거주 형태에 따른 에너지 섭취량과 소비량의 균형도 조사

박순목,고성경,남인수,윤재만,임승현,전중기,이종삼 대구대학교 인문과학연구소 2008 人文科學硏究 Vol.31 No.-

We investigated that the effects of residential type on energy balance in college students. Total sixteen college students were participated in this study, all subjects were assigned one of three groups: either school attendee students group, self-governed living students group, dormitory students group. Routine physical activity level (for 5 days including three weekday and two weekend) and food intake were surveyed. For investigation of degree of physical activity, all subjects were requested to record on their physical movements as possible as detail should be obtained. To all subjects, five-day dietary log form was given, and used for examining of calorie intake from their routine diet. There was no statistical difference in energy intake and consumption in each. However energy consumption was significantly higher than energy uptake in school attendee students group. All other groups were shown a similar energy values between energy uptake and consumption. There were no significant differences in energy intake and consumption in any of experimental groups when comparisons were made between weekdays and weekend. As far as energy uptake was concerned it was no statistical difference in any of major nutrients among groups. In conclusion, partial imbalance was found between energy intake and uptake in school attendee groups. This may be due to their more active life style than other groups'. In future studies, better controlled study should be performed not only more subjects are recruited but also minor nutrients are included for examining of energy balance.

위등세모근 통증유발점이 있는 목 통증 환자의 압력 통각 역치 및 근활성도에 대한 뉴렉 기법의 즉각적인 효과

하용목(Yong-Mok Ha),어인준(In-Joon Uh),손정호(Jung-Ho Son),신선실(Sun-Shil Shin) 한국임상움직임치료학회 2023 한국임상움직임치료학회지 Vol.3 No.2

Background Neck pain is a prevalent condition affecting 45-54% of the population, with chronic symp-toms experienced by 14% of individuals, leading to significant productivity reduction and healthcare costs. Therapeutic exercise, particularly active interventions, has shown efficacy in reducing chronic neck pain. The Neurac (Neuromuscular Activation) technique aims to enhance active movement and create pain-free movement. Objectives To investigate the immediate effects of Neurac technique on pressure pain threshold (PPT), resting muscle activity measured through surface electromyography (sEMG), and pain level assessed using the Visual Analogue Scale (VAS) in individuals with chronic neck pain. Methods Fifteen adult participants with chronic neck pain were recruited from a university in Busan, South Korea. Neurac technique, involving four specific neck, and shoulder exercises using a Redcord Trainer, PPT, resting muscle activity, and pain level (VAS) were evaluated before and after the Neurac technique intervention. Results Following the Neurac technique, participants demonstrated a significant increase in PPT (p < 0.001) and a significant decrease in pain level measured by VAS scores (p < 0.001), indicating reduced pain. However, no significant changes were observed in resting muscle activity during the rest period (p = 0.616). Conclusions This study found that the Neurac treatment program effectively reduced pain and in-creased pressure pain threshold in individuals with neck pain associated with trigger points in the upper trapezius muscle, although no significant changes in muscle activity at rest were observed.

The 13-year experience of performing pancreaticoduodenectomy in a mid-volume municipal hospital

Hongbeom Kim,Jung Kee Chung,Young Joon Ahn,Hae Won Lee,In Mok Jung 대한외과학회 2017 Annals of Surgical Treatment and Research(ASRT) Vol.92 No.2

Purpose: Pancreaticoduodenectomy (PD) is a complex surgery associated with high morbidity, mortality, and cost. Municipal hospitals have their important role in the public health and welfare system. The purpose of this study was to identify the feasibility as well as the cost-effectiveness of performing PD in a mid-volume municipal hospital based on 13 years of experience with PD. Methods: From March 2003 to November 2015, 183 patients underwent PD at Seoul Metropolitan Government – Seoul National University Boramae Medical Center.. Retrospectively collected data were analyzed, with a particular focus on complications. Hospital costs were analyzed and compared with a national database, with patients divided into 2 groups on the basis of medical insurance status. Results: The percentage of medical aid was significantly higher than the average in Korean hospitals. (19.1% vs. 5.8%, P = 0.002). Complications occurred in 88 patients (44.3%). Postoperative pancreatic fistula (POPF) occurred in 113 cases (61.7%), but the clinically relevant POPF was 24.6% (grade B: 23.5% and grade C: 1.1%). The median hospital stay after surgery was 20 days (range, 6–137 days). In-hospital mortality was 3.8% (n = 7), with pulmonary complications being the leading cause. During the study period, improvements were observed in POPF rate, operation time, and hospital stay. The mean total hospital cost was 13,819 United States dollar (USD) per patient, and the mean reimbursement from the National Health Insurance Service (NHIS) to health care providers was 10,341 USD (74.8%). The patient copayment portion of the NHIS payment was 5%. Conclusion: Performing PD in a mid-volume municipal hospital is feasible, with comparable results and cost-effectiveness.

Rat의 복강내에 투여한 5-fluorouracil-polyglycolic acid 제형이 장기에 미치는 영향에 관한 연구

강대영,송규상,최정목,노승무,정경수,오정연,김진향,양준묵,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

For more effective intraperitoneal chemotherapy, the authers made 5-fluorouracil-polyglycolic acid composite disks(FU-PGA disks) with 5-fluorouracil and polyglycolic acid, a biodegradable polymer. We inserted the FU-PGA disk into the peritoneal cavites of Sprague-Dawley male rats, the control and three experimental groups; one FU-PGA disk insert group(300mg/kg), two FU-PGA disk insert group(600mg/kg), and three FU-PGA disk insert group(900mg/kg). The control group received a similar number of PGA disk inserts. A pharmacokinetic study was performed to measure the 5-fluorouracil concentration in the peritoneal fluid, blood, and tissues(liver, kidney and heart) at 24 hours, 72hours and 168 hours after insertion of the FU-PGA disk. Light and electron microscopic studies were done. The results were as follows: 1) The number of white blood cells and platelets decreased after FU-PGA insertion. The degree was proportional to the duration and amounts inserted. The change in the number of red blood cells varied slightly. 2) Light microscopically, slight changes were noted at 168 hours in the 3 disk insert group (900mg/kg). Mild fatty change and hepatocyte degeneration around the central veins of the liver were noted, with vacuolar degeneration in the proximal convoluted tubules of the kidney. 3) Electron microscopically,the liver showed focal increases of lipid droplets in the hepatocytes, and irregular nuclear membrane with focal nucleolar segregation of the fibrillar and granular elements. Also the double membranous structure of the hepatocytes and Kupffer cells was widened with bleb formation. The kidney showed wide separation of the nuclear double membrane in the proximal convoluted tubular cells and mesangial cells, with vacuolation and myelin figure formation in the mitochondria of the proximal convoluted tubular cells, at 72 hours and 168 hours in the 2 to 3 FU-PGA insert groups. The heart showed focal loss of cristae,vacuolation and myelin figure formation in the mitochondria of the 2 to 3 FU-PGA insert groups. In conclusion, despite the large amont of FU-PGA inserted, the histopathological changes in the liver, kidney and heart were slight, and consonant with the very low amount of 5-fluorouracil concentrations detected in the liver, kidney and heart. The above results suggest that the FU-PGA composite can serve as a new device for releasing drugs in a controlled manner and easily targeted to intraperitoneal organs. This device can improve the efficacy of intraperitoneal chemotherapy for gastric cancer.

만성 복부대동맥 폐색증

김상준,이태승,하종원,정인목 대한혈관외과학회 1998 Vascular Specialist International Vol.14 No.1

Chronic abdominal aortic occlusion(CAO) is a rare entity and poses a particular management challenge. It shows a spectrum of clinical presentations due to chronic progression and suprarenal thrombus progression. Ongoing debate over the proximal thrombus propagation leading to renal and mesenteric artery occlusian results in controvetsy regarding the need of in-line aortic recanstruction with proximal thromboendarterectomy(TEA). To evaluate the management and surgical outcome of chronic abdominal aortic occlusion, a retrospective study of 24 patients surgically treated for angiographically documented CAO between September, 1986 and September, 1997 was conducted. Male to female ratio was 22:2 with a mean age of 56.8 yaes(range: 33-71 years). Mean follow-up period was 55.0 montbs. All patients presented with sympoms of vascular insufficiency of lower limbs including claudication in 10(41.7%), rest pain in 11(45.8%) and tissue loss in 3(12.5%). Impotence was present in 59.1% in men. Locaticm of aortic occlusion was distributed in juxtarenal and above(11, 45.8%) and infrarenal(13, 54.2%). Associated visceral arterial involvement included 18 inferior mesenteric arterygMA) occlusion, 8 renal artery(RA) stenosis and 1 superior mesenteric artery(SMA) occlusion. Infrainguinal arteries were involved in 11 patients(45.8%) including 9 superficial femoral artery obstruction. Aortobifemoral bypass(AoBF) grafts were implanted all but one case, which was treated with an axillobifemoral bypass(AxBF). In AoBF, proximal thrombectomy or thromboendarterectomy was performed and, in most cases, end to end anastomosis is favored in proximal anastomosis due to possibility of pmximal thrombus propagation. Concomitant visceral revascularizations were performed in selected cases(2 renal, 2 IMA) with inflow procedures. The operative mortality rate was 4.2%(1/24) and the perioperative morbidity rate was 37.5%. AoBF inflow procedures yielded 1, 5-year primary patency rate of 95.5% and 89.1%, respectively. The one AxBF graft was occluded graft at 26 days after surgery. Two patients died and the 5-year survival rate for AoBF was 95.7%. There was no statistical change in renal function between preand postoperative periods. Follow-up renal dysfunction(serum creatinine levels$gt;2.0 mg/dl) was documented in two patients, and one patient developed acute renal failure requiring dialysis. Aortobifemoral bypass following proximal thromboendarterectomy is the optimal treatment modality with high patency rate in chronic abdominal aortic occlusion. Visceral artery reconsttuction in clmically significant stenosis and judicious attention for prevention of renal damage in pararenal thrombectomy under supratenal clamping are helpful for better outcome in chronic abdominal aortic occlusion.

Comparison of Costs of Endovascular Repair versus Open Surgical Repair for Abdominal Aortic Aneurysm in Korea

민상일,민승기,Sanghyun Ahn,김서민,Daedo Park,Taejin Park,정진욱,Jae Hyung Park,하종원,Sang Joon Kim,In Mok Jung 대한의학회 2012 Journal of Korean medical science Vol.27 No.4

This study was designed to compare the hospital-related costs of elective abdominal aortic aneurysm (AAA) treatment and cost structure between endovascular aneurysm repair (EVAR) and open surgical repair (OSR) in Korean health care system. One hundred five primary elective AAA repairs (79 OSRs and 26 EVARs) performed in the Seoul National University Hospital from 2005 to 2009 were included. Patient characteristics were similar between two groups except for older age (P = 0.004) and more frequent history of malignancy (P = 0.031) in EVAR group. Thirty-day mortality rate was similar between two groups and there was no AAA-related mortality in both groups for 5 yr after repair. The total in-hospital costs for the index admission were significantly higher in EVAR patients (mean, KRW19,857,119) than OSR patients (mean KRW12,395,507) (P < 0.001). The reimbursement was also significantly higher in EVAR patients than OSR patients (mean,KRW14,071,081 vs KRW6,238,895, P < 0.001) while patients payments was comparable between two groups. EVAR patients showed higher follow-up cost up to 2 yr due to more frequent imaging studies and reinterventions for type II endoleaks (15.4%). In the perspective of cost-effectiveness, this study suggests that the determination of which method to be used in AAA treatment be more finely trimmed and be individualized.

Peroxide와 자간전증 환자의 혈청 관류에 따른 제대정맥의 prostaglandin 생성의 변화

목정은,김암,이필량,한지수,이인식 울산대학교 의과대학 1996 울산의대학술지 Vol.5 No.1

Objective This study was performed to evaluate the prostaglandin secretion rates in human umbilical vein with preeclamptic sera and peroxide perfusion. Study design Isolated human umbilical cords(n=10) were perfused for 30-minute intervals with cord buffer, 15% normal pregnant sera and preeclamptic patient sera, 100 mol/L t-butyl hydroperoxide alone, and after perfusion with low-dose aspirin(5×10( )mol/L). Cord buffer gassed with 95% oxygen and 5% carbon dioxide and warmed to 37℃ was used for the perfusion buffer. Effluent flow rates were measured during each experimental treatment. Effluent samples were measured for 6-keto prostaglandin Flα and thromboxane B( ) by enzyme immunoassays. Results The concentrations of 6-keto prostaglandin F( )α in preeclamptic sera were significantly higher than those in normal pregnant sera.(989.3849 ± 1602.927 vs. 1.3116 ± 1.22085 ng/ml, mean ± SD, p<0.01). However, the concentrations of thromboxane B( ) were not different between normal pregnant sera and preeclamptic sera. The secretion rate of 6-keto-prostaglandin F( )α in human umbilical endothelial cells was not significantly different(p=0.77) between two groups. Comparing to normal pregnant sera, the secretion rate of thromboxane B( ) was significantly increased(p<0.01) after preeclamptic sera perfusion. The secretion rate of 6-keto-prostaglandin F( ) was significantly increased(p<0.01) following peroxide perfusion and that was significantly decreased by aspirin. The secretion rate of thromboxane B( ) was not significantly different between preeclamptic sera and peroxide alone or subsequent perfusion with aspirin. Conclusions (1) Preeclamptic sera stimulate thromboxane production rather than prostacyclin production by endothelial cells of human umbilical vein in vitro. (2) Peroxide stimulates the secretion of both prostacyclin and thromboxane, and low dose aspirin mitigates hydroperoxide-induced prostacyclin secretion. We confirmed that thromboxane secretion is stimulated by preeclamptic sera and the role of peroxide in prostaglandin secretion. We established the perfusion system using human umbilical vein through this study. This perfusion system may be useful to understand the pathophysiology of preeclampsia.

백서의 복강내에 투여한 Mitomycin-C-Polyglycolic acid 제형이 장기에 미치는 영향에 관한 연구

송규상,강대영,최정목,노승무,정경수,오정연,김진향,양준목,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

To evaluate the in-vivo effects of mitomycin-C-polyglycolic acid composite(MMC-PGA) the disk: shaped composite were implanted into the peritoneal cavity of the Sprague-Dawley rats. The pathologic changes were examined at various time points up to 12 weeks. Initially the soft tissue around the inserted disks showed capillary congestion at 3 days. Inflammatory infiltrates with foreign body giant cells appeared from the 2nd week and reached peak response at 6-8 weeks. These reaction diminished prominently at 12 weeks. No specific pathologic change was found in the liver, the kidneys, and the heart. The above results suggest that the MMC-PGA composite can serve as a new device for intraperitoneal chemotherapy of various types of cancers.

Rat의 복강에 삽입한 Filorouracil-Polyglycolic acid제형의 Fluorouracil용출에 관한 연구

노승무,정경수,오정연,김진향,양준묵,강대영,송규상,최정목,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

A common form of relapse in adenocarcinoma of the stomach is intraperitioneal dissemination, in fact, among gastric adenocarcinoma patients who have undergone surgery intended to cure, approximately 50% of the patients develope initial recurrence in the peritoneal cavity regardless of the anatomic site of the primary tumor within the stomach. The efficacy of systemic postoperative chemotherapy to prevent peritoneal recurrence of gastrric adenocarcinoma is not satisfactory. There is still a great need for improved therapeutic strategies on the disseminated microscopic disease and small miliary nodules remaining on the peritoneal surface or lymphatics after operation. The authers have made fluorouracil-polyglycolic acid composite disks(Fu-PGA disks) with fluorouracil and biodegradable polymer: polyglycolic acid for more effective intraperitoneal chemotherapy. We inserted the Fu-PGA disk(s) in the peritoneal cavity of rat and pharmacokinetic study was performed to measure fluorouracil concentration in the peritoneal fluid, plasma, liver, kidney and heart tissue at 24 hour, 72 hour and 168 hour after insertion of Fu-PGA disk(s). Myelosuppressive action of this composite also was determined following its administration. The data of this study suggested that Fu-PGA composite will be a new device releasing drugs in a controlled manner and having targetability to peritoneum, and this device will be improving the efficacy of intraperitoneal chemotherapy for gastric adenocarcinoma.

정상임신 산모와 중증자간전증 산모의 혈소판지수 비교

박용범,한지수,정동근,이인식,김암,민원기,지현숙,목정은 울산대학교 의과대학 1993 울산의대학술지 Vol.2 No.1

The purpose of this retrospective study was to define platelet indices in severe preeclampsia(N=98) and to compare them to normal nonpregnant values(N=93) during the years 1990-1993 in the Department of Obstetrics and Gynecology, College of medicine, University of Ulsan, Asan Medical Center. Indices evaluated included platelet count, mean platelet volume, and platelet distribution width. Means platelet volume was statistically different between two groups, however mean platelet count was significantly decreased(p=0.029) and platelet distribution width was significantly increased(p=0.0001) and platelet distribution width was significantly increased(p=0.0001) in severe preeclampria. Mean platelet volume versus platelet count in normal pregnancy showed a significant inverse nonlinear relationship(r=-0.39, 9<0.001) and that in preeclampsia was congruent with notmal nonpregnant valus. With same mean platelet volume, platelet distribution width showed tendency to shift to right in severe preeclampsia. These findings support the concept of severe preeclampsia as a compensated state of increased platelet comsumption comparing with normal pregnancy. We concluded from above results that quantification of platelet indices may have some value in screening for and following severe preeclampsia.