• Childhood Kidney Diseases
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• 제11권1호
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• pp.59-64
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• 2007

목적 : 소변 가리기 훈련이 안된 영유아에서 치골상부 방광천자는 오염율이 낮은 최상의 방법(gold standard)이며 초음파 감시하에 시행하여 성공률을 높이고 합병증을 감소시킬 수 있다. 그러나 침습적인 방법으로 여겨져 기피되고 도뇨관 채뇨가 선호되는 경향이 있다. 따라서 저자들은 초음파 감시하 치골상부 방광천자와 도뇨관 채뇨의 성공률, 합병증과 정확도를 비교해 보고자 전향적인 연구를 시행하였다. 방법 : 2003년 6월부터 2004년 8월까지 원인불명의 발열로 이대 목동병원 응급실을 찾아온 영유아중에서 소변을 가리지 못하고 요로감염이 의심되어 소변검사를 시행하게 된 121명을 대상으로 하였다. 일차 조사에서는 초음파 감시하 치골상부 방광천자(32명)와 도뇨관 채뇨(32명)를 무작위로 시행하여 성공률과 합병증을 조사하였고 이차 조사에서는 상기 두 가지 채뇨법을 동시에 시행(57명)하여 도뇨관 채뇨의 정확도를 평가하였다. 성공 기준은 0.5 mL 이상의 소변을 얻은 경우로 하였고 요로감염의 진단은 단일 요로병원균이 $10^5CFU/mL$ 이상 배양된 경우로 정의하였다. 통계분석은 Chi-square test를 이용하였고 P값이 0.05 미만인 경우를 유의한 것으로 판정하였다. 결과 : 성공률은 초음파 감시하 치골상부 방광 천자군이 첫 번째 시도 시 71.9%(23/32), 두 번째 시도 시 25.0%(8/32)로 총 성공률은 96.9% (31/32)였고 도뇨관 채뇨군은 첫 번째 시도 시 90.6% (29/32), 두 번째 시도 시 6.3%(2/32)로 총 성공률 96.9%(31/32)를 보여 두 군간에 유의한 차이는 없었다(P>0.05). 천자된 소변량은 초음파 감시하 치골상부 방광천자군 $7.4{\pm}3.7mL$로 도뇨관 채뇨군의 $4.5{\pm}2.6mL$에 비하여 유의한 차이는 없었다(P>0.05). 합병증은 도뇨관 채뇨군의 53.1%(17/32)에서 배뇨통을 보여 초음파 감시하 치골상부 방광천자군의 0%에 비하여 유의하게 높았다(P<0.001). 이차 조사에서 도뇨관 채뇨의 정확도는 초음파 감시하 치골상부 방광천자에 비해 민감도 59.5%(25/42), 특이도 86.6%(13/15)였고 위양성률 13.3%(2/15), 위음성률 40.5%(17/42) 로 정확도가 낮았다. 결론 : 소변을 가리지 못하는 영유아에서 요로 감염을 진단하기 위해서는 도뇨관 채뇨에 비해 초음파 감시하 치골상부 방광천자가 정확하고 안전한 채뇨법으로 권장되어야 한다고 생각한다.

• Korean Journal of Radiology
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• 제24권9호
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• pp.890-902
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• 2023

Objective: The clinical impact of artificial intelligence-based computer-aided detection (AI-CAD) beyond diagnostic accuracy remains uncertain. We aimed to investigate the influence of the clinical implementation of AI-CAD for chest radiograph (CR) interpretation in daily practice on the rate of referral for chest computed tomography (CT). Materials and Methods: AI-CAD was implemented in clinical practice at the Seoul National University Hospital. CRs obtained from patients who visited the pulmonology outpatient clinics before (January-December 2019) and after (January-December 2020) implementation were included in this study. After implementation, the referring pulmonologist requested CRs with or without AI-CAD analysis. We conducted multivariable logistic regression analyses to evaluate the associations between using AI-CAD and the following study outcomes: the rate of chest CT referral, defined as request and actual acquisition of chest CT within 30 days after CR acquisition, and the CT referral rates separately for subsequent positive and negative CT results. Multivariable analyses included various covariates such as patient age and sex, time of CR acquisition (before versus after AI-CAD implementation), referring pulmonologist, nature of the CR examination (baseline versus follow-up examination), and radiology reports presence at the time of the pulmonology visit. Results: A total of 28546 CRs from 14565 patients (mean age: 67 years; 7130 males) and 25888 CRs from 12929 patients (mean age: 67 years; 6435 males) before and after AI-CAD implementation were included. The use of AI-CAD was independently associated with increased chest CT referrals (odds ratio [OR], 1.33; P = 0.008) and referrals with subsequent negative chest CT results (OR, 1.46; P = 0.005). Meanwhile, referrals with positive chest CT results were not significantly associated with AI-CAD use (OR, 1.08; P = 0.647). Conclusion: The use of AI-CAD for CR interpretation in pulmonology outpatients was independently associated with an increased frequency of overall referrals for chest CT scans and referrals with subsequent negative results.

• 전자공학회논문지SC
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• 제48권4호
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• pp.1-9
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• 2011

쇼크(shock)란 조직에 필요한 산소 요구량과 공급 간의 불균형에 의해 유발되는 임상증후군을 말한다. 환자의 치료효과와 생존율 향상을 위해서 쇼크의 조기 진단은 매우 중요하다. 그러나 현재 쇼크 진단에 사용되는 맥박, 혈압 등 생체 징후의 경우 출혈 정도를 제대로 반영하지 못하여 환자에 대한 처치가 늦어질 수 있다. 따라서 쇼크의 조기 진단을 위한 많은 연구들이 진행되어 왔으며, 조직의 저산소증, 대사성 산증을 반영해주는 지표인 젖산 농도와 관류 측정의 유용성이 입증된 바 있다. 본 연구에서는 흰쥐를 대상으로 정량적 출혈을 유도한 후, 젖산 농도 측정과 laser Doppler flowmeter를 통해 관류를 측정하였으며, 지혈 후 젖산 농도/관류의 비(ratio)를 생존 예측을 위한 새로운 지표로써 제안하였다. 새로 제안된 지표를 통한 생존예측을 ROC 커브 방법에 적용한 결과, 민감도 90.0%, 특이도 96.7%, 정확도 94.0%를 보였으며, 생존군과 사망군 간 새로운 지표의 유의한 차이도 가장 조기에 보여주었다. 향후 임상 적용 연구를 통해 새롭게 제안한 지표의 임상 적용이 가능하다면, 쇼크 환자를 조기 진단하고 치료효과를 높일 수 있을 것으로 생각된다.

• 생명과학회지
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• 제21권1호
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• pp.9-14
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• 2011

심박수(heart rate) 및 산소 소비량(oxygen consumption) 등의 생리학적 변수는 운동자각도(RPE)와 밀접한 관련이 있으며, RPE의 남녀차이에 의한 예측 운동강도의 정확성은 아직 밝혀지지 않고 있고, 본 연구는 남녀 대학생의 심장 혈관 및 신진대사의 반응을 평가하고 남녀의 차이를 밝히는 데 있다. 남자대학생($25.1{\pm}1.56$ yr)과 여자대학생($25.0{\pm}4.12$ yr) 각각 10명이 본 연구에 자발적으로 참여를 하였고, 본 연구를 위하여 설정된RPE는 Borg의 15 범주에서 결정을 하였으며, 점증적 운동부하(graded exercise testing)는 Bruce Treadmill Protocol을 이용하였다. 남녀의 평균 slope (p=0.501)와 RPE의 plotting rates와 최대산소섭취율(% $VO_2$max)은 유의한 차이가 나타나지 않았다. 각자의 상대적 최대산소섭취량은 남학생의 경우52.36${\pm}$7.35 ml/kg/min, 여학생은 41.44${\pm}$6.71 ml/kg/min로 나타나 두 그룹간에 유의하게 큰 차이가 있었으며, 절대적 최대산소섭취량은 남학생은 4.05${\pm}$0.36 l/min, 여학생은 2.53${\pm}$0.39 l/min로 나타나 두 그룹간에 큰 차이가 나타냈다. 남학생과 여학생간의 slope, y-intercept, SEE는 통계적으로 유의한 차이는 없었다. 본 연구에서 운동강도에 따른 남학생과 여학생의 RPE 의 차이는 유의하게 나타나지 않았다. 이상의 결과로 보아 RPE는 운동중 산소섭취량에 대한 운동강도의 예측에 남녀별 차이가 없어 유효한 예측인자라고 사료된다.

• 한국응급구조학회지
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• 제17권1호
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• pp.9-19
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• 2013

Purpose : The purpose of this study was to investigate the variation of elapsed time in the cardiopulmonary resuscitation (CPR) quality and the fatigue in continuous CPR by single rescuer. This study will provide basic data about the time for the alternation of the CPR providers. Methods : The volunteer students having healthcare provider certification were recruited from the department of emergency medical service. The students performed 30:2 CPR for 20 minutes, and the data were recorded and analyzed. Metrics were based on the 2010 American Heart Association (AHA) Guidelines, and the CPR continued without any feedback. Results : Among the indicators of CPR, the accuracy and the depth of chest compressions decreased after about 5.3 minutes, and the rate increased approximately after 6.8 minutes. Changes in clinical indicators appeared, and fatigue increased after about 3 minutes. According to the increase in fatigue level, the changes in the CPR indicators and clinical indicators showed up, and these results proved to be statistically significant. However, there were no associations among the time, fatigue, and gender. Conclusion : Even though the times of changes in the indicators appeared differently, the times of changes in fatigue and CPR quality were able to be confirmed.

• 센서학회지
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• 제29권2호
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• pp.100-104
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• 2020

Thus far, several in vivo biosensing platforms have been proposed to measure the mechanical contractility of cultured cardiomyocytes. However, the low sensitivity and screening rate of the developed sensors severely limit their practical applications. In addition, intensive research and development in cardiovascular disease demand a high-throughput drug-screening platform based on biomimetic engineering. To overcome the drawbacks of the current state-of-the-art methods, we propose a high-throughput drug-screening platform based on 16 functional high-sensitivity well plates. The proposed system simulates the physiological accuracy of the heart function in an in vitro environment. We fabricated 64 cantilevers using highly flexible and optically transparent silicone rubber and placed in 16 independent wells. Nanogrooves were imprinted on the surface of the cantilever to promote cell alignment and maturation. The adverse effects of the cardiovascular drugs on the cultured cardiomyocytes were systematically investigated. The 64 cantilevers demonstrated a highly reliable and reproducible mechanical contractility of the drug-treated cardiomyocytes. Real-time high-throughput screening and simultaneous evaluation of the cardiomyocyte mechanical contractility under multiple drugs verified that the proposed system could be used as an efficient drugtoxicity test platform.

• 전기학회논문지
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• 제60권9호
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• pp.1770-1776
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• 2011

In this study, a new method that can estimate ICG data from a subject's both hands to measure Cardiac Output under convenient sensor environment. With this aim, a grip-type electrode was implemented to measure ICG. To improve the accuracy of measurement, the regression equation was extracted using multiple bio-parameters and our result was compared with the thoracic ICG equipment(Physio Flow$^{(R)}$, PF104D, Manatec Biomedical, France), which is being used in clinics. The subjects consist of 26 men and 4 women(age in $22.0{\pm}3.32$). They are no cardiac disease. Parameters available for regression model were used gender, BMI, MBP, LVET, dZ/dt(max), distance between the measured electrodes, body impedance, and PTT. As a result of analyzing the ICG measurement value on thorax and both hands, the correlation with stroke volume, heart rate, and cardiac output was $R^2$=0.853, $R^2$=0.958 and $R^2$=0.899, respectively.

• 대한의용생체공학회:의공학회지
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• 제30권4호
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• pp.294-305
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• 2009

The bio signals essentially have different characteristics in each person. And the main purpose of automatic diagnosis algorithm based on bio signals focuses on discriminating differences of abnormal state from personal differences. In this paper, we propose automatic ECG diagnosis algorithm which discriminates normal heart beats from premature ventricular contraction using optimization of wavelet parameterization to solve that problem. The proposed algorithm optimizes wavelet parameter to let energy of signal be concentrated on specific scale band. We can reduce the personal differences and consequently highlight the differences coming from arrhythmia via this process. The proposed algorithm using ELM as a classifier show high discrimination performance between normal beat and PVC. From the experimental results on MIT-BIH arrhythmia database the performances of the proposed algorithm are 98.1% in accuracy, 93.0% in sensitivity, 96.4% in positive predictivity, and 0.8% in false positive rate. This results are similar or higher then results of existing researches in spite of small human intervention.

• 대한의용생체공학회:의공학회지
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• 제34권2호
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• pp.97-103
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• 2013

This paper proposes a new algorithm for sleep apnea detection based on stroke volume. It is very important to detect sleep apnea since it is a common and serious sleep-disordered breathing (SDB). In the previous studies, methods for sleep apnea detection using heart rate variability, airflow and blood oxygen saturation, tracheal sound have been proposed, but a method using stroke volume has not been studied. The proposed algorithm consists of detection of characteristic points in continuous blood pressure signal, estimation of stroke volume and detection of sleep apnea. To evaluate the performance of algorithm, the MIT-BIH Polysomnographic Database provided by Phsio- Net was used. As a result, the sensitivity of 85.99%, the specificity of 72.69%, and the accuracy of 84.34%, on the average were obtained. The proposed method showed comparable or higher performance compared with previous methods.

• 대한전기학회논문지:시스템및제어부문D
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• 제54권3호
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• pp.198-205
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• 2005

In this paper, we proposed a new algorithm for the separation of fetal ECG from single channel abdominal ECG. The algorithm consists of a stage of demixing vector calculation for initial signal and a stage of fetal beat detection for the rest of signal. The demixing vector was obtained by applying independent component analysis technique to projected signals into time-frequency domain. For the test of this algorithm, simulation signals, De Lathauwer's data and some measured data, which was acquired from 8 healthy volunteers whose pregnant periods ranged from 22 weeks to 35 weeks and whose ages from 27 to 37, were used. For each data, the accuracy of fetal beat detection was $100\%$ and with the location of fetal beats, fetal heart rate variability and morphology could be offered. In conclusion, this proposed algorithm showed the possibility of fetal beat separation with a single channel abdominal ECG and it might be adopted to a fetal health monitoring system, by which a single channel abdominal ECG is acquired.