• Tuberculosis and Respiratory Diseases
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• 제85권4호
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• pp.320-331
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• 2022

Coronavirus disease 2019 (COVID-19) has become a major health burden worldwide, with over 450 million confirmed cases and 6 million deaths. Although the acute phase of COVID-19 management has been established, there is still a long way to go to evaluate the long-term clinical course or manage complications due to the relatively short outbreak of the virus. Pulmonary fibrosis is one of the most common respiratory complications associated with COVID-19. Scarring throughout the lungs after viral or bacterial pulmonary infection have been commonly observed, but the prevalence of post-COVID-19 pulmonary fibrosis is rapidly increasing. However, there is limited information available about post-COVID-19 pulmonary fibrosis, and there is also a lack of consensus on what condition should be defined as post-COVID-19 pulmonary fibrosis. During a relatively short follow-up period of approximately 1 year, lesions considered related to pulmonary fibrosis often showed gradual improvement; therefore, it is questionable at what time point fibrosis should be evaluated. In this review, we investigated the epidemiology, risk factors, pathogenesis, and management of post-COVID-19 pulmonary fibrosis.

• 한국식품영양과학회지
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• 제43권1호
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• pp.151-161
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• 2014

본 연구는 전남지역 학교 급식에서의 식품알레르기에 대한 관리 실태를 알아보기 위하여 전남에 근무하는 초등학교와 중학교 영양(교)사 236명을 대상으로 식품알레르기 업무에 관한 인식과 수행도 및 지식수준을 조사하였고 그 결과는 다음과 같다. 식품알레르기 업무 우선순위에 대한 인식은 초등학교와 중학교 영양(교)사 모두 식품알레르기 유병 학생 파악, 제거식 대체식 제공, 식품알레르기 표시 식단표 게시 및 발송, 교직원 및 조리종사원 교육과 학생 학부모 교육 순이었다. 전남지역 영양(교)사의 89.3%가 식품알레르기 관련 영양교육 및 상담 자료가 충분치 않다고 인식하고 있었고, 교육 및 상담 자료는 스스로 인터넷 검색을 통하여 활용하는 경우가 전체 평균 55%로 가장 많았다. 또한 식품알레르기 학생 관리에 대한 영양(교)사의 역할에 대해서는 전체 대상자의 94.0%가 중요하다고 인식하였다. 자신의 식품알레르기 지식 및 이해수준은 초등학교 영양(교)사 37.1%, 중학교 영양(교)사 42.4%가 40~60% 정도라고 인식하고 있었다. 식품알레르기에 관한 업무 수행도는 식품알레르기 표시 식단표 게시 및 발송(63.6%), 식품알레르기 유병 학생파악(43.2%), 대체식 및 제거식 제공(23.7%), 식품알레르기 교육 및 상담실시(19.9%) 순이었으며, 이들 식품알레르기 관련 업무 우선순위와 수행도 사이에는 차이가 있었다. 한편 식품알레르기 유병 학생 파악 업무(P<0.001), 식품알레르기 유발식품 표시 식단표의 게시 및 발송 업무(P<0.05) 수행도는 초등학교가 중학교 영양(교사)보다 유의하게 높았다. 식품알레르기에 대한 문항에 대한 정답률은 초등학교 영양(교)사 71.5%였고, 중학교 영양(교)사 65.8%로 초등학교 영양(교)사가 유의하게 높았다(P<0.01). 식품알레르기 관련 교육 및 연수 이수율은 전체 조사대상자의 16.9%로 매우 낮았으며, 식품알레르기 교육 수강여부는 식품알레르기에 대한 지식 문항 정답률에 영향을 미치지 않았다. 본 연구 결과 전남지역 초등학교와 중학교 영양(교)사의 식품 알레르기에 대한 업무 우선순위, 영양(교)사의 역할 중요도, 연수 요구도 등에 대한 인식은 높은데 비하여, 업무 과다, 교육 자료 및 연수 기회 부족 등으로 식품알레르기에 관한 업무 수행도는 부분적으로 미흡하였고 지식수준은 분야에 따라 미흡한 상태였다. 따라서 본 연구 결과들은 학교 급식에서 식품알레르기 관련 업무에 대한 수행도를 높이기 위해서는 영양교사의 인식수준에 부합하는 체계적인 양질의 교육과 연수 기회 제공, 학생 스스로의 식품알레르기 관리와 예방을 위한 영양교육 시수 확보 및 단위학교에 적합한 식품 알레르기 관리 매뉴얼의 제작 보급이 우선적으로 필요함을 시사한다.

• Journal of Nutrition and Health
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• 제54권6호
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• pp.664-678
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• 2021

본 연구에서는 제주지역 일부 만 6세 이하 미취학 아동의 부모를 대상으로 아동의 식품알레르기 유병률 및 관리, 부모의 식품알레르기 관련 지식도와 양육 부담의 현황을 식품알레르기 유무에 따라 분석하였으며, 그 결과는 다음과 같다. 조사대상자 총 387명으로 남아가 51.4%, 여아가 48.6%이었고, 그 중 식품알레르기를 경험한 아동은 16.8% (남아: 58.5%, 여아: 41.5%)로 조사되었다. 식품알레르기를 경험한 아동 중 실제로 의사로부터 식품알레르기 진단을 받은 아동 44.6%로 나타났다. 식품알레르기를 경험한 아동의 주된 증상으로는 구토, 설사, 기침, 복통, 쌕쌕 거림과 호흡곤란 순으로 나타났으며, 원인 식품으로는 난류가 가장 높은 빈도로 나타났고, 우유, 갑각류, 땅콩 및 콩류, 밀, 쇠고기 등이 뒤를 이었다. 또한 식품알레르기를 경험한 전체 아동의 부모 중 15.4%만이 대체식품을 사용한다고 조사되어 대부분의 부모가 대체식품을 사용하지 않는 것으로 조사되었다. 식품알레르기를 경험한 아동의 부모에서 식품알레르기로 인한 양육 부담은 정서적 고충이 일상생활의 제약에 비해 더 큰 것으로 나타났으며, 부모의 식품알레르기 관련 지식도는 식품알레르기 경험 유무에 따라 유의적인 차이를 보였다. 즉, 조사대상자의 식품알레르기 관련 지식과 식품알레르기 관련 교육 및 상담 참여경험 (보건소 또는 병원)비율과 의지가 식품알레르기 경험이 없는 아동의 부모보다 높아, 자녀의 식품알레르기에 대한 관심과 동시에 그에 따른 양육 부담 및 근심 정도가 높게 나타났다. 이상의 연구결과를 토대로 살펴볼 때, 미취학 아동 부모를 대상으로 한 식품알레르기의 예방과 대처방안 및 대체식품을 이용한 영양관리 등 수요자의 니즈-맞춤형 영양교육과 상담을 위한 체계적인 교육 자료의 개발이 필요하며, 학부모의 접근성을 고려한 교육 및 상담 장소를 적극적으로 활용하는 방안이 모색되어야 할 것으로 사료된다.

• Tuberculosis and Respiratory Diseases
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• 제85권3호
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• pp.249-255
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• 2022

Background: The main cause of death in pulmonary embolism (PE) is right-heart failure due to acute pressure overload. In this sense, extracorporeal membrane oxygenation (ECMO) might be useful in maintaining hemodynamic stability and improving organ perfusion. Some previous studies have reported ECMO as a bridge to reperfusion therapy of PE. However, little is known about the patients that benefit from ECMO. Methods: Patients who underwent ECMO due to pulmonary thromboembolism at a single university-affiliated hospital between January 2010 and December 2018 were retrospectively reviewed. Results: During the study period, nine patients received ECMO in high-risk PE. The median age of the patients was 60 years (range, 22-76 years), and six (66.7%) were male. All nine patients had cardiac arrests, of which three occurred outside the hospital. All the patients received mechanical support with veno-arterial ECMO, and the median ECMO duration was 1.1 days (range, 0.2-14.0 days). ECMO with anticoagulation alone was performed in six (66.7%), and ECMO with reperfusion therapy was done in three (33.3%). The 30-day mortality rate was 77.8%. The median time taken from the first cardiac arrest to initiation of ECMO was 31 minutes (range, 30-32 minutes) in survivors (n=2) and 65 minutes (range, 33-482 minutes) in non-survivors (n=7). Conclusion: High-risk PE with cardiac arrest has a high mortality rate despite aggressive management with ECMO and reperfusion therapy. Early decision to start ECMO and its rapid initiation might help save those with cardiac arrest in high-risk PE.

• 대한한의학회지
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• 제44권4호
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• pp.41-58
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• 2023

Objectives: This retrospective observational study aimed to investigate the efficacy and safety of Cheongpebaedok-tang, a traditional Korean herbal medicine, provided via telemedicine to patients with asymptomatic to mild COVID-19 in Korea. Methods: From February to April 2020, a retrospective analysis investigated COVID-19 patients treated via Korean telemedicine. The study involved asymptomatic to mild cases receiving Cheongpebaedok-tang more than three times, along with continuous Korean medicine care in convalescence. Diagnoses and treatment adhered to the telemedicine guidelines of the Association of Korean Medicine, with varied Cheongpebaedok-tang prescriptions based on symptom severity. Symptom evaluation involved a detailed assessment using a 15-item tool at initial and final sessions. Results: The study included 27 patients, with a mean age of 48.7 ± 2.3 years (mean ± standard error). Patients began self-administering oral Cheongpebaedok-tang for an average of 19.4 ± 1.8 days after the date of COVID-19 diagnosis confirmation and continued the medication for 15.8 ± 1.2 days. The reported side effects of the Cheongpebaedok-tang included palpitations (11.1%), insomnia (7.4%), dizziness (3.7%), and diarrhea (3.7%). All side effects disappeared after adjusting the prescription according to standard treatment guidelines. The occurrence of all COVID-19-related adverse symptoms, except fatigue and myalgia, decreased. Fatigue was the most common chronic symptom persisting after 6 months (51.9%), followed by ocular symptoms (37.0%) and sore throat (22.2%). Conclusions: This study implies Cheongpebaedok-tang may offer a potentially safe, symptom-alleviating approach for managing mild COVID-19 cases via telemedicine, although further comprehensive research is warranted.

• 한국콘텐츠학회논문지
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• 제16권3호
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• pp.596-606
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• 2016

본 연구의 목적은 우리나라 청소년에서 천식, 알레르기 비염 및 아토피 피부염을 포함하는 알레르기 질환의 유병 영향요인을 파악하고자 하는 것이다. 본 연구는 제10차(2014년)청소년건강행태 온라인조사의 원시자료를 이용하였으며, 만 12-18세 청소년 총 72,060명을 연구대상자로 선정하였다. 알레르기 질환 유병 영향요인을 파악하기 위해 로지스틱 회귀분석 결과 모든 변수가 보정된 상태에서 천식은 성별, 연령, 체질량지수, 주관적 경제상태, 흡연 및 주관적 스트레스 인지가 알레르기 비염은 연령, 도시규모, 주관적 경제상태, 음주 및 주관적 스트레스 인지가 아토피 피부염은 성별, 연령, 주관적 경제상태, 음주 및 주관적 스트레스 인지가 알레르기 질환 유병 영향요인으로 나타났다. 따라서 앞으로 청소년의 알레르기 질환에 악영향을 미치는 흡연과 음주와 같은 생활습관들의 규제정책 강화, 포괄적인 예방교육 및 스트레스 관리가 국가적 측면에서 시행될 필요가 있다.

• Tuberculosis and Respiratory Diseases
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• 제82권4호
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• pp.277-284
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• 2019

Idiopathic nonspecific interstitial pneumonia (NSIP) is one of the varieties of idiopathic interstitial pneumonias. Diagnosis of idiopathic NSIP can be done via multidisciplinary approach in which the clinical, radiologic, and pathologic findings were discussed together and exclude other causes. Clinical manifestations include subacute or chronic dyspnea and cough that last an average of 6 months, most of which occur in non-smoking, middle-aged women. The common findings in thoracic high-resolution computed tomography in NSIP are bilateral reticular opacities, traction bronchiectasis, reduced volume of the lobes, and ground-glass opacity in the lower lungs. These lesions can involve diffuse bilateral lungs or subpleural area. Unlike usual interstitial pneumonia, honeycombing is sparse or absent. Pathology shows diffuse interstitial inflammation and fibrosis which are temporally homogeneous, namely NSIP pattern. Idiopathic NSIP is usually treated with steroid only or combination with immunosuppressive agents such as azathioprine, cyclophosphamide, cyclosporine, and mycophenolate mofetil. Prognosis of idiopathic NSIP is better than idiopathic pulmonary fibrosis. Many studies have reported a 5-year survival rate of more than 70%.

• Tuberculosis and Respiratory Diseases
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• 제82권4호
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• pp.269-276
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• 2019

Idiopathic interstitial pneumonia (IIP) is a histologically identifiable pulmonary disease without a known cause that usually infiltrates the lung interstitium. IIP is largely classified into idiopathic pulmonary fibrosis, idiopathic non-specific interstitial pneumonia, respiratory bronchiolitis-interstitial lung disease (ILD), cryptogenic organizing pneumonia, desquamative interstitial pneumonia, and acute interstitial pneumonia. Each of these diseases has a different prognosis and requires specific treatment, and a multidisciplinary approach that combines chest high-resolution computed tomography (HRCT), histological findings, and clinical findings is necessary for their diagnosis. Diagnosis of IIP is made based on clinical presentation, chest HRCT findings, results of pulmonary function tests, and histological findings. For histological diagnosis, video-assisted thoracoscopic biopsy and transbronchial lung biopsy are used. In order to identify ILD associated with connective tissue disease, autoimmune antibody tests may also be necessary. Many biomarkers associated with disease prognosis have been recently discovered, and future research on their clinical significance is necessary. The diagnosis of ILD is difficult because patterns of ILD are both complicated and variable. Therefore, as with other diseases, accurate history taking and meticulous physical examination are crucial.

• Tuberculosis and Respiratory Diseases
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• 제85권1호
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• pp.11-17
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• 2022

Background: In asthma, consistent control of chronic airway inflammation is crucial, and the use of asthma-controller medication has been emphasized. Our purpose in this study is to compare the incidence of acute exacerbation and healthcare costs related to the use of asthma-controller medication. Methods: By using data collected by the National Health Insurance Review and Assessment Service, we compared one-year clinical outcomes and medical costs from July 2014 to June 2015 (follow-up period) between two groups of patients with asthma who received different prescriptions for recommended asthma-controller medication (inhaled corticosteroids or leukotriene receptor antagonists) at least once from July 2013 to June 2014 (assessment period). Results: There were 51,757 patients who satisfied our inclusion criteria. Among them, 13,702 patients (26.5%) were prescribed a recommended asthma-controller medication during the assessment period. In patients using a recommended asthma-controller medication, the frequency of acute exacerbations decreased in the follow-up period, from 2.7% to 1.1%. The total medical costs of the controller group decreased during the follow-up period compared to the assessment period, from $3,772,692 to $1,985,475. Only 50.9% of patients in the controller group used healthcare services in the follow-up period, and the use of asthma-controller medication decreased in the follow-up period. Conclusion: Overall, patients using a recommended asthma-controller medication showed decreased acute exacerbation and reduced total healthcare cost by half.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제26권5호
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• pp.277-283
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• 2023

Purpose: Cow's milk protein allergy (CMPA) is a common condition in infants, but little is known about healthcare providers' clinical experience treating infants with CMPA. To address this gap, we analyzed prospectively collected data from healthcare providers (HCPs) who treated infants under six months old with suspected CMPA using hypoallergenic formulas. The study focused on a commercial extensively hydrolyzed formula containing Lactobacillus rhamnosus GG (ATCC53103) (eHF-LGG) or a commercial amino acid formula (AAF). Methods: In this secondary analysis of prospectively collected survey data, 52 HCPs treated 329 infants under six months old with suspected CMPA using hypoallergenic formulas. A series of two de-identified surveys per patient were collected by HCPs to assess short-term symptom relief in the patients and HCP's satisfaction with the management strategies. The initial survey was completed at the initiation of treatment of CMPA, and the second survey was completed at a follow-up visit. Results: The majority of HCPs (87%) in the study were general pediatricians, and most saw 2 to 10 CMPA patients weekly. Results showed that clinicians reported satisfaction with treatment in 95% of patients in the EHF cohort and 97% of patients in the AAF cohort and achieved expected clinical results in 93% and 97% of patients using eHF and AAF, respectively. Furthermore, few patients were switched from the hypoallergenic formula once initiated. Conclusion: The study provides new insights into HCP perspectives on treating infants with CMPA and supports using hypoallergenic formulas to manage this condition. However, additional prospective controlled studies are needed to confirm these initial findings.