• Archives of Plastic Surgery
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• 제34권6호
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• pp.697-704
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• 2007

Purpose: The objective of the study is to identify plastic surgeons' views on the effects of online communication between doctors and patients.Methods: Cross-sectional online survey of members of the Korean Society of Plastic and Reconstructive Surgeons was made to identify their evaluation on the accuracy and the relevance of the internet health information and their perceptions of the effects of discussing the information with the patients on time-efficiency, requests for specific interventions, health outcomes, and the doctor-patient relationship. A questionnaire with 25 items was sent to the surgeons' e-mails, and 111 replied. SPSS Win version 12.0 was used to analyze the statistical differences and meanings among data.Results: The percentage of the plastic surgeons who were experiencing the online communication was 65.8%, and the most frequent medium used was homepage of the clinic/hospital. Even though the percentage of the plastic surgeons who were using the online communication for their everyday practice was high, the percentage of patients who visited the clinic/hospital after using the website of the clinic/hospital was relatively low. The effects of online communication on doctor-patient relationship were neutral in 40(36.0%) and positive in 39(35.1%). The effects on the efficiency of the practice was positive in 45(40.5%), and the effects on the quality of care and the patients' outcome were positive in 46(41.4%) respectively.Conclusion: The ratio of surgeons who are experiencing the online communication is relatively high, whereas the ratio of patients who are using online communication is low. Most of plastic surgeons are positive on the effects of the online communication on doctor-patient relationship, quality of care, and patients' outcome.

• 정보화정책
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• 제18권1호
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• pp.24-44
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• 2011

지난 몇 년간 클라우드 서비스의 혁신은 IT발전에 기여한 가장 큰 잠재력을 가진 기술 중에 하나이다. 그러나 클라우드 서비스의 잠재력을 발휘하기 위해서는 서비스 제공자와 소비자관점에서 다양한 이슈들에 대한 명확한 정의와 이해가 필요하다. 현재의 클라우드 관련 연구들은 기술 자체에 중점을 두고 있으나, 클라우드 서비스를 둘러싸고 있는 비즈니즈 측면에서의 이슈들에 대한 이해도 시급하다. 점점 더 많은 개인과 기업의 정보들이 클라우드 서비스에 놓이게 되면, 주된 관심은 어떻게 안전하고 신뢰할 수 있는 클라우드 서비스를 제공할 것인가에 맞추어지게 된다. 따라서 성공적인 클라우드 서비스를 위해서는 클라우드 서비스의 안전성과 신뢰성을 보증할 수 있는 인증제도의 수립이 필요하다. 본 논문에서는 안전하고 신뢰할 수 있는 클라우드 서비스를 위한 인증제도의 프레임워크를 개발한다. 이를 위하여 클라우드 서비스 품질과 인증과 관련된 핵심 이슈들을 식별하고, 클라우드 서비스 영역과 클라우드 서비스 제공자 영역의 인증제도를 위한 시스템적인 프레임 워크를 개발한다. 또한 개발된 인증제도의 평가방안도 제안한다.

• 한국영어학회지:영어학
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• 제3권1호
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• pp.37-54
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• 2003

본 논문에서는 문장의 어떤 구성성분을 앞으로 이동한 후 주어-동사의 표준어순으로 나타나는 전치문과 동사-주어의 비표준어순으로 나타나는 도치문에 대하여 각각의 통사적 특징과 담화 화용론적 기능을 살펴보고, 전치문과 도치문을 비교하여 그 차이점과 공통점을 알아보았다. 다양한 구성요소의 이동에 따라 명사구 전치, 전치사구 전치, 형용사구 전치, 동사구 전치, 분사구 전치 등으로 구별되어 고려되어왔던 다양한 전치문들을 주제화라는 하나의 통합된 규칙으로 설명하였으며, 모든 전치 구성성분은 현 담화를 이전담화에 연결시키며, 이전 담화로부터 주어진 요소임과 동시에 현 담화의 틀을 제공한다는 점에서 그 문장 또는 그 담화의 주제라고 보았다. Ward(1990)가 논의한 동사구 전치의 네 가지 기능, 즉 독립적 명제확인, 양보적확인, 정도확인, 명제유보의 기능을 하나로 일반화하여 주제에 대한 논평을 첨가하는 ‘주제+논평’ 구조로 보았다. 전치와 후치를 모두 포함하고 있는 도치문에서 전치되는 요소들은 문장 또는 담화 내에서 구정보를, 후치된 성분은 신정보를 표시한다. 즉, 문장요소의 담화상의 친숙도가 이동하는 구성성분의 문장내의 위치를 결정하는데 결정적이다. 도치문에서 전치된 요소는 문장 내에서 ‘실용’, ‘연결’, ‘강조’, ‘소개’ 등의 다양한 기능을 하는데 이를 전치성분은 후치된 명사구를 이전 담화에 명시적으로 나타났거나 추론가능한 정보와 연결하는 ‘연결’기능을 하는 것으로 설명하였다. 전치문과 도치문은 이전 담화와 어떻게든 연결관계를 갖는다는 것이 공통적인데, 전치문에서 전치요소는 절대적인 구정보를 표시하나, 도치문에서는 담화상 상대적 구정보를 표시하기만 하면 된다. 이것으로 화자가 발화시 전치시키는 요소는 그 요소가 청자의 지식 내에서 어떤 정보상태에 있다고 화자가 평가하는가에 따라 전치문을 선택할지 도치문을 선택할지가 결정됨을 알 수 있다.

• Journal of Ecology and Environment
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• 제44권3호
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• pp.162-177
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• 2020

Background: Ecologists have achieved much progress in the study of mechanisms that maintain species coexistence and diversity. In this paper, we reviewed a wide range of past research related to these topics, focusing on five theoretical bodies: (1) coexistence by niche differentiation, (2) coexistence without niche differentiation, (3) coexistence along environmental stress gradients, (4) coexistence under non-equilibrium versus equilibrium conditions, and (5) modern perspectives. Results: From the review, we identified that there are few models that can be generally and confidently applicable to different ecological systems. This problem arises mainly because most theories have not been substantiated by enough empirical research based on field data to test various coexistence hypotheses at different spatial scales. We also found that little is still known about the mechanisms of species coexistence under harsh environmental conditions. This is because most previous models treat disturbance as a key factor shaping community structure, but they do not explicitly deal with stressful systems with non-lethal conditions. We evaluated the mainstream ideas of niche differentiation and stochasticity for the coexistence of plant species across salt marsh creeks in southwestern Denmark. The results showed that diversity indices, such as Shannon-Wiener diversity, richness, and evenness, decreased with increasing surface elevation and increased with increasing niche overlap and niche breadth. The two niche parameters linearly decreased with increasing elevation. These findings imply a substantial influence of an equalizing mechanism that reduces differences in relative fitness among species in the highly stressful environments of the marsh. We propose that species evenness increases under very harsh conditions if the associated stress is not lethal. Finally, we present a conceptual model of patterns related to the level of environmental stress and niche characteristics along a microhabitat gradient (i.e., surface elevation). Conclusions: The ecology of stressful systems with non-lethal conditions will be increasingly important as ongoing global-scale climate change extends the period of chronic stresses that are not necessarily fatal to inhabiting plants. We recommend that more ecologists continue this line of research.

• Journal of Korean Neurosurgical Society
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• 제58권3호
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• pp.236-241
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• 2015

Objective : We report on the technical feasibility and limitations of the transmanubrial approach for cervicothoracic junction (CTJ) lesions and emphasize the advantage of bisecting the upper part of the manubrium in an inverted Y-shape. Methods : Thirteen patients who underwent the fourteen transmanubrial approach for various CTJ lesions were enrolled during 2005-2014. For the evaluation of the accessibility for the CTJ lesion, we analyzed the two parallel line defined as a straight line parallel to the inferior and superior plateau of the upper and lower healthy vertebrae, the angle of the two parallel lines and the distance from the sternal notch to lines at the sternum on preoperative magnetic resonance images. Surgical limitations and perspectives, as well as postoperative clinical outcomes were evaluated retrospectively. Results : The CTJ lesions were six metastases, three primary bone tumors, two herniated discs, and one each of a traumatic dislocation with syrinx formation and tuberculous spondylitis and ossification of the posterior longitudinal ligament. If two parallel lines pass below the sternal notch, the manubriotomy should be inevitably performed. The mean preoperative Visual analogue scale score was 8 (range, 5-10), which improved to 4 (range, 0-6) postoperatively. Seven cases showed an increase in Frankel score postoperatively. Conclusion : The spatial relationship between the sternal notch and the two parallel lines to the lesion was rational to determine the feasibility of manubriotomy. The transmanubrial approach for CTJ lesions can achieve favorable clinical outcomes by providing direct decompression of lesion and effective reconstruction.

• 한국초등수학교육학회지
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• 제18권2호
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• pp.341-355
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• 2014

이 연구는 2004년부터 2013년까지 일본수학교육학회 발행의 학술지 '산수교육'에 게재된 논문 196편을 분석 대상으로 하여 일본의 초등수학교육의 연구 동향을 제시하고, 이러한 분석결과를 토대로 우리나라 초등수학교육의 다양하고 균형 있는 연구를 위한 자료를 제공하는데 목적을 두고 수행하였다. 일본의 초등수학교육의 연구 동향을 분석한 결과는 다음과 같다. 논문의 분석 기준에 따라 연구주제로는 '수업설계 및 방법' (36.7%)이, 내용영역별로는 '수와 연산' (47.4%)이, 학년을 기준으로 하면 5, 6학년인 고학년 (21.4%)이 각 조사 영역에서 활발하게 연구되고 있었다. 특징적인 것으로 학술지 '산수교육'에서는 영재아와 부진아에 대한 연구는 찾을 수 없었고 장애아에 대한 연구 (1.0%)는 극소수 이루어지고 있었다.

• Perspectives in Nursing Science
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• 제15권1호
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• pp.29-40
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• 2018

Purpose: The present study aimed to review the characteristics of cognitive behavioral therapy (CBT) programs for alcohol use disorders and to examine the outcomes of such programs. Methods: We searched for domestic and foreign studies that implemented a CBT program for alcohol use disorders, published from 2006 to 2017. Studies that met inclusion/exclusion criteria were selected and a quality assessment was performed using the Risk of Bias (RoB) and Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS) instruments. We utilized a five-stage analysis process, through which nine experimental studies were selected. Results: Of these nine studies, four were randomized controlled trials, four used a quasi-experimental design, and one used a qualitative design. The CBT involved the three domains of cognitive reconstruction, problem solving, and coping. Coping with drinking situations and communication constituted most of the sessions. The outcomes of such interventions showed that CBT had a positive effect on alcohol use and self-evaluation. Conclusion: CBT is an effective way to change alcohol use behaviors, motivation, interpersonal relationships, emotional control, and self-efficacy among patients with alcohol use disorders. This study provides evidence for the effectiveness of CBT-based programs for the treatment of alcohol use disorders.

• Journal of Chest Surgery
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• 제51권4호
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• pp.231-240
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• 2018

Background: Analyses of the efficacy and safety of transcatheter aortic valve replacement (TAVR) in most countries have been based on outcomes obtained in accordance with national practice guidelines and monitoring protocols. The purpose of this study is to share our experience regarding the process for establishing guidelines and monitoring protocols for the use of TAVR in Korea, in the hopes that it may be helpful to others undergoing a similar process in their own country. Methods: The Korean guidelines for TAVR were established on June 1, 2015 in through a tri-party agreement involving the Department of Health and Welfare, the Korean Society of Thoracic and Cardiovascular Surgery and the Korean Society of Cardiology. We agreed to monitor the guidelines transparently and to exchange opinions regarding amendments or continuation of its contents after 3 years of monitoring. Results: The monitoring meetings were not held as regularly as agreed, and monitoring was also made difficult by insufficient and incomplete data. Nevertheless, during the meetings, measures to improve the monitoring process were discussed, and accordingly, an agreement was made to continue the monitoring process, with the aim of completing data collection by 2018. Conclusion: Compliance with guidelines is critical for assessing the efficacy and safety of TAVR. Moreover, the TAVR monitoring process must be properly conducted for an accurate evaluation to be made. Any country planning to introduce TAVR may encounter difficulties with regards to the optimal initiation strategy and subsequent monitoring. Nevertheless, continued efforts should be made to persuade the government and the corresponding medical societies to facilitate the optimal application of TAVR.

• 한국임상약학회지
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• 제20권3호
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• pp.193-199
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• 2010

Tacrolimus, an immunosuppressant prescribed against graft-versus-host disease (GVHD) in patients with allogeneichematopoietic stem cell transplantation (HSCT), is affected to change its pharmacokinetic properties by various factors. For this reason, it is needed a close monitoring to adjust dosage amount in order to optimize the blood concentration of tacrolimus is located within the effective range. According to our in-house study, 62% of HSCT-patients were needed dosage-adjustment and it is necessary to optimize the current immunosuppressive regimen in clinical settings. A retrospective study was designed to evaluate the dosing regimen (converting ratio of IV:PO=1:4) of tacrolimus in HSCT patients (n=62). After collecting data from patient's profile and medical record, pharmacokinetic parameters were calculate and compared between the estimated and the actual values in the selected subjects (n=58). It was found that the bioavailabilty (BA) of oral tacrolimus was 40.5% very much different from that is known as 25%. It implies that the current protocol has a potent risk causes dose-related toxicities to the patients. Furthermore, analyses among factors demonstrated that there was no statistical significance between BA of tacrolimus and the variable factors. In the clinical perspectives, the current converting ratio of tacrolimus in patients with HSCT to be re-considered and an appropriate and optimal alternative regimen should be adopted to prevent GVHD and to increase the quality of life of patients.

• 한국임상약학회지
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• 제26권3호
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• pp.245-253
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• 2016

Objective: This study was conducted to evaluate payer-driven medication adherence intervention program from the patient's and counselor's perspectives. Methods: Target patients for intervention were selected by retrospective adherence measures based on national health insurance claims data for hypertension, diabetes and hyperlipidemia. As a serial intervention for higher risk groups of medication non-adherence, initial direct mailing, the first direct telephone call and the second direct call or a home visit were followed. Interview approach to qualitative inquiry was used to evaluate intervention results. Results: Participants including 4 patients received telephone calls, and 4 National Health Insurance Service staff and 4 pharmacists participated as counselors were interviewed regarding their impression of the intervention program. Three major themes arose: overall perception; necessities; and suggestions for success, of the intervention. Despite short period of intervention, educational intervention by telephone counseling involving pharmacists shows potential to improve self-management of chronic disease, and pharmacist-involvement. But more sophisticated selection of target patients requiring the intervention and complementation of electronic database system would be necessary. In addition, personal disposition of counselor was revealed to be an important factor for achieving successful outcome of intervention. Conclusion: The findings suggest that the individualized counseling intervention would be an efficient option for improved medication adherence. Further researches should include longer periods of interventions, a quantitative analysis using adherence measures based on claims data and consideration of clinical benefits associated with the intervention.