• The Korean Journal of Pain
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• v.9 no.1
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• pp.239-243
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• 1996

MS-Contin is an oral controlled-release preparation of morphine sulfate that has been used widely in the management of advanced cancer pain. It prolongs plasma concentration of morphine with no observable accumulation properties following repeated dosing, thereby promoting uninterrupted sleep and hopefully improving patient's quality of life. The common side effects of MS Contin are nausea, vomiting, drowsiness and constipation. But these symptoms are usually mild and respiratory depression is a rare problem. We experienced respiratory depression during oral administration of MS contin for the pain management of advanced gall bladder cancer of 76 years old male patient with metastasis at liver, intestine and cervical lymph node. After we increased the dosage of MS Contin from 160mg to 220mg per day, due to abdominal pain, we observed morphine reaction of MS Contin overdose such as pinpoint pupil, deeply slow respiration below 8/minute, and drowsiness. After intravenous bolus injection of 0.4 mg naloxone followed by continuous administration of 0.2 mg/hr for 4 hours, the patient regained consciousness. The administered route of morphine was changed to intravenous PCA (patient controlled analgesia). There was no aspiration sign as confirmed by chest x-ray. The patient was comfortable and delayed no signs of respiratory depression until now.

• The Journal of Pediatrics of Korean Medicine
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• v.18 no.2
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• pp.77-91
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• 2004

Objectives : In evaluating a child with enuresis, an organized approach to the history leads to a working diagnosis and an appropriate treatment plan. but, there's no study about history taking in enuretic children. This article was undertaken to evaluate the enuretic child exactly and to study nocturnal enuresis systematically. Methods : It was conducted a computerized literature search in following database: Medline (via Pubmed), NDSL, EBSCO. Korean articles via oriental pediatric association homepage, KISS. Key words to search were 'nocturnal enuresis', 'bedwetting', 'enuresis', 'incontinence', 'management', 'evaluation', 'assessment', 'questionnaire', 'guideline', 'voiding dysfunction'. Results : Questions are grouped in eight categories: primary history(sex, age, height, weight), family history, enuresis history(primary/secondary, frequency, time of enuresis, nocturia), voiding history(average number, frequency, pattern, volume, posture, daytime enuresis), medical history, constipation/encopresis, sleep(OSA). Conclusion : A careful, complete history taking will help to plan treatment properly and to study.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.10 no.1
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• pp.51-59
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• 2007

Purpose: Recently well-developed anorectal function tests have revealed that there is an obvious pelvic floor dyssynergia (PFD) pattern in pediatric patients with constipation, as well as in adult's. The use of biofeedback therapy (BT) has been widely implemented in adult PFD patients; however, this approach has only rarely been considered for pediatric PFD patients. Therefore, we assessed the effectiveness of BT in children with PFD. Methods: We studied 70 children with PFD, who were referred to the department of pediatrics at the Asan Medical Center for the management of soiling or chronic constipation from September 2002 to February 2005. Diagnosis of PFD and assessment of the efficacy of BT for PFD treatment were carried out along with several ano-rectal function tests (cine-defecography, ano-rectal manometry, balloon expulsion test and intra-anal EMG); in addition, a questionnaire was administered. The BT based intra-anal EMG was performed. A follow-up telephone interview was performed more than 6 months later. Results: Most of the symptoms and results of the ano-rectal function tests were statistically improved after BT. In comparisons between the BT and control groups (BT refusal group due to poor compliance), the symptoms were statistically improved at follow-up. Therefore, for the shortterm improvement of symptoms, BT was better than conservative therapy alone. The negative feelings associated with ano-rectal function testing and BT were directly associated with failure or success of therapy. Conclusion: Pediatric patients with constipation or soiling that presented with an obvious PFD pattern showed that BT was a useful therapeutic tool for rapid improvement of symptoms.

• Journal of dental hygiene science
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• v.14 no.1
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• pp.22-28
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• 2014

This research aimed to understand the relevance between irritable bowel syndrome (IBS) and sleep quality for dental hygiene students in certain areas. It was conducted on 344 students from four universities in Jeollabuk-do from May to September 2013 using a structured questionnaire. The following are the results. 57.6% of the IBS bowel movement conditions were mixed type, 10.5% constipation type, 7.6% uncategorized, and 6.1% diarrhea type. For sleep quality based on the subjects' general characteristics, third years were 11.45, second years 10.90, and first years 9.53 (p=0.034). The sleep quality was statistically significantly lower as the years increased, and even for IBS (p=0.026), it was low and showed a significant difference. For difference in sleep quality based on IBS presence, habitual sleep efficiency, sleeping pill dosage (p=0.043), and day time functional disorder (p=0.007) showed statistically significant differences and lower sleep quality than the control group. For difference in sleep quality based on IBS bowel movement condition, mixed type was the highest for sleep disturbance at 6.86, constipation type was 1.00 for habitual sleep efficiency, constipation type was 1.42 for subjective sleep quality, uncategorized type was 0.15 for sleeping pill dosage but not statistically significant. In day time functional disorder, constipation type was the highest at 2.61 and showed a significant difference (p=0.012). The correlation between the sub-factors of sleep quality was positive. Based on the above study results, we learned that for IBS, sleep quality becomes lower as the year increases, and functional disorder was observed during day time due to low sleep quality. Education on IBS symptoms is needed, adequate stress management method to alleviate symptoms and prevention programs for correct diet must be developed to enhance sleep quality.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.214-219
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• 1998

Pain is one of the most frequent and disturbing symptom of cancer patients. And almost of cancer patients are afraid of a attacks of pain related to cancer. Caring for the cancer patient can be divided into two phases. The phase of "active treatment" involves various interventions-surgical, chemical or radiological- that are designed to prolong the patient's life. "Terminal care" is the period from the end of active treatment until the patient's death. But in the majority of clinical settings, cancer pain is not being managed adequately results from a lack of education about how to treat the cancer pain management in the safest and most effective way during terminal phase. Althought organic factors represent the most important cause of their pain, it is also important to deal with the patient's psychological reactions and to take account of his or her social and family environment if treatment for chronic cancer pain is to prove adequate. Thus we try to evaluate a kinds of cancer related to pain, degree of pain, effectiveness of drugs, and patient's responses to management. In regard to the satisfaction for pain relief in pain clinics at Pusan National University Hospital(PNUH) are about 70% in patients and 90% in family. Average life expectancy in cancer patients are about 140 days (3 days- 5.7 years). Cancer patients are complained of several discomfortness (above 30 kinds) such as, pain associated with cancer (75%), nausea and vomitting (38%), sleeping disorder (38%), anorexia (38%), dyspnea (32%), constipation (31%), etc. Distributions of cancer associated with pain are stomach cancer (21%), lung cancer (16%), cervix cancer (10%), anorectal and colon cancer (8.6%), hepatoma (8%), pancreatic cancer (3%). About 1/3 of patients are suffer from incident pain in 3~5 times in a day especially in moving, coughing, and exercise. Methods for drug delivering system before death are transdermal fentanyl patch (42%), intravenous PCA (21%), oral intake of opioid (17%), epidural PCA (14%), etc.

• The Journal of Internal Korean Medicine
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• v.41 no.2
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• pp.275-282
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• 2020

Objectives: This case report presents the management of a paralytic ileus patient who was diagnosed with Soyangin. Methods: The patient was treated with Korean herbal medicine (Jihwangbaekho-tang, Hyeongbangsabaek-san, Ganghwajihwang-tang), acupuncture, and moxibustion therapy. Results: After undergoing Korean medical treatment, the patient's complaints of symptoms such as constipation, dyspepsia, anorexia decreased and improvements were shown on X-ray. Conclusions: This case report shows that Korean medical treatment is effective for treating paralytic ileus.

• Journal of Pharmacopuncture
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• v.21 no.1
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• pp.26-34
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• 2018

Objective: The purpose of this study was to investigate the efficacy and safety of spinal-Z, derived from Peganum harmala seeds and Dracocephalum Kotschyi Boiss leaves, in patients with esophageal and stomach adenocarcinoma, and squamous cell carcinoma of the esophagus. Methods: Sixty-one patients with malignancies of the upper gastrointestinal tract were randomly assigned to one of two groups (treatment or control) in a double-blind fashion. Six capsules of Spinal-Z were prescribed to the patients with the regimen of 600 mg/m2/day, and placebo to the control group, for six months. Results: There were no significant differences between the two groups with regard to age, sex, duration of cancer, type of cancer and family history of cancer. There were significant differences in abdominal pain, heartburn, constipation and vomiting between the two groups, following spinal-Z therapy. Evaluation of drug side effects showed no difference in cough or other respiratory symptoms, itching, headache or dizziness between the two groups, both before and after treatment. Conclusion: This study indicates that Spinal-Z is safe and efficacious in the management of patients with upper gastrointestinal tract cancers.

• Journal of Korean Academy of Nursing
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• v.33 no.2
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• pp.210-219
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• 2003

Purpose: The purpose of this study was to identify nursing importance and the performance of nursing interventions linked to five nursing diagnoses and find out core nursing interventions to each of the five nursing diagnosis. The five nursing diagnoses were Pain, Diarrhea, Constipation, Hyperthermia, and Infection: Risk for. Method: Data was collected from nurses working in four different hospitals. Data were analyzed using mean, SD, and paired t-test to compare difference between importance and performance of each intervention. Result: In general interventions related to medication, such as Medication Administration: IV, Medication Administration: IM, Medication Administration: Oral, Medication Management were all considered highly important and performed very often regardless of nursing diagnoses. And the level of importance was higher than the performance in most of all the interventions linked to five nursing diagnoses. Only two interventions, Medication Administration and Intravenous (IV) insertion had higher level of performance than importance in the diagnoses of Pain and Diarrhea respectively. Conclusion: Using the above findings, we now know which intervention should be performed more frequently to solve nursing problems and which interventions are more critically important to nursing diagnosis. This information can be very helpful for developing nursing information system.

• Advances in pediatric surgery
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• v.19 no.2
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• pp.130-139
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• 2013

The application of laparoscopic techniques for the surgical management of Hirschsprung's disease is the recent trend. We described the surgical technique and postoperative long-term outcomes of the one-stage, laparoscopic-assiseted endorectal pull-through operation for Hirschsprung's disease. The technique uses three to four small abdominal ports. Laparoscopic mobilization of the sigmoid colon and rectum is performed and marginal artery-preserving colon pedicle is prepared. The rectal mobilization is performed using a transanal endorectal sleeve technique. The anastomosis is performed 0.5~1 cm above the dentate line. The age at surgery ranged from 6 days to 4 years. The average operative time was 144 minutes. Almost all of the patients passed stool and flatus within 36 hours of surgery. The average hospital stay after surgery was 6.5 days. Among 42 patients, 32 patients older than 3 years old were evaluated for function on defecation. All 32 patients have been continent, of those who needed laxatives were 11 (34.3%) due to constipation and overflow incontinence. Four children (12.5%) have remained dependent on laxatives. Laparoscopic-assisted endorectal pull-through operation for Hirschsprung's disease appears to be safe, provides the less pain, shorter time to full feeding, shorter hospital stay, and excellent cosmetic outcomes. Helping patients and parents ensure the quality of life, they should be provided with counseling, education, and longer-term follow-up care.

• Journal of Korean Clinical Nursing Research
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• v.14 no.1
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• pp.61-70
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• 2008

Purpose: Women with gynecologic cancer often experience various physical and psychological symptoms relating to the cancer and its treatment. The purpose of this study was to identify symptom clusters. Method: A survey was conducted on 184 women with diagnoses of cervical, ovarian or endometrial cancer. Fifty symptoms were assessed for prevalence, severity and interference, and symptom clusters were identified. Cluster analysis was done using SPSS version 12.0. Results: Fatigue was identified as the most prevalent symptom (81.52%), lack of vaginal lubrication (2.26) as the most severe symptom, and lack of vaginal lubrication as the most interfering one (2.15). Identified six clusters were: Anorexia-pain cluster (loss of appetite, taste change, weight loss, appearance change, alopecia, weakness, pain), Fatigue cluster (lack of concentration, lack of memory, fatigue, dry mouth), Urinary-bowel distress cluster (urinary difficulty, constipation), Abdominal discomfort cluster (lower abdominal pain, abdominal pain, bloating), Emotional distress (sadness, anxiety-worry, nervousness, restlessness), and Menopausal cluster (sweating, hot flush, fever). Conclusion: The result of this study provides fundamental data to health care professionals in developing interventions for effective symptom management for women with gynecologic cancer by understanding identified 6 symptom clusters.