• Journal of Chest Surgery
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• 제48권4호
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• pp.289-293
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• 2015

A 38-year-old male was admitted with symptoms of upper respiratory infection. Despite medical treatment, his symptoms of dyspnea and anxiety became aggravated, and bilateral lung infiltration was noted on radiological imaging studies. His hypoxemia failed to improve even after the application of endotracheal intubation with mechanical ventilator care, and we therefore decided to initiate venovenous extracorporeal membrane oxygenation (VV ECMO) for additional pulmonary support. On his twentieth day of hospitalization, hypotension and desaturation (arterial saturated oxygen <85%) developed, and right ventricular failure was confirmed by two-dimensional echocardiography. Therefore, we changed from VV ECMO to venoarteriovenous (VAV) ECMO, and the patient ultimately recovered. In this case, right ventricular dysfunction and volume overloading were induced by long-term VV ECMO therapy, and we successfully treated these conditions by changing to VAV ECMO.

• Journal of Korean Neurosurgical Society
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• 제29권12호
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• pp.1612-1619
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• 2000

Objective : To retrospectively analyse the surgical outcome and efficacy of the lumbar spinal surgery in sixty to older patients who failed to conservative treatments. Methods : Between July 1990 and November 1996, the authors retrospectively investigated the medical records of 46 patients who over 60 years of age at the time of surgery. The clinical severity was assessed with Prolo's grade(economic and functional). Questionnaire was sent to each patient regarding long-term effect, satisfaction, and side effects. Results : In 46 patients, 2 patients(1 case died of lung cancer, 1 case lost in follow-up) were lost. Among 44 patients (28 men, 16 women ; mean age 64 years), 22 patients underwent partial or total laminectomy, 17 spinal fusion with instruments, 2 chemonucleolysis, 2 adhesiolysis for failed back surgery syndrome, and 1 automated percutaneous lumbar discectomy. Although postoperative complications were observed in 5 patients, they were successfully managed. No deaths were documented in the perioperative periods. The average Prolo's economic and functional grade improved from 2.98 to 3.48 and 2.81 to 3.75, respectively. Conclusion : In overall, the favorable surgical outcome was obtained. This results indicated that with appropriate preoperative selections and indications, careful intraoperative monitoring, and attentive postoperative care, the surgical treatment of eldery patients for the lumbar spinal disorders, significant improvement with acceptable levels of morbidity and mortality can be achived.

• 대한간호학회지
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• 제50권2호
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• pp.298-312
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• 2020

Purpose: This study had two objectives: 1) to develop a scale for the process of exercise engagement (SPEE) for prediabetic individuals (PDIs); 2) to validate a structural model for the process of exercise engagement for PDIs. Methods: A cross-sectional survey with simple random sampling was conducted from September 2013 to December 2015 (in Taiwan). A total of 310 PDIs were enrolled for scale development and model validation via item analysis, factor analyses, and structural equation modeling. The Kuo model was used as the basis for developing the Chinese version of the SPEE for PDIs. Results: The SPEE contains five subscales with a total of twenty-one items that account for 54.9% to 65.9% of the total variance explained for assessing participants' process of engagement during exercise. For Kuo model validation, the model measures indicated goodness of fit between the Kuo model and sample data. Analysis further revealed a direct effect between the creating health blueprints (CHB) stage and the spontaneous regular exercise (SRE) stage (β=.60). Conclusion: The SPEE includes five subscales for assessing the psychological transition and behavioral expression at each stage of the process of exercise engagement for PDIs. The SPEE for people with prediabetes provides deeper insights into the factors of behavioral change stages that are required to initiate long-term health care outcomes and avoid developing diabetes. These insights are significant as they allow for patient-specific mapping and behavior modification to effect exercise.

• Journal of Periodontal and Implant Science
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• 제37권2호
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• pp.287-295
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• 2007

As a general treatment modality of subgingival tooth defect in aethetic area, implant or crown and bridge therapy after extraction of affected tooth can be used. But as more conservative treatment, crown lengthening can be considered and not to lose periodontal attachment and impair aethetic appearance, surgical extrusion can be considered as a treatment of choice. In this case report, 3 cases of surgical extrusion was represented and appropriate time for initiation of endodontic treatment according to the post-surgical tooth mobility was investigated. In 8 patient who has subgingival tooth defect in aethetic area, intracrevicular incision is performed and flap was reflected with care not to injure interproximal papillae. With forcep or periotome, tooth was luxated and sutured in properely extruded position according to biologic width with or without $180^{\circ}$ rotation. 8 cases show favorable short and long term results. In some cases, surgical extrusion with $180^{\circ}$ rotation can minimized extent of extrusion and semi-rigid fixation without apical bone graft seems to secure good prognosis. In 8 cases, endodontic treatment started about 3 weeks after surgery. This time corresponds with the moment when mobility of extruded tooth became 1 degree and this results concide with other previous reports. If it is done on adequate case selection and surgical technique, surgical extrusion seems to be a good treatment modalilty to replace the implant restoration in aethetic area.

• 한방안이비인후피부과학회지
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• 제33권3호
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• pp.99-114
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• 2020

Objectives : To investigate treatment approaches of psoriasis, and to provide universal and holistic standards to assist in optimizing patient care and future research. Methods : Review articles of psoriasis regarding pathophysiology, risk factor or treatment were searched from Pubmed (January 2016 to June 2020). Treatment approaches were investigated based on the searched articles. Additional data collecting was done for further discussion by searching Pubmed and Google scholar with keywords relevant to the approaches, and the relevant references of articles retrieved were manually inspected to be included. Results : Modalities to directly regulate the relevant helper T cell or inflammatory cytokines can constitute the treatment approaches of psoriasis. Modalities to treat gastrointestinal tract inflammation, to correct metabolic syndrome and to improve epidermal lipid abnormality via whole body lipid metabolism can also constitute the treatment approaches of psoriasis. Probable adverse effects of long term use of western medication should be addressed carefully, and alleviating the hazards of western medication can be a treatment approach of psoriasis. Conclusion : Treatment of psoriasis should take account of systemic aspects such as gastrointestinal tract and lipid metabolism. Treatment approaches of psoriasis established on the pathophysiological basis can serve as universal standards.

• 한방재활의학과학회지
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• 제29권4호
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• pp.89-100
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• 2019

Objectives We are going to analyze patient's medical and Korean medicine use trends after lumbar surgery, and examine the percentage of use of Korean medicine after surgery and its relevance to the medical care outcome after lumbar surgery. Methods Using 3% patients' sample data of the Health Insurance Review and Assessment Service, two groups were compared the treatment progress of the Korean Medicine treatment group and the untreated group after lumbar surgery by hierarchical logistic regression analysis. After hierarchical logistic regression analysis(including propensity scores), two groups were compared after lumbar surgery, the Korean Medicine treatment group within 50days and untreated group within 50days. Results Lumbar surgery was performed in 2750 patients in 2015. It was 3.72 that the risk(odds ratio) of finished treatment of patients treated without Korean Medicine, compared to patients with Korean Medicine. It was 0.12 that the risk of continuing treatment(odds ratio) of patients treated with Korean Medicine within 50 days, compared to patients treatment more than 50 days. Conclusions The ratio of Korean Medicine treatment after lumbar surgery was 14.8%. The group that did not have Korean Medicine showed a higher possibility of treatment termination than the group who did not. Among the groups treated with Korean Medicine, the early treatment group was more likely to end treatment than the late treatment group. Considering various situations in the medical environment, further studies such as prospective studies and long-term data analysis are considered to be necessary.

• 한국컴퓨터정보학회논문지
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• 제19권11호
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• pp.149-157
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• 2014

당뇨병은 급성합병증을 예방하고 장기간의 합병증의 위험도를 감소하기 위하여 지속적인 치료와 환자 자가 관리 교육이 필요한 만성질환이다. 또한 전 세계적으로 당뇨병에 대한 유병률과 사망률이 대부분의 인구집단에서 역학적 비율에 도달하였다. 많은 연구에서 당뇨병에 대한 조기진단은 적절한 치료와 생활습관을 지키는 관리를 통하여 발병을 예방하는데 도움을 줄 수 있으며, 이를 통하여 당뇨병의 합병증을 감소시키고 생존률을 향상시킬 수 있다고 보고하고 있다. 본 연구는 PIMA Indians 당뇨 데이터에 대하여 mixture of expert 모형을 적용하여 당뇨유병환자의 여부를 분류하고, 이를 로지스틱 회귀분석, 신경망분석의 성능과 비교함으로서 그 유용성을 주장하고자 하였다. 연구결과 정확도 및 ROC 곡선, c-통계량에서 ME 모형이 다른 분류도구들에 비해서 높게 나타남을 확인할 수 있었다.

• Journal of Oral Medicine and Pain
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• 제46권2호
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• pp.41-48
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• 2021

Purpose: To evaluate compliance by analyzing and comparing treatment duration, degree of improvement after treatment and treatment response of oral lichen planus (OLP) patients according to characteristics of them and the severity of the lesion. Methods: According to treatment process, 132 subjects with OLP who first visited the Department of Oral Medicine at the Pusan National University Dental Hospital from January 2017 to December 2020were classified into three groups: Treatment completed (CT) group, Under treatment (UT) group, and Dropped out during follow-up (DT) group. The reticulation/keratosis, erythema, and ulceration (REU) scoring system was used to assess the severity of OLP. The degree of improvement after treatment was evaluated in CT group. Results: There were 53 (40.15%) CT, 27 (20.45%) UT and 52 (39.39%) DT. In CT group, according to initial REU score there was a statistical difference in the degree of improvement, but not in the length of time to complete treatment. There was no statistical difference between the days it took for patients to feel symptom relief, and the days of entire treatment among three groups. However, there was a positive correlation between the REU score of gingiva and duration of treatment in DT group. In the CT and DT groups, there was a correlation between the length of time taken to relieve symptoms and the duration of treatment. Conclusions: The severity of the gingival lesion and the initial response to treatment have a large effect on the entire treatment period and prognosis, so it should be considered when explaining the disease prognosis and treatment period to patients, and the clinician needs to focus on initial symptom relief.

• 한국엔터테인먼트산업학회논문지
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• 제14권3호
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• pp.443-454
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• 2020

본 연구는 ALS(루게릭)장애인의 병진행 단계에 따른 원스탑지원서비스 개발을 목적으로 하였다. 목적 달성을 위해 한국과 일본의 사례를 다중사례연구로 분석하였다. 연구분석에 사용된 자료는 한국과 일본의 루게릭장애인의 일기, 블로그, SNS, 유트브, 그리고 인터뷰 등을 통해 양국의 지원서비스를 분석하였다. 연구결과 루게릭병 발병단계에는 한국루게릭협회와 같은 당사자 조직에 루게릭질환을 경험한 사람이나 가족에 의한 동료상담가를 배치하여야 한다. 연화장애단계에서는 위루술시술 후 소독과 경관식투여와 같은 의료적 처치를 위해 방문간호사의 재택방문횟수가 늘어야 하며, OT,PT에 의한 재택서비스가 필요하다. 호흡장애의 단계에서는 인공호흡기의 착용과 거부를 스스로 결정할 수 있는 다양한 방법을 강구해야 한다. 호홉기착용단계에서는 루게릭전용활동지원인의 양성과 파견이 필요하다. 또한 주 부양자를 위한 가족쉼터나 루게릭장애인 당사자가 이용할 수 있는 단기보호센터의 설치가 필요하다. 무엇보다 이러한 서비스는 단계별로 연계성 있는 원스탑지원서비스가 되어야 한다.

• Restorative Dentistry and Endodontics
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• 제46권4호
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• pp.51.1-51.13
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• 2021

Objectives: This study aimed to evaluate the effect of improper positioning single-peak and multi-peak lights on color change, microhardness of bottom and top, and surface topography of bulk fill and incremental composites after artificial aging for 1 year. Materials and Methods: Bulk fill and incremental composites were cured using multi-peak and single-peak light-emitting diode (LED) following 4 clinical conditions: (1) optimal condition (no angulation or tip displacement), (2) tip-displacement (2 mm), (3) slight tip angulation (α = 20°) and (4) moderate tip angulation (α = 35°). After 1-year of water aging, the specimens were analyzed for color changes (ΔE), Vickers hardness, surface topography (Ra, Rt, and Rv), and scanning electron microscopy. Results: For samples cured by single-peak LED, the improper positioning significantly increases the color change compared to the optimal position regardless of the type of composite (p < 0.001). For multi-peak LED, the type of resin composite and the curing condition displayed a significant effect on ΔE (p < 0.001). For both LEDs, the Vickers hardness and bottom/top ratio of Vickers hardness were affected by the type of composite and the curing condition (p < 0.01). Conclusions: The bulk fill composite presented greater resistance to wear, higher color stability, and better microhardness than the incremental composite when subjected to improper curing. The multi-peak LED improves curing under improper conditions compared to single-peak LED. Prevention of errors when curing composites requires the attention of all personnel involved in the patient's care once the clinical relevance of the appropriate polymerization reflects on reliable long-term outcomes.