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Aquatic exercise for the treatment of knee osteoarthritis: a systematic review & meta analysis (무릎 골관절염 환자를 대상으로 한 수중 운동과 지상운동 비교: 체계적 문헌고찰 및 메타분석)

  • Kim, Young-il;Choi, Hyo-Shin;Han, Jung-haw;Kim, Juyoung;Kim, Gaeun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.9
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    • pp.6099-6111
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    • 2015
  • This study was a systematic review and meta-analysis comparing the effects of aquatic exercise and land-based exercise in the treatment of knee osteoarthritis. 7 studies (n=449) met selection and exclusion criteria out of 287 potential studies obtained from the literature search via Ovid-Medline, Cochrane Library CENTRAL, CINAHL, RISS and KISS. The overall risk of bias of selected studies using SIGN (Scottish Intercollegiate Guidelines Network) checklist for randomized controlled trials (RCT) was regarded as low. As a result of meta analysis, Standardized Mean Difference (SMD) for pain was -0.26(95% CI -0.49, -0.03, p=0.03, $I^2=14%$), which implies that aquatic exercise groups had significant less pain than land-based exercise groups. On the other hand, there was no significant difference between aquatic exercise groups and land based exercise groups for flexion Range of Motion (ROM) (-0.12, 95% CI -0.51, 0.27, p=0.53, $I^2=0%$), extension ROM (-0.04, 95% CI -0.55, 0.48, p=0.89, $I^2=43%$), physical function (-0.12, 95% CI -0.44, 0.19, p=0.44, $I^2=0%$), Quality of Life (QOL) (-0.15, 95% CI -0.54, 0.24, p=0.46, $I^2=0%$). This study has some limitations due to few RCTs comparing aquatic exercise groups and land-based exercise groups in the treatment of knee osteoarthritis. Therefore, further RCTs should be conducted along with long-term outcomes.

MARGINAL MICROLEAKAGE AND SHEAR BOND STRENGTH OF COMPOSITE RESIN ACCORDING TO TREATMENT METHODS OF ARTIFICIAL SALIVA-CONTAMINATED SURFACE AFTER PRIMING (접착강화제 도포후 인공타액에 오염된 표면의 처리방법에 따른 복합레진의 번연누출과 전단결합강도)

  • Cho, Young-Gon;Ko, Kee-Jong;Lee, Suk-Jong
    • Restorative Dentistry and Endodontics
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    • v.25 no.1
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    • pp.46-55
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    • 2000
  • During bonding procedure of composite resin, the prepared cavity can be contaminated by saliva. In this study, marginal microleakage and shear bond strength of a composite resin to primed enamel and dentin treated with artificial saliva(Taliva$^{(R)}$) were evaluated. For the marginal microleakage test, Class V cavities were prepared in the buccal surfaces of fifty molars. The samples were randomly assigned into 5 groups with 10 samples in each group. Control group was applied with a bonding system (Scotchbond$^{TM}$ Multi-Purpose plus) according to manufacture's directions without saliva contamination. Experimental groups were divided into 4 groups and contaminated with artificial saliva for 30 seconds after priming: Experimental 1 group ; artificial saliva was dried with compressed air only, Experimental 2 group ; artificial saliva was rinsed and dried. Experimental 3 group ; cavities were etched with 35% phosphoric acid for 15 seconds after rinsing and drying artificial saliva. Experimental 4 group ; cavities were etched with 35% phosphoric acid for 15 seconds and primer was reapplied after rinsing and drying artificial saliva. All the cavities were applied a bonding agent and filled with a composite resin (Z-100$^{TM}$). Specimens were immersed in 0.5% basic fuschin dye for 24 hours and embedded in transparent acrylic resin and sectioned buccolingually with diamond wheel saw. Four sections were obtained from one specimen. Degree of marginal leakage was scored under stereomicroscope and their scores were averaged from four sections. The data were analyzed by Kruscal-Wallis test and Fisher's LSD. For the shear bond strength test, the buccal or occlusal surfaces of one hundred molar teeth were ground to expose enamel(n=50) or dentin(n=50) using diamond wheel saw and its surface was smoothed with Lapping and Polishing Machine(South Bay Technology Co., U.S.A.). Samples were divided into 5 groups. Treatment of saliva-contaminated enamel and dentin surfaces was same as the marginal microleakage test and composite resin was bonded via a gelatin capsule. All specimens were stored in distilled water for 48 hours. The shear bond strengths were measured by universal testing machine (AGS-1000 4D, Shimaduzu Co., Japan) with a crosshead speed of 5 mm/minute. Failure mode of fracture sites was examined under stereomicroscope. The data were analyzed by ANOVA and Tukey's studentized range test. The results of this study were as follows : 1. Enamel marginal microleakage showed no significant difference among groups. 2. Dentinal marginal microleakages of control, experimental 2 and 4 groups were lower than those of experimental 1 and 3 groups (p<0.05). 3. The shear bond strength to enamel was the highest value in control group (20.03${\pm}$4.47MPa) and the lowest value in experimental 1 group (13.28${\pm}$6.52MPa). There were significant differences between experimental 1 group and other groups (p<0.05). 4. The shear bond strength to dentin was higher in control group (17.87${\pm}$4.02MPa) and experimental 4 group (16.38${\pm}$3.23MPa) than in other groups, its value was low in experimental 1 group (3.95${\pm}$2.51 MPa) and experimental 2 group (6.72${\pm}$2.26MPa)(p<0.05). 5. Failure mode of fractured site on the enamel showed mostly adhesive failures in experimental 1 and 3 groups. 6. Failure mode of fractured site on the dentin did not show adhesive failures in control group, but showed mostly adhesive failure in experimental groups. As a summary of above results, if the primed tooth surface was contaminated with artificial saliva, primer should be reapplied after re-etching it.

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Deterioration Characteristic Analysis for Stone Properties in the Taereung Royal Tomb of the Joseon Dynasty using Nondestructive Analysis (비파괴 분석을 활용한 조선왕릉 태릉 석조물의 손상특성 분석)

  • Lee, Myeonseong;Choie, Myoungju;Lee, Taejong;Chun, Yungun
    • Korean Journal of Heritage: History & Science
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    • v.53 no.2
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    • pp.222-241
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    • 2020
  • The Taereung Royal Tomb from the Joseon Dynasty is the tomb of Empress Munjeong, the second queen of King Jungjong, and it contains various types of stone artifacts. All of these stone artifacts were constructed using coarse- to medium-grained biotite granite. The major types of deterioration of the stone artifacts are identified as surface weathering and biological contaminants. Exfoliation (145 sculptures), granular decomposition (138 sculptures), and repair materials (156 sculptures), along with biological contaminant algae (154 sculptures), lichen (165 sculptures) and moss (97 sculptures), have a high occurrence frequency. In particular, it is deemed that immediate conservation treatment is required, as biological deterioration (algae) represents the most serious condition (grade 3 or higher in 94% of all stones), and it is thought that exfoliation and granulation decomposition are required for long-term conservation management. As a result of equo -tip hardness and ultrasonic measurement, more than 70% of stones were found to have very weak physical properties. Through hyperspectral analysis, organisms were shown to inhabit more than 80% of the surface of burial mound stone artifacts, and P (phosphorus), S (sulfur), Cl (chlorine), and Ca (calcium) were detected in this area. This is because Taereung Royal Tomb has been exposed to the outdoors for hundreds of years and has been weathered by physical, chemical, and biological factors. Therefore, among the stone artifacts in the Taereung Royal Tomb, those with high physical weathering grades are considered to require consolidation to reinforce them physically. Since organisms are highly likely to cause stone damage, they must be removed via dry and wet cleaning. In addition, in order to delay the reoccurrence of organisms following conservation treatment, it is necessary to regularly clean up the soil that has flowed into the burial mound, and to monitor conservation conditions over the long term.

Review of Copper Trihydroxychloride, a Green Pigment Composed of Copper and Chlorine (구리와 염소 주성분 녹색 안료 코퍼 트리하이드록시클로라이드(Copper Trihydroxychloride)에 대한 고찰)

  • Oh, Joonsuk;Lee, Saerom;Hwang, Minyoung
    • Korean Journal of Heritage: History & Science
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    • v.53 no.2
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    • pp.64-87
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    • 2020
  • Copper trihydroxychloride (atacamite, botallackite, paratacamite, etc.), the first green pigment used in Mogao Grotto's mural paintings of China, has been known as "copper green", "green salt", and "salt green", etc. and has been used as an important green pigment with malachite. At first, the natural mineral atacamite was employed, but after the Five Dynasties (907~960 CE), synthetic copper trihydroxychloride was primarily used. In Chinese literature, copper green, green salt, and salt green are recorded as being made via reaction with copper powder, Gwangmyeongyeom (natural sodium chloride), and Yosa (natural ammonium chloride), and the prepared material was analyzed to be copper trihydroxychloride. Copper trihydroxychloride pigment was not found in paintings prior to the Joseon Dynasty (1392~1910 CE) in Korea. In analysis of the green pigments used in paintings and the architectural paintworks in the Joseon Dynasty, copper trihydroxychloride was also shown to have been used as an important green pigment with malachite (Seokrok). In particular, the proportion of copper trihydroxychloride use was high in Buddhist paintings, shamanic paintings, and dancheongs (decorative coloring on wooden buildings). Some of these turned out to be synthetic copper trihydroxychloride, but it is unclear whether the rest of them are synthetic or natural pigments due to a lack of analyzed data. From literature and painting analyses, the pigment name of copper trihydroxychloride in the Joseon Dynasty turns out to be Hayeob, a dark green pigment. It is believed to have first been prepared by learning from China in the early Joseon period (early 15th century) and its use continued until the late 19th century with imported Chinese pigment. Round or oval particles with a dark core of copper trihydroxychloride which were used in Chinese literature were similar to the synthetic copper trihydroxychloride pigments used in the Joseon Dynasty and Chinese paintings. Therefore, the synthetic copper trihydroxychloride pigments of Korea and China are believed to have been prepared in a similar way.

An Economic Analysis of the Migration Decision: The Case of Korea (우리나라 인구이동결정에 관한 경제적 분석)

  • Lee, Seon
    • Korea journal of population studies
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    • v.10 no.1
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    • pp.70-86
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    • 1987
  • Going beyond the previous formulations of development theories, the present paper explores the effects other than political economy on quality of life in a rapidly developing country. The major analysis takes up the historical trend and nature of the developmental transformation that is partially a consequences of state structures and partially autonomous form it in South Korea. Also, it diagnoses developmental pathways for the future track by constructing a baseline model for state transition on the basis of power game between the state and civil society in the country. The results of the historical analysis show that civil society has been transformed in the course of confrontations and interactions between the state and nationalist social movement. The distinction between developmental(or bureaucratic authoritarian) and democratic state is presented to show that these are two qualitatively different aspects of state of state power, requiring separate analytical treatment. Furthermore, the state-centric approach which emphasizes the active role of the state at the sacrifice of societal fabric-constraining social conditions for quality of life - appears to be modified. On the contrary, the impact of civil society is transmitted both directly and indirectly via labor and ecological movement for quality of life, which is critical to the formation of the welfare state in the country. The prospect for sustainable development in Korea lies in providng and expanding quality of life in terms of the financial feasibility of the state through the public-private cooperation, and abstaining from drastic and radical commitment to welfare services as is the case with the European declines in welfare state, Further studies are needed to examine the interrelationships in different historical and cultural settings of developing counties to estimate a theory of quality of life and social justice.

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Experiences with Emergency Percutaneous Cardiopulmonary Support in In-hospital Cardiac Arrest or Cardiogenic Shock due to the Ischemic Heart Disease (허혈성 심질환으로 인해 병원 내에서 발생한 심정지 혹은 심정지 혹은 심인성 쇼크에 있어서의 경피적 심폐 보조장치의 치료 경험)

  • Rhee Il;Kwon Sung-Uk;Cho Sung Woo;Gwon Hyeon-Cheol;Lee Young Tak;Park Pyo Won;Park Kay-Hyun;Lee Sang Hoon;Sung Kiick
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.201-207
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    • 2006
  • Background: Percutaneous cardiopulmonary support (PCPS) provides passive support of gas exchange and perfusion, allowing the use of other methods of care for organ recovery, and saves lives of patients with severe cardiopulmonary failure in a wide variety of clinical settings with a minimal risk of bleeding and need for chest re~ exploration. We summarized a single center's experiences with PCPS in patients with cardiogenic shock or cardiac arrest due to the ischemic heart disease. Material and Method: Among the 20 consecutive patients with cardiogenic shock or cardiac arrest from May 1999 to June 2005, Biopump (Medtronic, Inc, Minneapolis, MN) was used in 7 patients and the self-priming, heparin-coated circuit of EBS (Terumo, Japan) was applied to remaining 13 patients. Most of cannulations were performed percutaneously via femoral arteries and veins. The long venous cannulas of DLP (Medtronic inc. Minneapolis, MN) or the RMI (Edwards's lifescience LLC, Irvine, CA) were used with the arterial cannulae from 17 Fr to 21 Fr and the venous cannula from 21 Fr to 28 Fr. Result: The 20 consecutive patients who were severely compromised and received PCPS for the purpose of resuscitation were comprised of 13 cardiac arrests and 7 cardiogenic shocks in which by-pass surgery was performed in 11 patients and 9 ongoing PCls under the cardiopulmonary support. The mean support time on the PCPS was 38$\pm$42 hours. Of the 20 patients implanted with PCPS, 11 patients ($55\%$) have had the PCPS removed successfully; overall, 8 of these patients ($40\%$) were discharged from the hospital in an average surviving time for 27$\pm$17 days after removing the PCPS and survived well with 31$\pm$30 months of follow-up after the procedure. Conclusion: The use of PCPS appears to provide the hemodynamic restoration, allowing the survival of patients in cardiac arrest or cardiogenic shock who would otherwise not survive, and patients receiving PCPS had a relatively long-term survival.

Pharmaco-mechanical Thrombectomy and Stent Placement in Patients with May-Thurner Syndrome and Lower Extremity Deep Venous Thrombosis (May-Thurner 증후군과 동반된 하지 심부정맥혈전환자에서 혈전제거술과 스텐트삽입술)

  • Jeon, Yonh-Sun;Kim, Yong-Sam;Cho, Jung-Soo;Yoon, Yong-Han;Baek, Wan-Ki;Kim, Kwang-Ho;Kim, Joung-Taek
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.757-762
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    • 2009
  • Background: Compression of the left common iliac vein by the overriding common iliac artery is frequently combined with acute deep vein thrombosis in patients with May-Thurner Syndrome. We evaluate the results of treatment with thrombolysis and thrombectomy followed by stenting in 34 patients with May-Thurner Syndrome combined with lower extremity deep venous thrombosis. Material and Method: The authors retrospectively reviewed the records of 34 patients (mean age: $65{\pm}14$ year old) who had undergone stent insertion for acute deep vein thrombosis that was caused by May-Thurner syndrome. After thrombectomy and thrombolysis, insertion of a wall stent and balloon angioplasty were performed to relieve the compression of the left common iliac vein. Urokinase at a rate of 80,000 to 120,000 U/hour was infused into the thrombosed vein via a multi-side hole thrombolysis catheter. A retrieval inferior vena cava (IVC) filter was placed to protect against pulmonary embolism in 30 patients (88%). Oral anticoagulation with warfarin was maintained for 3 months, and follow-up Multi Detector Computerized Tomography (MDCT) angiography was done at the date of the patients' hospital discharge and at the 6 months follow-up. Result: The symptoms of deep venous thrombosis disappeared in two patients (4%), and there was clinical improvement within 48 hours in twenty eight patients (82%), but there was no improvement in four patients (8%). The MDCT angiography at discharge showed no thrombus in 9 patients (26%) and partial thrombus in 21 (62%), whereas the follow-up MDCT at $6.4{\pm}5.5$ months (32 patients) revealed no thrombus in 23 patients (72%), and partial thrombus in 9 patients (26%). Two patients (6%) had recurrence of DVT, so they underwent retreatment. Conclusion: Stent insertion with catheter-directed thrombolysis and thrombectomy is an effective treatment for May-Thurner syndrome combined with acute deep vein thrombosis in the lower extremity.

Eco-friendly and efficient in situ restoration of the constructed sea stream by bioaugmentation of a microbial consortium (복합미생물 생물증강법을 이용한 인공해수하천의 친환경 효율적 현장 수질정화)

  • Yoo, Jangyeon;Kim, In-Soo;Kim, Soo-Hyeon;Ekpeghere, Kalu I.;Chang, Jae-Soo;Park, Young-In;Koh, Sung-Cheol
    • Korean Journal of Microbiology
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    • v.53 no.2
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    • pp.83-96
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    • 2017
  • A constructed sea stream in Yeongdo, Busan, Republic of Korea is mostly static due to the lifted stream bed and tidal characters, and receives domestic wastewater nearby, causing a consistent odor production and water quality degradation. Bioaugmentation of a microbial consortium was proposed as an effective and economical restoration technology to restore the polluted stream. The microbial consortium activated on site was augmented on a periodic basis (7~10 days) into the most polluted site (Site 2) which was chosen considering the pollution level and tidal movement. Physicochemical parameters of water qualities were monitored including pH, temperature, DO, ORP, SS, COD, T-N, and T-P. COD and microbial community analyses of the sediments were also performed. A significant reduction in SS, COD, T-N, and COD (sediment) at Site 2 occurred showing their removal rates 51%, 58% and 27% and 35%, respectively, in 13 months while T-P increased by 47%. In most of the test sites, population densities of sulfate reducing bacterial (SRB) groups (Desulfobacteraceae_uc_s, Desulfobacterales_uc_s, Desulfuromonadaceae_uc_s, Desulfuromonas_g1_uc, and Desulfobacter postgatei) and Anaerolinaeles was observed to generally decrease after the bioaugmentation while those of Gamma-proteobacteria (NOR5-6B_s and NOR5-6A_s), Bacteroidales_uc_s, and Flavobacteriales_uc_s appeared to generally increase. Aerobic microbial communities (Flavobacteriaceae_uc_s) were dominant in St. 4 that showed the highest level of DO and least level of COD. These microbial communities could be used as an indicator organism to monitor the restoration process. The alpha diversity indices (OTUs, Chao1, and Shannon) of microbial communities generally decreased after the augmentation. Fast uniFrac analysis of all the samples of different sites and dates showed that there was a similarity in the microbial community structures regardless of samples as the augmentation advanced in comparison with before- and early bioaugmentation event, indicating occurrence of changing of the indigenous microbial community structures. It was concluded that the bioaugmentation could improve the polluted water quality and simultaneously change the microbial community structures via their niche changes. This in situ remediation technology will contribute to an eco-friendly and economically cleaning up of polluted streams of brine water and freshwater.

The Role of Pelvic Irradiation after Hysterectomy in Early Stage Cervical Carcinoma with Pelvic Nodal Metastasis (림프절 전이를 동반한 초기 자궁경부암에서 수술 후 방사선치료의 역할)

  • Suh, Hyun-Suk
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.469-475
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    • 1998
  • Purpose : To determine the role of Pelvic irradiation in stage I or IIA cervical carcinoma with pelvic nodal metastasis after hysterectomy and bilateral pelvic lymphadenectomy. Materials and Methods : This is a retrospective study of 68 cervical carcinoma patients who were found to have pelvic nodal metastasis at hysterectomy and received pelvic irradiation from 1983 to 1996 at Inje University Seoul Paik Hospital. External beam radiation therapy to pelvis was delivered using 4 MeV Linac and intracavitary irradiation was given via vaginal ovoids or cylinders. Five-year survival and disease-free survival were estimated by Kaplan-Meier Method and prognostic factors related to survival were analysed by log-rank test and Cox proportional hazards regression model. Results : Median length of follow-up was 52months. Five-year overall survival and disease-free survival (DFS) were 81.8$\%$ and 81.7$\%$ respectively. Patients with endometrial invasion had a 57.1$\%$ 5-year DFS compared to 87.5$\%$ for those without endometrial invasion (p=0.0074). Multivariate analysis revealed endometrial invasion as an only statistically significant prognostic factor for 5-year DFS. Among total 15 (22$\%$) recurrences. pelvic recurrences occurred in 4 cases and distant metastases occurred in 13 cases. Conclusion : We have been able to confirm previous results demonstrating marked decrease in local recurrence after pelvic irradiation. In view of the high proportion of distant metastasis found in this study, a trial of aggressive adjuvant systemic therapy and irradiation in early stage cervical carcinoma patients with pelvic nodal metastasis, especially with endometrial invasion, appears to be warranted.

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The Violation of Medical law and liability of tort regarding National Health Insurance Service (NHIS) - Supreme Court 2013. 6. 13 Sentence 2012Da91262 Ruling, 2015. 5. 14 Sentence 2012Da72384 regarding the Judgment - (의료법 위반과 국민건강보험공단에 대한 민법상 불법행위책임 - 대법원 2013. 6. 13. 선고 2012다91262 판결, 2015. 5. 14. 선고 2012다72384 판결을 중심으로 -)

  • Lee, Dong Pil
    • The Korean Society of Law and Medicine
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    • v.16 no.2
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    • pp.131-157
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    • 2015
  • NHIS claimed for damages to doctors that by doing the treatment breaching medical insurance criteria caused by doctors, NHIS paid for medicine cost to pharmacy; as a result, the doctors caused the tort to NHIS. Following consecutive rulings afterwards, NHIS also argued that the medicine cost violating medical law or medical treatment expense paid to medical organizations are both the tort in civil law. NHIS claimed for all the damages, and the Supreme Court confirmed this judgment. However, within our national health insurance system, the subject of insurance payment is NHIS and the subject of medical treatment expense are also NHIS since the treatment expense is also insurance payment by asking the treatment to medical organizations. Further, national health insurance law is not made to control the violation of medical treatment cases; therefore, the breach of medical law cannot be covered by illegality of tort in civil law regarding NHIS. If that is the case, in the case that if the patients are treated according to treatment criteria via the doctors delegated the doctors' permission by Health and Welfare minister, NHIS acquired the benefits to remove the duty to give treatment payment to doctors in civil law; thus, even though the doctors have breached the medical law, NHIS does not have any damages. The fact that supreme court confirmed the ruling that the treatment is the tort in civil law towards NHIS is the judgment not counting the benefits of insurance payment as the subject but only considering the fact that NHIS paid to the doctors and this ruling have gone against the principle under civil code section 750. If the doctors have breached the medical law, the case should be sanctioned by medical law not national health insurance law, and the ruling of supreme court is assumed that they have confused both with the principle of national health insurance law and civil law.

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