• 감성과학
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• 제26권3호
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• pp.115-128
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• 2023

본 연구는 고기능 자폐 스펙트럼 장애아동을 대상으로 App-기반 청자 대화기술 훈련프로그램의 효과를 검증하고자 하였다. 연구대상은 26명의 자폐 스펙트럼 장애, 아스퍼거 증후군, 전반적 발달장애로 진단된 초등학생으로, 연령과 IQ, SCQ, ASSQ 점수를 사용하여 중재 집단과 통제 집단으로 짝지어 분배하였다. 중재 집단은 9주 동안 교사와의 비대면 학습을 주 1회 실시하고, 가정에서도 부모 또는 아동이 앱(App)을 활용하여 대화훈련을 실시하였다. 통제집단은 다른 특별한 프로그램에 참여하지 않았다. 그리고 훈련 전과 후에 평가자와 아동 간의 1:1 대화를 수행하여 대화 자료를 수집하고, 대화차례 주고받기와 주제 운용능력의 변화를 비교하였다. 연구 결과, 중재 집단에서 본 연구에서 개발한 청자 반응 대화훈련 프로그램의 긍정적 효과가 발견되었다. 구체적으로, 중재 집단은 청자 조건에서 적절한 청자 언어 반응이 유지되었고, 통제 집단은 적절한 청자 언어 반응이 감소하였다. 그리고 화자 조건의 대화 차례 주고받기에서는 개시율과 유지율이 증가하고, 주제 운용능력에서는 적절한 주제 개시율이 증가하고, 부적절한 주제 개시율은 감소하였다. 논의에서는 청자 반응 대화훈련 프로그램이 고기능 자폐 스펙트럼 장애아동의 대화 양상변화에 미치는 효과를 중점적으로 논의하였다.

• The Korean Journal of Pain
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• 제28권2호
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• pp.88-95
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• 2015

Background: Patients suffering from non-cardiac chest pain (NCCP) can interpret their chest pain wrongly despite having received a correct diagnosis. The objective of this study was to compare the efficacy of the relaxation method with metaphor therapy for reducing irrational beliefs and pain severity in patients with NCCP. Methods: Using a randomized controlled trial, 33 participants were randomly divided into a relaxation training group (n= 13), a metaphor therapy group (n = 10), and a control group (n = 10), and were studied for 4 weeks. The two tools used in this research were the Brief Pain Inventory (BPI) index for determining the degree of pain and the short version of the Jones Irrational Belief Test. Metaphor therapy and a relaxation technique based on ${\ddot{O}}$st's treatment were used as the interventions. The collected data were analyzed with a multivariate analysis of covariance (MANCOVA), a Chi-square test, and the Bonferroni procedure of post-hoc analysis. Results: The relaxation training method was significantly more effective than both metaphor therapy and the lack of treatment in reducing the patients' beliefs of hopelessness in the face of changes and emotional irresponsibility, as well as the pain severity. Metaphor therapy was not effective on any of these factors. In fact, the results did not support the effectiveness of metaphor therapy. Conclusions: Regarding the effectiveness of the relaxation method as compared with metaphor therapy and the lack of treatment in the control group, this study suggests that relaxation should be paid greater attention as a method for improving the status of patients. In addition, more studies are needed to determine the effectiveness of metaphor therapy in this area.

• 대한장애인치과학회지
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• 제9권1호
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• pp.25-29
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• 2013

Most of disabled people face hardness in caring their general oral hygiene by themselves. So that, they are once involved in dental caries or periodontal disease, they have much bigger chance of aggressive progress. Therefore preventive dentistry is more important to disabled one than non-disabled. They need to be checked with routine periodic dental examination and by that, oral disease must be found at initial stage. We selected 37 patients from newly visited 237 patients who had dental treatment at the free dental clinic, Gangnam district, Seoul, between 2000 and 2001. This study is a comparative evaluation of first 2 years' treatment records of selected 37 patients (male 28, female 9) with that of their last 2 years. 24 of 37 have mental retardation, 9 have autistic disorder, 2 have auditory disorder, 1 has brain disorder and 1 has crippled disorder. Their dental treatment records categorized by 4 level; score 4 stands for endodontic treatment, score 3 stands for general conservative treatment, score 2 stands for preventive treatment, such as sealant and score 1 stands for routine check. In first 2 years of treatment, average score was 2.85 which score means approximately general conservative treatment. And that of last 2 years was 1.44, which means routine check. In early time of their visit, they will receive the treatment due to their chief complaint. And after that early time, they can have a routine check so that they can be treated before the disease get worse. The patient's oral health can remain decent only by a simple treatment.

• 열처리공학회지
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• 제27권3호
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• pp.121-126
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• 2014

High-nitrogen Fe-18Mn-18Cr-N austenitic steels with higher yield strength have been recently developed and used for generator retaining rings because they have non-magnetic, high strength, high ductility, and good corrosion resistance. In the present study, a high-nitrogen Fe-18Mn-18Cr-0.61N austenitic steel was fabricated and then tensile and Charpy impact tests were conducted on them in order to investigate the effect of cold working on the mechanical properties. Although the yield and tensile strengths usually increased with cold working, the ductility and impact toughness significantly decreased after cold working. On the other hand, the high-nitrogen austenitic steel exhibited a ductile-brittle transition due to unusual brittle fracture at low temperatures despite having a face-centered cubic structure. The ductile-brittle transition temperature obtained from Charpy impact tests could be remarkably increased by $60^{\circ}C$ after 20% cold working because of the enhanced cleavage-like brittle fracture.

• Medical Lasers
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• 제8권1호
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• pp.13-18
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• 2019

Background and Objectives High-intensity focused ultrasound (HIFU) can produce small zones of thermal damage. A HIFU procedure is non-invasive and it can achieve rejuvenation of facial skin. Fractional CO₂ laser resurfacing delivers thermal damage to the pixilated columnar zone of the skin and so evoke collagen remodeling, the same as HIFU. In many cases, the patients who want rejuvenation with HIFU are also good candidates for cutaneous photorejuvenation such as can be accomplished via fractional CO₂ resurfacing. If patients are treated in a single session by remodeling both the superficial and deep compartments of skin by using both modalities, then improvement in rhytides and tightening of sagging skin will optimize the aesthetic result. Materials and Methods Between May 2014 and January 2018, a total of 44 patients were treated with combination HIFU and fractional CO₂ laser resurfacing according to our protocol. First, the HIFU was applied to the entire face with an average of 300 treatment lines. Immediately after HIFU treatment, the ultrasound gel was washed off and then fractional CO₂ laser resurfacing was performed. We evaluated the patients using 4-point grading scales. The clinician examined the skin for evidence of complications after the completion of treatment. Results All the patients' skin quality showed improvement. Further. the clinical results after duel modality treatment were substantially better than that after the use of either modality alone. The recovery times and the incidence of adverse events when quickly and consecutively performing both treatments were similar as compared to those with employing stepwise treatment. We encountered no complications whatsoever. Conclusion When compared with stepwise therapy, combination therapy with HIFU and fractional CO₂ resurfacing offers better, safer and more effective clinical results. Thus, for targeting multiple layers of aging facial skin, this combination therapy can be safely performed in a single treatment session.

• 대한후두음성언어의학회지
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• 제26권1호
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• pp.58-62
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• 2015

Xanthoma disseminatum (XD) is a benign, non-Langerhans cell histiocytosis characterized by disseminated xanthomatous lesions with face, flexures, and mucosa. Most of XD develops in mucocutaneous lesions including skin, oral cavity and pharynx, however laryngeal involvement is uncommon. While the natural course of XD is usually benign and often self-limiting, but XD develop in critical anatomical locations may result in morbidity and mortality. Localized mucous lesions in oropharynx and larynx lead to dysphagia, dyspnea and air way obstruction. The diagnosis of XD was based on clinical, histological and immunohistochemical findings. The treatment is complex and non-consensual. Local treatment with cryotherapy, radiotherapy, surgery, and carbon dioxide lasers have been attempted with various results. Systemic medication with peroxisome proliferator-activated gamma receptors, statins, fenofibrate, chlorodeoxyadenosine, cyclophosphamide, doxycycline, and cyclosporine have also been reported, but none have proven particularly successful. A 59-year-old man presented with respiratory symptoms because of laryngeal involvement of XD. We had to remove the obstructive lesion for relieving the symptoms. We experienced XD in Larynx that was rare in otorhinolaryngology. So we report this case with review of literatures.

• Journal of Preventive Medicine and Public Health
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• 제41권5호
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• pp.287-294
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• 2008

Objectives : To estimate the economic burden of osteoporotic vertebral fracture (VF) from a societal perspective. Methods : From 2002 to 2004, we identified all National Health Insurance claims records for women ${\geq}50$ years old with a diagnosis of VF. The first 6-months was defined as a "clearance period," such that patients were considered as incident cases if their first claim of fracture was recorded after June 30, 2002. We only included patients with ${\geq}$ one claim of a diagnosis of, or prescription for, osteoporosis over 3 years. For each patient, we cumulated the claims amount for the first visit and for the follow-up treatments for 1 year. The hospital charge data from 4 hospitals were investigated to measure the proportion of the non-covered services. Face-to-face interviews were conducted with 106 patients from the 4 study sites to measure the out-of-pocket spending outside of hospitals. Results : During 2.5 years, 131,453 VF patients were identified. The patients had an average of 3.38 visits, 0.40 admissions and 6.36 inpatient days. The per capita cost was 1,909,690 Won: 71.5% for direct medical costs, 20.6% for direct non-medical costs and 7.9% for indirect costs. The per capita cost increased with increasing age: 1,848,078 Won for those aged 50-64, 2,084,846 Won for 65-74, 2,129,530 Won for 75-84and 2,121,492 Won for those above 84. Conclusions : Exploring the economic burden of osteoporotic VF is expected to motivate to adopt effective treatment options for osteoporosis in order to prevent the incidence of fracture and the consequent costs.

• 보건의료산업학회지
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• 제3권1호
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• pp.78-90
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• 2009

The purpose of this study is to propose ways of promoting medical tourism in Busan. For the purpose, this researcher made a questionnaire survey of Japanese tourists who used in Busan International Ferry Terminal between January and April 30, 2008. Findings of the study can be summarized as follows. 86.3% of all respondents had never experienced any medical service in Korea. 57.3% said that the most important thing is the level of medical technology. Most of respondents preferred massage treatment using spa and sea water, followed by Oriental medical services. To make medical conditions(price competitiveness, high-level medical technology, high-quality medical facilities) of Busan properly informed to the outside, it is required to make the city itself more internationally recognized through public relations and strengthening individual medical services provided in the city. It is also required to build up a non-stop service system that helps foreign tourists not only easily use medical institutions, but also better cope with a variety of problems that they might face during stay in the city. To be more trustable to foreign patients, medical services of Busan should be certified by JCI. Furthermore, it is very much needed to develop products which connect medicine with tourism, for example, such programs that combine medical services, tourism, recreation and leisure.

• 보건행정학회지
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• 제16권2호
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• pp.96-116
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• 2006

To assess the economic value of pharmaceutical therapy with Kremezin, we investigated the maximum amount of willingness-to-pay (WTP) of patients with chronic renal failure (CRF) for a hypothetical effect of Kremezin in delaying the initiation of dialysis treatments. A face-to-face survey was carried out in a sample of 141 CRF patients from 2 dialysis centers, composed of 82 hemodialysis patients, 38 peritoneal dialysis patients, and 21 non-dialysis CRF patients. Using a bidding game method with a starting point of 320,000 Won, which is the average monthly out-of-pocket payment for dialysis treatment, we asked the study subjects how much they would pay per month to receive Kremezin therapy. The mean out-of-pocket monthly WTP for Kremezin was 310,000, 430,000, and 520,000 Won (p<0.05, repeated one-way ANOVA)) when Kremezin delays the initiation of dialysis treatments by 1, 2, and 4 years. Significant correlation between the respondent's WTP and income $(r=0.266{\sim}0.368,\;p<0.05)$ confirmed the construct validity of the WTP instrument. Regression results showed that patients with a higher education, with diabetes as a major causes of CRF, and undergoing hemodialysis treatments tended to express higher WTP for Kremezin. The economic value of WTP from the perspective of patients varied from 310,000 to 520,000 Won depending on the effect size of Kremezin. The mean WTP was higher than 32,000 Won, only when the hypothetical effect of Kremezin in delaying the initiation of dialysis is for 2 years. This implies that Kremezin might be the preferred choice of therapy by CRF patients if it delays the initiation of dialysis treatment for at least 2 years.

• 한국응용과학기술학회지
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• 제40권4호
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• pp.868-880
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• 2023

본 연구는 발달장애아동을 대상으로 케어로봇을 치료에 활용하기 위해 발달장애 아동의 부모를 대상으로 소셜로봇이 갖추어야 할 기능과 요구 등을 분석하고자 시행한 질적연구이다. 연구대상자는 자녀가 발달장애 진단을 받았거나 1년 이상 특수교육을 시행하고 있는 만 18세 미만 자녀를 둔 주양육자 11명을 대상으로 진행하였다. 면담질문지는 반구조화된 질문지로 구성하여 소셜로봇에 대한 인식, 필요성, 기대, 염려 및 기타 의견 등으로 구성하였다. 면담은 COVID 19로 인해 비대면 온라인 화상 면담으로 이루어졌다. 연구결과, 4개의 주제가 도출되었다. 4개의 주제는 낯설지만 곧 마주할 현실, 능동적인 기능이 탑재된 소셜로봇, 소셜로봇의 외형과 재질에 대한 바람 및 소셜로봇에 대한 염려로 도출되었다. 본 연구를 통하여 양적연구에서는 파악할 수 없었던 주양육자의 소셜로봇에 대한 기대, 제안 등을 파악할 수 있었고 이를 향후 개발할 소셜로봇에 반영할 수 있다면 보다 수용성이 높은 긍정적인 결과를 도출 할 수 있을 것으로 기대한다.