급성 Guiilain-Barre Syndrome 추정 환자 동서협진 치험 1례

소형진,손윤정,이범준,노병완,류재환,허홍,So, Hyung-Jin,Son, Yoon-Jung,Lee, Beom-Joon,Rho, Byoung-Wan,Lew, Jae-Hwan,Heo, Hong 대한한방성인병학회 2005 韓方成人病學會誌 Vol.10 No.1

Guillain-Barre syndrome (GBS) is a group of autoimmune syndromes consisting of demyelinating and acute axonal degenerating forms of the disease. Typically, Gullain-Barre syndrome can be diagnosed from the patient's symptoms and physical examination such as the rapid onset of weakness, paralysis and loss of reflexes. In most patients, resolution is complete or near complete. Treatment consists of supportive care, ventilatory management (in about one third of patients), and specific therapy with intravenous immunoglobulin or plasmapheresis. This clinical report is about suspected acute severe Guillain-Barre syndrome patient, 61-year-old man had quadriplegia, facial palsy, dysphasia, respiratory failure. After 5 weeks of East-West integrative medicine therapy - Conventional Conservative therapy(plasmaphresis and intravenous immunoglobulin) and Korean traditional medicine(Sasang medicine and acupuncture treatment) - most symptoms improved.

한의과대학 부속 한방병원 한방응급실 내원환자에 대한 임상적 분석

소형진,류재환,김영철,이범준 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2007 東西醫學硏究所 論文集 Vol.2007 No.-

Objectives : By recording basic data of patients visiting the emergency room of the oriental medicine center, we can understand their characteristics and gain better insight about them. Methods : We performed a retrospective study of 2,674 patients who visited the emergency room of Kyunghee Oriental Medical Center, from June 1, 2006 to May 31, 2007. Results : 1. Of 2,674 total patients, the male to female ratio was 0.94:1 and the 6th decade of life was the peak age group. 2. The majorit of patients visited our emergency room between 06:00 and 24:00(midnight). 3. Most patients visited on a Saturday or Sunday. 4. By monthly distribution, the patients incrcased slightly during June, July, August and October. 5. The majority of patients visited the emergency room within 24 hours of onset. 6. The patients were categorized as follows : neurological diseases 71.15%, musculoskeletal diseases 16.02%, internal medical discase 9.04% psychiatric and related disease 3.79%. 7. The average transit time waS about 1 hour 30 minutes. 8. Admission rate was 48% and the rate of admission to the intensive care unit (ICU) was 5% of total visiting patients. Conclusion : Assuming that this research will continue adding patien's data continuously, this work will help us to understand the features of patients who visiting the emergency room of the oriental medical center.

경희의료원 제3중환자실 입원 환자에 대한 임상적 고찰

소형진,허홍,이범준,류재환,손윤정,So, Hyung-jin,Heo, Hong,Lee, Beom-Joon,Rho, Byoung-Wan,Ryu, Jae-Hwan,Son, Yoon-Jung 대한한방성인병학회 2005 韓方成人病學會誌 Vol.10 No.1

We have analyzed 247 patients who were admitted to the 3rd ICU for intensive care between January 2003 and December 2003 to investigate characteristics of ICU patients and obtain better guidance and management in the ICU. The results are as follows: 1) The total number of patients was 247. The proportion of males was 59.1 %, of females was 40.9%, and the ratio of male to female was about 1.45:1. 2) The most prevalent age group is those in their seventies, the proportion is 33.6%. 3) The total admission days was 3,438days, and mean patient stay being 13.9days. 4) The total number of expired patients was 26, the mortality rate was 10.5%. The mortality in distribution by disease was higest in Cerebral infarction, rate was 53.8%. the proportion of raised intracranial pressure was 42.3%, of hemorrhagic transformation was 11.5%. 5) In distribution by admission channel, Oriental hospital E.R. was 60.7%, Oriental hospital ward was 38.5%, and etc. was 0.8%. 6) The number of patients of Cerebral infarction was 146(59.1%), being the highest in distribution by chief disease and the proportion of MCA territory infarction is highest in the Cerebral infarction(61.6%). 7) In distribution by Oriental Medicine therapy, the proportion of Acupuncture treatment was 15.8%, of Acupuncture treatment combination Herb medication was 78.5%, and of Acupuncture, Herb medication plus subcutaneous Acupuncture treatment was 5.7%.

한의과대학 부속 한방병원 한방응급실 내원환자에 대한 임상적 분석

소형진(Hyung-jin So),류재환(Jae-hwan Ryu),김영철(Young-chul Kim),이범준(Beom-jun Lee) 대한한의학회 2007 대한한의학회지 Vol.28 No.3

Immunoglobulin productivity assay를 이용(利用)한 홍삼투여(紅蔘投與) 실험동물(實驗動物)의 IgG, IgM, IgA 비교(比較) 연구(硏究)

이범준,소형진,김재완,류재환,Lee, Beom-Jun,So, Hyung-Jin,Kim, Jae-Wan,Lew, Jae-Hwan 대한한방내과학회 2007 大韓韓方內科學會誌 Vol.28 No.4

Objective : The immune system is a complex of systems, all of which work together to clear infection from the body. In Korea, red ginsenghas been one of the herbs most widely used to enhance the immune system for thousand of years. More recently, red ginseng has been reported to have many positive effects on the immune system. The purpose of this study was evaluate the effects of Korean red ginseng and Chinese red ginseng on IgG, IgM, and IgA, using immunoglobulin productivity assay. Methods : Male SD rats were separated into 3 groups. We administered Korean red ginseng (KRG) to one group and Chinese red ginseng (CRG) to another, with normal saline for the Control group consecutively and orally for 3 months. The dose of red ginseng was 500mg per day, as a powder with soluble water. Immunoglobulin levels from spleen cell were estimated by ELISA kit. Results : In immunoglobulin productivity assay (cell), the IgG level of the KRG group significantly increased but there was no significant difference in the IgG of the CRG group. The IgM level of the KRG group significantly increased stimulated with PWM. When it was unstimulated, the level of IgM in KRG and CRG increased together. The IgA level of the KRG group significantly increased when it was stimulated with PWM and unstimulated. Conclusion : According to the above results, oral administration of red ginseng for 3 months is considered useful for immunomodulatory effect, and Korean red ginseng may be superior to Chinese red ginseng in that effect.

경희의료원 제3 중환자실(동서협진중환자실)에 입원한 89명의 중증 급성기 뇌경색 환자에 대한 임상적 고찰

허홍,소형진,임주혁,조인영,이혜영,민경윤,류재환,이범준,Heo, Hong,So, Hyung-Jin,Im, Ju-Hyuk,Cho, In-Young,Lee, Hae-Yong,Min, Kyoung-Yoon,Ryu, Jae-Hwan,Lee, Beom-Jun 대한한방내과학회 2007 大韓韓方內科學會誌 Vol.28 No.4

Objects : To gain better insights of East-west integrated treatment of ischemic stroke. We analyzed 89 patients with severe acute ischemic stroke who were admitted to the East-west integrated intensive care unit. Methods : Subjects enrollment was from the East-west integrated intensive care unit of Kyung Hee Medical Center from March 2006 to February 2007. Patients were admitted within 14 days after the onset of ischemic stroke. We assessed the subjects' general characteristics, risk factors, admitting routes and periods, diagnostic imaging, process of western treatment and Korean traditional treatment, complication and consequence. Results : The proportion of males was 50.6%, of females 49.4%, average age was male 66.0$\pm$10.3 and female 71.1$\pm$10.5. Average length of hospital stays was 19.5 days. Monthly admissions were highest in November and December. The admission route was through emergency room (61.8%) or ward (34.8%). Mean Glasgow coma scale score was 10.0$\pm$2.5, average time from symptom of onset to hospital admission was 2.3$\pm$2.2 days. Dominant ischemic vascular territory was middle cerebral artery (66.3%). Initial western treatment was argatroban (22.5%), urokinase (28.1%), and heparinization (38.2%). Distribution of Sasang constitution of So-yang to Tae-eum to So-eum was equal to 5.4 to 2.9 to 1.5. Major complications were observed in 40 (42.7%) patients. In hospital mortality was 12.4% (11 deaths), all of them caused by aggravation of neurological deficit and only 3 of them with major complications. There appears to be a significant positive relationship between length of hospital stay and occurrence of complications (P<0.05). After discharge from the ICU, 64 (71.9%) patients were improved, 11 (12.4%) patients had expired, and 14 (15.8%) patients were transferred. Conclusions : From this study, we suggest that patients with severe acute ischemic stroke should be treated with East-west integrated therapy for more favorable consequences and decreased mortality.

현훈(眩暈)을 동반한 보행장애(步行障碍)를 가진 환자에 형방사백산과 형방도적산 투여 경과 치험 1례 - 부제 : 소양인(少陽人) 비수한표한병(脾受寒表寒病) 결흉증(結胸證) 환자에 대한 치험례

임주혁,소형진,허홍,민경륜,이혜영,최순영,류재환,조인영,Im, Ju-Hyuk,So, Hyung-Jin,Heo, Hong,Min, Kyoung-Yoon,Lee, Hae-Yong,Choi, Soon-Young,Ryu, Jae-Hwan,Cho, In-Young 대한한방내과학회 2007 大韓韓方內科學會誌 Vol.28 No.3

We made a comparative study, A patient who had suffered dizziness and ataxia took Hyungbangsabaek-san(荊防瀉白散) at first and next took Hyungbangdojeock-san(荊防導赤散). He was diagnosed as a Soyangin suffering chest knotting syndrome(結胸證) by Sasang constitutional medicine(四象醫學) and took two kinds of herbs in a row. We observed his phase of dizziness and ataxia with the conditions of stool and urine excavation, pink eye, sweating, and tongue color and tongue coating. When he took Hyungbangdojeock-san these conditions improved more than when he took the other one and his dizziness and ataxia also improved. Hyungbangdojeock-san was more useful when the severity of the disease was shallower and he had more exterior syndromes than Hyungbangsabaek-san.

삼황사심탕(三黃瀉心湯) 추출물의 lipopolysaccharide 유도에 의한 염증 조절과 대식세포 활성에 대한 연구

강희,권한올,소형진,이정민,류재환,최호영 대한본초학회 2012 大韓本草學會誌 Vol.27 No.6

Objectives: Samhwangsashim-tang (SHSST), a mixture of Rhei radix et rhizoma, Scutellariae radix, and Coptidis rhizoma, has been regarded as being able to treat bleeding, gastric discomfort, dry mouth, insomnia and purpura due to Blood Heat. Currently, this herbal formula is applied to gastritis, gastric ulcer, hypertension, atherosclerosis or other types of vascular inflammatory disorders. Methods: We extracted this herbal mixture with 30% ethanol and examined for its effects on systemic inflammatory responses and in vitro macrophage activity. Mice were orally given to SHSST for 7 days and then lipopolysaccharide (LPS) was intraperitoneally injected. Tumor necrosis factor-α(TNF-α) levels in serum were measured 1 h after LPS challenge. Peritoneal macrophages were isolated from thioglycollate-injected mice and used for in vitro cellular activity. Cell death was measured using the MTT method and annexin V/propidium iodide staining. LPS-stimulated signaling molecules necessary for TNF-α expression were determined by Western blotting. Results: Oral administration of SHSST for 7 days resulted in a significant reduction in LPS-stimulated TNF-α release into serum. In vitro treatment of SHSST was cytotoxic in a concentration-dependent manner. However, SHSST caused a concentration-dependent reduction in necrosis and increase in apoptosis in mouse peritoneal macrophages. SHSST inhibited the activation of NF- κB, p38 and JNK signaling molecules in response to LPS. Conclusion: Taken together, our results demonstrated that SHSST was effective in lowering LPS-stimulated TNF-α serum levels, possibly through its modulation of NF-κB, p38 and JNK in macrophages.

자발성 두개내저압 환자에서 요추부위에서 경막외 혈액봉합술

정기태,이보원,이현영,소형진,추인성,유보연,임경준 조선대학교 의학연구소 2014 The Medical Journal of Chosun University Vol.39 No.2

Spontaneous intracranial hypotension (SIH) causes headache in the absence of tissue injury such as trauma, spinal cord injury, surgery, or epidural anesthesia. Epidural blood patch in the epidural space where CSF leakage occurs is effective for treatment of SIH. However, when the leakage site is unknown, administration of autologous blood into the lumbar epidural space could be effective. Here we report on patients who suffered from headache by SIH and could not confirm the leakage site, however, treatment by lumbar epidural blood patch was administered successfully.

Clinical evaluation of a newly designed fluid warming kit on fluid warming and hypothermia during spinal surgery

정기태,김상훈,소금영,소형진,심수빈 대한마취통증의학회 2015 Korean Journal of Anesthesiology Vol.68 No.5

Background: The Mega Acer Kit® (MAK) is a newly designed heated and humidified breathing circuit that warms fluid passing through the circuit lumen. In this study, we investigated the system’s efficacy for the perioperative prevention of hypothermia and fluid warming. Methods: Ninety patients undergoing spinal surgery were enrolled in this study and randomly assigned to 3 groups based on the fluid warming device used: no fluid warming system (Group C, n = 30), via a Standard Ranger (Group R, n = 30), or via the MAK (Group M, n = 30). Distal esophageal temperatures (Teso) and infusion fluid temperature (TF) were recorded at 15 min intervals for duration of 180 min during surgery. If Teso was < 35.0oC, a forced-air convective warming device was used. Results: Final Teso values were 34.8 ± 0.3oC, 35.1 ± 0.1oC, and 35.8 ± 0.3oC in groups C, R, and M, respectively (P < 0.01). Teso was significantly higher in group M when compared with that in groups C and R throughout the study period (P < 0.05). The number of patients requiring a forced-air convective warming device was significantly lower in group M (n = 0) when compared with that in groups R (n = 17) and C (n = 30) (P < 0.05). The final infusion fluid temperature was higher in group M when compared with that in groups C and R throughout the study period (35.4 ± 1.0 vs. 23.0 ± 0.3 and 32.8 ± 0.6oC; P < 0.01). Conclusions: The MAK is more effective for preventing hypothermia and for warming fluid than the Standard Ranger.