http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
김평화,김재국,강구현,장용수,김원희,최현영,이윤재 대한응급의학회 2024 대한응급의학회지 Vol.35 No.1
Objective: The purpose of this study was to identify prognostic factors related to outcomes of out-of-hospital cardiac arrest caused by pesticide poisoning. Methods: This retrospective observational study used countrywide population-based data from the Out-of-Hospital Cardiac Arrest Surveillance of the Korean Centers for Disease Control and Prevention from January 2008 to December 2018. Adult out-of-hospital cardiac arrest (OHCA) patients (over the age of 18) poisoned by a pesticide who experienced cardiac arrest and a subsequent return of spontaneous circulation (ROSC) were included in the study. The primary outcome variables were prognostic factors related to survival at hospital discharge, and the secondary outcome variable was good neurological outcome (Cerebral Performance Categories 1 or 2) at hospital discharge. Results: Three hundred and three patients were enrolled in the study, and 48 (15.8%) survived until hospital discharge (the hospital discharge group), and 255 (84.2%) died in hospital (the in-hospital death group). Fifteen (4.9%) of the 303 study subjects had a good neurological outcome, and 288 (95.1%) had a poor neurological outcome. Multivariate logistic regression showed that sustained pre-hospital ROSC was significantly associated with survival to discharge (adjusted odds ratio [AOR]=3.186; 95% confidence interval [CI], 1.436-7.068; P=0.004) and good neurological outcome (AOR=8.945; 95% CI, 2.974-26.907; P≤0.001). Conclusion: Sustained pre-hospital ROSC is associated with a favorable outcome in cases of OHCA induced by pesticide poisoning.
김평화,Sang Hyun Choi,김진형,박성호 대한영상의학회 2019 Korean Journal of Radiology Vol.20 No.3
Objective: To compare the safety and efficacy of radioembolization with that of sorafenib for the treatment of hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). Materials and Methods: MEDLINE, EMBASE, and Cochrane databases were searched for studies reporting outcomes in patients with HCC and PVTT treated with radioembolization or sorafenib. Meta-analyses of cumulative overall survival (OS) and Kaplan-Meier survival rates according to the time to progression (TTP) and incidence of adverse events (AEs) were performed. Subgroup analyses were conducted on 1-year OS data. Results: Seventeen studies were identified (four involving radioembolization, 10 involving sorafenib, and three comparing both). Pooled OS rates were higher in the radioembolization group, notably at 6 months {76% (95% confidence interval [CI], 64–85%) vs. 54% (95% CI, 45–62%)} and 1 year (47% [95% CI, 38–57%] vs. 24% [95% CI, 18–30%]); TTP was also longer with radioembolization. In patients undergoing radioembolization, the proportion of patients with Eastern Cooperative Oncology Group status 0 (p < 0.0001), Child-Pugh A (p < 0.0001), extrahepatic metastasis (p = 0.0012), and a history of cancer treatment (p = 0.0048) was identified as a significant source of heterogeneity for the 1-year OS. Radioembolization was associated with a lower incidence of grade 3/4 AEs than sorafenib (9% [95% CI, 3–27%] vs. 28% [95% CI, 17–43%]). Conclusion: Compared with sorafenib, radioembolization is a safer and more effective treatment for HCC with PVTT and is associated with prolonged survival, delayed tumor progression, and fewer grade 3/4 AEs.
일개 한방병원에 내원한 산욕초기 산모의 한국표준질병・사인분류 분석
김평화 대한한방부인과학회 2019 大韓韓方婦人科學會誌 Vol.32 No.1
Objectives: The purpose of this study is to collect and analyze the KCD codes applied to the treatment of 27 postpartum women who had been treated with Korean traditional medicine in a Korean medicine hospital, so that this study may be used as a basic data for setting the direction of postpartum Korean medical treatment research. Methods: It was approved by the Institutional Review Board (IRB) of ⃝⃝ University medical center (IRB approval number : WSOH IRB H1708-02-01). Twenty-seven postpartum women who had been treated at ⃝⃝ University medical center were received outpatient treatment for two weeks (from September 27, 2017 to January 5, 2018), and the KCD codes applied to the mothers were collected after obtaining the consent. On the day of registration of the study, the fertility, obstetric history and high-risk pregnancies were identified through an interview. Results: 1. The mean age of the 27 subjects was 33.33±3.99 years old. Among the subjects, 17 mothers (63.0%) were high-risk pregnancy and 10 mothers (37.0%) were normal. 2. Among the 22 major disease categories, 8 categories were used. M code (musculoskeletal system) was used 243 times (70.85%), followed by R code (unclassified symptom) of 51 times (14.87%) and U code (special purpose code) of 23 times (6.71%). 3. The most commonly used code among the ten frequently used codes was M25.57 (joint pain, ankle and foot), a total of 47 times. Of the remaining nine codes, except for R60.1 (systemic edema) and U68.4 (The deficiency of yang in Bi), all codes were M codes (musculoskeletal system). 4. The M code (musculoskeletal system) was the most used major disease category in high-risk group, a total of 159 times. But in specific categories, the most commonly used code was R60.1 (systemic edema), a total of 28 times. 5. In normal group, the M code (musculoskeletal system) was the most used major disease category, a total of 84 times. Also, in specific categories, the most commonly used code was M25.57 (joint pain, ankle and foot), total 29 times. 6. The U code, corresponding to 'the diagnosis of childbirth and other obstetrical medical use', was used 23 times (6.71%), O code three times (0.87%) and Z code two times (0.58%), which was less than 10% of the total number of codes used. Conclusion: When analyzing KCD codes related to Korean medicine treatment for postpartum diseases, it is important to select the KCD codes that reflect the actual clinical state. 목적 : 일개 한방병원에서 한의치료를 받은 산욕초기 27명의 산모를 대상으로 치료 시 적용된 KCD 코드를 수집, 분석하여 산후의 한의진료 자료구축 연구에 대한 방향 설정의 기초자료로 활용하고자 하였다. 방법 : OO대학교기관생명윤리위원회(Institutional Review Board, 이하 IRB)의 승인을 받아 실시하였다(IRB 승인 번호 (WSOH IRB H1708-02-01). 2017년 9월 18일부터 2018년 1월 5일까지 OO대학교 부속한방병원 한방부인과에서 한의치료를 받은 초기 산욕기 산모 27명의 동의를 얻어 2주간 외래를 방문하여 한의치료를 받을 때마다 적용된 KCD코드를 수집하였다. 연구등록당일에는 문진을 통하여 출산력, 산과력 및 고위험산모 여부를 확인하였다. 결과 : 1. 대상자 27명의 평균 연령은 33.33±3.99세였으며, 고위험 산모가 17명(63.0 %), 일반 산모가 10명(37.0 %)이었다. 2. 전체 22개의 질병 대분류 8개의 분류가 사용되었으며, M코드(근골격계통)가 243회(70.85%), R코드(달리 분류되지 않은 증상)가 51회(14.87%), U코드(특수목적 코드)가 23회(6.71%) 순이었다. 3. 다빈도 상위 10개 세분류 상병코드 중 가장 많이 사용 된 코드는 총 47회로 M25.57(관절통, 발목 및 발)이었고, 나머지 9개의 코드 중 R60.1(전신부종), U68.4(비양허증)을 제외하면, 7개의 코드가 모두 M코드(근골격계통)였다. 4. 고위험군의 질병대분류 또한 M코드(근골격계) 가 159회로 가장 높았으나, 세분류 상병코드 중 가장 많이 사용된 것은 총28회로 R60.1(전신부종)이었다. 5. 일반군의 질병대분류 또한 M코드(근골격계) 가 84회로 가장 높았으며, 세분류 상병코드 중 가장 많이 사용된 것은 총29회로 M25.57(관절통, 발목 및 발)이었다. 6. ‘분만 및 기타 산과 의료이용 진단코드’에 해당하는 U코드가 23회(6.71%), O코드가 3회(0.87%), Z코드가 2회(0.58%)사용되어, 전체 사용된 코드 건수의 10% 미만이었다. 결론 : 출산 후의 한방의료 이용질환에 관한 상병코드 분석 시, 실제 임상현장을 반영한 상병코드의 선정이 중요함을 알 수 있다.
한의치료를 받은 산모의 산후 6주간 증상에 대한 전향적 관찰 연구
김평화,김안나,장현철,이은희,Kim, Pyung-Wha,Kim, An-Na,Jang, Hyun-Chul,Lee, Eun-Hee 대한한방부인과학회 2017 大韓韓方婦人科學會誌 Vol.30 No.4
Objectives: This study aims to investigate the changes of women's postpartum symptoms, including their weights, edema index and quality of life (QOL) over the first six weeks after childbirth. Methods: The study participants were 31 postpartum women treated in the Dept. of Obstetrics & Gynecology, at Woo-Suk University Korean Medicine Hospital, from May 20th to August 5th, 2016. In the first 2 weeks of the postpartum period, the main data collection method was to interview each patient and write down all of their complaints, and additionally referring to each participant's PHR (Personal Health Records). At the 3rd, 4th, 5th and 6th week, the researcher interviewed participants by phone once a week. The participants' weight, edema index (ECW/TBW) and the quality of life (by EQ-VAS) were measured at 1st and 2nd week after childbirth. And, EQ-VAS was assessed once more at the 6th week after childbirth. As a last step, the participants responded to a survey on satisfaction regarding their postpartum care with Korean Medicine. Results: 1. In the 1st one week after childbirth, edema was the most frequent complaint. It was about joint pain of the upper limbs in the 2nd and 3rd weeks, sweating in the 4th week, and joint pain of the upper limbs in the 5th and the 6th weeks. 2. In the 1st two weeks of the postpartum period, the weight of the participants decreased from $66.33{\pm}9.30kg$ to $62.60{\pm}8.92kg$ (p<0.001) and the edema index ECW/TBW decreased from $0.399{\pm}0.010$ to $0.385{\pm}0.0 4$ (p<0.001). The EQ-VAS significantly improved from $61.77{\pm}17.72$ to $73.51{\pm}14.67$ (p<0.001). In the last 4-weeks of the postpartum period, the EQ-VAS decreased from $74.30{\pm}14.25$ to $73.63{\pm}13.35$, but this difference was not statistically significant (p=0.749). 3. Regarding the satisfaction with postpartum care with Korean Medicine, 60% of the participants responded that it was 'Excellent' and 40% said it was 'Good'. Conclusion: Over the entire postpartum period, the most frequent complaints were about musculoskeletal symptoms. Postpartum care with Korean Medicine treatments in the early postpartum period improves various postpartum symptoms and the quality of life for postpartum women.
김평화,Seon Choe,Kyungsun Han,Changsop Yang,Jinbok Lee,Sungha Kim,Minseop Shin 대한약침학회 2021 Journal of pharmacopuncture Vol.24 No.2
While carpal tunnel syndrome (CTS) is the most common entrapment neuropathy affecting the wrist, resulting in substantial physical, psychological, and economic effects, there is no gold standard therapy for CTS. In this case series study, we aimed to report CTS patients treated with Carthami Semen Pharmacopuncture (CSP) and electroacupuncture (EA) showing improvements in their symptoms, and the combinatorial effects of CSP and EA. We collected medical records of CTS outpatients who received CSP and EA at Chuku Acupuncture & Moxibustion Korean Medicine Clinic from August 2017 to September 2018. The outcome measures were the visual analog scale (VAS) for pain, paresthesia, the Korean version of the Boston carpal tunnel questionnaire (K-BCTQ) score, and changes in nocturnal pain, Tinel sign, and Phalen’s test. We included patient satisfaction at the completion of all treatments. 17 patients were included for this case series study. After treatment, VAS for pain decreased significantly from 50.41 ± 16.19 to 9.59 ± 9.46, VAS for paresthesia also decreased significantly from 63.50 ± 11.49 to 14.75 ± 12.97, and KBCTQ symptom severity scale decreased from 2.48 ± 0.68 to 1.89 ± 0.70 (all p < 0.001). Nocturnal pain, Tinel signs, and Phalen’s test showed improvements after all the treatments. All the patients reported favorable overall satisfaction with the treatments, and 69.23% wanted future pharmacopuncture treatments if CTS recurred. No complications were detected. The combination of CSP and EA could be an effective and safe option in treating CTS.
점진적 강성 저하 모델을 이용한 복합재 이중 볼트 체결부의 점진적 파손 해석 연구
김평화,김성민,도성철,윤동현,박정선 항공우주시스템공학회 2019 항공우주시스템공학회지 Vol.13 No.6
In this paper, progressive failure analysis is performed on composite joints widely used in various industries such as the aerospace industry. The analysis was conducted on single bolted joints to confirm its reliability and in succession on double-bolted composite joints as well to study the characteristics of progressive failure. Hashin failure criteria and EGDM (energy based gradual degradation model) were used for the analysis. Failure variables are defined by four failure modes, respectively. According to the variables, stiffness degradation has been calculated. As a result of comparing the test and analysis results of single-bolted joints, the error was below 5% and it showed that the analytical results are rather credible. Also, the parametric analysis consequences were obtained conducting the process-progressive failure analysis on the double-bolted composite joints considering edge-distance ratio (e/d ratio) and bolt spacing. 본 논문에서는 항공우주분야 등 여러 분야에서 사용되는 복합재 볼트 체결부에 대해 점진적 파손 해석을 수행하였다. 단일 볼트 체결 시편에 대한 해석을 통해 해석 방법에 대해 검증하고 이를 이용해 이중 볼트 체결 시편의 점진적 파손에 관해 연구하였다. 점진적 파손 해석을 위해 Hashin 파손 판정식과 에너지 기반 점진적 파손모델을 사용하였다. 복합재료의 4가지 파손모드에 대해 손상변수를 정의했다. 이에 따른 물성저하를 계산하였다. 단일 볼트로 체결된 시편에 대해 시험 및 점진적 파손해석을 수행하여 시험 및 해석결과를 비교한 결과 약 5% 이하의 오차로 해석의 신뢰성을 확인하였다. 이중 볼트 체결 시편에 대해 점진적 파손해석을 이용해 볼트 원공으로부터 모서리까지의 거리와 볼트 사이의 간격을 고려하여 이중 볼트 체결부에 대한 매개변수 분석을 수행하였다.
주의집중 자기점검법이 지적장애학생의 독립적 과제수행행동과 성취에 미치는 영향
김평화 한국특수교육교과교육학회 2012 특수교육교과교육연구 Vol.5 No.3
The purpose of this study was to investigate the effect of using self-monitoring of attention on the independent on-task behavior and task performance of students with intellectual disability. To achieve this purpose, this study selected three students with intellectual disability who had inattention and external control problem among those who received special education at elementary schools in C-city, C-province and trained them to self-monitor for attention. As a single subject research, the investigator found the independent on-task behavior and the result of accomplishment during the baseline period, intervention and maintenance period in order, using multiple probe baseline design across subjects. The investigator used some math problems as a independent question which is suitable for students' current level and needs the proficiency. And she measured task completion and accuracy as well as on-task behavior using timing sampling which divides 10 minutes for watching into 60 periods. The results of this study were as follows. First, all the surveyed students increased the independent on-task behavior more than baseline period after they implemented the self-monitoring of attention. Second, using only self-monitoring of attention improved students' accomplishment, that is task completion and accuracy even if it showed different results according to each student. Third, the effect of self-monitoring of attention was still maintained 3 weeks after the end of intervention. Therefore the self-monitoring of attention can be an effective way for students with intellectual disability who have low concentrations and show high dependent attitudes for studying to improve the independent on-task behavior and completion. 본 연구는 주의집중 자기점검법이 지적장애학생의 독립적 과제수행행동과 성취에 미치는 영 향을 알아보기 위한 목적으로 실시된 실험 연구이다. 본 연구는 목적을 달성하기 위해 주의집 중 자기점검법의 사용은 자율학습 시간 동안에 지적장애학생의 독립적 과제수행행동과 독립적 과제 성취을 변화시키는가?와 주의집중 자기점검법의 사용으로 변화된 지적장애학생의 독립적 과제수행행동 및 성취 수준은 중재가 종결된 3주 후에도 유지될 것인가?를 연구문제로 설정하 였다. 본 연구는 문제를 해결하기 위해 C도 C시에 소재하는 3개의 초등학교 특수학급에 재학하 고 있는 학생들 중 지적장애학생 3명을 연구대상으로 선정하여 주의집중 자기점검법 훈련을 시행 하고,시간표집법을 활용하여 과제수행행동과 과제 완수율 및 정확률을 측정하였다. 본 연구의 결 과 주의집중 자기점검법을 사용한 대상학생 모두 기초선에 비해 독립적 과제수행행동이 증가하였 다. 그러므로 주의집중 자기점검법의은 혼자 해야 하는 독립적 과제에 대한 주의집중이 취약하고 외부의존성 경향이 높은 지적장애학생의 과제수행행동을 증가시키기 위한 효과적인 학습전략이라 고 할 수 있으며, 대상 학생마다 차이가 있는 결과를 나타내었지만 주의집중 자기점검법을 단독으 로 사용하여도 성취, 즉 과제 완수율과 정확률이 향상되었고, 독립적 과제수행행동과 성취에 미친 주의집중 자기점검법의 효과는 중재가 종결된 3주 후에도 유지되었다. 따라서 과제를 수행할 수 있는 능력이 있으면서도 독립적으로 과제를 해결하는 상황에서 주의집중도가 낮고 외부 의 존적인 학습태도를 보이는 지적장애학생의 과제수행행동과 성취를 향상시키기 위해 주의집중 자기점검법이 효과적인 방법이라고 할 수 있다.
김평화,박정선 한국항공우주학회 2023 International Journal of Aeronautical and Space Sc Vol.24 No.5
This paper proposes an approximate method for calculating the critical buckling load of conical composite lattice panels. The conical composite lattice panel consists of helical and hoop ribs and can be described by geometrical parameters. Using these geometric parameters, the critical buckling load of conical composite lattice panels under uniform compression is predicted. The present method is validated by comparing the critical buckling loads obtained under a simply supported boundary condition with those obtained by the finite element method. The results of the critical buckling load show good agreement between the present method and finite element analysis. A parametric study is performed using the present method to investigate the influence of the number of hoop and helical ribs on the critical buckling load. In the parametric study, the number of helical and hoop ribs is defined as design variables, and the critical buckling load is defined as the response. In addition, the present method is applied to the optimization of composite lattice conical panels using a genetic algorithm. The optimization of the panels is defined by minimizing the mass, while defining the critical load as the boundary condition. Therefore, the approximation method using geometric functions provides not only analysis of critical buckling loads for composite lattice panels but also a useful tool for optimal design.