Nowadays light therapy is accepted practice in the treatment for Seasonal Affective Disorder. The author reviewed the practical aspects of light therapy, latest treatment research on optimal parameters of light therapy and the mechanisms of action of light therapy. Therapeutic efficacy of light therapy using light visors & dawn simulators has been suggested but further studies are needed to clarify the efficacy. The treatment most strongly supported by research studies is light therapy using a light box to administer bright white light (2500 lux for 2 hours or 10000 lux for 30 minutes). Although some patients may be selective responders to morning light exposure, the optimal timing of light exposure still remains controversial. In practice, generally the duration of exposure can be increased or decreased as necessary and also the timing of exposure can be splitted (e.g. AM/PM usage) if optimal response is obtained. For most, a positive response of light therapy is usually noted within $4{\sim}5\;days$ and optimal response is obtained within 2 weeks. Generally the relapse of symptom occurs within days of discontinuation of light therapy, so to prevent relapse, light therapy should be continued throughout the winter season for typical seasonal affective disorder. Side effects of light therapy appear to be mild and well tolerated. Several theories for the mechanisms of action of light therapy at the basis of seasonal affective disorder had been suggested but remain still controversial. Further studies on the optimal parameters and the mechanisms of light therapy help us to better understand and treat not only seasonal affective disorders but also chronobiological disorders and nonseasonal affective disorders.
Seongchul Kim;Hayoun Jung;Jina Park;Jinsol Baek;Yeojin Yun;Junghwa Hong;Eunyoung Kim
Korean Journal of Clinical Pharmacy
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v.33
no.1
/
pp.43-50
/
2023
Background and Objective: With the advancement of cancer treatments and increased life expectancy, managing breakthrough cancer pain (BTcP) is essential to improve the quality of life for cancer patients. This study aimed to compare the major rapid onset opioids in Korea based on their characteristics and costs to determine the best option for each patient. Methods: Based on sales information from IQVIA-MIDAS, sublingual fentanyl tablet (SLF), fentanyl buccal tablet (FBT), and oral transmucosal fentanyl citrate (OTFC) were selected as the top three drugs for the treatment of BTcP in Korea, considering them the most comparable drugs. The cost and cost-pain relief ratio of the drugs for short-term (1 month) and long-term (1 year) treatment were compared and the ease of administration based on various factors, including pharmacokinetics, onset of action, and administration procedures were evaluated. Results: SLF was evaluated as the best overall in terms of rapid onset of action, ease of administration, and drug cost and also had the highest market share. SLF had the lowest cost pain relief ratio for both the initial and supplemental treatment for the 1-month pain intensity difference 15 (PID15) ratio. However, for the 1-month PID30 ratio, SLF was not superior to OTFC or FBT. The longer the breakthrough cancer pain duration, the more cost-effective the other rapid onset opioids. Conclusion: The rapid onset opioids that fit the patient's breakthrough cancer pain pattern have the best cost-effectiveness.
Dihydropyridine (DHP) calcium channel blockers (CCBs) have been widely used to treat of several cardiovascular diseases. An excessive shortening of action potential duration (APD) due to the reduction of $Ca^{2+}$ channel current ($I_{Ca}$) might increase the risk of arrhythmia. In this study we investigated the electrophysiological effects of nicardipine (NIC), isradipine (ISR), and amlodipine (AML) on the cardiac APD in rabbit Purkinje fibers, voltage-gated $K^+$ channel currents ($I_{Kr}$, $I_{Ks}$) and voltage-gated $Na^+$ channel current ($I_{Na}$). The concentration-dependent inhibition of $Ca^{2+}$ channel currents ($I_{Ca}$) was examined in rat cardiomyocytes; these CCBs have similar potency on $I_{Ca}$ channel blocking with $IC_{50}$ (the half-maximum inhibiting concentration) values of 0.142, 0.229, and 0.227 nM on NIC, ISR, and AML, respectively. However, ISR shortened both $APD_{50}$ and $APD_{90}$ already at $1{\mu}M$ whereas NIC and AML shortened $APD_{50}$ but not $APD_{90}$ up to $30{\mu}M$. According to ion channel studies, NIC and AML concentration-dependently inhibited $I_{Kr}$ and $I_{Ks}$ while ISR had only partial inhibitory effects (<50% at $30{\mu}M$). Inhibition of $I_{Na}$ was similarly observed in the three CCBs. Since the $I_{Kr}$ and $I_{Ks}$ mainly contribute to cardiac repolarization, their inhibition by NIC and AML could compensate for the AP shortening effects due to the block of $I_{Ca}$.
One of the main purposes of the marine gyrocompass follow-up system is to preserve the sensitive part from the wandering error due to the frictional or torsional torque around the vertical axis. This error can be diminished through the rapid follow-up action, which minimizes the relative azimuthal angular displacement between the sensitive and follow-up parts and shortens the duration of the same displacement. But an excessive rapidity of the follow-up action would result in a sustained oscillation to the system. Therefore, to design a new type of the follow-up system, the theoretical annlysis of the problems concerned should be studied systematically by introducing the control theory. This paper suggest a concrete procedure for the optimal adjustment of the gyrocompass follow-up system, utilizing the mathematic model and the stability informations formerly investiaged by the author. For theoptimal determination of the adjustable paramfter K, the performance index(P.I.), ITSE(Intergral of the Time multiplied by the Squared Error) is proposed, namely, P.I. = $\int_{0}^{\infty} t \cdot e^{2}(t)dt$ where t is time and e(t) means control error. Then, the optimal parameter minimizing the performance index is calculated by means of Parseval's theorem and numerical computation, and the validity of the obtained optimal value of the parameter Ka is examined and confirmed through the simulations and experiments. By using, the proposed method, the optimal adjustment can be performed deterministically. But, this can not be expected in the conventional frequency domain analysis. While the Mps of the original system vary to the extent of from 0.98 to 46.27, Mp of the optimal system is evaluated as 1.1 which satisfies the generally accepted frequency domain specification.
Kim, Jinhyung;Lee, Sung Eun;Shin, Jaewoo;Jung, Hyun Ho;Kim, Sung June;Chang, Jin Woo
Journal of Korean Neurosurgical Society
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v.57
no.1
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pp.6-11
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2015
Objective : Neuropathic pain causes patients feel indescribable pain. Deep Brain Stimulation (DBS) is one of the treatment methods in neuropathic pain but the action mechanism is still unclear. To study the effect and mechanism of analgesic effects from DBS in neuropathic pain and to enhance the analgesic effect of DBS, we stimulated the ventral posterolateral nucleus (VPL) in rats. Methods : To observe the effect from VPL stimulation, we established 3 groups : normal group (Normal group), neuropathic pain group (Pain group) and neuropathic pain+DBS group (DBS group). Rats in DBS group subjected to electrical stimulation and the target is VPL. Results : We observed the behavioral changes by DBS in VPL (VPL-DBS) on neuropathic pain rats. In our study, the pain score which is by conventional test method was effectively decreased. In specific, the time of showing withdrawal response from painful stimulation which is not used measuring method in our animal model was also decreased by DBS. Conclusion : The VPL is an effective target on pain modulation. Specifically we could demonstrate changes of pain response duration which is not used, and it was also significantly meaningful. We thought that this study would be helpful in understanding the relation between VPL-DBS and neuropathic pain.
Journal of the Korea Society of Computer and Information
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v.24
no.2
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pp.139-147
/
2019
A false alarm, which is an incorrect report of an emergency, could trigger an unnecessary action. The predictive maintenance framework developed in our previous work has a feature whereby a machine alarm is triggered based on sensor data evaluation. The sensor data evaluator performs three essential evaluation steps. First, it evaluates each sensor data value based on its threshold (lower and upper bound) and labels the data value as "alarm" when the threshold is exceeded. Second, it calculates the duration of the occurrence of the alarm. Finally, in the third step, a domain expert is required to assess the results from the previous two steps and to determine, thereby, whether the alarm is true or false. There are drawbacks of the current evaluation method. It suffers from a high false-alarm ratio, and moreover, given the vast amount of sensor data to be assessed by the domain expert, the process of evaluation is prolonged and inefficient. In this paper, we propose a method for automatic false-alarm labeling that mimics how the domain expert determines false alarms. The domain expert determines false alarms by evaluating two critical factors, specifically the duration of alarm occurrence and identification of anomalies before or while the alarm occurs. In our proposed method, Hierarchical Temporal Memory (HTM) is utilized to detect anomalies. It is an unsupervised approach that is suitable to our main data characteristic, which is the lack of an example of the normal form of sensor data. The result shows that the technique is effective for automatic labeling of false alarms in sensor data.
Background: Dental pain management is an important aspect of patient management in pediatric dentistry. Articaine is considered the most successful anesthetic agent for infiltration anesthesia. Buffered articaine has been observed to have faster onset and longer duration of action with less pain on injection. The aim of this study was to evaluate and compare pain on injection, onset of action, and pain during extraction using buffered (using Sodium bicarbonate (NaHCO3)) and non-buffered 4% articaine (with 1:100000 adrenaline) infiltrations for primary maxillary molar extractions in 4-10-year-old children. Methods: Seventy children who required extraction of maxillary primary molars were enrolled in this triple-blind randomized study. Children undergoing extraction were randomly divided into two groups, with 35 in each group. The study group was the buffered articaine group; the control group was the non-buffered articaine group. Buccal and palatal infiltrations were administered with either buffered or non-buffered articaine. Subjective evaluation was done for pain on injection, pain during extraction using Wong-Baker Faces Pain Rating Scale (WBFPR) and onset of anesthesia in seconds. Pain on injection, pain during extraction were objectively evaluated using Sound Eye Motor (SEM) scale and onset of anesthesia was also evaluated objectively by pricking with sharp dental probe. Results: The outcome was, significantly less pain on injection and significantly faster onset of anesthesia with significantly less pain during extraction for both subjective and objective evaluations in the buffered articaine group. Subgroup analysis was also performed and it showed variable results, with only significant difference for WBFPR scores in age subgroup 4-7 years for palatal infiltration. Conclusion: Less pain on injection, faster onset of anesthesia, and less pain during extraction were observed when buffered articaine was used for maxillary primary molar extraction.
Snoring and obstructive sleep apnea (OSA) are common sleep disordered breathing conditions. Habitual snoring is caused by a vibration of soft tissue of upper airway while breath in sleeping, and obstructive sleep apnea is caused by the repeated obstructions of airflow for a sleeping, specially airflow of pharynx. Researchers have shown that snoring is the most important symptom connected with the obstructive sleep apnea syndrome The treatment is directed toward improving the air flow by various surgical and nonsurgical methods. The current surgical procedures used are uvulopalatopharyngoplasty(UPPP), orthognathic surgery, nasal cavity surgery. Among the nonsurgical methods there are nasal continuous positive air pressure(CPAP), pharmacologic therapy. weight loss in obese patient, oral appliance(sleep splint). Sleep splint brings the mandible forward in order to increase upper airway volume and prevents total upper airway collapse during sleep. However, the precise mechanism of action is not yet completely understood, especially aerodynamic factor. The aim of this study evaluated the effect of conservative treatment of snoring and OSAS by sleep splint through measured aerodynamic change by an aerophone II. We measured a airflow, sound pressure level, duration, mean power from overall airflow by aerophone II mask. The results indicated that on a positive correlation between a decrease in maximum airflow rate and a decrease in maximum sound pressure level, on a negative correlation between a decrease in maximum airflow rate and a increase in duration.
Journal of Physiology & Pathology in Korean Medicine
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v.29
no.4
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pp.305-312
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2015
Paeonol is a major component found in the Paeoniaceae family such as Paeonia suffruticosa Andrews. Paeonia suffruticosa Andrews has traditionally been used to enhance blood flow and relieve joint pain in east Asian countries including China, Korea and Japan. Current research has shown that paeonol blocked the voltage-gated sodium channel and L-type calcium channel. However, there is a lack of research to reveal the relation between cardiac function and blockade of ion channels by paeonol. Therefore, the aim of this study is to investigate whether paeonol has anti-arrhythmic effects via modulating cardiac ion channels. It is collected that the effects of paeonol on multiple ion channels such as the fast sodium channel and L-type calcium channel from published papers. To incorporate the information on multi-channel block, we computed the effects using the mathematical cardiac model of the guinea-pig and rat ventricular cells (Noble 1998 and 1991 model) and induced early after-depolarizations (EADs) to generate an arrhythmia in the whole heart. Paeonol slightly shortened the action potential duration in the normal cardiac ventricular action potential by the inhibition of sodium channel and L-type calcium channel. Paeonol presented the protective effect from EADs by the inactivation of sodium channel but not L-type calcium channel. Paeonol did not show any changes when it treated on normal ventricular cells through the inhibition of sodium channel, but the protective effect of paeonol through sodium channel on EADs was dose-dependent. These findings suggest that paeonol and its original plant may possess anti-arrhythmic activity, which implies their cardioprotective effects.
Granule cells in dentate gyrus of hippocampus relay information from entorhinal cortex via perforant fiber to pyramidal cells in CA3 region. Their electrical activities are known to be closely associated with seizure activity as well as memory acquisition. Since action potential is a stereotypic phenomena which is based on all-or-none principle of $Na^+$ current, the neuronal firing pattern is mostly dependent on afterpotentials which follows the stereotypic $Na^+$ spike. Granule cells in dentate gyrus show afterdepolarization (ADP), while interneurons in dentate gyrus have afterhyperpolarizaton. In the present study, we investigated the ionic mechanism of afterdepolarization in hippocampal dentate granule cell. Action potential of dentate granule cells showed afterdepolarization, which was characterized by a sharp notch followed by a depolarizing hump starting at about $-49.04{\pm}1.69\;mV\;(n=43,\;mean{\pm}SD)$ and lasting $3{\sim}7$ ms. Increase of extracellular $Ca^{2+}$ from 2 mM to 10 mM significantly enhanced the ADP both in amplitude and in duration. A $K^+$ channel blocker, 4-aminopyridine (4-AP, 2 mM), enhanced the ADP and often induced burst firings. These effects of 10 mM $Ca^{2+}$ and 4-AP were additive. On the contrary, the ADP was significantly suppressed by removal of external $Ca^{2+},$ even in the presence of 4-AP (2 mM). A $Na^+$ channel blocker, TTX (100 nM), did not affect the ADP. From these results, it is concluded that the extracellular $Ca^{2+}$ influx contributes to the generation of ADP in granule cells.
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