• Journal of Yeungnam Medical Science
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• 제17권1호
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• pp.93-98
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• 2000

영남대학교 의과대학 부속병원에서 발생한 치골결합 분리증의 빈도는 1:693이며 분리된 정도가 심할수록 증상도 심했고 다른 합병증도 동반되었으며 완전히 회복되기까지의 기간도 길었다. 산모가 임신전 상태로 완전히 회복되기까지의 기간은 지난 후 1개월에서 4개월까지 다양하였는데 분리된 정도와 회복기간의 연장이 반드시 일치하는 것은 아니었다. 이전 임신 시의 치골결합 분리가 다음 임신 시 분만 방법에 영향을 미치기는 하지만 반드시 수술적 요법을 생각해야 하는 것은 아니다. 앞으로 치골결합 분리의 재발 유무와 적절한 상담을 위해 증례 보고를 한 환자들을 계속 추적 관찰할 예정이다.

• 동의신경정신과학회지
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• 제15권1호
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• pp.9-25
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• 2004

Behavioral characteristics of Attention Deficit Hyperactivity Disorder(ADHD) is one of the most common mental disorders among children.child psyachiatry. Inattention, Hyperactivity that is done by hyperkinesis or minimal brain dysfunction is major sypmton in ADHD, But etiology and pathological facor of ADHD is very much or unkown.. We brought to about a Study on the Oriental - medical pathologic Understanding about Inattention, Hyperactivity symptom in ADHD within Don yui bo gam Book are as follows. 1. Oriental medical pathologic concepts about Inattention, Hyperactivity are continuous with process of Yang Qi(陽氣), an unbalance of qi(氣) and shen ming(神明), excess of seven emotions(七情), pathology of Huo(火). 2. Immanent factors in inattention, Hyperactivity are improper diet, overtiredness and seven emotions, are continuous with pathological process of the heart, liver, gall bladder, spleen, stomach, kidneys. 3. In oriental medicine, considered as a child's qi of shao yang, dynamic physiological feature, excess and want of yin and yang, organs and bowels, immanently imbalance in growth rather than a child's mental disorder 4. Inattention, looseness in ADHD-PI type are continuous with forgetfulness, improper overtiredness, shortage of qi, the interior heat syndrome due to yin deficiency within Don yui bo gam Book 5. Hyperactivity, impulsive actions in ADHD-C type are continuous with sudden palpitation, severe palpitation, delirium, fidgeting due to deficiency, fidgetiness, hyperactivity of huo due to yin deficiency, fever, febrile disease with accumulation of blood.

• 동의생리병리학회지
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• 제21권6호
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• pp.1663-1669
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• 2007

Acute transverse myelitis(ATM) is defined as an acute intramedullary dysfunction of the spinal cord, ascendng or static involving both halves of the cord and appearing without any history of previous neurological diseases due to traumatic accident, tumor of all kind, encephalitis and of course excluding all possible viral, bacterial and fungal infection. It is mainly characterized by acute motor disorder of both limbs in respect to which spinal segments are affected as well as sensory disorder and dysuria & dyschezia. The exact cause is unknown, however it is recently suggested that immunological factors are highly involved. It has been reported by several reliable sources that it is often accompanied by immunological diseases such as systemic lupus erythematosus(SLE). As treatments non steroid anti-inflammatory drugs(NSAIDS) are primarily recommended as to steroids, limited doses are injected only with the proper prescription from the physician. Operative methods are not options as traumatic accidents and tumors are excluded as factors. To enhance muscle strength and prevent articular contracture physical therapy and passive exercise is imperative. The following patient whose chief complaints were mainly about hypoesthesia of Rt. lower limb and stiffness of phalanges of both fingers as well as to weakness of lower extermity. Therefore it has been diagnosed as arthalgia syndrome. In oriental medicine factors such as wind evil heat-evil, dampness-heat evil, cold evil cause the arthalgia syndrome. In this case the patient was diagnosed as dampness-heat evil and herbal medicine Chunglijagam-Tang and Dong-Qi acupuncture was applied to treat bladder disorder.

• 대한한의정보학회지
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• 제11권2호
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• pp.23-31
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• 2005

Central cord syndrome (CCS) is the most common incomplete spinal cord injury (SCI) syndrome, occured by cervical hyperextension injury. It is characterized by disproportionately greater motor impairment in the upper extremities compared to the lower extremities, bladder dysfunction, and variable degrees of sensory loss below the level of injury. Recently 36 year-old male was admitted with upper motor neuron weakness, sensory loss in the upper extremities and stiff neck. We report the improvement of his symptoms through both western medical treatment and oriental medical treatment.

• Journal of Korean Neurosurgical Society
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• 제61권6호
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• pp.767-773
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• 2018

Three male patients diagnosed with surfer's myelopathy (19-30 years) were admitted to our hospital. All three patients were novice surfers showing a typical clinical course of rapid progression of paraplegia following the onset of back pain. Typical history and magnetic resonance imaging features indicated the diagnosis of surfer's myelopathy. Two patients received high-dose steroid therapy and the other was treated with induced hypertension. One patient treated with induced hypertension showed almost full recovery; however, two patients who received high-dose steroid therapy remained completely paraplegic and required catheterization for bladder and bowel dysfunction despite months of rehabilitation. Our case series demonstrates the potentially devastating neurological outcome of surfer's myelopathy; however, early recovery in the initial 24-72 hours of presentation can occur in some patients, which is in accordance with previous reports. Ischemic insult to the spinal cord is thought to play a crucial role in the pathophysiology of surfer's myelopathy. Treatment recommendations include hydration, induced hypertension, early spinal angiography with intra-arterial intervention, intravenous tissue plasminogen activator, and high-dose steroid therapy; however, there is no standardized treatment option available. Early recovery appears to be important for long-term neurological outcome. Induced hypertension for initial treatment can be helpful for improving spinal cord perfusion; therefore, it is important for early and long-term neurological recovery. Education and awareness are essential for preventing surfer's myelopathy and avoiding further deterioration of neurological function.

• 한국임상수의학회지
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• 제39권5호
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• pp.235-239
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• 2022

A 10-year-old neutered male Siberian Husky presented with paraparesis and severe lethargy. On physical examination, the patient was unable to weight-bear and walk and exhibited significant muscle mass loss in both hindlimbs and generalized truncal alopecia with a dull coat of hair. On neurological examination, cranial lumbar vertebral pain, hind limb cross-extensor reflex, delayed hindlimb postural reaction, upper motor neuron bladder dysfunction, and total absence of cutaneous trunci reflex were identified. Computed tomography revealed diffuse idiopathic skeletal hyperostosis and spondylosis deformans of the cervical and thoracolumbar vertebrae. In addition, a generalized decrease in bone mineral density of the vertebrae was identified. Magnetic resonance imaging showed hyperplasia of the epidural fat compressing the spinal cord in the thoracolumbar region and concurrent mild multiple intervertebral disc herniations. No specific findings were observed in cerebrospinal fluid analysis. Blood analysis of thyroid function revealed decreased total T4 and free T4 levels, and increased TSH levels. The patient was tentatively diagnosed with spinal epidural lipomatosis (SEL) secondary to hypothyroidism. The patient was treated with levothyroxine, firocoxib, and gabapentin. Clinical signs gradually improved, and the patient showed normal ambulation 40 days after treatment initiation. SEL is extremely rare in dogs. To the best of our knowledge, this is the first case report of SEL secondary to hypothyroidism that was treated conservatively. Secondary SEL can be sufficiently managed by treating the underlying cause, if possible.

• 한국의료질향상학회지
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• 제3권2호
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• pp.36-51
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• 1997

Background : Clinical practice guidelines define "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances" and help to improve patient care. The purpose of this study is to develop a clinical practice guideline for the most effective diagnoses and treatments of benign prostatic hyperplasia based on patient preference and clinical need. Methods : For this research project, extensive literature searches (208 articles) were conducted. As well, critical reviews and syntheses (meta-analysis) were used to evaluate empirical evidence and significant outcomes of the BPH literature. Questionnaires about clinical practice for BPH patients were distributed and consensus meetings were undertaken to grasp variations in clinical practice and to reach agreement on the guideline's development. The guideline was promoted under the sponsorship of the Korean Medical Association and the Korean urological Cancer. Society. For the task, the Benign Prostatic Hyperplasia Guideline Panel was composed of multidisciplinary experts in the field. Results : BPH is a disease that affects a patient's quality of life. This Clinical Practice Guideline was developed for the typical man over age 50 with symptoms of prostatism, but with no significant medical morbidities such as diabetes or other known causes of voiding dysfunction, such as urethral stricture or neurogenic bladder. The guidelines detail the relative benefits and obstacles associated with all diagnostic and treatment approaches, including watchful waiting. Conclusion : This guideline provides a cornerstone for our medical association. It represents the most current scientific knowledge regarding the development, diagnosis, and treatment of BPH. It will be revised and updated as needed.

• Journal of Korean Neurosurgical Society
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• 제42권2호
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• pp.77-82
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• 2007

Objective : The authors tried to reveal some unique features of lipomeningomyelocele (LMMC), including clinical presentation, factors precipitating onset of symptoms, pathologic entities of LMMC associated with tethered cord syndrome, and surgical outcome in LMMC patients. Methods : Seventy-five patients with LMMC were enrolled in this study. Neuro-imaging and intraoperative findings allowed classification of LMMC into three Types. The patients were divided into two groups by age : A (51 patients), from birth to 3 years, and B (24 patients), from 3 to 24 years. For prevention of retethering of the cord, a mega-dural sac rebuilding procedure was performed in 15 patients. Results : During a mean postoperative follow-up period of 4 years, the surgical outcome was satisfactory in terms of improved pain and motor weakness, but disappointing with reference to the resolution of bowel and bladder dysfunction. Among these 75 patients with LMMC, preoperative deficits were improved after surgery in 29 (39%), remained stable in 28 (37%), changed slightly in 13 (17%), and worsened in 5 (7%). Patients in group A achieved better outcomes than those in group B. Depending on the type of lesion, patients with types I and II LMMC have better outcomes than those with type III LMMC. Finally, retethering of the cord with neurological deterioration occurred in 4 (5.3%) of the 75 patients, but no retethering was found in the 15 patients who were recently treated with a mega-dural sac rebuilding procedure. Conclusion : Our data continue to support the opinion that early diagnosis and optimal surgery are still essential for the treatment of patients with LMMC, since there is a high likelihood of residual neurological functions that can be preserved. Based on our surgical experience of untethering and decompression of lipomas, a mega-dural sac repair is useful to prevent retethering of the cord.

• Childhood Kidney Diseases
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• 제5권1호
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• pp.51-58
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• 2001

목 적 : 일차성 야뇨증의 치료는 민간 요법과 다양한 병인론에 근거한 각종 치료 방법이 개발 되어 있으나 가장 기본 치료인 야간 수분 제한의 치료 효과는 간과되어 왔다. 이에 저자들은 야뇨증의 일차적인 치료의 철저한 야간 수분 제한 효과만을 평가하고 성공 요인을 분석해 보고자 하였다. 대상 및 방법 : 1998년 10월부터 1999년 6월까지 이대목동병원 소아과 외래를 방문한 일차성 야뇨증 아동(주 3회 이상의 아뇨)중 2개월간의 야간 수분 제한에 순응도가 높은 41명(7.9${\pm}$2.3세)을 대상으로 하였다. 야간 수분 제한 전과 2개월 치료 후 매 2주마다 24시간 수분 섭취량과 요량을 (매주 1일이상) 기록하도록 하여 순응도를 평가하였다. 치료후 야뇨 횟수가 90$\%$이상 감소된 완전반응군, 50$\%$이상 9$\%$미만 감소된 부분반응군, 50$\%$이하로 감소된 무반응군으로 구분하여 치료율을 조사하였고, 치료에 대한 성공 요인으로 성별, 연령, 주간 배뇨 이상, 수분 섭취량, 요량, 최대 요량, 요농축능 등을 분석하였다. 치료 2개월 후 야간 요량, 최대 요량, 농축요삼투질 농도의 변화를 비교하였다. 결 과 : 야간 수분 제한 2개월 후의 반응률은 39.0$\%$ (l6/41)에서 완전반응, 43.9$\%$ (18/41)에서 부분반응, 17.1$\%$(7/41)에서 무반응을 보여 전체적으로 82.9$\%$ (34/41)에서 호전되었다. 야간 수분 제한의 치료 효과에 대한 예견 요인은 주간 배뇨 이상, 야간 수분 섭취량, 야간 요량, 방광 요인 등으로, 단증상 야뇨증 아동에서는 완전반응 50$\%$(13/26), 부분반응 46.2$\%$ (12/26)로 다증상 야뇨증 아동의 20$\%$ (3/15), 40$\%$ (6/15)에 비하여 유의하게 치료율이 높았다(P<0.05). 야간 수분 섭취량은 완전반응군 385${\pm}$109mL, 부분반응군 335${\pm}$105mL, 무반응군 233${\pm}$45 mL, 야간 다음은 각각 48.5$\%$(16/33), 42.4$\%$(14/33), 9.1$\%$(3/33)로 야간 수분 섭취량이 많을수록 유의하게 치료율이 높았다 (P<0.05). 야간 요량은 완전반응군 390${\pm}$62mL, 부분반응군 330${\pm}$136mL, 무반응군 140${\pm}$43mL, 야간 다뇨는 각각 59.3$\%$(16/27), 40.7$\%$(11/27), 0$\%$(0/27)로 야간 요량이 많을수록 유의하게 치료 효과가 좋았다(P<0.05). 일회 최대 요량은 완전반응군 236${\pm}$42 mL, 부분반응군 209${\pm}$56 mL, 무반응군 107${\pm}$36mL로 최대 요량이 많을수록 유의하게 치료 효과가 좋았다 (p<0.05). 연령, 성별, 일일 수분 섭취량, 다음, 일일 요량과 다뇨은 세 군간에 유의한 차이가 없었다. 야간 수분 섭취 제한 후 야간 요량의 감소 정도는 완전반응군 173${\pm}$56mL, 부분반응군 135${\pm}$83mL로 무반응군 28${\pm}$15mL에 비하여 유의하게 컸다 (P<0.05). 최대 요량의 증가도 완전반응군 88${\pm}$27mL, 부분반응군 79${\pm}$38mL로 무반응군 17${\pm}$13mL에 비하여 유의하게 컸다 (p<0.05). 농축요삼투질 농도의 증가 역시 완전반응군 190${\pm}$42mO느/kg, 부분반응군 254${\pm}$115mOsm/kg으로 무반응군 25${\pm}$32 mOsm/kg에 비하여 유의하게 컸다(p<0.05). 결 론 : 일차성 야뇨증은 야간 수분 섭취 제한만으로도 치료율이 높았고, 주간 배뇨 이상이 없고, 야간 다음, 야간 다뇨, 및 최대 방광용적이 높은 아동에서 치료 효과가 좋았다.

• Korean Journal of Acupuncture
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• 제30권4호
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• pp.252-263
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• 2013

목적 : 부항요법은 국소적 부위를 진공상태로 유지시키는 과정 중 유두층 안의 표피혈관을 파괴됨에 따라 발생하는 색소, 응결, 자반, 수포, 압통 반응 등을 살피어 오장육부의 기능이상을 진단하고 있다. 시각에 의존하는 주관적인 혈색소 판별로 인한 진단방법에서 벗어나 정량적으로 측정 및 분석이 가능하기 위하여 교차편광 촬영술을 접목하였으며, 새로운 혈색소 평가 가능성을 확인하고자 하였다. 방법 : 족태양방광경의 좌/우 폐수(BL13), 심수(BL15), 간수(BL18), 신수(BL23) 총 10개에 80 kPa 의 음압으로 1분 동안 자극하였다. 교차편광 촬영술을 이용하여 부항 자극 직전과 60분 이후까지 2분마다 이미지를 획득하였다. 획득한 이미지에서 $L^*a^*b^*$ space로 변환하여 분석하였으며, RGB space에서 홍반지수 (E.I: erythema index)를 계산하여 분석하였다. 또한 부항 자극 전 각 경혈에서 젖산 농도를 측정하여 색 지표들간의 관계성 분석을 통하여, 근육의 상태와 부항 자극으로 유도된 피부 색 변화와의 관계를 확인하고자 하였다. 결과 : 교차편광 촬영술을 이용하여 획득한 이미지에서의 $L^*$, $a^*$ 그리고 E.I 모두 부항 자극에 따른 피부 색 변화를 정량적으로 나타낼 수 있는 유의한 지표임을 확인하였다. 부항 자극 40분 후에 피부 색 변화가 더 이상 관찰되지 않았다. 또한 각 경혈에서의 젖산 농도와 피부 색 변화 정도와 유의한 차이가 없음을 확인하였다. 결론 : 설진을 포함하여 한의학적 색 진단을 하기 위한 방법으로 교차편광 촬영술 활용 가능성을 확인하였다. 또한 $L^*$, $a^*$ 그리고 E.I 모두 색 지표로서 유의성을 확인하였다. 향후, 장부 기능 이상과 혈색소 반응간의 상관성을 확보하기 위한 연구가 진행하기 전에, 음압 도중 발생하는 조직 내 다양한 반응과 혈색소 반응간의 관계를 확보하고자 하는 노력이 우선적으로 진행되어야 한다.