• Pediatric Infection and Vaccine
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• 제15권2호
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• pp.146-151
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• 2008

목 적 : 원내 감염 균주의 하나인 A. baumannii는 최근 다약제 내성을 가지며 성인에 대해서는 보고되고 있으나 소아 환자에 대한 체계적인 연구는 미흡한 실정이다. 이에 저자들은 소아 화상환자에서 분리된 A. baumannii에 대해 항생제 감수성의 변화 및 저항 균주의 출현에 대해 알아보고자 본 연구를 시행하였다. 방 법 : 1999년 1월부터 2005년 12월까지 만 7년간 화상을 주소로 한림대학교의료원 한강성심병원에 입원한 15세 미만의 환아들 가운데 A. baumannii가 분리된 환아 56명, 105주를 대상으로 후향적으로 자료를 분석하였다. 결 과 : 균이 분리된 환아의 남녀 성비는 1.15:1 이었으며 중앙연령은 48.3개월이었다. 균의 배양부위는 상처 부위 69례(65%), 객담 21례(20%), 혈액 6례(6%), 카테터 관 5례(5%), 기관 삽관용 튜브 2례(2%), 소변 2(2%)순이었으며 주로 3월과 11월, 12월에 분리되었으나 연중 분포하는 양상을 보였다. 항생제의 내성률은 2000년 이후 대부분 70% 이상을 보였으며, 98례(93.33%)에서 다약제 내성을 보였다. 한편 carbapenem과 ciprofloxacin에 대한 내성균주의 출현 여부에 대해 3례(25%)에서 내성균주가 출현하였고 항생제 사용 기간은 평균 10일로 매우 짧았으며 혈액에서 균주가 분리된 환아 6례는 모두 다약제 내성 균주였으며 이중 1례는 사망하였다. 결 론 : 다약제 내성 균주인 A. baumannii에 대해 원내 감염의 심각성을 인식하고 동시에 단순 격리보다는 철저한 치료 계획이 필요하다. 즉, 감수성 결과에 입각한 항생제 사용 및 새로운 항생제 조합, 의료인을 포함한 숙주가 될 수 있는 환경에 대한 철저한 관리 등이 필요하겠다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3465-3468
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• 2016

Background: Fluorodeoxyglucose ($^{18}FDG$) PET/CT imaging has become an important component of the management paradigm in oncology. However, the significant imparted radiation exposure is a matter of growing concern especially in younger populations who have better odds of survival. The aim of this study was to estimate the effective dose received by patients having whole body $^{18}F$-FDG PET/CT scanning as per recent dose reducing guidelines at a tertiary care hospital. Materials and Methods: This prospective study covered 63 patients with different cancers who were referred for PET/CT study for various indications. Patients were prepared as per departmental protocol and 18FDG was injected at 3 MBq/Kg and a low dose, non-enhanced CT protocol (LD-NECT) was used. Diagnostic CT studies of specific regions were subsequently performed if required. Effective dose imparted by 18FDG (internal exposure) was calculated by using multiplying injected dose in MBq with coefficient $1.9{\times}10^{-2}mSv/MBq$ according to ICRP publication 106. Effective dose imparted by CT was calculated by multiplying DLP (mGy.cm) with ICRP conversion coefficient "k" 0.015 [mSv / (mG. cm)]. Results: Mean age of patients was $49{\pm}18$ years with a male to female ratio of 35:28 (56%:44%). Median dose of 18FDG given was 194 MBq (range: 139-293). Median CTDIvol was 3.25 (2.4-6.2) and median DLP was 334.95 (246.70 - 576.70). Estimated median effective dose imparted by $^{18}FDG$ was 3.69 mSv (range: 2.85-5.57). Similarly the estimated median effective dose by low dose (non-diagnostic) CT examination was 4.93 mSv (range: 2.14 -10.49). Median total effective dose by whole body 18FDG PET plus low dose non-diagnostic CT study was 8.85 mSv (range: 5.56-13.00). Conclusions: We conclude that the median effective dose from a whole body 18FDG PET/CT in our patients was significantly low. We suggest adhering to recently published dose reducing strategies, use of ToF scanner with CT dose reducing option to achieve the lower if not the lowest effective dose. This would certainly reduce the risk of second primary malignancy in younger patients with higher odds of cure from first primary cancer.

• Journal of Trauma and Injury
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• 제27권4호
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• pp.126-132
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• 2014

Purpose: The field trauma triage for injured patients is essential for trauma care system. In this study, agreement of patient evaluation between by prehospital EMS personnel and by hospital staffs and the appropriateness of prehospital triage were evaluated. Methods: This observational study was conducted from September to October 2012 for 5 weeks. During this period, EMT evaluated patient's severity according to guideline for field triage and recorded. Same guideline was applied in 26 hospitals for patients with EMS use. Kappa statistics were used to measure agreement for each item of guideline. Finally, over-triage and under-triage rate of EMT were calculated. Results: During study period, total 3,106 patients were transferred to 26 hospital emergency departments with EMS use. Kappa statistics for "vital signs" items were 0.45 for mentality lower than V and 0.44 for systolic blood pressure lower than 90 mmHg as a moderate agreement. In "anatomy of injury" items Kappa statistics were very low. In "mechanism of injury" items Kappa statistics were 0.28 for high-rise fall down and 0.27 for high energy traffic accident but in other items Kappa statistics were very low. 362 patients (12.0%) were over-triaged and 281 patients (9.3%) were under-triaged. Conclusion: Field triage can be applied but need to evaluate and modify in order to become accurate and sensitive for decision of transportation.

• 한국산업보건학회지
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• 제24권3호
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• pp.263-271
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• 2014

Objectives: Along with the several cases of pulmonary disorders caused by exposure to indium that have been reported in Japan, China, and the United States, cases of Korean workers involved in processes that require handling of indium compounds with potential risk of exposure to indium compounds have also been reported. We performed biological monitoring for workers in various target manufacturing processes of indium, indium oxide, and indium tin oxide(ITO)/indium zinc oxide(IZO) in domestic factories. Materials: As biological exposure indices, we measured serum concentrations of indium using inductively coupled plasma mass spectrometry, and Krebs von den Lungen 6(KL-6) and surfactant protein D(SP-D) using enzyme-linked immunosorbent assays. We classified the ITO/IZO target manufacturing process into powdering, mixing, molding, sintering, polishing, bonding, and finishing. Results: The powdering process workers showed the highest serum indium level. The mixing and polishing process workers also showed high serum indium levels. In the powdering process, the mean indium serum concentration in the workers exceeded $3{\mu}g/L$, the reference value in Japan. Of the powdering, mixing, and polishing process workers, 83.3%, 50.0%, and 24.5%, respectively, had values exceeding the reference value in Japan. We suppose that the reason of the higher prevalence of high indium concentrations in powder processing workers was that most of the particles in the powdering process were respirable dust smaller than $10{\mu}m$. The mean KL-6 and SP-D concentrations were high in the powdering, mixing, and polishing process workers. Therefore, the workers in these processes who were at greater risk of exposure to indium powder were those who had higher serum levels of indium, as well as KL-6 and SP-D. We observed significant differences in serum indium, KL-6, and SP-D levels between the process groups. Conclusions: Five among the seven reported cases of "indium lung" in Japan involved polishing process workers. Polishing process workers in Korea also had high serum levels of indium, KL-6, and SP-D. The outcomes of this study can be used as essential bases for establishing biological monitoring measures for workers handling indium compounds, and for developing health-care guidelines and special medical surveillance in Korea.

• 대한임상검사과학회지
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• 제50권2호
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• pp.155-163
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• 2018

빌리루빈은 내인성 항산화제로서 항염작용이 있으며, 고혈압, 당뇨병, 대사증후군 및 인슐린 저항성과 역상관 관계에 있다고 보고된다. 그러나 간 특이적 지표와 비교하여 빌리루빈과 대사증후군간의 관련성을 평가한 연구는 부족하다. 본 연구에서는 건강검진을 실시한 한국 성인남녀를 대상으로 ALT, GGT와 비교하여 총 빌리루빈과 대사증후군 유병률 사이의 관련성을 조사하고자 하였다. 이 횡단면 연구에는 2015년 3월부터 2018년 2월까지 경기도 소재 종합병원에서 건강검진을 실시한 20세 이상 성인남녀 22,568명이 포함되었다. American Heart Association/National Heart, Lung, and Blood Institute(AHA/NHLBI)의 지침에 따라 대사증후군을 진단하였다. 남녀 모두에서 대사증후군 위험요인이 없는 군보다 대사증후군 진단군에서 간 효소치가 높았으며, 총 빌리루빈과 직접 빌리루빈치는 낮게 나타났다. 남녀 모두에서 혈청 총 빌리루빈은 복부비만(r=-0.066 vs r=-0.055), 중성지방(r=-0.127 vs r=-0.136)과 약한 역상관 관계를 보였으며, 이는 ALT와 GGT보다 약한 관련성이었다. 또한 남녀 모두에서 ALT와 GGT뿐만 아니라 총 빌리루빈은 대사증후군 발생 가능성을 예측하는 지표는 아닌 것으로 나타났다.

• 한국임상약학회지
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• 제9권2호
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• pp.109-118
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• 1999

The need for and components of a contemporary community pharmacy externship for pharmacy students have not been clearly identified in Korea. Mail survey was performed among 20 college of pharmacy deans and 800 community pharmacists to analyze the current status and develop a consensus regarding major focus area and criteria of community pharmacy externship to be implemented under the separation of dispensary from medical practice in year 2000. Mail survey yielded $80\%\;and\;23.5\%$ response rate for pharmacy school deans and community pharmacists, respectively. Of the 16 pharmacy schools that responded 14 said they have externship program in hospital pharmacy, and only 8 pharmacy schools responded of having externship program for community pharmacy. However, these community pharmacy programs lacked criteria and standard guideline for the externship. The results of survey revealed that community pharmacy externship program for students should be organized and directed toward developing expert knowledge and skills in pharmacy practice activities, clinical services, communications, pharmacy management, and professionalism. Pharmacy practice components should include competencies and skills in computer application, prescription processing, dispensing, pharmaceutical compounding, Narcotics Control Law application, maintenance and provision of drug information, and laws and regulations. Clinical service components should include the ability to identify patient's drug-related problems, provide long-term patient care and appreciate drug therapy services. Communication skills should be taught to effectively express his/her professional opinion, deduce the needs of others, utilize appropriate techniques and media to communicate ideas and conduct a patient interview and to obtain patient drug history. Pharmacy management skills should be taught to be efficient in medical insurance and drug control process. It was found that professionalism, morality, pharmacy practice experience, ability to provide clinical services, collect and provide drug information and regality are important criteria of preceptors. Externship sites should possess the ability to stock various drugs, access and provide diverse pharmacy services and should have private patient counseling area. Most pharmacists agreed that top 200 drugs' generic and brand name, indications, dosage, side effects, and contraindication should be instructed during the externship. It was also found that student and preceptor should be evaluated for their performances during the externship. This information will be incorporated into teaming objectives for students and to develop Academic Extemship Program Guidelines.

• 중소기업융합학회논문지
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• 제3권2호
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• pp.27-32
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• 2013

무선 신체 영역 네트워크 (WBAN)는 블루투스 활성화 장치 및 PDA와 같은 작고 가벼운 무선 시스템의 출현에 의해 가능하게 되었다. 안테나는 WBAN 시스템의 필수적인 부분입니다 및 기술적 요구 사항과 물리적 제약 여러 가지에, 자신의 디자인 및 배치의 주의 깊은 고려가 필요하다. 의류의 일부는 건강 관리 응용 프로그램에서 추적 및 네비게이션 등의 통신 기능을 제공하기 위해 본 논문은 착용할 수 있는 안테나의 디자인을 제안하고 있다. 착용할 수 있는 안테나의 기판은 착용할 수 있도록 하기 위해서 경량, 낮은 유지 보수, 눈에 거슬리지 않는 작은 크기로 만들도록 섬유 재료로 만든다 본 논문은 안테나 디자인 WBAN 요구 사항을 만족 하는지 확인하기 위해 섬유/기판의 유형을 포함하여 착용할 수 있는 안테나에 대한 다른 매개 변수의 영향을 조사한다. 안테나의특성 및 동작은 무선 표준 기술 및 시스템 요구 사항에 의해 설정된 사양을 준수 할 필요가 있다. 이것은 다양한 유닛의 송신 및 수신 주파수 대역을 적절하게 선택될 필요가 있다는 것을 의미한다. 인체에 노출 될 수 있는 힘의 레벨에 제한이 있기 때문에, 안테나 등의 RF 시스템의 구성 요소는 이러한 제한을 충족하도록 설계 되어야한다. 직접 전력 전송에 영향을 미치는 안테나 이득, 안전 지침 내에 전력 레벨을 보장하는 중요한 매개 변수이고 설계에 가장 중요하다. WBAN 안테나 및 장치와 인체 사이의 전자기 상호 작용은 또한 탐색 할 것이다.

• 대한간호학회지
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• 제28권1호
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• pp.171-183
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• 1998

The purpose of this study was to identify the incidence of urinary incontinence in adult women and to identify factors related to life style and sexual intercourse that were related to incontinence. The sample consisted of 1,065 women living in Seoul or one of five provinces. Data for this study were collected from January 16 to June 23 using structured questionnaires. The Urinary Symptom Questionnaire developed by Jackson and a demographic questionnaire were used to collect the data. The data were analyzed using frequency, percentage with an SPSS/PC$^{+}$ program. The major finding are as follows : 1. The distribution of age of subjects was as follows : 20-29(10.1%), 20-39(17.8%), 40-49(27.3%). 50-59(22.3%), 60-69(12.9%), 70-79(6.1%). 80-89(2.8%), more than 90(0.6%). The frequency of normal delivery, 0(155%), 1-2(36.0%), 3-4(29.2%), 5-6(13.0%). more than 7(6.3%). The rate of subjects with menopause was 40.8%. 2. It was reported that 50.7% of the subjects experienced urinary incontinence with stress, mixed. and urgency incontinence being 49.8%, 43.4%, 6.8% respectively. 3. The lower urinary symptoms and incidence with urinary incontinence were as follows : Daily frequency. 22.3%, nocturia. 40.8%, urgency, 71.2%, bladder pain 47.8%, unexplainned incontinence, 32.4%, noctural incontinence, 16.1%, and frequency of incontinence, 37.7%. In term of quantity of incontinence, drop/pants damp, 29.5%, dribble/pants wet, 20.5%, flood or soaking through to outer clothing, 1.7%, and flood or running down legs or onto floor, 0.2%. 4. The symptoms related to sexual intercourse and incidence of urinary incontinence were as follows : dry vagina, 39.1%, sex life trouble, 10.8%, pain during sexual intercourse, 27.4%, and urine leakage during sexual intercourse. 8.8%. 5. Life style problems related to urinary incontinence were as follows : fluid intake restriction, 20.0%, affected daily task, 24.5%. avoidance of placess and situations, 35.0%, interference in physical activities, 30.6%, interference in relationships with other people. 19.0%. interference in relationships with husband/companion, 8.1%, and time after attack of urinary symptoms, 76.9%. In term of the feeling about the rest of their lifves the women reported : perfectly happy, 11.3%. pleased, 16.9%. mostly satisfied, 20.2%, mixed feelings, 21.0%, mostly dissatisfied, 21.0%, very unhappy 8.5%, and desperate. 1.0%. In conclusion. this study was a preliminary study to provide nursing practices guidelines for incontinence in adult women. Nurse working with adult women should develop and provide adequate care for these women.n.

• 과학기술학연구
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• 제12권1호
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• pp.1-43
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• 2012

이 글은 BRCA1과 BRCA2 두 인간유전자에 관련된 특허들에 대한 최근의 소송에서 제기된 인간유전자 특허의 여러 경제적, 법률적, 그리고 윤리적 쟁점들을 분석한다. 기존의 인간유전자 특허관련 연구들이 이의 법률적 논리와 윤리적 정당성에 대한 규범적인(normative) 분석에 초점을 두었다면, 이 글은 BRCA 관련 특허소송에의 기저에는 반공유재의 비극(the tragedy of the anticommons)이라 불리는 지적재산권과 경제혁신, 공공의 이익의 관계에 대한 새로운 이해가 존재하고 있음을 보일 것이다. 첫 부분에서는 2001년 미 특허청의 인간유전자 특허에 대한 정책의 형성과정에 대한 역사적인 분석을, 다음으로는 생명과학에서 지적재산권의 확대를 가져온 여러 경제적 가정들과 제도적 변화, 그리고 법적 판결들에 대한 비판적 논의를 소개할 것이다. 지적재산권의 한계와 생명의 사유화에 대한 비판을 통해서 BRCA 소송은 지적재산권의 정의와 그 범주, 그리고 이의 소유권을 둘러싼 논쟁이 공공의 이익, 과학과 의학 공동체의 창조적 지적활동과 환자들의 인권과 윤리의 문제가 복잡다단하게 얽혀있음을 보여주고 있다.

• Journal of Magnetics
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• 제21권2호
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• pp.293-297
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• 2016

For mastectomy patients, sufficient doses of radiation should be delivered to the surface of the chest wall to prevent recurrence. A bolus is used to increase the surface dose on the chest wall, whereby the surface dose is confirmed with the use of a virtual bolus during the computerized treatment-planning process. The purpose of this study is an examination of the difference between the dose of the computerized treatment plan and the dose that is measured on the bolus. Part of the left breast of an Anderson Rando phantom was removed, followed by the attainment of computed tomography (CT) images that were used as the basis for computerized treatment plans that were established with no bolus, a 3 mm-thick bolus, a 5 mm-thick bolus, and a 10 mm-thick bolus. For the computerized treatment plan, a prescribed dose regimen was dispensed daily and planning target volume (PTV) coverage was applied according to the RTOG 1304 guidelines. Using each of the established computerized treatment plans, chest-wall doses of 5 points were measured; this chest-wall dose was used as the standard for the analysis of this study, while the level of significance was set at P < 0.05. The measurement of the chest-wall dose with no bolus is 1.6 % to 10.3 % higher, and the differences of the minimum average and the maximum average of the five measurement points are -13.8 and -1.9, respectively (P < 0.05); however, when the bolus was used, the dosage was measured as 3.7 % to 9.2 % lower, and the differences of the minimum average and the maximum average are 7.4 and 9.0, -1.2 and 17.4, and 8.1 and 19.8 for 3 mm, 5 mm, and 10 mm, respectively (P < 0.05). As the thickness of the bolus is increased, the differences of the average surface dose are further increased. There are a variety of factors that affect the surface dose on the chest wall during post-mastectomy radiation therapy, for which verification is required; in particular, a consideration of the appropriate thickness and the number of uses when a bolus is used, and which has the greatest effect on the surface dose on the chest wall, is considered necessary.