• Title/Summary/Keyword: Clinical Circumstances

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Study on Depressive Syndrome in Hyungsang Medicine (울증의 형상의학적 고찰)

  • Kang Kyung Hwa;Kim In Jin;Lee Yong Tae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.5
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    • pp.1285-1290
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    • 2004
  • From a view point of Hyungsang medicine a study is made on depressive syndromes through 'Donguibogam(東醫寶鑑)' ,'Clinical lectures by Mr. Jeesan(芝山先生 臨床學特講)' and other literature. Depressed energy(?) originally meant the disorder of vital energy in the circulation of nature with the lapse of time. In later, it has been changed to mean the disease of man, especially related to the mind. Depressive syndromes come from the stagnation of the Ki or the abnormal circulation(rising, falling, coming and going), which happens when man cannot adjust oneself to the circumstances due to the disharmony between internal and external conditions. Depressive syndrome easily attacks the following types of persons; Dam type person with excessive Ki and deficient Hyung(形), manly woman, womanly man, Bird type person who shows a great variety of emotion, Turtle type person declined to melancholy, Ki type person apt to be depressive, and Shin type person with upward gush of the fire. It also attacks the persons who have smudgy face with the scar between eyebrows, those whose pulses are mixture of two different kinds and those whose pulses extend on two ranges in Jeesan's diagram. Depressive syndromes recorded in 'Donguibogam' are globus hystericus, chest congestion, gastric discomfort, cough and asthma caused by depressed Ki, abdominal mass, edema, and tympanites. The most effective prescriptions for depressive syndromes are Eajintang(二陳湯), Guibitang(歸脾湯), Hyangsosan(香蘇散), and Gamisachiltang(加味四七湯).

Clinical Efficacy of Radiation-Sterilized Allografts for Sellar Reconstruction after Transsphenoidal Surgery

  • Kim, Se-Jin;Jeon, Chi-Man;Kong, Doo-Sik;Park, Kwan;Kim, Jong-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.50 no.6
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    • pp.503-506
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    • 2011
  • Objective : The aim of this study was to assess the safety and efficacy of radiation-sterilized allografts of iliac bone and fascia lata from cadaver specimens to repair skull base defects after transsphenoidal surgery. Methods : Between May 2009 and January 2010, 31 consecutive patients underwent endonasal transsphenoidal surgery and all patients received sellar reconstruction using allografts following tumor removal. The allografts were obtained from the local tissue bank and harvested from cadaver donors. The specimens used in our approach were tensor fascia lata and the flat area of iliac bone. For preparation, allografts were treated with gamma irradiation after routine screening by culture, and then stored at $-70^{\circ}C$. Results : The mean follow-up period after surgery was 12.6 months (range, 7.4-16 months). Overall, postoperative cerebrospinal fluid (CSF) leaks occurred in three patients (9.7%) and postoperative meningitis in one patient (3.2%). There was no definitive evidence of wound infection at the routine postoperative follow-up examination or during re-do surgery in three patients. Postoperative meningitis in one patient was improved with the use of antibiotics and prolonged CSF diversion. Conclusion : We suggest that allograft materials can be a feasible alternative to autologous tissue grafts for sellar reconstruction following transsphenoidal surgery under selected circumstances such as no or little intraoperative CSF leaks.

The Literature Review on Medications of Insomnia in Chapter Mong(夢) of Donguibogam (불면 처방에 관한 문헌고찰 - 동의보감(東醫寶鑑) 몽문(夢門)을 중심으로)

  • Park, Bo-Ra;Park, In-Sook;Kang, Hyung-Won;Lyu, Yeong-Su
    • Journal of Oriental Neuropsychiatry
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    • v.22 no.2
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    • pp.177-198
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    • 2011
  • Objectives : By analyzing and comparing indications, components and their doses of herb medicines, which were recorded in insomnia chapters of medical books, we examined historical changes and made clear documentary ground of medications. Methods : 1. 10 books which were noted in insomnia part of "The Eastern Medical Textbook of neuropsychiatry" and 13 books were mentioned in same part of "Uibujeonrok" were selected as reference. 2. We searched article database such as KISS, riss4U and journals issued by the Korean society of oriental neuropsychiatry. Finally, 39 books which were noted in 3 literature reviews, were chose as reference. 3. In reference books, we collected the herb medicines in chapters related to insomnia. 4. In case of no section associated with insomnia in books, we found prescriptions related to insomnia in whole chapters. 5. If the chief virtue of medication was not primarily for insomnia, we excluded applied or added herb medicines. 6. We classified prescriptions into small groups which had same name, and then rearranged them in chronological order. Results and Conclusions : 1. Banha-tang(banxiatang) of "Hwangjenaegyeong Youngchu" was the first-recorded prescription used for insomnia. 2. The chapter of insomnia appeared in "Chunkeumyobang" at first. 3. Ondam-tang(Wendantang) was most cited prescription in medical books. It was recorded totally 19 books from "Chunkeumyobang" to "Hyeoljeungron". 4. We suspects indications, components, dosage of medication of insomnia in Donguibogam were revised according to author's clinical experience and circumstances.

Pharmacologic Management of Chronic Pain

  • Park, Hue-Jung;Moon, Dong-Eon
    • The Korean Journal of Pain
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    • v.23 no.2
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    • pp.99-108
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    • 2010
  • Chronic pain is a multifactorial condition with both physical and psychological symptoms, and it affects around 20% of the population in the developed world. In spite of outstanding advances in pain management over the past decades, chronic pain remains a significant problem. This article provides a mechanism- and evidence-based approach to improve the outcome for pharmacologic management of chronic pain. The usual approach to treat mild to moderate pain is to start with a nonopioid analgesic. If this is inadequate, and if there is an element of sleep deprivation, then it is reasonable to add an antidepressant with analgesic qualities. If there is a component of neuropathic pain or fibromyalgia, then a trial with one of the gabapentinoids is appropriate. If these steps are inadequate, then an opioid analgesic may be added. For moderate to severe pain, one would initiate an earlier trial of a long term opioid. Skeletal muscle relaxants and topicals may also be appropriate as single agents or in combination. Meanwhile, the steps of pharmacologic treatments for neuropathic pain include (1) certain antidepressants (tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors), calcium channel ${\alpha}2-{\delta}$ ligands (gabapentin and pregabalin) and topical lidocaine, (2) opioid analgesics and tramadol (for first-line use in selected clinical circumstances) and (3) certain other antidepressant and antiepileptic medications (topical capsaicin, mexiletine, and N-methyl-d-aspartate receptor antagonists). It is essential to have a thorough understanding about the different pain mechanisms of chronic pain and evidence-based multi-mechanistic treatment. It is also essential to increase the individualization of treatment.

Clinical Report of Various Postpartium Symptoms (산후질환에 관한 임상보고)

  • Koo, Jin Suk;Lee, Young Jun;Seo, Bu Il
    • The Journal of Korean Medicine
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    • v.38 no.1
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    • pp.112-124
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    • 2017
  • Objectives: The purpose of this study is to investigate the various postpartum symptoms and the relevant factors. So it can provide fundamental data about postpartum health care. In conclusion, we can prevent and manage the postpartum disease by using this data. Methods: The subject of the present study was 94 women (63 women who completed vaginal delivery and 31 women who delivered by cesarean section) who completed labor between November 1, 2013 and January 31, 2016, at the clinic of OB&GYN. They have been taking good care of their health at postpartum clinic in Andong Woori Women Hospital. We investigated the various symptoms and situation which occurred from the moment of hospital to postnatal admission health care period, and Korean medical doctor examined the patients through the four examination methods. We classified the symptoms by maternal age, the frequency of maternal childbirth, the method of delivery, the delivery season, the term of pregnancy, the body weight of infant, the weight change of mother and the way of feeding. Results: There were no remarkable corelation in the frequency of symptoms according to maternal age, the way of delivery, the delivery season, the change of weight before and after of delivery, gestational weeks at delivery, the manner of feeding and the body weight of infants except for the frequency of maternal childbirth. Conclusion: The symptoms of hemorrhoids, the feeling of coldness and chilliness increased with increasing the frequency of maternal childbirth. Other circumstances, there was no relationship with symptoms of postpartum.

Analysis of Distances for MRI Scan to Maintain Pptimal Signal Intensity in a Surface Coil (MRI 검사 시 코일내 최적의 신호강도를 유지할 수 있는 거리의 기준 분석)

  • Son, Soon-Yong
    • The Journal of the Korea Contents Association
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    • v.18 no.10
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    • pp.158-164
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    • 2018
  • The purpose of this study is to statistically analyze the signal intensity pattern according distance from the surface coil center and to maintain optimal signal intensity under clinical circumstances where the surface coil centers are not correctly positioned due to various causes. The cylindrical fluid phantom was placed and moved from the coil center in vertical direction with 1 cm increments. The signal intensities were measured and compared. As a result, the signal intensity showed no significant difference within 4 cm and 1 cm from in T1 weighted images while in T2 weighted images the signal intensity was maintained up to 5 cm and lower 3 cm in the upper and lower direction from the coil center. In conclusion, to maintain the optimal signal intensity the target region should be located within the reference distances proposed in this study.

Awareness of Emotional Labor of Nursing College Students in Graduation Year (졸업학년 간호대학생의 감정노동에 대한 인식)

  • Yeom, Eun-Yi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.5
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    • pp.177-189
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    • 2017
  • The aim of this study was to understand and describe the awareness of the emotional labor of nursing college students in a graduation year. The participants were eleven students in nursing colleges. The data were collected from September 5, 2016 to November 25 through in-depth interviews until it was saturated. All interviews were recorded and transcribed as they were spoken. Colaizzi's phenomenological method was used for data analysis. In this study, twenty-one themes, ten theme clusters and five categories were generated. The five categories consisted of 'Confused by irrational circumstances,' 'Skepticism on nursing occupation,' 'Empathy for the nurse's difficult situation,' 'Learning nurses' words and behavior', and 'Preparing for the future.' These results will contribute to the qualitative improvement of nursing practice education by providing the grounds for an effective educational strategy development that manages the emotional labor of Nursing students from clinical practice. In-depth studies on the experience of nursing students' emotional labor and studies on various factors affecting the awareness of emotional labor in nursing students and problems will be required.

Is N-acetylcysteine Treatment Based on Ingestion Amount Valid in Acute Acetaminophen Overdose Patients? (급성 Acetaminophen 중독시 복용량에 의한 N-Acetylcysteine의 사용은 적절한가?)

  • Kim, Tae-Geun;Kim, Min-Joung;Lee, Jin-Hee;Chung, Sung-Pil;Lee, Hahn-Shick;Park, Yoo-Seok
    • Journal of The Korean Society of Clinical Toxicology
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    • v.4 no.2
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    • pp.107-112
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    • 2006
  • Purpose: In many Korean hospitals, serum acetaminophen concentrations in cases of overdose cannot be measured initially because of inadequate laboratory facilities. Under these circumstances, physicians base the administration of the antidote, N-acetylcysteine, on ingestion amounts as determined by initial history taking. We therefore examined the correlated between ingested amounts and serum acetaminophen concentrations. Methods: Medical records were reviewed retrospectively for patients who presented to the ED with acetaminophen overdose between January 2002 and March 2006. Fifty-nine patients were recruited and sixteen patients were excluded. The forty-three remaining patients were placed into either the high-risk or low-risk group based on their ingested amount (140 mg/kg), and were separately categorized into the toxic or non-toxic group based on their serum acetaminophen concentrations, according to the Rurnack-Matthew nomogram. Results: Ten patients (83.3%) among twelve in the high-risk group were found to have non-toxic serum concentrations, and just one patient (3.2%) among thirty-one in the low-risk group fell into the toxic group based on their serum concentrations. The sensitivity and specificity of risk stratification of the ingested amount as a predictor of intoxication requiring antidote therapy were 66.7% and 75.0%, respectively. Conclusion: This study suggests that the therapeutic decision for acetaminophen overdose should not be based solely on ingested amount only, but requires assessment of acetaminophen concentration.

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Microguidewire Looping to Traverse Stented Parent Arteries of Intracranial Aneurysms

  • Cho, Young Dae;Rhim, Jong Kook;Yoo, Dong Hyun;Kang, Hyun-Seung;Kim, Jeong Eun;Han, Moon Hee
    • Journal of Korean Neurosurgical Society
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    • v.60 no.2
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    • pp.262-268
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    • 2017
  • Objective : Stents are widely used in coil embolization of intracranial aneurysms, but on occasion, a microcatheter must traverse a stented segment of artery (so-called trans-cell technique) to select an aneurysm, or double stenting may necessary. In such situations, microguidewire passage and microcatheter delivery through a tortuous stented parent artery may pose a technical challenge. Described herein is a microguidewire looping technique to facilitate endovascular navigation in these circumstances. Methods : To apply this technique, the microguidewire tip is looped before entering the stented parent artery and then advanced distally past the stented segment, with the loop intact. Rounding of the tip prevents interference from stent struts during passage. A microcatheter is subsequently passed into the stented artery for positioning near the neck of aneurysm, with microguidewire assistance. The aneurysm is then selected, steering the microcatheter tip (via inner microguidewire) into the dome. Results : This technique proved successful during coil embolization of nine saccular intracranial aneurysms (internal carotid artery [ICA], 6; middle cerebral artery, 2; basilar tip, 1), performing eight trans-cell deliveries and one additional stenting. Selective endovascular embolization was enabled in all patients, resulting in excellent clinical and radiologic outcomes, with no morbidity or mortality directly attributable to microguidewire looping. Conclusion : Microguidewire looping is a reasonable alternative if passage through a stented artery is not feasible by traditional means, especially at paraclinoid ICA sites.

Collaboration through the Asia Pacific MPS Network (APMN), Asia Pacific MPS Registry (APMR), and Association for Research of MPS & Rare Diseases (ARMRD)

  • Cho, Sung Yoon
    • Journal of mucopolysaccharidosis and rare diseases
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    • v.1 no.1
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    • pp.2-4
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    • 2015
  • Though the rate of incidence of each rare disease, including mucopolysaccharidosis (MPS), is low, this is not the case if they are taken as a whole. Rare diseases often have genetic causes and vary in type. However, the signs and symptoms vary greatly by disease, making it difficult to make accurate diagnoses and conduct necessary research, which is why we believe it is a field that deserves more attention and research. It is important to establish an infrastructure of experts in each country and promote cooperation within the Asia-Pacific region in order to improve specialist training and communication. Given the need for a system of cooperation, the Asia Pacific MPS Network (APMN) was established by several MPS experts in South Korea, Japan, and Taiwan in January 2013. Thereafter, the Asia Pacific MPS Registry (APMR), an electronic remote data system, was established by the APMN. Then, the Association for Research of MPS & Rare Diseases (ARMRD), an academic society that supports research on MPS and other rare diseases, was established by President Dong-Kyu Jin in April in 2015. The main task of the ARMRD is to support APMN-related work. The ARMRD published a uniform guideline that reflects the characteristics and circumstances of local patients through the Korean MPS Expert Council. Now, the APMN, APMR, and the annual Korean MPS Symposium are supported by ARMRD. Organizations like the APMN and APMR are necessary because international cooperation and collaboration are needed to conduct clinical trials on those diseases. ARMRD members hope to encourage the interest of experts and researchers of MPS & rare diseases as well as active participation in the research and treatment of patients suffering from rare diseases, including MPS, to ultimately improve the quality of life of the patients as well as their families.