Park, Ji-Chan;Jang, Yi-Sun;Jeon, Eun-Kyoung;Kim, Dong-Kyu;Lee, Wook-Hyun;Lee, Guk-Jin;You, Si-Young;Choi, Hyun-Ho;Park, Suk-Young
Journal of Hospice and Palliative Care
/
v.12
no.4
/
pp.194-198
/
2009
Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea Purpose: Malignant bowel obstruction causes gastrointestinal symptoms and leads to diminished quality of life in patients with advanced cancer. Several studies have shown the efficacy of octreotide for the relief of malignant bowel obstruction-related symptoms. The aim of this study is to assess the efficacy and safety of octreotide in patients with malignant bowel obstruction. Methods: We retrospectively reviewed medical records of twenty nine patients who had suffered from malignant bowel obstruction without clinical improvement of conservative care and subsequently, received octreotide treatment. Initial dosage of octreotide was 0.1 mg/day, and dose was escalated depending on the clinical effect. For each patient, we assessed visual analogue scale (VAS) of pain, number of vomiting episode, and amount of nasogastric tube drainage. Results: Median dosage of octreotide was 0.2 mg/day (range 0.1~0.6), and median duration from initial medication to death was 20 days (range 2~103). VAS before and after octreotide treatment were 5.6$\pm$1.24, and 2.7$\pm$0.96, respectively. The numbers of vomiting episode before and after octreotide treatment were 3.6/day$\pm$2.5, and 0.4/day$\pm$0.8, respectively. The mean amounts of nasogastric tube drainage before and after octreotide treatment were 975$\pm$1,083 cc/day and 115$\pm$196 cc/day, respectively. Statistically significant reduction in VAS, the number of vomiting episode and the amount of nasogastric tube drainage were observed after octreotide treatment (P<0.05). Conclusion: Administration of octreotide in patients with malignant bowel obstruction, which is uncontrolled by other medication, was effective and safe. In such clinical situations, physicians should consider to add of octreotide for symptomatic control.
Most of stroke patients have not only physical difficulty but speech and neurological disorder because of hemiplegia and such unexpected changes cause psychologic disadaptability and absent-mindedness. Particularly, lowering of physical ability can lead to serious emotional problem from failure or frustration in daily life. Generally, treatment of patient with stroke put emphasis on physical rehabilitation but actually this patient had considerable speech disorder such as aphasia or articulation disorder. Moreover, failing of recognition function, mental disorder as hypochondria, and even visual and auditory disorder are represented. So it is effective to integrate verbal remediation and other treatments in medical care environment. In particular, patients with language disorder very often wither psychologically therefore it is efficient to use of music therapy that gives opulent emotion to aphasia patients. And primarily to investigate the effects of 10 sessions treatments; change in spoken total number of syllables, to confirm their own value by success of given task and reassure about themselves ability. All of 10 sessions stages were scored by MIT manual and its improvement were measured, that is, accomplishment was analyzed within each level in order to prove detail change of spoken total number of syllables. The result of this program organized from 2 syllables to 4 syllables is summarized as follows. Subject A completed in preliminary stage Level I, in 2 syllables case advanced to Level III in fifth session and to Level IV in seventh session, in 3 syllables case advanced to Level III in seventh session and to Level IV in ninth session, and in 4 syllables case showed 8% low success rate in first session but after repeated practice increased considerably in sixth session and in advanced to Level III in eighth session to Level IV in tenth session. Subject B also completed in preliminary stage Level I, in 2 syllables case advanced to Level III in forth session and to Level IV in sixth session, in 3 syllables case advanced to Level III in fifth session and to Level IV in seventh session, and in 4 syllables case showed 10% low success rate in first session and increased considerably in fifth session and in advanced to Level III in seventh session but could not reach to Level IV until tenth session. As a result, it was shown that music therapy using MIT was not statistically meaningful but improved spoken total number of syllables and success rate of task had improved as a whole. Therefore, music intervention using MIT it has positive affect on verbal ability of patients with Broca's Aphasia and their language rehabilitation.
Purpose: With the better understanding of cuff function, partial repair or "force couple repair" for treating massive irreparable rotator cuff tear has gained some popularity. However, there were few reports on the results of partial repair. The purpose of this study was to report the clinical outcome of massive irreparable rotator cuff tears who received arthroscopic force-couple repair or partial repair. Materials and Methods: From June 2005 to Feb 2008, arthroscopic partial repairs were performed for 16 irreparable rotator cuff tears among the 101 large to massive rotator cuff tears that were operated on. Clinical and radiographic evaluation were done at the final follow-up. Results: There were 7 men and 9 women with a mean age of 66.6 years. The mean follow-up period was 27.3 month (range: 15-46). The pain VAS improved from 4.4 ($\pm2.50$) to 2.1 ($\pm2.26$) and the functional VAS improved from 46.9 ($\pm16.64$) to 70.0 ($\pm22.80$). The ASES score improved from 39.0 ($\pm10.80$) to 80.3 ($\pm16.78$) and the KSS score was 81.9 ($\pm16.74$) at the final follow-up. The acromio-humeral distance was 6.6 cm ($\pm1.74$) preoperatively and 6.2 cm ($\pm1.69$) postoperatively without significant change (p=0.3874). The degenerative changes had no statistically progressed (p=0.2663). Conclusion: Partial repair for massive rotator cuff injury patients showed improvement in the clinical score without progression of arthritic change at a mean of 2.3 years follow-up.
Due to the COVID-19 pandemic, the size of the e-commerce has been increased rapidly. This pandemic, which made contact-less communication culture in everyday life made the e-commerce market to be opened even to the consumers who would hesitate to purchase and pay by electronic device without any personal contacts and seeing or touching the real products. Consumers who have experienced the easy access and convenience of the online purchase would continue to take those advantages even after the pandemic. During this time of transformation, however, the size of information source for the consumers has become even shrunk into a flat screen and limited to visual only. To provide differentiated and competitive information on products, companies are adopting AR/VR and steaming technologies but the reviews from the honest users need to be recognized as important in that it is regarded as strong as the well refined product information provided by marketing professionals of the company and companies may obtain useful insight for product development, marketing and sales strategies. Then from the consumer's point of view, if the ratings of reviews are widely diverged how consumers would process the review information before purchase? Are non-converged ratings always unreliable and worthless? In this study, we analyzed how consumer's regulatory focus moderate the attitude to process the diverged information. This experiment was designed as a 2x2 factorial study to see how the variance of product review ratings (high vs. low) for cosmetics affects product attitudes by the consumers' regulatory focus (prevention focus vs. improvement focus). As a result of the study, it was found that prevention-focused consumers showed high product attitude when the review variance was low, whereas promotion-focused consumers showed high product attitude when the review variance was high. With such a study, this thesis can explain that even if a product with exactly the same average rating, the converged or diverged review can be interpreted differently by customer's regulatory focus. This paper has a theoretical contribution to elucidate the mechanism of consumer's information process when the information is not converged. In practice, as reviews and sales records of each product are accumulated, as an one of applied knowledge management types with big data, companies may develop and provide even reinforced customer experience by providing personalized and optimized products and review information.
Son, In Seok;Hwang, Suk Hyun;Lee, Suk Ha;Kang, Min Seok
Journal of Korean Society of Spine Surgery
/
v.25
no.4
/
pp.147-153
/
2018
Study Design: Retrospective case series. Objectives: We retrospectively evaluated the clinical efficacy of postganglionic nerve block in symptomatic Schmorl nodules (SNs). Summary of Literature Review: SNs are common lesions that are often asymptomatic. In certain cases, SNs have been reported to cause severe axial back pain, thereby considerably impacting patients' quality of life. No consensus currently exists on the treatment of symptomatic SNs. Materials and Methods: From October 2015 to October 2017, a total of 21 patients with symptomatic SNs diagnosed by magnetic resonance imaging (MRI) that did not respond to conservative treatment after 4 weeks were included in the study. All patients received postganglionic nerve block. We evaluated effective pain relief (improvement of back pain of more than 50% compared with before the intervention) and functional improvements, assessed by visual analogue scale (VAS) and Oswestry Disability Index scores obtained at 4 hours, 4 weeks, 8 weeks, 3 months, and 6 months after the procedure. Results: Symptomatic SNs were more common at the L2-3 level, and the lower end plate was more commonly involved than the upper end plate. Eighteen of the 21 patients (85.7%) showed effective pain relief, and no deterioration was observed within the followup period. Throughout the follow-up period, the VAS remained significantly improved compared to before the procedure (p<0.05). Complications were not reported in any cases. Conclusions: Postganglionic nerve block for symptomatic SNs that do not respond to conservative treatment is a non-invasive modality for pain relief.
Journal of the Korean Institute of Landscape Architecture
/
v.47
no.3
/
pp.60-70
/
2019
Today, Deoksugung Doldam-gil, which is a well-known area in Seoul, has become a mixed place as many places reaching a critical age have been converted into parks. However, the previous research on the Deoksugung Doldam-gil was deficient in that the user, an essential variable, was not considered when assessing the place. Based on that, this study aims to analyze and interpret the perception of the places in Deoksugung Doldam-gil and to analyze factors to further enrich the place to visitors. According to the research, the representative idea of Deoksugung Doldam-gil is "the distance you want to go" and that has influencing factors, such as vehicle restrictions and the improvement of the walking environment. The analysis of classifying the variables that make up the perception of the place, physical environments, activities and meanings showed high awareness in, "streets of green (3.95)" and "stone walls of curves (3.88)." In the category of activities, "walking activities in the inner city (4.01)" and "love and romance (3.57)" were high. These results seem to reflect the spatial characteristics of the streets and the familiar image of the place were important. Five factors were extracted from the factor analysis to provide a more detailed understanding of the place perception, the correlation between each factor, and the place atmosphere of Deoksugung Doldam-gil. These factors confirmed a high correlation between 'green landscape' and 'historicity.' This can be attributed to the fact that the analysis reflects vital space, visual experience, and free walking conditions to be important, and these variables are present in urban parks. It also indicates the long-accumulated image and behavior near the site of Deoksugung Palace, including the historical and cultural heritage. It was confirmed that the factors related to the cognitive perception of Deoksugung Doldam-gil and the formation of the atmosphere of the place were strongly recognized. It found that there was a need to reflect the value and importance of 'green' in the future as culture or in the use of preservation and management related to heritage. This study presented a direction to be noted from the perspective of a user's place awareness, but considered only a fraction of the variables that affect the multidimensional sense of place and location recognition, and thus must be supplemented in the future.
Purpose Tc-99m HMPAO is widely used radiopharmaceutical for brain perfusion SPECT. Tc-99m HMPAO is chemically unstable and is liable to show deterioration of labeling efficiency due to high incidence of secondary Tc-99m HMPAO complex, free pertechnetate and reduced-hydrolyzed Tc-99m. In this study, we investigated whether sialogogues administration could reduce the impurities of Tc-99m HMPAO. Materials and Methods In thirty subjects(20 male and 10 female, age range 19~89 years, mean age $60.7{\pm}14.5years$), brain perfusion SPECT were performed at basal and citric acid stimulation states consecutively after injection of 555 MBq of Tc-99m HMPAO. In the salivary glands, the uptake coefficient was calculated using Siemens processing program. Statistical comparison between before and after the citric acid stimulation performed paired t-test. P value less than 0.05 was regarded as statistically significant. Results Salivary glands uptake was $12900{\pm}3101$ counts in basal and $10677{\pm}2742$ counts in citric acid stimulation states. Unnecessary impurities in the body is much decreased after citric acid administration(t=10.78, P<0.05). The image quality was much improved after administration of citric acid and the regional cerebral perfusion was clearly from demarcated the background. Conclusion The impurity is distributed throughout the body particularly in the salivary glands and nasal mucosa when Tc-99m HMPAO brain perfusion SPECT is performed. If this impurities is not removed, the quality of the image may deteriorate, resulting in errors in visual evaluation. The use of sialogogues could be helpful for decreasing unnecessary impurities in the body.
Park, Hannah;Park, Il-Seok;Lee, Sang Hyuk;Lee, Seung-Won;Lee, Sang Joon;Lee, Byung-Joo;Cheon, Yong-Il;Park, Jun-Ook;Oh, Kyoung Ho;Shin, Yoo Seob
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
/
v.33
no.1
/
pp.20-25
/
2022
Background and Objectives Globus pharyngeus is one of the most common symptoms of patients visiting otorhinolaryngology out-patient clinic, and usually long-lasting, difficult to treat, and frequently recurrent. Mucomyst®, N-acetyl cysteine is an inhalation agent mainly used for mucolysis and reducing inflammation in airway via antioxidative effect. The purpose of this study was to evaluate the efficacy of inhaled Mucomyst® treatment in patients with globus pharyngeus refractory to proton pump inhibitor (PPI). Materials and Method We prospectively evaluated the efficacy of Mucomyst® in relieving symptoms of globus pharyngeus refractory to PPI in nine medical centers. Three hundred and three patients enrolled and finally 229 patients finished the inhaled Mucomyst® therapy for 8 weeks. We analyzed the change of Reflux Symptom Index (RSI), Reflux Finding Score (RFS), Visual Analogue Scale (VAS) for globus, and Globus Pharyngeus Symptom Scale (GPS) after use of Mucomyst® for 4 and 8 weeks. Results The GPS, RSI, RFS, and VAS score significantly decreased serially in patients who finished 8 week-inhalation treatment. The GPS improvement gap was significantly correlated with initial GPS (p<0.001) in multiple regression analysis. Conclusion Inhaled Mucomyst® therapy was effective for the reduction of both subjective and objective findings in refractory globus patients. This study might suggest new treatment option for patients with globus. However, further thorough studies would be needed to assess the real effect of inhaled Mucomyst® treatment as a standard treatment for globus.
Huh, Soon Ho;Choi, Byeong Yeol;Han, Sang Roc;Chung, Woo Chull
Journal of the Korean Orthopaedic Association
/
v.56
no.2
/
pp.125-133
/
2021
Purpose: The clinical outcomes were investigated to determine if arthroscopic management is a useful method for 19 hips with iliopsoas tendon impingement (IPI) after total hip arthroplasty (THA). Materials and Methods: Eighteen patients (19 hips), who complained of groin pain and flexion pain that persisted after THA from September 2013 to December 2019, were the subjects of this investigation. The mean time to manifestation after THA was four months (range, 1-9 months) in patients of an average age of 60 years (range, 50-69 years). Thirteen out of 18 patients underwent THA using the direct anterior approach and five by the lateral approach. IPI was diagnosed by the medical history, physical examination, blood test, radiographic examination using X-ray and computed tomography, and topical injection therapy. All patients underwent arthroscopic treatment and a dynamic arthroscopic physical examination after exposure to the iliopsoas tendon revealed impingement. Tenotomy was then performed on the muscle portion through the total tendon portion. Symptoms and pain levels of preoperative, postoperative and follow-up period were investigated and compared. Results: The Western Ontario and McMaster Universities Osteoarthritis Index score decreased from an average of 58.4 (range, 40-88) before surgery to an average of 35.0 (range, 15-76) after surgery. Similarly, the visual analogue scale decreased from an average of 4.0 (range, 2-6) before surgery to an average of 1.4 (range, 0-4) after surgery. Sixteen patients (88.9%) showed pain relief and improvement in the straight leg raise test, and two patients showed postoperative muscle weakness and sustained pain. In the follow-up period, muscle weakness improved. One patient underwent arthroscopic iliopsoas tenotomy at the lesser trochanteric level but the symptoms persisted. The clinical symptoms were improved after one more tenotomy at the joint level. Conclusion: Arthroscopic iliopsoas tenotomy performed in patients with IPI after THA showed good clinical results.
본 웹사이트에 게시된 이메일 주소가 전자우편 수집 프로그램이나
그 밖의 기술적 장치를 이용하여 무단으로 수집되는 것을 거부하며,
이를 위반시 정보통신망법에 의해 형사 처벌됨을 유념하시기 바랍니다.
[게시일 2004년 10월 1일]
이용약관
제 1 장 총칙
제 1 조 (목적)
이 이용약관은 KoreaScience 홈페이지(이하 “당 사이트”)에서 제공하는 인터넷 서비스(이하 '서비스')의 가입조건 및 이용에 관한 제반 사항과 기타 필요한 사항을 구체적으로 규정함을 목적으로 합니다.
제 2 조 (용어의 정의)
① "이용자"라 함은 당 사이트에 접속하여 이 약관에 따라 당 사이트가 제공하는 서비스를 받는 회원 및 비회원을
말합니다.
② "회원"이라 함은 서비스를 이용하기 위하여 당 사이트에 개인정보를 제공하여 아이디(ID)와 비밀번호를 부여
받은 자를 말합니다.
③ "회원 아이디(ID)"라 함은 회원의 식별 및 서비스 이용을 위하여 자신이 선정한 문자 및 숫자의 조합을
말합니다.
④ "비밀번호(패스워드)"라 함은 회원이 자신의 비밀보호를 위하여 선정한 문자 및 숫자의 조합을 말합니다.
제 3 조 (이용약관의 효력 및 변경)
① 이 약관은 당 사이트에 게시하거나 기타의 방법으로 회원에게 공지함으로써 효력이 발생합니다.
② 당 사이트는 이 약관을 개정할 경우에 적용일자 및 개정사유를 명시하여 현행 약관과 함께 당 사이트의
초기화면에 그 적용일자 7일 이전부터 적용일자 전일까지 공지합니다. 다만, 회원에게 불리하게 약관내용을
변경하는 경우에는 최소한 30일 이상의 사전 유예기간을 두고 공지합니다. 이 경우 당 사이트는 개정 전
내용과 개정 후 내용을 명확하게 비교하여 이용자가 알기 쉽도록 표시합니다.
제 4 조(약관 외 준칙)
① 이 약관은 당 사이트가 제공하는 서비스에 관한 이용안내와 함께 적용됩니다.
② 이 약관에 명시되지 아니한 사항은 관계법령의 규정이 적용됩니다.
제 2 장 이용계약의 체결
제 5 조 (이용계약의 성립 등)
① 이용계약은 이용고객이 당 사이트가 정한 약관에 「동의합니다」를 선택하고, 당 사이트가 정한
온라인신청양식을 작성하여 서비스 이용을 신청한 후, 당 사이트가 이를 승낙함으로써 성립합니다.
② 제1항의 승낙은 당 사이트가 제공하는 과학기술정보검색, 맞춤정보, 서지정보 등 다른 서비스의 이용승낙을
포함합니다.
제 6 조 (회원가입)
서비스를 이용하고자 하는 고객은 당 사이트에서 정한 회원가입양식에 개인정보를 기재하여 가입을 하여야 합니다.
제 7 조 (개인정보의 보호 및 사용)
당 사이트는 관계법령이 정하는 바에 따라 회원 등록정보를 포함한 회원의 개인정보를 보호하기 위해 노력합니다. 회원 개인정보의 보호 및 사용에 대해서는 관련법령 및 당 사이트의 개인정보 보호정책이 적용됩니다.
제 8 조 (이용 신청의 승낙과 제한)
① 당 사이트는 제6조의 규정에 의한 이용신청고객에 대하여 서비스 이용을 승낙합니다.
② 당 사이트는 아래사항에 해당하는 경우에 대해서 승낙하지 아니 합니다.
- 이용계약 신청서의 내용을 허위로 기재한 경우
- 기타 규정한 제반사항을 위반하며 신청하는 경우
제 9 조 (회원 ID 부여 및 변경 등)
① 당 사이트는 이용고객에 대하여 약관에 정하는 바에 따라 자신이 선정한 회원 ID를 부여합니다.
② 회원 ID는 원칙적으로 변경이 불가하며 부득이한 사유로 인하여 변경 하고자 하는 경우에는 해당 ID를
해지하고 재가입해야 합니다.
③ 기타 회원 개인정보 관리 및 변경 등에 관한 사항은 서비스별 안내에 정하는 바에 의합니다.
제 3 장 계약 당사자의 의무
제 10 조 (KISTI의 의무)
① 당 사이트는 이용고객이 희망한 서비스 제공 개시일에 특별한 사정이 없는 한 서비스를 이용할 수 있도록
하여야 합니다.
② 당 사이트는 개인정보 보호를 위해 보안시스템을 구축하며 개인정보 보호정책을 공시하고 준수합니다.
③ 당 사이트는 회원으로부터 제기되는 의견이나 불만이 정당하다고 객관적으로 인정될 경우에는 적절한 절차를
거쳐 즉시 처리하여야 합니다. 다만, 즉시 처리가 곤란한 경우는 회원에게 그 사유와 처리일정을 통보하여야
합니다.
제 11 조 (회원의 의무)
① 이용자는 회원가입 신청 또는 회원정보 변경 시 실명으로 모든 사항을 사실에 근거하여 작성하여야 하며,
허위 또는 타인의 정보를 등록할 경우 일체의 권리를 주장할 수 없습니다.
② 당 사이트가 관계법령 및 개인정보 보호정책에 의거하여 그 책임을 지는 경우를 제외하고 회원에게 부여된
ID의 비밀번호 관리소홀, 부정사용에 의하여 발생하는 모든 결과에 대한 책임은 회원에게 있습니다.
③ 회원은 당 사이트 및 제 3자의 지적 재산권을 침해해서는 안 됩니다.
제 4 장 서비스의 이용
제 12 조 (서비스 이용 시간)
① 서비스 이용은 당 사이트의 업무상 또는 기술상 특별한 지장이 없는 한 연중무휴, 1일 24시간 운영을
원칙으로 합니다. 단, 당 사이트는 시스템 정기점검, 증설 및 교체를 위해 당 사이트가 정한 날이나 시간에
서비스를 일시 중단할 수 있으며, 예정되어 있는 작업으로 인한 서비스 일시중단은 당 사이트 홈페이지를
통해 사전에 공지합니다.
② 당 사이트는 서비스를 특정범위로 분할하여 각 범위별로 이용가능시간을 별도로 지정할 수 있습니다. 다만
이 경우 그 내용을 공지합니다.
제 13 조 (홈페이지 저작권)
① NDSL에서 제공하는 모든 저작물의 저작권은 원저작자에게 있으며, KISTI는 복제/배포/전송권을 확보하고
있습니다.
② NDSL에서 제공하는 콘텐츠를 상업적 및 기타 영리목적으로 복제/배포/전송할 경우 사전에 KISTI의 허락을
받아야 합니다.
③ NDSL에서 제공하는 콘텐츠를 보도, 비평, 교육, 연구 등을 위하여 정당한 범위 안에서 공정한 관행에
합치되게 인용할 수 있습니다.
④ NDSL에서 제공하는 콘텐츠를 무단 복제, 전송, 배포 기타 저작권법에 위반되는 방법으로 이용할 경우
저작권법 제136조에 따라 5년 이하의 징역 또는 5천만 원 이하의 벌금에 처해질 수 있습니다.
제 14 조 (유료서비스)
① 당 사이트 및 협력기관이 정한 유료서비스(원문복사 등)는 별도로 정해진 바에 따르며, 변경사항은 시행 전에
당 사이트 홈페이지를 통하여 회원에게 공지합니다.
② 유료서비스를 이용하려는 회원은 정해진 요금체계에 따라 요금을 납부해야 합니다.
제 5 장 계약 해지 및 이용 제한
제 15 조 (계약 해지)
회원이 이용계약을 해지하고자 하는 때에는 [가입해지] 메뉴를 이용해 직접 해지해야 합니다.
제 16 조 (서비스 이용제한)
① 당 사이트는 회원이 서비스 이용내용에 있어서 본 약관 제 11조 내용을 위반하거나, 다음 각 호에 해당하는
경우 서비스 이용을 제한할 수 있습니다.
- 2년 이상 서비스를 이용한 적이 없는 경우
- 기타 정상적인 서비스 운영에 방해가 될 경우
② 상기 이용제한 규정에 따라 서비스를 이용하는 회원에게 서비스 이용에 대하여 별도 공지 없이 서비스 이용의
일시정지, 이용계약 해지 할 수 있습니다.
제 17 조 (전자우편주소 수집 금지)
회원은 전자우편주소 추출기 등을 이용하여 전자우편주소를 수집 또는 제3자에게 제공할 수 없습니다.
제 6 장 손해배상 및 기타사항
제 18 조 (손해배상)
당 사이트는 무료로 제공되는 서비스와 관련하여 회원에게 어떠한 손해가 발생하더라도 당 사이트가 고의 또는 과실로 인한 손해발생을 제외하고는 이에 대하여 책임을 부담하지 아니합니다.
제 19 조 (관할 법원)
서비스 이용으로 발생한 분쟁에 대해 소송이 제기되는 경우 민사 소송법상의 관할 법원에 제기합니다.
[부 칙]
1. (시행일) 이 약관은 2016년 9월 5일부터 적용되며, 종전 약관은 본 약관으로 대체되며, 개정된 약관의 적용일 이전 가입자도 개정된 약관의 적용을 받습니다.