• 한국산학기술학회논문지
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• 제12권11호
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• pp.5019-5026
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• 2011

본 연구는 만성 편마비 환자의 교감신경 활동 강화가 근 긴장도 및 중추신경 흥분성 변화에 미치는 영향을 알아보기 위해 시행하였다. 연구기간은 2009년 10월 12일부터 12월 4일까지 실시하였으며, 연구대상자는 발병 후 6개월 이상 된 만성 편마비 환자 30명을 대상으로 하였다. 실험은 교감신경 활동을 강화하는 세 가지 과제(암산, 정적인 상태에서 쥐기운동, 쥐기운동 후 허혈)를 실시하였으며 측정은 과제를 수행하기 전과 중의 global synkinesis 수준과 중추신경원 활동전위을 각각 측정하였다. 중추신경원 활동전위는 H/Mmax비, V/Mmax비를 측정하였고, global synkinesis 수준은 근전도 활동전위의 실효치 값을 측정하여 분석하였다. 본 연구에서, global synkinesis 수준은 정적인 상태에서 쥐기 과제를 제외한 나머지 과제(암산, 쥐기 후 허혈)에서 슬관절 굴곡, 신전 시 감소했다(p<.05). 또한 V/Mmax비에서는 세 가지 과제 모두에서 감소하였다(p<.05). 결론적으로, 교감신경 활동 강화는 만성 편마비 환자의 중추신경 흥분성과 근 긴장도를 감소시킴을 알 수 있었다.

• Journal of Korean Neurosurgical Society
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• 제30권sup1호
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• pp.85-90
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• 2001

Objective : DREZotomy is effective for the treatment of deafferentation pain as a consequence of root avulsion, postparaplegic pain, posttraumatic syrinx, postherpetic neuralgia, spinal cord injury, and peripheral nerve injury. We performed microsurgical DREZotomy to the patients with deafferentation pain and relieved pain without any serious complication. The purpose of this study is to evaluate the usefulness of the microsurgical DREZotomy for deafferentation pain. Methods : We evaluated 4 patients with deafferntation pain who were intractable to medical therapy. Two of them were brachial plexus injury with root avulsion owing to trauma, one was axillary metastasis of the squamous cell carcinoma of the left forearm, and the last was anesthesia dolorosa after surgical treatment(MVD and rhizotomy) of trigeminal neuralgia. Preoperative evaluation was based on the neurologic examination, radiologic imaging, and electrophysiological study. In the case of anesthesia dolorosa, we produced two parallel lesions in cephalocaudal direction, 2mm in distance, from the C2 dorsal rootlet to the 5mm superior to the obex including nucleus caudalis, after suboccipital craniectomy and C1-2 laminectomy, with use of microelectrode. In the others, we confirmed lesion site with identification of the nerve root after hemilaminectomy. We performed arachnoid dissection along the posterolateral sulcus and made lesion with microsurgical knife and microelectrocoagulation, 2mm in depth, 2mm in distance, to the direction of 30-45 degrees in the medial portion of the Lissauer's tract and the most dorsal layers of the posterior horn at the one root level above and below the lesion. Results : Compared with preoperative state, microsurgical DREZotomy significantly diminished dosage of the drugs and relieved pain meaningfully. One patient showed tansient ipsilateral ataxia, but recovered soon. There was not any serious complication. Conclusion : It may be concluded that microsurgical DREZotomy is very useful and safe therapeutic modality for deafferentation pain, especially segmentally distributed intermittent or evoke pain. Complete preoperative evaluation and proper selection of the patients and lesion making device are needed to improve the result.

• Asian Pacific Journal of Cancer Prevention
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• 제17권6호
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• pp.2857-2860
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• 2016

Background: Chronic hepatitis B (CHB) infection is one of the important causes of hepatocellular carcinoma (HCC) in Thailand, involved in the pathogenesis and leading to a development of HCC with or without cirrhotic changes of the liver. This study was aimed to investigate the predictive factors for HCC among CHB patients in a tertiary care center in Thailand. Materials and Methods: We conducted a retrospective study of CHB patients with or without HCC during the period of January 2009 and December 2014 at Thammasat University Hospital, Pathumthani, Thailand. Data on clinical characteristics, biochemical tests and radiologic findings were collected from review of medical records. Results: A total of 266 patients were diagnosed with CHB in Thammasat university hospital during the study period. However, clinical information of only 164/266 CHB patients (98 males, 66 females with mean age of 49.4 years) could be completely retrieved in this study. The prevalence of HCC in CHB infection in this study was 38/164 (23.2%). CHB patients with HCC had a mean age older than those without HCC (59.5 vs 47 years, P-value = 0.01). Furthermore, history of upper GI bleeding, tattooing, blood transfusion, and chronic alcoholism were significantly more common in CHB patients with HCC than patients without HCC (13.2% vs 3.2% P-value 0.03, OR = 4.6, 95%CI = 1.2-18.1, 20% vs 3.9%, P-value = 0.01, OR= 6.1, 95% CI= 1.6-23.6, 20% vs 6.3%, P-value = 0.03, OR = 3.8, 95%CI =1.1-12.7, 62.2% vs 30.3%, P-value <0.0001, OR = 3.7, 95%CI= 1.7-8.1 respectively). Interestingly, more CHB patients with HCC had evidence of cirrhosis than those without HCC (78.9% vs 20.4%, P-value <0.0001, OR = 14.6, 95%CI = 5.8-36.7). In CHB patients with HCC, surgical therapy provided longer survival than radiofrequency ablation (RFA) (72 vs 46.5 months, P-value= 0.04). The mean survival time after HCC diagnosis was 17.2 months. Conclusions: HCC remains a major problem among patients with CHB infection in Thailand. Possible risk factors are male gender, history of upper GI bleeding, chronic alcoholism, tattooing, blood transfusion and evidence of cirrhosis. For early stage HCC patients, surgical treatment provided longer survival time than RFA. Most HCC patients presented with advanced disease and had a grave prognosis. Appropriate screening of CHB patients at risk for HCC might be an appropriate approach for early detection and improvement of long-term outcomes.

• 대한한방부인과학회지
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• 제20권3호
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• pp.200-212
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• 2007

Purpose: To find objective validity of minimal acupuncture using a modified guide tube as a method to verify the effect of acupuncture. Methods: Subjects of this study were participants of a randomized clinical trial which was practiced to verify the effect of acupuncture on postmenopausal hot flash. There were 2 arms of treatment, one's for active acupuncture group(AG) with manipulation and De qi, the other's for minimal acupuncture group(MG) using a modified guide tube which was designed to give minimal stimulation to the patient. After 8 weeks' treatment followed by 4 weeks' observation, participants were asked to fill in self-report forms on their education, previous experiences of acupuncture, original idea on the efficacy of acupuncture and recognition of blinding. Results: 19 participants of 26 in AG and 19 of 26 in MG completed the self-report form. There was no difference between AG and MG in their education(p=0.5976, Fisher exact test) and previous experiences of acupuncture(p=0.9999, Fisher exact test). In their original ideas on the efficacy of acupuncture, most of AG and MG respondents have been thought that acupuncture is very effective or quite effective, and there was no difference between 2 groups(p=0.5065). 16 of 19 in AG and 14 of 19 in MG believed that they underwent more effective way, there was no statistical difference between 2 groups(p=0.6928, Fisher exact test). Participants believed in undergoing more effective way not because they recognized treatment method, but they were satisfied with the effectiveness of treatment retrospectively. Conclusion: As the result of this study, these authors suggest that minimal acupuncture using a modified guide tube is acceptable as a method to verify the effect of acupuncture in acupuncture-familiar Korean culture. Also further studies on the stimulation-specific effect of minimal acupuncture are demanded.

• Parasites, Hosts and Diseases
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• 제59권5호
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• pp.507-512
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• 2021

Since 1993, vivax malaria has been recognized as a public health burden in Korea. Despite of pan-governmental malaria-control efforts and the dramatic reduction in the burden of this disease over the last 10 years, vivax malaria has not been well controlled and has remained continuously endemic. We focused interviewed and examined the charts of 28 confirmed vivax malaria patients given malarial therapy for whom daily records were kept from Gimpo-si, Gyeonggi-do of Korea. Various epidemiological characteristics of vivax malaria, including the incubation period, medication used, and recurrence, and an evaluation of the parasitic characteristics from the focused interviews of patients from this region are described here. Most of the participants indicated the 3 most common symptoms of malaria (headache, chills and fever). Of the 28 cases, 2 experienced a second attack and there were 17 and 11 cases with short- and long-term incubation periods, respectively, yielding a short-term to long-term ratio of 1.5. Based on the parasitemia stages, most of the participants were tested at 5 to 7 days (11 cases) and 7 to 15 days (11 cases) after initial wave of asexual parasites. In conclusion, public health authorities should consider developing management measures to decrease the time lag for diagnosis and drafting unified and robust guidelines for drug use for malaria and drawing up unified and robust guidelines on the use of medication for malaria. It also suggests that routine monitoring, surveillance, and precise medical surveys in high-risk vivax malaria endemic areas are pivotal to controlling this persistent public disease and finally eliminating it from Korea.

• Journal of Applied Biological Chemistry
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• 제64권3호
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• pp.217-223
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• 2021

광감각제를 이용한 광역학 치료는 필요한 특정 부위에만 빛을 조사하여 치료 효과를 나타내는 부작용이 적은 방법이다. 5-aminolevulinic acid (ALA)는 다양한 생물체에서 합성되는 대표적 광감제로 암진단과 치료를 포함하는 다양한 분야에서 사용되고 있다. 본 연구에서는 다양한 파장의 LED, 유기산 전구체 및 glucose 농도 변화를 통한 Rhodobacter sphaeroides의 최적 성장 조건과 ALA 생산 조건을 확립하기 위한 실험을 진행하였다. 백열등과 동일한 광도 아래에서 Rhodobacter sphaeroides에 850 nm LED 빛을 조사하면 대조군 대비 균주의 성장과 ALA의 생산 농도를 각각 1.5배 및 1.8배 증가시킬 수 있고, 전구체로 pyruvic acid를 첨가한 경우 850 nm 파장의 LED만 조사한 경우 보다 ALA의 생산 농도를 약 2.8배 증가 시켰으며 동일 배양 조건에 40 mM glucose를 첨가하여 배양한 결과 Rhodobacter sphaeroides의 성장은 850 nm 파장의 LED 조사와 pyruvic acid를 첨가한 것에 비해 약 2.9배, ALA의 생산 농도는 약 3.4배 (20 mM) 증가되었다. 건조체 질량당 ALA의 생산은 20 mM과 40 mM glucose에서 대조군 대비 각각 약 1.4배 높은 결과를 나타냈다. 결론적으로 다양한 파장의 LED 중 850 nm 파장의 LED가 Rhodobacter sphaeroides의 성장률 및 ALA의 생산을 최대로 높였으며, 5 mM pyruvic acid와 40 mM glucose의 농도에서 최적의 Rhodobacter sphaeroides 성장과 ALA 생산을 확인하였다.

• Clinical Psychopharmacology and Neuroscience
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• 제16권4호
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• pp.434-448
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• 2018

Objective: The Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was first published in 2002 through an expert consensus of opinion, and updated in 2006, 2010, and 2014. This study constitutes the fourth revision of the KMAP-BP. Methods: A 50-item questionnaire was used to obtain the consensus of experts regarding pharmacological treatment strategies for various phases of adult bipolar disorder and six items for pediatric bipolar disorder. The review committee included 84 Korean psychiatrists and 43 child and adolescent psychiatry experts. Results: The preferred first-step strategies for acute mania were the combination of a mood stabilizer (MS) and an atypical antipsychotic (AAP), MS monotherapy, and AAP monotherapy. A combination of a MS and an AAP, and AAP monotherapy were preferred for psychotic mania. The first-step strategies for mild to moderate bipolar depression were monotherapy with MS, AAP, or lamotrigine (LMT), and the combination of a MS and an AAP or LMT, or a combination of an AAP and LMT. The combination of two among a MS, AAP, and LMT were preferred for non-psychotic severe depression. A combination of a MS and an AAP or the combination of an AAP with an antidepressant or LMT were the first-line options for psychotic severe depression. Conclusion: The recommendations of the KMAP-BP 2018 have changed from the previous version by reflecting recent developments in pharmacotherapy for bipolar disorder. KMAP-BP 2018 provides clinicians with a wealth of information regarding appropriate strategies for treating patients with bipolar disorder.

• 임상이비인후과
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• 제29권2호
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• pp.212-222
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• 2018

Background and Objectives : The purpose of this study was to compare the measured values of acoustic and auditory perceptual assessments between normal and functional dysphonia (FD) groups. Materials and Methods : 102 subjects with FD and 59 normal voice groups were participated in this study. Mid-vowel portion of the sustained vowel /a/ and two sentences of 'Sanchaek' were edited, concatenated, and analyzed by Praat script. And then auditory-perceptual (AP) rating was completed by three listeners. Results : The FD group showed higher acoustic voice quality index version 2.02 and version 3.01 (AVQIv2 and AVQIv3), slope, Hammarberg index (HAM), grade (G) and overall severity (OS), values than normal group. Additionally, smoothed cepstral peak prominence in Praat (PraatCPPS), tilt, low-to high spectral band energies (L/H ratio), long-term average spectrum (LTAS) in FD group were lower than normal voice group. And the correlation among measured values ranged from -0.250 to 0.960. In ROC curve analysis, cutoff values of AVQIv2, AVQIv3, PraatCPPS, slope, tilt, L/H ratio, HAM, and LTAS were 3.270, 2.013, 13.838, -22.286, -9.754, 369.043, 27.912, and 34.523, respectively, and the AUC of each analysis was over .890 in AVQIv2, AVQIv3, and PraatCPPS, over 0.731 in HAM, tilt, and slope, over 0.605 in LTAS and L/H ratio. Conclusions : In conclusion, AVQI and CPPS showed the highest predictive power for distinguishing between normal and FD groups. Acoustic analyses and AP rating as noninvasive examination can reinforce the screening capability of FD and help to establish efficient diagnosis and treatment process plan for FD.

• Annals of Surgical Treatment and Research
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• 제95권5호
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• pp.286-296
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• 2018

Purpose: Sentinel lymph node (SLN) biopsy (SLNB) is widely accepted for staging of melanoma patients. It has been shown that clinico-pathological features such as Breslow thickness, ulceration, age, and sex are better predictors of relapse and survival than SLN status alone. The aims of this study were to evaluate the long-term (10-year) prognostic impact of SLNB and to determine predictive factors associated with SLN metastasis, relapse, and melanoma specific mortality (MSM). Methods: This was a prospective observational study on 289 consecutive patients with primary cutaneous melanoma who underwent SLNB from January 2000 to December 2007, and followed until January 2014, at an Italian academic hospital. Results: SLN was positive in 64 patients (22.1%). The median follow-up was 116 months (79-147 months). Tenyear disease-free survival and melanoma specific survival were poor in patients with positive SLN (58.7% and 66.4%, respectively). Only the increasing Breslow thickness resulted independently associated to an increased risk of SLN metastasis. Cox regression analysis showed that a Breslow thickness >2 mm was an independent predictor of relapse, and male sex and Breslow thickness >2 mm was a predictor of MSM. At 10 years, SLN metastasis was not significantly associated to either relapse or MSM. Conclusion: After the fifth year of follow-up, SLN metastasis is not an independent predictive factor of relapse or mortality which are mainly influenced by the characteristics of the primary tumor and of the patient. Patients with a Breslow thickness >2 mm regardless of the SLN status should be considered at high risk for 10-year relapse and mortality.

• 철학연구
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• 제131권
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• pp.353-381
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• 2014

사상의학은 비단 의학에서뿐만이 아니라, 경영학이나 정치학, 교육학 등 다양한 분야에서 응용되고 있다. 하지만 사상의학이 근본적으로 치심치병(治心治病)을 치료의 근본으로 하는 심신의학임에도 불구하고, 실제 심리나 정신치료에서 활용되는 경우는 극히 드물었다. 실제 임상에서의 치료법은 약물치료나 침구요법(체질침) 정도에 머물고 있다. 하지만 질병 병리 현상에 대해 사상의학이 제시하는 치유법은 개인의 성정(性情)의 다스림은 물론이고, 연령 지역에 따른 환경적 요인, 주(酒) 색(色) 재(財) 권(權)과 같은 사회적 문화적 요인을 포괄한다. 특히, 사상의학의 수양론은 인간의 타고난 성정 가운데 그림자처럼 항상 숨어 있고, 비밀스럽게 간직되어 있는 사심(邪心)과 태행(怠行)을 올바르게 인지하여 박통(博通)과 독행(獨行)으로 나아가는 것이 중요하다고 강조한다. 또한 의학의 통합적 접근을 시도하면서, 지인정기(知人正己)론을 근본으로 의론(醫論)을 전개하기 때문에 대인관계(對人關係)가 중시되는 현대인들에게 많은 시사점을 준다. 마찬가지로, 세계철학과 통합심리학을 주도하는 윌버(Ken Wilber, 1949~)는 실제적이고 체험적인 통합적 접근을 경험 차원에 적용하는 '통합적 삶을 위한 훈련(ILP)'을 제시하고 있다. ILP는 성장가능한(또는 깨어남이 가능한) 영역 전체의 성장을 위한 실제적인 훈련법(수련법)으로 선례가 없는 것이다. ILP에서는 몸 모듈, 마음(Mind) 모듈, 그림자(Shadow) 모듈, 영(Spirit) 모듈이라는 4가지 핵심 모듈과 윤리, 성(性), 일(Work), 정서(Emotion), 관계성(Relationships) 등의 성장을 지향하는 5가지 보조 모듈을 제시한다. 이에 ILP가 제시하는 핵심 보조 모듈과 다양한 심신치유기법들에 사상의학의 심신 치유법을 대입시켜 본다면 양자(兩者) 간에 보다 발전된 심신치유 접근법을 모색할 수 있을 것이다.