Purpose : Infants and children with cardiovascular diseases often present with respiratory symptoms. However, missed or delayed evaluation for potential airway problem may complicate overall prognosis. The aim of this study is to determine the clinical characteristics of these patients and explore the cause of airway problem. Methods : We reviewed the medical records of 64 patients(M : F=33:31, mean age : $6.3{\pm}7.5$ months) whose airway problems were proven by computed tomography or bronchoscopy in perioperative periods at the Asan Medical Center from January 1997 to June 2004. Patients were divided into two groups based on the duration of ventilator care : ${\leq}7$ days(group 1 : 23 cases, M : F=10 : 13) and >7 days(group 2 : 41 cases, M : F=23 : 18). Results : The patients in group 2 significantly developed more post-operative respiratory symptoms than group 1(P<0.001) and had more airway problems including extrinsic obstruction, intrinsic anomaly, and combined problem than group 1 although not significantly different(P=0.082). Among underlying diseases, the most common diseases were vascular anomaly(26.2 percent) and aortic arch anomaly(26.2 percent) in group 1 and pulmonary atresia with ventricular septal defect(22.4 percent) in group 2. The most frequent respiratory symptoms were recurrent wheezing pre-operatively and failure of ventilator weaning post-operatively. The major types of airway anomaly were tracheomalacia and tracheal stenosis(in each case 18.2 percent). Nineteen patients with persistent airway problems underwent aortopexy or other vascular correction. Of the 19 patients, 13(68.4 percent) were improved, but 2 failed in weaning ventilator and 4 died of non-airway problems. Conclusion : Early evaluation and treatment for potential airway problems may affect natural or surgical prognosis in patients with cardiovascular diseases presenting with respiratory symptoms.
Purpose : The purpose of this study is to evaluate the clinical results after arthroscopic PCL reconstruction and to compare the clinical results after arthroscopic PCL reconstruction using BPTB(bone patellar tendon bone) autograft(Group I : 11 cases), Achilles tendon allograft(Group II : 7 cases) and BPTB allograft(Group 111.6 cases). Materials and Methods : We reviewed the result of 24 patients who had been managed with arthroscopic reconstruction using different graft materials such as BPTB autograft, Achilles tendon allograft and BPTB allograft. Twenty-four patients(average age, 37 years) with PCL rupture were retrospectively evaluated more than one year(average, 31 months) after having arthroscopic posterior cruciate ligament reconstruction. The clinical results were evaluated by IKDC ligament standard evaluation form, using $KT-2000^{TM}$ knee ligament arthrometer and also evaluated Lysholm knee scoring scale. Results : The final evaluation was nearly normal in 11 patients($45\%$ in Group I, $43\%$ in Group II, $50\%$ in Group III). The corrected posterior sagging was abnormal(side to side difference more than 6mm) in 8 patients($36\%$ in Group I, $29\%$ in Group II, $33\%$ in Group III). We could not find significant difference among three groups by IKDC scale. Conclusion : Comparing with other reports, our overall results were not satisfactory. And also, we could not find any remarkable difference among the three groups. Further research is necessary to evaluate new surgical approaches as well as improved techniques for capsular and collateral ligament injuries.
Han Youngyih;Chu Sung Sil;Huh Seung Jae;Suh Chang-Ok
Radiation Oncology Journal
/
v.21
no.3
/
pp.238-244
/
2003
Purpose: The Planning of High-Dose-Rate (HDR) brachytherapy treatments are becoming individualized and more dependent on the treatment planning system. Therefore, computer software has been developed to perform independent point dose calculations with the integration of an isodose distribution curve display into the patient anatomy images. Meterials and Methods: As primary input data, the program takes patients'planning data including the source dwell positions, dwell times and the doses at reference points, computed by an HDR treatment planning system (TPS). Dosimetric calculations were peformed in a $10\times12\times10\;Cm^3$ grid space using the Interstitial Collaborative Working Group (ICWG) formalism and an anisotropy table for the HDR Iridium-192 source. The computed doses at the reference points were automatically compared with the relevant results of the TPS. The MR and simulation film images were then imported and the isodose distributions on the axial, sagittal and coronal planes intersecting the point selected by a user were superimposed on the imported images and then displayed. The accuracy of the software was tested in three benchmark plans peformed by Gamma-Med 12i TPS (MDS Nordion, Germany). Nine patients'plans generated by Plato (Nucletron Corporation, The Netherlands) were verified by the developed software. Results: The absolute doses computed by the developed software agreed with the commercial TPS results within an accuracy of $2.8\%$ in the benchmark plans. The isodose distribution plots showed excellent agreements with the exception of the tip legion of the source's longitudinal axis where a slight deviation was observed. In clinical plans, the secondary dose calculations had, on average, about a $3.4\%$ deviation from the TPS plans. Conclusion: The accurate validation of complicate treatment plans is possible with the developed software and the qualify of the HDR treatment plan can be improved with the isodose display integrated into the patient anatomy information.
Radiation treatment techniques using photon beam such as three-dimensional conformal radiation therapy (3D-CRT) as well as intensity modulated radiotherapy treatment (IMRT) demand accurate dose calculation in order to increase target coverage and spare healthy tissue. Both jaw collimator and multi-leaf collimators (MLCs) for photon beams have been used to achieve such goals. In the Pinnacle3 treatment planning system (TPS), which we are using in our clinics, a set of model parameters like jaw collimator transmission factor (JTF) and MLC transmission factor (MLCTF) are determined from the measured data because it is using a model-based photon dose algorithm. However, model parameters obtained by this auto-modeling process can be different from those by direct measurement, which can have a dosimetric effect on the dose distribution. In this paper we estimated JTF and MLCTF obtained by the auto-modeling process in the Pinnacle3 TPS. At first, we obtained JTF and MLCTF by direct measurement, which were the ratio of the output at the reference depth under the closed jaw collimator (MLCs for MLCTF) to that at the same depth with the field size $10{\times}10\;cm^2$ in the water phantom. And then JTF and MLCTF were also obtained by auto-modeling process. And we evaluated the dose difference through phantom and patient study in the 3D-CRT plan. For direct measurement, JTF was 0.001966 for 6 MV and 0.002971 for 10 MV, and MLCTF was 0.01657 for 6 MV and 0.01925 for 10 MV. On the other hand, for auto-modeling process, JTF was 0.001983 for 6 MV and 0.010431 for 10 MV, and MLCTF was 0.00188 for 6 MV and 0.00453 for 10 MV. JTF and MLCTF by direct measurement were very different from those by auto-modeling process and even more reasonable considering each beam quality of 6 MV and 10 MV. These different parameters affect the dose in the low-dose region. Since the wrong estimation of JTF and MLCTF can lead some dosimetric error, comparison of direct measurement and auto-modeling of JTF and MLCTF would be helpful during the beam commissioning.
Background: Paravalvular leakage or false aneurysm developed after isolated aortic valve replacement(AVR) for aortic regurgitation(AR) associated with Behcet's disease is one of the most serious complications, and requires subsequent reoperations. We describe the surgical result of homograft aortic root replacement(ARR) for AR associated with Behcet's disease. Material and Method: From January 1992 to December 2001, 6 patients with AR associated with Behcet's disease underwent 7 ARR with homograft and 1 Ross operation. Five patients were male and one was female. The grafts used for ARR were 5 aortic and 2 pulmonic homografts. Ages at operation ranged from 27 to 51 years(mean, 37$\pm$9 years). Two patients underwent ARR with aortic homograft at the first operation. In the remaining 4 patients, ARR using a homograft was performed for paravalvular leakage that developed after AVR, and the mean interval from AVR to ARR was 21 $\pm$29 months(range, 5 to 73.3 moths, median, 7.6 months). Result: There was no early death. All patients were followed up for an average of 18.9$\pm$24.0 months(range, 1.9 to 68.9 months, median, 8.4 months). Two of 4patients who had undergone ARR after AVR required subsequent reoperations for false aneurysm of the ascending aorta and failure of pulmonary homograft. One patient underwent re-replacement of the aortic root, ascending aorta and partial aortic arch with an aortic homograft, the other underwent Ross operation. Conclusion: This study suggests that aortic root replacement using a homograft in aortic regurgitation with Behcet's disease may provide good clinical results and decrease the incidence of paravalvular leakage or false aneurysm after aortic valve replacement. However, the adequate perioperative management and complete removal of the inflarrunatory tissue at operation were also important for the good long-term results.
The cache size tends to grow in the embedded processor as technology scales to smaller transistors and lower supply voltages. However, larger cache size demands more energy. Accordingly, the ratio of the cache energy consumption to the total processor energy is growing. Many cache energy schemes have been proposed for reducing the cache energy consumption. However, these previous schemes are concerned with one side for reducing the cache energy consumption, dynamic cache energy only, or static cache energy only. In this paper, we propose a hybrid scheme for reducing dynamic and static cache energy, simultaneously. for this hybrid scheme, we adopt two existing techniques to reduce static cache energy consumption, drowsy cache technique, and to reduce dynamic cache energy consumption, way-prediction technique. Additionally, we propose a early wake-up technique based on program counter to reduce penalty caused by applying drowsy cache technique. We focus on level 1 data cache. The hybrid scheme can reduce static and dynamic cache energy consumption simultaneously, furthermore our early wake-up scheme can reduce extra program execution cycles caused by applying the hybrid scheme.
Discontinuities such as faults, fractures and joints in rock mass play the dominant role in the mechanical and hydraulic properties of the rock mass. The key factors that influence on the flow of groundwater are hydraulic and geometric characteristics of discontinuities and their connectivity. In this study, a program that analyzes groundwater flow in the 3D discontinuity network was developed on the assumption that the discontinuity characteristics such as density, trace length, orientation and aperture have particular distribution functions. This program generates discontinuities in a three-dimensional space and analyzes their connectivity and groundwater flow. Due to the limited computing capacity In this study, REV was not exactly determined, but it was inferred to be greater than 25$\times$25$\times$25 ㎥. By calculating the extent of aperture that influences on the groundwater flow, it was found that the discontinuities with the aperture smaller than 30% of the mean aperture had little influence on the groundwater flow. In addition, there was little difference in the equivalent hydraulic conductivity for the the two cases when considering and not considering the boundary effect. It was because the groundwater flow was mostly influenced by the discontinuities with large aperture. Among the parameters considered in this study, the length, aperture, and orientation of discontinuities had the greatest influence on the equivalent hydraulic conductivity of rock mass in their order. In case of existence of a fault in rock mass, elements of the equivalent hydraulic conductivity tensor parallel to the fault fairly increased in their magnitude but those perpendicular to the fault were increased in a very small amount at the first stage and then converged.
The purpose of this study is to quantitate regional neurochemical profile of regional normal adult mice brain and assess regional metabolic differences by using ex vivo $^1H$ high-resolution magic angle spinning nuclear magnetic resonance spectroscopy ($^1H$ HR-MAS NMRS). The animals were matched in sex and age. The collected brain tissue included frontal cortex, temporal cortex, thalamus, and hippocampus. Quantitative 1D spectra were acquired on 40 samples with the CPMG pulse sequence (8 kHz spectral window, TR/TE = 5500/2.2 ms, NEX = 128, scan time: 17 min 20 sec). The mass of brain tissue and $D_2O$+TSP solvent were 8~14 mg and 7~13 mg. A total of 16 metabolites were quantified as follow: Acet, NAA, NAAG, tCr, Cr, tCho, Cho, GPC + PC, mIns, Lac, GABA, Glu, Gln, Tau and Ala. As a results, Acet, Cho, NAA, NAAG and mIns were showed significantly different aspects on frontal cortex, hippocampus, temporal cortex and thalamus respectively. The present study demonstrated that absolute metabolite concentrations were significantly different among four brain regions of adult mice. Our finding might be helpful to investigate brain metabolism of neuro-disease in animal model.
The differentiation between malignancy-related ascites(MRA) and non-malignant ascites (NMA) is important for further diagnostic and therapeutic purposes. Although many parameters were investigated, none has provided a complete distinction between MRA and NMA. We investigated several ascitic fluid parameters to determine the differential power, and to differentiate malignant-related from nonmalignant-related ascites with a sequence of sensitive parameters followed by specific parameters. For the present study, 80 patients with ascites were divided into two groups: MRA and NMA, The MRA group was consisted of 27 patients with proven malignancy by image study, biopsy, and follow up: 21 of these patients had peritoneal carcinomatosis, but the remaining 6 showed no evidence of peritoneal carcinomatosis. The NMA group was consisted of 53 patients with no evidence of malignancy: among these patients, one had SLE, and others had liver cirrhosis, The samples of blood and ascites were obtained simultaneously, and then the levels of ascites cholesterol, CEA. protein and LDH, cytology, albumin gradient, ascites/serum concen-tration ratios of LDH(LDH A/S), and ascites/serum concentration ratios of protein(protein A/S) were measured. Applying cut-off limits for determined parameters, we estimated the diagnostic efficacy of each parameter, Among the eight parameters investigated, ascites fluid cholesterol yielded the best sensitive value of 93%(cut-off value 30mg/dl), and cytologic examination and the protein A/S(cut-off value 0.5) showed the most specific value of 100% and 96%, respectively. Based on the above results, the diagnostic sequence with cholesterol as a sensitive parameter followed by the combination of cytologic examination and protein A/S as specific parameters, was tested in 80 patients. This diagnostic sequence identified 81.5% of patients with malignancy, and all patients with peritoneal carcinomatosis were classified as malignancy-related ascites. In spite of many limitations, this proposed diagnostic sequence may permit a cost-effective and simple differentiation of malignancy-related ascites from nonmalignant ascites.
Seo, Jung Nam;Na, Jong Eok;Bae, Sun Myung;Jung, Dong Min;Yoon, In Ha;Bae, Jae Bum;Kwack, Jung Won;Baek, Geum Mun
The Journal of Korean Society for Radiation Therapy
/
v.27
no.1
/
pp.53-60
/
2015
Purpose : The purpose of this study is to evaluate the usefulness of a 3D printed phantom for in-vivo dosimetry of a prostate cancer patient. Materials and Methods : The phantom is produced to equally describe prostate and rectum based on a 3D volume contour of an actual prostate cancer patient who is treated in Asan Medical Center by using a 3D printer (3D EDISON+, Lokit, Korea). CT(Computed tomography) images of phantom are aquired by computed tomography (Lightspeed CT, GE, USA). By using treatment planning system (Eclipse version 10.0, Varian, USA), treatment planning is established after volume of a prostate cancer patient is compared with volume of the phantom. MOSFET(Metal OXIDE Silicon Field Effect Transistor) is estimated to identify precision and is located in 4 measuring points (bladder, prostate, rectal anterior wall and rectal posterior wall) to analyzed treatment planning and measured value. Results : Prostate volume and rectum volume of prostate cancer patient represent 30.61 cc and 51.19 cc respectively. In case of a phantom, prostate volume and rectum volume represent 31.12 cc and 53.52 cc respectively. A variation of volume between a prostate cancer patient and a phantom is less than 3%. Precision of MOSFET represents less than 3%. It indicates linearity and correlation coefficient indicates from 0.99 ~ 1.00 depending on dose variation. Each accuracy of bladder, prostate, rectal anterior wall and rectal posterior wall represent 1.4%, 2.6%, 3.7% and 1.5% respectively. In- vivo dosimetry represents entirely less than 5% considering precision of MOSFET. Conclusion : By using a 3D printer, possibility of phantom production based on prostate is verified precision within 3%. effectiveness of In-vivo dosimetry is confirmed from a phantom which is produced by a 3D printer. In-vivo dosimetry is evaluated entirely less than 5% considering precision of MOSFET. Therefore, This study is confirmed the usefulness of a 3D printed phantom for in-vivo dosimetry of a prostate cancer patient. It is necessary to additional phantom production by a 3D printer and In-vivo dosimetry for other organs of patient.
본 웹사이트에 게시된 이메일 주소가 전자우편 수집 프로그램이나
그 밖의 기술적 장치를 이용하여 무단으로 수집되는 것을 거부하며,
이를 위반시 정보통신망법에 의해 형사 처벌됨을 유념하시기 바랍니다.
[게시일 2004년 10월 1일]
이용약관
제 1 장 총칙
제 1 조 (목적)
이 이용약관은 KoreaScience 홈페이지(이하 “당 사이트”)에서 제공하는 인터넷 서비스(이하 '서비스')의 가입조건 및 이용에 관한 제반 사항과 기타 필요한 사항을 구체적으로 규정함을 목적으로 합니다.
제 2 조 (용어의 정의)
① "이용자"라 함은 당 사이트에 접속하여 이 약관에 따라 당 사이트가 제공하는 서비스를 받는 회원 및 비회원을
말합니다.
② "회원"이라 함은 서비스를 이용하기 위하여 당 사이트에 개인정보를 제공하여 아이디(ID)와 비밀번호를 부여
받은 자를 말합니다.
③ "회원 아이디(ID)"라 함은 회원의 식별 및 서비스 이용을 위하여 자신이 선정한 문자 및 숫자의 조합을
말합니다.
④ "비밀번호(패스워드)"라 함은 회원이 자신의 비밀보호를 위하여 선정한 문자 및 숫자의 조합을 말합니다.
제 3 조 (이용약관의 효력 및 변경)
① 이 약관은 당 사이트에 게시하거나 기타의 방법으로 회원에게 공지함으로써 효력이 발생합니다.
② 당 사이트는 이 약관을 개정할 경우에 적용일자 및 개정사유를 명시하여 현행 약관과 함께 당 사이트의
초기화면에 그 적용일자 7일 이전부터 적용일자 전일까지 공지합니다. 다만, 회원에게 불리하게 약관내용을
변경하는 경우에는 최소한 30일 이상의 사전 유예기간을 두고 공지합니다. 이 경우 당 사이트는 개정 전
내용과 개정 후 내용을 명확하게 비교하여 이용자가 알기 쉽도록 표시합니다.
제 4 조(약관 외 준칙)
① 이 약관은 당 사이트가 제공하는 서비스에 관한 이용안내와 함께 적용됩니다.
② 이 약관에 명시되지 아니한 사항은 관계법령의 규정이 적용됩니다.
제 2 장 이용계약의 체결
제 5 조 (이용계약의 성립 등)
① 이용계약은 이용고객이 당 사이트가 정한 약관에 「동의합니다」를 선택하고, 당 사이트가 정한
온라인신청양식을 작성하여 서비스 이용을 신청한 후, 당 사이트가 이를 승낙함으로써 성립합니다.
② 제1항의 승낙은 당 사이트가 제공하는 과학기술정보검색, 맞춤정보, 서지정보 등 다른 서비스의 이용승낙을
포함합니다.
제 6 조 (회원가입)
서비스를 이용하고자 하는 고객은 당 사이트에서 정한 회원가입양식에 개인정보를 기재하여 가입을 하여야 합니다.
제 7 조 (개인정보의 보호 및 사용)
당 사이트는 관계법령이 정하는 바에 따라 회원 등록정보를 포함한 회원의 개인정보를 보호하기 위해 노력합니다. 회원 개인정보의 보호 및 사용에 대해서는 관련법령 및 당 사이트의 개인정보 보호정책이 적용됩니다.
제 8 조 (이용 신청의 승낙과 제한)
① 당 사이트는 제6조의 규정에 의한 이용신청고객에 대하여 서비스 이용을 승낙합니다.
② 당 사이트는 아래사항에 해당하는 경우에 대해서 승낙하지 아니 합니다.
- 이용계약 신청서의 내용을 허위로 기재한 경우
- 기타 규정한 제반사항을 위반하며 신청하는 경우
제 9 조 (회원 ID 부여 및 변경 등)
① 당 사이트는 이용고객에 대하여 약관에 정하는 바에 따라 자신이 선정한 회원 ID를 부여합니다.
② 회원 ID는 원칙적으로 변경이 불가하며 부득이한 사유로 인하여 변경 하고자 하는 경우에는 해당 ID를
해지하고 재가입해야 합니다.
③ 기타 회원 개인정보 관리 및 변경 등에 관한 사항은 서비스별 안내에 정하는 바에 의합니다.
제 3 장 계약 당사자의 의무
제 10 조 (KISTI의 의무)
① 당 사이트는 이용고객이 희망한 서비스 제공 개시일에 특별한 사정이 없는 한 서비스를 이용할 수 있도록
하여야 합니다.
② 당 사이트는 개인정보 보호를 위해 보안시스템을 구축하며 개인정보 보호정책을 공시하고 준수합니다.
③ 당 사이트는 회원으로부터 제기되는 의견이나 불만이 정당하다고 객관적으로 인정될 경우에는 적절한 절차를
거쳐 즉시 처리하여야 합니다. 다만, 즉시 처리가 곤란한 경우는 회원에게 그 사유와 처리일정을 통보하여야
합니다.
제 11 조 (회원의 의무)
① 이용자는 회원가입 신청 또는 회원정보 변경 시 실명으로 모든 사항을 사실에 근거하여 작성하여야 하며,
허위 또는 타인의 정보를 등록할 경우 일체의 권리를 주장할 수 없습니다.
② 당 사이트가 관계법령 및 개인정보 보호정책에 의거하여 그 책임을 지는 경우를 제외하고 회원에게 부여된
ID의 비밀번호 관리소홀, 부정사용에 의하여 발생하는 모든 결과에 대한 책임은 회원에게 있습니다.
③ 회원은 당 사이트 및 제 3자의 지적 재산권을 침해해서는 안 됩니다.
제 4 장 서비스의 이용
제 12 조 (서비스 이용 시간)
① 서비스 이용은 당 사이트의 업무상 또는 기술상 특별한 지장이 없는 한 연중무휴, 1일 24시간 운영을
원칙으로 합니다. 단, 당 사이트는 시스템 정기점검, 증설 및 교체를 위해 당 사이트가 정한 날이나 시간에
서비스를 일시 중단할 수 있으며, 예정되어 있는 작업으로 인한 서비스 일시중단은 당 사이트 홈페이지를
통해 사전에 공지합니다.
② 당 사이트는 서비스를 특정범위로 분할하여 각 범위별로 이용가능시간을 별도로 지정할 수 있습니다. 다만
이 경우 그 내용을 공지합니다.
제 13 조 (홈페이지 저작권)
① NDSL에서 제공하는 모든 저작물의 저작권은 원저작자에게 있으며, KISTI는 복제/배포/전송권을 확보하고
있습니다.
② NDSL에서 제공하는 콘텐츠를 상업적 및 기타 영리목적으로 복제/배포/전송할 경우 사전에 KISTI의 허락을
받아야 합니다.
③ NDSL에서 제공하는 콘텐츠를 보도, 비평, 교육, 연구 등을 위하여 정당한 범위 안에서 공정한 관행에
합치되게 인용할 수 있습니다.
④ NDSL에서 제공하는 콘텐츠를 무단 복제, 전송, 배포 기타 저작권법에 위반되는 방법으로 이용할 경우
저작권법 제136조에 따라 5년 이하의 징역 또는 5천만 원 이하의 벌금에 처해질 수 있습니다.
제 14 조 (유료서비스)
① 당 사이트 및 협력기관이 정한 유료서비스(원문복사 등)는 별도로 정해진 바에 따르며, 변경사항은 시행 전에
당 사이트 홈페이지를 통하여 회원에게 공지합니다.
② 유료서비스를 이용하려는 회원은 정해진 요금체계에 따라 요금을 납부해야 합니다.
제 5 장 계약 해지 및 이용 제한
제 15 조 (계약 해지)
회원이 이용계약을 해지하고자 하는 때에는 [가입해지] 메뉴를 이용해 직접 해지해야 합니다.
제 16 조 (서비스 이용제한)
① 당 사이트는 회원이 서비스 이용내용에 있어서 본 약관 제 11조 내용을 위반하거나, 다음 각 호에 해당하는
경우 서비스 이용을 제한할 수 있습니다.
- 2년 이상 서비스를 이용한 적이 없는 경우
- 기타 정상적인 서비스 운영에 방해가 될 경우
② 상기 이용제한 규정에 따라 서비스를 이용하는 회원에게 서비스 이용에 대하여 별도 공지 없이 서비스 이용의
일시정지, 이용계약 해지 할 수 있습니다.
제 17 조 (전자우편주소 수집 금지)
회원은 전자우편주소 추출기 등을 이용하여 전자우편주소를 수집 또는 제3자에게 제공할 수 없습니다.
제 6 장 손해배상 및 기타사항
제 18 조 (손해배상)
당 사이트는 무료로 제공되는 서비스와 관련하여 회원에게 어떠한 손해가 발생하더라도 당 사이트가 고의 또는 과실로 인한 손해발생을 제외하고는 이에 대하여 책임을 부담하지 아니합니다.
제 19 조 (관할 법원)
서비스 이용으로 발생한 분쟁에 대해 소송이 제기되는 경우 민사 소송법상의 관할 법원에 제기합니다.
[부 칙]
1. (시행일) 이 약관은 2016년 9월 5일부터 적용되며, 종전 약관은 본 약관으로 대체되며, 개정된 약관의 적용일 이전 가입자도 개정된 약관의 적용을 받습니다.