• Journal of Korean Neurosurgical Society
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• 제57권1호
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• pp.23-31
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• 2015

Objective : The aims of this study were to investigate the quantitative relationship between pituitary macroadenoma size and degree of visual impairment, and assess visual improvement after surgical resection of the tumor. Methods : The medical records of patients with pituitary adenoma, who had undergone trans-sphenoidal adenectomy between January 2009 and January 2011, were reviewed. Patients underwent an ocular examination and brain MRI before and after surgery. The visual impairment score (VIS) was derived by combining the scores of best-corrected visual acuity and visual field. The relationship between VIS and tumor size/tumor type/position of the optic chiasm was assessed. Results : Seventy-eight patients were included (41 male, 37 female). Thirty-two (41%) patients experienced blurred vision or visual field defect as an initial symptom. Receiver operating characteristic curve analysis showed that tumors <2.2 cm tended to cause minimal or no visual impairment. Statistical analysis showed that 1) poor preoperative vision is related to tumor size, displacement of the optic chiasm in the sagittal view on MRI and optic atrophy, and 2) poorer visual prognosis is associated with greater preoperative VIS. In multivariate analysis the only factor significantly related to VIS improvement was increasing pituitary adenoma size, which predicted decreased improvement. Conclusion : Results from this study show that pituitary adenomas larger than 2 cm cause defects in vision while adenomas 2 cm or smaller do not cause significant visual impairment. Patients with a large macroadenoma or giant adenoma should undergo surgical resection as soon as possible to prevent permanent visual loss.

• 사상체질의학회지
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• 제22권2호
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• pp.115-122
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• 2010

1. Objectives: This case study reports clinical improvement of a Soyangin benign arrhythmia patient who showed improvement of palpitation symptoms after treatment with Hyeongbangjihwang-tang. 2. Methods: The patient's subjective and objective symptoms were observed daily, and the VAS scores and duration times of palpitation were recorded daily throughout the hospitalization period. 3. Results: The general condition of the patient improved by the end of hospitalization. The VAS score dropped from 4-10 to 0-1, and the duration of palpitation dropped from 50-160 min to 0-5 min. Other symptoms such as diarrhea and lower back pain also showed improvement. 4. Conclusion: This case study shows the effectiveness of Hyeongbangjihwang-tang in the treatment of palpitation. Although the literature on Hyeongbangjihwang-tang does not report its usage on palpitation, the prescription was shown to be effective in the case where the palpitation symptom is concomitant to the general symptomatology of the Mangeum disease, a pathology indicative of Hyeongbangjihwang-tang.

• 생물정신의학
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• 제16권3호
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• pp.170-180
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• 2009

Objectives : To assess clinical improvement and change in plasma brain-derived neurotrophic factor(BDNF) level after repetitive transcranial magnetic stimulation(rTMS) in patients with treatment-resistant schizophrenia. Methods : Seven patients with DSM-IV schizophrenia, who were proven to be treatment-resistant, were treated with 15 sessions of rTMS for three weeks as an adjuvant therapy to antipsychotic treatment. Clinical improvement and change in plasma BDNF level were measured after the treatment period. The symptom severity was assessed with the Positive and Negative Syndrome Scale(PANSS) and the Korean Version of Calgary Depression Scale for Schizophrenia(K-CDSS) at baseline and 7 days after the treatment. Plasma BDNF level was measured by enzyme-linked immunosorbent assay(ELISA) at baseline and 7 days after the treatment. Results : After the rTMS treatment, there was no significant improvement in PANSS total score(Z=-1.693, p=0.090) and no significant change in plasma BDNF was found(Z=-1.183, p=0.237). Negative correlations were found between percentage change in PANSS positive subscale score and duration of illness(rho=-0.991, N=7, p<0.0005, two-tailed), and PANSS negative subscale score at baseline and percentage change in plasma BDNF level(rho=-0.821, N=7, p=0.023, two-tailed). Conclusion : This preliminary study suggests that rTMS didn't make a significant change in clinical symptoms nor in plasma BDNF level in treatment-resistant schizophrenia. Percentage change in plasma BDNF, however, might be correlated with treatment resistance in schizophrenic patients. This is a pilot study with a small sample size, therefore, a further study with a larger sample size is needed.

• Journal of Acupuncture Research
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• 제27권5호
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• pp.69-78
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• 2010

Objectives : To prove the effectiveness of acupuncture treatment targeting the insomnia-complaining patients from the group of hospital inpatients. Methods : Among Wonkwang University Iksan Oriental Medical Hospital impatients, needling Sinmaek($BL_{62}$) and Johae($KI_6$) and Venesection on Eunbaek(SP1) on the 15 insomnia-complaining patients. Then, confirmed the degree of insomnia symptom improvements through Saint's Mary Hospital(SMH) questionnaire, insomnia severity index(ISI), and Korean sleep scale(KSS). Results : 1. Result indicated after the acupuncture treatment, the total hours of sleeping increased in average per hour. 2. When evaluating the degree of improvement using Insomnia Severity Index(ISI) after the treatment, average score was lowered and the statistical data showed the result was significant. 3. When evaluating the degree of improvement using Korean Sleep Scale(KSS), the average score was increased and the statistical data showed the result was significant. Conclusions : Among the insomnia patients from the group of Oriental Medical Hospital inpatients, the total hours of sleeping increased, showed the score improvement by using the tool for evaluating sleeping, and indicated statistically significant treatment effectiveness.

• 대한약침학회지
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• 제24권3호
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• pp.122-137
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• 2021

Objectives: In South Korea, traffic accident victims can be treated under automobile insurance coverage. Korean medicine (KM) clinics have reported the largest number of automobile insurance fee claims among medical institutions. This study investigated the status of the KM automobile insurance system in a single KM clinic. Methods: We retrospectively surveyed the medical charts of 342 traffic accident patients treated at the Jisung KM clinic between January 2009 and June 2017. Results: Most of the patients were men and in their 30s. The most common method of locating the clinic was an internet search. The most common traffic accident type was collision between vehicles (83.63%), with 70.76% of patients visiting during the most acute phase. The major disease codes included S434, M4836, F072, S0600, and S3350. The most frequent treatment period was within 1 month of the accident, and most patients received 10 or fewer treatments. The mean treatment duration and number of treatments were 37.68 ± 45.11 days and 11.68 ± 10.63 treatments, respectively. The initial pain numerical rating scale (NRS), 7.32 ± 0.96, decreased to 3.57 ± 1.40 at the end of treatment, with a symptom improvement score of 1.87 ± 0.60. Regarding sex, age, disease duration, location at the time of the accident, presence of additional and psychological symptoms, and chuna, there were statistically significant differences in treatment duration and number of treatments. A higher number of treatments and the longer treatment duration was associated with a higher initial NRS, lower post-treatment NRS, and better improvement score. Since the introduction of traffic accident (TA) pharmacopuncture, the rate of use of a single type of pharmacopuncture increased; however, no significant differences in treatment duration and number, NRS before and after treatment, and improvement score were observed between treatment groups before and after TA pharmacopuncture. No adverse reactions were observed for any treatment. Conclusion: This study confirmed the previous findings of a high treatment effect of KM under automobile insurance. We also observed significant correlations based on a detailed medical status, which may explain the increasing use of KM in the automobile insurance system. Additional multi-center studies in different regions are needed.

• The Korean journal of internal medicine
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• 제39권1호
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• pp.57-67
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• 2024

Background/Aims: Abexol is a mixture of primary aliphatic alcohols purified from beeswax (Apis mellifera), that produces anti-inflammatory, antioxidant and gastroprotective effects, as well as it is safe and well tolerated. To investigate and compare the efficacy and safety of Abexol (suspension versus tablets) in patients with gastrointestinal symptoms. Methods: Monocentric study, open-label, randomized design, with two parallel groups receiving Abexol tablets (150 mg/d) or Abexol suspension (75 mg/d) for 8 weeks. Primary efficacy variable (significant improvement in the total score of Gastrointestinal Symptom Rating Scale [GSRS]). Significant reduction in the intensity of the gastrointestinal-symptoms and the reduction in the consumption of antacids are considered secondary efficacy variable. Short form-36 (SF-36) quality of life questionnaire was evaluated as collateral variable. Data were analyzed as per intention to treat. Results: A significantly decrease in the overall score of the survey was observed with respect to the baseline level (p < 0.001) of 81.4% in the Abexol suspension group and 77.9% in the Abexol tablets group. At the end of the trial, most gastrointestinal-symptoms disappeared or reduced significantly. The frequency of consumption of neutralizing antacids was low. The significantly improvement in the perception of the state of health obtained in the Abexol is in correspondence with the improvement achieved in some of the components evaluate in the SF-36 questionnaire. Both treatments were safe and well tolerated. Conclusions: Abexol suspension showed efficacy and safety similar to Abexol tablets in patients with gastrointestinal symptoms, but using half the dose.

• 한국안광학회지
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• 제16권1호
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• pp.65-74
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• 2011

목적: 본 연구는 시각적 난독증 증상을 나타내는 호소군을 대상으로 칼라필터렌즈인 크로마젠($ChromaGen^{TM}$)렌즈를 착용함으로써 읽기능력의 향상정도를 알아보고자 하였다. 방법: 설문을 통한 난독증 의심 학생 52명을 대상으로 윌킨스 독서속도검사법을 이용하여 난독증 교정렌즈인 크로마젠 렌즈를 착용 전과 후 그리고 3개월 동안 착용한 후 읽기능력의 향상정도를 알아보았다. 결과: 1분 동안의 읽은 단어 숫자는 크로마젠 렌즈 착용자가 평균 110.26${\pm}$22.07 단어를 읽었고, 나안 또는 교정안경 착용자는 평균 106.42${\pm}$22.70의 단어를 읽었다. 크로마젠 렌즈 3개월 착용 후에는 평균 114.16${\pm}$21.86 단어를 읽었고, 나안 또는 교정안경을 착용한 학생은 109.96${\pm}$21.67 단어를 읽었다. 크로마젠 렌즈 착용 전과 후에 대한 3개월 동안 크로마젠 렌즈를 착용한 후의 읽기능력은 각각 3.70%${\pm}$0.29(p=0.01, t=2.26), 4.50%${\pm}$0.10(p=0.01, t=2.78)의 향상을 보였으며 통계학적 유의성이 있었다(p<0.05). 크로마젠 렌즈의 교정 3개월 후 난독증 증상의 개선에 대한 만족도 조사에서 전체 대상자 중 88.4%가 크로마젠 렌즈에 의해 난독증 증상이 개선되었다고 답하였다. 결론: 시각적 난독증의 증상이 의심되는 대상자에게 난독증 교정안경렌즈인 크로마젠 렌즈는 읽기능력 향상에 효과가 있었으며 통계학적으로 유의성이 있었다(p<0.05).

• 대한불안의학회지
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• 제2권1호
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• pp.39-44
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• 2006

Objective : Chronic posttraumatic stress disorder (PTSD) is defined by the coexistence of symptoms (reexperiencing, avoidance and hyperarousal), persisting for more than months or years that causes significant impairment in social occupational functioning. This study was conducted to evaluate the effects of terazosin on posttraumatic nightmares which is one of chronic PTSD symptoms. Methods : Twenty patients with chronic PTSD and severe trauma-related nightmares were treated with terazosin (3-7 mg/day) for 8 weeks. Recurrent distressing dreams item of the Clinician administered PTSD Scale (CAPS), Total CAPS score, Clinical Global Impressions-Severity Scale (CGI-S) and Clinical Global Impressions-Change Scale (CGI-C) were performed at baseline, 4-week and 8-week. Mississippi Scale for Combat-Related PTSD and Combat Exposure Scale (CES) were used to evaluate PTSD symptom pattern and degree of exposure. Results : Significant decrease in recurrent distressing dreams item, reexperiencing, avoidance and hyperarousal symptom score and total CAPS score were at 4-week and 8-week treatment compared to baseline (recurrent distressing dreams item : $2.70{\pm}1.88$ and $1.25{\pm}1.49$ ; reexperiencing, avoidance and hyperarousal symptom score : $2.30{\pm}2.49$, $1.20{\pm}1.05$, $3.10{\pm}1.68$ and $4.00{\pm}3.59$, $1.55{\pm}1.50$, $5.60{\pm}3.23$ ; total CAPS score : $8.20{\pm}6.26$ and $5.40{\pm}5.89$). There were significant correlation between dosage of terazosin and improvement of PTSD symptoms. Adverse effects such as fatigue and orthostatic hypotension were showed, which were mild and self-limited. Conclusion : These results suggest that terazosin may improve severe trauma-related nightmares and overall PTSD symptoms. Randomized controlled study with more subjects would be necessary in the future.

• Journal of Korean Neurosurgical Society
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• 제29권6호
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• pp.754-762
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• 2000

Objectives : The surgical results of 80 patients with growth hormone(GH)-producing pituitary adenoma were analyzed retrospectively to evaluate the clinical manifestations and to determine which preoperative factors significantly influenced the surgical outcome. Patients and Methods : The patients consisted of 39 men and 41 women and the age of patients at the time of initial operation ranged from 17 to 67 years(mean age, 40.5 years) Between January 1990 and June 1996, 77 patients underwent transsphenoidal surgery and 3 patients underwent craniotomy for GH-producing pituitary adenoma at our institution. Preoperative administration of octreotide was performed in 18 patients. Surgical control was defined as a postoperative serum basal level of GH less than 5ng/ml. A logistic regression model was used for univariate and multivariate analysis. Probability value of less than 0.05 was considered as statistically significant. Results : The most common presenting symptom was acromegaly, followed by headache, visual disturbance, and fatigability. Visual symptoms were present in 39% of the patients. Diabetes mellitus was associated in 24 patients and hypertension in 12. Preoperative mean basal level of GH was 93.2ng/ml(range 72-500ng/ml) which was closely related with tumor size(p<0.05). Grade II by Hardy's classification was the most common radiological type. Preoperative octreotide treatment significantly reduced the level of GH(p<0.05), but not enough to induce endocrinological remission. One patient died of cerebral infarction after craniotomy. The most common surgical complication was transient diabetes insipidus. The symptom of the earliest improvement after surgery was paresthesia and tightness of the hand and foot, followed by headache and easy fatigability. The preoperative visual symptom was improved in all patients. The patients who had hypertension or DM experienced alleviated symptoms in 67% and 92%, respectively. The overall rate of endocrinological remission was 44%. By multivariate logistic regression analysis, the size of tumor, extrasellar extension, and extent of removal were significant prognostic factors for endocrinologial remission. Conclusion : Early detection of a small tumor without extrasellar extension followed by a complete resection is highly recommended in order to achieve endocrinological cure of GH-producing pituitary adenomas.

• Journal of Acupuncture Research
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• 제24권4호
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• pp.225-235
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• 2007

2007년 2월 20일부터 3월 12일까지 대전대학교 둔산 한방병원에 입원한 근위축성 측삭 경화증 환자 1례에 대한 임상 고찰을 통하여 다음과 같은 결론을 얻었다. 1. 본 증례의 환자는 한의학적으로 위증으로 진단 하였으며 폐열엽초(肺熱葉焦), 기혈양허(氣血兩虛)로 변증하였다. 2. 독취양명(獨取陽明)치법을 기준으로 비위경(脾胃經)의 경혈 위주로 자침하였고 입원초기의 한약은 기혈대보(氣血大補)하는 십전대보탕(十全大補湯), 자신양혈건보탕(滋腎養血健步湯)을 사용하였으나 입원 중기부터는 객담, 인후부 불편감을 사지무력감보다 심하게 호소하여 우담리습(祐痰利濕)의 효능이 있는 보음전(補陰煎), 절제화담환(節齊化痰丸)을 처방하였다. 3. 환자는 입원 초기 객담이 줄어들면서 연하작용도 완화되었으나 입원후기에는 객담이 다시 증가하여 연하 및 호흡곤란을 호소하였다. 4. 근육의 위축 속도 및 정도를 파악하기 위하여 1주일에 1회 하지둘레를 확인하였으며 입원 첫 주보다 퇴원 주에 1cm 가량 감소하였다. 5. 우상지부 악력은 입원 초기 6kg이었으나 입원 후기에는 11kg까지 증가하였다. 6. ALS는 아직 뚜렷한 치료법이 없는 상태로 향후 적극적인 한방치료에 대한 연구가 필요할 것이라고 사료된다.