• The Korean Journal of Physiology
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• 제25권1호
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• pp.87-99
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• 1991

In order to elucidate whether capsaicin applied topically acts as a pain-producing subastance or as a tastant, neuronal activities of the chorda tympani nerve(CN), lingual nerve(LN), solitary tract nucleus(STN), and trigeminal nucleus(TGN) were recorded while thermal and taste stimuli, and capsaicin were being applied topically, and algesics intra-arterially to the tongue of cats anesthetized with ${\alpha}-chloralsoe$. In addition, the STN neurons were examined after wheat germ agglutinin-horseradish peroxidase(WGA-HRP) was applied to the CN. The CN fibers responded to taste and thermal stimuli, algesics, and capsaicin. Responses to capsaicin were significantly correlated with those to taste and thermal stimuli. The LN fibers mainly responded to mechanical and thermal stimuli, algesics, and capsaicin. Responses to capsaicin were significantly correlated with those to algesics. The STN neurons responded to taste and thermal stiumli, algesics, and capsaicin. Responses to capsaicin were significantly correlated with those to taste and thermal stiumli in somewhat different fashion from those of the CN fibers. The TGN neurons mainly responded to mechanical stimuli, algesics, and capsaicin. Correlations between responses to capsaicin and any others were not significant. After WGA-HRP was applied to the CN, the STN neurons which receive input from the CN were identified largely in the medio-ventral portion to the solitary tract. These results suggest that capsaicin produce taste as well as pain sensation. Sensory information evoked by capsaicin can be conveyed to the STN, especially medio-ventral portion, via the CN as gustatory information on the one hand, and to the STN or TGN via the LN as noxious information on the other. In addiation, the noxious information may be conveyed to the STN via the CN.

• The Korean Journal of Pain
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• 제19권2호
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• pp.146-151
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• 2006

Background: Spinal cord stimulation is a well-established method for the management of several types of chronic and intractable pain. This form of stimulation elicits a tingling sensation (paresthesia) in the corresponding dermatomes. The goal of this study was to establish a correlation between the spinal levels of the implanted epidural electrodes and the paresthesia elicited due to stimulation of the neural structures. Methods: Thirty five patients, who received trial spinal cord stimulation, were evaluated. After the insertion of the lead to the selected position, the areas of paresthesia evoked by stimulation were evaluated. Results: Seventy-one percent of cases showed paresthesia in the shoulder area when the tip of the electrode was located between the C2⁣-C4 levels. At the upper extremities, paresthesia was evoked in 86⁣-93% of cases, regardless of the location of the electrode tip within the cervical spinal segments. The most common tip placement of the leads eliciting hand stimulation was at the C5 level. The most common level of electrode tip placement eliciting paresthesia of the anterior and posterior thigh and the foot were at the T7-⁣T12, T10⁣-L1 and T11-⁣L1 vertebral segments, respectively. Conclusions: Detailed knowledge of the patterns of stimulation induced paresthesia in relation to the spine level of the implanted electrodes has allowed the more consistent and successful placement of epidural electrodes at the desired spine level.

• The Korean Journal of Physiology
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• 제17권2호
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• pp.93-101
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• 1983

국소한냉자극이 전신 및 국소혈액순환에 미치는 영향과 동계에 있어서 한냉에 대한 적응을 관찰하기 위하여 동계 및 하계에 편균연령 21세의 남녀 대학생 각 60명 및 50명을 대상으로 $5^{\circ}C$의 냉수에 일측 손을 담구어 3분간 국소한냉자극을 가하였다. 침수 1, 2, 3분과 회복기 1, 3, 5분에 침수한 측과 침수 반대측에서 평균혈압, 분시심박수, 광전 모세혈관 맥박의 파고, 피부전기저항을 관찰하여 다음과 같은 결과를 얻었다. 국소한냉자극시 혈압은 증가하였고 하계에서 동계보다 더 큰 증가를 보였다. 회복기에 동계는 서서히 대조치로 회복되나 하계에는 대조치보다 유의하게 감소하였다. 분시심박수는 침수시 증가하며 하계에서 동계보다 더 증가하였고 회복기에는 동계 및 하계 모두 대조치보다 감소하였다. 광전 모세혈관 맥박의 파고는 동계에는 침수 및 침수 반대측 모두 감소하였으나 침수한 측에서 더 크게 감소하였으며 이는 침수한 측에 있어서 한냉의 국소효과에 기인한 것으로 보인다. 하계에는 동계보다 작은 감소를 보였으며 회복기에는 더 빠른 회복을 보여 대조치보다 증가하였다. 피부전기저항은 침수시 침수 반대측에서는 감소하나 침수한 측에서는 유의하게 증가하였다가 회복기에 서서히 감소하였다. 침수 반대측의 감소는 동통에 의한 반응이 한냉에 의한 반응에 첨가되어 나타난 것으로 보이며, 침수한 측은 한냉에 의한 국소효과가 크기 때문인 것으로 보인다. 이상으로 $5^{\circ}C$의 국소한냉자극시 전신적 반응은 한냉자극에 의한 동통성 stress에 기인한 반응이 우세한 것으로 생각되며 김 등$^{39)}$의 보고와는 달리 동계 및 하계의 반응의 차이는 계절에 따른 한냉자극에 대한 주관적 감각의 차이에 의한 것으로 동계에서 한냉기후에 의한 국소한냉자극의 적응현상은 나타나지 않는 것으로 사료된다.

• Clinics in Shoulder and Elbow
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• 제8권2호
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• pp.181-186
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• 2005

An anterior dislocation of the elbow without a fracture of the olecranon is an extremely rare injury. This paper reports a 36-year-old male who stumbled and fell on his outstretched hand during a soccer game. The anteroposterior and lateral radiographs indicated a simple anterior dislocation of the elbow, which was reduced using a closed method. The elbow joint was stable in the range of motion, but the sensation of the two ulnar digits was still reduced. MRI was useful for the identification of the pathoanatomy. At the follow-up examination three months after the initial trauma, the hypesthesia has fully recovered and the patient regained the full range of the elbow and forearm motion without pain and instability. After 18 months, the patient had a normal elbow function, and could play various sports. If an anterior elbow dislocation is detected early, a closed reduction with careful pathoanatomical considerations would be successful.

• 대한한방내과학회지
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• 제42권2호
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• pp.104-113
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• 2021

Introduction: The aim of this study is to report on the effectiveness of Korean medicine to improve symptoms of chemotherapy-induced peripheral neuropathy (CIPN). Some patients are treated with medication, but medications may have no effect in some patients. Korean medicine treatments have been used in such patients, but few reports exist. Case Presentation: A 58-year-old female patient with CIPN reported symptoms of bilateral limb pain and tingling sensations as well as cold sensations in bilateral lower legs and hands, fatigue, and bilateral limb weakness. To reduce the patient's symptoms, we provided Korean medical treatment, including herbal medicine (Uchashinki-hwan), acupuncture, and moxibation. To evaluate the results of this treatment, we used a numeric rating scale (NRS), the manual muscle test (MMT), the National Cancer Institute Common Toxicity Criteria for Adverse Events (CTCAE), and the European Organization for Research and Treatment of Cancer quality-of-life questionnaire about CIPN (EORTC-QLQ-CIPN20). After 49 days of treatment, the NRS scores decreased for bilateral limb pain and tingling, for bilateral lower leg and hand cold sensation, and for fatigue. The MMT results for the upper and lower extremities were improved. CTCAE Grade and EORTC QLQ-CIPN20 score were also decreased. Conclusion: According to these results, Korean medicine treatment may be considered an effective treatment for CIPN. Prospective studies are needed in the future to confirm and expand these findings.

• Clinical Pain
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• 제20권2호
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• pp.135-140
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• 2021

MiraDry^®, a microwave thermolysis device, is comparably new non-surgical agent in the field of eradication of sweat glands for treating axillary hyperhidrosis and osmidrosis. So far, altered sensation, swelling, and compensatory sweating are widely known as adverse effects of MiraDry^®. Of the few reported MiraDry^®-induced neuropathy cases, median and ulnar neuropathies are common. Although, one case has described radial nerve and posterior cord damage with maximized stimulation intensity, musculocutaneous nerve damage induced by MiraDry^® has not been reported. Here, we report a case of a 30-year-old woman experiencing left hand weakness after receiving MiraDry^® at a local dermatology clinic. Left brachial plexopathy, mainly involving the median nerve and the musculocutaneous nerve with partial axonotmesis, was confirmed by electrodiagnostic studies. Ultrasound evaluation showed corresponding results. This is the first case report of the musculocutaneous neuropathy by MiraDry^®.

• 한방재활의학과학회지
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• 제21권2호
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• pp.211-226
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• 2011

Objectives : The purpose of this study is to establish literatural evidence about traditional Korean medical physiotherapy through literatural review. Methods : Applicable paragraphs which were related to the traditional Korean medical physiotherapy were phrased from in "Hwang-je-nae-gyung(黃帝內經)", "Yumun-sa-chin(儒門事親)", "Geum-guei-yo-ryack(金匱要略)", "Eui-hack-ip-mun(醫學入門)", "Gyung-ack-jeon-seo(景岳全書)", "Eui-hack-gang-mock(醫學綱目)", "Dong-eui-bo-gam(東醫寶鑑)" where were archiving of Oriental or Korean medicine literatures. Searched paragraphs were analysed for establishing historical and theoretical bases of Korean medical physiotherapy. Results : 1. Theromtherapy is originated from yu(熨), hot hand, warm, water bath, warm earth, fumigation, lamp, torchlight and brazier. Matching indications are various musculoskeletal pain and diseases, skin diseases such as chronic inflammation, frostbite, gynecological and urogenital diseases such as uterine myoma, lower abdominal pain, metrorrhagia, breast diseases, digestive tract diseases such as vomiting, diarrhea, stomachache and also it treats cardiovascular disease. Other matching indications are sunstroke, rhinorrhea, psycosis and anal pain. And it used helping acupuncture therapy. 2. Cryotherapy is originated from lengfu(冷敷), lengtie(冷貼), cold stone and cold water. Matching indications are various fever disease, skin diseases such as acute inflammation, wound, fever skin disease, otorhinolaryngological diseases such as acute sore throat, otitis, stomatitis, nasal bleeding and contusions, abrasions, burn and dysuria. In addition, it treats extremity coldness, chillness, stomachache caused to accumulate fever. 3. Physiotherapy by circulating meridian system is originated from manipulation such as pushing, massage and beating to therapy point. Matching indications are musculoskeletal diseases such as various muscular pain, heavy sensation, convulsion, urogenital diseases such as dysuria, lower abdomen pain, digestive tract diseases such as stomachache, and paralysis due to blocked meridian system. And other matching indications are psycosis, leprosy, hypoesthesia, acute stroke. In addition it helps other therapy methods. In addition, the power of manipulation classify to strengthen and reduce. 4. Physiotherapy by balancing meridian system is originated from sunshine, magnet, horn, bamboo and tube. Sunshine helps improving self's care and cure inflammatory skin disease. Magnet's matching indications are paralysis, various injuries, abscess, fever and eye disease. Cupping therapy treats to skin diseases and internal diseases such as tuberculosis. Conclusions : Traditional Korean medical physiotherapy was widely used in traditional Korean medicine since ancient time based on the traditional Korean medical principle and anatomical knowledge. With modern physiotherapy and traditional Korean medicine together, effects of treatment are enhanced. And traditional Korean medical physiotherapy is appropriated to world physiotherapy's expectation.

• 대한간호학회지
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• 제27권2호
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• pp.433-443
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• 1997

Cardiac catheterization is a diagnostic procedure which is intrusive and anxiety provoking. Patient education and information offer have been suggested as effective nursing interventions to reduce patients' anxiety and stress. Main objectives of this study are : 1) to develop concrete objective information for patients undergoing cardiac catheterization : 2) to analyze the types of information included in the newly developed concrete objective information. The subjects of this study are 11 patients who were admitted to the CCU of a general hospital in Seoul. The subjects were provided with preparatory information about cardiac catheterization by using interview and a booklet. After the procedure, the subjects were asked to describe additional information which they suggest to be added into the booklet and the physical sensations felt during the procedure. The results of the study are summarized as follows : Most subjects were satisfied with the preparatory information that was provided by interview and the booklet before the procedure. But patients suggested several problems related to the content of the booklet. First, they reported difficulty to differentiate the terms -coronary angio gram and cardiac catheterization. Also, some patients expressed that they feared after reading the information about the incision of inguinal area. Subjects responded that the information about the direct process of the test did not reduce their anxiety and the information was not detail enough. Next, most subjects would want to know about the monitor and the sound from monitor. They said that they could not hear instructions from doctor or nurse during the procedure due to tension. Considering above response results, the need for more effective way to provide information, like visual and auditory information through video tape for giving information is suggested. Sensations related to the procedure were the smell coming from sterilization of inguinal area, stinging pain in groin when the doctor inserts a needle into artery, and the sensation of pressure and moving of vessels surrounding neck when the catheter was inserted and visualized on fluoroscopy. Besides, subject reported hot sensation and burning feeling in face and chest area, and nausea when dye is injected by hand. In the analysis of information content, there was 79% agreement on the actual units of analysis that were coded. In the analysis of type of information, procedural information was 60.4%. Concrete objective information was 28.1%. and other information was 11.5%. Agreement of the coders in categorizing the units of information was determined by using Cohen's kappa which corrects for chance agreement. Cohen's kappa was .84.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권1호
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• pp.29-36
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• 2019

Background: An inability to cope with threatening dental stimuli, i.e., sight, sound, and sensation of airotor, manifests as anxiety and behavioral management problems. Behavior modification techniques involving pre-exposure to dental equipment will give children a first-hand experience of their use, sounds, and clinical effects. The aim of this study was to compare the techniques of Tell-Show-Play-doh, a smartphone dentist game, and a conventional Tell-Show-Do method in the behavior modification of anxious children in the dental operatory. Methods: Sixty children in the age group of 4-8 years, with Frankl's behavior rating score of 2 or 3, requiring Class I and II cavity restorations were divided into three groups. The groups were Group 1: Tell-Show-Play-doh; Group 2: smartphone dentist game; and Group 3: Tell-Show-Do technique and each group comprised of 20 children. Pulse rate, Facial Image Scale (FIS), Frankl's behavior rating scale, and FLACC (Face, Leg, Activity, Cry, Consolability) behavior scales were used to quantify anxious behavior. Operator compliance was recorded through a validated questionnaire. Results: The results showed lower mean pulse rates, lower FIS and FLACC scores, higher percentage of children with Frankl's behavior rating score of 4, and better operator compliance in both the Tell-Show-Play-doh and smartphone dentist game groups than in the conventional Tell-Show-Do group. Conclusion: The Tell-Show-Play-doh and smartphone dentist game techniques are effective tools to reduce dental anxiety in pediatric patients.

• Clinical and Experimental Pediatrics
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• 제51권4호
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• pp.391-395
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• 2008

목 적 : 만성기능성 변비소아의 분변박힘제거 단계에서 전해질이 함유지 않은 PEG 4000의 적절한 용량, 효과 및 안전성에 대한 연구를 시행하였다. 방 법 : 2004년 3월부터 2006년 8월까지 건국대학교병원 소아과에서 만성기능성 변비로 진단된 환아 86명을 대상으로 전향적으로 시행하였으며, 주증상의 완화, 배변횟수와 배변 용이함의 향상, 복부 X선 검사 상 대변양의 감소 가운데 2가지를 충족하면 분변박힘제거가 성공적인 것으로 판단하였다. 치료효과를 판정하기위해 보호자나 환아가 기록한 변비 일지를 바탕으로 PEG 4000 복용전과 복용후의 주증상, 평균 배변횟수, 변의 굳기 및 단순 복부 X-선 사진을 비교하였으며, 임상적 증상 관찰과 함께 일반혈액검사와 전해질 검사, 칼슘, 마그네슘, 혈청삼투압검사를 시행하여 부작용을 확인하였다. 결 과 : 연구를 마친 83명 가운데 82명에서 분변박힘제거에 성공하였으며(99%), 분변박힘제거에 필요한 전해질이 함유되지 않은 PEG 4000의 평균용량은 $0.93{\pm}0.28g/kg/day$ (0.4-2.0 g/kg/day, 최대용량 30 g/day)이었다. 배변횟수는 83명 가운데 79명의 환아에서 치료 후에 배변횟수가 증가되었으며(평균 배변횟수 $5.02{\pm}2.71$회/1주 vs. $11.25{\pm}5.43$회/1주), 배변도 수월하고, 주증상도 거의 모든 환자에서 호전되었다. 치료 전후의 단순 복부 X-선 사진을 비교하였을 때, 통계학적으로 의미 있게 호전된 소견을 보였다(P=0.0007). 임상적으로 두드러기 1명, 심한 설사 1명과 설사와 복통 1명, 총 3명이 치료를 마치지 못하였으며, 대상 군에서는 손발 저림 증상이 1명에서 나타났으나, 약제 중단 후 아무런 처치 없이 호전되었다(4/86=4.7%). 검사소견상 1명에서 고삼투압혈증이 관찰되었으나, 임상적으로 증상이 관찰되지 않았으며, 6명에서 호산구 증가가 관찰되었다. 결 론 : 만성 기능성변비환아의 분변박힘제거에 안전하고 효과적인 PEG 4000 용량은 $0.93{\pm}0.28g/kg/day$ (최대용량 30 g/ day)로 생각된다.