• Archives of Plastic Surgery
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• 제37권3호
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• pp.233-238
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• 2010

Purpose: As the use of soft tissue fillers becomes more popular, complications such as foreign body granuloma (FBG) are increasing. We report 120 cases of facial FBG and review the available literatures. Methods: 120 patients of facial FBG in our clinic from Mar. 2003 to Feb. 2008 were complied and analyzed. A retrospective chart review was done and patient satisfaction was evaluated with a questionnaire using 5 score scale. Patients with severe inflammation sign or bizarre deformity underwent surgical excision and those with minimal symptoms or a history of hyaluronic acid injection received injection therapy using hyaluronidase. Results: 100 females and 20 males were observed. The average age was 43.7 years (from 16 to 74). 84 patients received surgical therapy and 36, injection therapy. Deformity of facial contour, foreign body sensation and inflammation sign were the three main chief complaints. 84 patients did not know what the injection materials were. The known materials are as follows: collagen, hyaluronic acid, silicone oil, paraffin. 92 cases were performed by unlicensed practitioners, 29 by physicians. Anatomical site most frequently affected by the foreign body granuloma was the cheek (25.8%), followed by forehead (19.2%), lips (15.8%), nose (9.2%), mentum (8.3%), eyelid and eyebrow (4.3%) and temple (0.8%). In 21 patients (17.5%), FBGs were found on multiple sites. Patients with inflammation sign got the highest satisfaction ($3.19{\pm}0.73$) (p=0.001) among 3 chief complaints. And patient satisfaction was statistically higher in surgical therapy group ($3.43{\pm}0.72$) than in injection therapy group ($2.97{\pm}0.88$) (p=0.003). Conclusion: We suggest that it may be beneficial to tailor the type of treatment for FBG relying on wound state and patient's chief complaints. In surgical therapy, resolute approach is necessary to correct facial deformity definitely and to minimize inflammation. Injection therapy could be another option for those with minimal symptoms or a history of hyaluronic acid injection. To prevent foreign body granuloma, not only plastic surgeons but also other physicians should inject soft tissue fillers with great caution and we should warn the public of disastrous consequences associated with illegal medical practice.

• Advances in pediatric surgery
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• 제10권1호
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• pp.1-8
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• 2004

A re-pull-through operation for Hirschsprung's disease is performed when the primary operation has failed because of the remnant or acquired aganglionosis, anastomotic stricture and/or fistula. The purpose of this study is to review our experience of the re-pull-through procedure for Hirschsprung's disease. From May 1978 to July 2003, 26 patients who underwent re-pull-through operations at the Department of Pediatric Surgery, Seoul National University Children's Hospital, were studied retrospectively by means of chart review as well as telephone interview. The mean age at primary operation and re-operation were llmonths (2 months - 10 years) and 43 months (1 year - 23 years 3 months), respectively. Initial operation for Hirschsprung's disease was Duhamel's procedure in 17, Swenson's in 6 and Soave's 3. Causes of failure of primary operation were remains of secondary aganglionic segment (n=23), vascular arcade injury (n= 1), rectoperineal fistula (n=2, due to mesenteric torsion and poor blood supply), Mean interval between the primary operation and the re-operation was 34 months (6 months-22 years). Reoperation methods were Soave's in 12, Duhamel's in 8, APSP (abdomino-posterosagittal pull-through procedure) in 5, and Swenson's in 1 case. In 2 cases of repeated rectoperineal fistula or rectourethral fistula, re-APSP were performed 3 times, respectively. A total of 29 re-pull-through operations were performed. Postoperative complications were wound infection (n=1), adhesive ileus (n=1), rectoperineal fistula (n=3), rectourethral fistula (n=2), and death due to pulmonary embolism (n=1). Mean follow up period of reoperation was 78 months (1 month-23years). In current state, 2 patients have an ileostomy because of repeated rectoperineal fistula and rectourethral fistula. Of the remaining 23 patients, 21(91 %) are totally continent with or without minimal soiling. Reoperation for Hirschsprung's disease was effective and safe for the patients complicated to the initial pull-through operation.

• 해양환경안전학회지
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• 제13권4호
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• pp.71-78
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• 2007

예부선은 항만 개발 및 매립, 해상교량 건설, 항로 준설 등 우리나라 해양 산업 건설에 핵심적인 공헌과 역할을 수행하여 왔다. 또한 국내 등록 척수로는 가장 많은 비중을 차지하고 있고, 부선의 경우 전용화와 대형화가 꾸준히 진행되어 일반 상선과 등급의 부선이 운항되고 있다. 이로 인한 해양사고의 증가에도 불구하고 예부선에 대한 국가적인 차원에서의 안전운항 대책이 미흡한 실정이다. 본 연구는 최근 빈번하게 발생하고 있는 해상교량과 관련된 예부선의 사고에 대한 안전 운항 대책을 제안하고자 한 것으로, 해양사고의 통계 자료와 사례 분석, 예부선 운항 실태를 운송계약 측면과 인원 구성을 검토하여 해상교량의 안전 통항을 위해 선학 자체적으로 점검해야 하는 항해계획과 운항점검표를 일례로 제시하고, 예부선의 안전운항 향상을 위한 전자차트시스템 기반의 안전항행지원시스템을 제안한다.

• 대한두개안면성형외과학회지
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• 제21권4호
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• pp.229-236
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• 2020

Background: Oncologic resection of the scalp confers several obstacles to the reconstructive surgeon dependent upon patient-specific and wound-specific factors. We aim to describe our experiences with various reconstructive methods, and delineate risk factors for coverage failure and complications in the setting of scalp reconstruction. Methods: A retrospective chart review was conducted, examining patients who underwent resection of fungating scalp tumors with subsequent soft-tissue reconstruction from 2003 to 2019. Patient demographics, wound and oncologic characteristics, treatment modalities, and outcomes were recorded and analyzed. Results: A total of 189 patients were appropriate for inclusion, undergoing a range of reconstructive methods from skin grafting to free flaps. Thirty-three patients (17.5%) underwent preoperative radiation. In all, 48 patients (25.4%) suffered wound site complications, 25 (13.2%) underwent reoperation, and 47 (24.9%) suffered from mortality. Preoperative radiation therapy was an independent risk factor for wound complications (odds ratio [OR], 2.85; 95% confidence interval [CI], 1.1-7.3; p=0.028) and reoperations (OR, 4.45; 95% CI, 1.5-13.2; p=0.007). Similarly, the presence of an underlying titanium mesh was an independent predictor of wound complications (OR, 2.49; 95% CI, 1.1-5.6; p=0.029) and reoperations (OR, 3.40; 95% CI, 1.2-9.7; p=0.020). Both immunosuppressed status (OR, 2.88; 95% CI, 1.2-7.1; p=0.021) and preoperative radiation therapy (OR, 3.34; 95% CI, 1.2-9.7; p=0.022) were risk factors for mortality. Conclusion: Both preoperative radiation and the presence of underlying titanium mesh are independent risk factors for wound site complications and increased reoperation rates following oncologic resection and reconstruction of the scalp. Additionally, preoperative radiation, along with an immunosuppressed state, may predict patient mortality following scalp resection and reconstruction.

• 농촌의학ㆍ지역보건
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• 제24권1호
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• pp.35-47
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• 1999

노인에서 처방약 복용에 대한 불순응의 문제는 의학적으로 심각한 문제의 발생과 경제적인 손실을 가져오게 된다. 이 연구는 1996년 7월 24 일부터 8월 13일 사이에 경상북도 김천시 금릉군에 거주하는 60세 이상의 농촌 노인을 대상으로 이루어진 단면적인 면접조사이다. 노인에서의 비고이적인 약물복용 불순응의 원인이 되는 약물복용 능력의 실태를 파악하고, 약물 복용능력과 건강상태, 일상적 생활 활동, 가족적 지지, 그리고 인지기능을 비롯한 다양한 변수, 일반적 특성 등과의 관련성을 조사 분석함으로써 약물 복용 실행능력을 예측할 수 있는 예측자를 찾고자 하였다. 현재 복용하고 있는 약물이 있다고 답한 사람은 48.8%였다. 93%가 혼자서 정확한 시간에, 정확한 용량으로 복용할 수 있다고 답하였고, 6%가 약간의 도움이 필요하다고 하거나 혼자 복용할 수 없다고 답하였다. 약물 복용 수행능력과 일반적 특성 및 연구 변수들간의 차이에는 연령과 교육수준, IADL, MMSE-K가 혼자서 독립적으로 복용할 수 없는 군 사이에 유의한 차이가 있었으며, 상관분석에는 ADL, IADL, MMSE-K, BDI가 유의한 상관이 있었다. 단일변수분석과 상관분석에서 약물 복용 능력과 유의한 관련성을 보인 변수를 선택하여 투입한 로지스틱 회귀분석에서 IADL과 성이 최종적으로 선택되었다. 다른 건강수준 측정법 보다 수단적 일상생활 정도는 약물복용 수행능력에 더 민감한 예측자로의 역할이 기대되므로 투약관리와 약물 복용 수행 능력에 대한 정신적 상태를 평가하는 고식적 방법에 추가정보를 제공할 수 있을것으로 판단된다. 추후 약물복용 순응도의 다면적인 면을 고려한 연구가 입 퇴원환자를 중심으로 한 정확한 투약 순응도와 규모 파악, 이를 향상시킬 수 있는 구체적인 방안을 모색하는 방향을 중재 연구와 인지기능 및 운동기등 등의 정신 및 신체조건에 따른 약물 복용 순응도에 초점이 맞춘 다양하고 집중적인 연구자 필요할 것으로 생각된다.

• 대한한방내과학회지
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• 제37권6호
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• pp.961-977
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• 2016

Objectives: This study was designed to analyze the treatment effects of Eunhwayeongyo-tang through retrospective chart reviews. We also checked the correlation between each pair of variables of the symptoms and curative rates of patients with cough. Methods: Thirty-three patients with cough who had satisfied the selection criteria were retrospectively reviewed through their basic medical records, nasal endoscopy, and questionnaires about cough on their first and second visits. The questionnaires used were "The questionnaire on clinical symptoms of cough & sputum", Leicester Cough Questionnaire Korean Version (LCQ-K), Total Nasal Symptom Scores (TNSS), Visual Analog Scale (VAS), and "Cold-heat patterns". The improvement rate, calculated by "The questionnaire on clinical symptoms of cough & sputum" was considered to be clinically effective if reduction of symptoms scored more than 30%. The state of nasopharyngeal mucosa was assessed to categorize the cold-heat patterns of the upper respiratory tract and for diagnosis. Results: According to this study, cough and sputum improved by $57.22{\pm}37.76%$. Most patients (76%) improved significantly after $12.18{\pm}6.59days$ of taking Eunhwayeongyo-tang. The cure rates of 26 patients among the 33 patients were judged as effective. All the mean scores of the questionnaires and the anterior nasal cavity states were significantly improved on the patients' second visits. After $18.39{\pm}15.68days$, 30 patients were completely cured and ended treatment. The nasopharyngeal mucosa states of all patients were categorized as heat patterns. Conclusions: The conditions of the patients with nasopharyngitis significantly improved after taking Eunhwayeongyo-tang. All of the patients had pharyngitis or rhinitis. The cold-heat pattern of nasopharyngeal mucosa was a significant indicator of upper respiratory inflammation diagnosis.

• 한국컴퓨터정보학회논문지
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• 제19권3호
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• pp.73-85
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• 2014

기업 경쟁력 제고를 위해 빅데이터 분석의 중요성이 대두됨에 따라, 기업의 문제점을 체계적으로 파악하고 이를 해결하여 사업적 가치로 재평가하기 위해서는 통합적 빅데이터 프로젝트 수행 방법이 필요하다. 이에 따라 실무적 활용 용이성을 높이도록 소프트웨어 개발과 프로젝트 관리가 융합된 "과학적 데이터 분석 방법론(SDAD)"를 제안한다. SDAD는 프로젝트 수행 과정을 문제정의, 데이터준비, 모델설계, 모델구현, 결과평가, 서비스구현의 6단계를 구성한 후, 단계별 과업을 공정별(47개)로 세분화하고 산출물(93개)을 도출한다. SDAD 는 기존의 ISP, DW, SW 개발 방법론에서 빅데이터 분석과 관련된 부분을 통합하고 쉽게 결과물을 연동할 수 있도록 하였다. 또한, 다양한 분야의 전문가로 구성된 참여자 간에 의사소통의 효율성을 높이기 위해 RACI 챠트를 통해 공정별 책임자를 할당하는 방법과 표준화된 의사소통 절차를 제시한다. SDAD 방법론은 한국고용정보원에서 수행한 빅데이터 프로젝트에 적용하여 감리의 평가를 받은 결과 적정한 것으로 나타났다.

• 대한한방종양학회지
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• 제9권1호
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• pp.39-46
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• 2003

Objectives : The former study of Oriental Medicine on cancer has been mostly focused on lab studies with herbal medicine. Among this atmosphere, the aim of this study is to investigate the suitability of Oriental Medicine institutions to participate in cancer registry programme in R.O.K by investigating the type of treatments used for cancer patients in Oriental Medicine institutes. Methods : To investigate the actual conditions of cancer patients who visited Oriental Medicine institutes, a survey was done based on clinical charts of 258 patients of cancer. Results : The order for the percentage of the original tumor organ of the patients, the number of patients who recognized the outbreak on the year of the first visit was the biggest, and the number gradually decreased while the years passed. For the type of treatment, herbal medicine was the most for 92.6%, acupuncture 52.6%, moxibustion 16.7%, cupping 14.7%. It can be seen that multiple treatment was preferred to single treatment. Among the periods for herbal medication, 10 days was the most for 34.1%, 29.8% for within 50 days and 10.5% for within 100 days. The percentage of patients who took treatment of western medicine at the same time and those who took treatment of Oriental medicine only was 47.4% and 43.8% respectively. By surveying categories such as the symptoms, diagnosis of syndrome, principle of treatment from the chart by a free description, there was 841 names of symptoms, 207 diagnoses of syndromes and 206 principles of treatment. But no relation or connection between these could be found statistically. At there were even occasions which the doctor didn't record the cancer itself, precise investigatio for the actual condition of cancer patients in Oriental Medicine institutions appeared to be very difficult. Conclusions : It seems impossible to enroll cancer patients of Oriental Medicine institutions to the cancer registry programme in R.O.K as far as the patients are recorded only under the paradigm of Oriental Medicine. However, if the Oriental Medicine doctors keep a consistency in classifying categories such as cause of death, syndrome diagnosis, principle of treatment and prescriptions, and limit the choices, for each category, a pilot study for cancer registry programme in R.O.K. in Oriental Medicine could be carried out.

• 해양환경안전학회:학술대회논문집
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• 해양환경안전학회 2007년도 춘계학술발표회
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• pp.101-108
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• 2007

예부선은 항만 개발 및 매립, 해상교량 건설, 항로 준설 등 우리나라 해양 산업 건설에 핵심적인 공헌과 역할을 수행하여 왔다. 또한 국내 등록 척수로는 가장 많은 비중을 차지하고 있고, 부선의 경우 전용화와 대형화가 꾸준히 진행되어 일반 상선과 동급의 부선이 운항되고 있다. 이로 인한 해양사고의 증가에도 불구하고 예부선에 대한 국가적인 차원에서의 안전운항 대책이 미흡한 실정이다. 본 연구는 최근 빈번하게 발생하고 있는 해상교량과 관련된 예부선의 사고에 대한 안전 운항 대책을 제안하고자 한 것으로, 해양사고의 통계 자료와 사례 분석, 예부선 운항 실태를 운송계약 측면과 인원 구성을 검토하여 해상교량의 안전 통항을 위해 선박 자체적으로 점검해야 하는 항해계획과 운항점 검표를 일례로 제시하고, 예부선의 안전운항 향상을 위한 전자차트시스템 기반의 안전항행지원시스템을 제안한다.

• 한국컴퓨터정보학회논문지
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• 제19권11호
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• pp.115-126
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• 2014

본 논문에서는 건강검진을 통해 얻은 PHR정보를 개인의 특성에 따라 맞춤형 표현 방법론 및 디자인을 제시하여, 긍정적인 동기 부여 및 건강 상태 인지력을 높이기 위해 의사결정지원시스템을 통한 가이드라인을 제공하고 통합한 의료 시각화 표현 서비스 방법을 제안한다. 색상, 형태, 위치 3가지 요소를 사용하여 이미지기반의 시각화하여 제안하는 표현 방법은 기존에 수치로만 제공하였던 정보를 방사형차트로 만들어 정보의 인지력을 높였으며, 정상수치를 물방울을 핏방울로 형상화한 모습으로 제공하여 자신의 수치가 핏방울보다 다른 정도에 따라 혈액검사의 결과에 대한 상태의 심각함을 알 수 있다. 표준 수치와 함께 결과를 제공하여 시각적으로 비교하여 자신의 건강상태를 정확히 알 수 있으며, 인체와 연관 지어 시각화하여 표현 하였다. 또 한 개발된 종합 검진결과 시각화는 사람의 신체의 위치를 표시하고 검사항목을 해당 장기부분에 위치시켰다. 검사를 대표할 수 있는 아이콘을 사용함으로 결과에 대한 집중도를 높일 수 있으며, 정보의 습득시간을 단축시켰다.