• Journal of Chest Surgery
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• v.47 no.3
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• pp.255-261
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• 2014

Background: To determine the predictors of clinical outcomes following surgical descending thoracic aortic (DTA) repair. Methods: We identified 103 patients (23 females; mean age, $64.1{\pm}12.3$ years) who underwent DTA replacement from 1999 to 2011 using either deep hypothermic circulatory arrest (44%) or partial cardiopulmonary bypass (CPB, 56%). Results: The early mortality rate was 4.9% (n=5). Early major complications occurred in 21 patients (20.3%), which included newly required hemodialysis (9.7%), low cardiac output syndrome (6.8%), pneumonia (7.8%), stroke (6.8%), and multi-organ failure (3.9%). None experienced paraplegia. During a median follow-up of 56.3 months (inter-quartile range, 23.1 to 85.1 months), there were 17 late deaths and one aortic reoperation. Overall survival at 5 and 10 years was $80.9%{\pm}4.3%$ and $71.7%{\pm}5.9%$, respectively. Reoperation-free survival at 5 and 10 years was $77.3%{\pm}4.8%$ and $70.2%{\pm}5.8%$. Multivariable analysis revealed that age (hazard ratio [HR], 1.10; 95% confidence interval [CI], 1.05 to 1.15; p<0.001) and left ventricle (LV) function (HR, 0.88; 95% CI, 0.82 to 0.96; p<0.003) were significant and independent predictors of long-term mortality. CPB strategy, however, was not significantly related to mortality (p=0.49). Conclusion: Surgical DTA repair was practicable in terms of acceptable perioperative mortality/morbidity as well as favorable long-term survival. Age and LV function were risk factors for long-term mortality, irrespective of the CPB strategy.

• 한국노년학
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• v.38 no.1
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• pp.225-241
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• 2018

Self-driving is meaningful activity for older persons because it enlarges the range of activity and provides opportunities for social participation. Driving is a complex activity that requires integration of physical, cognitive and sensory functions and is influenced by human and psychological factors. Age related functional deterioration affects the driving ability of older drivers. The purpose of this study is to investigate the factors affecting the risk of accidents and driving cessation of elderly drivers through systematic literature review. MEDLINE, EMBASE, Cochrane Library, KoreaMed, Pubmed were used for searching articles published from 2007 to 2017. 'aged', 'aging', 'automobile driving', 'age factors' were used as search terms and 18 articles were finally selected for analysis among 1,458 articles. In result of the study, the most significant effect showed in the physical domain, the driving habit and the performance function. The most frequent used tools evaluated driving habit and the cognitive function. In demographic characteristics, there was a correlation with the driving discontinue according to sex and age. This study emphasizes the necessity of preparing measures for safety driving with elderly. In addition, it suggests the necessity of systematically services such as individual education programs based on various driving cessation related factors of the elderly.

• 한국노년학
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• v.32 no.4
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• pp.993-1011
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• 2012

The purpose of this study is to investigate the factors associated with the incidence and the transition of disability among Korean older adults. Samples consist of 1,454(42.7%) men and 2,032(58.3%) women aged 65 and over who participated in the 1st and 2nd wave of the Korea Longitudinal Study of Aging: KLOSA. To estimate the level of disability, ADL and IADL disability indexes are used. As the results, major risk factors for ADL/IADL disability incidence include injury, vision problem, cognitive function, depression, health behavior, socioeconomic characteristics and age. Among the normal older adults, the odds ratio of having dementia symptoms at 2nd wave(2008) are 2.0 times greater for the older adults who have less cognitive function than those who don't have at 1st wave(2006). Among the older adults with chronic diseases, the odds ratio of having disability at 2nd wave are 1.8 times greater for the older persons who have depression than those who don't have at 1st wave. Secondly, concerning the predictors affecting the disability transition among the disabled older adults at 1st wave, the likelihood of remaining at the same level or deteriorating the level of IADL disability, as compared with improving the level, is associated with having less instrumental support or being older. These results indicate that it is necessary to prefer multilevel intervention in order not only to prevent the incidence of disability, but also to prolong the deterioration of disability in the older adults.

• Korean Journal of Clinical Pharmacy
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• v.31 no.1
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• pp.44-52
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• 2021

Background: Post-transplant immunosuppression with calcineurin inhibitors (CNIs) is associated with kidney function impairment while mammalian target of rapamycin (mTOR) inhibitors, such as everolimus, can be used for its renal-sparing effects. In this study, we compared the efficacy and safety of everolimus with low dose tacrolimus (EVR+Low TAC) and conventional dose tacrolimus (TAC) in liver transplantation recipients. Methods: Medical records of recipients who received liver transplantation at Seoul National University Bundang Hospital from January 1st 2009 to December 31st 2018 were retrospectively reviewed. Cohort entry date was defined as the day everolimus was initiated and tacrolimus dosage was reduced. All patients were followed up for 1 year. Indicator of efficacy was the incidence of rejection and safety was evaluated by incidence of drug adverse events including renal function. Results: Among 118 patients, there were 40 patients (33.9%) in EVR+Low TAC group. Incidence of rejection, including both biopsy proven acute rejection and clinical rejection, was similar in two groups [7.5% (n=3) vs. 6.4% (n=5), p=1.000]. Renal dysfunction was less frequent in EVR+Low TAC [17.5% (n=7) vs. 35.9% (n=28), p=0.038]. However, incidence rates of dyslipidemia, oral ulcer were more frequent in EVR+Low TAC [45.0% (n=18) vs. 21.8% (n=17), p=0.009; 15.0% (n=6) vs. 1.3% (n=1), p=0.006]. Conclusions: In terms of prevention of rejection, EVR+Low TAC was as effective as TAC and had renal-sparing effect but was associated with increased risk of dyslipidemia and oral ulcer. This study demonstrates that EVR+Low TAC could be an alternative to liver transplant recipients with nephrotoxicity after administration of conventional dose tacrolimus.

• Journal of Korea Entertainment Industry Association
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• v.15 no.7
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• pp.181-192
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• 2021

This study was conducted to investigate the effects of a participatory rehabilitation program on sit-rise and rise-to-walk test performances, and perception and motor skills in adults with medically vulnerable individuals and, adults with developmental disabilities in particular. Seventeen adults with developmental disabilities participated in a participatory rehabilitation program using resistance bands and exercise balls, for 60 minutes once weekly over 13 weeks. Their performances were measured before and immediately after the intervention, and 12 weeks after. The findings were as follows. In the sit-rise test, the number of times rising from sitting posture increased after the intervention versus before, but the difference was not statistically significant. In the rise-to-walk test, the performance showed statistically significant difference over time, and the post-hoc test showed a significant effect after the intervention versus before. There was no significant difference in perception and motor skills. In sum, the participatory rehabilitation program positively influenced dynamic balancing related to functional activities but had no significant effect on perception and motor skills, which is related to motor control and motor learning. It is suggested that to increase the participation in community activities, reduce fall risk, and improve dynamic balancing abilities in adults with developmental disabilities, participatory rehabilitation programs should be utilized to promote the physical wellbeing.

• Journal of Korean Neurosurgical Society
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• v.66 no.3
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• pp.332-339
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• 2023

Objective : The present study aimed to investigate the clinical characteristics of electrolyte imbalance in patients with moderate to severe traumatic brain injury (TBI) who underwent craniotomy and its influence on prognosis. Methods : A total of 156 patients with moderate to severe TBI were prospectively collected from June 2019 to June 2021. All patients underwent craniotomy and intracranial pressure (ICP) monitoring. We aimed to explore the clinical characteristics of electrolyte disturbance and to analyze the influence of electrolyte disturbance on prognosis. Results : A total of 156 patients with moderate and severe TBI were included. There were 57 cases of hypernatremia, accounting for 36.538%, with the average level of 155.788±7.686 mmol/L, which occurred 2.2±0.3 days after injury. There were 25 cases of hyponatremia, accounting for 16.026%, with the average level of 131.204±3.708 mmol/L, which occurred 10.2±3.3 days after injury. There were three cases of hyperkalemia, accounting for 1.923%, with the average level of 7.140±1.297 mmol/L, which occurred 5.3±0.2 days after injury. There were 75 cases of hypokalemia, accounting for 48.077%, with the average level of 3.071±0.302 mmol/L, which occurred 1.8±0.6 days after injury. There were 105 cases of hypocalcemia, accounting for 67.308%, with the average level of 1.846±0.104 mmol/L, which occurred 1.6±0.2 days after injury. There were 17 cases of hypermagnesemia, accounting for 10.897%, with the average level of 1.213±0.426 mmol/L, which occurred 1.8±0.5 days after injury. There were 99 cases of hypomagnesemia, accounting for 63.462%, with the average level of 0.652±0.061 mmol/L, which occurred 1.3±0.4 days after injury. Univariate regression analysis revealed that age, Glasgow coma scale (GCS) score at admission, pupil changes, ICP, hypernatremia, hypocalcemia, hypernatremia combined with hypocalcemia, epilepsy, cerebral infarction, severe hypoproteinemia were statistically abnormal (p<0.05), while gender, hyponatremia, potassium, magnesium, intracranial infection, pneumonia, allogeneic blood transfusion, hypertension, diabetes, abnormal liver function, and abnormal renal function were not statistically significant (p>0.05). After adjusting gender, age, GCS, pupil changes, ICP, epilepsy, cerebral infarction, severe hypoproteinemia, multivariate logistic regression analysis revealed that hypernatremia or hypocalcemia was not statistically significant, while hypernatremia combined with hypocalcemia was statistically significant (p<0.05). Conclusion : The incidence of hypocalcemia was the highest, followed by hypomagnesemia, hypokalemia, hypernatremia, hyponatremia and hypermagnesemia. Hypocalcemia, hypomagnesemia, and hypokalemia generally occurred in the early post-TBI period, hypernatremia occurred in the peak period of ICP, and hyponatremia mostly occurred in the late period after decreased ICP. Hypernatremia combined with hypocalcemia was associated with prognosis.

• Journal of The Korean Society of Integrative Medicine
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• v.12 no.1
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• pp.27-39
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• 2024

Purpose : Smoking is a major factor in chronic obstructive pulmonary disease (COPD), but the effect of electrical cigarette smoking on COPD development is still uncertain. This study aimed to compare the functions of airways and lungs exposed to combustible cigarettes and electrical cigarettes based on the pulmonary function test (PFT) results from the Korean National Health and Nutrition Examination Survey (NHANES). Methods : This study used data from 8,942 participants with PFT results out of 47,309 total subjects from the 6th to 8th Korean NHANES (2014-2015, 2016-2018, and 2019, respectively). Individuals with diseases such as cancer, ex-smokers, and dual tobacco users were excluded. The PFT results were analyzed according to the COPD diagnostic criteria. After adjusting for confounding variables, a complex sample generalized linear model ANOVA test was performed to investigate the association between PFT results and combustible smoker or electrical cigarette user groups. Results : In an analysis based on the obstructive ventilatory disorders (forced expiratory volume in 1 second[FEV₁]/forced vital capacity[FVC]<.7), combustible cigarette smokers showed a 3.46 times higher risk of COPD compared to non-smokers, while electrical cigarette smokers exhibited no significant difference in terms of COPD-related risks compared to non-smokers. FEV₁ showed a negative relation with combustible cigarette smokers as reported elsewhere (B=-.07, p<.001). FEV₁/FVC was negatively related to both combustible cigarette smokers (B=-.03, p<.001) and electrical cigarette smokers (B=-.02, p<.001). Conclusion : FEV₁/FVC decreases were observed in the long-term exposure to both combustible and electrical cigarettes. The lower FEV₁ in the combustible cigarette group implies the worsening of the severity of COPD, suggesting more damage to the airways and lungs in the short term. Therefore, the temporary electrical cigarettes use for the transition period in order to smoking cessation potentially aids to reduce the harmful effect of combustible cigarettes in COPD development.

• The Korean Journal of Physiology and Pharmacology
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• v.18 no.5
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• pp.411-418
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• 2014

Vascular remodelling is an adaptive mechanism, which counteracts pressure changes in blood circulation. Nicotine content in cigarette increases the risk of hypertension. The exact relationship between nicotine and vascular remodelling still remain unknown. Current study was aimed to determine the effect of clinically relevant dosage of nicotine (equivalent to light smoker) on aortic reactivity, oxidative stress markers and histomorphological changes. Twelve age-matched male Sprague-Dawley rats were randomly divided into two groups, i.e.: normal saline as control or 0.6 mg/kg nicotine for 28 days (i.p., n=6 per group). On day-29, the rats were sacrificed and the thoracic aorta was dissected immediately for further studies. Mean arterial pressure (MAP) and pulse pressure (PP) of nicotine-treated vs. control were significantly increased (p<0.05). Nicotine-treated group showed significant (p<0.05) increase tunica media thickness, and decrease in lumen diameter, suggesting vascular remodelling which lead to prior hypertension state. The phenylephrine (PE)-induced contractile response in nicotine group was significantly higher than control group ($ED_{50}=1.44{\times}10^5M$ vs. $4.9{\times}10^6M$) (p<0.05~0.001). However, nicotine-treated rat showed significantly lower endothelium-dependent relaxation response to acetylcholine (ACh) than in control group ($ED_{50}=6.17{\times}10^7M$ vs. $2.82{\times}10^7M$) (p<0.05), indicating loss of primary vascular function. Malondialdehyde (MDA), a lipid peroxidation marker was significantly higher in nicotine group. Superoxide dismutase (SOD) enzymatic activity and glutathione (GSH) were all reduced in nicotine group (p<0.05) vs. control, suggesting nicotine induces oxidative imbalance. In short, chronic nicotine administration impaired aortic reactivity, probably via redox imbalance and vascular remodelling mechanism.

• Transactions of the Korean hydrogen and new energy society
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• v.25 no.5
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• pp.509-515
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• 2014

At the fuel processing system (FPS) of fuel cell vehicle, hydrogen recirculation blower (HRB) is used for the recirculation of remained hydrogen after reaction. In this paper, noise and vibration improvement of HRB is studied by changing design and control. It is checked the campbell diagram and critical speed for stability of rotor, and housing stiffness is improved using simulation of frequency response function (FRF). A method is suggested that can decrease the unbalance amount of the rotor and impeller which main source of noise and vibration. In order to reduce the noise during deceleration of blower, electrical braking is applied and tested the risk impact of durability. Founded the optimum switching frequency of the motor control, and reduced the idle rpm by increasing of aerodynamic performance. The superiority of paper is proved by measurement of the improved product's noise and vibration.

• Journal of Korean Academy of Nursing
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• v.45 no.2
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• pp.231-239
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• 2015

Purpose: This study was conducted to examine the prevalence of successful aging and factors influencing successful aging. Methods: This was a secondary analysis study. Data were analyzed from 10,462 elderly people who participated in the 2011 National Elderly Survey. According to the use of community senior facilities, participants were divided into 4 groups: those who used senior centers (group A, n=580), village senior clubs (group B, n=3,240), both of the 2 facilities (group C, n=339), and neither of the 2 facilities (group D, n=6,303). Cross-tabulation and logistic regression were performed. Results: The prevalence of successful aging was highest in group C (20.94%) and lowest in group D (10.41%). The physical & mental function and active engagement domains were highest in group C, while they were lowest in group D. The disease & risk factors domain were highest in group A, while lowest in group B. An educational level of middle-school or higher and income level in the third or higher quintile were significant factors for predicting successful aging in all groups. Conclusion: These results provide a basis for designing prevention and management programs as interventions to increase the prevalence of successful aging in Korean older adults.