• 대한본초학회지
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• 제24권1호
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• pp.99-110
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• 2009

Objectives : The current treatment regimens for patients with nephrotic syndrome due to membranous nephropathy(MN) are based on steroids or immunosuppressive therapy with the aim of reducing proteinuria and improving outcome. Although these treatments attenuate the deterioration of renal function in MN patients, it has been suggested that all are burdened by significant toxicity. Therefore, more specific and less toxic therapies are needed. This study was to evaluate the effects of Coptidis Rhizoma Extract(CRE) on the MN induced by cBSA in mice. Methods : Mice were divided into 4 groups. One group named for 'Normal' was injected with a saline solution not to be immunized. The rest groups were treated as follows; After mice were immunized with 0.2 mg of cBSA and Freund's complete adjuvant one time every two weeks for 6 weeks, they received intra-peritoneal injection of 10 mg/kg of cBSA daily for 4 weeks. Also, they were divided into 3 groups. The first named for 'Control' was not given CRE. The second for 'CRE-250' was given oral administration of 250 mg/kg of CRE daily for 4 weeks. The third for 'CRE-500' was given 500 mg/kg of CRE. All of mice were sacrificed 4 weeks after the first immunization. We measured a body weight and 24hrs proteinuria as well as serological analysis. The morphologic changes of renal glomeruli were also observed with a light microscope and an electron microscope. Results : The levels of 24 hrs proteinuria, triglyceride, IgG, IL-6 were significantly decreased in both CRE groups. And the level of IgM was significantly decreased in CRE-250 group. In histological findings of kidney tissue, thickening of GBM and deposition of electron-density were consideraly decreased in both CRE groups. Conclusions : The present study suggests that CRE is highly effective when treating mice with MN induced by cBSA. More clinical data and studies are to be done for efficient application.

• Journal of Korean Neurosurgical Society
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• 제66권4호
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• pp.446-455
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• 2023

Objective : Chronic subdural hematoma (CSDH) is a common neurosurgical disease and generally treated with burr-hole surgery alone. Tranexamic acid (TXA) is an antifibrinolytic agent that potentially reduces recurrence rates and the residual hematoma volume. However, the role of postoperative TXA medication remains unclear to date. This study aimed to verify the effectiveness of adjunctive TXA in the view of early hematoma resolution. Methods : Between January 2018 and September 2021, patients with CSDH who underwent burr-hole trephination in a single tertiary institute were reviewed. The study population was divided into three groups, TXA, non-TXA, and antithrombotics (AT) groups, according to the medical history of cardio-cerebrovascular disease and TXA administration. The primary endpoint was CSDH recurrence, defined as re-appearance or re-accumulation of CSDH requiring neurosurgical interventions. The secondary outcome was CSDH resolution, defined as complete or near-complete resorption of the CSDH. The CSDH resolution time and serial changes of hematoma thickness were also investigated. Results : A total of 240 patients was included in the analysis consisting of 185 male and 55 female, with a median age of 74 years. During the median imaging follow-up period of 75 days, 222 patients were reached to the primary or secondary endpoint. TXA was administered as an adjunctive therapy in 41 patients (TXA group, 16.9%) while 114 patients were included in the non-TXA group (47.9%) and 85 were in the AT group. The recurrence rate was the lowest in the TXA group (2.4%), followed by non-TXA (7.0%) and AT (8.2%) groups. However, there was no statistical significance due to the small number of patients with recurrence. CSDH resolution was achieved in 206 patients, and the median estimated time to resolution was significantly faster in the TXA group (p<0.001). Adjunctive TXA administration was a significant positive factor for achieving CSDH resolution (p<0.001). The hematoma thickness was comparable among the three groups at the initial time and after surgery. However, CSDH thickness in the TXA group decreased abruptly in a month and showed a significant difference from that in the other groups (p<0.001). There was no TXA-related adverse event. Conclusion : The adjunctive use of TXA after CSDH surgery significantly facilitated the resorption of residual CSDH and resulted in the early CSDH resolution. Adjunctive TXA may be an effective treatment option to reduce recurrence by enhancing CSDH resolution in the selective patients.

• 분석과학
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• 제19권4호
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• pp.290-300
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• 2006

세계적으로 음용수 공급을 위한 정수 공정에는 여러 가지 방법이 쓰이고 있다. 그 중 염소는 값이 싸고 비교적 사용하기 쉬우며 미생물 제거 효과가 좋아 가장 많이 사용되는 소독제이다. 그러나 소독과정 중에 독성을 가지는 소독부산물을 생성시키는 문제가 있다. 대표적인 소독부산물에는 트리할로메탄같은 휘발성 물질과 유기염소산같은 비휘발성 물질이 있고, 최근 새로이 3-chloro-4-dichloromethyl-5-hydroxy-2(5H)-furanone (MX)라는 물질이 대두되고 있다. MX는 음용수 중 총 변이원성의 20-50%에 해당하는 강력한 변이원성을 가지는 물질이다. 이에 WHO에서는 MX를 유해물질로 선정하였으나 분석적 어려움과 독성 자료의 부족으로 인해 아직 정확한 기준치가 설정되지는 않았다. MX는 음용수 중에 21.9-30.3 ng/L 수준의 미량이 존재하였으므로 좀 더 효율적인 분석방법이 요구된다. 따라서 본 연구에서는 전처리 방법의 개선을 위해 액체-액체 추출방법과 고체상 추출방법을 사용하여 그 추출효율이 더 좋은, 고체상 추출방법을 채택하였다. 이미 여러 국가에서 MX의 분포를 조사한 바 있으나 국내에서는 MX의 분포 조사가 미흡한 실정이다. 따라서 본 연구에서는 국내의 각 정수장별 MX 함량과 수계별 MX 함량을 조사하여 국내의 MX 분포 실태를 파악하고자 하였다. MX의 생성패턴을 알고자 염소투입량, 정수장으로부터의 거리, 계절 수온 및 여러 수질조건에 따라 MX생성과의 상관관계를 확인해 본 결과 MX의 생성은 염소투입량과 계절, 수온의 영향을 받는 것으로 나타났다. 또한 MX의 최적 소독방법을 마련하기 위한 기초 연구로서 오존이나 입상활성탄(GAC)을 사용하는 고도처리수에서의 MX 함량을 측정하였다. 본 연구 결과 MX의 생성은 염소 투입량과 계절, 수온의 영향을 받는 것으로 나타났고, 오존 처리한 고도처리수에서의 MX 생성이 최소화되는 것을 확인하였다.

• Clinical Pain
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• 제18권1호
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• pp.24-30
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• 2019

Objective: Greater occipital nerve block (GONB) is a widely accepted treatment of primary headaches. Two ultrasound (US)-guided blockade techniques exist: 1) the classical distal nerve block technique performed medial to the occipital artery at the superior nuchal line, and 2) the new proximal nerve block technique performed at the obliquus capitis inferior muscle at the level of C2. Our study aim was to perform a head-to-head comparative study of these two US-guided techniques. Method: Forty-nine patients with primary headache treated in our university hospital were recruited. Patients were randomized into two groups of the classical nerve block and the new proximal nerve block techniques. The headache questionnaire was made to assess the intensity of the pain of headache attacks, number of days they experience headache, duration of headache, and amount of pain medication they consumed. Results: In both groups, a decrease in the severity and frequency of the headache was observed. There was no measurable difference in outcome between the two groups. Conclusion: Our study showed that the classic and new proximal techniques are equally effective in decreasing the headache severity and frequency.

• 한국심리학회지 : 문화 및 사회문제
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• 제15권3호
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• pp.359-375
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• 2009

본 연구의 목적은 한국형 마음 챙김 명상에 기반한 스트레스 감소 프로그램이 근로자의 만성통증완화에 미치는 영향을 연구 하는데 있다. 이러한 목적을 달성하기 위하여 만성통증을 가진 근로자 20명을 대상으로 프로그램의 효과를 알아보기 위해 사전 검사, 사후 검사, 추수 검사에서 측정한 평균점수로 혼합변량분석(Mixed ANOVA)을 실시하였다. 분석된 자료는 심리적, 신체적, 신경 생리적 반응이었다. 아울러 프로그램 후 각 효과가 지속적으로 유지될 것인가를 추가 검증하고자 3개월 후에 사후검증도 실시하였다. 본 연구 결과, 프로그램 참여 집단의 신체적 증상과 신체화, 강박증, 대인예민성, 우울, 불안, 적대감, 공포불안, 정신증 등의 반응이 프로그램 참여 전에 비해 유의미하게 감소하였고, 또한 생리 및 신경생리지표 또한 프로그램 전에 비해 유의미한 변화가 나타났으며, 3개월 후까지 이러한 변화의 효과가 유지되었다. 본 연구의 결과로 보아 마음 챙김 명상에 기반한 스트레스 감소 프로그램은 통증환자의 심리적, 신체적, 신경생리적 통증완화에 유의미한 영향력을 미치는 것으로 밝혀졌다. 따라서 본 연구결과를 통해 만성통증환자의 임상적 프로그램 개발의 기초자료를 제공하고자 한다.

• Journal of Animal Science and Technology
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• 제65권6호
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• pp.1242-1253
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• 2023

The present study aimed to investigate the feasibility of using a diet low in lysine content as a means for increasing the intramuscular fat (IMF) content and pork muscle quality of finishing pigs. Thirty-two crossbred gilts and barrows weighing approximately 80 kg were fed either a low-lysine diet (0.60%; Low-lys) or a control diet (0.80% lysine; Med-lys) under a 2 × 2 factorial arrangement of treatments. The animals were slaughtered at a 132-kg body weight (BW) on average, followed by physicochemical analyses and sensory evaluation on Longissimus lumborum (LL) and Semitendinosus (ST) muscles. The average daily gain (ADG) did not differ between the Med-lys and Low-lys groups. However, ADG exhibited a tendency of sex × diet interaction (p = 0.09), being greater for barrows vs. gilts on the Low-lys diet (p < 0.05), but not on the Med-lys diet. Backfat thickness adjusted for 132-kg BW also exhibited the interaction; it was greater for the Low-lys vs. Med-lys group within gilts but tended to be less for the former in barrows (p = 0.08). The IMF content was not influenced by the diet or sex in either LL or ST. The a^*, b^*, and Warner-Bratzler Shear Force values and fatty acid composition were influenced by the sex or diet in either or both of the muscles, but the treatment effects did not apparently influence the meat quality. Sensory scores for the flavor, juiciness, tenderness, umami, and palatability of cooked muscle were not influenced by the diet in either LL or ST. When the LL and ST data were pooled, scores for those sensory attributes were positively correlated with the IMF content, which was associated with overall greater IMF contents and greater sensory scores for ST vs. LL. Collectively, the Low-lysine diet seemingly elicited the intended lysine deficiency in gilts as indicated by the increased BFT due to the diet. However, the Low-lys diet was not effective for increasing the IMF deposition or eating quality of the pork muscle of finishing pigs slaughtered at high BW probably because its lysine content was not low enough to elicit either outcome.

• Journal of Korean Neurosurgical Society
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• 제66권6호
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• pp.690-702
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• 2023

Objective : To analyze the outcomes of coil embolization (CE) for unruptured intracranial aneurysm (UIA) according to region and hospital size based on National Health Insurance Service data in South Korea. Methods : The incidence of complications, including intracranial hemorrhage (ICRH) and cerebral infarction (CI), occurring within 3 months and the 1-year mortality rates in UIA patients who underwent CE in 2018 were analyzed. Hospitals were classified as tertiary referral general hospitals (TRGHs), general hospitals (GHs) or semigeneral hospitals (sGHs) according to their size, and the administrative districts of South Korea were divided into 15 regions. Results : In 2018, 8425 (TRGHs, 4438; GHs, 3617; sGHs, 370) CEs were performed for UIAs. Complications occurred in 5.69% of patients seen at TRGHs, 13.48% at GHs, and 20.45% at sGHs. The complication rate in TRGHs was significantly lower than that in GHs (p=0.039) or sGHs (p=0.005), and that in GHs was significantly lower than that in sGHs (p=0.030). The mortality rates in TRGHs, GHs, and sGHs were 0.81%, 2.16%, and 3.92%, respectively, with no significant difference. Despite no significant difference in the mortality rates, the complication rate significantly increased as the number of CE procedures per hospital decreased (p=0.001; rho=-0.635). Among the hospitals where more than 30 CEs were performed for UIAs, the incidence of CIs (p=0.096, rho=-0.205) and the mortality rates (3 months, p=0.048, rho=-0.243; 1 year, p=0.009, rho=-0.315) significantly decreased as the number of CEs that were performed increased and no significant difference in the incidence of post-CE ICRH was observed. Conclusion : The complication rate in patients who underwent CE for UIA increased as the hospital size and physicians' experience in conducting CEs decreased. We recommend nationwide quality control policies CEs for UIAs.

• 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.

• Journal of Periodontal and Implant Science
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• 제54권2호
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• pp.96-107
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• 2024

Purpose: Deproteinized bovine bone or synthetic hydroxyapatite are 2 prevalent bone grafting materials used in the clinical treatment of peri-implant bone defects. However, the differences in bone formation among these materials remain unclear. This study evaluated osteogenesis kinetics in peri-implant defects using 2 types of deproteinized bovine bone (Bio-Oss^® and Bio-Oss/Collagen^®) and 2 types of synthetic hydroxyapatite (Apaceram-AX^® and Refit^®). We considered factors including newly generated bone volume; bone, osteoid, and material occupancy; and bone-to-implant contact. Methods: A beagle model with a mandibular defect was created by extracting the bilateral mandibular third and fourth premolars. Simultaneously, an implant was inserted into the defect, and the space between the implant and the surrounding bone walls was filled with Bio-Oss, Bio-Oss/Collagen, Apaceram-AX, Refit, or autologous bone. Micro-computed tomography and histological analyses were conducted at 3 and 6 months postoperatively (Refit and autologous bone were not included at the 6-month time point due to their rapid absorption). Results: All materials demonstrated excellent biocompatibility and osteoconductivity. At 3 months, Bio-Oss and Apaceram-AX exhibited significantly greater volumes of formation than the other materials, with Bio-Oss having a marginally higher amount. However, this outcome was reversed at 6 months, with no significant difference between the 2 materials at either time point. Apaceram-AX displayed notably slower bioresorption and the largest quantity of residual material at both time points. In contrast, Refit had significantly greater bioresorption, with complete resorption and rapid maturation involving cortical bone formation at the crest at 3 months, Refit demonstrated the highest mineralized tissue and osteoid occupancy after 3 months, albeit without statistical significance. Conclusions: Overall, the materials demonstrated varying post-implantation behaviors in vivo. Thus, in a clinical setting, both the properties of these materials and the specific conditions of the defects needing reinforcement should be considered to identify the most suitable material.

• Korean Journal of Radiology
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• 제24권12호
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• pp.1249-1259
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• 2023

Objective: This study aimed to evaluate the clinical outcomes and cost-effectiveness of dual-energy X-ray absorptiometry (DXA) for osteoporosis screening. Materials and Methods: Eligible patients who had and had not undergone DXA screening were identified from among those aged 50 years or older at Kaohsiung Veterans General Hospital, Taiwan. Age, sex, screening year (index year), and Charlson comorbidity index of the DXA and non-DXA groups were matched using inverse probability of treatment weighting (IPTW) for propensity score analysis. For cost-effectiveness analysis, a societal perspective, 1-year cycle length, 20-year time horizon, and discount rate of 2% per year for both effectiveness and costs were adopted in the incremental cost-effectiveness (ICER) model. Results: The outcome analysis included 10337 patients (female:male, 63.8%:36.2%) who were screened for osteoporosis in southern Taiwan between January 1, 2012, and December 31, 2021. The DXA group had significantly better outcomes than the non-DXA group in terms of fragility fractures (7.6% vs. 12.5%, P < 0.001) and mortality (0.6% vs. 4.3%, P < 0.001). The DXA screening strategy gained an ICER of US$ -2794 per quality-adjusted life year (QALY) relative to the non-DXA at the willingness-to-pay threshold of US$ 33004 (Taiwan's per capita gross domestic product). The ICER after stratifying by ages of 50-59, 60-69, 70-79, and ≥ 80 years were US$ -17815, US$ -26862, US$ -28981, and US$ -34816 per QALY, respectively. Conclusion: Using DXA to screen adults aged 50 years or older for osteoporosis resulted in a reduced incidence of fragility fractures, lower mortality rate, and reduced total costs. Screening for osteoporosis is a cost-saving strategy and its effectiveness increases with age. However, caution is needed when generalizing these cost-effectiveness results to all older populations because the study population consisted mainly of women.