• 대한한방내과학회지
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• 제43권1호
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• pp.90-103
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• 2022

Objective: The purpose of this case study is to report the effectiveness of Baliao acupoints electro-acupuncture treatment on a neurogenic overactive bladder induced by stroke. Method: A patient suffering from middle cerebral artery infarction was diagnosed with a neurogenic overactive bladder and treated by Korean medicine, including electro-acupuncture on Baliao acupoints six times per week. The evaluation was performed by monitoring urinary frequency and using the Korean versions of the Overactive Bladder Symptom Score (OABSS) and Urinary Incontinence Quality of Life (I-QoL). Results: After 27 days of electro-acupuncture treatment, the OABSS score improved from 6 to 3. The I-QoL total score improved from 60 to 87. The patient also showed a decrease in nocturia frequency. Conclusion: This case suggests that electro-acupuncture on Baliao acupoints can be effective for overactive bladders due to supra-pontine lesions.

• BMB Reports
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• 제55권5호
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• pp.205-212
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• 2022

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a debilitating chronic disorder characterized by suprapubic pain and urinary symptoms such as urgency, nocturia, and frequency. The prevalence of IC/BPS is increasing as diagnostic criteria become more comprehensive. Conventional pharmacotherapy against IC/BPS has shown suboptimal effects, and consequently, patients with end-stage IC/BPS are subjected to surgery. The novel treatment strategies should have two main functions, anti-inflammatory action and the regeneration of glycosaminoglycan and urothelium layers. Stem cell therapy has been shown to have dual functions. Mesenchymal stem cells (MSCs) are a promising therapeutic option for IC/BPS, but they come with several shortcomings, such as immune activation and tumorigenicity. MSC-derived extracellular vesicles (MSC-EVs) hold numerous therapeutic cargos and are thus a viable cell-free therapeutic option. In this review, we provide a brief overview of IC/BPS pathophysiology and limitations of the MSC-based therapies. Then we provide a detailed explanation and discussion of therapeutic applications of EVs in IC/BPS as well as the possible mechanisms. We believe our review will give an insight into the strengths and drawbacks of EV-mediated IC/BPS therapy and will provide a basis for further development.

• 대한상한금궤의학회지
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• 제15권1호
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• pp.85-115
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• 2023

Objectives : This study reports on the cases of four ADHD patients who treated with herbal medication based on Disease Pattern Identification Diagnostic System (DPIDS). Methods : Two children and two adults were diagnosed with ADHD according to DSM-V, and Galgeunhwangryeonhwanggeum-tang was administered. The parents of the two children completed the Korean ADHD Rating Scale (K-ARS) before and after treatment, while the other patients used the Korean ADHD Self Rating Scale (K-ASRS). The patients' somatic symptoms and other issues were evaluated through interviews. Results : In the first case, the K-ARS scale exhibited a change from 28 to 3. The patient demonstrated improvements in attention, concentration, and social behavior, along with the elimination of self-injurious behavior. In the second case, the K-ARS scale showed a change from 41 to 9. The patient in the third case demonstrated improved chronic fatigue, increased attention, work efficiency, and enhanced social skills, leading to maintaining employment for over six months for the first time in their life after the treatments. Additionally, the patient in the fourth case demonstrated improved work concentration and relief in nocturia. Conclusions : In this study, four patients exhibited improvements in symptoms of attention deficit, hyperactivity, and impulsivity before and after herbal treatment, leading to enhanced academic and social relationships. As the patients progressed in their health restoration, symptoms related to the genitourinary system also showed improvement.

• 농촌의학ㆍ지역보건
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• 제22권1호
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• pp.49-59
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• 1997

Backgrounds : There has been many studies investigating the causes of farmers' syndrome. In some studies, psychologic stress is related to farmer's syndrome. And the diagnostic criteria of farmer's syndrome is similar to those of generalized anxiety disorder. So we carried out this study to investigate the psychiatric causes of farmers' syndrome. Methods : This study was done in some rural and urban areas of Kyoungsangnam Province, July, August, October and November of 1996. Those who came to free medical service and completed interview, medical examination and laboratory examination and 20-59 years old were 150 persons. And those who came to health center for health examination and completed only interview and 20-59 years old were 94 persons. The questionnaire was composed of sociodemographic factors, health risk factors, farmer's syndrome, work load, BEPSI(inventory to measure stress), Spielberger's state-trait anxiety inventory, self-rating depression scale. To examine statistical significance, we used X2-test, Mantel-Haenszel test for linear association, t-test, ANCOVA, correlation, multiple regression, logistic regression. Results : The prevalence of farmer's syndrome, adjusted for age and sex with population of Kyungsangnam Province of 1993 was 208 per 1,000(90 per 1,000 in men and 329 per 1,000 in women). In bivariate analysis, farmer's syndrome was significantly related to age, sex, job, income, smoking, alcohol drinking, work load, BEPSI, state anxiety, trait anxiety, depression, body mass index, Hwa-Byung, hypertension, anemia. However, when age and sex were adjusted, job was not significantly related to farmer's syndrome. The score of farmer's syndrome was significantly related to age, sex, work load, BEPSI, trait anxiety by multiple regression. Farmer's syndrome was significantly related to increasing age(odd ratio 1.079, 95% C.I. 1.060 - 1.099), sex(odds ratio of male 0.434, 95% C.I. 0.349 - 0.540), and BEPSI(odds ratio 1.231, 95% C.I. 1.148 - 1.320) by logistic regression. Results of logistic regression analysis of the component symptoms of farmer's syndrome were as follows. Shoulder stiffness was significantly related to increasing age, female sex and BEPSI. Lumbago was significantly related to increasing age, female sex and trait anxiety. Numb limbs and nocturia was significantly related to increasing age and female sex. Breathlessness was significantly related to work load, sleeplessness was significantly related to depression, dizziness was significantly related to job and state anxiety, and abdominal fullness was significantly related to female sex. Conclusion : Farmers' syndrome was related to work load, but was more related to psychiatric factors such as BEPSI and trait anxiety. And the occupation was not risk factor of farmers' syndrome in this study, so further study is needed to investigate the cause of farmers' syndrome.

• 여성건강간호학회지
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• 제8권3호
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• pp.412-423
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• 2002

This study was designed to evaluate the effect of pelvic floor muscle exercise using biofeedback and electrical stimulation after normal vaginal delivery. The data were collected from November 1999 to April 2000 at a university hospital located in Seoul, Korea. Out of 49 women with normal vaginal delivery, 25 of experimental group(with exercise) and 24 of control group(without exercise) were questioned about lower urinary symptoms, discomfort during sexual intercourse and daily life. The maximum pressure of pelvic floor muscle contraction(MPPFMC) and duration of pelvic floor muscle contraction(DPFMC) were measured at pre-treatment, the end of treatment and 8 weeks after a treatment program. The pelvic floor muscle exercise program(using biofeedback and electrical stimulation) was applied to the experimental group twice a week for 4 weeks at the incontinence clinic and the pelvic floor muscle exercise at home for that time and more 8 weeks. Data were analyzed by t-test, $x^2$-test, Fisher's exact test and the repeated measures ANOVA. The results were as follows; 1) MPPFMC(p=0.000) and DPFMC(p=0.021) were significantly increased in the experimental group. 2) In the lower urinary symptoms, daily frequency(p=0.001), nocturia(p=0.002), incontinence episode(p=0.016), stress incontinence(p=0.012), quantity of incontinence(p=0.026), straining(p=0.041), and strength of stream(p=0.009) were significantly decreased in the experimental group. 3) Discomfort during sexual intercourse had not a significant difference between the two groups, which was not significantly decreased as time passed. 4) In the discomfort during daily life, activity restriction(p=0.042), exercise restriction (p=0.008), interpersonal relationship restriction(p=0.046), and discomfort of general life(p=0.027) showed a significant difference between the two groups, which were not significantly decreased as time passed. In conclusion, it is suggested that the pelvic floor muscle exercise using biofeedback and electrical stimulation might be a safer and more effective program for the improvement of postpartum pelvic muscle contraction.

• 여성건강간호학회지
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• 제8권4호
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• pp.529-537
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• 2002

The purpose of this study was to investigate the prevalence, relative factor and the effects that overactive bladder or urinary incontinence have on women's lives. Data was gathered through an internet survey. The subjects included 3,372 women ranging from 20 years old to 49 years of age. The questionnaire included general characteristics (age, parity, family history, and history of UTI), overactive bladder symptoms (urgency, frequency, nocturia, urgent incontinence), urinary incontinence, discomfort in ADL and sexual activity. The data was analyzed by the SPSS/PC+ program using frequency, $x^2$ test, and multivariate logistic regression. The results were as follows; 1. The prevalence was 12.7 % in overactive bladder and 21.0% in urinary incontinence. 2. 19.2% of the subject have urge incontinence, 5% of them have coped with the use of a pad. 3. The significant factors to overactive bladder were age($x^2$=6.6, p<0.05), history of urinary tract infection ($x^2$=50.8, p<0.01) and family history ($x^2$=26.1, p<0.01). The significant factors to urinary incontinence were age ($x^2$=6.2, p<0.05), occupation ($x^2$=11.0, p<0.05), history of urinary tract infection($x^2$=20.2, p<0.01), parity ($x^2$=8.6, p<0.01), and family history ($x^2$=4.9, p<0.05). 4. Overactive bladder impacts on individual daily life was 5.0 times, urinary incontinence was 2.9 times higher than in non-symptoms. Also, overactive bladder impacts on their sexual activity disturbance was 4.3 times, urinary incontinence has 3.9 times higher than in non-symptoms. In conclusion, overactive bladder symptoms and urinary incontinence were health problems that disturbed women's lives. Also the most problem among overactive bladder may be urgency in Korean. Intervention based on these results needs to be provided for these women.

• The Korean Journal of Physiology and Pharmacology
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• 제16권1호
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• pp.37-42
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• 2012

The aim of the present study was to elucidate the direct effects of melatonin on bladder activity and to determine the mechanisms responsible for the detrusor activity of melatonin in the isolated rat bladder. We evaluated the effects of melatonin on the contractions induced by phenylephrine (PE), acetylcholine (ACh), bethanechol (BCh), KCl, and electrical field stimulation (EFS) in 20 detrusor smooth muscle samples from Sprague-Dawley rats. To determine the mechanisms underlying the inhibitory responses to melatonin, melatonin-pretreated muscle strips were exposed to a calcium channel antagonist (verapamil), three potassium channel blockers [tetraethyl ammonium (TEA), 4-aminopyridine (4-AP), and glibenclamide], a direct voltage-dependent calcium channel opener (Bay K 8644), and a specific calcium/calmodulin-dependent kinase II (CaMKII) inhibitor (KN-93). Melatonin pretreatment ($10^{-8}{\sim}10^{-6}M$) decreased the contractile responses induced by PE ($10^{-9}{\sim}10^{-4}M$) and Ach ($10^{-9}{\sim}10^{-4}M$) in a dose-dependent manner. Melatonin ($10^{-7}M$) also blocked contraction induced by high KCl ($[KCl]_{ECF}$; 35 mM, 70 mM, 105 mM, and 140 mM) and EFS. Melatonin ($10^{-7}M$) potentiated the relaxation response of the strips by verapamil, but other potassium channel blockers did not change melatonin activity. Melatonin pretreatment significantly decreased contractile responses induced by Bay K 8644 ($10^{-11}{\sim}10^{-7}M$). KN-93 enhanced melatonin-induced relaxation. The present results suggest that melatonin can inhibit bladder smooth muscle contraction through a voltage-dependent, calcium-antagonistic mechanism and through the inhibition of the calmodulin/CaMKII system.

• 대한간호학회지
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• 제28권1호
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• pp.171-183
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• 1998

The purpose of this study was to identify the incidence of urinary incontinence in adult women and to identify factors related to life style and sexual intercourse that were related to incontinence. The sample consisted of 1,065 women living in Seoul or one of five provinces. Data for this study were collected from January 16 to June 23 using structured questionnaires. The Urinary Symptom Questionnaire developed by Jackson and a demographic questionnaire were used to collect the data. The data were analyzed using frequency, percentage with an SPSS/PC$^{+}$ program. The major finding are as follows : 1. The distribution of age of subjects was as follows : 20-29(10.1%), 20-39(17.8%), 40-49(27.3%). 50-59(22.3%), 60-69(12.9%), 70-79(6.1%). 80-89(2.8%), more than 90(0.6%). The frequency of normal delivery, 0(155%), 1-2(36.0%), 3-4(29.2%), 5-6(13.0%). more than 7(6.3%). The rate of subjects with menopause was 40.8%. 2. It was reported that 50.7% of the subjects experienced urinary incontinence with stress, mixed. and urgency incontinence being 49.8%, 43.4%, 6.8% respectively. 3. The lower urinary symptoms and incidence with urinary incontinence were as follows : Daily frequency. 22.3%, nocturia. 40.8%, urgency, 71.2%, bladder pain 47.8%, unexplainned incontinence, 32.4%, noctural incontinence, 16.1%, and frequency of incontinence, 37.7%. In term of quantity of incontinence, drop/pants damp, 29.5%, dribble/pants wet, 20.5%, flood or soaking through to outer clothing, 1.7%, and flood or running down legs or onto floor, 0.2%. 4. The symptoms related to sexual intercourse and incidence of urinary incontinence were as follows : dry vagina, 39.1%, sex life trouble, 10.8%, pain during sexual intercourse, 27.4%, and urine leakage during sexual intercourse. 8.8%. 5. Life style problems related to urinary incontinence were as follows : fluid intake restriction, 20.0%, affected daily task, 24.5%. avoidance of placess and situations, 35.0%, interference in physical activities, 30.6%, interference in relationships with other people. 19.0%. interference in relationships with husband/companion, 8.1%, and time after attack of urinary symptoms, 76.9%. In term of the feeling about the rest of their lifves the women reported : perfectly happy, 11.3%. pleased, 16.9%. mostly satisfied, 20.2%, mixed feelings, 21.0%, mostly dissatisfied, 21.0%, very unhappy 8.5%, and desperate. 1.0%. In conclusion. this study was a preliminary study to provide nursing practices guidelines for incontinence in adult women. Nurse working with adult women should develop and provide adequate care for these women.n.

• 농촌의학ㆍ지역보건
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• 제25권2호
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• pp.245-263
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• 2000

본 연구는 자기기입식 설문조사를 통해 농약살포를 대부분 담당하는 남성 농민들에 대하여, 농부증을 포함한 만성증상과 농약살포시의 이상증상경험, 이상증상 경험시 살포한 농약, 농약살포시의 안전수칙 준수, 보호구의 착용실태, 가족 중 농약으로 인한 사고경험을 조사하고, 농약노출과 연관된 변수들간의 연관성, 급성중독경험 및 만성증상과 관련된 요인을 고찰하였다. 만성증상으로는 '몸이 나른하고 힘이 없다', '허리가 아프다'. '밤중에 소변을 보기 위해 깬다' 등의 증상이 많았으며, 농약살포 시의 임상증상 경험율은 '피부발진/가려움증', '어지러움/두통'의 경우가 가장 높은 것으로 조사되었다. 또한, 조사 대상자의 7.1%가 가족중 농약으로 인한 사고경험이 있는 것으로 조사되었으며, 이중 농약살포시 중독, 안전사고 및 자살사례를 확인할 수 있었다. 농약살포 시의 준수사항 중, '뿌린 후 목욕을 한다'와 '뿌린 후 바로 옷을 갈아입는다' 등의 경우가 준수율이 높았으나, '보호구를 잘 세탁해서 보관한다', '뿌린 후 용변을 볼 경우 손을 씻는다', '한낮에는 뿌리지 않는다' 등의 경우는 낮은 준수율을 보였다. 농약살포시 보호구는 '물에 타서 살포할 경우', '입제를 살포할 경우'에 비해 보호구를 더 잘 착용하였으며, 착용율은 모자, 장화, 마스크, 장갑, 방제복 하의의 순이었다. 농약살포시 이상증상경험과 관련된 요인은 농약살포시 준수사항 준수, 살포시간, 과수재배, 경작면적, 연간 농약살포일 등이었으며, 농민의 만성증상과 관련된 관련된 요인은 농약살포시 이상증상 경험, 경작면적, 농사경력, 농약살포시 준수사항 준수, 전업여부, 농약에 대한 노출 등이었다. 본 연구결과를 통해 농약살포시 준수사항의 준수율과 보호구 착용율을 높이며 농약으로 인한 안전사고를 방지하기 위한 체제적인 교육 및 홍보가 필요함을 알 수 있다. 또한, 농약에 대한 노출이 농민의 만성증상의 한 원인이라는 결론을 내리기는 어려우나, 원인적 연관성일 가능성을 배재할 수는 없을 것으로 생각되며, 따라서, 농약노출을 정확히 산출하고, 좀더 명확한 건강영향의 생물학적 지표(biological marker)를 측정하여 이들의 연관성을 고찰하는 연구가 이루어져야 할 것으로 생각된다.

• 농촌의학ㆍ지역보건
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• 제31권3호
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• pp.275-284
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• 2006

요실금 또는 과민성방광증후군은 국내외적으로 높은 유병률을 보이고 있으며, 삶의 질에 영향을 줄 수 있는 중요한 건강문제의 하나이다. 본 연구는 경상북도 일부 농촌 여성들을 대상으로 요실금 빛 과민성방광증후군의 실태를 파악하여, 예방, 조기진단 및 건강증진 등의 중재적 방안 수립의 기초 자료로 이용하고자 하였다. 연구대상자는 2001년 8월 16일부터 8월 18일까지 경상북도 울진군 북면 주민 중 자발적으로 건강검진에 참여한 여성 322명이었다. 설문조사는 본 연구진이 개발한 설문지를 사전교육을 받은 의학과 학생들이 직접 일대일 면접으로 실시하였다. 본 연구에 사용된 요실금 및 과민성방광증후군과 관련된 용어는 대한배뇨장애 및 요실금학회의 표준 용어를 사용하였으며, 요실금의 종류별 정의와 과민성방광증후군의 신 구 정의를 모두 이용하였다. 모든 자료는 Excel에 전산입력 하였고, 분석은 한글 SPSS 12.0 for Windows를 이용하였다. 조사대상자는 모두 여성으로 연령별 분포는 60대가 85명(26.4%)로 가장 많았다. 조사 대상자의 요실금 분율은 복압성요실금이 106명(32.9%)으로 가장 높았고, 절박성요실금 56명(17.4%), 혼합성요실금 48명(14.9%)의 순이었으며, 전체 요실금 분율은 114명(35.4%)이었다. 과민성방광증후군 및 요실금 관련 증상은 절박뇨 69명(21.4%), 빈뇨 77명(23.9%), 야간뇨 113명(35.1%), 절박성요실금 56명(17.4%) 등으로 과민성방광증후군 I의 분율은 36.0%이었으며, 과민성방광증후군 II의 분율은 14.0%이었다. 절박성요실금, 복압성요실금, 혼합성요실금 및 OABs와 연령과의 관련성에서는 요실금의 경우 연령이 증가함에 따라 요실금의 분율이 유의하게 증가하지는 않았으나, 40대 미만에서는 요실금 분율이 가장 낮았고, 40대에서 가장 높았으며, 50대 이상에서는 감소하는 경향을 보였다. 과민성방광증후군의 경우 OABs II의 경우 연령이 증가할수록 유의하게 OABs II의 분율이 증가하였다(p<0.05). 요실금의 증상은 '약뇨'가 가장 많았고, 과민성방광증후군은 '절박뇨'가 가장 많았다. 요실금 또는 과민성방광증후군으로 인하여 일상생활에서 경험하는 문제는 '낯선 곳에서 제일 먼저 화장실을 찾음'이 가장 많았다. 본 연구는 여러 제한점에도 불구하고, 농촌 지역 여성들을 대상으로 요실금 및 과민성방광증후군의 실태를 파악함으로서 앞으로 지역보건사업 또는 건강증진사업의 기초자료로 사용할 수 있는 자료를 제공하였다는데서 의의가 있다. 특히 본 연구를 통하여 이러한 질병들은 생명의 위중을 떠나 삶의 질을 좌우할 수 있는 중요한 건강문제라는 것을 인식할 수 있으며, 국가적 차원의 제도화된 접근이 절실히 요구되고 있다.