• 한국임상약학회지
• /
• 제22권4호
• /
• pp.330-339
• /
• 2012

Background : Hypertension is treated with both lifestyle modification and pharmacotherapy. The Seventh Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7), published in 2003, provides a streamlined management approach to hypertension for the primary care physician. The JNC-7 is the gold standard also in Korea. According to the JNC-7, special therapeutic considerations are recommended for high-risk individuals with compelling indications. The presence of compelling indications in any given patient should be considered when selecting specific pharmacotherapy to treat hypertension. However, in patients with compelling indications, it is unknown that hepatotoxicity is caused by Calcium Channel Blocker (CCB), one of 1st anti-hypertensive drugs. Now, the CCB is the most used 1st anti-hypertensive drug in Korea Therefore, we evaluated the changes in blood liver function parameters (ALT, AST, Total bilirubin, serum albumin) for the study group. Methods : We randomly collected and retrospectively analyzed Electronic Medical Record data (n=28,788) of patients, and who took calcium channel blockers(non-dihydropyridines; diltiazem, verapamil, dihydropyridines; amlodipine, barnidipine, benidipine, clinidipine, efonidipine, felodipine, isradipine, lacidipine, lercanidipine, nicardipine, nifedipine, nimodipine), with having liver function tests (LFTs) from July 1st 2009 to June 30th 2010 at the Seoul National University Hospital in Korea. Control groups are two antihypertensive agents: RAS blockade (ARB; candesartan, irbesartan, losartan, olmesartan, telmisartan, valsartan, ACE-I; cilazapril, enalapril, fosinopril, imidapril, perindopril, ramipril) and, Diuretics (loop; furosemide, torsemide, thiazide; hydrochlorothiazide[HCTZ], indapamide). Patients not having LFT results at these three standard points of time(baseline, during, medication, and after finishing medication) were excluded. The collected data were analyzed by using the SPSS (Version12.0) and Microsoft Excel (Version2007). Results : 711 patients who were treated CCB (297), RAS blockade (232) or Diuretics (182) monotherapy were selected for the study. In selected patients, liver damage degree(changes of each LFTs value) was higher in diuretics group than other groups, followed by RAS blockade and CCB. In diuretics group's was loop-diuretics group was higher than thiazide-diuretics group. In CCB group, Nondihydropyridine-CCB's damage degree was higher than Dihydropyrine-CCB's that. Conclusions : Despite the limitations due to the retrospective study, among patients with abnormal LFTs, the use of CCBs led to a less liver damage than other 1st anti-hypertensive agents. It can be recommended CCBs as one of the initial treatments of hypertension in patients with liver disease.

• 대한견주관절학회:학술대회논문집
• /
• 대한견주관절학회 2003년도 학술대회
• /
• pp.122-127
• /
• 2003

• The Korean Journal of Pain
• /
• 제7권1호
• /
• pp.25-33
• /
• 1994

• Journal of the Korean Data and Information Science Society
• /
• 제14권2호
• /
• pp.223-235
• /
• 2003

Using internet, most of students are still exposed to unreasonable commercial information and even tend to consumptive behaviors. Various programs have been mobilized to keep it with a blockade system against the noxious information. But guidance is more instructive than blockade in respect of education. Thus, the focus of this study is to induce and motivate their self-directed learning activities with internet guide contents. We develope a learning guidance material as one of the information platforms. Furthermore, we consider the availability of such learning guidance materials through interview and observation. We find that easy and meaningful internet access and utilizing environment influence the children's self-directed learning ability.

• 물과 미래
• /
• 제18권4호
• /
• pp.327-333
• /
• 1985

본 연구에서는 하구역에 이안제를 설치했을 경우 하천류가 없고 파가 경사져서 입사해 올 때 하구 및 제체 주변에 발생하는 해빈류의 흐름상태를 수치계산에 의해서 구하고 고정상 수리실험을 통하여 얻은 결과와 비교해서 본 수치모델의 타당성을 검증하였다. 또한 이동상 수리실험을 통하여 하구 및 이안제 주변에서 일어나는 지형변화를 검토하여 하구폐새 방지대책으로서 이안제공법의 효용성을 확인하였다.

• The Korean Journal of Pain
• /
• 제9권2호
• /
• pp.419-422
• /
• 1996

Pain arising from pelvic viscera and perineum is frequently associated with discomfort and disability and caused by local trauma, inflammation and malignancy within the pelvis. Although various interventions have been proposed for the management of intractable perineal pain, their efficacy and applications are limited. The ganglion impar is a solitary retroperitoneal structure located at the level of the sacrococcygeal junction that marks the terminations of sympathetic chains. We propose that blockade of the ganglion impar is an effective method in the management of patient suffered from perianal pain due to advanced rectal cancer.

• The Korean Journal of Pain
• /
• 제11권1호
• /
• pp.146-149
• /
• 1998

Herpes zoster is a viral disease characterized by skin rash and persistent pain. Early treatment with epidural analgesia provides very effective pain relief and reduces the incidence of postherpetic neuralgia. However, epidural analgesia in elderly, deliberated or hypovolemic patients may complicate circulatory depression such as hypotension and bradycardia. Even if temporary, a major decrease in blood pressure may decrease coronary blood flow of patients with arteriosclerosis and ischemic accident may occur. We experienced a case of unstable angina pectoris after lumbar epidural blockade in a herpes zoster patient with chronic stable angina pectoris.

• Journal of Yeungnam Medical Science
• /
• 제34권2호
• /
• pp.161-168
• /
• 2017

Peripheral nerve blocks are commonly used for surgical anesthesia, postoperative analgesia, and to reduce opioid requirements. Although these blocks have traditionally been carried out using local anesthetics, single-injection techniques can be short-lived and limited by the relatively brief duration of action of currently available local anesthetics. Increasing the dose or concentration of local anesthetics may prolong the duration of analgesia, but may also increase the risk such as unwanted motor weakness or systemic toxicity of local anesthetics. Numerous adjuvant medications have been added to local anesthetics to prolong the durations of anesthesia and analgesia achieved by peripheral nerve blocks, and currently, a number of different adjuvants are used to improve quality of the block. This article will review the several nerve block adjuvants used in combination with local anesthetics to provide blockade of peripheral nerves in clinical practice, describing the rationale for their use in peripheral nerve blocks, and the evidence for their effectiveness.

• The Korean Journal of Pain
• /
• 제9권1호
• /
• pp.223-225
• /
• 1996

Pain arising from disorders of the viscera and somatic structures within the pelvis and perineum is a frequent cause of discomfort and disability, especially among women. Recently, blockade of the ganglion impar(ganglion of Walther) has been introduced as an alternative means of managing intractable perineal pain of sympathetic origin. The first report of interruption of the ganglion impar for relief of perineal pain appeared in 1990. We successfully treated a patient who had suffered from intermittent severe coccygodynia with ganglion impar block.

• The Korean Journal of Pain
• /
• 제19권2호
• /
• pp.237-240
• /
• 2006

This report describes a case of spinal cord infarction after acupuncture. The patient was treated with lumbar sympathetic block with using C-arm fluoroscopy. A 66-year-old patient with chronic low back pain and radiating pain in the lower limb was treated with acupuncture and he suddenly had a loss of motor and sensory of both lower extremities. His clinical presentaion and neuroimaging studies were consistent with spinal cord infarction. He was treated with steroid megatherapy and he showed improved in motor function, but there was no pain relief despite the phamacological treatments that were combined with caudal blockade. He visited to our hospital and had lumbar sympathetic blockade performed. The pain was relieved without any related complication after 1 month (VAS $9/10{\rightarrow}2/10$), and he has been content with the results of treatment.