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Adverse Effects of Ma-huang according to Dose : A Randomized Double-Blind Placebo-Controlled Pilot Study (마황용량에 따른 이상반응에 관한 예비연구: 무작위배정이중맹검시험)

  • Hsing, Li-Chang;Lee, Tae-Ho;Son, Dong-Hyug;Yeo, Jin-Ju;Yang, Chang-Sop;Seo, Eui-Seok;Jang, In-Soo
    • The Journal of Internal Korean Medicine
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    • v.27 no.1
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    • pp.188-196
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    • 2006
  • Background: Ma-huang (Ephedra sinica) has been widely used to treat respiratory disease in oriental medicine for over a hundred years. Ma-huang preparations contain approximately 1.25% ephedrine alkaloids. Recently, the ephedra alkaloids have received much press lately due to adverse effects in those using whole extracts as 'dietary supplements' for weight loss or athletic performance enhancement, and these reports are troubling given the increasing use of Ma-huang by the general public. The purpose of this report is to determine the proper dosage to minimize adverse effects and maximize the potential curative value. Objectives : The object of this study was to find an effective yet low risk dosage of Ma-huang. Methods : The study was designed as a double-blind randomized placebo-controlled trial. The subjects of this study were 26 adults between 20 to 40 of age who agreed to participate in this study. They were allocated through randomization into three groups. Each group took three opaque capsules three times a day. A group (N=9) took one Ma-huang capsule and two placebo capsules, B group (N=8) took two Ma-huang capsules and one placebo capsule, C group (N=9) took three Ma-huang capsules. The total trial periods was two days. To compare the adverse effects of Ma-huang according to dosage, blood pressure and pulse were checked, and other adverse effects were assessed using a morning questionnaire, patient's global assessment scale and Wong-Baker faces pain rating. Results : The following result were obtained: 1. After taking 18 g of Ma-huang per day, pulse rate had a significant increase. 2. After taking more than 6 g of Ma-huang per day, palpitation would be increased significantly. 3. After taking more than 18 g of Ma-huang per day, tiredness would be increased significantly. Conclusion: According to the results, 12 g of Ma-huang per day will minimize adverse effects and maximize the potential curative value.

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Review on Clinical Studies of Traditional Herbal Medicine and Acupuncture Treatments for Colorectal Cancer Patients (대장암 환자의 한약 및 침치료에 대한 국내외 임상연구 결과에 대한 고찰 - Pubmed를 중심으로)

  • Kang, Yun Hwan;Hong, Mi-na;Han, Chang Woo;Choi, Jun Yong;Park, Seong Ha;Kim, So Yeon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.30 no.4
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    • pp.219-228
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    • 2016
  • The aim of this study was to collect and analyze the clinical studies of traditional herbal medicine and acupuncture treatments for colorectal cancer patients searched in Pubmed and Cochrane library in English. We collected the clinical studies, including randomized controlled trial, case control study and cohort study, in the PubMed and Cochrane library using keywords 'Colorectal Cancer', 'Korean Medicine', 'Traditional Chinese Medicine', 'Kampo' and 'Acupuncture'. Then we analyzed them according to the objective of the therapy, i.e. improving therapy prognosis, reducing chemotherapy's adverse event and reducing operational adverse event. In case RCT, we evaluate the quality of the study with jadad scale. Total 18 studies were selected. There were 3 studies about improving therapy prognosis, 6 studies about reducing chemotherapy's adverse event and 9 studies about reducing operational adverse event. Traditional medicine might improve therapy prognosis in terms of the survival rate, relapse/metastasis rate, quality of life and immune function. The specific herbal formula, 'Goshajinkigan' might not be successful about reducing chemotherapy's adverse event, peripheral neurotoxicity. 'Hangeshanshinto' might reduce the duration of oral mucositis but it is not clear to reduce the incidence of that. 'PHY906' might reduce the incidence of diarrhea. Acupuncture might reduce operational adverse event such as gastrointestinal dysfunction and pain. And 'Daikenchuto' might not be successful in reducing operational adverse event, gastrointestinal dysfunction. Further studies are needed to clarify the efficacy of traditional herbal medicine and acupuncture for colorectal cancer patients.

A Survey on the Demand for Home Care of the Mother's of the Hospitalized Children (입원 환아 어머니의 가정간호 요구도 조사)

  • Dim Young Hae;Kwon Bong Sook;Park Soon Og;Bae Young Soon;Lee Young Eun;Lee Ji Won;Lee Hwa Ja;Chung Gyung Ae
    • Child Health Nursing Research
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    • v.3 no.1
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    • pp.99-107
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    • 1997
  • The subjects of the study were the 120 mothers who had children hospitalized in 6 hospitals in P city during the period from Feb. 1. to May 30. 1996. The purpose of the study are(1) the problems encountered when they carried out Home Care after discharge and (2) the degrees of demand that they had against Home Care Services. In order to investigate the purposes above-mentioned the researchers used the 55 items of Home Care services belonging to 10 areas selected by Korea Home-Care Association in 1994. The items were modified and supplemented to 4-point scale. The selected data were analyzed by SPSS : PC+ and the following results were derived. 1. The subjects payed great attention to 5 items such as 'pain control, OPD visits, diet-control problems' among the 15 sources of anxiety that they had against Home Care services after discharge. Especially, 'OPD visits and knowledge deficit' would to be overcome by the nursing activities of the Home Care Nurses. 2. The acknowledge level of the subjects to the Home Care Project that governmental plans to carry out was surveyed and found as under 50. 0% responded they heard about Home Care Nursing System. 60.8% said that they thought the system was 'very necessary' and 'somewhat necessary'. 65.0% said they would like to use the system. However, the acknowledge level of 50.0% is still low and is thought to need further national promotion and propagation. 3. The demand of the subjects against 55 Home Care Services was investigated and found as

    . 'Assessment, Lab, basic nursing technology, relay ' transfer, training ' education and curative nursing' showed comparatively high scores. However, the items belonging to pediatric Home Care Services such as 'umbilical cord care, breast-feeding, infant care, and post-partum care & loan of breast-pump' showed relatively low scores.

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  • Arthroscopic Treatment of Calcific Tendinitis of the Rotator Cuff (회전근 개 석회화 건염의 관절경적 치료)

    • Lee Kwang-Won;Ryu Chang-Soo;Kim Ha-Yong;Kim Byung-Sung;Choy Won-Sik
      • Journal of the Korean Arthroscopy Society
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      • v.5 no.1
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      • pp.27-31
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      • 2001
    • Purpose : The purpose of this study was to evaluate results of the arthroscopic treatment of calcific tendinitis of the shoulder resistant to conservative treatment. Materials and Methods : From March, 1996 to June, 1998, fourteen patients underwent shoulder arthroscopy to treat resistant calcific tendinitis of the rotator cuff despite conservative treatment for more than 6 months. Calcium deposits were localized to the supraspinatus tendon only in eleven patients, the supraspinatus and infraspinatus tendon in two patients, and to the supraspinatus and subscapularis tendon in one patient. Each shoulder was evaluated with UCLA shoulder rating scale and Constant-Murley score Results : The Constant-Murley pain score improved from average score 3.2 before surgery to average score 8.3 after surgery, and the UCLA functional average score improved from 4.5 preoperatively to 8.3 postoperatively. Preoperative ROM averaged $110^{\circ}$ of flexion, $45^{\circ}$ of external rotation, $90^{\circ}$ of abduction, and internal rotation with the thumb reaching to the spinous process of the third lumbar vertebra, but postoperative range of motion averages improved as follows: $170^{\circ}$ or flexion, $50^{\circ}$ of external rotation, $140^{\circ}$ abduction, and internal rotation with the spinous process of the twelveth thoracic vertebra. Overall 3 patients were rated excellentm 9 were good, 2 were fair. Conclusion : Shoulder arthroscopy is an effective treatment in patients with refractory calcific tendinitis.

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    Posterior Interspinous Fusion Device for One-Level Fusion in Degenerative Lumbar Spine Disease : Comparison with Pedicle Screw Fixation - Preliminary Report of at Least One Year Follow Up

    • Kim, Ho Jung;Bak, Koang Hum;Chun, Hyoung Joon;Oh, Suck Jun;Kang, Tae Hoon;Yang, Moon Sool
      • Journal of Korean Neurosurgical Society
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      • v.52 no.4
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      • pp.359-364
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      • 2012
    • Objective : Transpedicular screw fixation has some disadvantages such as postoperative back pain through wide muscle dissection, long operative time, and cephalad adjacent segmental degeneration (ASD). The purposes of this study are investigation and comparison of radiological and clinical results between interspinous fusion device (IFD) and pedicle screw. Methods : From Jan. 2008 to Aug. 2009, 40 patients underwent spinal fusion with IFD combined with posterior lumbar interbody fusion (PLIF). In same study period, 36 patients underwent spinal fusion with pedicle screw fixation as control group. Dynamic lateral radiographs, visual analogue scale (VAS), and Korean version of the Oswestry disability index (K-ODI) scores were evaluated in both groups. Results : The lumbar spine diseases in the IFD group were as followings; spinal stenosis in 26, degenerative spondylolisthesis in 12, and intervertebral disc herniation in 2. The mean follow up period was 14.24 months (range; 12 to 22 months) in the IFD group and 18.3 months (range; 12 to 28 months) in pedicle screw group. The mean VAS scores was preoperatively $7.16{\pm}2.1$ and $8.03{\pm}2.3$ in the IFD and pedicle screw groups, respectively, and improved postoperatively to $1.3{\pm}2.9$ and $1.2{\pm}3.2$ in 1-year follow ups (p<0.05). The K-ODI was decreased significantly in an equal amount in both groups one year postoperatively (p<0.05). The statistics revealed a higher incidence of ASD in pedicle screw group than the IFD group (p=0.029) Conclusion : Posterior IFD has several advantages over the pedicle screw fixation in terms of skin incision, muscle dissection and short operative time and less intraoperative estimated blood loss. The IFD with PLIF may be a favorable technique to replace the pedicle screw fixation in selective case.

    Surgical Outcome of Cervical Arthroplasty Using $Bryan^{(R)}$

    • Kim, Hong-Ki;Kim, Myung-Hyun;Cho, Do-Sang;Kim, Sung-Hak
      • Journal of Korean Neurosurgical Society
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      • v.46 no.6
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      • pp.532-537
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      • 2009
    • Objective : Recently, motion preservation has come to the forefront of emerging technologies in spine surgery. This is the important background information of the emergence of cervical arthroplasty as an alternative to arthrodesis that offers the promise of restoring normal spinal movement and reduces a kinematic strain on adjacent segments. The study was designed to evaluate early surgical outcome and radiological effects of $Bryan^{(R)}$ cervical disc prosthesis. Methods : The authors retrospectively reviewed radiographic and clinical outcomes in 52 patients who received the $Bryan^{(R)}$ Cervical Disc prosthesis, for whom follow-up data were available. Static and dynamic radiographs were measured by computer to determine the angles formed by the endplates of the natural disc preoperatively, those formed by the shells of the implanted prosthesis, the angle of functional spine unit (FSU), and the C2-7 Cobb angle. The range of motion (ROM) was also determined radiographically, whereas clinical outcomes were assessed using Odom's criteria, visual analogue pain scale (VAS) and neck disability index (NDI). Results : A total of 71 $Bryan^{(R)}$ disc were placed in 52 patients. A single-level procedure was performed in 36 patients, a two-level procedure in 13 patients, and a three-level procedure in 3. Radiographic and clinical assessments were made preoperatively. Mean follow-up duration was 29.2 months, ranging from 6 to 36 months. All of the patients were satisfied with the surgical results by Odom's criteria, and showed significant improvement by VAS and NDI score (p < 0.05). The postoperative ROM of the implanted level was preserved without significant difference from preoperative ROM of the operated level (p < 0.05). 97% of patients with a preoperative lordotic sagittal orientation of the FSU were able to maintain lordosis. The overall sagittal alignment of the cervical spine was preserved in 88.5% of cases at the final follow up. Interestingly, preoperatively kyphotic FSU resulted in lordotic FSU in 70% of patients during the late follow up, and preoperatively kyphotic overall cervical alignment resulted in lordosis in 66.6% of the patients postoperatively. Conclusion : Arthroplasty using the $Bryan^{(R)}$ disc seemed to be safe and provided encouraging clinical and radiologic outcome in our study. Although the early results are promising, this is a relatively new approach, therefore long-term follow up studies are required to prove its efficacy and its ability to prevent adjacent segment disease.

    Survey on Satisfaction and Symptom Improvement of Korean Medicine Treatment in 122 Cases by Traffic Accident (교통사고 환자 122례에 대한 한방치료 만족도 및 호전도 조사)

    • Kim, Hye Ryeon;Kim, Seon Hye;Lee, Yeon Sun;Park, Seo Hyun;Sung, Won Suk;Cho, Hyun Seok;Keum, Dong Ho;Kim, Kap Sung;Kim, Eun Jung
      • The Journal of Korean Medicine
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      • v.39 no.3
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      • pp.61-72
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      • 2018
    • Objectives: This study conducted a survey research to characterize traffic accident(TA) patients seeking Korean medicine treatment and to analyze the symptom improvement and satisfaction scores. Methods: A survey was conducted in 122 outpatients, who visited OO University Korean Hospital due to TA-associated symptoms from November, 2017 to May, 2018. The questionnaire included information on patient demographic characteristics, accident circumstance details, pain levels, reason for treatment selection, treatment methods, treatment purpose, symptom improvement and satisfaction. All statistical analyses were performed using Windows SPSS version 20.0 Results: The characteristics of traffic accident patients using Korean medical institution were usually accidents that occurred while driving slowly, and minor injuries like a sprain. The most important consideration in choosing Korean medical institution was its past experience. The biggest reason for switching treatment from Western medicine to Korean medicine was for diverse treatments. Satisfaction with Korean medicine was measured between very satisfaction and satisfaction. Patients showed the highest satisfaction with acupuncture, followed by pharmacopuncture and chuna manual therapy. Most treatments were measured between very satisfaction and satisfaction. After treatment, 95.90 percent of the patients said they would recommend Korean treatment. Conclusions: Although this study has limitations as research in survey format, we intended to analyze determining factors for the use of Korean medicine treatment through satisfaction, symptom improvement, and Numeric rating scale (NRS) change.

    A Trial for Development of Health Profile (KHP 1.0) to Measure the Self-Perceived Health Status of Korean (한국인의 자가평가 건강수준 측정도구(KHP 1.0) 개발)

    • Yang, Jin-Sun;Chun, Jin-Ho
      • Journal of Preventive Medicine and Public Health
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      • v.36 no.1
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      • pp.11-23
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      • 2003
    • Objectives : The 1990s has seen advances in the conceptualization of self-perceived health status which has important roles for individual health and the quality of life. Many types of standardized questionnaires have been developed with the current wide use of SF-36, NHP, andEuroQol. However, the outcomes of these tools may be different with regard to regional, cultural and emotional backgrounds. The purpose of this study was to trial the development of a Korean Health Profile (KHP 1.0) to measure the self-perceived health stati of Koreans. Methods : The KHP 1.0 was designed on the basis of the Medical Outcome Study Form 36 (SF-36), the Nottingham Health Profile (NHP), and the EuroQOL. It was composed of 9 scales; physical functioning, role limitation-physical, pain, general health, energy, social isolation, sleep, role limitation-emotional, and e-motional health. Self-reported chronic disease conditions, and the Zung's Self-Rating Depression Scale (SDS), were also checked for the evaluation of clinical validity. This study was conducted, from December 2000 to January 2001, on 800 middle-aged parents, with four high school students, with 100 retest sets being conducted two weeks later. From the 800 subjects there were 588 complete responses (effective response 73.5%). The reliability of the test-retest results, and the factor analysis on the validity of the KHP 1.0 components, were evaluated using the SPSS (ver 10.0) software. Results : The reliability of the KHP 1.0 was good with Cronbach's alpha (>0.6), test-retest correlation coefficients (>0.5), but with no significant differences from the paired t-test. From the psychometric validity tests, the 9 scales of the KHP 1.0 were divided into two components; physical and mental, and trimmed to the established model with 55% of the total variance, with the exception of role limitation-emotional. The clinical validity on the basis of the comparison for the four characteristic groups; healthy, physical conditions only, mental conditions only, and physical and mental conditions were also good. Conclusions : The KHP 1.0 appears to be a valid measurement tool of self-perceived health stati of Koreans, although there are limitations, i.e. sample size was too small, a limited number of middle-aged subjects, and it was based on unconfirmed diagnoses, etc. Therefore, further study is required to standardize the assessment.

    A Study on Quality of Life of Breast Cancer Patients Undergoing Radiation Therapy (방사선 치료를 받는 유방암 환자의 삶의 질에 관한 연구)

    • Noh, Young-Hee;Han, You-Jeong;Yang, Kyoung-Mi
      • The Journal of Korean Society for Radiation Therapy
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      • v.14 no.1
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      • pp.187-199
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      • 2002
    • This descriptive study was undertaken to measure quality of life score and investigate the correlation between the demographic characteristics, the diagnostic related characteristics, physical symptom and quality of life of breast cancer patients undergoing radiation therapy as on attempt to provide basic data to help them attain better qualify of life. The subjects for this study were 74 out-patients undergoing radiation therapy at C University hospital in Gwangju, from June, 1998 to July, 2000. The data were obtained using a convenient sampling technique. The tool of this study was the quality of life scale developed by Ro Yoo Ja. The data were analyzed using the SAS program for percentage, mean, standard deviation, Pearson Correlation Coefficient, GLM. The results were as follows: 1. The total average score for quality of life of the subjects was 137.22 and the range was from 38 to 227, item mean score(range 1-5) was 3.15. For each factor in qualify of life of life score, the mean scores(range 1-5) were as follows; family relationship 3.69, relationship with neighbors factor 3.40, self esteem 3.10, physical state and function 2.95, economic life 2.91, emotional fate 2.88. 2. The incidence of physical symptoms was seen fatigue($82.4\%$), skin change($43.2\%$), alopecia($41.9\%$), pain($41.9\%$), anorexia($39.2\%$), anemia($39.2\%$), and headache($31.1\%$) in that order. 3. The result of the analysis of the relationships between the quality of life scores and demogaphic characteristics were as follows : there were significant differences, between age(F=3.44, p=0.013), educational level(F=3.84, p=0.007), duration of marriage((F=5.06, p=0.003) and monthly income(F=4.72, p=0.005). 4. The result of the analysis of the relationships between quality of life scores and diagnostic related characteristics was as follows: there was a significant difference between incidence durations(F=5.02, p=0.003). 5. The correlation of emotional state, economic life, self esteem, physical sate & function, relationship with neighbors, relationship with family in quality of life of cancer patients revealed a positive correlation.

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    A Prospective Study with Cage-Only or Cage-with-Plate Fixation in Anterior Cervical Discectomy and Interbody Fusion of One and Two Levels

    • Kim, Sam Yeol;Yoon, Seung Hwan;Kim, Dokeun;Oh, Chang Hyun;Oh, Seyang
      • Journal of Korean Neurosurgical Society
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      • v.60 no.6
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      • pp.691-700
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      • 2017
    • Objective : The authors prospectively analyzed the effect of one-level or two-level anterior cervical discectomy and fusion (ACDF), comparing stand-alone cages and cage-with-plate fixation constructs with respect to clinical outcomes and radiologic changes. Methods : A total of 84 patients who underwent one-level (n=52) or two-level ACDF (n=32) for cervical disc disease and who completed 2 years of follow-up were included in this study. The patients were divided by cervical level and grouped into ACDF-Cage-only and ACDF-Cage-with-plate groups. The following parameters were assessed using radiographs : subsidence, C2-C7 lordosis angle, fusion segment angle, adjacent disc space narrowing, and fusion status. Clinical outcomes were assessed using the neck disability index (NDI) and visual analog scale scores for arm pain. Results : In the comparison of one-level ACDF-cage-only and ACDF-cage-with-plate groups, the NDI score was better in the cage-only group at the 3-, 12-, and 24-month follow-ups : however, no significant difference in clinical outcomes was observed. In the comparison of two-level ACDF-cage-only and ACDF-cage-with-plate groups, no difference in any clinical outcome was observed between the two groups. At the 24-month follow-up, subsidence was observed in 45.8% of patients in the one-level cage-only group and 32.1% of patients in the one-level cage-with-plate fixation group. There was no statistically significant difference in the incidence rate between the two groups (p=0.312). Subsidence in the two-level cage-only group (66.6%) was significantly more frequent than in the two-level cage-with-plate fixation group (30%; p=0.049). The fusion rate for patients in the one-level cage-only group was not significantly different from that in the one-level cage-with-plate fixation group (cage-only, 87.5%; cage-with-plate fixation, 92.9%; p=0.425) ; fusion rate in the two-level patients were also similar between groups (cage-only, 83.3%; cage-with-plate fixation, 95%; p=0.31). Conclusion : Our clinical results showed that for single-level cases, plate fixation had no additional benefit versus cage-only; for two-level ACDF cases, the fusion rate and clinical outcomes were similar, although the cage-with-plate fixation group had a lower incidence of cage subsidence than did the cage-only group. We conclude that physicians should be aware of this possible disadvantage associated with using cervical plates in one-level ACDF. However, in two-level ACDF, subsidence is more likely to occur without plate fixation, and thus the addition of plate fixation should be considered.


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