• Title/Summary/Keyword: Hospital departments

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섭식장애의 한의학적 치료에 대한 국내외 최근 임상연구 동향 (A Review of the Recent Clinical Studies on Korean Medicine for the Treatment of Eating Disorders)

  • 장선우;구강모;박지원;권민진;권오빈
    • 동의신경정신과학회지
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    • 제34권4호
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    • pp.369-384
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    • 2023
  • Objectives: The purpose of this study was to review the recent clinical studies on Korean medicine for treatment of eating disorders. Methods: We searched clinical studies that verified the effectiveness of Korean medicine for the treatment of eating disorders. The search was done in 9 databases (Korean, Chinese, and English databases) from January 2016 to August 2023. Results: A total of 10 articles were retrieved. The articles were classified based on the type of study design: 1 database study, 2 case series, and 7 case reports. Among the articles, in 4 articles, acupuncture was used as a treatment intervention for bulimia nervosa, and in 6 articles herbal medicine was used as a treatment intervention for anorexia nervosa. The most frequent pattern identification was 'Liver qi depression', the most composed herb was 'Root of Glycyrrhiza uralensis (甘草)', and the most used acupoints were CV12 and SP6. All the studies showed positive results. Conclusions: Korean medicine for eating disorders treatments might be effective. However, the quality of evidence in the selected studies was low, and there was no comparison of the treatment effects using objective diagnostic tools. For more accurate results, systematically designed clinical studies using objective diagnostic tools should be conducted.

인체 말초혈액 림프구에서 방사선유도 염색체 손상 및 세포고사에 대한 중기염색체 분석 및 유세포계측 연구 (A Comparison Study of Metaphase Analysis of Chromosomal Aberration and Flow Cytometric Assessment of Radiation-induced Apoptosis in Human Peripheral Lymphocytes)

  • 범희승;이승연;이상구;민정준;정환정;송호천;김지열;신종희;서순팔;양동욱
    • 대한핵의학회지
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    • 제33권1호
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    • pp.94-99
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    • 1999
  • 목적: 조사선량별로 인체 말초혈액 림프구에서 염색체 손상은 중기염색체 분석법으로, 그리고 세포고사는 annexin V를 이용한 유세포계측법으로 정량화하여 서로 비교해 봄으로써, 인체 말초혈액 림프구가 조사선량에 따라 세포사망에 이르는 과정을 밝혀보고자 하였다. 대상 및 방법: 염색체 이상을 동반하는 질환이 없는 건강한 자원자 10명(남자 6명, 여자 4명, 연령범위 $23{\sim}41세$)을 대상으로 하였으며, 이들로부터 혈액을 채혈하여 실험에 이용하였다. 채혈한 혈액으로부터 림프구를 분리하여 0.18, 2, 5, 10, 20. 25 Gy를 조사하였으며, 방사선을 조사하지 않은 림프구를 대조군으로 하였다. 방사선에 조사된 실험군과 대조군을 각각 중기염색체 분석법과 유세포계측법으로 검사하였으며, 중기염색체 분석법에서는 600개의 림프구로부터 불안정 염색체인 2중심염색체와 반지모양 염색체의 수를 계수하였고, 유세포 계측법에서는 세포막의 변화는 annexin V에 결합된 FITC의 섭취로, 그리고 세포핵의 변화는 PI의 섭취로 보았다. 실험군 간의 차이는 ANOVA 검사로, 그리고 두 검사법간의 상관관계는 Pearson의 상관검사로 알아보았다. 결과: 방사선을 조사하지 않은 세포군에서도 불안정 염색체가 $0.5{\pm}0.53$개 관찰되었으며, 실험군에서는 조사선량의 증가에 따라 불안정 염색체의 숫자가 유의하게 증가되었다(p<0.001). 조사선량의 증가에 따라 초기 세포고사는 증가하다가 다시 감소하는 양상을 보이나, 후기 세포고사는 조사선량에 따라 증가하는 양상을 보였다. 중기염색체 분석에서 보이는 불안정 염색체의 수와 Ydr, Qdr 값은 초기 세포고사와는 유의한 상관관계를 보이지 않고, 후기 세포고사와는 매우 유의한 상관관계를 보이고 있었다(p<0.01). 결론: 조사선량에 따른 불안정 염색체의 증가는 유세포계측법으로 검사한 세포핵의 변화와 밀접한 상관관계를 가지고 있었다. 반면 세포막의 변화는 염색체 손상과 관계가 없었으며, 조사선량의 증가에 비례하여 증가하지도 않았다.

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기관지 탄분 섬유화증에서 동반된 기관지 협착에 따른 환기역학 (Ventilatory Dynamics According to Bronchial Stenosis in Bronchial Anthracofibrosis)

  • 정승욱;김연재;김건현;김민선;손혁수;김준철;류현욱;이수옥;정치영;이병기
    • Tuberculosis and Respiratory Diseases
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    • 제59권4호
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    • pp.368-373
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    • 2005
  • 연구배경 : 기관지 탄분 섬유화증은 주로 만성기관지염, 만성폐쇄성폐질환, 또는 천식 등과 같은 만성 기도 질환의 형태로 발현되며, 질환의 경과 중에 폐렴, 폐결핵과 같은 실질성 병변들이 동반될 수 있다. 저자들은 기관지 탄분 섬유화증에서 환기장애의 병형별 빈도 및 동반된 기관지 협착에 따른 기도의 환기기능 및 역학을 알아보고자 하였다. 방 법 : 기관지내시경검사 상 기관지 탄분 섬유화증으로 진단받은 환자 가운데 폐기능 검사를 실시한 113례의 환자를 대상으로 폐기능 검사에서 구한 여러 계측치들과 협착을 보인 기관지의 수와의 상관관계를 구하였다. 결 과 : 폐쇄성 환기장애가 56례(49.6%), 제한성 환기장애가 8례(7.1%), 혼합성 환기장애가 2례(1.8%), 그리고 정상환기가 47례(41.6%)였다. 노력성 호기곡선에서 구한 계측치 가운데 $FEV_1/FVC$$FEF_{25{\sim}75%}$은 상관계수가 각각 -0.208, -0.310으로 협착을 보인 기관지의 수에 따라 유의하게 감소하였다(p<0.05, p<0.005). 기류-용량 곡선에서 구한 PEF, $FEF_{25%}$, $FEF_{50%}$ 및 FEF75%는 모두 낮게 관찰되었으며, 상관계수가 각각 -0.309, -0.303, -0.416, 그리고 -0.318로 협착을 보인 기관지의 수에 따라 유의하게 감소하였다(p<0.05). Raw도 0.477로 협착을 보인 기관지의 수에 따라 유의하게 증가하였다(p<0.001). 결 론 : 기관지 탄분 섬유화증은 협착을 보인 기관지의 수가 많을수록 세소기도 병변과 함께 주로 폐쇄성 환기장애를 나타내는 것으로 생각된다.

국소뇌허혈에서 NMDA 수용체 길항제가 국소 뇌포도당 대사율에 미치는 영향 (Effect of NMDA Receptor Antagonist on Local Cerebral Glucose Metabolic Rate in Focal Cerebral Ischemia)

  • 김상은;홍승봉;윤병우;배상균;최창운;이동수;정준기;노재규;이명철;고창순
    • 대한핵의학회지
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    • 제29권3호
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    • pp.294-306
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    • 1995
  • 국소뇌허혈에서 MK-801의 신경세포방어효과를 검토하기 위하여 흰쥐의 중뇌동맥을 폐색시켜 뇌허혈 및 경색을 유발하기 전과 후에 MK-801을 투여한 후 국소뇌포도당이용률의 변화를 2-deoxy-D-(14C)glu-cose 자가방사기록법을 이용하여 측정하고 이를 대조군과 비교하였다. 중대뇌동맥폐색 시술 전과 후에 평균동맥압, 직장체온, 동맥혈 PH, $pCO_2,\;pO_2$의 유의한 차이는 없었다. [$^{14}C$]DG 실험 중 대조군, MK-801 전처처군과 MK-801 후처치군 사이에서 평균동맥압, 직장 체온, 동맥혈장 당농도, 동맥혈 pH, $pCO_2,\;pO_2$의 유의한 차이는 없었다. 대조군에서 중대뇌동맥폐색 24시간 후에 폐색된 대뇌반구의 전두엽피질, 두정엽피질, 담창구, 편도, 해마 CA-2 지역, CA-3 지역, 내비회, 후두엽피질, 측두엽피질의 국소뇌포도당이용률은 반대쪽정상 대뇌반구 상동부위의 국소뇌포도당이용률보다 유의하게 낮았다. MK-801 전처치군에서 전두엽피질, 두정엽피질, 편도, 해마 CA-2 지역, 내비회, 후두엽피질, 측두엽피질의 병변/정상 국소뇌포도당이용률 비는 대조군의 그것보다 유의하게 높았다. 한편 MK-801 후처치군에서는 전두엽피질, 두정엽피질, 해마 CA-2 지역, 후두엽피질, 측두엽피질의 병변/정상 국소뇌포도 당이용률 비가 대조관의 그것보다 유의하게 높았다. MK-801 전처치군 정상 대뇌반구의 미상핵-피각, 전두엽피질, 두정엽피질, 대상회전, 담창구, 시상, 뇌량, 해마 CA-1, CA-2, CA-3 지역, 후두엽피질, 측두엽피질의 국소뇌포도당이용률은 대조군 정상 대뇌반구의 그것보다 유의하게 높았다. 반면 MK-801 후처치군 정상 대뇌반구의 국소뇌포도당이용률은 대조군 정상대뇌반구의 국소뇌포도당이용률과 유의한 차이가 없었다. 뿐만 아니라 폐색된 대뇌반구에서도 정상 대뇌반구와 매우 유사한 결과를 보였다. 즉, MK-801 전처치군에서는 미상핵-피각, 전두엽피질, 두정엽피질, 대상회전, 담창구, 시상, 뇌량, 해마 CA-1, CA-2, CA-3 지역, 내비회, 후두엽피질, 측두엽피질의 국소뇌포도당이용률이 대조군보다 유의하게 높은 반면, MK-801 후처치군에서는 대조군과 유의한 국소뇌포도당이용률의 차이를 나타내지 않았다. 이상의 결과로부터 국소뇌허혈에서 MK-801은 신경세포방어효과를 나타낼 것으로 생각된다. MK-801은 뇌포도당이용률을 국소적으로 증가시키며, 이는 NMDA 수용체 길항제 투여와 뇌기능 변화의 유관성을 시사하는 것이다.

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신설 대학병원 행정직원과 기존 대학병원 행정직원의 갈등수준 비교 분석 (Comparison of Conflict Level among Administrative Department Staff between Newly Established and Existing University Hospitals)

  • 김종래;유승흠;손태용
    • 한국병원경영학회지
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    • 제3권1호
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    • pp.62-82
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    • 1998
  • The purpose of this study is to assess the cause and level of conflict arising within and between departments among administration office workers who work in a recently established tertiary hospitals of a major cooperation or related non-profit cooperation: The study also aimed to find methods for resolution of such conflicts by comparing with other existing university hospitals. The subject population included 299 business administration office workers randomly selected from two cooperate related tertiary hospitals of less than 3 years in its existence and two university hospitals over 700 beds in Seoul and Kyong In area. Data were collected through a survey questionnaire. To define related factors for the level of conflict among departments in each hospitals multivariate regression analysis was conducted. Independent factors were characteristics of subjects, conflicting factors within and between the departments. The results are as follows: 1. Those in the 30-39 rears of age group demonstrated significantly higher level of conflict between departments. Those working in the new hospitals, who were older and had long-term tenure, and those with short-term job experience at current working hospital had higher level of conflict between the departments with statistical significance. 2. Concerning the involvement of conflicting factors and the level of conflict in the administration there was statistically significant positive correlation between reliability and job-related intra- and interdepartmental level of conflict in existing hospitals. There was a significant positive correlation between intradepartmental conflicting factors of mutual dependence, difference in goal/orientation and intra- and interdepartmental level of conflict. 3. In multivariate regression analysis, women more than men, and those who had worked for many years in hospitals had statistically significant influence on factors involved in interdepartmental level of conflict, explaining 51.0% of the model. 4. In existing hospitals, gender was a significant factor with women showing a higher level of interdepartmental conflict compared to men. Among the interdepartmental factors, mutual dependence had statistically significant influence and showed a positive relationship with interdepartmental level of conflict. In the new hospitals, job position was a significant factor which showed that those in high position such as section chief or above, compared to those in managerial or general position had higher level of conflict. Among the interdepartmental characteristics, factors of mutual dependence and goal/orientation had statistically significant influence and showed a positive relationship with interdepartmental level of conflict. In the new hospital setting efforts to reduce conflict in areas among workers with high position, old age, and long tenure and those in Purchasing, Material and Computer Department should be made and prudent management and planning for improved manpower and increased budget or efficient allocation and clear definition of job description are necessary to adequately assess and make improved efforts for rapid stabilization of the premature hospital system from its inception, In the existing hospitals a lack of conflict within and between departments may give rise to stagnation or inefficiency of the organization. Future study are needed with respect to the relationship between interdepartmental level of conflict and the effectiveness of the hospital organization for improved resolution of conflict in the organization and hospital management.

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취약계층 환자의 의료사회 복지서비스 접근성 증진 활동 (Activities to Improve the Accessibility to clinical social work for Patients from Vulnerable/Disadvantaged/Marginalized Social Groups)

  • 허립;이영숙
    • 한국의료질향상학회지
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    • 제19권2호
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    • pp.80-88
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    • 2013
  • Objectives: With the increase in the number of people who are marginalized in receiving medical services, the role of Seoul National University Hospital as a public hospital is being emphasized. However, many patients are either experiencing delays in receiving medical services or simply being left out as a result of the inaccessibility to the department of social work on part of both the patients and the medical staff. Methods: In order to increase consultation from other departments and the accessibility to the department of social work for the socially marginalized group through early consultation from other departments, the following steps were taken. First, an orientation program for novice medical residents led by clinical social worker was introduced/implemented. Second, posters and brochures on various financial aids programs were produced and distributed. Third, a system of early screening was built/constructed, and once a week rounds and early screening meeting were executed/carried out. Result: The department of social work's rate of consultation from other departments increased by 4.4% compared to last year, while it showed 61% increase for those wards that had an early screening meeting. In addition, the average time of consultation from other departments was reduced by 3.1 days, securing sufficient amount of time for clinical social work services, both in terms of quality and quantity. Conclusion: It is believed that the various promotional activities, along with the strengthening of accessibility to clinical social work services and early consultation on part of social disadvantaged/marginalized group, would undoubtedly help provide quality services to patients and increase their level of satisfaction. In this way, the wards can effectively reduce the number of unnecessary hospital stay days while the hospital can prevent the accumulation of outstanding bills/fees as well as contribute to the publicness of hospitals. The promotion of clinical social work programs in various ways are crucial to ensuring the satisfaction of patients and hospital staff.

대퇴골두 무혈성 괴사의 탕약 치료에 대한 무작위대조군 연구의 최신 경향 분석: 중국지망(中國知網) 검색을 중심으로 (Research Trends of Randomized Controlled Trial Studies on the Herbal Treatment of Avascular Necrosis of the Femoral Head Using China National Knowledge Infrastructure Database)

  • 김현진;안재영;신나영;고아라;이영진;박재은;이민철;전명규;김현우;조혜정;채고은;남혜진
    • 한방재활의학과학회지
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    • 제32권3호
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    • pp.37-53
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    • 2022
  • Objectives This study was conducted to investigate a randomized controlled trial study on the clinical treatment of herbal medicines for avascular necrosis of the femoral head. Methods By March 2022, the China National Knowledge Infrastructure (CNKI) was reviewed about randomized controlled trial studies on the herbal treatment of avascular necrosis of the femoral head through. The publication year, evaluation criteria, treatment period, treatment method and effectiveness were analyzed for articles published from 2017 to 2022. Results 16 articles were selected and 14 kinds of herbal medicines were used. In most studies, Western medical treatments such as injection therapy, oral drug administration, traction therapy and mid-frequency electric therapy were treated alone in the control group, and a combination of Western medical treatment and herbal treatment was administered to the experimental group. Conclusions In China, there have been many studies on herbal treatment for avascular necrosis of the femoral head. In Korea, more clinical studies on the herbal treatment of avascular necrosis of the femoral head are needed. This study will be helpful for future research in Korean medicine on avascular necrosis of the femoral head.

한 대학병원의 진료과별 업무성과 평가 도구 개발 과정 (Development of Performance Evaluation Protocols for Physicians in a University Hospital)

  • 김창엽;김선민
    • 한국의료질향상학회지
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    • 제5권2호
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    • pp.296-310
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    • 1998
  • Background : Performance evaluation of medical care providers has become more important than before in Korea. Especially in university hospitals, job contents of medical staffs are so complicated that evaluation is not easily performed. In addition, in order that the feedback of evaluation be successful, acceptance of staffs to be evaluated is essential. This study is aimed at the development of items for evaluation and weighting of each item in one university hospital, and clustering departments by different weight given by medical staffs. Methods : Through resource group meeting. performance items were listed up by categories of education, research, medical services, and other activities in and out of the hospital. For each item, all the medical staffs were asked how important they thought, compared with publishing one original article. By factor analysis, the items in each category were grouped into a few subgroups. In turn, cluster analysis was done for the purpose of grouping departments by priority the medical staffs gave. Results and Conclusion : Among five major categories, medical staffs regard education, research, and medical services more important than other activities in and out of the hospital. Five categories consisted of two or three components. Departments in hospital were grouped into three. However, characteristics of each group was not clearly delineated. This result suggests that more comprehensive tool should be developed and applied in the process of performance evaluation in university hospitals.

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외측상과염의 추나 치료에 대한 체계적 문헌 고찰 (Chuna Manual Therapy for Lateral Epicondylitis: A Systematic Review)

  • 한다영;이지윤;남수현;손정민;정다해;조혜미
    • 한방재활의학과학회지
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    • 제32권3호
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    • pp.65-75
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    • 2022
  • Objectives This study was conducted to analyze the therapeutic effect of Chuna therapy for lateral epicondylitis. Methods Key words such as lateral epicondylitis and Chuna were searched in 10 databases (National Digital Science Library [NDSL], Oriental Medicine Advanced Searching Integrated System [OASIS], Research Information Sharing Service [RISS], Koreanstudies Information Service [KISS], KMBASE, Cochrane Library, PubMed, EMBASE, J-STAGE, China Academic Jurnals [CAJ]), and only suitable randomized controlled trials (RCTs) were selected. Results 8 RCTs were finally selected, and Chuna therapy showed positive results for lateral epicondylitis compared to western medicine, acupuncture, warm-acupuncture and Chinese medicine iontophoresis. Conclusions In this study, we finally reviewed 8 studies about Chuna therpay used for lateral epicondylitis. The studies showed that Chuna therapy is effective in treating lateral epicondylitis. However, because all of selected studies were found in Chinese database, more high-quality clinical trials about Chuna therapy for lateral epicondylitis are needed in Korea.

Spontaneous Regression of the Pseudoaneurysm Developed after Balloon Occlusion of the Direct Carotid-cavernous Fistula

  • Lee, Chae-Heuck;Kim, Myoung-Soo;Lee, Ghi-Jai
    • Journal of Korean Neurosurgical Society
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    • 제41권5호
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    • pp.323-326
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    • 2007
  • Direct carotid-cavernous fistula [CCF] is a common post-traumatic disease. However, pseudoaneurysm formation after balloon occlusion is a rare complication. The author present such a case with review of the literature. A 26-year-old man involved in a motor vehicle accident as a driver. Only mild conjunctival injection and minimal exophthalmos on the right eye were noted after trauma. However, angiography revealed a direct CCF and dissection of the proximal intracranial internal carotid artery [ICA]. After first balloon occlusion of the CCF, the patient redeveloped fistula due to early deflation of the balloon. After the second balloon occlusion, pseudoaneurysm and diplopia were developed with the change of balloon position and shape. However, visual symptom spontaneously resolved and pseudoaneurysm was also decreased within 6 months after balloon occlusion.