• Journal of Dental Anesthesia and Pain Medicine
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• 제21권6호
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• pp.527-545
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• 2021

The aim of this systematic review was to determine the success rate of nitrous oxide-oxygen procedural sedation (NOIS) in dentistry. A systematic digital search was conducted for publications or reports of randomized controlled trials evaluating the clinical performance of NOIS. Abstracts of research papers were screened for suitability, and full-text articles were obtained for those who met the inclusion and exclusion criteria accordingly. The quality of the studies was assessed using the revised Cochrane risk-of-bias tool (RoB 2). A total of 19 articles (eight randomized clinical trials with parallel intervention groups and 11 crossover trials), published between May 1988 and August 2019, were finally selected for this review. The studies followed 1293 patients reporting NOIS success rates, with a cumulative mean value of 94.9% (95% CI: 88.8-98.9%). Thirteen trials were conducted on pediatric populations (1098 patients), and the remaining six were conducted on adults (195 patients), with cumulative efficacy rates of 91.9% (95% CI: 82.5-98.1%) and 99.9% (95% CI: 97.7-100.0%), respectively. The difference was statistically significant (P = 0.002). Completion of treatment and Section IV of the Houpt scale were the most used efficacy criteria. Within the limitations of this systematic review, the present study provides important information on the efficacy rate of NOIS. However, further well-designed and well-documented clinical trials are required and there is a need to develop guidelines for standardization of criteria and definition of success in procedural sedation. Currently, completion of treatment is the most used parameter in clinical practice, though many others also do exist at the same time. To maximize NOIS efficacy, clinicians should strictly consider appropriate indications for the procedure.

• 한방안이비인후피부과학회지
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• 제36권3호
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• pp.74-98
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• 2023

Objectives : This study aims to evaluate the add-on effect of herbal bath combined with acitretin in patients with psoriasis. Methods : We searched randomized controlled trials(RCTs) reporting the effect of herbal bath and acitretin combined treatment for psoriasis in 10 electronic databases from their inception to January 2023. Study collection, data extraction, and risk of bias assessment were performed by two independent researchers. Data synthesis and risk of bias evaluation was conducted using Revman 5.4. Results : Ten RCTs with 1,008 subjects were included. Herbal bath and acitretin combined treatment group showed higher average total effective rate than acitretin alone group(RR 1.39; 95% CI: 1.15-1.68, P=0.0006, I² =0%). Herbal bath and additional treatments such as phototherapy(NB-UVB) and oral herbal medicine, combined with acitretin group also showed higher average total effective rate than acitretin alone group(RR 1.81; 95% CI: 1.47-2.22, P<0.00001, I² =43%). Herbal bath and phototherapy(NB-UVB) combined with acitretin group also showed higher average total effective rate than acitretin alone group(RR 1.51; 95% CI: 1.18-1.93, P=0.0009, I² =0%). The overall risk of bias of the included studies was unclear or of high risks. Conclusions : This review showed that the add-on of herbal bath combined with acitretin treatment could be more effective than acitretin alone treatment in patients with psoriasis. However, because of few included studies, heterogeneity between studies, and insufficient quality of included studies, further well-designed RCTs are needed to confirm the add-on effect of herbal bath on psoriasis.

• Korean Journal of Radiology
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• 제22권10호
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• pp.1730-1741
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• 2021

Objective: Although thermal ablation is effective in treating low-risk papillary thyroid microcarcinomas (PTMCs), comparison of treatment outcomes between thermal ablation and surgery has not yet been systematically evaluated. This study aimed to compare the efficacy and safety of thermal ablation and surgery for the treatment of low-risk PTMCs. Materials and Methods: Ovid-MEDLINE and EMBASE databases were searched for studies reporting comparisons of treatment results between thermal ablation and surgery for patients with low-risk PTMC published up to April 6, 2020. The analysis evaluated the efficacy (local tumor recurrence, occurrence of new tumor, metastasis, and rescue surgery) and safety (complication rate) of thermal ablation and surgery. Results: This systematic review included four studies with a total of 339 PTMCs in 339 patients who underwent thermal ablation and 320 PTMCs in 314 patients who underwent surgery. There was no local tumor recurrence or distant metastasis in either group. There was no significant difference in the pooled proportion of lymph node metastasis (2.6% with thermal ablation vs. 3.3% with surgery, p = 0.65), occurrence of new tumors (1.4% with thermal ablation vs. 1.3% with surgery, p = 0.85), or rescue surgery (2.6% with thermal ablation vs. 1.6% with surgery, p = 0.62). However, the pooled complication rate was significantly higher in the surgery group than in the ablation group (3.3% with thermal ablation vs. 7.8% with surgery, p = 0.03). Conclusion: Both thermal ablation and surgery are effective and safe options for the management of low-risk PTMCs, with thermal ablation achieving a lower complication rate. Therefore, thermal ablation may be considered as an alternative treatment option for low-risk PTMC in patients who refuse surgery and active surveillance or are ineligible for surgery.

• Korean Journal of Radiology
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• 제21권1호
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• pp.108-116
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• 2020

Objective: To investigate the concordance of three international guidelines: the Korean Thyroid Association/Korean Society of Thyroid Radiology, American Thyroid Association, and American College of Radiology for thyroid nodules classified by ultrasonography (US) and the diagnostic performance of simulated size criteria for malignant biopsies. Materials and Methods: A total of 2586 thyroid nodules (≥ 1 cm) were collected from two multicenter study datasets. The classifications of the thyroid nodules were based on three different guidelines according to US categories for malignancy risk, and the concordance rate between the different guidelines was calculated for the classified nodules. In addition, the diagnostic performance of criteria related to four different simulated biopsy sizes was evaluated. Results: The concordance rate of nodules classified as high- or intermediate-suspicion was high (84.1-100%), but low-suspicion or mildly-suspicious nodules exhibited relatively low concordance (63.8-83.8%) between the three guidelines. The differences in sensitivity, specificity, and accuracy between the guidelines were 0.7-19.8%, 0-40.9%, and 0.1-30.5%, respectively, when the original biopsy criteria were applied. The differences decreased to 0-5.9%, 0-10.9%, and 0.1-8.2%, respectively, when simulated, similar biopsy size criteria were applied. The unnecessary biopsy rate calculated with the original criteria (0-33.8%), decreased with the simulated biopsy size criteria (0-8.7%). Conclusion: We found a high concordance between the three guidelines for high- or intermediate-suspicion nodules, and the diagnostic performance of the biopsy criteria was approximately equivalent for each simulated size criterion. The difference in diagnostic performance between the three guidelines is mostly influenced by the various size thresholds for biopsies.

• Clinical Endoscopy
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• 제55권1호
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• pp.33-40
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• 2022

Background/Aims: Multiple outbreaks of multidrug-resistant organisms have been reported worldwide due to contaminated duodenoscopes. In 2015, the United States Food and Drug Administration recommended the following supplemental enhanced surveillance and reprocessing techniques (ESRT) to improve duodenoscope disinfection: (1) microbiological culture, (2) ethylene oxide sterilization, (3) liquid chemical sterilant processing system, and (4) double high-level disinfection. A systematic review and meta-analysis was performed to assess the impact of ESRT on the contamination rates. Methods: A thorough and systematic search was performed across several databases and conference proceedings from inception until January 2021, and all studies reporting the effectiveness of various ESRTs were identified. The pooled contamination rates of post-ESRT duodenoscopes were estimated using the random effects model. Results: A total of seven studies using various ESRTs were incorporated in the analysis, which included a total of 9,084 post-ESRT duodenoscope cultures. The pooled contamination rate of the post-ESRT duodenoscope was 5% (95% confidence interval [CI]: 2.3%-10.8%, inconsistency index [I²]=97.97%). Pooled contamination rates for high-risk organisms were 0.8% (95% CI: 0.2%-2.7%, I²=94.96). Conclusions: While ESRT may improve the disinfection process, a post-ESRT contamination rate of 5% is not negligible. Ongoing efforts to mitigate the rate of contamination by improving disinfection techniques and innovations in duodenoscope design to improve safety are warranted.

• 한국산림과학회지
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• 제98권1호
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• pp.55-65
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• 2009

부속서I국가의 Post-2012 LULUCF 협상을 위해 2008년 8월 가나 아크라에서 개최된 AWG-KP 회의에서 교토의정서 제1차 공약기간에 적용된 gross-net 탄소계정 방법을 개정하기 위한 4가지 협상 대안(gross-net, net-net, 베이스라인 설정, 토지기반 탄소계정 방법)을 결정하였다. 본 연구는 베이스라인 설정 방법을 제외한 3가지 대안에 대해 보고방식, 할인율과 배출권 인정 상한량(cap)에 따라 4가지 대안 시나리오를 설정하여 국가 간 산림 탄소배출권(RMU)을 추정 비교하였다. 교토의정서 3.4조 활동을 현재의 자발보고에서 의무보고로 개정할 경우 러시아, 호주, 뉴질랜드 및 잠재적으로 캐나다도 RMU의 손실이 클 것으로 추정되었다. net-net 및 토지기반 탄소계정 방법은 기준연도 또는 기준기간에 따라 RMU 차이가 큰데, 장령림이 많은 국가는 기준 연도 또는 기준 기간이 공약기간과 가까울수록 RMU가 감소하였다. 모든 국가는 산림경영 활동에 대한 현재의 85% 할인율을 낮출수록 RMU는 증가하였다. 신규조림 및 재조림의 잠재력이 낮은 우리나라는 할인율의 변화에 RMU가 가장 민감하게 변화하였다. 향후 Post-2012 LULUCF 협상은 gross-net 탄소계정 방법과 교토의정서 3.4조 활동의 자발보고라는 현행 탄소계정 체계의 승계가 유력할 것으로 전망된다. 다른 탄소계정 방법은 국가 간 이해관계가 크고 신뢰할만한 방법론 개발에 많은 비용과 시간이 요구된다는 측면에서 채택될 가능성이 낮다. Post-2012 온실가스 의무감축에 참여에 대비하여 우리나라는 기존 선진국과는 다른 차별화된 협상 전략이 필요한데, 특히 산림경영 활동에 대한 할인율을 낮추는 것이 유력한 대안이 될 수 있다.

• 대한인간공학회지
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• 제24권2호
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• pp.17-24
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• 2005

The objective of this study is to examine the prevalence of musculoskeletal disorders(MSDs) among nursing personnels. A self-reporting survey adapted from Nordic questionnaires was used as diagnostic tool, and conducted for 162 nurses working for a general hospital. The survey was performed five times every three months during a year. The MSDs were defined by using three criteria, depending upon the frequency, duration and pain intensity of the symptoms. The results showed that the 12-month prevalences of MSDs at any body site by criterion 1, 2, 3 were 56.8%, 53.7%, 45.7%, respectively, and that the shoulder was the most susceptible to MSDs, followed by knee/lower leg, lower back, hand/wrist, neck, ankle/feet, finger, etc. Only one statistically significant risk factor of departments or units was identified through the Chi-square test. The prevalence of MSDs was the highest in intensive care unit, second in surgical ward, while the prevalence was the lowest in emergency room. The MSDs prevalence of Korea at any body part or by body part was much lower than that of foreign countries such as Japan, USA, Sweden, etc. This implies that when considering poor working conditions and load in Korea, the incidence rate of MSDs may rapidly increase in Korea in the future.

• 기본간호학회지
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• 제12권2호
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• pp.215-222
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• 2005

Purpose: To identify the incidence of cutaneous injury in clinical nurses. Method: From Feb.1 to 28, 2005, 276 clinical nurses were surveyed by questionnaire. Results: 1. Of the nurses, 53.6% had at least one incidence of cutaneous injury, and the mean number of injuries was 1.34. A higher incidence rate for cutaneous injury was found in nurses who were under the age of 25, unmarried and who had less than 3 years career experience. 2. The major causes of injury were syringe needles at 65.0%, and medical instrument were next followed by sharp objects or blades. The injuries occurred when the nurses were rearranging equipment after care (25.2%), taking blood samples (22.8%), separating syringes and needles (17.1%), during surgical operations (14.2%), and distribution of medications, treatments and recapping of needles (5.7% each). The hands were the most common body parts injured, and the most prevalent pathogens contaminating the instruments causing the injury were HBV syphilis, HCV and HIV in that order. 3. Of the injured nurses, 77.9% did not report the accident and 25.8% did not receive any treatment because there were no pathogens, it was a bother or there was difficulty reporting the incident. Conclusion: To reduce cutaneous injuries, intensive training and supervision may be needed for those of nurses under the age of 25, unmarried and with less than 3 years career experience.

• 수산해양교육연구
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• 제13권1호
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• pp.63-86
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• 2001

Recently school violence has been increasing and what is worse, it has been more violent and cruel. The purpose of this study was to analyze the actual conditions of the elementary school violence and to propose the strategies to prevent it. Subjects were 762 male and female elementary school students in Pusan. They were asked to rate the questionnaire concerning school violence. The statistical method of this was verified by X2. The findings of the study were as follows: First, there was gender difference in degrees of school violence. Male students were more exposed to offensive and violent circumstances than female students. Second, there was grade difference in degrees of school violence. 3rd and 4th students were more vulnerable than other grade students. Third, school violence took place in a classroom, usually on break time or lunch time. Forth, half of the students reported to parents and teachers when they or their friends were assaulted. Fifth, the reasons of not reporting the school violence was due to fear of the assailants. The implications of these findings were discussed.

• 융합보안논문지
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• 제4권2호
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• pp.9-15
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• 2004

인터넷은 본질적으로 신뢰할 수 없는 네트워크들의 집합체이다. 인터넷상에서는 정보의 흐름을 통제하기가 대단히 어렵기 때문에, 산재한 자원을 충분히 활용하면서 내부의 중요한 자원을 인터넷으로부터 보호해 줄 수 있는 보안문제가 심각하게 대두되고 있다. 최근 발생하는 바이러스 사고와 시스템 불법 침입에 대한 발생률이 과거보다 훨씬 높으며 다양해지고 있다. 이러한 시기에 불법 행동을 막기 위한 침입 차단에 대한 연구가 활발하게 진행 중이며 계속적인 발전을 하고 있다. 본 논문에서는 침입자의 불법 행동에 대한 로그 정보를 XML 포맷 형식에 맞추어 관리자에게 통보하고, 원격으로 제어 할 수 있는 침입 차단 시스템을 개발하여 관리측면에서 발생하는 문제점을 해결하고자 하였다.