• 한국제4기학회지
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• 제18권1호통권22호
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• pp.21-30
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• 2004

일광단층은 NNE-SSW 방향으로 한반도 남동부의 울산에서 부산 해운대까지 연장되며 그 길이는 40 Km이다. 본 연구는 신고리 원자력발전소 1,2호기 건설과 관련된 일관단층석의 제4기 활동 여부를 판단하기 위해서, 지형면 분류와 트렌치 조사로 일광단층의 활동시기를 추정한 것이다. 일광역 부근의 해안에서 산록까지는 모래해안 및 충적면, 10m 해성단구면(MIS 5a), 20 m 해상단면(MIS 5e), 45m 해성단구면(MIS 7 or 9)의 변형면, 소기복침식면의 5개 지형면으로 분류된다. 일광단층선을 경계로 기반침식면은 해안 쪽에 분포하는데도 불구하고 내률 쪽의 45m 해성구면의 변형면 보다 비고가 10m 이상 높다. 그러나 동일한 단층선이 지나고 있는 20m 해성단구면은 변위를 나타내지 않는다. 10m 해성단구면과 20 m 해성단구면이 직선적으로 접하는 지대를 트렌치 조사하였으나 단층선이나 퇴적층의 변위를 관찰할 수 없어, 이 지대는 10m 해성단구면의 옛 해안선[구정선(구汀線)]으로 추정한다. 이에 45m 해성단구면 형성기의 고지리(古地理)로는 소기복침식면은 당시의 해수면 보다 높은 '섬' 이였을 것이며, 일광단층은 이천리층 형성 이후-45m 해성단구면 형성기(22만년 내지 32만년 전) 이전에 이루어졌을 것으로 판단한다.

• 한국임상수의학회지
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• 제32권4호
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• pp.308-312
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• 2015

본 연구는 개에서 트라마돌의 정맥투여가 아이소플루란의 최소폐포농도 ($MAC_{ISO}$)에 미치는 영향을 평가하기 위하여 수행되었다. 6마리의 암컷 저먼셰퍼드견이 본 실험에 사용되었다. 실험견의 마취유도는 안면마스크를 이용하여 시행되었으며 실험하는 동안 기계적 환기장치를 이용하여 호기말 이산화탄소 분압 ($P_{ET}CO_2$)을 35-45 mmHg로 유지하였다. 개에서 마취유도 후 45분이 경과한 다음 gross purposeful movement가 감지 될 때까지 후지 발가락을 클램핑하는 방법을 사용하여 baseline $MAC_{ISO}$ ($MAC_{ISO}B$) 측정을 시작하였다. $MAC_{ISO}B$가 결정된 후, 트라마돌 3 mg/kg을 투여하였고 뒤이어 2.6 mg/kg/h으로 지속점적투여 (CRI)를 실시하였다. CRI 시작 후 20분이 경과한 다음, 트라마돌 투여 후 $MAC_{ISO}$값 ($MAC_{ISO}T$) 측정을 시작하였다. 동맥혈압과 심박수는 지속적으로 기록하였고 $MAC_{ISO}B$와 $MAC_{ISO}T$의 결정 후 각각 20분간 평형기간이 경과한 다음 동맥혈가스분석을 실시하였다. $MAC_{ISO}B$와 $MAC_{ISO}T$는 각각 $1.33{\pm}0.04%$와 $1.23{\pm}0.04%$로 측정되었고 $MAC_{ISO}B$는 트라마돌 투여 후 $7.5{\pm}0.2%$의 유의적인 (P < 0.05) 감소효과를 나타냈다. 트라마돌 투여 후 심박수와 동맥혈압에서는 유의적인 변화가 나타나지 않았으며 동맥혈 가스분석 결과에서도 유의적인 차이가 없었다. 이상의 결과로 보아 개에서 아이소플루란을 이용한 전신마취 시 트라마돌의 투여는 심폐기능의 억압을 일으키지 않고 $MAC_{ISO}$값을 감소시켰으므로 마취의 안정성과 마취회복의 질을 향상시키는데 유용할 것으로 사료된다.

• Journal of Chest Surgery
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• 제52권4호
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• pp.248-329
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• 2019

Background: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. Methods: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors-primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. Results: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Conclusion: Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

• 대한불안의학회지
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• 제15권2호
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• pp.61-67
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• 2019

Objective : This study aimed to investigate the general process from the symptom onset to the psychiatric treatment in Korean panic patients and the effect of improved public awareness on it. Methods : This study has a retrospective design. The subjects were the new patients with panic disorder who visited the psychiatric outpatient clinic in twelve university-affiliated hospitals all across Korea. The medical chart was reviewed retrospectively and the data were collected including chief complaints of symptoms, recent stressors, the time to visit the psychiatric outpatient clinic, and visit of other departments and diagnostic approaches for their symptoms. Results : A total of 814 participants were included in the study. The most common department other than psychiatry the panic patients visited were cardiology (28.3%), general internal medicine (16.0%) and neurology (11.4%). The most frequently used diagnostic tests were a echocardiography (17.9%), 24-hour Holter monitoring (11.2%), and brain MRI (8.2%). Only 37.3% of participants visited psychiatric clinic directly. About 80% of participants visited psychiatric department within 1 year after their first panic symptoms and it took $13.8{\pm}13.7weeks$ on average. Comparing before and after 2012, the number of participants increased who visit directly the psychiatric clinic without visiting other departments (p=0.002) and without visiting emergency room (p<0.001). Conclusions : Our results suggest that a substantial number of patients visit departments other than psychiatry when they experience first panic symptoms. However, most patients begin psychiatric treatment within 1 year after their first symptoms and the number of patient are increasing who visit psychiatric department directly without visiting other departments.

• 생명과학회지
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• 제31권3호
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• pp.257-265
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• 2021

Kinesin은 세포의 중심부에서 세포막쪽으로 미세소관을 따라 이동하며, heterotrimeric kinesin-2는 kinesin superfamily (KIF)의 한 종류로 미세소관의 plus방향으로 이동하는 분자 모터 단백질이다. Heterotrimeric kinesin-2는 모터 활성을 가지는 3종류(KIF3A, KIF3B와 KIF3C)와 kinesin-associated protein 3 (KAP3)이 결합한 형태로 KIF3s의 운반체 결합 영역을 통하여 다양한 결합 단백질과 결합한다. 그러나, 다양한 운반체를 수송하는 heterotrimeric kinesin-2를 조절하는 조절단백질에 대하여서는 아직 밝혀지지 않았다. 본 연구에서는 heterotrimeric kinesin-2를 조절하는 조절단백질을 단백질을 분리하기 위하여 KIF3A의 운반체 결합 영역과 결합하는 단백질을 효모 two-hybrid system을 사용하여 탐색한 결과, 뇌에 특이적으로 발현하는 세포질 크레아틴 키나아제(CKB)를 분리하였다. CKB의 C-말단은 KIF3A의 운반체 결합 영역과 결합하지만, KIF3B, KIF5B와 KAP3과는 결합하지 않았다. 다른 단백질 키나아제인 CaMKIIa는 KIF3A와 결합하지만 GSK3a는 KIF3A와 결합하지 않았다. 또한 KIF3A은 GST-CKB-C와는 결합하지만 GST-CKB-C와 GST와는 결합하지 않았다. HEK-293T세포에 CKB와 KIF3A을 동시에 발현시켰을 때 두 단백질은 세포 내에서 같은 부위에 존재하며, CKB 혹은 KIF3A을 면역침강한 결과 KIF3A뿐만 아니라 KIF3B와도 같이 침강함을 확인하였다. 이러한 결과들은 CKB-KIF3A 결합은 세포내에서 에너지가 부족되는 조건에서 heterotrimeric kinesin-2의 운반체 수송을 조절할 가능성을 시사한다.

• Nutrition Research and Practice
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• 제15권2호
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• pp.213-224
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• 2021

BACKGROUND/OBJECTIVES: To evaluate the nutritional status and prevalence of malnutrition in hospitalized children at admission and during hospitalization in South Korea. SUBJECTS/METHODS: This first cross-sectional nationwide "Pediatric Nutrition Day (pNday)" survey was conducted among 872 hospitalized children (504 boys, 368 girls; 686 medical, 186 surgical) from 23 hospitals in South Korea. Malnutrition risk was screened using the Pediatric Yorkhill Malnutrition Score (PYMS) and the Screening Tool Risk on Nutritional status and Growth. Nutritional status was assessed by z-scores of weight-for-age for underweight, weight-for-height for wasting, and height-for-age for stunting as well as laboratory tests. RESULTS: At admission, of the 872 hospitalized children, 17.2% were underweight, and the prevalence of wasting and stunting was 20.2% and 17.3%, respectively. During hospitalization till pNday, 10.8% and 19.6% experienced weight loss and decreased oral intake, respectively. During the aforementioned period, fasting was more prevalent in surgical patients (7.5%) than in medical patients (1.6%) (P < 0.001). According to the PYMS, 34.3% and 30% of the children at admission and on pNday, respectively, had a high-risk of malnutrition, requiring consultation with the nutritional support team (NST). However, only 4% were actually referred to the NST during hospitalization. CONCLUSIONS: Malnutrition was prevalent at admission and during hospitalization in pediatric patients, with many children experiencing weight loss and poor oral intake. To improve the nutritional status of hospitalized children, it is important to screen and identify all children at risk of malnutrition and refer malnourished patients to the multidisciplinary NST for proper nutritional interventions.

• Tuberculosis and Respiratory Diseases
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• 제85권1호
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• pp.37-46
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• 2022

Background: Although respiratory tract infection is one of the most important factors triggering acute exacerbation of chronic obstructive pulmonary disease (AE-COPD), limited data are available to suggest an epidemiologic pattern of microbiology in South Korea. Methods: A multicenter observational study was conducted between January 2015 and December 2018 across 28 hospitals in South Korea. Adult patients with moderate-to-severe acute exacerbations of COPD were eligible to participate in the present study. The participants underwent all conventional tests to identify etiology of microbial pathogenesis. The primary outcome was the percentage of different microbiological pathogens causing AE-COPD. A comparative microbiological analysis of the patients with overlapping asthma-COPD (ACO) and pure COPD was performed. Results: We included 1,186 patients with AE-COPD. Patients with pure COPD constituted 87.9% and those with ACO accounted for 12.1%. Nearly half of the patients used an inhaled corticosteroid-containing regimen and one-fifth used systemic corticosteroids. Respiratory pathogens were found in 55.3% of all such patients. Bacteria and viruses were detected in 33% and 33.2%, respectively. Bacterial and viral coinfections were found in 10.9%. The most frequently detected bacteria were Pseudomonas aeruginosa (9.8%), and the most frequently detected virus was influenza A (10.4%). Multiple bacterial infections were more likely to appear in ACO than in pure COPD (8.3% vs. 3.6%, p=0.016). Conclusion: Distinct microbiological patterns were identified in patients with moderate-to-severe AE-COPD in South Korea. These findings may improve evidence-based management of patients with AE-COPD and represent the basis for further studies investigating infectious pathogens in patients with COPD.

• Journal of Gastric Cancer
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• 제22권1호
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• pp.67-77
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• 2022

Purpose: Tegafur/gimeracil/oteracil (S-1) and capecitabine plus oxaliplatin (CAPOX) are standard adjuvant chemotherapies (ACs) administered after gastrectomy to patients with stage II or III gastric cancer. However, the efficacy of AC in elderly patients remains unclear. The objective of this retrospective multicenter cohort study was to compare the efficacies of S-1 and CAPOX AC in patients aged ≥70 years. Materials and Methods: Nine hundred eighty-three patients who were treated with AC using S-1 (768 patients) or CAPOX (215 patients) were enrolled in this study. Each patient underwent AC after curative gastrectomy for stage II or III gastric cancer at one of 27 hospitals in the Republic of Korea between January 2012 and December 2013. Relapse-free survival (RFS) and overall survival (OS) were analyzed according to AC regimen and age group. Results: Of the 983 patients, 254 (25.8%) were elderly. This group had a similar RFS (P=0.099) but significantly poorer OS (p=0.003) compared with the non-elderly group. Subgroup analysis of the non-elderly group revealed no AC-associated differences in survival. Subgroup analysis of the elderly group revealed significantly better survival in the S-1 group than in the CAPOX group (RFS, P<0.001; OS, P<0.001). Multivariate analysis revealed that the CAPOX regimen was an independent poor prognostic factor for RFS (hazard ratio [HR], 1.891; 95% confidence interval [CI], 1.072-3.333; P=0.028) and OS (HR, 2.970; 95% CI, 1.550-5.692; P=0.001). Conclusions: This multicenter observational cohort study found significant differences in RFS and OS between S-1 and CAPOX AC among patients with gastric cancer aged ≥70 years.

• Tuberculosis and Respiratory Diseases
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• 제85권2호
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• pp.185-194
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• 2022

Background: The Korea Interstitial Lung Disease Study Group has made a new nationwide idiopathic pulmonary fibrosis (IPF) registry because the routine clinical practice has changed due to new guidelines and newly developed antifibrotic agents in the recent decade. The aim of this study was to describe recent clinical characteristics of Korean IPF patients. Methods: Both newly diagnosed and following IPF patients diagnosed after the previous registry in 2008 were enrolled. Survival analysis was only conducted for patients diagnosed with IPF after 2016 because antifibrotic agents started to be covered by medical insurance of Korea in October 2015. Results: A total of 2,139 patients were analyzed. Their mean age at diagnosis was 67.4±9.3 years. Of these patients, 76.1% were males, 71.0% were ever-smokers, 14.4% were asymptomatic at the time of diagnosis, and 56.9% were at gender-age-physiology stage I. Occupational toxic material exposure was reported in 534 patients. The mean forced vital capacity was 74.6% and the diffusing capacity for carbon monoxide was 63.6%. Treatment with pirfenidone was increased over time: 62.4% of IPF patients were treated with pirfenidone initially. And 79.2% of patients were treated with antifiboritics for more than three months during the course of the disease since 2016. Old age, acute exacerbation, treatment without antifibrotics, and exposure to wood and stone dust were associated with higher mortality. Conclusion: In the recent Korean IPF registry, the percentage of IPF patients treated with antifibrotics was increased compared to that in the previous IPF registry. Old age, acute exacerbation, treatment without antifibrotics, and exposure to wood and stone dust were associated with higher mortality.

• 생명과학회지
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• 제33권1호
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• pp.1-7
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• 2023

세포내 운반체는 kinesin과 dynein과 같은 미세소관 분자 모터단백질에 의하여 운반된다. Kinesin은 분자 모터단백질의 큰 그룹을 형성하며, kinesin-1은 미세소관 위를 정방향으로 세포내 소기관, 단백질 복합체, 그리고 mRNAs을 운반한다. Kinesin-1은 kinesin superfamily protein (KIF) 5A, 5B, 그리고 5C (또 다른 명칭으로 kinesin장쇄) 그리고 kinesin 단쇄로 구성되어져 있다. Kinesin-1은 KIF5s의 carboxyl (C)-말단 부위를 통하여 다양한 단백질과 결합한다는 사실은 알려져 있지만, 결합단백질에 대하여서는 아직 충분히 밝혀지지 않았다. 본 연구에서는 KIF5A의 C-말단 특정영역과 결합하는 단백질을 효모 two-hybrid system을 사용하여 탐색한 결과, Glutamate-rich 4 (ERICH4)를 분리하였다. ERICH4는 KIF5A의 C-말단 특정영역과 결합하지만, KIF5B와 KIF3A (kinesin-2의 모터단백질)와는 결합하지 않았다. 그리고 KIF5A는 ERICH4의 다른 isoform인 ERICH1과는 결합하지 않았다. 또한 KIF5A은 GST-ERICH4, GST-ERICH4-amino (N)-말단과는 결합하지만 GST-ERICH4-C말단과 GST와는 결합하지 않았다. HEK-293T 세포에 ERICH4와 KIF5A을 발현시켰을 때 ERICH4와 KIF5A는 세포 내의 같은 부위에서 발현하며, ERICH4을 면역침강한 결과 KIF5A와 KLC은 같이 침강하였다. 이러한 결과들은 ERICH4는 kinesin-1이 운반하는 수송체와 KIF5A와의 결합에 매개단백질로의 역할의 가능성을 시사한다.