• Clinical and Experimental Pediatrics
• /
• 제45권5호
• /
• pp.603-608
• /
• 2002

목 적 : 최근 연간 10여건으로 감소추세로 보고되고 있는 백일해의 유행실태와 임상양상을 분석함으로써 백일해에 대한 역학적 자료와 임상적 진단의 지침 마련에 도움이 되고자 본 연구를 시행하였다. 방 법 : 2000년 3월부터 2001년 3월까지 본원에 입원한 환아 중 1주일 이상의 심한 백일해양 기침 증상을 보인 환아 49명을 대상으로 비인두 가검물을 채취하여 PCR과 배양검사를 실시하였다. 결 과 : 49명의 검사 의뢰 환아 중 10명이 PCR 양성이었고 이중 4명이 배양검사 양성이었다. 이환 환아는 모두 봄철인 3-5월과 가을철인 9-11월에 발생하였고, 나이별로는 10명 모두 6개월 미만이였고 이중 8명이 DTaP 미접종 환아이었다. 결 론 : 본 연구에서 백일해로 진단된 환아들은 대부분 지역의원에서 질병 초기에 세기관지염, 폐렴 및 기관지염으로 진단되어 치료를 받다가 전원 되었다. 그러므로 특히 DTaP 접종을 받지 않은 영아에서 특징적인 '흡' 소리가 없더라도 심한 기침이 있는 경우 관심을 가지고 백일해 진단을 위한 검사를 시행한다면 보다 많은 수의 백일해 환자가 진단될 가능성이 있다고 사료된다.

• 대한소아치과학회지
• /
• 제33권2호
• /
• pp.317-322
• /
• 2006

소아환자를 진료하다 보면 불안과 공포가 극도로 심하여 일반적인 행동조절법으로는 양질의 치과치료가 불가능한 상황에 자주 접하게 된다. 음성조절과 신체 속박 또는 입 가리기 등의 강압적이고 물리적 인 방법을 사용하여도 역시 치료결과가 만족스럽지 않고 이러한 경우 환자와 보호자에게 가해지는 정신적인 상해는 결코 무시할 수 없다. 따라서 행동 조절의 어려움과 치과 질환의 심각성 등으로 인해 전신마취하의 치과치료가 필요한 경우가 많으며 이 경우 전신마취는 행동조절법의 하나로 간주될 수 있다. 치과전신마취는 비용이 많이 드는 것과 적지만 있을 수 있는 부작용의 위험성을 가지고 있다. 그러나 환자의 내원횟수를 줄일 수 있고 치과치료에 대한 부정적인 행동반응을 유발하지 않아 의사와 환자의 스트레스를 줄일 수 있으며 양질의 진료가 가능하다는 점에서 장점을 갖는다. 이번 실태조사는 2000년 12월부터 2005년 4월까지 전북대학교 치과병원 소아치과에서 전신마취하에 광범위한 치과치료를 받은 200여명의 환자를 대상으로 하여 나이, 성별 등의 인적 사항, 전신마취가 필요했던 이유, 전신마취시간, 치료의 종류, 전신마취횟수 등에 관하여 조사하였다.

• Tuberculosis and Respiratory Diseases
• /
• 제78권4호
• /
• pp.336-340
• /
• 2015

Background: Potentially harmful unplanned extubation (UE) may occur in patients on mechanical ventilation (MV) in an intensive care unit (ICU) setting. This study aimed to evaluate the clinical characteristics of UE and its impact on clinical outcomes in patients with MV in a medical ICU (MICU). Methods: We retrospectively evaluated MICU data prospectively collected between December 2011 and May 2014. Results: A total of 468 patients were admitted to the MICU, of whom 450 were on MV. Of the patients on MV, 30 (6.7%) experienced UE; 13 (43.3%) required reintubation after UE, whereas 17 (56.7%) did not require reintubation. Patients who required reintubation had a significantly longer MV duration and ICU stay than did those not requiring reintubation ($19.4{\pm}15.1days$ vs. $5.9{\pm}5.9days$ days and $18.1{\pm}14.2days$ vs. $7.1{\pm}6.5days$, respectively; p<0.05). In addition, mortality rate was significantly higher among patients requiring reintubation than among those not requiring reintubation (54.5% vs. 5.9%; p=0.007). These two groups of patients exhibited no significant differences, within 2 hours after UE, in the fraction of inspired oxygen, blood pressure, heart rate, respiratory rate, and pH. Conclusion: Although reintubation may not always be required in patients with UE, it is associated with a poor outcome after UE.

• Tuberculosis and Respiratory Diseases
• /
• 제58권6호
• /
• pp.600-606
• /
• 2005

Background : The development of bronchoscopic equipment along with the precision of radiographic techniques had reduced the mortality rate of patients with tracheobronchial foreign bodies but has been no change in the incidence of tracheobronchial foreign bodies since their introduction. The aim of this study was to assess the clinical characteristics of a tracheobronchial foreign body aspiration and to evaluate the efficacy of the treatment modality in children and adults. Methods : This is a retrospective review of 64 patients who underwent bronchoscopic procedures for the treatment of aspirated foreign bodies from December 1994 through March 2004 at the Chonnam national university hospital. Results : There were 47 males and 17 females, aged from 1 month to 78 years. Most of the patients had no underlying illness except for one patient with a cerebrovascular accident that contributed to the foreign body aspiration. The most common symptom was cough, which was noted in 54 patients (84.3%). The other presenting symptoms were dyspnea (48.8%), fever (20.3%), sputum (14%), vomiting (7.8%), and chest pain (4.6%). Those whose tracheobronchial foreign bodies were diagnosed more than 2 days after the aspiration (21 patients) were more likely to have pneumonia than those whose foreign bodies were diagnosed within 2 days (p = 0.009). Foreign bodies were visualized in the plain chest radiographs in 12 cases (18.8%), while others showed air trapping (21, 32.8%), pneumonia (15, 23.4%), atelectasis (7, 10.9%), and normal findings (9, 14.1%). The foreign bodies were more frequently found in the right bronchial tree (36) compared with the left bronchial tree (22, p = 0.04). In order to remove the foreign bodies, twenty (31.2%) cases were removed using flexible bronchoscopy, while 42 (65.6%) and 2 (3.2%) cases required rigid bronchoscopy and surgery, respectively. Conclusions : Tracheobronchial Foreign body aspiration had a bimodal age distribution in the infancy and old age around 60 years. They were found more frequently in the right bronchial tree. In addition, patients whose foreign bodies were diagnosed more than 2 days after the aspiration were more likely have a infection. Rigid bronchoscopy is the procedure of choice for uncooperative children and for those with foreign bodies lodged deeply in the small bronchial tree.

• Journal of Ginseng Research
• /
• 제44권2호
• /
• pp.222-228
• /
• 2020

Background: 20(S)-ginsenoside-Rg3 (C₄₂H₇₂O₁₃), a natural triterpenoid saponin, is extracted from red ginseng. The increasing use of 20(S)-ginsenoside Rg3 has raised product safety concerns. Methods: In acute toxicity, 20(S)-ginsenoside Rg3 was singly and orally administrated to Kunming mice and Sprague-Dawley (SD) rats at the maximum doses of 1600 mg/kg and 800 mg/kg, respectively. In the 26-week toxicity study, we used repeated oral administration of 20(S)-ginsenoside Rg3 in SD rats over 26 weeks at doses of 0, 20, 60, or 180 mg/kg. Moreover, a 4-week recovery period was scheduled to observe the persistence, delayed occurrence, and reversibility of toxic effects. Results: The result of acute toxicity shows that oral administration of 20(S)-ginsenoside Rg3 to mice and rats did not induce mortality or toxicity up to 1600 and 800 mg/kg, respectively. During a 26-week administration period and a 4-week withdrawal period (recovery period), there were no significant differences in clinical signs, body weight, food consumption, urinalysis parameters, biochemical and hematological values, or histopathological findings. Conclusion: The mean oral lethal dose (LD₅₀) of 20(S)-ginsenoside Rg3, in acute toxicity, is above 1600 mg/kg and 800 mg/kg in mice and rats, respectively. In a repeated-dose 26-week oral toxicity study, the no-observed-adverse-effect level for female and male SD rats was 180 mg/kg.

• 한국임상약학회지
• /
• 제12권1호
• /
• pp.29-38
• /
• 2002

Hypertension is an important public health problem because it increases the risk of stroke, angina, myocardial infarction, heart failure, and end-stage renal disease. If it is not actively treated, morbidity and mortality increase with hypertension-induced complications and quality of life decreases. This study was to evaluate the use of antihypertensive drugs and blood pressure changes and to compare algorithms chosen (or the 1st and 2nd line therapy of hypertension based on the JNC VI recommendations. The medical charts of 222 patients with essential hypertension at St. Vincent's Hospital in Suwon from January 1997 to January 2000 were reviewed retrospectively. Data collection and analysis included baseline BP underlying diseases and complications, administered antihypertensives, BP changes, changes of antihypertensive regimen, and adverse effects with treatments. As results, the higher BP the patients had, the more frequent they had target organ damages and clinical cardiovascular diseases. Mean duration to reduce blood pressure less than 140/90 mmHg was 8 weeks in $85.3\%$ of the patients. The rate of control in BP was $82.4\%$ at 6 months. The major antihypertensive drugs prescribed were calcium channel blockers $(61.8\%)$ , ACE inhibitors $(19.1\%),\;\beta-blockers\;(13.7\%)$ and diuretics $(5.3\%)$ as the 1st-line monotherapy. The methods of treatment used as the 1st-line therapy were monotherapy$(59\%)$ and combination therapy $(41\%)$. Blood pressure change was significantly greater for combination therapy than monotherapy$(-26.2\pm21.4\;vs.\;-18.56\pm16.7$ mmHg for systolic blood pressure; P<0.003, $-16.9\pm13.2\;vs.\;-9.2\pm12.8$ mmHg for diastolic blood pressure; p<0.001). When blood pressure was not completely controlled with the first antihypertensive selected, the 2nd line therapy had 4 options: addition of 2nd agent from different class; $66.2\%$, substitution with another drug, $21.9\%$ increase dose $11.9\%$ continue first regimen $27.9\%$ Calcium channel blockers were the most frequently prescribed agents. This was not comparable to the JNC VI guideline which recommended diuretics and $\beta-blockers$ for the 1st-line therapy. Most of patients achieved the goal BP and maintained it until 6 months, but the remaining patients should be controlled more tightly to improve their BP with combination of life style modification, patient education, and pharmacotherapy.

• 한국임상약학회지
• /
• 제12권1호
• /
• pp.39-50
• /
• 2002

Hypercholesterolemia is one of main causes of coronary heart disease(CHD). Clinical trials demonstrated that lowering serum cholesterol levels would reduce incidence of new cardiovascular events and mortality by primary or secondary preventions. The objective of this retrospective study was to compare efficacy and side effects of lovartatin and simvastatin in treatement of hypercholesterolemia. In Boramae Hospital, patients were included when they have taken lovastatin 20 mg or simvastatin 10 mg for 52 weeks with laboratory monitoring for cholesterol at baseline, 3, 6 and 12 month period. As results, total 128 outpatients were included with their total cholesterol level <240 mg/dl and triglyceride level <400 mg/dl at baseline. Total cholesterol and LDL cholesterol of lovastatin group (n=60) and simvastatin group (n=68) were significantly reduced from baseline (p=0.001). Lovastatin maximally reduced total cholesterol by $23.9\%,\;triglyceride\;by\;12.3\%$, LDL cholesterol by $36.1\;\%$ and increased HDL cholerterol by $7.8\%$ and simvastatin reduced by $24.1\%,\;20.5\%,\;34.3\%\;respectively$ and HDL increased by $11.2\%$. There were no significant differences between lovastatin and simvastatin in mean percent change of lipid levels at 12, 24 and 52 weeks from baseline. Cumulative percentage of patients reaching the target LDL cholesterol concentration by 24 weeks was $61.7\%$ in lovastatin and $64.7\%$ in simvastatin. Average time to reach the target LDL goal was 100.1 days in lovastatin and 99.8 days in simvastatin. Both lovastatin and simvastatin also significantly reduced total cholesterol and LDL cholesterol in all subgroups (diabetes mellitus, hypertension, and coronary heart disease). In this study, treatment efficacy in patients with coronary heart disease was lower than other patients. Considering clinical importance of secondary prevention, more intensive treatment is necessary to decrease LDL cholesterol level of 100 mg/dl or lower in patients with coronary heart disease or other clinical atherosclerotic disease. There were no serious side effects during the study period. Digestive side effects were most frequently reported (lovastatin $8.3\%\;vs\;simvastatin\;8.8\%$). In conclusion, both lovastatin and simvastatin were similar in lipid lowering effects and there was no difference in incidence of side effects.

• 대한약침학회지
• /
• 제7권1호
• /
• pp.37-51
• /
• 2004

Objective : Recently scolopendrid aqua-acupuncture has been a good effect on pain control but it has not been known about clinical safety. The purpose of this study was to investigate acute toxicity of scolopendrid aqua-acupuncture. Method : In order to prove the clinical safety of scolopendrid aqua-acupuncture, We have observed a bacteriological examination and clinical pathology test after scolopendrid aqua-acupuncture treatment. Balb/c mice were injected intravenous with Scolopendrid aquaacupuncture treatment for $LD_{50}$ and acute toxicity test. We analyzed physical reaction(side effect)and clinical pathology test before and after Scolopendrid aqua-acupuncture treatment of mice and 20 patients suffering from pain, who admitted department of Acupunture and Moxibustion, College of Oriental Medicine, Won-Kwang University Kwangju hospital. Results : In the Blood agar plate and Nutrient agar plate, a bacteriological examination did not show a bacillus. In acute $LD_{50}$ toxicity test, there was no mortality thus unable to attain the value. Examining the toxic response in the acute toxicity test, there was no sign of toxication. In acute toxic test, running biochemical serum test couldn't yield any differences between the control and experiment groups. In the 20 patients treated with Scolopendrid aqua-acupuncture, hematologic test did not show remarkable change. In the 20 patients treated with Scolopendrid aqua-acupuncture, Liver function test(AST, ALT, ALP) showed a slight decrease on the contrary, and abnormal rate showed a decrease of 5.0% compared with previous study. Reanl function test(BUN, Cr) and abnormal rate showed a decrease of 5.0% compared with previous study. In the 20 patients treated with Scolopendrid aqua-acupuncture, Electrolyte were normal range before and after treatment. In the Urine analysis of 20 patients, Leukocyte, Protein, Glucose, Keton, Bilirubin, U-bilinogen were not detected before and after Scolopendrid aqua-acupuncture treatment, and the rest almost made no difference.

• Journal of Chest Surgery
• /
• 제27권2호
• /
• pp.99-113
• /
• 1994

Pentastarch is a new synthetic hydroxyethyl starch similar to hetastarch. We report on the clinical comparisons the clinical efficacy and safety of 10% pentastarch in prime solutions for CPB in cardiac operations with that of 20% serum albumin. During CPB, group P [n = 20] received 500ml of 10% pentastarch and group A [n = 20] received 100ml of 20% albumin in prime solutions The postoperative time of ICU stay in group P and the day and amount of chest drain, hospital stay in group A were longer [p<0.05]. Fresh whole blood and PRBC were added only in group A and a higher amount of hartman solution was added in group A during CPB [p<0.05]. Prothrombin time was prolonged preoperatively and 2 days postoperatively in group A and 7 days postoperatively in group P [p<0.05] but there were no significant differences in bleeding time or fibrinogen level. Platelet count was higher immediately postoperatively in group A and preoperatively and 1, 2, and 7 days postoperatively in group P [p<0.05].Total protein and albumin level were higher 1 day postoperatively in group A and 2 and 7 days postoperatively in group P [p<0.05]. BUN was increased 2 days postoperatively in group A and Cr was increased 1 day postoperatively in group P [p<0.05]. CPK was higher preoperatively and 1, 2, and 7 days postoperatively in group A and plasma hemoglobin level was also higher 2 and 7 days postoperatively in group A [p<0.05]. There were no significant differences in arterial blood gas analysis but higher pO2 and lower pCO2 levels were maintained in group P and ejection fraction was higher 7 days postoperatively in group P [p<0.05]. Both groups were improved postoperatively in NYHA class and the hemodynamic parameters such as MAP, CO, CI, SV, LVSWI were well maintained in group P [p<0.05]. The amount of blood products used was higher in group A and urine output was higher immediately postoperatively in group A and 1, 2 days postoperatively in group P and the chest output was higher in group A. The complications were developed in 7 patients in group A and 5 patients in group P and mortality was not present in both groups.In conclusion, 10% pentastarch is as safe and effective as 20% albumin in prime solutions for cardiopulmonary bypass in cardiac operations.

• Journal of Chest Surgery
• /
• 제30권6호
• /
• pp.598-606
• /
• 1997

1994년 9월부러 1995년 8월까지 일년동안 부천 세종병원에서 시행된 승모판막질환 수술은 총 136례였으 며 이중 인공판륜을 사용하여 판막성형술을 시행된 44례를 대상으로 평가하였다 이 44례의 평균 연령은 38.2세(범위: 5세~63세)였으며 남성이 18례 여성이 26례였다, 사용된 인공판륜은 Carpentier ring이 32례, Dmm ring 이 12례였다. 판막질환의 원인은 류마치스가 30례(68%), 퇴행성 질환에 기인한 것이 13례(30%)였으며, 1례는 선천성 승 모판 부전증이었다. 판막질환의 형태로 보면 승모판막부전증이 33례(76%),승모판 협착증이 2 례(5%), 승모판 협착부전증이 9례(19%) 있었다. Carpentier의 기능적 분류는 I형이 5례(11%), II형이 24례(55%), III형이 4례(9%) 있었으며, II형과 III형의 혼합형이 11례(25%)에서 관찰되었고, 매 환자당 평균 3.7가지의 병변이 있었다. 승모판에 시행한 수술 수기는 전례에서 인공판륜성형술을 시행하였으며 한 환자 당 평균 3.4가지의 수기 를 사용하였다. 수술 사망은 2례에서 발생하였으며, 수술 후 승모판 부전증이 진행되어 2주에 시행한 재수술이 일 례 있 었다. 12개월의 추적 관찰에서 수술 전후의 NYHA 기능적 鈞畢\ulcorner평균 3.0에서 1.3으로 개선되었다. 심장 초음파 검사에서 술후의 승모판 면적은 2.07$\pm$0.11 cm2(평균 $\pm$ 표준오차)이었으며, 좌심실 수축력의 호전을 보였고, 판막부전의 정도는 전혀 판막부전 소견이 없어진 경우가 23례(53%), 경미한 폐쇄부전이 있는 경우가 18례(42%)였고, II도 부전의 소견을 보인 례가 2례(5%) 있었다.