• Journal of Acupuncture Research
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• 제17권4호
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• pp.149-159
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• 2000

Bee-venom Acupucture has good effect on pain control but We may be anxious about the problem of side-effect. Bee-venom components are composed of phospholipase $A_2$, hyaluronidase, melitin, apamin, MCD peptide, citrate and so on. Especially Apamin, MCD peptide and histamine cause severe reacting that is named Anaphylaxis. Anaphylaxis is a clinical syndrome characterized by the acute system reaction of multiple organ systems to an IgE-mediated immunologic mediator release in previously sensitized individuals. Respiratory and dermatologic manifestations are the most commonly expressed clinical features of anaphylaxis, and a majority of anaphylactic reactions initially appear to be localized to these two systems. Anaphylatic reaction of bee-venom are expressed clinically ulticaria, itching sensation, erythema, dizziness, nausea, hypotension and so on. Especially ulticaria and erythema are end points of increased vascular permeability and vasodilatation at the other extreme of the clinical spectrum, Gastrointestinal mucosal edema and smooth muscle contraction can result in cramping abdominal pain, nausea, and vomiting. Therefore, we have observed anaphylatic reaction of bee-venom in 11 patients, who visited WonKwang University Kunpo Oriental Medical Center, treated bee venom. The results were summarized as follows : 1. The patient distribution ratio, in regard to sex, was shown to be 1 : 2.67 for male to females. In regard to age, it was shown that people in their 30's was the most predominant case, followed by people in their 20's, 30's, 50's and 60's, respectively. 2. When Anaphylaxis was occured, it was observed to abnormality of CBC, LFT, IgE, IgG. 3. In regard to patient condition, it was observed that fatigue was most frequent. 4. In regard to the number of times and quantity of bee venom inj., it was observed that anaphylaxis is most frequent at 7-10 times(1.6-2.0cc) 5. In regard to duration of reaction, it was observed that people in their l0min' was most frequent. In disappearing duration of anaphylaxic reaction, The results showed under 60min lcases(9%), 60-120min 7cases(64%) and 180-240min 3cases(27%). 6. In symptoms of anaphylaxis, The results showed hypotension 8cases(19%), itching sensation 7cases(16%), nausea 4cases(9%), erythema 4cases(9%) and dizziness 4cases(9%). In mentality, The results showed drowsy 8case(73%) and alert 3cases(27%). 7. Generally, patients were treated with Avil, Dexa IM and PDS, peniramine, cimetidine, Q-zyme per os after H/S, N/S inj. $O_2$ was supplied according to patient's symptom. In 1 severe case, Dopamine was iv injected.

• Clinical and Experimental Pediatrics
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• 제52권11호
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• pp.1279-1282
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• 2009

당뇨병 환자에서 간비대와 간 기능 이상이 동반될 경우 간 내 당원축적증과 비알콜성 지방간염을 감별해야 한다. 저자들은 인슐린 치료를 제대로 받지 않아 혈당 조절이 불량한 환자에서 저혈당과 간비대로 발현한 간 내 당원축적증을 경험하여 보고한다. 만 6세경 1형 당뇨병으로 진단받은 환아로 10세경 우상복부 통증과 반복되는 고혈당과 저혈당으로 내원하였으며, 당시 진찰상 둥근 얼굴, 우측 늑골연 하방 6 cm 정도에서 만져지는 간비대가 있었다. 검사상 소변 케톤 양성, 당화혈색소는 9.6%였다. 간 효소치가 증가되어 있었고, 혈중 콜레스테롤/중성지방 250/267 mg/dL였다. 바이러스성 간염, 자가면역성 간염, 대사성 간 질환에 대한 검사는 모두 정상이었다. 복부 초음파 및 컴퓨터 단층 촬영상 지방간과 간비대 소견을 보였다. 간 조직 검사상 PAS 염색에서 양성, diastase-PAS 염색에서는 음성으로 전형적인 당원축적증의 소견을 보였다. 고혈당을 보일 때마다 초속효성 인슐린을 투여하고 심한 저혈당의 증상이 동반된 경우 글루카곤을 투여하였으며 생옥수수 전분 가루를 간식으로 먹이면서 저혈당 횟수가 감소하여 퇴원하였다. 현재 외래에서 초속효성 인슐린으로 혈당 조절하면서 관찰 중이다. 제1형 당뇨병 환자에서 당원축적증은 간비대와 간 효소치의 상승을 야기할 수 있는 원인이다. 본 증례에서는 심한 저혈당이 반복되어 하루에도 수 차례 글루카곤을 투여하였으며, 생옥수수 전분 가루을 투여하면서 저혈당이 호전되었다. 엄격한 혈당 관리로 간 비대 및 간 기능 이상이 호전될 수 있으므로 적절한 인슐린 치료로 혈당을 조절하고 저혈당을 예방해야 하겠다.

• Clinical and Experimental Pediatrics
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• 제51권2호
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• pp.156-161
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• 2008

목 적 : 막창자염은 면역기능이 저하되고 호중구가 감소된 소아암 환자에서 호발하는 괴사성 장염으로 사망률이 매우 높은 것으로 알려져 있다. 저자들은 항암치료 중 발생한 막창자염에 대하여 적극적인 내과적 치료와 항생제 치료를 시행하여 그 치료성적을 분석하고자 본 연구를 시행하였다. 방 법 : 2002년 8월부터 2007년 7월까지 영남대학교병원 소아과에 입원하여 항암화학요법을 받은 소아암 환자 207명 중 막창자염으로 진단받은 12명을 대상으로 의무기록을 분석하였다. 진단은 임상증상과 신체검진소견, 복부단순촬영검사, 복부초음파검사와 복부전산화단층촬영으로 하였다. 항암화학요법 시행 후 증상 발생일, 백혈구수, 절대호중구수, 치료항생제의 종류 및 치료기간과 치료결과를 분석하였다. 결 과 : 막창자염으로 임상적 진단을 받은 환자는 12명(5.7%)이었으며, 임상증상은 복부통증 및 압통 12명(100%), 발열 12명(100%), 설사 9명(75%), 구토 5명(41%), 반발압통 3명(25%) 등이었다. 항암화학요법 종료일로부터 증상 발생일까지의 기간의 중앙값은 12일(범위 3-18일)이었다. 백혈구수의 중앙값은 340 / L$(30-1,270/{\mu}L)$이었으며, 절대호중구수의 중앙값은 $116/{\mu}L(0-648/{\mu}L$)이었다. 치료는 항생제 요법과 충분한 수분 공급 및 장의 휴식 등 보존적 요법을 시행하였으며 환자 12명 모두 증상이 호전되었고, 수술적 치료를 받은 경우는 없었다. 항생제 조합의 선택에 따른 항생제 사용기간의 통계적인 차이는 없었다(P=0.74). 결 론 : 항암화학요법을 받는 소아암 환자에서 발열, 우하복부 압통, 호중구감소증이 있을 때는 막창자염을 의심하여야 하며, 조기진단 및 적극적인 내과적 치료와 항생제 요법을 시행하여 좋은 결과를 얻을 수 있다고 생각된다.

• Clinical and Experimental Reproductive Medicine
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• 제10권2호
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• pp.13-23
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• 1983

In recent days, family planning is not only a problem limitted to our country but an important problem for the while world to solve. Up to present, various methods of sterilization have been developed for population control. When a patient with a previous tubal sterilization by operative method develops any symptoms and signs of pregnancy, we strongly consider it ectopic pregnancy and intrauterine pregnancy. As the cause of sterilization failure, we think that the tubal loop sloughs away and tubal ends either unite and recanalization results or heal and failure of union results in fistula. This present study considered of the 34 cases of ectopic pregnancies and 2 cases of intrauterine pregnancies after tubal sterilization by laparoscopy and Pomeroy's method, at the Dept. of Gynecol. in Kyung Hee University Hospital, during 6 years from Jan. 1977 to Dec. 1982. Authors take result in this study retrospectively. 1. Mean age was 33.7 years for the laparoscopic tubal sterilization group, 31.5 years for the Pomeroy tubal sterilization group. 2. The number of mean gravida and parity at the sterilization was 4.9, 2.8 for the laparoscopic tubal sterilization group, 4.2, 2.2 for the Pomeroy tubal sterilization group, :respectively. 3. The number of mean artificial abortion at the sterilization was all 2.2 for the laparoscopic and Pomeroy tubal sterilization groups. 4. Mean intervals from the tubal surgery to the incidental pregnancy was 3.2 years for the laparoscopic tubal sterilization group, and 3.8 years for the Pomeroy tubal sterilization group. 5. 63.3% of the laparoscopic tubal sterilization group had problem of inadequate tubal ligation, in comparison to having no inadequate problem in the Pomeroy tubal sterilization group. 6. The previous tubal sterilized scar was found to be 6 cases (17.6%) of inner portion, 15 cases (44.4%) of midportion, 13 cases (38.2%) of outer portion at the time of operation. The tubal site of ectopic pregnancy was found to be 23 cases (67.6%) of ampullary portion,S cases ( 4.7%) of isthmic and fimbrial portion, respectively. 7. The causes of table sterilization failure were, in order of frequency, technical error (19 cases), fistula formation (6 cases) and recanalization (5 cases) for the laparoscopic tubal sterilization group and fistula formation (2 cases), technical error (l case), recanalization (l case) fo the Pomeroy tubal sterilization group. 8. As the new applicated contraceptive method in incidental pregnant patient, Authors used 2 gravigard insertion for the two intrauterine pregnancy and 34 Pomeroys' tubal ligation, 2 total abdominal hysterectomy (due to associated pelvic inflammatory disease) for the 36 tubal pregnancy.

• Advances in pediatric surgery
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• 제17권2호
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• pp.154-161
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• 2011

Tracheoesophageal fistula without esophageal atresia (H-type TEF) is a congenital anomaly that is characterized by a fistula between the posterior wall of the trachea and the anterior wall of the esophagus, not accompanied by esophageal atresia. The purpose of this study is to investigate the clinical characteristics, diagnostic time, the side of cervical approach and short term result after surgery by searching medical records of patients treated for H-type TEF. The search was done at University of Ulsan, Department of Pediatric Surgery of Asan Medical Center, and the total number of patients from May 1989 to December 2010 was 9 with M:F ratio of 1:2. The median gestational age was $39^{+6}$ ($32^{+6}{\sim}41^{+0}$) wks. Seven out of nine patients were born at term and the other two were born premature. The clinical presentation was aspiration pneumonia, difficulty in feeding, chronic cough, vomiting, abdominal distension and growth retardation. The symptoms presented right after birth. The diagnosis was made with esophagography and the median time of diagnosis was 52 days of life. The majority of surgical corrections were performed within two weeks of diagnosis (median; 15d, range; 1d - 6m). Six patients had associated anomalies, and cardiac anomalies were most common. The cervical approach was utilized in all cases (right 2, left 7). Transient vocal cord palsy and minor esophageal leakage complicated two cases. Although the diagnosis of H-type TEF was difficult and often delayed, we had a good short term result. The left cervical approach was preferred.

• Advances in pediatric surgery
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• 제18권2호
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• pp.68-74
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• 2012

Colonic atresia (CA) is the rare cause of intestinal obstruction, and diagnosis of CA is difficult. But only few research has been performed, so little information has been available. The purposes of this study was to analyze the clinical findings of CA so that help physicians make decision properly. Children with CA who were treated at the division of pediatric surgery at Asan Medical Center in the period from January 1989 to December 2011 were evaluated retrospectively. A total of 6 children were treated with CA. These accounted for 2.7% of all gastrointestinal atresias managed in Asan Medical Center. Only one child was premature and low birth weight, the others were fullterm neonates and showed normal birth weight. Vomiting and abdominal distension were common symptoms and simple X-ray and barium study were used for diagnose of CA. But only 66.7% of the babies were diagnosed as CA pre-operatively. And 2 children out of 6 underwent re-operation due to missed CA at the time of the first operation. In aspect of types of atresia, the type IIIa were two, type IV were two, type I was one case, and one child showed rectal stenosis due to rectal web. Various operations were done according to individual findings and associated diseases. The 50% (n=3) of children underwent the primary anastomosis and the others (n=3) underwent colostomy first and staged operation later for missed CA or associated disease. All of them were recovered any significant complications. Therefore, the prognosis of CA is satisfactory if diagnosis and surgical management could be made properly. But because of the low incidence of CA, delay of diagnosis and treatment may occur. To prevent delay of diagnosis, we suggest prompt evaluation of doubtful infant and careful inspection of distal patency of bowel including whole colon and rectum when operating patients with intestinal atresia at any level.

• Journal of Chest Surgery
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• 제43권6호
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• pp.753-757
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• 2010

식도 파열 후 발생한 식도 흉막루 및 대동맥 흉막루를 식도와 대동맥 이중 우회술로 치험하여 보고하고자 한다. 48세 남자가 폭발 사고로 인한 손상으로 하부 식도 파열을 진단받았다. 외부 병원에서 1차례 식도 봉합술을 시행받았으나 식도 누출이 지속되었고, 이로 인해 좌측 흉강의 농흉이 동반되어 있었고, 이차적인 대동맥 손상으로 흉부 하행 대동맥에 스텐트를 삽입한 상태로 본원으로 전원되었다. 반복적인 수술 및 농흉으로 인한 유착 및 대동맥 손상을 고려하여 흉골 하행 경로를 통해 식도-위 우회술을 시행하였다. 남아있는 농흉은 감염 징후 없이 만성화 단계를 거치던 중 흉관 삽입 부위로 출혈이 관찰되었다. 검사 결과 흉부 하행 대동맥의 감염성 동맥류로 대동맥 벽이 약해진 상태가 확인되어 대동맥 우회술을 시행하였다. 우측 흉강을 통해 상행 대동맥과 복부 대동맥에 인조혈관으로 우회술을 시행하였고, 흉부 대동액 부위는 결찰하였다. 이후 원위부 결찰 부위에 남아 있는 개통 부위에 대해 혈관 플러그(vascular plug)를 이용하여 색전술을 시행하였다. 환자는 더 이상 출혈 없이 4개월째 외래 관찰 중이다.

• 농촌의학ㆍ지역보건
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• 제22권1호
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• pp.49-59
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• 1997

Backgrounds : There has been many studies investigating the causes of farmers' syndrome. In some studies, psychologic stress is related to farmer's syndrome. And the diagnostic criteria of farmer's syndrome is similar to those of generalized anxiety disorder. So we carried out this study to investigate the psychiatric causes of farmers' syndrome. Methods : This study was done in some rural and urban areas of Kyoungsangnam Province, July, August, October and November of 1996. Those who came to free medical service and completed interview, medical examination and laboratory examination and 20-59 years old were 150 persons. And those who came to health center for health examination and completed only interview and 20-59 years old were 94 persons. The questionnaire was composed of sociodemographic factors, health risk factors, farmer's syndrome, work load, BEPSI(inventory to measure stress), Spielberger's state-trait anxiety inventory, self-rating depression scale. To examine statistical significance, we used X2-test, Mantel-Haenszel test for linear association, t-test, ANCOVA, correlation, multiple regression, logistic regression. Results : The prevalence of farmer's syndrome, adjusted for age and sex with population of Kyungsangnam Province of 1993 was 208 per 1,000(90 per 1,000 in men and 329 per 1,000 in women). In bivariate analysis, farmer's syndrome was significantly related to age, sex, job, income, smoking, alcohol drinking, work load, BEPSI, state anxiety, trait anxiety, depression, body mass index, Hwa-Byung, hypertension, anemia. However, when age and sex were adjusted, job was not significantly related to farmer's syndrome. The score of farmer's syndrome was significantly related to age, sex, work load, BEPSI, trait anxiety by multiple regression. Farmer's syndrome was significantly related to increasing age(odd ratio 1.079, 95% C.I. 1.060 - 1.099), sex(odds ratio of male 0.434, 95% C.I. 0.349 - 0.540), and BEPSI(odds ratio 1.231, 95% C.I. 1.148 - 1.320) by logistic regression. Results of logistic regression analysis of the component symptoms of farmer's syndrome were as follows. Shoulder stiffness was significantly related to increasing age, female sex and BEPSI. Lumbago was significantly related to increasing age, female sex and trait anxiety. Numb limbs and nocturia was significantly related to increasing age and female sex. Breathlessness was significantly related to work load, sleeplessness was significantly related to depression, dizziness was significantly related to job and state anxiety, and abdominal fullness was significantly related to female sex. Conclusion : Farmers' syndrome was related to work load, but was more related to psychiatric factors such as BEPSI and trait anxiety. And the occupation was not risk factor of farmers' syndrome in this study, so further study is needed to investigate the cause of farmers' syndrome.

• 생명과학회지
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• 제28권9호
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• pp.1118-1126
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• 2018

본 논문은 양식 어류에게 많은 경제적 피해를 입히고 있는 다양한 어류질병세균 중에서 연쇄구균증에 대한 일반적인 특성과 종류, 진단 방법에 대하여 기존에 연구 보고된 논문을 기반으로 알아보고자 한다. 대표적인 어류연쇄구균증의 원인체로는 Lactococcus garvieae, Streptococcus iniae, S. parauberis가 있다. 연쇄구균증에 감염 시 나타나는 증상으로는 체색변화, 안구이상, 아가미 퇴색, 출혈, 복부팽만, 신장과 비장의 종대 등의 보이다 폐사가 일어난다. 또한 수온이 상승하는 6월부터 10월까지 주로 일어나며 집단적으로 발병하여 폐사가 일어난다. 현재 연쇄구균증을 진단하기 위한 기술로는 16S rRNA, 16S-23S rRNA intergenic spacer region (ISR), Random Amplified polymorphic DNA (RAPD), Ribotyion (RT), Loop-mediated isothermal amplification (LAMP) 등이 있다. 이중에서 현장에서 적용 가능성이 높은 LAMP법이 각광을 받고 있지만 결과 확인 등의 문제로 인하여 현재는 어려움을 겪고 있는 실정이다. 이에 현장에서 진단부터 결과 확인까지 손쉽게 사용할 수 있도록 문제점을 보완하면 연쇄구균증에 대한 경제적 손실을 최소화 할 것으로 사료된다.

• 한국식품영양과학회지
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• 제33권9호
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• pp.1492-1500
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• 2004

저열량 처방을 위한 식사대체제와 식이섬유ㆍ탄수화물 가수분해 억제제ㆍHCA를 주 성분으로 하는 체중감량제의 섭취 효과를 판정하기 위하여 20대∼50대의 BMI 25이상의 여성 자원자를 모집하여 9주간 시험을 실시하였다. 시험기간 동안 1일 1끼 식사는 식사대체제로 대치하고 1일 2회 체중감량제를 섭취하게 한 후 신체계측과 체조성, 배변 상황, 식이섭취 실태, 자각 증상 등의 변화를 조사하여 효과를 판정하였다. 시험 결과는 9주 동안 지속적으로 체중과 체지방, BMI, 허리 및 엉덩이 둘레가 감소한 것으로 나타났으며 체중감소율은 영양학적으로 안전한 범위에 속해 있었다. 혈청 지질에는 유의적인 변화가 없었으며 혈당과 인슐린이나 C-peptide 함량에도 유의적인 차이는 없었으며 BUN이나 ALP는 감소하였고 헤모글로빈은 유의적으로 증가하였으나 모두 정상범위에 있었다. 배변 시간은 단축되었으며 건강에 대한 부정적인 자각증상도 감소되었다. 1일 섭취 열량은 1300 kcal 정도로 유지되었으며 비타민 A, 비타민 $B_2$, 엽산, 칼슘, 철, 아연등의 섭취량은 권장량의 80% 미만으로 나타났다. 그러므로 본 연구의 저열량식사와 체중감량제의 섭취는 체중 및 체지방 감소와 배변에 효과적이었으며 부정수소를 감소시킬 수 있었다.