• 제목/요약/키워드: skin disease

검색결과 1,440건 처리시간 0.041초

Association between Socioeconomic Status and Altered Appearance Distress, Body Image, and Quality of Life Among Breast Cancer Patients

  • Chang, Oliver;Choi, Eun-Kyung;Kim, Im-Ryung;Nam, Seok-Jin;Lee, Jeong Eon;Lee, Se Kyung;Im, Young-Hyuck;Park, Yeon Hee;Cho, Juhee
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권20호
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    • pp.8607-8612
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    • 2014
  • Background: Breast cancer patients experience a variety of altered appearance - such as loss or disfigurement of breasts, discolored skin, and hair loss - which result in psychological distress that affect their quality of life. This study aims to evaluate the impact of socioeconomic status on the altered appearance distress, body image, and quality of life among Korean breast cancer patients. Materials and Methods: A cross-sectional survey was conducted at advocacy events held at 16 different hospitals in Korea. Subjects were eligible to participate if they were 18 years of age or older, had a histologically confirmed diagnosis of breast cancer, had no evidence of recurrence or metastasis, and had no psychological problems at the time of the survey. Employment status, marital status, education, and income were assessed for patient socioeconomic status. Altered appearance distress was measured using the NCI's cancer treatment side effects scale; body image and quality of life were measured by the EORTC QLC-C30 and BR23. Means and standard deviations of each outcome were compared by socioeconomic status and multivariate linear regression models for evaluating the association between socioeconomic status and altered appearance distress, body image, and quality of life. Results: A total of 126 breast cancer patients participated in the study; the mean age of participants was 47.7 (SD=8.4). Of the total, 83.2% were married, 85.6% received more than high school education, 35.2% were employed, and 41% had more than $3000 in monthly household income. About 46% had mastectomy, and over 30% were receiving either chemotherapy or radiation therapy at the time of the survey. With fully adjusted models, the employed patients had significantly higher altered appearance distress (1.80 vs 1.48; p<0.05) and poorer body image (36.63 vs 51.69; p<0.05) compared to the patients who were unemployed. Higher education (10.58, standard error (SE)=7.63) and family income (12.88, SE=5.08) was positively associated with better body image after adjusting for age, disease stage at diagnosis, current treatment status, and breast surgery type. Similarly, patients who were married and who had higher education had better quality of life were statistically significant in the multivariate models. Conclusions: Socioeconomic status is significantly associated with altered appearance distress, body image, and quality of life in Korean women with breast cancer. Patients who suffer from altered appearance distress or lower body image are much more likely to experience psychosocial, physical, and functional problems than women who do not, therefore health care providers should be aware of the changes and distresses that these breast cancer patients go through and provide specific information and psychosocial support to socioeconomically more vulnerable patients.

서울시 간호사회 가정간호시범사업 서비스 내용 및 만족도 분석 (The Contents and Satisfation of Home Care Progral Delivered by Seoul Nurses Association)

  • 임난영;김금순;김영임;김귀분;김시현;박호란
    • 대한간호
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    • 제36권1호
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    • pp.59-76
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    • 1997
  • The purposes of this study were to identify the contents and satisfaction level of the patients received home care service, and to compare the differences of the contents by the characteristics of the patients. Seventy eight patients received home care service from 1st Jan. to 30th Sept., 1996 were data-collected to analyze the contents and outcomes of home care service. Sixty-nine patients currently receiving home care service were participated to evaluate the satisfaction level of home care service. The data were analyzed using mean, standard deviation, $x^2$ test, and ANOVA by SPSS $PC^+$ program. The findings of this study were as follow : 1. The contents & outcomes of home care service 1) The mean age of the subjects was 64.4 years: 58% of them were female. Those who living in Seoul were 83% and the rest of the subjects was living in Kyung-Gi. 2) The subjects who had one diagnosis were 41%. Over 60% of them had the disease of neurologic & sensory system. 3) The mean number of visit was 6. Only one visit was 22%. The mean time of care was 79 minutes. Duration of visit from 31 minutes to 60 minutes were 47 %. The subjects who terminated the visit because of death were 67.3%. 62% of the persons who referred them to the home care service were nurses. 4) The pain after the service was more relieved than before. The amounts of intake, the degree of bed sore, edema & fracture after the service were more improved than before. Health status after the service was improved in general. 5) There were significant differences between initial and last conscious level in tracheostomy care & oxygen inhalation care. There was significant difference between initial and last degree of activity in blood sugar check. 6) There were significant differences on the number of visit in assessment of the status, evaluation & observation, vital sign check, skin care, injection, medication, bed sore care, colostomy care, relaxation therapy for pain relief, patient education, family care, exercise therapy, position change, supply of disinfected equipments and infection control. There were significant differences on visiting time in nasogastric tube care, drainage tube care and oxygen inhalation care. 2. The satisfaction level of home care service 1) 50% were male. Over 60 years of the subjects was 61 %. Those who living in Seoul were 82%. 2) The subjects who had one or two diagnosis were 32% respectively. 55% of the persons who referred them to the home care service were nurses. 3) Total level of satisfaction of home care service was very high. 4) The older the age, the higher the satisfaction level. The larger the number of visit, the higher the satisfaction level. 5) The subjects who were in cloudy state were higher level of satisfaction than in alert or coma state. The subjects whose activity were normal or who needed assistance were higher level of satisfaction than bedridden or immobilized subjects. These findings suggested that the patients had substantial need for posthospital care. They tended to be elderly and to have experienced the wide range of health problems associated with aging, chronicity, including limitations in activities, and other serious health problems. So, the nationwide home care systems beyond the limit of demonstration program by local association and the development of the effective financial system of home based health care are necessary for the clients who are in need of home care.

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연세지역(延世地域)에 대(對)한 보건기초조사(保健基礎調査) (A Basie Health Survey of the Yonsei Community Health Service Area, Seoul)

  • 양재모;김명호
    • Journal of Preventive Medicine and Public Health
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    • 제1권1호
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    • pp.25-36
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    • 1968
  • Introduction In order to improve medical education through the introduction of a concept of comprehensive health care of a community, an area surrounding the University Campus was chosen for the Community Health Service Project. It has been on operation for last 4 years with its major emphasis on family planning services, and maternal and child health care. The major objectives of this survey at the area are to obtain: 1) The demographic data, 2) The health need and trend of medical care, 3) The attitude and practice in maternity care to be used for further improvement of the planning and the services of the project. Population and Survey Method Out of three Dongs of the Community Health Service Area, only two Dongs namely Changchun and Yonhee were selected for the survey. Total number of households and population in the area studied was 3,683 and 21,857 respectively. An interview was performed with questionnaire schedule which was recorded by interviewers. This includes the degree of utilization of health services provided by the Community Health Service Program such as family planning, prenatal care during their last pregnancy, delivery history and complications of the delivery as well as the incidence of illnesses in general. Prior to the interview, all interviewers were trained for interviewing technique for two days. The survey was carried out during the period from October December 1967. Results 1) Demographic Data : 41.3% of the population studied were children under age 15 and only 3.5% were over 60 years of age. Crude birth rate and crude death rate of this area studied during the period of November 1966-October 1967 were 20.5 and 7.7 respectively. Infant mortality rate during the same period was 35.9. 50.4% of the 2,832 households fell into the category of middle class, 39.8% to the lower class and 9.5% to the upper class in economic condition. 19.8% of 2,832 householders had no formal education, 22.7% primary school, and 57.5% middle or higher school education. 2) Health Status and Utilization of the Community Health Service: Those who suffered from many illnesses during the month of October, 1967 were 690(4.6% of 14,891 persons). Classification of these patients into the type of disease shown respiratory diseases 27.4%, gastrointestinal diseases 18.1%, tuberculosis 10.9%, skin and genitourethral diseases 4.5% and gynecologic patients 4.5%. Only 55.9% of the patients received medical care at hospital or doctor's clinic. But among TB and gynecologic patients, 70.7% and 72.4% were treated at medical facilities. 10.6% of 2,832 householders interviewed has ever utilized the Community Health Service Program provided by the Yonsei Medical School, Classifying these clients into the type of service, 35.9% utilized the wellbaby clinic, 31.0% the family planning clinic, 14.7% the home delivery care, and the rest utilized other services such as the premarital guidance cinlic and the sanitary inspection service. 3) Maternity Care: 23.6% of 2,151 deliveries were done at medical facilities such as hospital, private clinic, while 76.4% were done at home. Acceptance rate of prenatal care was 32.6% as whole, but 49.6 of 774 women who had the prenatal care service had their deliveries at medical facility. 45.1% of total deliveries were attended by medical and or paramedical personnel. 75.8% of the deliveries of those received prenatal care were attended by medical and or paramedical personnel while only 27.8% of the deliveries of those who did not have prenatal care attended by medical and or paramedical personnel. 49.8% of deliveries of the upper class, 29.8% of the middle class and 9.9% of the lower class were attended by medical and or paramedical personnel. 6.2, 3.3% and 24.8% of mothers reported about their xeperience of edema, coma and fever during the period of trimester of pregnancy and puerperium. 4) Family Planning: The rate of practice of family planning was 27.9%. 31.7% of them were by IUD, 2.9% by oral pill, 15.2% by sterilization and the rest by traditional methods. Those women who had 3 to 4 children had highest(30.2%). Practice rate among the various methods of family planning, oral pill was the most popular method to whom had 2 or less children. In relation between the practicing rate of family planning and living standard, the upper, middle and lower class practiced 37.5, 29.4 and 19.9% respectively.

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착유우의 톱밥발효우사 이용연구 제 1 보 : 낙농가의 톱밥발효우사 형태별 이용효과 비교 (Study on the Utilization of Sawdust Bedding Barn for Dairy Cows)

  • 권두중;권응기;기광석;이기종;한정대;정석찬;강승원;강상열;정형섭;장학주
    • 한국축산시설환경학회지
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    • 제1권1호
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    • pp.9-19
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    • 1995
  • This study was carried out to investigate the effect of sawdust bedding barn on manure handing, management labour and physiological aspect of dairy cows, and then to establish the criteria on the optimum utilization method of sawdust bedding barn. 46 tie stall barns and 49 sawdust bedding barns were surveyed to cmopare the milk productivity between two different barns, and also 5 tie stall barns, 15 sawdust bedding barns and 1 rice hull bedding barn were selected to study the utilization situation of sawdust barn in Kyung-Ki province area. The major results obtained were as follows; 1. The roof material of sawdust barn were consisted of 66% vinyl house, 23% PVC light and 11% slate and galvanum coated tin. Most of the floor structure was earth ground with the rate of the approximately 82%. 2. The average occupied area of sawdust bed per cow was 15.2 $m^2$, depth that 30 cm and the utilization period was 12 months. 3. Milk Yield was significantly higher at sawdust barn than at tie stall barn(P<0.01). Bacterial and somatic cell count in raw milk were less at the sawdust barn than in tie stall barn. However, there was not significance difference between two barns. 4. The labour hour needed to cow management in the sawdust barn was approximately 48% of that of tie stall barn. 5. The temperature and moisture content measured in sawdust bed were closely affected by seasonal ambient temperature. The skin and hair of cow were much cleaner at the PVC light roofed sawdust barn than any other roof materials. 6. The additives used for improving of fermentation did not show any effect on temperature and moisture content in sawdust bed. When the ambient temperature was $30.4^{\circ}C$, the surface temperature of measured 1 cm above the sawdust bed was $12.2^{\circ}C$ lower and the temperature of 100 cm above the sawdust bed was $2.4^{\circ}C lower under shading net facility than that of vinyl roofed one.7. The hoof length of miking cow was 7.95 cm in tie stall and 9.19 cm in sawdust barn with high significance (P<0.01). And disease occurence such as mastitis and foot-rot tended to decrease in the sawdust barn. 8. The number of total bacteria and coliform bacteria were less in the sawdust bed compared with earth ground resting area. And a parasite strongyloides papillosus was detected but without any infected cow. 9. The nitrate($NO_3N$) content in non-roofed earth ground resting area and earth ground under the sawdust bed was likely to pollute the ground water. 10. In economic point of view, rice hull bedding barn was the cheapest among different systems. And in the sawdust bedding barn PVC light + slate roofed barn was most desirable, and vinyl roofed one the least.

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Henoch-Sch$\"{o}$nlein 자반증에서 Tumor Necrosis Factor-${\alpha}$ 유전자 다형성 분석 (Analysis of the Tumor Necrosis Factor-${\alpha}$ Promoter Polymorphism in Children with Henoch-Sch$\"{o}$nlein Purpura)

  • 양혜란;고재성;서정기
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제10권1호
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    • pp.11-19
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    • 2007
  • 목 적: 본 연구에서는 Henoch-Sch$\"{o}$nlein 자반증으로 진단된 환아들에서 급성기와 관해기에 TNF-${\alpha}$ 농도를 측정함으로써 Henoch-Sch$\"{o}$nlein 자반증의 발병과 임상양상의 발현에 있어 TNF-${\alpha}$의 의의를 평가하고, 각 환자에서 TNF-${\alpha}$ -308, -238 유전자 다형성의 유전자형과 대립유전자 빈도를 분석함으로써 Henoch-Sch$\"{o}$nlein 자반증의 발병에 있어 TNF-${\alpha}$ 유전자 다형성이 갖는 의의를 알아보고자 하였다. 방 법: 2004년 3월에서 2005년 11월까지 서울대병원 및 분당서울대병원 소아과에 내원하여 Henoch-Sch$\"{o}$nlein 자반증으로 진단받은 40명의 소아 환자를 대상으로 하였고, 건강한 소아 환아 32명을 대조군으로 하였다. 후향적인 의무기록지 검토를 통해 환아들의 임상양상을 조사하여 임상 점수를 평가하였다. 환자군에서 급성기와 관해기에 혈청 TNF-${\alpha}$ 농도를 측정하였다. 환자군과 대조군에서 혈액을 채취하여 TNF-${\alpha}$ -308과 -238 유전자 다형성을 조사하였다. 결 과: Henoch-Sch$\"{o}$nlein 자반증으로 진단된 40명 (남아 20명, 여아 20명)의 환아에서 급성기에 측정한 혈청 TNF-${\alpha}$ 농도는 $23.17{\pm}11.31$ pg/mL였으며, 증세가 소실된 후에 측정한 혈청 TNF-${\alpha}$ 농도는 $10.56{\pm}5.59$ pg/mL로서 유의하게 감소하였다(p=0.000). 혈청 TNF-${\alpha}$와 Henoch-Sch$\"{o}$nlein 자반증의 임상 점수 간에 유의한 상관관계는 없었다(r=0.310, p=0.070). TNF-${\alpha}$ -308 유전자형 빈도는 환자군에서 GG 80%, GA 20% 였으며, 대조군에서는 GG 93.8%, GA 6.2%로서 환자군에서 높은 GA 유전자형의 빈도를 보였지만 통계적인 유의성은 없었다(P=0.094). TNF-${\alpha}$ -238 유전자형 분포는 환자군에서 GG 97.5%, GA 2.5%였으며, 대조군에서는 GG 93.8%, GA 6.3%로서 두 군 사이에 통계적인 유의성이 없었다(p=0.429). 결 론: TNF-${\alpha}$는 Henoch-Sch$\"{o}$nlein 자반증의 발병에 중요한 역할을 하는 사이토카인으로 여겨지지만, TNF-${\alpha}$ -308, -238 유전자 다형성이 Henoch-Sch$\"{o}$nlein 자반증의 발병과 다양한 임상양상의 발현에 미치는 영향에 대해서는 뚜렷한 연관성이 확인되지 못하였기에 향후 지속적인 연구를 통하여 Henoch-Sch$\"{o}$nlein 자반증의 발병기전과 유전적 감수성을 밝히려는 시도가 이루어져야 할 것이다.

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TNF-α 자극에 활성화된 HaCaT 세포주에서 Yakuchinone-A에 의한 건선 피부염 개선 효과 (Improving effect of psoriasis dermatitis by yakuchinone A in the TNF-α stimulated HaCaT cells)

  • 김민영;황형서
    • Journal of Applied Biological Chemistry
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    • 제63권1호
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    • pp.95-101
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    • 2020
  • 건선(psoriasis)은 인체 피부조직 중 표피의 과증식 및 다양한 크기의 홍반, 인설 등이 동반되는 난치성 자가면역 피부질환이다. 건선 피부염 발병 기작은 명확히 규명되지 않았으나 각질 형성세포의 과분화 과정에 관여하는 염증성 cytokine과 Th17 세포를 포함한 면역세포를 염증부위로 유인하는 chemokine (C-C motif) ligand 20 (CCL20)이 발병과정에 관여하는 것으로 알려진다. 따라서 건선치료에 효과적인 천연 소재를 발굴하기 위해 예로부터 항염증 활성이 알려진 익지인(Alpiniaoxyphylla Miquel)의 유효성분인 yakuchinone-A의 건선 피부염 개선효과를 연구하였다. 먼저 CCK-8 assay 통해 human keratinocyte (HaCaT) 세포에 tumor necrosis factor-alpha (TNF-α)와 yakuchinone-A를 동시 처리하여 세포독성을 관찰한 결과, yakuchinone-A는 10 ㎍/mL까지 세포독성이 관찰되지 않았다. TNF-α를 HaCaT 세포에 처리하여 염증을 유발한 후 yakuchinone-A를 농도별로 처리한 결과 IL-6, IL-8, TNF-α 등 건선 피부염 유발 cytokine의 mRNA 발현이 각각 61.4±7.5, 23.6±1.5, 46.0±4.8% 수준으로 감소하였고, Th17 세포를 유인하는 chemokine인 CCL20 또한 yakuchinone-A에 의해 유의적으로 억제되었다. 또한 CCL20 발현에 관여하는 NF-κB/IκB pathway에서 IκB 인산화 및 STAT3 인산화가 yakuchinone-A에 의해 79.1±5.0, 80.8±2.3% 수준만큼 농도 의존적으로 억제되었다. 마지막으로 Th17 세포에 의해 분비되는 IL-17A에 의해 활성화된 HaCaT 세포에 yakuchinone-A를 처리한 결과, CCL20 mRNA발현이 농도의존적으로 감소하였다. 이러한 결과들을 토대로 yakuchinone-A는 건선 피부염 개선 활성을 가지며, 향후 새로운 건선 피부염 개선 소재로 개발될 수 있을 것으로 기대된다.

대황 추출물의 항위염 작용과 유효성분에 관한 연구 (A Study on the Antigastritic Effects of Rheum Species Extracts and Their Active Components)

  • 황인영;정춘식
    • 한국식품위생안전성학회지
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    • 제28권4호
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    • pp.330-336
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    • 2013
  • 현재 대황은 지표성분의 규격이 한국, 일본과 중국이 다르고, 유통시장에서 대황과 종대황이 혼재되어 있으며 다양한 기원식물이 혼재되어 수입되고 있다. 따라서 대황의 효능을 현대 약리학적으로 해석하는 과정을 통해 약재의 표준화, 과학화 및 위염에 대한 지표성분 검색에 기여할 수 있을 것으로 사료되어 Rheum tanguticum(당고특대황)과 그 비교생약으로 Rumex cripus(양제근), Rheum officinale(약용대황), Rheum palmatum(장엽대황) 및 Rheum undulatum(종대황)의 물 및 70% 에탄올 추출물을 비교하였다. 그 결과, 흰 쥐를 이용한 위염 모델에서 양제근 70% 에탄올 추출물(73.2%)와 종대황 물 추출물(71%)이 각각 70% 이상으로 우수한 위손상 억제활성을 보여주었지만, 당고특대황의 70% 에탄올 추출물 투여시 91.8%로 실험군 중 가장 우수한 위염 억제 효과를 확인할 수 있었다. 공격인자로써의 산을 중화시킬 수 있는 능력을 알아보기 위한 제산력 시험법으로는 당고특대황 물 추출물과 70% 에탄올 추출물이 각각 약 14.2%, 약 15.8%로 억제함을 알 수 있었다. 이 결과로 보아 양성대조군으로 사용한 hydrotalcite(49.9%)보다는 제산작용이 약하였지만 과량 혹은 장기간 복용하면 효과가 있을 것으로 생각된다. 소화성궤양, 위암 및 변연부 B세포 림프종 발생에 있어 중요한 원인 인자로 밝혀졌고, 기능성 소화불량증, 위의 과형성 용종, 철결핍성 빈혈 등 기타 질환과의 연관성들이 제시되고 있는 H. pylori에 대한 colonization 억제 활성을 확인한 결과 당고특대황의 70% 에탄올 추출물 $100{\mu}g/mL$에서 H. pylori에 대한 항균작용(+)을 확인할 수 있었다. DPPH 용액을 이용하여 free radical의 소거능을 $IC_{50}$으로 나타낸 결과, 당고특대황은 물 및 70% 에탄올 추출물에서 $IC_{50}$$25.9{\mu}g/mL$, $5.8{\mu}g/mL$로 양성대조군으로 사용한 L-ascorbic acid ($IC_{50}=6.5{\mu}g/mL$)와 유사한 free radical 소거능을 나타내었다. 이 결과로 당고특대황의 70% 에탄올 추출물이 휜 쥐 위염모델의 위손상을 가장 우수하게 억제하였으며 항산화 활성 또한 가장 우수한 것으로 확인되었다. 당고특대황의 성분인 chysophanol, chrysophanol-8-O-glc, desoxyrhaponticin desoxyrhapontigenin, emodin, isorhaponticin, 2-methoxy-4-hydroxyanthraquinone-5-O-glc, physcion, piracetannol-3'-O-glc, resveratrol, rhaponticin 및 rhapontigenin을 이용하여 실험한 결과로는 효성분들 중 physcion $100{\mu}M$과 rhaponticin $50{\mu}M$$100{\mu}M$에서는 실험에 사용한 성분 들 중 비교적 우수한 colonization 억제작용(+)을 나타내었고, DPPH radical 소거 활성은 isorhaponticin, piracetannol-3'-O-glc, resveratrol 및 rhaponticin에서 $IC_{50}$이 각각 $129.5{\mu}M$, $94.1{\mu}M$ $80.1{\mu}M$$104.6{\mu}M$로 확인되었다. 실험결과를 토대로 항위염 효과가 있는 우수한 약용식물로써 천연물 의약품개발 가능성을 확인하였고 나아가 한약재의 효능을 과학적으로 검증하고 한약재 표준화에 기여할 수 있을 것으로 기대된다.

비위생리(脾胃生理)에 수용(授用)되는 황제내경(黃帝內經) 어구(語句)에 관(關)한 연구(硏究) (Studies on the phrases of Yellow Emperor's internal classic(黃帝內經) for the physiology on the spleen and stomach)

  • 원진희
    • 대한한의학회지
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    • 제16권2호
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    • pp.453-489
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    • 1995
  • The research of the phrases related with physiology of stomach and spleen in the contents of Huang Di Nei Jing(黃帝內經) known as the Bible of oriental medicine will make a contribution to a deep understanding of disease of stomach and spleen and a proper clinical diagnosis and treatment of them. In this research of the most appropriate glosses recorded nine kinds of representative medical books including Huang Di Nei Jing Somoon(黃帝內經素問) of Wang Bing(王氷) were picked out: The summaries of the selected contents are as follows: 1. The word 'saliva(涎)' in 'the spleen controls saliva(脾爲涎)' can be viewed as a generic term referring to oral cavity secretion gland as well as the secretion fluid of salivary gland. 2. The phases 'a large reservoir(太倉)', barn organs', 'a reserboir of food stuff', 'a stomach as the market(胃爲之市)', etc mean the function of stomach to receive food(胃主受納). 3. The phase 'generation of five tastes(五味出焉)' means both 'the function of stomach to transform food into chyme(胃主腐熟)' and 'the channelling function of spleen.(脾主運化)' 4. The flowing of the food-Qi(食氣) into stomach brings about spreading Jung(精) into liver and then percolating Jung(精) flow into channel. The channel-Qi(脈氣) flows into lung through channel. As a result, all kinds of channels gather together in lung and Jung(精) is sent into skin and hair. The assembly of Jung(精) with skins and channels moves Qi(氣) into fu-organ and so jung(精) and mental activity(神明) in fu-organ(府) come to be in four organs(四臟). Then if Qi(氣) comes back to power balance unit(權衡) being in the state of equilibrium(權衡以平), the hole of Qi(氣口) comes to determine the matter of life and death through achieving Chun-quan-chi(-寸-關-尺). The above mentioned phrases means the digestion, asorption and transmission of food. When food is taken in stomach, Jung-Qi(精氣) comes to be over flowed upward into spleen, back into lung, finally downward into bladders through water-conduit(水道) controlled by lung. When water- Jung(水精) radiates into whole body with channels of five organs(五臟), both of them fit together with and yin-yang(陰-陽). Therefore, the grasping of the rise and decline of yin-yang(陰C-陽) is necessary to consult patients. The above mentioned phrases is properly viewed to designate the asorption, transmission and excretion of food. 5. Spleen controls flesh(脾之合肉也), the state of spleen is known by human lips, and what this means is that liver plays functions of spread and expansion(肝主疏泄). 6. The phrase 'Jung Jung'((中精)) in 'gallbladder dominates Jung jung(膽主中精)', which in one of the specific expression of 'liver plays functions of spread and expansion(肝主疏泄). 7. It is right that the phase 'The eleven organs in all are determined by gallbladder'(凡十,一臟取決於膽也) is correctly paraphrased as 'only one of ten organs, spleen, is determined by gallbladder'.(凡十,一臟取決於膽也), 8. The small intestine is an organ. which receives the materials digested and sends them out. This means that the function of transforming materials(化物) factually refers to that of separating clearity and blur(泌別淸濁). And it is also thought to have the function of ascending clearity and descending blur(升淸降濁), 9. A large intestine is a transmitting organ(傳導之官) from which a change comes out(變化出焉). the phrase 'change'(變化) in this sentence means both the intake of water and nutrition and the formation procedure of stool through excretion of mucocele.

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폐결핵 재치료 환자에서 Prothionamide, Cycloserine, Paraminosalicylic acid, Ofloxasine을 이용한 경구 4제 요법의 임상 효과 (Clinical Effects of Prothinoamide, Cycloserine, Para-Aminosalicylic Acid, Ofloxasine in Retreatment of Pulmonary Tuberculosis)

  • 홍재락;유민규;정재만;김영준;손말현
    • Tuberculosis and Respiratory Diseases
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    • 제43권5호
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    • pp.693-700
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    • 1996
  • 연구배경: 1980년대 들어서 폐결핵의 치료는 INH, RFP, EMB(또는 SM)의 6개월 표준 단기 요법이 정착되었고 치료 성적 또한 괄목한 만한 향상을 보여왔으나 초치료 실패 및 재치료 실패 환자에서는 약제 내성 및 약제 부작용으로 인한 치료 중단이 큰 문제가 되었다. 1980년대 개발된 Quinolone 계통의 항생제인 OFX은 감영성 호흡기 질환 치료제로서의 역할을 할 뿐만 아니라, 최근에는 결핵 치료제로 사용되고 있다. 이에 따라 저자들은 PTA, CS, PAS, OFX을 사용하여 폐결핵 환자들의 재치료 또는 재재치료의 임상효과를 알아보았다. 방법: 1993년 3월부터 1995년 8월까지 국립 공주 결핵병원에 입원하였던 객담내 결핵균 양성 환자중 초치료및 재치료에 실패한 환자로 추척이 가능한 66명을 대상으로하여 후향적 조사를 하였다. 결과: 1) 객담내 균음전 객담 도말 양성 환자 66명 중 42 명(64%)이 15개월내에 객담내 균음전되었다. 2) 흉부 X-선상의 호전은 경증에서는 3명(75%), 중등중에서는 23명(64%), 중증은 12명(46%)이었고, 전체적으로는 38명(58%)에서 호전되었다. 4) 질병 기간에 따른 균 음전율은 각100%(병력이 1년미만), 88%(1-3년), 80%(3-5년) 그리고 52%(5년이상)이었다. 5) 부작용 PTA의 부작용은 위장판 장애(소화불량, 구역, 구토, 복통등)와 경한 간기능 장애를 보여주었고, CS은 정신상태 이상(주로 불면과 감정장애)이 8명(12%)에서 있었으며, 경련은 없었다. PAS에 의한 위장 장애는 오심, 구토, 복부 불쾌감과 같은 위장장애가 대부분으로 41명(62%)에서 관찰되었다(Table 5). 결론: 폐결핵 치료 역시 다른 모든 질환과 마찬가지로 환자의 병력이 젊을수록, 흉부 X-선상의 병변이 적을수록 좋은 성적을 보였으며, 38명(58%)의 경우에는 X-선상의 호전을 보였으나 일부에서는 매우 제한적이고 더 이상의 호전을 기대하기가 어려울 것으로 생각되는 예도 있었다. 부작용으로는 위장장애(소화장애, 오심, 구토, 변비, 설사)가 주가 되었으며, 위장장애는 대부분의 경우에서는 규칙적인 증상 치료로 많은 호전을 가져 왔다. 또한 무엇보다도 전문가에 의한 적절한 치료약제의 결정과 지속적인 항결핵제 복용을 위한 정기적인 의사와의 면담 및 추후검사가 필요할 것으로 생각된다.

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정위 체부 고정틀을 이용한 체부 방사선수술의 예비적 결과 (Preliminary Results of Stereotactic Radiosurgery Using Stereotactic Body Frame)

  • 안승도;이병용;최은경;김종훈;노영주;신경환;김경주;정원균;장혜숙
    • Radiation Oncology Journal
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    • 제18권4호
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    • pp.251-256
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    • 2000
  • 목적 : 1990년대 이후 개발된 정위 체부 고정틀을 이용한 체부 정위방사선수술의 치료효과, 치료의 정확성과 후유증에 대해 후향적으로 알아보고자 하였다. 대상 및 방법 : 1997년 12월부터 1999년 6월까지 간암 3명, 동정맥기형 1명, 폐전이 6명와 간전이 1명 등 모두 11명에서 정위 체부 고정틀을 이용하여 체부 방사선수술을 시행했다. 환자의 고정은 정위 체부 고정틀에 vacuum pillow를 이용하여 수행하였고 chest marker와 leg marker를 이용하여 흉골부위 또는 등부위와 경골부위의 피부에 환자 위치 표시를 하였다. 이후 모의치료실로 이동하여 X선 투시기를 통해 횡경막의 움직임을 측정한 후 Diaphragm control을 사용하여 1 cm 이하로 횡경막의 움직임을 최소화하였다. CT-simulator를 이용하여 치료부위의 단층촬영을 시행한 후 치료계획을 세웠다. 매회 치료전 CT-simulator를 이용하여 단층촬영을 반복하여 최초의 단층촬영의 영상과 수동적으로 비교하여 치료의 정확성을 확인하고 오차가 5 mm 이내인 경우 치료를 시행하였다. 방사선 치료는 90$\%$ 등선량곡선에 10 Gy씩 1일 내지 2일 간격으로 3회 시행하여 총30 Gy를 조사하였다. 결과 : 중앙 추적관찰기간은 12개월이었다. 11명의 환자 중 1명(9$\%$)의 환자에서 국소적 완전관해를 보였고 4명(36$\%$)에서 부분관해를 보였다. 계획용표적체적은 3$\~$111 cc 였고 평균값은 18.4 cc 였다. 치료 오차를 측정한 결과 X, Y, Z 축으로 오차범위는 모두 5 mm 이내를 보였다. 치료 중 또는 치료 직후에 올 수 있는 고열, 통증 등의 급성후유증은 관찰되지 않았다. 결론 : 정위 체부 고정틀을 이용한 체부 방사선수술은 뛰어난 치료의 재현성을 보여주었고 간 혹은 펴종양에서 유용한 치료 방법으로 이용될 수 있을 것으로 기대된다.

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