• 정신신체의학
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• 제26권2호
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• pp.94-101
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• 2018

연구목적 본 연구는 완화병동에 입원한 환자들에서 사망 직전에 발생하는 임종기 섬망의 발생을 사망 전 2주시점 전부터 관찰하여 변화양상과 선행 요인을 관찰한 연구이다. 방 법 2015년 10월부터 2017년 8월까지, 일 대학병원 완화병동에 입원한 말기 암환자 최종 180명을 대상으로 후향적 연구를 진행하였다. 대상자는 매일 3회 Richmond Agitation Sedation Scale과 Nursing Delirium Screening Scale로써 섬망의 세가지 아형으로 진단되었다. 결 과 임종 13일 전 섬망의 빈도는 46%였으며, 그 중 18.3%는 과활동성, 13.8%는 저활동성 그리고 혼합성 아형은 13.8%를 차지하였다. 과활동성 섬망은 임종일까지 점차 감소하는 양상이었으며, 저활동성 아형과 혼합성 아형의 섬망은 임종 4일 전까지 점차 증가하는 양상이었다. 임종 하루 전 86.9%의 환자들은 섬망으로 진단되었다. 다변량 분석에서 위장관 암보다 혈액학적 암이 낮은 임종기 섬망과 연관이 있었으며 과체중도 낮은 임종기 섬망과 연관이 있었다. 결 론 많은 완화의료 환자들은 섬망을 경험하였으며, 과체중은 임종기의 모든 아형의 섬망을 낮추는 보호인자로 고려되었다. 차후 임종기 섬망의 빈도와 위험 인자를 밝히는 전향적 연구가 필요할 것이다.

• Asian-Australasian Journal of Animal Sciences
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• 제30권11호
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• pp.1633-1642
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• 2017

Objective: Evaluation of exercise effects in racehorses is important in horseracing industry and animal health care. In this study, we compared metabolic patterns between before and after exercise to screen metabolic biomarkers for exercise effects in thoroughbreds. Methods: The concentration of metabolites in muscle, plasma, and urine was measured by $^1H$ nuclear magnetic resonance (NMR) spectroscopy analysis and the relative metabolite levels in the three samples were compared between before and after exercise. Subsequently, multivariate data analysis based on the metabolic profiles was performed using orthogonal partial least square discriminant analysis (OPLS-DA) and variable important plots and t-test was used for basic statistical analysis. Results: From $^1H$ NMR spectroscopy analysis, 35, 25, and 34 metabolites were detected in the muscle, plasma, and urine. Aspartate, betaine, choline, cysteine, ethanol, and threonine were increased over 2-fold in the muscle; propionate and trimethylamine were increased over 2-fold in the plasma; and alanine, glycerol, inosine, lactate, and pyruvate were increased over 2-fold whereas acetoacetate, arginine, citrulline, creatine, glutamine, glutarate, hippurate, lysine, methionine, phenylacetylglycine, taurine, trigonelline, trimethylamine, and trimethylamine N-oxide were decreased below 0.5-fold in the urine. The OPLS-DA showed clear separation of the metabolic patterns before and after exercise in the muscle, plasma, and urine. Statistical analysis showed that after exercise, acetoacetate, arginine, glutamine, hippurate, phenylacetylglycine trimethylamine, trimethylamine N-oxide, and trigonelline were significantly decreased and alanine, glycerol, inosine, lactate, and pyruvate were significantly increased in the urine (p<0.05). Conclusion: In conclusion, we analyzed integrated metabolic patterns in the muscle, plasma, and urine before and after exercise in racehorses. We found changed patterns of metabolites in the muscle, plasma, and urine of racehorses before and after exercise.

• The Korean Journal of Physiology and Pharmacology
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• 제14권4호
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• pp.213-221
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• 2010

The hypothalamic-pituitary-adrenal (HPA) axis is the primary endocrine system to respond to stress. The HPA axis may be affected by increased level of corticotrophin-releasing factors under chronic stress and by chronic administration of monosodium glutamate (MSG). The purpose of this study was to investigate whether chronic MSG administration aggravates chronic variable stress (CVS)-induced behavioral and hormonal changes. Twenty-four adult male Sprague-Dawley rats, weighing 200~220 g, were divided into 4 groups as follows: water administration (CON), MSG (3 g/kg) administration (MSG), CVS, and CVS with MSG (3 g/kg) administration (CVS＋MSG). In addition, for the purpose of comparing the effect on plasma corticosterone levels between chronic stress and daily care or acute stress, 2 groups were added at the end of the experiment; the 2 new groups were as follows: naive mice (n=7) and mice exposed to restraint stress for 2 h just before decapitation (A-Str, n=7). In an open field test performed after the experiment, the CVS＋MSG group significant decrease in activity. The increase in relative adrenal weights in the CVS and CVS＋MSG group was significantly greater than those in the CON and/or MSG groups. In spite of the increase in the relative adrenal weight, there was a significant decrease in the plasma corticosterone levels in the CVS＋MSG group as compared to all other groups, except the naive group. These results suggest that impaired HPA axis function as well as the decrease in the behavioral activity in adult rats can be induced by chronic MSG administration under CVS rather than CVS alone.

• 한국응급구조학회지
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• 제9권2호
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• pp.147-168
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• 2005

It examined the doubt point which AED motive relates until now, the AED should have bought a life how, present address of our country site pre-hospital care, comparison it tried to observe the advanced nation instance back. Gist of this research the AED important cold region once compared to informed to how many cardiac arrest patient, against him the what kind of preparation wanted informing the necessary cold region. It soaks simultaneously but the AED motive is widely supplied distant in future and it is generality and it is feeble but it wanted doing one morning. The habit difference of an American who does of course meat diet mainly and a Korean is many and it compares in the United States and the cardiac arrest patient comparison occurs holds a point few. To become Western anger but and be caused by with thin dietary life, stanching bleeding cung, with the fact that the heart attack is increasing rapidly with the hyperextension. It is a talk which anyone it knows all. The major league most Choi huy Sub in condition will catch the ball which floats and the multi co-player and to collide when falling down, the medical device which is committed with emergency aid is AED motive. From the United States subway station and the shopping which are a public place on the baseball field outside the jar which it will drive, the museum and the school, easily there is it will be able to discover the AED from the court of justice back. The Pittsburg university the students per the individual $30 the core phyey were receiving the smallness lifestyle alcoholic beverage and a AED motive actual training with mercy of degree. From the United States distant in future the AED motive is sold even from the retail store and. From our country like this plan government offices temporary disposal education from from 119 fire fighters emergency structure company in fire fighting government employee and nursing must magnify a former enterprise rainy spell in summer multi temporary disposal education with the head which it will burn with the head. This plan in early rising will be able to become fixed in Korea it forecasts with the fact that. The research which it sees it leads and like the United States to some day become fixed even from our country to believe and suspicion it is not and in the people in approach ease one AED supply plan fire fighting government employees stand in the first and feed with the fact that must be positive at this enterprise they become.

• Korean Journal of Radiology
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• 제21권11호
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• pp.1256-1264
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• 2020

Objective: Lung segmentation using volumetric quantitative computed tomography (CT) analysis may help predict outcomes of patients with coronavirus disease (COVID-19). The aim of this study was to investigate the relationship between CT volumetric quantitative analysis and prognosis in patients with COVID-19. Materials and Methods: CT images from patients diagnosed with COVID-19 from February 18 to April 15, 2020 were retrospectively analyzed. CT with a negative finding, failure of quantitative analysis, or poor image quality was excluded. CT volumetric quantitative analysis was performed by automated volumetric methods. Patients were stratified into two risk groups according to CURB-65: mild (score of 0-1) and severe (2-5) pneumonia. Outcomes were evaluated according to the critical event-free survival (CEFS). The critical events were defined as mechanical ventilator care, ICU admission, or death. Multivariable Cox proportional hazards analyses were used to evaluate the relationship between the variables and prognosis. Results: Eighty-two patients (mean age, 63.1 ± 14.5 years; 42 females) were included. In the total cohort, male sex (hazard ratio [HR], 9.264; 95% confidence interval [CI], 2.021-42.457; p = 0.004), C-reactive protein (CRP) (HR, 1.080 per mg/dL; 95% CI, 1.010-1.156; p = 0.025), and COVID-affected lung proportion (CALP) (HR, 1.067 per percentage; 95% CI, 1.033-1.101; p < 0.001) were significantly associated with CEFS. CRP (HR, 1.164 per mg/dL; 95% CI, 1.006-1.347; p = 0.041) was independently associated with CEFS in the mild pneumonia group (n = 54). Normally aerated lung proportion (NALP) (HR, 0.872 per percentage; 95% CI, 0.794-0.957; p = 0.004) and NALP volume (NALPV) (HR, 1.002 per mL; 95% CI, 1.000-1.004; p = 0.019) were associated with a lower risk of critical events in the severe pneumonia group (n = 28). Conclusion: CRP in the mild pneumonia group; NALP and NALPV in the severe pneumonia group; and sex, CRP, and CALP in the total cohort were independently associated with CEFS in patients with COVID-19.

• 한국학교ㆍ지역보건교육학회지
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• 제12권3호
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• pp.65-87
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• 2011

Objectives: The purpose of this study was to perform basic study on environmental and respiratory diseases in Ulsan and vicinities. Also, this study evaluated the actual state of environmental disease and health education at middle and high schools in Ulsan and surroundings. Methods: For this study, we conducted a survey on the health of the general public, environmental effects, and investigated the characteristics of environmental disease, health and hygiene education, etc. The populations of this study were middle and high school students in Ulsan, Korea. This study investigated the knowledge of environmental disease and health education at schools in Ulsan and vicinities from November 2009 to December 2009. All statistical calculations were performed with Statistical Package for Social Sciences (SPSS) for Windows, and gained the following results by implementing Frequency Analysis, Cross-tabulation Analysis and ANOVA. Results: As more and more environmental diseases are increased, the interest of the people has been increasing on this. The incidence rates of asthma and atopy were represented the top 25% of the country in Korea. The source of heavy metal, PAHs and VOCs in Ulsan includes the Petrochemical Complex at Nam-gu and Ulju-gun, the Nonferrous Metal Industrial Complex at Onsan-eup, Ulju-gun, and the Heavy Industrial Complex at Dong-gu and Buk-gu. Especially, there are a number of fossil fuel combustion facilities such as waste incineration plants and boilers at Nam-gu and the Onsan Industrial Complex. It may help greatly to investigate the characteristics of environmental pollutants such as environmental air pollutant and indoor contaminant to better manage the local student's health. Conclusions: It has been revealed that the hazardous chemicals and environmental contaminants are main substances of cause for asthma, atopy, dermatitis, and allergy disease. Therefore, through with collecting basic data such as environmental disease of inhabitants, health education, conscious and knowledgeable level in parents of students and students, We have to exert to improve knowledge and prevention with health life in school through development of health education program systematically for preventing of environmental disease.

• 한국응급구조학회지
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• 제6권1호
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• pp.153-168
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• 2002

Since 1992, conventional fire fighting businesses have been converted into a metropolitan autonomous fire fighting system to be ready for a variety of disasters. However, the corresponding investment has been overlapped due to the non-integration of businesses to prevent any potential disasters, and a series of collaborative systems have been not functioning so well. In the meantime, our fire fighting sector has been trying to set up its own clean and faithful position by abolishing any inconvenient system or outsourcing private sectors, and expanded its work scope from conventional fire fighting even to rescue and emergency works. While focusing on handling disaster, the fire fighting sector has been widely trusted and reliable throughtout our nation. Moreover, our fire fighting sector has secured nation wide mobile organizations, technical personnel by field, special equipments and independent communication network. In addition, the fire fighting sector has knowledges, expertise and capabilities required for managing disasters, while in charge of almost every disaster management works including fire, explosion, collapse, disaster and flood. It becomes an organization for comprehensive disaster management under an absolute national trust, which is based on the system for prevention, preparation and countermeasure against a variety of disasters. Thus, our fire fighting sector must make many efforts and try to modernize conventional education and training. The ways to facilitate rescue and emergency works may include the nurture of technical fire fighting personnel along with modernized equipments, the reinforcement of rescue and emergency education, the facilitation of operating civil defense corps, the facilitation of operating volunteer fire fighting corps, the better arrangement of 119 briefing room for public healthcare in provincial offices, the sterilization of rescue instruments and equipments the better repair education for emergency rescue member, the establishment of regional emergency assistant system and the expansion of fire fighting personnel and equipments. In terms of reinforcing the functions and services of rescue 119 and emergency corps, we must review the following considerations: Building up security system along with operational expansion, building up a system for emergency medical treatment, building up a comprehensive information management system for rescue and emergency, constructing a provincial safety museum and so forth. For the ways to better the works of rescue 119 we can review the following considerations : Improving the education for fire fighting training corps under Jeju Provincial Fire and Disaster Management Department, providing rescue members with more opportunities for clinical practices, enhancing the morale of rescue members, installing a comprehensive briefing room for emergency rescue members, building up medical networks along with reasonable policies for information service, operating the consulting system for rescue 119 and so on. If these requirements are met, it is expected that the fire fighting departments in Jeju province can cope with every accident and disaster a little more rapidly and quickly in compliance with local needs, so that they can keep their own position as a public fire fighting organization which may be trusted by the public.

• Journal of Digestive Cancer Reports
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• 제8권1호
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• pp.71-75
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• 2020

식도암은 장막이 없어 암의 침윤 및 전이가 쉽고, 흉부의 가운데 있어 수술이 힘든 장기이다. 이로 인해 명확하게 가이드라인을 따라 치료를 하지 못하는 경우도 있다. 이런 상황에서 다학제 치료를 통해 식도암 환자에서 치료를 효율적으로 하고, 생존율을 향상시키고자 하는 노력이 증가하고 있다. 본 증례에서는 경부 식도 1곳과 흉부 식도 2곳으로 총 3곳에 표재성 식도암이 있는 환자에서 다학제 논의를 통해 수술 대신 항암방사선 동시 치료를 시행한 경우를 보고 한다. 또한 치료 중 확인된 복강 내 림프절에 대해 전이 여부 및 향후 치료 계획을 다시 다학제 모임을 통해 논의하였다. 이런 과정을 통해 환자는 완전 관해에 도달하였다. 본 증례를 통해 경부 식도에 위치한 조기식도암에 대해 항암방사선 동시 치료가 효과적일 수 있으며, 또한 식도암의 치료에 있어 다학제적 접근이 효율적임을 알리고자 한다. 아직 사망률이 높다고 인식되는 식도암에서, 향후 다학제 치료를 통해 더 많은 환자가 도움 받을 것으로 생각된다.

• 정신신체의학
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• 제12권1호
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• pp.66-75
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• 2004

연구목적: 교통사고 후 외상의 심각도와 정신과적인 증상들과의 관계를 알아보고자 하였다. 방 법: 교통사고 후 장해평가나 감정의 목적으로 1994년부터 2003년까지 입원한 134명의 환자를 대상으로 하였다. 입원 시 기록과, 정신과적인 증상들, 심리검사로는 MMPI, BAI, BDI, K-WAIS을 평가하였다. 초진기록에 의한 외상심각도를 측정하고 맥브라이드 기준법에 의한 노동능력 상실률도 구하였다. 통계학적으로는 SPSS-10을 이용한 t-test와 Pearson correlation analysis를 시행하였다. 결 과: 외상의 심각도가 심하지 않을 경우에 오히려 자살시도가 더 많았다. 또 우울, 히스테리, 강박증, 및 반사회성척도의 점수가 높았다. 외상이 심하지 않은 경우에 집중력의 장애, 지남력의 장애, 지능의 저하가 더 심했다. 외상의 심각도와 증상을 가장하는 척도간의 관계는 없었다. 결 론: 교통사고 후 사고당시의 외상의 심각도가 정신과적 증상을 심하게 일으키는데 일치하는 것은 아니었다. 오히려 신체적 외상이 심하지 않았던 환자들이 정신의학적 증상이 심각한 경우가 많아서 신체적 손상의 정도에 기준을 두고 정신과적 증상의 평가를 섣불리 예측하는 것을 주의해야 할 것으로 생각된다.

• 의료커뮤니케이션
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• 제13권2호
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• pp.125-132
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• 2018

Purpose: The aim of this study is to investigate the quality of basic life support (BLS) information for primary Korean-speaking individuals on the internet. Methods: Using the $Google^{(C)}$ search engine, we searched for the terms 'CPR', 'cardiopulmonary resuscitation (in Korean)' and 'cardiac arrest (in Korean)'. The accuracy, reliability and accessibility of web pages was evaluated based on the 2015 American heart association(AHA) guidelines for CPR & emergency cardiovascular care, the health on the net foundation code of conduct and Korean web content accessibility guidelines 2.1, respectively. Results: Of the 178 web pages screened, 50 met criteria for inclusion. The overall quality of BLS information was not enough (median 5/7, IQR 4.75-6). 23(36%) pages were created in accordance with 2010 AHA guidelines. Only 24(48%) web pages educated on how to use the automated electrical defibrillator. The attribution and transparency of the reliability of pages was relatively low, 20(40%) and 16(32%). The web accessibility score was relatively high. Conclusion: A small of proportion of internet web pages searched by Google have high quality BLS information for a Korean-speaking population. Web pages based on past guideline were still being searched. The notation of the source of CPR information and the transparency of the author should be improved. The verification and evaluation of the quality of BLS information exposed to the Internet are continuously needed.