• 한국임상약학회지
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• 제32권1호
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• pp.37-46
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• 2022

Background: Non-valvular atrial fibrillation (NVAF) is associated with ischemic stroke risk in the aging population. Observational studies have indicated beneficial effects of direct-acting oral anticoagulant (DOAC) against ischemic stroke compared to warfarin. This study aimed to investigate ischemic stroke incidence and bleeding risk in patients on DOAC therapy. Methods: Using the database of Korean Health Insurance Review and Assessment-Aged Patient Sample 2015, we conducted a retrospective cohort study. Study subjects with NVAF diagnosis and prescribed anticoagulants were enrolled. Propensity score (PS) matching by age, sex, comorbidities, and medications were used. The clinical outcomes were major adverse cerebro-cardiovascular events (MACCEs, ischemic stroke/systemic embolism, myocardial infarction, cardiac death) and bleeding events. A cox proportional hazard model analysis was performed to compare the outcomes with hazard ratio (HR) and 95% confidence interval (CI). Results: Total 4,773 elderly patients with NVAF were initially included. Four PS-matched groups including rivaroxaban vs. warfarin-only (n=1,079), dabigatran vs. warfarin-only (n=721), rivaroxaban vs. dabigatran (n=721), and switchers of warfarin to rivaroxaban vs. warfarin-only (n=287) were analyzed. Every group showed statistically similar results of MACCEs and bleeding events, except for the group of rivaroxaban vs. dabigatran. Rivaroxaban users showed higher risks of bleeding events than dabigatran users (HR 2.25, 95% CI 1.01-4.99). Conclusion: In the elderly patients with NVAF, efficacy and safety outcomes among oral anticoagulants including DOACs and warfarin were similar, while rivaroxaban are more likely to have higher bleeding risks than dabigatran. Further research using large size sample is needed.

• 한국전문물리치료학회지
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• 제30권4호
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• pp.306-313
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• 2023

Background: As social problems due to the acceleration of the aging era and the increase in the elderly population are becoming serious, virtual reality (VR)-based healthcare is emerging as an approach for preventing and managing health issues. Objects: This study used validity and reliability analyses to examine the clinical efficacy that is, the clinical value and usability of a novel VR cognitive evaluation system index that we developed. Methods: We developed a VR cognitive evaluation system based on motion recognition analysis evaluation for individuals aged 65 to 85. After conducting the Korean version of the Mini-Mental State Exam (K-MMSE) cognitive evaluation, the evaluation score was verified through correlation analysis in the VR cognitive evaluation system. To verify the construct validity of the two groups, the Global Deterioration Scale (GDS) grades were categorized into a normal cognitive group (GDS grade 1) and a cognitive impairment group (GDS grades 2 and 3). The data were measured twice to determine the reliability between the two measurements and assess the stability and clinical value of the evaluation system. Results: Our evaluation system had a high correlation of 0.85 with the widely used K-MMSE cognitive evaluation. The system had strong criterion-related validity at the 95% confidence interval. Compared to the average score of GDS grade 1 in the VR cognitive evaluation system, the average score of GDS grades 2 and 3 in the VR cognitive evaluation system was statistically significantly lower while also having strong construct validity at the 95% confidence interval. To measure the reliability of the VR cognitive evaluation system, tests-retests were conducted using the intraclass correlation coefficient (3,1), which equaled 0.923 and was statistically significant. Conclusion: The VR cognitive evaluation system we developed is a valid and reliable clinical tool to distinguish between normal cognitive status and mild cognitive impairment.

• 한국가스학회지
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• 제28권1호
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• pp.35-43
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• 2024

산업 및 과학기술의 고도화로 인해 신규 화학물질 수와 사용량은 꾸준히 증가하고 있으며 이에 따른 화학물질 안전관리의 중요성이 사회적으로 부각됨에 따라 국민적 요구가 높아지고 있다. 정부적인 차원에서 화학물질의 안전관리에 대해 부처별로 역할을 구분하여 관리하고 있으나 시설 노후화 및 취급 부주의 등의 문제로 매년 화학물질로 인한 사고가 빈번하게 발생되고 있는 실정이다. 국내에서 발생한 화학물질 관련 사고사례를 바탕으로 사고 유형을 분석한 결과, 누출·폭발·화재·기타 등의 순으로 사고가 발생하고 있으며 사고의 원인은 시설결함, 안전관리 미준수로 순으로 분석되었다. 본 연구에서는 화학물질 중 불산을 취급하고 있는 사업장을 대상으로 HAZOP을 통해 취급공정에 대한 유해위험요인을 파악하여 Bow-Tie를 활용한 위험성평가를 수행하였다. 본 연구 결과를 바탕으로 동종·유사 사업장의 화학사고 예방을 위한 안전관리 계획을 개선할 수 있을 것이며 이를 통해 화학사고를 사전에 예방할 수 있는 화학안전관리 체계의 선진화에 기여할 수 있을 것으로 기대된다.

• The Korean Journal of Pain
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• 제37권1호
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• pp.51-58
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• 2024

Background: The rise in national health care costs has emerged as a global problem given the ever-aging population and rapid development of medical technology. The utilization of interventional pain management has, similarly, shown a continued rise worldwide. This study evaluates the differences in the medical costs in the field of interventional pain treatment (IPT) between two countries: Korea and Japan. Methods: Korean medical insurance costs for 2019 related to pain management focused on IPT were compared to those of Japan. Purchasing power parity (PPP) was used to adjust the exchange rate differences and to compare prices in consideration of the respective societies' economic power. Results: The cost of trigger point injections in Japan was 1.06 times higher than that of Korea, whereas the perineural and intraarticular injection prices were lower in Japan. The cost of epidural blocks was higher in Japan compared to Korea in both cervical/thoracic and lumbar regions. As for blocks of peripheral branches of spinal nerves, the cost of scapular nerve blocks in Japan was lower than that in Korea, given a PPP ratio 0.09. For nerve blocks in which fluoroscopy guidance is mandatory, the costs of epidurography in Japan were greater than those in Korea, given a PPP ratio 1.04. Conclusions: This is the first comparative study focusing on the medical costs related to IPT between Korea and Japan, which reveals that the costs differed along various categories. Further comparisons reflecting more diverse countries and socio-economic aspects will be required.

• 드라이브 ㆍ 컨트롤
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• 제21권2호
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• pp.53-64
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• 2024

Global population growth has resulted in an increased demand for food production. Simultaneously, aging rural communities have led to a decrease in the workforce, thereby increasing the demand for automation in agriculture. Drones are particularly useful for unmanned pest control fields. However, the current method of uniform spraying leads to environmental damage due to overuse of pesticides and drift by wind. To address this issue, it is necessary to enhance spraying performance through precise performance evaluation. Therefore, as a foundational study aimed at optimizing drone-based pest control technologies, this research evaluated water-sensitive paper (WSP) via density map estimation using convolutional neural networks (CNN) with a encoder-decoder structure. To achieve more accurate estimation, this study implemented multi-task learning, incorporating an additional classifier for image segmentation alongside the density map estimation classifier. The proposed model in this study resulted in a R-squared (R²) of 0.976 for coverage area in the evaluation data set, demonstrating satisfactory performance in evaluating WSP at various density levels. Further research is needed to improve the accuracy of spray result estimations and develop a real-time assessment technology in the field.

• Clinical Endoscopy
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• 제57권2호
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• pp.141-157
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• 2024

Antithrombotic agents, including antiplatelet agents and anticoagulants, are widely used in Korea because of the increasing incidence of cardiocerebrovascular disease and the aging population. The management of patients using antithrombotic agents during endoscopic procedures is an important clinical challenge. The clinical practice guidelines for this issue, developed by the Korean Society of Gastrointestinal Endoscopy, were published in 2020. However, new evidence on the use of dual antiplatelet therapy and direct anticoagulant management has emerged, and revised guidelines have been issued in the United States and Europe. Accordingly, the previous guidelines were revised. Cardiologists were part of the group that developed the guideline, and the recommendations went through a consensus-reaching process among international experts. This guideline presents 14 recommendations made based on the Grading of Recommendations, Assessment, Development, and Evaluation methodology and was reviewed by multidisciplinary experts. These guidelines provide useful information that can assist endoscopists in the management of patients receiving antithrombotic agents who require diagnostic and elective therapeutic endoscopy. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.

• 대한치매학회지
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• 제21권3호
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• pp.93-102
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• 2022

Background and Purpose: The effects of high-intensity interval training (HIIT) interventions on functional brain changes in older adults remain unclear. This preliminary study aimed to explore the effect of physical exercise intervention (PEI), including HIIT, on cognitive function, physical performance, and electroencephalogram patterns in Korean elderly people. Methods: We enrolled six non-dementia participants aged >65 years from a community health center. PEI was conducted at the community health center for 4 weeks, three times/week, and 50 min/day. PEI, including HIIT, involved aerobic exercise, resistance training (muscle strength), flexibility, and balance. Wilcoxon signed rank test was used for data analysis. Results: After the PEI, there was improvement in the 30-second sit-to-stand test result (16.2±7.0 times vs. 24.8±5.5 times, p=0.027), 2-minute stationary march result (98.3±27.2 times vs. 143.7±36.9 times, p=0.027), T-wall response time (104.2±55.8 seconds vs.71.0±19.4 seconds, p=0.028), memory score (89.6±21.6 vs. 111.0±19.1, p=0.028), executive function score (33.3±5.3 vs. 37.0±5.1, p=0.046), and total Literacy Independent Cognitive Assessment score (214.6±30.6 vs. 241.6±22.8, p=0.028). Electroencephalography demonstrated that the beta power in the frontal region was increased, while the theta power in the temporal region was decreased (all p<0.05). Conclusions: Our HIIT PEI program effectively improved cognitive function, physical fitness, and electroencephalographic markers in elderly individuals; thus, it could be beneficial for improving functional brain activity in this population.

• Clinics in Shoulder and Elbow
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• 제27권2호
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• pp.196-202
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• 2024

Background: As the population is aging and indications are expanding, shoulder arthroplasty is becoming more frequent, especially bilateral staged replacement. However, surgeons are hesitant to use bilateral reverse prostheses due to potential limitations on activities of daily living. Methods: This meta-analysis was conducted to compare bilateral anatomic to bilateral reverse shoulder implants. PubMed, Cochrane, and Google Scholar (pages 1-20) were searched until April 2023. The clinical outcomes consisted of postoperative functional scores (American Shoulder and Elbow Surgeons [ASES], Single Assessment Numeric Evaluation [SANE], Physical Component Score [PCS], Mental Component Score, and Simple Shoulder Test), pain, and range of motion (external rotation and forward elevation). Three studies were included in this meta-analysis. Results: Bilateral anatomic implants had better postoperative functional outcomes and range of motion, but no significant difference was seen in postoperative pain when compared to the reverse prosthesis. Better ASES score, SANE score, and PCS as well as better external rotation and forward elevation were seen in the bilateral anatomic shoulder replacement group, but no significant difference in pain levels was seen between the two groups Conclusions: The results may be explained by the lower baseline seen in the reverse prosthesis group, which may be due to an older population and different indications. Nevertheless, more randomized controlled studies are needed to confirm these findings. Level of evidence: III.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제12권2호
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• pp.256-262
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• 2001

연구 목적：측뇌실의 확장은 성인기의 정신분열병에서 잘 확립된 소견이지만, 조기에 발병한 정신증적 장애에서는 아직 논란이 있다. 본 연구에서는 자기공명영상을 이용한 후향적인 방법을 통하여 지금까지 비교적 연구가 많이 시행되지 않았던 조기발병한 정신분열병·양극성 장애 환아들을 대상으로 측뇌실의 구조적인 이상을 연구하여, 이러한 뇌의 구조적 이상이 병의 초기부터 시작되어 정상과는 다른 경과로 진행되는 것인가를 알아보고자 하였다 방 법：정신분열병과 양극성 장애의 DSM-III-R 진단 기준에 부합하는 14명의 환아(평균 연령 14.0세, 표준편차 2.1)와 26명의 두통 대조군에서 뇌자기공명 영상상을 후향적으로 모집하였다. 분석을 위하여 측뇌실이 가장 잘 보이는 축 영상(axial image)를 선택하였다. 뇌자기공명영상상은 평판형 스캐너로 읽어들여서 NIH IMAGE 프로그램을 통하여 분석하였다. 결 과：환자군에서는 측뇌실 크기, 측뇌실확장지수가 연령의 증가에 따라 함께 증가하는 상관관계를 나타내었으나, 대조군에서는 연령과 측뇌실 크기, 측뇌실확장지수 등이 유의한 상관관계를 보이지 않았다. 환자군에서는 정상군에서 보이는 좌우 측뇌실 비대칭성이 소실된 결과를 보였다. 그리고 통계적으로 유의한 정도는 아니었으나 환자군이 대조군에 비해 측뇌실과 측뇌실확장지수가 큰 경향을 보였다. 결 론：정신증적 환자에서의 뇌의 구조적 이상은 병의 비교적 초기 경과에서부터 시작되며, 정상과는 다소 다른 경과를 취하며 진행한다는 것을 시사하는 결과라 할 수 있다.

• Mycobiology
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• 제40권2호
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• pp.117-123
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• 2012

Nuruk contributes to the unique characteristics of Korean alcoholic beverages. In this study, the effects of nuruk extracts (NE) on anti-oxidant characters, melanogenesis, and anti-photoaging activity were investigated. NEs were obtained from the 70% ethanol extracts of six types of nuruk, which have been used in brewing of fermented alcohol beverages in Korea. First, various antioxidant characteristics were identified in terms of 2,2'-azino-bis(3-ethylbenzthiozoline-6-sulphonic acid) (ABTS) radical scavenging activity, superoxide dismutase (SOD) expression, and inhibition of xanthine oxidase activity. NE#4 exhibited potent ABTS radical scavenging activity ($IC_{50}$ = 19.51 ${\mu}g$/mL). Compared with NE#4, relatively lower levels of activity were observed for NE#3 and NE#6, with $IC_{50}$ values of 90.99 and 76.88 ${\mu}g$/mL, respectively. According to results of western blot analysis for determination of SOD expression in $H_2O_2$-treated HepG2 cells, NE#5 and NE#6 induced a dramatic increase in the expression ratio of SOD, compared to the group treated with $H_2O_2$ only. Activity of xanthine oxidase, which converts xanthine into uric acid, generating superoxide ions, was inhibited by NE#4 and NE#6 in a dose-dependent manner. NE#4 induced significant inhibition of mushroom tyrosinase activity. A reduction in cellular melanin contents of 80% was observed in B16F1 melanocytes treated with NE#5 and NE#6; these effects were similar to those of arbutin at 100 ${\mu}M$. In addition, gelatin zymography and reverse transcription-PCR analysis were performed for assessment of anti-photoaging activity of Nuruk. Treatment with NE#6 resulted in dramatically inhibited activities of matrix metalloproteinase (MMP)-2/-9, suppressed expression of MMP-1, and increased expression of type-1 procollagen. Results of gelatin zymography for NE#4 and NE#5 were similar, to a slightly lesser degree. These results suggest the potential of NE#4 and NE#6 as natural ingredients for use in functional foods and cosmetics.