• 동의신경정신과학회지
• /
• 제23권4호
• /
• pp.69-94
• /
• 2012

Objectives : The goals of the present study are to assess children with tic disorders, their clinical characteristic and to prove the effectiveness of herbal treatments of tic disorders. Methods : The present study was conducted from January 2006 to April 2011, with 200 out-patient children between the age of 6 to 12 diagnosed with tic disorder (after excluding 10 children who could not be clearly diagnosed) at the "H'herbal medicine clinic located in Seoul. Of these 200 children, we have evaluated the epidemiology and clinical manifestation, and analyzed the results of herbal medicine treatments. Results : 1. Among the children diagnosed with tic disorder, TTD was most prevalent (43.3%) and males were more likely than females to express tics (5.45:1). Children with TD sought help significantly later (average age of 9.03 years) than the other types. 2. The analysis results of herbal medicine treatments are as follows. Compared to the pre-treatment assessment, children who received herbal medicine treatment for more than three months (n=52) showed a marked decrease in symptoms of motor tics (the number of motor tics, frequency, severity, complexity) and vocal tics (the number of vocal tics, frequency, severity), in the impairment level of combined tics (motor and vocal tics together) and in the overall score. Conclusions : In conclusion, we apprehended demographic and clinical characteristics of tic disorder patients who visited a Korean traditional medicine clinic by analyzing the psychological assessment results. Furthermore, we identified the effectiveness of herb formula in tic disorder.

• 동의신경정신과학회지
• /
• 제20권2호
• /
• pp.85-99
• /
• 2009

Objectives : This study aimed to understand the influence of acupuncture on the human body by comparing changes within human bodies before and after people in normal health are treated with acupuncture at the acupoints HT7 and PC9, which are related to mental functions. Methods : The study was performed from January 3, 2008 to March 5, 2008 on 60 healthy males and females in their 20s. HRV, EEG, skin conductance response, respiration and peripheral skin temperature were measured for 5 minutes before acupuncture simulation was applied to the acupoints HT7 and PC9. During 20 minutes of acupuncture treatment, the same items were continuously measured to determine whether there had been any changes, and they were then measured for 5 minutes after the removal of the acupuncture needles in order to implement a comparative analysis. Results : 1. The HRV measurement showed that in the course of before, during and after acupuncture stimulation, heart rate, HF and HF norm decreased significantly (P<0.05) at HT7. LF, LF norm, and LF/HF ratio increased significantly (P>0.05), while heart rate, HF and HF norm decreased significantly (P<0.05) at PC9. 2. Skin conductance response increased significantly (P<0.05) at PC9 during and after the acupuncture simulation periods, compared with the pre acupuncture period. 3. the peripheral skin temperature increased significantly (P<0.05) both at HT7 and PC9 in the course of before, during and after acupuncture stimulation. 4. Compared with the pre-acupuncture period, respiration rate increased both at HT7 and at PC9 during and after the acupuncture simulation periods, but not in a statistically significance. 5. In the EEG measurement, when compared with the pre-acupuncture period at HT7, mid ${\beta}$ wave decreased significantly (P<0.05) during acupuncture treatment. Compared with the measurements during acupuncture treatment at PC9, low ${\beta}$ wave increased significantly (P<0.05) after the acupuncture needles were removed. Conclusions : When acupuncture treatment is applied at the acupoints HT7 and PC9, the activation of parasympathetic nerves decreases and the activation of sympathetic nerves increases in the HRV measurement. It was determined that PC9 makes the sympathetic nerves become highly activated in a skin conduction response. The effect of stability in the brain wave seemed to bo shown at HT7 than PC9.

• Pediatric Infection and Vaccine
• /
• 제24권1호
• /
• pp.23-30
• /
• 2017

목적: 소아 입원환자에서 A/H1N1, A/H3N2형 및 B형 인플루엔자 감염을 비교하고 항바이러스제의 효용성을 분석하고자 하였다. 방법: 2014년 1월부터 4월까지 창원파티마병원에 인플루엔자 감염으로 입원한 소아 환자들을 후향적으로 분석하였다. 결과: 총 302명 중 인플루엔자 A/H1N1형 15명(5.0%), A/H3N2형 100명(33.1%), B형 187명(61.9%)이었다. A는 24개월 미만, B는 24개월-6세 사이 감염자에서 높은 분포를 보였고(P=0.005). B형 인플루엔자 감염군에서 발열 기간이 유의하게 길었다(P=0.001). 총 161명(53.3%)가 백신 접종자였으며, 감염 환자군 모두에서 oseltamivir를 복용한 환자들의 발열 기간이 유의하게 더 짧은 것으로 나타났다. 결론: A형과 B형 인플루엔자 환자는 연령 분포 및 임상 경과에 유의한 차이를 보였으며, oseltamivir는 효과의 차이는 있었으나 두 군 모두에서 효용성이 있다.

• Childhood Kidney Diseases
• /
• 제11권2호
• /
• pp.264-271
• /
• 2007

목 적 : 소아과 외래에서 흔히 접할 수 있는 질환 중 하나인 야뇨증의 진단을 위해서는 병력의 정보를 얻는 것이 중요하다. 그러나 한정된 외래진료 시간에 병력 청취가 쉽지는 않기 때문에 설문지를 이용하여 야뇨증 환아를 단일 증상 야뇨증군과 비단일증상 야뇨증군으로 분류하고 임상양상등을 비교하여 야뇨증의 병형별 진단 및 치료에 도움을 주고자 하였다. 방 법 : 2004년 1월부터 2005년 7월까지 영남대학교 의과대학 부속병원 소아과를 방문하여 야뇨증의 진단이후 첫 내원시 보호자의 동의하에 약물치료 전 약 2-3주의 야뇨일지를 관찰하는 동안 보호자가 환아의 배뇨 습관, 과거력, 치료에 대한 부모와 어린이의 자세 등을 포함한 설문지에 응답을 하여 설문지를 통한 병력청취가 이루어졌고, 이후 지속적인 치료 및 추적 관찰이 가능하였던 34명의 야뇨증 환아를 대상으로 하였다. 결 과 : 단일 증상성 야뇨증 환아는 21명, 비단일 증상성 환아는 13명이었으며, 발달 지연이 있었던 환아는 없었다. 환아 출생 시 분만법, 제대일수, 출생 시 체중, 형제 순서, 잠버릇, 변비, 치료성적에 따른 두 군의 차이는 없었다. 요로 감염의 빈도는 비단일 증상군에서 많았으며, 낮 동안 배뇨빈도와 알러지 병력은 비단일 증상군에서 높은 경향을 나타내었다. 전체 야뇨증 환아의 부모는 병원방문 전 전문 치료 방법으로 한방치료를 52.9%으로 가장 많이 이용하였으나 67.6%에서 효과가 없거나 빈도는 줄었지만 여전히 야뇨가 있다고 하였다. 결 론 : 병력 청취 설문지를 이용한 단일 증상군과 비단일증상군의 비교는 야뇨증 환아의 세부적 진단에 도움이 되며, 치료 방침을 결정하고 치료성적을 향상시키는데 유용한 자료로 기여할 것으로 기대된다. 또한 병원 방문 전 전문 치료로 한방 치료가 많이 선택되고 있어 부모들을 대상으로 야뇨증의 교육이 필요함을 알 수 있었다.

• 대한핵의학회지
• /
• 제25권1호
• /
• pp.46-52
• /
• 1991

Radioaerosol inhalation imaging (RII) has been used in radionuclide pulmonary studies for the past 20 years. The method is well accepted for assessing regional ventilation because of its usefulness, easy fabrication and simple application system. To evaluate its clinical utility in the study of impaired regional ventilation in bronchial asthma, we obtained and analysed RIIs in 31 patients (16 women and 15 men; age ranging 21-76 years) with typical bronchial asthma at the Department of Radiology, Kangnam St. Mary's Hospital, Catholic University Medical college, from January, 1988 to August, 1989. Scintiscans were obtained with radioaerosol produced by a BARC(Bhabha Atomic Reserch Center, India) nebulizer with 15 mCi of $^{99m}Tc-phytate$. The scanning was peformed in anterior, posterior and lateral projections following 5-minute inhalation of radioaerosol on sitting position. The scans were analyzed and correlated with the results of pulmonary function study and the findings of chest radiography. Fifteen patients had concomitant lung perfusion image with $^{99m}Tc-MAA$. Follow-up scans were obtained in 5 patients after bronchodilator therapy. The patients were divided into (1) attack type (4 patients), (2) resistant type (5 patients), (3) remittent type (10 patients) and (4) bronchitic type (12 patients). Chest radiography showed hyperinflation, altered pulmonary vascularity, thickening of the bronchial wall and accentuation of basal interstitial markings in 26 of the 31 patients. Chest radiographs were norma! in the remaining 5 patients. Regardless of type, the findings of RII were basically the same, and characterized by the deposition of radioaerosol in the central parts or in the main respiratory air ways along with mottled nonsegmental ventilation defects in the periphery. Peripheral parenchymal defects were more extensive than that of expected findings from clinical symptoms, pulmonary function test and chest radiograph. Broomstick sign was present in 17 patients. The abnormality of RII was poorly correlated with perfusion scans. In all 5 patients treated with bronchodilators, follow-up study demonstrated a decrease in the degree of radioaerosol deposition in the central air way with improved ventilation defects. This study indicates that RII is a useful technique for the evaluation of regional ventilation abnormality and the effect of treatment with bronchodilators in patients with bronchial asthma.

• 대한임상검사과학회지
• /
• 제49권4호
• /
• pp.374-381
• /
• 2017

LAP 지수는 공복시 중성지방 농도와 허리둘레의 조합으로 과도한 지방축적을 평가하는 지표이다. 이 연구는 LAP 지수와 ALT간의 관련성과 LAP 지수가 ALT에 미치는 영향에 대해 알아 보고자 간질환의 병력이 없는 건강한 성인남성을 대상으로 횡단면 연구를 실시하였다. 2015년 1월부터 2017년 6월까지 경기지역 종합병원에서 건강검진을 시행한 20세 이상 70세 이하의 성인 남성 13,854명을 연구 대상자로 하였다. LAP 지수는 남성의 경우 [허리둘레(cm)-65]${\times}$[중성지방(mmol/L)]으로 산출하였으며, 혈청 ALT 농도의 이상치는 남성 40 IU/L 이상인 경우를 기준으로 설정하였다. 모든 대상자들은 인체측정학적 지표와 생리학적 검사를 실시하였다. LAP 분위수가 증가할수록 ALT는 통계적으로 유의한 증가를 보였다(p<0.001). LAP 지수는 ALT와 상관관계를 보였으며(r=0.238, p<0.001), 특히 인슐린(r=0.449, p<0.001) 및 HDL-콜레스테롤(r=-0.369, p<0.001)과 상관성이 높게 나타났다. 또한 LAP 지수는 ALT에 영향을 미치는 요인이었으며(p<0.001), LAP 지수가 높을수록 ALT가 상승할 위험이 높게 나타났다(p<0.001). 결론적으로 LAP 지수는 한국 성인남성에서 ALT 상승을 예측하는 지표로 나타났다.

• 대한지하수환경학회지
• /
• 제5권4호
• /
• pp.223-232
• /
• 1998

포항 옥명 폐기물 매립지는 우리나라의 주요 산업폐기물 처리장으로서 1988년 1월부터 현재까지 약 10년동안 사용되고 있다. 매립지에서 반경 2~3 km 범위의 일반지하수는 산성비의 영향으로 pH가 약산성이며, EC, NO$_3$, SO$_4$가 보통의 지하수보다 높게 나타난다. Piper의 삼각다이아그램에서의 수질유형은 Ca-SO$_4$와 Na-SO$_4$형인데, Ca-SO$_4$형이 우세하다. 매립지내의 5개 감시정 지하수의 수질은 침출수의 영향으로 pH가 약알카리성이며, TS, COD, Na, Cl, SO$_4$, Alkalinity, F 등이 일반지하수에 비하여 많이 나타난다. Mn, Zn, Pb, Cr Ni 등의 중금속도 많이 나타나지만, 유해유기원소는 검출이 되지 않는다. 옥명 매립지 지하수의 수질유형은 Na-SO$_4$형으로서, 서울난지도, 부산석대 등의 일반 생활폐기물 매립지의 Na-Cl형과 구별된다. 현재까지 확인된 지하수 오염범위는 매립지 입구에서 서쪽으로 약 120 m 떨어진 곳이다. 앞으로 침출수들이 매립지 주변지역으로 확산되는 것을 막기 위하여는 매립지 외곽에 차수벽을 설치하고, 매립지내에는 여러개의 채수정을 개발하여 오염된 지하수들을 주기적으로 양수하여 침출수처리장에서 처리하여야 한다.

• Journal of Trauma and Injury
• /
• 제23권2호
• /
• pp.119-127
• /
• 2010

Purpose: This study was conducted to shorten the time spent at each stage of treatment and to reduce the total amount of time patients spend in the emergency department (ED) by applying Six Sigma in the treatment of major trauma patients. Methods: This is a comparative study encompassing 60 patients presenting to the ED of Bundang CHA Hospital from January 2008 to December 2008 and from July 2009 to March 2010. The stages of treatment for major trauma patients were divided into six categories (T1: total emergency department staying time, T2: duration of visit-radiologic evaluation time, T3: duration of visit-consult to department of admission, T4: duration of consultation-issue of hospital admissions time, T5: duration of visit-issue of hospital admissions time, T6: duration of issue of hospital admission-emergency department discharge time) and the total time patients spent in the ED was compared and analyzed for periods; before and after the application of Six Sigma. Results: After the application of Six Sigma, the numerical values in four of the six categories were significantly reduced; T2, T3, T4, and T5. However, the average of the total time patients spent in the ED did not show any remarkable change because the T6 increased highly. The level of Six Sigma increased $0.17{\sigma}$. Conclusion: The application of Six Sigma for major trauma patients in the ED resulted in a significant improvement in the error rate for the total time patients spent in the ED. The Six Sigma activity has shown great potential. Therefore, the project is expected to bring better results in every stage of treatment if the levels of the hospital facilities are improved.

• Journal of Trauma and Injury
• /
• 제23권2호
• /
• pp.113-118
• /
• 2010

Purpose: Prolonged stay in the emergency department (ED), which is closely related with the time interval from the ED visit to a decision to admit, might be associated with poor outcomes for trauma patients and with overcrowding of the ED. Therefore, we examined the factors affecting the delay in the decision to admit severe trauma patients. Also, a multidisciplinary department system was preliminarily evaluated to see if it could reduce the time from triage to the admission decision. Methods: A retrospective observational study was conducted at a tertiary care university hospital without a specialized trauma team or specialized trauma surgeons from January 2009 to March 2010. Severe trauma patients with an International Classification of Disease Based Injury Severity Score (ICISS) below 0.9 were included. A multivariable logistic regression analysis was used to find independent variables associated with a delay in the decision for admission which was defined as the time interval between ED arrival and admission decision exceeded 4 hours. We also simulated the time from triage to the decision for admission by a multidisciplinary department system. Results: A total of 89 patients were enrolled. The average time from triage to the admission decision was $5.2{\pm}7.1$ hours and the average length of the ED stay was $9.0{\pm}11.5$ hours. The rate of decision delay for admission was 31.5%. A multivariable regression analysis revealed that multiple trauma (odds ratio [OR]: 30.6, 95%; confidence interval [CI]: 3.18-294.71), emergency operation (OR: 0.55, 95%; CI: 0.01-0.96), and treatment in the Department of Neurosurgery (OR: 0.07, 95%; CI: 0.01-0.78) were significantly associated with the decision delay. In a simulation based on a multidisciplinary department system, the virtual time from triage to admission decision was $2.1{\pm}1.5$ hours. Conclusion: In the ED, patients with severe trauma, multiple trauma was a significant factor causing a delay in the admission decision. On the other hand, emergency operation and treatment in Department of Neurosurgery were negatively associated with the delay. The simulated time from triage to the decision for admission by a multidisciplinary department system was 3 hours shorter than the real one.

• 동의생리병리학회지
• /
• 제24권6호
• /
• pp.1087-1093
• /
• 2010

The purpose of this study is to survey the effectiveness of oriental medicine treatment on lumbar herniated intervertebral disc and spondylolisthesis. The clinical study was performed on 32 cases of patients with lumbar herniated intervertebral disc and spondylolisthesis as diagnosed by X-ray, Magnetic resonance imaging(MRI) exams amongst the patients who were admitted to Jaseng Hospital of Oriental Medicine from January 2010 to June 2010. 32 cases of patients were analyzed according to the distribution of sex, age, duration of disease, contributory factor, symptoms, admission period, disc herniation type and level of spondylolisthesis. The efficacy of treatment was evaluated respectively. The number of the female patients were larger than that of male with the ratio of 1:0.6. Most of the patients were in their fifties(43.8%), choronic phase(46.9%), those patients suffered from lower back pain and leg pain radiation(90.6%), reasons unknown(56.3%). Most of them also had mixed disc(37.5%), bulging disc(37.5%) and spondylolisthesis of LS on L5(50.0%). Most of them stayed in the hospital for 21-25days. After treatment, the percentage with good improvement was 62.5%, fair 18.8%, poor 12.5%, and excellent 6.3%, respectively. Oriental medicine treatment has on useful effect on the recovery of lumbar herniated intervertebral disc with spondylolisthesis.