• Tuberculosis and Respiratory Diseases
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• 제65권6호
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• pp.487-494
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• 2008

연구배경: p53 유전자의 돌연변이가 모든 조직형의 폐암에서 가장 흔한 유전적 이상으로 알려져 있다. 이전의 연구에도 불구하고, 폐암 조직에서 p53 단백질의 과발현과 생존과의 관계에 대해서는 아직도 논란이 있다. 본 연구의 목적은 수술로 절제한 병리학적 병기 1기인 비소세포폐암 환자에서 p53 단백질 과발현과 관련된 임상적 특징을 평가하고, p53 단백질 과발현과 예후와의 관계를 평가하는 것이다. 방 법: 본 연구는 삼성서울병원에서 2003년 1월부터 2004년 6월까지 폐암으로 치료 받은 환자 중 병리학적 병기 제 1기의 비소세포폐암 환자를 대상으로 한 후향적 연구이다. 폐암 환자의 종양 조직을 이용하여 p53 단백질에 대한 면역조직화학 염색이 시행되었다. 성별, 연령, 흡연력, 조직형 및 병기 등의 임상적 특징들에 따른 p53 과발 현 여부를 단변량 및 다변량 분석으로 평가하였다. 한편, p53의 과발현 여부에 따른 DFS, DSS 및 OS은 Kaplan-Meier 방법으로 평가하였고, 군간 비교는 log-rank test를 이용하였다 결 과: 125명의 연구 대상 환자에서 p53 면역 염색양성 종양 세포 빈도의 중앙값은 10%였다. 편평세포암에서 p53 과발현(${\geq}10%$)의 빈도가 66%로 선암의 38%보다 통계적으로 유의하게 증가되어 있었다(p=0.002). 병리학적 병기가 IB인 경우 p53 과발현의 빈도가 59%로 IA의 38%보다 증가되어 있었다(p=0.024). 흡연의 기간은 p53이 과발현 된 경우(27년)에 그렇지 않은 경우(20년)보다 통계적으로 유의하게 길었다(p=0.032). 25갑년 이상의 흡연력도 p53이 과발현 된 경우(58%)에 그렇지 않은 경우(38%)보다 더 흔하게 관찰되었다(p=0.024). 다변량 분석에서 p53 과발현과 관련된 인자는 편평세포암의 조직형뿐인 것으로 평가 되었다(p=0.002). 한편, p53 과발현 여부에 따른 DFS, DSS 및 OS의 차이는 없었으며, 편평세포암과 선암의 세부 군 분석에서도 생존의 차이는 없었다. 결 론: 수술로 절제한 제 1기 비소세포폐암 조직에서 면역조직화학 염색으로 평가한 p53 과발현은 조직형, 병기 및 흡연력과 관련이 있었고, 다변량 분석에서 조직형만이 p53 과발현과 관련된 독립적 인자였다. 하지만, p53 과발현과 환자의 생존과는 관련이 없었다.

• Journal of Hospice and Palliative Care
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• 제22권4호
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• pp.185-197
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• 2019

목적: 호스피스 자원봉사자는 환자와 가족의 곁에서 보이지 않는 손의 역할을 하며 호스피스 완화의료팀 내에서 중추적인 역할을 수행하고 있다. 본 연구는 호스피스 자원봉사자 역량강화를 위한 지속교육과정의 효과를 혼합연구방법을 통해 파악하고자 하였다. 방법: 본 연구는 G도 J시에 소재한 G대학교의 매주 4시간씩 총 20시간의 호스피스 자원봉사자 지속교육 과정에 참여한 호스피스 자원봉사자 30명을 대상으로 하였다. 자료의 양적연구를 위해 대상자의 교육 전후 호스피스 태도, 의미 있는 삶, 자기효능감, 자원봉사활동 만족도를 조사하였다. 자료는 SPSS Window 20.0을 사용하여 기술통계, paired t-test, Wilcoxon signed-rank test로 분석하였다. 질적 연구를 위해 교육 참여자들에게 포커스그룹 인터뷰를 시행하였으며, 수집된 자료는 내용분석하였다. 결과: 호스피스 자원봉사자 지속교육 과정의 효과에 대한 양적연구 결과, 호스피스 자원봉사자의 호스피스 태도(t=-2.52, P=0.018)와 자기효능감(z=-2.06, P=0.40)을 향상시키는 것으로 나타났다. 질적 연구 결과, 참여자들은 자신의 신체를 다치지 않으면서 효과적으로 환자들을 돌볼 수 있는 방법과 영적 돌봄을 제공할 수 있는 실제적인 방법을 알기 원하였다. 참여자들은 삶의 마무리를 돕는 봉사에 대한 자부심과 베푸는 기쁨이 나의 삶에 감사로 돌아오기 때문에 지속적으로 봉사활동을 하고 있었으며, 개인시간 할애가 많음에도 불구하고 환자를 잘 돌보고 싶은 열정으로 지속적 배움에 대한 열의를 나타냈다. 결론: 호스피스 자원봉사자들은 지속교육 과정을 통해 환자와 가족을 돌보기 위한 역량 강화를 원하였으며, 이러한 교육은 호스피스 태도와 자기효능감을 높이는 것으로 나타났다. 자원봉사자들의 역량강화를 위해서는 대상자들의 신체적·사회적·영적인 접근을 모두 강화시키는 지속교육이 필요하다. 효율적이고 체계화된 지속교육을 위해서는 웹기반 교육과정 개발 및 지역별 컨소시엄 형성이 도움이 될 수 있다.

• 감성과학
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• 제24권4호
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• pp.139-148
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• 2021

본 연구의 목적은 뇌성마비 아동에게 다감각스토리텔링에 기반한 활동중심중재를 적용하고 사회적 상호작용에 미치는 영향에 대해 알아보는 것이다. 유사실험연구로 단일눈가림, 두 집단 사전-사후검사로 설계하였고, 경직형 뇌성마비로 진단받고, 대동작기능분류체계(GMFCS) I~III단계에 속하는 7~8세 아동 24명을 대상으로 하였다. 실험군과 대조군에 12명씩 무작위 배정하고 아동과 보호자는 집단이 어디에 속하는지 알 수 없도록 하였다. 집단별 프로그램은 회기당 60분, 주 2회, 8주간, 총 16회기 동안 진행되었고, 실험군은 다감각스토리텔링에 기반한 활동중심중재를 하였고, 대조군은 구조화된 신체활동을 실시하였다. 아동의 중재 전과 후에 사회적 상호작용의 변화정도를 확인하기 위해 또래관계기술척도를 사용하여 측정하였다. 수집된 자료는 SPSS 25.0 for windows (IBM Corp, USA) 프로그램을 이용하여 분석하였고, 통계적 검증을 위한 유의수준(α)은 0.05로 하였다. 실험군과 대조군의 또래관계기술의 집단 내 변화는 윌콕슨부호순위검정(Wilcoxon Signed-Rank test)으로 확인하고, 두 집단 간 변화량 차이의 비교는 맨휘트니검정(Mann-Whitney U test)으로 분석하였다. 연구결과 또래관계기술의 집단 내 변화에서 또래관계기술의 전체 값과 하위평가의 협동과 공감영역에서 실험군과 대조군 모두 유의한 차이가 있었고, 주도성 영역에서는 실험군은 유의한 차이를 나타냈으나 대조군은 유의한 차이가 없었다. 두 집단 간 변화량 차이에서 또래관계기술의 하위평가의 주도성영역과 전체 값에서 유의한 차이를 나타냈고, 협동과 공감 영역에서는 유의한 차이가 없었다. 본 연구에서는 뇌성마비 아동을 대상으로 다감각스토리텔링에 기반한 활동중심중재를 적용하여 또래관계기술에 유의한 향상을 확인하였다. 다감각스토리텔링에 기반한 활동중심중재는 뇌성마비 아동의 사회적 상호작용에 효과적인 중재방법으로 제안할 수 있다.

• 대한간호학회지
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• 제30권6호
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• pp.1400-1410
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• 2000

Purpose : To determine whether there is a discrepancy between the medical professions perception of what patients should know and that of the patients themselves, we studied patients need to be informed about different aspects of epilepsy and compared findings with medical personnels perceptions of the issue. Methods : Our study population consisted of 39 patients with epilepsy from the inpatient epilepsy unit, and 51patients from the outpatients clinic of the S. University Hospital between July and November 1997. However, the patients who declined to participate or who were not able to understand the directions and content of the questionnaire were excluded. The medical personnel participated in this study were 56 residents or nurses who were working in either Neurology or Neuro surgery Units. The questionnaire with 5 indicating the highest need. The data were analyzed with descriptive statistics, students t-tests, and chi-square. Results : Of the 90 patients and 56 medical personnel studied, the need for lifestyle information such as smoking, drinking, sleep, driving, employment, and marriage was significantly higher from medical personnel than that of the patients(p=0.00). Regarding medical knowledge about epilepsy, the patients group had higher scores in the need for information on the structure of the brain (p=0.00), whereas medical personnel had higher scores on the symptoms of epilepsy. There was no correlation between the length of epilepsy and the need for information on every item on the questionnaire. The patients had higher rank regarding diet, although it was not significantly different from the medical personnel. Regarding antiepileptic drugs and what to do when there is an attack, medical personnel scored higher. The items on which the patients group scored higher than 4.5 were the possibility of inheritance, the factors that might reduce the number of attacks, the period of usage of AED, and the food they have to avoid or the food they have to take to reduce seizure attacks. Conclusions : Our study indicates that the patients group requires higher educational need in the structure of the brain, diet, and surgical treatment, but less in lifestyles and what to do when there is an attack. The educational program for the patients with epilepsy should emphasize medical knowledge with regard to brain anatomy, what to eat and what to avoid, and details of surgical treatment.

• 한국산학기술학회논문지
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• 제17권6호
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• pp.233-238
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• 2016

본 연구는 스마트폰의 가속도 센서를 이용하여 정적균형능력을 측정하는데 있어 신뢰도를 알아보고자 실시하였다. 본 연구의 연구대상자는 최근 3개월 이내에 골절, 수술, 염증성 관절염이 없고 정기적인 운동을 시작하지 않은 Y대학교의 학생 30명을 대상으로 하였다. 본 연구에 사용된 스마트폰은 갤럭시S5LTE (SM-G900F, Samsung, Korea, 2014)였고 어플리케이션은 Sensor Kinetics pro (Ver.2.1.2, INNOVENTIONS Inc, US, 2015)를 사용하였다. 정적균형능력은 1회당 3번씩 측정하였으며 하루 간격으로 검사-재검사로 시행되었다. 1차 측정과 2차 측정은 동일하게 진행되었다. 본 연구의 분석은 Wilcoxon 부호순위검정, 급내상관계수(ICC(2,1))를 사용하였다. 본 연구의 연구결과는 다음과 같았다. 눈을 뜬 상태에서 1차 측정과 2차 측정 간에 유의한 차이가 없었고(p>0.05) 강한 양의 상관관계를 보였으며(r>0.75, p<0.05) 매우 높은 일치도(ICC>0.80)를 보였다. 눈을 감은 상태에서 1차 측정과 2차 측정 간에 유의한 차이가 없었고(p>0.05) 강한 양의 상관관계를 보였으며(r>0.75, p<0.05) 매우 높은 일치도(ICC>0.80)를 보였다. 본 연구를 통해 스마트폰은 정적균형능력 측정에 있어 가능성이 있다는 사실을 알 수 있었으며 본 연구가 향후 균형능력측정 전용 어플리케이션 개발에 기초자료가 되기를 기대해본다.

• 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.

• Asian Pacific Journal of Cancer Prevention
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• 제16권6호
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• pp.2531-2535
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• 2015

Background: Breast cancer diagnosed in young women may be more aggressive, with higher rates of local and distant recurrence compared to the disease in older women. Epidemiologic evidence suggests that Korean women have a lower incidence of breast cancer than women in the United States, but that they present at a younger age than their American counterparts. We sought to compare risk factors and management of young women with breast cancer in Boston, Massachusetts (US) with those in Seoul, South Korea (KR). Materials and Methods: A retrospective review was performed of consecutive patients less than 35 years old with a diagnosis of breast cancer at academic cancer centers in the US and KR from 2000-2005. Patient data were obtained by chart review. Demographic, tumor and treatment characteristics were compared utilizing Pearson's chisquare or Wilcoxon rank-sum tests where appropriate. All differences were assessed as significant at the 0.05 level. Results: 205 patients from the US and 309 from KR were analyzed. Patients in US were more likely to have hormone receptor positive breast cancer, while patients in KR had a higher rate of triple negative lesions. Patients in US had a higher mean body mass index and more often reported use of birth control pills, while those in the KR were less likely to have a sentinel node procedure performed or to receive post mastectomy radiation. Conclusions: Patients under 35 diagnosed with breast cancer in the US and KR differ with respect to demographics, tumor characteristics and management. Although rates of breast conservation and mastectomy were similar, US patients were more likely to receive post mastectomy radiation. The lower use of sentinel node biopsy is explained by the later adoption of the technique in KR. Further evaluation is necessary to evaluate recurrence rates and survival in the setting of differing disease subtypes in these patients.

• Asian Pacific Journal of Cancer Prevention
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• 제15권12호
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• pp.5089-5095
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• 2014

Background: As a common and essential contrast medium at present, gadobenate dimeglumine has shown better performance than some other agents when applied to Breast Magnetic Resonance Imaging Screening (Breast MRI Screening). Nevertheless, reports on the diagnostic performance of these two mediums (gadobenate dimeglumine and gadopentetate dimeglumine) are not completely consistent. Objective: To assess the diagnostic value of gadobenate dimeglumine and gadopentetate dimeglumine for Breast MRI Screening in patients suffering from breast cancer and to provide more convinced evidence to guide clinical practice in terms of appropriate contrast agents. Data Sources and Review Methods: Original articles in English and Chinese published before January 2013 were selected from available databases (The Cochrane Library, PUBMED, EMBASE, Chinese Biomedical Literature Database, Chinese Scientific Journals Full-text Database, Chinese Journal Full-text). The criteria for inclusion and exclusion were based on the standard for diagnosis tests. Meta-Disc software (Version 1.4) was used for data analysis. Then, the area under curve (AUC) of SROC and the spearman rank correlation of sensitivity against (1-specificity) were calculated. Results: Total of 17 researches involving 1934 patients were included. The pooled sensitivity of gadobenate dimeglumine and gadopentetate dimeglumine were 0.99 (0.97, 1.00) and 0.93 (0.88, 1.00) respectively. The pooled specificity for these two contrast agents were 0.924 (0.902, 0.943) and 0.838 (0.817, 0.858) respectively, and the AUC of SROC curve were 0.9781 and 0.9215 respectively. Conclusions: Gadobenate dimeglumine can be regarded as a more effective and feasible contrast medium for Breast MRI Screening. At least 5% differences in diagnostic performance are usually considered as clinically relevant.

• 한국농공학회지
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• 제17권4호
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• pp.3897-3920
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• 1975

Since the most of Korean dairy and cattle raising farms are too small to introduce western mechanized farming, it is necessary to develope small size equipments. This study has been carried to develop a rotary mower as on attachment of 8 to 10 horse powertiller which is widely spread in rural area. It will not ony be helpfull for the farmers to harvesting hay grass but also desirable to increase the power tiller utility. The protto type rotary mower designed through the fundamental investigations, has been modified and improved through the field trials, and a series of field tests has been carried to investigate its performance and economic feasibility comparing with existing vailable harvesting equipments. The results are as follows; 1. To increase the stability, two guide wheels are attached to both side of the protto type rotary mower. 2. To prevent the clinging of tall grasses, the vertical driving shafts are covered with cylindrical protectors. 3. The cutting height is adjustable in 8 steps from 2.5 to 20 centimeters by changing the length of guide wheel legs. 4. The practical Critical cutting speed were always higher than theoretical value in both case of single cutting blade and three when the cutting depth was 25 millimeter. 5. The peripheral speed of cutting blade was varied in response to the change of engine speed, mean while the peripheral speed was adequate as it was changhed from 25 to 35 meter per second when the power tiller is operated in proper working ground speed. 6. The time requirement to harvest 10 a were 88.7, 54.6 and 41.4 minutes for the first, second and third stage of ground speed respectively, and because of the difficulty of delivery, it was observed that operating with fourth stage of ground speed was not recomanendable when the grass height is taller than 90 centimeters. 7. The performance of rotary mower were 1.1-1.7, 1.4-4.0, 3.8-11.8 and 7.4-22.0 times of reciprocating mower, portable disc type cutter, hay scythe and ordinary sickle respectively. 8. When the slope exceeds, 20 degree the downward harvesting operation was impossible because of the excessive front end weight, while less than 5 degree of land slope did not effect in field operation. 9. Increased traveling spee caused higher cutting height and slight cutting failure, but seems not to effect to the gross yield, and the efficiency of cutting width were from 83 to 94 precent. 10. Tn rank of economy were rotary mower (3,2 stage operation), reciprocating mower, hay scythe, portable disc type cutter and sickle in order when the annul operation exdeeds 100 hours. From the above results, it is convinced that the protto type rotary mower is good enough to the livestock farmers as a hay harvesting equipment because of its economy, hardiness in operating and its out standing performance and hopefully it will contribute to the extension of Korean livestock farming.

• 대한약침학회지
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• 제11권1호
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• pp.21-29
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• 2008

Objectives : To investigate the therapeutic effects of SBVP in the treatment of patients with cancer-related pain. Design : A prospective randomized, double-blind, placebo-controlled study of SBVP. Setting : The study was conducted at the East West Cancer Center of Daejeon University Dunsan Oriental Hospital from March 1, 2007 to June 20, 2007. Patients : 11 patients diagnosed with cancer-related pain of over 3rd degree on the Numeric Rating Scale(NRS)(0, no pain at all, 10, worst pain imaginable) were entered into a double-blind, placebo-controlled trial of SBVP. They were randomized into Groups A and B(SBVP and control group, respectively) using the table of random sampling numbers and never informed of their affiliation by the coordinator. 5 of 6 patients in Group A and 4 of 5 patients in Group B completed the clinical trial. Intervention : SBVP(1ml/day) for group A and Normal Saline Placebo(1ml/day) for group B was injected into the abdomen acupoint, Zhong Wan(CV 12). The treatment was administered daily for five days. Outcome Measures : Degree of cancer-related pain was measured using the Numeric Rating Scale(NRS) before and after each treatment for "Pain right now" and "Average pain in last 24 hours". Statistical Analysis : Analysis regarding variations in NRS was carried out by applying t-tests(independent sample t-test and paired sample t-test) and Wilcoxon signed rank test with level of significance at 5%. Results : Differences in NRS of "Pain right now" for the two groups were statistically significant. The mean improvement point of SBVP was significantly higher than the control group($2.48^{\circ}{\pm}1.52$ vs $0.97^{\circ}{\pm}1.88$, p<0.05). Differences in average pain score before and after treatment in SBVP group were also significant($5.13^{\circ}{\pm}1.77$ vs $2.65^{\circ}{\pm}0.67$, p<0.05) compared with control group. The two groups showed no significant differences for long term effects in "Average pain in last 24 hours." Conclusion : Although further study will be needed on the large scale, SBVP shows potential as an effective treatment for immediate relief of cancer-related pain.