• Journal of Korean Neurosurgical Society
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• 제66권6호
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• pp.690-702
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• 2023

Objective : To analyze the outcomes of coil embolization (CE) for unruptured intracranial aneurysm (UIA) according to region and hospital size based on National Health Insurance Service data in South Korea. Methods : The incidence of complications, including intracranial hemorrhage (ICRH) and cerebral infarction (CI), occurring within 3 months and the 1-year mortality rates in UIA patients who underwent CE in 2018 were analyzed. Hospitals were classified as tertiary referral general hospitals (TRGHs), general hospitals (GHs) or semigeneral hospitals (sGHs) according to their size, and the administrative districts of South Korea were divided into 15 regions. Results : In 2018, 8425 (TRGHs, 4438; GHs, 3617; sGHs, 370) CEs were performed for UIAs. Complications occurred in 5.69% of patients seen at TRGHs, 13.48% at GHs, and 20.45% at sGHs. The complication rate in TRGHs was significantly lower than that in GHs (p=0.039) or sGHs (p=0.005), and that in GHs was significantly lower than that in sGHs (p=0.030). The mortality rates in TRGHs, GHs, and sGHs were 0.81%, 2.16%, and 3.92%, respectively, with no significant difference. Despite no significant difference in the mortality rates, the complication rate significantly increased as the number of CE procedures per hospital decreased (p=0.001; rho=-0.635). Among the hospitals where more than 30 CEs were performed for UIAs, the incidence of CIs (p=0.096, rho=-0.205) and the mortality rates (3 months, p=0.048, rho=-0.243; 1 year, p=0.009, rho=-0.315) significantly decreased as the number of CEs that were performed increased and no significant difference in the incidence of post-CE ICRH was observed. Conclusion : The complication rate in patients who underwent CE for UIA increased as the hospital size and physicians' experience in conducting CEs decreased. We recommend nationwide quality control policies CEs for UIAs.

• 한국농림기상학회지
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• 제25권3호
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• pp.117-128
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• 2023

2010년대 이후, 보전·육성 가치가 높은 금강소나무 핵심 서식지인 봉화군과 울진군 일대에서 소나무 고사 현상이 발생하고 있다. 이에, 남부지방산림청에서는 금강소나무 군락지의 고사피해 현황 파악과 추가적인 병해충 피해 예방을 위해 2020년부터 금강소나무 고사목 발생 모니터링 사업을 수행하고 있다. 본 연구에서는 고사목 발생 모니터링 자료를 바탕으로 울진·봉화일대 금강소나무의 고사 피해발생 특성과 위험지역 분석을 수행하였다. 그 결과, 울진·봉화지역 금강소나무 고사목은 해발고도가 높은 산능선부위, 건조한 남쪽사면, 연령이 높은 임분, 겨울철 기온상승이 높은 지역에서 많이 발생한 특성을 보였다. 이러한 특성을 이용하여 전체 연구 대상지에 대한 고사목 발생 위험성 평가를 실시한 결과, 소나무림 약 85천ha 중 6.2%인 5,294 ha 임분이 고사발생 위험 특성을 보유하고 있는 것으로 평가되었다. 고사발생 위험지역에서는 고온 및 가뭄과 관련된 기후변화 이벤트가 발생할 경우 고사 피해가 실제로 발생 가능성이 높으므로 소나무의 생육 스트레스를 기본적으로 낮춰주기 위한 상시적인 산림관리 활동이 필요하며, 보호 우선순위가 높은 소나무 임분에 대한 우선적인 관리조치가 수행될 필요가 있다. 본 연구 결과는 이상기상 및 기후변화로 인해 피해 위험성이 높은 지역을 사전에 제시함으로써 기후변화 적응 산림관리 이행의 기초자료로 활용될 수 있다.

• 산업융합연구
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• 제22권4호
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• pp.31-38
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• 2024

본 연구의 목적은 노인체육의 국내외 현황을 조사하고 노인체육의 한 종목으로서 실버태권도의 활성화 방안을 고찰하는 데 있다. 국내외 노인체육 현황조사를 위해 국가별 공공기관 및 체육시설(문화체육관광부, 보건복지부, 통계청, e-나라지표, 국민체육진흥공단)의 보도자료, 통계자료를 수집하였고 관련 논문, 학술지, 서적 등과 비교 분석하여 실버태권도 활성화 방안으로 다음과 같은 사항을 도출하였다. 첫째, 한국의 노인체육은 주로 복지관을 통해 행해지며 댄스, 요가, 음악이 선호되는 경향이 있으며 무술의 선호 비율은 낮았다. 실버태권도의 참여를 높이기 위해서는 해외와 같이 체육의 체험 사례를 미디어, 영화 제작, 배포, 전화 홍보 등 다양한 마케팅이 필요하다. 둘째, 수련 대상에 따른 실버태권도 프로그램의 개발이 필요하며 이를 수행할 수 있는 지도자의 양성이 필요하다. 프로그램의 개발은 태권도 기관, 태권도장, 대학, 평생교육원과 연계하여 전공 학생 및 노인 체육지도자의 참여가 필요하다.

• 재활치료과학
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• 제13권1호
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• pp.99-114
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• 2024

목적 : 본 연구에서는 정보통신기술(information and communication technology, ICT) 기반의 고령자를 위한 비대면 라이프스타일 프로그램을 개발하고 그 적용 가능성을 평가하였다. 연구방법 : 본 프로그램은 분석, 설계, 개발, 구현 및 평가 5단계로 구성된 ADDIE 모델을 기반으로 개발되었다. 5단계의 연구과정 동안 8단계를 거쳐 최종적으로 지역사회 고령자들을 대상으로 비대면 라이프 스타일 프로그램이 수행되었다. 결과 : 프로그램 분석 결과, 대상자들의 우울 증상과 외로움이 유의하게 감소한 것으로 나타났고 삶의 질 점수가 증가함을 확인할 수 있었다. 결론 : 본 연구를 통해 개발된 ICT 기반의 비대면 라이프스타일 프로그램은 고령자들이 성공적인 노화를 위한 생활 방식을 더 잘 이해하도록 동기부여하는 데 도움이 되었다.

• Korean Circulation Journal
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• 제53권7호
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• pp.483-496
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• 2023

Background and Objectives: Atrial fibrillation (AF) is associated with decreased cardiac resynchronization therapy (CRT) benefits compared to sinus rhythm (SR). Effective biventricular (BiV) pacing is a determinant of CRT success, but AF can interfere with adequate BiV pacing and affect clinical outcomes. We investigated the effect of device-detected AF on clinical outcomes and optimal BiV pacing in patients with heart failure (HF) treated with CRT. Methods: We retrospectively analyzed 174 patients who underwent CRT implantation between 2012 and 2019 at a tertiary center. The optimal BiV pacing percentage was defined as ≥98%. Device-detected AF was defined as an atrial high-rate episode ≥180 beats per minute lasting more than 6 minutes during the follow-up period. We stratified the patients without preexisting AF at pre-implantation into device-detected AF and no-AF groups. Results: A total of 120 patients did not show preexisting AF at pre-implantation, and 54 had AF. Among these 120 patients, 19 (15.8%) showed device-detected AF during a median follow-up of 25.1 months. The proportion of optimal BiV pacing was significantly lower in the device-detected AF group than in the no-AF group (42.1% vs. 75.2%, p=0.009). The devicedetected AF group had a higher incidence of HF hospitalization, cardiovascular death, and all-cause death than the no-AF group. The device-detected AF and previous AF groups showed no significant differences regarding the percentage of BiV pacing and clinical outcomes. Conclusions: For HF patients implanted with CRT, device-detected AF was associated with lower optimal BiV pacing and worse clinical outcomes than no-AF.

• Journal of Korean Neurosurgical Society
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• 제67권1호
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• pp.84-93
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• 2024

Objective : We aimed to examine trends in critically ill neurology-neurosurgery (NNS) patients who were admitted to the intensive care unit (ICU) in South Korea and identify risk factors for in-hospital mortality after ICU admission in NNS patients. Methods : This nationwide population-based retrospective cohort study enrolled adult NNS adult patients admitted to the ICU from 2010 to 2019 extracted from the National Health Insurance Service in South Korea. The critically ill NNS patients were defined as those whose main admission departments were neurology or neurosurgery at ICU admission. The number of ICU admission, age, and total cost for hospitalization from 2010 to 2019 in critically ill NNS patients were examined as trend information. Moreover, multivariable logistic regression modeling was used to identify risk factors for in-hospital mortality among critically ill NNS patients. Results : We included 845474 ICU admission cases for 679376 critically ill NNS patients in South Korea between January 1, 2010 to December 31, 2019. The total number of ICU admissions among NNS patients was 79522 in 2010, which increased to 91502 in 2019. The mean age rose from 62.8 years (standard deviation [SD], 15.6) in 2010 to 66.6 years (SD, 15.2) in 2019, and the average total cost for hospitalization per each patient consistently increased from 6206.1 USD (SD, 5218.5) in 2010 to 10745.4 USD (SD, 10917.4) in 2019. In-hospital mortality occurred in 75455 patients (8.9%). Risk factors strongly associated with increased in-hospital mortality were the usage of mechanical ventilator (adjusted odds ratio [aOR], 19.83; 95% confidence interval [CI], 19.42-20.26; p<0.001), extracorporeal membrane oxygenation (aOR, 3.49; 95% CI, 2.42-5.02; p<0.001), and continuous renal replacement therapy (aOR, 6.47; 95% CI, 6.02-6.96; p<0.001). In addition, direct admission to ICU from the emergency room (aOR, 1.38; 95% CI, 1.36-1.41; p<0.001) and brain cancer as the main diagnosis (aOR, 1.30; 95% CI, 1.22-1.39; p<0.001) are also potential risk factors for increased in-hospital mortality. Conclusion : In South Korea, the number of ICU admissions increased among critically ill NNS patients from 2010 to 2019. The average age and total costs for hospitalization also increased. Some potential risk factors are found to increase in-hospital mortality among critically ill NNS patients.

• Journal of Cardiovascular Imaging
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• 제31권1호
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• pp.51-61
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• 2023

BACKGROUND: Valvular heart disease (VHD) is a common cause of cardiovascular morbidity and mortality worldwide; however, its epidemiological profile in Korea requires elucidation. METHODS: In this nationwide retrospective cohort study from the Korean valve survey, which collected clinical and echocardiographic data on VHD from 45 medical centers, we identified 4,089 patients with VHD between September and October 2019. RESULTS: The aortic valve was the most commonly affected valve (n = 1,956 [47.8%]), followed by the mitral valve (n = 1,598 [39.1%]) and tricuspid valve (n = 1,172 [28.6%]). There were 1,188 cases of aortic stenosis (AS) and 926 cases of aortic regurgitation. The most common etiology of AS was degenerative disease (78.9%). The proportion of AS increased with age and accounted for the largest proportion of VHD in patients aged 80-89 years. There were 1,384 cases of mitral regurgitation (MR) and 244 cases of mitral stenosis (MS). The most common etiologies for primary and secondary MR were degenerative disease (44.3%) and non-ischemic heart disease (63.0%), respectively, whereas rheumatic disease (74.6%) was the predominant cause of MS. There were 1,172 tricuspid regurgitation (TR) cases, of which 46.9% were isolated and 53.1% were associated with other valvular diseases, most commonly with MR. The most common type of TR was secondary (90.2%), while primary accounted for 6.1%. CONCLUSIONS: This report demonstrates the current epidemiological status of VHD in Korea. The results of this study can be used as fundamental data for developing Korean guidelines for VHD.

• Journal of Ginseng Research
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• 제47권5호
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• pp.627-637
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• 2023

Background: Damage to the healthy intestinal epithelial layer and regulation of the intestinal immune system, closely interrelated, are considered pivotal parts of the curative treatment for inflammatory bowel disease (IBD). Plant-based diets and phytochemicals can support the immune microenvironment in the intestinal epithelial barrier for a balanced immune system by improving the intestinal microecological balance and may have therapeutic potential in colitis. However, there have been only a few reports on the therapeutic potential of plant-derived exosome-like nanoparticles (PENs) and the underlying mechanism in colitis. This study aimed to assess the therapeutic effect of PENs from Panax ginseng, ginseng-derived exosome-like nanoparticles (GENs), in a mouse model of IBD, with a focus on the intestinal immune microenvironment. Method: To evaluate the anti-inflammatory effect of GENs on acute colitis, we treated GENs in Caco2 and lipopolysaccharide (LPS) -induced RAW 264.7 macrophages and analyzed the gene expression of proinflammatory cytokines and anti-inflammatory cytokines such as TNF-α, IL-6, and IL-10 by real-time PCR (RT-PCR). Furthermore, we further examined bacterial DNA from feces and determined the alteration of gut microbiota composition in DSS-induced colitis mice after administration of GENs through 16S rRNA gene sequencing analysis. Result: GENs with low toxicity showed a long-lasting intestinal retention effect for 48 h, which could lead to effective suppression of pro-inflammatory cytokines such as TNF-α and IL-6 production through inhibition of NF-κB in DSS-induced colitis. As a result, it showed longer colon length and suppressed thickening of the colon wall in the mice treated with GENs. Due to the amelioration of the progression of DSS-induced colitis with GENs treatment, the prolonged survival rate was observed for 17 days compared to 9 days in the PBS-treated group. In the gut microbiota analysis, the ratio of Firmicutes/Bacteroidota was decreased, which means GENs have therapeutic effectiveness against IBD. Ingesting GENs would be expected to slow colitis progression, strengthen the gut microbiota, and maintain gut homeostasis by preventing bacterial dysbiosis. Conclusion: GENs have a therapeutic effect on colitis through modulation of the intestinal microbiota and immune microenvironment. GENs not only ameliorate the inflammation in the damaged intestine by downregulating pro-inflammatory cytokines but also help balance the microbiota on the intestinal barrier and thereby improve the digestive system.

• 대한영상의학회지
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• 제83권1호
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• pp.138-148
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• 2022

목적 본 연구는 전국 인구 기반 데이터베이스를 이용하여 국내 소아 전산화단층촬영의 비율과 연간 추세를 평가하였다. 대상과 방법 2012년부터 2017년까지 국내에서 촬영된 소아 전산화단층촬영에 대한 건강보험심사평가원의 데이터를 사용하였다. 연령, 성별, 진단명 및 해부학적 위치에 대한 데이터를 같이 추출하여 분석하였다. 결과 18세 미만 어린이 58527528명을 대상으로 총 576376건의 전산화단층촬영이 시행되었다(1000명당 9.8회). 어린이 1000명당 전산화단층촬영 횟수는 9.0회에서 11.0회로 23.2% 증가했다. 전산화단층촬영 건수는 6-12세 그룹에서 32.9%(1000명당 7.4회에서 9.8회로 증가), 13-18세 그룹에서 34.0% 증가했다(1000명당 11.4회에서 15.3회로 증가). 부위별 전산화단층촬영의 비율은 두부(39.1%), 사지(32.5%), 복부(13.7%) 순서로 확인되었다. 사지 전산화단층촬영 횟수는 83.6% 증가했으며(1000명당 2.3회에서 4.2회로 증가) 사지 전산화단층촬영의 비율은 25.3%에서 37.7%로 증가했다. 결론 소아 환자의 전산화단층촬영은 2012년부터 2017년까지 매년 4.4%의 속도로 지속적으로 증가했다. 따라서 의사는 소아 환자에서 전산화단층촬영으로 인한 이득과 방사선 노출로 인한 잠재적인 피해를 적절히 고려하여 신중하게 촬영을 결정해야 한다.

• Korean Circulation Journal
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• 제54권5호
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• pp.256-267
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• 2024

Background and Objectives: Accumulating evidence shows that sodium-glucose cotransporter 2 inhibitors (SGLT2is) reduce adverse cardiovascular outcomes. However, whether SGLT2i, compared with other antidiabetic drugs, reduce the new development of atrial fibrillation (AF) is unclear. In this study, we compared SGLT2i with dipeptidyl peptidase-4 inhibitors (DPP-4is) in terms of reduction in the risk of AF in individuals with type 2 diabetes. Methods: We included 42,786 propensity score-matched pairs of SGLT2i and DPP-4i users without previous AF diagnosis using the Korean National Health Insurance Service database between May 1, 2016, and December 31, 2018. Results: During a median follow-up of 1.3 years, SGLT2i users had a lower incidence of AF than DPP-4i users (1.95 vs. 2.65 per 1,000 person-years; hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.55-0.97; p=0.028]). In individuals without heart failure, SGLT2i users was associated with a decreased risk of AF incidence (HR, 0.70; 95% CI, 0.52-0.94; p=0.019) compared to DPP-4i users. However, individuals with heart failure, SGLT2i users was not significantly associated with a change in risk (HR, 1.04; 95% CI, 0.44-2.44; p=0.936). Conclusions: In this nationwide cohort study of individuals with type 2 diabetes, treatment with SGLT2i was associated with a lower risk of AF compared with treatment with DPP-4i.