• 대한임상독성학회지
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• 제8권2호
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• pp.61-68
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• 2010

Purpose: Poisoning is a major health problem for the elderly, and poisoning can cause fatal side effects. However, the characteristics and clinical features of elderly patients with acute poisoning have not been well studied in the previous domestic research. So, we tried to analyze the clinical characteristics and toxic substances of the patients who were 65 years old or older and who were admitted to the regional emergency medical center due to acute poisoning. Methods: We retrospectively reviewed the medical records and poisoning protocols of the patients who were 65 years of age or older and who had with acute poisoning and who visited the ED in our emergency center from January 2005 to December 2009. We collected the demographic information, the gender, the underlying diseases, the causes and toxic substances, the initial presentation, the treatment and the outcomes. Results: A total of 2179 poisoned patients visited the hospital during 5 years, and among them 244 were 65 years of age or older (11.2%). The mean age was $75.6{\pm}6.9$ years and the male:female ratio was 1:1.7. The most common cause of poisoning was suicide (73.4%) and the most common source of poisonous substances was their own drugs. Of the substances used for poisoning, benzodiazepine was the most common drug (25.8%), followed by sedatives other than benzodiazepine (25.4%), insecticide (12.7%), chemical agents (12.3%) and herbicides (8.2%). The most common initial presentation was mental change (64.8%). When comparing the factors between the three elderly groups, there was no difference in gender, the cause, the substances and the underlying disease. The outcomes of treatment included ICU admission (56.1%), a good condition at discharge (12.7%) and admission to a general ward (12.7%). The overall mortality rate was 10.2% for the elderly patients. Conclusion: In this Korean study, unlike the foreign studies, the most common cause of poisoning in elderly patients was intentional poisoning. The admission rate was 68.8% and mortality rate was 10.2%.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제32권1호
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• pp.17-27
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• 2021

Objectives: Deliberate self-poisoning (DSP) is the most common suicide method and can be life-threatening. The purpose of this study was to investigate the factors related to the lethality of DSP and the characteristics of the adolescent group. Methods: A retrospective study was conducted on patients who had visited an academic hospital's regional emergency medical center between 2015 and 2018. The data reviewed through their medical records included sociodemographic factors, clinical variables, and psychiatric treatment. Four groups (Q1-Q4) were categorized by descriptive analysis using the risk-rescue rating scale. Results: A total of 491 patients were enrolled in this study. This study showed that high lethality had statistically significant associations with male sex, older age, admitting suicidal intentions, and the use of herbicides for suicide. Logistic regression analyses showed a significant association between high-lethality and female [odds ratio (OR)=0.50, 95% confidence interval (CI)=0.30-0.81, p=0.01], non-psychiatric drugs (over-the-counter drug: OR=2.49, 95% CI=1.08-5.74, p=0.03; herbicide: OR=8.65, 95% CI=3.91-19.13, p<0.01), and denial of suicide intent (OR=0.28, 95% CI=0.15-0.55, p<0.01). Conclusion: This study showed the clinical factors associated with the high lethality of DSP and suggested that efforts were needed to care for and thoroughly examine patients with DSP.

• Archives of Plastic Surgery
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• 제48권6호
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• pp.614-621
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• 2021

Background Reconstruction of congenital microtia remains challenging, particularly in patients with a history of ear canaloplasty due to insufficient regional soft tissue. The insertion of a tissue expander prior to implantation of the cartilage framework has traditionally been employed. However, this procedure could induce additional morbidity. Herein, we present a method using V-Y advancement of a temporal triangular flap to gain additional soft tissue in these challenging cases. Methods Congenital microtia patients with a history of ear canaloplasty who underwent auricular reconstruction using the Nagata technique between 2016 and 2020 were reviewed. To obtain additional soft tissue, V-Y advancement of a temporal triangular flap was performed concurrently with implantation of the costal cartilage framework, without prior insertion of a tissue expander. The outcomes of these patients with respect to postoperative complications and esthetics were evaluated. Results Eight patients with bilateral lesions were included. No specific complications developed after the first-stage surgery. However, one patient experienced complications after the second stage (auricular elevation). An analysis of the esthetic results showed most patients had excellent outcomes, achieving a satisfactory convolution. The median number of operations needed to complete reconstruction was 2, which was fewer than required using the conventional method with prior insertion of a tissue expander. Conclusions In patients with a history of previous canaloplasty, V-Y advancement of a temporal triangular flap could serve as an alternative to tissue expansion for microtia reconstruction. This technique provided reliable and satisfactory results with a reduced number of surgical stages.

• 대한임상검사과학회지
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• 제47권4호
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• pp.267-272
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• 2015

밀착연접(tight junction)은 사람의 표피에서 관찰되는 세포간 이음(intercellular junction) 중 하나로서, 표피 과립세포층의 세포간격에 위치하여 인접한 세포들을 접합시키고 전해질과 수분의 이동을 조절하는 장벽기능을 비롯한 다양한 생물학적 기능을 수행한다. 이러한 밀착연접의 대표적 단백성분인 occludin은 그 발현도가 밀착연접의 표피-생물학적 기능성과 높은 상관관계가 있는 것으로도 알려져 있다. 본 연구에서는 신체 여러 부위의 정상피부에서 occludin의 발현도 또는 발현정도의 상이성 여부를 알아보기 위하여 occludin에 대한 항체를 이용한 간접 면역형광검사를 시행하여 그 결과를 비교 검토하고자 하였다. 신체 7개 부위별로 각 4개씩의 정상 피부조직을 채취하여 항 occludin 항체를 이용한 간접 면역형광검사를 시행한 결과, 양성반응을 보이는 최종 희석배수의 역수(reciprocal of end-point titer)로 표시한 부위별 occludin 항원의 발현도는 두피에서 300, 얼굴에서 600, 목에서 300, 팔에서 200, 배에서 600, 그리고 등과 다리에서는 모두 400으로 관찰되어 신체 부위별 occludin의 발현도에는 통계학적으로 유의한 차이가 있음을 알 수 있었다(p=0.001). 본 연구에서 관찰된 신체 부위별 occludin의 발현도의 차이는 밀착연접의 부위별 발현의 차등을 시사하는 소견으로서, 표피 피부장벽의 생물학적 기능의 가능한 부위별 차등성과도 관계가 있을 것으로 사료된다.

• 대한핵의학회지
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• 제33권3호
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• pp.327-336
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• 1999

목적: 이 연구의 목적은 3D FDG-PET 뇌영상의 정량적 정확도와 임상적 유용성을 연구하는 것이다. 대상 및 방법: 24명의 환자에게 약 370 MBq의 FDG를 주사하고 섭취되기까지 30분을 대기한 후 GE $Advance^{TM}$ PET을 사용하여 30분간의 2D 영상과 10분간의 3D 영상을 얻었다. 백질, 회백질, 병변, 정상조직의 관심영역 분석을 통하여 영상대비와 FDG 섭취비를 구하여 비교하였다. 3D PET의 효율을 최대화하기 위하여 투과스캔을 사용한 경우와 사용하지 않은 경우의 감쇠보정 효과를 비교하였다. 결과 3D 영상의 영상대비는 2D 영상이 1 일 때 산란보정을 실행한 경우 회백질 대 백질에서 $0.95{\pm}0.12$, 정상 대 병변에서 $0.96{\pm}0.05$이었다. 2D 영상의 FDG 섭취비가 1일 때 3D 영상의 FDG 섭취비는 산란보정을 실행한 경우 $1.02{\pm}0.08$이었다. 3D 영상은 영상대비, 분해능, 영상 잡음에 대한 순위 척도평가에서 각각 81%, 83%, 81%에 해당되는 등급을 받아 선호도가 우수하였다. 3D 영상에서 계산감쇠보정 방법은 측정감쇠보정 방법에 필적하는 결과를 얻었다. 결론: 산란보정과 계산감쇠보정을 실시한 3D 영상은 일반적인 2D 영상과 비교하여 정량적으로 정확한 결과를 나타냈으며 정성적으로 유용하였다. 3D 영상은 일상 임상환경에 충분히 적용할 수 있으며 환자 스캔 시간을 단축하고 방사능 피폭량을 감소시키는 장점이 있었다.

• The Korean Journal of Physiology and Pharmacology
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• 제12권4호
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• pp.185-191
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• 2008

Activation of c-Jun N-terminal kinase (JNK), a member of the mitogen-activated protein kinase family, is an important cellular response that modulates the outcome of the cells which are exposed to the tumor necrosis factor (TNF) or the genotoxic stress including DNA damaging agents. Although it is known that JNK is activated in response to genotoxic stress, neither the pathways to transduce signals to activate JNK nor the primary sensors of the cells that trigger the stress response have been identified. Here, we report that the receptor interacting protein (RIP), a key adaptor protein of TNF signaling, was required to activate JNK in the cells treated with certain DNA damaging agents such as adriamycin (Adr) and 1-${\beta}$-D-arabinofuranosylcytosine (Ara-C) that cause slow and sustained activation, but it was not required when treated with N-methyl-N-nitro-N-nitrosoguanidine (MNNG) and short wavelength UV, which causes quick and transient activation. Our findings revealed that this sustained JNK activation was not mediated by the TNF (tumor necrosis factor) receptor signaling, but it required a functional ATM (ataxia telangiectasia) activity. In addition, JNK inhibitor SP-600125 significantly blocked the Adr-induced cell death, but it did not affect the cell death induced by MNNG. These findings suggest that the sustained activation of JNK mediated by RIP plays an important role in the DNA damage-induced cell death, and that the duration of JNK activation relays a different stress response to determine the cell fate.

• 한국지리정보학회지
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• 제25권1호
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• pp.77-100
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• 2022

저성장·고령화시대에 접어들면서 지방의 많은 도시들이 인구감소문제를 경험하고 있다. 생산인 력감소, 재정감축, 삶의 질 저하, 공동체 기반 붕괴 등 다양한 형태의 쇠퇴현상들이 연쇄적으로 발생하면서 지방소멸의 벼랑 끝으로 몰리고 있다. 본 연구는 저성장·고령화 시대 인구감소도시의 효율적인 공간관리 정책으로써 컴팩시티 계획을 적용하기 위해 공간통계기법과 GIS를 활용하여 도시 내 고용창출중심지 추정과 고용 권역을 설정하는 방법론을 제안하였다. 구체적으로 컴팩시티에 관한 선행연구 검토를 통하여 종사자수, 정주인구수, 개발용지 면적을 고려한 새로운 지표 '고용복합지수'를 정의하고, 국지적 모란지수와 핫스팟 분석을 적용하여 고용창출중심지를 추정하였다. 창원시를 대상으로 2013년, 2015년, 2017년, 2019년의 4개 년도를 사례분석을 실시하여 고용창출중심지의 압축된 다핵구조를 확인하였다. 이 결과를 바탕으로 지속적 도시 성장을 위한 산업중심 권역 설정과 컴팩시티 공간정책의 시사점을 제시하였다. 본 분석 결과는 지역활성화 플랫폼을 위한 기능적·제도적 권역 거버넌스의 기초자료로써 인구감소, 지역총생산, 에너지 절감에 대응할 수 있는 공공시설배치, 교통계획, 의료보건 계획 등 공간정책 의사 결정에 필요한 유의미한 정보를 제공할 수 있을 것으로 기대한다.

• Journal of Preventive Medicine and Public Health
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• 제43권3호
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• pp.222-234
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• 2010

Objectives: Limited research has investigated the specific needs of patients with cancer. This study was performed to explore patients needs and the related factors. Methods: The data were collected by 1 National Cancer Center and 9 regional cancer centers in Korea. An interview survey was performed with using a structured questionnaire for the subjects(2661 patients who gave written informed consent to particiate) survey 4 months after diagnosis and review of medical records. Data were analyzed using t-test, ANOVA and multiple regression analysis. Results: When comparing the relating factors related with patient needs to the sociodemographic characteristics, the female group showed a higher level of recognition for physical symptoms, social support needs. The younger group showed a significantly higher level of recognition for health care staff, psychological problems, information and education, social support, hospital services needs. In addition, the higher educated group showed a higher level of recognition for health care staff, physical symptoms, social support needs. The higher income and office workers group showed a higher level of recognition for hospital services needs. When comparing the relating factors related with patient needs to the cancer, the breast cancer group showed a higher level of recognition for all needs excluding physical symptoms, accessibility and financial support needs. The combined radiotherapy with surgery and chemotherapy group showed a higher level of recognition for psychological problems, information and education, social support needs. Conclusions: This study showed that needs on patient with cancer was significantly influenced by female, higher educagion, lower income, having religion, office worker, liver cancer, breast cancer, colon cancer, chemotherapy, and combined therapy.

• Journal of Trauma and Injury
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• 제18권2호
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• pp.148-154
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• 2005

Purpose: This study was conducted to gather descriptive data on trauma victims and to observe the general demographic characteristics and clinical profile of trauma victims who were admitted to a regional emergency medical center in the west southern Kyungsangnam-do area. Objects & Method: The study population consisted of 1,909 trauma patients who visited the emergency department of Gyeongsang National University Hospital between January 2003 and December 2004. The medical records were reviewed in a retrospective manner. Demographic data, the mechanism of injury, and clinical information were collected by three professional medical affairs recorders and an emergency physician and a Revised Trauma Score (RTS) and an Injury Severity Score (ISS) were calculated for each patient. Collected data were analyzed with SPSS software version 12.0. Results: Male patients outmembered female patients (M:F=2.54:1), and the mean age of the population was $40.5{\pm}21.4$ years. The mean RTS and ISS were $7.45{\pm}1.11$ and $8.40{\pm}7.44$, respectively. The seventies showed the highest ISS($10.94{\pm}8.66$). The most common mechanism of injury was motor-vehicle accidents (45.57%), followed by falls or slips(28.26%), and other blunt injuries(12.68%). The most frequent causes of death was cerebral herniation due to head injury(68.4%) and irreversible shock(26.3%). Conclusion: The present study clarified the demographic and clinical characteristics of trauma patients in the Kyungsangnam-do area. In the future, prospective clinical data collection is needed for a more sophisticated trauma study.

• 근관절건강학회지
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• 제22권1호
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• pp.40-47
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• 2015

Purpose: The purpose of this study was to identify factors influencing on performance of preventive actions to be exposed to infection in emergency nurses. Methods: Participants were 200 emergency nurses working in a regional emergency medical center, 4 local emergency medical centers, and 5 local emergency medical facilities in B city. The data were analyzed with descriptive statistics, independent t-test, ANOVA, Scheff$\acute{e}$'s test, Pearson's correlation coefficients, and stepwise multiple regression analysis using SPSS/WIN 21.0 programs. Results: There was no difference in performance of preventive actions to be exposed to infection by socio-demographic and job-related characteristics. The results of stepwise multiple regression analysis showed that levels of perception of preventive actions to be exposed to infection (${\beta}$=.40, p<.001) and protective environment on exposure to infection (${\beta}$=.22, p<.001) were significantly associated with performance of preventive actions, explaining 26.3% of the variance. Conclusion: In conclusion, improving performance of preventive actions to be exposed to infection is important to protect emergency nurses from exposure to infection. Thus, efforts to enhance protective environment on exposure to infection and to improve perceptions of preventive actions to be exposed to infection are necessary to improve the performance of preventive actions in emergency nurses.