• 한방재활의학과학회지
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• 제33권3호
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• pp.149-160
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• 2023

Objectives This study is for reporting current status and strategies of thread embedding acupuncture (TEA) in temporomandibular joint disorder (TMD) using web-based survey. Methods Survey was conducted online via E-mail among Korean medicine doctors registered with the Association of Korean Medicine. The questionnaire is developed by Korean medicine doctor in Kyung Hee University Hospital at Gangdong. The survey consisted mainly of multiple-choice questions on the current status and strategies of TEA for TMD. Results Total of 427 doctors responded. TEA was mostly used for 'Cosmetic purpose and others' with 287 respondents (67.2%), and 102 respondents (23.9%) having experience with TEA for TMD. The most common purpose for TEA for TMD was 'Improving muscle contraction and tension' with 290 respondents (67.9%). The average interval was reported 2.12 weeks, and the most common response for the number of treatments was five sessions with 127 respondents (29.7%). The most common criterion for determining the treatment site was based on anatomical structure, accounting for 92.7%. The most effective anatomical structure was the 'Masseter muscle' with 83.1%, followed by the 'Temporal muscle' with 51.8%. TEA direction for TMD was dominant in 'affected side' for all muscles. Conclusions Through a survey, we can investigate clinical usage of TEA for TMD. This study can be helpful in creating standardized criteria for TEA on TMD in the future.

• 대한토목학회논문집
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• 제28권6B호
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• pp.697-707
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• 2008

격자기반 운동파 강우유출모형 KIMSTORM(grid-based KIneMatic wave STOrm Runoff Model)은 유역의 지표흐름, 지표하흐름 및 하천흐름의 시간적 변화와 공간적 분포를 모의할 수 있다. 본 모형은 유닉스 운영체제의 C++언어로 개발되었으며, 각 셀에서의 흐름을 모의하기 위하여 단방향흐름 알고리즘과 격자기반 수문학적 물수지요소를 채택하고 있으나 운영에 몇몇 제약사항이 있다. 본 연구에서는 기존모형을 개선하고자 하였으며, MS Windows 운영체제에서 실행 가능하도록 FORTRAN 90 언어를 이용하여 ModKIMSTORM을 개발하였다. 기존모형에 비해 개선된 주요사항으로, 물리적 기반의 침투기법인 GAML(Green-Ampt & Mein-Larson) 침투모형 추가, 격자 유출심과 Manning 조도계수에 의한 논에서의 지표유출 제어, 지표격자의 기저유출 요소 추가, 공간강우와 지점강우의 처리, 전 후 처리부문 개발, 5개 평가항목(피어슨의 결정계수 $R^2$, Nash & Sutcliffe 모형효율 E, 유출용적 편차 $D_v$, 첨두유출의 상대오차 $EQ_p$, 첨두시간의 절대오차 $ET_p$)을 이용한 모의결과의 자동 평가 기능을 개발하였다. 추가적으로, 모형의 계산효율을 향상시키고 지표격자의 기저유출을 하천격자로 이송하기 위하여 쉘정렬 알고리즘을 채택하였다. 모형의 입력자료는 ESRI ArcInfo W/S 또는 ArcView와 같은 GIS 소프트웨어 및 MS Excel을 이용하여 간단히 구축할 수 있으며, 모의결과의 공간적 분포를 확인할 수 있는 토양수분, 지표유출, 유출심 및 유속분포도는 BSQ, ESRI ASCII Grid, ESRI Binary Grid 및 IDRISI Raster 형식으로 출력할 수 있도록 개선하였다.

• 대한한방부인과학회지
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• 제36권4호
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• pp.96-120
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• 2023

Objectives: This study reports the findings that support the efficacy of herbal medicine (HM) for premenstrual syndrome (PMS). Methods: We conducted meta-analysis of findings from randomized controlled trials (RCTs) for PMS treated with HM. The articles were published before July 2022, located using 9 databases (Pubmed, EMBASE, Cochrane Library, CINAHL, CNKI, CiNii, SCIENCE ON, KoreaMed, OASIS). Results: We observed 2,034 studies, of which 23 RCTs met our inclusion criteria. The risk of bias in the included studies was relatively unclear or high. Meta-analysis of 3 RCTs showed that HM group had a significantly higher total effective rate than the western medicine group (RR 1.20 [95% CI 1.06, 1.36, p=0.004]). Meta-analysis of 1 RCT showed that HM group had a significantly lower symptom score (MD -3.04 [95% CI -5.36, -0.72, p=0.01]), while there was no significant difference in daily record of severity of problems scale (MD -20.52 [95% CI -49.33, 8.29, p=0.16]). Conclusions: HM significantly improved PMS symptoms than general treatment and no serious adverse events were reported. However, the evidence on the effectiveness and safety of HM for PMS was not enough to provide reliable results due to the small number and low quality of included studies. We believe that rigorous RCTs will lead to more reliable evidence of the intervention.

• Journal of Korean Neurosurgical Society
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• 제66권6호
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• pp.681-689
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• 2023

Objective : Subarachnoid hemorrhage (SAH) is a condition characterized by bleeding in the subarachnoid space, often resulting from the rupture of a cerebral aneurysm. Delayed cerebral ischemia caused by vasospasm is a significant cause of mortality and morbidity in SAH patients, and inflammatory markers such as systemic inflammatory response index (SIRI), systemic inflammatory index (SII), neutrophil-to-lymphocyte ratio (NLR), and derived NLR (dNLR) have shown potential in predicting clinical vasospasm and outcomes in SAH patients. This article aims to investigate the relationship between inflammatory markers and cerebral vasospasm after aneurysmatic SAH (aSAH) and evaluate the predictive value of various indices, including SIRI, SII, NLR, and dNLR, in predicting clinical vasospasm. Methods : A retrospective analysis was performed on a cohort of 96 patients who met the inclusion criteria out of a total of 139 patients admitted Trakya University Hospital with a confirmed diagnosis of aSAH between January 2013 and December 2021. Diagnostic procedures, neurological examinations, and laboratory tests were performed to assess the patients' condition. The Student's t-test compared age variables, while the chi-square test compared categorical variables between the non-vasospasm (NVS) and vasospasm (VS) groups. Receiver operating characteristic (ROC) curve analyses were used to evaluate the diagnostic accuracy of laboratory parameters, calculating the area under the ROC curve, cut-off values, sensitivity, and specificity. A significance level of p<0.05 was considered statistically significant. Results : The study included 96 patients divided into two groups : NVS and VS. Various laboratory parameters, such as NLR, SII, and dNLR, were measured daily for 15 days, and statistically significant differences were found in NLR on 7 days, with specific cut-off values identified for each day. SII showed a significant difference on day 9, while dNLR had significant differences on days 2, 4, and 9. Graphs depicting the values of these markers for each day are provided. Conclusion : Neuroinflammatory biomarkers, when used alongside radiology and scoring scales, can aid in predicting prognosis, determining severity and treatment decisions for aSAH, and further studies with larger patient groups are needed to gain more insights.

• Animal Bioscience
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• 제37권3호
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• pp.500-508
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• 2024

Objective: Due to current selection practices for increased egg production and peak persistency, the production profile, age at maturity, and body weight criteria for commercial layers are constantly changing. Body weight and age at the time of photostimulation will thus always be the factors that need to be adequately addressed among various production systems. The current study was carried out to determine the effects of pullets' body weight (low, medium, and heavy) on their performance, welfare, physiological response, and hormonal profile. Methods: With regard to live weight, 150 16-week-old pullets were divided into three groups using a completely randomized design (CRD) and held until the 50th week. One-way analysis of variance was used to evaluate the data under the CRD, and the least significant difference test was used to distinguish between treatment means. Results: In comparison to the medium and light birds, the heavy birds had higher body weight at maturity, an earlier age at maturity, and higher egg weight, eggshell weight, eggshell thickness, egg yolk index, breaking strength, egg surface area, egg shape index, egg volume, and hormonal profile except corticosterone. However, the medium and light birds had lower feed consumption rates per dozen eggs and per kilogram of egg mass than the heavy birds. Light birds showed greater body weight gain, egg production, and egg specific gravity than the other categories. At 20 weeks of age, physiological response, welfare aspects, and catalase were non-significant; however, at 50 weeks of age, all these factors-aside from catalase-were extremely significant. Conclusion: The findings of this study indicate that layers can function at lower body weights during photostimulation; hence, dietary regimens that result in lighter pullets may be preferable. Additionally, the welfare of the birds was not compromised by the lighter weight group.

• 대한두개안면성형외과학회지
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• 제25권2호
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• pp.62-70
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• 2024

Background: The management of cleft lip and palate aims at improving the patient's aesthetic and functional outcomes. Delaying primary repair can disrupt the patient's functional status. Long-term follow-up is essential to evaluate the need for secondary repair or revision surgery. This article presents the epidemiology of cleft lip and palate, including comprehensive patient characteristics, the extent of delay, and secondary repair at our institutional center, the Bandung Cleft Lip and Palate Center, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia. Methods: This retrospective study aimed to determine the epidemiology and recurrence rates of cleft lip and palate at the Bandung Cleft Lip and Palate Center, Indonesia, from January 2007 to December 2021. The inclusion criteria were patients diagnosed with cleft lip and/or palate. Procedures such as labioplasty, palatoplasty, secondary lip and nasal repair, and alveolar bone grafting were performed, and data on recurrence were available. Results: In total, there were 3,618 patients with cleft lip and palate, with an age range of 12 months to 67 years. The mean age was 4.33 years, and the median age was 1.35 years. Males predominated over females in all cleft types (60.4%), and the cleft lip was on the left side in 1,677 patients (46.4%). Most cases were unilateral (2,531; 70.0%) and complete (2,349; 64.9%), and involved a diagnosis of cleft lip and palate (1,981; 54.8%). Conclusion: Delayed primary labioplasty can affect daily functioning. Primary repair for patients with cleft lip and palate may be postponed due to limited awareness, socioeconomic factors, inadequate facilities, and varying adherence to treatment guidelines. Despite variations in the timing of primary cleft lip repair (not adhering to the recommended protocol), only 10% of these patients undergo reoperation. Healthcare providers should prioritize the importance of the ideal timing for primary repair in order to optimize physiological function without compromising the aesthetic results.

• Journal of Korean Neurosurgical Society
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• 제67권2호
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• pp.237-248
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• 2024

Objective : Postoperative data on Cushing's disease (CD) are equivocal in the literature. These discrepancies may be attributed to different series with different criteria for remission and variable follow-up durations. Additional data from experienced centers may address these discrepancies. In this study, we present the results obtained from 96 endoscopic transsphenoidal surgeries (ETSSs) for CD conducted in a well-experienced center. Methods : Pre- and postoperative data of 96 ETSS in 87 patients with CD were included. All cases were handled by the same neurosurgical team between 2014 and 2022. We obtained data on remission status 3-6 months postoperatively (medium-term) and during the latest follow-up (long-term). Additionally, magnetic resonance imaging (MRI) and pathology results were obtained for each case. Results : The mean follow-up duration was 39.5±3.2 months. Medium and long-term remission rates were 77% and 82%, respectively. When only first-time operations were considered, the medium- and long-term remission rates were 78% and 82%, respectively. The recurrence rate in this series was 2.5%. Patients who showed remission between 3-6 months had higher long-term remission rates than did those without initial remission. Tumors >2 cm and extended tumor invasion of the cavernous sinus (Knosp 4) were associated with lower postoperative remission rates. Conclusion : Adenoma size and the presence/absence of cavernous sinus invasion on preopera-tive MRI may predict long-term postoperative remission. A tumor size of 2 cm may be a supporting criterion for predicting remission in Knosp 4 tumors. Further studies with larger patient populations are necessary to support this finding.

• 동의신경정신과학회지
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• 제35권2호
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• pp.141-151
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• 2024

Objectives: To compare symptoms and characteristics among patients diagnosed with Hwabyung according to their yin-yang personality types. Methods: A structured clinical interview was conducted to diagnose Hwabyung, followed by a cross-sectional study involving a total of 118 Hwabyung patients (95 females). Various measures including the Sasang Personality Questionnaire (SPQ), Hwabyung Comprehensive Test (HCT), HwaByung Scale (HBS), State-Trait Anger Expression Inventory (STAXI), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Eogul Scale (ES), and Patient Health Questionnaire-15 (PHQ-15) were administered. Results: SPQ-total showed significant negative correlations with HBS-personality and STAXI-control, and a significant positive correlation with STAXI-out. SPQ-behavior showed significant positive correlations with HBS-symptom, STAXI-trait, STAXI-in, STAXI-out, BDI-II, BAI, ES, and PHQ-15. SPQ-cognition exhibited significant negative correlations with HBS-personality, STAXI-control, and ES. SPQ-emotion had significant negative correlations with HBS-personality and STAXI-in and a significant positive correlation with STAXI-out. SPQ-Yin demonstrated a significantly higher HBS-personality than SPQ-Yang. SPQ-Yang exhibited significantly higher STAXI-out than SPQ-Yin, whereas SPQ-Yin showed significantly higher STAXI-control and STAXI-in than SPQ-Yang. Although differences in depression, anxiety, resentment, and physical symptoms between yin and yang were not statistically significant, variations in interpretation criteria were observed. Conclusions: Anger expression patterns and physical/psychological symptoms among Hwabyung patients are different based on their yin-yang personality types. These findings can inform the prediction of symptoms in Hwabyung patients according to their yin-yang personality types and aid in establishing appropriate treatment plans.

• 대한감각통합치료학회지
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• 제21권3호
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• pp.65-78
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• 2023

목적 : 본 연구에서는 체계적 문헌 고찰을 통하여 국내 자폐스펙트럼장애 아동의 보호자를 대상으로 실시한 가족 중심 중재의 효과를 알아보고자 하였다. 연구방법 : 문헌검색은 2011년부터 2021년 사이의 문헌을 RISS, KISS, DBpia를 통하여 검색하였다. 검색어는 '자폐스펙트럼' OR '전반적발달장애' OR '고기능 자폐' OR '아스퍼거' AND '부모 교육' OR '가족중심중재' OR '부모코칭' OR '부모훈련' OR '가족참여' 등을 적용하였다. 선정 기준에 따라 최종적으로 11편의 실험연구를 선정하였다. 결과 : 연구 참가자의 일반적 특성, 중재 전략 및 효과, 중재 프로토콜을 확인한 결과, 연구대상은 영유아기 자폐스펙트럼장애 아동이 가장 많았고, 가족 중심 중재에 어머니들이 주로 참여하였다. 가족 중심 중재의 효과는 아동과 부모에게서 모두 나타났으며, 아동에게서는 상호작용 및 의사소통에 대한 효과가 가장 높은 비중을 차지하였고, 부모에게서는 양육 스트레스 감소 및 양육효능감 향상을 보였다. 중재 전략은 감각통합 중재, 반응적 의사소통 및 상호작용 중심 중재가 가장 많았고, 발달 중심 중재, 긍정적 행동 지원 중재(Positive Behavioral Supports; PBS), 중심축 반응 훈련(Pivotal Response Training; PRT)순으로 나타났다. 결론 : 본 연구의 결과를 통해 가족 중심 중재는 자폐스펙트럼장애 아동의 기능뿐만 아니라 부모의 양육 스트레스 및 양육효능감에 효과가 있음이 확인되었으며 임상 활용의 근거를 제시하였다는 점에서 의의가 있다.

• 대한방사선치료학회지
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• 제31권1호
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• pp.33-41
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• 2019

목 적: 식도암 방사선치료 시 세기조절방사선치료(Intensity Modulated Radiation Therapy, IMRT) 및 용적세기조절회전치료(Volumetric Modulated Arc Therapy, VMAT)에서 Jaw-Tracking 기법 유 무에 따라 저선량 영역에 대한 주변 정상장기의 용적선량을 분석하여 그 유용성을 평가하고자 한다. 대상 및 방법: 본 원에서 사용하고 있는 선형가속기 VitalBeamTM(Varian Medical System, U.S.A)으로 식도암 방사선치료를 받은 27명을 대상으로 하였으며, 치료계획은 Eclipse(Ver. 13.6 Varian, U.S.A)를 이용하여 Jaw-Tracking(JT)을 사용한 치료계획과 Non Jaw-Tracking(NJT) 치료계획을 수립하였으며, 치료계획용적(Planning Target Volume, PTV)에 빗장위림프절(Supraclavicular Lymph Nodes, SCL)이 포함되어 있는 T자형 PTV를 가진 환자를 대상으로 하였다. 조사범위에 대한 영향을 확인하기 위해 복강(Celiac) 포함 여부로 비교군을 나누었다. 수립된 치료계획의 비교를 위해 손상위험장기는 양측 폐, 심장, 척수를 비교하였으며 Conformity Index(CI), Homogeneity Index(HI)를 비교하였다. 임상적용 검증을 위해 전자포탈영상장치(Electronic Portal Imaging Device, EPID)를 이용하여 Portal Dosimetry를 실시하였고, 선량 영역의 임계치(Threshold)를 10 %, 5 %, 0 %로 매개변수로 설정하여 감마분석을 실시하였다. 결 과: 모든 치료계획은 3 mm / 3 %, 감마통과율 95 % 기준에 대해 Threshold 10 %의 경우 95 % 이상으로 JT, NJT 모두 통과하였으며, IMRT는 Threshold가 5 %, 0 %로 줄어들수록 JT보다 NJT의 값이 1 % 이상 줄어 들었다. IMRT에서 양측 폐의 $V_5$와 $V_{10}$은 JT에서 Celiac을 포함하지 않을 때 최대 14.7 %, 평균 8.5 %, 5.3 % 만큼 감소했고, $D_{mean}$은 $72.3{\pm}51cGy$ 감소하였으며, Celiac을 포함할 때 JT에서 선량감소가 증가하였다. 심장의 $D_{mean}$은 $68.9{\pm}38.5cGy$, 척수의 $D_{max}$는 $39.7{\pm]30.1cGy$만큼 감소하였다. VMAT은 JT기법 사용 시 폐에서 $V_5$ 평균 2.5 % 감소하였고, 심장 및 척수에서 소량 감소하였으며, Celiac 포함 시 JT의 선량감소가 증가하였다. 결 론: 식도암 치료계획에서 IMRT가 JT 사용 시 양측 폐의 $V_5$, $V_{10}$에서 유의미한 감소가 나타났고, 저 선량영역에서 조사범위가 클수록 선량감소가 크게 나타났다. 따라서 식도암 방사선치료에는 IMRT가 VMAT보다 JT 적용 시 더 효과적이며, 저 선량영역에서의 MLC 누설 및 투과선량으로부터 정상장기를 보호할 수 있다.