• 고신대학교 의과대학 학술지
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• 제33권3호
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• pp.380-385
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• 2018

Objectives: Aminophylline has been used for prevention or treatment of apnea in preterm infants with idiopathic apnea of prematurity. The aim of this study was to assess the clinical usefulness of prophylactic in comparison with therapeutic aminophylline therapy. Methods: This retrospective observational study included infants born with a birth weight of < 2,500 g or at < 36 weeks of gestation. Infants born between August 2013 and July 2014 who received aminophylline therapy within 24 hr after birth were assigned to the prophylactic group, while infants born between August 2014 and July 2015 who received aminophylline therapy after obvious apnea were assigned to the therapeutic group. We compared clinical characteristics, including days of ventilator and oxygen therapy and bronchopulmonary dysplasia (BPD) between both groups. Results: Sixty-four patients and 25 infants were identified in the prophylactic and therapeutic groups, respectively. The mean gestational age and birth weight were $32.57{\pm}1.96weeks$ and $1765{\pm}205g$, respectively, in the prophylactic group and $32.46{\pm}1.82weeks$ and $1770{\pm}250g$, respectively, in the therapeutic group. No significant differences in clinical characteristics were found between the two groups. Similar clinical outcomes, including days of ventilator and oxygen therapy, intraventricular hemorrhage (IVH), periventricular leukomalacia, and BPD, were observed between the two groups. Conclusions: The present study showed that the prophylactic use of aminophylline does not improve the clinical outcomes, including BPD, IVH, and ventilator dependency as compared with therapeutic use. In other words, routine prophylactic use of aminophylline is unnecessary.

• 고신대학교 의과대학 학술지
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• 제33권3호
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• pp.297-306
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• 2018

Objectives: Identification of axillary metastases in breast cancer is important for staging disease and planning treatment, but current techniques are associated with a number of adverse events. This report evaluates the diagnostic accuracy of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) techniques for identification of axillary metastases in breast cancer patients. Methods: We performed a meta-analysis of previous studies that compared SPIO enhanced MRI with histological diagnosis after surgery or biopsy. We searched PubMed, Ovid, Springer Link, and Cochrane library to identify studies reporting data for SPIO enhanced MRI for detection of axillary lymph node metastases in breast cancer until December 2013. The following keywords were used: "magnetic resonance imaging AND axilla" and "superparamagnetic iron oxide AND axilla". Eligible studies were those that compared SPIO enhanced MRI with histological diagnosis. Sensitivity and specificity were calculated for every study; summary receiver operating characteristic and subgroup analyses were done. Study quality and heterogeneity were also assessed. Results: There were 7 publications that met the criteria for inclusion in our meta-analysis. SROC curve analysis for per patient data showed an overall sensitivity of 0.83 (95% Confidence interval (CI): 0.75-0.89) and overall specificity of 0.97 (95% CI: 0.94-0.98). Overall weighted area under the curve was 0.9563. Conclusions: SPIO enhanced MRI showed a trend toward high diagnostic accuracy in detection of lymph node metastases for breast cancer. So, when the breast cancer patients has axillary metastases histologically, SPIO enhanced MRI may be effective diagnostic imaging modality for axillary metastases.

• 고신대학교 의과대학 학술지
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• 제33권3호
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• pp.307-317
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• 2018

Background: Detection of antibodies to extractable nuclear antigens (ENAs) is needed for the diagnosis in systemic autoimmune diseases. In this study, we compared three reagents using line immunoblot assay (LIA) or multiplex bead immunoassay for detecting the anti-ENAs. Methods: A total of 89 sera were tested by 3 different assays: EUROASSAY Anti-ENA Profile (Euroimmune, Germany), Polycheck Autoimmune Test (Biocheck GmbH, Germany), and $FIDIS^{TM}$ Connective Profile (Biomedical Diagnostics, France). The following individual ENAs were investigated: Sm, SS-A (Ro), SS-B (La), Scl-70, Jo-1 and RNP. We reviewed medical records to investigate the discrepant results among three methods. Results: Overall percent agreements were 96.1% between EUROASSAY Anti-ENA Profile and $FIDIS^{TM}$ Connective profile; 90.4% between EUROASSAY Anti-ENA Profile and Polycheck Autoimmune Test using the manufacturers' cutoff; 96.4% between EUROASSAY Anti-ENA Profile and Polycheck Autoimmune Test using a upward cutoff; 90.4% between $FIDIS^{TM}$ Connective profile and Polycheck Autoimmune Test the manufacturers' cutoff; and 96.4% between $FIDIS^{TM}$ Connective profile and Polycheck Autoimmune Test a upward cutoff. Conclusions: The three assays showed excellent agreement with each other. With appropriate cutoff, the all three assays for six of the anti-ENA tests investigated in this study can be used in clinical laboratories for detecting the anti-ENAs.

• 고신대학교 의과대학 학술지
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• 제33권3호
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• pp.318-327
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• 2018

Objectives: To investigate the effect of absorbable suture on surgically-induced corneal astigmatism in 3.0-mm sclera tunnel cataract surgeries. Methods: Medical records of patients who underwent phacoemulsification cataract surgery using a 3.0-mm sclera tunnel incision made by a single surgeon were reviewed. Uncorrected distant visual acuity, corneal astigmatism and surgically-induced astigmatism were measured in 56 patients' eyes that underwent sclera tunnel cataract surgery with absorbable sutures (sutured group) and in 23 patients' eyes without sutures (unsutured group). Uncorrected visual acuity, intraocular pressure, slit lamp examination, and automated keratometry were evaluated preoperatively and at 3 days, 2 weeks, 4 weeks, and 8 weeks after cataract operation. Results: There were no significant differences in preoperative average uncorrected distant visual acuity of the two groups (sutured group: $0.79{\pm}0.64$, unsutured group: $0.68{\pm}0.72$, P = 0.145). Corneal astigmatism measured using keratometry in the sutured and unsutured group at postoperative day 3 were $2.27{\pm}2.12D$ versus $0.83{\pm}0.55D$ at (P < 0.001), a difference which had disappeared after 4 weeks. Surgically induced astigmatism using the Holladay and Vector methods showed similar outcomes, suggesting that the sutured group exhibited higher astigmatism compared with the unsutured group until 2 weeks post-surgery. Conclusions: TPatients undergoing scleral tunnel cataract surgery with absorbable sutures have greater surgically induced astigmatism, especially in the early postoperative period, compared with those without sutures. However, this surgically induced astigmatism due to absorbable sutures in scleral tunnel cataract surgery is temporary and disappears at 4 weeks post-surgery.

• 고신대학교 의과대학 학술지
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• 제33권3호
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• pp.358-368
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• 2018

Objectives: To identify the relationship between surgical success rate and preoperative nasal mucosal thickness around the lacrimal sac fossa, as measured using computed tomography. Methods: We reviewed 33 eyes from 27 patients who underwent endoscopic dacryocystorhinostomy after diagnosis of primary nasolacrimal duct obstruction and who were followed-up with for at least six months between 2011 and 2014. We measured preoperative nasal mucosal thickness around the bony lacrimal sac fossa using computed tomography and analyzed patient measurements after classifying them into three groups: the successfully operated group, the failed operation group, and the non-operated group. Results: Surgery failed in six of the 33 eyes because of a granuloma at the osteotomy site and synechial formation of the nasal mucosa. The failed-surgery group showed a clinically significantly greater decrease in nasal mucosal thickness at the rearward lacrimal sac fossa compared with the successful-surgery group. However, nasal mucosal thickness of fellow eyes (i.e., non-operated eyes) was not significantly different between the two groups, and the location of the uncinate process did not appear to influence mucosal thickness. In the failed group, posteriorly located mucosal thickness of operated eye fossa was thinner than that of the non-operated eyes, but not significantly so. Conclusions: Our results from this quantitative anatomical study suggest that nasal mucosal thickness is a predictor of endoscopic dacryocystorhinostomy results.

• 디지털융복합연구
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• 제17권10호
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• pp.497-507
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• 2019

본 연구의 목적은 국내에서 ADHD 아동을 대상으로 실시된 음악 중재 프로그램의 효과를 체계적 문헌고찰과 메타분석을 통해 검증하는 것이다. 이를 위해 2000년부터 2019년 6월까지 출판된 논문 1,856편 가운데 선정기준에 부합하고 대조집단이 있는 실험연구 9편을 분석하였다. 일반적 특성, 음악 중재 특성, 연구별 목표 및 평가도구의 네가지 기준으로 체계적 문헌고찰을 실시한 결과, 대부분의 논문이 음악 활동, 목표, 평가도구를 각각 2가지 이상 사용하였으며, 특히 사회성과 주의집중력 향상을 위한 논문의 비중이 높았다. 메타분석 결과, 전체는 중간효과크기로 나타났으며, 주의력결핍과 사회성은 효과크기가 낮은 반면, 문제행동은 중간효과크기로 나타났다. 이는 ADHD 아동을 위한 음악 중재에서 표준화된 평가도구 사용의 중요성을 밝힌 것과, 음악 중재를 개발하는 데에 중요한 기초자료로 활용될 수 있다는 점에서 의의를 갖는다.

• 디지털융복합연구
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• 제18권12호
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• pp.37-46
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• 2020

본 조사연구의 목적은 베이비부머 세대의 음악활용 현황과 목적, 전반적인 요구를 파악하는 것이다. 전국 5개시에 거주하는 57-66세 연구 참여자 87명을 대상으로 온·오프라인 설문조사를 수행하였다. 연구 결과, 첫째, 베이비부머 세대는 휴식을 취할 때 혼자서 휴대폰으로 주로 대중음악을 감상하였으며, 음악활용의 목적은 행복, 취미, 자신감과 성취감 순으로 나타났다. 둘째, 베이비부머 세대는 음악활용 시 동호회의 형태로 노래 부르기 및 가사토의를 희망하는 것으로 조사되었다. 셋째, 성별에 따른 음악활용 목적에서 여성이 남성에 비해 유의하게 높게 봉사활동에 대한 목적을 두는 것으로 확인되었다. 본 연구는 베이비부머 세대의 특성에 적합한 음악프로그램 개발을 위한 기초자료를 제공하는 데에 의의를 갖는다.

• 한국융합학회논문지
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• 제12권2호
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• pp.77-85
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• 2021

본 연구의 목적은 가정방문형 음악치료 서비스에 대한 인식을 융복합적으로 살펴보는 것이다. 이를 위해, 음악치료대학원에 재학 중인 예비치료사와 전문 자격을 소지한 음악치료사 74명을 대상으로 설문조사를 실시하였다. 연구결과 첫째, 가정방문형 음악치료 서비스에 대한 인지도는 기존 가정방문 서비스에 비해 다소 낮았으나, 필요성과 기대효과에서는 유사하게 나타났다. 둘째, 운영방안에서는 국가공공기관이 주체가 되어 주2회 40분씩 진행하는 것의 비중이 높았다. 셋째, 자격증 소지 여부와 가정방문형 음악치료 서비스 세션 제공 경험 유무에 따라 해당 서비스에 대한 현황과 기대효과의 소항목에서 유의한 차이가 나타났다. 이는 가정방문형 치료서비스가 음악치료의 한 분야로 활용되는 데에 기초 자료를 제공하며, 향후 이를 토대로 실질적인 서비스 도입 방안을 마련할 것을 제안한다.

• 고신대학교 의과대학 학술지
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• 제33권2호
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• pp.171-180
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• 2018

Objectives: We investigated whether asthma attacks in asthmatic children were caused by short-term exposure to particulate $matter(PM)_{2.5}$. Methods: Subjects were 411 patients who received inhalation therapy in National Fukuoka Hospital, from March to May 2013. All subjects were outpatients. We surveyed the air quality measurement results in the stations closest to the address of the patients. Data were used from the City of Fukuoka website data on air pollution. We carried out a case-crossover study and compared $PM_{2.5}$ concentration between 7 days after asthma attack occurred and the day asthma attack occurred and 1, 2 and 3 days before asthma attack occurred. Results: Highest hourly concentration of the day (OR 1.013, 95%CI 1.000-1.025) showed a significant association with 1 day before $PM_{2.5}$ concentration statistically. And 0-1 year-old infants were more vulnerable to the highest concentration of 1 day before $PM_{2.5}$ concentration(P < 0.05). Average concentration of $NO_2$ and $O_3$ and asthma attack also showed a significant association. Conclusions: Maximal daily $PM_{2.5}$ concentrations within 24 hours prior to the attack affect asthma exacerbation. 0-1 year-old infants are particularly vulnerable to $PM_{2.5}$ concentration. Asthma exacerbation is aggravated by $NO_2$ and $O_3$ concentration on the day of the asthma attack.

• 고신대학교 의과대학 학술지
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• 제33권2호
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• pp.150-158
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• 2018

Objectives: Although Campylobacter is the main cause for bacterial acute gastroenteritis (AGE), there has been no notable clinical research into it, especially for Korean children. In this study, we share our experience of clinical, laboratory and image findings with Campylobacter AGE. Methods: Between May 2013 and June 2016, children diagnosed as having Campylobacter AGE were retrospectively enrolled in our study. Campylobacter AGE was considered diagnosed when a patient had symptoms of bacterial AGE and a positive Campylobacter result in stool using multiplex PCR. Results: Among 539 patients with suspected bacterial AGE, 31 (5.8%) patients had a positive result for Campylobacter. The average age of the 31 patients was $10.2{\pm}5.0$ years with a range between 1.1 and 16.9 years. Eighteen (58%) of the total patients were hospitalized between June and August. Diarrhea (93.5%), abdominal pain (83%) and fever (83%) were common symptoms. For 20 patients (65%), diarrhea lasted for less than three days, and fever lasted for 2.1 days on average. Among the 20 patients subjected to imaging studies, 12 patients (60%) showed bowel wall thickening on the right side of colon. In blood tests of 30 patients, 22 (73%) and 29 (97%) patients exhibited leukocytosis and elevated C-reactive protein, respectively. During treatment for Campylobacter AGE, prediagnostic empirical antibiotics were used for 6 (19%) patients. All patients recovered without complications. Conclusions: Among the children with suspected bacterial AGE, 5.8% had a positive result on Campylobacter in stool using multiplex PCR. Therefore, we observe that Campylobacter AGE should be considered in school-age children who have diarrhea, fever, and abdominal pain.