• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.28 no.1
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• pp.80-91
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• 2024

Backgrounds/Aims: Optimal intravenous fluid management during the perioperative period for patients undergoing pancreaticoduodenectomy (PD) within the framework of enhanced recovery after surgery (ERAS) is unclear. Studies have indicated that excessive total body salt and water can contribute to the development of oedema, leading to increased morbidity and extended hospital stays. This study aimed to assess the effects of an intravenous therapy regimen during postoperative day (POD) 0 to 2 in PD patients within ERAS. Methods: A retrospective interventional cohort study was conducted, and it involved all PD patients before and after implementation of ERAS (2009-2017). In the ERAS group, a targeted maintenance fluid regimen of 20 mL/kg/day with a sodium requirement of 0.5 mmoL/kg/day was administered. Outcome measures included the mmol of sodium and chloride administered, length of stay, and morbidity (postoperative pancreatic fistula, POPF; acute kidney injury, AKI; ileus). Results: The study included 169 patients, with a mean age of 64 ± 11.3 years. Following implementation of the intravenous fluid therapy protocol, there was a significant reduction in chloride and sodium loading. However, in the multivariable analysis, chloride administered (mmoL/kg) did not independently influence the length of stay; or rates of POPF, ileus, or AKI (p > 0.05). Conclusions: The findings suggested that a postoperative intravenous fluid therapy regimen did not significantly impact morbidity. Notably, there was a trend towards reduced length of stay within an increasingly comorbid patient cohort. This targeted fluid regimen appears to be safe for PD patients within the ERAS program. Further prospective research is needed to explore this area.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.1
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• pp.28-35
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• 2008

Purpose: The aim of this study is to report the efficacy of infliximab, a monoclonal antibody directed against tumor necrosis factor alpha which is used for both treatment of refractory pediatric Crohn disease (CD) and induction of remission. Methods: Among pediatric patients who were diagnosed with CD at Samsung Medical Center between March 2001 and August 2007, a total of 16 patients were given infliximab to treat conventional therapyresistant refractory CD and severe active CD for induction of remission. Patients needing maintenance therapy were treated with an infliximab infusion every 8 weeks, and fistulizing CD patients occasionally received the infusion upon the condition that a fistula developed. The efficacy of treatment was assessed by comparing the Pediatric Crohn Disease Activity Index (PCDAI), Hct, ESR, CRP, and serum albumin levels using paired t-test. Results: The male/female ratio was 13:3, and the median age was 13 years (range, 21 months~15 years). The patients included 7 cases of therapy-resistant refractory CD, 7 cases of severe active CD, and 2 cases of fistulizing CD. Mean PCDAI before infliximab therapy was 34.19${\pm}$14.96, and mean follow-up PCDAI within 2 to 4 weeks after the last infusion was significantly lower, at 6.88${\pm}$10.31 (p=0.000). Hematological markers such as ESR (p=0.000), serum albumin (p=0.016), and CRP (p=0.009) also improved significantly after infusion. Remission was achieved in 2 of 4 patients refractory to conventional therapy. Among 3 steroid-dependent patients, 2 were able to discontinue steroid therapy, and dose reduction was possible in 1 patient. Remission after top-down therapy without prior use of other immunomodulators was achieved in 6 weeks in all 7 of the patients who had severe CD. Nine of ten refractory fistulizing CD patients also showed improvement after infliximab therapy. Conclusion: Infliximab was effective in pediatric refractory CD for induction of remission and maintenance therapy, as well as in severe CD for top-down induction therapy. Furthermore, infliximab has contributed to steroid cessation and dose reduction. Long-term follow-up evaluation is needed to determine safety and efficacy of infliximab in the future.

• The Journal of the Korea Contents Association
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• v.9 no.8
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• pp.350-359
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• 2009

This thesis in the social welfare-related institutions in the Seoul area, art therapy and the therapist based on the status of welfare-related agencies in the community of art therapy is to present possibilities and challenges. Research results presented by Health and Welfare, where seven of the 14 kinds of social welfare facilities, participate in the survey and the target organ, 45.1% of art therapy's role in social welfare-related institutions and gradually establish the location was the result. Art therapy is to conduct the current difficulties in institutions about the environmental factors related to a professional therapist and art therapist in the therapist's expansion as a major research and maintenance was network. Welfare-related agencies and community relationships we maintain mutual relationship, and are formed within the community have an effect on consciousness and collectivization. To provide the opportunity which realize the value in the art therapy by applying more to expand the variety of professional method. First, secure the facility of art therapy environment and the therapists. Second, if the art therapy association secures the integrated system, it makes a connection with professional therapists to improve recruitment environment in the art therapy community and therapists need to be addressed by all involved is a challenge. Third, a therapist for the duration of training in order to access a variety of academic and clinical research is the importance of the process of learning the training and supervision is to discuss the issue.

• Journal of the Korean Society of Floral Art and Design
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• no.40
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• pp.3-24
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• 2019

This study aim to suggest connective potential of eco-therapy in interior therapy for integrative psychotherapy. The study method was literature review on qualitative study. The study scope was ranged as the following three steps: 1) Literature review on integrative psychological therapy; 2) Discussion on therapy and ecology in interior design; and 3) Association between three aspects of integrative psychotherapy(emotion, cognition and behavior) and psychological phases of interviewee (quasi-consideration, consideration, preparation, behavior, and maintenance). The study results are summarized below: 1) Emotional aspect of integrative psychotherapy utilizes installing and sensory aspects of space. 2) Cognitive aspect of integrative psychotherapy utilizes energetic and installing aspects of space. 3) Behavioral aspect of integrative psychotherapy utilizes structural, installing, emotional, and purposive aspects of space. This study has its significance in extending collaborative concept of plants as the decoration to broad sense of eco-therapy available as the psychological factor in organic relationship between human and environment, which will be used as the resource for design therapy training program in the future.

• The Journal of the Korean dental association
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• v.47 no.9
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• pp.585-595
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• 2009

Purpose : The aim of this study was to compare surgical complications between simple implant placement and implant placement combined with complicated surgical procedures. We also evaluated prosthetic complications according to the specific types of prosthesis. Material and Method : A retrospective analysis of dental chart of patients who was performed implant therapy during the period from June 2003 to December 2005 was carried out. This study was performed on 408 patients (208 male, 200 female). In addition, 1671 implants were performed. Based on their medical record and radiographs, the authors evaluated surgical and prosthetic complications, surgical procedures accompanied at the time of implant, risk factors of implant failure etc. Result : Surgical complications were developed on 358 implants(21.4% on total placed implants) and wound dehiscence was most prevalent complication. On maxillary posterior area, surgical complications developed more frequently on implants with major surgery and showed a significant difference. And complication rate of implants accompanied with GBR was higher than that of simple implants placement and also showed significant difference. The implant supported prosthesis showed no statistical difference in the occurrence of complications according to the types of prosthesis, and food retention was the most common post-prosthetic complication. Also we speculated that length and width of implant showed significant correlation to the failure of implant primary osseointegration. Conclusion : Based on the result, clinician should provide more careful maintenance for patients with implant placement accompanied by complicated surgical procedure. And periodic maintenance for the patient is requested for long-term survival of implant therapy.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.4
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• pp.356-365
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• 2020

Purpose: There have been many efforts to develop generalizable severity markers in children with acute pancreatitis (AP). Expert opinion panels have developed consensus guidelines on management but it is unclear if these are sufficient or valid. Our study aims to assess the effect of clinical and laboratory variables, in addition to treatment modality on hospital length of stay (LOS) as a proxy variable for severity in pediatric patients admitted with AP. Methods: We conducted a retrospective chart review of patients between ages of 0-18 years, who were admitted with AP at 2 institutions between 2013-2018, John R. Oishei Children's Hospital (Buffalo, NY, USA) and Medical University of South Carolina Children's Hospital (Charleston, SC, USA). We constructed three linear regression models to analyze the effect of clinical signs of organ dysfunction, laboratory markers and fluid intake on hospital LOS. Results: Ninety-two patients were included in the study. The mean age was 12 years (range, 7.6-17.4 years), 55% were females, and median LOS was 3 days. The most frequent cause of AP was idiopathic. Our study showed that elevated blood urea nitrogen (BUN) on admission (p<0.005), tachycardia that lasted for ≥48 hours (p<0.001) and need for fluid resuscitation were associated with increase LOS. Total daily fluid intake above maintenance did not have a significant effect on the primary outcome (p=0.49). Conclusion: Elevated serum BUN on admission, persistent tachycardia and need for fluid resuscitation were associated with increase LOS in pediatric AP. Daily total fluid intake above recommended maintenance did not reduce LOS.

• Journal of Ginseng Research
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• v.47 no.1
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• pp.117-122
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• 2023

Background: Human immunodeficiency virus-1 (HIV-1) that binds to the coreceptor CCR5 (R5 viruses) can evolve into viruses that bind to the coreceptor CXCR4 (X4 viruses), with high viral replication rates governing this coreceptor switch. Korean Red Ginseng (KRG) treatment of HIV-1 infected patients has been found to slow the depletion of CD4+ T cells. This study assessed whether the KRG-associated slow depletion of CD4+ T cells was associated with coreceptor switching. Methods: This study included 146 HIV-1-infected patients naïve to antiretroviral therapy (ART) and seven patients receiving ART. A total of 540 blood samples were obtained from these patients over 122 ± 129 months. Their env genes were amplified by nested PCR or RT-PCR and subjected to direct sequencing. Tropism was determined with a 10% false positive rate (FPR) cutoff. Results: Of the 146 patients naïve to ART, 102 were KRG-naïve, and 44 had been treated with KRG. Evaluation of initial samples showed that coreceptor switch had occurred in 19 patients, later occurring in 38 additional patients. There was a significant correlation between the amount of KRG and FPR. Based on initial samples, the R5 maintenance period was extended 2.35-fold, with the coreceptor switch being delayed 2.42-fold in KRG-treated compared with KRG-naïve patients. The coreceptor switch occurred in 85% of a homogeneous cohort. The proportion of patients who maintained R5 for ≥10 years was significantly higher in long-term slow progressors than in typical progressors. Conclusion: KRG therapy extends R5 maintenance period by increasing FPR, thereby slowing the coreceptor switch.

• Childhood Kidney Diseases
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• v.5 no.2
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• pp.109-116
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• 2001

Purpose Long- term use of steroid, cyclophosphamide and cyclosporin, which are frequently used in the therapy of SDNS, might cause severe side effects. Recently, the immune-modulator levamisole has been tried as a substitute therapy and it has been reported as a method with less side effects and more effectiveness. We started this research in order to observe the effects of levamisole and compare it to other therapy results. Patients and Methods : We chose 16 steroid dependent nephrotic syndrome children, those who had shown frequent relapse during the immunocompromised therapy period. Mean age was $9.1{\pm}1.4$ years in children and the male to female ratio was 15:1. All of subjects were diagonized with MCNS and had received cyclophosphamide or cyclosporin before receiving levamisole. Levamisole at a dose of 2.5mg/kg was used every other day for 1 year and the relapse rate was observed. Results : On average of 14 days after treatment, complete remission was visible in all of the children, and the relapse percentage was $50\%$, which represents 8 children, while remaining 8 children representing $50\%$ of the cases showed no relapse during treatment. During the levamisole therapy period, tile average relapse rate was reduced significantly from $2.18{\pm}0.9/year\;to\;0.77{\pm}0.9/year$(P=0.027). Also the average relapse rate after the therapy was reduced to $1.34{\pm}1.1/year$, which was a significant level compared to the level before treatment(P=0.003). There was no significant difference in terms of duration of remission maintenance. Duration of remission maintenance showed an average of $12.2{\pm}9.1$ months before the use of levamisole, but it was also $10.1{\pm}6.9$ month after therapy. No other side effects such as leukopenia, skin disease and other clinically significant symptoms appeared at all during therapy. Conclusion : The long-term medication of levamisole for the therapy of SDNS children is thought to be able to maintain stable remission by reducing the relapse frequency without causing severe side effects. Further study with a broader range of subjects is required to eluccidate the long-term effects of this treatment. (J. Korean Soc Pediatr Nephrol 2001;5 : 109-16)

• 재활복지
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• v.15 no.2
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• pp.147-173
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• 2011

The purpose of this study was to develop a stuttering therapy device to aid in stutter therapy. The research method used for this study was as follows: First, the stuttering therapy device based on analysis of the prolonged speech method used at home and abroad was designed to achieve the goal of research. Second, the stuttering therapy device was to be developed to maintain a vocalization state, to use bio-feedback visualization, to have enough inspiration, to use Korean language in this device, and to use transfer and maintenance training in daily life. Third, the stuttering therapy device effectiveness was to be verified through use in clinical cases. The results of subjects receiving speech therapy and using the breathing control prolonged speech device and SI(stuttering Interview) evaluation programs for 3 months were as follows: For subject A, the stuttered word rate was reduced from 3.20 SW/M to 0.5 SW/M. For subject B, the stuttered word rate was reduced from 1.90 SW/M to 0.75 SW/M. For subject C, the stuttered word rate was reduced from 3.37 SW/M to 0.34 SW/M. For Subject D, the stuttered word rate was reduced from 0.51 SW/M to 0 SW/M. Follow-up evaluations verified the effectiveness of how the stuttering therapy device can reduce subjects' SW/M.

• Journal of Korean Physical Therapy Science
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• v.9 no.1
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• pp.69-80
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• 2002

The objective of research provides the physical therapy of good quality to the patients to search for the problem pant against a physical therapy accident and it simultaneously respects physical therapy company law, the possibility of preparing a system defensive ability in order to be. The data were collected from 2000 October 1 to December 30th, and analyzed by a frequency and a percentage, oneway ANOVA, Scheffe method, $x^2$ official approvals. Conclusion (1) the accident where the patient falls from inside the treatment 'room is many and occasionally' 29.3% (63 people) with was many most. (2) Because of a mistake by a part-time therapist in holiday or a colleague therapist to do, the fracture or bum accident happens 12.5% (27 people), by a assist nurse due to more showed 12.1% (26 people) experience degree in the patient. (3) From physical therapy process breakdown of the medical treatment machinery and tools or it is in malfunction to do and the experience which has a failure to physical therapy is one enemy 68.1% (147 people) was in item. Also it treats and the patient or in the protector it sends an explanation in advance not to be, the experience which it enforces 50% (108 people), of service hour treatment equipment the medical treatment directives broad way of the doctor is accurate in insufficiency and does not enforce the experience is 45.4% (98 people), the patient whom I am treating Hot Pack (electricity has pack inclusion) with to do, the art dealer (over at 1 buffoonery) the experience which it puts on 27.1% (58 people), The patient whom I am treating is the electrotherapy flag (electricity has pack exclusion) with to do, the art dealer (1 degree art dealer over) the experience which it puts on 16.3% (35 people), the experience boat song the patient against a fracture from physical therapy process 9 person (4.2%) was visible an experience degree. (4) With hospital infection to do, from the patient the experience and the therapist which receive a problem proposal were caused by with hospital infection and the answer back regarding the experience which tries to receive a treatment appeared 6% (13 people), 42% (9 people) with each. (5) It listened to the treatment hour patient or the appeal of the protector and especially it does not appear to be being important it was not and and the management which is special it did not take, also the experience where the condition of the patient is deteriorated after that was 10.3% (22 people). (6) The condition or state of the patient does not agree with the medical treatment instruction of the doctor not to be, amendment one experience was 67.5% (145 people). (7) The experience degree of the physical therapy accident which relates with physical therapy recording and a secret maintenance 59.7% (129 people) 'is many and occasionally it is,' it showed an answer back and e it showed a most high accident experience degree. (8) The business overweight of physical therapy company 43.3% (93 people) with was high most from recognition degree of the physical therapy company against a physical therapy accident. (9) Against the question which asks the responsibility subject matter of physical therapy accident the whole answer back volition 42.8% did it is a joint responsibility where the multi person relates. (10) The accident occurs most the hour unit which plentifully in the afternoon 64.3% (133 people) with appeared from the recognition degree against the frequency hour unit of physical therapy accident. (11) Physical therapy it bought and after the various medical treatment accident which relates against the attitude of the, patient side against the physical therapy company it understood and trillion it was many most with 33.3% to be finished. (12) After physical therapy accident the management against the physical therapy company of the hospital authorities concerned above all do not experience 70.6% (149 people), from event right and wrong submission 22.7% (48 people), warning management 2.8% (6 people), the event report requirement and money compensation were each 0.5% (1 person). (13) As the prevention book of physical therapy accident most it is important, the fact which it thinks that, the persons supplement of physical therapy company 58.8% (127 people) with was high most. (14) It related with a physical therapy accident and the medical law 43.5%, civil law 23.9%, was visible the answer back ratio of the criminal law 13.7% from the degree which probably is a relation law.