탁리소독음과 황련해독탕 약침을 병용하여 호전된 4도 욕창 1례

정혜선,김하리,김서영,이상화,조승연,박성욱,고창남,박정미,Jeong, Hye-Seon,Kim, Ha-Ri,Kim, Seo-Young,Lee, Sang-Wha,Cho, Seung-Yeon,Park, Seong-Uk,Ko, Chang-Nam,Park, Jung-Mi 대한중풍순환신경학회 2019 대한중풍.순환신경학회지 Vol.20 No.1

■ Objectives The purpose of this case study is to report the effectiveness of Korean medicine and pharmacopuncture in the treatment of pressure ulcer. ■ Methods The patient with pressure ulcer was treated with herbal medicine, Hwangryunhaedoktang pharmacopuncture, acu-moxi treatment. We started herbal medicine mainly Taklisodok-um for pressure ulcer, but changed to Paljung-san due to urinary tract infection on Day 67. During the daily dressing, we inject pharmacopuncture solution subcutaneous ulcer area and spray solution on the cavity of right pressure ulcer. The severity of pressure ulcer was assessed using[NPUAP] pressure ulcer stage, healing rate of pressure ulcer and depth of right side ulcer cavity on Day1, Day15, Day40, Day73, Day95. ■ Results After treatment, the total size of the pressure ulcer was reduced from 90(10*9) to 56(8*7)cm², healing rate of pressure ulcer increased to 37.8%, depth of pressure ulcer was reduced from 3.5 to 2cm. Though NPUAP stage(Gr 4) was not changed, size and color of pressure ulcer definitely improved compared to Day1. ■ Conclusion This study suggested taht Korean medical treatment could be effective option for treating grade 4 pressure ulcer.

소화성궤양의 임상적 고찰

박승국,허정욱,강영우,안성훈,이상곤 啓明大學校 醫科大學 1993 계명의대학술지 Vol.12 No.2

저자들은 1981년부터 1990년사이에 64,207명을 대상으로 내시경검사를 시행하여 8,814명에서 소화성궤양을 진단하여 다음과 같은 결론을 얻었다. 소화성궤양의 발생률은 13.7%였다. 위궤양과 십이지장궤양의 발생비는 1981년에는 1:0.9였으나 그후로는 1:1.1-1:1.5로 십이지장궤양의 발생비율이 높았다. 발생비율을 남녀별로 보면 위궤양의 경우에는 약 4:1 십이지장궤양은 3:1로 남자에서 많았다. 연령별로는 위궤양은 40대, 50대, 60대의 순서였고, 십이지장궤양은 30대, 40대, 20대 순으로 호발하였다. 위궤양은 위체부에서 대부분 발생하였다. In this century, very striking changes in incidence and prevalence of peptic ulcers, as well as in sexual proportion, in the age of the affected population and in the proportion of duodenal to gastric ulcers had occured and these epidemiological changes are ongoing. Therefore, we reviewed 8,814 cases with endoscopically proven peptic ulcers from 1981 to 1990. The results obtained are as follows; The prevalence of peptic ulcers among patients received endoscopy was 13.7%. The ratio of peptic ulcers among patients received endoscopy was 13.7%. The ratio of gastric ulcer to duodenal ulcer was 1: 0.9 in 1981, but after then the propotion of duodenal ulcer was higher in 1: 1.1-1:1.5. The ratio of male to female was about 4:1 in gastric ulcer and 3:1 in duodenal ulcer. The prevalence of gastric ulcer was highest in foruth decade and then fifth and sixth in order and the prevalence of duodenal ulcer was highest in thrid decade and then fourth and second decade in order. Most of the gastric ulcers were found at the gastric body.

Helicobacter pylori에 감염된 십이지장궤양과 비궤양성 소화불량에서 ABO 혈액형과 HLA의 연관

채현석(Hiun Suk Chae),김태규(Tai Gyu Kim),한훈(Hoon Han),김성수(Sung Soo Kim),최규용(Kyu Yong Choi),정인식(In Sik Chung),차상복(Sang Bok Cha),박두호(Doo Ho Park),김부성(Boo Sung Kim) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.5

N/A Background/Aims: It has been known that genetic factors, for example, blood group, non-secretor and HLA system, are associated with duodenal ulcer and that Helicobacter pylori infection is the major cause of peptic ulcer. However, Helicobacter pylori is also found in non-ulcer dyspepsia and asyrnptomatic patients without ulcer formation. But, it is still not known regarding what kind of genetic factors have an effect on ulcer formation at the time of Helicobacter pylori infection. This study was performed to make clear wbich genetic factors are re1ated with duodenal ulcers among Koreans, and what kind of genetic factors could influence on the ulcer formation in the patients with Helicobacter pylori infection according to ABO blood groups and HLA antigen.'.. Methods: The duodenal ulcer patients (36), non-ulcer dyspepsia (19) and norraal healthy controls (103) were included in this study. Helicobacter pylori infection was detected with phenol red spray method in vivo which was confirmed with Warthin-Starry silver stain. HLA antigen expression (HLA-A,B) of peripheral blood T lymphocytes was studied with microlymphocytotoxicity teclmique. Results: Tbe frequency of HLA-A 33 was higher in duodenal ulcer patients (l4/36, 38.9%) compared with the control group (21/103, 20.4%). On the contrary, no difference in HLA-B has been shown between duodenal ulcer patients and controls. Among patients with Helicobacter pylori infection, blood group 0 was significant1y more frequent in patients with duodenal ulcers (21/36, 58.3%) than in non-ulcer dyspepsia (5/19, 26.3%). In patients with HLA-A 33, blood group 0 was significantly more frequent in duodenal ulcer patients (7/)4, 50%) than in non-ulcer dyspepsia patients (0/7, 0%). Conclusions: In Helicobacter pylori-infected patients, HLA-A 33 is related with duodenal ulcers and the patients with both blood group 0 and HI.A-A 33 are more likely to have duodeual ulcers than those with HLA-A 33 and without blood groop O. (Korean J Gastrnenterol 1996; 28:623 - 631)

간호사의 입원환자 욕창 사정에 대한 정확성

권은옥,엄인향,장선주,심미영,이수희 병원간호사회 2012 임상간호연구 Vol.18 No.1

Purpose: The purpose of this study was to examine the accuracy of general nurses' assessments of pressure ulcers in hospitalized patients. Methods: A total of 129 nursing records of assessments on pressure ulcers were analyzed. Assessment records of pressure ulcers by general nurses were compared to those by Wound, Ostomy, Continence Nurses (WOCN) on the same pressure ulcers. A WOCN of a nursing unit was a nurse certified by the hospital after completion of a formal WOCN course and passing a cyber education course, both offered by the hospital. The formal WOCN course was taught by an internationally certified WOCN. The inter-rater reliability among WOCNs was 98.2%. General nurses in this study did not receive a structured pressure ulcer education. Results: The accuracy for nursing assessment of pressure ulcers by general nurses compared to WOCNs' were evaluated in various ways and resulted in as follows; the existence of pressure ulcer 91.4%, site of pressure ulcer 85.3%, stage of pressure ulcer 85.3%, Braden scale 36.3%, size of pressure ulcer 51.9~64.3%, details of pressure ulcer 0~100%. Conclusion: The structured education about pressure ulcer assessment is important to enhance the accuracy of pressure ulcer assessment of hospitalized patients by general nurses.

시간 경과에 따른 중환자실 환자의 욕창과 영양 상태

이하늬(Lee Ha Nee),박정숙(Park, Jeong Sook) 계명대학교 간호과학연구소 2016 계명간호과학 Vol.20 No.2

Purpose: This study was to identify the pressure ulcer and nutritional status of ICU patient according to time. Methods: Research subjects were 112 patients who were admitted to an ICU of a university hospital. Data were collected on questionnaires including general characteristics, diet-related characteristics, nutritional status, and pressure ulcer status. Results: Pressure ulcer prevalence of ICU patient was 58.9% and pressure ulcer prevalence was increased as time passed in ICU. There were no pressure ulcer group 41.2%, healing pressure ulcer group 7.1%, newly developed pressure ulcer group 12.4%, and continuous pressure ulcer group 30.3%, and nutritional status of newly developed and continuous pressure ulcer group were poorer than no pressure ulcer group. The caloric intake, calrolric supply status, glucose of ICU patients were increased over time, but BMR, Triceps skinfold thickness, hemoglobin, hematocrit, albumin were decreased over time. Comparing nutritional status as time passed in ICU by group of pressure ulcer status, hemoglobin and hematocrit of newly developed pressure ulcer group were lower than no pressure ulcer, healing pressure ulcer, and continuous pressure ulcer group. Total protein of no pressure ulcer, newly developed pressure ulcer and continuous pressure ulcer group were decreased as time passed in ICU, but total protein and albumin of healing pressure ulcer group were increased significantly. The MNA-SF score of no pressure ulcer group was high in normal nutrition, newly developed pressure ulcer group was high in normal nutritional risk, and continuous pressure ulcer group was high in malnutrition. Conclusion: It is important to assess nutritional status of patients including MNA-SF in ICU admission as risk factor of pressure ulcer. And appropriate prevention and management of pressure ulcer including nutritional approach for ICU patients is needed.

소화성 궤양에 있어서 혈청 Pepsinogen I 의 의의에 관한 연구

이선희(Sun Hee Lee),이동필(Dong Pil Lee),신영민(Young Min Sin),황성윤(Sung Yoon Hwang),송근암(Kun Am Song),조몽(Mong Cho),양웅석(Ung Suk Yang),문한규(Han Kyu Moon) 대한내과학회 1995 대한내과학회지 Vol.49 No.1

Objectives: Peptic ulcer is heterogenous disease which has genetic or acquired etiologic factors and serum pepsinogen I (PG I) was reported as a marker of the genetic factor. In this study, the correlations of serum PG I level and natural course of peptic ulcer disease such as site, stage, recurrence and acquired factors such as smoking, H. pylori were evaluated. Methods: Fasting serum PG I levels were tested in 71 patients with peptic ulcer (Gastric ulcer 31, Duodenal ulcer 40) who had been confirmed by endoscopy, biopsy and 58 healthy control from January, 1991 to August, 1993 at Pusan National University Hospital. Serum PG I levels between ulcer and control group were compared and correlations of serum PG I level and natural course such as site, stage, complicaton, recurrence and acquired factors such as smoking, NSAID, H. pylori in ulcer group were observed. Results : 1) The patients with peptic ulcer showed significantly higher mean levels of serum PG I than those of the control group. Especially the mean levels of PG I of antral ulcer and duodenal ulcer were higher than ulcer of gastric body and angle. 2) The patients with active ulcer showed higher mean levels of serum PG I than healing stage ulcer. but there weas no statistical significance. 3) The patients with recurrence, smoking history, complications showed higher mean levels of PG I than those without recurrence, smoking history, complications. but there was no statistical significance. 4) The CLO test positive group of the duodenal ulcer patients showed higher mean levels of serum PG I than those of CLO test negative group. but there was no statistical significance. Conclusion: The above results suggest that serum pepsinogen I may be useful as a parameters of activity and recurrence and as a subclinical markers for acquired risk factors of the peptic ulcer.

한국인의 소화성 궤양에 대한 임상적 고찰

이동필(Dong Pil Lee),정영태(Yeong Tae Jeong),이재복(Jae Bok Lee),고우석(Woo Suk Ko),이선희(Sun Hee Lee),신영민(Young Min Shin),송근암(Geun Am Song),조몽(Mong Cho),양웅석(Ung Suk Yang),문한규(Han Kyu Moon) 대한내과학회 1995 대한내과학회지 Vol.48 No.6

Objectives: Although the peptic ulcer is a benign disease, it has relatively high incidence and recurrence rate in Koreans. It is important to understanding the current characteristics of peptic ulcer disease because that helps us to diagnose and treat and expect the exact prognosis of peptic ulcer disease. Methods: The clinical observation of the peptic ulcer was done retrospectively using medical records and protocl in 893 peptic ulcer patients who were diagnosed with gastroduodenoscopy at eight medical school hospitals in Korea during recent 10 years, Results: In 893 peptic ulcer patients, gastric ulcers were 499(55.9%) cases, duodenal ulcers were 319(35.7%) cases, and combined gastric and duodenal ulcers were 75(8.5%) cases. The incidence of duodenal ulcer was higher before forties and lower after forties than that of gastric ulcer. Among the peptic ulcer patients, males were 645/893 cases(72.2%) and females were 248/893 cases(29.8%) and the ratio of males and females was 2.6:1. The seasonal incidence of peptic ulcer was not remarkable except slightly lower in the fall. There was no special difference in the incidence of peptic ulcer between the alcoholics and nonalcolics. Regard in blood types, peptic ulcer was more common in the blood type O group than others. The location of gastric ulcer showed as 54.7% in body, 25.6% in angle, 19.7% in antrum. The location of duodenal ulcer showed as 57.5% in the anterior wall of bulb, 28.0% in lesser curvature, 11.4% in posterior wall and 3.0% in greater curvature. The single ulcer was noted 68.6% in gastric ulcer, 80.2% in duodenal ulcer. The complication rate was 38.2% in peptic ulcer and the bleeding was the most common with 73.6% of total complications(gastric ulcer 54.5%, duodenal ulcer 46.7%) followed by perforation(19.6%) and pyloric obstruction(6.4%). The recurrence rate of peptic ulcer was 51.6%(54.5% in gastric ulcer, 46.7% in duodenal ulcer). Conclusion: We analized the peptic ulcer disease in 893 patients using medical records and protocol. We report the characteristics of current peptic ulcer disease in koreans.

소화성궤양 환자의 성격 및 심리적특성 - MMPI 와 Spielberger 불안척도를 중심으로 -

이병호(Byung Ho Lee),현진해(Jin Hai Hyun) 대한내과학회 1989 대한내과학회지 Vol.36 No.5

N/A The aim of this study was to evaluate personality patterns and psychological characteristics of peptic ulcer patients and patients with functional dyspepsia by MMPI and Spielberger's Anxiety Test. The peptic ulcer diseases were categorized gastric ulcer, duodenal ulcer, and recurrent duodenal ulcer. The group with functional dyspepsia consisted of patients with upper gastrointestinal symptoms, including postprandial abdominal distension, nausea, cramping pain, and belching without evidence of a peptic ulcer or other organic gastrointestinal disorder. The results are as follows: 1) The mean age of the gastric ulcer group was higher than that of the other groups. But there was no significant mean age difference between the functional dyspepsia, duodenal ulcer, and recurrent ulcer groups. 2) In the basic MMPI scales, the functional dyspepsia group showed the tendency of neuroticism (higher mean score of the D, Hy, and Pt scales than those of the peptic ulcer groups) and psychopathy (higher mean score of the Pd and Mf scales than those of peptic ulcer groups), compared to the peptic ulcer groups. But the duodenal ulcer group showed a significantly higher mean score on the Pa scale than the other groups. 3) In the extended MMPI scales, the peptic ulcer group revealed a higher mean score of the BO, CI, and Im scales than those of the functional dyspesia group. 4) The functional dyspepsia group showed a higher mean score of Spielberger's state and trait anxiety scale than those of the peptic ulcer groups. 5) There was no significant difference between the gastric ulcer and duodenal ulcer groups in the mean score of the MMPI scales and Spielberger's Anxiety scales except the L scale.

Acute ulcer of vulva (Lipschutz ulcer): Different disease entity from Behcet`s disease

( Young In Lee ),( Hemin Lee ),( Shinwon Hwang ),( Do Young Kim ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

Lipschutz ulcers refer to the ulceration of vulva or lower vagina of non-venereal origin that usually presents in young women, especially virgins. We report a case of acute ulceration of vulva in an adolescent patient, who was initially diagnosed as suspected Behcet’s disease, and was finally diagnosed as Lipschutz ulcer. A 14-year-old female visited a gynecology clinic with a single acute ulceration of vulva. Her past history showed frequent ulceration of oral cavity, and she was sent to our dermatology clinic for a suspected Behcet’s disease. She was presented with fever, malaise and mild pharyngitis before development of the ulcer, but had no history of sexual contacts. We underwent serologic tests to rule out infectious etiologies. The bacterial swab showed no growth of pathologic flora, and the serologic labs for Epstein-Barr virus showed positive for EBV antibodies to IgG and IgM. When direct cytotoxic infections and specific systemic diseases for acute genital ulcer have been excluded, the patient meets the criteria for Lipschutz ulcers. Because of high incidence of Behcet’s disease in the East Asia, it is easy to misdiagnose as Behcet’s disease when patients present with recurrent aphthous stomatitis history with acute ulceration of vulva. Therefore, main causes of genital ulcer in young females have been excluded, and there is no history of sexual contact, Lipschutz ulcer should be included in the differential diagnosis.

종합건강검진 수진자의 소화성궤양

정훈용,민영일 울산대학교 의과대학 1996 울산의대학술지 Vol.5 No.1

1990년 7월 1일부터 1995년 6원 30일까지 5년간 건강검진을 위하여 본원 종합건강증진센터에 내원한 사람 중 위내시경 검사를 시행받은 44,213명을 대상으로 소화성 궤양의 발견 빈도와 연령별 및 성별 분포를 고찰하여 다음과 같은 결과를 얻었다. 1. 44,213명 중 4,477예(10.1%)에서 소화성궤양의 소견을 보였는데, 양성위궤양 소견만 보였던 예는 2.2%, 십이지장 궤양은 7.2%, 그리고 위, 십이지장혼재궤양은 0.7%였다. 2. 성별로 분석하였을 때, 남자는 13.2%, 여자는 4.6%의 빈도를 보였다. 3. 연령특이적 소화성궤양의 빈도는 10대, 20대, 30대, 40대, 50대, 60대, 70대가 각각 5.8%, 8.0%, 8.8%, 10.7%, 10.7%, 10.2%, 및 12.9%였으며, 십이지장궤양은 연령에 따른 빈도의 차이가 없었으나, 위궤양의 경우에는 연령에 따라 빈도가 점차 증가하는 경향을 보였다. 4. 위궤양은 65.3%가 활동성 혹은 치유기의 궤양이었으나, 십이지장궤양은 70%가 반흔기의 궤양이었다. Background Peptic ulcer is very common but frequently asymptomatic disease. The aim of this study is to investigate the prevalence of the peptic ulcer in Korean general health examinee. Methods A tota1 of 44,213 general health examinee received gastroscopy at General Health Promotion Center at Asan Medical Center between July 1990 and June 1995 were analyzed. Results Of 44,213, 4,477 (10.1%) had peptic ulcer: 963 (2.2%) gastric ulcer, 3,196 (7.2%) duodenal ulcer. Sex-specific prevalence of peptic ulcer was 13.2% in male and 4.6% in female. Age-specific prevalence in the 2nd, 3rd, 4th, 5th, 6th, 7th, and 8th decades was 5.8%, 8.0%, 8.8%, 10.7%, 10.7%, 10.2%, and 12.9%, respectively. According to ulcer stages by Sakada, 835 (18.7%) were in active, 990 (22.1%) in healing, and 2,652 (59.2%) in scar stage. The prevalence of peptic ulcers having ulcer crater was 4.1% of 44,213 examinee. Sixty-five percent of gastric ulcers was in active or healing stage, while 70% of duodenal ulcers was in scar stage. Conclusion The prevalence of peptic ulcer in Korean general health examinee was 10.1%, and that of peptic ulcer in active or healing stage was 4.1%.