• 제목/요약/키워드: Skin Disease

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Ehlers-Danlos syndrome 환아의 맹출장애 : 증례보고 (DENTAL MANAGEMENT ASSOCIATED WITH ERUPTION DISORDERS IN A PATIENT WITH EHLERS-DANLOS SYNDROME : A CASE REPORT)

  • 진달래;김종철;이상훈;김정욱;김영재;현홍근;신터전;장기택
    • 대한장애인치과학회지
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    • 제8권2호
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    • pp.127-133
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    • 2012
  • EDS는 관절의 과운동성, 피부의 과신장, 조직 약화 등을 임상적 특징으로 하는 유전 질환이다. 피부, 골격, 근육, 인대, 점막, 혈관 등을 구성하는 교원질의 합성 과정과 관련된 유전자의 결함으로 결합조직이 비정상적으로 변하므로 신체 전반에 걸쳐 그 증상이 나타난다. 구강 영역에서도 교원 질과 관련된 조직에 영향을 받게 된다. 구강 점막, 치주 조직, 측두하악관절 및 치아 경조직에 문제가 발생할 수 있으므로, 총체적이고 정기적인 구강관리가 이루어져야 한다. 이번 증례와 같이 EDS에 의해 치아의 맹출 장애가 발생하고, 치은비대, 유착, 매복, 선천적 결손치, 부정교합 등이 관찰되는 경우에도 구강 위생 관리와 함께 장기적인 계획 하에 맹출 관리 및 치료가 요구된다. EDS 환아의 치과 치료시에는 질환의 원인과 전신적 특징에 대한 이해를 바탕으로, 비정상적 교원질 대사에 의해 약화된 점막과 치주조직, 지혈 관리, 반흔 형성 및 측두하악관절에 대한 종합적인 고려와 지속적인 관리가 필요하다.

EIS(Electro Interstitial Scan) 방법의 임상적 유효성 연구 (Evaluation of Clinical Usefulness of EIS(Electro Interstitial Scan))

  • 김수찬;배장한;전민호;김재욱
    • 전자공학회논문지
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    • 제52권12호
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    • pp.124-133
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    • 2015
  • 전기체간스캔법(EIS, electro interstitial scan)은 미세 직류전류를 인체의 사지말단 또는 국소적 인가를 통해 인체의 전류 반응을 기준으로 인체의 질병 유무를 판별할 수 있는 비침습적인 질병 스크리닝 방법으로 가능성을 보이고 있다. 프랑스에서 개발된 DDFAO는 다채널 EIS로 다양한 질병, 특히 당뇨와 같은 내분비 기관의 진단에 효과적이라고 주장한다. 본 연구에서는 RC 팬텀 모델을 이용하여 DDFAO의 측정의 반복성과 민감도를 확인하고, 정상군과 당뇨 질환군을 대상으로 임상적 유용성을 검정하였다. 그 결과, 팬텀을 이용할 경우, 반복 측정시 값의 변화가 없고 팬텀 특성이 변화될 때 DDFAO의 측정 결과도 변화되었다. 그러나 임상 측정에 있어서 6개의 표면 전극을 이용하여 비침습적 방법으로 정상인과 당뇨병 환자의 구별은 어려울 뿐만 아니라 반복성과 정확성도 우수하지 않았다. 그러나, 이러한 문제점에도 불구하고 측정 방법의 편리성과 간편성으로 인해 국소적인 영역보다 인체 전반적인 특성을 파악하는 스크린 장비로써의 개발 가능성은 여전히 보이고 있기에 EIS에 대한 다양한 기반 연구가 필요하다.

골수이식환자의 교육요구도 (Learning Needs in Patients undergoing Bone Marrow Transplantation)

  • 최소은
    • 대한간호학회지
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    • 제30권2호
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    • pp.514-526
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    • 2000
  • The active treatment phase in preparation for bone marrow transplantation(BMT) of che- motherapy regimen and total body irradiation (TBI) containing regimen requires considerable teaching. There have been researches that are related to treatment onto BMT patients and to psychological change during BMT process. However, it was hard to find researches focused on learning needs of patients undergoing BMT. The purpose of this study was to provide the basic data for effective educational program about BMT by investigating the learning needs in patients undergoing BMT. The subjects consisted of 90 BMT patients have been admitted to the department of BMT at three university hospitals. Data were obtained from October 1998 to March 1999 and analyzed by SAS program for unpaired t-test, ANOVA, Duncan test. The results were as follows : 1. Learning needs related to demographic characteristics was identified as below. That of male was higher than that of female. That of under age 29, unmarried, religious and university graduated group was higher than that of opposite group but it didn't show significant difference. Learning needs of group of patients who were employed was significantly higher then that of unemployed patients. 2. According to types of diagnosis, learning needs of myelodysplastic syndrome(MDS) patients was the higher than that of others, but admission frequency was the least. Learning needs of unrelated matched BMT(UBMT) patients was higher than that of autologous BMT patients. However, it didn't show significant difference. With regard to learning needs according to process of BMT, learning needs of Pre- BMT period or Post-BMT period was significantly higher than that of BMT day. 3. Learning needs related to BMT was relatively high (total mean: 3.11 of 4.0). The order of the mean score of leaning needs was shown as follows : Restricted activities after discharge, Relapse symptom, Complications of BMT, Kinds of available drugs at home. Therefore the learning needs that is related to life after discharge and to relapse and complications after BMT was high. 4. Learning needs related to radiation therapy was high (total mean: 3.35 of 4.0). The learning needs in radiation therapy items was the Skin care of radiation therapy and Purpose of radiation therapy. 5. Learning needs related to graft versus host disease(GVHD) therapy was high (total mean: 3.55 of 4.0). The highest learning needs in GVHD therapy items was the Preventive method GVHD. less admission frequency and UBMT patients. It is necessary that education for BMT patients should be focused on life after discharge and on relapse and complications after BMT. Especially education for allogeneic BMT patients should be emphasized on GVHD. For all of these, it is necessary to develop systematic and concrete educational program.

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개구장애를 동반한 피부근염 환자 증례 (A Case Report: Limitation of Mouth Opening in Dermatomyositis)

  • 김혜경;김기석;김미은
    • Journal of Oral Medicine and Pain
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    • 제35권2호
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    • pp.155-163
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    • 2010
  • 피부근염은 특발성의 염증성 결합조직 질환으로서 점진적인 근육의 쇠약과 특징적인 피부 발진의 증상을 보이는 전신적 자가 면역 질환의 일종이며 근력 약화와 함께 나타나거나 흔히 선행하는 특징적 발진에 의해 진단된다. 가장 특징적인 피부증상은 상안검의 부종과 함께 나타나는 푸르면서 보라색 발진인 heliotrophic rash, 안면부와 상부 흉부의 넓적하고 붉은 발진 (flat red rash), 피부의 인설(scaling)현상을 나타내는 손가락 관절(knuckle)부위의 두드러진 Gottron's papules (violaceous scaly eruption)등 이다. 근육 증상으로 주로 근위부 사지 근육의 약화를 동반한 근육의 염증성 및 퇴행성 변화를 보인다. 피부 근염은 종종 소화기계 (gastrointestinal tract)와 호흡기계 (respiratory system)를 침범하며 15%~25%에서 악성변화를 보인다. 치료는 피부증상뿐 아니라 근육 증상도 악화시킬 수 있는 자외선에 대한 노출을 피하고 일차적으로 전신적 corticosteroid를 사용하며 증상이 심하거나 steroid에 반응이 없을 때 다른 면역억제제를 사용할 수 있다. 피부근염에서 안면근은 침범되지 않으며 저작근의 이환 역시 거의 없다. 본 증례를 통해 피부근염을 앓고 있는 환자에서 개구장애가 발생할 수 있으며, 이는 근경축과 유사한 양상을 보임을 알 수 있었다. 따라서 피부근염 환자에서 발생할 수 있는 개구장애는 회복이 어려울 수 있으므로, 점진적으로 개구량이 줄어드는 것을 막고 정상적인 개구량을 확보 할 수 있도록 지속적인 개구운동 등의 치료가 필요하다고 사료된다.

무, 양파의 시료제조 방법에 따른 흰쥐의 지방대사와 항산화능에 관한 연구 (Effect of Dry Powders, Ethanol Extracts and Juices of Radish and Onion on Lipid Metabolism and Antioxidative Capacity in Rats)

  • 안소진;김미경
    • Journal of Nutrition and Health
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    • 제34권5호
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    • pp.513-524
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    • 2001
  • This study was performed to investigate the effects of dry powders, ethanol extracts and juices of radish and onion on lipid metabolism, lipid peroxidation and antioxidative enzyme activity in rats. Forty-nine male Sprague-Dawley rats weighing 157$\pm$6g were blocked into seven groups according to body weight and raised for four weeks with diets containing 5%(w/w) dry powders of two different vegetables consumed frequently by Korean-radish(Raphanus sativus L.) and onion(Allium cepa L.), ethanol extracts and juices from equal amount of each dry powder. All the powders, ethanol extracts and juices of radish and onion decreased total lipids, triglycerides and total cholesterol concentrations in plasma and liver. Above all, onion ethanol extract decreased them most remarkably. It was thought that organosulfur compounds and flavonoids extracted from onion by ethanol inhibited biosynthesis and absorption of lipid and promoted degradation of lipid. Radish powder also decreased them by increasing fecal excretions of total lipids, triglycerides and total cholesterol most effectively. Catalase and glutathine peroxidase(GSH-px) activities in red blood cell(RBC) were most remarkably increased by radish powder and onion powder respectively. Superoxide dismutase(SOD), catalase and GSH-px activities in liver were most remarkably increased by onion ethanol extract, radish powder and onion ethanol extract respectively. Xanthine oxidase(XOD) activities in liver were most effectively decreased by ethanol extracts of radish and onion. Thiobarbituric acid reactive substance (TBARS) levels in plasma and liver of experimental groups were significantly lower than those of controls. Above all, onion powder decreased them most effectively. It was thought that vitamin E and high flavonoids in onion powder inhibited lipid peroxidation, promoting liver and RBC SOD, catalase and GSH-px activities and inhibiting XOD activities effectively. Flavonoids in onion ethanol extract inhibited lipid peroxidation, promoting three antioxident enzyme activities and inhibiting XOD activities most remarkably. Also flavonoids and high vitamin C in radish powder inhibited lipid peroxidation, promoting liver and RBC catalase most remarkably and inhibiting XOD activities. In conclusion, radish and onion were effective in lowering lipid levels and inhibiting of lipid peroxidation in animal tissue. From these data, radish and onion can be recommended in the treatment and prevention of diseases such as cardiovascular disease and cancer and in delaying aging. As ethanol from onion were most effective in lowering lipid level and promoting three antioxident enzymes, and inhibited lipid peroxidation as did we should try to utilize onion skin which is discarded though reported to have abundant flavonoids. (Korean J Nutrition 34(5) : 513~524, 2001)

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개에서 발생한 피부 상피친화성 T-세포 림프종: Lomustine 및 Gemcitabine에 대한 임상적 반응 (Cutaneous Epitheliotropic T-Cell Lymphoma in a Dog: Clinical Responses to Lomustine and Gemcitabine)

  • 강병택;김대영;강지훈;장동우;정동인;조규완;양만표
    • 한국임상수의학회지
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    • 제30권4호
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    • pp.315-319
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    • 2013
  • 5년령의 중성화된 암컷 말티즈가 1개월 동안 지속된 전신적 발적, 탈모 및 소양감으로 내원하였다. 피부조직구증으로 진단되어 면역억제치료를 1개월 간 지속하였지만 다발성의 발적된 반 및 판 병변들이 새롭게 발생하였다. 피부병변에 대한 압박도말검사에서 림프종을 지시하는 원형세포들이 관찰되었다. 조직학적 검사에서는 종양세포들의 외피 및 부속구조물에 대한 친화성이 나타났다. 면역염색결과 종양세포들은 CD3에 대하여 양성, CD79a에 대해서는 음성반응을 나타내어 피부 상피친화성 T-세포 림프종으로 확진하였다. $70mg/m^2$의 lomustine을 2-3주 간격으로 총 2회 투여하였으며 부분적인 치료반응이 관찰되었다. 피부병변의 악화와 lomustine의 이용제한으로 gemcitabine ($500mg/m^2$, 1주일당 1회 30분간 혈관주입)을 이용한 화학치료를 시작하였다. 총 3회 치료가 실시되었으나 질병의 진행을 억제하지 못하였으며, 최초 lomustine 치료 69일 후 안락사 되었다.

베트남전 참전자 2세의 건강상태에 관한 조사 - 부산지역 고엽제 위해증 환자를 대상으로 한 설문조사 결과 - (A Study on the Health Status of Korean Vietnam Veterans' Children - A Result of Questionnaire Survey on Vietnam Veterans of Pusan Area Who Diagnosed as Cases by Korean Veteran's Hospital Diagnostic Criteria -)

  • 김학준;손혜숙;엄상화;박수경;유병철;이종태;전진호
    • Journal of Preventive Medicine and Public Health
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    • 제33권1호
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    • pp.17-24
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    • 2000
  • Objectives : To propose the referential data to evaluate the health impacts of Vietnam veterans' children whose father were exposed to herbicides in Vietnam War. Methods : Vietnam veterans who visited to Pusan Veteran Hospital for medical care were recruited from April to October, 1998. They were 71 and asked about their own combat history, symptoms and illness, and health status of their 182 children. The informations were collected by direct and phone interview. Exposure estimation was also performed as exposure score depending on year and unit of participation, and personal episodes related to exposure to herbicide in the war. It classified into three groups; lower(<18.0), moderate(18-53), high$(\geq53)$ exposure group. Results : The mean age and the period into the combat of the veterans were 52.8 years and 15.0 months. The mean exposure score was $18.1{\pm}9.9$, and mainly distributed in lower (46.5%) and moderate(52.1%) exposure group. Most(90.1%) of them were diagnosed as sequelae(21 cases) and suspected sequelae(43 cases) of the herbicides by Korean veteran's hospital diagnostic criteria. The major sequelae was peripheral neuropathy 13 cases, chloracne 5 cases, and the major suspected sequelae was hypertension 20 cases, diabetes mellitus 18 cases, liver disease 12 cases, central neuropathy 11 cases, etc. About birth, 42.2% and 16.9% experienced spontaneous abortion and stillbirth, respectively. The mean exposure score was higher in stillbirth experience group(p<0.05). About half of the children(90 cases, 49.5%) hold the abnormal health status: those were skin pigmentation 38 cases, rash 23 cases, congenital anomaly 15 cases, general weakness 12 cases, purpura 8 cases, visual disturbance 8 cases, etc. These health problems had no association with father's exposure level(p>0.05). Conclusions : These results were depend on their own answers, and expectation for compensation did not excluded, therefore, this study may have limitations: inaccuracy of informations due to recall bias and response bias. Nevertheless, through this study, we could image the fundamental aspect for health impacts of Vietnam veterans' children for preparing the national control program and policy. A large scale epidemiologic study with valid exposure assessment on the health impacts of Vietnam veterans' children is recommneded.

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옥수수수염 추출액의 Klebsiella pneumoniae에 대한 항균활성 (Antimicrobial Activities of Corn Silk Extract of Klebsiella pneumoniae)

  • 강현경;배일권
    • 생명과학회지
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    • 제25권12호
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    • pp.1399-1407
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    • 2015
  • Klebsiella pneumoniae는 인간의 피부, 구강, 호흡기, 요로, 장관 등에서 일반적으로 존재하는 상재세균이다. 하지만 지역사회획득 폐렴의 주요 원인이 되는 기회감염균이기도 하다. 옥수수수염은 K. pneumoniae, Staphylococcus aureus, Bacillus subtilis, Shigella spp., Salmonella spp., Escherichia coli, Pseudomonas aeruginosa 등 병원성 세균에 대해 항균활성이 있는 것으로 알려져 있다. 본 연구에서는 옥수수수염 농축액의 K. pneumoniae에 대한 항균능을 확인하고자 하였다. 이를 위해 K. pneumoniae ATCC 13883, broad-spectrum β-lactamase (BSBL) 생성균주, exteded-spectrum β-lactamase (ESBL) 생성균주 및 carbapenemase 생성균주를 수집하였다. 항균제 감수성 검사는 디스크 확산법을 사용하였고 내성유전자는 PCR 증폭과 염기서열 분석을 통해 확인하였다. 또한 항균활성 실험을 위하여 옥수수수염 농축액을 이용하여 MacConkey agar 평판배지(50%, 100%)를 제조하였고 균주의 성장억제를 확인하기 위하여 제조된 배지에 K. pneumoniae를 평판도말하여 37℃ 항온기에서 18시간동안 배양하였다. 수집된 K. pneumoniae는 SHV-1 (n=8), SHV-2a (n=8), SHV-5 (n=2), SHV-11 (n=2), SHV-12 (n=18), TEM-1 (n=10), CTX-M-3 (n=2), CTX-M-14 (n=2), CTX-M-15 (n=1), GES-5 (n=5), KPC-2 (n=6), KPC-3 (n=4) 및 NDM-1 (n=2)을 보유하고 있었다. 시험에 사용된 K. pneumoniae 균주 가운데 K. pneumoniae ATCC 13883균주에 대해 항균활성이 있었으나 BSBL, ESBL 및 carbapenemase 생성균주에 대한 항균활성을 확인할 수는 없었다. 따라서 옥수수수염 추출액은 K. pneumoniae에 의한 지역사회획득 감염증 예방과 회복에 도움을 줄 수 있을 것으로 생각된다.

Salvage of Infected Breast Implants

  • Song, Joon Ho;Kim, Young Seok;Jung, Bok Ki;Lee, Dong Won;Song, Seung Yong;Roh, Tai Suk;Lew, Dae Hyun
    • Archives of Plastic Surgery
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    • 제44권6호
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    • pp.516-522
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    • 2017
  • Background Implant-based breast reconstruction is being performed more frequently, and implants are associated with an increased risk of infection. We reviewed the clinical features of cases of implant infection and investigated the risk factors for breast device salvage failure. Methods We retrospectively analyzed 771 patients who underwent implant-based breast reconstruction between January 2010 and December 2016. Age, body mass index, chemotherapy history, radiation exposure, and smoking history were assessed as potential risk factors for postoperative infection. We also evaluated the presence and onset of infection symptoms, wound culture pathogens, and other complications, including seroma, hematoma, and mastectomy skin necrosis. Additionally, we examined the mastectomy type, the use of acellular dermal matrix, the presence of an underlying disease such as hypertension or diabetes, and axillary node dissection. Results The total infection rate was 4.99% (58 of 1,163 cases) and the total salvage rate was 58.6% (34 of 58). The postoperative duration to closed suction drain removal was significantly different between the cellulitis and implant removal groups. Staphylococcus aureus infection was most frequently found, with methicillin resistance in 37.5% of the cases of explantation. Explantation after infection was performed more often in patients who had undergone 2-stage expander/implant reconstruction than in those who had undergone direct-to-implant reconstruction. Conclusions Preventing infection is essential in implant-based breast reconstruction. The high salvage rate argues against early implant removal. However, when infection is due to methicillin-resistant S. aureus and the patient's clinical symptoms do not improve, surgeons should consider implant removal.

대전 일부 지역 치과종사자의 화학소독제에 관한 지식도 연구 (Knowledge on the chemical disinfectants among dental workers in some Daejeon region)

  • 민희홍;안권숙
    • 한국치위생학회지
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    • 제7권4호
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    • pp.455-470
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    • 2007
  • The usage of appropriate disinfectants is essential for infection control in dental hospitals, dental clinics. Inadequate use of disinfectants is the cause of human or environmental toxicity and is a waste of cost. This study was aimed to assess the level of knowledge on the disinfection and chemical disinfectants among dental workers in dental hospitals, dental clinics. It's ultimately intended to serve as a basis for the preparation of more effective, appropriate educational programs on the disinfection and manuals on the use of disinfectants for dental workers. This study enforced a questionnaire with 184 dental workers employed in dental hospitals, dental clinics from 15 Aug. to 15 Sep. 2007, in the area of Daejeon. The obtained result were as follows; 1. The population sociological feature of dental hospital and dental clinic showed that significant differences of dental service career(pM0.039). Dental service career of dental workers shows; below 3 years 42.9%, 4~6 years 34.7%, more than 7 years 22.4% in dental hospitals, below 3 years 30.4%, 4~6 years 26.7%, more than 7 years 43.0% in dental clinics(pM0.039). 2. The average score of dental workers knowledge in 'Critical item soaks in high-level disinfectants for 20minutes was 2.73V0.49 point, got from knowledge of dental instrument is appropriate to immerse before sterilization in the dental device disinfection(pM0.002). 3. In the general disinfection which it follows in education experience of chemical disinfectants direction for use, 'Direction for use by Spaulding process classification' responded that the correct answer was the education experience dental workers 60.0%, the education non-experience dental workers 39.5%(p=0.026). 4. In the dental device disinfection which it follows in education experience of chemical disinfectants direction for use. 'High level disinfection is not applied for the non-critical items and equipment' responded that the education experience dental workers 49.2%, the education non-experience dental workers 31.9%(pM0.045), 'Semi-critical items is applied same method in presence of the infection disease which it acts responded that the education experience dental workers 44.6% answer back, the education non-experience dental workers 24.4%(pM0.017). 5. 'A hand disinfectants of anticeptics have effect' the education experience dental workers 78.5% answer back, the education non-experience dental workers 52.9%(pM0.003). 1t uses with hand disinfectants when the instruments which be imbrued and patient contact', the education experience dental workers 78.5% answer back, the education non-experience dental workers 62.2%(pM0.026), 'Boric acid solution uses for the skin disinfectants the education experience dental workers 52.3% answer back, the education non-experience dental workers is 37.0%(pM0.016), 'Gluconate have effective difference which it follows in chemical disinfectant consistency and the solution type' education experience dental workers 72.3% answer back, education non-experience dental workers 47.9%(pM0.004). 6. The education experience dental workers were appeared higher than the education non-experience dental workers in knowledge of the disinfection and chemical disinfectants. Consequently system and the specialty education which is standardized continuously must be provided to all dental workers.

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