• 구강회복응용과학지
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• 제34권2호
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• pp.97-103
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• 2018

목적: 본 연구의 목적은 콘빔형 전산화단층영상(cone-beam computerized tomography)을 이용하여 한국인의 본윌 삼각을 평가함으로써 그간 서양인을 기준으로 제시된 본윌 삼각 관련 수치와 비교하기 위함이다. 연구 재료 및 방법: 원광대학교 치과대학 대전치과병원에 내원하여 Cone-beam CT를 촬영한 환자 중, 본 연구의 기준에 적합한 한국인 120명(남성 60명, 여성 60명)이 선택되었으며 Invivo 5.1 (Anatomage, San Jose, USA)가 Cone-beam CT scan을 분석하기 위해 사용되었다. 축의 방향설정을 시행한 후, 과두간 거리는 각 과두의 중심점을 지정하여 측정하였으며, 과두-절치간 거리는 과두 중심점과 하악 양 중절치 절단연의 접촉점을 지정하여 측정하였다. 수집된 자료는 SPSS Version 23.0 (IBM Inc., Armonk, USA)을 이용하여 분석하였고, independent t-test를 이용하여 성별에 따른 통계적 유의성을 검증하였다. 결과: 한국인의 평균 과두간 거리는 105.9 mm였으며, 남성(108.3 mm)이 여성(103.4 mm)에 비해 통계학적으로 유의하게 크게 나타났다. 한국인의 평균 과두-절치간 거리는 105.2 mm였으며, 남성(108.1 mm)이 여성(102.3 mm)에 비해 통계학적으로 유의하게 크게 나타났다. 결론: 본 연구에서 측정된 한국인의 과두간 거리는 105.9 mm로 서양인을 대상으로 제시된 110 mm에 비해 작은 값을 보였으며, 남성이 여성에 비해 통계학적으로 유의하게 크게 나타났다. 본 제한된 연구 결과를 근거로 한국인의 보철적 수복 시 과두간 거리를 좀 더 개인에 맞게 조절할 수 있는 교합기 사용이 필요하다고 사료된다.

• Journal of Preventive Medicine and Public Health
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• 제30권1호
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• pp.195-207
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• 1997

High price equipment is one of the major factors that increases national health expenditure in developed countries. Computerized Tomography(CT), one of the important high price equipment, has been concerns of health service researchers and policy makers in many countries. In Korea, CT, first introduced in 1984, have spreaded nationwide with rapid speed. Though the Committee for Approving Import of High Price Medical Equipment, founded in 1981, tried to regulate the introduction of high price medical equipment including CT, the effort resulted in failure. The exact situation of diffusion of the high price equipment, however, was not yet investigated. We aimed at the description of the diffusion of CT in Korea and analysis of influencing factors on hospitals for the adoption of CT. We mainly used the database of CT, made in 1996 by the National Federation of Medical Insurance for the purpose of insurance payment for CT. Also characteristics of hospitals were gathered from yearbooks published by the central and local governments and by the Korean Hospital Association. We calculated the cumulative number of the CT per one million population year by year. In turn, multiple linear logistic regression was done to find out the contributing factors for the adoption of CT by each hospital. In the logistic regression model, it is regarded as dependent factor whether a hospital retained CT or not in 1988 and 1993. The major categories of the independent factors were hospital characteristics, environmental factors and competitive conditions of hospitals at the period of the adoption. The results are as follows: Number of CT scanners per one million persons in Korea marked more higher level compared with those of most OECD countries. Major influencing factors on the adoption of CT scanners were hospital characteristics, such as hospital referral level, and competitive condition of hospitals, such as number of CT scanners per 10,000 persons in each district where the hospital was located. In Korea, CT diffused with rather rapid speed, comparable with those of the United States and Japan. The major factors contributing on the adoption of CT for hospitals were competitive condition and hospital characteristics rather than regional health care need for CT. In conclusion, a kind of regulating mechanism would be necessary for the prevention of the indiscreet adoption and inefficient use of high price equipment including CT.

• 한국병원경영학회지
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• 제1권1호
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• pp.108-135
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• 1996

This paper investigates the current feature of management strategy of hospitals in Korea, and examines the relationships between adoption of a particular strategic orientation and the hospitals environmental and organizational characteristics, strategic behaviors and management improvement activities, and financial performance. Data were collected from CEOs of 88 hospitals among 650 hospitals for a 13.5% response rate using the self-administered questionnaire by mail survey. The major findings that obtained are as follows: 1. Only 37.2% of response hospitals carried out strategic planning, Most of these hospitals established the first strategic planning in 1991(81.3%) and renovated strategic planning by 4 or 5 years(56.3%), and modified strategic planning with flexibility(59.4%). Most strategic plans were documented, but informalized(68.8%). And only 29.0% of these hospitals had independent planning division. 2. Hospital services that CEOs assessed rank ordered for their impact on profitability are as follows: i)diagnostic ultrasound facility, computerized tomography scanner, obstetric inpatient unit, therapeutic X-ray, and physical therapy at present. ii)diagnostic ultrasound facility, physical therapy, computerized tomography scanner, emergency department, and health screening at future. And the services rank ordered that CEOs hoped to introduce are as follows: emergency department, physical therapy, health screening, volunteer services, and computerized tomography scanner. 3. Using a typology developed by Miles and Snow(l978), the strategic orientation of response hospitals are shifting significantly from defenders in the past to analyzers in the present, and to prospectors in the future(p<.01). 4. With regard to hospital environmental and organizational characteristics such as ownership, physician training, location, bed size, and hospital management training career and specialty of CEOs, the four strategic orientation archetypes varied not significantly. But, hospitals with a analyser orientation in the present and a reactor orientation in the future perceived competition significantly higher than the other three archetypes(p<.05). 5. The four archetypes rank ordered in terms of appling strategic behaviors and management improvement activities are as follows: prospector, analyzer, reactor, and defender. 6. The four archetypes differed significantly in terms of their financial performance using revenue per bed(p<.05). Reactors and prospectors in terms of total revenue per bed, prospectors in terms of outpatient revenue per bed, and reactors and prospectors in terms of inpatient revenue per bed had the best performance.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권6호
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• pp.566-574
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• 2006

Purpose : This study was performed to provide an anatomical information of the mandibular ramus for the successful inferior alveolar nerve block. Three dimensional images were reconstructed from the computerized tomography (CT) and the anatomical evaluation of the mandibular ramus was done. Materials and methods : Sixty-four patients who had been taken the facial CT scans from 2000, Jan to 2003, June was selected. The patients who had the anterior or posterior teeth misssing, edentulous ridge, and jaw fracture were excepted. In the occulusal plane, the lingual surface angle (LSA) between the mid-sagittal plane and the mandibular molar lingual surface from the 2nd premolar to the 2nd molar, the inner ramal surface angle (IRSA), the maximum inner ramal surface angle (MxIRSA), and the outer ramal surface angle (ORSA) to the-mid sagittal plane were measured. The inner ramal surface angle in the ligular tip level (IRSA-L) and the outer ramal surface angle in the ligular tip level (ORSA-L), the ramal length (RL), and the anterior ramal length (ARL) were also measured in the lingular tip level. Results : In the lingular tip level, the mean IRSA-L and ORSA-L were $28.6{\pm}6.3^{\circ}$ and $17.9{\pm}4.9^{\circ}$ respectively. The larger was the IRSA, the larger was the ORSA. In the lingular tip level, the mean ramal length was 35.8${\pm}$3.4 mm. The larger was the IRSA-L, the shorter was the ramal length. On the lingular tip level, the mean anterior ramal length from anterior ramus to lingular tip was 19.6${\pm}$3.3 mm. when the ramal length was longer, the anterior ramal length was also longer. On the lingular tip level, there was positive correlation vetween the IRSA and the ORSA, negative correlation between the IRSA and the ramal length, and positive correlation between the ramal length and the lingular tip level to the anterior ramus. There was no statistical meaning of data between sex and age. Conclusion : In the clinical view of the results so far achieved, if the direction of needle is closer to posterior it is able to contact bone on lingular tip when the internal surface of ramus is wided outer.

• 대한두개안면성형외과학회지
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• 제12권2호
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• pp.93-96
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• 2011

Purpose: In most cases of nasal bone fracture, closed reduction with internal or external splint fixation approach is selected. However, because of indiscriminate insertion of the internal splint without considering of anatomical difference or deformity, insufficient fixation happens frequently that need additional fixation. Therefore, we suggest a new method for providing adequate support in reduced nasal bone by carving $Merocel^{(R)}$ that is fixed for the anatomical structure. Method: Closed reduction and internal fixation with carved $Merocel^{(R)}$ was performed in 15 nasal bone fracture patients from March, 2010 to July, 2010. Each patient was evaluated by physical examination, facial photographic check, simple X-ray, and computerized tomography. On the first day post-operation, location of packing and amount of reduction were checked by follow up X-ray and computerized tomography. In addition, patients' symptoms were evaluated. During the 3-month post-op follow up at out-patient clinic, operator, 2 doctors in training and one assistant performed the objective evaluations by physical examination on nasal dorsal hump, nasal deviation, nasal depression, nasal breath difficulty, and nasal airway obstruction. A survey of subjective patients' satisfaction in 4-stages was also performed. Results: The results of follow-up computerized tomography of the 15 patients revealed that 11 patients had good reduced state. Three patients with combined maxillary frontal process fracture had over reductions. A survey performed on the first day post-operation showed that 14 of 15 patients answered that their current symptoms were more than tolerable. At the 3-month follow-up physical exam, one case had a dorsal hump. However, there were no nasal deviations, nasal depressions, nasal breath difficulties, or nasal airway obstructions. Twelve of the 15 patients answered more than moderate on the 3-month survey. Conclusion: Intranasal packing after carving the $Merocel^{(R)}$ considering anatomical structure is a new effective method to promote proper-reduction, maintain stability, and minimize patients' symptoms by addition of a simple procedure.

• 한국정보처리학회논문지
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• 제5권12호
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• pp.3275-3284
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• 1998

본 논문에서는 각종 단층 촬영 의료영상 장비로 촬영한 2차원 단면화상 데이터들을 차원 재구성 알고리즘을 사용하여 3차원 영상으로 재구성한 다음, 웹 서버의 데이터베이스에 저장하고 관리하며, 인터넷 가상현실 표준언어인 VRML(Virtual Reality Modeling Language)로 표현된 3차원 의료영상을 비롯한 각종 의료영상 정보를 웹브라우저를 사용하여 검색해 볼 수 있는 의료영상정보시스템(Medical Image Information System)에 관하여 기술한다. 본 연구를 통하여 개발한 의료영상정보시스템에서는 단층 촬영된 2차원 단면화상을 처리한 다음, 3차원 의료 영상을 생성하기 위하여 표면기반 랜더링 방법(Surface-based Rendering Method)을 사용하였다. 인터넷을 통하여 전송되는 영상파일의 크기를 줄이기 위하여 삼각형 매쉬(Triangle Meshes)을 이루는 다각형의 개수를 줄이는 알고리즘을 사용하며, 3차원 의료영상 데이터의 크기를 약 50%이상 줄일 수 있다. 아울러, 3차원 영상 데이터 파일을 압축을 하게 되면 파일의 크기를 80%이상 줄일 수 가 있으므로 웹상에서 신속하게 3차원 의료영상 데이터를 검색할 수 있고, 의료영상을 VRML을 사용하여 표현하므로 고성능의 그래픽 카드가 없는 일반 PC에서도 인터넷을 통하여 디스플레이 할 수 있다. 또한, CGI(Common Gateway Interface)방식을 사용하여 서버의 데이터베이스에 저장되어 있는 CT(Computerized Tomography), MRI(Magnetic Resonance Imaging), PET(Positron Emission Tomography), SPECT(Single Photon Emission Computed Tomography)등의 단층 촬영 장비로 촬영한 다양한 종류의 디지털 의료영상을 사용자에게 의료영상정보시스템을 통하여 2차원 단면화상 또는 3차원 영상으로 표현하여 보여주고, 환자에 관한 각종 정보와 진단정보 등을 신속하게 제공한다. 본 논문에서 제안하는 의료영상정보시스템은 초고속 정보통신 망을 통하여 원격의료시스템을 구축하는데 활용될 수 있을 것이다.

• 한국방사선학회논문지
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• 제17권3호
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• pp.385-392
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• 2023

카롤리병은 섬유낭성 간질환이다. 상염색체 열성 장애로 담관의 선천적 다발성 확장이 특징이다. 카롤리병을 진단하는 방법으로 전산화단층촬영, 자기공명영상 검사, 담관 조영술, 초음파 검사가 있다. 전산화단층촬영검사는 섬유다낭성 간 질환을 감지하고 구별하는데 필수적이며, 간 내 담관의 확장을 판별하는 데 유용하다. 하지만 조영제를 사용함으로써 일어날 수 있는 부작용에 대한 인지가 필요하다. 자기공명영상검사는 대표적으로 자기공명담췌관조영술 방법을 이용한다. 비침습적 검사로 환자의 고통을 경감할 수 있고, 담췌관부의 해부학적 구조와 병변 유무를 쉽고 빠르게 관찰이 가능하다. 담관 조영술은 비대해진 담관 전체에 걸친 여러 낭성 확장을 직접 시각화할 수 있는 효과적인 진단 방법이다. 하지만 이 시술 또한 침습적인 시술이므로 진단이 아닌 치료 목적으로 권장된다. 초음파 검사는 전산화단층촬영과 유사한 소견을 확인할 수 있다. 간동맥 뿌리는 기존의 그레이 스케일 초음파에서 증명하기 쉽지 않다. 하지만 관 내 혈관 뿌리를 가진 확장된 담관을 묘사할 수 있을 뿐만 아니라 관 내 색상 도플러 신호를 쉽게 식별할 수 있다는 점에서 임상적 가치를 갖고 있다. 최근엔 영상진단의 발전으로 전산화단층촬영 검사, 자기공명영상 검사, 담관 조영술, 초음파 검사 등으로 조기 진단이 가능해졌다. 조기 진단을 통해 치료 후에 장기적인 예후가 개선될 수 있도록 영상 진단 발전에 더욱 기여하고자 각 검사별 카롤리병에 대하여 어떠한 양상이 나타나는지 고찰하였다

• 생물정신의학
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• 제2권1호
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• pp.38-43
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• 1995

The application of neuroimaging techniques in psychiatry started in 1970s with the use of CT(computerized tomography). Neuroimaging methods can be categorized as anatomical and functional. Recently, attentions are focused on the functional neuroimaging methods those could give us various important informations. But results regarding to psychotropic medication effect on neuroimaging are not sufficient. Here, the study results of the medication effect with the functional imaging methods are mainly revieued.

• 대한의용생체공학회:의공학회지
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• 제12권1호
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• pp.43-48
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• 1991

As the computerized methods and equipments In nuclear medicine imaging increases, quantitative information is needed on the single photon emission computed tomographic Images as well as on the conventional nuclear medicine images. In this paper, the authors investigated the effect of several clinician - friendly reconstrution filters on the resultant transverse slices of backprojected Profiles of radioisotope distribution from the Quantitative point of view, and reduced the filter parameters such as cutoff frequency and order of filter which are neces mary to minimize the quantification error using computer-generated phantoms.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1997년도 춘계학술대회
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• pp.465-468
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• 1997

A Study on Computer Assisted Diagnosis (CAD) system extract ing lung cancer part from Digital X-ray Computerized Tomography(CT) image is discussed in this paper. It is very crucial to segment the image of lung into the three organ area such as inside, outside and the hilum so that the variant image processing algorithm can be applied an each area respectively. In this paper, the efficient algorithm extracting lung cancer part is proposed with characterizing lung hilum part and its associated vessel patterns.