• The Korean Journal of Pain
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• v.34 no.3
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• pp.304-314
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• 2021

Background: The study investigated virtual reality (VR) immersion in alleviating procedure-related pain in patients with chronic pain undergoing fluoroscopy-guided minimally-invasive intervention in a prone position at an outpatient clinic. Methods: In this prospective randomized controlled study, 38 patients undergoing lumbar sympathetic ganglion block were randomized into either the VR or the control group. In the VR group, procedure-related pain was controlled via infiltration of local anesthetics while watching a 30-minute VR hypnotic program. In the control group, the skin infiltration alone was used, with the VR device switched off. The primary endpoint was an 11-point score on the numerical rating scale, indicating procedure-related pain. Patients' satisfaction with pain control, anxiety levels, the need for additional local anesthetics during the procedure, hemodynamic stability, and any adverse events were assessed. Results: Procedure-related pain was significantly lower in the VR group (3.7 ± 1.4) than in the control group (5.5 ± 1.7; P = 0.002). Post-procedural anxiety was lower in the VR group than in the control group (P = 0.025), with a significant reduction from pre-procedural anxiety (P < 0.001). Although patients' satisfaction did not differ significantly (P = 0.158) between the groups, a higher number of patients required additional local anesthetics in the control group (n = 13) than in the VR group (n = 4; P = 0.001). No severe adverse events occurred in either group during the study. Conclusions: VR immersion can be safely used as a novel adjunct to reduce procedural pain and anxiety during fluoroscopic pain intervention.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.9 no.1
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• pp.46-50
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• 2013

Developmental disorders are a group of psychiatric conditions originating in childhood that involve serious impairments in different areas. These disorders comprise language disorders, learning disorders, motor disorders and autism spectrum disorders. Midazolam is a short-acting drug in the benzodiazepine class developed by Hoffmann-La Roche in the 1970s. The drug is used for treatment of acute seizures, moderate to severe insomnia, and for inducing sedation and amnesia before medical procedures. It possesses profoundly potent anxiolytic, amnestic, hypnotic, anticonvulsant, skeletal muscle relaxant, and sedative properties. The anterograde amnesia property of midazolam is useful for premedication before surgery to inhibit unpleasant memories. This article presents a case report including caries treatment of a 8-year-old male patient with developmental disorders using oral midazolam premedication as an alternative method of behavior management prior to general anesthesia.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.1 no.1
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• pp.130-147
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• 1990

This study intended to investigate the characteristics of adolescent drug user in Korea. A questionnaire on adolescent drug use was administered to 1st or 2nd grade 898 students (465 males, 433 females) from 9 senior high schools in Seoul area. The extent of current using six representative drugs such as cigarettes, alcohol, chemical substance inducing hallucination(e,g., thinner, bond etc.), psychostimulant, hypnotic and minor tranqulizer was self-reported. Also their psychological distress, self-concept and individual-related variables such as academic grade, deviant behavior, drug-using peers, the perceived availability of drugs, the degree of family discipline, and the perceived parents' attitude for drinking and smoking were surveyed. Subjects were grouped into six(male) or five(female) subgroups (nonuser, simple experiencer, one kind of drug user, two kinds of drugs user, three kinds of drugs user(male only), minor tranqulizer user) to their extent of drug use. Then ANOVA procedure performed for group comparison of their psychological distress, self-concept and individual-related variables. The results showed that the most popular drugs among adolescents in Korea were cigarettes and alcohol. Minor tranqulizer was used by about 2.8% of male and 7.41% of female subjects. In general abusers showed lower academic grade, more deviant experiences, having more drug-using peers, higher degree of psychological distress, and lower postitive self-concept than nonuser group. According to the results of discriminant analysis, hostility and deviant behavior were reliable predictive variables that distinguished abuser group from nonuser group among the associated variables in this study. These results suggest that some common factors affect drug use of Korean high school students : high school students who have many common risk factors could be abusers more easily. These findings supported risk factor theory that the extent of drug use of adolescents might be associated with general maladjustment in everyday life.

• Journal of Life Science
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• v.30 no.3
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• pp.278-284
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• 2020

Magnolia kobus is known to exert various biological effects, such as antioxidant and hypnotic activity. In this study, we investigated the antimicrobial and anti-inflammatory activity of M. kobus essential oil extracted using steam distillation. Its antimicrobial activity was tested against Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa by the paper disk diffusion and minimum inhibitory concentration (MIC) methods. Its anti-inflammatory activity was evaluated by measuring its inhibition ratio on the production of nitric oxide (NO) and PGE₂ in lipopolysaccharide (LPS)-induced RAW264.7 cells. Its composition was analyzed by gas chromatography-mass spectrometry (GC-MS). The results showed that M. kobus essential oil exhibited excellent antibacterial activity against S. aureus, with a clear zone of 18 mm and an MIC value of 0.25 mg/ml. Its clear zones against P. aeruginosa and E. coli were 14 mm and 17 mm, respectively, while its MIC values were 1 mg/ml and 0.5 mg/ml, respectively. The essential oil exhibited no cytotoxicity to the RAW264.7 cells at a concentration of 500 ㎍/ml while showing NO (37.7%) and PGE₂ inhibition (24.0%). Its three main fragrance ingredients identified were 3-carene (77.07%), β-elemene (6.92%), and caryphyllene (2.86%). The results suggest that M. kobus essential oil has potential as a cosmetic functional material with antimicrobial and anti-inflammatory effects.

• Journal of Oriental Neuropsychiatry
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• v.20 no.3
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• pp.65-88
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• 2009

Objectives : There has not been the comparison research of medication on the Insomnia as the complementary significance of the Oriental-Western Cooperative Therapeutic Viewpoint so far. The aim of this preliminary research is to study Eastern and Western Medication Model for the Insomnia through the comparison of Oriental Medication based on "Sang Han Lon" and "Dong yui bo gam". Methods : The author researched oriental-western viewpoints and the present treatment condition of Sleep and Sleeping Pills with reference to Korean articles issued since 1975, dissertations, journals registered or candidated on KCI, alternative medicine journals on Pubmed, and books concerning Neuropsychiatry. In the field of Oriental medical study, this study was demonstrated on "The Oriental Medical textbook of neuropsychiatry", "Sang han lon", "Dong yui bo gam" and the present research trend. Results : In Oriental Medicine, Insomnia is treated according to si-jie-bu-shui-zung (思結不睡證) type, rong-xie-bu-zu-zung (榮血不足證) type, yin-her-nae-re-zung (陰虛內熱證) type, xin-dan-her-qie-zung (心膽虛怯證) type, dam-xian-yu-jie-zung (痰涎鬱結證) type, and wei-zhong-bu-he-zung (胃中不和證) type etc. In Western Medicine, Insomnia has been treated by Barbiturate over 60's and BZ over 70's. According to recent treatment on Insomnia, Zolpidem or Zaleplon, which is short-lived and has less side effects, is used much, and tri-cyclic antidepressants are prescribed on a chronic psycho-physiological insomnia. Conclusions : Generally, Insomnia is being treated by controlling whole ways. The oriental medication is less effective for sleep induction. On the contrary, that of western medication is very effective for sleep induction, but there are many possibilities of side effects. If this two mutual therapy is conducted cooperatively, more effective medical care might be expected. Therefore, it is considered that not only the oriental medical study for sleep induction, but the study of Oriental-Western Cooperative Therapy should be preceded to treat Insomnia from now on.

• Journal of Yeungnam Medical Science
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• v.16 no.1
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• pp.25-33
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• 1999

Benzodiazepines(BZDs) are among the most widely prescribed drugs in the world. They are potent anxiolytic, antiepileptic, hypnotic, and muscle relaxing agents. There is an emerging model of the role of several neural systems in anxiety and their relation to the mechanism of action of BZDs. It has been postulated that BZD drugs exert their anxiolytic action by regulating GABAergic transmission in limbic areas such as the amygdala, in the posterior hypothalamus, and in the raphe nuclei. The involvement of the amygdala in the behaviors triggered by fear and stress has been suggested by many previous studies. In this review, reports about regulatory effects of endogenous BZD receptor ligands on the perception of anxiety and memory consolidation were summerized. These findings further support the contention that BZD receptor ligands modulate memory consolidation of averse learning tasks by influencing the level of stress and/or anxiety that accompanies a learning experience. The findings suggest that the decrease in the limbic levels of BZD-like molecules seen after the various behavioral procedures represent a general response to stress and/or anxiety, since it occurs in proportion to the level of stress and/or anxiety that accompany these tasks. In addition, these findings further support the hypothesis that the $GABA_A$/BZD receptor complex in limbic structures plays a pivotal role in the stress and anxiety.

• Journal of Oriental Neuropsychiatry
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• v.14 no.2
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• pp.183-189
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• 2003

Hysterical aphonia is one of the frequent symptoms in conversion disorders. If it has a recent onset, a manifest induced factor, and a good premorbid adaptation, and another mental disorder is not accompanied, its prognosis is good. We report one case of hysterical aphonia that was bad prognosis. This patient was suffering traumatic event before and after onset, and major depressive disorder was accompanied. Having hysterical aphonia, the patient who had no progress after over an years medicine therapy and often felt strong suicidal urge, was successfully treated by TFT(Thought field therapy) and oriental medicine therapy. Several case studies on hypnotic cure of hysterical aphonia has been reported but they are uncommon internally and have good prognosis. In addition, there were no relevant studies concerning alternative therapy and oriental medication. Our case report is focused on treatment through these methods.

• Journal of The Korean Society of Clinical Toxicology
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• v.8 no.2
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• pp.88-96
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• 2010

Purpose: Doxylamine is antihistamine drug that is used as a hypnotic. It is also used for suicidal attempts because it can be easily purchased at the pharmacy without a prescription. There were many articles about the complications after doxylamine intoxication such as a rhabdomyolysis, but only a few articles have reported on seizure. We reviewed the cases of doxylamine intoxication with seizure that were treated in the emergency department. Methods: We reviewed the medical records of the patients who were over 15 years old and who were intoxicated by doxylamine at 3 emergency medical centers from January 2006 to June 2010. We reviewed the patients' age, gender, the dose of doxylamine ingested, if gastrointestinal decontamination was done, the time from intoxication to hospital arrival, the seizure history, treatment of seizure, the electroencephalography (EEG) results, the brain computed tomography (CT) results and the blood test results. Results: There were 168 patients who were intoxicated by doxylamine during the study period. Twelve patients had a seizure episode. The differences between the patients who developed seizure and the patients who did not were the dose and the serum levels of sodium and creatinine. The only clinically meaningful difference was the amount of doxylamine. The amount of doxylamine ingested (>29 mg/kg) predicted the development of seizure with a sensitivity of 75% and a specificity of 92% on the ROC curve. One patient among the seizure patients expired in the emergency department. Conclusion: In case of doxylamine intoxicated patients, there is close relationship between seizure and ingested amount, so close observation needs to be done for the patients who ingest too much because doxylamine can cause death. Further prospective studies are needed for doxylamine intoxicated patients with a seizure episode.

• Journal of The Korean Society of Clinical Toxicology
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• v.17 no.2
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• pp.118-125
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• 2019

Purpose: Non-benzodiazepine hypnotic drugs (including zolpidem) are associated with an increased risk of suicide and suicidal ideation. Considering the wide usage of zolpidem, this drug should be considered a possible etiology for stupor or coma in any patient exposed to this drug. However, there are no reports on zolpidem blood levels in emergency department patients in Korea. We therefore reviewed the analyzed data of a toxicology laboratory at one university affiliated hospital. Methods: The sex, age, chief symptoms, suspiciousness of poisoning, and presumption of poison were analyzed from January 2018 to June 2019. The detection frequency and level of zolpidem in the patient blood were compared to the mental changes presented, which is the main consequence of zolpidem. Results: A total of 229 toxicological analyses, requested to a toxicological laboratory at one university affiliated hospital, were reviewed. Among 229 patients, the mean age was 54.3±20.7 years old with 113 women and 116 men. 8.7% of patients have psychiatric illness and 39.7% were poisoned intentionally. The chief symptoms detected were: mental change 55.0%, gastrointestinal 14.4%, cardiovascular 10.5%, focal neurological 7.4%, respiratory 3.5%, none 8.7%, and unknown 0.4%. A request for detailed reports revealed that causative poisons were specified only in 20.1% cases. Zolpidem was detected in 22.3% cases (51/229), with median blood level 1.26 mg/L (interquartile 0.1, 5.06 mg/L) and urine 0.90 mg/L (interquartile 0.11, 5.6 mg/L). Furthermore, zolpidem was more frequently detected in toxicology analysis of patients where mental change was the primary symptom, as compared to other symptoms (32.5% vs. 9.7%, p<0.01). Conclusion: This study reported the blood level of zolpidem in suspected poisoning patients admitted to the emergency department.

• Analytical Science and Technology
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• v.32 no.1
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• pp.24-34
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• 2019

The safety of food is occasionally questionable, as there have been some reports of products contaminated with illegal adulterants. In this study, the presence of 16 sedative-hypnotics and sleep inducers in dietary supplements was determined by ultra-high-performance liquid chromatography with UV detection (UPLC-UV) and quadruple Orbitrap mass spectrometry (Q-Orbitrap-MS). The UPLC method was validated, providing a linearity (R2) of more than 0.999, and LODs and LOQs that ranged from 0.2 to 0.5 and 0.6 to $1.5{\mu}g\;mL^{-1}$, respectively. The repeatabilities were 0.2-8.4 % (intra-day) and 0.3-4.5 % (inter-day), and the accuracies were 89.0-117.0 % (intra-day) and 87.8-111.9 % (inter-day). The mean recoveries of the spiked samples ranged from 98.7 to 107.3 %. The relative standard deviation (%RSD) of the stability was less than 2.4 %. Using the developed method, one sedative-hypnotic compound, phenobarbital, was detected in one of the nineteen samples tested. In addition, the major characteristic fragment ions of each target compound were confirmed using Q-Orbitrap-MS for higher accuracy. Monitoring the presence of these 16 sedative-hypnotics and sleep inducers in dietary supplements should be pursued in the interest of human health, and the results of this study confirmed that the developed method has value for this application.