• 한국임상약학회지
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• 제25권1호
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• pp.18-26
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• 2015

Background: The recent change in pharmaceutical education system following the paradigm shift to patient-oriented pharmacy service requires an in-depth discussion to reorganize a future direction and establish a basis for maximizing social values of community pharmacy service. Objective: This study was conducted to review the current status of community pharmacy service provision in Korea based on published literatures. Methods: The electronic databases of National Digital Science Library and Electronic National Assembly Library were used to search the journal articles and dissertation papers. A search term "community pharmacy" was used and the published period was limited to papers published after year 2001, when the legal separation of prescribing and dispensing was implemented. Relevant study reports were also searched manually. Information about pharmacy service provision and study outcomes were retrieved from the selected papers, and classified by predefined individual service scope. Results: A total 33 papers reporting services provided by community pharmacies were selected (journal article 11, dissertation paper 17, and study report 5). Pharmacy services identified in these papers could be classified into prescription dispensing service, pharmaceutical care service, self medication service, other products service, and health promotion service. Twenty papers reported prescription dispensing services, three papers reported pharmaceutical care service, and only two papers reported health promotion service. Current community pharmacy services are highly dependent on prescription drugs while expanded services such as pharmaceutical care and health promotion are peripheral. Most prevalent research topic was medication counseling service (18 papers), reflecting that community pharmacists generally consider it to be the most important and fundamental service. Overall, current pharmacy services are very limited and focus on prescription dispensing service. Conclusion: At this point of time requiring expansion and quality improvement of community pharmacy services, we suggest further lively discussion to strengthen pharmacist's functional identity and set conditions for providing socially expected services.

• Asian Pacific Journal of Cancer Prevention
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• 제14권7호
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• pp.4115-4119
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• 2013

Background: Previous reports have shown that human epidermal receptor (HER)-3 overexpression may be associated with poor prognosis in patients with breast cancer, but results have been conflicting. In this study, we sought to investigate the prognostic significance of HER-3 immunohistochemical expression in patients with metastatic breast cancer. Methods: We retrospectively analyzed HER-3 immunohistochemical expression profiles in 45 paraffin-embedded specimens from patients who had been treated between 1996 and 2006 in the Department of Oncology of the Uludag University School of Medicine, Bursa, Turkey. Membranous or cytoplasmic dominant expression patterns of HER-3 were analyzed using the Rajkumar score and a cytoplasmic 4-point scoring system, respectively. Progression-free survival (PFS) and overall survival (OS) served as the main outcome measures. Results: The median PFS in the study participants was 9 months (interquartile range: 4.5-13 months), whereas the median OS was 20 months (interquartile range: 7.5-28 months). Categorization of the patient population according to HER-3 positive immunohistochemical expression did not reveal any statistically significant difference in terms of both PFS (p=0.70) and OS (p=0.81). The results of multivariable Cox regression analysis indicated that tumor size was the only independent predictor of PFS, whereas estrogen and progesterone receptor status was independently associated with OS. Conclusions: HER-3 immunohistochemical expression did not correlate with outcomes in Turkish patients with metastatic breast cancer. Although our results suggest that HER-3 expression in cancer specimens is not of prognostic significance, further prospective studies are warranted to confirm these results.

• 재활치료과학
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• 제5권2호
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• pp.23-33
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• 2016

목적: 본 연구는 노인의 인지기능과 상지기능의 관련성을 알아보고자 하며, 근거 자료들을 P.I.C.O. 방법에 따라 제시하였다. 연구방법: 2015년 11월부터 2016년 1월까지 연구를 진행하였으며 2000년 1월부터 2015년 10월까지 국외 학술지에 개재된 논문을 Medline과 PubMed를 통하여 검색하였다. 검색용어로는 elderly, dementia, Alzheimer's disease, Mild cognitive impairment, age-related, aging, cognitive, upper extremity function, hand function, hand-grip strength, grip force, complex motor function, bimanual, dexterity, UE performance, coordination을 사용하였다. 연구결과: 본 고찰에 포함된 총 8개의 연구 중 7개의 연구에서 상지기능이 노화에 따라 영향을 받는다는 것으로 나타났고, 1개의 연구에서는 노화에는 영향을 받지 않으나, 쥐기 힘 및 성별에 의해 물건조작능력에 영향을 받는 것으로 나타났다. 연구 분석 결과 노인 및 치매환자의 인지기능이 상지기능에 영향을 미치며 상호 관련성을 보였다. 결론: 본 연구는 노인을 대상으로 인지기능이 상지기능에 미치는 영향 및 관련성을 알아보고자 하였으며, 인지기능 정도에 따른 작업치료 적용 및 중재기법을 선택하는데 근거 자료로 활용될 수 있을 것으로 사료된다. 향후 국내 연구에서는 다양한 평가도구를 사용하고 질적 수준이 높은 연구들이 체계적으로 이루어져야 할 것이다.

• 대한두개안면성형외과학회지
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• 제21권5호
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• pp.288-293
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• 2020

Background: Pilomatrixoma is a benign tumor that originates from the hair follicle matrix. It usually presents as a hard, slow growing, solitary mass that can be easily misdiagnosed as other skin masses. The aim of this study was to clinically analyze a case series of pilomatrixoma in pediatric patients from Korea. Methods: A total of 165 pediatric patients from 2011 to 2018 with a histological diagnosis of pilomatrixoma were included. A retrospective review was performed using the electronic medical records, including patient demographics, number and location of the mass, clinical and imaging presentation, and postoperative outcomes. Results: There were 61 male and 104 female patients with 152 solitary and 13 multiple pilomatrixomas. Among solitary pilomatrixomas, the lesion commonly occurred in the head and neck (84.2%), followed by upper limbs (11.2%), lower limbs (3.3%), and trunk (1.3%). The pilomatrixoma lesion presented as the following types based on our clinical classification: mass (56.02%), pigmentation (25.31%), mixed (12.65%), ulceration (4.82%), and keloid-like (1.2%). Ultrasonography showed a high positive predictive value (95.56%). There were no specific complications observed except for two cases of recurrence. Conclusion: Pilomatrixoma has various clinical feature presentations and commonly occurs in the head and neck. Ultrasonography is a helpful diagnostic tool. Surgical removal of the lesion is the main treatment method with a low recurrence rate.

• Journal of Periodontal and Implant Science
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• 제37권4호
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• pp.825-838
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• 2007

Endosseous implants are used in the treatment of various types of tooth loss, and numerous long-term studies have demonstrated the excellent reliability of this method of treatment. However, the increase of implant failure are associated with inadequate quality and/or height of bone. At the end of the 1980s, Wide(>3.75mm) implants were initially used for managing these difficult bone situations. The recommended indications for its use included poor bone quality, inadequate bone height. immediate placement in fresh extraction sockets, and immediate replacement of failed implants. At the 2000s, wider implants(6.0mm and 6.5mm) were used in a few studies. Although good clinical outcomes have been reported in recent years, there is still a controversy on this topic. Therefore, the purpose of this study was to estimate the survival rate of wide implants($6.0{\sim}8.0mm$) in molar regions, evaluating the clinical outcome. In this study, 1135 RBM surfaced wide implants($Rescue^{TM}$, MEGAZEN Co., Korea/595 maxillary, 540 mandibular) were placed in 650 patients(403 male, 247 female/age mean: $51.2{\pm}11.1$ years, range 20 to 83 years). Of the total, 68.3% were used to treat fully or partially edentulous situations, including single-tooth losses and 31.7% were placed immediately after teeth extraction or removal of failed implants, of which all were in the molar regions. Implant diameter and length ranged from 6.0 to 8.0mm and from 5.0 to 10.0mm respectively. The implants were followed for up to 42 months (mean: $14.6{\pm}9.5$ months). Of 1135 placed implants, 58 implants were lost. Among them, 53 implants were lost within 12 months after implant placement. The survival rate was 93.6% in the maxilla and 96.3% in the mandible, yielding an overall survival rate of 94.9%, for up to 42 months. As the result of Cox regression model, prosthetic type, sinus graft, and patient gender have an statistical significance on the implant survival rate in this study. This study suggests that the use of wide implants($6.0{\sim}8.0mm$) would provide a predictable treatment alternative in posterior areas.

• 한국산학기술학회논문지
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• 제16권11호
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• pp.7635-7647
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• 2015

본 논문은 간호사의 역량을 규명하고, 전체 간호업무의 80%를 통제할 수 있는 20%의 핵심간호역량을 도출하여 이를 기반으로 하는 간호교육과정 개발을 위한 간호역량을 모델링하기 위해 시도되었다. 각종 역량 관련 문헌고찰을 통하여 역량기반 교육과정, 역량 및 간호역량의 개념을 확인하고, 간호역량의 개념에 부합하는 각종 간호역량을 열거 및 유목화 하여 이들 간의 관계를 규명하였다. 또한 각종 역량 모델링의 방법을 검토하여 이를 토대로 역량기반 간호교육과정에 고유한 핵심역량 모델의 예시적 개념 지도를 제시하였다. 역량기반 간호교육과정을 위한 핵심역량은 기저역량, 실무역량, 인성역량으로 대별되고 기저역량은 전공(이론+실기)과 간호술로 역량의 기본이 된다. 실무역량은 임상적 판단, 대상자 교육, 의사소통, 환자 안전, 질 향상, 병동 및 자원 관리 등으로 구성되며 인성역량은 리더십, 책임 인식, 협력, 정책변화 대응 등으로 이루어진다. 이들은 자기주도적 학습과 비판적 사고 능력을 통하여 지속적인 순환 관계를 유지한다. 결국 이러한 역량을 가진 간호사는 지식근로자로써 자기주도적 학습자이며 전문적이고 효율적인 의사소통가이다. 간호역량을 확정시키는 후속연구가 계속되어야 하며 실제 역량기반교육과정에 적용하여 성과를 측정하고 이를 다시 반영하는 과정이 지속적으로 이루어져야 함을 제언한다.

• Journal of Preventive Medicine and Public Health
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• 제30권3호
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• pp.643-664
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• 1997

This study is to provide evidence-based recommendations for the most-effective treatments of benign prostatic hyperplasia based on patient preference or clinical need, and to meta-analyze the Korean literatures for the development of BPH treatment guidelines. For these analyses, extensive literature searches (208 articles), with priority given to the Korean Journal of Urology, were conducted from 1960 to August, 1996. Meta-analysis, like all statistical analysis, has two main functions: data summarization (qualitative meta-analysis) and smoothing o. pattern recognition (quantitative meta-analysis). As well, critical reviews and syntheses with the mean and 90-percent confidence intervals for the likelihood were used to evaluate empirical evidence and significant outcomes of the BPH treatment literatures (106 articles). For this task, the Methodologic Panel for BPH Guidelines was composed of multidisciplinary experts in the field. The results of the study were summarized as follows: For all that watchful waiting is an appropriate treatment strategy for the majority of patients with prostatism, we couldn't find the Korean literatures which carried this article. The literatures on alpha-1-adrenergic receptor blockers provide no evidence to suggest that any one alpha blocker is more effective than another. The finasteride reduces the size of the prostate, on average, and leads to a small yet perceptible reduction in sysptoms. Of all treatment options, prostate surgery with transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), and so on, offers the best chance for symptom improvement. However, surgery also has the highest rates of significant complications. Therefore, surgery need not always be a treatment of last resort. Balloon dilation of the prostatic urethra is clearly less effective than surgery in relieving symptoms, but it is associated with fewer complications. Emerging technologies for treating BPH include lasers, coils, stents, thermal therapy and hyperthermia. Established technologies will also be reanalyzed as results of new trials are reported. Although this study has some limitations due to lacking for good quality literatures, ' it provides a cornerstone for our medical research. It represents the most current scientific knowledge regarding the clinical epidemiology including treatment of BPH. It will be revised and updated as needed.

• 대한신경집중치료학회지
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• 제11권2호
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• pp.93-101
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• 2018

Background: At most centers, general anesthesia (GA) has been preferred for endovascular treatment (EVT) of ruptured intracranial aneurysms (RIAs). In this study, we analyzed procedural results, clinical outcomes, and follow-up angiographic findings for patients undergoing EVT for RIA under local anesthesia (LA) with conscious sedation (CS). Methods: We retrospectively evaluated 308 consecutive patients who underwent EVT for RIAs at a single institution between June 2009 and February 2017. EVT under LA with CS was considered for all patients with aneurysmal subarachnoid hemorrhage, regardless of Hunt and Hess (HH) scale score. Results: EVT was performed for 320 aneurysms in 308 patients with subarachnoid hemorrhages. The mean patient age was $55.5{\pm}12.6$ years. Moderate (III) and poor (IV, V) HH grades were observed in 75 (24.4%) and 77 patients (25%), respectively. Complete occlusion immediately after EVT was achieved for 270 (84.4%) of 320 aneurysms. Thromboembolic complications and intraprocedural ruptures occurred in 25 (7.8%) and 14 cases (4.3%), respectively. The morbidity rate at discharge (as defined by a modified Rankin scale score of 3 or greater) was 27.3% (84/308), while the mortality rate was 11.7% (36/308). Follow-up angiographic results were available for 210 (68.1%) of 308 patients. Recanalization was observed in 64 (29.3%) of 218 aneurysms in 210 patients. Conclusion: Based on our experience, EVT for RIAs under LA with CS was feasible, regardless of the clinical grade of the subarachnoid hemorrhage. Complication rates and follow-up angiographic results were also comparable to those observed when GA was used to perform the procedure.

• 대한통합의학회지
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• 제9권3호
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• pp.87-97
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• 2021

Purpose : The purpose of this meta-analysis was to evaluate the effects of transcranial direct current stimulation on the lower extremity function of stroke patients. Methods : Domestic data were gathered from studies that conducted clinical trials associated with transcranial direct current stimulation and its impact on lower extremity function of stroke patients. A total of 592 studies published between 2012 and 2020 were identified, with 7 studies satisfying the inclusion data. The studies consisted of patient, intervention, comparison, and outcome (PICO) data. The search outcomes were items associated with muscle activity, balance, muscle strength and walking ability. Cochrane risk of bias (ROB) was used to evaluate the quality of 3 randomized control trials. The quality of 4 non-randomized control trials was evaluated using risk of bias assessment tool for non-randomized studies (RoBANS). Effect sizes in this study were computed as the corrected standard mean difference (SMD). A random-effect model was used to analyze the effect size because of the high heterogeneity among the studies. Egger's regression and 'trim-and-fill' tests were carried out to analyze the publishing bias. Results : The following factors had a large total effect size (Hedges's g=2.10, 95 %CI=1.54~2.66) involving transcranial direct current stimulation on stroke patients: muscle activity (Hedges's g=2.38, 95 %CI=1.08~3.68), balance (Hedges's g4=2.41, 95 %CI=1.33~3.60), walking ability (Hedges's g=1.54, 95 %CI=0.49~2.59), and muscle strength (Hedges's g=2.45, 95 % CI: 0.85~4.05). Egger's regression test showed that the publishing bias had statistically significant differences but 'trim-and-fill' test showed that there was still statistical difference. Conclusion : This study provides evidence for the effectiveness of transcranial direct current stimulation on the lower extremity in terms of muscle activity, balance, walking ability, and muscle strength in stroke patients. However, due to the low quality of studies and high heterogeneity factors, the results of our study should be interpreted cautiously.

• 한국심리학회지 : 문화 및 사회문제
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• 제15권3호
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• pp.339-357
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• 2009

본 연구의 목적은 한국사회가 고령화되고 있는 시점에서 치매환자 가족부양자의 부양부담과 사회지원이 건강 및 삶의 질과 어떤 관계가 있는지를 탐색하고, 부양자의 건강 및 삶의 질에 대한 부양부담과 사회지원의 상호작용을 검증하는 것이다. 본 연구의 참여자는 서울, 경기, 충청 지역에 거주하는 치매환자 가족부양자 207명(여: 106)이었으며, 그들의 평균 연령은 51.62(SD=9.25)세였다. 본 연구에서 사용된 심리검사는 다차원부양자부담설문지, 전겸구의 신체증상척도, 한덕웅과 장은영의 건강지각척도, 자기진술 부정정서질문지, Cambell의 주관안녕척도, MOS의 사회지원질문지, 권중돈의 치매노인 부적응문제척도이다. 분석 결과, 치매환자 가족부양자의 부양부담은 신체증상이나 우울과는 정적으로 건강지각이나 주관안녕과는 부적으로 관계하고 있었다. 사회지원은 치매환자 부양부담이 건강지각, 우울 및 주관안녕에 미치는 영향을 중재하는 것으로 나타났다. 이는 치매환자 부양에 따른 부정적 효과에 대해 완충 작용을 할 수 있는 것을 의미한다. 부양부담이 가족부양자의 신체증상과 우울의 변량을 30~40% 가량이나 설명하고 있었기 때문에 결과를 부양자의 건강이나 삶의 질의 중재를 중심으로 논의하였다. 사회지원이 부양부담 수준에 따라 다르게 작용하는 것 외에도 치매증상이 더 심각할 경우 사회지원이 적은 것 등과 관련해서도 선행연구를 바탕으로 논의하였다.