• Journal of Chest Surgery
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• 제31권6호
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• pp.591-597
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• 1998

배경: 이 연구의 목적은 대동맥판막 치환술의 조기 및 중기의 결과를 분석하였다. 대상 및 방법 : 1986년 1월부터 1996년 1월까지 대동맥판막 치환술을 시행한 61명의 환자를 대상으로 하였다. 남자가 38명이었고 여자는 28명으로 남녀의 비는 1.7:1로 남자에 많았고 연령분포는 10세에서 71세까지로 평균 40.5$\pm$11.2세이었다. 조기 사망률은 4.9%(3/61)이었다. 전체적인 추적 관찰은 퇴원한 58명의 환자 중 93.1%에서 이루어 졌으며 평균 추적기간은 51.5 환자-달이었다. 결과: 퇴원한 환자 58명 중 3명이 사망하여 만기 사망률은 5.2 %이었다. 5명의 환자에서 항응고제에 관련된 출혈이 있었으나 모두 경미하였고 3명의 환자에서 혈전경색을 보였다. 용혈이나 사용된 판막의 구조적인 실패는 없었고, 생존한 환자 중 NYHA 기능등급은 의의있게 호전되었다. 혈전경색과 항응고제에 관련된 출혈률은 각각 1.58 % 환자-년, 2.0% 환자-년이었다. 10년 생존률은 83.6%를 보였다. 결론 : 조기 및 중기의 추적관찰에서 대동맥판막 치환술에 사용한 기계판막은 낮은 인공판막에 연관된 합병증과 훌륭한 혈역학적 기능을 보이고 신뢰성이 있으면서 내구성이 좋은 인공판막이라 할 수 있었다.

• 보건행정학회지
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• 제30권1호
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• pp.112-119
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• 2020

Suicide has been a long-standing problem for global public health, along with almost 800,000 deaths from suicide worldwide in 2016, accounting for 1.4% of all deaths. South Korea was ranked first in suicide mortality in 2018 among countries in the Organization for Economic Cooperation and Development. This study aimed to suggest up-to-date information about suicide-related indicators such as the rate of suicidal ideation, suicide attempt, and suicide death, and its trends by applying sampling weight to make it nationally representative. In this study, we used the data sources: Korea National Health and Nutrition Examination (KNHANES, '07-13, '15-18), Korean Community Health Survey (KCHS, '08-09, '13, '17), Korean Wealth Panel Study (KOWEPS, '12-18), Korea Health Panel Survey (KHP, '10-13), and Statistics Korea (1983-2017). The rate of suicidal ideation as recent year was 4.73% (KNHANES, '17), 6.96% (KCHS, '17), 2.29% (KOWEPS, '18), and 5.39% (KHP, '13). That of suicide attempt as recent year was 0.51% (KNHANES, '18), 0.32% (KCHS, '17), and 0.15% (KOWEPS, '18). Annual percentage change (APC) of suicidal ideation was -15.4% (KNHANES, '07-13, '15, '17), -2.5% (KCHS, '08-09, '13, '17), -10.8% (KOWEPS, '12-18), and -10.9% (KHP, '10-13). APC of suicide attempt was -4.4% (KNHANES, '07-13, '15-18), -4.4% (KCHS, '08-09, '13, '17), and -13.6% (KOWEPS, '12-18). APC of death by intentional self-harm was -1.25% (Statistics Korea, '07-18). All suicide-related indicators were found to be decreasing in the overall from 2009. Individuals with lower income level were more likely to experience suicidal ideation and suicide attempts. Even though suicide rate had been continuously decreasing from its highest point in 2011 (suicide rate: 31.7 per 100,000 population) to 2017 (suicide rate: 24.3 per 100,000 population), it increased again in 2018 (suicide rate: 26.6 per 100,000 population). This information would be grounded on policy implementation for suicide prevention, thus continuous data observation is necessary.

• Journal of Trauma and Injury
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• 제20권2호
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• pp.96-100
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• 2007

Purpose: Trauma is the 5th most common leading cause of death in Korea, but there has been no appropriate management system for patients until now. We analyzed the main causes of death in trauma patients by comparing the characteristics of those patients with the characteristics of patients who survived. We feel this analysis should have a positive effect on the development of an appropriate trauma management system in Korea. Methods: We retrospectively reviewed trauma patients who had been admitted to the Department of General Surgery from February 2002 to February 2007. We compared several expected risk factors between the mortality and the survival group. Data on the transportation, arrival time at the emergency center, amount of transfusion, initial shock index, cause of death, and initial physical condition according to RTS (Revised trauma score), ISS (Injury severity score) and TRISS (Trauma and Injury Severity Score) were collected. Patients with ISS lower than 12 were excluded. Results: Three hundred sixty-six(366) patients with multiple injuries were included. There were 40 patients in the mortality group and 326 patients in the survival group. The mean arrival time (minutes) to emergency center was longer in the mortality group (137.6 vs 93.6 p 0.04). The total amount of transfusion (ml) was larger in the mortality group (7139 vs 2470 p 0.01). The initial shock index was higher in the mortality group (1.45 vs 1.17 p<0.01). The RTS, ISS, and TRISS were not statistically different between the groups. In the multivariate analysis, mean arrival time and initial shock index were important factors for survival. Conclusion: If the mortality rate of trauma patients is to be reduced, the arrival time at the emergency center should be minimized. Improvement of the emergency medical transfer service system is very important for achieving that.

• Oncology Letters
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• 제42권4호
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• pp.1621-1630
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• 2019

One million females are diagnosed worldwide every year with breast cancer, and the mortality rate of these patients remains high. Several treatments, including surgery, are available for breast cancer. β-Lapachone (β-Lap), a natural quinone compound, has been developed for cancer treatment due to its strong cytotoxic effect through its action on NAD(P)H:quinone oxidoreductase 1 (NQO1)-dependent activity. However, the mechanism in regards to how β-Lap induces cytotoxicity in breast cancer cells is still elusive. In the present study, we showed that β-Lap induced apoptotic cell death via activation of protein kinase A (PKA) in NQO1-overexpressing MDA-MB-231 human breast cancer cells. This PKA-dependent cell death was observed solely in NQO1-overexpressing 231 cells via the high production of reactive oxygen species (ROS). Cell survival of antioxidant [N-acetylcysteine (NAC)]-treated NQO1-overexpressing 231 cells was significantly recovered, and NQO1-negative 231 cells did not respond to β-Lap. Antiapoptotic proteins such as Bcl2 and Bcl-xL were decreased, while proapoptotic proteins, including cytochrome c, activation of caspase-3, and cleavage of PARP were increased after β-Lap treatment of NQO1-overexpressing 231 cells. Furthermore, PKA activators, forskolin or dibutyryl-cAMP, an analog of cAMP, aggravated the β-Lap-induced apoptotic cell death by decreasing antiapoptotic proteins and further activating proapoptotic proteins in NQO1-positive 231 cells. Treatment with a PKA inhibiter, H89, significantly increased cell viability even in NQO1-overexpressing cells treated with β-Lap. These data showed that β-Lap activated PKA via ROS accumulation, subsequently leading to apoptotic cell death in NQO1-positive breast cancer cells.

• Journal of Hospice and Palliative Care
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• 제7권1호
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• pp.37-48
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• 2004

목적: 보완대체요법을 이용하는 인구 및 비용이 전 세계적으로 꾸준히 늘고 있다. 젊은 인구에 비해 노인인구에서 이용량이 높을 것으로 생각된다. 본 연구에서는 노인사망자를 대상으로 사망전 6개월간의 보완대체요법 이용실태를 조사하고자 했다. 방법: 2001년 하반기동안 사망한 후 건강보험에서 장제비를 지급 받은 서울지역 65세 이상 노인 4210명을 선정하였다. 이들을 성별 연령별로 배열하여 14명씩 총 301군으로 구분하였고, 각 군에서 1명씩 선택하여(총 301명) 사망시 연령, 성별, 사망 원인질환, 보완대체요법에 대한 설문조사를 시행하였다. 보완대체요법은 심신조정요법, 한의학 관련요법, 한방민간요법, 식이 영양 요법, 수기신체 치료 요법, 약물요법, 에너지 요법으로 총 7가지 영역으로 구분하였다. 결과: 사망 전 6개월간 보완대체요법을 이용한 사망자는 247명으로 전체 대상자의 83.1%였다. 보완대체요법중 특히 식이 영양 요법의 이용률(65.5%)이 가장 높았고 약물요법(29.9%)도 많이 이용하였다. 성별과 사망원인에 따라 이용률에 유의한 차이를 보였는데 여성(60%)이 남성(40%)보다 높았고, 노인성 질환군(30.8%)이 가장 높고, 암인 군(16.8%)이 가장 낮았다. 보완대체요법의 전체 만족도와 부작용 점수를 보면 6점 만점에 평균 4.25점, 부작용은 평균 5.55점으로 부작용이 거의 없었다. 식이 영양요법의 만족도(평균4.41점)가 가장 높았고 수기신체치료요법(평균 3.38점)이 가장 낮았다. 수기신체치료요법에서 부작용이 가장 없었고(평균 5.88점), 한의학 관련요법의 부작용 점수가 가장 낮았다(평균 5.35점). 또한 연령과 사망원인 질병에 따라 만족도와 부작용 수준에 유의한 차이를 보였다. 결론: 65세 이상 노인의 대다수가 사망전 6개월간 보완대체요법을 이용하였으며 전체 만족도도 상당히 높고 부작용도 거의 없었다. 현실적인 대안을 마련하는 것이 필요하다.0.04{\pm}0.20$ P=0.1519), 우울 정도, 불안 정도, 스트레스 정도는 자가치료 순응도가 좋을수록 감소하는 경향을 보였으나, 통계적으로 유의하지는 않았다. 아로마 자가 치료군에서 수축기 혈압은 약간 증가하였으나 통계학적 의의는 없었다($4.53{\pm}14.43mmHg\;vs\;0.0{\pm}7.22mmHg$, P=0.152). 자가 치료군에서 환자들은 두통(20%), 감각이상(6.7%), 오심(6.7%) 등의 부작용을 호소했으나, 이들 모두 일시적인 것으로 자가치료를 중단할 정도는 아니었다. 결론: 유방암 환자들에게 아로마 손 마사지 교육을 시킨 후 자기 스스로 2주간 시행한 결과, 통증강도, 우울 및 불안 정도가 의미 있게 감소하였다.임의 유무와 이유에 대해서는, '망설이지 않았다'(34명)가 '망설였다'(6명)보다 높게 나타났다. 사별가족모임에 참석한 후의 소감, 개선사항, 아쉬운 점에 대한 질문에는, 대부분의 응답자들이 '의미 있는 시간이었다', '사별가족에 대한 배려와 관심에 대해 감사한다.'라는 긍정적인 응답이 있었고, '고인에 대한 회상을 할 수 있는 자리여서 좋았다.' '사별가족모임이 일년에 한 번이 아니라 계속적으로 있었으면 한다.', '한편은 슬프고 한편은 기쁘다.' 등의 의견이 있었다. 사별 후 느끼는 가장 큰 어려움에 대해 참석가족은, '우울감'(10명), '외로움'(7명)의 빈도가 높았고, '그리움'(1명), '경제적/역할상 어려움'(4명), 무응답(6명)으로, '우울감'이 가장 큰 어려움으로 나타났다. 반면에, 비참석 가족에서는, 가장 큰 어려움은 '경제적/역할상 어려움'(6명), '외로움'(5명), '우울감'(3명), '후회감'(1명), '고인에 대한 원망감'(1명), '특별히 어려움이 없다'(1명)라고 답하였다. 결론: 호스피스 서비스를

• 한국동물생명공학회지
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• 제34권3호
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• pp.166-172
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• 2019

Heart rate is a relatively simple and non-invasive method that is used as an important physiological indicator in many studies and has a close relationship with heart structure and function, cardiovascular disease and sudden cardiac death. In general, appropriately low heart rate during resting means effective heart function and cardiovascular fitness; heart rate at recovery is an important indicator of health and disease condition. We found a beagle dog (Dog_1) with a high heart rate in the previous preliminary experiment. Therefore, purpose of this study was to compare the heart rate response of the Dog_1 with the control group during 12 weeks of interval exercise, to evaluate the structural and functional abnormalities of the heart and to verify the applicability of exercise program. Heart rate was checked during 12 weeks of interval exercise, and after the exercise was over, imaging examination and hematological and serum biochemistry were performed. As a result, Dog_1 (165.6 ± 1.5) showed significantly higher heart rate in low intensity session of interval exercise than control group (133.3 ± 0.5, p < 0.01). In addition, Dog_1 (181.2 ± 1.4) showed significantly higher heart rate than control group (155.1 ± 0.9) in high intensity session (p < 0.01). The heart rate (30 sec, 60 sec) during recovery state was higher in Dog_1 (30 sec: 156.8 ± 4.0, 60 sec: 166.8 ± 5.8) than in the control group (30 sec: 111.2 ± 2.5, 60 sec: 104.0 ± 5.1, p < 0.01). The results of the imaging examination of Dog_1 with high heart rate confirmed that the heart had no functional and structural abnormalities. All beagles with the interval exercise program did not show maladjustment, and in the hematological and serum biochemistry results, all the parameter were within the reference range. If the interval exercise program of this study is used in the future, it is expected to be used as an important basic data to achieve the purpose of health, welfare, and physical fitness improvement of dogs.

• Journal of Preventive Medicine and Public Health
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• 제47권1호
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• pp.47-56
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• 2014

Objectives: The purpose of this study was to investigate the current status of and problems with the Safe Community Programs in Gangbuk-gu, one of the 25 districts of the capital city of Korea. Methods: The study subjects were 396 individuals who were involved in Safe Community Programs between 2009 and 2011. We examined the effectiveness and willingness of respondents to participate as a safety leader of the Safe Community Program with a questionnaire. We examined the injury death rates of Gangbuk-gu by using of the death certificate data of Korea's National Statistical Office. Descriptive statistics and chi-squared tests were used. Results: The effectiveness of programs did not differ but active participation differed significantly among subjects (p<0.05). The injury death rate of Gangbuk-gu as a whole increased during the implementation period. However, senior safety, in particular, may be a helpful program for reducing injuries in Gangbuk-gu. Conclusions: This study suggests that the lack of active participation may be a major problem of Safe Community Programs in Gangbuk-gu. Therefore, Safe Community Programs should be expanded to the entire district of Gangbuk-gu and more active participation programs should be developed.

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 2005년도 춘계학술대회
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• pp.53-60
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• 2005

Parkinson's disease (PD) is a progressive neurodegenerative disorder affecting $1\%$ of the population above the age of 65 and is characterized by a selective loss of dopaminergic neurons in the substantia nigra pars compacta. Although the underlying cause of dopaminergic cell death or the mechanism by which these cells degenerate is still not clearly understood, oxidative stress, mitochondrial dysfunction, and protein misfolding are thought to play important roles in the dopaminergic degeneration in PD. Tetrahydrobiopterin (BH4) is synthesized exclusively in the monoaminergic, including dopaminergic, cells and serves as an endogenous and obligatory cofactor for syntheses of the potential oxidative stressors dopamine and nitric oxide. In addition to its contribution toward the syntheses of these two potentially toxic molecules, BH4 itself can directly generate oxidative stress. BH4 undergoes oxidation during the hydroxylation reaction as well as nonenzymatic autooxidation to produce hydrogen peroxide and superoxide radical. We have previously suggested BH4 as an endogenous molecule responsible for the dopaminergic neurodegeneration. BH4 exerts selective toxicity to dopamine-producing cells via generation of oxidative stress, mitochondrial dysfunction, and apoptosis. BH4 also induces morphological, biochemical, and behavioral characteristics associated with PD in vivo. BH4 as well as enzyme activity and gene expression of GTP cyclohydrolase I, the rate-limiting enzyme in BH4 synthesis pathway, are readily upregulated by cellular changes such as calcium influx and by various stimuli including stress situations. This points to the possibility that cellular availability of BH4 might be increased in aberrant conditions, leading to increased extracellular BH4 subsequent degeneration. The fact that BH4 is specifically and endogenously synthesized in dopaminergic cells, Is readily upregulated, and generates oxidative stress-related cell death provides physical relevance of this molecule as an attractive candidate with which to explain the mechanism of pathogenesis of PD.

• 한국정보통신학회논문지
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• 제14권11호
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• pp.2423-2428
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• 2010

현대 사회는 기술의 발전에 따라 다양한 분야에서 급격히 발전을 이루고 있으며, 자동치 또한 예외가 아니다. 또한 자동차의 수가 늘어가면서 그에 따라 문제점도 많이 발생하고 있는데, 자동차 개체수의 증가와 더불어 가장 큰 문제는 자동차 사고로 인한 재산 및 인명피해가 급격하게 증가하는 것이다. 자동차 사고 시 빈번하게 발생하고 있는 운전자의 의식불명에 따른 초기 응급조치 미흡, 뺑소니 등으로 발생하는 2차 교통사고를 방지하기 위해 블랙박스 기반의 차량용 응급상황 감지 및 통보시스템이 필요하게 되었다. 본 논문에서는 사고감지, 정보분석 및 정보운용기술을 바탕으로 기존의 블랙박스보다 차량상황 감지의 정확성을 높였으며, 현재 높은 보급률을 보이는 스마트폰을 이용한 응급상황 감지 및 통보시스템을 설계 및 구현하였다.

• Clinical and Experimental Pediatrics
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• 제61권10호
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• pp.315-321
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• 2018

Purpose: To investigate the effectiveness of transient intubation for surfactant administration and extubated to nasal continuous positive pressure (INSURE) for treatment of respiratory distress syndrome (RDS) and to identify the factors associated with INSURE failure in extremely premature infants. Methods: Eighty-four infants with gestational age less than 28 weeks treated with surfactant administration for RDS for 8 years were included. Perinatal and neonatal characteristics were retrospectively reviewed, and major pulmonary outcomes such as duration of mechanical ventilation (MV) and bronchopulmonary dysplasia (BPD) plus death at 36-week postmenstrual age (PMA) were compared between INSURE (n=48) and prolonged MV groups (n=36). The factors associated with INSURE failure were determined. Results: Duration of MV and the occurrence of BPD at 36-week PMA were significantly lower in INSURE group than in prolonged MV group (P<0.05), but BPD plus death at 36-week PMA was not significantly different between the 2 groups. In a multivariate analysis, a reduced duration of MV was only significantly associated with INSURE (P=0.001). During the study period, duration of MV significantly decreased over time with an increasing rate of INSURE application (P<0.05), and BPD plus death at 36-week PMA also tended to decrease over time. A low arterial-alveolar oxygen tension ratio (a/APO2 ratio) was a significant predictor for INSURE failure (P=0.001). Conclusion: INSURE was the noninvasive ventilation strategy in the treatment of RDS to reduce MV duration in extremely premature infants with gestational age less than 28 weeks.