• Asian Pacific Journal of Cancer Prevention
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• 제17권10호
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• pp.4591-4597
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• 2016

Purpose: Decisions as to whether to provide adjuvant treatment in older breast cancer patients remains challenging. Side effects of chemotherapy have to be weighed against life expectancy, comorbidities, functional status, and frailty. To aid decision-making, we retrospectively analyzed 110 women with breast cancer treated with a curative intention from 2006 to 2012. Survival data with clinical and pathological parameters were evaluated to address the role of adjuvant chemotherapy in this study population. Method: A total of 110 elderly (>70 years) patients that received mastectomy at two hospitals in Taiwan were observed retrospectively for a medium of 51 months. After mastectomy, patients received conservative treatment or adjuvant chemotherapy, or hormone therapy following clinical guidelines or physician's preference. Data were collected from the cancer registry system. Results: Median age at diagnosis was 75.7 years. Thirty-five percent of patients received adjuvant chemotherapy, these having a significantly younger age ($mean=74.0{\pm}5.3$ vs $77.5{\pm}5.3$, p<0.001) and higher tumor staging (p=0.003) compared with their non-chemotherapy counterparts.Five-year overall survival was non-significantly higher in patients who received adjuvant chemotherapy (with chemotherapy 64.2% vs without chemotherapy 62.6%, p=0.635), while five-year recurrence free survival was non-significantly lower (with chemotherapy 64.1% vs without chemotherapy 90.5%, p=0.80). Conclusions: In this analysis, adjuvant chemotherapy tended to be given to patients with a younger age and higher tumor staging at our institute. It was not associated with any statistically significant improvement in survival and recurrence rate. Until age specific recommendations are available, physicians must use their clinical judgment and assess the tumor biology with the patient's comorbidities to make the best choice. Clinical trials focusing on this critical issue are warranted.

• 벤처창업연구
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• 제11권1호
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• pp.85-95
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• 2016

본 연구에서는 바이오 벤처기업에 벤처캐피탈이 투자금을 집행하였을 경우와 그렇지 않을 경우에 따른 성장성과 수익성을 비교, 확인하여 본 연구로 바이오 벤처기업의 경우에는 선별적으로 벤처캐피탈의 투자금을 유치하지 아니한 기업이 투자금을 유치한 기업보다 오히려 성장성과 수익성이 높게 나타났다. 이에 대한 원인을 분석한 결과 벤처캐피탈이 투자금을 유치하지 아니한 바이오벤처기업들은 대기업군의 자회사 형태 또는 전문 의료기관의 자회사 형태였으며, 이는 역으로 바이오 벤처기업은 막대한 자금 투입과 오랜 기간이 필요로 하는 바이오산업만의 특성이 반영된 결과로 이해할 수 있다. 또한, 바이오벤처 산업분야의 기업공개(IPO)에 적용되는 <기술성평가 상장특례>제도로 인해 그동안 바이오벤처기업의 매출 및 이익이 발생하지 않는 상태에서도 코스닥(KOSDAQ)에 기업을 상장됨에 따라 선행연구에서의 소프트웨어 및 정보통신업 산업군 등에서는 매출 및 이익이 일정요건 이상이 되어야 하는 상장요건을 갖추어야만 기업공개(IPO)가능했다는 점이 본 연구의 결과에 기존 선행연구와 상반된 결론이 도출되게 됨을 확인할 수 있다. 향후, 바이오벤처 분야의 발전적 성장을 위하여서는 벤처캐피탈은 물론 엔젤투자 등의 활성화를 통하여 산업별 구분을 통한 성장 모델을 만들 필요성이 제기된다. 본 연구의 한계는 아직 국내 상장한 투자 바이오벤처의 절대수가 부족하며 이로 인한 통계상 의미의 문제점이 있다. 또한 다각도의 관점보다는 경제성의 관점으로만 평가한 부분은 이후의 연구를 통하여 보완 발전해 나갈 필요성이 제기된다.

• 동의신경정신과학회지
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• 제3권1호
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• pp.3-24
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• 1992

This paper is aimed at finding out the clue to the medical solution to the pathological phenomena of the dehumanizing and demoralizing state of our society by centering around the Chiljeong that originates from Oriental Medicine, Sung Confucianism and Sa-sang Medicine(四象醫學). In these fields,the Chiljeong is based on the theory of Eum-yang and Viscera(陰陽.臟腑論) in Oriental Medicine, on the problems of good and evil in Sung Cunfucianism and on the theory of Sa-sang Visceral Localization(四象.臟局의 理論) in Sa-sang Medicine. The principles of geneation of Chiljeong : In case of Oriental Medicine, Sin(神) controls Chiljeong and of it is stored in five Viscera, it becomes Sin in the Heart, Hon(魂) in the Liver, Sa(思) in the Spleen, Bed-Woo(悲.憂) in the Lung, and Kyeong-Kong(驚.恐) in the Kidney. Then five Viscera react with outer stimuli or Sin, it gives off Chiljeong as Joy(from the Heart), Anger(from the Liver). Thought (from the Spleen), Anxiety and Sorrow(from the Lung) and Surprise and Fear(from the Kidney) In Sung Confucianism, Sim(心) comtrols Seong-jeong(性.情), and at the moment of that Sim gives off Jeong(情), it becomes good when the Li(理) gibes off itself and then Chi(氣) follows Li, or Chi gives off itself and is regulated optimally, out it becomes evil when Li cannot preside over Chi and then shaded by cloudy Chi. The pathology: If the Chiljeong exceeds one's capacity, the corresponding Vicsera will be damaged, and the Passions(喜.怒.哀.樂) that may harm to four types of constitution severly are the Joy and Pleasure(in Tae-eum-in 太陰人 and So-eum-in 少陰人) and Grief and Anger(in Tae-yang-in 太陽人 and So-yang-in 少陽人), so one should be alert on some passions by regrding his constitutional frailty. More over, because of the variations in Sa-sang Visceral Localyzatin there is various ability in human affairs, but as the clumsiness in human affairs may make him hurt by it, so one should be prevented from these passions and human affairs, that is flowing Joy and Participations(黨與) in Tae-yang-in, flowing Pleasure and Dwelings(居處) in So-yang-in, explosive Anger and Companies(交遇) in So-eum-in, explosive Grief and Affairs(事務) in Tae-eum-in. How to clutivate the human nature: The ulitmate purpose in Oriental Medicine is preserving Cheon-Jin(天眞), that is following the Tao(道) by making him be in harmony with the Chi(氣) of the Seasons and by living a simple life. In Sung Confucianism, the way preventing the lustful desire and preserving Cheon-li(天理) is to observate derectly the calm, original place of human nature with reverence, when Sim has nat given off itself yet, and when Sim has already given off, it also is to meditating on one's passion and thought that the principle of good should be researched on or the evil should be cut off according to it's being good or evil. Such like as these various aspects of research on the Chiljeong it will be helpful in understanding human nature by producing the various materials on it, moreover, by doing so, we can lead out appropriate solution on the confusions of judgement value and demoralization.

• 한국산학기술학회논문지
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• 제20권5호
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• pp.394-405
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• 2019

본 연구의 목적은 허약노인에 대한 개념의 명확한 속성 규명과 이론적 근거를 마련하는 것이다. 연구방법은 Walker와 Avant(2005)의 개념분석을 위한 기본 원리에 근거하여 절차에 따라 진행하였다. 허약노인에 대한 개념 사용의 연구결과는 허약노인은 건강과 질병의 중간상태에 있다. 허약노인은 신체적으로 근감소증, 염증, 인슐린 저항성에서 신체적으로 취약하고, 진행된 질병의 결과로 입원, 낙상, 장애, 사망에 이를 수 있다. 생리적, 심리적, 사회적 생활습관, 경제적 요인과 관련된 다면적 속성을 가지며, 일상생활에 제한으로 다른 사람의 도움을 필요로 하여 의존적이며, 회복시간과 회복의 정도가 저하되는 것과 소진(exhaustion)의 속성을 가지고 있는 것으로 확인되었다. 즉, 역동적 과정(dynamic process), 다면적 요소(multidimensional factors), 의존성(dependency), 취약성(vulnerability)이다. 허약노인은 건강과 질병의 중간 상태로 변화 가능성을 내포한 역동적 과정이며, 신체적, 정신적, 인지적, 사회 환경적 요소를 포함한다. 또한 일상생활에 어려움이 있는 노인으로, 신체적 취약성과 함께 적응에 어려움을 가지고 있는 노인을 의미하였다. 결론적으로 본 연구는 허약노인의 개념분석과 이해를 통해 노인의 허약 수준을 파악하고, 체계적으로 관리함으로써 장기요양상태에 이르지 않도록 지역사회 방문간호를 포함한 보건의료체계 마련을 위한 기초자료 제공에 기여할 것이다.

• 한국산학기술학회논문지
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• 제22권3호
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• pp.252-260
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• 2021

노쇠의 관리를 위해 근력운동의 중요성이 강조되고 있고 다양한 운동기구들이 개발되어지고 있다. 최근에는 전자기 저항을 디지털 중량으로 변환하여 제어하는 디지털 중량제어기술이 주목을 받고 있으나 국내에서 고령자를 대상으로 하여 디지털 중량제어기술 기반 운동기구의 효과성과 안전성을 검증한 보고는 전무하다, 따라서, 본 연구는 디지털 중량제어기술을 활용한 고령친화운동기구의 인간공학적 분석을 통하여 이후 개발방향의 지표 제시를 목적으로 하였다. 총 20명의 성인 남녀 (연령: 62.40 ± 2.09 세) 를 대상으로 적용 가능한 운동강도를 분류하기 위하여 운동기구의 부하를 레벨화하였고, 세가지 실험대상 동작시의 근 활성도와 심박수를 측정하였다. 또한, 국제 표준 ISO 9241-11에 준거한 설문지를 활용하여 소프트웨어부와 기기부의 안정성, 조작성, 효율성, 만족도 등을 평가하였다. 그 결과, 운동 부하, 근활성도, 심박수가 일관되게 증가하는 결과를 통해서 현장에서 적용 가능한 3단계의 운동 강도를 분류할 수 있었다. 모니터 사이즈의 확대, 메뉴의 한글화, 기구의 소형화, 소음의 최소화가 필요한 것으로 나타났다. 이러한, 결과들을 고려할 때 향후 신제품 개발시에는 기구 크기, 표시부, 소음의 보완을 통한 고도화된 고령친화운동기구 개발의 필요성이 시사 되어 진다.

• 대한통합의학회지
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• 제10권3호
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• pp.199-208
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• 2022

Purpose : The study aimed to examine gender-differences in muscle tone, elasticity, and stiffness of the erector spinae in young and old subjects. This study also aimed to assess the effect of aging on muscle tone, elasticity, and stiffness of the erector spinae in men and women, and compare the trend of the aging effect between the two gender groups. Methods : With the muscle in the relaxed state and subjects in the prone position, a myotonometer was used to quantify muscle tone, elasticity, and stiffness, of the erector spinae in 102 participants[46 males (29 young subjects, aged 22.48±2.23 years and 17 old subjects, aged 76.35±3.71 years), 56 females (40 young subjects, aged 20.38±1.43 years and 16 old subjects, aged 74.56±5.40 years)]. Results : The tone and stiffness of the erector spinae muscles were greater in men than in women for both age groups (p<.001-.01), while elasticity did not show a significant difference between men and women. For the direction of change, both male and female groups showed significantly increased tone and stiffness, and decreased elasticity with increasing age (p<.001). For age-related changes, a different tendency was observed between men and women. Men showed a greater increase in tone than women with aging. in contrast, both men and women exhibited a similar decrease or increase in elasticity and stiffness. Conclusion : Gender-differences in the erector spinae in terms of muscle tone and stiffness were observed. Regardless of the age, men had higher muscle tone and stiffness than women, but not elasticity. The erector spinae muscles showed age-related changes in all aspects of muscle tone, elasticity, and stiffness, in both men and women. Notably, men presented greater variation than women in the amount of increase of muscle tone with aging. These findings have implications for musculoskeletal therapeutic approaches, and gender-customized tuning may be indicated for designing exercise interventions to prevent and manage gender-sensitive muscular injuries or diseases and frailty.

• Journal of Korean Dental Science
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• 제16권2호
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• pp.128-148
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• 2023

Dementia is an umbrella term that describes the loss of thinking, memory, attention, logical reasoning, and other mental abilities to the extent that it interferes with the activities of daily living. More than 50 million individuals worldwide live with dementia, which is expected to increase to 131 million by 2050. Recent research has shown that poor oral health increases the risk of dementia, while oral health declines with cognitive decline. In this narrative review, the literature was based on the "hypothesis" that dementia and oral health have a close relationship, and appropriate oral health and occlusal rehabilitation treatment can improve the quality of life of patients with dementia and prevent progression. We conducted a literature search in PubMed and Google Scholar databases, using the search terms "dementia," "major neurocognitive disorder," "dentition," "occlusion," "tooth loss," "dental prosthesis," "dental implant," and "occlusal rehabilitation" in the title field over the past 30 years. A total of 131 studies that scientifically addressed dementia, oral health, and/or oral rehabilitation were included. In a meta-analysis, the random effect model demonstrated significant tooth loss increasing the dementia risk 3.64-fold (pooled odds ratio=3.64, 95% confidence interval [2.50~5.32], P-value=0.0348). Tooth loss can be an important indicator of cognitive function decline. As the number of missing teeth increases, the risk of dementia increases. Loss of teeth can lead to a decrease in the ascending information to the brain and reduced masticatory ability, cerebral blood flow, and psychological atrophy. Oral microbiome dysbiosis and migration of key bacterial species to the brain can also cause dementia. Additionally, inflammation in the oral cavity affects the inflammatory response of the brain and the complete body. Conversely, proper oral hygiene management, the placement of dental implants or prostheses to replace lost teeth, and the restoration of masticatory function can inhibit symptom progression in patients with dementia. Therefore, improving oral health can prevent dementia progression and improve the quality of life of patients.

• Tuberculosis and Respiratory Diseases
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• 제87권2호
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• pp.176-184
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• 2024

Background: Results of studies investigating the association between body mass index (BMI) and mortality in patients with coronavirus disease-2019 (COVID-19) have been conflicting. Methods: This multicenter, retrospective observational study, conducted between January 2020 and August 2021, evaluated the impact of obesity on outcomes in patients with severe COVID-19 in a Korean national cohort. A total of 1,114 patients were enrolled from 22 tertiary referral hospitals or university-affiliated hospitals, of whom 1,099 were included in the analysis, excluding 15 with unavailable height and weight information. The effect(s) of BMI on patients with severe COVID-19 were analyzed. Results: According to the World Health Organization BMI classification, 59 patients were underweight, 541 were normal, 389 were overweight, and 110 were obese. The overall 28-day mortality rate was 15.3%, and there was no significant difference according to BMI. Univariate Cox analysis revealed that BMI was associated with 28-day mortality (hazard ratio, 0.96; p=0.045), but not in the multivariate analysis. Additionally, patients were divided into two groups based on BMI ≥25 kg/m² and underwent propensity score matching analysis, in which the two groups exhibited no significant difference in mortality at 28 days. The median (interquartile range) clinical frailty scale score at discharge was higher in nonobese patients (3 [3 to 5] vs. 4 [3 to 6], p<0.001). The proportion of frail patients at discharge was significantly higher in the nonobese group (28.1% vs. 46.8%, p<0.001). Conclusion: The obesity paradox was not evident in this cohort of patients with severe COVID-19. However, functional outcomes at discharge were better in the obese group.

• International Journal of Heart Failure
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• 제6권3호
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• pp.129-136
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• 2024

Background and Objectives: Heart failure (HF) is a leading cause of hospitalization and death worldwide. The Steady Movement with Innovating Leadership for Heart Failure (SMILE HF) aims to evaluate the clinical characteristics, management, hospital course, and long-term outcomes of patients hospitalized for acute HF in South Korea. Methods: This prospective, observational multicenter cohort study was conducted on consecutive patients hospitalized for acute HF in nine university hospitals since September 2019. Enrolment of 2000 patients should be completed in 2024, and follow-up is planned through 2025. Results: Interim analysis of 1,052 consecutive patients was performed to understand the baseline characteristics. The mean age was 69±15 years; 57.6% were male. The mean left ventricular ejection fraction was 39±15%. The prevalences of HF with reduced ejection fraction, HF with mildly reduced ejection fraction, and HF with preserved ejection fraction were 50.9%, 15.3%, and 29.2%. Ischemic cardiomyopathy (CMP) was the most common etiology (32%), followed by tachycardia-induced CMP (12.8%) and idiopathic dilated CMP (9.5%). The prescription rate of angiotensin-converting enzyme inhibitor/angiotensin receptor blockers/angiotensin receptor/neprilysin inhibitor, beta-blockers, spironolactone, and sodium-glucose cotransporter-2 inhibitors at discharge were 76.8%, 66.5%, 50.0%, and 17.5%, respectively. The post-discharge 90-day mortality and readmission rates due to HF aggravation were 2.0% and 6.4%, respectively. Our analysis reveals the current state of acute HF in South Korea. Conclusions: Our interim analysis provides valuable insights into the clinical characteristics, management, and early outcomes of acute HF patients in South Korea, highlighting the current state and treatment patterns in this population.

• 한국전통조경학회지
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• 제34권3호
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• pp.38-49
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• 2016

본 연구는 기문과 시문이 장소성의 함의와 원형경관의 유추 및 향유양상을 탐색할 수 있는 근거가 될 수 있다는 전제로 임실 만취정의 원래 위치 및 이건된 위치에서 입지 및 원형경관을 탐색하고 그 의미를 추론하였다. 임실 만취정의 이건 전 후의 장소적 가치와 원형경관 보존을 위해 시도된 연구 결과는 다음과 같다. 첫째, 정자의 당호 만취(晩翠)는 작정자 김위가 자신의 호로 삼았으며, 소나무를 마주보게 심고 만취라 편액하였는데, 시문에 근거하면 푸른 소나무와 같은 꿋꿋한 기개를 상징하고 있다. 특히 정자에 내재된 의미와 도입된 상징식물 등을 살펴보았을 때 당호는 절개, 가문의 장생, 생명력 등을 반영한 것으로 해석된다. 둘째, 만취정은 풍수적으로 강 건너 제비형국과 마주한 사두형에 자리잡아 팽팽한 균형을 갖고 있어 절개와 가문 번영을 염원하는 장소성을 지니고 있다. 한편, 이건된 만취정은 풍수적 복치형(伏雉形) 형국으로 해석되는데, 학문과 가문 번영에 대한 계승노력이 전승되고 있음을 유추할 수 있다. 셋째, 만취정은 1572년에서 1582년 사이에 건립되었으며, 이건은 1880년대 말에 이루어졌을 것으로 추정하였다. 넷째, 만취정은 변치 않는 절개와 가문번영의 염원을 장소적 언어로 대입시켰으나 후손들에 의해 만취 김위의 묘 옆으로 이건 됨으로서 조상 추모, 후손 학문번영이라고 하는 가치이동 양상이 추적된다. 다섯째, 이건된 만취정은 온돌방에 비중을 둔 사계절 활용, 공간 확장성을 고려한 툇마루, 주련의 내용 등으로 볼 때 강학공간으로서의 의미를 공유, 전승한 것으로 추론된다. 여섯째, 제영시에 나타난 소나무, 연못, 식물, 계곡, 시냇물 등을 통해 절개, 지조, 깨긋한 심성, 유유자적한 삶, 자아성찰, 인생무상 등의 의미가 투영되는 경관향유 양상이 드러나고 있다. 마지막으로 십영의 제영 언어는 원운과 차별성이 인정되지만 의미나 감흥을 통해 원운십영이 지닌 원형경관 향유양상은 전승되고 있는바 관련 시문분석에 따른 경관탐색은 원형경관 보존 및 활용을 위한 근거가 될 수 있음을 보여준다.