• Tuberculosis and Respiratory Diseases
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• 제82권2호
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• pp.118-125
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• 2019

Background: Lung cancer is a leading cause of morbidity and mortality worldwide, and the incidence continues to rise. Although many prognostic factors have been identified, the clinical characteristics and outcomes in Korean lung cancer patients are not well defined. Methods: Of the 23,254 new lung cancer cases registered at the Korea Central Cancer Registry in 2013, total 489 patients from 19 hospitals were abstracted by the Korean Central Cancer Registry. The clinical data retrospectively analyzed, patients were followed up until December 2015. Results: The median age was 69 years (interquartile range, 60-74 years); 65.4% were male and 62.1% were ever-smokers. Cough was the most common initial symptom (33.5%); 13.1% of patients were asymptomatic. While squamous cell carcinoma was the most common subtype in male patients (37.2%), adenocarcinoma was the most frequent histological type in all patients (48.7%) and females (76.3%). The majority of patients received treatment (76.5%), which included surgery, radiation therapy, and chemotherapy. Older age (hazard ratio [HR], 1.037), lower body mass index (HR, 0.904), ever-smoker (HR, 2.003), small cell lung cancer (HR, 1.627), and distant metastasis (HR, 3.990) were independent predictors of mortality. Patients without symptoms (HR, 0.387) and without treatment (HR, 0.364) were associated with a favorable outcome in multivariate Cox analysis. Conclusion: Lung cancer in Korea occurs predominantly in elderly patients, with adenocarcinoma being the most frequent subtype. The prognosis was poorer in ever-smokers and older, malnourished, and untreated patients with advanced lung cancer.

• 생물정신의학
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• 제27권2호
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• pp.94-100
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• 2020

Objectives Amyloid β positron emission tomography (Aβ PET) is widely used as a diagnostic tool in patients who have symptoms of cognitive impairment, however, this diagnostic examination is too expensive. Thus, predicting the positivity of Aβ PET before patients undergo the examination is essential. We aimed to analyze clinical predictors of patients who underwent Aβ PET retrospectively, and to develop a predicting model of Aβ PET positivity. Methods 468 patients who underwent Aβ PET with cognitive impairment were recruited and their clinical indicators were analyzed retrospectively. We specified the primary outcome as Aβ PET positivity, and included variables such as age, sex, body mass index, diastolic blood pressure, systolic blood pressure, education, dementia family history, Mini Mental Status Examination (MMSE), Clinical Dementia Rating (CDR), Clinical Dementia Rating-Sum of Box (CDR-SB), hypertension (HTN), diabetes mellitus (DM) and presence of apolipoprotein E (ApoE) E4 as potential predictors. We developed three final models of amyloid positivity prediction for total subjects, mild cognitive impairment (MCI) and Alzheimer's disease (AD) dementia using a multivariate stepwise logistic regression analysis. Receiver operating characteristic (ROC) curve analysis was performed and the area under curve (AUC) value was calculated for the ROC curve. Results Aβ PET negative patients were 49.6% (n = 232), and Aβ PET positive patients were 50.4% (n = 236). In the final model of all subjects, older age, female sex, presence of ApoE E4 and lower MMSE are associated with Aβ PET positivity. The AUC value was 0.296. In the final model of MCI subjects (n = 244), older age and presence of ApoE E4 are associated with Aβ PET positivity. The AUC value was 0.725. In the final model of AD subjects (n = 173), lower MMSE scores, the presence of ApoE E4 and history of HTN are associated with Aβ PET positivity. The AUC value was 0.681. Conclusions The cerebral amyloid positivity model, which was based on commonly available clinical indicators, can be useful for prediction of amyloid PET positivity in MCI or AD patients.

• 한국콘텐츠학회논문지
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• 제21권2호
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• pp.248-261
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• 2021

본 연구의 목적은 성인 여성의 혈액 영양소 지표가 우울 지표에 미치는 영향을 파악하는 데 있다. 77명의 폐경기 전 여성(평균연령 44.2±6.5세)을 모집하였으며, 결측치를 제외하고 53명의 혈액지표가 우울 지표(Beck Depression Inventory)에 미치는 영향을 통계로 확인하였다. 연구대상자들의 Beck 평균은 7.6±7.2로 대부분 우울 증상은 정상치 범위였다. 다만 약간 우울 2명과 매우 심각한 우울이 2명이었다. 본 연구에서 요인분석을 한 결과 21개 문항의 Beck 우울 지표는 5개의 하위요인으로 분류되었다. 이중 신체적 우울 2개, 기분 우울 1개, 인지적 우울 1개, 미정 1개 등으로 나타났다. 상관분석 결과 중성지방, LDL(low density lipoprotein) 콜레스테롤, 칼륨이 우울 요인들과 통계적으로 유의한 정의 관계를 보인 반면, HDL(high density lipoprotein) 콜레스테롤과 나트륨, 염화이온은 우울 요인들과 부(-)의 관계를 보였다. 중성지방, 콜레스테롤, 혈당, 케톤체를 원인변수로 설정한 후 우울에 대한 영향을 다중 회귀분석을 하였을 때, HDL(high density lipoprotein) 콜레스테롤은 우울 3 요인에 통계적으로 유의한 부(-)의 영향을 미치고 있었다. 미네랄 성분만으로 우울 하위요인에 다중회귀 분석을 하였을 때, 칼륨이 정(+)의 영향을, 염화이온은 부(-)의 영향을 우울 3 요인에 영향을 미치고 있었다. 본 연구에 의하면 폐경기 전 여성의 경우 혈액 지표들 중 칼로리와 관련된 영양소와 미네랄 등은 신체적 우울 지표에 영향을 미치고 있었다. 본 연구는 혈액 지표의 우울에 대한 영향을 실증적으로 분석하였다는 의미를 갖는다. 특히 칼륨과 염화이온의 우울에 대한 영향을 수치적으로 보고한 첫 연구이다. 본 연구는 53명의 폐경기 전 여성을 대상으로 하였다는 한계를 갖는다. 향후 폐경기 이후 여성과의 비교연구, 남성과의 비교연구, 우울 환자, 기타 신경 질환자들과의 비교 연구 등이 가능할 것이다.

• Tuberculosis and Respiratory Diseases
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• 제84권2호
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• pp.96-104
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• 2021

Background: Many chronic obstructive pulmonary disease (COPD) patients receiving monotherapy continue to experience symptoms, exacerbations and poor quality of life. This study aimed to assess the efficacy and safety of direct switch from once-daily tiotropium (TIO) 18 ㎍ to indacaterol/glycopyrronium (IND/GLY) 110/50 ㎍ once daily in COPD patients in Korea. Methods: This was a randomized, open-label, parallel group, 12-week trial in mild-to-moderate COPD patients who received TIO 18 ㎍ once daily for ≥12 weeks prior to study initiation. Patients aged ≥40 years, with predicted post-bronchodilator forced expiratory volume in 1 second (FEV₁) ≥50%, post-bronchodilator FEV₁/forced vital capacity <0.7 and smoking history of ≥10 pack-years were included. Eligible patients were randomized in a 1:1 ratio to either IND/GLY or TIO. The primary objective was to demonstrate superiority of IND/GLY over TIO in pre-dose trough FEV₁ at week 12. Secondary endpoints included transition dyspnea index (TDI) focal score, COPD assessment test (CAT) total score, and rescue medication use following the 12-week treatment, and safety assessment. Results: Of the 442 patients screened, 379 were randomized and 347 completed the study. IND/GLY demonstrated superiority in pre-dose trough FEV₁ versus TIO at week 12 (least squares mean treatment difference [Δ], 50 mL; p=0.013). Also, numerical improvements were observed with IND/GLY in the TDI focal score (Δ, 0.31), CAT total score (Δ, -0.81), and rescue medication use (Δ, -0.09 puffs/day). Both treatments were well tolerated by patients. Conclusion: A direct switch from TIO to IND/GLY provided improvements in lung function and other patient-reported outcomes with an acceptable safety profile in patients with mild-to-moderate airflow limitation.

• 대한임상검사과학회지
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• 제54권1호
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• pp.9-14
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• 2022

궤양성 대장염은 면역학적인 이상과 유전적인 요소에 의해 대장의 점막 또는 점막밑층에 염증을 유발하는 질환이다. 이전 연구에 의하면, 비만은 궤양성 대장염의 유병률을 높이고, 진행을 악화시키는 것으로 보고되었다. 따라서 본 연구에서는 커큐민이 비만에 의한 대장염의 진행을 억제하는지에 대해 조사하였다. 비만을 유도하기 위해 고지방 식이로 마우스를 사육하였고, 커큐민의 염증억제 효과를 확인하기 위해 고지방 식이와 함께 커큐민을 섭취시켰다. 궤양성 대장염을 유도하기 위해서 DSS를 경구투여 하고 대장염의 임상 증상을 관찰하였다. 대장염의 진행을 확인하기 위해 질병활성지수와 결장의 길이를 측정하였다. 커큐민에 의한 대장염 완화를 조직학적으로 평가하기 위해 결장, 간, 복부지방의 조직표본을 제작하고 H&E 및 Alcian blue-PAS 염색법으로 분석하였다. 커큐민은 질병활성지수의 점수를 감소시키고, 결장의 길이가 짧아지는 것을 억제하는 것으로 확인하였다. 또한, 비만으로 악화된 궤양성 대장염의 결장 조직에서 염증세포 침윤과 점막손상을 억제하였다. 커큐민은 간의 지방증과 복부지방의 지방세포를 유의하게 감소시키는 것으로 확인하였다. 결론적으로 커큐민은 비만에 의한 대장염의 진행을 억제함으로써 궤양성 대장염을 치료할 수 있는 치료제로서 활용될 것으로 사료된다.

• 대한한의학방제학회지
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• 제30권1호
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• pp.27-36
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• 2022

장미색 비강진 환자에게 방풍통성산(防風通聖散)을 투여하여 증상의 호전과 치료의 안전성을 확인할 수 있었다. 소양감이 심하여 일상에 영향을 받는 등 치료가 필요한 상황이었고, 앞선 스테로이드 치료에는 반응하지 않았지만 한약 복용 후 소양감 및 피부 증상의 뚜렷한 개선을 보였다. 기존의 연구 보고를 근거로 방풍통성산(防風通聖散)이 소염 및 해열작용을 통해 피부 질환에서 유효한 효과를 갖는 것으로 보이고, 이로써 장미색 비강진에서 치료 효과를 발휘한 것으로 사료된다.

• 대한한방내과학회지
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• 제42권2호
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• pp.75-85
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• 2021

Objectives: This study reported about a patient with a right middle cerebral artery infarction whose gait disturbance was improved by Korean medicine treatment. Methods: The patient was treated with a Korean herbal medicine (Gami-yukmijihwang-tang) along with acupuncture, electroacupuncture, moxibustion, cupping, and physical therapy. The treatment effect was evaluated with the manual muscle test (MMT) and the Korean version of the modified Barthel index (K-MBI). The gait of the patient was evaluated by a 10-m walk test (10MWT), the timed up and go (TUG) test, the functional ambulation profile (FAP) score, and the functional ambulatory category (FAC) score. Spatiotemporal parameters were evaluated using a walkway system (GAITRite®, CIR Systems, Inc., USA). Results: After 83 days of traditional Korean medicine treatment, the K-MBI and FAC scores improved from 50 to 70 and from 1 to 4, respectively. The 10MWT and TUG tests also improved from 24.86 to 16.66 sec and from 22.35 to 17.62 sec, respectively. GAITRite® measurements reflected gait improvements: the FAP score improved from 55 to 86 sec; the step time improved from 0.72 to 0.669 sec; the step length improved from 31.076 cm to 41.284 cm; the gait velocity improved from 42.8 cm/sec to 64.1 cm/sec; the cadence improved from 93.6 steps/min to 90.8 steps/min. No adverse effects resulting from treatment or evaluation occurred during the admission period. Conclusions: This study suggests that traditional Korean medicine treatment may reduce symptoms and improve the quality of life in patients with cerebral infarction.

• 대한약침학회지
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• 제25권3호
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• pp.233-241
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• 2022

Objectives: Asthma is a chronic disease, and the demand for herbal medicines in this field has increased in recent years. The new findings highlight the role of the gut-lung axis in the pathophysiology of asthma. Hence, this study will evaluate the safety and efficacy of Glasthma syrup, an herbal formula based on Persian medicine, in improving asthma and regulating intestinal permeability. The formula consists of five herbal ingredients that have anti-inflammatory effects on the respiratory tract, also known as gut tonics. Methods: The study will be conducted as a placebo-controlled, triple-blind, randomized trial. It will consist of a 4-week intervention followed by a 4-week follow-up period. The target sample size is 20 patients with moderate asthma aged 18 to 60 years. Eligible participants will be randomly assigned to either the experimental group or the control group in equal numbers. Patients in the experimental group will take Glasthma syrup (7.5 mL, twice a day), while patients in the control group will take a matching placebo. Both groups will receive a 4-week combination of a long-acting beta2 agonist and a leukotriene modulator as standard of care. Inhaled corticosteroids can be used as rescue medication as needed. Results: The primary outcomes are asthma symptom scale, lung function, and intestinal permeability. Secondary outcomes include quality of life, symptom recurrence rates, and blood tests. A safety assessment will also be conducted during the trial. Conclusion: In this trial, the effects of Glasthma syrup in patients with moderate asthma will be examined. The study will also assess the effects of the formulation on the gut-lung axis by simultaneously monitoring the gut permeability index, asthma symptoms, and lung function.

• Pediatric Infection and Vaccine
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• 제29권2호
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• pp.77-83
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• 2022

소아청소년에서 코로나바이러스 감염증(coronavirus disease 2019, COVID-19)은 성인에 비해 증상이 심하지 않은 것으로 알려져 있다. 본 연구는 2021년 8월부터 11월 사이에 COVID-19으로 진단받은 후 고열과 호흡곤란이 동반되어 입원치료를 받았던 18세 미만의 소아청소년 환자 중 산소 공급에도 불구하고 지속적인 호흡곤란과 저산소증으로 항바이러스제인 remdesivir와 스테로이드(dexamethasone) 병합 치료를 시행한 환자를 대상으로 심한 폐렴의 위험인자를 알아보고자 후향적으로 의무 기록을 검토하였다. 소아청소년 8명이 심한 폐렴으로 산소치료, remdesivir와 스테로이드를 투여하였고, 남자 5명, 여자 3명이었다. 중간 나이는 16세(범위: 9-17세)였으며, 8명 중 6명의 체질량지수가 중간값이 30.5 kg/m² (범위: 29.4-38.5 kg/m²)였다. 모든 환자가 고열과 저산소증을 동반한 호흡곤란이 있었다. 흉부 단순 X-ray 검사에서 다양한 폐렴의 양상을 보였다. 7명은 remdesivir와 스테로이드 투여 후 1-2일 이내에 증상 호전되었다. 본 증례 연구에서는 심한 폐렴을 동반한 COVID-19 환자 8명 중 6명에서 비만이 있었다.

• BMB Reports
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• 제55권6호
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• pp.275-280
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• 2022

The treatment of atopic dermatitis (AD) is challenging due to its complex etiology. From epidermal disruption to chronic inflammation, various cells and inflammatory pathways contribute to the progression of AD. As with immunosuppressants, general inhibition of inflammatory pathways can be effective, but this approach is not suitable for long-term treatment due to its side effects. This study aimed to identify a plant extract (PE) with anti-inflammatory effects on multiple cell types involved in AD development and provide relevant mechanistic evidence. Degranulation was measured in RBL-2H3 cells to screen 30 PEs native to South Korea. To investigate the anti-inflammatory effects of Parasenecio auriculatus var. matsumurana Nakai extract (PAE) in AD, production of cytokines and nitric oxide, activation status of FcεRI and TLR4 signaling, cell-cell junction, and cell viability were evaluated using qRT-PCR, western blotting, confocal microscopy, Griess system, and an MTT assay in RBL-2H3, HEK293, RAW264.7, and HaCaT cells. For in vivo experiments, a DNCBinduced AD mouse model was constructed, and hematoxylin and eosin, periodic acid-Schiff, toluidine blue, and F4/80-staining were performed. The chemical constituents of PAE were analyzed by HPLC-MS. By measuring the anti-degranulation effects of 30 PEs in RBL-2H3 cells, we found that Paeonia lactiflora Pall., PA, and Rehmannia glutinosa (Gaertn.) Libosch. ex Steud. show an inhibitory activity of more than 50%. Of these, PAE most dramatically and consistently suppressed cytokine expression, including IL-4, IL-9, IL-13, and TNF-α. PAE potently inhibited FcεRI signaling, which mechanistically supports its basophil-stabilizing effects, and PAE downregulated cytokines and NO production in macrophages via perturbation of toll-like receptor signaling. Moreover, PAE suppressed cytokine production in keratinocytes and upregulated the expression of tight junction molecules ZO-1 and occludin. In a DNCB-induced AD mouse model, the topical application of PAE significantly improved atopic index scores, immune cell infiltration, cytokine expression, abnormal activation of signaling molecules in FcεRI and TLR signaling, and damaged skin structure compared with dexamethasone. The anti-inflammatory effect of PAE was mainly due to integerrimine. Our findings suggest that PAE could potently inhibit multi-inflammatory cells involved in AD development, synergistically block the propagation of inflammatory responses, and thus alleviate AD symptoms.