• 재활치료과학
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• 제10권2호
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• pp.141-150
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• 2021

목적 : 본 연구는 뇌졸중 환자에게 Cognitive Orientation to daily Occupational Performance(CO-OP) 중재법을 적용하여 작업수행의 질, 상지기능 및 실행기능에 영향을 주는지 확인하고자 하였다. 연구방법 : 연구대상은 재활치료를 받고 있는 입원, 외래 환자 중 발병한지 3개월 이상된 뇌졸중 환자 5명이었다. 연구는 단일집단 사전-사후 평가로 설계되었다. 중재는 1일 1회 30분간 주 5회로 총 20회기를 적용하였다. 중재활동은 환자가 선정한 중요도는 높지만 만족도와 수행도는 낮은 활동을 선정하여 진행하였다. 평가도구로는 수행의 질을 평가하는 Performance Quality Rating Scale(PQRS)과 Canadian Occupational Performance Measure(COPM), 실행기능을 알아보기 위한 Executive Function Performance Test for Koreans(EFPT-K), 상지기능을 알아보기 위한 Motor Activity Log(MAL)를 사용하였다. 중재 전·후를 비교할 수 있는 통계방법으로는 비모수 검정인 Wilcoxon's signed rank test를 사용하였다. 통계학적 유의수준은 p<0.05로 하였다. 결과 : 상지기능은 모든 항목에서 유의미한 변화를 나타냈으며 실행기능은 시작하기 항목을 제외한 준비하기, 순서정하기, 판단과 안전, 종결하기 전 항목에서 유의미한 변화를 나타냈다. 또한, 작업수행도 유의미한 차이를 보였다. 결론 : 만성 뇌졸중 환자를 중심으로 20회기의 CO-OP 중재를 통해 상지기능, 실행기능, 작업수행을 향상시켰다. 뇌졸중 환자의 작업수행뿐 아니라 세부적인 작업 요소 향상에 긍정적인 영향을 도출하였다.

• 한방재활의학과학회지
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• 제32권3호
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• pp.131-140
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• 2022

Objectives This study aimed to investigate whether the concurrent use of conventional and herbal medications affects liver and kidney function, by examining blood test data. Methods We retrospectively reviewed the electronic medical records of 590 inpatients with musculoskeletal diseases between 2013 and 2017. We investigated cases of drug-induced liver injury (DILI) according to the Roussel Uclaf Causality Assessment Method criteria and cases of drug-induced kidney injury (DIKI) based on the Kidney Disease Improving Global Outcomes definition. Results One case (0.17%) of DILI and one case (0.17%) of DIKI were identified. Significant improvements in serum laboratory data were observed after the concurrent use of both types of medications (p<0.05). The kappa coefficients ranged from 0.26 to 0.72, indicating that the values after the concurrent use of conventional and herbal medications showed a fair similarity to the baseline values of the patients. The linear regression test showed that female sex and high body mass index (BMI) were risk factors for an increase in the serum blood levels of liver function parameters. Conclusions The concurrent use of conventional and herbal medications for musculoskeletal disorders is relatively safe; however, clinicians should exercise caution when prescribing these medications to female patients and patients with a high BMI because of their potential effect on hepatic function.

• 대한한방내과학회지
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• 제43권4호
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• pp.656-679
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• 2022

Objectives: The aims of this study were to evaluate the fidelity of stroke stage reporting, the timeliness of the outcome measures, and the use of the core outcome set. Methods: We searched the literature using 6 domestic databases. We selected studies that used Korean medicine interventions and targeted stroke patients with motor sequelae. We examined whether the included studies reported the stroke stage and whether they used the outcome measures in the appropriate period based on the recommendations of the "Stroke Evidence Database to Guide Effectiveness". We also confirmed the use of the essential assessment tools suggested by the core outcome set. Results: Overall, 77 studies were finally selected, with 16 (21%), 55 (71%), and 6 (8%) published on the acute, subacute, and chronic phases, respectively. Only 11 of the studies directly mentioned the stroke stage. The most commonly used assessments were the National Institutes of Health Stroke Scale, Modified Barthel Index, and Manual Muscle Testing. Only 5 studies failed to apply the stage-related outcome measures at the recommended period. The outcome variables used inadequately were the National Institutes of Health Stroke Scale, Functional Ambulation Categories, 36-Item Short Form Health Survey, and Mini-Mental State Examination. Among the core outcome set items, some studies used liver and renal function tests, but no herbal medicine safety reporting was conducted. Conclusions: In future studies, we propose to ensure accurate reporting of the stroke stage with reliable outcome measures to deliver better clinical and research outcomes. Furthermore, in future clinical studies on stroke, a standard protocol that reflects the core outcome set should be developed.

• 한국문헌정보학회지
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• 제56권4호
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• pp.129-159
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• 2022

본 연구에서는 공공도서관 방문의 활성화를 위하여, 도서관의 홍보 및 마케팅 전략으로 장소브랜딩을 적용하기 위한 자료를 수집하고 분석하였다. 문헌분석을 통한 장소브랜딩에 대한 이해를 바탕으로 먼저 공공도서관 장소브랜딩의 구성요인 그리고 그 요인들 간의 관계를 도출하였다. 그다음으로 공공도서관을 장소브랜딩한 이후의 기대효과인 이용자 충성도와 장소브랜딩의 구성요인들과의 관계를 도출하여 연구모형 및 연구가설을 세우고 구조방정식모형으로 검증하였다. 총 34개 연구가설 중 21개가 채택되었고 장소이미지요인인 도서관신뢰성, 도서관호혜성, 도서관안전성 모두 이용자충성도에 유의하였다. 본 연구는 공공도서관의 브랜드이미지 창출에 기반이 될 장소이미지요인과 새로운 장소가치로 사회공헌가치를 도출하고, 공공도서관이 자관의 핵심가치(장소가치)에 적합한 장소이미지요인의 선택을 제안함으로써, 공공도서관의 홍보 및 마케팅을 위하여 장소브랜딩을 도입하기 위한 기초연구라는 점에 의의가 있다. 장소브랜딩을 통해 공공도서관이 지역사회에서 높은 인지도와 충성도로 형성된 브랜드파워를 가지며 리더십을 확보할 것으로 기대한다.

• 정보관리학회지
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• 제40권4호
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• pp.229-257
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• 2023

본 연구는 독서공간으로서의 학교도서관에 주목하고 독서를 위한 학교도서관 이용 시 공간특성 요소에 대한 중학생 이용자의 인식을 파악하는데 목적이 있다. 선행연구와 예비 연구를 통해 공간특성 요소를 선정하고 각 공간특성 요소에 대해 학생들이 중요하게 생각하는 정도와 충족하는 정도를 살펴보고자 하였다. 그리고 이용자의 인식이 이용현황 및 학교도서관 독서활동 경험에 따라 차이가 있는지 살펴보았으며, 학교도서관 이용자 만족도와 지속이용의도에 영향을 미치는지 파악하였다. 더불어 공간특성 요소의 인식이 지속이용의도에 영향을 미치는데 있어 학교도서관 이용자 만족도가 매개 역할을 하는지 검증하고자 하였다. 이를 위해 중학교 4곳에 재학 중인 342명의 학생을 대상으로 설문조사를 진행하였다. 연구 결과, 공간특성 요소 중 소통성, 다양성, 안전성, 편의성에 대한 이용자의 인식이 이용현황에 따라 차이를 보였으며, 소통성, 쾌적성, 분위기가 이용자 만족도에, 심미성과 소통성이 지속이용의도에 긍정적인 영향을 주는 것으로 나타났다. 이 중 소통성, 쾌적성, 분위기는 학교도서관 이용자 만족도를 매개하여 지속이용의도에 영향을 미치는 것으로 확인되었다. 본 연구는 독서를 위한 공간으로서 학교도서관을 조사함으로써 학생들의 독서 지원을 위한 방안을 제시하였다는 점에서 의의를 찾을 수 있다.

• Korean Journal of Radiology
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• 제25권3호
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• pp.289-300
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• 2024

Objective: To prospectively evaluate the outcomes of ultrasound (US)-guided radiofrequency ablation (RFA) in tertiary hyperparathyroidism (THPT). Materials and Methods: Patients with THPT underwent RFA between September 2017 and January 2022. Laboratory parameters, including serum intact parathyroid hormone (iPTH) levels, were monitored for 48 months after RFA and compared with the levels at baseline. Complications related to RFA and changes in hyperparathyroidism-related clinical symptoms were recorded before and after RFA. Results: A total of 42 patients with THPT were recruited for this study. Ultimately, 36 patients with renal failure and 2 patients who underwent successful renal transplantation (male:female, 17:21; median age, 54.5 years) were enrolled. The follow-up time was 21.5 ± 19.0 months in the 36 patients with renal failure. In these 36 patients, iPTH levels were significantly decreased to 261.1 pg/mL at 48 months compared with the baseline value of 1284.9 pg/mL (P = 0.012). Persistent hyperparathyroidism, defined as iPTH levels maintained at > 585.0 pg/mL for 6 months after treatment, occurred in 4.0% of patients (1/25). Recurrent hyperparathyroidism, defined as iPTH levels > 585.0 pg/mL after 6 months, were 4.0% (1/25) and 0.0% (0/9) at 6 months and 4 years after treatment, respectively. In two patients with THPT after successful renal transplantation, iPTH decreased from the baseline value of 242.5 and 115.9 pg/mL to 171.0 and 62.0 pg/mL at 6 months after treatment. All complications resolved within 6 months of ablation without medical intervention, except in 10.5% (4/38) patients with permanent hypocalcemia. The overall symptom recovery rate was 58.8% (10/17). The severity scores for bone pain, arthralgia, and itchy skin associated with hyperparathyroidism improved after treatment (P < 0.05). Conclusion: US-guided RFA is an effective and safe alternative to surgery in the treatment of patients with TPTH and improves hyperparathyroidism-related clinical symptoms.

• Korean Journal of Radiology
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• 제25권5호
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• pp.438-448
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• 2024

Objective: To evaluate the therapeutic outcomes of no-touch radiofrequency ablation (NT-RFA) using twin cooled wet (TCW) electrodes in patients experiencing recurrent hepatocellular carcinoma (HCC) after undergoing locoregional treatments. Materials and Methods: We conducted a prospective, single-arm study of NT-RFA involving 102 patients, with a total of 112 recurrent HCCs (each ≤ 3 cm). NT-RFA with TCW electrodes was implemented under the guidance of ultrasonography (US)-MR/CT fusion imaging. If NT-RFA application proved technically challenging, conversion to conventional tumor puncture RFA was permitted. The primary metric for evaluation was the mid-term cumulative incidence of local tumor progression (LTP) observed post-RFA. Cumulative LTP rates were estimated using the Kaplan-Meier method. Multivariable Cox proportional hazard regression was used to explore factors associated with LTP. Considering conversion cases from NT-RFA to conventional RFA, intention-to-treat (ITT; including all patients) and per-protocol (PP; including patients not requiring conversion to conventional RFA alone) analyses were performed. Results: Conversion from NT-RFA to conventional RFA was necessary for 24 (21.4%) out of 112 tumors. Successful treatment was noted in 111 (99.1%) out of them. No major complications were reported among the patients. According to ITT analysis, the estimated cumulative incidences of LTP were 1.9%, 6.0%, and 6.0% at 1, 2, and 3 years post-RFA, respectively. In PP analysis, the cumulative incidence of LTP was 0.0%, 1.3%, and 1.3% at 1, 2, and 3 years, respectively. The number of previous locoregional HCC treatments (adjusted hazard ratio [aHR], 1.265 per 1 treatment increase; P = 0.004), total bilirubin (aHR, 7.477 per 1 mg/dL increase; P = 0.012), and safety margin ≤ 5 mm (aHR, 9.029; P = 0.016) were independently associated with LTP in ITT analysis. Conclusion: NT-RFA using TCW electrodes is a safe and effective treatment for recurrent HCC, with 6.0% (ITT analysis) and 1.3% (PP analysis) cumulative incidence of LTP at 2 and 3-year follow-ups.

• Korean Journal of Radiology
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• 제23권5호
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• pp.548-554
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• 2022

Objective: To evaluate the safety and feasibility of prostatic artery embolization (PAE) via transradial access (TRA) compared with transfemoral access (TFA). Materials and Methods: This retrospective study included 53 consecutive men with lower urinary tract symptoms (LUTS) who underwent PAE between September 2018 and September 2021. Thirty-one patients (mean age ± standard deviation: 70.6 ± 8.4 years) were treated with TFA, including 14 patients treated before adopting TRA. Since December 2019, TRA has also been attempted with the procedure's selection criteria of patent carpal circulation and a height ≤ 172 cm, with 22 patients treated via TRA (69.1 ± 9.6 years). Parameters of technical success (defined as successful bilateral embolization), clinical success (defined as LUTS improvement), procedural time, radiation dose, and adverse events were compared between the two groups using the Fisher's exact test, independent sample t test, Wilcoxon signed-rank test, or Mann-Whitney test. Results: All patients received at least one-side PAE. Technical success of PAE was achieved in most patients (TRA, 21/22; TFA, 30/31; p > 0.999). No technical problem-related conversion from TRA to TFA occurred. The clinical success rate was 85% (11/13) in patients with TRA, and 89% (16/18) in patients with TFA for follow-up > 2 weeks post-PAE (median, 3 months) (p > 0.999). The median procedure time was similar in both groups (TRA, 81 minutes vs. TFA, 94 minutes; p = 0.570). No significant dose differences were found between the TRA and TFA groups in the dose-area product (median Gycm², 95 [range, 44-255] for TRA and 84 [34-255] for TFA; p = 0.678) or cumulative air kerma (median mGy, 609 [236-1584] for TRA and 634 [217-1594] for TFA; p = 0.551). No major adverse events occurred in either of the groups. Conclusion: PAE via TRA is a safe and feasible method comparable to conventional TFA. It can be safely implemented by selecting patients with patent carpal circulation and adequate height.

• 대한영상의학회지
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• 제84권3호
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• pp.606-614
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• 2023

목적 자궁체부암 출혈에 대한 경카테터 동맥 색전술의 효과와 안전성을 평가하였다. 대상과 방법 20년 동안 자궁체부암 출혈로 경카테터 동맥 색전술(transcatheter arterial embolization; 이하 TAE)을 시행 받은 여섯 명의 환자들의 자료를 후향적으로 수집하였다. 혈관조영술 및 단면 영상 소견, TAE의 세부사항과 임상 경과를 탐구하였으며, TAE의 기술적, 임상적 성공률(technical and clinical success rate)을 각각 계산하였다. 결과 환자군은 자궁내막양 선암종, 육종, 그리고 임신융모종양으로 이루어졌으며, 대부분이 말기 암 환자들이었다. 출혈은 네 명의 환자에서 질출혈로 나타났다. 여섯 명의 환자들에서 일곱 번의 TAE가 시행되었고, 모든 TAE 시술에서 기술적 성공이 달성되었다. 자궁절제술을 받은 두 명의 환자들에서는 골반강 내 재발한 종양의 출혈이 혈변으로 나타났고, 이 환자들에서도 TAE는 기술적 성공을 보였다. 임상적 성공률은 50%로 절반의 환자에서 일주일 이상 출혈 조절이 되었다. 재출혈은 한 명의 환자에서 사망과 직접적으로 연관되었다. 한 명의 환자에서 시술 다음 날 경미한 부작용이 있었다. 결론 TAE는 자궁체부암 출혈에 대한 효과적이고 안전한 방법이며 특히 진행암, 말기암 환자들의 질병 경과 중의 위험한 시기에서 고려될 수 있다.

• Korean Journal of Radiology
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• 제22권12호
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• pp.2082-2093
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• 2021

Objective: We conducted a systematic review and meta-analysis of the tissue adequacy and complication rates of percutaneous transthoracic needle biopsy (PTNB) for molecular analysis in patients with non-small cell lung cancer (NSCLC). Materials and Methods: We performed a literature search of the OVID-MEDLINE and Embase databases to identify original studies on the tissue adequacy and complication rates of PTNB for molecular analysis in patients with NSCLC published between January 2005 and January 2020. Inverse variance and random-effects models were used to evaluate and acquire meta-analytic estimates of the outcomes. To explore heterogeneity across the studies, univariable and multivariable metaregression analyses were performed. Results: A total of 21 studies with 2232 biopsies (initial biopsy, 8 studies; rebiopsy after therapy, 13 studies) were included. The pooled rates of tissue adequacy and complications were 89.3% (95% confidence interval [CI]: 85.6%-92.6%; I² = 0.81) and 17.3% (95% CI: 12.1%-23.1%; I² = 0.89), respectively. These rates were 93.5% and 22.2% for the initial biopsies and 86.2% and 16.8% for the rebiopsies, respectively. Severe complications, including pneumothorax requiring chest tube placement and massive hemoptysis, occurred in 0.7% of the cases (95% CI: 0%-2.2%; I² = 0.67). Multivariable meta-regression analysis showed that the tissue adequacy rate was not significantly lower in studies on rebiopsies (p = 0.058). The complication rate was significantly higher in studies that preferentially included older adults (p = 0.001). Conclusion: PTNB demonstrated an average tissue adequacy rate of 89.3% for molecular analysis in patients with NSCLC, with a complication rate of 17.3%. PTNB is a generally safe and effective diagnostic procedure for obtaining tissue samples for molecular analysis in NSCLC. Rebiopsy may be performed actively with an acceptable risk of complications if clinically required.