• Korean Journal of Radiology
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• 제19권6호
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• pp.1119-1129
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• 2018

Objective: To compare the image quality of low-tube-voltage and low-iodine-concentration-contrast-medium (LVLC) computed tomography urography (CTU) with iterative reconstruction (IR) with that of conventional CTU. Materials and Methods: This prospective, multi-institutional, randomized controlled trial was performed at 16 hospitals using CT scanners from various vendors. Patients were randomly assigned to the following groups: 1) the LVLC-CTU (80 kVp and 240 mgI/mL) with IR group and 2) the conventional CTU (120 kVp and 350 mgI/mL) with filtered-back projection group. The overall diagnostic acceptability, sharpness, and noise were assessed. Additionally, the mean attenuation, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and figure of merit (FOM) in the urinary tract were evaluated. Results: The study included 299 patients (LVLC-CTU group: 150 patients; conventional CTU group: 149 patients). The LVLC-CTU group had a significantly lower effective radiation dose ($5.73{\pm}4.04$ vs. $8.43{\pm}4.38mSv$) compared to the conventional CTU group. LVLC-CTU showed at least standard diagnostic acceptability (score ${\geq}3$), but it was non-inferior when compared to conventional CTU. The mean attenuation value, mean SNR, CNR, and FOM in all pre-defined segments of the urinary tract were significantly higher in the LVLC-CTU group than in the conventional CTU group. Conclusion: The diagnostic acceptability and quantitative image quality of LVLC-CTU with IR are not inferior to those of conventional CTU. Additionally, LVLC-CTU with IR is beneficial because both radiation exposure and total iodine load are reduced.

• Clinical and Experimental Reproductive Medicine
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• 제45권4호
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• pp.170-176
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• 2018

Objective: To assess whether the "testicular pool" could be used for histological analysis and whether it gave more accurate information than the standard testicular biopsy. Methods: Between January 2017 and March 2018, this single-center prospective study included 60 azoospermic men undergoing conventional bilateral testicular sperm extraction. Six samples were excised from each testicle and transferred to an embryologist. One additional biopsy was randomly taken from each testis for a histological analysis. After processing, the testicular pool was also sent for a histological analysis, which showed normal spermatogenesis (NS), hypospermatogenesis (HYPO), maturation arrest (MA), Sertoli cell-only syndrome (SCOS), and tubular atrophy (TA). Results: Twenty of the 60 patients (33.3%) had obstructive azoospermia (OA), while the remaining 40 (66.6%) had nonobstructive azoospermia. Their mean age was 40.5 years. All patients with OA had previously undergone unsuccessful testicular fine-needle aspiration. Successful sperm retrieval (SSR) occurred in 93.3% of patients. Histological analysis of the testicular biopsy revealed NS in 12 patients (20%), HYPO and TA in 28 patients (46.6%), MA in eight patients (13.3%), and SCOS in 12 patients (20%). The testicular pool analysis showed NS in 12 patients (20%), HYPO and TA in 44 patients (73.3%), MA in four patients (6.6%), and SCOS in no patients. In four patients with MA (6.6% of the total sample) and 12 patients with SCOS (20% of the total sample) according to the standard testicular biopsy, the embryologist found SSR with cryopreservation. Overall, in 44 patients (73.3%), the testicular pool analysis confirmed the histological findings of the standard testicular biopsy. In the 16 cases (26.6%) with a discrepancy between the single-biopsy histological findings and SSR, the testicular pool analysis confirmed the embryological data on SSR. Conclusion: The testicular pool proved to be easily analyzable, practical, manageable, and more accurate for predicting sperm retrieval than standard testicular biopsy.

• Journal of Yeungnam Medical Science
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• 제35권2호
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• pp.199-204
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• 2018

Background: The authors have performed ultrasound-guided stellate ganglion block (SGB) in our clinic using a lateral paracarotid approach at the level of the 6th cervical vertebra (C6). Although SGB at C6 is a convenient and safe method, there are ongoing concerns about the weak effect of sympathetic blockade in the ipsilateral upper extremity. Therefore, ultrasound-guided SGB was attempted using a lateral paracarotid approach at the level of the 7th cervical vertebra (C7). This prospective study aimed to compare changes in skin temperature after SGB was performed at C6 and C7, and to introduce a lateral paracarotid approach for SGB. Methods: Thirty patients underwent SGB twice: once at C6 and once at C7. For every SGB, the skin temperature of the patient's hypothenar area was measured for 15 min at 1-min intervals. Skin temperatures before and after SGB and side effects were compared between C6 and C7 groups. Results: The temperature of the upper extremity increased after SGB was performed at C6 and C7. There were significant differences between mean pre-SGB and the largest increases in post-SGB temperatures ($0.50{\pm}0.38^{\circ}C$ and $1.41{\pm}0.68^{\circ}C$ at C6 and C7, respectively; p<0.05). Significantly increased post-SGB temperatures (difference > $1^{\circ}C$) were found in 5/30 (16.7%) and 24/30 (80%) cases for C6 and C7, respectively (p<0.05). There were no significant differences in side effects between SGB performed at C6 or C7 (p>0.05). Conclusion: The lateral paracarotid approach using out-of-plane needle insertion for ultrasound-guided SGB performed at C7 was feasible and more effective at elevating skin temperature in the upper extremity than SGB at C6.

• 대한임상독성학회지
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• 제16권2호
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• pp.93-101
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• 2018

Purpose: The Korean government has tried to decrease the suicide death rate over the last decade. Suicide attempts, particularly non-fatal attempts, are the most powerful known risk factor for a completed suicide. An analysis of suicide attempt methods will help establish the effective preventive action of suicide. Fit prevention according to the method of suicide attempt may decrease the incidence of suicide death. Self-poisoning is suggested as a major method of both suicide attempts and suicide death. The aim of this study was to determine if a self-poisoning patient is a suitable target for the prevention of the suicide. Methods: This was retrospective analysis of a prospective cohort, which included patients who presented to the emergency department (ED) after a self-harm or suicide attempt from Jan 2013 to Dec 2017. The proportion of methods in suicide attempts, psychological consultation, and fatality according to the suicide attempt method were analyzed. The types of poison were also analyzed. Results: Poisoning was the most common method of suicide attempts (52.1%). The rate of psychological consultations were 18.8% for all patients and 29.1% for poison patients (p<0.001). The rate of mortality in poisoning was 0.6%. Psychological consultation was performed more frequently in admission cases than discharged cases. The most common materials of poisons was psychological medicines and sedatives that had been prescribed at clinics or hospital. Conclusion: Self-poisoning is a major method of suicide attempt with a high rate of psychiatric consultation, low mortality rate, versus others methods. The prevention of suicide death for suicide attempts may focus on self-poisoning, which is the major method of suicide attempts. A suitable aftercare program for self-poisoning may be an effective method for preventing suicide if an early diagnosis and management of psychiatric disorders through psychiatric consultation can be made, and early connection to social prevention program for non-fatal patients are possible.

• 한국콘텐츠학회논문지
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• 제21권5호
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• pp.247-258
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• 2021

본 연구의 목적은 공익광고 유튜브를 활용한 수업이 사범대생들의 인성에 미치는 영향을 심리·사회적 성숙도를 중심으로 살펴보는 데 있다. 자료수집을 위해 사범대학 23명의 2학년 학생들을 대상으로 설문과 반 구조화된 인터뷰를 하였다. 연구 결과는 다음과 같다. 첫째, 수업 참가자들의 전체 심리·사회 성숙도가 통계적으로 유의미하게 향상되었다. 둘째, 전체 심리성숙도와 전체 사회성숙도 각각에 대한 향상도도 통계적으로 유의미하게 나타났다. 셋째, 심리·사회 성숙도의 하위요인 분석에서는 심리 성숙 요인들의 평균 증가 폭과 비교해 사회성숙 요인들의 상승 폭은 낮게 나타났다. 이러한 결과에는 개별화, 핵가족화 경향으로 인한 개인 중심적 삶이 작용했을 가능성이 있다고 할 수 있다. 넷째, 사전 심리성숙도와 사전 사회성숙도, 사후 심리성숙도와 사후 사회성숙도 간의 상관관계도 통계적으로 유의미한 결과를 나타냈다. 특히 사전과는 달리 사후 심리성숙도와 사후 사회성숙도 간의 정적 상관관계가 상대적으로 강하게 나타났다. 이는 심리적 측면과 사회적 측면이 서로 긍정적인 영향을 준 결과로 해석된다. 다섯째, 성별 간 차이는 없었다. 결론적으로 공익광고 유튜브라는 영상매체를 통한 수업이 심리·사회적 성숙도 함양에 긍정적인 영향을 끼쳤음을 알 수 있었다. 특히나 이러한 방식의 수업은 흥미와 집중력을 높일 수 있으며, 타인을 향한 관심과 더불어 학습한 내용이 지식수준에 그치지 않고 행동을 수반할 수 있게 작용했음을 알 수 있었다.

• 동의신경정신과학회지
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• 제32권1호
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• pp.1-11
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• 2021

Objectives: To investigate the prevalence of acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) in patients with traffic injuries. In addition, PTSD patients was classified using 'pattern identification for jing ji and zheng chong'. Methods: Questionnaires such as the primary care PTSD screen for DSM-5(PC-PTSD-5), Korean version of PTSD checklist-5 (PCL-5-K), and the instrument of pattern identification for jing ji and zheng chong were conducted on 195 patients within 3 days to 1 year after traffic accidents. Patients were recruited from six medical institutions. Collected data were used to determine the prevalence of acute stress disorder and post-traumatic stress disorder. Results: On PC-PTSD-5, the prevalence was 39.1% for ASD and 50% for PTSD. On PCL-5-K, the prevalence was 20.4% for ASD and 29.3% for PTSD. Satisfying both PC-PTSD-5 and PCL-5-K, the prevalence was 18.2% for ASD and 25.8% for PTSD. As a result of pattern identification for jing ji and zheng chong, 'weakness of heart and gall bladder type' accounted for the highest proportions in both ASD and PTSD groups. Conclusions: In this study, the prevalence was 39.1% for ASD and 50% for PTSD by PC-PTSD-5. Satisfying both PC-PTSD-5 and PCL-5-K, the prevalence was 18.2% for ASD and 25.8% for PTSD. Further large-scale prospective studies are needed to analyze the prevalence of ASD and PTSD, the rate of progression from ASD to PTSD, and the type of pattern identification.

• 정보교육학회논문지
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• 제25권2호
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• pp.355-365
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• 2021

2020년 이후 학교에서는 온라인에서 수업하는 것이 일상이 되었으며 동시에 교사들에게는 스마트기기와 앱을 활용하여 수업을 설계하고 진행하는 역량이 중요해지고 있다. 이에 이 연구에서는 온라인으로 스마트기기와 앱을 활용하여 수업을 시연하는 것이 향후 실제 현장에서 그것을 활용하여 수업하고자 하는 예비교사의 의도에 어떠한 영향을 미치는지를 확인하고자 하였다. 이를 위해 예비교사의 스마트교육 역량 향상을 위한 설계 원칙에 따라 수업을 설계하고 예비교사를 대상으로 그 수업을 진행하였다. 이후 UTAUT모델에서 비롯한 변인인 성과기대, 노력기대, 사회적영향, 자발성, 활용의도, 촉진조건을 수업 전·후에 각각 측정하고 대응 표본 t검정을 통해 수업의 효과성을 검증하였다. 그 결과 촉진조건을 제외한 모든 변인에서 유의한 정(+)의 영향을 주는 것으로 확인되었다. 이러한 결과는 온라인 수업 시연 교육이 예비교원으로 하여금 스마트 교육이 필수가 되어버린 교육현장에 보다 실제적으로 적응할 수 있게 하는 한 가지 방안이 될 수 있음을 시사한다.

• Tuberculosis and Respiratory Diseases
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• 제85권2호
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• pp.155-164
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• 2022

Background: The remarkable efficacy of osimertinib in non-small cell lung cancer (NSCLC) with acquired T790M mutation has been widely documented in clinical trials and real-world practice. However, some patients show primary resistance to this drug. Even patients who initially show a favorable response have inconsistent clinical outcomes later. Therefore, the aim of this study was to identify additional clinical predictive factors for osimertinib efficacy. Methods: A prospective cohort of patients with acquired T790M positive stage IV lung adenocarcinoma treated with osimertinib salvage therapy in Hallym University Medical Center were analyzed. Results: Sixty-one eligible patients were analyzed, including 38 (62%) women and 39 (64%) who never smoked. Their mean age was 63.3 years. The median follow-up after treatment with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) was 36.0 months (interquartile range, 24.7-50.2 months). The majority (n=45, 74%) of patients were deceased. Based on univariate analysis, low baseline neutrophil-to-lymphocyte ratios (NLR), age ≥50 years, never-smoking history, stage IVA at osimertinib initiation, and prolonged response to previous TKIs (≥10 months) were associated with a significantly longer progression-free survival (PFS). Multivariate analysis showed that never-smoking status (hazard ratio [HR], 0.54; 95% confidence interval [CI], 0.30-0.98; p=0.041) and a baseline NLR less than or equal to 3.5 (HR, 0.23; 95% CI, 0.12-0.45; p<0.001) were independently associated with a prolonged PFS with osimertinib. Conclusion: Smoking history and high NLR were independent negative predictors of osimertinib PFS in patients with advanced NSCLC developing EGFR T790M resistance after the initial EGFR-TKI treatment.

• 한국가정과교육학회지
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• 제33권2호
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• pp.1-25
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• 2021

본 논문의 목적은 고교학점제 연구학교 운영사례를 통해 가정과 교육공동체에서 고교학점제를 준비하기 위한 방안을 탐색하는데 있다. 이를 위해 2019년 고교학점제 연구학교를 운영한 강원도 지역 H 고등학교의 운영 과정을 5개월간 모니터링 하고, 학생, 학부모, 교사를 대상으로 설문조사와 면담을 실시하여 교육과정 운영 내용을 파악하였다. H 고등학교의 고교학점제 운영사례를 바탕으로 가정과 교육공동체의 준비 방안을 제안하면 다음과 같다. 가정과 교사들은 학생들에게 매력적이고 의미 있는 가정 수업을 제공할 수 있도록 수업과 평가를 개선하고, 온라인 공동교육과정을 포함하여 가정교과 영역의 다양한 선택과목을 개설하는데 적극적인 노력을 기울여야 한다. 가정과 교사 공동체 및 관련 학회는 지역의 가정교과 연구회를 하나로 연결하는 공고한 네트워크를 구축하여 교육과정 운영과 관련된 정보를 공유하고 수업 연구 결과를 확산하는 채널로 삼을 필요가 있다. 가정교과 교원양성기관은 변화하는 교원양성정책에 발맞추어 예비교사가 현장에서 다교과를 지도할 수 있는 역량을 기르도록 교육과정을 혁신하고, 현장교사 재교육을 위한 질 높은 온/오프라인 프로그램을 개발하여 제공해야 한다.

• 한국의상디자인학회지
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• 제24권2호
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• pp.117-129
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• 2022

In terms of junior high school girls' growth patterns during early adolescence, unlike childhood when relatively balanced growth patterns are found and high school years in which the normal adult body type is almost reached, junior high school girls display imbalanced and rapid growth. In fact, diverse size changes by body part occur with a significant difference among individuals. Therefore, it has been difficult for junior high school students to select their exact size when buying a school uniform. This study attempted to develop winter blouse and skirt patterns reflecting the latest comfortable and active school uniform trends, using middle school girl avatars of various body shapes. Skirt and blouse pattern-drawing methods and margins differed. Based on such results, research prototypes were prepared. Then, virtual wear prospective drawings, clothing pressure, and appearance were assessed by body shape. Skirts were assessed with 22 factors while blouses were analyzed with 25 factors. Then, correlations between skirts and blouses were analyzed. According to the analysis, the reason why the dart & pleats position and margin were rated low was confirmed. In a virtual wear assessment on skirt patterns by body shape, a significant difference was found in all categories except for position of the hip circumference, margin of the hips, width of the skirt, and appropriateness of waist line position. The virtual wear assessment on the blouse patterns by body shape also revealed a significant difference in all categories but fit and shape pf the back part. In blouses, a significant difference was observed around shoulders and waist in type 1 and around the belly in type 2. On the contrary, for skirts, a significant difference was found around the hips and waists in type 1 and type 2. Therefore, these factors should be considered in making blouses and skirts. The above results suggested that skirt and blouse patterns should vary by body shape. It is anticipated that there should be further studies comparing brand-name school uniforms for high school girls and school uniforms by body shape.