• Journal of Korean Neurosurgical Society
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• 제30권8호
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• pp.970-975
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• 2001

Objective : By conducing a review of clinical outcomes for patients with aneurysm treated using current microneurosurgical techniques and intensive care unit management, we speculated that grading systems based only on clinical condition or CT finding after admission failed to provide a significant stratification of outcome between individual grades of patients, because these systems did not include the factor for postoperative vasospasm. We hypothesized that postoperative blood flow velocity could have a significant impact on outcome prediction for patients surgically treated for intracranial aneurysms. Methods : We conducted a analysis on patient- and lesion-specific factors that might have been associated with outcome in a series of 55 aneurysm operations performed with measurements of blood-flow velocity with transcranial Doppler ultrasonography(TCD). In the new scale(NS) score system, 1 point is assigned additionally for the case with Hunt and Hess(H-H)/World Federation of Neurological Surgeons(WFNS) Grade IV or V, Fisher Scale(FS) score 3 or 4, aneurysm size greater than 10mm, patient age older than 60 years, blood-flow velocity higher than 120cm/sec, and posterior circulation lesion. By adding the total points, a 6-point scale score(score 0-6) is obtained. Results : Age of patient, size of aneurysm, clinical condition(H-H grade and WFNS), FS score, and blood flow velocity(TCD 1day after operation) were independently and strongly associated with long-term outcome. When NS scores were applied to 55 patients with at least 6 months follow-up, the correlation of individual scores with outcome was strongly validated the retrospective findings. Conclusion : It was speculated that TCD could be used to assess postoperative vasospasm and to monitor noninvasively the patients with aneurysmal SAH. This NS score system is easy to apply, divide patients into groups with different outcome, and is comprehensive, allowing for more accurate prediction of surgical outcome.

• 한국산학기술학회논문지
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• 제20권11호
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• pp.121-129
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• 2019

본 연구의 목적은 비디오 흉강경을 이용한 폐기포 절제술을 받은 기흉 환자에게 계획된 퇴원 간호 중재 지침을 개발하여 적용한 후 약물복용 이행도, 치료 지시 이행도, 질병에 대한 지식과 간호 만족도에 미치는 효과를 확인하기 위한 것이다. 서울 소재 K 종합병원에서 비디오 흉강경을 이용한 폐기포 절제술을 받은 기흉 환자를 대상으로 자료수집 기간은 2010년 3월 16일부터 12월 31일까지이며, 실험군 29명, 대조군 30명이 연구 대상자로 참여하였다. 계획된 퇴원 간호 중재 지침은 포괄적인 문헌 고찰과 임상 경험을 바탕으로 개발되었다. 계획된 퇴원 간호 중재는 흉부외과 간호사가 3회 실시하였으며 1회 교육시간은 약 30~40분 정도가 소요되었다. 연구결과 계획된 퇴원 간호 중재 제공 후 치료 지시 이행도는 유의한 차이가 없었다. 그러나 복약순응도(t=-2.05, p=.044), 약알 세기 약물 이행도(t=-2.61, p=.011), 질병에 대한 지식(t=-4.39, p=.001), 간호 만족도(t=-4.13, p=.001)는 유의한 차이가 있었다. 본 연구에서 계획된 퇴원 간호 중재의 제공은 기흉 진단으로 수술을 시행 받은 환자를 위한 임상에서 적용 가능한 효과적인 간호 중재임을 확인하였다. 합병증이나 재발과 같은 장기적 영향을 평가하기 위한 종단적 연구가 필요하다.

• 한국산학기술학회논문지
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• 제16권1호
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• pp.418-428
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• 2015

본 연구는 뇌졸중에 영향을 미치는 요인과 매개효과를 파악하여 뇌졸중 질환자의 올바른 건강행태를 유도하고 이에 따른 뇌졸중 질환 예방의 기초자료를 제공하고자 하였다. 자료는 국민건강영양조사 4기 및 5기 데이터를 이용하였으며 분석방법은 빈도분석과 다중로지스틱회귀분석 및 구조방정식 분석을 실시하였다. 분석결과 남자의 경우 뇌졸중에 영향을 미치는 인구사회학적 특성으로는 연령, 직업, 주관적 건강상태, 음주, 고혈압과 당뇨병 유무 변수이었고, 여자의 경우는 연령, 직업, 주관적 건강상태, 스트레스 정도, 고혈압 유무이었다. 건강행태가 뇌졸중 여부에 영향을 미치는 과정에서 선행질환은 부분매개 모형과 완전매개 모형의 ${\chi}^2$ 값의 차이가 5.80으로 통계적으로 유의하여(p<0.01), 부분매개 효과가 있는 것으로 분석되었다. 뇌졸중 예방을 위해 잘못된 건강행태를 변화시키기 위한 예방적 건강 교육과 건강관리 네트워크를 강화할 수 있는 정책이 필요하며, 선행질환이 있는 경우 건강상태에 대한 장기적인 진단 및 지속적인 생활습관개선이 필요하다.

• 대한한방내과학회지
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• 제35권1호
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• pp.12-23
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• 2014

Objectives : The purpose of this study was to report possibility of acupuncture or moxibustion for the treatment of Parkinson's disease (PD) by reviewing literature about its effectiveness. Methods : In this review, PubMed, SCOPUS, Science Direct and CINAHL of EBSCOhost were used to search medical journals, using keywords "Parkinson's disease and acupuncture" and "Parkinson's disease and moxibustion". The search range included randomized controlled trials (RCT) about Parkinson's disease combined with another disease and other treatments with acupuncture or moxibustion. Non-randomized controlled trial (nRCT), case study, animal experiment, human experiment, review, survey, essay, letter, and protocol for review were excluded. Results : From 311 studies, 111 were selected during the title and the screening. Finally, 16 RCTs (15 for acupuncture research and one for moxibustion) were included in this review, after scanning and matching the inclusion and exclusion criteria. The number of patients varied between 5 and 88. A total of 12 studies using electroacupuncture (EA) were classified into acupuncture studies. The body acupuncture studies numbered 4, scalp acupuncture 4, body and scarp acupuncture mixed studies 4, and bee venom, ear and abdomen acupuncture were each one study. In evaluation methods, total effective rate method was used in 9 studies, the Unified Parkinson's Disease Rating Scale (UPDRS) was used in 8, and the Webster score in 2. In addition, the Berg balance scale (BBS), 30 m walking time, steps to walk 30 m, PD motor function score, and Motor Performance Series by Schoppe (MLS) method were used for evaluation. In 15 of the 16 studies, the verum acupuncture group showed significant improvement compared with the control. In 9 studies using total effective rate method, the effective rate was reported as 80.0-97.3% in verum acupuncture groups and 52.6-86.4% in controls. Conclusions : Acupuncture may be a plausible alternative method to care for the long term symptoms and treat movement impairment of Parkinson's disease. However, to confirm this result, high quality studies including randomized, placebo-controlled double-blind trials are warranted.

• 종양간호연구
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• 제5권1호
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• pp.52-62
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• 2005

Purpose: This study was to analyze the research trend centering on the theses to cancer nursing research in digestive system released in Korea. Method: The researcher collected the academic degrees and theses published on the book of the academic soceity from January 1993 to August, 2004, and examined 38 domestic papers of cancer nursing research in digestive system. Results: 1) As for the subject, the results were : patients with stomach cancer 25(66%), colon cancer 4(11%), rectal cancer 3(8%), and others(taxi drivers 2, family of cancer patents. 2) As for the research designs the result were : quantitative studies were 33(87%), and qualitative studies were 9(23%). 3) As for key concepts of survey, the results were : life patterns of patients with rectal cancer, oral intake of stomach cancer patients, fatigue of stomach cancer patients undergoing chemotherapy, nursing needs when discharging from hospital after operation with gastrectomy, and so on. 4) As for the comparative studies, the results were : risk factors between colorectal patients and general population, early symptom and risk factors between stomach cancer patients and general population, and risk factors between stomach cancer and patients with gastritis. 5) As for main concepts of correlational studies, the results were : quality of life, health belief, fatigue, health promotion behavior, social support, straitanxiety. 6) The treatment of experimental research, the results were : information services, arc reflex massage, acupressure, educational program for discharge, 7)As for the qualitative studies, in terms of subjects, stomach cancer patients were 2, spouse of patients with stomach cancer was 1, rectal cancer patients were 2. In the theme of the qualitative studies, the results were: experience of family of patients with stomach cancer, experience of long term survival of patients with rectal cancer, experience of disease process of rectal cancer patiens. 8) As for the used instrument in studies, the results were : Strait-anxiety Scale by Spielberger, Nausea and Vomiting Scale by Rhodes, Social support by Tae and Lee, Health belief by Champion, Becker, and Moon. QOL by NCCN, Roh, Pdilla, Kwon, Revised Fatigue Scale by Piper, Health Locus of Control by Wallston and Wallston, Uncertainty Scale by Mishel. Conclusions: More research needs to be encouraged in various subject of cancer patients in digestive system. More nonexperimental and experimental researches should be conducted for the establishment of the basis of practical and theoretical framework and the providing good quality of care for cancer patients.

• Clinical and Experimental Pediatrics
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• 제53권6호
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• pp.694-700
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• 2010

Purpose: To assess the validity of individual and combined prognostic effects of severe bronchopulmonary dysplasia (BPD), brain injury, retinopathy of prematurity (ROP), and parenteral nutrition associated cholestasis(PNAC). Methods: We retrospectively analyzed the medical records of 80 extremely low birthweight (ELBW) infants admitted to the neonatal intensive care unit (NICU) of the Severance Children's Hospital, and who survived to a postmenstrual age of 36 weeks. We analyzed the relationship between 4 neonatal morbidities (severe BPD, severe brain injury, severe ROP, and severe PNAC) and poor outcome. Poor outcome indicated death after a postmenstrual age of 36 weeks or survival with neurosensory impairment (cerebral palsy, delayed development, hearing loss, or blindness) between 18 and 24 months of corrected age. Results: Each neonatal morbidity correlated with poor outcome on univariate analysis. Multiple logistic regression analysis revealed that the odds ratios (OR) were 4.9 (95% confidence interval [CI], 1.0-22.6; $P$=0.044) for severe BPD, 13.2 (3.0-57.3; $P$<.001) for severe brain injury, 5.3 (1.6-18.1; $P$=0.007) for severe ROP, and 3.4 (0.5-22.7; $P$=0.215) for severe PNAC. Severe BPD, brain injury, and ROP were significantly correlated with poor outcome, but not severe PNAC. By increasing the morbidity count, the rate of poor outcome was significantly increased (OR 5.2; 95% CI, 2.2-11.9; $P$<.001). In infants free of the above-mentioned morbidities, the rate of poor outcome was 9%, while the corresponding rates in infants with 1, 2, and more than 3 neonatal morbidities were 46%, 69%, and 100%, respectively. Conclusion: In ELBW infants 3 common neonatal mornidifies, severe BPD, brain injury and ROP, strongly predicts the risk of poor outcome.

• Journal of Pharmaceutical Investigation
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• 제33권2호
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• pp.113-120
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• 2003

Drug interactions with food, on occasion, lead to serious nutritional and functional changes in the body as well as alternations of pharmacological effect. It, therefore, should be necessary to take drug interactions with food into consideration for effective and safe therapeutics. Diabetes mellitus is a heterogeneous group of disorders characterized by abnormal glucose homeostasis, resulting in hyperglycemia, and is associated with increased risk of micovascular, macrovascular, and neuropathic complications. However, the precise mechanism of diabetes mellitus remains unclear. Three basic objectives in the care of diabetic patients are maintaining optimal nutrition, avoiding hypo- or hyperglycemia and preventing complications. The purpose of this study was to investigate thε effect of Laminaria japonica diet on the absorption, distribution, metabolism and excretion of glipizide which are frequently used in the treatment of diabetes. Diabetic rats induced by streptozotocin were employed in this study. Blood concentrations of oral hypoglycemic agents were measured by HPLC and resultant pharmacokinetic parameters were calculated by RSTRIP. The mechanisms of drug interaction with food were evaluated on the basis of pharmacokinetic parameters such as $k_{a},\;t_{1/2},\;C_{max},\;t_{max}$ and AUC. Administration of glipizide in normal rats treated with Laminaria japonica diet showed significant increase in AUC, $k_{a},\;t_{1/2},\;t_{max}$ and decrease in $C_{max}$, compared to those without Laminaria japonica diet. This might result from adsorption of glipizide on components of Laminaria japonica, causing delayed absorption. Administration of glipizide in diabetic rats treated with Laminaria japonica diet showed significant increase in $t_{1/2}\;and\;t_{max}$, and decrease in $C_{max}$, compared to those without Laminaria japonica diet. This might also result from adsorption of glipizide on components of Laminaria japonica, causing delayed absorption and flattened blood concentration of glipizide. The oral glucose test showed that Laminaria japonica diet could lower blood glucose level probably through either inhibiting the activity of disaccharidases, intestinal digestive enzymes, or delaying the absorption of glucose. More studies should be followed to fully understand pharmacokinetic changes of glipizide caused by long-term Laminaria japonica diet.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2505-2510
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• 2014

Background: The standard radiotherapy (RT) fractionation practiced in India and worldwide is 50Gy in 25 fractions over 5 weeks to the chest wall or whole breast followed by tumour bed boost in case of breast conservation (BCS). A body of validated data exists regarding hypofractionation in breast cancer. We here report initial results for 135 patients treated at our center with the START-B type of fractionation. Materials and Methods: From May 2011 till July 2012, women with all stages of breast cancer (excluding metastatic), who had undergone BCS or mastectomy were planned for 40Gy in 15 fractions over 3weeks to chest wall/whole breast and supraclavicular fossa (where indicated) followed by tumour bed boost in BCS patients. Planning was done using Casebow's technique. The primary end point was to assess the acute toxicity and the cosmetic outcomes. Using cosmetic scales; patients were assessed during radiotherapy and at subsequent follow up visits with the radiation oncologist. Results: Of the 135 patients, 62 had undergone BCS and 73 mastectomy. Median age of the population was 52 years. Some 80% were T1&T2 tumours in BCS whereas most patients in mastectomy group were T3&T4 tumours (60%). 45% were node negative in BCS group whilst it was 23% in the mastectomy group. Average NPI scores were 3.9 and 4.9, respectively. Most frequently reported histopathology report was infiltrating ductal carcinoma (87%), grade III being most common (58%), and 69% were ER positive tumours, and 30% were Her 2 Neu positive. Triple negative tumours accounted for 13% and their mean age was young (43 yrs.) The maximum acute skin toxicity at the end of treatment was Grade 1 in 94% of the mastectomy grouppatients and 71% in BCS patients. Grade 2 toxicity was 6% in mast group and 23% in BCS group. Grade 3 was 6% in BCS group, no grade 3 toxicity in mastectomy patients and there was no grade 4 skin toxicity in any case. Post RT at 1 month; 39% of BCS patients had persisting Grade I skin reaction which was only 2% in mastectomy patients. At 3 months post RT, 18% patients had persisting hyperpigmentation. At 6 months 8% patients had persisting erythema in the BCS group only. Some 3% BCS and 8% mastectomy patients had lymph edema till the date of evaluation. Cosmetic outcome in BCS patients remained good to excellent 6 months post surgery and radiotherapy. 1 patient of BCS and 3 patients of mast had developed metastatic disease at the time of evaluation. Conclusions: Hypofractionated RT is well tolerated in Indian population with reduced acute skin toxicity and good cosmetic outcome. Regimens such as these should be encouraged in other centers to increase machine output time. The study is on-going to assess long term results.

• 정신신체의학
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• 제14권1호
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• pp.47-52
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• 2006

연구목적 : 우울증상은 여성에게 흔하며 적절한 혈당 조절은 당뇨병 치료에 있어 매우 중요하다. 당뇨병 환자에서 우울증은 상대적으로 흔히 발견된다. 그러나 아직 우울증과 혈당조절의 상호관계에 대해서는 명확히 밝혀진 바가 없다. 본 연구는 한국 여성 당뇨병 환자의 혈당 조절과 우울증상 사이의 상호관계를 평가하려 한다. 방법: 여성 당뇨병 환자 216명을 포함한 연구 대상자 4,567명을 대상으로 Beck 우울 척도와 장기 혈당조절 지표인 $HbA_{1c}$ 수치를 측정하여 우울증과 혈당조절간의 연관성을 분석하였다. 공복 혈당 수치와 비만도 지표인 체질량지수도 함께 측정하여 분석하였다. 임상적으로 우울증을 의심할 수 있는 분할점은 16점으로 하였다. 결과: 당뇨병 보유 여성군에서 우울 여성군이 유의미하게 많았고(P<0.001), Beck우울 척도 평균치도 통계적으로 유의하게 높았다(p<0.001). 우울 여성군에서 $HbA_{1c}$, 평균치 (p<0.01)와 공복 혈당 평균치 (p<0.05)가 유의미하게 높았고, 혈당 조절의 장애가 심할 수록 우울 여성군의 비율이 증가하는 경향을 보였다(p=0.001). 결론: 본 연구는 한국 여성에서 우울증상과 당뇨병 및 혈당 조절간 연관성이 존재함을 지지하는 결과를 보였다. 향후 종적 연구를 통한 우울장애와 당뇨병간 상호작용에 대한 원인-결과론적 이해가 요구된다.

• 기술혁신학회지
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• 제20권1호
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• pp.153-174
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• 2017

본고는 다양한 이유로 단절된 남북관계를 회복하기 위한 과학기술의 역할과 이를 추진하기 위한 전략적 접근을 중심으로 남북과학기술협력에 대해서 탐색해 보고자 하였다. 이를 위해 상대적으로 정보가 제한적이고 정보의 신뢰성이나 정확성을 확보하기 어려운 북한연구에 대한 제약요인을 극복하고자 통합연구방법을 적용하였으며, 설문조사와 FGI조사 그리고 전문가 회의 등을 활용하여 남북협력에 대한 추진전략과 협력과제를 도출하였다. 설문조사와 FGI결과를 종합한 결과 향후 협력분야로 농 축 임업분야, 전기 에너지 분야, 정보통신분야, 보건 의약분야로 제시되었다. 그러나 이러한 협력분야보다 중요한 것은 앞으로 어떻게 남북과학 기술협력에 접근할 것인가라고 할 수 있다. 우선 과거와 같이 정부중심의 단기적 접근방법에서 벗어나, 남북과학기술협력의 지속성을 유지하기 위해 제3국이나 INGOs를 포함한 다자협력이 추진되어야 할 것이다. 또한 북한과의 과학기술협력을 추진할 때, 한 분야나 우선과제를 선정하더라도 그것이 북한이 직면한 다른 문제와 연계된다는 점에서 포괄적인 프로그램 기획이 필요하다. 마지막으로 북한과의 정보 비대칭문제를 해결하기 위한 기반연구는 지속적으로 진행되어야 하며, 남북과학기술협력에 대한 지속적인 연구와 관련 전문가를 양성하는 것이 추진되어야 할 것이다. 본고는 북한에 대한 연구제약을 보완하고자 통합연구방법을 활용하였음에도 여전히 결론을 도출하기 위한 관련 자료가 부족하다는 근원적인 한계를 지닌다. 이와 더불어 결과로 제시한 협력분야나 추진전략도 북한의 직접적인 입장이나 의견을 수렴한 것이 아니라는 점에서 한계를 갖는다. 이러한 한계는 지속적으로 북한 관련 전문정보를 확보하고 관련연구를 축적함으로써 극복해 나가야 할 것이다.