• Radiation Oncology Journal
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• 제27권3호
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• pp.120-125
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• 2009

목 적: 편도암 환자를 대상으로 시행한 세기조절방사선치료의 예비적 임상결과를 보고하고자 하였다. 대상 및 방법: 2002년 11월부터 2007년 2월까지 서울아산병원에서 세기조절방사선치료를 시행 받은 12명의 편도암 환자를 대상으로 후향적 분석을 시행하였다. 수술 후 방사선치료는 5명, 근치적방사선치료는 7명에서 시행되었고, 이중 6명의 환자가 cisplatin을 기본으로 하는 항암화학요법과 병용으로 치료를 받았다. 세기조절방사선치료는 9명의 환자에서 동시차등조사가속치료(simultaneous modulated accelerated radiation therapy)가 이용되었다. 근치적치료의 경우 일회선량 2.4 Gy 씩 총 72 Gy, 그리고 수술 후 치료의 경우 일회선량 2.2 Gy 씩 총 61.6 Gy의 방사선량이 조사되도록 하였다. 전체 환자의 추적 관찰 기간은 24~80개월(중앙값 34개월)이었다. 결 과: 전체 대상 환자 12명 모두 치료 중단 없이 계획된 치료를 수행 받았다. 방사선치료 종료 후 11명의 환자에서 완전반응을 보였고 한 명의 환자에서 잔존림프절종양이 발견되어 구제 경부곽청술을 시행하였으나 3개월 후 국소림프절종양이 재발하였다. 완전 반응을 보인 11명의 환자는 마지막 추적 관찰 시점까지 국소림프절 재발 및 원격전이는 관찰되지 않았다. 치료 기간 중 급성 합병증은 Radiation Therapy Oncology Group 3도 이상의 구강 점막염, 인두염과 구강건조증이 각각 3명, 3명, 6명에서 관찰되었다. 결 론: 세기조절방사선치료는 편도암의 치료에 있어서 초기 종양반응과 국소제어면에서 임상적으로 적용 가능한 치료법임을 확인 할 수 있었다. 향후 궁극적인 종양반응과 만성 합병증을 알기 위해서는 추가적인 연구대상과 추적 관찰이 필요하겠다.

• Spatial Information Research
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• 제12권2호
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• pp.193-209
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• 2004

본 연구는 응급환자의 의료기관 이용 현황자료를 토대로 GIS를 이용하여 응급의료 진료권을 분석하는데 목적을 두었다. 진료권을 분석하기 위해 6개 응급의료센터를 사례로 선정하여 2003년 9-11월까지 내원한 환자의 주소 자료를 수집하였다. 해당 응급의료기관을 중심으로 하여 거리에 따른 내원환자의 분포 비율을 산출하여 진료권을 분석한 결과 해당 응급의료센터와 인접한 지역에 거주하고 있는 환자의 비율이 가장 높게 나타났다. 그러나 6개 응급의료센터의 1차 진료권의 범위는 상당한 차이를 나타내었는데, 이는 병상 규모 뿐만 아니라 인지도와 환자들의 선호도 등에 따라 응급의료센터의 진료권역이 달라짐을 말해준다. 본 연구에서는 서울시 응급의료 서비스의 공급 표면도를 구축하는 방법을 모색하였다. 32개 응급의료센터로 부터 거리에 따른 내원환자의 분포 비율을 가중치로 부여하여 거리조락에 따른 공급력 수준을 나타내는 개개의 커버리지를 구축한 후, 이를 지도 대수 연산을 통해 합성하였다. 이렇게 구축된 응급의료 서비스의 공급 표면도를 통해 응급의료 서비스 공급 수준은 공간상에서 상당한 차이가 나타나는 것으로 파악되었다.

• 대한의생명과학회지
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• 제17권3호
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• pp.197-202
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• 2011

Mitosis count is one of the most helpful morphologic features for distinguishing pulmonary typical carcinoid (TC) from atypical carcinoid (AC). However, identifying areas of highest mitotic activity is tedious and time-consuming, and mitosis count may vary substantially among pathologists. Anti-phosphohistone H3 (PHH3) is an antibody that specifically detects histone H3 only when phosphorylated at serine 10 or serine 28, an event that is concurrent with mitotic chromatin condensation and not observed during apoptosis. In this study, immunohistochemical staining for PHH3 was performed to determine whether PHH3 was a reliable and objective mitosis-specific marker for pulmonary carcinoid tumors. Seventeen cases of surgically resected pulmonary carcinoid tumors (12 TCs and 5 ACs) were obtained and classified according to the 2004 World Health Organization classification. Mitotic counts determined by PHH3 correlated to ones determined by hematoxylin and eosin (H&E) staining; however, PHH3 mitotic counts (mean mitotic counts: 1 in TCs and 3.2 in ACs) were slightly higher than H&E mitotic counts (mean mitotic counts: 0.25 in TCs and 1.8 in ACs). The mitotic counts determined by experienced observer were more correlated to those determined by inexperienced observer with the PHH3-based method (R=0.968, P<0.001) rather than H&E staining (R=0.658, P<0.001). These results suggest that the PHH3 mitotic counting method was more sensitive and simple for detecting mitoses compared to traditional H&E staining. Therefore, PHH3 immunohistochemistry may contribute to more accurate and reproducible diagnosis of pulmonary carcinoid tumors and may be a valuable aid for administrating appropriate clinical treatment.

• 동서간호학연구지
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• 제26권2호
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• pp.185-195
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• 2020

Purpose: This study examines the factors affecting patient-centered nursing among regional public hospital nurses, with a focus on communications, professionalism, organizational culture, and teamwork. Methods: We included 162 nurses working at five regional public hospitals in G province. Data were collected from October 7 through October 19, 2019 using self-report questionnaires. Data were analyzed using descriptive statistics, t-test or ANOVA, Pearson's correlation coefficient, and hierarchical multiple regression analysis using SPSS (Version 24.0). Results: The factors affecting patient-centered nursing included an innovation-oriented culture, working in an intensive care unit, hierarchy-oriented culture, and nursing professionalism. These variables explained 43% of patient-centered nursing. Conclusions: These results suggest that enhancing an innovation-oriented culture is necessary for patient-centered nursing and to improve nurses' awareness about the importance of patient-centered nursing. Moreover, organizational efforts are required to increase nurses' professionalism through suitable educational programs in regional public hospitals.

• 보건행정학회지
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• 제26권4호
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• pp.382-389
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• 2016

Background: National cancer screening reduces mortality from stomach, colon, breast, and cervical cancer. However, cancer screening rates remain lower than 50% in Korea. This research was designed to make effective guidelines for cancer screening promotion to increase participation rate in cancer screening. Methods: Data was collected from Incheon regional cancer center's telephone survey 'Recognition of cancer prevention and control' of 861 Incheon citizens over age 40. Logistic regression was used to analyse a relationships between cancer screening rates and promotional methods. PASW SPSS ver. 18.0 program (SPSS Inc., Chicago, IL, USA) was used for statistical analysis. Results: About 27.4% of respondents (236 of 861 respondents) have recognized the promotional program of Incheon regional cancer center for cancer screening participation. Cancer screening rate was associated with age group, educational level for stomach cancer, age group, bus advertisement (odds ratio, 1.19 to 2.75) for colon cancer, educational level, residential area for breast cancer, and age group for cervical cancer. Conclusion: There was relationship between stomach cancer screening rates and promotional methods. Therefore, cancer screening promotion guidelines to increase participation rate should be considered.

• Clinical and Experimental Pediatrics
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• 제54권12호
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• pp.481-488
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• 2011

In the current era of low-birth rate in Korea, it is important to improve our neonatal intensive care and to establish an integrative system including a regional care network adequate for both high-risk pregnancies and high-risk newborn infants. Therefore, official discussion for nation-wide augmentation, proper leveling, networking, and regionalization of neonatal and perinatal care is urgently needed. In this report, I describe the status of neonatal intensive care in Korea, as well as nationwide flow of transfer of high-risk newborn infants and pregnant women, and present a short review of the regionalization of neonatal and perinatal care in the Unites States and Japan. It is necessary not only to increase the number of neonatal intensive care unit (NICU) beds, medical resources and manpower, but also to create a strong network system with appropriate leveling of NICUs and regionalization. A systematic approach toward perinatal care, that includes both high-risk pregnancies and newborns with continuous support from the government, is also needed, which can be spearheaded through the establishment of an integrative advisory board to propel systematic care forward.

• Tuberculosis and Respiratory Diseases
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• 제84권3호
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• pp.176-181
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• 2021

At the beginning of February 2020, Daegu faced a serious situation due to the rapid outbreak of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2. The healthcare system in Daegu Metropolitan City was ill-prepared for this sudden disaster situation. The COVID-19 pandemic is still ongoing in South Korea. Daegu has limited medical resources compared to the Seoul Metropolitan Area, and it is hypothesized that a review of the outbreak therein could provide information that will be valuable for dealing with future outbreaks. The likelihood of death due to COVID-19 depends on the capacity of the area for the treatment of critically ill patients. This report reviews the overall treatment process followed for critically ill patients in Daegu.

• 한국응급구조학회지
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• 제25권2호
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• pp.39-53
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• 2021

Purpose: Emergency medical technicians (EMTs) have so far been trained as professionals under the same conditions, with no change in the 1995 Act. We aimed to find ways for them to secure expertise in accordance with social needs by strengthening the quality of the EMT education. Methods: This is a descriptive study comparing the operation status of the national emergency medical examination conducted by the Korea Health Personnel Licensing Examination Institute, and the national examinations of EMT paramedic and EMT basic. The scope of the national examinations for EMT was compared by subject and area. Results: The national written exam for EMT paramedic consists of five areas. EMT basic does not include basic medicine in three related subjects, 11 areas, and 18 detail areas. Paramedic care does not include advanced pediatric life support. In addition, nine areas and 20 detail areas are not included. Conclusion: The study suggests the need for institutional supplementation so that those who have completed EMT basic and the subjects prescribed by the ordinance of the Ministry of Health and Welfare at universities, etc., in the Higher Education Act can take the EMT paramedic national exam.

• Journal of Ginseng Research
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• 제32권2호
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• pp.107-113
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• 2008

In this study, we have investigated the effect of panaxatriol (PT) on phosphoinositides (PIS) breakdown and $Ca^{2+}$-elevation in thrombin-induced platelet aggregation. Thrombin (5U/ml), a potent platelet agonist which activates phospholipase $C_{\beta}$ via protease activated receptor (PAR), hydrolyzed PIS in platelet membrane. The phosphatidylinositol 4, 5-bisphosphate $(PIP_2)$ was hydrolyzed after 10 sec of the thrombin-stimulation, and both the phosphatidylinositol 4-monophosphate (PIP) and phosphatidylinositol (PI) were brokendown after 30 sec of the thrombin-stimulation. However, PT inhibited the thrombin-stimulated hydrolysis of $PIP_2$, PIP, and PI. On the other hand, thrombin increased the level of phosphatidic acid (PA) which is phosphorylated from diacylglycerol (DG) generated by PIS-hydrolysis. However, Pr inhibited the thrombin-increased PA level non-significantly. Thrombin increased cytosolic free $Ca^{2+}([Ca^{2+}])_i$) up to 72% as compared with control $(30.8{\pm}0.9 nM)$ in intact platelet. However, PT (100 ${\mu}g/ml$) inhibited the thrombin-elevated $[Ca^{2+}]_i$ to 100%. These results suggest that PT may have a beneficial effect on platelet aggregation-mediated thrombotic disease by inhibiting thrombin-induced platelet aggregation via suppression of the $[Ca^{2+}]_i$ level and PIS breakdown.

• Journal of Trauma and Injury
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• 제37권1호
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• pp.37-47
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• 2024

Purpose: This study aimed at developing a novel tube thoracostomy technique using the sternum, a fixed anatomical structure, as an indicator to reduce the possibility of incorrect chest tube positioning and complications in patients with chest trauma. Methods: This retrospective study analyzed the data of 184 patients with chest trauma who were aged ≥18 years, visited a single regional trauma center in Korea between April and June 2022, and underwent chest computed tomography (CT) with their arms down. The conventional gold standard, 5th intercostal space (ICS) method, was compared to the lower 1/2, 1/3, and 1/4 of the sternum method by analyzing CT images. Results: When virtual tube thoracostomy routes were drawn at the mid-axillary line at the 5th ICS level, 150 patients (81.5%) on the right side and 179 patients (97.3%) on the left did not pass the diaphragm. However, at the lower 1/2 of the sternum level, 171 patients (92.9%, P<0.001) on the right and 182 patients (98.9%, P= 0.250) on the left did not pass the diaphragm. At the 5th ICS level, 129 patients (70.1%) on the right and 156 patients (84.8%) on the left were located in the safety zone and did not pass the diaphragm. Alternatively, at the lower 1/2, 1/3, and 1/4 of the sternum level, 139 (75.5%, P=0.185), 49 (26.6%, P<0.001), and 10 (5.4%, P<0.001), respectively, on the right, and 146 (79.3%, P=0.041), 69 (37.5%, P<0.001), and 16 (8.7%, P<0.001) on the left were located in the safety zone and did not pass the diaphragm. Compared to the conventional 5th ICS method, the sternum 1/2 method had a safety zone prediction sensitivity of 90.0% to 90.7%, and 97.3% to 100% sensitivity for not passing the diaphragm. Conclusions: Using the sternum length as a tube thoracostomy indicator might be feasible.