• Clinical and Experimental Pediatrics
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• 제53권7호
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• pp.759-765
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• 2010

Purpose: This study evaluated the clinical manifestations of and risk factors for pituitary insufficiency in children and adolescents with Rathke's cleft cysts. Methods: Forty-four patients with Rathke's cleft cysts younger than 19 years who visited Seoul National University Children's Hospital between January 1995 and September 2009 were enrolled. Rathke's cleft cysts were confirmed histologically through an operation in 15 patients and by brain magnetic resonance imaging (MRI) in 29 patients. The clinical, hormonal, and imaging features were reviewed retrospectively. Results: The clinical presentation of symptomatic patients was as follows: headache (65%), endocrinopathy (61%), and visual disturbance (19%). Endocrinopathy included central precocious puberty (18%), diabetes insipidus (14%), general weakness (11%), and decreased growth velocity (7%). After surgery, hyperprolactinemia resolved in all patients, but growth hormone insufficiency, hypothyroidism, and diabetes insipidus did not improve. Pituitary insufficiency except gonadotropin abnormality correlated significantly with severe headache, visual disturbance, general weakness, and cystic size. Suprasellar extension of cysts and high signals in the T2-weighted image on brain MRI were related to hypothyroidism, hypocortisolism, and diabetes insipidus. Multivariable linear regression analysis showed that only general weakness was a risk factor for pituitary insufficiency ($R^2$=0.549). Conclusion: General weakness is a risk factor for pituitary insufficiency in patients with Rathke's cleft cysts. When a patient with a Rathke's cleft cyst complains of general weakness, the clinician should evaluate pituitary function and consider surgical treatment.

• Restorative Dentistry and Endodontics
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• 제39권2호
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• pp.132-136
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• 2014

The presence of radix entomolaris (RE) in a mandibular first molar is a common occurrence in certain ethnic groups, but the presence of RE in a mandibular second molar is a rare occurrence. In the present case, RE was identified from preoperative radiographs and confirmed using cone-beam computed tomography (CBCT). The access cavity was modified to locate the RE. Cleaning and shaping were performed with nickel-titanium rotary instruments. Obturation was completed with gutta-percha cones using AH Plus (Dentsply Detrey GmbH) as sealer. From the CBCT axial images, the RE was determined to have a Type III curvature by the De Moor classification, Type B separate RE by the Carlsen and Alexandersen classification, and radiographically, a Type i image by the Wang classification. The presence of RE in the mandibular second molar makes it essential to anticipate and treat the distolingual root canal. This case report highlights the usefulness of CBCT for assessing RE in the mandibular second molar, which can help the clinician in making a confirmatory diagnosis and assessing the morphology of the root canal.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제1권1호
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• pp.77-88
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• 1990

주의력 결핍장애아동의 치료는 악물치료가 중요하지만 중복장애아동과 같은 원칙에서 인지-행동적, 교육적 접근과 상호보완이 필요하다. 치료의 첫단계는 진단을 확립하고, 아동, 부모, 교사에게 이장애의 특성을 설명해 주고 치료의 대책을 세운다. 약물치료는 주로 중추신경자극제-그중에서도 메칠페니데이트를 중심으로 논의하였고, 그외에 삼환계 항우울제, 클로니딘, 항정신병약물이 소개되었다. 약물치료이외의 방법들로는 정신요법, 인지행동요법, 교육적 방법과 부모및 가족상담의 원칙들을 논의하였다. 이들 전통적인 치료방법이외에 논란되고 있는 식이요법, 비타민요법, 저당분요법, 미네랄요법, 정제된 당분의 투여, 신경학적 조직의 이론에 근거한 운동요법들을 소개하고 설명하였다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제11권2호
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• pp.161-178
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• 2000

놀이정신치료의 역사와 분류를 통해 놀이정신치료의 다양한 발전 과정을 살펴보았고, 놀이의 기능과 임상적 응용을 통해 기본 개념과 실제적 요소를 짚어보았으며 주요 치료적 접근에서는 대표적 치료 방법인 정신분석적 기법과 비지시적 치료의 이론과 실제기법을 정리하여 소개하였다. 또한 놀이치료에서의 발달론적 접근을 이해하기 위해 발달과정으로서의 놀이, 그 치료적 적용, 인지발달적 측면 그리고 치료과정에 대해 조명해 보았다.

• 대한추나의학회지
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• 제3권1호
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• pp.111-123
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• 2002

Objectives : There have been many studies of the effect of Bee Venom therapy about arthritis, but no one study was reported about its whole functional mechanism to musculo-skeletal system. This study was designed to investigate the effect, Indication, and side effect of Bee Venom therapy on musculo-skeletal disease by literature review of articles. Results : The effects of Bee Venom therapy to musculo-skeletal system are divided to Anti_inflammatory effect and Anti-nociceptive effect. Anti_inflammatory effect is achieved through competitive chemotaxis, immuno-regulation, increasing of cortisol secretion by stimulating hypothalamus-pituitary gland-adrenal cortex axis. Anti-nociceptive effect is achieved by Anti-inflammatory mechanism and it works similar to anti-nociceptive effect of the acupuncture acting on central and peripheral nociceptive transduction system. The Bee Venom therapy could cause severe side effect, for example, hypersensitivity and anaphylaxis, injury to central nerve system and cardiovascular system, peripheral blood system, and renal dysfunction. Conclusions : With its Anti-inflammatory and Anti-nociceptive mechanism, Bee Venom therapy is considered that has good effects to autoimmune disease, chronic inflammation of various musculo-skeletal disease and various pain syndrome. But the clinician must be careful for its side effects.

• 대한소아치과학회지
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• 제26권1호
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• pp.119-125
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• 1999

Air turbine handpiece를 사용하여 치간 법랑질을 삭제하는 Air-rotor stripping 술식은 악궁확장이나 발치 술식에 대한 대체방안으로써 arch length discrepancy를 해결할 수 있는 효과적인 접근법으로 사료된다.

• 대한치과보철학회지
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• 제38권3호
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• pp.366-374
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• 2000

FRC/ceromer system provides the clinician with a durable, flexible, and esthetic alternative to conventional porcelain fused to metal crowns. FRC is the matrix which is silica-coated and embedded in a resin matrix. The ceromer material which is a second generation indirect composite resin contains silanized, microhybrid inorganic fillers embedded in a light-curing organic matrix. FRC/ceromer restoration has a several advantages: better shock absorption, less wear of occluding teeth, translucency, color stability, bonding ability to dental hard tissues, and resiliency. It has versatility of use including inlay, onlay, single crown, and esthetic veneers. With adhesive technique, it can be used for single tooth replacement in forms of inlay adhesion bridge. In single tooth missing case, conventional PFM bridge has been used for esthetic restoration. However, this restoration has several disadvantages such as high cost, potential framework distortion during fabrication, and difficulty in repairing fractures. Inlay adhesion bridge with FRC/ceromer would be a good alternative treatment plan. This article describes a cases restored with Targis/Vectris inlay adhesion bridge. Tooth preparation guide, fabrication procedure, and cementation procedure of this system will be dealt. The strength/weakness of this restoration will be mentioned, also. If it has been used appropriately in carefully selected case, it can satisfy not only dentist's demand of sparing dental hard tissue but also patient's desire of seeking a esthetic restorations with a natural appearance.

• 대한감각통합치료학회지
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• 제2권1호
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• pp.43-52
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• 2004

Objective : This study is to know about the play awareness of occupational therapists with using the sensory integration approach, and is to suggest educational strategies of play as occupation and research. Methods : 124 occupational therapists completed the questionnaires including the general use of play in occupational practice and the use of play assessments with preschoolers, and factors influence on the use of play in occupational therapy for children. Results : Respondents used the play as therapy modality and performed much with based on sensory integration and development approach in individual occupational therapy room with variable play tools. It was restricted to use as objective assessment tools and methods, and had important factors that influence on the use of play in occupational therapy for children; role of occupational therapy in work setting, personal frame of reference and availability of play assessments. Conclusion : The results suggest a need for increasing the emphasis on play in entry-level curricula and continuing education, improving clinician access to valid and reliable play assessments, and completing studies designed to examine the use and efficacy of play in sensory integration therapy intervention.

• Tuberculosis and Respiratory Diseases
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• 제67권6호
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• pp.491-498
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• 2009

Severe sepsis and septic shock are major healthcare problems with high mortality, ranging from 20% to 60%, affecting millions of individuals around the world each year. The speed and appropriateness of therapy administered in the initial hours after severe sepsis develops have an important impact on the outcome. In 2004, an international guideline that the bedside clinician could use to improve the outcomes in severe cases of sepsis and septic shock was published. Several landmark studies recently demonstrated that therapeutic strategies may reduce mortality substantially. The "Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock: 2008", using a new evidence-based methodology system for assessing the quality of evidence and the strength of the recommendations, was updated. The revised version is based on an updated search into 2007. Evidenced-based recommendations regarding the acute management of sepsis and septic shock are the first step toward improving the outcomes of critically ill patients. We review the treatment guidelines of sepsis and septic shock.

• 생물정신의학
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• 제6권1호
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• pp.49-66
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• 1999

Polypharmacotherapy, both psychotropic and nonpsychotropic, is widespread in various situations including psychiatric hospitals and general hospitals. As the clinical practice of using more than one drug at a time increase, the clinician is faced with ever-increasing number of potential drug interactions. Although many interactions have little clinical significances, some may interfere with treatment or even be life-threatening. The objective of this review is evaluation for drug-drug interactions often encountered in psychiatric consultation. Drug interactions can be grouped into two principal subdivisions : pharmacokinetic and pharmacodynamic. These subgroups serve to focus attention on possible sites of interaction as a drug moves from the site of administration and absorption to its site of action. Pharmacokinetic processes are those that include transport to and from the receptor site and consist of absorption, distribution on body tissue, plasma protein binding, metabolism, and excretion. Pharmacodynamic interactions occur at biologically active sites. In psychiatric consultation, these two subdivisions of drug interactions between psychotropic drugs and other drugs are likely to happen. We gathered informations of the drugs used in physically ill patients who are consulted to psychiatric department in Korea University Hospital. And we reviewed the related literatures about the drug-drug interactions between psychotropic drugs and other drugs.