• Tuberculosis and Respiratory Diseases
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• 제87권3호
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• pp.378-385
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• 2024

Background: Intrapleural fibrinolytic therapy (IPFT) has been used as an effective agent since 1949 for managing complicated pleural effusion and empyema. Several agents, such as streptokinase, urokinase (UK), and recombinant tissue plasminogen activator (rt-PA), have been found to be effective with variable effectiveness. However, a head-tohead controlled trial comparing the efficacy of the most frequently used agents, i.e., UK and rt-PA (alteplase) for managing complicated pleural effusion has rarely been reported. Methods: A total of 50 patients were randomized in two intervention groups, i.e., UK and rt-PA. The dose of rt-PA was 10 mg, and that of UK was 1.0 lac units. UK was given thrice daily for 2 days, followed by clamping to allow the retainment of drugs in the pleural space for 2 hours. rt-PA was instilled into the pleural space twice daily for 2 days, and intercostal drainage was clamped for 1 hour. Results: A total of 50 patients were enrolled into the study, of which 84% (n=42) were males and 16% (n=8) were females. Among them, 30 (60%) patients received UK, and 20 (40%) patients received alteplase as IPFT agents. The percentage of mean±standard deviation changes in pleural opacity was -33.0%±9.9% in the UK group and -41.0%±14.9% in the alteplase group, respectively (p=0.014). Pain was the most common adverse side effect, occurring in 60% (n=18) of the patients in the UK group and in 40% (n=8) of the patients in the alteplase group (p=0.24), while fever was the second most common side effect. Patients who reported early (within 6 weeks of onset of symptoms) showed a greater response than those who reported late for the intervention. Conclusion: IPFT is a safe and effective option for managing complicated pleural effusion or empyema, and newer agents, such as alteplase, have greater efficacy and a similar adverse effect profile when compared with conventional agents, such as UK.

• 보건의료생명과학 논문지
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• 제10권2호
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• pp.329-339
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• 2022

본 연구는 2019 개정 누리과정을 준비하고 실행하는 과정에서의 초임교사의 경험을 알아보고, 초임교사를 지원하는 방안을 찾아보는 것을 목적으로 하였다. 이를 위해 대전·충남 지역의 사립유치원 및 어린이집의 경력 2년 미만의 초임교사 12명을 대상으로 전화 면담을 실시하여 자료를 수집하였고, 수집된 자료는 텍스트 연결망 분석을 통해 분석하였다. 연구결과는 다음과 같다. 첫째, 초임교사들은 2019 개정 누리과정을 준비하면서 누리과정을 구체적으로 알지 못하고 있음을 걱정하고 있었다. 이를 보완하기 위해 유아 관찰, 동료 교사들과의 정보 공유, 누리과정 해설서 참고 등의 준비를 하고 있었다. 또한, 초임교사들은 연수를 통해 실제적인 놀이 사례를 간접적으로 경험하는 차원에서 도움을 받고 있다고 생각하고 있었다. 둘째, 초임교사들은 누리과정을 실행하면서 유아의 놀이에 초점을 맞추어 다양한 지원을 하고 있었다. 누리과정을 실제로 운영하면서 좋은 점으로 유아의 흥미와 생각을 고려하여 유아 중심의 놀이를 진행하고 이에 대해 교사가 고민하고 생각하면서 유아들의 놀이를 지원할 수 있다는 점을, 어려운 점으로 유아의 놀이에서 유아의 생각을 읽고 주제를 잡아 놀이를 진행하는 것과 놀이를 충분히 할 수 있는 시간의 부족 등을 강조하고 있었다. 또한 초임교사들은 인터넷 자료나 동료 교사와의 의견 공유 등을 참고하고 있었으며, 직접 경험이 놀이 실행에 도움이 되었다고 언급하였다. 마지막으로 교사에게 필요한 역량으로 놀이에 대한 교사의 관심과 관찰, 창의적인 사고, 순발력, 놀이를 지원하고자 하는 의지 등이 중요하다고 생각하였다.

• 보건의료생명과학 논문지
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• 제10권2호
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• pp.295-303
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• 2022

본 연구는 2015년 담배가격 인상 정책 전후의 흡연율 및 금연 계획 변화에 대해 알아보고자 하였다. 이에 본 연구는 국민건강영양조사를 토대로 담배가격을 인상하기 전 2013년도와 인상을 시작한 2015년, 그 후 2017년도의 인구 사회학적 변인(성별, 연령, 소득 5분위, 직업분류, 교육 수준, 고혈압 유병, 당뇨병 유병)과 건강행태(음주, 스트레스 인지, 비만)에 따른 흡연율 변화와 금연 계획 변화를 분석하였다. 연구 결과 2013년의 흡연율은 23.3%, 2015년의 흡연율은 20.5%, 2017년의 흡연율은 21.0%로 나타나 담배가격을 인상하기 전보다는 흡연율이 감소한 것을 확인할 수 있었다. 담배가격 상승은 사회학적 변인 중 소득, 직업, 교육 수준은 흡연율의 차이를 보였고 건강행태는 흡연율에 큰 영향을 주지 않는 것으로 나타났다. 또한, 담배가격 인상이 금연 계획 증가에 일시적인 효과를 보였으나 금연계획의 상승이 반드시 흡연율 감소로 이어지는 것은 아닌 것으로 나타났다. 따라서 향후에는 성별, 연령별, 사회적 요인별로 맞춤형 금연 프로그램을 제공하여 금연계획이 흡연율 감소로 이어질 수 있도록 국가적인 차원에서 노력이 필요하겠다. 그리고 본 연구에서 크게 확인하지 못한 건강행태에 따른 연구도 진행되어야 하며 향후 가격인상 정책을 고려하거나, 새로운 정책을 시행할 경우 본 연구가 흡연율 영향을 예측하는데 도움이 되기를 바란다.

• 보건의료생명과학 논문지
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• 제10권2호
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• pp.351-359
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• 2022

본 연구 대상자는 충청북도 E군에 소재한 G대학교 임상실습을 경험한 간호학과 3,4학년 재학생 167명을 대상으로 실시하였다. 자료수집기간은 2020년 12월 1일부터 12월 18일까지 이루어졌다. 수집된 자료는 SPSS 26.0 프로그램을 이용하여 분석하였으며, 대상자의 일반적 특성, 임상실습 스트레스와 임상실습만족도는 빈도와 백분율, 평균, 표준편차로 분석하였고, 일반적 특성에 따른 임상실습 스트레스, 임상실습만족도, 간호전문직관의 차이는 t-test와 one way ANOVA로 분석하였다. 임상실습 스트레스, 임상실습만족도, 간호전문직관의 상관관계는 Pearson Correlation Coefficients로 분석하였고, 간호전문직에 미치는 요인을 분석하기 위해 stepwise multiple regression을 이용하여 분석하였다. 연구결과 전공만족도(β=.256, p=.001)가 가장 강력한 영향변수였으며, 임상실습만족도(β=.237, p=.004), 임상실습 스트레스(β=.-.143, p=.068)순으로 간호전문직관에 영향을 주는 요인으로 확인되었다. 이들 전체변수의 설명력은 21.8%로 나타났다(F=.14..44, p=.000). 이상의 연구결과로 간호전문직관을 향상시키기 위한 교육전략 및 구체적인 프로그램을 개발 및 적용이 필요함을 시사한다.

• 대한치매학회지
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• 제21권1호
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• pp.30-41
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• 2022

Background and Purpose: In this study we aimed to find the association between neuropsychological performance and body mass index (BMI) in patients with mild cognitive impairment (MCI). In addition, we investigated the effects of the apolipoprotein E (APOE) genotype in the relationship between the BMI and cognition in MCI. Methods: We enrolled a cohort of 3,038 subjects with MCI aged 65-90 from the Clinical Research Center for Dementia of South Korea and a dementia cohort of the Ewha Womans University Mokdong Hospital. MCI patients were classified into three subgroups according to the Asian standard of BMI. We compared cognitive performances between groups by one-way analysis of variance. To investigate the effects of the APOE genotype, we used multivariate linear regression models after adjusting for possible confounders. Results: Even though normal BMI groups were younger, had more females, and had less comorbidities, the higher BMI groups had better cognitive functions. Among subjects with APOE ε4 carriers, there was a positive relationship between the BMI and the memory task alone. Conclusions: Our findings suggested that higher BMI in patients with MCI were associated with better cognitive performance. The effects of the APOE ε4 genotype in the associations between BMI and cognition were distinguishing. Therefore, according to physical status, APOE ε4 genotype-specific strategies in the assessments and treatments may be necessary in elderly patients with MCI.

• 대한치매학회지
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• 제21권4호
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• pp.147-161
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• 2022

Background and Purpose: Subjective cognitive decline (SCD) refers to the self-perception of cognitive decline with normal performance on objective neuropsychological tests. SCD, which is the first help-seeking stage and the last stage before the clinical disease stage, can be considered to be the most appropriate time for prevention and treatment. This study aimed to compare characteristics between the amyloid positive and amyloid negative groups of SCD patients. Methods: A cohort study to identify predictors for the clinical progression to mild cognitive impairment (MCI) or dementia from subjective cognitive decline (CoSCo) study is a multicenter, prospective observational study conducted in the Republic of Korea. In total, 120 people aged 60 years or above who presented with a complaint of persistent cognitive decline were selected, and various risk factors were measured among these participants. Continuous variables were analyzed using the Wilcoxon rank-sum test, and categorical variables were analyzed using the χ² test or Fisher's exact test. Logistic regression models were used to assess the predictors of amyloid positivity. Results: The multivariate logistic regression model indicated that amyloid positivity on PET was related to a lack of hypertension, atrophy of the left temporal lateral and entorhinal cortex, low body mass index, low waist circumference, less body and visceral fat, fast gait speed, and the presence of the apolipoprotein E ε4 allele in amnestic SCD patients. Conclusions: The CoSCo study is still in progress, and the authors aim to identify the risk factors that are related to the progression of MCI or dementia in amnestic SCD patients through a two-year follow-up longitudinal study.

• 한국간담췌외과학회지
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• 제26권3호
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• pp.257-262
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• 2022

Backgrounds/Aims: Middle hepatic vein (MHV) is usually preserved as a part of the right or left hepatectomy in order preserve the venous outflow of remnant liver. The aim of this study was to evaluate if resection of MHV could influence post-resection outcomes of standard right or left hepatectomy. Methods: Patients who underwent standard right or left hepatectomy between January 2015 and December 2019 were included. Anatomical remnant liver volumes were measured retrospectively using the Hermes workstation (Hermes Medical Solutions AB, Stockholm, Sweden). Uni- and multi-variate analyses were performed to assess the difference in outcomes of those with preservation of MHV and those without preservation. Results: A total of 144 patients were included. Right hepatectomy was performed for 114 (79.2%) and left hepatectomy was performed for 30 (20.8%) patients. MHV was resected for 13 (9.0%) in addition to the standard right or left hepatectomy. Median remnant liver volume was significantly higher in the MHV resected group (p < 0.01). There was no significant difference in serum level of bilirubin, international normalized ratio, alanine aminotransferase, creatinine on postoperative day 1, 3, 5, or 10, ≥ grade IIIa complications (p = 0.44), or 90-day mortality (p = 0.41). On multivariable analysis, resection of the MHV did not influence the incidence of post hepatectomy liver failure (p = 0.52). Conclusions: Resection of the MHV at standard right or left hepatectomy did not have a negative impact on postoperative outcomes of patients with adequate remnant liver volume.

• Clinics in Shoulder and Elbow
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• 제27권2호
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• pp.176-182
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• 2024

Background: This study compares the outcomes of Latarjet-Patte procedures (LPs) performed for primary glenohumeral instability in the setting of critical bone loss (LP-BL) versus salvage surgery performed after a failed arthroscopic Bankart repair (LP-FB). Methods: LP's performed by senior author from 2017 to 2021 were separated into cohorts by LP indication. Data abstracted from electronic medical records included demographic information, preoperative clinical scores, radiological imaging, and complications. Postoperative clinical outcome scores collected after a 2-year minimum follow-up included: patient-reported outcomes measurement information system (PROMIS) upper extremity (UE), PROMIS pain interference, PROMIS pain intensity, American Shoulder and Elbow Surgeons (ASES), and visual analog scale pain scores. Results: A total of 47 patients (LP-BL: n=29, LP-FB: n=18) with a mean age of 29 years (range, 15-58 years) were included in this study. Both cohorts achieved good upper extremity functionality without significant differences as indicated by mean PROMIS UE (LP-BL: 52.6±10.0 vs. LP-FB: 54.6±7.6, P=0.442) and ASES score (LP-BL: 89.9±15.7 vs. LP-FB: 91.5±14.4, P=0.712). However, the LP-FB cohort reported lower levels of pain (LP-FB: 0.5±1.1 vs. LP-BL: 1.9±2.7, P=0.020) at their latest follow-up. There were no significant differences in complication rates including re-dislocation between cohorts (LP-BL: 2/29 [6.9%] vs. LP-FB: 2/18 [11.1%], P=0.629). Conclusions: When performed after failed Bankart repair, the LP results in similar postoperative functional outcomes and similar rates of complications and re-dislocations when compared to the primary indication of recurrent glenohumeral instability in the setting of critical bone loss.

• Journal of Ginseng Research
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• 제48권5호
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• pp.454-463
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• 2024

Background: Panax quinquefolius L, widely recognized for its valuable contributions to medicine, has aroused considerable attention globally. Different from the extensive research has been dedicated to the root of P. quinquefolius, its berry has received relatively scant focus. Given its promising medicinal properties, this study was focused on the structural characterizations and anti-inflammatory potential of acidic polysaccharides from the P. quinquefolius berry. Materials and methods: P. quinquefolius berry was extracted with hot water, precipitated by alcohol, separated by DEAE-52-cellulose column to give a series of fractions. One of these fractions was further purified via Sephadex G-200 column to give three fractions. Then, the main fraction named as AGBP-A3 was characterized by methylation analysis, NMR spectroscopy, etc. Its anti-inflammatory activity was assessed by RAW 264.7 cell model, zebrafish model and molecular docking. Results: The main chain comprised of α-L-Rhap, α-D-GalAp and β-D-Galp, while the branch consisted mainly of α-L-Araf, β-D-Glcp, α-D-GalAp, β-D-Galp. The RAW264.7 cell assay results showed that the inhibition rates against IL-6 and IL-1β secretion at the concentration of 625 ng/mL were 24.83 %, 11.84 %, while the inhibition rate against IL-10 secretion was 70.17 % at the concentration of 312 ng/mL. In the zebrafish assay, the migrating neutrophils were significantly reduced in number, and their migration to inflammatory tissues was inhibited. Molecular docking predictions correlated well with the results of the anti-inflammatory assay. Conclusion: The present study demonstrated the structure of acidic polysaccharides of P. quinquefolius berry and their effect on inflammation, providing a reference for screening anti-inflammatory drugs.

• 한국환경보건학회지
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• 제50권4호
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• pp.282-290
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• 2024

Background: In order to evaluate the national effort to improve air quality through the Act on Air Quality Management Regions, an investigation of the current status of air quality in respective regions and the health impact of air pollution should be undertaken. Objectives: This study is a preliminary study on the status of PM_2.5 in the central region of South Korea and its health effects. It can be applied to the evaluation of the effectiveness of the Act on Air Quality Management Regions. Methods: Time series variation of PM_2.5 concentrations in the air quality management region (hereafter referred to as AQMR) and in the non-AQMR area in the central region of South Korea were created. Odds ratios (OR) were calculated based on the survey results of whether the residents of Jeollabuk-do were feeling anxiety caused by air pollution by sex, region, and regional characteristics. Relative risk (RR) values of lung cancer deaths in each city in the AQMR for the central region of South Korea were calculated. Results: During the period from Dec. 2018 to Dec. 2021, the average concentration of PM_2.5 was higher in the AQMR at 26.0 ㎍/m³ compared to 19.5 ㎍/m³ in the non-AQMR. The odds ratio (OR) calculated using data from the Jeonbuk Research Institute (2020) suggested that women were more uncomfortable or anxious about their lives due to air pollutants than were men. The OR evaluation results also showed that in terms of PM_2.5 sensitivity, residents in the non-AQMR were relatively more sensitive than those in the AQMR. The relative risk (RR) was calculated to evaluate the relationship between health hazards (PM_2.5) and diseases (lung cancer). As a result, for super-aged people over 80 years old, compared to the non-AQMR (Muju-gun and Jangsu-gun), the residents in the AQMR (Jeonju, Gunsan, and Iksan) have about twice the relative risk of lung cancer. Conclusions: It is necessary to make efforts to improve residents' health and extend their healthy lives through efforts to reduce air pollutants such as PM_2.5 in areas specially selected as an AQMR.