• 한국콘텐츠학회논문지
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• 제22권6호
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• pp.428-438
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• 2022

본 연구는 약사여래 신앙의 현대적 의미와 신앙적 가치를 고찰하는 데 목적을 두었다. 이에 따라 약사여래에 관한 대표적 문헌인 『약사경』을 비롯해 여러 문헌 자료에 기초해 약사여래 신앙에 대한 이론적 배경에 대해 고찰을 하였고, 뒤이어 약사여래 신앙의 2가지 핵심 지향점인 질병의 치유와 횡사의 구제를 종류 및 유형, 방법으로 구분해 분석 틀을 설정한 뒤 내용 분석을 하였다. 본 연구의 결과로서 약사여래 신앙이 갖는 현대적 의미와 신앙적 가치를 다음과 같이 제시하였다. 먼저 약사여래 신앙이 갖는 현대적 의미이다. 약사여래 신앙은 첫째, 질병이 치료가 아닌 치유의 대상이라는 관점 전환을 촉진한다. 둘째, 약사여래 신앙은 질병을 의학적 질환뿐만 아니라 장애로까지 확대하여 치유의 대상으로 삼는다. 셋째, 약사여래 신앙은 마음의 긍정성을 강화하는 수행을 통해 치유를 도모한다. 다음 약사여래 신앙이 갖는 신앙적 가치이다. 약사여래 신앙은 첫째, 신앙적 수용성이 강력하다. 둘째, 약사여래 신앙은 종교와 종파를 뛰어넘어 현대인에게 수용되고 있다는 특징을 갖고 있다. 이러한 연구 결과를 토대로 본 연구는 질병과 횡사 등으로 일상생활 속에서 고통에 시달리고 있는 현대인들의 삶의 질 증진을 위한 제언을 하였다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권3호
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• pp.163-179
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• 2022

Although functional gastrointestinal disorders (FGIDs) are very common in pediatric patients, there is a scarcity of published epidemiologic data, characteristics, and management patterns from Saudi Arabia, which is the 2nd largest Arabic country in terms of area and the 6th largest Arabic country in terms of population, with 10% of its population aged <5 years. Functional constipation (FC) is an FGID that has shown a rising prevalence among Saudi infants and children in the last few years, which urges us to update our clinical practices. Nine pediatric consultants attended two advisory board meetings to discuss and address current challenges, provide solutions, and reach a Saudi national consensus for the management of pediatric constipation. The pediatric consultants agreed that pediatricians should pay attention to any alarming signs (red flags) found during history taking or physical examinations. They also agreed that the Rome IV criteria are the gold standard for the diagnosis of pediatric FC. Different therapeutic options are available for pediatric patients with FC. Dietary treatment is recommended for infants with constipation for up to six months of age. When non-pharmacological interventions fail to improve FC symptoms, pharmacological treatment with laxatives is indicated. First, the treatment is aimed at disimpaction to remove fecal masses. This is achieved by administering a high dose of oral polyethylene glycol (PEG) or lactulose for a few days. Subsequently, maintenance therapy with PEG should be initiated to prevent the re-accumulation of feces. In addition to PEG, several other options may be used, such as Mg-rich formulas or stimulant laxatives. However, rectal enemas and suppositories are usually reserved for cases that require acute pain relief. In contrast, infant formulas that contain prebiotics or probiotics have not been shown to be effective in infant constipation, while the use of partially hydrolyzed formula is inconclusive. These clinical practice recommendations are intended to be adopted by pediatricians and primary care physicians across Saudi Arabia.

• 대한한방내과학회지
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• 제44권2호
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• pp.167-177
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• 2023

Background: Pressure injuries are localized areas of damage to the skin and/or underlying tissue, usually over a bony prominence due to pressure. Cerebrovascular disease increases the risk of pressure injuries due to the immobility caused by physical paralysis. The general approach to managing a patient with pressure injuries should include pain relief, the treatment of the infection, optimizing nutritional intake, proper positioning, and contamination prevention. Nonetheless, the duration of treatment for pressure injuries varies from person to person. Case report: An 80-year-old female intracerebral hemorrhage patient developed a pressure injury. To improve the injury faster, a Radix Astragali pharmacoacupuncture solution was applied to the pressure sore. The pressure injury's width, length, and depth was assessed using a ruler, and the exudate amount and tissue types were assessed. The treatment was performed for 35 days. The rate at which the size of the pressure sore lessened increased since the Radix Astragali pharmacoacupuncture solution was applied to the pressure sore. In addition, the tissue type of the pressure injury improved, and the exudates decreased. There was no significant difference in the Pressure Ulcer Scale for Healing Tool 3.0, since the Radix Astragali pharmacoacupuncture solution was applied to the pressure injury. Conclusion: This clinical case study suggests that the Radix Astragali pharmacoacupuncture solution might be effective in speeding up the healing of pressure injuries.

• Korean Journal of Radiology
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• 제23권9호
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• pp.901-910
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• 2022

Objective: This study aimed to assess the technical feasibility, efficacy, and safety of the safe triangular working zone (STWZ) approach applied in percutaneous vertebroplasty (PV) for spinal metastases involving the posterior part of the vertebral body. Materials and Methods: We prospectively enrolled 87 patients who underwent PV for spinal metastasis involving the posterior part of the vertebral body, with or without the STWZ approach, from January 2019 to April 2022. Forty-nine patients (27 females and 22 males; mean age ± standard deviation [SD], 57.2 ± 11.6 years; age range, 31-76 years) were included in group A (with STWZ approach), accounting for 54 vertebrae. Thirty-eight patients (18 females and 20 males; 59.1 ± 10.9 years; 29-81 years) were included in group B (without STWZ approach), accounting for 57 vertebrae. Patient demographics, procedure-related variables, and pain relief as assessed using the visual analog scale (VAS) were collected at different time points. Tumor recurrence in the vertebrae after PV was analyzed using Kaplan-Meier curves. Results: The STWZ approach was successful from T1 to L5 without severe complications. Cement filling was satisfactory in 47/54 (87.0%) and 25/57 (43.9%) vertebrae in groups A and B, respectively (p < 0.001). Cement leakage was not significantly different between groups A and B (p = 1.000). Mean VAS score ± SD before and 1 week and 1, 3, 6, 9, and 12 months after PV were 7.6 ± 1.8, 4.2 ± 2.0, 2.7 ± 1.9, 1.9 ± 1.5, 1.7 ± 1.4, 1.7 ± 1.1, and 1.6 ± 1.3, respectively, in group A and 7.2 ± 1.7, 4.0 ± 1.3, 3.4 ± 1.6, 2.4 ± 1.2, 1.8 ± 1.0, 1.4 ± 0.5, and 1.7 ± 0.9, respectively, in group B. Kaplan-Meier analysis showed a lower tumor recurrence rate in group A than in group B (p = 0.001). Conclusion: The STWZ approach may represent a new, safe, alternative/auxiliary approach to target the posterior part of the vertebral body in the PV for spinal metastases.

• 대한한방내과학회지
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• 제45권3호
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• pp.381-395
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• 2024

Objectives: The main purpose of this study is to investigate the clinical characteristics of patients complaining of indigestion after COVID-19 infection (CI) or COVID-19 vaccination (CV) and to confirm the effectiveness and safety of Korean medical treatment. Methods: We retrospectively collected and investigated the medical records of 39 patients admitted to the Kyung Hee University Korean Medicine Hospital with a chief complaint of dyspepsia from January 1, 2020 to February 29, 2024 who reported the onset or significant exacerbation of dyspepsia after CV or CI. Patients were divided into vaccination and infection groups, and their demographic characteristics, Ryodoraku results, presenting symptoms, traditional Korean medicine treatments, and treatment outcomes were analyzed. Results: When comparing the groups with dyspepsia after CV and after CI, it was observed that the CI group had significantly lower average body weight, and the measurements of LH6, LF1, and LF6 in the Ryodoraku test were significantly lower. Additionally, compared to the CV group, the CI group showed significantly more abdominal distension, nausea, and abdominal pain. Significant relief of upper gastrointestinal symptoms was observed in both the CV and CI groups after treatment. No adverse reactions were observed during the course of treatment. Conclusion: The CI group tended to complain more severely of various dyspeptic symptoms and had a tendency to lower body weight than the CV group, as was also reflected in the results of the Ryodoraku test. Korean medical treatment can be effective and safe in treating these patients.

• The Journal of Korean Physical Therapy
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• 제15권3호
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• pp.126-152
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• 2003

The purpose of this study was to evaluate the value of passive caudal gliding mobilization of the glenohumeral joint on the range of motion (ROM) of active and passive abduction; to evaluate the value of pain relief through visual analogue scale (VAS); to evaluate the correlation between improvement of shoulder abduction and intra-articular movement measured by fluoroscopy in frozen shoulder patients. The subjects consisted of twenty-one patients with clinically diagnosed frozen shoulder (11 males, 10 females) between 40 and 63 years of age (mean age : 52.7 years). The traction and caudal gliding mobilization based on the convex-concave rule in the resting position and at end range of abduction was peformed for 15 minutes per day and was repeated 10 times during a 2 week period. The ROM of abduction was measured by goniometer and pain was measured by VAS. The intra-articular movement was measured by fluoroscope, Neurostar Plus TOP (Siemens, Germany). ROM measurements of each patient was acquired at pre-treatment, immediate post-treatment and 2 week post-treatment. Statistical analysis was performed using SPSS 10.0 for Windows software and data was analyzed using the paired-test and the pearson correlation. The results of this study are as follows: 1. There was a significant decrease of VAS between pre-treatment data and 2 week post-treatment data (P<.05) but no significant difference between pre-treatment and immediate post-treatment data (P>.05). 2. There was a significant increase in ROM of active and passive abduction in the pre-treatment data, immediate post-treatment data, and in 2 week post-treatment data (P<.05). 3. With regard to results of the joint play test, there was a significant difference in the grade of traction between pre-treatment data and immediate post-treatment data and between pre-treatment data and 2 week post-treatment data (P<.05). There was no significant difference between immediate post-treatment data and 2 week post-treatment data (P>.05). 4. With regard to results of the joint play test, there was a significant difference in the grade of caudal gliding between pre-treatment data and immediate post-treatment data and between pre-treatment data and 2 week post-treatment data (P<.05). There was no significant difference between immediate post-treatment data and 2 week post-treatment data (P>.05), 5. With regard to the results of fluoroscopic findings, there was a significant change of the glenohumeral joint space between pre-treatment data and immediate post-treatment data and between immediate post-treatment data and 2 week post-treatment data (P<.05). There was no significant change of the glenohumeral joint space between immediate post-treatment data and 2 week post-treatment data (P>.05). 6. With regard to the results of fluoroscopic findings, there was a significant change of acromiohumeral joint space between the three data (pre-treatment data, immediate post-treatment data, 2 week post-treatment data) (P<.05). 7. Mobility grade by joint play test was significantly increased and was correlated to improved ROM of active and passive abduction (P<.05). In this study of frozen shoulder, passive caudal gliding techniques of the glenohumeral joint results in statistically significant changes in active and passive abduction as well as in VAS. There is also a significant correlation between joint play test and ROM of abduction.

• 대한정형외과 초음파학회지
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• 제2권2호
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• pp.85-89
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• 2009

목적: 견관절의 극상건에 발생한 급성 석회화 건염에 대하여 초음파를 이용한 스테로이드 국소 주사 요법을 시행하고 임상적 결과를 알아보고자 하였다. 대상 및 방법: 2007년 1월부터 2009년 4월까지 증상이 있는 50세에서 70세 사이의 견관절 극상건의 급성 석회화 건염 20례를 대상으로 하였으며, 평균 연령은 58.2세, 평균 추시 기간은 18개월(12개월~24개월)이었으며, 우측이 18례이며, 모두 극상건에 칼슘 침착이 있었다. 석회화 부위에 5-12MHz 고해상도 초음파 영상을 이용하여 18게이지 바늘로 다발성 천공을 한 후 건 주변에 2% lidocaine 1cc와 depomedrol 40mg/ml 1cc를 혼합한 국소주사를 시행하였다. 치료효과의 평가 항목으로 UCLA견관절 평가 양식, 운동 범위, VAS 점수를 이용하였다. 통계학적 검정은 SAS를 이용하여 ANOVA와 Tukey's post-hoc test로 유의 수준 5%에서 유의성을 조사하였다. 결과: 주사 직 후 10분이내에 전예에서 압통점이 소실되었으며, UCLA견관절 평가 양식에서 시술 전에는 15례에서 보통(fair), 5례에서 불량(poor)의 양상을 보였으나, 시술 후 16례에서 우수(excellent), 4례에서 양호(good)의 결과를 보였으며 보통(fair)이나 불량은(poor)은 관찰되지 않았다. 시술 후 전례가 양호 이상의 결과를 보였고, 운동 기능의 제한은 없었으며, VAS 점수는 시술 전 평균 8.9(8~10)이었으나 시술 후 평균 0.5(1~2)로 유의하게 향상되었다(p<0.0001). 합병증은 1례도 없었다. 결론: 초음파를 이용한 다발성 천공술 후 스테로이드 국소주사 요법은 극상근 석회화 건염의 급성 통증기에 이용할 수 있는 유용한 치료 방법 중의 하나이다.

• 대한관절경학회지
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• 제10권2호
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• pp.178-183
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• 2006

목적: 주관절의 퇴행성관절염에 대해 측와위에서 견인 후 관절경을 이용한 수술적 치료를 시행하고 그 결과와 술식의 유용성을 보고하고자 한다. 대상 및 방법: 12개월 이상 추시가 가능하였던 주관절의 퇴행성관절염 21례를 대상으로 하였다. 남자가 15례 여자가 6례였으며 평균 연령은 47세, 우세지가 14례였다. 모든 례에서 수술은 전신 마취하에 측와위에서 10파운드의 견인 상태로 관절내 활액막염, 골성 유리체, 관절의 전방 및 후방의 골극을 제거 하였다. 수술 후 최대 신전 상태에서 고정을 하였으며 2일부터 CPM을 이용한 운동을 시행하였다. 결과: 수술전 관절 운동 범위는 평균 $30{\sim}115$도였으며 수술 후 평균 $5{\sim}130$도로, 신전과 굴곡 각각 25도 16도, 전체적으로 41도 증가하였다. 통증에 대한 VAS상 7.5점에서 2.3점으로 감소, 기능 만족도는 1.8에서 9.0으로 증가하였다. 합병증은 2례로 1례는 척골 신경의 이상 감각증상이 있었으나 보존적 치료에 소실되었고, 1례는 수포가 형성되었으나 치유되었다. 결론: 주관절 관절경 수술시 측와위에서의 견인은 넓은 시야 확보에 도움을 주었다. 간단한 견인 방법으로 주관절의 퇴행성 관절염에 대해 관절경 수술을 시행한 바 통증의 의 해결과 관절 운동 범위 회복에 있어 우수한 결과를 얻을 수 있었다.

• 대한간호
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• 제36권1호
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• pp.59-76
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• 1997

The purposes of this study were to identify the contents and satisfaction level of the patients received home care service, and to compare the differences of the contents by the characteristics of the patients. Seventy eight patients received home care service from 1st Jan. to 30th Sept., 1996 were data-collected to analyze the contents and outcomes of home care service. Sixty-nine patients currently receiving home care service were participated to evaluate the satisfaction level of home care service. The data were analyzed using mean, standard deviation, $x^2$ test, and ANOVA by SPSS $PC^+$ program. The findings of this study were as follow : 1. The contents & outcomes of home care service 1) The mean age of the subjects was 64.4 years: 58% of them were female. Those who living in Seoul were 83% and the rest of the subjects was living in Kyung-Gi. 2) The subjects who had one diagnosis were 41%. Over 60% of them had the disease of neurologic & sensory system. 3) The mean number of visit was 6. Only one visit was 22%. The mean time of care was 79 minutes. Duration of visit from 31 minutes to 60 minutes were 47 %. The subjects who terminated the visit because of death were 67.3%. 62% of the persons who referred them to the home care service were nurses. 4) The pain after the service was more relieved than before. The amounts of intake, the degree of bed sore, edema & fracture after the service were more improved than before. Health status after the service was improved in general. 5) There were significant differences between initial and last conscious level in tracheostomy care & oxygen inhalation care. There was significant difference between initial and last degree of activity in blood sugar check. 6) There were significant differences on the number of visit in assessment of the status, evaluation & observation, vital sign check, skin care, injection, medication, bed sore care, colostomy care, relaxation therapy for pain relief, patient education, family care, exercise therapy, position change, supply of disinfected equipments and infection control. There were significant differences on visiting time in nasogastric tube care, drainage tube care and oxygen inhalation care. 2. The satisfaction level of home care service 1) 50% were male. Over 60 years of the subjects was 61 %. Those who living in Seoul were 82%. 2) The subjects who had one or two diagnosis were 32% respectively. 55% of the persons who referred them to the home care service were nurses. 3) Total level of satisfaction of home care service was very high. 4) The older the age, the higher the satisfaction level. The larger the number of visit, the higher the satisfaction level. 5) The subjects who were in cloudy state were higher level of satisfaction than in alert or coma state. The subjects whose activity were normal or who needed assistance were higher level of satisfaction than bedridden or immobilized subjects. These findings suggested that the patients had substantial need for posthospital care. They tended to be elderly and to have experienced the wide range of health problems associated with aging, chronicity, including limitations in activities, and other serious health problems. So, the nationwide home care systems beyond the limit of demonstration program by local association and the development of the effective financial system of home based health care are necessary for the clients who are in need of home care.

• 대한정형외과스포츠의학회지
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• 제3권1호
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• pp.60-65
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• 2004

목적: 슬개골 상외측부 통증을 동반한 이분슬개골의 치료로 시행한 제한적 외측지대 유리술의 단기 추시 결과를 분석하고자 하였다. 연구대상 및 방법: 1995년 1월부터 2002년 6월까지 통증을 동반한 이분슬개골을 주소로 내원한 환자들 중 제한적인 외측지대 유리술을 시행받은 14명의 환자 16예를 대상으로 하였다. 환자는 전 예에서 남자였으며 평균 연령은 22.3세 (20$\~$44세)였고 방사선학적 검사상 이분슬개골은 Saupe 분류상 2형이 3예, 3형이 13예였다. 핵의학적 검사상 이분슬개골 부위에 동위원소 섭취증가의 소견을 보였다. 수술은 관혈적 방법을 이용하여 이분슬개골에 부착된 외측 광근건을 골막하에서 분리하였다. 임상적으로는 통증의 감소 여부와 활동정도, 방사선학적으로 이분슬개골편의 경사도(fragment tilting angle)와 이분슬개골편의 슬개골과의 간격 등을 술전과 후를 비교하여 평가하였고 평균 추시기간은 14개월 (12$\~$16개월)이었다. 결과: 제한적 외측지대 유리술 후 이분슬개골 부위의 통증을 호소한 예는 없었으며 임상평가상 전예에서 양호 이상의 결과를 보였다. 방사선학적 평가상 이분슬개골편의 경사도와 이분슬개골편과 슬개골과의 간격은 술전에 비해 통계적으로 의미있는 감소의 소견을 보였다. 결론: 통증을 동반한 이분슬개골의 치료에 있어서 제한적인 외측지대 유리술은 보다 덜 침습적인 치료방법으로 임상적 및 방사선학적으로 양호한 결과를 가져와 상기 질환의 치료로서 우수한 치료방법으로 사료된다.