• Title/Summary/Keyword: Index of Nausea

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Clinical Observation of Changes in Subjective Evaluation Index and Electrogastrography Parameters of Patients with Functional Dyspepsia before and after Oriental Medical Interventions (기능성 소화불량 환자의 한방치료 전후의 주관적 평가지표와 Electrogastrography Parameters를 이용한 객관적 지표의 변화 관찰)

  • Han, Ga-Jin;Kim, Jin-Sung;Ryu, Bong-Ha
    • The Journal of Internal Korean Medicine
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    • v.32 no.4
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    • pp.584-598
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    • 2011
  • Objectives : Functional dyspepsia is a type of disease characterized by bothersome postprandial fullness, early satiation, epigastric pain and burning without structural gastrointestinal disease. The aim of this study was to analyze the characteristics of functional dyspepsia patients and evaluate changes in symptoms, quality of life, and electrogastrography parameters before and after oriental medical interventions. Methods : We recruited forty-six functional dyspepsia patients who visited gastroenterology clinic in the oriental medicine hospital of Kyung Hee University between November 2009 and February 2011. Patients were assessed for their frequency of dyspepsia (based on short form-Leeds Dyspepsia Questionnaire: SF-LDQ), quality of life (based on functional dyspepsia-related quality of life questionnaire: FD-QoL), gastric motility (based on electrogastrography: EGG) on the first visit. Then, the effect of oriental medical interventions was evaluated using EGG on the second visit. Results : The majority of patients had symptoms of nausea and indigestion. The largest decrease in EGG parameters was found in the indigestion group. The frequency of regurgitation and postprandial EGG power % bradygastria showed a significant correlation. Also, significant correlations were found between some items of FD-QoL and some EGG parameters. Compared to the EGG parameters before oriental medical interventions, some parameters after treatment had positive results, implying the improvement of gastric motility disorder. We also found improvement of EGG parameters in both digestant medicinal group and digestant combined with qi-tonifying medicinal group. Conclusions : The results of this study suggest that clinical application of EGG can be an objective diagnostic tool in functional dyspepsia patients visiting oriental medical hospital.

Pharmaceutical Studies on Microencapsulated Pivampicillin Hydrochloride (염산피밤피실린의 마이크로캅셀에 관(關)한 약제학적(藥劑學的) 연구(硏究))

  • Lee, Wan-Ha;Jee, Ung-Kil;Lee, Young-Hwan;Kim, Sang-Rin
    • Journal of Pharmaceutical Investigation
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    • v.15 no.2
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    • pp.53-62
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    • 1985
  • Pivampicillin hydrochloride is a kind of broad spectrum antibiotics with bactericidal action, and is used in many countries, although it has bitter taste, unpleasant odour and side effects of irritating gastric mucosa, nausea, penicillin allergy, etc. For the improvement of such side effects of pivampicillin hydrochloride, microcapsules, with wall of ethylcellulose, have been prepared by coacervation method. The shape was observed through the scanning electron microscope, the release of the drug into an aqueous medium was studied and the effects of core: ethylcellulose ratio were interpreted as well as making sensory evaluation of taste and odour. There was decreasing trend in dissolution rate of the drug with the increase of core: ethylcellulose ratios, and the smaller microcapsules released their contents more rapidly. A linear relationship was established between the amount of ethylcellulose and the time for 60% release of the drug, and the release pattern was found to have similar characteristics to the release of the drug from an insoluble porous matrix. The release of the drug in the artificial intestinal fluids (pH 6.8) was found to be similar to that in water, while the release in the artificial gastric juice (pH 1.2) was slightly slower. Bioavailability of microcapsule was compared with that of pivampicillin hydrochloride in rabbits using serum concentration and urinary excretion measurements. Microcapsule gave showed slightly higher serum level than pivampicillin hydrochloride from 2 hours after administration, while no significant difference was observed in the accumulated urinary excretion rate between pivampicillin hydrochloride and microcapsule. The ulcer index of pivampicillin hydrochloride administered group was 2.6, and microcapsule administered group was 1.5, while control group was 0.8. Therefore it may be concluded that microencapsulation of pivampicillin hydrochloride is a useful pharmaceutical approach to protect the gastrointestinal tract from being injured by direct contact of pivampicillin hydrochloride without any significant difference of bioavailability.

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Difference in Psychiatric Comorbidity of Panic Disorder According to Age of Onset (공황장애의 발병연령에 따른 정신과적 공존질환의 차이)

  • Kim, Eun-Jee;Lim, Se-Won;Oh, Kang-Seob
    • Korean Journal of Biological Psychiatry
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    • v.16 no.1
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    • pp.37-45
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    • 2009
  • Objectives : It is reported that panic disorder is frequently comorbid with other psychiatric illnesses. The aim of this study was to investigate differences of psychiatric comorbidity according to age of onset of panic disorder. Methods : Three hundred-two patients participated in the study. All the patients were evaluated by clinical instruments for the assessment the presence of other comorbid psychiatric disorders and various clinical features; Korean version of Mini International Neuropsychiatric Interview, Self-report questionnaires(Beck Anxiety Inventory, Beck Depression Inventory, Anxiety Sensitivity Index and State-Trait Anxiety Inventory) and clinical rating scale (Hamilton Anxiety Scale, Hamilton Depression Scale and Global Assessment of Functional score). Chi-square test was used to determine the difference between early onset and late onset panic disorder. Results : Forty percent of panic patients were found to have at least one comorbid psychiatric diagnosis. There were no differences among the groups divided by number of comorbidity in sex, agoraphobia comorbidity, duration of panic disorder, except onset age of panic disorder. Early onset group had more comorbidy with social phobia, agoraphobia, PTSD. We also found that Early onset panic disorder patients were more likely to experience derealization, nausea, parethesia than late onset panic disorder patients. Conclusion : The results of our study are in keeping with previous data from other parts of the world. Our finding suggest that earier onset of panic disorder related to more psychiatric comorbidity.

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The Effect of Coffee Enema on Constipation (커피관장이 변비정도의 변화 및 만족도에 미치는 영향)

  • Kim, Ho-Jun;Lee, Myung-Jong;Song, Mi-Young
    • Journal of Korean Medicine for Obesity Research
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    • v.5 no.1
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    • pp.31-45
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    • 2005
  • Background and Objectives : Constipation is a common digestive disorder and enema is one of the external intervention for constipation. Coffee enema was originated by Dr. Gerson for the purpose of colon cleansing and detoxification. However there has been no study about the effect of coffee enema on constipation. Therefore, this study was planned to evaluate the effect of coffee enema on constipation in the terms of constipation degree and satisfaction questionnaire. Methods : 42 patients were treated of the coffee enema 2 times a week. The constipation score(Constipation Assessment Scale) and frequency of defecation were checked 3 times (before treatment, 1 week and 1 month later). The satisfaction score was also checked 1 week and 1 month later. The interval differences of constipation score between pre- and post-treatment according to body mass index were also analyzed. Results and Conclusions : The constipation scores, frequency of defecation scores checked 1 week and 1 month later were significantly(p<0.01) improved as compared with those before the treatment. The satisfaction scores were close to 'moderately satisfied' 1 week and 1 month later. The scores of 6 parameters in constipation assessment scale, frequency of defecation scores and satisfaction scores were maintained until 1 month later. There was no significant difference in the change of constipation scores between normal BMI and overweight group. 4.2% of the patients reported adverse effects, which were nausea, abdominal distension each.

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A Case of Renal Cortical Necrosis in a 15-year-old Boy with Acute Kidney Injury

  • Lee, Mi-ji;Yim, Hyung Eun;Yoo, Kee Hwan
    • Childhood Kidney Diseases
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    • v.23 no.1
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    • pp.53-57
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    • 2019
  • Renal cortical necrosis (RCN) is patchy or diffuse ischemic destruction of the renal cortex caused by significantly reduced renal arterial perfusion. It is a rare cause of acute kidney injury (AKI) and is associated with high mortality. Here, we review the case of RCN in a 15-year-old boy who developed AKI. A 15-year-old boy was referred to our hospital from a local hospital due to a sharp decrease in his renal function. He presented with acute flank pain, nausea with vomiting, and oliguria for the past two days. He had taken a single dose of antihistamine for nasal congestion. At our hospital, his peak blood pressure was 148/83 mmHg and he had a high body mass index of $32.9kg/m^2$. The laboratory data showed a blood urea nitrogen (BUN) of 28.4 mg/dL, a creatinine of 4.26 mg/dL, and a glomerular filtration rate estimated from the serum cystatin C of $20.2mL/min/1.73m^2$. Proteinuria (spot urine protein to creatinine ratio 1.66) with pyuria was observed. Kidney sonography showed parenchymal swelling and increased renal echogenicity. Due to rapidly progressing nephritis, steroid pulse therapy (750 mg/IV) was done on the second day of his admission and the patient showed complete recovery with normal renal function. However, the kidney biopsy findings revealed renal cortical hemorrhagic necrosis. Multifocal, relatively well-circumscribed, hemorrhagic necrotic areas (about 25%) were detected in the tubulointerstitium. Although RCN is an unusual cause of AKI, especially in children, pediatricians should consider the possibility of RCN when evaluating patients with rapidly decreasing renal function.

Study on Perceptions and Intake of Caffeine-Containing Favorite Foods by Rural and Urban Middle School Students in Kyungnam (농촌과 도시 중학생의 카페인 함유 기호식품에 대한 인식 및 섭취실태 비교)

  • Kim, Eun-Ju;Cheong, Hyo-Sook
    • Korean journal of food and cookery science
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    • v.30 no.5
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    • pp.650-662
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    • 2014
  • This study was conducted to identify middle school students' caffeine intake from their favorite foods containing caffeine as well as several factors related to their intake. The objects of the investigation were 369 middle school students in the urban area of Changwon-si and 358 middle school students in the rural area of Haman-gun. The average height was 162.3cm, average weight was 52.3 kg and average BMI was 19.8. The food habit score was generally positive at an average of 3.37. The food habit scores of rural area students were higher than those of urban area students (p<.05). The average stress score was somewhat low at 2.82. The stress index for rural students was lower than that of urban students (p<.01). The recognition of caffeine in favorite foods was 8.12 out of a 12 point scale. The average nutritional knowledge score regarding caffeine was very low at 3.08 out of a 10 point scale. The main reason for selecting favorite foods was 'taste'. The percentage of students who don't check food labels was 49.1%. 'House' was the main location while 'good taste' was the biggest reason for eating caffeine-containing foods. The main side effect of caffeine intake was 'nausea'. The average daily caffeine intake for all subjects was 26.96 mg, with the urban students averaging 27.90 mg and the rural students averaging 25.99 mg. The correlations between several factors and caffeine intake were examined. Food habit showed a negative correlation with stress score and caffeine intake. Nutritional knowledge and recognition of caffeine had positive correlations with caffeine intake. Hence nutritional education about caffeine should be emphasized to improve students' healthy food habits.

Can oliceridine (TRV130), an ideal novel µ receptor G protein pathway selective (µ-GPS) modulator, provide analgesia without opioid-related adverse reactions?

  • Ok, Hwoe Gyeong;Kim, Su Young;Lee, Su Jung;Kim, Tae Kyun;Huh, Billy K;Kim, Kyung Hoon
    • The Korean Journal of Pain
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    • v.31 no.2
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    • pp.73-79
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    • 2018
  • All drugs have both favorable therapeutic and untoward adverse effects. Conventional opioid analgesics possess both analgesia and adverse reactions, such as nausea, vomiting, and respiratory depression. The opioid ligand binds to ${\mu}$ opioid receptor and non-selectively activates two intracellular signaling pathways: the G protein pathway induce analgesia, while the ${\beta}$-arrestin pathway is responsible for the opioid-related adverse reactions. An ideal opioid should activate the G protein pathway while deactivating the ${\beta}$-arrestin pathway. Oliceridine (TRV130) has a novel characteristic mechanism on the action of the ${\mu}$ receptor G protein pathway selective (${\mu}$-GPS) modulation. Even though adverse reactions (ADRs) are significantly attenuated, while the analgesic effect is augmented, the some residual ADRs persist. Consequently, a G protein biased ${\mu}$ opioid ligand, oliceridine, improves the therapeutic index owing to increased analgesia with decreased adverse events. This review article provides a brief history, mechanism of action, pharmacokinetics, pharmacodynamics, and ADRs of oliceridine.

A Study on the Sodium and Potassium Intakes and Their Metabolism of the Pregnant Women in Korea (한국인임신부(韓國人姙娠婦)의 Sodium과 단백질섭취량(蛋白質攝取量) 및 대사(代謝)에 관(關)한 연구(硏究))

  • Nam, Hae-Won;Lee, Ki-Yull
    • Journal of Nutrition and Health
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    • v.18 no.3
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    • pp.194-200
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    • 1985
  • The purpose of this study was to investigate sodium intake and protein metabolism for pregnant women in Korea. The relationship between salt consumption and hypertension, electrolyte changes in pregnancy, and the tendency of weight gain of pregnant women were also examined. The dietary survey and twelve or twenty-four hour's urine collection was performed in this study. The subjects were pregnant women who came to gynecology clinic for prenatal care from July to August in 1984. The results were as follows: 1) Intakes of calorie and iron of Korean pregnant women were 2,036 Kcal and 16mg per day per person. The calorie composition consists of 65% carbohydrate, 16% protein, and 19% lipids. The average level of all nutrients was about 87% of Korean Recommended Dietary Allowances. 2) The sodium intakes in pregnant women estimated by dietary survey was 318.6 mEq Na (7,966 mg Na), which is equivalent to 20.2 g NaCl. 3) Daily sodium excretion was 112.5 mEq per liter, that is equal to 147.4 mEq. Potassium excretion was 24.95 mEq per liter and creatinine excretion was 594.0 mg per day. 4) There were statistically significant correlations between sodium intake and the excretions of sodium, potassium and creatinine. The blood pressure was positively correlated with sodium intakes. As sodium and potassium ratio was increased, systolic blood pressure and diastolic blood pressure were also significantly increased 5) Urinary nitrogen and creatinine ratio known to be reliable index for nutritional status of protein was 5.5 : 1. These values were comparable to the values in American pregnant women. 6) The weight gain during the pregnancy was examined. There was little weight gain during the first trimester, because of nausea, vomit and decrease of appetite. The weight gain during the second trimester was 4.9Kg, and 11.1Kg for third trimester.

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The Effects of Panax Ginseng Radix Pharmacopuncture and Zizyphi Spinosi Semen Pharmacopuncture on the Heart Rate Variability (인삼약침과 산조인약침이 정상인의 심박 변이도에 미치는 영향)

  • Seol, Hyun;Song, Beom-Yong;Yook, Tae-Han
    • Journal of Acupuncture Research
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    • v.26 no.5
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    • pp.19-28
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    • 2009
  • Objectives : We tried to investigate the effects of Panax Ginseng Radix pharmacopuncture and Zizyphi Spinosi Semen pharmacopuncture on human body with the Heart Rate Variability (HRV) in adult man. As well as we tried to investigate how safe Panax Ginseng Radix and Zizyphi Spinosi Semen pharmacopuncture on the the human being. Methods : We investigated on 44 healthy volunteers consisted of 16 subjects in Panax Ginseng Radix pharmacopuncture group, 13 subjects in Zizyphi Spinosi Semen pharmacopuncture group and 15 subjects in Normal Saline. We ruled out subjects who wasn't stable by rest, with in the limit of normal heart beat(60-120cycle/min). Study form was a randomized, clinical trial. Each group was injected Panax Ginseng Radix pharmacopuncture, Zizyphi Spinosi Semen pharmacopuncture and Normal Saline $0.2m{\ell}$ at $GB_{21}$(Kyonjong). We measured HRV on 7 times : before and after injection per 5 minutes during 30 minutes. The SPSS 13.0 for windows was used to analyze the data by the paired t-test(in the group) and Anova test(among the groups) were used to verify the result. Results : 1. After Panax Ginseng Radix pharmacopuncture injection, SDNN was significantly high, pNN50 was significantly low, Ln(TP) was significantly high, Ln(VLF) was significantly high, Ln(LF) was significantly high at 30 minutes. 2. After Zizyphi Spinosi Semen pharmacopuncture injection, Complexity was significantly low, Ln(VLF) was significantly high at 30 minutes. 3. HRV-index made a significant difference between the Zizyphi Spinosi Semen pharmacopuncture and normal saline at 5 minutes(p=0.02). 4. There wasn's any pain the injected region and whole body, rubefaction, uredo, nausea, vomiting, colic, headache, dizziness within 24 hours. Measured data and mean value of Mean-HRV was within normal range. Conclusions : The results suggested that and Panax Ginseng Radix pharmacopuncture in healthy adult man tended to activate the vagus nervous system within normal range.

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Effect of Aprepitant in Patient with Gastroparesis and Related Disorders (위마비증과 만성 구역 구토 증후군 환자에서 Aprepitant의 효과)

  • Jung, Kyoungwon;Park, Moo In
    • The Korean Journal of Gastroenterology
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    • v.72 no.6
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    • pp.325-328
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    • 2018
  • 위마비증(gastroparesis)이나 만성 구역 구토 증후군(chronic unexplained nausea and vomiting)으로 인한 구역과 구토에 대한 치료는 일반적으로 사용하는 위장관 촉진제에 만족스럽지 못한 경우가 많고, 여러 부작용으로 인하여 장기적으로 사용하기 어려워 보다 효과적인 치료 방법이 필요하다. 최근 미국에서 발표된 본 연구는 위마비증이나 연관 증후군 환자에서 구역과 구토 증상을 줄이기 위한 aprepitant(neurokinin-1 receptor antagonist) 치료의 효과를 분석한 것으로, 향후 일반적인 치료에 불응성 위마비증 환자에서 새로운 약제 사용을 시도해볼 수 있어 소개하고자 한다. 본 Aprepitant for the Relief of Nausea (APRON) 연구는 기질적 질환을 배제하기 위하여 최근 2년 이내 위내시경이 정상이며, 적어도 6개월 이상 조기 포만감(early satiety), 식후 만복감(postprandial fullness), 팽만감(bloating) 그리고 명치부 통증(epigastric pain)을 유발하는 증상과 함께 만성적인 구역이 있는 18세 이상의 성인 중 4시간의 위배출 검사를 시행받은 환자를 대상으로 하였다. 객관적인 지표로 0점에서 45점까지 보이는 9-증상 Gastroparesis Cardinal Symptom Index(GCSI)가 2주 이상 총 21점 이상이며, 0-100 mm의 visual analog scale (VAS)의 7일간의 구역 증상 평균 25 mm 이상인 환자를 대상으로 하였다. 일주일에 3일 이상 narcotics를 사용하였거나 와파린이나 pimozide, terfenadien, astemizole, cisapride를 복용하였던 환자, 2배 이상으로 간 효소 수치상승을 보이거나 Child-Pugh score 10점 이상, aprepitant에 알레르기를 보이는 환자는 제외되었다. 그렇지만 metoclopramide나 erythromycin을 안정적으로 사용 중인 환자는 제외되지 않았다. 위배출 검사는 2시간에서 60% 이상 남아 있거나 4시간에서 10% 이상 남아 있는 경우에 지연된 것으로 정의되었으며, 지연된 위배출 검사 결과 자체는 환자의 등록 기준에 포함되진 않았다. 등록 기준에 포함된 환자는 1:1로 무작위 배정되어 하루 한 번 125 mg의 aprepitant 복용군과 위약군으로 나누어져 연구가 진행되었으며, 약제 복용 4주간 2주 간격으로, 그리고 복용 후 2주 뒤까지 구역 증상의 호전 정도와 약제 안전성을 확인하였다. 이러한 효과를 판정하기 위하여 환자가 방문하는 동안 GCSI를 포함한 Patient Assessment of Upper GI Symptoms (PAGI-SYM), Gastrointestinal Symptom Rating Scale, daily VAS, daily diary version of the GCSI 그리고 정신 측정 도구와 삶의 질 도구인 Patient health Questionnaire 15와 Short Form 36 version이 측정되었다. 구역에 대한 aprepitant와 위약의 치료 효과의 일차적 판정은 이전 항암 요법에 대한 aprepitant 연구와 같이 28일 평균 VAS 25 mm 미만이거나 치료 전 7일간의 VAS와 비교하여 28일 치료 기간 동안 25 mm 이상 감소한 경우로 정의하였고, 이차 결과는 구역의 매일 시간, 치료 중 구역이 없는 날짜의 퍼센트, PAGI-SYM score의 개선 등으로 확인하였다. 2013년 4월부터 2015년 7월까지 총 126명의 환자가 등록되어 aprepitant군 63명, 위약군 63명으로 무작위 배정되었다. 전체의 57%인 72명에서 위배출 지연이 보였으며, 나머지 43%에서는 정상 또는 빠른 위배출 소견을 보여 만성적으로 설명할 수 없는 구역과 구토에 포함된 환자군으로 확인되었다. 또한 29%에서 당뇨를 가지고 있었으며, 8%에서 수면제를 사용하고 있었다. 최종적으로 aprepitant군은 59명, 위약군은 63명이 연구를 끝까지 종료하였다. 일차 결과에서 aprepitant 군 46%, 위약군 40%의 구역 호전을 보여 두 치료군 간에 통계적으로 의미 있는 차이는 보이지 않았다(상대 위험도 1.2, 95% CI: 0.8-1.7; p=0.43). 그러나 일차 분석의 두 가지 척도(28일 평균 VAS 25 mm 미만과 기저 VAS보다 평균 28일 VAS의 25 mm 이상 감소)를 모두 함께 고려한 민감도 분석에서는 aprepitant군이 37% (22/59)로 위약군의 17%(11/63)에 비하여 통계적으로 의미 있는 구역의 호전을 보였다(상대 위험도 2.1, 95% CI: 1.1-4.1; p=0.01). 또한 이차 분석을 살펴보면 aprepitant군에서 PAGI-SYM 중증도 지수로 확인하였을 때, 구역(1.8 vs. 1.0; p=0.005)과 구토(1.6 vs. 0.5; p=0.001)의 중증도 및 매일 구역 시간의 감소를 보였고, 28일 동안 구역이 없는 날짜의 퍼센트 증가 소견을 보였다. 다른 이차 결과 분석에서 aprepitant군이 PAGI-SYM 중증도 지수의 GCSI 종합 점수(1.3 vs. 0.7; p=0.001), 상당한 증상호전, 구역 구토의 세부 점수, 팽만감 세부 점수 그리고 위식도 역류 증상 점수에서 호전을 보였고, 매일 일기로 표현한 daily diary version of the GCSI에 상복부 통증 중증도, 전체 증상 그리고 Gastrointestinal Symptom Rating Scale의 종합 점수에서 호전을 보였다. 연구 중 발생한 부작용은 주로 경증과 중등도 정도의 부작용이 주로 발생하였지만, aprepitant군(35% vs. 17% 위약군, p=0.04)에서 더 많이 발생하였다. 결론적으로 위마비증 또는 위마비증 유사 증후군으로 인한 만성 구역 및 구토 환자의 무작위 시험에서 aprepitant는 VAS 점수를 통한 주요 결과를 분석하였을 때는 구역의 중증도를 호전시키지 못하였지만 다른 이차적 결과에 대해서는 위약군에 대하여 호전 소견을 보였다. 따라서 aprepitant에 효과적인 반응을 보이는 위마비증 환자를 감별하는 추가 임상시험이 필요할 것으로 판단된다.