Objectives: Pityriasis rubra pilaris (PRP) is a rare papulosquamous disorder with unknown etiology. Studies on adults have not been conducted yet in Korean medicine. We report the progress of Korean medicine treatment for adult-type pityriasis rubra pilaris. Methods: A 62-year-old female patient was diagnosed with PRP in June 2019. After the diagnosis of PRP, retinoid treatment was continued for about 6 months, and then the drug was switched to an oral immunosuppressant. However, the patient's symptoms did not improve, but instead worsened. The patient was treated with Mihudeungsikjang-tang and acupuncture therapy. We evaluated her treatment progress based on the Dermatology Life Quality Index (DLQI), a visual analogue scale (VAS), and the changes in the patient's subjective symptoms. Results: After Korean medicine treatment, the DLQI and VAS scores improved from 18 points to 16 points and from 6 points to 4 points, respectively. The whole-body itching and scaling were reduced by 30% compared to pretreatment. The itching and pain in the neck, which had been severely symptomatic, decreased by 50%. The pain and dysesthesia in the upper and lower extremities disappeared, but the erythema still remained. Conclusions: Conventional treatments for PRP have limitations due to adverse effects and difficulty in treating refractory forms. Korean medicine treatment is worth considering as it can complement the limitations of conventional treatments, although more studies will be needed.
The contrast medium is very commonly used in more than 90% of computed tomography(CT) scans. It is difficult to predict the occurrence of adverse reactions and the degree of adverse reactions are diverse from mild urticaria, itching, nausea, vomiting to even cardiopulmonary arrest. The purpose of this study was to evaluate the symptoms, occurrence rate and risk factors of the adverse reactions in patients after contrast injection during CT examinations. Two hundreds sixty-five patients showed symptoms of adverse reactions out of 71,117 adult patients who received intravenous contrast administration during CT scans from January 2003 to December 2003 at a general hospital. Data was collected by reviewing adverse reaction records and electronic medical record. The results of this study were as follows; 1. Adverse reactions occurred in 265 out of a total of 71,117 patients(0.37%). Clinical symptoms of adverse reactions were most commonly dermatologic problems such as urticaria(69.81%) and itching(63.02%), followed by dyspnea(14.34%), dizziness(11.70%), nausea(6.79%), and vomiting(7.17%). 2. Anaphylactoid reactions occurred in 47 out of a total of 265 patients, and their pattern of symptoms were most commonly related to cardiovascular system(90.91%), followed by respiratory system(82.22%), gastrointestinal system(51.72%), and dermatologic system(16.51%). Eleven patients were transferred to emergency room for further treatment and two patients needed cardiopulmonary resuscitation. 3. The adverse reactions were significantly more common in women than in men(0.46% vs.0.32%, p=.003) and in type D contrast medium than the others(p<.001). The occurrence rate of adverse reactions was not significantly different according to the age and infusion speed of the contrast medium.
Background: Epidural coadministration of opioids and local anesthetics has provided excellent analgesia during postoperative period. However, it is usually associated with the occurance of many side effects which were induced by epidural morphine. Low dose of intravenous naloxone has been known to reduce morphine-induced side effects without reversing analgesia, but the effect of epidural naloxone has not been defined in human study. Therefore we evaluated side effects and analgesia when naloxone was administered via epidural route. Methods: Eighty patients having epiduro-general anesthesia for hysterectomy were randomly assigned to one of four study groups. As a mean of postoperative pain control, all received 2 mg of epidural morphine bolusly at 1 hr before the end of surgery and continuous epidural infusion was started by Two-day Infusor containing morphine 4 mg in 0.125% bupivacaine 100 ml with either none of naloxone(Group 1, n=20), 2 ug/kg/day of naloxone(Group 2, n=20), 3 ug/kg/day of naloxone(Group 3, n=20) or 4 ug/kg/day of naloxone(Group 4, n=20). Study endpoints included visual analog scales(VAS) for pain, severity of nausea, itching, somnolence and respiratory depression. They were assessed at 2, 4, 8, 16, 32, and 48 hr postoperatively. Results: VAS for pain showed significant difference in Group 4 compared with Group 1 at all of the evaluation time. Itching score decreased significantly in Group 3 and 4 after 8 hr postoperatively and nausea score decreased significantly in Group 3 after 4 hr postoperatively. Alertness score decreased significantly in Group 3 and 4 especially in early postoperative period. Conclusion: This study suggests that epidural naloxone reduce morphine-induced side effects in dose-dependent fashion without reversal of the analgesic effect of epidural morphine.
Adverse drug reactions(ADRs) were caused by dexran 40 in patient with ischemic stroke and related 22 patients reported to formal ADRs at Jesus Hospital in Jeonju. This study was aimed to search ADRs related factors, type and the degree associated with dextran 40. Adverse Effects of Dextran 40 is including marked hypotension, nausea, dyspnea, generalized urticaria, fever and pulmonary edema. The average hospitalization period was 20 days and it was extended 26.8%. ADRs of Dextran 40 to incidence is 12.4%, and 9 persons(28.1%), itching, rash was 7 people (21.9%). Dextran induced ADRs reaction may be reported on early injection period and first time shot, but adverse drug reactions occurred after 4 days in 4 patients(18.2%). US FDA has recommanded that Dextran 1 significantly reduces the incidence of severe ADRs in USA. Because low molecular weighted dextran 1 prevented dextran molecules from combined Ig G completely. In Korea. Generally not yet introduced dextran 1, active use dextran 1 is able to be a good way in order to reduce ADRs of dextran 40.
Pubescent Angelica is generally used in musculoskeletal diseases of lower extremity, itching, external contraction (外感) and furuncle, with the effect of dispelling wind, draining dampness, dispersing the external (解表) and stopping pain. The disease parts of Treasured Mirror of Eastern Medicine (東醫寶鑑) contain 121 examples of the usage of Pubescent Angelica. Cases of musculoskeletal diseases and itching are mainly in the External Bodily Elements section (外形篇), and those of external contraction and furuncle are mainly in the Miscellaneous Disorder section (雜病篇). Internal Bodily Elements section (內景篇) has 10 prescriptions that involve Pubescent Angelica, in Dreams (2), Voice (1), Uterus (4), Parasites (1), and Feces (2) chapters. Their specific symptoms are insomnia and sleep paralysis (Dreams), loss of voice due to external contraction (Voice), uterine hemorrhage (Uterus), phthisis (Parasites), and constipation and diarrhea (Feces). It is not easy for students beginning their clinical training to link the effects of Pubescent Angelica and its actual usage, especially in the area of internal medicine. By Analyzing the whole cases of Pubescent Angelica in the Treasured Mirror, we found various usages out of reach of basic knowledge of the herb. Such method can be utilized not only in developing herbal knowledge-based products, but also in improving Korean medicine education, by enhancing the occupational competency bridging basic and clinical knowledge.
Kim, Hyo Young;Kim, Jung Won;Park, Jin Hyung;Kim, Jung Hun;Han, Yea Sik
Archives of Plastic Surgery
/
v.40
no.4
/
pp.414-424
/
2013
Background In esthetic surgery, understanding the factors that influence patient satisfaction is important for successful practice. We hypothesize that the factors that influence patient satisfaction include not only aesthetic and functional outcomes, but also personal factors such as the level of familiarity with factors affecting wound healing and expectations regarding aesthetic outcome. Methods One hundred patients who underwent esthetic closure after thyroidectomy were included in this study. In order to evaluate the individual characteristics of the patients, a preoperative survey was administered to the patients. We estimated the patient satisfaction six months postoperatively and assessed the aesthetic and functional outcomes using the Patient and Observer Scar Assessment Scale. Results According to the results of correlation analysis, level of familiarity with wound healing factors had a positive correlation with satisfaction. High expectations, pain, itching, and high observer scale score had negative correlations with satisfaction. The factors that were correlated with satisfaction were included in the multiple regression analysis. Level of familiarity with wound healing factors was found to have a positive relationship with satisfaction, while itching and observer scale were found to have a negative relationship with satisfaction. After excluding 10 patients who had hypertrophic scars, only level of familiarity with wound healing factors and expectations affected satisfaction. Conclusions The level of familiarity with factors affecting wound healing and expectations were found to independently affect satisfaction. Improving patients' level of familiarity with wound healing factors and reducing their expectations by providing suitable preoperative education has the potential to improve patient satisfaction.
Journal of the Society of Cosmetic Scientists of Korea
/
v.25
no.4
s.34
/
pp.1-5
/
1999
The purpose of this study was to determine the effect of IPBC(3-lodo-2-propynylbutylcarbamate) on dandruff caused by the anthropophilic fungus Malassezia furfur. The effects of IPBC on dandruff were examined by evaluating (a) the MIC value of IPBC using broth dilution method; (b) the remnant antimicrobial activity of IPBC containing shampoo on skin disc; (c) the antidandruff efficacy of 1.0 % IPBC containing shampoo in double blind clinical trial. To investigate the remnant antimicrobial activity of IPBC against Malassezia furfur, guinea pig-skin disc was washed with antidandruff shampoo and then the diameter of inhibition zone per disc was measured. For clinical trial, thirty healthy volunteers, aged 25-35, participated in 4 week study. At 0, 2, 4 weeks, examinations of scaling, itching on scalp were carried out. The MIC(Minimun Inhibition Concentration) values of IPBC range from 0.10 to 1.00${\mu}g/ml$ and it seems that IPBC is more effective in the MIC values than zinc pyrithione, selenium disulphide, piroctone olamine and comparable to ketoconazole, climbazole. When the remnant antimicrobial activity of IPBC shampoo on skin disc was determined, 0.5% IPBC shampoo and 2.0% Ketoconazole shampoo resulted in similar antimicrobial effect. In addition, 1.0%, 2.0% IPBC shampoo was more effective than 2.0% ketoconazole shampoo. After two and four-weeks of 1.0% IPBC shampoo treatment, there was significant reduction of scaling, itching in test group compared to control group. On the basis of these results, it can be concluded that 1.0% IPBC is more effective than 2.0% Ketoconazole in reducing dandruff. It seems that strong capacity of drug binding to the stratum corneum plays a role in its antidandruff effect since adsorption of active ingredients on scalp is very important factor in reducing dandruff.
Kim, Ha-Yan;Kim, Sun-Mi;Ha, Kwang-Su;Ha, Su-Yun;Song, In-Seon;Jeong, A-Rong;Hong, Sol-Yi
The Journal of Pediatrics of Korean Medicine
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v.20
no.3
/
pp.97-104
/
2006
Objectives : There were few reports on Erysipelas, from Secondary Skin Infection after Herpes Zoster. We treated Erysipelas, from Secondary Skin Infection after Herpes Zoster with Oriental medical approach, and got a significant results. So We are reporting this case. Methods : Herb medication, acupuncture treatment were applied for treating patient`s chief symptoms (erythema, heat sensation, swelling, pain, itching and general weakness) Results : The patient was 5-year-old boy who had the symptoms caused by Erysipelas, which was caused by secondary skin infection after herpes zoster. He had erythema, heat sensation, swelling, pain, itching and general weakness. We judged him as Soyangin(少陽人), and prescribed Hyeongbangsaback-san. After he took Hyeongbangsaback-san, the symptom and general condition were improved. In this report, we want to explain the healing process and the result of the treatment of Erysipelas. Conclusions : More study about oriental treatment on Erysipelas, from Secondary Skin Infection after Herpes Zoster is needed.
Journal of the Korean Society of Physical Medicine
/
v.2
no.2
/
pp.205-212
/
2007
Purpose : Herpes zoster is a common dermatologic disorder and is caused by reactivation of varicella zoster virus lying dormant in the ganglion of the dorsal root Methods : The aim of this study is to elucidate the clinical characteristics of herpes zoster and it's nature of pain, and is to review the method of physical therapy for pain control. Results : Herpes zoster is characterized by segmental rash, pain, and sensory symptoms, For most patients skin healing and pain resolution occur within 3-4 weeks, However, pain can continue after the rash has healed. Pain and paresthesia often the eruption of herpes zoster and vary from itching to stabbing. The preeruptive pain may simulate other diseases and may lead to misdiagnosis and misdirected interventions. Motor symptomatology is less well known and is most often related to central nervous system disease, although true lower motor neuron application is also thought to exist Subclinical motor involvement is relatively more common than clinical motor weakness and is easily detected by using electromyography. Higher incidences of herpes zoster were observed in female and in the elderly. Conclusion : The nature of pain associated with herpes zoster varied from a superficial itching to server stabbing or bursting, and paresthesia occurred most frequently. Therefore, the study of herpes zoster will be more research and comprehend, and the approach of physical therapy should be need positively.
Background: Contraction of anal sphincter muscle produces severe pain in perianal surgery postoperatively. Recent reports have indicated that effective and prolonged pain relief can be obtained by the injection of small doses of morphine into the subarachnoid space. We attempted to use this technique for perianal surgery and investigated postoperative pain control and its side effects. Methods: Forty five patients scheduled for hemorrhoidectomy and anal fistulectomy were studied to determine the minimal effective dose of intrathecal morphine for postoperative analgesia. In order to control the pain, 7 mg of 0.5% hyperbaric bupivacaine with 0.05 mg (group I), 0.1 mg (group II) and 0.15 mg (group III) of morphine hydrochloride was injected with a 25 gauge spinal needle into the subarachnoid space. We estimated the duration of analgesia until the pain score attained to above 3 in 10 cm VAS (visual analogue scale) and incidence of itching, nausea and vomiting by percentage, headache, backpain and respiratory depression by positive and negative. We also checked the time of self-voiding. Results: The mean time of analgesia was $10.3{\pm}1.54$, $19.7{\pm}2.22$ and $20.3{\pm}2.29$ hours in group I, II and III respectively. Urinary retention of group I, II and III after block persisted for an average of $20.3{\pm}2.31$, $21.2{\pm}2.51$ and $23.3{\pm}3.74$ hours. Nausea and vomiting were observed 33%, 53%, 67% and itching was observed 53%, 67%, 80% in group I, II and III respectively and respiratory depression did not occur in all groups. Conclusions: It is not necessary to use more than 0.1mg of intrathecal morphine in perianal surgery because analgesia is not prolonged and side effects are increased.
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