• 제목/요약/키워드: clinical case

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Chiari malformation 환아에서 상악 구치부의 부유치 (MAXILLARY FLOATING TEETH IN A CHIARI MALFORMATION PATIENT)

  • 신은영;최병재;이제호;손흥규
    • 대한소아치과학회지
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    • 제28권4호
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    • pp.649-653
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    • 2001
  • Chiari malformation은 하부 뇌간과 소뇌가 대공 속으로 들어가 하향 편위의 소견을 보이는 중추 신경계의 기형으로 3가지 type으로 분류된다. 본 증례는 7세 10개월 된 여환이 10일전부터 칫솔질시 상악 우측 어금니가 아프고 얼굴이 약간 붓고 아프다는 주소로 내원하였는데, 임상구강검사결과 상악 우측 제1대구치 원심에 치은낭이 형성되어 있었고 동요도와 동통이 존재하였다. 악골 방사선사진검사결과 상악 구치부의 골밀도가 정상에 비해 낮으며, 특히 좌우측 제1대구치 하방의 골의 부재가 보였다. 유년성 치주염의 가진 하에 치주치료 중 전신질환과의 연관성 문진으로 Chiari malformation의 의과적 병력을 확인한 후 3차원 전산화단층촬영을 시행하였다. 두개골이 전반적으로 않으며 다수의 골결손이 관찰되고 대공이 다소 커져있으며 후두골과 상악골의 골밀도가 감소되어 있었고 특히 상악 구치부의 치조골이 거의 없어 상악 좌우측 제1대구치가 부유치처럼 보였다. 이에 본원 신경외과로 협의진료를 의뢰하여 계속적으로 관찰하고 있는 중이다. 소아에서 치주염이 의심될 때 leukemia, hystiocytosis X, hypoposphatasia 등의 잠재된 전신질환과 연관되어 있을 수 있으므로 적절한 검사를 시행해야 하며 전신질환의 근본적인 원인을 치료할 수 있도록 고려해야 한다.

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인삼의 약리작용 (Pharmacological Action of Ginseng)

  • 홍사악;임정규;박찬웅;차인준
    • Journal of Ginseng Research
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    • 제3권1호
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    • pp.66-93
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    • 1979
  • Panax ginseng C. A. Meyer, which has been known for more than EWO years. occupies a Particular prince in folk medicine as so called tonic remedy. The pharmacolgical investigations of ginseng, based on the scientific concepts and methodology, have been performed by many researchers through the past 50∼60 years at different parts of the world. The pharmacological action of Panax ginseng compiled from the numerous reports can be summarized as follows: 1. On central nervous system, the effect of Panax ginseng is timulatory in smaller doses and somewhat depressive in larger doses. From the psychopharmacological aspect, ginseng seems to increase the mental efficiency of man. 2. Ginseng has the effect tending to Protect organism from various physical and chemical stresses. 3. The growth and basal metabolic rates of experimental animals are stimulated by ginseng. Ginseng also prolongs the survival time of animals under adverse influences. 4. Increasing the physical and mental efficiency, ginseng postpones the onset of fatigue and increases the working capacities. 5. In the case of the intravenous administration of ginseng, a transitory and slight hypotensive effect is observed. These hypotensive effects seems to include that of a direct action and actions related to the release of histamine and/or serotonin by ginseng. 6. It is Presumed that ginseng lowers the elevated bleed ingar and cholesterol level. 7. Ginseng tends to increase the gastrointestinal motizity and tone 8. It is presumed that ginseng Promotes the iron metabolism and activates the hematopoietic factors. 9. Ginseng tends to stimulate the biosynthesis of nucleic acid and release of histamine and serotonin. 10. The toxicity end adverse reactions of ginseng appear to be nothing that warrants apprehension. 11. Anticancer erects of ginseng seem to be due to indirect action rather than direct action on cancer cell, by improving the host condition 12. Recent clinical trials of ginseng harts obtained sent good results, but Present trial is still limited in its range, so it is necessary to broaden the scope of trial covering many kinds of organs and diseases. From the above, although it appears that substantial advancements have been achieved in the studies on the Pharmacological actions of Panax ginseng there are many discrepancies noticed in the reported data. Furthermore the precise mechanisms of actions of ginseng are sometimes obscure, even unknown in other actions as the students stand now. The main reasons for this are considered to be that even though saponin has been identified at one of the active substances of ginseng, other components have not fully been identified and that the experimental approaches of the investigations varied with different researchers. Thus a thorough analysis of the chemical components and newer standardized concepts and metohds appear to be the pre-requisites for further study of the pharmacolgical effects and mechaisms of Panax ginseng.

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병원 전 심폐소생술에 의한 자발순환 회복 8례: 일 지역 하트세이버 수여자를 기준으로 (A Case Report of ROSC for Out-of Hospital Cardiopulmonary Resuscitation: Based on one Area Heart Saver)

  • 방성환;김지희;김경용;노상균
    • 한국화재소방학회논문지
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    • 제27권4호
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    • pp.61-67
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    • 2013
  • 이 연구는 병원 전 심정지 환자에게 심폐소생술과 후 72시간 이상 자발순환이 회복된 환자 8례를 대상으로 하였다. 분석 결과 심정지 원인으로는 심장질환이 3례, 응급상황으로 인해 병력을 구하지 못한 경우가 5례를 보였다. 심정지 환자의 6례가 가정에서 발생하였고, 가족이나 동료에 의해 심정지가 목격된 경우가 8례였으며, 가족이나 동료 등 목격자의 의해 시행된 심폐소생술은 5례였다. 구급대원 도착 후 임종 호흡을 보인 환자가 3례로 확인되었다. 심정지 환자의 최초 초기리듬은 심실세동 7례, 무맥성전기활동 1례를 보였다. 출동에서 현장 도착까지 소요시간은 6.1분(${\pm}2.7$), 출동에서 병원 도착까지 소요시간은 23.0분(${\pm}8.8$), 자발순환이 회복되기까지 심폐소생술 지속 시간은 8.7분(${\pm}3.4$)이 소요되었다. 출동한 구급대원의 자격은 1급응급구조사 6례, 2급응급구조사 2례였으며, 3명 출동이 7례를 보였다. 병원 전 심정지 환자의 소생률 향상을 위해서는 무엇보다도 목격자에 의한 심폐소생술이 필요하며, 이를 위해서는 일반인 심폐소생술 교육을 지속적으로 진행하여야 한다.

경피적 관동맥 확장술의 시술량과 조기 시술결과의 관련성 (Relationship between Percutaneous Transluminal Coronary Anigioplasty Volume and Associated Immediate Outcome)

  • 김용익;김창엽;이영성;김선민;이진석;오병희;강영호
    • Journal of Preventive Medicine and Public Health
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    • 제34권1호
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    • pp.9-20
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    • 2001
  • Objectives : To explore the relationship between Percutaneous Transluminal Coronary Angioplasty(PTCA) volume and the associated immediate outcome. Methods : A total of 1,379 PTCAs were peformed in 25 hospitals in Korea between October 8 and December 31 in 1997. Data from 1,317 PTCAs (95.5%) were collected through medical record abstraction. Inter-observer reliability of the data was examined using the Kappa statistic on a subsample of 110 PTCA procedures from five hospitals. Intra-observer reliability of the data was also examined. PTCA success and immediate adverse outcomes were selected as the outcome variables. A successful PTCA was defined as a case that shows less than 50% diameter stenosis and more than 20% reduction of diameter stenosis. Immediate adverse outcomes included deaths during the same hospitalization, emergency coronary artery bypass graft (CABG) within 24 hours after PTCA, and acute myocardial infarction within 24 hours after PTCA. The numbers of PTCAs performed in 1997 per hospital were used as the volume variables. Results : Without adjusting for patient risk factors that may affect outcomes, procedures at high volume hospitals ($\geq200$ cases per year) had a greater success rate (P=0.001) than low volume hospitals. There was a marginally significant difference (P=0.070) in major adverse outcome rates between high and low volume hospitals. After adjusting for risk factors, there were significant differences in procedural failure and major adverse outcome rates between high and low volume hospitals. Conclusions : After adjusting for patient clinical risk factors, the hospital volume of PTCA was associated with immediate outcomes. It is recommended that a PTCA volume per year be established in order to improve the immediate outcome of this procedure in Korea.

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송곳니구름버섯(Irpex zonatus) BN2에 의한 아조계, 트리페닐메탄계 및 헤테로싸이클릭계 염료의 탈색 (Decolorization of Azo, Triphenylmethane and Heterocyclic Dyes by Irpex zonatus BN2)

  • 윤경하;최양순
    • 한국균학회지
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    • 제26권1호통권84호
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    • pp.8-15
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    • 1998
  • 우리 나라 자연 환경에서 분리 동정된 송곳니구름버섯(Irpex zonatus) BN2 균주의 리그닌분해효소활성과 아조(azo)계, 트리페닐메탄(triphenylmethane)계 및 헤테로싸이클릭(heterocyclic)계에 속하는 몇몇 염료의 탈색능을 조사하였다. 송곳니구름버섯 BN2 균주는 lignin peroxidase(LiP)와 veratryl alcohol oxidase(VAO)를 생산하지 않고 laccase와 manganese dependent peroxidase(MnP)를 생산했다. MnP는 배양 3일부터 생산되었으나 효소활성은 매우 낮았다. 반면 laccase는 배양 초기부터 지속적으로 생산되었고 활성은 대단히 높았다. 균주를 염료와 함께 10일간 배양했을 때 아조계 염료인 orange II, orange G, tropaeolin O 및 congo red의 탈색율은 각각 98.0%, 97.4%, 99.0% 및 95.3%로 나타났고 트리페닐메탄계 염료인 basic fuchsin, malachite green 및 crystal violet 들은 98.5%, 95.7% 및 99.4%로, 헤테로싸이클릭계 염료에 속하는 eosin Y, toludine blue, methyl blue 및 azur B는 각각 97.4% 98.7%, 99.9% 및 94.0%의 탈색율을 보였다. 송곳니구름버섯 BN2 균주에 의한 염료의 탈색은 주로 laccase에 의하여 이루어진다고 생각된다.

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결핵과 호지킨 림프종이 액와부 림프절에 공존하였던 1예 (Coexistence of Hodgkin's Lymphoma and Tuberculosis in the Same Axillary Lymph Nodes)

  • 반우호;강현희;백명기;김재경;김현진;백인운;김은오;고선혜;이상학;문화식;민기옥
    • Tuberculosis and Respiratory Diseases
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    • 제70권4호
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    • pp.342-346
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    • 2011
  • Herein we report the case of a 71-year-old woman who complained of fatigue and enlarged right axillary lymph nodes for 18 months. At her first visit, her chest X-ray showed diffuse nodular opacities in both lung fields. Initial excisional biopsy of the axillary lymph nodes showed granulomatous lesions and acid fast bacilli were seen on Ziehl-Neelsen staining. However, even after 15 months of anti-tuberculosis (TB) medication, her right axillary lymph nodes were enlarged. We re-performed an excisional biopsy of the nodes, which showed Hodgkin's lymphoma (HL). A retrograde review of the biopsy before anti-tuberculous medication, revealed HL coexisting with TB. HL and TB cause difficulties in differential diagnosis due to similarities in clinical course, imaging procedures and histopathological analysis of the involved tissue. Therefore, it is important to consider the possibility of concurrent HL and TB when patients who undergo treatment for TB or chemotherapy for lymphoma complain of persistent systemic symptoms or enlarged lymph nodes.

간기능검사이상의 위험요인으로써 한약복용영향에 관한 단면연구 (A Cross-sectional Study between Herbal Medicine Intake and Abnormal Liver Function Test Results)

  • 박해모;신헌태;박철수;이선동
    • 대한예방한의학회지
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    • 제12권2호
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    • pp.61-72
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    • 2008
  • Objectives : The aim of this study was to evaluate effects of herbal medicine and other associated factors for abnormal liver function tests(especially total bilirubin, AST, ALT, and ${\gamma}$GT) levels in outpatients at an oriental medical clinic. Methods : A cross-sectional study based on clinical records was conducted on 504 patients at one Oriental medical clinic in Seoul, Korea. They were tested a liver function tests for screening and 497 patients ranging from the age of 4 to 74 were chosen for the study. Patients with basal liver disease or DM were excluded during the screening process. Patients were classified into case(abnormal) and control(normal) groups by normal liver function test references. Results and Conclusions : In this study, Significant correlations for abnormal total bilirubin levels was age, for abnormal AST was gender, for abnormal ALT were gender, smoking, marriage status, and job, for abnormal ${\gamma}$GT were age, gender, obesity, alcohol, smoking, marriage status, and job using the Chi-square test(p<0.05). There was no significant correlations for abnormal LFTs by using herbal medication history, and intake duration. After controlling other covariates, logistic regression analysis showed that the significant associated factors for abnormal total bilirubin levels were age(odds ratio[OR]=0.87, 95% confidence intervals [CI]=0.87-0.99). For abnormal AST levels was obesity(OR=2.45, CI=1.2-4.9), for abnormal ALT levels were age(OR=1.01, CI=0.99-1.03), male gender(OR=3.31, CI=1.62-6.76), and obesity(OR=3.71 CI=2.28-6.08). For abnormal ${\gamma}$GT levels were male gender(OR=4.83 CI=1.34-17.43), obesity(OR=3.29, CI=1.74-6.22), alcohol (OR=2.51, CI=1.19-5.28), and smoking(OR=2.29, CI=1.16-4.50). Herbal medication history was not as a risk factor for all abnormal liver function tests. Therefore, people who are male, obese, alcohol drinker and smoker will have higher liver function test levels. But intake of herbal medication or the duration of intake may not be the risk factor for abnormal liver function test results.

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De-Interlace 기법을 이용한 내시경 영상의 화질 개선 (Improvement of Endoscopic Image using De-Interlacing Technique)

  • 신동익;조민수;허수진
    • 대한의용생체공학회:의공학회지
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    • 제19권5호
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    • pp.469-476
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    • 1998
  • 초음파, 내시경 등의 NTSC 영상을 PC를 통해 획득하고, 고해상도의 YGA 모니터에 표시할 경우 주사변환 과정을 거치면서 치명적인 영상의 왜곡(tear-drop)이 나타난다. 본 연구에서는 이러한 왜곡을 해소하는 여러 가찌 방법을 살펴보고 실시간으로 왜곡을 보정할 수 있는 하드웨어를 PC상에서 구현하였다. 하드웨어 시스템은 De-Interlace 전용의 소자와 PCI bridge 등을 이용함으로써 고화질의 영상표현과 실시간의 영상전송이 가능하다 구현된 시스템에서 영상의 질은 눈에 띄게 향상되었으며, PC 기반의 시스템으로 구성함으로써 영상의 저장, 전송 및 텍스트의 기록 등 다양한 기능을 쉽게 구현할 수 있었다.

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침구소난요지(鍼灸素難要旨)에 대한 연구(硏究) (A study on zhenjiusunanyaozhi(鍼灸素難要旨))

  • 심철웅;김재중;김장생;이시형
    • 대한한의정보학회지
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    • 제17권2호
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    • pp.130-287
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    • 2011
  • "zhenjiusunanyaozhi(鍼灸素難要旨)" is composed of three volumes and published in 1529 by Gao Wu(高武). Gao Wu(高武) is skillful in astronomy, the art of war and the law as well as a medical practitioner in Ming Dynasty. The books he wrote "zhenjiujuying(鍼灸聚英)", "zhizhi(直指)", "douzhenzhengzong(痘疹正宗)", "shexuezhinan(射學指南)", "zhenjiujieyao(鍼灸節要)". "zhenjiusunanyaozhi鍼灸素難要旨" is written by classifying the origin of acupuncture and moxibustion. In other words, it is edited by classifying the contents related to acupuncture and moxibustion out of the ancient Chinese medical book "yellow emperor's canon of medicine and yellow emperor eighty-one difficult" in which are composed of 3 volumes as follows, Volume 1 says the main diseases on "the nine acupuncture needles figure" (九針圖), "the reinforcing and reducing the meridian" (補瀉), "the needle depth" (針刺深淺), "the five shu points - metal, wood, water, fire, earth" (正,滎,輸,經,合) based on 18 chapters in terms of acupuncture in "yellow emperor eighty-one Difficult "難經"", in which it quotes the annotation of "the difficulty by the original meaning "難經本義"" written by Hua Shou(滑壽) in Yuan Dynasty. Volume 2 is composed of 2 parts. Part 1 says the method of treatment on 36 Chapters, the method of acupuncture use in the Linshu "靈樞" and the Suwen "素問" such as "the rule of acupuncture use" (用針方宜), "the nine-pin method" (九針式) and "the nine-pin to only use the time appropriate to consider nature of Heaven, Earth and person" (九針應天地人時以起用) etc., Part 2 says "the five difficult acupuncture(五亂刺)", "the rise and fall of energy and blood(氣血盛衰)". "the pain tolerance(耐痛)" and ect., in which are in terms of method of treatment collected the original texts of 59 chapters on acupuncture to each disease and of 8 chapters on moxibustion in the Linshu "靈樞" and the Suwen "素問". Volume 3 includes 10 chapters in which consist of "the stabbing to disease in 12 meridians (十二經病刺)", "the eight extra meridian disease (寄經八脈病)", "the twelve meridians(十二經脈)", "the fifteen collaterals (十五絡脈), the twelve meridian muscles (十二經筋)", "the acupoint (孔穴)" and etc. This is the book edited comprehensively by classifying the contents on the theory of acupuncture and moxibustion and the circulations of meridians in "yellow emperor's canon of medicine and yellow emperor eighty-one difficult" and there is no case story in particular except his comments in person. This study is for the purpose of helping researching and developing acupuncture and moxibustion and applying their clinical training.

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패치형 무선 피부 온도 측정 시스템의 설계 및 구현 (Design and implement of patch type wireless skin temperature measuring system)

  • 우상효;박수영;지아 모이 우딘;원철호;이정현;박희준;이정우;홍영진;서진호;염영일;조진호
    • 센서학회지
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    • 제17권5호
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    • pp.350-360
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    • 2008
  • In every large hospital, nurses must perform simple repetitive tasks such as measuring body temperature. Such tedious work reduces nurses' motivation to provide quality medical care, which is an important element of the medical services provided by a hospital. If a device were available to measure body temperature, nurses could focus on the more important aspects of providing quality medical care to the patients. However, body temperature is generally measured from the throat, anus, tympanum or armpit, where it is difficult to affix a patch type device. In addition, general body temperature measuring points shows moving artifact error; therefore, it is not good point to continually measure the temperature. In this paper, a patch type skin temperature measuring system was developed. To appropriately measure the skin temperature, a thermal transducer was implemented with a thin (0.5 mm) temperature sensor. The system is small and thin ($H6.6{\sim}5.3{\times}L35{\times}W24\;mm$), and weighs only 5 g including a battery, case and circuit; therefore, it is small and light enough to function as a patch type device. Moreover, the system worked for 5 days. To investigate differences between the experimental and conventional thermometer, simple clinical experiments were performed with 17 volunteers, and the result showed some correlation between the implemented system and conventional thermometer (Correlation coefficient = 0.647, P<0.1).