• Journal of Preventive Medicine and Public Health
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• 제49권4호
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• pp.230-239
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• 2016

Objectives: We aimed to evaluate the effect of geographic units of analysis on measuring geographic variation in medical services utilization. For this purpose, we compared geographic variations in the rates of eight major procedures in administrative units (districts) and new areal units organized based on the actual health care use of the population in Korea. Methods: To compare geographic variation in geographic units of analysis, we calculated the age-sex standardized rates of eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee-replacement surgery, caesarean section, hysterectomy, computed tomography scan, and magnetic resonance imaging scan) from the National Health Insurance database in Korea for the 2013 period. Using the coefficient of variation, the extremal quotient, and the systematic component of variation, we measured geographic variation for these eight procedures in districts and new areal units. Results: Compared with districts, new areal units showed a reduction in geographic variation. Extremal quotients and inter-decile ratios for the eight procedures were lower in new areal units. While the coefficient of variation was lower for most procedures in new areal units, the pattern of change of the systematic component of variation between districts and new areal units differed among procedures. Conclusions: Geographic variation in medical service utilization could vary according to the geographic unit of analysis. To determine how geographic characteristics such as population size and number of geographic units affect geographic variation, further studies are needed.

• 한국산학기술학회논문지
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• 제16권9호
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• pp.6019-6026
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• 2015

본 연구에서는 소량생산 및 개인 맞춤형 제작으로 매우 유용한 3D 프린팅 기술을 이용하여 자가 맞춤형 부목을 제작하고자 하였다. 방법으로는 3D 프린터를 이용하여 용융적층조형방식(fused deposition modeling)으로 부목을 제작하였으며, 재료는 열가소성 플라스틱 계열인 ABS(acrylonitrile butadiene styrene) 수지를 이용하였다. 부목의 모델링은 실제 인체의 손 부위 3차원 전산화단층영상을 이용하였으며 통풍이 가능하도록 설계하였다. 그 결과 실제 인체 손 모양과 일치하는 자기 맞춤형 부목이 성공적으로 출력되었다. 또한 기존 부목보다도 우수한 방사선영상을 획득할 수 있었다. 결론적으로 본 연구에서 제시한 3D 프린팅 사례는 ABS 수지를 이용한 용융적층조형방식의 유사한 구조물을 출력할 때 기초자료로 사용할 것으로 판단된다.

• Nuclear Engineering and Technology
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• 제53권1호
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• pp.216-233
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• 2021

In this work, Rhizophora spp. particleboard phantoms were made using SPI-based adhesives, modified with sodium hydroxide and itaconic acid polyamidoamine-epichlorohydrin (0, 5, 10, and 15 wt%). An X-ray computed tomography (CT) imaging system was used to ascertain the CT numbers and density distribution profiles of the particleboards. The SPI-based/NaOH/IA-PAE/Rhizophora spp. particleboard phantoms with 15 wt% IA-PAE addition level had the highest solid content, flexural strength, flexural modulus, and internal bonding strength of 36.06 ± 1.08%, 18.61 ± 0.38 Nmm^-2, 7605.76 ± 0.89 Nmm^-2, and 0.463 ± 0.053 Nmm^-2, respectively. The moisture content, mass density, water absorption, and dimensional stability were 6.93 ± 0.27%, 0.962 ± 0.037 gcm^-3, 22.36 ± 2.47%, and 10.90 ± 0.86%, respectively. The results revealed that the mass attenuation coefficients and effective atomic number values within the 16.59-25.26 keV photon energy region, were close to the calculated XCOM values in water, with a p-value of 0.077. Moreover, the CT images showed that the dissimilarities in the discrepancy of the profile density decreased as the IA-PAE concentrations increased. Therefore, these results support the appropriateness of the SPI-based/NaOH/IA-PAE/Rhizophora spp. particleboard with 15 wt% IA-PAE adhesive as a suitable tissue-equivalent phantom material for medical health applications.

• Journal of Industrial and Engineering Chemistry
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• 제67권
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• pp.244-254
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• 2018

Surface modified poly ${\text\tiny{L}}$-lactic acid (PLLA) samples with hydroxyapatite (HA), heparin and bone morphogenetic protein-2 (BMP-2) mediated by polydopamine (pDA) coating (PLLA/pDA/HA/Hep/BMP-2) were prepared, and their effects on the enhancements of bone formation and osseointegration were evaluated in vitro and in vivo as compared to PLLA, PLLA/pDA/HA, and PLLA/pDA/Hep/BMP-2. The changes in surface chemical compositions, morphologies and wettabilities were observed by X-ray photoelectron spectroscopy (XPS), field-emission scanning electron microscopy (FE-SEM), atomic force microscopy (AFM) and water contact angle measurements. Pre-coating of HA particles with pDA provided uniform and homogeneous anchoring of particles to PLLA surface. In addition, the strong ionic interaction between heparin and pDA led PLLA surface readily heparinized for loading of BMP-2. In vitro experiments revealed that the levels of alkaline phosphatase (ALP) activity, calcium deposition, and osteocalcin (OCN) gene expression were higher in MG-63 human osteosarcoma cell lines grown on PLLA/pDA/HA/Hep/BMP-2 than on control PLLA, PLLA/pDA/HA, and PLLA/pDA/Hep/BMP-2. In vivo studies using micro-computed tomography (micro-CT) also showed that PLLA/pDA/HA/Hep/BMP-2 screw exhibited greatest value of bone volume (BV) and bone volume/tissue volume (BV/TV) among samples. Histological evaluations with H&E and Von Kossa staining demonstrated that a combination of HA and BMP-2 contributed to the strong osseointegration.

• 한국분말재료학회지
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• 제21권4호
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• pp.266-270
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• 2014

Metal foams have a cellular structure consisting of a solid metal containing a large volume fraction of pores. In particular, open, penetrating pores are necessary for industrial applications such as in high temperature filters and as a support for catalysts. In this study, Fe foam with above 90% porosity and 2 millimeter pore size was successfully fabricated by a slurry coating process and the pore properties were characterized. The Fe and $Fe_2O_3$ powder mixing ratios were controlled to produce Fe foams with different pore size and porosity. First, the slurry was prepared by uniform mixing with powders, distilled water and polyvinyl alcohol(PVA). After slurry coating on the polyurethane(PU) foam, the sample was dried at $80^{\circ}C$. The PVA and PU foams were then removed by heating at $700^{\circ}C$ for 3 hours. The debinded samples were subsequently sintered at $1250^{\circ}C$ with a holding time of 3 hours under hydrogen atmosphere. The three dimensional geometries of the obtained Fe foams with an open cell structure were investigated using X-ray micro CT(computed tomography) as well as the pore morphology, size and phase. The coated amount of slurry on the PU foam were increased with $Fe_2O_3$ mixing powder ratio but the shrinkage and porosity of Fe foams were decreased with $Fe_2O_3$ mixing powder ratio.

• Journal of Chest Surgery
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• 제46권2호
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• pp.130-134
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• 2013

Background: Rib fractures are the most common type of thoracic trauma and cause other complications. We explored the risk factors for pneumonia in patients with multiple rib fractures. Materials and Methods: Four hundred and eighteen patients who visited our hospital with multiple rib fractures between January 2002 and December 2008 were retrospectively reviewed. Chest X-rays and chest computed tomography were used to identify injury severity. Patients with only a single rib fracture or who were transferred to another hospital within 2 days were excluded. Results: There were 327 male patients (78%), and the median age was 53 years. The etiologies of the patients' trauma included traffic accidents in 164 cases (39%), falls in 78 cases (19%), slipping and falling in 90 (22%), pedestrian accidents in 30 (7%), industrial accidents in 41 (10%), and assault in 15 (4%). The median number of rib fractures was 4.8. Pulmonary complications including flail chest (2.3%), lung contusion (22%), hemothorax (62%), pneumothorax (31%), and hemopneumothorax (20%) occurred. Chest tubes were inserted into the thoracic cavity in 216 cases (52%), and the median duration of chest tube insertion was 10.26 days. The Injury Severity Score (ISS) and rib score had a median of 15.27 and 6.9, respectively. Pneumonia occurred in 18 cases (4.3%). Of the total cases, 33% of the cases were managed in the intensive care unit (ICU), and the median duration of stay in the ICU was 7.74 days. Antibiotics were administered in 399 patients (95%) for a median of 10.53 days. Antibiotics were used for more than 6 days in 284 patients (68%). The factors affecting pneumonia in patients with multiple rib fractures in multivariate analysis included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). The use of antibiotics was not associated with the occurrence of pneumonia (p=0.28). In-hospital mortality was 5.3% (n=22). Conclusion: The factors affecting risk of pneumonia in patients with multiple rib fractures included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). Elderly patients with multiple traumas have a high risk of pneumonia and should be treated accordingly.

• 대한임상독성학회지
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• 제3권1호
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• pp.40-44
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• 2005

Nitrogen dioxide ($NO_2$), which produced during the process of silage, metal etching, explosives, rocket fuels, welding, and by-product of burning of fossil fuels, is one of major components of air pollutant. Accidental exposure of high level of $NO_2$ produces cough, dyspnea, pulmonary edema which may be delayed $4\~12$ hours and, in $2\~6$weeks, bronchiolitis obliterans. We experienced a case of acute pulmonary injuny induced by industrial exposure to high level of $NO_2$ during repair of $NO_2$ pipeline in a refinery. A 55-year-old man experienced nausea and severe dyspnea in 6 hours after $NO_2$ inhalation. Initial blood gas examination revealed severe hypoxemia accompanying increased alveolar-arterial O2 difference. Radiological examination showed diffuse ground glass opacities in both lung fields. Clinical symptoms and laboratory findings, including radiological study and pulmonary function test were improved with conservative treatment using inhaled oxygen and bronchodilator. and there was no evidence of bronchial fibrosis and bronchiolitis obliterance in chest high resolution computed tomography performed 6 weeks after exposure. Here, we report a case of $NO_2$ induced acute pulmonary injuny with a brief review of the relevant literature.

• 한국의학물리학회지:의학물리
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• 제16권1호
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• pp.47-51
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• 2005

전산화단층검사에서 조영제를 자동주입기를 이용해 주입하여 검사하는 경우에 혈관 외 유출된 성인환자를 대상으로 하였다. 환자의 혈관외유출 사고의 조영제 양은 47 ml로 오른쪽 손목 부위가 부종을 동반하였다. 혈관외유출된 손상부위를 axial 스캔하여 MPR (multi-planar reformation), MIP (maximum intensity protection), volume rendering, SSD (shaded-surface display) 기법으로 구성하였다. 이러한 3D 영상은 조영제의 혈관외유출 환자의 예방 및 사후 조치에 적절한 치료계획의 방법으로 기대된다.

• 한국정밀공학회지
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• 제26권10호
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• pp.122-128
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• 2009

The aim of this study was to investigate, through a longitudinal tracking, whether gender influences morphological characteristics on trabeucular bone of tibia during unloading. 12 male and 15 female ICR mice at 6 week of age were used and randomly allocated into two groups in each gender; unloading and normal group, respectively Mice in unloading group were operated on denervation (sciatic neurectomy). The tibiae were scanned by using in vivo micro-computed tomography (micro-CT) at 0 day (before denervation) and after 14 days. Structural parameters and BMD on tibia were measured. In female, BV/TV (65%), Tb. Th (5%), Tb.N (61%) and BMD (62%) were significantly decreased and BS/BV (17%), Tb.Sp (54%), SMI (19%) and Tb.Pf (75%) were significantly increased after unloading (p<0.05). In male, BV/TV (1%) and Tb.N (10%) were significantly decreased and SMI (5%) was significantly increased after unloading (p<0.05). In addition, trabeuclar bone loss of female was significantly bigger than that of male (p<0.05). These results indicated that effects of unloading on trabecular bone in growing mice might have difference between female and male, although unloading result in loss of quantity and quality on trabecular bone both female and male.

• 한국의학물리학회지:의학물리
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• 제23권4호
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• pp.292-302
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• 2012

최근 방사선치료 분야에 있어서 환자 선량이 중요한 쟁점이 되고 있다. 선량 감소를 위해 선진 기술을 이용한 방사선치료 시 사용하는 진단영상 장비에 대한 평가가 이루어져야 한다. 특히 CT는 방사선치료 분야에서 널리 사용되는 영상 장비이며, 본 연구에서는 CT의 선량과 영상에 대한 평가를 실시하였다. 선량과 영상을 동시에 비교할 수 있도록 동일한 조건 하에서 평가를 실시하였다. 또한 몬테카를로 시뮬레이션 툴인 MCNPX를 이용한 선량과 영상 평가가 가능하다는 것을 확인하였다. 저 선량 CT 영상의 질을 향상시키기 위하여 MLEM기법을 이용한 반복적 영상재구성 기법을 구축하였다. 본 연구의 평가 방법을 통해 방사선 치료 분야에서의 환자 선량을 줄이는 것뿐만 아니라 산업 연구 분야에서의 영상장비들의 총체적인 평가가 가능할 것이다.