• Nutrition Research and Practice
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• 제7권4호
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• pp.315-325
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• 2013

We evaluated folate status of child-bearing age women diagnosed with abnormal pap smear in the US post-folic acid (FA) fortification era and assessed the determinants of NTD-protective and supra-physiologic (SP) concentrations of folate. The distribution of 843 women according to NTD-protective concentrations of RBC folate, plasma folate and SP concentrations of plasma folate were tested in relation to demographic and life-style factors. Logistic regression models specified NTD-protective concentrations of RBC and plasma folate or SP concentrations of plasma folate as dependent variables and demographic and life-style factors as independent predictors of interest. More than 82% reached NTD-protective concentrations of RBC and plasma folate and ~30% reached SP concentrations of plasma folate. FA supplement use was associated with having SP concentrations of plasma folate rather than NTD-protective concentrations of folate. African American (AA) women and smokers were significantly less likely to achieve NTD-protective concentrations of RBC and plasma folate. A large majority of women reached NTD-protective concentrations of folate with the current level of FA fortification without using supplementary FA. Therefore, the remaining disparities in AA women and in smokers should be addressed by targeted individual improvements in folate intake.

• Clinical and Experimental Emergency Medicine
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• 제5권4호
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• pp.256-263
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• 2018

Objective We conducted a study to validate the effectiveness of the Korean criteria for trauma team activation (TTA) and compared its results with a two-tiered system. Methods This observational study was based on data from the Korean Trauma Data Bank. Within the study period, 1,628 trauma patients visited our emergency department, and 739 satisfied the criteria for TTA. The rates of overtriage and undertriage in the Korean one-tiered system were compared with the two-tiered system recommended by the American College of Surgery-Committee on Trauma. Results Most of the patient's physiologic factors reflected trauma severity levels, but anatomical factors and mechanism of injury did not show consistent results. In addition, while the rate of overtriage (64.4%) was above the recommended range according to the Korean criteria, the rate of undertriage (4.0%) was within the recommended range. In the simulated two-tiered system, the rate of overtriage was reduced by 5.5%, while undertriage was increased by 1.8% compared to the Korean activation system. Conclusion The Korean criteria for TTA showed higher rates of overtriage and similar undertriage rates compared to the simulated two-tier system. Modification of the current criteria to a twotier system with special considerations would be more effective for providing optimum patient care and medical resource utilization.

• Tuberculosis and Respiratory Diseases
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• 제44권1호
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• pp.136-145
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• 1997

연구배경 : Tracheal gas insuff1ation (이하 TGI)는 이산화탄소가 없는 가스를 기관 하부에 직접 유입시키는 인공환기 기법으로 사강호흡(Vd/Vt)을 줄이는 것이 보고되고 있다. 그러나 아직 임상에서 널리 시행되지 못하고 있으며 그 작용기전이나 효과를 결정하는 인자에 대한 연구도 불충분하다. 이에 연자 등은 기계호흡 중 사강호흡이 증가된 환자들을 대상으로 TGI를 시행하여 TGI가 가스교환에 미치는 효과 및 이에 관련된 지표를 조사하였다. 방법 : 대상은 7명(남:여=6:1, $58.8{\pm}10.6$세)으로 임상 상태가 안정되고 생리학적 사강이 60% 이상인 환자들이었으며 인공환기 양식은 Pressure control 하에서 흡기시간 25% 및 $FIO_2$, 1.0 으로 하였다. TGI 는 100% 산소를 Hi-Lo Jet Tracheal Tube(Mallincrodt, USA)의 Insufflation lumen을 통하여 Continuous flow법으로 15분간 투여하였으며 TGI 전, TGI 3 L/min 및 5 L/min (각각 TGI 3, 5 라 함)에서 동맥혈 이산화탄소분압, 호기말 이산화탄소 분압 (End tidal $CO_2$ 이하 $ETCO_2$), 혼합호기 이산화탄소분압 (Mixed expired $CO_2$, 이하 $P_ECO_2$ : Nonnocap, Datex, Finland), 흡기 및 호기량 및 평균 기도압 (CP- l00 Pulmonary monitor, Bicore, USA)을 측정하였다. 결과 : 1. $PaCO_2$는 TGI 전, TGI 3 및 TGI 5에서 각각 $51.4{\pm}17.6$, $49.1{\pm}18.9$, $45.0{\pm}14.9$ mm Hg ( p = 0.050)로, $ETCO_2$, 는 각각 $36.6{\pm}9.1$, $32.0{\pm}7.6$, $30.6{\pm}7.9$ mm Hg (p<0.001)로 감소하였으며, $P_ECO_2$는 유의한 변동이 없었다(p=0. 336). 생리학적 사강율은 TGI 전, TGI 3 및 TGI 5에서 각각 $73.0{\pm}7.9$%, $69.8{\pm}10.0$%, $67.1{\pm}10.1$%으로 감소하였다 (p=0.015). 2. TGI 에 의한 생리학적 사강율의 최대감소량은 기저 해부학적 사강율/생리학적 사강율 비와 r=0.790 (p=0.035), 폐포 사강율과 r=-0.754 (p= 0.050)의 역상관관계를 보였고, $PaC0_2$의 최대감소율은 기저 해부학적 사강율/생리학적 사강율 비와 r=0.714 (p=0.072)의 정상관관계 를 보였다. 3. TGI 전후의 흡기량, 폐포-동맥혈 산소분압차, 평균 기도압 및 평균 동맥압 등에는 유의한 변동이 관찰되지 않았다. 결론 : TGI는 생리학적 사강율이 증가된 환자에서 사강호흡율을 줄여 $PaC0_2$를 감소시켰다. TGI에 의한 사강호흡율과 $PaC0_2$의 감소 효과는 모두 기저 해부학적 사강율/생리학적 사강율 비와 정상관관계가 있었다.

• 대한간호학회지
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• 제26권4호
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• pp.868-877
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• 1996

This study was done to analyze research trends and to suggest future perspectives for nursing research on fatigue. The author reviewed 31 Korean and foreign research papers which have been published in the literature since 1970. An analysis of the study focused on the type of research subjects, type of study design. measurement instrument, and its correlated parameters. The results of the study are summarized as follows : First, within all of the studies analayzed, 14 studies were publised in Korea and 17 were published abroad. The number of studies done abroad have been increasing rapidly since 1991. Second, an analysis of the research design of the studies showed, eight studies each, Korean and foreign used survey design. Two Korean studies and seven foreign studies used a correlational design. Four comparative studies were done in Korea, but only two experimetal studies were performed abroad. Therefore, it was found that the trend of the study design used is survey design and there are more correlational studies done abroad than in Korea. Third, the type of the study subjects ; 11 Korean and three foreign studies dealt with healthy people. In addition, three Korean and 14 foreign studies investigated patients with various illnesses. It was found that patients with various illnesses were studied more frequently in foreign studies than in Korean studies. Fourth, the measurement tool used in the Korean studies ; 13 studies used a testible tool to assess patients' subjective symtoms or complaints of fatigue. The most commonly used tool used in 10 studies, was the Fatigue Self-Perception Scale, which was designed by the Labor and Health Institute of Japan. The Visual Analogue Scale was used in two studies, and Piper Fatigue Scale, addtional with physiologic parameters, was used in one study. In the foreign studies, subjective measurement tools were used in 16 studies. A combination of a subjective measurement tool with objective parameters was used in ten studies. For the subjective measurement tool used in the foreign studies, a specific measurement tool developed by the researcher which was used in seven studies. Either Rhoten Fatigue Scale or the Visual Analog Scale were used in three studies. Additionally, in order to identify the relationship between fatigue and psychological factors, The Profile of Mood State was used in three studies. Beck Depression Inventory was used in two studies. The Self Rated Depression Scale, developed by Zung, was used in one study and other measurement tools were used to measure various psychological parameters. Rhoten fatigue Checklist was also used to observe behavior patterns. Lastly, nine studies identified correlations between fatigue and other parameters. A significant correlation was found between fatigue and psychological factors such as depression, and pain. As a result of the above findings, it can be said that research trends on fatigue are increasing internationally. The selected study designs are survey studies both in Korea and abroad. There are more correlational studies abroad than in Korea. In addition, subjective measurement tools and objective parameters are used variously and combined with each other. had, there is a significant correlation between fatigue and psychological factors such as depression, and pain. More survey and correlational studies need to be done to identify the relationship of fatigue in patients with various condition or diagnoses and to suggest a scientific basis for nursing interventions with fatigue. Also, a tool to assess patient's subjective, objective, and behavioral aspects on fatigue needs to be developed.

• Journal of Chest Surgery
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• 제23권2호
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• pp.213-221
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• 1990

We have experienced 62 cases of modified Fontan operations in Seoul Nat’l University Hospital from Apr. 1986 to Jul. 1989, They were 38 males and 24 females, and their age was ranged from 16 months to 15.5 years of age. [mean age : 5.73$\pm$2.99 years] There were 16 operative deaths and 2 late deaths, therefore 29% of overall mortality. Their diagnoses were as follows; 28 single ventricle, 11 tricuspid atresia, 6 DORV with LV hypoplasia, 3 pulmonary atresia with hypoplastic RV, 3 TGA with hypoplastic RV, 3 cor\ulcornerGA with hypoplastic LV and PA, 6 AV canal defects with PA, and 2 others. Low cardiac output and pleural effusion were developed frequently, so we divide 40 patients into some groups to analyze the physiologic and anatomic causes of them. By the degree of the LCO, group A was no LCO[mean amount of inotropics used: 0-5 \ulcornerg/kg/min] with 17 cases, B mild LCO [5-10] with 11, C moderate to severe LCO but alive[>10] with 8, D severe LCO to death with 4 cases. For the pleural effusion, group 1 was to be removed the chest tube within 1 week with 8 cases, group II within 3 weeks with 21 cases, group III beyond 3 weeks with 12 cases. We considered their age, diagnosis, pulmonary artery size[PA index], pulmonary artery abnormality, palliative shunt, systemic ventricular type, pulmonary artery wedge pressure, as preoperative factors, and operative methods, and as postoperative factors, CVP, LAP, arrhythmia, thrombosis, atrioventricular valvular insufficiency, etc. In the view of LCO, pulmonary artery size and PCWP were statistically significant [P<0.05], and arrhythmia, A-V valve insufficiency were inclined to the group C and D Pleural effusion was influenced by the pulmonary artery size, pulmonary artery resistance, PCWP, and CVP significantly. [P<0.05] And arrhythmia, residual shunt, and A-V valvular insufficiency were inclined to group II and III, too. As a results, the followings are to be reminded as the important factors at the care of post-Fontan LCO, and persistent pleural effusion [1] pulmonary artery size, [2] pulmonary artery resistance, [3] PCWP, [4] CVP, [5] arrhythmia, [6] residual shunt, [7]A-V valvular insufficiency.

• 동서간호학연구지
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• 제9권1호
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• pp.35-45
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• 2004

This study as a cross survey study was conducted to provide basic data for more practical approach to nursing the aged, by analyzing the relationship of the loneliness, self-esteem and quality of life on the hearing disturbance aged. This study was based on the survey data from the 90 aged, who are over sity years old and resident in Seoul. In order to measure the general characteristics and subjective audition, Cantril's Ladder Scale Tool was used. For the loneliness, UCLA Loneliness Scale Tool (translated into Korean to suit the Korean environment by Kim's). In order to measure the self-esteem, Rosenberg's Self-esteem Measurement Tool (translated into Korean by Chun) was used. No's Quality of Life Measurement Tool was used to the measure the quality of life. The Data were collected by direct interviewing on the subjects for this study from August 10, 1999 to September 15, 1999. In accordance with each purpose of this study, appropriate analyzing methods such as Descriptive Statistics, T-test, and ANOVA were used in analyzing the collected data. Pearson correlation coefficient was used to test the relationship of the loneliness, self-esteem and quality of life on the hearing disturbance aged. The result of this study is as follows: 1) The average of the degrees of subjective audition was 7.22, The factors that cause the result were sex, religion, the perception of health, the married state. 2) The average of the degrees of loneliness was 55.18, The factor that cause the result was the perception of health. 3) The average of the degrees of self-esteem was 28.42, The factors that cause the result were the number of family, the number of children, the perception of health. 4) The average of the degrees of quality of life was 71.87 the factors that cause the result were age, education, the number of children, the perception of health. 5) Correlation of Loneliness, self-esteem and quality of life is the perception of loneliness showed significant negative correlation with self-esteem (r=-.466, p=.0001) and quality of life (r=-.450, p=.0001). As a result of analysis above: Because of the recognition change of the aged, it seems to them that the subjective audition scale on the hearing disturbance aged is measured by only 10-point ladder scale is inappropriate. Therefore, it is necessary that the physiologic-index can confirm more exactly should be applied to them. It is very important that the social-psychological factor that has influence on the aged should be the self-perception of health. Thus, proper development of nursing intervention should be required to process in the self-perception of health on the aged.

• Journal of Periodontal and Implant Science
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• 제29권1호
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• pp.31-40
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• 1999

Many factors may affect periodontal changes during the physiologic conditions of woman(e.g. puberty, menstrual cycle, pregnancy, menopause). Recently many research has focused on the immunological changes of host, but the exact mechanism is not clear. Collagen is a major constituent of periodontium, and collagenase specifically digests the collagen and plays a role in destruction of periodontal tissue. So, I suppose that it participates with the cytokines in the inflammation of gingiva and vascular response during the changes of female sex hormones. Because there are some evidences of the existence of the receptors of estrogen and progesterone in the gingiva, it may be a target tissue of female sex hormones. In this experiment, gingival fibroblast and periodontal ligament cell were cultured in the presence of various concentrations of estrogen or progesterone corresponding to the menstrual cycle and pregnancy. Collagenase activity of the supernatant of culture media was determined by Spectrophotometric collagenase assay. The enzyme activity was calculated by the % decrease of the coated collagen. 1. The estrogen at both concentrations had no effect on the activity of collagenase of the gingival fibroblast. 2. The progesterone had some effect on the collagenase activity of the gingival fibroblast at low and high concentration of menstrual cycle, and elevated the enzyme activity at all range of pregnancy concentrations. 3. In periodontal ligament cells, estrogen elevated the enzyme activity at the early pregnancy concentration and progesterone elevated at the concentration just before menstruation. In this experiment, pregesterone elevated the collagenase activity of gingival fibroblast and periodontal ligament cells. But the mechanism of the up-regulation of the enzyme activity was not confirmed. The more experiments of direct effect of progesterone on gingival at the molecular level(e.g. northern blot analysis) can reveal the exact mechanism.

• Childhood Kidney Diseases
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• 제19권2호
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• pp.56-64
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• 2015

To revise the clinical guideline for childhood urinary tract infections (UTIs) of the Korean Society of Pediatric Nephrology (2007), the recently updated guidelines and new data were reviewed. The major revisions are as follows. In diagnosis, the criterion for a positive culture of the catheterized or suprapubic aspirated urine is reduced to 50,000 colony forming uits (CFUs)/mL from 100,000 CFU/mL. Diagnosis is more confirmatory if the urinalysis is abnormal. In treating febrile UTI and pyelonephritis, oral antibiotics is considered to be as effective as parenteral antibiotics. In urologic imaging studies, the traditional aggressive approach to find primary vesicoureteral reflux (VUR) and renal scar is shifted to the targeted restrictive approach. A voiding cystourethrography is not routinely recommended and is indicated only in atypical or complex clinical conditions, abnormal ultrasonography and recurrent UTIs. $^{99m}Tc$-DMSA renal scan is valuable in diagnosing pyelonephritis in children with negative culture or normal RBUS. Although it is not routinely recommended, normal scan can safely avoid VCUG. In prevention, a more natural approach is preferred. Antimicrobial prophylaxis is not supported any more even in children with VUR. Topical steroid (2-4 weeks) to non-retractile physiologic phimosis or labial adhesion is a reasonable first-line treatment. Urogenital hygiene is important and must be adequately performed. Breast milk, probiotics and cranberries are dietary factors to prevent UTIs. Voiding dysfunction and constipation should be properly treated and prevented by initiating toilet training at an appropriate age (18-24 months). The follow-up urine test on subsequent unexplained febrile illness is strongly recommended. Changes of this revision is not exclusive and appropriate variation still may be accepted.

• Archives of Plastic Surgery
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• 제39권2호
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• pp.106-112
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• 2012

Background : Complicated diabetic patients show impaired, delayed wound healing caused by multiple factors. A study on wound healing showed that platelet-rich plasma (PRP) was effective in normal tissue regeneration. Nonetheless, there is no evidence that when platelet-rich plasma is applied to diabetic wounds, it normalizes the diabetic wound healing process. In this study, we have analyzed matrix metalloproteinase (MMP)-2, MMP-9 expression to investigate the effect of PRP on diabetic wounds. Methods : Twenty-four-week-old male Otsuka Long-Evans Tokushima Fatty rats were provided by the Tokushima Research Institute. At 50 weeks, wounds were arranged in two sites on the lateral paraspinal areas. Each wound was treated with PRP gel and physiologic saline gauze. To determine the expression of MMP-2, MMP-9, which was chosen as a marker of wound healing, reverse transcription polymerase chain reaction (RT-PCR) was performed and local distribution and expression of MMP-2, MMP-9 was also observed throughout the immunohistochemical staining. Results : RT-PCR and the immunohistochemical study showed that the levels of MMP-2, MMP-9 mRNA expression in PRP applied tissues were higher than MMP-2, MMP-9 mRNA expression in saline-applied tissues. MMP-9 mRNA expression in wounds of diabetic rats decreased after healing began to occur. But no statistical differences were detected on the basis of body weight or fasting blood glucose levels. Conclusions : This study could indicate the extracellular matrix-regulating effect observed with PRP. Our results of the acceleration of wound healing events by PRP under hyperglycemic conditions might be a useful clue for future clinical treatment for diabetic wounds.

• 한국콘텐츠학회:학술대회논문집
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• 한국콘텐츠학회 2006년도 춘계 종합학술대회 논문집
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• pp.267-272
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• 2006

영상 문화의 발달과 함께 영상의 그래픽적인 요소인 이미지 일러스트레이션과 타이포그래피 등을 이용하여 정보 전달을 극대화할 수 있는 모션그래픽의 중요성도 날로 강조되고 있으며 최근 의도하는 내용을 창의적인 타이포그래피로 시각화한 사례들을 TV광고, 영화 또는 웹과 같은 다양한 미디어 매체에서 쉽게 찾아 볼 수 있으며 또한 증가 추세에 있다. 이러한 영향으로 모션 타이포그래피에서는 무형의 의미적 개념을 타이포그래피라는 시각적 형식을 통하여 표현하기 위하여 언어적 요소, 시간, 형태, 움직임, 색채 그리고 사운드 등과 같은 다양한 요소들을 응용하여 제작할 수 있는 다양한 방법들이 제안되고 있다. 하지만 실제 의사전달 과정에서 더 큰 영향을 미칠 수 있는 성별, 나이, 건강상태, 병적 상태, 신체 사이즈 등의 생리학적 특징을 들 수 있는데 이것을 의사전달이 시각적 형식으로만 표현되어야 하는 모션 타이포그래피에서도 준언어적 음성의 특성을 창의적으로 활용하여 이러한 생리적인 특성을 적절하게 반영할 수 있다면 빠르게 발전하고 있는 다른 미디어 매체보다 더 효과적인 결과를 얻을 수 있을 것이다.