• THE JOURNAL OF KOREAN ORIENTAL ONCOLOGY
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• v.6 no.1
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• pp.113-123
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• 2000

Carcinous pain is severe and continuous so difficult to alleviate. Western drugs give rise to reaction such as anorexia, constipation, vomiting, general weakness and dyspnea, And they cause tolerence. External treatment is a way to put a patch or rub a liquid on the skin. The patch and liquid are made from herb medicine. In china, they have a good effect of alleviating carcinous pain to make use of external treatment. Usually they use the medicine with effect of reprecussion (消腫), removing obstruction(散結), activating blood flow and removing blood stasis (活血化瘀) such like Borneloum(?片). Bufonis Venenum (蟾?), Aconiti ciliane Tubber(草烏), Arisaematis Rhizoma(南星), Asari herba cum Radice (細辛) etc. We can get the alleviating effect more quickly and prevent reaction through external treatment.

• Nutritional Sciences
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• v.9 no.4
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• pp.288-294
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• 2006

In this study, the effects of smoking cessation and relative antioxidant activities on the oxidative stress were determined by using in vitro method. Thirty healthy smokers who were free of any disease and smoked more than 1 pack per day for the past 10 years participated in this study. For smoking cessation, smokers were asked to wear nicotine patch (21mg nicotine/ patch) everyday for 30 days and then to replace at the same time of the day. Smoking cessation program in conjunction with nicotine patch replacement was also conducted every week, one hour/each session, for 4 weeks. Canthaxanthin, $\beta-carotene$, and $\alpha-tocopherol$ were added into red blood cells at pre and post smoking cessation. As indicators of oxidative stress, hemoglobin degradation, lipid peroxidation, and percent hemolysis were determined at both pre and post smoking cessation. After 30 days of smoking cessation, the subjects gained an average of 5 pounds, varying 2 to 8 pounds, by suggesting that behavioral problems rather than nicotine itself are more important for gaining weight in ex-smokers. The total hemoglobin concentrations in blood were similar in pre and post smoking cessation, but smoking cessation resulted in a decrease in the percentage of methemoglobin from 0.96% to 0.85% Smoking cessation also caused to decease malondialdehyde (MDA) values ($26.7{\pm}7.8$ vs. $23.6{\pm}4.5$ (without oxidation), $179.3{\pm}21$ vs. $161.2{\pm}28$ nmol/ml (with oxidation) (p<0.05)), not percent hemolysis. Various antioxidants with smoking cessation significantly decreased MDA values(p<0.05), in contrast to marginal decrease of MDA in smoking cessation only. Three antioxidants used in this stu study were similarly effective in inhibiting MDA production, but relative effectiveness of canthaxanthin or $\alpha-tocopherol$ was greater than that of $\beta-carotene$ (p<0.05), in case of oxidation induced. The percent hemolysis was greatly decreased when antioxidants were added into the blood of ex-smokers (p<0.05) but no statistical significance in relative effectiveness of antioxidants was observed.

• The Korean Journal of Pain
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• v.35 no.2
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• pp.224-230
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• 2022

Background: An epidural blood patch (EBP) is a procedure to treat intracranial hypotension that does not respond to conservative treatment. EBPs are commonly repeated when the symptoms persist. In this study, we used a large single-center retrospective cohort and evaluated the factors associated with repeated EBPs. Methods: From January 2010 to December 2020, a total of 596 patients were treated with EBPs for intracranial hypotension. We evaluated the factors associated with repeated EBPs in the entire population, in patients with spontaneous intracranial hypotension (SIH), and in those with available myelographies. Results: In a total of 596 patients, 125 (21.1%) patients required repeated EBPs, and 96/278 (34.5%) in SIH and 29/314 (9.2%) in iatrogenic population. In patients with SIH, international normalized ratio (INR) and cerebrospinal fluid (CSF) leakage on myelographies consistently exhibited significant associations (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.02-1.87; P = 0.043 and OR, 2.18; 95% CI, 1.28-3.69; P = 0.004). In patients with iatrogenic injury, INR and CSF leakage on myelogram did not show difference in repeated EBPs. Conclusions: Repeated EBPs may be more frequently required in patients with SIH. Prolonged INR and CSF leakage were associated with repeated EBPs in patient with SIH. Further studies are needed to determine factors associated with repeated EBP requirements.

• The Korean Journal of Pain
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• v.20 no.2
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• pp.235-239
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• 2007

Spontaneous intracranial hypotension (SIH) is believed to be a benign disease. However, numerous studies have reported serious complications related to SIH, including subdural hematoma. In this case report, a 54-year-old male patient visited the emergency room with orthostatic headache. A brain magnetic resonance imaging (MRI) study showed diffuse mild thickening and enhancement of pachymeninges, with a suspicious minimal amount of subdural fluid collected in the left posterior parietal area. His orthostatic headache showed no improvement with conservative treatment; but his pain was almost completely relieved after two trials of cervical epidural blood patch. On the 74th day after the onset of his pain, the patient showed a drowsy mental status and slurred speech when he visited the pain clinic. Brain computerized tomography indicated a left subdural hemorrhage, and he underwent emergency operation to drain the SDH. In conclusion, pain clinicians should pay attention to abrupt changes in mental status as well as continuous headache, for the early diagnosis of SDH in SIH patients.

• Journal of Pharmaceutical Investigation
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• v.35 no.4
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• pp.273-278
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• 2005

Nicotine transdermal therapeutic systems $(TTS_S)$ have been regarded as an effective mean to aid smoking cessation. However, most of nicotine $TTS_S$ in the market have some problems such as unpleasant side effects and skin irritation due to the excess amount of the drug permeated and the properties of the additives employed. In order to solve these problems, new nicotine $TTS_S$ were formulated using biocompatible additives. The optimized formula of the drug layer consisted of nicotine, propylene glycol and poloxamer 188 at the ratio of 1.2: 17.0: 2.0. The drug layer had the sickness of $1,250\;{\mu}m$, the pH of 8.12. The skin permeation rate of nicotine from optimized nicotine patch (NP) was $21.5\;{\mu}g/cm^2/h$. Transdermal administration of nicotine patch has been carried out for the determination of pharmacokinetic parameters in rats. Steady-state plasma concentration of nicotine following transdermal application of NP (area of patch = $15\;cm^2$) on the dorsal skin of rats was 143.2 ng/ml and AUC for 24 hrs was 3,022 ng h/ml. In case of $EXODUS^{\circledR}$ and Nicotinell $TTS^{\circledR}$, the steady-state plasma concentration of nicotine and ACU for 24 hrs were 428.9 ng/ml, $9,121\;ng{\cdot}hr/ml$ and 155.3 ng/ml, $3,152\;ng{\cdot}h/ml$, respectively. NP showed the experimental plasma nicotine concentration profile was very similar to the simulated one and had an appropriate skin permeation rate and a steady-state concentration of nicotine, which can show therapeutic blood levels of the drug for 24 hrs without severe side effects.

• The Korean Journal of Pain
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• v.18 no.1
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• pp.60-63
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• 2005

This report describes the successful treatment of spontaneous intracranial hypotension (SIH) with multiple cerebrospinal fluid (CSF) leaks using 10 applications of epidural blood patches (EBP). A forty year old female who suffered with a postural headache was diagnosed as having SIH. On the cisternography, multiple CSF leaks were noted at the thoracic and lumbar area. Her headache was not improved with conservative treatments such as bed rest, hydration and NSAIDS. So, she underwent treatment with EBPs. After 10 applications of site-directed EBPs, her headache was resolved gradually and completely without any complications.

• Journal of Pharmaceutical Investigation
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• v.27 no.4
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• pp.303-311
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• 1997

Proliposomal patch of clenbuterol, ${\beta}_2-agonist$ bronchodilator, was prepared and its feasibility as a novel transdermal drug delivery system was examined. Proliposomal granules containing clenbuterol was prepared by a standard method using sorbitol and lecithin with (Rx 2) or without cholesterol (Rx 1). The porous structure of sorbitol in the proliposomes was maintained allowing tree flowability of the granules. Following contact with water, the granules were converted probably to liposomes almost completely within several minutes. It indicates that proliposomes may be hydrated, when they are applied on the skin under occlusive condition in vivo, by the sweat to form liposomes. Clenbuterol release from Rx 1 and Rx 2 proliposomes to pH 7.4 isotonic phospate buffer (PBS) across cellulose membrane (mol. wt. cut-off of 12000-14000) was retarded significantly compared with that from the mixture of clenbuterol powder and blank proliposomes. Interestingly, proliposomes prepared with lecithin and cholesterol (i.e., Rx 2 proliposomes) showed much more retarded release of clenbuterol than proliposomes prepared only with lecithin (i.e.. Rx 1 proliposomes), indicating that clenbuterol release from proliposomes can be controlled by the addition of cholesterol to the proliposomes. Proliposomal patches were prepared using PVC film as an occlusive backing sheet, two sides adhesive tape (urethane, 1.45 mm thickness) as a reservoir for proliposome granules and Millipore MF-membrane (0.45 mm pore size) as a drug release-controlling membrane. Rx 1 or Rx 2 proliposomes containing 4.6 mg of clenbuterol were loaded into the reservoir of the patch. Clenbuterol release from the patches to pH 7.4 PBS was determined using USP paddle (50 rpm)-over-disc release method. Clenbuterol release from the proliposomal patches was much more retarded even than from a matrix type clenbuterol patch (Boehringer Ingelheim ltd). Being consistent with clenbuterol release from the proliposomal granules, the release from the patches was highly dependent on the presence of cholesterol in the proliposomes : Patches containing Rx 2 proliposomes showed several fold slower drug release than patches containing Rx 1 proliposomes. When the patch containing Rx 1 proliposomes was applied on to the back of a hair-removed rat, clenbuterol concentration in the rat blood was maintained during 6-72 hrs. Transdermal absorption of clenbuterol from the patch was accelerated when the patch was prehydrated with 50 ml of pH 7.4 PBS before topical application. Above results indicate that sustained transdermal delivery of clenbuterol is feasible using proliposomal patches if the cholesterol content and pore size of the release rate-controlling membrane of patches, for example, are appropriately controlled.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.338-342
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• 1998

Postural headache due to spontaneous intracranial hypotension occurs without any diagnostic lumbar puncture, myelography, cranial or spinal injury, or spinal anesthesia. The clinical characteristics of the syndrome are disappearance of the headache or a notable decrease in its severity with recumbency, the finding of meningeal enhancement and subdural fluid collection on brain MRI, the pleocytosis and the increased CSF protein concentration. We report a case of a 40-year-old woman who exhibited the signs and symptoms of postural headache due to low CSF pressure. Her headache started suddenly at the occiput and radiated to frontal head. Magnetic resonance imaging (MRI) of her brain showed enhancement of the meninges and subdural fluid collection. Intrathecal radionuclide cisternography showed the delayed appearance of the isotope in the cranium and the minimal CSF leak at the left upper thoracic region. Her headache was relieved completely after a lumbar (L2-L3) epidural injection of 12 ml of autologous blood and remained asymptomatic.

• The Korean Journal of Pain
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• v.30 no.2
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• pp.93-97
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• 2017

The sphenopalatine ganglion (SPG) is a parasympathetic ganglion, located in the pterygopalatine fossa. The SPG block has been used for a long time for treating headaches of varying etiologies. For anesthesiologists, treating postdural puncture headaches (PDPH) has always been challenging. The epidural block patch (EBP) was the only option until researchers explored the role of the SPG block as a relatively simple and effective way to treat PDPH. Also, since the existing evidence proving the efficacy of the SPG block in PDPH is scarce, the block cannot be offered to all patients. EBP can be still considered if an SPG block is not able to alleviate pain due to PDPH.

• Journal of Chest Surgery
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• v.31 no.7
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• pp.718-721
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• 1998

The surgical closure of VSD in patient with severe pulmonary hypertension has been considered a difficult problem for surgeons, because sudden hemodynamic change after closure of the defect could bring on high perioperative mortality. Recently, it was reported that UVP(unidirectional valve patch), which allows some blood to flow from right to left in case of acute right heart failure, is effective in improving the postoperative hemodynamics after closing septal defects. This 42-year old woman had suffered from VSD for 20 years and recently complained of worsening exertional dyspnea for three months, and was diagnosed of a large VSD(2.0 cm in diameter) with severe pulmonary hypertension(116/38 mm Hg), equal to systemic arterial pressure. We could successfully close VSD with severe pulmonary hypertension using one UVP and the other UVP for the creative ASD to be prepared against possible acute right heart failure. She was discharged on the fourteenth postoperative day and has been well for twelve months with spontanenous closure of UVP patch at the ninth postopeative month.