• The Korean Journal of Gastroenterology
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• v.72 no.5
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• pp.271-273
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• 2018

내시경 시술 전 일시적으로 항응고제를 중단하는 것은 위장관 출혈의 위험과 혈전색전증의 위험 사이에 적절한 균형을 잡기 어렵기 때문에 논란의 여지가 많다. 와파린은 새로운 경구용 항응고제(direct oral anticoagulant agent, DOAC)보다 임상의에게 더 친숙하고, 효과를 쉽고 빠르게 전환시킬 수 있다는 장점이 있지만 복잡한 약역동학 특징과 좁은 치료적 범위 때문에 관리가 어렵다. 반면, DOAC는 약물의 모니터링 및 용량 조절 없이 정해진 용량으로 처방이 가능하며, 빠르게 작용하고, 반감기가 짧아 관리가 쉽지만 해독제가 없다는 단점이 있다. 이전 연구들에서 DOAC를 복용한 환자들은 와파린을 복용한 환자들보다 시술과 관련되지 않은 위장관 출혈의 위험이 높았다고 보고한 바 있다. 하지만 시술과 관련된 위장관 출혈 위험에 대하여는 알려진 바가 없는 실정이다. 미국이나 유럽 내시경 가이드라인들에서는 저위험 내시경 시술을 받는 환자들에서는 와파린과 DOAC를 유지하도록 권고하고 있으며, 고위험 시술의 경우에는 와파린를 사용하는 환자들에서 헤파린 교량 요법(heparin bridging)을 시행하도록 권고하고 있다. 임상적으로 DOAC를 사용하는 환자들 또한 혈전색전증을 예방하기 위하여 헤파린 교량 요법을 시행해볼 수 있는데, 와파린 및 DOAC의 헤파린 교량 요법과 관련된 출혈 및 혈전색전증 위험의 차이 또한 명확하지 않다. 따라서 저자들은 1) 와파린과 DOAC 치료를 받는 환자들에서의 출혈, 혈전색전증 및 사망의 위험을 비교하고자 하였으며, 2) 13종류의 고위험 내시경 시술 중에서 시술별 위험을 비교하고, 3) 헤파린 교량 요법이 합병증의 발생을 증가시키지 않는지 확인하고자 본 연구를 진행하였다. 일본 대규모 국가 입원 환자 데이터베이스를 이용하여 2014년 4월부터 2015년 5월까지 시술 전 와파린 또는 DOAC(rivaroxaban, apixaban, dabigatran, edoxaban)를 복용하고, 13종류의 고위험 내시경 시술을 시행받은 20세 이상의 성인 환자 총 16,977명을 확인하였다. 고위험 시술은 용종 절제술, 내시경 점막절제술, 내시경 점막하박리술, 협착 부위의 풍선확장술, 내시경 지혈술, 내시경 정맥결찰술, 내시경 주사 경화요법, 내시경 괄약근절개술, 내시경 초음파 유도하 미세침 흡인 검사, 경피적 위루술을 포함하였다. 일대일 성향 점수 매칭 분석(propensity score matching, 나이, 성별, 체질량 지수, 기저 질환, 병원의 규모, 시술의 종류, 약물의 종류를 매칭)을 시행하여 와파린군과 DOAC군에서 시술 위장관 출혈 및 혈전색전증, 사망의 발생을 비교하였다. 또한 경구항혈전제와 헤파린 교량 치료 시행 유무에 따라, DOAC 단독군, 와파린 단독군, DOAC와 헤파린 교량 요법군, 와파린과 헤파린 교량요법군으로 나누어, 하위군(subgroup) 분석을 시행하였다. 5,046쌍이 성향 점수 매칭 분석에 포함되었으며, 와파린군에서 DOAC군보다 통계적으로 의미 있게 위장관 출혈의 비율이 높았다(12.0% vs. 9.9% p=0.02). 혈전색전증 발생률(5.4% vs. 4.7%)과 입원중 사망률(5.4% vs. 4.7%)은 양 군에서 의미 있는 차이는 없었다. DOAC 종류별로 나누어 하위군 분석을 시행하였을 때, 와파린군은 rivaroxaban군에 비하여 위장관 출혈의 비율이 높았으며, rivaroxaban군, dabigatran군에 비하여 혈전색전증의 비율이 높았고, 입원 중 사망률에서는 의미 있는 차이는 없었다. 내시경 시술의 종류로 보정하였을 때 위장관 출혈 및 혈전색전증, 사망률은 DOAC 단독으로 치료한 환자에서보다 와파린과 헤파린 교량 요법(bridging) 또는 DOAC과 헤파린 교량 요법을 시행한 환자에서 높았다. 시술 종류 중에서는 위루관 삽입술에 비하여 내시경 점막하박리술, 내시경 점막절제술 및 내시경 정맥류결찰술, 내시경 주사경화요법을 시행한 환자에서 위장관 출혈의 위험이 가장 높았으며, 하부 내시경 점막절제술, 하부 용종 절제술, 내시경적 유두괄약근절제술 또는 내시경 초음파 유도하 미세침 흡인 검사는 중등도 위험을 보였다.

• Korean Journal of Breeding Science
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• v.40 no.4
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• pp.484-489
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• 2008

A new whole crop silage barley cultivar, "Youngyang", was developed from the cross between "Bunong and Milyang55 at the Yeongnam Agricultural Research Institute (YARI) in 2002. An elite line, YB3882-3B-17-1-3-1, was selected in 1999 and designated as "Milyang111". It showed good agronomic performance in the regional adaptation yield trials (RYT) from 2000 to 2002 and was released by the name of "Youngyang" with higher yield and better animal feed quality than that of Olbori. The average heading and maturing dates of Youngyang were May 2 and June 6, which were late by 2 & 1 days than those of Olbori, respectively, in Suwon. Youngyang had longer culm length, 83cm but it had lesser spikes per $m^2$ 637 than that of Olbori, respectively, in RYT from 2000 to 2002. The rate of leaf sheath/whole length (culm+leaf) and the rate of the grains/whole crop weight was similar to Olbori. It showed resistance to BaYMV at the regions of Naju, Jinju, Milyang andt Iksan. however, the response of Youngyang to other environmental stresses (tolerance of cold and wet) was similar to Olbori. The dried whole crop yield potential of Youngyang in the RYT was about 11.67 MT/ha in paddy fields which was about 18% higher than that of Olbori. The grain yield potential was 6.32 MT/ha in paddy fields which was about 5% higher than that of Olbori. Youngyang had lower rate of shattering, higher content of protein and NDF, lower ADF and TDN, and better quality of silage than those of Olbori.

• Journal of the Korean Association of Geographic Information Studies
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• v.22 no.1
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• pp.1-18
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• 2019

This research measured and visualized the spatial dependency and the spatial heterogeneity of the small business in Cheonan-si, Asan-si with $100m{\times}100m$ grids based on global and local spatial autocorrelation. First, we confirmed positive spatial autocorrelation of small business in the research area using Moran's I Index, which is ESDA(Exploratory Spatial Data Analysis). And then, through Getis-Ord $GI{\ast}$, one kind of LISA(Local Indicators of Spatial Association), local patterns of spatial autocorrelation were visualized. These verified that Spatial Regression Model is valid for the location factor analysis on small business commercial buildings. Next, GWR(Geographically Weighted Regression) was used to analyze the spatial relations between the distribution of small business, hourly mobile traffic-based floating population, land use attributes index, residence, commercial building, road networks, and the node of traffic networks. Final six variables were applied and the accessibility to bus stops, afternoon time floating population, and evening time floating population were excluded due to multicollinearity. By this, we demonstrated that GWR is statistically improved compared to OLS. We visualized the spatial influence of the individual variables using the regression coefficients and local coefficients of determinant of the six variables. This research applied the measured population information in a practical way. Reflecting the dynamic information of the urban people using the commercial area. It is different from other studies that performed commercial analysis. Finally, this research has a differentiated advantage over the existing commercial area analysis in that it employed hourly changing commercial service population data and it applied spatial statistical models to micro spatial units. This research proposed new framework for the commercial analysis area analysis.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.19 no.1
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• pp.12-19
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• 2019

Purpose: Isolated methylmalonic acidemia (MMA) is an autosomal recessive inherited disorder of propionate metabolism. There are two subtypes of MMUT gene defects. $Mut^0$ represents complete loss of methylmalonyl-CoA mutase (MCM) activity while mut- is associated with residual MCM activity, which can be stimulated by hydroxocobalamin (OHCbl) supplementation. The objective of this study is to investigate cobalamin responsiveness and mutations present in Korean MMA population. Methods: We evaluated 10 MMA patients using somatic cell complementation analysis on their fibroblasts to measure MCM activity and vitamin B12 responsiveness for the optimal treatment. MMUT gene was sequenced to identify the MMA mutations. Results: For all patients, the incorporation of $[^{14}C]-propionate$ was low, and there was no response to OHCbl. The incorporation of $[^{14}C]-methyltetrahydrofolate$ and $[^{57}Co]-CNCbl$ fell within the normal range. There was adequate synthesis of methylcobalamin while the synthesis of adenosylcobalamin was low. The complementation analysis showed all patients were $mut^0$. The sequence analysis identified 12 different MMUT mutations, including 2 novel mutations, p.Gln267Ter and p.Ile697Phe, were identified. All the patients in this study had neonatal onset of symptoms, belonged to $mut^0$ complementation class, and as a result, showed no cobalamin responsiveness. Conclusion: No Korean MMA patient showed cobalamin responsiveness.

• Journal of Society of Occupational Therapy for the Aged and Dementia
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• v.12 no.2
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• pp.87-95
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• 2018

Objective : Vibration stimulators are easier to obtain in clinical settings than other treatment tools, and it is advantageous that the arm activation training can be performed passively. Despite the following advantages, recent studies on vibration sense have not been activated yet. The purpose of this study was to investigate the effect of vibration sensation on the hands of the affected upper limb on unilateral reduction of stroke patients. Method : Patients with unilateral neglect due to stroke were enrolled in this study for about 3 weeks from October 19, 2018 to November 7, The research design used ABA design among the single-subject experimental research design, and a total of 18 circuits (4 baseline, 6 intervention, 3 baseline regression) were performed once a day on weekdays Respectively. MMES-K was used to select the subjects. Line bisection test (LBT), Albert's test and Star Cancellation Test (SCT) were used as unilateral neglect test. For the analysis, the baseline and intervention period measurements were visually analyzed using graphs and mean values were used. Result : All three evaluations showed that the number of errors missed during the training period was lower than the baseline period, and this decrease remained after training. The error was reduced by an average of $2{\pm}1.2$ omissions and an average omissions of $0.6{\pm}0.5$ omitting an average of $4.5{\pm}1$ omissions in the line break test. As a result of the Albert test, the average error decreased by $22.5{\pm}1.9$ omissions and $8{\pm}7.3$ omissions and $0.3{\pm}0.5$ omissions, respectively. In the star clearance test, the average error decreased from $26{\pm}4.6$ to $21.8{\pm}1.7$ and $20{\pm}0$, respectively. Conclusion : In this study, vibrotactile stimulation therapy showed a continuous effect on improving unilateral neglect. Based on these findings, further research should be conducted in order to improve objectivity in future studies. Further research on various arbitration methods that maximize the effect of intervention will be needed.

• Pediatric Infection and Vaccine
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• v.25 no.3
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• pp.148-155
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• 2018

Purpose: The purpose of this study was to investigate the clinical significance of Bacille Calmette-$Gu{\acute{e}}rin$ (BCG) site reaction in terms of diagnosis and outcome prediction in young children with Kawasaki disease (KD). Methods: The incidence of BCG site reaction in the respective age ranges was investigated in 1,058 patients who were admitted at Asan Medical Center between January 2006 and February 2017. The 416 patients under 18 months of age were enrolled as subjects for the analysis of the association between BCG site reaction and other laboratory and clinical findings. The analysis was performed separately in complete and incomplete KD groups. Results: The incidence rate of BCG site reaction was peaked at 6-12 months (83%) and decreased with increasing age after 12 months in 1,058 patients (P<0.001). The incidence rate was above 70% in KD aged less than 18 months and more frequent than those of cervical lymphadenopathy. The logistic regression analyses showed that the principal clinical findings including conjunctivitis (P=0.781), red lips/oral mucosa (P=0.963), rash (P=0.510), cervical lymphadenopathy (P=0.363), changes in extremities (P=0.283) and the coronary artery aneurysm (P=0.776) were not associated with the BCG site reaction. Conclusions: The BCG site reaction could be a useful diagnostic tool independent to principal clinical findings in KD developing in children aged <18 months, who underwent BCG vaccination. Outcome of KD patients was not different between groups with or without the BCG site reaction in both complete KD and incomplete KD.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.29 no.2
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• pp.87-93
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• 2018

Background and Objectives : Laryngopharyngeal reflux disease (LPRD) is relatively common disease. N-acetyl cysteine (NAC) has both mucolytic and antioxidant effect, also may be beneficial in inflammatory airway diseases. The purpose of this study was to evaluate the efficacy and safety of inhaled NAC therapy in LPRD. Materials and Method : We retrospectively reviewed the medical records of 525 LPRD patients at 12 medical centers. Finally 401 patients subjected to inhaled NAC therapy for 2 months were enrolled in the study. We analyzed the change of Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) after use of NAC for 4 weeks and 8 weeks in addition to the patient's compliance of the treatment. Results : The RSI score significantly decreased from $19.87{\pm}6.34$ to $12.78{\pm}6.93$ after 4 weeks and to $10.65{\pm}7.47$ after 8 weeks. The RFS score also significantly decreased from $9.29{\pm}3.4$ to $7.17{\pm}3.41$ after 4 weeks and to $6.1{\pm}3.73$ after 8 weeks (p<0.05). During the treatment periods, 42 patients (10.4%) reported to have 80 episodes of discomfort. Throat discomfort (33%) and nausea (28%) were most common complaints, but the duration of discomfort was usually less than 4 weeks. Conclusion : Inhaled NAC treatment is highly effective for the reduction of both subjective and objective findings in LPRD patients. This study will provide the evidence of new treatment option for patients with LPRD. However, further studies will be needs to assess the real effect of inhaled NAC therapy as a standard treatment regimen of LPRD.

• Journal of Korean Foot and Ankle Society
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• v.23 no.1
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• pp.24-30
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• 2019

Purpose: To evaluate the efficiency of the electronic foot function index (eFFI) through a prospective, random based, multi-institutional study. Materials and Methods: The study included 227 patients ranging in age from 20 to 79 years, visited for surgery in different 15 institutes, and agreed to volunteer. The patients were assigned randomly into a paper-based evaluated group (n=113) and tablet-based evaluated group (n=114). The evaluation was done on the day of hospital admission and the method was changed on the second day of surgery and re-evaluated. PADAS 2.0 (https://www.proscore.kr) was used as an electronic evaluation program. Results: There were no differences in age and sex in both groups. The intraclass correlation coefficient (ICC) evaluation revealed an eFFI ICC of 0.924, showing that both results were similar. The evaluation time was shorter in the tablet-based group than the paper-based group (paper vs tablet, $3.7{\pm}3.8$ vs $2.3{\pm}1.3minutes$). Thirty-nine patients (17.2%) preferred to use paper and 131 patients (57.7%) preferred the tablet. Fifty-seven patients (25.1%) found both ways to be acceptable. Conclusion: eFFI through tablet devices appears to be more constant than the paper-based program. In addition, it required a shorter amount of time and the patients tended to prefer the tablet-based program. Overall, tablet and cloud system can be beneficial to a clinical study.

• Korean Journal of Agricultural and Forest Meteorology
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• v.21 no.1
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• pp.55-64
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• 2019

The flowering seasons can be advanced due to climate change that would cause an abnormally warm winter. Such warm winter would increase the frequency of crop damages resulted from sudden occurrences of low temperature before and after the vegetative growth stages, e.g., the period from germination to flowering. The degree and pattern of freezing damage would differ by the development stage of each individual fruit tree even in an orchard. A critical temperature, e.g., killing temperature, has been used to predict freeze damage by low-temperature conditions under the assumption that such damage would be associated with the development stage of a fruit flower bud. However, it would be challenging to apply the critical temperature to a region where spatial variation in temperature would be considerably high. In the present study, a phenological model was used to estimate major bud development stages, which would be useful for prediction of regional risks for the freeze damages. We also derived a linear function to calculate a probabilistic freeze risk in spring, which can quantitatively evaluate the risk level based solely on forecasted weather data. We calculated the dates of freeze damage occurrences and spatial risk distribution according to main production areas by applying the spring freeze risk function to apple, peach, and pear crops in 2018. It was predicted that the most extensive low-temperature associated freeze damage could have occurred on April 8. It was also found that the risk function was useful to identify the main production areas where the greatest damage to a given crop could occur. These results suggest that the freezing damage associated with the occurrence of low-temperature events could decrease providing early warning for growers to respond abnormal weather conditions for their farm.

• The Korean Journal of Mycology
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• v.49 no.3
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• pp.337-349
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• 2021

This study aimed to isolate wild yeasts from water and soil sample of the Nonsan stream and Sapgyoho (lake) in Chungcheonnam-do, Korea, and to further characterize previously unrecorded wild yeast strains. In total, 102 strains, representing 55 different species of wild yeast were isolated from 95 samples collected from the Jangseoncheon and Ipchoncheon of Nonsan stream in Jellabuk-do and Chungcheonnam-do. Among these, 33 strains were isolated from alkalophilic yeast extract-peptone-dextrose (YPD) medium (pH 9.0), and 9 strains were isolated concurrently on general YPD medium (pH 6.5) and alkalophilic medium. Seventeen strains of Cryptococcus laurentii were predominantly isolated. Additionally, 65 strains, representing 27 different species of wild yeast were isolated from 58 samples obtained from Sapgyoho (lake). Among the 82 isolated wild yeast strains, 8 strains, including Candida fructus JSC 72-1(JSL-GGU 015), had not previously been recorded. All 8 previously unrecorded yeasts were oval in shape except C. fructus JSC72-1(JSL-GGU-015), and only the Filobasidium chernovii JSC39-1(JSL-GGU-013) strain formed spores. All strains except Pseudosydowia eucalypti JSC23-6(JSL-GGU-012) grew well in yeast extract-peptone-dextrose (YPD) and yeast extract-malt extract media and grew in vitamin-free medium. Four strains, including P.eucalypti JSC23-6(JSL-GGU-012) grew well in 15% NaCl-containing YPD medium. F.chernovii JSC39-1(JSL-GGU-013) and Sirobasidium intermedium JSC7-3(JSL-GGU-014) assimilated lactose, and five strains, including F. chernovii JSC39-1(JSL-GGU-013) also assimilated starch. All strains were resistant to 800 ppm of Ca, Cu, Li, and Mg ions.