• Journal of Pharmacopuncture
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• v.21 no.1
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• pp.7-13
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• 2018

Objective: Hwa-byung is one of the cultural concept of distress in Korea resulted from chronic accumulated anger. It is characterized by various symptoms like stuffy in the chest, hot or heat sensation, something pushing up in the chest, feeling of mortification, and a flush of anger. This protocol aims to explore the efficacy and safety of Huanglian-jie-du decoction on various somatic symptoms and insomnia in patients with Hwa-byung. Methods: This is study protocol for a randomized, double-blind, placebo-controlled trial. A total of 44 patients will be randomly assigned to the experimental group or the placebo group in a 1:1 ratio. All medications will be taken orally 3 times per day for 7 consecutive days. The primary outcomes are the mean changes in Patient Health Questionnaire of physical symptoms (PHQ-15) and Insomnia Severity Index (ISI) after the 7 days of administration. The secondary outcomes include the scales to assess stress response, symptoms of Hwa-byung, and state anger. Conclusion: The results of this study will provide high quality and explorative evidence to investigate the effect of Huanglian-jie-du decoction on Hwa-byung.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.1
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• pp.41-46
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• 2018

Background: The purpose of this prospective randomized single-blind clinical trial was to evaluate the effect of tilting the head on the anesthetic efficacy of inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis. Methods: Ninety-two patients were divided into two groups: the first group received IANB and the head was tilted in the direction of the block for 15 min, whereas the second group received IANB and the head was tilted to the opposite side. Access cavity preparation was initiated after 15 min. Success was defined as no pain or faint/weak/mild pain during endodontic access preparation and instrumentation. The anesthetic success rates were analyzed by Pearson chi-square test at 5% significance levels. Results: The same side position and opposite side position yielded 41% and 30% anesthetic success rates, respectively; there was no significant difference between the two sides. Conclusions: Relative head position has no effect on the anesthetic success rate of IANB.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.4
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• pp.2197-2202
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• 2020

Background: If there is a difference in leg length, the center of gravity shifts unilaterally toward the short leg, causing loss of balance and secondary postural imbalance, trunk muscle tone changes, gait abnormalities and pelvic imbalance. Objectives: To investigate effects of self exercise program on leg length, balance in adults with leg-length discrepancy. Design: Single blind randomized controlled trial. Methods: Twenty-eight participants were selected and divided into resistance exercise, flexibility exercise, and core exercise. Each exercise was performed for 40 minutes, 3 times a week for 6 weeks. Leg length and balance before and after exercise were measured and analyzed. Results: Following the interventions, resistance exercise group showed significant improvement in balance, but leg length difference did not show significant results. Flexibility exercise group showed significant improvement in leg length difference, but balance did not show significant results. Core exercise group showed significant improvement in leg length difference and balance. There was no significant difference in the comparison between the three groups. Conclusion: This study suggests that customized exercise according to the patient's level is beneficial to the patients.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.6
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• pp.575-582
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• 2021

Background: The aim of this randomized, triple-blind trial was to determine the anesthetic, analgesic, and hemodynamic effects of articaine and bupivacaine in the extraction of impacted mandibular third molar teeth. Methods: Twenty-six patients who underwent removal of bilaterally symmetric mandibular third molars were randomly assigned to articaine and bupivacaine groups in a split-mouth design. The onset of anesthetic action, intraoperative comfort, total amount of solution used, duration of postoperative anesthesia and analgesia, rescue analgesic use, postoperative pain, intraoperative bleeding, and hemodynamic parameters were evaluated. Results: In the articaine group, the onset of anesthetic activity was faster, intraoperative comfort was greater, and effective anesthesia required less local anesthetic solution. The bupivacaine group showed a significantly longer duration of postoperative anesthesia and analgesia, in addition to lower visual analog scale values at 6 and 48 hours postoperatively. There were no significant differences between the two solutions regarding rescue analgesic medication use, intraoperative bleeding, or hemodynamics. Conclusion: Articaine showed greater clinical efficacy than bupivacaine in intraoperative anesthesia, achieving faster onset of anesthetic action and greater patient comfort while also requiring less reinforcement during surgery. However, bupivacaine was superior in terms of postoperative anesthesia, reducing postoperative pain due to its residual anesthetic and analgesic effects. Both anesthetic solutions led to similar hemodynamics at low doses in mandibular third molar surgery

• The Korean Journal of Emergency Medical Services
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• v.28 no.1
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• pp.77-95
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• 2024

Purpose: This study aimed to analyze the counseling status of overseas Koreans using emergency medical counseling services, identify frequently occurring types of diseases, explore approaches to emergency treatment guidance, and protect overseas Koreans from medical blind spots, thereby enhancing the quality of emergency medical counseling services. Methods: This study was approved by the Institutional Review Board of Kongju National University (KNU_IRB_2023-31), and data were collected and analyzed from 10,951 cases of emergency medical counseling services utilized by overseas Koreans from the National Fire Agency from 2018 to 2022. Results: Emergency medical consultation services for overseas Koreans included a majority of non-trauma patients, with medical consultations being predominant. Terrestrial patients commonly seek advice for internal medical symptoms, whereas maritime patients frequently present with trauma-related symptoms, with a higher incidence of cardiac arrest and altered consciousness cases at sea. The development of self-diagnostic tests based on internal medicine symptoms is necessary for terrestrial patients, whereas stakeholder education is required for maritime patients. Conclusion: Due to the different types of diseases occurring in terrestrial and maritime patients, emergency medical consultation services for overseas Koreans should be implemented according to the specific characteristics of each patient. Therefore, it is necessary to develop and disseminate response manuals that are tailored to medical and trauma-related symptoms.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.3
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• pp.121-128
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• 2015

Background: The authors studied the hemodynamic effect influent by using the novel high concentration of lidocaine HCl for surgical removal impacted lower third molar. The objective of this study was to evaluate the hemodynamic change when using different concentrations of lidocaine in impacted lower third molar surgery. Methods: Split mouth single blind study comprising 31 healthy patients with a mean age of 23 years (range 19-33 years). Subjects had symmetrically impacted lower third molars as observed on panoramic radiograph. Each participant required 2 surgical interventions by the same surgeon with a 3-week washout period washout period. The participants were alternately assigned one of two types of local anesthetic (left or right) for the first surgery, then the other type of anesthetic for the second surgery. One solution was 4% lidocaine with 1:100,000 epinephrine and the other was 2% lidocaine with 1:100,000 epinephrine. A standard IANB with 1.8 ml volume was used. Any requirement for additional anesthetic and patient pain intra-operation was recorded. Post-operatively, patient was instructed to fill in the patient report form for any adverse effect and local anesthetic preference in terms of intra-operative pain. This form was collected at the seven day follow up appointment. Results: In the 4% lidocaine group, the heart rate increased during the first minute post-injection (P < 0.05). However, there was no significant change in arterial blood pressure during the operation. In the 2% lidocaine group, there was a significant increase in arterial blood pressure and heart rate in the first minute following injection for every procedure. When the hemodynamic changes in each group were compared, the 4% lidocaine group had significantly lower arterial blood pressure compared to the 2% lidocaine group following injection. Post-operatively, no adverse effects were observed by the operator and patient in either local anesthetic group. Patients reported less pain intra-operation in the 4% lidocaine group compared with the 2% lidocaine group (P < .05). Conclusions: Our results suggest that a 4% concentration of lidocaine HCl with 1:100,000 epinephrine has better clinical efficacy than 2% lidocaine HCl with 1:100,000 epinephrine when used for surgical extraction of lower third molars. Neither drug had any clinical adverse effects.

• The Korean Journal of Pain
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• v.20 no.2
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• pp.169-173
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• 2007

Background: Although the use of intravenous patient controlled analgesia (IVPCA) has been compared to the use of patient conrolled epidural analgesia (PCEA), there is no optimal administration route of alfentanil for the treatment of postoperative pain. This randomized double-blind study compared the efficacy of the use of IVPCA and PCEA for postoperative pain and the side effects after a total abdominal hysterectomy (TAH). Methods: Sixty patients undergoing a TAH were randomly assigned to receive either IVPCA (Group I) or PCEA (Group E) for the infusion of alfentanil for postoperative pain control. In both groups, a loading dose of $750{\mu}g$ alfentanil was administered. All patients received the same continuous infusion rate (0.3 mg/h), bolus dose (0.15 mg), and lockout time (15 min). The incidence of side effects, the VAS (visual analog scale) of pain, blood pressure, and heart rate were checked for 20 hours after the loading dose injection. Results: The VAS of pain was not significantly different between the two groups of patients. The onset of the analgesic effect was significantly more rapid in the Group I patients than in the Group E patients. There was no difference in side effects for either group. Conclusions: When considering multiple factors such as the onset of analgesia, technical difficulties or infection after the procedure, IVPCA using alfentanil is more useful than PCEA for postoperative pain control after a TAH.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.4 no.2
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• pp.77-83
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• 2011

Purpose: We compared with USG-guided steroid injection group and blind steroid injection group for the treatment of calcific tendinitis to evaluate the effectiveness of the treatment modalities. Materials and Methods: We reviewed two groups of calcific tendinitis treated with steroid injection and follow up upto 6 month after injection. Group I was blind injection for 88 patient with average age of 53years old and female gender in 77%. Group II was USG- guided injection for 102 patients with average age of 54years old and female gender in 85%. We compared follow up results according to age, gender, size of tendon involvement, initial VAS score, and phase of the calcific tendinitis between two groups. Results: At 6 month's follow up period, USG-guided injected group was more prevalent compared to blind injection group with 92%(94/102) and 72%(64/88) (P<0.05). In Group I, 77%(49/64) patients have improved symptom. And in Group II, 92%(86/94) patients have improved symptom in formative or resorptive phase. Despite of symptom improvement, calcium deposit is remained 47%(30/64) in Group I, and 20%(19/94) in Group II. Conclusion: Conservative treatment of Shoulder calcific tendinitis patients through USG-guided injection is more effective than Blind injection in pain relief & calcium decrease. The patients USG-guided injected group was more prevalent in follow up at outpatient clinic, throughout more accurate injection with improved confidence.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.134-139
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• 2014

Purpose: Adaptive statistical iterative reconstruction (ASIR) technique is a reconstruction method of CT image using statistical noise modeling which is known to reduce image noise and to preserve image quality despite reducing radiation dose. The aim of this study is to evaluate images using ASIR on bone SPECT/CT which is primarily performed in our hospital. Materials and Methods: We compared the images of applied ASIR (ASIR level: 20-80%) and none ASIR by changing the mA based on 120 kVp, 100 mA using Discovery NM/CT 670 (GE, U.S.A). First, we evaluated attenuation correction in SPECT image by changing the ASIR level using Anthropomorphic phantom. Second, we compared the contrast to noise ratio (CNR), image noise and spatial resolution in CT image using ACR phantom. Third, after selecting the ASIR level applicable patient using lower torso phantom, we examined 2 patients who followed up bone SPECT/CT and we performed blind test. Results: The degree of attenuation correction in SPECT image showed no significant difference between applied ASIR and none ASIR (P>0.05). When applied ASIR, the noise of CT image were reduced at least 17 up to 52% by changing the mA. The CNR of image with ASIR was maintained more than 0.8 at 40 mA (ASIR 60%) while those without ASIR showed 0.42 at standard 40 mA. In comparison of the high contrast object, we distinguished 12 line pairs/cm at 40 mA regardless of appling ASIR. Comparison of the patients image applied ASIR level 60% (40 mA) which found out by spine image of lower torso phantom showed no signigicant difference between applied ASIR and none ASIR in blind test. The CTDIvol and DLP for applied ASIR 60% showed decreased by 60%, 60% on average than using standard mA. Conclusion: The study show that the radiation dose in SPECT/CT using ASIR can be reduced despite degradation of SPECT and CT images. In addition, higher ASIR level could be possibly applied characteristics of SPECT/CT that region of interest is limited to bone.

• 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.