• Tuberculosis and Respiratory Diseases
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• 제78권4호
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• pp.321-325
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• 2015

Background: The adverse effects of the phosphodiesterase-4 inhibitor roflumilast, appear to be more frequent in clinical practice than what was observed in chronic obstructive pulmonary disease (COPD) clinical trials. Thus, we designed this study to determine whether adverse effects could be reduced by starting roflumilast at half the dose, and then increasing a few weeks later to $500{\mu}g$ daily. Methods: We retrospectively investigated 85 patients with COPD who had taken either $500{\mu}g$ roflumilast, or a starting dose of $250{\mu}g$ and then increased to $500{\mu}g$. We analyzed all adverse events and assessed differences between patients who continued taking the drug after dose escalation and those who had stopped. Results: Adverse events were reported by 22 of the 85 patients (25.9%). The most common adverse event was diarrhea (10.6%). Of the 52 patients who had increased from a starting dose of $250{\mu}g$ roflumilast to $500{\mu}g$, 43 (82.7%) successfully maintained the $500{\mu}g$ roflumilast dose. No difference in factors likely to affect the risk of adverse effects, was detected between the dose-escalated and the discontinued groups. Of the 26 patients who started with the $500{\mu}g$ roflumilast regimen, seven (26.9%) discontinued because of adverse effects. There was no statistically significant difference in discontinuation rate between the dose-escalated and the control groups (p=0.22). Conclusion: Escalating the roflumilast dose may reduce treatment-related adverse effects and improve tolerance to the full dose. This study suggests that the dose-escalated regimen reduced the rate of discontinuation. However, longer-term and larger-scale studies are needed to support the full benefit of a dose escalation strategy.

• 정신신체의학
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• 제6권1호
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• pp.22-27
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• 1998

DSM-IV 진단 기준에 의하여 신체화 장애, 미분화 신체형 장애, 그리고 달리 분류되지 않은 신체형 장애여성 환자 13명과 정상 여성 20명을 대상으로 압통에 대한 통각 역치와 혈청 testosterone을 측정하여 다음과 같은 결과를 얻었다. 1) 가변 하중 압통 예민도 측정기 (Variable Weight Pressure Algometer)로 측정한 통각 역치는 환자군이 153.8${\pm}$39.5gm/$0.05mm^2$로서 대조군의 197.5${\pm}$66.7gm/$0.05mm^2$보다 유의하게 낮았다(p<0.05). 2) 혈청 testosterone치는 환자군에서는 0.175${\pm}$0.081ng/ml였고, 대조군에서는 0.174${\pm}$0.108ng/ml로서 양군간에 유의한 차이가 없었다. 3) Testosterone과 통각 역치와의 상관관계를 보면, 환자군에서는 혈청 testosterone치와 통각 역치 사이에 유의한 정적 상관관계가 있었으나(r=0.632, p<0.05, two tailed, Pearson's correlation test), 대조군에서는 유의하지 않았다(r=-0.405). 이상의 결과로 보아 신체화 장애 환자와 정상인 사이에 통각 예민도 조절 기전이 서로 다를 수 있다고 사료 된다.

• 한국전문물리치료학회지
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• 제26권3호
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• pp.67-75
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• 2019

Background: Stress urinary incontinence (SUI) is an involuntary leakage of urine from the urethra when intra-abdominal pressure increases, such as from sneezing, coughing, or physical exertion. It is caused by insufficient strength of the pelvic floor and sphincter muscles, resulting from vaginal delivery, obesity, hard physical work, or aging. The pelvic floor electrical stimulator is a conservative treatment generally used to relieve the symptoms of urinary incontinence. it recommended to applied before surgery is performed. Objects: The purpose of this study was to determine if the transcutaneous electrical stimulation (TCES) would be effective for the physiological symptoms and psychological satisfaction of women with SUI for an 8-weeks intervention. Methods: Easy-K is a specially designed user-friendly TCES. Five female who were diagnosed with SUI by a gynecologist but who did not require surgical intervention were included in this study. Intervention was implemented over an 8-week period. Outcome measures included vaginal ultrasonography, Levator ani muscle (LAM) contraction strength, incontinence quality of life (I-QOL), and female sexual function index (FSFI) questionnaires. Results: The bladder neck position significantly decreased across assessment time. Funneling index and urethral width significantly decreased after 8 weeks of intervention (p<.05). The bladder necksymphyseal distance and posterior rhabdosphincter thickness statistically increased and the anterior rhabdosphincter thickness showed a tendency to increase. All participants demonstrated a significant increase in the LAM contraction score across three assessment times (p<.05). Although the total score of the I-QOL did not show significant improvement, it steadily increased and among I-QOL subscales, only the "avoidance" subscale showed statistical improvements (p<.05). The total score of the FSFI statistically improved and the "desire" score significantly changed (p<.05). Conclusion: The TCES is recommended for women who want to apply conservative treatments before surgery and who have suffered from SUI in aspects of sexual function and quality of life.

• Journal of Gastric Cancer
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• 제23권3호
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• pp.476-486
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• 2023

Purpose: The optimal tumor mutational burden (TMB) value for predicting treatment response to programmed cell death-1 (PD-1) checkpoint inhibitors in advanced gastric cancer (AGC) remains unclear. We aimed to investigate the optimal TMB cutoff value that could predict the efficacy of PD-1 checkpoint inhibitors in AGC. Materials and Methods: Patients with AGC who received pembrolizumab or nivolumab between October 1, 2020, and July 27, 2021, at Samsung Medical Center in Korea were retrospectively analyzed. The TMB levels were measured using a next-generation sequencing assay. Based on receiver operating characteristic curve analysis, the TMB cutoff value was determined. Results: A total 53 patients were analyzed. The TMB cutoff value for predicting the overall response rate (ORR) to PD-1 checkpoint inhibitors was defined as 13.31 mutations per megabase (mt/Mb) with 56% sensitivity and 95% specificity. Based on this definition, 7 (13.2%) patients were TMB-high (TMB-H). The ORR differed between the TMB-low (TMB-L) and TMB-H (8.7% vs. 71.4%, P=0.001). The progression-free survival and overall survival (OS) for 53 patients were 1.93 (95% confidence interval [CI], 1.600-2.268) and 4.26 months (95% CI, 2.992-5.532). The median OS was longer in the TMB-H (20.8 months; 95% CI, 2.292-39.281) than in the TMB-L (3.31 months; 95% CI, 1.604-5.019; P=0.049). Conclusions: The TMB cutoff value for predicting treatment response in AGC patients who received PD-1 checkpoint inhibitor monotherapy as salvage treatment was 13.31 mt/Mb. When applying the programmed death ligand-1 status to TMB-H, patients who would benefit from PD-1 checkpoint inhibitors can be selected.

• 대한영상의학회지
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• 제83권3호
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• pp.645-657
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• 2022

목적 수술 검체를 사용하여 동일한 갑상선 결절에 시행한 세침 흡인 세포검사와 중심부 바늘 생검의 진단 결과를 비교 평가하고자 하였다. 대상과 방법 2015년 2월부터 2016년 1월까지 88명의 20 mm 이상 크기의 89개의 갑상선 결절이 연구에 포함되었다(평균 크기: 40.0 ± 15.3 mm). 갑상선이 적출된 후 검체에 초음파 보조하에 세침 흡인 검사와 중심부 바늘 생검을 차례대로 시행하였다. 세포 병리 검사 결과는 수술 병리 진단 결과와 비교하였다. 결과 89개의 결절 중 30개는 악성, 59개는 양성이었다. 악성 결절에서 양성 결절보다 유의하게 비진단적 세침 흡인 검사 결과율이 높았다(80.0% vs. 39.0%, p < 0.001). 중심부 바늘 생검의 경우 양성과 악성 결절 사이에 결과의 유의한 차이가 없었다(p = 0.796). 크기가 40 mm 이상인 결절과(62.5% vs. 22.9%, p = 0.028) 초음파 소견과는 상관없이, 악성 결절에서 비진단적 세침 흡인 검사 결과율이 높았다. 30개의 갑상선암 중 11개(36.7%)가 중심부 바늘 생검으로 진단되었으나, 세침 흡인 검사에서는 진단된 검체가 없었다. 결론 수술 검체를 이용한 본 실험 연구에서, 중심부 바늘 생검은 갑상선암에 대한 진단적 민감도를 높일 수 있는 가능성이 있는 것으로 생각된다.

• 한국습지학회지
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• 제18권4호
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• pp.481-487
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• 2016

본 연구는 도시 강우유출수 처리를 위한 하이브리드 빗물정원 시스템을 개발하고자 수행되었으며, Pilot scale 모니터링을 통하여 시스템 내의 서로 다른 구성요소간의 효율을 검증하였다. 유입수는 국내 외 도로강우유출수의 농도를 고려한 인공강우유출수를 이용하여 수행하였다. 모니터링 결과 하이브리드 빗물정원은 시설 내 저류 80%, 지하수의 침투 15%로 유입수의 약 95% 저감되는 것으로 나타났다. 이는 ST의 저류 및 PB와 IT의 침투 기작이 물순환 효과에 기여한 것으로 판단된다. 또한 오염물질 저감효율을 산정한 결과, TSS의 경우 평균 87%으로 나타났으며, 유기물은76%, 영양염류는 46%, 중금속은 56%으로 나타났다. 이는 PB와 IT에 포함된 여재의 여과, 침투 및 식생과 토양의 생물학적 흡수 기작 영향에 의해 나타난 결과로 판단된다. 이러한 연구 결과는 향후 빗물정원의 효율을 향상시키기 위한 시설의 개선 및 설계방안으로 활용 가능할 것으로 평가된다.

• 한국식품과학회지
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• 제49권1호
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• pp.14-19
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• 2017

본 연구에서는 전자코를 사용하여 가열 시 레토르트 파우치와 내용물 간의 상호반응으로 발생하는 휘발성분의 변화를 알아보고자 하였다. 레토르트 파우치와 물의 상호반응에 의해 포장재의 휘발성분이 용기 내 물 쪽으로 이행되어 물의 휘발성분이 증가하였고 포장재 자체의 경우에는 휘발성분의 농도가 감소한 것으로 나타났다. 포장재 내 식품의 결과에서도 마찬가지로 20분 이상 가열 시 휘발성분의 변화가 나타났다. GC/MS 분석 결과, 이러한 휘발성분의 변화는 헵탄알, 옥탄알, 노난알, BHT 등에 의한 것으로 식품의 지방성분에 의한 휘발성분의 증가와 포장재로부터 이행되는 휘발성분의 변화임을 확인하였다. 또한 전자코 분석으로 얻어진 이온분획을 비교하였을 때 GC/MS 분석에서 검출된 노난알과 BHT의 추적이 가능하였다. 포장재로부터 이행되는 이취는 식품의 관능적 품질특성에 부정적인 영향을 끼칠 것으로 예상되기 때문에 레토르트 파우치 내 식품을 가열하여 섭취 시에 방치시간을 20분 내로 하여야 할 것이다.

• Clinical and Experimental Reproductive Medicine
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• 제9권1_2호
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• pp.29-41
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• 1982

This retrospective clinical study was done based under the delivery records of 146 cases of twin pregnancies in Yonsei University, Severance Hospital and Wonju Christian Hospital from 1977 through 1980 with particular interest in the second twins. Clinical factors, Apgar scores related to neonatal prognosis, and perinatal mortality rate were statistically analyzed and the following results were obtained. The mean - birthweight for A (first) twins was 2,377 grams and for B (second) twins 2,296 grams. In comparison of the percentage of low-birth-weight (less than 2,500 grams) infants, there were more small B twins, but the difference was statistically not significant. Because there were no significant statistical differences in birth weight-grouping between A and B twins, they could be compared with the comprehensive Apgar scores, but this method was also shown to be statistically not significant. In comparison of the percentage of breech deliveries in A and B twins, the percentage was more than three times in B twin (A twin, 7.5 per cent; B twin, 24.0 per cent), and the difference was statistically very significant (p < 0.0005). There were no significant statistical differences between the Apgar scores of A and B twins in reference to the manner of delivery. According to the manner of delivery of B twins, spontaneous vertex delivery and total breech extraction revealed higher infant mortality rate than others. B twins presented by the vertex in 88 cases (61.0 per cent), by the breech in 55 cases (37.0 per cent), and by the shoulder in 3 cases (2.0 per cent). And this therefore disclosed no significant statistical differences in Apgar scores in relation to the presentation. The duration of labor appeared to have no clear correlation with the Apgar scores and the perinatal mortality of A and B twins. The delivery interval between A and B twins was 11.9 minutes on an. averge, varying from 3 to 65 minutes. The length of this interval was not found to have any significant effect on the Apgar scores and the perinatal mortality rate of B twin.

• 대한족부족관절학회지
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• 제6권1호
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• pp.40-45
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• 2002

Purpose: To analyze the radiographic results between the simple bone excision and simple bone excision and posterior tibial tendon advancement for prehallux. Materials and Methods: Thirty-four patients who underwent operative treatment for prehallux between 1995 and 2000 were reviewed. Twenty-six patients who underwent simple bone excision and posterior tibial tendon advancement and eight patients who underwent simple bone excision were available for follow-up. Follow-up averaged 44 months(15-59 months). We evaluated and compared the cuboidal height and the talo-1st metatarsal angle in the preoperative and postoperative radiography. Results: The average span of disappearing pain is 3.7 months(2-7 months) after the operation. Mean cuboidal height and talo-1st metatarsal angle were increased $6.7{\pm}1.8mm$, $5.0{\pm}2.1^{\circ}$ before to $7.8{\pm}0.2mm$, $5.6{\pm}0.7^{\circ}$ after simple bone excision and posterior tibial tendon advancement. Mean cuboidal height and talo-1st metatarsal angle were increased $6.6{\pm}0.7mm$, $4.6{\pm}1.1^{\circ}$ before to $7.7{\pm}0.9mm$, $5.1{\pm}0.4^{\circ}$ after simple bone excision and posterior tibial tendon advancement. One case of extra-osseous migration of the Mitek anchor inserted into navicula was seen during the follow-up period. Conclusion: This study shows that the remarkable differences between the two procedures are not found. So, simple bone excision without advancement of posterior tibial tendon for prehallux can generate relatively good results.

• 한국비블리아학회지
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• 제5권1호
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• pp.37-84
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• 1981

Korean private colleges under the period of Japanese control was the kernel for the educational resistance, one of the save-the-nation movements because of inculcating in Koreans the spirit of independence and self-respect under that period. Posung College Library building, erected in Commemoration of the 30th Anniversary of the Foundation, especially, was the result of Koreans systematizing ability and iron will of independence for the future generations. In this paper, an attempt to study the Korean private college libraries under the period of Japanese control is provided. The main institutions in this study are Posung College library, Chosen Christian College library (Yunhee College Library), and Ewha College Library. This study will focus to review the followings: 1. The historical background of above mentioned libraries. 2. The educational resistance under that period. 3. The comparative and analytical study of these private college libraries and Keijo Imperial University library. 4. The facilities and the basic collection development plan on the basis of presentation. 5. library services including readers services. 6. The impact of these libraries on the present private university libraries. 7. The organization and staffing pattern, and budget of these private college libraries. The followings are the outlines conclusions: 1. Korean private college libraries had been established in order to perform the educational resistance. They are one of the supporting agencies for the research activities, among the most important means of social education, and provide, no doubt, the full nutriment for hungry soul under that period. 2. These libraries have not outstripped Keijo Imperial University in collection of books as well as man power, but their collection of books coincided, in general, with their curricula, and had feature to perform the save-the-nation-movement by education. 3. The library services were appeared in the forms such as the Circulation Library, Lectures on the Use of Books and Libraries, Library Week, and Training Course for the Librarians, etc. It is thought that these activities contributed to the social and cultural development of Korea indirectly. 4. The library administration of the private colleges depended upon the director of library because of the frequent changes of staffs and the simple functional system without its middle class. 5. The Japanese Government-General in Korea gave no financial assistance to the private colleges though they were in financial difficulties more than Keijo Imperial University. 6. The ambitious ideal for foundation of universities in reality as well as in name was not achieved during that period because of the monstrous obstacle so-called the Japanese Government-General in Korea, but its ideal had a desirable effect upon these college libraries development, in particular, before and after 1935.