• 보험의학회지
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• 제29권2호
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• pp.29-32
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• 2010

Moyamoya disease (MMD) is a progressive occlusive disease of the cerebral vasculature with particular involvement of the circle of Willis and the arteries that feed it. MMD is one of cerebrovacular accident,which is treated with sugical maeuver in pediatic neurosurgery. Moyamoya (ie, Japanese for "puff of smoke") characterizes the appearance on angiography of abnormal vascular collateral networks that develop adjacent to the stenotic vessels. The steno-occlusive areas are usually bilateral, but unilateral involvement does not exclude the diagnosis. The exact etiology of moyamoya disease is unknown. Some genetic predisposition is apparent because it is familial 10% of the time. The disease may be hereditary and multifactorial. It may occur by itself in a previously healthy individual. However, many disease states have been reported in association with moyamoya disease, including the following: 1) Immunological - Graves disease/thyrotoxicosis 2) Infections - Leptospirosis and tuberculosis 3) Hematologic disorders - Aplastic anemia, Fanconi anemia, sickle cell anemia, and lupus 4) Congenital syndromes - Apert syndrome, Down syndrome, Marfan syndrome, tuberous sclerosis, Turner syndrome, von Recklinghausen disease, and Hirschsprung disease 5) Vascular diseases - Atherosclerotic disease, coarctation of the aorta and fibromuscular dysplasia, 6)cranial trauma, radiation injury, parasellar tumors, and hypertension etc. These associations may not necessarily be causative but do warrant consideration due to impact on treatment.(Mainly neurosurgical operation.) The incidence of moyamoya disease is highest in Japan. The prevalence of MMD is 1 person per 100,000 population. The prevalence and incidence of moyamoya disease in Japan has been reported to be 3.16 cases and 0.35 case per 100,000 people, respectively. With regard to sex, the female-to-male ratio is 1.4:1. A bimodal peak of incidence is noted, with symptoms occurring either in the first decade(5-10yr) or in the third and fourth decades (30-40yr)of life. Mortality rates of moyamoya disease are approximately 10% in adults and 4.3% in children. Death is usually from hemorrhage. In aspect of life insurance, MR is 1700%, EDR is 16 per 1000 persons. Children and adults with moyamoya disease (MMD) may have different clinical presentations. The symptoms and clinical course vary widely from asymptomatic to transient events to severe neurologic deficits. Adults experience hemorrhage more commonly; cerebral ischemic events are more common in children. Children may have hemiparesis, monoparesis, sensory impairment, involuntary movements, headaches, dizziness, or seizures. Mental retardation or persistent neurologic deficits may be present. Adults may have symptoms and signs similar to those in children, but intraventricular, subarachnoid, or intracerebral hemorrhage of sudden onset is more common in adults. Recently increasing diagnosis of MMD with MRI, followed by surgical operation is noted. MMD needs to be considered as the "CI" state now in life insurance fields.

• 지식경영연구
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• 제18권1호
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• pp.83-116
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• 2017

The purpose of this study is to analyze empirically analyze how the characteristics of participants in educational and social learning forums and the quality of events influence expectations and satisfaction of forums. The study also aims to provide strategic implications for forum organizers and give them suggestions on how to set up target audience, manage forum contents, speakers, and services, improve attendee satisfaction, and ultimately maximize overall outcomes. As exchanges among individuals, enterprises, and organizations, as well as countries are growing rapidly, the convention industry has become a key player in the market. Conventions have also become a venue for people to discuss a specific agenda or topic, exchange information and learn knowledge and insights. Especially, the forum - as part of the convention industry - plays a vital role providing educational and social learning opportunities as scholars and expertise come together to share their knowledge and experience through a variety of discussions. With its role, many of forums are taking place in recent years; however, there have been few empirical studies upon the forum itself. Also, there have been few attempts to research how the quality of forums affect participants' satisfaction along with their characteristics and how much of practical knowledge is provided throughout the events. This study is meaningful in that it is the first practical study that takes a deep understanding of the forum and sees how the quality of the forums influences participants' satisfaction and whether the characteristics of participants have a moderating effect in increasing the level of satisfaction. Forum organizers could also take a strategic approach as their major concerns are to increase the number of participants and raise degree of satisfaction by providing significant information. There are four key elements that determine success or failure of a social learning forum. The four elements are contents, speakers, services, and participants. Content plays an important role in providing rich information and knowledge for participants. Speakers are the main knowledge providers who contribute to the forum's social learning role. Also, the services provided by forum organizers such as simultaneous interpretation services, program brochures, lunch and refreshments, and the overall design of event hall can also influence the level of participants' satisfaction. Lastly, the participants and their characteristics are important since they are the ones who receive knowledge from the providers. The results of this study show that the quality of forum (content, speaker, and services) has a decisive effect on the participants' satisfaction and there are some differences in expectation among the participants in the forum. Also, some groups of participants were more likely to be stimulated by the quality of forum when determining their satisfaction. The study is modeled after MBN Y Forum 2016 and its participants' characteristics. The forum is one of the most representative social learning forums of South Korea and its audiences are mostly young people. It has analyzed how the participants' characteristics influence their satisfaction by grouping them into ${\Delta}participants$ who have invited for free and those who paid for the entrance fee, ${\Delta}first-time$ participants and returning participants, ${\Delta}voluntary$ and involuntary participants, ${\Delta}participants$ who registered through web and those who did through mobile, and ${\Delta}participants$ who registered during pre-sale opens and those who registered during general opens.

• 의료법학
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• 제12권1호
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• pp.133-173
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• 2011

Since mid-1960s the reports from the Surgeon General, the World Health Organization, and other health experts state that there is no risk-free level exposure to smoking and secondhand smoke. Tobacco smoke is made up of more than 7,000 chemicals. Hundreds are toxic, and at least 70 are carcinogens. The chemicals in tobacco smoke reach smoker's lungs quickly every time smoker inhale causing damages immediately. Inhaling even the smallest amount of tobacco smoke can also damage smoker's DNA, which can lead to cancers. Smoking is responsible for more than 87% of lung cancers, but there are a host of other chronic diseases directly related to exposure to tobacco smoke. It's also a major cause of heart disease, stroke, aortic aneurysm, peripheral arterial disease and most of the other diseases. In the United States, each year with more than from 440,000 to 520,000 deaths caused by smoking and exposure to involuntary smoke. They conclude that smoking is the single most important source of preventable morbidity and mortality. The United States of America have about 60-year history of tobacco litigation. Tobacco litigation has been an important tool in tobacco control strategies aimed at limiting the activities of tobacco companies and providing redress to people who have become ill as a result of their use of tobacco products. Tobacco litigation is a kind of tort litigation. Quite often, as in the asbestos and other mass tort litigation episodes, tobacco litigation can play an educational role, warning the public about the magnitude of health risks that might otherwise be less clearly perceived. Tobacco litigation allows smokers, their families or other victims of smoking to sue tobacco companies in order to be compensated for the harm they have suffered. Potential benefits of tobacco litigation include compensation for smoking-related damages, strengthening regulatory activity, publicity, documents disclosure and changing tobacco industry behavior. And also tobacco litigation can limit the political activities of tobacco industry, protect human rights of smokers and non-smokers, increase burden to tobacco price-up and enhance the effects of law and politics in public health.

• Clinics in Shoulder and Elbow
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• 제3권1호
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• pp.1-9
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• 2000

Purpose: To report the mid-term results of the inferior capsular shift procedure for the multidirectional instability, and to analyze whether the bilateral laxity, the generalized ligamentous laxity and the voluntary instability can influence upon the final outcome. Material and Method: We reviewed 95 patients with 96 shoulders treated by the inferior capsular shift procedure for multidirectional instability through an anterior approach. In total, 49 shoulders(51%) showed generalized ligamentous laxity, 56 shoulders(58%) bilateral laxity, and 65 shoulders(68%) voluntary subluxation. Mean follow-up was 27 months(11-60 months). Result: The final Rowe score was 75 points in patients who had had at least one of the bilateral laxity, generalized ligamentous laxity, or the voluntary subluxation and 84 points without any of these in each element. Seventy-five percent of the bilateral laxity and 87% of the unilateral instability continued to function well without any pain and instability postoperatively. Those with a voluntary(74%), those with an involuntary instability(83%), those with a generalized ligamentous laxity(73%) and without laxity(84%) could do well a daily living activity without instability Eighty-six percent who had had the voluntary instability was eliminated completely the voluntability. Eighty-four percent of the patients stated that they were subjectively satisfied with the status of their shoulder. Nine shoulders(9.4%) had recurrence of symptomatic and disabling instability and theses patients had had at least voluntary instability preoperatively. Seven patients(7.3%) suffered from the stiff shoulder after the inferior capsular shift procedure. Conclusion: The inferior capsular shift procedure in multidirectional instability provided satisfactory results both in objective and subjective terms. Nonetheless, a patient who has a bilateral laxity, a generalized ligamentous laxity or a voluntary instability could be expected less favorable results compared to those with neither of these. A careful selection of the inferior capsular shift procedure for the multidirectional instability is needed before surgery. But our results suggests that a voluntary instability is not always poor candidate for the inferior capsular shift procedure.

• 기본간호학회지
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• 제7권1호
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• pp.109-121
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• 2000

Increasingly nursing science is embracing the concepts and methodology derived from psycho-neuroimmunology. It has been previously shown that stress increases and immune function declines in students undergoing examinations. To date, however, no many studies have been reported on stress levels, immune function and interventions in Korean students undergoing their first clinical nursing rotation. It was proposed that nursing students during their first clinical rotation experience increase in stress because of the novelty of the situation and their lack of clinical knowledge. It was also hypothesized that biofeedback and progressive relaxation, methods of self-regulation of involuntary autonomic nervous system responses, would reduce the stress response. The purpose of this study is to test the effectiveness of progressive muscle laxation using biofeedback The effectiveness of the experimental methods was tested by measuring the degree of symptoms of stress (SOS) and the values of ephinephrine, pulse rate, blood pressure and natural killer cells. The subjects of this study were thirty nursing students divided into two groups: experimental group was progressive muscle relaxation group using biofeedback and control group. This study was conducted for 8 weeks of clinical practice. Biofeedback training was done by software developed by J&J company (1-410 form for progressive muscle training). Progressive muscle relaxation training according to Jacobson's Theory was done by messaged word from biofeedback. The data was analyzed using Chronbach' ${\alpha}$ and t-test of the SPSS program and the significance level of statistics was 5%. The results of the study were : 1) The progressive muscle relaxation training using biofeedback was effective for the reduction of symptoms of stress(t=-4.248, p<.001) under clinical practice stress conditions. 2) The progressive muscle relaxation training using biofeedback was not effective for the values of epinephrine(t=-1.294, p=.206). 3) The progressive muscle relaxation training using biofeedback was effective for the reduction of systolic blood pressure (t=-2.757, p=.01). 4) The progressive muscle relaxation training using biofeedback was effective for the reduction of diastolic blood pressure (p=-2.032, 0=.05). 5) The progressive muscle relaxation training using biofeedback was not effective for the reduction of pulse rate(t=-15, p=.988). 6) The progressive muscle relaxation training using biofeedback was effective for the maintenance of natural killer cells (t=2.381, p=02). The first clinical rotation for student nurses is a stressful experience as seen by the rise in the SOS in the control group. Biofeedback using progressive muscle relaxation were effective in preventing the rise of symptoms of stress and the blood pressure means when comparing the pre to post clinical experience, The mean natural killer cell count was depressed in the control group but not significantly different in the experimental groups, It is proposed here that stress via the hypothalamic - pituitary - adrenal axis suppressed the NK cell count whereas the relaxation methods prevented the rise in stress and the resulting immune depression. We recommend relaxation techniques using biofeedback as a health promotion technique to reduce psychological stress. In summary. the progressive muscle relaxation training using biofeedback was effective for the reduction of symptoms of stress under clinical practice stress conditions.

• 구강회복응용과학지
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• 제32권4호
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• pp.301-306
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• 2016

총의치 환자에 있어 환자가 만족할 만한 의치의 유지와 안정을 얻는 것은 어려운 일이다. 특히 파킨슨병 등의 전신질환으로 하악에서 불수의적 운동이나 운동제한이 나타나는 환자에 있어서, 총의치의 기능적 한계는 임상가에게 더욱 더 힘든 문제이다. 이러한 어려움을 극복하기 위해 잔존치근의 보존을 통한 피개의치가 도움이 될 것이다. 본 증례는, 45세 남성환자로, 내원 당시 당뇨와 파킨슨 병의 약을 장기 복용 중이었고 우식으로 인해 대다수의 치아를 발치해야 했다. 상악은 총의치, 하악은 2개의 잔존 치근을 이용한 자성 어태치먼트로 유지와 안정을 증진시킨 피개의치 증례로서, 기능적으로 개선된 보철물을 제작했기에 보고하는 바이다.

• 국제물리치료학회지
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• 제11권1호
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• pp.2012-2020
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• 2020

Background: Multifaceted approaches will be needed, such as global synkinesis (GS) achieve functional improvements in the arms of stroke patients from involuntary movements during exercise. Objective: To identify changes in arm GS and muscle activity, functional evaluation and the correlation with variables through action observation training, combined with functional electrical stimulation (FES), thereby verifying the effect on stroke patients. Design: A quasi-experimental study. Methods: The subjects of this study were 20 stroke patients who were divided into two groups: Control group (n=10) and experimental group (n=10). Before the intervention, arm GS and muscle activity were measured using surface electromyography (EMG), and arm function was evaluated using the Fugl-Meyer Assessment (FMA) scale. At the end of the intervention, which lasted 4-wk, arm GS and muscle activity were measured again using the same scale. Results: There was a decrease statistically significant difference in GS during the bending action in experimental group (P<.01). Both groups showed a significant difference increased only in the activity of the anterior deltoid (AD) and biceps brachii (BB) (P<.05). The results of the arm functional assessment revealed a significant difference increase in both groups (P<.05). In the between-group comparison, there was a significant difference decrease in GS during the bending action (P<.05). Only the muscle activity of the AD and BB were significantly increase different (P<.05). There was a significant between-group difference increase in the arm functional assessment (P<.05). There was a positive correlation between GS and muscle activity on the FMA in the control group (r=.678, P<.05). In experimental group, GS during the bending arm action exhibited a negative correlation (r=-.749, P<.05), and the muscle activity of the AD and BB showed a positive correlation (r=.701, P<.05). Furthermore, in experimental group, the activity of the extensor carpi radialis increased, and the activity of the flexor carpi radialis decreased, which exhibited a negative correlation (r=-.708, P<.05). Conclusion: These results suggest that brain plasticity could be more efficiently stimulated by combining surface stimulation in the affected arm of stroke patients.

• 한방재활의학과학회지
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• 제29권4호
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• pp.109-115
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• 2019

Cervical dystonia (CD) is a disorder characterized by sustained or intermittent, involuntary muscle contractions which cause twisting, repetitive movements and abnormal postures. In this case report, a CD patients was treated with transfer energy capacitive and resistive (TECAR) therapy and conventional Korean medicine, which consists of acupuncture, Chuna manual medicine, pharmacopuncture and herbal medicine. For outcome measures, this study evaluated Cobb's angle, EuroQol five dimension scale (EQ-5D), numerical rating scale (NRS), neck disabillity index (NDI) and cervical range of motion. As a result, improvements were found in Cobb's angle ($18.65^{\circ}$ to $15.90^{\circ}$), EQ-5D score (0.808 to 0.862), NRS (5 to 3), NDI (16 to 8) and angle of cervical lateral bending ($15^{\circ}$ to $25^{\circ}$). In conclusion, this study shows that combined therapy of conventional Korean medicine treatment and TECAR therapy can be effective for CD patients.

• 한국방사선학회논문지
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• 제15권7호
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• pp.935-942
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• 2021

호흡에 의한 체내 장기의 불수의적 움직임은 방사선 치료 및 진단의 결과에 큰 영향을 주는 요소이다. 본 논문에서는 호흡에 따른 장기 또는 종양의 움직임을 모사하기 위한 움직임 팬텀을 제작하고 다양한 호흡모사 조건에서 ¹⁸F-FDG PET 스캔 영상을 획득하여 호흡에 따른 종양의 움직임 범위와 종양의 크기에 따른 인공물의 수준 및 표준섭취계수 최대값(maximum standardized uptake value, SUVmax)를 분석하였다. 운영체계로 윈도우 CE(Windows CE) 6.0 기반으로 전동액추에이터, 전동액추에이터 포지셔닝 드라이버, PLC(Programmable Logic Controller)을 이용한 위치 및 속도 조절 모듈은 이동거리 0-5 cm와 왕복이동 10회, 15회, 20회에서 정상적으로 동작하였다. 지연시간 100분에서 구의 지름 10, 13, 17, 22, 28, 37mm일 때 각각 80.4, 99.5, 107.9, 113.1, 128.0, 124.8%로 측정되었다. 이동거리가 같을 때 호흡수에 따른 차이는 미미하였다. 호흡수를 20회 하고 이동거리를 1 cm, 2 cm, 3 cm, 5 cm일 때 구의 지름이 10, 13, 17, 22, 28, 37 mm에서 이동거리가 길어질수록 구의 크기가 작은 것 부터영상의 구분 능력이 저하되었다. 정지영상에 비하여 이동거리를 5 cm로 하였을 때, 표준섭취계수의 최대값은 구의 지름이 10, 13, 17, 22, 28, 37 mm에서 각각 18.0%, 23.7%, 29.3%, 38.4%, 49.0%, 67.4%이었다.

• 한국교육논총
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• 제42권1호
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• pp.1-34
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• 2021

이 논문은 세계사적 단계들과 그 구분 원리를 제시하는 柄谷行人(가라타니 고진)의 『세계사의 구조』와 Deleuze와 Guattari의 『안티 오이디푸스』를, 사건을 보고하는 육하원칙이라는 공통항에 입각하여 해석하고 비교한다. 평가적 비교의 전 단계로서의 해석적 비교는 두 저서의 텍스트적 해석과 비교, 그리고 교육적 측면에서의 해석과 비교로 반복하여 두 번 시행된다. 이 논문에서 사용한 사건적 교육은 본성적 교육과 대비된다. 텍스트적 비교에 있어서, 1) 육하원칙의 What은 Kant와 Nietzsche적 Marx 활용, 2) Who는 교환하는 인간과 생산적 기계라는 현실적 주체, 3) When/Where는 교환양식과 기입양식이라는 사회, 4) How는 세계동시혁명과 분열증적 과정이라는 혁명의 방도, 5) Why는 연합적 인간과 욕망해방적 비인간이라는 이상적 주체이다. 교육적 비교에 있어서, 1) 교육의 경로로서의 What은 자율적 윤리성과 능동적 힘, 2) 교육의 현실적 주체의 긍정성으로서의 Who는 이념적 긍정성과 실재적인 힘의 긍정성, 3) 교육의 사이-시공간으로서의 When/Where는 개체들 사이의 공약불가능한 소통적 시공간과 기계들 사이의 갈등적 시공간, 4) 이미-있음의 이상에 도달하는 교육의 방법으로서의 How는 과거에 이미 있던 이상의 비자발적 회복과 현재에 이미 있는 과정의 완성과 돌파, 5) 교육의 목적으로서의 Why는 코스모폴리턴과 위버멘쉬이다.