• 한국방재안전학회논문집
• /
• 제16권3호
• /
• pp.17-26
• /
• 2023

프리스트레스드 콘크리트(Prestressed Concrete, PSC) 거더는 프리텐션과 포스트텐션 긴장 방식으로 구분되고, 단면 형상에서는 I형과 U형으로 구분된다. 각 긴장 방식과 단면 형상에 따른 장단점이 있고, 각각의 방식으로 교량 건설 현장에 적용되고 있다. 본 연구에서는 프리텐션 긴장 방식과 U형 단면의 단점을 극복하여 적용한 새로운 거더 형식을 제안하고 구조 성능을 검증하고자 하였다. 프리텐션 긴장 방식의 거더는 반력대가 필요한 관계로 주로 공장에서 제작되며, 이동을 위하여 무게와 경간장이 제한되는 단점이 있다. 또한 U형 단면의 경우 전도 등 시공 시 구조 안정성이 높으나, 자중이 I형에 비해 상대적으로 커서 현장 제작 후 포스트텐션 긴장 방식이 주로 적용되고 있다. 본 연구에서는 현장 프리텐션 긴장 방식을 적용한 PSC 거더 제작 방식 제시하고 40 m급 실대형 실험체를 제작하여 구조 성능을 검증하였다.

• 대한한방내과학회지
• /
• 제44권5호
• /
• pp.904-910
• /
• 2023

Objectives: The aim of this case report is to present the effects of Korean medicine treatment in a patient with left facial paraesthesia, temporomandibular joint (TMJ) pain, and post-traumatic neck pain induced by cerebral infarction. Methods: A 26-year-old male patient was treated with Cheongpa-Jeon H, acupuncture, pharmacopuncture (Shinbaro2), and Chuna Therapy for 24 days of hospitalization. Left facial paraesthesia, TMJ pain, and post-traumatic neck pain were assessed with a Numeric Rating Scale (NRS) and EuroQoL-5 Dimension (EQ-5D). Post-traumatic neck pain was assessed using the Neck Disability Index (NDI). Results: After 24 days of treatment, the patient's left facial paraesthesia and left arm tingling sensation were relieved from NRS 6 to NRS 2. Left TMJ pain was reduced from NRS 5 to NRS 2. The EQ-5D score increased from 0.138 to 0.73. The NDI score decreased from 71.11 to 37.78. Conclusion: These results show that left facial paraesthesia, TMJ pain, and post-traumatic neck pain can be relieved with Korean medicine treatment. However, further well-designed studies are required to confirm these findings.

• Pediatric Infection and Vaccine
• /
• 제31권1호
• /
• pp.55-63
• /
• 2024

목적: 수두 감염에 대한 백신 효과성을 높이기 위해 수두백신 2회접종 전략이 여러 국가에 도입이 되었다. 본 연구에서는 Bayesian 모델을 통해 수두 예방 접종 전략의 종합적인 평가와 효과를 제공하고자 한다. 방법: 체계적 문헌고찰을 통해 수집된 연구에 대해 1회 및 2회 접종, 인구특성 및 관심대상결과와 같은 결과값들을 수집했다. 다양한 접종 횟수를 포함하는 연구의 경우 동일한 투여 횟수에 대한 데이터를 하나의 그룹으로 집계했다. 수두 백신의 1회 및 2회 접종의 예방 효과는 오즈 비 (OR) 및 해당하는 95% 신뢰 구간 (95% CI)을 기준으로 평가하였다. 결과: 문헌 검색을 통해 총 903개의 연구가 검색되었고, Bayesian 네트워크 메타 분석을 위해 25개의 개입 또는 관찰 연구가 선택되었다. 총 49,265명의 관찰 대상자가 이 연구에 포함되었다. 미접종군과 비교하여, 모든 수두 감염의 OR은 각각 2회 및 1회 접종에 대해 0.087 (95% CI, 0.046-0.164) 및 0.310 (95% CI, 0.198-0.484)이었으며, 이는 각각 1회 및 2회의 VE가 각각 69.0% (95% CI, 51.6-81.2) 및 91.3% (95% CI, 83.6-95.4)에 해당한다. 결론: 체계적인 검토 및 네트워크 메타 분석 결과, 2회 접종 백신 전략은 수두 감염 부담을 크게 감소시키는 것을 확인하였고, 2회 접종을 받은 어린이들은 1회 접종을 받은 어린이들보다 수두 감염 위험이 낮았으며, 유행 발생 시 더 나은 보호를 받는 것을 확인하였다.

• Korean Journal of Radiology
• /
• 제22권12호
• /
• pp.1974-1984
• /
• 2021

Objective: This study aimed to compare the efficacy between no-touch (NT) radiofrequency ablation (RFA) and conventional RFA using twin internally cooled wet (TICW) electrodes in the bipolar mode for the treatment of small hepatocellular carcinomas (HCC). Materials and Methods: In this single-center, two-arm, parallel-group, prospective randomized controlled study, we performed a 1:1 random allocation of eligible patients with HCCs to receive NT-RFA or conventional RFA between October 2016 and September 2018. The primary endpoint was the cumulative local tumor progression (LTP) rate after RFA. Secondary endpoints included technical conversion rates of NT-RFA, intrahepatic distance recurrence, extrahepatic metastasis, technical parameters, technical efficacy, and rates of complications. Cumulative LTP rates were analyzed using Kaplan-Meier analysis and the Cox proportional hazard regression model. Considering conversion cases from NT-RFA to conventional RFA, intention-to-treat and as-treated analyses were performed. Results: Enrolled patients were randomly assigned to the NT-RFA group (37 patients with 38 HCCs) or the conventional RFA group (36 patients with 38 HCCs). Among the NT-RFA group patients, conversion to conventional RFA occurred in four patients (10.8%, 4/37). According to intention-to-treat analysis, both 1- and 3-year cumulative LTP rates were 5.6%, in the NT-RFA group, and they were 11.8% and 21.3%, respectively, in the conventional RFA group (p = 0.073, log-rank). In the as-treated analysis, LTP rates at 1 year and 3 years were 0% and 0%, respectively, in the NT-RFA group sand 15.6% and 24.5%, respectively, in the conventional RFA group (p = 0.004, log-rank). In as-treated analysis using multivariable Cox regression analysis, RFA type was the only significant predictive factor for LTP (hazard ratio = 0.061 with conventional RFA as the reference, 95% confidence interval = 0.000-0.497; p = 0.004). There were no significant differences in the procedure characteristics between the two groups. No procedure-related deaths or major complications were observed. Conclusion: NT-RFA using TICW electrodes in bipolar mode demonstrated significantly lower cumulative LTP rates than conventional RFA for small HCCs, which warrants a larger study for further confirmation.

• 핵의학기술
• /
• 제28권1호
• /
• pp.49-56
• /
• 2024

Purpose: When performing nuclear medicine examinations, body wraps or plastic supports are used to support and immobilize the patient's upper extremities to prevent patient safety accidents. However, the existing plastic supports compromised patient and staff safety, including finger entrapment and falls. Moreover, the body wrap provided by manufacturers compromised image quality such as upper extremities cutoff during whole body bone scan. Therefore, a new design of body wrap was developed to improve the issue, and this study aims to evaluate the usability of this medical body wrap. Materials and Methods: To evaluate the usability of the newly designed medical body wrap, a quality assessment of whole body bone scan images and a user satisfaction survey were conducted. Adult patients (male:female=129:152, age: 60.3±12.4 years, BMI: 24.0±4.2) aged 16 years or older who underwent a whole body bone scan during two periods: June to July 2022 (before improvement, n=139) and June to July 2023 (after improvement, n=142) were randomly selected for image quality evaluation. Five radiotechnologists visually evaluated the posterior view of the whole body bone image, including the left and right elbow (2 points), arm (2 points), whether the hand is extended (2 points), whether the hand is included (2 points), and the number of visible fingers (10 points), with a total of 18 points, which were converted to 100 points and analyzed for difference before and after improvement using an independent sample t-test. The user satisfaction questionnaire was evaluated using a 5-point Likert scale among 16 radiotechnologists from three general hospitals who experienced the new body wrap. Results: The image quality assessment was 82.0±13.8 before the improvement and 89.3±10.1 after the improvement, an average of 7.3 points higher, with a statistically significant difference (t=5.02, p<0.01). The user satisfaction survey showed an overall satisfaction rating of 4.1±0.8 for ease of use, 3.8±0.7 for scan preparation time, 3.9±0.7 for patient safety, 3.8±1.2 for scan accuracy, and 4.2±0.7 for recommendation (87.5% questionnaire response rate). Conclusion: The developed body wrap showed higher image quality and user satisfaction compared to the old method. Considering these results, it is deemed that the new body wrap may be more useful than existing methods.

• Korean Journal of Radiology
• /
• 제22권2호
• /
• pp.233-242
• /
• 2021

Objective: To evaluate the association of MRI features with the major genomic profiles and prognosis of World Health Organization grade III (G3) gliomas compared with those of glioblastomas (GBMs). Materials and Methods: We enrolled 76 G3 glioma and 155 GBM patients with pathologically confirmed disease who had pretreatment brain MRI and major genetic information of tumors. Qualitative and quantitative imaging features, including volumetrics and histogram parameters, such as normalized cerebral blood volume (nCBV), cerebral blood flow (nCBF), and apparent diffusion coefficient (nADC) were evaluated. The G3 gliomas were divided into three groups for the analysis: with this isocitrate dehydrogenase (IDH)-mutation, IDH mutation and a chromosome arm 1p/19q-codeleted (IDHmut1p/19qdel), IDH mutation, 1p/19q-nondeleted (IDHmut1p/19qnondel), and IDH wildtype (IDHwt). A prediction model for the genetic profiles of G3 gliomas was developed and validated on a separate cohort. Both the quantitative and qualitative imaging parameters and progression-free survival (PFS) of G3 gliomas were compared and survival analysis was performed. Moreover, the imaging parameters and PFS between IDHwt G3 gliomas and GBMs were compared. Results: IDHmut G3 gliomas showed a larger volume (p = 0.017), lower nCBF (p = 0.048), and higher nADC (p = 0.007) than IDHwt. Between the IDHmut tumors, IDHmut1p/19qdel G3 gliomas had higher nCBV (p = 0.024) and lower nADC (p = 0.002) than IDHmut1p/19qnondel G3 gliomas. Moreover, IDHmut1p/19qdel tumors had the best prognosis and IDHwt tumors had the worst prognosis among G3 gliomas (p < 0.001). PFS was significantly associated with the 95th percentile values of nCBV and nCBF in G3 gliomas. There was no significant difference in neither PFS nor imaging features between IDHwt G3 gliomas and IDHwt GBMs. Conclusion: We found significant differences in MRI features, including volumetrics, CBV, and ADC, in G3 gliomas, according to IDH mutation and 1p/19q codeletion status, which can be utilized for the prediction of genomic profiles and the prognosis of G3 glioma patients. The MRI signatures and prognosis of IDHwt G3 gliomas tend to follow those of IDHwt GBMs.

• Korean Journal of Radiology
• /
• 제22권2호
• /
• pp.179-188
• /
• 2021

Objective: This study aimed to prospectively compare the efficacy, safety, and mid-term outcomes of dual-switching monopolar (DSM) radiofrequency ablation (RFA) to those of conventional single-switching monopolar (SSM) RFA in the treatment of hepatocellular carcinoma (HCC). Materials and Methods: This single-center, two-arm, parallel-group, randomized controlled study was approved by the Institutional Review Board. Written informed consent was obtained from all patients upon enrollment. A total of 80 patients with 94 HCC nodules were randomized into either the DSM-RFA group or SSM-RFA group in a 1:1 ratio, using a blocked randomization method (block size 2). The primary endpoint was the minimum diameter of the ablation zone per unit time. The secondary endpoints included other technical parameters, complication rate, technique efficacy, and 2-year clinical outcomes. Results: Significantly higher ablation energy per unit time was delivered to the DSM-RFA group than to the SSM-RFA group (1.7 ± 0.2 kcal/min vs. 1.2 ± 0.3 kcal/min; p < 0.001). However, no significant differences were observed between the two groups for the analyzed variables, including primary endpoint, regarding size of the ablation zone and ablation time. Major complication rates were 4.9% in the DSM-RFA group and 2.6% in the SSM-RFA group (p = 1.000). The 2-year local tumor progression (LTP) rates of the HCC nodules treated using DSM-RFA and SSM-RFA were 8.5% and 4.7%, respectively (p = 0.316). The 2-year LTP-free survival rates of patients in the DSM-RFA and SSM-RFA groups were 90.0% and 94.4%, respectively (p = 0.331), and the 2-year recurrence-free survival rates were 54.9% and 75.7%, respectively (p = 0.265). Conclusion: Although DSM-RFA using a separable clustered electrode delivers higher ablation energy than SSM-RFA, its effectiveness failed to show superiority over SSM-RFA in the treatment of HCC.

• 대한통합의학회지
• /
• 제12권1호
• /
• pp.49-62
• /
• 2024

Purpose : This study was conducted to compare two non-face-to-face exercise interventions depending on whether mobile applications and wearable exercise aids are used to find out which interventions are more effective in improving senile sarcopenia. Ultimately, it was conducted to provide basic data for developing non-face-to-face intervention methods to improve sarcopenia. Method : In this study, 18 elderly sarcopenia and possible sarcopenia aged 65 or older were randomly assigned to the digital and self-exercise intervention groups. The digital exercise intervention group performed eight exercise programs with mobile applications and wearable exercise aids to record and manage the elderly performing the programs in real time. And the self-exercise intervention group performed the same program on its own as implemented in the digital exercise group. The intervention was applied for 8 weeks, and before and after the intervention, sarcopenia evaluation and physical function evaluation were performed. Results : In the digital exercise intervention group, arm muscle mass, skeletal muscle index, SPPB, 5TSTS, and BBS were improved, and in the self-exercise intervention group, grip strength, SPPB, 5TSTS, and BBS were improved. Conclusion : It was confirmed that both groups are effective in improving physical performance and physical function, the digital exercise intervention is effective in improving muscle mass and self-exercise intervention is effective in improving muscle strength. Therefore, this study proposes to apply intervention methods separately according to the indicators to improve and prevent sarcopenia, and also simplify the instructions of applications used to improve sarcopenia and to create an environment where users can be trained regularly on how to use it. And, In the future, studies for the development of devices to be designed to help non-face-to-face exercise interventions or studies on the differences between face-to-face and non-face-to-face exercise interventions should be conducted in terms of the effect of improving sarcopenia.

• 대한한방내과학회지
• /
• 제44권6호
• /
• pp.1212-1242
• /
• 2023

Objectives: This study aims to explore the current usage status of orally administered Korean herbal medicine in randomized controlled trials (RCTs) published in the Journal of Korean Medicine and member journals using the CONSORT-Chinese Herbal Medicine Formulas 2017 (CONSORT-CHM 2017) checklist. Methods: We searched the OASIS, RISS, and KMBASE archives as well as the websites of the Journal of Korean Medicine and 45 member journals to identify RCTs that used herbal interventions. Two independent researchers searched and categorized the RCTs and performed a quantitative evaluation by journal, study design, and target disease, as well as qualitative evaluation of the literature using CONSORT-CHM 2017. Results: After the search, 66 articles were selected. The quantitative evaluation resulted in 13 articles (19.6%) that were published in the Journal of Korean Medicine and 12 articles (18.1%) in the Journal of Internal Korean Medicine. In terms of study design, 62 articles (93.9%) were parallel, 4 articles (6%) were crossover, and 2-arm parallel study designs were the most common in 45 articles (68.2%). In terms of the study participants, physiological characteristics and mechanisms in healthy individuals were the most common in 21 studies (31.8%) and obesity in 9 studies (13.6%). In terms of assessing completeness in the CONSORT-CHM 2017 items, 29 articles were rated high, 31 were rated moderate, and 6 were rated low. Items 4a, 6a, and 7a had low reporting rates (≤ 30%), while items 2a, 2b, and 12a were completely reported in all studies. Conclusion: Future RCTs using orally administered Korean herbal medicine need to be reported completely, and the CONSORT-CHM 2017 checklist can be a helpful tool for this purpose.

• Korean Journal of Radiology
• /
• 제25권6호
• /
• pp.565-574
• /
• 2024

Objective: To evaluate the safety and clinical outcomes of the Passeo-18 Lux drug-coated balloon (DCB) in endovascular revascularization procedures under real-world conditions in a Korean population with atherosclerotic disease of the infrainguinal arteries, including below-the-knee (BTK) arteries. Materials and Methods: Eight institutions in the Republic of Korea participated in this prospective, multicenter, single-arm, post-market surveillance study. Two hundred patients with Rutherford class 2-5 peripheral arterial disease and infrainguinal lesions suitable for endovascular treatment were competitively enrolled. Data were collected at baseline, the time of intervention, discharge, and 1-, 6-, 12-, and 24-month follow-up visits. The primary safety endpoint was freedom from major adverse events (MAE) within 6 months (except when limiting the time frame for procedure- or device-related mortality to within 30 days), and the primary effectiveness endpoint was freedom from clinically driven target lesion revascularization (CD-TLR) within 12 months after the procedure. Results: A total of 197 patients with 332 target lesions were analyzed. Two-thirds of the patients had diabetes mellitus, and 41.6% had chronic limb-threatening ischemia. The median target lesion length was 100 mm (interquartile range: 56-133 mm). Of the target lesions, 35.2% were occlusions, and 14.8% were located in the BTK arteries. Rate of freedom from MAE was 97.9% at 6 months, and the rate of freedom from CD-TLR was 95.0% and 92.2% at 12 and 24 months, respectively. Subgroup analysis of 43 patients and 49 target lesions involving the BTK arteries showed rate of freedom from MAE of 92.8% at 6 months and rates of freedom from CD-TLR of 88.8% and 84.4% at 12 and 24 months, respectively. Conclusion: The results of the present study, including the BTK subgroup analysis, showed outcomes comparable to those of other DCB studies, confirming the safety and effectiveness of Passeo-18 Lux DCB in the Korean population.