• 한국산업보건학회지
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• 제24권4호
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• pp.518-527
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• 2014

Objectives: The adverse health effects attributed to exposure to radon have been well known over the world. However, the efforts for prevention and mitigation of radon have not been taken in Korea so far. The purpose of this study was to evaluate the effectiveness of mitigation methods applied for various types of houses and public buildings with high level of radon. Methods: Based on the results of "National Radon Survey" performed by the National Institute of Environmental Research(NIER) in 2010-2012, we selected 30 candidate buildings consisting of 20 houses and 10 public buildings with greater than $148Bq/m^3$ of radon level. We measured the concentration of radon in 30 buildings, using E-PERMs and RAD-7 during January to March of 2013. More than five E-PERMs and one RAD-7 per house were installed for seven days. Ten houses and five public buildings were finally chosen to be mitigated after mainly considering the level of radon and the location of buildings nationwide. Three mitigation methods such as Sealing, two types of Active Ventilation(window-shaped and wall-typed ventilations), and Active Soil Depressurization(ASD) were applied, and the concentrations of radon were measured before and after mitigation, respectively. To evaluate the effectiveness of mitigation methods, reduction rates of radon were calculated and Wilcoxon's signed-rank test was performed. Results: The mean concentration of 15 buildings just before radon mitigation was $297.8Bq/m^3$, and most of the buildings were located in Gangwon, Chungbuk, Chungnam, and Daegu areas(73.3%), and built in 1959-1998. The level of radon decreased from 48% to 90% and kept the below recommendation limit of $148Bq/m^3$ after installation of radon mitigation. Among mitigation methods applied, the reduction rate(58.7-90.4%) of radon attributed to ASD was the greatest than that of other methods, followed by Active Ventilation(48.4-78.4%) and Sealing(<22%). The effectiveness of radon reduction by window-shaped Active Ventilation(63.2-75.2%) was relatively better than that of wall-typed Active Ventilation(48.4-54.3%). Conclusions: The results of this study indicate that ASD could be more effective for radon mitigation. Moreover, our findings would be background information in future for making the strategy for radon mitigation nationwide, as well as for developing Korean-version of mitigation techniques according to types of dwellings in Korea.

• Journal of Acupuncture Research
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• 제27권4호
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• pp.239-245
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• 2010

Objectives : The aim of this study is to evaluate the effect of cervical Hyeopcheok(Jiaji) point for neck pain. Methods : The twenty-nine patients who feel neck pain, are chosen from chart review, received acupuncture treatment on cervical Hyeopcheok(Jiaji) point. The evaulation of progress was checked by NDI(neck disability index), and VAS(visual analog scale). Data were analyzed by Friedman two way analysis of variance and Wilcoxon matched pairs signed rank test. Results : NDI value(mean${\pm}$SD) was $17.76{\pm}8.26$(n=29) at the first visit, $13.41{\pm}8.04$(n=29) at 3days after treatment, $10.85{\pm}8.46$(n=26) at 5days, $11.00{\pm}7.80$(n=13) at 9days, $7.22{\pm}4.76$(n=9) at 15days, $3.86{\pm}4.06$(n=7) at 20days, and $3.33{\pm}3.78$(n=6) at 30days. VAS value(mean${\pm}$SD) was $4.07{\pm}1.33$(n=29) at the first visit, $12.97{\pm}1.05$(n=29) at 3days after treatment, $2.15{\pm}1.12$(n=26) at 5days, $2.15{\pm}0.99$(n=13) at 9days, $1.56{\pm}0.73$(n=9) at 15days, $1.29{\pm}0.49$(n=7) at 20days, and $0.83{\pm}0.41$(n=6) at 30days. The value of NDI and VAS gradually decreased. Repeated measurement results(the difference between the first visit and each measurement day) and the difference between before and after the interval(except between 5 and 9days, between 20 and 25days) were statistically significant. Conclusions : This result was shown that treatment of cervical Hyeopcheok(Jiaji) acupuncture point for neck pain can be effective. Further systematic research will be needed.

• 근관절건강학회지
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• 제5권2호
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• pp.174-190
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• 1998

Osteoporosis has been known as a common complication of rheumatoid arthritis and a major preventable health problem. Lots of studios have demonstrated that changes in life style can help delay or prevent osteoporosis. Therefore nursing intervention related osteoporosis prevention have consisted of education programs aimed at changing dietary and exercise habit. However knowledge gained from education haven't always leaded to behavior change. Therefore it is important to consider other psychological variables in effecting behavior change. Numerous research have found self efficacy and health belief to be an important factor in individual decision making behavior. The purpose of the study was to develop health belief and efficacy expectation promoting program based on Health Belief Model & Self Efficacy Model and to investigate its effects in women with rheumatoid arthritis. For this purpose, one group pretest-post design was used. The subject of the study were 16 women with rheumatoid arthritis in Pusan city and data collection was carried out from April, 1997 to May, 1998. The intervention program was consisted of educating on osteoporosis and enhancing and reinforcing self efficacy by verbal persuasion during the period of 4 weeks. The instruments were used to collect data in this study were Osteoporosis Health Belief Scale, Osteoporosis Self Efficacy Scale, and Osteoporosis Preventive Behavior Scale. Data was analyzed by Wilcoxon signed rank test using SPSS $PC^+$ program. The results are as follows : 1) The behavior should be increased after intervention was supported(Z=-3.5162, p=.0004, diet : Z=-3.2942, p=.0010, exercise). 2) The sub-hypothesis that perceived sensitivity should be increased after intervention was supported (Z=-2.3854, p=.0171). 3) The sub-hypothesis that perceived severity should be increased after intervention was rejected(Z=-1.4327, p=.1520). 4) The sub-hypothesis that perceived benefit should be increased after intervention was supported(Z=-2.6410, p=.0083). 5) The sub-hypothesis that perceived barrier should be decreased after intervention was supported (Z=-2.4138, p=.0158). 6) The sub-hypothesis that efficacy expectation should be increased after intervention was supported(Z=-3.5162, p=.0004). As a conclusion, it was found that health belief and self efficacy promoting program was an effective nursing intervention for preventing osteoporosis of rheumatoid arthritis.

• Investigative Magnetic Resonance Imaging
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• 제21권2호
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• pp.71-81
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• 2017

Purpose: To compare three, motion-resistant, T1-weighted MR sequences on the hepatobiliary phase for gadoxetic acid-enhanced MR imaging of the liver. Materials and Methods: In this retrospective study, 79 patients underwent gadoxetic acid-enhanced, 3T liver MR imaging. Fifty-nine were examined using a standard protocol, and 20 were examined using a motion-resistant protocol. During the hepatocyte-specific phase, three MR sequences were acquired: 1) gradient recalled echo (GRE) with controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA); 2) radial GRE with the interleaved angle-bisection scheme (ILAB); and 3) radial GRE with golden-angle scheme (GA). Two readers independently assessed images with motion artifacts, streaking artifacts, liver-edge sharpness, hepatic vessel clarity, lesion conspicuity, and overall image quality, using a 5-point scale. The images were assessed by measurement of liver signal-to-noise ratio (SNR), and tumor-to-liver contrast-to-noise ratio (CNR). The results were compared, using repeated post-hoc, paired t-tests with Bonferroni correction and the Wilcoxon signed rank test with Bonferroni correction. Results: In the qualitative analysis of cooperative patients, the results for CAIPIRINHA had significantly higher ratings for streak artifacts, liver-edge sharpness, hepatic vessel clarity, and overall image quality as compared to, radial GRE, (P < 0.016). In the imaging of uncooperative patients, higher scores were recorded for ILAB and GA with respect to all of the qualitative assessments, except for streak artifact, compared with CAIPIRINHA (P < 0.016). However, no significant differences were found between ILAB and GA. For quantitative analysis in uncooperative patients, the mean liver SNR and lesion-to-liver CNR with radial GRE were significantly higher than those of CAIPIRINHA (P < 0.016). Conclusion: In uncooperative patients, the use of the radial GRE sequence can improve the image quality compared to GRE imaging with CAIPIRINHA, despite the data acquisition methods used. The GRE imaging with CAIPIRINHA is applicable for patients without breath-holding difficulties.

• 한국산학기술학회논문지
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• 제21권11호
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• pp.693-700
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• 2020

본 연구의 목적은 전통적인 인상채득방식으로 제작된 석고모형과 구강 디지털 인상법을 이용하여 제작된 폴리우레탄 모형의 각 계측지점을 비교함으로써 첨단 제조기술로 제작된 모형의 정확성을 검증하는 것이다. 유치악 아크릴릭 구강모형을 선정하여 기존에 사용하던 방식의 석고모형과 최신경향의 방식으로 모형을 각 10개씩 제작하였다. 계측지점은 총 6곳을 지정한 후, 2인의 검사자가 2회로 나누어 버니어 캘리퍼스를 이용하여 측정하였다. 제작방법에 따른 모형의 각 계측치의 평균, 표준편차, 계측치 차이의 평균 등의 기술 통계량으로 제시하였고, 정확성 검정을 위해 윌콕슨 부호순위 검정을 시행하였으며, 검사자 내, 검사자 간, 제작방법 간의 신뢰성 분석은 급내 상관계수 분석과 측정오차를 구하였다. 실험결과 신뢰성은 급내 상관계수의 범위는 0.76에서 0.99의 값이 나타나 높은 신뢰도를 보였으며, 모형 제작방법에 따른 정확성은 모든 계측지점 간의 거리를 비교하였을 때 폴리우레탄 모형이 작게 계측되었으며 0.09~0.20mm의 범위로 선행연구의 결과에 의해 임상적으로 오차범위를 허용할 수 있는 것으로 나타났다. 구강 디지털 인상법의 사용으로 제작된 모형은 임상적으로 적절한 것으로 판단되지만, 향후 보다 정밀하고 사용하기 편리한 치과용 모형을 제작하기 위한 연구들이 추가적으로 이루어져야 할 것이며, 다양한 임상 데이터를 활용한 평가가 이루어져야 할 것으로 사료된다.

• 성인간호학회지
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• 제12권1호
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• pp.122-133
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• 2000

The purpose of this study was to identify the effect of body positioning on $PaO_2$, $SpO_2$, systolic blood pressure, diastolic blood pressure, pulse, and respiration(above all defined physiologic index), of patients with unilateral lung disease. The subjects for this study were eleven patients admitted to I.C.U. of K.H.M.C. with a diagnosis of unilateral lung disease confirmed by chest X-ray and the attending doctor, from January 30th. to April 20th. 1999. A quasi-experimental repeated-measures cross-over design was used to compare three body positions(semi-Fowler's, lateral decubitus with good lung dependent, and lateral decubitus with diseased lung dependent). Each subject spent 30 minutes in semi-Fowler's position and 2 hours in good lung dependent position and diseased lung dependent position. Starting in the semi-Fowler's position, then in the lateral position with the good lung dependent or the diseased lung dependent as assigned in random order. Thirty minutes after each positioning, arterial blood sample was analyzed. Measurements of all physiologic index were recorded at the specified intervals(0, 30, 60 90, and 120 minutes) in good lung dependent and diseased lung dependent position. Statistical comparison of $PaO_2$ value was done using the Wilcoxon Signed Rank Test, and Multivariate repeated-measures analysis of variance was performed to analyse the within-subject effect of two dependent position for 2 hours on the five dependent variables: (1) $PaO_2$ (2) $SpO_2$ (3) systolic blood pressure (4) diastolic blood pressure (5) pulse. The results obtained were as follows: 1. The $PaO_2$ value in the good lung dependent position was significantly higher than the $PaO_2$ value in the diseased lung dependent position(Z=-2.8451, p=.002). 2. The $PaO_2$ value in the good lung dependent position was significantly higher than the $PaO_2$ value in the semi-Fowler's position (Z=-2.6673, p=.003). 3. The difference between the $PaO_2$ value in the semi-Fowler's position and the $PaO_2$ value in the diseased lung dependent position was not significant(Z=-1.2448, p=.10). 4. There were no statistically significance in the trends of physiologic index in the good lung dependent position and the diseased lung dependent position. From the results, it may be concluded that the good lung dependent position is the most effective position for patients with unilateral lung disease that improve oxygenation. Identification of positioning over time may be need further studies.

• 한국항만경제학회지
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• 제31권1호
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• pp.85-110
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• 2015

본 논문에서는 아시아 컨테이너항만들 간의 클러스터링 추세를 분석하기 위해서 퍼지(평균지수변환)DEA모형과 교차효율성모형에 대해서 이론적으로 설명하고, 아시아 38개 컨테이너항만들의 12년간 자료를 4개의 투입요소(선석길이, 수심, 총면적, 크레인 수), 1개의 산출요소(컨테이너화물처리량)를 이용하여 국내항만(부산, 인천, 광양항)들이 어떤 항만들과 클러스터링 해야만 하는지에 대한 측정방법을 실증적으로 보여 주고 분석하였다. 실증분석의 주요한 결과는 다음과 같다. 첫째, 퍼지(평균지수변환)DEA모형에 의한 클러스터링 추세분석에서 국내항만들은 클러스터링을 통해서 효율성을 증대[부산항(56.29%), 인천항(57.96%), 광양항(66.80%)]시 킬 수 있는 것으로 나타났다. 둘째, 원자료를 이용한 교차효율성 모형을 이용한 클러스터링분석에서는 부산항(홍콩, 코오베, 마닐라, 싱가포르, 카오슝, 림찬방, 방콕항), 인천항(아카바, 담만, 카라치, 모하메드 빈 오아심, 다바오), 광양항(담만, 요코하마, 나고야, 킬롱, 카오슝, 방콕항)과 각각 클러스터링을 해야만 하는 것으로 나타났다. 셋째, 퍼지(평균지수변환)DEA모형에 교차효율성 모형을 접목시킨 모형에서는 부산항은 71.38%, 인천항은 103.89%, 광양항은 168.55% 증가가 이루어 졌다. 넷째, 효율성 순위를 검정한 윌콕슨부호순위검정에서는, 세 가지 모형사이의 효율성 순위에 대해서는 약 66%-67% 수준에서 순위에 차이가 없는 것으로 나타났다. 본 논문이 갖는 정책적인 함의는 첫째, 항만정책입안자들이 본 연구에서 사용한 두 가지 모형과 접목시킨 모형을 항만의 클러스터링 정책에 도입하여 해당항만이 발전할 수 있는 전략을 수립하고 이행해 나가야만 한다는 점이다. 둘째, 본 논문의 실증분석결과 국내항만들의 참조항만, 클러스터링항만들로서 나타난 아시아항만들에 대하여, 그들 항만들의 항만개발, 운영에 대한 내용을 정밀하게 분석하고 도입하여 실시하는 것이 필요하다.

• 지역연구
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• 제36권1호
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• pp.17-36
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• 2020

이 연구는 역량 접근법을 기반으로 수도권-비수도권 간 삶의 질 격차의 측면에서 사회적 약자 계층과전체 인구 사이에 차이가 있는지를 비교하는 것을 목적으로 한다. 이를 위해 소득, 주거, 건강, 사회관계 등 역량의 9개 차원을 측정할 수 있는 지표를 선정하여 사회적 약자 계층과 전체 인구에 대해 각각 지표 값을 산출하고, 이를 표준화한 후 윌콕슨 부호순위 검정과 SUR 모형을 이용하여 비교 분석하였다. 그 결과 사회적 약자 대 전체 인구 사이에는 수도권-비수도권 격차에서 유의미한 차이가 있으며, 그 차이는 비수도권의 사회적 약자에게 가장 불리한 방향으로 대체로 일관되게 나타남을 확인하였다. 또한 전체 인구 평균의 관점에서 보면 수도권-비수도권 격차는 크지 않지만, 사회적 약자의 관점에서 보면 지역 격차는 아직도 상당한 수준임을 보여준다. 이러한 결과는 전체 인구의 평균에 대한 분석에 기초한 '평균적' 지역정책이 갖는 한계를 보여주고, 지역문제 분석에서 나타날 수 있는 생태학적 오류를 보여주는 의의를 갖는다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권6호
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• pp.521-530
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• 2020

Purpose: Malnutrition is a common feature in critically ill children. Enteral nutrition (EN) is the main strategy to nutritionally support critical ill children, but its use can be hindered by the development of intolerance. The study aimed to assess the effectiveness and safety of amoxicillin/clavulanate (A/C) to treat EN intolerance. Methods: We retrospectively evaluated patients admitted to the pediatric intensive care unit from October 2018 to October 2019. We conducted a case-control study: in the first 6 months (October 2018-April 2019) we implemented the nutritional protocol of our Institution with no drug, whereas in the second half (May 2019-October 2019) we employed A/C for 1 week at a dose of 10 mg/kg twice daily. Results: Twelve cases were compared with 12 controls. At the final evaluation, enteral intake was significantly higher than that at baseline in the cases (from 2.1±3.7 to 66.1±27.4% of requirement, p=0.0001 by Wilcoxon matched-pairs signed rank test) but not in the controls (from 0.2±0.8 to 6.0±14.1% of the requirement, p=NS). Final gastric residual volume at the end of the observation was significantly lower in the cases than in the controls (p=0.0398). The drug was well tolerated as shown by the similar safety outcomes in both cases and controls. Conclusion: Malnutrition exposes critically ill children to several complications that affect the severity of disease course, length of stay, and mortality; all may be prevented by early EN. The development of intolerance to EN could be addressed with the use of A/C. Future prospective clinical trials are needed to confirm these conclusions.

• Journal of Radiation Protection and Research
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• 제39권4호
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• pp.206-212
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• 2014

진폐요양기관에 대한 실태조사를 실시하여 진폐요양환자에게 사용되는 흉부 CT촬영 선량이 국내외 진단 참고 준위 내에서 사용되는지 알아보았다. 진폐요양기관은 27개 중에서 운용자 콘솔 컴퓨터에서 환자 피폭선량(dose length product, $mGy^*cm$, 이하 DLP) 확인이 가능한 2-Detector 이상 설치된 17개 기관을 대상으로 하였다. 연구대상기관을 직접 연구자가 방문하여 위치잡이촬영, 조영제 사용전,후촬영 및 총 DLP 값을 각각 확인하였다. 또한, 장치의 기본 항목, 위치잡이촬영 조건, 본촬영(scanning) 조건 및 영상 획득 조건을 확인하였다. 흉부 CT촬영에서 확인된 총 DLP 값, 조영제주입전촬영 DLP 값의 상향서열 3/4 순위에 해당하는 DLP 값을 구하였다. SPSS ver. 19.0을 사용하여 전체 영상과 폐야영상 간에 조영제주입전촬영 DLP 값의 비교는 비모수 검정(Wilcoxon signed rank test)을 실시하였다. 전체영상보다 폐야영상을 얻을 때 20.2%의 유의한 DLP 값 감소를 보였다(707.2 vs. 555.9, p<0.001). 흉부 CT촬영에서 확인된 총 DLP 값의 상향서열 3/4 순위(third quartile)의 DLP 값은 $1036.1mGy{\cdot}cm$였다. 흉부 CT촬영의 조영제 주입전촬영에서 확인된 DLP 값의 상향서열 3/4 순위의 DLP 값은 $504.1mGy{\cdot}cm$였다. 진폐요양환자의 흉부 CT촬영에 사용하는 선량은 국내외 진단 참고 준위와 큰 차이를 보이지 않았다.