• Journal of Chest Surgery
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• 제31권3호
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• pp.279-285
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• 1998

손과 발에 정상 이상의 많은 땀이 나는 것은 정신적으로나 직업적으로 난처하고 때로는 무력한 상태를 만든다. 다한증은 자율신경계의 흔한 질병중 하나이다. 다한증은 특별한 치료법이 없었으며 따라서 액와 또는 경부 쪽에서 접근하는 절제술이 있었다. 최근에는 흉강경을 이용한 흉부수술(VATS)이 수장부와 액와부의 다한증에 가장 널리 사용되고 있다. 경희의료원에서는 1996년 3월부터 1997년 3월까지 양쪽 수장부에 다한증이 있는 15명의 환자를 양측 흉부 교감신경 절제술 (T2, T3, T4)을 시행하였고, 수술 전후로 컴퓨터 적외선 전신 체열 측정 (DITI)을 하였다. 이들 모두 개흉술로의 전환은 없었다. 3건의 술후 합병증으로 폐부종 1건, Horner씨 증후군 1건, 미각 다한증 1례가 있었다. 반 이상의 환\ulcorner에서 하복부, 둔부,배부, 대퇴부에 보상성 다한증이 나타났다. 결론적으로, 대부분의 환자는 수장부와 액와부에 땀이 나지 않고, 통증이 적고, 미용상 더 낫고, 족저부와 안면부에도 땀이 줄어 흉강경 수술 후의 결과에 대해 만족하였다. 또한 수술중에 수장부 온도를 측정함으로써 흉강경 교감신경 절제술의 성공 여부를 평가할 수 있었으며, 컴퓨터 적외선 체열 측정을 수술 전후로 시행함으로써 이 방법이 흉강경 교감신경 절제술의 성공적인 결과를 평가하는 객관적인 방법이 될 수 있었다고 사려된다.

• Nutrition Research and Practice
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• 제9권4호
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• pp.385-392
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• 2015

BACKGROUND/OBJECTIVES: Recent studies have reported an association of the angiotensin II type 2 receptor (AT2R) 3123Cytosine/Adenine (3123C/A) polymorphism with essential hypertension and cardiovascular diseases. The purpose of the study was to investigate whether the AT2R 3123C/A polymorphism affects blood pressure for free-living hypertensive men during a 5-month intervention period. SUBJECTS/METHODS: The subjects were free-living hypertensive Japanese men aged 40 to 75 years who agreed to intervention in the period from 2004 to 2011. Detection of the AT2R 3123C/A polymorphism was determined by polymerase chain reaction. The dietary intervention was designed to decrease salt level and to increase potassium level through cooking instructions and self-monitoring of the diet. The exercise session consisted of activities such as stretching, resistance training, and walking. Blood pressure, urinary sodium and potassium excretion, dietary and lifestyle data, and non-fasting venous blood sample were collected at baseline and after the intervention period. RESULTS: Thirty nine subjects were eligible for participation and the follow-up rate was 97.4%. The C allele proportion was 57.9%. AT2R 3123C/A polymorphism was X-chromosome-linked, therefore we analyzed the C and A genotypes. At baseline, no significant differences were observed between the genotype groups. After the intervention, there were no significant differences in lifestyle habit between the groups. Nevertheless, the estimated salt excretion (g/day) was significantly decreased only in the C genotype (13.0-10.3, P = 0.031). No significant change was observed in systolic blood pressure (SBP) (mmHg) in the A genotype, but a significant decrease was observed in the C genotype (150.0-141.5, P = 0.024). CONCLUSTIONS: In the C genotype, it might be easy to improve SBP through lifestyle intervention in free-living hypertensive Japanese men, however generalization could not be achieved by the small sample size.

• Tuberculosis and Respiratory Diseases
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• 제66권6호
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• pp.467-470
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• 2009

CA 125의 상승은 난소의 악성종양에 나타날 수 있지만 비특이적이다. CA 125의 상승은 다양한 양성 질환 혹은 악성 종양에서 나타날 수 있다. 저자들은 최근 지속적으로 혈중 CA 125 수치가 증가되어 있지만 경질 초음파, 흉부 CT, PET-CT 등에서 악성 종양이 발견되지 않은 기관지확장증 1예를 경험하였다. 14개월의 추적 관찰 기간 중에도 난소암과 같은 악성 종양은 발견되지 않고 기관지확장증에 병발된 폐렴 이외에는 특이 소견이 없어, 혈중 CA 125의 상승은 기관지확장증에 의한 급성 폐 손상에 의한 것으로 추정된다. 혈중 CA 125 수치의 상승은 환자의 임상 양상과 연관하여 조심스럽게 판단하여야 될 것으로 생각된다.

• Journal of Trauma and Injury
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• 제30권4호
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• pp.113-119
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• 2017

Purpose: Despite the numerous protocols and evidence-based guidelines that have been published, application of the therapeutics to eligible patients is limited in clinical settings. Therefore, a rounding checklist was developed to reduce errors of omission and the implementation results were evaluated. Methods: A checklist consisting of 12 components (feeding, analgesia, sedation, thromboembolic prophylaxis, head elevation, stress ulcer prevention, glucose control, pressure sore prevention, removal of catheter, endotracheal tube and respiration, delirium monitoring, and infection control) was recorded by assigned nurses and then scored by the staff for traumatized, critically ill patients who were admitted in the trauma intensive care unit (ICU) of Dankook University Hospital for more than 2 days. A total of 170 patients (950 sheets) between April and October 2016 were divided into 3 periods (period 1, April to June; period 2, July to August; and period 3, September to October) for the analysis. Questionnaires regarding the satisfaction of the nurses were conducted twice during this implementation period. Results: Record omission rates decreased across periods 1, 2, and 3 (19.9%, 12.7%, and 4.2%, respectively). The overall clinical application rate of the checklist increased from 90.1% in period 1 to 93.8% in period 3. Among 776 (81.7%) scored sheets, the rates of full compliance were 30.2%, 46.2%, and 45.1% for periods 1, 2, and 3, respectively. The overall mean score of the questionnaire regarding satisfaction also increased from 61.7 to 67.6 points out of 100 points from period 1 to 3. Conclusions: An ICU rounding checklist could be an effective tool for minimizing the omission of preventative measures and evidence-based therapy for traumatized, critically-ill patients without overburdening nurses. The clinical outcomes of the ICU checklist will be evaluated and reported at an early date.

• 대한소아치과학회지
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• 제40권3호
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• pp.194-200
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• 2013

본 연구는 단국대학교 치과병원 소아치과에 2012년 1월부터 2012년 5월까지 내원한 환자 중 세보플루란을 이용한 깊은 진정으로 치과치료를 받은 환자 총 14명의 마취기록지를 분석하여 적정 수준의 진정을 얻기 위한 유효한 세보플루란의 농도를 측정하고 진정 과정 중의 호흡 및 심혈관계 평가를 통해 안정성을 평가해 보고자 함에 있다. 심박수(Heart rate)는 평균 101.4회/분(76.4~135.4회/분)을 보였다. 혈압(Blood pressure)은 수축기혈압은 평균 96.9 mmHg(84.2~109.2 mmHg), 이완기혈압은 평균 50.5 mmHg(34.0~62.0 mmHg)를 보였다. 호흡수(Respiration rate)는 평균 24.4회/분(15.0~36.7회/분)을 보였다. 산소포화도($SpO_2$)는 평균 99.4%(97.5~100.0%)를 보였다. 호기말 이산화탄소 농도(end tidal $CO_2$ volume; $ETCO_2$)는 평균 27.8 mmHg(16.4~38.0 mmHg)를 보였다. 호기말 세보플루란 농도(end tidal sevoflurane volume)는 평균 1.9 vol%(1.0~3.4 vol%)를 보였다.

• Journal of Chest Surgery
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• 제36권5호
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• pp.316-320
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• 2003

배경: 경두개 초음파 검사에 의한 미세색전의 진단은 향후 뇌색전증의 위험이 높은 환자의 선별에 큰 도움이 되리라 기대된다. 우리는 전향적으로 심장 판막 수술 전과 후의 미세색전의 양성률과 빈도를 검사하였다. 대상 및 방법: 심장 판막 질환이 있는 50명의 환자를 대상으로 본 연구는 진행되었다. 뇌경색의 병력이 있거나, 과거에 인공 기계 심장 판막 수술을 받은 환자는 본 연구에서 제외하였다. 경두개 초음파 검사는 중대뇌동맥에서 1시간 동안 미세색전을 감시하였고, 수술 전과 수술 후 2차례 검사하였다. 결과: 기계 심장 판막 수술은 28명, 조직 판막 수술은 10명, 승모판막 성형술은 12명에서 시행되었다. 미세색전의 양성률은 수술 전(8%)에 비하여 수술 후(50%)에 의미 있게 증가하였으며 (p=0.00), 미세색전은 항응고제 강도, 심장 부정맥, 환자의 연령, 고혈압의 병력과 관련성이 없었다. 기계 심장 판막 이식수술 후 미세색전의 양성률(71.4%)은 조직 판막 이식수술(10%)이나 승모판막 성형술(33.3%)에 비하여 의미 있게 높았다(p=0.002). 결론: 미세색전은 심장 판막 수술 후 의미 있게 증가하며 이러한 변화는 인공 기계 심장 판막 수술 후 색전증의 위험과 관련되어 있다고 추정된다.

• 한국임상약학회지
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• 제12권1호
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• pp.39-50
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• 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.

• 대한한방내과학회지
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• 제22권2호
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• pp.199-205
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• 2001

Background and Purpose : Transcranial doppler ultrasonography(TCD) is a noninvasive and nonradioactive technique for evaluation of the hemodynamics in large cerebral vessels. Sahyangsohap-won(SS) has been considered to be effective for the treatment of various disease, especially cerebrovascular, cardiovascular, and psychosomatoform disorders. But, there is no study about the effect of SS on the cerebral hemodynamics in humans. The aim of this study was to assess the effect of SS on the changes in cerebral hemodynamics and the dose-dependant effect by using TCD. Subjects and Methods : 30 healthy subjects were randomly divided into three group: group 1 took no drug, group 2 took SS one pill, and group 3 took SS 2 pills. Changes in the mean blood flow velocity(MBFV) and pulsatility index(PI) in the middle cerebral artery were evaluated by means of TCD. We obtained hypercapnia with breath-holding and evaluated cerebrovascular reactivity with the breath-holding index(BHI). Systolic blood pressure(SBP), diastolic blood pressure(DBP), and heart rate(HR) were measured by means of ambulatory blood pressure monitoring. In group 2 and group 3, the evaluations were performed during the baseline and were repeated at 20, 40, and 60 minutes after SS administration. In group 1, the evaluation was performed at corresponding time intervals. Results : In mean values of MSFV, PI, SSP, DBP, and HR, no stastically significant differences were found between the 3 groups. However, BHI values were significantly lower in groups 2 and 3 than in group 1 at 40 minutes after SS administration(P<0.05, group 1 vs group 2, group 1 vs group 3 by post-hoc analysis: Scheffe's test) but in dose-dependant effect, there was no difference between group 2 and group 3. Conclusion : These results suggest that SS can decrease vascular resistance in cerebral small arteries or arterioles and enhance their distensibility. Further studies on larger numbers of subjects are needed to confirm these effects and the dose-dependant effects.

• 대한수혈학회지
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• 제23권2호
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• pp.136-144
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• 2012

배경: 신선동결혈장은 응고인자의 보충을 위한 치료적 투여를 주된 목적으로 하지만, 실제로 적응증이 아닌 경우에도 부적절하게 사용되는 경우가 종종 있다. 방법: 년 2010년 7월부터 2011년 6월까지 1년간 세브란스병원 혈액은행에서 출고된 신선동결혈장의 적정 사용에 대한 평가를 시행하였다. 평가기준은 2009년 대한수혈학회에서 발간한 수혈가이드라인과 세브란스병원의 수혈적정성 평가 전산시스템에 기초하였다. 결과: 신선동결혈장은 1년 간 총 1,949명에게 4,982회에 걸쳐 17,733단위가 출고되었고, 이 중 1,990회(총 건수의 39.9%)가 부적절 수혈로 평가되었다. 진료과별 사용 건수는 소화기내과 등의 내과 계열이 흉부외과나 일반외과 등의 외과 계열보다 많았다. 그러나 부적절 사용 비율은 외과 계열이 내과 계열보다 높았다. 질병분류별 사용건수와 이들의 부적절 사용 비율은 유사한 양상을 보였는데, 종양, 소화 계통의 질병, 순환 계통의 질병군이 높은 사용 건수와 부적절 사용 비율을 보였다. 결론: 수혈의 적정성 유지를 위해서는 각 의료기관에서 수혈 적정성이 항상 평가되고, 그 결과를 임상의사들에게 정기적으로 피드백하는 과정이 중요하며, 이와 더불어 신선동결혈장 수혈 적응증에 대한 새로운 고찰이 필요할 것으로 사료된다.

• Journal of Ginseng Research
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• 제45권5호
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• pp.546-554
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• 2021

Background: Diabetes mellitus and hypertension often occur together, amplifying cardiovascular disease (CVD) risk and emphasizing the need for a multitargeted treatment approach. American ginseng (AG) and Korean Red Ginseng (KRG) species could improve glycemic control via complementary mechanisms. Additionally, a KRG-inherent component, ginsenoside Rg3, may moderate blood pressure (BP). Our objective was to investigate the therapeutic potential of coadministration of Rg3-enriched Korean Red Ginseng (Rg3-KRG) and AG, added to standard of care therapy, in the management of hypertension and cardiometabolic risk factors in type-2 diabetes. Methods: Within a randomized controlled, parallel design of 80 participants with type-2 diabetes (HbA1c: 6.5-8%) and hypertension (systolic BP: 140-160 mmHg or treated), supplementation with either 2.25 g/day of combined Rg3-KRG + AG or wheat-bran control was assessed over a 12-wk intervention period. The primary endpoint was ambulatory 24-h systolic BP. Additional endpoints included further hemodynamic assessment, glycemic control, plasma lipids and safety monitoring. Results: Combined ginseng intervention generated a mean ± SE decrease in primary endpoint of 24-h systolic BP (-3.98 ± 2.0 mmHg, p = 0.04). Additionally, there was a greater reduction in HbA1c (-0.35 ± 0.1% [-3.8 ± 1.1 mmol/mol], p = 0.02), and change in blood lipids: total cholesterol (-0.50 ± 0.2 mmol/l, p = 0.01), non-HDL-C (-0.54 ± 0.2 mmol/l, p = 0.01), triglycerides (-0.40 ± 0.2 mmol/l, p = 0.02) and LDL-C (-0.35 ± 0.2 mmol/l, p = 0.06) at 12 wks, relative to control. No adverse safety outcomes were observed. Conclusion: Coadministration of Rg3-KRG + AG is an effective addon for improving BP along with attaining favorable cardiometabolic outcomes in individuals with type 2 diabetes. Ginseng derivatives may offer clinical utility when included in the polypharmacy and lifestyle treatment of diabetes. Clinical trial registration: Clinicaltrials.gov identifier, NCT01578837;