• The Korean Journal of Emergency Medical Services
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• v.12 no.3
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• pp.5-15
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• 2008

Purpose : This study is a descriptive research to provide basic factors of posttraumatic stress in Firefighters. This study was carried out to develop the effective program for the fire fighters to cope with the posttraumatic stress following the disasters. Methods : The questionnaires were collected among fire fighters who serviced in K and I community from April 1 to June 30 in 2008. Total 304 questionnaires were analyzed by SPSS WIN program for descriptive statistics, Pearson's correlation coefficient and t-test. Results : 1. 48.0% of 300 fire fighters were at the age of 31-40, and 42.3% were under 30. 2. Work burden had a significant difference of 2.30 in low-risk group, 2.60 in high-risk group(t-value=-3.85, p=0.00). However, life event had no significant difference 0.79 event in low-risk group, 1.41 event in high-risk group(t-value=-2.27, p=0.24). 3. Concerning posttraumatic stress factors, there was positive correlation between mobilization impact level r=0.38(P<0.01), work burden r=0.38(p<0.01), and life event r=0.27(p<0.01). 4. According to the Symptom Check List-Revised(SCL-90-R), somatization had a significant differences(t-value=5.46, p=0.00), obsessive-compulsive(t-value=7.16, p=0.00), interpersonal sensitivity(t-value=6.15, p=0.00), depression(t-value=6.62, p=0.00), anxiety (t-value=7.33, p=0.00), hostility(t-value=5.94, p=0.00), phobia anxiety(t-value=6.85, p=0.00), paranoid ideation(t-value=5.55, p=0.00), psychotism(t-value=6.52, p=0.00) in low-risk and high-risk group. Conclusion : As a consequence, mobilization impact, work burden, and life event were the influential factors on posttraumatic stress. Also, high-risk group revealed significantly higher score on all 9 scales. The information obtained from surveys made recommendation to develop the intervention of stress management to control mobilization impact and posttraumatic stress.

• Journal of Pharmaceutical Investigation
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• v.34 no.6
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• pp.499-504
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• 2004

Paroxetine, a potent and selective serotonine reuptake inhibitor, has been used for the treatment of depression, obsessive-compulsive disorder, panic disorder and social phobia. The bioequivalence of two paroxetine preparations was evaluated according to the guidelines of Korea Food & Drug Administration (KFDA). The test product was Samchully Paroxetine $tablet^{\circledR}$ made by Samchully Pharm. Co. and the reference product was Seroxat $tablet^{\circledR}$ made by GlaxoSmithKline. Twenty healthy male subjects, $22.4{\pm}2.6$ years old and $63.8{\pm}4.2\;kg$, were divided into two groups and a randomized $2{\times}2$ cross-over study was employed. After one tablet containing 20 mg paroxetine was orally administered, blood was taken at predetermined time intervals and the concentration of paroxetine in plasma was determined using a validated HPLC method with fluorescence detector. Two pharmacokinetic parameters, $AUC_t$ and $C_{max}$, were calculated and analyzed statistically for the evaluation of bioequivalence of two products. Analysis of variance was carried out using logarithmically transformed parameter values. The 90% confidence intervals of $AUC_t$ and $C_{max}$ were log 0.84-log 1.16 and log 0.85-log 1.14, respectively. These values were within the acceptable bioequivalence intervals of log 0.8 to log 1.25. Thus, the criteria of the KFDA guidelines for the bioequivalence was satisfied, indicating that Samchully Paroxetine tablet is bioequivalent to Seroxat tablet.

• The Journal of the Korea Contents Association
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• v.8 no.2
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• pp.205-212
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• 2008

Needle phobia of medical devices is a significant problem in children patients. We conducted study in 130 pediatric patients aged $8{\sim}13$(mean age 10.5) who had venipuncture performed in a computed tomography. This review aims to explore the research available relating to three commonly used pain rating scales of children, the visual analogue scale(VAS), numeric pain rating scale(NPRS) and Wong-Baker faces pain scale(WBFPS) with scores. Its validity is supported by a strong positive correlation with the three-pain rating scales(correlations ranging from 0.70 to 0.92) measure in children. There were no significant differences between the means on the VAS and either of the pain rating scales. It has the advantage of being suitable for use with the most widely used metric for scoring($0{\sim}10$), and conforms closely to a linear interval scale. These scales presented moderate to good correlation and moderate agreement, sufficient for valid use in children. All three pain-rating scales are valid, reliable and appropriate for use in intravenous catheter placement.

• The Journal of Information Technology
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• v.9 no.1
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• pp.21-32
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• 2006

Acrophobia is a symptom of feeling an abnormal fear of heights. Medications or cognitive-behavior methods have been mainly used to treat the acrophobia. In these days the virtua1 reality technology has been applied to treat such an anxiety disorders. In this thesis, an telemedicine assistant system for treatment of acrophobia using biomedical signals and virtual reality technique is proposed. I made two virtual reality simulations for treatment of acrophobia and telemedicine system for communication between doctor and patient using personal computer. A virtual environment provides patient with stimuli which arouses phobia, and exposition to such environment makes him have ability to overcome the fear. Recently, the patient can take diagnosis from a medical doctor in distance with the telemedicine system. Multimedia conference service, on-line questionary, signal transfer system are needed to configure such system. Virtual reality simulation system that composed of position sensor, head mount display, and audio system, is also included in this telemedicine system. I added virtual environment update system to this virtual reality telemedicine system for treatment of acrophobia. Former acrophobia treatment systems use only patient's score of the questionary to appraise. The new system developed in this thesis uses not only patient's score of the questionary but also biomedical signals such as HR, GSR amplitude, GSR RT to increase the objectivity and quantitativity. The experimental results show that HR and GSR amplitude are useful for decision of acrophobia. We will apply this system to the acrophobia patient in distance and be able to offer better medical treatment for mental illness in near future.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.2
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• pp.75-91
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• 2012

Background: Dental sedation reduces fear and phobia during dental treatment and helps patients get quality treatment by inducing adequate consciousness control. Propofol has recently grabbed the spotlight, but no meta-analysis for efficacy and safety of propofol in dentistry has yet been performed. Thus, the purpose of this study was to perform meta-analysis to verify the efficacy and safety of propofol for use in dental sedation. Methods: Articles published between 1980 and 2010 were searched in the web sites, journals and medical database including The Cochrane Library, MEDLINE and EMBASE. And a total of 22 studies were selected among the randomized controlled trials (RCTs) that compared the use of propofol with other sedatives (control group). The data was collected from these studies and meta-analysis for efficacy and safety was performed using Comprehensive Meta-Analysis 5.0 (CMA 5.0). Results: The patient recovered significantly faster and discharged significantly earlier in the propofol group (SMD = -1.442, P < 0.001). The satisfaction of patient and that of operator was higher in the propofol group (P < 0.05). The incidence of arrhythmia and apnea/ hypoventilation was significantly lower in the propofol group (OR = 0.071, P < 0.05), and there was no significant difference in the other side effects. On the level of sedation, although the sedation score was significantly lower in the propofol group (SMD = -0.430, P < 0.05). Conclusions: The present analysis showed that the use of propofol resulted in high satisfaction levels on the part of the patients and operators, a shorter recovery time, and faster hospital discharge. The incidence of complications, however, was lower in the propofol groups or not much different between the propofol and control groups. Thus, the adequate use of propofol in dentistry is believed to be helpful for the effective and safe sedation of the patients.

• The Korean Journal of Oral and Maxillofacial Pathology
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• v.42 no.5
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• pp.145-152
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• 2018

A 57 years old female complained of severe pain on the right temporomandibular joint (TMJ) area. Her right condyle had been partly resected under surgical operation 13 years ago due to condyle hypertrophy, thereafter she felt dull pain on TMJ area and recently the lesion became severely swelled and painful leading to cancer phobia. The present radiological views showed slightly enlarged and sclerosed condyle with increased radiopacity, but its articular sliding function was almost disable during mouth opening. The patient's TMJ lesion was carefully managed with conservative physiotherapy and pain treatment. The microsection of condyle head obtained from the previous operation was re-evaluated histologically, and it was finally diagnosed as osteochondrosis dissecans (OCD), exhibiting hyperplastic proliferation of cartilage in condyle head and marked vascular dilatation in epiphyseal zone. This abnormal cartilage tissue was distinguishable from normal cartilage tissue found in the peripheral cartilaginous cap of the same microsection. The involved cartilage cap showed thick hypertrophic chondrocyte zone with horizontal and vertical clefts accompanying diffuse hyaline degeneration. The superficial fibrous zone of cartilage cap was thickened and frequently peeled off, while lower hypertrophic zone of cartilage cap was highly cellular and proliferative. Consequently, the endochondral ossification became aberrant and resulted pre-mature apoptosis of many hypertrophic chondrocytes, followed by diffuse and mild inflammatory reaction in the underlying marrow tissue. Therefore, it was suggested that this hypertrophic condyle lesion, OCD, be differentiated depending on radiological and histological features from ordinary condyle hyperplasia, osteochondroma, and osteoarthritis, and that the pathological confirmation of OCD may provide a reliable modality for dental and medical treatment of chronic and painful TMJ lesion.

• Journal of Oriental Neuropsychiatry
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• v.31 no.4
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• pp.279-288
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• 2020

Objectives: Many fields have changed since covid-19, psychotherapy being no exception. With the pandemic associated increase in untact treatment, interest in virtual reality exposure therapy has also increased. The aim of study was to analyze recent literature using virtual reality therapy for the treatment of anxiety disorders. Methods: We searched five databases from dates between October 1 to November 1, 2020. We selected articles related to the treatment of anxiety disorders using virtual reality therapy and analyzed the trend of that, not thesis but domestic articles. Results: There were 6 RCT studies and 3 were case reports where, based on the DSM-4, the participants presented with anxiety disorders including 2 with presentation anxiety, 1 heterosexual anxiety, 1 test anxiety, 1 social anxiety, 1 dental anxiety, 2 Acrophobia, and 1 social phobia. Treatment sessions varied from 1 session to 18 sessions, but 5 studies conducted 4 sessions, and all studies attempted virtual reality exposure for 30-minute time periods. 8 studies used HMD as the VR device and 1 study did not report a device. Conclusions: Anxiety disorders treated using virtual reality included speech anxiety and acrophobia. Median treatment session number was 4 and sessions were less than 30 minutes. The most common VR device used was an HMD. VR psychotherapy showed limitations relating to patient experience including cyber sickness and a lack of immersion. In addition, most of the studies were conducted with patients who visited hospitals utilizing Western medical practices. Currently, virtual reality therapy (VRT) intervention in oriental medicine is lacking. The lack of research in this area suggests analyzing data from VR psychotherapy in oriental medicine could provide novel and useful information.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.6
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• pp.331-341
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• 2022

This systematic review evaluates current evidence regarding the feasibility of using needleless jet injection instead of a conventional local anesthetic needle. EBSCO, ProQuest, PubMed, and Scopus databases were used to identify relevant literature published in English from 2005 to 2020. Ten studies were selected. Five of them were randomized clinical trials, 3 case-control studies, and 2 equivalence trials. Using the Critical Appraisal Skills Program checklist, 6 studies scored between 67% and 100%, and 4 studies scored between 34% and 66%. According to Jadad's scale, 2 studies were considered strong, and 8 studies were considered moderate in quality. The results of the 10 studies showed differences in patient preference for needleless jet injection. Needleless injection technique has been found to be particularly useful in uncooperative patients with anxiety and needle phobia. Needleless jet injection is not technique sensitive. However, with needleless jet anesthesia, most treatments require additional anesthesia. Conventional needle anesthesia is less costly, has a longer duration of action, and has better pain control during dental extraction. Needleless jet anesthesia has been shown to be moderately accepted by patients with a fear of needles, has a faster onset of action, and is an efficient alternative to conventional infiltration anesthesia technique.

• Mood & Emotion
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• v.9 no.1
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• pp.30-36
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• 2011

Purpose : Anxiety disorder and depressive disorder are often comorbid with each other, and the comorbidity is associated with poorer psychiatric outcome, resistance to treatment, increased risk for suicide, greater chance for recurrence. We aimed to investigate the comorbidity of anxiety disorder in Korea. Method : Subjects were total of 867 depressed patients recruited CRESCEND-K multicenter trial. We used SCID (Structured Clinical Interview for DSM - IV) to find comorbidity of anxiety disorders in depressed patient. Results : Of 867 patients, total 8.2% had anxiety disorder. Proportion of anxiety disorder Not Otherwise Specified was 3.5%, panic disorder was 1.7%, generalized anxiety disorder was 1.1%, post traumatic stress disorder was 0.9%, obsessive compulsive disorder was 0.6%, social phobia was 0.4%. Conclusion : In this study, anxiety disorder in depression were measured at a low comorbidity rate in compare to previous studies. Selection bias, use of antidepressants at registration, severity of depression symptoms, and point of SICD administration seems to have affected these results. It is probable that comorbidity evaluation would be more precise if shorter, structured interviews such as M. I.N.I.-Plus were used during first clinical interview for depression diagnosis.

• Journal of Hospice and Palliative Care
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• v.5 no.1
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• pp.24-30
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• 2002

Background : Pain is one of the most feared consequences of cancer. $65{\sim}85%$ of cancer patients experienced severe pain, and sometimes high dose morphine is used to these patients. But many doctors still have 'opioid-phobia' and hesitate to use high dose morphine. We investigated the morphine therapy in terminal cancer patients during the last 1 week to death, and found any differences according to the morphine dosage. Methods : 93 patients admitted to National Health Insurance Corporation Ilsan Hospital, department of family medicine for hospice care between September 2000 and the end of October 2001 and lived more than 1 week entered in the study. We investigated the demographic data, laboratory tests and sufficient dosage of morphine for pain control. According to the calculated dosage by OME(oral morphine equivalent), patients were divided into low dosage group (${\leq}150mg/day$) and high dosage group (>150 mg/day). The chi-squared test were used to evaluate the influence of age, gender, tumor sites, metastasis and adverse effects of morphine. Results : Mean age was $65.0{\pm}13.1year$ in low dosage group and $59.9{\pm}11.6year$ in high dosage group. 32 men (50.0%) and 32 women (50.0%) were included in low dosage group and 15 men (51.7%) and 14 women (48.3%) in high dosage group. Stomach was the most frequent tumor site and lung was the next. Metastasis were found 58 (90.6%) in low dosage group and 28 (96.6%) in high dosage group. In other palliative radiotherapy and adverse effects, there were no differences in both group. Conclusion : During the last 1 week to death in cancer patients, there were no difference according to the morphine dosage. So we don't have to have 'opioid-phobia' in treating the terminal cancer patients.