• 한국콘텐츠학회논문지
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• 제10권7호
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• pp.268-275
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• 2010

관상동맥 석회수치(CACS)는 조직학적으로 동맥경화반의 총량과 높은 상관관계를 보이며, 관상동맥의 협착을 예측하는 지표와 향후 허혈성 심장질환 발생의 독립적인 위험인자가 된다. 본 연구는 2006년 1월부터 2008년 12월까지 화순전남대학교병원 건강증진센터에서 건강검진을 목적으로 CACS검사를 시행한 1042명을 대상자로 심혈관질환 위험요소 및 관상동맥 석회수치와 Framingham Risk Scores(FRS)와의 상관관계를 알아보고자 하였다. CACS와 FRS는 남성(OR, 2.38; 95% CI, 1.83-3.11), 여성(OR, 2.12; 95% CI, 1.03-4.35) 모두 관상동맥 석회수치가 없는 군과 비교하여 통계적으로 유의하게 높았으며, CACS와 심혈관질환 위험요인과의 관계에서는 연령과 성별을 통제한 다변량분석에서 여자는 연령(OR, 1.10; 95% CI, 1.06-1.15), 고밀도지단백콜레스테롤(OR, 2.38; 95% CI, 1.04-5.44), 공복혈당(OR, 2.89; 95% CI, 1.16-7.21)이 남자에서는 연령(OR, 1.11; 95% CI, 1.08-1.14), 저밀도지단백콜레스테롤(OR, 2.12; 95% CI, 1.28-3.50), 감마-글루타밀전이효소(OR, 1.73; 95% CI, 1.17-2.55), 당뇨병(OR, 3.92; 95% CI, 1.73-8.89)이 관상동맥 석회수치의 유의한 위험인자로 나타났다.

• Journal of Chest Surgery
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• 제46권2호
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• pp.104-110
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• 2013

Background: We reviewed the long-term outcomes of aortic root replacement at Asan Medical Center and investigated the predictors affecting mortality. Materials and Methods: A retrospective analysis was performed on 225 consecutive adult patients undergoing aortic root replacement with mechanical conduits (n=169), porcine aortic root prosthesis (n=23), or aortic homografts (n=33) from January 1992 to September 2009. The median follow-up duration was 6.1 years (range, 0 to 18.0 years). Results: The porcine root group was older than the other groups (freestyle $55.9{\pm}14.3$ years vs. mechanical $46.3{\pm}14.6$ years, homograft $48.1{\pm}14.7$ years; p=0.02). The mechanical group had the highest incidence of the Marfan syndrome (mechanical 22%, freestyle 4%, homograft 3%; p=0.01). Surgery performed for infective endocarditis was more frequent in the homograft group (mechanical 10%, freestyle 10%, homograft 40%; p<0.001). The overall 30-day mortality was 5.3% (12/225). Actuarial survival rates in the mechanical, porcine root, and homograft groups were 79.4%, 81.5%, and 83.5% at 5 years and 67%, 61.9%, and 61.1% at 10 years, respectively (p=0.73). By multivariate analysis, preoperative diabetes mellitus, older age, and longer cardiopulmonary bypass time were independent predictors of mortality. Incidence of postoperative complications, including infective endocarditis and thromboembolism were comparable in all of the groups. Conclusion: Aortic root replacement can be safely performed with different types of prostheses as the outcome was not affected by the choice of prosthesis. Further studies are required to assess the long-term durability of biological prostheses.

• Journal of Oral Medicine and Pain
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• 제35권1호
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• pp.41-47
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• 2010

구강작열감증후군은 임상적 증상이나 검사실 소견없이 구강점막에 나타나는 작열감을 말하며 중년이후 폐경기 여성에게 높은 발생율을 보인다. 구강작열감증후군에서 보여지는 통증은 자발적이며 뚜렷한 악화요인을 보이고 있지 않다. 통증 유발과 관련해서 치과적 술식, 최근의 질환, 투약(항생제 요법)등을 포함하고 있으며, 작열감이 한 번 시작되면 수년간 지속된다. 대부분의 구강작열감 환자는 국소적 또는 전신적 요인을 가지고 있으며, 구강작열감증후군은 신경병리학적 활성화에서 기원되는 만성구강증상으로 고려할 수 있으며, 정신학적 원인에 대한 역할은 아직은 명확하지 않다. 구강작열감의 신경학적 측면에 대하여 연구가 증가하고 있고 이런 연구는 구강작열감에 중추신경계, 말초신경계가 관여함을 제시하고 있다. 그 중에 하나로 대두 되고 있는 것이 미각에서의 이상이 존재한다는 것이다. 구강작열감증후군에서 supertaster의 존재에 대해 언급하고 있으며, 이는 미각과 유해수용성 기전에 상호작용함을 제시하고 있다. 즉 중추신경계에서 미각과 구강 통증 감각이 연결되어 있고 이것은 구강작열감증후군에서 고삭신경, 설인신경수준에서 미각체계 변형에 의한 말초신경계와 중추신경계가 같이 상호 작용하여 구강작열감증후군을 발생시킴을 보여준다. 이에 본 저자는 만성구강통증으로 여겨지는 구강작열감증후군을 유발하는 요인과 병태 생리를 고찰하여 환자의 진단과 원인 지향적인 치료에 도움을 주고자 한다.

• Journal of Oral Medicine and Pain
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• 제33권2호
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• pp.111-120
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• 2008

다양한 전신질환으로 입원한 환자들의 전신질환별 구강질환의 주소와 치료내용을 조사하여 기본적인 구강질환의 실태를 파악하고자 본 연구를 시행하였는데, 전신질환으로 입원하여 구강질환의 진단과 치료를 위하여 내원한 환자를 대상으로 연구한 결과 다음과 같은 결론을 얻었다. 1. 주된 전신질환인 내분비, 영양 및 대사 질환의 경우 구강질환은 치은염 및 치주질환 44.9%, 타액선의 질환 22.4%, 치아우식증 12.2%, 치수 및 치근단주위의 질환 4.1%, 매몰치와 매복치, 치아경조직의 기타질환 각각 2% 순서로 나타났다. 2. 주된 구강질환인 치은 및 치주질환의 경우 전신질환은 인슐린-비의존성 당뇨 39.2%, 뇌경색 29.4%, 신경근 및 신경총장애 5.6%, 뇌내출혈 3.9%, 위의 악성 신생물, 갑상선기능항진증, 정신분열증, 알콜성 간질환, 신증후군 각각 2% 순서로 나타났다. 이상의 결과로 전신질환이 있는 환자의 구강질환과 구강질환이 있는 환자의 전신질환에 대해서는 일정부분 파악이 되었으나 향후 전신질환으로 입원한 환자의 구강질환과 전신질환과의 상관관계에 대한 연구가 이루어져야 한다고 사료된다.

• 한방안이비인후피부과학회지
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• 제23권3호
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• pp.109-121
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• 2010

Objectives : This study was performed to analysis the effect of oriental medical care for inpatients with facial paralysis that had visited Dept. of Otolaryngology Oriental medical hospital Dong-eui university. Methods : From January 2008 to September 2010, a clinical study was done on 250 inpatients who were treated as facial nerve paralysis at the Dept. of Otolaryngology Oriental medical hospital Dong-eui university. This study was assessed using the chart analysis. Results : 1. The distribution of sex : female 54.8%, male 45.2%. The distribution of age was pregented that fifty to sixty was the most in 67 cases(26.8%). 2. The distribution of the period of admission : female 12.5 days, male 9.9 days. 3. The distribution of past history : hypertention(18.8%), diabetes-mellitus(10.85%), facial paralysis(9.25%), cerebrovascular disease(4.4%), liver disease(5.6%), hyperlipidemia(1.2%), otitis media(1.2%), herpes zoster(1.2%), cardiac disease(2.45%), thyroid disease(1.2%). 4. The distribution of the region of facial paralysis : Rt(55.36%), Lt(56.52%). 5. Check the mastoid pain : 66.8%(female 73.91%, male 58.04%). 6. Out of prescription(Ko-Bang, 古方), Galgeun-Tang(葛根湯) and Gaejigeogaegayoungchul-Tang was used most in each 34 cases, Daesiho-Tang(大柴胡湯) 30 cases, Galgeungabanha-Tang(葛根加半夏湯) 27 cases, Sihogaeji-Tang(柴胡桂枝湯) 14 cases, Hwanggigaejiomul-Tang 12 cases, Odu-Tang(烏頭湯) 10 cases, Chijadaehwangsi-Tang 10 cases, Gaejigagalgeun-Tang(桂枝加葛根湯) 7 cases, Banhasasim-Tang(半夏瀉心湯) 5 cases, Injinho-Tang(茵蔯蒿湯) 5 cases in order. 7. The distribution of herb group : Mahwang-Jae(麻黃劑) 31.72%, Gaeji-Jae(桂枝劑) 26.00%, Siho-Gae(柴胡劑) 20.70%, Chija-Gae(梔子劑) 7.49%, Buja-Jae(附子劑) 4.41%, Banhahwanggeum-Gae(半夏黃芩劑) 3.08%, Daehwang-Gae(大黃劑) 2.64%, Bockryeong-Gae(茯笭劑) 1.76%, Jisil-Gae(枳實劑) 1.32%, Insam-Gae(人蔘劑) 0.88% in order. 8. The distribution of House-Brackmann grade of admission : Gr Ⅳ 74.85%, Gr.III 13.6%, Gr.V 11.6% in order. 9. The distribution of House-Brackmann grade of discharge : Gr.III 56%, Gr.IV 38.4%, Gr.II 5.6% in order. 10. The average number of OPD follow up is 6.46. Conclusion : This results indicated that oriental medical treatment with Ko-bang(古方) can be an effective way to treat facial paralysis. The more patients we treat with Ko-bang(古方), the more clinical report is accumulated. Then it would be helpful to map out a systematic treatment on facial paralysis.

• 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.

• Tuberculosis and Respiratory Diseases
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• 제41권2호
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• pp.120-126
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• 1994

연구배경 : 내과적 치료에 반응이 없는 폐농양 환자와 감염성 낭포환자에서 대체 치료방법은 폐농양 환자에서는 페엽절제술과 같은 수술이나 감염성 낭포환자에서는 계속적 항생제 투여였는데, 저자들은 이와같은 경우 직경이 작은 카테타로 국소마취하에 경피적 배농술을 시행하여 그 치료효과와 부작용을 알아 보고자 본 연구를 시행하였다. 방법 : 1주 이상의 항생제를 포함한 내과적 치료에 반응이 없고, 공동의 직경이 6cm 이상인 만성적 기저질환을 가지는 폐농양 환자 9에와 감염성 낭포환자 3예에서 흉부 단순촬영과 흉부 전산화 단층촬영 후 투시하에 seldinger 방법을 사용하여 8.3~12.3 Fr의 카테타를 삽입 후 배농시키면서 임상경과를 관찰하였다. 결과 : 카테타 삽입 후 농흉이 발생한, 폐암과 동반된 1예를 제외한 8예의 폐농양과 3예의 감염성 낭포에서 경피적 배농술 후 임상적 호전을 보였다. 배농 후 평균 1.9일 내 해열되었고, 평균 배농기간은 9.9일이였다. 7예에서 퇴원 후 1~7개월간 외래 관찰되었으며, 재발 등의 문제는 없었다. 결론 : 내과적 치료에 반응이 없는 거대 폐암 환자에게 경피적 배농술은 효과적이고 안전한 방법이므로, 수술보다 우선적으로 고려되어야 하겠다. 그러나 감염성 낭포환자에 대한 경피적 배농술은 본 연구의 결과만으로 내과적 치료보다 더 안전하고 효과적이라고 할 수 없으므로 더 많은 연구가 있어야 하겠다.

• The Korean Journal of Physiology and Pharmacology
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• 제5권5호
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• pp.397-405
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• 2001

The ryanodine receptor, a $Ca^{2+}$ release channel of the sarcoplasmic reticulum (SR), is responsible for the rapid release of $Ca^{2+}$ that activates cardiac muscle contraction. In the excitation-contraction coupling cascade, activation of SR $Ca^{2+}$ release channel is initiated by the activity of sarcolemmal $Ca^{2+}$ channels, the dihydropyridine receptors. Previous study showed that the relaxation defect of diabetic heart was due to the changes of the expressional levels of SR $Ca^{2+}$ATPase and phospholamban. In the diabetic heart contractile abnormalities were also observed, and one of the mechanisms for these changes could include alterations in the expression and/or activity levels of various $Ca^{2+}$ regulatory proteins involving cardiac contraction. In the present study, underlying mechanisms for the functional derangement of the diabetic cardiomyopathy were investigated with respect to ryanodine receptor, and dihydropyridine receptor at the transcriptional and translational levels. Quantitative changes of ryanodine receptors and the dihydropyridine receptors, and the functional consequences of those changes in diabetic heart were investigated. The levels of protein and mRNA of the ryanodine receptor in diabetic rats were comparable to these of the control. However, the binding capacity of ryanodine was significantly decreased in diabetic rat hearts. Furthermore, the reduction in the binding capacity of ryanodine receptor was completely restored by insulin. This result suggests that there were no transcriptional and translational changes but functional changes, such as conformational changes of the $Ca^{2+}$ release channel, which might be regulated by insulin. The protein level of the dihydropyridine receptor and the binding capacity of nitrendipine in the sarcolemmal membranes of diabetic rats were not different as compared to these of the control. In conclusion, in diabetic hearts, $Ca^{2+}$ release processes are impaired, which are likely to lead to functional derangement of contraction of heart. This dysregulation of intracellular $Ca^{2+}$ concentration could explain for clinical findings of diabetic cardiomyopathy and provide the scientific basis for more effective treatments of diabetic patients. In view of these results, insulin may be involved in the control of intracellular $Ca^{2+}$ in the cardiomyocyte via unknown mechanism, which needs further study.

• 대한한방내과학회지
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• 제10권1호
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• pp.25-38
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• 1989

Clinical observation was done on 1092 cases of cerebrovascular disease which were confirmed by Brain CT scan in Oriental Medical Hospital in Kyung Hee Univ. from May 1987 to May 1988. Specially, clinical prognosis of 250 patients who had been hospitalized for over 4 weeks, were obserbed. The results were obtained as follows; 1. In this study, Occlusive CVD was 77.9%, Cerebral hemorrhage was 18.8%, Subarachnoid hemonhage was 0.8%. 2. The ratio of male to female was 1.4:1. In the age distribution, 60th decade, 50th decade, 40th decade, 30th's, 20th's were in order of frequency and specially 60th decade was 35.53% over 70th decade was 17.1% in ratio. 3. The most common preceding disease of CVD was hypertension (54.21%) and diabetes mellitus (19.96%) was second. 4. Almost, the duration of hospitalization was 2-4 weeks in 34.8%, within 4 weeks in 78.02%. 5. Primary attack was 75.7%, 2nd attack was 17.9%, over 3rd attack was 3.1% in ratio of recurrence. 6. The level of consciousness was Grade I in 96.4%, Grade II in 3.2%, Grade III in 1% at attack. 7. A few complications of C.V.A. were observed in the studies: pneumonia was noted frequently in 3.2%, bed sore, urinary tract infection, gastro intestinal bleeding in order of frequency. 8. The ratio of neurologic deficiency in occlusive CVD decreased from 51.9% to 29.3% in upper limb, 52.6% to 24.4% in lower limb, and that in cerebral hemorrhage decreased from 69.5% to 25% in upper limb, 50% to 20% in lower limb. 9. The ratio of left side hemiplegia to right was 1.04:1 in male, 1:1.18 in female. 10. The herb medications for C.V.A. were various Chungg-Paesagantang, Sunghanggeonggisan were used most frequently to Chungyeold, Geopung, Soongi, Haldam and Chungsimtang, the drugs for Bogiheol were used as discharge. In these oriental medical therapy of C.V.A. objective diagnosis and more various therapeutic method must be obtained through east-west medical co-operation.

• Journal of Oral Medicine and Pain
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• 제34권4호
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• pp.429-433
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• 2009

구강 작열감 증후군은 혀나 구강점막에 객관적인 이상징후(abnormal sign)를 보이지 않으면서 혀 및 구강점막의 지속적인 통증을 보이는 만성 질환이다. 연관된 것으로 추정되는 요인이 다양하고 환자마다 통증 양상이 다소 다르게 나타날 수 있어 적절한 진단 및 효과적인 치료를 제공하기 어려운 경우가 많다. 혀나 구강점막의 작열감은 알러지, 캔디다감염, 부기능습관, 타액선 기능저하 등과 같은 국소요인과 당뇨병, 갑상선기능저하증, 영양결핍 등과 같은 전신적 요인, 그리고 우울증, 걱정, 암공포증 등과 같은 심인성 요인과 연관되어 발생할 수 있다. 그러므로, 임상가들은 작열감을 유발할 수 있는 원인들에 대하여 숙지하고 있어야 하며, 혈액검사 등의 관련 검사를 통한 적절한 평가를 정확하고 세심하게 시행하여 효과적인 치료를 제공할 수 있어야 한다. 이러한 구강 작열감 증후군의 치료에는 약물요법, 인지행동요법, 심리치료 등 다양한 치료들이 시도되어지고 있다. 현재 구강작열감 증후군의 치료에 이용되고 있는 약물에는 클로나제팜(clonazepam), 가바펜틴(gabapentin), 삼환성항우울제(amitriptyline), 알파리포산(alpha-lipoic acid), 캡사이신(capsaicin) 등이 보고되고 있으며, 이 중 클로나제팜을 국소적으로 적용하는 것이 전신 투여하는 다른 약물에 비해 부작용이 적으면서 효과도 상당히 좋은 것으로 보고되고 있다. 이에 구강 작열감 증후군 환자에게 클로나제팜을 국소적으로 적용한 증례를 통해 그 효과를 확인하고자 하였다.