• 대한소아치과학회지
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• 제25권4호
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• pp.710-716
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• 1998

It is one of difficulties to control children who show definitely negative behavior in dental clinic. In such a case, the pharmacologic management has been used to provide quality care, minimize the extremes of disruptive behavior, promote a positive psychologic response to treatment and patient welfare and safety. Deep sedation can be defined as a controlled, pharmacologically-induced state of depressed consciousness from which the patient is not easily aroused which may be accompanied by a partial loss of protective reflexes. In this retrospective report, the sedation records of 200 pediatric dental patients of ASA Class I & II who were not successfully treated under conscious sedation were used for analysis. Most frequently used regimen of deep sedation was the co-medication of midazolam(0.3mg/kg), enflurane(1.0-2.0 vol%) and 50-70% $N_2O_2$. The average age and weight of the patients was 4.6 yr (S.D: 2.72) and 18.7kg(S.D: 6.35) respectively. The average operative time was 52 minutes and midazolam (0.1-0.2cc) was additionally administered intranasally to prolong the operative time as needed. The episodes of untoward side effects were reported during and/or after the procedure in 58 patients. Serious adverse reactions such as cyanosis or laryngospasm were even reported in 7 patients but without mortality. Deep sedation is a very effective way of completing the dental treatments for those who failed to respond well to the conscious sedation. This technique has many practical advantages over general anesthesia case but the demands for the rigid monitoring criteria limit its use in general practice setting. The continuous efforts to improve the safety of the medication and the technique are required for the benefits of the patients and parent.

• Archives of Plastic Surgery
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• 제35권2호
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• pp.159-164
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• 2008

Purpose: Microvascular free tissue transfer has become a reliable technique for the reconstruction of complex wounds. Occasionally, unexpected intraoperative thrombosis and/or spasm of recipient artery might be annoying problems even for the technically competent microvascular surgeons. If such problems are not treated properly, they will inevitably cause to flap failure. Methods: From January 2006 to February 2007, soft tissue reconstructions by free tissue transfers were performed on 21 patients having complex defects in the lower extremity. Although segmental revision and various pharmacologic agents were repeatedly applied, arterial occlusions were not managed in 6 cases. For removal of thrombi and release of spasm, Fogarty No. 2 or No. 3 catheters were inserted into the lumen to the proximal recipient artery. Its balloon was then inflated after passing through a resistant area. Next, the catheter was gently withdrawn backward. Results: After the Fogarty catheter was inserted two or three times, the pulsatile arterial flow was restored. When the catheter was inserted into the lumen, a feeling of resistance existed in a 5-10cm more proximal portion that could not be easily accessed from the vascular end. After the reestablishment of blood flow, successful anastomoses were achieved and immediate rethrombosis or spasm did not occur. No long-term sequelae associated with balloon trauma to the arterial wall were observed. Conclusion: The use of the Fogarty catheter can be an effective method in treating pedicle thrombosis and spasm. This is a very simple and rapid technique that offers microvascular surgeons another option to increase the success rate of microvascular anastomosis in free tissue transfers.

• Biomolecules & Therapeutics
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• 제26권2호
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• pp.210-217
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• 2018

Neuroinflammation is an immune response within the central nervous system against various proinflammatory stimuli. Abnormal activation of this response contributes to neurodegenerative diseases such as Parkinson disease, Alzheimer's disease, and Huntington disease. Therefore, pharmacologic modulation of abnormal neuroinflammation is thought to be a promising approach to amelioration of neurodegenerative diseases. In this study, we evaluated the synthetic flavone derivative 3',4'-dihydroxyflavone, investigating its anti-neuroinflammatory activity in BV2 microglial cells and in a mouse model. In BV2 microglial cells, 3',4'-dihydroxyflavone successfully inhibited production of chemokines such as nitric oxide and prostaglandin $E_2$ and proinflammatory cytokines such as tumor necrosis factor alpha, interleukin 1 beta, and interleukin 6 in BV2 microglia. It also inhibited phosphorylation of mitogen-activated protein kinase (MAPK) and nuclear factor $(NF)-{\kappa}B$ activation. This indicates that the anti-inflammatory activities of 3',4'-dihydroxyflavone might be related to suppression of the proinflammatory MAPK and $NF-{\kappa}B$ signaling pathways. Similar anti-neuroinflammatory activities of the compound were observed in the mouse model. These findings suggest that 3',4'-dihydroxyflavone is a potential drug candidate for the treatment of microglia-related neuroinflammatory diseases.

• Journal of Ginseng Research
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• 제40권3호
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• pp.304-308
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• 2016

Background: Joboksansam, Korean bird wild ginseng, is an artificially cultivated wild ginseng germinated from bird feces. Although numerous pharmacologic activities of wild ginsengs have been reported, the beneficial effect of joboksansam in cancer has not been elucidated. In this study, we investigated the in vivo and in vitro anticancer activities of joboksansam powder. Methods: To evaluate the in vivo anticancer activity of joboksansam, we established a xenograft mouse model bearing RMA cell-derived cancer. Direct cytotoxicity induced by joboksansam powder was also investigated in vitro using (3-4-5-dimethylthiazol-2-yl)-2-5-diphenyltetrazolium bromide (MTT) assay. The inhibitory activity of this powder on the activation of cell survival signaling involving Akt and Src was examined with immunoblot analysis. Results: Joboksansam powder displayed strong inhibitory activity against the increased tumor size, increased weight of total body and cancer tissues, and mortality of tumor-bearing mice. Joboksansam powder also suppressed the activation of survival regulatory enzymes Akt and Src, as assessed by phosphorylation levels in the immunoblot analysis of tumor tissues. Interestingly, the viability of RMA cells in vitro was directly decreased by joboksansam treatment. Conclusion: Overall, our results strongly suggest that joboksansam powder has the potential to protect against cancer generation by direct cytotoxic effects on cancer cells resulting from suppression of cell survival signaling.

• 대한소아치과학회지
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• 제31권4호
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• pp.696-700
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• 2004

치은 섬유종증은 유리 치은과 부착 치은이 점진적으로 증식되는 비염증성 질환이다. 대부분 가족력이 있으며 영구치 맹출과 함께 발병하지만 유치 맹출시기에 드물게 출생 시부터 나타나기도 한다. 본 6세 여아의 경우 태어날 때부터 치은의 일부가 증식되어 있었고 가족력 및 치은 증식을 유발하는 약물을 복용한 병력은 없었다. 구강내 검진 시 섬유성 치은 증식 이 관찰되어 절제 생검을 시행하였고 그 결과 치은 섬유종증으로 진단하였다. 치은 섬유종증의 치료는 치은 절제술과 철저한 구강 위생의 관리이다. 그러나 치료 후 재발성 때문에 치료시기에 대해서는 논란 중이다. 일반적으로 영구치가 모두 맹출 한 이후에 치료할 것을 추천하지만 조기 치료는 구강의 기능 및 환아의 심미적, 심리적인 문제점을 개선시켜 주는 장점이 있다.

• 임상간호연구
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• 제17권2호
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• pp.275-285
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• 2011

Purpose: Head-up position during sleep is one of the non-pharmacologic interventions for the treatment of orthostatic hypotension. Because the head-up position causes discomfort in many patients, this approach may not be acceptable to all patients. We compared the systolic blood pressure in erect position, orthostatic hypotension, orthostatic disability score, and the improvement rates of orthostatic hypotension between the 20 cm head-up group and the 10 cm head-up group. Methods: A control pre/post-test design was used. Between August 1, 2009 and November 15, 2010, we consecutively enrolled patients who showed orthostatic hypotension in patients with Parkinsonian disorders. Sixty-seven patients were prospectively enrolled and forty-four patients were completed the study. Results: There were no statistically significant differences found in the systolic blood pressure in erect position, orthostatic hypotension, and orthostatic disability scores between the two groups. However, five patients showed improvement in 20 cm head-up group and one patient was showed improvement in 10 cm head-up Group. Conclusion: Orthostatic hypotension is decreased with 20 cm head-up position in some patients with Parkinsonian disorders (p=.034). Further research investigating the relationships between orthostatic hypotension and head-up position are warranted.

• 대한본초학회지
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• 제28권5호
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• pp.79-85
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• 2013

Objectives : This study was aimed at producing emulsion by using butanol fractions of Sanguisorbae radix(SRA-B) which have high antioxidative and anti-inflammatory actions, and then evaluating stabilities of the emulsion. Methods : We measured antioxidant efficacy of SRA-B by using DPPH assay. Also, we checked the expressions of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) by using the Western blot to evaluate the anti-inflammatory effects of SRA-B3. We prepared emulsion containing SRA-B3(E-SRA-B3) and analysed its particle size distribution under a microscope. Also, we performed the test for stability of the emulsion. Results : SRA-B3 showed the highest efficacy in electronic donating abilities' activity. The Western blot's results indicated that the protein expression's amount of iNOS and COX-2 in macrophage stimulated by LPS were reduced by SRA-B3 treatment. The average particle size of E-SRA-B3 was $5{\sim}6{\mu}m$ in diameter and was $6.7{\mu}m$ in a view of the particle distribution. For a period of a observation, E-SRA-B3 has not made particular changes with storage temperature. It was observed that E-SRA-B3 could preserve its stable condition without a particular difference of viscosity during 28 days. Conclusions : From the above results, it was confirmed that SRA-B3 has potentiality enough to be applied to industrialization and could be utilized as antioxidative natural materials and anti-inflammatory cosmetics.

• Journal of Yeungnam Medical Science
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• 제25권1호
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• pp.19-30
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• 2008

골다공증은 골밀도와 골의 질로 구성되는 골의 강도가 손상됨으로 골절의 위험이 높아지는 골격질환이며, 최근 유병율이 점차 증가하고 있는 추세이다. 임상적으로 무증상인 경우가 많으며 방사선학적 검사인 단순 방사선 검사, 골 스캔, CT, MRI 등이 골밀도 및 골절의 진단에 유용하다. 골밀도의 정량적 검사로는 이중에너지 방사선 흡수법, 정량적 전산화 단층촬영이 사용되고 있다. 골다공증의 진단은 WHO 기준에 따라 T-score가 -2.5 이하일 경우 진단할 수 있다. 그 외에 생화학적 골표지자들도 진단에 도움이 된다. 골다공증 치료제는 골흡수억제제와 골형성자극제(formation stimulator)로 나눌 수 있는데 골흡수억제제로는 칼슘, 에스트로겐, 칼시토닌, 비스포스포네이트(bisphosphonate), 비타민 D 등이 있으며 골량을 증가시키는 골형성자극제로는 현재 부갑상선 호르몬이 유일하며 최근 strontium ranelate가 추가되었다. 일일 1200 mg의 칼슘과 800 IU 의 비타민 D 섭취가 권장되고 있으며, 폐경기 여성에서 에스트로겐이 효과가 입증되었고 골다공증으로 인한 통증에는 칼시토닌이 효과가 있다. 비스포스포네이트는 폐경 후 골다공증의 치료, 예방 및 스테로이드에 의한 골다공증 치료에 대해 FDA의 승인을 받았다. 폐경 후 골다공증의 치료, 예방에 사용되는 SERM은 골의 질을 향상시킴으로써 골절을 예방한다고 알려져 있다. 골형성자극제인 부갑상선 호르몬이 골절의 위험을 감소시킨다고 보고된 바 있으며, strontium은 최근에 개발된 약제로 3상 연구에서 골절 위험율 감소효과를 보였으나 더 많은 연구가 필요할 것으로 생각된다.

• 대한한방소아과학회지
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• 제31권1호
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• pp.52-62
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• 2017

Objectives The purpose of this study is to review pre-existing clinical practice guidelines for autism spectrum disorders, and refer those in developing a new practice guideline. Methods A total of 9 existing clinical practice guidelines for autism spectrum disorder developed from 2010 to 2016 were searched by Google scholar and Pubmed, and were reviewed those literatures in three parts: general, diagnosis & evaluation, and intervention. Results There were no consistency in the recommendation methods of 9 clinical care guidelines (such as the method of rating and recommendation intensity for diagnosis, evaluation, and treatment). However, in the diagnosis and evaluation section, frequently used evaluation and diagnostic tools are mentioned in most clinical practice guidelines, and the types of pharmacologic and non-pharmacological treatments that are mainly recommended in treatment are equally mentioned in most clinical practice guidelines could confirm. Conclusions 1. Some guideline recommendations are graded according to each criterion. Recommendations presented in various databases were based on systematic reviews or other literatures. The most utilized database were PsycINFO, CINAHL, Cochrane. 2. DSM-5 and ICD-10 were the most common used diagnostic criteria, and DSM-IV was used as a diagnostic standard in the guideline published before 2013. The tools used for diagnosis and evaluation were also varied. However, most recommended ones were ADI-R, ADOS-G, and DISCO. 3. Treatment was largely divided into pharmacological intervention and non-pharmacological intervention. In some guideline, the interventions were divided into pediatric and adult. Most of the pharmacological interventions were not recommended due to lack of evidence, but in cases in which specific symptoms were aimed, they recommended to seek professional help. 4. In addition to interventions, each guideline referred to supportive interventions that may be helpful in the daily life of patients with ASD, which may need to be addressed in future clinical guidelines.

• Clinical and Experimental Reproductive Medicine
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• 제8권2호
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• pp.45-55
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• 1981

Clomiphene citrate. antiestrogen, was given to 39 infertile males whose spermatogenesis were disturbed and the efficacy of the drug was evaluated at the Department of Urology in 1980. (Table 1). Patients were divided into 3 clinical observation groups such as group I composed of 19 cases of idiopathic azoospermia, group II consisted of 15 cases of oligospermia following the vasovasostomy, and group III comprised 5 cases of testicular azoospermia. (Table 2). Clinical characteristics of these patients were as follows: Age of the patients ranged from 26 to 43 years old with mean of 34, and that of their wives ranged from 24 to 41 years old with mean of 31. Duration of marital life ranged from 1 to 21 years with mean of 5 years. Sizes of testis ranged from 6 to 25 ml with mean of 16 ml. Coital frequency ranged from 0.5 to 6 per week with mean of 2.4 per week. Levels of plasma FSH ranged from 3.15 to 23.06 lU/1 with mean of 8.15 lU/1, those of LH ranged from 2.98 to 19.89 lU/1 with mean of 8.18 lU/1 and those of testosterone ranged from 3.09 to 9.97 ng/ml with mean of 6.48 ng/ml. (Table 3). Clomiphene citrate was given in dosage of 50 mg per day (in d.) orally to 31 patients for 3 to 9 months and in dosage of 100 mg per day (b.i.d.) orally to 8 patients for 3 to 9 months. (Table 8). Semen samples were analysed monthly on each patient by routine analysis techniques. For the assessment of the efficacy of Clomiphene citrate on faulty spermatogenesis following empirical criteria were used: For semen quality: Improvement (I) represents that semen parameter increased more than 25% from basal level after the treatment, Unchange (U) expresses that semen parameter increased less than 25% of basal level or not changed after the treatment and Deterioration (D) means that semen parameter decreased from basal level after the treatment. For fertility unit (total counts ${\times}$ motility ${\times}$ morphology ${\div}10^6$): Improvement (I) represents that fertility unit increased more than 10 units after the treatment, Unchange (U) expresses that fertility unit increased less than 10 units or not changed after the treatment, and Deterioration (D) means that fertility unit decreased after the treatment. (Table 4). Results obtained from the Clomiphene therapy were as follows: Changes of spermiograme before and after the Oomiphene therapy shown in the Table 5. Sperm counts increased from 23 to 31 ${\times}10^6$/ml in group I, from 17 to 29 ${\times}10^6$/ml in group II. Other parameters of spermiogramme were not changed significantly after the treatment. Fertility units increased from 14 to 18 units after the treatment in group I, and from 16 to 18 units after the treatment in group II. Effectiveness of Clomiphene citrate on spermatogenesis was summarised in the Tables 6 and 7. After the treatment, sperm count increased in 11 patients, motility increased in 6 patients, morphology increased in 4 patients and fertility units increased in 9 patients. No sperm could be produced by Clomiphene citrate in group III of testicular azoospermia. Dosage of 50 mg of Clomiphene citrate per day for 3 to 6 months was proved to be the most effective in the present series. (Table 8). Pregnancy occurred in 2 patients after the treatment. No particular side effects were noted by the treatment. Pharmacologic compounds used for male infertility were shown in the Table 9. Reported results of Clomiphene citrate were shown in the Table 10.