관절ㆍ류마티스 질환의 한ㆍ양방 협진에 관한 임상적 고찰

신예지,김찬영,권나현,권신애,이정우,고형균,우현수,박동석,백용현 대한침구의학회 2009 대한침구의학회지 Vol.26 No.6

Objectives : To evaluate the current status of East-West combination treatment in joint disorders. Methods : The medical records of patients who visited the Joints & Rheumatism Center at the Kyung Hee East-West Neo Medical Center from April 2006 to June 2009 were evaluated. The general characteristics of patients who underwent combination treatment, trend in number of cross-system referrals, and disorders and involved body regions of patients referred to the Eastern medical hospital from the Western medical hospital were initially assessed. 6 major disorders were found from the initial scanning. The trend in number of cross-hospital referrals, number of visits to the Eastern medical hospital, current status of combination treatment, treatment modality, and reason for cross-system referral was evaluated. Results : 1. 1510 patients were referred from the Eastern medical hospital to the Western medical hospital, and 1065 patients were referred from the Western medical hospital to the Eastern medical hospital. First visit patients reached a peak at the second quarter of 2007 and fourth quarter of 2006 respectively, and have steadily decreased from then on. Referrals of female patients were twice as common as male patient referrals. Patients in their sixth or seventh decade of life were most commonly referred, and more outpatients were referred compared to inpatients. 2. Patients with knee joint disorders were most commonly referred from the Western medical hospital to the Eastern medical hospital, followed by hip, shoulder, ankle, wrist, and elbow joint disorders. The most common disorders for each of the above regions in referred patients were knee osteoarthritis, avascular necrosis of the hip, adhesive capsulitis, and ankle strain and sprain. The generalized disorders rheumatoid arthritis and ankylosing spondylitis followed. 3. Patients referred to the Eastern hospital received approximately 3 to 10 Eastern medical treatment sessions. 45 percent remained on constant combination treatment, and 98 percent of referred patients received acupuncture treatment. Conclusions : In regard to the number of patients and duration of combination treatment, combination treatment was successfully performed for knee osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis, while it was not so for avascular necrosis of the hip, adhesive capsulitis, and ankle strain and sprain. Further research on this subject is required.

중풍 뇌 질환의 한 방향 협진에 관한 임상적 고찰

신애숙,이인환,김나희,김혜미,김민경,심소라,조승연,박성욱,박정미,배형섭,고창남,Shin, Ae-sook,Lee, ln-whan,Kim, Na-hee,Kim, Hye-rni,Kim, Min-kyung,Sim, So-ra,Cho, Seung-yeon,Park, Seong-uk,Park, Jung-mi,Bae, Hyung-sup,Ko, Chang-nam 대한중풍순환신경학회 2010 대한중풍.순환신경학회지 Vol.11 No.1

Objectives : This study was aimed to evaluate the current status of East-West integrated treatment in stroke and brain disease and to discuss further plans. Methods : The medical records of patients who visited the stroke and brain disease center at Kyung Hee University, East-West Neo Medical Center from May 2006 to August 2010 were evaluated. The general characteristics of patients who underwent integrated treatment, trend in the number of cross referrals were initially evaluated. Later major disorders, the reasons of referrals and the number of visits in outpatients were analyzed. Results : 1. 3496 patients were referred from the eastern medical hospital to the western medical hospital and 2440 patients from the western medical hospital to the eastern medical hospital. The number of patients reached a peak alter the opening of the hospital and has decreased from then on. Referrals of female patients were more than those of male patients and patients over 50 years old were the most. 2. Admitted patients with stroke of chronic stage were most commonly referred from the eastern medical hospital to the western medical hospital and cerebral infarction was most common from the western medical hospital to the eastern medical hospital. Among the outpatients cerebral infarction topped from east to west, and stroke of chronic stage from west to east. 3. 36.6% of the patients from east to west received integrated treatment more than 3 times and 28.6% from west to east. Headache was the second most common reason to be referred from west to east and 36.7% of patients didn't continue to have either of the treatment and 30.3% received eastern treatment only, Conclusions: According to this study, chronic stroke management was successfully performed in the outpatient clinic in the form of East-West integration treatment. Further research on other diseases such as headache is recommended.

헌법상 치료거부권 -의사무능력자를 중심으로-

허순철 ( Soon Chul Huh ) 한국법정책학회 2011 법과 정책연구 Vol.11 No.2

최근 헌법재판소는 환자가 미리 의료인 등에게 연명치료 거부 또는 중단에 관한 의사를 밝히는 등의 방법으로 죽음에 임박한 상태에서 인간으로서의 존엄과 가치를 지키기 위하여 연명치료의 거부 또는 중단을 결정할 수 있으며, 이는 헌법상 기본권인 자기결정권의 한 내용으로서 보장된다고 하였다. 그런데 환자가 의식이 없고 사전의료지시서와 같이 환자의 의사를 확인할 수 있는 ``명백하고 확신을 주는 증거``가 없는 경우에 있어서도 과연 자기결정권을 치료거부 내지치료중단의 근거로 볼 수 있을지 의문이다. 이는 특히 연명치료 중단의 경우처럼 의사능력이 있다가 이를 상실한 경우뿐만 아니라 영·유아와 같이 처음부터 의사능력이 없는 경우에도 문제될 수 있다. 미국의 경우 치료거부는 종교적 이유로 수혈을 거부한 경우에 주로 문제되어 왔으나, 1990년 연방대법원은 Cruzan 판결에서 처음으로 헌법상 치료거부권이 자기결정권과 신체의 불훼손권에 의하여 인정될 수 있다고 하였다. 이러한 자기결정권은 자신의 운명 내지 삶에 관한 중대한 사항을 결정할 수 있는 능력을 전제로 한다. 따라서 의사능력이 없는 환자의 경우에도 치료중단의 근거를 자기결정권으로 볼 것인가에 대하여는 견해가 대립한다. 이는 결국 기본권 보유능력과 기본권 행사능력의 문제라고 볼 수 있다. 자기결정권과 같이 기본권 주체에 의하여 직접 행사되어야 하는 기본권의 경우에는 그 주체가 의사능력이 없어서 기본권을 행사할 수 없다면 기본권 보유능력도 인정될 수 없다고 할 것이다. 그러므로 환자의 의사능력이 없는 경우에는 치료거부권의 근거를 자기결정권에서 찾을 수 없다. 그렇다면 기본권을 행사하는 능력을 전제로 하지 않는다고 볼 수 있는 신체의 안전성 내지 신체의 불훼손권을 헌법상 근거로 볼 수 있을 것이다. 그러나 신체를 훼손당하지 않을 권리 역시 절대적 기본권은 아니며 헌법 제37조 제2항에 의하여 제한될 수 있다. Recently the Constitutional Court of Korea decided that a patient on the final stage of irreversible death is able to reject or choose to withdraw her life-sustaining medical treatment for her human dignity and value with a prior medical instruction expressing her wish to refuse or terminate the medical treatment to hospital employees, and that the Constitution of the Republic of Korea grants her a right to refuse the treatment as a constitutional right of self-determination. However, it is uncertain whether the right of self-determination is the legal basis of the right to refuse treatment when a patient is incompetent and there is no clear and convincing evidence such as prior medical instruction. This difficulty also occurs when a patient is regarded as mentally incompetent not only because of a persistent vegetative state but also because of mental capability such as a newborn child or an infant. In the U.S. the problem of the right to refuse medical treatment had been related with some cases of Jehovah`s Witness patients rejecting blood transfusion. However, in 1990 the U.S. Supreme Court assumed for the first time that the U.S. Constitution would grant a competent person a constitutional right of self-determination and bodily integrity to refuse lifesaving treatment. This right to self-determination needs the ability to decide some important choices regarding his/her destiny and life. Therefore, different theories conflict regarding whether even a mentally incompetent patient has a constitutional right of self determination to refuse medical treatment. It seems that it is a problem between an ability to have a consitutional right and an ability to exercise his/her right. Thus, as for a consitutional right such as a right to self-determination which is required to be exercised by the owner of the right, it seems reasonable to say that a patient has no ability to have the right when he/she has no ability to exercise that right because of his/her incompetency. Accordingly, I think that an incompetent patient is not able to have a constitutional right to self-determination to refuse medical treatment. Consequently, it seems that the right of bodily integrity is an alternative constitutional right because it does not need the owner`s ability to exercise it. However, the right of bodily integrity is not so absolute that the State may impose some limitation on the right according to Article 37 (2) of the Constitution of the Republic of Korea.

중증급성호흡기증후군(SARS)의 한약 치료에 관련된 WHO 임상논문 보고에 대한 개관

장인수,형례창,한창호,Jang, In-Soo,Hsing, Li-Chang,Han, Chang-Ho 대한한방내과학회 2005 大韓韓方內科學會誌 Vol.26 No.2

Objective: In the winter of 2002, severe acute respiratory syndrome(SARS) began to spread throughout the world. More than 5,000 cases were reported in China, including over 1,700 cases in Hong Kong Special Administrative Region(Hong Kong SAR). The total number of cases reported from Canada and Singapore was more than 200. The total number of SARS cases world-wide reached 8,437 with incidences in 29 counties. Mortality from SARS is estimated at $10{\sim}12%$. When the SARS outbreak occurred in China, the State Administration of Traditional Chinese Medicine of China immediately initiated clinical research projects on the use of integrated herbal medicine and Western medicine for treating SARS. and, in Hong Kong SAR, research on the use of herbal medicine for the prevention and treatment of SARS. Reports were released during convalescence. The objective of this study is to overview twelve clinical SARS reports of WHO on the treatment of SARS with herbal medicine and evaluate the efficacy and safety of treatment of SARS with herbal medicine, and further to share experiences and knowledge of the treatment of SARS. Methods: Twelve clinical reports about SARS from the WHO were selected, overviewed and evaluated for efficacy and safety of treatments of SARS. Results and Conclusion: Twelve clinical reports about SARS showed that the integrated treatment may have advantages, and the advantages are reflected in the following findings: Firstly, herbal medicine is not targeted only at a specific etiology or a certain pathological link, but also at the pathological status of the patients at that particular time. Therefore, comprehensive readjustment was made through various angles, targets and channels to restore the balance of the body. Secondly, there are advantages in the differentiation of the disease and the treatment. Based on the various symptoms, herbal medicine enables the physician to adopt the most suitable principle, provide individual treatment, and to administer medicine in accordance with the actual process and nature of the illness. Thirdly, there are advantages in the results of the treatment; herbal medicine can relieve symptoms, promote absorption of lung inflammation, improve the degree of blood oxygen saturation, regulate immunological functions, reduce the required dosage of glucocorticoid and other Western medicines, and reduce case fatality rate, in addition to lowering the cost of treatment.

담관 및 직장 이중암 환자의 통합암치료를 통한 증상완화 증례 보고

양진성 ( Jin-sung Yang ),고명현 ( Myeong-hyun Ko ),고은주 ( En-ju Ko ),박지혜 ( Ji-hye Park ),박소정 ( So-jung Park ),유화승 ( Hwa-seung Yoo ) 대전대학교 한의학연구소 2021 혜화의학회지 Vol.30 No.2

Objective: To report the improvement of abdominal pain in patients with bile duct and rectal double cancer with integrative cancer treatment. Methods : A 59-year-old female patient was diagnosed with bile duct cancer and rectal cancer at ○○ Medical Center in February, mid day, 2020 and applied chemotherapy treatment and Percutaneous catheter drainage (PCD) and percutaneous transhepatic biliary drainage (PTBD) injection from January 31, 2020 to March 11, 2021. Integrated cancer treatment was performed for abdominal pain and fatigue, and evaluations were conducted with numeric rating scores (NRS), Visual Analogue Scale(VAS), the Eastern Cooperative Oncology Group (ECOG), frequency of drug pain medication, liver count, and C-reactive protein (CRP) to improve symptoms. Results : After integrative cancer treatment, abdominal pain in patients decreased from NRS 8 to 6, Fatigue was maintained between 4 and 5 times without any difference in Vas but sleeping time increased 4 hours to 7 hours, and mid-term awakening decreased from 4 to 2 times. and ECOG improved from 3 to 2, indicating improvement in drug-induced pain medication prevalence, liver count, and CRP. Conclusion : Integrated cancer treatment may show improvement in abdominal pain in patients with bile duct and rectal double cancer.

Integration of Bological and Chemical Methods for the Control of Pepper Gray Mold Rot Under Commercial Greenhouse Conditions

Park, Seon-Hee,Bae, Dong-Won,Lee, Joon-Taek,Chung, Sung-Ok,Kim, Hee-Kyu The Korean Society of Plant Pathology 1999 Plant Pathology Journal Vol.15 No.3

Integration of microbial antagonists with fungicides was tried to control the gray mold caused by Botrytis cinerea on pepper in greenhouse conditions and to reduce fungicide uses. All of the selected bacterial antagonists, Bacillus amyloliquefaciens BL3, Paenibacillus polymyxa BL4, and Pseudomonas putida Cha94, completely inhibited the conidial germination of B. cinerea until 30 days after treatment. However, bacterial colonization of pepper phylloplane was poor in BL4, while the other bacterial isolates and the fungal antagonist Trichoderma harzianum TM colonized well on the phylloplane, maintaining the population density of 104-105 cfu/g until 15 days after microbial treatments. Out of 13 kinds of selected fungicides used for gray mold diseases, polyoxin B and BKF 1995 showed the most discriminatory activity on the fungal growth between B. cinerea and TM. TM grew readily on the media containing those fungicides, while B. cinerea showed poor or no mycelial growth on them. The selected fungicides and antagonists alone reduced incidence of gray mold on pepper, showing disease indices of about 2.4 to 3.0, while its was increased up to 4.2 in the untreated control. Alternate treatments with the antagonists and 2-fold diluted fungicides inhibited the disease incidence as much as the antagonists or fungicides alone, and reduced the secondary inoculum more than the single treatments. This suggests that integration of antagonists and fungicides may be an efficient way to reduce fungicide sprays with reliable control efficacy of the disease. However, there was not much difference in the early and mid-term disease progress among the treatments and the untreated control, probably due to extremely favorable environmental conditions for the disease development in this experiment.

탈모 치료에 관한 최신 동향

장인욱,고우신,윤화정,Jang, In-Wook,Ko, Woo-Shin,Yoon, Hwa-Jung 대한한방안이비인후피부과학회 2015 한방안이비인후피부과학회지 Vol.28 No.4

Objective : The purpose of this study is to analyse research trend on alopecia including androgenetic alopecia, alopecia areata, etc.Methods : We searched Pubmed, CNKI and OASIS on the title "alopecia" in recent 5 years.Results : We found 23 studies on Pubmed, 20 on CNKI, and 3 on OASIS about treatments of alopecia. The subjects of them were about 5α-reductase inhibitor, Minoxidil, steroids, immunosuppression, laser therapy, PRP, microneedling, stem cell, herbal medicine, integrative medicine, external treatments and syndrome differentiation.Conclusions : In recent studies in western medicine were about combination therapy or safety and presented validities and superiorities about new treatments. Integrative medicine, external treatment and researches about patients' characteristics were reported in TCM. Korean medicine has advantages of considering whole body and phychological problems.

통합암치료를 적용한 난소암 뇌, 척추전이 환자의 5년 추적관찰 증례보고

배혜리,김은지,이남헌 대한한방내과학회 2023 大韓韓方內科學會誌 Vol.44 No.6

Objectives: This long-term case report presents the case of an ovarian cancer patient with brain, cervical lymph node, and vertebral metastasis suppressed by traditional Korean medicine in combination with cytokine-induced killer (CIK) cell-based immunotherapy. Methods: The patient received acupuncture, moxibustion, GunChil-go, Hangam-dan, and CIK cell-based immunotherapy. The Eastern Cooperative Oncology Group and tumor markers were used to evaluate the treatment effects. Results: Integrative cancer treatment suppressed the progression of cancer, and the patient achieved eight-year survival. The performance status improved, and the tumor marker level was maintained. Conclusions: We suggest that an integrative cancer treatment that includes traditional Korean medicine can be a meaningful treatment option for advanced ovarian cancer.

Clinical Effects of Moving Cupping Therapy Combined with Integrative Korean Medicine Treatment on Peripheral Facial Palsy: Case Series

Jihun Kim,Yeonhak Kim,Taewook Lee,Eunseok Kim,Gi Young Yang 대한침구의학회 2023 대한침구의학회지 Vol.40 No.2

This study aimed to report the effect of moving cupping therapy (MCT) on peripheral facial palsy (PFP). Four patients with PFP treated with MCT combined with integrative Korean medicine treatment (KMT). Patients were hospitalized for < 17 days. House–Brackmann Grading System (HBGS), Yanagihara grading score (Y-score), and Sunnybrook Facial Grading System (SBGS) were used to assess the changes during treatment periods, and facial photos were taken at admission, interim, and discharge. Facial paralysis symptoms and HBGS grades improved in all patients (Patient 1: HBGS of IV to II; Patient 2: HBGS of V to III; Patient 3: HBGS of IV to II; Patient 4: HBGS of IV to II) following an average of 14.5 days of treatment. The mean (± standard deviation) Y-scores and SBGS scores also increased (Δ[Y-score]: 13.75 ± 3.50 and Δ[SBGS]: 40.00 ± 13.11) from baseline to end of treatment. These findings suggest the clinical effectiveness of MCT combined with integrative KMT in treating patients with PFP.

재발된 췌장암 환자의 한의 기반 통합 암 치료에 대한 증례보고

김재욱,주한음,박지혜,조영민,서현식,고은주,박소정,유화승 대한암한의학회 2022 大韓癌韓醫學會誌 Vol.27 No.1

Objectives: To report recurrent pancreatic cancer treated by Korean medicine based-integrated oncology treatment, who is improved quality of life without progression of cancer Method: A 63-year-old female patient diagnosed with recurrent pancreatic cancer in April, 2022 received Chemotherapy with Korean medicine based integrative oncology treatment. Radiologic outcome was assessed by Abdomen Computed Tomography (CT) based on Response Evaluation Criteria In Solid Tumors (RECIST). Clinical outcomes were assessed by National Cancer Institute Common Terminology Criteria for Adverse Event (NCI-CTCAE), Eastern Cooperative Oncology Group (ECOG), Numeric Rating Scale (NRS) Result: During 2months of treatment, Cancer size was stable in Abdominal CT. Chief complaints, Abdominal pain and dyspepsia, were improved and ECOG score was improved from grade 2 to 1. There were no toxicity on laboratory test and no side effects of grade 3 or higher on NCI-CTCAE. Conclusion: This report shows that Korean medicine based integrative oncology treatment might contribute to synergetic effect to Chemotherapy and improvement of quality of life