• 대한한의학회지
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• 제36권4호
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• pp.8-18
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• 2015

Objectives: There have been several studies evaluated effect of electroacupuncture (EA) on spasticity but most studies could not assess spasticity quantitatively because they used clinical rating scales for assessment spasticity. The objective of this study is to evaluate effect of EA on poststroke spasticity quantitatively using tendon reflex (T-reflex). Methods: 29 stroke patients with upper extremity spasticity were randomized to EA group and control group. The EA group received combined EA and rehabilitation therapy 5 times a week for 3 weeks. Acupuncture treatment was given at Jian Yu (LI 15), Qu Chi (LI 11), Shao Hai (HT 3), Wai Guan (TE 5), He Gu (LI 4), Lie Que (LU 7), Hou Xi (SI 3) of the affected side, 30 minutes of electrical stimulation with a frequency of 40/13 Hz was applied at Qu Chi (LI 11), He Gu (LI 4). The control group received only rehabilitation therapy. The efficacy of treatment was assessed using T-reflex latency and amplitude, modified Ashworth scale (MAS) of biceps brachii, brachioradialis and triceps brachii. Fugl-Meyer motor function assessment (FMA) and functional independence measure (FIM) were also measured to assess motor function and functional independence. All outcomes were measured before treatment, immediately after 3 weeks of treatment and 1 week after 3 weeks of treatment. Results: No statistically significant differences were found in outcomes including T-reflex between the study groups except for FIM values immediately after 3 weeks of treatment (p=0.037). Conclusions: These results suggest that 3 weeks of EA does not reduce poststroke upper extremity spasticity electrophysiologically and clinically. However, small sample sizes and contradictory tendency between results from T-reflex and those from MAS require cautious judgement on interpretation of the results. A larger, well-designed clinical trials for quantitative evaluation of effect of EA on poststroke spasticity will be needed.

• 대한한방내과학회지
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• 제19권1호
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• pp.301-317
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• 1998

A clinical analysis was carried out for 32 patients who were treated in Dept. of Dong-shin Oriental Medicine Hospital from 10st January to 16st May in 1998 and ruled out as dememtia. The results were summarized as follows. 1. In the distribution of sex, female was more than male. And the age of seventies(17 cases, 53.125%) was highest in the frequency of age. 2. In the distribution of having history of drinking and smoking were each 4 cases(12.5%) and 7 cases(21.875%). 3. In the distribution of seasons, the ratio of spring and winter were each 16 cases(50.0%), 15 cases(46.875%), that of summer and fall were comparatively low. 4. In the period from onset to admission, the period within a week had 20 cases(62.5%) as top, and the most period of treatment was 2 and 3 weeks(28.125%). 5. The number of cases that had preceding disease was 35 cases(71.875%), a major portion of preceding diseases were hypertension, diabetes mellitus, stroke. 6. The most common symptom was disorientation(78.125%), and the next common symptom was motor desability(71.875%), and memory disturbance, verbal disturbance was each 59.375 and 47.1%. 7. In the distribution of the CT scan films, 15 cases(46.875%) showed cerebral infarction and that of another 5cases (15.625%) showed cerebral hemorrhage, that of another 2 cases(6.25%) showed brain atrophy. 8. In the lipid density of blood, T-Cholesterol, TG, HDL-Cholesterol, LDL- Cholesterol was within normal limit. 9. In the MMSE-K, the most score was from 16 point to 20 point, and second only was from 11 point to 15 point, and the next was from 6 point to 10 point. 10. In the Ischemic score, 20 cases(62.5%) was diagnosed as brain vascular type dementia, and mixed type dementia was 9 cases(28.125%), Alzheimer type dementia was 3 cases(9.375%). 11. The most used recipes were a sort of recipes to activate of flow the vital energy and the blood, to remove the phlegm(41 cases 33.9%), especially DODAMHOALHEL TANG (12 cases, 9.9%), ANSINCHUNGNOITANG (8 case, 6.6%) was the most used recipe. 12. In the judgement of efficacy, 17 cases(53.125%) showed excellent efficacy, 10 cases(31.25%) showed good efficacy, 5 cases(15.625%) showed no change and that according to MMSE-K, 4 case(18.18%) showed excellent efficacy, 15 cases(68.18%) showed good efficacy, 15 cases(68.18%) showed no change.

• 혜화의학회지
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• 제1권1호
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• pp.151-165
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• 1992

Clinical studies were done on 18 people chosen from admission patients didn't have will of stop-smoking who were treated with the auricular acupuncture therapy to stop-smoking in the Dep. of the Acupuncture and Moxibution, Hospital of Oriental Medicine in Dae Jeon University from 1991. 5. 28 to 1991. 6. 15. The following results have obtained 1. Distribution of sex; male(83%), Female(17%) 2. In the distribution of age, 30s age group made up 33.3%, 20s, 50s, 60s age group made up each 16.6%, 40s made up 11.1%, 70s made up 5.5% of the group. 3. Distribution of occupation in descending order; labour man(38.8%), businessman(22.4%), housewife, office woker was each 16.6%, students(5.5%). 4. Distribution of human coporal constitution in descending order; Tae-Eum-In(50%), So-Yang-In(27.8%), So-Eum-In(22.2%). 5. Distribution of statring tense to smoking in descending order; 10s, 20s, were each 44. 4%, 30s(11.1%). 6. Distribution of duration in descending order; 10-19years(33.3%), 40-49years(22.2%), 1-9, 20-29years were each 16.6%, 30-39years(11.1%). 7. Distribution of smoking amount(1day) in descending order; 11-20 cigarettes(38.8%), 21-30 cigarettes(22.7%), 1-10 cigarettes, 31-40 cigarettes were each 16.6%. 8. Distribution of the motive to smoking in descending order; curiosity(61.1%), hyperemesis gravidarum, abdominal pain, stress, inducement. 9. Distribution of symptoms within smoking in descending order; sputum(83%), liver disorder(11%), stomach disorder(6%). 10. Distribution in symptoms of post treatment of stop-smoking by acupuncture in descending order; nausea, headache were 12%, ear-radiating pain(6%), no variation(82%). 11. Distribution in change of cigarettes taste after the auricular acupuncture treatment; some decrease, complete decrease were each 38. 8%, decrease of post taste in smoking, burning-paper odored were each 5.5%, no variation(11.1%). 12. Total judgement of efficacy in descending order; excellent(50. 0%), good(28.8%), fair(10. 0%), failure(11.1%).

• Clinical and Experimental Pediatrics
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• 제49권6호
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• pp.672-676
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• 2006

목 적 : 가와사끼병에서 급성기 항염치료 후 회복기에 항혈전 요법으로 저용량 아스피린을 사용한다. 대개 6-8주간 투여하고 종료 시기에 혈소판 치를 포함한 각종 혈액검사와 관상동맥 이상 유무를 알기 위한 심초음파 검사를 시행하기도 한다. 발병 6주째에 시행하는 각종 추적검사가 임상적으로 얼마나 유용한지 알아보고자 본 조사를 시행하였다. 방 법 : 1997년 1월부터 2004년 12월까지 만 8년간 원광대학교병원 소아과에 입원하여 가와사끼병으로 치료받았던 282명의 환자를 대상으로 후향적으로 조사하였다. 입원 당시와 6주째에 백혈구수와 혈소판수, ASO, ESR, CRP, AST, ALT, 소변검사, 심초음파 검사를 시행하였다. 6주째에 혈소판이 증가했던 군과 대조군을 각종 검사 척도로 비교하였고, 나이와 성별, 재치료 여부, 발열-입원 기간, 치료-해열 기간, 관상동맥 이상 등이 6주째의 혈소판 증가에 영향을 미치는지 비교 분석하였다. 통계적 비교는 paired t-test와 Fisher's exact test, logistic 회귀분석으로 하였다. 결 과 : 입원 시에 증가를 보였던 ESR과 CRP는 6주째 시행한 검사상 각각 35명(12.4%), 12명(4.3%)을 제외하고 정상화되었고, 무균성 농뇨는 전례에서 모두 정상화되었다. 혈소판 증가는 36명(12.8%), 백혈구 이상 15명(5.3%), 관상동맥 이상 6명(2.1%), AST 상승 22명(7.8%), ALT 상승 3명(1.1%), AST/ALT 동시 상승은 3명(1.1%)에서 관찰되었다. 관상동맥 이상은 발병 초기에 이상을 보였던 경우에서만 관찰되었다. 6주째의 혈소판 증가군에서 대조군에 비해 성별과 재치료, 입원 시의 백혈구 이상, 농뇨, AST/ALT의 동시상승, 관상동맥 이상 빈도의 비교에서 모두 유의한 차이가 없었다. 6주째의 혈소판 증가에 영향을 주는 인자로는 어린 나이와 발병초기의 혈소판 증가증이었다. 발열-입원 기간과 치료-해열 기간, 입원 시의 ESR, CRP, AST, ALT치는 영향을 주지 않았다. 입원 시와 6주째의 혈소판 증가는 관상동맥 이상에 영향을 주지 않았다. 결 론 : 가와사끼병에서 6주째에 시행하는 각종 추적검사에서 소변 검사는 생략해도 될 것으로 보이며, 심초음파 검사는 발병 초기에 이상이 있었던 군에서만 선택적으로 시행해도 될 가능성을 시사했지만 이에 대한 연구가 더 필요하다고 판단된다. 혈소판 수는 계속적인 항혈전 치료와 관련이 있으므로 6주째의 검사가 필요하나, 백혈구수와 AST, ALT, ESR, CRP 검사의 임상적 의의는 크지 않다고 판단된다.

• Journal of Nutrition and Health
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• 제8권4호
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• pp.9-14
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• 1975

Growth retardation and a variable degree of body disproportion are recognized features of malnutrition, and mild and moderate protein-calorie malnutrition(PCM). Among the various body measurements suggested to assess the prevalence of all grades of PCM as judged by growth retardation and by body disproportion, the 'mid-upper-arm circumference'-abbreviated to 'arm-circumference' has been suggested as a potential useful simple field index for the assessment of PCM showing that the measurement would give composite information simultaneously on three important effects on PCM-deficit in the muscle protein reservoirs, availability of calorie stores in the form of subcutaneous fat, and growth failure. And this is selected because of its easy accessibility, and less involvement with clinical edema. This study is conducted to make a comparison between the percentage of Korean weight for age standards and the percentage of mid-upper-arm circumference for age standards of 175 preschool children aged $3{\sim}72$ months who are selected among the low-income residents in Seoul. In this study, a comparison is made between the results obtained by expressing the observed weight of the child as a percentage of Korean standard, referred to as 'weight-for-age' and the observed arm-circumference expressed as a percentage of the age-specific arm standard of Jelliffe, referred to as 'arm-for-age'. All the measurements were taken following the techniques described by Jelliffe. The left mid upper arm was measured using a glass-fibre tape and the Fairbanks Morse beam balance was used for weighing. 80% level of weight for age Korean standard and 85% level of arm for are Jelliffe standard were used as an upper borderline limit for PCM. Comparing the 80% weight-for-age and the 85% arm-for-age standard as an upper limit for PCM, for children aged $3{\sim}72$ months, results in 84.6% agreement with the sensitivity of 86.4% and its specificity of 83.5%. If arm circumference alone had been measured and judgement made on this basis, then only 5.1% of the children would have been 'wrongly' classified. And there is a moderately close correlation between arm circumference and weight for age as the data in Table 4 shows. The problem therefore lies in the standard for arm circumference in normal children and in determining what is the lower limit of normal. Once this is clearly difined, one can rely more confidently on arm circumference measurements alone for the nutritional assessment of early childhood.

• 한국한의학연구원논문집
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• 제5권1호
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• pp.27-53
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• 1999

The goal of this study is to review and define the role of nurses' who are engaged in Korea Oriental medical treatments in oriental medical hospitals. We think this study can contribute to the development of 'Korea Oriental medical science & nursing science' and 'Public health care'. A large portion of nurses's role in Korea Oriental Medicine(KOM. 한방/한의학) is assistance to doctors treatment. But besides of these role, we think there are many things that are riskless for nurses to do alone. But in present situation, few nurses in KOM. have enough knowledge to treat these medical treatments alone. So we believe this study will provide a way for nurses to participate more actively in KOM. public health care. With the goal of this study, we checked all medical treatments that have been practiced in oriental medical hospitals, and classified these treatments with some groups. And we organized a inquiry. At this inquiry, we ask 'What is the adequate role of nurses in Korea Oriental medical treatment? & What kind of treatment can nurses do?' We got 58 responses from nationwide 121 hospitals. From these response, more than half of them said nurses can do following medical treatment in the oriental medical hospital: 1. starting and ending part of following treatments; External treatments by instrument, by hydrotheraphy, by herb, by suction, moxibustion, Manipulative therapies on soft structure, Living and mind-body therapies. 2. pulling out Acupuncture. 3. boiling herb, judgement on dosing temperature, assisting in dosing, 4. assisting Diet, 5. operating from Living and mind-body therapies. 6. leading Physical training However, these results are coming out from present situation. So, after well-oriented instructions for nurses, this study will be need to carry out again. From this study, we suggest a desirable curriculum for students who study 'Korea Oriental Nursing Science.' That is to say, at basic course students take 4 subject for 6 credits. And at as an expert course, it should be dividend into Clinical Nursing Specialist in KOM., Self-care Nursing Specialist, Regimen Nursing Specialist and take 17 credits per each course.

• 감성과학
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• 제10권1호
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• pp.79-86
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• 2007

치매노인의 주요 문제특성의 추출을 위해 시설에 입소해 있는 치매노인 110명을 대상으로 기본특성 조사, 인지기능 선별검사, 문제특성 설문조사를 실시하였다. 요인분석결과 총 20개의 주요 문제특성이 추출되었다. 본 연구에서는 치매노인 보호를 위해 주요 문제특성 20개의 위험순위를 결정하였다. 치매진단 및 치매환자를 접한 경험이 있는 정신보건 임상심리사 32명을 대상으로 설문조사를 실시하였다. 계층분석법을 이용하여 상대적 위험도를 분석하였고, 20개의 문제특성 전체에 대하여 위험도 서열을 정하도록 하여 위험순위를 결정하였다. 두 가지 분석 결과 모두 치매 노인의 일상생활 수행 시 기억력, 판단력, 지남력 장애와 같은 인지문제가 가장 위험한 것으로 나타났다.

• 대한소아치과학회지
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• 제27권2호
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• pp.208-215
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• 2000

선천성 심장질환 환자는 감염성 심내막염에 감수성을 가지고 있고, 치과치료후에 균혈증에 의해서 감염성 심내막염이 발생할 수 있다. 따라서 선천성 심장질환 환자에 있어서 감염성 심내막염을 유발할 수 있는 치과치료를 시행 시에는 예방적항생제의 투여가 추천된다. 1997년 미국 심장학회에서는 감염성 심내막염의 예방을 위한 개정된 지침을 발표하였다. 개정된 지침은 예방적 항생제 투여의 적응증, 항생제의 선택, 투여용량 등에 있어서 이전의 지침과 차이가 있다. 이전의 지침은 출혈을 유발할 수 있는 모든 치과시술에 대해서 예방적 항생제의 투여를 추천하고 있으나 개정된 지침은 술자의 판단에 따라 심한 출혈이 있는 경우에만 예방적 항생제를 투여할 것을 추천하고 있다. 또한 이전의 지침에선 술전과 술후 2회의 예방적 항생제 투여를 추천하였으나 개정된 지침에서는 술후 투여가 없어지고 술전 1회만 예방적 항생제를 투여 할 것을 추천하고 있다. 본 증례는 미국심장학회에서 최근에 발표한 선천성 심장질환 환자의 치과치료시의 예방적 항생제 투여 지침에 따라서 3명의 선천성 심장질환 환아를 대상으로 치과치료 후 그 예후를 관찰한 것이다.

• 대한간호학회지
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• 제7권2호
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• pp.11-21
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• 1977

Many in nursing look back on Nursing Research history and proudly point to the fact that emphasis in nursing research has changed from studying the nurse to studying nursing practice. In recent years, much emphasis has been placed on seeking a method of evaluating the quality of nursing care. In spite of these attempts, however, an instrument for evaluating the quality of nursing care that is actually applicable in the clinical area has not been found. The Purposes of this study are as follows: 1) To develop the instrument to be used in evaluating the quality of nursing care provided in the Neuro - Surgery Constant Care Unit of Severance Hospital 2) To evaluate the quality of nursing care in the clinical area. 3) To provide the necessary information for improvement of quality of nursing care. The instrument for evaluating the quality of nursing care, developed by the investigator, was composed of 7 nursing goals and divided into 65 standards of nursing performance. The 7 nursing goal are as follows : 1) Maintenance of airway 2) Maintenance of fluid at electrolyte balance 3) Maintenance of elimination 4) Personal hygiene 5) Optimum activity 6) Prevention of accidents 7) Emotional care The study population defined was composed of all the case (51) who were admitted in the Neuro- Surgery Constant Care Unit of Severance Hospital from May 7-13, 1976. The observation method was used and the data was subjected to the %, X²-test, T-test, F-test and Correlation. The results of tile study were as follows : 1. Levels of nursing performance regarding nursing goals. Seven different nursing care indices were constructed in terms of nursing goals. The index scores were grouped arbitrarily into ,j categories such as "excellent", "good", "moderate", "incomplete", and "poor"based upon the investigator′s personal judgement. a. The nursing index of maintaining airway showed that 78% of the patients fell within the "excellent" and 22% of the patients, fell within the "good" category. b. The nursing index of maintaining fluid & electrolyte balance showed that 95% of the patients fell within the "excellent" and 5 % of the patients fell within the "good" category. c. The nursing index of maintaining elimination showed that 100% of the patients fell within the "excellent" category. d. The nursing index of personal hygiene revealed that 49% of the patients fell within the "excellent" and 51% of the patients fell within the "good" category. e. The nursing index of optimum activity showed that 63% of the patients fell within the "excellent" and 32% of the patients fell within tile "good" and 5% of patients fell within the "moderate" category. f. The nursing index of prevention of accidents showed that 100% of the patients foil within the "excellent" category. g. The nursing index of emotional cart revealed that 27% of the patients fell within the "excellent", 24 % of the patients fell within tile "good", 29 % of the patients fell within the "incomplete" category. From these findings it is disclosed that the quality of nursing care provided in the Neuro- Surgery Constant Care Unit of Severance Hospital was excellent. h. There were statistically significant differences between the nursing index of physical care and emotional care. (t=8.73, D. F. =100. p<0.01) It is revealed that more physical care then emotional care was carried out by nurses. 2. Levels of nursing performance regarding general characteristics of the patients. No significant differences were observed statistically with the nursing indices of nursing goals according to the sex (t=0.084, D. F. =12, p>0.05). Age (F=0.1251, D. F. : 3.18. p 〉0.05), absence or presence of operating experiences (t=0.6032, D. F. =12, p〉0.05, levels of consciousness (F=0.31, D. F. :3. 18, p >0.05) 3. Relationship between the levels of consciousness and the nursing index of each nursing goal. There was negative correlation between the levels of consciousness and the nursing index of maintaining airway (r=-0. 5449, p<0.01) and personal hygiene (r= -0.4075, p<0.01) There was positive correlation between the levels of consciousness and the nursing index of optimum activity (r=0.3936, p <0.01) and emotional care (r=0.7819, p〈0.01). There was slight correlation between the levels of consciousness and the nursing index of maintaining fluid & electrolyte balance (r=-0.3418, 0.010.05) and preventing accidents (r=0.1441, p>0.05.

• Tuberculosis and Respiratory Diseases
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• 제47권3호
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• pp.365-373
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• 1999

연구배경: 중환자실에서 기관절개의 적용은 보편화된 술기중의 하나이지만, 장기간의 기계 호흡으로 인한 기관삽관으로부터 기관절개로의 이행의 최적의 시기에 대해서는 아직 논란이 있다. 조기 기관절개는 기도 유지가 용이하며 구강 관리나 이동이 보다 자유로운 등의 장점이 있으나 병원내 감염이나 기도 협착의 위험을 증가시키는 단점을 갖고 있다. 이에 본 연구에서는 기관절개의 시행시기와 예후간의 관련성을 관찰하여 최적의 기관 절개의 시기를 알아 보고자 하였다. 방법: 본 연구는 후향적인 연구로서 35명의 내과계 및 15명의 외과계 환자를 대상으로 APACHE III 점수, 병원내 감염의 발생, 임상상의 변화에 대해 기관절개일로부터 28일간의 자료를 관찰하였다. 조기 및 후기 기관절개의 구분은 기관삽관시로부터 7 일을 기준으로 하였으며 각각 25명씩이었다. 결과: 조기 기관절개군과 후기 기관절개군은 각각 25명이었으며 평균연령은 각각 $48{\pm}18$세 및 $63{\pm}17$세로 조기 기관절개군에서 유의하게 낮았다. 기관절개까지 소요된 평균 시간은 조기 기관절개군과 후기 기관절개군에서 각각 3일과 13일이었다. 대상 환자의 원인 장기별 분포는 뇌 신경계 27례(54%), 호흡기계 14례(28%), 순환기계 4례(8%), 소화기계 4례(8%), 요로계 l례(2%)의 순이었고, 기관절개의 목적은 장기간 기계호흡이 필요하여 사행한 경우가 43례로 가장 많았고, 응급 기도확보가 5례, 그리고 분비물 제거를 위해 시행한 경우가 2례였으며, 조기 및 후기의 양환자군 사이의 기관절개 목적에 따른 통계학적 차이는 없었다. 기관삽관시, 기관절개시와 기관절개일로부터 7일간의 APACHE III 점수는 조기 및 후기군의 양군에서 유사하였다. 이를 다시 생존자군과 사망자군으로 나누어 분석했을 때도 양군간의 유의한 차이는 관찰되지 않았다. 병원내 감염의 발생, 기계호흡으로부터의 이탈과 사망률에 있어서도 가관절개일로부터 28일간을 관찰시 조기 및 후기 기관절개군간에 어떤 차이도 보이지 않았다. 사망률은 기관절개일부터 7일간 관찰기간중에 APACHE III 점수가 높을수록 증가하였다. 그러나, 기관절개의 시기와 기관절개 이전의 기계호흡 시행 일수 등에 따른 사망률의 증가는 없었다. 결론: 조기 기관절개는 병의 중증도, 원내 감염, 기계호흡의 지속 일수, 그리고 사망률에 있어 어떤 장점도 보이지 않았으며, 최적의 기관절개 시기는 개개의 임상적 판단에 따라야 할 것으로 사료되나 이에 대한 대규모 전향적인 연구가 필요할 것으로 생각된다.