Long-Term Changes in Post-Stroke Depression, Emotional Incontinence, and Anger

Boseong Kwon,Eun-Jae Lee,박성호,Ji Sung Lee,Min Hwan Lee,Daeun Jeong,Dongwhane Lee,Hyuk Sung Kwon,Dae-Il Chang,Jong-Ho Park,Jae-Kwan Cha,허지회,Sung-Il Sohn,Dong-Eog Kim,Smi Choi-Kwon,Jong S. Kim 대한뇌졸중학회 2021 Journal of stroke Vol.23 No.2

Background and Purpose Long-term changes in post-stroke depression (PSD), post-stroke emotional incontinence (PSEI), and post-stroke anger (PSA) have rarely been studied. Methods This is a sub-study of EMOTION, a randomized, placebo-controlled trial, that examined the efficacy of escitalopram on PSD, PSEI, and PSA in patients with stroke. We interviewed patients at the long-term period (LTP) using predefined questionnaires: Montgomery-Åsberg depression rating scale (MADRS) for PSD, modified Kim’s criteria for PSEI, and Spielberger trait anger scale for PSA. Additionally, the ENRICHD Social Support Instrument (ESSI) for the social support state and the modified Rankin Scale (mRS) were measured. We investigated the changes in and factors behind PSD, PSEI, and PSA at LTP. Results A total of 222 patients were included, and the median follow-up duration was 59.5 months (interquartile range, 50 to 70). Compared to the data at 6 months post-stroke, the prevalence of PSEI (11.7% at 6 months, 6.3% at LTP; P=0.05) and mean anger score (21.62, 16.24; P<0.01) decreased, while the prevalence of PSD (35.6%, 44.6%; P=0.03) and mean MADRS (6.16, 8.67; P<0.01) increased at LTP. ESSI was associated with PSD and PSA, but not with PSEI. The effect of the baseline National Institutes of Health Stroke Scale score on PSD decreased over time. The effect of low social support on PSD was greater than that of mRS at LTP. Conclusions The prevalence and degree of PSD significantly increased, while those of PSEI and PSA decreased at LTP. PSD in this stage appeared to be more closely associated with a lack of social support than patients' physical disabilities.

위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

전방 불안정성 견관절에서 이두박근의 근전도 활동성

김승호,하권익,김현숙,김선우,박종혁,김영민 대한견.주관절학회 2000 大韓肩.주關節學會誌 Vol.3 No.2

성인 IgA 신병증의 임상적 고찰

김영학,권용은,허경무,윤채중,김종인,김건영,배학연,정종훈 조선의대 1998 The Medical Journal of Chosun University Vol.23 No.1

임신 종결 후 발생한 자궁 동정맥 누공에서 자궁동맥색전술로 치료한 1예

김종민,이해혁,김태희,남계현,심일구,이권해,김형문,이임순,장종호 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Arteriovenous fistula of uterus is rarely reported disease. This vascular malformation is very dangerous condition because Dilatation & curettage can cause massive uterine bleeding without accurate diagnosis. The diagnosis is made by angiography, gray scale ultrasonography, color and duplex doppler ultrasonography, computed tomography, and magnetic resonance imaging is helpful. Especially color and duplex doppler ultrasonography is allows convincing detection and diagnosis of arteriovenous fistula. Recently transcatheter uterine artery embolization is treatment of choice. We have experienced a case of arteriovenous fistula of uterus. Which is presented with a brief review of literature.

ZnO:In 가스 감지막의 특성 및 응용

김영범,박종아,김진해,김권태,김정규,마대영,박기철 경상대학교 생산기술연구소 2001 工學硏究院論文集 Vol.1 No.-

The microsensors to detect NH3 gas were fabricated by continous deposition of In film by evaporation and ZnO film by rf magnetron sputtering onto the Si3N4 diaphragm that was prepared by MEMS technology. The sensors were heat-treated to dope In into the ZnO thin film. The electrical characteristics of sensitive films were studied as a function of heat-temperature by 4-point probing method and electrometer. The dependence of the sensitivity, selectivity and time response of sensor on heat-treatment temperature was investigated. The microsensor heat-treated at 400℃ that 3000 A ZnO:In film was chosen as gas sensitive film, showed the highest sensitivity 23% at 350ppm NH3 under 366mW heater power. The time response was 90sec. The sensitivity for CO and NOx was not observed.

Failure with Strain Localization of Aluminum Alloy 7075 Sheets at Elevated Temperature and its Application to Two-Step Hybrid Forming

Jong‑Hwa Hong,Hyunki Kim,Wonjae Kim,Yong‑Nam Kwon,Daeyong Kim 대한금속·재료학회 2022 METALS AND MATERIALS International Vol.28 No.4

In this work, the onset of failure induced by severe strain at elevated temperature was numerically estimated with crossformedempirical hardening law describing material softening. The hardening law can replicate the rate-sensitive behaviorof aluminum alloy 7075 sheets (thickness of 2.0 mm) with initial hardening and progressive material deterioration causedby dynamic recrystallization, dynamic recovery, and micro-void development. The characterized material was applied to thetwo-step hybrid forming process consisting of a drawing at 400 °C followed by a pneumatic forming at 470 °C to produce ashock absorber housing with an extremely complex shape. The user-defined subroutine codes, VUMAT (ABAQUS/Explicit)and UMAT (ABAQUS/Standard), were sequentially utilized for the drawing and the pneumatic forming, respectively. Theidentified hardening parameters based on uniaxial tensile tests were validated by simulating the two-step hybrid formingprocess and compared with the conventional Voce type law (converging function) and the combined Swift-Voce type law(ever-increasing function) since they play a key role in accurately predicting the onset of failure induced by severe strainlocalization. Finally, simulation results are reasonably well matched with experiments in terms of the moment of failureoccurrence, failure location, final blank shape, and thickness distribution.

조혈모세포이식 환자에서 침습성 진균 감염에 대한 Micafungin의 예방 효과 및 안전성

김시현,이동건,최수미,권재철,박선희,최정현,유진홍,이성은,조병식,김유진,이석,김희제,민창기,조석구,김동욱,이종욱,민우성,박종원 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Background: Micafungin, a potent inhibitor of 1,3-β-D-glucan synthase, is a novel antifungal agent of the echinocandin class. In vitro study showed that micafungin was effective against Aspergillus species as well as Candida species, but clinical data on the prophylactic efficacy against invasive fungal infections (IFIs) other than candidiasis are still lacking. Materials and Methods: We identified 60 consecutive adult hematopoietic stem cell transplantation (HSCT) recipients who received at least 3 doses of micafungin during neutropenic period. Micafungin was started as an alternative in patients who were intolerant or had adverse events (AEs) to primary prophylactic antifungal agents. We retrospectively reviewed the medical records and analyzed the efficacy and safety of micafungin for prophylaxis against IFIs. Results: The patients either had autologous (n=9) or allogeneic (n=51: 1 syngeneic, 24 sibling, 26 unrelated donor) HSCT. Itraconazole oral solution (n=58) was the most frequently used first line antifungal agent for prophylaxis and was administered for median 11 days. The most frequent cause of switch to micafungin was vomiting (n=42). The duration of neutropenia and micafungin administration was median 13 and 12 days, respectively. A successful outcome was achieved in 45 (75%) patients. Empirical antifungal therapy was initiated in 13 (22%) patients. There were 2 cases (3.3%) of breakthrough fungal infections which comprised a probable invasive pulmonary aspergillosis and a possible invasive fungal sinusitis. There was no case of invasive candidiasis. A total of 53 (88%) patients experienced at least one AE regardless of causality during micafungin administration. The most frequent AEs were hypokalemia, vomiting, diarrhea, and elevated serum aspartate aminotransferase or alanine aminotransferase. Among the aforementioned AEs, only 1 case of diarrhea could be classified as a probable relation with micafungin when causality was assessed. There was no AEs that caused discontinuation of micafungin. Conclusions: Micafungin seems to be a safe and effective agent for prophylaxis of IFIs including aspergillosis as well as candidiasis in HSCT recipients. However, further large, prospective, and randomized comparative studies are warranted for aspergillosis.

The effect of combined Rehmannia glutinosa Libosch and Eleutherococcus senticosus Max(OPB) extracts on bone mineral density in ovariectomized rats.

Kim,Jung-Keun 대한구강생물학회 2007 International Journal of Oral Biology Vol.32 No.4

This study was conducted to investigate the preventingeffects of OPB (Rehmannia glutinosa Libosch and Eleuth-erococcus senticosus Max extracts) and combined OPB/Calcium therapy on bone loss in ovariectomized rats. SixtySprague Dawley rats of 12-week-old were divided into eightgroups: OVX (ovariectomized), OPBL (OPB 50mg/kg),OPBM (OPB100mg/kg), OPBH (OPB 200mg/kg), OPBL/CAL(OPBL+CAL), OPBM/CAL (OPBM+CAL), OPBH/CAL (OPBH+CAL) and CAL (Calcium citrate 88.33mg/kg+1α, 25-dihydroxy-vitamin D3 33.33IU/kg). Bone mineraldensity (BMD), bone mineral content (BMC), bone strengthindices and cortical thickness were analyzed by peripheralquantitative computerized tomography (pQCT). pQCTscanning showed that OVX induced a significant decreasein trabecular bone mineral density and bone mineralcontent in the proximal tibia (-36.4±2.4%, -21.8±12.7%).These decreases were significantly prevented by theadministration of OPBM and OPBM/CAL. Cortical BMDand BMC of tibia were slightly enhanced by OPB and OPB/CAL. However there was no significant difference betweenOVX and OPB, OPB/CAL treated group. Bone strengthindices and cortical thickness were not significantly different.Our results suggest that OPB and combined OPB/Calciumtherapy are effective in preventing the development of boneloss induced by ovariectomy in rats.

VDT작업별 정신사회적 스트레스와 근골격계 장애에 관한 연구

백남종,강종두,주영수,배인근,권호장,박종만,조수헌,김돈규,김재용,최홍렬 大韓産業醫學會 1998 대한직업환경의학회지 Vol.10 No.4

It has been hypothesized that jobs that have both high psychological demands and low decision latitude("job strain") can lead to musculoskeletal disorder. The objective of this study was to test whether job strain was correlated with the presence of work-related musculoskeletal disorder, especially myofascial pain syndrome(MPS). Information on demographic factors, confounders such as household load and taking care of children or not, and scores for decision latitude, job demand, and social support was obtained by self-administered questionnaire, which had been developed in Korean language, by adopting NIOSH instrument and Extended Karasek Model(16 items). All subjects were also examined by rehabilitation medicine specialists for musculoskeletal disorders. Subjects(n=370) could be categorized into 4 groups, these were, housewives(n=89), shipyard CAD workers(n=89), general female workers(n=79; nurses, insurance counselors, public officials, clerks, etc), and telephone directory assistance operators(n=113). Results from univariate analyses indicated that all demographic factors, all confounders, scores for decision latitude and social support were not associated with the risk of musculoskeletal disorder. However, score for job demand was higher in musculoskeletal disorder cases than others. In subgroup analysis, this association was convinced again, in telephone directory assistance operators. Job strain model showed that the group of telephone directory assistance operators was high-stain group, and OR of musculo skeletal disorder was 2.446(95% C. I. : 1.174, 5.096), when comparing this with the low strain group. In conclusion, job strain is a risk factor for work-related musculoskeletal disorder.