• Clinical and Experimental Pediatrics
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• 제48권2호
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• pp.138-142
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• 2005

목 적 : 자율신경계 기능 장애로 생각되는 OD는 소아에서 성적저하와 만성피로, 식욕저하, 수면장애, 일상생활의 장애와 같은 삶의 질 저하를 초래할 수 있다. 최근에 어지러움과 실신 등의 OD 증상 때문에 병원을 찾는 환자가 증가하는 추세이며 특히 여자에서 남자보다 더 많은 환자를 볼 수 있다. 우리나라 초등학교 아동에서 OD 유병률과 진단 기준이 되는 각각의 주증상과 부증상의 빈도를 알아보고자 하였다. 방 법 : 2002년 5월 1일부터 6월 30일까지 광주시내 2개 초등학교 4-6학년 아동 1,000명을 대상으로 자기 기입식 설문으로 보호자와 함께 응답하도록 설문조사 하였고, 수거되지 않거나 답변이 미비한 275명을 제외한 725명을 대상으로 하였다. OD의 진단은 Okuni와 Oshima의 진단 기준에 따라 주증상과 부증상의 조합으로 하였는데 주증상 한 개에 부증상 3개 이상이거나, 주증상 2개에 부증상 1개 이상, 주증상 3개 이상인 경우 OD 로 진단하였다. 대상의 아동에서 OD의 주증상과 부증상의 빈도와 OD의 나이, 성별, 빈도와 OD로 진단된 대상아의 주증상과 부증상의 빈도를 알아보았다. 결 과 : 대상 아동에서 주증상의 빈도는 '운동을 하면 심하게 가슴이 두근거린 적이 있다가' 68.6%로 가장 높았으며, 부증상의 빈도는 '두통을 경험한 적이 있다가' 58.3%로 가장 높았다. OD로 진단된 아이는 53.5%(388명)이었고, 남자 59.2%, 여자 46.8%로 남자가 통계학적으로 의의 있게 높았다(P<0.05). OD로 진단된 아이의 주증상의 빈도는 '운동을 하면 심하게 가슴이 두근거린 적이 있다가' 95.9%로 가장 높았으며, 부증상의 빈도는 '두통을 경험한 적이 있다' 85.8%로 가장 높았다. 결 론 : 우리의 연구에서 OD로 진단된 아이는 53.5%(388명)로 다른 보고에 비해 다소 높은 유병률을 나타내었는데 오히려 남자에서 여자보다 더 높은 빈도를 보였다. OD를 좀더 정확한 진단과 적극적인 치료를 위해 구체적이고 객관적인 진단 기준에 대한 재고가 필요할 것으로 생각된다.

• Childhood Kidney Diseases
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• 제21권2호
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• pp.53-60
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• 2017

Proteinuria is common in pediatric and adolescent patients. Proteinuria is defined as urinary protein excretion at levels higher than $100-150mg/m^2/day$ in children. It can be indicative of normal or benign conditions as well as numerous types of severe underlying renal or systemic disease. The school urine screening program has been conducted in Korea since 1998. Since then, numerous patients with normal or benign proteinuria as well as early stage renal diseases have been referred to the hospital. Benign proteinuria includes orthostatic proteinuria and transient proteinuria. Most causes of proteinuria can be categorized into 3 types: 1) overflow, 2) tubular, and 3) glomerular. Although treatment should be directed at the underlying cause of the proteinuria, prompt evaluation, diagnosis, and long-term monitoring of these pediatric patients can prevent potential progression of the underlying disease process. This article provides an overview of proteinuria: its causes, methods of assessment, and algorithmic suggestions to differentiate benign from pathologic renal disease.

• 대한한방내과학회지
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• 제38권6호
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• pp.1096-1100
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• 2017

The carotid artery is one of the main vessels supplying blood to the brain. Carotid artery stenosis is mostly caused by atherosclerosis, a disease where cholesterol is deposited in the arterial blood vessels. Tremor refers to rhythmic shaking of a body part. Tremor is a symptom of many diseases, including Parkinson's disease, essential tremor, orthostatic tremor, cerebellar disease, peripheral neuropathy, and alcohol withdrawal. Tremors may be classified as postural, rest, and action tremors. Tremor of a patient with stenosis of the left carotid artery decreased with acupuncture treatment. The acupoints were GB20, TE17, GV8 and GV11. This case shows that the acupuncture treatment is effective against tremor.

• The Korean Journal of Pain
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• 제23권1호
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• pp.46-50
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• 2010

Spontaneous intracranial hypotension (SIH) is considered to be a very rare disorder. It is characterized by an orthostatic headache that is aggravated with the patient in the upright position and it is relieved by the patient assuming the supine position. SIH is caused by a spontaneous spinal cerebrospinal fluid leakage without the patient having undergone trauma, surgery or dural puncture or having any other significant medical history. An autologous epidural blood patch (EBP) is effective in relieving SIH. We report here on a case of SIH with cerebrospinal fluid leakage at the upper cervical vertebral level and the middle thoracic vertebral level. The points of leakage were identified by radionuclide cisternography, and this patient was successfully managed by injecting an EBP at each level of leakage.

• Journal of Korean Neurosurgical Society
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• 제50권3호
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• pp.274-276
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• 2011

Spontaneous cerebrospinal fluid (CSF) leak is a recognized cause of spontaneous intracranial hypotension (SIH). Subdural hematoma (SDH) is a serious but rare complication of SIH. An autologous epidural blood patch at the CSF-leak site can effectively relieve SIH. We report a case of bilateral SDH with SIH caused by a CSF leak originating at the C1-2 level. A 55-year-old male complained of orthostatic headache without neurological signs. His symptoms did not respond to conservative treatments including bed rest, hydration and analgesics. Magnetic resonance imaging showed a subdural hematoma in the bilateral fronto-parietal region, and computed tomography (CT) myelography showed a CSF leak originating at the C1-2 level. The patient underwent successful treatment with a CT-guided epidural blood patch at the CSF-leak site after trephination for bilateral SDH.

• 대한전자공학회:학술대회논문집
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• 대한전자공학회 1998년도 하계종합학술대회논문집
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• pp.561-564
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• 1998

This paper evaluated autonomic nervous system function in 23 patients with syncope and a positive tilt test result, 21 with a negative test result, and 19 healthy controls. Indexes of heart rate variability were measured during supine resting, immediately afte rtilt-up, standing rsting, immediately before syncope and immediately after tiltdown. There were no significant differences among the groups in any of the indexes of heart rate varability over the 24-hour holter recordings. In patients with a positive tilt result, tilting gaused a decrease in low-frequency (LF) immediately before syncope and incsrease in high-frequency (HF) bands immediately before. In patients with a negative tilt result, tilting caused a decrease in low-frequency (LF) immediately before syncope and decrease in high-frequency (HF) bands immediately before, different from positive tilt results. Our findings showed that patients with vasovagal syncope have no chronic differences from normal subjects in autonomic nervous system activity, but that these patients respond differently to the orthostatic stimulus.

• Journal of Korean Neurosurgical Society
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• 제47권1호
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• pp.48-50
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• 2010

Spontaneous intracranial hypotension is often idiopathic. We report on a patient presenting with symptomatic intracranial hypotension and pain radiating to the right leg caused by a transdurallumbar disc herniation. Magnetic resonance (MR) imaging of the brain revealed classic signs of intracranial hypotension, and an additional spinal MR confirmed a lumbar transdural herniated disc as the cause. The patient was treated with a partial hemilaminectomy and discectomy. We were able to find the source of cerebrospinal fluid leak, and packed it with epidural glue and gelfoam. Postoperatively, the patient's headache and log radiating pain resolved and there-was no neurological deficit. Thus, in this case, lumbar disc herniation may have been a cause of spontaneous intracranial hypotension.

• Childhood Kidney Diseases
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• 제7권2호
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• pp.125-132
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• 2003

목적 : Lipoprotein(a)는 LDL 콜레스테롤, 심근 경색의 가족력 다음으로 동맥경화의 독립적인 위험 인자로 보고되고 있다. 그러나 아직까지 Lp(a)의 농도를 조절하는 유전적, 대사적 요인은 잘 알려지지 않았다. 최근 연구에서는 신장 질환에 있어서 신증후군이나 말기신부전 환자의 경우 Lp(a) 농도가 상승하는 것으로 알려지고 있다. 이에 본 연구에서는 신증후군 이외의 신장 질환에서 Lp(a)의 농도를 측정함으로써 Lp(a)의 변화유무를 확인하고 그 의의를 알아보며 Lp(a)의 농도에 영향을 미치는 요인을 알아보고자 한다. 방법 : 1999년 3월부터 2003년 2월까지 중앙대학교 용산병원 소아 신장 클리닉에 내원하거나 입원한 환아들 중 75명(원인 불명의 혈뇨 34명, 고칼슘뇨증을 동반한 혈뇨 10명, IgA 신염 8명, 연쇄상구균 감염 후 급성 사구체 신염이 이환된 환자 8명, Hench-Schonlein 자반증 신염 환자 3명, 요로 감염 환자 7명, 기립성 단백뇨 환자 5명)을 대상으로 하였고 대조군은 신장 질환이나 간질환이 없는 외래환자 20명으로 하였다. 대상환자들은 혈청에서 Lp(a), BUN, 크레아티닌, 알부민, 단백질을, 일반 소변 검사 중 현미경적 검사를 통해 적혈구와 백혈구 수를, 24시간 소변검사를 통해 크레아티닌 청소율과 칼슘을 분석하였다. Lp(a)는 Enzyme-linked immunosorbent assay(Bio-RAD 450, Japen)을 이용하여 측정하였다. 결과 : 소아 신장 질환 가운데 기립성 단백뇨군(P=0.031)이 통계적으로 의미있게 높았으며 기타 질환들에서는 Lp(a)값이 통계적으로 의미가 없었으며 조사된 여러 가지 인자 중 단백뇨(P=0.000, r=0.440), 혈장 단백질(P=0.004), 알부민(P=0.007)이 Lp(a)값과 통계적으로 의미있는 상관 관계를 보였다. 결론 : 소아에서 흔한 신장 질환 환아에서 Lp(a)에 영향을 받는 환아는 연구된 집단군에서 기립성 단백뇨군에서만 확인할 수 있었으며 이는 Lp(a) 농도에 영향을 미치는 것이 신장이라기 보다는 단백질 감소에 따른 또는 알부민 감소에 따른 것으로 생각된다. 이후에 더 많은 환자들을 대상으로 조사하여 통계적 오류를 줄여야 하며 기립성 환아를 추적 관찰하여 Lp(a) 상승에 따른 신장 기능에 대한 영향을 평가해 보아야 한다.

• 대한치과마취과학회지
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• 제12권4호
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• pp.215-221
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• 2012

The loss of consciousness in the dental office have many causes, such as, vasodepressor syncope, drug administration, orthostatic hypotension, epilepsy, hypoglycemic reaction, acute adrenal insufficiency, acute allergic reaction, acute myocardial infarction, cerebrovascular accident, hyperglycemic reaction and hyperventilation. Patients have fainted during all phases of dental care: during tooth extraction and other surgical procedures, during local anesthetic injections, or during procedures such as venipuncture, on being seated in the dental chair, and even on first entering the dental office. If an elderly patient with known cardiovascular or cerebrovascular problems experiences a syncopal episode, differentiation from cerebrovascular insufficiency of more serious etiology, such as cerebrovascular accident, must be considered. And anaphylactic shock is also suggested during intravenous drug administration. This is a case report of syncope care during venous injection of cephalosporin in patient with cerebrovascular accident.

• 대한한의학회지
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• 제40권4호
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• pp.84-90
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• 2019

Objectives: Chronic fatigue syndrome (CFS) is a debilitating illness impairing seriously quality of life, while CFS would be an optimized target disorder of Korean medicine. This study aims to present the recent information especially in aspect of medical policy and new diagnosis criteria for CFS. Methods: The literature survey was conducted using the terms of "chronic fatigue syndrome", "myalgic encephalomyelitis" and "fibromyalgia" in PubMed database and Google database in its entirety from January 2011 to February 2019. The in-depth review was made focusing on the changes in policy and medical perspective for CFS. Results: Recently large medical attentions and researches for CFS have been existed worldwide. By supporting of USA government, IOM made a report which leaded to a turning point in clinical practices and research in 2015. This report recommended a new name of CFS to systemic exertion intolerance disease (SEID), and new diagnostic criteria focusing on post-exertional malaise, unrefreshing sleep, cognitive impairment and orthostatic intolerance. The medical perspective also was changed into "a serious, chronic, complex, systemic disease" from a psychological-like disorder, and then UAS and EU governments sharply increased the research grants. Conclusions: This study provided practitioners in Korean medicine (KM) a core information about the recent changes in CFS-related perspectives. This review would be helpful for KM-derived researches or therapeutics development for CFS.