• Journal of Trauma and Injury
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• 제36권4호
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• pp.376-384
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• 2023

Purpose: The Armed Forces Trauma Center of Korea was established in April 2022. This study was conducted to report our 1-year experience of treating soldiers with open fractures of the lower extremity. Methods: In this case series, we reviewed the medical records of 51 Korean soldiers with open fractures of the lower extremity between April 2022 and March 2023 at a trauma center. We analyzed patients with Gustilo-Anderson type II and III fractures and reported the duration of transportation, injury mechanisms, injured sites, and associated injuries. We also presented laboratory findings, surgery types, intensive care unit stays, hospital stays, rehabilitation results, and reasons for psychiatric consultation. Additionally, we described patients' mode of transport. Results: This study enrolled nine male patients who were between 21 and 26 years old. Six patients had type II and three had type III fractures. Transport from the accident scene to the emergency room ranged from 75 to 455 minutes, and from the emergency room to the operating room ranged from 35 to 200 minutes. Injury mechanisms included gunshot wounds, landmine explosions, grenade explosions, and entrapment by ship mooring ropes. One case had serious associated injuries (inhalation burn, open facial bone fractures, and hemopneumothorax). No cases with serious blood loss or coagulopathies were found, but most cases had a significant elevation of creatinine kinase. Two patients underwent vascular reconstruction, whereas four patients received flap surgery. After rehabilitation, six patients could walk, one patient could move their joints actively, and two patients performed active assistive movement. Eight patients were referred to the psychiatry department due to suicidal attempts and posttraumatic stress disorder. Conclusions: This study provides insights into how to improve treatment for patients with military trauma, as well as medical services such as the transport system, by revising treatment protocols and systematizing treatment.

• 한국동물생명공학회지
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• 제38권3호
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• pp.109-120
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• 2023

Background: Pluripotent stem cells (PSCs) including embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs) offer the immense therapeutic potential in stem cell-based therapy of degenerative disorders. However, clinical trials of human ESCs cause heavy ethical concerns. With the derivation of iPSCs established by reprogramming from adult somatic cells through the transgenic expression of transcription factors, this problems would be able to overcome. In the present study, we tried to differentiate porcine iPSCs (piPSCs) into endothelial cells (ECs) for stem cell-based therapy of vascular diseases. Methods: piPSCs (OSKMNL) were induced to differentiation into ECs in four differentiation media (APEL-2, APEL-2 + 50 ng/mL of VEGF, EBM-2, EBM-2 + 50 ng/mL of VEGF) on cultured plates coated with matrigel^® (1:40 dilution with DMEM/F-12 medium) for 8 days. Differentiation efficiency of these cells were exanimated using qRT-PCR, Immunocytochemistry, Western blotting and FACS. Results: As results, expressions of pluripotency-associated markers (OCT-3/4, SOX2 and NANOG) were higher observed in all porcine differentiated cells derived from piPSCs (OSKMNL) cultured in four differentiation media than piPSCs as the control, whereas endothelial-associated marker (CD-31) in the differentiated cells was not expressed. Conclusions: It can be seen that piPSCs (OSKMNL) were not suitable to differentiate into ECs in the four differentiation media unlike porcine epiblast stem cells (pEpiSCs). Therefore, it would be required to establish a suitable PSCs for differentiating into ECs for the treatment of cardiovascular diseases.

• Archives of Plastic Surgery
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• 제51권2호
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• pp.208-211
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• 2024

Intraneural hematoma is a rare disease that results in an impaired nerve function because of bleeding around the peripheral nerve, with only 20 cases reported. Trauma, neoplasm, and bleeding disorders are known factors for intraneural hematoma. However, here we report atypical features of asymptomatic and spontaneous intraneural hematoma which are difficult to diagnose. A 60-year-old woman visited our clinic with the complaint of a palpable mass on the right calf. She reported no medical history or trauma to the right calf and laboratory findings showed normal coagulopathy. Ultrasonography was performed, which indicated hematoma near saphenous vein and sural nerve or neurogenic tumor. We performed surgical exploration and intraneural hematoma was confirmed on sural nerve. Meticulous paraneuriotomy and evacuation was performed without nerve injury. Histological examination revealed intraneural hematoma with a vascular wall. No neurologic symptoms were observed. In literature review, we acknowledge that understanding anatomy of nerve, using ultrasonography as a diagnostic tool and surgical decompression is key for intraneural hematoma. Our case report may help establish the implications of diagnosis and treatment. Also, we suggested surgical treatment is necessary even in cases that do not present symptoms because neurological symptoms and associated symptoms may occur later.

• 대한치매학회지
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• 제22권2호
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• pp.49-60
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• 2023

Background and Purpose: The National Responsibility Policy for Dementia Care was implemented in September 2017 in Korea. This study aimed to compare dementia incidence in Seoul and Gangwon-do before and after the implementation of this policy. Methods: We extracted insurance claim data from the Korean Health Insurance Review and Assessment Service for people diagnosed with diabetes, hypertension, or dyslipidemia for the first time in Seoul and Gangwon-do, Korea. We defined two enrollment groups based on the policy implementation date: 1) January 1, 2015 to December 31, 2016 (Index 1, pre-implementation), and 2) January 1, 2017 to December 31, 2018 (Index 2, post-implementation). Each group was followed up for 1 year from the time of enrollment. Then, we calculated hazard ratios to compare the incidence of dementia between the two groups, and between Seoul and Gangwon-do. Results: In Seoul, the incidence of dementia was significantly lower in Index 2 than in Index 1 (hazard ratio [HR], 0.926; 95% confidence interval [CI], 0.875-0.979). However, the incidence rate did not differ between the 2 groups (HR, 1.113; 95% CI, 0.966-1.281) in Gangwon-do. In Index 1, the incidence of dementia did not differ between Seoul and Gangwon-do (HR, 1.043; 95% CI, 0.941-1.156), but in Index 2, was significantly higher in Gangwon-do than in Seoul (HR, 1.240; 95% CI, 1.109-1.386). Conclusions: After implementing the National Responsibility Policy for Dementia Care, the dementia incidence rate decreased significantly in Seoul, consistent with other studies, but not in Gangwon-do.

• 생명과학회지
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• 제31권9호
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• pp.787-795
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• 2021

등골나물은 오랫동안 음식으로 사용되어 왔으며 한방에서 한약재로 사용되어왔으며, 특히 등골나물 추출물은 항염 및 항산화 효과가 보고되었다. 심혈관 질환인 동맥경화증은 동맥 혈관에서 발생하는 만성 염증이며 다양한 질환에 관여하고 있다. 재협착 및 신경병증 증식과 같은 심혈관 질환은 주로 혈관 평활근 세포의 다중 성장인자로 인한 비정상적인 성장과 이동으로 인해 발생하며, 혈소판유래 성장인자는 손상된 혈관벽에서 방출되며 혈관 평활근 세포의 증식 및 이동에 관여한다. 본 연구에서는 혈관 평활근 세포의 비정상적인 증식 및 이동에 대한 등골나물 추출물의 효과를 확인하였고, 혈소판유래 성장인자로 유도된 혈관 평활근 세포내에서 신호전달 경로를 조사하였다. 혈소판유래 성장인자로 유도된 혈관 평활근 세포에서 등골나물 추출물의 전처리는 세포 증식 및 이동을 효과적으로 감소시켰다. 또한, 세포 내 신호전달 경로 AKT, phospholipase C gamma (PLC-γ) 및 mitogen-activated protein kinase (MAPK)의 웨스턴 블롯 실험 결과, 이들 경로의 인산화 억제를 확인하였다. 유세포분석 데이터는 혈관 평활근 세포의 세포주기가 등골나물 추출물에 의해 차단되었음을 보여주었다. 이 결과는 혈소판유래 성장인자가 세포주기와 세포 내 신호전달 인자를 조절하여 혈관 평활근 세포의 증식과 이동을 억제 할 수 있음을 시사한다. 또한, 이는 등골나물 추출물이 혈관 평활근 세포의 비정상적인 증식 및 이동을 차단하여 심혈관 질환 예방에 하나의 소재로 사용될 수 있음을 시사한다.

• 농촌의학ㆍ지역보건
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• 제39권1호
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• pp.25-36
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• 2014

본 연구는 다중절편 방사선단층촬영을 이용하여 관상동맥 석회화와 심혈관질환 위험인자와의 관련성에 관하여 알아보기 위하여 수행되었다. 이를 위하여 일개 대학병원에서 2010년 1월부터 2011년 12월까지 다중절편 방사선단층촬영을 시행한 30~59세의 성인 남성 5,899명을 대상으로 문진, 설문, 신체계측, 혈액검사 등을 시행하였다. 다중절편 방사선단층촬영 영상을 통해 대상자의 관상동맥 칼슘 점수를 확인하고, 기존의 심혈관질환 위험인자에 대해 확인하였다. 대상자 5,899명의 평균 관상동맥 칼슘 점수는 8.20이었고, 773명(13.1%)에서 관상동맥 석회화가 관찰되었다. 관상동맥 석회화 유무와 알려진 심혈관질환 위험인자(나이, 혈압, 공복혈당, 콜레스테롤, 아포지방단백, 비만)는 유의한 관련성을 보였으며, 심혈관질환 발병 위험도평가도구들과도 유의한 관련성이 있었다. 30-39세, 40-49세, 50-59세의 연령 군에서 관상동맥 석회화와 통계적으로 유의한 관련 요인은 각기 다른 양상을 나타냈다. 본 연구를 통하여 관상동맥 석회화와 전통적인 심혈관질환 위험인자와의 관련성 및 심혈관질환 발병위험도 평가도구와의 관련성을 확인할 수 있었다. 또한 연령 군에 따라 각기 다른 양상의 위험인자를 확인할 수 있었다. 따라서 향후 심혈관질환 예방을 위한 관리전략 수립에 연령에 따른 차이를 고려한 접근이 필요할 것으로 사료된다.

• Journal of Korean Neurosurgical Society
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• 제61권4호
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• pp.478-484
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• 2018

Objective : Cerebrovascular disease (CVD) was the third most common cause of death in South Korea in 2014. Evidence from abroad suggests that comprehensive stroke centers play an important role in improving the mortality rate of stroke. However, surgical treatment for CVD is currently slightly neglected by national policy, and there is still regional imbalance in this regard. For this reason, we conducted a survey on the necessity of, and the requirements for, establishing regional comprehensive cerebrovascular surgery centers (CCVSCs). Methods : This investigation was performed using the questionnaire survey method. The questionnaire was consisted with two sections. The first concerned the respondent's opinion regarding the current status of demand and the regional imbalance of cerebrovascular surgery in South Korea. The second section asked about the requirements for establishing regional CCVSCs. We sent the questionnaire to 100 board members of the Korean Society of Cerebrovascular Surgeons. Results : Most experts agreed that cerebrovascular surgery patients were concentrated in large hospitals in the capital area, and 83.6% of respondents agreed that it was necessary to alleviate the regional imbalance of cerebrovascular surgery. With regards to personnel, over 90% of respondents answered that at least two neuro-vascular surgeons and two neuro-interventionists are necessary to establish a CCVSC. Regarding facilities, almost all respondents stated that each CCVSC would require a neuro-intensive care unit and hybrid operating room. The survey asked the respondents about 13 specific neurovascular surgical procedures and whether they were necessary for a regional CCVSC. In the questions about the necessity of cerebrovascular surgical equipment, all seven pieces of equipment were considered essential by all respondents. A further five pieces of equipment were considered necessary on site: computed tomographic angiography, magnetic resonance angiography, conventional angiography, surgical microscope, and surgical navigation. Our results may provide a basis for future policy regarding treatment of cerebrovascular disease, including surgery. Conclusion : Raising the comprehensiveness of treatment at a regional level would lower the national disease burden. Policies should be drafted regarding comprehensive treatment including surgery for cerebrovascular disease, and related support plans should be implemented.

• Journal of Preventive Medicine and Public Health
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• 제31권4호
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• pp.728-739
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• 1998

To improve wellness and quality of life by recognizing the health efforts of stress, the author estimated the relationships between stress, subjective symptoms and clinical diagnosis through a questionnaire and a battery of specified laboratory tests; electrocardiography, blood pressure, cholesterol, aspartate aminotransferase(AST), alanine aminotransferase(ALT), gamma glutamyl transferase$(\gamma-GTP)$, fasting blood sugar, gastro-endoscopy or UGI, abdominal sonography, etc. The data was gathered from 337 clients who were undergoing multiphasic screening program at a University Hospital from January to March 1998. The mean age of subjects was $46.5{\pm}11.2$ years and the mean of body mass index was $24.0{\pm}3.7kg/m^2$. The mean vol of stress was $18.5{\pm}6.0$ expressed as the score out of 40. By general characteristics and lift style among male, mean level of stress was significantly higher in case of lower socioeconomic status, habitual drug use, longer daily working time(>10 hours), no regular exercise, drinkers, irregular meal, skip-ping breakfast(p<0.05). In case of female, that was significantly higher in case of lower education, lowe. socioeconomic status, longer daily working time(>10 hours), no regular exercise, drinkers, smokers, irregular meal, skipping breakfast(p<0.05). Significant correlations were observed between stress and subjective symptoms in all kinds of organ system (p<0.01). Correlation coefficients of stress among male were relatively high with neuro-psychiatric symptom$(\gamma=0.476)$ and cardio-vascular symptom$(\gamma=0.361)$ in order, and correlation coefficients of stress among female was highest with neuro-psychiatric symptom$(\gamma=0.371)$. The prevalence of the diagnosis through the battery of laboratory tests was high in upper gastrointestinal disorders and hypercholesterolemia in order in both sex group. Among male the mean score of stress was significantly high in ulcerative peptic disorder of upper gastrointestine and hepatopathy in order (p<0.05) . Among female that was significantly high in diabetes mellitus. In summary, it is likely that there are associations between stress, subjective symptoms and clinical diagnosis. To promote wellness and quality of life it would be of value that periodic stress evaluation program and stress management including apropriate control of smoking and drinking, regular exercise and meal.

• 한국산업보건학회지
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• 제6권1호
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• pp.1-16
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• 1996

This study was conducted at an automobile assembly line located in Kyonggi-do, Korea from January 16 to February 28, 1995. The purposes of this study were to assess worker exposures to hand-arm vibration and the performance of gloves for reduction of vibration. The exposure to vibration was measured using to the ISO 5349(1986) method. Vibration acceleration and frequency spectra for each tool were determined on-line replicating actual working conditions and analyzed together with exposure time for evaluating individual worker exposure. Eight pneumatic hand tools, 60 workers exposured to hand-arm vibration, and three pairs of gloves were involved in this study. Results are summarized as follows. 1. Dominant frequencies of vibration for all tools(n=8) measured in this study ranged from 250 Hz to 800 Hz. 2. There was no significant correleration between dominant frequencies and free running speed (p>0.05). 3. Total predicted exposure times of using impact, hammer type did not exceed 40 minutes, but metal finish task, using grinder and sander exceeded 40 minutes. Total exposure time affected significantly the frequency-weighted, 4 hr equivalent acceleration. 4. Predicted prevalence and observed exposure period data were compared in workers(n=60), according to ISO 5349. In this results, 23(50.0 %) and 24(48.07 %) persons exceeded the mean latency periods for vibration-induced white finger(VWF) at 10 % (n=46) and 50 % (n=52) standards, respectively. On the basis of ISO equation, mean latent periods for VWF were 3.23, 4.72 years at 10 %, 50 % standards, respectively. 5. Reduction of vibration by gloves was evaluated. Since impact pneumatic tools produced low frequency vibrations, conventional gloves did not provide any protection. Gloves A and C amplify somewhat the signal at frequency below 400 Hz; the attenuation increases progressively by frequency to reach 18 dB ($7.94{\times}10^{-6}m/s^2$) at 1,000 Hz, slightly worsening Glove B did not provide any protection and made the situation slightly worse. However, since they make the hands warm, the occurrence of vibration-induced white fingers may be reduced.

• 한국콘텐츠학회논문지
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• 제18권4호
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• pp.114-127
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• 2018

본 연구는 허혈성 심뇌혈관질환자의 폐쇄성 수면무호흡증 위험정도를 파악하고 그 영향요인을 규명하기 위해 시도되었다. 심뇌혈관집중치료실에 입원한 허혈성 심뇌혈관질환자 141명을 대상으로 구조화된 자가설문지 사용하였고, 펄스 옥시미터를 사용하여 세 시점에서 수면 중 혈중산소포화도를 측정하였으며 SPSS/WIN 20.0을 이용하여 통계분석을 시행하였다. 연구 결과 대상자의 평균연령은 $64.4{\pm}11.1$세였고 남자가 61%였다. 심뇌혈관질환자의 21.3%가 폐쇄성 수면무호흡증 고위험군으로 파악되었고 71.6%에서 수면의 질이 낮은 것으로 나타났다. 폐쇄성 수면무호흡증 고위험군의 수면 중기와 말기에 측정한 산소포화도는 저위험군보다 통계적으로 유의하게 낮은 것으로 나타났으며, 다중회귀분석 결과, 심뇌혈관질환자의 폐쇄성 수면무호흡증 영향요인으로서 과거흡연, 잦은 코골이, 비만, 운동부족이 확인되었다. 따라서, 본 연구결과는 심뇌혈관질환 간호에 있어 폐쇄성 수면무호흡증 또는 잦은 코골이를 위험요인으로 중요하게 인식하고, 심뇌혈관질환의 이차적 재발 예방을 위해 폐쇄성 수면무호흡증 고위험군의 조기선별 및 환자와 가족을 지지하고 건강행태 개선을 위한 상담과 퇴원교육을 강화하기 위한 기초자료로 활용될 것이다.