• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권4호
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• pp.236-243
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• 2017

Purpose: Studies on the efficacy of infliximab (IFX) in a large population of pediatric patients with Crohn's disease (CD) are limited, and prognostic factors are not well-known. The aim of this study was to evaluate outcomes of IFX in pediatric patients with CD and to identify factors associated with poor prognosis. Methods: We retrospectively analyzed medical data of 594 pediatric patients with CD between 1987 and 2013 in a tertiary center. Of these, 156 children treated with IFX were enrolled and were followed up for at least a year with intact data. Outcomes of induction and maintenance, classified as failure or clinical response, were evaluated on the tenth and 54th week of IFX therapy. Results: We treated 156 pediatric patients with CD with IFX, and the median duration of IFX therapy was 47 months. For IFX induction therapy, 134 (85.9%) patients experienced clinical response on the 10th week. Among the 134 patients who showed response to induction, 111 (82.8%) patients maintained the clinical response on the 54th week. In multivariate analysis, low hematocrit (p=0.046) at the time of IFX initiation was associated with the failure of IFX induction. For IFX maintenance therapy, longer duration from the initial diagnosis to IFX therapy (p=0.017) was associated with maintenance failure on the 54th week. Conclusion: We have shown the acceptable outcomes of IFX in a large cohort of pediatric CD patients in Korea. Hematocrit and early introduction of IFX may be prognostic factors for the outcomes of IFX.

• 융합정보논문지
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• 제11권7호
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• pp.164-171
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• 2021

본 연구에서는 흡연자와 비흡연자를 대상으로 단기 금연 동안 실시하는 몸통 안정화 운동이 단기 금연자의 허파기능, 최대 산소 섭취량, 심장박동수, 회복 시간에 미치는 영향에 대해 알아보고자 하였다. 본 연구는 충남 소재 N대학교의 20대 남성 26명으로 흡연자 13명과 비흡연자 13명을 선정하였다. 대상자의 신체적 특성 파악 후 사전 측정 시 허파기능(FVC, SVC, MVV)과 최대 산소 섭취량를 측정하였으며 3일 간 심장박동수와 회복 시간을 측정하였다. 측정 후 3일 금연과 함께 몸통 안정화 운동 프로그램을 실시하였다. 사후 측정으로 허파기능과 최대 산소 섭취량을 측정하였고, 당일 운동 후 즉시 1일차, 2일차 3일차의 심장박동수, 회복 시간을 측정하였다. 본 연구의 자료는 SPSS(Statistical Package for the Social Sciences) Ver. 23.0 for windows를 이용하여 분석되었다. 몸통 안정화 운동이 흡연자와 비흡연자의 심장허파기능에 미치는 영향을 분석한 결과, 흡연자 집단과 비흡연자 집단 모두 운동 전후 허파기능(FVC, SVC, MVV), 최대산소섭취량, 회복 시간에 유의한 차이가 나타났다. 이는 몸통 안정화 운동이 짧은 기간이라도 비흡연자뿐만 아니라 단기 금연자의 심장허파기능에 긍정적인 영향을 미칠 수 있는 것으로 생각되며, 금연 활동을 더한 몸통 안정화 운동이 심장허파기능 감소 예방 및 향상을 위한 더욱 안전하고 효과적인 방법이 될 수 있을 것으로 사료된다.

• Tuberculosis and Respiratory Diseases
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• 제40권3호
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• pp.283-291
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• 1993

연구배경 : 장기간의 저농도 산소요법은 저산소혈증을 가진 만성폐쇄성폐질환 환자들의 생존율을 향상시킬 뿐만 아니라 삶의 질을 향상시킨다. 저자들은 재택산소요법을 시행하는 환자의 실태를 알아보고 효과적인 개선책을 알아보기 위하여 추적관찰중인 환자 26예에 대한 임상적 관찰을 하였다. 방법 : 대상환자는 경북대학병원 호흡기내과에서 진료를 받고 있는 환자 가운데 가정에서 장기간의 저농도 산소요법을 시행하고 있는 남자 18명 여자 8명 이었으며 재택산소요법을 시행하기전에 신체적 특성과 병력, 폐기능검사, 심전도, 동맥혈가스 및 말초 혈액검사 소견들과 사용중인 산소용기의 종류, 하루에 흡입하는 시간, 투여산소의 농도, 그리고 사용기간 및 문제점 등에 대해서 조사하였다. 결과 : 원인질환은 만성폐쇄성폐질환 14예, 중증폐결핵의 후유증 9예, 기관지확장증 2예 그리고 특발성 폐섬유증 1예였다. 산소치료의 시행동기는 폐성심이 21예, 운동시 호흡곤란 및 심한 환기장애 4예, 그리고 수면중 산소포화도가 90%미만인 경우가 1예였다. 치료시작전의 동맥혈가스소견의 평균치는 $PaO_2$ 57.7 mmHg, $PaCO_2$ 48.2 mmHg 및 $SaO_2$ 87.7% 였으며 폐활량의 평균치는 VC 2.05 L, $FEV_1$ 0.92 L, $FEV_1$/FVC% 51.9%였다. 사용중인 산소용기는 산소탱크를 사용하는 경우가 19예, 산소농축기를 사용하는 경우가 1예, 산소탱크와 액화산소를 함께 사용하는 경우가 2예, 그리고 산소탱크와 휴대용산소를 함께 사용하는 경우 4예였다. 산소사용 기간은 1년 미만이 3예, 1년에서 2년이 15예, 3년에서 5년이 6예 그리고 9년, 10년 동안 산소요법을 시행한 경우도 각각 1예씩 있었다. 산소농도는 전예에서 2.5L/min 이하를 사용하고 있었고 하루 사용시간은 10예 만이 15시간 이상을 사용하였고 대부분이 짧은 시간 동안만 산소를 사용하고 있었다. 결론 : 효과적인 산소투여를 위해서는 환자 및 주위의 사람들에게 장기간의 저농도 산소요법에 대한 교육이 필요하며 편리하게 사용할 수 있는 산소용기의 구입을 위한 제도적 뒷받침이 필요하다.

• Journal of Chest Surgery
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• 제16권4호
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• pp.602-614
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• 1983

Six hundred fourteen consecutive cases of bioprosthetic cardiac valve replacement performed during the period from March 1976 through December 1982 were reviewed. A total of 748 tissue valves [534 Ionescu-Shiley valves, 144 Hancock valves, 46 Angell-Shiley, and 24 Carpentier-Edwards] were implanted in 610 patients. Of these, 477 had single valve replacements [403 mitral, 60 aortic, and 14 tricuspid] including three REDO MVR and one REDO AVR. The remaining 129 had double valve replacements [95 AVR and MVR and 34 MVR and TVR] and 8 had triple valve replacement.592 cases were evaluated. Overall early mortality rate [within 30 days of operation] was 7.1% [6.2% in single valve replacement, 10.2% in double valve replacement, and 16.7% in triple valve replacement]. Leading causes of mortality were low cardiac output or myocardial failure and ventricular arrhythmias. The follow-up period was from one month to 7 years with a cumulative follow-up of 906.6 patient-years [mean 1.53 years]. The late mortality was 1.6%, 3.9%, 0%, 2.6%, 6.6% and 2.0% per patient-year for MVR, AVR, TVR or triple valve replacement, AVR+MVR, MVR+TVR and total, respectively. Actuarial analysis of late results including early mortalities indicates an expected survival rate of 87.6+1.8% at 3 years and 85.92.4% at 7 years for all cases. We also analyzed actuarial survival rate between groups of each valve replacement [AVR, TVR, Double valve, and Triple valve] and the tissue valve groups in MVR. We experienced 7 cases [0.77% per patient-year] of confirmed endocarditis, two of which were fatal. Valve failure-free rates calculated according to the confirmed cases were 97.5% at 4 years, 87.5% at 7 years, and 88.3% at 6 years for Ionescu-Shiley, Hancock and Angell-Shiley valves, respectively. The occurrence rate of thromboembolism was 2.0% per patient-year in total cases, although almost all the patients were given anticoagulant therapy for one year. The occurring rate in MVR was 1.5% and 2.7% per patient-year for Ionescu-Shiley and Hancock valve groups, respectively. The difference in actuarial rate free from thromboemboli between Ionescu-Shiley and Hancock groups was statistically significant [P value less than 0.001]. Thromboembolic events beyond the period of anticoagulation therapy mainly occurred in patients with atrial fibrillation. The actuarial thromboemboli free survival was 95.71.4% at 3 years and 80.17.3% at 7 years. The incidence of hemorrhagic complications was 1.2% per patient-year [fatality 0.55% per patient-year] for anticoagulated patients. Although our clinical data favorably compares with results from other reports, our results suggest that anticoagulant therapy be given on a short-term basis or not at all to hemodynamically stable patients. Long-term therapy with antiplatelet drugs is probably inevitable with patients who have thromboembolic risk factors [such as atrial fibrillation].

• Journal of Periodontal and Implant Science
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• 제30권2호
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• pp.305-324
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• 2000

This study compared the short-term(4 months) clinical results of regenerative therapy with bioabsorbable membranes($BioMesh^{(R)}$) and bone allograft for the treatment of periodontal(intrabony and furcation) defects in smokers and nonsmokers.(16 smokers) 32 subjects with 92 defects participated in the study(46 in smokers and 46 in non-smokers). This study also evaluated a bioresorbable barrier with and without decalcified freeze-dried bone allograft(DFDBA). The 92 periodontal defects were randomly treated with either the resorbable barrier alone or resorbable barrier in combination with DFDBA following thorough defect debridement and root preparation with tetracycline. Each patient received both types of treatment modalities. Clinical examinations(probing depth, gingival recession, clinical attachment level, plaque index and gingival index) were carried out immediately before and 4 months after surgery. Significant(p<0.001) gains in mean attachment level were observed for both smokers(2.93mm) and non-smokers(3.30mm) but there were not significant difference between two groups. Similarly, significant reductions in mean probing depthshowed for smokers(4.52mm) and non-smokers(4.26mm). However, when comparing gingival recession, smokers were found to exhibit significantly poorer treatment results(1.59mm vs 0.96mm, p<0.05). Using the split-mouth-design, no statistically significant difference between the two modalities could be detected with regard to pocket depth reduction, gingival recession, or attachment gain. These results illustrate that the attachment gain is better in the non-smoker and the best in the non-smoker with the combination therapy of resorbable barrier and DFDBA than with resorbable barrier alone but smoking had no significant effect on clinical treatment outcome, even though smokers show more significant gingival recession. In addition, both treatments, either resorbable barrier plus DFDBA or resorbable barrier alone, promoted significant resolution of periodontal defects but the addition of DFDBA with a bioabsorbable membrane appears to add no extra benefit to the only membrane treatment.

• 대한간호학회지
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• 제39권6호
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• pp.829-839
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• 2009

Purpose: The purpose of this study was to determine the effects of music therapy and rhythmic exercise on health related quality of life, blood pressure and upper extremity muscle strength in the institution-dwelling elderly women. Methods: The study was designed using a nonequivalent control group pretest-posttest design. The participants consisted of 35 elders (18 in the experimental group and 17 in the control group). The music therapy and rhythmic exercise were developed by the investigators. The experimental group took part in this program twice a week for 8 weeks. The Short Form 36 health survey questionnaire, blood pressure and grasp power scale were used as instruments. The data were analyzed using SPSS 14.0. Results: Repeated measures ANOVA revealed that music therapy and rhythmic exercise had positive effects on quality of life, especially on vitality, general health and mental health. Also, there were statistically significant differences in diastolic blood pressure and upper extremity muscle strength between the pretest and posttest in the experimental group. Conclusion: The study suggests that this program can be applied for older women in long-term facilities to improve quality of life, blood pressure and upper extremity muscle strength.

• 융합정보논문지
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• 제10권3호
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• pp.176-184
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• 2020

본 연구는 집단놀이치료가 발달장애아동의 문제행동 감소에 효과가 있는지 알아보고 위하여 연구를 실시하였다. 연구대상은 특수학교에 재학 중이며 장애인 단기보호센터를 이용하는 장애아동 5명이다. 연구기간은 2018.1. 2. - 2. 28. 까지 겨울방학을 활용하여 매주 2회 40분씩 총 12회기를 실시하였으며 측정도구는 문제행동 진단척도(K-CBCL)로 매 회기마다 행동변화를 질적으로 관찰하였다. 본 연구결과를 요약하면 다음과 같다. 첫째, 회기별 과정에서 장애아동들은 공격성, 위축, 우울, 불안 등이 유의미하게 감소하고 활동적이 모습이 증가하였다. 둘째, 집단놀이치료 개입 후 문제행동이 감소하고 외현화 문제보다 내재화 문제에서 더 많은 감소를 보였다. 본 연구의 결과는 집단놀이치료는 장애아동의 개별적인 특성에 따라 문제행동을 감소시키는데 의미가 있으므로 실천현장에 적용하고자 한다.

• 국제물리치료학회지
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• 제10권4호
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• pp.1921-1925
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• 2019

Background: Neurodynamic mobilization is divided into slider mobilization and tensioner mobilization. However, movement direction in neurodynamic mobilization has been overlooked in neurodynamic exercise program. Objective: To examine the effect of movement direction in neurodynamic mobilization on upper limb mobility and pain. Design: Quasi-experimental study Methods: Twenty-two adults positive for neurodynamic test for the median nerve were recruited for participation in this study. Twenty-two subjects were allocated to the applied neurodynamic mobilization at limited side group (ANTLS, n=7), the applied neurodynamic mobilization at contralateral limited side group (ANTCLS, n=7), and the applied neurodynamic mobilization at bilateral side group (ANTBS, n=8). Before the intervention upper limb limited was measured neurodynamic test for the median nerve, pain was measured using visual analogue scale (VAS), movement direction in neurodynamic mobilization was applied to each group, and then re-measured using neurodynamic test for the median nerve and VAS. Differences the Intra-groups before and between the intergroups after intervention were analyzed. Results: In the ANTLS and ANTBS groups, a statistically significant increase in ROM and decrease in VAS score in the population before and after intervention were indicated. Statistically significant differences in VAS and ROM from before to after intervention were found among the ANTLS, ANTCLS, and ANTBS groups. Conclusions: The results of the present study indicate that movement direction in neurodynamic mobilization must be considered within the limits of its selected range of the neurodynamic exercise program.

• 인간식물환경학회지
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• 제21권6호
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• pp.557-564
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• 2018

Along with the aging society, the prevalence of dementia is also increasing. Dementia causes short-term memory loss as well as difficulties of performing daily activities and gradually causes suffering of the patients and their family. In spite of various programs for prevention of dementia of older people are being implemented, there is a lack of developing natural-based program for physical and mental health promotion. Therefore, it is necessary to develop programs for the elderly living alone who are more vulnerable to dementia because of their social and economic isolation. The purpose of this study was to develop a natural-based program and investigate the effects of 10 weeks forest therapy program for dementia prevention to improve the psychological and physical health of the elderly living alone. The experimental subjects were 30 elderly (aged 65 or older) and 31 elderly participated in control group. The Stress response, depressive symptoms, weight, body mass index (BMI), fat mass and muscle mass were measured for pre and post test. The results showed that the experimental group showed subjective stress relief (t=5.249, p=.000), improvement in symptoms of depression (t=4.152, p=.000), and decreases in weight (t=2.686, p=.012), BMI (t=2.629, p=.014) and fat mass (t=2.918, p=.007) after the forest therapy program. The experimental group showed lower stress reactions(t=-7.185, p=.000) and less depressive symptoms (t=-5.303, p=.000) than control group after participating the program. These results suggest that periodic forest exposure can help having less stressful and depressive status than non-forest exposure and the forest therapy program can reduce participants' psychological and physical risk factors of dementia.

• Physical Therapy Rehabilitation Science
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• 제10권1호
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• pp.1-9
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• 2021

Objective: Joint mobilization for arthrokinematics altered by the positional fault of chronic ankle instability (CAI) is an effective intervention for stabilization. In this study, we compared the effects of ankle dorsi flexion range of motion (DFROM) and dynamic balance ability (DBA) in CAI patients via passive joint mobilization (PJM), a method traditionally performed in previous studies, and active joint mobilization (AJM), a method that can have a greater effect on cortical excitability with spontaneous movements. Design: Single-blind two-arm randomized controlled trial Methods: A total of 30 participants were registered: 15 each to the PJM and AJM groups. Each participant received a total of 10 intervention sessions, 10 minutes per session, 5 times a week for 2 weeks. PJM used Maitland's mobilization method to apply joint mobilization with talus in the posterior direction and AJM used an angular joint motion to induce patient's voluntary motion of medial malleolus anterior gliding and lateral malleolus posterior gliding, respectively. DFROM of the ankle was measured by using tape and DBA was evaluated by using the balance system. Results: Significant improvement was observed after intervention in both the PJM and AJM groups except for the DBA-anterior and DBA-right variables of the PJM group. There were statistically significant differences between the AJM and PJM groups in the DFROM, DBA-anterior, DBA-posterior, and DBA-right variables. Conclusions: The overall improvement of DFROM and DBA was found to be more effective in joint mobilization including voluntary movement. When it is accompanied by voluntary movement, it further affects the neuromuscular system of the ankle.