• 대한한방내과학회지
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• 제45권1호
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• pp.1-10
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• 2024

Objectives: This study investigated the pattern identification (PI) and clinical index of Parkinson's disease (PD) for personalized diagnosis and treatment. Methods: This prospective observational multi-center study recruited 100 patients diagnosed with PD from two Korean medicine hospitals. To cluster new subtypes of PD, items on a PI questionnaire (heat and cold, deficiency and excess, visceral PI) were evaluated along with pulse and tongue analysis. Gait analysis was performed and blood and feces molecular signature changes were assessed to explore biomarkers for new subtypes. In addition, unified PD rating scale II and III scores and the European quality of life 5-dimension questionnaire were assessed. Results: The clinical index obtained in this study analyzed the frequency statistics and hierarchical clustering analysis to classify new subtypes based on PI. Moreover, the biomarkers and current status of herbal medicine treatment were analyzed using the new subtypes. The results provide comprehensive data to investigate new subtypes and subtype-based biomarkers for the personalized diagnosis and treatment of PD patients. Ethical approval was obtained from the medical ethics committees of the two Korean medicine hospitals. All amendments to the research protocol were submitted and approved. Conclusions: An objective and standardized diagnostic tool is needed for the personalized treatment of PD by traditional Korean medicine. Therefore, we developed a clinical index as the basis for the PI clinical evaluation of PD. Trial Registration: This trial is registered with the Clinical Research Information Service (CRIS) (KCT0008677)

• 동서간호학연구지
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• 제17권1호
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• pp.66-70
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• 2011

Purpose: The aim of this study was to examine the types of nursing problems in oriental nursing practice. Methods: This study employed a descriptive survey design. Nursing documentation was retrospectively reviewed for patients discharged from an oriental medicine hospital during three months. Nursing diagnoses documented were mapped into the Clinical Care Classification System. Data were summarized using descriptive statistics. Results: Data were collected from 110 patients using nursing documentation. The number of nursing diagnoses documented was 204 with a mean of 1.9 per patient. The frequently occurring nursing diagnoses were 'risk for trauma' (48.0%), 'pain' (13.7%), and 'urinary elimination alteration' (7.8%). According to the Clinical Care Classification system, the safety component (51.5%) was the most common nursing problem in oriental nursing practice. Conclusion: The study finding suggested that major nursing problems in oriental nursing practice were related to patient safety. Therefore, oriental nursing education on patient safety should be emphasized to improve the quality of nursing care in oriental medicine hospitals.

• 대한한의학회지
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• 제35권2호
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• pp.60-68
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• 2014

Background: Pattern identification is a unique diagnostic method of traditional Oriental medicine that has recently been the target of questionnaire-based research. Sasang (four-types) constitutional medicine (SCM) is a practice in traditional Korean medicine that seeks to promote objectivity in diagnostics. This paper attempts to illuminate the relationship between constitutions and the pathogenic factors of pattern identification through questionnaires completed by menopausal women about their symptoms. Methods: From March to October 2012, we examined 291 women from the general population, with ages ranging from 40 to 60 years, applying the Kupperman index, the Menopause-Specific Quality of Life Questionnaire (MENQOL), pattern identification based on the Diagnosis System of Oriental Medicine (DSOM), and SCM. We then analyzed the relationship between constitutional type and pathogenic factors. Results: No significant differences were found in the scores of either the Kupperman index or MENQOL questionnaire in relation to constitutional type. However, in a statistical analysis correlating the DSOM pathogenic factor scores (PFS) with the scores of the Kupperman index and MENQOL vasomotor subscale, heat showed a significant positive correlation with SoYang type (SY) and TaeEum type (TE), but not SoEum type (SE), while insufficiency of yin and insufficiency of yang, as well as blood deficiency, showed a significant positive correlation with the TE and SE types. Conclusion: The pathogenic factors in the menopausal symptoms of middle-aged women, specifically the prominent menopausal symptom of facial flushing, differed significantly according to constitutional type.

• Korean Journal of Radiology
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• 제23권1호
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• pp.77-88
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• 2022

Objective: Our study aimed to evaluate the quality of radiomics studies on brain metastases based on the radiomics quality score (RQS), Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) checklist, and the Image Biomarker Standardization Initiative (IBSI) guidelines. Materials and Methods: PubMed MEDLINE, and EMBASE were searched for articles on radiomics for evaluating brain metastases, published until February 2021. Of the 572 articles, 29 relevant original research articles were included and evaluated according to the RQS, TRIPOD checklist, and IBSI guidelines. Results: External validation was performed in only three studies (10.3%). The median RQS was 3.0 (range, -6 to 12), with a low basic adherence rate of 50.0%. The adherence rate was low in comparison to the "gold standard" (10.3%), stating the potential clinical utility (10.3%), performing the cut-off analysis (3.4%), reporting calibration statistics (6.9%), and providing open science and data (3.4%). None of the studies involved test-retest or phantom studies, prospective studies, or cost-effectiveness analyses. The overall rate of adherence to the TRIPOD checklist was 60.3% and low for reporting title (3.4%), blind assessment of outcome (0%), description of the handling of missing data (0%), and presentation of the full prediction model (0%). The majority of studies lacked pre-processing steps, with bias-field correction, isovoxel resampling, skull stripping, and gray-level discretization performed in only six (20.7%), nine (31.0%), four (3.8%), and four (13.8%) studies, respectively. Conclusion: The overall scientific and reporting quality of radiomics studies on brain metastases published during the study period was insufficient. Radiomics studies should adhere to the RQS, TRIPOD, and IBSI guidelines to facilitate the translation of radiomics into the clinical field.

• Imaging Science in Dentistry
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• 제50권3호
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• pp.227-236
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• 2020

Purpose: Image artifacts caused by patient motion cause problems in cone-beam computed tomography (CBCT) because they lead to distortion of the 3-dimensional reconstruction. This prospective study was performed to quantify patient movement during CBCT acquisition and its influence on image quality. Materials and Methods: In total, 412 patients receiving CBCT imaging were equipped with a wireless head sensor system that detected inertial, gyroscopic, and magnetometric movements with 6 dimensions of freedom. The type and amplitude of movements during CBCT acquisition were evaluated and image quality was rated in 7 different anatomical regions of interest. For continuous variables, significance was calculated using the Student t-test. A linear regression model was applied to identify associations of the type and extent of motion with image quality scores. Kappa statistics were used to assess intra- and inter-rater agreement. Chi-square testing was used to analyze the impact of age and sex on head movement. Results: All CBCT images were acquired in a 10-month period. In 24% of the investigations, movement was recorded (acceleration: >0.10 [m/s²]; angular velocity: >0.018 [°/s]). In all examined regions of interest, head motion during CBCT acquisition resulted in significant impairment of image quality (P<0.001). Movement in the horizontal and vertical axes was most relevant for image quality (R²>0.7). Conclusion: Relevant head motions during CBCT imaging were frequently detected, leading to image quality loss and potentially impairing diagnosis and therapy planning. The presented data illustrate the need for digital correction algorithms and hardware to minimize motion artefacts in CBCT imaging.

• 전자공학회논문지
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• 제50권12호
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• pp.247-253
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• 2013

본 연구의 목적은 Direct DR(Digital Radiography), Indirect DR, I.I(Image Intensifier) DR에서 X선 광자 검출 방식에 따른 선량측정 및 획득된 영상을 정량적이고 객관적인 측정을 통해 DR System을 비교 평가 하는 것이다. Rando phantom을 사용하여 입사표면선량을 측정하였으며, 측정된 입사표면선량 값을 통해 PCXMC 프로그램을 사용하여 유효선량과 방사선 조사로 인한 위험을 평가하였다. 21cm 아크릴 phantom을 사용하여 SNR(Signal to Noise Ratio), NPS(Noise Power Spectrum), CNR(Contrast to Noise Ratio)을 측정하였으며, 측정값은 통계학적 분석기법을 사용하여 유의성을 평가하였다. 입사표면선량, 주요장기선량, 유효선량 모두 direct DR이 가장 낮게 측정되었으며, direct DR 선량을 기준으로 I.I type DR은 약 1.3배, indirect DR은 약 2.4배 높은 선량 비율로 측정되었다. 방사선량에 따른 위험도 역시 동일한 비율로 측정되었다. SNR 측정 결과 direct DR측정값을 기준으로 I.I DR은 약 7.25배, indirect DR이 약 1.48배 낮은 비율로 측정되었다. CNR 측정 결과 direct DR 측정값을 기준으로 I.I DR은 약 1.16배 높고, indirect DR이 약 0.87배 낮은 비율로 측정되었다. 따라서 a-selenium 검출소자를 사용하여 X선 광자를 검출하는 방식인 direct DR은 적은 선량으로 우수한 화질의 영상을 구현함으로써 선량에 민감한 소아나 생식선이 포함된 검사 등에 유용할 것으로 사료된다. 또한 많은 진단 정보를 위한 영상 평가가 요구되는 경우에는 indirect DR이 유용할 것으로 판단된다.

• 대한통합의학회지
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• 제10권3호
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• pp.173-184
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• 2022

Purpose : The purpose of this study was two-fold: to identify the effect of dental hygienist's self-determination motivation on their job engagement and to analyze the moderating effect of compensation satisfaction that affect the relevance. Methods : Data were collected using a structured self-report questionnaire administered to 260 dental hygienists working in dental hospitals and clinics in Busan, South Korea. These were analyzed using IBM SPSS Statistics version 26.0 and SPSS Process Macro 3.5. A frequency analysis, including the respondents' general characteristics, frequency, percentages, and standard deviations, was performed. A regression analysis was also performed using SPSS Process Macro to verify the moderating effect of compensation satisfaction in the effect of self-determination motivation on job engagement. Results : The self-determination motivation of the dental hygienists had a statistically significant positive effect on their job engagement, which was the dependent variable. Higher intangible compensation satisfaction levels led to a stronger effect of intrinsic motivation but a weaker effect of extrinsic motivation on job engagement. Moreover, higher tangible compensation satisfaction levels strengthened the effect of intrinsic motivation on job engagement. Conclusion : Recently, the demand for oral health care has been increasing, Competition in the dental medical service market warrants, high-quality dental services based on accurate diagnosis and treatment. In this context, dental hygienists' job engagement must be improved. For this purpose, increasing the satisfaction of dental hygienists with self-determination motivation and appropriate compensation is effective. In addition, attention must be paid to the moderating effect of compensation satisfaction on the relationship between intrinsic motivation and job engagement. On the basis of the implications of this study, the results can be used as basic data for improving dental hygienists' welfare system and manpower management.

• Journal of Hospice and Palliative Care
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• 제13권3호
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• pp.181-189
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• 2010

목적: 최근 보건의료 정책 결정은 근거에 기반하여 이루어지는 추세에 있으며, 말기암환자 정보시스템은 이러한 필요에 부응하기 위하여 개발되었다. 본 고에서는 말기암환자 정보시스템의 개발과정 및 6개월 데이터로부터의 통계 결과를 보고하고자 한다. 방법: 말기암환자 정보시스템의 입력항목은 실무 전문가들의 자문을 받아 개발되었으며, 이벨로스 임상연구관리시스템을 기반으로 구축하였다. 2009년 보건복지가족부에서 지정된 34개 암환자완화의료 기관에 2009년 1월 1일부터 6월 30일까지 등록된 환자들에 대한 정보가 수집되었다. 분석은 기술적 통계를 이용하였다. 결과: 총 2,940명의 전국적으로 대표성 있는 데이터로부터 아래와 같은 결과를 얻었다. 평균연령은 $64.8{\pm}12.9$ 세였고, 56.6%가 남자였다. 폐암(18.0%)이 가장 많았다. 2인 이상의 의사에 의하여 말기진단을 받은 경우는 50.3% 였으며, 입원 당시 말기라는 사실을 알고 있는 환자는 69.7%였고, 거의 절반에 가까운 환자가 특별한 의뢰 없이 입원하였다. 평균 통증 및 최고 통증은 입원 1주 후에 통계적으로 유의하게 감소하였다. 사망 퇴원한 환자가 73.4%였으며, 집으로 퇴원하는 경우는 13.3%에 불과했다. 1회당 평균 입원일수는 $20.2{\pm}21.2$일이었으며, 중위값은 13일이었다. 결론: 말기암환자 정보시스템의 운영을 통하여 완화의료 기관 이용 환자 및 가족의 특성, 서비스 제공에 관한 현황 등에 관한 전국적으로 대표성 있는 자료를 얻을 수 있었다.

• Journal of the Korean Data and Information Science Society
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• 제27권4호
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• pp.925-934
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• 2016

21세기에 접어들면서 사람들은 건강 및 삶의 질에 관심을 많이 가지고 있다. 이에 본 연구에서는 사람들이 질병에 걸리면 치료에 많은 비용과 시간이 소요되므로 미리 아건강 상태를 진단하여 적극적인 치료 계획을 수립한다면 건강관리가 수월하고 사회적 비용을 줄일 수 있을 것으로 생각이 되어 특정 집단의 구성원을 대상으로 생활관리와 아건강 설문지에 각각 응답한 자료를 바탕으로 통계적 분석을 수행하였다. 분석 결과는 성별에 따른 생활관리와의 차이분석에서는 유의수준 5%에서 차이가 없는 것으로 나타났으며, 성별에 따른 아건강과의 차이 분석에서는 유의수준 5%에서 면역계, 장, 뇌신경, 호르몬 및 비뇨기에 대해서는 여학생이 남학생보다 건강 상태가 좋지 않은 것으로 나타났다. 또한 단과대학에 따른 생활관리와는 차이가 없는 것으로 나타났으며, 아건강과도 유의한 차이가 없는 것으로 나타났다. 생활관리와 아건강과의 분석 결과에서는 유의수준 5%에서 소화계, 장, 뇌신경, 호르몬 및 호흡기와는 관계가 있는 것으로 나타났다. 마지막으로 의사결정나무분석 결과는 호르몬과 골격계의 불량 비율이 생활관리의 불량 비율보다 월등히 높은 비율을 보여주었다. 이들을 종합해보면 생활관리를 잘 조절한다면 아건강 상태를 양호하게 할 수 있다는 것을 보여주는 결과라고 할 수 있다.

• 한국직업건강간호학회지
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• 제17권1호
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• pp.86-95
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• 2008

Purpose: The objectives for this study are to produce the comprehensive management indexes and find their application strategies for appropriate medical care in primary care clinics under workers' compensation insurance. Method: Data of this study was workers' compensation insurance medical fees claim's data from July 2006 to June 2007. Data were analyzed using SAS 9.1 version by applying descriptive statistics and Pearson's correlation. The indexes such as costliness index(CI), standard medical fee were calculated based on the fourth revision of korean classification of diseases(KCD-4.). Results: The CI, visiting index(VI), outliers index(OI), and medical review adjustment percentage were positively correlated in the both inpatient and outpatient medical fees in primary care clinics under workers' compensation insurance. The major medical specialities were neurological surgery, general medicine, general surgery, rehabitational medicine, and orthopedic surgery. The CIs were slightly high in rehabitational medicine among major medical specialities. The CIs were mostly high in diagnosis, test, anesthesia, and rehabitational assistive device fees among major medical specialities. The CIs were slightly high in Kwangju, Daegu, Daejeon, and Busan districts among district management centers of Korea Workers' Compensation and Welfare Service. Conclusions: We suggest the continuous development of appropriate disease classification system and medical care quality indicators to successfully take root the comprehensive management for appropriate medical care under workers' compensation.