• 제목/요약/키워드: digestive disease

검색결과 415건 처리시간 0.119초

신선동결혈장의 적정수혈 분석 (Audit of Appropriateness of Fresh Frozen Plasma Transfusion)

  • 서유경;김문정;김신영;김현옥
    • 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.

서울시내 동물병원의 애완견 진료와 관리시스템에 관한 연구 (Study on Companion Dog Practice and Management System on Animal Hospital in Seoul City)

  • 강동준;정병현;허정;강정부
    • 농업생명과학연구
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    • 제43권2호
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    • pp.39-46
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    • 2009
  • 동물병원에서 행해진 진료현황, 총 41,305건에 대해 WHO의 질병분류법(ICD)에 따라 검증한 결과 예방의학이 42.2%, 피부질환이 16.4%, 소화기계가 12.0%, 이과(耳科)가 8.5%, 호흡기계 질환이 4.3%이었다. 내과질환에서는 내원한 진료 중에서 소화기계 질환이 호흡 52.9% 기계 질환이 18.9%, 순환기질환이 13.2%, 종양이 4.4%순이었다. 피부질환 총 6,774건 중에서 농피증이 50%, 외부기생충증이 12.2%, 피부사상균증이 11.0%, 알레르기성 피부병이 9.8%이었다. 동물병원의 수입을 진료부분과 용품 판매, 애견 미용 등 크게 3부분으로 구분하였을 때 전체 매출의 71.6%가 진료부분, 용품의 판매가 16.9%, 애견 미용이 11.5%를 차지하였다. 동물병원의 홍보 형태는 인터넷 웹사이트를 통한 홍보가 47%로 가장 많았으며, 지역광고지가 23.5%, 전단지와 전화통신 서비스가 11.8% 순이었다. 동물병원의 인적구성에서는 수의사가 절반정도인 45.5%를 차지하였으며 전문적인 교육과정을 거친 수의테크니션은 없었다. 동물병원의 시설구획에서는 평균 진료실은 2.7실, 입원실은 1.7실, 격리입원실은 0.5실이었고 이외 수술실과 방사선촬영실을 병용하는 동물병원도 있었고 일반 처치실의 시설은 미흡하였다.

폴립 가중치 영상 생성을 통한 캡슐내시경 영상의 학습 성능 비교 연구 (A Study on the Comparison of Learning Performance in Capsule Endoscopy by Generating of PSR-Weigted Image)

  • 임창남;박예슬;이정원
    • 정보처리학회논문지:소프트웨어 및 데이터공학
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    • 제8권6호
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    • pp.251-256
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    • 2019
  • 캡슐 내시경은 식도부터 항문까지 소화기관 전체를 한 번에 촬영할 수 있는 의료기기로, 한 번의 검사에서 평균 8~12시간의 길이와 5만장 이상의 프레임으로 구성된 영상을 생성한다. 그러나 생성된 영상에 대한 분석은 전문가에 의해 수작업으로 진행되고 있어서, 질병 영상 진단을 돕기 위한 영상 분석 자동화에 대한 수요가 증가하고 있다. 그 중에서도 본 연구에서는 위장관 내에서 발견될 수 있는 융기성 병변인 폴립 영상 자동 검출에 초점을 맞추었다. 본 연구에서는 멀티 스케일 분석을 통해 폴립 의심 영역을 추출하고, 이것을 원본 영상과 합성하여 폴립 학습을 강화시킬 수 있는 가중치 영상을 생성하는 기법을 제안한다. 수집한 452장의 데이터에 대해 머신 러닝 기법중 하나인 SVM과 RF로 실험한 결과, 원본 영상을 이용한 폴립 검출의 F1점수는 89.3%였지만, 생성된 가중치 영상을 통해 학습한 결과 F1점수가 93.1%로 향상된 것을 확인하였다.

장수풍뎅이 유충의 장내 미생물을 이용한 다양한 식물 균류병의 생물적 방제 및 생장촉진 (Plant Growth Promotion and Biocontrol Potential of Various Phytopathogenic Fungi Using Gut Microbes of Allomyrina dichotoma Larva)

  • 김준영;김병섭
    • 식물병연구
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    • 제26권4호
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    • pp.210-221
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    • 2020
  • 곤충은 장내에 서식하고 있는 미생물과 상호작용을 통해 공생하는 것으로 알려져 있으며, 이러한 공생자는 공진화를 통하여 극한 환경에서도 서식을 가능하게 한다. 이러한 관점에서 토양 속에서 부엽토와 식물 잔재를 먹고 사는 장수풍뎅이 유충의 장내에 존재하는 공생자는 식물병원균을 방제하는 데 유용한 미생물이 존재할 것으로 생각된다. 따라서, 식물병원균에 대해 활성을 갖는 유용 미생물 10종을 장수풍뎅이 유충의 소화기관 전장, 중장, 후장으로부터 분리하였다. 분리된 10종의 유용 미생물은 유묘 검정을 통하여 토마토 잿빛곰팡이병, 배추 뿌리혹병, 고추 탄저병, 고추 역병에 대하여 강력한 항균 활성을 확인하였다. 10종의 항균활성 미생물은 형태적 특성과 16s rRNA gene 분석으로 Bacillus속 4종, Paenibacillus속 3종 및 Streptomyces속 3종으로 동정되었다. 유용 미생물은 인산 가용화, indole-3-acetic acid, siderophore 생성 활성이 우수하며 진균외막가수분해 효소인 β-1,3-glucanase, pretease 활성을 보였다. 10종의 유용 미생물 중, DM152 균주는 토마토와 고추 식물체의 모든 기관에서 생장을 촉진시켰다. 따라서, 장수풍뎅이 유충의 소화기관으로부터 분리된 10종의 장내 미생물은 생물학적 방제제 및 생물비료의 활용 가능성을 나타내었다.

Clinical characterization of 3-month-old pigs infected with African swine fever virus from Vietnam

  • Oh, Sang-Ik;Bui, Vuong Nghia;Dao, Duy Tung;Bui, Ngoc Anh;Yi, Seung-Won;Kim, Eunju;Lee, Han Gyu;Bok, Eun-Yeong;Wimalasena, S.H.M.P;Jung, Young-Hun;Hur, Tai-Young;Lee, Hu Suk
    • 한국동물위생학회지
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    • 제45권2호
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    • pp.71-77
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    • 2022
  • African swine fever (ASF) is a fatal viral disease in pigs, with a short incubation period and causing immediate death. Few studies exist on the Asian epidemic ASF virus (ASFV) challenge in older pigs, including growing and fattening pigs and sows. We aimed to investigate clinical outcomes, pathomorphological lesions, and viral distribution in organs of 3-month-old growing pigs that were inoculated with the ASFV isolated in Vietnam. The clinical outcomes were recorded daily, and the dead or euthanized pigs immediately underwent necropsy. Viral loads were determined in 10 major organs using quantitative polymerase chain reaction. The average incubation period in growing pigs was more delayed (5.2±0.9 dpi) than that in weaned pigs, and the clinical signs were milder in growing pigs than in weaned pigs. The digestive and respiratory clinical signs in growing pigs showed at the end period of life, but these were observed at an early stage of infection in weaned pigs. The pathomorphological features were severe and nonspecific with hemorrhagic lesions in various organs. The viral loads in organs from growing pigs were higher than those from piglets, and the number of viral copies was related to gross lesions in the tonsil and intestine. In the absence of vaccines against ASF, early clinical detection is important for preventing the spread of the virus. Our findings elucidated that the clinical signs and gross lesions in growing pigs differed from those in weaned pigs, which provide valuable information for diagnosis of pigs with suspected ASF infection.

진행성 위암에서 1차 항암화학요법에 실패한 환자에서 2차 항암화학요법으로 FOLFIRI요법의 효용성에 대한 연구 (FOLFIRI Regimen as a Second-line Chemotherapy after Failure of First-line Chemotherapy in Advanced Gastric Cancer)

  • 이용강;김재현;박준철;문희석;김성은;장진석;조주영;김은선;이시형;이상길
    • Journal of Digestive Cancer Research
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    • 제5권2호
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    • pp.113-119
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    • 2017
  • Background: Second line chemotherapy is often considered in advanced gastric cancers. We assessed irinotecan in combination with fluorouracil in patients experienced diseases progression after first line chemotherapy. Methods: Prospective trial was done at 7 centers in republic of Korea. Patients aged 18 years or older with advanced gastric adenocarcinoma and disease progression on or within 4 months after first-line chemotherapy were assigned to receive irinotecan 180 mg/m2 and 5-fluorouraicl 400 mg/m2 intravenously bolus injection on days 1 and leucovorin 200 mg/m2 for 2 hours and 5-fluorouracil 600 mg/m2 for 22 hours intravenously infusion on day 2 of a 14-day cycle (FOLFIRI group). The primary endpoint was objective tumor response (OR). Efficacy analysis was by per-protocol, and safety analysis included all patients who received at least one treatment with study drug. Results: Between January 1, 2014 and December 31, 2016, 28 patients were assigned to FOLFIRI treatment. Of those 20 patients were completed the study protocol. Per-protocol analysis, two patients among 20 subjects (10.0%) showed partial response. Overall survivals of FOLFIRI group; median 10.1 months [95% CI 4.9-15.3] Grade 3 and higher adverse event that occurred about 5%, but grade 3 or higher febrile neutropenia or life threatening complication was not reported. Conclusion: Combination chemotherapy with irinotecan, 5-FU, and LV is feasible in gastric cancer patients previously treated with platinum-based chemotherapy

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항암화학요법에 이은 확대 담낭절제술로 치료한 절제 불가능한 담낭암 (A Case of Unresectable Gallbladder Cancer Treated with Chemotherapy Followed by Extended Cholecystectomy)

  • 정광현;박진명;이재민;이상협;류지곤;김용태
    • Journal of Digestive Cancer Research
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    • 제1권2호
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    • pp.104-107
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    • 2013
  • 담낭암은 진행된 상태에서 발견되었을 경우 예후가 매우 불량한 암으로 전신항암화학요법으로 치료를 하게 되나 일반적으로 고식적인 역할에 그치는 경우가 대부분이다. 본 증례는 원위부 림프절 전이가 있어서 수술적 절제가 불가능한 담낭암 환자에서 gemcitabine과 cisplatin을 병합한 전신항암화학요법으로 여섯 주기 치료 후 부분 관해를 얻어서 확대 담낭절제술이 가능하였던 증례로 매우 드문 증례를 경험하였기에 보고하는 바이다. 담낭암에서 수술 전 항암화학요법의 효과는 아직까지 확립되어 있지 않으나, 최근 양호한 종양 반응률과 종양 억제율을 보이는 항암화학요법이 개발됨에 따라서 그 가능성이 기대되고 있다.

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북방전복, Haliotis discus hannai 에 대한 Bacillus amyloliquefaciens의 probiotic 효과 (Potential use of Bacillus amyloliquefaciens as a probiotic bacterium in abalone culture)

  • 박진영;김위식;김흥윤;김은희
    • 한국어병학회지
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    • 제29권1호
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    • pp.35-43
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    • 2016
  • 전복의 면역, 생리 및 생태에 관한 기초 연구는 매우 부족하며 전복 질병에 관한 연구 또한 어류에 비하여 극히 취약한 상태이다. 외국의 경우 전복 치패에서 vibrios로 인한 피해 사례가 많이 보고되어 있으나 우리나라에서는 세균성 질병으로 인한 전복 폐사에 관한 보고가 드물다. 그러나 폐사체로부터 vibrios가 높은 빈도로 분리되고 있어 이들 Vibrio속 세균과 전복 폐사와의 관련성에 대한 검토가 필요하다. 현재 전복 양식 현장에서는 질병으로 인한 피해를 최소화하기 위해 항균제를 사용하고 있지만 치료 효과는 미미한 수준이다. 이에 대한 대책으로 probiotics에 대한 요구가 증가하고 있어 본 연구에서는 인체에 위해하지 않은 균을 분리하여 전복 probiotics로서의 개발 가능성을 알아보았다. 잘 숙성된 김치액에서 분리된 균들 중 다양한 vibrios에 대하여 항균력을 나타낸 KC16-2을 candidate probiotic 균으로 선발하였다. KC16-2는 생화학적 특성과 16S rRNA gene sequence에 근거하여 Bacillus amyloliquefaciens로 동정되었다 (B. amyloliquefaciens KC16-2). B. amyloliquefaciens KC16-2는 in vitro 실험에서 병원성 비브리오에 대하여 광범위한 생장 억제 효과를 보였으며, 온도 $15{\sim}25^{\circ}C$의 해수에서 4일까지 일정수를 유지하였으므로 겨울 이외의 기간에는 사용이 가능하다고 판단되었다. 또한 담즙에 의해 생장이 억제되었으나 시간 경과에 따라 처음 투여 농도보다 증가하는 양상이 관찰되어 담즙이 있는 곳에서도 생존 가능하다고 판단되었다. 시판 사료에 KC16-2를 혼합하여 12주간 전복에 투여하였을 때 대조구에 비해 다소 좋은 성장을 보였으나 통계학적으로 유의한 차이는 없었다. 한편 전복에 병원성을 가진 Vibrio tubiashii의 인위감염실험에서 probiotic사료를 공급한 수조에서 폐사율을 약 50% 감소시키는 결과를 나타냄으로써 기회성 vibrios로 인한 전복의 폐사를 줄이기 위하여 KC16-2의 사용이 긍정적으로 검토될 수 있음을 시사하였다.

기능성 소화불량증 환자에서 헬리코박터 파일로리 제균 치료 효과 및 관련 요인: 국내 전향적, 다기관 연구 (Female Gender is a Poor Predictive Factor of Functional Dyspepsia Resolution after Helicobacter pylori Eradication: A Prospective, Multi-center Korean Trial)

  • 김성은;김나영;박선미;김원희;백광호;조윤주;박경식;이주엽;심기남;김광하;이봉은;홍수진;박선영;최석채;오정환;김현진
    • 대한소화기학회지
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    • 제72권6호
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    • pp.286-294
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    • 2018
  • Background/Aims: The predictive factors of functional dyspepsia (FD) remain controversial. Therefore, we sought to investigate symptom responses in FD patients after Helicobacter pylori (H. pylori) eradication and used predictive factor analysis to identify significant factors of FD resolution at one-year after commencing eradication therapy. Methods: This prospective, multi-center clinical trial was performed on 65 FD patients that met Rome III criteria and had H. pylori infection. Symptom responses and factors that predicted poor response were determined by analysis one year after commencing H. pylori eradication therapy. Results: A total of 63 patients completed the one-year follow-up. When an eradication success group (n=60) and an eradication failure group (n=3) were compared with respect to FD response rate at one year, results were as follows; complete response 73.3% and 0.0%, satisfactory response 1.7% and 0.0%, partial response 10.0% and 33.3%, and refractory response 15.0% and 66.7%, respectively (p=0.013). Univariate analysis showed persistent H. pylori infection (p=0.021), female gender (p=0.025), and medication for FD during the study period (p=0.013) were associated with poor FD response at one year. However, age, smoking, alcohol consumption, and underlying disease were not found to affect response. Finally, multivariate analysis showed that female gender (OR, 4.70; 95% CI, 1.17-18.88) was the sole independent risk factor of poor FD response at one year after commencing H. pylori eradication therapy. Conclusions: Female gender was found to predict poor response in FD patients despite H. pylori eradication. Furthermore, successful H. pylori eradication appears to be associated with FD improvement, but the number of non-eradicated patients was too small to conclude.

사무 자동화에 따른 사무직 근로자의 건강과 연관된 자각 증상에 대한 조사연구 (An Investigation on the self-consciousness Symptoms of the Clerical Workers attendant upon Office Automation)

  • 정미화
    • 한국직업건강간호학회지
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    • 제3권호
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    • pp.54-70
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    • 1993
  • According as the automation of clerical work(OA ; Office Automation) develops, the use of VDT(Visual or Video Display Terminal) is increasing suddenly. But, in proportion to the spread of office automation(OA tendency), the self-conciousness syptom attendant upon the work is appearing also (Kim, Jung Tae, Lee, Young Ook, 1990). The apparatuses of office enable the clerical workers to be convenient and perform mass businesses. But, they are increasing the opportunity to be exposed to VDT syndrom, techno stress, computer terminal disease, pain by muscle strain(RSI), bradycausia of noise nature, and electromagnetic waves, etc. which are referred to as the new type of occupational diseases to the workers. It is the real situation that the workers to use VDT is complaining of the physical inconvenience sense in the recent newspaper and literature, it is the point of time that the sydrome to come from VDT use and computer terminal disease, etc. must be classified into the occupational disease(Lee, Kwang Young 1990, Lee, Kyoo Hak 1990, Lee, Won Ho 1991, Lee, Si Young 1991, Lee, Joon 1991, Choi, Young Tae 1991, Heo, Seung Ho 1989). In addition, it is the real situation that the scientifitic study result about the scope that electromagnetic waves has influence on the human body has not been suggested yet, and criticism on the stable exposure permission standard about electromagnetic waves to be emitted from VDT and on the problem in the health about electromagnetic waves is continuing. (IEEE Spectrum, 1990). In addition according to the experience of nursery business of industry field, it is the real situation that the patients who consult complaining of physical and mental inconvenience sence, among the users of apparatus of office automation, are reaching 10% of the patients coming to doctor's room. Therefore, it is necessary to confirm the self-consciousness symptom that the clerical workers complain of multilaterally with the actual state examination about the use of the apparatuses of offices automaton. Thus, this study was tried as th basic data for the cosultation and education for the maintenance and furtherance of the health of workers as the nurse of industry field, by confirming the contents of self-consciousness symptom attendant upon the use of the apparatus for office outomation making the financial institution in which the spparatus for office automation in most frequently used as the subject, and by examining whether there is the difference according to the subject of study, the data were collected, by using the questionnaire method, making 200 workers who consented to the study participation as the subject, among the persons who have spent over 3 months since they used the apparatuses for office automation and didn't receive the treatment in hospital due to the clerical disease for recent 3 years. The period of data collection was from Oct. 9, 1991 to Oct. 12. As for the measurement instrument about the complaint if self-consciousness symptom attendant upon the use of apparatuses fo office automation, the question item on the complaint symptom of health problem attendant upon the treatment of VDT that Kim(1991) developed and on CMI health problem and the question items on the fatigue degree due to industry were used by previous examination to 25 persons. Collected data were analyzed with the statistical method such as percentage, arithmetic mean, Person correlation coeffient, Kai square verfication, t-test, ANOVA, etc. by using SPSS/PC+ program, and the result is as follows : 1. The self-consciousness symptom that the clerical workers complained of most frequetly appeared high in 'My eyes are tired'(99.4%), 'I feel fatigue and weariness'(99.4%), 'I feel that my head is heavy5(90.0%), 'eyesight fell'(88.8%), 'I have a stiff neck'(88.8%), 'I fell pain in the shoulder'(85.0%), 'I feel cold and painful in the eyes'(76.9%), 'I feel the dry sense of eyeball'(76.2%), 'My nerves are edgy, and I an fretful, (75.6%), 'I feel pain in the waist'(73.2%) and 'I fell pain in the back'(72.8%). It emerged that the subject use the apparatuses for office automation complained of self-consciousness symptoms related to visual symptoms and musculoskeletal symptoms. 2. As for the general feature of examination subjects, the result to see the distribution by classifying into sex, age, school career, use career of apparatuses for office automation, skillfulness degree of the use of apparatus for office automation, use hours of the apparatuses for office automation per 1 day, type of business of the apparatus for office automation, rest hours during the use of apparatus for office automation, satifaction degree of business of office automation, and work circumstance, etc. emerged as follows : As for the sex of subjects, the distribution showed that men were 58.8% and women were 41.3%, Age was average 26.9. As the distribution of school career, the distribution showed that4below the graduation of high school' was 58.8%, 'graduation from junior college-university' was 35.0%, and 'over graduate school' was 6.3%. In the question to ask the existence or non-existence of experience of health consultation in connection with the work of office automation, the response that I had the consultation exprience and I feel the necessity emergerd as 90.1% And, the case that the subject who didn't wear the glasses or lens before using the OA apparatus wear glasses or lens after using OA apparatus emerged as 28.3% of whole. As for the existence or non-existence of use career of OA apparatus, the case under 3 years was highest as 52. 7%. As for the skillfulnness degree about the use of apparatus for office automation, most of them are skillful with the fact that 'common' was 44.4%, 'skill' was 42.5%, and 'unskillful' was 13.1% As for the use average hours of the apparatus for office automation per 1 day, the distribution showed that the case under 3-6 hours was 33.1%, the case under 6-9 hours was 28.1%, the case under 3 hours was 30.6%, and the case over 9 hours was 8.1% Main OA business and the use hours for 1 day showed in the order of keeping and retrieval, business of information transmission(162min), business of information transmission(79.3 min), business of document framing(55.5 min), and business of duplication and printing(25.4min). as for the rest during the use of apparatus for affice automation, that I take rest occasion demands the major portion, but that I take after completing the work emerged as 33.8%. Though the subiness gets to be convenient by the use of the apparatus for of office automation, respondents who showed the dissatisfaction about the present OA business emergd high as 78.1%. The work circumstances of each office was good with the fact that the temperature of office was 21.8, noise was average 42.7db, and the illumination was average 364.4 lx, in the light of ANSi/HFS 100 Standard. 3. Sight syptom, musculoskeletal symptom, skin and other symptoms showed the significant difference according to the extent of skillfulness of the apparatus for office automation. All the symptoms exept skin symptom showed the difference according to the use hours of the apparatus for office automation. All the question items exept the sytoms of digestive organs and the rest hours during the apparatus for office automation showed the signicant difference. The question item which showed the signicant difference from the satisfaction degree of present OA business showed the significant difference from all the question item classified into 6 groups. But, age and school career didn't significant difference from the complaint of any self-consciousness symptoms.

    . In conclusion, the self-consciousness symptoms of the subjects to use OA apparatus appeared differently, according to sex distiction, skillfull degree of OA apparatus, use hours of OA apparatus, the rest hours during th use of OA apparatus, and the satiafaction degree of persent business. Therefore, it is necessary that the nurse in the inuctry field must recognize to receive the education about the human technological physical condition which is most proper for te use of OA apparatus and about the proper rest method until they get accustomed to the use of OA apparatus. In addition, the simple exercise relax the tention of muscle due to the repetitive simple movement, and the education for the protection of eyesight are necessary.

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