• 한국신경인지재활치료학회지
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• 제10권2호
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• pp.45-52
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• 2018

목적: 본 연구는 뇌졸중 환자를 대상으로 BBS, MoCA-K, MBI와의 상관관계를 제시하고 각 변수들과의 영향력을 분석하여 뇌졸중 환자의 기능적 수행능력 평가에 기초연구가 되고자 한다. 방법: 연구 대상자는 고양시에 소재하는 Y재활병원에 입원하여 치료받고 있는 뇌졸중 환자 34명을 대상으로 2017년 12월부터 2018년 3월까지 실시하였으며 선정기준은 첫째, 뇌졸중으로 진단받고 6개월 이상 경과한 자, 둘째, 의사소통이 가능하며 MMSE-K 20점 이상인 자, 셋째, 편측무시가 없는 자, 넷째, 하위운동신경 병변이 없고 양하지 및 척추에 정형외과적 질환이 없는 자, 다섯째, 시청각계 이상이 없고 운동기능에 영향을 주는 약물 또는 수술을 받지 않은 자, 여섯째, 환자본인이 연구 참여에 동의한 자로 하였다. 평가는 재원 중 물리치료사와 작업치료사에 의해 BBS, MoCA-K, MBI를 측정하였으며 균형능력 평가 시 안전을 위하여 한명의 보조자가 동반하여 측정하였다. 결과: BBS와 MoCA-K r=.459, BBS와 MBI r=.550, MoCA-K와 MBI r=.565로 비교적 높은 상관관계가 있었다(p<.01). 결론: 본 연구는 임상적인 평가도구로서 BBS, MoCA-K, MBI의 적극적인 활용과 그 유용성에 대한 근거를 제시하였다는데 의미가 있다.

• Journal of Gastric Cancer
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• 제21권2호
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• pp.169-178
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• 2021

Purpose: The aim of this study was to investigate the oncologic safety and identify potential candidates for proximal gastrectomy (PG) in upper third advanced gastric cancer (AGC) and esophagogastric junction (EGJ) cancers. Materials and Methods: Among 5,665 patients who underwent gastrectomy for gastric adenocarcinoma between January 2011 and December 2017, 327 patients who underwent total gastrectomy with standard lymph node (LN) dissection for upper third AGC and Siewert type II EGJ cancers were enrolled. We analyzed the correlation between the metastatic rates of distal LNs (No. 4d, 5, 6, and 12a) around the lower part of the stomach and the clinicopathological characteristics. We identified subgroups with no metastasis to the distal LNs. Results: The metastatic rate of distal LNs in proximal AGC and Siewert type II EGJ cancers was 7.0% (23 of 327 patients). On multivariate analysis, pathological T stage (P=0.001), tumor size (P=0.043), and middle third invasion (P=0.003) were significantly associated with distal LN metastases. Pathological 'T2 stage' (n=88), or 'T3 stage with ≤5 cm tumor size' (n=87) showed no metastasis in distal LNs, regardless of middle third invasion. Pathological T3 stage with tumor size > 5 cm (n=61) and T4 stage (n=91) had metastasis in the distal LNs. Conclusions: In the upper third AGC and Siewert type II EGJ cancer, pathological T2 and small-sized T3 stage groups are possible candidates for PG in cases without distal LN metastasis. Further validation studies are required for clinical application.

• Korean Journal of Acupuncture
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• 제37권4호
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• pp.209-230
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• 2020

Objectives : Practice-Based Research Networks (PBRNs), collaborations of practitioners and academic researchers, have provided platforms for conducting research to address clinical questions generated from daily routine care. This review aimed to critically analyse articles from PBRNs that are related to complementary and integrative medicine (CIM) and to suggest future directions for a PBRN which is appropriate for Korean Medicine (KM). Methods : PubMed, PBRN registries in Agency for Healthcare Research and Quality and relevant PBRN websites were searched up to November 2019 for research articles from PBRNs that focused on CIM regardless of study design. Methodological quality of the included studies was assessed. The included studies were read in full, classified and summarised according to their topics. Results : A total of 51 articles published from 1998 through 2020 were included in this review. They were categorised into three principal themes based on research questions and findings: health services research (embracing researches examining characteristics of patients and CIM practitioners/practices, and communication between patients and practitioners); effectiveness and safety of CIM practices/interventions; and feasibility studies of instruments and interventions in PBRN settings. The study designs varied including surveys (n=30), prospective observational studies (n=6), 2ndary analyses of existing studies (n=7), protocols (n=7), retrospective chart review (n=1) and qualitative study (n=1). Quality of the included studies greatly varied. Conclusions : PBRNs can serve as a feasible platform for conducting practice-relevant research on KM and CIM. Considering growing demands on evidence-base for routine practice of KM amid various stakeholders, a PBRN in KM community and further researches nested within PBRN designs are warranted.

• 대한치과의료관리학회지
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• 제8권1호
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• pp.15-23
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• 2020

The aim of this study is to identify future-oriented tasks for Korean dental hygienists based on a literature review. A literature search is performed using 14 keywords related to tasks carried out by dental hygienists, and included articles published from 2000 to 2019 in the databases KISS, RISS, DBpia, NDSL, Papersearch, Pubmed, and Google Scholar. Six reviewers assessed the titles and abstracts of articles, and an article was selected if the study was considered to cover future-oriented tasks for Korean dental hygienists. Based on the results six local studies and two foreign studies were used for literature review and data extraction. In total, 38 tasks were classified as future-oriented tasks of dental hygienists according to the following criteria: 1) tasks that were specifically referred to as future-oriented tasks, and 2) tasks that could be classified as future-oriented tasks although no specific reference was made. Of these, the most frequently mentioned tasks were measuring periodontal pocket depth, dental hygiene assessment, providing dietary advice, infiltration anesthesia, and root planing. These were extracted from five of the eight studies, including both local and foreign studies. Dental hygiene planning, emergency, emergency management, and smoking cessation were the next most common tasks based on four studies. Even though some of these future-oriented tasks for Korean dental hygienists are included in the dentistry curriculum, and are currently performed as clinical practice for dental hygienists. Nonetheless, the reference to the legal scope is unclear. It is necessary to reconsider the scope of tasks of dental hygienists to reflect changes in domestic and foreign dental care delivery, thereby contributing to the oral health promotion of the public, where safety is guaranteed under legal protection.

• 셀메드
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• 제11권3호
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• pp.13.1-13.9
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• 2021

Background and Objective: Nux-vomica based traditional Unani formulation, Habb-e-Azaraqi (HAZ) is an important drug used by Unani physicians since several decades. It possesses Muqawwi-i-A'sab (nervine tonic), Muharrik-i-A'sab (nervine stimulant) properties and is an effective treatment option for diseases like Laqwa (facial palsy), Falij (paralysis), Niqris (gout) and Waja'al-Mafasil (arthritis) etc. The aim of the study is to access and provide information of HAZ for its TLC, HPTLC Fingerprinting defining its clear qualitative perspective and acute oral toxicity evaluation for its safety assessment which was not done earlier, thus contributing in the field of research. Materials and Methods: The chief ingredient, nux-vomica was detoxified as per method mentioned in Unani Pharmacopeia before its use in formulation. TLC and HPTLC was developed under four detection system i.e., UV 366nm, UV 254nm, exposure to iodine vapours and after derivatization with anisaldehyde sulphuric acid. Acute toxicity studies were performed as per OECD Guidelines 425 at a limit dose of 2000 mg/kg. Observations were done for signs of toxicity, body weight, and feed consumption at regular intervals followed by haematological and biochemistry evaluation. Results: The generated data proved the authenticity and established the TLC and HPTLC profile of the formulation. Acute toxicity revealed no significant differences in HAZ-treated animals with respect to body weight gain, feed consumption, haematology, clinical biochemistry evaluation. No significant gross pathological observation was noticed in necropsy. Conclusion: Data of the present study is substantial and scientific proof of HAZ in terms of standardization and toxicity study that can be utilize in future research activities.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권2호
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• pp.145-153
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• 2022

Background: Postoperative analgesia (POA) is an important determinant of successful treatment. Dexmedetomidine (DEX) has recently gained attention as a promising adjuvant to local anesthetics (LA). The present study aimed to evaluate the efficacy and safety of levobupivacaine (LB) as an adjuvant during inferior alveolar nerve block (IANB) in the extraction of lower impacted third molars (LITM). Methods: A prospective, randomized, placebo-controlled, triple-blind, parallel-arm, and clinical study was performed on 50 systemically healthy participants who required removal of an asymptomatic LITM. Using a 1:1 distribution, the participants were randomized into two groups (n = 25). Group L (control group) received 1.8 mL of 0.5% LB and 0.2 mL normal saline (placebo) and Group D (study group) received a blend of 1.8 mL of 0.5% LB and 0.2 mL (20 ㎍) DEX. The primary outcome variable was the duration of POA and hemodynamic stability, and the secondary variable was the total number of analgesics required postoperatively for up to 72 h. The participants were requested to record the time of rescue analgesic use and the total number of rescue analgesics taken. The area under the curve was plotted for the total number of analgesics administered. The pain was evaluated using the visual analog scale. Data analysis was performed using paired students and unpaired t-test, Mann-Whitney U test, Chi-square test, and receiver operating characteristic analysis. Statistical significance was set at P < 0.05. Results: The latency, profoundness of anesthesia, and duration of POA were statistically significant (P < 0.05). The differences between mean pain scores at 6, 12, 24, 48, and 72 h were found to be significant (each P = 0.0001). Fewer analgesics were required by participants in group D (2.12 ± 0.33) than in L (4.04 ± 0.67), with a significant difference (P = 0.0001). Conclusion: Perineurally administered LA with DEX is a safe, effective, and therapeutic approach for improving latency, providing profound POA, and reducing the need for postoperative analgesia.

• Pediatric Infection and Vaccine
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• 제29권1호
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• pp.37-45
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• 2022

본 델파이 연구에서는 5-11세 소아청소년의 코로나19 백신 접종과 관련하여 소아청소년 감염 분과 전문의와 코로나19 백신 전문가들을 대상으로 온라인 설문 조사를 시행하였다. 총 20문항에 대해 두 라운드 동안 각각 46명, 38명이 설문에 응답하였다. 패널들은 5-11세 소아청소년들이 코로나19에 쉽게 감염되지만 중증 진행의 위험도는 여전히 낮은 것으로 판단하였고, 만성 질환을 가진 소아는 중증 진행 위험도가 약간 있는 것으로 평가하였다. 코로나19 백신은 5-11세 소아에게 대체로 위험하지 않다고 응답하였고, 백신 접종의 기대 이익과 잠재적인 위해에 대한 비교는 대체적으로 중립적인 견해를 보였다. 또한 현재 소아에게 유일하게 허가된 mRNA 백신 플랫폼은 지속 가능하겠지만 소아에게는 재조합 단백질 플랫폼 백신이 추후 가장 적절할 것으로 평가되었다. 최종적으로 5-11세 소아에게 코로나19 예방 접종 권장에 대해서는 중립적인 입장을 보였다. 이에 모든 소아청소년들에게 일괄적인 접종 보다는 개별화된 선별 접종이 더 바람직할 것으로 보이며, 소아의 코로나19 백신 접종에 대한 과학적 근거 마련을 위한 지속적인 모니터링이 필요할 것으로 보인다.

• Journal of Korean Neurosurgical Society
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• 제65권6호
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• pp.765-771
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• 2022

Objective : Stent-assisted coil embolization (SAC) has been increasingly used to treat various types of intracranial aneurysms. Delayed thromboembolic complications are major concerns regarding this procedure, so dual antiplatelet therapy with aspirin and clopidogrel is needed. However, clinicians vary the duration of dual antiplatelet therapy after SAC, and no randomized study has been performed. This study aims to compare the safety and efficacy of long-term (12 months) dual antiplatelet therapy and short-term dual antiplatelet therapy (6 months) after SAC for patients with unruptured intracranial aneurysms (UIAs). Methods : This is a prospective, randomized and multicenter trial to investigate the optimal duration of dual antiplatelet therapy after SAC in patients with UIAs. Subjects will receive dual antiplatelet therapy for 6 months (short-term group) or 12 months (long-term group) after SAC. The primary endpoint is the assessment of thromboembolic complications between 1 and 18 months after SAC. We will enroll 528 subjects (264 subjects in each group) and perform 1 : 1 randomization. This study will involve 14 top-performing, high-volume Korean institutions specializing in coil embolization. Results : The trial will begin enrollment in 2022, and clinical data will be available after enrollment and follow-up. Conclusion : This article describes that the aim of this prospective randomized multicenter trial is to compare the effect of short-term (6 months) and long-term (12 months) dual antiplatelet therapy on UIAs in patients undergoing SAC, and to find the optimal duration.

• 산업융합연구
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• 제20권10호
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• pp.51-59
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• 2022

본 연구의 목적은 입원환자가 낙상사고 전후에 따라 건강상태 관련 특성의 차이를 확인하기 위함이며, 2016년 1월 1일부터 2020년 12월 31일까지 입원 후 낙상사고가 발생하여 환자안전보고시스템에 보고된 환자 328명의 데이터를 활용한 후향적 연구이다. 연구대상자의 연령은 평균 68.57±14.13세로서 70대가 30.49%로 가장 많았고, 입원 이후 평균 13.86±25.03일이 경과 시에 낙상사건이 발생하였고, 발생 시간대는 야간(22:30- 06:59)이 42.99%로 가장 많았다. 입원 후 낙상 전후에 배변문제(x²=314.0, p<.001), 배뇨문제(x²=284.0, p<.001), 정맥수액요법(x²=85.16, p<.001), 걸음걸이의 허약감(x²=69.77. p<.001), 와상(x²=51.60, p<.001), 의식이 불명하거나 자신의 기능을 과대평가한 경우(x²=17.52, p<.001) 비협조적 태도(x²=220.17, p<.001)에서 통계적으로 유의한 차이가 있었다. 낙상 전후 환자의 건강상태 관련 특성의 차이를 파악하여 환자의 특성에 맞는 적절한 낙상예방 및 개별적인 교육중재활동을 모색할 필요가 있다.

• 대한한방내과학회지
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• 제43권4호
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• pp.559-566
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• 2022

서론: 본 체계적 문헌 고찰의 프로토콜 논문은 간암의 한약 치료에 대한 효과와 안전성의 근거를 제시하는 것을 목표로 한다. 방법: 본 체계적 문헌 고찰은 간암에 한약 치료에 대한 무작위 대조 임상시험을 포함할 것이다. 오직 무작위 대조 임상시험 유형의 임상 연구만 포함할 것이다. 시험군의 한약 치료는 한약을 사용한 모든 제형을 포함할 것이며, 대조군은 다른 치료, 플라시보 치료, 서양의학적 치료 등을 포함할 것이다. 다음 11개의 데이터베이스를 활용하여 검색할 것이다: the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, AMED, CINAHL, Chinese database(CNKI), 그리고 다섯 개의 한국데이터베이스(OASIS, DBpia, RISS, KISS, and NDSL). 연구의 선정, 데이터 추출 및 분석 등의 업무는 3명의 연구자가 독립적으로 수행할 것이다. 비뚤림 위험 평가를 포함한 연구의 질적 평가는 Cochrane risk-of-bias assessment tool을 사용할 것이다. 결과: 본 간암에 대한 한약 치료의 체계적 문헌 고찰은 최신의 근거를 요약적이고 분석적으로 제공할 것이다. 결론: 간암의 한약 치료에 대한 효과와 안전성의 근거를 제시할 것이며, 이는 종양학이나 한의학과 보완·대체의료 분야의 종사자들에게 유용한 정보를 제공할 것이다.