• Title/Summary/Keyword: internal medicine

Search Result 16,033, Processing Time 0.056 seconds

Modern approach of the discourse on viscera and bowels and retrogressive disorder (사상의학(四象醫學) 장부론(臟腑論)의 현대적 접근과 퇴행성질환의 조건)

  • Cho, Hwang-sung
    • Journal of Sasang Constitutional Medicine
    • /
    • v.12 no.1
    • /
    • pp.84-100
    • /
    • 2000
  • Are the body and th spirit to different things? How individual ability and feeling displays in a human being and what correation between the two lise physiologically? Namely, what determines the external and the internal world? By what physiological functions and circulations, it makes possible to indciate individual's characteristic? These kinds of questions in constitutional medicine is able us lead to the following approach.

  • PDF

Clinical Analysis of 500 Cases of Coronary Artery Bypass Grafting (관상동맥 우회술 500례의 임상적 고찰)

  • Shin, Yoon-Cheol;Kim, Ki-Bong;Ahn, Hyuk;Chae, Hurn;Rho, Joon-Ryang;Suh, Kyung-Phill
    • Journal of Chest Surgery
    • /
    • v.32 no.6
    • /
    • pp.525-531
    • /
    • 1999
  • Background: We analyzed five hundred patients who underwent either isolated or concomitant coronary artery bypass grafting(CABG) between November 1981 and June 1997. Material and Method: There were 330 males and 170 females with a mean age of 57.4$\pm$8.9 years. To evaluate the preoperative status, we performed electrocardiograghy, echocardiography, MIBI scan, Duplex sonogram, common blood test including CK and LDH and coronary angiography. Result: Preoperative clinical diagnoses were unstable angina in 282 (56.4%), stable angina in 141 (28.2%), postinfarction angina in 58 (11.6%), acute myocardial infarction in 8 (1.6%), variant angina in 7 (1.4%) and failed percutaneous transluminal coronary angioplasty in 4 (0.8%) patients. Preoperative angiographic diagnoses were three-vessel disease in 263 (52.6%), two-vessel disease in 93 (18.6%), one-vessel disease in 71 (14.2%), left main disease in 68 (13.6%), and others in 5 (1.0%) patients. Patients had various risk factors for coronary disease, and the frequency of the risk factors such as hypertension, diabetes and smoking showed increasing tendency year by year. We used saphenous vein grafts in 1143, internal thoracic artery grafts in 442, radial artery graft in 17, and gastroepiploic artery graft in 1 anastomosis. The mean number of grafts was 3.2$\pm$1.2 per patient. Concomitant operations were prosthetic valve replacement or valvuloplasty in 31, coronary endarterectomy and angioplasty in 27, left main coronary angioplasty in 13, carotid endarterectomy in 5, and neurologic problems, bleeding, and perioperative myocardial infarction. The mean follow-up period was 25$\pm$23 months and there were 5 cases of reoperation. Conclusion: We hope that the surgical results would improve with the accumulation of experience, application of new myocardial protection technique, and timely intervention of mechanical assisted devices.

  • PDF

PRELIMINARY STUDY OF MENTAL REPRESENTATIONS OF PRESCHOOL CHILDREN EXPERIENCING SINGLE, SEVERE TRAUMA (심한 정신적 외상 경험을 한 학령 전기 아동의 정신적 표상에 대한 예비연구)

  • Eon, So-Yong;Song, Won-Woung;Oh, Kyung-Ja;Choi, Eui-Gyum;Shim, Eun-Ji;Shin, Yee-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • v.15 no.1
    • /
    • pp.61-74
    • /
    • 2004
  • Objectives:This study was performed to introduce a psychoeducational family therapy model for the families of schizophrenic patient and to investigate the effect of this model on the changes in coping style and depressive symptoms of the family members, and in perception of emotional support by families and depressive symptoms of patients. Methods:Nine preschool children, 3-5 years old, experiencing physical injuries caused by attack from a psychotic patient at kindergarten, were evaluated for psychological assessments;Intelligence test, MSSB(MacArthur Story-Stem Battery), H-T-P test(House-Tree-Person test). And their parents completed rating scale, KPI-C(Korean Personality Inventory for Children about children’s psychological conditions). Results:With respects to the contents and emotional reactions of MSSB, 9 preschool children showed generally high levels of anxiety, depression, avoidance, aggression, probably related to the traumatic experiences. Even though children couldn't verbally report directly about their traumatic experiences, in both MSSB, structured play narrative assessment tool, and HPT, free drawing and association test, they demonstrated psychiatric problems through reenactment plays, regardless of clinical diagnoses. Conclusion:Present study allowed us the chance to see beyond the outer pathological behaviors of PTSD in preschool children, through deeper evaluations of their mental representation. These preliminary data suggest deep understanding of internal representation would be of help for thorough evaluations and treatment plan for preschool children, experiencing severe trauma.

  • PDF

Standardization and Reliability and Validity of the Korean Edition of Profile of Mood States(K-POMS) (한국판 기분상태척도(K-POMS)의 표준화와 신뢰도와 타당도 평가)

  • Kim, Eui-Joong;Lee, Sang-Ick;Jeong, Do-Un;Shin, Min-Sup;Yoon, In-Young
    • Sleep Medicine and Psychophysiology
    • /
    • v.10 no.1
    • /
    • pp.39-51
    • /
    • 2003
  • Objectives: The Profile of Mood States (POMS) has been used broadly and frequently in various medical studies with various subjects. For the development and application of the Korean edition of POMS, called K-POMS, we translated POMS into Korean and then evaluated the reliability and validity of K-POMS. Methods: The subjects were 161 male students with a mean age of 18.1 years (15-30) and 244 female students with a mean age of 16.6 years (14-23). They were requested to perform K-POMS and SCL-90-R (Korean version) at the same time. Means, reliability coefficients, and test-retest correlations of K-POMS were calculated. Content validities, correlations with SCL-90-R, and discrimination validities in comparison with 76 depressive patients were obtained, and factor analyses were carried out. Results: Mean scores of Total Mood Disturbance (TMD) and some subscales (T, F, C, V factor) showed a significant difference between male and female students. The internal consistency coefficient ($\alpha$) of the total 65 items was 0.93, and ranged from 0.67 to 0.90 for subscales. Test-retest correlations of 43 subjects ranged from 0.27 to 0.63. Seven psychiatrists rated the properness of the content of each item as more than moderate degree (mean scale points=2.66, in the range of 0 to 4). Every subscale of KPOMS exhibited significant correlation with the matching subscale of SCL-90-R. Mean scores of K-POMS of the total 405 subjects were significantly different from those of the 76 depressive subjects after age correction. Six factors were extracted, accounting for 51.2% of total variance. Factor 6 consisted of 6 items which came from various subscales of POMS and represented "uncertainty and helplessness," which may be somewhat different to depression or sadness proper. Conclusion: The validity and reliability of K-POMS could be confirmed. The significant difference in K-POMS scores between depressive subjects and normal subjects suggests that K-POMS can be used clinically for the evaluation and screening of depression. The main structure of K-POMS is very similar to that of POMS, except the Confusion-Bewilderment factor which shows weak factor consistency in K-POMS. This may reflect some emotional characteristic of Koreans such as an undifferentiated aspect of cognitive efficiency. The sixth factor newly extracted from K-POMS also may be indicative of an unique emotional aspect of young Koreans.

  • PDF

Studies on Identification and Drug Resistance of Atypical Mycobacteria isolated from Patients with Pulmonary Tuberculosis (폐결핵환자에서 비정형항산균의 분리, 동정 및 약제감수성에 관하여)

  • Chung, Dong-Hyun;Kim, Sung-Kwang;Kim, Joo-Deuk
    • Journal of Yeungnam Medical Science
    • /
    • v.1 no.1
    • /
    • pp.49-58
    • /
    • 1984
  • The differential diagnosis of atypical mycobacteriosis caused by atypical mycobacteria (with the exception of Mycobacterium tuberculosis, Mycobacterium bovis, and Mycobacterium leprae) which are widly distributed in soil and water, from pulmonary tuberculosis is possible only when atypical mycobacteria are isolated and identified. In this investigation, attempts were made to isolate atypical mycobacteria from persons registered as tuberculosis patients in the Anyang Health Center in Anyang City, Kyungki province, Korea. Biological and biochemical tests were performed for the atypical mycobacteria isolated from these patients, also retrospective analysis of clinical and X-ray findings of the patients with bacteriologically confirmed atypical mycobacteriosis were done. The results can be summarized as follows: 1. 103 strains of mycobacteria were isolated among 334 sputum samples from patients. 2. Among the isolated mycobacteria, 10 strains (9.7%) were found to be a atypical mycobacteria and 93 strains (90.3%) were tubercle bacilli of human type. 3. On the basis of Runyon's grouping of atypical mycobacteria, there were 3 strains (30.0 %) of scotochromogen and nonphotochromogen respectively, 4 strains (40.0%) of rapid grower, and no photochromogen. 4. By biochemical tests, 3 strains of scotochromogen were identified as Mycobacterium scrofulaceum (2 strains) and Mycobacterium szulgai (1 strain) 3 strains of nonphotochromogen were Mycobacterium avium-complex (2 strains) and Mycobacterium terriae (1 strain), and 4 strains of rapid grower were Mycobacterium fortuitum (3 strains) and Mycobacterium chelonei. 5. In drug sensitivity tests, all 10 strains isolated atypical mycobacteria showed resistance to various concentration of INH and SM and low concentration (10mcg, 40mcg and 50mcg) of EB, TH, and CS, and were sensitive to only high concentration (20mcg and 100mcg) of EB, TH, CS, and RFP. 6. In analysis of clical findings by the patients with bacteriologically confirmed atypical mycobacteriosis, it was found that clinical symptoms of these patients appeared not to be mild than those of patients with pulmonary tuberculosis. The patients with atypical mycobacteriosis had been treated for pulmonary tuberculosis for a long time and they showed no improvement.

  • PDF

Development of Needs Assessment Instrument for the Patients with Cancer (암환자의 요구 조사 도구 개발)

  • Kim, Gi-Yon;Choi, Sang-Soon;Pak, So-Mi;Song, Hee-Young;Hur, Hea-Kung
    • Journal of Hospice and Palliative Care
    • /
    • v.5 no.2
    • /
    • pp.136-145
    • /
    • 2002
  • Purpose : This study was designed to develop an instrument that could be used for comprehensive and effective need assessment for patients with cancer. Methods : In the first phase, a conceptual framework for the instrument was established by Wingate & Lackey (1989). In the second phase, the preliminary instrument was drawn up through a review of the literature and in consultation with three professors in Nursing. In the third phase validity and reliability of the preliminary instrument were tested as follows; 1) an expert validity test of the preliminary instrument was done by nine head nurses and charge nurses who had over ten years experience caring for patients with cancer at Wonju Christian Hospital. 2) A construct validity test and reliability test was done for the instrument by 116 staff nurses selected by convience sampling from hospitals located in Kang-Won, Kyoung-Ki, and Choong-Chung Provinces. The collected data were analyzed using SPSS 10.0 WIN program. For the factors of the instrument, factor analysis was used. The reliability of the scale was analyzed by Cronbach's alpha. Results : The results of the experts' test of validity, showed that, of 32 items, only one item had less than 55.4%. It was then deleted and a total of 31 items was selected. On the basis of the results of the factor analysis, the following six components were identified: physiological, informational, spiritual, and emotional needs, available resources, and legal/financial needs. These factors explained 61.8% of the variance. In the factor analysis, the first factor (physiological needs) and the second factor (informational needs) explained 25.4% and 10.9% of the variance respectively, which were major factors for the needs of patients with cancer in Korea. Cronbach' alpha for the scale was .90 indicating internal reliability. Conclusion : This instrument can be effectively utilized for assessment of needs of patients with cancer in Korea. Use of the needs assessment instrument developed in this study will allow nurses to develop nursing interventions that provide comprehensiveness and continuity in meeting the needs of patients with cancer.

  • PDF

A Study on Minimizing the Residual $^{18}F$-FDG in the Tubing Using Nitrogen Gas (FDG 합성 후 질소가스를 이용한 튜빙의 잔류 $^{18}F$-FDG 최소화를 위한 방법의 유용성)

  • Kim, Dong-Il;Park, Hoon;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
    • /
    • v.14 no.1
    • /
    • pp.8-12
    • /
    • 2010
  • Purpose: In $^{18}F$-FDG automated synthesizer, deliver is done in automated mode after synthesis until the dispenser. After the delivery, the yield is calculated from the radioactivity which was read by the dose calibrator located in the dispenser. However, when the distance between the automated synthesizer and the dispenser is far, there are $^{18}F$-FDG residues, which results in loss of the amount of $^{18}F$-FDG. This study investigated the usefulness of a method that minimizes $^{18}F$-FDG residues. Materials and Methods: The structure of the tubing between the (TRACERlab Mx FDG; GE.) and the dispenser is that the distance is 8 m and the internal diameter is 1/16 inch. The synthesis process of The module goes through the synthesis process of trap, synthesis, delivery in the automated module. The time taken for synthesis is about 25 to 26 minutes, after which rinsing is done. However, after rinsing, as the distance of the tubing increased, there were 10~13% of $^{18}F$-FDG residues. Therefore, a method of using push syringe and $N_2$ gas in manual mode to minimize $^{18}F$-FDG residues is analyzed. Results: In manual mode, there were $^{18}F$-FDG residues of 4~5% for the push syringe, and there were $^{18}F$-FDG residues of less than 1% for the $N_2$ gas, which showed that the method using $N_2$ gas had superior usefulness. Also, there were no $^{18}F$-FDG residues in the cleaning the next day. Conclusion: The distance between the synthesizer and the dispenser needs to be reduced as much as possible, to reduce the rate of loss of $^{18}F$-FDG resulting from the distance of the tubing. However, in case the distance between the synthesizer and the dispenser has to be increased due to the system structure, using push syringe and $N_2$ gas simultaneously is a useful method for minimizing $^{18}F$-FDG residues.

  • PDF

Comparison of the Medication Effects between Milnacipran and Pregabalin in Fibromyalgia Syndrome Using a Functional MRI: a Follow-up Study (섬유근통 환자에 대한 Milnacipran과 Pregabalin 약물치료에 대한 기능적 자기공명영상에서의 후속 영향 비교)

  • Kang, Min Jae;Mun, Chi-Woong;Lee, Young Ho;Kim, Seong-Ho
    • Investigative Magnetic Resonance Imaging
    • /
    • v.18 no.4
    • /
    • pp.341-351
    • /
    • 2014
  • Purpose : In this study, the medication effects of Milnacipran and Pregabalin, as well known as fibromyalgia treatment medicine, in fibromyalgia syndrome patients were compared through the change of BOLD signal in pain related functional MRI. Materials and Methods: Twenty fibromyalgia syndrome patients were enrolled in this study and they were separated into two groups according to the treatment medicine: 10 Milnacipran (MLN) treatment group and 7 Pregabalin (PGB) treatment group. For accurate diagnosis, all patients underwent several clinical tests. Pre-treated and post-treated fMRI image with block-designed pressure-pain stimulation for each group were obtained to conduct the statistical analysis of paired t-test and two sample t-test. All statistical significant level was less than 0.05. Results: In clinical tests, the clinical scores of the two groups were not significantly different at pre-treatment stage. But, PGB treatment group had lower Widespread Pain Index (WPI) and Brief Fatigue Inventory (BFI) score than those of MLN treatment group at post-treatment stage. In functional image analysis, BOLD signal of PGB treatment group was higher BOLD signal at several regions including anterior cingulate and insula than MLN treatment group at post-treatment stage. Also, paired t-test values of the BOLD signal in MLN group decreased in several regions including insula and thalamus as known as 'pain network'. In contrast, size and number of regions in which the BOLD signal decreased in PGB treatment group were smaller than those of MLN treatment group. Conclusion: This study showed that MLN group and PGB group have different medication effects. It is not surprising that MLN and PGB have not the same therapeutic effects since these two drugs have different medicinal mechanisms such as antidepressants and anti-seizure medication, respectively, and different detailed target of fibromyalgia syndrome treatment. Therefore, it is difficult to say which medicine will work better in this study.

Operative Treatment of Distal Clavicle Fracture with Acromioclavicular Joint Injury (견봉 쇄골 관절의 손상을 동반한 원위 쇄골 골절의 수술적 치료)

  • Kang, Ho-Jung;Koh, Il-Hyun;Joo, Jong-Hwan;Chun, Yong-Min;Kim, Hyung-Sik
    • Clinics in Shoulder and Elbow
    • /
    • v.14 no.1
    • /
    • pp.59-66
    • /
    • 2011
  • Purpose: We wanted to evaluate the clinical and radiological outcomes and the prognosis of various surgical treatments for the distal clavicle fracture with an acromioclavicular joint injury. Materials and Methods: A retrospective study of 21 patients with a minimum of 12 months follow up was done. We classified acromioclavicular (AC) injury into type I (only intra-articular fracture (IAF), 5 cases), type II (IAF with widening of the AC joint > 7 mm, 9 cases) and type III (IAF with AC joint superior subluxation > 50%, 7 cases). The distal clavicle fractures were fixed using plate (9 cases), mini screws (1 case), K wire and tension band wiring (10 cases) and transarticular pinning (1 case). Acromioclavicular or coracoacromial ligament reconstruction was not done in all the cases. Results: In 20 of 21 cases, bone union was achieved at an average of 8.4 weeks. Traumatic arthritis (5 cases), AC joint widening (4 cases) and AC joint subluxation (2 cases) were noted at the last follow up. The average UCLA score was 32.6 in the type I AC joint injuries, 34 in type II and 34.1 in type III. There was no relationship between the clinical outcomes and the preoperative AC joint injury pattern, postoperative traumatic arthritis, AC joint widening or AC joint subluxation (p>0.05). Conclusion: Satisfactory results were achieved by acute reduction and firm fixation of the distal clavicle fracture with AC joint injury. There was no relationship between the pattern of AC joint injury, the residual radiologic findings and the functional outcome.

The Radiotherapeutic Significance of Serum NSE Level in Non-Small Cell Lung Cancers(NSCLC) (비 소세포성 폐암의 방사선 치료에서 혈청내 NSE 치의 중요성)

  • Yun Sang Mo;Kim Sang Bo;Park In Kyu;Jung Tae Hoon
    • Radiation Oncology Journal
    • /
    • v.12 no.1
    • /
    • pp.73-80
    • /
    • 1994
  • From December 1989 to February 1993, 108 patients with Non-Small Cell Lung Cancers(NSCLC) were studied retrospectively to evaluate radiotherapeutic significance of serum levels of NSE. We considered elevated serum neuron specific enolase(S-NSE) level as one of the neuroendocrine features in NSCLC. Histopathologic evaluation revealed 86 squamous cell carcinomas, 11 adenocarcinomas.3 large cell carcinomas, 3 mucoepidermoid carcinomas, and 5 unknown pathology. Eight Patients had stage 1,40 stage IlIA, and 60 stage lIIB.S-NSE level greater than 15 ng/ml was considered as elevated, and below this considered as normal. All patients recieved radiotherapy as primary treatment modality. The responders to radiotherapy had significantly higher mean S-NSE level than non-responders (28.5 ng/ml vs 20 ng/ml, p=0.01). Overall 2-year survival rate(YSR) was 23.6$ \% $. According to radiotherapy response, 2 YSR for Patients with CR, PR, and NR were 39.2$ \% $, 28.6$ \% $, and 6.2$ \% $ respectively(p=0.001). 2 YSR for patients with elevated and normal S-NSE were 14.6$ \% $ and 31.7$ \% $(p=0.02). The patients with NR showed no difference in survival according to S-NSE level. When we considered all patients, S-NSE level showed no significant impact on response. But for squamous cell carcinomas alone, patients with elevated S-NSE had more responders(80$ \% $ vs 61$ \% $, p=0.05). There was no correlation between tumor characteristics and S-NSE level. But the patients with elevated S-NSE had more patients with higher nodal stage, Based on our and other datas, NSCLC with neuroendocrine features have different response to treatment and clinical behavior compared to other NSCLC. Thus, this subgroup may need different treatment modality, and S-NSE level may have prognostic significance.

  • PDF