• Title/Summary/Keyword: 국립의료원

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Fundamental Study of Relative Measurement for Accurate Measurement of Stent Size in Computed Tomography Angiography (컴퓨터단층 혈관조영술에서 스텐트 사이즈의 정확한 측정을 위한 상대적 측정법의 기초연구)

  • Lee, Seung-Young;Hong, Joo-Wan;Kang, Su-Mi;Kim, Su-Bin;Joon, Sang-Hoon;Heo, Yeong-Cheol
    • Journal of the Korean Society of Radiology
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    • v.13 no.5
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    • pp.713-720
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    • 2019
  • The purpose of this study was to propose a new measurement method for accurate measurement of vessel diameter in computed tomography angiography(CTA). CTA test was performed after non-ionic iodine contrast agent was flowed at a constant rate to self-maded perfusion phantom. After obtaining raw data, images were reconstructed with multi-planar reconstruction(MPR) and maximal intensity projection(MIP). Diameters of vascular models were measured for each technique. Relative and conventional measurements were then compared. The mean diameter of the vascular model was closer to the actual measurement when relative measurement was used compared to that when conventional measurement was used both in MPR and MIP. Relative measurements of MPR and MIP were closer to actual measurement than those of conventional measurement (34% VS, 24%, p<0.05). The relative measurement method proposed in this study was closer to the actual measurement than the conventional measurement method. However, both test methods were still larger than actual results. Therefore, further study of relative measurement method is needed using this study as basic data.

The Effect of Job stress related to COVID-19, Emotional labor and Empowerment on Retention intention of nurses working at a infectious disease-specialized hospital (일 감염병 전담병원 간호사의 COVID-19 관련 직무스트레스, 감정노동, 임파워먼트가 재직의도에 미치는 영향)

  • Kim, Haneul;Yang, Seung Ae
    • Journal of Internet of Things and Convergence
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    • v.8 no.6
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    • pp.35-47
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    • 2022
  • This study aims to identify the degree of job stress related to COVID-19, emotional labor, empowerment, and retention intention of nurses in hospitals dedicated to infectious diseases, and confirmed the effect of job stress related to COVID-19, emotional labor, and empowerment on retention intention. The data collection of this study was conducted from August 27, 2021 to September 17, 2021 through a structured questionnaire targeting 162 nurses at an infectious disease hospital in S city. The data were analyzed analyzed using frequency and percentage, mean and standard deviation, t-test, ANOVA, Pearson's Correlation Coefficient, and multiple linear regression using SPSS/WIN 25.0. As a result of analyzing differences according to general characteristics, retention intention showed a significant difference according to work department and work satisfaction. And as a result of analyzing the correlation between retention intention and COVID-19 related job stress, emotional labor, and empowerment, it showed a significant negative correlation (r=-0.215, p=0.006) with job stress related to COVID-19 and a significant positive correlation (r=0.343, p<0.001) with empowerment. As a result of multiple linear regression analysis, job satisfaction, job stress related to COVID-19, and empowerment were identified as significant variables affecting retention intention (F=23.751, p<0.001), and the explanatory power was 30.0%. Through the above results, we intend to provide basic data for strategic development for efficient nursing manpower management.

Network Analysis Using the Established Database (K-herb Network) on Herbal Medicines Used in Clinical Research on Heart Failure (심부전의 한약 임상연구에 활용된 한약재에 대한 기구축 DB(K-HERB NETWORK)를 활용한 네트워크 분석)

  • Subin Park;Ye-ji Kim;Gi-Sang Bae;Cheol-Hyun Kim;Inae Youn;Jungtae Leem;Hongmin Chu
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.313-353
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    • 2023
  • Objectives: Heart failure is a chronic disease with increasing prevalence rates despite advancements in medical technology. Korean medicine utilizes herbal prescriptions to treat heart failure, but little is known about the specific herbal medicines comprising the network of herbal prescriptions for heart failure. This study proposes a novel methodology that can efficiently develop prescriptions and facilitate experimental research on heart failure by utilizing existing databases. Methods: Herbal medicine prescriptions for heart failure were identified through a PubMed search and compiled into a Google Sheet database. NetMiner 4 was used for network analysis, and the individual networks were classified according to the herbal medicine classification system to identify trends. K-HERB NETWORK was utilized to derive related prescriptions. Results: Network analysis of heart failure prescriptions and herbal medicines using NetMiner 4 produced 16 individual networks. Uhwangcheongsim-won (牛黃淸心元), Gamiondam-tang (加味溫膽湯), Bangpungtongseong-san (防風通聖散), and Bunsimgi-eum (分心氣飮) were identified as prescriptions with high similarity in the entire network. A total of 16 individual networks utilized K-HERB NETWORK to present prescriptions that were most similar to existing prescriptions. The results provide 1) an indication of existing prescriptions with potential for use to treat heart failure and 2) a basis for developing new prescriptions for heart failure treatment. Conclusion: The proposed methodology presents an efficient approach to developing new heart failure prescriptions and facilitating experimental research. This study highlights the potential of network pharmacology methodology and its possible applications in other diseases. Further studies on network pharmacology methodology are recommended.

A Study on History and Archetype Technology of Goli-su in Korea (한국 고리수의 역사와 원형기술의 복원 연구)

  • Kim, Young-ran
    • Korean Journal of Heritage: History & Science
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    • v.46 no.2
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    • pp.4-25
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    • 2013
  • Goli-su is the innovative special kind of the embroidery technique, which combines twining and interlacing skill with metal technology and makes the loops woven to each other with a strand. The loops floating on the space of the ground look like floating veins of sculpture and give people the feeling of the openwork. This kind of characteristic has some similarities with the lacework craft of Western Europe in texture and technique style, but it has its own features different from that of Western Europe. It mainly represents the splendid gloss with metallic materials in the Embroidered cloth, such as gold foil or wire. In the 10th century, early days of Goryo, we can see the basic Goli-su structure form of its initial period in the boy motif embroidery purse unearthed from the first level of Octagonal Nine-storied Pagoda of Woljeong-sa. In the Middle period of Joseon, there are several pieces of Goli-su embroidered relic called "Battle Flag of Goryo", which was taken by the Japanese in 1592 and is now in the Japanese temple. This piece is now converted into altar-table covers. In 18~19th century, two pairs of embroidered pillows in Joseon palace were kept intact, whose time and source are very accurate. The frame of the pillows was embroidered with Goli-su veins, and some gold foil papers were inserted into the inside. The triangle motif with silk was embroidered on the pillow. The stitch in the Needle-Looped embroidery is divided into three kinds according to comprehensive classification: 1. Goli-su ; 2. Goli-Kamgi-su ; 3. Goli-Saegim-su. From the 10th century newly establishing stage to the 13th century, Goli-su has appeared variational stitches and employed 2~3 dimensional color schemes gradually. According to the research of this thesis, we can still see this stitch in the embroidery pillow, which proves that Goli-suwas still kept in Korea in the 19th century. And in terms of the research achievement of this thesis, Archetype technology of Goli-su was restored. Han Sang-soo, Important Intangible Cultural Heritage No. 80 and Master of Embroidery already recreated the Korean relics of Goli-su in Joseon Dynasty. The Needle-Looped embriodery is the overall technological result of ancestral outstanding Metal craft, Twining and Interlacing craft, and Embroidery art. We should inherit, create, and seek the new direction in modern multi-dimensional and international industry societyon the basis of these research results. We can inherit the long history of embroidering, weaving, fiber processing, and expand the applications of other craft industries, and develop new advanced additional values of new dress material, fashion technology, ornament craft and artistic design. Thus, other crafts assist each other and broaden the expressive field to pursue more diversified formative beauty and beautify our life abundantly together.

Early Clinical Experience in Valve Replacement Using On-X Prosthetic Heart Valve (On-X 기계판막을 이용한 판막치환술의 단기성적분석)

  • 김인섭;김우식;신용철;유환국;김병열;정성철
    • Journal of Chest Surgery
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    • v.37 no.9
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    • pp.742-748
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    • 2004
  • The On-X valve was recently introduced. It was the aim of this study to assess the safety and feasibility from the data derived from 28 patients who underwent aortic and/or mitral valve replacement with this prosthesis in National Medical Center. Material and Method: From May 1999 and May 2003, a series of 28 consecutive patients who had been implanted with 32 On-X prosthesis were reviewed, The operative procedure comprised of 12 MVR, 10 AVR and 6 DVR. The study followed the guidelines of AATS/STS. Mean follow-up was 27 months (total 04 patient-years). Result: Early ($\leq$30 days) mortality was 7.44% (2/28) and no late mortality occurred in the study. Total actuarial freedom from mortality at 2 years was 92.86$\pm$4.87% for all cases, 100% for MVR, 90$\pm$9.49% for AVR, and 83.3$\pm$1.52% for DVR. Thromboembolic event occurred in 2 MVR patients and that was the only complication; therefore, the linearized incidence of valve related complications was 3.17%/ patient-years for all cases and 6.5%/patient-years for MVR and the actuarial freedom from valve related complications at 2 years was 84.85$\pm$10.75%. Preoperatively, 24 (85.71%) patients were in NYHA functional class III or IV but postoperatively, 25 (89,29%) patients were in NYHA functional class I or II. The levels of hemoglobin, hematocrit, serum LDH, reticulocyte rate and indirect bilirubin were all within normal range at postoperative 3 month. In mitral position, the peak gradient was 6.1$\pm$1.8 mmHg and the mean gradient was 3.0$\pm$0.6 mmHg and EOA were 2.54$\pm$0.56 $m^2$, 2.39$\pm$0.73 $m^2$, 2.34$\pm$0.55 $m^2$, 2.40$\pm$0.63 $m^2$ at 27 mm, 29 mm, 31 mm, 33 mm respectively. In aortic postion, the peak gradient was 21.1 $\pm$14.12 mmHg and the mean gradient was 12.3$\pm$6.52 mmHg. Conclusion: Since there was no significant difference in the postoperative mortality, valve related complications and echocardiographic hemodynamic data compared to standard bileaflet design and since there was an improvement in the NYHA functional class and normal values of hemolytic indicators, it can be assumed that On-X valve is safe and feasible. However, accumulation of cases and long-term follow-up of this patient group is needed to establish this result.

The Clinical Study on the Neonate Delivered Under the Condition of the Maternal Smoking and Alcohol in Pregnancy (재태기간 중 산모의 음주와 흡연에 노출된 신생아의 임상적 고찰)

  • Kong, Sun Hui;Kim, Soo Yeon;Lee, Ho Jun;Kim, Hak Sung;Lee, Dong Woo;Kim, Jae Yoon
    • Clinical and Experimental Pediatrics
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    • v.48 no.1
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    • pp.34-39
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    • 2005
  • Purpose : Perinatal complications associated with maternal smoking and alcohol ingestion in pregnancy have been well documented. But until now there has been no clinical data on it collected in our country. In this paper, we tried to research the association between maternal smoking and alcohol ingestion in pregnancy and the physical indices of the neonate at delivery among unmaried mothers from one charitable institution. Methods : We enlisted 125 unmarried with a history of smoking and alcohol consumption during pregnancy who delivered a baby in National Medical Center from March, 2001 to March, 2004 as a study group. As a control, 174 unmarried mothers without a history of smoking and alcohol were enlisted. Then, we compared the physical indices - birth weight, height, and the head circumference - of the neonates from both groups. Furthermore, we investigated the effects of the period and the quantity of maternal smoking and alcohol ingestion on the physical indices of the neonates from the both groups. Results : Low physical indices of neonates were found in the study group(either smoking group, or drinking group) compared with the control group. The quantity of smoking or drinking and the period of smoking or drinking have no significant effect on physical indices. Conclusion : We found that maternal smoking and alcohol result in the low physical index of neonates, and educational initiatives must be directed at expectant mothers to emphasize the harmful effects of smoking and alcohol ingestion in pregnancy.

The Study on the Confidence Building for Evaluation Methods of a Fracture System and Its Hydraulic Conductivity (단열체계 및 수리전도도의 해석신뢰도 향상을 위한 평가방법 연구)

  • Cho Sung-Il;Kim Chun-Soo;Bae Dae-Seok;Kim Kyung-Su;Song Moo-Young
    • The Journal of Engineering Geology
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    • v.15 no.2 s.42
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    • pp.213-227
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    • 2005
  • This study aims to assess the problems with investigation method and to suggest the complementary solutions by comparing the predicted data from surface investigation with the outcome data from underground cavern. In the study area, one(NE-1) of 6 fracture zones predicted during the surface investigation was only confirmed in underground caverns. Therefore, it is necessary to improve the confidence level for prediction. In this study, the fracture classification criteria was quantitatively suggested on the basis of the BHTV images of NE-1 fracture zone. The major orientation of background fractures in rock mass was changed at the depth of the storage cavern, the length and intensity were decreased. These characteristics result in the deviation of predieted predicted fracture properties and generate the investigation bias depending on the bore hole directions and investigated scales. The evaluation of hydraulic connectivity in the surface investigation stage needs to be analyze by the groundwater pressures and hydrochemical properties from the monitoring bore hole(s) equipped with a double completion or multi-packer system during the test bore hole is pumping or injecting. The hydraulic conductivities in geometric mean measured in the underground caverns are 2-3 times lower than those from the surface and furthermore the horizontal hydraulic conductivity in geometric mean is six times lower than the vertical one. To improve confidence level of the hydraulic conductivity, the orientation of test hole should be considered during the analysis of the hydraulic conductivity and the methodology of hydro-testing and interpretation should be based on the characteristics of rock mass and investigation purposes.

Clinical Analysis of Bronchogenic Cyst (기관지성 낭종의 임상적 고찰)

  • 안재범;정성철;김우식;신용철;유환국;이정호;김병열;김인섭
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.585-590
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    • 2004
  • Bronchogenic cyst is a rare and benign disease. Because of its complication or associated disease, Bronchogenic cyst requires surgical treatment. Recently, with the development of diagnostic methods, its incidence has increased. So we reviewed our results from the past 30 years. Material and Method: We reviewed 27 cases surgically treated from March 1971 to March 2003. This investigation is designed to illustrate the peak age incidence, sex ratio, symptoms, anatomic location, radiologic imagings, associated diseases, operative methods, postoperative pathologic findings and postoperative complications. Result: The peak age incidence laid in the 1st to 3rd decade and the ratio of male and female was 1 : 1.5. The most common complaints were cough and dyspnea, but some had hemoptysis. There were 22 cases (81%) of Intrapulmonary bronchogenic cysts and 5 cases(19%) of mediastinal bronchogenic cysts. Thirteen cases (48.1%) showed cystic lesion in simple chest X-ray. Ten cases showed cystic lesion among 13 cases that had taken computed tomography. We found associated disease in 15cases (56%). The inflammatory diseases from infection were many in intrapulmonary bronchogenic cysts and especially, one case showed carcinosarcoma. Mitral regurgitation and Bronchial obstruction could be seen in mediastinal bronchogenic cysts. The 13 cases (48%) were managed by lobectomy, and cystectomy, pneumonectomy, and segemental resection were done in 7 cases (26%), 4 cases (15%), 3 cases (11%) respectively. Cystic contents were mucus in 9 cases, pus in 9 cases, blood in 2 cases, and carcinosarcoma in 1 case. Bronchotracheal communications were in 13 cases (48%). Five cases showed Postoperative complications, which were pneumothorax, empyema, bleeding. Postoperative death could not be found. Conclusion: Almost all patients had clinical symptoms. Severe complications could be associated with bronchogenic cysts. Recently, With the development of diagnostic methods, preoperatively accurate diagnosis is possible; therefore, invasive study has decreased. Bronchogenic cyst is a benign disease. However, because of its clinical symptoms, complications, and possibility of malignant change, immediate surgical treatment is needed.

Radiation Results and Survival Rate of Small Cell Lung Cancer (소세포폐암의 방사선치료 성적 및 생존율)

  • Oh, Won-Yong;Song, Mi-Hee;Whang, In-Soon
    • Radiation Oncology Journal
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    • v.14 no.2
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    • pp.105-113
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    • 1996
  • Purpose : To improve treatment modality and results by analysis of clinical characteristics, local control, survival and recurrence rate in limited stage small cell lung cancer. Materials and Methods : patients with limited stage small cell lung cancer were treated with combined radiation and chemotherapy from Feb. 1986 to Dec. 1992 at the National Medical Center We followed up on 21 patients ($81\%$), who were mostly irradiated with 4,000-5.000cGy ($75\%$ of all Patients) in the results by the analysis retrospectively. Survival rate was evaluated by the Kaplan-Meier method Results : Mean survival of irradiated patients with limited small cell lung cancer was 12 months. 1-rear and 2-rear survival rate were $65.3\%$ and $15.4\%$ Tumor response rate and median survival after combined chemotherapy and irradiation were the following: $50\%$ and 15 months of complete response, and $23\%$ and 11 months of partial response respectively. Response rates by radiation dose were $66\%$ for below 4,000cGy $69\%$ for between 4,000-5,000cGy and $86\%$ for above 5,000cGy. 21 of all patients showed treatment failure($81\%$) which as appeared 9 of local failure.9 of distant failure and 3 of local and distant failure. Conclusion : Local response rate after induction chemotherapy alone in limited stage of small cell lung cancer was $54\%$. Furthermore it was increased to $73\%$ after adding of radiation. We have to increase radiation dose above 5,000cGy and need to try new effective chemotherapy agents for the improvement of local control and survival rate and also will try concurrent chemoradiotherapy in near time.

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Surgical Treatment for Chronic Peptic Ulcer with Gastric Outlet Obstruction (만성 소화성 궤양에 합병된 위출구 폐색의 수술적 치료)

  • Lee, Jei Hee;Yang, Shi Joon;Jeon, Young Woong;Park, Sei Hyeog;Kim, Jong Heung;Park, Jong Min
    • Journal of Gastric Cancer
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    • v.8 no.3
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    • pp.160-165
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    • 2008
  • Purpose: With the introduction of H. pylori eradication and proton pump inhibitor, the operative treatments for the acute or chronic complications of peptic ulcer, such as perforation, bleeding and stricture, have decreased. Also owing to the development of non-operative treatment such as interventional endoscopic treatment, the surgical approach to the acute complications, like perforation and bleeding, has diminished. The non-operative treatments for the stricture and obstruction of chronic peptic ulcer in part related to discontinuation of medication have not been satisfactory. We analyzed the clinical outcomes of the patients who underwent operative treatment for outlet obstruction with peptic ulcer. Materials of Methods: From January 1994 to December 2007, we reviewed 31 patients who had been operated on at the National Medical Center for peptic ulcer obstruction. We excluded the cases of adhesive obstructions that were caused by a former ulcer operation and also the cases of obstructions found during emergency operations for treating perforation and bleeding. We classified the surgical treatment group into the bypass operation group and the surgical resection group. We evaluated the effects of the operations by the Visick score. The recurrences were confirmed only by the endoscopic observation of peptic ulcer. Results: The number of patients in the bypass operation group was 6 (19.4%) and that of resection group was 25 (80.6%). The mean age was 57.5 (25~81) years. The number of male patients was 29 (93.5%) and the number of females was 2 (6.5%). The mean symptom duration was 29.6 months. There were 19 smokers (61.3%), 6 NSAID users (19.4%) and 7 H. pylori positive patients (22.6%). Two patients underwent endoscopic balloon dilatation with no success. The locations of lesion were the stomach, the duodenum and both in 9, 20 and 2 cases, respectively. There were operative complications in 13 cases (41.9%), recurrent ulcers in 2 cases (6.5%), and reoperations in 4 cases. The mean Visick score was 1.8 (1~4). There were no statistically significant clinicopathologic differences between the bypass operation group and the resection group. The two groups had 1 case each of recurrence. Although the bypass group had a greater complication rate (83.3%) than the resection group (32%), this was not statistically meaningful (P=0.175). The mean Visick score was 3.0 in the bypass group and 1.6 in the resection group, so the resection group was better (P=0.001). Conclusion: For a case of chronic peptic ulcer with outlet obstruction, even though it has been reported that endoscopic balloon dilatation worked well, surgery is still regarded as an important treatment. If you consider the patients' satisfaction and the difficulty of diagnosing malignant ulcers, surgical resection should be recommended more often than a bypass operation.

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