• 대한두개안면성형외과학회지
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• 제12권1호
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• pp.53-57
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• 2011

Purpose: Pyoderma gangrenosum is a rare inflammatory, reactive dermatosis marked by painful cutaneous ulcer. The causes of pyoderma gangrenosum remain unclear. Gastrointestinal, hematological, rheumatological, and immmune disorders may be associated with pyoderma gangrenosum. The appearance of this disease may range from mild skin ulcers to life-threatening conditions. Generalized multiple ulcerative pyoderma gangrenosum is very rare. Here we report our experience with a case of multiple ulcerative pyoderma gangrenosum accompanied by ulcerative colitis. Methods: A 67-year-old man had cutaneous ulcers at multiple sites including the scalp, face, chest, abdomen, hands, and buttocks. He also developed gastrointestinal symptoms such as intermittent dyspepsia and bloody excrement. Debridement and irritation aggravated the disease progress. We gave a diagnosis of pyoderma gangrenosum with ulcerative colitis based on the clinical appearance and biopsy. The patient was treated with systemic intravenous steroid therapies and careful wound cares. Ulcers of the scalp and buttocks were treated with split thickness skin grafts. Results: Most of the multiple cutaneous ulcers were treated by systemic intravenous steroid therapies and wound cares. The rest of the ulcers were treated with skin grafts. Systemic intravenous steroid therapy was used to treat the ulcerative colitis. Conclusion: Generalized multiple ulcerative pyoderma gangrenosum is very rare. Without making an accurate diagnosis, hasty surgical treatments could aggravate the progression of the disease. Additionally, care should be taken to systemically treat underlying disease as well as administrating local treatments for the skin lesions. Intravenous systemic steroid therapy and skin grafts are useful treatments for generalized pyoderma gangrenosum.

• 보건행정학회지
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• 제30권4호
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• pp.522-530
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• 2020

Background: In 2008, Korea implemented a new type of social insurance known as "long-term care insurance". We examined the association between ownership of long-term care facilities and the incidence of pressure ulcers after the implementation of "long-term care insurance". This study is a population-based retrospective cohort study from 2006 to 2013. Methods: We used medical claims data from the Korean National Health Insurance Corporate Elderly Cohort Database from 2006 to 2013. These data comprise a nationally representative sample. To avoid confounders, only patients admitted to one long-term care facility and who stayed for >70% of the follow-up time were included; as a result, 3,107 individuals were enrolled. The main independent variable was the operating entity of the long-term care facility (local government, corporate bodies, and private for-profit owners), and the dependent variable was the 1-year incidence of pressure-ulcers. Survival analysis (Cox proportional hazard model) was used as an analysis method. Results: Compared to patients admitted to local government long-term care facilities, patients admitted to private long-term care facilities had a significantly higher 1-year risk of pressure ulcers (hazard ratio [HR], 1.94; 95% confidence interval [CI], 1.29-2.91); the risk was especially high among patients who were cognitively dependent (HR, 2.34; 95% CI, 1.25-4.37). Conclusion: Patients admitted to private for-profit long-term care facilities were more likely to have pressure ulcers compared to those in local government and corporate body long-term care facilities. Appropriate assessment tools and publicly available information, as well as more restricted legal requirements, are needed to improve the care quality and outcomes of patients in long-term care facilities.

• 임상간호연구
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• 제16권3호
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• pp.5-23
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• 2010

Purpose: This study was conducted to determine the validity and reliability of performance measurement tools based on the nursing process for prevention and management of pressure ulcers, falls and pain. Methods: The performance measurement tools were reviewed by a panel of experts and refined on the basis of the panel's suggestions. The validity of the performance measurement tools was measured by surveying hospital nurses. The reliability of these tools was tested by having nursing experts use the tools in five nursing units to assess nursing performance in prevention and management of pressure ulcers, falls and pain. Results: The performance measurement tools in this study were found to be acceptable as tools to evaluate quality of nursing care in pressure ulcers, falls and pain. The reliability of the performance measurement tools was acceptable. Conclusion: These results indicate that the performance measurement tools developed in this study are valid and reliable instruments to monitor and improve quality of nursing care in prevention and management of pressure ulcers, falls and pain.

• 대한한의학회지
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• 제21권3호
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• pp.220-224
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• 2000

After stroke, there are many cases of gastro-intestinal bleeding in patients with dysphagia who are fed by Levin tubes. Ulcers in the stomach and duodenum are occasionally produced by psychiatric stress, irritation with the Levin tube and central nerve rusturbances. Because Dansambohyul-tang has been used to treat deficiency of blood, alleviate pain, tranquilize and to treat patients differentiated with an insufficiency of the heart and the spleen in oriental medicine, we treated a 62 year-old male patient who suffered from gastric ulcers with gastro-intestinal bleeding after stroke, and who was differentiated with an insufficiency of the heart and the spleen with Dansambohyul-tang, herb complex. After 20 days of treatment with Dansambohyul-tang, we observed improvement in the gastric ulcer through gastroscopy; serum hemoglobin increased by 5.1g/dl after 2 months; and symptoms (pale complexion.dysphagia.general weekness) were alleviated. So Dansambohyul-tang shows therapeutic effects on gastric ulcers with gastro-intestinal bleeding after stroke.

• 한국약용작물학회지
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• 제10권3호
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• pp.177-180
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• 2002

유백피 물 추출물의 위궤양치료 효과를 확인하기 위하여 여러 비율의 농도로 rat에 대한 투여량을 조절하면서 Shay, aspirin 및 Indomethacin으로 유도된 위궤양에 대하여 실험하였던 바 유백피의 물 추출물을 각기 500 및 1000mg/kg을 투여하였을 때 항궤양 효과가 유의성 있게 농도 의존적으로 증가하였으며 Shay궤양이나 aspirin유발 궤양보다도 indomethacin유발 궤양의 경우에 더욱 항궤양 효과가 좋았다.

• Natural Product Sciences
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• 제15권2호
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• pp.96-100
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• 2009

A novel gastric ulcer healing formulation, a mixture of Dioscoreae Rhizoma, Halloysitum Rubrum and Ostreae Testa (Dihaos), was examined for gastric ulcer healing effects. The effect of Dihaos was assessed in various gastric ulcer models in rats. Oral administration of Dihaos significantly reduced HCl-ethanol-induced gastric ulcers. Dihaos also significantly reduced gastric and duodenal ulcers induced by cysteamine. Ostreae Testa decreased secretion of gastric juice and increased the pH of gastric juice. Furthermore, the extracts of Dioscoreae Rhizoma affected the cell proliferation of MKN 74 cells. These results suggest that the healing effect of Dihaos on gastrohemorrhagic lesions results from its protective effect against acid secretion and proliferation of mucosal cells in induced gastric ulcers in rats.

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 2000년도 춘계학술대회
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• pp.3-5
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• 2000

Of 16 million diabetic patients in the USA, 2.4 millions have experienced diabetic foot ulcer and 67,000 have amputations every year. For treatment of diabetic foot ulcer, Americans spend more than $1 billion each year, including $36,000 per patient for complete treatment and $60,000 for each amputation. Neuropathy and ischemia, two common complications of diabetes mellitus, are the primary underlying risk factors for development of diabetic foot ulcers. Ischemic ulcers develop as a result of low perfusion pressure in the foot with inadequate blood supply, whereas neuropathic ulcers develop from loss of protective sensation. In addition, diabetes also increases the risk of infection by impairing the body's ability to eliminate bacteria. From these circumstances, results are chronic wounds with impaired healing ability.

• 한국산학기술학회논문지
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• 제14권7호
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• pp.3390-3399
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• 2013

본 연구는 2009년 한 해 동안 건강보험심사평가원의 요양급여 전체 청구자료를 통계적으로 표본 추출 한 환자표본자료를 이용하여 의료기관 종류 별 욕창 발생현황과 이중 요양병원 환자의 욕창 발생에 영향을 주는 요인을 규명하기 위해 시도되었다. 전체 의료기관 입원환자의 3.2%(n=25,339)에서 욕창이 발생하였다. 의료기관 종별로는 요양병원 입원환자의 8.2%(n=11,895)에서 욕창이 발생하여 종합병원(2.7%, n=8,052), 일반병원(1.7%, n=5,059) 보다 상대적으로 높은 비율을 보였다. 요양병원 입원환자(n=144,523)의 욕창발생에 영향을 주는 요인을 분석한 결과 의학적 진단 중 요실금을 가진 환자 군이 가지지 않은 군에 비해 욕창 발생이 2.46배 유의하게 높게 나타났다(Odds ratio(OR)=2.462, 95% confidence interval(CI)=2.038-2.974). 더하여, 고혈압질환(OR=1.456, CI=1.400-1.515), 말초혈관 질환(OR=1.357, CI=1.200-1.534)군 순으로 욕창 발생에 영향을 미쳤다. 진단 수(OR=1.193, CI=1.187-1.199)와 나이(OR=1.011, CI=1.009-1.012) 및 100침상 당 의사 수(OR=1.063, CI=1.035-1.091)가 증가할수록, 의료기관의 전체 침상수(OR=.889, CI =.869-.909)가 적을수록 욕창발생은 유의하게 높은 것으로 나타났다.

• Journal of Oral Medicine and Pain
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• 제17권2호
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• pp.75-86
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• 1992

Of the many first-occuring major manifestations of Behcet's disease, the oral ulcer is most frequently observed, shows the highest mean recurrence rate, and the longest mean duration period. A study of the relationship between mechanical irritation buy local factors and the recurrence of oral ulcers was carried out to see if there is a correlation. The subjects chosen for the study were 81 patients who were referred to the Department of Oral Diagnosis at Yonsei University Dental Hospital from the Behcet clinic of Severace Hospital after being diagnosed as Behcet's disease patients. 1. By Shimuzu's classification, possible type was the most numerous with 55.55% ; while suspected type was 19.76% ; incomplete type, 17,28% ; and complete type, 7.41% were observed in that order. The male to female ration was 1 to 1.61, and the average age of onset was 17.63 years. 2. Oral ulcers developed most frequently on the tongue (48.28%), and lip(23.15%), buccal mucosa (20.69%), palate\pharynx(4.43%), and gingiva(3.45%) also showed ulceration. 3. 38.27% of the patients were HSV positive : 27.16% were CRP positive ; 12.34% were ASO positive ; 9.87% were RF positive ; and 3.7% were ANA positive. 4. According to the answers to the survey, fatigue(85.18%) was most frequently associated with Behcet's diseage. Trauma by tooth brushing (22.22%), un specified reasons (20.98%), hard food chewing (12.35%), and irritation by dentition and/or prosthesis (13.58%) were observed in association with Behcet's disease. 23.46% had a history of tonsilitis. 5. Oral ulcers on the anterior part of tongue and buccal mucosa were associated with local irritatants. 6. Oral ulcers on the lip and posterior portion of tongue were not associated with local irritants. Local irritation by dentition and oral ulcer on the anterior part of tongue and buccal mucosa was observed to coexit with one another : in other words, lo9cal factors can act to cause of recurrence of an oral ulcer and to delay the healing process in Behcet's disease. Therefore, elimination of local factors along with systemic therapy must be recommended when treating oral ulcers.

• 한방안이비인후피부과학회지
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• 제14권2호
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• pp.84-88
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• 2001

Livedo vasculopathy clinically shows purpuric papules and recurrent ulcers in the lower extremities, mainly on the ankles, leaving characteristic scars called atrophie blanche after the healing of the ulcers. In Korean literture, about 10 cases of this disease have been reported but nothing in korean oriental medicine. So, we report a case of livedo vasculopathy in a 46 year-old female patient treated by oriental medicine therapy.