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Indomethacin 이 말기 신부전증 환자의 자율신경계 기능에 미치는 영향에 관한 연구
하성규(Sung Kyu Ha),한대석(Dae Suk Han),주현영(Hyung Young Ju),김형직(Hyung Jik Kim),구철회(Chul Hoe Koo),김문재(Moon Jae Kim),이호영(Ho Yung Lee) 대한내과학회 1987 대한내과학회지 Vol.33 No.2
N/A The authors studied autonomic nervous system fucntion in 63 patients with uremia and 56 normal control subjects. Among these, automonic nervous system function was evaluated in 11 normal control subjects, 18 hemodialysis patients and 6 CAPD patients before and after indomethacin administration. The results were as follow: 1) The valsalva ratio and heart rate variation ratio were significantly lower in CRF group than normal control group (p<0.05); however, there was no statistically significant differences among CRF patient group (p<0.l). 2) The change of diastoloic blood pressure after orthostasis was significantly lower in CRF group than normal control group (p<0.05). The heart rate was more rapid in normal cantrol group, hemoidalysis patients group and CAPD patient group than predialysis patient group (p<0.05). 3) The change of blood pressure after hand grip exercise was lower in predialysis (p<0.05), The degree of increase in heart rate was lower in predialysis patients than normal control group. 4) Although the valsalva ratio and heart rate variation ratio seem to improve after indomethacin administration, they were not statistically significanct (p<0.1), The change of heart rate in response to valsalva maneuver after indomethacin administration was not sign-ficiant (p<0.1). 5) The change in blood pr re and heart rate before and after indomethacin administration were not statistically significant (p>0.05). However, there was significant increase in systologic and diastolic blood pressure in CAFD patients with hand grip exercise after indomethacin administration (p<0.025). In summary, the function of ANS in patients with CRF was significantly reduced than the normal control group. Although, the function of ANS seemed to improve slightly after indomethacin administration in patients with CRF, the results were not satatistically significant, The prostaglandin has been proposed to play a role in ANS dysfunction. However, the results of this study does not seem to support this theory. Futher studies would be required in odrer to show the role of prostaglandin in ANS dysfunction in patients with CRF.
척수 손상 환자의 라이프 스타일 개선을 위한 재활 중재 효과 : 무작위 대조군 연구의 체계적 고찰 및 메타분석
하성규(Ha, Sung Kyu),박혜연(Park, Hae Yean) 대한신경계작업치료학회 2020 재활치료과학 Vol.9 No.4
목적 : 척수손상환자를 대상으로 한 무작위 대조군 연구의 체계적 고찰과 메타분석을 통해 척수손상환자의재활 중재의 효과성과 근거를 알아보고자 한다. 연구방법 : 국외 논문데이터베이스에서 검색어를 사용하여 학술지에 게재된 연구를 2명의 연구자가 독립적으로 검색하여 선정하였다. 선정기준에 부합한 연구는 총 21편이었고, PEDro Scale을 사용하여 연구의질적 평가를 실시하였다. 메타분석은 Comprehensive Meta-Analysis 3.0 프로그램을 사용하였다. 결과 : 분석된 연구에 참여한 연구대상자는 총 713명이었고, 메타분석을 실시한 결과 신체활동을 이용한중재는 0.406(95.0% 신뢰구간: 0.221~0.591), 전기 자극 치료중재는 0.505(95.0% 신뢰구간: 0.449~1.528) 로 중간크기(Medium)의 효과를 보이는 것으로 나타났고 교육적 방법 중재는 0.248(95.0% 신뢰구간: 0.033~0.464), 복합 중재는 0.280(95.0% 신뢰구간: 0.122~0.438)로 작은 크기(Small)의 효과를 보이는것으로 나타났다. 통계적 이질성 검정에서 유의미한 이질성이 있어 연구결과 통합 시 랜덤효과 모형을선택하여 분석하였고, 출판편견은 유의미하지 않아 신뢰할만한 연구결과였다. 결론 : 분석된 결과 척수손상환자를 대상으로한 재활 중재는 효과적임을 알 수 있었다. 척수손상환자를대상으로한 재활분야에서 임상가들이 대상자의 라이프 스타일을 개선하기 위한 프로그램을 구성할 때기여할 것으로 사료된다. Objective : The purpose of this study was to investigate the effectiveness and basis of rehabilitation intervention in patients with spinal cord injury by systematic review and meta-analysis of randomized controlled studies. Methods : Two researchers independently searched and selected a study published in an academic journal using a search term in an international thesis database. A total of 21 studies met the selection criteria, and qualitative evaluation of the study was conducted using the PEDro Scale. Meta-analysis was performed using Comprehensive Meta-Analysis 3.0 program. Results : A total of 713 subjects were included. The results of the meta-analysis showed a score of 0.406 (95.0% confidence interval: 0.221 ~ 0.591) for intervention using physical activity and 0.505 (95.0% confidence interval: 0.449 ~ 1.528) for electronic stimulation therapy, which showed medium effect; educational intervention had a 0.248 (95.0% confidence interval: 0.033 ~ 0.464), and mixed intervention 0.280 (95.0% confidence interval: 0.122 ~ 0.438). It was shown that the effect of small (small). There was a significant heterogeneity in the statistical heterogeneity test, and thus the random effects model was selected and analyzed. Conclusion : The results showed that rehabilitation interventions were effective for patients with spinal cord injury. During the rehabilitation of spinal cord injury patients, clinicians are expected to contribute to the development of programs to improve their lifestyles.
최규헌(Kyu Hun Choi),이호영(Ho Yung Lee),한대석(Dae Suk Han),하성규(Sung Kyu Ha),류동렬(Dong Ryeol Ryu),송현용(Hyun Yong Song),신석균(Suk Kyun Shin),황재하(Jae Ha Hwang),노현정(Hyun Jung Roh),유태현(Tae Hyun Yoo),김주성(Joo Seong Kim 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.1
N/A Lupus nephritis is a major cause of morbidity and mortality arising from systemic lupus erythematous. It is generally acknowledged that the presence of diffuse proliferative lupus nephritis(DPLN) is highly predictive of a poor prognosis in terms of renal and patient out- come on survival. The objective of this study was to evaluate the clinicopathologic characteristics, renal out- come according to therapeutic regimen, and prognostic factors of biopsy-proven diffuse proliferative lupus nephritis. Among the biopsy-proven lupus nephritis patients who were admitted to Yonsei University Medical Center from January 1986 to June 1997, 36 patents who were diagnosed DPLN by renal biopsy and treated for at least 6 months and regularly followed-up for at least 12 months were included. We retrospec-tively reviewed the medical recorders. Patients were treated with steroid regimen with or without cyclo-phosphamide. According to the therapeutic response, patients were divided into two groups : a therapeutic response group(n=24), and a therapeutic non-response group<n=12). The mean age of the patients was 27.4 years and the mean follow-up duration was 51 months. Lupus nephritis developed at a mean 9.7 months after SLE diagnosis and mean duration of nephritis was 39.2 months. Mean serum creatinine was 1.6mg/ dL, 24 hour proteinuria was 4,873mg, and anti-DNA antibody was positive in 8196 of patients at the time of renal biopsy. Activity index and chronicity index were 10.4 and 2.8, respectively. Overall 5 year renal survival rate was 7596 and no difference between steroid single therapy and cyclophosphamide combination therapy was observed. Factors affecting therapeutic response included delayed development of nephritis(3.1 vs 13.8 months, p<0.05) and elevated serum creatinine level(0.9 vs 1.9mg/dL, p<0.05), which were associated with poor therapeutic response. Other clinicopathologic, biochemical and immunologic parameters were not different between the therapeutic response group and the therapeutic non-response group. In conclusion, delayed development of lupus nephritis and elevated serum creatinine at nephritis presentation are poor prognostic factors of DPLN, but further randomized prospective study{including divided cytoxan intravenous pulse therapy and oral therapy, with long-term follow-up) is necessary.