• 제목/요약/키워드: past medicine history

검색결과 516건 처리시간 0.036초

단일기관에서 소아 호산구성 수막염의 임상특징 분석 (Clinical Manifestation of Eosinophilic Meningitis in Korean Children: A Single Institution's Experience)

  • 변정희;최성열;김동수;김기환
    • Pediatric Infection and Vaccine
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    • 제22권1호
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    • pp.23-28
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    • 2015
  • 목적: 호산구성 수막염은 척수액에서 호산구가 ${\geq}10/mm^3$ 또는 백혈구 중 10% 이상인 것으로 정의하며, 기생충에 의한 신경계 감염으로 주로 보고된다. 기생충에 의한 감염이 흔한 국가 외에서는 호산구성 수막염에 관한 소아에 대한 국내외 보고는 드물다. 이 연구는 국내 단일기관에서 소아 호산구성 수막염 임상특징 분석하고자 한다. 방법: 2007년 1월에서 2012년 7월까지 5년간 세브란스 어린이병원을 방문한(입원, 외래) 18세 미만의 환자들 총 6,335명을 스크리닝했고, 그 중 호산구성 수막염에 맞는 39명을 대상으로 의무기록을 바탕으로 후향적으로 분석하였다. 결과: 뇌척수액 검사상 호산구성 수막염으로 진단된 환자는 39명(0.6%)이었으며, 평균연령은 6세(생후 7일-18세)였고, 남녀의 비는 1.3:1이었다. 혈액검사에서 호산구 증가가 동반되는 경우가 18례(46%) 있었다. 기저질환 및 과거력으로 신경계 질환 36례(92%) 있었다. 항경련제를 복용한 경우는 22례가 있었고, 이외 다른 약물의 복용이 1례 있었다. 뇌수술 이후에 발생한 경우가 35례(90%)였다. 증상은 주로 발열(50%), 두통(20%), 구토(15%), 경련(10%), 어지러움증(5%) 등이 있었다. 뇌척수액의 단백 수치는 평균 180 mg/dL (16-633 mg/dL)로 상승된 값을 보였다. 증상 지속시간은 평균 5일로 치료는 정맥 항생제 및 스테로이드를 투여하였다. 세균배양 된 예가 1례, 애완동물을 기른 예가 1례 있었고 이외에 기생충 관련된 정보는 없었다. 결론: 국내 소아 호산구성 수막염은 기생충 감염보다는 중추신경계의 수술과 관련 있거나 약제에 의한 것으로 생각된다. 따라서 호산구성 수막염의 원인을 잘 고려하여 불필요한 검사나 치료를 줄일 수 있을 것이며, 향후 다기관을 통한 분석이 필요하다.

혈관미주 신경성 실신 소아에서 기립경사 검사 동안에 뇌혈류 변화 (Change of Cerebral Blood Flow during Tilt Tests in Children with Vasovagal Syncope)

  • 김수정;염혜원;홍영미;유정현;이숙희;김종희
    • Clinical and Experimental Pediatrics
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    • 제46권10호
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    • pp.983-988
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    • 2003
  • 목 적 : 실신은 소아에서 가장 흔한 증상이지만 기전은 잘 알려져 있지 않다. 증가된 미주신경의 활동과 감소된 교감신경의 자극이 저혈압, 서맥을 일으키고 마침내는 의식 소실을 초래한다. 이 연구의 목적은 혈관미주 신경성 실신으로 진단된 소아에서 기립경사 검사를 하는 동안 뇌 도플러 초음파를 실시하여 실신 전후의 뇌혈류 속도와 혈압, 심박동수 변화를 측정하고자 하였다. 방 법 : 실신의 과거력을 갖고 있는 64명의 소아를 대상으로 혈압을 10분간 안정 후와 15분 동안 기립 후에 측정하였고, 기립 경사 검사는 $80^{\circ}$에서 45분간 시행하였다. $80^{\circ}$ 각도의 경사 테이블에서 소아를 5분 간격으로 45분 동안 혈압, 심박동수, 산소 포화도를 측정하였다. 기립경사 검사를 하는 동안 실신이나 실신 전 증상이 나타난 소아에서는 검사를 중단하였다. 12-유도 심전도, 뇌파 검사, 심장 초음파를 시행하였다. 기립경사 검사에서 양성으로 나온 10명의 소아에서 Acouson 128XP/10 model 초음파 기기를 이용하여 중 대뇌동맥 혈류 속도, pulsatility 지수, time velocity integral, 혈압, 심박동수, 산소포화도 등을 측정하였다. 결 과 : 기립경사 검사에서 31.3%(20/64)의 양성률을 보였다. 검사 동안에 혈압과 맥박은 감소되지 않았고 뇌혈류 속도와 integral은 유의하게 감소되었다. 결 론: 뇌혈류 속도는 혈압이나 심박동수가 감소하기 전에 미리 감소하므로 실신 전 증상을 미리 예측할 수 있다. 뇌혈류의 자율 조절의 장애가 혈관미주 신경성 실신의 병인론에 중요한 역할을 하리라 생각된다.

비만 환자에 대한 조위승청탕의 효과 및 부작용에 관한 임상적 고찰 (Clinical Observation on Effects and Adverse Effects of Choweseuncheng-tang on Obesity Patients)

  • 서동민;이상훈;이재동
    • Journal of Acupuncture Research
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    • 제22권3호
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    • pp.145-153
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    • 2005
  • 비만이 질병으로 인식되기 시작하면서 치료에 대한 관심이 높아져 가고 있으며, 한방 치료에 대한 효과 및 부작용에 대한 연구가 필요한 실정이다. 이에 의정부 한방병원에 비만 치료를 위해 내원한 20명을 대상으로 조위승청탕 가미방 치료 후에 조사한 결과는 다음과 같다. 1. 비만 환자 20명에 대한 전기침 치료 및 약물 요법 치료 후 체중감소 결과는 치료 1주 후 평균 $1.33{\pm}0.85kg$, 2주 후에 평균 $2.45{\pm}1.64kg$, 3주 후에 평균 $3.25{\pm}2.09kg$, 4주 후에 평균 $4.15{\pm}2.38kg$이 감소된 것으로 나타났으며, BMI는 치료 4주 후 $1.62{\pm}1.05$ 감소된 것으로 나타났다. 2. BMI 기준으로 4주 치료 후 위험체중에서 평균 $3.15{\pm}1.74kg$ 감소하였고, 비만 Class I에서 평균 $3.57{\pm}1.62kg$ 감소하였으며, 비만 Class II에서 평균 $6.98{\pm}2.88kg$ 감소하였다. 3. 태음인에서 $4.47{\pm}2.51kg$가 감소되었으며, 소음인에서 $3.20{\pm}0kg$ 감소되었으며, 소양인에서 $2.50{\pm}1.93kg$ 감소되었다. 4. 복약이후 식욕의 감소에 따른 체중감소량은 식욕의 저하군에서 평균 $4.94{\pm}2.64kg$ 감소하였고, 보통에서는 $3.35{\pm}1.25kg$ 식욕 증가 군에서는 $2.25{\pm}2.62kg$ 감소하였다. 5. 치료 후 체지방율은 평균 $3.16{\pm}1.25%$ 감소되었다. 6. 치료 전 후에 혈압과 맥박 모두 증가나 감소는 없었으며, 정상적으로 나타났으며, 치료 전 측정한 수치와 치료 4주 후에 재측정한 BUN, Cr, GOT, GPT는 모두 참고치 이하에서 변화를 보여 정상 소견으로 나타났으며, 각종 호소 증상으로 자율신경계 항진 증상은 11명이 호소하였으며, 불면이 1례, 발한이 9례, 심계 항진이 1례였다. 위장관 증상은 7명이 호소하였으며, 오심이 3례, 복통이 4례였으며 기타 증상으로 3명이 호소하였으며 두통이 2례 현훈이 1례였다.

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감염성 심내막염의 외과적 치료 (Surgical Treatment of Native Valve Endocarditis)

  • 김애중;김민호;김공수
    • Journal of Chest Surgery
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    • 제28권9호
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    • pp.822-828
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    • 1995
  • This paper reports 15 native valve endocarditis cases had surgical operation in the past 10 years at the department of Cardiovascular and Thoracic Surgery, Chonbuk National University Hospital. In this study, 10 cases out of 15 were in class I or II by the New York Heart Association functional classification. None of the cases had a history of taking addictive drugs. Five cases were congenital heart disease, three cases were rheumatic heart disease and two cases were degenerative heart disease. Thus 10 cases had the underlying disease. All cases had antibiotics treatment for 3 to 6 weeks before operation. In the culture test, only four cases were positive in the blood culture and one case was positive in the excised valve culture. Organisms on blood and valve culture were Streptococcus epidermis, Streptococcus viridans, Staphylococcus aureus and Staphylococcus epidermidis. In the 10 cases without ventricular septal defect, the aortic valve was involved in four, mitral in four, both in two and involved valves in the 5 cases with ventricular septal defect were tricuspid in three, pulmonic in two. Eight cases had operation because they showed moderate congestive heart failure due to valvular insufficiency and vegetation with or without embolism. Seven cases had operation because they showed persistent or progressive congestive heart failure and/or uncontrolled infection. Five cases with ventricular septal defect underwent the closure of ventricular septal defect, vegetectomy and leaflet excision of the affected valves without valve replacement. In the cases without ventricular septal defect, the affected valves were replaced with St. Jude mechanical prosthesis. Postoperative complications were recurrent endocarditis in two, embolism in one, allergic vasculitis in two, spleen rupture in one and postpericardiotomy syndrome in one. At the first postoperative day, one case died of cerebral embolism. At the 11th postoperative month, one case died of recurrent endocarditis and paravalvular leakage in spite of a couple of aortic valve replacement. In the survived cases[13 cases in this study , all cases but one became class I or II by the New York Heart Association functional classification.

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"온사상수(溫邪上受)" 개념의 형성요인에 대한 고찰 (A Study on the Development of the Understanding that the Cause of Warm Pathogen Lies in Upper Portion of Body)

  • 은석민
    • 대한한의학원전학회지
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    • 제30권2호
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    • pp.11-29
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    • 2017
  • Objectives : Contemporary researches suspect that, contrary to the past belief, the understanding that the cause of warm pathogen lies in the upper portion of human body is an understanding that had been well-established even before Yetianshi. This new understanding now requires us to contemplate the process of theoretical development which this understanding, termed Onsasangsu, had taken within the boundary of the theory of warm pathogen. This paper aims to shed light on this within the framework that this is the emergence of a new theory of warm pathogen caused by a new understanding of warm pathogen. Methods : First, the theories of warm pathogen as developed by historical doctors were studied, and elements that seem to be related to the understanding of Onsasangsu were selected and studied to understand their theoretical characteristics. Furthermore, the paper studied what academic significance do these theories have on the development of the theory of warm pathogen. Results & Conclusions : Provided that the underlying assumption of Onsasangsu is that febrile diseases are caused through moutn and nose, the study showed that this understanding arose before the period of Qing Dynsasty from the need by many doctors to differentiate the pathogens of various diseases such as the disease of heat, febrile disease, and epidemic. The reason that these discussions could not have much impact on the study of febrile disease during the Qing Dynasty could be because they were not passed on down to the future generations, or because commonly held perspective was unable to accept criticisms.

비행청소년 인성치료를 위한 독서요법 (Bibliotherapy for human nature therapy of the juvenile delinquent)

  • 변우열
    • 한국도서관정보학회지
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    • 제26권
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    • pp.131-168
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    • 1997
  • The future of a country is influenced by the youth. Sound fostering of the youth is important for the country's future. Because of mechanization, industrialization and urbanization of our society, many social problems, such as confusion of the sense of value, dehumanization, money worshi n.0, ppings, juvenile delinquency are increasing. For the solution of problems of juvenile crime and dehumanization, bibliotherapy should be practiced in juvenile reformatories, schools and societies. The purpose of this study is to investigate the effectiveness and value of reading. And also the characteristics, brief history, principles and procedures of bibliotherapy are examined. In addition, the book catalog suitable for bibliotherapy is considered. The results of the study are as follows. (1) In order to solve the problem of dehumanization, and the confusion of the sense of value among young adults, we should enrich and cultivate the characters of young adults through the bibliotherapy. So, bibliotherapy for the treatment of human nature of juveniles should be practiced in the juvenile reformatories, schools and societies. (2) The values of reading in the past were inspiration, information and recreation. But, in recent times, the interest in therapeutic value of reading is increasing. (3) Bibliotherapy is a kind of psychotherapy using selected reading materials. A n.0, pplication scopes of bibliotherapy are very wides, including mental medicine, alcoholic poisoning, drug addiction, juvenile delinquency, counselling and education for school life, etc. (4) The principles of bibliotherapy consist of identification, catharsis, insight and it has self therapeutic principles through the reading. The procedures of bibliotherapy is similar to any other kind of psychotherapy: the participant's statement, diagnosis, treatment, continuous recognition of remedial value. (5) The well suited reading materials for bibliotherapy are literature and biography. Literature and biography are familiar to everyone, because they describe the mentalities, emotions and life styles of human beings. (6) The standard reading lists for bibliotherapy for the proper guidance of juvenile delinquency should be prepared for the solution of developmental tasks, such as, drinking, smoking, friendship, family, love, money, marriage, pregnancy, violence, etc. Finally, Bibliotherapy should be introduced to our school settings and corrections institutions for the proper guidance and prevention of the malpractice of the youths. In addition, we should be endeavor to develop the standard reading lists for bibliotherapy and case study.

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정상 성인의 발목에 부가된 하중에 의한 보행 중 에너지 소모도 변화 (Change of energy consumption according to loading on the ankle of normal adults during gait)

  • 김봉옥;채수성;김용건;한동욱
    • The Journal of Korean Physical Therapy
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    • 제11권2호
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    • pp.43-50
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    • 1999
  • The purpose of this study was to evaluate the change of the energy consumption when loading to leg of the 60persons who don't have past history of cardiopulmonary and neuromuscular disease, To evaluate the change or energy consumption, heart rate was measured in sitting position for 5minute, during walking for 3minute at for 4.8km on treadmill, and during resting state after walking with 1Kg loading to right ankle, and the other 1Kg loading was added to left ankle and then heart rates were measured in the The results were as follow; 1. PCI value without loading to Ankle were significantly increased compared to 1Kg, and 2Kg. (p<0.05) 2. Female Subjects showed mon increased PCI value in without leading and 2Kg loading compared to male subjects. ( p<0.05) 3. When 1Kg ana 2Ka loading to ankle significantly differences were showed between them. (p<0.05) 4. In the case of 1Kg and 2Kg loading, the difference among age groups was observed and the significant difference among PCI, PCI 1kg, PCI 2kg was showed in the only group that is less than 30 years old. 5. In every PCI condition the difference among height groups was observed and the significant difference among PCI conditions was showed in the only group that is less than 165cm. 6. The difference among weight groups in each PCI condition was not observed, but the significant differences among PCI conditions was showed in every group except the group that h from 60kg to 69kg. These results showed that energy consumption was increased according to loading on the ankle during Sate so weight of orthosis or prosthesis met be considered when choosing them and during gait training with these ones.

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Colorectal Cancer Screening in High-risk Populations: a Survey of Cognition among Medical Professionals in Jiangsu, China

  • Chen, Yao-Sheng;Xu, Song-Xin;Ding, Yan-Bing;Huang, Xin-En;Deng, Bin;Gao, Xue-Feng;Wu, Da-Cheng
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.6487-6491
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    • 2013
  • To investigate the cognition of medical professionals when following screening guidelines for colorectal cancer (CRC) and barriers to CRC screening. Between February 2012 and December 2012, an anonymous survey with 19-questions based on several CRC screening guidelines was randomly administered to gastroenterologists, oncologists, general surgeons, and general practitioners in Jiangsu, a developed area in China where the incidence of CRC is relatively high. The average cognitive score was 26.4% among 924 respondents. Gastroenterologists and oncologists had higher scores compared with others (p<0.01 and p<0.01, respectively); doctor of medicine (M.D.) with or without doctor of philosophy (Ph.D.) or holders with bachelor of medical science (BMS) achieved higher scores than other lower degree holders (P<0.05). More importantly, doctors who finished CRC related education in the past year achieved higher scores than the others (p<0.001). The most commonly listed barriers to referring high-risk patients for CRC screening were "anxiety about colonoscopy without anesthesia", "lack of awareness of the current guidelines" and "lack of insurance reimbursement". Lack of cognition was detected among doctors when following CRC screening guidelines for high-risk populations. Educational programs should be recommended to improve their cognition and reduce barriers to CRC screening.

Fluorescence-in-situ-hybridization in the Surveillance of Urothelial Cancers: Can Use of Cystoscopy or Ureteroscopy be Deferred?

  • Ho, Christopher Chee Kong;Tan, Wei Phin;Pathmanathan, Rajadurai;Tan, Wei Keith;Tan, Hui Meng
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권7호
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    • pp.4057-4059
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    • 2013
  • Background: Fluorescence in situ hybridization (FISH) testing may be useful to screen for bladder carcinoma or dysplasia by detecting aneuploidy chromosomes 3, 7, 17 and deletion of the chromosome 9p21 locus in urine specimens. This study aimed to assess the sensitivity, specificity, positive and negative predictive value of FISH in a multi-ethnic population in Asia. Materials and Methods: Patients with haematuria and/or past history of urothelial cancer on follow-up had their voided urine tested with FISH. Patients then underwent cystoscopy/ureteroscopy and any lesions seen were biopsied. The histopathological reports of the bladder or ureteroscopic mucosal biopsies were then compared with the FISH test results. Results: Two hundred sixty patients were recruited. The sensitivity and specificity of the FISH test was 89.2% and 83.4% respectively. The positive (PPV) and negative predictive values (NPV) were 47.1% and 97.9%. By excluding patients who had positive deletion of chromosome 9, the overall results of the screening test improved: sensitivity 84.6%; specificity 96.4%; PPV 75.9% and NPV 97.9%. Conclusions: UroVysion FISH has a high specificity of detecting urothelial cancer or dysplasia when deletion of chromosome 9 is excluded. Negative UroVysion FISH-tests may allow us to conserve health resources and minimize trauma by deferring cystoscopic or ureteroscopic examination.

사관혈(四關穴)자침이 체열변화에 미치는 영향 (Study on thermographic change of DITI by acupuncture on sakwan point)

  • 조원영;박쾌환
    • Journal of Acupuncture Research
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    • 제20권1호
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    • pp.51-60
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    • 2003
  • Objective: Hapkok(L14) and Taechung(Liv3) are acupuncture points located on both sides of each foot and hand of the human body. These two points are called sakwan points. Matching these acupuncture points have a significant reason in pints of not only regulating the circulation of Yin-Yang as a source point of each meridian, but also playing a basic role of twelve meridian by controlling circulation of ki and blood in the whole body. There are already related documents and studies on stimulating sakwan points. Since those papers mostly studied on either hapkook or taechung, we came to have a doubt of stimulation the two point at the same time when an unbalance of Yin-Yang and ki-blood appears. Accordingly, we got to investigate how thermogram of body changes after applying an acupuncture on sakwan points. Our study is as follows ; Method : Our study was performed on 30 normal cases(M:F=17:13) with no past history to observe the effects of the acupuncture. We measured temperature of abdomen and the back of both hands by D.I.T.I(Digital infrared Thermographic Imaging) before and after acupuncture on sakwan points. Results and Conclusions: The thermographic change on abdomen was $0.51{\pm}0.71^{\circ}C$. Temperature of abdomen after acupuncture was higher than before acupuncture with high validity(p<0.01). And the thermographic changes on the back of both hands were right hand $0.54{\pm}1.17^{\circ}C$, left hand $0.56{\pm}1.28^{\circ}C$. Temperature on the back of both hands after acupuncture was higher than before acupuncture, but the difference between them had little validity(p<0.01). In addition, we found that it doesn't necessarily follow that the thermographic changes on abdomen and back of both hands after acupuncture on sakwan points happen concurrently.

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