. In the I to II regions of the frontal cortex, N. s. and H. p. also reversed the CMS-induced decrease in$5-HT_{1A}$receptor binding, and even showed a significant increase in $5-HT_{1A}$receptor binding compared to the F treatment group (N. s. vs. P, p<0.05, H. p. vs. P, p<0.05). However, in the hypothalamus, all treatments reversed the CMSinduced decrease in $5-HT_{1A}$receptor binding. This reversal effect of N. s. on the decrease in $5-HT_{1A}$receptor binding in the frontal cortex, hippocampus and hypothalamus of rat brains was very similar to that of H. p, but different from that of F. It is concluded that N. s. presents an anti-depression effect through enhancing $5-HT_{1A}$receptor binding.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.11 no.2
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• pp.209-220
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• 2000

The purpose of this study is to find out the characteristics of depressive episode about major depression and bipolar disorder in child and adolescent. The subjects of this study were 34 major depression patients and 17 bipolar disorder patients hospitalized at child and adolescent psychiatry in OO university children's hospital from 1st March 1993 to 31st October 1999. The method of this study is to review socio-demographic characteristics, diagnostic classification, chief problems and symptoms at admission, frequency of symptoms, maternal pregnancy problem history, childhood developmental history, coexisting psychiatric disorders, family psychopathology and family history and therapeutic response through their chart. 1) The ratio of male was higher than that of female in major depressive disorder while they are similar in manic episode, bipolar disorder. 2) Average onset age of bipolar disorder was 14 years 1 month and it was 12 years 8 months in the case of major depression As a result, average onset age of major depression is lower than that of bipolar disorder. 3) The patients complained of vegetative symptoms than somatic symptoms in both bipolar disorder and depressive disorder. Also, the cases of major depression developed more suicide idea symptom while the case of bipolar disorder developed more aggressive symptoms. In the respect of psychotic symptoms, delusion was more frequently shown in major depression, but halucination was more often shown in bipolar disorder. 4) Anxiety disorder coexisted most frequently in two groups. And there coexisted symptoms such as somartoform disorder, mental retardation and personality disorder in both cases. 5) The influence of family loading was remarkable in both cases. Above all, the development of major depression had to do with child abuse history and inappropriate care of family. It is apparent that there are distinctive differences between major depression and bipolar disorder in child and adolescent through the study, just as in adult cases. Therefore the differences of clinical characteristics between two disorders is founded in coexisting disorders and clinical symptoms including onset age, somatic symptoms and vegetative symptoms.

• Journal of Pharmacopuncture
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• v.9 no.3 s.21
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• pp.23-35
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• 2006

Objectives : The aim of this study was to investigate the effect of Asthma-depression and Immunoregulation with PR-HAS(Herbal-acupuncture with Platycodi Radix infusion solution) infection at Joksamni(St36) on ovalbumin-induced asthma in mice. Methods : C57BL/6 mice were sensitized and challenged with OVA(ovalbumin) for 12 weeks(once a week). The experimental group(OVA-PR-HA) was treated with concentrations(1%) of PR-HAS at Joksamni(St36) for the later 8 weeks(3times/week). The second experimental group(OVA-Needle prick) was treated with Needle-Prick at Joksamni(St36) for the later 8 weeks(3times/week). Results : 1. The weight and total cells in the mice lung treated with PR-HA decreased significantly compared with that of control group. 2. Total leukocytes and eosinophils in BALF of the mice group treated with PR-HA decreased remarkably compared with those of control group. 3. The sticking of collagen on histological analysis of lung sections, the mice group treated with PR-HA decreased significantly compared with those of control group. 4. The concentrations of IL-4, IL-5, IgE in BALF, and IL-4, IL-5, IL-13 in serum of the mice group treated with PR-HA decreased significantly compared with those of control group. 5. The number of Gr-1+/CD11b+ and CD11b+ cells in the lungs of the mice group treated with PR-HA decreased significantly compared with that of control group. 6. The numbers of CCR3+ cells, CD4+ cells and CD8+ cells in the lungs, and CD3e+/CD69+ in the lungs of the mice group treated with PA-HA decreased significantly compared with those of control group. 7. The mRNA expression of ${\beta}$-actin, TNF-${\alpha}$, IL-4, IL-5, IL-13 in the mice group treated with PR-HA with RT-PCR decreased significantly compared with those of control group. Conclusions : These result suggests that Platycodi Radix Herbal-acupuncture at Joksamni(St36) in C57BL/6mice may be an effictive part to OVA-induced asthma in C57BL/6 mice.

• Journal of Acupuncture Research
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• v.22 no.6
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• pp.61-74
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• 2005

Objectives : The aim of this study was to investigate the effect of Asthma-depression and Immunoregulation with PR-HAS(Herbal-acupuncture with Platycodi Radix infusion solution) injection at Joksamni(St36) on ovalbumin-induced asthma in mice. Methods : C57BL/6 mice were sensitized and challenged with OVA(ovalbumin) for 12 weeks(once a week). The experimental group(OVA-PR-HA) wase treated with concentrations(1%) of PR-HAS at Joksamni(St36) for the later 8 weeks(3times/week). The second experimental group(OVA-Needle prick) was treated with Needle-Prick at Joksamni(St36) for the later 8 weeks(3times/week). Results : 1. The weight and total cells in the mice lung treated with PR-HA decreased significantly compared with that of control group. 2. Total leukocytes and eosinophils in BALF of the mice group treated with PR-HA decreased remarkably compared with those of control group. 3. The sticking of collagen on histological analysis of lung sections, the mice group treated with PR-HA decreased significantly compared with those of control group. 4. The concentrations of IL-4, IL-5, IgE in BALF, and IL-4, IL-5, IL-13 in serum of the mice group treated with PR-HA decreased significantly compared with those of control group. 5. The number of $Gr-1^+/CD11b^+\;and\;CD11b^+$ cells in the lungs of the mice group treated with PR-HA decreased significantly compared with that of control group. 6. The numbers of $CCR3^+\;cells,\;CD4^+\;cells\;and\;CD8^+\;cells$ in the lungs, and $CD3e^+/CD69^+$ in the lungs of the mice group treated with PR-HA decreased significantly compared with those of control group. 7. The mRNA expression of ${\beta}-actin,\;TNF-{\alpha}$, IL-4, IL-5,IL-13 in the mice group treated with PR-HA with RT-PCR decreased significantly compared with those of control group. Conclusion : The concentrations of IL-4, IL-5, IgE in BALF, and IL-4, IL-5, IL-13 in serum of the mice group treated with PR-HA decreased significantly compared with those of control group. The number of $Gr-1^+/CD11b^+\;and\;CD11b^+$ cells in the lungs of the mice group treated with PR-HA decreased significantly compared with that of control group. The numbers of $CCR3^+\;cells,\;CD4^+\;cells\;and\;CD8^+\;cells$ in the lungs, and $CD3e^+/CD69^+$ in the lungs of the mice group treated with PR-HA decreased significantly compared with those of control group. The mRNA expression of ${\beta}-actin,\;TNF-{\alpha}$, IL-4, IL-5, IL-13 in the mice group treated with PR-HA with RT-PCR decreased significantly compared with those of control group. These result suggests that Platycodi Radix Herbal-acupuncture at Joksamni(St36) in C57BL/6mice may be an effictive part to OVA-induced asthma in C57BL/6 mice.

• The Journal of Korean Medicine
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• v.26 no.3 s.63
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• pp.66-73
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• 2005

Objectives : The purpose uf this study was to evaluate the effect of Choksmni$(ST_{36})$ moxibustion in hypertensive patients who showed sudden elevation of blood pressure. Methods : Among patients admitted to Woosuk University Hospital from June to September 2004, sixty-one patients who had shown sudden elevation in systolic blood pressure over 100mmHg were chosen by random sampling and divided into a treatment group (Choksamni moxibustion group) and a control group. In the Choksamni $(ST_{36})$ moxibustion group, moxibustion was done at the point between tibial tuberosity and head of fibula where the $ST_{36}$ is known to be located. Direct moxibustion was practiced on the patients 5 times with an increase of size from a grain of rice to a bigger cluster. Male patients were chosen to practice on the left meridian and female patients were chosen to practice on the right meridian point. Changes in blood pressure after He moxibustion were checked 4 times at tine intervals of 30 minutes. In the control group, the patients took bed rest without my medical treatment. The two groups were compared in order to demonstrate whether then were any remarkable changes in depression of blood pressure. Results : There were significant decreases in the systolic and diastolic blood pressure before and after moxibustion. We found significant decreases in systolic blood pressure at 60 minutes, 90 minutes, and 120 minutes ana diastolic blood pressure at 120 minutes in the patient group compared with the control group. Conclusions : There was a statistically significant depressing effect on blood pressure elevation observed in the group with moxibustion at $ST_{36}$ versus the control group without any medical treatment.

• Journal of The Korean Society of Clinical Toxicology
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• v.20 no.1
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• pp.1-7
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• 2022

Purpose: In patients with acute drug overdose, identification of drugs ingested is crucial to make a precise diagnosis. In most cases, the diagnoses are made on the medical history and physical examination findings. This study was undertaken to determine the concordance of diagnosis made on the basis of patient history by comparing it with urine toxicology analysis. Methods: This was a retrospective study of drug intoxicated patients over 18 years old who presented to the emergency center from 2017 to 2019. Specimens from urine were tested using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-TMS). The test results were compared with information obtained from patients. Diagnostic concordances for drug detection in intoxicated patients were calculated. Logistic regression analysis was used to examine the association between clinical characteristics and diagnostic discrepancy. Results: Totally, 370 patients were included in the analysis. Overall, 66 types of drugs were detected by UPLC-TMS. The drugs detected most frequently were zolpidem (104, 27.8%), citalopram (70, 18.7%), and paracetamol (66, 17.6%). The mean diagnostic concordance of patients was 52.7%. There were statistically significant diagnostic discrepancies in patients with underlying depression and patients intoxicated with multiple types of drugs. Conclusion: In ED patients with acute drug overdose, the diagnoses made on history alone were often inaccurate. It is essential to perform urine toxicology tests such as UPLC-TMS as a confirmatory instrument to improve accuracy in evaluating patients with drug intoxication.

• Journal of Oriental Neuropsychiatry
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• v.26 no.1
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• pp.1-10
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• 2015

Objectives: The purpose of this study was to evaluate the effect of breath-counting meditation on anxiety disorder patients with panic attack. Methods: Two anxiety disorder patients with panic attack were treated with Breath-counting Meditation, acupunctures, and herb-medications. The patients have been predicted for anxiety disorder with panic attack through Dignosis and Statistical Manual (DSM-IV), Panic Disorder Severity Scale (PDSS), BDI (Beck Depression Inventory), and BAI (Beck Anxiety Inventory) on their 1st and 6th treatments. Results: After the treatments, both the physical and psychological symptoms have decreased. Conclusions: This study suggests that the breath-counting meditation is an effective way for treating patients who are suffering from anxiety disorder with panic attack.