• Asian Spine Journal
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• v.12 no.6
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• pp.1010-1016
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• 2018

Study Design: Retrospective cohort study. Purpose: To report on spinal fusion assessment using computed tomography (CT) after adult spinal deformity (ASD) surgery using ultra-low dose recombinant human bone morphogenetic protein 2 (RhBMP-2). Overview of Literature: The reported dose of RhBMP-2 needed for successful spinal posterolateral fusion in ASD ranges from 10 to 20 mg per spinal level. This study reports the use of ultra-low dose of RhBMP-2 (0.07 mg per facet) to achieve spinal fusion in multilevel ASD surgery. Methods: Consecutive patients who underwent ASD surgery using ultra-low dose RhBMP-2 were recruited. Routine postoperative CT analysis for spinal fusion was performed by two spine surgeons. Inter-observer agreement was calculated for facet fusion (FF) and interbody fusion (IBF) at 6 and 12 months after the procedure. Results: Six consecutive ASD patients with a mean age of 62 years (28-72 years) were examined. Each patient received a total dose of 12 mg with an average dose of $0.69{\pm}0.2mg$ (0.42-1 mg) per single FF and $1.38{\pm}0.44mg$ (0.85-2 mg) for IBF. Total 131 FF and 15 IBF were examined in the study, with 88 FFs and nine IBFs being analyzed specifically at 6 months after the surgery. FF and IBF reported by surgeons A and B at 6 months were 97.7% vs. 91.9% FF, respectively (${\kappa}=0.95$) and 100% vs. 100% IBF, respectively (${\kappa}=1$). Two patients underwent longitudinal follow-up CT at 12 months, and the FF rates reported by surgeons A and B were 100% vs. 95.8%, respectively (${\kappa}=0.96$). Five out of nine facet (56%) non-unions were identified at the cross-links. The remaining four facet pseudarthrosis were noted at 1-2 spinal levels caudal to the cross-links. At the final clinical follow-up, there was no rod breakage, deformity progression, neurological deficit, or symptom recurrence. The Oswestry Disability Index improved by an average of $32.8{\pm}6.3$, while the mental component summary of the 36-item Short-Form Health Survey improved by an average of $4.7{\pm}2.1$, and physical component summary improved by an average of $10.5{\pm}2.1$. Conclusions: To our knowledge, this is the first study to report a CT that defined 92%-98% FF and 100% IBF using the lowest reported dose of RhBMP-2 in multilevel ASD surgery. The use of ultra-low dose RhBMP-2 reduces the RhBMP-2 related complications and healthcare costs.

• Journal of Korean Foot and Ankle Society
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• v.23 no.1
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• pp.12-17
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• 2019

Purpose: This study examined the clinical outcomes and usefulness of triamcinolone acetonide (TA) injections as an option in the conservative treatment of patients with lateral malleolar bursitis of the ankle. Materials and Methods: A total of 27 patients (27 ankles), in whom TA injection had been performed between March 2016 and June 2017, were reviewed retrospectively. After the aspiration of fluid in the lateral malleolar bursal sac, 1 mL (40 mg) of TA was injected into the malleolar bursal sac. After the injection, the ankle was compressed with an elastic cohesive bandage for 2 to 4 weeks. The clinical outcomes and side effects were evaluated at the following time points: 2 weeks, 4 weeks, 3 months, 6 months, and 1 year after TA injection therapy. The responses to treatment were assessed according to the degree of fluctuation, shrinkage of the bursal sac, and soft tissue swelling. Results: The mean age was 62.1 years (range, 41~81 years); there were 19 males and 8 females. Complete resolution was observed in 26 patients (96.3%) after the first or second application of a TA injection, and a partial response was observed in 1 patient (3.7%) after the first TA injection. The physical component scores of Medical Outcomes Study 36-item Short-Form Health Survey improved from 71.1 to 76.0 at the last follow-up (p=0.001). Associated complications were 1 patient (3.7%) with skin atrophy and 3 patients (11.1%) with transient hyperglycemia in diabetes mellitus. Conclusion: TA injection is a useful and safe procedure for patients not responding to the usual conservative treatment of lateral malleolar bursitis of the ankle.

• The Journal of Internal Korean Medicine
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• v.43 no.4
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• pp.656-679
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• 2022

Objectives: The aims of this study were to evaluate the fidelity of stroke stage reporting, the timeliness of the outcome measures, and the use of the core outcome set. Methods: We searched the literature using 6 domestic databases. We selected studies that used Korean medicine interventions and targeted stroke patients with motor sequelae. We examined whether the included studies reported the stroke stage and whether they used the outcome measures in the appropriate period based on the recommendations of the "Stroke Evidence Database to Guide Effectiveness". We also confirmed the use of the essential assessment tools suggested by the core outcome set. Results: Overall, 77 studies were finally selected, with 16 (21%), 55 (71%), and 6 (8%) published on the acute, subacute, and chronic phases, respectively. Only 11 of the studies directly mentioned the stroke stage. The most commonly used assessments were the National Institutes of Health Stroke Scale, Modified Barthel Index, and Manual Muscle Testing. Only 5 studies failed to apply the stage-related outcome measures at the recommended period. The outcome variables used inadequately were the National Institutes of Health Stroke Scale, Functional Ambulation Categories, 36-Item Short Form Health Survey, and Mini-Mental State Examination. Among the core outcome set items, some studies used liver and renal function tests, but no herbal medicine safety reporting was conducted. Conclusions: In future studies, we propose to ensure accurate reporting of the stroke stage with reliable outcome measures to deliver better clinical and research outcomes. Furthermore, in future clinical studies on stroke, a standard protocol that reflects the core outcome set should be developed.

• Journal of Oriental Neuropsychiatry
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• v.35 no.1
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• pp.115-140
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• 2024

Objectives: This study investigates the impact of M&L psychotherapy on an adolescent with anxiety disorders transitioning into adulthood, using a retrospective mixed-method approach. Methods: An adolescent with Diagnostic Statistical Manual of Mental Disorders (DSM)-5-diagnosed anxiety disorders underwent combined treatment with M&L psychotherapy and complex Korean medicine therapy over a period of approximately two years. Patient records tracked the diagnosis, treatments, and progress. In-depth interviews were also conducted. The study used a convergent parallel mixed-method approach, integrating quantitative analysis from psychological assessments, including the State-Trait Anxiety Inventory (STAI-X), the Core Seven Emotions Inventory-short form (CSEI-s), and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), with qualitative analyses of traditional Korean medicine counseling session notes, interviews, and other qualitative psychological assessments. Results: State anxiety decreased from 40 to 36, and trait anxiety decreased from 42 to 34. MMPI-2 L scale scores decreased slightly to 64T, whereas S scale scores increased to 62T, and FRS scores decreased to 70T from an initial score of 78T. Qualitative analysis revealed an increase in the MMPI-2 Es scale, identified as "subjectivity." Joy (喜) emerged as the highest emotional profile score in the CSEI-S. Scores for anger (怒), thought (思), fear (恐), and fright (驚) decreased, indicating improved negative emotions. Qualitatively, expressions of determination to "move forward" and "strengthen the mind" were noted, suggesting enhanced "lower danjeon (下丹田)." Conclusions: Integrating traditional Korean medicine treatment with M&L psychotherapy for a vulnerable adolescent with anxiety disorders demonstrated efficacy. Further research is warranted to substantiate the effectiveness of M&L psychotherapy and advocate for its wider adoption in mainstream practice.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.36 no.3
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• pp.88-99
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• 2018

After UNESCO appointed Royal Tombs of the Joseon Dynasty to be World Cultural Heritages(2009), Cultural Heritage Administration in Korea established Management Office of Royal Tombs of the Joseon Dynasty(2012) and conducted Mid to Long-Term Plan on Conservation, Management, Utilization of World Heritage 'Royal Tombs of the Joseon Dynasty(2015)'. The report, as an implementation plan, provides detailed contents of the maintenance planning of Royal Tombs of the Joseon Dynasty. From this background, with a view to comprehending the characteristics of the maintenance planning of trees in historical landscape forests, this study extracted the contents related to the historical landscape forests of the 40 Royal Tombs of the Joseon Dynasty from the "Mid to Long-term Plan" and conducted literature research. The results of the study are as follows. First, from 2016, the short-term plans have provided detailed contents on logging, transplanting and planting trees in the plans divided by stages. On the other hand, the long-term plans, instead of presenting abstract contents repeatedly for each royal tomb, should seek vegetation landscape that each royal tomb should aim for. Second, since the areas that are in charge of the various functions of the royal tombs have been subjects to the maintenance planning, it is effective to establish a maintenance planning by separating functional areas instead of the comprehensive concept as historical landscape forests. Third, the maintenance planning of trees in historical landscape forest of the Royal Tombs of Joseon Dynasty is based on daily management such as density control and maintaining the shape of trees, which is necessary to sustain the forest. Also, due to the goal of preserving the pine forest, which is recognized as a prototype vegetation landscape, foreign species and other trees have been more cut down. With a few limited types of tall tree but few shrubs and flowers, it is characterized that the orientation toward aesthetic landscapes is insufficient in large green spaces. Fourth, according to the function of the tomb, it is divided into entrance area, ceremonial area, burial area and outer forest, and the contents of the maintenance planning are analyzed by basic conditions of tree management: prototype, ecology, functionality, and aesthetics. After studying the tree management characteristics of each area, four suggestions are made: understanding the diversity of trees that form prototype landscape as a management plan, sustainability of various forests adapted to ecological environment, convenience required in addition to ceremony and safety characterizing the Royal Tombs of Joseon Dynasty, and the necessity of access to aesthetic landscape on the tombs.

• Journal of Korean Society of Forest Science
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• v.36 no.1
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• pp.9-25
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• 1977

As a successive work of the variation studies of natural Pinus densiflora stands, some characteristics of individual trees of the three natural populations selected from the Kwang-won Province, the middle-east part of Korean peninsula, as shown in the location map, were investigated. And the statiscal differences between individuals within population, and between populations were analysed. Twenty trees from each population were selected for this study purpose. Doing this, those trees lagged in growth, usually showing poorer form, were eliminated. The results obtained are summarized as follows: 1. Though the average population ages had the ranage between 50 and 63, the growth of height or diameter was similar. Population No.9 is, however, considered to have better tree forms at glance. Population No.8 showed the heighest value not only in the clear-stem-length ratio. 0.53 but also in the crown-index 0.91. The higher value can be result from those trees having long lateral branches and relatively short crown height, meaning undesirable crown shape. In regard to the fine branchedness and the acuteness of branching angle, the population No.9. is considered to be a better one, whereas there was almost no difference in crown height among populations. 2. Checking the frequency distributions of the ratio of the clear-stem-height to the total height and the crown-indices, some difference between populations are considered. These might be attributed to the previous way of stand mangement which alters the density. 3. In the serration density, the average number of 54 per 1cm needle length, the significant differences exist between individual trees within population but not between populations. A few trees which extremly high serration density were observed. As in serration, so tendencies were in the number of stomata row and resin duct. 4. The population 8 had the resin duct index value of 0.074 as the highest which was twice or triple of the other ones. 5. The patterns of increasing process of the average 10-year-ring-segment were not similar till the 30 years of age, but beyond this, the tendency lines were aggregated. 6. Regading the average summer wood ratio, no diffrence between populations, but in the ranges, i.e. 23 to 30 in population No.8. and 16 to 36 in population No.9., with regad to the specific gravity of wood, there were hardly observed any difference between populations even in the ranges values. As the increase of tree ages, the increase of specific gravity was followed but the increasing patterns were not similar between populations. 7. No significant differences between populations in the average tracheid length and the range were detected. However, the length was increased according to the age increase. The increasing pattern was same between populations.

• Korean Security Journal
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• no.34
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• pp.233-258
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• 2013

In the early days of the Goryeo Dynasty, the royal guard was comprised of the central regular army in the 2-gun-6-wi system, and Nasungeomgun was in charge of the security inside the palace. However, the military system became disorganized during the period of military rule and the royal guard had to rely on military subjects. The military officials suppressed the civil ministers centering on Jungbang, the guarding organization close to the King to incapacitate the royal authority and control the state affairs. When the rule of the three leaders of the military rule became short-lived and Dae-seung Gyeong is raised to the ruler, he organized a do-or-die squad comprised of a hundred and more people for his personal safety, and this became the first dobang. Dobang was disassembled after Dae-seung Gyeong died of disease, but under the rule of Chung-heon Choe, Dae-seung Gyeong's dobang was revived and reinforced into 'Yukbeon Dobang' to provide the ruler with personal protection and intensify the ruling system, and it was quite a large organization with more refined system. Yukbeon Dobang was expanded and reinforced into Naeoedobang under the rule of Woo Choe, the son of Chung-heon Choe, and it was enhanced even more into Dobang Samsipyukbeon System under the rule of the grandson, Hang Choe. Dobang can be considered as the guard organization in modern sense, and it collected information and surveyed the area where guarding is required and house troops that belonged to Naedobang eliminated the risks that may follow afterwards to make assurance doubly sure for guarding. The Choe's regime established Mabyeolcho as a private guard organization in addition to dobang, and this formed the cavalry and infantry units with dobang. Yabyeolcho organized by Woo Choe in the reign of King Gojong was divided into Joabyeolcho and Ubyeolcho, and later Sineuigun was integrated with them to form Sambyeolcho. Originally, Yabyeolcho was established under the rule of Woo Choe to prevent crime in the evening, but after Sineuigun was organized with the ones who were captured by Mongolian army but escaped, in other words when Sambyeolcho was organized, the organization displayed much broader influence by covering military and police affairs as well as punishment and imprisonment. The guarding organization during the Period of Military Rule in the Goryeo Dynasty did not have strict distinction between official guard and personal guard. The private guard in modern days which is the equivalent of personal guard is characterized by its commerciality, however, house troops and the members of dobang did not seem to pursued profit. The guard organization during the period of military rule started from dobang which was organized for personal safety but gradually developed publicness through the participation of civil ministers and expansion, and later it played the pivotal role for social security serving official purpose up to the level where the distinction between official and private activities was blurred during the period of Sambyeolcho.

• Journal of Nutrition and Health
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• v.41 no.8
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• pp.818-831
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• 2008

The purpose of this study was to investigate the dietary behavior, health-related lifestyles and nutrient intake status of college students according to physical activity levels. The physical activity levels were measured using the Korean version of the International Physical Activity Questionnaire (IPAQ) short form. The subjects of this study were 438 college students (243 males and 195 females) in Incheon area and were divided by gender and by physical activity levels, which included low, moderate and high physical activity groups. The average age of male and female students were 23.7 and 21.0 years old, respectively. The prevalence of the low physical activity group was 11.5% for males and 30.8% for females and that of the high physical activity group was 38.7% for males and 22.6% for females. According to the criteria for obesity in Asia-Pacific region, 39.1% of the males and 64.1% of the female students investigated were in the normal range of BMI and 30.9% of the males and 4.6% of the female students were in the obesity category. However, percent of body fat in the female students was significantly higher than that of the male students. The soft lean mass of the high physical activity group was higher compared to the other groups. In the low physical activity group, frequency of “eating out” was lower compared to the other groups. The average consumption of energy was 74.4% for males and 80.1% for females of the estimated energy requirement (EER). The mean intakes of vitamin C, vitamin B2, folic acid and Ca were 67.3%, 84%, 52.7% and 36.7% for males and 64.8%, 99.9%, 51.1% and 40.1% for females of recommended intake (RI), respectively. Therefore, it was necessary for obesity prevention as well as health promotion to increase physical activity and to eat an adequate, balanced diet in female college students.

• Applied Microscopy
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• v.36 no.1
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• pp.35-45
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• 2006

Plants of Vitex negundo are known to develop numerous trichomes throughout their body, where certain trichome types have been believed to be one of the plausible structures for the unique scents. In the current study. structural aspects of the trichomes have been examined in leaves and stems of Vitex negundo using TEM and SEM. Trichome types as well as structural changes that occurred in certain trichomes during secretion have been mainly focused. Three type of glandular trichomes and two types of non-glandular trichomes were developed in the epidermis of young and mature Vitex negundo plants. The glandular trichomes included the peltate type (Type 1), the capitate type (Type 2), and degraded capitate type (Type 3), whereas the non-glandular warty trichomes contained the multicellular (Types 4) and unicellular type (Type 5). Type 1 and 2 consisted of head and stalk cells, but their number and size were different. One secretory cavity was formed from the four head cells in the former, but only two head cells were involved in the latter. The cytoplasmic density in the head cell was quite high and in particular, sER and Golgi bodies were well developed. At initiation of their development, the cuticle layer of the head cells separated from the outer tangential wall to form a secretory cavity. Subsequently the cavity expanded acropetally and a large number of secretory vesicles continuously produced from the head cells until they filled the entire cavity. The cavity contained materials that would be soon discharged into intercellular spaces and/or into the air. The cavity began to decrease the volume by contracting at initial secretion but degrade rapidly within short time. It has been suggested that the mode of secretion in V. negundo is probably the eccrine secretion, since no break or rupture of the cavity has been observed during examination. Contrastingly Type 3 exhibited deterioration of the head cell at early stage. Type 4 was about $110{\sim}190{\mu}m$ long, consisting of $2{\sim}3$ cells, and distributed more in the adaxial epidermis compared to the abaxial surface. However, $20{\sim}30{\mu}m$ long Type 5 was extremely dense in both epidermis. Among several trichome types, Type 1 and 2 probably play an important role in discharging unique aromatic scents in plants of V. negundo.

• The Korean Journal of Gastroenterology
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• v.72 no.6
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• pp.325-328
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• 2018

위마비증(gastroparesis)이나 만성 구역 구토 증후군(chronic unexplained nausea and vomiting)으로 인한 구역과 구토에 대한 치료는 일반적으로 사용하는 위장관 촉진제에 만족스럽지 못한 경우가 많고, 여러 부작용으로 인하여 장기적으로 사용하기 어려워 보다 효과적인 치료 방법이 필요하다. 최근 미국에서 발표된 본 연구는 위마비증이나 연관 증후군 환자에서 구역과 구토 증상을 줄이기 위한 aprepitant(neurokinin-1 receptor antagonist) 치료의 효과를 분석한 것으로, 향후 일반적인 치료에 불응성 위마비증 환자에서 새로운 약제 사용을 시도해볼 수 있어 소개하고자 한다. 본 Aprepitant for the Relief of Nausea (APRON) 연구는 기질적 질환을 배제하기 위하여 최근 2년 이내 위내시경이 정상이며, 적어도 6개월 이상 조기 포만감(early satiety), 식후 만복감(postprandial fullness), 팽만감(bloating) 그리고 명치부 통증(epigastric pain)을 유발하는 증상과 함께 만성적인 구역이 있는 18세 이상의 성인 중 4시간의 위배출 검사를 시행받은 환자를 대상으로 하였다. 객관적인 지표로 0점에서 45점까지 보이는 9-증상 Gastroparesis Cardinal Symptom Index(GCSI)가 2주 이상 총 21점 이상이며, 0-100 mm의 visual analog scale (VAS)의 7일간의 구역 증상 평균 25 mm 이상인 환자를 대상으로 하였다. 일주일에 3일 이상 narcotics를 사용하였거나 와파린이나 pimozide, terfenadien, astemizole, cisapride를 복용하였던 환자, 2배 이상으로 간 효소 수치상승을 보이거나 Child-Pugh score 10점 이상, aprepitant에 알레르기를 보이는 환자는 제외되었다. 그렇지만 metoclopramide나 erythromycin을 안정적으로 사용 중인 환자는 제외되지 않았다. 위배출 검사는 2시간에서 60% 이상 남아 있거나 4시간에서 10% 이상 남아 있는 경우에 지연된 것으로 정의되었으며, 지연된 위배출 검사 결과 자체는 환자의 등록 기준에 포함되진 않았다. 등록 기준에 포함된 환자는 1:1로 무작위 배정되어 하루 한 번 125 mg의 aprepitant 복용군과 위약군으로 나누어져 연구가 진행되었으며, 약제 복용 4주간 2주 간격으로, 그리고 복용 후 2주 뒤까지 구역 증상의 호전 정도와 약제 안전성을 확인하였다. 이러한 효과를 판정하기 위하여 환자가 방문하는 동안 GCSI를 포함한 Patient Assessment of Upper GI Symptoms (PAGI-SYM), Gastrointestinal Symptom Rating Scale, daily VAS, daily diary version of the GCSI 그리고 정신 측정 도구와 삶의 질 도구인 Patient health Questionnaire 15와 Short Form 36 version이 측정되었다. 구역에 대한 aprepitant와 위약의 치료 효과의 일차적 판정은 이전 항암 요법에 대한 aprepitant 연구와 같이 28일 평균 VAS 25 mm 미만이거나 치료 전 7일간의 VAS와 비교하여 28일 치료 기간 동안 25 mm 이상 감소한 경우로 정의하였고, 이차 결과는 구역의 매일 시간, 치료 중 구역이 없는 날짜의 퍼센트, PAGI-SYM score의 개선 등으로 확인하였다. 2013년 4월부터 2015년 7월까지 총 126명의 환자가 등록되어 aprepitant군 63명, 위약군 63명으로 무작위 배정되었다. 전체의 57%인 72명에서 위배출 지연이 보였으며, 나머지 43%에서는 정상 또는 빠른 위배출 소견을 보여 만성적으로 설명할 수 없는 구역과 구토에 포함된 환자군으로 확인되었다. 또한 29%에서 당뇨를 가지고 있었으며, 8%에서 수면제를 사용하고 있었다. 최종적으로 aprepitant군은 59명, 위약군은 63명이 연구를 끝까지 종료하였다. 일차 결과에서 aprepitant 군 46%, 위약군 40%의 구역 호전을 보여 두 치료군 간에 통계적으로 의미 있는 차이는 보이지 않았다(상대 위험도 1.2, 95% CI: 0.8-1.7; p=0.43). 그러나 일차 분석의 두 가지 척도(28일 평균 VAS 25 mm 미만과 기저 VAS보다 평균 28일 VAS의 25 mm 이상 감소)를 모두 함께 고려한 민감도 분석에서는 aprepitant군이 37% (22/59)로 위약군의 17%(11/63)에 비하여 통계적으로 의미 있는 구역의 호전을 보였다(상대 위험도 2.1, 95% CI: 1.1-4.1; p=0.01). 또한 이차 분석을 살펴보면 aprepitant군에서 PAGI-SYM 중증도 지수로 확인하였을 때, 구역(1.8 vs. 1.0; p=0.005)과 구토(1.6 vs. 0.5; p=0.001)의 중증도 및 매일 구역 시간의 감소를 보였고, 28일 동안 구역이 없는 날짜의 퍼센트 증가 소견을 보였다. 다른 이차 결과 분석에서 aprepitant군이 PAGI-SYM 중증도 지수의 GCSI 종합 점수(1.3 vs. 0.7; p=0.001), 상당한 증상호전, 구역 구토의 세부 점수, 팽만감 세부 점수 그리고 위식도 역류 증상 점수에서 호전을 보였고, 매일 일기로 표현한 daily diary version of the GCSI에 상복부 통증 중증도, 전체 증상 그리고 Gastrointestinal Symptom Rating Scale의 종합 점수에서 호전을 보였다. 연구 중 발생한 부작용은 주로 경증과 중등도 정도의 부작용이 주로 발생하였지만, aprepitant군(35% vs. 17% 위약군, p=0.04)에서 더 많이 발생하였다. 결론적으로 위마비증 또는 위마비증 유사 증후군으로 인한 만성 구역 및 구토 환자의 무작위 시험에서 aprepitant는 VAS 점수를 통한 주요 결과를 분석하였을 때는 구역의 중증도를 호전시키지 못하였지만 다른 이차적 결과에 대해서는 위약군에 대하여 호전 소견을 보였다. 따라서 aprepitant에 효과적인 반응을 보이는 위마비증 환자를 감별하는 추가 임상시험이 필요할 것으로 판단된다.