• 정신신체의학
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• 제7권2호
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• pp.241-246
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• 1999

섬망은 두부손상, 혈관성 질환, 뇌종양 등의 중추신경계 질병뿐 아니라 여러 가지 신체 질병(대사 장애 및 내분비장애, 감염, 심혈관 질병)과 약물에 의해 야기되는 각성 수준의 감퇴, 지남력 장애, 수면-각성 주기 장애, 기억력 장애, 지각장애 등을 특징으로 하는 증후군이다. 1) 섬망을 일으킬 수 있는 약물의 하나인 scopolamine(Kimite$^{(R)}$)은 차멀미 예방을 위해 흔히 사용되며 피부 부착형으로 사용하는데 항콜린성 작용을 갖는belladonna akaloid제제이다. 저자들은 차멀미 예방 목적으로 사용된 transdermal scopolamine(Kimite$^{(R)}$)으로 유발된 섬망 2례를 경험하였기에 이를 문헌 고찰과 함께 보고하였다. 두 증례의 공통점은 여자 노인 환자였다는 점, 멀미 예방을 위해 transdermal scopolamine부착 후 여행지에서 갑자기 증상이 발생하였다는 점, 증상이 2~3일이내에 호전되어 추적 관찰상 아무런 이상이 없었던 점 등이다. Transdermal scopolamine(Kimite$^{(R)}$)으로 인한 섬망의 예방을 위해 사용자와 판매자 모두에게 올바른 사용법에 관해 교육하는 것이 필요할 것으로 사료된다.

• 대한한방소아과학회지
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• 제15권2호
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• pp.53-68
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• 2001

Purpose : This Study was conducted to evaluate clinical manifestations of abdominal pain(AP) in childhood according to its symptoms and to find out characteristic of children with abdominal pain. Methods : Pacients who visited Dong-Eui Oriental Medical hospital from August to November 2001 due to abdominal pain were included. According to questionaire and history taking abdominal pain was classified by its six subtype in the Oriental Pediatic Text Book and Dong Eui Bo Gam(東醫寶鑑). Result : According to the Oriental Pediatic Text Book, among 41 children, 31.7% had symptoms of AP caused by cold in internal organs of deficiency(臟腑虛冷腹痛), 29.3% had symptoms of AP caused by diet(食積腹痛), 19.5% had symptoms of AP caused by cold(寒腹痛), 9.8% had symptoms of AP caused by both cold and diet, 7.3% had symptoms of AP caused by internal diet and external cold(內食外寒腹痛), 2.4% had symptoms of AP caused by stagnation of Ki and stasis of blood(氣滯血瘀腹痛). There is no AP caused by parasites(蟲腹痛). Otherwise, according to Dong Eui Bo Gam, 43.9% had symptoms of AP caused by cold, 26.8% had symptoms of AP caused by diet, 9.8% had symptoms of AP caused by both cold and diet, 7.3% had symptoms of AP caused by fire(熱腹痛), 7.3% had symptoms of AP caused by phlegm(痰飮腹痛), 4.9% had symptoms of AP caused by stagnated blood(瘀血腹痛). Also There is no AP caused by parasites. Conclusion : 1. The type of AP in Childhood is different from AP in adults. AP in Childhood is most occured by cold of deficiency and food, and there is few AP caused by fire. Six subtype in Dong Eui Bo Gam prefer adults to children and It is more studied that what kind of subtype is proper for AP caused by stress or drugs. So the study on subclassification and clinical Manifestations of AP in Childhood is more performed.

• 대한임상독성학회지
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• 제4권2호
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• pp.107-112
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• 2006

Purpose: In many Korean hospitals, serum acetaminophen concentrations in cases of overdose cannot be measured initially because of inadequate laboratory facilities. Under these circumstances, physicians base the administration of the antidote, N-acetylcysteine, on ingestion amounts as determined by initial history taking. We therefore examined the correlated between ingested amounts and serum acetaminophen concentrations. Methods: Medical records were reviewed retrospectively for patients who presented to the ED with acetaminophen overdose between January 2002 and March 2006. Fifty-nine patients were recruited and sixteen patients were excluded. The forty-three remaining patients were placed into either the high-risk or low-risk group based on their ingested amount (140 mg/kg), and were separately categorized into the toxic or non-toxic group based on their serum acetaminophen concentrations, according to the Rurnack-Matthew nomogram. Results: Ten patients (83.3%) among twelve in the high-risk group were found to have non-toxic serum concentrations, and just one patient (3.2%) among thirty-one in the low-risk group fell into the toxic group based on their serum concentrations. The sensitivity and specificity of risk stratification of the ingested amount as a predictor of intoxication requiring antidote therapy were 66.7% and 75.0%, respectively. Conclusion: This study suggests that the therapeutic decision for acetaminophen overdose should not be based solely on ingested amount only, but requires assessment of acetaminophen concentration.

• 대한치과보철학회지
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• 제51권3호
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• pp.208-213
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• 2013

장애인치과는 비장애인과 별차이 없는 경증 장애인에서부터 질환의 진단이 쉽지 않고 전신관리의 필요에 따른 의학적인 전문성이 요구되거나 행동조절 및 치료의 어려움으로 특수기술과 장비를 필요로 하는 장애인까지 다양하다. 본 증례는 자폐성 장애를 갖은 25세 남자 환자로 구강위생관리가 잘 되지 않아 다수의 우식으로 전반적인 치료를 위해 내원하였다. 장애인 환자에 대한 정보 부족으로 인한 치료 계획 수립의 어려움 및 전신마취 하에서 시술의 어려움을 경험하며 장애인 치과치료시 충분한 상담과 기왕력 파악 후 적절한 치료가 필요할 것으로 사료되었다.

• 한국치위생학회지
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• 제10권5호
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• pp.807-817
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• 2010

Objectives : The purpose of this study was to analyzes the job implementation of dental hygienist at dental hospital(university), dental clinic and general hospital in the city of Gwangju. Methods : The subjects in this study were dental hygienists who worked at dental hospital(university), dental clinic and general hospital in the city of Gwangju. A survey was conducted by post from June 10 to August 10. Out of the collected data, 204 answer sheets were analyzed. Results : 1. 'Medical & Dental history taking', 'Extra & Intra oral examination' and 'Dental hygiene care plane' in dental clinic were significantly higher than dental hospital(university) and general hospital(p<0.001). 'Remove of extrinsic stain' and 'Treatment of hypersensitivity tooth' in dental clinic and general hospital were significantly higher than dental hospital(university)(p<0.001). 'Preventive dental caries treatment' and 'Diet control' were shown the low frequency of job implementation. 2. Almost task elements of dental assistance duty shown that dental hygienists under the 24 years old were significantly higher dental hygienists over the 30 years old(p<0.05) and dental clinic and general hospital were significantly higher than dental hospital(university)(p<0.05) in frequency of job implementation. 3. 'Dental staff supervision', 'Patient management' and 'Dental chart arrangement' shown that dental hygienists over the 30 years old were significantly higher than dental hygienists under the 24 years old in frequency of job implementation(p<0.05). 'Infection control' of dental hygienists over 30 years old was significantly lower than dental hygienists under the 24 years old(p<0.001). Conclusions : The results of this study indicate that a scope of dental hygienists' job need to extend also in order to accomplish a job efficiently, is suggested that the effort is necessary to improve a quality of dental hygienist and to change of recognition of the dentist about dental hygienists' job.

• 한방재활의학과학회지
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• 제23권2호
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• pp.185-191
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• 2013

본 증례에서는 절식치료 중인 환자에 있어 글리세린 관장을 실시한 직후 발생한 허혈성 대장염 1례에 대해 고찰하여, 관장으로 인한 장관 내압 상승, 상온의 체온보다 낮은 관장액으로 인한 혈관 경련, 선택적 세로토닌 재흡수 억제제에 의한 출혈 경향 증가 및 글리세린 용액의 화학적 삼투작용으로 인한 점막 손상 가능성 등을 제시하였다. 관장으로 인한 이와 같은 부작용을 예방하기 위하여 임상의들의 주의가 요구된다.

• 사상체질의학회지
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• 제16권2호
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• pp.71-83
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• 2004

1. Objectives The purpose of nursing is to promote health and well-being for all persons. It is connected with Sasang Constitution theory have regard for viewpoint by other's a special quality & individual difference. A nursing is helping behavior to recover health, disease protection & self care ability through health education. There is need for Oriental nursing research continually. 2. Methods This study attempted to develop a fundamental nursing theory for Sasang Constitution on the focus "Dongyi Soose Bowon Sasang Chobongyun". Because the book is important to understand Lee Je-ma's early medical mind and thinking. 3. Results and Conclusions The Sasang Constitution theory lay great emphasis upon health caring medicine to promote health according to self Constitution at normal times, preventive medicine to manage byself body and mind in ordinary times. The way of Sasang Constitutional Nursing Theory is expected to set up a landmark stone in Korean nursing. It is also can product a new nursing theory. In view of 'Nature and Order' is explained inborned general human being who were gifted from nature. On the other hand, in view of 'Knowledge and Deed' based on Constitutions are explained autonomical human being. There are depend on independant control and make efforts themselves or not. It have a connected in four paradigm (human- environment-health- nursing) of nursing theory. The history taking stage claim caring of sick-people before. The ways of assesment for sick-people have to know a process of illness.

• 한방안이비인후피부과학회지
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• 제30권4호
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• pp.75-96
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• 2017

Objectives : The purpose of this study was to investigate the treatment trend for allergic rhinitis in Korean Medicine. Methods : We conducted an online survey for Korean Medicine Doctors who were registered in the association of Korean Medicine. The questionnaire was consisted of patient characteristics, diagnosis status, treatment status, and future research needs. Results : Data from total of 396 respondents were analyzed. More than 70% of the patient came to the Korean Medicine Clinic after visiting the Western Medicine Clinic in 43.9% of the respondents. 55.6% of the respondents performed combination therapy. History taking, nasal examination, x-ray, and Korean Medicine diagnostic test were used for diagnosis. The mean duration of treatment ranged from $4.9{\pm}2.91$ to $15.2{\pm}8.45$ for pediatric and early childhood patients and from $17.5{\pm}16.15$ to $5.3{\pm}3.85$ weeks for adolescents and adult patients. The mean number of treatment times was from $9.8{\pm}7.00$ to $33.5{\pm}24.45$ for pediatric and early childhood patients and from $10.8{\pm}11.55$ to $40.4{\pm}48.18$ times for adolescents and adult patients. 64.5%, 48.0%, and 91.2% of the respondents used herbal medication in national health insurance coverage, herbal medication uninsured in health insurance and herbal prescription filled at each medical institution, respectively for pediatric and early childhood patients and 67.6%, 42.8% and 86.1% for adolescents and adult patients. 36.9% and 36.4% of respondents answered that the study of acupuncture and herbal medicine are needed preferentially. Conclusions : The results of this survey will be used to develop clinical practice guideline that reflect actual clinical practice.

• 대한치과마취과학회지
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• 제13권4호
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• pp.209-214
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• 2013

Multiple caries in a pediatric patient often requires dental treatment under general anesthesia, especially when the patient is suffering from a systemic disease. The patient was a 6-year-old boy with Marfan syndrome and needed extensive dental treatment. Marfan syndrome is an inherited disorder resulting from mutations in Fibrillin-1 gene. Patients are known to have mainly cardiovascular, ocular, and musculoskeletal problems. Although clinical symptoms of the syndrome are age-realted, thus hindering early diagnosis of the disease in young children, our patient had been confirmed by a gene study at a younger age. Medical history of the patient revealed moderate to severe mitral regurgitation and aortic root dilatation, which required mitral valve replacement surgery with a mechanical valve. As a result, the patient was taking warfarin post-operatively and changes in medication had to be made before the dental treatment. Also, prophyalctic antibiotics had to be given before the treatment for prevention of (to prevent the) infective endocarditis. With careful control of the medications and bleeding tendency, general anesthesia and the treatment were done successfully without any complications.

• Journal of Medicine and Life Science
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• 제20권4호
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• pp.158-165
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• 2023

This study prospective randomized controlled trial aims to test the impact of adding health education, awareness of some contributing factors and clinical guidance to therapeutic cabergoline given to infertile women with unexplained resistant hyperprolactinemia. It comprised 120 infertile women with unexplained persistent hyperprolactinemia not responding to therapeutic doses of cabergoline 1.5-2 mg/week who were subjected to proper history taking to exclude concomitant drug intake or possible brain problems in all cases. They were classified into group A (60 cases) who received health education and clinical guidance to search for possible contributing factors and were instructed to avoid them in addition to proper therapeutic doses of cabergoline, while group B (60 cases) received proper therapeutic doses of cabergoline only without clinical guidance. After 1 month, serum prolactin (PRL) was measured for all cases. All cases had high PRL level at the start of the study (79.9±28.4 [39-195] and 78.2±19.9 [42-189] in group A and B, respectively) without any significant difference. Pretreatment counselling revealed that lifestyle factors, sexual behaviors or feeding habits may contribute to resistant hyperprolactinemia in all cases without a significant difference between both groups. Serum PRL dropped significantly more in group A (20.14±10.31 [11-45] vs. 49.32±37.03 [12-100]) after combined health education, clinical guidance of the couple and proper treatment. It is concluded that lifestyle factors, sexual behaviors, and feeding habits would affect the response of hyperprolactinemia to treatment. Health education and clinical guidance with some advice to avoid them, would concomitantly improve the response of resistant hyperprolactinemia to therapeutic doses of dopamine agonists.