• 한방재활의학과학회지
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• 제29권3호
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• pp.87-101
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• 2019

Objectives The purpose of this study is to investigate characteristics of low back pain patients and trends of Korean medicine conservative treatment effects of low back pain patients by registry data. Methods A total of 78 patients were analyzed, statistical analysis was performed using a generalized linear model. The comparison between groups was performed using independent two samples t-test or Wilcoxon rank sum test according to the distribution of normality. Before and after the treatment effects, ANOVA and Kruskal-Wallis method were used for the comparison, Sheffe method was used for the post test. Results The average age of hospitalized patients was 31.8 years old and out-patient department (OPD) patients was 44.9 years old. Lots of OPD patients and hospitalized patients were classified to 'Lumbago due to Coexist Qu Stagnation and Bloos Stasis'. Both OPD patients and hospitalized patients classified to 'Lumbago due to Coexist Qu Stagnation and Bloos Stasis' showed statistically significant decrease in RMDQ (Roland-Morris disability questionnaire) and NRS (numeric rating scale) on 1 month and 3 month after clinical research start date. Comparing the treatment effects of Chuna manual therapy, both Chuna group and non-Chuna group showed statistically significant decrease in RMDQ and NRS on discharge date, 1 month and 3 month after clinical research start date. Conclusions We expect that a larger scale registry study will be carried out to provide a higher level of basis for the Korean medical treatment of low back pain.

• Journal of Korean Neurosurgical Society
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• 제62권6호
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• pp.643-648
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• 2019

Objective : Shunt-dependent hydrocephalus (SdHCP) is a well-known complication of aneurysmal subarachnoid hemorrhage (SAH). The risk factors for SdHCP have been widely investigated, but few risk scoring systems have been established to predict SdHCP. This study was performed to investigate the risk factors for SdHCP and devise a risk scoring system for use before aneurysm obliteration. Methods : We reviewed the data of 301 consecutive patients who underwent aneurysm obliteration following SAH from September 2007 to December 2016. The exclusion criteria for this study were previous aneurysm obliteration, previous major cerebral infarction, the presence of a cavum septum pellucidum, a midline shift of >10 mm on initial computed tomography (CT), and in-hospital mortality. We finally recruited 254 patients and analyzed the following data according to the presence or absence of SdHCP : age, sex, history of hypertension and diabetes mellitus, Hunt-Hess grade, Fisher grade, aneurysm size and location, type of treatment, bicaudate index on initial CT, intraventricular hemorrhage, cerebrospinal fluid drainage, vasospasm, and modified Rankin scale score at discharge. Results : In the multivariate analysis, acute HCP (bicaudate index of ${\geq}0.2$) (odds ratio [OR], 6.749; 95% confidence interval [CI], 2.843-16.021; p=0.000), Fisher grade of 4 (OR, 4.108; 95% CI, 1.044-16.169; p=0.043), and an age of ${\geq}50years$ (OR, 3.938; 95% CI, 1.375-11.275; p=0.011) were significantly associated with the occurrence of SdHCP. The risk scoring system using above parameters of acute HCP, Fisher grade, and age (AFA score) assigned 1 point to each (total score of 0-3 points). SdHCP occurred in 4.3% of patients with a score of 0, 8.5% with a score of 1, 25.5% with a score of 2, and 61.7% with a score of 3 (p=0.000). In the receiver operating characteristic curve analysis, the area under the curve (AUC) for the risk scoring system was 0.820 (p=0.080; 95% CI, 0.750-0.890). In the internal validation of the risk scoring system, the score reliably predicted SdHCP (AUC, 0.895; p=0.000; 95% CI, 0.847-0.943). Conclusion : Our results suggest that the herein-described AFA score is a useful tool for predicting SdHCP before aneurysm obliteration. Prospective validation is needed.

• 대한임상독성학회지
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• 제16권2호
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• pp.131-140
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• 2018

Purpose: The National Emergency Medical Center has been running a project for the storage and delivery of antidotes for acute poisoning patients of the Department of Health and Welfare, Korea. This study analyzed the results of this project over the past two years. Methods: The requests received by the National Emergency Medical Center and the data on the delivery process were analyzed. Results: This study analyzed a total of 121 patients with acute poisoning, who were requested to receive an antidote reserved at 20 key hospitals in 2015-2017, and whose age was $52.3{\pm}23.5\;years$; old; 54 were women. Intentional poisoning were 58.7%, and the home was the most common place of exposure (66.9%). The toxic substances were chemicals (32.2%), pesticides (27.3%), medicines (24.8%), and snake venom (4.1%). The patient's poison severity score was $2.4{\pm}0.7$ (median 3) indicating moderate-to-severe toxicity. Antidote administration was the cases treated in key hospitals 67.8% (82/121), in which transferred patients accounted for 57.3% (47/82). After receiving an antidote request from a hospital other than the key hospitals, the median was 75.5 minutes (range 10 to 242 minutes) until the antidote reached the patient, and an average of 81.5 minutes was required. The results of emergency care were intensive care unit (70.3%), general wards (13.2%), death (10.7%), and discharge from emergency department (5.0%). Conclusion: This study showed that the characteristics of acute poisoning patients treated with an antidote were different from previous reports of poisoned patients in the emergency department, and basic data on the time required for delivery from key hospitals was different.

• 대한응급의학회지
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• 제29권5호
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• pp.493-499
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• 2018

Objective: This study aimed to identify the effects of serum potassium and lactate on neurologic outcomes in out-of-hospital post-cardiac arrest adult patients. Methods: This study was a single center, retrospective observational study. We recruited out-of-hospital post-cardiac arrest adult patients admitted to an intensive care unit from 2011 to 2017. Primary outcome was good neurologic outcome at discharge. To evaluate the prognostic impact of serum potassium and lactate, univariate and multivariate logistic regression analyses were performed. Results: A total of 57 patients were included in this study. The number of patients with good neurologic outcome was 19 (33.3%). In the univariate analysis, good neurologic outcome patients showed a higher smoking rate, shorter pre-hospital transportation time, higher rate of percutaneous coronary intervention, and lower severity score (all P<0.05). The good neurologic outcome patients also presented higher pH, lower partial pressure of carbon dioxide, and lower potassium regarding laboratory findings on the first hospital day (all P<0.05). In the multivariate analysis, the independent factors favoring good neurologic outcome were pre-hospital transportation time (adjusted odds ratio [aOR], 0.82; 95% confidence interval [CI], 0.69-0.97; P=0.019) and lower partial pressure of carbon dioxide on the first hospital day (aOR, 0.95; 95% CI, 0.91-0.99; P=0.034). Conclusion: Serum potassium and lactate were not significantly associated with good neurologic outcome in out-of-hospital post-cardiac arrest adult patients. The prognostic factors for good neurologic outcome were pre-hospital transportation time and initial partial pressure of carbon dioxide.

• Journal of Korean Neurosurgical Society
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• 제64권5호
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• pp.791-798
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• 2021

Objective : The period of mechanical ventilator (MV)-dependent respiratory failure after cervical spinal cord injury (CSCI) varies from patient to patient. This study aimed to identify predictors of MV at hospital discharge (MVDC) due to prolonged respiratory failure among patients with MV after CSCI. Methods : Two hundred forty-three patients with CSCI were admitted to our institution between May 2006 and April 2018. Their medical records and radiographic data were retrospectively reviewed. Level and completeness of injury were defined according to the American Spinal Injury Association (ASIA) standards. Respiratory failure was defined as the requirement for definitive airway and assistance of MV. We also evaluated magnetic resonance imaging characteristics of the cervical spine. These characteristics included : maximum canal compromise (MCC); intramedullary hematoma or cord transection; and integrity of the disco-ligamentous complex for assessment of the Subaxial Cervical Spine Injury Classification (SLIC) scoring. The inclusion criteria were patients with CSCI who underwent decompression surgery within 48 hours after trauma with respiratory failure during hospital stay. Patients with Glasgow coma scale 12 or lower, major fatal trauma of vital organs, or stroke caused by vertebral artery injury were excluded from the study. Results : Out of 243 patients with CSCI, 30 required MV during their hospital stay, and 27 met the inclusion criteria. Among them, 48.1% (13/27) of patients had MVDC with greater than 30 days MV or death caused by aspiration pneumonia. In total, 51.9% (14/27) of patients could be weaned from MV during 30 days or less of hospital stay (MV days : MVDC 38.23±20.79 vs. MV weaning, 13.57±8.40; p<0.001). Vital signs at hospital arrival, smoking, the American Society of Anesthesiologists classification, Associated injury with Injury Severity Score, SLIC score, and length of cord edema did not differ between the MVDC and MV weaning groups. The ASIA impairment scale, level of injury within C3 to C6, and MCC significantly affected MVDC. The MCC significantly correlated with MVDC, and the optimal cutoff value was 51.40%, with 76.9% sensitivity and 78.6% specificity. In multivariate logistic regression analysis, MCC >51.4% was a significant risk factor for MVDC (odds ratio, 7.574; p=0.039). Conclusion : As a method of predicting which patients would be able to undergo weaning from MV early, the MCC is a valid factor. If the MCC exceeds 51.4%, prognosis of respiratory function becomes poor and the probability of MVDC is increased.

• 한국지구과학회지
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• 제43권2호
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• pp.303-311
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• 2022

자기공명영상(MRI) 장비의 조영제로 흔히 사용되는 가돌리늄(Gd)은 매우 안정된 상태로 하수처리과정에서 거의 제거되지 않고 수환경으로 유입된다고 알려져 있다. 따라서 본 연구에서는 세 가지의 공법으로 하수처리를 하는 부산 수영 하수처리장에서 채취한 하수 시료의 공정별 용존 희토류 원소의 제거율 및 수환경으로 배출되는 인위적 기원 Gd(Gd_anth)의 배출량을 평가하고자 하였다. 용존 희토류 원소는 공정별 처리 단계에 따라 무거운 희토류 원소(Tb-Lu)에 비해 가벼운 희토류 원소(La-Eu)에서 농도가 감소하는 경향을 보였다. 또한 일부 시료에서 나타난 음의(negative) Sm anomaly (<1)는 생물학적 제거 과정에서 Sm이 입자나 인산염과 흡착되어 함께 제거되었을 가능성을 시사한다. 모든 시료에서 양의(positive) Gd anomaly (149±50, n=9)를 보였으며, 공정별로 측정된 Gd의 총 농도 중 Gd_anth은 약 97% 이상을 차지하는 것으로 나타났다. 이는 하수처리과정에서 Gd_anth 이 거의 제거되지 않고 수영강 하류로 배출된다는 것을 의미한다. 일별 처리용량을 고려하여 각 공정에서 배출되는 Gd_anth의 배출량은 259 mmol/day로 추정할 수 있다. 본 연구의 결과는 하수처리장을 통해 수영만 연안으로 Gd_anth이 지속적으로 배출될 것으로 예상되며, 향후 Gd의 중장기적인 관측이 필요함을 시사한다.

• Ecology and Resilient Infrastructure
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• 제9권4호
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• pp.237-246
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• 2022

하구습지는 생물생산성이 높고 물리적 환경도 독특하여 국가 생물다양성 관리 및 그들의 서식처 확보 관점에서 중요성이 대두되고 있다. 본 연구는 하구습지 보전 및 관리를 위해 열린 하구이며 다양한 서식공간이 분포하는 것으로 알려진 가화천하구습지의 식생 및 생물상 조사를 통해 생태적 특성을 분석하였다. 정수역 다년생 초본식생, 염습지식생, 암극지식생 등 5개 상관식생형의 12개 식물군락이 확인되었다. 남강댐 방류, 조수의 영향으로 수변부의 좁은 입지를 따라 식생이 대상분포하고 있었다. 생물종 다양성은 멸종위기 야생생물 12종 포함 총 715종이 확인되었다. 다양한 하상구조와 미소서식처가 분포하고 있는 I, III구간에서 종다양성이 상대적으로 높았다. 해수 유입에 따른 기수역의 형성으로 다양한 기능군을 가지는 멸종위기 야생생물도 분포하여 보전가치가 높은 지역인 것으로 나타났다. 가화천하구습지의 생태정보의 수집은 하구 생태계의 보전·관리 기반을 마련하고 정책 수립을 지원하는 데 기초자료로 활용될 수 있을 것이다.

• Ocean and Polar Research
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• 제44권4호
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• pp.297-310
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• 2022

To understand the chemical composition of aerosols in the Cheju-Korea Straits and their contribution to the ocean by deposition, aerosol samples were collected on board R/V Eardo from November 1997 to May 1999. The average concentrations of Al, NO₃^-, non-sea-salt (nss)-SO₄^2-, and NH₄⁺ in aerosols were 2.19, 5.59, 6.16 and 2.08 ㎍ m^-3, respectively. The Al concentration in the high yellow dust period was about 100 times higher than that in the non-yellow dust period. The concentration ratio of NO₃^-/nss-SO₄^2- ranged between 0.47 and 1.5, indicating that the aerosols in the Cheju-Korea Straits are under the effects of NO_x and SO_x emitted from China, Korea and Japan. The equivalent concentration ratio of [NH₄⁺]/[nss-SO₄^2-+ NO₃^-] with the average of 0.58±0.29 indicates that nss-SO₄^2- and NO₃^- are not neutralized by NH₄⁺. A high activity concentration of ²¹⁰Pb with 1.13-1.23 mBq m^-3 was observed during the high yellow dust period, indicating that ²¹⁰Pb is easily adsorbed in the yellow dust originating from the continent of Asia. The distribution of ⁷Be and NH₄⁺ concentrations showed a strong negative linear correlation during the low yellow dust period, April 1998. The total mineral dust flux in the Cheju-Korea Straits was estimated to be 1.21×10⁶ tons yr^-1, accounting for about 12% of the annual sediment discharge via the Nakdong River. The combined annual deposition of NH₄⁺ and NO₃^- was 0.103 mole N m^-2 yr^-1 was estimated to support 4% of the annual primary productivity in the East China Sea.

• Journal of Korean Neurosurgical Society
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• 제65권5호
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• pp.751-757
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• 2022

Objective : Tumours of the brain are a rare occurrence accounting for approximately 2% of all neoplasms in adults. Few studies have been done in Nigeria on the profile of brain tumours. The aim of this study is to determine the profile of brain tumours in general and determine the change in Kanofsky Performance Score (KPS) after treatment. Methods : This is a prospective hospital-based study in Kaduna. All consecutive patients over 18 years of age with diagnosis of brain tumours from January 2016 to December 2019 were included in the study. Demographic and clinical data was collected using a proforma during the study. Patients who received treatment were followed up for 12 months. The primary outcome data was the difference in the quality of life as measured by KPS at the point of first contact and at 1-month after treatment and at 12-month follow up. Data obtained was analysed with SPSS version 25.0 for Windows. Descriptive statistics was done to determine the profile. Paired t-test at 95% confidence interval was done to check for significant correlation between the mean KPS. Results : A total of 39 consecutive patients were included in the study. There was a slight male preponderance with a M : F of 1.17 : 1. Meningioma and metastasis were more common in females while gliomas and pituitary tumours were more common in males. The mean age of patients was 49.8 years and standard deviation of 11.8 years. Pituitary tumours were the most common tumours. The most common location of the tumour was frontal lobe followed by the pituitary gland. The mean duration of symptoms before neurosurgical consultation was 38 weeks. The most common presenting symptoms of patient with brain tumour was headache. The quality of life improve compare to the baseline in 81% of patient at discharge and at 1 year follow up. The overall mortality rate was 25.6%. Conclusion : The most common brain tumour in our study is pituitary tumour. Most patients present late. The most common presenting symptoms is headache. There is significant improvement in the KPS of patients following treatment. The overall mortality rate at 1-year post treatment is 25.6%.

• 동의생리병리학회지
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• 제36권4호
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• pp.138-142
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• 2022

This study aimed to evaluate the effectiveness of Korean rehabilitation treatement for patients with post-TKR. The medical records of inpatients undergoing Korean rehabilitation treatment after TKR from 2016.01.01. to 2021.12.31. during the admission, were analyzed retrospectively. The effect of treatment was evaluated by using a numeric rating scale(NRS) and range of motion(ROM) of knee. Statistical analysis was done using the IBM SPSS statistics 26 program. If the period of hospitalization was within 7 days or change of NRS and ROM was not recorded properly, the case was excluded. All inpatients received acupuncture treatment, Electro-acupuncture. Soyeom pharmaco-acupuncture were used at a high rate. Blood letting cupping therapy, dry cupping therapy, Interferential Current Therapy(ICT) continuous passive motion(CPM), cryotherapy were used at a high rate. A significant improvement was noted when comparing the NRS and knee ROM results at the time of admission and discharge. Korean medical rehabilitation can be effectively used for patients who have undergone TKR, to relieve pain and enable returning to daily activities. It is expected to be helpful in future studies of post-TKR in Korean Medicine. Also It can be used for medical treatment of post-TKR in Korean Medicine Hospital and clinic. However, further research with a high level of evidence is necessary to support this finding.