• 대한의용생체공학회:의공학회지
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• 제45권1호
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• pp.26-36
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• 2024

Functional brain imaging techniques have been used to diagnose psychiatric disorders such as dementia, depression, and autism. Recently, these techniques have also been actively used to study hearing loss. The present study reviewed the application of the functional brain imaging techniques in auditory research, especially those focusing on hearing loss, over the past decade. EEG, fMRI, fNIRS, MEG, and PET have been utilized in auditory research, and the number of research studies using these techniques has been increasing. In particular, fMRI and EEG were the most frequently used technique in auditory research. EEG studies mostly used event-related designs to analyze the direct relationship between stimulus and the related response, and in fMRI studies, resting-state functional connectivity and block designs were utilized to analyze alterations in brain functionality in hearing-related areas. In terms of age, while studies involving children mainly focused on congenital and pre- and post-lingual hearing loss to analyze developmental characteristics with and without hearing loss, those involving adults focused on age-related hearing loss to investigate changes in the characteristics of the brain based on the presence of hearing loss and the use of a hearing device. Overall, ranging from EEG to PET, various functional brain imaging techniques have been used in auditory research, but it is difficult to perform a comprehensive analysis due to the lack of consistency in experimental designs, analysis methods, and participant characteristics. Thus, it is necessary to develop standardized research protocols to obtain high-quality clinical and research evidence.

• 한국산업정보학회논문지
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• 제29권2호
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• pp.1-14
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• 2024

본 연구는 다문화가족의 건강욕구 및 관련 정책들을 파악하고, ICT를 활용한 건강정보의 접근성을 개선할 수 있는 방안을 모색하는 것을 목적으로 하였다. 본 연구에서 사용된 방법은 질적 연구로서, 선행문헌 검토를 통해 다문화가족의 건강실태를 1차적으로 분석한 후, 다문화가족을 대상으로 심층인터뷰를 진행하였다. 본 연구결과, 그간 다문화가족의 건강정책은 타 부문에 비해 정책우선순위가 밀려 있고, 다문화가족의 건강정보 접근성 향상을 위한 ICT 활용 논의가 미미한 것으로 분석되었다. 다문화가족을 심층인터뷰한 결과, "한국사회 진입초기 경험", "의료기관 이용시 높은 언어장벽", "다양한 이유로 인한 미충족의료 경험", "보건의료 관련 서비스 욕구가 높은 영역" 등의 4개 주제가 도출되었다. 다문화가족의 건강권 보장 및 건강정보 접근성을 향상하기 위해서 의료기관의 언어적 지원체계 강화, 정부의 다문화가족을 위한 정책적 노력, 수요자 중심의 쌍방향 ICT 플랫폼 설계 등을 제언하였다.

• 융합보안논문지
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• 제24권2호
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• pp.55-61
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• 2024

IoT 기술 발전으로 스마트 헬스케어나 스마트 의료서비스도 급격히 발전하고 있다. 이 서비스에 필요한 웨어러블 디바이스는 스마트 밴드 등의 형태로 센서, 컨트롤러로 사용되고 있다. 웨어러블 디바이스는 가능한 장시간 사용을 위해 매우 간결한 SW 로직으로 구현할 뿐만 아니라, 편의성 증진을 위해 무선 통신 프로토콜을 사용한다. 그러나 이 웨어러블 디바이스는 경량성을 추구하고 있어, 다른 정보서비스에 사용되는 단말보다 보안에 취약하다. 본 연구에서는 웨어러블 서비스의 기술적인 운영 환경을 분석, 웨어러블 디바이스에 대한 인증 정보 재사용 공격, BIAS 공격, 배터리 소진 공격, 펌웨어 공격을 식별하고, 각 보안 위협의 메커니즘을 분석하고 공격 효과를 조사하였다. 또 본 연구에서는 식별한 보안 위협에 대한 대응 방안을 제시하였다. 웨어러블 서비스를 개발할 때 본 연구에서 제안한 대응 방안을 고려한다면, 더 안전한 서비스를 구축할 수 있을 것으로 기대된다.

• 대한두경부종양학회지
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• 제40권1호
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• pp.1-5
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• 2024

The Bethesda System for Reporting Thyroid Cytopathology (TBSRCT) is crucial for cytopathologists to use a standardized, category-based reporting system for thyroid fine needle aspirations and is effective for clear communication with the referring physicians. The new Bethesda System for Reporting Thyroid Cytopathology, the third edition in 2023, provides several key updates. The most important update is the assignment of only single name for each of the six diagnostic categories: (I) nondiagnostic; (II) benign; (III) atypia of undetermined significance; (IV) follicular neoplasm; (V) suspicious for malignancy; and (VI) malignant. An implied risk of malignancy (ROM) for each of six categories has been updated based on extensively published data since the second edition of TBSRTC in 2017 and offers both an average ROM for each category and the expected range of cancer risk. Estimated final ROM after excluding "Noninvasive Follicular Thyroid Neoplasm with Papillary Like Nuclear Features (NIFTP)" for each of six categories has been updated based on the reported mean decreases in the ROM if excluding NIFTP. For atypia of undetermined significance (AUS) category, the subcategorization is simplified and more formalized into 2 subgroups, AUS-nuclear atypia or AUS-other, based on the implied ROM and molecular profiling. For the pediatric thyroid disease, pediatric ROMs and management algorithms are newly added for the same six reporting categories for this age group. New or revised disease nomenclatures including high-grade follicular-derived carcinoma has been updated according to the recently published 2022 World Health Organization Classification of Thyroid Neoplasms. Brand new two chapters are added including clinical perspectives and imaging studies (Chap. 13) and the use of molecular and other ancillary tests (Chap. 14). The atlas is updated with new images to illustrate more effectively for new disease entity and diagnostic criteria.

• 대한족부족관절학회지
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• 제28권2호
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• pp.55-59
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• 2024

Purpose: Tumors of the foot and ankle account for approximately 3%~5% of all musculoskeletal tumors, and accurate diagnosis is often delayed due to their rare prevalence. Therefore, the authors aimed to analyze the incidence, treatment methods, and prognostic factors of foot and ankle tumors treated at the authors' hospital. Materials and Methods: A retrospective single-center study examined 342 patients treated for foot and ankle tumors at the authors' hospital from January 2011 to February 2022. Data were collected from the electronic medical records (EMR) and picture archiving and communication systems (PACS). The information analyzed included gender, age, follow-up period, diagnosis, tumor occurrence and recurrence, treatment, and clinical outcomes. Results: Most cases (93.3%) were benign, but 6.7% were malignant. The main treatment for malignant tumors was surgical resection (91.3%). Approximately 53.1% of benign tumors and 91.3% of malignant tumors were treated with surgery, and two of the malignant tumors that did not undergo surgery had metastatic cancer. After surgery, 8.2% of benign lesions and 19.0% of malignant lesions recurred, and 9.5% of the patients with malignant tumors died after surgery. Conclusion: Most foot and ankle tumors are benign tumors, and the prognosis is not poor if treated properly, but most malignant tumors often require amputation. In some cases, however, amputation can be avoided with a combination of chemotherapy and radiation therapy.

• 대한치위생과학회지
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• 제6권2호
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• pp.141-150
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• 2023

연구의 배경 및 목적: 본 연구에서는 노인구강관리에 대한 산업체 수요기반의 교육과정을 개발하여 운영함으로써 노인치위생학 교육의 효과를 확인해 보고자 진행하였다. 연구방법: 산업체 수요기반 현장중심 실무교육에 따른 전공역량달성도, 노인치위생과정 인식, 수업만족도의 전후차이를 검증하기 위하여 비모수 분석으로 윌콕슨 부호순위 검정(Wilcoxon signed rank test)을 수행하였으며, 각 요인간의 연관성을 확인하기 위해 스피어만 상관분석(Spearman's correlation analysis)을 수행하였다(p<0.05). 결과: 전공역량달성도의 경우 산업체 수요기반 현장중심 실무교육을 수행 후 '노인과의 의사소통 역량'이 유의미하게 향상되었다(p=0.031). 고찰: 노인치위생학 교육과정은 산업체 현장에서 활용가능한 실무중심의 교육과정이 학습자에게 제공되었을 때 노인에 대한 실제적인 이해와 노인구강관리에 대한 현장실무전공역량이 더욱 개발될 수 있을 것으로 판단된다.

• Journal of Hospice and Palliative Care
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• 제27권1호
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• pp.1-10
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• 2024

This article underscores the importance of integrating comprehensive palliative care for noncancer patients who are undergoing hemodialysis, with an emphasis on the aging populations in Asian nations such as Taiwan, Japan, the Republic of Korea, and China. As the global demographic landscape shifts towards an aging society and healthcare continues to advance, a marked increase has been observed in patients undergoing hemodialysis who require palliative care. This necessitates an immediate paradigm shift to incorporate this care, addressing the intricate physical, psychosocial, and spiritual challenges faced by these individuals and their families. Numerous challenges impede the provision of effective palliative care, including difficulties in prognosis, delayed referrals, cultural misconceptions, lack of clinician confidence, and insufficient collaboration among healthcare professionals. The article proposes potential solutions, such as targeted training for clinicians, the use of telemedicine to facilitate shared decision-making, and the introduction of time-limited trials for dialysis to overcome these obstacles. The integration of palliative care into routine renal treatment and the promotion of transparent communication among healthcare professionals represent key strategies to enhance the quality of life and end-of-life care for people on hemodialysis. By embracing innovative strategies and fostering collaboration, healthcare providers can deliver more patient-centered, holistic care that meets the complex needs of seriously ill patients within an aging population undergoing hemodialysis.

• 대한영상의학회지
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• 제84권1호
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• pp.3-14
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• 2023

유방영상 판독과 자료 체계(Breast Imaging Reporting and Data System; 이하 BI-RADS)는 유방영상 판독의 표준화 및 판독 질 관리를 위해 유방 병변의 특성을 기술하는 용어 사전(lexicon), 평가 범주(assessment category) 및 처치(management)를 위한 권고들을 제시한 시스템이다. 판독의는 BI-RADS에서 권장하는 표준화된 용어를 이용하여 검사 결과를 임상의에게 간결하고 재현 가능하게 전달할 수 있고, 평가 범주 판정을 통하여 검사에서 발견된 병변이 악성일 가능성을 추정된 확률로 제공하고 이에 따른 처치를 권고할 수 있다. 현재 사용 중인 BI-RADS 5판이 가지는 한계는 표준화된 용어 사전이 정립되지 않은 일부 영역들이 존재한다는 것과 MRI 판정 범주 3-4의 평가 기준이 유방촬영술이나 초음파의 기준에 비해 모호하다는 점이다. BI-RADS의 다음 개정판에는 이러한 한계들을 극복하기 위한 개선안이 포함될 것으로 예상한다.

• Journal of Chest Surgery
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• 제57권4호
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• pp.390-398
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• 2024

Background: In this study, we examined the impact of a patient blood management (PBM) program on red blood cell (RBC) transfusion practices in cardiothoracic surgery. Methods: The PBM program had 3 components: monitoring transfusions through an order communication system checklist, educating the medical team about PBM, and providing feedback to ordering physicians on the appropriateness of transfusion. The retrospective analysis examined changes in the hemoglobin levels triggering transfusion and the proportions of appropriate RBC transfusions before, during, and after PBM implementation. Further analysis was focused on patients undergoing cardiac surgery, with outcomes including 30-day mortality, durations of intensive care unit and hospital stays, and rates of pneumonia, sepsis, and wound complications. Results: The study included 2,802 patients admitted for cardiothoracic surgery. After the implementation of PBM, a significant decrease was observed in the hemoglobin threshold for RBC transfusion. This threshold dropped from 8.7 g/dL before PBM to 8.3 g/dL during the PBM education phase and 8.0 g/dL during the PBM feedback period. Additionally, the proportion of appropriate RBC transfusions increased markedly, from 23.9% before PBM to 34.9% and 58.2% during the education and feedback phases, respectively. Among the 381 patients who underwent cardiac surgery, a significant reduction was noted in the length of hospitalization over time (p<0.001). However, other clinical outcomes displayed no significant differences. Conclusion: PBM implementation effectively reduced the hemoglobin threshold for RBC transfusion and increased the rate of appropriate transfusion in cardiothoracic surgery. Although transfusion practices improved, clinical outcomes were comparable to those observed before PBM implementation.

• 보건의료생명과학 논문지
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• 제10권2호
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• pp.169-178
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• 2022

본 연구는 보건의료직 종사자의 업무능력에 대한 중요도와 이에 대한 최종학교 기여도의 인식 수준 및 이들 간의 차이를 파악하고, IPA를 활용하여 분석함으로써 보건의료직 양성 교육과정의 방향성을 탐색하고자 하였다. 이를 위해 제14차(2020년) 청년패널조사의 원자료 중 보건의료직 종사자 총 465명의 응답자료를 분석하였다. IPA를 활용한 분석결과, 개선시급영역은 도출되지 않았으며, 지속유지영역은 전문분야 지식, 전문분야 실용적 지식, 의사소통, 타인과 협력하는 능력, 고객상대능력, 스스로 배우는 능력, 계획적인 생활습관, 변화적응능력, 올바른 직업관과 비즈니스 매너, 문서 이해로 나타났고, 낮은 우선순위영역은 컴퓨터 사용능력, 창의적 문제해결능력, 외국어 읽고 쓰기, 수학문제 풀이, 외국어회화로 나타났으며, 과잉투입 영역은 문서 작성으로 나타났다. 이러한 연구결과를 바탕으로 보건의료직 종사자들을 양성하기 위한 효과적인 교육과정 개발을 위한 시사점을 제언하였다.