• Journal of Dental Anesthesia and Pain Medicine
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• 제18권3호
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• pp.129-142
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• 2018

Introduction: This systematic review evaluated the use of buffered versus non-buffered lidocaine to increase the efficacy of inferior alveolar nerve block (IANB). Materials and Methods: Randomized, double-blinded studies from PubMed, Web of Science, Cochrane Library, Embase, and ProQuest were identified. Two of the authors assessed the studies for risk of bias. Outcomes included onset time, injection pain on a visual analog scale (VAS), percentage of painless injections, and anesthetic success rate of IANB. Results: The search strategy yielded 19 references. Eleven could be included in meta-analyses. Risk of bias was unclear in ten and high in one study. Buffered lidocaine showed 48 seconds faster onset time (95% confidence interval [CI], -42.06 to -54.40; P < 0.001) and 5.0 units lower (on a scale 0-100) VAS injection pain (95% CI, -9.13 to -0.77; P=0.02) than non-buffered. No significant difference was found on percentage of people with painless injection (P = 0.059), nor success rate (P = 0.290). Conclusion: Buffered lidocaine significantly decreased onset time and injection pain (VAS) compared with non-buffered lidocaine in IANB. However due to statistical heterogeneity and low sample size, quality of the evidence was low to moderate, additional studies with larger numbers of participants and low risk of bias are needed to confirm these results.

• 동의신경정신과학회지
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• 제15권1호
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• pp.101-119
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• 2004

Ginseng Radix Alba and Cyperi Rhizoma were investigated for their anti-depressant effects. For this purpose, forced-swimming test, tail suspension test, hot plate test, reserpine-induced hypothermia, aggressive behavior test were performed. In addition, the brain content of 5-hydroxyindoleacetic acid(a metabolite of serotonin), the monoamine oxidase activity, anticonvulsant effect, sleep enhancement effect were determined. The results are as follows: In the forced swimming test, Ginseng Radix diminished the duration of immobility by 45.5% compared to the control group, while Cyperi Rhizoma showed weaker effect (12.4% reduction) at 2g/kg. In the tail suspension test, the effect of Ginseng Radix(43.7% reduction) are also better than that of Cyperi Rhizoma(15.6% reduction) at 2g/kg. In the hot plate test, Ginseng Radix showed no difference as compared to control, while Cyperi Rhizoma increased the jump latency time by about 25% after administration for 10 days. In the reserpine-induced hypothermia test, both drugs slowly dropped the body temperature compared to the control group, especially the rate of hypothermia of Ginseng Radix was 24.0% at 1g/kg. In the aggressive behavior test, both drugs delayed the onset time, decreased the duration and frequency, of which effects were better in Cyperi Rhizoma. The content of 5-hydroxyindoleacetic acid in mice brain was slightly increased in Ginseng Radix, while Cyperi Rhizoma increased its level almost to the control group. Both drugs inhibited the monoamine oxidase activity in a dose-dependent manner, but the effect(51.2%) of Cyperi Rhizoma was more potent than the effect(11.8%) of Ginseng Radix. In the pentobarbital-induced sleep test, Cyperi Rhizoma exhibited no significant difference against the control group, while Ginseng Radix showed about two-fold enhancement at 2g/kg. The anticonvulsant effect of both drugs delayed the onset time, shortened the duration of convulsion and diminished the lethality, but Ginseng Radix were better than Cyperi Rhizoma.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권3호
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• pp.135-141
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• 2023

Background: The limited studies on the effect of buffering on the clinical efficacy of articaine have reported controversial results. The purpose of this study was to clinically compare the pain of injection, anesthetic success, onset, and duration of pulpal anesthesia of buffered 4% articaine with epinephrine 1:100000 versus a non-buffered 4% articaine with epinephrine 1:100000 formulation for buccal infiltration of the mandibular first molar. Methods: Sixty-three volunteers were enrolled in the study. All volunteers received two injections consisting of a single mandibular first molar buccal infiltration with 1.8 ml of 4% articaine with epinephrine 1:100000 and 1.8 ml of 4% articaine with epinephrine 1:100000 buffered with 8.4% sodium bicarbonate. The infiltrations were applied in two separate appointments spaced at least one week apart. After injection of the anesthetic solution at the examined site, the first molar was pulp-tested every 2 min for the next 60 min. Results: Successful pulpal anesthesia was recorded in 69.8% of cases using non-buffered articaine solution and 76.2% of cases using buffered articaine solution, with no significant difference between the formulations (P = 0.219). The mean time of anesthesia onset for the volunteers with successful anesthetic outcome in both formulations (n = 43) was 6.6 ± 1.6 min for the non-buffered articaine solution and 4.5 ± 1.6 min for the buffered solution, which differed significantly (P = 0.001). In the same volunteers, the mean duration of pulpal anesthesia was 28.4 ± 7.1 min for non-buffered articaine solution and 30.2 ± 8.5 min for buffered articaine solution, with no significant difference between the formulations (P = 0.231). Considering the pain of injection, regardless of the anesthetic success, the mean values of VAS were 11.3 ± 8.2 mm for the non-buffered articaine solution and 7.8 ±6.5 mm for the buffered articaine solution, which differed significantly (P = 0.001 < 0.05). Conclusion: According to the present study, 4% articaine with epinephrine can benefit from buffering and provide better anesthetic behavior, with improved onset and less pain during injection.

• Human Ecology Research
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• 제51권4호
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• pp.383-393
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• 2013

The purpose of this study is to investigate the infant feeding and weaning practices in multicultural families. We surveyed 159 married female immigrants in Jeonbuk province from April 2010 to April 2011. They are from Vietnam (49.7%), China (25.8%), Cambodia (8.8%), Japan (8.2%), and the Philippines (7.5%). The average rate of colostrum feeding of all the subjects was 91% and there were significant differences between nationalities (p<.05), family types (p<.01), and delivery methods (p<.001). 41.5% of those answered did breast feeding, while 49.1% combined breast and bottle feeding, and 9.4% did bottle feeding only. The reason for bottle feeding is either because they are unable to produce enough breast milk or because they think the formula is better than breast milk. Average period of breast feeding was 10.3 months. There were significant differences of breast feeding duration between maternal age (p<.05) and economic level (p<.001). The mean onset time of weaning was 7.8 months, and there were significant differences between nationalities (p<.05), family types (p<.05), and feeding methods (p<.05). There was no significant difference in methods of supplementary food preparation between nationalities, family types, jobs, and education levels. The mean onset time of commercial milk was 12.8 months, and there were significant differences between nationalities (p<.05), the duration of marriages (p<.05), education levels (p<.05) and feeding methods (p<.001).

• 대한응급의학회지
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• 제29권6호
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• pp.656-662
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• 2018

Objective: Acute appendicitis is one of the most urgent surgical problems. Several factors have been considered as predictors of perforation, but this study focused on the change in pain pattern. The degree of pain and progression of appendicitis were analyzed assuming that the pain intensity would increase until the perforation and the degree of pain would decrease immediately after the perforation occurred. Methods: In this study, 385 out of 467 patients, who were diagnosed with appendicitis in a single institution and aged between 15 and 65 years, were reviewed retrospectively. The patients' pain scores and the diameters of appendices were analyzed along with the accompanying complications. Correlation analysis and a Student's t-test were performed. Results: In patients with complicated appendicitis, the mean numerical rating scale (NRS) was slightly higher than that of simple appendicitis, but there was no significant difference in the absolute value. Only the size of the appendix showed meaningful differences according to the combined computed tomography findings. The NRS distribution or appendiceal size did not correlate with the time duration from symptom onset. Conclusion: The appendiceal size tended to increase with progressing appendicitis. No significant correlation was observed between the patient's pain level and complications. The time duration from symptom onset did not show a relationship with the progression of appendicitis.

• 대한후두음성언어의학회지
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• 제8권1호
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• pp.18-26
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• 1997

There are two types of phonetic study, acoustic and physiologic, for differentiating the three manner categories of Korean stop consonants. On the physiologic studies, there are endoscopic, electromyographic(EMG), electroglottographic(EGG) and aerodynamic studies. In this study, I tried to investigate general features of Korean stops using EGG study for the open quotient of vocal fold and baseline shift during speech, and aerodynamic characteristics for e subglottal air pressure, air flow and glottal resistance at consonants. On the aerodynamic study, the glottalized and aspirated stops may be characterized by e increasing subglottal pressure comparing with lenis stop at consonants. The airflow is largest in the aspirated stops followed by lenis stops and glottalized. The glottal airway resistance (GAR) showed highest in the glottalized followed by the lenis, but lowest in e aspirated during e production of consonants, and showed highest in e aspirated, but low in the glottalized and lenis during the production of vowel. The glottal resistance at consonant showed significant difference among consonants and significant interaction between subject and types of consonant. The glottal resistance at vowel showed significant difference among consonants, and e interaction occured between subject and types of consonant. The electroglottography(EGG) has been used for investigating e functioning of e vocal folds during its vibration. The EGG should be related to the patterns of the vocal fold vibration during phonation in characterizing the temporal patterns of each vibratory cycle. The purpose of this study is to investigate the dynamic change of EGG waveforms during continuous speech. The dynamic changes of EGG waveforms fir the three-way distinction of Korean stops were characterized that the aspirated stop appears to be characterized by largest open quotient and smallest glottal contact area of the vocal folds in e initial portion of vocal fold vibration ; the lenis stop by moderate open quotient and glottal contact area ; but the glottalized stop by smallest open quotient and largest glottal contact area. There may be close relationship between the OQ(open quotient) in the initial voice onset and the glottal width at the time of consonant production, the larger glottal width just before vocal fold vibration results in the smaller OQ of the vocal fold vibration in the initial voice onset. The EGG changes of baseline shift during continuous speech production were characterized by the different patterns for the three types of Korean consonants. The small and less stiffness change of baseline shift was found for the lenis and the glottalized, and the largest and stiffest change was found for the aspirated. On the baseline shift for the initial voice onset, they showed so similar patterns with for the consonant production, larger changed in the aspirated. for the lenis and the glottalized during the initial voice onset, three subjects showed individual difference each other. I suggest at s characteristics were strongly related with articulatory activity of vocal tract for the production of consonant, especially for the aspirated stop. The suspecting factors to affect EGG waveforms are glottal width, vertical laryngeal movement and the intrapharyngeal pressure to neighboring tissue during connected spech. So the EGG may be an useful method to describe laryngeal activity to classify pulsing conditions of the larynx during speech production, and EGG research can be controls for monitoring the vocal tract articulation, although above factors to affect EGG would have played such a potentially role on vocal fold vibratory behavior obtained using consonant production.

• 대한한방내과학회지
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• 제29권4호
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• pp.1011-1024
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• 2008

Objectives : The aim of this study was to assess the distribution of general characteristics and risk factors according to onset time in acute stroke patients. Methods : We studied hospitalized patients within 4 wks after the onset of stroke who were admitted to the Department of Internal Medicine at Kyunghee University Oriental Medical Hospital, Kyunghee University East-West Neo Medical Hospital, Kyungwon University Songpa Oriental Medical Hospital, Kyungwon University Incheon Oriental Medical Hospital, and Dongguk University Ilsan Oriental Medical Hospital from April 2007 to August 2008. The 24-hour day was divided into quartiles (6:00 to 12:00, 12:00 to 18:00, 18:00 to 24:00 and 24:00 to 6:00). We analyzed the general characteristics and risk factors according to onset time in acute stroke patients. Results : 468 subjects were included into the final analysis. 1. The most common time period for ischemic stroke onset was between 6:00 and 12:00. It demonstrated a 50% excess risk between 6:00 and 12:00. 2. On the demographic variables of the patients, the rate of hypertension was significantly higher from 18: 00 to 24: 00 than 24:00 to 6:00. 3. There was no significant difference of stroke type, Sasang constitution, or lifestyle between times. 4. According to the blood test, high density lipoprotein cholesterol was significantly higher at 24:00 to 6:00 and lower at 12:00 to 18:00 than other time-groups. 5. The patients diagnosed with metabolic syndrome were significantly more at 12:00 to 18:00 and fewer at 24:00 to 6:00. 6. Hypertension and coffee drinking showed close relationship with patients whose stroke occurred while awake in multivariate analysis. Conclusions : The above results showed that the overall tendency of acute stage cerebral infarction patients varied according to their onset time. These results can be utilized in the future as a basis material.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권5호
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• pp.271-279
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• 2020

Background: The present study aimed to evaluate and compare the efficacy of buffered and unbuffered local anesthesia solutions during inferior alveolar nerve block (IANB) administration in children. Methods: PubMed, Ovid SP, and Cochrane databases were searched separately by two independent reviewers for potential papers published between 1980 and April 2020 using relevant MeSH terms and pre-specified inclusion and exclusion criteria. T Studies of IANB administration in children comparing buffered and unbuffered local anesthesia solutions were evaluated. The primary outcome evaluated was pain (perception and reaction), while the secondary outcome was the onset of anesthesia. Results: A total of five articles were included in a qualitative analysis; among them, four qualified for quantitative analysis of the primary outcome and three for quantitative analysis of the secondary outcome. A fixed-effects model was used to perform the meta-analysis. Pain perception (child-reported pain): Significantly lower pain scores were reported with buffered local anesthesia solution than with unbuffered solution (P = 0.006, MD: -0.32, 95% CI: -0.55 to -0.09). Pain reaction (observer-reported pain reaction in child): No significant difference was found between buffered and unbuffered solution in terms of observer-reported pain behavior in the child (P = 0.09, MD: -0.21, 95% CI: -0.46 to 0.04). Onset of anesthesia: A significantly lower duration of anesthesia onset was reported with buffered local anesthesia solution than with unbuffered solution (P = 0.00001, MD: -12.38, 95% CI: -17.64 to -7.13]. Conclusion: Buffering local anesthesia solution may reduce discomfort due to IANB injection administration and lower the initial onset time of anesthesia. More randomized control trials with adequate sample sizes should be carried out to validate the accuracy of these results.

• 한국방사선학회논문지
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• 제7권1호
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• pp.99-106
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• 2013

본 연구는 급성염증과 비슷한 지연성 근육통이 있을 때 초기 한냉치료를 적용함에 있어 냉기에 의한 냉각통증을 최소화하면서, 근육온도를 낮출 수 있는 방법으로 냉기단독과 냉기와 적외선 조사 병용을 적용하여 피부온도에 미치는 영향을 측정하고, 냉기와 적외선 병용치료의 효율성을 평가함과 동시에 초음파를 통한 근 두께를 바탕으로 등척성 근기능을 평가해보고자 하였다. 본 연구의 결과 냉기와 적외선 병용치료 시 냉기 단독치료보다 냉각통증의 빈도가 낮게 나타났으며, 냉각통증 자각 시점도 늦게 나타났다. 또한 충분한 냉기적용 후 피부온도가 재가온되는데 있어서 냉기를 2회 적용할 때가 1회 적용할 때 보다 더 느려지며, 냉기 단독치료보다 냉기와 적외선 광선 조사 병용치료 시 더 느려짐을 나타내어 2회 이상의 반복적인 냉기 적용이 냉기의 효용이 있다고 나타났다. 또한 상완이두근 두께 변화에 있어서 병용군이 대조군보다 더 크게 나타나 이 효과를 뒷받침하게 되었다. 이러한 연구결과 자료는 향후 급성염증이 있는 환자에게 한냉치료와 관련된 치료적인 자료로써 활용될 수 있을 것이라 생각되고 근골격계 초음파 진단기를 활용하여 통증에 대한 자각도를 간접적으로 표현하는 것이 구체화되어 임상에서 널리 활용될 것으로 보여진다.

• Communications for Statistical Applications and Methods
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• 제25권3호
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• pp.321-328
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• 2018

In clinical trials with repeated measurements, the time-averaged difference (TAD) may provide a more powerful evaluation of treatment efficacy than the rate of changes over time when the treatment effect has rapid onset and repeated measurements continue across an extended period after a maximum effect is achieved (Overall and Doyle, Controlled Clinical Trials, 15, 100-123, 1994). The sample size formula has been investigated by many researchers for the evaluation of TAD in two treatment groups. For the evaluation of TAD in multi-arm trials, Zhang and Ahn (Computational Statistics & Data Analysis, 58, 283-291, 2013) and Lou et al. (Communications in Statistics-Theory and Methods, 46, 11204-11213, 2017b) developed the sample size formulas for continuous outcomes and count outcomes, respectively. In this paper, we derive a sample size formula to evaluate the TAD of the repeated binary outcomes in multi-arm trials using the generalized estimating equation approach. This proposed sample size formula accounts for various correlation structures and missing patterns (including a mixture of independent missing and monotone missing patterns) that are frequently encountered by practitioners in clinical trials. We conduct simulation studies to assess the performance of the proposed sample size formula under a wide range of design parameters. The results show that the empirical powers and the empirical Type I errors are close to nominal levels. We illustrate our proposed method using a clinical trial example.