• 제목/요약/키워드: External ointment

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복막 투석 환자에서 도관 관련 감염 및 복막염에 대한 Mupirocin과 도관 전환술(Catheter revision)의 효과 (The Effects of Catheter Revision and Mupirocin on Exit Site Infection/Peritonitis in CAPD Patients)

  • 박준범;김정미;최준혁;조규향;정항재;김영진;도준영;윤경우
    • Journal of Yeungnam Medical Science
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    • 제16권2호
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    • pp.347-356
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    • 1999
  • 복막 투석은 혈액 투석 및 신 이식과 함께 말기 신 질환의 중요한 치료 방법의 하나로 성공적인 복막 투석을 위해서는 복막 투석에 따른 여러 합병증을 줄이는 것이 필수적이다. 그러나 도관 출구 감염이나 복막염 등 투석 관련 감염은 여전히 도관 제거로 인한 복막 투석의 중단을 유발하는 중요한 원인이 되고 있다. 영남대학 의과대학 부속병원에서 1993년 10월부터 1999년 2월까지 복막 투석을 시행 후 추적 가능한 139명의 환자를 대상으로 도관 출구 감염과 복막염의 발생 빈도 및 원인 균주, 도관 제거의 빈도 및 원인 균주, 도관 전환술의 성적, 그리고 mupirocin ointment 사용 전과 사용 후의 도관 출구 감염의 빈도 차이 등을 후향 분석하였다. 복막 투석을 시행한 총 환자-투석기간은 2,401개월이었고 도관 출구 감염은 36명의 환자에서 105례 발생하여 발생 빈도는 1/22.8 환자-개월이었고 복막염은 67명의 환자에서 112례 발생하여 그 빈도는 1/21.4 환자-개윌로 나타났다. 대다수 출구 감염의 경우 일반적인 투약에 잘 반응하였으나 치료에 불응하여 도관 전환술을 시행한 7명 중 5명은 메티실린 저항성 포도상 구균(Methicillin Resistant, Staphylococcus aureus, MRSA), 2명은 Pseudomonas aeruginosa에 의한 감염이었다. revision후 3명에서 감염이 재발하였으나 한 명은 항생제에 바로 치유되었고 또 한 명은 second revision으로 치료하였으며 나머지 한 명은 MRSA에 의한 반복 감염이 지속되어 결국 도관 제거와 동시에 도관 재삽입을 시행하였다. 재발에 대한 치료 후 평균 추적기간 14.0개월 동안 더 이상의 출구 감염은 없었다. 1998년 10월부터 1999년 2월까지 mupirocin을 국소 도포 한 34명의 환자를 살펴보면, pre-mupirocin 기간의 총 투석기간은 687개월이었고 그 기간동안 도관 출구 감염이 54례 발생하여 발생 빈도는 1/12.7 환자-개월로 나타났으나 mupirocin 기간의 경우 총 투석기간 136개월 동안 4례 발생하여 그 빈도가 1/34.0 환자-개월로 유의하게(P<0.01) 감소하였다. 도관 출구 감염의 72.2%가 SA에 의한 것으로 조기에 적절한 항생제 치료를 함으로써 대부분 완치되었고 일부 약제에 잘 반응하지 않고 반복 감염되어 도관 탈락의 위험이 있는 경우에도 도관 전환술을 통하여 비교적 안전하고 효과적으로 난치성 출구 감염을 치유할 수 있었다. 그리고 도관 출구 부위에 mupirocin을 간헐적으로 국소 도포 함으로써 포도상 구균(Staphylococcus aureus)에 의한 출구 감염을 예방할 수 있었다. 그러나 이러한 도관 전환술과 mupirocin의 장기적인 효과 및 부작용에 대해서는 보다 많은 환자군을 대상으로 하는 전향적 연구가 있어야 할 것으로 생각된다.

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서장의학(西藏醫學)에 나타난 진단(診斷)과 치료(治療)에 관한 연구(硏究) (Study on the division of disease and various methods of treatment appeared in the Tibetan Medicine)

  • 장은영;윤창열
    • 대한한의학원전학회지
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    • 제18권2호통권29호
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    • pp.45-69
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    • 2005
  • The condition contrary to the physiological conditions obtained by the normal functioning of seven constituents of the body is defined as disease. The primary causes of the disease are emotional defilements of desire, hatred and delusion. The secondary causes of diseases are seasonal climatic changes, the agency of harmful demons, and improper diet or conduct. Once a disease occurs, it brings the disfunctioning of the three humors of wind, bile, and phlegm. Therefore all the disease should be examined and determined which of theses three humors effect its nature the most. There are five main techniques of external therapy, namely bloodletting, which extract the impure blood produced by disease of heat; moxibustion, which debilitates cold diseases, medicinal compresses, fomentation, massage with ointment, and minor surgery. Among these, the former three are the mild treatment and the latter three the severe ones because of the pain the patient has to suffer during the whole procedure.

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소풍산가감방(消風散加減方)과 외치방(外治方) 병용이 NC/Nga 아토피 생쥐에 미치는 영향 (Effects of Sopoongsangagambang Administration along with External Spray Treatment on Atopic Dermatitis Development in NC/Nga Mice)

  • 민영규;김종한;박수연;최정화
    • 한방안이비인후피부과학회지
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    • 제18권1호
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    • pp.116-134
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    • 2005
  • Although the parallel prescription of Sopoongsangagambang (SG) administration along with external treatment such as spraying or ointment application on the skin is clinically used for the treatment of atopic dermatitis (AD), molecular mechanism underlying its effectiveness is unknown. Thus in the present study, diverse immune responses in terms of chemical mediators related to AD were investigated using an atopic mouse model NC/Nga after SG administration and external treatment (ET), and major findings are summarized as follows. 1. The clinical severities in 16 and 20 week old NC/Nga mice with SG and ET treatment were decreased to 72.2% and 62.3% respectively compared to the control NC/Nga mice with no drug treatment. 2. IgE, IL-4, IL-5, IL-6, IL-13, IgM, IgG1 and IgG2a levels in the serum of SG and ET treated NC/Nga mouse group were significantly decreased compared to the untreated control mice. In contrast, $IFN-{\gamma}$ showed a significant increase in the experimental group compared to the untreated control group. 3. The spleen weight of SG and ET treated NC/Nga mice was significantly decreased compared to the untreated control group. 4. The B/T ratio in the lymph node of SG and ET treated NC/Nga mice was increased compared to the untreated control group. $CD4^+\;and\;CD8^+$ cell numbers in the lymph node of SG and ET treated NC/Nga mice were significantly increased compared to the untreated control group, but $CD69^+\;and\;CD11a^+$ cells were significantly decreased. 5. mRNA expression levels of IL-4, IL-5, and CCR3 in the skin tissues of SG and ET treated NC/Nga mice were significantly decreased, and expression levels of IL-6, IL-13, $CD69^+/CD3{\varepsilon}^+\;and\;CD19^+/CD44^+$ in the skin tissues of SG and ET treated NC/Mga mice were significantly decreased compared to the untreated control group. $IFN-{\gamma}$ mRNA expression levels were increased compared to the untreated control group. 6. Histological observation of the ear and neck skin tissues showed that the extents of inflammation and infiltrated immune cells in the epidermis and dermis of SG and ET treated NC/Nga mice were highly reduced compared to the untreated control group. 7. Lymphokine assay showed a significant decrease in IL-4 levels in SG and ET treated NC/Nga mice compared to the untreated control group, but the levels of $IFN-{\gamma}$ secretion were significantly increased drug treated NC/Nga mice.

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아토피피부염에 대한 Lactobacillus 혼합배양액의 임상 증례 (The Case Study of Lactobacillus mixture culture fluid on Atopic dermatitis)

  • 조을화;김태근;홍수정;정도연;황성연;안성훈
    • 대한한의학회지
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    • 제36권3호
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    • pp.135-143
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    • 2015
  • Objectives: Recently lactic acid formulation was known as the adjuvant therapy on atopic dermatitis(AD) symptoms because of little side effects. In this study, it was studied that Lactobacillus mixed culture appliment was effective on not on AD symptoms. Methods: The case-photos 30-40 times of AD symptoms from case were observed with literatures. The case-photos were acquired with environmental AD dermatitis experience program which is conducted in SUNCHANG RESERCH INSTITUTE OF HEALTH AND LONGEVITY from 2014.01 to 2014.08. Experience applicants were limited the oral administration and chemical external administration. Results: Lactobacillus mixed culture appliment was effective because of the mitigation or disappearance of AD primary symptoms like pruritus, erythema, edema, effusion, dry skin, scaly, scab etc. AD symptom degree was dependent on lactobacillus mixed culture appliment times, and classified as Reaction Period (RAP), Reduction Period (RDP), Efection Period (EP), Reproduction Period (RPP) on a single mixed culture appliment time. And AD symptoms which were appeared in RPP were classified as Rebound Period (RBP), Effection Period (EP), Subclinical Period (SCP). Conclusions: Lactobacillus mixed culture appliment is considered to be useful for AD symptoms and is estimated to be effective by different mechanism with oral administration or steroid ointment application. Lactobacillus mixed culture appliment is expected to induce a synergistic effects on AD symptom reliefs with the other oral administration.

치창(痔瘡)과 치루(痔漏)에 대한 침구학적(鍼灸學的) 문헌고찰(文獻考察) (A acupuncture therapy literature study on the hemorrhoids and hemorrhoids complicated by anal fistula)

  • 송원섭;이병렬;이현;채상진
    • Journal of Acupuncture Research
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    • 제20권1호
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    • pp.131-143
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    • 2003
  • Objective : The purpose of this study is to arrange the literature about acupuncture therapy on the hemorrhoids and hemorrhoid complicated by anal fistula. Methods : We arrange Huang Di Nei Jing and fifteen kinds of literature about the hemorrhoids and hemorrhoid complicated by anal fistula. Results : 1. The cause of hemorrhoids are overfatigue, overeating, imbalance of stool(const-ipation or diarrhea), uncontrol sexual excess or abstinence, pathgenic factors of wetness, heat, wind, dry, fire, chronical hemorrhoids that has not been treated, and general weakness. 2. Symptom of hemorrhoids is that skin is projected form the nine holes or varicose extension to become hemorrhoid. Hemorrhoids is small nodosity that projected on the anal inter or outer region, and hemorrhoid complicated by anal fistula is pus which comes out form one or some fistula on the anal around inter and outer region. 3. Therapy method of hemorrhoid and hemorrhoid complicated by anal fistula are elimination pathological heat from blood, promote blood flow to remove blood stasis, cold in nature and purge away fire, remove heat form the blood, promote blood flow to remove blood stasis, cold in nature and purge away fire, remove heat from the blood and eliminate dampness, tonify the spleen and replenish Ki, dispel wind and alleviate pain and so forth. Therapy method of hemorrhoid is to give the first consideration to relieve blood: eliminating pathological heat form blood complicated by anal fistula is to tonify the blood first, than after that eliminating pathological heat form blood. About external method are method of fumigation, method of ointment, method of close with medicine, necrotizing method and also operation(injection, bind etc.)was used for treatment. 4. The prescription are Gurgak-hwan, Wypi-hwan, Gunggyi-tang, Jingyochangchul-tang, Jingyobangpung-tang, Mokhyangbinrang-hwan, Ochi-san, Gamihyanso-san, Jojang-hwan, Sinyung-hwan used frequently. 5. food taboo on patient's diet of the hemorrhoid and hemorrhoid complicated by anal fistula are raw grain, cold or dampness food, alcohol, hot food, Singiberis rhizoma recens, Cinnamomi ramulus. 6. Acupuncture therapy on the hemorrhoid and hemorrhoid complicated by anal fistula are, in the first stage eliminating pathological heat form blood and eliminate dampness, and in the long term eliminate dampness, promote and remove meridian energy, remove that form the intestines, dispel channels and collaterals. 7. Acupuncture points at B2, CV1, B58, B36, B56, Sp5, S30, B25, B54, GV1, GV20, L6, B40 used frequently for the acupuncture therapy, and acupuncture point at GV4, GV1, B30, hemorrhoidal point used form moxibustion. Reduction blood at B40 and blue capillary of Sp9 and acupuncture Chungbaek, Ki-gack, Ki-jung, Ki-mun(Dongsh Kihyel) makes the treatment very effective.

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Afatinib 복약 후 발생한 비소세포성 폐암환자의 피부독성 부작용에 대한 한방치료 1례 (Traditional Korean Medicine for Skin Toxic Side Effects from Afatinib in a Non-Small Cell Lung Cancer Patient: A Case Report)

  • 심소현;서희정;최진용;배고은;서형범;김소연;한창우;박성하;윤영주;이인;권정남;홍진우;최준용
    • 대한한방내과학회지
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    • 제39권5호
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    • pp.973-983
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    • 2018
  • Objectives: We report a case of traditional Korean medicine (TKM) treatment for skin side effects after taking afatinib (Giotrif$^{(R)}$). Methods: A 62-year-old female who was diagnosed with non-small cell lung cancer stage 4 (T4N2M1b) and was on treatment with afatinib (29.56 mg/day for 4 months) complained of skin toxicity as a side effect. For 16 admission days, the patient was treated with acupuncture, moxibustion, and herbal medicine (oral decoction and external ointment). Results: Improvement of skin toxicity was measured by a numeric rating scale. In addition, Quality of life (QOL) was measured using EORTC Quality of Life Questionnaire, Core 30 (EORTC QLQ-C30) and EORTC Quality of Life Questionnaire, 13-item lung cancer-specific module (EORTC QLQ-LC13) Developed by the European Organization for Research and Treatment of Cancer (EORTC). Tumor size and carcinoembryonic antigen (CEA) were also examined during follow up. Conclusions: After a combined TKM treatment, skin toxicity symptoms and quality of life scales were significantly improved with no side effects. The tumor size was not changed on computed tomography during follow-up period. CEA levels were decreased.

『산번방(刪繁方)』의 의방(醫方)에 관한 연구 (A Study on the prescriptions of 『Sanbeon-bang(刪繁方)』)

  • 김도훈;정창현
    • 한국의사학회지
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    • 제17권2호
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    • pp.111-127
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    • 2004
  • This paper is mainly on the rsearch of the prescriptions of "Sanbeon-bang(刪 繁方)". For the research of prescription, investigated "Sanbeon-bang" from the side of symptoms of a disease, number of drugstuffs, table of contents, drugstuffs and acupuncture and moxibustion. With these investigation, made out a few tables, and with these tables made an attempt to understand the whole prescriptions of "Sanbeon-bang". "Sanbeon-bang" is of rich contents in internal medicine. Among internal medicine, related to Oro-Yukgeuk-Chilsang(五勞-六極-七傷) was most abundant. So we can guess "Sanbeon-bang" was a medical book specialized in exhaustion syndromes. It also deals with the Samcho-syndromes, as investigate from medical comments, has the perfect system of prescription in relative. From the investigation of the combination of drugstuffs, ascertained that, the number of simple prescription composed of one drugstuff was 38, combinational prescription composed of two drugstuffs was 9, minor prescription composed of three to five drugstuffs was 47, midum prescription composed of six to ten drugstuffs was 95, major prescription composed of eleven to twenty drugstuffs was 45, and mixed prescription composed over twenty drugstuffs was 1. Mentionable unique prescriptions in internal use were the forms of keeping in mouth. In external use they were fumigants, suppositories, powdered medicines, spraying the granular medication into the nasal cavity and eyedrops. And were abundant in soft extract(ointment) and plaster. In addition, there were the recordings of 18 types of cellulitis, types of incurable cellulitis and curing an illness by a charm. By the way, when comparing "Sanbeon-bang" with "Cheongeum-bang", all of which was quoted a lot in "Oedaebiyo-bang", "Cheongeum-bang" rather took medical comments of "Sanbeon-bang" than prescription. Although there were some prescriptons in "Sanbeon-bang" at the same category, "Cheongeum-bang" took another prescriptions which are more complexed than those of "Sanbeon-bang". In the same way, when comparing "Cheongeum-bang" with "Sonjinin-Cheongeum-bang(孫眞人千金方)", which didn't go through the correction of GyojeongUiseoguk of Bug-Song goverment, "Cheongeum-bang" often didn't take the prescriptions of "Sonjinin-Cheongeum-bang". Hence we can guess, "Cheongeumyo-bang" may have added a lot of prescriptions when undergoing the correction of of GyojeongUiseoguk. The total number of species of drugstuffs in "Sanbeon-bang" from the investigation was 284. The plant drugs were 208 species, the animal were 31 species, the minerals were 19 species and the other were 26 species. The prescriptions related to acupuncture and moxibustion in "Sanbeon-bang" were only moxibustional prescriptions. Which appeared one time per exhaustion and steaming of bone syndrome, Oro-Yukgeuk-Chilsang and Samcho syndrome. Appeared six times in muscle syndromes. But I cannot imagine the original form of acupuncture and moxibustion in "Sanbeon-bang" for deficiency of data.

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