• Tuberculosis and Respiratory Diseases
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• 제79권3호
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• pp.111-120
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• 2016

Asthma is a prevalent and serious health problem in Korea. Recently, the Korean Asthma Guideline has been updated by The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) in an effort to improve the clinical management of asthma. This guideline focuses on adult patients with asthma and aims to deliver up to date scientific evidence and recommendations to general physicians for the management of asthma. For this purpose, this guideline was updated following systematic review and meta-analysis of recent studies and adapting some points of international guidelines (Global Initiative for Asthma [GINA] report 2014, National Asthma Education and Prevention Program [NAEPP] 2007, British Thoracic Society [BTS/SIGN] asthma guideline 2012, and Canadian asthma guideline 2012). Updated issues include recommendations derived using the population, intervention, comparison, and outcomes (PICO) model, which produced 20 clinical questions on the management of asthma. It also covers a new definition of asthma, the importance of confirming various airflow limitations with spirometry, the epidemiology and the diagnostic flow of asthma in Korea, the importance and evidence for inhaled corticosteroids (ICS) and ICS/formoterol as a single maintenance and acute therapy in the stepwise management of asthma, assessment of severity of asthma and management of exacerbation, and an action plan to cope with exacerbation. This guideline includes clinical assessments, and treatment of asthma-chronic obstructive pulmonary disease overlap syndrome, management of asthma in specific conditions including severe asthma, elderly asthma, cough variant asthma, exercise-induced bronchial contraction, etc. The revised Korean Asthma Guideline is expected to be a useful resource in the management of asthma.

• 대한한방부인과학회지
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• 제29권2호
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• pp.83-98
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• 2016

Objectives: This Study was designed to investigate the effect of Oxygen chamber to recover muscle fatigue. Methods: Twenty Subjects were divided into Oxygen Chamber Group (n=10) and Rest group (n=10). Subjects visited hospital two times, blood tests were performed 3 times for each visit. 1st blood test was performed in 4 hours hunger state. 2nd blood test was performed within 5 minutes after the 6 minutes bike exercise. 3rd blood test was performed after the 40 minutes Oxygen treatment or 40 minutes rest in bed. Blood test items were Lactate, Glucose, Lactate Dehydrogenase, Creatine Kinase, Free Fatty Acid. 2nd visit was applied 1st visit process, But Oxygen Chamber group was crossed over to Rest Group, Rest Group was crossed over to Oxygen Chamber group. The Blood test result was analyzed with paired T-test using SPSS for Windows version 21. Results: The reduction of Lactate in Oxygen Chamber Group (6.86±2.07 mmol/ℓ) was higher than Rest group (6.57±2.33 mmol/ℓ), but it was not statically significant (p=0.68). The reduction of Glucose in Oxygen Chamber Group (6.85±12.14 mg/dl) was lower than Rest group (7.60±9.83 mg/dl), but it was not statically significant (p=0.83). The reduction of Lactate Dehydrogenase in Oxygen Chamber Group (16.10±14.91 mmol/ℓ) was lower than Rest group (19.75±12.46 mg/dl), but it was not statically significant (p=0.41). The reduction of Creatine Kinase in Oxygen Chamber Group (13.40±5.69 U/ℓ) was lower than Rest group (15.25±8.01 U/ℓ), but it was not statically significant (p=0.41). The reduction of Free Fatty Acid in Oxygen Chamber Group (285.50±174.13 uEq/ℓ) was higher than Rest group (196.15±131.58 uEq/ℓ), but it was not statically significant (p=0.07). Conclusions: This study showed Oxygen chamber therapy could be effective to recover muscle fatigue.

• Journal of Hospice and Palliative Care
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• 제20권2호
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• pp.81-92
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• 2017

만성 폐쇄성 폐질환은 비가역적, 점진적 기도 폐쇄가 특징인 주요 사망 원인중의 하나이다. 말기 폐쇄성 폐질환 환자는 다양한 신체적, 정서적, 사회적, 기능적 문제로 인해 호스피스 완화의료가 필요하다. 따라서, 완화의료의 목적은 증상 조절, 운동 능력 및 삶의 질 향상이며, 아울러 급성 악화 빈도를 줄이고 질병의 진행을 늦추는 효과를 기대할 수 있다. 다양한 진행 과정 때문에 말기 시점을 예측하기 어렵다. 호흡곤란 정도, 폐기능, 혈액학적 임상 지표를 이용하여 대상자를 선정하는 기준을 마련하고 적용시점을 논의해야 한다. 질환의 특성상 진단 후 초기에는 완치 목적의 치료가 중심이 되어 완화의료가 이를 보완하는 방식으로 적용되다가, 완치 목적의 치료를 위해 입 퇴원을 반복하거나 치료의 반응이 낮고 나쁜 예후가 예상될 때 완화의료 비중이 확대되는 것이 바람직하겠다. 폐쇄성 폐질환 환자에게 적극적으로 호흡재활을 적용하고, 환자의 의사결정을 존중하여 증상 악화 이전에 미리 대책을 마련하고 앞으로의 치료 목표를 논의하기 위한 완화의료 팀을 구성하고, 국내 현실에 맞는 진료 연계 체계를 마련하는 것이 필요하다. 제도가 잘 정착하기 위해서는 일차 의료 및 암환자 대상의 완화의료 전문 팀과의 협업이 중요하며, 우선 고려되어야 할 것이다.

• 한국콘텐츠학회논문지
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• 제20권2호
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• pp.394-404
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• 2020

목적 : 본 연구의 목적은 지역사회 재가 노인들을 대상으로 한 한방간호중재 프로그램이 신체 건강 상태, 일상 생활 활동 (ADL), 우울증, 삶의 만족도 및 양생에 미치는 영향을 조사하기 위해 수행되었다. 방법 : 본 연구는 비동등성 대조군 전후 설계이다. 연구 참여자들은 서울 일개 지역사회에 거주하는 65세 이상의 노인으로 정상적인 인지 상태와 의사소통이 가능한 노인으로 총 79 명의 노인이 (실험군 : n=39, 대조군 : n=40) 연구에 참여하였다. 대상자는 편의표출통해 모집되었고 무작위 할당법으로 실험군과 대조군으로 선정되었다. 한방간호중재 프로그램은 경락체조와 기공요법의 하나인 팔단금으로 구성하였다. 프로그램은 총 10주 동안 총 20회기로 구성되었다. 측정 변수로는 신체 건강 상태, 일상 생활 활동 (ADL), 우울증, 삶의 만족도, 양생이었고, SPSS WIN21.0에 의해 기술 통계, x²-test 및 독립 t-test를 사용하여 데이터를 분석 하였다. 결과 : 실험군의 신체 건강 상태(t=10.295, p<.001), ADL(t=7.571, p<.001), 우울증 (t=-15.434, p<.001), 삶의 만족도(t=21.257, p<.001), 그리고 양생(t=9.527, p<.001)은 통계적으로 유의한 차이가 있었고 중재의 결과 모든 변수에서 점수가 향상됨을 보였다. 결론 : 본 한방간호중재 프로그램은 지역 사회에 거주하는 노인들의 신체 건강 상태, ADL, 우울증, 삶의 만족도 및 양생을 개선하는 데 효과적이었다. 이 중재 프로그램은 지역 사회에서 노인의 건강 증진을 위해 사용될 수 있다.

• Journal of Oral Medicine and Pain
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• 제35권2호
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• pp.155-163
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• 2010

피부근염은 특발성의 염증성 결합조직 질환으로서 점진적인 근육의 쇠약과 특징적인 피부 발진의 증상을 보이는 전신적 자가 면역 질환의 일종이며 근력 약화와 함께 나타나거나 흔히 선행하는 특징적 발진에 의해 진단된다. 가장 특징적인 피부증상은 상안검의 부종과 함께 나타나는 푸르면서 보라색 발진인 heliotrophic rash, 안면부와 상부 흉부의 넓적하고 붉은 발진 (flat red rash), 피부의 인설(scaling)현상을 나타내는 손가락 관절(knuckle)부위의 두드러진 Gottron's papules (violaceous scaly eruption)등 이다. 근육 증상으로 주로 근위부 사지 근육의 약화를 동반한 근육의 염증성 및 퇴행성 변화를 보인다. 피부 근염은 종종 소화기계 (gastrointestinal tract)와 호흡기계 (respiratory system)를 침범하며 15%~25%에서 악성변화를 보인다. 치료는 피부증상뿐 아니라 근육 증상도 악화시킬 수 있는 자외선에 대한 노출을 피하고 일차적으로 전신적 corticosteroid를 사용하며 증상이 심하거나 steroid에 반응이 없을 때 다른 면역억제제를 사용할 수 있다. 피부근염에서 안면근은 침범되지 않으며 저작근의 이환 역시 거의 없다. 본 증례를 통해 피부근염을 앓고 있는 환자에서 개구장애가 발생할 수 있으며, 이는 근경축과 유사한 양상을 보임을 알 수 있었다. 따라서 피부근염 환자에서 발생할 수 있는 개구장애는 회복이 어려울 수 있으므로, 점진적으로 개구량이 줄어드는 것을 막고 정상적인 개구량을 확보 할 수 있도록 지속적인 개구운동 등의 치료가 필요하다고 사료된다.

• 재활간호학회지
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• 제2권1호
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• pp.61-71
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• 1999

This quasi-experimental study was intended to test the effect of self-help group program, which is one of the way to enhance adaptation and quality of life to mastectomy patients. Data was collected from July 14, 1998 to Oct. 31, 1998 at two Medical Center in Seoul. The subjects for this study were the patients who had undergone mastectomy and were follow-up ; 14 in experimental group and 14 in control group matched with age and treatment. The instruments for this study were adaptation in Lee(1994)'s physical symptom questionnaire, Zung's Self-rating Depression Scale(SDS, 1965), and Self-rating Anxiety Scale(SAS, 1970), quality of life in Spranger(1996)'s and No(1988)'s Quality of Life Questionnaire. The self-help group program for mastectomy patients was developed based on literature review and pilot study by the investigator. The subjects of experimental group were participated in 6 weeks self-help group program and were received arm and shoulder exercise, informational support, and interpersonal support by group members. The control group were received no intervention, Both group answered questionnaires prior to intervention and 6 weeks later. The data analyzed by frequency, $X^2$-test, Mann-Whitney U test. Wilcoxon Signed Rank test, Pearson's Correlation Coefficient and Stepwise Multiple Regression using SPSS WIN. The results are as follows ; Hypothesis 1. "The experimental group with the self-help group program will have a higher score on adaptation state than control group." was not supported. But the post test score of anxiety and depression in experimental group were declined and the depression score was reduced relatively. Hypothesis 2. "The experimental group with the self-help group program will have a higher score on quality of life than control group." was not supported. But the posttest score of quality of life in experimental group was reduced relatively. Hypothesis 3. "The higher adaptation state of mastectomy patients, the higher quality, of life." was supported(r=,80, p<.001). Additionally, the lower physical symptom, depression and anxiety, the higher quality of life And depression, which was the main predictor of quality of life, accounted for 59.5%, depression and anxiety accounted for 65.5% of the variance in quality of life. In conclusion, when the self-help group program was intervened to mastectomy patients, it was tended to increase quality of life and to reduce depression and anxiety. So self-help group program can be considered useful nursing inter vention effect on adaptation and quality of life of mastectomy patients. With discussion, I suggest repeated further re search on self-help group with appropriate sample size and longitudinal study. Also during adjuvant therapy, it is needed to develop convenient method to be supported from peer group and family, such as computer mediated support group.

• 대한지역사회영양학회지
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• 제21권4호
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• pp.378-385
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• 2016

Objectives: This study was conducted to investigate the association between sarcopenia and sarcopenic obesity and cardiovascular disease risk in Korean postmenopausal women. Methods: We analyzed data of 2,019 postmenopausal women aged 50-64 years who participated in the Korea National Health and Nutrition Examination Survey in 2008-2011 and were free of cardiovascular disease history. Blood pressure, height, and weight were measured. We analyzed the serum concentrations of glucose, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and triglyceride levels. Waist circumference was used to measure obesity. Appendicular skeletal muscle mass was measured by dual-energy X-ray absorptiometry. Sarcopenia was defined as the appendicular skeletal muscle mass/body weight<1 standard deviation below the gender-specific means for healthy young adults. The estimated 10-year risk of cardiovascular disease risk was calculated by Pooled Cohort Equation. Subjects were classified as non-sarcopenia, sarcopenia, or sarcopenic obesity based on status of waist circumference and appendicular skeletal muscle mass. Results: The prevalence of sarcopenia and sarcopenic obesity was 16.3% (n=317) and 18.3% (n=369), respectively. The 10-year risk of cardiovascular disease risk in the sarcopenic obesity group was higher ($3.82{\pm}0.22%$) than the normal group ($2.73{\pm}0.09%$) and sarcopenia group ($3.17{\pm}0.22%$) (p < 0.000). The odd ratios (ORs) for the ${\geq}7.5%$ 10-year risk of cardiovascular disease risk were significantly higher in the sarcopenic obesity group (OR 3.609, 95% CI: 2.030-6.417) compared to the sarcopenia group (OR 2.799, 95% CI: 1.463-5.352) (p for trend < 0.000) after adjusting for independent variables (i.e., exercise, period of menopausal, alcohol use disorders identification test (AUDIT) score, income, education level, calorie intake, %fat intake and hormonal replacement therapy). Conclusions: Sarcopenia and sarcopenic obesity appear to be associated with higher risk factors predicting the 10-year risks of cardiovascular disease risk in postmenopausal women. These findings imply that maintaining normal weight and muscle mass may be important for cardiovascular disease risk prevention in postmenopausal women.

• 한국임상수의학회지
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• 제24권1호
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• pp.32-34
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• 2007

3개월 령, 35kg의 수컷 볼조이가 간헐적인 좌측 전지 파행을 주 증상으로 내원 하였다. 1년 전 심한 운동 후 간헐적인 파행 및 동통을 호소하였으며, 증상은 계속 악화되었다. 신체 검사 상에서 좌측 두갈래근의 촉진과 견관절의 굴곡 및 신장 시에 통증을 호소하였다. 일반방사선 검사에서 좌측 견관절의 결절사이고랑에서 골증식체와 관절주위변성이 관찰되었다. 관절 조영상에서는 좌측 두갈래근 힘줄에 거칠고 불규칙한 영상을 확인할 수 있었다. 활액 검사 상에서는 퇴행성 관절 질환 소견이 보였다. 이상의 검사들을 바탕으로 두갈래근 힘줄 윤활막염으로도 진단하고, 내과적 치료를 실시하였다. 무균적으로methylprednisolone acetate 40mg을 관절낭 내로 주사하고, 3주간 엄격한 운동 제한을 실시하였다. 3주 후 내원 시 두갈래근 힘줄의 통증은 완전히 소실되었으나 퇴행성 관절염에 의한 경등도의 파행이 존재하여 NSAIDs의 투여를 실시하였다. 장기적인 예후의 관찰이 필요할 것으로 생각되며, 원발질환의 재발 시에는 2차 약물치료 또는 힘줄 절단술(힘줄 고정술, 힘줄박리술)등 을 통한 수술적인 치료가 고려될 수 있다.

• The Korean Journal of Physiology and Pharmacology
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• 제21권6호
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• pp.651-656
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• 2017

Ursolic acid (UA) supplementation was previously shown to improve skeletal muscle function in resistance-trained men. This study aimed to determine, using the same experimental paradigm, whether UA also has beneficial effects on exercise-induced skeletal muscle damage markers including the levels of cortisol, B-type natriuretic peptide (BNP), myoglobin, creatine kinase (CK), creatine kinase-myocardial band (CK-MB), and lactate dehydrogenase (LDH) in resistance-trained men. Sixteen healthy participants were randomly assigned to resistance training (RT) or RT+UA groups (n=8 per group). Participants were trained according to the RT program (60~80% of 1 repetition, 6 times/week), and the UA group was additionally given UA supplementation (450 mg/day) for 8 weeks. Blood samples were obtained before and after intervention, and cortisol, BNP, myoglobin, CK, CK-MB, and LDH levels were analyzed. Subjects who underwent RT alone showed no significant change in body composition and markers of skeletal muscle damage, whereas RT+UA group showed slightly decreased body weight and body fat percentage and slightly increased lean body mass, but without statistical significance. In addition, UA supplementation significantly decreased the BNP, CK, CK-MB, and LDH levels (p<0.05). In conclusion, UA supplementation alleviates increased skeletal muscle damage markers after RT. This finding provides evidence for a potential new therapy for resistance-trained men.

• 동국한의학연구소논문집
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• 제8권1호
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• pp.159-169
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• 1999

고령화와 육체적 활동의 감소로 증가 추세에 있는 골연화증(骨軟化症)의 임상치료(臨床治療)에 도움을 얻고자 역대의서(歷代醫書)와 중의서(中醫書), 중의잡지(中醫雜誌)를 중심으로 증상(症狀), 병인(病因), 병리(病理), 치법(治法), 치방(治方) 등을 동서의학적(東西醫學的)으로 고찰하였다. 골연화증(骨軟化症)은 골의 석회화 장애로 골밀도가 감소되는 대사성 골질환으로, 동양의학(東洋醫學)에서는 골위, 골고(骨枯) 등의 골질환(骨疾患)에서 유사한 증상(症狀)이 나타나며, 병인(病因)은 주로 신허(腎虛)로서 서양의학의 신장 질환으로 인한 인(燐)의 재흡수 불량, Vit-D 대사 이상과 유사하다. 증상(症狀)으로는 요통(腰痛), 골통증(骨痛症), 다발성 골절, 동요성 보행 등이 나타난다. 치법(治法)은 보신(補腎)을 위주(爲主)로 하여 건비익신(健脾益腎),자양기혈(滋養氣血), 강장근골(强壯筋骨) 등이 있고, 치방(治方)은 육미지황탕(六味地黃湯)을 위주로 하여, 호잠환(虎潛丸), 제생신기환(濟生腎氣丸), 대보음환(大補陰丸) 등이 활용되고 있으며, 약물(藥物)은 숙지황(熟地黃), 호경골(虎脛骨), 호도육(胡挑肉), 자하차(紫河車), 두충(杜沖), 녹각교(鹿角膠), 녹용(鹿茸) 등의 보신지제(補腎之劑)가 주로 사용되고 있다.