• 대한기관윤리심의기구협의회지
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• 제3권1호
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• pp.11-18
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• 2021

Purpose: The purpose of this study is to investigate a satisfaction survey of untact education and platforms that can be used for untact education to provide recommendations on future development of Education of Persons Conducting Clinical Trials. Methods: Online survey was distributed among students who have taken Untact Education of Persons Conducting Clinical Trials. The result was separated according to topic and descriptive statistics was used for analysis. The satisfaction survey used 10-point scale. Results: Of the 1,720 students who received the survey, 1,347 (78.3%) responded to the lecture satisfaction survey. The satisfaction level for broadcasting program (Kakao TV), an untact educational platform for the education of clinical trial workers at Kyung Hee University Medical Center, was relatively high with 8.09±1.99 points. Average score respondents recommending Kyung Hee University Untact Education of Persons Conducting Clinical Trials was 8.03±1.83 and customer recommendation score (Net Promotor Score) was 27.1%. Satisfaction level of the preferred training time was divided into weekday-morning (8-11 AM) (8.16±1.75), weekday-afternoon (12-4 PM) (7.73±2.07), weekday-evening (5-9 PM) (7.78±2.22), and weekend-morning (9-11 AM) real-time untact education (8.48±1.76) and analyzed. There was a noticeable difference between weekend-morning and weekday-afternoon (p<0.0001) and weekend-morning and weekday-evening (p=0.0001) real-time untact education. When asked about conducting education after COVID-19 pandemic ends, 79.2% (1,012 of 1,279) of the respondents answered that they prefer real-time untact education while 20.8 % (266 of 1,279) preferred face-to-face education. Conclusion: Online education, without time and space constraint, is expected to be the mainstream market in Korea for Education of Persons Conducting Clinical. Kyung Hee University Untact Education of Persons Conducting Clinical has achieved above average satisfaction using Kakao TV. Kyung Hee University Real-time Untact Education of Persons Conducting Clinical Net Promotor Score is 27.1%, which is above industry average, communication with trainees should be considered to improve Net Promotor Score.

• 구강회복응용과학지
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• 제37권2호
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• pp.88-94
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• 2021

목적: 대표적인 만성 구강내 염증성 질환인 치주염의 치료에 저온상압 플라즈마의 적용 가능성을 평가해 보고자, 치주 조직내 많이 분포하고 있는 치은섬유모세포에 대한 항염효과를 평가해보았다. 연구 재료 및 방법: 두명의 환자의 구강내에서 건강한 치은조직을 채득하여 primary culture 시행한 후 실험실에서 치은섬유모세포를 계대배양하였다. 세포 실험을 위해 헬륨 가스를 이용하는 저온상압 플라즈마 장치를 제작하였다. 치주염증을 유도하기 위해 Porphyromonas gingivalis (Pg)의 LPS를 처리하고, CCK-8 kit를 통해 세포생존율 평가를 시행하고 염증성 사이토카인인 interleukin (IL)-8, IL-6의 분비정도를 평가하였다. 결과: 인간치은섬유모세포 생존율 평가에서는 Pg LPS를 처리한 군과 플라즈마를 처리한 군, Pg LPS와 플라즈마를 함께 처리한 군 모두에서 생존율이 92.28%에서 100% 사이로 존재하고 통계적으로 유의성은 관찰되지 않았다. 6시간과 24시간 세포배양시간에 따른 세포생존율 차이도 관찰되지 않았다. Pg LPS를 적용하였을 때 대조군에 비해 IL-8과 6의 분비가 증가되었으며, 저온상압 플라즈마의 적용시 그 분비가 통계적으로 유의하게 감소되었다. 결론: 저온상압 플라즈마가 인간섬유모세포의 세포 생존율에 유의한 영향을 끼치지 않았고, 치주염유발 염증성 사이토카인인인 IL-8과 IL-6의 분비를 억제하였다.

• 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.

• 재활치료과학
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• 제10권3호
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• pp.57-69
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• 2021

목적 : 본 연구는 임상지침 중 뇌졸중 환자의 작업치료를 다룬 지침을 확인하고, 확인된 지침들의 질과 특성에 대해 알아보고자 하였다. 연구방법 : 본 연구는 2008년부터 2019년까지 국내·외의 재활 치료 지침을 살펴보았으며, 검색어는 'stroke', 'guideline', 'practice guideline', 'recommendation', 'protocol compliance', 'practice guideline', '뇌졸중 가이드라인', '뇌졸중 지침' 등으로 하였다. 결과 : 검색을 통해 총 708편의 논문이 검색되었고, 자료 선정 기준에 부합한 지침 8편을 최종적으로 선정하였다. 선정된 논문은 캐나다, 미국, 영국, 한국, 호주 등에서 개발한 지침이었으며. 8개의 지침 중 1개는 작업치료 지침이었고, 나머지 7개는 재활치료 지침이었다. 지침에서 다룬 내용을 총 36개의 주제로 분류하였으며, 이 중 호주 뇌졸중 재활치료 지침은 28개, 영국과 미국심장협회(AHA)의 지침은 24개, 한국에서 개발한 뇌졸중 재활치료 지침은 23개 등의 내용을 포함하고 있었다. 결론 : 본 연구에서는 기존의 뇌졸중 환자를 위한 작업치료 지침을 확인하고, 지침들의 질과 특성을 비교해 보았다. 이는 추후 뇌졸중 작업치료 지침 개발을 위한 중요한 기초자료가 될 수 있을 것으로 사료된다.

• 한국컴퓨터정보학회논문지
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• 제27권3호
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• pp.119-126
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• 2022

담석증의 원인으로 잘 알려진 위험 요소는 고령의 나이, 여성성별, 비만, 대사증후군, 제주 이주민이다. 많은 젊은 성인들이 교통이 원활하고 상업 활동이 활발한 제주시에 사는 경향이 있다. 반면에 고령자들은 어업과 농업에 종사하기 때문에 서귀포에 많이 거주하는 경향이 있다. 이주민과 고령자의 비율은 두 지역 거주자의 담석증 유병률에 영향을 미칠 수 있다. 따라서 이 연구의 목적은 제주도 두 지역 거주민들에서 담석증 유병률과 임상적으로 연관된 위험인자들을 비교해 보고자 하는 것이다. 이 연구는 2012년 1월부터 2019년 12월까지 제주도에 소재한 단일 건강검진센터에서 검진을 시행한 13,050명을 대상으로 하였고 거주자들의 주소지에 따라 분석하였다. 제주도 거주민들의 담석증 유병률은 제주시 거주민들에서 5.7%, 서귀포시 거주민들에서 5.8%였다. 다변량 분석에서 연령 (P=0.008), 체질량지수 (P=0.044), 고밀도지질단백질-콜레스테롤 (P=0.006) 및 감마-글루타밀전이효소 (P=0.013)가 담석증에 영향을 미치는 독립적인 요인이었다. 고령, 평균 체질량지수, 감마-글루타밀전이효소 및 낮은 고밀도지질단백질-콜레스테롤은 담석증의 독립적인 위험인자였다. 그러나 거주지는 담석증의 유병률에 영향을 미치지 않았다.

• 구강회복응용과학지
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• 제38권2호
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• pp.71-80
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• 2022

다양한 치과용 도재가 개발되고 있으나 현재 단일구조 보철물로 사용할 수 있는 수준의 기계적, 광학적 성질을 보이는 도재는 반투명 지르코니아와 리튬디실리케이트 결정화유리가 대표적이다. 기계적 성질의 경우 지르코니아가, 광학적 성질은 리튬디실리케이트가 상대적으로 더 우수하다고 알려져 있으나 물성개선을 통해 보다 다양한 증례에 보철물을 적용할 수 있게 되었다. 그 결과 반투명 지르코니아와 리튬디실리케이트 보철물의 적응증이 서로 중복되는 경우가 발생하고 있다. 그러나 두 도재는 유리질(glass matrix) 포함여부뿐만 아니라 강화기전, 탄성계수 등이 서로다르다. 이에 본 문헌고찰에서는 두 단일구조 치과용 도재의 물성을 평가한 다양한 연구결과들을 살펴보고 특히 가공치가 포함된 고정성 보철물의 디자인 시 고려사항에 대해 알아보고자 한다.

• Pediatric Infection and Vaccine
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• 제29권1호
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• pp.28-36
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• 2022

목적: 5-11세 소아에서 코로나19 백신의 효능과 안전성을 평가하기 위해서 체계적 문헌고찰을 시행하였다. 방법: 2022년 1월 4일까지 Ovid-MEDLINE 및 medRxiv를 검색하여 문헌을 선정하고 자료를 추출하였다. 근거 수준을 평가하기 위해 GRADE 도구를 사용하였다. 결과: 총 1,675 건의 연구가 일차적으로 검색되었고 최종적으로 5편의 연구가 포함되었다. 서로 다른 4개의 코로나19 백신(BNT162b2, mRNA-1273, CoronaVac, BBIBP-CorV)에 대한 무작위 대조군 연구 결과들은 5-11세 연령에서 각 백신의 양호한 면역원성과 안전성을 보여주었다. 미국에서 5-11세 소아 연령에서 BNT162b2 백신 접종 후 이상사례 모니터링 연구에서는 승인 전 임상시험을 통해 예상되었던 국소반응 및 전신반응이 보고되었으나 중대한 이상사례는 거의 보고되지 않았다. 결론: 5-11세 연령에서 코로나19 백신 접종에 대한 데이터는 제한적이다. 이 연령에서 코로나19 백신의 안전성과 효과에 대한 체계적인 평가를 위해 지속적이고 포괄적인 모니터링이 필요할 것으로 보인다.

• 대한의용생체공학회:의공학회지
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• 제43권5호
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• pp.341-352
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• 2022

Medical image segmentation is the most important task in radiation therapy. Especially, when segmenting medical images, the liver is one of the most difficult organs to segment because it has various shapes and is close to other organs. Therefore, automatic segmentation of the liver in computed tomography (CT) images is a difficult task. Since tumors also have low contrast in surrounding tissues, and the shape, location, size, and number of tumors vary from patient to patient, accurate tumor segmentation takes a long time. In this study, we propose a method algorithm for automatically segmenting the liver and tumor for this purpose. As an advantage of setting the boundaries of the tumor, the liver and tumor were automatically segmented from the CT image using the 2D CoordConv DeepLab V3+ model using the CoordConv layer. For tumors, only cropped liver images were used to improve accuracy. Additionally, to increase the segmentation accuracy, augmentation, preprocess, loss function, and hyperparameter were used to find optimal values. We compared the CoordConv DeepLab v3+ model using the CoordConv layer and the DeepLab V3+ model without the CoordConv layer to determine whether they affected the segmentation accuracy. The data sets used included 131 hepatic tumor segmentation (LiTS) challenge data sets (100 train sets, 16 validation sets, and 15 test sets). Additional learned data were tested using 15 clinical data from Seoul St. Mary's Hospital. The evaluation was compared with the study results learned with a two-dimensional deep learning-based model. Dice values without the CoordConv layer achieved 0.965 ± 0.01 for liver segmentation and 0.925 ± 0.04 for tumor segmentation using the LiTS data set. Results from the clinical data set achieved 0.927 ± 0.02 for liver division and 0.903 ± 0.05 for tumor division. The dice values using the CoordConv layer achieved 0.989 ± 0.02 for liver segmentation and 0.937 ± 0.07 for tumor segmentation using the LiTS data set. Results from the clinical data set achieved 0.944 ± 0.02 for liver division and 0.916 ± 0.18 for tumor division. The use of CoordConv layers improves the segmentation accuracy. The highest of the most recently published values were 0.960 and 0.749 for liver and tumor division, respectively. However, better performance was achieved with 0.989 and 0.937 results for liver and tumor, which would have been used with the algorithm proposed in this study. The algorithm proposed in this study can play a useful role in treatment planning by improving contouring accuracy and reducing time when segmentation evaluation of liver and tumor is performed. And accurate identification of liver anatomy in medical imaging applications, such as surgical planning, as well as radiotherapy, which can leverage the findings of this study, can help clinical evaluation of the risks and benefits of liver intervention.

• Investigative Magnetic Resonance Imaging
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• 제26권2호
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• pp.104-116
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• 2022

The purpose of this study is to systematically determine an optimal percentile cut-off in histogram analysis for calculating the mean parameters obtained from a non-Gaussian continuous-time random-walk (CTRW) diffusion model for differentiating individual glioma grades. This retrospective study included 90 patients with histopathologically proven gliomas (42 grade II, 19 grade III, and 29 grade IV). We performed diffusion-weighted imaging using 17 b-values (0-4000 s/mm²) at 3T, and analyzed the images with the CTRW model to produce an anomalous diffusion coefficient (D_m) along with temporal (𝛼) and spatial (𝛽) diffusion heterogeneity parameters. Given the tumor ROIs, we created a histogram of each parameter; computed the P-values (using a Student's t-test) for the statistical differences in the mean D_m, 𝛼, or 𝛽 for differentiating grade II vs. grade III gliomas and grade III vs. grade IV gliomas at different percentiles (1% to 100%); and selected the highest percentile with P < 0.05 as the optimal percentile. We used the mean parameter values calculated from the optimal percentile cut-offs to do a receiver operating characteristic (ROC) analysis based on individual parameters or their combinations. We compared the results with those obtained by averaging data over the entire region of interest (i.e., 100th percentile). We found the optimal percentiles for D_m, 𝛼, and 𝛽 to be 68%, 75%, and 100% for differentiating grade II vs. III and 58%, 19%, and 100% for differentiating grade III vs. IV gliomas, respectively. The optimal percentile cut-offs outperformed the entire-ROI-based analysis in sensitivity (0.761 vs. 0.690), specificity (0.578 vs. 0.526), accuracy (0.704 vs. 0.639), and AUC (0.671 vs. 0.599) for grade II vs. III differentiations and in sensitivity (0.789 vs. 0.578) and AUC (0.637 vs. 0.620) for grade III vs. IV differentiations, respectively. Percentile-based histogram analysis, coupled with the multi-parametric approach enabled by the CTRW diffusion model using high b-values, can improve glioma grading.

• 대한기관윤리심의기구협의회지
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• 제4권1호
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• pp.16-22
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• 2022

Purpose: The traditional ethical study only suggests a blurred insight on the research using medical big data, especially in this rapid-changing and demanding environment which is called "4th Industry Revolution." Current institutional/ethical issues in big data research need to approach with the thoughtful insight of past ethical study reflecting the understanding of present conditions of this study. This study aims to examine the ethical issues that are emerging in recent health care big data research. So, this study aims to survey the public perceptions on of health care big data as part of the process of public discourse and the acceptance of the utility and provision of big data research as a subject of health care information. In addition, the emerging ethical challenges and how to comply with ethical principles in accordance with principles of the Belmont report will be discussed. Methods: Survey was conducted from June 3th August to 6th September 2020. The online survey was conducted through voluntary participation through Internet users. A total of 319 people who completed the survey (±5.49%P [95% confidence level] were analyzed. Results: In the area of the public's perspective, the survey showed that the medical information is useful for new medical development, but it is also necessary to obtain consents from subjects in order to use that medical information for various research purposes. In addition, many people were more concerned about the possibility of re-identifying personal information in medical big data. Therefore, they mentioned the necessity of transparency and privacy protection in the use of medical information. Conclusion: Big data on medical care is a core resource for the development of medicine directly related to human life, and it is necessary to open up medical data in order to realize the public good. But the ethical principles should not be overlooked. The right to self-determination must be guaranteed by means of clear, diverse consent or withdrawal of subjects, and processed in a lawful, fair and transparent manner in the processing of personal information. In addition, scientific and ethical validity of medical big data research is indispensable. Such ethical healthcare data is the only key that will lead to innovation in the future.