• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제16권1호
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• pp.28-33
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• 2013

Purpose: Anorectal malformations are often associated with other anomalies, reporting frequency with 40-70%. Gastrointestinal anomalies have been known to be relatively less common than associated anomalies of other organ system. This study was performed to assess a distinctive feature of cases associated with esophageal atresia. Methods: Clinical data (from January 2000 through December 2011) on the 196 subjects with anorectal malformations, managed in our Hospital, were reviewed. Total 14 neonates were identified with accompanying esophageal atresia and retrospective analysis was conducted. Results: The incidence was 7.1% and there were 8 male and 6 female subjects. Only 2 cases were associated with esophageal atresia without tracheoesophageal fistula. Although variable cases of anorectal malformation in female subjects, almost cases were anorectal malformations with rectourethral fistula in male. Other associated anomalies were identified in all cases, with more than 3 anomalies in 10 cases. There were 4 VACTERL (Vertebral abnormalities, Anal atresia, Cardiac anomalies, Tracheoesophageal fistula, Esophageal atresia, Renal and Limb anomalies) associations accounting for 28.6%, but could not identify chromosomal anomaly. Most cases were managed with staged procedure, usually primary repair of esophageal atresia and diverting colostomy. Overall mortality rate was 21.4%, mainly caused by heart problems. Conclusion: This study shows that early diagnosis and rational surgical approach with multidisciplinary plan are mandatory in managing anorectal malformations with esophageal atresia, when considering a high frequency of associated anomaly and a relative high mortality.

• Safety and Health at Work
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• 제10권4호
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• pp.420-427
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• 2019

Introduction: To prevent and manage the societal and economic burden of occupational diseases (ODs), countries should develop strong prevention policies, health surveillance and registry systems. This study aims to contribute to the improvement of OD surveillance at national level as well as to identify priority actions in Turkey. Methods: The history and current status of occupational health studies were considered from the perspective of OD surveillance. Interpretative research was done through literature review on occupational health at national, regional and international level. Analyses were focused on countries' experiences in policy development and practice, roles and responsibilities of institutions, multidisciplinary and intersectoral collaboration. OD surveillance models of Turkey, Belgium and the Netherlands were examined through exchange visits. Face-to-face interviews were conducted to explore the peculiarities of legislative and institutional structures, the best and worst practices, and approach principles. Results: Some countries are more focused on exploring OD trends through effective and cost-efficient researches, with particular attention to new and emerging ODs. Other countries try to reach every single case of OD for compensation and rehabilitation. Each practice has advantages and shortcomings, but they are not mutually exclusive, and thus an effective combination is possible. Conclusion: Effective surveillance and registry approaches play a key role in the prevention of ODs. A well-designed system enables monitoring and assessment of OD prevalence and trends, and adoption of preventive measures while improving the effectiveness of redressing and compensation. A robust surveillance does not only provide protection of workers' health but also advances prevention of economic losses.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.899-904
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• 2014

Concurrent chemo-radiation (CRT) has been established as the standard of care for non-metastatic loco-regionally advanced nasopharyngeal carcinoma (NPC) but recently the addition of induction chemotherapy in the already established regimen has presented an attractive multidisciplinary approach. This retrospective study was carried out to evaluate the efficacy of induction chemotherapy (IC) followed by CRT for the management of loco-regionally advanced NPC. Between July 2005 and September 2010, 99 patients were treated with cisplatin based IC followed by CRT. Induction chemotherapy included a 2 drug combination; intravenous gemcitabine $1000mg/m^2$ on day 1 and 8 and cisplatin $75mg/m^2$ on day 1 only. Radiotherapy (RT) was given as a phase treatment to a total dose of 70 Gy in 35 fractions. Concurrent cisplatin ($75mg/m^2$) was administered to all patients on days 1, 22 and 43. All patients were evaluated for tumor response and adverse effects after IC and 6 weeks after the completion of the treatment protocol. Statistical analysis was performed using SPSS version 17 and Kaplan Meier estimates were applied to project survival. Median follow-up duration was 20 months. The 5-year overall survival (OS), loco regional control (LRC) and relapse free survival (RFS) rates were 71%, 73% and 50%respectively. Acute grade 4 toxicity related to induction chemotherapy and concurrent chemo-radiation was 4% and 2% respectively, with only 3 toxicity-related hospital admissions. We conclude that induction gemcitabine and cisplatin followed by chemo-radiation is a safe and effective regimen in management of nasopharyngeal carcinoma, meriting further investigation in randomized clinical trials.

• Journal of Korean Neurosurgical Society
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• 제37권1호
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• pp.25-28
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• 2005

Objective: Giant invasive pituitary adenoma looks histologically benign, but these tumors have an aggressive clinical course. The authors review 10 cases and discuss the results obtained and the strategy to use for the management of giant invasive pituitary adenoma. Methods: Out of a series of 155 pituitary adenomas treated surgically between 1994 and 2002, ten patients with giant invasive pituitary adenoma were selected and their clinical problems, radiologic findings, extent and invasiveness, hormonal and histologic findings and surgical results were analyzed retrospectively. Results: There were 4 male and 6 female patients, with an average age of 47 years and an average follow-up period of 42 months. The average size of tumor was 50.7mm. These tumors revealed severe invasions into surrounding structures. 8 patients underwent transsphenoidal approach(TSA) operations, 1 patient with transcranial operation and 1 patient with combined TSA and transcranial operation. In all cases, subtotal resection was performed. The histologic findings were 2 prolactinomas and 3 hormonal non-function adenomas. The therapies administered after surgical removal consisted of conventional fractionated radiotherapy (2 patients), treatment with dopamine agonists to control hyperprolactinemia (2 patients), and treatment with hormone replacement (2 patients). Conclusion: Giant invasive pituitary adenomas are characterized by different forms of expansion and invasiveness and variable clinical problems. Because of their aggressive expansion and invasiveness, there are many different strategies which can be considered for their management. The authors obtain good results by choosing conservative surgical removal and multidisciplinary treatments with serial radiological and hormonal follow-up.

• Child Health Nursing Research
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• 제20권2호
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• pp.105-112
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• 2014

목적 본 연구는 입원 환아에게 최적의 간호를 제공하기 위한 전제조건인 입원 환아 간호에 대한 부모의 참여의 개념을 탐색함으로써 아동간호 실무에 대한 이해를 증진시키고자 시도되었다. 방법 Walker와 Avant (2005)의 개념분석 방법을 사용하였으며, 선행연구를 근거로 1994년부터 2012년 사이에 이루어진 부모의 참여 관련 논문 중 입원 환아 간호, 부모참여를 주요어로 하여 고찰한 논문 30편을 통해 속성, 선행요인, 결과를 확인하였다. 결과 입원 환아 간호에 대한 부모의 참여의 속성은 협상, 돌봄 활동 수행, 개별화된 간호 제공으로 확인되었다. 선행요인은 환아의 연령과 상태, 환아 부모 참여 필요성에 대한 환아 부모와 아동간호사의 태도 및 상호 이해이며, 결과는 환아 부모와 아동간호사의 효율적인 파트너십이 이루어지고, 환아 부모와 아동간호사를 임파워먼트시키게 되는 것으로 확인되었다. 결론 본 연구에서 확인된 입원 환아 간호에 대한 부모의 참여의 개념 정의와 속성은 아동간호실무 이론 개발의 기초자료로 활용될 것이다.

• 산학경영연구
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• 제14권
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• pp.189-210
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• 2001

소비자 연구는 매우 다양한 방법론을 적용하는 분야로서 이론정립이나 실증분석에 대한 접근방식의 차이에 따라 positivism과 relativism에 근거한 연구로 분류할 수 있다. 객관적 현실(objective reality)의 존재여부, 실증자료의 객관성, 연구 결과의 일반화 가능성 등에 대한 가정이 서로 다른 이유로, positivism이나 relativism을 연구방법론으로 수용한 학자들 간의 긴장이 각자의 연구를 dog food managerialism (positivism에 대하여), weird science (relativism에 대하여)라는 수식어를 사용하며 비난하는 경우까지 있었다. 이 연구의 목적은 positivism과 relativism에 근거한 연구방법론의 차이를 살펴보고 절충주의의 가능성을 모색하는 것이다. 그러나 Kuhn (1970)이 지적했듯이, philosophy of science의 선택은 궁극적으로 개인적이고, 주관적인 것이기 때문에, 절충주의의 가능성을 제시하기보다는 연구주제의 선택이나 방법론에 있어서 positivism과 relativism이 상호 보완할 수 있는 부분을 제안하였다.

• 대한간호학회지
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• 제47권5호
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• pp.577-588
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• 2017

Purpose: This study was intended to integrate the evidence of home care service intervention for mothers and children in vulnerable groups through an integrative literature review. Methods: We searched the MEDLINE (PubMED), EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, DBpia databases. The quality of the articles was assessed by one doctoral researcher and verified by one professor of community health nursing who had participated in the systematic review of literature. A framework was developed to identify the intervention patterns in the selected papers and categorize various elements. The extracted intervention elements were grouped into potential themes, which were verified by assessors on whether they clearly reflected the interventions in the papers. Results: Among 878 searched papers, we selected 16 papers after excluding literature that does not satisfy the selection criteria and quality evaluation. The intervention elements of 16 selected papers were categorized into six themes. The extracted intervention elements were divided into the themes of Patient-specific/Situation-specific care planning and intervention, Emphasis on self care competency, Intense home visit by developmental milestone, Reinforcing and modeling mother-child attachment, Communication and interaction across the intervention, Linkage with community resource and multidisciplinary approach. Conclusion: As a result of the analysis of proper interventions of home care services for mothers and children in vulnerable groups, it was found that it is necessary to consider indispensable intervention elements that can standardize the quality of home care services, and conduct studies on developing intervention programs based on the elements.

• 한국주거학회논문집
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• 제25권4호
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• pp.111-123
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• 2014

Housing can be defined as the vessel containing human life and each country has considerably different form and culture of it. This study aims to understand the society's common cultural values of house selection, decision making, an various housing issues. Consequently, applying a multidisciplinary approach, this project seeks to explore the correlations between people and housing, and between society and housing, to better understand the thought and culture of the housing residents. In order for doing it, adopting cultural value of housing as a tool, a comparative cultural study of housing values in East Asia starting from Korea and China will be conducted. Through such a comparative cultural study, it will be ultimately possible to grasp the locality and uniqueness of specific cultures with more clarity. A survey using questionnaire was conducted on 126 Korean Students and 145 Chinese students who are studying at K University in Seoul on a random sampling basis. The results of survey are as follow. Both Korean and Chinese college students gave higher values on neighborhood environment, convenience of transportation, privacy and safety, and to be given a higher value. On the other hand, they gave lower values on the symbolism of social status. Korean university college students gave higher considerations in the list of , , and than Chinese. Chinese college students gave higher consideration in the list of , and than Koreans. Even though this study has some limitations in generalizing the findings, we can understand the identity of Koreans and Chinese through the comparative study.

• 디지털융복합연구
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• 제15권3호
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• pp.99-106
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• 2017

본 연구는 직업전문학교 재학생의 학습동기와 학습 자율성이 직무창의성과 전공만족도 및 학교만족도와 어떤 영향관계인지 파악하는 것을 연구목적으로 하였다, 국내 전문직업학교가 비교적 최근에 활성화되었고 학술적 연구가 매우 부족한 현실이다. 직업전문학교 제과제빵 전공 재학생 설문조사를 통해 이론적 선행연구에 근거한 연구가 설들을 검증하였다. 직무창의성은 학생의 학습동기와 학습 자율성의 복합적인 영향을 받는 것으로 나타났다. 내재적 학습동기와 학습 자율성은 전공만족도에 유의한 수준의 긍정적 영향을 미치나 외재적 학습동기는 전공만족도에 부적 영향관계를 보였다, 직업전문학교 교육은 실무중심의 기술전달 방식 위주라서 본 연구는 학습동기, 창의성, 학습 자율성 등의 심리적 성향이 학생 만족도에 미치는 영향을 파악하였고 교과정책 반영에 참고할 결과를 제시하였다. 향후 신입생 홍보나 교과운영, 학사관리를 위하여 더 체계적이며 복합적인 연구가 필요하다.

• 대한심미치과학회지
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• 제23권1호
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• pp.27-33
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• 2014

본 증례는 26세 여성환자로 폭식증과 이로 인한 구토 및 위산역류로 상악 전치부에 광범위한 치질 손상과 더불어 산부식으로 인해 상아질 노출로 기능뿐만 아니라 심미적인 문제를 주소로 내원했다. 환자는 단시간 내 심미성 회복을 원하는 상태로 교정 등의 치료는 원치 않았다. 이를 감안해 치료계획은 이미 손상된 치질을 최대한 보존하면서 심미성 및 기능 회복을 목표로 하였다. 상악 전치부의 치관 비율 및 치은 형태 개선을 위해 치은절제술 및 치관연장술을 시행했으며, 전부도재관을 이용해 수복하였다. 회전 이동되어있는 우측 상악 측절치는 치질 삭제 없이 veneer 형태로 제작했다. 산 부식 및 마모에 강한 지르코니아에 도재로 순측을 veneering해 기능 회복뿐만 아니라 심미적인 면에서도 만족할만한 결과를 얻을 수 있었다. 추후 미백치료를 고려해 최종보철물의 색상을 결정했으며, 환자는 색상과 형태에 만족했으며 자신감있는 미소를 회복할 수 있었다.