• The Korean Journal of Pain
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• 제29권2호
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• pp.136-140
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• 2016

Myofascial pain syndrome (MPS) is one of the common musculoskeletal conditions of the shoulder which may develop sensory-motor and autonomic dysfunctions at the various level of the neuromuscular system. The pain and dysfunction caused by MPS were primarily treated with physical therapy and pharmacological agents in order to achieve painfree movements. However, in recent years intramuscular electrical stimulation (IMES) with conventional electrode placement was used by researchers to maximise therapeutic values. But, in this study an inverse electrode placement was used to deliver electrical impulses intramuscularly to achieve neuro-modulation at the various level of the nervous system. Nine patients with MPS were treated with intramuscular electrode stimulation using inversely placed electrodes for a period of three weeks. All nine subjects recovered from their shoulder pain and disability within the few weeks of intervention. So, this inverse electrode placement may be more appropriate for chronic pain management.

• 한국농촌간호학회지
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• 제17권1호
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• pp.1-8
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• 2022

Purpose: This study was to evaluate the effects of a lettuce-based sleep promotion program on sleep, depression, and life satisfaction of the elderly in the community. Methods: Data collection was conducted from April 19 to May 28, 2021, and 49 elderly people with sleep disorders over the age of 60 living in G province. The program consisted of a total of 6 weeks, and evaluated sleep patterns, insomnia severity, depression, and life satisfaction. The collected data were analyzed using the IBM SPSS/WIN 23.0 program descriptive statistics and paired t-test. Results: As a result, the lettuce-based sleep promotion program was found to be effective for total sleep time (t=-2.71, p=.009), deep sleep (t=-3.98, p<.001), insomnia severity (t=10.11, p<.001), depression (t=2.14, p=.038), and life satisfaction (t=-2.15, p=.036). Conclusion: The results of this study suggest that this program should be used as a non-pharmacological intervention to promote sleep of the elderly.

• 임상간호연구
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• 제16권3호
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• pp.175-186
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• 2010

Purpose: Delirium can be a highly prevalent symptom in intensive care units but it may still be under-recognized despite its relation with inclined morbidity, mortality, cost, and readmission. Therefore, this study aimed to develop a protocol that covers risk factors and non-pharmacological interventions to prevent delirium in ICU patients. Methods: This study was conducted using methodological design, and it followed the Scottish Intercollegiate Guideline Network (SIGN) guideline development steps: 1) the scope of protocol was decided (population, intervention, comparison, and outcomes); 2) guidelines, systematic reviews, and protocols were reviewed and checked using methodology checklist; 3) the level of evidence and recommendation grades was assigned; 4) the appropriateness of recommendations was scored by experts; 5) the final protocol & algorithm was modified and complemented. Results: The evidence-based delirium prevention protocol was completed that includes predisposing factors, precipitating factors and recommendations with evidenced grades. Conclusion: This protocol can be used as a guide nurses in screening patients with high risk factors of delirium as well as in intervening the patients non-pharmacologically to prevent delirium.

• Physical Therapy Rehabilitation Science
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• 제13권1호
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• pp.124-133
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• 2024

Objective: This study aims to investigate the immediate effects of myofascial release and Duoball assisted self-relaxation (DASR) techniques on pain and muscle tension in patients experiencing chronic cervical pain. Design: A randomized controlled trial. Methods: This study is a randomized controlled experimental study. Eighteen patients with chronic neck pain who met the selection criteria were randomly assigned to myofascial release group and myofascial release group using Duoball. Results: The frequency results for assessment muscle tension showed a decrease of about 10% in the suboccipital muscle, SCM, Pect m, UT, and LS in both the MFR and DASR groups, and the stiffness results showed a decrease in all muscles except the upper trapezius in the MFR group and the DASR group. All were found to decrease by about 10% in the suboccipital muscle, SCM, Pect m, UT, and LS, and the decrement results showed an increase of about 15% in the suboccipital muscle, SCM, Pect m, UT, and LS in both the MFR and DASR groups(p<0.05). Conclusions: In patients experiencing chronic neck pain, application of MFR and duoball assisted self relaxion was shown to be effective on pain and muscle tension. MFR is a non-pharmacological intervention method with few potential side effects and is considered a universal and easily applicable treatment method.

• Korean Circulation Journal
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• 제52권5호
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• pp.341-353
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• 2022

Cardiovascular disease (CVD) is the leading causes of morbidity and death globally. In particular, a heart failure remains a major problem that contributes to global mortality. Considerable advancements have been made in conventional pharmacological therapies and coronary intervention surgery for cardiac disorder treatment. However, more than 15% of patients continuously progress to end-stage heart failure and eventually require heart transplantation. Over the past year, numerous numbers of protocols to generate cardiomyocytes (CMCs) from human pluripotent stem cells (hPSCs) have been developed and applied in clinical settings. Number of studies have described the therapeutic effects of hPSCs in animal models and revealed the underlying repair mechanisms of cardiac regeneration. In addition, biomedical engineering technologies have improved the therapeutic potential of hPSC-derived CMCs in vivo. Recently substantial progress has been made in driving the direct differentiation of somatic cells into mature CMCs, wherein an intermediate cellular reprogramming stage can be bypassed. This review provides information on the role of hPSCs in cardiac regeneration and discusses the practical applications of hPSC-derived CMCs; furthermore, it outlines the relevance of directly reprogrammed CMCs in regenerative medicine.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제13권1호
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• pp.129-138
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• 2002

목 적：소아청소년 정신과 질환의 가장 대표적이라 할 수 있는 주의력결핍-과잉행동장애(ADHD)의 최적치료모델 개발을 위한 연구의 일환으로, 우선 실제 ADHD로 의심되는 환자가 병원을 방문했을 때 임상의들이 현재 (1) 어떠한 진단 평가적 도구를 사용하여 진단적 접근을 하며, (2) 어떠한 치료적 접근을 시행하고 있는지, (3) 현재 시행하고 있지는 않지만, 어떤 모델을 추구하는지에 대해 구조화된 설문도구를 이용하여 파악하고자 하였다. 방 법：대학병원 및 종합병원 소아정신과 담당 전문가 32명을 대상으로 구조화된 설문조사를 하였고, 여기에 포함되는 조사내용으로는 진단검사도구, 약물치료, 비약물치료 현황파악이었다. 이 자료를 Texas Algorithm Project(TAP)와 비교 검토하였다. 결 과：(1) 모든 ADHD 환아에게 실시해야 할 기본적인 검사는 지능검사, 문장완성검사, 지속적 집중력검사, 코너씨 설문지였고, (2) 전반적 ADHD 투여 약물은 TAP 지침과 차이가 없었고, 다만 약효가 인정된 aderall, bupropion, guanfacin의 국내이용이 요구된다고 하였으며, (3) 틱 장애가 동반된 경우는 임상의들이 정신자극제 사용을 자제하는 경향을 보여 TAP 지침과 분명한 차이를 보였고, (4) 파탄적 행동장애가 동반된경우 임상의들은 다른 약물로 교체하기보다는 MPH 투여에 다른 약물을 추가하는 경향을 보였으며, (5) 과반수 이상의 임상의가 꼭 실시하여야 한다고 보고한 치료로는, 개별적 부모상담, 부모교실, 개인별 행동인지 치료였다. 결 론：본 연구 결과를 통해 알 수 있었던 여러 제한점들을 보완하고 또한 본 연구에서 제기된 논쟁점을 위주로 하여서, 한국적 실정에 맞는 ADHD 최적치료모델 개발을 위한 연구와 더불어 전문가들의 합의가 이루어져야 하겠다.

• 한국엔터테인먼트산업학회논문지
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• 제15권8호
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• pp.291-303
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• 2021

본 연구는 최근 증가하고 있는 시설거주 노인을 대상으로 건강문제로 보고되고 있는 우울과 수면장애에 대하여 웃음요법의 적용 효과를 확인하기 위한 연구이다. 이를 위해 시설거주 노인에게 웃음요법을 적용한 국내·외 실험연구들을 대상으로 체계적 고찰을 통해 연구 특성을 파악하고, 메타분석을 통해 우울과 수면장애에 대한 전체 효과크기와 중재 변인에 따른 효과크기를 파악하는 것을 목적으로 하고 있다. 최종 선정된 12편의 실험연구를 체계적으로 고찰하고 결과 변수에 영향을 미치는 전체 효과크기를 분석한 결과, 웃음요법은 시설거주 노인의 우울 감소에 유의한 효과가 있었으며, 수면장애 감소에는 유의한 효과가 없었다. 중재 변인에 따라 분석한 결과 웃음요법은 시행 횟수 10회 미만, 중재 소요 시간 400분 미만이나 400-1,000분 미만에서 우울 감소에 효과적이었다. 수면장애의 경우 전체 효과크기는 유의하지 않았으나 중재 소요 시간 300분 미만에서 수면장애 감소에 효과적이었다. 이러한 결과는 웃음요법이 시설거주 노인의 우울 감소에 효과적이며, 이를 적용할 때 시행 횟수와 중재 소요 시간과 같은 중재 변인을 고려하는 것이 필요함을 시사한다. 시설거주 노인의 수가 증가하고 있고, 우울과 수면장애와 같은 건강문제의 발생률이 증가하고 있는 점을 감안할 때 추후 연구에서 본 연구 결과를 토대로 시설거주 노인의 우울과 수면장애 감소를 위한 적용지침이 개발될 필요가 있다.

• 운동영양학회지
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• 제16권2호
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• pp.65-71
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• 2012

Oxygen is the final acceptor of electron transport from fat and carbohydrate oxidation, which is the rate-limiting factor for cellular ATP production. Under altitude hypoxia condition, energy reliance on anaerobic glycolysis increases to compensate for the shortfall caused by reduced fatty acid oxidation [1]. Therefore, training at altitude is expected to strongly influence the human metabolic system, and has the potential to be designed as a non-pharmacological or recreational intervention regimen for correcting diabetes or related metabolic problems. However, most people cannot accommodate high altitude exposure above 4500 M due to acute mountain sickness (AMS) and insulin resistance corresponding to a increased levels of the stress hormones cortisol and catecholamine [2]. Thus, less stringent conditions were evaluated to determine whether glucose tolerance and insulin sensitivity could be improved by moderate altitude exposure (below 4000 M). In 2003, we and another group in Austria reported that short-term moderate altitude exposure plus endurance-related physical activity significantly improves glucose tolerance (not fasting glucose) in humans [3,4], which is associated with the improvement in the whole-body insulin sensitivity [5]. With daily hiking at an altitude of approximately 4000 M, glucose tolerance can still be improved but fasting glucose was slightly elevated. Individuals vary widely in their response to altitude challenge. In particular, the improvement in glucose tolerance and insulin sensitivity by prolonged altitude hiking activity is not apparent in those individuals with low baseline DHEA-S concentration [6]. In addition, hematopoietic adaptation against altitude hypoxia can also be impaired in individuals with low DHEA-S. In short-lived mammals like rodents, the DHEA-S level is barely detectable since their adrenal cortex does not appear to produce this steroid [7]. In this model, exercise training recovery under prolonged hypoxia exposure (14-15% oxygen, 8 h per day for 6 weeks) can still improve insulin sensitivity, secondary to an effective suppression of adiposity [8]. Genetically obese rats exhibit hyperinsulinemia (sign of insulin resistance) with up-regulated baseline levels of AMP-activated protein kinase and AS160 phosphorylation in skeletal muscle compared to lean rats. After prolonged hypoxia training, this abnormality can be reversed concomitant with an approximately 50% increase in GLUT4 protein expression. Additionally, prolonged moderate hypoxia training results in decreased diffusion distance of muscle fiber (reduced cross-sectional area) without affecting muscle weight. In humans, moderate hypoxia increases postprandial blood distribution towards skeletal muscle during a training recovery. This physiological response plays a role in the redistribution of fuel storage among important energy storage sites and may explain its potent effect on changing body composition. Conclusion: Prolonged moderate altitude hypoxia (rangingfrom 1700 to 2400 M), but not acute high attitude hypoxia (above 4000 M), can effectively improve insulin sensitivity and glucose tolerance for humans and antagonizes the obese phenotype in animals with a genetic defect. In humans, the magnitude of the improvementvaries widely and correlates with baseline plasma DHEA-S levels. Compared to training at sea-level, training at altitude effectively decreases fat mass in parallel with increased muscle mass. This change may be associated with increased perfusion of insulin and fuel towards skeletal muscle that favors muscle competing postprandial fuel in circulation against adipose tissues.

• 재활치료과학
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• 제9권2호
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• pp.27-38
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• 2020

서론 : 본 연구는 무작위 대조군 실험(Randomized control trial: 이하 RCT) 연구에서 치료의향분석(Intention-to-treat analysis)의 올바른 활용에 대해서 고찰하고자 한다. 본론 : 치료의향분석은 RCT 연구에서 무작위 분배 이후에 모든 대상자의 데이터를 결과에 포함하는 분석방법이다. RCT 연구의 결과는 일반화에 있어서 매우 높은 타당성을 갖는다. 이런 측면에서 중도 탈락을 포함한 모든 대상자의 데이터를 결과 분석에 포함하여야 그 결과를 실제 임상에 적용했을 때 중재의 효과가 예측 가능하기 때문이다. 이런 이유로 RCT 연구에 대한 질평가 도구들은 치료의향분석 실시여부를 확인하고 있다. 그럼에도 많은 연구자들은 치료의향분석의 이해도가 낮아 잘못 활용하고 있거나 활용하지 않는 경우가 많다. 결론 : 본 고찰 연구를 통해 국내 많은 연구자들이 치료의향분석방법을 정확하게 이해하고 올바르게 활용하여 RCT 연구에 반영할 것을 기대한다.

• 임상간호연구
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• 제22권2호
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• pp.118-131
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• 2016

Purpose: This study was conducted to develop a useful evidence-based guideline for preventing venous thromboembolism(VTE) in Korea adapting previously developed VTE guidelines. Methods: The guideline adaptation process was performed using 24 steps according to the nursing practice guideline adaptation manual developed by Hospital Nurses Association in 2012. Results: The newly developed VTE prevention guideline was consisted of 16 domains and 163 recommendations. The number of recommendations in each domain were: 4 general issues, 4 risk factors, 2 intervention at occurrence of VTE, 14 mechanical interventions, 30 pharmacological interventions, 19 VTE prevention for medical patient, 10 stroke patient, 16 cancer patient, 14 pregnancy, 6 for long distance traveller, 5 for abdominal surgery, 10 thoractic surgery, 10 orthopedic surgery, 5 neurosurgery, 4 other surgical patient, 2 urological surgery, 1 ENT surgery, 1 plastic surgery, 3 day surgery, 3 education of VTE prevention. Fourteen point three percent, 61.1%, and 24.6% of the recommendations were graded A, B, and C, respectively. Conclusion: The findings suggest that the new VTE prevention guideline can be more efficiently used to prevent VTE in hospital settings.