• 대한예방한의학회지
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• 제17권3호
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• pp.1-18
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• 2013

Objectives: Korea has a dual medical system where traditional Korean Medicine (KM) and Western Medicine (WM) exist au equal terms with exclusive practice boundaries. The aim of this study was to identify complementary and substitute relationships between KM and WM in Korea. Methods: The data of 19,413 respondents were collected from the 2009 Korea Health Panel dataset. General characteristics and the medical utilization of respondents were analyzed descriptively. the Univariable Analysis was used to compare the factors that affected KM and WM utilization, and the Multivariable Analysis was applied to identify complementary or substitute relationships between the respondents' choices for KM and WM. The data were analyzed by the seven disease groups; diseases of nervous system, circulatory system, respiratory system, digestive system, skin and subcutaneous tissue, musculoskeletal system, and connective tissue, injury, poisoning and others. Results: 13.6% and 76.9% of respondents used KM and WM respectively last 12 mouths. 12.7% used both, and 0.9% used KM only. In overall, respondents who visited KM institutions used also WM. However, according to the analysis of choices of medical institutions, non-pharmacological KM treatment and WM has been used as a substitute for another in the diseases of the skin and subcutaneous tissue, diseases of the musculoskeletal system, and connective tissue, injury, poisoning and others. Conclusions: Despite some exceptional disease areas, Korean people use KM complementarily to WM, and this result can rationalize the recent Korean government policies encouraging the cooperation of KM and WM. This study can he used for the future policies development for KM service delivery.

• 동서간호학연구지
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• 제3권1호
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• pp.17-26
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• 1998

The purposes of this study were to identify the contents, frequency of use, and the rationales of folk remedies frequently used for first aid at home for stomachache, vomiting, strain, food poisoning, vaginal bleeding, or wounds of snake or dog bite, or bee sting. As the method of the study, data were collected by conducting a questionnaire of 185 persons, who filled it out or who were interviewed from May to August in 1998. The collected data was analyzed by using frequency and the rationales for the contents of the folk remedies were described base on literatures. The results were as follows,. 1. The folk remedies for stomachache in frequency order were 'warming the abdomen', 'rubbing the abdomen with a hand', or 'pricking a finger to bleed', which have the rationals. 2. The folk remedies for vomiting in frequency order are 'drinking water of watery radish' and 'pricking a finger to bleed', which have the rationales. 3. The folk remedies for strain in frequency order are 'soaking the affected area into cold water or applying an ice pack' and 'after soaking jasmine in water, making a dough with flour, and then attaching it on the affected area', which have the rationales, Additionally, although the frequencies are low, 'drinking brewed Achyranthis Radix' and 'applying brewed leaves and stalks of Sambuci Cortex' have the rationales. 4. The folk remedies for food poisoning in frequency order are 'drinking black beans and licorice brewed together' and 'eating mung beans', which have the scientific grounds. 5. The folk remedies for bloody discharge in frequency order are 'drinking brewed lotus root' and 'eating boiled chicken stuffed with root of bell-flower'. However, 'drinking brewed Thujae orientalis Folium' has the rationales. 6. The folk remedy for snake bite wounds that has the scientific grounds is 'sucking blood by a person without hurt in the mouth'. However, quite a lot of people apply alum or soy paste, which has no rationales. 7. The folk remedies for the bee sting in frequency order are 'after removing the sting, applying soy paste or sauce' and 'applying saliva'. No rationales for 'applying saliva' have been found. 8. The folk remedy for the dog bite wound that has the rationales is 'applying juice of leaves or stalks of Xanthii Fructus'. However, 85% of surveyed people use remedies that have no scientific grounds, such as 'applying burnt dog hair mixed with (sesame) oil' and 'applying soy paste or sauce'. Various materials are used in folk remedies for first aid treatment as shown above. Some of the folk remedies have the rationales since their medicinal actions have been found. However, the medicinal actions of the majority have not been found, but only known that they are effective, Especially for the materials except botanical drugs, they are used without knowing the effects since their components and pharmacognosies have not been described in any literature. The results of this research may be used for materials to educate the surveyed people or to consult them. Accordingly, the folk remedies that have the rationales are required to continue to study to find out the effects.

• 대한임상독성학회지
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• 제14권2호
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• pp.115-121
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• 2016

Purpose: Because carbon monoxide (CO)-intoxicated patients with an alert mental status and only mild cognitive dysfunction may be inadequately assessed by traditional bedside neurologic examination in the emergency department (ED), they may not receive appropriate treatment. Methods: We retrospectively investigated the incidence and features of cognitive dysfunction using the Korean version of the Mini-Mental State Examination (MMSE-K) in ED patients with CO poisoning with alert mental status. We conducted a retrospective review of 43 consecutive mild CO poisoned patients with a Glasgow Coma Scale score of 15 based on documentation by the treating emergency physician in the ED between July 2014 and August 2015. Results: Cognitive dysfunction, defined as a score of less than 24 in the MMSE-K, was diagnosed in six patients (14%) in the ED. In the MMSE-K, orientation to time, memory recall, and concentration/calculation showed greater impairments. The mean age was significantly older in the cognitive dysfunction group than the non-cognitive dysfunction group (45.3 yrs vs. 66.5 yrs, p<0.001). Among the initial symptoms, experience of a transient change in mental status before ED arrival was significantly more common in the cognitive dysfunction group (32.4% vs. 100%, p=0.003). Conclusion: Patients with CO poisoning and an alert mental status may experience cognitive dysfunction as assessed using the MMSE-K during the early stages of evaluation in the ED. In the MMSE-K, orientation to time, memory recall, and concentration/calculation showed the greatest impairment.

• 대한임상독성학회지
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• 제10권1호
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• pp.15-21
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• 2012

Purpose: Toxic alcohols are responsible for accidental and suicide motivated poisonings, resulting in death or permanent sequelae for the afflicted patients. Major therapeutic modalities in these cases include treatment with alcohol dehydrogenase inhibitors and extracorporeal elimination. There have been a number of case reports of toxic alcohol intoxication in Korea. The purpose of this study was to review the clinical characteristics of patients suffering toxic alcohol intoxication. Methods: We retrospectively reviewed the medical records of patients who presented with toxic alcohol intoxication at 8 emergency departments (ED) from Jun 2005 to Nov 2011. Patients who ingested methanol, isopropyl alcohol, ethylene glycol, and other alcohols except ethanol, were included in this study. The clinical characteristics of these patients were analyzed to include anion and osmolar gap, and estimated concentration of alcohol in the body. Results: During the study period, 21 patients were identified who had ingested toxic alcohol (methanol; 12 patients, ethylene glycol; 9 patients). At ED arrival, the mean anion gap was $18.7{\pm}6.9$ and the osmolar gap was elevated in 13 patients. Oral and IV ethanol were administrated to 11 patients in order to inhibit alcohol dehydrogenase. Extracorporeal elimination procedures such as hemodialysis were performed in 9 patients. There were no fatalities, but the one patient suffered permanent blindness. Conclusion: This study found that ethylene glycol and methanol were the substances ingested which produced toxic alcohol intoxication. The patients presented with high anion gap metabolic acidosis and were typically treated with oral ethanol and hemodialysis.

• 한국응용곤충학회지
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• 제53권4호
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• pp.479-483
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• 2014

1990년대 초반 이후 국내 시설 원예작물 재배면적은 급격히 증가하였지만 농가당 재배면적은 협소하여 생산성 증대를 위한 생력관리기술개발이 절실히 요구되고 있다. 하지만 시설하우스에서는 해충들이 다발생하고 방제가 어려워 많은 양의 살충제를 사용하고 있어 생력재배를 어렵게 하고 있다. 또한 과도하고 부적절한 살충제의 사용은 저항성 해충의 출현과 농약중독이라는 문제를 야기하였다. 본 연구에서는 시설 재배 온실에서 무인 연무방제기를 이용한 목화진딧물(Aphis gossypii)과 복숭아혹진딧물(Myzus persicae)의 효율적 방제 가능성을 조사하였다. 무인 연무방제기를 가동시키는 동안 시설 내 측창과 출입구가 완전히 폐쇄된 조건하에서는 시설 내 상대습도가 높게 유지되었고(>95%) 관행방제 약제처리구와 유사한 방제 효과를 보였다(방제가 61.0~94.1%). 반면 무인 연무방제기 가동 시간 동안 측창과 출입구를 50% 정도 개방한 조건에서는 시설 내 상대습도가 상대적으로 낮았고(<95%) 측창과 출입구가 모두 폐쇄된 온실 조건보다 방제 효율이 낮았다(방제가 36.0~54.4%).

• 한국식품영양과학회지
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• 제46권11호
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• pp.1271-1277
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• 2017

가미십전대보탕(이하 KSD로 표기) 추출물은 생약 성분으로 인체 및 동물에 투여 시 세포 독성 및 장기에 중금속 등에 의한 독성 물질이 발생할 수 있어 안전성이 매우 중요하다. 따라서 본 연구에서는 KSD의 안전성 확보를 위해 중금속 검사, 간과 신장 기능 지표 검사 및 RAW 264.7 세포 생존 시험을 거친 후 RAW 264.7 세포를 이용하여 KSD 추출물의 항산화 및 항염증 효과를 알아보았다. KSD 추출물에서 중금속은 발견되지 않거나 기준치 미만으로 검출되었다. 간기능지표인 AST, ALT는 정상군에 비해 낮게 나타났으며 신기능 지표인 Cr, BUN도 정상군과 같거나 낮아 인체에 안전함을 확인하였다. RAW 264.7 세포 독성은 대조군 대비 농도별 생존율에 차이가 없었다. KSD 추출물의 항산화 효능 측정 결과 DPPH 라디칼 소거능과 ABTS 라디칼 소거능은 $10{\mu}g/mL$ 이상의 농도에서 의존적으로 활성이 증가하였다. 항염증 효과 측정 결과 NO 생성량은 대조군에 비해 10, $100{\mu}g/mL$에서 유의성 있는 감소를 보였으며, $IL-1{\beta}$와 IL-6는 농도 의존적으로 발현량이 감소하였고, $TNF-{\alpha}$는 유의적 차이점을 발견할 수 없었다. 이상의 결과를 보아 KSD는 골절 치료를 위한 생약으로 안전성 및 항산화 및 염증 감소에 효과가 있을 것으로 생각된다.

• 대한안과학회지
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• 제59권11호
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• pp.1097-1102
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• 2018

목적: 클로르페나피르 음독 후 중추신경계 손상을 동반한 독성 시신경병증 1예를 보고하고자 한다. 증례요약: 44세 여자가 7일 전부터의 양안 시력저하를 주소로 내원하였다. 환자는 내원 2주 전 자살 목적으로 클로르페나피르 한 모금을 음독했고, 직후 근처 병원에서 위세척을 시행하였다. 초기 최대교정시력은 우안 안전수지 30 cm, 좌안 안전수동이었다. 양안 동공은 5.0 mm로 커져 있었고, 빛에 대한 반응은 느렸으며 좌안에는 상대구심동공운동장애가 관찰되었다. 안저검사에서 양안 시신경유두부종이 관찰되었고, 뇌자기공명영상에서 양안 시신경과 속섬유막, 뇌량, 중소뇌각, 뇌간 등 백질 신경로를 따라 양쪽에 대칭적인 고강도신호가 관찰되었다. 클로르페나피르 중독으로 인한 독성 시신경병증으로 진단 후, 고용량 스테로이드치료를 3일간 시행하였으나 양안 최대교정시력은 광각무로 악화되었다. 3개월 후, 안저검사에서 양안 시신경위축이 관찰되었고, 빛간섭단층촬영에서 망막신경섬유층 및 신경절세포-내망상세포층 두께가 감소하였다. 결론: 매우 적은 양이라도 클로르페나피르에 노출되면 적절한 치료에도 불구하고 잠복기를 거쳐 심각한 시신경손상이 발생할 수 있으므로 주의해야 하겠다.

• 대한임상독성학회지
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• 제16권2호
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• pp.86-92
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• 2018

Purpose: Cardiovascular or respiratory complications of acute intoxication are the most common causes of mortality. Advanced cardiac life support (ACLS) or specific antidotes help manage these cardiac or respiratory complications in acute intoxication. On the other hand, some cases do not respond to ACLS or antidotes and they require some special treatment, such as extracorporeal life support (ECLS). ECLS will provide the chance of recovery from acute intoxication. This study examined the optimal timing of ECLS in acute intoxication cases. Methods: This paper is a brief report of a case series about ECLS in acute poisoning. The cases of ECLS were reviewed and the effects of ECLS on the blood pressure and serum lactate level of the patients were analyzed. Results: A total of four cases were reviewed; three of them were antihypertensive agent-induced shock, and one was respiratory failure after the inhalation of acid. The time range of ECLS application was 4.8-23.5 hours after toxic exposure. The causes of ECLS implementation were one for recurrent cardiac arrest, two for shock that did not respond to ACLS, and one for respiratory failure that did not respond to mechanical ventilator support. Three patients showed an improvement in blood pressure and serum lactate level and were discharged alive. In case 1, ECLS was stared at 23.5 hours post toxic exposure; the patient died due to refractory shock and multiple organ failure. Conclusion: The specific management of ECLS should be considered when a patient with acute intoxication does not recovery from shock or respiratory failure despite ACLS, antidote therapies, or mechanical ventilator support. ECLS improved the hemodynamic and ventilator condition in complicated poisoned patients. The early application of ECLS may improve the tissue perfusion state and outcomes of these patients before the toxic damage becomes irreversible.

• 보건의료산업학회지
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• 제3권1호
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• pp.14-24
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• 2009

This study aims at deriving any useful information necessary to strengthen the competitiveness for growth through empirical analyses on general hospital located in a province in order to countermeasure the opening and competition of medical markets. The characteristics of user were identified on the basis of disease groups under KCD in the research method. In addition, the analysis on the expenses of diagnosis and treatment was divided into the treatment progress and degree of hospital resource utilization And the regression was carried out to identify the impacts of characteristics of inpatient users on the degree of hospital resource utilization. As a result of major research, the inpatient users of the general hospital located in the provincial area in consideration of inpatient users were formed around the inpatient disease groups representative for Korea(diseases of the respiratory system, injury and poisoning & certain other consequences of external causes). And it was understood that most of residents within a distance of 40 minute by the public transportation were using. And mostly were under the age of 9 or over 60, and the provision of medical features such as the degree of consultation and operational functions were inadequate. When we classify inpatient treatment cost for each resource application as the medical cost being the center of patient care function, the equipment and human resource application sector are constituted over half. Accordingly, the following suggestions are made as plans to strengthen the competitiveness for the growth of general hospitals located in the provincial areas on the basis of analytical results. First, it is necessary to have the characterization matching to the age and disease groups with a high frequency. Second, it is necessary to increase the degree of hospital resource utilization according to the characterization. Third, it is necessary to concentrate on public relations. The above suggestion, as a method for securing image improvement and competitive power as a general hospital, and through expansion of social function that a regional general hospital needs to secure not only as an individual institution but also as a general hospital, it can be seen that a general improvement of image as a regional general hospital is possible.

• 농촌의학ㆍ지역보건
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• 제6권1호
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• pp.33-41
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• 1981

To investigate the status of medical accident attack rate and medicare utilization during last 27months from 1st Oct., 1977 to 31st Dec. 1979 in the area under Sam Wha Medicare Insurance Union, the study was carried out through analyzing the medicare records of patients who were enrolled. "The medical accident" in this study was used as the meaning of the state that the people who have been treated morbid condition with insurance money. For the study, 2 doctors and one nurse were mobilized and the results are as follows: 1) The total number of the Medicare Insurance Union members among the 37,044 total population of the study area, (Hea-mi, Unsan, Eumam Myun) were 57, 35 composed of 3,000 males (52.3%) and 27, 35 females (47.7%) in 1977, 3,383 composed of 2,006 males (59.3%) 1,377 females (40.7%) in 1978, 2,573 composed of 1,437 males and 1,336 females (44.2%) in 1979. 2) Total number of medical accident attack cases were 6,774 case (partially overlapped the number of the 1977 with that of the 1978) and average annual medical accident attack rate per 1,000 population was 700.9. 3) Five major disease group in the past three years were disease of the respiratory system (177.7), disease of the digestive system (165.8), disease of the skin and subcutaneous(64.9), symptoms, signs and ill-defined conditions (64.6), any injury and poisoning (51.9). Mental disorders (32.6) was the 6th order disease group. 4) The order of the medical accident attack rate of age group per 1,000 population per year was the year group of 0~4(877.8), 45~64(832.6), 25~44(810.3), 5~14(495.1) 15~24(494.7) 65 and over (460.7). 5) Medical accident attack rate of age group per 1,000 population in the 5 major disease groups were the year group of 45~64 (100.0) in the mental disorders 0~4(525.1) in the disease of the respiratory system 45~64 (328.5) in the disease of the digestive system 0~4 (202.8) in the disease of the skin and subcutanous tissue, 25~44 (98.3) in the accidents and poisoning. 6) Monthly medical accidents attack rate were 87.0 in the winter (Dsc., Jan., Feb.) and 86.2 in the summer (Jun., July, Aug.). So the trend of the medical accidents attack rate during the year was bimount figure. 7) Monthly medical accidents attack rate in the major disease group were highest in Jan., Apr., (31.1) in the disease of the respiratory system, in Jan., Feb., Mar. (24.9) in the disease of the digestive system, in Jan., Jun., Aug. (9.8) in the injury and poisoning. 8) Duration of the treatment of the 93.1% of the total cases were within 5 days. 9) 299 cases (4.5%) of the total number of cases, 6,587 cases were referred to secondary and tertiary medicare facilities. 10) The order of the major 10 kinds of diagnosis of the disease, 6,587 cases during 27 months, were URI and chillness (1,063 cases, 16.1%), gastritis(830 cases, 12. 6%) dermatitis(360 cases, 5.5%), bronchitis(291 cases, 4.4%), neurosis (284 cases, 4.3%), contusion (165 cases, 2.5%), tooth extraction (157 cases, 2.4%), tonsillitis (109 cases, 0.7%), laceration (107 cases, 1.6%), neuralgia (105 cases, 1.6%), arthritis (104 cases, 1.6%), otitis media and mastoiditis (103 cases, 1.6%), so total case were 3,678 cases (55.9%).