• 한국전문물리치료학회지
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• 제14권1호
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• pp.46-54
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• 2007

The purposes of the present study were to determine the difference of functional outcome, and to identify factors associated with functional difference in patients with stroke. The sample consisted of 56 stroke patients who had received physical therapy at the physical therapy unit of the Dongeui Medical Center in Busan city between January 2000 and June 2002. Stroke patients were evaluated by physical therapists 3 times; The first day in physical therapy (PT) (T1), one month after the first day in PT (T2), and two months after the first day in PT (T3). Functional status was assessed with the Functional Independence Measure (FIM) instrument, a validated instrument for documenting the severity of disability and assessing the outcome of rehabilitation treatment. Functional gain was calculated over T2-T1, T3-T1, and T3-T2. SAS statistical software was used for the analysis. The Student's t-test, paired t-test, analysis of variance (ANOVA/Tukey and Scheffe), and analysis of covariance (ANCOVA) were used to examine the functional difference in variables. Repeated measures ANOVA was also used to analyze the functional difference by time (T1, T2, and T3). Multiple regression analysis was performed to determine the effects of independent variables on the difference of functional outcome as defined by the FIM score. A total of 56 stroke patients were evaluated, their average age${\pm}$standard deviation was $61.6{\pm}9.3$ years (range: 40~81 yr). The functional status of patients who received physical therapy for about 2~3 months was significantly improved (mean FIM scores, $20.5{\pm}1.8$, $28.9{\pm}1.9$, and $8.41{\pm}1.1$ points for each time period, respectively) (p<.0001). Diabetes was significantly associated with the FIM score for T2-T1 (p<.05). The type of diagnosis was significantly associated with the FIM score for T3-T1 (p<.05). Gender, smoking, and the FIM score on admission were significantly associated with the FIM score for T3-T2 (p<.05). In conclusion, gender, smoking, diabetes, the type of diagnosis, and the FIM score on admission were significantly associated with improved FIM scores. We recommend that further research should explore the functional outcome by using larger sample sizes, longer follow-up periods, and more sensitive assessment instruments.

• Journal of Korean Neurosurgical Society
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• 제49권5호
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• pp.267-272
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• 2011

Objective : Although iliac crest autograft is the gold standard for lumbar fusion, the morbidity of donor site leads us to find an alternatives to replace autologous bone graft. Ceramic-based synthetic bone grafts such as hydroxyapatite (HA) and b-tricalcium phosphate (b-TCP) provide scaffolds similar to those of autologous bone, are plentiful and inexpensive, and are not associated with donor morbidity. The present report describes the use of Polybone$^{(R)}$ (Kyungwon Medical, Korea), a beta-tricalcium phosphate, for lumbar posterolateral fusion and assesses clinical and radiological efficacy as a graft material. Methods : This study retrospectively analyzed data from 32 patients (11 men, 21 women) who underwent posterolateral fusion (PLF) using PolyBone$^{(R)}$ from January to August, 2008. Back and leg pain were assessed using a Numeric Rating Scale (NRS), and clinical outcome was assessed using the Oswestry Disability Index (ODI). Serial radiological X-ray follow up were done at 1, 3, 6 12 month. A computed tomography (CT) scan was done in 12 month. Radiological fusion was assessed using simple anterior-posterior (AP) X-rays and computed tomography (CT). The changes of radiodensity of fusion mass showed on the X-ray image were analyzed into 4 stages to assess PLF status. Results : The mean NRS scores for leg pain and back pain decreased over 12 months postoperatively, from 8.0 to 1.0 and from 6.7 to 1.7, respectively. The mean ODI score also decreased from 60.5 to 17.7. X-rays and CT showed that 25 cases had stage IV fusion bridges at 12 months postoperatively (83.3% success). The radiodensity of fusion mass on X-ray AP image significantly changed at 1 and 6 months. Conclusion: The present results indicate that the use of a mixture of local autologous bone and PolyBone$^{(R)}$ results in fusion rates comparable to those using autologous bone and has the advantage of reduced morbidity. In addition, the graft radiodensity ratio significantly changed at postoperative 1 and 6 months, possibly reflecting the inflammatory response and stabilization.

• 생명과학회지
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• 제30권11호
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• pp.939-946
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• 2020

뇌졸중은 전 세계적으로 신경계 장애를 일으키는 주요 원인 중 하나이며, 뇌졸중 환자는 다양한 운동, 인지 및 정신 장애를 나타낸다. GPR88은 orphan G protein coupled receptor이며 striatal medium spiny neurons에서 높게 발현이 되며, GPR88이 결손이 된 경우 motor coordination과 motor learning에 문제가 발생하게 된다. 본 연구에서는 Western blot 및 real-time PCR을 사용하여 허혈성 마우스 모델에서 GPR88 발현이 감소함을 발견 하였다. 또한, 뇌에서 유래한 세 가지 유형의 세포들, 뇌혈관내피세포(brain microvascular endothelial cells), 미세 아교세포(microglial cells) 및 신경 세포들에서 GPR88의 발현정도를 확인한 결과, HT22 신경 세포에서 GPR88의 발현이 가장 높음을 관찰하였고, 뇌졸중과 유사한 실험조건인 oxygen glucose deprivation (OGD) 조건에 배양한 HT22 신경세포에서 GPR88의 발현이 감소하였다. 또한 GPR88 효현제인 RTI-13951-33 (10 mg/kg)을 전처리후에 뇌허혈을 유발하였을 때, infarct volume의 감소, vestibular-motor function 및 neurological score의 개선효과를 관찰할 수 있었다. 이러한 결과는 GPR88이 허혈성 뇌졸중을 포함한 CNS 질환의 치료를 위한 잠재적인 약물표적이 될 수 있음을 제시한다.

• 대한한의학회지
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• 제28권1호통권69호
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• pp.72-86
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• 2007

Objectives : The purpose of this study was to evaluate and compare the cost-effectiveness of Eastern, Western, and collaborative treatments and suggest a cost-effective approach for patients with frozen shoulder pain. Methods : Using the data of fifty-two patients, treatment effectiveness was measured by CSA, SPABI, and ROM scales and changes from the baseline score were evaluated. Data source for cost estimation was based on the national health insurance (NHI) payment system. Because the price in NHI was differentiated by health care institutions, five collaborative types were considered in assessing costs. Cost-effective ratios were computed for economic evaluation. Results : Compared with Eastern treatment, collaborative and Western treatments showed better effects on CSA scale after 4 weeks' treatment. The collaborative approach was also the most effective treatment on SPADI and ROM scales. The direct cost per patient receiving Eastern treatment was less than other treatments. In general, collaborative treatment dominated Eastern and Western treatments in cost-effectiveness an analysis. However, the cost-effectiveness ratio of Eastern treatment resulted in \9,000 compared to \29,000 of collaborative treatment on SPADI. Four different indicators of ROM scales resulted in different approaches as the cost-effective treatment. Conclusions : Considering cost-effectiveness ratios, collaborative treatment was the best treatment on CSh and SPADI scales after 4 weeks' treatment. As for ROM scales, the recommended alternatives were Eastern treatment for patients with abduction and adduction disabilities, Western treatment for those with flexion disability, and collaborative approach fir those with extension disabiliry.

• 디지털융복합연구
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• 제14권9호
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• pp.515-523
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• 2016

본 연구는 유방암절제술환자 대상으로 가정치료융합프로그램을 실시하여, 유방암절제술환자의 팔 기능, 작업수행력, 삶의 질, 우울감에 미치는 영향에 대해 알아보았다. 대상자는 유방암절제술환자 20명을 대상으로 12주간 주 2회 40분간 외래로 작업치료실에 방문한 환자를 실시하였다. 중재 전과 후의 팔 기능을 알아보기 위해, 한국형 상지 장애 척도(Korean version of the Disability of the Arm, Shoulder, and Hand; K-DASH)와 부종을 줄자로 측정하였고, 작업수행력을 알아보기 위해 캐나다작업수행측정(Canadian Occupational Performance Measure, COPM)실시하였으며, 삶의 질을 알아보기 위해 Functional Assessment Cancer Therapy-Brest(FACT-B)을 사용하였으며, 우울감을 알아보기 위해 자기평가 우울척도(Beck Depression Inventory, BDI)를 이용하였다. 중재 결과 팔 기능은 유의하게 증가하였으나, 부종은 유의하게 감소하지 않았으며, 작업수행력, 삶의 질에서 유의하게 향상하였으며, 우울감은 유의하게 감소하였다. 따라서 가정치료융합프로그램은 유방암절제술환자의 팔 기능, 작업수행력, 삶의 질 우울감에 긍정적인 영향을 미친다는 사실을 알 수 있었다.

• Journal of Acupuncture Research
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• 제23권5호
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• pp.219-228
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• 2006

Objectives : To observe the effect of acupuncture treatment on Digital Infrared Thermographic Imaging(DITI) in frozen shoulder patients. Methods : 17 voluntary patients received acupuncture treatment on LI15, TE14, GB21 and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The patients were instructed to practice self exercise during their daily lives. Evaluations were made before treatment, after 1 week of treatment, after 2 weeks, 3 weeks and after 4 weeks of treatment. Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI), Range of Motion(ROM) and the patient's satisfaction concerning the treatment was measured by Visual Analogue Scale(VAS). DITI was measured before treatment and after 4weeks of treatment. The obtained data was analyzed. Results : CSA, SPADI, VAS, adduction and extension showed significant(p<0.05) improvement. Abduction and flexion both improved after 4 weeks of treatment, but the improvement was statistically insignificant(p>0.05). DITI showed improvement but the improvement was insignificant(p>0.05). Conclusion : 4 weeks of acupuncture treatment significantly improved CSA, SPADI, VAS, adduction and extension in frozen shoulder patients(p<0.05). The improvement of abduction and flexion after 4 weeks of acupuncture treatment was insignificant(p>0.05). DITI results improved after 4 weeks of acupuncture treatment. But the change of thermal difference was insignificant(p>0.05).

• Journal of Acupuncture Research
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• 제23권5호
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• pp.187-198
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• 2006

Objectives : The purpose of this study is to assess the effect of Daekumeumja herb-acupuncture on neural cell proliferation and nitric oxide synthase(NOS) expression in hippocampus of ethanol-intoxicated Sprague-Dawley(SD) rats. Methods : SD rats were randomly assigned into 5 groups ; the normal group, the alcohol-treated(control) group, the alcohol- and 1 mg/kg Daekumeumja- treated(sample A) group, the alcohol- and 5mg/kg Daekumeumja-treated (sample B) group, the alcohol- and 10 mg/kg Daekumeumja-treated (sample C) group(n = 6 in each group). Normal group were received with Saline, while control group were injected intraperitoneally with alcohol(2 g/kg) once per day for 5 days. Sample groups were treated Daekumeumja herb-acupuncture on Chungwan(CV12) for 5 consecutive days. Bromo-deoxyuridine(BrdU) was injected into all animals once per day for 5 days. For the detection of BrdU-positive cells and NADPH-d- positive cells in hippocampus, immunohistochemistry was performed. Results : 1. In the dentate gyrus area, the number of BrdU-positive cells in the sample $B(278.08{\pm}6.46)$, $C(331.33{\pm}16.68)$ groups was significantly(p<0.05) increased compared with the control group. 2. In the dentate gyrus area, the number of NADPH-d-positive cells in the sample $C(86.50{\pm}10.02)$ groups was significantly(p<0.05) increased compared with the control group. 3. In the CAI area, the number of NADPH-d-positive cells in the sample $A(63.90{\pm}2.69)$, $B(75.70{\pm}3.01)$, $C(97.70{\pm}4.06)$ groups was significantly(p<0.05) increased compared with the control group. 4. In the CA 2-3 area, the number of NADPH-d-positive cells in the sample $B(30.20{\pm}1.89)$, $C(62.70{\pm}2.08)$ groups was significantly(p<0.05) increased compared with the control group. Conclusion : These results indicate that, neural cell proliferation and NOS expression in hippocampus was reduced in ethanol-intoxicated group. Treatment of Daekumeumja herb-acupuncture increased this diminution. Daekumeumja could be able to effect on the prevention of the amnesia and learning disability in alcoholism.

• 한국사회복지학
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• 제56권1호
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• pp.155-179
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• 2004

본 연구는 현행 노동부와 한국장애인고용촉진공단이 주도하는 직업훈련사업의 효과성을 분석하고자 실시되었으며 장애인직업훈련시설수료생을 대상으로 설문조사를 실시하였다. 장애인 직업훈련의 효과성은 '생산성 효과'와 '취업효과'로 개념화하였고 '생산성 효과'는 자격증 취득, 자아효능감, 교육성취도 변수로 측정되었으며 분석결과 훈련시설유형, 훈련직종, 훈련기간이 주요한 요인으로 나타났다. '취업효과' 즉 훈련수료 후 취업가능성에 영향을 미치는 요인은 훈련시설로 나타나 훈련생산성보다 훈련시설의 취업노하우와 훈련생관리가 취업에 더 중요한 요인임을 예측할 수 있었다. 따라서 장애인직업 훈련사업의 효과성을 높이기 위해 프로그램과 교육자원을 공유할 수 있도록 공공, 민간, 보건복지부산하 훈련시설의 기능을 재정립하여 훈련시설 간 직업훈련 효과의 격차를 줄이고, 지역별 훈련사업을 특성화시키며, 장애인고용촉진기금의 효율적 운용을 위해 실적에 따른 지원차등화가 필요한 것으로 나타났다.

• 한국사회복지학
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• 제59권4호
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• pp.217-244
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• 2007

본 연구는 사고로 중도장애인이 된 사람들의 사고 이후 생애경험을 재구성하여 그들의 삶을 이해하는데 그 목적을 두고 있다. 이를 위하여 F. Schutze의 이야기식 인터뷰(narrative interview)를 조사도구로 3 사례를 수집하여 '인생진행의 과정구조'로 분석하였다. 특별히 그 과정에서 피면접자 자신이 직접 구성한 삶의 경험을 연구자가 구성한 후, 각 사례의 공통점과 차이점을 중심으로 전체 사례를 비교하며 재구성하였다. 이 결과 생애사 연구 방법이 현 사회복지실천에 대한 반성을 이끌어, 중도장애인들의 사고 이후 경험을 이해하고 직접적 서비스를 제공하는 전문적 실천을 위한 사정도구로 사용되기를 바라며, 특히 미래의 사회복지사들에게 사회복지실천현장에서 클라이언트를 총체적(holistic)으로 이해하는 접근방법임을 제언하였다.

• 정보화정책
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• 제21권2호
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• pp.67-88
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• 2014

이 논문의 연구가설은 스마트기기 활용 교육이 장애인들의 교육 및 학습효과로 스마트기기에 대한 사용능력과 활용 정도의 수준을 높여줄 수 있을 것이라는 것이다. 한국정보화진흥원의 '2012년 정보격차 실태조사 원자료' 중 장애인 데이터를 사용하고, 표본선택편의문제 해결을 위해 Heckman의 2단계 추정법을 활용하였다. 실증 분석결과, 스마트기기 활용 교육을 받은 장애인일 경우 종합적인 스마트기기 사용능력과 활용도 수준이 각각 더 높다는 가설이 채택되었다. 스마트기기 사용능력 및 활용도 측면에서는 스마트기기 활용 교육과 높은 학력 가구소득, 전문사무직, 젊은 연령층 등이 긍정적인 유의미한 영향을 미쳤고, 특히 지체장애에 비해서 시각장애일 경우 스마트기기 사용능력 및 활용도 수준이 낮아지는 것으로 나타났다. 이는 시각장애의 경우 특수 보조기기 및 어플리케이션 없이는 생활이 거의 불가능하므로 지체장애의 경우 두 팔 또는 두 손 전체에 이상이 있는 중증장애가 아닌 한 스마트기기 활용 교육을 통해 스마트기기 사용능력 및 활용도 수준이 높아짐을 알 수 있었다. 본 연구결과는 장애인의 스마트기기 활용도를 높이기 위한 공공 정책 또는 민간 협력의 교육프로그램 진행이 그 목적을 달성하면서 교육의 긍정적인 효과를 보여주면서, 한편 장애유형에 따라 보다 정교한 교육내용과 방법이 필요하다는 것을 보여준다.