• Journal of Acupuncture Research
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• 제33권4호
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• pp.15-31
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• 2016

Objectives : The aim of this study is to review the instruments used to assess patient condition and the effects of Korean medical treatment for patients injured in traffic accidents in clinical studies in the Korean medical field published in South Korea. Methods : A literature study was performed, and clinical studies on patients injured in traffic accidents visiting Korean medical clinics or hospitals were examined. Data about chief complaints, tools used to assess either patients' condition or the effectiveness of Korean medical treatment, and time point of assessment were extracted. The studies were classified according to symptom. The use-frequency and the parent category of the assessment tools were also analyzed. Results : 78 studies were selected and classified into 5 categories based on the chief complaints, neck pain, lower back pain, headache, psychological symptoms and unspecified symptoms. Various scales were used to report the patient's pain severity, and functional or psychological status resulting from traffic accidents. Pain index, in particular VAS, was most frequently used and a few mechanical instruments and Korean medicinal assessment tools were mentioned. Conclusion : Most instruments used in Korean medicine clinical studies on patients injured in traffic accidents are self-reported tools. To assess both the patient's condition precisely and the effectiveness of Korean medical treatment on patients injured in traffic accidents, more appropriate and unified tools should be designed that consider pain, functional disability, psychological status and objective assessments measured by devices together.

• 대한족부족관절학회지
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• 제17권1호
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• pp.23-27
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• 2013

Purpose: The optimal management for ankle fracture in elderly patients remains controversial. This study was undertaken to review the results of surgical treatment of ankle fracture in the elderly and to compare with other studies. Materials and Methods: The participants in this study were 33 patients over the age of 65(average 71.5 years) who underwent surgical treatment of ankle fracture from January 2004 to December 2011. The study was a retrospective review of outcomes after open reduction and internal fixation (ORIF) of ankle fractures. To measure the clinical outcomes, we assessed postoperative complications, the pre- and post-operative mobility status, fracture union status, the time of fracture union and the AOFAS (American Orthopaedic Foot and Ankle Society) Ankle-Hindfoot scale. The level of patient satisfaction was also identified. Results: Delayed wound healing occurred in three patients(9.1%) but their wounds healed with repeated dressings without additional surgical treatment. Malunion occurred in one patient(3%). One patient(3%) had postoperative infection but healed with antibiotic treatment. 24 patients(96%) returned to preoperative mobility status. VAS score was lower than 2 in all patients. Bone union occurred with the 3.8 months (average months) after the surgery in all patients. Average AOFAS score was 87.4 and these were similar results as other studies of young patients. All patients were satisfied with surgical outcomes according to interviews. Conclusion: Surgical treatment of ankle fractures in the elderly can carry a significant risk of delayed wound healing and infection but incidence is relatively low. Internal fixation of ankle fractures in the elderly can be undertaken safely and the majority of patients can expect good outcome.

• Clinics in Shoulder and Elbow
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• 제14권1호
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• pp.117-124
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• 2011

목적: 골성 방카르트 병변의 여러 가지 치료 방법 중 관절경적 재건술에 대하여 문헌 고찰과 함께 대략적으로 설명하기로 한다. 대상 및 방법: 견관절 전방 불안정성의 치료에 있어 관절경적 복원술의 임상결과 향상으로 개방적 수술보다 관절경적 수술을 더욱 선호하게 되었고 점차 표준 치료법으로 인정받게 되었다. 그러나 관절와의 골 결손이 있는 경우 골 결손의 정도를 측정하는 방법은 연구자에 따라 다양하며 관절경적 복원술의 방법 또한 지속적 발전과 함께 다양하게 소개되고 있다. 결과: 골 결손의 관절경적 재건술 중 방카르트 병변의 이열 봉합술은 일열 봉합술의 단점을 보완하여 보다 견고한 고정과 해부학적 복원을 위해 최근에 소개되었으나 앞으로 많은 증례와 장기간 추시를 통해 그 결과가 입증되어야 할 것이다. 또한 관절경을 이용한 오구돌기 이전술, 즉 Bristow-Latarjet 술식 등 여러 가지 방법이 시도되고 있다. 결론: 전방 불안정성 환자의 관절경적 치료 방법은 다양하게 시도되고 있으며 지속적인 발전을 거듭하고 있다. 성공적인 결과를 얻기 위해서는 수술 전 환자의 골 결손 상태를 정확히 파악해야 하며 치료와 연관된 술 중, 술 후 요소들을 잘 알고 있어야 한다.

• 재활치료과학
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• 제4권1호
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• pp.7-17
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• 2015

목적 : 본 연구의 목적은 집중적 양손활동훈련을 편측 뇌성마비 아동에게 적용한 후 상지 재활 효과와 양손 협응 능력의 변화를 살펴본 연구에 대해서 분석하는 것이다. 연구방법 : 2004년부터 2014년 현재까지 국내 외 학회지에 게재된 논문을 RISS, Pubmed를 통해 검색하였다. 1, 2차 분류를 통해 총 6개의 실험연구 논문이 대상논문으로 선정되었다. 결과 : 선정된 6편의 문헌은 모두 국외 논문이었으며, PEDro score는 5점 이상으로 높은 편 이었다. 사용된 중재는 강제유도운동치료의 변형형태가 가장 많았으며, 상지기능과 양손 협응 측정 위한 평가도구로는 AHA와 JTTHF가 가장 많은 빈도를 보였고, 그 외 QUEST, ABILHAND-Kids, COPM, GAS, PEDI, 3-D movement kinematics가 중재효과의 다양한 측면을 평가하는데 사용되었다. 고찰 : 본 연구를 통하여 집중적 양손활동훈련이 편측 뇌성마비아동의 상지 기능뿐만 아니라 양손 협응에 긍정적인 영향을 준다는 것을 확인하였고, 더 나아가 양손 협응이 요구되는 대부분의 일상생활의 참여에 도움을 줄 수 있음을 알아보았다. 이와 같은 결과는 작업치료사로서 국내 임상가들에게 편측 뇌성마비 아동을 위한 새로운 중재방법의 기초자료를 제시하고, 효과적인 치료 접근법을 알려주는 데 도움이 될 것이다.

• Journal of Trauma and Injury
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• 제27권4호
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• pp.133-138
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• 2014

Purpose: If the survival of patients suffering from severe blunt trauma is to be improved, appropriate interventions should be taken immediately. The purpose of this study is to evaluate the clinical utility of end-tidal carbon dioxide ($ETCO_2$) as a surrogate marker for predicting both the need for intervention and the prognosis. Methods: This is a prospective observational study. Nasal cannula was applied to measure $ETCO_2$, and the following parameters, which are known to be related to the prognosis for a patient, were recorded: injury severity score (ISS), revised trauma score (RTS), arterial blood gas (ABG), lactate, and hemoglobin (Hb). To evaluate the outcome, we investigated the details of emergent interventions and expired patients. Results: A total of 93 patients were enrolled in this study. Emergent intervention was significantly associated with systolic blood pressure (sBP, p-value=0.001), $ETCO_2$ (p-value<0.001), serum lactate level (p-value<0.001), pH (p-value< 0.003), $HCO_3$ (p-value=0.004), base excess (p-value<0.002), ISS (p-value<0.001) and RTS (p-value=0.005). In the multivariate logistic regression, only $ETCO_2$ (odds ratio (OR): 0.897, 95% confidence interval (CI): 0.792-0.975, p-value= 0.048) and ISS (OR: 1.132, 95% CI: 1.053-1.233, p-value=0.002) were associated with emergent intervention whereas $ETCO_2$ (p-value=0.973) and ISS (p-value=0.511) were not statistically significant in predicting the survival of patients in the univariate analysis. An optimal ETCO cut-off of 29 mmHg on the ROC curve was determined, with the area under the ROC curve (AUC) being 0.824 (0.732-0.917)]. Conclusion: This study has revealed that $ETCO_2$, which can be rapid and easily measured through a nasal cannula, and the ISS may be prognostic indicators of emergent interventions in Emergency Departments.

• 환경영향평가
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• 제27권3호
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• pp.322-333
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• 2018

본 연구는 환경영향평가 제도 운영의 성과를 정량적으로 분석하기 위하여 화력발전소 대기질 분야에서 환경영향평가를 통한 환경영향 저감효과를 계량화하고 그로 인한 사회적 편익을 추정하였다. 환경영향평가의 성과는 제도의 시행여부에 따른 차이로 정의하고, 개별 사업이 환경영향평가를 시행하지 않더라도 준수해야하는 환경 관련 기준과 환경영향평가를 통해 협의된 협의기준을 비교하였다. 2010년부터 10년간 협의완료된 화력발전소 건설사업 전체 60건을 대상으로 환경영향평가의 시행여부에 따른 차이를 추정한 결과 주요 대기오염물질의 배출량이 크게 저감된 것으로 나타났다. $PM_{10}$의 경우 연간 3,745톤, $NO_2$는 74,569톤, $SO_2$는 37,647톤의 배출량이 저감되었으며, 이를 사회적 편익으로 환산한 결과 방법론에 따라 연간 2,397억 원에서 5조 9,665억 원으로 추정되었고, 이는 화력발전소의 운영기간 30년 동안 7조 1,916억 원에서 178조 9,944억 원에 이르는 규모의 사회적 비용이 절감되는 것을 의미한다. 저감된 대기오염물질의 배출량의 규모는 전국의 에너지 발전시설에서 배출되는 양의 절반에 이르며, 우리나라의 연간 경상의료비보다 큰 금액의 경제적 가치를 지닌다. 이는 모든 사업이 배출허용기준과 같이 관련 근거법에 따라서 획일적인 기준을 적용받지만, 환경영향평가 과정을 통해 대상 지역과 사업의 특성 등을 고려하여 각각의 사업계획이 수립됨에 따라 발생한 성과임을 의미한다.

• Journal of Periodontal and Implant Science
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• 제27권1호
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• pp.1-17
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• 1997

Tetracycline is known to be effective in eliminating periodontopathogens and have collagenolytic activity. This study was performed to observe the desorption kinetics and structural changes of tetracycline-treated barrier membranes for guided tissue regeneration. Four kinds of barrier membranes were tested : $Tefgen^{(R)}$(American Custom Medical, USA) and $Gore-Tex^{(R)}$(W.L. Gore & Associates Inc., USA) as nonresorbable membranes ; Resolut(polyglycolide & polylactide copolymer, W.L. Gore & Associates Inc., USA) and $Biomend^{(R)}$(collagen, Collatec Co., USA) as resorbable membranes. The membranes were cut into discs(diameter : 4mm) and were immersed in 5% tridodecylmethylammonium chloride(TIMAC) ethanol and air-dried. The membrane discs were absorbed with $100{\mu}g/ml tetracycline solution(pH8) for one minute and dried. For desorption kinetics, TC treated discs were immersed in phosphate buffered saline solution (PBS, pH 7.4). PBS was exchanged daily and TC concentration was measured by absorbance at 276nm on UV spectrophotometer. To measure remaining antibacterial activity, discs of 1 day to 4 weeks after desorption were placed on Mueller Hinton agar containing Bacillus cereus and incubated aerobically in $37^{\circ}C$ for twelve hours and the inhibition diameters were measured. To observe the structural change of membranes after TIMAC treatment or immersion in PBS, the membrane discs were examined under SEM. The results were as follows : 1. Total amounts of TC absorbed into membrane discs($0.7536mm^2$) were $2000{\mu}g$, $1800{\mu}g$, $2625{\mu}g$ and $2499{\mu}g$ for $Tefgen^{(R)}$, $Gore-Tex^{(R)}$, $Biomend^{(R)}$ and $Resolut^{(R)}$. 2. The concentration of TC released from barrier membrane discs was maintained over $4{\mu}g/ml$ until the fifth day in nonresorbable membranes and $Resolut^{(R)}$, but until the fourth day in $Biomend^{(R)}$, Until the ninth day in nonresorbable membranes and until the seventh day in resorbable membranes, the TC concentration was maintained over $1{mu}g/ml$. 3. The four membrane discs in the first day showed similar size of inhibition zone. One to four weeks later, the inhibition zone was much smaller in resorbable membrane discs than nonresorbable membrane discs. 4. Any structural change due to treatment of TIMAC was not observed on the nonresorbable membranes. $Resolut^{(R)}$ did not show any structural change except fibrillar loosening during immersion period, but Biomend showed destruction of membrane structure from the first week of immersion. This study indicates that tetracycline treated barrier membranes lead to the sustained release of tetracycline for over 7 days. This slow release pattern of tetracycline may contribute to the favorable clinical outcome of guided tissue regeneration.

• Journal of Magnetics
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• 제19권2호
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• pp.161-169
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• 2014

The aim of this study is to investigate the efficacy of pulsed electromagnetic field (PEMF) on the alleviation of lumbar myalgia. This is a randomized, real-sham, double blind pilot study. 38 patients were divided into the PEMF group and the Sham group, each of which was composed of 19 patients (1 patient dropped out in the Sham group) of randomized allocation. The PEMF group was treated by using the PEMF device and the Sham group by using a sham device on the lumbar muscle and acupuncture points, three times a week for a total of two weeks. Evaluations of Visual Analogue Scale for bothersomeness (VASB), Visual Analogue Scale for pain intensity (VASP), Oswestry Disability Index (ODI), 36-Item Short Form Health Survey Instrument (SF-36), EuroQol-5Dimension (EQ-5D), Beck's Depression Inventory (BDI) and Roland-Morris Disability Questionnaire (RMDQ), etc. before and 1 week after treatment were carried out. The primary outcome measure was the VASB, measured 1 week after the end of the pulsed electromagnetic therapy. VASB scores for the PEMF group changed by $-2.06{\pm}2.12$ from the baseline, and that for the Sham group changed by $-0.52{\pm}0.82$ (p < 0.05). VASP scores for the PEMF group were reduced by $-2.10{\pm}2.12$ from the base line, and that for the Sham group was reduced by $-0.53{\pm}1.50$ (p < 0.05). PEMF group showed significant improvements in all VASB, VASP, ODI, SF-36, EQ-5D, BDI and RMDQ scores, while the Sham group showed significant improvements in all scores, except the VASP score. However, the VASB, VASP and RMDQ scores of the PEMF group were much lower than those of the Sham group. The two groups showed no significant difference in ODI, SF-36, EQ-5D and BDI. This study demonstrates the effectiveness of PEMF treatment for alleviating lumbar myalgia.

• Clinical and Experimental Reproductive Medicine
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• 제25권2호
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• pp.109-113
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• 1998

Objective: To ananlyze the direct effect of nitric oxide (NO), generated from sodium prusside (SNP) on the embryo developments in reproductive process. Design: Ova from mouse were treated to allow fertilization in in vitro culture. And the samples of fertilized ova were alloted into five alliqutos. Each alliquot was cultured in media treated with either concentration at 0 (n=92), $25{\mu}M$ (n=84), $50{\mu}M$ (n=80), $100{\mu}M$ (n=77), $500{\mu}M$ (n=54) of SNP. Main Outcome Measure: Rates of embryonal cell cleavages, viability and cell morphology were assessed during in vitro fertilization and culture. Results: As analyse the cell cleavage at 24 hours after in vitro culture of fertilised egg in variuos NO concentration, all of egg cells of each alliquot were developed to $2\sim4$ cell stage. But the alliquot of egg cells treated with $50{\mu}M$, which were totally degenerated. And also all embryonal cells of each alliquot were developed to 8 cell stage and morula stage on culture continuosly. And the embryonal cells of each alliquot were analysed at 24 and 48 hours following the in vitro culture. The rates of cell fragmentation and fusion were $4.2{\pm}3.4%$ in control group which is not treated with NO, while experimental groups was high, as rated $23.4{\pm}6.2%$ in $25{\mu}M$, $28.2{\pm}5.7%$ in $50{\mu}M$ and $32.1{\pm}6.4%$ in $100{\mu}M$ concentration of NO. Accordingly the rate of abnormal morphology of embryonal cell in control was lower significantly than that in each alliquot of experimental groups (p<0.05). And the degenerated rates of embryonal cells were 0% in control, $17.8{\pm}6.7%$ in $25{\mu}M$, $23.6{\pm}4.7%$ in $50{\mu}M$ and $26.8{\pm}11.2%$ in $100{\mu}M$ at 8 cells and morula on culture of 48 and 72 hours. On the examination of embryonal cells developed to blastocyst through in vitro culture, the rates of degenerated cells were $16.8{\pm}7.2%$ in control, $37.5{\pm}6.2%$ in $25{\mu}M$, $73.4{\pm}4.6%$ in $50{\mu}M$, 100% in $100{\mu}M$. Conclusion: This results suggeted that the NO in any concentrations is harmful on embryos in view of morphology as well as viability of cell, and the toxicity of NO on embryo is stronger at condition in higher concentration of NO.

• 디지털융복합연구
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• 제13권2호
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• pp.237-244
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• 2015

본 연구는 뇌졸중 환자의 정신건강과 삶의 질 간의 상관성을 파악하고 정신건강이 삶의 질에 미치는 영향을 알아보고자 하였다. 뇌졸중으로 진단받은 224명을 대상으로 삶의 질의 측정을 위해 뇌졸중 환자 삶의 질 평가도구(Stroke Specific Quality of Life: SS-QOL), 정신건강은 간이정신진단검사(Symptom Check-List-90-Revised: SCL-90-R)를 사용하였다. 정신건강과 삶의 질 간의 상관성을 알아보기 위해 피어슨 상관관계를 이용하였고, 정신건강이 삶의 질에 미치는 영향을 확인하기 위해 단순 회기분석과 하위 요인들을 알아보기 위해 단계적 다중 회귀분석을 실시하였다. 정신건강과 삶의 질은 통계적으로 유의한 상관성을 보였으며, 정신건강이 삶의 질 변화에 영향을 미치는 유의한 요인으로 $R^2$ 0.28로 28%의 설명력을 보였으며, 하위영역 중 우울은 $R^2$ 0.42로 42%의 설명력을 보였다. 뇌졸중 환자에서 우울이 낮을수록 환자의 삶의 질이 높아지는 것을 알 수 있었다. 그러므로 뇌졸중 환자의 삶의 질을 향상시키기 위해 재활 초기부터 정신건강 요인을 포함한 전인적 접근과 중재에 초점을 두어야 할 것이다.