• 대한임상독성학회지
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• 제12권2호
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• pp.92-96
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• 2014

Dabigatran is the first oral direct thrombin inhibitor approved by the US Food and Drug Administration (FDA) for prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation. Because dabigatran is excreted mainly by the kidneys, serum levels of dabigatran can be elevated to a supratherapeutic range in patients with renal failure, predisposing to emergent bleeding. We describe the case of a 66-year-old man taking dabigatran 150 mg twice daily for atrial fibrillation and cerebral infarction who presented with hematochezia and disseminated intravascular coagulation. Laboratory evaluation showed a hemoglobin level of 6.3 g/dL, platelets of $138,000/mm^3$, activated partial thromboplastin time (aPTT) of 10 s, and an international normalized ratio (INR) of 8.17. Colonoscopy showed a bleeding anal fissure. Hemostasis was provided by hemoclips and packed red blood cells and fresh frozen plasma were transfused. Since then, there was no further hematochezia, however, bleeding including oral mucosal bleeding, hematuria, and intravenous site bleeding persisted. At presentation, his serum creatinine was 4.96 mg/dL (baseline creatinine, 0.9 mg/dL). Dabigatran toxicity secondary to acute kidney injury was presumed. Because acute kidney injury of unknown cause was progressing after admission, he was treated with hemodialysis. Fresh frozen plasma transfusion was provided with hemodialysis. At 15 days from admission, there was no further bleeding, and laboratory values, including hemoglobin, partial thromboplastin time, and prothrombin time were normalized. He was discharged without bleeding. After 2 months, he undergoes dialysis three times per week and no recurrence of bleeding has been observed.

• 한방안이비인후피부과학회지
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• 제37권2호
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• pp.37-57
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• 2024

Objectives : The purpose of this study is to evaluate the efficacy and safety of hair Ampoules with Malva Verticillata Seed Extract in alopecia patients. Methods : This 24-week clinical study enrolled 70 patients with Alopecia. A series of clinical examinations, subjects were evaluated at 0, 8, 16 and 24-week, counting of the number of hairs on the crown, and subject survey after using the Ampoules. Results : The clinical evaluation showed a significantly difference (p<0.05) after 24 weeks of product use compared to the baseline in the change in hair count in the treatment group compared to the control group within and between groups. It showed greater improvement in the treatment group than in the control group in hair count, hair thickness, and hair loss symptoms in the top of the head and forehead. No severe adverse events were observed during the clinical trial. Counclusions : This suggests that this hair ampoules containing Malva Verticillata Seed Extract could help prevent hair loss in alopecia patients without inducing side effects.

• 한국의학물리학회지:의학물리
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• 제25권2호
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• pp.72-78
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• 2014

연구의 목적은 의사호흡정지(QBH) 바이오 피드백이 의료영상획득 시간의 큰변화 없이 잔류 호흡 운동을 조절함으로써 호흡 운동에 의한 영상 오류를 줄이고, 게이트 3차 흉부 자기 공명 영상을 향상시킬 수 있다는 가설을 실험하는 것이다. 가설을 확인하기 위해 건강한 다섯 사람을 대상으로 3T 지멘스 엠알아이의 호흡 탐색기가 포함된 T2 가중 스페이스 엠알 펄스 시퀀스를 이용해 두번의 게이트 자기공명 영상 연구를 시행 하였다: 자유 호흡 상태와 의사호흡정지 바이오 피드백 호흡상태, 의사호흡정지 바이오 피드백 시스템은 알피엠(RPM) 시스템(실시간 위치 관리시스템, 베리안)을 사용하여, 복부의 외부 위치를 측정하고, 음향과 시각적으로 각각의 호흡주기의 90% 위치에서 2초 숨을 정지하도록 안내하는 방법을 사용했다. 평가방법은 의사호흡정지 바이오 피드백 시스템을 이용시 간 상부의 호흡정지모습의 재현성이 게이팅 영역 내에서 향상되는지를 지원자의 실험을 통해 평가하였다. 자유호흡상태와 의사호흡정지 바이오 피드백상태에서 3차 흉부자기공명영상내에 호흡 운동에 의한 영상 오류와 게이팅영역 내에서의 잔류 호흡 운동 조절여부도 함께 평가했다. 또한, 복부 변위의 RMSE도 (제곱근오차) 조사되었다. 의사호흡정지 바이오 피드백방법을 사용함으로 자유호흡의 경우보다 게이트 3차 흉부 엠알 영상에서 폐와 간에서 호흡운동에 의한 영상오류의 감소 결과를 획득했다(영상획득시간: ~6분). 이는 의사호흡정지 바이오 피드백사용시, 게이팅 영역에서 복부 운동 감소와 횡경막의 잔류 움직임 감소가 일치함을 의미한다. 따라서, 알피엠을 통해 얻은 복부 변위의 전체 자료에서평균 RMSE는 (제곱근오차) 자유 호흡의 2.0 mm에 비해 7 mm (67% 감소, p값=0.02)로 감소하였으며, 게이팅영역만을 고려했을때는 자유 호흡의 1.7 mm가 의사호흡정지 바이오 피드백 호흡을 사용함으로써 0.7 mm (58 % 감소, p값=0.14) 로 개선되었다. 선형 피팅을 사용하여 얻은 평균 기준 이동값은 의사호흡정지 바이오 피드백 을 사용하면 자유 호흡 5.5 mm/분보다 0.6 mm/분(89% 감소, p값=0.017)으로 감소되었다. 이 연구는 의사호흡정지 바이오 피드백을 이용해 게이트 3차 흉부 자기 공명 영상 중에 간 상부의 호흡정지 재현성이 향상되는 것을 보여 주었다. 이 시스템은 내부 해부학의 운동을 조절함으로써 게이트 의료 영상과 방사선 치료에 임상적으로 적용 할 수 있다.

• 한국임상약학회지
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• 제25권2호
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• pp.80-93
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• 2015

Objective: Pegfilgrastim is recently introduced that is long acting G-CSF for prophylaxis of febrile neutropenia. Treatment of non-Hodgikin's lymphoma (NHL) with R-CHOP is classified with relative high risk of febrile neutropenia. The study evaluated the prophylactic effect of pegfilgrastim to reduce the incidence of febrile neutropenia associated with R-CHOP of patient in NHL. And the risk factors associated with the incidence of FN and related events were evaluated. Methods: This retrospective study reviews the Electronic Medical Record of 68 NHL patients who received R-CHOP chemotherapy in single center between September 2013 and August 2014. These patients were classified who receive prophylaxis pegfilgrastim or no prophylaxis. Results: Sixty eight patients received R-CHOP with NHL. In 144 cycles of patients receiving pegfilgrastim, compared with no prophylaxis 178 cycles, had a lower incidence of febrile neutropenia (5.5% vs. 23.6%, p = 0.001), grade 3 or grade 4 neutropenia (14.4% vs. 89.8%, p < 0.001) and neutropenia related events (p < 0.05). The risk of febrile neutropenia after prophylaxis was significantly associated with age ${\geq}65$ (OR: 5.87, 95% CI 1.07-32.27, p = 0.042), $IPI{\geq}3$ (OR: 7.2, 95% CI 1.31-39.6, p = 0.023), S.alb < 3.5 g/dL (OR: 31.01, 95% CI 6.32-152.17, p < 0.0001). In multiple logistic regression analysis, lower baseline serum albumin (OR: 21.1, 95% CI 3.8-116.98, p = 0.001) was significantly associated with occurrence of febrile neutropenia. Conclusion: The study recommends prophylactic pegfilgrastim through risk assessment of febrile neutropenia in patients with non-Hodgikin's lymphoma receiving R-CHOP.

• Journal of Ginseng Research
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• 제42권2호
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• pp.144-148
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• 2018

Background: Panax ginseng is a well-known immune modulator, and there is concern that its immune-enhancing effects may negatively affect patients with rheumatoid arthritis (RA) by worsening symptoms or increasing the risk of adverse effects from other drugs. In this randomized, crossover clinical trial, we evaluated the impact of Korean Red Ginseng (KRG) on disease activity and safety in RA patients. Methods: A total of 80 female RA patients were randomly assigned to either the KRG (2 g/d, n = 40) treatment or placebo (n = 40) groups for 8 wk, followed by crossover to the other treatment group for an additional 8 wk. The primary outcome was the disease flare rate, defined as worsening disease activity according to the disease activity score 28 joints-erythrocyte sedimentation rate (DAS28-ESR). The secondary outcomes were development of adverse events (AEs) and patient reported outcomes. Outcomes were evaluated at baseline and 8 wk and 16 wk. The outcomes were compared using the Chi-square test. Results: Of the 80 patients, 70 completed the full study. Their mean age was 51.9 yr, and most exhibited low disease activity (mean DAS28-ESR $3.5{\pm}1.0$) at enrollment. After intervention, the flare rate was 3.7% in each group. During KRG treatment, 10 AEs were reported, while five AEs were developed with placebo; however, this difference was not statistically significant (p = 0.16). Gastrointestinal- and nervous system-related symptoms were frequent in the KRG group. Conclusion: KRG is not significantly associated with either disease flare rate or the rate of AE development in RA patients.

• Journal of Periodontal and Implant Science
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• 제44권2호
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• pp.71-78
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• 2014

Purpose: Host modulatory therapy has been proposed as a treatment for periodontal diseases. A class of herbal medicines, known to be immunomodulators, alters the activity of immune function through the regulation of informational molecules such as cytokines. In the current study, we tested the hypothesis that herbal immunomodulator drugs act as an adjuvant to scaling and root planing (SRP) in alleviating periodontal inflammation by improving clinical and biochemical parameters. Methods: Sixty healthy subjects (30 in each group) with moderate and severe chronic periodontitis were enrolled in a double-blind, placebo-controlled, double-masked randomised controlled trial. The control group was treated with SRP and a placebo, whereas the test group was treated with SRP followed by dietary supplementation of Septilin for 3 weeks. Periodontal clinical parameters and serum C-reactive protein (CRP) levels were evaluated for all patients at the baseline, 3 weeks, and 6 weeks. Results: Improved gingival index scores found in the test group as compared to the control group were found to be statistically significant only after 3 weeks (P<0.001). In contrast, the decrease in the sulcus bleeding index and pocket depth scores was statistically highly significant in the test group as compared to the control group after 3 weeks and 6 weeks (P<0.001). However, reduced clinical attachment level and CRP scores, as reflected in the test group as compared to the control group, were not found to be statistically significant after both 3 weeks (P>0.05) and 6 weeks (P>0.05). Conclusions: The results of this clinical-biochemical study suggest that dietary supplementation with herbal immunomodulatory agents may be a promising adjunct to SRP and may aid in improving periodontal treatment outcomes.

• 생물정신의학
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• 제15권2호
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• pp.92-100
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• 2008

Objectives : The purpose of this study was to investigate 1) the neuropsychological deficits with major depressive disorder(MDD) in depressed state and 2) the changes of neuropsychological dysfunctions during depressed episodes and remitted periods in the MDD group. Methods : 12 patients with MDD and 70 normal controls who were diagnosed and classified by DSM-IV and SCID-IV interview participated in this study. The psychopathology was measured using the Hamilton rating scale for depression(HAM-D) and Brief Psychiatric Rating Scale(BPRS). The memory function, executive function, and sustained attention were measured by a trained psychologist using the Korean version of Memory Assessment Scale(K-MAS), Wisconsin Card Sorting Test(WCST), and Vigilance(VIG) and Cognitrone (COG) in Vienna Test System. After 6 weeks of treatment, we retested the cognitive tests in order to measure the cognitive functions in remitted states. Results : Patients with MDD achieved significantly lower score in sentence immediately recall, verbal memory score and total memory score of the K-MAS, total errors of the WCST, response time of Vigilance and response time at "Yes" response of Cognitrone than normal controls at baseline. After 6 weeks of medication, the psychiatric symptoms in the patient group were attenuated, and most of the neuropsychological functions including attention, memory, and frontal/executive function were improved except for response time of Cognitrone. Conclusions : This study provides evidence for distinct neuropsychological deficits in patients with MDD on their depressed states and remitted periods. The impairment on response time remains after remission, and this would be a trait marker of major depressive disorder.

• 한국치위생학회지
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• 제12권3호
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• pp.631-640
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• 2012

Objectives : This study mean to confirm the antibacterial activity of a garlic extract widely culturing in our region and was to determine the effect of dentifrice containing 0.1% extracts of garlic on dental plaque and gingivitis in a double blind and clinical studies in 50 healthy adults aged from 20 to 22 years who provided a consent for their participation. Methods : The antibacterial activity was evaluated using triple distilled water and the Kirby-Bauer disk diffusion method and the minimal inhibitory concentration(MIC) against various pathogens for periodontal disease, such as P. gingivalis 381(ATCC33277), was estimated. The experimental groups classified according to the concentration of garlic extract used: 10,000ppm(A), 5,000ppm(B), 2,500ppm(C), 1,000ppm(D). Oral examination of subjects was performed through clinical periods and on day of baseline, 6, 12, 19, 25 days plaque index and gingival index were scored by Turesky' modified index and Loe & Silness index. After 12, 19, 25 days use of their respective dentifrices, statistically decreases of plaque index, gingival index were shown in both the experimental and the control group, respectively. Results : There was significant antibacterial activity in the "2,500ppm(C)" group against P. gingivalis 381. Experimental group exhibited significantly the lower plaque levels and the higher levels of gingival health by the use of the dentifrices contained extract of garlic from 6 days compare with control group(p<0.05). The degree of decrease was more significant on gingivitis level of the experimental group than the control group(p<0.05). Conclusions : This findings indicated that the oral products containing a garlic extract is effective in preventing and treating periodontal diseases, and has potential value in inhibiting periopathogens.

• 대한치과의사협회지
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• 제48권6호
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• pp.436-442
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• 2010

Objective: Transmission of S. mutans, a major dental caries pathogen, occurs mainly during the first 2.5 years of age. Children appear to acquire S. mutans mostly from their mothers, but few studies have investigated preventive effect of xylitol to S. mutans transmission from mother to child. The aim of this study was to perform a follow-up evaluation the preventive effect of xylitol chewing gum of the S. mutans of children's oral cavities, which included the characteristics of vertical transmission from mother to child. Methods: The mothers voluntarily participating in a women's oral health prevention program were divided into two groups (a control and a xylitol group). The subjects were 20 mother-child pairs, who were monitored for 30 months. Xylitol chewing gum group had consumed 2 gum pellets, 3 times a day for 24 months, and then they were followed until 30 months. At baseline, 24 and 30 months whole stimulated saliva samples were collected from the mothers. Children were also recruited from 6 months to 30 months after birth and were collected their dental plaque samples. After isolation and identification, the analysis of the colony count, transmission electron microscopy and real-time RT-PCR were performed to analyze the characteristics of S. mutans. Results: The S. mutans counts decreased steadily in the xylitol group at 24 months, but increased at 30 months. The similar results were showed at their children. While the glucan synthesis was decreased at xylitol group both mother and child. The expression of gtfB, gtfD and ftf were significantly reduced in the xylitol group both mother and child (p<0.05). Conclusions: These findings indicate that chewing xylitol gum over a long period may decrease the expression of the genes associated virulence and reduced the glucan synthesis of S. mutans, which can result the preventing the mother-to-child transmission of S. mutans.

• Smart Structures and Systems
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• 제20권6호
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• pp.683-696
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• 2017

In this study, the reliability of nonlinear ultrasonic modulation based fatigue crack detection is improved using a feature-level data fusion approach. When two ultrasonic inputs at two distinct frequencies are applied to a specimen with a fatigue crack, modulation components at the summation and difference of these two input frequencies appear. First, the spectral amplitudes of the modulation components and their spectral correlations are defined as individual features. Then, a 2D feature space is constructed by combining these two features, and the presence of a fatigue crack is identified in the feature space. The effectiveness of the proposed fatigue crack detection technique is experimentally validated through cyclic loading tests of aluminum plates, full-scale steel girders and a rotating shaft component. Subsequently, the improved reliability of the proposed technique is quantitatively investigated using receiver operating characteristic analysis. The uniqueness of this study lies in (1) improvement of nonlinear ultrasonic modulation based fatigue crack detection reliability using feature-level data fusion, (2) reference-free fatigue crack diagnosis without using the baseline data obtained from the intact condition of the structure, (3) application to full-scale steel girders and shaft component, and (4) quantitative investigation of the improved reliability using receiver operating characteristic analysis.