• 한국콘텐츠학회논문지
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• 제14권3호
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• pp.203-214
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• 2014

본 연구는 메타분석을 통해 뇌손상 환자를 대상으로 한 최근 연구들의 지역사회재활의 효과를 ICF 요소별로 알아보고, 최근 지역사회재활 프로그램 적용방법 등을 알아봄으로써 지역사회재활 프로그램의 개발 및 활성화를 위한 기초자료를 제시하고자 하였다. 선정기준에 적합한 논문은 총 15건을 ICF 요소별로 나누어 효과크기 값을 구하였으며 대상 논문들의 동질성 검정과 출판편견 검정을 실시하였다. 그 결과 지역사회 재활 프로그램의 전체 효과크기는 0.22였고, ICF 요소별 효과크기는 신체기능과 구조 0.21, 활동과 참여 0.20으로 작은(small) 효과크기를 보였다. 또한 메타분석에 포함된 연구들은 통계적 이질성이나 출판편견이 없는 것으로 간주되어 본 연구 결과는 객관적이고 신뢰할 수 있었다. 이러한 결과는 뇌손상 환자의 지역사회재활 프로그램이 ICF 요소들인 신체기능과 구조, 활동과 참여 요소에 대한 변화 정도 즉 개입 효과를 잘 설명해 주고 있음을 알 수 있었다.

• Clinical and Experimental Pediatrics
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• 제63권4호
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• pp.151-156
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• 2020

Background: Acute kidney injury (AKI) is one of the most significant postoperative complications of pediatric cardiac surgery. Because serum creatinine has limitations as a diagnostic marker of AKI, new biomarkers including neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and interleukin-18 (IL-18) are being evaluated to overcome these limitations and detect AKI at an early stage after cardiac surgery. Purpose: This study aimed to investigate the clinical usefulness of these biomarkers in young children. Methods: Thirty patients with congenital heart diseases who underwent cardiac surgery using cardiopulmonary bypass (CPB) were selected, and their urine and blood samples were collected at baseline and 6, 24, and 48 hours after surgery. Serum creatinine and blood urea nitrogen levels as well as NGAL, KIM-1, and IL-18 levels in urine samples were measured, and clinical parameters were evaluated. Results: Of the 30 patients, 12 developed AKI within 48 hours after cardiac surgery. In the AKI group, 8 of 12 (66.6%) met AKI criteria after 24 hours, and urine KIM-1/creatinine (Cr) level (with adjustment of urine creatinine) peaked at 24 hours with significant difference from baseline level. Additionally, urine KIM-1/Cr level in the AKI group was significantly higher than in the non-AKI group at 6 hours. However, urine NGAL/Cr and IL-18/Cr levels showed no specific trend with time for 48 hours after cardiac surgery. Conclusion: It is suggested that urine KIM-1/Cr concentration could be considered a good biomarker for early AKI prediction after open cardiac surgery using CPB in young children with congenital heart diseases.

• 한방재활의학과학회지
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• 제27권4호
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• pp.11-19
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• 2017

Objectives We attempted to investigate the trends of Korean Medical treatments for neck pain caused by whiplash injury by analyzing domestic clinical studies. Methods We searched for studies listed on Korean electronic databases (KTKP, OASIS, RISS, KMbase, NDSL, KCI, and National Assembly Library). Clinical studies were chosen according to the inclusion criteria. Subsequently, we compared and analyzed the data. Results The search yielded 35 studies, of which there were 12 randomized controlled trials (RCTs), 15 non-randomized controlled trials (NRCTs), 6 case reports, and 2 before-after studies. Among these, 54.7% of participants were in the acute stage of the damage period. Pharmacopuncture was used the most in main treatment methods. Only 14.3% of studies mentioned approval by an institutional review board (IRB) and only 8.6% of studies considered side effects. Conclusions There is some evidence that Korean Medical treatment is effective for neck pain caused by whiplash injury. Since all studies, however, were exposed to the risk of bias. Therefore, future studies of a higher quality are required.

• 생물정신의학
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• 제9권2호
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• pp.120-128
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• 2002

Objectives:The purpose of this study was to develop a cognitive rehabilitation program and to investigate the effect of the program that restores the deficiency of memory, which is necessary to operate on high cognitive function such as problem-solving or judgement, for TBI(traumatic brain injury) patients. Methods:Sixteen TBI patients participated in this study. The inclusion criteria were : 1) aged 18 to 60 ; 2) higher than IQ 80 ; 3) lower than MMSE-K 25 and K-MAS(Korean version of Memory Assessment Scale) 85. We administered our program to an experimental group(N=8) in order to improve attention and memory for 4 weeks(total 12 section). Our program was not administrated to a control group(N=8) for 4 weeks. After administrating this program, we measured MMSE-K and K-MAS for the experimental and control groups. Results:The findings of the study were as follows. 1) the experimental group showed significant improvement on MMSE-K score in comparison with baseline, but the control group did not. 2) the experimental group showed significant improvement on K-MAS score in comparison with baseline, but the control group did not. In particular, among the three subscales of K-MAS, only verbal memory scale revealed significant improvement, while visual and short-term memory scales revealed no differences. Conclusion:Our cognitive rehabilitation program improves cognitive state and memory, particulary verbal memory, for TBI patients. These results imply that our program aids in rehabilitation of basic cognition such as memory which is necessary to operate on high cognitive function such as problem-solving or judgement, for TBI(traumatic brain injury) patients.

• Childhood Kidney Diseases
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• 제22권2호
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• pp.52-57
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• 2018

Purpose: Rhabdomyolysis is a metabolic disorder in which the content of damaged muscle cells is released into plasma. Its manifestations include asymptomatic, myalgia, gross hematuria, and complications of acute kidney injury. Because of limited data on rhabdomyolysis in children, we performed this study to determine clinical characteristics of rhabdomyolysis in children. Methods: We retrospectively reviewed the records of patients with rhabdomyolysis who were treated at the Pusan National University Children's hospital from January 2011 to July 2016. The diagnostic criteria were serum myoglobin level of ${\geq}80ng/mL$, exclusive of acute myocardial injury, cardiac arrest, and brain damage. Results: Forty-five patients were enrolled; mean age, $116{\pm}68$ months. Of these, 35 were boys and 10 were girls. Twenty-six patients experienced myalgia and 12 patients showed gross hematuria. Among these, seven patients initially had both myalgia and gross hematuria. The most common causes of rhabdomyolysis were infection, physical exertion, prolonged seizures, metabolic abnormalities, and drug addiction. Acute kidney injury (AKI) was the most common complication, followed by disseminated intravascular coagulation. Thirty-seven patients improved with sufficient fluid supply but two patients underwent hemodialysis due to deterioration of kidney function. Gross hematuria, positive occult blood test, and positive urine protein were more common in patients with AKI than in those without AKI. Conclusions: In children, infection was the most common cause of rhabdomyolysis. Most patients recovered by sufficient fluid therapy. However, in severe cases, especially in patients with underlying kidney disease, hemodialysis may be necessary in the present study.

• Journal of Chest Surgery
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• 제49권1호
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• pp.15-21
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• 2016

Background: We aimed to evaluate the incidence, predictive factors, and impact of acute kidney injury (AKI) after thoracic endovascular aortic repair (TEVAR). Methods: A total of 53 patients who underwent 57 TEVAR operations between 2008 and 2015 were reviewed for the incidence of AKI as defined by the RIFLE (risk, injury, failure, loss, and end-stage kidney disease risk) consensus criteria. The estimated glomerular filtration rate was determined in the perioperative period. Comorbidities and postoperative outcomes were retrospectively reviewed. Results: Underlying aortic pathologies included 21 degenerative aortic aneurysms, 20 blunt traumatic aortic injuries, six type B aortic dissections, five type B intramural hematomas, three endoleaks and two miscellaneous diseases. The mean age of the patients was $61.2{\pm}17.5years$ (range, 15 to 85 years). AKI was identified in 13 (22.8%) of 57 patients. There was an association of preoperative stroke and postoperative paraparesis and paraplegia with AKI. The average intensive care unit (ICU) stay in patients with AKI was significantly longer than in patients without AKI (5.3 vs. 12.7 days, p=0.017). The 30-day mortality rate in patients with AKI was significantly higher than patients without AKI (23.1% vs. 4.5%, p=0.038); however, AKI did not impact long-term survival. Conclusion: Preoperative stroke and postoperative paraparesis and paraplegia were identified as predictors for AKI. Patients with AKI experienced longer average ICU stays and greater 30-day mortality than those without AKI. Perioperative identification of high-risk patients, as well as nephroprotective strategies to reduce the incidence of AKI, should be considered as important aspects of a successful TEVAR procedure.

• Journal of Trauma and Injury
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• 제32권1호
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• pp.26-31
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• 2019

Purpose: Rhabdomyolysis (RB) is a syndrome characterized by the decomposition of striated muscles and leakage of their contents into the bloodstream. Acute kidney injury (AKI) is the most significant and serious complication of RB and is a major cause of mortality in patients with RB. Severe RB (creatine kinase [CK] ${\geq}5,000$) has been associated with AKI. However, early prediction is difficult because CK can reach peak levels 1-3 days after the trauma. Hence, the aim of our study was to identify predictors of severe RB using initial patient information and parameters. Methods: We retrospectively analyzed 1,023 blunt trauma patients admitted to a single tertiary hospital between August 2011 and March 2018. Patients with previously diagnosed chronic kidney disease were excluded from the study. RB and severe RB were defined as a CK level ${\geq}1,000U/L$ and ${\geq}5,000U/L$, respectively. The diagnosis of AKI was based on RIFLE criteria. Results: The overall incidence of RB and severe RB was 31.3% (n=320) and 6.2% (n=63), respectively. On multivariable analysis, male sex (odds ratio [OR] 3.78, 95% confidence interval [CI] 1.43 to 10.00), initial base excess (OR 0.85, 95% CI 0.80 to 0.90), initial CK (OR 2.07, 95% CI 1.67 to 2.57), and extremity abbreviated injury scale score (OR 1.78, 95% CI 1.39 to 2.29) were found to predict severe RB. The results of receiver operating characteristic analysis showed that the best cutoff value for the initial serum CK level predictive of severe RB was 1,494 U/L. Conclusions: Male patients with severe extremity injuries, low base excess, and initial CK level >1,500 U/L should receive vigorous fluid resuscitation.

• 대한기관윤리심의기구협의회지
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• 제3권1호
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• pp.1-10
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• 2021

In 2004, India began investing in the clinical trial industry; the country now boasts a 20% market share with the help of a valuable resource - the world's second largest population. The Contract Research Organization has been able to generate profits efficiently conducting clinical trials via a large pool of participants, skilled researchers, and reduced developmental costs. As the demand and sheer number of global clinical trials increased, the International Council of Harmonization-Good Clinical Practice was introduced, and the need for the Institutional Review Board increased. While the clinical trial industry in India boomed, it came at the expense of the participants' civil rights. The increased media attention regarding the ethical issues forced the Indian Supreme Court to take action. Consequently, India is the only country, by law, that specifically compensates participants suffering from injury directly resulting from participation in clinical trials. This research paper will describe and compare the relevant laws of India and Korea including compensation criteria. In addition, the ethical issues and aspects of indemnity in clinical trials will be discussed. While the clear advantage of the compensation is one of the protected rights of a clinical subject, the current system is not perfect. Furthermore, laws created to redeem ethical issues can have unintended, negative consequences.

• Journal of Ginseng Research
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• 제46권1호
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• pp.11-22
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• 2022

Spinal cord injury (SCI) is defined as damage to the spinal cord that temporarily or permanently changes its function. There is no definite treatment established for neurological complete injury patients. This study investigated the effect of ginseng extract and ginsenosides on neurological recovery and antioxidant efficacies in rat models following SCI and explore the appropriate dosage. Searches were done on PubMed, Embase, and Chinese databases, and animal studies matches the inclusion criteria were selected. Pair-wise meta-analysis and subgroup analysis were performed. Ten studies were included, and the overall methodological qualities were low quality. The result showed ginseng extract and ginsenosides significantly improve neurological function, through the Basso, Beattie, and Bresnahan (BBB) locomotor rating scale (pooled MD = 4.40; 95% CI = 3.92 to 4.88; p < 0.00001), significantly decrease malondialdehyde (MDA) (n = 290; pooled MD = -2.19; 95% CI = -3.16 to 1.22; p < 0.0001) and increase superoxide dismutase (SOD) levels (n = 290; pooled MD = 2.14; 95% CI = 1.45 to 2.83; p < 0.00001). Both low (<25 mg/kg) and high dosage (25 mg/kg) showed significant improvement in the motor function recovery in SCI rats. Collectively, this review suggests ginseng extract and ginsenosides has a protective effect on SCI, with good safety and a clear mechanism of action and may be suitable for future clinical trials and applications.

• 한국산림과학회지
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• 제85권4호
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• pp.577-585
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• 1996

대기오염과 산성우 피해를 평가하는 기준을 마련하고자, 인공산성연무(pH 2.5, 3.5 및 4.5)와 지하수(pH 6.5)를 쥐똥나무, 박태기나무, 무궁화 및 회화나무의 유묘에 처리하고 엽록소 함량, 엽피해 특성, 엽표면의 친수성을 조사하여 다음과 같은 결과를 얻었다. 1. 6월 12일 측정에서 쥐똥나무와 무궁화는 pH 2.5처리구에서 엽록소 함량이 가장 높았고, 박태기나무와 회화나무는 상대적으로 낮았다. 9월 1일 측정에서 쥐똥나무는 pH 2.5처리구에서 엽록소 함량이 가장 높았고 박태기나무, 무궁화, 회화나무에서는 대조구에서 가장 높았다. 2. 산성연무 처리에 따른 엽록소 함량의 변화는 수종에 따라 상이한 결과를 보였다. 3. 수종별 산성연무 처리가 계속되면서 모든 수종에서 처리산성연무의 pH값이 작아질수록 엽피해-피해엽수, 엽피해율, 피해엽면적 - 가 증가하는 경향이 뚜렷하였다. 4. 산성연무에 의한 활엽수 엽조직의 피해는 표피의 wettability에 의해 결정되는 것으로 판단된다. 표피에 떨군 물방울의 직경측정은 털이 없고 평활한 표면을 갖는 박태기나 회화나무 등의 수종에서는 산성우나 산성연무의 피해를 측정하는 기준으로 이용가능한 것으로 판단된다.