• 대한한방내과학회지
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• 제44권3호
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• pp.387-401
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• 2023

Objective: This study was conducted to investigate the preventive effect of herbal medicines on restenosis after percutaneous coronary intervention (PCI) by reviewing randomized controlled trials (RCTs). Methods: RCTs were searched for herbal medicine treatment after PCI using eight online databases (PubMed, CNKI, Wanfang, J-STAGE, OASIS, ScienceON, KTKP, and KISS). Studies that confirmed restenosis through coronary angiography at follow-up were selected according to the inclusion and exclusion criteria. The primary outcome was the restenosis rate, and the secondary outcome was the angina recurrence rate. Data were extracted from the final selected studies according to the research methodology and then analyzed with Review Manager 5.4.1. Study quality was assessed using Cochrane's risk-of-bias (RoB) tool. Results: Of the 252 papers obtained through the primary search, nine studies that met the selection criteria were finally selected. In these nine studies, herbal medicine combined with western medicine was used for the experimental group, and western medicine treatment was used alone for the control group. The meta-analysis result revealed that the restenosis rate and angina recurrence rate were significantly lower in the experimental group than in the control group (RR=0.34, 95% CI: 0.22-0.53, p<0.00001, I²=0% and RR=0.47, 95% CI: 0.29-0.78, p=0.004, I²=0%, respectively). Furthermore, the quality of studies assessed by Cochrane's RoB was low. Conclusions: This study showed that the combined treatment of herbal medicine and western medicine was effective in preventing restenosis and angina after PCI. As the number of papers included in this study was small, a large number of high-quality clinical studies should be considered in the future.

• 종양간호연구
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• 제1권1호
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• pp.5-17
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• 2001

It is known that aggressive treatment of chemotherapy, radiation and autogenous stem cell transplantation is effective for prevention of recurrence in the high-risk breast cancer patients. It was assumed that this procedure takes a longer time and decreases the quality of life more than the standard adjuvant chemotherapy. However, there are few studies comparing the quality of life of patients having bone marrow transplantation and adjuvant chemotherapy. Most of the studies were focused on the quality of life in one point of time, such as only during the early treatment stage, only overall quality of life rather than specific dimensions of the quality of life. The purposes of this study are 1) to identify the difference of the quality of life between two different treatment patterns, adjuvant chemotherapy and autogenous stem cell transplantation: 2) to identify the mostly affected dimension and the periods of time affected by the treatment patterns; and 3) to identify the trajectories of quality of life in each treatment pattern. This is a time series design that measures 4 different points of times. At the beginning of the study, 19 patients were placed in the chemotherapy group and 12 in the group of auto-peripheral blood stem cell transplantation. The inclusion criterion was the advanced disease stage of 3 or over with metastasis of more than 5 lymph nodes. The exclusion criteria were 1) anyone who has metastasis to other organ; 2) anyone who had psychological problems. Ferrell's Quality of Life Scale for Cancer Survivors 41 items on a 10 point scale was used. The QOL-CS includes 4 dimensions, which were labeled physical, psychological, social, and spiritual. The Cronbach‘s alpha of this scale was 0.89. Mann-Whitney U test and Friedman test were used to test each hypothesis. In comparison of the two groups, the quality of life of the bone marrow transplantation group dramatically increased at the 3rd and 6th month after transplantation, while the chemotherapy groups results stayed lower. The most affected dimension of the quality of life at the end of the treatment was the physical dimension. However, it and increased along with time, while the psychological dimension values remained low over the long-term period. Intensive nursing care is needed during the entire period of chemotherapy in all patients having chemotherapy, and is also required for right after cases of bone marrow transplantation.

• 대한임상검사과학회지
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• 제50권1호
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• pp.44-53
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• 2018

WHtR과 ABSI는 기존 비만지표의 단점을 보완하기 위해 개발된 복부비만을 반영한 지표이다. 이 연구는 성인남녀를 대상으로 ABSI와 WHtR의 인슐린저항성과 대사증후군에 대한 예측능력을 허리둘레, WHR과 비교하여 알아보고자 하였다. 이 연구는 횡단면 조사에 기초하여 2017년 1월부터 2017년 9월까지 경기지역 일개 종합병원에서 건강진단을 받은 20세 이상 4,395명을 대상으로 하였다. 대사증후군은 AHA/NHLBI (American Heart Association/National Heart, Lung, and Blood Institute)의 진단기준에 따라 정의하였다. 인슐린저항성은 HOMA-IR값이 3.0 이상인 경우 인슐린저항성으로 판정하였다. WHtR 및 ABSI와 대사적 위험요인간에 상관계수를 비교한 결과 남성과 여성 모두에서 ABSI보다 WHtR과 대사적 위험요인간의 상관성이 더 높았다. 대사증후군을 예측하기 위한 WHtR의 AUC 값은 0.849, ABSI의 AUC 값은 0.676 이었다(각각 p<0.001). 인슐린저항성을 예측하기 위한 WHtR의 AUC 값은 0.818, ABSI의 AUC 값은 0.641 이었다(각각 p<0.001). 결론적으로, 한국인을 대상으로 ABSI가 허리둘레, WHR, WHtR 지표보다 인슐린저항성과 대사증후군에 대한 예측력이 낮은 지표였으며, WHtR은 인슐린저항성 및 대사증후군 위험 예측력이 가장 높은 지표임을 확인하였다.

• 한국임상약학회지
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• 제27권2호
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• pp.92-98
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• 2017

Background: Nebulized colistimethate is increasingly used, because there are problems such as renal dysfunction and low distribution within the lungs when colistimethate is administered intravenously. This study was designed to compare and analyze the changes in renal function by of nebulized colistimethate treatment for its safe administration. Methods: This study retrospectively reviewed the electronic medical records of adult patients above 19 years old, receiving only the nebulized colistimethate at least 4 days in Yonsei university health system from Nov 2014 to Aug 2015. Acute kidney injury (AKI) was determined by using the RIFLE criteria (Risk, Injury, Failure, Loss and End-stage renal disease) according to serum creatinine (SCr) levels before and after use of nebulized colistimethate. Results: 48 patients were included our study and their SCr increased significantly after nebulized colistimethate treatment ($SCr_0$ vs. $SCr_1$; $0.85{\pm}0.80$ vs. $1.00{\pm}0.82mg/dL$, n=48, p<0.001), but the changes were in normal range according to the standards at Yonsei university health $system^a$. Among 48 patients, 38 patients were in the non-AKI group (79.2%), and 10 patients developed AKI (20.8%). Within the AKI group, 2 patients were in the Injury group (20%) and the other 8 in the Risk group (80%). Conclusion: There was no significant difference in age, dosage and duration of treatment between AKI group and non-AKI group (p>0.05). The study has a significance in that it reviewed the safety of nebulized colistimethate only treatment to national patients, analyzing its nephrotoxicity. It has confirmed that nebulized colistimethate is a safer method than intravenous injection, and requires to establish a guideline for the use of nebulized colistimethate in further studies with broader patient groups. $^a$ : SCr Male 0.68-1.19 mg/dL, Female 0.49-0.91 mg/dL.

• 한국농촌간호학회지
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• 제7권1호
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• pp.5-17
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• 2012

Purpose: The objectives of this study were to investigate the prevalence of the metabolic syndrome (MetS) and to identify associated factors with MetS among rural residents. Methods: Data were collected from 1,196 subjects over aged 30 years by a self-administered questionnaire, physical measurement, and blood test in a rural area. The prevalence of MetS was determined by the criteria of the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) and 2005 the Korean society for the study of obesity. Results: The prevalence of MetS was 40.5% for men, 49.2% for women. The prevalence of risk factors of MetS was 57.4% for elevated blood pressure, 49.0% for low HDL-cholesterol, and 48.6% for abdominal obesity. Unemployment and higher Body mass index (BMI) were associated factors for MetS regardless of gender. And higher age and physical inactivity in women only increased the odds of the MetS. Especially, BMI was a strong risk factor of MetS in both men and women. Conclusion: The prevalence of metabolic syndrome was higher in a rural area. Therefore, health care providers should develop lifestyle modification program to increase physical activity level and to prevent the obesity among rural residents in order to decrease the prevalence of MetS.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권5호
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• pp.379-396
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• 2021

Background: Trigeminal neuralgia (TN) is characterized by brief, unilateral, sharp, stabbing, and shooting pain of the fifth cranial nerve. The objective of this systematic review with meta-analysis was to determine the effect of medications compared to placebo in adult patients with TN. Methods: Review authors identified randomized placebo-controlled trials (RCTs) from PubMed, Web of Science, Cochrane, and EMBASE up to February 2021. We assessed the inclusion and exclusion criteria as well as the risk of bias of the studies based on the Cochrane Handbook. A total of 324 unduplicated references were scanned independently and reduced to eight relevant RCTs, with 89 patients included. Medications investigated included oral carbamazepine, subcutaneous sumatriptan, lidocaine (intranasal, 8% spray on the oral mucosa or intravenous), buprenorphine (ganglionic local opioid analgesia), and oral Nav1.7, a selective sodium channel blocker. Results: Meta-analyses showed that overall patients receiving lidocaine reported a significantly lower post-treatment intensity of pain -3.8 points on a 0-10 scale (95% Cl = -4.653 to -2.873; P < 0.001). Patients who received lidocaine were 8.62 times more likely to have pain improvement than patients on placebo (P < 0.001). In one RCT, patients receiving oral carbamazepine showed a significant improvement in pain intensity of -32% compared to the placebo (P < 0.001). In one trial, patients receiving 3 mg subcutaneous sumatriptan had a significantly lower intensity of pain on average -6.1 points on a scale of 0-10 compared to placebo (P < 0.001) and a significant improvement in pain intensity of -75% compared to the improvement in the placebo group (P < 0.001). Patients who received subcutaneous sumatriptan were 10 times more likely to have pain improvement than those who received placebo (P = 0.001) in one study. Due to the unclear/high risk of bias and small sample size, the quality of the evidence for lidocaine in the treatment of TN was low. Conclusion: Further studies are needed for carbamazepine, sumatriptan, buprenorphine, and oral Nav1.7 sodium channel blockers, as only one study reported outcomes.

• Korean Journal of Radiology
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• 제22권3호
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• pp.344-353
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• 2021

Objective: The mitotic count of gastrointestinal stromal tumors (GIST) is closely associated with the risk of planting and metastasis. The purpose of this study was to develop a predictive model for the mitotic index of local primary GIST, based on deep learning algorithm. Materials and Methods: Abdominal contrast-enhanced CT images of 148 pathologically confirmed GIST cases were retrospectively collected for the development of a deep learning classification algorithm. The areas of GIST masses on the CT images were retrospectively labelled by an experienced radiologist. The postoperative pathological mitotic count was considered as the gold standard (high mitotic count, > 5/50 high-power fields [HPFs]; low mitotic count, ≤ 5/50 HPFs). A binary classification model was trained on the basis of the VGG16 convolutional neural network, using the CT images with the training set (n = 108), validation set (n = 20), and the test set (n = 20). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated at both, the image level and the patient level. The receiver operating characteristic curves were generated on the basis of the model prediction results and the area under curves (AUCs) were calculated. The risk categories of the tumors were predicted according to the Armed Forces Institute of Pathology criteria. Results: At the image level, the classification prediction results of the mitotic counts in the test cohort were as follows: sensitivity 85.7% (95% confidence interval [CI]: 0.834-0.877), specificity 67.5% (95% CI: 0.636-0.712), PPV 82.1% (95% CI: 0.797-0.843), NPV 73.0% (95% CI: 0.691-0.766), and AUC 0.771 (95% CI: 0.750-0.791). At the patient level, the classification prediction results in the test cohort were as follows: sensitivity 90.0% (95% CI: 0.541-0.995), specificity 70.0% (95% CI: 0.354-0.919), PPV 75.0% (95% CI: 0.428-0.933), NPV 87.5% (95% CI: 0.467-0.993), and AUC 0.800 (95% CI: 0.563-0.943). Conclusion: We developed and preliminarily verified the GIST mitotic count binary prediction model, based on the VGG convolutional neural network. The model displayed a good predictive performance.

• Clinical and Experimental Pediatrics
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• 제52권8호
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• pp.898-903
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• 2009

목 적 : 생후 3개월 미만의 발열이 있는 환아에서는 뚜렷한 임상증상이 없어 세균감염을 감별하기가 어려워 거의 대부분 입원하여 항생제 치료를 하면서 패혈증에 대한 전반적인 검사를 받게 된다. 그래서 저자들은 3개월 미만의 발열을 주소로 내원한 영아들 중, 국소 증상이나 징후가 없는 환아들을 대상으로 하여 내원 당시의 다양한 임상 양상과 외래 및 응급실에서 응급 검사 항목들을 이용하여, 입원 이후 세균 감염으로 밝혀지거나 불량한 임상 경과에 영향을 주는 인자들을 예측할 수 있는가를 알아보고자 하였다. 방 법 : 2006년 2월부터 2008년 12월까지 액와 체온 $38^{\circ}C$ 이상의 발열을 주소로 동국대학교 경주병원에 입원한 3개월 미만의 영아 167명을 대상으로 하였다. 각 환아의 입원 기록을 후향적으로 검토하여 명백한 세균 감염이나 심한 감염 질환으로의 진단 여부에 따라 고위험군과 저위험군으로 분류하였고, 각 환아의 내원 당시 임상 증상, 병력, 진찰 소견, 응급 검사 결과와 입원 후의 임상 경과 및 검사 결과, 주 진단 등을 조사하였다. 결 과 : 진단 기준에 따라 대상 환아 167명 중 고위험군 77명, 저위험군 90명으로 분류되었고, 남아가 고위험군에서 유의하게 높은 것으로 확인되었다. 검사 소견으로는 적혈구 침강 속도, C 반응단백의 정량 검사가 두 군의 유의한 차이를 보였다. 그러나 다변량 분석 결과 남아인 경우 2.9배, 적혈구 침강 속도는 11 mm/시간 이상에서 3.5배 더 유의하게 나타났다. 결 론 : 3개월 미만의 발열을 주소로 내원하는 환자에게 세균감염이 있는 특징적인 임상증상과 응급 검사를 찾지 못하였으나, 세균감염이 남아에서 특히 많았으며, 적혈구 침강속도가 응급 검사로 가능한 의료 기관에서는 중증 세균 감염을 예측하는데 사용할 수 있을 것이다.

• 한국화재소방학회논문지
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• 제18권1호
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• pp.54-66
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• 2004

본 논문은 도시 가스 지하배관의 위험관리체계를 유지하는데 필요한 요소들 중 배관의 위험성평가에 적절한 기법을 제안하고, 그 평가결과에 근거하여 가장 비용-효과가 큰 배관 유지관리방안을 찾아내는데 그 목적이 있다. 본 연구에서 제안된 지하배관의 위험성서열화의 접근방법은 세 가지 측면에서 행하여졌는데, 첫째는 RBI(Risk Based Inspection)으로서 배관의 위험도에 영향을 주는 주변인구조건, 관의 크기 및 두께. 사용시간 등을 기준으로 일차적 평가를 함으로서 노출위험도의 높고 낮음을 정성적으로 평가하였고, 둘째는 Scoring System으로서 매설된 배관의 환경적인 요소에 기초하여 점수화하여 구체적으로 위험도를 서열화 하였다. 셋째로는 THOMAS 이론으로부터 대상배관의 누출빈도를 정량화 하였다. 그 결과 도시 가스 대상배관의 노출위험도는 대략 중간이상의 값을 갖는 것으로 나타났으며, 제안된 SPC기법을 적용하여 위험성을 평가한 결과, 대상배관의 부식위험성 점수 값이 허용범위(30-70)에 골고루 분포하는 것으로 보아 설정된 평가기준이 실제배관에 대해 상대적인 부식위험성을 잘 서열화 됨을 알 수 있었다. 또한 THOMAS모델을 적용한 평가결과로서의 Score값은 배관의 길이를 포함한 여러 치수들에 무관한 환경요인에 관련된 값인 반면, 기본누출빈도는 배관의 길이를 포함해서 다른 치수들에 비례함을 보여주고 있다. 그 결과 점수 값이 상대적으로 적은 배관구간(상대적으로 위험성이 낮은 구간)도 배관길이가 훨씬 더 크다면 누출발생빈도가 더 높은 값을 갖는다는 것을 알 수 있었다. 또한 대상 파이프라인의 허용위험수용범위는 전체 누출 빈도 값인 최대 1.00E-01/yr로부터 최소 2.50E-02의 영역을 나타내고 있어 이에 상응되는 높은 Consequence를 수용 가능한 영역으로 낮추는 조치가 필요함을 보여주고 있고, 종합파손확률에 대해 사용시간을 회기 분석법(Regression Analysis)으로 예측한 결과, 이에 대한 방정식을 유추할 수 있었고, 그에 대한 결과가 대상 파이프라인의 사용 년 수인 11년에서 13년으로 나타나 실제 대상배관들의 연령과 거의 일치함을 알 수 있었다. 따라서 본 연구에서 제안된 위험성 서열화 접근방법은 실제적으로 지하배관의 유지관리를 하는데 있어서 매우 효율적으로 적용될 수 있을 것으로 사료된다.

• 한국산림과학회지
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• 제107권4호
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• pp.361-377
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• 2018

본 연구는 환경부의 멸종위기 야생생물의 지정이 지역 적색목록 방법을 올바르게 적용하였는지 보고서 내용을 전반적으로 검토하였다. IUCN의 지역 적색 평가에서는 평가 항목중 적용불가(NA)라는 범주가 존재한다. 해당 범주를 통해 전세계나 동아시아 전체에 매우 넓게 분포하는 종은 평가에서 제외하도록 명시하고 있다. 환경부에서 제시한 평가 결과물중 관속식물 377종이 언급되는데 이중 238종(63.1%)이 적용불가(NA)에 해당되며 일부는 분류학적 실체에 대한 논란의 여지가 되는 분류군(waiting)으로 13종(3.4%)이 확인된다. 환경부의 지역평가에 포함된 목록중 전 세계 평가 대상이 되는 소위 '진정 멸종위기' 분류군은 21종(9.3%)으로 매우 적었으며 앞으로 지역평가 시도가 가능한 분류군은 103종(27.3%)로 확인된다. 환경부의 멸종위기 야생생물인 관속식물 전체 목록중 66.6%는 지역 적색 평가로 부적절하거나 유보된다. 환경부의 종 목록과 평가의 문제점은 집단이 사라지는 '절멸'과 종이 사라지는 '멸종'의 용어상의 오용과 지역 적색평가의 그릇된 해석으로 혼란을 자초하고 있어 실제 IUCN의 지역 평가기준을 준용했다고 볼 수 없으며, 환경부에서 제시한 평가 조사방법도 적색목록을 평가하기 위한 자료 수집 방법론으로 보기가 어렵다. 지역 적색이라는 평가도 남한이라는 좁은 국가적 시각보다는 분포와 생물상을 고려하여 한반도와 접경지역인 러시아, 중국 대륙, 그리고 일본, 대만의 자료도 적극 수용한 새로운 '지역'의 개념 도입이 필요하다. 환경부의 올바른 지역 적색 평가를 위해서는 정확한 학명을 사용함과 동시에 주관적 잣대가 아닌 IUCN 지역 적색의 기준을 사용할 필요가 있다.