• 한방안이비인후피부과학회지
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• 제35권3호
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• pp.25-35
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• 2022

Objectives : This study is designed to analyze outpatients who received medical treatments in ophthalmology, otolaryngology & dermatology clinic in Cheonan for 3 years. Based on the results, we intend to identify the trends of outpatients and provide the base data that can be used for future researches on patient characteristics, and Korean medicine treatments on field, statistical surveys, policy setting related to medical services. Methods : We retrospectively analyzed outpatients according to gender, year, age, season, main diagnosis, number of visits. The statistical analysis performed using IBM SPSS 25.0 for Windows. Results : The results of analyzing the electronic medical records of 1,260 patients are as follows. 1. Patients increased in 2019 compared to 2018, but decreased due to the influence of COVID-19 in 2020, and women visited more than men. The most visited age group was 40s and 50s, and summer was the highest in season. 2. By analyzing the number of visits per patient, men visited more than women, under the age of 20 was highest in age group and spring was highest in season. 3. Every year, sudden hearing loss, a frequent disease in otology, increased, and rhinitis, a frequent disease in ophthalmology, decreased. And the proportion of patients in dermatology was about 30% of the total 100 diseases. Conclusions : In order to increase the supply and use of Korean medicine in the Cheonan area in the future, it is essential to provide support at the association level and systematic supplement at the government level in consideration of the characteristics of the patient group and the trend of frequency diseases.

• Pediatric Infection and Vaccine
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• 제29권3호
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• pp.141-146
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• 2022

목적: 선천 결핵은 비특이적 증상을 보이는 경우가 많아 진단이 지연되는 경우가 흔하다. 진단이 지연되면 함께 입원하고 있는 신생아와 의료 종사자에게 결핵이 전파될 가능성은 높아진다. 미숙아로 태어나 신생아집중치료실에 입원해 있던 쌍둥이들이 출생 후 63일, 입원 후 48일째에 선천 결핵으로 뒤늦게 진단되었다. 이에 본 연구에서는 쌍둥이들과 입원 기간 중 함께 접촉했던 신생아 및 의료 종사자들에게 결핵의 전파 여부를 조사하였다. 방법: 선천 결핵으로 진단된 쌍둥이와 접촉한 의료 종사자 24명과 신생아 35명을 대상으로 결핵 접촉자 검진을 실시하였다. 결과: 쌍둥이들과 접촉한 신생아 35명 중에서 Bacille Calmette-Guérin 백신 접종을 받았던 신생아 중 2명은 투베르 쿨린 피부 검사 결과 양성 반응을 보였다. 24명의 의료 종사자 중 4명은 쌍둥이와 접촉하기 이전에 이미 인터페론-감마 방출 분석(interferon-gamma release assay, IGRA) 검사 결과가 양성이었다. 이들을 제외하고 나머지 20명을 대상으로 IGRA 검사를 시행하였고 모두 음성이었다. 쌍둥이와 접촉한 모든 의료 종사자와 신생아들은 흉부 방사선 검사에서 정상이었다. 결론: 선천 결핵이 신생아집중치료실에서 발생되었을 때 드물지만 결핵의 전파가 가능하므로 접촉한 신생아, 가족 및 의료종사자에 대한 결핵 접촉자 검진은 반드시 필요하다.

• 핵의학기술
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• 제27권1호
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• pp.42-46
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• 2023

Purpose The reference range described in Adrenocorticotropic Hormone reagent used in our laboratory is 10-60 pg/mL at 8 a.m. to 10 a.m., and 6-30 pg/mL at 8 p.m. to 10 p.m. However, in the case of outpatients, blood is mainly collected between 10 a.m. and 6 p.m., accounting for 57.8% of the total. Therefore, This study is intended to help make a more accurate diagnosis by reevaluating the reference range provided by the manufacturer of the Adrenocorticotropic Hormone reagent and setting split-timed reference range. Materials and Methods The patients collected blood before 10 a.m. were group A (68 people), and the patients collected blood after 10 a.m. were set to group B (80 people). A T-test was performed between groups to test their significance. And it was confirmed whether it was necessary to set the gender classification as a subgroup. The method of setting the reference range was calculated by the Bayesian's method and the Hoffmann's method. Results The reference range of Group A was 8.6 to 60.6 pg/mL by the Bayesian's method, and the Hoffmann's method was 3.6 to 61.3 pg/mL. The reference range of Group B was 6.9 to 50.5 pg/mL when applying the Bayesian's method, and the Hoffmann method's was 2.3 to 48.9 pg/mL. Conclusion This study was concluded that it was necessary to set the split-timed reference range. Through this study, the later the blood collection time, the lower the level of Adrenocorticotropic Hormone, indicating that blood collection time is important for patients with clinical significance. If a large number of subjects are selected and supplemented in the future, it is believed that systematic and accurate reference range can be set.

• 대한감각통합치료학회지
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• 제21권1호
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• pp.34-46
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• 2023

목적 : 본 연구의 목적은 장애 아동 및 청소년에게 적용한 가상현실(Virtual Reality; VR) 기반 작업치료 중재의 효과와 적용 방법에 대해서 체계적으로 분석하고자 한다. 연구방법 : 2012년 1월부터 2022년 8월까지 RISS, DBpia, KCI, Science direct, CINAHL MEDLINE에서 문헌을 검색하였다. 주요 검색용어로 '가상현실', '작업치료', '아동', '청소년', 'Virtual Reality', 'Occupational Therapy', 'Child', 'Adolescent'을 사용하였다. PRISMA의 Flowchart 4단계를 거쳐 총 16편의 문헌을 분석 대상으로 선정하였다. 결과 : 선정된 16편의 연구에서 장애 아동 및 청소년에게 사용된 VR 기반 작업치료 중재가 유의미한 효과를 보였다. 중재 대상자는 뇌성마비 유형 중 편마비 아동을 대상으로 한 연구가 가장 많았으며, 효과 측정에 사용된 평가도구는 일상생활활동, 인지, 운동기술, 사회적-상호작용기술, 시-지각 평가이었다. 중재 도구로는 Nintendo Wii와 Microsoft Kinect가 운동기술 및 일상생활 향상을 위하여 가장 많이 사용되었다. 결론 : 본 연구를 바탕으로 향후에는 장애 아동 및 청소년의 진단과 중재목적에 맞는 VR 도구 선택과 구체적인 방법의 제시를 통하여 VR중재가 임상에서 더욱 효과적으로 사용될 수 있을 것이라 기대한다.

• 해양환경안전학회지
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• 제29권4호
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• pp.332-337
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• 2023

우리나라는 3면이 바다로 둘러싸여 있을 뿐만 아니라 국가하천과 지방하천의 연장이 26,843km에 달하고 있어 풍부한 해수면과 내수면이 함께 공존하는 지리적 특징이 있다. 국민소득의 향상 등으로 내수면에서 운항하는 선박이 지속적으로 증가하고 있어 내수면에서 선박사고 및 인명사고의 위험성도 증가하고 있다. 본 연구에서는 내수면관련 법령조사 및 운영현황 분석을 통하여 거시적인 내수면 선박의 안전관리 대책 방안을 제시하였다. 그 개선방안으로 하드웨어적 인프라로서 사고 초기대응 및 인명구조의 골든타임 확보를 위한 충분한 내수면 소방정의 확보와 내수면 선박 사고예방 전문기관의 운영을 제언하며, 소프트웨어적 인프라로서 내수면 선박의 출항통제기준 마련과 현행 해수면 선박에만 적용하고 있는 안전진단제도를 기반으로 내수면 선박의 특성에 맞는 맞춤형 제도도입을 제언하였다. 이러한 내수면 안전관리 정책은 내수면 선박 사고발생 시 신속하고 체계적인 대처 방안 마련에 기여할 것으로 기대되며, 세월호 사건 이후 잠시 활성화 되었던 내수면 선박에 대한 안전관련 연구에 지속적인 관심을 갖는 기회가 되었으면 한다.

• 한국문헌정보학회지
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• 제57권4호
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• pp.49-74
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• 2023

본 연구에서는 충남도서관이 광역대표도서관으로서 도민의 삶의 질을 향상시킬 수 있는 도서관 서비스를 개발하고, 도내 공공도서관을 종합적이고 체계적으로 지원할 수 있도록 하는 제2차 충청남도 도서관 발전종합계획을 마련하고자 하였다. 이를 위해 제1차 도서관 발전종합계획의 성과분석, 충청남도 도내 도서관의 진단과 분석, 충청남도 정책환경 분석 및 도서관정책 환경전망 분석을 실시했다. 그리고 최종적으로 충청남도 제2차 도서관 발전종합계획의 사명, 비전, 목표, 추진전략 및 실행계획을 제안했다. 먼저, 사명은 '충청남도 도민을 포용하고 미래 지식·문화 가치를 선도한다'로 제안했고, 비전은 '미래의 지식·문화를 이끄는 포용의 공간'으로 제안했으며, 목표는 1) 누구나 즐길 수 있는 차별 없는 도서관 환경 구축, 2) 공동체를 포용하는 도서관 서비스, 3) 지식문화 가치를 실현하는 도서관 운영, 4) 미래를 선도하는 도서관 인프라, 5) 공동체 교류·협력 네트워크 강화의 5가지이다.

• 대한치과보철학회지
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• 제61권4호
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• pp.316-327
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• 2023

구치부 심한 골소실을 보이는 완전 무치악 환자에게 이공 전방에 4개 이상의 임플란트를 식립 후 전악 수복을 하는 'All-on-X' 임플란트 지지 고정성 보철 수복을 고려해 볼 수 있다. 과거에는 이러한 임플란트 고정성 보철 수복시 특별한 기준점 없이 술자의 판단에 의존하여 잔존 치조제에 임플란트를 식립하고 보철 수복 단계에선 이미 식립된 임플란트에 맞춰서 보철물을 제작하는 방식이었지만, 최근 디지털 치의학의 발전으로 진단, 수술, 보철 제작 등 모든 과정에서 계획적이고 예지력 있는 치료가 가능해졌다. 디지털 총의치, 임플란트 서지컬 가이드, 안면스캔 그리고 복제 의치를 통한 인상 채득 등의 디지털 기술들을 사용하여 복잡한 기공 과정을 줄이고, 임시 수복물의 심미와 기능을 최종 보철물로 효과적으로 이행할 수 있다. 상기 환자는 상악 디지털, 하악 'all-on-x' 임플란트 고정성 보철물 수복환자로, 진단부터 최종 수복까지 디지털 기술을 활용하여 기능과 심미성을 만족시키는 보철물을 제작할 수 있었기에 이를 보고하고자 한다.

• 치위생과학회지
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• 제23권4호
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• pp.320-329
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• 2023

Background: Oral frailty has garnered considerable interest following its identification as a risk factor for physical frailty. The Korean oral frailty diagnosis criteria have emphasized the need for extensive research on oral frailty diagnostic items and interventions. Our study performed an in-depth analysis of the tongue-palate pressure patterns in healthy community-dwelling older adults. Methods: Of the 217 older adults aged ≥60 years who visited a senior center in Wonju, 205 participants who completed tongue pressure measurement were included in the final analysis. Pressure changes over time were recorded by instructing the participants to press their tongue against the hard palate with for 7 seconds per cycle. The participants were divided into the normal and abnormal tongue pressure (NTP and ATP, respectively) groups based on whether they achieved the target tongue pressure at least once; tongue pressure patterns were compared between the groups. Furthermore, the average time taken to achieve the standard tongue pressure value was calculated for the participants in the NTP group and used to evaluate the decrease in tongue pressure in the ATP group. Results: Among the 205 participants, 40.5% had ATP. The tongue pressure graph revealed a gentle and consistent incline that was maintained even after achieving standard tongue pressure in the NTP group. The graph was more extreme in the ATP group, and the changes in the pressure type varied across individuals; the tongue pressure was only 48.4%, 40.7%, 31.9%, and 22.6% of the NTP in the participants in their 60s, 70s, 80s, and ≥90s, respectively (p<0.05). Conclusion: Tongue pressure weakness was observed in 40.5% of the healthy community-dwelling older adults. Furthermore, ATP graphs were observed in the patients with tongue pressure weakness. Thus, activities improving the oral function in community-dwelling older adults and systematic oral rehabilitation programs should be devised to promote normal swallowing.

• Korean Journal of Radiology
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• 제21권7호
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• pp.812-828
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• 2020

Objective: To provide an evidence-based guide for the MRI interpretation of complete tumor response after neoadjuvant chemoradiation therapy (CRT) for rectal cancer using visual assessment on T2-weighted imaging (T2) and diffusion-weighted imaging (DWI). Materials and Methods: PubMed MEDLINE, EMBASE, and Cochrane Library were searched on November 28, 2019 to identify articles on the following issues: 1) sensitivity and specificity of T2 or DWI for diagnosing pathologic complete response (pCR) and the criteria for MRI diagnosis; 2) MRI alone vs. MRI combined with other test(s) in sensitivity and specificity for pCR; and 3) tests to select patients for the watch-and-wait management. Eligible articles were selected according to meticulous criteria and were synthesized. Results: Of 1615 article candidates, 55 eligible articles (for all three issues combined) were identified. Combined T2 and DWI performed better than T2 alone, with a meta-analytic summary sensitivity of 0.62 (95% confidence interval [CI], 0.43-0.77; I² = 80.60) and summary specificity of 0.89 (95% CI, 0.80-0.94; I² = 92.61) for diagnosing pCR. The criteria for the complete response on T2 in most studies had the commonality of remarkable tumor decrease to the absence of mass-like or nodular intermediate signal, although somewhat varied, as follows: (near) normalization of the wall; regular, thin, hypointense scar in the luminal side with (near) normal-appearance or homogeneous intermediate signal in the underlying wall; and hypointense thickening of the wall. The criteria on DWI were the absence of a hyperintense signal at high b-value (≥ 800 sec/mm²) in most studies. The specific algorithm to combine T2 and DWI was obscure in half of the studies. MRI combined with endoscopy was the most utilized means to select patients for the watch-and-wait management despite a lack of strong evidence to guide and support a multi-test approach. Conclusion: This systematic review and meta-analysis provide an evidence-based practical guide for MRI assessment of complete tumor response after CRT for rectal cancer.

• 지역사회간호학회지
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• 제10권1호
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• pp.154-172
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• 1999

In order to analyse the prevalence rate of hypertension and the actual conditions of control, we selected five districts out of eleven eups and myuns in Chinan Country. We administered structured questionaries to 309 adults above the age of 40, computerized the data using SPSS - PC+. More than 40.1% of adults over 40 in Chinan County have health disorders ranging from high blood pressure to hypertension including alert high blood pressure at 36.2%, relatively high. Among general characteristics, differences in the rate of hypertension were influenced by age, occupation and places of residence. Over 71 who are engaged in agriculture, who don't have jobs, who reside in Sungsu, Jungchun, Chinan-eup all have higher hypertension rates than other groups. Accordingly, the control of hypertension should be focused on these people. As a result of the control of blood pressure, the survey showed 93.0% of the subjects were checked mainly at hospitals clinics, health centers subhealth centers and community health posts more than once a year, relatively high level of blood pressure management. However, the difference between their blood pressure measurements at ordinary times and the level of blood pressure at the time of research was quite considerable. Only 47.3% of the subjects diagnosed with high blood pressure and 70.3% of the subjects with normal blood pressure recognized their blood pressure accurately 52.7% of the subjects diagnosed with high blood pressure showed errors in understanding their blood pressure at normal times. Because these errors can cause problems in the control of blood pressure, proper management should be executed through a systematic examination. As a result of the high blood pressure control condition, the average period of hypertension was 74.5( ${\pm}92.8$) months, 92.3% of the subjects were diagnosed with high blood pressure at hospitals clinics, health centers subhealth centers community health posts, but only 29.5% were examined after a general check up on high blood pressure was completed. 70.5% were diagnosed with high blood pressure only after measuring their blood pressure. 14.1% of the subjects were hospitalized because of falls influenced by high blood pressure. 33.3% attended hospitals and health centers regularily for medical treatment and this shows how low the rate of the control of blood pressure. Most people did not undergo medical treatment, because they had no painful symptoms (46.7%), they didn't need to take the medicine(28.9%), or they forget to take the medicine(20.0%). These problems in the control of hypertension were discovered in the process of diagnosing high blood pressure at health medical institutions. Many people did not recognize the need for consistent control of blood pressure. That is, although the diagnosis for high blood pressures performed at hospitals clinics, health centers subhealth centers and community health posts, was 92.3%, more than 70.5% of the subjects were not examined completely with regard to blood pressure. Accordingly, heath medical institutions must diagnose high blood pressure not only by only measuring blood pressure but also by using systematic process of examination. As for the people diagnosed with high blood pressure, one should perform consistent medical approaches and help them to recognize the importance of the continuous control of blood pressure through subject-oriented education. Problems the subjects experienced were the following numbness in the limbs easily paralyzed stitches in their shoulders which felt painful, stiff necks, occiputs felt heavy, headaches when they got up in the morning, felt dizzy when standing and moving their heads and poor eyesight. The rate of knowledge related to high blood pressure was 78.7 points, comparatively low. Whether they had normal blood pressure or hypertension made no difference. These results are not desirable. Adult-oriented education forgot the prevention and management of high blood pressure should be implemented. Hypertensive-oriented education should be especially reinforced. Because there was a difference in the level of knowledge according to age, academic career, occupation or place of residence, education related to hypertension should be intensified and focused on those over the age of 71 those who did not attend school, those who do not have jobs and are engaged in agriculture and residents living in Bugui, Jungchun regions. The degree of healthy life practice in hypertensives is poor, particularly weight control, as opposed to people who have normal blood pressure. It makes no difference in smoking, the amount of daily smoking, drinking, the control of salt because each result means that they are not practicing healthy life or modifying their life-style. The development and programs to improve a healthy life should be executed.