• Journal of Preventive Medicine and Public Health
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• 제56권3호
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• pp.248-254
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• 2023

Objectives: Measuring the quality of care is paramount to inform policies for healthcare services. Nevertheless, little is known about the quality of primary care and acute care provided in Korea. This study investigated trends in the quality of primary care and acute care. Methods: Case-fatality rates and avoidable hospitalization rates were used as performance indicators to assess the quality of primary care and acute care. Admission data for the period 2008 to 2020 were extracted from the National Health Insurance Claims Database. Case-fatality rates and avoidable hospitalization rates were standardized by age and sex to adjust for patients' characteristics over time, and significant changes in the rates were identified by joinpoint regression. Results: The average annual percent change in age-/sex-standardized case-fatality rates for acute myocardial infarction was -2.3% (95% confidence interval, -4.6 to 0.0). For hemorrhagic and ischemic stroke, the age-/sex-standardized case-fatality rates were 21.8% and 5.9%, respectively in 2020; these rates decreased since 2008 (27.1 and 8.7%, respectively). The average annual percent change in age-/sex-standardized avoidable hospitalization rates ranged from -9.4% to -3.0%, with statistically significant changes between 2008 and 2020. In 2020, the avoidable hospitalization rates decreased considerably compared with the 2019 rate because of the coronavirus disease 2019 pandemic. Conclusions: The avoidable hospitalization rates and case-fatality rates decreased overall during the past decade, but they were relatively high compared with other countries. Strengthening primary care is an essential requirement to improve patient health outcomes in the rapidly aging Korean population.

• 사상체질의학회지
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• 제13권3호
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• pp.145-150
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• 2001

Aconitine has much Heat and Toxicity in its property, so many consideration is needed during its use. And there are many contraindications of its use. In the book of Dongyisusebowon, it has to be used when Soeumin has extreme Cold accompanied by Heat of deficiency type. In this case report, a 84 year-old male patient who had taken drugs containing Aconitine had severe Yin-Deficiency-Midday-Fever(陰虛午熱). And he had been treated with Sukjiwhanggosamtang(熟地黃苦參湯) and Dokwhaljiwhangtang(獨活地黃湯). Four conclusions can be made through this case. 1. Soyangin(少陽人) patients may have many side effects or adverse effects when they take drugs containing Aconitine even at a little volume. 2. Soyangin may have chest discomfort when they are constipated. This patient also complained chest discomfort after stroke and toxicosis of Aconitine. 3. Between Sukjiwhanggosamtang(熟地黃苦參湯) and Dokwhaljiwhangtang(獨活地黃湯), Sukjiwhanghosamtang is more effective for this patient who has been skin psoriasis and lower diabetes(下消) for a long time. 4. Although Sukjiwhanghosamtang does not include any antidote drug of Aconitine, it may be used only when defferenciation of symdrome is proper on Sasang Constituional Medicine.

• 대한융합한의학회지
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• 제6권1호
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• pp.29-36
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• 2024

Objectives: Psoriasis is a common chronic inflammatory skin disease characterized by keratinocyte hyperproliferation and an excessive inflammatory response. Agents that can attenuate keratinocyte hyperproliferation and excessive inflammatory responses are considered potentially useful for the treatment of psoriasis. Daehwangmokdanpitang (DHMDPT) exhibits a broad range of bioactivities, including anti-proliferative and anti-inflammatory effects. This study aims to evaluate the anti-psoriatic potential of DHMDPT in vitro. Methods: HaCaT keratinocytes were stimulated with a mixture of IL-17A, IL-22, oncostatin M, IL-1α, and TNF-α (M5) to establish an in vitro psoriatic keratinocyte model. Cell viability was measured using the MTT assay. Quantitative real-time PCR (qRT-PCR) was performed to measure the mRNA levels of the hyperproliferative marker gene keratin 6 (KRT6) and inflammatory factors such as IL-6, TNF-α, and IL-23A. Additionally, chemokines including CCL5, CCL2, CCL20, and CXCL1 were measured by qRT-PCR. Results: DHMDPT attenuated M5-induced hyperproliferation, as indicated by a reduction in KRT6 expression in HaCaT keratinocytes. M5 stimulation significantly upregulated the mRNA levels of IL-6, TNF-α, and IL-23A. However, DHMDPT treatment attenuated the upregulation of IL-6 but not TNF-α or IL-23A. Additionally, DHMDPT inhibited the expression of CCL5, CCL2, and CXCL1, but not CCL20. Conclusion: DHMDPT effectively attenuated the M5-induced proliferation and inflammatory response in HaCaT keratinocytes. Therefore, DHMDPT could be an attractive candidate for future development as an anti-psoriatic agent.

• Korean Circulation Journal
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• 제53권8호
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• pp.499-518
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• 2023

Cardiovascular diseases (CVDs), including coronary artery disease, stroke, heart failure, and hypertension, are the global leading causes of death, accounting for more than 30% of deaths worldwide. Although the risk factors of CVDs have been well understood and various treatment and preventive measures have been established, the mortality rate and the financial burden of CVDs are expected to grow exponentially over time due to the changes in lifestyles and increasing life expectancies of the present generation. Recent advancements in metagenomics and metabolomics analysis have identified gut microbiome and its associated metabolites as potential risk factors for CVDs, suggesting the possibility of developing more effective novel therapeutic strategies against CVD. In addition, increasing evidence has demonstrated the alterations in the ratio of Firmicutes to Bacteroidetes and the imbalance of microbial-dependent metabolites, including short-chain fatty acids and trimethylamine N-oxide, play a crucial role in the pathogenesis of CVD. However, the exact mechanism of action remains undefined to this day. In this review, we focus on the compositional changes in the gut microbiome and its related metabolites in various CVDs. Moreover, the potential treatment and preventive strategies targeting the gut microbiome and its metabolites are discussed.

• Korean Journal of Radiology
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• 제2권4호
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• pp.183-191
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• 2001

Objective: To document the signal characteristics of intracerebral hemorrhage (ICH) at evolving stages on diffusion-weighted images (DWI) by comparison with conventional MR images. Materials and Methods: In our retrospective study, 38 patients with ICH underwent a set of imaging sequences that included DWI, T1-and T2-weighted imaging, and fluid-attenuated inversion recovery (FLAIR). In 33 and 10 patients, respectively, conventional and echo-planar T2^* gradient-echo images were also obtained. According to the time interval between symptom onset and initial MRI, five stages were categorized: hyperacute (n=6); acute (n=7); early subacute (n=7); late subacute (n=10); and chronic (n=8). We investigated the signal intensity and apparent diffusion coefficient (ADC) of ICH and compared the signal intensities of hematomas at DWI and on conventional MR images. Results: DWI showed that hematomas were hyperintense at the hyperacute and late subacute stages, and hypointense at the acute, early subacute and chronic stages. Invariably, focal hypointensity was observed within a hyperacute hematoma. At the hyperacute, acute and early subacute stages, hyperintense rims that corresponded with edema surrounding the hematoma were present. The mean ADC ratio was 0.73 at the hyperacute stage, 0.72 at the acute stage, 0.70 at the early subacute stage, 0.72 at the late subacute stage, and 2.56 at the chronic stage. Conclusion: DWI showed that the signal intensity of an ICH may be related to both its ADC value and the magnetic susceptibility effect. In patients with acute stroke, an understanding of the characteristic features of ICH seen at DWI can be helpful in both the characterization of intracranial hemorrhagic lesions and the differentiation of hemorrhage from ischemia.

• Earthquakes and Structures
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• 제27권1호
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• pp.1-15
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• 2024

In order to enhance the seismic performance of base-isolated structures on soft foundations, the hybrid system of base-isolated system (BIS) and shape memory alloy inerter (SMAI), referred to as BIS+SMAI, is for the first time here proposed. Considering the nonlinear hysteretic relationships of both the isolation layer and SMA, and soil-structure interaction (SSI), the equivalent linearized state space equation is established of the structure-BIS+SMAI system. The displacement variance based on the H₂ norm is then formulated for the structure with BIS+SMAI. Employing the particle swarm optimization, the optimization design methodology of BIS+SMAI is presented in the frequency domain. The evolvement rules of BIS+SMAI in the effectiveness, robustness, SMA driving force, inertia force, stroke, and damping enhancement effect are revealed in the frequency domain through changing the inerter-mass ratio, structural height, aspect ratio, and relative stiffness ratio between the soil and structure. Meanwhile, the validation of BIS+SMAI is conducted using real earthquake records. Results demonstrate that BIS+SMAI can effectively reduce the isolation layer displacement. The inerter can significantly increase the hysteretic displacement of SMA and thus enhance its energy dissipation capacity, implying that BIS+SMAI has better effectiveness than BIS+SMA. Although BIS+SMAI and BIS+ tuned inerter damper (TID) have practically the same effectiveness, BIS+SMAI has the lower optimum damping, significantly smaller inertia force, and higher robustness to perturbations of the optimum parameters. Therefore, BIS+SMAI can be used as a more engineering realizable hybrid system for enhancing the performance of base-isolated structures in soft soil areas.

• Korean Circulation Journal
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• 제52권10호
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• pp.755-767
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• 2022

Background and Objectives: Cryoballoon catheter ablation for the treatment of patients with symptomatic atrial fibrillation (AF) has been adopted globally, but there are limited multicenter reports of 12-month outcomes in the Korean patient population. This analysis evaluated the clinical performance and safety of cryoballoon ablation (CBA) according to standard-of-care practices in Korea. Methods: This evaluation of Korean patients with AF was conducted within the larger Cryo Global Registry, which is a prospective, multicenter, post-market registry. Freedom from a ≥30-second recurrence of atrial arrhythmias (after a 90-day blanking period until 12 months) and procedural safety were examined in subjects treated with CBA at 3 Korean centers. Results: Overall, 299 patients with AF (60±11 years old, 24.7% female, 50.5% paroxysmal AF) underwent CBA using the Arctic Front Advance cryoballoon. Of those, 298 were followed-up for at least 12 months. Mean procedure-, left atrial dwell- and fluoroscopy time was 76±21 minutes, 56±23 minutes, and 27±23 minutes, respectively. Freedom from AF recurrence at 12 months was 83.9% (95% confidence interval [CI], 76.9-88.9%) in the paroxysmal and 61.6% (95% CI, 53.1-69.0%) in the persistent AF cohort. Rhythm monitoring was performed on average 4.7±1.4 times during the follow-up period. Serious device- or procedure-related adverse events occurred in 2 patients (0.7%). The 12-month Kaplan-Meier estimate of freedom from repeat ablation and cardiovascular-related hospitalization was 93.8% (95% CI, 90.4-96.1%) and 89.7% (95% CI, 85.6-92.7%), respectively. Conclusions: CBA is an efficient, effective, and safe procedure for the treatment of AF patients when used according to real-world practices in Korea.

• 디지털융복합연구
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• 제13권11호
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• pp.149-156
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• 2015

식생활의 변화로 인하여 고혈압, 심장병, 뇌출혈, 암 질환 등 다양한 질환을 앓고 있는 환자들이 점점 증가하고 있다. 그러나, 병원에서는 환자 치료에 앞서 환자들이 의료 서비스를 제공받기 위해서는 많은 병원 행정 업무를 처리해야 한다. 본 논문에서는 다양한 질환을 앓고 있는 환자 중 체내삽입장치를 부착한 환자를 대상으로 체내삽입장치에 RFID 칩을 이식하여 환자가 병원에 외래왔을 경우 RFID 리더를 통해 환자를 자동인식하여 병원 행정업무 처리를 간소화함으로써 환자가 불편없이 의료 서비스를 제공받을 수 있는 m-헬스케어 서비스 모델을 제안한다. 특히, 제안 모델은 응급상황의 환자가 환자의 질병 종류 및 상태를 의료 담당자에게 알려주지 않아도 자동으로 환자의 상태 정보를 확인할 수 있도록 의료담당자의 진료시간을 단축함으로써 기존 의료 시스템의 업무 효율성을 향상시킨다. 실험결과, 서비스 지연시간, 업무 효율성, 환자의 의료 서비스 만족도 등에서 기존 의료 시스템과 비교 평가한 결과, 제안 모델은 기존 모델보다 서비스 지연시간은 평균 16.5% 향상되었고, 업무 효율성은 27% 높았으며, 환자의 서비스 만족도는 평균 22.4% 향상되었다.

• Journal of Oral Medicine and Pain
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• 제24권4호
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• pp.439-453
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• 1999

This study was performed to investigate the masicatory efficiency in patients with temporomandibular disorders (TMDs), especially internal derangement of temporomandibular (TM) joint. For this study, 26 patients after treatment and 33 dental students who had no signs and symptoms of TMDs were selected as the patients group and as the normal group, respectively. Mean treatment duration of the patients was. 5.1 months. Verbal rating scale(VRS) and Visual analogue scale(VAS) were used for recording of subjective symptoms. Treatment index (VAS Ti) derived from VAS was calculated for evaluation of treatment progress and clinical examination was also performed for objective symptoms. BioEGN(Bioresearch Inc., Milwaukee, USA) was used for observation chewing movement pattern on peanut, caramel candy, and gum chewing. Chewing time in second and symptoms after chewing were recorded, and pattern of chewing stroke between in affected side and in contralateral side or between in right in left side were compared, and especially, gum chewing pattern between before and after treatment were also compared in the patients group. The data obtained were analysed by SPSS windows program and the results of this study were as follows : 1. Subjective symptoms evaluated by VAS showed no difference between the two groups, but those by VRS showed slight difference for TM joint pain, head not neck symptoms, and chewing ability. 2. There were no difference at the level of subjective symptoms between the subgroups divided by treatment duration of five months in the patients group. However, value of VAS Ti of pain was higher in subgroup of long treatment duration than that of subgroup of short treatment duration. 3. There were no difference in chewing time for peanut or caramel candy between the two groups, but on caramel candy chewing, the patients group complained slight discomfort after swallowing. Chewing velocity and range of motion on gum chewing after treatment in the patients group showed significant difference and greatly improved compared to those to before treatment, and which were not differ from those of normal subjects. In conclusion, treatment of temporomandibular disorders about for five months would greatly improve chewing ability and movement pattern in most of the patients with TMDs.

• Journal of Korean Neurosurgical Society
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• 제54권6호
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• pp.467-476
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• 2013

Objective : This study aimed to evaluate the hypotheses that administration routes [intra-arterial (IA) vs. intravenous (IV)] affect the early stage migration of transplanted human bone marrow-derived mesenchymal stem cells (hBM-MSCs) in acute brain infarction. Methods : Male Sprague-Dawley rats (n=40) were subjected to photothrombotic infarction. Three days after photothrombotic infarction, rats were randomly allocated to one of four experimental groups [IA group : n=12, IV group : n=12, superparamagnetic iron oxide (SPIO) group : n=8, control group : n=8]. All groups were subdivided into 1, 6, 24, and 48 hours groups according to time point of sacrifice. Magnetic resonance imaging (MRI) consisting of T2 weighted image (T2WI), $T2^*$ weighted image ($T2^*WI$), susceptibility weighted image (SWI), and diffusion weighted image of rat brain were obtained prior to and at 1, 6, 24, and 48 hours post-implantation. After final MRI, rats were sacrificed and grafted cells were analyzed in brain and lung specimen using Prussian blue and immunohistochemical staining. Results : Grafted cells appeared as dark signal intensity regions at the peri-lesional zone. In IA group, dark signals in peri-lesional zone were more prominent compared with IV group. SWI showed largest dark signal followed by $T2^*WI$ and T2WI in both IA and IV groups. On Prussian blue staining, IA administration showed substantially increased migration and a large number of transplanted hBM-MSCs in the target brain than IV administration. The Prussian blue-positive cells were not detected in SPIO and control groups. Conclusion : In a rat photothrombotic model of ischemic stroke, selective IA administration of human mesenchymal stem cells is more effective than IV administration. MRI and histological analyses revealed the time course of cell migration, and the numbers and distribution of hBM-MSCs delivered into the brain.