• Clinical and Experimental Pediatrics
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• 제49권10호
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• pp.1093-1099
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• 2006

목 적 : 호모시스테인은 성인에서 관상동맥 질환을 포함한 심혈관 질환의 독립적인 위험 인자로서, 혈관 내피세포 손상과 혈액 응고 촉진, 혈전 형성 등의 기전으로 동맥경화증의 위험을 증가시킨다고 알려져 있으나 이러한 호모시스테인이 소아에 미치는 영향은 아직까지 연구된 바가 없다. $TNF-{\alpha}$는 전염증성 사이토카인으로서 혈관 내피세포 손상과 관상동맥의 염증 반응을 초래한다. 본 연구에서는 호모시스테인이 가와사키병의 관상동맥 합병증에 미치는 영향과 $TNF-{\alpha}$의 연관성에 대해 알아보고자 하였다. 방 법 : 가와사키병 환아 24명(관상동맥 확장이 없는 군(1군) : 8명, 관상동맥 확장이 있는 군(2군) : 16명)에 대한 임상 양상과 면역글로불린 투여 전과 후, 회복기에서의 호모시스테인과 $TNF-{\alpha}$ 혈중 농도를 비교하였다. 대조군은 같은 시기에 내원한 열이 없는 정상 소아(3군 : 10명)와 열성 질환 소아(4군 : 11명)로 정하였다. 결 과 : 면역글로불린 투여 전의 호모시스테인은 1군($14.0{\pm}7.0{\mu}mol/L$)에서 3군($5.9{\pm}1.1{\mu}mol/L$)에 비해 유의하게 높았으며(P<0.05), 2군($17.4{\pm}8.0{\mu}mol/L$)에서는 3군($5.9{\pm}1.1{\mu}mol/L$)과 4군($9.2{\pm}2.0{\mu}mol/L$) 각각에 비해 유의하게 높았다(P<0.05). $TNF-{\alpha}$에서도 면역글로불린 투여 전 2군($858.4{\pm}934.0pg/mL$)이 3군($8.0{\pm}1.1pg/mL$)과 4군($54.1{\pm}146.3pg/mL$)에 비해 유의하게 높았다(P<0.05). 2군에서 시간 경과에 따른 호모시스테인과 $TNF-{\alpha}$를 비교해 보면 면역글로불린 투여 전에 각각 $17.4{\pm}8.0{\mu}mol/L$, $858.4{\pm}934.0pg/mL$로 가장 높았고, 면역글로불린 투여 후와 회복기로 갈수록 감소하였다. 또한 가와사키병 급성기에서 호모시스테인과 $TNF-{\alpha}$는 양의 상관관계를 가진다(r=0.488, P<0.05). 결 론 : 호모시스테인의 혈중 농도가 높을수록 가와사키병에서 관상동맥 병변이 발생할 가능성이 더 높았으며 $TNF-{\alpha}$와 같은 사이토카인도 관상동맥 병변의 형성에 중요한 역할을 할 것으로 생각된다.

• 대한임상독성학회지
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• 제12권1호
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• pp.31-34
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• 2014

We report on a patient who developed acute hepatic failure despite intravenous N-acetyl cysteine therapy who was treated with the Molecular Adsorbents Recirculating System (MARS). She presented 20 hours after the ingestion of 13 g of acetaminophen. The MARS is based on albumin dialysis principle which can be applied for patients with acute poisoning from drugs that have high protein-binding capacity because of its ability to selectively remove from circulation protein-bound toxins. The clinical toxicologist should be consider this technology when treating patients with hepatic failure following acetaminophen poisoning.

• 한국화재소방학회논문지
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• 제22권3호
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• pp.293-299
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• 2008

119 구급대를 이용하여 급성관상동맥증후군을 진단 받은 97명의 환자평가로는 혈압 27.8%, 호흡 23.7%, 맥박 33.0%를 측정하였고, 응급처치로는 산소공급 52.6%, 안정 12.4%, 심전도 체크 4.1%, Nitroglycerin(NTG) Aspirin 정맥로 확보 둥은 0%로 전체적인 수행율이 낮게 확인되어 급성관상동맥증후군 환자의 병원 전 처치가 제대로 이루어지지 못하고 있다. 따라서 구급대인의 질적 향상을 위해서 실무중심의 지속적인 교육, 교육 후에는 반드시 평가를 병행하여 적정수준 미달자에게는 재교육을 받도록 하는 등 구급대원의 자질을 강화시킬 수 있도록 내부적인 초안이 마련되어야 할 것이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제17권2호
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• pp.121-124
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• 2014

Omega (${\omega}$)-3 polyunsaturated fatty acids appear to be effective in preventing and treating parenteral nutrition-associated liver disease, and several mechanisms were proposed for this observation. An 8-week-old male infant with cholestasis and acholic stool was diagnosed non-syndromic intrahepatic interlobular bile duct paucity by open-wedge liver biopsy. Initially he was treated with usual supportive medical therapy, including ursodeoxycholic acid. However, the clinical status and laboratory tests did not improve. Omega (${\omega}$)-3 polyunsaturated fatty acids (initially intravenous administration and oral administration later), were started and his liver function, including aminotransferase level and bilirubin levels normalized, and the ivory stool color turned green. We report the possible effectiveness of ${\omega}$-3 polyunsaturated fatty acids as a potent choleretic agent for non-syndromic intrahepatic interlobular bile duct paucity, a very rare structural pediatric hepatic disease.

• Tuberculosis and Respiratory Diseases
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• 제64권2호
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• pp.138-143
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• 2008

특징적인 피부병변, 근력약화 등 분명한 피부근염의 임상소견을 보이지 않는 환자에서 동반된 NSIP 치료경과 중 자발성 종격동기종, 피하기종 및 대장기종이 발생한 증례를 경험하였고 스테로이드와 cyclosporin을 사용하여 좋은 치료반응을 경험하였다. 간질성폐렴을 동반한 피부근염에서 자발성 종격동기종, 피하기종 또는 대장기종 등이 드물게 보고되었고 이 경우 나쁜 예후를 보이므로 주의할 필요가 있다. 비교적 드물지만 NSIP에서 종격동기종, 대장기종이 발생하는 경우 임상경과 중 피부근염이 동반 또는 이환되었는지 세심한 관찰이 필요하겠다. 또 NSIP에서 기종이 발견되는 경우 스테로이드와 cyclosporin 또는 다른 면역억제제의 병용투여 등 적극적인 치료가 치료반응과 예후에 좋은 영향을 주리라 사료되어 본 증례를 보고하는 바이다.

• Journal of Chest Surgery
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• 제35권8호
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• pp.608-610
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• 2002

폐암의 흉막 파종은 그 예후가 매우 불량하며, 경정맥 항암화학요법 이외에는 일반적으로 다른 치료가 시행 되지 않고 있다. 저자들은 층막 파종이 있는 두 명의 환자에게 온열요법을 병행한 흡막강내 고농도 항암약제의 관류요법을 시행하였기에, 그 결과를 문헌 고찰과 함께 보고하고자 한다.

• 대한예방한의학회지
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• 제4권2호
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• pp.108-118
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• 2000

According to the North Korean documents , North Korean government have emphasized the development of the Koryo medicine (traditional korean medicine) and encouraged the combination of the Koryo and the modern medicine. It is regarded that this attitude arose from the ruler's will toward independency in the medical field and at the same time the lack of modern medical resources . Combinations of the Koryo medicine and the modern medicine in the clinical textbooks are classified as follows: first, mixed medication of the Koryo and the modern medicine. Second, combination of the traditional acupuncture(or moxibustion) and the medication of modern medicines. Third, injection of modern medicines at acupoints. Forth, an intramuscular or an intravenous injection of the Koryo medicine. Fifth, anesthesia using Koryo medicine. Sixth, simple surgery at the acupoints. Lastly, combination of injection and the traditional therapy(eg. acupuncture, moxibustion and cupping) Despite of many achievements in the field of combined medical treatment, recent economic failure and severe famine for several years caused collapse of the health care delivery system in North Korea, and it is hard to find combined practices actually.

• 대한두경부종양학회지
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• 제27권2호
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• pp.230-233
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• 2011

Head and neck abscess usually requires hospitalization, intravenous antibiotic therapy, and surgical incision and drainage. Open surgical drainage may result in unsightly scars. We report two cases of a 56-year-old man with a facial abscess and a 47-year-old man with a parotid abscess. The patients were successfully treated with ultrasound-guided angiocatheter irrigation and drainage without scar. Ultrasound-guided angiocatheter irrigation and drainage can be a simple, safe and effective alternative procedure to open surgery in the management of the selected head and neck abscesses.

• Journal of Yeungnam Medical Science
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• 제33권1호
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• pp.48-51
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• 2016

Milk-alkali syndrome (MAS), a triad of hypercalcemia, metabolic alkalosis, and renal failure, is associated with ingestion of large amounts of calcium and absorbable alkali. MAS is the third most common cause of hypercalcemia in hospital, after primary hyperparathyroidism and malignant neoplasm. MAS is not often reported in the Korean literature. We describe MAS secondary to intake of calcium citrate for the treatment of osteoporosis with thoracic spine compression fracture. A 70-year-old man presented to our hospital with a 1-week history of general weakness and lethargy. He was found with acute kidney injury (serum creatinine, 4.6 mg/dL), hypercalcemia (total calcium, 14.8 mg/dL), and alkalosis. Laboratory evaluation excluded both hyperparathyroidism and malignancy. Mental status and serum calcium level was normalized within a week after proper hydration and intravenous administration of furosemide. However, he developed aspiration pneumonia, pseudomembranous colitis, and sepsis with multi-organ failure. Despite intensive treatment including inotropics, mechanical ventilation, and renal replacement therapy, he expired with no signs of renal recovery on the 28th hospital day.

• Journal of Korean Neurosurgical Society
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• 제41권1호
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• pp.65-68
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• 2007

Objective : A new point of view on the chronic back pain proposed which is, named neuropathic back pain[NBP]. Some proposed a certain pain scale as an useful diagnostic tool. Before scientific verification, some doctors prescribed a new anticonvulsant for the NBP. We investigated diagnostic tools for NBP by a review of the literature. Methods : A comprehensive computer search of the English literature concerning neuropathic low back pain was performed using the key words such as neuropathic back pain and diagnosis in the PubMed. Results : In 1998, the term NBP was first used in a patient with lung cancer. In the English literature, there were two diagnostic methods for the NBP, Neuropathic pain scale[NPS] and a pharmacological test. NPS is a pain questionnaire, which depends on the patients' subjective reports on the given questions, such as 'how hot is your pain feel'. By the pharmacological test, NBP was defined as 50% or more decrease of pain on intravenous lidocaine and on local anesthetic epidurally. It also depends on the patients' subjective response to the therapy. Conclusion : There were still no reliable objective diagnostic criteria for the NBP. It seems to be better to reserve the new anticonvulsants for the NBP till scientific approval.