• 제목/요약/키워드: contraindications

검색결과 73건 처리시간 0.029초

사총혈가(四總穴歌)에 관(關)한 연구(硏究) (The study of clinical usefulness of Si-Zong-Sue-Ge(四總穴歌))

  • 양기중;배건태;윤종화
    • Journal of Acupuncture Research
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    • 제17권1호
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    • pp.1-12
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    • 2000
  • Ge-Fu(歌賦) means prose and poetry individually, and they both have a meaning of all the rhythmical poetrical compositions making it ease for people to remember the content. All the Ge-Fus used in oriental medicine are made in Yuan(元), Mine(明)and Qing(靑)dynasty, and they have been largely used in most of all the fields of medicine such as Ben-Cao(本草), Tang-Ye(湯液), Zhen-Jiu(鍼灸), Zhen-Duan(診斷). Zhen-Jiu-Ge-Fu(鍼灸歌賦) has about 90 poetries and 10 proses and they contain the names of meridian; courses of meridian streams; accurate positions of acupuncture points; functions; effects; meanings of the name of acupuncture points; usages and effects of special points; manipulations of reinforcing and reducing method; contraindications of acupuncturing; principles of selections and orders of acupuncture points in therapy; and eight diadgoses. Zhen-Jiu-Ge-Fu is subdivided into Jing-Xue(經穴歌), Zhi-Jiu-Ge(刺灸歌), Shu-Xue-Ge(輸穴歌), Zhi-Liao-Ge(治療歌). And In Zhi-Liao-Ge, the most brief and essential Ge-Fu-Si-Zong-Sue-Ge- contains theraputic designs using far apart acpuncture points from the right painful areas in the body. In this study, the author opinionated the Si-Zong-Sue-Ge can be the prototype of the distant needling; the research on this can open the importance of Ge-Fus. On conclusion, 1. "Upper and lower Abdomen - Zu-San-Li($S_{36}$) (肚腹三里留)" means when there are problems and disorders in upper and lower abdomen, distinctively, such as gastric pain, maldigestion, flatulence, abdominal pain, constipation, diarrhea, vomiting, menstrual disorer, knee pain and tonic functioning, 족삼리 can be a right choice for distant needling point for treating. 2. "Face and Eye-He-Gu($Li_4$) (面目合谷收)" means when there are problems and disorders in facial, eye, ear, nose, throat, mouth regions, distinctively, such as facial edema, toothache, headache, sore throat, rhinorrhea, frontal headache, abdominal pain, dizziness, He-Gu can be a right choice for distant needling point for treating. 3. "Upper and lower back - Wei-Zhong($B_{40}$) (腰背委中求)" means when there are problems and disorders in upper and lower back, distinctively, such as upper back pain, lumbargo, hamstring muscle pain, popliteal region pain, lower extremity compartment syndrom, Inguinal region pain, muscle twitch, vomiting and diarrhea, hemorrhoidal bleeding, skin rash, Wei-Zhong can be a right choice for distant needling point for treating. 4. "Head and neck - Lie-Que($L_7$) (頭項審列缺)" means when there are problems and disorders in capital and nuchal area, distinctively, such as migraine, frontal headache, rhinorrhea, asthmatic dyspnea, aphasia, coughing, neck stiffness, occipital headache, upper extremity pain, Lie-Que can be a right choice for distant needling point for treating.

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구강악안면 영역의 재건을 위한 경골 근위부 내측 골이식술의 후향적 분석 (A RETROSPECTIVE ANALYSIS OF THE MEDIOPROXIMAL TIBIAL BONE GRAFT FOR ORAL AND MAXILLOFACIAL RECONSTRUCTION)

  • 백민규;김일규;조현영;장금수;박승훈;박종원;소경모
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제30권3호
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    • pp.241-248
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    • 2008
  • Tibial bone grafts provide an adequate volume of cancellous bone with cortical bone, high biologic value of bone, minimal gait disturbance and complications, and no special contraindications, and offer a superior clinical results than any other donor sites. Lateral appoach in tibial bone graft was used to gain large bone volume traditionally, but medial approach provides low morbidity associated with the tibial anatomic structure, simple and safety surgical procedure, and better comfortable to patients recently. We have undertaken clinical and retrospective studies on patients in Dept. of Oral and Maxillofacial Surgery, Inha University Hospital from April 2004 to January 2008. 50 patients have maxillofacial bony defect as resection of bening tumor, cyst enucleation, alveolar bone resorption, sinus pneumatization were received the tibial proximal autogenous particulated cancellous bone grafts. They were analyzed sex, age, diagnosis of recipient site, lesion size, dornor site, cortical bone repositioning, complications and we concluded favorable following results. 1. Medial approach for proximal tibia is safer and technically easier than lateral approach, associated with the proximal tibial anatomic structures, and short operative times. 2. Proximal tibia provides an adequate bone volume with predictability for oral and maxillofacial reconstruction. 3. Patients rarely complain of pain, swelling, discomfort and dysfunction such as gait disturbance. In conclusion, medial approach for proximal tibial graft seems to be a valuable tool for oral and maxillofacial reconstruction.

광범위한 안와파열골절에서 Titanium Mesh Plate와 Porous Polyethylene (Medpor®) 동시 사용의 유용성 (Treatment of Blow-out Fractures Using Both Titanium Mesh Plate and Porous Polyethylene (Medpor®))

  • 구자혜;원창훈;동은상;윤을식
    • 대한두개안면성형외과학회지
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    • 제11권2호
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    • pp.85-90
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    • 2010
  • Purpose: The goals of a blow-out fracture reconstruction are to restore the osseous continuity, provide support for the orbital contents and prevent functional and anatomic defects. Over the past several years, a range of autogenous and synthetic implants have been used extensively in orbital reconstructions. None of these implants have any absolute indications or contraindications in certain clinical settings. However, in extensive blow-out fractures, it is difficult to restore support of the orbital contents, which can cause more complications, such as enophthalmos. This study examined the clinical outcomes of extensive or comminuted blow-out fractures that were reconstructed by the simultaneous use of a titanium mesh plate and $Medpor^{(R)}$. Methods: Eighty six patients with extensive orbital fractures, who were admitted between March 1999 and February 2007, were reviewed retrospectively. The patients' chart and CT were inspected for review. Twenty three patients were operated on with both a titanium mesh plate (Matrix MIDFACE pre-formed orbital plate, Synthes, USA) and $Medpor^{(R)}$ (Porex, GA, USA). The patients underwent pre-operative CT scans to evaluate the fracture site and measure the area of the fracture. A transconjunctival approach was used, and titanium mesh plates were inserted subperiosteally with screw fixation. $Medpor^{(R)}$ was inserted above the titanium mesh plate. The patients were evaluated post-operatively for enophthalmos, diplopia, sensory disturbances and eyeball movement for a period of at least 6 months. Results: No implant-related complications were encountered during the follow-up period. Enophthalmos occurred in 1 patient, 1 patient had permanent sensory disturbance, and 3 patients complained of ocular pain and fatigue, which recovered without treatment. Although there were no significance differences between groups, the use of 2 implants had fewer complications. Therefore, it can be an alternative method for treating blow out fractures. Conclusion: The use of both a titanium mesh plate and $Medpor^{(R)}$ simultaneously may be a safe and acceptable technique in the reconstruction of extensive blow-out fractures.

Trends and Future Direction of the Clinical Decision Support System in Traditional Korean Medicine

  • Sung, Hyung-Kyung;Jung, Boyung;Kim, Kyeong Han;Sung, Soo-Hyun;Sung, Angela-Dong-Min;Park, Jang-Kyung
    • 대한약침학회지
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    • 제22권4호
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    • pp.260-268
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    • 2019
  • Objectives: The Clinical Decision Support System (CDSS), which analyzes and uses electronic health records (EHR) for medical care, pursues patient-centered medical care. It is necessary to establish the CDSS in Korean medical services for objectification and standardization. For this purpose, analyses were performed on the points to be followed for CDSS implementation with a focus on herbal medicine prescription. Methods: To establish the CDSS in the prescription of Traditional Korean Medicine, the current prescription practices of Traditional Korean Medicine doctors were analyzed. We also analyzed whether the prescription support function of the electronic chart was implemented. A questionnaire survey was conducted querying Traditional Korean Medicine doctors working at Traditional Korean Medicine clinics and hospitals, to investigate their desired CDSS functions, and their perceived effects on herbal medicine prescription. The implementation of the CDSS among the audit software developers used by the Korean medical doctors was examined. Results: On average, 41.2% of Traditional Korean Medicine doctors working in Traditional Korean Medicine clinics manipulated 1 to 4 herbs, and 31.2% adjusted 4 to 7 herbs. On average, 52.5% of Traditional Korean Medicine doctors working in Traditional Korean Medicine hospitals adjusted 1 to 4 herbs, and 35.5% adjusted 4 to 7 herbs. Questioning the desired prescription support function in the electronic medical record system, the Traditional Korean Medicine doctors working at Korean medicine clinics desired information on 'medicine name, meridian entry, flavor of medicinals, nature of medicinals, efficacy,' 'herb combination information' and 'search engine by efficacy of prescription.' The doctors also desired compounding contraindications (eighteen antagonisms, nineteen incompatibilities) and other contraindicatory prescriptions, 'medicine information' and 'prescription analysis information through basic constitution analyses.' The implementation of prescription support function varied by clinics and hospitals. Conclusion: In order to implement and utilize the CDSS in a medical service, clinical information must be generated and managed in a standardized form. For this purpose, standardization of terminology, coding of prescriptions using a combination of herbal medicines, and unification such as the preparation method and the weights and measures should be integrated.

미숙아 동맥관 개존증의 외과적 교정에 관한 임상적 고찰 (Clinical Considerations of the Surgical Closure of the PDA in the Premature Infants)

  • 김상익;박철현;현성열;김정철;권진형;박국양
    • Journal of Chest Surgery
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    • 제32권8호
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    • pp.702-708
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    • 1999
  • 배경: 미숙아 동맥관 개존증의 약물적 치료로 Indomethacin을 사용하는데 이때 발생하는 합병증, 부적응증, 또는 동맥관이 다시 열릴 경우 외과적으로 교정함으로써 수술에 따른 위험성 및 합병증이 적고 지속적인 동 맥관 폐쇄가 가능하다. 대상 및 방법: 1996년 4월부터 1998년 8월까지 동맥관 개존증을 동반한 미숙아중 수 술 당시의 체중이 1.5 kg 이하인 11명의 환아(남아: 5, 여아: 6)를 대상으로 하였다. 술전 동반질환으로 선천 성 심질환(7), 유리질막증(6), 폐렴(4), 뇌실내 출혈(4), 기흉(3), 고빌리루빈혈증(2), 괴사성 장염(2), 신부전증 (1), 간질(1), 수두증(1) 등이 있었다. 사용된 외과적 술식은 헤모클립을 사용한 경우(8)와 동맥관을 결찰한 경 우(3)가 있었다. 동맥관의 크기는 3~6 mm(5.0$\pm$1.2)였다. 결과: 동맥관을 폐쇄한후 수축기 및 확장기 혈압이 상승하였고 심박동수는 감소하였다. 동맥혈 개스 결과도 호전되었다. 수술과 관련된 합병증은 없었다. 술후 6명의 환아에서 호흡기 증상의 호전과 함께 인공호흡기이탈이 가능했고 모두 외래 추적 관찰중이다(3개월~ 12개월). 술후 5명의 환아가 사망하였는데 사망 원인은 유리질막증(2례), 기관지폐 이형성증과 폐렴(1례), 패 혈증(1례), 심부전증과 특발성 호흡곤란증(1례)이었다. 결론: Indomethacin에 부적응증 혹은 합병증이 있거나, Indomethacin용법에 효과가 없거나 또는 혈역학적으로 의미있는 단락을 동반하는 미숙아 동맥관의 우선 치료 법은 조기 외과적 교정술이다.

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"침구자생경(鍼灸資生經)"의 침구 문헌적 특징에 관한 연구 (A Study about Characteristics of literature of acupuncture and moxibustion in "Chimgujasaenggyeong(鍼灸資生經)")

  • 박현국;김기욱
    • 대한한의학원전학회지
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    • 제21권4호
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    • pp.61-74
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    • 2008
  • The acupuncture and moxibustion documentary characteristics of "Chimgujasaenggyeong" can be summarized into 6 parts such as the follwing 1. "Chimgujasaenggyeong" was written at about 1180-1195 during the Southern Song period. It contains 7 volumes in all. The acupuncture points and their variations in volume 1 were all directly recorded from Wang-yuil(王維一)'s "Dong-insuhyeolchimgudogyeong(銅人腧穴鍼灸圖經)" and 11 points were added from volumes 99 and 100 of "Taepyeongseonghyebang(太平聖惠方)", bringing the total to 365 points, which was different from the 360 that the people knew. Volume 2 is the actual collection of theses on acupuncture and moxibustion by Wangjipjung(王執中) and shows his unique views on the basic problems of acupuncture and moxibustion such as selection of points[取穴], application of moxas[施灸], aftercare of moxibustion[灸後護理] and acupuncture and moxibustion contraindications[鍼灸禁忌]. Volumes 3${\sim}$7 mostly divide the indications(主治) from "Dong-insuhyeolchimgudogyeong", "Taepyeongseonghyebang", "Cheon-geumyobang(千金要方)" by disease into chapters. 2. Of the remaining editions the 'Cheonryeok Guanggeunseodang Inbon(天曆 廣勤書堂 印本)' of the Won dynasty is the first, and the Jeongtong(正統) new edition is a reprint based on the Cheonryeok(天曆) edition, and the Jeongtong edition reprinted in the 9th year of Guanmun(寬文) of Japan has many missing and wrong characters compared to the original copy. 3. The big letters[大字] under the line in the current editions are all postscripts[按語] of Wangjipjung and the 5 verses quoted from other books that do not have their origin listed and have the qualities of rules for treatment in the first chapter of volume 3 'Heoson(虛損)' were put together by Wang. 4. In the annotations in small print of the current edition of "Jasaenggyeong" there are Wisegeol(衛世傑)'s added annotations in addition to Wangjipjung's original ones. 5. Some of the many medical books quoted by the "Jasaenggyeong" that are from before the Song dynasty have been lost completely and only can be seen here in this important text. 6. The quotations said to be from 'Myeongdanggyeong(明堂經)'(or 'Myeongdang(明堂)', 'Myeong(明)') in "Jasaenggyeong" are directly from volume 77 'Chimgyeong(鍼經)' and volume 100 'Myeongdang' of "Taepyeongseonghyebang" and not another book. The quotes from 'Myeongdang' in accupuncture and moxibustion books after the Song dynasty were directly or indirectly copied from "Jasaenggyeong".

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의안(醫案)을 통한 신종 인플루엔자의 한의학적 대처방안 (A Study on Traditional Korean Medical Countermeasures of Influenza A by Case Histories)

  • 안상영;한창현;권오민;박상영;안상우
    • 대한한의학원전학회지
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    • 제22권4호
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    • pp.221-239
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    • 2009
  • Background: The recent outbreak of the novel strain of influenza A (H1N1) virus has raised a global concern of the future risk of pandemic. Traditional Korean Medicine(TKM) has been combatting against contagious diseases and developed its own particular and efficient way in treating those diseases. Objectives: Provide a distinctive and effective TKM method in understanding the principles of treatment, prevention, and contraindications against influenza A through case histories. Method: We revised case histories of eminent doctors of Ming and Qing dynasties according to their clinical manifestations similar to those of influenza A. We also verified prescriptions of the "Dong-uibogam(東醫寶鑑)" through examining clinical practices of China today. Results: 1. The subtypes of Warm disease; Wind Warmth and Pestilence has the most similar clinical manifestation in comparison to Influenza A. Specifying these terms is important in recognizing and classifying various diseases under the name of Warm disease. 2. TKM considered not only external factors but also individual factors like general condition, diet, emotion, constitutional types, etc in the treatment of febrile diseases. 3. TKM developed a new way in the treatment of contagious diseases. considering the characteristics of each pathogen. TKM described the Warm pathogen being light as a feather, which enters through the nose, principally affecting the Lung. Therefore, they emphasized treatment with Pungent Sweet Cooling Moistening[辛甘凉潤] method. 4. As the conservation of fluid and humor is the primordial concern in the treatment of Warm disease, they restricted release of the exterior with pungent-warm and purgation method. The purgation methods was used exclusively to decrease fever and preserve fluid and humor. 5. The only differentiating characteristics of Influenza A with seasonal influenza are vomiting and diarrhea. Case research revealed the possibility of these manifestations to be a mechanism of restoration. 6. TKM provides alimento prevention method like Mint Pear Porridge, mung bean, and etc also combination of herbal medicine. Also emphasized in the conservation of essence for the prevention of contagious diseases. Conclusions: TKM developed its unique way in understanding the pathogenesis, diagnosis, treatment, and prevention of contagious diseases and formed its independent scheme of Warm Disease. This knowledge in febrile contagious disease is relevant today in providing diverse treatment and prevention for influenza A.

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추체사대 수막종의 수술과 관련하여 뇌 정맥조영상의 의미 (Significance of Cerebral Venography in Surgery of Petroclival Meningiomas)

  • 황승균;곽호신;백선하;오창완;이상형;김동규;김현집;정희원
    • Journal of Korean Neurosurgical Society
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    • 제30권10호
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    • pp.1200-1209
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    • 2001
  • Objective : A thorough understanding of the related venous structure is mandatory for successful removal of the petroclival meningiomas. This study was planned to investigate the guideline for safe ligation and incision of transverse or sigmoid sinuses and the importance of drainage pattern of vein of $Labb{\acute{e}}$ in surgical removal of petroclival meningiomas. Patients and Methods : The authors reviewed the venogram of the consecutive 37 cases of petroclival meningiomas and retrospectively analyzed their surgical findings. The drainage pattern of confluence of Herophili was classified as Type A(confluent & equal on both sides), Type B(confluent & non-dominant on tumor side), Type C(confluent & dominant on tumor side) and Type D(unilateral drainage only) as these findings gave the information on safe ligation and resection of the sinus. Usefulness of intraoperative test clamping of sinus for safe ligation was also reviewed. The vein of $Labb{\acute{e}}$ was analyzed with respect to its draining point and its collaterals to other superficial veins. Results : Contraindications of the sinus ligation and resection according to the drainage pattern at the confluence of Herophili were Type C(n=10, 27%)and Type D(n=4, 11%). Patients with Type A(n=12, 32%)and Type B(n=11, 30%) were tolerable to sinus ligation ipsilateral to tumor, if the test clamping proved to be safe. Identification of no brain swelling, after intraoperative test clamping of the sinus for more than 30 minutes performed in 7 out of 11 cases, was a reliable indicator of safe sinus ligation. The drainage pattern of the vein of $Labb{\acute{e}}$, especially low-lying type, could predict the possibility of postoperative hemorrhage and infarction. Its drainage into tentorium or superior petrosal sinus, however, made the transtentorial approach impossible, leading to restricted operative field. Conclusion : For a successful removal of the petroclival meningiomas preoperative venogram should be examined carefully. The extent of exposure in a planned approach can be estimated by analyzing the variation of sinuses and the drainage pattern of vein of $Labb{\acute{e}}$.

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Effect on quanti-quality milk and mozzarella cheese characteristics with further increasing the level of dried stoned olive pomace in diet for lactating buffalo

  • Taticchi, A.;Bartocci, S.;Servili, M.;Di Giovanni, S.;Pauselli, M.;Mourvaki, E.;Zilio, D. Meo;Terramoccia, S.
    • Asian-Australasian Journal of Animal Sciences
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    • 제30권11호
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    • pp.1605-1611
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    • 2017
  • Objective: Following a previous report, an experiment was conducted to determine the effect of increasing level of dried stoned olives pomaces (DSOP) in the diet of lactating buffaloes on milk and mozzarella cheese yield and characteristics. Methods: Sixteen pluriparous buffaloes distributed into two groups were fed an isoenergetic (0.9 milk forage unit/kg) and isoprotein (149 g/kg dry matter [DM] of crude protein) diet, with or without DSOP. Each animal received 17 kg DM/d. Samples of forages and concentrates were weekly collected and used for duplicate chemical analyses. Individual milk samples from each control were analyzed for chemical and coagulating parameters and daily production of mozzarella cheese was estimated. At the end of the trial, bulk milk of each group was processed to produce mozzarella cheese and chemical (fat, protein, ash, pH) composition, fatty acids composition, carotenoids and tocopherols content were determined. A sensory test was also performed. The oxidative stability was measured on mozzarella cheese and on governing liquid. Results: No significant differences were observed, neither for milk yield and body condition score, nor for milk characteristics. The fat was higher (p<0.05) in mozzarella of DSOP fed group but, saturated fatty acids were lower and unsaturated higher (p<0.01). Furthermore, lower atherogenic (p<0.01), and thrombogenic (p<0.05) indices were found in mozzarella cheese of DSOP fed group. In addition, the administration of DSOP did not affect the mozzarella cheese oxidative stability and no negative effect was found in the sensory properties. Conclusion: No contraindications appeared for the inclusion of DSOP in the diet of lactating buffaloes. Besides, important effects on mozzarella cheese quality were obtained, such as a modification of fat content and attributes with an increment in the mono-unsaturated. Additionally, a lower saturated/unsaturated ratio and atherogenic and thrombogenic indices suggest an improvement of dietetic and nutritional characteristics of mozzarella cheese.

구강건조증에 대한 필로카핀 구강양치액의 효과 (Effect of Pilocarpine Mouthwash on Xerostomia)

  • 김지현;박주현;권정승;안형준
    • Journal of Oral Medicine and Pain
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    • 제36권1호
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    • pp.21-24
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    • 2011
  • 구강건조증이란 주관적인 구강 내 건조감으로 정의되며, 이는 약물, 타액선 질환, 방사선 치료, 쉐그렌 증후군, 심리적 요인 등과 같은 다양한 원인에서 비롯된다. 구강 건조증 환자 중 현저한 타액선 기능 감소가 존재하는 경우 구강캔디다증, 치아우식증, 치주질환, 미각변화, 구취 등의 병발증이 나타날 수 있다. 이러한 구강건조증의 치료로는 우선적으로 구강건조를 유발하는 원인요소를 제거하거나, 환자의 불편감을 감소시키기 위한 대증요법이 주가 되며 실제로 타액 분비 기능이 감소된 경우 이로 인한 합병증을 예방하기 위한 치료와 타액분비를 자극할 수 있는 약물치료를 시행할 수 있다. 이 중 타액분비를 촉진시키는 약물인 필로카핀은 구강건조증 치료제로 널리 사용되어 왔다. 하지만 발한작용, 비뇨기 및 위장관계의 비정상적인 기능유도, 심혈관계 및 호흡기계에 대한 위험 등의 부작용이 있어 천식, 만성폐질환, 심혈관계 질환자에게는 주의 깊은 사용이 요구되며, 특히 조절되지 않는 천식환자의 경우 필로카핀의 절대적 금기증으로 사용이 금지된다. 이처럼 구강건조증 치료에 있어 필로카핀은 부작용으로 인해 전신적인 투여에 많은 제한이 있다. 따라서, 필로카핀의 부작용을 최소화하기 위해 국소적으로 사용되는 방법 중의 하나인 필로카핀 양치액을 이용하여 치료한 증례를 통해 그 효과를 확인해보고자 하였다.