• 한국지식정보기술학회논문지
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• 제13권5호
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• pp.607-614
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• 2018

오령산은 몸 속의 수분을 순환시키고 소변으로 배출이 잘 되게 하는 효능이 있어 수분이 정체되어 나타나는 질환에 많이 쓰이는 처방이다. 본 연구에서는 시스템 약리학 접근 방법을 이용해서 오령산의 작용 기전을 탐색하기 위해서 오령산의 구성약재의 성분-타겟 네트워크를 구축하고 분석하였다. 우선, 오령산의 475개 성분에 대해서 STITCH 데이터베이스에서 연관된 타겟을 검색하였으며, 성분과 타겟의 상호작용에 대한 검색 결과는 XML 파일로 다운로드하였다. 본 연구에서 성분-타겟 네트워크는 Gephi를 이용해서 시각화하고 탐색하였다. 노드는 성분과 타겟이 되고, 링크는 성분과 타겟들간에 상호작용이 존재하면 연결되며, 상호작용의 신뢰도에 따라 링크에 가중치를 부여하였다. MCL 알고리즘을 이용해서 네트워크를 클러스터링 하였으며, 총 130개의 클러스터가 생성되었다. 가장 많은 노드를 가지는 클러스터에서 노드의 개수는 32개였다. 성분-타겟 네트워크에서 약재의 유효 성분들이 신장의 혈압 조절 기능과 관련된 타겟들과 연결되어 있는 것을 발견할 수 있었다. 향후에는 질병 데이터베이스와 연계해서 보다 명확한 오령산의 작용 기전을 밝힐 수 있도록 할 계획이다.

• 한방재활의학과학회지
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• 제33권4호
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• pp.125-144
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• 2023

Objectives This study aimed to investigate domestic clinical research trends in Shinbaro pharmacopuncture, identify diseases managed using Shinbaro pharmacopuncture, and suggest the direction for future studies to increase its clinical utilization. Methods This study used five steps proposed by Arksey and O'Malley and the PRISMA-extension for scoping reviews checklist. We examined published literature on Shinbaro pharmacopuncture studies reported until June 5, 2023, in the following eight databases (Research Information Sharing Service, Science ON, Oriental Medicine Advanced Searching Integrated System, KMBASE, The Society of Internal Korean Medicine, PubMed, EMBASE, and the Cochrane Library). The search terms used were 'Shinbaro' or 'Sinbaro'. Results A total of 47 studies were included in our analysis. Of these, 37 (78.7%) were interference time series studies. Shinbaro pharmacopuncture was the most frequently used treatment for lumbosacral disease (n=15). In the facial area, ST4 and ST6 were used in five out of six studies, and in the shoulder area, TE14 and LI15 were used in all studies. Nine of the 15 studies in the lumbosacral area used the EX-B2. The other parts mostly used the pressure points. Compared to other pharmacopuncture methods, the treatment effect was similar to that of bee venom, and faster than that of jungsongouhyul. Conclusions This is the first scoping review of Shinbaro pharmacopuncture therapy in South Korea. Studies with a high level of evidence based on sole treatment, large capacities, and standardization of Shinbaro pharmacopuncture need to be conducted to increase its clinical utilization.

• 대한한방내과학회지
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• 제44권6호
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• pp.1212-1242
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• 2023

Objectives: This study aims to explore the current usage status of orally administered Korean herbal medicine in randomized controlled trials (RCTs) published in the Journal of Korean Medicine and member journals using the CONSORT-Chinese Herbal Medicine Formulas 2017 (CONSORT-CHM 2017) checklist. Methods: We searched the OASIS, RISS, and KMBASE archives as well as the websites of the Journal of Korean Medicine and 45 member journals to identify RCTs that used herbal interventions. Two independent researchers searched and categorized the RCTs and performed a quantitative evaluation by journal, study design, and target disease, as well as qualitative evaluation of the literature using CONSORT-CHM 2017. Results: After the search, 66 articles were selected. The quantitative evaluation resulted in 13 articles (19.6%) that were published in the Journal of Korean Medicine and 12 articles (18.1%) in the Journal of Internal Korean Medicine. In terms of study design, 62 articles (93.9%) were parallel, 4 articles (6%) were crossover, and 2-arm parallel study designs were the most common in 45 articles (68.2%). In terms of the study participants, physiological characteristics and mechanisms in healthy individuals were the most common in 21 studies (31.8%) and obesity in 9 studies (13.6%). In terms of assessing completeness in the CONSORT-CHM 2017 items, 29 articles were rated high, 31 were rated moderate, and 6 were rated low. Items 4a, 6a, and 7a had low reporting rates (≤ 30%), while items 2a, 2b, and 12a were completely reported in all studies. Conclusion: Future RCTs using orally administered Korean herbal medicine need to be reported completely, and the CONSORT-CHM 2017 checklist can be a helpful tool for this purpose.

• Korean Journal of Radiology
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• 제23권12호
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• pp.1260-1268
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• 2022

Objective: To propose standardized MRI-proton density fat fraction (PDFF) cutoff values for diagnosing hepatic steatosis, evaluated using contemporary PDFF measuring methods in a large population of healthy adults, using histologic fat fraction (HFF) as the reference standard. Materials and Methods: A retrospective search of electronic medical records between 2015 and 2018 identified 1063 adult donor candidates for liver transplantation who had undergone liver MRI and liver biopsy within a 7-day interval. Patients with a history of liver disease or significant alcohol consumption were excluded. Chemical shift imaging-based MRI (CS-MRI) PDFF and high-speed T2-corrected multi-echo MR spectroscopy (HISTO-MRS) PDFF data were obtained. By temporal splitting, the total population was divided into development and validation sets. Receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic performance of the MRI-PDFF method. Two cutoff values with sensitivity > 90% and specificity > 90% were selected to rule-out and rule-in, respectively, hepatic steatosis with reference to HFF ≥ 5% in the development set. The diagnostic performance was assessed using the validation set. Results: Of 921 final participants (624 male; mean age ± standard deviation, 31.5 ± 9.0 years), the development and validation sets comprised 497 and 424 patients, respectively. In the development set, the areas under the ROC curve for diagnosing hepatic steatosis were 0.920 for CS-MRI-PDFF and 0.915 for HISTO-MRS-PDFF. For ruling-out hepatic steatosis, the CS-MRI-PDFF cutoff was 2.3% (sensitivity, 92.4%; specificity, 63.0%) and the HISTO-MRI-PDFF cutoff was 2.6% (sensitivity, 88.8%; specificity, 70.1%). For ruling-in hepatic steatosis, the CS-MRI-PDFF cutoff was 3.5% (sensitivity, 73.5%; specificity, 88.6%) and the HISTO-MRI-PDFF cutoff was 4.0% (sensitivity, 74.7%; specificity, 90.6%). Conclusion: In a large population of healthy adults, our study suggests diagnostic thresholds for ruling-out and ruling-in hepatic steatosis defined as HFF ≥ 5% by contemporary PDFF measurement methods.

• Korean Journal of Radiology
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• 제22권4호
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• pp.584-595
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• 2021

Objective: Immune checkpoint inhibitor (ICI) therapy has shown activity against melanoma brain metastases. Recently, promising results have also been reported for ICI combination therapy and ICI combined with radiotherapy. We aimed to evaluate radiologic response and adverse event rates of these therapeutic options by a systematic review and meta-analysis. Materials and Methods: A systematic literature search of Ovid-MEDLINE and EMBASE was performed up to October 12, 2019 and included studies evaluating the intracranial objective response rates (ORRs) and/or disease control rates (DCRs) of ICI with or without radiotherapy for treating melanoma brain metastases. We also evaluated safety-associated outcomes. Results: Eleven studies with 14 cohorts (3 with ICI combination therapy; 5 with ICI combined with radiotherapy; 6 with ICI monotherapy) were included. ICI combination therapy {pooled ORR, 53% (95% confidence interval [CI], 44-61%); DCR, 57% (95% CI, 49-66%)} and ICI combined with radiotherapy (pooled ORR, 42% [95% CI, 31-54%]; DCR, 85% [95% CI, 63-95%]) showed higher local efficacy compared to ICI monotherapy (pooled ORR, 15% [95% CI, 11-20%]; DCR, 26% [95% CI, 21-32%]). The grade 3 or 4 adverse event rate was significantly higher with ICI combination therapy (60%; 95% CI, 52-67%) compared to ICI monotherapy (11%; 95% CI, 8-17%) and ICI combined with radiotherapy (4%; 95% CI, 1-19%). Grade 3 or 4 central nervous system (CNS)-related adverse event rates were not different (9% in ICI combination therapy; 8% in ICI combined with radiotherapy; 5% in ICI monotherapy). Conclusion: ICI combination therapy or ICI combined with radiotherapy showed better local efficacy than ICI monotherapy for treating melanoma brain metastasis. The grade 3 or 4 adverse event rate was highest with ICI combination therapy, and the CNS-related grade 3 or 4 event rate was similar. Prospective trials will be necessary to compare the efficacy of ICI combination therapy and ICI combined with radiotherapy.

• Korean Journal of Radiology
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• 제22권11호
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• pp.1875-1885
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• 2021

Objective: Central nervous system involvement in coronavirus disease 2019 (COVID-19) has been increasingly reported. We performed a systematic review and meta-analysis to evaluate the incidence of radiologically demonstrated neurologic complications and detailed neuroimaging findings associated with COVID-19. Materials and Methods: A systematic literature search of MEDLINE/PubMed and EMBASE databases was performed up to September 17, 2020, and studies evaluating neuroimaging findings of COVID-19 using brain CT or MRI were included. Several cohort-based outcomes, including the proportion of patients with abnormal neuroimaging findings related to COVID-19 were evaluated. The proportion of patients showing specific neuroimaging findings was also assessed. Subgroup analyses were also conducted focusing on critically ill COVID-19 patients and results from studies that used MRI as the only imaging modality. Results: A total of 1394 COVID-19 patients who underwent neuroimaging from 17 studies were included; among them, 3.4% of the patients demonstrated COVID-19-related neuroimaging findings. Olfactory bulb abnormalities were the most commonly observed (23.1%). The predominant cerebral neuroimaging finding was white matter abnormality (17.6%), followed by acute/subacute ischemic infarction (16.0%), and encephalopathy (13.0%). Significantly more critically ill patients had COVID-19-related neuroimaging findings than other patients (9.1% vs. 1.6%; p = 0.029). The type of imaging modality used did not significantly affect the proportion of COVID-19-related neuroimaging findings. Conclusion: Abnormal neuroimaging findings were occasionally observed in COVID-19 patients. Olfactory bulb abnormalities were the most commonly observed finding. Critically ill patients showed abnormal neuroimaging findings more frequently than the other patient groups. White matter abnormalities, ischemic infarctions, and encephalopathies were the common cerebral neuroimaging findings.

• Korean Journal of Radiology
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• 제21권4호
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• pp.471-482
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• 2020

Objective: We aimed to determine the optimized image-based surrogate endpoints (IBSEs) in targeted therapies for glioblastoma through a systematic review and meta-analysis of phase III randomized controlled trials (RCTs). Materials and Methods: A systematic search of OVID-MEDLINE and EMBASE for phase III RCTs on glioblastoma was performed in December 2017. Data on overall survival (OS) and IBSEs, including progression-free survival (PFS), 6-month PFS (6moPFS), 12-month PFS (12moPFS), median PFS, and objective response rate (ORR) were extracted. Weighted linear regression analysis for the hazard ratio for OS and the hazard ratios or odds ratios for IBSEs was performed. The associations between IBSEs and OS were evaluated. Subgroup analyses according to disease stage (newly diagnosed glioblastoma versus recurrent glioblastoma), types of test treatment, and types of response assessment criteria were performed. Results: Twenty-three phase III RCTs published between 2000 and 2017, including 8387 patients, met the inclusion criteria. OS showed strong correlations with PFS (standardized β coefficient [R] = 0.719), 6moPFS (R = 0.647), and 12moPFS (R = 0.638). OS showed no correlations with median PFS and ORR. In subgroup analysis according to types of therapies, PFS showed the highest correlations with OS in targeted therapies for cell cycle pathways (R = 0.913) and growth factor receptors and their downstream pathways (R = 0.962). 12moPFS showed the highest correlation with OS in antiangiogenic therapy (R = 0.821). The response assessment in neuro-oncology criteria provided higher correlation coefficients between OS and IBSEs than the Macdonald criteria. Conclusion: Overall, PFS is an optimized IBSE in targeted therapies for glioblastoma; however, 12moPFS is optimal in antiangiogenic therapy.

• 한국학교ㆍ지역보건교육학회지
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• 제9권1호
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• pp.85-97
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• 2008

학교구강보건은 학생의 구강건강을 합리적으로 관리하고, 구강건강에 대한 지식과 태도 및 행동을 변화시켜, 일생동안 구강건강을 적절히 관리할 수 있는 능력을 배양시키는 과정이다. 이러한 학교구강보건의 목적은 학생의 구강질환을 예방하고 초기에 치료함으로써, 구강건강을 증진 유지시켜 건전한 심신을 양성하여 교육 본래의 목표를 달성함에 있다. 이에 본 연구는 중학생의 구강건강에 대한 인식 및 행동을 파악하여 대상에 알맞은 학습 목표와 교육방법을 모색하고 효과적인 구강건강관리 방안을 위한 기초자료로 활용하고자 실시하였다. 농촌 지역인 충청북도 OO군에 소재한 중학교 학생들을 대상으로 자기기입방식의 설문조사를 실시한 결과 다음과 같은 결론을 얻었다. 1. 중학생의 구강건강 지식에 대한 항목 중 치과질환의 증상에 대한 인지율에 비해 부정 교합의 원인(51.5%)과 잇몸병 예방법(15.1%) 등 치과질환의 원인과 예방법에 대한 인지율이 낮은 것으로 조사되었다. 2. 잇솔질 시기에 대한 지식과 행동을 비교하여 살펴본 결과 인식 및 행동 모두 50% 수준 또는 그 이하였으며, 특히 점심식사 후에는 46.2%가 인식, 실천은 33.0%에 불과하였다. 3. 하루 잇솔질 횟수는 하루에 두 번 하는 경우(47.5%)가 가장 많았으나, 한 번 또는 한 번도 닦지 않는다는 응답(5.8%)도 있어 소수의 학생들이지만 잇솔질 실천이 매우 저조한 것으로 조사되었다. 4. 중학생들의 간식섭취 횟수는 일일 2회 이하가 68.8%였으나, 5회 이상 섭취하는 학생도 9.8%로 조사되었으며, 남학생은 5회 이상이 15.8%로 조사되어 성별의 차이가 있었다(p<0.01). 5. 전신건강 중 치아가 차지하는 비중에 대해 30-40% 중요하다는 응답이 31.3%로 가장 많았으며, 다음으로 50-60% 중요하다 30.6%, 60%이상 중요하다 29.9%고 응답하여 학생들은 전신건강 중 구강건강이 매우 중요하다고 인지하고 있는 것으로 조사되었다. 반면, 치과내원은 이가 아플 때에만 간다 49.3%로 가장 많았으며, 이가 아팠지만 치과에는 가지 않았다 21.7%로 응답하여 치아의 중요성에 대한 인지도에 비해 치과에 내원하는 비율은 매우 낮은 것으로 분석되었다. 6. 현재 우리나라 학교구강보건사업은 초등학생을 대상으로 한 세부적인 프로그램과 국가의 지원은 있으나 청소년을 위한 구체적인 프로그램 및 지원은 미비한 상태이다. 건강에 대해 자기 스스로 관리할 수 있는 시기인 청소년 시기의 학교구강보건사업은 효과적이라고 판단되며, 이 시기에 구강보건교육을 비롯한 구체적인 구강건강증진 프로그램이 개발되어 학교구강보건사업이 중 고등학교에도 확대 실시되어야 할 것으로 검토되었다.

• Journal of Chest Surgery
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• 제52권4호
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• pp.248-329
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• 2019

Background: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. Methods: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors-primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. Results: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Conclusion: Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

• 헤리티지:역사와 과학
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• 제43권1호
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• pp.100-117
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• 2010

본 연구는 천연기념물로 지정된 모감주나무군락의 보존 관리방안을 모색하고자 식생구조와 수목의 활력도, 토양특성 및 병충해 현황 등을 분석하였으며 결론은 다음과 같다. 식생구조를 분석한 결과, 모감주나무군락(Koelreuteria paniculata Community)은 크게 쇠무릎아군락(Achyranthes japonica Subcommunity)과 병아리꽃나무아군락(Rhodotypos scandens Subcommunity), 마삭줄아군락(Trachelospermum asiaticum var. intermedium Subcommunity)으로 구분되었다. 지역별 모감주나무군락의 식생구조를 보면, 안면도 모감주나무군락은 아교목층과 초본층의 2층 구조로 구성된 반면, 포항과 완도 대문리 모감주나무군락은 교목층과 아교목층, 관목층, 초본층의 4층 구조로 구성되어 있었다. 수목의 활력도 분석결과 안면도 모감주나무군락은 포항, 완도에 비해 비교적 낮은 것으로 나타났다. 이는 타 지역에 비해 모감주나무군락의 층위구조가 단순하고, 경쟁수종 등이 비교적 적어 병충해 등에 취약하며, 모감주나무군락의 밀도가 높아 이로 인해 수관경쟁 등으로 나타나는 자연낙지와 수목 자체의 활력도 저하로 인한 두 가지 측면으로 볼 수 있다. 토양특성 분석결과 토성, 토양산도, 유기물, 유효인산, 치환성 양이온은 수목 생장에 양호한 수준이지만 전질소함량은 국부적으로 결핍이 심하였으나 시비에는 신중을 기해야 할 것으로 판단된다. 병충해로는 갈반병과 흰가루병 및 알락하늘소에 의한 피해가 있었으나 전체 면적의 10~15% 내외정도로 나타났고, 지속적인 예찰이 필요하다. 본 연구를 통하여, 천연기념물 모감주나무군락의 보전을 위한 관리방안을 제시한다. 첫째, 모감주나무군락지 주변의 개발로 인한 환경 악화에 영향을 최소화 할 수 있는 지정면적의 확보가 필요하다. 특히 과거에 비해 면적이 감소된 구역의 경우 토지매입 등을 통한 지정구역의 확대 방안에 대한 검토도 필요할 것이다. 둘째, 모감주나무군락의 인위적 간섭(하예작업, 외과수술, 토양시비 등)은 군락의 유지기작에 영향을 줄 수 있다. 따라서, 인위적 간섭에 따른 군락의 변화양상에 대한 모니터링이 필요하며 이에 근거하여 보호사업 등이 시행되어야 할 것으로 사료된다. 셋째, 모감주나무군락의 유지기작에 영향을 주는 유묘, 치수의 발생을 분석한 결과 과년도와 비교하여 감소한 것으로 나타나 원인 규명이 필요하다. 따라서, 모감주나무군락의 종자 결실률과 이에 따른 발아와 유묘의 추이, 종조성의 변화 등 군락의 동태 파악을 통한 적극적 관리 방안이 필요할 것으로 판단된다.