• 대한임상독성학회지
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• 제8권1호
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• pp.46-49
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• 2010

"Stacker 3" is one of the most popular caffeine-containing weight-reduction supplements and it has ephedra-free properties as "Stacker 2 Ephedra-Free" in many countries, including Korea. We describe here a 26-year-old woman who took an acute intentional overdose of "Stacker 3"(approximately 50 capsules, total amount: 25 grams, as caffeine 250 mg/kg) and who had delirium, rhabdomyolysis and acute renal failure. She had to be treated by forced diuresis and urine alkalinization, and she subsequently recovered. This is the first such case report in the medical literature.

• Childhood Kidney Diseases
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• 제1권2호
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• pp.179-182
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• 1997

Cyclosporine is an immunosuppressant usually used to prevent renal transplantation rejection. Nephrotoxicity and hypertension are considered as the most frequent side effects of cyclosporine treatment. The neurotoxic effects of cyclosporine such as agitation, anxiety, delirium, depression and psychosis have recently been found. Methylprednisolone may increase as well plasma concentration of cyclosporine, which leads to side effects. Here we report a $Henoch-Sch\"{o}nlein$ nephritis patient treated with cyclosporine and methylprednisolone who has experienced psychosis including visual and auditory hallucination and convulsion.

• Journal of Chest Surgery
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• 제22권6호
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• pp.1088-1091
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• 1989

Foramen of Morgagni hernia is the least common type of all congenital diaphragmatic hernias. These foraminal hernias result from a congenital defect in the development or attachment of the diaphragm to the sternum and costal arch. They occur most commonly on the right side, possibly because of pericardial reinforcement of the left. In our case, occurred on the right side and the contents of the hernial sac were omental fat and a part of transverse colon. We performed transthoracic approach for reduction and repair of foraminal hernia with ligation and interrupted mattress sutures of the margin of the defected diaphragm to the posterior part of the sternum and costal cartilage. The postoperative course was uneventful except posttraumatic delirium and discharged at 21st postoperative day.

• 정신신체의학
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• 제3권2호
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• pp.214-221
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• 1995

There appears to be an increased incidence of anxiety symptoms in association with certain medical illness. It is usually assumed that certain medical disorders are directly associated with anxiety symptoms in that the pathophysilolgy of the medical illness somehow causes the anxiety symptoms. However, the pathophysilolgies of many such medical illnesses as well as anxiety are not known and no discrete group of medical illnesses is clearly more likely to produce anxiety symptoms than any other Moreover, anxiety symptoms may be the representation of other psychiatric symptoms, like depression and delirium. Though it is important to differentiate primary and other causes(secondary) of anxiety clinically, the clear differentiation is somewhat arbitrary, as the confusion of mind-body dichotomy. for the purpose of accurate treatment of anxiety symptoms relating medical illness, this review article focuses on those clinical features and mechanisms of anxiety that are potentially useful in differential diagnosis.

• 한국정보처리학회:학술대회논문집
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• 한국정보처리학회 2019년도 추계학술발표대회
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• pp.864-867
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• 2019

본 연구에서는 러프 근사화 개념을 활용하여 섬망 환자를 사전에 구별할 수 있는 임상적 지식을 유도할 수 있는 방법을 제안하였다. 실험 결과에서는 평균 섬망기간이 13일 이상 유지되는 6가지 임상적 분류기준을 유도하였고, 통계적 5겹 교차검정 실험을 통해 73%의 분류 성능을 제공함을 확인하였다.

• Journal of Hospice and Palliative Care
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• 제25권4호
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• pp.139-197
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• 2022

Patients with terminal cancer experience very severe symptoms during the end of life, and palliative sedation (PS) may be considered if those symptoms are refractory to any other treatment. This brief report presents ethical considerations, practices, and recent concerns on PS. PS is quite different from euthanasia. There is a lack of consensus and standards on protocols, but its notable effects have been reported in hospice care settings. Most studies to date have reported no difference in survival between patients receiving PS and those not, and PS must be conducted proportionally with the lightest level of sedation. The most common indication for PS is delirium, and midazolam is the main sedative used. It is recommended that information regarding PS should be provided to patients and their caregivers repeatedly as early as possible. Existential suffering alone is not an indication for PS, and there is a lack of evidence on bispectral analysis. Additional research on PS is needed in Korea.

• 한국정보처리학회:학술대회논문집
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• 한국정보처리학회 2022년도 추계학술발표대회
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• pp.980-982
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• 2022

본 연구는 와상환자에게 자주 발생하는 낙상, 욕창, 불면증을 영상기술을 통해 인식하여 섬망의 조기진단 모형을 구현한다. 실시간 모니터링을 통해 섬망 잠재환자를 선별하고 집중적인 관리와 치료로 이어질 수 있도록 간호인력을 보조하는 데 주된 목적을 두고 있다. 과활동형 섬망은 파생위험 중 하나인 낙상과, 저활동형 섬망은 원인 요소인 욕창과 묶어 자세인식을 통해 판정한다. 또한 주로 밤에 악화되는 섬망의 특성을 고려해 눈 깜빡임을 통한 불면증 검사를 추가로 반영하였다. 낙상과 욕창을 섬망과 묶어 융복합적인 위험예측 시스템을 구축함과 동시에, 기존의 섬망 사정도구들이 지니는 시공간적 제약을 개선함으로써 간호인력의 부담을 덜어줄 것으로 기대된다.

• 정신신체의학
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• 제31권2호
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• pp.89-99
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• 2023

연구목적 본 연구는 일 대학병원에 입원하여 정신건강의학과로 협진 의뢰가 된 65세 이상의 노인 입원 환자들을 연소노인, 고령노인, 초고령노인으로 분류하여, 각 연령대별로 초조(agitation) 양상에 기여하는 요인 및 차이, 초조 양상의 심각도에 대한 차이를 알아보기 위해 시행되었다. 방 법 2021년 7월 1일부터 2021년 12월 31일까지 인하대병원에 입원한 환자 중, 정신건강의학과에 협진 의뢰된 65세 이상 환자들의 의무기록을 후향적으로 검토하였다. 연령, 성별, 입원경로, 의뢰과, 의뢰 사유, 치료방법, 내외과적 질환여부, 혈액학적 검사자료 등을 조사하였다. 결 과 65-74세의 연소노인은 외과계열 협의진료 의뢰(OR 4.833, 95% CI 1.533-15.234, p=0.007), 높은 CRP수치(OR 2.111, 95% CI 1.007-4.426, p=0.048)에 해당될 경우, 75~84세의 고령노인은 외과계열 협의진료 의뢰(OR 3.568, 95% CI 1.334-9.544, p=0.011), 치매(OR 5.503, 95% CI 1.164-26.026, p=0.031), 저나트륨혈증(OR 0.344, 95% CI 0.149-0.791, p=0.012)에 해당될 경우, 85세이상의 초고령노인은 치매(OR 9.728, 95% CI 1.151-82.242, p=0.037)에 해당될 경우 초조와 유의한 관련성이 있었다. 또한 RASS 평균점수의 경우 65-74세의 연소노인은 1.22점, 75-84세의 고령노인은 1.54점, 85세이상의 초고령노인은 1.79점(F=5.368, p=0.005)으로 연령대 간의 초조 양상의 심각도에 대한 차이가 있었다. 결 론 연령대가 증가함에 따라 초조 양상의 심각도가 높게 나타났고, 초조 양상에 기여하는 여러 관련 요인들도 연령대 별로 차이가 있었다. 따라서, 고령 환자 진료시 연령대에 따라 초조에 영향을 미칠 수 있는 인자에 대한 주의가 필요하다.

• 사상체질의학회지
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• 제23권3호
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• pp.275-284
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• 2011

1. Objective: This literary review investigates Lee Jema's clinical experiences with Soyang-type patients and their influence on his conceptualization of the Soyang physiology and pathology. 2. Methods: 1) The case reports in "Soyang constitutional type: Spleen Cold-based Exterior-Cold disease" were compared before and after the Sinchuk revision to explore the temporal change in the Sasang medical concepts. 2) The texts in Donguisusebowon (Gabo edition) and Donguisusebowon (Sasangchobongwon) were analyzed to investigate the pathological concepts appearing before the completion of the Donguisusebowon (Gabo edition). 3) The texts in Donguisusebowon (Sinchuk edition) was analyzed to investigate the pathological concepts formed between the Gabo and Sinchuk editions of Donguisusebowon. 3. Results and Conclusions: 1) Gabo edition : The Gabo edition divided the External-origin Exterior disease into Cold-dominant (Heat-moderate) and Heat-dominant (Cold-moderate) patterns and differentiated the severity of Exterior-based Exterior disease and Interior-based Interior disease into mild, moderate, severe, and critical conditions. Cold-damage Delirium disease pattern was categorized as an Interior-based Interior disease, and the treatment protocol using Baekho-tang (Baihu-tang) was established. The stool condition and bowel movement reflecting the patient's defecation habits, the prime indicator of health in the Soyang constitutional type, were emphasized on their importance. 2) Sinchuk edition: The Delirium disease pattern was moved into the Exterior-cold disease, and the treatment protocol applying Jihwangbaekho-tang (Dihuangbaihu-tang) and Hyeongbangsabaek-san (Jingfangxiebai-san), with variational usage of Gypsum, was newly established. The Seong-Jeong and basal disease patterns were suggested as important factors in treating the patients. Also, it was proposed that the symptoms and signs reflecting the condition of the life-preserving energy be assessed to understand the patient's current condition. The importance of post-acute rehabilitation and aftercare as well as the most appropriate acute-stage treatment were emphasized.

• 정신신체의학
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• 제21권2호
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• pp.114-121
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• 2013

연구목적 타과 입원 중 정신건강의학과에 자문 의뢰된 초로기와 노년기 환자의 특징에는 어떠한 차이가 있는지 알아보기 위하여 연구를 실시하였다. 방 법 일 대학병원 정신건강의학과에 자문 의뢰된 타과 입원환자 중 50세부터 64세 범위의 초로기 환자(N=162)와 65세 이상의 노년기 환자(N=171)의 자문기록지를 비교분석하였다. 결 과 1) 정신건강의학과 자문의 주소는 초로기에 신체증상, 불안, 수면장애 순, 노년기에 인지저하, 의식혼탁, 우울한 기분 순으로 많았다. 2) 자문 결과에 의한 정신의학적 진단명은 초로기에 섬망, 기분장애, 물질사용장애순, 노년기에 섬망, 기분장애, 주요 신경인지장애 순으로 많았다. 3) 신체질환 치료제의 수는 초로기보다 노년기에 더 많았다. 결 론 정신건강의학과 자문의 특성은 초로기와 노년기 환자에서 차이가 있었으므로, 노인정신의학 자문 활동에 있어서 더욱 세분화된 노인 연령층별 접근이 필요하다고 제시된다.