• The Journal of Internal Korean Medicine
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• v.44 no.3
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• pp.544-554
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• 2023

Background: Postural hypotension refers to a drop in systolic blood pressure of 20 mmHg or diastolic blood pressure of 10 mmHg or more within three minutes after standing up from lying down. Symptoms of postural hypotension not only include dizziness and blurred vision but also fatigue, cognitive decline, leg weakness, headache, and, in severe cases, fainting. Postural hypotension is a phenomenon that occurs in about 6% of the total population, and in Korea, the number of patients with postural hypotension is continuously increasing. Both pharmacological and non-drug therapies, which are treatment methods for this disease, do not show a satisfactory symptom improvement effect. Case summary: A 65-year-old male patient who visited the hospital complaining of dizziness and paresthesia due to postural hypotension was treated with acupuncture, moxibustion, and herbal medicine. For symptom evaluation, the numeric rating scale (NRS) of each symptom was used, and blood pressure change according to posture was measured. After treatment, the NRSs of dizziness and dysesthesia were decreased, and blood pressure changes according to posture was improved. Conclusion: This case report suggests that Korean medicine treatment, including acupuncture, electro-acupuncture, moxibustion, and herbal medicine, can be an effective treatment for dizziness with postural hypotension.

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1053-1068
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• 2020

In accordance with the new healthcare policy of government (Moon Jae-In Care) to strengthen health insurance coverage, the National Health Insurance (NHI) coverage of brain magnetic resonance imaging (MRI), brain/neck MR angiography (MRA), and head and neck MRI have been expanded since 2018 in Korea. This article has been reviewed focusing on the "Detailed matter concerning criteria and method for providing reimbursed services in the NHI. Some revisions" regarding reimbursement for MRI, which was revised from October 2018 to April 2020 and is currently in effect. It included the MRI reimbursement system in Korea, recent adjustment of the reimbursement coverage for patients with headache or dizziness, and reimbursement coverage, standard imaging, and radiologic report of brain MRI, brain/neck MRA and head and neck MRI. This article could help radiologists gain knowledge on health insurance to protect the expertise of the radiologist and to play a leading role in the hospital. As the policy changes, detailed matter concerning criteria and method for providing reimbursed services in the NHI may be revised. Therefore, radiologists should update issues related to insurance reimbursement for MRI continuously.

• Journal of Oriental Neuropsychiatry
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• v.26 no.3
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• pp.225-234
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• 2015

Objectives: We aimed to evaluate the use of Korean medicine in patients with dizziness or vertigo, since such study has not been performed previously. Methods: In the current study, we included 3 diagnoses i.e., Disorders of vestibular function (H81), Vertiginous syndromes in diseases classified elsewhere (H82), and Dizziness and giddiness (R42) from the Health Insurance Review and Assessment Service (HIRAS) database for 4 years. We analyzed the database and compared treatment with Korean vs. Western medicine. Results: 1. Korean medical visits and cost have been increasing for 4 years, except 2011. Western medical visits are 11.9 times higher than Korean medical visits. 2. The number of women who received Korean medicine was 2.6 times higher than that of men. 3. Among all ages, the 70~79 years group were the most frequent users of Korean medicine. The older age was correlated with more patients' visits. 4. The comparative number of visits by patient care type for 4 years indicated that outpatients had more visits than hospitalization. Furthermore, outpatient visits have been increasing for 4 years. 5. The comparative number of visits by hospital type for 4 years indicated that visits to the Korean medical clinic were the highest. In primary care, patients used more Korean medicine than Western medicine. In tertiary care, patients used more Western medicine than Korean medicine. 6. Korean medical cost per patient by patient care type for 4 years was a total 89,000 won, hospitalization 449,000 won and outpatient 83,000 won. Costs of all patient care types have been increasing. 7. Korean medical cost per patient by hospital type for 4 years was 156,000 won for Korean medical hospital, 83,000 won for local clinic and 127,000 won for miscellaneous facilities. Costs of all types have been increasing. Conclusions: This study provided objective information about epidemiologic characteristics of Korean medicine in patients with dizziness or vertigo. Furthermore, it provides an understanding of the recent status and forms the basis for further expansion of demand for Korean medicine among patients with dizziness or vertigo.

• Journal of Hospice and Palliative Care
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• v.20 no.2
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• pp.131-135
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• 2017

Purpose: Oral naloxone is combined with oxycodone to alleviate or prevent opioid-induced constipation in cancer pain patients. However, there is still concern that oral naloxone may precipitate opioid withdrawal symptoms in patients on opioids. We retrospectively investigated clinical characteristics of cancer patients who experienced opioid withdrawal symptoms. Methods: We reviewed medical records of all patients who were prescribed with oral oxycodone/naloxone at a tertiary cancer center from January 1, 2012 through December 31, 2016. Eligible patients were screened based on demographics, opioid and naloxone dosages, clinical manifestation and pain intensity. Results: Among a total of 1,641 patients, 10 patients were selected. Seven patients were male, and the average age was 68.1 years. The median dose of naloxone that induced withdrawal symptoms was 20 mg. Most common withdrawal symptom was shivering (seven patients) followed by cold sweating (five), and muscle twitching (five). Other symptoms included restlessness, fever, dizziness, and yawning. Pain was exacerbated from the median intensity of numeric rating scale (NRS) 3 to NRS 6. Conclusion: Opioid withdrawal symptoms may occur when switching to oral oxycodone/naloxone for cancer patients who have been treated with other strong opioids. A prospective, multicenter study on this issue should be conducted in future.

• Journal of Physiology & Pathology in Korean Medicine
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• v.29 no.5
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• pp.378-385
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• 2015

Dizziness is one of the most common symptoms in clinical practice. The purpose of this study was to investigate the characteristics of patients with dizziness who visited Korean medicine hospital. This study analyzed 328 patients with dizziness who visited Dunsan Korean Medicine Hospital of Dae-Jeon University from Nov. 1st, 2012 to Oct. 31st, 2014. We gathered the data of the patients based on the medical charts. The patients were divided into 4 gorups ; central dizziness group, peripheral dizziness group, presyncope dizziness group, functional dizziness group, In the distribution according to sex, the number of female patients was higher than the male patients in all the types of dizziness except the presyncope group. The average age of the central group was higher than any other types. The peripheral and central group were most frequently admitted. The average hospitalization period were categorized as follows : central group 37.31, presyncope group 17, functional group 14.21, peripheral group 13.5 days. The following numbers of patients showed the distribution of each syndrome differentiation ; deficiency of qi and blood(氣血兩虛) 58.8%, plegm-dampness syndrome(濕痰中阻) 18.0%, hyperactivity of liver yang(肝陽上亢) 14.3%, deficiency of kidney essence(腎精不足) 8.8%. The distribution of herbal medicine for dizziness were categorized as follows ; Jaeumkeonbi-tang(Ziyinjianpi-tang, 滋陰健脾湯) 50.4%, Banhabaekchulcheonma-tang(Banxiabaishutianma-tang, 半夏白朮天麻湯) 10.2% and Bojungikgi-tang(Buzhongyiqi-tang, 補中益氣湯) 4.1%. The 86.0% of patients with dizziness has improved. The peripheral showed highest rate of improvement(100%). This report would serve as a reference data for further study about patients with dizziness in the clinical field of Korean medicine.

• Journal of Physiology & Pathology in Korean Medicine
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• v.24 no.1
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• pp.171-176
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• 2010

Jaeumgeonbi-tang Gamibang is noted as effective method to treat a dizziness in Korean Medicine. The main purpose of this research is analysis of the effects of Jaeumgeonbi-tang Gamibang on dizziness patients. In following research, 70 cases of dizziness patients who treated in Daejeon oriental medicine hospital from Oct, 2004 to Feb, 2009 were researched. The research is focused on clinical efficacy of Jaeumgeonbi-tang Gamibang. This research measured DHI and VAS before Jaeumgeonbi-tang Gamibang were prescribed. And Jaeumgeonbi-tang Gamibang were treated to all 70 patients. Finally DHI and VAS were measured again. Before this research, We had characterized and searched such as age, prevalence period, prescribed dosage, sex, vertigo type, pathological history in 70 patients. And DHI and VAS score were compared each other. The compared characteristic data shows that every cases were effective, in the DHI and VAS comparison, between pre-treatment and post-treatment group, vertigo and dizziness group, man and woman group. but In the age case, some age group were not effective. Conclusion: Most cases, we gained effective results. These result suggest that Jaeumgeonbi-tang might be effective in treatment of dizziness patients although man or woman, vertigo or dizziness.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.1
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• pp.9-19
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• 2016

Many patients with dizziness present with a symptom pattern that does not reveal the cause by neurotologic diagnostic approaches. In such cases, the physician frequently diagnoses psychogenic dizziness. Psychogenic dizziness is not characterized by true vertigo, and occurs in combination with other psychiatric symptom cluster. One out of two to four patients with dizziness are psychogenic dizziness. But there are few concern about this including clinical practice and study in Korea. I wrote this paper to increase concerning and attending to this for psychiatrists in Korea. I reviewed etiology including biological and psychological relations between dizziness and psychiatric disorder(especially anxiety), diagnostic approaches of, characteristics of dizziness of various psychiatric disorders related to, and the treatment of psychogenic dizziness. I also briefly reviewed the central and peripheral dizziness for psychiatrists. I suggest psychiatrists and clinicians in the psychosomatic field in Korea to acknowledge, concern, and attend to psychogenic dizziness. In turn, it will be helpful to well treat the patients with psychogenic dizziness.

• Clinical and Experimental Pediatrics
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• v.52 no.5
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• pp.557-566
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• 2009

Purpose : To evaluate the clinical features and characteristics of childhood periodic syndromes (CPS) in Korea using the new criteria of the International Classification of Headache Disorders (ICHD)-II. Methods : The study was conducted at pediatric neurology clinics of five urban tertiary-care medical centers in Korea from January 2006 to December 2007. Patients (44 consecutive children and adolescents) were divided into three groups (cyclic vomiting syndrome [CVS], abdominal migraine [AM], and benign paroxysmal vertigo of childhood [BPVC]) by recurrent paroxysmal episodes of vomiting, abdominal pain, dizziness, and/or vertigo using the ICHD-II criteria and their characteristics were compared. Results : Totally, 16 boys (36.4%) and 28 girls (63.6%) were examined (aged 4-18 yr), with 20 CVS (45.5%), 8 AM (18.2%), and 16 BPVC (36.4%) patients. The mean age at symptom onset was $6.3{\pm}3.6$ yr, $8.5{\pm}2.7$ yr, and $8.5{\pm}2.9$ yr in the CVS, AM, and BPVC groups, respectively, showing that symptoms appeared earliest in the CVS group. The mean age at diagnosis was $8.0{\pm}3.4$ yr, $10.5{\pm}2.6$ yr, and $10.1{\pm}3.2$ yr the CVS, AM, and BPVC groups, respectively. Of the 44 patients, 17 (38.6%) had a history of recurrent headaches and 11 (25.0%) showed typical symptoms of migraine headache, with 5 CVS (25.0%), 2 AM (25.0%), and 4 BPVC (25.0%) patients. Family history of migraine was found in 9 patients (20.4%): 4 in the CVS group (20.0%), 2 in the AM group (25.0%), and 3 in the BPVC group (18.8%). Conclusion : The significant time lag between the age at symptom onset and final diagnosis possibly indicates poor knowledge of CPS among pediatric practitioners, especially in Korea. A high index of suspicion may be the first step toward caring for these patients. Furthermore, a population-based longitudinal study is necessary to determine the incidence and natural course of these syndromes.