• 대한상부위장관⦁헬리코박터학회지
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• 제18권4호
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• pp.231-234
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• 2018

Peptic ulcer bleeding (PUB) is the most common cause of non-variceal upper gastrointestinal bleeding, and its frequency has been declining over the past decades. However, mortality from PUB persists, and it is still a serious challenge in clinical practice. Although endoscopic intervention is the basic treatment modality for PUB, pharmacological therapy is an important adjunct. The emergence of proton pump inhibitors (PPIs) enables maintenance of intragastric pH >6, which greatly helps in the treatment of PUB. Continuous intravenous infusion of high-dose PPI reduces the re-bleeding rate, thereby helping avoid additional surgery in patients with high-risk stigmata. Moreover, administration of PPIs prior to endoscopy may reduce the need for additional endoscopic intervention. Recently introduced gastric acid suppressants, such as potassium-competitive acid blockers, have shown promising results in further treatment of PUB.

• Childhood Kidney Diseases
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• 제26권1호
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• pp.31-39
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• 2022

Alport syndrome (AS) is a progressive hereditary nephritis that is often accompanied by sensorineural hearing loss and ocular abnormalities. It is inherited in three modes of X-linked AS (XLAS), autosomal recessive AS (ARAS), and autosomal dominant AS (ADAS). XLAS is caused by pathogenic variants in COL4A5, while ARAS and ADAS are caused by those in COL4A3 or COL4A4. There is currently no curative treatment for AS; however, angiotensin-converting enzyme inhibitors (ACEi) can improve the outcome of AS. In the past decade, multiple studies have shown that early intervention with ACEi upon isolated microscopic hematuria or microalbuminuria could delay disease progression, and early diagnosis is crucial for early treatment. Therefore, a new classification of AS based on molecular diagnoses has been proposed, including the paradigm shift of re-classifying female "carriers" to "patients" and "thin basement membrane nephropathy" to "ADAS." In addition, with the detection of COL4A mutations in some patients with biopsy-confirmed IgA nephropathy, focal segmental glomerulosclerosis, and chronic kidney disease of unknown origin, it is suggested that the phenotype of AS should be expanded. In this review, we highlight the landmark studies and guidelines published over the past decade and introduce strategies for early diagnosis and treatment to improve the outcomes of AS.

• 대한간호학회지
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• 제33권6호
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• pp.829-838
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• 2003

Purpose: In South Korea, as growing the need of psychological support in disaster situation psychological assessment on stress after disaster is important to find out the factors affecting coping, and to plan intervention in the community. Method: The volunteers of Korea Redcross who live around K city, and the research team visited all homes at Jirye town, one of the high-impact area, 4 month after the typhoon. One of the family members who is over 18 years old, answered the self-report questionnaire composed of disaster experience, damage, exposure to traumatic event, and posttraumatic stress with IES-K (Impact of Event Scale-korea) He also, described his family members symptom related to re-experiencing, hyper-arousal, and avoidance. Six hundreds households were surveyed. Result: The prevalence of moderate to severe PTSD symptom was 36% of the subjects. The severity of PTSD was affected by gender, economic status and affected by damaged property, physical injury, worsening existing disease, getting infectious disease, amount of experienced traumatic event before disaster, warning, taking shelter, and subjects revealed differences in somatization as severity of PTSD. According to the description, community members had re-experiencing, hyper-arousal and avoidance. Conclusion: At a rural area, South Korea, community members have suffered from psychological distress after disaster. So psychological interventions are required as affecting factors and also to plan for warning and shelter in disaster situation is needed for preventing PTSD.

• 성인간호학회지
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• 제27권2호
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• pp.156-169
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• 2015

Purpose: This study identified the reasons why tuberculosis (TB) patients withhold treatment in a bid to develop a assessment scale to select patients who needs nursing intervention in the early stage and decrease the risk of discontinuation of treatment. Sample: There were two samples. A sample of 191 patients with TB and having primary treatment and a second sample of N who were under re-treatment Methods: The study design included qualitative and quantitative methods. Qualitative data were collected from in-depth interviews of TB patients under re-treatment. The quantitative data were collected from 191 patients with TB under primary treatment. Results: Exploratory factor analysis revealed 11 factors explaining 69.6% of total variance. These factors were categorized into four subgroups. A depression scale was used to establish concurrent validity. The depression scale had a positive relationship (r=54) with the discontinuing of primary treatment. The internal consistency reliability for the four subgroups was over .84. The confidence coefficient was Cronbach's ${\alpha}$ .95. The final scale was a self-reported four Likert scale including 50 items. Conclusion: Reliability and validity was established for the scale and the scale can be used to examine the risk of treatment discontinuation for TB. The scale is an important resource for nursing interventions in identifying and treating high risk clients.

• 정보보호학회논문지
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• 제31권6호
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• pp.1279-1290
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• 2021

차량 기술이 성장하면서 운전자의 개입이 필요 없는 자율주행까지 발전하였고, 이에 따라 차량 내부 네트워크인 CAN 보안도 중요해졌다. CAN은 해킹 공격에 취약점을 보이는데, 이러한 공격을 탐지하기 위해 기계학습 기반 IDS가 도입된다. 하지만 기계학습은 높은 정확도에도 불구하고 적대적 예제에 취약한 모습을 보여주었다. 본 논문에서는 IDS를 회피할 수 있도록 feature에 잡음을 추가하고 또한 실제 차량의 physical attack을 위한 feature 선택 및 패킷화를 진행하여 IDS를 회피하고 실제 차량에도 공격할 수 있도록 적대적 CAN frame 생성방법을 제안한다. 모든 feature 변조 실험부터 feature 선택 후 변조 실험, 패킷화 이후 전처리하여 IDS 회피실험을 진행하여 생성한 적대적 CAN frame이 IDS를 얼마나 회피하는지 확인한다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권10호
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• pp.5867-5870
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• 2013

Background: Cervical cancer is the second most common cancer among Malaysian women with an ASR of 17.9 and a mortality rate of 5.6 per 100,000 population in 2008 (GLOBOCAN, 2008). The 5 year prevalence was estimated to be 14.5 per 100,000 population. As the second most common cancer affecting productive females, cervical cancer imposes an impact to the socioeconomic aspect of the country. However, the poor uptake of cervical cancer screening is a major problem in detecting early pre-cancerous lesions and thus, delay in initiating treatment for cervical cancer. Realizing the urgency to increase the uptake of PAP smear, besides enhancing the promotion of PAP smear screening for women above 35 years old, the call-recall system for pap smear screening had been piloted in one of the suburban districts which aimed to improve regular participation of women for cervical and breast cancer screening. This is of public health importance as identifying the best feasible option to increase patient's respond to participate in the screening program effectively in our setting will be helpful in implementing an organized regular population based screening program tailored to our setting. The pilot program of cervical cancer screening in Klang was an opportunity to assess different options in recalling patients for a repeat pap smear to increase their participation and adherence to the program. Methods and Results: This was a population based randomized control trial. Women aged 20-65 years in the population that matched the inclusion and exclusion criteria were re-called for a repeat smear. There are four different intervention groups; letter, registered letters, short messages services (SMS) and phone calls where 250 subjects were recruited into each group. Samples were generated randomly from the same population in Klang into four different groups. The first group received a recall letter for a repeat smear similar to the one that has been given during the first invitation. The intervention groups were either be given a registered letter, an SMS or a phone call to re-call them. The socio-demographic data of the patients who came for uptake were collected for further analysis. All the groups were followed up after 8 weeks to assess their compliance to the recall. Conclusions: The study will provide recommendations about the most effective methods for recall in a population based pap smear screening program on two outcomes: i) patients response; ii) uptake for repeat pap smear.

• 한국콘텐츠학회논문지
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• 제19권12호
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• pp.279-288
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• 2019

본 연구는 흉통이 발생되어 관상동맥조영술을 실시한 후 재입원한 대상자의 관상동맥중재술 시행 여부에 따른 건강행위와 건강지표의 차이를 종단적으로 비교하고자 수행되었고, 2010년 1월부터 2017년 12월까지 일개병원에서 247명의 흉통발생자의 간호정보조사지와 전자의무기록을 분석한 2차 자료 분석연구이다. 대상자는 관상동맥중재술 비시행자와 시행자로 구분하여 병원 1차 입원 시점과 재입원 시점에서 흡연, 음주, 수면장애등 건강행위와 혈압과 혈중 지질 수치등 건강지표를 측정하였다. 수집된 자료는 SPSS 24.0를 사용하여 분석하였고, 연구 결과, 초기 입원시에는 관상동맥중재술 시행자와 비시행자간 건강행위와 건강지표에는 유의한 차이가 없었으나, 재입원시에는 관상동맥중재술 시행자가 비시행자에 비해 흡연과 지질 수치에 있어서 유의하게 건강한 양상을 나타내었다. 관상동맥중재술 비시행자의 경우 관상동맥협착의 위험이 많은 환자임에도 불구하고 흡연률이 높았고, 전체 대상자중 60%가 퇴원후 6-12개월 사이에 흉통으로 재입원하여, 흉통환자에게 의학적 치료와 더불어 건강행위를 도모하는 지속적인 통합관리가 필요함을 알 수 있었다. 본 연구의 의의는 관상동맥중재술 실시 여부에 따른 건강행위와 건강지표를 종단적으로 비교하여 관상동맥질환자와 위험환자의 건강행위의 중요성을 확인한 것이다.

• 한국융합학회논문지
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• 제8권3호
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• pp.63-70
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• 2017

본 연구는 $Qraycam^{TM}$을 활용한 구강보건교육 피드백의 효과를 알아보고자 하였다. 중학교 2학년 총 118명을 대상으로 4주간 실험을 진행한 후 다음과 같은 결과를 얻었다. $Qraycam^{TM}$을 활용한 치면세균막 검사에서는 이미지로 피드백을 받은 실험군의 ${\Delta}R30$, ${\Delta}R70$, ${\Delta}R120$값 모두 통계적으로 유의하게 감소하였다(p<0.001). SPS는 실험군과 대조군 모두 중재 후에 감소하였으나 실험군에서만 통계적으로 유의한 결과가 나타났다(p<0.001). 구강보건행태에서는 칫솔질 시간이 중재 후 실험군이 대조군에 비해 유의하게 높은 결과가 나왔다(p<0.001). 주관적 구강건강상태에서는 주관적 구강건강의 중요성이 대조군에 비하여 실험군에서 통계적으로 유의하게 높았다(p<0.001). 이상의 결과를 종합해 보면 $Qraycam^{TM}$이미지로 피드백을 받은 실험군에서 치면세균막 감소효과가 컸으며, 칫솔질 시간, 주관적 구강건강의 중요성이 높게 나타났으므로 $Qraycam^{TM}$을 구강보건교육에 시각적인 피드백 도구로 활용할 수 있을 것으로 보여진다.

• 말소리와 음성과학
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• 제13권2호
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• pp.77-90
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• 2021

본 연구는 국외에서 개발된 비단어 중재접근법을 수정 및 보완하여 한국어 비단어 중재접근법을 확립하고, 아동기 말실행증 아동에게 직접 적용하여 그 효과를 확인하기 위해 실시되었다. 궁극적인 목적은 비단어를 이용한 중재가 아동기 말실행증의 말운동프로그래밍 능력을 개선시켜 비단어 산출 및 단어로의 일반화에 효과적인지 알아보기 위함에 있다. 중재는 아동기 말실행증의 진단 특성을 보이는 5세 6개월의 남아를 대상으로, ABA설계를 사용한 단일대상연구를 실시하였다. 중재에 사용된 비단어는 아동 맞춤형으로 제작하였으며, 한 회기당 60분씩 주 2회로, 총 12회기를 실시하였다. 그 결과 중재한 3음절 비단어의 모든 지표가 향상되었으며, 중재하지 않은 3음절, 4음절 비단어 및 단어로의 일반화를 확인하였다. 단, 단어로의 일반화 효과는 비단어로의 일반화 효과에 비해 미비하였다. 비단어 중재는 대상 아동의 말운동프로그래밍 능력을 개선시키는데 효과적이었다. 그 결과 운동프로그래밍 손상에 기인한 전환 오류가 크게 감소하였고, 중재하지 않은 비단어의 산출 능력이 큰 폭으로 증가하였다. 그러나 강력하게 습관화된 단어 오류를 완전히 개선시키는 데에는 한계가 있었으며, 이는 보다 집중적이고 반복적인 중재 일정을 제공했을 때 기대할 수 있는 결과일 것이다.

• The Journal of Korean Physical Therapy
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• 제28권2호
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• pp.149-154
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• 2016

Purpose: The aim of this study is to suggest an intervention method for clinical use in the future by analyzing the effect of breathing exercise on activity of sternocleidomastoid muscle and scalenus anterior muscle, which are respiratory synergist muscles, and pulmonary functions in patients with forward head posture. Methods: Prior to the experiment, 12 patients (experimental group) performed feedback exhalation exercise along with conventional deep neck exercise, and 11 subjects (control group) performed feedback deep neck exercise along with conventional deep neck exercise. The intervention programs were performed for 40 minutes once a day (three times a week for four weeks). Results: Before intervention, %RMS was measured for surface electromyography (sEMG), and FVC, FEV1, and FEV1/FVC were measured using a spirometer. After four weeks, these items were re-measured under the same condition and analyzed. In within-group comparison of the experimental group, activity of sternocleidomastoid muscle and scalenus anterior muscle showed a significant decrease (p<0.05)(p<0.001), and forced vital capacity (FVC) showed a significant increase (p<0.05). In within-group comparison of the control group, activity of sternocleidomastoid muscle and scalenus anterior muscle showed a significant decrease (p<0.05), and in between-group comparison, there were significant differences in activity of sternocleidomastoid muscle and FVC (p<0.05). Conclusion: Long-term forward head posture restrains exercise performance of the neck and leads to exercise avoidance of the neck during daily activities, thus restraint factors might be created even while breathing. To cut off this link, a constant effort is required and diversified research on the correlation between neck functions and breathing should be conducted.