• Title/Summary/Keyword: Headache

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모야모야병(moyamoya disease) 환자의 전신마취 하 치과치료: 증례보고 (DENTAL MANAGEMENT OF A PATIENT WITH MOYAMOYA DISEASE UNDER GENERAL ANESTHESIA: CASE REPORT)

  • 채종균;송지수;신터전;현홍근;김정욱;장기택;이상훈;김영재
    • 대한장애인치과학회지
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    • 제15권1호
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    • pp.40-44
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    • 2019
  • 본 증례는 다수의 치아우식증을 주소로 내원한 모야모야병 환자의 전신마취 하 치과치료에 대한 보고이다. 모야모야병은 치과치료 동안 상당히 주의를 필요로 하는 다양한 전신질환과 관련이 있다. 여러 과의 의사들과 협진이 필요하고, 치과 예방치료에 초점을 맞추면서 적절한 시기에 치료하는 것이 중요하다. 모야모야 환자에서 울음과 과호흡은 저칼륨혈증을 일으킬 수 있고, 대뇌 혈관 수축 효과를 일으킬 수 있다. 치과치료 시 뇌졸중 발생을 예방하기 위해서 통증과 불안을 조절하는 것이 매우 중요하다. 비협조적이거나 매우 어린 모야모야병 환자에게 치과치료를 하기 위해서는 전신마취가 필요할 수 있다.

Campylobacter Enteritis: Clinical Features and Laboratory Findings in Children Treated at a Single Hospital

  • Jang, Won Tae;Jo, Na Hyun;Song, Mi Ok;Eun, Byung Wook;Ahn, Young Min
    • Pediatric Infection and Vaccine
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    • 제26권1호
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    • pp.22-31
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    • 2019
  • 목적: 캄필로박터 장염은 박테리아 장염의 흔한 원인 중 하나로 알려져 있다. 그러나 국내에서 소아에서의 캄필로박터 장염의 빈도와 임상 양상에 대한 연구는 드물다. 본 연구는 단일 병원 소아청소년과 환자에서 경험한 캄필로박터 장염의 빈도와 임상적 특징을 파악하고자 시행하였다. 방법: 2012년 1월부터 2017년 12월까지 을지대학교 을지병원 소아청소년과에 급성 위장관염으로 방문한 18세 이하 소아환자로부터 대변 검체를 확보하였다. 그 중에서 배양 혹은 polymerase chain reaction을 통해 캄필로박터 장염으로 진단된 환자들의 의무기록을 후향적으로 검토하였다. 결과: 총 123명의 환자가 캄필로박터 장염을 진단받았으며 환자의 나이 중앙값은 12 세(사분위수, 8-16세)이었다. 캄필로박터 장염은 일년 내내 발생했지만 주로 6월과 9월 사이에 86명(69.9%)으로 집중적으로 발생하였다. 증상은 설사(97.6%), 발열(96.7%), 복통(94.3%), 구토(37.4%)와두통(34.1%) 순으로발생하였다. 복부컴퓨터단층촬영은 25.2%의사례에서시행되었다. 다른 치료군과 비교했을 때, azithromycin 3일 요법으로 치료하는 것이 더 짧은 입원 기간과 관련이 있었다 (P<0.05). 결론: 캄필로박터 장염은 청소년기와 여름철에 흔하다. 설사 증상을 보이기 전에 심한 복통과 열이 발생하여 병원에 내원하게 된다. 캄필로박터 장염에 대한 올바른 이해를 수반한다면 적절한 진단과 항생제 사용을 통해 장염의 이환시간을 줄일 수 있을 것으로 보인다.

특발성 안면 통증 환자에서 수면 이갈이의 임상적 특징 (Clinical characteristics of sleep bruxism patients with idiopathic facial pain)

  • 명양호;서정일;김복음;김영건;김성택
    • 구강회복응용과학지
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    • 제37권2호
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    • pp.81-87
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    • 2021
  • 목적: 특발성 안면 통증 환자에서 수면 이갈이의 임상적 특징을 알아보기 위함이다. 연구 재료 및 방법: 특발성 안면 통증을 호소한 210명의 환자 중 수면 이갈이가 존재하는 28명의 환자의 성별, 나이, 통증의 기간, 위치 및 강도, 통증에 영향을 받은 부위를 포함한 차트 분석을 시행하였다. 결과: 특발성 안면 통증이 있는 수면 이갈이 환자는 남성(14.3%)보다 여성(85.7%)이 많았다. 평균 연령은 48.9세였으며 가장 흔한 안면 통증 부위는 우측 상악 치아(28.6%)와 하악 치아(25.0%) 부위였다. 2개의 치아에 통증이 발생한 경우가 가장 많았으며(50.0%), 1개 치아(28.6%), 3개 치아 이상(21.4%) 순으로 통증이 나타났다. 평균 통증 강도는 visual analogue scale (범위: 0 - 10) 기준 5.9였다. 20명의 환자에서 통증은 자발통의 양상으로 나타났으며(71.4%), 평균 통증 기간은 24.4개월이었다. 결론: 특발성 안면 통증 환자에서 수면 이갈이가 있는 환자들의 임상적 특징은 다양한 특발성 안면 통증 환자의 진단에 유용할 수 있으며, 상기 통증을 줄이기 위해 시행하는 불필요한 치료를 감소시키는데도 효과적이다. 보다 체계화된 진단 방법 및 개발을 위한 치료 지침을 위해 후속 연구는 충분한 기간 및 다수의 환자를 대상으로 진행될 필요가 있을 것이다.

고령의 만성 C형 간염 환자에서 Daclatasvir와 Asunaprevir 병용 요법의 유효성 및 안전성 평가 (Efficacy and Safety of Daclatasvir and Asunaprevir Combination Therapy in Elderly Chronic Hepatitis C Patients)

  • 박유경;신수진;최유옥;최혜정;강진숙;황보신이
    • 병원약사회지
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    • 제35권4호
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    • pp.453-462
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    • 2018
  • Background : The prevalence of chronic hepatitis C virus (HCV) tends to be higher in the elderly. Pegylated interferon and ribavirin therapy (Peg-IFN/RBV) was recommended as the first-line treatment in the past decades, but this regimen showed unsatisfactory results in terms of safety and efficacy especially in elderly patients. Recently, it was demonstrated that dual therapy with daclatasvir and asunaprevir was well tolerated and led to high sustained virological response (SVR) rates, irrespective of age. We conducted a study to evaluate the efficacy and safety of daclatasvir plus asunaprevir by involving elderly patients aged above 65 years. Methods : We retrospectively analyzed clinical data from chronic hepatitis C virus (HCV) genotype 1b patients treated with daclatasvir plus asunaprevir from September 2015 to December 2016 at Seoul St. Mary's hospital. The patients were divided into two groups as elderly patients (older than 65 years) and non-elderly patients (younger than 65 years) and compared the efficacy and safety. Results : A total of 112 patients were treated with daclatasvir plus asunaprevir for chronic hepatitis C. Among them, 101 patients completed the whole treatment, and in 88 patients the amount of HCV RNA was measured after 12 weeks of treatment. There was no significant difference in SVR at 12 weeks between both the groups (p=0.68). Typically, 91.4%(32/35) of elderly patients and 94.3%(50/53) of non-elderly patients achieved SVR12. Common adverse events included elevation in transaminase level, headache, and gastrointestinal disorders. There was no statistical difference in the symptoms between the two groups. Conclusions : The combination therapy with daclatasvir plus asunaprevir exhibited similar rates of SVR12 in HCV elderly patients without leading to further adverse events compared to non-elderly patients. Therefore, it is proposed that daclatasvir plus asunaprevir therapy could be considered as an effective and safe treatment, even in patients aged over 65 years.

교통사고로 인한 어지럼 환자의 임상양상 (Clinical Characteristics of the Patients with Dizziness after Car Accidents)

  • 하영민;양철원;김상훈;여승근;박문서;변재용
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • 제60권8호
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    • pp.390-395
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    • 2017
  • Background and Objectives With increasing frequency of car accidents, patients of dizziness caused by car accidents are also increasing. Various types of dizziness or vertigo can occur from car accidents depending on different injury mechanisms. Since accurate diagnosis is important for providing proper treatments, we evaluated clinical characteristics related to vestibular function of patients with dizziness caused car accidents. Subjects and Method In this retrospective case review study that runs from January 2011 to March 2013, a total of 82 patients with dizziness following car accident were enrolled consecutively. We analyzed the final diagnosis of dizziness according to different mechanisms of injury during car accident through clinical record review. Patients who developed dizziness within one month of car accident were included, excluding those who had temporal bone fracture and previous history of dizziness. Results Of the different types observed, 36.6% was head injury, 24.4% whiplash injury, 3.7% complex injury, 2.4% others and the rest was unknown. In the final diagnosis, the different types included 36.6% benign paroxysmal positional vertigo (BPPV), 23.2% unclassifiable dizziness, 18.3% cervical vertigo, 7.3% labyrinthine concussion, 3.7% BPPV with labyrinthine concussion and the rest was others. Of the different types of dizziness symptoms, 58.5% was headache, 45.1% was audiologic symptoms, and others included earfullness, tinnitus and hearing disturbance. Tinitogram and pure tone audiogram results show that 2.9% (27 people) of patients have tinnitus and 7.3% (6 people) have hearing disturbance. Conclusion An accurate diagnosis and timely management would be very important in forming a proper approach for post traumatic vertigo patients.

대사공학에 의해 개발된 코리네박테리움 글루타미컴에 의한 4-히드록시벤질 알코올 생산 (Production of 4-Hydroxybenzyl Alcohol Using Metabolically Engineered Corynebacterium glutamicum)

  • 김부연;정혜빈;이지영;페러 레니;푸완토 헨리 슈쿠르;이진호
    • 한국미생물·생명공학회지
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    • 제48권4호
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    • pp.506-514
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    • 2020
  • 4-Hydroxybenzyl alcohol (4-HB alcohol)은 두통, 경련 행동, 현기증과 같은 신경계 질환에 유익한 효과를 나타내며 천마의 주요 생리활성 성분 중의 하나이다. 대사공학을 통해 4-hydroxybenzoate (4-HBA)를 생산하는 균주로부터 4-HB alcohol을 생산하는 재조합 Corynebacterium glutamicum을 개발하였다. 먼저 4-HBA를 생산하는 APS809로부터 염색체 내 NCgl2922 유전자에 Methanocaldococcus jannaschii 유래의 aroK 유전자를 삽입한 APS963을 개발하였다. 4-HBA의 카로복실 산을 4-hydroxybenzaldehyde (4-HB aldehyde)로의 환원을 촉매하는 Nocardia iowensis 유래의 car 유전자를 염색체에서 발현하는 균주를 개발하기 위해 NCgl1112 유전자 일부 단편에 car 유전자가 삽입된 GAS177를 개발하였다. 더 높은 농도의 4-HB alcohol을 생산하기 위해 4-HB alcohol을 aldehyde로 산화를 촉매하는데 관여하는 creG 유전자를 염색체상에서 제거된 GAS255를 개발하였다. 최종적으로 chorismate를 4-HBA로 전환하는 효소의 유전자 ubiCpr을 pcaHG에 삽입된 GAS355를 개발하였으며, 80 g/l 포도당을 함유한 삼각플라스크에서 발효하여 생산성을 평가한 결과, 2.3 g/l 4-HB alcohol이 생산되었으며 부산물로 0.32 g/l 4-HBA, 0.3 g/l 4-HB aldehyde가 축적되었다.

두개천골요법의 국내외 임상 연구 동향: 스코핑 리뷰 (Trends in Domestic and International Clinical Research of Craniosacral Therapy: Scoping Review)

  • 곽민제;한윤희;금지혜;박신혁;우현준;하원배;이정한
    • 한방재활의학과학회지
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    • 제32권3호
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    • pp.13-27
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    • 2022
  • Objectives This study investigated the trends in domestic and international clinical research in craniosacral therapy, classified as a type of Chuna manual therapy, and suggested further directions in Korean medicine. Methods This scoping review was performed using the Arksey and O'Malley methodological framework and preferred reporting items as per the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews checklist. Eight electronic databases (PubMed, EMBASE, Cochrane Library, Koreanstudies Information Service System [KISS], KMBASE, Oriental Medicine Advanced Searching Integrated System [OASIS], Research Information Sharing Service [RISS], ScienceON) were searched to identify articles with the search terms "craniosacral therapy" and "cranial osteopathy" until December 2021. Results Forty-five studies were eligible as per our inclusion criteria. Most research studies (n=44) were conducted in the field of medicine and pharmacy, especially in rehabilitation medicine (n=16). As a result of the study design, randomized controlled trials (n=20) were the most common, and chronic pain (n=9) was the most frequently targeted disease, followed by headache (n=7). Thirty-two studies suggested interventions and 20 studies used Upledger's 10-step protocol. The average duration of craniosacral therapy was 41 min per session, administered 1.4 times per week. Outcome measurements were analyzed and categorized with the examination procedure for the patient. Conclusions This is the first scoping review of craniosacral therapy in Korea, and we believe that our findings could support its utility as Chuna. In the future, more studies should be conducted to establish the evidence of clinical efficacy of craniosacral therapy and develop standard techniques in Korean medicine.

대전한방병원 한방안이비인후피부과로 내원한 돌발성 난청 환자 특성 분석 - 2013년 1월부터 2021년 12월까지 - (A Clinical Analysis on Outpatients with Sudden Sensorineural Hearing Loss of Korean Medicine Ophthalmology, Otolaryngology & Dermatology Department at Daejeon Korean Medicine Hospital - From January, 2013 to December, 2021 -)

  • 최윤영;변정아;백종찬;황미리;안재현;정현아
    • 한방안이비인후피부과학회지
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    • 제35권4호
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    • pp.31-46
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    • 2022
  • Objectives : The purpose of this study is to analyze outpatients who visited for treatment for sudden sensorineural hearing loss in ophthalmology & otolaryngology & dermatology clinic of Daejeon Korean medical hospital from January 1st, 2013 to December 31th, 2021. Methods : We retrospectively analyzed outpatients who visited for treatment for sudden sensorineural hearing loss in ophthalmology & otolaryngology & dermatology clinic of Daejeon Korean medical hospital from January 1st, 2013 to December 31th, 2021. according to year, season, gender, age, clinical symptoms, number of visits and initial degree of hearing loss. The statistical analysis performed using IBM SPSS 25.0 for Windows. Results : The results of analyzing the medical records of 194 patients are as follows. 1. The number of patients showed a gradual increase from 2014 to 2021 and spring was highest in season. Acc ording to gender, women visited more than men and the age group that visited the most was middle-aged, including 40s and 50s. 2. Patients experienced 13 symptoms and the average number was 4.06. In the analysis of the major symptoms according to gender, hyperacusis and headache were found to be more common in female. 3. The average of initial hearing loss was 52.54dB and was higher in male. The loss was relatively higher in 60s or older than in the younger age group. Conclusions : If treatment and management methods that reflect these symptoms are developed, it is thought that it will greatly helpful to improve the quality of life of patients with sudden hearing loss.

자가혈위지압을 활용한 모바일 의료 어플에 대한 체계적 문헌고찰 (A Systematic Review of Mobile Health Applications Using Self-Acupressure)

  • 박서경;이조현;정가영;장세린;김상호
    • Korean Journal of Acupuncture
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    • 제40권1호
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    • pp.1-12
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    • 2023
  • Objectives : This study aims to provide information regarding the status and quality of mobile applications (MAs) using self-acupressure by performing a systematic review. Methods : We conducted comprehensive searching on five international databases and two app markets from inception to July 31, 2022 to identify MAs using self-acupressure. We analyzed the characteristics of each MA regarding the name of the MA, registered app markets, target symptoms, developers, the year and country of development, cost, target age, media function, and expertise. We assessed the quality of each MA using Mobile Application Rating Scale (MARS). Results : We identified a total of 30 MAs using self-acupressure (25 MAs from the app market and 6 MAs from clinical studies, with 1 MA in common). 17 out of 24 MAs from the app market provided self-acupressure regimens for various symptoms and the others provided regimens for specific symptoms such as memory, anxiety, depression, asthma, allergy, low back pain, and headache. 14 developers were reported. 23 MAs were developed after 2013. The largest number of MAs were developed in the United States. The target age group of 12 MAs was above the age of 3, and that of 11 MAs was above the age of 12. 14 MAs provided multimedia functions such as videos. 13 MAs provided information of expertise. From clinical studies, only 3 out of 6 MAs were accessible through the app market. 4 MAs were developed by the researchers of the study. In terms of MARS, the score of MAs from the app market was higher than that of MAs from clinical studies in both objective and subjective evaluation areas. Conclusions : This study summarizes the characteristics of MAs using self-acupressure. More MAs using self-acupressure should be developed and further clinical research for MA on each symptom and disease is warranted for the diversification of MA fields using self-acupressure.

두통에 대한 이혈 방혈요법의 유효성 분석: 체계적 문헌고찰 및 메타분석 (Effectiveness of Auricular Blood-letting Therapy for Headaches: A Systematic Review and Meta-Analysis)

  • 이경은;박민령;이지원;황인준;이보람;서종철;권찬영
    • 동의신경정신과학회지
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    • 제34권3호
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    • pp.259-274
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    • 2023
  • Objectives: The purpose of this study was to provide clinical evidence to support the use of auricular blood-letting therapy (ABT) for headaches. Methods: Studies were identified by a comprehensive search of five databases. Randomized controlled trials (RCTs) that investigated the effects of the ABT for headaches were included. Two authors independently extracted the data and assessed the methodological quality of the included studies using Cochrane's risk-of-bias tool. If two or more studies reported the same outcome, a meta-analysis was performed. Meta-analysis results for dichotomous variables are expressed as risk ratios (RRs) and 95% confidence intervals (CIs). Results: A total of eight RCTs were included in this review. The total effective rate (TER) was the most commonly used outcome measurement. Among the eight RCTs, five were included in the metaanalysis. The TER was not statistically significantly different in the ABT group compared to the medication group (two studies, n=55, RR=1.24, 95% CI: 0.78 to 1.96, p=0.36, I2 =86%). However, the TER of the combined ABT and medication group was significantly different compared to the medication alone group (four studies, n=159, RR=1.23, 95% CI: 1.12 to 1.35, p<0.0001, I2 = 0%). Pain and mental health-related outcomes in the combined ABT and medication group were significantly different from the control groups. The methodological quality of the included RCTs was generally low. Conclusions: ABT combined with medication may be effective for treating headaches. However, the number of studies included was small, so the results were insufficient, and statistically significant effects were not confirmed for a single implementation of ABT. Thus, well-designed further studies based on the findings of this study are recommended.