• 혜화의학회지
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• 제2권2호
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• pp.219-246
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• 1993

In 1991, Obesity rate of South Korea has reached to 18.7%. Because of economical development, the pattern of diet is exchanged from carbohydrate to rich protein and fat. The more problem is not only obesity of adult but also one of little child. Obesity is induced to diabetes mellitus, hypertension, artherosclerosis, hyperlipoidemia. heart and C.V.A disease, etc. In Woman, special important ploblem is the complex of beauty about Woman's figure. In Oriental Medicine, the factor of obesity is mainly regarded as dampness. And there are many treatments and methods to body weight loss, but obesity patients dislike to use them because of their side effects and inconvenience, intolerance. Now ear acupuncture is applied on so many disease because of its easy handly, non-side effect and high efficiency in clinics. Here obesity acupuncture is used to ear and whole body acupuncture. Because they react eachother for lack point. Therefore, in order to investigate the effect of obesity acupuncture and develop non-drug, non-starvation etc, we analyzed 453 the cases of body weight loss patients treated with ear and whole body acupuncture in Oriental Medicine Hospital of Jeon-Ju Woo-Sug University from April.1.1992. to March.17. 1993. The results were summarized as follows. 1. Distribution of sex ; male (4.4%), Female(95.6%) 2. Distribution of age in descending order ; 30s, 20s, 40s, 10s, 50s, below 10s, abowe 60s. The 20s-30s are group made up 60.7% of the group. 3. Distribution of occupation in descending order; housewife, student, service, salaried, merchant, teacher, farmer, inoccupation. 4. Distribution of human coporal constitution in descending order : Tae-Eum-In, So-Eum-In, So-Yang-In. 5. Distribution of body height and weight, 155-164cm ; 71.1%, 60-70kg, 74.6% are majority. 6. Distribution of weight variation, 2-6kg(71.0%) is majority, also 13-14kg(0.4%). 7. Distribution of duration in descending order ; 1-3 years, 3-6 years, 1-12months, above 10 years but in success, 1-12 months, 1-3 years, 3-6 years, above 10 years. Therefore, we know that the shorter duration of obesity is, the more loss of body weight. 8. Past experiences to body weight loss; Yes(69.5%), No(30.5%). The success rate accordant with the past temporary experiences shows that the cases without experience is higher than the ones with experience. 9. In distribution of times(treatments), 10 times is top. The rate of body weight loss is the highest in 14 times. Therefore, I think that one would need at least 10 times. in order lose body weight 10. Distribution of body weight variation in treatments times is at 2 times(3-4kg loss), and surprisingly is 14kg loss at above 15 times. 11. Distribution of symptoms improvement, in descending order ; heavy sense in body, dec. of appetite, inc.of exercise, lumbago, edema, knee pain, inc.of urine, inc. of fullness sense, thirsty, disease of gynecology, white tung, chest burning, heart burning, dec.of tobacco, drink taste. motion sickness, allergy, water eczema, arthma, belching. 12. Distribution of snack; Yes(87.4%), No(78.6%) 13. Distribution of exercise; Yes(21.4%), No(78.6%) 14. Distribution of sleeping times, above 7 hours(79.0%) 15. Distribution of the reason to body loss, the complex of beauty(68.7%) is top. 16. Distribution of side effect in obesity acupuncture, constipation (17.4%) is top. 17. Distribution of method in body weight loss ; dietary treatment (31.1%), sauna(26.7%), exercise(19.7%), the center of body weight loss (15.0%) herb-med and starvation treatments (5.1%), hand-finger acupuncture (hand-foot acupuncture) is 1.6%, diet pill(0.3%), etc(0.6%).

• 치위생과학회지
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• 제14권4호
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• pp.516-524
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• 2014

본 연구는 직장구강검진의 인식도 및 만족도를 조사하여 직장구강검진의 수검률을 높일 방안을 제안하고자, 편의추출된 대전과 인천지역 20개 사업장 근로자 중 본 조사에 동의한 379명을 대상으로 2014년 6월 30일부터 7월 30일까지 근로자의 직장검진, 직장구강검진의 수검현황과 만족도, 건강행위의도 등을 조사 분석하고, 종사업종, 고용형태, 월급여에 따른 차이를 비교하였다. 1. 직장건강검진 수검경험은 76.0%였으며, 직장구강검진 수검경험은 51.7%였고, 회사에서 직장건강검진 고지는 64.9%이었고, 직장구강검진 고지는 28.2%였다. 2. 직장구강검진 결과에 따라 치료할 용의가 있음은 3점 척도에서 $2.75{\pm}0.52$, 구강검진 결과에 따라 스케일링할 용의가 있음 $2.72{\pm}0.57$, 구강검진 결과에 따라 잇솔질 방법을 변화할 용의가 있음 $2.69{\pm}0.66$, 건강검진의 필요성 $2.69{\pm}0.96$, 직장구강검진의 필요성 $2.68{\pm}0.66$, 직장구강검진이 구강건강유지에 도움이 됨 $2.61{\pm}0.59$, 직장건강검진이 건강유지에 도움이 됨 $2.61{\pm}1.14$로 타 문항에 비해 긍정적이었다. 3. 종사업종 별로는, 사무직이 회사로부터 직장건강검진 및 구강검진 수검에 관한 공지 받는 비율이 유의하게 높았으며, 치료에 대한 금전적 여유가 유의하게 높았고, 영업직은 음주자제 의도가 낮은 것으로 나타났다. 4. 고용형태 별로는, 정규직이 직장건강검진 경험, 주기적 직장검진, 직장에서의 건강검진 고지, 내원검진, 직장구강건강검진 경험에서 유의하게 높은 비율을 보였으며 의료진의 태도 만족, 구강검진결과에 따른 스케일링 의향, 금연에 대한 의도에서 유의하게 높은 점수를 나타내었다. 5. 200만원 월급여를 기준으로, 200만원 미만이 직장건강검진 경험, 주기적 직장검진, 직장에서의 직장검진 고지, 내원검진, 직장구강검진 경험, 직장에서의 직장구강검진 고지에서 유의하게 낮았으나, 만족도에 있어서는 금전적 여유를 제외하고는 차이가 없었고, 건강행위에서는 주기적 운동과 구강보조용품 사용에 있어 200만원 이상이 더 긍정적으로 답변하였다. 구강검진결과에 따라 잇솔질 방법 개선, 스케일링, 치과치료에 대한 의향은 매우 긍정적이었으므로, 국가구강검진 수검률을 높이고 신뢰도를 높일 수 있는 제도적 뒷받침과 치과계의 관심이 필요하며 경제적 고용환경이 열악한 근로자들에 대한 국가 구강검진에 대한 적극적 홍보가 필요하다.

• 대한가정학회지
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• 제27권2호
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• pp.133-148
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• 1989

This study attempts of analyze empirically the living status of the elderly in Korea by finding out the problems of it in the family and by clarifying the influences of the family environmental variables and the values on the adjustment of the aged. To carryout the aim of this study, the causes and the patterns of the problems for the aged had been found out through the review of literature. Based on them the questionnaire was prepared including the questions of the values, family environmental vriables as well as the degree of satisfaction of thier liver and the extent of life interchange. The former variables were taken as independent and the latter were taken as dependent variables, so that the relationship between the two variables could be exemplified. The 400 aged over 60 living in Seoul and the other cities were selected through the purposive sampling and interviewed. The answers of the 376 respondents, 94% of the sample, were analyzed for this study. The following results have been found out through the various statistical analysis such as frequency distribution, chi-square test, pearson's correlation, analysis of variance and cluster analysis. At first, the results from the examination of the frequency distribution regarding the living status of the aged are; I) sixteen percent of the respondents living with their married offspring were receiving economical support, though they pointed out the problems of the extended family are the inconveniences with their children (60%) and simpleness (20%) of their livers. It seems that the aged in Korea are poor and have negative opinion on the relationship with their offspring even if they live in the same house. Secondly, it has been found out that the family environmental variables, especially such as sex, occupation, residence, education, level, living ability and the family type, play and important role not only on the degree of satisfaction of their liver but also on the extent of interchange of their lives. However, the variables such as religion and whether the spouse is alive or not do not play and important role. Thirdly, the reported main reasons of their delightness were healthy life (1.87%), the well-being of their offspring (2.08%), the spouse's long life (3.38%), religious activity (5.05%), the hobby activity (4.31%) and the participation in the social activity (5.05%). While, they mainly concern about the illness (1.98%), offspring (2.00%), econmic difficulties (3.39%), inharmonious home (3.81%) and the despicable treatment (3.81%). The respondents wer classified into two groups, they are dependent and independent, using cluster analysis. Health, social activity, offspiring, religion, couple's long life among the factors which lead them to be delighted were turned out to be statistically signhificant at 0.01 significance level between the two groups. As far as their worrisome matters are concerned, health and economic difficulties were significantly different between the two groups. Fourthly, regarding the life interchange, it has been proved that there is a statistically significant differences betwwen the two groups in the economic and the emotional satisfaction, help for ordinary life, status in the family, subjective and objective relationship with offspring, but not in economic dependency and the activity status. Fifthly, it has been noted that there is a high correlation between the degree of life's satisfaction and the extent of life interchange. On the basis of the results mentioned above, it could be concluded taht; i) The majority of the aged in Korea are not economically active, and thus they live with their married offspring even of they have a negative opinion on the subjective relationship with them. This can be pointed out as the main problem of the aged and thus it needs to be studied further. ii) the environmental variables such as age, sex education level, family type and occuption (which can not be changed by their effrot) turned out to give an important effect on the extent of the life interchange among the aged. iii) The respondents who are identified as independent group have a higher degree of life satisfaction and family status than the group identified as defendent. Thus, it can be inferred that it is possible for them to adjust their life by making an effort to modify themselves. iv) The high correlation between the extent of life interchange and the degree of life satisfaction indicates that the elderly themselves can adjust in order to obtain the higher degree of life satisfaction. Therefore, the following suggestions are derived from this study. First of all, the aged should try to be psychologically independent. Second, they need to control themselves in order to achieve self-assurance. Third, the community have to prepare a program of self-development for the aged. Fourth, the social welfare policy that can solve the problem of illness and poverty of the elderly should be introduced, so that their minimum requirements can be satisfied.

• Journal of Gastric Cancer
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• 제4권4호
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• pp.230-234
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• 2004

목적: 최근 위 질환에서 복강경 사용이 증가하고 있는 추세이다. 그러나, 조기위암의 경우 그 적응증과 표준 술식에 대해서는 논란이 있어 왔다. 본 연구의 목적은 handassisted laparoscopic distal gastrectomy (HALDG), laparos-copy-assisted distal gastrectomy (LADG), 그리고 개복하 원위 위 절제술간의 임상적 결과의 비교를 통해 조기 위암에서 복강경 술기의 유용성을 알아보고자 하였다. 대상 및 방법: 2001년 8월부터 2004년 7월까지 본원에서 조기위암으로 진단받아 HALDG (=18)와 LADG (=7)를 시행한 25명의 환자들을 대상으로 하였으며, 같은 시기에 개복하 원위 위 절제술을 시행한 40명의 환자와 수술시간, 재원 기간, 식이 시작 시기, 절제된 림프절 수 등의 임상적 결과를 비교 분석하였다. 또한 수술 시기에 따라 HALDG와 LADG을 각각 전기와 후기로 분류하여 임상적 결과를 비교하였다. 결과: 복강경 군과 개복술 군 간의 절제된 림프절 수에는 차이가 없었으며, 수술 시간은 복강경 군에서 유의하게 길었다(P<0.05). 또한, 그 외 임상적 결과들에서도 두 군 간에 차이가 없었다. 전기와 후기의 비교에서 후기의 HALDG 군에서 비록 수술 시간의 증가는 있었으나 절제된 림프절 수는 $22.31\pm4.29$에서 $29.40\pm3.21$로 후기에서 유의하게 증가하였다(P<0.05). 결론: 복강경하 위절제술의 경험을 통해 D1+$\beta$ 이상의 림프절 절제가 가능하였고 술식의 안정성 등 조기위암에서도 복강경 술식이 적용될 수 있음을 알 수 있었다. 하지만, 술식의 표준화가 필요하며, 대규모 전향적 연구를 통해 복강경 술식에서도 개복술에서 보인 종양학적 근치성이 입증되어야 할 것이다.

• Journal of Gastric Cancer
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• 제9권3호
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• pp.143-151
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• 2009

목적: 위암은 한국에서 제일 흔한 암으로 저자들은 단일 술자에 의해 위절제술을 시행받은 환자들을 대상으로 임상병리학적 특성 및 5년 생존율과 이에 따른 예후인자를 알아보고자 한다. 대상 및 방법: 1998년 9월부터 2003년 8월까지 만 5년간 위암으로 진단되어 인제대학교 서울백병원 한국위암센터에서 위절제술을 시행한 위암환자 1,435예의 환자를 대상으로 성별 및 연령, 종양의 위치 및 크기, 육안적 분류 및 조직학적 분류, 위벽 침윤도, 림프절 전이, 혈관, 신경초, 림프관 침윤 및 수술 방법 등의 인자들을 후향적으로 조사하였다. 결과: 남녀 비는 2.29 : 1이었고 평균 연령은 56.7세였으며 UICC TNM Stage IA 35.4%, Stage IB 14.1%, Stage II 12.6%, Stage IIIA 12.3%, Stage IIIB 8.3%, Stage IV 17.3%였고 전체 5년 생존율은 69.6%였다. 단변량 분석 결과 연령, 종양의 위치, 종양의 크기, Borrmann type, 분화도, Lauren 분류, 위벽 침윤도, 림프절 전이, UICC TNM 변기, 신경초 침윤, 혈관 침윤, 림프관 침윤, 수술방법에 따라 생존율에 유의한 차이가 있었다. 다변량 분석결과 위벽 침윤도, 림프절 전이만0| 독립적인 예후인자였다. 결론: 다양한 임상병리학적 특성들이 위암환자의 예후에 영향을 주지만 이들 인자들 중 결국 위벽 침윤도와 림프절 전이, 즉 병기가 예후에 가장 중요함을 알 수 있었다. 따라서 위암환자 생존을 향상을 위해서 조기 검진을 통한 위암의 조기 발견과 예후 영향인자에 대한 다각적인 치료 방법이 연구, 개발되어야 하겠다.

• Journal of Gastric Cancer
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• 제9권4호
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• pp.215-222
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• 2009

목적: 원위부 위절제술 후 재건술의 하나인 Billroth II 위공장문합술은 오랫동안 사용되어온 방법이나 역류성 위염의 빈도가 높다는 것이 문제점 중의 하나이다. 이를 보완하기 위한 여러 시도가 있었으나 그 중 잔위의 크기에 따라 Roux-en-Y 위공장문합술, Braun 공장문합술 및 Billroth II 위공장문합술을 달리 시행한 후 그 적용의 적합성을 알아보고자 하였다. 대상 및 방법: 2003년 9월부터 2007년 4월까지 하부 및 중위 위선암으로 단일 술자에 의해 원위부 위절제를 받은 후 잔위의 크기가 10% 이하일 때 Roux-en-Y 위공장문합술 (14명)을, 잔위가 10~20%일 때 Braun 공장문합술(17명)을, 잔위가 20~40%일 때 Billroth I이 부적합하다고 판단된 경우 - Billroth II 위공장문합술(14명)을 시행 후, 각각의 치료성적을 분석하였다. 분석 방법은 전화 설문과 의무기록을 조사하여 환자의 증상 및 내시경 소견을 평가하였고 술 후 영양 상태를 평가하기 위하여 혈중알부민, 혈색소농도 및 체중의 변화를 측정하였다. 결과: 수술 사망률 0%, 수술 합병률 8.9% (4/45)로 모든 수술은 안전하게 시행되었다. 내시경 소견에서 역류성 위염은 Roux-en-Y군, Braun군 및 Billroth II군에서 각각 7.63%, 18.65%, 40.0%에서 보였다(P=0.13). 가벼운 역류성 식도염이 Roux-Y군과 Braun군에서 각각 1명씩 있었다. 내시경적 위저류는 Roux-en-Y군에서 2예가 보였으며 이 중 1예는 역류성식도염의 원인이 되었다. Roux-en-Y군과 Braun군이 Billroth II 군보다 식사량의 감소가 적었으며(각각 7.1%, 0.0%, 28.7%, P=0.036), 식후 불편감(각각 14.3%, 23.5%, 57.1%, P=0.035)과 역류 증상(각각 0.0%, 11.8%, 42.9%, P=0.009)을 적게 호소하였다. 결론: 작은 잔위를 가지는 환자에서 시행된 Roux-en-Y 위공장문합술과 Braun 공장문합술은 역류증상의 방지와 위절제 후 불편감을 줄이는데 효과적이라고 생각하며, 10% 미만의 잔위에서는 Roux-en-Y를, 그 외의 경우에는 Braun 문합을 확대적용을 고려하는 것이 좋겠다.

• 대한간호학회지
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• 제18권2호
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• pp.197-210
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• 1988

The purposes of this study were : 1) to assess the level of pain and to identity the varieties and the degree of pain-related behavior, 2) to measure the level of correlation between the level of pain and the degree of pain- related behavior, 3) to test the correlation between the Korean Pain Rating Scale (KPRS) and Graphic Rating Scale(GRS), and 4) to gather data relevant to the Socio-demographic status of the subjects. The level of pain was measured by KPRS and GRS developed by the researchers. The KPRS consists of three dimensions ; the sensory, the affective and the miscellaneous and the GRS of two separate scales ; the intensity scale and the unpleasantness scale. Of the 2, 025 who had visited orthopedic and neurosurgical out-patients department of 11 university hospitals in various districts of Korea with the episode of Joint pain, 405 subjects were self-selected by responding to the data gathering tools and questionaires mailed. The results are summaried as follows : 1. Maale(217, 53.6%) exceeded female patients(188, 46.4%) in number and the onset of joint pain was more prevalent in the age groups of the 20s and the 30s. 160(39.5%) had been hospitalized for the treatment of, and 87(21.5%) had retired because of the joint pain. 2. Mean pain score measured by KPRS was 128.31 (range; 0-1.344.8) ; mean sensory score was 43.23(range ; 0-645.88%), mean affective score was 46.09(range ; 0- 356.72), and mean miscellaneous score was 39.99(range ; 0-341.68). Mean pain scores measured by GRS were ; sensory intensity score ; 109.1(range ; 0-200) and distress score ; 99.1 (range ; 0-200). 3. The prevalent sites of joint pain revealed to be the right knee joint(203; 50.1%), left knee joint(181(44.7%), left ilium(147, 36.3%), lumbar region (106; 26.2%), hip joint(92; 22.7%) and the ankle(84; 20.7%). 4. The average sleep hour was 6.8hours per day and the average rest hour during the day hours was 3.3hours (range 0-20). 5. The average duration of suffering from joint pain was 49.1 months. 6. Most of the subjects(298; 73.6%) used some sorts of pain relieving practices ; the most prevalent pain relieving practice was the compliance with the physician prescribed treatments(34.4%). 7. The level of discomfort in carrying out the ADL(activities of daily living was 101.16(38.83) and the level of needs for aid in carrying out the ADL was 76.62(31.79). 8. The interrelation between KPRS total score and GRS sensory intensity score(.4438), as well as that of GRS distress score(r＝.4446) were not highly correlated, however, sensory and affective dimension within KPRS (.7547) and pain intensity and distress score of GRS(.6975) revealed moderate intercorrelation. 9. Pain-related behaviors such as discomfort in carrying out ADL, the need for aids in carrying out ADL, frequency of pain relieving practices, varieties of pain sites and length of rest hours during the day hours revealed to be highly correlated with the level of pain measured by KPRS, GRS sensory intensity scale and GRS distress scale. The following are recommended ; 1. Test for the correlation of KPRS total score and the summated score of GRS ; sensory intensity and distress scores. 2. Possibilities of utilization of the pain-related behaviors which revealed high correlation as indirect assessment tool for measuring the level of pain.

• 구강회복응용과학지
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• 제24권2호
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• pp.169-181
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• 2008

치과용 자석의 개선으로 자성 어태치먼트를 이용한 임플란트 피개의치의 사용이 늘고 있다. 또한 여러 형태의 자성 어태치먼트가 개발되어 임상 상황에 따라 적절히 선택하여 사용할 수 있게 되었다. 이에 시중에 판매되는 세 가지 형태의 임플란트용 자성 어태치먼트를 이용해 자성 어태치먼트의 형태와 임플란트 수에 따른 임플란트 피개의치의 유지력을 비교 분석하였다. 식립된 임플란트가 1개인 경우를 1군, 2개인 경우 2군, 4개인 경우를 3군으로 하였고, 자성 어태치먼트의 형태에 따라 flat type, cushion type, dome type으로 세분하였다. Instron으로 수직방향, 사선방향, 전후방향의 인장력을 가하여 자성 어태치먼트의 형태에 따른 유지력의 차이, 힘의 방향에 따른 유지력의 차이, 자성 어태치먼트의 수에 따른 유지력의 변화를 비교 분석하여 다음의 결과를 얻었다. 1) 임플란트의 수와 상관없이 수직력은 flat type이 가장 컸으며, 측방력은 dome type이 가장 작은 것으로 나타났다. 2) 임플란트가 1개일 때 flat type의 수직력이 전후방회전력보다 크게 나타났고, 임플란트가 2개일 때는 dome type과 flat type이, 임플란트가 4개일 때는 cushion type과 flat type에서 수직력이 전후방회전력보다 크게 나타났다. 3) 임플란트 수에 따른 유지력 측정결과, 자석의 형태에 상관없이 임플란트 수가 많을수록 유지력은 증가하였다. 이상의 결과로 볼 때, 큰 유지력이 필요한 환자에게는 flat type이, 유해한 수평력이 존재하는 환자에게는 dome type의 이용이 유리하고, 임플란트가 1개일 때 flat type, 2개일 때 dome type과 flat type, 임플란트가 4개일 때 cushion type과 flat type이 피개의치의 안정성이 더 좋은 것으로 나타났다. 또한 자성 어태치먼트의 형태에 상관없이 임플란트의 수가 증가할수록 더 큰 유지력을 나타냈다. 따라서 임플란트 피개의치 사용 시 적절한 유지력과 안정성을 얻기 위해서 임플란트의 수와 자성 어태치먼트 형태의 고려가 필요하다고 사료된다.

• Tuberculosis and Respiratory Diseases
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• 제58권5호
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• pp.465-472
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• 2005

연구배경 : 일차항암화학요법 후에 생존의 이득을 얻었음에도 불구하고 비소세포폐암 환자들의 대다수가 결국은 재발하거나 진행성 병변을 보인다. 이에 저자들은 기존의 여러 연구에서 보고 된 구제요법으로서 docetaxel의 항암효과와 비교적 적은 독성의 결과를 바탕으로, platinum을 근거로 한 항암화학요법을 시행 받았으나 재발되거나 진행된 비소세포폐암 환자들을 대상으로 docetaxel 단독요법의 치료효과와 부작용에 대하여 알아보고자 하였다. 방 법 : 조직학적으로 비소세포폐암으로 진단을 받고 platinum을 근거로 한 항암화학요법을 받았으나 재발 또는 진행성 병변을 보인 31명의 환자들을 대상으로 docetaxel $75mg/m^2$ 또는 $100mg/m^2$을 3주마다 정주하였다. 임상기록을 통한 후향적인 방법으로 분석하였다. 결 과 : 1) 재발 또는 진행성 병변을 보인 31명중 남녀 비는 24:7이고 중앙연령은 60세였다. 2) 반응평가로 완전 관해는 없었고 부분관해는 14명(45.2%), 불변이 10명(32.3%), 진행이 7명(22.6%)으로 전체적인 반응율은 45.2%이었다. 3) 중앙생존기간은 12.5개월(95% 신뢰구간: 7.3개월-17.6개월) 이었고, 1년 생존율은 52%였다. 무진행생존기간의 중앙값은 3.0개월(95% 신뢰구간: 1.6개월 - 4.5개월)이며, 반응군에서의 중앙반응지속기간은 3.7개월(95% 신뢰구간: 3.0개월 - 4.4개월)이었다. 4) 60세 미만인 경우(20.1 months vs 6.6 months, p=0.0105), 조직학적 아형이 선암일 경우(25.6 months vs 7.9 months, p=0.0055) 통계적으로 유의한 생존기간의 증가가 있었다. 5) 부작용으로 3도 이상의 백혈구 감소증은 12명(38.7%), 호중구 감소증에 동반된 발열은 6명(19.3%), 감염이 동반된 호중구 감소증은 4명(12.9%)에서 발생했다. 치료와 관련되어 1명이 사망하였다. 6) Docetaxel 용량에 따른 생존기간의 차이나 독성의 차이는 없었다. 결 론 : Platinum을 근거로 하는 항암화학요법으로 치료받은 후 재발 또는 진행성 병변을 보이는 비소세포폐암 환자들에게 docetaxel을 투여하는 것은 비교적 안전하고 효과적인 항암치료법으로 사료된다.

• Asia pacific journal of information systems
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• 제21권3호
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• pp.71-96
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• 2011

Within the traditional medical delivery system, patients residing in medically vulnerable areas, those with body movement difficulties, and nursing facility residents have had limited access to good healthcare services. However, Information and Communication Technology (ICT) provides us with a convenient and useful means of overcoming distance and time constraints. ICT is integrated with biomedical science and technology in a way that offers a new high-quality medical service. As a result, rapid technological advancement is expected to play a pivotal role bringing about innovation in a wide range of medical service areas, such as medical management, testing, diagnosis, and treatment; offering new and improved healthcare services; and effecting dramatic changes in current medical services. The increase in aging population and chronic diseases has caused an increase in medical expenses. In response to the increasing demand for efficient healthcare services, a telehealth service based on ICT is being emphasized on a global level. Telehealth services have been implemented especially in pilot projects and system development and technological research. With the service about to be implemented in earnest, it is necessary to study its overall acceptance by consumers, which is expected to contribute to the development and activation of a variety of services. In this sense, the study aims at positively examining the structural relationship among the acceptance factors for telehealth services based on the Technology Acceptance Model (TAM). Data were collected by showing audiovisual material on telehealth services to online panels and requesting them to respond to a structured questionnaire sheet, which is known as the information acceleration method. Among the 1,165 adult respondents, 608 valid samples were finally chosen, while the remaining were excluded because of incomplete answers or allotted time overrun. In order to test the reliability and validity of the assessment scale items, we carried out reliability and factor analyses, and in order to explore the causal relation among potential variables, we conducted a structural equation modeling analysis using AMOS 7.0 and SPSS 17.0. The research outcomes are as follows. First, service quality, innovativeness of medical technology, and social influence were shown to affect perceived ease of use and perceived usefulness of the telehealth service, which was statistically significant, and the two factors had a positive impact on willingness to accept the telehealth service. In addition, social influence had a direct, significant effect on intention to use, which is paralleled by the TAM used in previous research on technology acceptance. This shows that the research model proposed in the study effectively explains the acceptance of the telehealth service. Second, the research model reveals that information privacy concerns had a insignificant impact on perceived ease of use of the telehealth service. From this, it can be gathered that the concerns over information protection and security are reduced further due to advancements in information technology compared to the initial period in the information technology industry, and thus the improvement in quality of medical services appeared to ensure that information privacy concerns did not act as a prohibiting factor in the acceptance of the telehealth service. Thus, if other factors have an enormous impact on ease of use and usefulness, concerns over these results in the initial period of technology acceptance may become irrelevant. However, it is clear that users' information privacy concerns, as other studies have revealed, is a major factor affecting technology acceptance. Thus, caution must be exercised while interpreting the result, and further study is required on the issue. Numerous information technologies with outstanding performance and innovativeness often attract few consumers. A revised bill for those urgently in need of telehealth services is about to be approved in the national assembly. As telemedicine is implemented between doctors and patients, a wide range of systems that will improve the quality of healthcare services will be designed. In this sense, the study on the consumer acceptance of telehealth services is meaningful and offers strong academic evidence. Based on the implications, it can be expected to contribute to the activation of telehealth services. Further study is needed to assess the acceptance factors for telehealth services, such as motivation to remain healthy, health care involvement, knowledge on health, and control of health-related behavior, in order to develop unique services according to the categorization of customers based on health factors. In addition, further study may focus on various theoretical cognitive behavior models other than the TAM, such as the health belief model.