耳鳴에 관한 임상적 연구

최인화,Choi, In-Hwa 대한한방안이비인후피부과학회 2001 한방안이비인후피부과학회지 Vol.14 No.2

Introduction: Noises in the ear, whether real or imagined, are called tinnitus. Subjective causes of tinnitus(which is heard only by the patient) are extremely common and the majority of them are treated conservatively. For certain individuals their tinnitus is a major handicap; for others a trivial concern. The most common from of subjective tinnitus is a rushing, hissing or buzzing noise; it is frequently associated with sensorineural heanng loss. The patient may be unaware of the hearing loss, especially if it is a high frequency deficit of moderate severity. The character of the tinnitus may give a clue to the etiology. But the patient often has difficulty in explaining his/her tinnitus in absolute terms, as they have no other tinnitus with which to compare it but their own Tinnitus, like pain, is a subjective state and trying to objectively assess the severity is problematic. Audiological techniques to match subjective loudness to machine-produced noise may offer some help, in that sound intensity matches can bear little correspondence to subjective complaint. In spite of many studies, most patients presently seen complaining of tinnitus are told by their doctors that there is no treatment and that they will have to learn to live with this symptom. Objectives: To perform a clinical analysis of tinnitus and estimate the efficacy of Oriental Medical treatment according to the Byeonjeung(辨證). Subject: We studied 34 patients with complaints of tinnitus who had visited Pundang Cha Oriental Medicine Hospital Department of Otorhinolaryngology from March 1998 to February 2000. All of them had been treated 2 or 3 times a week with acupuncture treatment and had taken herbs according to the Byeonjeung(辨證) method. It was therefore possible for me to know whether their symptoms improved or not. Parameters Observed and Method: We treated them with acupuncture & herb-medication. Sometimes we gave them moxibustion or negative therapy with bloodletting at the acupuncture points(耳門, 聽宮, 聽會). Parameters Observed 1) Distribution of age & sex 2) Chief complaints 3) The sites of tinnitus 4) The quality of tinnitu 5) The duration of disease 6) The problem induced tinnitus 7) Factors increasing disease severity 8) The classification of the Byeonjeung(辨證) 9) The efficacy of treatments Results: 1. Age and sex distribution: The most common occurrence was found in males in their twenties: 6 males($17.7\%$), and in females in their thirties and over sixty: 8 females($23.5\%$). Total patient numbers for men and women were 20 men($58.8\%$), 14 women ($41.2\%$). 2. The most frequent major complaints were hearing disturbances related to tinnitus; and dizziness with tinnitus; each comprising 10 cases($29.4\%$). There were also 7 patients($20.6\%$) with only tinnitus. 3. Tinnitus sites: 13($38.2\%$) said that they felt tinnitus in both ears, equally. In the right ear, 9($26.5\%$), in the left, 6($17.7\%$). 4. The most frequent descriptive symptoms of tinnitus were: humming, hissing, buzzing etc. 5. The duration of disease. 14cases($41.2\%$) had a duration of less than 1 year. 6. 15cases($44.1\%$) complained that it was hard to watch TV or make a phone call because of tinnitus. 10 cases($29.4\%$) complained about depression. 7. Factors increasing severity of tinnitus: ⅰ) fatigue: 18cases($52.9\%$) ⅱ) stress/ tension: 10 cases($29.4\%$) ⅲ) alcohol and tobacco: 5cases($l4.7\%$) 8. Classification through Byeonjeung : ⅰ) 19 cases($55.9\%$) were classified as showing Deficiency syndrome. ⅱ) 15 cases($44.l\%$) were classified as showing Excess syndrome. The deficiency of Qi was 7($20.6\%$), deficiency of Xue, 8($23.5\%$) and insufficiency of the Kidney Yin & Yang, 4($11.8\%$). The flare of Liver fire was 8($2

副鼻洞炎에 關한 臨床的 硏究

최인화,채병윤,Choi, In-hwa,Chae, Byung-yoon 대한한방안이비인후피부과학회 1998 한방안이비인후피부과학회지 Vol.11 No.1

Paranasal sinusitis, especially chronic is one of the most common diseases in the field of otolaryngology. It is similar to Bee Yeun(鼻淵) in oriental medicine. Most cases of sinusitis are due to anatomical abnormalities within ostiomeatal unit or disturbed mucocilliary flow. The ostiomeatal unit is the first place of contact with bacteria and allergens during aspiration, and it can be obstructed easily by minute mucosal swelling due to anatomical narrowness. Therefore the treatment of paranasal sinusitis is not easy and often leads to recurrences in spite of long term treatment or surgical therapy. We studied 83 patients who had visited our hospital with complaints of nasal symptoms; they had been diagnosed as having paranasal sinusitis through an endoscopy or CT scan in another hospital and were diagnosed as the paranasal sinusitis through a PNS series. The results were as follows: 1. Age and sex distribution: The most common occurence was found between 6-10 and 1-5 years old. The Males Were 52($62.7\%$) and Females were 31($37.3\%$). 2. By residence 58 cases lived in apts: 25 lived in houses. 3. The longest duration of disease varied from a lower of 13 to a higher of 36 months in 22 cases and from 7 to 12 months in 21 cases. 4. The most common complication & past history with otolaryngologic or allergic disease were adenoid or tonsil hypertrophy & tonsillectomy and adenoidectomy (21 cases). In decreasing order the others were atopic dematitis, otitis media with effusion and allergic rhinitis. 5. Distribution of paranasal sinus disease was most common in both maxillary sinuses in 52 cases. 12 cases showed a normal PNS X-ray series but these had been diagnosed as paranasal sinusitis with an endoscopy or CT scan in another hospital. 6. Common sinusitis - related symptoms were from highest incidence to lowest nasal obstruction, postnasal drip rhinorrhea, frontal headache, cough with sputum. 7. The most administered of prescription was Gamibangpoongtongsungsan and Sunbangpaedoksan extract. 8. In 26 cases the subjects showed significant improvement symptoms in PNS X-ray series : In 21 case showed partial improvement symptoms.

아토피 피부염 임상 연구의 최근 3년간 동향

최인화,Choi, In-Hwa 대한한방안이비인후피부과학회 2007 한방안이비인후피부과학회지 Vol.20 No.3

Objective : To observe the trend in clinical study on atopic dermatitis(AD) over the last 3 years in order to develop a study methodology of AD in Oriental Medicine. Methods : Using the Pub med on line site; search terms: atopic dermatitis, field as title/abstract, limitation as published in the last 3 years, only items with links to full text, Humans, Clinical Trial, English. I observed the study contents of all this research and focused on the classification of treatments. I also observed of AD clinical trials registered on a clinical trial site(www.clinicaltrial.gov) on 23rd of June, 2007: study contents, localization and study designs. Results : Through the Pub Med site, I found 169 articles. Classified according to study subject, the studies related to treatment were 114(67.5%); physiology, pathology and prevention 12(7.1%); Diagnosis and Evaluation(7.1%); psychological aspects including quality of life 10(5.9%); diet and management 10(5.9%); epidemiology 7(4.1%); and others 7(4.1%). However, the treatment study of herb-medicine as intervention showed only 1 article. Futhermore, it wasn't based on Oriental Medicine philosophy. In the clinical trial site, there were 31 studies in which patients were recruited or planned for the future. The study on efficacy and safety of the medicine produced 14 trials, 5 comparative trials, 2 phototherapy, 2 diagnosis, 6 physiology and pathology, and 2 epidemiology. The trial institutions were concentrated in U.S.A. Conclusion : I suggest we'd better try to make a good clinical guideline and standardization of diagnosis and herb-medicine in order to develop a clinical study methodology of AD as soon as possible in the future. Even though it 's very hard to find the study methodology, we should aim to achieve positive results and show the evidence of the efficacy and safety of herb-medicine treatment for AD using Oriental Medicine.

소아 해면상 혈관종 한방 치험 1례

최인화,Choi In-Hwa 대한한방소아과학회 2001 대한한방소아과학회지 Vol.15 No.2

Cavernous hemangiomas, one of common hemangiomas, are collections of dilated vessels deep in the dermis and subcutaneous tissue that are present at birth. Clinically they appear as pale, skin-colored, red, or blue masses that are ill defined and rounded. Like strawberry hemangiomas, the lesions enlarge for several months, become stationary for an indefinite period, and undergo spontaneous resolution. Usually, they are managed like strawberry hemangiomas, for example, compression, take corticosteroids or interferon and use lasers(pulsed dye lasers and argon lasers). It is similar to 血瘤 and 紅絲瘤 in Oriental Medicine. We observed and treated a 8 month old male infant who had been diagnosed with cavernous hemangiomas on near medial side of the right transverse cubital crease. He had been treated by lasers three times each month about 2 months after the on set of disease in another College of Medicine Hospital. However, his sign didn't any change. He first visited our clinic about 7 months after the on set of disease. bout 1 year after our treatment, herb-medication and acupuncture treatment, the volume of hemangiomas was decreased remarkably and the colour was lighter. It was tender to the touch more and more. It is very rate that someone has cavernous hemangiomas and visits Oriental Medicine Hospital. Also we don't have much the treatment experience of this disease. I expect this case will be one of the base of treatment and management on this kind of diseases.

동서의 피부 질환 명칭에 대한 소고

최인화,Choi, In-Hwa 대한한방안이비인후피부과학회 2004 한방안이비인후피부과학회지 Vol.17 No.3

Objectives: In order to establish a base for proper treatment and management of patients with dermal problems through correct diagnosis, I considered the naming rule for dermatology in Oriental Medicine, referring to the dermatology literature compared to western medicine. In addition, this paper examines the characteristic classification of dermatology. Methods: I examined the naming rule of dermatology in Oriental Medicine and then compared the disease names in Oriental and Western medicine and the characteristic classification of dermatology referred to the records. Results: The dermal diseases have been named according to their colors and morphologies, causes, progress of symptoms, recurrent sites, the character of distribution, recurrent seasons, ages, the character of patients' jobs and locations. Sometimes some have been named by referring to their main morphologies, sites, causes, colors and seasons synthetically. However it was found some names for dermal diseases, even though the same diseases, had been named differently according to for example: historical times, condition of locations and the quality of doctors whose process of naming developed and changed over time. The relationship between Oriental and Western medicine of each name for dermal diseases is basically divided into 5 types: same names - same diseases; same names but different diseases; same diseases but different names; one disease with multiple names; and one name with multiple diseases. Considering the methods of classification, these were generally achieved according to their places of origin. It is a method unique to Oriental medicine that we classified some dermal diseases into 疥, 癬, 瘡, 風, 丹, 疱, 疹, 癰, 痘, 疽 and so on and it is very easy to diagnose which part they belong to. This was classified by putting first the causes of diseases; for instance: viruses, bacteria, fungi. Sometimes, however there was a problem, connected to the classification of morphology. Conclusions: I suggest that we need to unify and refine dermatological terms in Oriental Medicine in order to establish a base for proper treatment and management of patients with dermal problems through correct diagnoses.

잣나무 인공림(人工林)의 간벌계획(間伐計劃)에 관한 연구(硏究)(I)

최인화,서옥하,Choi, In-Hwa,Seo, Ok-Ha 강원대학교 산림과학연구소 1997 Journal of Forest Science Vol.13 No.-

잣나무는 최근 10년간 우리나라 인공조림실적 중 31%를 차지하는 주요 조림수종이다. 현재 우리나라 산림(山林)은 대부분의 인공조림지를 포함하여 30년생 이하의 유령림(幼齡林)이 87%를 점유하고 있음에도 보육간벌은 거의 실시되지 못하고 있는 실정이다. 또한 현실정에 적합한 잣나무의 보육간벌 지침도 충분히 확립되어 있지 못하다. 본 연구는 잣나무림의 장기적 보육간벌 시험을 통하여 장차 최적(最適)한 간벌계획(間伐計劃) 및 방법(方法)의 확립 에 기여하고자, 우선 강원대학교(江原大學校) 연습림(演習林)에 설정된 잣나무의 간벌시험지와 기존의 임분수확표를 대상으로 생장함수를 이용하여 잣나무의 생장과정의 변화 등을 분석 고찰하였다. 간벌과정을 파악하기 위한 기초적인 단계로 생장과정을 표현하기 적합한 이론적 생장함수를 선정할 필요가 있다. 이를 위해 Mitscherlich, 4 parameter Richards, 3 parameter Richards의 3종의 생장함수식(生長函數式)을 간벌시험지에서 채취한 임령 18년 전후의 공시목의 직경생장 과정에 적용하였다. 그 결과 3변수 Richards 생장함수식이 가장 적합한 것으로 나타났다. 또한 산림청에서 작성한 잣나무 수확표의 직경과 수고생장, 입목본수의 감소 과정도 3변수 Richards 생장함수식에 의하여 적합하게 추정할 수 있음을 확인하였다. 장래 단목의 간벌에 따른 생장의 변화과정을 추정하기 위해, 단목의 점유 면적에 관계하는 계수 h를 포함하는 생장(生長)모델을 제안하였다. 현재 설치된 간벌시험지에서 향후 일정간격으로 얻어질 간벌시험지의 직경생장 공시자료를 이용하면 계수 h를 추정할 수 있고, 이를 이용하여 제안된 모델의 유용성을 검증, 보완한다면 단목의 생장과정을 사전에 유추하여 간벌의 효과를 표현할 수 있는 수식을 구축할 수 있을 것으로 사료된다. Pinus koraiensis is one of the major speciese which have been recently planted for ten years and consists of 31% of total plantation. Presently young stand less than 30 years consists of 87% of total forest, but tending thinning of it is hardly carried out and the desirable direction for the thinning is not established yet. The objective of the study is to introduce the optimum thinning plan and thinning method through the long-run experiment of tending thinning for the Pinus koraiensis stand. The experiments carry out to interprete its growth model on the subject of two thinning experimental plots and yield table of Pinus koraiensis. As the basic step for understanding the thinning process, a theoretical growth model which is suitable to express the growth process is required. For that purpose, three growth functions (Mitscherlich, 4 parameter Richards, 3 parameter Richards) are applied to the diameter growth of the sample trees which are taken in the two plots. The results show that 3 parameter Richards is the most suitable. It is also verified that the diameter growth, the height growth, and the decrease in the number of stocks can be estimated by this function. To estimate the growth change of single tree, growth model including parameter h which is related to the occupation area of single tree are introduced. The parameter h can be estimated by using the data of the diameter growth obtained from the established experimental plots. Therefore, if both verification and modification of the usefulness of the model suggested is made, equations which tell about the thinning effects could be drived by estimating the growth process of single tree in advance.

여드름에 관한 임상적 연구

최인화,Choi In-Hwa 대한한방안이비인후피부과학회 2000 한방안이비인후피부과학회지 Vol.13 No.2

Acne is a common chronic disease which most frequently affects the face, appearing in both males and females near puberty, and in most cases becomes less active as adolescence ends. The intensity and duration of activity vary for each individual. The disease may be minor, with only a few comedones or papules, or it may occur as the highly inflammatory and diffusely scarring acne conglobation. Permanent scarring of the skin and psyche can result from such inaction. The disease, however, has implications far beyond the few marks that may appear on the face. The lesions cannot be hidden under clothing; each is prominently displayed and detracts significantly from one's personal appearance and self-esteem. Recently many of acne patients are visiting to Oriental Medicine Hospitals. They want to receive the treatment of acne related another disease and causes, or worry about side effects of antibiotics and hormone therapy. This study was performed at Pundang Cha Oriental Medicine Hospital Department of Dermatology from March 1, 1997 to February 29, 2000 in 31 patients with recurrent acne. We investigated the clinical findings, included distribution of age & sex, severity of acne, sites on face, related causes, duration of disease and causes of visiting Oriental Medicine Hospital and so on. The results were as follows : The peak age at onset was 20-29 years old in females with 16 cases reported. The 22 total cases patients had severe signs with most frequently sites being forehead & chin. They visited Oriental Medicine Hospital because they want to take the treatment of acne related with another body problems(12 cases) and worry about side effects of antibiotics. Twenty cases were diagnosed 肺熱血熱(20 cases). And given acupuncture treatment, herb-medication and sometimes we used external applications. Relatively, their satisfaction grade was high. Dermatologists are trying to treat new methods in order to remove scar and decrease sebaceous gland secretion,. And we, Oriental Medicine doctors, have to develop and offer to patients the most effective management and successful treatment of this disease.

알레르기성 비염을 포함하는 과민성 비염 환자에 관한 임상적 연구

최인화,Choi, In-Hwa 대한한방안이비인후피부과학회 2002 한방안이비인후피부과학회지 Vol.15 No.2

Background: Allergic rhinitis(AR) is a heterogeneous disorder that despite its high prevalence is often undiagnosed. It is characterized by one or more symptoms including sneezing, itching, nasal congestion, and rhinorrhea. And it is frequently accompanied by symptoms involving the eyes, ears, and throat, including postnasal drainage. There are many different causes of rhinitis in children and adults. Approximately 50$\%$ of all cases of rhinitis are caused by allergy. In the case of rhinitis caused by allergens, symptoms arise as a result of inflammation induced by a gamma globulin E-mediated immune response to specific allergens such as pollens, molds, animal dander, and dust mites. The immune response involves the release of inflammatory mediators and the activation and recruitment of cells to the nasal mucosa. AR is similar to 鼻?, hypersensitive rhinitis in Oriental Medicine. I think hypersensitive rhinitis is including of AR, vasomotor rhinitis and non-allergic rhinitis related with eosinophil increased and so on. Purpose: To perform a clinical analysis of hypersensitive rhinitis including allergic rhinitis and estimate the efficacy of Oriental Medical treatment. Objective: We studied 96 patients who had visited our hospital with complaints of nasal symptoms from March 2000 to February 2002; they had the signs more than 2 - nasal obstruction, watery discharge, sneezing and eye or nasal itching. Parameters Observed & Methods: We treated them with acupuncture & herb-medication. Sometime they used aroma oil or external medicine. 1) the distribution of sex & age groups 2) the clinical type based on duration & the severity of symptom 3) the breakdown of complication & pasl history of Otolaryngologic or allergic disease 4) the clinical assessment and classification of rhinitis(sneezers and runners & blockers) 5) the associated symptoms and signs 6) the classification of Byeonjeung 7) the classification of prescriptions and 8) the efficacy of treatment. Result: 1. In the clinical type of based on duration, the intermittent type was 42.7$\%$ and the persistent was 57.3$\%$. 2. We observed the severity of symptoms based on the quality of life. The mild type was 24.0$\%$ and the moderate-severe was 76.0$\%$. 3. In the clinical assessment and classification of rhinitis, the sneezers and runners type was 69.8$\%$ and the blockers was 30.2$\%$. 4. The most common family history with otolaryngologic or allergic disease were allergic rhinitis(17.7$\%$), urticaria, paranasal sinusitis and T.B.(3.1$\%$). 5. The most common past history with otolaryngologic or allergic disease were paranasal sinusitis(14.6$\%$), atopic dermatitis and asthma(8.3$\%$). It was 31.3$\%$ they had a family history and 44.8$\%$, past history. 6. The most common complication was paranasal sinusitis(15.6$\%$). In decreasing order the others were otitis media with effusion(9.4$\%$), GERD and headache(6.3$\%$), asthma, bronchitis, nasal bleeding and allergic dermatitis(5.2$\%$). 7. Classification through Byeonjeung : ⅰ) 39 cases(34.9$\%$) were classified as showing Deficiency syndrome. The insuffficiency of Qi was 17.7$\%$, deficiency of Kidney-Yang, 12.5$\%$ and Lung-Cold, 10.4$\%$. ⅱ) 57 cases(59.4$\%$) were classified as showing Excess syndrome. The Fever of YangMing-meridian was 35.4$\%$, Lung-Fever, 24.0$\%$. 8. The efficacy of treatments showed: an improvement in 22cases(22.9$\%$); an improvement partly in 24 cases(25.0$\%$); no real improvement or changes in 16 cases(16.7$\%$); and couldn't check the results 18cases(18.6$\%$). Conclusion: We suggest that this study could be utilized as a standard of clinical Oriental Medical treatment when we treat h

한방병원에 내원한 노장층 피부과 환자에 관한 임상적 고찰

최인화,Choi, In-Hwa 대한한방안이비인후피부과학회 2002 한방안이비인후피부과학회지 Vol.15 No.2

Background: It is axiomatic that average life span is prolonged in proportion to the advance of socio-economic improvements and medical science. Consequently, the number of elderly patients with skin diseases is increasing. Objective: This study was performed to examine the patterns of skin diseases in elderly patients that had visited Dongguk Oriental Medical hospital, Dept. of Dermatology. We also compared these patients to the young generational groups. Methods: We studied 67 elderly patients with complaints of skin diseases who had visited our hospital from March 2000 to February 2002. We analysed their skin diseases and compared them with the younger group's. Results: The results were as follows; 1. The common disease groups were eczema(32.8$\%$); pruritus(23.9$\%$); viral infections (13.4$\%$); psoriasis(9.0$\%$); fungal infections and urticaria(6.0$\%$). 2. The disorders prevalent in men were eczema(30.0$\%$); herpes zoster & pruritus(23.3$\%$); fungal infection(13.3$\%$); psoriasis (3.3$\%$); melasma(6.7$\%$). 3. The common diseases of women's group were observed in the following order; eczema(35.l$\%$); pruritus(24.3$\%$); psoriasis(13.5$\%$); urticaria(10.8$\%$); other dermatoses(8.1$\%$); herpes zoster(5.4$\%$). 4. The most frequent skin disease for those in their 50's was eczema(32.3$\%$); 60's, pruritus(36.8$\%$); 70's, eczema(50.0); and over eighties., eczema and pruritus(40.0$\%$). Conclusion: This study suggests that dermatologic problems in the elderly are very common, especially eczema, pruritus. It is a very different pattern from the younger group's. And we have to better consider more effective management and treatment for them; especially further dermatologic studies including substantial medical care. Usually Oriental medicine is good at treating chronic diseases and less harmful. So we expect it to be generally better for elderly patients than western medicine.

폐렴구균 열충격 단백질 GroEL의 특성

최인화,김수남,김승환,권창희,표석능,이동권,Choi, In hwa,Kim, Su Nam,Kim, Seung Hwan,Kweon, Chang Hee,Pyo, Suhk Neung,Rhee, Dong Kwon 한국미생물학회 1998 미생물학회지 Vol.34 No.1

여러가지 환경 stress에서 유도되는 폐렴구균 열충격단백질 GroEL의 특성에 대하여 검토하였다. 비병원성인 폐렴구균(Streptococcusa pneumoniae)을 사용하여 stress 조건을 설정하고 이 설정된 조건에서 stress에 의해 유도되는 단백질을 $^{35}S$]-methionine으로 표지하여 autoradiography를 실시하였다. 열충격을 가했을 때 유도되는 단백질(65, 73, 84-kDa 등) 중 65 kDa의 단백질(hsp65)을 DEAE-Sepharose ion exchange 및 ATP-agarose affinity chromatography를 이용하여 분리 정제하였으며 hsp65에 대해 생성된 항체를 이용하여 immunoblot을 실시하였을 때 약 60 kDa의 대장균 단백질과 반응하였으며 정제된 폐렴구균 hsp65가 대장균의 anti-GroEL monoclonal 항체와 반응함으로써 폐렴구균 hsp65가 대장균GroEL과 유사한 단백질임을 확인하였다. Induction and purification of the GroEL homolog from Streptococcus pneumolliae were characterized. The stress conditions were determined by temperature, ethanol, NaCI, $H_2O_2$ methyl methanesulfonate, and ethyl methanesulfonate. And stress induced proteins were analyzed using [$^{35}S$]-methionine labeling method. Heat shock induced the synthesis of a set of about 3 heat shock proteins (hsps) (65, 73, and 84-kDa). Of those 3 hsps, a 65 kDa protein, hsp65, was purified by DEAE-Sephacel and ATP-agarose column chromatography, and used for antibody preparation. Immunoblot analysis employing antisera raised against pneumococcus hsp65 demonstrated cross-reactivity with a 60 kDa protein in Eschericha coli. Also cross reaction of the purified p65 with anti-Escherichia coli GroEL monoclonal antibody demonstrated that pneumococcal hsp65 is the GroEL homolog.