• Journal of Korean Neurosurgical Society
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• v.63 no.2
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• pp.261-267
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• 2020

Objective : We investigated the effect of hypnotics on sleep quality, cognitive function, and depressive mood in patients with insomnia following brain tumor resection. Methods : From patients who underwent brain tumor resection, we recruited 10 patients with insomnia who received hypnotics for more than 1 week during a 3-week follow-up period (insomnia group). We also recruited 12 control patients with brain tumors but without insomnia (control group). We evaluated sleep quality at baseline and 3 weeks later using the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI), the Stanford Sleepiness Scale (SSS), and the Epworth Sleepiness Scale (ESS) and investigated cognitive function and depression using the Computerized Neuropsychological Test and the Beck Depression Inventory (BDI). Results : At baseline, SSS, ISI, PSQI, and BDI scores were significantly higher and visual continuous performance test (VCPT) and auditory continuous performance test (ACPT) scores were significantly lower in the insomnia than in the control group. Three weeks later, the patients who had received hypnotics had significantly higher ISI, PSQI, ESS, VCPT, ACPT, visual span forward and backward, and visual recognition test scores, and significantly lower BDI scores. Conclusion : Quality of sleep in patients with insomnia following brain tumor resection was initially poor but improved significantly after taking hypnotic medication. Further, the hypnotic medications appeared to contribute to the amelioration of cognitive impairments and depressive moods in patients who previously underwent brain tumor resection. We thus recommend the use of hypnotics for patients with brain tumors with insomnia.

• Journal of The Korean Society of Clinical Toxicology
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• v.13 no.2
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• pp.95-102
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• 2015

Purpose: Drug overdose is easily found in the emergency department (ED). Sedative-hypnotics overdose causes the aspiration pneumonia in patients with decreased mental status. The purpose of this study was to investigate the risk factors of aspiration pneumonia in patients poisoned with sedative-hypnotics. Methods: One hundred seventy eight patients who were poisoned with sedative-hypnotics and who visited ED between 2009 and 2015 were included. This study was conducted retrospectively, with collection of data by review of medical records. We collected the data concerning the characteristics of patients and classified them into two groups based on the development of aspiration pneumonia. Logistic regression analysis was performed to investigate the factors for the development of aspiration pneumonia. Results: Thirty five patients had an aspiration pneumonia during their hospital stay in 178 patients. The age, amount of ingestion, Glasgow Coma Scale (GCS) score at admission, a history of hypertension and diabetes mellitus, and the hypotension at admission were significantly different between two groups in univariate analysis. The age, amount of ingestion and GCS score at admission were associated with the development of aspiration pneumonia in the multivariate logistic regression analysis (OR 1.028 (95%CI, 1.002-1.056, p=0.037), 1.026 (95%CI, 1.004-1.043, p=0.001), 0.737 (95%CI, 0.683-0.915, p=0.002)). All patients with aspiration pneumonia were discharged without a sequelae. Conclusion: The development of aspiration pneumonia in the patients of sedative-hypnotics overdose is associated with old age, amount of drug ingestion, and GCS score at admission.

• Journal of Yeungnam Medical Science
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• v.8 no.2
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• pp.164-173
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• 1991

Clinical observations were made on 349 cases of acute drug intoxication who were visited to emergency room of Yeungnam University Hospital during recent 7 years from January 1984 to December 1990. The following results were obtained 1) Total number of cases of acute drug intoxication was 349 which was 0.39% of the total patients of the emergency room during the same period. 2) The ratio of male to female was 1.1 : 1. The age incidence was highest in the third decade(26.7%). The monthly incidence was hightest in May. Higher frequency was observed in summer season. 3) The most common drug of the intoxication was pesticides and herbicides(71.9%), the remainders were miscellaneous drugs(11.2%), sedatives(7.7%), rodenticides(6.3%) and unknown drug(3.2%) in orders. 4) The most common cause of drug intoxication was suicide(69.1%) and the others were accident, unknown cause, intention in orders. 5) Main clinical manifestations were the impairment of consciousness, nausea, vomiting and convulsion. Physical examination revealed increased pulses, increased blood pressure, miosis of the pupil and sweating. Above symptoms and signs were more prominent in pesticide intoxication. Leukocytosis, glycosuria and abnormal LFT were common findings in acute intoxications. 6) The complications were developed in 18.3% among 349 cases and the most common complication was respiratory failure, pneumonia, cardiovascular collapse and pulmonary edema in orders. 7) Overall mortality rate was 8.3% of total cases and mortality rate was highest in herbicide intoxication(22.2%).

• The Journal of Internal Korean Medicine
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• v.39 no.5
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• pp.1061-1067
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• 2018

A patient had central fever following pontine hemorrhage. Central hyperthermia caused by stroke is a rare case, and it is difficult to control. There are few case reports about central hyperthermia in Korean medical treatment (KMT). The patient suffered central hyperthermia accompanied by tachycardia, dyspnea, and irritability. However, there was no evidence of infection. Thus, hypnotics, sedatives, and a minor tranquilizer (Lorazepam and Midazolam) was prescribed. Despite a temperature peak of $39.9^{\circ}C$, most of the symptoms were alleviated. The patient's average body temperature was about $37^{\circ}C$, which is higher than most people at $36.5^{\circ}C$. His symptoms were diagnosed as ascendant hyperactivity of liver Yang (肝陽上亢), and the patient was prescribed Shihogayonggolmoryo-tang. During the 44 days of KMT, there was no change in his average body temperature and no central hyperthermia over $39^{\circ}C$. This case report demonstrates the possibility of controlling central hyperthermia caused by pontine hemorrhage using KMT.

• Journal of Trauma and Injury
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• v.27 no.4
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• pp.178-185
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• 2014

Purpose: The aim of this study was to assess the clinical efficacy of combined treatment with local anesthesia and ketamine procedural sedation for pediatric facial laceration repair in the Emergency Department (ED). Methods: Patients aged 1 to 5 years receiving ketamine for facial laceration repair were prospectively enrolled in a double-blind, randomized, and controlled study at an ED. All patients were to receive intravenous ketamine (2 mg/kg). The local anesthesia group (LA group) received a local anesthetic along with ketamine, whereas the no local anesthesia group (NLA group) received only ketamine. The total time of sedation, the patients' movements and groans, adverse events, and the satisfaction ratings of physicians, nurses, and parents were recorded. Results: A total of 186 patients were randomized (NLA group: 90, LA group: 96). The total time of sedation (30.5 minutes for the NLA group, 32.6 minutes for the LA group; p=0.660), patients' groans (26 (28.9%) versus 23 (24.0%); 0.446) and movements (27 (30%) versus 35 (36.5%); p=0.350) was not affected by the addition of local anesthesia. Other adverse events were similar between the two groups. Also, the satisfaction ratings of physicians (median 4 for the NLA group versus 4 for the LA group (p=0.796)), nurses (2 versus 2.5 (p=0.400)), and parents (4 versus 4 (p=0.199)) were equivalent between the two groups. Conclusion: In this study, we found that local anesthesia was not required along with ketamine sedation for pediatric facial laceration repair.

• Journal of Veterinary Clinics
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• v.23 no.1
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• pp.31-35
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• 2006

This study was performed to evaluate sedation with quantitative electroencephalography (EEG) analysis in dogs. EEG is used to evaluate objectively the effects of CNS acting with brain and behavioral changes. Especially, spectral edge frequency 95 (SEF 95) parameter is an effective method to determine the sedative status. The SEF 95 is the frequency below 95% of the total power. Twelve healthy intact male Miniature Schnauzer dogs, which did not show any neurological abnormalities and disease, were used for the study. EEG electrodes were inserted in subcutaneous tissue over the calvaria without entering adjacent muscles. The EEG data were acquired and analyzed by EEG raw wave and spectral edge frequency 95 analysis. After the administration of sedatives, the SEF 95 values were shown the significant changes compared with the normal state In all groups (p<0.05). It is suggested that SEF 95 analysis is useful method for assessing the state of sedation in dogs.

• Journal of Veterinary Clinics
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• v.14 no.2
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• pp.244-253
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• 1997

This study was performed to evaluate the possibility of inducing analgesia by electroacupuncture stimulation at single acupoint or combined acupoints and to examine the analgesic effects following the combination of premedication and electroacupunrture analgesia(EA). Analgesia was induced by EA with the current of 1-4 volts and the frequency of 10-45 Hz to the acupoints Uown to be related to analgesia on the head/necIL axial part thoracic and pelvic limb. In Yi Feng acupoint of head/neck part pain responses were not disappeared after electroacupunrture stimulation to the head/necIL thoracic limbo thoraxl abdomen, loin, rear and pelvic limb. Pain responses were remained after EA of Tian Men-Tian Ping and Shen Yu arupoints of axial park whereas hypoalgesia was observed after EA of Tian Ping-Bai Hui acupoint in all parts of body. There was no analgesic effects after EA stimulation of the brachial plexus and Wai Kuan acupoint, whereas after EA stimulation of San Yang Lo, pain responses were disappeared in headfnecll, thoracic limb and pelvic limbo and in the other parts of body hypoalgesia was shown. In EA stimulation of Tsu San Li acupoint pain responses were disappeared in pelvic limb and in San Yin Chiao acupoint pain responses were disappeared in head/necIL thoracic and pelvic limb, and hypoalgesia was shown in abdomen. On the combination of San Yang Lo Pli Men) and San Yin Chiao (Pu Yan6 acupoints, pain response in heauneck was decreased in 5 minutes, whereas analgesia in thoracic and pelvic limb was induced after 20-30 minutes and in abdomen was noted after 50 minutes. The more frequrncy was increased, the more rapid analgesic e11%t was induced. The analgesic effects wert not good in laparotomy under EA at the combination of San Yang Lo (Xi Men) and San Yin Chiao (Pu Yang) arufoints. Enteroanastomosis could not be continued under acrpromazine, xylazine and diazepam with EA. However, under EA followed by tiletaminetzolazepam, the operation could be completed without additional anesthesia and the analgesic effects were good. There were no changes in clinical signs, hematological and serological values after combination of the premeditation of tiletamine+zolaEepam and EA. It is considered that EA alone is not suitable for the main surgery, but the combination method of EA and sedatives can be utilized in practice.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.4
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• pp.380-383
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• 2006

Tetanus is rare in Korea due to the introduction of vaccination programs and the advancement in public health. Its common signs are trismus, voice disturbance, neck stiffness, and difficulty in swallowing, etc. A 56 years old man was injured by grasping a high voltage electric cable. After the accident, he fell down on a steel plate and had a head trauma. When he visited Emergency Department, there was multiple electric burn wound on left arm and left facial area. He was hospitalized on a department of neurosurgery, because intra cranial hemorrhage was presumed. 12 days later, he was referred to department of OMFS with developed painful masseter spasms and trismus. That night he violently bit his tongue with his denture. Because masseter muscle and temporal muscle constriction was involuntary, tongue was lacerated and denture was distorted. At first we supposed that the symptom was related with neurologic disturbance following head trauma or electric shock. But it was revealed that trismus was caused by tetanus on an electrophysiological test. By using mechanical ventilation and administration of tetanus immunoglobulin, muscle-relaxant, and sedatives at ICU, symptoms had subsided (4-weeks). Because tetanus is rare disease, we rarely suppose tetanus infection to be a cause of a trismus. Especially it is more difficult to diagnose in patient who has head trauma, burn and neurologic problem as in this case.

• Korean Journal of Pharmacognosy
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• v.44 no.3
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• pp.257-262
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• 2013

Osteoporosis is a disease of bones that leads to an increased risk of fracture. In osteoporosis, the bone mineral density is reduced, bone microarchitecture deteriorates, and the amount and variety of proteins in bone are altered. $It^{\circ}{\emptyset}s$ caused by the imbalance between born resorption and born formation. Recently natural products from plants have been extensively studied as therapeutic drugs to treat and prevent various diseases. Wheat bran is the hard outer layers of wheat grain and produced as a by-product of milling in the production of refined grains. In oriental medicines, Bu So Maek (Tritici Immaturi Semen) with wheat bran has been used as bronchitis, sedatives and anti-sweating effects. However effects of wheat bran butanol fraction (WBB, 50 ${\mu}g/ml$) in osteoclast differentiation remains unknown yet. Thus we investigated the effects of WBB on RANKL induced osteoclast differentiation. WBB inhibited osteoclast differentiation by downregulating the RANKL-induced activations of MAP kinases. Moreover mRNA expression of osteoclast-mediating molecules such as c-Fos, NFATc1 and DC-STAMP were attenuated by WBB during osteoclast differentiation. The finding of this study show that WBB and its components might prevent osteoclast-related bone loss.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.2
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• pp.75-91
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• 2012

Background: Dental sedation reduces fear and phobia during dental treatment and helps patients get quality treatment by inducing adequate consciousness control. Propofol has recently grabbed the spotlight, but no meta-analysis for efficacy and safety of propofol in dentistry has yet been performed. Thus, the purpose of this study was to perform meta-analysis to verify the efficacy and safety of propofol for use in dental sedation. Methods: Articles published between 1980 and 2010 were searched in the web sites, journals and medical database including The Cochrane Library, MEDLINE and EMBASE. And a total of 22 studies were selected among the randomized controlled trials (RCTs) that compared the use of propofol with other sedatives (control group). The data was collected from these studies and meta-analysis for efficacy and safety was performed using Comprehensive Meta-Analysis 5.0 (CMA 5.0). Results: The patient recovered significantly faster and discharged significantly earlier in the propofol group (SMD = -1.442, P < 0.001). The satisfaction of patient and that of operator was higher in the propofol group (P < 0.05). The incidence of arrhythmia and apnea/ hypoventilation was significantly lower in the propofol group (OR = 0.071, P < 0.05), and there was no significant difference in the other side effects. On the level of sedation, although the sedation score was significantly lower in the propofol group (SMD = -0.430, P < 0.05). Conclusions: The present analysis showed that the use of propofol resulted in high satisfaction levels on the part of the patients and operators, a shorter recovery time, and faster hospital discharge. The incidence of complications, however, was lower in the propofol groups or not much different between the propofol and control groups. Thus, the adequate use of propofol in dentistry is believed to be helpful for the effective and safe sedation of the patients.