• 동의신경정신과학회지
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• 제35권2호
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• pp.205-216
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• 2024

Objectives: To evaluate the effectiveness of Mindfulness & Loving Beingness (M&L) psychotherapy combined with traditional Korean medicine in treating acute sleep disorders in patients hospitalized following traffic accidents. Methods: We applied traditional Korean medicine treatments in conjunction with various mindfulness meditation techniques from M&L therapy, including Resource Mindfulness and Nourishment Brief Therapy. This study was conducted on three patients who reported acute sleep disorder symptoms on the first day of hospitalization following a traffic accident. The effectiveness of these interventions was assessed using the PTSD Checklist for DSM-5 (PCL-5-K), Insomnia Severity Index (ISI), EuroQol 5-Dimension (EQ-5D), Numerical Rating Scale (NRS), and Patient Global Impression of Change (PGIC). Results: ISI and PCL-5-K scores showed significant improvements after treatment, indicating reduced sleep disturbances and stress symptoms. Additionally, EQ-5D and PGIC scores were enhanced, reflecting an overall improvement in quality of life. Conclusions: This study suggests that integrating M&L therapy with traditional Korean medicine could significantly improve symptoms in patients with acute sleep disorders following traffic accidents.

• 대한영상의학회지
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• 제82권1호
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• pp.162-172
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• 2021

목적 요추 후궁절제술 시행 부위 후관절 활액낭에 대해 투시유도 하 경피적 낭종파열술 및 스테로이드 주입술을 시행 받은 환자에 관하여 후향적으로 시술의 성공률 및 임상적 효과를 분석하였다. 대상과 방법 투시유도 하 경피적 후관절 낭종파열술과 관절 내 스테로이드 주입술을 시행 받은 환자이면서, 시술 전 6개월 이내 촬영한 요추 자기공명영상 상 이전 후궁절제술 부위와 후 관절 활액낭종의 위치가 일치하는 것이 증명된 환자, 그리고 그 낭종의 위치가 신경학적 증상을 설명하는 것으로 판단되는 환자를 대상(14명)으로 하였으며 시술 후 낭종파열의 성공유무와 증상의 호전 정도를 조사하였다. 결과 시술이 반복될수록 낭종파열의 성공률은 감소하였지만(첫 시술에서는 62.5%, 그 이후의 시술에서는 0~33%), 80%의 환자가 시술 후 증상 호전을 보였다. 추적관찰 기간 내 낭종에 대한 수술률은 14.3%였다. 결론 요추 후궁절제술 시행 부위 후관절 활액낭에 대한 투시유도 하 경피적 낭종파열술 및 스테로이드 주입술은 효과적인 치료 방법으로서, 수술적 치료를 고려하기 전에 먼저 시도해 볼 수 있다.

• Korean Journal of Radiology
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• 제20권1호
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• pp.114-125
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• 2019

Objective: Segmented cardiac cine magnetic resonance imaging (MRI) is the gold standard for cardiac ventricular volumetric assessment. In patients with difficulty in breath-holding or arrhythmia, this technique may generate images with inadequate quality for diagnosis. Real-time cardiac cine MRI has been developed to address this limitation. We aimed to assess the performance of retrospective electrocardiography-gated real-time cine MRI at 3T for left ventricular (LV) volume and mass measurement. Materials and Methods: Fifty-one patients were consecutively enrolled. A series of short-axis cine images covering the entire left ventricle using both segmented and real-time balanced steady-state free precession cardiac cine MRI were obtained. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), and LV mass were measured. The agreement and correlation of the parameters were assessed. Additionally, image quality was evaluated using European CMR Registry (Euro-CMR) score and structure visibility rating. Results: In patients without difficulty in breath-holding or arrhythmia, no significant difference was found in Euro-CMR score between the two techniques (0.3 ± 0.7 vs. 0.3 ± 0.5, p > 0.05). Good agreements and correlations were found between the techniques for measuring EDV, ESV, EF, SV, and LV mass. In patients with difficulty in breath-holding or arrhythmia, segmented cine MRI had a significant higher Euro-CMR score (2.3 ± 1.2 vs. 0.4 ± 0.5, p < 0.001). Conclusion: Real-time cine MRI at 3T allowed the assessment of LV volume with high accuracy and showed a significantly better image quality compared to that of segmented cine MRI in patients with difficulty in breath-holding and arrhythmia.

• 대한물리의학회지
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• 제19권1호
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• pp.81-94
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• 2024

PURPOSE: This study aimed to investigate the effect of a progressive balance training program with whole-body vibration stimulation on knee joint pain, dysfunction, psychosocial status, and balance ability in individuals aged ≥ 65 years with knee osteoarthritis. METHODS: A total of 40 individuals aged ≥ 65 years with osteoarthritis of the knees participated in the study. Using a randomization program, participants were assigned to an experimental group (n = 20) or a control group (n = 20). Both groups were assigned a knee strength training program, and a progressive balance training program with whole-body vibration stimulation was assigned to the experimental group. All interventions were conducted three times a week for four weeks. Participants were evaluated for the following: pain (numeric rating scale, NRS), knee dysfunction (Korean version of the Western Ontario and McMaster Universities Arthritis Index, K-WOMAC), fall efficacy (Korean Version Falls Efficacy Scale, K-FES), quality of life (Euro Quality of life 5 Dimension, EQ-5D), and advanced balance scale score (Fullerton advanced balance scale, FAB) before and after the intervention, and the effects of the intervention were compared accordingly between groups. RESULTS: Both groups showed significant differences in the results of the NRS, K-WOMAC, K-FES, and EQ-5D assessments before and after the intervention, and there was a significant difference in the amount of change between the two groups (p < .05). There was a significant improvement in FAB in all but items FAB 8 and FAB 9 after the intervention in the experimental group. In the control group, there was a significant improvement in FAB 1, FAB 2, FAB 7, and FAB total after the intervention (p < .05). In addition, there was a significant difference in the amount of change between the two groups in all items except FAB 8 and FAB 9 (p < .05). CONCLUSION: The progressive balance training program with whole body vibration stimulation is an effective intervention method with clinical significance in improving knee joint pain, knee disability index, psychosocial level, and balance ability in adults aged ≥ 65 with osteoarthritis of the knees.

• 품질경영학회지
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• 제51권4호
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• pp.531-550
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• 2023

Purpose: The unique nature of life-and-death healthcare services sets them apart from other service industries. While many studies exist on the relationship between healthcare services and customer satisfaction, most of them focus on mildly ill patients, ignoring the differences between critically ill and non-seriously ill patients. This study discusses the actual quality of healthcare services for patients who are facing life-threatening illnesses and are on life support, as well as their right to protection and dignity. Methods: The survey conducted to 149 patients with the four major illnesses: cancer, heart disease, brain disease and rare and incurable disease, those who have experiences with senior general hospitals. Results: The basic statistics of this study are adequate to represent the four major critical illnesses, and the reliability and validity of this study's hypotheses, which were measured by multiple items, were analyzed, and the internal consistency was judged to be high. In addition, it was found that the convergent validity was good and the discriminant validity was also secured. When examining the goodness of fit of the hypotheses, the SRMR, which is the standardized root mean square of residuals that measures the difference between the covariance matrix of the data variables and the theoretical covariance matrix structure of the model, met the optimal criteria. Conclusion: The academic implications of this study are differentiated from other studies by moving away from evaluating the quality of healthcare services for mildly ill patients and focusing on the rights and dignity of patients with life-threatening illnesses in four senior general hospitals. In terms of academic implications, this study enriches the depth of related studies by demonstrating the right to protection and dignity as a factor of patient-centeredness based on physical environment quality, interaction quality, and outcome quality, which are presented as sub-factors of healthcare quality. We found that the three quality factors classified by Brady and Cronin (2001) are optimized for healthcare quality assessment and management, and that the results of patients' interaction quality assessment can be used to provide a comprehensive quality rating for hospitals. Health and human rights are inextricably linked, so assessing the degree to which rights and dignity are protected can be a superior and more comprehensive measurement tool than traditional health level measures for healthcare organizations. Practical implications: Improving the quality of the physical environment and the quality of outcomes is an important challenge for hospital managers who attract patients with life and death conditions, but given the scale and economics of time, money, and human inputs, improving the quality of interactions and defining them as performance indicators in hospital quality management is an efficient way to create maximum value in the short term.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권2호
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• pp.109-117
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• 2024

Background: Dental fear and anxiety are significant challenges in managing behavior in children. Oral administration of sucrose or sweet-tasting solutions has shown effectiveness in reducing procedural pain in infants and neonates. This study aimed to investigate whether pre-application of sucrose solution had an effect on minimizing pain perception during injection and to assess the potential impact of the child's age and sweet preference. Methods: A randomized control clinical trial was conducted on 60 children aged 3-9 years requiring buccal infiltration injections. Following parental consent, demographic data of the children were recorded. Sweet preferences was assessed using a modified forced-choice test. Children were equally and randomly allocated into study (sucrose) and control groups using a lottery method. Sucrose solution or distilled water, respectively, was applied to the lateral surface of the tongue for 2 min. Topical anesthetic was applied at the site of injection, followed by local anesthesia administration. The children rinsed their mouths thrice with water immediately after anesthetic injection. A video was recorded during injection which was then scored by three blinded examiners on the Sound Eye Motor (SEM) scale. The children also self-evaluated using Wong-Baker Faces Pain Rating Scale (WBFPS). Results: The mean SEM scores and WBFPS scores were analyzed using the Kruskall-Wallis test. The mean SEM score in the study group was 1.37 ± 0.61, compared to 3.17 ± 0.87 in the control group, showing a statistically significant difference (P < 0.001). Mean pain scores assessed by WBFPS in the study group were 0.60 ± 1.4, while in the control group, they were 6.27 ± 2.33, also showing a statistically significant difference (P < 0.001). Children with a sweet preference demonstrated a subjective reduction in pain perception. Conclusion: Application of sucrose before dental injections in children helps to minimize pain upon injection across all age groups.

• 대한한방내과학회지
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• 제45권3호
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• pp.519-531
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• 2024

Objectives: This case study reports the effectiveness of Korean medical treatment in a patient with cyclic vomiting syndrome. Methods: A 29-year-old female Korean patient with cyclic vomiting syndrome received acupuncture, electroacupuncture, herbal medicine, and moxibustion for 2 weeks in hospital. Changes in symptoms were evaluated using the Gastrointestinal Symptom Rating Scale (GSRS), Visual Analog Scale (VAS), Index for Nausea, Vomiting, and Retching (INVR), Nausea Severity Scale (NSS), Nepean Dyspepsia Index-Korean version (NDI-K), quality of life using the Functional Dyspepsia Related Quality of Life questionnaire (FD-QoL), and gastric motility using electrogastrography (EGG). Results: Post-treatment, the patient showed high satisfaction and improvement in symptoms of nausea and vomiting. The following changes were observed in scores: GSRS: 23 to 19; VAS of nausea: 88 to 95; VAS of dyspepsia: 95 to 12; INVR: 13 to 1; NSS: 17 to 5; NDI-K: 107 to 78; and FD-QoL 84 to 27. We also found positive results in Channel 3 of EGG parameters, implying the improvement of gastric motility disorder. Conclusion: Korean medical treatment can be a therapeutic option for cyclic vomiting syndrome.

• 대한통합의학회지
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• 제12권3호
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• pp.37-47
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• 2024

Purpose : Cancer survivors often suffer from postoperative sequelae. the diagnosing and provision of manual therapy using spiral taping significantly improves the quality of life of cancer patients. The aim of this case study is to investigate the immediate effects of spiral taping on pain, range of motion (ROM), chemotherapy-induced peripheral neuropathy (CIPN), and lymphedema following breast cancer surgery. Methods : The taping techniques were performed as follows by spiral taping. The measurements were taken before, in the middle, and after taping using a mobile phone camera, tape measure, and a numerical rating score (NRS). The evaluation employed a single-group pre-post design based on a primitive experimental design. Results : Out of four patients, all four exhibited Reverse circle flow energy (RCFE), Passive cervical right (Rt) rotation test, anterior-posterior movement pattern, nerve type (+), cold energy (CE), sangcho acupuncture point, blood clot, hwal point. Comparing before and after treatment, almost all values were reduced to zero after treatment in terms of pain complaints. The lack of range of motion (ROM) caused by the shortened tissue after surgery did not increase. The range of motion (ROM) lost due to pain returned to normal. The circumference of lymphedema did not show a tendency. The symptoms of CIPN improved. Conclusion : There was a significant change in joint range of motion, with pain decreasing, but there were structural limitations in the tissue due to total resection, and the chemotherapy-induced peripheral neuropathy scale. It was effectively treated surgical site pain, axillary membrane syndrome-induced pain, and unexplained pain. While there was a treatment effect for lymphedema in the evaluation of circumference values, there was no significant change in circumference. There was a significant effect on chemotherapy-induced peripheral neuropathy, particularly in treating numbness in the feet, which is a side effect of TC anticancer drugs. This case study found that spiral balance taping provides a rapid therapeutic effect for most side effects in patients who have undergone total breast cancer resection. However, the generalization is limited due to the small sample size, and further research is needed to determine the extent to which the effects of one treatment are maintained.

• Radiation Oncology Journal
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• 제20권4호
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• pp.359-366
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• 2002

목적 : 본 연구 목적은 암 환자의 삶의 질에 대한 국내 연구논문을 분석 평가하여 선행연구의 단점을 보완한 후속 연구의 방향을 제시하기 위함이다. 대상 및 방법 : 전남대학교 보건연구 정보센타, KoreaMed 및 의학연구정보센타의 DB Bank를 검색하여 '삶의 질'과 '암'이라는 용어가 포함된 논문 31편을 선정하였다. 선정된 연구논문을 암 부위, 삶의 질 정의에 대한 개념적 영역(domains), 사용된 독립변수(예측변수), 연구설계(단면적/종적연구), 측정의 주체(자가측정/대리측정), 사용된 도구(단일도구/일련의 도구 세트), 질문지 번역과정(번역-역번역), 신뢰도, 타당도, 점수계산방법, 및 연구결과에 따라 분석하였다. 결과 :전체 31편의 연구논문 중 약 반이 여러 종류의 암 환자를 대상으로 실시되었고, 삶의 질의 정의에 대해서는 많은 연구에서 다차원적으로 정의하였다. 연구설계는 약 30%의 논문만이 종적연구설계를 하여 삶의 질 변화에 대한 연구를 하였다. 삶의 질 측정도구로는 거의 전 연구에서 환자가 직접 측정하는 질문지 방법을 이용하였으나, 도구의 선택에 있어 신뢰도와 타당도에 대해서는 고려하지 않은 편이다. 또한 외국에서 개발된 질문지를 번역하여 사용할 때 번역-역번역 과정을 통해 한글로 번역한 도구는 하나도 없었다. 측정된 삶의 질 계산방법은 전부 전통적인 방법인 평균이나 합으로 계산하였다. 연구에서 삶의 질에 영향을 미치는 독립변수로 검정되었던 변수들은 다양하지 않았다. 결론 : 앞으로 암 환자의 삶의 질에 대한 국내 연구가 나아가야 할 방향은 치료과정에 따른 삶의 질 변화 파악을 위한 종적 연구설계의 시도와 신뢰도와 타당도가 수립된 적절한 측정도구의 사용, 그리고 삶의 질에 영향을 미치는 제 변수들에 대한 반복적 연구 및 새로운 변수 파악을 위한 연구라고 할 수 있다.

• 지능정보연구
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• 제27권3호
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• pp.157-173
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• 2021

소비자의 욕구와 관심에 맞추어 개인화된 제품을 추천하는 추천 시스템은 비즈니스에 필수적인 기술로서의 그 중요성이 증가하고 있다. 추천 시스템의 대표적인 모형 중 협업 필터링은 우수한 성능으로 다양한 분야에서 활용되고 있다. 그러나 협업필터링은 사용자-아이템의 선호도 정보가 충분하지 않을 경우 성능이 저하되는 희소성의 문제가 있다. 또한 실제 평점 데이터의 경우 대부분 높은 점수에 데이터가 편향되어 있어 심한 불균형을 갖는다. 불균형 데이터에 협업 필터링을 적용할 경우 편향된 클래스에 과도하게 학습되어 추천 성능이 저하된다. 이러한 문제를 해결하기 위해 많은 선행연구들이 진행되어 왔지만 추가적인 외부 데이터 또는 기존의 전통적인 오버샘플링 기법에 의존한 추천을 시도하였기에 유용성이 떨어지고 추천 성능 측면에서 한계점이 있었다. 본 연구에서는 CGAN을 기반으로 협업 필터링 구현 시 발생하는 희소성 문제를 해결함과 동시에 실제 데이터에서 발생하는 데이터 불균형을 완화하여 추천의 성능을 높이는 것을 목표로 한다. CGAN을 이용하여 비어있는 사용자-아이템 매트릭스에 실제와 흡사한 가상의 데이터를 생성하여, 희소성을 가지고 있는 기존의 매트릭스로만 학습한 것과 비교했을 때 높은 정확도가 예상된다. 이 과정에서 Condition vector y를 이용하여 소수 클래스에 대한 분포를 파악하고 그 특징을 반영하여 데이터를 생성하였다. 이후 협업 필터링을 적용하고, 하이퍼파라미터 튜닝을 통해 추천 시스템의 성능을 최대화하는데 기여하였다. 비교 대상으로는 전통적인 오버샘플링 기법인 SMOTE, BorderlineSMOTE, SVM-SMOTE, ADASYN와 GAN을 사용하였다. 결과적으로 데이터 희소성을 가지고 있는 기존의 실제 데이터뿐만 아니라 기존 오버샘플링 기법들보다 제안 모형의 추천 성능이 우수함을 확인하였으며, RMSE, MAE 평가 척도에서 가장 높은 예측 정확도를 나타낸다는 사실을 증명하였다.