• 대한한방체열의학회지
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• 제8권1호
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• pp.33-38
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• 2010

Purpose : Dam-eum and women about this disease is closely related to the fact that research is not developed encounter the report. The purpose of this disorder is associated with women with Dameum hew to evaluate the affects around Dongulbogam Search and compare some of the knowledge gained. are reported. Methods : Donguibogam focused on search and related papers were. Results : In Donguibogam Dam-eum(痰), Yoen(涎), Eum(飮) to distinguish, but the reason was that one, 痰飮 sap needed to nutritious the body, such as a material or normal for various reasons by the sap from the leaves to cause disease states may be the cause. Conclusion: Digestive, respiratory-related, but now the recognition of the Dameum changes in diet and lack of exercise, stress, lifestyle diseases due to climate change are increasing asa Dameum and women in the pathogenesis of disease high enough proportion of the treatment for Dameum Applications will be denied a lot of disease is considered.

• 대한물리치료과학회지
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• 제4권1호
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• pp.243-253
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• 1997

The purpose of this study was to determine the effect of systolic blood pressure, heart rate and myocardial oxygen consumption on 3-point nonweight bearing ambulation with axillary wooden crutch according to age. The subjects were fifty healty volunteers(22 male, 28 female), ages from 20 to 69(mean age of 43.8 years) with no history of cardiovascular or respiratory disease, diabetes mellitus, arthritis and orthopedic disorder within the past three years. This study was carried out from May 10 to August 10, 1996. The data were analyzed by percentage, mean and standard deviation and ANOVA. The results were as follows : 1. In systolic blood pressure(SBP), there was no significantly change between before walk and after 20 m in crutch walking with age, however, there did differ significantly after 40 m and 60 m in crutch walking(p<0.01, p<0.001). 2. In heat rate(HR), there was no significantly change between before walk and after 20 m, 40 m in crutch walking with age, however, there did differ significantly after 60 m in crutch walking(p<0.05). 3. In myocardial oxygen consumption($MVO_{2}$), there was no significantly change between before walk and after 20m in crutch walking with age, however, there did differ significantly after 40 m and 60 m in crutch walking(p<0.01, p<0.001). These result showed that cardiovascular system had a great effect on the olderly when 3-point nonweight bearing ambulation with axillary wooden crutch. Therefore, when train for axillary crutch in the olderly, we needed suitably basis of walking distance.

• Journal of Chest Surgery
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• 제18권4호
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• pp.872-880
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• 1985

Myasthenia gravis is a neuromuscular transmission disorder characterized by fatigue and weakness of voluntary muscles. Although the pathogenesis is known as reduction of available acetylcholine receptors at neuromuscular junctions by autoimmune attack, the thymic role in myasthenia gravis is still unclear and under investigation. But thymectomy in the management of myasthenia gravis has become increasingly important since the first successful operation with remission of symptoms in 1939 by Blalock. From January 1983 to June 1985, authors performed 17 thymectomies for patients with myasthenia gravis. Among them, 12 patients were free from thymoma [Croup A] and 5 were coupled with thymoma [Group B]. The results were as follows: 1] Sex distribution was 11 females and 6 males. Mean age of the patients was 32.2 year old. Sex and age distribution by the Group A and B are shown Table 1. 2] Clinical manifestations of ocular symptoms were seen in 5 patients [88.2%], extremity weakness in 13 patients, bulbar weakness in 12 patients and dyspnea in 6 patients. According to the Osserman`s classification, 5 patients were in group IIA, 6 in IIB and 6 in IIC. 3] Pre-operatively, all patients were positive response to the anti-cholinesterase test and 12 patients [92.3%] revealed positive findings in electromyography [EMC] which was done in 13 patients. 4] The postoperative complications were respiratory distress in 3 patients, myasthenic crisis in 2 patients and wound disruption in one patients. 5] Pathologic examination of the thymus showed hyperplasia in 10 patients [90%] and thymoma in 5 patients, of which 4 were mixed type with invasion to the adjacent tissues and one lymphocytic type without invasion. Normal thymus was noticed in only 2 patients. 6] In postoperative evaluations, among the 12 patients c free from thymoma [Group A], complete remission of symptoms was noticed in 3 patients and improvement in 7 patients. But among the 5 patients coupled with thymoma [Group B], only one patients showed improvement [Table 8]. Therefore, remission and clinical improvement were noticed in 11 patients [64.7%] of the all and complete remission was noticed in 3 patients [17.6%].

• Clinical and Experimental Pediatrics
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• 제62권2호
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• pp.55-61
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• 2019

Purpose: Myotonic dystrophy, also known as dystrophia myotonica (DM), is an autosomal dominant disorder with 2 genetically distinct forms. DM type 1 (DM1) is the more common form and is caused by abnormal expansion of cytosine/thymine/guanine (CTG) repeats in the DM protein kinase (DMPK ) gene. Our study aimed to determine whether the age of onset is correlated with CTG repeat length in a population of pediatric patients with DM1. Methods: We retrospectively identified 30 pediatric patients with DM1 that underwent DMPK testing, of which the clinical data of 17 was sufficient. The cohort was divided into 2 subgroups based on the clinical phenotype (congenital-onset vs. late-onset) and number of CTG repeats (<1,000 vs. ${\geq}1,000$). Results: We found no significant difference between the age of onset and CTG repeat length in our pediatric patient population. Based on clinical subgrouping, we found that the congenital-onset subgroup was statistically different with respect to several variables, including prematurity, rate of admission to neonatal intensive care unit, need for respiratory support at birth, hypotonia, dysphagia, ventilator dependence, and functional status on last visit, compared to the late-onset subgroup. Based on genetic subgrouping, we found a single variable (poor feeding in neonate) that was significantly different in the large CTG subgroup than that in the small CTG subgroup. Conclusion: Clinical variables exhibiting statistically significant differences between the subgroups should be focused on prognosis and designing tailored management approaches for the patients; our findings will contribute to achieve this important goal for treating patients with DM1.

• 한국임상약학회지
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• 제31권1호
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• pp.21-26
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• 2021

Background: Pharmacogenomics is the study of how genetic mutations in patients affect their response to drugs. Pharmacogenomic studies aim to maximize drug effects and minimize adverse drug events. The Food and Drug Administration and the European Medicine Agency published guidelines for pharmacogenetics in 2005 and 2006, respectively; the Korean Ministry of Food and Drug Safety followed suit in 2015. Methods: This study analyzed pharmacogenomic information in the Korean Ministry of Food and Drug Safety's integrated drug information system to evaluate whether domestic pharmaceutical products reflect the current research on pharmacogenomic differences. Results: In June 2020, the Korean pharmacogenomic database contained genomic data on 90 compounds. Of these, 45 compounds were classified as "Antineoplastic and immunomodulating agents." The other 45 non-antineoplastic agents were in the following categories: Anti-infectives, Mental & behavior disorder, Hormone & metabolism related diseases, Cardiovascular system, Skin & subcutaneous tissue disease, Genito-urinary system and sex hormones, Blood and blood forming organs, Nervous system, Alimentary tract and metabolism, Musculo-skeletal system, and Other conditions including the respiratory system. In addition, 30 additives unrelated to the main ingredient were associated with genetic precautions. Conclusion: This study showed that antineoplastic and immunomodulating agents accounted for half the drugs associated with pharmacogenetic information. For antitumor and immunomodulatory drugs, genomic tests were recommended depending on the indication; this was in contrast to genomic testing recommendations for non-antineoplastic medications. Genomic tests were rarely requested or recommended for non-antineoplastic medications because the relationships between genotype and efficacy among those drugs were relatively weak.

• 한국농공학회논문집
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• 제64권1호
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• pp.99-110
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• 2022

In this study, the generation and emission characteristics of particulate matter and gaseous matter in a mechanically ventilated layer house were evaluated. Each concentration of PM₁₀, PM_2.5, inhalable dust, respirable dust, and NH₃ was measured and compared with occupational limit considering seasons and respiratory disorder. CAPPS (Clean Air Policy Support System) of the Ministry of Environment proposes the emission factors of PM₁₀, PM_2.5, and NH₃ for a layer houses however, emission factors are still calculated from foreign factors such as CONINAIR values. As a result, it is urgent to develop national emission factors for domestic layer house. Emission coefficients of the studied mechanically-ventilated layer house in a summer season were calculated as 0.052 kg/head/year for PM₁₀, about 12% lower than that of CAPSS, and 0.0068±0.0038 kg/head/year for PM_2.5, showing no significant difference. Emission factor of NH₃ was calculated as 0.159±0.031 kg/head/year, about 51% lower than that of CAPSS.

• Childhood Kidney Diseases
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• 제18권2호
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• pp.71-76
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• 2014

목적: 주의력결핍 과잉운동장애(ADHD)는 소아에서 3-5%의 유병률을 보이며 전두엽의 억제기전 저하와 대뇌의 카테콜라민 대사이상이 관련된다고 알려져 있다. ADHD 환아에서 야뇨증을 비롯한 다양한 하부요로계 증상을 동반한다는 보고가 있지만 국내에서는 ADHD 환아들에 대한 보고가 없기에 저자들은 ADHD 환아에서 배뇨증상을 알아보기 위해 본 연구를 시행하였다. 방법: 2009년 10월부터 2011년 3월까지 DSM-IV 진단기준에 근거하여 ADHD로 진단받은 33명의 환아들과 같은 기간 동안 신경계 질환이나 요로계 질환 없이 상기도 감염으로 외래를 내원한 환아 30명을 대상으로 배뇨와 배변에 대한 설문지를 시행하였다. 결과: ADHD 환자군의 평균 연령은 $9.09{\pm}2.8$세(남 28: 여 5) 이었고, 대조군의 평균 연령은 $8.58{\pm}3.1$ (남 20: 여 10) 이었다. ADHD 환아군에서 대조군에 비해 요절박(P=0.017), 절박 요실금(P=0.033), 변비(P=0.045)의 유병률이 대조군에 비해 유의하게 높았고, 복압배뇨, 간헐뇨, 배뇨지연 행동에는 두 군간에 유의한 차이가 없었다. 야뇨증은 ADHD 환아군에서 12.1% (4/33)로 대조군의 0%에 비해 많았지만 통계학적인 유의성은 없었다. 결론: ADHD 환아는 대조군에 비해 요절박, 절박 요실금과 변비의 유병률이 유의하게 높았다.

• 수면정신생리
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• 제3권1호
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• pp.85-95
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• 1996

Obstructive sleep apnea syndrome(OSAS) in childhood is unique and different n-om that in adulthood in several aspects, including pathophysiology, clinical features, diagnostic criteria, complications, management, and prognosis. Characteristic features of childhood OSAS in comparison with the adult form are the variety of severe complications such as developmental delay, more prominent behavioral and cognitive impairments, vivid cardiovascular symptoms, and increased death risk, warranting a special attention to the possible diagnosis of OSAS in children who snore. However, the childhood OSAS is often neglected and unrecognized. We, therefore, report a case of very severe OSAS in a 5-year-old boy who was sucessfully treated with continuous positive airway pressure(CPAP) treatment. Interestingly, the patient was comor-bid with the attention deficit hyperactivity disorder. Prior to the initial visit to us, adenotonsillectomy had been done at the age of 4 with no significant improvement of apneic symptoms and heavy snoring. On the initial diagnostic procedures, marked degree of snoring was audible even in the daytime wake state and the patient was observed to be very hyperactive. Increased pulmonary vascularity with borderline cardiomegaly was noted on chest X-ray. The baseline polysomnography revealed that the patient was very sleep-apneic and snored very heavily, with the respiratory disturbance index(RDI) of 46.9 per hour of sleep, the mean SaO2 of 78.8%, and the lowest SaO2 of 40.0%(the lowest detectable oxygen level by the applied oxymeter). The second night polysomnography was done for CPAP titration and the optimal pressure turned out to be $8.0\;cmH_2O$. The applied CPAP treatment was well tolerated by the patient and was found to be very effective in alleviating heavy snoring and severe repetitive sleep apneas. After 18 months of the CPAP treatment, the patient was followed up with nocturnal polysomnography(baseline and CPAP nights) and clinical examination. Sleep apneas were still present without CPAP on the baseline night. However, the severity of OSAS was significantly decreased(RDI of 15.7, mean SaO2 of 96.2%, and the lowest SaO2 of 83.0%), compared to the initial polysomnographic findings before initiation of long-term CPAP treatment. Wechsler intelligence tests done before and after the CPAP treatment were compared with each other and surprising improvement of intelligence(total 9 points, performance 16 points) was noted. Clinically he was found to be markedly improved in his attention deficit hyperactive behavior after CPAP treatment, but with minimal change of TOVA(test of variables of attention) scores except conversion of reaction time score into normal range. On the chest X-ray taken after 18 months of CPAP application, the initial cardiopulmonary abnormalities were not found at all. We found that the CPAP treatment in a young child is very effective, safe, and well-tolerated and also improves the co-morbid attention deficit hyperactive symptoms. Overall, the growth and development of the child has been facilitated with the long-term use of CPAP. Cardiovascular complications induced by OSAS have been also normalized with CPAP treatment. We suggest that early diagnosis and active treatment intervention of OSAS in children are crucial in preventing and ameliorating possible serious complications caused by repetitive sleep apneas and consequent hypoxic damage during sleep.

• 수면정신생리
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• 제8권1호
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• pp.22-29
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• 2001

목 적 : 폐쇄성 수면무호흡증의 진단에 있어 야간 수면다원검사가 중요함에도 비용이나 시간의 문제로 임상의들이나 환자들이 이 검사의 시행을 주저하는 측면이 있다. 만약 진찰로 어느 정도 수면호흡장애의 정도를 가늠할 수 있다면 수면다원검사를 포함하는 다음 단계 진단과정 선택이나 경과의 관찰에 중요한 길잡이가 될 수 있을 것이며 환자들을 이해시키는 일도 좀 더 쉬워 질 것이다. 이에 저자는 Simmons등이 처음 제안한 턱 압박술을 이용해 체계화한 새로운 호흡장애지수(이하 CPS)를 고안하고 진찰시 이것을 측정하여 야간 수면다원검사로 나타나는 여러 호흡장애 변수들과의 상관관계를 분석함으로써 이 지수의 타당도를 검토하고자 하였다. 방 법 : 임상적으로 폐쇄성 수면무호흡증(이하 OSA)이 의심되어 수면다원검사실에 의뢰된 환자들 중 검사 결과 폐쇄성 수면호흡장애로 최종 진단된 43명을 연구 대상으로 하였다. 이 중 상기도 저항증후군(이하 UARS)이 15명, OSA가 28명이었다. CPS(범위 $0{\sim}6$)범주와 진단 범주간의 카이제곱 검정을 실시하여 상관성을 검토한 뒤 이 지수와 수면무호흡지수(이하 AHI), 수면 시간당 산소포화도 저하 건수(이하 SaO2 dips) 등의 기존 수면무호흡 관련 변수와 상관분석을 시행하였다. 결 과 : 연구 대상의 평균연령은 $45.95{\pm12.47$세(범위 $14{\sim}76$세)였고 BMI의 평균은 $25.98{\pm}3.61$(범위 19.65${\sim}$37.64)였다. OSA군과 UARS군 사이에 나이, 성별, BMI에 유의한 차이는 없었다. 두 진단군 사이에 호흡장애지표와 ESS에서는 유의한 차이가 있었으나(p<0.05) 수면 변수에는 차이가 없었다. 전체 대상의 CPS 구간 중앙값 평균은 4.14(범위 $1{\sim}6$)이었다. 진단범주와 CPS범주간의 카이제곱 검정 결과 진단에 따라 CPS의 차이가 있었다(Likelihood Ratio $X^2$ test ; $X^2=17.41$, df=5, p=0.004). 결합도 Somers'd는 0.65로 나와($0.65{\pm}0.12$, t=4.83, p=0.000) CPS가 OSA군에서 뚜렷이 높아지는 양상을 보이고 있다. Spearman 상관관계분석에서 CPS가 AHI(r=0.77), SaO2 dips(r=0.83)와 좋은 정 상관관계를 보여주었다(p<0.001). 그 외에 90%이하 산소포화도 누적시간 백분율(r=0.76), Epworth 졸음척도치(r=0.57), 일 단계 수면의량(r=0.55)과도 강하거나 뚜렷한 정 상관관계를 보였으며 (p<0.05), 동맥혈 최저 산소포화도(r=-0.69)하고는 뚜렷한 역 상관관계를 보였다(p<0.05). 그러나 동맥혈 산소포화도 저하 건의 평균 지속시간과는 상관관계가 약했다. CPS와 AHI에 대한 회귀 분석 결과 턱 압박시 약간 호흡장애를 느끼는 수준(CPS가 3) 이상의 경우 수면다원검사를 시행하면 AHI가 5이하로 나올 확율은 약 3분의 1이하로 나왔다. 결 론 : CPS가 AHI, SaO2 dips 등 기존의 수면 무호흡 지수들과 뚜렷한 정 상관관계를 보여 턱 압박술은 수면무호흡증의 진단시 그 정도를 예측하는데 있어 유용하다.

• Clinical and Experimental Pediatrics
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• 제48권2호
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• pp.148-153
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• 2005

목 적 : 혈장의 항산화 능력, 항혈전 작용, 혈관 투과성 등에 관여하는 알부민이 낮은 경우 호흡곤란증후군, 기관지폐 이형성증, 괴사성 장염, 뇌실 내 출혈, 태아수종 등이 동반되어 나타날 수 있으며, 특히 신생아의 폐질환에서는 폐 모세혈관의 삼투성이 증가하고 폐포 흡인액에서 알부민이 증가되어 폐부종이 발생될 수 있으나 이때 저알부민혈증의 교정을 위해 알부민을 투여하는 것은 오히려 알부민 누출을 증가시켜 부종을 증가시킬 수도 있고 폐 표면활성제의 작용을 저해하여 나쁜 결과를 초래할 수도있다. 그러므로 저자들은 미숙아에서 출생 직후 재태 기간에 따른 알부민의 정상범위를 결정하고, 신생아 호흡 곤란 증후군, 뇌실 내 출혈, 미숙아 망막증, 무호흡, 기관지폐 이형성증 등의 임상증상이 발생된 군과 대조군의 알부민치를 비교하고, 출생 직후의 알부민치가 이들 질환의 발생을 예측할 수 있는지를 후향적으로 조사하고자 하였다. 방 법 : 1997년 1월부터 2003년 6월까지 원주기독병원에서 출생한 재태 23-41주의 신생아 208명을 대상으로 출생시 체중, 재태 기간, 생후 1일의 혈중 알부민치를 의무기록을 검토하여 조사하고, 최종 진단에서 신생아 호흡 곤란 증후군, 뇌실 내 출혈, 미숙아 망막증, 무호흡, 기관지폐 이형성증 유무를 조사하여 이들 임상증상이 있었던 군과 없었던 대조군으로 나누어 혈중 알부민치를 비교하였다. 결 과 : 혈중 알부민치는 재태 기간 23-24주에서 평균 2.36g/dL 만삭에 3.43 g/dL으로 재태 기간이 증가함에 따라 증가하였으며, 임상 증상에 따른 혈중 알부민치는 재태 기간 30-36주의 미숙아중 신생아 호흡 곤란 증후군, 뇌실 내 출혈, 미숙아 망막증, 무호흡이 있었던 군과 대조군 사이에 의미있는 차이를 보였으며 특히 신생아 호흡 곤란 증후군, 뇌실 내 출혈, 미숙아 망막증, 무호흡증이 있었던 경우 알부민치가 감소함에 따라 이들 질환의 발생 위험률이 증가함을 보였다. 결 론 : 신생아에서 저알부민혈증은 반드시 재태 기간을 고려하여 정의되어야 하며, 출생 직후 알부민치는 30-36주 사이의 미숙아에서 신생아 호흡 곤란 증후군, 뇌실 내 출혈, 미숙아 망막증, 무호흡 등 각각의 증상이 나타난 군에서 증상이 없었던 군보다 의미있게 낮았으며, 저알부민혈증이 이들 질환의 발병과 관계가 있는 것으로 사료된다