• Journal of Hospice and Palliative Care
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• v.20 no.3
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• pp.159-166
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• 2017

According to the advance of antiretroviral regimen and the early treatment strategy, people living with human immunodeficiency virus (PLWH) are achieving the goal of virologic suppression and immune restoration. Most of them no more die of acquired immunodeficiency syndrome (AIDS) defining illnesses, and become older with chronic comorbidities such as cardiovascular, metabolic, hepatic, renal and neurological diseases. However some PLWH still visit hospitals as late presenters with very low CD4+ T cell counts, so that they suffer AIDS defining illnesses to die or experience severe neurological complications resulting in disabilities. Early palliative interventions are needed on the various symptoms of PLWH. Thus far chronic pains such as distal symmetric sensory polyneuropathies have been underevaluated. Active pain-relieving interventions are important to them. Recently we define end of life condition of human immunodeficiency virus (HIV) or eligibility to hospice care after adjusting current status of HIV treatment. Hospice teams should pay attention to the specific medical conditions, psychological needs, and social circumstances of PLWH. With just standard precautions as common infection control measures, general hospice cares can be provided to them like to other hospices subjects. For giving PLWH opportunities to have the end of life with value and dignity, hospice multidisciplinary team should intervene them early and aggressively. Now we need more clinical experiences and institutional improvements.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.17 no.1
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• pp.38-42
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• 2006

Background and Objectives: There has been a gradual decline in the incidence of laryngeal tuberculosis due to effective an-tituberculous chemotherapy and improvement in the standard of living. During the last decade, however, the disease has changed its clinical pattern. We aimed to study a clinical and telescopic evaluation of laryngeal tuberculosis. Materials and Method: A retrospective clinical analysis was done for 16 patients who diagnosed laryngeal tuberculosis from January 2000 through December 2004. All patients had a complete clinical and laboratory work-up including telescopy, chest X-rays, sputum cultures, Tbc PCR(polymerase chain reaction). Laryngeal biopsies were performed in some cases. All the patients received proper antituberculous chemotherapy. Results: The patients age ranged from 21 to 59 with a mean age 43. The male to female ratio was 10:6. The prominent presenting symptom was hoarseness. The various telescopic findings were categorized: 7 patients showed ulcerative, 4 patients granulomatous, 3 patients ulcerofungative, 2 patients had nonspecific inflammatory lesions. Involving sites were true vocal cord most commonly in 12 patients. Three of 16 patients had normal chest X-ray fmding. Among 16 patients, 4 patients showed positive response for AFB stain, 13 patients showed positive for Tbc PCR. Biopsy was done for 3 patients who were not confirmed in initial tuberculous test. All patients responded satisfactorily to antituberculous medication. Conclusion: The telescopic findings and clinical manifestations of laryngeal tuberculosis have changed and seemed to be different from those of classic reports. Thus, the clinicians who deal with the various symptoms and diseases should be aware of the existence of laryngeal tuberculosis and the changing patterns of the disease.

• Journal of the Korean Society of School Health
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• v.14 no.1
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• pp.145-160
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• 2001

The main purpose of this study is to identify the effects of a structured nursing intervention program on dysmenorrhea in middle school girls. This study employed two methods of research at the same time: a quasi-experiment pre- and post-test to use for comparison. Subjects were middle school girls assigned to the research program: 40 girls in the second grade, 40 girls in the third grade at K Girls' Middle School and H Girls' Middle School located in J city. The data were collected for 68 days from August 23 to October 30, 1999. The data were collected by observation technique and by a self-administered questionnaire. The instruments used for this study were as follows: the "Face Interval Pain Scale" menstrual pain instrument developed by McGreth(1987) and the "Menstrual Distress Questionnaire" dysmenorrhea instrument developed by Moos(1968). The dysmenorrhea knowledge instrument was developed by the researcher and refered to above. The research procedure was as follows: after preliminary examination, the experimental groups were provided educational programs with O.H.P. films developed by the researcher and with the videotape "first meeting" supported by P&G company and produced by EBS. The groups followed the educational programs twice for two weeks. At the beginning of menstruation, these subjects could choose one among the following choices: * Jacobson's progressively muscle relaxation method and massage treatment * Jacobson's progressively muscle relaxation method and hot bag treatment * Jacobson's progressively muscle relaxation method, a pain killer treatment, and massage treatment * Jacobson's progressively muscle relaxation method, a pain killer treatment, and hot bag treatment The dysmenorrhea of the control group were measured during the same period. The analysis of the collected data was done using an SPSS-PC+, descriptive statistic including real numbers, percentage, averages, standard deviations and t-test, $x^2$ test, and ANCOVA. The results of this study were as follows. (1) The knowledge level of the girls provided with the planned nursing intervention program was higher when compared to these who did not follow the educational programs. (2) The original difference in the dysmenorrhea level having been controled, the dysmenorrhea level made, nevertheless, a statistical difference between the experimental group and the control group(F=63.8, p=.00). Observed pain on quantity measurement of dysmenorrhea showed significant difference depending on the treatment(t=4.6, p=.00). In conclusion, those in the planned nursing intervention program had a higher knowledge level and fewer symptoms than the control group. Accordingly, the nursing intervention program for dysmenorrhea developed by the researcher can be effectively applied in nursing practice and can be the foundation for this kind of program.

• Korean Journal of Veterinary Research
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• v.34 no.3
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• pp.517-527
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• 1994

An attempt was made to isolate a causative viral agents from the fecal specimens of the diseased dogs with the gastroenteritis symptoms. Two coronavirus-like agents were isolated by serial dilution end point method and plaque assay. The isolates were characterized in terms of cytopathology, antigenicity, replication, physicochemical and morphological properties. The results obtained through the experiment were as follows; 1. Among 7 fecal specimens collected from the dogs with enteric disease, 2(28.6%)coronavirus-like agents showing typical cytopathic effects of canine coronavirus were isolated, and designated as CCV D1 and CCV D2, respectively. 2. By the cross-neutralization test and indirect immunofluoresence antibody test, the isolates were antigenically indentified as the standard CCV. The viruses were replicated only in the cytoplasm of A-72 cells. 3. The isolates showed no haemagglutinating activity against the erythrocytes from 11 kinds of animals. 4. The electron microscopic observation for the isolates showed spherical and pleomorphic features, covered with club-shaped projections on the surface. The size of particles was ranged from 70 to 150nm. 5. In one-step growth curve for the isolates in A-72 cells, maximum titers of intracellular vius was $10^{4.6}$ $TCID_{50}/0.1ml$ at 46 hrs postinoculation(pi) of CCV Dl and $10^{4.4}$ $TCID_{50}/0.1ml$ at 34 hrs pi of CCV D2. The maximum titers of extracellular virus was $10^{5.5}$ $TCID_{50}/0.1ml$ at 58 hrs pi of CCV D1 and $10^{5.8}$ $TCID_{50}/0.1ml$ at 46 hrs pi of CCV D2. 6. In physicochemical property test, the isolates were very sensitive to choroform and were found to be RNA virus. The viruses was stable at pH 3.0 for 1 hr and at $22{^{\circ}C}$ for 5 hrs. However, infectivity titers reduced remarkably by treatment with $56{^{\circ}C}$ for 10min.

• Journal of Chest Surgery
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• v.22 no.4
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• pp.594-600
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• 1989

Primary intracardiac repair of tetralogy of Fallot with low mortality and early good results, has been accomplished in recent years. But palliative procedures have been reserved for those hypoplastic pulmonary arteries, a hypoplastic left ventricle or anomalies of the coronary artery would make total correction difficult. And the Blalock-Taussig shunt operation is recognized as a standard and popular palliative procedure. I undertook a retrospective determination of the effect of the Blalock-Taussig shunt operation on the development of the main pulmonary artery and the right and left pulmonary arteries. Between January, 1980, and April, 1987, at the Severance Hospital, 16 patients were studied by cardiac catheterization and angiocardiography, before undergoing Blalock-Taussig shunting procedures for the palliation of severe symptoms of tetralogy of Fallot, and some time later, usually prior to a second procedure. The mean interval between catheterizations was 22.25 months. Patients with tetralogy of Fallot and pulmonary atresia or with an occluded shunt were not included. The primary and secondary angiograms of each patient were reviewed, and measurements of the diameter of the main pulmonary artery, the right and left pulmonary arteries, and the descending thoracic aorta were taken. The results are as follows; 1. The hematocrit decreased from 56.39% to 50.34%[p< 0.05], and the arterial oxygen saturation increased from 62.00 % to 81.31 %[p< 0.001] following shunt procedures 2. The ratio of the diameter of the right pulmonary artery plus the left pulmonary artery to the diameter of the descending thoracic aorta increased 1.30 k 0.28 times [p< 0.01]; but the ratio of the diameter of the main pulmonary artery to the diameter of the descending thoracic aorta increased 1.10 * 0.33 times, which was not. significant[p< 0.05]. 3. The interval between shunting and second catheterization was not related to the magnitude of change in the pulmonary arteries[r=0.141, p >0.05]. 4. The changes in the ratio of the diameter of the right pulmonary artery plus the diameter of the left pulmonary artery to the diameter of the descending thoracic aorta was inversely related to the initial ratio[r=0.757, p >0.001], but the change in the ratio of the diameter of the main pulmonary artery to the descending thoracic aorta was not related[r=0.059, p >0.05]. 5. There were no differences in enlargement of the pulmonary artery on the side of the shunt [ipsilateral] versus enlargement on the opposite side [p >0.05], nor according to the size of the shunt[p >0.05]. In conclusion, this study suggests that the Blalock-Taussig shunt is effective for the development of the right and left pulmonary arteries but not effective for the main pulmonary artery.

• Journal of Korean Neurosurgical Society
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• v.30 no.4
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• pp.501-508
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• 2001

Objectives : Hemifacial spasm is painless uncommon disorder characterized by involuntary paroxysmal movement on one side of face. It is known that hemifacial spasm is mainly due to pulsatile compression by vessels at the root exit zone(REZ) of the facial nerve. Microvascular decompression at REZ of the facial nerve has become the standard treatment modality for hemifacial spasm. The authors have analized patients with hemifacial spasm treated with microvascular decompression to evaluate operation result and clinical course after operation. Patients and Methods : From 1992 to 1999, 41 patients with hemifacial spasm underwent this operation. Retrospective analysis of operation results and clinical recovery patterns was done. The length of observation had been more than 6 months in all cases. Results : The ratio of male to female was 1:1.4, and age at operation ranged from 24 to 66 years. Their mean age was 47.6 years and the mean preoperative duration of symptoms was 7.2 years. Most common offending vessels were AICA in 18 cases(48%) and second most common were PICA in 13 cases(31.7%). The rest of them were 3 case in vertebral artery, and 7 cases(13%) in multiple offending vessels. Patterns of improvement after surgery could be divided into 4 clinical types. There was complete recovery in 3 days after operation in 24 cases(58.6%, Immediate complete recovery). There was complete recovery in 3 days after operation, and symptom was recurred partially, which was gradually subsided in 2 weeks after operation in 4 cases(9.8%, Delayed complete recovery type I). There was partial recovery after operation and symptom was compretely disappeared gradually in 6 months after operation in 7 cases(17.1%, Delayed complete recovery type II). Finally, there was partial recovery after operation, and symptom was somewhat remained after 6 months later(14.5%, Delayed partial recovery). Conclusion : In conclusion, microvascular decompression for hemifacial spasm is a safe and reliable treatment modality with good results of improvement and there are 4 recovery patterns in clinical course after operation in our series. Therefore, follow-up observation after microvascular decompression is necessary to evaluate the operative results and complication, especially in the delayed resolved cases.

• Korean Journal of Biological Psychiatry
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• v.4 no.2
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• pp.198-210
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• 1997

To examine the double-faced thymoleptic(antidepressant and antimanic) effects of risperidone in mood disorders, this article reviews the psychotropic-induced mania, thymoleptic effects of antipsychotics, therapeutic effects of risperidone and risperidone(RIS)-induced mania(RIM) in mood disorders, risk factors of RIM, possible neurochemical mechanism of these thymoleptic effects, pathophysiological and clinical significance of thymoleptic effects, and suggestive clinical guideline of RIS in mood disorders. RIS appeared effective for bipolar disorder at a lower dose than that recommended for schizophrenia, especially in the cases of maintenance of mood stabilizers, and gradual titration from low doses. Manic induction/exacerbation can occur by chance during RIS treatment in mood disorders, schizoaffective disorders, and schizophrenias. The possible risk factors for RIM are refractory mood disorder, especially in bipolar I disorder with poor initial response ; refractory schizoaffective disorders, especially in bipolar type with poor initial response ; refractory chronic schizophrenias, especially with initial responses ; psychotic features ; higher initial doses ; rapid titration ; combined therapy with antidepressants in refractory depression ; and RIS monotherapy in mania/hypomania. RIS is a drug that preferentially block 5-HT2 receptors. The effects of low dose are due mainly to the blockade of 5-HT2 receptors. There are more gradual increase in D2 blockade with increasing dose and this D2 blocking properties become apparent at higher doses. This may be related to a modulation of dopaminergic transmission by 5-HT2 antagonism at lower doses with the direct action of RIS on DA receptors coming into play at higher dose. The serotonergic antagonistic effect may be important for its effects on depressive symptoms. This, together with adequate blo-ckade of D2 receptors, may not necessarily lead to destabilization of mood disorder, but rather to more therapeutic effects. Therefore, this dose-receptor affinity relationship with both antidepressant and antimanic effects according to treatment duration can explain a continuum of antidepressant effect, antimanic effect, behavioral stimulation, and manic/hypomanic induction/exacerbation. It was the recognition of a useful psychiatric side effects by a thoughtful observer with fertile minds that led to their ultimate utilization as psychotropic drugs, i.e., phenothiazine, MAOI, TCA, and lithium. And, in vivo pharmacological challenge by novel psychotropics, as a neurochemical probe, with more specific actions is a useful tool to select pharmacologically homogeneous subgroup of the same phenotypical(clinical) condition, to further study the unknown underlying pathogenesis of various mental illnesses. Finally, RIS may be a useful alternative or adjunctive drug for patients with mood disorders without psychotic features or refractory to treatment with standard antipsychotic drugs. The more conservative doses(tirated slowly from 1-3 mg/d) of RIS, and maintenance of mood stabilizer in the cases with risk factors of RIM are recommended in mood disorder.

• Journal of Chest Surgery
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• v.48 no.5
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• pp.345-350
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• 2015

Background: Conventional stripping is considered to be the standard procedure for great saphenous vein (GSV) varicosities, but many other alternative treatments such as cryostripping, endovenous laser therapy (EVLT), radiofrequency ablation, and ultrasound-guided foam sclerotherapy have been developed. Among them, both cryostripping and laser therapy have been reported to be less traumatic, with lower rates of complications and recurrences when compared to conventional stripping. To compare the efficacy of these treatments, we have analyzed and compared the mid-term clinical outcomes of cryostripping and EVLT. Methods: Patients diagnosed with varicose veins of the GSV and treated with cryostripping or laser therapy between September 2008 and April 2013 were enrolled in this study. Duplex ultrasonography was used for the diagnosis and evaluation of varicosity and reflux, and the clinical-etiology-anatomy-pathophysiology classification was used to measure the clinical severity. The symptoms, Venous Clinical Severity Score (VCSS), recurrence rates, and complication rates of the cryostripping and laser therapy groups were analyzed and compared. Results: A total of 68 patients were enrolled in this study. 32 patients were treated with cryostripping, and 36 patients were treated with laser therapy. The median follow-up period was 29.6 months. Recurrence was noted in three patients from the cryostripping group and in two patients from the EVLT group. There was no difference in the VCSS score, operative time, duration of hospital stay, and complication rate between the cryostripping group and the EVLT group. Conclusion: The mid-term clinical outcomes of cryostripping were not inferior to those of EVLT. Further, considering its cost-effectiveness, cryostripping seems to be a safe and feasible method for the treatment of varicose veins.

• Science of Emotion and Sensibility
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• v.22 no.3
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• pp.3-20
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• 2019

With advancements in technology of virtual reality, it is used for various purposes in many fields such as medical care and healthcare, but as the same time there are also increasing reports of nausea, eye fatigue, dizziness, and headache from users. These symptoms of motion sickness are referred to as cybersickness, and various researches are under way to solve the cybersickness problem because it can cause inconvenience to the user and cause adverse effects such as discomfort or stress. However, there is no official standard for the causes and solutions of cybersickness at present. This is also related to the absence of tools to quantitatively measure the cybersickness. In order to overcome these limitations, this study proposed quantitative and objective cybersickness evaluation method. We measured 128-channel EEG waves from ten participants experiencing visually stimulated virtual reality. We calculated the relative power of delta and alpha in 11 regions (left, middle, right frontal, parietal, occipital and left, right temporal lobe). Multiple regression models were obtained in a stepwise manner with the motion sickness susceptibility questionnaire (MSSQ) scores indicating the susceptibility of the subject to the motion sickness. A multiple regression model with the highest under the area ROC curve (AUC) was derived. In the multiple regression model derived from this study, it was possible to distinguish cybersickness by accuracy of 95.1% with 11 explanatory variables (P_D.MF, P_D.LP, P_D.MP, P_D.RP, P_D.MO, P_A.LF, P_A.MF, P_A.RF, P_A.LP, P_A.RP, P_A.MO). In summary, in this study, objective response to cybersickness was confirmed through 128 channels of EEG. The analysis results showed that there was a clearly distinguished reaction at a specific part of the brain. Using the results and analytical methods of this study, it is expected that it will be useful for the future studies related to the cybersickness.

• The Journal of Korean Medicine
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• v.21 no.4
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• pp.55-63
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• 2000

Objectives : Fatigue is a common symptom experienced by everyone. Nevertheless, clinicians have a tendency of ignoring it since fatigue itself is not considered a distinct disease. Actually, some limited research about chronic fatigue syndrome has been made within the country, but in reality, the probability of getting this syndrome is still considered very low due to the strict diagnosis standard. Therefore, there are tremendous numbers of patients who do not get enough attention from clinicians for their fatigue symptoms only because technically they do not belong to the syndrome. Therefore, a basic statistical database must be compiled and patient management programs must be developed. To accomplish this, we conducted this study by measuring degree of fatigue, clinical characteristics and processes of Oriental medical treatment of fatigue patients. Methods : The objects of this study were selected from the new patients who entered the tonification Clinic in Kynnghee Oriental Medical Center between August 11, 2000 and October 7, 2000. Their main complaint was fatigue and they did not suffer from any physical or mental problem either historically or at the time of the study. The objects were divided into two groups based on duration of fatigue; fatigue under 6 months is considered as acute fatigue and fatigue for longer than 6 months is chronic fatigue. The prepared survey sheet for measuring fatigue degree was distributed to the patients with their consent. The patients were divided again into three subgroups : the fIrst group went through 1st test and constitution test after tonification clinic; the second one went into constitution test skipping Ist measuring test; the third one went into only tonification clinic with neither 1st measuring test nor constitution test. Results : The total number of object patients was 47 and 80% of them were considered as 'fatigue patients' by the Chalder scale. Among all patients, 29.5% requested treatment for chronic fatigue, which is over 6 months. The average of scale II for all patients was 14.8, which indicates moderate fatigue. The averages of scale II-1, II-2, II-3 were respectively 7.5, 5.9, and 3.7 so the most common complaint was physical fatigue. When compared scale II based on occupations, student group scored 6.9 and office man group scored 8.5 in scale II-1, physical fatigue, but it was not significant. Conclusions : Numerous number of patients have come to Oriental medical centers or hospitals in Korea. Therefore, deeper statistical research and follow-up-monitoring are reqnired in the Oriental medical academic world. In this study, among all patients who entered the tonification Clinic in Kyunghee Oriental Medical Center, 29.5% requested treatment for chronic fatigue, which is over 6 months. This kind of statistical report is the first time trial in the Oriental medical academy world. Through these steps, more objective treatment can be made and standards of prognosis assessment can be established.tablished.