• Title/Summary/Keyword: 일차적 예방

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Clinical Applications and Efficacy of Korean Ginseng (고려인삼의 주요 효능과 그 임상적 응용)

  • Nam, Ki-Yeul
    • Journal of Ginseng Research
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    • v.26 no.3
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    • pp.111-131
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    • 2002
  • Korean ginseng (Panax ginseng C.A. Meyer) received a great deal of attention from the Orient and West as a tonic agent, health food and/or alternative herbal therapeutic agent. However, controversy with respect to scientific evidence on pharmacological effects especially, evaluation of clinical efficacy and the methodological approach still remains to be solved. Author reviewed those articles published since 1980 when pharmacodynamic studies on ginseng have intensively started. Special concern was paid on metabolic disorders including diabetes mellitus, circulatory disorders, malignant tumor, sexual dysfunction, and physical and mental performance to give clear information to those who are interested in pharmacological study of ginseng and to promote its clinical use. With respect to chronic diseases such as diabetes mellitus, atherosclerosis, high blood pressure, malignant disorders, and sexual disorders, it seems that ginseng plays preventive and restorative role rather than therapeutics. Particularly, ginseng plays a significant role in ameliorating subjective symptoms and preventing quality of life from deteriorating by long term exposure of chemical therapeutic agents. Also it seems that the potency of ginseng is mild, therefore it could be more effective when used concomitantly with conventional therapy. Clinical studies on the tonic effect of ginseng on work performance demonstrated that physical and mental dysfunction induced by various stresses are improved by increasing adaptability of physical condition. However, the results obtained from clinical studies cannot be mentioned in the indication, which are variable upon the scientist who performed those studies. In this respect, standardized ginseng product and providing planning of the systematic clinical research in double-blind randomized controlled trials are needed to assess the real efficacy for proposing ginseng indication. Pharmacological mode of action of ginseng has not yet been fully elucidated. Pharmacodynamic and pharmacokinetic researches reveal that the role of ginseng not seem to be confined to a given single organ. It has been known that ginseng plays a beneficial role in such general organs as central nervous, endocrine, metabolic, immune systems, which means ginseng improves general physical and mental conditons. Such multivalent effect of ginseng can be attributed to the main active component of ginseng,ginsenosides or non-saponin compounds which are also recently suggested to be another active ingredients. As is generally the similar case with other herbal medicines, effects of ginseng cannot be attributed as a given single compound or group of components. Diversified ingredients play synergistic or antagonistic role each other and act in harmonized manner. A few cases of adverse effect in clinical uses are reported, however, it is not observed when standardized ginseng products are used and recommended dose was administered. Unfavorable interaction with other drugs has also been suggested, which the information on the products and administered dosage are not available. However, efficacy, safety, interaction or contraindication with other medicines has to be more intensively investigated in order to promote clinical application of ginseng. For example, daily recommended doses per day are not agreement as 1-2g in the West and 3-6 g in the Orient. Duration of administration also seems variable according to the purpose. Two to three months are generally recommended to feel the benefit but time- and dose-dependent effects of ginseng still need to be solved from now on. Furthermore, the effect of ginsenosides transformed by the intestinal microflora, and differential effect associated with ginsenosides content and its composition also should be clinically evaluated in the future. In conclusion, the more wide-spread use of ginseng as a herbal medicine or nutraceutical supplement warrants the more rigorous investigations to assess its effacy and safety. In addition, a careful quality control of ginseng preparations should be done to ensure an acceptable standardization of commercial products.

The Short Term Clinical Follow-up Study for Hemiarthroplasty in Proximal Humeral Fracture (상완골 근위부 분쇄 골절에서의 상완골 두 치환술의 단기 추시 결과)

  • Sung, Chang-Meen;Cho, Se-Hyun;Jung, Soon-Taek;Hwang, Sun-Chul;Park, Hyung-Bin
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.92-98
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    • 2007
  • Introduction: The treatment of proximal humeral fracture is traditionally determined by Neer's classification system. The severely displaced three-part or four-part fracture is an indication for primary hemiarthroplasty. The current authors report the clinical results of 10 patients who received hemiarthroplasty for proximal comminuted fractures. The minimum follow-up period was 12 months. Materials and Methods: The current authors studied 10 patients who, between July 1999 and March 2005, each received hemiarthroplasty for a proximal humeral fracture of one shoulder. According to Neer's classification system, 5 of the patients had three-part fractures, and 5 of the patients had 4-part fractures. The mean interval between trauma and hemiarthroplasty was 6.1 days. The mean age of the 6 female and 4 male patients was 67.4 years(range: 56 to 76). Shoulder function was evaluated using the Constant score, the Simple Shoulder Test, and the modified UCLA score. Results: The mean Constant score was 51.4(range: 34 to 60). The mean modified SST score was 7.8 out of 12 tasks. Excluding the one patient who had also sustained an axillary artery rupture and a brachial plexus injury after the initial trauma, the mean Constant score for the remaining 9 patients was 53.5(range: 44 to 60), and the mean SST score was 7.2 tasks. The modified UCLA score averages for pain, function, and active forward flexion and strength were, respectively, 8.2($6{\sim}10$), 6.6($2{\sim}8$), and 6.9($4{\sim}8$). The total UCLA score was an average of 21.7($12{\sim}26$). Patients' the modified UCLA ratings were as follows: Excellent: 3, Good: 6, and Poor: 1. The patient with the poor outcome was the one who had also sustained the neurovascular injury. Patient's subjective satisfaction rating were as follows: Excellent: 2, Good: 7, and Poor: 1. Conclusion: Based on short term follow-up results, this study indicates that hemiarthroplasty is the treatment of choice for proximal humeral fractures on which it would be difficult to perform open reduction and internal fixation. Hemiarthroplasty is a useful treatment modality to prevent shoulder stiffness and to allow daily living tasks in elderly patients. However, restoration of muscle power and range of joint motion were not recovered satisfactorily.

Comparison of Efficacy of Steroid Oint with Different Potency in Phimosis (생리적 포경 치료를 위한 역가가 다른 스테로이드 연고의 효과 비교)

  • Hwang, In Ok;Lee, Eun Sil;Park, Yong Hoon
    • Clinical and Experimental Pediatrics
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    • v.48 no.6
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    • pp.594-598
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    • 2005
  • Purpose : Phimosis is the inability to retract the foreskin of the penis over the glans of the penis. Even though phimosis is not pathogenic, the presence of phimosis is known to increase the risk of urinary tract infection in infancy. The use of topical steroids has been advocated as a safe and economical alternative to surgical intervention. The purpose of the study was to assess the effectiveness of topical steroids for the treatment of phimosis in young boys. Methods : A total of 53 boys with phimosis were divided into two groups to distinguish between the efficacy of low-potency topical steroid(group 1, 27 cases) and of high-potency topical steroid (group 2, 26 cases). Results : The success rate increased in the process of time. After 6 weeks, the success rate was 21 cases in group 1 and 22 cases in group 2. There was no significant differences in treatment outcomes between the two groups. The age of the boys, the appearance of prepuce prior to treatment, and the presence of previous symptoms, including symptoms of UTI, and ballooning of the prepuce at micturation had no significant difference on treatment outcomes. Conclusion : Topical steroid was effective in treatment of phimosis in boys younger than 4 years old. Although treatment outcomes between low- and high-potency topical steroids were not significantly different, those treated with a high-potency steroid cream showed more fast improvement. Further studies are necessary to assess systemic side effects of steroid treatment, duration of treatment and prevention of genitourinary tract infection in male infants.

Morphologic Changes of the Pulmonary Arteries after Stent Implantation on Branch Pulmonary Artery Stenosis - Impact of Pulmonary Insufficiency - (폐동맥 분지협착에 스텐트 삽입 후 유발되는 폐동맥의 형태변화 - 폐동맥 폐쇄 부전의 역할 -)

  • Kim, Me Jin;Kang, Du Cheol;Choi, Jae Young;Lee, Jong Kyun;Sul, Jun Hee;Lee, Sung Kyu
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.67-75
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    • 2003
  • Purpose : Intravascular stent implantation for the treatment of postoperative branch pulmonary artery(PA) stenosis has been used successfully. However, the cross sectional area of contralateral branch PA does not regress in spite of the successful dilation of the stenotic branch PA after stent implantation. We analyzed the morphologic and hemodynamic factors on the size of branch PA after successful stent implantation. Methods : The subjects in our study were 23 children who had undergone stent implantaion from Jan. 1995 to Jul. 2002 in the Division of Yonsei Pediatric Cardiology. We evaluated the cross sectional area index(CSAI) of branch PA before and after stent implantation at follow-up catheterization. We also investigated factors such as residual pulmonary stenosis, pulmonary regurgitation(PR), systolic pressure of right ventricle, and lung perfusion scan. Results : The CSAI of the RPA without stenosis changed from mean $238{\pm}17mm^2/BSA$ to mean $249{\pm}20mm^2/BSA$(P=0.47), but didn't regress. The CSAI of the LPA with stenosis was increased effectively by stent implantation from the mean $102{\pm}12mm^2/BSA$ to mean $125{\pm}11mm^2/BSA$(P< 0.05). At follow up after stent implantation, the CSAI of PA is correlated with the residual PR fraction after stent implantation. Conclusion : In a group with increased residual PR, CSAI of RPA was found to be significantly increased between the pre- and post-stages of stent implantation. So, we suspect that the pulmonary regurgitation remaining after right ventricle outlet tract(RVOT) dilatation surgery is correlated with the increase in CSAI of RPA.

Sprachtypologische Fehleranalyse - Im Vergleich der deutschen und koreanischen Sprache - (독일어와 한국어를 비교한 언어 유형적 분석)

  • Park Jin-Gil
    • Koreanishche Zeitschrift fur Deutsche Sprachwissenschaft
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    • v.7
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    • pp.1-24
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    • 2003
  • 우리는 지금까지 독일어와 한국어 두 언어간의 오류분석을 논의해 왔다. 특히 언어유형학적인 측면에서 몇 가지 오류유형과 분석을 시도했다. 그 결과는 대체로 다음과 같이 요약될 수 있다. 독일어와 한국어가 서로 근본적으로 상반되는 언어현상과 더불어 약간의 공통성을 나타내며 일정한 유형을 나타낸다. 이는 두로 인간의 언어습득장치에 기인된 언어습득의 결정주의(Determinismus)에서 비롯될 것이다. 언어특성/문제의 체계성/규칙성 또는 일관성은 이를 반영한다. 거대한 언어자료 중에 극히 미미한 일부, 즉 언어최소량를 정복함으로써 그 효용성을 극대화할 수 있는 것은 매우 중요한 의미를 지닌다. 이를 연구 이용하는 경우에는 엄청난 효과와 가능성을 기대할 수 있을 것이다. (1) 독일어와 한국어의 학습 및 오류분석에서 가장 핵심적인 것은 언어유형학적으로 드러난 언어특성, 즉 전치성(독일어/영어)과 후치성(한국어)이다. 이를 토대로 형성된 대립적인 면과 공통적인 문제를 체계화하는 것이 역시 오류분석 문제의 관건이다. 또한 독일어가 아직 후치성 언어(한국어(TXV))에서 출발해서 전치성 언어(영어(SVX))로 발전/변화해 가는 과정, 즉 중간단계인 TVX에 머물고 있다는 사실이 중요한 의미를 지닌다. 즉 그들의 대극성과 유사성을 연결하는 실마리로 볼 수 있기 때문이다. (2) 일치(Kongruenz)/상관(Korrelation) 및 반복(Wiederholung) 현상, 그리고 격변화와 인칭변화 현상은 어순문제와 더불어 형태론적 문제를 통해 문법적인 확인수단으로 작용한다. 이들은 대부분 체계적/구조적으로 나타나기 때문에 학습자는 흔히 같은 유형에서 반복적으로 오류를 범하기 마련이다. 이를 극복하기 위해서 언어 유형학적 오류분석을 이해하고 또한 이를 통해 오류를 줄이거나 예방하는 학습이 필요하다. (3) 명사가 한정사구 안에서 성/수/격에 따라 변화하는 것과 동사가 동사구에서 주어의 인칭/수에 따라 인칭변화 하는 것은 우리 한국인에게는 아주 이색적인 현상이다. 이는 양면적인 수식구조에 대한 확인수단 및 원자가에 의한 강력한 형식위주 언어인 독일어와 전위적인 단일 수식구조와 부정형 동사를 특성으로 형성된 핵/최소문 언어간의 필연적인 적응관계 및 결과라고 볼 수 있다. 이 두 가지 유형 역시 언어특성에 따라 도식화/공식화 할 수 있다. (4) 괄호현상, 즉 으뜸머리(Hauptkopf)가 버금머리(Nebenkopf)와 분리하는 것은 우리 한국인에게는 아주 이색적인 언어현상이다. 한국어에는 머리의 이동이 없기 때문이다. 긴 구문에서 버금머리를 잊어버리거나 실수하는 것은 모든 괄호구문에서 예견되는 결과이다. 그러나 이는 정치성과 후치성 언어간의 전이 과정으로 이해될 수 있다. 으뜸머리가 원래의 자리를 박차고 소속 구/문의 앞자리로 도약한 것처럼 느껴지기 때문이다. (5) 전치 및 후치 수식이 유동적으로 작용하는 독일어는 전치 수식만으로 고정된 한국어보다 복잡하지만 균형적인 언어구조이다. 이러한 수식구조에서 한국인은 흔히 형태 및 어순에서, 그리고 번역에서 오류를 범하고 만다. (6) 그러나 가장 중요한 것은 아는 것을 제대로 이용하는 문제이다. 모국어/L2를 자유로이 말하고 쓸 때까지, 즉 언어습득에는 일체이 문법이나 도표/도식을 이용할 필요가 없다는 사실이다. 이는 17세기 서구의 이성주의 철학자들의 한결같은 경고이다. 오늘날 초고속 과학문명에서 더욱 빛을 발하는 것은 당연한 결과이다. 한 언어 속에 들어있는 문법체계를 익혀 가는 것이 곧 언어습득 과정이지만, 이를 달성하는 가능성 내지 첩경은 실제적인 언어자료와 체험이지 결코 문법이나 추상적인 개념적 접근이 아님을 웅변하고 있기 때문이다. 핵심적인 문제는 모국어교육에서도 최대 장점인 대화를 통한 언어연습/대화 기회를 최대한 보장하는 데 있다. 또한 언어간섭 현상을 조장하는 분위기를 막아야 할 것이다. 이러한 의미에서 교수법 개발이 외국어/L2 성공의 관건일 것이다. (7) 언어학습에서 오류를 극복하는 데는 일차적인 실제 상황에 부합하는 대화적인 연습, 그리고 효과적인 언어자료 접촉, 즉 독서와 모방이 중요하다. 이차적이고 직접적인 것은 통사(Syntax) 및 형태론(Morphologie)를 익힐 수 있는 말/문을 끊임없이 익히는 일이다. 이것이 또한 언어최소량을 충족시켜 언어습득에 이르는 첩경이다. 자연 생태적인 모국어 학습 또는 조정 및 제도적인 언어학습에서도 실제상황에 어긋나는 문법적인 체계에 얽매이는 도식 및 도표 위주의 텟스트는 일시적인 기대일 뿐이다. 인간의 언어습득장치를 이해하지 못한 결과이기 때문이다. 문법적인 개념위주 접근은 상당한 설명이 필요해서 절박한 자료와 체험까지 앗아가기 마련이다. 더구나 이를 위해 수준을 무시하고 모국어로 일관하여 벙어리와 문맹을 자초하는 것은 참으로 어리석은 일이다. 지식 정보화 시대 및 세계화 시대에는 무엇보다도 교육 및 언어정책이 국가 발전의 원동력이다. 특히 영어를 비롯한 외국어 학습능력과 학습방법은 매우 중요하다. 학습자에게 말하고 쓰는 기본 능력을 보장하는 것이 급선무이다. 이를 위한 작업의 하나가 바로 언어간의 오류분석일 것이다. 언어의 습득과 활용이 체계적이듯이 오류분석 역시 상당히 체계적이다. 그래서 인간의 언어습득과 언어습득장치를 두고 결정론(Determinismus)이 지배적이다. 이러한 의미에서 언어습득의 3대 요소, 즉 언어습득장치를 구비한 인간으로 태어나고, 해당 언어를 통한 일관된 언어체험/학습으로 언어최소량을 충족해야 한 언어를 정복할 수 있다는 것은 결정적인 사실이다. 학생고객에게 다가서는 책임교육으로 교육개방에 대비하는 일 역시 시대적인 상황이요 또한 결정적인 단계임엔 틀림이 없을 것이다.

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The Relation Between Work-Related Musculoskeletal Symptoms and Rapid Upper Limb Assessment(RULA) among Vehicle Assembly Workers (자동차 조립 작업자들에서 상지 근골격계의 인간공학적 작업평가(Rapid Upper Limb Assessment) 결과와 자각증상과의 연관성)

  • Kim, Jae-Young;Kim, Hae-Joon;Choi, Jae-Wook
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.1
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    • pp.48-59
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    • 1999
  • Objectives. This study was conducted to evaluate the association between upper extremity musculoskeletal symptoms and Rapid Upper Limb Assessment(RULA) in vehicle assembly line workers. The goal of this study is to show the feasibility of RULA as a checklist for work related musculoskeletal symptoms (WMSDs) in Korean workers. Methods. The total number of 199 people from the department of assembly and 115 people from the department of Quality Control(QC) in automotive plant were subjects for this cross sectional study. A standard symptom questionnaire survey has been used for the individual characteristics, work history, musculosketal symptoms and non-occupational covariates. The data were obtained by applying one-on-one interview for the all subjects. RULA has been applied for ergonomic work posture analysis and the primary ergonomic risk sure was computed by RULA method. Association between upper extremity musculoskeletal symptoms and RULA were assessed by multiple logistic regression analysis. Results. A total of 314 workers was examined. The prevalence of musculoskeletal symptoms by NIOSH case definition was 62.4%. The distribution of musculoskeletal symptoms by the part of the body turned out to be following; back:41.4%, neck: 32.8%, shoulder: 26.4%, arm: 10.5% and hand:29.3%. The relationship of the individual RULA scores were statistically significant for the prevalence of musculoskeletal symptoms. As the result of the multiple logistic regressioin analysis, grand final score (OR=2.250 95% CI: 1.402-3.612) was associated with musculoskeletal symptoms in any part of the body.; upper arm score(OR=1.786 95% CI: 1.036-3.079) and posture score A(OR=1.634 95% CI: 1.016-2.626) in neck; muscel use score(OR=3.076 95% CI:1.782-5.310) and posture score A(OR=1.798 95% CI: 1.072-3.017) in shoulder; upper arm score(OR=1.715 95% CI: 1.083-2.715) and muscel use score(OR=2.057 95% CI:1.303-3.248) in neck & shoulder; muscle use score(OR=10.662 95% CI: 3.180-35.742) in arm; writst/wist score(OR=2.068 95% CI: 1.130-3.786) and muscle use score(OR=2.215 95% CI: 1.284-3.819) in hand & wrist.; muscle use score of trunk (OR=2.601 95% CI: 1.147-5.901) in back. Conclusions. Musculoskeletal symptoms of the extremities were strongly associated with individual RULA body score. These results show that RULA can be used as a useful assessment tool for the evaluation of musculoskeletal loading which is known to contribute to work-related musculoskeletal disorders. RULA also can be used as a screening tool or incorporated into a wider ergonomic assessment of epidemiological, physical, mental, environmental and organizational factors. As shown in this study, complement of the analysis system for the other risk factors and characterizing between the upper limb and back part will be needed for future work.

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