• Journal of Oral Medicine and Pain
• /
• v.34 no.2
• /
• pp.207-216
• /
• 2009

Trigeminal neuralgia is defined "a sudden, usually unilateral, severe, brief, stabbing, recurrent pain in the distribution of one or more branches of the fifth cranial nerve". The initial treatment of choice for trigeminal neuralgia is medical therapy. In patients with medically intractable pain or intolerable medication side effects, invasive therapeutic approaches are often necessary. Based on the amount of evidence and estimated efficacy, carbamazepine is the drug of choice in the management of trigeminal neuralgia. In case of insufficient or no response to carbamazepine, second-line drugs can be added. In this study, the author tried to review and analyzed the cases of 90 patients whom had visited for treatment of trigeminal neuralgia at the Department of Oral Medicine, Kyungpook National University Hospital from 2003 to 2008. The results were as follows: 1. Trigeminal neuralgia was significantly more common with advancing age, and nearly twice as common in women than men (ratio of 2.1:1) 2. The maxillary branch of the trigeminal nerve involved most often (51.1%), and the right side of the face is affected more commonly than the left (ratio of 2.9:1). 3. 85(94.4%) patients had experiences visiting medical or dental specialties before being referred to the Department of Oral Medicine. 4. 40(44.4%) patients with trigeminal neuralgia had systemic diseases. 5. Treatment with carbamazepine monotherapy was satisfactory initially in 69(76.7%) the patients, and the mean daily dose of carbamazepine was 402.9mg. On the other hand, 16(17.8%) patients expressed effectiveness after combination therapy of carbamazepine and other drugs. 6. Of the 69 patients who had a good initial response to carbamazepine monotherapy, 18 patients became resistant, so that combination therapy of carbamazepine and other drugs were necessary. 7. 54(60%) patients developed side effects such as dizziness, drowsiness, nausea, vomiting, blood dyscrasias, skin rash and constipation, and 11 of the patients decided to stop tmedicaion due to side effects.

• Journal of Oral Medicine and Pain
• /
• v.34 no.2
• /
• pp.169-177
• /
• 2009

Recently it is very interesting that the plant extracts use to prevent or treat the oral diseases. The present study was performed to observe the antibacterial effect on S. gordonii Challis, S. gordoii G9B, S. mutans GS5, S. sobriuns 6715, E. faecalis ATCC 4083, A. actinomycetem Y4, P. gingivalis A7A1-28, P. gingivalis W83, Pr. intermedia ATCC 25611, F. nucleatum KTCT 2488, C. albicans ATCC 18804 of Artemisa capillaris THUNB employing the viable cell counts. The results were as follows: 1. Minimum inhibitory concentration(MIC) and Minimum bactericidal concentration(MBC) of extracts of Artemisa capillaris THUNB for P. gingivalis A7A1-28, P. gingivalis W83, and Pr. intermedia ATCC 25611, which are the pathologic bacteria of periodontal diseases, was observed under 2%. 2. MIC of extracts of Artemisa capillaris THUNB for P. gingivalis A7A1-28 was determined to be 1.2% and MBC was determined to be 2.0% respectively. 3. MIC of extracts of Artemisa capillaris THUNB for P. gingivalis W83 was determined to be 1.4% and MBC was determined to be 2.0% respectively. 4. MIC of extracts of Artemisa capillaris THUNB for Pr. intermedia ATCC 25611 was determined to be 1.2% and MBC was determined to be 2.0% respectively. The overall results indicate that Artemisa capillaris THUNB used for this study has a strong antibacterial activity against P. gingivalis A7A1-28, P. gingivalis W83, and Pr. intermedia ATCC 25611, which are the periodontopathic bacteria. Therefore, the extracts of Artemisa capillaris THUNB can be used as a candidate for prevention and therapeutic agent against periodontal diseases.

• Journal of Korean Medical Science
• /
• v.33 no.52
• /
• pp.346.1-346.11
• /
• 2018

Background: To evaluate the therapeutic benefits of the treat-to-target (T2T) strategy for Asian patients with early rheumatoid arthritis (RA) in Korea. Methods: In a 1-year, multicenter, open-label strategy trial, 346 patients with early RA were recruited from 20 institutions across Korea and stratified into 2 groups, depending on whether they were recruited by rheumatologists who have adopted the T2T strategy (T2T group) or by rheumatologists who provided usual care (non-T2T group). Data regarding demographics, rheumatoid factor titer, anti-cyclic citrullinated peptide antibody titer, disease activity score of 28 joints (DAS28), and Korean Health Assessment Questionnaire (KHAQ) score were obtained at baseline and after 1 year of treatment. In the T2T group, the prescription for disease-modifying antirheumatic drugs was tailored to the predefined treatment target in each patient, namely remission (DAS28 < 2.6) or low disease activity (LDA) ($2.6{\leq}DAS28$ < 3.2). Results: Data were available for 163 T2T patients and 162 non-T2T patients. At the end of the study period, clinical outcomes were better in the T2T group than in the non-T2T group (LDA or remission, 59.5% vs. 35.8%; P < 0.001; remission, 43.6% vs. 19.8%; P < 0.001). Compared with non-T2T, T2T was also associated with higher rate of good European League Against Rheumatism response (63.0% vs. 39.8%; P < 0.001), improved KHAQ scores (-0.38 vs. -0.13; P = 0.008), and higher frequency of follow-up visits (5.0 vs. 2.0 visits/year; P < 0.001). Conclusion: In Asian patients with early RA, T2T improves disease activity and physical function. Setting a pre-defined treatment target in terms of DAS28 is recommended.

• Journal of Korean Medical Science
• /
• v.33 no.49
• /
• pp.323.1-323.12
• /
• 2018

Background: Vitamin K antagonist (VKA) to prevent thromboembolism in non-valvular atrial fibrillation (NVAF) patients has limitations such as drug interaction. This study investigated the clinical characteristics of Korean patients treated with VKA for stroke prevention and assessed quality of VKA therapy and treatment satisfaction. Methods: We conducted a multicenter, prospective, non-interventional study. Patients with $CHADS_2{\geq}1$ and treated with VKA (started within the last 3 months) were enrolled from April 2013 to March 2014. Demographic and clinical features including risk factors of stroke and VKA treatment information was collected at baseline. Treatment patterns and international normalized ratio (INR) level were evaluated during follow-up. Time in therapeutic range (TTR) > 60% indicated well-controlled INR. Treatment satisfaction on the VKA use was measured by Treatment Satisfaction Questionnaire for Medication (TSQM) after 3 months of follow-up. Results: A total of 877 patients (age, 67; male, 60%) were enrolled and followed up for one year. More than half of patients (56%) had $CHADS_2{\geq}2$ and 83.6% had $CHA_2DS_2-VASc{\geq}2$. A total of 852 patients had one or more INR measurement during their follow-up period. Among those patients, 25.5% discontinued VKA treatment during follow-up. Of all patients, 626 patients (73%) had poor-controlled INR (TTR < 60%) measure. Patients' treatment satisfaction measured with TSQM was 55.6 in global satisfaction domain. Conclusion: INR was poorly controlled in Korean NVAF patients treated with VKA. VKA users also showed low treatment satisfaction.

• Therapeutic Science for Rehabilitation
• /
• v.8 no.4
• /
• pp.53-63
• /
• 2019

Objective : Many communication recovery strategies should be used when communication breakdowns occur for successful communication, however, communication problems increase due to inadequate use of such strategies in older people with dementia. The purpose of this study was to investigate the difference of recovery strategy between dementia and the elderly in conversational discourse. Method : The subjects were eight of Alzheimer's dementia and 10 general elderly. Conversation discourse tasks were conducted face-to-face with the subjects. Communication breakdown and communication recovery strategies were analyzed based on 200 utterances collected in the conversation discourse. Result : First, the AD group had more communication breakdown than the control group, but the recovery rate did not differ between the groups. Second, in the AD group, the nonspecific recovery strategy and the clarification demand strategy were used as the expression strategy. The recovery rate after using expressive strategy was more than 90% in explanation strategy, combined strategy, nonspecific repair strategy, and repetition confirmation strategy. The response strategy used a lot of paraphrase strategy and combined strategies, and the recovery rate after using the response strategy was 100% for the simplification strategy, repeat strategy and gesture strategy. Conclusion : The AD group showed more breakdown of research subjects and breakdown of researchers than control group, and it showed ability to use various expression strategy and response strategy though there was difference in repair rate between communication repair strategy. AD group used nonspecific repair strategy in expression strategy the most and paraphrase strategy in response strategy the most. This shows different characteristic from ordinary elderly people. Therefore, it is necessary to utilize this repair strategy for rehabilitation of AD elderly.

• Korean Journal of Psychosomatic Medicine
• /
• v.24 no.2
• /
• pp.184-190
• /
• 2016

Objectives : This study analyzed the differences of body mass index(BMI) in Korean patients with Alzheimer's diseases(AD), Mild Cognitive Impairment(MCI), and healthy controls to verify whether low BMI is associated with cognitive impairment. Furthermore, this study also sought to examine any association between BMI and Mini Mental State Examination-Korean version(MMSE-K), Clinical Dementia Rating(CDR), and Global Deterioration Scale(GDS). Methods : A total of 257 subjects were included in the study. History taking, mental status examination, physical examination and neurocognitive function test were carried out for the diagnosis of AD and MCI. The subjects' demographic data and presence of diseases were also surveyed. The overall cognitive function and severity of diseases were assessed using MMSE-K, GDS, and CDR. Results : The order of BMI was found to be healthy controls>MCI>AD, with statistically significant differences among the groups. The order of MMSE-K scores was similar, with healthy controls>MCI>AD in statistically significant differences. The healthy controls had the lowest CDR and GDS scores, and AD patients had the highest scores. There was a significant positive correlation between BMI and MMSE scores(r=0.238, p=0.000). BMI was negatively correlated with CDR(r=-0.174, p=0.008) as well as with GDS(r=-0.233, p= 0.000). Conclusions : Measuring BMI of patients with AD or MCI is expected to be meaningful in that BMI could be a clinical indicator of AD. We expect this to be beneficial for the diagnosis, prevention, and therapeutic approach of AD and also expect large-scale, long-term longitudinal studies to follow.

• Journal of Korean Society of Spine Surgery
• /
• v.25 no.4
• /
• pp.147-153
• /
• 2018

Study Design: Retrospective case series. Objectives: We retrospectively evaluated the clinical efficacy of postganglionic nerve block in symptomatic Schmorl nodules (SNs). Summary of Literature Review: SNs are common lesions that are often asymptomatic. In certain cases, SNs have been reported to cause severe axial back pain, thereby considerably impacting patients' quality of life. No consensus currently exists on the treatment of symptomatic SNs. Materials and Methods: From October 2015 to October 2017, a total of 21 patients with symptomatic SNs diagnosed by magnetic resonance imaging (MRI) that did not respond to conservative treatment after 4 weeks were included in the study. All patients received postganglionic nerve block. We evaluated effective pain relief (improvement of back pain of more than 50% compared with before the intervention) and functional improvements, assessed by visual analogue scale (VAS) and Oswestry Disability Index scores obtained at 4 hours, 4 weeks, 8 weeks, 3 months, and 6 months after the procedure. Results: Symptomatic SNs were more common at the L2-3 level, and the lower end plate was more commonly involved than the upper end plate. Eighteen of the 21 patients (85.7%) showed effective pain relief, and no deterioration was observed within the followup period. Throughout the follow-up period, the VAS remained significantly improved compared to before the procedure (p<0.05). Complications were not reported in any cases. Conclusions: Postganglionic nerve block for symptomatic SNs that do not respond to conservative treatment is a non-invasive modality for pain relief.

• The Korean Journal of Gastroenterology
• /
• v.72 no.5
• /
• pp.271-273
• /
• 2018

내시경 시술 전 일시적으로 항응고제를 중단하는 것은 위장관 출혈의 위험과 혈전색전증의 위험 사이에 적절한 균형을 잡기 어렵기 때문에 논란의 여지가 많다. 와파린은 새로운 경구용 항응고제(direct oral anticoagulant agent, DOAC)보다 임상의에게 더 친숙하고, 효과를 쉽고 빠르게 전환시킬 수 있다는 장점이 있지만 복잡한 약역동학 특징과 좁은 치료적 범위 때문에 관리가 어렵다. 반면, DOAC는 약물의 모니터링 및 용량 조절 없이 정해진 용량으로 처방이 가능하며, 빠르게 작용하고, 반감기가 짧아 관리가 쉽지만 해독제가 없다는 단점이 있다. 이전 연구들에서 DOAC를 복용한 환자들은 와파린을 복용한 환자들보다 시술과 관련되지 않은 위장관 출혈의 위험이 높았다고 보고한 바 있다. 하지만 시술과 관련된 위장관 출혈 위험에 대하여는 알려진 바가 없는 실정이다. 미국이나 유럽 내시경 가이드라인들에서는 저위험 내시경 시술을 받는 환자들에서는 와파린과 DOAC를 유지하도록 권고하고 있으며, 고위험 시술의 경우에는 와파린를 사용하는 환자들에서 헤파린 교량 요법(heparin bridging)을 시행하도록 권고하고 있다. 임상적으로 DOAC를 사용하는 환자들 또한 혈전색전증을 예방하기 위하여 헤파린 교량 요법을 시행해볼 수 있는데, 와파린 및 DOAC의 헤파린 교량 요법과 관련된 출혈 및 혈전색전증 위험의 차이 또한 명확하지 않다. 따라서 저자들은 1) 와파린과 DOAC 치료를 받는 환자들에서의 출혈, 혈전색전증 및 사망의 위험을 비교하고자 하였으며, 2) 13종류의 고위험 내시경 시술 중에서 시술별 위험을 비교하고, 3) 헤파린 교량 요법이 합병증의 발생을 증가시키지 않는지 확인하고자 본 연구를 진행하였다. 일본 대규모 국가 입원 환자 데이터베이스를 이용하여 2014년 4월부터 2015년 5월까지 시술 전 와파린 또는 DOAC(rivaroxaban, apixaban, dabigatran, edoxaban)를 복용하고, 13종류의 고위험 내시경 시술을 시행받은 20세 이상의 성인 환자 총 16,977명을 확인하였다. 고위험 시술은 용종 절제술, 내시경 점막절제술, 내시경 점막하박리술, 협착 부위의 풍선확장술, 내시경 지혈술, 내시경 정맥결찰술, 내시경 주사 경화요법, 내시경 괄약근절개술, 내시경 초음파 유도하 미세침 흡인 검사, 경피적 위루술을 포함하였다. 일대일 성향 점수 매칭 분석(propensity score matching, 나이, 성별, 체질량 지수, 기저 질환, 병원의 규모, 시술의 종류, 약물의 종류를 매칭)을 시행하여 와파린군과 DOAC군에서 시술 위장관 출혈 및 혈전색전증, 사망의 발생을 비교하였다. 또한 경구항혈전제와 헤파린 교량 치료 시행 유무에 따라, DOAC 단독군, 와파린 단독군, DOAC와 헤파린 교량 요법군, 와파린과 헤파린 교량요법군으로 나누어, 하위군(subgroup) 분석을 시행하였다. 5,046쌍이 성향 점수 매칭 분석에 포함되었으며, 와파린군에서 DOAC군보다 통계적으로 의미 있게 위장관 출혈의 비율이 높았다(12.0% vs. 9.9% p=0.02). 혈전색전증 발생률(5.4% vs. 4.7%)과 입원중 사망률(5.4% vs. 4.7%)은 양 군에서 의미 있는 차이는 없었다. DOAC 종류별로 나누어 하위군 분석을 시행하였을 때, 와파린군은 rivaroxaban군에 비하여 위장관 출혈의 비율이 높았으며, rivaroxaban군, dabigatran군에 비하여 혈전색전증의 비율이 높았고, 입원 중 사망률에서는 의미 있는 차이는 없었다. 내시경 시술의 종류로 보정하였을 때 위장관 출혈 및 혈전색전증, 사망률은 DOAC 단독으로 치료한 환자에서보다 와파린과 헤파린 교량 요법(bridging) 또는 DOAC과 헤파린 교량 요법을 시행한 환자에서 높았다. 시술 종류 중에서는 위루관 삽입술에 비하여 내시경 점막하박리술, 내시경 점막절제술 및 내시경 정맥류결찰술, 내시경 주사경화요법을 시행한 환자에서 위장관 출혈의 위험이 가장 높았으며, 하부 내시경 점막절제술, 하부 용종 절제술, 내시경적 유두괄약근절제술 또는 내시경 초음파 유도하 미세침 흡인 검사는 중등도 위험을 보였다.

• Journal of Life Science
• /
• v.29 no.4
• /
• pp.402-409
• /
• 2019

Korean red ginseng made from steaming and drying fresh ginseng has long been used as a traditional herbal medicine due to its effects on the immune, endocrine, and central nerve systems and its anti-inflammatory activity. In this study, we investigated the molecular mechanism responsible for the anti-inflammatory effects of a formulated Korean red ginseng extract (RGE) in response to lipoteichoic acid (LTA), a cell wall component of gram-positive bacteria. RGE inhibited LTA-induced nitric oxide (NO) secretion and inducible nitric oxide synthase (iNOS) expression in BV-2 microglial cells, without affecting cell viability. RGE also inhibited nuclear translocation of nuclear factor kappa B ($NF-{\kappa}B$) p65 and degradation of $I{\kappa}B-{\alpha}$. In addition, RGE increased the expression of heme oxygenase-1 (HO-1) in a dose-dependent manner, and the inhibitory effect of RGE on iNOS expression was abrogated by small interfering RNA-mediated knockdown of HO-1. Moreover, RGE induced nuclear translocation of nuclear factor E2-related factor 2 (Nrf2), a transcription factor that regulates HO-1 expression. Furthermore, the phosphoinositide-3-kinase (PI-3K) inhibitor and mitogen-activated protein kinase (MAPK) inhibitors suppressed RGE-mediated expression of HO-1, and RGE enhanced the phosphorylation of Akt, extracellular signal-regulated kinases (ERKs), p38, and c-JUN N-terminal kinases (JNKs). These results suggested that RGE suppressed the production of NO, a proinflammatory mediator, by inducing HO-1 expression via PI-3K/Akt- and MAPK-dependent signaling in LTA-stimulated microglia. The findings indicate that RGE could be used for the treatment of neuroinflammation induced by grampositive bacteria and that it may have therapeutic potential for various neuroinflammation-associated disorders.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.20 no.8
• /
• pp.303-312
• /
• 2019

Oxidative stress in kidneys can precede the development of chronic renal injury. We investigated the antioxidative effect of membrane-free stem cell extract (MFSCE) from adipose tissue in LLC-$PK_1$ renal proximal tubule cells. Treatment of LLC-$PK_1$ cells with MFSCE showed the up-regulation of heme-oxygenase-1, thioredoxin reductase 1, and NADPH quinine oxidoreductase-1 protein expressions, which are proteins related with antioxidative activities. When oxidative stress was induced by 3-morpholinosydnonimine (SIN-1), cell viability was decreased, indicating that LLC-$PK_1$ cells were damaged by SIN-1. However, MFSCE significantly elevated cell viability from 58.84% to 64.43% at the concentration of $2.5{\mu}g/mL$ in oxidative stress-induced LLC-$PK_1$ cells. Furthermore, MFSCE ameliorated inflammation and apoptosis in SIN-1-treated LLC-$PK_1$ cells by modulating protein expressions. Inducible nitric oxide synthase and cyclooxygenase-2 protein expressions were down-regulated when LLC-$PK_1$ cells were treated with MFSCE. Apoptosis-related proteins, including B-cell lymphoma-2-associated X protein/B-cell lymphoma-2 ratio, cleaved caspase-3, and cleaved-poly (ADP-ribose) polymerase, were also down-regulated. It indicated that MFSCE protected apoptosis against oxidative stress in LLC-$PK_1$ cells. Taken together, these results suggested that MFSCE had a protective effect against SIN-1-induced oxidative stress in LLC-$PK_1$ cells. Therefore, MFSCE could be a promising therapeutic agent for oxidative stress-induced renal injury.