• 무역학회지
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• 제43권3호
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• pp.101-124
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• 2018

한국 제조물책임법 제정 후 입증책임에 관한 신설조항이 추가되고 소비자 보호의 목적에 맞게 개정된 후 시행되고 있다. 신설조항 제3조 2는 입증책임 완화를 위해 간접사실을 입증하면 인과관계를 추정하는 규정을 명문화하였다. 소비자의 권익이 높아지고 소비자 문제에 대중의 관심이 쏠리고 있지만 여전히 문제점이 대두하고 있는 상황이다. 이 문제점을 해결하기 위해 강력한 소비자의 권리를 가지고 있는 미국 제조물책임법을 연구하여 소비자 보호의 측면에서 한국의 제조물책임법이 나아가야 할 방향에 대해 서술하였다. 비교분석 결과를 도출하면 엄격책임의 엄격성, 소비자분쟁해결, 입증가능성, 소송접근성의 기준에서 미국이 한국에 비해 엄격책임의 개념이 확장되어 제조물책임에 엄격책임을 적용 시 더욱 강하게 다루어졌으며, 소비자분쟁해결제도는 교육과 체제적인 소비자 ADR제도를 운영하여 소비자를 철저하게 보호하였다. 입증가능성기준에서 한국은 입증내용이 3가지, 미국은 1가지로 증명내용의 수가 작음에 따라 미국이 입증가능성이 높았고, 소비자소송이 빈번하게 이루어지는 미국은 입증책임 당사자가 제조자로 전환되어 소송 시 입증책임을 당사자가 소비자인 한국에 비해 소송접근성이 높았다. 본 연구에서는 소비자 보호에 초점을 맞추어 한국 제조물책임법이 발전될 수 있는 시사점을 제공한다.

• International Journal of Oral Biology
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• 제48권2호
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• pp.9-18
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• 2023

The rapid detection of bacteria in the oral cavity, its species identification, and bacterial count determination are important to diagnose oral diseases caused by pathogenic bacteria. The existing clinical microbial diagnosis methods are time-consuming as they involve observing patients' samples under a microscope or culturing and confirming bacteria using polymerase chain reaction (PCR) kits, making the process complex. Therefore, it is required to analyze the development status of substances and systems that can rapidly detect and analyze pathogenic microorganisms in the oral cavity. With research advancements, a close relationship between oral and systemic diseases has been identified, making it crucial to identify the changes in the oral cavity bacterial composition. Additionally, an early and accurate diagnosis is essential for better prognosis in periodontal disease. However, most periodontal disease-causing pathogens are anaerobic bacteria, which are difficult to identify using conventional bacterial culture methods. Further, the existing PCR method takes a long time to detect and involves complicated stages. Therefore, to address these challenges, the concept of point-of-care (PoC) has emerged, leading to the study and implementation of various chair-side test methods. This study aims to investigate the different PoC diagnostic methods introduced thus far for identifying pathogenic microorganisms in the oral cavity. These are classified into three categories: 1) microbiological tests, 2) microchemical tests, and 3) genetic tests. The microbiological tests are used to determine the presence or absence of representative causative bacteria of periodontal diseases, such as A. actinomycetemcomitans, P. gingivalis, P. intermedia, and T. denticola. However, the quantitative analysis remains impossible, and detecting pathogens other than the specific ones is challenging. The microchemical tests determine the activity of inflammation or disease by measuring the levels of biomarkers present in the oral cavity. Although this diagnostic method is based on increase in the specific biomarkers proportional to inflammation or disease progression in the oral cavity, its commercialization is limited due to low sensitivity and specificity. The genetic tests are based on the concept that differences in disease vulnerability and treatment response are caused by the patient's DNA predisposition. Specifically, the IL-1 gene is used in such tests. PoC diagnostic methods developed to date serve as supplementary diagnostic methods and tools for patient education, in addition to existing diagnostic methods, although they have limitations in diagnosing oral diseases alone. Research on various PoC test methods that can analyze and manage the oral cavity bacterial composition is expected to become more active, aligning with the shift from treatment-oriented to prevention-oriented approaches in healthcare.

• 정신신체의학
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• 제31권2호
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• pp.72-78
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• 2023

연구목적 코로나19 감염으로 인한 다양한 정신과적 증상, 정신신체증상을 파악하고 장기적 영향을 조사하였다. 방 법 체계적 문헌고찰을 통해 국내외 데이터베이스에서 논문을 선정하고, "COVID-19", "psychosomatic" 등의 검색어를 활용하였다. 정신신체증상에 대한 구조화된 측정도구를 사용한 연구를 포함하여, 총 16편의 논문이 최종 분석 대상으로 포함되었다. 결 과 코로나19 급성 감염과 관련된 정신증상으로는 불안, 우울, 신체증상 등이 보고되고 있다. 장기간 지속되는 포스트 코로나증후군의 증상으로는 흉통, 피로 등이 보고되었고, 이와 관련된 정신신체증상의 발생 빈도는 10%-20%로 파악되었다. 감염병으로 인한 심리사회적 스트레스, 여성, 노인, 정신과적 기왕력이나 동반 정신질환 등의 요인이 관련을 미친다. 전신염증, 자가면역, 자율신경계의 이상반응 등이 관련이 있을 것으로 생각되고 있다. 결 론 코로나19 감염 이후 발생하는 정신신체증상은 삶의 질과 심리사회적 기능에 부정적인 영향을 미칠 뿐 아니라 증상에 대한 정신과적 이해와 접근은 예방과 치료에도 중요하다.

• Journal of Korean Neurosurgical Society
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• 제67권4호
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• pp.451-457
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• 2024

Objective : Exploring protein requirements for critically ill patients has become prominent. On the other hand, considering the significant impact of coma therapy and targeted temperature management (TTM) on the brain as well as systemic metabolisms, protein requirements may plausibly be changed by treatment application. However, there is currently no research on protein requirements following the application of these treatments. Therefore, the aim of this study is to elucidate changes in patients' protein requirements during the application of TTM and coma therapy. Methods : This study is a retrospective analysis of prospectively collected data from March 2019 to May 2022. Among the patients admitted to the intensive care unit, those receiving coma therapy and TTM were included. The patient's treatment period was divided into two phases (phase 1, application and maintenance of coma therapy and TTM; phase 2, tapering and cessation of treatment). In assessing protein requirements, the urine urea nitrogen (UUN) method was employed to estimate the nitrogen balance, offering insight into protein utilization within the body. The patient's protein requirement for each phase was defined as the amount of protein required to achieve a nitrogen balance within ±5, based on the 24-hour collection of UUN. Changes in protein requirements between phases were analyzed. Results : Out of 195 patients, 107 patients with a total of 214 UUN values were included. The mean protein requirement for the entire treatment period was 1.84±0.62 g/kg/day, which is higher than the generally recommended protein supply of 1.2 g/kg/day. As the treatment was tapered, there was a statistically significant increase in the protein requirement from 1.49±0.42 to 2.18±0.60 in phase 2 (p<0.001). Conclusion : Our study revealed a total average protein requirement of 1.84±0.62 g during the treatment period, which falls within the upper range of the preexisting guidelines. Nevertheless, a notable deviation emerged when analyzing the treatment application period separately. Hence, it is recommended to incorporate considerations for the type and timing of treatment, extending beyond the current guideline, which solely accounts for the severity by disease.

• 대한임상검사과학회지
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• 제55권4호
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• pp.306-313
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• 2023

패혈증은 병원성 감염에 의해 여러 장기에 나타나는 전신성 염증 반응으로, 현재로서는 유망한 치료제가 없다. Signal transducer and activator of transcription 3 (STAT3)은 세포 신호전달 전사 인자로서 항염증 및 염증 반응과 관련된 다양한 세포의 생물학적 과정에서 중요한 역할을 한다. Niclosamide는 FDA에서 승인된 구충제로 STAT3 조절에 관여한다고 알려져 있다. C57BL/6 마우스에 복강 주사로 지질 다당체 (lipopolysaccharide, LPS)를 투여해 패혈증을 유발하였고, Niclosamide를 LPS 주사 2시간 후에 경구 투여하였다. 본 연구에서 Niclosamide가 LPS로 유발된 패혈증 모델의 생존률과 폐 손상을 완화시켰고, 혈청 내 interleukin (IL)-6, 종양괴사인자(tumor necrosis factor-α, TNF-α), IL-1β, AST, ALT, LDH 수치를 유의하게 감소시켰다. 또한 폐 조직 면역 블롯을 통해 PI3K, AKT, NF-κB, STAT3 신호 전달 경로가 Niclosamide에 의해 조절되는 것을 확인하였다. Niclosamide는 LPS를 자극한 RAW 264.7 세포주에서 IL-6, TNF-α, IL-1β와 같은 염증성 사이토카인의 발현을 감소시켰으며, 또한 STAT3의 인산화를 감소시켰다. 본 연구를 통해 Niclosamide에 의한 STAT3 조절이 염증 반응을 억제함으로써 패혈증 모델에 대한 새로운 치료 전략을 제시하였다.

• 한국산업보건학회지
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• 제34권1호
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• pp.57-66
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• 2024

Objective: Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow obstruction that is only partly reversible, inflammation in the airways, and systemic effects. This study aimed to investigate the association between low peripheral oxygen saturation levels (SpO₂), and composite indices predicting death in male patients with (COPD). Method: A total of 140 participants with post-bronchodilator FEV₁/FVC ratio less than 0.7 were included. Three composite indices (ADO, DOSE, BODEx) were calculated using six variables such as age (A), airflow obstruction (O), body mass index (B), dyspnea (D), exacerbation history (E or Ex), and smoking status (S). Severity of airflow limitation was classified according to Global Initiative for Obstructive Lung Disease (GOLD) guidelines. SpO₂ was measured by pulse oximetry, and anemia and iron deficiency were assessed based on blood hemoglobin levels and serum markers such as ferritin, transferrin saturation, or soluble transferrin receptor. Results: Participants with low SpO₂ (<95%) showed significantly lower levels of %FEV₁ predicted (p=0.020) and %FEV₁/FVC ratio (p=0.002) compared to those with normal SpO₂ levels. The mMRC dyspnea scale (p<0.001) and GOLD grade (p=0.002) showed a significant increase in the low SpO₂ group. Receiver Operating Characteristic analysis revealed higher area under the curve for %FEV₁ (p=0.020), %FEV₁/FVC(p=0.002), mMRC dyspnea scale (p=0.001), GOLD grade (p=0.010), ADO (p=0.004), DOSE (p=0.002), and BODEx (p=0.011) in the low SpO₂ group. Conclusion: These results suggest that low SpO₂ levels are related to increased airflow limitation and the composite indices of COPD.

• Journal of Nutrition and Health
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• 제57권1호
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• pp.88-104
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• 2024

본 연구는 국민건강영양조사 2015년부터 2018년도 자료를 활용하여 우리나라 만 19세 이상 성인의 KHEI와 복부비만의 관련성 및 hs-CRP의 매개 효과를 분석한 연구이다. 한국 성인 남성의 경우 허리둘레 90 cm 이상, 여성은 허리둘레 85 cm 이상인 경우에 복부비만군으로 정의하였다. 남성에서 복부비만군은 2,587명, 정상군은 5,007명이였고 여성의 복부비만군은 2,869명, 정상군은 7,307명이였다. KHEI, hs-CRP, 복부비만의 연관성 분석에서는 모든 공변량을 보정하였을 때 남성의 KHEI는 복부비만과 유의한 연관이 없었지만, hs-CRP와 음의 연관성이 있었다. 여성의 경우, 복부비만과 hs-CRP 모두 음의 연관성이 관찰되었다. 또한, 남성과 여성에서 hs-CRP 위험군 (> 1.0 mg/L) 이 hs-CRP 정상군 (≤ 1.0 mg/L)보다 복부비만 유병률이 유의하게 높았다. Bootstrapping을 이용한 매개효과 분석에서는 KHEI와 복부비만 관계에서 hs-CRP가 매개 효과를 가지는 것으로 나타났으며 공변량을 단계적으로 보정하였을때 증가하는 양상이 나타났다. 결론적으로, 본 연구 결과는 균형잡힌 식생활를 통한 높은 식사의 질이 hs-CRP에 영향을 미쳐 복부비만 예방에 중요한 영향을 미칠 수 있음을 시사한다.

• 치위생과학회지
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• 제24권2호
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• pp.115-123
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• 2024

Background: The population of Gangneung City in South Korea has shown a gradual increase in the proportion of individuals aged 65 years and older, and the most frequently reported diseases for several years have consistently been periodontal diseases, including gingivitis and periodontitis. The regional imbalance in the distribution of dental personnel and resources has emerged as a problem of inequality in the use of dental care. It has been advocated to identify areas with disadvantages in dental care and develop public dental policies based on that. This study aimed to develop a customized oral healthcare program for local seniors based on a Public-Private-Academic Partnership, and to evaluate the oral health status of older adults in Gangneung City. Methods: The participants were residents aged 60 years and above in Gangneung City. A questionnaire including general information, systemic health status, and oral health status was administered to the participants. In addition, oral healthcare and education tailored to each individual's health status were provided once or twice based on their oral health status. The collected data were analyzed using IBM SPSS Statistics 25 for descriptive statistical analysis. Results: Among the older adults in Gangneung City, 75% had at least one prosthesis and exhibited symptoms of gingivitis or periodontitis. Additionally, the modified sulcus bleeding index decreased among participants who underwent the program twice. Over 90% of the participants expressed satisfaction with the program. Conclusion: The program appeared to contribute positively to the oral health promotion among local seniors. Further oral healthcare programs should focus on seniors in rural and old urban areas to reduce disparities in oral health across regions.

• 한국간담췌외과학회지
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• 제28권2호
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• pp.134-143
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• 2024

Backgrounds/Aims: The hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is classified as the advanced stage (BCLC stage C) with extremely poor prognosis, and in current guidelines is recommended for systemic therapy. This study aimed to evaluate the surgical outcomes and long-term prognosis after hepatic resection (HR) for patients who have HCC combined with PVTT. Methods: We retrospectively analyzed 332 patients who underwent HR for HCC with PVTT at ten tertiary referral hospitals in South Korea. Results: The median overall and recurrence-free survival after HR were 32.4 and 8.6 months, while the 1-, 3-, and 5-year overall survival rates were 75%, 48%, and 39%, respectively. In multivariate analysis, tumor number, tumor size, AFP, PIVKA-II, neutrophil-to-lymphocyte ratio, and albumin-bilirubin (ALBI) grade were significant prognostic factors. The risk scoring was developed using these seven factors-tumor, inflammation and hepatic function (TIF), to predict patient prognosis. The prognosis of the patients was well stratified according to the scores (log-rank test, p < 0.001). Conclusions: HR for patients who have HCC combined with PVTT provided favorable survival outcomes. The risk scoring was useful in predicting prognosis, and determining the appropriate treatment strategy for those patients who have HCC with PVTT.

• 한국간담췌외과학회지
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• 제26권1호
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• pp.40-46
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• 2022

Backgrounds/Aims: The role of inflammation in malignant cell proliferation has been well described. High values of platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) as markers of systemic inflammation have shown associations with unfavorable long-term outcomes. The purpose of this study was to determine values of NLR and PLR evaluated prior to and after surgery and their associations with mortality and recurrence rates of liver transplant patients with hepatocellular carcinoma (HCC). Methods: A total of 105 patients with HCC who underwent orthotopic liver transplantation (OLT) were retrospectively reviewed. NLR and PLR values were obtained from complete blood counts prior to and after surgery. Overall survival (OS) and recurrence-free survival (RFS) in relation with delta NLR and PLR were estimated. Results: Serum alpha-fetoprotein levels > 100 ng/mL (p = 0.014) and lymphovascular emboli in the specimen (p = 0.048) were identified to be significant predictors of RFS. Child-Pugh score (p = 0.016) was found to be an independent factor associated with poorer OS. An increasing delta PLR was associated with worse RFS, although it showed no significant association with OS. Conclusions: The analysis of PLR as a continuous variable may predict recurrence outcomes in patients undergoing OLT for HCC. It is more representative than isolated values.