• Journal of Chest Surgery
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• 제20권1호
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• pp.112-127
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• 1987

Myasthenia gravis is a neuromuscular transmission function disorder characterized by fatigue and weakness of voluntary muscles. This muscular weakness is intensified by activity and stress, and improved by the use of anticholinesterase compounds. It was initially described by Erb in 1879 and later named myasthenia gravis by Jolly in 1895. Although the pathogenesis is Known to be an autoimmune related reduction in the number of available acetylcholine receptors at neuromuscular junctions, the role of thymus in myasthenia gravis is still unclear and under investigation. Thymectomy in the management of myasthenia gravis has become increasingly important since Dr. Blalock observed in 1939 that some patients with thymic tumors and myasthenia gravis improved following thymectomy. A clinical study of 102 cases of myasthenia gravis was performed at Yonsei University College of Medicine. Seoul, Korea from Jan. 1976 to Jun. 1986. In order to determine which factors are of prognostic significance, attention is focused upon pre-operative patient evaluation, problems in operative and post-operative care, and long-term follow-up observations. The results were as follows: 1. The sex distribution was 67 females and 35 males, the mean age of onset was 28.95*1.69 years, and the maximal incidence occurred between 21 and 40 years of age [56 cases: 54.9%]. 2. Clinical manifestations of ocular symptoms were seen to 70 patients [68.6%] extremities weakness in 33 [32.3%], bulbar weakness in 29 [28.4%], and dyspnea in 13 [12.7%]. 3. Study cases more than two thirds were classified as mild types [MG 1 and MG 11A] and 6 cases as grave [MG 1V] based on the modified Osserman`s classification system, 4. Thymectomy was performed in 19 cases which presented in severe myasthenia symptoms and showed no improvement with cholinergic drugs. Histologic examination of the excised thymus glands revealed no abnormalities in 4 cases, thymic hyperplasia in 5, benign thymoma in 5, and malignant thymoma in 5. 5. Immediate post-operative complications included 2 cases of pneumothorax which were treated by tube thoracostomies, there was no operative mortality. 6. The response to cholinergic drugs in 36 cases younger than 20 years old and in 27 cases older than 40 years was relatively poor, while that in 35 cases between the ages of 21 and 40 years old was good. 7. Thirty of 39 cases in groups IIB, III & IV improved markedly with medical or surgical management while only 16 of 59 cases in the mild groups [I and IIA] improved, almost all surgical cases improved in all categories. 8. There were 5 deaths. occurring between 7 months and 3 years 3 months of treatment of myasthenia gravis. The causes of death were myasthenic crisis in 2 cases, respiratory failure due to candidiasis & radiation pneumonitis in one case, cerebral hemorrhage due to high blood pressure in two case.

• Clinical and Experimental Pediatrics
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• 제51권7호
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• pp.775-779
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• 2008

후두개 낭종은 신생아 및 영아에서 협착음을 일으킬 수 있는 드문 질환이지만, 이 질환에 이환된 환아는 갑작스런 기도 협착을 일으켜 사망할 수도 있다. 따라서, 협착음을 보이는 환아에서 후두개 낭종을 감별해 냄으로써 갑작스런 기도 협착으로 인한 사망을 방지할 수 있다. 후두개 낭종은 협착음, 쉰목소리, 흉골 함몰, 무호흡, 수유시 청색증 및 성장 장애를 일으킬 수 있는 질환으로 이 질환이 의심되면 굴곡성 후두경으로 진단해야 한다. 이 질환의 치료는 $CO_2$ 레이저를 이용한 후두미세수술이며, 적절한 치료를 통해 재발을 방지할 수 있다. 저자들은 협착음, 쉰목소리, 흉골 함몰, 수유시 청색증 및 성장 장애를 주소로 전원된 1개월 남아에서 굴곡성 후두경을 통해 후두개 낭종을 진단하였고, $CO_2$ 레이저를 통한 후두미세수술 후 증상이 호전된 증례 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 한국산학기술학회논문지
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• 제18권6호
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• pp.381-388
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• 2017

심폐소생술 가이드라인에서는 효과적인 가슴압박을 강조하지만, 구조자들이 가슴압박을 시행하는 것과 관련한 피로에 대해서는 적절히 다루지 않는다. 본 연구에서는 건강한 소방대원들을 대상으로 마네킨에 심폐소생술을 여러 사이클을 수행한 후에 보일 수 있는 증상, 혈역학적 상태, 그리고 심전도 등을 측정하였다. 연구 대상자의 활력징후, 심전도, 주관적 피로도 점수를 심폐소생술 시작 전, 심폐소생술 5주기 후, 10주기 시행 후에 측정하였으며, 심폐소생술 후 나타나는 증상에 대해 설문하였다. 39명의 연구 대상자들의 평균 연령은 $35.54{\pm}10.26$세이었으며, 심폐소생술 후 피로와 숨가뿜, 어지러움 등을 호소했다. 심폐소생술 시작 전, 5주기 후, 10주기 후 심박수, 호흡수, 호기말이산화탄소, 산소포화도, 맥압에서 유의한 차이를 보였으며, 1명의 참가자에서 심페소생술 10주기 후 부정맥이 나타났다. 본 연구 결과 지속적인 심폐소생술은 건강한 성인들에서 피로와 혈역학적 변화 등을 초래할 수 있다고 판단되며, 심폐소생술 가이드라인 및 교육에서는 장시간 심폐소생술을 하는 경우 구조자들에게 미칠 수 있는 영향에 대한 적극적인 안내가 필요하다.

• 생명과학회지
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• 제30권8호
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• pp.731-741
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• 2020

코로나바이러스감염증-19(COVID-19)는 SARS-CoV-2에 의해 발병된다. 지금까지 인간에게 감염되는 7 가지 종류의 코로나 바이러스가 보고되었다. 그 중, HCoV-229E, HCoV-OC43, HCoV-NL63, 그리고 HCoV-HKU1 등 4종류의 코로나바이러스는 감기와 같은 단순 호흡기 질환을 유발한다고 보고되었다. 반면, SARS-CoV는 2002년에, MERS-CoV는 2012년에 각각 대유행을 일으킨 바 있다. 가장 최근에는 2019년 12월 중국 우한에서 처음 보고된 SARS-CoV-2가 전세계적인 대유행의 원인이 되고 있다. 이러한 SARS-CoV-2를 진단하고, 치료하고, 예방하기 위해서는 신속 정확한 진단키트, 치료제, 그리고 안전한 백신의 개발의 필수적으로 요구된다. 이러한 강력한 도구들을 개발하기 위해서는 SARS-CoV-2의 표현형, 유전자형, 그리고 생활주기 등의 연구가 선행되어야 한다. SARS-CoV-2의 진단기술은 현재 크게 두가지의 큰 분야인 분자진단과 면역혈청학적 진단으로 구분할 수 있다. 분자진단의 경우 SARS-CoV-2의 유전체를 대상으로 하며, 면역혈청학적 진단은 SARS-CoV-2의 항원 단백질 혹은 SARS-CoV-2에 대한 항체를 대상으로 한다. 본 총설에서는 SARS-CoV-2의 표현형, 유전체 구조, 그리고 유전자 발현에 대해서 정리하고, SARS-CoV-2에 대한 다양한 진단 기술 등에 대한 기초지식을 제공하고자 한다.

• 한국방사선학회논문지
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• 제5권6호
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• pp.391-400
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• 2011

폐렴은 호흡기계의 감염이고 원인균, 병인, 침범부위, 그 밖의 여러 가지 상황에 따라서 다양하게 분류된다. 비정형 병원균주 페렴으로 의심되어 내원한 46세의 남자 환자에서 이학학적 소견이나 혈액검사, 객담도말검사, 소변검사, 기생충검사, 기관지내시경검사, 침생검 등에서 특이할만한 원인균을 찾지 못했으며, 청진이상, 고열, 고혈압, 객담, 호흡곤란 등의 증상 또한 보이지 않았다. 세균성 또는 비정형 병원균의 광범위치료 항생제 복용이나 기생충제제를 복용하였으나 재발되었으며, 자연치유 및 재발이 반복되며 호전되었다. 반흔을 남기며 호전되고 새로운 부위에 결절이 재발하기를 반복하면서 서서히 없어지는 기간은 평균 20일 정도였다. 재발 이후 흉부엑스선 촬영과 흉부 고해상 전산화단층촬영을 추적 검사한 결과 흉부엑스선 촬영에서는 특이한 징후를 관찰하지 못했으나 고해상 전산화단층촬영에서는 병변이 호전되어가고 새로운 부위에 재발되는 모습을 관찰할 수가 있었다. 양측 하부 폐에 재발성 경과를 취한 비정형병원균주 폐렴이 의심되는 환자의 경우, 흉부엑스선 촬영 소견은 횡격막이나 간(Liver), 척추 등에 의해 숨기 때문에 추적검사로서 도움을 주는 데는 한계가 있으며, 흉부 고해상 전산화단층촬영 검사를 하여 비교하는 것이 바람직하다. 저자는 재발성 경과를 취한 비정형 병원균주 폐렴1예에 대한 문헌고찰과 함께 보고한다.

• 대한유전성대사질환학회지
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• 제16권3호
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• pp.148-154
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• 2016

요소 회로 대사 이상은 요소 합성에 관련된 효소의 결핍으로 인해 발생하는 질환으로, ornithine과 carbamylphosphate로부터 citrulline을 생성하는 과정에 관여하는 효소인 OTC 결핍증이 가장 흔하다. OTC 결핍증은 ammonia, glutamate, glutamine, alanine 등의 축적되면서 고암모니아 혈증 및 고글루타민 혈증으로 인한 신경학적 증상이 나타나게 되며, 근긴장 저하, 호흡 부전, 경련, 기면, 혼수로 진행하여 사망에 이르게 된다. 저자들은 생후 4일 경부터 구토와 함께 의식의 저하를 보인 환자에서 직열 질량 분석법을 통해 OTC 결핍증을 진단하였고, 증상 발생 31시간 만인 생후 118시간 째에 지속적 정정맥 혈액여과(continuous venovenous hemofiltration, CVVH)을 적용하여 고암모니아 혈증을 치료하였다. 또한 직접염기서열분석법을 통해 780번과 781번 염기 사이에 CAGGCAGTGT가 삽입되는 변이(c.780_781insCAGGCAGTGT (p.Ile261Glnfs*35))를 발견하였다. 환자는 4일 간의 CVVH 이후 혈중 암모니아 농도와 의식이 호전되어 생후 53일 째 퇴원하였으나, 생후 12개월 경 좌측 대퇴골의 골절과 골수염이 발생하였고, 이후 패혈증 쇼크, 고혈당, 다발성 장기부전으로 사망하였다. 이에 저자들은 OTC 결핍증 환자에서 CVVH 치료 및 패혈증과 당뇨를 경험하였고, 유전자 검사에서 이전에 보고된 바 없는 새로운 변이를 확인하였기에 증례를 보고하는 바이다.

• 대한한의학회지
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• 제20권3호
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• pp.45-53
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• 1999

Since Radix Stemonae was recorded hypothennal and a little toxic in the 'Myngyubelrok (名醫別錄)', it has been recorded as having the same nature in many herbal books. However, the security of Radix Stemonae when used to treat respiratory disease over a long term has not been studied until now. Therefore, the objective of this study is to determine the effects of Radix Stemonae on the main organs if Radix Stemonae is administrated over a long term. In order to investigate the histological changes of the liver and kidneys of rats after oral administration of Radix Stemonae extract, the experimental rats were subdivided into control, 1, 3, 5, 7, 21, 28 and 35 days after administration groups, and 10 rats per group were used in this study. The control group was sufficiently supplied with water and solid forage. The other groups were administrated the reagent at 5mg/kg once a day by oral injection. Several times each day, the experimental groups were carefully observed for any changes of general condition, toxic symptoms, activity, appearance and the number of dead rats. The experimental groups were weighed and narcotized. For the histological observation, the tissues of liver and kidneys of the experimental groups were collected, stained by hematoxylin-eosin stain, and evaluated by observing the changes of gross appearance and by observing microscopic findings. 1. This drug, during the experimental term, did not induce any toxicological effect in mortality, abnormal symptoms or changes of body weight except for the 1 day after administration groups whose body weights were decreased, compared to the control group. 2. No gross changes of the liver and kidneys were observed in this study. 3. No histological changes of the liver were detected in 1 day after administration groups. However, dilation of the central vein was observed in 3, 5 and 7 days after administration groups and chronic passive congestion of the liver was demonstrated in the 21 days after administration groups. In the 28 and 35 days after administration groups, a centrolobular disposition of fatty tissue (adipose cell) was observed. 4. No histological changes of the kidneys were observed in this study. It is evaluated that if Radix Stemonae is administrated for a long term, it induces toxicity in the liver. So, to examine the toxicity of Radix Stemonae on the liver and kidney, it is necessary that the studies of biochemistry and electron microscopic findings about Radix Stemonae be systematically performed.

• 기본간호학회지
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• 제2권1호
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• pp.45-53
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• 1995

In order to nursing practice of the patient in Oriental medicine, it is suggested that the fundamental recognition of Oriental medicine should be preceded. It is, however, difficult that we comprehend Oriental medicine generally since it is different from Western medicine in the point of th symptom. We have thought that is to be carried out to select and analyze a disease by the sense of Oriental medicine for the establishment of Oriental medical nursing. So we have tried out the analysis of Tae-Yang In view of the results so far achieved, it has been suggested that Tae-Yang Symptom applies to the first step of Sanghan Yug Kyung Symptom and consists of Palsy, Sanghan, Onbyung, Dropsy, and Congestion. In the Oriental medicine, Tae-Yang Symptom is recognized to be concerned with a common cold and the respiratory, renal and hepatic diseases. In the points of Orintal medicine, it is noticed that Tae-Yang Symptom is caused by the wind and cold evil, is related to human resisting force, and is fused with each other. And the treatment of Tae-Yang Symptom is various by the cause and the pathological mechanism. In the points of Western medicine. it is difficult to comprehend that various disease germs revolving each disease are implied by identical symptom. The summary of this study are as follows ; 1. In the outer-caused diseases. so called Tae-Yang Symptom, it is an important index to the patient's resisting force and the type of a disease whether he sweats, chills and the pulse is tense or not. 2. The treatments are various according the body's resisting force and the type of symptoms; harmonizing Yung & Wee(調榮衛) to Weaknees of surface(表虛證), sudorifics flourishing of evils(表實證), and antifebriles to On-byung(溫病). 3. If Tae-Yang Symptom is not cured, it progresses to develop complications ; Dropsy(蓄水) & congestion(蓄血), the former brings about renal diseases and the latter hepatic diseses. According to the resuslts mentioned above, we have come to the conclusion that the Oriental - medical nursing must emphasis the body's sesiting force and the type of symptoms rather than the name of a disease.

• Advances in pediatric surgery
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• 제16권2호
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• pp.126-133
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• 2010

Malrotation is a congenital anomaly that becomes symptomatic more frequently during infancy. The indication for surgical treatment at that age is straightforward. In older children, the diagnosis may be more difficult because of chronic and vague complaint. The aim of this study is to compare the symptoms, rate of volvulus and surgical findings in children younger and older than one year. A retrospective study of 40 patients in a a single medical center diagnosed with malrotation from April 1996 to May 2010 was performed. There were 20 (50 %) boys and 20 (50 %) girls. At the time of operation, 27 (67.5 %) patients were younger and 13 (32.5 %) were older than 1 year. Vomiting was seen in 20 cases (74.1 %) of the younger group compared to 2 cases (15.4 %) of the older group. Abdominal sonography and upper gastrointestinal series showed a sensitivity of 100%. Operative findings: 12 (44.4 %) of the younger group presented with volvulus compared to none of the older group. The Ladd's procedure was routinely performed with appendectomy in all cases and bowel resection was requires when volvulus included bowel necrosis or other anomalies were found. After definite procedures, surgical correction for adhesive obstruction was necessary in 5 menbers (18.5 %) of the younger group and 1 patient (7.7 %) in the older group. There was 1 death due to respiratory failure and pneumonia. Abdominal pain was more frequent symptom and bilious vomiting was less frequent. Volvulus did not occur in the older group. Malrotation should be diagnosed promptly in children over 1 year of age by upper gastrointestinal series and abdominal ultrasonography even though symptoms are not as clear cut as in infants.

• 혜화의학회지
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• 제9권1호
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• pp.201-214
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• 2000

Precise and detailed clinical research and evaluation based on objective standards are imperative factors in securing reliability of a clinical test. Built on this principle, this clinical test has been conducted during the period between March 1999 and March 2000 dealing with 31 outpatients treated with ShiHo-GuizhiTang or ShiHo-GuizhiTang modify and ShiHo-GuizhiTang mixed prescriptions at the Sung-bo ORIENTAL MEDICAL CLINIC. A variety of information relating to those patients has been collected and analyzed under such criteria as precise diagnoses and their clinical effectiveness. The analysis was duly based on "The theory of cold syndrome". Then, the 31 patients' individual clinical information was compared one another by breaking down the results into sub-categories including gender, age, disease, main symptom, blood pressure, pulse beats, syndrome of abdomen, treatment period, modify and mixed prescription, and evaluation. The result of this clinical test can be summarized as follows: First, ShiHo-GuizhiTang appears to be more frequently prescribed in the case of female patients than in the case of male patients despite the fact that it does not necessarily need to be applied only to female. In addition, the numbers of prescriptions of ShiHo-GuizhiTang in the two age groups consisting of elementary school children and economically active adults respectively were the highest among other age groups. Second, ShiHo-GuizhiTang proved to be most effective in treatment for respiratory ailments and arthritis. Third, ShiHo-GuizhiTang brought down blood pressure of hypertension patients and at the same time benefited patients with normal or lower-than-normal blood pressure who were vulnerable to diseases due to low disease-resistance. Fourth, ShiHo-GuizhiTang was effective in the case of frequent pulse(rapid pulse) and thereby indicating the fact it carries Taiyang superficies syndrome. 지맥 arises from suppressed immune responses owing to adrenocortical hormones. ShiHo-GuizhiTang controls and revitalizes those suppressed immune systems which stem from slow pulse and, as a consequence of that process, helps them return to normal condition of pulse. Fifth, from the standpoint of syndrome of abdomen, feeling of obstruction in the epigastrium serves as an important standard in the process of diagnosing diseases and evaluating effectiveness of treatments. Sixth, according to the results of the clinical test with the 31 patients, a total of 81 percent of test subjects benefited from the treatment. The figure is the sum of 52 percent of I-class (both main symptom and accompanying symptoms had been eliminated) and 29 percent of II-class (part of main symptom and accompanying symptoms had been eliminated) respectively. All told it is safe to say that ShiHo-GuizhiTang can elect to be a viable clinical treatment. In conclusion, it is estimated that this clinical study has drawn up guidelines for objective diagnostic standards and evaluation on specific treatments' effectiveness. This will lead to more general application of ShiHo-GuizhiTang. On top of that, this study could also provide an opportunity to stress the significance of ShiHo-GuizhiTang and ShiHo-GuizhiTang modify and ShiHo-GuizhiTang mixed prescriptions as an alternative treatment for collagen disease which comes from environmental degradation and pollution.