梓木이 腦血流 및 血壓에 미치는 影響

황경택,경은호,나한일,소응향,최병화,한종현 한국전통의학연구소 2003 한국전통의학지 Vol.13 No.1

The purpose of this study is to measure the changes of regional cerebral blood flow (rCBF) and blood pressure (BP) in rats, following the intravenous injection of Catalpa Ovata Water Extract (COWE). The measurement was continually monitored by laser-doppler flowmeter (Transonic Instrument, USA) and pressure tranducer(Grass, USA) in anesthetized adult Sprague-Dawley rats through the data acquisition system composed of MacLab and Macintosh computer. The result of this experiment was as following : COWE increased the changes of rCBF and BP significantly. After pretreatment with propranolol and indomethacin, the changes of rCBF were inhibited significantly, but not by L-NNA and methylene blue. Also, after pretreatment with propranolol, the changes of BP were inhibited significantly, but not by L-NNA, methylene blue and indomethacin. According to above result, it is considered that Catalpa Ovata increased the rCBF and BP, related to adrenergic β-receptor.

당뇨병 환자에서 발생한 피부 털곰팡이증

박지환,박서화,강은규,경규천,안효동,안소연 이화여자대학교 의과학연구소 2016 EMJ (Ewha medical journal) Vol.39 No.1

Mucormycosis is a rare disease caused by fungi. Most commonly involved sites of mucormycosis infection are sinuses, lungs, skin and soft tissues. Systemic risk factors for mucormycosis are diabetes mellitus, neutropenia, corticosteroid use, hematological malignancies, organ transplantation, metabolic acidosis, deferoxamine use and advanced age. Local risk factors are history of trauma, burns, surgery and motor vehicle accidents. We present a case of cutaneous mucormycosis in a patient with diabetes mellitus. A 66-year-old female with uncontrolled diabetes mellitus, admitted with necrotizing lesion after minor abrasions on leg. We took a culture of the lesion and it is diagnosed with mucormycosis. Disease progressed despite administration of systemic amphotericin B. We performed above-knee amputation and changed antifungal agents into liposomal amphotericin B. A tissue biopsy showed nonseptate, irregularly wide fungal hyphae with frequent right-angle branching. Our case report suggests that patients with risk factors should be observed carefully.

수술실 손 소독제의 종류에 따른 균주 수의 변화

홍성윤,김정민,김소영,이수정,오은실,양서인,김화실,김남초 병원간호사회 2006 임상간호연구 Vol.11 No.2

Purpose: The present study purposed to compare the hand washing effect of 7.5% powidone-iodine, which is used in the operation room of C university hospital in Seoul, with that of Ethyl alcohol-CHG mixture recommended by the US Association of Operating Room Nurses (2002) and to adopt a more effective hand disinfectant. Method: In a quasi-experimental design, 48 medical staff who participated in operations during the period from November 2004 to February 2005 had hand washing using the two kinds of hand disinfectants: 7.5% povidone-iodine and the ethyl alcohol-CHG mixture. Their palms were swabbed and cultured just after hand washing and again after taking dff sterile gloves after the operation. The number of colonies from the two occasions were counted and compared. Result: The number of general bacillus increased significantly in the group using 7.5% povidone-iodine compared to that in the group using the ethyl alcohol-CHG mixture. The number of general bacillus increased signficantly in doctors compared to that in nurses. The factors affecting the increase of the number of general bacillus were disinfectants and medical personnel. The number of general bacillus was expected to increase 9.41 times with 7.5% povidone-iodine than with the ethyl alcohol-CHG mixture and 14.87 times in doctors than in nurses. Conclusion: This study shows that the ethyl alcogol-CHG mixture has a stronger hand disinfection effect than 7.5% povidone iodine. Thus we need to change the hand disinfectant used in operating rooms as soon as possible in order to minimize the infection of wounds resulting from operations.

간호실무에서 신봉이론(Espoused theories)에 대한 탐색적 연구

서문자,김혜숙,이은희,박영숙,조경숙,강현숙,임난영,김주현,이소우,조복희,이명하,지성애,하양숙,손영희,권성복,김희진,추진아 성인간호학회 2001 성인간호학회지 Vol.13 No.1

As a nursing practice involves nurses' actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives, Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal) ; excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, account- ability and commitment(4 theories of nursing ethics) ; human respect. partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences. positive perspectives(4 theories of nurse), role of intervention. rewarding peer relationship(3 theories of situations) The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore. it is recommended to review the theories-in-use in order to and any discrepancies between the espoused theories and the reality of nursing actions

항문주위 괴사근막염 수술 후 발생한 두덩결합 골수염의 경험

김지연,김태형,추은주,전민혁,이은정,김종화,박의주,이재철,진소영 대한감염학회 2009 감염과 화학요법 Vol.41 No.3

Osteomyelitis of the pubic symphysis is not common and has often been reported to occur after urological or gynecological procedures, It can be spontaneous in origin but it also is associated with trauma, athletic exertion, pregnancy, and parturition. The early symptoms of osteomyelitis of the pubic symphysis mimic those of osteitis pubis and therefore, the differential diagnosis between these two entities is of clinical importance. A fifty nine-year-old man who had previously received debridement and wide excision of perianal necrotizing fasciitis visited our hospital with pain on both inguinal areas. The core biopsy of the pubic symphysis and aspiration culture were performed, from which Pseudomonas aeruginosa was recovered. He was treated with parenteral ceftazidime for 5 days followed by cefepime for 7 weeks and showed favorable clinical response. To our knowledge this is the first report on osteomyelitis of pubic symphysis resulting from debridement and wide excision of perianal necrotizing fasciitis in Korea.

KAAACI Guidelines for Allergen Immunotherapy

Lee Hwa Young,이상민,강성윤,Kim Kyunghoon,Kim Ju Hee,Ryu Gwanghui,Min Jin-Young,Park Kyung Hee,Park So-Young,Sung Myongsoon,Lee Youngsoo,Yang Eun Ae,Jee Hye Mi,Ha Eun Kyo,Shin Yoo Seob,Chung Eun Hee,Choi Su 대한천식알레르기학회 2023 Allergy, Asthma & Immunology Research Vol.15 No.6

Allergen immunotherapy (AIT) is a causative treatment for various allergic diseases such as allergic rhinitis, allergic asthma, and bee venom allergy that induces tolerance to offending allergens. The need for uniform practice guidelines in AIT is continuously growing because of the increasing discovery of potential candidates for AIT and evolving interest in new therapeutic approaches. This guideline is an updated version of the Korean Academy of Asthma Allergy and Clinical Immunology recommendations for AIT published in 2010. This updated guideline proposes an expert opinion by allergy, pediatrics, and otorhinolaryngology specialists with an extensive literature review. The guideline deals with basic knowledge and methodological aspects of AIT, including mechanisms, clinical efficacy, patient selection, allergens extract selection, schedule and doses, management of adverse reactions, efficacy measurements, and special consideration in pediatrics. The guidelines for sublingual immunotherapy will be covered in detail in a separate article.

소아청소년 간질 환자에서 ADHD 치료 실태에 대한 다기관 공동연구

은소희(So-Hee Eun),권순학(Soonhak Kwon),권영세(Young Se Kwon),김성구(Sung Koo Kim),김원섭(WonSeop Kim),남상욱(Sang-Ook Nam),심지윤(Gi Youn Sim),은백린(Baik-Lin Eun),이준화(Jun Hwa Lee),허윤정(Yun Jung Hur),황태규(Tae Gyu Hwang),주찬웅(C 대한소아신경학회 2011 대한소아신경학회지 Vol.19 No.2

목적 : 소아청소년기 간질 치료는 단순히 경련 조절뿐 아니라 간질과 흔히 동반될 수 있는 인지장애 및 정신신경 질환 유무를 확인하고 이에 대한 적절한 동반치료가 필수적이다. 특히 소아 간질 환자의 16-77%에서 동반하는 ADHD에 대한 치료가 성장기 소아환자의 장기 예후에 중요한 역할을 하고 있다. 하지만 국내에서 소아간질 환자에서 ADHD 치료 실태에 대한 보고가 미미한 상태로 이에 대한 연구가 필요하여 본 연구를 실시하고자 한다. 방법 : 규격화된 설문지를 전국 대한소아신경학회원에게 배포하여 참여한 의료기관을 대상으로 의무기록을 후향적으로 분석 조사하였다. 실험 대상으로 2005년 1월부터 2010년 6월까지 간질로 진단 받고 치료중인 만 4-20세 환자에서 DSM-IV 기준으로 ADHD에 합당한 소아청소년 간질 환자를 조사 대상으로 하였다. 또한 2005년부터 2010년 6월까지 매년 각 기관에서 치료 받고 있는 등록된 소아 및 청소년 간질 환자의 수를 파악하여 간질 환아에서 ADHD 유병률, 치료 실태 등을 조사 분석하였다. 결과 : 총 10기관 178명의 환자 설문지를 얻을수 있었으며, 이중 불충분한 자료를 보인 4명을 제외하고 174명(남:녀=139:35, 평균나이 12.2±3.3세)을 대상으로 분석하였다. 이중 부분 간질 환자는 125명(복합부분발작 102, 이차전범화발작 8, 단순부분발작 3, 로란딕 간질 13), 전신발작 40명(특발성 29, 결신발작 11), LG 증후군 8명이었다. 간질발생 나이는 평균 5.69세, 간질 치료 나이는 6.52세때 치료를 시작하였다. 동반질환으로 66명(37.9%)에서 정신지체를, 66명(37.9%)에서 적어도 한 가지 이상의 정신-신경 질환을 동반하였다. 112명에서 DSM-IV를 기준으로 진단하였으며 이중 80명이 ADHD-combined 형태였다. 174명 중 162명에서 ADHD 약물 치료는 받았으며 ADHD 치료율은 평균1.9% (기관별 0.3-8.9%)을 보였다. ADHD 평균진단 나이는 8.94세, 치료 시작 나이는 9.26세였으며 평균 21개월 동안 약물 치료를 받았으나, 51명에서 6개월 미만의 단기 유지율을 보였다. 92명에서 concerta, 66명은 methyphenidate를 사용하였다. 완전 조절 18명 등 130명(80.2%)에서 치료 효과를 보였다. 9명에서 발작 증가, 17명에서 식욕감퇴를 보이는 등 총 48명(29.6%)에서 부작용을 보였다. 18명은 부작용으로, 18명은 효과가 없어 중단하였고, 39명(24.1%)에서는 보호자 임의로 중단하였다. 결론 : 간질을 동반한 ADHD 아동에게 현재 시행되고 있는 치료방법 및 치료 효과는 간질을 동반하지 않은 ADHD 아동과 비슷하다. 간질과 ADHD를 가진 아동의 많은 수가 다른 정신신경계 질환을 동반하고 있어 이에 대한 적극적인 대처가 필요하다. 특히 본 연구의 간질 환자에서 ADHD 치료률은 다른 보고와 비교 할 때 매우 낮은 수치를 보여 간질환자에서 ADHD에 대한 적극적인 치료가 요구된다. Purpose : The purpose of this study was to assess the current therapeutic status of attention deficit-hyperactivity disorder (ADHD) in children with epilepsy. Methods : A cross-sectional survey of 178 patients aged 4-20 years from ten pediatric neurology clinics in eight cities in South Korea from January 2005 to July 2010 was used to assess clinical characteristics of ADHD patients with epilepsy and risk factors associated with ADHD. Results : A total of 178 pediatric epileptic patients were recruited for this study. One hundred seventy-four subjects' (M:F=4:1, mean age: 12.2±3.3 yrs old) records were evaluated excluding four patients due to incomplete data. One hundred twentyfive of 174 patients (71.8%) had partial epilepsy and 45 had generalized epilepsy. Eighty of 112 patients showed ADHD combined type from the DSM IV. The mean prevalence rate of ADHD treatment among the epileptic patients was 1.9%. Over 45 % of patients showed complete or persistent symptoms without difficulties in school life with CNS stimulants. Adverse reactions were reported in 19.8% of patients who received ADHD medication, and 18 patients discontinued ADHD medication due to severe adverse effects such as aggravated seizures (5.6%) or ADHD symptoms (3.7%). About 60% of children with ADHD and epilepsy had psychiatric comorbid disorders. Conclusion : The results indicate that ADHD treatment in epilepsy patients is safe and effective. However, these data also show that ADHD in pediatric epilepsy patients in Korea is under-diagnosed and under-treated.

Development and Evaluation of Non-Hydrous Skin Anal Liquid Crystal using Thermo-Sensitivity Smart Sensor

Kwang-Ho Yoo,Jae-Hwa Hong,So-Hee Eun,Tae-Hwa Jeong,Kwan-Young Jeong 한국유화학회 2014 한국응용과학기술학회지 Vol.31 No.3

In this study, skin permeation enhancement was confirmed by designing it to have a structure and composition similarity to the intercellular lipids that improve miscibility with skin by cross-linked lipids poloxamer. The cross-linked lipids poloxamer was synthesized and analyzed by 1H NMR that structure dose had conjugated pluronic with ceramide3. Active component is released by modification of liquid crystal structure because PPO part, large-scale molecule block of pluronic, has hydrophobic nature at skin temperature of 35℃. Conjugated pluronic with ceramide3 was synthesized using Pluronic F127 and p-NPC (4-nitrophenyl chloroformate) at room temperature yielded 89%. Pluronic(Ceramide 3-conjugated Pluronic) was synthesized by reaction of p-NP-Pluronic with Ceramide3 and DMAP. The yield was 51%. This cross-linked lipids poloxamer was blended and dissolved at isotropic state with skin surface lipids, phospholipid, ceramide, cholesterol and anhydrous additive solvent. Next step was preceded by α-Transition at low temperature for making the structure of Meso-Phase Lamella, and non-hydrous skin analogue liquid crystal using thermo-sensitivity smart sensor, lamellar liquid crystal structure through aging time. For confirmation of conjugation thermo-sensitivity smart sensor and non-hydrous skin analogue liquid crystal, structural observation and stability test were performed using XRD(Xray Diffraction), DSC(Differential Scanning Calorimetry), PM (Polarized Microscope) And C-SEM (Cryo-Scanning Electron Microscope). Thermo-sensitivity observation by Franz cell revealed that synthesized smart sensor shown skin permeation effect over 75% than normal liquid crystal. Furthermore, normal non-hydrous skin analogue liquid crystal that not applied smart sensor shown similar results below 35℃ of skin temperature, but its effects has increased more than 30% above 35℃.

The Body Mass Index as a Prognostic Factor of Critical Care

( So Yeon Lim ),( So I Kim ),( Yon Ju Ryu ),( Jin Hwa Lee ),( Eun Mi Chun ),( Jung Hyun Chang ) 대한내과학회 2010 The Korean Journal of Internal Medicine Vol.25 No.2

Background/Aims: Obesity is a worldwide concern, but its influence on critical care outcomes is not well understood. We tested the hypothesis that abnormal body mass index (BMI) would be an independent predictor of higher mortality rates in intensive care unit (ICU). Methods: We retrospectively reviewed patients who had admitted to the ICU from January 2007 to December 2007. Admission BMI was analyzed as both a three categorical (underweight, <18.5 kg/m2; normal weight, 18.5 to 24.9 kg/m2; overweight and obese, ≥25 kg/m2) and continuous variables among all patients with an ICU lenth of stay ≥4 days. The primary outcome was ICU mortality. Results: The multivariate analysis on ICU mortality selected Mortality Prediction Model-Admission (MPM at time zero) (hazard ratio [HR], 1.024; p=0.001; 95% confidence interval [CI], 1.010 to 1.037), failed extubation (HR, 5.092; p=0.0001; 95% CI, 2.742 to 9.456) as significant risk factors. When controlling these variables, none of the BMI group and BMI as a continuous variable had an independent association with ICU mortality. Conclusions: BMI did not have a significant influence on ICU mortality. The ICU mortality was influenced more strongly by severity of illness and failed extubation rather than BMI. (Korean J Intern Med 2010;25:162-167)

L1210 세포증식에 대한 Glycyrrhizin의 억제작용 기전

殷載淳,徐龍勳,權鎭,柳東和,吳贊鎬,蘇俊魯,全焄,黃甲洙 우석대학교 의약품개발연구소 1996 藥學硏究誌 Vol.1 No.-

The purpose of this research was to investigate the mechanism of inhibitory action of Glycyrrhizin(GZ) on the proliferation of mouse leukemia cell-line, L1210 cells. The cytotoxic activity was tested using a colorimetric tertrazolium assay(MTT assay), the apoptosis was tested using flow cytometry. Nitric oxide(NO) production form mouse peritoneal macrophage was tested using a Griess method and the phagocytosis of human polymorphonuclear cells was tested using a lucigenin chemiluminescence. GZ ingibited the proliferation of L1210, BALB/c 3T3 cells and mouse thymocytes at 50 ug/ml/ GZ did not affect nitric oxide production from mouse peritoneal macrophages in vitro, but ingibited nitric oxide production from lipopolysaccharide and y-interferon treated macrophages. Macrophages of GZ-administered mice accelerated NO production. The proliferation of L1210 cells apoptosis of L1210 cells were induced by co-culture with macrophage of GZ-administered mice. The apoptosis of L1210 cells were induced by co-culture with macrophage of GZ-administered mice. GZ increased the phagocytosis of human polymorphonuclear cells. These results suggest that GZ inhibit the proliferation of L1210 cells not only as a direct cytotoxic agent o tumor cells, but also by the enhancement of NO production and phagocytic activity.