• IMMUNE NETWORK
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• v.20 no.3
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• pp.23.1-23.20
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• 2020

Sepsis is conceptually defined as life-threatening organ dysfunction that is caused by a dysregulated host response to infection. Although there has been significant advancement in recent decades in defining and understanding sepsis pathology, clinical management of sepsis is challenging due to difficulties in diagnosis, a lack of reliable prognostic biomarkers, and treatment options that are largely limited to antibiotic therapy and fundamental supportive measures. The lack of reliable diagnostic and prognostic tests makes it difficult to triage patients who are in need of more urgent care. Furthermore, while the acute inpatient treatment of sepsis warrants ongoing attention and investigation, efforts must also be directed toward longer term survival and outcomes. Sepsis survivors experience incomplete recovery, with long-term health impairments that may require both cognitive and physical treatment and rehabilitation. This review summarizes recent advances in sepsis prognosis research and discusses progress made in elucidating the underlying causes of prolonged health deficits experienced by patients surviving the early phases of sepsis.

• Journal of Korean Public Health Nursing
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• v.16 no.1
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• pp.77-94
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• 2002

This study was a quasi-experimental study of nonequivalent control group pretest- posttest design to investigate the effect of home rehabilitation exercise program on the physical and psychological functions of home stayed chronic hemiplegic stroke patients. The data were collected during the period of May 20th to August 15th, 200l. The subjects for this study were 40 hemiplegic stroke patients with the experimental group consisting of 19 patients and the control group being composed of 21 patients. The patients selected for this study were: (a)living in J city who had been diagnosed with stroke and at home after being discharged from the hospital, (b) suffering from stroke for 6 months to 5 years, (c) without recognition disorder with the MMSE-K(Mini-Mental State Examination-K)score above 25, (d) below 2 on the modified Ashworth scale, (e)free from heart and pulmonary disease, (f)able to walk beyond 15 minutes for themselves, (g) not taking regular exercises. The program for the experimental group provided 8 weeks' home rehabilitation exercise, two times of group education during the first week and individual education and supportive care after the second week through home visiting and telephoning more than once a week. The amount of time spent on rehabilitation exercise by the experimental group was 35 to 50 minutes a day, three times a week. In order to understand the effects of experiment the two groups were compared and verified by measuring the physical and psychological functions of both groups. The data were analysed by $\chi^{2}-test$, paired t-test and unpaired t-test and ANCOVA through SAS/PC program. The results of the study were as follows: 1. In terms of physical variables: grip strength. lower extremity muscle strength, walking time, ADL and serum lipid levels 1) There was no significant difference in the unaffected and affected grip strength between the two groups, even though the unaffected and affected grip strength was more improved in the experimental group than in the control group. 2) There was no significant difference in the unaffected lower extremity muscle strength between the two groups, even though the unaffected lower extremity muscle strength was more improved in the experimental group than in the control group. There was no significant difference either in the affected lower extremity muscle strength between the two groups, even though the affected lower extremity muscle strength was more improved in the experimental group than in the control group. 3) There was significant difference in walking time between the two groups. Walking time was significantly reduced in the experimental group whereas it increased in the control group. 4) There was significant difference in ADL score between the two groups. ADL score was significantly increased in the experimental group, but it significantly decreased in the control group. 5) There was significant difference in serum total cholesterol level between the two groups. After experiment the serum T-C level became lower in the experimental group whereas it became sigficantly higher in the control group. 2. In terms of psychological variables: depression and self-esteem 1) There was no significant difference in the depression between the two groups, even though the depression showed constant in the experimental group, but it showed a significant increase in the control group. 2) There was no significant difference in the self-esteem between the two groups, even though the self-esteem showed some increase in the experimental group, but it significant decrease in the control group. As shown above, the results of 8 weeks' home rehabilitation exercise program for chronic hemiplegic stroke patients produced positive effects on walking time, ADL score and serum T-C level, shortening walking time, improving activities of daily living(ADL) and lowering serum total cholesterol level.

• The Journal of Korean Medicine
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• v.43 no.2
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• pp.51-60
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• 2022

Objectives: Currently, Korea's medical services are divided into Western medicine and Korean medicine, and people who are not satisfied with the existing treatments are looking for complementary and alternative medicine(CAM). Therefore, this study attempted to confirm patients' perception of the ongoing collaborative treatment and integrated medical service that added CAM to collaborative treatment based on tertiary hospital users. So that we can confirm the expected advantage and disadvantage of integrated medical service system and the necessity of supporting medical expenses for it. Methods: The survey was conducted on 100 people who experienced tertiary hospital treatment and other 100 people who experienced both tertiary hospital treatment and Korean medicine treatment at the same period. The survey was conducted until the number of respondents in both group reached 100. The survey was conducted through e-mail and was conducted from September 27, 2021 to October 8, 2021. Results: For the advantages of collaborative treatment 'increased in psychological stability,' and for disadvantages 'longer time spent for treatment' were the most common. If integrated medical services are implemented in the future, expected advantages include 'consideration of various treatments.' and expected disadvantages include 'increased medical cost.' The needs to expand support for health insurance for integrated medical services were 75.5% among responders. Conclusions: We were able to find out the (expected) advantages and disadvantages of the collaborative medical care and the integrated medical system that medical users experienced or expected, also confirmed positive answers to the expansion of health insurance support for the integrated medical system.

• The Journal of Korean Medicine
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• v.44 no.1
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• pp.65-75
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• 2023

Objectives: Objectives: In this study, we define a medical service type that combines Western medicine, Korean medicine, and complementary and alternative medicine (CAM) as an integrated medical service. This study, as part of tertiary hospital-based integrated medical service model and clinical field application, aims to collect status and opinions on integrated medical service for medical staff in the field. Methods: This is a survey study, and was conducted on doctors from Kyung Hee University Hospital and Korean medicine doctors from Kyung Hee University Korean Medicine Hospital. Respondents were recruited on a first-come, first-served basis until the number of respondents reached 120. The investigation was conducted for a total of 16 days from October 4, 2021 to October 19, 2021 by e-mail. Results: Recognition of integrated medical services was confirmed to be 45.8%, and 49.2% responded positively to the necessity of it. As a group of diseases that require the establishment of integrated medical services in the future, 'disorders of musculoskeletal systems and connective tissues' was the highest. The most expected advantages of providing integrated medical services were 'increased satisfaction of patients and guardians' and 'increased treatment effects.' Conclusions: In this study, we investigated the perception of doctors and Korean medicine doctors on integrated medical services that combine Western medicine, Korean medicine, and CAM. It has been confirmed that medical staff generally have a positive perception of integrated medical services, and if the scientific basis for the effect of integrated medical services is supported, the rate of positive perception is expected to increase.

• Tuberculosis and Respiratory Diseases
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• v.44 no.4
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• pp.806-814
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• 1997

The incidence, type and distribution of polyneuropathy in patients with chronic obstructive pulmonary disease (COPD) were assessed and also analyzed the causative factors. Forty-four patients, mean age 66.1 years (42 male, 2 female), have been investigated with arterial gas analysis, pulmonary function test, clinical and electrodiagnostic studies. None of them had conditions known to affect the peripheral nervous system such as metabolic disorders or drugs. In a selected group of 44 patients, electrophysiological findings of polyneuropathy were found in 22 patients(50%), clinical polyneuropathy were diagnosed in 13 patients(9 patients were diagnosed by electrophysiological studies, 4 patients were normal by electrophysiological studies). These findings indicate that subclinical polyneuropathy(13 patients, 30%) more commonly occurs than clinical polyneuropathy(9 patients, 20%) in associated with COPD. In the patients with polyneuropathy, the lesions were predominant axonal degeneration, the changes were more involved in leg than arm, more frequently affected sensory fibers. We could not find etiologic factor to cause polyneuropathy in COPD patients.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7567-7573
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• 2015

Background: Catastrophic effects of mustard gas as a chemical warfare agent have always been a major problem for those exposed to this agent. In this meta-analysis it was tried to evaluate carcinogenesis, ocular, cutaneous and respiratory complications of mustard gas exposure among Iranians who had been exposed to this agent during the Iran-Iraq war. Materials and Methods: In this meta-analysis, the required data were collected using keywords "mustard gas", "sulfur mustard", "cancer", "neoplasm", "respiratory complications", "ocular complications", "lung disease", "chronic complication", "eye", "skin", "cutaneous complication", "carcinogenesis" and their combination with keywords "Iran", "Iranian", "prevalence", "mortality" and their Farsi equivalent terms from the databases of SID, Iranmedex, Magiran, Pubmed, Science Direct, Google Search engine, Gray Literature and Reference of References. To determine the prevalence of each complication and perform meta-analysis, CMA: 2 (Comprehensive Meta-Analysis) software with a randomized model was used. Results: Of the 542 articles found, 7 national articles, consistent with the aims of this study were selected. Meta-analysis of seven papers revealed that cancer risk, especially cancer of the respiratory system was elevated, so that the relative risk (RR) of cancer role of mustard gas was inconsistent from 2/1 to 4 in this survey. Also prevalence of delayed skin disorders due to sulfur mustard was 94.6%, pulmonary complications 94.5% and ocular complications 89.9%. The incidence of various cancers in victims exposed to mustard gas was 1.7% worldwide where the rate was 2.2% in Iranian victims of the Iraq-Iran war. Conclusions: Based on present study the prevalence of delayed mustard gas related cutaneous, pulmonary and ocular complications is above 90% and risk of carcinogenesis is higher in comparison to worldwide statistics. This may suggest need for long-term and persistent follow-up and rehabilitation procedures for populations exposed to this agent.

• Journal of the Korea Convergence Society
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• v.11 no.9
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• pp.51-57
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• 2020

The purpose of this study was to examine the effects of a thoracic mobilization exercise using the Kaltenborn on the convergence lung function. The study was conducted on 20 university students in their 20s over a four-week period. The 20 subjects were randomly selective assigned to a Kaltenborn thoracic mobilization exercise group and diaphragm exercise control group. The experimental group performed a Kaltenborn thoracic mobilization exercise for 30 minutes. The control group performed a diaphragmatic breathing exercise for 30 minutes. Each exercise program was performed three times a week for four weeks. When comparing the breathing capacity of the experimental and controls before and after the experiment, the experimental group showed significant changes in TV, IRV. In testing the differences between the experimental and controls in their changes after the experiment, TV, IRV showed a significant change. Based on the results of this study, a thoracic mobilization exercise using the Kaltenborn thoracic mobilization exercise may have positively affected the extrementals lung function. Therefore, if a thoracic mobilization exercise using the Kaltenborn is combined with a respiratory exercise program in the future, it will likely become a more effective treatment technique.

• Physical Therapy Korea
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• v.17 no.1
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• pp.9-16
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• 2010

This study aimed to compare 2 protocols recommended to patients with chronic cervical cord injury: each protocol included breathing exercises (inhalation-oriented or exhalation-oriented) and facilitation maneuver for the accessory respiratory muscles. Seventeen patients with chronic cervical cord injury volunteered to participate in this study, and we randomized these patients into 2 groups: the inhalation-oriented breathing exercise group (IOBEG) and exhalation-oriented breathing exercise group (EOBEG), consisting of 8 and 9 patients, respectively. Patients in the IOBEG performed inspiratory exercises using intermittent positive pressure breathing devices, while those in the EOBEG performed expiratory exercises using incentive spirometry. All exercises were performed by the subjects twice a day for 4 weeks, with each session lasting an average of 20 min. The outcomes were assessed on the basis of the pre- and post-treatment values of vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC. In the IOBEG, no significant differences were observed between the pre- and post-treatment values of any of the measured variables (p>.05); however, in the EOBEG, significant improvement was noted in the VC, FVC, FEV1 measured (p<.05) after the treatment. In addition, the rates of change in the values of VC, FVC, and FEV1 differed significantly between the 2 groups (p<.05). These findings suggest that the EOBEs can enhance respiratory function and are clinically feasible in patients with chronic cervical cord injury. Further studies will be undertaken to evaluate the clinical application of these findings.

• Journal of Oriental Neuropsychiatry
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• v.18 no.3
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• pp.309-319
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• 2007

Chest pain is classified into two major categories of cardiac chest pain and non-cardiac chest pain. Cardiac chest pain is caused by cardiovascular disease, for example, myocardial infarction, angina pectoris, valvular heart disease, cardiac enlargement or hypertrophy, dissecting aortic aneurysm, pericarditis, myocarditis, etc. When the chest pain is not attributed to heart disease, it is termed non-cardiac chest pain. Non-cardiac chest pain is caused by pulmonary, gastrointestinal, musculoskeletal disease, psychiatric factor, etc. In tills case, we treated a 54-year old female patient who was diagnosed with dilated cardiomyopathy and suspicious sick sinus syndrome. She complained of chest pain, exertional dyspnea, dizziness and headache. For treatment, we made use of Yugultangami(六鬱湯加味) and Daejobwan(大造丸). Before and after treatment, we measured Heart rate variability(HRV). In result, the clinical symptoms were improved and there was a significant increase in assessmeut by Heart rate variability(HRV). Tills result suggests that Yugultaugami aud Daejowhan have a good effect on cardiac chest pain.

• Clinical and Experimental Pediatrics
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• v.61 no.2
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• pp.59-63
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• 2018

Purpose: Cardiomyopathy is becoming the leading cause of death in patients with Duchenne muscular dystrophy because mechanically assisted lung ventilation and assisted coughing have helped resolve respiratory complications. To clarify cardiopulmonary function, we compared cardiac function between the home ventilator-assisted and non-ventilator-assisted groups. Methods: We retrospectively reviewed patients with Duchenne muscular dystrophy from January 2010 to March 2016 at Gangnam Severance Hospital. Demographic characteristics, pulmonary function, and echocardiography data were investigated. Results: Fifty-four patients with Duchenne muscular dystrophy were divided into 2 groups: home ventilator-assisted and non-ventilator-assisted. The patients in the home ventilator group were older ($16.25{\pm}1.85years$) than those in the nonventilator group ($14.73{\pm}1.36years$) (P=0.001). Height, weight, and body surface area did not differ significantly between groups. The home ventilator group had a lower seated functional vital capacity ($1,038{\pm}620.41mL$) than the nonventilator group ($1,455{\pm}603.2mL$). Mean left ventricular ejection fraction and fractional shortening were greater in the home ventilator group, but the data did not show any statistical difference. The early ventricular filling velocity/late ventricular filling velocity ratio ($1.7{\pm}0.44$) was lower in the home ventilator group than in the nonventilator group ($2.02{\pm}0.62$. The mitral valve annular systolic velocity was higher in the home ventilator group (estimated ${\beta}$, 1.06; standard error, 0.48). Patients with Duchenne muscular dystrophy on a ventilator may have better systolic and diastolic cardiac functions. Conclusion: Noninvasive ventilator assistance can help preserve cardiac function. Therefore, early utilization of noninvasive ventilation or oxygen may positively influence cardiac function in patients with Duchenne muscular dystrophy.