• Title/Summary/Keyword: 목표증상

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Dental Management in a Patient with Glanzmann's Thrombasthenia : A Case Report (글란즈만 혈소판무력증 환자의 치과적 관리)

  • Han, Miran;Kim, Jongsoo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.3
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    • pp.352-358
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    • 2020
  • Glanzmann's thrombasthenia (GT) is a rare, autosomal recessive inherited congenital disorder, characterized by impaired blood coagulation due to platelet dysfunction. It was first reported by the pediatrician Glanzmann in 1918. GT affects both males and females, and it is more common in regions of the Middle East, India, and France, where intermarriage is common. It has an incidence of about 1 in 1,000,000 people. In South Korea, according to the Division of Rare Diseases, Korea Centers for Disease Control and Prevention, around 200 cases have been reported in 2018. Clinical symptoms include petechia, ecchymosis, epistaxis, and gingival bleeding. The spontaneous loss of deciduous teeth can result in excessive bleeding with that blood transfusion should be considered. Preventing hemorrhages and hemostasis are most important factors in dental treatment. Local bleeding can be controlled by compression, but platelet transfusion can be required by prolonged bleeding. Pediatric dentists can minimize the gingival bleeding by control of the oral hygiene to prevent gingivitis and dental caries. The importance of oral hygiene and periodic recall check-up should be emphasized. During dental treatment, the examination and the treatment plan of patient should be modified to prevention of hemorrhages carefully. A 6-year-old girl with GT was referred for the treatment of dental caries, and resin restoration was performed under nitrous oxide inhalation sedation. After treatment, compression was required for the bleeding control.

Hospice and Palliative Care in Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환의 호스피스 완화의료)

  • Shin, Jinyoung;Park, Hye Yun;Lee, Jungkwon
    • Journal of Hospice and Palliative Care
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    • v.20 no.2
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    • pp.81-92
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    • 2017
  • Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation that is usually progressive. It is a major cause of morbidity and mortality worldwide, leading to substantial and increasing economic and social burden. Palliative care for COPD patients aims to reduce symptoms and exacerbations and improve exercise tolerance and quality of life. It is difficult to make a prognosis for COPD patients due to the variable illness trajectory and advanced care of patients. However, severity of breathlessness, assessment of lung function impairment, and frequency of exacerbations can help to identify palliative care needs and determine effective methods to mitigate symptoms, which is discussed in this paper. In these patients, it is recommended to provide individualized palliative care along with curative/restorative care at the onset of COPD symptoms. Before launching a palliative care system in Korea, it is necessary to prepare pulmonary rehabilitation resources, patient-centered communication, timely palliative responsiveness, and a program for effective advanced care planning. A multidisciplinary approach involving collaboration with not only the respiratory and palliative care teams but also primary care offers a new model of care for these patients and should be considered with a priority.

Exploring Factors to Minimize Hallucination Phenomena in Generative AI - Focusing on Consumer Emotion and Experience Analysis - (생성형AI의 환각현상 최소화를 위한 요인 탐색 연구 - 소비자의 감성·경험 분석을 중심으로-)

  • Jinho Ahn;Wookwhan Jung
    • Journal of Service Research and Studies
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    • v.14 no.1
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    • pp.77-90
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    • 2024
  • This research aims to investigate methods of leveraging generative artificial intelligence in service sectors where consumer sentiment and experience are paramount, focusing on minimizing hallucination phenomena during usage and developing strategic services tailored to consumer sentiment and experiences. To this end, the study examined both mechanical approaches and user-generated prompts, experimenting with factors such as business item definition, provision of persona characteristics, examples and context-specific imperative verbs, and the specification of output formats and tone concepts. The research explores how generative AI can contribute to enhancing the accuracy of personalized content and user satisfaction. Moreover, these approaches play a crucial role in addressing issues related to hallucination phenomena that may arise when applying generative AI in real services, contributing to consumer service innovation through generative AI. The findings demonstrate the significant role generative AI can play in richly interpreting consumer sentiment and experiences, broadening the potential for application across various industry sectors and suggesting new directions for consumer sentiment and experience strategies beyond technological advancements. However, as this research is based on the relatively novel field of generative AI technology, there are many areas where it falls short. Future studies need to explore the generalizability of research factors and the conditional effects in more diverse industrial settings. Additionally, with the rapid advancement of AI technology, continuous research into new forms of hallucination symptoms and the development of new strategies to address them will be necessary.

Analysis and Usefulness of Microelectrode Recording during Deep Brain Stimulation Surgery in Movement Disorders (이상운동질환에 대한 뇌심부자극 수술 중에 미세전극 기록의 분석과 유용성)

  • Baek, Jae-Seung;Park, Sang-Ku;Kim, Dong-Jun;Park, Chan-Woo;Lim, Sung-Hyuk;Hyun, Soon-Chul
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.4
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    • pp.468-474
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    • 2019
  • Deep brain stimulation (DBS) is an effective surgical procedure for treating drug refractory movement disorders, and DBS involves delivering high frequency electrical stimulation to deep brain nuclei. Microelectrode recording (MER) is a complementary test that can precisely identify the location of deep brain nuclei, along with MRI correlation, during DBS surgery to improve the surgical outcome and minimize side effects. The purpose of this paper is to analyze the neuro-physiological waveforms and identify the usefulness of MER by analyzing the MER performed during DBS surgery for treating movement disorders. We retrospectively reviewed 28 patients who underwent MER during DBS surgery for movement disorders from January to December 2018. Of the 28 patients, 38 MERs for the subthalamic nucleus (STN), 10 MERs for the globuspallidusinternus (Gpi), and 4 MERs for the ventral intermediate thalamic nucleus (VIM) were performed. In all the cases, the target sites were found and micro-stimulations were used to check for side effects and to readjust the target sites. The clinical symptoms of all 28 patients improved after surgery. In conclusion, MER is a useful test that employs neuro-physiological waveforms to accurately identify the deep brain nuclei, along with MRI correlation, to improve the DBS surgical outcomes for movement disorders and to minimize side effects.

Oral-Motor Facilitation Technique (OMFT): Part I-Theoretical Base and Basic Concept (구강운동촉진기술: 1 부-이론적 배경과 기초 요소)

  • Min, Kyoung Chul;Seo, Sang Min;Woo, Hee-soon
    • Therapeutic Science for Rehabilitation
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    • v.10 no.1
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    • pp.37-52
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    • 2021
  • Introduction : Oral motor function is basic function of sensory exploration, feeding, and communication, that develops from the fetal stage to childhood. Problems with oral motor function result in difficulty within handling food in the oral cavity, decreased swallowing and feeding skills, difficulty with communication, and problems with oral hygiene. To treat these symptoms, oral motor therapy is provided for normalizing sensory adaptation in the oral cavity, and increasing postural control, oral movement and oral motor function. Discussion : The oral motor facilitation technique (OMFT) was developed for increasing general and integrated oral motor function based on the following: 1) understanding orofacial muscular physiology; 2) a comprehensive approach to sensory·adaptation·behavior·cognition; 3) sensorimotor stimulation by a manual approach; 4) motor control and motor learning theory. The OMFT is a new evidence-based treatment protocol, for children and adults with neuromuscular and oral motor problems. Conclusion : The goal of this article is to provide a theoretical background for OMFT development and the basic concept for the clinical application of OMFT. We hope that this article will help oral motor therapy experts to provide effective therapy in a more professional way.

매우 치사율이 높은 H5Nl 독감바이러스에 대한 킬러 T임파구 반응에 대한 연구

  • 서상희
    • Proceedings of the Korea Society of Poultry Science Conference
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    • 2002.11a
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    • pp.59-63
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    • 2002
  • 1997년 홍콩 가금시장에서의 H5N1 조류독감바이러스의 발병은 18명의 감염된 사람 중에서 6명의 사람의 생명을 앗아갔다. 이 사건은 조류독감바이러스가 매개체를 통하지 않고 닭에서 바로 사람에게 감염한 처음 있는 사건이다. 홍콩가금시장에서의 역학조사는 H5Nl과 H9N2 조류독감바이러스가 함께 공존한다는 것을 밝혔다. 가금에서는 H5N1과 H9N2 조류독감바이러스가 검출되었다. 우리는 H5N1 조류독감바이러스로부터 자을 방어하는데 H9N2 조류독감바이러스의 역할에 대해 연구했다. H5N1과 H9N2 바이러스의 혼합바이러스를 동시에 자에 접종하면 자은 생존하지 못했다. 그러나, H5N1 조류 독감바이러스감염 이전에 H9N2 조류독감바이러스를 감염한 닭들은 생존할 수 있었다 H9N2 조류 독감바이러스로 감염된 닭으로부터 얻어진 혈청은 H5N1 조류독감바이러스와 교차반응을 일으키지 않는다. H9N2 조류독감바이러스로 감염시킨 닭으로부터 얻어진 T임파구 또는 CD8 T임파구를 감염하지 않은 닭에 주입할 때 닭은 H5N1 조류독감바이러스로부터 생존할 수 있었다. 실험실외 킬러임파구실험은 H9N2 조류독감바이러스로 감염된 닭으로부터 얻어진 T임파구는 H5N1과 H9N2 조류독감바이러스로 감염된 목표세포를 동시에 감지했다. 게다가, 생체내 T임파구의 제거실험은 교차보호면역은 a/b TCR를 가진 CD8 T임파구가 중요한 역할을 하며, a/b TCR (Vbl)형의 T임파구가 목표세포를 감지한다는 것을 증명했다. H9N2 조류독감바이러스에 의한 방어면역은 시간이 지남에 따라 감소를 했고, 감염 100일까지 방어력을 나타냈다. 1997년 조류독감바이러스인 H5N1의 홍콩에서의 발병에 대한 풀리지 않은 것 중의 하나는 약 20%의 조류들이 매우 치사율이 높은 H5N1 독감바이러스를 가지고 있음에도 홍콩가금시장에서의 대부분의 닭들은 건강했다. 얻을 수 있는 정보에 따르면 대부분의 자들은 H5N1조류독감바이러스를 변으로 방출했고, 단지 두 곳의 가금시장에 있는 자들이 질병증상을 보였다. 홍콩가금시장에서 분리된 모든 H5N1 조류독감바이러스를 닭에 감염하면 100%의 치사율을 나타낸다. 바이러스 측면에서의 연구에 따르면, H9N2 조류독감바이러스는 홍콩가금시장에서 두 번째로 많이 분리되었다. H9N2 조류독감바이러스에 대한 연구에 따르면 세 가지 형이 홍콩가금시장에서 검출되었다. 1997년에 가장 많이 분리된 H9N2 조류독감바이러스는 PB1과 PB2가 A/Chicken/HongKong /156/97 (H5N1)과 유전적으로 유사한 A/HongKong/G9/97 (H9N2)형이다. A/Chicken/Hong Kong/156/97(H5N1)의 나머지 유전자는 A/Chicken/HongKong/739/94 (H9N2)와 A/chicken /Hong Kong/G23/97의 유전자와 비슷하다. 하나의 A/Quail/Hong Kong/G1/97은 Quail에서 분리되었고, 두 개의 A/Duck/Hong Kong/Y280/97 (H9N2)은 오리에서 분리되었다. A/Quail/Hong Kong/G1/97 (H9N2)의 6개의 내부유전자는 A/HongKon9/156/97 (H5N1)에 유사하나, A/Duck/ Hongkong/Y280/97 (H9N2)의 유전자는 A/HongKong/156/97 (H5N1)과 유사하지 않다. 킬러임파구는 바이러스로 감염된 목표세포를 MHC에 의존하여 파괴한다. 독감바이러스 특이 킬러임파구는 독감바이러스로 감염된 mice의 폐로부터 독감바이러스를 제거하는데 중요하다고 알려져 있다. 독감바이러스의 HA단백질은 특이 킬러임파구의 주요 목표항원 단백질이 아니다. 내부단백질인 nucleoprotein, polymerase (PB1 PB2, PA), Matrix protein, 그리고 비 구조단백질인 NS1에 대한 특이 킬러임파구의 반응이 사람과 mice에서 보고되었다. 독감바이러스에 대한 mice의 킬러임파구의 인식영역은 제한되어 있다고 알려져 있다. 많은 mice MHC 1은 독감바이러스 단백질의 킬러임파구의 epitope를 표현하지 못한다. 사람 기억킬러임파구는 다양한 종류의 독감바이러스의 단백질을 인식한다고 알려져 있다. 지금까지, 닭에서의 독감바이러스의 킬러임파구에 대한 연구는 되지 않았다.

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Cases and Literature Review of Timing for Withdrawal of Palliative Chemotherapy (진행성 암환자에서 완화적 항암치료 중단 시점의 결정에 대한 증례보고와 문헌고찰)

  • Jeong, Yun Jin;Kim, Do Yeun
    • Journal of Hospice and Palliative Care
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    • v.19 no.1
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    • pp.70-75
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    • 2016
  • Advanced incurable cancer patients receive palliative chemotherapy to prolong their life and improve quality of life. However, physicians should assess the timing to discontinue the treatment, especially near the final months of life, as palliative chemotherapy may accompany considerable toxicity. Even though there are no clear guidelines regarding the withdrawal timing for anticancer treatment in palliative setting, it is important clarify the issue for quality of care for advanced cancer patients. Here, we present two patients who received palliative chemotherapy for advanced colon cancer and non-small cell lung cancer, respectively. In both cases, it was jointly determined to stop palliative chemotherapy, and best efforts are made to relieve troublesome symptoms. The cases and up-to-date literature review will highlight the importance of the timing of discontinuation of cancer treatments when changes are being made to the health care system and hospice and palliative medicine is taking root in Korea.

Assessment and Treatment of Somatization (신체화의 평가 및 치료)

  • Koh, Kyung-Bong
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.2
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    • pp.149-164
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    • 2000
  • Somatization is regarded as a process rather than a diagnostic entity. It should be emphasized to identify psychopathology rather than to make a choice regarding diagnosis in assessing somatizing patients. Psychiatrists should be aware of the psychosocial cues underlying the patients' physical symptoms. Special skills and strategies are required by nonpsychiatric physicians to facilitate the patients' acceptance of psychiatric treatment. The goal of treatment for somatization is management but not cure. The approach should be flexible, depending on the patients' responses and need. The difficulty in diagnosing and treating somatization is likely to be related to abnormal illness behavior such as the patients' denial of their psychosocial problems and resistance to psychiatric approach. In conclusion, biopsychosocial approach is needed to treat these patients effectively. Psychiatrists should also teach other physicians the interview skill that they could identify these patients as early as possible and facilitate their acceptance of psychiatric treatment.

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Psychiatric Treatment of Chronic Pain Disorder (만성 통증장애의 정신과적 치료)

  • Rho, Seung-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.256-262
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    • 1999
  • Because chronic pain disorder may has multiple causes or contributing factors, including physical, psychological, and socio-environmental variables, the treatment of patients with the disorder requires biopsychosocial approaches in a multidisciplinary setting. In treating chronic pain, it is important to address functioning as well as pain, and treatment should be to increase functional capacity and manage the pain as opposed to curing it. Therefore treatment goal should be adaptation to pain or minimizing pain with corresponding greater functioning. Treatment begins with the initial assessment, which includes evaluation of psychophysiologic mechanisms, operant mechanisms, and overt psychiatric comorbidity. Psychiatric treatment of the patients requires adherence to sound pharmacologic and behavioral principles. There are four categories of drugs useful to psychiatrist in the management of chronic pain patients : 1) narcotic analgesics, 2) nonsteroidal antiinflammatory drugs, 3) psychotropic medications, and 4) anticonvulsants, but antidepressants are the most valuable drugs in pharmnacotherpy for them. Psychological treatments tend to emphasize behavioral and cognitive-behavioral modalities, which are divided into self-management techniques and operant techniques. Psychodynamic and insight-oriented therapies are indicated to some patients with long-standing interpersonal dysfunction or a history of childhood abuse.

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The Effectiveness of the Short-term Intensive Intervention Program: Case Report (감각통합기능장애 아동에게 적용한 단기집중치료프로그램의 효과)

  • Choi, Hyun-Ae;Kang, Eun-A
    • The Journal of Korean Academy of Sensory Integration
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    • v.6 no.1
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    • pp.25-33
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    • 2008
  • Objective : To identify the effectiveness of a short-term intensive intervention program on the improvement of adaptive response of a child with mixed sensory integration disorder. Method : Four and half years old boy who has been diagnosed of PDD received 40 min of one intervention session and 50 min of 3 intervention sessions. The intervention was a part of the 2008 Sensory Integration Treatment Course developed by the Korean Academy of Sensory Integration (KASI) and all sessions were implemented under supervision by experts. Result : Adaptive responses of the child were enhanced throughout the intervention process in terms of postural response and peer interaction. His oral defensiveness is improved. As the intervention progressed, he exhibited more active movements, louder voice, and coherence within peer group. Conclusion : This case report demonstrates effectiveness of a short-term intensive intervention program in terms of improving adaptive response. To enrich the effectiveness, tt is suggested to educate parents about neurological base of the child's behaviors so the they understand the importance of various sensory experience within play.

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