• 대한치과마취과학회지
• /
• 제12권3호
• /
• pp.157-163
• /
• 2012

Background: The major goal of dental management before and after liver transplantation is the prevention of bacteremia from an oral source that could lead to systemic infection. However dental treatment in liver transplant patients have the risk of infection and bleeding. so it is needed special dental consideration. Methods: 42 liver transplant candidates who visited department of Advanced General Dentistry in Yonsei University College of dentistry from March 1, 2010 to February 29, 2012 were selected. The clinical data of those patients were analyzed; coagulation status such as PT, INR, aPTT, platelet count before and 6 months after liver transplantation, dental infectious foci, time interval between dental visit and operation date of liver transplantation. Results: Before liver transplant, the patient's PT and INR was prolonged, and the platelet count was lower than normal range. But 6 months later from liver transplantation, most of the figures turned into a normal range. The dental infection foci were chronic periodontitis, dental caries, chronic apical periodontitis, root rest et al but we did extraction of 6 root rest before liver transplantation and postponed other treatment after liver transplantation due to bleeding and infection risk of patients. Because of insufficient interval between dental visit and operation date, 64.3% of patients could not finish the dental treatment. Conclusions: The patients before liver transplantation have the risk of bleeding. The treatment of those patient should be removal of only factors that can cause dental infections after transplantation and other treatment must be postponed until the stable period of the transplant that patient's condition has improved.

• 대한임상독성학회지
• /
• 제5권1호
• /
• pp.36-42
• /
• 2007

Purpose: To assess the epidemiology and the clinical features of Glufosinate herbicide in Korea. Methods: Data was prospectively collected during 1 year since August 2005 from 38 hospital in Korea. We analyzed the epidemiologic characters and clinical manifestations of Glufosinate poisoning. In addition, the characteristics of patients with severe central nervous system toxicity were separately analyzed to find poor prognosis relating factors. Results: During study periods, there were 715 persons of poisoning of herbicides and insecticides. 6.3% (45 persons) of the agricultural chemicals poisoning had Glufosinate poisoning. There were 36 cases of suicide attempts and 7 cases of accidental exposure, The major of poisoning route was oral ingestion (44 cases). 28.9 % of the study patients had not toxic symptoms. The most common symptoms were gastrointestinal symptoms relating surfactant irritation. 67.7% of central nervous symptoms occurred lately. 10 persons showed severe central nervous system toxicity. 4 persons of them showed poor outcomes (1 death, 3 hopeless discharged). Complications of respiratory failure and renal failure related with poor outcome. Conclusion: Majority of patients ingested Glufosinate for suicide attempt. 22.2% of patients with Glufosinate poisoning showed delayed serious central nervous system toxicity. Early supportive care of altered mentality may prevent late respiratory complications and improve the outcomes.

• 의료법학
• /
• 제11권2호
• /
• pp.239-274
• /
• 2010

Advance directive refers to a description of the treatment method a patient wants to be provided with in case where the person is unconscious or lacks an ability to decision making in a future period or a declaration of intention that delegates and appoints another person who makes a decision regarding a treatment method on behalf of the person. Advance directive is usually a document form, but oral statement is acceptable as well. Advance directive may have a variety of forms though, it basically consists of two basic forms. That is, one is a living will, and the other is a surrogate decision making. Though the importance of advance directive has been emphasized, and the necessity of adopting the system has been strongly argued for so far, the debates on criteria, method, and procedure alike have not yet reached an agreement. It is because even the concept of advance directive is more or less ambiguous, and each specific method has its own theoretical limitations and practical constraints. Thus the inquiries on advance directive raised in the study are summarized as the meaning, practicability, and philosophical foundation of the advance directive. Firstly, the theoretical limitations of Advance directive may be categorized into conceptual and moral limitations. In case of conceptual limitations, authors of advance directives may not be well aware, in advance, of the particular situation in which he or her will experience in the future, and patients may experience the change in his or her values and lack the understanding and information about the future situation due to the changes in treatment methods. In case of moral limitations, a patient has a limited moral autonomy right and self identity that have an impact on his or her preference. Secondly, in case of practical constraints for advance directive, there exist cultural features, low ratio of documentation, as patients themselves admit, and low predictability and stability of patient's own preference regarding life-sustaining care. And the problem of validity and accuracy in proxy's decision making is also raised. Those who administer a living will, especially, may have a difficulty in understanding the directive by a patient, so that the accuracy of execution cannot be secured. In the sense, it is needed to implement a legal device in order to solve such problems. In summary, it is urgently required to understand the limitations and explore desired alternatives to overcome the relevant problems in advance, which must contribute to successfully adopting and effectively operating the advance directive system in Korea.

• 대한지역사회작업치료학회지
• /
• 제2권1호
• /
• pp.25-35
• /
• 2012

목적 : 본 연구는 농촌지역 노인을 대상으로 실시한 바우처사업 서비스 만족도와 여가시간사용을 조사한 자료를 바탕으로 지역사회거주 노인들의 서비스 선호도를 고려한 여가시간 활용방안을 모색하고자 하였다. 연구방법 : 본 연구는 부여군에 거주하고 있는 노인 71명을 대상으로 하였으며, 노인들의 특성에는 성별, 배우자 유무, 건강수준, 학력, 월 생활비, 자녀수, 직업 등의 변수들이 포함되었다. 대상자들의 자아존중감, 생활만족도, 삶의 질, 프로그램 만족도에 대한 조사는 설문지를 사용하였으며, t-검증과 상관분석을 이용하여 각 변인들 간의 상관관계를 확인하였다. 결과 : 대상자들의 여가활동에 대해 조사한 결과, TV시청하기, 친구만나기, 전화통화하기 등의 정적인 활동에 많은 시간을 소모하고 있었으며, 바우처 사업에 대한 만족도를 조사한 결과, 노인구강관리 서비스, 건강검진 서비스, 스포츠마사지 서비스 등 건강과 관련된 서비스에 만족도가 비교적 높게 나타났다. 결론 : 이 연구결과를 통하여 농촌지역 노인의 의미 있는 여가시간활용이 부족한 것을 확인할 수 있었으며, 건강관련 서비스에 대한 욕구가 강한 것을 확인 할 수 있었다. 그러므로 추후 여가활동에 대한 경험 및 지식습득의 기회를 제공하여 의미 있는 여가시간을 증진 할 필요가 있으며, 이를 바탕으로 노인들의 욕구에 부합하는 다양한 프로그램이 마련되어야 한다.

• 대한한방소아과학회지
• /
• 제12권1호
• /
• pp.63-76
• /
• 1998

BACKGROUND : The purpose of this study was to investigate the new effective oriental medical treatments in pediatric diseases and its clinical applicability. METHOD : The study was composed of 1725 new patients who had been treated at the pediatric unit in the Dongguk Bun-Dang Oriental Medicine Hospital for 1 year, from 1 January 1997 to 31 December 1997, and had ages between 0 and 18 years. The chief complaint was mainly categorized by oral examination on patients and their care-givers. RESULT 1. The ratio of male to female was 1.35:1 and the number of each age group and its percentage distribution was 228 patients (13.2%) for the age group between 0 and 1 year, 746 patients (43.2%) between 2 and 6 years, and 751 patients (43.6%) for the age group over 7 years. 2. The chief complaint of the new outpatients was weakness, asthma, common cold, sinustis, skeletal disease, atopic dermatitis, stomach-ache, short stature, diarrhea, nasal blooding, night terror, allergic rhinitis, gastric disorder, enuresis, dermatitis, strabismus in the order of majority.3. The number of patients and its percentage for the most three complaints was 494 patients (28.6%) for weakness, 647 patients (37.4%) for respiratory disease, 144 patients (8.3%) for digestive disease. 4. The digestive disease tended to increase in summer, and appeared mostly in the age group between 0 and 2 years. The respiratory disease increased In inter-season and winter, but decreased significantly in summer. The age group between 1 and 5 years was the largest group of respiratory disease. CONCLUSION 1. The chief complaint in pediatric diseases that needed an oriental medical treatment was mainly the disease that tends to take long time and the weakness, and appeared frequently in digestive and respiratory diseases. 2. The oriental medical treatment was still preferred as a way to improve the weakness by patients, rather than a way to overcome their disease. In particular, the study shows that the oriental medical treatment should be emphasized in terms of preventing the disease. 3. The new diseases, which were developed with the change of human life and environment, (atopic dermatitis, enuresis, short stature, obesity, dysthymic disorder, strabismus), should be investigated as a new field of oriental medical treatment.

• Archives of Plastic Surgery
• /
• 제33권5호
• /
• pp.669-671
• /
• 2006

Purpose: Congenital insensitivity to pain with anhidrosis(CIPA) is a rare form of autosomal recessive peripheral sensory neuropathy. Patients with CIPA show loss of pain sensation, which leads to corneal ulcers and opacities, self-mutilation of the tongue and fingertips, as well as fractures with subsequent joint deformities and chronic osteomyelitis. The purpose of this report is to highlight the fact that pressure sores also are a potential complication of CIPA. Methods: This case report describes a patient presenting with pressure sores resulting from CIPA. A 5-year-old boy was referred to our department for the treatment of a $5{\times}5cm$ sacral pressure sore as a result of a hip spica cast applied for the treatment of a left hip joint dislocation. He had a history suggesting CIPA such as multiple bony fractures, mental retardation, recurrent hyperpyrexia, anhidrosis, and clubbing fingers due to oral mutilation. A microscopic examination of the sural nerve showed mainly large myelinated fibers, a few small myelinated fibers and an almost complete loss of unmyelinated fibers. After wound preparation for two weeks, the exposed bone was covered with two local advancement flaps. Results: Two weeks later, complete wound healing was achieved. A 16-month follow-up showed no recurrence. However, the patient presented with a new pressure sore on the left knee due to orthosis for the treatment of the left hip joint dislocation. Conclusion: The early diagnosis of CIPA and special care of pressure sores are important for preventing and treating pressure sores resulting from CIPA.

• 종양간호연구
• /
• 제5권1호
• /
• pp.52-62
• /
• 2005

Purpose: This study was to analyze the research trend centering on the theses to cancer nursing research in digestive system released in Korea. Method: The researcher collected the academic degrees and theses published on the book of the academic soceity from January 1993 to August, 2004, and examined 38 domestic papers of cancer nursing research in digestive system. Results: 1) As for the subject, the results were : patients with stomach cancer 25(66%), colon cancer 4(11%), rectal cancer 3(8%), and others(taxi drivers 2, family of cancer patents. 2) As for the research designs the result were : quantitative studies were 33(87%), and qualitative studies were 9(23%). 3) As for key concepts of survey, the results were : life patterns of patients with rectal cancer, oral intake of stomach cancer patients, fatigue of stomach cancer patients undergoing chemotherapy, nursing needs when discharging from hospital after operation with gastrectomy, and so on. 4) As for the comparative studies, the results were : risk factors between colorectal patients and general population, early symptom and risk factors between stomach cancer patients and general population, and risk factors between stomach cancer and patients with gastritis. 5) As for main concepts of correlational studies, the results were : quality of life, health belief, fatigue, health promotion behavior, social support, straitanxiety. 6) The treatment of experimental research, the results were : information services, arc reflex massage, acupressure, educational program for discharge, 7)As for the qualitative studies, in terms of subjects, stomach cancer patients were 2, spouse of patients with stomach cancer was 1, rectal cancer patients were 2. In the theme of the qualitative studies, the results were: experience of family of patients with stomach cancer, experience of long term survival of patients with rectal cancer, experience of disease process of rectal cancer patiens. 8) As for the used instrument in studies, the results were : Strait-anxiety Scale by Spielberger, Nausea and Vomiting Scale by Rhodes, Social support by Tae and Lee, Health belief by Champion, Becker, and Moon. QOL by NCCN, Roh, Pdilla, Kwon, Revised Fatigue Scale by Piper, Health Locus of Control by Wallston and Wallston, Uncertainty Scale by Mishel. Conclusions: More research needs to be encouraged in various subject of cancer patients in digestive system. More nonexperimental and experimental researches should be conducted for the establishment of the basis of practical and theoretical framework and the providing good quality of care for cancer patients.

• Journal of Yeungnam Medical Science
• /
• 제13권2호
• /
• pp.261-271
• /
• 1996

저자들은 1992년 1월 1일부터 1995년 6월 30일까지 영남대학병원에서 양에너지 방사선 골밀도 측정기로 요추 골밀도를 측정한 자연적 폐경기 여성 136명을 대상으로 설문과 의무기록지를 검토하여 연령, 신장, 체중, 초경 및 폐경 연령, 자녀수, 모유수유 자녀수, 경구 피임력, 골다공증의 가족력, 우유 및 커피섭취량, 흡연 및 음주력 그리고 신체활동량을 평가하였다. 평균 연령은 55.2세였고, 평균 폐경 연령은 47.9세였다. 골밀도는 신장, 체중 그리고 신체활동량과 유의한 양의 상관관계를 보였고, 나이, 폐경 후 기간 그리고 자녀수와는 유의한 음의 상관관계를 보였다. % age-matched 골밀도는 나이, 신장, 체중, 신체활동량 그리고 폐경 후 기간과 유의한 상관관계를 보였다. 골밀도를 종속변수로 한 다중회귀분석에서는, 폐경 후 기간, 신체활동량 그리고 체중이 골밀도에 영향을 주는 유의한 변수였고, 그 중 폐경 후 기간이 가장 영향을 주는 변수였다. 나이의 효과를 통제하기 위해 % age-matched 골밀도를 종속변수로 한 다중회귀분석에서는, 신체활동량과 체중이 % age-matched 골밀도에 영향을 주는 유의한 변수였고, 신체활동량이 가장 영향을 주는 변수였다. 그 결과 폐경기 여성의 골밀도에 영향을 미치는 인자들 중 나이의 영향을 배제하면 신체활동량과 체중이 중요한 인자로 생각된다. 그러므로 지속적인 신체활동이 골다공증의 예방에 중요하다는 것을 알 수 있었다.

• Journal of Microbiology and Biotechnology
• /
• 제25권12호
• /
• pp.2146-2152
• /
• 2015

Apios americana Medik (hereinafter Apios) has been reported to treat diseases, including cancer, hypertension, obesity, and diabetes. The therapeutic effect of Apios is likely to be associated with its anti-inflammatory activity. This study was conducted to evaluate the protective effects of Apios in animal models of acute lung injury induced by lipopolysaccharide (LPS) or pandemic H1N1 2009 influenza A virus (H1N1). Mice were exposed to LPS or H1N1 for 2-4 days to induce acute lung injury. The treatment groups were administered Apios extracts via oral injection for 8 weeks before LPS treatment or H1N1 infection. To investigate the effects of Apios, we assessed the mice for in vivo effects of Apios on immune cell infiltration and the level of pro-inflammatory cytokines in the bronchoalveolar lavage (BAL) fluid, and histopathological changes in the lung. After induction of acute lung injury, the numbers of neutrophils and total cells were lower in the Apios-treated groups than in the non-Apios-treated LPS and H1N1 groups. The Apios groups tended to have lower levels of tumor necrosis factor-a and interleukin-6 in BAL fluid. In addition, the histopathological changes in the lungs were markedly reduced in the Apios-treated groups. These data suggest that Apios treatment reduces LPS- and H1N1-induced lung inflammation. These protective effects of Apios suggest that it may have therapeutic potential in acute lung injury.

• 치위생과학회지
• /
• 제10권3호
• /
• pp.155-160
• /
• 2010

국민의 구강건강을 효율적으로 관리할 수 있는 치과위생사의 역량강화를 위하여 학습자의 자기주도적 학습을 통한 학습자의 문제 해결력을 향상시키기 위한 목적으로 실시한 본 연구는 2009학년도 2학년 41명을 대상으로 2009년 8월 31일부터 2009년 12월 7일까지 15주 동안 기존 실습 교과목의 문제점을 분석하여 이를 개선하기 위한 통합치위생실습모형을 개발하여 적용시켜 치위생실습을 진행하였고 다음과 같은 결론을 도출하였다. 1. 통합 치위생 실습 모형 적용 전 후를 비교분석한 결과 학습동기, 자기주도적 학습력, 만족 도 전반적인 과정 모두 적용 전보다 적용 후 높은 것으로 조사되었다. 특히 학습동기에서는 학습동기의 관련성, 만족감에서 유의한 차이가 있는 것으로 나타났고(p<0.001), 자기주도적 학습력에서는 학습자로서의 자기 확신, 학습에 대한 호기심, 학습에 대한 책임수용에서 유의 한 차이가 있는 것으로 나타났으며(p<0.01), 만족감에서는 학습 전보다 학습 후가 만족감이 큰 것으로 나타났다(p<0.001). 2. 학업수준에 따른 학습동기의 변화와 자기주도학습력의 변화, 수업만족도의 변화를 알아본 결 과, 통합치위생실습 모형이 하위집단 학생들을 긍정적으로 변화시키는데 효과적인 것으로 나 타났다. 3. 통합치위생실습을 통해 기존 단편적인 실습 교육에서 벗어나 실제 환자를 대상으로 예방구 강관리를 시행하는 실물 위주의 교육과 실천학습을 통해 학습자는 자신감을 회복을 비롯한 학업성취도를 높이는 등 긍정적 결과를 보였다. 본 연구 결과를 토대로 학습자의 개인구강관리능력 향상을 위한 학습효과 개선을 위해서는 통합 치위생 실습모형을 실기 교과목에만 한정할 것이 아니라 이론 교과에도 적용하여 이론과 실기 교과목이 연계되어 포괄적인 구강관리 능력을 함양시켜야 하고, 국가고시 합격률 결과만을 위해 주입식 교육만을 행할 수밖에 없는 여건만을 고집할 것이 아니라 학습자 참여를 유도할 수 있는 새로운 교수 학습법을 개발하고 적용해야 할 것으로 사료된다.