• Tuberculosis and Respiratory Diseases
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• 제63권5호
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• pp.444-448
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• 2007

저자 등은 대학 병원 응급실을 내원한 2명의 환자에서 근육내 자극 요법 후 부작용으로 발생한 의인성 기흉의 증례를 경험하였기에 보고하는 바이다.

• 한국환경보건학회지
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• 제35권1호
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• pp.21-35
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• 2009

The Asian dust storms which originated in the deserts of Mongolia and China transported particles to Korea and led to a high concentration of atmospheric particulate matters (PM) of more than $1000{\mu}g/m^3$ throughout the country in the spring, of 2007. Public concern, in Korea, about the possible adverse effects of these dust events has increased, as these dust storms can contain various air pollutants emitted from heavily industrialized eastern China. The objectives of this study were to understand the concentration characteristics of PM as a function of particle size between the Asian dust storm episodes and non-Asian dust period and to consider the mass size distribution of PM in the Asian dust storms and their water soluble ion species on the potential, possible effects on deposition levels in the three regions (nasopharyngeal, tracheobronchial, and alveolar) of the human respiratory system. The size distribution of PM mass concentration during the Asian dust storms showed a peak in the coarse particle region due to the long-range transport of soil particles from the deserts of Mongolia and China, which was identified by HYSPLIT-4 model for backward trajectory analysis of air arriving in the sampling site of Iksan. During the non-Asian dust period, there were two different types in PM size distribution: bimodal distribution when low concentrations of $PM_{2.5}$ were observed, while unimodal distribution having a peak in fine particle region when high concentrations of $PM_{2.5}$ were showed. This unimodal distribution with high concentrations of fine particulate and secondary air pollutants such as ${SO_4}^{2-}$, ${NO_3}^-$, ${NH_4}^+$ was found to be due to the long-range transport of air pollutants from industrialized eastern China. During the Asian dust storms, the mean concentrations of PM that can be deposited in the nasopharyngeal, tracheobronchial, and alveolar region were $128.8{\mu}g/m^3$, $216.5{\mu}g/m^3$, and $89.6{\mu}g/m^3$, respectively. During the non-Asian dust period, the mean concentrations of PM that can be deposited in the nasopharyngeal, tracheobronchial, and alveolar region were $8.4{\mu}g/m^3$, $9.5{\mu}g/m^3$ and $38.5{\mu}g/m^3$, respectively.

• Journal of Radiation Protection and Research
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• 제32권2호
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• pp.79-88
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• 2007

원자력발전소 사고 시 방사성물질이 발전소외 지역으로 유출이 되거나 예상될 때 주민을 안전하게 보호하기 위한 조치의 일환으로 주민소개가 고려된다. 소개시간 산정에 필요한 인자를 도출하고, 각각의 인자에 대해 원전 주변의 현장자료를 토대로 부지주변의 교통환경 여건을 반영하여 월성원전의 방사선 비상계획구역 내의 주민전체를 소개시키는데 소요되는 시간을 예측하였다. 월성원전 방사선비상계획구역 내 주요 간선도로와 교차로에서 교통량을 조사하였고, 소개시작시간 분포를 추정하기 위해 상주거주자와 일시거주자를 대상으로 사회행동특성에 대한 설문조사를 실시하였다. 평시와 관광객이 많이 유입되어 차량정체가 예상되는 여름철을 대상으로 주간 및 야간, 평상기상 및 악기상의 경우로 나누어 주민소개시간을 예측하였다. 주민 소개시간 예측을 위한 교통분석은 TSIS 패키지 프로그램이 이용되었다. 비상계획구역 경계 남단과 북단에서 모든 소개차량(인구)이 비상계획구역을 벗어나는 데 걸리는 시간은 전체적으로는 $118{\sim}150$분 정도로 예측되었다. 여름 첨두교통량 유입시, 소개 시간은 낮이 밤보다 최대 17분 정도 더 소요되는 것으로 예측되었다.

• 한방비만학회지
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• 제15권1호
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• pp.1-8
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• 2015

Objectives: The aim of this study was to evaluate the effectiveness and safety of electroacupuncture for non-alcoholic fatty liver disease (NAFLD). Methods: A randomized, controlled pilot trial was conducted. Twenty-two participants were randomized into one of the two groups: an acupuncture group (n=11) and wait-list group (n=11). The treatment group received 8 sessions of electroacupuncture over 8 weeks. Twenty points (CV4, CV12, both LR14, GB26, ST25, ST34, ST40, ST36, SP4, SP6, LR3) were selected for needling. The control group did not receive acupuncture treatment during study period and followup were done in the 4th and 8th weeks after randomization in both groups. The primary outcome was body fat computed tomography and the secondary outcomes included blood test (aspartate aminotransferase, alanine transferase, triglyceride, total cholesterol, high density lipoproteincholesterol, low density lipoprotein-cholesterol, blood sugar test, ${\gamma}$-guanosine triphosphate) and body composition test (body mass index, weight, body fat mass, body fat rate, waist hip ratio). Safety was assessed at every visit. Results: There was no significant differences in between the experimental group and control group. There were no adverse events. Conclusions: The results suggest that In patients with NAFLD, electroacupuncture treatment did not induce worsening of liver disease and liver function, but it was no improvement symptoms of fatty liver. Study of herb medicine treatments and other acupuncture therapy of NAFLD are required later.

• 한국습지학회지
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• 제21권4호
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• pp.354-364
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• 2019

스리랑카는 지리적으로 섬으로 형성된 국가로 기후변화에 민감한 나라이다. Kurunegala시는 2009년부터 2019년까지 약 11년 동안 도심지 내 연평균 기온이 0.69±0.37℃로 꾸준하게 증가하였으며, 강우패턴도 변화하고 있다. 그러나 도시 개발 계획시 기후변화 및 기후재난에 대한 규정이 미흡하여 인적 및 물적 피해가 우려되고 있다. 따라서 본 연구는 스리랑카 Kurunegala시의 인문학적 및 자연적 특성을 조사분석하고 기후변화 적응에 대한 방안을 수립하기 위하여 수행되었다. Kurunegala시의 기후변화 적응방안은 기후변화에 대한 정성적 위험 평가를 수행하여 개발하였다. 정성적 위험평가 결과 Kurunegala시의 주요 문제점은 음용수, 수자원 및 건강 관련 인프라로 분석되었다. 물부족 및 도시 내 온도를 완화하기 위한 방안으로는 기존 사회인프라에 비점오염저감, 도시 열섬현상 저감 및 건전한 물순환 체계 구축 등 다양한 효과를 유도하는 저영향개발기술(Low Impact Development, LID)의 적용이 효과적인 것으로 나타났다. 본 자료는 Kurunegala시와 같이 기후변화에 따른 물문제를 안고 있는 도시의 물문제 해결에 활용될 수 있다.

• Tuberculosis and Respiratory Diseases
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• 제68권2호
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• pp.87-92
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• 2010

Background: D-dimer testing is widely applied as a first step in the diagnostic work-up of pulmonary embolism (PE). Although this is the most sensitive assay for ruling out PE, the prognostic implications of D-dimer testing in patients with normotensive PE are not well known. The aim of this study was to determine if D-dimer testing on admission predicts major adverse cardiac events (MACE) in patients with normotensive PE. Methods: A total of 180 consecutive patients with normotensive PE admitted between January 2003 and June 2009 were included. The group was divided into quartiles on the basis of their D-dimer levels. We compared the frequency of MACE by quartile of D-dimer level and estimated sensitivity, specificity, and predictive values for MACE in the first and fourth quartile. Results: In the 37 (20.6%) patients with MACEs, the median D-dimer level (7.94[IQR:4.03~18.17]${\mu}g/mL$) was higher than in patients with a benign course (5.29[IQR:2.60~11.52]${\mu}g/mL$, p<0.01). The occurrence of MACEs was increased with increasing D-dimer level (p=0.017). In the first quartile (D-Dimer <$2.76{\mu}g/mL$) sensitivity, specificity, and positive and negative predictive values for predicting MACEs were, respectively, 91.9%, 29.4%, 25.2%, and 93.3%. Conclusion: Patients with D-dimer levels below $2.76{\mu}g/mL$ have a low risk of MACEs. Our study suggest that D-dimer level may be used to identify low risk patients with normotensive PE.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권3호
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• pp.129-135
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• 2020

Background: Postoperative fluid retention is a factor that causes delay in recovery and unexpected adverse events. It is important to prevent intraoperative fluid retention, which is putatively caused by intraoperative release of stress hormones, such as ADH (anti-diuretic hormone) or others. We hypothesized that intraoperative analgesia may prevent pathological fluid retention. We retrospectively explored the relationship between analgesics and in-out balance in surgical patients from anesthesia records. Methods: Anesthetic records of 80 patients who had undergone orthognathic surgery were checked in this study. Patients were anesthetized with either TIVA (propofol and remifentanil) or inhalational anesthesia (sevoflurane and remifentanil). During surgery, acetated Ringer's solution was infused for maintenance at a rate of 3-5 ml/kg/h at the discretion of the anesthetist. The perioperative parameters, including the amount of crystalloid and colloid infused, and the amount of urine and bleeding were checked. Furthermore, we checked the amount and administration rate of remifentanil during the surgical procedure. The correlation coefficient between the remifentanil dose and the in-out balance or the urinary output was analyzed using the Pearson correlation coefficient. The contributing factor to fluid retention, including urinary output, was statistically examined by means of multivariate logistic regression analysis. Results: A significant positive correlation was found between remifentanil dose and urinary output. Urinary output less than 0.04 ml/kg/min was suggested to cause positive fluid balance. Although in-out balance approaches zero balance with increase in remifentanil administration rate, no contributing factor for near-zero fluid balance was statistically picked up. The remifentanil administration rate was statistically picked up as the significant factor for higher urinary output (> 0.04 ml/kg/min) (OR, 2,644; 95% CI, 3.2-2.2 × 10⁶) among perioperative parameters. Conclusions: In conclusion, remifentanil contributes in maintaining the urinary output during general anesthesia. Although further prospective study is needed to confirm this hypothesis, it was suggested that fluid retention could be avoided through suppressing intraoperative stress response by means of appropriate maintenance of remifentanil infusion rate.

• Radiation Oncology Journal
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• 제38권2호
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• pp.119-128
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• 2020

Purpose: Colorectal cancer is becoming an increasing concern in the middle-aged population of Iran. This study aimed to compare the preliminary results of short-course and long-course neoadjuvant chemoradiotherapy treatment for rectal cancer patients. Materials and Methods: In this clinical trial we recruited patients with rectal adenocarcinoma located from 5 cm to 15 cm above the anal verge. Patients in group I (short-course) received three-dimensional conformational radiotherapy with a dose of 25 Gy/5 fractions in 1 week plus concurrent XELOX regimen (capecitabine 625 mg/㎡ from day 1-5 twice daily and oxaliplatin 50 mg/㎡ on day 1 once daily). Patients in group II (long-course) received a total dose of 50-50.4 Gy/25-28 fractions for 5 to 5.5 weeks plus capecitabine 825 mg/㎡ twice daily. Both groups underwent consolidation chemotherapy followed by delayed surgery at least 8 weeks after radiotherapy completion. The pathological response was assessed with tumor regression grade. Results: In this preliminary report on complications and pathological response, 66 patients were randomized into two study groups. Mean duration of radiotherapy in the group II (long-course) was 5 ± 1 days (range, 5 to 8 days) and 38 ± 6 days (range, 30 to 58 days). The median follow-up was 18 months. Pathological complete response was achieved in 32.3% and 23.1% of patients in the shortcourse and long-course groups, respectively (p = 0.558). Overall, acute grade 3 or higher treatment-related toxicities occurred in 24.2% and 22.2% of patients in group I and II, respectively (p = 0.551). No acute grade 4 or 5 adverse events were observed in either group except one grade 4 hematologic toxicity that was seen in group II. Within one month of surgery, no significant difference was seen regarding grade ≥3 postoperative complications (p = 0.333). Conclusion: For patients with rectal cancer located at least 5 cm above the anal verge, short-course radiotherapy with concurrent and consolidation chemotherapy and delayed surgery is not different in terms of acute toxicity, postoperative morbidity, complete resection, and pathological response compared to long-course chemoradiotherapy.

• Journal of Yeungnam Medical Science
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• 제35권1호
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• pp.76-83
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• 2018

Background: Elderly patients with multiple myeloma (MM) are vulnerable to adverse events (AEs). This study evaluated adherence to chemotherapy and treatment outcomes in elderly patients treated with a frontline bortezomib (BTZ), melphalan, and prednisone (VMP) regimen and regimens without BTZ. Methods: One-hundred and forty elderly patients who were diagnosed with MM from March 2007 to March 2015 were included in this retrospective study. To evaluate regimen adherence, patients who were treated with more than 4 cycles were assigned to the good adherence group. Results: Among the 140 patients, 71 were treated with a frontline VMP and 69 with non-BTZ regimens. The median age was 71 years (range, 65-90 years). The VMP group showed a higher complete response rate than the non-BTZ group: 26.8% vs. 7.2%. More patients in the VMP group achieved ${\geq}$very good partial response (VGPR) and ${\geq}PR$. In the VMP group, 27 patients (38.0%) received less than 4 cycles. The VMP good adherence group showed a higher 3-year overall survival (OS) rate (70.9%) than the poor adherence group (60.2%, p=0.059). In the multivariate analysis, treatment with ${\geq}4$ cycles of VMP was a favorable factor for OS. Conclusion: A good adherence to a frontline VMP regimen resulted in favorable long-term survival. Adequate management of AEs will be needed to achieve favorable outcomes in elderly patients with MM.

• Gut and Liver
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• 제12권6호
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• pp.728-735
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• 2018

Background/Aims: The combination of nab-paclitaxel and gemcitabine (nab-P/Gem) is widely used for treating metastatic pancreatic cancer (MPC). We aimed to evaluate the therapeutic outcomes and prognostic role of treatment-related peripheral neuropathy in patients with MPC treated with nab-P/Gem in clinical practice. Methods: MPC patients treated with nab-P/Gem as the first-line chemotherapy were included. All 88 Korean patients underwent at least two cycles of nab-P/Gem combination chemotherapy (125 and $1,000mg/m^2$, respectively). Treatment-related adverse events were monitored through periodic follow-ups. Overall survival and progression-free survival were estimated by the Kaplan-Meier method, and the Cox proportional hazards regression linear model was applied to assess prognostic factors. To evaluate the prognostic value of treatment-related peripheral neuropathy, the landmark point analysis was used. Results: Patients underwent a mean of $6.7{\pm}4.2$ cycles during $6.3{\pm}4.4$ months. The median overall survival and progression-free survival rates were 14.2 months (95% confidence interval [CI], 11.8 to 20.3 months) and 8.4 months (95% CI, 7.1 to 13.2 months), respectively. The disease control rate was 84.1%; a partial response and stable disease were achieved in 30 (34.1%) and 44 (50.0%) patients, respectively. Treatment-related peripheral neuropathy developed in 52 patients (59.1%), and 13 (14.8%) and 16 (18.2%) patients experienced grades 2 and 3 neuropathy, respectively. In the landmark model, at 6 months, treatment-related peripheral neuropathy did not have a significant correlation with survival (p=0.089). Conclusions: Nab-P/Gem is a reasonable choice for treating MPC, as it shows a considerable disease control rate while the treatment-related peripheral neuropathy was tolerable. The prognostic role of treatment-related neuropathy was limited.