• Clinical Endoscopy
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• 제57권2호
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• pp.141-157
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• 2024

Antithrombotic agents, including antiplatelet agents and anticoagulants, are widely used in Korea because of the increasing incidence of cardiocerebrovascular disease and the aging population. The management of patients using antithrombotic agents during endoscopic procedures is an important clinical challenge. The clinical practice guidelines for this issue, developed by the Korean Society of Gastrointestinal Endoscopy, were published in 2020. However, new evidence on the use of dual antiplatelet therapy and direct anticoagulant management has emerged, and revised guidelines have been issued in the United States and Europe. Accordingly, the previous guidelines were revised. Cardiologists were part of the group that developed the guideline, and the recommendations went through a consensus-reaching process among international experts. This guideline presents 14 recommendations made based on the Grading of Recommendations, Assessment, Development, and Evaluation methodology and was reviewed by multidisciplinary experts. These guidelines provide useful information that can assist endoscopists in the management of patients receiving antithrombotic agents who require diagnostic and elective therapeutic endoscopy. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.

• 마케팅과학연구
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• 제20권2호
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• pp.188-198
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• 2010

此研究旨在考察负口碑(即NWOM)对在线行销的影响, 着重分析服务失败的描述以及通信服务商的意向是如何影响消费者对企业竞争力的评估, 对企业的态度, 以及积极的口碑行销和行为意向. 对通信说服力的研究着重于 "谁说了什么; 对谁;通过何渠道;有何影响(Chiu 2007)". 在此我们研究了电子网络发布, 尤其是 "什么" 的两个方面: 通信服务失败的等级以及个人发布的知觉意向. 电子负口碑看似正在毁掉产品或企业的声誉, 这也就不难理解为什么人们总对它带有偏见, 认为其不可靠. 根据归因理论, 人们总会寻求事件的原因, 尤其是那些消极的意外的事件(Weiner 2006). Hennig-Thurau和Walsh (2003)提出 "既然读者的知识和对在线信息的作者信任度都很有限, 可以把电子口碑当做是表达-行为关系的有效调节. 此据此我们提出以下假设: 假设1. 在衡量(a)企业竞争力, (b)人们对企业的态度, (c)积极的口碑, 以及(d)行为意向时, 面临高等级服务失败电子负口碑的对象得分低于面临低等级服务失败电子负口碑的对象. 假设2. 在衡量(a)企业竞争力, (b)人们对企业的态度, (c)积极的口碑, 以及(d)行为意向时, 面临警告意向电子负口碑的对象得分低于面临报复意向电子负口碑的对象假设3. 在电子负口碑中, 服务失败的等级和知觉意向互相影响, 因此在衡量(a)企业竞争力, (b)人们对企业的态度, (c)积极的口碑, 以及(d)行为意向时, 警告意向的电子负口碑的平均反应值大于报复意向的电子负口碑. 主要研究包括一个2 (服务失败的严重性) x 2(警告意向VS报复意向的负口碑)的析因实验. 将通过模拟的在线网络发布信息刺激在线对象. 这一方案描述的服务失败是在传统的零售机构不接受礼物卡, 通过一家在线的研究公司从全国抽样. 共有113个对象参与此研究, 共分析了104份调查问卷. 研究对象认为该方案很现实, 92.3%对此反应强烈. 方案的运作相当令人满意, 所有的措施都经预先的测试验证, 各个项目也经分析证实可靠并有效. 多变量方差分析结果显示多变量间无明显的互相影响, 因此我们只研究主要影响-后倾向和服务失败的严重性. 后倾向主要影响对企业的态度, 积极的口碑和行为意向. 服务失败的严重性主要影响4个因变量: 企业的竞争力, 对企业的态度, 积极的口碑和行为意向. 需特别指出的是, 当电子负口碑描述为严重的服务失败时, 企业的竞争力低于电子负口碑描述为较轻的服务失败时. 当电子负口碑描述为严重的服务失败时, 对企业的态度差于电子负口碑描述为较轻的服务失败时. 当电子负口碑描述为严重的服务失败时, 企业的口碑差于电子负口碑描述为较轻的服务失败时. 当电子负口碑描述为严重的服务失败时, 行为意向低于电子负口碑描述为较轻的服务失败时. 因此, 假设1中的abcd都得到了支持. 另外, 衡量对企业的态度时, 警告意向的电子负口碑得分低于报复意向的电子负口碑. 衡量企业的口碑时, 警告意向的电子负口碑得分低于报复意向的电子负口碑. 衡量行为意向时, 警告意向的电子负口碑得分低于报复意向的电子负口碑. 因此与假设2中的a项不符, 尽管结果指向的是假设方向. 除此之外, 在假设的三个变量中, 后倾向对服务失败的严重性无明显的多变量或单变量影响. 因此, 假设3被推翻. 此研究有研究和管理的双重蕴涵, 如之前的研究一样, 此研究结果证实了服务失败的严重性影响消费者知觉, 态度, 积极的口碑以及行为意向(Weun et al. 2004). 关于进一步的相关性, 在线内容证实了该反应, 这意味着企业需要努力进行服务补救. 至于电子负口碑的知觉意向, 如之前的研究一样, 此研究结果意味着读者对原始资料的意向影响其对知觉, 态度, 积极口碑和行为意向的作用大小. 对管理者的蕴涵在于, 当消费者发现在线交流可靠且有影响力时, 不是所有的交流都同等重要. 电子口碑的好处在于它可以监测潜在的问题并提供纠正的可能性, 即使有潜在的危害.

• International Journal of Quality Innovation
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• 제8권3호
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• pp.123-155
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• 2007

This research treated the secondary school teachers as the research scale and the research targets included the following: secondary school (employ unit), center of teacher education, and qualified teachers. In terms of these three groups of people, the topics of exploration focused on the perception of suitable teachers, perception of evaluation standard during the process of teacher examination and the relationship among teacher examination systems. The research was managed by two phases: the first phase referred to literature reorganization, expert interview, the qualities and conditions of suitable teachers, important evaluation standard during the process of teacher examination and teacher examination system used; the second phase included questionnaire survey, employ school acquisition, the perception of centers of teacher education and qualified teachers toward the suitability condition and examination evaluation standard in the first phase and teacher examination system used. This research found out that as to the perception of suitable teachers, through data collection, there were six factors reorganized. The levels of their importance were as follows: education devotion, teaching capacity, class management, capacity to guide special students, capacity to communicate with the parents and the will to undertake administrative works. Noticeably, employee unit and centers of teacher education apparently valued class management more, compared with trained teachers; as to evaluation standard of examination, the analytical result found out that the perception of three groups were different in terms of the views toward educational works, written examination data, candidate's age, club experience at school and capacity to use multimedia support teaching materials. This research further proposed six suggestions for centers of teacher education and trained teachers: (l) employ schools considerably valued educational devotion; (2) trained teachers tended to neglect the importance of class management; (3) employee unit considerably cared about the new teachers' competence to use multimedia support teaching materials; however, trained teachers did not have the same view; (4) employee unit considerably cared about new teachers' views toward educational works as well as the candidates' ages; (5) generally speaking, trained teachers neglected the importance of club experience at school; (6) the data revealed that written examination data was not relatively important in terms of teacher examination.

• 부모자녀건강학회지
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• 제8권2호
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• pp.123-136
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• 2005

This research is to compare the infant's temperament and parenting stress perceived by premature infants' mother and full-term infants' mother. It aims at establishing the healthy relationship between mothers and infants. It investigates the basic data of nursing intervention program to help the mother of premature infant. The period of data collection was from May 1, 2005 to May 30, 2005, and the subjects were total 123 mothers: 44 mothers of premature infants and 79 mothers of full-term infants under 6 months who visited general hospitals, individual pediatrics, and health center located in G city. "What My Baby Is Like(WBL)" developed by Pridham, Chang, and Chiu(1994) and translated by Bang Kyeong Sook(1999) was used as a measuring instrument of infants' temperament, and Parenting Stress Index (PSI) developed by Abidin(1990) and revised and complemented by Kim Dong Hee(1997) was used as a measuring instrument of parenting stress. Collected Data were analyzed through $X^2$-test, t-test, Pearson's correlation with SPSS 12.0 window program. The results are as follows: 1. There was a significant difference in the infant's temperament perceived by premature infants' mothers and full-term infants' mothers (t=-4.08, p=.00). In subcategory, there were significant difference between premature infants' mother and full-term infants' mother in geniality(t=-3.62, p=.00), adaptation(t=-3.43, p=.00) and reaction(t=-2.01, p=.05). 2. There was a significant difference in parenting stress between premature infants' mother and full-term infants' mother(t=6.57, p=.00). The parenting stress of premature infants mothers appeared to be higher than full-term infants' mothers. They showed the higher stress in the mother-child relationship area(t=6.27, p=.00) and child area(t=7.38, p=.00) among 3 areas of parenting stress. 3. There were negative correlation between infants' temperament and parenting stress. As mothers perceived the infant's temperament negatively, the parenting stress. Especially, the negative correlation of infants' temperament and parenting stress of premature infants' mothers(r=-.44) was stronger than that of full-term infants' mothers(r=-37). From the research, as mothers of premature infants receive more stress, their stress can cause the serious problem to the relationship of the mother and the infant. Therefore, the nursing intervention should be carried out in order to change the negative perception of mothers towards their infants into the positive perception reduce the parenting stress.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6585-6590
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• 2013

Background: Although FOLFOX (infusional fluorouracil/leucovorin plus oxaliplatin) is established as a standard chemotherapeutic regimen, the long term efficacy of adjuvant XELOX (oral capecitabine plus intravenous oxaliplatin) in Asian colorectal cancer (CRC) patients remains anecdotal. Moreover, uncertainties persist as to whether pharmacogenetic differences in Asian populations preclude equally tolerable and effective administration of these drugs. Method: One hundred consecutive patients with resected colorectal cancer received adjuvant XELOX (oxaliplatin 130 $mg/m^2$ on day 1 plus capecitabine 900 $mg/m^2$ twice daily on day 1 to 14 every 3 weeks for 8 cycles) at Queen Mary Hospital, Hong Kong. Endpoints monitored during follow-up were disease-free survival (DFS) and disease recurrence, overall survival (OS) and adverse events (AEs). Results: The median patient age was 56 years, 56% were diagnosed with rectal cancer and 44% with colonic cancer. After a median follow-up of 4.3 years (95% confidence interval, 3.2-4.7), 24 recurrences were confirmed including 13 patients who died due to progressive disease. Four-year DFS was 81% in colon cancer patients and 67% in rectal cancer patients (p=0.06 by log-rank test). For the cohort as a whole, OS was 90% at 3 years and 84% at 5 years. Treatment-related AEs led to early withdrawal in four patients. The commonest non-hematological AEs were neuropathy (91%), hand-foot syndrome (49%) and diarrhea (46%), while the commonest grade 3/4 AEs were neutropenia (11%) and diarrhea (10%). Conclusion: These results confirm the favourable long term survival benefit with good tolerability in using adjuvant XELOX in treating East Asian colorectal cancer patients.

• Asian-Australasian Journal of Animal Sciences
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• 제15권9호
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• pp.1348-1353
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• 2002

The purpose of this study was to evaluate the changes and readjustment capacity in the hematological characteristics of the horse during and after a prolonged training program. One pony and two hot-blooded horses were used in this study. Resting or basal blood parameters were assessed by collecting blood samples of the animals for 1 to 2 months prior to start of the training program. Each animal was subjected to arbitrary exercise for 30 min by an automatic hot trotter and was bled at 0, 15, 30, 45 (15 min of recovery), 60 (30 min of recovery), and 75 min (45 min of recovery) after onset of exercise. All animals were exercised 3 times a week over a fivemonth period. Hematological parameters including average white blood cell counts (WBC, ${\times}$$10^3$/$\mu$l), erythrocyte concentrations (RBC, ${\times}$$10^6$/$\mu$l), hematocrit (HCT, %), mean corpuscular volume (MCV, fl), number of platelets (PLT, ${\times}$$10^4$/$\mu$l), hemoglobin concentration (Hb, g/dl), mean corpuscular hemoglobin (MCH, pg), and mean corpuscular hemoglobin concentration (MCHC, g/dl) were analyzed using an automatic cell counter. All animals showed that RBC, WBC, and HCT were significantly (p<0.05) increasing from 7.09, 8.55, and 43.5 to 8.11, 9.67, and 49.5, respectively, during the 30 min of exercise and were back to or lower than the initial basis (resting and 0 min) 30 min after exercise. However, no significant differences were detected in MCV (50.3-51.3 fl), MCH (17.2-17.4 pg), and MCHC (33.7-34.4 g/dl) values (p>0.05) regardless of the training periods. Similar trends were observed after 1, 3, 4, and 5 months of training when compared to the resting state. When these parameters were analyzed by the effect of training periods (month), mean WBC concentrations significantly reduced in the fourth and fifth month after onset of training compared to that in resting condition or the first month of training program (p<0.05). The RBC values elevated at the second month (9.40) and reaching a significantly low level (p<0.001) at the fifth month (8.62) after training compared to the first month of training (7.89). In conclusion, a mild training program enhances blood parameters gradually in both the horse and the pony. Therefore, an optimized training program is beneficial in promoting the endurance performance of the horse.

• Journal of Hospice and Palliative Care
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• 제19권4호
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• pp.292-295
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• 2016

목적: 대만의 호스피스와 완화 의료는 지속적으로 증가하고 있다. Economist Intelligence Unit에서 평가한 2015년 죽음의 질 지수 등급에서 대만은 아시아 국가 중에서 1위, 세계에서 6위를 기록했다. 이 리뷰 기사에서 우리는 성공에 기여한 것으로 보이는 세 영역, 즉 법률 및 규정, 영적 치료, 연구 네트워크에 주목하였다. 마지막으로 대만 사람에게 적용을 위한 미래의 도전과 전망에 대해 논의하기로 한다. 방법: PubMed에서 "대만의 호스피스 완화의료" 검색어를 이용해 체계적인 검토를 수행하였다. 결과: 2000년에 "자연사법"의 통과로 아시아에서 환자의 자기결정권에 대한 획기적인 본보기가 만들어지고 확립되었다. 이는 의료진에게 연명치료중지(DNR, do not resuscitate)를 요청할 수 있고 삶의 마지막에 기타 무의미한 의료 행위를 거부할 수 있는 환자의 권리를 보장하며 더불어 정책적 관점에서 완화의료의 중요성을 반영하는 것이다. 2015년에 대만은 "환자의 자기결정권 특별법"이라는 선구적인 법률을 통과시켰다. 이 법은 환자가 그/그녀의 자기의지에 따라 의료 행위를 거부할 수 있다는 것을 규정한다. 대만 고유의 영적 치료는 2000년에 도입되었는데, 불교 수행을 죽음에 직면한 환자에 적용하기 이전의 임상실습뿐 아니라 강의들로 구성된 훈련 프로그램을 성공적으로 이수하기 위해서는 불교 사제가 필요하다. 일본-한국-대만 연구 네트워크는 죽음의 과정을 자세히 설명(EASED, Elucidate the Dying process)하기 위한 동아시아 공동의 비교 문화 집단 연구를 위해 설립되었다. 결론: 대만에서의 호스피스와 완화의료는 정부와 사회의 우선적 합의에 따라 꾸준하게 성장하고 있다.

• International Journal of Quality Innovation
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• 제8권1호
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• pp.40-75
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• 2007

In the early industrial age which with high intensity of machine and labor, using financial measurement index was good enough to tie in company's mechanization and philosophy of management and been in efficiency. But being comply with "New Economic age," a new economic environment is full of knowledge and information, the enterprise competition had changed from tangible assets, plants to intangible innovation ability of knowledge. As recognizing the new tendency by enterprise, they value gradually the growth and influence from learning. Practice of organization learning not only needs firm structure and be in coordination with both hardware and software, but also needs an affect measurement model to offer enterprise to estimate learning performance. It's a good instrument of financial performance measure mold in the past years, But it's for measuring the past, couldn't formulate enterprise trend to future, hard to estimate investment for future, such as development of products, organization learning, knowledge management etc, as which intangible assets and knowledge ability just the key factors of being win around competition environment in the future. In 1992, Kaplan and Norton brought up Balance Scorecard (BSC) on Harvard Business Review, as an instrument helping enterprise to measure performance, which is being considered to be a most influence management instrument. It added non-financial index such as customer, internal process and learning growth besides traditional financial index, as offering enterprise an index to measure and manage intangible assets and intellectual property. As being aware of organization learning is hard to be ignored in the new economic age, this research is based on learning and growth of BSC, and citing one national material company try to let the most difficult measurement performance of organization learning, to be estimate through BSC, analyze of factor and individual case, to discuss the company how to make the related strategy and vision of organization learning to develop learning and growth of the structure of BSC, subject the matter of out put factors to be discussed, and measure the outcomes as a result of research. The research affect offers (1) the base implement procedure of carrying out BSC; (2) the reference of formulating measurement index while enterprise using BSC to estimate performance of organization learning; (3) the possibility bottleneck maybe forcing while carrying out BSC, to be an improvement or preventive for enterprise.

• Korean Journal of Radiology
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• 제19권6호
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• pp.1161-1171
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• 2018

Objective: The aim of this study was to investigate diffusion tensor (DT) imaging-derived properties of benign oligemia, true "at risk" penumbra (TP), and the infarct core (IC) during the first 3 hours of stroke onset. Materials and Methods: The study was approved by the local animal care and use committee. DT imaging data were obtained from 14 rats after permanent middle cerebral artery occlusion (pMCAO) using a 7T magnetic resonance scanner (Bruker) in room air. Relative cerebral blood flow and apparent diffusion coefficient (ADC) maps were generated to define oligemia, TP, IC, and normal tissue (NT) every 30 minutes up to 3 hours. Relative fractional anisotropy (rFA), pure anisotropy (rq), diffusion magnitude (rL), ADC (rADC), axial diffusivity (rAD), and radial diffusivity (rRD) values were derived by comparison with the contralateral normal brain. Results: The mean volume of oligemia was $24.7{\pm}14.1mm^3$, that of TP was $81.3{\pm}62.6mm^3$, and that of IC was $123.0{\pm}85.2mm^3$ at 30 minutes after pMCAO. rFA showed an initial paradoxical 10% increase in IC and TP, and declined afterward. The rq, rL, rADC, rAD, and rRD showed an initial discrepant decrease in IC (from -24% to -36%) as compared with TP (from -7% to -13%). Significant differences (p < 0.05) in metrics, except rFA, were found between tissue subtypes in the first 2.5 hours. The rq demonstrated the best overall performance in discriminating TP from IC (accuracy = 92.6%, area under curve = 0.93) and the optimal cutoff value was -33.90%. The metric values for oligemia and NT remained similar at all time points. Conclusion: Benign oligemia is small and remains microstructurally normal under pMCAO. TP and IC show a distinct evolution of DT-derived properties within the first 3 hours of stroke onset, and are thus potentially useful in predicting the fate of ischemic brain.

• Imaging Science in Dentistry
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• 제51권2호
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• pp.117-127
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• 2021

Purpose: The aim of this study was to evaluate the volumetric characteristics of mucous retention cysts(MRCs) in the maxillary sinus and to analyze potential associations of MRCs with dentoalveolar pathologies. Materials and Methods: Cone-beam computed tomography (CBCT) scans exhibiting bilateral maxillary sinuses that were acquired from January 2016 to February 2019 were initially screened. A total of 227 scans(454 sinuses) that fulfilled the inclusion criteria were included. The presence, location, and volumetric characteristics of the diagnosed MRCs were evaluated on CBCT images using the 3D-Slicer software platform. The presence of MRCs was correlated with potential influencing factors including age, sex, and dentoalveolar pathology. For MRCs located on the sinus floor, factors with a potential impact on the volume, surface, and diameter were analyzed. Results: An MRC was present in 130 (28.6%) of the 454 sinuses. Most MRCs were located on the sinus walls and floor. The mean MRC volume, surface, and diameter were 551.21±1368.04 mm³, 228.09±437.56 mm², and 9.63±5.40 mm, respectively. Significantly more sinuses with associated endodontically treated teeth/periapical lesions were diagnosed with an MRC located on the sinus floor. For MRCs located on the sinus floor, endodontic status exhibited a significant association with increased volume, surface, and diameter. Conclusion: Periapical lesions might be a contributing factor associated with the presence and volume of MRCs located on the sinus floor. The 3D-Slicer software platform was found to be a useful tool for clinicians to analyze the size of MRCs before surgical interventions such as sinus floor elevation procedures.