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A Clinical Study of Tinnitus (耳鳴에 관한 임상적 연구)

  • Choi, In-Hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.14 no.2
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    • pp.134-145
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    • 2001
  • Introduction: Noises in the ear, whether real or imagined, are called tinnitus. Subjective causes of tinnitus(which is heard only by the patient) are extremely common and the majority of them are treated conservatively. For certain individuals their tinnitus is a major handicap; for others a trivial concern. The most common from of subjective tinnitus is a rushing, hissing or buzzing noise; it is frequently associated with sensorineural heanng loss. The patient may be unaware of the hearing loss, especially if it is a high frequency deficit of moderate severity. The character of the tinnitus may give a clue to the etiology. But the patient often has difficulty in explaining his/her tinnitus in absolute terms, as they have no other tinnitus with which to compare it but their own Tinnitus, like pain, is a subjective state and trying to objectively assess the severity is problematic. Audiological techniques to match subjective loudness to machine-produced noise may offer some help, in that sound intensity matches can bear little correspondence to subjective complaint. In spite of many studies, most patients presently seen complaining of tinnitus are told by their doctors that there is no treatment and that they will have to learn to live with this symptom. Objectives: To perform a clinical analysis of tinnitus and estimate the efficacy of Oriental Medical treatment according to the Byeonjeung(辨證). Subject: We studied 34 patients with complaints of tinnitus who had visited Pundang Cha Oriental Medicine Hospital Department of Otorhinolaryngology from March 1998 to February 2000. All of them had been treated 2 or 3 times a week with acupuncture treatment and had taken herbs according to the Byeonjeung(辨證) method. It was therefore possible for me to know whether their symptoms improved or not. Parameters Observed and Method: We treated them with acupuncture & herb-medication. Sometimes we gave them moxibustion or negative therapy with bloodletting at the acupuncture points(耳門, 聽宮, 聽會). Parameters Observed 1) Distribution of age & sex 2) Chief complaints 3) The sites of tinnitus 4) The quality of tinnitu 5) The duration of disease 6) The problem induced tinnitus 7) Factors increasing disease severity 8) The classification of the Byeonjeung(辨證) 9) The efficacy of treatments Results: 1. Age and sex distribution: The most common occurrence was found in males in their twenties: 6 males($17.7\%$), and in females in their thirties and over sixty: 8 females($23.5\%$). Total patient numbers for men and women were 20 men($58.8\%$), 14 women ($41.2\%$). 2. The most frequent major complaints were hearing disturbances related to tinnitus; and dizziness with tinnitus; each comprising 10 cases($29.4\%$). There were also 7 patients($20.6\%$) with only tinnitus. 3. Tinnitus sites: 13($38.2\%$) said that they felt tinnitus in both ears, equally. In the right ear, 9($26.5\%$), in the left, 6($17.7\%$). 4. The most frequent descriptive symptoms of tinnitus were: humming, hissing, buzzing etc. 5. The duration of disease. 14cases($41.2\%$) had a duration of less than 1 year. 6. 15cases($44.1\%$) complained that it was hard to watch TV or make a phone call because of tinnitus. 10 cases($29.4\%$) complained about depression. 7. Factors increasing severity of tinnitus: ⅰ) fatigue: 18cases($52.9\%$) ⅱ) stress/ tension: 10 cases($29.4\%$) ⅲ) alcohol and tobacco: 5cases($l4.7\%$) 8. Classification through Byeonjeung : ⅰ) 19 cases($55.9\%$) were classified as showing Deficiency syndrome. ⅱ) 15 cases($44.l\%$) were classified as showing Excess syndrome. The deficiency of Qi was 7($20.6\%$), deficiency of Xue, 8($23.5\%$) and insufficiency of the Kidney Yin & Yang, 4($11.8\%$). The flare of Liver fire was 8($23.5\%$) and phlegm-fire, 7($20.6\%$), 9. The efficacy of treatments showed: an improvement in 17cases($50.0\%$); no real improvement or changes in 13 cases($38.2\%$); and some worsening in 4 cases($11.8\%$). In the group with deficiency in Qi, 4($57.1\%$) improved, 1($14.3\%$) showed no change and 2($28.6\%$) were aggravated. In the cases of deficiency in Xue, 6($75.0\%$) improved, 2($25.0\%$) showed no change. In the cases of insufficiency of Kidney Yin & Yang, 3($75.0\%$) showed no change and 1($25.0\%$) were aggravated. In the group of flare of Liver fire, 4($50.0\%$) improved, 3($37.5\%$) no change and 1($12.5\%$) were aggravated. In the cases of phlegm-fire, 3($42.9\%$) improved, 4($57.1\%$) showed no change. Conclusion: We would recommend that any further studies of tinnitus utilize trial treatments of longer than 2 months duration, as any positive effects observed in our study showed that improvement occurred fairly slowly. And we suggest that this study could be utilized as a reference for clinical Oriental Medical treatment of tinnitus. If we try to apply music or sound therapy treatment properly combined with ours, we expect it to provide psycological stability in addition to inducing masking effects, even though it may not directly decrease or completely remove tinnitus.

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A Clinical Study on Allergic rhinitis (알레르기 鼻炎의 臨床的 硏究)

  • Cho Soo-hyun;Jee Seon-young
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.14 no.2
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    • pp.173-182
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    • 2001
  • This Study is attempted in order to observe a clinical analysis from Constitution medical view point about allergic rhinitis. We studied 71 patients who had visited Dept. surgery, opthalmology & otolaryngology, col1ege of Oriental Medicine, Kyungsan University, Pohang, Korea and were treated by medications of Sasang Constitution and Constitution-Acupunture with allergic rhinitis from March 1, 2000 to February 28, 2001. The results were as follows: 1. The sex distribution was 71 males($69\%$), 22 femail($31\%$), In age distribution, the average was 29.6. The peak age was thirties($36.7\%$), teen-ager was $23.9\%,\;fortieth\;was\;15.5\%,\;under\;10\;years\;old\;was\;9.9\%,\;twenties\;was\;7\%,\;fifties\;was\;5.6\%,\;sixtisth\;was\;1.41\%$. 2. In the age of onset, thirties was $29.6\%$, teen-ager was $19.7\%$, twenties was $18.3\%$, under 10 years old and fortieth was $14.1\%$, fifties was $3.8\%$, sixtisth was $1.41\%$. 3 In monthly distribution. september was $25.8\%$, january was $14.1\%$, october was $11.3\%$. november and august was $8.5\%$, april was $7\%$, febuary and may were $5.6\%$, june, july. December were each $4.2\%$, In the distribution of season. the peak season was fall from september to November. 4. In the duration of the disease, 1-3 years was $26.8\%$, 3-5 years was $19.7\%$, 6 months - 1 year $16.9\%$, 5-10 years was $14.1\%$, under 6 months was $11.3\%$, over 10years and over 15 years were each $5.6\%$. 5. In the three main symptom, hydrorrhoea was $71.8\%$, nasal obstruction was $67.6\%$, sneezing was $64.8\%$. In others, fatique was $25.6\%$, headache was $14.1\%$, itching and cough was $11.3\%$, laryngopharyngeal discomfort and red eye were $4.2\%,\;infirmity\;was\;2.8\%$. 6. Patients whose families have allergic disease account for 26 cases($36.6\%$). 7. There was no past history in 37 cases($52.l\%$). In past history distribution, digestive tract disease was $12.7\%$, paranasal sinusitis was $8.5\%$, allergic dermatitis was $7\%$, common cold was $4.2\%$. otitis media, bronchitis, asthma, tonsillitis were $2.8\%$. 8. Sasang Constitution classification was Soyanggin in 52 cases($73.2\%$), Taeumgin in 12 cases($16.9\%$). Soumgin in 7 cases($9.9\%$). 9. In the duration of treatment, it was 1-2 weeks in 26 cases($36.6\%$), 2-4 weeks was $21.1\%$, under 1weeks was $14.1\%$, 4-6 weeks was $11.3\%$, 6-8 weeks was $8.5\%$, 8-10 weeks was $5.6\%$, over 10 weeks was $2.8\%$. 10. We had a follow-up survey the effect of treatment in the 60 cases. there was fair in 25 cases($41.7\%$), good in 21cases($35\%$), excellent in 3cases($5\%$)로 total rate of treatment was $81.7\%$. The case of no change was $16.7\%$, the case of poor was $1.6\%$.

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Effects of Dietary Mineral Extract from Granite on the Performance of Broiler Chickens and Ammonia Production from the Litter (화강암 추출 활성 광물질의 사료 내 첨가가 육계의 생산성과 깔짚 암모니아 발생에 미치는 영향)

  • Cho J. H.;Jung B. Y.;Paik I. K.
    • Korean Journal of Poultry Science
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    • v.32 no.1
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    • pp.43-48
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    • 2005
  • An experiment was conducted to investigate the effects of mineral extract from granite on the performance, ammonia production from the litter, components of blood, Newcastle Disease (ND) titer and intestinal microflora in broiler chickens. Nine hundred sixty one-day-old broiler chickens (Ross) were assigned to five treatments: C; control, Zeolite; control + zeolite 1$\%$, AM10: control + active mineral water $10\%$ adsorbed zeolite $1\%$, AM20; control + active mineral water $20\%$ adsorbed zeolite $1\%$ and AM30; control + active mineral water $30\%$ adsorbed zeolite $1\%$. Each treatment consisted of four replicates with 48 broiler chicks for feeding trial. In order to test the effect of ND vaccine on the components of blood, ND titer and intestinal microflora, a separate group of 48 broiler chicks were assigned to the same 5 treatment as the feeding trial plus one negative control (No ND vaccine). Weight gain, feed intake, feed conversion and mortality were not significantly affected by dietary treatments but AM30 tended to be higher than other treatments in weight gain and feed intake, especially during later period (4 to 5 weeks of age). Ammonia production from the litter of AM30 treatment was significantly (P<0.01) lower than the control. Components of blood and ND titer in serum of broiler chickens were not significantly affected by treatments but MCHC (mean corpuscular hemoglobin concentration) of blood was significantly lower (P<0.05) in Zeolite treatment compared to others. The colony forming unit (CFU) of Clostridium perfringens in the small intestinal content of all zeolite and AM treated groups was significantly (P<0.01) lower than the control while the CFU of Escherichia coli was not significantly affected. The CFU of Lactobacilli in AM30 treatment was significantly (P<0.05) higher than the control. In conclusion, dietary supplement of active mineral water adsorbed to zeolite at $30\%$ level (AM30) tended to improve growth performance of broiler chickens and significantly reduced ammonia production from the litter. It also significantly increased CFU of intestinal Lactobacilli.

Comparison of Stress Response in Diallel Crossed Korean Domestic Chicken Breeds (토종 종계를 이용한 이면 교배조합 계통 간 스트레스 반응정도 비교 분석)

  • Cho, Eun Jung;Park, Ji Ae;Choi, Eun Sik;Sohn, Sea Hwan
    • Korean Journal of Poultry Science
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    • v.43 no.2
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    • pp.77-88
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    • 2016
  • To establish a new synthetic Korean meat chicken breed, we tested $5{\times}5$ diallel cross mating experiment with domestic chicken breeds. Comparing stress responses among diallel crossed chicken breeds, we analyzed telomere length, DNA damage and expressions of heat shock protein genes (HSPs) as the markers of the stress response. The telomere length was measured by quantitative fluorescence in situ hybridization on the nuclei of lymphocytes. The expression levels of HSP-70, $HSP-90{\alpha}$ and $HSP-90{\beta}$ genes were analyzed by quantitative real-time polymerase chain reaction in lymphocytes. The DNA damage rate of lymphocytes was quantified by the comet assay known as the single cell gel electrophoresis. In results, there were significant differences in the values of the stress markers such as telomere length, HSPs and DNA damage rate, and also were significant differences in viabilities and body weights among the $5{\times}5$ diallel crossed chicken breeds. The telomere shortening rate, expression values of HSPs and DNA damage rate were significant low in W and Y crossed chickens compare to the others, but GG pure breed showed the highest values in the 25 crossed chickens. Estimating correlation coefficient, the survival rate positively correlated to telomere length, but negatively correlated to the expression levels of HSP-70, $HSP-90{\alpha}$, $HSP-90{\beta}$ genes and to the value of % DNA in tail as DNA damage rate. The expression levels of HSP-70, $HSP-90{\alpha}$ and $HSP-90{\beta}$ genes of dead chickens had significantly higher than those of survival chickens. According to the results on the stress marker analysis, it would be considered that the crossed breeds had more stress resistant than the pure breeds, and the crossed chickens with a light strain such as W or Y were relatively resistant to stress, but the crossed chickens with a heavy strain such as G, H, F were susceptible to stress.

The Comparison of Protective Effects of Adenosine Included Cardioplegia According to Adenosine Dosage (심정지액 속에 포함된 아데노신의 용량에 따른 심근보호 효과 비교)

  • 유경종;강면식;이교준;임상현;박한기;김종훈;조범구
    • Journal of Chest Surgery
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    • v.31 no.9
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    • pp.837-844
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    • 1998
  • Background: Adenosine is secreted by myocardial cells during myocardial ischemia or hypoxia. It has many beneficial effects on arrhythmias, myocardial ischemia, and reperfusion ischemia. Although many investigators have demonstrated that cardioplegia that includes adenosine shows protective effects in myocardial ischemia or reperfusion injury, reports of the optimal dose of adenosine in cardioplegic solutions vary. We reported the results of beneficial effects of single dosage(0.75 mg/Kg/min) adenosine by use of self-made Langendorff system. But it is uncertain that dosage was optimal. The objective of this study is to determine the optimal dose of adenosine in cardioplegic solutions. Material and Method: We used a self-made Langendorff system to evaluate the myocardial protective effect. Isolated rat hearts were subjected to 90 minutes of deep hypothermic arrest(15$^{\circ}C$) with modified St. Thomas' Hospital cardioplegia including adenosine. Myocardial adenosine levels were augmented during ischemia by providing exogenous adenosine in the cardioplegia. Three groups of hearts were studied: (1) group 1 (n=10) : adenosine - 0.5 mg/Kg/min, (2) group 2(n=10): adenosine -0.75 mg/Kg/min, (3) group 3 (n=10) : adenosine -1 mg/Kg/min. Result: Group 3 resulted in a significantly rapid arrest time of the heart beat(p<0.05) but significantly slow recovery time of the heart beat after reperfusion(p<0.05) compared to groups 1 and 2. Group 2 showed a better percentage of recovery(p<0.05) in systolic aortic pressure, aortic overflow volume, coronary flow volume, and cardiac output compared to groups 1 and 3. Group 1 showed a a better percentage of recovery(p<0.05) in the heart rate compared to the others. In biochemical study of drained reperfusates, CPK and lactic acid levels did not show significant differences in all of the groups. Conclusion: We concluded that group 2 [adenosine(0.75 mg/Kg/min) added to cardioplegia] has better recovery effects after reperfusion in myocardial ischemia and is the most appropriate dosage compared to group 1 and 3.

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Effectiveness of MDCT for the Followup of CABG Patients with LIMA to LAD and Saphenous Veins to Others (좌내흉동맥과 복재정맥편을 사용한 관상동맥우회로술 환자에서의 추적조사에서 MDCT의 유용성)

  • Kang Joon Kyu;Kim Hyung Tai;Park In Duk;Chung Young Mi;Lee Cheol Joo
    • Journal of Chest Surgery
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    • v.38 no.6 s.251
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    • pp.410-414
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    • 2005
  • There are several options for choosing a graft in CABG, we routinely chose LIMA for LAD and great saphenous vein for other target vessels. To evaluate the posoperative graft patency, we have studied the results using a 16 slices multi-detector computed tomography. Material and Method: From 1995 to 2003, 80 CABG patients who did not complain any event of MACE have been examined by 16-MDCT, mostly in an out patient clinic. Result: There were 61 men and 19 women. MDCT was used as early as 7 days to 9 years post-operatively with a median follow-up period of 6.5 years, and mean follow-up peiod of $31.5\pm25.4$ months. Mean age was $58.4\pm12.6$ years old in men and $61.5\pm17.2$ years old in women. 72180 patients received LIMA to LAD, and all other patients received vein grafts for bypass. The target vessel of vein grafts were 8 in LAD, 47 in RCA, 60 in diagonals, and 61 in obtuse marginals. Among them 42 sequential anastomoses were performed. The mean graft number was $3.1\pm1.8$ grafts. 5 year graft patency rate of each grafts was as followings; $93.1\%$ in LIMA to LAD, $94.9\%$ in vein to diagonals, $92.1\%$ in vein to obtuse marginals, and $79.2\%$ in vein to RCA. Sequential grafting showed better graft patency than the isolated grafting $(95.2\%\;vs\;78.7\~95.0\%)$. Conclusion: In this study, CABG with LIMA and saphenous veins showed satisfactory longterm results. 16-MDCT provided good images for follow-up study after CABG. Additionally, as radiologic tools (64-MDCT, MRI) improve more in the future, they can be used for diagnosing preoperative anatomical coronary disease as well as cardiac functions.

Surgical Treatment of Pulmonary Metastases (전이성 폐암의 외과적 치료)

  • Kang, Jeong-Ho;Ro, Sun-Kyun;Chung, Won-Sang;Kim, Hyuck;Ban, Dong-Gyu;Kim, Young-Hak
    • Journal of Chest Surgery
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    • v.40 no.2 s.271
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    • pp.103-108
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    • 2007
  • Background: Surgical resection is an important modality in the treatment of pulmonary metastases from various solid tumors. We analyzed 37 patients who underwent surgical treatments of pulmonary metastases in our hospital from 1996 to 2005. Material and Method: Age, sex, disease free interval, operative procedure, the number of pulmonary metastases, and lymphatic metastasis were investigated with admission and operative records, and pathologic reports. Actuarial survival and comparisons between each survival rate were calculated according to Kaplan-Meier method and log-rank test, respectively, Result: Complete resections were carried out in 34 of 37 patients. The primary tumor was carcinoma in 25 cases, sarcoma in 10, and others in 2. The number of pulmonary metastases was 1 in 25 cases and 2 or more in 12 cases. 3-year and 5-year survival rates after complete resection were 50.5% and 35.9%, respectively. 3-year and 5-year survival rates for carcinoma were 64.5% and 45.0%, respectively, and 3-year survival rate for sarcoma was 17.5%. Otherwise, none of the operative procedures, the number of pulmonary metastases, lymphatic metastasis, adjunctive therapy and the disease free interval in the case of carcinoma significantly affected the survival rates. Conclusion: Complete resection of pulmonary metastasis in well selected patients allows high long term survival rate with low mortality and morbidity. Long-term follow up and randomized prospective studies were necessary to determine the prognostic factors of pulmonary metastases after surgical resection.

Video-Assisted Thoracic Surgery Lobectomy: Experience with 36 Cases (비디오 흉강경을 이용한 폐엽절제술: 치험 36예)

  • Lee, Hee-Sung;Lee, Jae-Woong;Kim, Kun-Il;Cho, Sung-Woo;Park, Sang-Jun;Kim, Hyoung-Soo;Shin, Yoon-Cheol;Shin, Ho-Seung
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.732-737
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    • 2009
  • Background: Many video-assisted thoracic surgery (VATS) lobectomies are performed as a potential alternative to thoracotomy despite the controversy about the safety and the associated morbidity/mortality rates. Material and Method: Between November 2006 and August 2008, we performed 87 lobectomies (VATS 36, Thoracotomy 51) and we retrospectively reviewed the surgical treatment results. A VATS lobectomy was performed by a 4~5 cm thoracotomy without rib spreading and this included anatomic hilar dissection, individual vessel and bronchus stapling and lymph node dissection. Result: We studied 52 male and 35 female patients whose age ranged from 6 to 79 (average age: $59.8{\pm}15.0$ years). The cases were diagnosed with lung cancer (66) (SQC 24, ADC 38, others 4), pulmonary metastasis (2), carcinoid (2) and benign diseases (17). There was no intraoperative death. Postoperative complications were seen in 5 (15.6%) VATS and 33 (64.7%) thoracotomies, and perioperative death caused by adult respiratory distress syndrome occurred in 1 (2.8%) VATS and 3 (5.9%) thoracotomies. Three patients Underwent conversion to thoracotomy (8.3%). The mean time to chest tube removal was 6 days for VATS and 9.4 days for thoracotomy (p<0.001), and the mean length of the hospital stay was 8 days for VATS and 12.8 days for thoracotomy (p<0.001). Conclusion: VATS lobectomy can be performed safely with low morbidity/mortality rates. Furthermore, all the patients benefited from earlier postoperative rehabilitation and less pain and they were candidates for an earlier return to normal activities.

Three Phases and Water Characteristics of Horticultural Substrates (원예(園藝) 상토재료(床土材料)의 삼상(三相)과 수분특성(水分特性))

  • Jo, In-Sang;Hyun, Byung-Keun;Cho, Hyun-Jun;Jang, Yong-Seon
    • Korean Journal of Soil Science and Fertilizer
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    • v.30 no.1
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    • pp.56-61
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    • 1997
  • A study was carried out to find out the basic information in physical properties for selection and manufacturing the good seedling media through the analysis of the physical properties, such as particle size, water retention and three phases of the major horticultural substrates. Easily available water(EAW), the water contents between 1kPa and 5kPa water potental, was highest in peatmoss with 39%, and perlite 34.0%, vermiculite 16.9%, but the values of osmunda and bark were lower than 4.8%. Water buffering capacity(WBC), the water content between 5kPa and 10kPa, was 6.1% in peatmoss and 2.3% in vermiculite but it was lower than 1.0% in other substrates. To adjust the suitable range of water potential at crossing point of water and air curves to 1.5~2.5kPa, more finer materials were needed in osmunda and bark, and more coarser materials must be added to peatmoss, perlite and vermiculite. Water potentials of substrates in saturated pot condition were equivalent to 2.2kPa in peatmoss and others were ranged in 1.0kPa to 4.3kPa of water potential in pressure chamber.

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Development of the Risk Evaluation Model for Rear End Collision on the Basis of Microscopic Driving Behaviors (미시적 주행행태를 반영한 후미추돌위험 평가모형 개발)

  • Chung, Sung-Bong;Song, Ki-Han;Park, Chang-Ho;Chon, Kyung-Soo;Kho, Seung-Young
    • Journal of Korean Society of Transportation
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    • v.22 no.6
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    • pp.133-144
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    • 2004
  • A model and a measure which can evaluate the risk of rear end collision are developed. Most traffic accidents involve multiple causes such as the human factor, the vehicle factor, and the highway element at any given time. Thus, these factors should be considered in analyzing the risk of an accident and in developing safety models. Although most risky situations and accidents on the roads result from the poor response of a driver to various stimuli, many researchers have modeled the risk or accident by analyzing only the stimuli without considering the response of a driver. Hence, the reliabilities of those models turned out to be low. Thus in developing the model behaviors of a driver, such as reaction time and deceleration rate, are considered. In the past, most studies tried to analyze the relationships between a risk and an accident directly but they, due to the difficulty of finding out the directional relationships between these factors, developed a model by considering these factors, developed a model by considering indirect factors such as volume, speed, etc. However, if the relationships between risk and accidents are looked into in detail, it can be seen that they are linked by the behaviors of a driver, and depending on drivers the risk as it is on the road-vehicle system may be ignored or call drivers' attention. Therefore, an accident depends on how a driver handles risk, so that the more related risk to and accident occurrence is not the risk itself but the risk responded by a driver. Thus, in this study, the behaviors of a driver are considered in the model and to reflect these behaviors three concepts related to accidents are introduced. And safe stopping distance and accident occurrence probability were used for better understanding and for more reliable modeling of the risk. The index which can represent the risk is also developed based on measures used in evaluating noise level, and for the risk comparison between various situations, the equivalent risk level, considering the intensity and duration time, is developed by means of the weighted average. Validation is performed with field surveys on the expressway of Seoul, and the test vehicle was made to collect the traffic flow data, such as deceleration rate, speed and spacing. Based on this data, the risk by section, lane and traffic flow conditions are evaluated and compared with the accident data and traffic conditions. The evaluated risk level corresponds closely to the patterns of actual traffic conditions and counts of accident. The model and the method developed in this study can be applied to various fields, such as safety test of traffic flow, establishment of operation & management strategy for reliable traffic flow, and the safety test for the control algorithm in the advanced safety vehicles and many others.