• Childhood Kidney Diseases
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• v.18 no.1
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• pp.51-55
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• 2014

Primary renal artery aneurysm has been estimated to account for an incidence of 0.015-1% with associated morbidities including renovascular hypertension and rupture. Renovascular hypertension associated renal artery aneurysms in children is not a common disease. In patients with complicated renal vascular disease, renal autotransplantation has been used as an alternative to percutaneous transluminal angioplasty, which may be hazardous in these situations. We report a case of a renal artery aneurysm in a 13-year-old Korean child presenting hypertension detected during school health examination. Preoperative workup demonstrated a $2.8{\times}2.1{\times}1.9$ cm saccular aneurysm in the right renal hilum that was not amendable to endovascular repair. A surgical strategy including extracorporeal renal artery reconstruction with autotransplantation was applied in order to restore renal artery anatomy and to treat renovascular hypertension. Immediately he complained of severe right flank pain and postoperative doppler sonography revealed lack of perfusion. On the 5th day after autotransplantation, the patient underwent a transplant nephrectomy. He was well postoperatively and was found to have a normal kidney function and stable blood pressure control without antihypertensive medication. This is the first pediatric case of renal artery aneurysm in Korea who underwent extracorporeal repair followed by autotransplantation failure. More pediatric cases with renal artery aneurysm should be reported to identify therapeutic outcome and long term prognosis.

• Journal of Hospice and Palliative Care
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• v.20 no.1
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• pp.18-25
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• 2017

Purpose: Adequate control of breakthrough pain is essential for patients with cancer. Managing breakthrough pain mainly depends on understanding the concept of breakthrough pain and the proper usage of rescue medication by physicians. This study aims to assess the attitudes and practice patterns of palliative physicians in managing breakthrough pain for patients in Korea. Methods: This study was based on data from the 2014 breakthrough cancer pain survey conducted by the Korean Society for Hospice and Palliative Care. One hundred physicians participated in the online survey. Among total 33 self-reported questionnaires, twelve items were selected in this analysis. Results: Rapid onset of action is the main influencing factor in selecting rescue opioids. Oral oxycodone (65%) and parenteral morphine (27%) are commonly used. A few physicians (3%) prefer to use transmucosal fentanyl. The percentage of physicians prescribing oral oxycodone due to its rapid onset of action is just 21.5%, whereas the percentage of physicians using parenteral morphine is 81.5%. Two thirds of respondents (66%) answered that breakthrough pain is not well controlled with rescue medications. Conclusion: There is a gap between the needs of physicians in terms of the perceived difficulties of managing breakthrough cancer pain and their practice patterns selecting rescue medications.

• Journal of Biomedical Engineering Research
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• v.25 no.5
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• pp.343-349
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• 2004

Electroglottograph(EGG) is a signal recorded from the vocal cord vibration by measuring electrical impedance across the vocal folds through the neck skin. The purpose of this study was to develop EGG system and to evaluate possibility for the application on speech analysis and laryngeal disease diagnosis. EGG system was composed of two pairs of ring electrodes, tuned amplifier, phase sensitive detector, low pass filter, and auto-gain controller. It was designed to extract electric impedance after detecting by amplitude modulation method with 2.7MHz carrier signal. Extracted signals were transmitted through line-in of PC sound card, sampled and quantized. Closed Quotient(CQ), Speed Quotient(SQ), Speed Index(SI), fundamental frequency of vocal cord vibration(F0), pitch variability of vocal fold vibration (Jitter), and peak-to-peak amplitude variability of vocal fold vibration(Shimmer) were analyzed as EGG parameters. Experimental results were as follows: the faster vocal fold vibration, the higher values in CQ parameter and the lower values in SQ and SI parameters. EGG and speech signals had the same fundamental frequency. CQ, SQ, and SI were significantly different between normal subjects and patients with laryngeal cancer. These results suggest that it is possible to implement portable EGG system to monitor the function of vocal cord and to test functional changes of the glottis.

• The Journal of Korean Academy of Prosthodontics
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• v.37 no.2
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• pp.269-288
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• 1999

현재 골 유착성 임플랜트는 안전하고 유용한 보철 수복 분야의 하나로 자리잡아 가고있다. 과거 완전 무치악 환자에게 있어서 저작 기능의 회복이란 면에 중점을 두었던 경향에서 현재 골유착 임플랜트의 높은 성공률에 의해 부문 무치악, 단일치 수복에 까지 다양하게 사용되고 있다. 특히 심미성과 인접치의 손상을 가하지 않는다는 면에서 단일치 수복에서 골유착 임플랜트 치료에 관심이 모아지고 있다. 단일치 수복에 있어서 심미성이 중요한 문제로 대두되면서 이런 수복에 사용될 수 있는 다양한 계통의 임플랜트들이 개발되어 사용되고 있다. 이중 가장 기본적인 Branemark 계통의 CeraOne 지대주, 최근에 개발된 전부도재 지대주인 CerAdapt 전부주조 지대주인 UCLA 계통등은 높은 성공률을 보이며 많이 사용되고 있다. 임상가들에 의해 나사유지형 보철물이 착탈성이란 관점에서 선호되고 있다. 시멘트유지형 보철물에서는 나사공이 없는 온전한 교합면을 유지한다는 면과 교합력을 받는 면적에 있어서 더 넓은 면을 가진다는 점등 더 많은 장점을 가진다고 주장하는 사람도 있다. 임상가들의 기호에 의해 선택되어지는 나사 유지형과 시멘트 유지형에 있어서 교합력이 야기하는 하중하에서 각각의 응력 분포를 분석할 필요성이 요구되었다. 이 연구는 단일치 수복에 사용되는 CeraOne, CerAdapt UCLA 계통에서 각각의 나사 유지형과 시멘트유지형에서의 응력분포를 삼차원 유한요소법으로 분석하고 상부 구조물에 가해지는 수직하중, 수평 하중, 경사 하중에 의해 야기되는 응력을 비교 분석한 것이다. 본 연구의 연구 결과는 다음과 같다. 1. CeraOne, CerAdapt, UCLA 지대주 모두 시멘트유지형보다 나사유지형에서 응력집중이 컸다. 2. CeraOne 시멘트유지형인 1번 모델에서 응력분산이 유리하였고, UCLA 나사 유지형인 6번 모델에서 가장 불리하였다. 3. 모든 모델에서 고정체 경부에서 가장 큰 응력 집중이 있었고 이것은 UCLA 지대주에서 가장 컸다. 4. 상부 구조물에서 주된 응력의 집중은 교합면에서 일어났다. 5. 골은 상부 피질골, 즉 고정체경부와 만나는 부위에서 가장 큰 응력의 집중이 일어났으며 수평, 경사 하중시 응력집중 양상은 힘을 가한 쪽의 반대쪽 고정체 경부에 응력이 집중되는 양상을 보였다. 6. 전체 모델과 골, 고정체 모두에서 수평 하중과 경사 하중시 보다는 수직 하중시 더 적은 응력값을 보였다.

• Proceedings of the Korean Reliability Society Conference
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• 2006.05a
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• pp.239-246
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• 2006

프레스다이용 코일스프링은 자동차 및 전자제품의 외형생산에 필요한 금형 내에 장착되는 금형용 스프링으로서 녹아웃 및 스트리퍼 등에 사용되고 있다. 프레스다이용 코일스프링이 사용 중 파손 시에는 고가인 금형의 손상 및 생산성에 영향을 미칠 수도 있기 때문에 사용 환경에서의 신뢰성확보가 요구되어지고 있다. 특히 중(重)하중 및 극중(極重)하중용 스프링은 과거 현장에서 파손사례가 자주 발생함으로 인해 외산을 선호하는 경향이 있는 형편이다. 이에 국산 스프링의 신뢰성검증 및 확보를 위해 신뢰성기반구축사업을 통해 신뢰성평가기준(RS D 0014)가 제정되었으며, 이 평가기준에 의거하여 국내 업체의 제품에 대해 신뢰성평가를 실시하였다. 프레스다이용 코일스프링의 파손원인은 주로 반복하중에 의한 피로파손과 일정한 변위의 변형으로 발생하는 코일스프링 자유높이의 축소로 크게 구분되어질 수 있다. 시험결과 주 파손양상은 피로에 의한 균열발생이었으며, 코일 끝단부와 끝단부 직하부의 코일과의 마찰에 의한 균열발생이 주원인이었다. 즉, 코일의 끝단면과 직하면 코일이 연속적으로 부딪침으로써 발생한 변형 및 마모에 의해 표면균열이 발생하고, 표면균열에서 반복적인 부하하중이 가해짐으로써 피로균열 진전을 통해 점차적으로 파손이 진행되어졌음을 알 수 있었다. 본 발표에서는 기준에 의거하여 로하중용 프레스 다이용 코일스프링을 평가한 신뢰성평가시험 결과에 대해 보고하고, 파단면 관찰과 외산제품과의 미세조직 및 조성 등의 비교분석결과 등을 기초로 파손원인을 분석한 결과에 대해 보고하고자 한다.제고할 수 있을 것으로 기대한다.X>$CdCl^+,\;CdSO_4$ 등이 형성되었다. 수은의 경우는 해수 및 증류수를 용출용매로 이용한 모든 경우에서 납, 구리, 카드뮴과는 달리 대부분 침전하였다. 더욱이 해수에 존재하는 고농도 염소($Cl^-$)와의 수착으로 인해 finite solid인 calomel($Hg_2Cl_2$)이 형성되어 대부분 침전(SI=0)되기 때문에 납, 구리, 카드뮴 보다 더 낮은 환경이동성을 갖을 것으로 사료된다. 상기 실험결과 용출용매로 증류수와 해수를 이용했을 때, 제강 슬래그에서 용출되는 납, 구리, 카드뮴, 수은의 용출 경향의 차이를 확인할 수 있었고 이에 따라서, 납, 구리, 카드뮴의 용출 유해성은 낮기 때문에 해양구조물로의 제강슬래그 유효이용은 적합할 것으로 판단되었다.im80%$로 계산되었다. 열형광선량계로 측정된 방사선량은 각각 1.8, 1.2, 0.8, 1.2, 0.8 (70 cm 거리) cGy로 측정되었으며, 환자의 복부 표면에서의 서베이메터를 이용한 측정량은 10.9 mR/h였다. 차폐구조물의 사용 시 전체 치료 동안에 태아선량은 약 1 cGy 정도로 평가되었다. 결론 : AAPM Report No.50의 자료에 따르면, 임산부의 방사선 치료 시 태아의 방사선 피폭선량은 5 cGy 이하일 경우에 방사선 피폭에 따른 태아의 위험이 거의 없는 것으로 제시되고 있다. 본원에서 차폐 구조물을 설치하였을 경우에 측정된 태아선량은 약 1 cGy로 측정되었고, 고안된 차폐구조물

• Journal of the Economic Geographical Society of Korea
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• v.10 no.2
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• pp.153-166
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• 2007

This study attempts to investigate the spatial characteristics of medical hospital distributions in Korea. For the purpose we examine the inter- and intra regional variations in the distributions of clinics by specialty subject. In particular, we analyze the distribution patterns of Location Quotients of clinics for 12 specialty subjects in Seoul. Medical services tend to be concentrated on the large cities, especially in the Metropolitan Seoul Area. In particular, clinics and medical doctors as well as large scale general hospitals have been strongly concentrated on the Metropolitan Seoul area. These circumstace may be related with the fact that medical hospitals are established and operated by private sector in Korea, and thus they attempt to find their location where they can get maximum profit. The distribution patterns of clinics of 12 specialty subjects can be classified to several characteristic patterns. In particular, clinics of plastic surgeon tend to be strongly concentrated on the Gangnam area in Seoul. Finally, clinics of plastic surgeon tend to be located on the areas near the subway stations along the subway Line 2 and Line 3 in the beginning. The existence of plastic surgeons turns out to have significant role on determining the location for the newly opening plastic surgeons in the later. Therefore, their agglomeration has been getting more strongly.

• The Journal of the Convergence on Culture Technology
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• v.5 no.2
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• pp.23-30
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• 2019

The purpose of this study was to examine job stress, job satisfaction, and turnover intention of the nurses who work at the comprehensive nursing service units in two academic medical institutions that provide healthcare service at the tertiary care level in Korea. A descriptive study was conducted with the nurses by using self-reported questionnaires. We used descriptive statistics to summarize the data and Mann-Whitney U test for group comparison. The mean scores of job stress, job satisfaction, and turnover intention were $89.17{\pm}12.56$, $107.25{\pm}6.85$, $37.19{\pm}4.86$, respectively. Nurses with religion showed more job stress than those without. Nurses with their age below 30 years old had significantly less job satisfaction than those older than 30 years old. Monthly income was significantly associated with turnover intention in our data. The top three sub-category of the job stress were conflict with physicians, patients and their caregivers, and conflicts with others; and those of the job satisfaction were pay and promotion and task requirement. Job stress, job satisfaction, and turnover intention were significantly correlated. In order to reduce turnover intention of nursing professionals in the comprehensive nursing service, job stress related to issues on relationships with patients, their family, health care providers need to be taken into consideration. Policy and administrative support are needed to improve their work environment.

• Tuberculosis and Respiratory Diseases
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• v.64 no.2
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• pp.109-124
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• 2008

Background: The incidence of chronic obstructive pulmonary disease (COPD) is increasing and the disease is becoming an important cause of morbidity and mortality worldwide. It is important to implement evidence-based guidelines by primary care physicians (PCPs) to establish qualified management of COPD patients. The aim of this survey is to investigate the pattern of COPD management among PCPs and to apply it to the development of Korean COPD guidelines. Methods: A web-based questionnaire was prepared that consisted of 25 questions on the pattern of COPD management. A total of 217 PCPs participated in the survey from June 2006 to May 2007. Results: Many PCPs (61.8%) possessed a spirometer, but the application rate was relatively low (35.8%) and more than half of the COPD patients (57%) did not receive a diagnosis based on spirometry. Administration of oral medication was preferred than the administration of inhaled medication for both stable COPD and acutely exacerbated COPD. More than 90% of the PCPs endorsed educational measures to quit smoking and vaccinate against influenza. It was noted that 56.7% of the PCPs were aware of the GOLD guidelines, but only 7.3% tended to fully implement the recommendations of the guidelines in daily practice. Conclusion: The results of the survey indicate that despite the high awareness rate of the current COPD guidelines, deficits exist among the PCPs with respect to the diagnosis and treatment of COPD. The results of this survey should be applied for the development of new COPD guidelines in order to decrease the discrepancy between the guidelines and the daily practice of the PCPs.

• Childhood Kidney Diseases
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• v.8 no.2
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• pp.129-137
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• 2004

Purpose : Nocternal enuresis is a common disorder. Tricyclic antidepressant and desmopressin have been accepted pharmacological treatment for this disorder We conducted a cooperative study to investigate the efficacy and adverse reactions of imipramine, desmopressin and combination treatment in children with primary monosymptomatic nocturnal enuresis(PMNE). Methods: Data from a large multicenter study were analysed. In the period of 8 months in 2002, the study comprised of 168 children(78 boys and 90 girls, 5 to 15 years old) with PMNE for imipramine, desmopressin or combination treatment. Before treatment a history, physical examination and laboratory tests were performed and the children were observed for 2 weeks. Response rate, adverse reactions and enuresis episodes after stopping drug administration were evaluated after 12-weeks of imipramine, desmopressin or combination of both. Results: After 4 weeks, the frequency of bed wetting in all treated patients decreased during treatment significantly Even though a 30-50%, reduction in the number of wet nights were 68.6%, 74.4% and 86.1% during 12 weeks treatment by imipramine, desmopressin and both of them respectively, there was no significant difference between them. The most common adverse reaction was decreased appetite from imipramine administration. But no serious drug-related adverse events were reported. Conclusion: Efficacy of the combination therapy of imipramine and desmopressin in PMNE appears not to be better than either drug alone. It is necessary to pay attention on account of adverse reactions during imipramine treatment even though imipramine and desmopressin were generally well tolerated.

• The Korean Journal of Nuclear Medicine
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• v.33 no.3
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• pp.327-336
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• 1999

Purpose: To assess the quantitative accuracy and the clinical utility of 3D volumetric PET imaging with FDG in brain studies, 24 patients with various neurological disorders were studied. Materials and Methods: Each patient was injected with 370 MBq of 2-[$^{18}F$]fluoro-2-deoxy-D-glucose. After a 30 min uptake period, the patients were imaged for 30 min in 2 dimensional acquisition (2D) and subsequently for 10 min in 3 dimensional acquisition imaging (3D) using a GE $Advance^{TM}$ PET system, The scatter corrected 3D (3D SC) and non scatter-corrected 3D images were compared with 2D images by applying ROIs on gray and white matter, lesion and contralateral normal areas. Measured and calculated attenuation correction methods for emission images were compared to get the maximum advantage of high sensitivity of 3D acquisition. Results: When normalized to the contrast of 2D images, the contrasts of gray to white matter were $0.75{\pm}0.13$ (3D) and $0.95{\pm}0.12$ (3D SC). The contrasts of normal area to lesion were $0.83{\pm}0.05$ (3D) and $0.96{\pm}0.05$ (3D SC). Three nuclear medicine physicians judged 3D SC images to be superior to the 2D with regards to resolution and noise. Regional counts of calculated attenuation correction was not significantly different to that of measured attenuation correction. Conclusion: 3D PET images with the scatter correction in FDG brain studies provide quantitatively and qualitatively similar images to 2D and can be utilized in a routine clinical setting to reduce scanning time and patient motion artifacts.