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Diastolic Function in Patients with Hypertrophic Cardiomyopathy: Evaluation Using the Phase-contrast MRI Measurement of Mitral Valve and Pulmonary Vein Flow Velocities (비대성심근증 환자의 이완기능평가: 승모판과 폐정맥 유속을 측정한 위상차 MRI의 이용)

  • Kim, Eun Young;Choe, Yeon Hyeon;Kim, Sung Mok;Lee, Sang-Chol;Chang, Sung-A;Oh, Jae K.
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.4
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    • pp.314-322
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    • 2014
  • Purpose: Diastolic dysfunction is a common problem in patients with hypertrophic cardiomyopathy (HCM). The purpose of this study was to assess the role of MRI in the assessment of diastolic function using mitral valve and pulmonary vein flow velocities in HCM patients. Methods and Results: Phase-contrast MRI (mitral valve and pulmonary vein) and transthoracic echocardiography was successfully performed for 59 HCM patients (44 men and 15 women; mean age, 51 years). Forty-nine patients had a diastolic dysfunction; grade 1 (n = 20), grade 2 (n = 27), and grade 3 (n = 2) using echocardiography, and ten patients had normal diastolic function. The transmitral inflow parameters (E, A, and E/A ratios) obtained by MRI showed positive correlation with the same parameters measured by echocardiography (Pearson's r values were 0.47, 0.60, and 0.75 for E, A, E/A, respectively, all P < 0.001). With the flow information of the pulmonary vein from cardiac MRI, pseudo-normalized pattern (n = 8) could be distinguished from true normal filling pattern (n = 17), and the diastolic function grades by cardiac MRI showed moderate agreement with those of echocardiography (kappa value = 0.45, P < 0.001). Conclusions: Assessment of left ventricle diastolic function is feasible using phase-contrast MRI in HCM patients. Analysis of pulmonary vein flow velocity on MRI is useful for differentiating pseudo-normal from normal diastolic function in HCM patients.

One Year Follow-up for Successfully Treated Children with Accommodative Dysfunction (조절이상이 성공적으로 치료된 어린이에 대한 1년 후의 추적검사)

  • Shin, Hoy Sun;Youk, Do Jin;Sung, Duk Yong;Park, Sang Chul;Lee, Sun Haeng
    • Journal of Korean Ophthalmic Optics Society
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    • v.15 no.2
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    • pp.169-174
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    • 2010
  • Purpose: The purpose of this study is to evaluate the long-term stability of the improved symptoms and accommodative functions after completion of accommodative therapy. Methods: Seven children (mean age${\pm}$SD: $12{\pm}1.41$ years) who were successfully treated with a vision therapy program for either accommodative insufficiency or infacility were followed for 1 year. The visual symptoms of the subjects were measured by the College of Optometrists in Vision Development Quality of Life (COVD-QOL) checklist, and this was followed by measurement of the monocular and binocular accommodative facility with ${\pm}2.00$ D flipper lens. Results: The mean visual symptoms at the 1 year follow-up examination ($15.14{\pm}8.59$) showed a small increase, but there was no significant difference (p=0.446) from post-therapy ($11.86{\pm}7.22$). There was small regression in the monocular (left eye, $13.86{\pm}3.93cpm$) and binocular ($11.14{\pm}3.13cpm$) accommodative facility at the 1 year follow-up examination, but there were no significant different from the monocular ($15.86{\pm}4.14cpm$, p=0.147) and binocular ($13.21{\pm}3.76cpm$, p=0.066) accommodative facility measurements at post-therapy. Also, every subject met the normative values of ${\geq}7$ cpm for monocular accommodative facility and ${\geq}5$ cpm for binocular accommodative facility in the long-term. Conclusions: There was long-term maintenance of the improved visual symptoms and accommodative functions, and so it is clear that the positive therapeutic effects persist with accommodative therapy.

Significance of brain magnetic resonance imaging(MRI) in the assessment of occupational manganese exposure (직업적 망간 폭로에 있어서 뇌자기공명영상의 의의)

  • 정해관
    • Investigative Magnetic Resonance Imaging
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    • v.2 no.1
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    • pp.14-30
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    • 1998
  • Manganese is an essential element in the body. It is mainly deposited in the liver and to a lesser degree in the basal ganglia of the brain and eliminated through the bile duct. Rapid turnover of managanese in the body makes it difficult to evaluate the manganese exposure in workers, esecially in those with irregular or intermittent exposure, like welders. Therefore, conventional biomarkers, including blood and urine manganese can provide only a limited information about the long-tern or cumulative exposure to manganese. Introduction of magnetic resonance imaging (MRI) made a progress in the assessment of manganese exposure in the medical conditions related to manganese accumulation, e. g. hepatic failure and long-term total parenteral nutrition. Manganese shortens spin-lattice(T1) relaxation time on MRI due to its paramagnetic property, resulting in high signal intensity (HSI) on T1-weighted image(T1W1) of MRI. Manganese deposition in the brain, therefore, can be visualizedas an HSI in the globus pallidus, the substantia nigra, the putamen and the pituitary. clinical and epidemiologic studies regarding the MRI findings in the cases of occupational and non-occupational manganese exposure were reviewed. relationships between HSI on T1W1 of MRI and age, gender, occupational manganese exposure, and neurological dysfunction were analysed. Relationships betwen biological exposure indices and HSI on MRE werealso reviewed. Literatures were reviewed to establish the relationships between HSI, Manganese deposition in the brain, pathologic findings, and neurological dysfunction. HSI on T1W1 of MRI reflects regional manganese deposition in the brain. This relationship enables an estimation of regional manganese deposition in the brain by analysing MR signal intensity. Manganese deposition in the brain can induce a neuronal loss in the basal ganglia but functional abnormality is supposed to be related to the cumulative exposure of manganese in the brain, use of brain MRI for the assessment of exposure in a group of workers seems to be hardly rationalized, while ti can be a useful adjunct for the evaluation of manganese exposure int he cases with suspected manganese-related health problems.

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Clinical Applications and Efficacy of Korean Ginseng (고려인삼의 주요 효능과 그 임상적 응용)

  • Nam, Ki-Yeul
    • Journal of Ginseng Research
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    • v.26 no.3
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    • pp.111-131
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    • 2002
  • Korean ginseng (Panax ginseng C.A. Meyer) received a great deal of attention from the Orient and West as a tonic agent, health food and/or alternative herbal therapeutic agent. However, controversy with respect to scientific evidence on pharmacological effects especially, evaluation of clinical efficacy and the methodological approach still remains to be solved. Author reviewed those articles published since 1980 when pharmacodynamic studies on ginseng have intensively started. Special concern was paid on metabolic disorders including diabetes mellitus, circulatory disorders, malignant tumor, sexual dysfunction, and physical and mental performance to give clear information to those who are interested in pharmacological study of ginseng and to promote its clinical use. With respect to chronic diseases such as diabetes mellitus, atherosclerosis, high blood pressure, malignant disorders, and sexual disorders, it seems that ginseng plays preventive and restorative role rather than therapeutics. Particularly, ginseng plays a significant role in ameliorating subjective symptoms and preventing quality of life from deteriorating by long term exposure of chemical therapeutic agents. Also it seems that the potency of ginseng is mild, therefore it could be more effective when used concomitantly with conventional therapy. Clinical studies on the tonic effect of ginseng on work performance demonstrated that physical and mental dysfunction induced by various stresses are improved by increasing adaptability of physical condition. However, the results obtained from clinical studies cannot be mentioned in the indication, which are variable upon the scientist who performed those studies. In this respect, standardized ginseng product and providing planning of the systematic clinical research in double-blind randomized controlled trials are needed to assess the real efficacy for proposing ginseng indication. Pharmacological mode of action of ginseng has not yet been fully elucidated. Pharmacodynamic and pharmacokinetic researches reveal that the role of ginseng not seem to be confined to a given single organ. It has been known that ginseng plays a beneficial role in such general organs as central nervous, endocrine, metabolic, immune systems, which means ginseng improves general physical and mental conditons. Such multivalent effect of ginseng can be attributed to the main active component of ginseng,ginsenosides or non-saponin compounds which are also recently suggested to be another active ingredients. As is generally the similar case with other herbal medicines, effects of ginseng cannot be attributed as a given single compound or group of components. Diversified ingredients play synergistic or antagonistic role each other and act in harmonized manner. A few cases of adverse effect in clinical uses are reported, however, it is not observed when standardized ginseng products are used and recommended dose was administered. Unfavorable interaction with other drugs has also been suggested, which the information on the products and administered dosage are not available. However, efficacy, safety, interaction or contraindication with other medicines has to be more intensively investigated in order to promote clinical application of ginseng. For example, daily recommended doses per day are not agreement as 1-2g in the West and 3-6 g in the Orient. Duration of administration also seems variable according to the purpose. Two to three months are generally recommended to feel the benefit but time- and dose-dependent effects of ginseng still need to be solved from now on. Furthermore, the effect of ginsenosides transformed by the intestinal microflora, and differential effect associated with ginsenosides content and its composition also should be clinically evaluated in the future. In conclusion, the more wide-spread use of ginseng as a herbal medicine or nutraceutical supplement warrants the more rigorous investigations to assess its effacy and safety. In addition, a careful quality control of ginseng preparations should be done to ensure an acceptable standardization of commercial products.

HyungSang Medical Approach to Phlegm-Fire (담화(痰火)에 대한 형상의학적(刑象醫學的) 고찰)

  • Kim, Jong-Won;Jun, Soo-Hyung;Ji, Gyu-Yong;Kim, Kyung-Chul;Lee, In-Sun;Lee, Tae-Sik;Kim, Kyu-Kon;Lee, Yong-Tae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.1
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    • pp.1-6
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    • 2009
  • Many of our contemporaries suffer from the symptoms of phlegm-fire, which is caused by stress, processed food, heavy diet, and unseasonal fruits and vegetables. With consultations from 'Euihaklpmoon', 'DongeuiBogham', and 'Ji-San's clinical lectures' this research, which is mainly focused on phlegm-fire, concluded as following. Phlegm-fire is caused by congestion of seven emotions, congestion of qi, complication of phlegm on fire, depletion of body fluids after long periods of disease, heavy diet, or congenital unbalance of yin-yang and qi-hyul. Concentration of phlegm-fire on the head causes headache, dizziness, frontal headache, tinnitus, and auditory dysfunction. The patient usually complains breaking pain. Dhamhwabang of Yijin-tang, Chunghoonhwadham-tang, and Yijin-tang variation for right headache can be used. Concentration of phlegm-fire on the thorax causes insomnia, palpitation, and insanity. Samhoohndham-tang variation, Chungsimgondhanhwan can be used. Concentration of phlegm-fire on the gastric region causes reflux of gastric acid, eructation, vomiting, abdominal discomfort, dysmenorrhea, and fluor gentalis. Yijin-tang variation for abdominal discomfort, Yanghyulsamul-tang, Hwadhamchunghwa-tang can be used. Shin type or Gi type, female with prevalence of qi and tendency of fire, female with dark facial color, female with raised eye tails and large noses, female with pointed noses, and male or female with large noses and mouths are likely to possess phlegm-fire. Abdominal discomfort of male with thick eyebrow and headache of Gi type female is usually caused by phlegm-fire.

A Study on Perceived Family Support and Anxiety in Hemiplegic Patients (편마비 환자가 지각한 가족지지와 불안과의 관계 연구)

  • 이명해;강현숙
    • Journal of Korean Academy of Nursing
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    • v.21 no.1
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    • pp.50-62
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    • 1991
  • The purposes of this study were to identify causal factors of Anxiety and to analyze correlation between perceived family support and anxiety in hemiplegic patients. The subjects of this study were 88 hospitalized hemiplegic patients at Kyung - Hee Oriental medicine Hospital. Data were collected by using interview with questionaire from Jan. 15 to Mar, 31, 1990. The measurement tools used by this researcher were Kang's family support scale, Spielberger's trait anxiety scale and the other anxiety scale which was developed by this researcher, approved it's reliability and validity. For the purposes of the study, the collected data were analyzed by frequency, t-test, ANOVA and the hypothesis was tested by pearson correlation, partial correlation. The results of the study were as follow. 1) The analysis of causal factor of anxiety higher anxiety these three cases ; \circled1 1st causal factor was the delayed recovery of paralyzed upper limbs(2.42$\pm$1.27). \circled2 End causal factor was the dysfunction of physical ability(2.30$\pm$1.29). \circled3 3rd causal factor was difficulty for walking(2.30$\pm$0.83) and the anxiety level(2.02$\pm$0.83) of physical factor was the highest level than any other factors. 2) The hypothesis that the more perceived family support level is the less anxiety level of patient was supported(r=-.29, p=.003). 3) The analysis of the general characteristics exerting influences on anxiety level patients ; (sex, age, marrital status, religious, education level, occupation, economic status, experience of hospitalization, care giver, the period of hospitalizatiot side of paralysis). In this analysis, any factor has not a statistical significance.(p>.05). 4) The analysis of the relationship about effective factors of family support level by the general characteristics of patient (sex, age, marrital status, religious, education level, occupation, economic status, experience of hospitalization, care giver, the period of hospitalization, side of paralysis). In this analysis, there was significant difference on perceived family support between married and bereaved patients(t=-2.68, p= .009) As a result of this study, anxiety level of physical factor was higher than any other factors (psychological factor, social factor) and the delayed recovery of paralyzed upper limbs is the largest causal factor of anxiety of physical factor. Meanwhile, the relationship between the degree of family support and the level of anxiety was negatively correlated but the degree of relationship was low. Therefore, one can infer from this study that sufficient information about recovery of physical problems and family support were effective in preventing and reducing anxiety in hemiplegic patient.

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A New Approach to the Whole Body Intervention Program(General Coordinative Manipulation Program) of Nonspecific Back Disorder

  • Moon Sang-Eun
    • The Journal of Korean Physical Therapy
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    • v.15 no.4
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    • pp.112-128
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    • 2003
  • Since areas of pain and dysfunction of musculoskeletal typically suffered by the patients with back disorders spread all over the body, WBIP(GCM Program) for the primary treatment and management is required. The purpose of this study is to analyze if WBIP(GCM Program) based on the hyper/hypomobility pattern of Four Body Types can identify the effective treatment of back disorders and the effect on the postural balanced restoration of the spine and extremities. Non-specific back disorder is still a major reason for sick leave. And moreover, its been reported that there was often recurrence to the patients whose symptom had been diminished. As a WBIP(GCM Program) based on kinematic chain patterns of Four Body Types, this study gave a new information on the effective diagnosis, treatment and management of non-specific back disorders. 337 patients above the twenty-five years old with the non-specific back disorders at the hospital and oriental medical clinics at Kyungnam and Busan areas in South Korea from August 24th, 2000 to Feb 23rd, 2001 have randomly been assigned to four experimental groups such as Whole Body Intervention Program Group, Physical Therapy Group like modality treatments, Acupuncture-Treatment Group, and Placebo Control Group. According to intervention program applied to the each four group for three times per week(twelve times per 4weeks), as the time-series methods, we compared and evaluated the body status of the pretest with that of post treatment completion of four week, three month, and six month, respectively. As the analytical method of measurement, our researchers used the Moire Interferometry Unit and Postural Kit that could measure the postural balance of spine and extremities. The collection of data was performed in the designated hospital and oriental medical clinics. For the analysis of the data, the SPSS 10.0 package program was used. X2-test has been taken in order to compare and analyze characteristics and GPES of the patients in four experimental groups. Repeated Measure ANOVA and Tukey post hoc test has been adopted in order to compare the effects of the balanced restoration of the spine and extremities among four Groups categorized for this study. Statistical significance was accepted at the 0.05 level of confidence The effect of the balanced restoration on the spine and extremities of the patients with non-specific back disorders has been proved in all of the Groups. As for the restoration degree, however, WBIP(GCM Program) Group produced the highest effectiveness in terms of the fact that it had a dense moire in comparison with the other three Groups and that the Moires of both sides had the same level by the time(p<0.01). WBIP(GCM Program) based on four tilting types of scapular and ilium and hyper/hypomobility pattern took a higher effect on the balanced restoration of the spine and extremities through a whole body as well as the treatment of back disorders than the other three Groups which the usual remedy without classification of body type had been applied to.

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A Study on the Clinical Characteristics of Patients with Dry Mouth (구강건조증 환자의 임상적 특징에 관한 연구)

  • Oh, Jeong-Kyu;Kim, Youn-Joong;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.26 no.4
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    • pp.331-343
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    • 2001
  • Advances in medical procedures and utilization of medication have resulted in expanding aged population, which leads to increased aged patients with salivary hypofunction and its associated symptoms in dental clinic. The purpose of this study was to investigate clinical characteristics of patients with dry mouth and its correlation with their salivary flow rate. Forty dry mouth patients (7 males, 33 females, mean age 42.0 years) whose flow rate of unstimulated whole saliva was less than 0.15 ml/min were included and their gender- and age-matched controls (7 males, 33 females, mean age 42.9 years) who did not report any complaints, suggestive of salivary gland dysfunction and had the flow rate of greater than 0.20 ml/min were included for comparison. The salivary flow rate was measured in both unstimulated and stimulated conditions. Dry mouth-related clinical information including history, dry mouth associated symptoms, exacerbating and relieving factors, drugs, systemic diseases, and family history was investigated using questionnaires. The differences in distribution of patients and control subjects to each question and their relation to the salivary flow rate were analyzed and we came to following conclusions. 1. There were statistically significant differences in the distribution of patients and controls to the following questions: the period and frequency of suffering from dry mouth; severity of dry feeling during a meal; severity of discomfort during swallowing; necessity of sipping liquids during swallowing dry foods, severity of discomfort in usual life due to dry feeling; self-assessment of residual salivary volume; taking medications. 2. The patients had more stress-related medical histories including indigestion, insomnia, and gastritis compared with controls. The patients took many kinds of medications to control their systemic diseases. 3. There were statistically significant differences in the salivary flow rate between different groups of patients to following questions: severity of dry feeling during a meal; severity of discomfort during swallowing; necessity of sipping liquids during swallowing dry foods. The difference was more significant in the case of stimulated salivary flow rate rather than unstimulated one. 4. The salivary flow rate of patients taking medications was significantly less than that of patients who did not take medications. The difference was more significant in the case of stimulated salivary flow rate rather than unstimulated one.

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The Relationship between Sleep Quality and Clinical Features of Adolescents with Temporomandibular Disorder

  • Park, Yang Mi;Lee, Sunhee;Kim, Kyung-Hee;Ahn, Yong-Woo;Jeong, Sung-Hee;Ok, Soo-Min
    • Journal of Oral Medicine and Pain
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    • v.43 no.2
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    • pp.27-33
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    • 2018
  • Purpose: Many researchers have established a connection between sleep disturbances and the symptoms of temporomandibular disorder (TMD) in adults, but there are a few studies targeted at adolescents with TMD. The aim of this study was to analyze the sleep pattern of adolescents with TMD and to determine the effect of poor sleep quality on their clinical symptoms. Methods: The subjects were composed of 47 adolescents with TMD. The sleep pattern and preliminary information of patients were measured by self-reported questionnaires; Pittsburgh Sleep Quality Index (PSQI) and Questionnaire for TMD analysis. TMD pain was scored using the Numerical Rating Scale. The Kruskal-Wallis test, Mann-Whitney U test, Fisher's exact test and logistic regression were used for statistical analysis. Results: The poor sleeping group had statistically more females (25.00% males, 75.00% females) than the good sleeping group. As compared with that of good sleepers, sleep quality of poor sleepers was significantly worse in the items of subjective sleep quality, sleep latency, sleep duration, sleep disturbances, daytime dysfunction and global PSQI score. The sleep time of adolescents was much longer during vacation ($7.20{\pm}1.38hours$) than during school days ($6.10{\pm}1.26hours$). Poor sleep of patients was associated with the pain in the ear or in front of the ear, in the face, jaw, throat or temple and in neck or back. Adolescents with pain in those areas had significantly higher proportion of poor sleepers than adolescents with no pain in those areas. Conclusions: The high ratio of girls in poor sleeping group could reflect the greater prevalence of TMD in women than in men. Pain in peri-temporomandibular joint areas, neck or back could negatively influence sleep quality of adolescents with TMD.

Protective Effects of Traditional Korean Medicine Preparations, Herbs, and Active Compounds on the Blood-brain Barrier in Ischemic Stroke Models (허혈성 뇌졸중 모델에서 혈액-뇌 장벽에 보호효과를 나타내는 한약처방, 한약재 및 활성화합물)

  • Shin, Su Bin;Jang, Seok Ju;Lee, Na Gyeong;Choi, Byung Tae;Shin, Hwa Kyoung
    • Journal of Life Science
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    • v.32 no.7
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    • pp.550-566
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    • 2022
  • Stroke is among the leading causes of death and long-term physical and cognitive disabilities worldwide, affecting an estimated 15 million people annually. The pathophysiological process of stroke is complicated by multiple and coordinated events. The breakdown of the blood-brain barrier (BBB) in people with stroke can significantly contribute to the development of ischemic brain injury. Therefore, BBB disruption is recognized as a hallmark of stroke; thus, it is important to develop novel therapeutic strategies that can protect against BBB dysfunction in ischemic stroke. Traditional medicines are composed of natural products, which represent a promising source of new ingredients for the development of conventional medicines. Indeed, several studies have shown the effectiveness of Korean medicine on stroke, highlighting the value of Korean medicinal treatment for ischemic stroke. This review summarizes the current information and underlying mechanisms regarding the ameliorating effects of the formula, decoction, herbs, and active components of traditional Korean medicine on cerebral ischemia-induced BBB disruption. These traditional medicines were shown to have protective effects on the BBB in many cellular and animal ischemia models of stroke, and experiments in various animal species, such as mice and rats. In addition, they showed brain-protective effects by protecting the BBB through the regulation of tight junction proteins and matrix metalloproteinase-9, reducing edema, neuroinflammation, and neuronal cell death. We hope that this review will help promote further investigation into the neuroprotective effects of traditional Korean medicines and stimulate the performance of clinical trials on Korean herbal medicine-derived drugs in patients with stroke.