• 해부∙생물인류학
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• 제31권4호
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• pp.133-142
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• 2018

조직표본의 실제적인 3차원 구조에 대한 정보를 3차원 조직학이라고 하였다. 무른 성분들이 섞여 있고, 물을 포함 하고 있는 조직 내부의 미세구조의 3차원적 분석을 위해 방사광의 X선을 광원으로 하는 위상대조 미세단층 촬영이 활용되고 있다. 하지만, X선 위상대조영상 분석에서 물을 포함하고 있는 조직에서는 위상대조가 제대로 구현되지 않다는 것을 알게 되었다. 이러한 현상을 해결하기 위해 다양한 방법들을 적용하였으며, 표본을 얼렸을 때 위상대조가 강화된다는 사실을 확인하였다. 방사광 전파위상대조 동결미세단층촬영은 포항가속기연구소 X선 영상빔라인에서 수행하였다. 표본을 동결상태로 유지하면서 $0.18^{\circ}$ 간격으로 $180^{\circ}$ 회전하였으며, 표본을 통과한 X선에 의해 섬광기에 맺힌 영상을 광학렌즈로 확대하여 CCD카메라로 모았다. 각 표본 전체 투사영상을 OCTOPUS 소프트웨어로 재구성하여 2차원 단면영상으로 만들고, Amira 소프트웨어를 이용하여 3차원 영상으로 재구성하였으며, 단면영상에서 각 구조에 대한 구역화와 랜더링 작업을 수행하였다. 물에 의한 위상대조 방해 영향을 줄이기 위해 표본을 얼렸을 때 위상대조는 강화되었으나 동결팽창에 의한 조직변형이 관찰되었다. 표본을 막힌 공간에 넣고 주위를 포매제로 채워 급속냉동 동안 표본이 압박되도록 하였을 때 위상대조의 강화와 동결팽창에 의한 조직변형을 줄일 수 있었다. 결론적으로, 생체조직 내부 미세구조의 비파괴, 고해상도 3차원 영상분석에 있어 조직표본을 동결포매제로 포매 후 급속냉동하고, 방사광에서 방출되는 X선을 광원으로 하는 전파위상대조 동결미세단층촬영법은 효과적인 방법이 될 수 있을 것으로 기대한다.

• Journal of Hospice and Palliative Care
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• 제2권1호
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• pp.36-45
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• 1999

목적 : 우리나라의 주된 사망원인인 암은 최근 들어 진단기술의 발전과 치료방법의 개선으로 전점 만성화되고 있어 결과적으로 집에서 치료받고 있는 재가암환자의 수가 증가추세에 있다. 그러나 지속적이고 체계적인 암환자 관리체계의 미비로 많은 환자들이 적정한 보건의료서비스를 받지 못하고 방치되고 있는 실정이다. 본 연구는 재가암환자의 삶의 질을 높이고 가족의 부담을 줄여주기 위한 지역사회 재가암환자 관리체계를 개발하기 위한 전단계로서 재가암환자의 서비스 요구를 파악하고자 한다. 방법 : 본 연구는 재가 암환자와 환자를 주로 돌보고 있는 가족을 대상으로 그들이 겪고 있는 어려움과 보건의료 분야의 도움을 필요로 하는 요구를 직접 면접 조사를 실시하여 조사하였다(연구대상, 중앙암등록본부 등록 환자, 455명). 결과 : 1) 암환자의 가장 중요한 증상인 통증조절에 대한 만족도는 경증 환자에서는 25.5%, 중증환자의 경우에는 46.5%가 불만이라고 응답하여 만족스러운 통증조절이 안되고 있었다. 2) 재가 암환자 및 보호자에 대한 요구도 조사결과를 보면 가장 필요한 도움으로는 경제적인 도움, 통증 및 증상조절 의료에 대한 정보제공 및 상담이었다. 3) 기본간호에 대해서는 간호필요율에 대한 충족율이 대부분 $20{\sim}30%$ 대로 낮았다. 특수간호의 경우에는 요구도가 있는 재가암환자가 많지 않았으며(5% 이내), 기본간호에 비해 간호충족율이 높았으나, 여전히 50% 정도로 낮아, 충분한 서비스가 충족되고 있지 않았다. 결론 : 재가암환자들의 서비스 요구도를 분석한 결과 암환자들이 충분한 통증 및 증상조절이 이루어지지 않고 있으며, 기본 및 특수간호의 충족률이 매우 낮은 실정이다. 향후에 재가암환자의 삶의 질을 높이고 가족의 부담을 줄여주기 위한 재가암환자 관리체계를 개발이 필요하다.

• 한국산학기술학회논문지
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• 제18권10호
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• pp.442-447
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• 2017

이 연구의 목적은 등속성 장비를 이용하여 고등학교 야구선수들을 대상으로 주관절 근육의 평가 기준치를 설정하는데 있다. 상지에 의학적으로 문제가 없는 고등학교 야구선수 201명을 대상으로 하였다. 주관절 검사는 HUMAC NORM(CSMI, USA) system을 이용하여 굴곡, 신전운동을 부하속도 $60^{\circ}/sec$에서 4회를 실시하였으며, 절대근력(peak torque)와 상대근력(peak torque % body weight)을 측정하였다. Cajori의 5단계(6.06%, 24.17%, 38.30%, 24.17%, and 6.06%)로 구분한 구간추정(interval estimation)방식에 의해 평가 기준치를 나타내었다. 이 연구의 결과에서 각속도 $60^{\circ}/sec$에서 주관절의 절대근력(peak torque) 굴근의 평균은 $37.88{\pm}8.14Nm$ 신근은 $44.59{\pm}11.79Nm$으로 나타났으며, 상대근력(peak torque % body weight) 굴근의 평균은 $50.06{\pm}8.66Nm$ 신근은 $58.28{\pm}12.84Nm$로 나타났다. 각속도 $60^{\circ}/sec$에서 주관절 굴근(flexer)과 신근(extensor)의 절대근력(peak torque)과 상대근력(peak torque % body weight)의 평가기준치는 설정하였다. 이 연구에서 분석 된 결과를 토대로 다음과 같이 결론을 이끌어 냈다. 주관절은 야구선수들에게 가장 많이 발생되는 손상임에도 불구하고 국내외 주관절 근력에 관한 연구가 미비한 실정이다. 주관절 손상을 예방하고 경기력 향상을 위해 상대적 근력 수준과 훈련효과를 보다 객관적으로 평가할 수 있는 근력 척도가 필요하다. 주관절의 절대근력과 상대근력의 평가기준치를 제시함으로서 고교선수, 야구지도자, 선수트레이너, 재활전문가 등에게 손상회복 및 재활 복귀 시 유용하게 자료가 될 것으로 생각되며, 객관적인 임상 평가 데이터로 활용하는 데 매우 유용한 정보라고 사료된다.

• 동의신경정신과학회지
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• 제21권4호
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• pp.21-39
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• 2010

Objectives : This study was to investigate the characteristics of the heart rate variability(HRV), types of insomnia and accompanying symptoms of 175 insomnia patients. Methods : For this study we carried out HRV, Inbody of 175 patients with insomnia who have come to Dongeui oriental hospital of Dongeui university from the period of Janaury 2008 to September 2010. We studied the association of the insomnia patients' age and gender with HRV, accompanying symptoms and the types of insomnia. The information of the accompanying symptoms and types of insomnia was based on each patients' progress note. Results : l. There was no significant differences in the characteristics of HRV between male and female. 2. The most frequent symptom shown among the insmonia patents' was headache(41.14%). 3. Comparing the symptoms between the gender, female patients had more dry mouth, alternative periodic chill and fever, and hot flush symptoms than the male patients. 4. Comparing the symptoms between the age groups(divided in two), the lower age group (20~59) had more dizziness and constipation symptoms than the higher age group (over 60). 5. Comparing the types of insomma between the age group, the higher age group (over 60) had more termination insomnia. 6. The types of insomnia of the entire insomnia patients were onset insomnia (73.1%), maintenance insomnia(20.6%), termination insomma(l7.1 %), shallow sleep (52.6%), listed by order of frequency. 7. The patients who takes hypnotics had more anorexia symptoms than the patients who doesn't take hypnotics. 8. There was no visible differences of the average fractal portrait between male and female. The age group of 20~30yrs. had the highest average fractal portrait, and the age group of 30~59yrs. the second highest, and the age group over 60yrs. the lowest. 9. The average of the regulation reserves of the autonomic nervous system(B2) - was lower than the regulation level of the ANS at the present (Bl). 10. When compared the priority of the function of the ANS, it showed that the proportion of HF($38.61{\pm}29.19%$)was the most, and than VLF($30.65{\pm}23.36%$), LF($20.04{\pm}19.13%$) the least. 11. The average of the compensation level of the central nervous system at present(Cl) - was lower than the compensation reserves of the CNS(C2). 12. The average of the control reserves of the cerebrum(D2) - was lower than the control level of the cerebrum at the present (Dl). 13. There was no visible differences between different sexes and ages in pulse rate. 14. The abdomen fat ratio above the line of the insomnia patients was 77.97% in male and 93.1% in female. Both sexes showed that insomnia patients had more abdomen fat that the standard, and female patients had more abd. fat than male patients. Conclusions : This study shows that the HRV of insomnia patients had no significant differences between gender. Fractal portrait, HF, LF and VLF of the insomnia patients are in inverse proportion to the age. The study of the Body Component Analysis showed that female had more abdomen fat than male, and both gender showed more abdomen fat than the standard. When looked into the accompanying symptoms of the insomnia patients, the symptoms show differences according to gender, age and hypnotics taking, as shown as below. In the entire patients, Headache was the most accompanying symptom. Female had more dry mouth, alternative periodic chill and fever, and hot flush symptoms than male. Higher age groups had more dizziness and constipation as accompanying symptoms than lower age groups. Patients who takes hypnotics had more anorexia than those who dont.

• 핵의학기술
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• 제21권1호
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• pp.60-64
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• 2017

검사의 질 향상과 국제표준화의 상용화 정도관리물질을 이용한 Westgard multi-rules 적용의 유용성은 이미 알려져 있다. 그러나 핵의학 체외검사의 특성상 정도관리물질과 환자검체의 동시 계측으로 인한 측정횟수의 증가에 따라 Westgard multi-rules법을 적용함에 있어 어려움이 있다. 이에 본 연구는 핵의학 체외검사에서 상용화 정도관리물질을 이용한 Westgard multi-rules 적용의 유용성과 보완, 개선을 통해 내부정도관리의 효율성 향상을 조사하였다. 2013년 01월부터 2016년 06월까지 삼성서울병원 핵의학과 체외검사실 통합의료시스템에 기록된 총 282건의 적용된 계통오차 multi-rules (22s, 101s)과 117건의 조치사항 기록을 분석하였다. 조치사항은 multi-rules 중 계통오차의 규칙이 적용 되었을 때 기록하는 원인분석으로 정도관리물질 오류, 실험과정 오류, 검사키트 로트번호 관리 오류, 기타 등 총 4개의 대분류로 구성하였다. Westgard multi-rules 적용을 통해 조치사항을 분석한 결과 정도관리물질 오류가 62건, 실험과정 오류가 24건, 검사키트 로트번호 관리오류가 18건, 기타 13건으로 분류되었다. 정도관리물질 오류를 방지하고자 개선사항으로 기존에 각 검사자마다 사용하던 방식을 담당자 지정 방식으로 변경하여 모든 검사의 하루 소비량을 분주하여 공동사용을 하였고, 나머지 오류를 방지하고자 검사 전후 모든 과정을 표준화 하여 검사실내 어느 검사자가 시행 하더라도 일원화할 수 있게 하였다. 정도관리물질 오류를 개선한 결과 해동 후 2일 이내 신선한 물질을 사용 가능하였고 같은 물질을 사용하는 검사끼리 비교가 가능해져 물질에 의한 오류인지 명확해짐으로 계통오차 발생원인이 정도관리물질 오류로 기록하는 건수가 줄어들었다. 또한 정도관리물질의 로트번호 변경 시 교체시기가 같아 관리가 용이해졌고, 물질 사용량의 감소로 경제적 효과를 얻을 수 있었다. 그리고 검사표준화 적용 후, 계통오차의 규칙인 22s와 101s의 발생건수가 개선 전 보다 월 평균 2건 이상 줄어드는 결과를 보였다. Multi-rules의 적용을 통한 계통오차의 빠른 확인을 위해 정도관리물질의 체계적인 관리와 목표값과 표준편자의 설정 및 관리가 바탕이 되어야하며, 계통오차 발생 시 검사의 원인분석을 통한 조치사항을 기록하는 것이 중요함을 확인하였다. 본 실험의 결과로 Westgard multi-rules 적용 분석을 통해 발생 오류의 기재와 원인을 효율적으로 분석함으로써 핵의학 검사 내부정도관리의 질적 향상과 정확하고 신속한 결과보고에 기여할 것으로 사료된다.

• 한국보건간호학회지
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• 제3권2호
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• pp.77-108
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• 1989

The purpose of this study was to find out the present condition of clinical practice and to develop a scheme on the efficiency of clinical practice for nursing education in junior college of nursing in korea. This study was conducted by 2 sections. Ist section was to find out the present condition of clinical practice to 42 directors of nursing collegd and data were collected July 8 to September 30, 1988. 2nd section wat to develop a scheme on the efficiency of clinical practice for nursing education and subjects were nursing professors 258: and clinical nurses 223 in 42 junior nursing colleges their clinical settings in korea. So total subjects were 481. Data were collected july 8, 1988 to June 30, 1988 and were analysed to get the mean, standand deviation, frequency, percentage, t-test, x-test used by SPSS - pc. Major findings were as follows: 1. The present condition of clinical education in junior college of nursing in Korea. 1) 32 colleges (76.2%) were managed by a-yeas system. 2) 25 colleges (59.5%) were performed by individual practice for each subject. 3) 4 weeks interval between class education and clinical education was a major type among total colleges(36.6%, J5 colleges) 4) 30 colleges (71.4%) provided clinical education for all subjects that should be practiced. Nursing administration wes not practiced in 5 colleges (41.9%) among the remainder(12 colleges). The main cause that all practice subjects were not practiced was the lack or absence of suitable clinical settings(8 colleges. 66.7%) 5) 18 colleges (42.9%) responded that a clinical educator was, subject-charged professor. 6) 12 colleges (29.3%) responded that a clinical instructor was in charge of 6~10 students. 7) The evaluation ration ratio(professor to head nurse) by each evaluator was mostly 50% to 50 % and 60% to 40%, respectively 11 colleges(27.5%) The most common evaluation methods were evaluation by head nures, report, presence, conference (11 colleges, 27.5%) 8) The field carrier of professor was mostly 2 years (79 persons, 20.7%) and mean was 3.2 years. The education carrier of a professor was mostly over than 6 years (261 persons, 66.4%) and mean was 9.2 years. The charge hours per-week of a professor were mostly 16-18 hours (16 persons, 131.8%) 9) 34 colleges (82.9%) approved that clinical practice hour was class hour and 18 colleges (43.9 %) counted that 2 hours of clinical education equaled 1 hour of class education. 2. A study 'on the efficiency of clinical practice for nursing education. L) general characteristics of subjects were as follows: kung-sang province (145 persons, 30.5%), 30-34 years (190 persons, 39.8%), graduated degree (245 persons, 51.5%), 6-10 years of carrier (199 persons, 41.4%) were the majority. 2) suitable clinical setting was responded the systematic ward with responsible clinical educator by 210 persons(43.8%) The response by working field of subjects showed a significant difference (p< 0.01) 3) 259 subjects (54.0%) responded that the desirable qualfication of clinical instructor was 3-5 years of clinical experience with master degree or higher. 4) The mean score of desirable quality degree of clinical instructor was 3.43 professors, score (3.54) was significantly higher than clinical nurses' (3.28) (p<0.01) 412 subjects (86.0%) responded that the insufficient guality of instructor was improved by continuing to seek more new information in reference. 5) 196 subjects (41.4%) responded that desirable qualification of head nurse was more than 2 years of head position among 5 years of clinical experience. The response by working' field of subjects showed a significant difference (p<0.05) 6) The mean score of desirable quality degree of head nurse was 3.18 Clinical nurses' score(3.38) was significantly higher than professors' (3.01) (p<0.01) 419 subjects (87.8%) responded that the insufficient of head nurse was improved by continuing relationship with instructor and being responsible from planing of clinical education. 7) The mean score of performance level of the desirable clinical education guide incollege was 2.91 Professors' score (2.96) was significantly higher than clinical nurses' (2.84) (p<0.01) 340 subjects (71.1%) responded that the possible resolution for poor performance was the more specified syllabus of clinical education and the satisfiable orientation for students. 8) The mean score of performance level of the desirable clinical education guide in hospital was 3.03 9) 141 subjects (29.6%) responded that the desirable clinical evaluator was the group of professor, head nurse, staff nurse. Response by working field of subjects was a significant difference (p< 0.05) 10) The mean score of performance level of the evaluation content needed in clinical education was 3.50 Clinical nurses' score (3.56) was significantly higher than professors' (3.45) (p<0.01) 11) 433 subjects (90.2%) responded that6 desirable evaluation method for clinical education was the presence. 12) The mean score of performance level about how personal difference among clinical educators was minimized was 2.89 and response by working field of subjects was not significant. The cause of poor performance was too much workload at clinical settings and too many students st colleges by 386 subjects (81.1%).

• 대한예방한의학회지
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• 제6권1호
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• pp.15-35
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• 2002

This study was conducted to provide basic data for policy of Oriental medicine by analyzing community resident's consciousness of taking herb medicine and its related factors. Data were collected from 1478 residents from March 2, 2001 to May 31, 2001. The results of this study are summarized as follows. 1) The rate of experience of taking herb medicine was 85.2%(88.2% of 'male'; 82.5% of 'female'). It appeared to be significantly higher in the groups of 'the married', 'housewife', and 'Buddhist'. As the age increased, so the rate of experience of taking herb medicine was significantly high. 2) In case of purpose of taking herb medicine, taking herb medicine as a restorative(66.8%) was much higher than taking it as a curative medicine. 3) 52.1% of the respondents satisfied with the effect of herb medicine. The groups of 'male', 'older age', 'residents in a big city', 'insurant in company', and 'the employed' showed significantly high rate in satisfying with herb medicine than the other groups. 4) According to the reason for preferring herb medicine, 36.7% of the respondents preferred herb medicine because the herb medicine was effective, while 27.8% preferred it because its side effect was low. 16.7% preferred it because persons around them recommended it. 5) 42.6% of the respondents did not want to take the herb medicine because the price of the herb medicine was high. Also 20.6% of the respondents did not want to take herb medicine because it is uneasy to take herb medicine. 15.8% did not want to take it because certain food should not be taken during the period of taking it. 9.4% did not want to take it because it tasted bitter. 6) In case of opinions on side effects of herb medicine, 40.8% of the respondents thinks that herb medicine is free from side effects, while 37.5% thinks that it causes side effects. There were significant difference in the opinions on side effects by sex, age, marital status, resident area, education level, occupation, and type of health insurance. 7) 60.7% of the respondents thinks the price of herb medicine is not resonable, while only 10.9% thinks it is resonable. 8) 45.2% of the respondents uses packs of decocted herbs although they think the packs of decocted herb are a little low effective because decocting herbs in home is bothersome. 45.2% uses packs of decocted herbs because they are convenient, being not related to the effect. 7.6% takes medicinal herbs after decocting them in a clay pot because they think the packs of decocted herbs have low effect. 51.9% does not know whether taking herb medicine in summer is effective or not because the effect is different according to their physical constitutions. 35.5% thinks that taking herb medicine is summer is effective because their physical stamina is weakened after sweated a lot, while 12.6% thinks that it is not effective because the effect of herb medicine disappears with sweat. 9) According to the level of satisfaction with Oriental medical care, the respondents marked $3.47{\pm}0.64$ points on the base of 5 points. It was significantly higher in the groups of 'male', 'the married, resident in a big city', 'highschool graduate', 'the unemployed', 'office clerk', 'growing up in a big city', 'insurant in region', and 'the middle class'. 10) According to the result of a regression analysis of factors influencing preference for herb medicine, the factors displayed significant difference by sex, age, education level, health status, and times of receiving Oriental medical care. As shown in the above results, the community residents satisfy with the effect of herb medicine. Therefore, the method of taking herb medicine without difficulty must be devised. The medicinal herbs in packages need to be included in health insurance coverage and resonable price of herb medicine must be set. Also, education program for community residents must be developed in order to provide right information in herb medicine. Therefore, related public authority, associations, and professionals must make efforts, forming organic cooperative system.

• 대한예방한의학회지
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• 제3권2호
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• pp.25-53
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• 1999

This study was conducted to provide basic data for policy of Oriental medicine by analyzing community residents' consciousness of taking herb medicine and its related factors. Data were collected from 1478 residents from March 2, 1999 to May 31, 1999. The results of this study are summarized as follows. 1. According to general characteristics of the subjects, 52.3% of the subjects was 'female'; 25.0% 'fifties of age'; 21.4% 'forties of age'; 20.9% 'thirties of ages'; 69.1% 'married'; 60.1% 'resident in a big city'; 12.1% 'residents in a small town or village'; 39.0% 'highschool graduate'; 35.9% 'above college graduate'; 23.4% 'housewife'; 23.4% 'professional' 34.1% 'Buddhist'; 81.1% 'middle class'. 2. The rate of experience of taking herb medicine was 85.2%(88.2% of 'male'; 82.5% of 'female'). It appeared to be significantly higher in the groups of 'the married', 'housewife', and 'Buddhist'. As the age increased, so the rate of experience of taking herb medicine was significantly high. 3. In case of purpose of taking herb medicine, taking herb medicine as a restorative(66.8%) was much higher than taking it as a curative medicine. Taking herb medicine as a curative medicine appeared to be significantly higher in the groups of 'male', 'thirties of age', 'resident in a town or village', 'above college graduate', 'professional technician', 'Christian', and 'the upper class'. 4. 52.1% of the respondents satisfied with the effect of herb medicine. The groups of 'male', 'older age', 'residents in a big city', 'insurant in company', and 'the employed' showed significantly high rate in satisfying with herb medicine than the other groups. 5. According to the reason for preferring herb medicine, 36.7% of the respondents preferred herb medicine because the herb medicine was effective, while 27.8% preferred it because its side effect was low. 16.7% preferred it. because persons around them recommended it. The preference for the herb medicine displayed significantly higher rate in the groups 'sixties of age', 'the unmarried', 'resident in a big city', 'office clerk', and 'the lower class'. 6. 42.6% of the respondents did not want to take the herb medicine because the price of the herb medicine was high. Also 20.6% of the respondents did not want to take herb medicine because it is uneasy to take herb medicine. 15.8% did not want to take it because certain foods should not be taken during the period of taking it. 9.4% did not want to take it because it tasted bitter. 7. In case of opinions on side effects of herb medicine, 40.8% of the respondents thinks that herb medicine is free from side effects, while 37.5% thinks that it causes side effects. There were significant difference in the opinions on side effects by sex, age, marital status, resident area, education level, occupation, and type of health insurance. 8. 60.7% of the respondents thinks the price of herb medicine is not resonable, while only 10.9% thinks it is resonable. 9. 14.2% of the respondents thinks health foods which contain herbs are good, while 16.8% thinks it is bad. 76.7% thinks that medicinal herbs in packages must be included in health insurance coverage, while only 3.0% thinks it needs not be included in health insurance coverage. 10. 45.2% of the respondents uses packs of decocted herbs although they think the packs of decocted herb are a little low effective because decocting herbs in home is bothersome. 45.2% uses packs of decocted herbs because they are convenient, being not related to the effect. 7.6% takes medicinal herbs after decocting them in a clay pot because they think the packs of decocted herbs have low effect. 11. According to the level of satisfaction with Oriental medical care, the respondents marked $3.47{\pm}0.64$ points on the base of 5 points. It was significantly higher in the groups of 'male', 'the married, resident in a big city', 'highschool graduate', 'the unemployed', 'office clerk', 'growing up in a big city', 'insurant in region', and 'the middle class'. 12. According to the result of a regression analysis of factors influencing preference for herb medicine, the factors displayed significant difference by sex, age, education level, health status, and times of receiving Oriental medical care. As shown in the above results, the community residents satisfy with the effect of herb medicine. Therefore, the method of taking herb medicine without difficulty must be devised. The medicinal herbs in packages need to be included in health insurance coverage and resonable price of herb medicine must be set. Also, education program for community residents must be developed in order to provide right information in herb medicine. Therefore, related public authority, associations, and professionals must make efforts, forming organic cooperative system.

• Tuberculosis and Respiratory Diseases
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• 제52권3호
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• pp.251-259
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• 2002

연구배경 : 급성호흡곤란증후군(ARDS)에서 호흡역학의 특징적인 변동은 폐 탄성(compliance) 감소와 폐 저항의 증가이다. 폐 저항의 증가 기전은 잘 밝혀지지 않았으나 임상에서는 ARDS 환자들의 기계환기시 기관지확장제를 흔히 투여하고 있다. 또한 상기 환자들에게 적용하는 호기말양압이 호흡저항에 미치는 영향에 대해서도 논란이 있다. 본 연구는 기계호흡을 받는 ARDS 환자들에서 기관지확장제 투여 및 호기말양압의 적용수준이 기도저항에 미치는 영향에 대하여 조사 하였다. 연구방법 : 2000년 1월부터 12월까지 서울중앙병원 내과계중환자실에서 내원하였던 15명의 ARDS 환자들 (남 : 여 14:1, 평균나이 58세) 이 대상이었다. 기관지확장제 투여 전과 투여 후(정량식흡입기로 salbutamol 100ug 씩 6회) 무작위로 호기말양압을 8, 10, 12 cm $H_2O$로 변화시키면서 일정 흡기류에서 흡기말폐쇄 방법을 이용하여 폐 탄성, 최대흡기저항, 최소흡기저항 및 부가적저항을 측정하였다. 각종 호흡역학치는 CP-100 pulmonary monitor(Bicore, Irvine, CA, USA)를 이용하여 측정하였다. 연구결과 : 1) 대상 환자들의 최대흡기저항은 $8.27{\pm}3.70cmH_2O$/L/sec로 정상치보다 증가되었으며, 최소흡기저항 및 부가적저항 모두 증가되었기 때문이다. 2) 호기말양압 10 cm $H_2O$에 비교시 호기말양압 12 cm $H_2O$에서 최대흡가저항과 최고기도압이 증가되었다. 3) 흡입제 투여시 호기말양압 8 cm $H_2O$과 10 cm $H_2O$에서는 최대흡기저항, 최소흡기저항 및 부가적저항 모두 변화가 없었으나 호기말양압 12 cm $H_2O$에서 최대흡기저항이 감소하였으며 주로 최소흡기저항이 감소되었고 부가적저항은 큰 변동이 없었다(각각 $15.66{\pm}1.99$에서 $13.54{\pm}2.41$으로, $10.24{\pm}2.98$에서 $8.04{\pm}2.34$으로, 그리고 $5.42{\pm}3.41$에서 $5.50{\pm}3.58cmH_2O$/L/sec 으로 변동). 4) 폐 탄성은 호기말양압 변화와 흡입제 투여에 변동이 없었다. 결 론 : ARDS 환자들에서 기도 저항이 증가되어 있으며 기도확장제에 의한 기도 저항의 감소 효과는 적용된 호기말 양압의 수준에 따라 다르게 나타났다.

• Journal of Radiation Protection and Research
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• 제35권1호
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• pp.34-42
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• 2010

현대 의학에서 방사선 이용 영역이 확대되고 비중이 커짐에 따라 개인 피폭선량을 줄이기 위한 노력을 하고 있는 가운데 가장 중요한 문제로 대두되고 있는 것이 방사선 기기에 관한 정도관리이다. 그래서 광주광역시 1차병원을 5개의 구로 나누어 각 구에서 임의로 10개소의 병원을 선정하여 정도관리 항목들의 실제 측정 실험과 광주지역 정도관리 현황에 대해 알아보고자 한다. 실험은 관전압, 관전류, 조사시간의 재현성 시험, 조도측정, 반가층 측정, 중심선속 일치 실험을 시행하였으며, 관전압 재현성 실험 결과 전체 50군데의 병원 합격률은 95.3%로 나타났고 관전류와 조사시간은 각각 77.0%의 합격률을 보였다. 조도는 86.0%의 합격률을 보였다. 반가층은 52.0%의 합격률을 보여 네개의 실험중 가장 낮은 합격률을 보였다. 중심선속 일치실험에서는 대체로 $1.5^{\circ}$ 이내로 중심선속이 일치하였으나 전체 50군데중 30.0%가 중심선속이 $3^{\circ}$이내로 벗어났다. 설문조사 결과로는 58.0%가 정도관리 주기에 대해 알고 있다고 답했으며, 50명 모두 현재 근무하는 병원에서 정도관리에 관한 교육을 받은 적이 없다고 답했다. 비교적 정도관리는 잘 이루어지고 있었지만 가장 시급한 문제는 정도관리의 중요성에 관한 인식이다. 따라서 방사선 작업 종사자들에게 전문적으로 안전관리에 관한 교육과 정확한 방사선 정도관리를 시행한다면 방사선 작업 종사자와 환자에 대한 피폭을 줄일 수 있으며 또한 적은 선량으로 질 높은 영상을 만들 수 있을 것으로 사료된다.