• 제목/요약/키워드: Hyperplasia

검색결과 999건 처리시간 0.03초

한의사의 초음파 진단기기 사용은 무면허의료행위인가? -대법원 2022. 12. 22. 선고 2016도21314 전원합의체 판결- (The Use of Diagnostic Ultrasound Devise by Oriental Medical Doctors)

  • 이동진
    • 의료법학
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    • 제24권1호
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    • pp.3-42
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    • 2023
  • 대법원 2022. 12. 22. 선고 2016도21314 전원합의체 판결은 한의사가 진단용 초음파기기를 사용하여 자궁내막증식증을 진단한 것이 무면허의료행위가 아니라고 판단하였다. 이 판결은 서양의학에 속하는 영상의학적 방법을 사용한 특정 의료행위가 무면허의료행위가 아니라고 판단한 것이 아니라 진단용 초음파기기 사용만으로 서양의학에 속하는 영상의학적 진단행위가 있었다고 단정할 수 없고 그러한 사정은 검사가 구체적으로 특정하여 기소하고 증명하여야 함을 분명히 하는 취지라고 할 수 있고, 그러한 한 타당하다. 한의학계에서 주장해온 바와 같이 특정 기기 사용 자체를 금지하는 규정은 없는 것이다. 그러나 당해 사안에서 실제로 서양의학에 속하는 영상의학적 진단방법을 사용하였을 가능성이 상당하고 그러한 경우 무면허의료행위임 또한 분명하다. 지금까지 의료와 한방의료의 경계획정이 문제된 사안 중 상당수가 시험적 성격을 띤 반면, 위 사건의 의료행위는 다수의 한의원에서 널리 행해지고 있다고 의심된다는 점에서 일정한 대응이 필요하다. 나아가 실제로 서양의학에 속하는 영상의학적 진단방법을 쓴 것이 아니라 하더라도 여전히 문제가 있다. 다수의 한의원이 전체적으로 진단에 관한 한 서양의학에 속하는 영상진단을 하는 것처럼 오인하기 쉽게 하고 있는바, 이는 부정경쟁행위이자 의료 소비자의 실질적 선택권을 침해하는 행위이기 때문이다. 현행법상 무면허의료행위만으로 이 문제에 대응하는 데는 한계가 있을 뿐 아니라 장차 무면허의료행위 규율을 개선하는 방법으로 대응하는 것도 쉽지 아니하다. 별도의 규율장치를 도입할 필요가 있다.

새로 개발된 말초동맥용 자가팽창성 개방형 니티놀 스텐트의 유효성 및 안전성 평가: 미니피그 전임상실험 (Efficacy and Safety of a Newly Developed Self-Expanding Open-Cell Type Nitinol Stent for Peripheral Arteries: A Preclinical Study in Minipigs)

  • 김민욱;이재환;윤창진;최원석;허세범;정진욱
    • 대한영상의학회지
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    • 제81권4호
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    • pp.899-911
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    • 2020
  • 목적 얇고 새로운 구조로 개발된 말초동맥용 자가팽창성 개방형 니티놀 스텐트의 유효성 및 안전성을 기존에 사용하는 스텐트와 비교 평가하였다. 대상과 방법 미니피그 14마리를 대상으로 실험군과 대조군 스텐트를 무작위배정 후 각 개체의 장골동맥에 대칭적으로 삽입하여 1개월(n = 5) 및 6개월(n = 9) 추적관찰하였다. 혈관조영술로 혈관 직경, 후기 내강 손실 및 협착 정도를 평가하고 조직계측학적으로 내탄력층 면적, 내강 면적, 신생 내막 면적 및 협착 정도를 분석하였다. 추적기간 중 모든 실험 개체에 대하여 매일 임상적 평가 및 식이 정도를 추적관찰하였다. 결과 모든 개체는 추적관찰 기간 중 생존하였으며 중대한 유해 반응을 보이지 않았다. 혈관조영술상 6개월 추적관찰군에서 실험군의 내강 직경이 유의하게 컸으며(p = 0.014), 후기 내강 손실이 적었고(p = 0.019), 협착 정도가 낮았다(p = 0.014). 조직학적으로 1개월 추적관찰군에서 실험군이 신생 내막 면적 및 면적 협착이 유의하게 낮았다(각, p = 0.008, p = 0.016). 6개월 추적관찰군에서는 실험군이 대조군에 비하여 내강 면적이 유의하게 넓었으며(p = 0.040), 내탄력층 면적, 신생 내막 면적 및 면적 협착이 통계적으로 유의하게 낮았다(각, p = 0.004, p = 0.008, p = 0.014). 결론 새로 개발된 말초혈관용 자가팽창성 개방형 니티놀 스텐트는 기존에 사용하는 스텐트와 비교하여 안전하며 신생 내막 증식의 정도가 적었다.

기관지 암의 진단에서 형광기관지 내시경검사의 유용성 (Usefulness of LIFE in diagnosis of bronchogenic carcinoma)

  • 이상화;심재정;이소라;이상엽;서정경;조재연;김한겸;인광호;최영호;김학제;유세화;강경호
    • Tuberculosis and Respiratory Diseases
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    • 제44권1호
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    • pp.69-84
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    • 1997
  • 배경 : 폐암은 13%만이 완치할 수 있는 예후가 불량한 질환으로 조기진단이 중요한 것으로 알려져 있다. 상피내암이나 미세침윤성 기관지암 등의 조기폐암은 조기에 효과적으로 치료할 수 있어 그 진단이 중요하며, 최근에는 전구암 병변도 조기에 진단 가능하므로써 그 예방적인 치료가 시도되고 있다. 조기진단을 위한 객담 세포진 검사나 기존의 기관지 내시경검사는 조기폐암과 전구암 병변에 대한 진단율이 떨어져 진단에 어려운 실정이다. 최근에는 정상과 암세포의 자기형광 (autofluorescence)을 이용한 형광 기관지 내시경(lung imaging fluorescence endoscope device : LIFE)을 통하여 조기 폐암과 전구암 병변의 진단에 효과적인 것으로 알려져 있다. 목적 : 본 연구는 기존의 내시경을 시행하는 환자를 대상으로 형광기관지 내시경 검사를 시행하여 기관지 점막에 이상이 있는 경우 조직검사를 통하여 두 검사 사이에 민감도와 특이도의 차이를 비교하였다. 방법 : 대상환자는 총 35명으로 평균연령 59.3(27-77)세였으며, 남자 26명, 여자 9명이었다. 흉부 방사선상에 폐암 환자 9명, 폐구엽성 무기폐환자 4명, 폐렴환자 3명, 객담에서 악성세포 양성을 보인 2명, 원인 모르는 흉수 환자 2명, 혈담환자 9명, 만성 기침환자 6명이였다. 대상환자 중 악성종양으로 진단된 환자는 15명이였으며, 기존의 백색빛 광원의 기관지 내시경검사와 형광 기관지 내시경 검사를 시행하였으며, 두 검사에 중에 한 검사에서도 이상병변이 있는 경우 조직검사를 시행하여 총 79조직을 얻어 두 검사간에 민강도와 특이도를 비교하여 다음과 같은 결과를 얻었다. 결과 : 1) 총 79조직은 정상조직이 8, 상피세포 증식이 21, 상피세포의 이형성이 23, 침윤성 폐암이 27조직이었다. 2) 상피세포의 이형성인 23조직에서 백색빚 기관지내시경은 14조직에서 양성으로 60.9 % 였으나, LIFE는 19조직에서 양성으로 82.6 %로 높은 경향을 보였다. 3) 27조직의 침윤성 폐암에 대한 백색빛 기관지내시경는 27조직 모두 양성(100%)인 반면에, LIFE는 19조직이 양성으로 70.3 %의 양성율을 나타냈다. LIFE에서 음성으로 보인 8조직의 침융성 폐암은 선암 7조직 중 3조직, 소세포암 8조직 중 5조직이었으며, 이들은 모두 상피조직은 정상이나 암조직이 점막이하에 침윤되어 있었던 조직이었다. 반면에 상피조직에 이상이 있던 7조직의 편평상피 세포암 조직, 1조직의 대세포암, 2조직의 유암과 2조직의 전이성 앙은 모두 양성이었다. 결론 : 이상의 결과로 LIFE는 전구암 병변과 기관지 기관지 폐암증에 상피세포에 이상이 있는 기관지 폐암의 진단에는 백색빛 기관지내시경보다 민감도가 높아 기관지 상피세포에 이상이 있는 전구암 병변과 조기폐암에는 유용할 것으로 사료되나, 기관지 폐암중에 정상의 기관지 점막하에 칩윤하는 기관지 폐암의 진단에는 한계가 있을 것으로 사료된다.

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급성 간질성 폐렴의 임상적 고찰 (Clinicopathologic features of Acute Interstitial Pneumonia)

  • 심재정;박상면;이상화;이진구;조재연;송관규;인광호;유세화;강경호
    • Tuberculosis and Respiratory Diseases
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    • 제42권1호
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    • pp.58-66
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    • 1995
  • 연구배경: 급성 간질성 폐렴(Acute interstitial pneumonia)은 Hamman-Rich증후군, accelerated interstitial pneumonia 등의 다양한 이름으로 불리던 질환으로, 임상적으로 급속히 진행하는 급성 호흡 부전증과 양폐야에 미만성 침윤을 보이며, 조직학적으로는 organizing diffuse alveolar damage를 보이는 원인 불명의 질환을 Katzenstein이 급성 간질성 폐렴으로 명명하였다. 이 질환은 발병후 급속히 진행되는 임상양상, 방사선소견, 조직학적 소견에서 특발성 폐섬유화증과 차이가 있으며, 예후도 80~90%의 사망률을 보이나 만성으로 진행되는 특발성 폐섬유화증과는 달리 가역적인 것에서 차이가 있다. 이에 저자들은 최근에 급성 간질성 폐렴 5예를 경험하여 이들에 대한 임상적 고찰을 보고하는 바이다. 방법: 본원에 내원하여 조직학적으로 진단된 급성 간질성 폐렴 환자 5명을 대상으로 하였으며 5예에 대한 연령 및 성별의 분포, 초기증상과 기간 및 전구증상 후 호흡곤란의 발생한 기간 등을 확인하였으며, 호흡곤란후 실시한 전혈구검사와 동맥혈 가스 분석소견을 확인하였으며, 3명에서 실시한 폐기능 검사 소견, 호흡곤란이 발생된 후 촬영한 단순 흉부 방사선 소견과 3명에서 실시한 고해상 흉부 단층 촬영 소견을 각각 관찰하였다. 폐조직소견은 간질의 부종, 유리막질의 형성, 제2형의 폐상피세포의 증식과 섬유아세포의 증식 유무와 정도를 관찰하였다. 5예의 치료에 대한 반응 결과를 의무기록지로 후향적으로 조사하였다. 결과: 1) 남자 2명, 여자 3명으로 나이는 31세에서 77세였으며, 증상은 6~40일간의 마른기침과 미열감이 있었으며, 2예에서는 피부발진과 다발성 관절통이 동반되었고, 이후 급속히 진행하는 성인성 호흡곤란증후군(ARDS)의 소견을 보였다. 2) 모든 환자에서 백혈구증다증, 증가된 적혈구침강반응 및 심한 저산소혈증이 있었으며, 뚜렷한 원인없이 발병하였으며, 3예에서 실시한 폐기능 검사상 제한성 환기장애를 보였다. 3) 흉부 방사선 검사상 불규칙적인 분포의 유리음영과 consolidation과 함께 망상의 변형이 있었으며, 조직학적으로는 광학현미경 소견상 폐포와 간질의 부종, 유리막질의 형성, 제2형의 폐상피세포의 증식 및 활발한 섬유아세포의 증식을 보였으며, 면역형광현미경 검색을 실시한 2예에서는 특징적으로 간질의 비후가 관찰되었으나 anti-fibrin만이 폐포와 폐포 내강에 염색되었으며, 3예에서 실시한 전자현미경 검사상 폐포 기저막의 분절성 붕괴가 관찰되었으며, 이중 1예는 면역복합체의 침착이 있었다. 4) 스테로이드 강압요법과 기계적 호흡에도 불구하고 급속히 진행되는 호흡부전으로 5명 중 4명이 발병 14일 내지 90일만에 사망하였고, 조직학적으로 비교적 초기의 급성 간질성 폐렴 환자 1명만 생존하였다. 결론: 이상의 조직학적으로 증명된 5예의 급성 간질성 폐렴을 임상적 고찰을 한 바 임상 경과와 조직학적 특징이 만성으로 진행하는 특발성 폐섬유화증과는 뚜렷한 차이를 보이므로 따로 구별되어야 할 것으로 생각된다. 특히 비교적 초기에 진단된 1예에서는 스테로이드 강압요법에 의하여 아무런 후유증없이 완치되었으므로 이 질환의 조기진단 및 치료에 대한 많은 연구가 필요할 것으로 사료된다.

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흰쥐의 갑상선기능(甲狀腺機能)이 비유(泌乳)에 미치는 영향(影響) (Effects of Thyroid Function on Lactation in Female Rats)

  • 서길웅;김덕임
    • 농업과학연구
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    • 제19권1호
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    • pp.51-64
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    • 1992
  • 본(本) 실험(實驗)은 수유중(泌乳中)인 흰쥐를 대상(對象)으로 갑상선기능(甲狀腺機能)이 체중(體重)과 수유(泌乳)에 미치는 영향(影響)을 구명(究明)코져 실시(實施)하였는 바 체중 250g 정도(程度)의 정상분만(正常分娩)한 암흰쥐 105마리를 thyroxine 처리군(處理群)(THY.군(群)), propylthiouracil 처리군(處理群)(PTU군(群)) 및 정상대조(正常對照) 군(群)(CON.군(群))의 3개군(個群)으로 나누어 35마리씩 배치(配置)한 다음 THY.군(群)에서는 L-thyroxine을 체중 100g당(當) $30{\mu}m$씩 3일(日) 간격(間隔)으로 주사(注射)하였고 PTU군(群)에서는 음수(飮水)를 0.03%의 propylthiouracil 용액(溶液)으로 만들어 자유급수(J自由給水)시켰다. 또한 각(各) 군별(群別)로 시간(時間)의 경과(經過)에 따라 3, 6, 9, 12, 15, 18 및 21일(日)에 체중(體重)을 측정(測定)하였고 도살(屠殺) 후(後)에 갑상선(甲狀腺)의 중량측정(重量測定), 갑상선(甲狀腺)과 유선(乳腺)의 조직학(組織學)적 검색(檢索)을 실시(實施)하였으며 아울러 혈청중(血淸中) prolactin의 농도(濃度)를 측정(測定)하여 비교(比較) 검토(檢討)한 결과(結果)는 다음과 같다. 1. 체중(體重)은 처리후(處理後) 3일(日)과 6일(日) 그리고 15일(日)과 18일(日)에서 비교군간(比較群間) 유의성(有意性)이 인정(認定)되는 변화(變化)를 보였는데 PTU군(群)이 CON.군(群)과 THY.군(群)에 비(比)하여 낮은 중량치(重量値)를 나타냈다. 2 갑상선(甲狀腺)의 중량(重量)은 처리(處理) 9일(日) 후(後)부터 비교군간(比較群間)에 유의성(有意性)이 인정(認定)되었는데 PTU군(群)은 CON.군(群)과 THY.군(群)에 비(比)하여 고도(高度)의 유의성(有意性)이 인정(認定)되는 높은 중량치(重量値)를 나타냈다. 3. 갑상선(甲狀腺)의 조직상(組織象)은 PTU군(群)의 경우 처리(處理) 6일(日) 후(後)부터 농포상피세포(濃胞上皮細胞)가 증식(增殖).비대(肥大)를 동반(同伴)한 원주화(圓柱化) 현상(現象)이 나타나기 시작하였고 이러한 현상(現象)은 수유말기(泌乳末期)까지 계속되었다 THY.군(群)은 처리(處理) 9일(日) 후(後)부터 핵농축(核濃縮)을 동반(同伴)한 농포상피세포(農胞上皮細胞)가 편평화(扁平化)되는 퇴행성(退行性) 변화(變化)를 나타냈다. 4. CON.군(群)의 prolactin 농도(濃度)는 처리(處理) 18일후(日後)에 최고치(最高値)를 보였고 THY.군(群)은 처리(處理) 12일후(日後)에 고도(高度)의 유의성(有意性)이 인정(認定)되는 높은 농도(濃度)를 나타냈으며 PTU군(群)은 전(全) 실험기간(實驗其間)동안 다른 실험군(實驗群)에 비(比)하여 낮은 농도(濃度)를 나타냈다. 5. 유선(乳腺)의 조직학적(組織學的) 변화(變化)는 CON.군(群)과 THY.군(群)은 처리(處理) 12일후(日後)까지는 유선상피세포(乳腺上皮細)가 입방화(立方化)되는 조직상(組織象)을 나타냈으나 처리(處理) 후(後) 15일(日)부터는 THY.군(群)이 CON.군(群)보다 유선조직(乳腺組織)의 분화(分化)가 빠른 속도(速度)로 진행(進行)되었으며 PTU군(群)은 처리(處理) 후(後) 시간(時間)이 경과(經過)할수록 유선조직(乳腺組織)의 퇴행성(退行性) 변화(變化)가 야기(惹起)되어 처리(處理) 15일후(日後)부터는 유선상피세포(乳腺上皮細胞)의 탈락현상(脫落現象)과 유선포(乳腺胞)의 위축(萎縮)이 인지(認知)되는 조직소견(組織所見)이었다. 6. 신생자(新生仔)의 체중(體重)은 처리(處理) 후(後) 시간(時間)이 경과(經過)할수록 모든 실험군(實驗群)이 점차(漸次) 증가(增加)하였으나 PTU군(群)은 다른 실험군(實驗群)에 비(比)하여 유의성(有意性)이 인정(認定)되는 낮은 체중치를 나타냈다.

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Proinflammatory Cytokines과 TGF-beta가 섬유모세포의 증식에 미치는 영향 (The Effects of Proinflammatory Cytokines and TGF-beta, on The Fibroblast Proliferation)

  • 김철;박춘식;김미호;장헌수;정일엽;기신영;어수택;문승혁;김용훈;이희발
    • Tuberculosis and Respiratory Diseases
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    • 제45권4호
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    • pp.861-869
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    • 1998
  • 연구배경: 조식의 손상에의한 염증반응후 회복과정에서 정상조직으로 환원되지 않고 일부는 결체조직으로 대체되어 섬유화가 일어난다. 이 비정상적 섬유화에 의해 섬유화증이 일어나 조직의 원래 기능을 상설하기도 한다. 이때 염증에 관계되는 세포로부터 분비된 여러종류의 cytokine들이 섬유모세포의 증식과 교원질 합성을 조절한다. 이에 관계된 cytokine들의 상호 관련성과 섬유모세포증식에의 영향을 알아내어 조절함으로써 섬유화증을 예방하고 치료하는데 도움을 줄 수 있다. 본 연구에서는 proinflammatory cytokine인 TNF-$\alpha$, IL-1$\beta$, IL-6와 섬유모세포의 증식에 큰 영향을 미치는 TGF-$\beta$의 상호 관련성을 알아보고자 하였다. 방 법: 섬유모세포는 사람 태아의 섬유모세포주인 MRC-5를 사용하였으며, 0, 0.5, 1, 5, 10, 20%의 우태아 혈청을 첨가하여 1, 2, 3, 4, 5일째의 MRC-5 증식을 측정하여, 최소한으로 MRC-5의 증식을 억제하면서 생존을 유지시킬 수 있는 배양액중 혈청농도를 먼저 확정한 후, TGF-$\beta$, TNF-$\alpha$, IL-1$\beta$, IL-6를 각각 RPMI 배지에 첨가하여 $37^{\circ}C$, 5% $CO_2$ 보온기에서 96 시간동안 배양하여 0.5 % naphthol blue black으로 염색한 뒤, 50mM의 NaOH로 naphthol blue black을 유리시켜 630nm에서의 분광흡수를 잼으로써 MRC-5의 수를 측정하였다. 또한 TGF-$\beta$와 다른 cytokine의 관련성을 알아보기위해 TGF-$\beta$와 함께 IL-1$\beta$, IL-6, TNF-$\alpha$를 각각 배지에 첨가하여 96 시간 배양 후, 위와 동일한 방법으로 MRC-5의 수를 측정하였으며, TNF-$\alpha$와 IL-1$\beta$, IL-6의 상호 관련성을 알아보기 위해 TNF-$\alpha$와 함께 IL-1$\beta$, IL-6를 각각 배지에 첨가하여 96 시간 배양한 뒤 위와 동일한 방법으로 MRC-5의 수를 측정하였고, 마지막으로 TGF-$\beta$와 TNF-$\alpha$의 섬유모세포 증식에 미치는 상호 관련성을 알아보기 위하여 TGF-$\beta$와 TNF-$\alpha$를 함께 배지에 첨가하여 96 시간 배양 후, MRC-5의 수를 역시 통일한 방법으로 측정하였다. 결 과: 1. 최소한으로 MRC-5의 증식을 억제하면서 생존을 유지할 수 있는 배양액중 혈청 농도를 측정한 결과, 0.5% 혈청 농도에서 MRC-5의 증식이 50% 증가된 상태로 배양 6일째 까지 유지되었다. 따라서 이후의 실험에서 사용된 배양액에는 0.5%의 우태아혈청을 포함시켰다. 2. 각 cytokine이 MRC-5 증식에 미치는 영향 0.5%의 우태아혈청만이 있는 상태에서의 MRC-5 증식 정도를 100%로 기준하였을 때, IL-1$\beta$는 50 ng/ml의 농도에서만 45%의 증식 촉진효과를 보였고, IL-6는 영향이 없었으며, TGF-$\beta$와 TNF-$\alpha$는 농도에 의존성을 보이며 MRC-5의 증식을 최고 160% 까지 증가시켰다. 3. TGF-$\beta$에 의한 MRC-5 증식능증가에 IL-1$\beta$, IL-6, TNF-$\alpha$가 미치는 영향 50 ng/ml의 TGF-$\beta$ 단독 자극에 비하여, IL-1$\beta$ 혼합배양시 농도에 의존성으로 보이며 최고 64% 까지, TNF-$\alpha$ 혼합배양시 농도에 의존성을 보이며 최고 159% 까지 MRC-5의 증식을 증가시켰다. IL-6는 약한 억제효과를 보였으나 TGF-$\beta$에 의한 MRC-5 증식능 증가에 영향을 미치지 못하였다. 4. TNF-$\alpha$에 의한 MRC-5 증식능 증가에 IL-1$\beta$, IL-6가 미치는영향 50 ng/ml의 TNF-$\alpha$ 단독자극에 비하여, IL-1$\beta$을 혼합 배양하였을때 농도에 의존성을 보이며 최고 50%까지 MRC-5의 증식을 억제하였고, IL-6는 영향을 미치지 못하였다. 5. TNF-$\alpha$와 TGF-$\beta$의 MRC-5 증식능 증가에서의 상호관련성 50 ng/ml의 TGF-$\beta$와 TNF-$\alpha$는 MRC-5의 증식을 각각 89%, 135% 증가시켰으며, TGF-$\beta$와 TNF-$\alpha$ 공존시에는 MRC-5의 증식을 222% 증가시켰다. 결 론: TNF-$\alpha$ TGF-$\beta$, IL-1$\beta$의 순서로 MRC-5에 대한 증식 자극효과가 있으며 IL-6는 증식을 억제하는 효과가 있었다. TGF-$\beta$의 MRC-5에 대한 증식 자극효과는 IL-1과 TNF-$\alpha$에 의해 첨가효과를 관찰할 수 있었고, TNF-$\alpha$의 MRC-5 증식 자극효과는 IL-1$\beta$에 의하여 억제되었다.

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일개 보훈병원 입원환자의 상병 및 진료비 구조분석 (Analysis of Frequent Disease and Medical Expenses Structure of Patients Admitted in a Vaterans Hospital)

  • 김경환;이석구;김정연
    • 농촌의학ㆍ지역보건
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    • 제30권1호
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    • pp.1-14
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    • 2005
  • 보훈병원 입원환자의 재원기간과 진료비분석을 위해 일개 보훈병원에서 2001년 1월부터 2003년 12월 31일까지의 입원환자를 대상으로 9,640명의 진료비 대장을 분석하여 다음과 같은 결과를 얻었다. 1. 조사대상자의 성별 분포는 남자 70.9%, 여자 29.1%로 남자의 비율이 여자보다 높았다. 연령별로는 70대이상 42.6%, 50-60대 31.8%, 20대이하 13.4%, 30-40대 12.1%로 나타났으며, 의료보장별로는 의료보험이 78.1%, 의료보호가 14.2%, 일반환자가 4.1%, 자보환자가 2.8%, 산재환자가 0.8%로 나타났다. 진료과목별 분포는 내과가 28.3%, 정형외과 21.3%, 외과 16.6%, 신경외과 7.1%, 소아과 5.9%로 나타났다. 보훈 대상자군의 성별분포는 남자 99.3%, 여자 0.7%이였으며, 연령별로는 70대 이상 51.6%, 50-60대 42.2%, 30-40대 4.7%. 20대이하 1.6%였으며, 지역별로 살펴보면 대전 거주자 1, 550명 43.5%, 충남 거주자 838명 23.5%, 충북 거주자 785명 22.0%순으로 나타났다. 2. 보훈병원 입원환자의 21대분류 상병분포는 손상, 중독 및 외인에 의한 특정기타 결과 17.1%, 소화기계의 질환 16.1%, 근골격계 및 결합조직의 질환 13.9%, 호흡기계 질환 9.4%, 비뇨 생식계의 질환 8.6%로 나타났다. 보훈대상자군을 21대 분류상병별로 보면 근골격계 및 결합조직의 질환 19.4%, 소화기계의 질환 16.8%, 손상, 중독 및 외인에 의한 특정 기타 결과 15.7%, 비뇨 생식계의 질환 9.7%, 순환기계 질환이 8.2%순으로 나타났다. 3. 평균 재원일수는 29.0일, 보훈대상자군 51.8일, 비대상자군은 15.7일이며, 총진료비는 평균 3,669,579원, 보훈대상자군 7,263,877원, 비대상자군 1,560,333원이다. 본인 및 보험자 부담비율은 55.2 : 44.8로 나타났고, 본인부담 비율은 보훈 대상자군의 경우 61.7%, 비대상군의 경우 33.0%였다. 4. 대분류 상병별 총진료비는 순환기계 질환 6,593,662원, 근골격계 및 결합조직의 질환 4,716,317원, 비뇨 생식계 질환 4,487,799원, 손상, 중독 및 외인에 의한 특정 기타 결과가 4,199618원이며, 항목별 진료비 구조는 입원료가 34.7%, 약제비 13.2%, 행위료 부분이 48.6%, 기타 3.4%로 나타났고, 항목별로는 입원료가 34.7%, 물리치료 및 처치료가 26.3%, 수술료 9.7%, 주사재료비 7.8%, 투약재료비 5.4%, 검사료 52%순으로 나타났다. 보훈대상자군의 경우 물리치료비 및 처치료 35.3%, 입원료 35.2%, 주사재료비 62%, 수술료 5.9%로 나타났으며, 비대상자군의 경우 입원료 35.7%, 수술료 16.4%, 주사재료비 11.4%, 검사료 8.3%로 나타났다. 5. 보훈대상자의 거주지와 병원간 거리별로 상병구조를 비교해 보았을 때 21.5Km내의 지역에서는 달리 분류되지 않은 증상, 징후와 임상 및 검사의 이상소견 56.0%, 손상, 중독 및 외인에 의한 특정 기타 결과 55.6%, 눈 및 눈 부속기의 질환 52.9%순으로 나타났고, 21.5km 밖의 지역에서는 신생물 57.4%, 근골격계 및 결합조직의 질환 55.9%, 비뇨생식계의 질환 53.5%순으로 나타났다. 결론적으로 보훈대상자의 70.6%가 60세 이상이고, 평균재원일수가 51.8일 점을 볼 때 보훈병원에 장기요양시설에 대한 대책이 절대적으로 필요하다는 것을 알 수 있으며, 총진료비가 높은 순환기 질환, 근골격계 질환, 신생물 등 만성질환 관리를 위한 노력이 필요하리라 생각된다. 상위 7개 질환군이 77.9%를 차지하고 있으므로 노인연령층에서 지속적으로 발생하고 있는 치사율이 높은 뇌혈관 및 심혈관의 순환기계 질환, 악성신생물, 그리고 불의의 사고를 주요 건강문제로 설정하여 뇌혈관 및 심혈관의 순환기계 질환은 적절한 신체적, 정신적, 사회적 활동유지를, 악성신생물의 경우는 만성질환 조기 발견 및 관리를, 불의의 사고와 관련해서는 장애 및 만성질환에 따른 불편의 최소화를 주요 목표로 하여 다양한 프로그램을 개발하여 시행해야 한다.

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Sensory Information Processing

  • Yoshimoto, Chiyoshi
    • 대한의용생체공학회:의공학회지
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    • 제6권2호
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    • pp.1-8
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    • 1985
  • The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70$\pm$1.32mmHg/min)compared to CF dialyzers(4.32$\pm$0.55mmHg/min)(p<0.05). However, there was no observable difference in the UFR between the two dialyzers. Neither APD nor UFR showed any significant increase with an increasing number of reuses for up to more than 20reuses. A substantial number of failures observed in APD(larger than 20mmHe/min)on the reused dialyzers(2 out of 40 CP and S out 26 C-DAK) were attributed to the Possible damage on the fibers. The CF 15-11 HFDs which failed APD test did not show changes in the UFR compared to normal dialyzers indicating that APD is a more sensitive test than UFR test to evaluate the integrity of the fibers. 30527 T00401030527 ^x For quantitative measurement of reflected light from a clinical diagnostic strip, a prototype old reflectance photometer was designed. The strip loader and cassette were made to obtain more accurate reflectance parameters. The strip was illuminated at 45˚c through optical fiber and the intensity of reflected light was determined at rectanguLat angle using a photodiode. The kubelka-munk coefficient and reflection optical density were determined ar four different wavelengths(500, 550, 570 and 610nm) for blood glucose strip. For higher concentration than 300mg/41 about glucose, a saturation state of abforbance was observed at 500, 550 and 570nm. The correlation between glucose concentration and parameters was the best at 610nm. 30535 T00401030535 ^x Radiation-induced fibrosarcoma tumors were grown on the flanks of C3H mice. The mice were divided into two groups. One group was injected with Photofrin II, intravenously (2.5mg/kg body weight). The other group received no Photofrin II. Mice from both groups were irradialed for approximately 15 minutes at 100, 300, or 500 mW/cm2 with the argon (488nm/514.5 nm), dye(628nm) and gold vapor (pulsed 628 nm) laser light. A photosensitizer behaved as an added absorber. Under our experimental conditions, the presence of Photolfrin II increased surface temperature by at least 40% and the temperature rise due to 300 mW/cm2 irradiation exceeded values for hyperthermia. Light and temperature distributions with depth were estimated by a computer model. The model demonstrated the influence of wavelength on the thermal process and proved to be a valuable tool to investigate internal temperature rise. 30536 T00401030536 ^x We investigated the structural geometry of thirty-eight Korean femurs. The purpose of this study is to identify major geometrical differences between Korean femurs 3nd others that we believe belong to Caucasians so that we would be able to get insights into the femoral component design that fits Asians including Koreans. We utilized computerized tomography (CT) images of femurs extracted from cadavers. The CT images were transformed into bitmap data by using a film scanner, and then analyzed by using a commercially available software called Image v.1.0 and a Macintosh IIci computer.The resulting data were compared with already published data. The major results show that the geometry of the Korean femurs is significantly different from that of Caucasians: (1) the anteversion angle and the canal flare index are greater by the amount of approximately 8˚ and 0.5, respectively, (2) the shape of the isthmus cross section is more round, and (3) the distance between the teaser trochanter and the proximal border of the isthmus is shelter by about 15 mm. The results suggested that the femoral component suitable for Asians should be different from the currently-used components designed and manufactured mostly by European or American companies. 30537 T00401030537 ^x It is well known that nonlinear propagation characteristics of the wave in the tissue may give very useful information for the medical diagnoisis. In this paper, a new method to detect nonlinear propagation characteristics of the internal vibration in the tissue for the low frequency mechanical vibration by using bispectral analysis is proposed. In the method, low frequency vibration of f0( = 100Hz) is applied on the surface of the object, and the waveform of the internal vibration x (t) is measured from Doppler frequency modulation of silmultaneously transmitted probing ultrasonic waves. Then, the bispectra of the signal x (t) at the frequencies (f0, f0) and (f0, 2f0) are calculated to estimate the nonlinear propagation characteristics as their magnitude ratio, w here since bispectrum is free from the gaussian additive noise we can get the value with high S/N. Basic experimental system is constructed by using 3.0 MHz probing ultrasonic waves and the several experiments are carried out for some phantoms. Results show the superiority of the proposed method to the conventional method using power spectrum and also its usefulness for the tissue characterization. 30541 T00401030541 ^x This paper describes the implementation of a computerized radial pulse diagnosis by aids of a clinical expert. On this base, we composed of the radial pulse diagnosis system in korean traditional medicine. The system composed of a radial pulse wave detection system and a radial pulse diagnosis system. With a detection system, we detected Inyoung and Cheongu radial pulse wave and processed it. Then, we have got the characteristic parameters of radial pulse wave and also quantified that according to the method of Inyoung-Cheongu Comparison Radial Pulse Diagnosis. We defined the jugement standard of radial pulse diagnosis system and then we confirmed the possibility for realization of automatic radial pulse diagnosis in korean traditional medicine. 30545 T00401030545 ^x Microspheres are expected to be applied to biomedical areas such as solid-phase immunoassays, drug delivery systems, immunomagnetic cell separation. To synthesize microspheres for biomedical application, "two stage shot growth method" was developed. The uniformity ratio of synthesized microspheres was always smaller than 1.05. And the surface charge density (or the number of ionizable functional groups) of the microspheres synthesized by "two stage shot growth method" was 6~13 times higher than that of the microspheres synthesized by conventional seeded batch copolymerization. As a previous step for biomedical application, adsorption experiments of bovine albumin on microspheres were carried out under various conditions. The maximum adsorbed amount was obtained in the neighborhood of pH 4.5. Isoelectric point of bovine albumin is pH 5.0, so experimental result shows that it shifted to acid area. The adsorption isotherm was obtained, the plateau region was always reached at 2.Og/L (bulk concentration of bovine albumin).The effect of the kind and the amount of surface functional group was also examined. 30575 T00401030575 ^x A medical image workstation was developed using multimedia technique. The system based on PC-486DX was designed to acquire medical images produced by medical imaging instruments and related audio information, that is, doctors' reporting results. Input information was processed and analyzed, then the results were presented in the form of graph and animation. All the informations of the system were hierarchically related with the image as the apex. Processing and analysis algorithms were implemented so that the diagnostic accuracy could be improved. The diagnosed information can be transferred for patient diagnosis through LAN(local area network). 30592 T00401030592 ^x In the conventional infrared imaging system, complex infrared lens systems are usually used for directing collimated narrow infrared beams into the high speed 2-dimensional optic scanner. In this paper, a simple reflective infrared optic system with a 2-dimensional optic scanner is proposed for the realization of medical infrared thermography system. It has been experimentally proven that the intfrared thermography system composed of the proposed optic system has the temperature resolution of 0.1˚c under the spatial resolution of lmrad, the image matrix size of 256 X 240, and tile imaging time of 4 seconds. 30593 T00401030593 ^x In this paper, MIIS (Medical Image Information System) has been designed and implemented using INGRES RDBMS, which is based on a client/server architecture. The implemented system allows users to register and retrieve patient information, medical images and diagnostic reports. It also provides the function to display these information on workstation windows simultaneously by using the designed menu-driven graphic user interface. The medical image compression/decompression techniques are implemented and integrated into the medical image database system for the efficient data storage and the fast access through the network. 30594 T00401030594 ^x In this paper, computerized BEAM was implemented for the space domain analysis of EEG. Trans-formation from temporal summation to two-dimensional mappings is formed by 4 nearest point inter-polaton method. Methods of representation of BEAM are two. One is dot density method which classify brain electrical potential 9 levels by dot density of gray levels and the other is colour method which classify brain electrical 12 levels by red-green colours. In this BEAM, instantaneous change and average energy distribution over any arbitrary time interval of brain electrical activity could be observed and analyzed easily. In the frequency domain, the distribution of energy spectrum of a special band can easily be distinguished normality and abnormality. 30608 T00401030608 ^x Laboratory information system (LIS) is a key tool to manage laboratory data in clinical pathology. Our department has developed an information system for routine hematology using down-sized computer system. We have used an IBM 486 compatible PC with 16MB main memory, 210 MB hard disk drive, 9 RS-232C port and 24 pin dot printer. The operating system and database management system were SCO UNIX and SCO foxbase, respectively. For program development, we used Xbase language provided by SCO foxbase. The C language was used for interface purpose. To make the system use friendly, pull-down menu was used. The system connected to our hospital information system via application program interface (API), so the information related to patient and request details is automatically transmitted to our computer. Our system interfaced with fwd complete blood count analyzers(Sysmex NE-8000 and Coulter STKS) for unidirectional data tansmission from analyzer to computer. The authors suggests that this system based on down-sized computer could provide a progressive approach to total LIS based on local area network, and the implemented system could serve as a model for other hospital's LIS for routine hematology. 30609 T00401030609 ^x To develop an artificial bone substitute that is gradually degraded and replaced by the regenerated natural bone, the authors designed a composite that is consisted of calcium phosphate and collagen. To use as the structural matrix of the composite, collagen was purified from human umbilical cord. The obtained collagen was treated by pepsin to remove telopeptides, and finally, the immune-free atelocollagen was produced: The cross linked atelocollagen was highly resistant to the collagenase induced collagenolysis. The cross linked collagen demonstrated an improved tensile strength. 30618 T00401030618 ^x This paper is a study on the design of adptive filter for QRS complex detection. We propose a simple adaptive algorithm to increase capability of noise cancelation in QRS complex detection with two stage adaptive filter. At the first stage, background noise is removed and at the next stage, only spectrum of QRS complex components is passed. Two adaptive filters can afford to keep track of the changes of both noise and QRS complex. Each adaptive filter consists of prediction error filter and FIR filter The impulse response of FIR filter uses coefficients of prediction error filter. The detection rates for 105 and 108 of MIT/BIH data base were 99.3% and 97.4% respectively. 30619 T00401030619 ^x To develop an artificial bone substitute that is gradually degraded and replaced by the regenerated natural bone, the authors designed and produced a composite that is consisted of calcium phosphate and collagen. Human umbilical cord origin pepsin treated type I atelocollagen was used as the structural matrix, by which sintered or non-sintered carbonate apatite was encapsulated to form an inorganic-organic composite. With cross linking atelocollagen by UV ray irradiation, the resistance to both compressive and tensile strength was increased. Collagen degradation by the collagenase induced collagenolysis was also decreased. 30620 T00401030620 ^x We have developed a monoleaflet polymer valve as an inexpensive and viable alternative, especially for short-term use in the ventricular assist device or total artificial heart. The frame and leaflet of the polymer valve were made from polyurethane, To evaluate the hemodynamic performance of the polymer valve a comparative study of flow dynamics past a polymer valve and a St. Jude Medical prosthetic valve under physiological pulsatile flow conditions in vitro was made. Comparisons between the valves were made on the transvalvular pressure drop, regurgitation volume and maximum valve opening area. The polymer valve showed smaller regurgitation volume and transvalvular pressure drop compared to the mechanical valve at higher heart rate. The results showed that the functional characteristics of the polymer valve compared favorably with those of the mechanical valve at higher heart rate. 30621 T00401030621 ^x Explosive evaporative removal process of biological tissue by absorption of a CW laser has been simulated by using gelatin and a multimode Nd:YAG laser. Because the point of maximun temperature of laser-irradiated gelatin exists below the surface due to surface cooling, evaporation at the boiling temperature is made explosively from below the surface. The important parameters of this process are the conduction loss to laser power absorption (defined as the conduction-to-laser power parameter, Nk), the convection heat transfer at the surface to conduction loss (defined as Bi), dimensionless extinction coefficient (defined as Br.), and dimensionless irradiation time (defined as Fo). Dependence of Fo on Nk and Bi has been observed by experiment, and the results have been compared with the numerical results obtained by solving a 2-dimensional conduction equation. Fo and explosion depth (from the surface to the point of maximun temperature) are increased when Nk and Bi are increased.To find out the minimum laser power for explosive evaporative removal process, steady state analysis has been also made. The limit of Nk to induce evaporative removal, which is proportional to the inverse of the laser power, has been obtained. 30622 T00401030622 ^x N1 and N2 gross neural action potentials were measured from the round window of the guinea pig cochlea at the onset of the acoustic stimuli. N1-N2 audiograms were made by means of regulating stimulant intensities in order to produce constant N1-N2 potentials as criteria for different input tone pip frequencies. The lowest threshold was measured with an input tone pip I5 dB SPL in intensity and 12 KHz in frequency when the animal was in normal physiological condition. The procedure of experimental measurements is explained in detail. This experimental approach is very useful for the investigation of the Cochlear function. Both noN1inear and active functions of the Cochlea can be monitored by N1-N2 audiograms. 30623 T00401030623 ^x In electrical impedance tomography(EIT), we use boundary current and voltage measurements toprovide the information about the cross-sectional distribution of electrical impedance or resistivity. One of the major problems in EIT has been the inaccessibility of internal voltage or current data in finding the internal impedance values. We propose a new image reconstruction method using internal current density data measured by NMR. We obtained a two-dimensional current density distribution within a phantom by processing the real and imaginary MR images from a 4.77 NMR machine. We implemented a resistivity mage reconstruction algorithm using the finite element method and sensitivity matrix. We presented computer simulation results of the mage reconstruction algorithm and furture direction of the research. 30624 T00401030624 ^x A new method of digital image analysis technique for discrimination of cancer cell was presented in this paper. The object image was the Thyroid eland cells image that was diagnosed as normal and abnormal (two types of abnormal: follicular neoplastic cell, and papillary neoplastic cell), respectively. By using the proposed region segmentation algorithm, the cells were segmented into nucleus. The 16 feature parameters were used to calculate the features of each nucleus. A9 a consequence of using dominant feature parameters method proposed in this paper, discrimination rate of 91.11% was obtained for Thyroid Gland cells. 30625 T00401030625 ^x An electrical stimulator was designed to induce locomotion for paraplegic patients caused by central nervous system injury. Optimal stimulus parameters, which can minimize muscle fatigue and can achieve effective muscle contraction were determined in slow and fast muscles in Sprague-Dawley rats. Stimulus patterns of our stimulator were designed to simulate electromyographic activity monitored during locomotion of normal subjects. Muscle types of the lower extremity were classified according to their mechanical property of contraction, which are slow muscle (msoleus m.) and fast muscle (medial gastrocneminus m., rectus femoris m., vastus lateralis m.). Optimal parameters of electrical stimulation for slow muscles were 20 Hz, 0.2 ms square pulse. For fast muscle, 40 Hz, 0.3 ms square pulse was optimal to produce repeated contraction. Higher stimulus intensity was required when synergistic muscles were stimulated simultaneously than when they were stimulated individually. Electrical stimulation for each muscle was designed to generate bipedal locomotion, so that individual muscles alternate contraction and relaxation to simulate stance and swing phases. Portable electrical stimulator with 16 channels built in microprocessor was constructed and applied to paraplegic patients due to lumbar cord injury. The electrical stimulator restored partially gait function in paraplegic patients. 30626 T00401030626 ^x Two-Dimensional modelling of the Cochlear biomechanics is presented in this paper. The Laplace partial differential equation which represents the fluid mechanics of the Cochlea has been transformed into two-dimensional electrical transmission line. The procedure of this transformation is explained in detail. The comparison between one and two dimensional models is also presented. This electrical modelling of the basilar membrane (BM) is clearly useful for the next approach to the further. Development of active elements which are essential in the producing of the sharp tuning of the BM. This paper shows that two-dimension model is qualitatively better than one-dimensional model both in amplitude and phase responses of the BM displacement. The present model is only for frequency response. However because the model is electrical, the two-dimensional transmission line model can be extended to time response without any difficult. 30627 T00401030627 ^x A method has been proposed for the fully automatic detection of left ventricular endocardial boundary in 2D short axis echocardiogram using geometric model. The procedure has the following three distinct stages. First, the initial center is estimated by the initial center estimation algorithm which is applied to decimated image. Second, the center estimation algorithm is applied to original image and then best-fit elliptic model estimation is processed. Third, best-fit boundary is detected by the cost function which is based on the best-fit elliptic model. The proposed method shows effective result without manual intervention by a human operator. 30628 T00401030628 ^x The intelligent trajectory control method that controls moving direction and average velocity for a prosthetic arm is proposed by pattern recognition and force estimations using EMG signals. Also, we propose the real time trajectory planning method which generates continuous accelleration paths using 3 stage linear filters to minimize the impact to human body induced by arm motions and to reduce the muscle fatigue. We use combination of MLP and fuzzy filter for pattern recognition to estimate the direction of a muscle and Hogan's method for the force estimation. EMG signals are acquired by using a amputation simulator and 2 dimensional joystick motion. The simulation results of proposed prosthetic arm control system using the EMf signals show that the arm is effectively followed the desired trajectory depended on estimated force and direction of muscle movements. 30638 T00401030638 ^x A new neural network architecture for the recognition of patterns from images is proposed, which is partially based on the results of physiological studies. The proposed network is composed of multi-layers and the nerve cells in each layer are connected by spatial filters which approximate receptive fields in optic nerve fields. In the proposed method, patterns recognition for complicated images is carried out using global features as well as local features such as lines and end-points. A new generating method of matched filers representing global features is proposed in this network. 30659 T00401030659 ^x An implementation scheme of the magnetic nerve stimulator using a switching mode power supply is proposed. By using a switching mode power supply rather than a conventional linear power supply for charging high voltage capacitors, the weight and size of the magnetic nerve stimulator can be considerably reduced. Maximum output voltage of the developed magnetic nerve stimulator using the switching mode power supply is 3, 000 volts and switching time is about 100 msec. Experimental results or human nerve stimulations using the developed stimulator are presented. 30768 T00401030768 ^x In this paper, we describe the design methodology and specifications of the developed module-based bedside monitors for patient monitoring. The bedside monitor consists of a main unit and module cases with various parameter modules. The main unit includes a 12.1" TFT color LCD, a main CPU board, and peripherals such as a module controller, Ethernet LAN card, video card, rotate/push button controller, etc. The main unit can connect at maximum three module cases each of which can accommodate up to 7 parameter modules. They include the modules for electrocardiograph, respiration, invasive blood pressure, noninvasive blood pressure, temperature, and SpO2 with Plethysmograph.SpO2 with Plethysmograph.

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High Resolution HC$_3$N Observations toward the Central Region of Sagittarius B2

  • H.S-Ching;Oh, M.ishi;M.Morimoto
    • 한국우주과학회:학술대회논문집(한국우주과학회보)
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    • 한국우주과학회 1993년도 한국우주과학회보 제2권2호
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    • pp.17-17
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    • 1993
  • The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70${\pm}$1.32mmHg/min)compared to CF dialyzers(4.32${\pm}$0.55mmHg/min)(p<0.05). However, there was no observable difference in the UFR between the two dialyzers. Neither APD nor UFR showed any significant increase with an increasing number of reuses for up to more than 20reuses. A substantial number of failures observed in APD(larger than 20mmHe/min)on the reused dialyzers(2 out of 40 CP and S out 26 C-DAK) were attributed to the Possible damage on the fibers. The CF 15-11 HFDs which failed APD test did not show changes in the UFR compared to normal dialyzers indicating that APD is a more sensitive test than UFR test to evaluate the integrity of the fibers. 30527 T00401030527 ^x For quantitative measurement of reflected light from a clinical diagnostic strip, a prototype old reflectance photometer was designed. The strip loader and cassette were made to obtain more accurate reflectance parameters. The strip was illuminated at 45˚c through optical fiber and the intensity of reflected light was determined at rectanguLat angle using a photodiode. The kubelka-munk coefficient and reflection optical density were determined ar four different wavelengths(500,550,570 and 610nm) for blood glucose strip. For higher concentration than 300mg/41 about glucose, a saturation state of abforbance was observed at 500,550 and 570nm. The correlation between glucose concentration and parameters was the best at 610nm. 30535 T00401030535 ^x Radiation-induced fibrosarcoma tumors were grown on the flanks of C3H mice. The mice were divided into two groups. One group was injected with Photofrin II, intravenously (2.5mg/kg body weight). The other group received no Photofrin II. Mice from both groups were irradialed for approximately 15 minutes at 100,300, or 500 mW/cm2 with the argon (488nm/514.5 nm), dye(628nm) and gold vapor (pulsed 628 nm) laser light. A photosensitizer behaved as an added absorber. Under our experimental conditions, the presence of Photolfrin II increased surface temperature by at least 40% and the temperature rise due to 300 mW/cm2 irradiation exceeded values for hyperthermia. Light and temperature distributions with depth were estimated by a computer model. The model demonstrated the influence of wavelength on the thermal process and proved to be a valuable tool to investigate internal temperature rise. 30536 T00401030536 ^x We investigated the structural geometry of thirty-eight Korean femurs. The purpose of this study is to identify major geometrical differences between Korean femurs 3nd others that we believe belong to Caucasians so that we would be able to get insights into the femoral component design that fits Asians including Koreans. We utilized computerized tomography (CT) images of femurs extracted from cadavers. The CT images were transformed into bitmap data by using a film scanner, and then analyzed by using a commercially available software called Image v.1.0 and a Macintosh IIci computer.The resulting data were compared with already published data. The major results show that the geometry of the Korean femurs is significantly different from that of Caucasians: (1) the anteversion angle and the canal flare index are greater by the amount of approximately 8˚ and 0.5, respectively, (2) the shape of the isthmus cross section is more round, and (3) the distance between the teaser trochanter and the proximal border of the isthmus is shelter by about 15 mm. The results suggested that the femoral component suitable for Asians should be different from the currently-used components designed and manufactured mostly by European or American companies. 30537 T00401030537 ^x It is well known that nonlinear propagation characteristics of the wave in the tissue may give very useful information for the medical diagnoisis. In this paper, a new method to detect nonlinear propagation characteristics of the internal vibration in the tissue for the low frequency mechanical vibration by using bispectral analysis is proposed. In the method, low frequency vibration of f0( = 100Hz) is applied on the surface of the object, and the waveform of the internal vibration x (t) is measured from Doppler frequency modulation of silmultaneously transmitted probing ultrasonic waves. Then, the bispectra of the signal x (t) at the frequencies (f0, f0) and (f0, 2f0) are calculated to estimate the nonlinear propagation characteristics as their magnitude ratio, w here since bispectrum is free from the gaussian additive noise we can get the value with high S/N. Basic experimental system is constructed by using 3.0 MHz probing ultrasonic waves and the several experiments are carried out for some phantoms. Results show the superiority of the proposed method to the conventional method using power spectrum and also its usefulness for the tissue characterization. 30541 T00401030541 ^x This paper describes the implementation of a computerized radial pulse diagnosis by aids of a clinical expert. On this base, we composed of the radial pulse diagnosis system in korean traditional medicine. The system composed of a radial pulse wave detection system and a radial pulse diagnosis system. With a detection system, we detected Inyoung and Cheongu radial pulse wave and processed it. Then, we have got the characteristic parameters of radial pulse wave and also quantified that according to the method of Inyoung-Cheongu Comparison Radial Pulse Diagnosis. We defined the jugement standard of radial pulse diagnosis system and then we confirmed the possibility for realization of automatic radial pulse diagnosis in korean traditional medicine. 30545 T00401030545 ^x Microspheres are expected to be applied to biomedical areas such as solid-phase immunoassays, drug delivery systems, immunomagnetic cell separation. To synthesize microspheres for biomedical application, "two stage shot growth method" was developed. The uniformity ratio of synthesized microspheres was always smaller than 1.05. And the surface charge density (or the number of ionizable functional groups) of the microspheres synthesized by "two stage shot growth method" was 6~13 times higher than that of the microspheres synthesized by conventional seeded batch copolymerization. As a previous step for biomedical application, adsorption experiments of bovine albumin on microspheres were carried out under various conditions. The maximum adsorbed amount was obtained in the neighborhood of pH 4.5. Isoelectric point of bovine albumin is pH 5.0, so experimental result shows that it shifted to acid area. The adsorption isotherm was obtained, the plateau region was always reached at 2.Og/L (bulk concentration of bovine albumin).The effect of the kind and the amount of surface functional group was also examined. 30575 T00401030575 ^x A medical image workstation was developed using multimedia technique. The system based on PC-486DX was designed to acquire medical images produced by medical imaging instruments and related audio information, that is, doctors' reporting results. Input information was processed and analyzed, then the results were presented in the form of graph and animation. All the informations of the system were hierarchically related with the image as the apex. Processing and analysis algorithms were implemented so that the diagnostic accuracy could be improved. The diagnosed information can be transferred for patient diagnosis through LAN(local area network). 30592 T00401030592 ^x In the conventional infrared imaging system, complex infrared lens systems are usually used for directing collimated narrow infrared beams into the high speed 2-dimensional optic scanner. In this paper, a simple reflective infrared optic system with a 2-dimensional optic scanner is proposed for the realization of medical infrared thermography system. It has been experimentally proven that the intfrared thermography system composed of the proposed optic system has the temperature resolution of 0.1˚c under the spatial resolution of lmrad, the image matrix size of 256 X 240, and tile imaging time of 4 seconds. 30593 T00401030593 ^x In this paper, MIIS (Medical Image Information System) has been designed and implemented using INGRES RDBMS, which is based on a client/server architecture. The implemented system allows users to register and retrieve patient information, medical images and diagnostic reports. It also provides the function to display these information on workstation windows simultaneously by using the designed menu-driven graphic user interface. The medical image compression/decompression techniques are implemented and integrated into the medical image database system for the efficient data storage and the fast access through the network. 30594 T00401030594 ^x In this paper, computerized BEAM was implemented for the space domain analysis of EEG. Trans-formation from temporal summation to two-dimensional mappings is formed by 4 nearest point inter-polaton method. Methods of representation of BEAM are two. One is dot density method which classify brain electrical potential 9 levels by dot density of gray levels and the other is colour method which classify brain electrical 12 levels by red-green colours. In this BEAM, instantaneous change and average energy distribution over any arbitrary time interval of brain electrical activity could be observed and analyzed easily. In the frequency domain, the distribution of energy spectrum of a special band can easily be distinguished normality and abnormality. 30608 T00401030608 ^x Laboratory information system (LIS) is a key tool to manage laboratory data in clinical pathology. Our department has developed an information system for routine hematology using down-sized computer system. We have used an IBM 486 compatible PC with 16MB main memory, 210 MB hard disk drive, 9 RS-232C port and 24 pin dot printer. The operating system and database management system were SCO UNIX and SCO foxbase, respectively. For program development, we used Xbase language provided by SCO foxbase. The C language was used for interface purpose. To make the system use friendly, pull-down menu was used. The system connected to our hospital information system via application program interface (API), so the information related to patient and request details is automatically transmitted to our computer. Our system interfaced with fwd complete blood count analyzers(Sysmex NE-8000 and Coulter STKS) for unidirectional data tansmission from analyzer to computer. The authors suggests that this system based on down-sized computer could provide a progressive approach to total LIS based on local area network, and the implemented system could serve as a model for other hospital's LIS for routine hematology. 30609 T00401030609 ^x To develop an artificial bone substitute that is gradually degraded and replaced by the regenerated natural bone, the authors designed a composite that is consisted of calcium phosphate and collagen. To use as the structural matrix of the composite, collagen was purified from human umbilical cord. The obtained collagen was treated by pepsin to remove telopeptides, and finally, the immune-free atelocollagen was produced: The cross linked atelocollagen was highly resistant to the collagenase induced collagenolysis. The cross linked collagen demonstrated an improved tensile strength. 30618 T00401030618 ^x This paper is a study on the design of adptive filter for QRS complex detection. We propose a simple adaptive algorithm to increase capability of noise cancelation in QRS complex detection with two stage adaptive filter. At the first stage, background noise is removed and at the next stage, only spectrum of QRS complex components is passed. Two adaptive filters can afford to keep track of the changes of both noise and QRS complex. Each adaptive filter consists of prediction error filter and FIR filter The impulse response of FIR filter uses coefficients of prediction error filter. The detection rates for 105 and 108 of MIT/BIH data base were 99.3% and 97.4% respectively. 30619 T00401030619 ^x To develop an artificial bone substitute that is gradually degraded and replaced by the regenerated natural bone, the authors designed and produced a composite that is consisted of calcium phosphate and collagen. Human umbilical cord origin pepsin treated type I atelocollagen was used as the structural matrix, by which sintered or non-sintered carbonate apatite was encapsulated to form an inorganic-organic composite. With cross linking atelocollagen by UV ray irradiation, the resistance to both compressive and tensile strength was increased. Collagen degradation by the collagenase induced collagenolysis was also decreased. 30620 T00401030620 ^x We have developed a monoleaflet polymer valve as an inexpensive and viable alternative, especially for short-term use in the ventricular assist device or total artificial heart. The frame and leaflet of the polymer valve were made from polyurethane, To evaluate the hemodynamic performance of the polymer valve a comparative study of flow dynamics past a polymer valve and a St. Jude Medical prosthetic valve under physiological pulsatile flow conditions in vitro was made. Comparisons between the valves were made on the transvalvular pressure drop, regurgitation volume and maximum valve opening area. The polymer valve showed smaller regurgitation volume and transvalvular pressure drop compared to the mechanical valve at higher heart rate. The results showed that the functional characteristics of the polymer valve compared favorably with those of the mechanical valve at higher heart rate. 30621 T00401030621 ^x Explosive evaporative removal process of biological tissue by absorption of a CW laser has been simulated by using gelatin and a multimode Nd:YAG laser. Because the point of maximun temperature of laser-irradiated gelatin exists below the surface due to surface cooling, evaporation at the boiling temperature is made explosively from below the surface. The important parameters of this process are the conduction loss to laser power absorption (defined as the conduction-to-laser power parameter, Nk), the convection heat transfer at the surface to conduction loss (defined as Bi), dimensionless extinction coefficient (defined as Br.), and dimensionless irradiation time (defined as Fo). Dependence of Fo on Nk and Bi has been observed by experiment, and the results have been compared with the numerical results obtained by solving a 2-dimensional conduction equation. Fo and explosion depth (from the surface to the point of maximun temperature) are increased when Nk and Bi are increased.To find out the minimum laser power for explosive evaporative removal process, steady state analysis has been also made. The limit of Nk to induce evaporative removal, which is proportional to the inverse of the laser power, has been obtained. 30622 T00401030622 ^x N1 and N2 gross neural action potentials were measured from the round window of the guinea pig cochlea at the onset of the acoustic stimuli. N1-N2 audiograms were made by means of regulating stimulant intensities in order to produce constant N1-N2 potentials as criteria for different input tone pip frequencies. The lowest threshold was measured with an input tone pip I5 dB SPL in intensity and 12 KHz in frequency when the animal was in normal physiological condition. The procedure of experimental measurements is explained in detail. This experimental approach is very useful for the investigation of the Cochlear function. Both noN1inear and active functions of the Cochlea can be monitored by N1-N2 audiograms. 30623 T00401030623 ^x In electrical impedance tomography(EIT), we use boundary current and voltage measurements toprovide the information about the cross-sectional distribution of electrical impedance or resistivity. One of the major problems in EIT has been the inaccessibility of internal voltage or current data in finding the internal impedance values. We propose a new image reconstruction method using internal current density data measured by NMR. We obtained a two-dimensional current density distribution within a phantom by processing the real and imaginary MR images from a 4.77 NMR machine. We implemented a resistivity mage reconstruction algorithm using the finite element method and sensitivity matrix. We presented computer simulation results of the mage reconstruction algorithm and furture direction of the research. 30624 T00401030624 ^x A new method of digital image analysis technique for discrimination of cancer cell was presented in this paper. The object image was the Thyroid eland cells image that was diagnosed as normal and abnormal (two types of abnormal: follicular neoplastic cell, and papillary neoplastic cell), respectively. By using the proposed region segmentation algorithm, the cells were segmented into nucleus. The 16 feature parameters were used to calculate the features of each nucleus. A9 a consequence of using dominant feature parameters method proposed in this paper, discrimination rate of 91.11% was obtained for Thyroid Gland cells. 30625 T00401030625 ^x An electrical stimulator was designed to induce locomotion for paraplegic patients caused by central nervous system injury. Optimal stimulus parameters, which can minimize muscle fatigue and can achieve effective muscle contraction were determined in slow and fast muscles in Sprague-Dawley rats. Stimulus patterns of our stimulator were designed to simulate electromyographic activity monitored during locomotion of normal subjects. Muscle types of the lower extremity were classified according to their mechanical property of contraction, which are slow muscle (msoleus m.) and fast muscle (medial gastrocneminus m., rectus femoris m., vastus lateralis m.). Optimal parameters of electrical stimulation for slow muscles were 20 Hz, 0.2 ms square pulse. For fast muscle, 40 Hz, 0.3 ms square pulse was optimal to produce repeated contraction. Higher stimulus intensity was required when synergistic muscles were stimulated simultaneously than when they were stimulated individually. Electrical stimulation for each muscle was designed to generate bipedal locomotion, so that individual muscles alternate contraction and relaxation to simulate stance and swing phases. Portable electrical stimulator with 16 channels built in microprocessor was constructed and applied to paraplegic patients due to lumbar cord injury. The electrical stimulator restored partially gait function in paraplegic patients. 30626 T00401030626 ^x Two-Dimensional modelling of the Cochlear biomechanics is presented in this paper. The Laplace partial differential equation which represents the fluid mechanics of the Cochlea has been transformed into two-dimensional electrical transmission line. The procedure of this transformation is explained in detail. The comparison between one and two dimensional models is also presented. This electrical modelling of the basilar membrane (BM) is clearly useful for the next approach to the further. Development of active elements which are essential in the producing of the sharp tuning of the BM. This paper shows that two-dimension model is qualitatively better than one-dimensional model both in amplitude and phase responses of the BM displacement. The present model is only for frequency response. However because the model is electrical, the two-dimensional transmission line model can be extended to time response without any difficult. 30627 T00401030627 ^x A method has been proposed for the fully automatic detection of left ventricular endocardial boundary in 2D short axis echocardiogram using geometric model. The procedure has the following three distinct stages. First, the initial center is estimated by the initial center estimation algorithm which is applied to decimated image. Second, the center estimation algorithm is applied to original image and then best-fit elliptic model estimation is processed. Third, best-fit boundary is detected by the cost function which is based on the best-fit elliptic model. The proposed method shows effective result without manual intervention by a human operator. 30628 T00401030628 ^x The intelligent trajectory control method that controls moving direction and average velocity for a prosthetic arm is proposed by pattern recognition and force estimations using EMG signals. Also, we propose the real time trajectory planning method which generates continuous accelleration paths using 3 stage linear filters to minimize the impact to human body induced by arm motions and to reduce the muscle fatigue. We use combination of MLP and fuzzy filter for pattern recognition to estimate the direction of a muscle and Hogan's method for the force estimation. EMG signals are acquired by using a amputation simulator and 2 dimensional joystick motion. The simulation results of proposed prosthetic arm control system using the EMf signals show that the arm is effectively followed the desired trajectory depended on estimated force and direction of muscle movements. 30638 T00401030638 ^x A new neural network architecture for the recognition of patterns from images is proposed, which is partially based on the results of physiological studies. The proposed network is composed of multi-layers and the nerve cells in each layer are connected by spatial filters which approximate receptive fields in optic nerve fields. In the proposed method, patterns recognition for complicated images is carried out using global features as well as local features such as lines and end-points. A new generating method of matched filers representing global features is proposed in this network. 30659 T00401030659 ^x An implementation scheme of the magnetic nerve stimulator using a switching mode power supply is proposed. By using a switching mode power supply rather than a conventional linear power supply for charging high voltage capacitors, the weight and size of the magnetic nerve stimulator can be considerably reduced. Maximum output voltage of the developed magnetic nerve stimulator using the switching mode power supply is 3,000 volts and switching time is about 100 msec. Experimental results or human nerve stimulations using the developed stimulator are presented. 30768 T00401030768 ^x In this paper, we describe the design methodology and specifications of the developed module-based bedside monitors for patient monitoring. The bedside monitor consists of a main unit and module cases with various parameter modules. The main unit includes a 12.1" TFT color LCD, a main CPU board, and peripherals such as a module controller, Ethernet LAN card, video card, rotate/push button controller, etc. The main unit can connect at maximum three module cases each of which can accommodate up to 7 parameter modules. They include the modules for electrocardiograph, respiration, invasive blood pressure, noninvasive blood pressure, temperature, and SpO2 with Plethysmograph.

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