• Journal of Yeungnam Medical Science
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• v.7 no.2
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• pp.121-130
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• 1990

Plain 0.5% bupivacaine and hyperbaric 0.5% tetracaine were compared for spinal anesthesia in 40 patients undergoing operation of lower extremities. Lumbar puncture was performed with a 22 gauge spinal needle with the patient in the lateral recumbent position. The third lumbar interspace was chosen for the puncture, when a free flow of clear CSF was obtained, the local anesthetic solution (2.5ml of 0.5% bupivacaine or 2.0ml of hyperbaric 0.5% tetracaine) was injected at a rate of 0.1ml/sec without barbotage. After injection of anesthetics, clinical features were observed and compared between the two groups. The results were as follows : 1. The two groups were well matched for age, sex, height and weight. 2. In both groups, sensory block to $T_{12}$ dermatome was obtained within 4 minutes, mean maximal level of analgesia was $T_{6-7}$, and the mean time for maximal level was around 20 minutes. 3. The onset times of motor block were similar in both groups and complete motor block was obtained in all cases within 20 minutes. 4. The duration of analgesia above the $T_{12}$ dermatome was 3 hours, postoperative analgesia was 7 hours. These values were significantly prolonged than those of the tetracaine group(p<0.05). 5. The changes in systolic pressure in the bupivacaine group were significantly less than those of the tetracaine group(p<0.05). 6. The complications after spinal anesthesia were headache, numbness, urinary retention and backpain, and were no significant difference in both groups. From the obtained results, we concluded that plain 0.5% bupivacaine was a relatively satisfactory agent for spinal anesthesia for operation of lower extremities. The time of onset, height of block and the complications of postoperative period were similar in both groups. The advantages of plain 0.5% bupivacaine were less hypotension and long duration of analgesia.

• The Journal of Internal Korean Medicine
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• v.30 no.1
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• pp.144-152
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• 2009

Background : Ephedra (Ephedra sinica) has been widely used to treat respiratory disease in traditional medicine of East Asia for over a hundred years. Despite safety concerns raised by some, the use of ephedra in traditional medicine is documented over more than 1,800 years. It is well established that ephedra is one of the central medicines in Korean 'Seseng constitution' medicine. In Sasang constitution medicine, all humans can be divided into one of four types: Soeumin, Soyangin, Taeumin or Taeyangin, and each constitution type has their own typical characteristics. Accordingly, it is hypothesized that the adverse effects of ephedra differ depending on the Sasang constitution classification. Objectives : The aim of this study was to determine adverse effects of ephedra which is classified as a Taeumin herb, and to observe whether the response differs or not. according to Sasang constitution classification. Methods : The study design was a double-blind randomized controlled trial. The subjects were healthy adults 20 - 50 years old who agreed to participate in this study. They were allocated through randomization to either ephedra group (N=55) or placebo group (N=24). where ephedra extract (6 g of dried ephedra) and placebo with similar opaque capsules were given twice for one day. To compare the adverse events of ephedra according to Sasang constitution classification, we analyzed blood pressure (systolic and diastolic), pulse rate, the morning questionnaire, and patient's global assessment scale score for well known adverse events: palpitation, headache, sweating, tiredness, dyspepsia, and dry mouth. Results : After ingestion of ephedra, the pulse rate had a significant increase in all constitution types. The changes of diastolic pressure in Soeumin and the changes of pulse rate in Soeumin, Soyangin and Taeumin had a significant increase in the ephedra over the control group. In the ephedra group, the palpitation and dyspepsia score of the patients' global assessment scale had a significant increase in Soeumin, with palpitation and sweating score increasing in Soyangin. Others observations were insignificant results. Conclusion : The results of this study may confirm that the physical responses or adverse effects of herbs differ for each type of Sasang constitution. Future studies using other herbs will be required to ascertain the herbal drug reaction of Sasang constitutions.

• Journal of Oral Medicine and Pain
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• v.33 no.4
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• pp.339-352
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• 2008

Aims: The aims of this study were to identify the association between cervical muscle pain and TMD by pressure pain response, and to find cervical muscles showing moderate to severe pressure pain that are correlated with masticatory muscle pain. Methods: Patients(n=129, female 65.9%, mean age 28.8 years) answered a TMD questionnaire asking about headache, neck pain, emotional stress, sleep disturbance, parafunction habits, and pain intensity. A clinical examination of the masticatory system was performed. Of the neck muscles, (1) the upper sternocleidomastoid, (2) the middle sternocleidomastoid, (3) the upper trapezius, (4) the splenius capitis, (5) the semispinalis capitis, (6) the scalene medius, and (7) the levator scapulae muscles were examined by palpation. Pressure pain or tenderness of all palpation sites was scored from 0 to 3 according to the pain response. The variables of sum of pressure pain scores were calculated from pressure pain scores and were used for statistical analyses. Results: Eighty patients(62.0%) answered that they suffer from neck pain in the TMD questionnaire. More than 40% of sternocleidomastoid and upper trapezius examination sites showed moderate to severe tenderness in the cervical muscles, and 36% of middle masseter in the masticatory muscles. For the 129 patients, the sum of cervical muscle pain scores(mean=12.88, SD=8.06) and the sum of TMD pain scores(mean=5.36, SD=5.10) were moderately correlated($\rho$ = 0.502, P < 0.001). The sum of TMD pain scores tends to increase as the sum of cervical muscle pain scores increases(Y = 0.395${\cdot}$X, $R^2$ = 0.659, P < 0.001). In the patients with masticatory muscle disorders, the sum of sternocleidomastoid and upper trapezius pain scores(mean = 8.67, SD = 4.95) and the sum of temporalis and masseter pain scores(mean = 3.37, SD = 3.56) showed moderate correlation($\rho$ = 0.375, P < 0.001). Those two variables were in a proportionate relationship(Y = 0.359${\cdot}$X, $R^2$ = 0.538, P < 0.001). In a partial correlation analysis of the sum of unilateral pain scores, the sum of right cervical muscle pain scores and the sum of left cervical muscle pain scores showed the highest correlation(r = 0.802, P < 0.001). The sum of right TMD pain scores and the sum of left TMD pain scores were moderately correlated(r = 0.481, P < 0.001). For the twenty patients with unilateral TMD pain, the partial correlation coefficient between the sum of ipsilateral cervical muscle pain scores and the sum of contralateral cervical muscle pain scores was the largest(r = 0.597, P = 0.009). A partial correlation between the sum of primary TMD side pain scores and the sum of ipsilateral cervical muscle pain scores was 0.564(P = 0.015). Conclusions: TMD is associated with cervical muscle pain on condition of pressure pain response to palpation. Of the cervical muscles, sternocleidomastoid and upper trapezius frequently exhibit moderate to severe pressure pain, and they are closely related to the masticatory muscle pain. The characteristic of symmetric involvement of pain is prominent in cervical muscles; however, TMD can affect the level of cervical muscle pain to modify its symmetric nature.

• Journal of Korean Academy of Nursing
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• v.22 no.4
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• pp.636-652
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• 1992

This study identified the impact of childhood cancer on the Korean family. The purpose was to contribute knowledge for family nursing and pediatric hospice care practice with sick children and their families. This descriptive study was conducted during a 6 month period with children who were being treated for cancer at six university hospitals in Seoul. The data were gathered from members of 68 families ; 24(Group A), with a child newly diagnosed with cancer : 27(Group B), with a child under treatment and without complications, and 17 (Group C), with a child in relapse. Medical records, structured questionnaires and interviews were used for data collection. The questionnaires and interview schedules had been used previously in Martinson's research in the USA and China. The findings, conclusions, and suggestions are as follows. 1. The impact of childhood cancer on the family. Members of the family experienced fear, helplessness, guilty feelings, and anger at the time of the initial diagnosis and at relapse. Mothers complained of headache, anorexia and poor appetite, weight loss, sleep disturbance, and bad dreams. Many of the fathers either lost or changed jobs, and all working mothers stopped working. Half the parents reported changes in their marital relationships such as frequent quarrels but also stronger unity. Family members perceived cancer as the most frightening disease. Change in their world view was expressed as living on faith understanding suffering, determining to live a better life, wanting to live an upright life and valuing health as the most important. Religious activities are found most helpful through this difficult experience. Financial debt due to the treatment and care of the sick child, burdened 22 families. The above mentioned impact was most evidant in Group B(those presently undergoing treatment) and Group C(those in relapse). Findings indicate that nursing care should embrace the family of a child who is being treated for cancer. 2. Characteristics of the child with cancer The majority of the children in this sample had a diagnosis of leukemia. Their mean age was 6.8 and the ratio of boys to girls was 1.12 ; 1. The mean hospitalization frequency was 13.5 times and the mean duration of illness was 16.8 months. Most of 1.he children perceived cancer as the most frightening disease ; 32.7% of the children described their sickness as serious. Children in Group C were hospitalized more frequently, stayed in hospital for longer periods, and expressed their sickness as quite serious more often than the other two groups. These findings indicate how much comprehensive pediatric hospice nursing care services are needed along with relevant research and nursing education. 3. Characteristics of the families. The mean age of the father was 39.5 and the mother, 36,6 ; they are in their most productive life period. Mothers especially expressed feelings of financial uneasiness and powerlessness about giving up their jobs, and guilty feelings for not providing enough care and concern to other children due to taking care of the sick one. The burden of caring for the sick child can bring negative changes in family dynamics which they think provoke potential health problems in members of the family These findings suggest a need for nursing support and counselling resources. Findings also suggest the need for ethical inquiry about such questions as who should give information to the child in regard to diagnosis and prognosis, when, and how. Other suggestions included : 1) Quality health care for childhood cancer such as home care and pediatric hospice programs should be established. 2) Special and practical consideration for long-term patients should be made in the present insurance coverage. The reimbursement period for long-term patients should be lengthened. 3) Further in-depth qualitative studies are needed. 4) Education programs including guided practice experience for pediatric hospice care practitioners are needed.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.22 no.2
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• pp.128-138
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• 2009

Objectives : The purpose of this study is to make a survey on the oriental medical care and to enlarge the domain of oriental medical treatment concerning facial paralysis. Methods : From May 2008 to April 2009, a clinical study was done on 100 inpatients who were diagnosed and treated as facial nerve paralysis at Mok-dong Oriental Medicine Hospital, Dong-shin University Results : The result were as the following 1. The distribution of sex: male 35%, female 65%. The distribution of age was disclosed that fifty was the most in 22 cases(22%). 2. The distribution of the region of facial palsy: Lt 58%(male 23%, female 35%) Rt 41%(male 11%, female 30%) 3. In distribution of contributing frequence in month, June was the most in number(12%) and in season, spring, summer, winter were the same percentage(26%). 4. In distribution of cause, stress(34%), excessive labor(25%), unknown(22%) were investigated higher than other conditions. 5. The distribution of past history: hypertension 14%, diabetes mellitus 4%, both(hypertension, diabetes mellitus) 6% 6. The distribution of period before admission: within a week 80%, 1$\sim$2 week 8%, 3$\sim$4 week 6% in order. 7. The distribution of attended symptoms: mastoid pain 43 cases, dryness of eye 26 cases, tearing 22 cases, headache 12 cases, dizziness 9 cases in order. 8. Other offices patients visited before coming to this clinic: oriental clinic or hospital 35%, local clinic or hospital 29%, none 26%, both(oriental clinic & local clinic) 10%. 9. The distribution of House-Brackmann grade on admission: Gr III 38%, Gr IV 26%, Gr II 22%, Gr V 14% in order. 10. The distribution of House-Brackmann grade on discharge: Gr II 34%, Gr I 32%, Gr III 22%, Gr V 7%, Gr IV 5% in order.

• The Korean Journal of Nuclear Medicine
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• v.27 no.1
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• pp.59-64
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• 1993

To evaluate the usefulness and differences in diagnosing coronary artery disease (CAD) between men and women of intravenous dipyridamole $^{99m}Tc$-MIBI myocardial SPECT, we obtained $^{99m}Tc$-MIBI myocardial SPECT and compared with the findings of coronary angiographies. Ninety eight male and 37 female patients who underwent dipyridamole $^{99m}Tc$-MIBI myocardial imaging within one month of cardiac catheterization were studied. Scans were considered abnormal if perfusion defect was detected and the defect size was more than 12% for left anterior descending artery (LAD) and circumflex (LCX) and 8% for right coronary artery (RCA) territories. Lesions${\geqq}$50% luminal diameter narrowing were considered significant CAD. Overall sensitivity for detection of CAD was 94.3% in men and 96.4% in women; specificity was 70% in men and 52.6% in women (P=not significant, ns). Vessel-matched sensitivity was 75.3% in men and 72.7% in women (P=ns): specificity was 84.6% in men and 67.9% in women (P < 0.025). For individual coronary artery, the sensitivity in men and women was 87.7%, 81.8% for LAD; 78%, 83.3% for RCA and 52.2%, 46.7% for LCX (P=ns): the specificity was 80%, 40% for LAD (P<0.01), 82.5%, 68.4% for RCA, 88.9%, 86.4% for LCX (P=ns). The hemodynamic parameter after intravenous dipyridamole in men and women were significantly changed; the heart rate was increased and systolic, diastolic blood pressure was decreased. Adverse effects were reported in 58.8% of men and 72.7% in women (P=ns). The incidence of chest pain and headache were higher in women. There was no significant difference in the incidences of nausea, abdominal pain, dizziness, facial flushing, dyspnea. In conclusion, dipyridamole $^{99m}Tc$-MIBI myocardial SPECT is a safe, noninvasive test for evaluation of CAD. There was no gender difference to detect CAD, but more false-positive rate in women especially in the territory of LAD.

• Journal of Haehwa Medicine
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• v.1 no.1
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• pp.151-165
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• 1992

Clinical studies were done on 18 people chosen from admission patients didn't have will of stop-smoking who were treated with the auricular acupuncture therapy to stop-smoking in the Dep. of the Acupuncture and Moxibution, Hospital of Oriental Medicine in Dae Jeon University from 1991. 5. 28 to 1991. 6. 15. The following results have obtained 1. Distribution of sex; male(83%), Female(17%) 2. In the distribution of age, 30s age group made up 33.3%, 20s, 50s, 60s age group made up each 16.6%, 40s made up 11.1%, 70s made up 5.5% of the group. 3. Distribution of occupation in descending order; labour man(38.8%), businessman(22.4%), housewife, office woker was each 16.6%, students(5.5%). 4. Distribution of human coporal constitution in descending order; Tae-Eum-In(50%), So-Yang-In(27.8%), So-Eum-In(22.2%). 5. Distribution of statring tense to smoking in descending order; 10s, 20s, were each 44. 4%, 30s(11.1%). 6. Distribution of duration in descending order; 10-19years(33.3%), 40-49years(22.2%), 1-9, 20-29years were each 16.6%, 30-39years(11.1%). 7. Distribution of smoking amount(1day) in descending order; 11-20 cigarettes(38.8%), 21-30 cigarettes(22.7%), 1-10 cigarettes, 31-40 cigarettes were each 16.6%. 8. Distribution of the motive to smoking in descending order; curiosity(61.1%), hyperemesis gravidarum, abdominal pain, stress, inducement. 9. Distribution of symptoms within smoking in descending order; sputum(83%), liver disorder(11%), stomach disorder(6%). 10. Distribution in symptoms of post treatment of stop-smoking by acupuncture in descending order; nausea, headache were 12%, ear-radiating pain(6%), no variation(82%). 11. Distribution in change of cigarettes taste after the auricular acupuncture treatment; some decrease, complete decrease were each 38. 8%, decrease of post taste in smoking, burning-paper odored were each 5.5%, no variation(11.1%). 12. Total judgement of efficacy in descending order; excellent(50. 0%), good(28.8%), fair(10. 0%), failure(11.1%).

• The Korean Journal of Nuclear Medicine
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• v.27 no.2
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• pp.203-209
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• 1993

Dipyridamole is an agent that may be used to noninvasively evaluate coronary artery disease. The effect of dipyridamole infusion its generally related to its induced peripheral vasodilatory effect. In normal person, heart rate is generally increased slightly while blood pressure decrease, but the achieved double product and related myocardial oxygen consumption have no significant change. The purpose of this study is to examine the effect and side effect of dipyridamle, and to compare different response to dipyridamole among the patients. We evaluated 847 patients who underwent dipyridamole stress myocardial SPECT. 93.6% of them had induced hypotension, 0.9% showed no change of blood pressure, 5.5% had increased blood pressure. 8.3% had no change of pulse rate more than 10% of basal pulse rate. Among diabetes, 16.9% was not change of pulse rate, 6.7% in non-diabetes. There was no significant correlation between age and rate pressure product rest(RPPr), in patiens without perfusion defects on SPECT(y=7.1x+ 48.4 r=0.13 p>0.01). As increasing age, RPPs/RPPr was declined(y= -11.6x+68.9 r=0.17 p<0.01), similar results were obtained in patients with perfusion defect. The size of perfusion defect on myocardial SPECT have no correlation between RPPr and RPPs/RPPr. The side effects of dipyridamole included chest pain and chest tightness, headache, abdominal pain, dizzness, nausea, and dyspnea. As increasing age, dipyridamole-induced cardiac work at rest was increased, cardiac response to dipyridamole was decreased.

• Journal of Oral Medicine and Pain
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• v.37 no.4
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• pp.233-242
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• 2012

The purposes of this study were to compare psychological profiles, to investigate the differences in the clinical characteristics, and to compare treatment outcomes between myogenous pain and arthrogenous pain subgroups of temporomandibular disorder (TMD) based on Research Diagnostic Criteria for Temporomandibular disorders (RDC/TMD). Two hundred and fifty two patients diagnosed as TMD were divided into three groups based on the RDC/TMD axis I diagnostic guidelines; myogenous pain group, arthrogenous pain group, and mixed pain (both myogenous pain and arthrogenous pain) group. RDC/TMD history questionnaire was administered to each patient and depression, somatization, jaw disability, pain intensity, disability days, and graded chronic pain scale were analyzed. Bruxism, clenching, insomnia, headache, and unilateral chewing were assessed in a standardized TMD dysfunction questionnaire and the duration of onset, chronicity of pain, treatment period, the effectiveness of the treatment, and improvement of symptoms also analyzed. Myogenous pain group had higher depression (p=0.002), and somatization scales (p<0.001) than the arthrogenous pain group. Mixed pain group showed higher pain intensity (p=0.008), disability days (p<0.001), graded chronic pain scale (p=0.005), somatization (p<0.001), and depression scores (p=0.002) than the arthrogenous pain group. Jaw disability did not show any significant differences among the three groups (p=0.058). Arthrogenous pain group reported more limitation of mouth opening than myogenous pain group (p=0.007). Duration of onset showed that the arthrogenous pain group had lowest prevalence of chronicity among three groups (p=0.002). Mixed pain group patients showed lowest symptom improvements among three groups (p=0.007). Multiple linear regression analysis results showed that the treatment effectiveness was significantly associated with somatization score (${\beta}$=-0.251, p=0.03).

• Pediatric Infection and Vaccine
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• v.25 no.1
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• pp.35-44
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• 2018

Purpose: This study aimed to evaluate the immunogenicity and safety of a trivalent inactivated influenza vaccine (TIV) among healthy Korean children and adolescents. Methods: From October to December 2008, 65 healthy patients aged 6 months to 18 years who visited Korea University Ansan Hospital for influenza vaccination were enrolled in this study. We measured the hemagglutinin inhibition antibody titers at baseline and 30 days after vaccinating enrollees with split influenza vaccine and calculated the seroprotection rates, geometric mean titers, and seroconversion rates. Local and systemic adverse events were assessed after vaccination. Results: The seroprotection rates against all three viral strains (A/H1N1, A/H3N2, B) were 87.7%, 89.2%, and 89.2% (${\geq}70%$), respectively; seroconversion rates were 44.6%, 73.8%, and 63.1% (${\geq}40%$), respectively; and seroconversion factors were 4.5, 8.4, and 10.5 (>2.5), respectively. The TIV immunogenicity was acceptable according to the CPMP (Committee for Proprietary Medicinal Products) criteria. Although 48 patients (73.8%) reported one or more adverse events, no severe adverse events such as anaphylaxis and convulsion were observed. Forty-two patients (64.6%) reported a local skin reaction, including redness (29.2%), pain (43.1%), or swelling (41.5%) of the injected site, and 26 (40.0%) reported a systemic reaction: fatigue (23.1%), myalgia (20.0%), headache (10.8%), arthralgia (10.8%), chills (9.2%), or fever (7.7%). Conclusions: This study shows that the immunogenicity of the TIV vaccine is acceptable. As there were no serious adverse events aside from local reactions and mild systemic reactions, this vaccine can be safely used among healthy Korean children and adolescents.