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  • 1.
  • Dementia causes decreased cognitive function and disrupts daily life. Early detection of dementia and subsequent drug
    treatment may delay the onset of dementia. However, research resources for the development of early diagnosis
    technology and standardization of diagnosis are lacking. To overcome these, “Analysis of cohort-based amyloid pathologyrelated
    biomarkers” project planned by the Division of Brain diseases in the Korea National Institute of Health was
    conducted by the Samsung Medical Center. Blood specimens and clinical information, including positron emission technology
    (PET) images of amyloid were collected from 60 normal controls, 40 subjects with mild cognitive impairment, and 20
    subjects with Alzheimer’s disease. The collected resources were donated to the National Biobank of Korea to be used for
    dementia research.
    This research project resulted in two achievements. First, we developed a model for predicting dementia conversion among
    the patients with mild cognitive impairment using neuropsychological tests. Second, reliable reference regions for amyloid
    imaging of subcortical vascular dementia (SVaD) were identified using Centiloid scores. The results will contribute to the
    early diagnosis of dementia and diagnosis standardization.
  • 2.
  • The Korea National Health and Nutrition Examination Survey (KNHANES) is a national surveillance system that has been
    assessing the health and nutritional status of Koreans since 1998. Based on the National Health Promotion Act, the surveys
    have been conducted by the Korea Centers for Disease Control and Prevention (KCDC). The oral health component of
    KNHANES obtained data to assess the oral health status of Koreans, determine the prevalence of dental caries and
    periodontal disease. The prevalence of dental caries in male declined from 41.6% in 2007 to 33.4% in 2015. The prevalence
    of dental caries was higher in 20s than in 70s among male and female. And the prevalence of periodontal disease in female
    declined from 29.4% in 2007 to 22.1% in 2015. The prevalence of periodontal disease was higher in 70s than in 20s among
    male and female. The prevalences of dental caries and periodontal disease increased with lower household income levels.
  • 3.
  • Background: The nationwide surveillance for severe fever with thrombocytopenia syndrome (SFTS) was initiated in 2013 in the Republic of Korea. SFTS is an emerging tick-borne disease characterized by fever, thrombocy topenia and gastrointestinal symptoms including diarrhea, abdominal pain and vomiting. We analyzed the epidemiological and clinical features of reported SFTS cases in 2017.
    Methods/Results: A total of 272 cases were analyzed: 270 were laboratory-confirmed cases and 2 were suspect cases. There were 54 deaths (Case Fatality Rate, CFR: 19.9%) and the majority of cases were reported from May to November. The peak of cases were observed in October with 79. The age distribution of cases ranged between 19 and 91 years (median 66 years). 253 (93.0%) cases were aged more than 50 years and 118 (43.4%) cases were farm workers. Geographically, cases were mainly reported in Gyeonggi, Gangwon, Gyeongbuk, Chungnam, and Jeju provinces. In terms of risk behaviors, 197 cases (72.4%) had history of outdoor activities including farmworks.
    Conclusion: Age and neurologic symptoms including decreased level of consciousness, slurred speech and convulsions were markedly associated with SFTS-related mortality. The risk of death was 6.931 (95% CI=2.217-22.579) times higher among the cases with neurological symptoms than among the cases without ones. Those who experience symptoms after outdoor activities such as fever, gastrointestinal symptoms are advised to receive early diagnosis and proper treatment.
  • 4.
  • The graphic health warnings (GHWs) on cigarette packs are an effective smoking cessation policy, which has been implemented since December 2016 in Korea. Based on the results of the Korea Youth Risk Behavior Web-based Survey, seven in ten adolescents were aware of GHWs on cigarette packs. Eight in ten perceived GHWs on cigarette packs as conveying that smoking is harmful to health or that one should not smoke. In the future, Korea should pursue a stronger smoking cessation policy, and the Korea Centers for Disease Control and Prevention will continue to monitor smokingrelated indicators and produce basic data for establishing a policy on tobacco control.
  • 5.
  • 6.
  • Background: Inflammatory bowel disease (IBD) is characterized by chronic inflammation and refers to ulcerative colitis (UC) and Crohn's disease. In Crohn's disease, inflammation occurs in all body parts, from the mouth to the rectum, and UC involves inflammation only in the large intestine. IBD usually involves severe diarrhea, pain, fatigue, and weight loss. Although the etiology of IBD remains unknown, several studies have shown that the development of IBD is caused by genetic or environmental factors.
    Current status: In recent years, the incidence rate of IBD has increased rapidly in Asia, as well as in Western countries. In Korea, it increased by 29.7% in 2017 compared with that in 2013. Although there are some treatments including 5-aminosalicylates and corticosteroids, their therapeutic effects are low. Recently, several studies have been conducted to identify the cause of IBD. In addition, effective therapies are being proposed. Epidemiological and experimental data show that intestinal microbial composition may be becoming a major cause of IBD. It would be useful to develop a therapeutic agents to change the composition of intestinal microorganisms or use intestinal microorganisms. From this point of view, further research will be conducted on the development of therapeutic methods for parasites such as Trichuris suis that can change the composition of intestinal microorganisms and have been stably recognized through successful clinical trials.
    Future perspective: The Division of Vectors and Parasitic Diseases in the Korea Centers for Disease Control and Prevention (KCDC) will conduct research on the development of therapeutic agents using intestinal parasites or excretory secretory proteins.
  • 7.
  • In Korea, based on “Rare Disease Management Act”, rare diseases are defined as those affecting fewer than 20,000 patients or those with unknown prevalence due to the difficulty of diagnosis. In general, the lack of information, diagnosis, treatment, and research makes it difficult for patients with rare diseases to adequately receive healthcare services. Specifically patients with undiagnosed diseases suffer from the lack of experts for diagnosis and treatment, for example, in addition to the disease burden itself. Therefore, the undiagnosed program is important for patients to reduce the socioeconomic burden in the diagnostics odyssey. Recently, international collaborations such as the Undiagnosed Diseases Network International or International Rare Diseases Research Consortium have globally been emphasized to overcome the limit in the lack of information. Through the pilot project performed in 2017, the Korean Undiagnosed Diseases Program was launched in 2018.
    There are four categories in the UDP: categories I (undetermined due to the lack of medical and laboratory information), II (clinically undiagnosed with low awareness), III (genetically undiagnosed due to extreme genetic heterogeneity or clinical diversity), and IV (unknown knowledge). Through expert group review, enrollment and evaluation are performed. The patients included category IV are registered in the unspecified diseases group, and various data are collected for rare diseases research. The UDP is crucial for diagnosis, treatment, and research of rare diseases. However, the lack of experts, limitation in budget, and expansion of networks across various fields (biology, bioinformatics, animal model development, and omics among others) remain unresolved.
  • 8.
  • 9.
  • Background: Korea is experiencing a population decline and rapid aging. The life expectancy of women is greater than that of men, but these extra years generally do not involve good health for women. This study aimed to develop a differentiated physical activity program based on local community health promotion for elderly women and to evaluate the program’s effectiveness.
    Methods/results: The participants were divided into an exercise group (n = 57) and a control group (n = 52). The exercise group underwent a regular physical activity intervention program 3 times a week for 12 weeks. We compared changes in anthropometric characteristics between before and after a application of the program, and the percentage of body fat mass decreased significantly in the exercise group. The exercise group also showed a significant decrease in total cholesterol (TC) and low-density lipoprotein (LDL) cholesterol levels. In particular, the change in triglyceride levels after application of the program was approximately 54.3 mg/dl (range from 171.9 mg/dl pre-exercise to 117.6 mg/dl post-exercise). Basal physical fitness improved markedly among the exercise group participants. On the other hand, in the control group, with no application of a regular physical activity program, the body fat mass and the of LDL-cholesterol levels slightly increased after 12 weeks. Additionally, sarcopenia was seen to have significantly decreased after physical activity programs.
    Conclusion: The elderly women undergoing a regular exercise program showed improvement across several health indices through reduction in hyperlipidemia, hypercholesterolemia, and sarcopenia, leading to improved physical fitness. Further studies that consider psychosocial factors and nutrition status should be undertaken to increase the effectiveness of the regular physical activity program applied in this study.
  • 10.
  • Hypertension and cardiovascular disease due to high blood pressure are leading causes of death worldwide. Korea is rapidly becoming an aging society, and prevalence of hypertension is also increasing. Hypertension is usually defined as systolic blood pressure (SBP) ≥ 140 mmHg or diastolic blood pressure (DBP) ≥ 90 mmHg, or on the basis of current prescription of antihypertensive agents. According to the National Health and Nutrition Examination Survey (NHANES) in 2016, 29.1% (35.0% men, 22.9% women) of adults ≥ 30 years of age had hypertension. Although the awareness, treatment, and control rates for hypertension have steadily increased due to efforts by the government and the Korean Society of Hypertension, the control rate for hypertension remains less than 50%. In November 2017, the American Heart Association (AHA) presented a new standard for hypertension criteria (SBP/DBP ≥ 130/80 mmHg) based on the results of many clinical trials, including the Systolic Blood Pressure Intervention Trial (SPRINT), and recommended control rate of < 130/80 mmHg in hypertensive patients at high risk of cardiovascular disease. However, since the SPRINT included only 2% of those of Asian ethnicity and did not include patients with diabetes, stroke, and heart failure, it may be difficult to apply the new guideline to all high-risk hypertensive patients directly. Therefore, the government and related societies need to undertake further research to develop a Korean model for predicting the risk of incident cardiovascular disease; they also need to conduct research on the development of appropriate criteria for diagnosing hypertension in Koreans through clinical intervention studies involving high-risk patients. In addition, the Korea Centers for Disease Control and Prevention (KCDC) plans to more actively promote the impor tance of hyper tension prevention and management through a campaign to prevent hypertension.
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