• Journal of Genetic Medicine
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• 제15권2호
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• pp.72-78
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• 2018

Purpose: Physicians' attitudes may have a strong influence on women's decision regarding prenatal screening options. The aim of this study is to assess the physicians' attitudes toward prenatal screening for fetal aneuploidy including non-invasive prenatal testing (NIPT) in South Korea. Materials and Methods: Questionnaires were distributed and collected at several obstetrics-gynecological conferences and meetings. The questionnaire included 31 multiple choice and 5 fill-in-the-blank questions. Seven questions requested physicians' demographic information, 17 questions requested information about the NIPT with cell-free fetal DNA, and 12 questions requested information about general prenatal screening practices. Results: Of the 203 obstetricians that completed the survey. In contrast with professional guidelines recommending the universal offering of aneuploidy screening, only 53.7% answered that prenatal aneuploidy testing (screening and/or invasive diagnostic testing) should be offered to all pregnant women. Physicians tended to have positive attitudes toward the clinical application of NIPT as both primary and secondary screening methods for patients at high-risk for fetal trisomy. However, for patients at average-risk for fetal trisomy, physicians tended to have positive attitudes only as a secondary screening method. Physicians with more knowledge about NIPT were found to tend to inform their patients that the detection rate of NIPT is higher. Conclusion: This is the first study to investigate expert opinion on prenatal screening in South Korea. Education of physicians is essential to ensure responsible patient counseling, informed consent, and appropriate management after NIPT.

• 산업융합연구
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• 제21권4호
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• pp.165-170
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• 2023

이동약자가 집에서 밖으로 나오는 순간부터 이동에 대한 어려움을 겪는 경우가 있다. 보호자들 또한 시간적 여유가 없어 사회적 약자인 가족을 보호시설에 위탁하게 되는 경우 피보호자의 위치를 알기 위해서는 보호자가 직접 확인할 수밖에 없다. 이러한 보호자의 불안감과 수고를 덜어주고, 보호시설 관계자와 이용자의 편의성을 제공하기 위해 AI 홈케어 솔루션에 대한 설계를 하게 되었다. 비영리재단, 보호시설에 서비스를 무료로 배포하여 사용하는 시설이 많아진다면 보호자의 걱정이 줄어들고, 시설 이용자들을 관리해야 하는 시설 관계자의 부담도 줄어들게 될 것이다. 본 논문에서는 이동약자를 고려하여 이동과 관련한 모든 데이터인 보호자에게 피보호자의 위치, 상태 알람뿐만 아니라 위급한 일이 발생하면 보호자에게 긴급 알림서비스 기능을 제공한다. 나아가 시설 관계자의 편의와 부담을 덜어주기 위해 내비게이션 기능을 사용하여 최적의 경로를 추천해주는 서비스 기능도 제공할 필요가 있다. 이동약자가 이용하는 셔틀의 위치, 승하차 시간 등 보호자에게 필요한 정보를 제공하여 불안감을 덜어줄 필요가 있다. 또한 서비스를 무료로 제공하면서 시설 관리자는 봉사의 질, 이동약자는 서비스의 질을 높여주는 데 목표가 있다.

• Archives of Plastic Surgery
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• 제34권5호
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• pp.580-586
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• 2007

Purpose: High tension electrical injuries result in major tissue(eg. bones, tendons, vessels and nerves) destruction. Therefore, the management of mutilating wrist caused by electrical injuries still represents a challenge. There are various approaches to this problem including local and regional flaps as well as pedicled distant flaps and microsurgical free tissue transfer. Although it has not gained wide acceptance, because of the technically demanding dissection of the pedicle, posterior interosseous flap is now well accepted for the reconstruction of hand and wrist in hand surgery. The principal advantages of this flap are minimal donor site morbidity, minimal vascular compromise, one stage operation. This flap also offers the advantages of ideal color match and composition. In this report, we describe our experience with the reverse posterior interosseous island flap for reconstruction of mutilating wrist with main vessel injuries. Methods: From October, 2004 to June, 2006, we treated 11 patients with soft tissue defects and main vessel injuries on the wrist that were covered with reverse posterior interosseous island flap. Results: These 11 patients were all male. The ages ranged from 27 to 67 years(mean age 41.75) and the follow-up period varied from 4 to 19 months. Complete healing of the reverse posterior interosseous island flaps were observed in 11 patients(12 flaps). The majority of these flaps showed a certain degree of venous congestion, which in a flap was treated with medical leech. 1 flap has partial necrosis owing to sustained venous congestion, requiring secondary skin graft. flap size varied from $3.5{\times}8cm$ to $10{\times}12cm$(mean size $6.4{\times}8.9m$). The donor site defect was closed directly in 5 flaps, and by skin graft in 7 flaps. Conclusion: We found that the reverse posterior interosseous island flap is reliable and very useful for reconstruction of mutilating wrist and we recommend it as first choice in coverage of soft tissue defects in the wrist with electrical arc injuries.

• 한국포장학회지
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• 제8권2호
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• pp.49-59
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• 2002

플라스틱 포장재의 주요 기능은 식품을 수송, 보관과정에서 안전하게 보존하는 것이다. 식품과 플라스틱 포장재간의 반응은 식품의 품질과 안전성 문제에 있어서 상당한 이슈가 되고 있는데 이는 주로 플라스틱에 남아있는 잔류용제, 단량체, 첨가물 등이 식품으로 전이되는 문제들이다. 플라스틱 포장재에 항산화제를 첨가하는 것은 필름의 열화는 물론 포장된 식품, 특히 유지가 많은 제품의 산화를 막을 수 있다. 현재 BHT와 같은 항산화제를 플라스틱 포장재에 적용하는 것이 상업화되어 제품의 유통기간을 연장시키는 방법으로 사용되고 있다. Alpha tocopherol은 가장 중요한 자유기 제거제의 하나로 생물 시스템에는 잘 알려져 있는데 이것을 포장재에 사용함으로써 생산자와 소비자 모두 매우 긍정적인 반응을 보이고 있다. Alpha tocopherol은 폴리올레핀계 레진에 적용되어 BHT를 대체하고 있다. 이 연구는 포장재와 제품간의 증발-흡착 메카니즘을 이용한 항산화제의 효과와 그 적용, 그리고 이러한 메카니즘을 예측할 수 있는 분석기법을 설명하였다.

• Asian-Australasian Journal of Animal Sciences
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• 제16권10호
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• pp.1443-1450
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• 2003

Crossbred (Bos taurus${\times}$Bos indicus) calves were used from birth till 14 weeks of age to evaluate three sources of protein that differed in ruminal degradability viz. groundnut cake alone (HD) or in combination with cottonseed meal (MD) and meat and bone meal (LD), when fed along with two sources of non-structural carbohydrates viz. raw (R) and thermally processed (P) maize. Twenty four new born calves were arranged in six groups in a $3{\times}2$ factorial design and fed on whole milk up to 56 d of age. All the different calves received calf startes along with green oats (Avena sativa) from 14 d of age onwards free-choice. A metabolism trial of 6d starters duration, conducted after 90 d of experimental feeding, revealed greater (p<0.05) digestibility of DM, OM, total carbohydrates, NDF and ADF in calves fed on the P diets than on the R diets promoting greater (p<0.05) metabolizable energy intake. The digestibility of NDF was higher (p<0.01) on LD diets where as calves on MD diets exhibited significantly lower digestibility of ADF (p<0.01). The retention of nitrogen per unit metabolic body size was significantly (p<0.05) higher on the LD-P diet than on the diet HD-P which, in turn, was higher (p<0.05) than that of HD-R. Nitrogen retention as percentage of intake was significantly greater (p<0.05) on LD-P than on LD-R diets (52.2 vs. 36.4%). Also, P fed calves utilized nitrogen more efficiently than the R fed as shown by retention of significantly greater proportions of intake (47.4 vs. 40.9%) and absorbed (65.8 vs. 59.5%) nitrogen. Calorimetric evaluation of the diets through open-circuit respiration chamber revealed that the dietary treatments had no impact on methane production by calves. The intake of DE and ME was improved (p<0.01) because of maize processing resulting in greater (p<0.01) retention of energy. The protein degradability exerted no influence on the partitioning or retention of energy. A significant interaction between cereal and protein types was evident with respect to retention of both nitrogen (p<0.01) and energy (p<0.05). In conclusion, no discernible trend in the influence of cereal processing was apparent on the dietary protein degradability, but the positive effect of cereal processing on energy retention diminished with the increase in dietary undegradability.

• 한국보육지원학회지
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• 제11권1호
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• pp.305-327
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• 2015

본 연구는 3-5세 누리과정 교사용 지도서 활동에서 창의성 요소가 어떻게 다루어지고 있는지 조사하고자 하였다. 창의성 요소를 포함하고 있는 지도서의 1883개 활동을 대상으로 하여 지도서의 연령, 생활주제, 활동유형, 누리과정의 영역에 따른 창의성 요소의 분포를 분석하였다. 분석한 결과, 첫째, 지도서 활동 중 창의성 관련 활동은 89%이었으며 3세, 4세, 5세 지도서 순으로 창의성 활동 비율이 높았다. 둘째, 지도서 활동은 인지적, 성향적, 동기적 창의성 요소의 순으로 많이 반영하고 있었다. 셋째, 창의성 요소는 생활주제 '생활도구'에서 가장 많이, '세계 여러 나라'에서 가장 적게 포함되었다. 넷째, 창의성 요소는 자유선택활동 보다 대 소집단활동으로 더 많이 다루어지고 있었다. 다섯째, 누리과정 영역 중 자연탐구, 사회관계, 의사소통, 예술경험, 신체운동 건강의 순으로 창의성 요소를 많이 포함하고 있었다. 본 연구결과는 유아교육현장에서 누리과정 교사용 지도서를 활용한 효율적 창의성 교육의 기초자료로서 의미가 있다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권10호
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• pp.4591-4597
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• 2016

Purpose: Decisions as to whether to provide adjuvant treatment in older breast cancer patients remains challenging. Side effects of chemotherapy have to be weighed against life expectancy, comorbidities, functional status, and frailty. To aid decision-making, we retrospectively analyzed 110 women with breast cancer treated with a curative intention from 2006 to 2012. Survival data with clinical and pathological parameters were evaluated to address the role of adjuvant chemotherapy in this study population. Method: A total of 110 elderly (>70 years) patients that received mastectomy at two hospitals in Taiwan were observed retrospectively for a medium of 51 months. After mastectomy, patients received conservative treatment or adjuvant chemotherapy, or hormone therapy following clinical guidelines or physician's preference. Data were collected from the cancer registry system. Results: Median age at diagnosis was 75.7 years. Thirty-five percent of patients received adjuvant chemotherapy, these having a significantly younger age ($mean=74.0{\pm}5.3$ vs $77.5{\pm}5.3$, p<0.001) and higher tumor staging (p=0.003) compared with their non-chemotherapy counterparts.Five-year overall survival was non-significantly higher in patients who received adjuvant chemotherapy (with chemotherapy 64.2% vs without chemotherapy 62.6%, p=0.635), while five-year recurrence free survival was non-significantly lower (with chemotherapy 64.1% vs without chemotherapy 90.5%, p=0.80). Conclusions: In this analysis, adjuvant chemotherapy tended to be given to patients with a younger age and higher tumor staging at our institute. It was not associated with any statistically significant improvement in survival and recurrence rate. Until age specific recommendations are available, physicians must use their clinical judgment and assess the tumor biology with the patient's comorbidities to make the best choice. Clinical trials focusing on this critical issue are warranted.

• 대한두경부종양학회지
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• 제12권1호
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• pp.3-7
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• 1996

Nasopharyngeal carcinoma(NPC) is a disease whose primary initial treatment is radiation. Results of radiation therapy in early stage disease is promising; however, in stage IV disease, the best reported five-year survival is only about 30%. In patients with post-radiation recurrent disease, radiation controls only a small portion of patients, as well as being associated with significant radiation injury. In this paper we discuss the use of salvage treatment modalities for post-radiation recurrence. A retrospective chart review and analysis of salvage treatment results were performed for 39 patients with recurrent post-radiation NPC and positive cervical lymph nodes during the period beginning 1985 until 1995. Mean age of these patients was 52.3$\pm$10.37 years and male: female ratio was 1.8 : 1. Twenty patients were treated with salvage treatment, and ten patients were treated by salvage chemotherapy. A total of nine patients underwent surgical salvage treatment, including neck dissection(6), transnasal laser surgery and booster radiotherapy(2), and primary surgery(1). Salvage treatment were effective in reducing patients' pain in twenty patients (51.3%) and prolonging life in nine patients(23.1%); however, recurrence of disease within six months and/or residual disease by clinical or radiologic exam was noted in all patients receiving salvage radiotherapy, chemotherapy, laser surgery with radiotherapy, and primary site surgery. In the group undergoing salvage neck dissection, three patients(50%) were disease free for at least two years. Of the different modalities, radiotherapy was associated with the best quality of life while catastrophic salvage surgery resulting in insignificant prolongation of life was associated with the poorest quality of life. We conclude that salvage surgery is the optimal choice of treatment for regional recurrence such as nodal failure, however palliative salvage therapy could be preferred in other cases with recurrent post-radiation NPC.

• Archives of Plastic Surgery
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• 제38권6호
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• pp.791-797
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• 2011

Purpose: Angiosarcoma is a rare and aggressive malignant soft tissue tumor. Due to a lack of the established optimal treatment modalities, however, an extensive resection followed by an early detection has been reported to be the best treatment of choice. We analyzed the clinical course of six patients, hence attempted to contribute to making a treatment plan for patients with angiosarcoma. Methods: Six patients who have been surgically treated between 2005 and 2010 are included. Through a retrospective analysis of the medical records, we evaluated the pattern of disease detection, a past history, time span between the detection and the primary surgery, surgical treatment modalities, time span between the primary surgery and the recurrence/metastasis, the sites of metastasis and the secondary treatment modalities. Results: The mean age of patients was 70.5 years; all male; and the sites were the scalp. Four patients underwent the reconstruction using a local flap with a skin graft and two patients using a free flap. The mean period elapsed until the primary operation since the identification was 7.3 months and until a recurrence or a metastasis occurred following the primary operation was 12 months. Four patients had pulmonary metastasis. As a secondary therapy, four patients underwent the radiotherapy and one was treated with the chemotherapy. At the present, five patients died and one undergoes a monitoring of the clinical course. Conclusion: It would be mandatory to shorten the length of hospital stay and to return patients to their daily lives as the earliest as possible using relatively simpler surgical methods, thus attempting to give them opportunity to resume their previous normal life.

• Asian-Australasian Journal of Animal Sciences
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• 제25권2호
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• pp.224-233
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• 2012

The limiting sequence and relative ratio of lysine (Lys), methionine (Met), and threonine (Thr) for calves about 2 mo of age fed milk replacers (MR) containing soy protein are not clearly defined. The objective of the study was to investigate the effect of supplementing MR containing 22% CP, half from soy protein concentrate (SPC, 40.56% CP, flour) and half from whey proteins, with Lys, Met, and Thr to estimate amino acid (AA) sequence and their relative ratio for calves about 2 mo of age. A method of partial deduction of AA was adopted. Twenty-four newborn calves (half males and half females, $40.7{\pm}0.9$ kg of BW) were fed 1 of 4 MR diets for 56 d (n = 6/diet). The diets were supplemented with all (positive control) or with 2 of the 3 AAs: Lys, Met and Thr, (i.e., PC (22% CP, 2.34% Lys, 0.72% Met and 1.80% Thr), PC-Lys (22% CP, 1.64% Lys, 0.72% Met and 1.80% Thr), PC-Met (22% CP, 2.34% Lys, 0.50% Met and 1.80% Thr), and PC-Thr (22% CP, 2.34% Lys, 0.72% Met and 1.26% Thr)). Calves were fed thrice daily; starter (20% CP, 1.03% Lys, 0.30% Met and 0.69% Thr), hay (3.23% CP, 0.29% Lys, 0.12% Met and 0.23% Thr) and water were offered free choice. Starter and hay were only offered beginning on d 36 (after 5 wk) and d 43 (after 6 wk), respectively. BW, body size and blood samples measures were taken every two weeks. Three-day total collection of feed refusals, feces, and urine were recorded starting at d 33 and d 54 of age, respectively. From the results, the limiting sequence and relative ratio between the 3 AAs in calves with different diet structures were calculated. The limiting sequence of the 3 AAs were ranked as Lys, Met and Thr; the proper ratio was 100:29:70 for MR-only diet and 100:30:60 for diets consisted of MR, starter and hay. Nitrogen digestion and utilization and nutrient digestibility were negatively affected by AA deletion treatments. From the evidence of this experiment, it did not appear that the AA limiting sequence was selectively altered by differences in diet structures such as would be encountered in practice. The relative ratio between the 3 AAs varied with the offer of starter and hay to calves, and the average ratio was 100:29.5:65 for calves during 2 to 10 wk of age.