• 한국문헌정보학회지
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• 제54권1호
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• pp.5-27
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• 2020

국내 지자체들은 경쟁적으로 공공도서관 건립과 운영에 많은 관심을 갖고 다양한 사업을 추진해오고 있다. 그 일환으로 최근 각 지자체마다 외부 전문기관에 연구용역을 의뢰하여 도출된 결과를 바탕으로 자체 현황을 고려한 공공도서관 중·장기발전계획을 수립하여 시행하는 곳이 늘어나고 있다. 청주시는 2011년에 제1차 계획(2012~2016)을, 2016년에 "제2차 청주시 도서관 중·장기 종합발전계획 (2017~2021)"을 수립하여 시행해오고 있다. 이 연구는 청주시의 제2차 계획에 대한 중간 점검 성격으로, 2차 계획의 수립 내용과 현안 등을 분석하여 계획 대비 목표 달성에 도움을 주는 것을 목적으로 하였다. 이러한 연구 목적을 달성하기 위해, 첫째, 청주시 공공도서관 제1차 계획의 성과와 한계를 파악하였다. 둘째, 청주시 공공도서관 문화 환경 변화 추이를 분석하였다. 셋째, 청주시 공공도서관 제2차 계획의 추진 전략과 운영 성과를 살펴보았다. 특히 이 연구는 청주시 공공도서관 발전의 핵심요소인 조직체계 확충과 전문 인력 충원 및 예산지원 확대라는 측면에 중점을 두고 고찰하였다.

• Journal of Korean Neurosurgical Society
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• 제56권1호
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• pp.34-41
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• 2014

Objective : The purpose of this study was to describe the clinical characteristics, treatment outcomes, and prognostic factors in patients with brain abscesses treated in a single institute during a recent 10-year period. Methods : Fifty-one patients with brain abscesses who underwent navigation-assisted abscess aspiration with antibiotic treatment were included in this study. Variable parameters were collected from the patients' medical records and radiological data. A comparison was made between patients with favorable [Glasgow Outcome Scale (GOS) ${\geq}4$] and unfavorable (GOS <4) outcomes at discharge. Additionally, we investigated the factors influencing the duration of antibiotic administration. Results : The study included 41 male and 10 female patients with a mean age of 53 years. At admission, 42 patients (82%) showed either clear or mildly disturbed consciousness (GCS ${\geq}13$) and 24 patients (47%) had predisposing factors. The offending microorganisms were identified in 25 patients (49%), and Streptococcus species were the most commonly isolated bacteria (27%). The mean duration of antibiotic administration was 42 days. At discharge, 41 patients had a favorable outcome and 10 had an unfavorable outcome including 8 deaths. The decreased level of consciousness (GCS <13) on admission was likely associated with an unfavorable outcome (p=0.052), and initial hyperglycemia (${\geq}140mg/dL$) was an independent risk factor for prolonged antibiotic therapy (p=0.032). Conclusion : We found that the level of consciousness at admission was associated with treatment outcomes in patients with brain abscesses. Furthermore, initial hyperglycemia was closely related to the long-term use of antibiotic agents.

• Journal of Gastric Cancer
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• 제15권1호
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• pp.46-52
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• 2015

Purpose: The aim of this study was to compare the short-term surgical and long-term functional outcomes of Billroth I, Billroth II, and Roux-en-Y reconstruction after laparoscopic distal gastrectomy. Materials and Methods: We retrospectively collected data from 697 patients who underwent laparoscopic distal gastrectomy for operable gastric cancer between January 2009 and December 2012. The patients were classified into three groups according to the reconstruction methods: Billroth I, Billroth II, and Roux-en-Y. The parameters evaluated included patient and tumor characteristics, operative details, and postoperative complications classified according to the Clavien-Dindo classification. Endoscopic findings of the remnant stomach were evaluated according to the residue, gastritis, bile (RGB) classification and the Los Angeles classification 1 year postoperatively. Results: Billroth I, Billroth II, and Roux-en-Y were performed in 165 (23.7%), 371 (53.2%), and 161 patients (23.1%), respectively. Operation time was significantly shorter ($173.4{\pm}44.7$ minute, P<0.001) as was time to first flatus ($2.8{\pm}0.8$ days, P=0.009), time to first soft diet was significantly faster ($4.3{\pm}1.0$ days, P<0.001), and postoperative hospital stay was significantly shorter ($7.7{\pm}4.0$ days, P=0.004) in Billroth I in comparison to the other methods. Postoperative complications higher than Clavien-Dindo grade III occurred in 61 patients (8.8%) with no statistically significant differences between groups (P=0.797). Endoscopic findings confirmed that gastric residue, gastritis, bile reflux, and reflux esophagitis were significantly lower in Roux-en-Y (P<0.001) patients. Conclusions: Roux-en-Y reconstruction after laparoscopic distal gastrectomy for middle-third gastric cancer is beneficial in terms of long-term functional outcome, whereas Billroth I reconstruction for distal-third gastric cancer has a superior short-term surgical outcome and postoperative weight change.

• 대한심미치과학회지
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• 제16권2호
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• pp.7-18
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• 2007

There is now an increased demand for harmony between the peri-implant gingiva and adjacent dentition. In the event of a pending loss of a single tooth in the aesthetic zone with healthy periodontium, expectation for optimal gingival and prosthodontic aesthetics are often very high. Unfortunately, bone resorption is common following the removal of an anterior tooth, compromising the gingival tissue levels for the eventual implant restoration. Also, improper implant placement and inadequate osseous-gingival support potentially deleterious aesthetic result. The creation of an esthetic implant restoration with gingival architecture that harmonizes with the adjacent dentitionis formidable challenge. The predictability of the peri-implant esthetic outcome may ultimately be determined by the patient's own presenting anatomy rather than the clinician's ability to manage state-of-the-art procedures. To more accurately predict the peri-implant esthetic outcome before removing a failing tooth, a considering of diagnostic keys is essential. This presentation addresses the useful diagnostic keys that affect the predictability of peri-implant gingival aesthetics and the overcoming of the risk factors in anterior single-tooth replacement; it also describes a surgical and prosthodontic technique in achieving a long term successful esthetic outcome. Proper diagnosis and understanding of the biological and periodontal variables of failing dentition and their response to surgical and prosthodontic procedures are the essence of predictability. Using a smart protocol that alters the periodontium toward less risk and more favorable assessment of the diagnostic keys before implant placement will provide the most predictable esthetic outcome. Simple diagnostic keys suggested this presentation are useful method to evaluate the overcoming of the risk factors in anterior single implant restoration.

• 한국기록관리학회지
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• 제17권1호
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• pp.73-92
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• 2017

기록관은 사회의 기록을 저장하고 이용토록함으로써 사회를 지탱하는 기반이 되는 장소이다. 이에 본 연구는 기록관이 사회에 미치는 영향을 분석하기 위한 프레임워크를 개발하였다. 제안 모델은 기존의 기록관의 사회적 영향에 관한 선행연구의 결과를 기반으로 하였으며 영향은 성과의 한 영역이자 축적된 성과의 발현이라는 점에서 대표적인 성과평가 모델중의 하나인 논리모형을 적용하여 개발되었다. 실제 측정을 위한 프레임워크 개발을 위해 광범위한 사회적 영향 중에서 지역사회 강화 측면을 측정하기 위한 모형을 제안했다. 초기, 중기, 장기 성과를 포함하는 제안모형은 기록관 이용을 통해 지식, 태도, 기술의 변화가 만들어 내는 사회적 참여활동의 증가를 측정하였다. 또한 시민의 사회참여의 증가로 인한 지역사회 강화를 최종 성과로 제안하고 있다. 제안된 모형을 기반으로 한 양적/질적 연구가 진행된다면 기록관의 사회적 영향이 분석될 것으로 기대된다

• Journal of Korean Neurosurgical Society
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• 제41권2호
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• pp.82-87
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• 2007

Objective : Pontine hemorrhages usually result in a much higher morbidity and mortality than any other intracranial vascular lesion. The purpose of this study was to evaluate survival and the contributing factors for patients with pontine hemorrhage. Methods : Of the 41 patients who were admitted to our hospital with their first acute pontine hemorrhage from 1997 to 2005, 35 patients were included in this study. Medical records were reviewed to confirm the accuracy of diagnosis and collect demographic, clinical and radiological data. The patients were divided into two groups, survivors and deceased patients; then the survivors were divided again into a group of patient with good results and those with poor results. The location of the hematoma, maximum anteroposterior [AP] diameter, maximum transverse diameter, hematoma volume, ventricular extension, extension into the midbrain, hydrocephalus and initial Glasgow coma scale [GCS] were evaluated. Results : The two year survival rate was 58.5%. The survival of patients with pontine hemorrhage was affected by initial GCS score and transverse hematoma dimeter. Functional outcome of patients who survived was affected by initial GCS, maximum transverse diameter, maximum AP diameter and hematoma volume. Conclusion : The rate of survival after pontine hemorrhage is associated with the transverse diameter of the hematoma and more importantly the initial GCS. Long-term outcome of survivors is influenced by the initial GCS, transverse diameter, AP diameter and volume. Through the multivariate analysis, initial GCS is the only significant factor on survival. Strictly speaking, initial GCS is not modifiable. However, surgical reduction may be considered to amend theses decisive factors. Additional study for indication, timing and method of surgical management is needed.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6513-6518
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• 2013

Background: To evaluate the treatment outcome and major late complications of all patients with recurrent nasopharyngeal carcinoma (NPC) treated with intracavitary brachytherapy (ICBT) in Hospital Kuala Lumpur. Materials and Methods: This retrospective study was conducted at the Department of Radiotherapy and Oncology, Hospital Kuala Lumpur, Malaysia. All patients with histologically confirmed recurrent NPC in the absence of distant metastasis treated in the period 1997-2010 were included in this study. These patients were treated with ICBT alone or in combination with external beam radiotherapy (EBRT). Treatment outcomes measured were local recurrence free survival (LRFS), disease free survival (DFS) and overall survival (OS). Results: Thirty three patients were eligible for this study. The median age at recurrence was 56 years with a median time to initial local recurrence of 27 months. Majority of patients were staged as rT1-2 (94%) or rN0 (82%). The proportion of patients categorised as stage III-IV at first local recurrence was only 9%. Twenty one patients received a combination of ICBT and external beam radiotherapy while 12 patients were treated with ICBT alone. Median interval of recurrence post re-irradiation was 32 months (range: 4-110 months). The median LRFS, DFS and OS were 30 months, 29 months and 36 months respectively. The 5 year LRFS, DFS and OS were 44.7%, 38.8% and 28.1% respectively. The N stage at recurrence was found to be a significant prognostic factor for LRFS and DFS after multivariate analysis. Major late complications occurred in 34.9% of our patients. Conclusions: Our study shows ICBT was associated with a reasonable long term outcome in salvaging recurrent NPC although major complications remained a significant problem. The N stage at recurrence was a significant prognostic factor for both LRFS and DFS.

• Asian Pacific Journal of Cancer Prevention
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• 제16권16호
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• pp.7315-7319
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• 2015

Objectives: The study analyzed and compared the long term outcome in locally advanced rectal cancer treated with preoperative and postoperative concurrent chemoradiation (CCRT). Materials and Methods: A retrospective review of 105 patients with stage T3-T4 or regional lymph node positive adenocarcinoma of rectum treated with preoperative or postoperative CCRT at Ramathibodi Hospital during 2005 to 2010 was performed. The results of treatment were reported with 5-year overall survival (OS), 5-year locoregional recurrence free survival (LRFS), and toxicity according to preoperative versus postoperative concurrent chemoradiation (CCRT) groups. Results: Among 105 patients, 34 (32%) were treated with preoperative CCRT and 71 (68%) with postoperative CCRT. At the median follow-up time of 50.5 months (range 2-114 months), five-year OS and LRFS of all patients were 87% and 91.6%, respectively. The study found no difference in 5-year OS (81.7% vs 89.2 %) or LRFS (83.4% vs 95.1%) between preoperative versus postoperative CCRT. Seven cases of loco-regional recurrence were diagnosed, 4 (11.8%) after preoperative CCRT and 3 (4.2%) after postoperative CCRT. The recurrent sites were anastomosis in all patients. There was no significant factor associated with outcome after univariate and multivariate testing. Grade 3 or 4 acute and late complications were low in both preoperative and postoperative CCRT groups. Conclusions: Locally advanced rectum cancer patients experience good results with surgery and adjuvant concurrent chemoradiation.

• Archives of Plastic Surgery
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• 제48권2호
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• pp.175-178
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• 2021

The umbilicus is an important aesthetic component of the abdomen; therefore, its absence is both cosmetically and psychologically distressing to the patient. However, loss of the umbilicus during abdominal surgical procedures is often unavoidable. Umbilical reconstruction is aimed at obtaining a natural, three-dimensional appearance. We propose a simple method for immediate umbilical reconstruction with good long-term results. This technique was used successfully on a patient who underwent tumor excision. A 49-year-old woman presented with a large mass, measuring 5.8×4.0 cm, on her umbilicus. The mass, an epidermal cyst, developed after laparoscopic uterine myomectomy 5 years earlier. Complete excision of the mass resulted in a large defect, and immediate umbilical reconstruction was planned. Our procedure involved apposing and anchoring two opposing flaps onto the abdominal wall, so that the umbilicus would retain its depth over a long period of time. Negative-pressure wound therapy was applied for 72 hours as a mild compressive dressing. No complications were encountered. The healing process was uneventful and the aesthetic outcome was pleasing; a natural-appearing navel was created. The patient was satisfied with the end result. This technique provides a permanent and sufficient depression for the umbilicus.

• 한국사회복지학
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• 제41권
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• pp.119-146
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• 2000

The goals and strategies of welfare-to-work (WTW) policies have been sources of contentious political debate. In the United States, despite 20 years of welfare reform, there remain important differences of opinion regarding how best to design and deliver WTW programs. The proliferation of state and local WTW experiments has led to the identification of two ideal-types of WTW programs: the Labor Force Attachment and Human Capital Development models. Most of the recent policy debate about WTW in America has focused on the relative merits and performance of LFA and HCD. While the Primary goal of the LFA model is for welfare recipients to achieve a rapid transition into work, the HCD model seeks to improve the long-term employability of welfare dependents through education and skill development. LFA policies tend to be strongly outcome-oriented and generally can yield quick results. Their "any job is a good job" philosophy has proved attractive to policy-makers who are anxious to see concrete results in a short-term period. In contrast, the HCD policies do not simply dump welfare dependents at the bottom of the labor market, but aim to secure relatively stable and well-paid jobs. However, these strengths are offset by several practical weaknesses including high unit costs and long-term investment in human capital. In recent years, LFA policies have been increasingly favored by both policy officials and politicians in the United States. The introduction of Temporaray Assistance to Needy Families of 1996 has been accelerating the trend. What is going to happen to welfare recipients? This simple shift to the LFA model, however, will only see an alarming increase of working poor in a near future.