• Perspectives in Nursing Science
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• v.9 no.1
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• pp.51-60
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• 2012

Purpose: The purpose of this study was to develop a self-directed e-learning program for ICU nurses and to evaluate how the proposed e-learning program affects the level of knowledge, nursing performance and job satisfaction of ICU nurses. Methods: The e-learning program was developed with the Computer Assisted Instruction Design Model using sources of self-efficacy which included the inactive attainment, vicarious experience, and verbal persuasion of ICU nurses. The program was evaluated by experts. Following the revision of the program, it was applied to a total of 59 ICU nurses (experimental group n=29, control group n=30) from three hospitals. Four weeks later, we measured the level of knowledge, nursing performance and job satisfaction. Results: The level of knowledge significantly improved in the experimental group (t=5.691, p<.001). Moreover, the level of nursing performance significantly increased in the areas of circulatory diagnostic test (t=2.143, p=.039), EKG (t=2.911, p=.006), aortic balloon pump (t=2.491, p=.017), and nebulizer therapy (t=2.085, p=.044). Overall, job satisfaction did not significantly increase (t=1.664, p=.105); however, job satisfaction in terms of relationships with coworkers (t=2.371, p=.023) and the needs of nursing performance (t=2.940, p=.006) were significantly increased. Conclusion: The results showed that the proposed e-learning program using sources of self-efficacy from ICU nurses was an effective learning method to increase the level of knowledge and nursing performance. The propose de-learning program would be a useful teaching tool for ICU nurses improving the quality of ICU patient care.

• Korean Journal of Biological Psychiatry
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• v.26 no.1
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• pp.1-7
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• 2019

Since non-cardiac chest discomfort (NCCD) can result in substantial healthcare burden and lower quality of life, interventions such as cognitive behavioral therapy (CBT) have been investigated for the relief of NCCD. In this review, we aimed to summarize the evidence on the efficacy of the CBT for the treatment of NCCD while introducing a newly-developed computerized CBT program for NCCD. Studies applying CBT to individuals with NCCD were searched for from both English and Korean electronic databases. Among 37 studies, 11 randomized controlled trials, 4 case-control studies, 1 case series, and 2 review articles were eligible for this review. Efficacy of conventional CBT for NCCD was shown in a series of studies as most of them reported improved symptom severity of NCCD or NCCD-related anxiety. However, a substantial variability existed among these studies in participants, treatment procedures and durations. High attrition rates were also reported in these studies on conventional CBT. Computerized CBT could be an alternative to the conventional CBT as it can be standardized and more easily accessible, but it was only reported in one previous study. In addition to the literature review, we presented a newly-developed computerized CBT program for NCCD which may overcome some of the limitations of conventional CBT. A computerized CBT could be an alternative treatment of NCCD, however, need further studies on its usefulness.

• Journal of Veterinary Clinics
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• v.39 no.1
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• pp.16-22
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• 2022

A 12-year-old spayed female beagle dog was presented with pollakiuria and stranguria. Abdominal ultrasonography identified irregular a marginated, hyperechoic mass in the urethra and trigon area of the bladder. Computed tomography (CT) revealed a heterogeneous mass in the trigone area leading to a urethra. There was no evidence of regional or distant metastasis. Cytologic analysis suspected transitional cell carcinoma (TCC). The patient was treated with piroxicam, mitoxantrone, and once weekly fractionated radiation therapy (RT) with volumetric modulated arc therapy (VMAT). A follow-up CT scan at 6 months after RT revealed a reduction in tumor size. At 17 months after the start of RT, the patient became severely anorectic and lethargic. Ultrasound examination revealed a hyperechoic mass in the apex area of bladder while the trigone area of the bladder and urethra appeared normal. Multiple hypoechoic nodules of various sizes were found in the liver and spleen. The patient was humanely euthanized at the request of the owner. A combination of piroxicam, mitoxantrone, and hypofractionated RT with VMAT protocol was well tolerated. This case described tumor response and survival time of a canine TCC treated with piroxicam, mitoxantrone, and once weekly palliative RT using computer-assisted planning and VMAT.

• Journal of Acupuncture Research
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• v.27 no.2
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• pp.115-121
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• 2010

Objectives : Based on a national sample survey, we present an analysis of the current situation in the use of moxibustion therapeutics by qualified medical practitioners in Korea. Methods : The survey population of 11,737 hospitals is stratified by administrative regions, and 331 of them are randomly selected from the list of hospitals. The same number of Korean medical doctors is interviewed under the computer-assisted telephone interviewing(CATI) system. The bound on the error of estimation is ${\pm}\;5.0%$ point. Results : Of the 331 Korean medical doctors surveyed, 69% have used moxibustion therapy for remedial treatment. About half of those doctors have employed the therapy for their patients over 30%. The average number of acupuncture points per treatment using the therapy mostly ranges 1 between 5. The percent of practitioners, who have the number of average minutes less than 20 in treatment, is 74%. The number of practitioners who primarily use modified moxibustion is 4 times as many as that of those using traditional moxibustion. Conclusions : Considering the survey results, if the laser heater, alternative to conventional moxibustion, which not only gives high thermal effect but also reduces both the users inconvenience and side effects, are developed, it may benefit more patients as well as Korean medical doctors.

• Therapeutic Science for Rehabilitation
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• v.7 no.1
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• pp.79-88
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• 2018

Objective : Conventional therapy approaches for stroke survivors have required considerable demands on therapist's effort and patient's expense. Thus, new robotics rehabilitation therapy technologies have been proposed but they have suffered from less than optimal control algorithms. This article presents a novel technical healthcare solution for the real-time, simultaneous and propositional myoelectric control for stroke survivors' upper limb robotic rehabilitation therapy. Methods : To implement an appropriate computational algorithm for controlling a portable rehabilitative robot, a linear regression model was employed, and a simple game experiment was conducted to identify its potential of clinical utilization. Results : The results suggest that the proposed device and computational algorithm can be used for stroke robot rehabilitation. Conclusion : Moreover, we believe that these techniques will be used as a prominent tool in making a device or finding new therapy approaches in robot-assisted rehabilitation for stroke survivors.

• Radiation Oncology Journal
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• v.35 no.4
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• pp.368-379
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• 2017

Purpose: The purpose of this study was to explore the dosimetric difference between simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) and three-dimensional conformal radiotherapy (3DCRT), and the clinical outcomes of anal squamous cell carcinoma (ASCC) chemoradiotherapy featuring SIB-IMRT. Materials and Methods: This study included ten patients with ASCC who underwent chemoradiotherapy using SIB-IMRT with 5-fluorouracil and mitomycin C. SIB-IMRT delivered 54 Gy to each primary tumor plus metastatic lymph nodes and 45 Gy to regional lymph nodes, in 30 fractions. Four patients received additional boosts to the primary tumors and metastatic lymph nodes; the median total dose was 54 Gy (range, 54 to 60 Gy). We additionally created 3DCRT plans following the Radiation Therapy Oncology Group 9811 protocol to allow dosimetric comparisons with SIB-IMRT. Locoregional control, overall survival, and toxicity were calculated for the clinical outcome evaluation. Results: Compared to 3DCRT, SIB-IMRT significantly reduced doses to the external genitalia, bladder, and intestine, delivering the doses to target and elective nodal region. At a median follow-up time of 46 months, 3-year locoregional control and overall survival rates were 88.9% and 100%, respectively. Acute toxicities were treated conservatively. All patients completed radiotherapy with brief interruptions (range, 0 to 2 days). No patient experienced ${\geq}grade$ 3 late toxicity during the follow-up period. Conclusion: The dosimetric advantages of SIB-IMRT appeared to reduce the toxicity of chemoradiotherapy for ASCC achieving high locoregional control in the extended period.

• Therapeutic Science for Rehabilitation
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• v.12 no.2
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• pp.85-98
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• 2023

Objective : We investigated the efficacy of an artificial intelligence computerized cognitive training program using motion capture to identify changes in cognition, depression, and quality of life in older adults with mild cognitive impairment. Methods : A total of seven older adults (experimental group = 4, control group = 3) participated in this study. During the COVID-19 period from October to December 2021, we used a program, "MOOVE Brain", that we had developed. The experimental group performed the program 30 minutes 3×/week for 1 month. We analyzed patients scores from the Korean version of the Mini-Mental State Examination-2, the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet for Daily Life Evaluation, the short form Geriatric Depression Scale, and Geriatric Quality of Life Scale. Results : We observed positive changes in the mean scores of the Stroop Color Test (attention), Stroop Color/Word Test (executive function), SGDS-K (depression), and GQOL (QoL). However, these changes did not reach statistical significance for each variable. Conclusion : The study results from "MOOVE Brain" can help address cognitive and psychosocial issues in isolated patients with MCI during the COVID-19 pandemic or those unable to access in-person medical services.

• International Neurourology Journal
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• v.22 no.4
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• pp.260-267
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• 2018

Purpose: A major question remaining in approaches to tissue engineering and organ replacement is the role of native mobilized native cells in the regeneration process of damaged tissues and organs. The goal of this study was to compare the cell mobilizing effects of the chemokine CXCL12 and cell therapy on the urinary sphincter of nonhuman primates (NHP) with chronic intrinsic urinary sphincter dysfunction. Methods: Either autologous lenti-M-cherry labeled skeletal muscle precursor cells (skMPCs) or CXCL12 were injected directly into the sphincter complex of female NHPs with or without surgery-induced chronic urinary sphincter dysfunction (n=4/treatment condition). All monkeys had partial bone marrow transplantation with autologous lenti-green fluorescent protein (GFP) bone marrow cells prior to treatment. Labeled cells were identified, characterized and quantified using computer-assisted immunohistochemistry 6 months posttreatment. Results: GFP-labeled bone marrow cells (BMCs) were identified in the bone marrow and both BMCs and skMPCs were found in the urinary sphincter at 6-month postinjection. BMCs and skMPCs were present in the striated muscle, smooth muscle, and lamina propria/urothelium of the sphincter tissue. Sphincter injury increased the sphincter content of BMCs when analyzed 6-month postinjection. CXCL12 treatment, but not skMPCs, increased the number of BMCs in all layers of the sphincter complex (P<0.05). CXCL12 only modestly (P=0.15) increased the number of skMPCs in the sphincter complex. Conclusions: This dual labeling methodology now provides us with the tools to measure the relative number of locally injected cells versus bone marrow transplanted cells. The results of this study suggest that CXCL12 promotes mobilization of cells to the sphincter, which may contribute more to sphincter regeneration than injected cells.

• Proceedings of the Korean Society of Computer Information Conference
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• 2014.07a
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• pp.21-24
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• 2014

본 연구는 뇌손상(뇌졸중, 외상성 뇌손상, 뇌성마비 등)으로 인하여 손의 능동적 움직임이 결여되어 발생하는 관절의 구축, 근육의 단축, 근육의 탄력성 저하 등의 문제점을 분석하여 인체 역학적 모델에 따른 과학적 설계를 기반으로 환자의 손 기능 회복을 위하여 로봇 기술과 스마트폰의 융합을 통한 재활 로봇 보조 치료기를 설계하고 구현하였다. 제안된 시스템은 일반적인 근 경직을 치료하는 방법을 응용하여 IT 기술과 로봇기술을 융합하여 치료사들의 부담을 덜어 주고, 환자들에게 오랫동안 정확한 운동을 반복적으로 할 수 있도록 하는데 목적이 있다. 하나의 구동기로 2자유도의 움직임을 조절 할 수 있는 링크 매커니즘과 링크의 길이를 조절하여 신전(extension)과 과신전(Hyperextension)의 범위 조절이 가능하도록 로봇 플랫폼을 설계하였다. 또한 환자의 재활정도 및 상태에 적합한 운동속도, 운동반복횟수 등을 손쉽게 조작할 수 있는 등의 개인 맞춤형 재활훈련이 가능한 사용자 인터페이스를 설계 및 구현하였다.

• Radiation Oncology Journal
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• v.32 no.1
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• pp.23-30
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• 2014

Purpose: The goal of this study is to determine whether the magnitude of overlap between planning target volume (PTV) and rectum ($Rectum_{overlap}$) or PTV and bladder ($Bladder_{overlap}$) in prostate cancer volumetric-modulated arc therapy (VMAT) is predictive of the dose-volume relationships achieved after optimization, and to identify predictive equations and cutoff values using these overlap volumes beyond which the Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC) dose-volume constraints are unlikely to be met. Materials and Methods: Fifty-seven patients with prostate cancer underwent VMAT planning using identical optimization conditions and normalization. The PTV (for the 50.4 Gy primary plan and 30.6 Gy boost plan) included 5 to 10 mm margins around the prostate and seminal vesicles. Pearson correlations, linear regression analyses, and receiver operating characteristic (ROC) curves were used to correlate the percentage overlap with dose-volume parameters. Results: The percentage $Rectum_{overlap}$ and $Bladder_{overlap}$ correlated with sparing of that organ but minimally impacted other dose-volume parameters, predicted the primary plan rectum $V_{45}$ and bladder $V_{50}$ with $R^2$ = 0.78 and $R^2$ = 0.83, respectively, and predicted the boost plan rectum $V_{30}$ and bladder $V_{30}$ with $R^2$ = 0.53 and $R^2$ = 0.81, respectively. The optimal cutoff value of boost $Rectum_{overlap}$ to predict rectum $V_{75}$ >15% was 3.5% (sensitivity 100%, specificity 94%, p < 0.01), and the optimal cutoff value of boost $Bladder_{overlap}$ to predict bladder $V_{80}$ >10% was 5.0% (sensitivity 83%, specificity 100%, p < 0.01). Conclusion: The degree of overlap between PTV and bladder or rectum can be used to accurately guide physicians on the use of interventions to limit the extent of the overlap region prior to optimization.