• The Korean Journal of Gastroenterology
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• v.72 no.5
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• pp.271-273
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• 2018

내시경 시술 전 일시적으로 항응고제를 중단하는 것은 위장관 출혈의 위험과 혈전색전증의 위험 사이에 적절한 균형을 잡기 어렵기 때문에 논란의 여지가 많다. 와파린은 새로운 경구용 항응고제(direct oral anticoagulant agent, DOAC)보다 임상의에게 더 친숙하고, 효과를 쉽고 빠르게 전환시킬 수 있다는 장점이 있지만 복잡한 약역동학 특징과 좁은 치료적 범위 때문에 관리가 어렵다. 반면, DOAC는 약물의 모니터링 및 용량 조절 없이 정해진 용량으로 처방이 가능하며, 빠르게 작용하고, 반감기가 짧아 관리가 쉽지만 해독제가 없다는 단점이 있다. 이전 연구들에서 DOAC를 복용한 환자들은 와파린을 복용한 환자들보다 시술과 관련되지 않은 위장관 출혈의 위험이 높았다고 보고한 바 있다. 하지만 시술과 관련된 위장관 출혈 위험에 대하여는 알려진 바가 없는 실정이다. 미국이나 유럽 내시경 가이드라인들에서는 저위험 내시경 시술을 받는 환자들에서는 와파린과 DOAC를 유지하도록 권고하고 있으며, 고위험 시술의 경우에는 와파린를 사용하는 환자들에서 헤파린 교량 요법(heparin bridging)을 시행하도록 권고하고 있다. 임상적으로 DOAC를 사용하는 환자들 또한 혈전색전증을 예방하기 위하여 헤파린 교량 요법을 시행해볼 수 있는데, 와파린 및 DOAC의 헤파린 교량 요법과 관련된 출혈 및 혈전색전증 위험의 차이 또한 명확하지 않다. 따라서 저자들은 1) 와파린과 DOAC 치료를 받는 환자들에서의 출혈, 혈전색전증 및 사망의 위험을 비교하고자 하였으며, 2) 13종류의 고위험 내시경 시술 중에서 시술별 위험을 비교하고, 3) 헤파린 교량 요법이 합병증의 발생을 증가시키지 않는지 확인하고자 본 연구를 진행하였다. 일본 대규모 국가 입원 환자 데이터베이스를 이용하여 2014년 4월부터 2015년 5월까지 시술 전 와파린 또는 DOAC(rivaroxaban, apixaban, dabigatran, edoxaban)를 복용하고, 13종류의 고위험 내시경 시술을 시행받은 20세 이상의 성인 환자 총 16,977명을 확인하였다. 고위험 시술은 용종 절제술, 내시경 점막절제술, 내시경 점막하박리술, 협착 부위의 풍선확장술, 내시경 지혈술, 내시경 정맥결찰술, 내시경 주사 경화요법, 내시경 괄약근절개술, 내시경 초음파 유도하 미세침 흡인 검사, 경피적 위루술을 포함하였다. 일대일 성향 점수 매칭 분석(propensity score matching, 나이, 성별, 체질량 지수, 기저 질환, 병원의 규모, 시술의 종류, 약물의 종류를 매칭)을 시행하여 와파린군과 DOAC군에서 시술 위장관 출혈 및 혈전색전증, 사망의 발생을 비교하였다. 또한 경구항혈전제와 헤파린 교량 치료 시행 유무에 따라, DOAC 단독군, 와파린 단독군, DOAC와 헤파린 교량 요법군, 와파린과 헤파린 교량요법군으로 나누어, 하위군(subgroup) 분석을 시행하였다. 5,046쌍이 성향 점수 매칭 분석에 포함되었으며, 와파린군에서 DOAC군보다 통계적으로 의미 있게 위장관 출혈의 비율이 높았다(12.0% vs. 9.9% p=0.02). 혈전색전증 발생률(5.4% vs. 4.7%)과 입원중 사망률(5.4% vs. 4.7%)은 양 군에서 의미 있는 차이는 없었다. DOAC 종류별로 나누어 하위군 분석을 시행하였을 때, 와파린군은 rivaroxaban군에 비하여 위장관 출혈의 비율이 높았으며, rivaroxaban군, dabigatran군에 비하여 혈전색전증의 비율이 높았고, 입원 중 사망률에서는 의미 있는 차이는 없었다. 내시경 시술의 종류로 보정하였을 때 위장관 출혈 및 혈전색전증, 사망률은 DOAC 단독으로 치료한 환자에서보다 와파린과 헤파린 교량 요법(bridging) 또는 DOAC과 헤파린 교량 요법을 시행한 환자에서 높았다. 시술 종류 중에서는 위루관 삽입술에 비하여 내시경 점막하박리술, 내시경 점막절제술 및 내시경 정맥류결찰술, 내시경 주사경화요법을 시행한 환자에서 위장관 출혈의 위험이 가장 높았으며, 하부 내시경 점막절제술, 하부 용종 절제술, 내시경적 유두괄약근절제술 또는 내시경 초음파 유도하 미세침 흡인 검사는 중등도 위험을 보였다.

• Proceedings of the KAIS Fall Conference
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• 2012.05a
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• pp.97-99
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• 2012

본 연구는 본 연구는 경두개직류자극(transcranial direct current stimulation)을 편마비 환자의 대뇌피질 운동영역에 적용하여 상지기능에 미치는 효과를 알아보고자 실시하였다. 뇌졸중으로 인해 편마비된 환자를 대상으로 두 군으로 구분하여 경두개직류자극과 일반적인 물리치료를 함께 시행하였고, 실험 전후의 두 군의 기능적 평가항목과 전기생리학적 평가를 함께 실시하였다. 통계처리 방법으로 실험 전 후 차이를 검증하였고, 모든 통계적 유의수준은 0.05로 하였다. 본 연구의 결과 실험군과 대조군에서 주관절 기능평가의 값과 손 기능 평가에서 치료 전, 후 값이 증가하였고 통계적으로 유의한 차이를 보였다(p<0.05). 결론적으로, 경두개직류자극이 뇌졸중 환자의 상지기능에 변화에 효과적인 것으로 나타났다. 따라서, 임상에서 뇌졸중 환자를 대상으로 한 경두개직류자극의 활용 가능성에 대해 재활 관점에서의 추가적인 연구가 더욱 필요할 것으로 생각된다.

• Journal of the Korean Arthroscopy Society
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• v.4 no.2
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• pp.138-143
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• 2000

Purpose : We analyzed clinical and radiological results of the treatment of osteochondritis dissecans in the femoral condyle under arthroscopic guidance. Materials and Methods : The study group consists 19 cases in 17 patients. Average follow up period was 34 months and average age was 16 years. The cases were classified by 4 different groups, using the fellowing system: Group 1-stable lesion and no specific treatment after arthroscopic examination; Group 2-early separation and multiple drilling; Croup 3-unstable lesion and Herbert screw fixation; Croup 4-loose body removal and/or crater curettage. The results were analyzed by the criteria of Hughston which including clinical and radiologic outcomes. Results : There were 14 cases$(74\%)$ of good and excellent results in 19 knees in which, $75\%$(3/4) in Group 1, $75\%$(3/4) in Group 2, $86\%$(7/8) in Group 3 and $33\%$(1/3) in Group 4. The result of Herbert screw fixation group was better than that of other groups with statistically significant differences. Conclusion : In the treatment of osteochondritis dissecans of skekletally immature patients, arthroscopic finding was reliable guidance in decision of treatment method and active fixation was recommended in patients with large, unstable lesion.

• Culinary science and hospitality research
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• v.8 no.2
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• pp.197-206
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• 2002

The present study attempted to obtain a basic data concerning the effect of $\pi$-water, a sort of physiological water, on the maintenance of chicken freshness. The meats were divided into three groups: the control, 20% - dilution, and 5% - dilution groups. In the experiment, the changes of the TBA-values of the meats started to appear on the 3rd day in the control group, and from the 4th day in the 20% - and 5% - dilution groups. The changes of pH didn't appear in the meats as the storage time passed. The number of general bacteria increased rapidly on the 3th day in the control, and on the 5th day in the 20% -, and 5% - dilution groups. As for the color, the meats turned greenish on the 5th day in the control, 7th, in 20% - dilution, and, l0th in the 5%-dilution groups. As for the order, the meats emitted the unpleasant order, such as that of ammonia, on the 3rd day in the control, 5th, in the 20% - dilution, and, 7th, in the 5ft-dilution group.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.9 no.2
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• pp.218-225
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• 2006

Purpose: With a remarkable increase in the prevalence of childhood obesity, the prevalence of nonalcoholic fatty liver disease is assumed to be increasing. The aim of this study is to evaluate the prevalence of nonalcoholic fatty liver disease, hyperlipidemia, and glucose intolerance in normal and obese children. Methods: A total of 2,206 elementary students (boys: 1340, girls: 866) were grouped according to obesity index; normal group and obesity group (mild, moderate, severe). Aspartate aminotransferase (AST, SGOT) and alanine aminotransferase (ALT, SGPT) were measured with total cholesterol, triglyceride, and fasting blood glucose. Results: Compared with the 4.6% of elevated aminotransferases in normal group, obese groups showed significantly higher prevalence; 12.1% in mild obesity group, 19.4% in moderate group, and 21.6% in severe group (p<0.0001). The prevalence of hypertriglyceremia was 16.9% in normal weight group, which was significantly lower than obesity group (mild obesity group 30.3%, moderate and severe 37.6%, 38.2% each). In boys, the prevalences of elevated aminotransferases in normal weight and obese groups (mild, moderate, severe) were 6.8%, 18.0%, 23.0%, and 26.0%, respectively (p<0.0001). In girls, those were 2.1%, 5.1%, 12.0%, and 12.6%, respectively (p< 0.0001). The prevalence of hypertriglyceremia was relative to severity of obesity in boys and girls (p<0.0001). Conclusion: The prevalence of elevated serum liver enzymes increased with severity of obesity. For the prevention and treatment of fatty liver and hypertriglycemia, it is important to lower the obesity degree and enforce the education for a weight loss in the student and the parents.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.1
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• pp.1-11
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• 2005

Purpose: The aim of this study was to evaluate the relationship between H. pylori infection and recurrent abdominal pain (RAP) in children and to evaluate the effects of eradication therapy on RAP. Methods: From January 1998 to January 2005, 166 children with RAP (61 male, 105 female) aged $10.0{\pm}3.3$ years were included. Upper gastrointestinal endoscopies were performed for all the patients. All H. pylori infected children (n=70) received the eradication therapy and were divided into two groups: Group Ia (n=52); eradicated, Group Ib (n=18); non-eradicated. H. pylori-negative children (n=96) were divided into three groups according to the medication: Group IIa (n=67); no medication, Group IIb (n=13); acid-suppressant, Group IIc (n=16); both acid-suppressant and antibiotics. Questionnaire for symptoms were asked at the first, 6th, 12th, 24th, and 36th months following the treatment (grade 0; completely resolved, grade 1; definitely improved, but there are occasional episodes of mild abdominal pain, grade 2; no change in the frequency and intensity of abdominal pain). Results: In about 90% of H. pylori positive children, RAP improved in the both H. pylori-eradicated and non-eradicated children in a follow-up survey. In about 75% of H. pylori-negative children, RAP also improved among in the three groups of patients regardless of medication. Conclusion: These results suggest that there was no correlations between improvement of RAP and eradication of H. pylori, and between improvement of RAP and medication. Consequently the reassurance that the children with RAP have no serious organic cause was important to improvement of RAP.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.2
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• pp.296-309
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• 1999

Autopolymerized resin facilitates a more rapid and easier means for the construction of removable orthodontic appliances than heat cured resin. But many reports reveal that more unreacted monomer is found in autopolymerized resin. It is very important to achieve maximum degree of polymerization because if polymerization is inadequate, high level of unreacted monomer has been shown to adversely affect mechanical and physical properties, and also the question of allergy or toxicity to methylmethacrylate must be considered. The purpose of this study was to compare the degree of polymerization according to curing method and curing time. Five groups were desinged ; Group 1 was polymerizied at room temperature($28^{\circ}C$) ; Group 2 in $28^{\circ}C$ water ; Group 3 in $28^{\circ}C$ water under 30psi pressure ; Group 4 in $43^{\circ}C$ water ; Group 5 in $43^{\circ}C$ water under 30psi pressure for 10 minutes, 1 hour 12 hours, 1 day and 3 days. The degree of polymerization was measured by means of Fourier Transform Infrared spectroscopy. The results were as follows: 1. The degree of polymerization increased constantly in accordance with curing time in all groups and after curing for 10 minutes, Group 1 showed significantly higher degree of polymerization after 12 hours and Group 2, Group 3, Group 4, Group 5 after 1 hour(p<0.05). 2. The degree of polymerization decreased in the order of Group 5, Group 4, Group 3, Group 2, Group 1 except when the curing time was 1 hour and 12 hours(p<0.05). 3. The degree of polymerization of Group 4, Group 5 cured at $43^{\circ}C$ showed significantly higher degree of polymerization than Group 2, Group 3 at $28^{\circ}C$ except when the curing time was 1 day(p<0.05). 4. Among Group 2, Group 3 and Group 4, Group 5, the pressure had no effect on polymerization except when the curing time was 12 hours(p<0.05). 5. Between Group 1 and Group 2, the method of storage had no effect on polymerization except when the curing time was 1 hour(p<0.05).

• Food Science and Preservation
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• v.10 no.3
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• pp.417-420
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• 2003

In order to study optimum culture condition of yeast medium added deep seawater, we examed samples with 9 yeast strains. The growth rate were measured for Saccharomyces cerevisiae 10, 11, 12, 901 and RCY and Saccharomyces kluyvery DJ97, Saccharomyces cerevisiae YJK, JK99, CMY-28 etc.. The growth of S. cerevisiae 12 was found most active in the deep seawater(hardness 500). The growth rate of S. cerevisiae 901 on medium containing deep seawater(hardness 1000) was faster than that of the yeast on medium without deep seawater. The use of deep seawater on the growth of Sacch.cerevisiae kluyvery DJ97 revealed maximum growth under the condition of hardness 200 of deep seawater and 10％ of sugar concentration.

• THE HEALTH and ORGANIC FARMING
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• no.219
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• pp.11.1-11.1
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• 2005

고교생 친환경농업 글짓기 작품 공모전 - 친환경인증신청, 전남도 9월 현재 11.908ha로 급증 - 화천군, 친환경농업대학 1기생 모집 - 전남도, 친환경농업육성 조례 제정

• The Journal of the Korea Contents Association
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• v.20 no.9
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• pp.520-530
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• 2020

The purpose of this study was to investigate the effects of occupation-based bilateral upper extremity training and transcranial direct current stimulation on upper limb function in stroke patients. The study group was divided into 13 experimental groups with occupation-based bilateral upper extremity training and transcranial direct current stimulation, and 13 controls with only occupation-based bilateral upper extremity training. A total of 4 weeks, 50 minutes, 5 times a week conducted, the patients were tested with Canadian Occupational Performance Measure(COPM), Accelerometer, Fugle-Meyer Assessment(FMA), and Motor Activity Log(MAL). As a result of the study, the experimental group and the control group showed significant improvement in both occupation satisfaction and performance, usage of the affected side and the tendon side, recovery of upper limb function, and quality of movement, In particular, the experimental group showed a significant difference in the amount of the affected side than the control group. Therefore, it was found that the combination of occupation-based bilateral upper extremity training and transcranial direct current stimulation had a positive effect on the recovery of upper limb function in stroke patients.