• Title/Summary/Keyword: Urinary Disturbance

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Controlled Release of Tamsulosin from Nanopore-Forming Granules (미세 다공성 과립을 이용한 탐스로신의 방출제어)

  • Seo, Seong-Mi;Lee, Hyun-Suk;Lee, Jae-Hwi;Lee, Ha-Young;Lee, Bong;Lee, Hai-Bang;Cho, Sun-Hang
    • Journal of Pharmaceutical Investigation
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    • v.36 no.1
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    • pp.39-44
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    • 2006
  • Tamsulosin or a salt thereof such as its hydrochloride salt has been known to have an adrenaline ${\alpha}$ receptor blocking action for urethra and prostate areas. It has been widely used as a drug which lowers the prostate pressure and improves urinary disturbance accompanied by prostate-grand enlargement, thus for the treatment of prostatic hyperplasia. To avoid dose-dependent side effects of tamsulosin upon oral administration, the development of sustained-release delivery system is essentially required, that can maintain therapeutic drug levels for a longer period of time. The aim of this study was therefore to formulate sustained-release tamsulosin granules and assess their formulation variables. We designed entric coated sustained-release tamsulosin granules for this purpose. Nano-pores in the outer controlled release membrane were needed in order to obtain initial tamsulosin release even in an acidic environment such as gastric region. In our sustained release osmotic granule system, hydroxypropylmethylcellulose in a drug-containing layer was used as a rate controller. The drug-containing granules were coated with hydroxypropylmethylcellulose phthalate (HPMCP) and Eudragit, along with glycerol triacetate as an aqueous nano-pore former. The release of tamsulosin depended heavily on the type of Eudragit such as RS, RL, NE 30D, used in the formulation of controlled release layer. These results obtained clearly suggest that the sustained-release oral delivery system for tamsulosin could be designed with satisfying drug release profile approved by the Korean Food and Drug Administration.

Yearly Report on CVA patients (IV) (뇌졸중환자(腦卒中患者)에 대한 연례보고(年例報告)(IV))

  • Shim, Mun-Ki;Jun, Chan-Yong;Park, Chong-Hyeong
    • The Journal of Korean Medicine
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    • v.19 no.2
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    • pp.59-74
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    • 1998
  • Clinical observation was done on 272 cases of patients who were diagnosed as CVA with brain CT, TCD, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from 1st January to 31st December in 1997. 1. The cases were classified into the following kinds: cerebral infarction, cerebral hemorrhage. and transient ischemic attack. The most case of them was the cerebral infarction. 2. There is no significant difference in the frequency of strokes in male and female. And the frequency of strokes was highest in the aged over 50. 3. In cerebral infarction the most frequent lesion was the territory of middle cerebral artery, and in cerebral hemorrhage the most frequent lesion was the basal ganglia. 4. The most ordinary preceding disease was hypertension. and the next was diabetes. 5. The rate of recurrence was high in cerebral infarction. 6. The cerebral infarction occurred usually in resting and sleeping, and the cerebral hemorrhage in acting. 7. The common symptoms were motor disability and verbal disturbance. 8 The average time to start physical therapy was 1l.3rd day after stroke in cerebral infarction and it was 15.2th day after stroke in cerebral hemorrhage. 9. The common complications were urinary tract infection, pneumonia, myocardial infarction. 10. Hypercholesterolemia and hypertriglyceridemia are usually found more frequently in cerebral infarction than in hemorrhage. 11. In acute or subacute stage, the methods of smoothening the flow of ki(順氣), dispelling phlegm(祛痰), clearing away heat(淸熱) or purgation(瀉下) were frequently used. and in recovering stage, the methods of replenishing ki(補氣), tonifying the blood(補血) or tranquilization(安神) were frequently used.

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Study on the Development of Home Care Nursing Intervention Protocol for Stroke Patients (뇌졸중 환자의 가정간호중재 프로토콜 개발)

  • Yoo Ji-Soo
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.1
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    • pp.122-136
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    • 2000
  • Stroke patient needs rehabilitation after receiving an acute treatment in a hospital. When stroke patient gets involved in an early discharge program, home care nurse plays a pivotal role to make them to gain a full strength and to come back to his/her prior life before he/she is sick. In spite of the importance of home care nursing intervention protocol for home care nurses to perform home care nursing autonomously, home care nursing intervention protocol for stroke patient is rarely developed. Therefore this study was conducted to develop home care nursing protocol that is applicable for stroke patients in home care nursing area. 41 home care nursing charts for stroke patients registered in home care nursing agencies from December 1st 1994 to August 31st 1999 at Y hospitals in Seoul and Won-Ju city were analyzed. 44 home care nurses who were having over three years' experience on stroke patients were participated in this study as a user validity validation group. The results of this study are as follows. 1. 28 nursing diagnoses were selected on the basis of evaluation of nursing diagnoses of stroke patients presented in a previous literature and case studies on home care nursing. 2. 17 nursing diagnoses were classified through the frequency analysis of home care nursing charts for 41 stroke patients who had received home care nursing. The order of sequence was like these: impaired skin integrity, risk for infection, nutritional deficit, impaired physical mobility, constipation, knowledge deficit, ineffective airway clearance, anxiety in family members, risk for aspiration, self care deficit, altered urinary elimination, ineffective individual coping, social isolation, risk for injury, self-esteem disturbance, impaired verbal communication, fatigue of family caregiver. 3. Based on validation on expert and user validities, 44 nursing interventions which were above ICV=.80 were chosen. 4. Nursing intervention protocols which showed above ICV=.90 were developed and were like these; pressure ulcer care, position change, preventive care for circulatory dysfunction, tube care : catheter, vital sign monitor, constipation/impaction management, artificial airway management, suction of airway secretion, environmental management : safety, and fall prevention.

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Prediction of Sleep Disturbances in Korean Rural Elderly through Longitudinal Follow Up (추적 관찰을 통한 한국 농촌 노인의 수면 장애 예측)

  • Park, Kyung Mee;Kim, Woo Jung;Choi, Eun Chae;An, Suk Kyoon;Namkoong, Kee;Youm, Yoosik;Kim, Hyeon Chang;Lee, Eun
    • Sleep Medicine and Psychophysiology
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    • v.24 no.1
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    • pp.38-45
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    • 2017
  • Objectives: Sleep disturbance is a very rapidly growing disease with aging. The purpose of this study was to investigate the prevalence of sleep disturbances and its predictive factors in a three-year cohort study of people aged 60 years and over in Korea. Methods: In 2012 and 2014, we obtained data from a survey of the Korean Social Life, Health, and Aging Project. We asked participants if they had been diagnosed with stroke, myocardial infarction, angina pectoris, arthritis, pulmonary tuberculosis, asthma, cataract, glaucoma, hepatitis B, urinary incontinence, prostate hypertrophy, cancer, osteoporosis, hypertension, diabetes, hyperlipidemia, or metabolic syndrome. Cognitive function was assessed using the Mini-Mental State Examination for dementia screening in 2012, and depression was assessed using the Center for Epidemiologic Studies Depression Scale in 2012 and 2014. In 2015, a structured clinical interview for Axis I psychiatric disorders was administered to 235 people, and sleep disturbance was assessed using the Pittsburgh Sleep Quality Index. The perceived stress scale and the State-trait Anger Expression Inventory were also administered. Logistic regression analysis was used to predict sleep disturbance by gender, age, education, depression score, number of coexisting diseases in 2012 and 2014, current anger score, and perceived stress score. Results: Twenty-seven percent of the participants had sleep disturbances. Logistic regression analysis showed that the number of medical diseases three years ago, the depression score one year ago, and the current perceived stress significantly predicted sleep disturbances. Conclusion: Comorbid medical disease three years previous and depressive symptoms evaluated one year previous were predictive of current sleep disturbances. Further studies are needed to determine whether treatment of medical disease and depressive symptoms can improve sleep disturbances.

Clinical Study of CT-diagnosed Olivopontocerebellar Atrophies (Olivopontocerebellar Atrophy의 임상상과 전산화단층뇌촬영 소견)

  • Park, Mee-Yeong;O, Khyoung-Yhun;Hah, Jung-Sang;Byun, Yeung-Ju;Park, Choong-Suh
    • Journal of Yeungnam Medical Science
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    • v.5 no.2
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    • pp.87-93
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    • 1988
  • The diagnosis of OPCA could be made clinically with important aid of brain CT scanning, although the definite and conclusive diagnosis only by postmortem pathological determination. We reviewed, clinically and with brain CT examination, 12 cases of patients with OPCA who were admitted to the Yeungnam University Hospital for a recent 5 years. The result were as following. : 1. The distribution of age is from 49 to 72, mainly 50 to 60. Man is more frequent than women at the 4.5 times. 2. The interval period from Sx. onset to diagnosis is 1 year to 6 years. 3. The usual initial Sxs. were dizziness(58%), ataxia(33%), and other less frequent Sxs. were weakness of low extremities, dysarthria, headache and urinary incontinence. The clinical manifestations at the initial diagnosis were cerebellar disturbance(100%), dysarthria(83%), and increased deep tendon reflexes(58%). 4. The results of brain CT finding are like this : ${\cdot}$ the width of cerebellar sulci is more than 1mm, other 4 cases more than 2mm. ${\cdot}$ the width of cerebellar pontine cistern of the patient if usually 3 to 4mm, other 2 cases extended to the 5mm. ${\cdot}$ the A. P and lateral lengths of 4th. ventricle is 4mm and 4 to 8mm respectively. ${\cdot}$ 6 cases of whole patients show coincidentally cerebral atrophy.

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The Effects of Phellodendri Cortex Treatment on Hematological and Cyto-pathological Alterations in Non-Bacterial Prostatitis Rat Model (황백이 만성 비세균성 전립선염 모델에서 혈액학적 및 세포조직학적 변화에 미치는 영향)

  • Kim, Soon-Il;Ahn, Young-Min;Ahn, Se-Young;Doo, Ho-Kyung;Lee, Byung-Cheol
    • The Journal of Korean Medicine
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    • v.27 no.3 s.67
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    • pp.51-62
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    • 2006
  • Objective: Although chronic non-bacterial prostatitis is a common disease, it is very difficult to treat effectively. Lygodium japonicum has traditionally been used in treatment of urinary tract inflammation and voiding disturbance. In this study, we investigated the therapeutic effects and action mechanism of Lygodium japonicum in the rat model of non-bacterial prostatitis induced by castration and testosterone treatment. Methods: Five-month-old rats were treated with $17\beta-estradiol$ after castration for induction of experimental non-bacterial prostatitis, which is similar to human chronic prostatitis in histopathological profiles. Lygodium japonicum and testosterone were administered as an experimental specimen and a positive control, respectively. The prostates were evaluated by histopathological parameters including the epithelial score and epithelio-stromal ratio for glandular damage, proliferating cell nuclear antigen (PCNA) labeling index for cyto-proliferation and a TUNEL (deoxyuridine triphosphate biotin nick end-labeling) assay for cell apoptosis. Results: While prostates of control rats revealed severe acinar gland atrophy and stromal proliferation, the rats treated with Lygodium japonicum showed a lesser range of tissue damage. Epithelial score was improved in Lygodium japonicum than that of the control (P<0.05). The epithelio-stromal ratio was lower in Lygodium japonicum when compared to that of the control (P<0.05). Although there was no difference in PCNA and TUNEL positive cells of the glandular epithelia, we found an decreased number of PCNA positive cell and concurrent increase of TUNEL positive cells in the stroma of Lygodium japonicum treated rats (P<0.01). Conclusions: These findings suggest that Lygodium japonicum may protect the glandular epithelial cells and also inhibit stromal proliferation in association with suppression of cyto-proliferation and stimulation of apoptosis. We concluded that Lygodium japonicum may be a useful remedy agent for treating the chronic non-bacterial prostatitis.

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'Clinical Observation on the 290 cases of Cerebrovascular Accident' (뇌졸중환자(腦卒中患者) 290례(例)에 대(對)한 임상(臨床) 고찰(考察) (III))

  • Kang, Kwan-Ho;Jun, Chan-Yong;Park, Chong-Hyeong
    • The Journal of Korean Medicine
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    • v.18 no.2
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    • pp.223-244
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    • 1997
  • Clinical observation was done on 290 cases of patients who were diagnosed as CVA with brain CT, TCD, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from 1st January to 31st December in 1996. 1. The cases were classified into the following kinds : cerebral infarction, cerebral hemorrhage, and transient ischemic attack. The most case of them was the cerebr진 infarction. 2. There is no significant difference in the frequency of strokes in male and female. And the frequency of strokes was highest in the aged over 50. 3. In cerebral infarction the most frequent lesion was the territory of middle cerebral artery, and in cerebral hemorrhage the most frequent lesion was the basal ganglia. 4. The most ordinary preceding disease was hypertension, and the next was diabetes. 5. The rate of recurrence was high in cerebral infarction. 6. The frequency of strokes seems to have no relation to the season. 7. The cerebral infarction occurred usually in resting and sleeping, and the cerebral hemorrhage in acting. 8. The course of entering hospital, most patients visited this hospital as soon as CVA occurred. And the half of patient visited this hospital within 2 days after CVA attack. 9. In the cases of patients who were unconscious at the admission, the prognosis was worse than that of the alert patients. 10. The common symptoms were motor disability and verbal disturbance. 11. The average duration of hospitalization was 27.4 days, and in case of cerebral hemorrhage the duration was prolonged. 12. The average time to start physical therapy was 13.3rd day after stroke in cerebral infarction and it was 19.9th day after stroke in cerebral hemorrhage. 13. The common complications were urinary tract infection, pneumonia, myocardial infarction and so on. 15. At the time of entering hospital, in most cases the blood pressure was high, but blood pressure was well controlled at the time of discharge. 16. Generally reported, hypercholesterolemia and hypertriglyceridemia are usually found in cerebral infarction. But in this study, they were found more frequently in cerebral hemorrhage than in infarction. 17, In the most cases, western and oriental medical treatments were given simultaneously. 18. In acute or subacute stage, the methods of smoothening the flow of KI(順氣), dispelling phlegm(祛痰), clearing away heat(淸熱) or purgation(瀉下) were frequently used. And in recovering stage, the methods of replenishing KI(補氣), tonifying the blood(補血) or tranquilization(安神) were frequently used.

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Effect of Pilocarpine Mouthwash on Xerostomia (구강건조증에 대한 필로카핀 구강양치액의 효과)

  • Kim, Ji-Hyun;Park, Ju-Hyun;Kwon, Jeong-Seung;Ahn, Hyung-Joon
    • Journal of Oral Medicine and Pain
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    • v.36 no.1
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    • pp.21-24
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    • 2011
  • Xerostomia is subjective feeling of dry mouth, a symptom that may or may not be accompanied by hyposalivation, an objective decrease in salivary flow. There are many causes induced xerostomia like drugs, salivary gland diseases, radiation therapy to the head and neck region, Sjogren syndrome, emotional stress etc. Insufficient salivary flow creates complications with oral candidiasis, dental caries, periodontitis, halitosis, dysgeusia. So finally, these complications lead to an overall decline in quality of life. Managements of xerostomia are eliminating or alterating the etiologic factors, relieving symptoms, preventing or correcting the consequences of salivary dysfunction, treating underlying disease and stimulating salivation. One of the salivation stimulation agents studied to treat xerostomia was the pilocarpine muscarinic agonist. Pilocarpine is one of salivation stimulants, a parasympathomimetic drug and non-selective muscarinic receptor agonist. Systemic pilocarpine has been used to stimulate salivary secretion. But systemic administration of pilocarpine has limitations such as increased risk of side effects and contraindications. Side effects of systemic pilocarpine administration are sweating, urinary and gastrointestinal disturbance, risk of cardiovascular and pulmonary disorders. This drug must be used carefully by patients with controlled asthma, chronic bronchitis, pulmonary or cardiac disease. Patient with acute asthma, narrow angle glaucoma, iritis should not use pilocarpine. Like this, systemic pilocarpine has many limitations. So, many investigators also have looked at the effectiveness of topical pilocarpine. Here we present patients with xerostomia which was relieved by pilocarpine mouthwash.

치매에 대한 한의학적 임상연구

  • Whang Wei-Wan;Kim Jong-Woo;Lee Jo-Hee;Eom Hyo-Jin;Lee Seung-Gi
    • Journal of Oriental Neuropsychiatry
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    • v.7 no.1
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    • pp.1-13
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    • 1996
  • 1. Out of 21 examples on a clinical base Alzheimer type dementia were 8 examples(38%), 11 vascular types(52%), 1 Alzheimer and vascular mixed type and rest 1 was secondary dementia type(NPH).2. Between the genders, there were 5 males and 3 females for Alzheimer types, 6 males and 5 females for the vascular types, 1 male for Alzheimer and vascular mixed type, and 1 female for secondary dementia type(NPH).3. For the degrees of Alzheimer type dementia there were 2 mild dementia, 4 moderate dementia, and 2 severe dementia. 4. Among the Alzheimer types 2 mild dementia were almost recovered back to normal in approximately 2 months, 2of 4 moderate dementia became significantly better in approximately 2 months and recovered to almost normal state in 3 to 5 months. The rest 2 have been under treatment for 3 months, but showed a little improvement. Out of 2 severe dementia examples, one showed a little improvement even if it has been under treatment over 2 years. The other example did not show any improvement, but dementia did not proceed any more.5. Among the 11 vascular examples, 7 recovered in 2 to 3 months, 1 in 5 months, 2 recovered in a year, and the treatment was stopped arbitrary for the last one.6 In the case of Alzheimer and vascular mixed type dementia, even the moderate dementia did not show any apparent result in 6 months.7. For NPHI (Normal Pressure Hydrocephalus), there was an improvement on dementia in 2 months after the treatment, but gait disturbance and urinary incontinence did not show any noticeable difference. As a conclusion, almost all the Alzheimer and vascular type patients recovered, but the treatment periods varied depending on the types of the dementia and the degree of seriousness, especially in the case of the severe Alzheimer patients, the treatment oniy suppression the progression of the dementia. The most important aspect from clinical point of view was even if almost all the patients were almost completely cired, they need to keep being cured for a long period of time. The method with respect to Four Constitutions is thought of the most desirable.

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Home-Based Hospice Care Provided by a Free-Standing Hospice Center: Patients' Characteristics and Service Conditions (일개 독립형 호스피스 기관의 가정호스피스 이용자 특성 및 서비스 제공 실태)

  • Kim, Hyoung Suk;June, Kyung Ja;Son, Young Sun
    • Journal of Hospice and Palliative Care
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    • v.19 no.2
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    • pp.145-153
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    • 2016
  • Purpose: This study was conducted to investigate patients' characteristics and actual conditions of home-based services offered by a free-standing hospice center. Methods: A retrospective review was performed with the medical records of 75 patients who received home-based hospice care from a free-standing hospice center from January 2014 through December 2014. Results: Most patients (54.7%) were enrolled via self-directed referral. The reason for the service termination was death at home 25.3%, admission to a hospice ward 50.7%, hospitalization 22.6% and patients' refusal 2.7%. Seventy three patients had cancer, and two patients had ALS. Among all, 58.7% were in a dying phase, and 34.7% were almost completely bedfast at the time of their enrollment in this study. When they enrolled, the patients' physical symptoms were characterized as pain (89.4%), sleep disturbance (71.2%), urinary difficulties (35.8%) and defecation difficulties (47.8%). Among all, 77.4% terminated the home visit service within one month. The mean frequency of the home visits was 3.25 (${\pm}3.98$), and less than five in 82.7% of patients. The mean frequency of the phone service was 3.40 (${\pm}3.12$). The frequency of doctor's home visits was $1.21{\pm}0.79$ on average, and the figure increased when patients' conditions turned unstable. Conclusion: It is necessary to develop a home-based hospice care model with consideration of patients' characteristics and the actual service conditions delivered by free-standing hospice facilities.