• Journal of Chest Surgery
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• 제57권1호
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• pp.25-35
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• 2024

Background: Prothrombin complex concentrate (PCC) and fresh frozen plasma (FFP) are commonly used to manage bleeding in patients during cardiac surgery. However, the relative efficacy and safety of these 2 strategies remain uncertain. Methods: MEDLINE, Embase, and Cochrane were searched for studies comparing PCC and FFP in patients who underwent cardiac surgery complicated by bleeding. Review Manager (RevMan) ver. 5.4 (Nordic Cochrane Centre, The Cochrane Collaboration) was used for statistical analysis. Binary and continuous outcomes were compared using pooled risk ratios and mean differences, respectively. The meta-analysis protocol was registered in the International Prospective Register of Systematic Reviews under protocol number CRD42022379144. Results: We included 8 studies with 1,500 patients, of whom 613 (40.9%) received PCC. The mean follow-up period ranged from 28 to 90 days. The PCC group had significantly lower chest tube drainage at 24 hours (mean difference [MD], -148.50 mL; 95% CI, -253.02 to -43.99 mL; p=0.005; I² =42%). Fewer units of red blood cells (RBCs) were transfused within the first 24 hours (MD, -1.02 units; 95% CI, -1.81 to -0.24 units; p=0.01; I² =56%), and fewer patients required RBC transfusion within the first 24 hours (risk ratio, 0.85; 95% CI, 0.78-0.93; p<0.007; I² =45%) in the PCC group. There were no statistically significant differences in secondary outcomes. Nonetheless, a subgroup analysis of randomized controlled trials failed to corroborate the results obtained from the main analysis. Conclusion: Our findings suggest that PCC can be effective, without increased adverse events, when compared with FFP in patients undergoing cardiac surgery complicated by bleeding.

• 한국간담췌외과학회지
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• 제26권2호
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• pp.190-198
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• 2022

Backgrounds/Aims: Traumatic pancreatic injury (TPI) is rare as an isolated injury. There is a trend to perform conservative treatment even in patients with complete duct dissection and successful treatment. This study reviewed our 20 years of experience in the management of TPI and assessed patient outcomes according to age group and treatment strategy. Methods: A retrospective analysis of patients diagnosed and treated with TPI at a level-I trauma center from 2000-2019. Patients were divided into two groups: adults and pediatrics. Conservative treatment cases were subjected to subgroup analysis. Level of evidence: IV. Results: Of a total of 77 patients, the mean age was 24.89 ± 15.88 years. Fifty-six (72.7%) patients had blunt trauma with motor vehicle accident. Blunt trauma was the predominant mechanism in 42 (54.5%) patients. Overall, 38 (49.4%) cases had grade I or II injury, 24 (31.2%) had grade III injury, and 15 (19.5%) had grade IV injury. A total of 30 cases had non-operative management (NOM). Successful NOM was observed in 16 (20.8%) cases, including eight (32.0%) pediatric cases and eight (15.4%) adult cases. Higher American association for the surgery of trauma (AAST) grade of injury was associated with NOM failure (16.7% for grade I/II, 100% for grade III, and 66.7% for grade IV injury; p = 0.001). An independent factor for NOM failure was female sex (69.2% in females vs. 29.4% in males; p = 0.03). Conclusions: High AAST grade TPI is associated with a high rate of NOM failure in both pediatric and adults.

• 농촌의학ㆍ지역보건
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• 제47권3호
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• pp.181-188
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• 2022

당뇨병 발생에는 생활습관이나 생활환경과 관련된 다양한 원인들이 있는데 최근 연구에서 중금속에 많이 노출된 사람에서 당뇨병 발생 및 당뇨병의 악화가 늘어났다는 역학적 연구가 많이 발표되고 있다. 이에 국내 대규모 철강공업단지를 가진 일개 도시 지역 주민을 대상으로 당화혈색소와 체내 중금속의 상관성을 파악하고자 하였다. 2008~2009년 연구대상 총 414명에 대한 설문조사와 생체시료를 채취하였다. 설문은 성별, 연령, 인구학적 특성, 흡연, 음주, 직업, 당뇨진단 유무 등의 항목으로 구성하였다. 혈액을 채취하여 HbA1c, 혈중 납 농도를 측정하였고, 소변을 채취하여 요중 카드뮴, 무기비소, 수은 농도를 측정하였다. HbA1c는 6.5%기준으로 미만군과 이상군으로 분류하였다. 각 중금속별 10분위수부터 90분위수 농도에 해당하는 기준으로 미만군과 이상군 등 두 군을 분류하였다. 당뇨관련검사 결과 HbA1c 6.5% 기준으로 이상군은 남자 14(9.9%)명, 여자 17(6.2%)명이었다. 혈중 납의 기하평균 농도는 2.48 (1.80) ㎍/dl, 요중 카드뮴의 기하평균농도는 1.20 (2.26) ㎍/g creatinine, 요중 무기비소의 기하평균농도는 12.08 (1.80) ㎍/g creatinine, 요중 수은의 기하평균농도는 1.63 (2.23) ㎍/g creatinine 이었다. 연령, 지역, 성별, 흡연으로 보정하였을때 요중 카드뮴 농도 30분위수 이상군이 미만군에 비하여 교차비 5.26(95% 신뢰구간 : 1.44~19.17)으로 유의하게 높았다. 납, 무기비소, 수은은 HbA1c(6.5% 기준) 변수와의 교차분석에서 유의한 분포 차이는 없었다. 여러 요인을 보정하고도 요중 카드뮴과 HbA1c의 유의한 양의 상관관계를 파악하였고, 특히 유의한 상관관계를 보인 요중 카드뮴 농도의 특정 컷오프 값을 찾아내어 이를 통해 우리나라에 적합한 생물학적 노출값 설정의 참고자료로 활용될 수 있다는 점에서 의의가 있다고 생각한다.

• Asian-Australasian Journal of Animal Sciences
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• 제22권8호
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• pp.1069-1077
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• 2009

Castration of male pig produces significant negative effects on skeletal muscle development. The androgen receptor (AR), two splice variants of insulin-like growth factor-I (IGF-I Ea and MGF) and the myostatin gene may play important roles in this process. In the present study, the expression of AR, IGF-I Ea, MGF and myostatin genes in three skeletal muscles, the brachialis, longissimus and semitendinosus, were studied using real-time quantitative RT-PCR. Our experimental design used 14 pairs of male Landrace sire${\times}$Yorkshire dam piglets. The two piglets in each pair were full sibs, one of which was castrated at 21 d of age; the other remained intact. The study group was divided into subgroups of equal size. Animals in the first subgroup were slaughtered at 147 d and those of the second at 210 d of age. Carcass weight and lean meat yield were similar between boars and barrows at 147 d of age (p>0.05), whereas barrows had lower carcass weight and less lean meat yield at 210 d of age (p<0.05). Castration caused down-regulation of AR gene expression at both 147 and 210 d of age (p<0.05). The two splice variants of the IGF-I gene from porcine skeletal muscle were cloned using RT-PCR, and it was found that MGF differs from IGF-I Ea in having a 52-base insert in the last coding exon of the mRNA. Both splice variants were down-regulated by castration only at 210 d of age (p<0.05). No differences in expression of the myostatin gene were observed between boars and barrows at either 147 or 210 d of age (p>0.05). These results suggest that the downregulation of AR, IGF-I Ea and MGF gene expression following castration helps to explain the negative effect of castration on skeletal muscle development.

• Toxicological Research
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• 제13권1_2호
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• pp.103-110
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• 1997

This study was performed to investigate the effects of cadmium chloride on the acute and chronic toxicity on rats. Several toxic effects of cadmium has been shown following short-term and longterm pretreatment with cadmium and zinc. Four groups of rats (A, B, C, D), each consisting of 16 rats, were studied and each group was divided into four subgroups (1, 2, 3, 4), 4 rats for each subgroup. Rats were subcutaneously pretreated with $CdCl_2$ (0.5 mg/kg, A & C), and $ZnCl_2$ (13.0 mg/kg, B & D) during time periods of 1 weeks (group A & B) and 6 weeks (group C & D). At the end of the period, rats were challenged with $CdCl_2$ (3.0, 6.0 and 9.0 mg/kg, i.p.). After giving the challenge dose, cadmium and metallothionein(MT) concentrations were determined. The concentrations of cadmium were higher in the liver than the kidney irrelevantly to cadmium and zinc pretreatment and increased dose-dependently to the challenge dosage. The metallothioneins showed higher concentrations in the liver than the kidney following cadmium pretreatment and were higher in the long-term pretreatment groups than the short-term pretreatment groups in the liver and the kidney of rats. These data suggest that metallothioneins are induced preferentially in the liver by pretreatment of cadmium and then, formed in the form of Cd-MT, may play an important role in the nephrotoxicity.

• 성인간호학회지
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• 제21권6호
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• pp.705-717
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• 2009

Purpose: The purpose of this study was to identify symptom clusters in patients with breast cancer and to investigate the associations among them with functional status and quality of life (QOL). Methods: A convenient sample of 303 patients was recruited from an oncology-specialized hospital. Results: Two distinct clusters were identified: A gastrointestinal- fatigue cluster and a pain cluster. Each cluster significantly influenced functional status and QOL. Based on these two clusters, we identified subgroups of symptom clusters using K-means cluster analysis. Three relatively distinct patient subgroups were identified in each cluster: mild, moderate, and severe group. Disease-related factors (i.e., stage, metastasis, type of surgery, current chemotherapy, and anti-hormone therapy) were associated with these subgroups of symptom clusters. There were significant differences in functional status and QOL among the three subgroups. The subgroup of patients who reported high levels of symptom clusters reported poorer functional status and QOL. Conclusion: Clinicians can anticipate that breast cancer patients with advanced stage, metastasis, and who receive mastectomy, and chemotherapy will have more intense gastrointestinal-fatigue or pain symptoms. In order to enhance functional status and QOL for patients with breast cancer, collective management for symptoms in a cluster may be beneficial.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권2호
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• pp.87-98
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• 2020

The aim of this study was to determine the efficacy of oral splints in reducing the intensity of pain in patients with temporomandibular joint dysfunction in both short and long-term treatment durations. Electronic databases, Cochrane Library, MEDLINE via PubMed, Web of Science, Egyptian Knowledge Bank, and EMBASE were searched for randomized controlled trials comparing different types of splints to non-occluding splints, behavioral therapy, pharmacotherapy, counseling, and no treatment. The risk of bias was assessed by using Cochrane risk of bias recommendations. Fixed and random effects were used to summarize the outcomes. The effect estimates were expressed as standardized mean differences (SMD) or risk ratios with a 95% confidence interval (CI). Subgroup analyses were carried out according to the treatment duration. Twenty-two studies met the inclusion criteria. A meta-analysis of short-term studies up to three months revealed no significant difference between the study groups. However, long-term studies exhibited a significant difference in pain reduction in favor of the control group. Total analysis revealed that the control group resulted in significant pain reduction (SMD 0.14, 95% CI 0.05-0.23, P=0.002, I²=0%). Oral splints are not effective in reducing pain intensity or improving function in patients with temporomandibular joint dysfunction.

• 한국컴퓨터정보학회논문지
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• 제23권3호
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• pp.71-77
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• 2018

The purpose of this study was to investigate the effectiveness of elastic band resistance training for muscle strength among community-dwelling older adults. The systematic review and meta-analysis was conducted by following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). Data were pooled using fixed effect models. Sit to stand, arm curl, and grip strength were analyzed for main effects. Heterogeneity between studies was assessed using the I2 statistics and publication bias was evaluated by funnel plots. Twelves studies were included representing 611 participants. Elastic band resistance training was effective for lower (d=3.89, 95% CI: 3.03, 4.75) and upper extremity muscle strength (d=4.08, 95% CI: 2.94, 5.23). Heterogeneity was moderate and no significant publication bias was detected. Based on these findings, there is clear evidence that elastic band resistance training has significant positive effects on muscle strength among community-dwelling older adults. Further study will be needed to perform subgroup analysis using number of sessions and exercise intensity as predictors.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권3호
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• pp.162-173
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• 2020

Dental implants are the first option for replacement of missing teeth. Failure usually involves additional cost and procedures. As a result, the physician should limit the risk factors associated with implant failures. Implant site is one of many factors that can influence the success or failure of dental implants. The association between early implant failure (EIF) and implant site has yet to be documented. This review aims to estimate the impact of insertion site on the percentage of EIFs. An electronic and manual search of studies that reported early failure of dental implants based on collection site. A total of 21 studies were included in the review and examined for the association between EIF and alveolar site. Subgroup analysis, including a comparison between implants inserted in four alveolar ridge regions of both jaws was performed. The early failure rate was higher for maxillary implants (3.14%) compared to mandibular implants (1.96%). Applying a random effect, risk ratio (RR), and confidence interval (CI) of 95% revealed higher failure in the maxilla compared to the mandible (RR 1.41; 95% CI [1.19, 1.67]; P<0.0001; I²=58%). The anterior maxilla is more critical for early implant loss than other alveolar bone sites. Implants in the anterior mandible exhibited the best success rate compared of the sites.

• 대한수학회보
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• 제59권6호
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• pp.1511-1522
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• 2022

Let H be a subgroup of $\mathbb{Z}^*_n$ (the multiplicative group of integers modulo n) and h₁, h₂, …, h_l distinct representatives of the cosets of H in $\mathbb{Z}^*_n$. We now define a polynomial J_n,H(x) to be $$J_{n,H}(x)=\prod^l_{j=1} \left( x-\sum_{h{\in}H} {\zeta}^{h_jh}_n\right)$$, where ${\zeta}_n=e^{\frac{2{\pi}i}{n}}$ is the nth primitive root of unity. Polynomials of such form generalize the nth cyclotomic polynomial $\Phi_n(x)={\prod}_{k{\in}\mathbb{Z}^*_n}(x-{\zeta}^k_n)$ as J_n,{1}(x) = Φ_n(x). While the nth cyclotomic polynomial Φ_n(x) is irreducible over ℚ, J_n,H(x) is not necessarily irreducible. In this paper, we determine the subgroups H for which J_n,H(x) is irreducible over ℚ.