Revised Subjects of the Current Korean Oriental Pharmacists' Licensing Examination

This study is designed to draw out new integrated subjects of the Korean Oriental Pharmacists' Licensing Examination (KOPLE). In 2004, for the revision of subjects, we have analyzed the curriculums of the Oriental Pharmacy department, the oriental pharmacist's (OP's) job description book, and the elementary items of KOPLE. We also examined the system of the Chinese Herb Pharmacists' Examination and other health personnel licensing examinations and studied the data of items and compared them with KOPLE. We heard the public opinion on the present KOPLE. We developed a subfield of 18 subjects, a middle category of 188 items, and a small category of 1,026 items. We proposed a new KOPLE that consists of three subjects: basic oriental pharmacy, applied oriental pharmacy, and laws and regulations

Prognostic Factors for Endotracheal Silicone Stenting in the Management of Inoperable Post-Intubation Tracheal Stenosis

∙ The authors have no financial conflicts of interest. © Copyright: Yonsei University College of Medicine 2012 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial Licens

Arthroscopic Treatment of Septic Arthritis of the Shoulder: Technical Pearls to Reduce the Rate of Reoperation

Background The aim of this study was to evaluate clinical experience with arthroscopic debridement for septic arthritis of the shoulder joint and to report on our patient outcomes. Methods The retrospective analysis included 36 shoulders (male:female, 15:21), contributed by 35 patients (mean age, 63.8 years) treated by arthroscopy for septic arthritis of the shoulder between November 2003 and February 2016. The mean follow-up period was 14.3 months (range, 12–33 months). An additional posterolateral portal and a 70º arthroscope was used to access the posteroinferior glenohumeral (GH) joint and posteroinferior subacromial (SA) space, respectively. Irrigation was performed with a large volume of fluid (25.1±8.1 L). Multiple suction drains (average, 3.3 drains) were inserted into the GH joint and SA space and removed 8.9±4.3 days after surgery. Intravenous antibiotics were administered for 3.9±1.8 weeks after surgery, followed by oral antibiotic treatment for another 3.6±1.9 weeks. Results Among the 36 shoulders, reoperation was required in two cases (5.6%). The average range of motion achieved was 150.0º for forward flexion and T9 for internal rotation. The mean simple shoulder test score was 7.9±3.6 points. Nineteen shoulders (52.8%) had acupuncture or injection history prior to the infection. Pathogens were identified in 15 shoulders, with Staphylococcus aureus being the most commonly identified pathogen (10/15). Both the GH joint and the SA space were involved in 21 shoulders, while 14 cases involved only the GH joint and one case involved only the SA space. Conclusions Complete debridement using an additional posterolateral portal and 70º arthroscope, a large volume of irrigation with >20 L of saline, and multiple suction drains may reduce the reoperation rate

Herb Mixture Inhibits Proinflammatory Mediators Through the Suppression of JNK and P38 Activation in LPS-Stimulated Raw 264.7 Macrophages

ABSTRACT Inflammation has been implicated as a pathophysiological feature underlying many chronic diseases. In the present study, we investigated the anti-inflammatory effect of new formulation of herb medicine, DG1102, composed by five different herbal ingredients such as Taraxaci Herba, Rhei Rhizoma, Houttuynia cordata Thunb. Houttuyniae Herba, Eriobotryae Folium which has been used for inflammatory diseases, in LPS-stimulated Raw 264.7 macrophages. DG1102 suppressed nitric oxide (NO), tumor necrosis factor-α (TNF-α), interleukin (IL)-1α, IL-6, IL-10 and macrophage inflammatory protein production in the lipopolysaccharide (LPS)-stimulated RAW 264.7 macrophages, as well as inducible nitric oxide synthase and cyclooxygenase 2 expression. Furthermore, DG1102 suppressed the activation of p38 and c-Jun N-terminal kinase (JNK). Our results suggest that DG1102 has an immune-modulatory activity suppressing production of pro-inflammatory cytokines and chemokine via the suppression of JNK and p38 MAPK activation in LPS-stimulated RAW 264.7 macrophages. The present study provides the biological evidence of the efficacy of medicinal plants in the treatment of inflammatory diseases

A Paragonimiasis Patient with Allergic Reaction to Praziquantel and Resistance to Triclabendazole: Successful Treatment after Desensitization to Praziquantel

Paragonimiasis is an infectious disease caused by trematodes of the genus Paragonimus. This trematode can be treated successfully with praziquantel in more than 90% of the cases. Although praziquantel is generally well tolerated, anaphylactic reactions to this drug have been reported in a few cases. We report here a 46-year-old Korean female with paragonimiasis, presumed to be due to Paragonimus westermani, who displayed an allergic reaction to praziquantel and resistance to triclabendazole treatment. The patient was successfully treated with praziquantel following a rapid desensitization procedure. Desensitization to praziquantel could be considered when no alternative drugs are available

Canine model of ischemic stroke with permanent middle cerebral artery occlusion: clinical and histopathological findings

The aim of the present study was to assess the clinical and histopathological findings in a canine model of ischemic stroke. Cerebral ischemic stroke was induced by middle cerebral artery occlusion in four healthy beagle dogs using silicone plugs. They showed neurological signs of forebrain dysfunction such as reduced responsiveness, head turning, circling, postural reaction deficits, perceptual deficits, and hemianopsia. These signs gradually regressed within 4 weeks without therapy. On magnetic resonance imaging, T2 hyperintensity and T1 hypointensity were found in the cerebral cortex and basal ganglia. These lesions were well-defined and sharply demarcated from adjacent brain parenchyma with a homogenous appearance. No abnormalities of the cerebrospinal fluid were observed. At necropsy, atrophic and necrotic lesions were observed in the cerebral cortex. The cerebral cortex, basal ganglia, and thalamus were partially unstained with triphenyl-tetrazolium chloride. Histopathologically, typical features of infarction were identified in cortical and thalamic lesions. This study demonstrates that our canine model resembles the conditions of real stroke patients

Two Methods of Setting Positive End-expiratory Pressure in Acute Lung Injury: An Experimental Computed Tomography Volumetric Study

This study was conducted to observe effects of two methods of setting positive end-expiratory pressure (PEEP) based on the pressure-volume (PV) curve. After lung injury was induced by oleic acid in six mongrel adult dogs, the inflation PV curve was traced and the lower inflection point (LIP) was measured. The 'PEEPINF' was defined as LIP+2 cmH2O. After recruitment maneuver to move the lung physiology to the deflation limb of PV curve, decremental PEEP was applied. The lowest level of PEEP that did not result in a significant drop in PaO2 was defined as the 'PEEPDEF'. Arterial blood gases, lung mechanics, hemodynamics, and lung volumes (measured on computed tomography during end-expiratory pause) were measured at PEEP of 0 cmH2O, PEEPINF and PEEPDEF sequentially. The median PEEPINF was 13.4 cm H2O (interquartile range, 12.5-14.3) and median PEEPDEF was 12.0 cm H2O (10.0-16.5) (p=0.813). PEEPDEF was associated with significantly higher PaO2 and lung volumes, and significantly lower shunt fraction and cardiac index when compared to PEEPINF (p<0.05). Setting the PEEP based on the deflation limb of the PV curve was useful in improving oxygenation and lung volumes in a canine lung injury model