• 한국임상수의학회지
• /
• 제27권2호
• /
• pp.136-141
• /
• 2010

개에서 Medetomidine (MED)과 tiletamine/zolazepam (ZT) 병용마취시에 통증자극에 대한 반응으로 판단되는 외과적 마취기에 적절한 진통효과가 나타나는지를 확인하기 위해 뇌파를 이용하여 실험을 실시하였다. 임상적으로 건강한 비글견 7두를 이용하여 동일견을 대조군과 통증자극군에 이용하였다, 대조군은 MED $30\;{\mu}g/kg$ 투여 후 15분에 ZT 10 mg/kg을 각각 근육주사하였으며, 통증자극군은 대조군과 동일한 방법으로 약물을 투여한 다음 ZT 투여 후 10분부터 45분까지 5분 간격으로 pedal withdrawal reflex test를 실시하였다. 각각의 기록시간대에서 뇌파의 band power,평균동맥혈압과 심박수를 측정하여 실험군간 비교하였다. 뇌파 기록전극은 International 10-20 system을 이용하여 Cz에, 기준전극과 접지전극은 양쪽 귀에 장착하였다. 뇌파 분석상 저주파 band가 높은 power를 보이고 고주파 band가 낮은 power를 나타냈으나 군간 유의성 있는 차이는 발견할 수 없었다. 평균 동맥혈압과 심박수는 TZ 투여 10분 후 두 군 모두 상승하였으나 군간 유의성은 없었다. 본 실험 결과, 개에서 MED와 ZT 병용마취는 외과적 마취기에 우수한 진통효과를 제공하는 것으로 사료된다.

• Journal of Korean Neurosurgical Society
• /
• 제29권2호
• /
• pp.240-248
• /
• 2000

Objective : Spontaneous intracranial hypotension is a rarely reported syndrome of spontaneous postural headache associated with low CSF pressure and has rarely been demonstrated radiographically or surgically. But recently, it is being recognized with increasing frequency. The purpose of this study was to characterize clinical and imaging features, etiologic factors, and outcome in the spontaneous intracranial hypotension. Patients and Methods : We reviewed our experience with documented cases of spontaneous intracranial hypotension in 5 consecutive patients with orthostatic headaches from April 1998 to April 1999. Results : The mean age was 41 years(from 35 to 49 years). All patients had postural headaches, which were completely alleviated by recumbency position. Nausea, neck pain, horizontal diplopia, photophobia, and blurred vision were noted in some of the patients. Brain MRI showed diffuse pachymeningeal gadolinium enhancement, subdural collections of fluid, and descent of the brain. The opening pressure from lumbar puncture was $4cmH_2O$ or less in three of five patients whereas the opening pressure was within normal range in two patients. All patients underwent radioisotope cisternography and computerized tomographic myelography. On radioisotope cisternography, CSF leakage was suspected at the level of cervical area(1 patient), upper thoracic area(2 patients), mid-thoracic area(1 patient). Computed tomography myelography revealed extraarachnoid accumulation of contrast media(compatible finding with CSF leakage) at the level of cervical or thoracic area. In all patients, the symptoms resolved in response to supportive measures or epidural blood patch(1 patient). Conclusion : Spontaneous spinal CSF leakage is increasingly recognized as a cause of spinal postural headache. Most CSF leaks are located at the cervicothoracic junction or in the thoracic spine and can be demonstrated by variable diagnostic method. The condition is usually self-limiting and its prognosis is typically good.

• Journal of Preventive Medicine and Public Health
• /
• 제36권1호
• /
• pp.11-23
• /
• 2003

Objectives : The 1990s has seen advances in the conceptualization of self-perceived health status which has important roles for individual health and the quality of life. Many types of standardized questionnaires have been developed with the current wide use of SF-36, NHP, andEuroQol. However, the outcomes of these tools may be different with regard to regional, cultural and emotional backgrounds. The purpose of this study was to trial the development of a Korean Health Profile (KHP 1.0) to measure the self-perceived health stati of Koreans. Methods : The KHP 1.0 was designed on the basis of the Medical Outcome Study Form 36 (SF-36), the Nottingham Health Profile (NHP), and the EuroQOL. It was composed of 9 scales; physical functioning, role limitation-physical, pain, general health, energy, social isolation, sleep, role limitation-emotional, and e-motional health. Self-reported chronic disease conditions, and the Zung's Self-Rating Depression Scale (SDS), were also checked for the evaluation of clinical validity. This study was conducted, from December 2000 to January 2001, on 800 middle-aged parents, with four high school students, with 100 retest sets being conducted two weeks later. From the 800 subjects there were 588 complete responses (effective response 73.5%). The reliability of the test-retest results, and the factor analysis on the validity of the KHP 1.0 components, were evaluated using the SPSS (ver 10.0) software. Results : The reliability of the KHP 1.0 was good with Cronbach's alpha (>0.6), test-retest correlation coefficients (>0.5), but with no significant differences from the paired t-test. From the psychometric validity tests, the 9 scales of the KHP 1.0 were divided into two components; physical and mental, and trimmed to the established model with 55% of the total variance, with the exception of role limitation-emotional. The clinical validity on the basis of the comparison for the four characteristic groups; healthy, physical conditions only, mental conditions only, and physical and mental conditions were also good. Conclusions : The KHP 1.0 appears to be a valid measurement tool of self-perceived health stati of Koreans, although there are limitations, i.e. sample size was too small, a limited number of middle-aged subjects, and it was based on unconfirmed diagnoses, etc. Therefore, further study is required to standardize the assessment.

• Radiation Oncology Journal
• /
• 제12권2호
• /
• pp.191-199
• /
• 1994

Purpose : This study was undertaken to show the clinical results of combined radiotherapy and hyperthermia in primary hepatoma Materials and Methods : Between December 1989 and March 1993, 50 patients with hepatomas were treated by combined radiotherapy and hyperthermia. Among them, we analyzed retrospectively 33 patients who received the complete course of treatment. The ages of the patients ranged from 36 to 75(mean age: 55.5 years). Twenty-six patients ($78.8\%$) were men, and 7 ($21.2\%$ were women. According to Child's classification, nine patients ($27.3{\%}$) were A group, 9 ($27.3\%$) were B group, 15 ($45.4\%$) were C group. Radiation therapy was done by a 6 MV and 15 MV linear accelerator. Patients were treated with daily fractions of 150-180 cCy to doses of 2550 cGy -4950 cGy (median : 3000 cGy). Local hyperthermia was done by 8 MHZ RF capacitive heating device (Cancermia. Green Cross Co., Korea), 50-60 min/session, 1-2 sessions/wk, and 8.5 sessions (median number)/patient. We analyzed the prognostic factors including age, sex, tumor type, Child's classification, $\alpha$-fetoprotein, liver cirrhosis, ascites, portal vein invasion, esophageal varix, number of hyperthermia, chemotherapy, total bilirubin level, Karnofsky perfomance status. Results : The overall 1-year survival was $24.2\%$, with a mean survival of 10months. Of 33 patients, tumor regression (PR+MR) was seen in $30.4\%$, no response was seen in $52.2\%,\;17.4\%$ patient was progressed. In patients who had tumor regression, the overall 1-year survival was $42.1\%$ with a mean survival of 14 months. Factors influencing the survival were sex (p=0.05), tumor type (p=0.0248), Child's classification (p=0.0001), liver cirrhosis (p=0.0108), ascites (p=0.0009), and Karnofsky perfomance status (p=0.0028). Complications developed in 28 patients, including 18 hot pain,5 fat necrosis, 3 transient fever, 2 nausea and vomiting. Conclusion : In this study, the results suggests that combined radiotherauy and hyperthermia may improve the survival rate of hepatoma.

• 한국직업건강간호학회지
• /
• 제9권1호
• /
• pp.5-17
• /
• 2000

The occupational health nursing guideline for primary care was developed by the Korean Academic Society of occupational health nursing and the organization for occupational health nurses (currently known as the Korean Association of Occupational Health Nurses) in 1993. Since then, there have been many changes in the health care environment and job performance of occupational health nurses. Appropriate revisions are necessary of the guidelinea based on this background. The purpose of this study was to describe the use of the occupational health nursing guideline for primary care and to analyze the characteristics of primary care activities by occupational health nurses. The questionnaire was mailed to 150 occupational health nurses(OHNs) with the response rate of 64%. The results can be summarized as follows; 1. 65.6% of OHNs have been using the guideline for primary care and 75.9% of them agreed that the guideline was be helpful for their job. 2. Common symptom care, emergency care and chronic illness care were more frequently implemented than occupational disease care by OHNs. In manufacturing industries, emergency care was more frequently implemented than chronic illness care in contrast to the service industries. 3. Most frequent common symptoms treated by OHNs were indigestion, diarrhea, abdominal pain, headache, and coughing. In the case of chronic illness, OHNs more frequently treated diseases of the gastro-intestinal system, skin and sensory organs, and the respiratory system. Emergency care for bruises, burn, and abrasions was more frequently provided. VDT syndrome was the most common occupational disease cared by OHNs in manufacturing and service industries. 4. OHNs prescribed the medicine for external application more frequently than internal medicine. Remedy for colds, analgesics, vitamins, and digestives were more frequently used. From these results, we suggest that the guideline should be revised to emphasize the activities consisting problem finding such as health assessment, physical examinations, monitoring and screening, and to renew the drug list in the range of over- the counter medication (OTC). In the future, the guideline will include the strategies for the role as the case manager.

• 가정∙방문간호학회지
• /
• 제8권2호
• /
• pp.121-134
• /
• 2001

The purpose of this study were to analyze the home care services and to evaluate the client's satisfaction with the home care services provided by home care service center in the C hospital. The data were collected by reviewing charts of 128 home care clients who were receiving home care services at C hospital from October 1997 to September 2000. The subjects for satisfaction of home care service were 20 clients from July 10 to September 30, 2000. The tool for measurement of present condition of home care service was developed by the researchers. The satisfactions of the home care services were measured by using the instrument developed by Im(997). The data were analyzed by using the SPSS/PC+. The results of this study were as followings : 1. Majority of the subjects was female(61.7%). The average of age was 63.5 years. The service has been used mostly by the elderly 60 years of age or older(71.1%). The economic level of most of subjects was in middle class(94.5%). 2. Majority of the subject had a cancer(55.4%), following stroke(25.0%). The average duration of disease for the subjects was 31 months. The average time of hospitalization for the subjects was 3.3 times. The duration of hospitalization was 10$\sim$30 days(26.6%), 30$\sim$60 days(23.4%) and above of the 210 days(9.4%). 3. Most of the subjects used his/her doctor (47.7%), as a consultant, following his/her nurse (28.1%), other patients or their family (21.9%). Most of reasons for a consultation were supportive management(Infusion or medication, 60.94%), following tube management(L-tube or T-tube, 25%), Foley catheter management (15.63%) etc. 4. 28 types of nursing diagnoses were used by the home care service. The nursing diagnosis altered nutrition: less than body requirement were used mostly by the home care service, following risk for infection, impaired skin integrity, impaired swallowing, ineffective airway clearance altered comfort: pain, impaired physical mobility. By the human-response pattern, exchanging(63.2%), moving(7.5%), feeling(10.4%), knowing(5.2%), communicating (2.6%), relating(0.5%) perceiving(0.4%) and choosing(0.3%). There were 42 nursing intervention types were performed by the home care service. By the NIC(nursing intervention classification. McCloskey. Bulech. 1996). physiologic: complex (30.3%) was the most, safety(28.3%), behavioral(20.0%), physiologic: basic(10.8%) and health system(1.7%). Observation or assessment was the most nursing intervention performed by the home care service. following IV infusion. vital sign observation. infusion management and fluid-electrolyte balance management. 5. The level of client's satisfaction with provided home care services showed considerably high(2.67/ 3).

• Journal of Radiation Protection and Research
• /
• 제20권3호
• /
• pp.181-186
• /
• 1995

자외선이 피부에 조사되면 다양한 피부반응을 초래한다. 이러한 반응은 크게 1) 급성 반응과 2) 만성반응으로 나눌 수 있다. 급성반응으로서는 피부가 붉어지는 홍반반응, 피부색이 검어지는 색소반응, 그리고 피부두께의 변화 등을 들 수 있다. 홍반반응은 피부의 주된 세포인 각질형 세포를 비롯하여 진피세포들이 광여하여 진피혈관을 확장시키는 반응을 말한다. 홍반반응은 자외선의 파장, 광량, 피부의 조건, 환경조건 등에 따라 달라지며 피부에는 각질형성세포가 변형된 일광화상세포가 출형한다. 홍반반응은 가장 흔한 주된 반응이나 그 기전에는 명확하지 않은 점이 아직도 많이 있다. 색소반응은 멜라닌세포가 관여하는 반응으로서 자외선 조사 후 즉시 피부가 검어지는 즉시세포침착과 수일 후 검어지는 지연색소침착으로 나눌 수 있다. 색소반응과 피부두께의 변화 등은 자외선 조사로부터 몸을 보호하기 위한 방어작용의 일종이다. 자외선 조사에 의한 만성반응으로는 광노화현상과 광 발암현상을 들 수 있다. 광노화란 장기간에 걸친 광노출로 인한 피부의 노화를 말하며 생리적인 노화와는 임상적, 조직학적으로 다른 점이 많다. 자외선의 장기노출은 피부암을 발생시키는 중요한 원인의 하나로서 우리나라도 피부암 발생이 점차 증가하고 있다. 서울대학교병원 피부과에서의 피부암 발생빈도는 70년대에는 외래환자의 0.2% 정도였으나 80년대에는 0.4-0.8%를 차지하고 있다. 앞으로 우리나라의 경제성장과 함께 수명의 증가, 레져나 스포츠의 증가, 피부노출의 증가와 함께 오존층 파괴로 인하여 피부에 조사되는 자외선의 절대량의 증가는 자외선에 의한 피부의 급 만성반응을 더욱 증가시킬 것으로 예상되며 이에 대한 적절한 대책이 요구된다.

• 대한한방내과학회지
• /
• 제33권2호
• /
• pp.126-144
• /
• 2012

Background : Peripheral nerves more rapidly recover than central nerves. However, it has been known that the degree of reaction of axons of peripheral nerves is affected by distinctive characteristics of axons and environmental factors near the axons. Taxol is a widely used medicine as for ovarian, breast, lung and gastric cancer. However it causes patients difficulties under treatment due to its toxic and side effects, which include persistent pain. Objectives : This study reviewed how SJT extract in vitro and in vivo affects nerve tissues of a sciatic nerve damaged by Taxol. It also studied how SJT extract in vivo affects axons of the sciatic nerve after the sciatic nerve was damaged by pressing. Methods : After vehicle, Taxol, and Taxol plus SJT were treated respectively for tissue of the sciatic nerve in vitro and then tissues were observed using Neurofilament 200, Hoechst, ${\beta}$-tubulin, $S100{\beta}$, caspase-3 and anti-cdc2. SJT was also oral medicated by injecting Taxol into the sciatic nerve of in vivo rats. Tissues of the sciatic nerve and axons of DRG sensory nerves were then observed using Neurofilament 200, Hoechst, ${\beta}$-tubulin, $S100{\beta}$, caspase-3 and p-Erk1/2. After inflicting pressing damage to the sciatic nerve of in vivo rats, tissues of the sciatic nerve and DRG sensory nerve were observed using Neurofilament 200, Hoechst, $S100{\beta}$, caspase-3, anti-cdc2, phospho-vimentin, ${\beta}1$-integrin, Dil reverse tracking and p-Erk1/2. Results : The group of in vitro Taxol plus SJT treatment had meaningful effects after sciatic nerve tissue was damaged by Taxol. The group of in vivo SJT treatment had effects of regenerating Schwann cells and axons which were damaged by Taxol treatment. The group of in vivo SJT had effects of regenerating axons in damaged areas after the sciatic nerve was damaged by pressing, and also had variations of distribution in Schwann cells at DRG sensory nerves and axons. Conclusions : This study confirmed that SJT treatment is effective for growth of axons in the sciatic nerve tissues and improvement of Schwann cells after axons of the sciatic nerve tissues was damaged. After tissues of sciatic nerve was damaged by pressing in vivo, SJT treatment had effects on promoting regeneration of axon in the damaged area and reactional capabilities in axons of DRG sensory nerves.

• Biomolecules & Therapeutics
• /
• 제22권4호
• /
• pp.347-354
• /
• 2014

Larrea nitida is a plant that belongs to the Zygophyllaceae family and is widely used in South America to treat inflammatory diseases, tumors and menstrual pain. However, its pharmacological activity remains unclear. In this study we evaluated the property of selective estrogen receptor modulator (SERM) of Larrea nitida extracts (LNE) as a phytoestrogen that can mimic, modulate or disrupt the actions of endogenous estrogens, depending on the tissue and relative amount of other SERMs. To investigate the property of SERM of LNE, we performed MCF-7 cell proliferation assays, estrogen response element (ERE)-luciferase reporter gene assay, human estrogen receptor (hER) binding assays and in vivo uterotrophic assay. To gain insight into the active principles, we performed a bioassay-guided analysis of LNE employing solvents of various polarities and using classical column chromatography, which yielded 16 fractions (LNs). LNE showed high binding affinities for $hER{\alpha}$ and $hER{\beta}$ with $IC_{50}$ values of $1.20{\times}10^{-7}$ g/ml and $1.00{\times}10^{-7}$ g/ml, respectively. LNE induced $17{\beta}$-estradiol (E2)-induced MCF-7 cell proliferation, however, it reduced the proliferation in the presence of E2. Furthermore, LNE had an atrophic effect in the uterus of immature rats through reducing the expression level of progesterone receptor (PR) proteins. LN08 and LN10 had more potent affinities for binding on $hER{\alpha}$ and ${\beta}$ than other fractions. Our results indicate that LNE had higher binding affinities for $hER{\beta}$ than $hER{\alpha}$, and showed SERM properties in MCF-7 breast cancer cells and the rat uterus. LNE may be useful for the treatment of estrogen-related conditions, such as female cancers and menopause.

• Clinics in Shoulder and Elbow
• /
• 제18권3호
• /
• pp.120-127
• /
• 2015

Background: We prospectively compared the response to blind and ultrasound-guided glenohumeral injection of corticosteroids for treatment of shoulder stiffness. Methods: A total of 77 patients with shoulder stiffness between April 2008 and March 2012 were recruited. Patients were randomized to receive either a blind (group 1, n=39) or ultrasound-guided (group 2, n=38) glenohumeral injection of 40 mg triamcinolone. The clinical outcomes and shoulder range of motion (ROM) before injection, at 3, 6, and 12 months after injection and at the last follow-up were assessed. The same rehabilitation program was applied in both groups during the follow-up period. Results: There was no significant difference in demographic data on age, sex, ROM, and symptom duration before injection between groups (p>0.05). There were no significant differences in ROM including forward flexion, external rotation at the side, external rotation at $90^{\circ}$ abduction, and internal rotation, visual analogue scale for pain and functional outcomes including American Shoulder and Elbow Surgeons score, Simple Shoulder test between the two groups at any time point (p>0.05). Conclusions: Based on the current data, the result of ultrasound-guided glenohumeral injection was not superior to that of blind injection in the treatment of shoulder stiffness. We suggest that ultrasound-guided glenohumeral injection could be performed according to the patient's compliance and the surgeon's preference. Once familiar with the non-imaging-guided glenohumeral injection, it is an efficient and reliable method for the experienced surgeon. Ultrasound could be performed according to the surgeon's preference.