• Title/Summary/Keyword: 재치료

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남녀(男女)의 차이(差異)에 근거(根據)한 남녀형상(男女形象)의 의학적(醫學的) 운용(運用)에 대한 연구(硏究)

  • Lee, In-Su;Yun, Chang-Ryeol
    • Journal of Korean Medical classics
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    • v.19 no.1 s.32
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    • pp.47-109
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    • 2006
  • 서양의학상인위남녀근근시재생식기부동적인(西洋醫學上認爲男女僅僅是在生殖器不同的人). 최근(最近), Legato, Marianne J.박사창립료(博士創立了)‘성인지의학(性認知醫學)’학(學), 개시인식도남녀적차이(開始認識到男女的差異), 주장남녀재치료방법상역부동법(主張男女在治療方法上亦不同法), 종이저일연구진입도료신적단계(從而這一硏究進入到了新的段階). 단시한의학종(但是韓醫學從)${\ulcorner}$황제내경(黃帝內經)${\lrcorner}$개시(開始), 취인위남녀재구조상유근본적차이(就認爲男女在構造上有根本的差異), 이차재생리(而且在生理), 병리(病理), 진단(診斷), 치료상야부동(治療上也不同). 기록한의학기본원리적주역적상관서적화(記錄韓醫學基本原理的周易的相關書籍和)${\ulcorner}$황제내경(黃帝內經)${\lrcorner}$, 이급역대적주요한의서적급종사임상적한의사적서적상(以及歷代的主要韓醫書籍及從事臨床的韓醫師的書籍上), 역도인위남녀유차이(亦都認爲男女有差異). 관어남녀적생성(關於男女的生成), 재(在)${\ulcorner}$보제방(普濟方) 방맥총론(方脈總論)${\lrcorner}$적변남녀형생신육론중제출료(的辨男女形生神毓論中提出了男女的形成有異). ${\ulcorner}$동의보감(東醫寶鑑)${\lrcorner}$여기타한의서부동(與其他韓醫書不同), 불시이질병위주(不是以疾病爲主), 이시이신위중심(而是以身爲中心), 즉목차안형상진행료배열(卽目次按形象進行了排列), 차상세지언급료남녀(且詳細地言及了男女). 나요남녀시고정불변적마 불시적(不是的). ${\ulcorner}$동의보감(東醫寶鑑) 신형장부론(身形臟腑論)${\lrcorner}$인위(認爲)‘인적형색유차이(人的形色有差異), 장부이유이(臟腑易有異), 고외증수동(故外症雖同), 치법인인이이(治法因人而異).’ 안형상선용부동적치법적관점(按形象選用不同的治法的觀点), 이통과주단계지언이표명(已通過朱丹溪之言而表明). 불변관점상여자체격소이동(不變觀点上女子體格小易動), 남자체격대이와(男子體格大易臥). 남자속양기이산(男子屬陽氣易散). 여남자정서초차(如男子情緖稍差), 즉음주해수(卽飮酒解愁), 불이득우울증(不易得憂鬱症). 응보기정기(應補其精氣). 여자속음기이울체(女子屬陰氣易鬱滯), 다유인기지성질(多有忍氣之性質), 이득우울증(易得憂鬱症), 고다용산기약(故多用散氣藥). 간단이언(簡單而言)‘남자위병허증(男子爲病虛證), 여자위병실증(女子爲病實證).’ 종변화적관점래용약(從變化的觀点來用藥), 예여남자수소가용여자약적사물탕(例如男子瘦小可用女子藥的四物湯). 여자비가용남자약적사군자탕(女子肥可用男子藥的四君子湯). 여자골장가용남자약적육미지황환(女子骨壯可用男子藥的六味地黃丸). 위료갱용역이해(爲了更容易理解)‘남녀불변화변화적관점재의학적운용(男女不變和變化的觀点在醫學的運用)’, 이임상병례진행설명(以臨床病例進行說明). 재임상상통과형색맥증적합일화변증론치결정처방(在臨床上通過形色脈證的合一和辨證論治決定處方). 즉불능단순적인위(卽不能單純的認爲), 인위시남자취용육미지황환(因爲是男子就用六味地黃丸), 여자취용사물탕(女子就用四物湯). 남자약소가용사군자탕(男子若小可用四君子湯) 사물탕(四物湯) 육미지황탕(六味地黃湯), 이여자약대가용사군자탕(而女子若大可用四君子湯) 이진탕(二陳湯) 평위산(平胃散) 육군자탕(六君子湯). 인차(因此) 남녀재구조(男女在構造) 생리(生理) 병리유근본성차이(病理有根本性差異), 불이형상래구분(不以形象來區分), 용약상시지불변적입장(用藥上是持不變的立場), 이이형상용약(而以形象用藥), 시종변화적입장래고려적(是從變化的立場來考慮的). 인위이남녀위기준종사임상(認爲以男女爲基準從事臨床), 시부합한의학기본원리지음양관(是符合韓醫學基本原理之陰陽觀).

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The Fate of Intractable Tuberculosis Cases Under National Tuberculosis Programme (국가결핵관리 체계내의 난치성 결핵환자(만성 배균자)의 운명)

  • Lew, Woo-Jin;Lee, Eun-Gyu;Kwon, Dong-Won;Kim, Sang-Jae;Hong, Yong-Pyo;Kim, Jeong-Bae
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.1
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    • pp.11-18
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    • 1995
  • Background: The natural history of bacillary tuberculosis was studied in India and results showed that at the end of the 5-year period, 49% of the patients were dead, 33% were cured and 18% remained sputum-positive. The aim of this survey is to observe the natural course of the patients with intractable tuberculosis disease who were incurable with all drug regimens of the national tuberculosis programme(NTP). Method: Of the patients who have been found as intractable cases in Kang-Weon Province by the supervisory medical officer during the period from January 1,1987 to December 31,1992, 179 were eligible for this study. Sputum examination was done for those who were survived until October in 1993 at the Kang-Weon provincial laboratory of KNTA. 49 out of 179 patients were transferred to the private sectors and retreated with the combination of prothionamide, cycloserine, ofloxacin, enviomycin, etc. They seemed to have been bacteriologically cured, and so they were excluded from the study. Finally 130 patients were analyzed by modified life table method to calculate the fatality rate and the survival rate during the period of 7 years. Results: 1) 80.8% of intractable cases were male and 19.2%, female. 2) More than 94% of intractable cases showed moderately or far advanced Tb findings on their X-rays at the time of registration at health centres. 3) The cumulative case-fatality rate was 19.74% at the end of 1-year period and has risen to 34.55% by the end of 4-year period(increasing by 4.9% a year on an average). The case-fatality rate has shown no appreciable rise since then until the end of 7-year period. 4) The case-survival rate was 80.26% at the end of 1-year period and has decreased to 65.45% by the end of 4-year period. And then there was no appreciable change in the survival rate until the end of 7-year observation. Conclusion: The case-survival rate of intractable cases was higher than that of untreated pulmonary tuberculosis patients and they may have risk of spreading multidrug resistant organisms. It is time we made an effort to improve case-management qualitatively.

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Clinical Courses of Cavitary Lesions in Pulmonary Tuberculosis (처음 진단시 발견된 공동성병변의 경과)

  • Park, Seung-Kyu;Choi, In-Hwan;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.3
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    • pp.323-330
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    • 1996
  • Objective : Cavitary lesion in pulmonary tuberculosis sometimes makes problems in the course of treatment. Especially, retreatment cases tend to respond poorly to current antituberculosis agents. So, authors tried to render a guideline for clinical approach toward cavitary lesions in pulmonary tuberculosis. Methods : Retrospective analysis of 33 pulmonary tuberculosis patients with cavitary lesions was made. All the patients had got treatment at National Masan Tuberculosis Hospital from Jan. 1995 to Aug. 1995. Results: The ratio between male and female was 10:1. Age distribution was 69.7% in 3rd and 4th decades. The locations of cavitary lesion were 60.6% in right upper lung field and 36.4% in left upper lung field. In the extent of disease, there were 12 cases(36.4%) in moderate advanced and 21 cases in far advanced. Cavitary lesions were closed in 5 eases and remained in 28 eases. In the cases of closed cavity, it was happened within $10.6{\pm}4.72$ months after they took treatment, the size of cavity was $35.5{\pm}17.1$ in long diameter, $27.0{\pm}12.2$ in short diameter and $4.6{\pm}2.1\;mm$ in wall thickness. In the cases of remained cavity, the size of cavity was $31.9{\pm}12.3$ in long diameter, $21.0{\pm}9.8$ in short diameter and $5.04{\pm}2.0\;mm$ in wall thickness. In terms of negative conversion, it took $3.8{\pm}2.17$ months in the case of closed cavity but it was happened within 5 months for only 4 patients in the case of remained cavity. In the point of past medication history, there was none in closed cavities but there were none in 1 case, once in 3 cases, two times in 9 cases and more than three times in 13 cases among remained cavitary lesions. Conclusion : In the retreatment cases of pulmonary tuberculosis with cavitary lesions, they tend to respond poorly to current antituberculosis agents. So, if the lesions are localized, operative intervention may be a proper method as adjunctive treatment.

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Long Term Follow Up of Interferon-alpha Treatment in Children with Chronic Hepatitis B (만성 B형간염 환아에 대한 Interferon-alpha 치료결과의 장기 추적관찰)

  • Baek, Seoung-Yon;Eom, Ji-Hyun;Chung, Ki-Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.2
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    • pp.140-151
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    • 2003
  • Purpose: We tried to evaluate the long term efficacy and positive predictive factors of interferon-alpha treatment in children with chronic hepatitis B. Methods: The study population included 113 children who received interferon therapy between May 1982 and July 2002 (20 years) for chronic hepatitis B in Department of Pediatrics, Yonsei University College of Medicine. Male to female ratio was 2.3 : 1 and the mean age at diagnosis was $11.1{\pm}4.1$ years old. Response to treatment was defined as normalization of alanine aminotransferase (ALT), disappearance of HBeAg and HBV-DNA Eighty two children responded while 32 did not. Interferon-alpha was given intramuscularly for 6 months at a dosage of $3{\times}10^6$ unit, 3 times weekly. In relapsed cases, lamivudine or interferon retreatment was done. Results: Seroconversion rate was 77.0% in terms of HBeAg, 74.3% in terms of HBV-DNA, and 80.5% in terms of ALT normalization after treatment. Seroconversion rate of both HBeAg and HBV-DNA was 72.6%. Analyzed by life table method, the effect of the treatment had been maintained over 10 years after cessation of therapy. Pre-treatment ALT level was the only significant positive predictive factor of response. Eleven cases (13.4%) relapsed, and 2 out of 3 showed response when treated with lamivudine and 1 out of 3 with interferon retreatment. Conclusion: Interferon-alpha showed significant efficacy in the treatment of chronic hepatitis B in our study. Further studies about the effect of interferon therapy on complications of hepatitis such as hepatocarcinoma, cirrhosis are warranted.

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Success and failure of endodontic microsurgery (미세 치근단 수술의 성공과 실패)

  • Song, Min-Ju;Kim, Eui-Seong
    • Restorative Dentistry and Endodontics
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    • v.36 no.6
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    • pp.465-476
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    • 2011
  • In current endodontic practice, introduction of operating microscope, ultrasonic instruments, and microinstruments has induced a big change in the field of surgical retreatment. In this study, we aimed to offer key steps of endodontic microsurgery procedure compared with traditional root-end surgery, and to evaluate factors influencing success and failure based on published articles. Endodontic microsurgery is a surgical procedure performed with the aid of a microscope, ultrasonic instruments and modern microsurgical instruments. The microscope provides magnification and illumination - essential for identifying minute details of the apical anatomy. Ultrasonic instruments facilitate the precise root-end preparation that is within the anatomical space of the canal. Modern endodontics can therefore be performed with precision and predictability, thus eliminating the disadvantages inherent in traditional periapical surgery such as large osteotomy, beveled apicoectomy, inaccurate root-end preparation and the inability to observe isthmus. Factors influencing the outcomes of endodontic microsurgery may be diverse, but standardization of procedures can minimize its range. Among patient and tooth-related factors, periodontal status and tooth position are known to be prognostic, but there are only few articles concerning this matter. High-evidence randomized clinical trials or prospective cohort studies are needed to confirm these findings.

A Retrospective Statistical Study on Sedation Cases in Department of Pediatric Dentistry at Dankook University Dental Hospital for 5 Years (단국대학교 치과병원 소아치과에서 5년간 시행된 진정법에 대한 후향적 통계 연구)

  • Park, Changhyun;Shin, Jisun;Kim, Jongsoo;Kim, Jongbin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.45 no.1
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    • pp.75-81
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    • 2018
  • Recently, sedation is routinely used in children who lacked cooperation in pediatric dental clinics. The purpose of this study is to analyze dental treatment cases in department of pediatric dentistry at Dankook University Dental Hospital associating with sedation during 5 years. From January 2011 to December 2015, information about dental treatment cases in department of pediatric dentistry was collected and reviewed. The information gathered included patient gender, age, sedation type, sedative agents, date of operation, and type of procedure. The proportion of treatment cases with conscious sedation for total treatment cases continued to decline until 2014. On the other hand, the incidence of general anesthesia increased gradually. The frequency of midazolam administration and nitrous oxide inhalation sedation increased recently. The use of conscious sedation was significantly decreased when the age of patient was 3 years or older. The frequency of general anesthesia was similar in all age groups. There was a tendency to perform treatment with deeper sedation when the patient was male than female, and when the pulp treatment was performed together with the restorative treatment than not performed. The frequency of re-treatment within 90 days after restoration treatment decreased as the depth of sedation increased.

A SURVEY ON THE USING STATUS AND PERCEPTION OF PIT AND FISSURE SEALANT (치면열구전색제 사용실태와 인식에 관한 조사)

  • Choi, Jung-In;Kim, Young-Jae;Kim, Jung-Wook;Lee, Sang-Hoon;Kim, Chong-Chul;Hahn, Se-Hyun;Jang, Ki-Taek
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.1
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    • pp.53-61
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    • 2009
  • The property of pit and fissure sealant has been improved and many studies on the bond strength, penetration, microleakage have been published. But there are few studies on the using status and perception of pit and fissure sealant within the country. Therefore, this study made a survey on it. Pedodontists and non-pedodontists were surveyed by interview. The Results were as follows; 1. On caries prevention effect, 96.7% of the pedodontists replied that sealants were effective on both permanent teeth and primary teeth. On the other hand, 13.5% of the non-pedodontists replied that sealants weren't effective on both. 2. All of the pedodontists and 27% of the non-pedodontists used rubber dams. 83.3% of the pedodontists and 40.5% of the non-pedodontists used bonding agents. 3. Non-pedodontists used enameloplasty more frequently than Pedodontists but the pattern was not significantly different. 4. The causes of sealant failures included salivary contamination, caries under sealant, low strength, low flowability, overfilling. 5. In the pedodontists, 90% replied that PRR application was desirable and PRR applications were more frequent than sealant application.

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Clinical Characteristics of Kawasaki Disease in Infants Younger than 3 Months of Age (3개월 이하 영아에서 가와사끼병의 임상 특징)

  • Lee, Soo Jeong;Kim, So Jung;Kim, Hae Soon;Sohn, Sejung
    • Clinical and Experimental Pediatrics
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    • v.46 no.6
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    • pp.591-596
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    • 2003
  • Purpose : Kawasaki disease(KD) is rare in infants <3 months of age. In this younger group, the diagnosis may be delayed due to lack of most of the clinical criteria, resulting in a high risk of cardiac complications. We examined clinical characteristics in these patients for early recognition and treatment. Methods : We conducted a retrospective study on the infants with KD aged three months or younger treated at our hospital from January 1998 to July 2002. Results : Of a total of 291 patients treated during the study period, 11(3.8%) were three months old or younger. Of the 11 patients, 10 had atypical presentations. Infants had fewer of the accepted criteria, and the most common findings were fever(100%) and oral mucosal changes(72.7%). Erythema at the site of BCG inoculation was observed in six of the 11 patients(unknown in the remaining five). This feature proved a definite diagnostic clue in two patients in whom cardiac complications developed in the subacute phase. Cardiac complications were found in six patients(54.5%) : three had coronary dilatation, two had coronary wall irregularity, and one had mitral valve prolapse with regurgitation. Defervescence occurred within $1.1{\pm}0.3day$ in 10 of the 11 patients treated with intravenous immunoglobulin(IVIG) and one was given a second course of IVIG. Echocardiographic abnormality persisted in only one patient with mitral regurgitation at the 6-month follow-up. Conclusion : Most patients with KD younger than three months of age have atypical presentations and a high complication rate. For early diagnosis, erythema at the BCG inoculation site, if present, could be used as a valid diagnostic clue to atypical KD in this age group.

Prognosis of Recurred TMD Patients According to Conservative Treatment (재발된 측두하악장애 환자의 보존적 처치에 따른 예후)

  • Jang, Dong-Hun;Tae, Il-Ho;Ahn, Yong-Woo;Ko, Myung-Yun
    • Journal of Oral Medicine and Pain
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    • v.33 no.2
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    • pp.219-228
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    • 2008
  • The purpose of this study is to compare the differences between first visits and the recurred time of TMD patients about the number of visits, the treatment plans, the symptoms and the results after the conservative treatments. This could lead us to assess the prognoses of TMDs treated conservatively. We investigated 54 patients who have visited the Department of Oral Medicine in PNUH from 1991 to 2001, diagnosed as TMDs and treated conservatively with medications, physical therapies and splints. The treatments were terminated since the subjects have shown much improvements and resumed when TMDs recurred from 1992 to 2002. We researched the diagnoses, symptoms, the number of visits, the treatment plans and the results comparing the time before and after the treatments were carried out and following are the results. 1. Both the primary and the recurred groups improved after having been treated conservatively. 2. Both the primary and the recurred groups showed no differences in pains and MCOs when they first visited though the noises and LOMs turned out to be more serious in primary group. 3. Both the primary and the recurred groups had no differences in pains, noises, LOMs, MCOs when the treatments were over. 4. The results of treatments were not affected by treatment plans, sex, diagnoses in both primary and recurred groups. 5. Most of the patents tended to visit less than 10 times in recurred patients.

Nasopharyngeal Carcinoma : Correlations with Prognostic Factors and Survival (비인강암의 예후인자가 생존율에 미치는 영향)

  • Park, Charn-Il;Park, Woo-Yoon;Kim, Jong-Sun
    • Radiation Oncology Journal
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    • v.7 no.1
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    • pp.29-36
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    • 1989
  • One hundred and ten patients with carcinoma of the nasopharynx were treated by radiation therapy in Department of Therapeutic Radiology, Seoul National University Hospital between 1979 and 1985. Among these, one hundred and five patients were treated with curative intent and 5 patients with palliative aim. Excluding 16 patients who did not receive a full course of radiation therapy, the remaining 89 patients were reviewed for this analysis. Minimum follow-up period of survivors was 36 months. Forty-three percent of the patients had T4 primary lesions and $72\%$ had stage IV disease. The histology was squamous cell carcinoma in $46\%$ of the patients. undifferentiated carcinoma in $49\%$, and lymphoepithelioma in $5\%$. Total radiation dose to the primary site averaged 6,500cCY for T1, T2 lesions and 7500cCY for T3, T4 lesions. Neck node were given boost treatment to a maximum 7,500cCY depending on the extent of disease. Early primary lesion (T1, T2) and neck nodes were successfully controlled in most cases when dose of greater than 6,500cCY was delievered. Forty two patients $(47\%)$ had recurred, 16 of whom $(38\%)$ed at the primary site and $24(57\%)$ developed distant metastases. Of these. 9 patients received re-irradiation with or without chemotherapy and local control was obtained in 2 patients$(22\%)$. Actuarial overall survival and disease-free survival rate was $42\%\;and\;38\%$ at 5 years. T-stage and histologic subtype were not correlated with survival. However, N-stage was related to survival significantly (p=0.043).

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