• Journal of Korean Neurosurgical Society
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• 제63권5호
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• pp.539-549
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• 2020

The efficacy of P2Y12 reaction unit (PRU) of VerifyNow still remains as a controversial issue in neurointervention. So we investigated the usefulness of PRU of VerifyNow to predict the peri-procedural thromboembolic events (TE) and hemorrhagic events (HE). And we evaluated the safety of modified dual antiplatelet therapy (DAPT) or triple antiplatelet therapy (TAPT) for clopidogrel hyporesponders. We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science and Scopus on August 19 2018. Data was collected the 1) incidence of TE between clopidogrel responder and clopidogrel hypo-responder, 2) incidence of HE between clopidogrel hyper-responder and clopidogrel responder and hypo-responder, and 3) incidence of TE and HE between modified DAPT or TAPT and standard DAPT in clopidogrel hypo-responder. High cut-off value of PRU was defined as PRU >40% or <220. Fifteen studies were enrolled. Clopidogrel responder showed lower incidence of TE than hypo-responder (risk ratio [RR], 0.32; 95% confidence interval [CI], 0.17-0.61; p<0.001). With the high cut-off value of PRU, clopidogrel responder showed more lower incidence of TE than hypo-responder (RR, 0.11; 95% CI, 0.02-0.45; p=0.002). The incidence of periprocedural HE have higher on clopidogrel hyper-responder than clopidogrel responder and hypo-responder (RR, 4.26; 95% CI, 1.10-16.44; p=0.04; I²=66%). The incidence of periprocedural TE after changing regimen of DAPT for clopidogrel hypo-responder have a tendency to reduce, but there was no significant difference between modified DAPT or TAPT group and standard DAPT group (p>0.05). The incidence of periprocedural HE after changing regimen of DAPT for clopidogrel hypo-responder was no significant difference between modified DAPT or TAPT group and standard DAPT group (p>0.05). PRU is a useful tool as a predictor of peri-procedural TE or HE on neurointervention. PRU has a threshold effect of cut-off value to predict the peri-procedural TE. Modified DAPT or TAPT to prevent TE in clopidogrel hypo-responders could not reduce the incidence of TE. We should investigate the further research about modification of regiment on neurointervention.

• 산경연구논집
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• 제10권5호
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• pp.67-76
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• 2019

Purpose - The Korean child welfare services may have different feelings between providers and users. Few studies on the child welfare service quality have been conducted and research on the coorientation model of child welfare services are nonexistent. We compared the perceptions of Korean child welfare service providers and users in this study. It will have many applications in the service quality fields by applying a coorientation model. Research design, data, and methodology - In order to enhance user satisfaction with child welfare services, around 200 samples were carried out both in Busan and Kyungsangnamdo randomly. Seven point Likert scale was used in the questionnaire. Two measurements were made to evaluate the different positions on the part of child welfare service providers and users to assess their mutual orientation. Paired t-test verification was conducted for congruency analysis, and the verification of agreement and accuracy was analyzed by independent t-tests. Results - We empirically examined the differences between the providers and the users stance. The results are as follows. We have verified the statistical significance of the difference in perception between providers and users. We also confirmed a degree of agreement, a degree of congruency, a degree of accuracy and a degree of meta agreement in the study. In the Korean child welfare service quality, the coorientation model of process quality appeared in the form of semi-dissensus, the coorientation model of results quality were shown in the form of ignorances and the coorientation model of physical environment quality were investigated in the form of semi-dissensus. Conclusion - The study concluded that users need to understand more about the providers in order to enhance the coorientation model in process quality and physical environmental quality, and the providers need to persuade the users clearly about the positive factors. To enhance the coorientation model of the result quality, it can be misunderstood by guessing that the other party will positively evaluate it. Therefore, users believe that they need to talk more clearly to the provider about the results of the korean child welfare service quality to reduce misunderstandings and to understand each other about the resulting quality.

• 한국산학기술학회논문지
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• 제18권5호
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• pp.436-444
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• 2017

본 연구는 미국작업치료학회지(AJOT)에 게재된 연구를 바탕으로 작업치료 영역에서 직업재활과 관련된 연구동향을 살펴보고자 실시하였다. 2000년 1월부터 2016년 6월까지 미국작업치료학회지에 게재된 직업재활과 관련 있는 35편의 논문을 대상으로 연구형태, 연구의 질적 수준, 연구대상자, 연구주제 등을 분류하여 기술적 통계를 실시하였다. 연구 분석 결과 연구형태에서는 종설과 메타분석이 8편(22.9%), 질적 및 자연주의적 연구가 7편(20%), 집단비교 및 상관관계연구, 실험 및 결과연구는 각 4편(11.4%), 사례 연구 및 단일대상연구, 설문조사는 각 3편(8.6%)순으로 나타났으며, 질적 수준은 level V 14편(40.0%), 연구 대상자의 진단명은 정신과 환자를 대상으로 한 연구가 7편(33.3%)으로 가장 많았다. 연구주제별 분류 및 결과에서는 직업재활 과정과 관련된 연구 25편(71.4%), 일의 의미 및 가치에 관련된 연구 10편(28.6%)으로 나타났다. 본 연구를 통해 미국의 작업치료 분야에서 직업재활과 관련된 주요 연구동향과 대상자, 연구형태, 질적 수준을 알 수 있었고 추후 국내에서도 직업재활과 관련하여 질적으로도 높고, 다양한 질환을 대상으로 하는 연구가 필요하며 아울러 직업재활의 과정과 일의 의미 및 가치에 대한 연구도 수행되어야 함을 알 수 있었다.

• 한방비만학회지
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• 제9권1호
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• pp.15-22
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• 2009

Objectives The aim of this study is to review and analyze the status on the recent clinical trials of 'obesity' and 'metabolic syndrome'. Methods We search 'www.clinicaltrail.gov' for research trend of Obesity and metabolic syndrome. Search terms used were 'obesity' and 'metabolic syndrome'. In order to see detail review, searching was performed from 01, 01, 2007 to 05, 31, 2009 with intervention, phase III or phase IV, And we classified all the searched studies into design, intervention, purpose, end point, diseases and condition Results We could search total 232 trials. Of them, we found 32 trials with intervention, phase III or phase IV from 01, 01, 2007 to 05, 31, 2009 Also we could see various design of clinical trials. Conclusion To improve obesity and metabolic study in Traditional Korean Medicine, it is need to activate clinical trial, meta analysis, develope of clinical practice guidelines, co-works with conventional medicine and etc.

• 대한한방부인과학회지
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• 제33권2호
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• pp.44-62
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• 2020

Objectives: The purpose of this study is to evaluate the effectiveness of herbal medicine for recovery and treatment of cervical intraepithelial neoplasia (CIN) after loop electrosurgical excision procedure (LEEP). Methods: We searched two english, one chinese and four korean database up to November 4, 2019. Randomised controlled trials (RCTs) were eligible. Primary outcome included Human papilloma virus (HPV) clearance rate and the effective ratio of treatment. And vaginal bleeding time and volume, improvement of symptoms, and recovery of wound were regarded as secondary outcomes. The risk of bias was assessed by two independent authors using the Cochrane risk of bias tool. Results: Of 47 screened, 10 RCTs were included. Number of participants per study ranged from 58 to 360. The studies which used HPV clearance rate as primary outcome were considered as low risk of bias. Most of the studies had considerable heterogeneity in terms of type of intervention, comparison and time-points for outcome measurement. Compared to LEEP alone, herbal vaginal suppository combined group showed favorable results for HPV clearance in patients (5 studies, n=627, 95% CI 1.26 to 1.55, I²=75%). And compared to LEEP alone, herbal external application also showed favorable results for HPV clearance in patients (2 studies, n=252, 95% CI 1.19 to 1.61, I²=86%). Three studies reported mild and temporary adverse events, and no serious adverse events were reported. Conclusions: The studies showed that herbal medicine can significantly effective on recovery of CIN after LEEP. However, included studies suffered from incomplete reporting, high or unclear risk of bias and substantial heterogeneity between studies. In the Future, further high-quality RCTs are needed to prove effectiveness of herbal medicine for CIN after LEEP and reduce the risk of bias.

• Asian Pacific Journal of Cancer Prevention
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• 제15권10호
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• pp.4265-4269
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• 2014

Purpose: This study aimed at summarizing epidemiological evidence of the association between gestational diabetes mellitus (GDM) and subsequent risk of cancer. Materials and Methods: We searched Medline, Embase, Cancer Lit and CINAHL for epidemiological studies published by February 1, 2014 examining the risk of cancer in patients with history of GDM using highly inclusive algorithms. Information about first author, year of publication, country of study, study design, cancer sites, sample sizes, attained age of subjects and methods used for determining GDM status were extracted by two researchers and Stata version 11.0 was used to perform the meta-analysis and estimate the pooled effects. Results: A total of 9 articles documented 5 cohort and 4 case-control studies containing 10,630 cancer cases and 14,608 women with a history of GDM were included in this review. Taken together, the pooled odds ratio (OR) between GDM and breast cancer risk was 1.01 (0.87-1.17); yet the same pooled ORs of case-control and cohort studies were 0.87 (0.71-1.06) and 1.25 (1.00-1.56) respectively. There are indications that GDM is strongly associated with higher risk of pancreatic cancer (HR=8.68) and hematologic malignancies (HR=4.53), but no relationships were detected between GDM and other types of cancer. Conclusions: Although GDM increases the risk of certain types of cancer, these results should be interpreted with caution becuase of some methodological flaws. The issue merits added investigation and coordinated efforts between researchers, antenatal clinics and cancer treatment and registration agencies to help attain better understanding.

• 한국간호교육학회지
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• 제15권1호
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• pp.32-43
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• 2009

Purpose: The purpose of this study was to identify the trend of nursing research by analyzing the doctoral dissertations in one college of nursing in Korea. Method: The areas of research, the methodological characteristics, and theories used in the research were explored in all doctoral dissertations (n=120) published from 1989 to 2006. Result: Mainly "Nursing" has been studied (44.9%) among four meta-paradigms of nursing science. The "client" domain (46.7%) and the "practice" domain (41.7%) were most frequently studied in type of nursing knowledge. The main purpose of the thesis was to develop nursing interventions and examine the effectiveness of the practice (40.8%) in quantitative research. Almost all (94.7%) of the qualitative dissertation studies were to explore phenomena in the nursing field. Almost half of the dissertations (43.9%) were an experimental design, 34.7% were a model construction, and 15.8% were a qualitative design. The majority of dissertations (83.3%) were to apply the specific theory and almost half (43.8%) studied borrowed theories from other fields. Conclusion: It is necessary to develop more rigorous and various research designs such a longitudinal design, or randomized controlled trial and this will lead to expanding the body of nursing knowledge.

• 콘크리트학회논문집
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• 제27권1호
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• pp.65-73
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• 2015

하수슬러지는 도시 하수처리시설이나 공단 폐수종말처리시설 등에서 배출되는 유기성 슬러지로서 높은 함수상태 (70-80%)와 중금속, 다량의 유기물 등으로부터 그 처리 및 재활용에 큰 제약이 되고 있으며, 아직까지 효과적인 방법이 없다. 이에 본 연구에서는 경제성 및 2차 환경오염 방지 차원의 보다 근본적인 하수슬러지 처리 및 자원화 기술개발의 기초연구로서, 특정 온도범위($650{\sim}800^{\circ}C$)내로 열처리하고 소정의 분말도로 조정된 소성하수슬러지의 포졸란 반응 활성도와 그 영향인자를 분석하여 콘크리트용 혼화재료로서의 활용 가능성을 검토하고자 수행되었다. 본 연구의 수산화칼슘(알칼리 활성제)을 이용한 소성하수슬러지 혼입 모르타르의 압축강도 발현특성 및 수화생성물 분석결과는 재령에 따른 소성하수슬러지의 포졸란 반응 활성을 명백히 보여주었으며, 기존 콘크리트용 혼화재인 플라이애쉬나 고로슬래그미분말과 비교해 볼 때, 콘크리트용 혼화재로서의 활용가능성을 확인할 수 있었다.

• 한국식품영양과학회지
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• 제43권10호
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• pp.1467-1476
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• 2014

본 연구에서는 비타민 D와 정신질환, 특히 전 세계적으로 높은 유병률 추이를 보이고 있는 우울증과의 연관성을 살펴보기 위해 비타민 D의 종류, 급원 식품, 비타민 D 영양상태 현황 및 이에 영향을 미치는 요인, 비타민 D와 우울증과의 연관성에 대한 국내외 문헌을 체계적으로 고찰하여 요약하였다. 그 결과 첫째, 비타민 D는 자연계에 주로 비타민 $D_2$(ergocalciferol)와 $D_3$(cholecalciferol) 두 가지 형태로 존재하며 주로 대구간유, 고등어, 정어리와 같은 지방이 많은 생선, 난황, 표고버섯 등이 주요 급원 식품이다. 둘째, 국내 외 다양한 인구 집단을 대상으로 비타민 D 수준을 고찰한 결과 비타민 D 결핍은 매우 높은 수준을 보이고 있다. 특히 한국인의 청소년을 대상으로 한 연구 결과 혈청 25(OH)D 20 ng/mL 미만인 남녀는 각각 89%, 99%로 매우 낮은 비타민 D 수준을 보였다. 셋째, 체내 비타민 D의 수준에 영향을 미칠 수 있는 요인으로는 인종, 거주 지역, 위도, 의복차림, 계절적 차이, 직업, 자외선 노출 정도, 보충제 복용 여부 등이 보고되었으며, 일반적으로 연령의 증가(한국인 및 일본인의 경우 반대 방향), 자외선 차단제의 사용, 어두운 피부색, 흡수 불량 및 비만은 비타민 D의 합성, 흡수 및 이용률에 영향을 주어 비타민 D 부족증의 원인이 될 수 있다고 보고되었다. 넷째, 최근 비타민 D 수준과 우울증과의 연관성을 분석한 국외 역학연구들은 꾸준히 보고되고 있으며 이에 대한 횡단 연구와 코호트 연구 결과는 불일치한 양상을 보이고 있다. 또한 최근 비타민 D 보충과의 관계를 규명하기 위해 임상시험연구도 일부 진행되었으나 이 또한 불일치한 결과를 보였지만 보충제로 얻는 비타민 D는 식이로부터 얻는 비타민 D와 다르다는 가능성을 제시하고 있다. 더 나아가 횡단 연구 및 코호트 연구를 메타 분석한 연구 결과 우울증에 대한 비타민 D의 이로운 효과에 대하여 비교적 일치하는 연구 결과를 제시하고 있다. 그러나 대부분의 연구 결과는 국외에서 진행된 연구이며 한국인을 대상으로 분석된 연구는 매우 제한적이다. 따라서 한국인을 대상으로 한 후속 연구가 요구된다.

• Tuberculosis and Respiratory Diseases
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• 제79권3호
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• pp.111-120
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• 2016

Asthma is a prevalent and serious health problem in Korea. Recently, the Korean Asthma Guideline has been updated by The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) in an effort to improve the clinical management of asthma. This guideline focuses on adult patients with asthma and aims to deliver up to date scientific evidence and recommendations to general physicians for the management of asthma. For this purpose, this guideline was updated following systematic review and meta-analysis of recent studies and adapting some points of international guidelines (Global Initiative for Asthma [GINA] report 2014, National Asthma Education and Prevention Program [NAEPP] 2007, British Thoracic Society [BTS/SIGN] asthma guideline 2012, and Canadian asthma guideline 2012). Updated issues include recommendations derived using the population, intervention, comparison, and outcomes (PICO) model, which produced 20 clinical questions on the management of asthma. It also covers a new definition of asthma, the importance of confirming various airflow limitations with spirometry, the epidemiology and the diagnostic flow of asthma in Korea, the importance and evidence for inhaled corticosteroids (ICS) and ICS/formoterol as a single maintenance and acute therapy in the stepwise management of asthma, assessment of severity of asthma and management of exacerbation, and an action plan to cope with exacerbation. This guideline includes clinical assessments, and treatment of asthma-chronic obstructive pulmonary disease overlap syndrome, management of asthma in specific conditions including severe asthma, elderly asthma, cough variant asthma, exercise-induced bronchial contraction, etc. The revised Korean Asthma Guideline is expected to be a useful resource in the management of asthma.