• 성인간호학회지
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• 제21권6호
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• pp.570-579
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• 2009

Purpose: The aim of this research was to determine knowledge and management of tracheal tube cuffs among nurses of ICU. Methods: This descriptive survey recruited 150 nurses working at 8 different adult ICUs within 2 tertiary hospitals in Seoul. A survey questionnaire was developed to measure cuff management. The internal reliability of the tool was examined by Cronbach's ${\alpha}$. Descriptive statistics and multiple regressions were used to analyze data. Results: Among the 150 nurses, 94.0% replied that they would measure the pressure themselves. With regard to nurses' knowledge about tracheal tube cuffs, only 6% answered that they knew 'the appropriate cuff pressure'. The existence of a measuring device (p < .001), a guideline (p < .001), the level of knowledge on its related complications(p = .003), and clinical experience (p < .001) together accounted for 35.0% of the total variation in cuff management. They pointed out that the lack of time and the lack of education were major barriers to appropriate management; whereas education update was the most imperative factor for good management. Conclusion: ICU nurses have inappropriate knowledge and practice in cuff management. Therefore continuing education is necessary for better practice of tracheal tube cuff management.

• 한국임상약학회지
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• 제23권2호
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• pp.97-105
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• 2013

Background: This study was aimed to establish the systematic management methods of tar color additives used in Korea for drugs and quasi-drugs. Although tar color additives have been used in various areas, safety problems are continuously being reported by several studies. For that reason, major countries like US, Japan, Europe are trying to update the safety information of tar color additives and the related management methods, and Korea also need to complement them based on the updated information for their safer use. Method: This report includes the compared information of all legally used tar color additives of each country, such as color additive name, compound name and chemical abstracts service registry number. Conclusion: It is expected that these investigated results will be useful as the basic materials for proper management guidelines of tar color additives in Korea.

• Clinical and Experimental Pediatrics
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• 제49권6호
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• pp.581-588
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• 2006

Asthma is a chronic inflammation of the airway associated with increased bronchial hyperresponsiveness that leads to recurrent episodes of cough, wheezing, breathless, chest tightness. According the recent studies, repeated airway inflammation leads to structural changes so called 'airway remodeling' and associated with decreased pulmonary function. Airway remodeling begins form the early stage of asthma and the early diagnosis and management is very important to prevent airway remodeling. Medication for asthma can be classified into acute symptom reliever and chronic controller. Short acting beta2 agonist is a well-known reliever that reduced asthma symptoms within minutes. Controllers should be taken daily as a long-term basis to control airway inflammation. Inhaled corticosteroid(ICS) is the most effective controller in current use. However, in some patients ICS monotherapy is not sufficient to control asthma. In those cases, other medications such as long acting beta2 agonist, leukotriene modifier or sustained-release theophylline should be added to ICS, which called Add-on-Therapy. Combination inhaler devices are easy to use. Oral leukotriene modifier has a good compliance especially in children. Finally, as asthma is a chronic disease, the development of on-going partnership among health care professionals, the patients, and the patients' family is necessary for the effective management of asthma.

• 한국임상약학회지
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• 제27권2호
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• pp.113-118
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• 2017

Objective: International institutes such as Global institute for Asthma(GINA), KAAACI(Republic of Korea), NHLBI(USA), BTS(UK) and JSA(Japan) have published guidelines for asthma treatment. The aim of this study was to compare the representatives' international guidelines of pharmacotherapy for pediatric asthma. Methods: The recommendations related to pharmacotherapy for pediatric asthma were extracted from the latest representatives' international guidelines, and comprehensive comparisons were conducted. Results: Major comparison outcomes between international guidelines were evaluated as follows: classification system on severity and pediatric age group, recommendation for inhaled corticosteroid dose, recommendation for pediatric age group of theophylline in mild asthma, and recommendation for pediatric age group of tiotropium in severe asthma. Clinical trials emphasized the adverse effects of theophylline, whereas tiotropium demonstrated beneficial actions for pediatric asthma. Therefore, theophylline was recommended for older patients with persistent asthma, and tiotropium was considered to be suitable for younger patients with severe asthma according to GINA guidelines. Conclusion: These findings address the requirement to harmonize international guidelines of pharmacotherapy in pediatric asthma. In addition, the findings suggest that KAAACI needs to update its pharmacotherapy guidelines of theophylline, tiotropium and other medicines recently approved.

• 한국ITS학회 논문지
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• 제11권4호
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• pp.19-33
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• 2012

그동안 교통시스템은 지역간 교통수단과 지역내 교통수단의 연계체계가 미흡하고 공항, 철도역, 터미널과 같이 다양한 교통수단이 연계되는 대형 교통결절점의 경우 이용자 관점에서의 시설운영이 미흡했다. 국토해양부에서는 "국가통합교통체계효율화법(이하 법)"을 전부 개정하여 연계교통체계를 고도화하기 위한 방안들을 마련하였는데, 그 중 핵심사항이 복합환승센터의 개발이다. 복합환승센터는 대중교통 중심의 복합수단 교통연계환승체계를 기반으로 문화 업무 상업 등의 다양한 기능이 어우러진 교통시설이라 할 수 있다. 복합환승센터 관련 법 지침에서 이용자의 환승편의성 향상을 위해 환승정보안내시설 설치 운영을 의무화 하고 있다. 그러나 이용자 서비스와 관련된 환승지원정보시스템 구축방안, 제공 서비스 내용, 세부서비스에 대한 이용자 선호도 등 참고할 수 있는 연구는 미비한 실정이다. 이에 본 연구에서는 김포공항에 적용된 복합환승센터 환승지원정보시스템을 기반으로 시범운영 과정에서 수행된 환승지원정보서비스에 대한 이용자 서비스 만족도 조사를 통해 서비스 선호분석, 제공 정보별 중요도, 서비스 만족도, 서비스 구현 시 고려사항 등을 제시하였다. 또한 환승지원정보서비스 중 이용자의 상황과 교통수단 운행현황 등에 대응하여 개인 맞춤형 정보를 제공하는 스마트환승정보서비스의 가치를 조건부가치측정법(CVM)으로 평가하여 복합환승센터 환승지원시설에 대한 투자를 효과적으로 추진할 수 있는 기초자료로 제공하고자 한다.

• Environmental Analysis Health and Toxicology
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• 제22권1호
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• pp.91-101
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• 2007

The new chemicals are developed and circulated without the verified toxicity data. So, the accidents and occupational diseases, such as explosion, fire, suffocation about deadly poisons etc. are frequently to workers. Classifications of chemicals suited with guideline and an offer of correct chemical information data are the molt important thing for the establishment of suitable chemical management system. The GHS (Globally Harmonized System of classification and labeling of chemicals) is based with the chemical classifications and unification plan. The warning symbol and phrases are established for improvements of chemical information data system. According to these unified and improved systematic form of data, and the chemical information data, the workplaces will be presented many chemical safety and risk data correctly. In this paper, we will present constructions and accomplishment contents-based chemical management of workplace through development of chemical information data and the nice using for new chemical investigation and risk assessment of chemicals in workplaces.

• Clinical and Experimental Pediatrics
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• 제64권11호
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• pp.559-572
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• 2021

The International Society for the Study of Vascular Anomalies classifies vascular anomalies into vascular tumors and vascular malformations. Vascular tumors are neoplasms of endothelial cells, among which infantile hemangiomas (IHs) are the most common, occurring in 5%-10% of infants. Glucose transporter-1 protein expression in IHs differs from that of other vascular tumors or vascular malformations. IHs are not present at birth but are usually diagnosed at 1 week to 1 month of age, rapidly proliferate between 1 and 3 months of age, mostly complete proliferation by 5 months of age, and then slowly involute to the adipose or fibrous tissue. Approximately 10% of IH cases require early treatment. The 2019 American Academy of Pediatrics clinical practice guideline for the management of IHs recommends that primary care clinicians frequently monitor infants with IHs, educate the parents about the clinical course, and refer infants with high-risk IH to IH specialists ideally at 1 month of age. High-risk IHs include those with life-threatening complications, functional impairment, ulceration, associated structural anomalies, or disfigurement. In Korea, IHs are usually treated by pediatric hematology-oncologists with the cooperation of pediatric cardiologists, radiologists, dermatologists, and plastic surgeons. Oral propranolol, a nonselective beta-adrenergic antagonist, is the first-line treatment for IHs at a dosage of 2-3 mg/kg/day divided into 2 daily doses maintained for at least 6 months and often continuing until 12 months of age. Topical timolol maleate solution, a topical nonselective beta-blocker, may be used for small superficial type IHs at a dosage of 1-2 drops of 0.5% gel-forming ophthalmic solution applied twice daily. Pulse-dye laser therapy or surgery is useful for the treatment of residual skin changes after IH involution.

• 대한비뇨기종양학회지
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• 제16권3호
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• pp.89-96
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• 2018

Upper tract urothelial carcinoma (UTUC) has a relatively low prevalence rate of about 1.8 per 100,000 people. According to the recent literature, the development of diagnostic techniques has gradually increased the prevalence and diagnosis rate. In the past, when UTUC was diagnosed, more than 60% of the patients were diagnosed as locally advanced or metastatic cancer. However, since 2010, approximately 70% of the patients have been diagnosed as operable stage. Although radical nephroureterectomy is known as the basis of treatment for UTUC, overall survival is poor in patients with lymph node invasion. Especially, the finding that a localized UTUC is associated with a high risk of cancer metastasis in approximately 50% of patients suggests that these patients may not have sufficient treatment through surgery alone. The European Association of Urology and the National Comprehensive Cancer Network guideline 2017 suggested that postoperative adjuvant chemotherapy may be considered in patients with advanced UTUC beyond pT2. Also, recent meta-analyses have reported that cisplatin-based adjuvant chemotherapy can be expected to have a synergistic effect of overall survival and disease-free survival. However, many patients with UTUC undergo postoperative renal failure, which may result in failure to perform cisplatin-based adjuvant chemotherapy with adequate dose. For this reason, several researchers have suggested that it is beneficial to apply neoadjuvant chemotherapy when the preoperative renal function is maintained to a certain extent. But, neoadjuvant chemotherapy has not been used by many clinicians because of the lack of studies and the rarity of the disease. We are currently discussing the outcomes and prospects of perioperative chemotherapy.

• 한국터널지하공간학회 논문집
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• 제17권3호
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• pp.237-242
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• 2015

현대사회가 빠르게 발전함에 따라 지하철은 도시의 대표적인 이동수단으로 발전해왔다. 그러나 2003년 대구지하철 화재사고를 통하여 지하철의 인명안전과 방재의 중요성 인식되었으며, 현재까지 많은 연구가 진행되어 왔다. 특히 지하철 전동차 내장재의 난연화 불연화와 승강장의 스크린 도어 및 안내표시 등이 대표적 결과라고 볼 수 있으나, 지하철 대피기준에 대한 연구의 진행은 미진하다. 이에 본 연구에서는 지하철 대피기준 개선의 기초연구를 진행하였다. 그러나 복잡하고 다양한 지하철 전체를 대상으로 하기에는 어려움이 있어, 기존의 연구 중 승강장을 유형화 한 연구를 참고하여 개찰구를 유형화 하였다. 기존 연구의 지하철 역사 승강장의 유형 10개와 본 연구의 개찰구의 유형 8개를 정리하여, 1~4호선 지하철 역사 중 가장 많은 유형을 선정하여 대피 시간을 계산하였다. 대피시간 계산결과가 지하철의 대피 기준 시간 6분을 초과하는 것으로 나타남에 따라 지하철 대피 시간에 대한 기준을 개선하거나 추가적인 조건이 필요하다고 판단되었다. 따라서 지하철 역사에 안전을 위한 시설 및 방재대책이 요구된다.

• 한국산업보건학회지
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• 제19권4호
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• pp.347-362
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• 2009

The United Nation agreed to adopt the Globally Harmonized System of Classification and Labelling of Chemicals (GHS) until 2008 to solve the significant differences enough to result in different labels or MSDS for the same chemical in different jurisdictions. Though the GHS is an ideal solution in the respect of pursuing only one format of a MSDS throughout the world, it may cause confusion at the beginning due to lack of information. So the Korean Ministry of Labor (MOL) revised the Industrial Safety and Health Act (ISHA) and related public notice on the classification & labelling of chemicals according to the GHS in 2006. The transition period for the implementation of the GHS for substances was set until Jun 30, 2010, and for mixtures until Jun 30, 2013. To promote the implementation of the GHS in Korea, we developed an application program for constructing MSDS database and a management program for providing MSDS contents on the web in accordance with the GHS. We analyzed the sixteen sections of MSDS by the GHS guideline, and the result showed the necessity to construct logically connected DB for chemical identifier, hazard classification, label, standard phrases and regulatory information. Each section of a MSDS was divided into sub-databases to update the database efficiently. According to Relational Database Management System (RDBMS), the sub-databases were automatically assembled and subsequently a full MSDS is produced. At present, MSDS database for 6,314 substances has been built and provided through internet as the MSDS Editing program. During the service period from January 1 to March 31, 13,666 users have searched MSDSs for 33,401 substances. During program review, some comments about the classification results and other MSDS element sources were reported but no technical bug reported. We expect that the MSDS DB management system in accordance with GHS will accelerate the implementation of the GHS in Korea.