• 제목/요약/키워드: Clinical anatomy

검색결과 637건 처리시간 0.032초

과민성대장증후군의 형상의학적 고찰 -동의보감(東醫寶鑑)을 중심으로- (Hypersensitive Large Intestine Syndrome in Hyungsang Medicine)

  • 최병래;최영현;한진수;이용태
    • 동의생리병리학회지
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    • 제19권5호
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    • pp.1129-1136
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    • 2005
  • The writer reports the conclusions gained from study about the cause of the hypersensitive large intestine syndrome with Dongeuibogam as the central figure through researching the disharmony among Body Essence, Vital Energy, Mentality, and Blood, mutual action of five viscera and six bowels, and external shapes. The hypersensitive large intestine syndrome is generally chronic and recurred in many cases, so it is more efficacious than symptomatic to treat according to find the contradictions of individual shapes. The shapes and cases suffering frequently the hypersensitive large intestine syndrome are Gi-kwa and Sin-kwa, having a long nose, having a bruised spot on Triple warmer, man with inclined mouth, Taeeum type, man with congested fluids, man with colic symptoms. The hypersensitive large intestine syndrome in Oriental medicine is recognized of diarrhea, constipation, abdominal pain, abdominal distention and fullness caused by seven emotions. In Dongeuibogam it can be found out the similarity in depressive symptoms due to disorder of Gi, stagnation of Gi, dysphasia due to disorder of Gi, diarrhea due to disorder of Gi, fullness of due to Gi, diarrhea due to phlegm-retention, retention of undigested food, immoderate drinking, hypo-function of the spleen, or deficiency, abdominal pain from colic symptom, and difficulty in defecation and urination, internal injury, diarrhea due to weakness and fatigue. If the Jung, Gi, Sin, and Hyul composed the human body is broken harmony, the function of large intestinal transmission would be fallen, so similar symptoms like the hypersensitive large intestine syndrome are gotten. Especially Gi-kwa suffers diarrhea, constipation abdominal pain, and abdominal distention and fullness due to depressive symptoms from disorder of Seven emotions or Seven Gi. And Sin-kwa suffers from the hypersensitive large intestine syndrome due to emotional restlessness having an influence on rhythmic movement of abdomen. Examining between five viscera and six bowels and the hypersensitive large intestine syndrome, Liver cannot disperse well having influence on mutual relation of Liver-Large intestine, Heart reduces the function of defecation and urination not to control the seven emotions, Lung having exterior and interior relation with intestine has an influence on primordial energy and let the main symptoms occur, Spleen circulating the body fluid let the main symptoms occur due to malfunction of circulation, Kidney locating in lower part of the body has deep connection with intestine, so let the disorder. Urinary bladder is connected with intestine in moisture metabolism, Stomach is connected in receive and transmission, Small intestine is connected in absorption and excretion, from small intestine pain disturbing the abdominal movement, Samcho managing the catharsis of lower heater if declined its function causes the hypersensitive large intestine syndrome. The colic symptoms of Front private parts which disorder in lower abdomen give rise to abdominal pains, difficulty in defecation and urination due to Cold are similar to the hypersensitive large intestine syndrome. The treatments of applying the shapes of colic syndrome advocated by Master Park can be efficacious cure in clinic. Researching after the clinical cases of Master Park advocating Hyungsang medicine, we came to know that plenty of prescriptions of internal injury are applied and take good effects.

제 2근심협측근관이 존재하는 상악유구치의 치험례 (THE SECOND MESIOBUCCAL CANAL OF UPPER PRIMARY MOLAR : CASE REPORT)

  • 김창기;홍성수;고승백;이창섭;이상호
    • 대한소아치과학회지
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    • 제29권2호
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    • pp.139-145
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    • 2002
  • 유치에서는 영구치에 비해 법랑질의 두께가 얇고 약하며 상대적으로 큰 치수강으로 인하여 단시간에 치아우식증이 치수까지 이환되며, 외상 또는 치과치료 중 갑작스런 움직임으로 인하여 치수가 노출되는 경우가 빈번하다. 이러한 이유로 어린이에서의 치수처치는 필수적이며, 유치에서 치수치료의 목적은 감염된 치수조직을 제거하여 동통을 완화시키는 것 이외에도 크게는 치열궁을 보존하여 저작기능을 보호하고, 미래의 영구치열이 적절한 교합관계를 이루게 하는데 있다. 유치열에서 성공적인 치수치료를 위해서는 유치 치수의 형태, 유치 근관의 해부학적 형태, 치근형성, 그리고 유치 치근의 흡수와 관련된 특별한 문제점들에 대한 이해를 필요로 한다. 상악 대구치와 마찬가지로 상악 유구치의 근심 치근이 형태에 있어서 가장 큰 변이를 보인다고 알려져 있으며, 이 치근 내에 존재하는 모든 근관을 처치하지 못한다면 결국 치수치료는 실패할 것이다. 본 증례는 근관치료 중이거나 후에 지속적인 동통이나 근관 내 출혈이 지속되는 경우에서 상악 유구치의 근심협측치근의 제 2근심협측근관을 발견하고 처치한 후 임상증상 및 동통이 사라지고, 양호한 예후를 보였다. 또한 발거된 상악 유구치를 대상으로 한 조사 결과 상악 제 1유구치는 35개 증 8개(22.8%), 상악 제 2유구치는 33개 중 22개(66.6%)의 치아에서 제 2근심협측근관이 발견되었으며. 이는 상악 유구치의 근심협측치근 내에 두 개의 근관이 존재할 가능성이 높다는 것을 의미한다.

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콜레스테롤이 동결-해동 후 인간정자의 생존과 기능보존에 미치는 영향 (Effect of Cholesterol Supplementation in Freezing Medium on the Survival and Integrity of Human Sperm after Cryopreservation)

  • 임정진;성수예;김계성;송승훈;이우식;윤태기;이동률
    • Clinical and Experimental Reproductive Medicine
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    • 제35권3호
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    • pp.203-212
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    • 2008
  • 목 적: 정자의 동결 과정에서 생길 수 있는 급격한 온도 차에 의한 동결 충격이나 동결 상해등에 의한 세포막의 손상, 세포의 기능 장애 등은 정자의 수정능에 영향을 미칠 수 있다. 본 연구에서는 인간 정자를 동결 보존하는 과정에서 콜레스테롤 전처리가 정자의 운동성 및 기능보존에 미치는 영향을 알아보고자 하였다. 연구방법: 본원을 내원한 14명 남성의 정자를 대상으로 콜레스테롤을 첨가하지 않은 대조군 (control)과 여러 농도의 콜레스테롤을 동결보존액에 첨가한 실험군에서 정자의 동결-융해 후 상태를 다음 3가지 방법으로 비교, 분석하였다. 1) 정자 분석, 2) calcium ionophore로 유도된 첨체 반응 검사, 3) 정자 염색질 구조 분석 (sperm chromatin structure assay). 결 과: 첫째로 인간 정자의 운동성은 $0.5{\mu}g$ 농도의 콜레스테롤을 첨가한 동결보존액에서 동결-해동하였을 경우, 콜레스테롤을 첨가하지 않은 군에 비해 유의적 차이를 보이며 증가하는 것을 확인하였다 ($33.46{\pm}1.48%$ vs. $30.10{\pm}1.07%$, p<0.05). 다음으로 동된 정자의 첨체 반응 검사에서도 콜레스테롤을 첨가한 동결보존액에서의 첨체 반응이 일어나는 정자의 비율이 첨가하지 않은 군에 비해 유의하게 높게 관찰되었다 ($53.60{\pm}1.60%$ vs. $47.40{\pm}1.86%$, p<0.05). 마지막으로 정자 염색질 구조 분석에서는 콜레스테롤을 첨가한 군이 첨가하지 않은 군에 비해 정자의 DNA손상이 적게 나타남을 확인하였다. 결 론: 본 실험은 동결보존액을 통한 정자 원형질막 내 콜레스테롤 함유량의 증가가 동결-융해 후 정자의 운동성과 수정능(capacitation status)을 증가시키고 DNA 손상을 방지하는 역할을 한다는 결과를 보여주었다. 이러한 결과를 통해 동결보존액 내 콜레스테롤의 첨가는 인간 정자의 동결보존 동안 발생할 수 있는 동결 상해를 줄여줄 수 있는 유용한 방법으로 사료된다.

체외배양에서 인간 난포액이 생쥐의 배 발달에 미치는 영향 (The Effects of Human Follicular Fluid on Embryonal Development of Mouse in In Vitro Culture)

  • 민부기;최기욱;김기석;이희섭;홍기연;이봉주;이선영;박승택
    • Clinical and Experimental Reproductive Medicine
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    • 제26권2호
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    • pp.171-178
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    • 1999
  • The follicular fluid (FF) of ovary contains various biological active products which affected on the growth of follicles and the fertilization of oocyte in physiological reproductive process of mammals. This study was designed to determine the effects of human FF on fertilization of oocyte and embryonal development in vitro culture. The FF was prepared as clear without blood contamination by needle aspiration from mature follicles of human at the time of oocytes retrieval for in vitro fertilization (IVF). As the medium for culture in vitro of embryonal cells, human tubal fluid (HTF) supplemented with follicular fluids at concentrations of 10%, 40% and pure FF were used. These effects were compared to control group of cultured embryos in HTF supplemented with 0.4% BSA (bovine serum albumin). For IVF, 64 eggs in control group, 67 eggs in 10% FF, 57 eggs in 40% FF and 64 eggs in pure FF were respectively allocated. And the rates of fertilization were almost similar in all groups as resulting 82.81% in control, 85.07% in 10% FF, 87.71% in 40% FF and 81.25% in pure FF. On the examination for embryonal cleavage from fertilized eggs, the rates of developing to 4 cell stage was similar in all groups, as results 98.11% in control, 98.27% in 10% FF and 98% in 40% FF but 78.84% in pure FF. And the rates of developing to 8-16 cell stage were significantly reduced as 44% in 40% FF and 44.23% in pure FF (p<0.05) compare to 71.69% in control media. As likewise, the rates of developing to morular stage were also significantly reduced to 36% (p<0.05) and 21.15% (p<0.01) respectively in 40% FF and pure FF. And the rates to blastocystic stage of embryo was lowest as 7.69% in pure FF (Table 1). The quality of embryonal cells on cleavage to the 8-16 cell stage was poorer, higher concentrations of FF. The rates of grade 1 in pure FF, as 23.07%, was lowest compare to those of other groups, in which the rates of grade 1 in control, 10% FF and 40% FF were 58.49%, 47.36% and 34% respectively. And on the contrary, the rate of grade 4 in pure FF was highest as 23.07%, while those were 5.66% in control, 8.77% in 10% FF and 20% in 40% FF (Table 2). On the viability of embryos, the rate of embryonal cell death was more rise, at the higher concentrations as well as longer exposure in the follicular fluid. At 48 hours after in vitro culture of embryos, the rate of survival embryos in pure FF was markedly lowered as 44.23%, compare to that of control (p<0.05). But there was not significant difference between the rates of survival embryos in each group beside the pure FF, which the rates were 77.35% in control, 70.17% in 10% FF and 60% in 40% FF respectively. And at 72 hours after in vitro culture, the rates of survival embryos were also significantly dropped to 21.15% in pure and 36% in 40% at concentration of FF compare to 62.26% in control (p<0.05, p<0.01). Finally, the rate of embryonal death at 96 hours after in vitro culture was highest as 82.69% in pure FF among all groups which those were 35.84 in control, 56.14% in 10% FF and 64% in 40% FF respectively (Fig. 1, 2, 3). In conclusion, this study suggests that the FF has no effects, in particular, to the in vitro fertilization of oocytes but exerted a bad effect to the cleavage, quality and viability of the embryonal cells during in vitro culture. However, the FF is harmful on embryonal development at conditions in higher concentration and especially on the embryos after $8{\sim}16$ cell stage.

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퇴행성 슬관절염 환자에 대한 도침요법의 효능 및 안전성 연구: 임상예비연구 (Efficacy and Safety of Miniscalpel Acupuncture in Knee Degenerative Osteoarthritis Patients: A Study Protocol for a Randomized Controlled Pilot Trial)

  • 전승아;박무섭;오세정;이정희;공한미;최성훈;황보민;이현종;김재수
    • Korean Journal of Acupuncture
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    • 제33권2호
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    • pp.67-74
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    • 2016
  • 목적 : 본 연구는 퇴행성 슬관절염 환자들을 대상으로 도침치료가 통증을 감소시키는데 효과적이고 안전한 치료법임을 증명하기에 적합한지를 알아보기 위한 예비연구이다. 방법 : 본 연구는 5주간 진행되는 무작위배정 대조군 예비임상연구이며, 총 20명의 피험자들은 시험군(도침치료)과 대조군(침치료+전침치료)으로 무작위 배정된다. 시험군의 경우에는 주 1회, 3주간 총 3회의 도침치료를 실시하고 대조군의 경우에 주 2회, 3주간 총 6회의 침치료와 전침치료를 받게된다. 1차 유효성 평가변수는 통증에 대한 Visual analogue system와 관절가동범위를, 2차 유효성 평가변수는 Short form McGill pain questionnaire와 Western Ontario and McMaster Universities Osteoarthritis Index로 측정한다. 평가는 시험시작 전, 시험 1주, 2주, 3주 및 5주후에 이루어지게 된다. 결론 : 본 연구는 추후 본격적인 무작위배정 대조군 임상시험을 위한 예비연구로서, 본 연구를 통해 퇴행성 슬관절염에 있어서 도침치료가 임상적으로 유효함을 증명할 수 있는 근거를 마련해 줄 것이라 사료된다.

단일 박동형 생명구조장치의 인공폐 적용 -실험연구- (Application of a Single-pulsatile Extracorporeal Life Support System for Extracorporeal Membrane Oxygenation -An experimental study -)

  • 김태식;선경;이규백;박성영;황재준;손호성;김광택;김형묵
    • Journal of Chest Surgery
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    • 제37권3호
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    • pp.201-209
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    • 2004
  • 생명구조장치(ECLS)는 호흡부전 및 심부전에 적용하는 장치로 세계적으로 많은 연구개발과 임상시도가 계속되고 있다. 현재까지 생명구조장치의 혈류펌프로는 비박동형 구동장치가 표준으로 사용되고 있으며, 박동형 구동장치는 생리적인 측면에서 유리하지만 급격한 회로압 상승과 그에 따른 혈구손상에 대한 우려가 있고 특히 막형산화기를 사용하는 인공폐 회로에서 기피되어 왔다. 본 연구는 인공폐 실험모델에서 단일 박동형 구동펌프와 막형 산화기 사이에 압력완충장치를 설치함으로써 언급한 부작용을 최소화시키면서 생리적인 박동혈류를 유도할 수 있을 것이라는 가능성을 검증하였다. 실험대상은 올레익산으로 급성 호흡부전증이 유발된 잡견(N=16)을 사용하였다. 실험군은 사용된 구동펌프의 종류와 압력완충장치의 유무에 따라 3개 군으로 분류하였다. 제1군(n=6)은 대조군으로 원심펌프를 이용하였고, 제2군(n=4)은 단일 박동형 구동펌프를 사용하였으며, 제3군(n=6)은 단일 박동형 구동펌프에 압력완충장치를 설치하였다. 실험모델은 흉강 절개 후 우심방-대동맥을 우회시키는 부분 체외순환 형태로, 1.8~2 L/min의 펌프박출량에서 2시간을 구동하였다. 관찰지표는 주로 혈역학 변화, 회로압, 혈액검사 및 혈구세포에 미치는 영향 등에 한정하였다. 맥동압(pulse pressure)은 박동형 구동펌프를 이용한 2군(47$\pm$10 mmHg)과 3군(41$\pm$9 mmHg)에서 비박동형 원심펌프를 이용한 1군(17$\pm$7 mmHg)에 비해 유의하게 높았다(p<0.001). 막형산화기에 걸리는 회로압은 1 군의 경우 222$\pm$8mmHg, 2군의 경우 739 $\pm$ 35 mmHg, 3군의 경우 470$\pm$ 17 mmHg였다(p<0.001). 순환 2시간째의 동맥혈 산소분압은 1군에 비해 박동혈류를 사용하는 2군과 3군에서 현저하게 높았다(77$\pm$41, 96$\pm$48, 97$\pm$25 mmHg; p<0.05). 혈구손상지표인 혈장 유리 헤모글로빈치는 1군에서 가장 낮았고, 2군에서 가장 높았으며, 3군에서 유의하게 감소하였다(55.7$\pm$43.3, 162.8$\pm$113.6, 82.5$\pm$25.1 mg%; p<0.05). 기타 혈액검사치는 특별한 차이가 없었다. 이상의 결과에서 단일 박동형 구동펌프는 비박동형 원심펌프에 비해 막형산화기의 산소교환에 유리한 반면, 회로압과 혈구세포 손상 측면에서 불리하다는 것을 알 수 있었다. 그러나 단일 박동형 구동펌프와 막형 산화기 사이에 압력완충장치를 설치하는 경우, 회로압 상승과 혈구세포손상을 유의하게 감소시킬 수 있었다.

간호학 교과과정 개선을 위한 조사 연구 (A Study on improvement of curriculum in Nursing)

  • 김애실
    • 대한간호학회지
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    • 제4권2호
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    • pp.1-16
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    • 1974
  • This Study involved the development of a survey form and the collection of data in an effort-to provide information which can be used in the improvement of nursing curricula. The data examined were the kinds courses currently being taught in the curricula of nursing education institutions throughout Korea, credits required for course completion, and year in-which courses are taken. For the purposes of this study, curricula were classified into college, nursing school and vocational school categories. Courses were directed into the 3 major categories of general education courses, supporting science courses and professional education course, and further subdirector as. follows: 1) General education (following the classification of Philip H. phoenix): a) Symbolics, b) Empirics, c) Aesthetics. 4) Synthetics, e) Ethics, f) Synoptic. 2) Supporting science: a) physical science, b) biological science, c) social science, d) behavioral science, e) Health science, f) Educations 3) Professional Education; a) basic courses, b) courses in each of the respective fields of nursing. Ⅰ. General Education aimed at developing the individual as a person and as a member of society is relatively strong in college curricula compared with the other two. a) Courses included in the category of symbolics included Korean language, English, German. Chines. Mathematics. Statics: Economics and Computer most college curricula included 20 credits. of courses in this sub-category, while nursing schools required 12 credits and vocational school 10 units. English ordinarily receives particularly heavy emphasis. b) Research methodology, Domestic affair and women & courtney was included under the category of empirics in the college curricula, nursing and vocational school do not offer this at all. c) Courses classified under aesthetics were physical education, drill, music, recreation and fine arts. Most college curricula had 4 credits in these areas, nursing school provided for 2 credits, and most vocational schools offered 10 units. d) Synoptic included leadership, interpersonal relationship, and communications, Most schools did not offer courses of this nature. e) The category of ethics included citizenship. 2 credits are provided in college curricula, while vocational schools require 4 units. Nursing schools do not offer these courses. f) Courses included under synoptic were Korean history, cultural history, philosophy, Logics, and religion. Most college curricular 5 credits in these areas, nursing schools 4 credits. and vocational schools 2 units. g) Only physical education was given every Year in college curricula and only English was given in nursing schools and vocational schools in every of the curriculum. Most of the other courses were given during the first year of the curriculum. Ⅱ. Supporting science courses are fundamental to the practice and application of nursing theory. a) Physical science course include physics, chemistry and natural science. most colleges and nursing schools provided for 2 credits of physical science courses in their curricula, while most vocational schools did not offer t me. b) Courses included under biological science were anatomy, physiologic, biology and biochemistry. Most college curricula provided for 15 credits of biological science, nursing schools for the most part provided for 11 credits, and most vocational schools provided for 8 units. c) Courses included under social science were sociology and anthropology. Most colleges provided for 1 credit in courses of this category, which most nursing schools provided for 2 creates Most vocational school did not provide courses of this type. d) Courses included under behavioral science were general and clinical psychology, developmental psychology. mental hygiene and guidance. Most schools did not provide for these courses. e) Courses included under health science included pharmacy and pharmacology, microbiology, pathology, nutrition and dietetics, parasitology, and Chinese medicine. Most college curricula provided for 11 credits, while most nursing schools provide for 12 credits, most part provided 20 units of medical courses. f) Courses included under education included educational psychology, principles of education, philosophy of education, history of education, social education, educational evaluation, educational curricula, class management, guidance techniques and school & community. Host college softer 3 credits in courses in this category, while nursing schools provide 8 credits and vocational schools provide for 6 units, 50% of the colleges prepare these students to qualify as regular teachers of the second level, while 91% of the nursing schools and 60% of the vocational schools prepare their of the vocational schools prepare their students to qualify as school nurse. g) The majority of colleges start supporting science courses in the first year and complete them by the second year. Nursing schools and vocational schools usually complete them in the first year. Ⅲ. Professional Education courses are designed to develop professional nursing knowledge, attitudes and skills in the students. a) Basic courses include social nursing, nursing ethics, history of nursing professional control, nursing administration, social medicine, social welfare, introductory nursing, advanced nursing, medical regulations, efficient nursing, nursing english and basic nursing, College curricula devoted 13 credits to these subjects, nursing schools 14 credits, and vocational schools 26 units indicating a severe difference in the scope of education provided. b) There was noticeable tendency for the colleges to take a unified approach to the branches of nursing. 60% of the schools had courses in public health nursing, 80% in pediatric nursing, 60% in obstetric nursing, 90% in psychiatric nursing and 80% in medical-surgical nursing. The greatest number of schools provided 48 crudites in all of these fields combined. in most of the nursing schools, 52 credits were provided for courses divided according to disease. in the vocational schools, unified courses are provided in public health nursing, child nursing, maternal nursing, psychiatric nursing and adult nursing. In addition, one unit is provided for one hour a week of practice. The total number of units provided in the greatest number of vocational schools is thus Ⅲ units double the number provided in nursing schools and colleges. c) In th leges, the second year is devoted mainly to basic nursing courses, while the third and fourth years are used for advanced nursing courses. In nursing schools and vocational schools, the first year deals primarily with basic nursing and the second and third years are used to cover advanced nursing courses. The study yielded the following conclusions. 1. Instructional goals should be established for each courses in line with the idea of nursing, and curriculum improvements should be made accordingly. 2. Course that fall under the synthetics category should be strengthened and ways should be sought to develop the ability to cooperate with those who work for human welfare and health. 3. The ability to solve problems on the basis of scientific principles and knowledge and understanding of man society should be fostered through a strengthening of courses dealing with physical sciences, social sciences and behavioral sciences and redistribution of courses emphasizing biological and health sciences. 4. There should be more balanced curricula with less emphasis on courses in the major There is a need to establish courses necessary for the individual nurse by doing away with courses centered around specific diseases and combining them in unified courses. In addition it is possible to develop skill in dealing with people by using the social setting in comprehensive training. The most efficient ratio of the study experience should be studied to provide more effective, interesting education Elective course should be initiated to insure a man flexible, responsive educational program. 5. The curriculum stipulated in the education law should be examined.

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