• Journal of Acupuncture Research
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• 제21권5호
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• pp.137-147
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• 2004

Objective : The aim of the study was to compare the therapeutic effect of the superficial and in-depth insertion of acupuncture needles in the treatment of patients with ankle sprain. Design : A prospective randomized single-blind study of superficial and deep acupuncture was conducted. Setting : The study was conducted in the Kang-nam Oriental Hosp. of Dong-Guk University. Patients: The study comprised 14 patients with ankle sprain who were divided into two groups (A and B). Intervention : In group A, the needle was introduced in the skin at a depth of 2 mm, whereas in group B the needle was placed deeply into muscular tissue or the articular capsule at a depth more than 1.5 Cm The treatment was planned for a duration of 1 week, 3 times. Outcome Measures : The intensity of pain was evaluated with the Ankle grade pain chart(AGPC) before and after treatment and at the 1-week follow-up examination. The AGPC includes Swelling, Tenderness, Exudation, Bruise, Medial/Lateral. stability test, Anterior drawer test, Squeeze test, Bearing weight, Pressure Algometer, Walking state and VAS. Results : Although at the end of the treatment there was no evidence of significant statistical differences between the two different groups, Pain reduction(VAS) was greater in the group treated with deep acupuncture. A statistical difference existed between the two groups at the 1 week follow up, with a better result in the deeply stimulated group in VAS. Conclusion : Clinical results show that deep stimulation has a better analgesic effect when compared with superficial stimulation in pain reduction(VAS, Visual analogic scale).

• 한국의료질향상학회지
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• 제14권2호
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• pp.125-132
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• 2008

Background : The number of outpatient injected anticancer drug is increasing. and the pathway of prescribing, compounding, and injecting anticancer drug is processed very rapidly in out-patient department. Moreover, Dose of anticancer drug is often changed depending on side effect of patients. So we need more effective inspection of anticancer drug prescriptions. The purpose of this study was to analyze the prescription errors for anticancer drugs in Out-Patient Department and to suggest system to prevent them. Method : The study took place at Asan Medical Center from July to September 2007. The pharmacists performed inspection of anticancer drug prescriptions before compounding and injecting. We used protocol-based anticancer drug order program and Electronic Medical Record (EMR). Result : During the study period, we analyzed 4683 prescriptions for out-patient. And we detected 55 medication errors (1.2%). Most common errors included dosage above or below the correct ones (56.3%), followed by incorrect treatment duration. Because most of dosing errors were in the range of usual dosage, it was hard to detect them. So when inspecting the prescription, we considered the medical records of individual patients. As a result, we could raise the efficiency of intervention. Therefore inspection using EMR could possibly reduce the number of anticancer drug errors. Conclusion : we are preventing the medication errors on stability and dosage above or below the maximum therapeutic dose according to the previous inspection system. However most of dosing errors were in the range of usual dosage according to the result of this study. Because of there was interpatient variability of dosage depending adverse effect. For improvement of quality assurance, we suggest inspection system based on patient's medical history.

• 대한두개안면성형외과학회지
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• 제18권2호
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• pp.82-88
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• 2017

Background: Turbinate hypertrophy is one of the common causes of chronic nasal obstruction. In principle, therapeutic guidelines recommend medical treatment. Failure to treat turbinate thickening despite drug therapy may indicate the need for surgery. The main aim of this study was to determine the effect of radiofrequency surgery, among various other surgical procedures, on people with both nasal septal deviation and turbinate hypertrophy. Methods: Among people with nasal deviation who visited the subject hospital between July 2008 to July 2014, 21 people with nasal septal deviation and severe turbinate hypertrophy before their surgery had undergone septoplasty with turbinoplasty using radiofrequency combined with septoplasty. The degree of the turbinate's hypertrophy was appraised in all the patients before and after the surgery using the rhinoscopy, and acoustic rhinometry was objectively carried out. The subjective effect of the turbinoplasty using radiofrequency was explored through the visual analog scale (VAS) score. Results: The degree of contraction of the nasal mucosa after the rhinoscopy changed from Grades 3 and 4 (100%) to Grades 1 and 2 (95.2%) and Grades 3 (4.8%). The minimal cross-sectional area significantly increased from $0.44{\pm}0.07$ to $0.70{\pm}0.07cm^2$ (p<0.05). The nasal cavity volume increased from $4.79{\pm}0.49$ to $6.76{\pm}0.55cm^2$ (p<0.05). The subjective symptoms evaluated with VAS score a year after the surgery significantly improved (p<0.05). Conclusion: Turbinoplasty using Coblator with septoplasty is an effective treatment method because it expands nasal cavity, has a low incidence of complications, subjectively improves symptoms, and has short treatment duration.

• 대한약침학회지
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• 제8권2호
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• pp.11-16
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• 2005

Objective : The aim of the study was to investigate the therapeutic effect of BVA in the treatment of patients with acute ankle sprain. Design : A prospective randomized double-blind study of BVA was conducted. Setting : The study was done in the Kyungwon University Seoul Hospital from August 1st, 2004 to June 15th, 2005. Patients : 30 patients diagnosed with acute ankle sprain, especially 2nd degree on the Ankle grade pain chart(AGPC) participated in the study, who were divided into two groups (A and B) randomly by a coordinator flipping a coin. Group A and B were relevant to control and BVA group respectively, of which a coordinator never informed any other participant involved. Eventually 13 of 17 in group A and 11 of 13 in Group B finished all the process of the clinical trial. Intervention : In both group A and B, The Procedure of acupuncture treatment was made similar by appearance that four acupoints such as 坵墟(GB40), 中封(LR4), 商丘(SP5), 解谿(ST41) of the injured side were selected and Normal saline aqua-acupuncture(control, as a placebo) or BVA was done and then acupuncture at 坵墟(GB40), 中封(LR4), 商丘(SP5), 解谿(ST41), 足三里(ST36), 陽陵泉(G34) of the affected side was given again. the needles were retained for 20 minutes under the infrared rays. The treatment was given daily for a week. Outcome Measures : Ankle-Hindfoot Scale (AHS) and Visual Analogue Scale(VAS) were followed by three treatments. Statistical Analysis : Analysis regarding variations in AHS and VAS is carried out by applying Mann-Whitney test and Wilcoxon signed rank test sign test with level of significance at 5%. Results : At the end of the treatment, there was significant statistical differences between the two groups in VAS and AHS as well, while at the 3rd day only a VAS showed statistical significance. In each group, both VAS and AHS showed statistical significance along with duration of treatment. Conclusions : BVA was thought to be effective alternatives for relieving symptoms of acute ankle sprain, although further study was needed on the large scale.

• 대한예방한의학회지
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• 제20권1호
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• pp.89-97
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• 2016

Objectives : The purpose of this study was to investigate the real status of the utilization of Korean medicine (KM) treatment among children with cerebral palsy (CP). Methods : In a prospective observational multicenter study for children with CP aged from 6 months to 78 months, we analyzed 69 questionnaires of children currently receiving or have received KM treatment such as acupuncture and Korean herbal medicine for CP. Results : Of all the 170 participants, 32 children was currently getting KM treatment and they were getting acupuncture therapy 2.5 times per week on average. The mean expenditure per month for acupuncture and herbal medicine was respectively 32,000won and 501,000won. 37 children have discontinued KM treatment. The most frequent reason for quitting acupuncture therapy was 'inconvenience' (40.7%), followed by 'suffering of children' (33.3%). The average duration of taking Korean herbal medicine was 3.78 months and the highest reason of stopping medicine was 'rejection of children' (32.3%), followed by the 'cost burden' (22.6%). 75% of currently KM using group answered they have experienced positive effect of KM and the rate was 48.6% among the group who have ceased KM. There was a significant difference between the two groups(p=0.025). Conclusions : Further study will be required to increase the therapeutic effect and utilization of KM among the children with CP. More efforts should be made to develop less invasive acupuncture method and various shape of KM herbal medicine and to expand the insurance coverage of KM for children with CP.

• Journal of Pharmaceutical Investigation
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• 제41권1호
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• pp.9-17
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• 2011

The objective of this work is to study transdermal delivery of calcitonin using iontophoresis and to evaluate various factors which affect the transdermal transport. We have studied the effect of polarity, current density, drug concentration, penetration enhancers (isopropyl myristate [IPM] and ethanol) and laser treatment on transdermal flux and the results were compared. We also investigated the iontophoretic flux from microemulsions containing calcitonin together with oleic acid (OA) or IPM. In vitro flux study was performed at $33^{\circ}C$, using side-by-side diffusion cell and full thickness hairless mouse skin. Anodal delivery at pH 3.0 was much larger than cathodal and passive delivery, due to the positive charge of calcitonin. Cumulative amount delivered (CUM) by cathodal or passive delivery was close to zero for 10 hours. The pretreatment of skin by neat IPM markedly increased the CUM anodically. CUM increased as the current density, drug concentration or the duration of IPM treatment increased. Microemulsion containing IPM or oleic acid was prepared and the phase diagram was constructed. CUM also increased when IPM was incorporated into a microemulsion. OA microemulsion showed similar enhancing effect to IPM microemulsion. The delivery of calcitonin from 70% (v/v) ethanol aqueous solution showed a large increase in flux. Laser treatment of skin before flux experiment exhibited about 2 fold increase in total calcitonin amount transported for 12 hours, when compared to that delivered by IPM microemulsion. Based on these results, we have evaluated the possibility of delivering enough amount of calcitonin to reach the therapeutic level. The data suggest that it is highly possible to deliver clinically effective amount of calcitonin using iontophoresis patch with small area (<10 $cm^2$).

• 대한치과마취과학회지
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• 제3권1호
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• pp.6-9
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• 2003

Background: The use of neurolytic agents to control neuropathic pain has been described from the last century Phenol and ethyl alcohol have been widely used as neurolytic agents, however, their neurolytic effect is variable in efficacy and duration of action, and infrequently accompanied with grave complications. It has been found that 5% lidocaine causes irreversible conduction blockade in animal studies. The goal of this study was to evaluate the neurolytic effect of 5%o lidocaine on various neuropathic pain syndromes for prolonged analgesia. Methods: Twenty-five patients with a diagnosis of neuropathic pain including trigeminal neuralgia (n = 7), postherpetic neuralgia (n = 10), and postsurgical neuralgia (n = 8) were selected after failure of routine therapeutic regimens. After performing a diagnostic nerve block with 1% lidocaine and 5% lidocaine was injected. The patients were followed for 6 months. Visual analog scale (VAS) scores and side effects were recorded for each patients. Results: A significant decrease in pain scores after neurolytic blockade with 5% lidocaine was seen in all of three pain groups. All the patients reported immediate and prolonged pain relief lasting from 4 weeks to 6 months. None of patients exhibited any appreciable side effects or complications. Conclusions: We suggest that 5% lidocaine may be used safely and effectively for the purpose of prolonged analgesia in selected patients with intractable neuropathic pain syndromes.

• Journal of Korean Neurosurgical Society
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• 제46권4호
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• pp.346-350
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• 2009

Objective : The purpose of this study was to analyze in detail the relationship between outcome and time course of effect in medically refractory primary cervical dystonia (CD) with phasic type that was treated by bilateral globus pallidus internus (Gpi) deep brain stimulation (DBS). Methods : Six patients underwent bilateral implantation of DBS into the Gpi under the guide of microelectrode recording and were followed for $18.7{\pm}11.1$ months. The mean duration of the CD was $5.8{\pm}3.4$ years. The mean age at time of surgery was $54.2{\pm}10.2$ years. Patients were evaluated with the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and relief scale using patient self-reporting. Results : The TWSTRS total scores improved by 64.5%, 65.5%, 75.8%, and 76.0% at 3, 6, 12 months, and at the last available follow-up after surgery, respectively. Statistically significant improvements in the TWSTRS scores were observed 3 months after surgery (p=0.028) with gradual improvement up to 12 months after surgery, thereafter, the improvement was sustained. However, there was no statistically significant difference between the scores at 3 and 12 months. Subjective improvement reported averaged $81.7{\pm}6.8%$ at last follow-up. Mild dysarthria, the most frequent adverse event, occurred in 3 patients. Conclusions : Our results show that the bilateral Gpi-DBS can offer a significant therapeutic effect from 3 months postoperatively in patients with primary CD with phasic type, without significant side effects.

• 대한중풍순환신경학회지
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• 제12권1호
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• pp.68-72
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• 2011

본 증례에서는 경항통에 대해 음양균형장치를 포함한 침치료, 한약치료를 통해 양호한 치료효과를 관찰했다.

• Tuberculosis and Respiratory Diseases
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• 제41권5호
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• pp.475-483
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• 1994

연구배경 : N-acetylcysteine(ACE)은 임상에서는 객담용해제로 널리 쓰이고 있으나 시험관내 실험 또는 동물실험에서 ACE는 염증세포에서의 산소유리기를 감소시키고, 세포내 강력한 항산화기능을 갖고있는 glutathione(GSH)의 합성을 촉진한다고 알려졌다. 저자들은 만성폐쇄성폐질환 환자에게 통상 투여용량인 매일 600mg씩 1주일간 ACE를 투여했을때 말초혈액내 호중구의 superoxide 분비, chemotaxis 등의 기능에 변화가 오는지 또는 혈장의 GSH 농도가 증가되는지를 살펴보고 동시에 시험관내 실험으로 정상인의 호중구에 ACE를 가했을때 ACE의 농도에 따라 superoxide나 GSH의 양에 변화가 오는지를 관찰하였다. 방법 : ACE 투여 전, 후에 만성폐쇄성폐질환 환자의 말초혈액에서 호중구를 분리하여 PMA로 자극하거나 안했을때의 superoxide 분비를 분광광도계로, luminol-enhanced chemiluminescence를 luminometer로, 혈장의 GSH 농도를 분광광도계로 각각 측정하였다. 한편 정상인의 호중구를 분리하여 $10^{-2}-10^{-5}$ mole의 ACE와 혼합배양시의 superoxide, chemiluminescence 및 GSH를 각각 같은 방법으로 측정하였다. 결과 : ACE를 투여하기 전, 후의 말초혈액내 호중구의 superoxide 분비는 $1.97{\pm}1.75nM/1.4{\times}10^6\;cells/15min$, $2.75{\pm}2.14nM$이었고 PMA로 자극하였을때는 $67.52{\pm}13.41nM$, $67.99{\pm}13.54\;nM$로서 각각 유의한 차이가 없었다(p>0.05). 호중구의 chemiluminescence도 ACE 투여전, 후에 $2.64{\pm}2.29mV$, $2.91{\pm}3.58mV$이었고 PMA로 자극하였을때는 $40.76{\pm}30.09mV$, $37.33{\pm}30.03mV$로서 유의한 차이가 없었다(p>0.05). 호중구의 chemotaxis를 chemotactic index로 비교하였을때 ACE투여전, 후에 $55.71{\pm}16.34$, $59.68{\pm}11.57$이었고 혈장의 GSH는 $0.37{\pm}0.17nM/4{\times}10^5cells$, $0.39{\pm}0.18nM$로서 역시 유의한 차이가 없었다(p>0.05). 정상인의 호중구를 분리하여 $10^{-5}-10^{-2}$ mole의 ACE와 동시배양하며 PMA로 자극하였을때 superoxide는 ACE를 가하지 않은 대조군에서의 $56.54nM/1.4{\times}10^6\;cells/15min$에 비해 ACE의 $10^{-2}$ mole에서 37.0nM로서 유의하게 감소하였고 ACE의 농도에 따라 감소하는 양상을 보였다(r=-0.269, p<0.05). 호중구의 GSH 농도는 대조군의 $0.27nM/4{\times}10^5\;cells$에 비하여 ACE의 $10^{-3}$ mole에서 0.35nM, $10^{-2}$ mole 에서 1.15 nM로서 유의하게 증가하여 ACE의 농도에 따라 증가하였다(r=0.72, p<0.01). 결론 : ACE를 만성폐쇄성폐질환 환자에게 매일 600mg씩 1주일간 투여하였을때 말초혈액내 호중구의 superoxide 분비, chemotaxis에 영향을 주지 않았고 혈장의 glutathione 농도에도 변화가 없었다. 그러나 정상인의 호중구를 분리하여 ACE와 같이 배양한 실험에서 ACE는 농도에 비례하여 호중구의 superoxide 분비를 억제하였고 GSH를 증가시켰다. 이상으로 미루어 ACE는 염증세포에서의 superoxide 분비를 억제하고 GSH를 증가시킴으로서 oxidant-antioxidant 간의 불균형으로 야기되는 ARDS, 폐기종, 간질성폐질환등의 치료에 이용될수 있을것으로 생각되나 폐기종을 포함한 만성폐쇄성폐질환의 치료에 이용되기 위해서는 ACE의 혈중농도 또는 폐포세척액내의 농도를 충분히 증가시키는 방법이 강구되어야 할 것으로 사료된다.