• 제목/요약/키워드: Etiological classification

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늘어지는 영아 증후군의 진단적 분류와 발달 예후: 단일 3차 병원에서의 연구 (Etiological Classification and Developmental Outcomes in Floppy Infants: A Single Tertiary Center Experience)

  • 박정민;최영하;이하늘;정희정
    • 대한소아신경학회지
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    • 제26권4호
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    • pp.189-196
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    • 2018
  • 목적: 늘어지는 영아 증후군은 중추신경계 이상, 말초 신경계 이상 혹은 둘 모두의 이상으로 발생할 수 있다. 늘어지는 영아에서 원인을 진단하는 것은 환아의 치료와 발달 예후를 결정하는 중요한 요소로 현재까지 다양한 진단 알고리듬이 제안되고 있다. 본 논문에서는 늘어지는 영아 증후군의 원인에 대한 새로운 분류 및 증상 발현 시기에 따른 원인, 그리고 이들의 발달 예후에 대해 연구하였다. 방법: 2005년부터 2016년까지 세브란스병원에 내원한 늘어지는 영아들을 대상으로 EMR 차트를 후향적으로 분석하여 진단 및 임상적 특징을 분석하였고 환아들의 발달에 대해 보호자에게 일대일 전화인터뷰를 통해 조사하였다. 결과: 전체 116명의 환아 중에 원인에 대한 확진을 받은 경우가 69명으로 전체 진단율이 59.5%이었고 이들 중 Prader-Willi syndrome, myotonic dystrophy, spinal muscular atrophy가 가장 흔한 진단이었다. 전 연령대에 걸쳐 Prader-willi syndrome이 가장 흔한 진단이었고 특히 1개월 미만 증상 발현군에서는 Prader-willi syndrome, myotonic dystrophy, early infantile epileptic encephalopathy가 흔한 3가지의 진단이었다. 발달 예후 면에서 원인군 중 combined hypotonia에서 전 영역에 걸쳐 가장 나쁜 예후를 보였다. 결론: 현재까지의 논문과 본 논문에서의 늘어지는 영아 증후군에 대한 진단율은 유사했고 각 연령에 따른 흔한 진단에 대해서도 알아보았다. 발달 예후가 가장 나쁜 combined hypotonia군에 속하는 진단으로 확진되거나 의심되는 경우 초기 진단시부터 발달에 대해 체계적이고 단계적인 추적관찰이 필요하다.

痔瘡과 痔瘻에 對한 文獻的 考察 (A Literatural study on the hemorrhoids and hemorrhoids complicated by anal fistula)

  • 노현찬;노석선
    • 한방안이비인후피부과학회지
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    • 제10권1호
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    • pp.284-305
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    • 1997
  • A Literatural study on the etiological factors, classification, prescription of hemorrhoids and hemorrhoids complicated by anal fistula following results were obtained. 1. The cause of hemorrhoids are long time sit, long time gate, overfatigue, overeating, imbalance of stool( constipation or diarrhea), pregnant fertility(overfatigue after childbirth, insufficiency of middle warmer energy), uncontrol sexual excess, pathgenic factors of wetness, heat, wind, dry, genetic cause, excess of anxiety, pile up of heat poison, weakness of entrails and viscera. The cause of hemorrhoid complicated by anal fistula are attack of external wind, heatness, dry, fire, wetness(pathgenic factors), inapporiate treatment and chronic disease, greasy diet, excess of anxiety, constipation, uncontrol sexual excess, obstacle of circulation of vital energy and blood on anal site. 2. Classification of hemorrhoids are female hemorrhoids, male hemorrhoids, pulse hemorrhoids, intestines hemorrhoids, vital energy hemorrhoids, wine hemorrhoids, blood hemonhoids, flowing hemorrhoids. Classification with other method are external hemorrhoids, internal hemorrhoids, mixed hemorrhoids, excrescence hemorrhoids, nipple homorrhoids. External hemorrhoids is classified of varicosis of hemorrhoidal vein, connective tissue form, thrombus form. Classification of hemorrhoid complicated by anal fistula are simple lower hemorrhoid, lower mixed hemorrhoid, deep hemorrhoid, outer of one hole hemorrhoid, a horseshoe hemorrhoids. Once more classificated of four are space of sphincter muscle form, penetration sphincter muscle form, upper of sphincter muscle form, outer of sphincter muscle form. 3. Therapy method of hermorrhoid and hemorrhoid complicated by anal fistula are internal method, fumigation method method, ointment, method of close with medicine, necrotizing method, hot medicated compress( gxternal method), injection, insertion, bind, (operation) and acupuncture therapy (the others method) 4. Herb medicine for many used of internal method are Scutellaria baikalensis George(黃芩), Coptis japonia Makino(黃連), Rehmania giutinosa Liboschitz ex Fischer & Meyer(生地黃), Poncirus trifoliata Refinesque(枳殼), Sanguisorba officinalis Linne(地楡), Sophora japonica L.(槐花), Cnidium officinale Makino (川芎), Astragalus membranaceus Bunge(황기), Angelica gigas Nakai (當歸). 5. Herb medicine for many used of fumigation are Schlechtendalia Chinesis J. Bell (五倍子), Artemisia Vulgaris L. var indica Maxim(艾葉), Poncirus trifoliata Refinesque (枳殼), Nepeta japonica Maximowicy(荊芥), And herb medicine for many used of ointment are Calomelas(輕粉), Alum(白礬), Boswellia carterii Birdwood(乳香), Os Draconis Fossilia Ossis Mastodi(龍骨).

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Clinical characteristics and outcomes in patients with lesion-positive transient ischemic attack

  • Kang, Su-Jeong;Lee, Sang-Gil;Yum, Kyu Sun;Kim, Ji-Seon;Lee, Sung-Hyun;Lee, Sang-Soo;Shin, Dong-Ick
    • Journal of Biomedical and Translational Research
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    • 제19권4호
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    • pp.110-115
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    • 2018
  • Transient ischemic attack (TIA) indicates high risk for major stroke and is considered a medical emergency. Diffusion-weighted imaging (DWI) enables detection of acute ischemic lesions. The clinical significance of DWI positive lesions in TIA is obscure and its prevalence, clinical features are not established. Therefore, we performed a clinical, etiological and prognostic analysis through a cross-sectional analysis of 235 TIA patients, grouped according to presence of DWI lesion. Clinical features, underlying risk factors for stroke, outcome and rate of recurrence were analyzed. 3 months follow-up of modified Rankin Scales (mRS) were done with telephone survey. DWI positive lesions were present in 14.0% of patients. Etiological factors significantly associated with DWI lesions in TIA patients were male sex (p = 0.038), stroke history (p = 0.012) and atrial fibrillation (p < 0.001). Presence of at least one medium or high risk of cardioembolism from TOAST classification were not associated with lesions when excluding association to atrial fibrillation (p = 0.108). Clinical features showed no significant difference. Whether the patients had lesion-positive DWI was not related to an increase in mRS score during the hospital stay or at the 3-month follow-up after discharge. Future studies should include multi-center samples with large numbers, considering each unique medical environment. Routine acquisition of follow-up DWI for proper evaluation of the tissue-based definition of TIA should also be considered.

Cardiomyopathies in small animals

  • Fujii, Yoko
    • 한국임상수의학회:학술대회논문집
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    • 한국임상수의학회 2009년도 춘계학술대회
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    • pp.127-133
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    • 2009
  • Cardiomyopathies were previously defined as "an idiopathic myocardial disease that is not secondary to any other type of congenital/acquired heart disease or systemic diseases." With increasing understanding of etiology and pathogenesis in human medicine, the difference between cardiomyopathy and specific heart muscle disease has become indistinct. Cardiomyopathies are now classified by the dominant pathophysiology or, if possible, by etiological/pathogenetic factors. The American Heart Association recently advocated the following new definition of cardiomyopathy: Cardiomyopathies are a heterogeneous group of diseases of the myocardium associated with mechanical and/or electrical dysfunction that usually (but not invariably) exhibit inappropriate ventricular hypertrophy or dilatation and are due to a variety of causes that frequently are genetic. Cardiomyopathies either are confined to the heart or are part of generalized systemic disorders, often leading to cardiovascular death or progressive heart failure-related disability. Because the understanding of etiology or pathogenesis of cardiomyopathy has been limited in veterinary medicine, the previous classification is generally used. It is considered a dilated, hypertrophic and restrictive group on the basis of the predominant morphological and functional abnormalities. In addition, arrhythmogenic right ventricular cardiomyopathy and unclassified cardiomyopathy were also recognized in dogs and/or cats.

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소아 용혈성 빈혈 환자에서 원인에 따른 임상적 분석 (A Clinical Study on Childhood Hemolytic Anemia According to Etiological Classification)

  • 권해식;강정철;원성철;오승환;유철주
    • Clinical and Experimental Pediatrics
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    • 제46권9호
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    • pp.883-888
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    • 2003
  • 목 적 : 용혈성 빈혈은 진단방법의 발전과 관심의 증대로 해마다 빈도가 증가하고 있다. 저자들은 지난 15년간 용혈성 빈혈로 진단받은 환자들을 토대로 원인에 따라 적혈구 내적 요인과 외적 요인으로 나누어 임상적 양상을 후향적으로 조사하여 차이를 분석하였다. 방 법 : 1987년 1월에서 2002년 5월까지 연세대학교 의과대학 세브란스병원 소아과에 내원하여 용혈성 빈혈을 진단 받은 58명의 환자들을 대상으로 진단 당시 연령, 성별, 증상, 혈색소, 망상구 수, 백혈구 수, 혈소판 수, 총 빌리루빈과 간접 빌리루빈, 비장비대 여부, Coombs' 반응, Alanine aminotransferase/Aspartate aminotransferase, 혈액요소질소 및 크레아티닌 치, 소변 검사, 치료 방법, 재원일수, 수혈 횟수를 분석하였다. 결 과 : 전체 환자 58명 중 적혈구 내적 결함에 의한 용혈성 빈혈(group I)이 21례(36%)로 유전성 구상적혈구증 19례, glucose-6-PD 결핍증 2례가 있었고, 적혈구 외적 결함에 의한 용혈성 빈혈(group II)은 34례(59%)로 용혈성요독증후군 9례, 온항체에 의한 자가면역 7례, 한랭 항체에 의한 자가면역 6례, 약물에 의한 경우 4례, 신생아 용혈성 질환 3례, 기계적 손상에 의한 경우 2례, 전신성 홍반성 낭창 2례, 악성종양 1례였다. 미분류는 3례(5%)였다. 성별 분포는 남자 : 여자의 비율이 group I은 2.5 : 1(15명 : 6명), group II는 1 : 1.5(15명 : 22명)이었다. 두 군간의 임상 양상을 비교 분석하였을 때 통계적으로 의미 있게(P<0.05) 차이를 보인 항목으로는 진단 시 혈색소 치, 혈액요소 질소 및 크레아티닌 치, 비장비대 여부로 나타났다. 치료에 있어서 내적 요인에서는 비장절제술만 시행한 경우가 대부분이었으며 외적 요인에서는 스테로이드, 복막투석, 면역글로불린 등 다양한 치료가 시행되었다. 결 론 : 소아 용혈성 빈혈 환자에서 원인에 따른 임상 양상을 비교 분석하여 본 결과, 외적 요인으로 인한 경우 진단 당시 혈색소 치가 더 낮고, 혈액요소질소 및 크레아티닌 치가 더 높은 것이 의미 있게 관찰되었으며, 내적 요인으로 인한 경우 비장비대가 의미 있게 더 많은 것으로 나타났다.

새로운 한의학 병인분류체계의 연구 (The New Etiologic Classification System of Korean Medicine)

  • 박해모;이기남;황귀서;신용철;고성규;이해웅;이영준;임병묵;이상재;정명수;장보형;박선주;이선동
    • 대한예방한의학회지
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    • 제17권2호
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    • pp.47-68
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    • 2013
  • Objectives : This research aimed to develop a new etiologic classification for traditional Korean Medicine in order to respond to the social and environmental change. Methods : We reviewed the existing theories on etiological classification for East Asian Medicine thoroughly and discussed the problems and limitations. Based on the experts' consensus, we abstracted disease factors and etiologic items. Results : The disease factors are classified into three parts: the human body, the environment, and the interaction between the human body and the environment. We defined them as the inner factor, the external factor, and the interaction between the inner and the external factors. The inner factor is free from the influence of the environment, and it causes diseases solely from the components of the human body. It is divided into genetic factors. The external factor is defined as a case when a disease occurs due to a factor outside the human body and includes external injuries, environmental pollution, and natural disasters. The interaction between the inner and the external factors is a disease factor that causes diseases by the interaction of the human body and the environment and includes emotions, habits, and social environment. As a result of the analysis, it was possible to see the meanings at a single glance as the scattered and fractional meanings were integrated with focus on medicinal herbs, but the increasing number of analyzed medicinal herbs tended to more and more complicate their relationships, thus, requiring additional work like filtering. Conclusions : The new etiologic classification of Korean Medicine fully reflects the perspectives on life in Korean Medicine while embracing the changes in modem society. Also, by avoiding the usage of ambivalent terms and wrong classification methods, the new classification system constructs intuitive and concise etiology and improves usability in clinical medicine.

진심통(眞心痛)에 관(關)한 문헌적(文獻的) 고찰(考察) (The Literatural Study of True Heartache)

  • 전찬용;조기호;이원철;김영석;배형섭;이경섭;구본홍
    • 대한한방내과학회지
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    • 제11권1호
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    • pp.121-126
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    • 1990
  • The true heartache is a condition of severe heartache corresponding to angina pectoris, as recorded from Hwang Jae Nai Kyung. According to the literatural study of true heartache, some results can be acquired, such as follows. 1. The site of the true Heartache, can be divided into two categories, first, its superficial and conscious area is the chest as same as the other heartache. But its inner lesion is the Heart-Meridian as others occupied at the Pericardium-Meridian in stead of the Heart-Meridian. 2. The etiological classification of true heartache, are Cold-evil, Heat-evil, Wind-evil, Blood stasis etc. But its major factor is Cold-evil, more than anything else. 3. The symptomatic signs of true heartache, consist of cyanotic change from hands and feet to phalanges; severe heartache pale complexion with cold breathing and its extreme state can manifestate unceased sweating called as Yang exhaustion.

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Risk Factors for Breast Cancer, Including Occupational Exposures

  • Weiderpass, Elisabete;Meo, Margrethe;Vainio, Harri
    • Safety and Health at Work
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    • 제2권1호
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    • pp.1-8
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    • 2011
  • The knowledge on the etiology of breast cancer has advanced substantially in recent years, and several etiological factors are now firmly established. However, very few new discoveries have been made in relation to occupational risk factors. The International Agency for Research on Cancer has evaluated over 900 different exposures or agents to-date to determine whether they are carcinogenic to humans. These evaluations are published as a series of Monographs (www.iarc.fr). For breast cancer the following substances have been classified as "carcinogenic to humans" (Group 1): alcoholic beverages, exposure to diethylstilbestrol, estrogen-progestogen contraceptives, estrogen-progestogen hormone replacement therapy and exposure to X-radiation and gamma-radiation (in special populations such as atomic bomb survivors, medical patients, and in-utero exposure). Ethylene oxide is also classified as a Group 1 carcinogen, although the evidence for carcinogenicity in epidemiologic studies, and specifically for the human breast, is limited. The classification "probably carcinogenic to humans" (Group 2A) includes estrogen hormone replacement therapy, tobacco smoking, and shift work involving circadian disruption, including work as a flight attendant. If the association between shift work and breast cancer, the most common female cancer, is confirmed, shift work could become the leading cause of occupational cancer in women.

선천성 기형의 임상적 접근 (Clinical Approaches to Patients with Congenital Malformations)

  • 이진성
    • Journal of Genetic Medicine
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    • 제5권2호
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    • pp.94-99
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    • 2008
  • 선천성 기형은 출생 신생아에서 2-5% 정도의 빈도를 보이며 영아기 사망의 주요한 원인이 되고 있다. 상당수의 선천성 기형의 예후는 정확하고 빠른 진단에 따른 적절한 처치 및 치료에 의해 결정된다고 할 수 있다. 따라서 임상적으로는 선천성 기형에 대한 기전 파악 및 정확한 분류에 따른 정확한 진단이 중요하다. 우선 해당 기형이 소기형(minor anomaly) 또는 대기형(major anomaly) 중 어디에 속하는지, 또는 기형(malformation), 변형(deformation), 파형(disruption) 및 이형(dysplasia) 중 어느 것에 속하는지 결정하고 다발성 기형 등은 특정 증후군과 연관이 있는지 여부에 대한 판단을 필요로 한다. 진단이 된 후, 선천성 기형을 위한 유전상담은 환자나 가족이 기형 혹은 증후군에 대하여 또는 재발률에 대하여 이해할 수 있도록 돕는 과정을 포함한다.

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만성골반통의 동서의학적 고찰(부인과 질환으로 중심으로) (The Study on Chronic Pelvic Pain in Orietal and Occidental Medicine)

  • 김순열;윤종원
    • 동국한의학연구소논문집
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    • 제5권
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    • pp.15-31
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    • 1996
  • The purpose of this study was to generalize the conception of chronic pelvic pain(CPP)through the literature of oriental medicine and occidental medicine. The results are obtained as follows. First, chronic pelvic pain(pain of more than 6 months duration) may include pain of gynecologic, gastroenterologic, urologic, neurologic, and musculoskeletal origin. In this study, the etiology of chronic pelvic pain may remain obscure and the relationship between certain types of pathology, such as endometriosis or adhesions, and the pain response may be inconsistent and often inexplicable. Second, the causes of CPP through the literature of oriental medicine were reviewed as pains due to a wind-pathogen, a cold, disorder of Qi, disorder of blood stasis, a improper diet, disorder of fluid, and deficiency type etc... And the charateristic pains were concerned with a aching pain, a heavy pain, a distending pain. a pain due to mass in the abdoman, a pain likes pulling etc... The degree and classification of charateristic pains in current of time were dependent on subjective factors. Third. in oriental medicine, it wasn't to be suggested concretely recognition of etiological factor in pain. But they recognised that facters were influenced by pain. For example, diretic peripheral demages were concerned with a blood stasis, a phlegm, a damp phlegm, heart, and the pains that were occurrenced by sevn emotions were concerned with a stagnancy of Qi or a stagnancy of liver-Qi.

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