• 동의생리병리학회지
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• 제23권4호
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• pp.789-798
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• 2009

In Sasang constitutional medicine, I have researched the process of visceral structure in the Eight Constitutionals under circulation of the five elements and the formation of primary source of illness. From this research, I could draw following conclusions through combination of the auxiliary psycho-formulas by applying the constitutional acupuncture therapy on the five elements diagnostic calculation. Since the arrangement for the five dimensions of organs in the eight constitutions has been formulated by circulation of the five elements in Sasang constitutions, if the five elements begin circulating count-clockwise from the reference point at the organs in Sasang constitutional medicine, the positive constitutional arrangement of organs is built up such as, the positive constitution of metal, earth, wood and water, while begin circulating clockwise, the negative constitutional arrangement of organs is formulated, such as the negative constitutions of metal, earth, wood and water. The source of illness results from imbalance of the organic force being generated by transfer of the five elements from compatibility to incompatibility when the five elements circulate. Hence, it has been acknowledged that if the source of illness comes from the strongest organ, it is the time when circulation of the five elements progresses from the second organ (the second strongest) in incompatibility, and if the source of illness comes from the weakest organ, it is the time when circulation of the five elements progresses from the third organ (the middle) in incompatibility. It is considered proper to diagnose meridians of the pericardium and the Triple Burners rather than to diagnose meridians of the heart and the small intestine which forms the visceral arrangement of the eight constitutions. For instance, the auxiliary psycho-formula obtains its prescription by attenuating the first organ (the strongest) while augmenting the fourth organ (the second weakest) when the axis of incompatibility in the five elements circulation crosses the second and the third organs, and it gets its prescription by attenuating the second organ(the second strongest) while augmenting the fifth organ(the weakest) when the axis of incompatibility in the five elements circulation crosses the third and the fourth organs. In addition, when medicating, the $4{\sim}5$ times of repeated performance can be assumed to represent the amount of an energy that each organ bears depending on the phase in the arrangement of the eight constitutional organs.

• Tuberculosis and Respiratory Diseases
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• 제44권6호
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• pp.1382-1389
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• 1997

저자들은 감기증상 후에 빠른 시간내에 급성호흡부전증에 이르렀던 환자에서 신증후성 출혈열과는 다르게 주로 호흡기와 순환기를 침범하는 한타바이러스 폐 증후군 1예률 경험하였기에 고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제59권sup1호
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• pp.133-138
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• 2016

Anti-N-methyl D-aspartate receptor (anti-NMDAR) encephalitis, recently recognized as a form of paraneoplastic encephalitis, is characterized by a prodromal phase of unspecific illness with fever that resembles a viral disease. The prodromal phase is followed by seizures, disturbed consciousness, psychiatric features, prominent abnormal movements, and autonomic imbalance. Here, we report a case of anti-NMDAR encephalitis with initial symptoms of epilepsia partialis continua in the absence of tumor. Briefly, a 3-year-old girl was admitted to the hospital due to right-sided, complex partial seizures without preceding febrile illness. The seizures evolved into epilepsia partialis continua and were accompanied by epileptiform discharges from the left frontal area. Three weeks after admission, the patient's seizures were reduced with antiepileptic drugs; however, she developed sleep disturbances, cognitive decline, noticeable oro-lingual-facial dyskinesia, and choreoathetoid movements. Anti-NMDAR encephalitis was confirmed by positive detection of NMDAR antibodies in the patient's serum and cerebrospinal fluid, and her condition slowly improved with immunoglobulin, methylprednisolone, and rituximab. At present, the patient is no longer taking multiple antiepileptic or antihypertensive drugs. Moreover, the patient showed gradual improvement of motor and cognitive function. This case serves as an example that a diagnosis of anti-NMDAR encephalitis should be considered when children with uncontrolled seizures develop dyskinesias without evidence of malignant tumor. In these cases, aggressive immunotherapies are needed to improve the outcome of anti-NMDAR encephalitis.

• Annals of Clinical Neurophysiology
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• 제8권1호
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• pp.71-73
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• 2006

Many neurologic signs are found in Miller Fisher syndrome (MFS) especially including pupillary abnormalities. But when internal ophthalmoparesis is first manifestation in MFS, diagnosis may be difficult in acute phase of illness. We report two cases of MFS presenting with internal ophthalmoplegia. Pupillary areflexia may be involved in acute phase of MFS. When acute bilateral internal ophthalmoparesis is encounted in clinical practice, initial manifestation of MFS should be included in differential diagnosis.

• Journal of Preventive Medicine and Public Health
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• 제38권4호
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• pp.386-390
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• 2005

Influenza A viruses periodicall y cause worldwide epidemics, or pandemics, with high rates of illness and death. A pandemic can occur at any time, with the potential to cause serious illness, death and social and economic disruption throughout the world. Historic evidence suggests that pandemics occurred three to four times per century. In the last century there were three influenza pandemics. The circumstances still exist for a new influenza virus with pandemic potential to emerge an d spread. The unpredictability of the timing of the next pandemic is underlined by the occurrence of several large outbreaks of highly pathogenic avian influenza since the early 1980s. In 1999, the World Health Organization published the Influenza pandemic plan. The role of WHO and guidelines for national and regional planning. And in 2005, WHO revised the global influenza preparedness plan for new national measures before and during pandemics. This document outlines briefly the Korean Centers for Disease Control's plan for responding to an influenza pandemic. According to the new pandemic phases of WHO, we set up the 4 national levels of preparedness and made guidelines for preventing and control the epidemics in each phase. And also we described the future plans to antiviral stockpiles and pandemic vaccine development.

• 대한신경집중치료학회지
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• 제11권2호
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• pp.71-80
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• 2018

Nutritional assessment and support are often overlooked in the critically ill due to other urgent priorities. Unlike oxygenation, organ dysfunction, infection, or consciousness, there is no consensus of indicators. Making it difficult to evaluate the effectiveness of an intervention. Nevertheless, appropriate nutritional support in the critically ill has been associated with less morbidity and lower mortality. But, nutritional support has been considered an adjunct, for body weight maintenance and to help patients during the inflammatory phase of illness. Thus, it has been assigned a lower priority, compared to mechanical ventilation or hemodynamic stability. Recent findings have shown that nutritional support may prevent cellular injury due to oxidative stress and help strengthen the immune response. Large-scale randomized trials and clinical guidelines have shown a shift from nutritional support to nutritional therapy, with an emphasis on the importance of protein, minerals, vitamins, and trace elements. Nutrition is also important in neurocritically ill patients. Since there are few studies or recommendations with regard to the neurocritical population, the general recommendations for nutritional support should be applied.

• 대한핵의학회지
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• 제17권1호
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• pp.63-69
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• 1983

Fifteen cases of Korean hemorrhagic fever who were admitted Chungnam National University Hospital from October 1981 to December 1981 were analysed on the evaluation of metabolic.changes of the thyroid hormones, and thyroid function status in each clinical phase. 1. Serum $T_3,\;T_4$ concentratron, $FT_4I\;and\;T_4/TBG$ ratio were significantly lower (p<0.001, p<0.005, p<0.005, p<0.001, respectively) than control group in oliguric and early diuretic phase of Korean hemorrhagic fever. With the recovery of illness, abnormal thyroid hormones and thyroid function indices tend to become normal range. But Serum $FT_4$, TSH and TBG concentration were within normal range in all phase of KHF. Thus in Korean hemorrhagic fever, euthyroidism is probably maintained by normal or elevated serum $FT_4$ 2. $T_4/T_3\;and\;rT_3/T_3$ rato (p<0.005, p<0.005) were increased in oliguric and early diuretic phase of KHF. These results might be explained by decreased peripheral conversion of $T_4\;to\;T_3$ in oliguric and early diuretic phase.

• Journal of Preventive Medicine and Public Health
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• 제24권4호
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• pp.485-495
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• 1991

This study examined the effects of referral requirements for insurance patients which have been enforced since July 1, 1989 when medical insurance coverage was extended to the whole population except beneficiaries of medical assistance program. The requirements are mainly aimed at discouraging the use of tertiary care hospitals by imposing restrictions on the patient's choice of a medical service facility. The expectation is that such change in the pattern of medical care utilization would produce several desirable effects including increased efficiency in patient care and balanced development of various types of medical service facilities. In this study, these effects were assessed by the change in the number of out-patient visits and bed-days per illness episode and the share of each type of facility in the volume of services and the amount of expenditures after the implementation of the new referral system. The data for analysis were obtained from the claims to the insurance for government and school employees. The sample was drawn from the claims for the patients treated during the first six months of 1989, prior to the enforcement of referral requirements, and those of the patients treated during the first six months of 1990, after the enforcement. The 1989 sample included 299,824 claims (3.6% of total) and the 1990 sample included 332,131 (3.7% of total). The data were processed to make the unit of analysis an illness episode instead of an insurance claim. The facilities and types of care utilized for a given illness episode are defined to make up the pathway of medical care utilization. This pathway was conceived of as a Markov Chain process for further analysis. The conclusion emerged from the analysis is that the enforcement of referral requirements resulted in less use of tertiary care hospitals, and thereby decreased the volume of services and the amount of insurance expenses per illness episode. However, there are a few points that have to be taken into account in relation to the conclusion. The new referral system is likely to increase the use of medical services not covered by insurance, so that its impact on national health expenditures would be different from that on insurance expenditures. The extension of insurance coverage must have inereased patient load for all types of medical service organizations, and this increase may be partly responsible for producing the effects attributed to the new referral system. For example, excessive patient load for tertiary care hospitals may lead to the transfer of their patients to other types of facilities. Another point is that the data for this study correspond to very early phase of the new system. But both patients and medical care providers would adapt themselves to the new system to avoid or overcome its disadvantages for them, so as that its effects could change over time. Therefore, it is still necessary to closely monitor the impact of the referral requirements.

• 대한간호학회지
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• 제30권1호
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• pp.122-136
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• 2000

Chronic illness requiring attention and management during a long period of time puts great burden onto patients, their family and society. For patients with chronic illnesses, providing social support is the most important, and the fundamental support comes from their spouses. Amount and quality of support from spouses seems to differentiated according to the sex of patients. Female patients tend to believe that their spouses are not very supportive. Therefore, the researchers assessed the burden of husbands of female arthritis patients to discover the factors that result in greater burden. Also, they developed a theoretical model of husbands′ care for their wives through a qualitative research into husbands′ experience. Method 1: The study material was 650 female arthritis patients registered in an arthritis clinic. The questionnaire about the disease experience of female arthritis patients and the burden of husbands were sent. Returned questionnaires numbered 210(32.3%) and 27 were excluded because of inadequate answers. The remaining 183 questionnaires were analyzed. The mean age of the patients was 51 years and the mean age of spouses was 55 years. The mean marital period was 28 years. The average duration since diagnosis was 9.1 years. Education level was varied from primary school to graduate school, and average income/month was 1,517,300 won. Method 2: Initial questionnaire studies on the burden of husbands were performed. Among 183 responding husbands, 23 consented to participate for a qualitative research. Data was obtained by direct and telephone interviews. The mean age of participants was 58 years, and the educational level and socioeconomic status also varied. Result: 1. Husbands′ burden: The average burden was 57.68 with a range of 6-96. 2. Burden and general characteristics: The husband′s burden correlated with the age of the patients, numbers in the family, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and the husband′s understanding of the level of severity. 3. Linear correlation analysis on burden: The husbands′ burden is explained in 22.5% by husband′s recognition of level of severity and husbands′ age. 4. There were four patterns of the burden on husbands: both objectve burden and subjective burden were high(pattern I), both of objectve burden and subjective burden were low(pattern II), objective burden was high but subjective burden was low(pattern III), objective burden was low but subjective burden was high(pattern IV). The pattern was correlated with the family income, educational level of the patients and their husbands, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and husband′s understanding of level of severity. 5. The core category of the caring experience of the husbands with arthritis patients was "companionship". The causal factor was the patients′ experience due to symptoms : physical disfigurement, pain, immobility, limitation of house chores, and limitation of social activities. Contextural factors are husbands′ identification of housework and husbands′ concern about the disease. The mediating factors are economic problems, fear of aging, feeling of limitation and family support. The strategy for interaction is mind control and how to solve emotional stress. The "companionship" resulted from caring activities, participation of household activities, helping patients′ to coping with emotional experience. 6. Companionship is established through the process of entering intervention, and caring state of mind. Entering intervention is the phase of participation of therapy and involvement of houseworks. The caring phase consists of decision on therapy, providing therapy, providing direct care, and taking over the household role of wife. Through caring phase, the changing phase set a stage in which husbands consolidate the relationship with their wives, and are reminded of the meaning of marriage. As a result, in changing phase, husbands′ companionship is enhanced. In conclusion, nursing care of chronic illnesses should include a family member especially the spouse. All information on disease shoud be provided to patients and whole family member. Strong support should also be provided to overcome difficulties in taking over role of other sex. Then the quality of life of patients and families will be much improved.

• KSBB Journal
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• 제13권6호
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• pp.662-668
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• 1998

Viruses belonging to the Hantavirus genus cause two acute severe illness in humans, i.e., Haemorrhagic Fever with Renal Syndrome (HFRS) and Hantavirus Pulmonary Syndrome(HPS). Among them, Hantaan virus is one of the most important viruses causing HFRS. Recombinant expression vectors, pKK-NP and pET-NP, with Hantaan viral nucleocapsid gene were constructed, and used to transform Eschericia coli BL21(DE3). Stability of the vectors in the host strain, and effects of some environmental conditions on the expression of nucleocapsid gene were studied. Expression vector, pKK-NP, was very unstable, and the expression level of nucleocapsid gene was very low compared to that of pET-NP. BL21(pET-NP) produced about 100 mg of N protein per liter of culture broth. Induction time did not show any significant difference on the expression level of nucleocapsid gen and cell growth. BL21(pET-NP) culture at 35$^{\circ}C$ showed a little higher expression level than at 30$^{\circ}C$ during growth phase, but reached to the same level at stationary phase. Total expression level was proportional to supplemented glucose concentration of media up to 0.5% along with cell growth, but expression level per unit cell mass was inversely proportional to glucose concentration and maximal when glucose was not supplemented at all.