• Title/Summary/Keyword: 외래치료

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The Analysis of Related Variables on the Center of Gravity Deviation: Focus on the Musculoskeletal Pain (중력중심 이동과 관련 변인분석 -근골격계 통증을 중심으로-)

  • Ko, Tae-Sung;Joung, Ho-Bal
    • Physical Therapy Korea
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    • v.10 no.4
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    • pp.85-94
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    • 2003
  • 본 연구에서는 근골격계 통증이 자세유지와 균형능력에 핵심이 되는 중력중심 이동에 미치는 영향에 대해 알아봄으로서, 균형과 자세에 영향을 주는 다양한 요소들에 대한 새로운 접근을 시도해 보고자 한다. I-병원의 입원 및 외래 환자 중 신경계 손상이 없고 중력중심 이동에 직접적인 영향을 줄 수 있는 하지에 정형외과적 장애가 없으며, 전정계 손상이나 시력장애로 인한 균형에 문제가 없이 근골격계 질환으로 요통과 견통을 주소로 하는 71명의 환자(남자 38, 여자 33; 평균연령=44, 표준편차=13.8, 범위=19~79)와 신경계, 근골격계 및 평형감각에 문제가 없는 정상인 30명의 대조군(남자 16, 여자 14; 평균연령=39.2, 표준편차=13.7, 범위=21~72)을 대상으로 전산화된 힘판을 이용하여 중력중심 이동의 궤적을 표준편차값으로 측정하였다. 측정된 중력중심 이동값은 두 군간에 상이한 차이를 보이고 있음이 검증되었다(p<.01). 또 측정된 여러 변수들의 중력중심 이동에 대한 영향력을 알아보기 위해 나이, 체중 및 신장과 중력중심 이동과의 상관분석 결과 중력중심 이동의 15.8%를 체중의 변화에 의한 것으로 설명할 수 있다는 결과를 얻었으며, 그 외의 변수들과의 연관성에 대해선 유의미한 차이가 없었다(p<.01). 결과적으로 근골격계 통증은 올바른 자세유지와 균형유지를 위한 감각통합과 반응과정에 직접, 간접적으로 영향을 미치고 있다. 따라서 중력 중심 이동이 크면 클수록 중심을 잡기 위한 근육활동으로 추가적인 에너지가 사용되고, 편중된 중력중심 이동은 근골격계에 무리한 부담을 주어 통증을 증가시킬 수 있을 것이다. 또 통증으로 인한 중력중심 이동은 이를 보상하기 위해 신체 먼 곳에서의 이차적인 변형을 초래하여 각종 근골격계 증상의 원인이 될 수 있으므로 근골격계에 대한 적절한 치료는 통증을 감소시켜 자세의 이차적인 변형을 막고 자세유지 시 작용하는 근육의 에너지 효율을 높일 수 있을 것으로 사료된다.

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A Case of Gilbert's Syndrome with Severe Neonatal Hyperbilirubinemia

  • Hong, Ye-Seul;Jin, Jang-Yong;Lee, Woo-Ryoung
    • Neonatal Medicine
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    • v.17 no.2
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    • pp.266-269
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    • 2010
  • Gilbert's syndrome is caused by a reduction in the activity of uridine diphosphate glucuronosyltransferase (UGT) and induces chronic, non-hemolytic unconjugated hyperbilirubinemia. It has been suggested that 3-10% of the population has Gilbert's syndrome. Commonly, Gilbert's syndrome causes mild symptoms. However, a case of Gilbert's syndrome with severe neonatal hyperbilirubinemia is presented here. The patient developed jaundice three days after birth. Five days after birth, the patient's total serum bilirubin level was 34 mg/dL. The patient received intensive phototherapy and was given oral phenobarbital. Hemolytic hyperbilirubinemia was excluded on the basis of laboratory tests. Heterozygote polymorphisms of the promoter region (-3279T>G) and exon 1 (211G>A) were found in UGT1A1 gene. After discharge, the patient did not require any further treatment. This is the first case of proven Gilbert's syndrome with severe neonatal hyperbilirubinemia in Korea.

Perforation of IVC by Chest Draings Tube -Report A Case (흉강삽관술시 하대정맥 천공 치험 1례)

  • Jeong, Won-Seok;Mun, Dong-Seok
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1128-1131
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    • 1997
  • Injuries to versa cave continue to be associated with a high mortality. Essentials to successful treatment are immediate recognition of the injury and prompt control of the hemorrhage. We have experienced one case of inferior versa java perforation by a chest rainage tube in the patient with post-operative chronic empyema thoracic. The patient was 38-year old male who was taken RLL lobectomy after 6 cycle of chemotherapy due to small cell carcinoma in the RLL & suffered from post-operative chronic empyema thoracis at D hospital. He moved to our hospital for further evaluation with accidental removal of chest drainge tube. We inserted closed drainage tube and dark blood gushed out abruptly just after insertion of the drainage tube. CTscan, MRI, and angiogram were performed and showed the perforation of IVC just below RA. The IVC was repaired using simple interrupted 4-0 Prolene suture through right posterolateral thoracotomy. The patient recovered without event and doing well until now.

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Alveoloar Rhabdomyosarcoma of Tongue Base in an Infant : A Case Report (영아의 설근부에 발생한 폐포성 횡문근육종 1예)

  • Kim, Jisung;Yeon, Je Yeob;Park, Jae-Hong;Lee, Yong-Moon;Lee, Dong Wook
    • Korean Journal of Head & Neck Oncology
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    • v.29 no.2
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    • pp.75-78
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    • 2013
  • 영아의 설근부에 발생하는 악성 종양은 매우 드물다. 저자들은 연하곤란과 폐쇄성 수면 무호흡증으로 의뢰된 17개월 남아의 설근부에 발생한 횡문근육종을 경험하였기에 문헌고찰과 함께 보고하는 바이다. 외래에서 실시한 이학적 검사 상 설근부 전체가 돌출되어 있었으며 단단한 종괴가 촉지 되었다. 조직검사와 기관절개술을 시행하였으며 컴퓨터단층촬영, 양전자 방출 단층 촬영 그리고 뼈 스캔과 함께 염색체 분석을 실시하였다. 조직검사 결과 폐포성 횡문근육종이 확인되었으며 전이의 증거는 없었다. 염색체 분석상 폐포성 횡문근육종에 상응하는 PAX7-FKHR 유전자 전좌가 발견되었다. 8 회의 항암화학요법과 방사선 치료 후 촉지되는 설근부의 종괴는 없었으며 환자가 호소하는 증상도 개선되었다. 추적 관찰 시 시행된 자기공명영상 결과 확연한 종괴 크기의 감소를 확인할 수 있었다. 횡문근육종은 매우 드문 악성 종양으로 수술과 함께 항암화학요법, 방사선치료 등 여러 치료 방법이 동원되지만 전이나 재발이 있을 시 예후는 매우 불량하다. 그러므로 영아에서 연하곤란, 호흡 곤란 등의 증상이 있을 시에는 설근부를 포함한 상부호흡소화관을 적극적으로 검사하여야 하며 악성 종양의 가능성을 염두에 두어야 하겠다.

Lymphoproliferative Disease After Lung Transplantation in Transplanted Lung (폐이식후 발생한 이식폐의 임파종 1예)

  • 이교준;김도형;함석진;김해균
    • Journal of Chest Surgery
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    • v.34 no.12
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    • pp.956-959
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    • 2001
  • The Iymphoproliferative disease after the organ transplantation is more commonly seen with the increase according to the increasing number of the organ transplantations and it occurs more frequently in the cases of heart and lung transplantations that needs more aggressive immunosuppression. It demands urgent evaluation and management because of poor prognosis. We transplanted left lung of a man to the woman who suffered from severe dyspnea due to terminal pulmonary emphysema in discrepancy of ABO blood type. Postoperatively, We used triple regimen immunotherapy(cyclosporin, azathioprine, prednisolone) and followed up in the out patient clinic. During the follow up, we found abnormal mass lesion on the transplanted lung and performed gun biopsy. We confirmed malignant lymphoma on the pathollgic examination and two cycled chemotherapy was given after reducing dose of immunosupression. The patient died of sudden onset of pulmonary edema of the transplanted lung.

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Loss of Disc Height after Spontaneous Regression of a Herniated Lumbar Disc - A Case Report - (탈출된 요추 추간판 자연 소실 후 발생한 추간판 간격 감소 - 증례 보고 -)

  • Kim, Hyoung Bok;Chung, Hoon-Jae
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.175-179
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    • 2018
  • Study Design: Case report. Objectives: We report 3 cases of loss of disc height after spontaneous regression of a herniated lumbar disc. Summary of Literature Review: Reports of spontaneous regression of a herniated lumbar disc were identified. Materials and Methods: We conservatively treated 3 patients who were diagnosed with a herniated lumbar disc. During outpatient follow-up, radiating pain improved in all patients, but they complained of chronic lower back pain. Magnetic resonance imaging (MRI) was performed for diagnostic purposes. Results: On MRI, spontaneous regression of the herniated lumbar discs was observed, but loss of disc height was also found. Conclusions: A herniated lumbar disc may be a risk factor for loss of disc height. It is important to recognize that a patient with a herniated lumbar disc can struggle with chronic lower back pain even if spontaneous regression of the herniated lumbar disc occurs.

MAGNETIC RESONANCE IMAGING FINDINGS OF THE BRAIN IN AUTISTIC CHILDREN (자폐장애 아동의 뇌자기공명영상 소견)

  • Park, Pil-Sang;Jung, Chul-Ho;Choi, Sang-Yong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.1
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    • pp.113-122
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    • 1997
  • The purpose of this study was to examine brain structural abnormalities in autistic children. Magnetic resonance imaging(MRI) findings in 22 male children with a DSM-Ⅲ-R diagnosis of autistic disorder and 17 non-autistic male control children were investigated. The ratio measures by lineometry was used to examine the cerebrum, midbrain, cerebellum, brain stem and ventricular system. The left to right ratio of the lateral ventricle was larger in autistic children than in controls. The pons was significantly larger in autistic children than in controls, and the cerebellum was smaller in autistic children. There were no significant differences between autistic children and controls in the symmetricity of the fontral lobe, parietal lobe, occipital lobe and temporal lobe, and in the size of the midbrain and 4th ventricle. These findings suggest that autistic disorder may be related to structural impairment of the brain.

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Viral Etiology and Epidemiology of Outpatients with Acute Respiratory Illnesses in Busan: 2007-2008 (부산지역 급성 호흡기 증상으로 외래 방문한 환자의 바이러스 원인과 역학: 2007-2008년)

  • Jeong, Jin Woo;Hwang, Youn Ha;Cho, Kyung Soon;Jung, Myung Ju;Min, Sang Kee;Kim, Seong Joon;Chung, Woo Sik
    • Pediatric Infection and Vaccine
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    • v.17 no.2
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    • pp.130-136
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    • 2010
  • Purpose : The purpose of this study is to identify the viral etiology of acute respiratory illnesses and to determine epidemiology in outpatients in Busan, Korea. Methods : We collected nasal wash samples from 990 patients who visited the hospital for acute respiratory illnesses between January 2007 and December 2008. Extracted DNA or RNA from specimens was used for viral detection by an RT-PCR method. Results : Of a total of 990 samples, viruses were detected in 351 cases (35.5%). The ratio of male to female was 1.6:1 and 93.7% were less than 5 years old. Rhinovirus was detected year-round in 202 cases (57.5%), respiratory syncytial virus from October to March in 57 cases (16.2%), adenovirus year-round in 37 cases (10.5%), influenza virus from December to April in 21 cases (6%), bocavirus from January to August in 15 cases (4.3%), parainfluenza virus from April to July in 9 cases (2.6%), coronavirus from January to July in 7 cases (2%), and enterovirus from June to September in 3 cases (0.9%). Conclusion : We identified the etiology and epidemiology of viruses that caused the acute respiratory diseases that were prevalent in Busan, 2007-2008. Further surveillance will be necessary.

Effects of the Mother's about Amblyopia Occlusion Therapy (약시아동 어머니의 가림치료 교육의 효과)

  • Han, Seung-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.8
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    • pp.369-378
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    • 2016
  • The purpose of this study was to determine the effects of mother's education about amblyopia occlusion therapy on parenting stress and efficacy and the visual acuity improvement of the amblyopia child. The study was designed as a nonequivalent control group pretest posttest quasi-experimental study. The mothers with amblyopia children who signed the consent form were assigned to one of two groups, the experimental group (29) and control group (31). The data were collected from March 5 to October 5, 2010, at G university hospital outpatient department located in G city. The subjects in the experimental group participated in the Mothers Education about Amblyopia Occlusion Therapy for 24 weeks, which included face to face consultations, telephone counseling, etc.. The degree of parenting stress and efficacy were measured by using questionnaires and the visual acuity was measured by visual examination. The data were analyzed using the ${\chi}^2-test$, Fisher's exact probability test, t-test and Repeated Measure ANOVA using SPSS PC+20.0 for Windows. The following results were found after the therapy. The experimental group had statistically significantly higher visual acuity (Rt, F=40.64, p<.001, Lt, F=10.28, p<.001), lower parenting stress scores (F=9.85, p=.003) and higher parenting efficacy scores (F=22.19, p<.001) than the control group. In conclusion, the Mothers about Amblyopia. Occlusion Therapy Education Program was effective in improving the visual acuity of the amblyopia children, and decreasing the parenting stress and enhancing the parenting efficacy of their parents.

Sudden Deafness (돌발적난청)

  • 조중환;류태현
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1976.06a
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    • pp.85.3-86
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    • 1976
  • Sudden deafness requires immediate investigation and treat if there is to be any prospect of salvaging the hearing. It present an otological emergency and a diagnostic challenge. Sn Sudden sensorineural deafness can be caused by a wide variety of pathologies. A battery of tests and investigations must be performed forthwith if treatment is to be started without further delay. The concept that nothing can be done for the patient with sensori-neural deafness must be abandoned. Some pathologies causing sudden deafness are not amenable to therapy or can show only partial reversibility. But there are several causes, showing little or no spontaneous recovery, which do responed to appropriate treatment. It is important to identify them and concentrate on their management. The age and sex ratios and the unilaterral or bilateral nature of the lesion are related to the etiology and depend upon which type of case is included in the series. Though individually rare, collecting for about 2.5 per cent of new otoloical patients. Some 70 per cent of cases are unilateral. Viral, bacterial and treponemal infections accounted for about 30 per cent of the cases. Some 16 per cent were due to vascular lesions of the cochlea. In almost 22 per cent there was no obvious cause (idiopathic), they occurred in young adult and were either sensory or neural. About 12 per cent were traumatic and 9 per cent were ototoxic in origin. The remaining 11 per cent were due to a group of rarities. The two vital factors are the site of the lesion and the duration of the hearing loss. The earlier these are diagnosed and treated the better the response. The etiology, pathology and treatment are reviewed.

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