• 대한의용생체공학회:의공학회지
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• 제43권4호
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• pp.185-192
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• 2022

Early detection of mild cognitive impairment can help prevent the progression of dementia. The purpose of this study was to design and validate a machine learning model that automatically differential diagnosed patients with mild cognitive impairment and identified cognitive decline characteristics compared to a control group with normal cognition using resting-state quantitative electroencephalogram (qEEG) with eyes closed. In the first step, a rectified signal was obtained through a preprocessing process that receives a quantitative EEG signal as an input and removes noise through a filter and independent component analysis (ICA). Frequency analysis and non-linear features were extracted from the rectified signal, and the 3067 extracted features were used as input of a linear support vector machine (SVM), a representative algorithm among machine learning algorithms, and classified into mild cognitive impairment patients and normal cognitive adults. As a result of classification analysis of 58 normal cognitive group and 80 patients in mild cognitive impairment, the accuracy of SVM was 86.2%. In patients with mild cognitive impairment, alpha band power was decreased in the frontal lobe, and high beta band power was increased in the frontal lobe compared to the normal cognitive group. Also, the gamma band power of the occipital-parietal lobe was decreased in mild cognitive impairment. These results represented that quantitative EEG can be used as a meaningful biomarker to discriminate cognitive decline.

• 한국전문물리치료학회지
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• 제29권2호
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• pp.147-155
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• 2022

Background: Although various conventional approaches have been employed to reduce spasticity in neurological rehabilitation, only a few studies have shown scientific evidence for its effectiveness. Thus, we introduced a different concept (Ueda method) of rehabilitation therapy that can complement the limitations of conventional therapy. Objects: This study aimed to investigate the immediate effects of the application of the Ueda method on patients with spasticity after stroke via an electrophysiological study. Methods: We conducted a randomized double-blind pilot study in two rehabilitation hospitals involving 30 stroke patients who were randomly allocated to the Ueda (n = 15) and convention (n = 15) groups. Electromyographic data of six examined muscles in both upper extremities of all patients were recorded. The A-ApA index and activation ratios of upper extremity muscles were evaluated and compared between the groups to confirm post-intervention changes in upper-extremity flexor spasticity and flexion synergies. Repeated-measures analysis of variance was conducted to confirm the therapeutic effect (2 × 2) as a function of group (Ueda vs. convention) and time (pre-/post-intervention) on all outcome measures (p < 0.05). Results: In the Ueda group, the mean A-ApA index values differed significantly before and after the intervention (p = 0.041), indicating a weak evidence level; however, the effect size was medium (d = -0.503). The interaction effects of the A-ApA index between the Ueda and convention groups and between pre-intervention and post-intervention stages were significant (p = 0.012). The effect size was large (n_p² = 0.220). In the Ueda group, the activation ratios of the anterior deltoid fiber significantly decreased after the intervention in all reaching tasks. Conclusion: The Ueda method reduces upper-extremity flexor spasticity and changes its synergy in stroke patients and should be considered a rehabilitation therapy for spastic stroke patients.

• Journal of Hospice and Palliative Care
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• 제26권4호
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• pp.160-170
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• 2023

Purpose: The aim of this study was to examine the effects of death anxiety and perceived end-of-life care competencies on the fear of terminal care among clinical nurses. Methods: This correlational study was conducted from June to July 2021. The study included 149 clinical nurses employed at a tertiary hospital and seven other hospitals. The measurement tools used in this study were the Thanatophobia Scale (Cronbach's α=0.87), the Death Anxiety Scale (Cronbach's α=0.80), and the Scale of End-of-life Care Competencies (Cronbach's α=0.94). These instruments were chosen to assess the levels of fear of terminal care, death-related anxiety, and competencies in end-of-life care. Results: The mean score for fear of terminal care was 3.32±1.32. Differences in fear of terminal care were observed based on the working unit, position, number of patients requiring terminal care, and experience with end-of-life care education. Fear of terminal care was significantly positively correlated with death anxiety and significantly negatively correlated with end-of-life care competencies. In multiple regression analysis, the factors influencing fear of terminal care were attitudes toward end-of-life care competencies (𝛽=-0.39, P<0.001), death anxiety (𝛽=0.24, P<0.001), knowledge of end-of-life care competencies (𝛽=-0.22, P=0.005), and behaviors related to end-of-life care competencies (𝛽=-0.16, P=0.021). These factors explained 64.6% of the total variance (F=25.54, P<0.001). Conclusion: This study suggests that developing nurses' end-of-life care competencies and reducing death anxiety are crucial for managing the fear of terminal care. Therefore, providing end-of-life care education and psychological support programs is important.

• The Journal of Advanced Prosthodontics
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• 제16권1호
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• pp.1-11
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• 2024

PURPOSE. The present experiment aimed to evaluate the placement accuracy of fully guided implant surgery using a mucosa-supported surgical guide when the protocol of osteotomy and installation was modified (MP) compared to when the protocol was sequentially and conventionally carried out (CP). MATERIALS AND METHODS. For 24 mandibular dentiform models, 12 dentists (6 experts and 6 beginners) performed fully guided implant placements two times at the right first and second molar sites using a mucosa-supported surgical guide, once by the CP (CP group) and at the other time by the MP (MP group). The presurgical and postsurgical stereolithographic images were superimposed, and the deviations between the virtually planned and actually placed implant positions and the procedure time were compared statistically (P < .05). RESULTS. The accuracies were similar in the CP and MP groups. In the CP group, the mean platform and apex deviations at the second molar site for the beginners were +0.75 mm and +1.14 mm, respectively, which were significantly larger than those for the experts (P < .05). In the MP group, only the mean vertical deviation at the second molar site for the beginners (+0.53 mm) was significantly larger than that for the experts (P < .05). The procedure time was significantly longer for the MP group (+94.0 sec) than for the CP group (P < .05). CONCLUSION. In fully guided implant surgery using a mucosa-supported guide, the MP may improve the placement accuracy when compared to the CP, especially at sites farther from the most-posterior natural tooth.

• Journal of Hospice and Palliative Care
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• 제27권1호
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• pp.1-10
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• 2024

This article underscores the importance of integrating comprehensive palliative care for noncancer patients who are undergoing hemodialysis, with an emphasis on the aging populations in Asian nations such as Taiwan, Japan, the Republic of Korea, and China. As the global demographic landscape shifts towards an aging society and healthcare continues to advance, a marked increase has been observed in patients undergoing hemodialysis who require palliative care. This necessitates an immediate paradigm shift to incorporate this care, addressing the intricate physical, psychosocial, and spiritual challenges faced by these individuals and their families. Numerous challenges impede the provision of effective palliative care, including difficulties in prognosis, delayed referrals, cultural misconceptions, lack of clinician confidence, and insufficient collaboration among healthcare professionals. The article proposes potential solutions, such as targeted training for clinicians, the use of telemedicine to facilitate shared decision-making, and the introduction of time-limited trials for dialysis to overcome these obstacles. The integration of palliative care into routine renal treatment and the promotion of transparent communication among healthcare professionals represent key strategies to enhance the quality of life and end-of-life care for people on hemodialysis. By embracing innovative strategies and fostering collaboration, healthcare providers can deliver more patient-centered, holistic care that meets the complex needs of seriously ill patients within an aging population undergoing hemodialysis.

• 대한안과학회지
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• 제59권11호
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• pp.1049-1055
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• 2018

목적: 거짓비늘증후군에서 개방각녹내장 병합 유무에 따른 전안부 소견과 생체 계측치들을 비교 분석하여 거짓비늘증후군에서 녹내장 발생과 관련된 인자들을 알아보고자 하였다. 대상과 방법: 본원에서 거짓비늘증후군으로 진단된 96명(115안)을 대상으로 하였으며, 단순거짓비늘증후군 64명(76안)과 녹내장 병합 거짓비늘증후군 32명(39안)의 두 군으로 나누어 나이, 성별, 기저질환, 거짓비늘물질이 관찰된 부위 및 홍채의 변화, 핵백내장 정도, 산동 정도, 각막내피세포 수, 중심각막두께, 전방깊이, 안축장, 각막곡률, 안압을 비교하였다. 결과: 두 군 간 나이(p=0.694), 성별(p=0.161), 당뇨(p=0.440), 고혈압(p=0.238), 거짓비늘물질의 관찰 위치로 전낭, 동공연(p=0.700, 0.210), 홍채의 변화 양상으로 동공연 탈색소, 주름 소실(p=0.526, 0.708), 핵백내장 정도(p=0.617), 산동 정도(p=0.526), 중심각막두께(p=0.097), 전방깊이(p=0.283), 안축장(p=0.095), 수평, 수직 각막곡률(p=0.066, 0.306)에서 유의한 차이를 보이지 않았으며, 녹내장병합거짓비늘증후군에서 안압이 높고(p=0.026) 동공연의 막형성이 많으며(p=0.047), 각막내피세포 수의 감소(p=0.048)가 유의하게 관찰되었다. 결론: 거짓비늘증후군에서 개방각녹내장이 병합된 경우 높은 안압, 각막내피세포 수 감소, 동공연의 막형성 소견이 유의하게 비교 관찰되므로 이러한 변화 양상이 관찰될 때 녹내장 병합 가능성이 높음을 인지하여 경과관찰 시 세심한 주의가 필요할 것으로 사료된다.

• 한국조경학회지
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• 제38권1호
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• pp.12-24
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• 2010

본 연구의 목적은 미국에 있는 한국전쟁 메모리얼의 설계요소인 설계개념, 공간적 특성, 조경디테일 및 조각의 특성을 분석하고, 메모리얼에 나타난 기념성을 고찰하는 것이다. 연구를 위해 현장답사, 문헌연구 및 사례연구, 인터넷 검색을 통하여 외부공간 설계가 이루어진 25개의 연구대상지를 선정하였으며, 이를 대상으로 평면도, 위성사진, 관련사진을 수집 하여 분석하였다. 연구의 주요 결과는 다음과 같다. 1. 한국전쟁 메모리얼에서 나타나는 주요한 개념으로 희생자 추모, 지역 부대 국가의 명예 고양, 집단적 헌신과 정체성 등을 기본으로 하여 전쟁의 의미와 감정, 한국전쟁의 사실적 묘사 및 상징적 표현이 나타났다. 2. 한국전쟁 메모리얼은 기념공원이나 광장의 제한된 부지에 조성되어 독립적인 공간의 완성을 추구하였다. 공간형태 다양하여 원형이나 사각형 형태가 축을 이루는 것이 많이 나타났지만 일부 부정형도 있었으며, 공간적 연속성과 같은 간적 질서가 일부 메모리얼에서 나타났다. 3. 조경디테일은 희생자를 추모하기 위한 요소로서 기념벽과 기념석, 집단의 정체성을 나타내기 위한 기(旗)와 엠블렘 (emblem)이 주로 사용되고 있었다. 또한 한반도 지도 및 태극문양이 한국과 한국전쟁을 상징하기 위해 자주 도입되었으며, 잊혀진 한국전쟁을 기억하고 미군의 한국참전의 타당성과 의미를 나타내고자 'Forgotten War(잊혀진 전쟁)'과 'Freedom is not Free(자유는 거저 얻어지는 것이 아니다)'가 사용되었다. 4. 조각은 기념성을 다양하게 구현하기 위한 중요한 매체로서 활용되었다. 주로 사실적인 조각이 사용되었고, 일부는 추상적 형태를 갖는 것도 있었으며, 한국전쟁을 상징적이고 은유적으로 표현하였다. Washington D.C. 한국전쟁 참전용사 메모리얼(Korean War Veterans Memorial: KWVM)이나 Minnesota 한국전쟁 메모리얼(Korean War Memorial: KWM)의 조각은 현대적인 메모리얼의 상징적 매체로서 뛰어났다. 향후 한국과 미국에 있는 한국전쟁 메모리얼의 비교문화적 연구와 설계양식론 관점에서 메모리얼의 특성에 대한 연구가 필요하다.

• 디지털융복합연구
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• 제15권6호
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• pp.481-491
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• 2017

본 연구에서는 대한민국 특수임무유공자(수행자)들의 삶의 질, 분노표현, 자살생각 정도를 파악하고 대상자들이 느끼는 삶의 질과 분노표현이 자살생각에 미치는 융복합적 영향을 파악하고자 하였다. 자료 수집을 위해 2016년 3월부터 2016년 5월까지 대한민국 특수임무유공자(수행자) 362명의 일반적 특성을 비롯한 삶의 질, 분노표현, 자살생각을 조사하여 SPSS 23.0 Statistics Program을 이용하여 분석하였다. 연구결과 삶의 질은 분노표현(r=-.151, p<.001)과 자살생각(r=-.539, p<.001)과 역 상관관계를 보였으며, 분노표현의 경우 자살생각(r=.601, p<.001)과 정 상관관계가 있는 것으로 나타났다. 또한 삶의 질과 분노표현은 자살생각에 대하여 42.9% 설명력을 가지는 유의한 예측요인으로 확인되었다. 본 연구결과를 바탕으로 대한민국 특수임무유공자(수행자)들에 대해 관심을 가지고 대상자들의 자살예방을 위해 삶의 질 향상을 위한 국가적인 대책마련과 대상자들의 특성을 고려한 사회적응 프로그램 및 분노조절 교육 프로그램의 개발과 효율적 운영이 요구된다.

• 대한불안의학회지
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• 제4권1호
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• pp.34-41
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• 2008

Objective : The aim of this study is to examine the characteristics of somatic symptoms in patients with PTSD according to trauma type. Methods : The subjects of this study were 84 patients diagnosed with PTSD according to the DSM-IVTR and CAPS criteria. The subjects ranged in age from 18 to 76 years, and they were recruited from 18 hospitals across the nation. All participants were asked about their trauma history, and they all completed the Davidson Trauma Scale (DTS), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Impact of Event Scale-Revised (IES-R) and Korean-Physical Somatic Symptom Inventory (K-PSI). The items of the K-PSI were categorized into 5 groups according to organ system, and the participants were classified into 6 groups according to trauma type. We compared the results of the social demographical scale, DTS, BDI, STAI, IES-R and each recategorized subscale of the K-PSI among the six groups. Results : There were significant differences between the 6 groups in terms of the Korean-Physical Somatic Symptom Inventory scores for each organ system, except for the cardiopulmonary system, as well as the BDI scores. Post hoc analysis revealed differences between the combat-related trauma group and all other groups but not among any of the other groups. Conclusion : Our result showed that there were significant differences in the somatic symptom scores among the 6 trauma groups. However, patient age and the time elapsed since the traumatic event may have hada crucial influence on the result of this study.

• 한국방사선학회논문지
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• 제13권6호
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• pp.857-864
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• 2019

캐나다 등 많은 국가들이 초음파사(sonographer) 면허제도를 방사선사면허와 별도로 운영하고 있다. 그러나 한국에서는 방사선사가 의사의 지도아래 초음파영상검사를 수행하고 있다. 이에 방사선사의 초음파영상검사에 대한 직무역량을 분석하여 체계적으로 교육할 기회를 갖기 위하여 캐나다 초음파사의 표준직무역량(National Competency Profile)을 토대로 한국에서 방사선사가 초음파영상검사를 수행함에 있어 요구되는 직무역량과 세부역량들에 대한 직무 내용타당도를 측정하였다. 한국 방사선사 직무역량에 포함된 핵심역량의 중요도과 직무수행 정도를 비교분석한 결과 전체 중요도의 평균은 4.087점, 전체 수행도의 평균은 3.640점으로 중요도가 더욱 높았으며, 통계적으로 유의한 차이를 보였다. 그 결과 'A 의사소통', 'B 전문가적 책임', 'D 장비취급', 'G 근무 장소의 건강 및 안전'은 직무 내용타당도가 높았다. 그러나 'C 환자 평가와 돌봄', 'E 비평적 사고와 문제해결', 'H 영상'은 직무 내용타당도가 낮게 나타나 이들 역량을 강화하고 보완할 수 있는 방안이 모색되어야 한다.