• Title/Summary/Keyword: otitis media

검색결과 188건 처리시간 0.029초

알레르기성 비염 환자에 대한 임상적 고찰 - 외치요법(吹鼻法)을 응용하여 - (A Clinical study of Allergic Rhinitis (treated with aroma-therapy))

  • 신진욱;김남권
    • 대한한의학회지
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    • 제21권4호
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    • pp.174-182
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    • 2000
  • Objectives : In order to apply herbal medicine to aroma-therapy, we observed clinically remedical effect for allergic rhinitis of aroma-therapy using herbal medicine. Methods : Twenty-four allergic rhinitis patients were treated in the Kun-po Oriental Medical Hospital of Wonkwang University from September 2000 to October 2000. They were treated with aroma-therapy and analyzed clinically. Results : 1. 25.0% (6 cases) of all cases involved pre-teenagers; teenagers 29.2% (7 cases); patients in their 20s, 20.8% (5 cases); patients in their 30s, 12.5% (3 cases); patients in their 40s, 8.3% (2 cases); patients in their 50s, 4.2% (1 cases). 2. The ratio of male to female patients was 58.3%(14 cases) to 41.7%(10 cases). 3. Cases involving patients under the age of six months was 0%; under 1 year 12.5% (3 cases); under 2 years 33.3%(8 cases); under 3 years 16.7%(4 cases); over 3 years 37.5%(9 cases). 4. Past history : The cases of sinusitis were 33.3%(8 cases); otitis media 20.8%(5 cases), bronchitis 16.7%(4 cases), atopic dermatitis 12.5%(3 cases), asthma 8.3%(2 cases). 5. The ratio of allergic onset based on seasons were : spring 16.7%(4 cases), summer 0%, fall 29.2%(7 cases), winter 16.7%(4 cases), and not defined 37.5%(9 cases). 6. The cases of nasal obstruction was 91.7%(22 cases); followed by : sneezing 83.3(20 cases), white rhinorrhea 70.8%(17 cases), eye itching 66.7%(16 cases), nasal itching 58.3%(14 cases), rhinalgia 58.3%(14 cases), postnasal drip 50.0%(12 cases), headache 41.7%(10 cases), yellow rhinorrhea 33.3%(8 cases), cough 33.3%(8 cases), fatigue 29.2%(7 cases). 7. The cases of familial factor was 66.7%(16 cases); the non-familial factor 33.3%(8 cases). 8. The remedical effect of the treatment showed an improvement in 58.4% of the total cases studied. 9. The improvement-rate of the 1st group (mahwang group) was 66.7%; of the 2nd group (hwangkum group) 48.5%, and of the 3rd group (pine group) 55.8%. Conclusions : Considering the above results, we have concluded that the remedical effect for allergic rhinitis of aroma-therapy using herbal medicine showed to be intentional in comparison with aroma-therapy using aroma-oil.

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개의 전이도적출술 중 전기지혈에 의해 발생한 삼차신경심장반사 1례 (Trigeminocardiac Reflex Induced by Electrohemostasis during Total Ear Canal Ablation in a Dog)

  • 조상민;손원균;장민;김완희;이병천;이인형
    • 한국임상수의학회지
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    • 제33권4호
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    • pp.234-236
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    • 2016
  • A 14 kg, 9-year-old, spayed female, Cocker Spaniel was presented to the Veterinary Medical Teaching Hospital of Seoul National University with a history of head tilt and circling. Otitis externa and media were diagnosed by computerized tomography, and total ear canal ablation was performed. In preanesthetic evaluation, systemic hypertension and second-degree atrioventricular block were observed, but there was no regurgitation through the heart valves. Systemic hypertension was managed with amlodipine (0.1 mg/kg, PO, BID) for the anesthesia. The dog was premedicated with cefazolin (22 mg/kg, IV) and midazolam (0.2 mg/kg, IV). Anesthesia was induced with alfaxalone (2 mg/kg, IV) and maintained with isoflurane and 100% oxygen following intubation. During surgery, vital signs (heart rate, respiratory rate, blood pressure, end tidal carbon dioxide partial pressure and body temperature) were maintained within normal ranges, but bradycardia was observed and corrected with glycopyrrolate (5 ug/kg IV, twice). During subcuticular suture, electrohemostasis was applied at the incision line, which was close to the trigeminal nerve. In no time at all, heart rate dramatically decreased from 110 to 60 beats per minute. No additional treatment was done because mean blood pressure was maintained above 70 mmHg. The heart rate recovered according to the decrease of end tidal isoflurane concentration and there were no complications associated with the anesthesia and surgery. Sudden bradycardia after electrical stimulation around the trigeminal nerve was considered as trigeminocardiac reflex (TCR). It is recommended to be careful of bradycardia from TCR when electrocautery is used in the craniofacial area during surgery.

Wolf-Hirschhorn syndrome 환아의 치과 치료 치험례 (Dental Treatment of a Wolf-Hirschhorn Syndrome Patient: A Case Report)

  • 김미애;박지현;마연주
    • 대한소아치과학회지
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    • 제43권3호
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    • pp.313-319
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    • 2016
  • Wolf-Hirschhorn syndrome (WHS)은 4번 염색체 단완의 결실로 발생하며, 지능 및 성장 발달의 저하, 경련, 선천성 심기형과 특징적인 두개안면기형 등을 초래하는 질환이다. 사이가 넓고 돌출된 미간과 코의 기저부가 넓은 특징을 보이는 얼굴 모양은 그리스 전사의 투구(Greek warrior helmet appearance) 와 비슷한 모양을 보인다. 구강 내에서는 구순열, 우상치아, 원뿔형 치관, 다수의 결손치와 이로 인한 만기 잔존 유치 등의 소견을 보인다. 본 증례는 충치치료를 주소로 내원한 9세 여환으로 타병원에서 WHS으로 진단받았으며, 성장 지연, 정신 박약 및 WHS의 특징적인 얼굴 형태를 보였다. 구강 검사를 통해 다수의 영구치 결손과 만기 잔존된 유치 및 다수의 충치를 관찰하였으며, 환자의 협조도 미약으로 전신마취 하에 충치치료 하였다. 다수의 영구치 결손으로 현재 맹출한 영구치 및 유치의 관리가 중요하고, 이를 위해서는 구강 위생 관리 및 불소도포를 위해 주기적인 치과 검진이 필요하다.

건강보험청구자료를 이용한 외래 급성 호흡기계 질환 방문과 항생제 처방률 변화 분석 (The Trend of Acute Respiratory Tract Infections and Antibiotic Prescription Rates in Outpatient Settings using Health Insurance Data)

  • 김지애;박주희;김보연;김동숙
    • 한국임상약학회지
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    • 제27권3호
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    • pp.186-194
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    • 2017
  • Objectives: A significant concern has been raised about the emerging resistance that is largely caused by the excessive or inappropriate use of antibacterial agents for viral respiratory infections. This study investigated the trend of respiratory tract infections (RTIs) and the use of antibiotics. Methods: Utilizing the national level health insurance claims data from 2005 to 2008, we examined encounter days, antibiotic use, and the prescription rate for respiratory tract infections including upper respiratory tract infections (URTIs), lower respiratory tract infections (LRTIs), and otitis media in outpatient settings. The antibiotic use was measured as defined daily dose per 1,000 patients per day (DDD/1,000 patients/day). Results: The visit for URTI increased from 141,693,465 in 2005 to 120,717,966 in 2008 and the visit for LRTI decreased from 61,778,718 to 66,930,122. For RTIs, prescription rates of antibiotics decreased from 65.2% to 58.5% for URTIs and 76.9% to 68.3% for LRTIs from 2005 to 2008. The antibiotic use decreased to 20.85 DDD/1,000 patients/day after a significant increase of 22.01 DDD/1,000 patients/day in 2006. Among antibiotics, J01CR had the highest use- 7.93 DDD/1,000 patients/day followed by J01DC of 3.71 DDD/1,000 patients/day and J01FA of 3.2 DDD/1,000 patients/day. One notable trend is that J01FA presented a continuous increase in antibiotic use from 2.3 in 2005 to 3.26 DDD/1,000 patients/day in 2008. Conclusion: The use of antibiotics had poor compliance to guidelines for RTIs. Despite decrease in the use of antibiotics, prescription rates for URTIs were still about 50% indicating that the delayed prescribing antibiotics (or wait-and-see) were not observed.

폐구균에 의한 괴사성 폐렴 후 합병한 비전형적 용혈성 요독 증후군 1례 (A Case of Hemolytic Uremic Syndrome Complicated by Pneumococcal Necrotizing Pneumonia)

  • 조은영;최영준;이선희;조희연;이진아;최은화;하일수;정해일;이환종;최용
    • Pediatric Infection and Vaccine
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    • 제15권2호
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    • pp.206-211
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    • 2008
  • 소아 연령에서 침습성 질환의 가장 흔한 원인균인 폐구균은 드물게 용혈성 요독 증후군을 일으키는 원인이 되기도 하며, 심한 폐렴을 일으키는 경우 농흉이나 괴사성 폐렴을 합병하기도 한다. 저자들은 33개월 여자가 폐렴 및 흉막 삼출로 내원하여 용혈성 요독 증후군으로 진행하였고, 급성 호흡곤란증후군 및 괴사성 폐렴이 합병되었으며, 혈액 및 흉수배양검사상 혈청형 19A의 폐구균 감염이 확인된 1례를 경험하였다. 환아는 항생제, 복막투석과 인공호흡기 적용등의 치료를 받았으며, 약 2개월 간의 입원치료 후 신기능이 정상화되어 퇴원하였고, 5년간의 외래 추적관찰 결과 신장 계통의 합병증 및 폐기능의 이상 소견 없이 완전히 회복되었기에 보고하는 바이다.

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말초성 안면마비 입원환자 250례에 대한 임상적 고찰 (A Clinical Analysis on 250 cases of Inpatients with Facial Paralysis)

  • 강나루;탁명림;변석미;고우신;윤화정
    • 한방안이비인후피부과학회지
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    • 제23권3호
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    • pp.109-121
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    • 2010
  • Objectives : This study was performed to analysis the effect of oriental medical care for inpatients with facial paralysis that had visited Dept. of Otolaryngology Oriental medical hospital Dong-eui university. Methods : From January 2008 to September 2010, a clinical study was done on 250 inpatients who were treated as facial nerve paralysis at the Dept. of Otolaryngology Oriental medical hospital Dong-eui university. This study was assessed using the chart analysis. Results : 1. The distribution of sex : female 54.8%, male 45.2%. The distribution of age was pregented that fifty to sixty was the most in 67 cases(26.8%). 2. The distribution of the period of admission : female 12.5 days, male 9.9 days. 3. The distribution of past history : hypertention(18.8%), diabetes-mellitus(10.85%), facial paralysis(9.25%), cerebrovascular disease(4.4%), liver disease(5.6%), hyperlipidemia(1.2%), otitis media(1.2%), herpes zoster(1.2%), cardiac disease(2.45%), thyroid disease(1.2%). 4. The distribution of the region of facial paralysis : Rt(55.36%), Lt(56.52%). 5. Check the mastoid pain : 66.8%(female 73.91%, male 58.04%). 6. Out of prescription(Ko-Bang, 古方), Galgeun-Tang(葛根湯) and Gaejigeogaegayoungchul-Tang was used most in each 34 cases, Daesiho-Tang(大柴胡湯) 30 cases, Galgeungabanha-Tang(葛根加半夏湯) 27 cases, Sihogaeji-Tang(柴胡桂枝湯) 14 cases, Hwanggigaejiomul-Tang 12 cases, Odu-Tang(烏頭湯) 10 cases, Chijadaehwangsi-Tang 10 cases, Gaejigagalgeun-Tang(桂枝加葛根湯) 7 cases, Banhasasim-Tang(半夏瀉心湯) 5 cases, Injinho-Tang(茵蔯蒿湯) 5 cases in order. 7. The distribution of herb group : Mahwang-Jae(麻黃劑) 31.72%, Gaeji-Jae(桂枝劑) 26.00%, Siho-Gae(柴胡劑) 20.70%, Chija-Gae(梔子劑) 7.49%, Buja-Jae(附子劑) 4.41%, Banhahwanggeum-Gae(半夏黃芩劑) 3.08%, Daehwang-Gae(大黃劑) 2.64%, Bockryeong-Gae(茯笭劑) 1.76%, Jisil-Gae(枳實劑) 1.32%, Insam-Gae(人蔘劑) 0.88% in order. 8. The distribution of House-Brackmann grade of admission : Gr Ⅳ 74.85%, Gr.III 13.6%, Gr.V 11.6% in order. 9. The distribution of House-Brackmann grade of discharge : Gr.III 56%, Gr.IV 38.4%, Gr.II 5.6% in order. 10. The average number of OPD follow up is 6.46. Conclusion : This results indicated that oriental medical treatment with Ko-bang(古方) can be an effective way to treat facial paralysis. The more patients we treat with Ko-bang(古方), the more clinical report is accumulated. Then it would be helpful to map out a systematic treatment on facial paralysis.

만성 중이염의 수술시 소견에 대한 임상통계적 관찰 (CLINICOSTATISTICAL ANALYSIS OF SURGICAL FINDINGS IN CHRONIC OTITIS MEDIA)

  • 최덕주;전병훈;민원식;함태영
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1987년도 제21차 학술대회 연제순서 및 초록
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    • pp.6-6
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    • 1987
  • 만성중이염은 현재 그 빈도가 줄어드는 추세에 있으나 아직도 이과 영역에서 큰 비중을 차지하는 질환이다. 또한 청력개선, 정상구조의 보존, 병변 제거의 목적을 위하여 대부분 수술적 요법이 필요하게 된다. 이에 저자들은 본 병원에서 시행한 만성 중이염 451예, 남자 238예, 여자 213예. 진주종성 중이염 170예, 비진주종성 중이염 273예에 대한 수술시 소견에 대한 임상 통계적 관찰을 한 바, 다음과 같은 결과를 얻었다. 1) 관찰대상을 술식별로 분류하면 진주종성 중이염과 비진주종성 중이염의 비가 $\circled1$ Myningoplasty ; 19.1% : 0%, $\circled2$ Tympanoplasty without mastoidectomy ; 34.5% : 14.4%, $\circled3$ Tympanoplasty with mastoidectomy ; 3.0% :12.1% 이었다. 2) 고막천공부위는, 진주종성 중이염과 비진주종성 중이염의 비가 변연부천공이 10.1% : 5.5%, 상고실천공이 38.8% : 1.4%, 중심부천증이 12.9% : 47.3%, 전천공이 32.5% : 39.6%, 고막유착이 5.6% : 6.2% 을 보였다. 3) 이소골의 상태는 진주종성중이염과 비진주종성 중이염의 비가, 모든 이소골의 손실은 26.6% : 4.3%, 모든 이소골이 정상에 가까운 예는 16.6% : 69.3%, 가장 병변이 심했던 침골 이상은 76.9% : 24.8% 를 보였다. 4) 중이강 점막소견은 진주종성 중이염과 비진주종성 중이염의 비가, 정상에 가까운 예가 16.7% : 47.0%, 병적 소견을 보인 예가 83.3% : 53.0% 이었다. 5) 진주종성 중이염과, 비진주종성 중이염에서의 안면신경관노출은 2.2% : 0.3%, 뇌막노출은 9.5% : 2.9%, 횡정맥동노출은 5.0% : 1.1%, 미로누공은 1.7% : 0% 이었다.lant, engineering service business can be said "The Software of Total Industry." Engineering service is what is called a higher business which offers specialized engineering know-how and experience. Engineering service compaines offer Its specialized knowledge and experience to government, industry and commerce. Whether the task is to modernize plant equipment, to design a building or to manage construction, an engineering company will develop and implement the most appropriate and cost effective solution. Clients use the engineering service of firm knowing that the engineer′s professional judgement is not influenced or biased by other commercial affiliations. While benefiting from the diverse experience that professional engineers can apply to a specific problem, government and industry also reduce the need for permanent in-house engineering staff. Engineering firms may be specialized or multi-disciplinary.도말표본에서와 같이 제 14 일 이전에는 호중구가, 그 이후에는 단핵구가 주종을 이루었다.>18.9dB

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荊芥連翹湯加味가 알레르기性 鼻炎에 미치는 效能에 대한 臨床報告 (Clinical Study on 340 Cases of Allergic rhinitis)

  • 송영림;김희택;노석선
    • 한방안이비인후피부과학회지
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    • 제8권1호
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    • pp.163-176
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    • 1995
  • The cilinical study was done in 340 patients with allergic rhinitis who had been dosed with HYUNG GAE YUN GYO TANG GAMI. The results were summarized as follows 1. Distridution by Sex and Age $64\%\;of\;them\;were\;man,\;and\;36\%$ of them were women(It was common to men than to women) Of those who were attacted(very diverse), $25.0\%$ of them were between 10 and 19 years of age(most frequent), $23.8\%$ were between 30 and 39, $18.2\%$ between 20 and 29, $14.1\%$ between birth and 9, $12.6\%$ between 40 and 49, and $6.2\%$ of them were 50 years and over. 2. Duration $47.6\%$ of them suffered from this disease for 1 to 5 years, $13.8\%$ for 10 years or longer, $24.1\%$ for both 5 to 10 years and $7.4\%$ for 6 months to 1 years, and $6.5\%$ shorter than 6 months. 3. Symptom that appeared to them were nasal obstruction($91.5\%$,top), sneezing($90\%$), rhinorrhagir($77.4\%$), headache ($30.9\%$), itch($26.8\%$), nasal discharge through gullet($15.3\%$), and pharyngitis($15.3\%$). 4. Other diseases that occured with it were sinusitis(most often), Atopic keratoconjunctivitis, allergic dermatitis, asthma, otitis media, tonsillitis, hepertropic rhinitis, nasal polyp, and atropic rhinitis(most unusual). 5. Time and Improvement After 6 months 2 cases($20\%$) were improved excellently, 3 cases($30\%$) considerablely, after 6 months to 1 year 5 case($38.5\%$) considerably, after 1 year to 5 year 10 cases($13\%$) excellently, 20 cases ($26\%$) considerably, after 5 year to 10 years 4 cases($8.7\%$) excellently, 13 cases($28.3\%$) considerable, and after 10 years 2 cases($10\%$) improved excellently, 2 cases($10\%$) considerab. 6. Dosage and Improvemont With 10 papers 6 cases($7.8\%$) were improved excellently, 22 cases($27.8\%$) considerably, with 20 papers 4 cases($10.3\%$) were improved excellently, 6 cases($15.4\%$) considerably, with 30 papers 3 cases($15.8\%$) excellently, 2 ($10.5\%$) considerably, with 40 papers 3 cases($23.1\%$) excellently, 5($38.5\%$) considerably, with 50 papers 1 cases($10\%$) excellently, 4($40\%$) considerably, with 60and 70 papers one cases($33.3\%,\;100\%$) for each was improved considerable, with 80 papers 1 cases($100\%$) excellently, and 90 papers 2 cases($66.6\%$) considerable. 7. Improvement with additional outward application With external application 8 cases($16.6\%$) were improved excellently, 9 cases($18.7\%$) considerably without external application 10 cases($8.4\%$) were improved excellently, 34 cases($28.8\%$) considerably. 8. General Improvement 18 cases($10.8\%$) were improved excellently, 43 cases($25.9\%$) improved considerably, and 40 cases($24.0\%$) improved quite a little.thus has improvement shown in 60.8 per cent of case, and proved its efficacy.

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서울 지역 소아의 구인강에서 폐구균 보균율과 항균제 내성 (Oropharyngeal Carriage and Antimicrobial Resistance of S. pneumoniae in Children of Seoul)

  • 김영기;이창규
    • Pediatric Infection and Vaccine
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    • 제4권2호
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    • pp.218-224
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    • 1997
  • 목 적 : 전 세계적으로 폐구균의 항균제 내성이 증가하고 있고, 우리 나라의 경우 그 어느 나라보다 급속한 폐구균 내성의 증가가 보고 되고 있다. 일반적으로 상기도에 정착되어 있던 폐구균은 부비동염, 중이염, 수막염, 폐렴들을 일으키는 것으로 알려져 있어 저자들은 정상 소아의 구인강에서 폐구균의 보균율을 알아보고 이들의 항균제 내성양상과 DNA분자 형별을 조사하였다. 방 법 : 1997년 4월 서울 한 유치원의 어린이 117명에서 구인강 점막을 면봉으로 도말하여 검체를 얻었다. 이들을 배양후 optochin검사와 capsule에 대한 다가항체를 이용하여 Latex 방법으로 폐구균을 동정하였고, 디스크확산법으로 페니실린, vancomycin, erythromycin, TMP-SMZ에 대한 감수 검사를 시행하였다. 분리된 폐구균에 대하여 액체배지 미량 희석법을 이용하여 페니실린의 MIC값을 구하였다. 또 분리된 폐구균들에 대하여 REP1R-Dt와 REP2-Dt primer를 사용한 rep-PCR법으로 DNA 분자 형별을 시행하였다. 결 과 : 서울지역의 유치원에서 폐구균 보유율은 38%(45/117)였고, 디스크 확산법에 의한 페니실린 내성 폐구균의 비율은 89%(40/45)였고, erythromycin은 91%, TMP/SMZ은 63%였고 vancomycin에는 모두 감수성을 보였다. 그리고 페니실린에 고도 내성균주는 21예로 전체의 47%를 차지하였고 다제내성 폐구균은 64%였다. DNA 분자형은 7가지로 분류할 수 있었고, 이중 3가지 유형이 전체의 78%를 차지하였다. 결 론 : 서울 지역의 건강한 유치원 어린이들이 보유하고 있는 폐구균의 항균제 내성이 예상보다 훨씬 높았고, 이는 이들 어린이들이 빈번한 항균제 노출과 유치원의 밀집환경의 때문이라 추정된다.

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소아 Mycoplasma Pneumoniae 폐렴의 임상적 고찰 (A Clinical Study of Mycoplasma Pneumoniae Pneumonia)

  • 강미화;전진곤
    • Journal of Yeungnam Medical Science
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    • 제6권1호
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    • pp.21-29
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    • 1989
  • 1986년 3월부터 1989년 2월까지 영남대학병원 소아과에 폐렴으로 진단받고 입원한 315명 중 M. pneumoniae에 의한 폐렴으로 진단된 환아 71명을 대상으로 임상적 고찰 결과 다음과 같은 결론을 얻었다. 1. M. pneumoniae에 의한 폐렴은 전체 폐렴 환아중 22.5%에 해당하였으며, 그 중 5-9세 사이가 31.7%로 가장 많았다. 또한 M. pneumoniae에 의한 폐렴의 연령별로는 5-9세 사이가 53.5%로 가장 많았다. 2. 월별 분포는 10월에서 1월 사이가 59.2%로 늦가을 및 겨울에 높은 발생빈도를 보였다. 3. 성별 발생빈도는 1.3대 1로 남아에서 다소 높았다. 4. 임상 증상으로는 기침이 98.6%로 가장 많았으며 발열 49.3%, 콧물 19.7% 동의 빈도를 보였으며 입원전 기침을 한 기간은 개개 21주 이내였다. 5. 이학적 소견으로는 수포음이 95.7%로 가장 많았으며 인후발적이 43.7%, 천명음이 18.3%에서 나타났다. 6. 혈액 검사상 백혈구 수는 47.9%에서 정상 범위였으며 혈구 침강 속도(57.7%) 및 CRP 양성(87.3%)이 많았다. 7. 방사선 소견상 간질성 폐렴과 소엽성 폐렴이 각각 45.5%, 39.4%로 대부분을 차지하고, 대엽성 폐렴이 15.5%였고, 늑막 삼출이 5.6%에서 나타났다. 8. 동반질환 또는 합병증으로는 중이염 4례(5.6%), 간염 3례(4.2%), 급성사구체 신염, 기관지 천식, 부비동염이 각각 2례(2.8%)에서 동반되었고 1례에서는 혈소판 감소증이 있었다.

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