• Title/Summary/Keyword: Gall bladder

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중이염의 한의학적 치료에 대한 국내 임상 논문 분석 (Review of Korean Medicine Treatments for Otitis Media in Korean Journals)

  • 이주현;박준영
    • 한방안이비인후피부과학회지
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    • 제37권2호
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    • pp.58-73
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    • 2024
  • Objectives : This study was designed to review and analyze domestic research trends of Korean medicine treatment on otitis media, and present data for further research and treatment of otitis media. Methods : Two researchers used six search engines to search for papers on Korean medicine treatment for otitis media published from January 1, 2000 to December 31, 2023. A total of 16 papers were searched, and bibliographic information, main and accompanying symptoms, treatment period, treatment method, evaluation scale, and treatment results of each study were analyzed. Scottish Intercollegiate Guidelines Network was used to evaluate the evidence level. Results : The most common otitis media symptom was hearing loss (12 times). The most frequently mentioned herbs were Ledebouriella seseloides (22 times) and Angelica gigas (20 times), which are the ingredients of the most commonly used prescriptions, Hyunggyeyungyo-tang (5 times), Takrisodok-yeum (4 times), and Bojungikgi-tang (3 times). All the clinical trial papers were conducted on Kamihyunggyeyungyo-tang, which showed improvement in otitis media-related indicators. The most frequently mentioned meridians were the Triple Energizer (44 times), Clinical trials were conducted on the Triple Energizer, the Gall Bladder, and the Small Intestines meridians. The most frequently used acupoints were SI19 (10 times), TE21 (9 times), TE17 (9 times). In clinical trials, acupuncture treatment with TE05, GB15, TE06, SI05, GB38, and KI02 showed a significant improvement in otitis media symptoms. Conclusions : It is believed that more efficient otitis media treatment and follow-up research can be performed by using the above-mentioned research results.

담낭 및 간외 담도계암의 방사선 치료성적 (External Beam Radiotherapy for Carcinoma of the Extrahepatic Biliary System)

  • 전하정;이명자
    • Radiation Oncology Journal
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    • 제14권2호
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    • pp.129-136
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    • 1996
  • 목적 : 담낭과 간외 담도를 포함한 간외 담도계암에 대한 방사선치료의 효과를 평가하고 방사선치료의 역할에 관하여 알아보고자 함이 본 연구의 목적이다. 대상 및 방법 : 1986년 4월에서 1994년 7월까지 본원 치료방사선과에서 외부 방사선치료를 받은 43명의 담낭 및 간외 담도계암 환자를 후향적으로 분석하였다. 23명은 담낭암이었고 20명은 간외 담도암이었다. 23명의 담낭암 환자중에서 제 2병기는 2명, 제 3 병기는 12명, 제 4병기는 9명이었다. 남녀비는 11명대 12명이었다. 15명은 근치적 절제술을 시행하였고, 8명은 조직생검과 우회수술만을 시행하였다. 3명을 제외한 모든 환자에서 수술후 4500 cGy 이상의 방사선을 조사하였으며, 추적기간은 11-82개월 이었다. 20명의 간외 담도암 환자중에서 제 1병기는 1명, 제 2병기는 2명, 제 3병기는 10명, 제 4병기는 7명이었다. 남녀비는 16명대 4명이었다. 16명이 근치적 목적으로 위플씨 수술 또는 절제와 배액술을 시행하였고, 나머지 4명은 우회수술만을 시행하였다. 16명은 수술후 방사선 치료로 4500 cGy 이상 조사하였고, 4명은 3180-4140cGy를 조사하였다. 추적기간은 8-34개월 이었다. 결과 : 담낭암 환자의 전체 중앙 생존기간은 11개월이었다. 제 3병기와 제 4병기의 중앙생존기간은 14개월과 5개월이었으며, 2년 생존율은 각각 $36\%$(4/11)와 $13\%$(1/8) 이었다. 근치적 목적으로 수술을 받은 환자들이 우회수술 만으로 치료받은 환자들보다 통계적으로 유의하게 생존율이 높았다. ($67\%$ : $13\%$ 12개월) 치료와 연관된 합병증으로 사망한 환자는 없었다. 20명의 간외 담도암 환자의 전체 중앙 생존기간은 10개월이었다. 제 3병기 10명과 제 4병기 7명의 중앙 생존기간은 각각 10개월과 8개월이었다. 위플씨 수술을 시행한 2명은 각각 11개월과 14개월간 생존하였으며, 절제와 배액술로 치료한 환자들의 중앙 생존기간은 10개월이었다. 결론 : 간외 담도계암 환자에서 수술후 외부 방사선치료에 의한 합병증은 미미하였으며, 특히 수술후 현미경적 또는 육안적 잔여병변이 있는 환자에서 방사선 치료에 의해 생존율이 증가하는 양상을 나타내었다.

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개에서 자연개구부를 통한 하이브리드 내시경적 담낭절제술: 경위장관, 경결장 및 경질 접근법 (Hybrid Natural Orifice Transluminal Endoscopic Cholecystectomy in Dogs: Transgastric, Transcolonic and Transvaginal Approaches)

  • 김수현;정성목;신사경;김성수;신범준;이재연;김명철;박지영;김영일;이상일;김지연
    • 한국임상수의학회지
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    • 제28권5호
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    • pp.497-505
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    • 2011
  • 자연개구부를 통한 내시경적 수술 (NOTES)은 최근 많은 잠재적인 장점들로 인해 새롭게 주목받고 있는 수술방법이다. 하지만 국내에서 대부분 사용되어지고 있는 내시경은 기구가 삽입되는 포트가 한 개인 것이 대부분으로 순수 NOTES를 시행하기에는 다소 어려움이 있을 수 있다. 이에 본 실험에서는 복강경과 순수 NOTES의 중간 단계 인 하이브리드 NOTES를 통해 담낭절제술을 실시하였다. 이 방법은 한 개의 복강경 포트를 삽입함으로써 이를 통해 복강경용 겸자를 사용하여 담낭의 견인 역할을 할 수 있다는 장점을 지닌다. 내시경은 경위장관, 경결장 및 경질을 통 해 외부 피부 절개 없이 복강 내로 삽입되어 수술이 진행되었으며 복강 내압은 $CO_2$를 이용하여 4 mmHg로 유지하였다. 위 세 경로를 통한 접근으로 담낭절제술은 모두 성공적으로 이루어졌으며 모든 실험견들은 실험기간동안 임상적인 유의성 없이 좋은 회복을 나타내었다. 본 연구를 통해 개에서 최소 침습적 수술로 담낭절제술을 실시할 수 있는 방법을 확립하고 시술 시에 발생할 수 있는 부작용 등을 확인함으로써 소동물 수의 임상영역에서 최소 침습적 수술이 보급될 수 있는 기초가 되며, 복강경과 내시경의 임상 활용도를 높일 수 있을 것으로 생각된다. 하지만 경결장의 경우 내시경 접근 시 복강 내에서 소수의 세균 감염이 확인되었으며 경결장 접근의 경우 접근 방법에 대한 다른 연구가 필요할 것으로 생각된다.

기구맥진법(氣口脈診法)의 장부배속(藏府配屬)에 관한 연구(硏究) (A Study on the assignment of vicera of the pulsation examination method of the KiGu)

  • 황원덕;김중한
    • 대한한의학원전학회지
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    • 제12권1호
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    • pp.226-254
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    • 1999
  • For the first time, the theory of ChonKwanChuk(寸關尺) and the examination method of KyungJung(輕重法) of KiGu(氣口) were formed in "NanKyung(難經)". After that, the vicera assignment theory at left and right hands(左右守藏府記屬理論) was established in "MaekKyung(脈經)" After Reserching the theoretical relevance of the two books, theories between the doctors who understood the examination method of ChukBu(尺部診法) of "Somun MaekYoJungMiRon(素問 脈要精微論)" as the examination method of KyungJung(輕重法) and the doctors who understood that method as the method of ChonKwanChuk(寸關尺) were compared and researched. The results were as follows : 1. The posit ion of ChonKwanChuk(寸關尺) of the examination method of ChonKwanChuk(寸關尺法) is explained at 2nd Nan(二難) of "NanKyung" as follows. Chuk(尺) is the position which is 1Chon(1寸, unit) distant from Kwan(關) to the direction of ChukTaek acupuncture point(尺澤穴) and Chon(寸) is the position which is 9Pun(9分, unit) distant from Kwan(關) to the direction of EoJe acupuncture point(魚際穴). And the six vessels(六經) were assined to ChonKwanChuk(寸關尺) on the basis of OHangJaMoSnagSaeng(五行子母相生) at 18th Nan(18難) of NanKyung. After that Yang Hyun-Jo(楊玄操) at Dang Dynasty, Jung Deok-Yong(丁德用), Woo Seo(廬庶) at Song dynasty explaind the examination method of ChonKwanChuk(寸關尺法) of NanKyung as the method of ChonKwanChuk of two hands(兩手寸關尺法) from the viewpoint of "MaekKyung(脈經)". 2. From the viewpoint of MaeKyung, the vicera assignment of the two hand ChonKwanChuk method is as follows. At Chuk of left hand, the Heart and Small intestine are assigned. At Kwan of left hand, the Liver and Gall Bladder are assigned. At Chuk of left hand, the Kidney and Bladder are assigned. At Chuk of right hand, the Lung and Large in testine are assigned. At Kwan of right hand, the Spleen and Stomach are assigned. At Chuk of Right hand, the Vital Gate(命門) and Bladder are assigned. 3. For the first time, HwalSu(滑壽) at Won dynasty said that the paragraph "尺內兩傍${\cdots}{\cdots}$" of "Somun MaekYoJungMiRon" is the first of the examination method of KiGu(氣口診脈法). After that Ma Shi(馬蒔), Jang Gae-Bin(張介賓) of Myung Dynasty, Jang Ji-Chong(張志聰), Seo Dae-Chun(徐大椿) of Chung Dynasty who were influenced by him explained that paragraph as the method of KiGuChonKwanChuk(氣口寸關尺法). 4. Lee Kyu-Jun(李圭晙) explained the paragraph "尺內兩傍${\cdots}{\cdots}$" of "Somun MaekYoJungMiRon" as the method of KyungJung(輕重法) and explained Chok(尺) as the paragraph 'Chuk is low position of Kigu, and it means the depth(氣口之下位也, 言其深也)' and explained that 'the Left and the Right is layers(左右者層數). And he revised that the Jang(臟) must be examined at the inner part and the Bu(府) must be examined at the outer part. By this, he settled the theoratical basis of the method of KyungJung(輕重法). 5. The doctors who used the examination method of ChonKwanChok(寸關尺診法) settled their logical justification of the two hand examination method of ChonKwanChuk(兩手寸關尺診法) by connecting with "Somon MaekYoJungMi-Ron" from the viewpoint of 2nd Nan(難) and 18th Nan(難) of NanKyung and MaekKyung. On the contrary, the doctors who used the examination method of KyungJung(輕重診法) settled their logical justification of the examination method of KyungJung(輕重診法) by connecting with "Somun MaekYoJungMiRon" from the viewpoint of 4th Nan(四難) and 5th Nan(五難).

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폐암 환자에서 혈청 soluble ICAM-1농도의 변화 (Changes of Serum soluble ICAM-1 levels in Patients with Lung Cancer)

  • 류완희;이용철;이양근
    • Tuberculosis and Respiratory Diseases
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    • 제43권4호
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    • pp.527-535
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    • 1996
  • 연구배경 : 내피세포와 백혈구 및 상피세포에서 주로 발견되는 sICAM-1은 백혈구 표면의 배위자인 (ligand)인 LFA-1과 결합함으로서 염증성 질환 이외에 악성 종양의 전이와 진행에 중요한 역할을 하는 것으로 알려졌다. 최근에는 혈청내 sICAM-1의 농도가 악성 흑세포종의 전이와 비례하여 증가되는 것으로 보고되었으며, 또한 sICAM-1의 이형이 여러 질환에서 발견되고 이들의 혈청 농도의 증가는 위암, 대장암, 담낭암, 췌장암의 간전이와 관련되며, 악성 흑세포종 환자의 생존율의 감소와 관련되는 것으로 보고하였으나 폐암에서는 이에 대한 보고는 거의 없다. 이에 저자들은 폐암 환자의 혈청에서 sICAM-1을 측정하여 폐암의 조직학적 분류와 진행 및 전이의 정도에 따른 변화를 알아보고 폐암의 진단적 가치에 대하여 알아 보고자 하였다. 방법 : 1995년 1월부터 1996년 3월까지 전북대학교병원 내과에 입원하여 폐암을 진단 받은 환자 38명을 대상으로 하였으며, 정상 대조군은 비슷한 연령의 다른 질환을 갖고 있지 않은 8명을 대상으로 하였으며, 기관지 내시경을 통한 조직 생검이나 경피적 세침 흡입술을 이용하여 확진을 하였으며, 각 조직학적 분류에 따른 진행정도를 알기 위하여 TNM system 을 이용하여 분류하였고, 소세포 폐암은 limited stage와 extensive stage로 분류하였다. Genzyme사의 Predicts sICAM-1 ELISA kit를 이용하여 혈청 sICAM-1농도를 측정하였다. 결과 : 1. 소세포 폐암군에서 혈청 sICAM-1은 정상 대조군에 비해 유의한 증가가 없었으나, extensive stage군에서 limited stage군에 비해 유의한 증가를 보였다. 2. 편평상피암군에서 혈청 sICAM-1은 정상 대조군에 비해 유의한 증가를 보였으며, stage IIIa기 이하군에 비해 stage IIIb기 이상군에서 유의한 증가를 보였다. 3. 선폐암 환자군에서 혈청내 sICAM-1은 정상 대조군에 비해 유의한 증가를 보였다. 결론 : 혈청 sICAM-1농도의 변화는 폐암의 조직학적 분류에 따라 다르게 나타나며, 폐암의 전이 및 진행과 관련이 있을 것으로 보인다. 폐암 환자에서 혈청 sICAM-1농도의 측정은 폐암에서 진행의 정도를 평가하는 데 지표로서 이용될 수 있을 것으로 사료된다.

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한국인 비만 여성의 GNB3, ACE, ADRB3, ADRB2 유전자 다형성간의 상호관계에 관한 연구 (Study of Gene-gene Interaction within GNB3, ACE, ADRB3, ADRB2 among Korean Female Subject)

  • 최현;배현수;홍무창;신현대;신민규
    • 동의생리병리학회지
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    • 제18권5호
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    • pp.1426-1436
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    • 2004
  • There have been several reports on the relationship between G protein β3 subunit gene (GNB3), angiotensin converting enzyme gene (ACE), β3-adrenergic receptor gene (ADRB3), and β2-adrenergic receptor gene (ADRB2) genotype and obesity or obesity related disease. The objective of this study was to examine the relationship between the combinations of these four genes' polymorphism and probability of obesity related disease in Korean female subjects. The experimental group was consisted of 85 obese Korean female subjects (body mass index, BMI≥27㎏/㎡). To determine the polymorphism, genomic DNA was isolated, and PCR was performed. Serological examinations (fasting plasma glucose, FPG; aspartate aminotranferase, AST; alanine aminotransferase, ALT; total cholesterol, TC; triglyceride, TG; high density lipoprotein-cholesterol, HDL; low density lipoprotein-choles terol, LDL) were carried by an autoanalyzer and serological methods. BMI, waist circumference (WC), hip circumference and waist hip ratio (WHR) were measured. Consequencely in the analysis with grouping of general genotyping and variant allele carrier/non-carrier, the result was not significantly different within all gene combinations and polymorphic pairings except higher waist circumference in Arg16Arg group of ADRB2 codon16 (P=0.024). And there was no significantly contrast result about age, height, weight, AST and ALT that are index feature of liver and gall bladder disease in polymorphic pairings of gene combinations. However, the statistical analysis of waist-hip ratio and waist circumference that could be recognized as the physical type of obesity showed T-Arg16 pairing carrier in GNB3-ADRB2 codon16 combination had increased WHR and WC significantly (P=0.046 and P=0.015 respectively). Futhermore, the levels of total cholesterol (TC) and low density lipoprotein choresteral (LDL) were significantly lower in C-I pairing of GNB3-ACE combination (P=0.032 and P=0.005). These results suggest that the T-Arg16 pairing carrier in GNB3-ADRB2 codon16 gene might have increased waist circumference and C-I pairing carrier in GNB3-ACE combination have lower possibility of contraction of cardiovascular disease related cholesterol and LDL despite of obese state.

간(肝) Scintigram의 임상적(臨床的) 고찰(考察) (Clinical Observation of Liver Scintigram)

  • 문성수;오경식;김열자;김영철;이종석;이학중
    • 대한핵의학회지
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    • 제14권2호
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    • pp.19-27
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    • 1980
  • Although primary application of radioisotope scanning technics to the liver has been of use in the detection of the intra-hepatic space occupying lesion from the normal functioning liver parenchyme, there has been on increasing awareness of its use in evalution of Liver function. In this study, the diseases of the liver were classified into group A,B,C and D by the liver scanning findings, conventional liver function tests and clinical findings. Following were the results: 1. The colloidal radiogold liver scan appeared normal in the group A, also the albumin in serum, alkaline phosphatase activity and prothrombin time were within normal levels in this group. 2. In the group B, there were acute hepatitis 24(48%), chronic hepatitis 5(10%), toxic hepatitis 3(6%), subacute hepatic necrosis 3(6%), typhoid liver 4(8%), hepatic tuberculosis 2(4%), diabetes mellitus 3(6%) and others 3(6%). In this group, SGOT and SGPT were increased predominantly as compared with group A, and the liver scan showed small amount of mottling of activity and faintly visualized spleen. 3. In the group C, there were postnecrotic liver cirrhosis 30(60%), Laennec cirrhosis 10(20%), cardiac cirrhosis 1(2%), cholangiocarcinoma 1(2%), chronic active hepatitis 6(12%), hepatic milliary tuberculosis 1(2%) and gall bladder cancer 1(2%). In this group, the albumin in serum and prothrombin time were lowered significantly and the liver scan showed severe mottling of activity with extra-hepatic uptake in the spleen and bone marrow along the vertebral column. 4. In the group D, there were primary hepatoma 26(52%), hepatoma with liver cirrhosis 7(14%), metastatic liver cancer 5(10%), liver abscess 10(20%), multiple liver cyst 1(2%) and cystic duct adenoma 1(2%), In this group, the alkaline phosphatase activity was elevated with single or multiple intrahepatic space occupying lesion in the radiogold colloid liver scan.

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대장직장암 및 기타 소화기암에서의 단세포군항체를 이용한 방사면역신티그라피의 진단 (Immunoscintigraphy of Colorectal and Other Gastrointestinal Cancers with Radioactive Monoclonal Antibodies to CEA and CA 19-9)

  • 장대환;최덕주;이범우;박원;한창순;김학산;김종순
    • 대한핵의학회지
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    • 제22권1호
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    • pp.83-92
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    • 1988
  • The cocktails of two $^{131}I$ labeled Monoclonal antibody (MCAB) (Anti CA 19-9 F$(ab')_2$ + Anti CEA $F(ab')_2$ fragment), which react specially, with human gastrointestinal cancers, were administered to 10 patients with colorectal (7), stomach(2) and pancreas(1) cancer for scintigraphic detection. All patients were known or postoperatively recurrent cases, and serum tumor markers, CA 19-9 and CEA, were measured with immunoradiometric assay, just before immunoscintigraphy (ISG). The tumor marker's level in serum is not correlated with positive tumor uptake in ISG. The sensitivity and specificity of ISG in detection of 21 tumor sites, based on surgery, CT, ultrasonography and pathology, were 90.5% and 100% One case of colon cancer showed gall bladder metastasis, which was neglected on CT study. Tumor/non tumor uptake ratio of radiolabelled antibody were progressively increased from day 3 to day 7 during study. We summerized as follows 1) The use of cocktails of CEA and CA 19-9 MCAB $F(at')_2$ increased sensitivity and specificity in ISG. 2) Delayed imaging (later than 5 days) increases sensitivitv and specificity due to exclusion of nonspecific iodine accumulation in stomach and lung. 3) Second tracer technique is essential for anatomical landmark by use of a double isotope scan, but subtraction technique, a possible source of artifacts, is no longer necessory when delayed imaging is performed. 4) It may be possible to use two MCAB cocktails of CA 19-9 and CEA in Radioimmunodetection of stomach and pancreas cancer. In conclusion, ISG using MCAB cocktails, $F(ab')_2$ fragment of anti CA 19-9 and Anti CEA, provide additional opportunity for tumor localization and detection of colorectal and other G-I cancer, such as stomach and pancreas.

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정상인에서 지방식 투여와 CCK 연속주입에 의한 담낭 수축의 비교 연구 (Comparison of Gallbladder Emptying Induced by a Fatty Meal and an Infusion of Cholecystokinin)

  • 류진숙;신상기;문대혁;이명혜;이성구;김명환;민영일
    • 대한핵의학회지
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    • 제26권1호
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    • pp.86-94
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    • 1992
  • Quantitative analysis of gallbladder emptying is important in diagnosis of motility disorder of gallbladder and in studies of biliary physiology. However, the normal range of gallbladder ejection fraction (GBEF) has not been determined yet and the best method for stimulating the gallbladder to contract has not been elucidated adequately. The purpose of this study was to compare the gallbladder emptying effect of the fatty meal ingestion with that of the continuous infusion of cholecystokinin (CCK) and to establish the normal GBSF values of normal subjects. Quantitative hepatobiliary scan with $^{99m}Tc-DISIDA$ after a fatty meal was performed for 22 normal healthy volunteers. Among them, 10 subjects repeated the test with a fatty meal. Again, for 7 subjects quantitative heaptobiliary scan with an infusion of CCK (sincalide) at a rate of 20 ng/kg/hr for 45 minutes was performed repeatedly. The results were as follows. 1) With a fatty meal, the mean GBEF was $89.6{\pm}8.2%$ in 22 normal subjects, and there was no difference between subjects. 2) With a continuous infusion of CCK, the mean GBEF was $62.4{\pm}16.6%$ in 7 normal subjects, and there was a significant difference between subjects(p<0.05). 3) The reproducibility of GBEF by a fatty meal was significantly higher than by an infusion of CCK (p < 0.05). 4) The mean GBEF by a fatty meal was significantly higher than that by an infusion of CCK (p < 0.05). We concluded that a fatty meal is superior to a continuous infusion of CCK for inducing gall-bladder contraction because that induces more complete emptying and the response is more reproducible and constant.

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간장의 병리변화 인식에 대한 문헌적 고찰 (The Literatual Study on Pathologic Change Cognition to the Liver Disease)

  • 이영수;곽정진;이강녕;최창원;김희철
    • 동의생리병리학회지
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    • 제16권4호
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    • pp.630-636
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    • 2002
  • After The Yellow Emperor's Canon of Internal Medicine, The text researches of pathologic change to the liver disease concluded the next, 1, The category of liver-disease(肝病) include the Symptoms of abnormality due to vital energy and blood motion, emotion and intention, muscular and reproductive function, and legions around descending liver channel. 2. In the theory that Liver-Yang energy(肝陽氣) is always overproducing, Liver-Yin blood(肝陰血) is always lacking, pathologic characteristics for liver disease is functional change of malfunction of the use of body(體用失調), So nourishing the liver and kidney is used for the principal aspects of a disease. regulating and calm the liver is used for the secondary aspects of a disease as the treatment plan, 3. If malfunctioning of the functions of dispersion and discharge(疏泄), Iiver-energy(肝氣) is becoming degected, So overproduct and overflow of ascent and exhalation of liver-yang(肝陽) is becoming blood are ascending following energy. complete usage of Yin-blood(陰血) is responsible for some kinds of mass formed by blood stasis in the early stage of pathogenesis of liver disease syndrome of the energy system as the progession of disease extravasated blood is forming. the pathologic characteristics is appeared loss of control of the vital energy and blood(體用失調) at the liver disease. 4. Sthenia-syndrome of liver(肝實證) and liver-heat syndrome(肝熱證) is appered that overproducing and overflow of dispersion(疏泄太過) and discharge is responsible for overfunctioning of liver disease or some kinds of heat syndrome such as liver fire(肝火), Sthenia of liver-yang(肝陽上亢), the syndromes of sthenic liver heat(肝實熱) are appered. deficiency of the liver(肝虛證) and cold syndrome of liver(肝寒證) is classified pathologic characteristics of cold and heat, deficiency and excess that regression of sensory, motor, mental due to lack of dispersion and discharge(疏泄不及), or intruding of the cold miasma, are degected. 5. The liver is close relation of physiologic function and internal organ such as spleen, stomach, lung, heart, kidney, gall bladder by the meridian channels, because of property of wind Zang, rapid progession is classified by phthologic charateristics.