• 융합정보논문지
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• 제11권1호
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• pp.62-70
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• 2021

본 연구의 목적은 노인의 건강문해력 정도를 파악하고 건강문해력과 건강상태 간의 관계를 규명하기 위함이다. 본 연구는 횡단적 서술적 조사 연구방법으로, 2019년 7월부터 12월까지 158명의 참여자를 대상으로 수행되었다. 언어적 건강문해력과 기능적 건강문해력은 각각 한국형 의료정보이해능력측정도구와 Newest Vital Sign을 이용하였고, 주관적 신체적, 정신적 건강상태의 자료를 수집하였다. 노인 대상자의 1/3 이상이 언어적, 기능적 건강문해력이 낮은 것으로 나타났고, 거주지, 배우자 유무, 동거가족 유무, 교육수준, 직업 유무, 월평균 가족 소득수준, 보유질환 개수에 따라 건강문해력에 차이를 보였다. 언어적, 기능적 건강문해력 수준에 따라 주관적 신체적, 정신적 건강상태에 차이가 있는 것으로 나타났다. 건강문해력을 향상시키기 위한 교육 프로그램 개발 시 거주지, 교육수준, 월평균 가족소득, 보유질환 개수와 같은 사회인구학적 요인과 질병관련 요인을 고려할 필요가 있으며, 맞춤형 융합적 교육 프로그램으로 건강문해력 수준을 향상시킴으로써 건강상태 증진을 도모할 수 있겠다.

• Journal of Korean Neurosurgical Society
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• 제64권5호
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• pp.818-826
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• 2021

Objective : The widely accepted treatment option of a traumatic carotid cavernous fistula (TCCF) has been detachable balloon or coils based fistula occlusion. Recently, covered stent implantation has been proving an excellent results. The purpose of this study is to investigate our experiences with first line choice of covered stent implantation for TCCF at level 1 regional trauma center. Methods : From November 2004 to February 2020, 19 covered stents were used for treatment of 19 TCCF patients. Among them, 15 cases were first line treatment using covered stents. Clinical and angiographic data were retrospectively reviewed. Results : Procedures were technically successful in all 15 cases (100%). Immediate angiographic results after procedure were total occlusion in 12 patients (80%). All patients except two expired patients had image follow-up (mean 15 months). Recurred symptomatic three patients underwent additional treatments and achieved complete occlusion. Mean clinical follow-up duration was 32 months and results were modified Rankin Scale 1-2 in five, 3-4 in five, and 5 in three patients. Conclusion : The covered stent could be considered as fist line treatment option for treating TCCF patients especially in unstable vital sign. Larger samples and expanded follow-up are required to further develop their specifications and indications.

• Animal Bioscience
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• 제35권7호
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• pp.955-963
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• 2022

Objective: The aim of this study was to estimate genetic parameters for 305-day cumulative milk yield and components, growth, and reproductive traits in Guzerá cattle. Methods: The evaluated traits were 305-day first-lactation cumulative yields (kg) of milk (MY305), fat (FY305), protein (PY305), lactose (LY305), and total solids (SY305); age at first calving (AFC) in days; adjusted scrotal perimeter (cm) at the ages of 365 (SP365) and 450 (SP450) days; and adjusted body weight (kg) at the ages of 210 (W210), 365 (W365), and 450 (W450) days. The (co)variance components were estimated using the restricted maximum likelihood method for single-trait, bi-trait and tri-trait analyses. Contemporary groups and additive genetic effects were included in the general mixed model. Maternal genetic and permanent environmental effects were also included for W210. Results: The direct heritability estimates ranged from 0.16 (W210) to 0.32 (MY305). The maternal heritability estimate for W210 was 0.03. Genetic correlation estimates among milk production traits and growth traits ranged from 0.92 to 0.99 and from 0.92 to 0.99, respectively. For milk production and growth traits, the genetic correlations ranged from 0.33 to 0.56. The genetic correlations among AFC and all other traits were negative (-0.43 to -0.27). Scrotal perimeter traits and body weights showed genetic correlations ranging from 0.41 to 0.46, and scrotal perimeter and milk production traits showed genetic correlations ranging from 0.11 to 0.30. The phenotypic correlations were similar in direction (same sign) and lower than the corresponding genetic correlations. Conclusion: These results suggest the viability and potential of joint selection for dairy and beef traits in Guzerá cattle, taking into account reproductive traits.

• 임상간호연구
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• 제15권1호
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• pp.5-17
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• 2009

Purpose: This study was to develop a factor-type patient classification system for general nursing unit based on nursing needs (KPCS; Korean patient classification system for nurses). Method: We reviewed workload management system for nurses(WMSN) of Walter Reed Medical Center, Korean patient classification system for ICU, and nursing activities in nursing records and developed the first version of KPCS. The final version KPCS was evaluated via validity and reliability verifications based on panel discussions and data from 800 patient classifications. Content validity was performed by Delphi method and concurrent validity was verified by the correlation of two tools (r=.71). Construct validity was also tested by medical department (p<.001), patient type (p<.001), and nurse intuition (p<.001). These verifications were performed from April to October, 2008. Results: The KPCS has 75 items in classifying 50 nursing activities, and categorized into 12 different nursing area (measuring vital sign, monitoring, respiratory treatment, hygiene, diet, excretion, movement, examination, medication, treatment, special treatment, and education/emotional support). Conclusion: The findings of the study showed sound reliability and validity of KPCS based on nursing needs. Further study is mandated to refine the system and to develop index score to estimate the necessary number of nurses for adequate care.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제18권2호
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• pp.456-477
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• 2024

With information technology's rapid development, the Internet faces serious security problems. Studies have shown that malware has become a primary means of attacking the Internet. Therefore, adversarial samples have become a vital breakthrough point for studying malware. By studying adversarial samples, we can gain insights into the behavior and characteristics of malware, evaluate the performance of existing detectors in the face of deceptive samples, and help to discover vulnerabilities and improve detection methods for better performance. However, existing adversarial sample generation methods still need help regarding escape effectiveness and mobility. For instance, researchers have attempted to incorporate perturbation methods like Fast Gradient Sign Method (FGSM), Projected Gradient Descent (PGD), and others into adversarial samples to obfuscate detectors. However, these methods are only effective in specific environments and yield limited evasion effectiveness. To solve the above problems, this paper proposes a malware adversarial sample generation method (PixGAN) based on the pixel attention mechanism, which aims to improve adversarial samples' escape effect and mobility. The method transforms malware into grey-scale images and introduces the pixel attention mechanism in the Deep Convolution Generative Adversarial Networks (DCGAN) model to weigh the critical pixels in the grey-scale map, which improves the modeling ability of the generator and discriminator, thus enhancing the escape effect and mobility of the adversarial samples. The escape rate (ASR) is used as an evaluation index of the quality of the adversarial samples. The experimental results show that the adversarial samples generated by PixGAN achieve escape rates of 97%, 94%, 35%, 39%, and 43% on the Random Forest (RF), Support Vector Machine (SVM), Convolutional Neural Network (CNN), Convolutional Neural Network and Recurrent Neural Network (CNN_RNN), and Convolutional Neural Network and Long Short Term Memory (CNN_LSTM) algorithmic detectors, respectively.

• 생물정신의학
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• 제4권2호
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• pp.265-271
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• 1997

2,3-benzodiazepine계 항불안제인 tofisopam의 항불안 효과 및 안전성을 조사하기 위해 단일맹검 비교연구를 시행하였다. 외래로 내원한 불안 장애 환자 40명을 대상으로 무작위로 tofisopam군과 lorazepam군으로 할당하였으며, 최종 연구를 완결한 환자는 tofisopam군 17명(남자 7명, 여자 10명), lorazepam군은 15명(남자 6명, 여자 9명)이었다. 초기용량으로 tofisopam군은 50mg을 하루 3회 복용하고, lorazepam군은 0.75mg을 하루 2회 복용하도록 하였으며, 임상상태와 부작용에 따라 용량을 임의로 증감하도록 하였고, 일일 최대 용량은 tofisopam군 300mg, lorazepam군 3mg으로 하였다. 임상상태에 대한 평가는 Hamilton rating scale for anxiety(HAM-A)와 Clinical global impression(CGI)으로 하였으며, 약물 투여전과 투여 1주후, 2주후, 4주후에 측정되었다. 결과는 다음과 같다. 1) HAM-A 총점수의 경우, 약물 치료군과 시점을 변인으로 한 two-way repeated-measure ANOVA에서 양군간에 시점에 따른 유의한 차이는 없었다. HAM-A 심리적 불안과 신체적 불안아척도 점수에서 양군간 시점에 따른 유의한 차이는 없었다. 각 군에서 HAM-A 총점수의 시점에 따른 유의한 변화를 나타내었으며, 양군 모두 1주후부터 유의한 감소를 나타내었다. 2) CGI의 질병의 전반적인 심각도에서 약물 치료군과 시점을 변인으로 한 two-way repeated-measure ANOVA에서 양군간에 시점에 따른 유의한 차이는 없었다. 각 군에서 CGI 심각도의 시점에 따른 유의한 변화를 나타내었으며, tofisopam군은 1주후부터 lorazepam군은 4주후부터 유의한 감소를 나타내었다. CGI 호전도에선 각 시점에서"minimally improved"이상을 보인 환자군이 tofisopam군이 94.1%로서 lorazepam군 66.7% 보다 높았다. 3) 안전성 분석에서 각 군에서 생명징후, 혈액학, 생화학, 심전도, 체중에서 유의한 변화를 보이지 않았다. 4) 부작용 면에서 tofisopam군이 lorazepam군보다 각 시점에서 부작용을 호소한 환자수가 적었다. 이상에서 tofisopam은 lorazepam과 유사한 항불안효과를 보였으며, 내약성은 lorazepam에 비해 우수하였다.

• 가정간호학회지
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• 제14권2호
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• pp.91-97
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• 2007

Purpose: This thesis focuses on researching the burden of the Home Health Care that the Family Care-givers have. Method: This study had been conducted for the duration of 3 consecutive months from January 2006 to March 2006 and had investigated 120 person registered as the Home Health Care Clients to a University Hospital located in Incheon City. The thesis adopted the 'feeling of burden' measuring method jointly developed by Seo, Mi-Hye and Oh, Ga-Sil(1993), and FACES-III(Family Adaptability Cohesion Evaluation) developed by Olson(1985) etc. translated by Kim, Yun-Hee(1989) as the measuring method for Family Function. Result: The overall Health Status of the Home Health Care Clients was 2.18 point of average out of 3 point, where as 1.83 for Activities of Daily living and 1.98 for Vital sign, which are below the average. In the mean time, the Competence for Modified Barthel Index marked 30.88 point out of the full mark. The analyzed result of the burden that the family members have was 3.43 point of average out of 5 point which shows that the interviewee feel that they are considerable burden to their families. When it comes to 'the Burden to the family members' and 'the Function of the family' according to the characteristics of the patient, the result shows statistically significant differences, which are varied according to gender, the relationship between the care-givers and the patients. When it comes to the Family Cohesion, the difference was examined as 'statistically significant' according to the Academic background of the patients and the relationship between the patients and the interviewee.(p<0.05). The result also suggests that there exists 'Negative correlation' among the level of patients' health status, the Family Cohesion and the Family Burden. Conclusion: From the result of this study stated above, this thesis is strongly insisting that there is an urgent need for us to develop a health care mediation program, which could eventually reduce the burden of home health care that the patients' family have. At the same time, a follow-up research to prove the effect of the program is imminent.

• 한국산학기술학회논문지
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• 제13권11호
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• pp.5238-5246
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• 2012

본 연구는 신경계 중환자에 적용한 간호행위에 따른 중환자 중증도 분류도구를 신경계 중환자에게 적용하여 그 결과를 분석하고 그에 따른 중환자 중중도 분류도구에 미치는 영향을 규명하여 신경계 중환자의 간호중재를 위한 기초자료를 파악하고자 시도되었으며 2008년 1월부터 2009년 5월, 2011년 10월부터 2011년 12월까지 서울시 소재 C 대학 병원 중환자실에 입원한 만 18세 이상의 신경계환자 203명의 의무기록지를 분석하였다. 신경계 중환자의 일반적 특성 및 임상관련 특성에 따른 중환자 중증도 분류도구 차이는 사망, 생존(p=<.001), 혈색소(p=<.001), 중탄산(p=<.001), 백혈구(p=<.001), 기관 내 삽관 유무(p=<.001), 중심 정맥관 삽입 유무(p=<.001), 중증도(p=<.001)가 통계적으로 유의한 차이를 보였다. 본 연구의 대상자 203명 중 64명이 사망하여 사망률은 31.5%였다. 중환자 중중도 분류도구로 측정된 신경계 중환자의 평균 점수는 $112.09{\pm}18.91$로 나타났고 중중도가 높아질수록 중환자 중중도 분류도구 점수도 유의하게 높아지는 경향을 보였다. 각 영역별로는 활력징후 측정 $3.74{\pm}2.15$, 감시 측정 $28.97{\pm}4.31$, 일상 활동 $34.99{\pm}3.66$, 영양 $.19{\pm}.98$, 정맥 주입 및 약물요법 $18.20{\pm}8.27$, 치료 및 시술 $16.93{\pm}4.90$, 호흡치료 $8.61{\pm}7.07$로 확인되었다. 감시 측정, 일상 활동, 정맥 주입 및 약물요법, 치료 및 시술, 호흡치료영역이 포함된 모형은 유의한 것으로 나타났으며(F=678.789, p<.001) 이들이 중환자 중증도 분류도구를 설명하는 설명력은 98.1%를 나타내어 신경계 중환자의 중중도를 예측하는데 유용한 영역이라 사료된다.

• Journal of Trauma and Injury
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• 제29권4호
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• pp.139-145
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• 2016

Purpose: The major pelvic trauma results in high mortality with associated fatal other injuries. During early stage of resuscitation, multidisciplinary approach is essential to improve the survival and outcomes. This study aims to report the effect and positive outcome of the trauma team approach on the management of hemodynamically unstable pelvic bone fracture. Methods: This retrospective review included all patients with hemodynamically unstable pelvic bone fracture admitted between March 2007 and December 2015. Patients were divided into group A, which comprised those admitted before the trauma team approach was started, and group B, which comprised those admitted after the approach was started. The advanced trauma life support protocol was followed for all patient. The comparisons between the two groups were based on medical records. Study variables included demographics, initial vital sign, injury severity score, fracture type, and injury mechanism. We analyzed the outcomes in each group with respect to the time interval for doctors' arrival, total length of stay in the emergency department (ED), time interval for computed tomography evaluation, 24-hour mortality, time interval for definitive fixation, and definitive fixation in the time-window of opportunity. Results: Fifty-three patients met the inclusion criteria. No statistically significant differences in demographic data existed between the two groups. The time interval for doctors' arrival (min, $63.09{\pm}50.48$ vs $21.48{\pm}17.75$; p=0.038) and total length of stay in the ED (min, $269.33{\pm}105.96$ vs $115.49{\pm}56.24$; p=0.023) were significantly improved. The 24-hour mortality was not significantly different between the two groups.(%, 14.3 vs 12.0; p=1.000) However, the time interval for definitive fixation and definitive fixation in the time-window of opportunity showed better results. Conclusion: The trauma team approach has positive effects, which include initial resuscitation through multidisciplinary approach and shortening the time interval to definitive fixation, on the management of hemodynamically unstable pelvic bone fracture.

• Journal of Trauma and Injury
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• 제29권4호
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• pp.204-208
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• 2016

For an orthopaedic surgeon, the critical decisions to either amputate or salvage a limb with severe crushing injury with progressive ischemic change due to arterial rupture or occlusion can become a clinical dilemma at the Emergency Department (ED). And reperfusion injury is one of the fetal complications after vascular reconstruction. The authors present a case which was able to save patient's life by rapid vessel ligation at bedside to prevent severe reperfusion injury. A 43-year-old male patient with no pre-existing medical conditions was transported by helicopter to Level I trauma center from incident scene. Initial result of extended focused assessment with sonography for trauma (eFAST) was negative. The trauma series X-rays at the trauma bay of ED showed a multiple contiguous rib fractures with hemothorax and his pelvic radiograph revealed a complex pelvic trauma of an Anterior Posterior Compression (APC) Type II. Lower extremity computed tomography showed a discontinuity in common femoral artery at the fracture site and no distal run off. Surgical finding revealed a complete rupture of common femoral artery and vein around the fracture site. But due to the age aspect of the patient, the operating team decided a vascular repair rather than amputation even if the anticipated reperfusion time was 7 hours from the onset of trauma. Only two hours after the reperfusion, the patient was in a state of shock when his arterial blood gas analysis (ABGA) showed a drop of pH from 7.32 to 7.18. An imminent bedside procedure of aseptic opening the surgical site and clamping the anastomosis site was taken place rather than undergoing a surgery of amputation because of ultimately unstable vital sign. The authors would like to emphasize the importance of rapid decision making and prompt vessel ligation which supply blood flow to the ischemic limb to increase the survival rate in case of profound reperfusion injury.