• 제목/요약/키워드: negative medicine reactions

검색결과 75건 처리시간 0.024초

우유 과민성 장병증(cow's milk-sensitive enteropathy)의 장기 추적관찰 (A Follow-Up Study of Cow's Milk-Sensitive Enteropathy: Clinical Outcome)

  • 송애령;최은진;한창호;정혜리;권영대;황진복
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제4권1호
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    • pp.47-53
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    • 2001
  • 목 적: 우유 과민성 장병증(cow's milk-sensitive enteropathy, CMSE)은 글루텐 과민성 장병증과는 달리 일시적인 질환으로 알려져 있다. CMSE의 장기 추적관찰을 통하여 우유 및 타 음식에 대한 내성 시기, 발현 증상, 알레르기 질환 동반 유무, 가족력 등을 파악하여 환자에 대한 예후설명, 수유방법의 변화시기와 이유식의 이용 등 향후 식이 조절에 대한 지침을 마련하고자 본 연구를 시행하였다. 대상 및 방법: 1992년 3월부터 1997년 3월까지 대구가톨릭대학병원 소아과에서 성장장애와 설사를 주소로 내원하여, 우유 유발 및 제거시험, 소장 생검조직의 형태학적 계측을 통하여 CMSE로 진단받은 후 추적 관찰과 전화 설문이 가능하였던 21명을 대상으로 하였다. 입원당시 연령은 $30.7{\pm}8.8$ (18~47)일, 설문당시는 $43.4{\pm}23.7$ (16~84)개월이였다. 생후 6개월까지는 절대적으로 단백가수 분해물을 수유하게 하였으며, 추후 2개월 간격으로 유발시험을 시행하는 치료 계획서를 작성 이용하였다. 결 과: 1) 우유를 먹여도 내성을 보였던 최종 연령은 $12.6{\pm}3.7$ (6~24)개월이었다. 2) 나이에 적합한 식이 가능한 모든 식품에 내성을 보였던 연령은 $15.5{\pm}3.7$ (10~24)개월이었다. 3) 우유 유발시험에 따라 관찰된 유해반응 19회 중 구토(31%), 설사(31%), 보챔 혹은 기면(21%), 발진(10%), 복부팽만(5%)의 증세를 보였다. 4) 입원당시 혈중 IgE와 우유 RAST에 양성을 보인 5명과 음성을 보였던 16명을 비교하여 우유 및 타 식품에 대한 내성 시기(p>0.05), 타 알레르기 질환의 발현 유무, 알레르기 가족력에서 의미 있는 차이가 관찰되지 않았다. 결 론: CMSE는 2세 이내에 임상적으로 완전한 회복을 보인다. 우유에 대하여 61%에서 1세까지, 전례에서 2세 전까지 내성을 보여 영유아기의 일시적 질환으로 판단된다. 타 식품에 대한 알레르기 발현은 특정 음식보다는 개인에 따른 다양한 음식물에서 발생하며, 전례에서 2세까지 내성을 보인다. 진단 당시 우유 RAST, 혈중 IgE의 상승과 우유 및 타 식품에 대한 내성의 발현 시기와는 무관하다.

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집단 미술치료가 피학대 아동의 우울 및 불안, 자기상에 미치는 영향 -아동학과 미술치료학의 융복합적관점 (An effect of the group art-therapy on abused children's depression, anxiety, self image -Children's Art Therapy Department of complex convergence perspective)

  • 이숙민;송순
    • 디지털융복합연구
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    • 제13권12호
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    • pp.291-301
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    • 2015
  • 본 연구는 피학대 아동을 위한 중재방법으로 미술치료를 실시하였으며 미술치료전문가와 아동학전문가가 공동으로 참여하여 미술활동이 아동 행동에 미치는 영향을 파악하고자 하는 목적에서 시도되었다. 연구대상자는 00시 00그룹 홈 초등학생 4명으로 2013년 9월부터 2014년 8월까지 주 1회 60분간 48회기 적용하였다. 미술치료효과를 분석하기 위해 연구자들은 매 회기마다 치료적 목표와 함께 대상자들의 정서적 반응과 태도 행동들을 기록하였고 행동변화에 대한 타당도검증을 위해 CDI, TAIC, SAIC, 자아상척도 검사를 실시하였다. 척도는 사전측정(2013년 9월)과 사후측정(2014년8월)하였다. 척도의 신뢰도검사를 위해 SPSS 21.0프로그램을 사용하였다. 연구문제에 대한 결과는 다음과 같다. 첫째, 학대받은 아동들은 작품에서 그들의 정서상태를 표현했고 행동이 변화하였고 친구관계가 향상되었다. 둘째, CDI, STAIC(TAIC, SAIC)서 우울과 불안에 대한 사후검사결과가 사전 검사결과보다 낮았다. 셋째, 자아상 검사결과 사후검사결과가 사전검사결과보다 높았다. 즉 아동들은 충동적 행동이 감소했고 가족, 친구들과 우호적 관계를 유지하였다. 위탁양육자는 아동들을 잘 이해할 수 있었고 그래서 양육의 어려움이 감소하였다.

허혈양상화와 KATP 통로가 허혈후 재관류된 흰쥐의 골격근육에서 SOD 활성 및 apoptosis에 미치는 영향 (Effects of ischemic preconditioning, KATP channel on the SOD activation and apoptosis in ischemic reperfused skeletal muscle of rat)

  • 안동춘;백두진;양홍현
    • 대한수의학회지
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    • 제39권5호
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    • pp.878-895
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    • 1999
  • Ischemic preconditioing (IPC), i.e., a preliminary brief episode of ischemia and reperfusion, has been shown to reduce the cell damage induced by long ischemia and reperfusion. Superoxide radical which is produced during reperfusion after ischemia was recognized as a factor of the ischemic injury and it is dismutated into $H_2O_2$ and $O_2$ by two types of intracellular superoxide dismutase (SOD), Cu,Zn-SOD in cytoplasm and Mn-SOD in mitochondria. Recently oxygen free radicals are suggested to induce the apoptosis, however mechanism of the reduced apoptosis by ischemic preconditioing was unknown, while many studies performed in mammalian heart indicated that ATP-sensitive $K^+$ ($K_{APT}$) channel activation related with the protective effects. The aim of present study is to investigate 1) whether IP upregulate the Cu,Zn-SOD and Mn-SOD activities, and 2) whether ischemic preconditioning decreases apoptosis via $K_{APT}$ channel activation in timely reperfused skeletal muscle after long ishemia. The experimental animals, Sprague-Dawley rats weighing 250~300g, were divided into 8 groups; 1) control group, 2) ischemic preconditioning only groups, 3) pinacidil, a $K_{APT}$ channel opener, treatment only groups, 4) glibenclamide, a $K_{APT}$ channel blocker, treatment only groups, 5) ischemia groups, 6) ischemia after IPC groups, 7) ischemia and pinacidil treatment groups, and 8) IP and ischemia after glibenclamide pretreatment groups. Animals of the control group were administered with the vehicle (DMSO) alone. Pinacidil (1mg/kg) was administered intravenously 5 minutes after initiation of ischemia, and glibenclamide (0.5mg/kg) was injected intravenously 20 minutes before IPC. In rats that were ischemic preconditioned, the left common iliac artery was occluded for 5 minutes followed by 5 minutes of reperfusion by three times using vascular clamp. Ischemia was done by occlusion of the same artery for 4 hours. The specimens of left rectus femoris muscle were obtained immediately (0 hour), 12 hours, 24 hours after drug administrations, IP or ischemia and reperfusion. The immunoreactivities of SOD and its alterations were observed by use of sheep antihuman Cu,Zn-SOD and Mn-SOD antibodies on the $10{\mu}m$ cryosections. The incidencies of apoptosis were observed by TUNEL methods with in situ apoptosis detection kit on $6{\mu}m$ paraffine section. The results obtained were as follows : 1. After IPC, immunoreactivities of Cu,Zn-SOD mainly in the small-sized fibers were increased by 24 hours, that of Mn-SOD at 0 hour and 24 hours. 2. No significant changes in immunoreactivities of SOD was observed in the pinacidil and in the glibenclamide treatment only groups, and in the ischemia only groups. 3. The immunoreactivities of the Cu,Zn-SOD were increased in the ischemia after IPC groups and the ischemia and pinacidil treatment groups. 4. The immunoreactivities of the Cu,Zn-SOD in the IPC and ischemia after glibenclamide pretreatment groups were not increased except for the 12 hours reperfusion group. But, Mn-SOD immunoreactivities were increased in the 0 hours, 12 hours and 24 hours after reperfusion. 5. In the control group, the IPC only groups, and the pinacidil treatment only groups, negative or trace apoptotic reactions were observed, but the positive apoptotic reaction occured in the glibenclamide treatment groups. 6. Moderate or many number of apoptosis were revealed in the ischemia groups, and also the IPC and ischemia after glibenclamide pretreatment group except for 12 hours and 24 hours after reperfusion. However, the incidence of apoptosis was decreased in the ischemia after IPC groups and in the ischemia and pinacidil treatment groups. 7. There is a coincidence between the increase of Cu,Zn-SOD immunoreactivities and the decrease of apoptosis in the presence of ischemia and reperfusion. These results suggest that the protective effects of ishemic preconditioing may related to the SOD activation, and the ischemic preconditioning decreases the apoptosis partially via $K_{APT}$ channel activation in timely reperfused rat skeletal muscle. It is also suggested that inhibition of apoptosis by IPC may related with the SOD activation.

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간흡충 피내반응 양성자에 대한 Agar-gel Diffusion, Counterimmunoelectrophoresis 및 Enzyme-Linked Immunosorbent Assay의 비교 (Comparison of Agar-gel Diffusion Test, Counterimmunoelectrophoresis and Enzyme-Linked Immunosorbent Assay in the sera of skin teat positives for paragonimiasis)

  • 이옥란;최원영
    • Parasites, Hosts and Diseases
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    • 제21권2호
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    • pp.270-280
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    • 1983
  • 임상적으로 폐흡충증이 의심되나 충란검출이 안되었던 155예(3예는 충란발견)의 피내반응 양성례에 대하여 Agar-gel Diffusion (AGD)반응, Counterimmunoelectro-phoresis(CIEP)반응 및 Enzyme-Linked Immunosorbent Assay(ELISA)를 실시하여 이들사이의 상관관계를 검토하였다. AGD 반응과 CIEP 반응은 폐흡충친항원원액(단백농도 7.56mg1m1)과 혈청원연을 사용하였고 ELISA반응에서는 상기 조항원의 40,000배 희석항원을, 그리고 혈청은 100배 및 200배 희석혈청을 사용하였다. 1. AGD 반응과 CIEP 사이의 양성반응의 일치률은 98%이었고 융성반응의 일치률은 100%이었다. 침강대는 AGD 반응에서 1∼3개가 흔히 관찰되었고 CIEP 반응에서는 1∼7개가 관찰되었으며 염색강도도 후자에서 일부의 피검혈청에서 강하게 나타났다. 2. AGD 반응과 ELISA 반응은 사성반응에서는 100배 희석혈청에서 96%, 그리고 200배 희석혈청에서 94%의 일치률을 나타내었고, 음성반응에서는 100석 희석혈청 및 200배 회석혈청에서 각각 97%와 99%의 일치율을 나타내었다. 3. CIEP와 ELISA 반응은 양성반응에서 100배 희석혈청에서는 98%, 200배 희석혈청에서는 96%의 일치률을 나타내었고 융성반응에서는 100배 희석혈청에서 97%, 200배 희석혈청에서 99%의 일치률을 나타내었다. 4. 대조혈청인 간흡충감염 혈청, 아메바감염 혈청 및 Toxoplaima형광항체반응 양성혈청에 대한 AGD 반응, CIEP 및 ELISA 반응은 전례에서 음성이었다. 이상의 결과로 볼 때 반응에 사용된 항원-항혈청의 농도로 보아서는 ELISA 반응의 감수성이 월등히 높았다. 같은 농도의 항원과 혈청을 사용한 AGD와 CIEP 반응에서는 CIEP에서 침강반응의 염색강도가 보다 강하게 나타난 것으로 보아 세가지 반응의 감수성의 높은 순위는 ELISA, CIEP, AGD라고 보여진다. 그러나 본 실험에서 AGD와 CIEP반응에서 ELISA보다 높은 농도의 항원과 항혈청을 사용하였을 때 감수성의 차이는 거의 볼 수 없는 유사한 상관관계의 반응을 나타내었다. 즉 반응방법에 따라 적절한 농도의 항원과 항혈청을 사용한다면 감수성의 차이는 없다고 본다. 세가지 반응의 유효성 으로 볼 때 가장 수기가 간편한 AGD 반응은 조항원을 사용할 때 용이하게 사용할 수 있는 방법이라 생각되며 CIEP는 AGD보다 전기영동장치가 필요한 번거로움이 있으나 보다 조기에 반응 결과를 알 수 있다. 가장 감수성이 예민한 ELISA반응은 항원을 정제하여 소동의 항원으로 다수의 집권집사를 할 수 있는 가장 바람직한 방법이라 생각된다. (본 실험을 수행함에 있어 ELISA 반응을 검사해 주신 연세의대 기생충학교실의 장재경 선생님께 감사드립니다)

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암환자를 위한 호스피스 케어에 관한 탐색적 연구 (An Exploratory Study of Hospice Care to Patients with Advanced Cancer)

  • 박혜자
    • 대한간호
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    • 제28권3호
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    • pp.52-67
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    • 1989
  • True nursing care means total nursing care which includes physical, emotional and spiritual care. The modern nursing care has tendency to focus toward physical care and needs attention toward emotional and spiritual care. The total nursing care is mandatory for patients with terminal cancer and for this purpose, hospice care became emerged. Hospice case originated from the place or shelter for the travellers to Jerusalem in medieval stage. However, the meaning of modem hospice care became changed to total nursing care for dying patients. Modern hospice care has been developed in England, and spreaded to U.S.A. and Canada for the patients with terminal cancer. Nowaday, it became a part of nursing care and the concept of hospice care extended to the palliative care of the cancer patients. Recently, it was introduced to Korea and received attention as model of total nursing care. This study was attempted to assess the efficacy of hospice care. The purpose of this study was to prove a difference in terms of physical, emotional a d spiritual aspect between the group who received hospice care and who didn't receive hospice care. The subject for this study were 113 patients with advanced cancer who were hospitalized in the S different hospitals. 67 patients received hospice care in 4 different hospitals, and 46 patients didn't receive hospice care in another 4 different hospitals. The method of this study was the questionaire which was made through the descriptive study. The descriptive study was made by individual contact with 102 patients cf advanced cancer for 9 months period. The measurement tool for questionaire was made by author through the descriptive study, and included the personal religious orientation obtained from chung(originated R. Fleck) and 5 emotional stages before dying from Kubler Ross. The content ol questionaire consisted in 67 items which included 11 for general characteristics, 10 for related condition with cancer, 13 for wishes far physical therapy, 13 for emotional reactions and 20 for personal religious orientation. Data for this study was collected from Aug. 25 to Oct. 6 by author and 4 other nurse's who received education and training by author for the collection of data. The collected data were ana lysed using descriptive statistics, $X^2-test$, t-test and pearson correlation coefficient. Results of the study were as follows: "H.C Group" means the group of patient with cancer who received hospice care. "Non H.C Group" means the group of patient with cancer who did not receive hospice care. 1. There is a difference between H.C Group and Non H.C Group in term of the number of physical symptoms, subjective degree of pain sensation and pain control, subjective beliefs in physical cure, emotional reaction, help of present emotional and spiritual care from other personal, needs of emotional and spiritual care in future, selection of treatment method by patients and personal religious orientation. 2. The comparison of H.C Group and Non H.C Group 1) There is no difference in wishes for physical therapy between two groups(p=.522). Among Non H.C Group, a group, who didn't receive traditional therapy and herb medicine was higher than a group who received these in degree of belief that the traditional therapy and herb medicine can cure their disease, and this result was higher in comparison to H.C Group(p=.025, p=.050). 2) Non H.C Group was higher than H.C Group in degree of emotional reaction(p=.050). H.C Group was higher than Non H.C Group in denial and acceptant stage among 5 different emotional stages before dying described by Kubler Ross, especially among the patient who had disease more than 13 months(p=.0069, p=.0198). 3) Non H.C Group was higher than H. C Group in demanding more emotional and spiritual care to doctor, nurse, family and pastor(p=. 010). 4) Non H.C Group was higher than H.C Group in demanding more emotional and spiritual care to each individual of doctor, nurse and family (p=.0110, p=.0029, P=. 0053). 5) H.C Group was higher th2.n Non H.C Group in degree of intrinsic behavior orientation and intrinsic belief orientation of personal religious orientation(p=.034, p=.026). 6) In H.C Group and Non H.C Group, the degree of emotional demanding of christians was significantly higher than non christians to doctor, nurse, family and pastor(p=. 000, p=.035). 7) In H.C Group there were significant positive correlations as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and: the degree of intrinsic behavior orientation in personal religious orientation(r=. 5512, p=.000). (2) Between the degree of emotional demandings to doctor, nurse. family & pastor and the degree of intrinsic belief orientation in personal religious orientation(r=.4795, p=.000). (3) Between the degree of intrinsic behavior orientation and the degree of intrinsic: belief orientation in personal religious orientation(r=.8986, p=.000). (4) Between the degree of extrinsic religious orientation and the degree of consensus religious orientation in personal religious orientation (r=. 2640, p=.015). In H.C. Group there were significant negative correlations as following; (1) Between the degree of intrinsic behavior orientation and extrinsic religious orientation in personal religious orientation (r=-.4218, p=.000). (2) Between the degree or intrinsic behavior orientation and consensus religious orientation in personal religious orientation(r=-. 4597, p=.000). (3) Between the degree of intrinsic belief orientations and the degree of extrinsic religious orientation in personal religious orientation(r=-.4388, p=.000). (4) Between the degree of intrinsic belief orientation and the degree of consensus religious orientation in personal religious orientation(r=-. 5424, p=.000). 8) In Non H.C Group there were significant positive correlation as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of intrinsic behavior orientation in personal religious orientation(r= .3566, p=.007). (2) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of intrinsic belief orientation in personal religious orientation(r=.3430, p=.010). (3) Between the degree of intrinsic behavior orientation and the degree of intrinsic belief orientation in personal religious orientation(r=.9723, p=.000). In Non H.C Group there were significant negative correlation as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of extrinsic religious orientation in personal religious orientation(r= -.2862, p=.027). (2) Between the degree of intrinsic behavior orientation and the degree of extrinsic religious orientation in personal religious orientation(r=-. 5083, p=.000). (3) Between the degree of intrinsic belief orientation and the degree of extrinsic religious orientation in personal religious orientation(r=-. 5013, p=.000). In conclusion above datas suggest that hospice care provide effective total nursing care for the patients with terminal cancer, and hospice care is mandatory in all medical institutions.

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