• International Journal of Stem Cells
• /
• 제16권2호
• /
• pp.234-243
• /
• 2023

The recent advances in human pluripotent stem cells (hPSCs) enable to precisely edit the desired bases in hPSCs to be used for the establishment of isogenic disease models and autologous ex vivo cell therapy. The knock-in approach based on the homologous directed repair with Cas9 endonuclease, causing DNA double-strand breaks (DSBs), produces not only insertion and deletion (indel) mutations but also deleterious large deletions. On the contrary, due to the lack of Cas9 endonuclease activity, base editors (BEs) such as adenine base editor (ABE) and cytosine base editor (CBE) allow precise base substitution by conjugated deaminase activity, free from DSB formation. Despite the limitation of BEs in transition substitution, precise base editing by BEs with no massive off-targets is suggested to be a prospective alternative in hPSCs for clinical applications. Considering the unique cellular characteristics of hPSCs, a few points should be considered. Herein, we describe an updated and optimized protocol for base editing in hPSCs. We also describe an improved methodology for CBE-based C to T substitutions, which are generally lower than A to G substitutions in hPSCs.

• 재활치료과학
• /
• 제6권2호
• /
• pp.47-58
• /
• 2017

목적: 뇌졸중 환자에게 의미 있는 작업을 기반으로 한 양측성 상지 훈련의 효과를 알아보기 위한 예비연구로 실시되었다. 연구방법: 뇌졸중으로 인한 편마비를 가진 환자 4명을 대상으로 실험군(2명)과 대조군(2명)으로 나누어 진행되었다. 2016년 5월부터 8월까지 진행하였으며, 대상자 당 총 5주간, 주 3회, 회기 당 60분의 작업기반 양측성상지훈련 중재와 전통적 양측성 상지 훈련을 각 각 실시하였다. 중재 전 후로 EMG, 가속도계, ARAT, Y-BAT, SIS, COPM를 실시하여 각 군간 비교 하였다. 결과: 실험군은 대조군 보다 노쪽 손목폄근과 앞 어깨 세모근의 근 활성도, SIS에서 손 기능(Hand function), 기억력(Memory)항목을 제외한 모든 항목에서 중재 전 후 큰 변화량을 나타냈으며, 양손의 사용량을 측정한 가속도계와 COPM, Y-BIT, ARAT평가의 잡기(grasp), 집기(pinch), 대동작 (gross movement)항목에서 실험군은 대조군 보다 중재 전 후 큰 변화량을 나타냈다. 결론: 본 연구를 통해 작업기반 양측성 상지 훈련이 신경학적 변화를 통한 상지기능 회복 및 사회참여 등에 효과적임을 알 수 있었다. 추후 연구에서는 작업기반 양측성 상지 훈련 프로토콜의 내용에 대해 높은 내용 타당도를 확보하기 위한 개발 연구가 필요할 것이며, 이를 토대로 많은 뇌졸중 환자를 대상으로 한 무작위대조군 실험 연구를 통한 효과 검증과 효과지속성에 대한 검증이 필요할 것이다.

• 대한한방내과학회지
• /
• 제22권4호
• /
• pp.691-702
• /
• 2001

Objectives : This study was done to assess the effects of the clinical interchange between the Western Medicine and the Oriental Medicine for ischemic stroke patients. The patient outcomes include changes in neurologic function by modified NIH stoke scale, stroke pattern identification scale, and patient satisfaction, Methods : For the assessment of effects, this study was performed with 178 inpatients who had undergone the stroke care at three hospitals (W Hospital adopted western therapy, S Oriental Hospital adopted Sasang constitution medicine therapy, and H Oriental Hospital adopted mixed therapy according to a joint protocol on Western Oriental medical care) from November 1997 to December 1998. Patients were interviewed or written with self-entered questionnaire forms, and clinical data were obtained, Physicians or oriental doctors wrote clinical questionnaire forms according to the care process. Results : The patient outcomes within three hospitals at 2 stages (at admission and discharge in the modified NIH stroke scale. at admission and second weeks during admission in the stroke pattern identification scale) were found to be decreased, Especially in the results of hierarchical multiple regression analysis, the degree of improvement of modified NIH stroke scale of the stroke patients at W Hospital was significant large than it at S Oriental Hospital. Also, the degree of improvement of stroke pattern identification scale at W Hospital was significantly large than it at other two hospitals. However, the patient's satisfaction score at three hospitals wasn't significantly different. Conclusions : The result of this study suggested that the joint clinical research of Western & Oriental medical practitioners was possible even if there was a conflict between Western Medicine and Oriental Medicine. Therefore Western & Oriental medical practitioners share a mutual responsibility to apply evidence-based practice, to seek scientific empirical proof through randomized clinical trials between the multicenter.

• Journal of Korean Neurosurgical Society
• /
• 제54권4호
• /
• pp.329-335
• /
• 2013

Objective : Brain metastases in primary breast cancer patients are considerable sources of morbidity and mortality. Gamma knife radiosurgery (GKRS) has gained popularity as an up-front therapy in treating such metastases over traditional radiation therapy due to better neurocognitive function preservation. The aim of this study was to clarify the prognostic factors for local tumor control and survival in radiosurgery for brain metastases from primary breast cancer. Methods : From March 2001 to May 2011, 124 women with metastatic brain lesions originating from a primary breast cancer underwent GKRS at a tertiary medical center in Seoul, Korea. All patients had radiosurgery as a primary treatment or salvage therapy. We retrospectively reviewed their clinical outcomes and radiological responses. The end point of this study was the date of patient's death or the last follow-up examination. Results : In total, 106 patients (268 lesions) were available for follow-up imaging. The median follow-up time was 7.5 months. The mean treated tumor volume at the time of GKRS was 6273 $mm^3$ (range, 4.5-27745 mm3) and the median dose delivered to the tumor margin was 22 Gy (range, 20-25 Gy). Local recurrence was assessed in 86 patients (216 lesions) and found to have occurred in 36 patients (83 lesions, 38.6%) with a median time of 6 months (range, 4-16 months). A treated tumor volume >5000 $mm^3$ was significantly correlated with poor local tumor control through a multivariate analysis (hazard risk=7.091, p=0.01). Overall survival was 79.9%, 48.3%, and 15.3% at 6, 12, and 24 months, respectively. The median overall survival was 11 months after GKRS (range, 6 days-113 months). Multivariate analysis showed that the pre-GKRS Karnofsky performance status, leptomeningeal seeding prior to initial GKRS, and multiple metastatic lesions were significant prognostic factors for reduced overall survival (hazard risk=1.94, p=0.001, hazard risk=7.13, p<0.001, and hazard risk=1.46, p=0.046, respectively). Conclusion : GKRS has shown to be an effective and safe treatment modality for treating brain metastases of primary breast cancer. Most metastatic brain lesions initially respond to GKRS, though, many patients have further CNS progression in subsequent periods. Patients with poor Karnofsky performance status and multiple metastatic lesions are at risk of CNS progression and poor survival, and a more frequent and strict surveillance protocol is suggested in such high-risk groups.

• Journal of Korean Neurosurgical Society
• /
• 제47권4호
• /
• pp.252-257
• /
• 2010

Objective : Barbiturate coma therapy (BCT) is a useful method to control increased intracranial pressure (IICP) patients. However, the complications such as hypotension and hypokalemia have caused conditions that stopped BCT early. The complications of low dose BCT with $Bispectral^{TM}$ index (BIS) monitoring and those of high dose BCT without BIS monitoring have been compared to evaluate the efficacy of low dose BCT with BIS monitoring. Methods : We analyzed 39 patients with high dose BCT group (21 patients) and low dose BCT group (18 patients). Because BIS value of 40-60 is general anesthesia score, we have adjusted the target dose of thiopental to maintain the BIS score of 40-60. Therefore, dose of thiopental was kept 1.3 to 2.6 mg/kg/hour during low dose BCT. However, high dose BCT consisted of 5 mg/kg/hour without BIS monitoing. Results : The protocol of BCT was successful in 72.2% and 38.1% of low dose and high dose BCT groups, respectively. The complications such as QT prolongation, hypotension and cardiac arrest have caused conditions that stopped BCT early. Hypokalemia showed the highest incidence rate in complications of both BCT. The descent in potassium level were $0.63{\pm}0.26$ in low dose group, and $1.31{\pm}0.48$ in high dose group. The treatment durations were $4.89{\pm}1.68$ days and $3.38{\pm}1.24$ days in low dose BCT and high dose BCT, respectively. Conclusion : It was proved that low dose BCT showed less severe complications than high dose BCT. Low dose BCT with BIS monitoring provided enough duration of BCT possible to control ICP.

• The Journal of Korean Physical Therapy
• /
• 제16권4호
• /
• pp.90-114
• /
• 2004

This study was conducted to examine the influence and effect of muscle enforcement program on Activity of daily living(ADL) improvement and posture balance of the old, and to provide more effective muscle enforcement program and educational data. The muscle enforcement exercise program was performed on the old(institution, 16 men, 10 women) for 8 weeks from April 22, 2002 through June 17,2002. Programed Exercise 1 - Exercise 10 were practised 8 times per program for 3 days a week. The load of exercise was increased per two weeks. The methods of measurement were questionnaire, Indiana 47903(action-response analysis machine) and Sample exercise protocol for KAT 2000(balance training device). SAS/PC statistic analysis was used for data analysis. T-test was used for analysis of change before and after exercise in this study. The summary and conclusions are as follows. 1. On subjectively recognized health states, the healthy were $42.3\%$. On the satisfaction with health states, the satisfied were $50.0\%$. On the factors of effects on daily-life behavior performance, the group who had troubles was $50\%$ and the group who was so and so was $34.6\%$ compared with the old of the same age. On prospect about health states in the future, the group who would be better was $38.\%$. On effective methods for problem solving, exercise was $42.3\%.\;88.5\%$ of respondents answered the need of health care. The participation intention in health program was $92.3\%$. 2. On the change of psychological emotion and behavior aspects, the group who had repeated complaints or anxieties and reduced activities or interests was effective(P<0.01). 3. On the improvement effects of IADL difficulties, the group who had difficulties in doing daily-life indoors was improved effectively compared with before and after exercise(P<0.01). On medication management, the effects of improvement after exercise were high compared with before exercise(P<0.01), the effects of improvement was high on the whole. 4. On the effects of ADL function improvement, putting on upper clothing and lower clothing was improved effectively(P<0.05), toilet use and individual sanitation was improved effectively(P<0.05). 5. On the effects of action-response, the results of 8weeks regular exercise program were not different significantly compared with before and after exercise. The behavior quickness of the old by muscle enforcement program was not increased. This means that the old needs much time for exercise sense training because of the regression of cognition sense. 6. In the effect of posture balance, the whole grades were effective from 1272.69 before excercise to 476.92 after exercise(P<0.01). Especially right balance 657.65 was lowered to 208.57 after exercise most effectively(P<0.01). Rear balance 776.34 before exercise was lowered to 136.65 after exercise. The results of measurement were significant(P<0.05).

• 대한소아치과학회지
• /
• 제48권1호
• /
• pp.21-30
• /
• 2021

이 연구의 목적은 indocyanine green (ICG)과 근적외선 diode 레이저의 사용이 다종 우식원성 바이오필름에 미치는 항균 효과를 조사하는 것이다. Streptococcus mutans, Lactobacillus casei, Candida albicans를 포함하는 다종 바이오필름이 ICG와 808 nm 근적외선 diode 레이저를 사용하여 서로 다른 조사 시간에 따라 처리되었다. Colony-forming unit (CFU)을 측정하였고, 바이오필름의 정성적 평가를 위해 공초점 레이저 주사 현미경(Confocal laser scanning microscopy, CLSM) 관찰을 시행하였다. 또한 광열 치료의 효과를 평가하기 위해 온도 측정이 시행되었다. ICG와 근적외선 diode 레이저를 사용한 군에서 CFU의 감소량이 통계적으로 유의하였으나, L. casei와 C. albicans에서는 시간에 따른 항균 효과의 유의한 차이는 관찰되지 않았다. CLSM 관찰에서도 유사한 세균 감소를 확인할 수 있었다. ICG와 근적외선 diode 레이저를 사용한 군은 ICG 없이 광조사를 시행한 군보다 더 높은 온도 상승을 보였으며, 측정된 온도는 열 치료의 온도 범위와 유사하였다. 결론적으로, ICG와 근적외선 diode 레이저는 다종 우식원성 바이오필름에 항균 효과를 보였다. 우식 예방을 위한 보조 수단으로 사용될 가능성을 가지나, 임상적인 적용을 위해서는 적용 프로토콜에 관한 연구가 필요하다.

• 재활치료과학
• /
• 제10권2호
• /
• pp.7-22
• /
• 2021

목적 : 본 연구의 목적은 뇌졸중 환자의 인지기능 회복에 대한 경두개 직류자극(tDCS)의 효과를 살펴본 연구를 분석하기 위함이다. 연구방법 : 2009년부터 2019년까지 국내외 학술지에 게재된 논문들을 NDSL, RISS, PubMed, CINAHL을 통해 검색하였다. 선정기준과 배제기준을 통해 총 11개의 실험연구 논문이 선정되었다. 이를 질적평가를 시행하고, 이 중 7편의 논문에서 9개의 결과값에 대해 메타분석을 실시하였다. 결과 : 메타 분석을 실시한 결과 효과크기는 attention 0.725, memory 0.796으로 모두 '보통 효과크기'를 보였다. 두 영역 모두 통계적으로 유의한 변화가 있던 것으로 분석되었다(p<0.05) 결론 : 본 연구 결과를 통하여 인지기능이 제한된 뇌졸중 환자에게 tDCS는 효과가 있음을 알 수 있었다. 또한, tDCS 적용법이 연구 간 서로 상이함을 알게 되었으며 이에 따라 정형화된 tDCS 프로토콜과 전문가 양성이 필요할 것으로 보인다.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
• /
• 제60권5호
• /
• pp.209-214
• /
• 2017

Background and Objectives Tinnitus retraining therapy (TRT) is one of the most effective treatment modalities of tinnitus based on the neurophysiological model proposed by Jastreboff and Hazell. This study was performed to evaluate the effect of counselor factor on treatment outcomes of TRT. Subjects and Method The total of 78 patients who had TRT from three different counselors in a tinnitus clinic of tertiary referral center from Jan 2015 to Dec 2015 were included in this study. Their medical records were retrospectively reviewed to evaluate the therapeutic response to TRT. Results Among 78 patients who were followed-up for more than 6 months, 47, 20, and 11 patients were treated by counselors A, B, C (all ENT specialists), respectively. Counselor A had 15-year-experience of TRT counseling, whereas counselor B and C were well trained but beginners of TRT counseling. Initial clinical characteristics including Tinnitus Handicap Inventory (THI) and tinnitus Visual Analogue Scale (VAS) scores of the patients among three groups were not significantly different. Treatment responses evaluated via THI and most of the tinnitus VAS scores after at least 6 months after TRT were significantly improved in all three groups (p<0.05) with no significant difference between the senior (A) and junior (B, C) group. Conclusion TRT seems to be an effective treatment modality of tinnitus even in this short term follow-up study. Treatment outcomes of TRT may not depend on the counselors once they are well trained and follow the same protocol.

• 대한소아치과학회지
• /
• 제49권3호
• /
• pp.321-328
• /
• 2022

이 연구는 Streptococcus mutans 바이오필름에 대한 에리스로신 매개 광역동 치료에서 potassium iodide (KI)의 효과를 평가하는 In vitro 실험이다. S. mutans ATCC 25175를 배양하여 hydroxyapatite disk에 바이오필름을 형성하였다. 광감각제인 에리스로신을 20 μM, KI를 각각 10, 50, 100 mM로 희석하여 적용한 뒤 광역동 치료를 시행하였다. 생존한 세균의 수는 colony forming units (CFU)/mL로 산정하였으며 Bonferroni 사후 분석을 통해 그룹 간 차이의 유의성을 확인하였다. Confocal laser scanning microscopy (CLSM)을 이용하여 세포 생존율을 시각적으로 평가하였다. 실험 결과 KI를 적용한 후 광역동 치료를 시행한 실험군에서 KI의 농도의 관계 없이 현저한 CFU의 감소가 관찰되었다(p < 0.05). 또한 10 mM KI에 비해 100 mM KI를 적용한 실험군에서 유의한 CFU의 감소가 관찰되었다(p < 0.05). CLSM 관찰 시에도 동일한 결과를 확인하였다. KI는 모든 농도에서 S. mutans 바이오필름에 대한 에리스로신 매개 광역동 치료의 효과를 유의하게 향상시켰다. 이는 바이오필름 상태의 균주에 대한 광역동 치료의 낮은 감수성을 보완할 수 있지만, 추가적인 연구를 통한 최적의 임상 프로토콜 확립이 필요하다.