• 대한치과의사협회지
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• 제58권6호
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• pp.354-363
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• 2020

Patients often seek consultation with dentists for their temporomandibular disorders (TMD), especially for pain. Acute pains refer to pains that are of short duration. Common acute TMD are arthralgia and local myalgia. Diagnosis should be made based on careful history taking and clinical examination. Most acute TMD are well controlled by education, cognitive awareness training, and conservative treatment. The aggressive and irreversible treatments should not be applied. Acute TMD should be controlled in the early phase so as not to be proceed to chronic pain.

• 대한약학회:학술대회논문집
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• 대한약학회 2002년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2
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• pp.223-224
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• 2002

Pharmacokinetic (PK) and pharmacodynamic (PD) study of a new reversible proton pump inhibitor (YH1885, Yuhan Pharmaceutical Co.) was done as a phase 1 clinical trial in Seoul national University Hospital Clinical trialcenter. Single dose of 60, 100, 150, 200, and 300mg were administered to total 20 healthy subjects under fasting state. Six subjects were given 100 mg after food and 12 subjects were given multiple doses of 150 and 300 mg every day for 7 days under fasting state. (omitted)

• Nuclear Medicine and Molecular Imaging
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• 제42권1호
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• pp.44-51
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• 2008

목적: 외상 후 복합부위통증증후군으로 진단된 환자에서 시행한 삼상 뼈 스캔의 판독 신뢰도를 평가하기 위하여 판독 일치도를 조사하였다. 대상 및 방법: 1994년 국제통증연구학회(IASP) 기준에 따라 외상 후 복합부위통증증후군으로 진단된 34명을 대상으로 하였다. 두 명의 핵의학 전문의가 삼상 뼈 스캔의 세부영상에서 섭취의 양상, 정도와 범위를 평가하여 관찰자내 와 관찰자간 일치도(kappa value)를 구하였다. 환측 사지 전체의 관류와 섭취가 증가되었을 때(기준 1), 지연영상에서 전체적으로 증가되었을 때(기준2), 국소이상의 섭취가 증가되었을 때(기준3)를 양성으로 판정하는 기준에 따라 재분류하여 판독자 임의로 분류하였을 때와 최종판독 일치도를 비교하였다. 결과: 세 영상에서 섭취 양상, 정도, 범위에 대한 관찰자내 일치도는 우수하였다. 세부 영상에 대한 관찰자간 일치도(0.64-0.90)에 비하여 혈액풀의 섭취 범위에 대한 일치도는 낮았다(0.55). 관찰자간 일치도는 임의의 기준으로 최종 판정하였을 때(0.63)에 비하여 공통의 양성 판정 기준에 따라 다시 분류하였을 때 약간 향상되었다(0.77-0.88). 임상시기별 임의 기준으로 분류한 관찰자간 일치도는(급성: 0.29, 만성: 0.37) 양성 판정 기준을 적용시에 크게 향상되었다(급성: 0.47-0.82, 만성: 1.0). 임상시기별 예민도는 급성에 비해 만성에서 대체적으로 낮았다. 결론: 본 연구에서 외상 후 복합부위통증증후군 환자에서 시행한 삼상 뼈 스캔의 판독 시 관찰자간 변동성이 있는 것이 검증되었다. 그 변동성은 양성 평가의 기준이 관찰자마다 다른데서 기인하였다. 외상 후 복합통증증후군 환자에서 삼상 뼈 스캔의 판독 신뢰도를 높이기 위해서는 세부 영상 및 임상시기에 따른 구체적인 양성 판정 기준을 정할 필요가 있다.

• BMB Reports
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• 제45권9호
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• pp.509-514
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• 2012

We have found that the previously uncharacterized bone morphogenetic protein-9 (BMP9) is one of the most osteogenic factors. However, it is unclear if BMP9 cross-talks with $TGF{\beta}1$ during osteogenic differentiation. Using the recombinant BMP9 adenovirus, we find that low concentration of rh$TGF{\beta}1$ synergistically induces alkaline phosphatase activity in BMP9-transduced C3H10T1/2 cells and produces more pronounced matrix mineralization. However, higher concentrations of $TGF{\beta}1$ inhibit BMP9-induced osteogenic activity. Real-time PCR and Western blotting indicate that BMP9 in combination with low dose of $TGF{\beta}1$ potentiates the expression of later osteogenic markers osteopontin, osteocalcin and collagen type 1 (COL1a2), while higher concentrations of $TGF{\beta}1$ decrease the expression of osteopontin and osteocalcin but not COL1a2. Cell cycle analysis reveals that $TGF{\beta}1$ inhibits C3H10T1/2 proliferation in BMP9-induced osteogenesis and restricts the cells in $G_0/G_1$ phase. Our findings strongly suggest that $TGF{\beta}1$ may exert a biphasic effect on BMP9-induced osteogenic differentiation of mesenchymal stem cells.

• Journal of Trauma and Injury
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• 제24권2호
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• pp.95-97
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• 2011

Purpose: We analyzed the medical costs for severely traumatized patients according to the severity and medical performance so that we could improve the financial balance of the trauma center. Methods: Retrospective analysis was performed on patients visiting SNUH Trauma Center from May 2011 to August 2011. Among a total of 55 severely traumatized patients, 31 patients whose medical bills were available and categorized were included in this study. The injury severity score (ISS) was calculated from the abbreviated injury score (AIS), which was updated in 2008,for each patient to assess the severity of injury. Major trauma was defined as an ISS above 15. Results:The 31 patients in this study included 20 males and 11 females. The average ISS was $33.23{\pm}16.65$ points. We categorize the patients into three groups according to ISS, 16-24: group 1, 25-40: group 2, and above 41: group 3. Total incomes, admission fees, surgery fees, and imaging test fees are shown in table 1. The costs seem to be higher costs in group 2, but this result has no statistical significance. Statistical significantly data are as follows: high radiologic test fees in group 1, short hospital stay in groups 1 and 2, and short ICU stay in group 1. The average hospital stay was 17 days, and the average emergency intensive care unit (EICU) stay was 7.5 days. Although the EICU stay was only 44% of the total hospital stay, the income from the EICU covers 79.4% of the total hospital income. Conclusion: From this study, we found several items that show relatively high medical income from severely traumatized patients visiting the SNUH Trauma Center. Most of the medical fees arise in the early phase of acute medicine usually in the ICU. Efforts to identify the items with high income and to minimize expenses will improve the financial structure of the Trauma Center,which is facing a budget crisis.

• 한국의료질향상학회지
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• 제9권2호
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• pp.116-133
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• 2002

Background : It is very common in Korea to take care of non-acute patients in an acute setting, due to the lack of long-term facilities. Long term hospitalization increase medical expenses and decreases the bed utilization, which can affect the urgent and emergent admissions, and eventually jeopardize the hospital financially. In this study, strategies for effective transfers to the lower levels of care, and to decrease the length of stay were presented by surveying and analyzing the patient's knowledge of the transfer needs, and the willingness to transfer those whose hospital length of stay was more than 30days. Method : The survey is subject to a group of 251 patients who have been hospitalized over 30 days in a general hospital in Seoul. Excluding those that were in the Intensive Care Unit and psychiatric ward, 214 in-patients were used as participants. They were surveyed from April 9, 2002 to April 17, 2002. One hundred and thirty seven out of 214 were responded which made the response rate 64%. Data were analyzed by SAS and SPSS. Result : Multi-variable Logistic Regression Analysis showed a significant effect in medical expenses, knowledge of referral system and the information of the receiving hospital. The financial burden in medical expenses made the patient 10.7 times more willing to be transferred, knowledge of the referral system made them 5 times more willing to be transferred, and the information of receiving hospital makes 6.5 times more willing to be transferred. Reasons for willing to be transferred to a lower level of care were the phase of physical therapy, the distance from home, the attending physician's advice and being unable to be treated as an out patient. Reasons for refusing to be transferred were the following. The attending physician's competency, not being ready to be discharged, not trusting the receiving hospital's competency due to the lack of information, or never hearing about the referring system by the attending physician. Conclusion : Based on this, strategies for the effective transfer to the lower levels of care were suggested. It is desirable for the attending physician to be actively involved by making an effort to explain the transfer need, and referring to the Healthcare Coordinating Center, which can help the patient make the right decision. Nationwide networking for the referral system is the another key factor that may need to be suggested as an alternative to decrease the medical expenses. Collaborating with the Home Health Agency for the early discharge planning and the Social Service Department for financial aid are also needed. It is recommended that the hospital should expedite the transfer process by prioritizing the cost and the information as medical expenses, knowledge of referring system and the information of the receiving hospital, are the most important factors to the willingness to transfer to a lower level of care.

• 대한치매학회지
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• 제22권3호
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• pp.100-108
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• 2023

Background and Purpose: The efficacy and safety of GV1001 have been demonstrated in patients with moderate-to-severe Alzheimer's disease (AD). In this study, we aimed to further demonstrate the effectiveness of GV1001 using subscales of the Severe Impairment Battery (SIB), which is a validated measure to assess cognitive function in patients with moderate-to-severe AD. Methods: We performed a post hoc analysis of data from a 6 month, multicenter, phase 2, randomized, double-blind, placebo-controlled trial with GV1001 (ClinicalTrials.gov, NCT03184467). Patients were randomized to receive either GV1001 or a placebo for 24 weeks. In the current study, nine subscales of SIB-social interaction, memory, orientation, language, attention, praxis, visuospatial ability, construction, and orientation to name-were compared between the treatment (GV1001 1.12 mg) and placebo groups at weeks 12 and 24. The safety endpoints for these patients were also determined based on adverse events. Results: In addition to the considerable beneficial effect of GV1001 on the SIB total score, GV1001 1.12 mg showed the most significant effect on language function at 24 weeks compared to placebo in both the full analysis set (FAS) and per-protocol set (PPS) (p=0.017 and p=0.011, respectively). The rate of adverse events did not differ significantly between the 2 groups. Conclusions: Patients with moderate-to-severe AD receiving GV1001 had greater language benefits than those receiving placebo, as measured using the SIB language subscale.

• 여성건강간호학회지
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• 제8권4호
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• pp.538-549
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• 2002

This study was designed to test the effects of a full body massage on uterine contraction, length of labor, type of delivery, and drug intervention for primipara during labor. Data were collected using a quasi-experiment method (nonequivalent control group, pre-post test design) from November 1, 2001 to July 31, 2002. The subjects of this experiment consisted of 28 women in the experimental group and 29 in the control group, out of 57 primipara hospitalized at the U OB & GYN hospital in Inchon. The experimental group was given a 20 minute full body massage for each of the three delivery phases (latent, active, and transition). The control group was given conventional delivery care. Three (3) parameters were analyzed in this experiment. (1) The interval, duration, and strength of uterine contraction, using an electric tocodynamometer (2) The elapsed time for stage 1 and stage 2 labor. (3) The types of deliveries and drug interventions, using postpartum medical records The data collected were analyzed using the repeated measures analysis of variance (ANOVA), t-test, and $x^2$ test of the SPSS program. The results of the experiment are as follows: 1) Uterine contraction interval was significantly reduced (F=3.210, p=.050). Duration of uterine contraction showed significant increase only during the transition phase (t=-2.319, p=.023). Strength of uterine contraction showed no significant difference. 2) Total length of labor was significantly shortened (t=-5.245, p=.000). The length of 1st stage labor was significantly shortened (t=-5.164, p=.000), with latent phase showing (t=-4.709, p=.000), active phase (t=-2.973, p=.005), and transition phase (t=-2.031, p=.047). The length of 2nd stage labor showed no significant difference. 3) The number of natural deliveries were significantly increased ($x^2$=13.127, p=.004). 4) The number of drug interventions were significantly fewer ($x^2$= 4.493, p=.034). In conclusion, this study shows that a full body massage has a significantly positive effect on uterine contraction interval, length of labor, type of delivery, and drug intervention. Therefore, this study suggests that a full body massage be used clinically to help primipara during labor.

• Asian Pacific Journal of Cancer Prevention
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• 제13권9호
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• pp.4807-4814
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• 2012

Purpose: The chemoresistance of human hepatocellular carcinoma (HCC) to cytotoxic drugs, especially intrinsic or acquired multidrug resistance (MDR), still remains a major challenge in the management of HCC. In the present study, possible mechanisms involved in MDR of HCC were identified using a 5-fluorouracil (5-FU)-resistant human HCC cell line. Methods: BEL-7402/5-FU cells were established through continuous culturing parental BEL-7402 cells, imitating the pattern of chemotherapy clinically. Growth curves and chemosensitivity to cytotoxic drugs were determined by MTT assay. Doubling times, colony formation and adherence rates were calculated after cell counting. Morphological alteration, karyotype morphology, and untrastructure were assessed under optical and electron microscopes. The distribution in the cell cycle and drug efflux pump activity were measured by flow cytometry. Furthermore, expression of potential genes involved in MDR of BEL-7402/5-FU cells were detected by immunocytochemistry. Results: Compared to its parental cells, BEL-7402/5-FU cells had a prolonged doubling time, a lower mitotic index, colony efficiency and adhesive ability, and a decreased drug efflux pump activity. The resistant cells tended to grow in clusters and apparent changes of ultrastructures occurred. BEL-7402/5-FU cells presented with an increased proportion in S and G2/M phases with a concomitant decrease in G0/G1 phase. The MDR phenotype of BEL-7402/5-FU might be partly attributed to increased drug efflux pump activity via multidrug resistance protein 1 (MRP1), overexpression of thymidylate synthase (TS), resistance to apoptosis by augmentation of the Bcl-xl/Bax ratio, and intracellular adhesion medicated by E-cadherin (E-cad). P-glycoprotein (P-gp) might play a limited role in the MDR of BEL-7402/5-FU. Conclusion: Increased activity or expression of MRP1, Bcl-xl, TS, and E-cad appear to be involved in the MDR mechanism of BEL-7402/5-FU.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권6호
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• pp.431-436
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• 2009

There are five principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (genetic defect, drug-aspirin, autoimmune disease) (3) Thrombocytopenic purpuras (radiation, leukemia), (4) Inherited disorders of coagulation (hemophilia, Christmas disease, vitamin deficiency, anticoagulation drug-heparin, coumarin). If the hemorrhage from postextraction wound is unusually aggressive, and then dehydration and airway problem are occurred, the socket must be packed with gelatine sponge(Gelfoam) that was moistened with thrombin and wound closure & pressure dressing are applied. The thrombin clots fibrinogen to produce rapid hemostasis. Gelatine sponges moistened with thrombin provide effective coagulation of hemorrhage from small veins and capillaries. But, in dental alveoli, gelatine sponges may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding control by continuous rubber strip & iodoform gauze drainage (without gelfoam packing) of active bleeding infection sites of three teeth extraction wounds in a 46-years-old female patient with advanced liver cirrhosis.